Drug_Generic|Drug_HTW_code|Drug_limit_fp|Drug_limit_ds|Drug_limit_ppg|Drug_limit_refill|Drug_NDC|Drug_Descr|Drug_Pkg|Drug_Unit|Drug_340B|Drug_med_EffDate|Drug_med_EndDate|Drug_Med_Code|Drug_CMP_V|Drug_Med_Comment|Drug_chip_EffDate|Drug_chip_EndDate|Drug_chip_code|Drug_CMP_P|Drug_cshcn_EffDate|Drug_cshcn_EndDate|Drug_cshcn_code|Drug_CMP_C|Drug_cshcn_comment|Drug_khc_EffDate|Drug_KHC_EndDate|Drug_khc_code|Drug_CMP_K|Drug_htw_EffDate|Drug_htw_EndDate|Drug_legend_status|Drug_PDL_pa_required|Drug_pdl_EffDate|Drug_MKID|Drug_Clinical_pa_required|Drug_Retail|Drug_Retail_EffDate|Drug_LTC|Drug_LTC_EffDate|Drug_SPC|Drug_SPC_EffDate|Drug_VAC|Drug_VAC_EffDate|Drug_MKID_Desc|ID|Drug_med_EndReason|Drug_chip_EndReason|Drug_cshcn_EndReason|Drug_khc_EndReason|Drug_limit_larc|Drug_limit_injection|Drug_admin_fee|Drug_manufacturer|Drug_HTWPLUS_code|Drug_htwplus_EffDate|Drug_htwplus_EndDate|Drug_chip_comment|Drug_khc_comment
dulaglutide|No|No|No|No|75%|00002143380|TRULICITY 0.75 MG/0.5 ML PEN|.5|ML|190.6104|11/03/2014||Yes|No||11/03/2014||Yes|No|11/03/2014||Yes|No||||No|No|||Prescription required|No||111|Yes|425.66609|01/18/2022|415.4501|01/18/2022|418.21693|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|1|||||No|No||ELI LILLY & CO.|No||||
dulaglutide|No|No|No|No|75%|00002143480|TRULICITY 1.5 MG/0.5 ML PEN|.5|ML|190.6104|11/03/2014||Yes|No||11/03/2014||Yes|No|11/03/2014||Yes|No||||No|No|||Prescription required|No||111|Yes|425.63441|01/18/2022|415.41918|01/18/2022|418.1858|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2|||||No|No||ELI LILLY & CO.|No||||
galcanezumab-gnlm|No|No|No|No|75%|00002143611|EMGALITY 120 MG/ML PEN|1|ML|280.704|02/12/2019||Yes|No||02/12/2019||Yes|No|02/12/2019||Yes|No||||No|No|||Prescription required|No||537|No|631.97186|01/18/2022|616.80453|01/18/2022|620.91235|01/18/2022|||ANTIMIGRAINE AGENTS: OTHER|3|||||No|No||ELI LILLY & CO.|No||||
ixekizumab|No|No|No|No|75%|00002144509|TALTZ 80 MG/ML AUTOINJ (3-PK)|1|ML|2697.304|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|071|Yes|6147.344|01/11/2022|6059.5248|01/11/2022|5770.976|01/11/2022|||CYTOKINE AND CAM ANTAGONISTS|4|||||No|No||ELI LILLY & CO.|No||||
ixekizumab|No|No|No|No|75%|00002144511|TALTZ 80 MG/ML AUTOINJECTOR|1|ML|2697.304|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|071|Yes|6147.344|01/11/2022|6059.5248|01/11/2022|5770.976|01/11/2022|||CYTOKINE AND CAM ANTAGONISTS|5|||||No|No||ELI LILLY & CO.|No||||
ixekizumab|No|No|No|No|75%|00002144527|TALTZ 80 MG/ML AUTOINJ (2-PK)|1|ML|2697.304|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|071|Yes|6147.344|01/11/2022|6059.5248|01/11/2022|5770.976|01/11/2022|||CYTOKINE AND CAM ANTAGONISTS|6|||||No|No||ELI LILLY & CO.|No||||
dulaglutide|No|No|No|No|75%|00002223601|TRULICITY 3 MG/0.5 ML PEN|.5|ML|190.6104|06/01/2021||Yes|No||06/01/2021||Yes|No|06/01/2021||Yes|No||||No|No|||Prescription required|No||111|Yes|434.4144|01/11/2022|428.20848|01/11/2022|407.8176|01/11/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|7|||||No|No||ELI LILLY & CO.|No||||
dulaglutide|No|No|No|No|75%|00002223680|TRULICITY 3 MG/0.5 ML PEN|.5|ML|190.6104|06/01/2021||Yes|No||06/01/2021||Yes|No|06/01/2021||Yes|No||||No|No|||Prescription required|No||111|Yes|426.02158|01/18/2022|415.79706|01/18/2022|418.5662|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|8|||||No|No||ELI LILLY & CO.|No||||
galcanezumab-gnlm|No|No|No|No|75%|00002237711|EMGALITY 120 MG/ML SYRINGE|1|ML|280.704|08/22/2019||Yes|No||08/22/2019||Yes|No|08/22/2019||Yes|No||||No|No|||Prescription required|No||537|No|630.62272|01/18/2022|615.48777|01/18/2022|619.58682|01/18/2022|||ANTIMIGRAINE AGENTS: OTHER|9|||||No|No||ELI LILLY & CO.|No||||
selpercatinib|No|No|No|No|75%|00002298026|RETEVMO 80 MG CAPSULE|120|EA|73.81666|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|No||551|No|168.23332|02/02/2021|165.82999|02/02/2021|157.93332|02/02/2021|||ONCOLOGY: ORAL - LUNG|10|||||No|No||ELI LILLY & CO.|No||||
selpercatinib|No|No|No|No|75%|00002298060|RETEVMO 80 MG CAPSULE|60|EA|73.81666|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|No||551|No|168.23332|02/02/2021|165.82999|02/02/2021|157.93332|02/02/2021|||ONCOLOGY: ORAL - LUNG|11|||||No|No||ELI LILLY & CO.|No||||
galcanezumab-gnlm|No|No|No|No|75%|00002311509|EMGALITY 300 MG (100 MG X3SYR)|1|ML|233.92|08/29/2019||Yes|No||08/29/2019||Yes|No|08/29/2019||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|537|No|523.61974|01/18/2022|511.05286|01/18/2022|514.45639|01/18/2022|||ANTIMIGRAINE AGENTS: OTHER|12|||||No|No||ELI LILLY & CO.|No||||
dulaglutide|No|No|No|No|75%|00002318201|TRULICITY 4.5 MG/0.5 ML PEN|.5|ML|190.6104|06/01/2021||Yes|No||06/01/2021||Yes|No|06/01/2021||Yes|No||||No|No|||Prescription required|No||111|Yes|434.4144|01/11/2022|428.20848|01/11/2022|407.8176|01/11/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|13|||||No|No||ELI LILLY & CO.|No||||
dulaglutide|No|No|No|No|75%|00002318280|TRULICITY 4.5 MG/0.5 ML PEN|.5|ML|190.6104|06/01/2021||Yes|No||06/01/2021||Yes|No|06/01/2021||Yes|No||||No|No|||Prescription required|No||111|Yes|426.09504|01/18/2022|415.86875|01/18/2022|418.63837|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|14|||||No|No||ELI LILLY & CO.|No||||
atomoxetine HCl|No|No|No|No|75%|00002322730|STRATTERA 10 MG CAPSULE|30|EA|5.6674|01/02/2003||Yes|No||01/02/2003||Yes|No|01/02/2003||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|12.9164|09/25/2018|12.73188|09/25/2018|12.1256|09/25/2018|||STIMULANTS AND RELATED AGENTS|15|||||No|No||ELI LILLY & CO.|No||||
atomoxetine HCl|No|No|No|No|75%|00002322830|STRATTERA 25 MG CAPSULE|30|EA|5.6674|01/02/2003||Yes|No||01/02/2003||Yes|No|01/02/2003||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|12.5658|08/24/2021|12.26422|08/24/2021|12.34589|08/24/2021|||STIMULANTS AND RELATED AGENTS|16|||||No|No||ELI LILLY & CO.|No||||
atomoxetine HCl|No|No|No|No|75%|00002322930|STRATTERA 40 MG CAPSULE|30|EA|6.1576|01/02/2003||Yes|No||01/02/2003||Yes|No|01/02/2003||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|13.64986|05/25/2021|13.32226|05/25/2021|13.41098|05/25/2021|||STIMULANTS AND RELATED AGENTS|17|||||No|No||ELI LILLY & CO.|No||||
olanzapine/fluoxetine HCl|No|No|No|No|75%|00002323030|SYMBYAX 3-25 MG CAPSULE|30|EA|4.2183|07/19/2007||Yes|No||07/19/2007||Yes|No|07/19/2007||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|027|Yes|9.6138|06/01/2016|9.47646|06/01/2016|9.0252|06/01/2016|||ANTIPSYCHOTICS|18|||||No|No||ELI LILLY & CO.|No||||
olanzapine/fluoxetine HCl|No|No|No|No|75%|00002323130|SYMBYAX 6-25 MG CAPSULE|30|EA|5.7663|01/28/2004||Yes|No||01/28/2004||Yes|No|01/28/2004||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|027|Yes|13.1418|06/01/2016|12.95406|06/01/2016|12.3372|06/01/2016|||ANTIPSYCHOTICS|19|||||No|No||ELI LILLY & CO.|No||||
duloxetine HCl|No|No|No|No|75%|00002323560|CYMBALTA 20 MG CAPSULE|60|EA|3.483|08/26/2004||Yes|No||08/26/2004||Yes|No|08/26/2004||Yes|No||||No|No|||Prescription required|Yes|12/12/2014|232|No|7.938|01/11/2022|7.8246|01/11/2022|7.452|01/11/2022|||NEUROPATHIC PAIN|20|||||No|No||ELI LILLY & CO.|No||||
atomoxetine HCl|No|No|No|No|75%|00002323830|STRATTERA 18 MG CAPSULE|30|EA|5.6674|01/02/2003||Yes|No||01/02/2003||Yes|No|01/02/2003||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|12.9164|09/25/2018|12.73188|09/25/2018|12.1256|09/25/2018|||STIMULANTS AND RELATED AGENTS|21|||||No|No||ELI LILLY & CO.|No||||
atomoxetine HCl|No|No|No|No|75%|00002323930|STRATTERA 60 MG CAPSULE|30|EA|6.1576|01/02/2003||Yes|No||01/02/2003||Yes|No|01/02/2003||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|13.66972|08/24/2021|13.34164|08/24/2021|13.43049|08/24/2021|||STIMULANTS AND RELATED AGENTS|22|||||No|No||ELI LILLY & CO.|No||||
duloxetine HCl|No|No|No|No|75%|00002324030|CYMBALTA 30 MG CAPSULE|30|EA|3.9044|08/26/2004||Yes|No||08/26/2004||Yes|No|08/26/2004||Yes|No||||No|No|||Prescription required|Yes|12/12/2014|232|No|8.72367|01/18/2022|8.5143|01/18/2022|8.571|01/18/2022|||NEUROPATHIC PAIN|23|||||No|No||ELI LILLY & CO.|No||||
duloxetine HCl|No|No|No|No|75%|00002324090|CYMBALTA 30 MG CAPSULE|90|EA|3.9044|07/19/2013||Yes|No||07/19/2013||Yes|No|07/19/2013||Yes|No||||No|No|||Prescription required|Yes|12/12/2014|232|No|8.72367|01/18/2022|8.5143|01/18/2022|8.571|01/18/2022|||NEUROPATHIC PAIN|24|||||No|No||ELI LILLY & CO.|No||||
atomoxetine HCl|No|No|No|No|75%|00002325030|STRATTERA 80 MG CAPSULE|30|EA|6.6435|03/06/2006||Yes|No||03/06/2006||Yes|No|03/06/2006||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|14.7872|03/01/2022|14.4323|03/01/2022|14.52842|03/01/2022|||STIMULANTS AND RELATED AGENTS|25|||||No|No||ELI LILLY & CO.|No||||
atomoxetine HCl|No|No|No|No|75%|00002325130|STRATTERA 100 MG CAPSULE|30|EA|6.6435|03/06/2006||Yes|No||03/06/2006||Yes|No|03/06/2006||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|15.141|09/25/2018|14.9247|09/25/2018|14.214|09/25/2018|||STIMULANTS AND RELATED AGENTS|26|||||No|No||ELI LILLY & CO.|No||||
duloxetine HCl|No|No|No|No|75%|00002327030|CYMBALTA 60 MG CAPSULE|30|EA|3.9044|06/28/2010||Yes|No||06/28/2010||Yes|No|06/28/2010||Yes|No||||No|No|||Prescription required|Yes|12/12/2014|232|No|8.74473|01/18/2022|8.53485|01/18/2022|8.59169|01/18/2022|||NEUROPATHIC PAIN|27|||||No|No||ELI LILLY & CO.|No||||
selpercatinib|No|No|No|No|75%|00002397760|RETEVMO 40 MG CAPSULE|60|EA|49.21106|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|No||551|No|112.15544|02/02/2021|110.55322|02/02/2021|105.28878|02/02/2021|||ONCOLOGY: ORAL - LUNG|28|||||No|No||ELI LILLY & CO.|No||||
olanzapine|No|No|No|No|75%|00002411230|ZYPREXA 2.5 MG TABLET|30|EA|5.5728|10/20/2005||Yes|No||10/20/2005||Yes|No|10/20/2005||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|027|Yes|12.7008|01/11/2022|12.51936|01/11/2022|11.9232|01/11/2022|||ANTIPSYCHOTICS|29|||||No|No||ELI LILLY & CO.|No||||
olanzapine|No|No|No|No|75%|00002411530|ZYPREXA 5 MG TABLET|30|EA|6.5747|10/28/2005||Yes|No||10/28/2005||Yes|No|10/28/2005||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|027|Yes|14.9842|01/11/2022|14.77014|01/11/2022|14.0668|01/11/2022|||ANTIPSYCHOTICS|30|||||No|No||ELI LILLY & CO.|No||||
olanzapine|No|No|No|No|75%|00002411630|ZYPREXA 7.5 MG TABLET|30|EA|7.998|10/20/2005||Yes|No||10/20/2005||Yes|No|10/20/2005||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|027|Yes|18.228|01/11/2022|17.9676|01/11/2022|17.112|01/11/2022|||ANTIPSYCHOTICS|31|||||No|No||ELI LILLY & CO.|No||||
olanzapine|No|No|No|No|75%|00002411730|ZYPREXA 10 MG TABLET|30|EA|9.9072|10/19/2005||Yes|No||10/19/2005||Yes|No|10/19/2005||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|027|Yes|22.05325|01/18/2022|21.52397|01/18/2022|21.66731|01/18/2022|||ANTIPSYCHOTICS|32|||||No|No||ELI LILLY & CO.|No||||
baricitinib|No|No|No|No|75%|00002418230|OLUMIANT 2 MG TABLET|30|EA|35.7932|10/18/2018||Yes|No||10/18/2018||Yes|No|10/18/2018||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|071|Yes|81.5752|01/11/2022|80.40984|01/11/2022|76.5808|01/11/2022|||CYTOKINE AND CAM ANTAGONISTS|33|||||No|No||ELI LILLY & CO.|No||||
raloxifene HCl|No|No|No|No|75%|00002418402|EVISTA 60 MG TABLET|100|EA|2.838|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|No||060|Yes|6.468|04/27/2021|6.3756|04/27/2021|6.072|04/27/2021|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|34|||||No|No||ELI LILLY & CO.|No||||
raloxifene HCl|No|No|No|No|75%|00002418430|EVISTA 60 MG TABLET|30|EA|2.838|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|No||060|Yes|6.468|04/27/2021|6.3756|04/27/2021|6.072|04/27/2021|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|35|||||No|No||ELI LILLY & CO.|No||||
lasmiditan succinate|No|No|No|No|75%|00002431208|REYVOW 50 MG TABLET|8|EA|37.926|11/03/2020||Yes|No||11/03/2020||Yes|No|11/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|537|No|84.51188|01/18/2022|82.48359|01/18/2022|83.03292|01/18/2022|||ANTIMIGRAINE AGENTS: OTHER|36|||||No|No||ELI LILLY & CO.|No||||
olanzapine|No|No|No|No|75%|00002441530|ZYPREXA 15 MG TABLET|30|EA|14.8608|10/18/2005||Yes|No||10/18/2005||Yes|No|10/18/2005||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|027|Yes|33.16391|01/18/2022|32.36797|01/18/2022|32.58354|01/18/2022|||ANTIPSYCHOTICS|37|||||No|No||ELI LILLY & CO.|No||||
olanzapine|No|No|No|No|75%|00002442030|ZYPREXA 20 MG TABLET|30|EA|19.8144|10/19/2005||Yes|No||10/19/2005||Yes|No|10/19/2005||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|027|Yes|44.19089|01/18/2022|43.1303|01/18/2022|43.41754|01/18/2022|||ANTIPSYCHOTICS|38|||||No|No||ELI LILLY & CO.|No||||
olanzapine|No|No|No|No|75%|00002445385|ZYPREXA ZYDIS 5 MG TABLET|30|EA|6.9961|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|027|Yes|15.9446|01/11/2022|15.71682|01/11/2022|14.9684|01/11/2022|||ANTIPSYCHOTICS|39|||||No|No||ELI LILLY & CO.|No||||
olanzapine|No|No|No|No|75%|00002445485|ZYPREXA ZYDIS 10 MG TABLET|30|EA|10.3286|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|027|Yes|23.5396|01/11/2022|23.20332|01/11/2022|22.0984|01/11/2022|||ANTIPSYCHOTICS|40|||||No|No||ELI LILLY & CO.|No||||
olanzapine|No|No|No|No|75%|00002445585|ZYPREXA ZYDIS 15 MG TABLET|30|EA|15.2822|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|027|Yes|34.8292|01/11/2022|34.33164|01/11/2022|32.6968|01/11/2022|||ANTIPSYCHOTICS|41|||||No|No||ELI LILLY & CO.|No||||
olanzapine|No|No|No|No|75%|00002445685|ZYPREXA ZYDIS 20 MG TABLET|30|EA|20.2358|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|027|Yes|46.1188|01/11/2022|45.45996|01/11/2022|43.2952|01/11/2022|||ANTIPSYCHOTICS|42|||||No|No||ELI LILLY & CO.|No||||
abemaciclib|No|No|No|No|75%|00002448354|VERZENIO 50 MG TABLET|14|EA|105.78|01/31/2018||Yes|No||01/31/2018||Yes|No|01/31/2018||Yes|No||||No|No|||Prescription required|No||502|No|241.08|01/18/2022|237.636|01/18/2022|226.32|01/18/2022|||ONCOLOGY: ORAL - BREAST|43|||||No|No||ELI LILLY & CO.|No||||
lasmiditan succinate|No|No|No|No|75%|00002449108|REYVOW 100 MG TABLET|8|EA|37.926|11/03/2020||Yes|No||11/03/2020||Yes|No|11/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|537|No|84.50663|01/18/2022|82.47847|01/18/2022|83.02776|01/18/2022|||ANTIMIGRAINE AGENTS: OTHER|44|||||No|No||ELI LILLY & CO.|No||||
baricitinib|No|No|No|No|75%|00002473230|OLUMIANT 1 MG TABLET|30|EA|35.7932|08/05/2020||Yes|No||08/05/2020||Yes|No|08/05/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|071|Yes|81.5752|01/11/2022|80.40984|01/11/2022|76.5808|01/11/2022|||CYTOKINE AND CAM ANTAGONISTS|45|||||No|No||ELI LILLY & CO.|No||||
abemaciclib|No|No|No|No|75%|00002481554|VERZENIO 100 MG TABLET|14|EA|105.78|01/31/2018||Yes|No||01/31/2018||Yes|No|01/31/2018||Yes|No||||No|No|||Prescription required|No||502|No|241.08|01/18/2022|237.636|01/18/2022|226.32|01/18/2022|||ONCOLOGY: ORAL - BREAST|46|||||No|No||ELI LILLY & CO.|No||||
prasugrel HCl|No|No|No|No|75%|00002512130|EFFIENT 5 MG TABLET|30|EA|6.579|06/05/2012|02/28/2022|Yes|No||06/05/2012|02/28/2022|Yes|No|06/05/2012|02/28/2022|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|004|No|14.994|03/26/2019|14.7798|03/26/2019|14.076|03/26/2019|||PLATELET AGGREGATION INHIBITORS|47|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ELI LILLY & CO.|No||||
prasugrel HCl|No|No|No|No|75%|00002512152|EFFIENT 5 MG TABLET|24|EA|6.579|06/05/2012|02/28/2022|Yes|No||06/05/2012|02/28/2022|Yes|No|06/05/2012|02/28/2022|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|004|No|14.994|03/26/2019|14.7798|03/26/2019|14.076|03/26/2019|||PLATELET AGGREGATION INHIBITORS|48|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ELI LILLY & CO.|No||||
prasugrel HCl|No|No|No|No|75%|00002512330|EFFIENT 10 MG TABLET|30|EA|6.579|06/05/2012|03/31/2022|Yes|No||06/05/2012|03/31/2022|Yes|No|06/05/2012|03/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|004|No|14.994|06/29/2021|14.7798|06/29/2021|14.076|06/29/2021|||PLATELET AGGREGATION INHIBITORS|49|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ELI LILLY & CO.|No||||
prasugrel HCl|No|No|No|No|75%|00002512377|EFFIENT 10 MG TABLET|90|EA|6.579|06/05/2012|02/28/2022|Yes|No||06/05/2012|02/28/2022|Yes|No|06/05/2012|02/28/2022|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|004|No|14.994|06/29/2021|14.7798|06/29/2021|14.076|06/29/2021|||PLATELET AGGREGATION INHIBITORS|50|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ELI LILLY & CO.|No||||
abemaciclib|No|No|No|No|75%|00002533754|VERZENIO 150 MG TABLET|14|EA|105.78|01/31/2018||Yes|No||01/31/2018||Yes|No|01/31/2018||Yes|No||||No|No|||Prescription required|No||502|No|241.08|01/18/2022|237.636|01/18/2022|226.32|01/18/2022|||ONCOLOGY: ORAL - BREAST|51|||||No|No||ELI LILLY & CO.|No||||
glucagon|No|No|No|No|75%|00002614501|BAQSIMI 3 MG SPRAY|1|EA||02/06/2020||Yes|No||02/06/2020||Yes|No|02/06/2020||Yes|No||||No|No|||Prescription required|No||583|No|269.392|03/01/2022|262.92659|03/01/2022|264.67764|03/01/2022|||GLUCAGON AGENTS|52|||||No|No||ELI LILLY & CO.|No||||
glucagon|No|No|No|No|75%|00002614502|BAQSIMI 3 MG SPRAY|1|EA||02/06/2020||Yes|No||02/06/2020||Yes|No|02/06/2020||Yes|No||||No|No|||Prescription required|No||583|No|269.392|03/01/2022|262.92659|03/01/2022|264.67764|03/01/2022|||GLUCAGON AGENTS|53|||||No|No||ELI LILLY & CO.|No||||
glucagon|No|No|No|No|75%|00002614511|BAQSIMI 3 MG SPRAY ONE PACK|1|EA|120.744|02/06/2020||Yes|No||02/06/2020||Yes|No|02/06/2020||Yes|No||||No|No|||Prescription required|No||583|No|269.392|03/01/2022|262.92659|03/01/2022|264.67764|03/01/2022|||GLUCAGON AGENTS|54|||||No|No||ELI LILLY & CO.|No||||
glucagon|No|No|No|No|75%|00002614527|BAQSIMI 3 MG SPRAY TWO PACK|2|EA|120.744|02/06/2020||Yes|No||02/06/2020||Yes|No|02/06/2020||Yes|No||||No|No|||Prescription required|No||583|No|269.6575|09/28/2021|263.18572|09/28/2021|264.93849|09/28/2021|||GLUCAGON AGENTS|55|||||No|No||ELI LILLY & CO.|No||||
abemaciclib|No|No|No|No|75%|00002621654|VERZENIO 200 MG TABLET|14|EA|105.78|01/31/2018||Yes|No||01/31/2018||Yes|No|01/31/2018||Yes|No||||No|No|||Prescription required|No||502|No|241.08|01/18/2022|237.636|01/18/2022|226.32|01/18/2022|||ONCOLOGY: ORAL - BREAST|56|||||No|No||ELI LILLY & CO.|No||||
insulin lispro|Yes|No|No|No|75%|00002751001|HUMALOG 100 UNIT/ML VIAL|10|ML|11.8121|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No||029|No|26.37712|06/29/2021|25.74406|06/29/2021|25.91552|06/29/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|57|||||No|No||ELI LILLY & CO.|No||||
insulin lispro|Yes|No|No|No|75%|00002751017|HUMALOG 100 UNIT/ML VIAL|3|ML|11.8121|11/14/2012||Yes|No||11/14/2012||Yes|No|11/14/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||029|No|26.9206|09/28/2021|26.53602|09/28/2021|25.2724|09/28/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|58|||||No|No||ELI LILLY & CO.|No||||
insulin lispro protamin/lispro|No|No|No|No|75%|00002751101|HUMALOG MIX 75-25 VIAL|10|ML|12.2421|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||029|No|27.26154|07/27/2021|26.60726|07/27/2021|26.78446|07/27/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|59|||||No|No||ELI LILLY & CO.|No||||
insulin lispro protamin/lispro|No|No|No|No|75%|00002751201|HUMALOG MIX 50-50 VIAL|10|ML|12.2421|09/05/2007||Yes|No||09/05/2007||Yes|No|09/05/2007||Yes|No||||No|No|||Prescription required|No||029|No|27.9006|03/29/2022|27.50202|03/29/2022|26.1924|03/29/2022|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|60|||||No|No||ELI LILLY & CO.|No||||
insulin lispro|No|No|No|No|75%|00002751659|HUMALOG 100 UNIT/ML CARTRIDGE|3|ML|14.6329|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||029|No|32.53889|09/28/2021|31.75795|09/28/2021|31.96945|09/28/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|61|||||No|No||ELI LILLY & CO.|No||||
olanzapine|No|No|No|No|75%|00002759701|ZYPREXA 10 MG VIAL|1|EA|20.984|04/27/2004||Yes|No||04/27/2004||Yes|No|04/27/2004||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|027|Yes|47.824|01/11/2022|47.1408|01/11/2022|44.896|01/11/2022|||ANTIPSYCHOTICS|62|||||No|No||ELI LILLY & CO.|No||||
olanzapine pamoate|No|No|No|No|75%|00002763511|ZYPREXA RELPREVV 210 MG VL KIT|1|EA|253.5624|02/18/2014||Yes|No||02/18/2014||Yes|No|02/18/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|027|Yes|577.8864|06/01/2016|569.63088|06/01/2016|542.5056|06/01/2016|||ANTIPSYCHOTICS|63|||||No|Yes|12.56|ELI LILLY & CO.|No||||
olanzapine pamoate|No|No|No|No|75%|00002763611|ZYPREXA RELPREVV 300 MG VL KIT|1|EA|362.232|02/18/2014||Yes|No||02/18/2014||Yes|No|02/18/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|027|Yes|825.552|06/01/2016|813.7584|06/01/2016|775.008|06/01/2016|||ANTIPSYCHOTICS|64|||||No|Yes|12.56|ELI LILLY & CO.|No||||
olanzapine pamoate|No|No|No|No|75%|00002763711|ZYPREXA RELPREVV 405 MG VL KIT|1|EA|489.0132|02/18/2014||Yes|No||02/18/2014||Yes|No|02/18/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|027|Yes|1114.4952|06/01/2016|1098.57384|06/01/2016|1046.2608|06/01/2016|||ANTIPSYCHOTICS|65|||||No|Yes|12.56|ELI LILLY & CO.|No||||
insulin lispro|Yes|No|No|No|75%|00002771227|HUMALOG 200 UNIT/ML KWIKPEN|3|ML|30.4096|08/18/2015||Yes|No||08/18/2015||Yes|No|08/18/2015||Yes|No||||No|No|04/08/2020||Prescription required|Yes|09/18/2020|029|No|67.84838|07/27/2021|66.22001|07/27/2021|66.66103|07/27/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|66|||||No|No||ELI LILLY & CO.|No||||
insulin lispro|No|No|No|No|75%|00002771459|HUMALOG JR 100 UNIT/ML KWIKPEN|3|ML|15.2048|01/05/2018||Yes|No||01/05/2018||Yes|No|01/05/2018||Yes|No||||No|No|||Prescription required|No||029|Yes|34.02549|03/01/2022|33.20887|03/01/2022|33.43004|03/01/2022|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|67|||||No|No||ELI LILLY & CO.|No||||
insulin glargine,hum.rec.anlog|Yes|No|No|No|75%|00002771559|BASAGLAR 100 UNIT/ML KWIKPEN|3|ML|9.35565|04/12/2017||Yes|No||04/12/2017||Yes|No|04/12/2017||Yes|No||||No|No|04/08/2020||Prescription required|Yes|07/29/2021|029|No|20.93024|03/01/2022|20.42791|03/01/2022|20.56396|03/01/2022|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|68|||||No|No||ELI LILLY & CO.|No||||
ixekizumab|No|No|No|No|75%|00002772401|TALTZ 80 MG/ML SYRINGE|1|ML|2697.304|04/01/2019||Yes|No||04/01/2019||Yes|No|04/01/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|071|Yes|6147.344|01/18/2022|6059.5248|01/18/2022|5770.976|01/18/2022|||CYTOKINE AND CAM ANTAGONISTS|69|||||No|No||ELI LILLY & CO.|No||||
ixekizumab|No|No|No|No|75%|00002772411|TALTZ 80 MG/ML SYRINGE|1|ML|2697.304|09/11/2020||Yes|No||09/11/2020||Yes|No|09/11/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|071|Yes|6147.344|01/11/2022|6059.5248|01/11/2022|5770.976|01/11/2022|||CYTOKINE AND CAM ANTAGONISTS|70|||||No|No||ELI LILLY & CO.|No||||
insulin lispro|No|No|No|No|75%|00002775205|INSULIN LISPRO JR 100 UNIT/ML|3|ML|4.56144|10/08/2020||Yes|No||10/08/2020||Yes|No|10/08/2020||Yes|No||||No|No|||Prescription required|No||029|Yes|10.20905|03/29/2022|9.96403|03/29/2022|10.03039|03/29/2022|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|71|||||No|No||ELI LILLY & CO.|No||||
glucagon|No|No|No|No|75%|00002803101|GLUCAGON 1 MG EMERGENCY KIT|1|EA|120.744|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||583|No|270.32378|12/21/2021|263.836|12/21/2021|265.59311|12/21/2021|||GLUCAGON AGENTS|72|||||No|No||ELI LILLY & CO.|No||||
somatropin|No|No|No|No|75%|00002814701|HUMATROPE 6 MG CARTRIDGE|1|EA|381.0918|10/21/2005||Yes|No||10/21/2005||Yes|No|10/21/2005||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|Yes|07/29/2021|014|Yes|868.5348|01/11/2022|856.12716|01/11/2022|815.3592|01/11/2022|||GROWTH HORMONE|73|||||No|No||ELI LILLY & CO.|No||||
somatropin|No|No|No|No|75%|00002814801|HUMATROPE 12 MG CARTRIDGE|1|EA|762.1836|10/21/2005||Yes|No||10/21/2005||Yes|No|10/21/2005||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|Yes|07/29/2021|014|Yes|1737.0696|01/11/2022|1712.25432|01/11/2022|1630.7184|01/11/2022|||GROWTH HORMONE|74|||||No|No||ELI LILLY & CO.|No||||
somatropin|No|No|No|No|75%|00002814901|HUMATROPE 24 MG CARTRIDGE|1|EA|1524.3672|10/21/2005||Yes|No||10/21/2005||Yes|No|10/21/2005||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|Yes|07/29/2021|014|Yes|3474.1392|01/11/2022|3424.50864|01/11/2022|3261.4368|01/11/2022|||GROWTH HORMONE|75|||||No|No||ELI LILLY & CO.|No||||
insulin regular, human|Yes|No|No|No|75%|00002821501|HUMULIN R 100 UNIT/ML VIAL|10|ML|6.3941|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Over the counter|No||029|No|14.27129|07/27/2021|13.92877|07/27/2021|14.02154|07/27/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|76|||||No|No||ELI LILLY & CO.|No||||
insulin regular, human|Yes|No|No|No|75%|00002821517|HUMULIN R 100 UNIT/ML VIAL|3|ML|6.3941|10/08/2012||Yes|No||10/08/2012||Yes|No|10/08/2012||Yes|No||||No|No|07/01/2016||Over the counter|No||029|No|14.29467|06/29/2021|13.95159|06/29/2021|14.04451|06/29/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|77|||||No|No||ELI LILLY & CO.|No||||
insulin lispro protamin/lispro|No|No|No|No|75%|00002823305|INSULIN LISPRO MIX 75-25 KWKPN|3|ML|4.56144|10/08/2020||Yes|No||10/08/2020||Yes|No|10/08/2020||Yes|No||||No|No|||Prescription required|No||029|No|10.16129|03/29/2022|9.91741|03/29/2022|9.98346|03/29/2022|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|78|||||No|No||ELI LILLY & CO.|No||||
insulin NPH human isophane|Yes|No|No|No|75%|00002831501|HUMULIN N 100 UNIT/ML VIAL|10|ML|6.3941|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Over the counter|No||029|No|14.29527|03/01/2022|13.95218|03/01/2022|14.0451|03/01/2022|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|79|||||No|No||ELI LILLY & CO.|No||||
insulin NPH human isophane|Yes|No|No|No|75%|00002831517|HUMULIN N 100 UNIT/ML VIAL|3|ML|6.3941|10/03/2012||Yes|No||10/03/2012||Yes|No|10/03/2012||Yes|No||||No|No|07/01/2016||Over the counter|No||029|No|14.5726|01/25/2022|14.36442|01/25/2022|13.6804|01/25/2022|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|80|||||No|No||ELI LILLY & CO.|No||||
teriparatide|No|No|No|No|75%|00002840001|FORTEO 600 MCG/2.4 ML PEN INJ|2.4|ML|710.68428|10/15/2008||Yes|No||10/15/2008||Yes|No|10/15/2008||Yes|No||||No|No|||Prescription required|No||060|No|1596.69708|01/18/2022|1558.37635|01/18/2022|1568.75488|01/18/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|81|||||No|No||ELI LILLY & CO.|No||||
insulin regular, human|No|No|No|No|75%|00002850101|HUMULIN R 500 UNIT/ML VIAL|20|ML|31.9705|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||029|No|71.13781|03/01/2022|69.4305|03/01/2022|69.89289|03/01/2022|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|82|||||No|No||ELI LILLY & CO.|No||||
insulin NPH hum/reg insulin hm|Yes|No|No|No|75%|00002871501|HUMULIN 70-30 VIAL|10|ML|6.3941|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Over the counter|No||029|No|14.30359|07/27/2021|13.9603|07/27/2021|14.05327|07/27/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|83|||||No|No||ELI LILLY & CO.|No||||
insulin NPH hum/reg insulin hm|Yes|No|No|No|75%|00002871517|HUMULIN 70-30 VIAL|3|ML|6.3941|10/08/2012||Yes|No||10/08/2012||Yes|No|10/08/2012||Yes|No||||No|No|07/01/2016||Over the counter|No||029|No|14.5726|05/29/2018|14.36442|05/29/2018|13.6804|05/29/2018|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|84|||||No|No||ELI LILLY & CO.|No||||
insulin lispro protamin/lispro|No|No|No|No|75%|00002879759|HUMALOG MIX 75-25 KWIKPEN|3|ML|15.2048|03/04/2009||Yes|No||03/04/2009||Yes|No|03/04/2009||Yes|No||03/04/2009||Yes|No|||Prescription required|No||029|No|33.95867|07/27/2021|33.14366|07/27/2021|33.36439|07/27/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|85|||||No|No||ELI LILLY & CO.|No||||
insulin lispro protamin/lispro|No|No|No|No|75%|00002879859|HUMALOG MIX 50-50 KWIKPEN|3|ML|15.2048|01/14/2008||Yes|No||01/14/2008||Yes|No|01/14/2008||Yes|No||01/14/2008||Yes|No|||Prescription required|No||029|No|33.87433|03/01/2022|33.06134|03/01/2022|33.28152|03/01/2022|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|86|||||No|No||ELI LILLY & CO.|No||||
insulin lispro|No|No|No|No|75%|00002879959|HUMALOG 100 UNIT/ML KWIKPEN|3|ML|15.2048|01/14/2008||Yes|No||01/14/2008||Yes|No|01/14/2008||Yes|No||01/14/2008||Yes|No|||Prescription required|No||029|No|33.9305|10/26/2021|33.11616|10/26/2021|33.33671|10/26/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|87|||||No|No||ELI LILLY & CO.|No||||
insulin NPH hum/reg insulin hm|No|No|No|No|75%|00002880359|HUMULIN 70/30 KWIKPEN|3|ML|13.5106|04/02/2014||Yes|No||04/02/2014||Yes|No|04/02/2014||Yes|No||||No|No|||Over the counter|No||029|No|30.22992|03/01/2022|29.5044|03/01/2022|29.70089|03/01/2022|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|88|||||No|No||ELI LILLY & CO.|No||||
insulin NPH human isophane|No|No|No|No|75%|00002880559|HUMULIN N 100 UNIT/ML KWIKPEN|3|ML|13.5106|04/02/2014||Yes|No||04/02/2014||Yes|No|04/02/2014||Yes|No||||No|No|||Over the counter|Yes|01/28/2021|029|No|30.14887|03/01/2022|29.42529|03/01/2022|29.62126|03/01/2022|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|89|||||No|No||ELI LILLY & CO.|No||||
insulin regular, human|No|No|No|No|75%|00002882427|HUMULIN R 500 UNIT/ML KWIKPEN|3|ML|41.151|02/24/2017||Yes|No||02/24/2017||Yes|No|02/24/2017||Yes|No||||No|No|||Prescription required|No||029|No|91.78976|03/01/2022|89.5868|03/01/2022|90.18343|03/01/2022|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|90|||||No|No||ELI LILLY & CO.|No||||
triamcinolone acetonide|No|No|No|No|75%|00003029305|KENALOG-40 40 MG/ML VIAL|1|ML|4.0248|10/18/2006||Yes|No||10/18/2006||Yes|No|10/18/2006||Yes|No||||No|No|||Prescription required|No|||No|8.924|03/29/2022|8.70982|03/29/2022|8.76783|03/29/2022||||91|||||No|No||BMS PRIMARYCARE|No||||
triamcinolone acetonide|No|No|No|No|75%|00003029328|KENALOG-40 400 MG/10 ML VIAL|10|ML|3.05128|10/18/2006||Yes|No||10/18/2006||Yes|No|10/18/2006||Yes|No||||No|No|||Prescription required|No|||No|6.8606|10/26/2021|6.69594|10/26/2021|6.74053|10/26/2021||||92|||||No|No||BMS PRIMARYCARE|No||||
triamcinolone acetonide|No|No|No|No|75%|00003049420|KENALOG-10 50 MG/5 ML VIAL|5|ML|1.03974|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|2.36964|04/27/2021|2.33578|04/27/2021|2.22456|04/27/2021||||93|||||No|No||BMS PRIMARYCARE|No||||
dasatinib|No|No|No|No|75%|00003052411|SPRYCEL 70 MG TABLET|60|EA|125.99473|07/18/2006||Yes|No||07/18/2006||Yes|No|07/18/2006||Yes|No||||No|No|||Prescription required|No||173|No|287.15078|01/11/2022|283.04862|01/11/2022|269.57012|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|94|||||No|No||BMS PRIMARYCARE|No||||
dasatinib|No|No|No|No|75%|00003052711|SPRYCEL 20 MG TABLET|60|EA|62.9975|07/18/2006||Yes|No||07/18/2006||Yes|No|07/18/2006||Yes|No||||No|No|||Prescription required|No||173|No|143.57571|01/11/2022|141.52463|01/11/2022|134.78536|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|95|||||No|No||BMS PRIMARYCARE|No||||
dasatinib|No|No|No|No|75%|00003052811|SPRYCEL 50 MG TABLET|60|EA|125.99473|07/18/2006||Yes|No||07/18/2006||Yes|No|07/18/2006||Yes|No||||No|No|||Prescription required|No||173|No|287.15078|01/11/2022|283.04862|01/11/2022|269.57012|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|96|||||No|No||BMS PRIMARYCARE|No||||
hydroxyurea|No|No|No|No|75%|00003083050|HYDREA 500 MG CAPSULE|100|EA|.58699|11/04/2014||Yes|No||11/04/2014||Yes|No|11/04/2014||Yes|No||||No|No|||Prescription required|No||173|No|1.33779|06/01/2016|1.31868|06/01/2016|1.25589|06/01/2016|||ONCOLOGY: ORAL - HEMATOLOGIC|97|||||No|No||BMS ONCO/IMMUN|No||||
dasatinib|No|No|No|No|75%|00003085222|SPRYCEL 100 MG TABLET|30|EA|227.08443|08/25/2014||Yes|No||08/25/2014||Yes|No|08/25/2014||Yes|No||||No|No|||Prescription required|No||173|No|508.95971|01/18/2022|496.74467|01/18/2022|500.05291|01/18/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|98|||||No|No||BMS PRIMARYCARE|No||||
dasatinib|No|No|No|No|75%|00003085522|SPRYCEL 80 MG TABLET|30|EA|227.08443|08/25/2014||Yes|No||08/25/2014||Yes|No|08/25/2014||Yes|No||||No|No|||Prescription required|No||173|No|517.54126|01/11/2022|510.14781|01/11/2022|485.85506|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|99|||||No|No||BMS PRIMARYCARE|No||||
dasatinib|No|No|No|No|75%|00003085722|SPRYCEL 140 MG TABLET|30|EA|227.08443|08/25/2014||Yes|No||08/25/2014||Yes|No|08/25/2014||Yes|No||||No|No|||Prescription required|No||173|No|517.54126|01/11/2022|510.14781|01/11/2022|485.85506|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|100|||||No|No||BMS PRIMARYCARE|No||||
apixaban|No|No|No|No|75%|00003089321|ELIQUIS 2.5 MG TABLET|60|EA|3.79123|02/06/2013||Yes|No||02/06/2013||Yes|No|02/06/2013||Yes|No||||No|No|||Prescription required|No||068|Yes|8.46728|01/18/2022|8.26406|01/18/2022|8.3191|01/18/2022|||ANTICOAGULANTS|101|||||No|No||BMS PRIMARYCARE|Yes|09/01/2020|||
apixaban|No|No|No|No|75%|00003089331|ELIQUIS 2.5 MG TABLET|100|EA|3.79156|02/06/2013||Yes|No||02/06/2013||Yes|No|02/06/2013||Yes|No||||No|No|||Prescription required|No||068|Yes|8.46728|01/18/2022|8.26406|01/18/2022|8.3191|01/18/2022|||ANTICOAGULANTS|102|||||No|No||BMS PRIMARYCARE|No||||
apixaban|No|No|No|No|75%|00003089421|ELIQUIS 5 MG TABLET|60|EA|3.79123|02/06/2013||Yes|No||02/06/2013||Yes|No|02/06/2013||Yes|No||||No|No|||Prescription required|No||068|Yes|8.46451|01/18/2022|8.26136|01/18/2022|8.31638|01/18/2022|||ANTICOAGULANTS|103|||||No|No||BMS PRIMARYCARE|Yes|09/01/2020|||
apixaban|No|No|No|No|75%|00003089431|ELIQUIS 5 MG TABLET|100|EA|3.79156|02/06/2013||Yes|No||02/06/2013||Yes|No|02/06/2013||Yes|No||||No|No|||Prescription required|No||068|Yes|8.46451|01/18/2022|8.26136|01/18/2022|8.31638|01/18/2022|||ANTICOAGULANTS|104|||||No|No||BMS PRIMARYCARE|No||||
apixaban|No|No|No|No|75%|00003089470|ELIQUIS 5 MG TABLET|74|EA|3.79131|07/09/2018||Yes|No||07/09/2018||Yes|No|07/09/2018||Yes|No||||No|No|||Prescription required|No||068|Yes|8.46451|01/18/2022|8.26136|01/18/2022|8.31638|01/18/2022|||ANTICOAGULANTS|105|||||No|No||BMS PRIMARYCARE|Yes|09/01/2020|||
entecavir|No|No|No|No|75%|00003161112|BARACLUDE 0.5 MG TABLET|30|EA|19.67221|07/12/2005||Yes|No||07/12/2005||Yes|No|07/12/2005||Yes|No||||No|No|||Prescription required|No|||No|44.83434|01/23/2018|44.19385|01/23/2018|42.08938|01/23/2018||||106|||||No|No||BMS PRIMARYCARE|No||||
entecavir|No|No|No|No|75%|00003161212|BARACLUDE 1 MG TABLET|30|EA|19.67221|07/12/2005||Yes|No||07/12/2005||Yes|No|07/12/2005||Yes|No||||No|No|||Prescription required|No|||No|44.83434|01/23/2018|44.19385|01/23/2018|42.08938|01/23/2018||||107|||||No|No||BMS PRIMARYCARE|No||||
entecavir|No|No|No|No|75%|00003161412|BARACLUDE 0.05 MG/ML SOLUTION|210|ML|1.96718|07/12/2005||Yes|No||07/12/2005||Yes|No|07/12/2005||Yes|No||||No|No|||Prescription required|No|||No|4.48335|01/10/2017|4.4193|01/10/2017|4.20886|01/10/2017||||108|||||No|No||BMS PRIMARYCARE|No||||
abatacept|No|No|No|No|75%|00003218811|ORENCIA 125 MG/ML SYRINGE|1|ML|544.89277|01/06/2014||Yes|No||01/06/2014||Yes|No|01/06/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|071|Yes|1231.28693|01/18/2022|1201.73604|01/18/2022|1209.7394|01/18/2022|||CYTOKINE AND CAM ANTAGONISTS|109|||||No|No||BMS PRIMARYCARE|No||||
abatacept|No|No|No|No|75%|00003218851|ORENCIA CLICKJECT 125 MG/ML|1|ML|544.89277|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|071|Yes|1230.49954|01/18/2022|1200.96755|01/18/2022|1208.96579|01/18/2022|||CYTOKINE AND CAM ANTAGONISTS|110|||||No|No||BMS PRIMARYCARE|No||||
abatacept|No|No|No|No|75%|00003281411|ORENCIA 50 MG/0.4 ML SYRINGE|.4|ML|1362.23193|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|071|Yes|3104.62162|01/11/2022|3060.26988|01/11/2022|2914.54275|01/11/2022|||CYTOKINE AND CAM ANTAGONISTS|111|||||No|No||BMS PRIMARYCARE|No||||
abatacept|No|No|No|No|75%|00003281811|ORENCIA 87.5 MG/0.7 ML SYRINGE|.7|ML|778.41825|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|071|Yes|1774.0695|01/11/2022|1748.72565|01/11/2022|1665.453|01/11/2022|||CYTOKINE AND CAM ANTAGONISTS|112|||||No|No||BMS PRIMARYCARE|No||||
atazanavir sulfate|No|No|No|No|75%|00003362212|REYATAZ 300 MG CAPSULE|30|EA|28.9884|06/28/2007||Yes|No||06/28/2007||Yes|No|06/28/2007||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|47.34772|04/27/2021|46.67132|04/27/2021|44.44888|04/27/2021|||HIV / AIDS|113|||||No|No||BMS PRIMARYCARE|No||||
atazanavir sulfate|No|No|No|No|75%|00003362412|REYATAZ 150 MG CAPSULE|60|EA|14.63259|07/01/2003|12/31/2022|Yes|No||07/01/2003|12/31/2022|Yes|No|07/01/2003|12/31/2022|Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|23.8999|01/23/2018|23.55847|01/23/2018|22.43664|01/23/2018|||HIV / AIDS|114|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||BMS PRIMARYCARE|No||||
atazanavir sulfate|No|No|No|No|75%|00003363112|REYATAZ 200 MG CAPSULE|60|EA|14.63259|07/01/2003||Yes|No||07/01/2003||Yes|No|07/01/2003||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|23.8999|12/25/2018|23.55847|12/25/2018|22.43664|12/25/2018|||HIV / AIDS|115|||||No|No||BMS PRIMARYCARE|No||||
atazanavir sulfate|No|No|No|No|75%|00003363810|REYATAZ 50 MG POWDER PACKET|30|EA|4.5204|12/19/2014||Yes|No||12/19/2014||Yes|No|12/19/2014||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|7.38332|01/10/2017|7.27784|01/10/2017|6.93128|01/10/2017|||HIV / AIDS|116|||||No|No||BMS PRIMARYCARE|No||||
atazanavir sulfate/cobicistat|No|No|No|No|75%|00003364111|EVOTAZ 300 MG-150 MG TABLET|30|EA|32.10939|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||237|No|51.96913|08/24/2021|50.72187|08/24/2021|51.05967|08/24/2021|||HIV / AIDS|117|||||No|No||BMS PRIMARYCARE|No||||
apixaban|No|No|No|No|75%|00003376474|ELIQUIS DVT-PE TREAT START 5MG|74|EA|3.79131|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No||068|Yes|8.46936|01/18/2022|8.26609|01/18/2022|8.32114|01/18/2022|||ANTICOAGULANTS|118|||||No|No||BMS PRIMARYCARE|Yes|09/01/2020|||
hydroxyurea|No|No|No|No|75%|00003633517|DROXIA 200 MG CAPSULE|60|EA|.32543|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||580|No|.72486|08/24/2021|.70746|08/24/2021|.71217|08/24/2021|||SICKLE CELL ANEMIA TREATMENTS|119|||||No|No||BMS ONCO/IMMUN|No||||
hydroxyurea|No|No|No|No|75%|00003633617|DROXIA 300 MG CAPSULE|60|EA|.32543|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||580|No|.74169|03/01/2022|.73109|03/01/2022|.69628|03/01/2022|||SICKLE CELL ANEMIA TREATMENTS|120|||||No|No||BMS ONCO/IMMUN|No||||
hydroxyurea|No|No|No|No|75%|00003633717|DROXIA 400 MG CAPSULE|60|EA|.34822|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||580|No|.79363|06/01/2016|.78229|06/01/2016|.74504|06/01/2016|||SICKLE CELL ANEMIA TREATMENTS|121|||||No|No||BMS ONCO/IMMUN|No||||
valganciclovir HCl|No|No|No|No|75%|00004003822|VALCYTE 450 MG TABLET|60|EA|38.013|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||||No|No|||Prescription required|No||136|No|86.63428|01/29/2019|85.39665|01/29/2019|81.33014|01/29/2019|||ANTIVIRALS: GENERAL|122|||||No|No||GENENTECH, INC.|No||||
valganciclovir HCl|No|No|No|No|75%|00004003909|VALCYTE 50 MG/ML SOLUTION|88|ML|5.22923|03/31/2010||Yes|No||03/31/2010||Yes|No|03/31/2010||Yes|No||||No|No|||Prescription required|No||136|No|11.91779|02/26/2019|11.74754|02/26/2019|11.18813|02/26/2019|||ANTIVIRALS: GENERAL|123|||||No|No||GENENTECH, INC.|No||||
clonazepam|No|No|No|No|75%|00004005801|KLONOPIN 1 MG TABLET|100|EA|1.25177|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||056|Yes|2.78788|08/24/2021|2.72097|08/24/2021|2.73909|08/24/2021|||ANTICONVULSANTS|124|||||No|No||ROCHE LABS.|No||||
clonazepam|No|No|No|No|75%|00004006801|KLONOPIN 0.5 MG TABLET|100|EA|1.09736|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||056|Yes|2.44342|11/23/2021|2.38477|11/23/2021|2.40066|11/23/2021|||ANTICONVULSANTS|125|||||No|No||ROCHE LABS.|No||||
clonazepam|No|No|No|No|75%|00004009801|KLONOPIN 2 MG TABLET|100|EA|1.73449|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||056|Yes|3.95302|07/11/2017|3.89655|07/11/2017|3.711|07/11/2017|||ANTICONVULSANTS|126|||||No|No||ROCHE LABS.|No||||
ibandronate sodium|No|No|No|No|75%|00004018683|BONIVA 150 MG TABLET|3|EA|82.10706|06/02/2016||Yes|No||06/02/2016||Yes|No|06/02/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|060|No|187.12772|01/23/2018|184.45447|01/23/2018|175.67092|01/23/2018|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|127|||||No|No||ROCHE LABS.|No||||
saquinavir mesylate|No|No|No|No|75%|00004024451|INVIRASE 500 MG TABLET|120|EA|6.0087|02/23/2005||Yes|No||02/23/2005||Yes|No|02/23/2005||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|9.81421|01/23/2018|9.674|01/23/2018|9.21334|01/23/2018|||HIV / AIDS|128|||||No|No||GENENTECH, INC.|No||||
mycophenolate mofetil|No|No|No|No|75%|00004025901|CELLCEPT 250 MG CAPSULE|100|EA|3.86823|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|229|No|8.81598|01/29/2019|8.69003|01/29/2019|8.27622|01/29/2019|||IMMUNOSUPPRESSIVES: ORAL|129|||||No|No||GENENTECH, INC.|No||||
mycophenolate mofetil|No|No|No|No|75%|00004025943|CELLCEPT 250 MG CAPSULE|500|EA|3.86823|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|229|No|8.81598|01/29/2019|8.69003|01/29/2019|8.27622|01/29/2019|||IMMUNOSUPPRESSIVES: ORAL|130|||||No|No||GENENTECH, INC.|No||||
mycophenolate mofetil|No|No|No|No|75%|00004026001|CELLCEPT 500 MG TABLET|100|EA|7.73647|06/17/2009||Yes|No||06/17/2009||Yes|No|06/17/2009||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|229|No|17.63196|01/29/2019|17.38007|01/29/2019|16.55245|01/29/2019|||IMMUNOSUPPRESSIVES: ORAL|131|||||No|No||GENENTECH, INC.|No||||
mycophenolate mofetil|No|No|No|No|75%|00004026043|CELLCEPT 500 MG TABLET|500|EA|7.73647|06/17/2009||Yes|No||06/17/2009||Yes|No|06/17/2009||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|229|No|17.63196|01/29/2019|17.38007|01/29/2019|16.55245|01/29/2019|||IMMUNOSUPPRESSIVES: ORAL|132|||||No|No||GENENTECH, INC.|No||||
mycophenolate mofetil|No|No|No|No|75%|00004026129|CELLCEPT 200 MG/ML ORAL SUSP|160|ML|3.71108|06/17/2009||Yes|No||06/17/2009||Yes|No|06/17/2009||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|229|No|8.45782|02/26/2019|8.33699|02/26/2019|7.93999|02/26/2019|||IMMUNOSUPPRESSIVES: ORAL|133|||||No|No||GENENTECH, INC.|No||||
peginterferon alfa-2a|No|No|No|No|75%|00004035009|PEGASYS 180 MCG/ML VIAL|1|ML|439.2407|11/06/2002||Yes|No||11/06/2002||Yes|No|11/06/2002||Yes|No||||No|No|||Prescription required|Yes|04/08/2015|064|No|1001.0602|01/09/2018|986.75934|01/09/2018|939.7708|01/09/2018|||HEPATITIS C AGENTS|134|||||No|No||GENENTECH, INC.|No||||
peginterferon alfa-2a|No|No|No|No|75%|00004035730|PEGASYS 180 MCG/0.5 ML SYRINGE|.5|ML|878.4814|12/01/2011||Yes|No||12/01/2011||Yes|No|12/01/2011||Yes|No||||No|No|||Prescription required|Yes|04/08/2015|064|No|2002.1204|01/09/2018|1973.51868|01/09/2018|1879.5416|01/09/2018|||HEPATITIS C AGENTS|135|||||No|No||GENENTECH, INC.|No||||
enfuvirtide|No|No|No|No|75%|00004038140|FUZEON 90 MG VIAL|60|EA|35.85559|06/20/2012||Yes|No||06/20/2012||Yes|No|06/20/2012||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|58.56414|01/23/2018|57.72751|01/23/2018|54.97858|01/23/2018|||HIV / AIDS|136|||||No|No||GENENTECH, INC.|No||||
oseltamivir phosphate|No|No|No|No|75%|00004080085|TAMIFLU 75 MG CAPSULE|10|EA|6.53084|09/21/2009||Yes|No||09/21/2009||Yes|No|09/21/2009||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|025|No|14.63029|03/01/2022|14.27916|03/01/2022|14.37425|03/01/2022|||ANTIVIRALS: ORAL|137|||||No|No||ROCHE LABS.|No||||
oseltamivir phosphate|No|No|No|No|75%|00004080185|TAMIFLU 45 MG CAPSULE|10|EA|5.99162|04/28/2008||Yes|No||04/28/2008||Yes|No|04/28/2008||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|025|No|13.65532|01/26/2021|13.46024|01/26/2021|12.81928|01/26/2021|||ANTIVIRALS: ORAL|138|||||No|No||ROCHE LABS.|No||||
oseltamivir phosphate|No|No|No|No|75%|00004080285|TAMIFLU 30 MG CAPSULE|10|EA|5.99162|04/30/2009||Yes|No||04/30/2009||Yes|No|04/30/2009||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|025|No|13.65532|01/26/2021|13.46024|01/26/2021|12.81928|01/26/2021|||ANTIVIRALS: ORAL|139|||||No|No||ROCHE LABS.|No||||
oseltamivir phosphate|No|No|No|No|75%|00004082205|TAMIFLU 6 MG/ML SUSPENSION|60|ML|1.08847|08/14/2013||Yes|No||08/14/2013||Yes|No|08/14/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|025|No|2.4807|03/23/2021|2.44526|03/23/2021|2.32882|03/23/2021|||ANTIVIRALS: ORAL|140|||||No|No||GENENTECH, INC.|No||||
capecitabine|No|No|No|No|75%|00004110020|XELODA 150 MG TABLET|60|EA|5.82979|07/14/2004||Yes|No||07/14/2004||Yes|No|07/14/2004||Yes|No||||No|No|||Prescription required|No||502|No|13.2865|01/10/2017|13.09669|01/10/2017|12.47304|01/10/2017|||ONCOLOGY: ORAL - BREAST|141|||||No|No||GENENTECH, INC.|No||||
capecitabine|No|No|No|No|75%|00004110150|XELODA 500 MG TABLET|120|EA|19.42994|07/14/2004||Yes|No||07/14/2004||Yes|No|07/14/2004||Yes|No||||No|No|||Prescription required|No||502|No|44.28219|06/26/2018|43.64958|06/26/2018|41.57103|06/26/2018|||ONCOLOGY: ORAL - BREAST|142|||||No|No||GENENTECH, INC.|No||||
suvorexant|No|No|No|No|75%|00006000530|BELSOMRA 5 MG TABLET|30|EA|5.7792|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|054|Yes|12.79361|01/18/2022|12.48656|01/18/2022|12.56972|01/18/2022|||SEDATIVE HYPNOTICS|143|||||No|No||MERCK SHARP & D|No||||
alendronate sodium|No|No|No|No|75%|00006003144|FOSAMAX 70 MG TABLET|4|EA|13.7428|08/26/2008||Yes|No||08/26/2008||Yes|No|08/26/2008||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|060|No|31.3208|12/29/2020|30.87336|12/29/2020|29.4032|12/29/2020|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|144|||||No|No||MERCK SHARP & D|No||||
ivermectin|No|No|No|No|75%|00006003220|STROMECTOL 3 MG TABLET|20|EA|2.00057|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|4.46876|11/23/2021|4.3615|11/23/2021|4.39055|11/23/2021||||145|||||No|No||MERCK SHARP & D|No||||
suvorexant|No|No|No|No|75%|00006003330|BELSOMRA 10 MG TABLET|30|EA|5.7792|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|054|Yes|12.88254|01/18/2022|12.57335|01/18/2022|12.65709|01/18/2022|||SEDATIVE HYPNOTICS|146|||||No|No||MERCK SHARP & D|No||||
finasteride|No|No|No|No|75%|00006007231|PROSCAR 5 MG TABLET|30|EA|2.0253|10/06/2006||Yes|No||10/06/2006||Yes|No|10/06/2006||Yes|No||||No|No|||Prescription required|Yes|07/18/2006|003|No|4.6158|10/09/2018|4.54986|10/09/2018|4.3332|10/09/2018|||BPH TREATMENTS|147|||||No|No||MERCK SHARP & D|No||||
finasteride|No|No|No|No|75%|00006007258|PROSCAR 5 MG TABLET|100|EA|2.0253|10/06/2006||Yes|No||10/06/2006||Yes|No|10/06/2006||Yes|No||||No|No|||Prescription required|Yes|07/18/2006|003|No|4.6158|10/09/2018|4.54986|10/09/2018|4.3332|10/09/2018|||BPH TREATMENTS|148|||||No|No||MERCK SHARP & D|No||||
sitagliptin phos/metformin HCl|No|No|No|No|75%|00006007861|JANUMET XR 50-500 MG TABLET|60|EA|3.7367|02/14/2012||Yes|No||02/14/2012||Yes|No|02/14/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|8.32608|01/18/2022|8.12625|01/18/2022|8.18037|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|149|||||No|No||MERCK SHARP & D|No||||
sitagliptin phos/metformin HCl|No|No|No|No|75%|00006007862|JANUMET XR 50-500 MG TABLET|180|EA|3.7367|02/14/2012||Yes|No||02/14/2012||Yes|No|02/14/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|8.32608|01/18/2022|8.12625|01/18/2022|8.18037|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|150|||||No|No||MERCK SHARP & D|No||||
sitagliptin phos/metformin HCl|No|No|No|No|75%|00006007882|JANUMET XR 50-500 MG TABLET|1000|EA|3.7367|02/14/2012||Yes|No||02/14/2012||Yes|No|02/14/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|8.32608|01/18/2022|8.12625|01/18/2022|8.18037|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|151|||||No|No||MERCK SHARP & D|No||||
sitagliptin phos/metformin HCl|No|No|No|No|75%|00006008061|JANUMET XR 50-1,000 MG TABLET|60|EA|3.7367|02/14/2012||Yes|No||02/14/2012||Yes|No|02/14/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|8.33442|01/18/2022|8.13439|01/18/2022|8.18856|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|152|||||No|No||MERCK SHARP & D|No||||
sitagliptin phos/metformin HCl|No|No|No|No|75%|00006008062|JANUMET XR 50-1,000 MG TABLET|180|EA|3.7367|02/14/2012||Yes|No||02/14/2012||Yes|No|02/14/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|8.33442|01/18/2022|8.13439|01/18/2022|8.18856|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|153|||||No|No||MERCK SHARP & D|No||||
sitagliptin phos/metformin HCl|No|No|No|No|75%|00006008082|JANUMET XR 50-1,000 MG TABLET|1000|EA|3.7367|02/14/2012||Yes|No||02/14/2012||Yes|No|02/14/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|8.33442|01/18/2022|8.13439|01/18/2022|8.18856|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|154|||||No|No||MERCK SHARP & D|No||||
sitagliptin phos/metformin HCl|No|No|No|No|75%|00006008131|JANUMET XR 100-1,000 MG TABLET|30|EA|7.4734|02/14/2012||Yes|No||02/14/2012||Yes|No|02/14/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|16.66769|01/18/2022|16.26766|01/18/2022|16.376|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|155|||||No|No||MERCK SHARP & D|No||||
sitagliptin phos/metformin HCl|No|No|No|No|75%|00006008154|JANUMET XR 100-1,000 MG TABLET|90|EA|7.4734|02/14/2012||Yes|No||02/14/2012||Yes|No|02/14/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|16.66769|01/18/2022|16.26766|01/18/2022|16.376|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|156|||||No|No||MERCK SHARP & D|No||||
sitagliptin phos/metformin HCl|No|No|No|No|75%|00006008182|JANUMET XR 100-1,000 MG TABLET|1000|EA|7.4734|02/14/2012||Yes|No||02/14/2012||Yes|No|02/14/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|16.66769|01/18/2022|16.26766|01/18/2022|16.376|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|157|||||No|No||MERCK SHARP & D|No||||
sitagliptin phosphate|No|No|No|No|75%|00006011231|JANUVIA 50 MG TABLET|30|EA|7.4734|11/02/2006||Yes|No||11/02/2006||Yes|No|11/02/2006||Yes|No||||No|No|||Prescription required|No||111|Yes|16.69261|01/18/2022|16.29198|01/18/2022|16.40048|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|158|||||No|No||MERCK SHARP & D|No||||
sitagliptin phosphate|No|No|No|No|75%|00006011254|JANUVIA 50 MG TABLET|90|EA|7.4734|11/02/2006||Yes|No||11/02/2006||Yes|No|11/02/2006||Yes|No||||No|No|||Prescription required|No||111|Yes|16.69261|01/18/2022|16.29198|01/18/2022|16.40048|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|159|||||No|No||MERCK SHARP & D|No||||
sitagliptin phosphate|No|No|No|No|75%|00006022131|JANUVIA 25 MG TABLET|30|EA|7.4734|11/02/2006||Yes|No||11/02/2006||Yes|No|11/02/2006||Yes|No||||No|No|||Prescription required|No||111|Yes|16.66353|01/18/2022|16.2636|01/18/2022|16.37191|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|160|||||No|No||MERCK SHARP & D|No||||
sitagliptin phosphate|No|No|No|No|75%|00006022154|JANUVIA 25 MG TABLET|90|EA|7.4734|11/02/2006||Yes|No||11/02/2006||Yes|No|11/02/2006||Yes|No||||No|No|||Prescription required|No||111|Yes|16.66353|01/18/2022|16.2636|01/18/2022|16.37191|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|161|||||No|No||MERCK SHARP & D|No||||
raltegravir potassium|No|No|No|No|75%|00006022761|ISENTRESS 400 MG TABLET|60|EA|18.216|02/08/2008||Yes|No||02/08/2008||Yes|No|02/08/2008||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|29.50195|01/18/2022|28.7939|01/18/2022|28.98566|01/18/2022|||HIV / AIDS|162|||||No|No||MERCK SHARP & D|No||||
rizatriptan benzoate|No|No|No|No|75%|00006026718|MAXALT 10 MG TABLET|18|EA|15.7251|05/25/2011||Yes|No||05/25/2011||Yes|No|05/25/2011||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|021|No|35.8386|11/26/2019|35.32662|11/26/2019|33.6444|11/26/2019|||ANTIMIGRAINE AGENTS: TRIPTANS|163|||||No|No||MERCK SHARP & D|No||||
alendronate sodium/vitamin D3|No|No|No|No|75%|00006027044|FOSAMAX PLUS D 70 MG-5600 UNIT|4|EA|18.6319|06/18/2007||Yes|No||06/18/2007||Yes|No|06/18/2007||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|060|No|42.4634|06/13/2017|41.85678|06/13/2017|39.8636|06/13/2017|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|164|||||No|No||MERCK SHARP & D|No||||
sitagliptin phosphate|No|No|No|No|75%|00006027728|JANUVIA 100 MG TABLET|100|EA|7.4734|11/02/2006||Yes|No||11/02/2006||Yes|No|11/02/2006||Yes|No||||No|No|||Prescription required|No||111|Yes|16.68166|01/18/2022|16.2813|01/18/2022|16.38973|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|165|||||No|No||MERCK SHARP & D|No||||
sitagliptin phosphate|No|No|No|No|75%|00006027731|JANUVIA 100 MG TABLET|30|EA|7.4734|11/02/2006||Yes|No||11/02/2006||Yes|No|11/02/2006||Yes|No||||No|No|||Prescription required|No||111|Yes|16.68166|01/18/2022|16.2813|01/18/2022|16.38973|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|166|||||No|No||MERCK SHARP & D|No||||
sitagliptin phosphate|No|No|No|No|75%|00006027754|JANUVIA 100 MG TABLET|90|EA|7.4734|11/02/2006||Yes|No||11/02/2006||Yes|No|11/02/2006||Yes|No||||No|No|||Prescription required|No||111|Yes|16.68166|01/18/2022|16.2813|01/18/2022|16.38973|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|167|||||No|No||MERCK SHARP & D|No||||
sitagliptin phosphate|No|No|No|No|75%|00006027782|JANUVIA 100 MG TABLET|1000|EA|7.4734|02/20/2019||Yes|No||02/20/2019||Yes|No|02/20/2019||Yes|No||||No|No|||Prescription required|No||111|Yes|16.68166|01/18/2022|16.2813|01/18/2022|16.38973|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|168|||||No|No||MERCK SHARP & D|No||||
suvorexant|No|No|No|No|75%|00006032530|BELSOMRA 15 MG TABLET|30|EA|5.7792|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|054|Yes|12.85974|01/18/2022|12.5511|01/18/2022|12.63469|01/18/2022|||SEDATIVE HYPNOTICS|169|||||No|No||MERCK SHARP & D|No||||
suvorexant|No|No|No|No|75%|00006033530|BELSOMRA 20 MG TABLET|30|EA|5.7792|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|054|Yes|12.87191|01/18/2022|12.56298|01/18/2022|12.64665|01/18/2022|||SEDATIVE HYPNOTICS|170|||||No|No||MERCK SHARP & D|No||||
aprepitant|No|No|No|No|75%|00006046102|EMEND 80 MG CAPSULE|2|EA|94.0711|02/19/2008||Yes|No||02/19/2008||Yes|No|02/19/2008||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|085|Yes|214.3946|01/29/2019|211.33182|01/29/2019|201.2684|01/29/2019|||ANTIEMETIC/ANTIVERTIGO AGENTS|171|||||No|No||MERCK SHARP & D|No||||
raltegravir potassium|No|No|No|No|75%|00006047361|ISENTRESS 25 MG TABLET CHEW|60|EA|1.1385|01/07/2015||Yes|No||01/07/2015||Yes|No|01/07/2015||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|1.85955|01/11/2022|1.83298|01/11/2022|1.7457|01/11/2022|||HIV / AIDS|172|||||No|No||MERCK SHARP & D|No||||
raltegravir potassium|No|No|No|No|75%|00006047761|ISENTRESS 100 MG TABLET CHEW|60|EA|4.554|01/07/2015||Yes|No||01/07/2015||Yes|No|01/07/2015||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|7.4382|01/11/2022|7.33194|01/11/2022|6.9828|01/11/2022|||HIV / AIDS|173|||||No|No||MERCK SHARP & D|No||||
simvastatin|No|No|No|No|75%|00006054331|ZOCOR 80 MG TABLET|30|EA|3.4658|07/11/2006||Yes|No||07/11/2006||Yes|No|07/11/2006||Yes|No||||No|No|||Prescription required|Yes|01/23/2007|063|Yes|7.8988|06/13/2017|7.78596|06/13/2017|7.4152|06/13/2017|||LIPOTROPICS: STATINS|174|||||No|No||MERCK SHARP & D|No||||
simvastatin|No|No|No|No|75%|00006054354|ZOCOR 80 MG TABLET|90|EA|3.4658|01/30/2007||Yes|No||01/30/2007||Yes|No|01/30/2007||Yes|No||||No|No|||Prescription required|Yes|01/23/2007|063|Yes|7.8988|06/13/2017|7.78596|06/13/2017|7.4152|06/13/2017|||LIPOTROPICS: STATINS|175|||||No|No||MERCK SHARP & D|No||||
vorinostat|No|No|No|No|75%|00006056840|ZOLINZA 100 MG CAPSULE|120|EA|53.7844|10/19/2006||Yes|No||10/19/2006||Yes|No|10/19/2006||Yes|No||||No|No|||Prescription required|No||173|No|122.5784|01/16/2018|120.82728|01/16/2018|115.0736|01/16/2018|||ONCOLOGY: ORAL - HEMATOLOGIC|176|||||No|No||MERCK SHARP & D|No||||
sitagliptin phos/metformin HCl|No|No|No|No|75%|00006057561|JANUMET 50-500 MG TABLET|60|EA|3.7367|05/01/2007||Yes|No||05/01/2007||Yes|No|05/01/2007||Yes|No||||No|No|||Prescription required|No||111|Yes|8.34537|01/18/2022|8.14508|01/18/2022|8.19932|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|177|||||No|No||MERCK SHARP & D|No||||
sitagliptin phos/metformin HCl|No|No|No|No|75%|00006057562|JANUMET 50-500 MG TABLET|180|EA|3.7367|05/01/2007||Yes|No||05/01/2007||Yes|No|05/01/2007||Yes|No||||No|No|||Prescription required|No||111|Yes|8.34537|01/18/2022|8.14508|01/18/2022|8.19932|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|178|||||No|No||MERCK SHARP & D|No||||
sitagliptin phos/metformin HCl|No|No|No|No|75%|00006057582|JANUMET 50-500 MG TABLET|1000|EA|3.7367|02/20/2019||Yes|No||02/20/2019||Yes|No|02/20/2019||Yes|No||||No|No|||Prescription required|No||111|Yes|8.34537|01/18/2022|8.14508|01/18/2022|8.19932|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|179|||||No|No||MERCK SHARP & D|No||||
sitagliptin phos/metformin HCl|No|No|No|No|75%|00006057761|JANUMET 50-1,000 MG TABLET|60|EA|3.7367|05/01/2007||Yes|No||05/01/2007||Yes|No|05/01/2007||Yes|No||||No|No|||Prescription required|No||111|Yes|8.32834|01/18/2022|8.12845|01/18/2022|8.18259|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|180|||||No|No||MERCK SHARP & D|No||||
sitagliptin phos/metformin HCl|No|No|No|No|75%|00006057762|JANUMET 50-1,000 MG TABLET|180|EA|3.7367|05/01/2007||Yes|No||05/01/2007||Yes|No|05/01/2007||Yes|No||||No|No|||Prescription required|No||111|Yes|8.32834|01/18/2022|8.12845|01/18/2022|8.18259|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|181|||||No|No||MERCK SHARP & D|No||||
sitagliptin phos/metformin HCl|No|No|No|No|75%|00006057782|JANUMET 50-1,000 MG TABLET|1000|EA|3.7367|02/20/2019||Yes|No||02/20/2019||Yes|No|02/20/2019||Yes|No||||No|No|||Prescription required|No||111|Yes|8.32834|01/18/2022|8.12845|01/18/2022|8.18259|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|182|||||No|No||MERCK SHARP & D|No||||
alendronate sodium/vitamin D3|No|No|No|No|75%|00006071044|FOSAMAX PLUS D 70 MG-2800 UNIT|4|EA|18.6319|05/05/2005||Yes|No||05/05/2005||Yes|No|05/05/2005||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|060|No|42.4634|03/26/2019|41.85678|03/26/2019|39.8636|03/26/2019|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|183|||||No|No||MERCK SHARP & D|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|00006071731|HYZAAR 50-12.5 TABLET|30|EA|1.763|09/11/2010||Yes|No||09/11/2010||Yes|No|09/11/2010||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|113|Yes|4.018|06/29/2021|3.9606|06/29/2021|3.772|06/29/2021|||ANGIOTENSIN MODULATORS|184|||||No|No||MERCK SHARP & D|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|00006071754|HYZAAR 50-12.5 TABLET|90|EA|1.763|09/11/2010||Yes|No||09/11/2010||Yes|No|09/11/2010||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|113|Yes|4.018|06/29/2021|3.9606|06/29/2021|3.772|06/29/2021|||ANGIOTENSIN MODULATORS|185|||||No|No||MERCK SHARP & D|No||||
simvastatin|No|No|No|No|75%|00006073531|ZOCOR 10 MG TABLET|30|EA|1.9866|07/07/2006||Yes|No||07/07/2006||Yes|No|07/07/2006||Yes|No||||No|No|||Prescription required|Yes|01/23/2007|063|Yes|4.5276|06/13/2017|4.46292|06/13/2017|4.2504|06/13/2017|||LIPOTROPICS: STATINS|186|||||No|No||MERCK SHARP & D|No||||
simvastatin|No|No|No|No|75%|00006073554|ZOCOR 10 MG TABLET|90|EA|1.9866|07/07/2006||Yes|No||07/07/2006||Yes|No|07/07/2006||Yes|No||||No|No|||Prescription required|Yes|01/23/2007|063|Yes|4.5276|06/13/2017|4.46292|06/13/2017|4.2504|06/13/2017|||LIPOTROPICS: STATINS|187|||||No|No||MERCK SHARP & D|No||||
simvastatin|No|No|No|No|75%|00006074031|ZOCOR 20 MG TABLET|30|EA|3.4658|07/07/2006||Yes|No||07/07/2006||Yes|No|07/07/2006||Yes|No||||No|No|||Prescription required|Yes|01/23/2007|063|Yes|7.8988|10/26/2021|7.78596|10/26/2021|7.4152|10/26/2021|||LIPOTROPICS: STATINS|188|||||No|No||MERCK SHARP & D|No||||
simvastatin|No|No|No|No|75%|00006074054|ZOCOR 20 MG TABLET|90|EA|3.4658|07/07/2006||Yes|No||07/07/2006||Yes|No|07/07/2006||Yes|No||||No|No|||Prescription required|Yes|01/23/2007|063|Yes|7.8988|10/26/2021|7.78596|10/26/2021|7.4152|10/26/2021|||LIPOTROPICS: STATINS|189|||||No|No||MERCK SHARP & D|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|00006074531|HYZAAR 100-12.5 TABLET|30|EA|2.408|09/15/2010||Yes|No||09/15/2010||Yes|No|09/15/2010||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|113|Yes|5.488|06/13/2017|5.4096|06/13/2017|5.152|06/13/2017|||ANGIOTENSIN MODULATORS|190|||||No|No||MERCK SHARP & D|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|00006074554|HYZAAR 100-12.5 TABLET|90|EA|2.408|09/15/2010||Yes|No||09/15/2010||Yes|No|09/15/2010||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|113|Yes|5.488|06/13/2017|5.4096|06/13/2017|5.152|06/13/2017|||ANGIOTENSIN MODULATORS|191|||||No|No||MERCK SHARP & D|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|00006074731|HYZAAR 100-25 TABLET|30|EA|2.408|09/16/2010||Yes|No||09/16/2010||Yes|No|09/16/2010||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|113|Yes|5.5924|03/01/2022|5.45818|03/01/2022|5.49453|03/01/2022|||ANGIOTENSIN MODULATORS|192|||||No|No||MERCK SHARP & D|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|00006074754|HYZAAR 100-25 TABLET|90|EA|2.408|09/16/2010||Yes|No||09/16/2010||Yes|No|09/16/2010||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|113|Yes|5.5924|03/01/2022|5.45818|03/01/2022|5.49453|03/01/2022|||ANGIOTENSIN MODULATORS|193|||||No|No||MERCK SHARP & D|No||||
simvastatin|No|No|No|No|75%|00006074931|ZOCOR 40 MG TABLET|30|EA|3.4658|07/07/2006||Yes|No||07/07/2006||Yes|No|07/07/2006||Yes|No||||No|No|||Prescription required|Yes|01/23/2007|063|Yes|7.8988|06/26/2018|7.78596|06/26/2018|7.4152|06/26/2018|||LIPOTROPICS: STATINS|194|||||No|No||MERCK SHARP & D|No||||
simvastatin|No|No|No|No|75%|00006074954|ZOCOR 40 MG TABLET|90|EA|3.4658|07/07/2006||Yes|No||07/07/2006||Yes|No|07/07/2006||Yes|No||||No|No|||Prescription required|Yes|01/23/2007|063|Yes|7.8988|06/26/2018|7.78596|06/26/2018|7.4152|06/26/2018|||LIPOTROPICS: STATINS|195|||||No|No||MERCK SHARP & D|No||||
losartan potassium|No|No|No|No|75%|00006095154|COZAAR 25 MG TABLET|90|EA|1.1911|09/11/2010||Yes|No||09/11/2010||Yes|No|09/11/2010||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|113|Yes|2.7146|06/13/2017|2.67582|06/13/2017|2.5484|06/13/2017|||ANGIOTENSIN MODULATORS|196|||||No|No||MERCK SHARP & D|No||||
losartan potassium|No|No|No|No|75%|00006095231|COZAAR 50 MG TABLET|30|EA|1.5953|09/03/2010||Yes|No||09/03/2010||Yes|No|09/03/2010||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|113|Yes|3.72061|01/25/2022|3.63131|01/25/2022|3.65549|01/25/2022|||ANGIOTENSIN MODULATORS|197|||||No|No||MERCK SHARP & D|No||||
losartan potassium|No|No|No|No|75%|00006095254|COZAAR 50 MG TABLET|90|EA|1.5953|09/03/2010||Yes|No||09/03/2010||Yes|No|09/03/2010||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|113|Yes|3.72061|01/25/2022|3.63131|01/25/2022|3.65549|01/25/2022|||ANGIOTENSIN MODULATORS|198|||||No|No||MERCK SHARP & D|No||||
losartan potassium|No|No|No|No|75%|00006096031|COZAAR 100 MG TABLET|30|EA|2.1758|09/04/2010||Yes|No||09/04/2010||Yes|No|09/04/2010||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|113|Yes|5.12753|01/25/2022|5.00446|01/25/2022|5.03779|01/25/2022|||ANGIOTENSIN MODULATORS|199|||||No|No||MERCK SHARP & D|No||||
losartan potassium|No|No|No|No|75%|00006096054|COZAAR 100 MG TABLET|90|EA|2.1758|09/04/2010||Yes|No||09/04/2010||Yes|No|09/04/2010||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|113|Yes|5.12753|01/25/2022|5.00446|01/25/2022|5.03779|01/25/2022|||ANGIOTENSIN MODULATORS|200|||||No|No||MERCK SHARP & D|No||||
montelukast sodium|No|No|No|No|75%|00006171131|SINGULAIR 4 MG TABLET CHEW|30|EA|3.2723|07/13/2012||Yes|No||07/13/2012||Yes|No|07/13/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|042|Yes|7.4578|06/26/2018|7.35126|06/26/2018|7.0012|06/26/2018|||LEUKOTRIENE MODIFIERS|201|||||No|No||MERCK SHARP & D|No||||
aprepitant|No|No|No|No|75%|00006306603|EMEND 125 MG POWDER PACKET|1|EA|146.9869|08/10/2016||Yes|No||08/10/2016||Yes|No|08/10/2016||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|085|No|334.9934|01/16/2018|330.20778|01/16/2018|314.4836|01/16/2018|||ANTIEMETIC/ANTIVERTIGO AGENTS|202|||||No|No||MERCK SHARP & D|No||||
doravirine|No|No|No|No|75%|00006306901|PIFELTRO 100 MG TABLET|30|EA|31.944|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|No||237|No|51.74929|01/18/2022|50.5073|01/18/2022|50.84367|01/18/2022|||HIV / AIDS|203|||||No|No||MERCK SHARP & D|No||||
elbasvir/grazoprevir|No|No|No|No|75%|00006307402|ZEPATIER 50-100 MG TABLET|14|EA|111.8|09/21/2016||Yes|No||||No|No|09/01/2021||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|064|Yes|254.8|12/10/2019|251.16|12/10/2019|239.2|12/10/2019|||HEPATITIS C AGENTS|204|||||No|No||MERCK SHARP & D|No||||
letermovir|No|No|No|No|75%|00006307502|PREVYMIS 240 MG TABLET|28|EA|101.9186|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|||Prescription required|No|||No|232.2796|01/11/2022|228.96132|01/11/2022|218.0584|01/11/2022||||205|||||No|No||MERCK SHARP & D|No||||
letermovir|No|No|No|No|75%|00006307504|PREVYMIS 240 MG TABLET|14|EA|101.9186|05/23/2018||Yes|No||05/23/2018||Yes|No|05/23/2018||Yes|No||||No|No|||Prescription required|No|||No|232.2796|01/11/2022|228.96132|01/11/2022|218.0584|01/11/2022||||206|||||No|No||MERCK SHARP & D|No||||
letermovir|No|No|No|No|75%|00006307602|PREVYMIS 480 MG TABLET|28|EA|101.9186|01/02/2020||Yes|No||01/02/2020||Yes|No|01/02/2020||Yes|No||||No|No|||Prescription required|No|||No|232.2796|01/11/2022|228.96132|01/11/2022|218.0584|01/11/2022||||207|||||No|No||MERCK SHARP & D|No||||
letermovir|No|No|No|No|75%|00006307604|PREVYMIS 480 MG TABLET|14|EA|101.9186|08/08/2018||Yes|No||08/08/2018||Yes|No|08/08/2018||Yes|No||||No|No|||Prescription required|No|||No|232.2796|01/11/2022|228.96132|01/11/2022|218.0584|01/11/2022||||208|||||No|No||MERCK SHARP & D|No||||
raltegravir potassium|No|No|No|No|75%|00006308001|ISENTRESS HD 600 MG TABLET|60|EA|18.216|07/17/2017||Yes|No||07/17/2017||Yes|No|07/17/2017||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|29.5736|01/18/2022|28.86383|01/18/2022|29.05606|01/18/2022|||HIV / AIDS|209|||||No|No||MERCK SHARP & D|No||||
imipenem/cilastatin sodium|No|No|No|No|75%|00006351659|PRIMAXIN 500 MG VIAL|1|EA|14.04001|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|31.99817|06/01/2016|31.54105|06/01/2016|30.0391|06/01/2016||||210|||||No|No||MERCK SHARP & D|No||||
dorzolamide HCl|No|No|No|No|75%|00006351936|TRUSOPT 2% EYE DROPS|10|ML|3.2594|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|088|No|7.4284|10/29/2019|7.32228|10/29/2019|6.9736|10/29/2019|||OPHTHALMICS: GLAUCOMA AGENTS|211|||||No|No||MERCK SHARP & D|No||||
raltegravir potassium|No|No|No|No|75%|00006360361|ISENTRESS 100 MG POWDER PACKET|60|EA|4.554|07/22/2019||Yes|No||07/22/2019||Yes|No|07/22/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|7.4382|01/11/2022|7.33194|01/11/2022|6.9828|01/11/2022|||HIV / AIDS|212|||||No|No||MERCK SHARP & D|No||||
rizatriptan benzoate|No|No|No|No|75%|00006380118|MAXALT MLT 10 MG TABLET|3|EA|15.7251|05/25/2011||Yes|No||05/25/2011||Yes|No|05/25/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|021|No|35.8386|06/29/2021|35.32662|06/29/2021|33.6444|06/29/2021|||ANTIMIGRAINE AGENTS: TRIPTANS|213|||||No|No||MERCK SHARP & D|No||||
caspofungin acetate|No|No|No|No|75%|00006382210|CANCIDAS IV 50 MG VIAL|1|EA|145.2153|02/23/2006||Yes|No||02/23/2006||Yes|No|02/23/2006||Yes|No||||No|No|||Prescription required|No|||No|330.9558|06/01/2016|326.22786|06/01/2016|310.6932|06/01/2016||||214|||||No|No||MERCK SHARP & D|No||||
caspofungin acetate|No|No|No|No|75%|00006382310|CANCIDAS IV 70 MG VIAL|1|EA|150.8784|02/23/2006||Yes|No||02/23/2006||Yes|No|02/23/2006||Yes|No||||No|No|||Prescription required|No|||No|343.8624|06/01/2016|338.95008|06/01/2016|322.8096|06/01/2016||||215|||||No|No||MERCK SHARP & D|No||||
montelukast sodium|No|No|No|No|75%|00006384130|SINGULAIR 4 MG GRANULES|30|EA|3.2723|10/15/2003||Yes|No||10/15/2003||Yes|No|10/15/2003||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|042|Yes|7.4578|06/26/2018|7.35126|06/26/2018|7.0012|06/26/2018|||LEUKOTRIENE MODIFIERS|216|||||No|No||MERCK SHARP & D|No||||
ertapenem sodium|No|No|No|No|75%|00006384371|INVANZ 1 GM VIAL|1|EA|55.3238|07/08/2008||Yes|No||07/08/2008||Yes|No|07/08/2008||Yes|No||||No|No|||Prescription required|No|||No|126.0868|01/29/2019|124.28556|01/29/2019|118.3672|01/29/2019||||217|||||No|No||MERCK SHARP & D|No||||
aprepitant|No|No|No|No|75%|00006386203|EMEND TRIPACK|3|EA|110.9916|09/08/2007||Yes|No||09/08/2007||Yes|No|09/08/2007||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|085|Yes|252.9576|01/29/2019|249.34392|01/29/2019|237.4704|01/29/2019|||ANTIEMETIC/ANTIVERTIGO AGENTS|218|||||No|No||MERCK SHARP & D|No||||
doravirine/lamivu/tenofov diso|No|No|No|No|75%|00006500701|DELSTRIGO 100-300-300 MG TAB|30|EA|48.618|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|No||237|No|79.4094|01/11/2022|78.27498|01/11/2022|74.5476|01/11/2022|||HIV / AIDS|219|||||No|No||MERCK SHARP & D|No||||
vericiguat|No|No|No|No|75%|00006502801|VERQUVO 2.5 MG TABLET|14|EA|8.772|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|No|||No|19.992|01/11/2022|19.7064|01/11/2022|18.768|01/11/2022||||220|||||No|No||MERCK SHARP & D|No||||
vericiguat|No|No|No|No|75%|00006502802|VERQUVO 2.5 MG TABLET|30|EA|8.772|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|No|||No|19.992|01/11/2022|19.7064|01/11/2022|18.768|01/11/2022||||221|||||No|No||MERCK SHARP & D|No||||
vericiguat|No|No|No|No|75%|00006502804|VERQUVO 2.5 MG TABLET|100|EA|8.772|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|No|||No|19.992|01/11/2022|19.7064|01/11/2022|18.768|01/11/2022||||222|||||No|No||MERCK SHARP & D|No||||
vericiguat|No|No|No|No|75%|00006502901|VERQUVO 5 MG TABLET|14|EA|8.772|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|No|||No|19.992|01/11/2022|19.7064|01/11/2022|18.768|01/11/2022||||223|||||No|No||MERCK SHARP & D|No||||
vericiguat|No|No|No|No|75%|00006502902|VERQUVO 5 MG TABLET|30|EA|8.772|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|No|||No|19.992|01/11/2022|19.7064|01/11/2022|18.768|01/11/2022||||224|||||No|No||MERCK SHARP & D|No||||
vericiguat|No|No|No|No|75%|00006502904|VERQUVO 5 MG TABLET|100|EA|8.772|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|No|||No|19.992|01/11/2022|19.7064|01/11/2022|18.768|01/11/2022||||225|||||No|No||MERCK SHARP & D|No||||
vericiguat|No|No|No|No|75%|00006503001|VERQUVO 10 MG TABLET|30|EA|8.772|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|No|||No|19.992|01/11/2022|19.7064|01/11/2022|18.768|01/11/2022||||226|||||No|No||MERCK SHARP & D|No||||
vericiguat|No|No|No|No|75%|00006503002|VERQUVO 10 MG TABLET|90|EA|8.772|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|No|||No|19.992|01/11/2022|19.7064|01/11/2022|18.768|01/11/2022||||227|||||No|No||MERCK SHARP & D|No||||
vericiguat|No|No|No|No|75%|00006503004|VERQUVO 10 MG TABLET|100|EA|8.772|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No|||No|19.992|01/11/2022|19.7064|01/11/2022|18.768|01/11/2022||||228|||||No|No||MERCK SHARP & D|No||||
molnupiravir|No|No|No|No|75%|00006505506|MOLNUPIRAVIR 200 MG CAP (EUA)|40|EA|.0043|12/27/2021||Yes|No||12/27/2021||Yes|No|12/27/2021||Yes|No||||No|No|||Prescription required|No|||No|.0098|01/03/2022|.00966|01/03/2022|.0092|01/03/2022|.0001|12/27/2021||229|||||No|No||MERCK SHARP & D|No||||
belzutifan|No|No|No|No|75%|00006533101|WELIREG 40 MG TABLET|90|EA|126.13333|02/22/2022||Yes|No||02/22/2022||Yes|No|02/22/2022||Yes|No||||No|No|||Prescription required|No||548|No|287.46666|02/22/2022|283.35999|02/22/2022|269.86666|02/22/2022|||ONCOLOGY: ORAL - RENAL CELL|230|||||No|No||MERCK SHARP & D|No||||
ertugliflozin pidolate|No|No|No|No|75%|00006536303|STEGLATRO 5 MG TABLET|30|EA|4.6526|07/19/2018||Yes|No||07/19/2018||Yes|No|07/19/2018||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|535|No|10.38202|01/18/2022|10.13285|01/18/2022|10.20033|01/18/2022|||HYPOGLYCEMICS: SGLT2|231|||||No|No||MERCK SHARP & D|No||||
ertugliflozin pidolate|No|No|No|No|75%|00006536306|STEGLATRO 5 MG TABLET|90|EA|4.6526|07/19/2018||Yes|No||07/19/2018||Yes|No|07/19/2018||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|535|No|10.38202|01/18/2022|10.13285|01/18/2022|10.20033|01/18/2022|||HYPOGLYCEMICS: SGLT2|232|||||No|No||MERCK SHARP & D|No||||
ertugliflozin pidolate|No|No|No|No|75%|00006536307|STEGLATRO 5 MG TABLET|500|EA|4.6526|07/19/2018||Yes|No||07/19/2018||Yes|No|07/19/2018||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|535|No|10.38202|01/18/2022|10.13285|01/18/2022|10.20033|01/18/2022|||HYPOGLYCEMICS: SGLT2|233|||||No|No||MERCK SHARP & D|No||||
ertugliflozin pidolate|No|No|No|No|75%|00006536403|STEGLATRO 15 MG TABLET|30|EA|4.6526|07/19/2018||Yes|No||07/19/2018||Yes|No|07/19/2018||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|535|No|10.39813|01/18/2022|10.14857|01/18/2022|10.21616|01/18/2022|||HYPOGLYCEMICS: SGLT2|234|||||No|No||MERCK SHARP & D|No||||
ertugliflozin pidolate|No|No|No|No|75%|00006536406|STEGLATRO 15 MG TABLET|90|EA|4.6526|07/19/2018||Yes|No||07/19/2018||Yes|No|07/19/2018||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|535|No|10.39813|01/18/2022|10.14857|01/18/2022|10.21616|01/18/2022|||HYPOGLYCEMICS: SGLT2|235|||||No|No||MERCK SHARP & D|No||||
ertugliflozin pidolate|No|No|No|No|75%|00006536407|STEGLATRO 15 MG TABLET|500|EA|4.6526|07/19/2018||Yes|No||07/19/2018||Yes|No|07/19/2018||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|535|No|10.39813|01/18/2022|10.14857|01/18/2022|10.21616|01/18/2022|||HYPOGLYCEMICS: SGLT2|236|||||No|No||MERCK SHARP & D|No||||
ertugliflozin/sitagliptin|No|No|No|No|75%|00006536703|STEGLUJAN 5-100 MG TABLET|30|EA|7.8819|09/07/2018||Yes|No||09/07/2018||Yes|No|09/07/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|111|Yes|17.71284|01/25/2022|17.28773|01/25/2022|17.40286|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|237|||||No|No||MERCK SHARP & D|No||||
ertugliflozin/sitagliptin|No|No|No|No|75%|00006536706|STEGLUJAN 5-100 MG TABLET|90|EA|7.8819|09/07/2018||Yes|No||09/07/2018||Yes|No|09/07/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|111|Yes|17.71284|01/25/2022|17.28773|01/25/2022|17.40286|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|238|||||No|No||MERCK SHARP & D|No||||
ertugliflozin/sitagliptin|No|No|No|No|75%|00006536803|STEGLUJAN 15-100 MG TABLET|30|EA|7.8819|09/07/2018||Yes|No||09/07/2018||Yes|No|09/07/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|111|Yes|17.66861|09/28/2021|17.24456|09/28/2021|17.3594|09/28/2021|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|239|||||No|No||MERCK SHARP & D|No||||
ertugliflozin/sitagliptin|No|No|No|No|75%|00006536806|STEGLUJAN 15-100 MG TABLET|90|EA|7.8819|09/07/2018||Yes|No||09/07/2018||Yes|No|09/07/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|111|Yes|17.66861|09/28/2021|17.24456|09/28/2021|17.3594|09/28/2021|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|240|||||No|No||MERCK SHARP & D|No||||
ertugliflozin/metformin|No|No|No|No|75%|00006536903|SEGLUROMET 2.5-500 MG TABLET|60|EA|2.3263|07/19/2018||Yes|No||07/19/2018||Yes|No|07/19/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|535|No|5.3018|01/11/2022|5.22606|01/11/2022|4.9772|01/11/2022|||HYPOGLYCEMICS: SGLT2|241|||||No|No||MERCK SHARP & D|No||||
ertugliflozin/metformin|No|No|No|No|75%|00006536906|SEGLUROMET 2.5-500 MG TABLET|180|EA|2.3263|07/19/2018||Yes|No||07/19/2018||Yes|No|07/19/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|535|No|5.3018|01/11/2022|5.22606|01/11/2022|4.9772|01/11/2022|||HYPOGLYCEMICS: SGLT2|242|||||No|No||MERCK SHARP & D|No||||
ertugliflozin/metformin|No|No|No|No|75%|00006536907|SEGLUROMET 2.5-500 MG TABLET|500|EA|2.3263|09/30/2019||Yes|No||09/30/2019||Yes|No|09/30/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|535|No|5.3018|01/11/2022|5.22606|01/11/2022|4.9772|01/11/2022|||HYPOGLYCEMICS: SGLT2|243|||||No|No||MERCK SHARP & D|No||||
ertugliflozin/metformin|No|No|No|No|75%|00006537003|SEGLUROMET 7.5-500 MG TABLET|60|EA|2.3263|07/19/2018||Yes|No||07/19/2018||Yes|No|07/19/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|535|No|5.19873|01/18/2022|5.07396|01/18/2022|5.10775|01/18/2022|||HYPOGLYCEMICS: SGLT2|244|||||No|No||MERCK SHARP & D|No||||
ertugliflozin/metformin|No|No|No|No|75%|00006537006|SEGLUROMET 7.5-500 MG TABLET|180|EA|2.3263|07/19/2018||Yes|No||07/19/2018||Yes|No|07/19/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|535|No|5.19873|01/18/2022|5.07396|01/18/2022|5.10775|01/18/2022|||HYPOGLYCEMICS: SGLT2|245|||||No|No||MERCK SHARP & D|No||||
ertugliflozin/metformin|No|No|No|No|75%|00006537007|SEGLUROMET 7.5-500 MG TABLET|500|EA|2.3263|09/30/2019||Yes|No||09/30/2019||Yes|No|09/30/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|535|No|5.19873|01/18/2022|5.07396|01/18/2022|5.10775|01/18/2022|||HYPOGLYCEMICS: SGLT2|246|||||No|No||MERCK SHARP & D|No||||
ertugliflozin/metformin|No|No|No|No|75%|00006537303|SEGLUROMET 2.5-1,000 MG TABLET|60|EA|2.3263|07/19/2018||Yes|No||07/19/2018||Yes|No|07/19/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|535|No|5.20969|01/18/2022|5.08465|01/18/2022|5.11852|01/18/2022|||HYPOGLYCEMICS: SGLT2|247|||||No|No||MERCK SHARP & D|No||||
ertugliflozin/metformin|No|No|No|No|75%|00006537306|SEGLUROMET 2.5-1,000 MG TABLET|180|EA|2.3263|07/19/2018||Yes|No||07/19/2018||Yes|No|07/19/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|535|No|5.20969|01/18/2022|5.08465|01/18/2022|5.11852|01/18/2022|||HYPOGLYCEMICS: SGLT2|248|||||No|No||MERCK SHARP & D|No||||
ertugliflozin/metformin|No|No|No|No|75%|00006537307|SEGLUROMET 2.5-1,000 MG TABLET|500|EA|2.3263|09/30/2019||Yes|No||09/30/2019||Yes|No|09/30/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|535|No|5.20969|01/18/2022|5.08465|01/18/2022|5.11852|01/18/2022|||HYPOGLYCEMICS: SGLT2|249|||||No|No||MERCK SHARP & D|No||||
ertugliflozin/metformin|No|No|No|No|75%|00006537403|SEGLUROMET 7.5-1,000 MG TABLET|60|EA|2.3263|07/19/2018||Yes|No||07/19/2018||Yes|No|07/19/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|535|No|5.1954|01/18/2022|5.07071|01/18/2022|5.10448|01/18/2022|||HYPOGLYCEMICS: SGLT2|250|||||No|No||MERCK SHARP & D|No||||
ertugliflozin/metformin|No|No|No|No|75%|00006537406|SEGLUROMET 7.5-1,000 MG TABLET|180|EA|2.3263|07/19/2018||Yes|No||07/19/2018||Yes|No|07/19/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|535|No|5.1954|01/18/2022|5.07071|01/18/2022|5.10448|01/18/2022|||HYPOGLYCEMICS: SGLT2|251|||||No|No||MERCK SHARP & D|No||||
ertugliflozin/metformin|No|No|No|No|75%|00006537407|SEGLUROMET 7.5-1,000 MG TABLET|500|EA|2.3263|09/30/2019||Yes|No||09/30/2019||Yes|No|09/30/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|535|No|5.1954|01/18/2022|5.07071|01/18/2022|5.10448|01/18/2022|||HYPOGLYCEMICS: SGLT2|252|||||No|No||MERCK SHARP & D|No||||
carbidopa/levodopa|No|No|No|No|75%|00006672268|SINEMET 10-100 MG TABLET|100|EA|.4472|07/30/2021||Yes|No||07/30/2021||Yes|No|07/30/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|1.0192|07/30/2021|1.00464|07/30/2021|.9568|07/30/2021|||ANTIPARKINSON'S AGENTS|253|||||No|No||MERCK SHARP & D|No||||
carbidopa/levodopa|No|No|No|No|75%|00006672468|SINEMET 25-100 MG TABLET|100|EA|.5031|07/30/2021||Yes|No||07/30/2021||Yes|No|07/30/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|1.1466|08/03/2021|1.13022|07/30/2021|1.0764|07/30/2021|||ANTIPARKINSON'S AGENTS|254|||||No|No||MERCK SHARP & D|No||||
montelukast sodium|No|No|No|No|75%|00006911731|SINGULAIR 10 MG TABLET|30|EA|3.2723|07/13/2012||Yes|No||07/13/2012||Yes|No|07/13/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|042|Yes|7.7018|01/25/2022|7.51695|01/25/2022|7.56701|01/25/2022|||LEUKOTRIENE MODIFIERS|255|||||No|No||MERCK SHARP & D|No||||
montelukast sodium|No|No|No|No|75%|00006911754|SINGULAIR 10 MG TABLET|90|EA|3.2723|07/13/2012||Yes|No||07/13/2012||Yes|No|07/13/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|042|Yes|7.7018|01/25/2022|7.51695|01/25/2022|7.56701|01/25/2022|||LEUKOTRIENE MODIFIERS|256|||||No|No||MERCK SHARP & D|No||||
montelukast sodium|No|No|No|No|75%|00006927531|SINGULAIR 5 MG TABLET CHEW|30|EA|3.2723|07/13/2012||Yes|No||07/13/2012||Yes|No|07/13/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|042|Yes|7.4578|06/26/2018|7.35126|06/26/2018|7.0012|06/26/2018|||LEUKOTRIENE MODIFIERS|257|||||No|No||MERCK SHARP & D|No||||
carvedilol phosphate|No|No|No|No|75%|00007337313|COREG CR 80 MG CAPSULE|30|EA|4.53736|02/01/2007||Yes|No||02/01/2007||Yes|No|02/01/2007||Yes|No||||No|No|||Prescription required|Yes|07/17/2007|070|No|10.34096|10/05/2021|10.19323|10/12/2021|9.70784|10/05/2021|||BETA-BLOCKERS|258|||||No|No||GSK/ WOODWARD P|No||||
carvedilol|No|No|No|No|75%|00007413920|COREG 3.125 MG TABLET|100|EA|2.44356|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/23/2008|070|No|5.56904|10/12/2021|5.48948|10/12/2021|5.22808|10/12/2021|||BETA-BLOCKERS|259|||||No|No||GSK/ WOODWARD P|No||||
carvedilol|No|No|No|No|75%|00007414020|COREG 6.25 MG TABLET|100|EA|2.44356|09/28/2007||Yes|No||09/28/2007||Yes|No|09/28/2007||Yes|No||||No|No|||Prescription required|Yes|01/23/2008|070|No|5.56904|10/12/2021|5.48948|10/12/2021|5.22808|10/12/2021|||BETA-BLOCKERS|260|||||No|No||GSK/ WOODWARD P|No||||
carvedilol|No|No|No|No|75%|00007414120|COREG 12.5 MG TABLET|100|EA|2.44356|09/28/2007||Yes|No||09/28/2007||Yes|No|09/28/2007||Yes|No||||No|No|||Prescription required|Yes|01/23/2008|070|No|5.56904|10/12/2021|5.48948|10/12/2021|5.22808|10/12/2021|||BETA-BLOCKERS|261|||||No|No||GSK/ WOODWARD P|No||||
carvedilol|No|No|No|No|75%|00007414220|COREG 25 MG TABLET|100|EA|2.44356|09/28/2007||Yes|No||09/28/2007||Yes|No|09/28/2007||Yes|No||||No|No|||Prescription required|Yes|01/23/2008|070|No|5.56904|10/12/2021|5.48948|10/12/2021|5.22808|10/12/2021|||BETA-BLOCKERS|262|||||No|No||GSK/ WOODWARD P|No||||
venlafaxine HCl|No|No|No|No|75%|00008083321|EFFEXOR XR 75 MG CAPSULE|30|EA|7.33465|02/24/2006||Yes|No||02/24/2006||Yes|No|02/24/2006||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|031|Yes|16.29997|03/29/2022|15.90877|03/29/2022|16.01472|03/29/2022|||ANTIDEPRESSANTS: OTHER|263|||||No|No||PFIZER/VIATRIS|No||||
venlafaxine HCl|No|No|No|No|75%|00008083322|EFFEXOR XR 75 MG CAPSULE|90|EA|7.33531|02/24/2006||Yes|No||02/24/2006||Yes|No|02/24/2006||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|031|Yes|16.29997|03/29/2022|15.90877|03/29/2022|16.01472|03/29/2022|||ANTIDEPRESSANTS: OTHER|264|||||No|No||PFIZER/VIATRIS|No||||
venlafaxine HCl|No|No|No|No|75%|00008083621|EFFEXOR XR 150 MG CAPSULE|30|EA|7.9894|02/23/2006||Yes|No||02/23/2006||Yes|No|02/23/2006||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|031|No|17.82213|03/29/2022|17.39439|03/29/2022|17.51024|03/29/2022|||ANTIDEPRESSANTS: OTHER|265|||||No|No||PFIZER/VIATRIS|No||||
venlafaxine HCl|No|No|No|No|75%|00008083622|EFFEXOR XR 150 MG CAPSULE|90|EA|7.98911|02/23/2006||Yes|No||02/23/2006||Yes|No|02/23/2006||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|031|No|17.82213|03/29/2022|17.39439|03/29/2022|17.51024|03/29/2022|||ANTIDEPRESSANTS: OTHER|266|||||No|No||PFIZER/VIATRIS|No||||
venlafaxine HCl|No|No|No|No|75%|00008083721|EFFEXOR XR 37.5 MG CAPSULE|30|EA|6.54617|03/03/2006||Yes|No||03/03/2006||Yes|No|03/03/2006||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|031|Yes|14.91918|03/22/2022|14.70605|03/22/2022|14.00576|03/22/2022|||ANTIDEPRESSANTS: OTHER|267|||||No|No||PFIZER/VIATRIS|No||||
venlafaxine HCl|No|No|No|No|75%|00008083722|EFFEXOR XR 37.5 MG CAPSULE|90|EA|6.54598|03/03/2006||Yes|No||03/03/2006||Yes|No|03/03/2006||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|031|Yes|14.91875|03/22/2022|14.70563|03/22/2022|14.00536|03/22/2022|||ANTIDEPRESSANTS: OTHER|268|||||No|No||PFIZER/VIATRIS|No||||
pantoprazole sodium|No|No|No|No|75%|00008084181|PROTONIX DR 40 MG TABLET|90|EA|7.1421|08/31/2009||Yes|No||08/31/2009||Yes|No|08/31/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|15.96595|09/28/2021|15.58276|09/28/2021|15.68654|09/28/2021|||PROTON PUMP INHIBITORS|269|||||No|No||WYETH/PFIZER|No||||
pantoprazole sodium|No|No|No|No|75%|00008084381|PROTONIX DR 20 MG TABLET|90|EA|7.1421|09/01/2009||Yes|No||09/01/2009||Yes|No|09/01/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|Yes|16.27735|01/25/2022|16.04482|01/25/2022|15.28078|01/25/2022|||PROTON PUMP INHIBITORS|270|||||No|No||WYETH/PFIZER|No||||
pantoprazole sodium|No|No|No|No|75%|00008084402|PROTONIX 40 MG SUSPENSION|30|EA|7.10919|11/12/2012||Yes|No||11/12/2012||Yes|No|11/12/2012||Yes|No||||No|No|||Prescription required|No||047|No|15.90121|01/11/2022|15.51958|01/11/2022|15.62293|01/11/2022|||PROTON PUMP INHIBITORS|271|||||No|No||WYETH/PFIZER|No||||
pantoprazole sodium|No|No|No|No|75%|00008092355|PROTONIX IV 40 MG VIAL|1|EA|2.18225|10/20/2004||Yes|No||10/20/2004||Yes|No|10/20/2004||Yes|No||||No|No|||Prescription required|No|||No|4.9735|01/04/2022|4.90245|01/04/2022|4.669|01/04/2022||||272|||||No|No||WYETH/PFIZER|No||||
sirolimus|No|No|No|No|75%|00008103006|RAPAMUNE 1 MG/ML ORAL SOLN|60|ML|13.53554|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||229|No|30.84844|01/04/2022|30.40774|01/04/2022|28.95976|01/04/2022|||IMMUNOSUPPRESSIVES: ORAL|273|||||No|No||WYETH/PFIZER|No||||
sirolimus|No|No|No|No|75%|00008104005|RAPAMUNE 0.5 MG TABLET|100|EA|7.10648|10/23/2012||Yes|No||10/23/2012||Yes|No|10/23/2012||Yes|No||10/23/2012||Yes|No|||Prescription required|No||229|No|16.28323|01/11/2022|15.89243|01/11/2022|15.99827|01/11/2022|||IMMUNOSUPPRESSIVES: ORAL|274|||||No|No||WYETH/PFIZER|No||||
sirolimus|No|No|No|No|75%|00008104105|RAPAMUNE 1 MG TABLET|100|EA|14.2121|03/24/2008||Yes|No||03/24/2008||Yes|No|03/24/2008||Yes|No||03/24/2008||Yes|No|||Prescription required|No||229|No|32.16655|01/11/2022|31.39455|01/11/2022|31.60363|01/11/2022|||IMMUNOSUPPRESSIVES: ORAL|275|||||No|No||WYETH/PFIZER|No||||
sirolimus|No|No|No|No|75%|00008104110|RAPAMUNE 1 MG TABLET|100|EA|14.2121|06/09/2006||Yes|No||06/09/2006||Yes|No|06/09/2006||Yes|No||06/09/2006||Yes|No|||Prescription required|No||229|No|32.16655|01/11/2022|31.39455|01/11/2022|31.60363|01/11/2022|||IMMUNOSUPPRESSIVES: ORAL|276|||||No|No||WYETH/PFIZER|No||||
sirolimus|No|No|No|No|75%|00008104205|RAPAMUNE 2 MG TABLET|100|EA|28.42407|03/08/2006||Yes|No||03/08/2006||Yes|No|03/08/2006||Yes|No||03/08/2006||Yes|No|||Prescription required|No||229|No|64.16221|01/11/2022|62.62231|01/11/2022|63.03937|01/11/2022|||IMMUNOSUPPRESSIVES: ORAL|277|||||No|No||WYETH/PFIZER|No||||
estrogens,conj/bazedoxifene|No|No|No|No|75%|00008112312|DUAVEE 0.45-20 MG TABLET|30|EA|2.74053|03/17/2014||Yes|No||03/17/2014||Yes|No|03/17/2014||Yes|No||||No|No|||Prescription required|No|||Yes|6.24586|01/25/2022|6.15663|01/25/2022|5.86346|01/25/2022||||278|||||No|No||WYETH/PFIZER|No||||
desvenlafaxine succinate|No|No|No|No|75%|00008121030|PRISTIQ ER 25 MG TABLET|30|EA|6.27757|02/10/2016||Yes|No||02/10/2016||Yes|No|02/10/2016||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|031|No|14.04555|01/11/2022|13.70845|01/11/2022|13.79975|01/11/2022|||ANTIDEPRESSANTS: OTHER|279|||||No|No||WYETH/PFIZER|No||||
desvenlafaxine succinate|No|No|No|No|75%|00008121101|PRISTIQ ER 50 MG TABLET|90|EA|6.27732|06/02/2008||Yes|No||06/02/2008||Yes|No|06/02/2008||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|031|No|13.99675|01/11/2022|13.66082|01/11/2022|13.7518|01/11/2022|||ANTIDEPRESSANTS: OTHER|280|||||No|No||WYETH/PFIZER|No||||
desvenlafaxine succinate|No|No|No|No|75%|00008121114|PRISTIQ ER 50 MG TABLET|14|EA|6.27707|06/02/2008||Yes|No||06/02/2008||Yes|No|06/02/2008||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|031|No|13.99675|01/11/2022|13.66082|01/11/2022|13.7518|01/11/2022|||ANTIDEPRESSANTS: OTHER|281|||||No|No||WYETH/PFIZER|No||||
desvenlafaxine succinate|No|No|No|No|75%|00008121130|PRISTIQ ER 50 MG TABLET|30|EA|6.27757|06/02/2008||Yes|No||06/02/2008||Yes|No|06/02/2008||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|031|No|13.99675|01/11/2022|13.66082|01/11/2022|13.7518|01/11/2022|||ANTIDEPRESSANTS: OTHER|282|||||No|No||WYETH/PFIZER|No||||
desvenlafaxine succinate|No|No|No|No|75%|00008122201|PRISTIQ ER 100 MG TABLET|90|EA|6.27732|06/02/2008||Yes|No||06/02/2008||Yes|No|06/02/2008||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|031|No|13.97675|01/11/2022|13.6413|01/11/2022|13.73215|01/11/2022|||ANTIDEPRESSANTS: OTHER|283|||||No|No||WYETH/PFIZER|No||||
desvenlafaxine succinate|No|No|No|No|75%|00008122214|PRISTIQ ER 100 MG TABLET|14|EA|6.27707|06/02/2008||Yes|No||06/02/2008||Yes|No|06/02/2008||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|031|No|13.97675|01/11/2022|13.6413|01/11/2022|13.73215|01/11/2022|||ANTIDEPRESSANTS: OTHER|284|||||No|No||WYETH/PFIZER|No||||
desvenlafaxine succinate|No|No|No|No|75%|00008122230|PRISTIQ ER 100 MG TABLET|30|EA|6.27757|06/02/2008||Yes|No||06/02/2008||Yes|No|06/02/2008||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|031|No|13.97675|01/11/2022|13.6413|01/11/2022|13.73215|01/11/2022|||ANTIDEPRESSANTS: OTHER|285|||||No|No||WYETH/PFIZER|No||||
tigecycline|No|No|No|No|75%|00008499020|TYGACIL 50 MG VIAL|1|EA|68.30894|06/20/2017||Yes|No||06/20/2017||Yes|No|06/20/2017||Yes|No||||No|No|||Prescription required|No|||No|155.68084|01/04/2022|153.45682|01/04/2022|146.14936|01/04/2022||||286|||||No|No||WYETH/PFIZER|No||||
hydrocortisone sodium succ/PF|No|No|No|No|75%|00009001103|SOLU-CORTEF 100 MG ACT-O-VIAL|1|EA|7.955|09/13/2011||Yes|No||09/13/2011||Yes|No|09/13/2011||Yes|No||||No|No|||Prescription required|No|||No|17.70216|01/11/2022|17.2773|01/11/2022|17.39237|01/11/2022||||287|||||No|No||PFIZER US PHARM|No||||
hydrocortisone sodium succ/PF|No|No|No|No|75%|00009001104|SOLU-CORTEF 100 MG ACT-O-VIAL|1|EA|7.95947|09/13/2011||Yes|No||09/13/2011||Yes|No|09/13/2011||Yes|No||||No|No|||Prescription required|No|||No|18.14019|01/04/2022|17.88104|01/04/2022|17.02956|01/04/2022||||288|||||No|No||PFIZER US PHARM|No||||
hydrocortisone|No|No|No|No|75%|00009001201|CORTEF 5 MG TABLET|50|EA|.43223|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|168|Yes|.98509|01/04/2022|.97102|01/04/2022|.92478|01/04/2022|||GLUCOCORTICOIDS: ORAL|289|||||No|No||PHARMACI/PFIZER|No||||
hydrocortisone sodium succ/PF|No|No|No|No|75%|00009001305|SOLU-CORTEF 250 MG ACT-O-VIAL|1|EA|14.7232|09/13/2011||Yes|No||09/13/2011||Yes|No|09/13/2011||Yes|No||||No|No|||Prescription required|No|||No|33.5552|01/04/2022|33.07584|01/04/2022|31.5008|01/04/2022||||290|||||No|No||PFIZER US PHARM|No||||
hydrocortisone sodium succ/PF|No|No|No|No|75%|00009001306|SOLU-CORTEF 250 MG ACT-O-VIAL|1|EA|14.72251|09/13/2011||Yes|No||09/13/2011||Yes|No|09/13/2011||Yes|No||||No|No|||Prescription required|No|||No|33.55363|01/04/2022|33.07429|01/04/2022|31.49932|01/04/2022||||291|||||No|No||PFIZER US PHARM|No||||
methylprednisolone|No|No|No|No|75%|00009002201|MEDROL 8 MG TABLET|25|EA|.76815|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|168|Yes|1.75067|01/04/2022|1.72566|01/04/2022|1.64348|01/04/2022|||GLUCOCORTICOIDS: ORAL|292|||||No|No||PHARMACI/PFIZER|No||||
alprazolam|No|No|No|No|90%|00009002901|XANAX 0.25 MG TABLET|100|EA|2.08507|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|4.75202|03/22/2022|4.68413|03/22/2022|4.46108|03/22/2022|||ANXIOLYTICS|293|||||No|No||PFIZER/VIATRIS|No||||
alprazolam|No|No|No|No|90%|00009002902|XANAX 0.25 MG TABLET|500|EA|2.08506|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|4.752|03/22/2022|4.68411|03/22/2022|4.46106|03/22/2022|||ANXIOLYTICS|294|||||No|No||PFIZER/VIATRIS|No||||
hydrocortisone|No|No|No|No|75%|00009003101|CORTEF 10 MG TABLET|100|EA|.73001|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|168|Yes|1.66374|01/04/2022|1.63997|01/04/2022|1.56188|01/04/2022|||GLUCOCORTICOIDS: ORAL|295|||||No|No||PHARMACI/PFIZER|No||||
hydrocortisone|No|No|No|No|75%|00009004401|CORTEF 20 MG TABLET|100|EA|1.38382|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|168|Yes|3.15383|01/04/2022|3.10878|01/04/2022|2.96074|01/04/2022|||GLUCOCORTICOIDS: ORAL|296|||||No|No||PHARMACI/PFIZER|No||||
medroxyprogesterone acetate|No|No|No|No|75%|00009005011|PROVERA 10 MG TABLET|500|EA|2.12276|03/01/2002|12/14/2022|Yes|No||03/01/2002|12/14/2022|Yes|No|03/01/2002|12/14/2022|Yes|No||||No|No|||Prescription required|No|||No|4.83792|01/12/2021|4.76881|01/12/2021|4.54172|01/12/2021||||297|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||PHARMACI/PFIZER|No||||
alprazolam|No|No|No|No|90%|00009005501|XANAX 0.5 MG TABLET|100|EA|2.59763|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|5.83153|03/29/2022|5.69157|03/29/2022|5.72947|03/29/2022|||ANXIOLYTICS|298|||||No|No||PFIZER/VIATRIS|No||||
alprazolam|No|No|No|No|90%|00009005503|XANAX 0.5 MG TABLET|500|EA|2.59766|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|5.83153|03/29/2022|5.69157|03/29/2022|5.72947|03/29/2022|||ANXIOLYTICS|299|||||No|No||PFIZER/VIATRIS|No||||
methylprednisolone|No|No|No|No|75%|00009005602|MEDROL 4 MG TABLET|100|EA|.13097|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|168|Yes|.2985|01/04/2022|.29424|01/04/2022|.28023|01/04/2022|||GLUCOCORTICOIDS: ORAL|300|||||No|No||PHARMACI/PFIZER|No||||
methylprednisolone|No|No|No|No|75%|00009005604|MEDROL 4 MG DOSEPAK|21|EA|.13084|07/06/2006||Yes|No||07/06/2006||Yes|No|07/06/2006||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|168|Yes|.29237|01/11/2022|.28535|01/11/2022|.28725|01/11/2022|||GLUCOCORTICOIDS: ORAL|301|||||No|No||PHARMACI/PFIZER|No||||
alprazolam|No|No|No|No|90%|00009005707|XANAX XR 0.5 MG TABLET|60|EA|4.01827|10/23/2006||Yes|No||10/23/2006||Yes|No|10/23/2006||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|9.15793|03/22/2022|9.0271|03/22/2022|8.59724|03/22/2022|||ANXIOLYTICS|302|||||No|No||PFIZER/VIATRIS|No||||
alprazolam|No|No|No|No|90%|00009005907|XANAX XR 1 MG TABLET|60|EA|5.00004|10/23/2006||Yes|No||10/23/2006||Yes|No|10/23/2006||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|11.39544|03/22/2022|11.23264|03/22/2022|10.69776|03/22/2022|||ANXIOLYTICS|303|||||No|No||PFIZER/VIATRIS|No||||
alprazolam|No|No|No|No|90%|00009006607|XANAX XR 2 MG TABLET|60|EA|6.63633|05/10/2004||Yes|No||05/10/2004||Yes|No|05/10/2004||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|15.12466|03/22/2022|14.90859|03/22/2022|14.19866|03/22/2022|||ANXIOLYTICS|304|||||No|No||PFIZER/VIATRIS|No||||
alprazolam|No|No|No|No|90%|00009006807|XANAX XR 3 MG TABLET|60|EA|9.95364|10/23/2006||Yes|No||10/23/2006||Yes|No|10/23/2006||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|22.68504|03/22/2022|22.36096|03/22/2022|21.29616|03/22/2022|||ANXIOLYTICS|305|||||No|No||PFIZER/VIATRIS|No||||
methylprednisolone|No|No|No|No|75%|00009007301|MEDROL 16 MG TABLET|50|EA|1.23625|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|168|Yes|2.8175|01/04/2022|2.77725|01/04/2022|2.645|01/04/2022|||GLUCOCORTICOIDS: ORAL|306|||||No|No||PHARMACI/PFIZER|No||||
alprazolam|No|No|No|No|90%|00009009001|XANAX 1 MG TABLET|100|EA|3.46614|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|7.89958|03/22/2022|7.78673|03/22/2022|7.41593|03/22/2022|||ANXIOLYTICS|307|||||No|No||PFIZER/VIATRIS|No||||
alprazolam|No|No|No|No|90%|00009009004|XANAX 1 MG TABLET|500|EA|3.46613|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|7.89956|03/22/2022|7.78671|03/22/2022|7.41591|03/22/2022|||ANXIOLYTICS|308|||||No|No||PFIZER/VIATRIS|No||||
alprazolam|No|No|No|No|90%|00009009401|XANAX 2 MG TABLET|100|EA|5.89336|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|13.11617|03/29/2022|12.80138|03/29/2022|12.88663|03/29/2022|||ANXIOLYTICS|309|||||No|No||PFIZER/VIATRIS|No||||
methylprednisolone|No|No|No|No|75%|00009017601|MEDROL 32 MG TABLET|25|EA|4.31307|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|168|Yes|9.82979|01/04/2022|9.68936|01/04/2022|9.22796|01/04/2022|||GLUCOCORTICOIDS: ORAL|310|||||No|No||PHARMACI/PFIZER|No||||
clindamycin HCl|No|No|No|No|75%|00009022502|CLEOCIN HCL 150 MG CAPSULE|100|EA|.0626|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|146|No|.14268|01/04/2022|.14064|01/04/2022|.13395|01/04/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|311|||||No|No||PHARMACI/PFIZER|No||||
colestipol HCl|No|No|No|No|75%|00009026001|COLESTID GRANULES PACKET|30|EA|3.0186|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|055|No|6.8796|01/04/2022|6.78132|01/04/2022|6.4584|01/04/2022|||LIPOTROPICS: OTHER|312|||||No|No||PHARMACI/PFIZER|No||||
colestipol HCl|No|No|No|No|75%|00009026002|COLESTID GRANULES|500|GM|.35942|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|055|No|.81916|01/04/2022|.80746|01/04/2022|.769|01/04/2022|||LIPOTROPICS: OTHER|313|||||No|No||PHARMACI/PFIZER|No||||
estradiol cypionate|No|No|No|No|75%|00009027101|DEPO-ESTRADIOL 5 MG/ML VIAL|5|ML|10.9521|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|24.43127|01/11/2022|23.84491|01/11/2022|24.00372|01/11/2022||||314|||||No|No||PHARMACI/PFIZER|No||||
methylprednisolone acetate|No|No|No|No|75%|00009027401|DEPO-MEDROL 20 MG/ML VIAL|5|ML|2.85778|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|6.51308|01/05/2021|6.42003|01/05/2021|6.11432|01/05/2021||||315|||||No|No||PHARMACI/PFIZER|No||||
methylprednisolone acetate|No|No|No|No|75%|00009028002|DEPO-MEDROL 40 MG/ML VIAL|5|ML|3.96202|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|9.02972|01/05/2021|8.90072|01/05/2021|8.47688|01/05/2021||||316|||||No|No||PHARMACI/PFIZER|No||||
methylprednisolone acetate|No|No|No|No|75%|00009028003|DEPO-MEDROL 40 MG/ML VIAL|10|ML|3.96589|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|9.03854|01/05/2021|8.90941|01/05/2021|8.48516|01/05/2021||||317|||||No|No||PHARMACI/PFIZER|No||||
methylprednisolone acetate|No|No|No|No|75%|00009030602|DEPO-MEDROL 80 MG/ML VIAL|5|ML|7.93178|11/27/2002||Yes|No||11/27/2002||Yes|No|||No|No||||No|No|||Prescription required|No|||No|18.07708|01/05/2021|17.81883|01/05/2021|16.97032|01/05/2021||||318|||||No|No||PHARMACI/PFIZER|No||||
clindamycin HCl|No|No|No|No|75%|00009033102|CLEOCIN HCL 75 MG CAPSULE|100|EA|.09601|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|146|No|.21883|01/04/2022|.2157|01/04/2022|.20543|01/04/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|319|||||No|No||PHARMACI/PFIZER|No||||
glyburide,micronized|No|No|No|No|75%|00009034101|GLYNASE 1.5 MG PRESTAB|100|EA|.80362|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|1.83152|01/04/2022|1.80535|01/04/2022|1.71938|01/04/2022||||320|||||No|No||PHARMACI/PFIZER|No||||
testosterone cypionate|No|No|No|No|90%|00009034702|DEPO-TESTOSTERONE 100 MG/ML VL|10|ML|3.31788|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|7.56168|01/25/2022|7.45365|01/25/2022|7.09872|01/25/2022||||321|||||No|No||PHARMACI/PFIZER|No||||
glyburide,micronized|No|No|No|No|75%|00009035201|GLYNASE 3 MG PRESTAB|100|EA|1.35897|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|3.09719|01/04/2022|3.05294|01/04/2022|2.90756|01/04/2022||||322|||||No|No||PHARMACI/PFIZER|No||||
colestipol HCl|No|No|No|No|75%|00009037003|COLESTID FLAVORED GRANULES|60|EA|3.31128|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|055|No|7.54664|01/04/2022|7.43883|01/04/2022|7.0846|01/04/2022|||LIPOTROPICS: OTHER|323|||||No|No||PHARMACI/PFIZER|No||||
colestipol HCl|No|No|No|No|75%|00009037005|COLESTID FLAVORED GRANULES|450|GM|.30897|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|055|No|.70417|01/04/2022|.69411|01/04/2022|.66106|01/04/2022|||LIPOTROPICS: OTHER|324|||||No|No||PHARMACI/PFIZER|No||||
clindamycin HCl|No|No|No|No|75%|00009039514|CLEOCIN HCL 300 MG CAPSULE|100|EA|.1222|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|146|No|.27851|01/04/2022|.27453|01/04/2022|.26146|01/04/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|325|||||No|No||PHARMACI/PFIZER|No||||
testosterone cypionate|No|No|No|No|90%|00009041702|DEPO-TESTOSTERONE 200 MG/ML|10|ML|5.24385|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|6.9624|03/29/2022|6.7953|03/29/2022|6.84055|03/29/2022||||326|||||No|No||PHARMACI/PFIZER|No||||
colestipol HCl|No|No|No|No|75%|00009045003|COLESTID 1 GM TABLET|120|EA|.94718|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|055|No|2.10409|01/11/2022|2.05359|01/11/2022|2.06726|01/11/2022|||LIPOTROPICS: OTHER|327|||||No|No||PHARMACI/PFIZER|No||||
lincomycin HCl|No|No|No|No|75%|00009055502|LINCOCIN 300 MG/ML VIAL|10|ML|7.23518|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|146|No|16.48948|01/04/2022|16.25391|01/04/2022|15.47992|01/04/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|328|||||No|No||PHARMACI/PFIZER|No||||
methylprednisolone sod succ|No|No|No|No|75%|00009069801|SOLU-MEDROL 1 GRAM VIAL|1|EA|18.9114|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|43.1004|01/05/2021|42.48468|01/05/2021|40.4616|01/05/2021||||329|||||No|No||PHARMACI/PFIZER|No||||
clindamycin phosphate|No|No|No|No|75%|00009072809|CLEOCIN PHOS 9 G/60 ML VIAL|60|ML|.16723|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|146|No|.38115|01/04/2022|.3757|01/04/2022|.35781|01/04/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|330|||||No|No||PHARMACI/PFIZER|No||||
methylprednisolone sod succ|No|No|No|No|75%|00009075801|SOLU-MEDROL 500 MG VIAL|1|EA|10.4404|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|23.7944|01/05/2021|23.45448|01/05/2021|22.3376|01/05/2021||||331|||||No|No||PHARMACI/PFIZER|No||||
clindamycin palmitate HCl|No|No|No|No|75%|00009076004|CLEOCIN PEDIATRIC 75 MG/5 ML|100|ML|.13312|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|146|No|.3034|01/04/2022|.29907|01/04/2022|.28483|01/04/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|332|||||No|No||PHARMACI/PFIZER|No||||
clindamycin phosphate|No|No|No|No|75%|00009077526|CLEOCIN PHOS 600 MG/4 ML VIAL|4|ML|.31643|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|146|No|.72118|01/04/2022|.71087|01/04/2022|.67702|01/04/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|333|||||No|No||PHARMACI/PFIZER|No||||
hydrocortisone sod succinate|No|No|No|No|75%|00009082501|SOLU-CORTEF 100 MG VIAL|1|EA|5.8867|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|13.12432|01/11/2022|12.80933|01/11/2022|12.89464|01/11/2022||||334|||||No|No||PHARMACI/PFIZER|No||||
clindamycin phosphate|No|No|No|No|75%|00009087026|CLEOCIN PHOS 150 MG/ML VIAL|2|ML|.53474|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|146|No|1.21872|01/04/2022|1.20131|01/04/2022|1.14411|01/04/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|335|||||No|No||PHARMACI/PFIZER|No||||
clindamycin phosphate|No|No|No|No|75%|00009090218|CLEOCIN PHOS 150 MG/ML VIAL|6|ML|.30555|11/27/2002||Yes|No||11/27/2002||Yes|No|||No|No||||No|No|||Prescription required|Yes|07/17/2014|146|No|.69638|01/04/2022|.68643|01/04/2022|.65375|01/04/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|336|||||No|No||PHARMACI/PFIZER|No||||
methylprednisolone acetate|No|No|No|No|75%|00009307301|DEPO-MEDROL 40 MG/ML VIAL|1|ML|4.5666|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|10.4076|01/05/2021|10.25892|01/05/2021|9.7704|01/05/2021||||337|||||No|No||PHARMACI/PFIZER|No||||
methylprednisolone acetate|No|No|No|No|75%|00009307322|DEPO-MEDROL 40 MG/ML VIAL|1|ML|4.5666|10/26/2009||Yes|No||10/26/2009||Yes|No|10/26/2009||Yes|No||||No|No|||Prescription required|No|||No|10.4076|01/05/2021|10.25892|01/05/2021|9.7704|01/05/2021||||338|||||No|No||PFIZER/NOVAPLUS|No||||
methylprednisolone acetate|No|No|No|No|75%|00009307323|DEPO-MEDROL 40 MG/ML VIAL|1|ML|4.56866|10/26/2009||Yes|No||10/26/2009||Yes|No|10/26/2009||Yes|No||||No|No|||Prescription required|No|||No|10.4123|01/05/2021|10.26355|01/05/2021|9.77481|01/05/2021||||339|||||No|No||PFIZER/NOVAPLUS|No||||
clindamycin phosphate|No|No|No|No|75%|00009332901|CLEOCIN T 1% LOTION|60|ML|.83936|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|04/05/2008|104|No|.46517|03/29/2022|.454|03/29/2022|.45702|03/29/2022|||ACNE AGENTS: TOPICAL|340|||||No|No||PHARMACI/PFIZER|No||||
clindamycin phosphate|Yes|No|No|No|75%|00009344801|CLEOCIN 2% VAGINAL CREAM|40|GM|2.16171|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|11/01/2012||Prescription required|Yes|02/10/2009|124|No|4.9267|01/04/2022|4.85632|01/04/2022|4.62507|01/04/2022|||ANTIBIOTICS: VAGINAL|341|||||No|No||PHARMACI/PFIZER|No||||
glyburide,micronized|No|No|No|No|75%|00009344901|GLYNASE 6 MG PRESTAB|100|EA|2.14281|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|4.88363|01/04/2022|4.81386|01/04/2022|4.58463|01/04/2022||||342|||||No|No||PHARMACI/PFIZER|No||||
methylprednisolone acetate|No|No|No|No|75%|00009347522|DEPO-MEDROL 80 MG/ML VIAL|1|ML|7.9249|10/26/2009||Yes|No||10/26/2009||Yes|No|10/26/2009||Yes|No||||No|No|||Prescription required|No|||No|17.11833|01/25/2022|16.70749|01/25/2022|16.81875|01/25/2022||||343|||||No|No||PFIZER/NOVAPLUS|No||||
methylprednisolone acetate|No|No|No|No|75%|00009347523|DEPO-MEDROL 80 MG/ML VIAL|1|ML|7.92644|10/26/2009||Yes|No||10/26/2009||Yes|No|10/26/2009||Yes|No||||No|No|||Prescription required|No|||No|18.06492|01/05/2021|17.80685|01/05/2021|16.95891|01/05/2021||||344|||||No|No||PFIZER/NOVAPLUS|No||||
tolterodine tartrate|No|No|No|No|75%|00009454102|DETROL 1 MG TABLET|60|EA|3.22887|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|006|No|7.35882|01/12/2021|7.25369|01/12/2021|6.90828|01/12/2021|||BLADDER RELAXANT PREPARATIONS|345|||||No|No||PFIZER/VIATRIS|No||||
tolterodine tartrate|No|No|No|No|75%|00009454402|DETROL 2 MG TABLET|60|EA|3.31422|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|006|No|7.55335|01/12/2021|7.44544|01/12/2021|7.0909|01/12/2021|||BLADDER RELAXANT PREPARATIONS|346|||||No|No||PFIZER/VIATRIS|No||||
linezolid|No|No|No|No|75%|00009513601|ZYVOX 100 MG/5 ML SUSPENSION|150|ML|1.95478|06/02/2009||Yes|No||06/02/2009||Yes|No|06/02/2009||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|146|No|4.45508|01/04/2022|4.39143|01/04/2022|4.18232|01/04/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|347|||||No|No||PHARMACI/PFIZER|No||||
linezolid|No|No|No|No|75%|00009513802|ZYVOX 600 MG TABLET|20|EA|116.53516|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|Yes|12/23/2016|146|No|265.59176|01/04/2022|261.79759|01/04/2022|249.33104|01/04/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|348|||||No|No||PHARMACI/PFIZER|No||||
linezolid|No|No|No|No|75%|00009513803|ZYVOX 600 MG TABLET|30|EA|2.70197|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|Yes|12/23/2016|146|No|6.15798|01/04/2022|6.07001|01/04/2022|5.78096|01/04/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|349|||||No|No||PHARMACI/PFIZER|No||||
linezolid in dextrose 5%|No|No|No|No|75%|00009514004|ZYVOX 600 MG/300 ML-D5W|300|ML|.06891|06/28/2017||Yes|No||06/28/2017||Yes|No|06/28/2017||Yes|No||||No|No|||Prescription required|Yes|12/23/2016|146|No|.15706|01/04/2022|.15482|01/04/2022|.14744|01/04/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|350|||||No|No||PHARMACI/PFIZER|No||||
tolterodine tartrate|No|No|No|No|75%|00009519001|DETROL LA 2 MG CAPSULE|30|EA|5.25789|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|006|Yes|11.9831|01/12/2021|11.81191|01/12/2021|11.24944|01/12/2021|||BLADDER RELAXANT PREPARATIONS|351|||||No|No||PFIZER/VIATRIS|No||||
tolterodine tartrate|No|No|No|No|75%|00009519002|DETROL LA 2 MG CAPSULE|90|EA|5.2577|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|006|Yes|11.98267|01/12/2021|11.81149|01/12/2021|11.24904|01/12/2021|||BLADDER RELAXANT PREPARATIONS|352|||||No|No||PFIZER/VIATRIS|No||||
tolterodine tartrate|No|No|No|No|75%|00009519003|DETROL LA 2 MG CAPSULE|500|EA|5.25764|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|006|Yes|11.98253|01/12/2021|11.81135|01/12/2021|11.24891|01/12/2021|||BLADDER RELAXANT PREPARATIONS|353|||||No|No||PFIZER/VIATRIS|No||||
tolterodine tartrate|No|No|No|No|75%|00009519101|DETROL LA 4 MG CAPSULE|30|EA|5.25789|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|006|No|11.9831|01/25/2022|11.81191|01/25/2022|11.24944|01/25/2022|||BLADDER RELAXANT PREPARATIONS|354|||||No|No||PFIZER/VIATRIS|No||||
tolterodine tartrate|No|No|No|No|75%|00009519102|DETROL LA 4 MG CAPSULE|90|EA|5.2577|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|006|No|11.98267|01/25/2022|11.81149|01/25/2022|11.24904|01/25/2022|||BLADDER RELAXANT PREPARATIONS|355|||||No|No||PFIZER/VIATRIS|No||||
tolterodine tartrate|No|No|No|No|75%|00009519103|DETROL LA 4 MG CAPSULE|500|EA|5.25764|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|006|No|11.98253|01/25/2022|11.81135|01/25/2022|11.24891|01/25/2022|||BLADDER RELAXANT PREPARATIONS|356|||||No|No||PFIZER/VIATRIS|No||||
nicotine|No|No|No|No|75%|00009540001|NICOTROL CARTRIDGE INHALER|168|EA|1.23425|07/07/2016||Yes|No||||No|No|07/07/2016||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|040|No|2.76785|01/11/2022|2.70142|01/11/2022|2.71941|01/11/2022|||SMOKING CESSATION|357|||||No|No||PHARMACI/PFIZER|No||||
nicotine|No|No|No|No|75%|00009540101|NICOTROL NS 10 MG/ML SPRAY|10|ML|5.44304|07/07/2016||Yes|No||||No|No|07/07/2016||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|040|No|12.01725|01/11/2022|11.72883|01/11/2022|11.80694|01/11/2022|||SMOKING CESSATION|358|||||No|No||PHARMACI/PFIZER|No||||
pegvisomant|No|No|No|No|75%|00009716801|SOMAVERT 15 MG VIAL|1|EA|153.9615|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|No|||No|350.889|01/04/2022|345.8763|01/04/2022|329.406|01/04/2022||||359|||||No|No||PHARMACI/PFIZER|No||||
pegvisomant|No|No|No|No|75%|00009718801|SOMAVERT 20 MG VIAL|1|EA|205.2691|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|No|||No|467.8226|01/04/2022|461.13942|01/04/2022|439.1804|01/04/2022||||360|||||No|No||PHARMACI/PFIZER|No||||
pegvisomant|No|No|No|No|75%|00009719901|SOMAVERT 25 MG VIAL|1|EA|256.5853|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|No|||No|584.7758|01/04/2022|576.42186|01/04/2022|548.9732|01/04/2022||||361|||||No|No||PHARMACI/PFIZER|No||||
pegvisomant|No|No|No|No|75%|00009720001|SOMAVERT 30 MG VIAL|1|EA|307.9015|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|No|||No|701.729|01/04/2022|691.7043|01/04/2022|658.766|01/04/2022||||362|||||No|No||PHARMACI/PFIZER|No||||
medroxyprogesterone acetate|Yes|Yes|No|No|75%|00009737611|DEPO-PROVERA 150 MG/ML SYRINGE|1|ML|23.6285|02/25/2013||Yes|No||||No|No|01/01/2013||Yes|No|Refer to program requirements|||No|No|02/25/2013||Prescription required|No|||No|53.851|02/02/2021|53.0817|02/02/2021|50.554|02/02/2021||||363|||||No|No||PFIZER US PHARM|No||||
exemestane|No|No|No|No|75%|00009766304|AROMASIN 25 MG TABLET|30|EA|16.50024|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||502|No|37.6052|01/04/2022|37.06798|01/04/2022|35.30284|01/04/2022|||ONCOLOGY: ORAL - BREAST|364|||||No|No||PHARMACI/PFIZER|No||||
clindamycin phosphate|No|No|No|No|75%|00009766701|CLEOCIN 100 MG VAGINAL OVULE|3|EA|26.3375|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||124|No|58.57162|01/11/2022|57.1659|01/11/2022|57.54661|01/11/2022|||ANTIBIOTICS: VAGINAL|365|||||No|No||PHARMACI/PFIZER|No||||
sulfasalazine|No|No|No|No|75%|00013010120|AZULFIDINE 500 MG TABLET|300|EA|.63807|03/01/2002|01/26/2022|Yes|No||03/01/2002|01/26/2022|Yes|No|03/01/2002|01/26/2022|Yes|No||||No|No|||Prescription required|Yes|04/28/2004|010|No|1.45422|02/02/2021|1.43344|02/02/2021|1.36518|02/02/2021|||ULCERATIVE COLITIS AGENTS|366|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||PHARMACI/PFIZER|No||||
sulfasalazine|No|No|No|No|75%|00013010220|AZULFIDINE ENTAB 500 MG|300|EA|.85213|03/01/2002|05/06/2022|Yes|No||03/01/2002|05/06/2022|Yes|No|03/01/2002|05/06/2022|Yes|No||||No|No|||Prescription required|Yes|04/28/2004|010|No|1.94206|01/12/2021|1.91432|01/12/2021|1.82316|01/12/2021|||ULCERATIVE COLITIS AGENTS|367|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||PHARMACI/PFIZER|No||||
estramustine phosphate sodium|No|No|No|No|75%|00013013202|EMCYT 140 MG CAPSULE|100|EA|7.20585|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||550|No|16.42264|01/04/2022|16.18803|01/04/2022|15.41717|01/04/2022|||ONCOLOGY: ORAL - PROSTATE|368|||||No|No||PHARMACI/PFIZER|No||||
estradiol|No|No|No|No|75%|00013215036|ESTRING 2 MG VAGINAL RING|1|EA|216.9436|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|483.53755|01/11/2022|471.93264|01/11/2022|475.07564|01/11/2022||||369|||||No|No||PHARMACI/PFIZER|No||||
somatropin|No|No|No|No|75%|00013262681|GENOTROPIN 5 MG CARTRIDGE|1|EA|299.4348|12/21/2009||Yes|No||12/21/2009||Yes|No|12/21/2009||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|No||014|Yes|678.527|01/11/2022|662.24235|01/11/2022|666.65277|01/11/2022|||GROWTH HORMONE|370|||||No|No||PHARMACI/PFIZER|No||||
somatropin|No|No|No|No|75%|00013264681|GENOTROPIN 12 MG CARTRIDGE|1|EA|718.6547|12/21/2009||Yes|No||12/21/2009||Yes|No|12/21/2009||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|No||014|Yes|1637.8642|01/04/2022|1614.46614|01/04/2022|1537.5868|01/04/2022|||GROWTH HORMONE|371|||||No|No||PHARMACI/PFIZER|No||||
somatropin|No|No|No|No|75%|00013264902|GENOTROPIN MINIQUICK 0.2 MG|7|EA|13.05357|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|No||014|Yes|29.74999|01/04/2022|29.32499|01/04/2022|27.92856|01/04/2022|||GROWTH HORMONE|372|||||No|No||PHARMACI/PFIZER|No||||
somatropin|No|No|No|No|75%|00013265002|GENOTROPIN MINIQUICK 0.4 MG|7|EA|26.11082|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|No||014|Yes|59.50839|01/04/2022|58.65827|01/04/2022|55.86502|01/04/2022|||GROWTH HORMONE|373|||||No|No||PHARMACI/PFIZER|No||||
somatropin|No|No|No|No|75%|00013265102|GENOTROPIN MINIQUICK 0.6 MG|7|EA|39.1644|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|No||014|Yes|89.2584|01/04/2022|87.98328|01/04/2022|83.7936|01/04/2022|||GROWTH HORMONE|374|||||No|No||PHARMACI/PFIZER|No||||
somatropin|No|No|No|No|75%|00013265202|GENOTROPIN MINIQUICK 0.8 MG|7|EA|52.21981|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|No||014|Yes|119.01259|01/04/2022|117.31241|01/04/2022|111.7261|01/04/2022|||GROWTH HORMONE|375|||||No|No||PHARMACI/PFIZER|No||||
somatropin|No|No|No|No|75%|00013265302|GENOTROPIN MINIQUICK 1 MG|7|EA|65.27645|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|No||014|Yes|148.76959|01/04/2022|146.64431|01/04/2022|139.66125|01/04/2022|||GROWTH HORMONE|376|||||No|No||PHARMACI/PFIZER|No||||
somatropin|No|No|No|No|75%|00013265402|GENOTROPIN MINIQUICK 1.2 MG|7|EA|78.33125|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|No||014|Yes|178.52239|01/04/2022|175.97207|01/04/2022|167.59245|01/04/2022|||GROWTH HORMONE|377|||||No|No||PHARMACI/PFIZER|No||||
somatropin|No|No|No|No|75%|00013265502|GENOTROPIN MINIQUICK 1.4 MG|7|EA|91.38421|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|No||014|Yes|208.27099|01/04/2022|205.29569|01/04/2022|195.5197|01/04/2022|||GROWTH HORMONE|378|||||No|No||PHARMACI/PFIZER|No||||
somatropin|No|No|No|No|75%|00013265602|GENOTROPIN MINIQUICK 1.6 MG|7|EA|104.43778|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|No||014|Yes|238.02099|01/04/2022|234.62069|01/04/2022|223.44828|01/04/2022|||GROWTH HORMONE|379|||||No|No||PHARMACI/PFIZER|No||||
somatropin|No|No|No|No|75%|00013265702|GENOTROPIN MINIQUICK 1.8 MG|7|EA|117.49627|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|No||014|Yes|267.78219|01/04/2022|263.95673|01/04/2022|251.38736|01/04/2022|||GROWTH HORMONE|380|||||No|No||PHARMACI/PFIZER|No||||
somatropin|No|No|No|No|75%|00013265802|GENOTROPIN MINIQUICK 2 MG|7|EA|130.54922|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|No||014|Yes|297.53079|01/04/2022|293.28035|01/04/2022|279.31462|01/04/2022|||GROWTH HORMONE|381|||||No|No||PHARMACI/PFIZER|No||||
rifabutin|No|No|No|No|75%|00013530117|MYCOBUTIN 150 MG CAPSULE|100|EA|11.67264|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|19.06531|01/04/2022|18.79295|01/04/2022|17.89804|01/04/2022||||382|||||No|No||PHARMACI/PFIZER|No||||
latanoprost|No|No|No|No|75%|00013830304|XALATAN 0.005% EYE DROPS|2.5|ML|40.45956|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|088|No|90.25876|03/29/2022|88.09254|03/29/2022|88.67923|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|383|||||No|No||PFIZER/VIATRIS|No||||
gentamicin sulf/prednisolone|No|No|No|No|75%|00023010605|PRED-G 1% EYE DROPS|5|ML|13.7944|03/01/2002|11/30/2022|Yes|No||03/01/2002|11/30/2022|Yes|No|03/01/2002|11/30/2022|Yes|No||||No|No|||Prescription required|Yes|07/28/2004|036|No|31.4384|01/12/2021|30.98928|01/12/2021|29.5136|01/12/2021|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|384|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ALLERGAN INC.|No||||
mineral oil/petrolatum,white|No|No|No|No|75%|00023031204|REFRESH LACRI-LUBE OINTMENT|3.5|GM|1.20031|09/01/2012||Yes|No||||No|No|09/01/2012||Yes|No||||No|No|||Over the counter|No|||No|2.73559|12/04/2018|2.69651|12/04/2018|2.5681|12/04/2018||||385|||||No|No||ALLERGAN INC.|No||||
mineral oil/petrolatum,white|No|No|No|No|75%|00023031207|REFRESH LACRI-LUBE OINTMENT|7|GM|1.03875|11/27/2002||Yes|No||||No|No|||No|No||||No|No|||Over the counter|No|||No|2.36739|12/25/2018|2.33357|12/25/2018|2.22245|12/25/2018||||386|||||No|No||ALLERGAN INC.|No||||
sulfacetamide/prednisolone|No|No|No|No|75%|00023031304|BLEPHAMIDE EYE OINTMENT|3.5|GM|18.76765|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|036|No|42.77279|01/12/2021|42.16175|01/12/2021|40.15405|01/12/2021|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|387|||||No|No||ALLERGAN INC.|No||||
fluorometholone|No|No|No|No|75%|00023031604|FML S.O.P. 0.1% OINTMENT|3.5|GM|19.70628|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|013|No|44.91199|01/12/2021|44.27039|01/12/2021|42.16228|01/12/2021|||OPHTHALMICS: ANTI-INFLAMMATORIES|388|||||No|No||ALLERGAN INC.|No||||
carboxymethylcellulose sodium|No|No|No|No|75%|00023040350|REFRESH PLUS 0.5% EYE DROPS|50|EA|.11008|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No|||No|.25088|06/29/2021|.24729|06/29/2021|.23552|06/29/2021||||389|||||No|No||ALLERGAN INC.|No||||
ketorolac tromethamine|No|No|No|No|75%|00023218105|ACULAR 0.5% EYE DROPS|5|ML|23.68698|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|10/23/2010|013|No|53.98428|01/12/2021|53.21307|01/12/2021|50.67912|01/12/2021|||OPHTHALMICS: ANTI-INFLAMMATORIES|390|||||No|No||ALLERGAN INC.|No||||
bimatoprost|No|No|No|No|75%|00023320503|LUMIGAN 0.01% EYE DROPS|2.5|ML|39.21944|10/11/2010||Yes|No||10/11/2010||Yes|No|10/11/2010||Yes|No||||No|No|||Prescription required|Yes|07/22/2009|088|No|87.52762|02/08/2022|85.42695|02/08/2022|85.99588|02/08/2022|||OPHTHALMICS: GLAUCOMA AGENTS|391|||||No|No||ALLERGAN INC.|No||||
bimatoprost|No|No|No|No|75%|00023320505|LUMIGAN 0.01% EYE DROPS|5|ML|39.2031|10/11/2010||Yes|No||10/11/2010||Yes|No|10/11/2010||Yes|No||||No|No|||Prescription required|Yes|07/22/2009|088|No|87.49978|02/08/2022|85.39978|02/08/2022|85.96853|02/08/2022|||OPHTHALMICS: GLAUCOMA AGENTS|392|||||No|No||ALLERGAN INC.|No||||
bimatoprost|No|No|No|No|75%|00023320508|LUMIGAN 0.01% EYE DROPS|7.5|ML|39.20109|10/11/2010||Yes|No||10/11/2010||Yes|No|10/11/2010||Yes|No||||No|No|||Prescription required|Yes|07/22/2009|088|No|87.38985|02/08/2022|85.29249|02/08/2022|85.86052|02/08/2022|||OPHTHALMICS: GLAUCOMA AGENTS|393|||||No|No||ALLERGAN INC.|No||||
ketorolac tromethamine/PF|No|No|No|No|75%|00023350730|ACUVAIL 0.45% OPHTH SOLUTION|30|EA|4.79063|08/26/2009|04/30/2022|Yes|No||08/26/2009|04/30/2022|Yes|No|08/26/2009|04/30/2022|Yes|No||||No|No|||Prescription required|Yes|07/28/2010|013|Yes|10.91818|01/12/2021|10.7622|01/12/2021|10.24972|01/12/2021|||OPHTHALMICS: ANTI-INFLAMMATORIES|394|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ALLERGAN INC.|No||||
ketorolac tromethamine/PF|No|No|No|No|75%|00023350731|ACUVAIL 0.45% OPHTH SOLUTION|30|EA|4.79063|12/21/2021||Yes|No||12/21/2021||Yes|No|12/21/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|013|Yes|10.91818|12/21/2021|10.7622|12/21/2021|10.24972|12/21/2021|||OPHTHALMICS: ANTI-INFLAMMATORIES|395|||||No|No||ALLERGAN INC.|No||||
alcaftadine|No|No|No|No|75%|00023429003|LASTACAFT 0.25% EYE DROPS|3|ML|33.92126|06/22/2011|02/22/2022|Yes|No||06/22/2011|02/22/2022|Yes|No|06/22/2011|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|07/27/2011|002|No|77.30892|03/29/2022|76.20451|03/29/2022|72.57572|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|396|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ALLERGAN INC.|No||||
carboxymethylcellulose sodium|No|No|No|No|75%|00023455430|REFRESH CELLUVISC 1% EYE GEL|30|EA|.13874|11/27/2002||Yes|No||||No|No|||No|No||||No|No|||Over the counter|No|||No|.3162|06/29/2021|.31168|06/29/2021|.29684|06/29/2021||||397|||||No|No||ALLERGAN INC.|No||||
cyclosporine|No|No|No|No|75%|00023530105|RESTASIS MULTIDOSE 0.05% EYE|5.5|ML|50.47652|02/23/2017||Yes|No||02/23/2017||Yes|No|02/23/2017||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|086|No|112.6932|02/08/2022|109.98856|02/08/2022|110.72106|02/08/2022|||OPHTHALMICS: ANTI-INFLAMMATORY/IMMUNOMODULATOR|398|||||No|No||ALLERGAN INC.|No||||
carboxymethyl/gly/poly80/PF|No|No|No|No|75%|00023577330|REFRESH OPTIVE MEGA-3 DROPS|30|EA|.18332|11/08/2017||Yes|No||||No|No|11/08/2017||Yes|No||||No|No|||Over the counter|No|||No|.42582|12/28/2021|.4156|12/28/2021|.41836|12/28/2021||||399|||||No|No||ALLERGAN INC.|No||||
mesalamine|No|No|No|No|75%|00023585318|DELZICOL DR 400 MG CAPSULE|180|EA|1.66818|11/09/2016||Yes|No||11/09/2016||Yes|No|11/09/2016||Yes|No||||No|No|||Prescription required|No||010|No|3.72815|04/27/2021|3.63867|04/27/2021|3.6629|04/27/2021|||ULCERATIVE COLITIS AGENTS|400|||||No|No||ALLERGAN INC.|No||||
oxybutynin chloride|No|No|No|No|75%|00023586110|GELNIQUE 10% GEL SACHET|1|GM|5.6674|02/20/2019||Yes|No||02/20/2019||Yes|No|02/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|No|12.9164|02/20/2019|12.73188|02/26/2019|12.1256|02/20/2019|||BLADDER RELAXANT PREPARATIONS|401|||||No|No||ALLERGAN INC.|No||||
oxybutynin chloride|No|No|No|No|75%|00023586111|GELNIQUE 10% GEL SACHET|1|GM|5.66926|02/20/2019||Yes|No||02/20/2019||Yes|No|02/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|No|12.92064|02/20/2019|12.73606|02/20/2019|12.12958|02/20/2019|||BLADDER RELAXANT PREPARATIONS|402|||||No|No||ALLERGAN INC.|No||||
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|00023586230|TAYTULLA 1 MG-20 MCG CAPSULE|28|EA|3.32353|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No|Refer to program requirements|||No|No|02/17/2017||Prescription required|No|||No|7.44638|02/08/2022|7.26766|02/08/2022|7.31606|02/08/2022||||403|||||No|No||ALLERGAN INC.|No|||Only covered for non-contraceptive (medical) purposes|
mesalamine|No|No|No|No|75%|00023590118|ASACOL HD DR 800 MG TABLET|180|EA|4.04319|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|010|No|9.21471|10/26/2021|9.08307|10/26/2021|8.65054|10/26/2021|||ULCERATIVE COLITIS AGENTS|404|||||No|No||ALLERGAN INC.|No||||
testosterone|No|No|No|No|90%|00023599002|ANDRODERM 2 MG/24HR PATCH|1|EA|4.4161|02/20/2019||Yes|No||02/20/2019||Yes|No|02/20/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|084|No|9.7909|11/23/2021|9.55591|11/23/2021|9.61955|11/23/2021|||ANDROGENIC AGENTS|405|||||No|No||ALLERGAN INC.|No||||
testosterone|No|No|No|No|90%|00023599060|ANDRODERM 2 MG/24HR PATCH|60|EA|4.41395|02/20/2019||Yes|No||02/20/2019||Yes|No|02/20/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|084|No|9.7909|11/23/2021|9.55591|11/23/2021|9.61955|11/23/2021|||ANDROGENIC AGENTS|406|||||No|No||ALLERGAN INC.|No||||
testosterone|No|No|No|No|90%|00023599204|ANDRODERM 4 MG/24HR PATCH|1|EA|8.8279|02/20/2019||Yes|No||02/20/2019||Yes|No|02/20/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|084|No|19.64948|06/29/2021|19.17789|06/29/2021|19.30561|06/29/2021|||ANDROGENIC AGENTS|407|||||No|No||ALLERGAN INC.|No||||
testosterone|No|No|No|No|90%|00023599230|ANDRODERM 4 MG/24HR PATCH|30|EA|8.8279|02/20/2019||Yes|No||02/20/2019||Yes|No|02/20/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|084|No|19.64948|06/29/2021|19.17789|06/29/2021|19.30561|06/29/2021|||ANDROGENIC AGENTS|408|||||No|No||ALLERGAN INC.|No||||
noreth-ethinyl estradiol/iron|Yes|Yes|No|No|75%|00023603003|GENERESS FE CHEWABLE TABLET|28|EA|2.51268|04/09/2019||Yes|No||04/09/2019||Yes|No|04/09/2019||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|5.72658|01/28/2020|5.64477|01/28/2020|5.37597|01/28/2020||||409|||||No|No||ALLERGAN INC.|No|||Only covered for non-contraceptive (medical) purposes|
iron dextran complex|No|No|No|No|75%|00023608210|INFED 100 MG/2 ML VIAL|2|ML|6.9245|02/20/2019||Yes|No||02/20/2019||Yes|No|02/20/2019||Yes|No||||No|No|||Prescription required|No|||No|15.78143|02/01/2022|15.55598|02/01/2022|14.81522|02/01/2022||||410|||||No|No||ALLERGAN INC.|No||||
lipase/protease/amylase|No|No|No|No|75%|00023611001|ZENPEP DR 10,000 UNIT CAPSULE|100|EA|1.61847|06/12/2018|06/21/2022|Yes|No||06/12/2018|06/21/2022|Yes|No|06/12/2018|06/21/2022|Yes|No||||No|No|||Prescription required|No||108|No|3.66012|01/04/2022|3.57227|01/04/2022|3.59606|01/04/2022|||PANCREATIC ENZYMES|411|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ALLERGAN/NESTLE|No||||
lipase/protease/amylase|No|No|No|No|75%|00023611101|ZENPEP DR 15,000 UNIT CAPSULE|100|EA|2.33756|08/06/2018|05/25/2022|Yes|No||08/06/2018|05/25/2022|Yes|No|08/06/2018|05/25/2022|Yes|No||||No|No|||Prescription required|No||108|No|5.29138|01/04/2022|5.16438|01/04/2022|5.19878|01/04/2022|||PANCREATIC ENZYMES|412|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ALLERGAN/NESTLE|No||||
lipase/protease/amylase|No|No|No|No|75%|00023611201|ZENPEP DR 20,000 UNIT CAPSULE|100|EA|3.17529|01/04/2018|06/17/2022|Yes|No||01/04/2018|06/17/2022|Yes|No|01/04/2018|06/17/2022|Yes|No||||No|No|||Prescription required|No||108|No|7.19514|01/04/2022|7.02245|01/04/2022|7.06922|01/04/2022|||PANCREATIC ENZYMES|413|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ALLERGAN/NESTLE|No||||
lipase/protease/amylase|No|No|No|No|75%|00023611301|ZENPEP DR 3,000 UNIT CAPSULE|100|EA|.85815|12/03/2018|11/16/2022|Yes|No||12/03/2018|11/16/2022|Yes|No|12/03/2018|11/16/2022|Yes|No||||No|No|||Prescription required|No||108|No|1.94212|01/04/2022|1.8955|01/04/2022|1.90813|01/04/2022|||PANCREATIC ENZYMES|414|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ALLERGAN/NESTLE|No||||
lipase/protease/amylase|No|No|No|No|75%|00023611401|ZENPEP DR 40,000 UNIT CAPSULE|100|EA|6.2666|01/30/2018|04/27/2022|Yes|No||01/30/2018|04/27/2022|Yes|No|01/30/2018|04/27/2022|Yes|No||||No|No|||Prescription required|No||108|No|14.17938|01/04/2022|13.83907|01/04/2022|13.93124|01/04/2022|||PANCREATIC ENZYMES|415|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ALLERGAN/NESTLE|No||||
lipase/protease/amylase|No|No|No|No|75%|00023611501|ZENPEP DR 5,000 UNIT CAPSULE|100|EA|.81876|04/03/2018|06/14/2022|Yes|No||04/03/2018|06/14/2022|Yes|No|04/03/2018|06/14/2022|Yes|No||||No|No|||Prescription required|No||108|No|1.85294|01/04/2022|1.80846|01/04/2022|1.82051|01/04/2022|||PANCREATIC ENZYMES|416|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ALLERGAN/NESTLE|No||||
lipase/protease/amylase|No|No|No|No|75%|00023611601|ZENPEP DR 25,000 UNIT CAPSULE|100|EA|3.92929|04/03/2018|03/15/2022|Yes|No||04/03/2018|03/15/2022|Yes|No|04/03/2018|03/15/2022|Yes|No||||No|No|||Prescription required|No||108|No|8.87797|01/04/2022|8.66489|01/04/2022|8.7226|01/04/2022|||PANCREATIC ENZYMES|417|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ALLERGAN/NESTLE|No||||
podofilox|No|No|No|No|75%|00023611803|CONDYLOX 0.5% GEL|3.5|GM|77.81034|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||||No|No|||Prescription required|No|||No|173.30057|01/25/2022|169.14135|01/25/2022|170.26781|01/25/2022||||418|||||No|No||ALLERGAN INC.|No||||
silodosin|No|No|No|No|75%|00023614730|RAPAFLO 4 MG CAPSULE|30|EA|3.74788|02/20/2019||Yes|No||02/20/2019||Yes|No|02/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|003|No|8.54168|01/28/2020|8.41965|01/28/2020|8.01872|01/28/2020|||BPH TREATMENTS|419|||||No|No||ALLERGAN INC.|No||||
progesterone, micronized|No|No|No|No|75%|00023615108|CRINONE 8% GEL|1.125|GM|11.4208|01/04/2019||Yes|No||01/04/2019||Yes|No|01/04/2019||Yes|No||||No|No|||Prescription required|No|||No|26.0288|01/28/2020|25.65696|01/28/2020|24.4352|01/28/2020||||420|||||No|No||ALLERGAN INC.|No||||
progesterone, micronized|No|No|No|No|75%|00023615109|CRINONE 8% GEL|1.125|GM|11.4208|02/20/2019||Yes|No||02/20/2019||Yes|No|02/20/2019||Yes|No||||No|No|||Prescription required|No|||No|26.0288|02/26/2019|25.65696|02/26/2019|24.4352|02/20/2019||||421|||||No|No||ALLERGAN INC.|No||||
oxybutynin|No|No|No|No|75%|00023615301|OXYTROL 3.9 MG/24HR PATCH|1|EA|36.5414|02/20/2019||Yes|No||02/20/2019||Yes|No|02/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|No|83.2804|08/25/2020|82.09068|08/25/2020|78.1816|08/25/2020|||BLADDER RELAXANT PREPARATIONS|422|||||No|No||ALLERGAN INC.|No||||
oxybutynin|No|No|No|No|75%|00023615308|OXYTROL 3.9 MG/24HR PATCH|8|EA|36.54193|02/20/2019||Yes|No||02/20/2019||Yes|No|02/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|No|83.28162|08/25/2020|82.09188|08/25/2020|78.18275|08/25/2020|||BLADDER RELAXANT PREPARATIONS|423|||||No|No||ALLERGAN INC.|No||||
ubrogepant|No|No|No|No|75%|00023649810|UBRELVY 50 MG TABLET|10|EA|40.29659|05/19/2020||Yes|No||05/19/2020||Yes|No|05/19/2020||Yes|No||||No|No|||Prescription required|No||537|No|89.77877|02/08/2022|87.62407|02/08/2022|88.20764|02/08/2022|||ANTIMIGRAINE AGENTS: OTHER|424|||||No|No||ALLERGAN INC.|No||||
ubrogepant|No|No|No|No|75%|00023650110|UBRELVY 100 MG TABLET|10|EA|40.29659|05/19/2020||Yes|No||05/19/2020||Yes|No|05/19/2020||Yes|No||||No|No|||Prescription required|No||537|No|90.07494|02/08/2022|87.91314|02/08/2022|88.49862|02/08/2022|||ANTIMIGRAINE AGENTS: OTHER|425|||||No|No||ALLERGAN INC.|No||||
polymyxin B sulf/trimethoprim|No|No|No|No|75%|00023782410|POLYTRIM EYE DROPS|10|ML|3.43441|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|058|No|7.82726|01/12/2021|7.71544|01/12/2021|7.34804|01/12/2021|||OPHTHALMIC ANTIBIOTICS|426|||||No|No||ALLERGAN INC.|No||||
nedocromil sodium|No|No|No|No|75%|00023884205|ALOCRIL 2% EYE DROPS|5|ML|19.30786|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/22/2009|002|No|44.00396|01/12/2021|43.37533|01/12/2021|41.30984|01/12/2021|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|427|||||No|No||ALLERGAN INC.|No||||
cyclosporine|No|No|No|No|75%|00023916330|RESTASIS 0.05% EYE EMULSION|30|EA|4.6268|06/26/2008||Yes|No||06/26/2008||Yes|No|06/26/2008||Yes|No||||No|No|||Prescription required|No||086|No|10.31325|02/08/2022|10.06573|02/08/2022|10.13276|02/08/2022|||OPHTHALMICS: ANTI-INFLAMMATORY/IMMUNOMODULATOR|428|||||No|No||ALLERGAN INC.|No||||
cyclosporine|No|No|No|No|75%|00023916360|RESTASIS 0.05% EYE EMULSION|60|EA|4.62701|11/19/2012||Yes|No||11/19/2012||Yes|No|11/19/2012||Yes|No||||No|No|||Prescription required|No||086|No|10.33963|02/08/2022|10.09147|02/08/2022|10.15868|02/08/2022|||OPHTHALMICS: ANTI-INFLAMMATORY/IMMUNOMODULATOR|429|||||No|No||ALLERGAN INC.|No||||
brimonidine tartrate|No|No|No|No|75%|00023917705|ALPHAGAN P 0.15% EYE DROPS|5|ML|16.97812|12/06/2002||Yes|No||12/06/2002||Yes|No|12/06/2002||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|088|No|37.64244|02/08/2022|36.73902|02/08/2022|36.98369|02/08/2022|||OPHTHALMICS: GLAUCOMA AGENTS|430|||||No|No||ALLERGAN INC.|No||||
brimonidine tartrate|No|No|No|No|75%|00023917710|ALPHAGAN P 0.15% EYE DROPS|10|ML|16.97382|12/06/2002||Yes|No||12/06/2002||Yes|No|12/06/2002||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|088|No|37.76068|02/08/2022|36.85442|02/08/2022|37.09986|02/08/2022|||OPHTHALMICS: GLAUCOMA AGENTS|431|||||No|No||ALLERGAN INC.|No||||
brimonidine tartrate|No|No|No|No|75%|00023917715|ALPHAGAN P 0.15% EYE DROPS|15|ML|16.97554|04/27/2004||Yes|No||04/27/2004||Yes|No|04/27/2004||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|088|No|37.92662|02/08/2022|37.01638|02/08/2022|37.2629|02/08/2022|||OPHTHALMICS: GLAUCOMA AGENTS|432|||||No|No||ALLERGAN INC.|No||||
brimonidine tartrate/timolol|No|No|No|No|75%|00023921105|COMBIGAN 0.2%-0.5% EYE DROPS|5|ML|17.55518|02/04/2008||Yes|No||02/04/2008||Yes|No|02/04/2008||Yes|No||||No|No|||Prescription required|No||088|No|39.18914|02/08/2022|38.2486|02/08/2022|38.50333|02/08/2022|||OPHTHALMICS: GLAUCOMA AGENTS|433|||||No|No||ALLERGAN INC.|No||||
brimonidine tartrate/timolol|No|No|No|No|75%|00023921110|COMBIGAN 0.2%-0.5% EYE DROPS|10|ML|17.55561|02/04/2008||Yes|No||02/04/2008||Yes|No|02/04/2008||Yes|No||||No|No|||Prescription required|No||088|No|39.10077|02/08/2022|38.16235|02/08/2022|38.4165|02/08/2022|||OPHTHALMICS: GLAUCOMA AGENTS|434|||||No|No||ALLERGAN INC.|No||||
brimonidine tartrate/timolol|No|No|No|No|75%|00023921115|COMBIGAN 0.2%-0.5% EYE DROPS|15|ML|17.55432|08/15/2016||Yes|No||08/15/2016||Yes|No|08/15/2016||Yes|No||||No|No|||Prescription required|No||088|No|39.21785|02/08/2022|38.27662|02/08/2022|38.53153|02/08/2022|||OPHTHALMICS: GLAUCOMA AGENTS|435|||||No|No||ALLERGAN INC.|No||||
ketorolac tromethamine|No|No|No|No|75%|00023927705|ACULAR LS 0.4% OPHTH SOL|5|ML|24.3509|09/04/2003||Yes|No||09/04/2003||Yes|No|09/04/2003||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|013|No|55.4974|01/12/2021|54.70458|01/12/2021|52.0996|01/12/2021|||OPHTHALMICS: ANTI-INFLAMMATORIES|436|||||No|No||ALLERGAN INC.|No||||
brimonidine tartrate|No|No|No|No|75%|00023932105|ALPHAGAN P 0.1% DROPS|5|ML|15.92548|09/19/2007||Yes|No||09/19/2007||Yes|No|09/19/2007||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|088|No|35.54361|02/08/2022|34.69056|02/08/2022|34.92159|02/08/2022|||OPHTHALMICS: GLAUCOMA AGENTS|437|||||No|No||ALLERGAN INC.|No||||
brimonidine tartrate|No|No|No|No|75%|00023932110|ALPHAGAN P 0.1% DROPS|10|ML|15.91817|09/19/2007||Yes|No||09/19/2007||Yes|No|09/19/2007||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|088|No|35.43484|02/08/2022|34.5844|02/08/2022|34.81473|02/08/2022|||OPHTHALMICS: GLAUCOMA AGENTS|438|||||No|No||ALLERGAN INC.|No||||
brimonidine tartrate|No|No|No|No|75%|00023932115|ALPHAGAN P 0.1% DROPS|15|ML|15.9206|09/19/2007||Yes|No||09/19/2007||Yes|No|09/19/2007||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|088|No|35.56652|02/08/2022|34.71292|02/08/2022|34.9441|02/08/2022|||OPHTHALMICS: GLAUCOMA AGENTS|439|||||No|No||ALLERGAN INC.|No||||
clopidogrel bisulfate|No|No|No|No|75%|00024117190|PLAVIX 75 MG TABLET|90|EA|3.21443|12/29/2020||Yes|No||12/29/2020||Yes|No|12/29/2020||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|004|No|7.17246|01/18/2022|7.00032|01/18/2022|7.04694|01/18/2022|||PLATELET AGGREGATION INHIBITORS|440|||||No|No||SANOFI-AVENTIS|No||||
dronedarone HCl|No|No|No|No|75%|00024414260|MULTAQ 400 MG TABLET|60|EA|5.18737|07/22/2009||Yes|No||07/22/2009||Yes|No|07/22/2009||Yes|No||||No|No|||Prescription required|No|||No|11.55648|01/18/2022|11.27912|01/18/2022|11.35424|01/18/2022||||441|||||No|No||SANOFI-AVENTIS|No||||
zolpidem tartrate|No|No|No|No|90%|00024540131|AMBIEN 5 MG TABLET|100|EA|8.79909|05/18/2007||Yes|No||05/18/2007||Yes|No|05/18/2007||Yes|No||||No|No|||Prescription required|Yes|07/18/2006|054|Yes|19.62369|01/18/2022|19.15272|01/18/2022|19.28027|01/18/2022|||SEDATIVE HYPNOTICS|442|||||No|No||SANOFI-AVENTIS|No||||
zolpidem tartrate|No|No|No|No|90%|00024542131|AMBIEN 10 MG TABLET|100|EA|8.79909|05/18/2007||Yes|No||05/18/2007||Yes|No|05/18/2007||Yes|No||||No|No|||Prescription required|Yes|07/18/2006|054|Yes|19.67316|01/18/2022|19.201|01/18/2022|19.32887|01/18/2022|||SEDATIVE HYPNOTICS|443|||||No|No||SANOFI-AVENTIS|No||||
zolpidem tartrate|No|No|No|No|90%|00024550131|AMBIEN CR 6.25 MG TABLET|100|EA|8.79909|07/01/2009||Yes|No||07/01/2009||Yes|No|07/01/2009||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|054|Yes|20.05374|01/11/2022|19.76725|01/11/2022|18.82596|01/11/2022|||SEDATIVE HYPNOTICS|444|||||No|No||SANOFI-AVENTIS|No||||
zolpidem tartrate|No|No|No|No|90%|00024552131|AMBIEN CR 12.5 MG TABLET|100|EA|8.79909|07/01/2009||Yes|No||07/01/2009||Yes|No|07/01/2009||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|054|Yes|19.52677|01/18/2022|19.05812|01/18/2022|19.18505|01/18/2022|||SEDATIVE HYPNOTICS|445|||||No|No||SANOFI-AVENTIS|No||||
lixisenatide|No|No|No|No|75%|00024574502|ADLYXIN 10-20 MCG STARTER PACK|3|ML|48.62798|01/15/2018||Yes|No||01/15/2018||Yes|No|01/15/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|111|Yes|110.82656|01/12/2021|109.24332|01/12/2021|104.04126|01/12/2021|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|446|||||No|No||SANOFI-AVENTIS|No||||
lixisenatide|No|No|No|No|75%|00024574702|ADLYXIN 20 MCG MAINTENANCE PK|3|ML|48.62798|01/15/2018||Yes|No||01/15/2018||Yes|No|01/15/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|111|Yes|110.82656|01/12/2021|109.24332|01/12/2021|104.04126|01/12/2021|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|447|||||No|No||SANOFI-AVENTIS|No||||
insulin glargine/lixisenatide|No|No|No|No|75%|00024576105|SOLIQUA 100 UNIT-33 MCG/ML PEN|3|ML|23.1641|08/04/2017||Yes|No||08/04/2017||Yes|No|08/04/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|111|Yes|51.68669|01/18/2022|50.4462|01/18/2022|50.78217|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|448|||||No|No||SANOFI-AVENTIS|No||||
tamsulosin HCl|No|No|No|No|75%|00024583701|FLOMAX 0.4 MG CAPSULE|100|EA|3.98317|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|003|No|9.07793|01/11/2022|8.94825|01/11/2022|8.52214|01/11/2022|||BPH TREATMENTS|449|||||No|No||SANOFI-AVENTIS|No||||
irbesartan|No|No|No|No|75%|00024585090|AVAPRO 75 MG TABLET|90|EA|2.97875|12/09/2013||Yes|No||12/09/2013||Yes|No|12/09/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|113|Yes|6.78878|01/11/2022|6.6918|01/11/2022|6.37314|01/11/2022|||ANGIOTENSIN MODULATORS|450|||||No|No||SANOFI-AVENTIS|No||||
irbesartan|No|No|No|No|75%|00024585130|AVAPRO 150 MG TABLET|30|EA|3.1347|12/09/2013||Yes|No||12/09/2013||Yes|No|12/09/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|113|Yes|7.00907|01/18/2022|6.84085|01/18/2022|6.88641|01/18/2022|||ANGIOTENSIN MODULATORS|451|||||No|No||SANOFI-AVENTIS|No||||
irbesartan|No|No|No|No|75%|00024585230|AVAPRO 300 MG TABLET|30|EA|3.76895|12/09/2013||Yes|No||12/09/2013||Yes|No|12/09/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|113|Yes|8.39692|01/18/2022|8.19539|01/18/2022|8.24997|01/18/2022|||ANGIOTENSIN MODULATORS|452|||||No|No||SANOFI-AVENTIS|No||||
irbesartan/hydrochlorothiazide|No|No|No|No|75%|00024585530|AVALIDE 150-12.5 MG TABLET|30|EA|3.7926|12/09/2013||Yes|No||12/09/2013||Yes|No|12/09/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|113|Yes|8.6436|01/11/2022|8.52012|01/11/2022|8.1144|01/11/2022|||ANGIOTENSIN MODULATORS|453|||||No|No||SANOFI-AVENTIS|No||||
irbesartan/hydrochlorothiazide|No|No|No|No|75%|00024585630|AVALIDE 300-12.5 MG TABLET|30|EA|4.13101|12/09/2013||Yes|No||12/09/2013||Yes|No|12/09/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|113|Yes|9.41486|01/11/2022|9.28036|01/11/2022|8.83844|01/11/2022|||ANGIOTENSIN MODULATORS|454|||||No|No||SANOFI-AVENTIS|No||||
insulin glargine,hum.rec.anlog|Yes|No|No|No|75%|00024586903|TOUJEO SOLOSTAR 300 UNIT/ML|1.5|ML|37.14435|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||05/12/2015||Yes|No|04/08/2020||Prescription required|Yes|09/18/2020|029|No|82.9503|06/29/2021|80.95949|06/29/2021|81.49866|06/29/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|455|||||No|No||SANOFI-AVENTIS|No||||
insulin glargine,hum.rec.anlog|Yes|No|No|No|75%|00024587102|TOUJEO MAX SOLOSTR 300 UNIT/ML|3|ML|37.14483|08/16/2018||Yes|No||08/16/2018||Yes|No|08/16/2018||Yes|No||08/16/2018||Yes|No|07/22/2019||Prescription required|Yes|09/18/2020|029|No|82.95974|03/01/2022|80.9687|03/01/2022|81.50794|03/01/2022|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|456|||||No|No||SANOFI-AVENTIS|No||||
sarilumab|No|No|No|No|75%|00024590801|KEVZARA 150 MG/1.14 ML SYRINGE|1.14|ML|728.99144|01/05/2018||Yes|No||01/05/2018||Yes|No|01/05/2018||Yes|No||||No|No|||Prescription required|Yes|05/24/2017|071|Yes|1661.42236|01/11/2022|1637.68775|01/11/2022|1559.70262|01/11/2022|||CYTOKINE AND CAM ANTAGONISTS|457|||||No|No||SANOFI-AVENTIS|No||||
sarilumab|No|No|No|No|75%|00024591001|KEVZARA 200 MG/1.14 ML SYRINGE|1.14|ML|728.99144|01/05/2018||Yes|No||01/05/2018||Yes|No|01/05/2018||Yes|No||||No|No|||Prescription required|Yes|05/24/2017|071|Yes|1661.42236|01/11/2022|1637.68775|01/11/2022|1559.70262|01/11/2022|||CYTOKINE AND CAM ANTAGONISTS|458|||||No|No||SANOFI-AVENTIS|No||||
dupilumab|No|No|No|No|75%|00024591401|DUPIXENT 300 MG/2 ML SYRINGE|2|ML|358.13947|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|Yes|02/01/2018|034|Yes|805.40883|03/29/2022|786.07901|03/29/2022|791.31417|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|459|||||No|No||SANOFI-AVENTIS|No||||
dupilumab|No|No|No|No|75%|00024591502|DUPIXENT 300 MG/2 ML PEN|2|ML|358.13947|03/01/2021||Yes|No||03/01/2021||Yes|No|03/01/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|034|Yes|805.7296|01/25/2022|786.39208|01/25/2022|791.62933|01/25/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|460|||||No|No||SANOFI-AVENTIS|No||||
dupilumab|No|No|No|No|75%|00024591801|DUPIXENT 200 MG/1.14 ML SYRING|1.14|ML|628.31486|12/28/2018||Yes|No||12/28/2018||Yes|No|12/28/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|034|Yes|1421.13191|01/18/2022|1387.02474|01/18/2022|1396.2621|01/18/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|461|||||No|No||SANOFI-AVENTIS|No||||
dupilumab|No|No|No|No|75%|00024591902|DUPIXENT 200 MG/1.14 ML PEN|1.14|ML|628.31486|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|034|Yes|1431.97341|02/23/2022|1411.51664|02/23/2022|1344.30157|02/23/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|462|||||No|No||SANOFI-AVENTIS|No||||
sarilumab|No|No|No|No|75%|00024592001|KEVZARA 150 MG/1.14 ML PEN INJ|1.14|ML|728.99144|11/01/2018||Yes|No||11/01/2018||Yes|No|11/01/2018||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|071|Yes|1661.42236|01/11/2022|1637.68775|01/11/2022|1559.70262|01/11/2022|||CYTOKINE AND CAM ANTAGONISTS|463|||||No|No||SANOFI-AVENTIS|No||||
sarilumab|No|No|No|No|75%|00024592201|KEVZARA 200 MG/1.14 ML PEN INJ|1.14|ML|728.99144|11/01/2018||Yes|No||11/01/2018||Yes|No|11/01/2018||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|071|Yes|1661.42236|01/11/2022|1637.68775|01/11/2022|1559.70262|01/11/2022|||CYTOKINE AND CAM ANTAGONISTS|464|||||No|No||SANOFI-AVENTIS|No||||
insulin lispro|Yes|No|No|No|75%|00024592410|ADMELOG 100 UNIT/ML VIAL|10|ML|4.21701|05/25/2018||Yes|No||05/25/2018||Yes|No|05/25/2018||Yes|No||05/25/2018||Yes|No|05/25/2018||Prescription required|Yes|09/18/2020|029|No|9.42775|01/18/2022|9.20148|01/18/2022|9.26276|01/18/2022|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|465|||||No|No||SANOFI-AVENTIS|No||||
insulin lispro|Yes|No|No|No|75%|00024592505|ADMELOG SOLOSTAR 100 UNIT/ML|3|ML|5.42803|05/25/2018||Yes|No||05/25/2018||Yes|No|05/25/2018||Yes|No||05/25/2018||Yes|No|04/08/2020||Prescription required|Yes|09/18/2020|029|No|12.14244|01/18/2022|11.85102|01/18/2022|11.92994|01/18/2022|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|466|||||No|No||SANOFI-AVENTIS|No||||
insulin lispro|Yes|No|No|No|75%|00024592605|ADMELOG 100 UNIT/ML VIAL|3|ML|5.62296|06/03/2019||Yes|No||06/03/2019||Yes|No|06/03/2019||Yes|No||06/03/2019||Yes|No|09/27/2019||Prescription required|Yes|09/18/2020|029|No|12.81512|07/09/2019|12.63205|07/09/2019|12.03052|07/09/2019|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|467|||||No|No||SANOFI-AVENTIS|No||||
diphenoxylate HCl/atropine|No|No|No|No|75%|00025006131|LOMOTIL 2.5-0.025 MG TABLET|100|EA|1.27056|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|2.8957|01/04/2022|2.85433|01/04/2022|2.71841|01/04/2022||||468|||||No|No||PFIZER US PHARM|No||||
nafarelin acetate|No|No|No|No|75%|00025016608|SYNAREL 2 MG/ML NASAL SPRAY|8|ML|159.35477|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|363.18065|01/04/2022|357.99235|01/04/2022|340.9451|01/04/2022||||469|||||No|No||PHARMACI/PFIZER|No||||
spironolactone|No|No|No|No|75%|00025100131|ALDACTONE 25 MG TABLET|100|EA|1.14177|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|2.60219|01/04/2022|2.56501|01/04/2022|2.44287|01/04/2022||||470|||||No|No||PHARMACI/PFIZER|No||||
spironolact/hydrochlorothiazid|No|No|No|No|75%|00025101131|ALDACTAZIDE 25-25 TABLET|100|EA|1.17187|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|2.67079|01/04/2022|2.63263|01/04/2022|2.50727|01/04/2022||||471|||||No|No||PHARMACI/PFIZER|No||||
spironolact/hydrochlorothiazid|No|No|No|No|75%|00025102131|ALDACTAZIDE 50-50 TABLET|100|EA|2.1613|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|4.92577|01/04/2022|4.8554|01/04/2022|4.62419|01/04/2022||||472|||||No|No||PHARMACI/PFIZER|No||||
spironolactone|No|No|No|No|75%|00025103131|ALDACTONE 100 MG TABLET|100|EA|3.36143|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|7.66095|01/04/2022|7.55151|01/04/2022|7.19191|01/04/2022||||473|||||No|No||PHARMACI/PFIZER|No||||
spironolactone|No|No|No|No|75%|00025104131|ALDACTONE 50 MG TABLET|100|EA|2.00509|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|4.56974|01/04/2022|4.50445|01/04/2022|4.28996|01/04/2022||||474|||||No|No||PHARMACI/PFIZER|No||||
oxaprozin|No|No|No|No|75%|00025138131|DAYPRO 600 MG CAPLET|100|EA|3.52419|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|059|Yes|8.03188|01/04/2022|7.91714|01/04/2022|7.54013|01/04/2022|||NSAIDS|475|||||No|No||PHARMACI/PFIZER|No||||
diclofenac sodium/misoprostol|No|No|No|No|75%|00025141160|ARTHROTEC 50 MG-200 MCG TAB|60|EA|3.68825|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|8.40578|01/04/2022|8.2857|01/04/2022|7.89114|01/04/2022|||NSAIDS|476|||||No|No||PHARMACI/PFIZER|No||||
diclofenac sodium/misoprostol|No|No|No|No|75%|00025141190|ARTHROTEC 50 MG-200 MCG TAB|90|EA|3.68805|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|8.40534|01/04/2022|8.28526|01/04/2022|7.89072|01/04/2022|||NSAIDS|477|||||No|No||PHARMACI/PFIZER|No||||
diclofenac sodium/misoprostol|No|No|No|No|75%|00025142160|ARTHROTEC 75 MG-200 MCG TAB|60|EA|3.68825|11/30/2009||Yes|No||11/30/2009||Yes|No|11/30/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|8.40578|01/04/2022|8.2857|01/04/2022|7.89114|01/04/2022|||NSAIDS|478|||||No|No||PHARMACI/PFIZER|No||||
misoprostol|No|No|No|No|75%|00025145160|CYTOTEC 100 MCG TABLET|60|EA|1.70086|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|3.87639|01/04/2022|3.82101|01/04/2022|3.63906|01/04/2022||||479|||||No|No||PHARMACI/PFIZER|No||||
misoprostol|No|No|No|No|75%|00025146131|CYTOTEC 200 MCG TABLET|100|EA|2.47774|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|5.64695|01/04/2022|5.56628|01/04/2022|5.30122|01/04/2022||||480|||||No|No||PHARMACI/PFIZER|No||||
misoprostol|No|No|No|No|75%|00025146160|CYTOTEC 200 MCG TABLET|60|EA|2.47787|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|5.64725|01/04/2022|5.56657|01/04/2022|5.3015|01/04/2022||||481|||||No|No||PHARMACI/PFIZER|No||||
celecoxib|No|No|No|No|75%|00025151501|CELEBREX 50 MG CAPSULE|60|EA|1.79023|09/19/2007||Yes|No||09/19/2007||Yes|No|09/19/2007||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|4.08006|03/22/2022|4.02177|03/22/2022|3.83026|03/22/2022|||NSAIDS|482|||||No|No||PFIZER/VIATRIS|No||||
celecoxib|No|No|No|No|75%|00025152031|CELEBREX 100 MG CAPSULE|100|EA|3.83082|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|8.73072|03/22/2022|8.60599|03/22/2022|8.19618|03/22/2022|||NSAIDS|483|||||No|No||PFIZER/VIATRIS|No||||
celecoxib|No|No|No|No|75%|00025152034|CELEBREX 100 MG CAPSULE|100|EA|3.83082|02/05/2010||Yes|No||02/05/2010||Yes|No|02/05/2010||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|8.73072|03/22/2022|8.60599|03/22/2022|8.19618|03/22/2022|||NSAIDS|484|||||No|No||PFIZER/VIATRIS|No||||
celecoxib|No|No|No|No|75%|00025152051|CELEBREX 100 MG CAPSULE|500|EA|3.8309|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|8.73089|03/22/2022|8.60617|03/22/2022|8.19635|03/22/2022|||NSAIDS|485|||||No|No||PFIZER/VIATRIS|No||||
celecoxib|No|No|No|No|75%|00025152531|CELEBREX 200 MG CAPSULE|100|EA|6.28359|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|14.04188|03/29/2022|13.70487|03/29/2022|13.79614|03/29/2022|||NSAIDS|486|||||No|No||PFIZER/VIATRIS|No||||
celecoxib|No|No|No|No|75%|00025152534|CELEBREX 200 MG CAPSULE|100|EA|6.28359|02/05/2010||Yes|No||02/05/2010||Yes|No|02/05/2010||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|14.04188|03/29/2022|13.70487|03/29/2022|13.79614|03/29/2022|||NSAIDS|487|||||No|No||PFIZER/VIATRIS|No||||
celecoxib|No|No|No|No|75%|00025152551|CELEBREX 200 MG CAPSULE|500|EA|6.28355|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|14.04188|03/29/2022|13.70487|03/29/2022|13.79614|03/29/2022|||NSAIDS|488|||||No|No||PFIZER/VIATRIS|No||||
celecoxib|No|No|No|No|75%|00025153002|CELEBREX 400 MG CAPSULE|60|EA|9.42574|12/09/2002||Yes|No||12/09/2002||Yes|No|12/09/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|21.48192|03/22/2022|21.17503|03/22/2022|20.1667|03/22/2022|||NSAIDS|489|||||No|No||PFIZER/VIATRIS|No||||
eplerenone|No|No|No|No|75%|00025171001|INSPRA 25 MG TABLET|30|EA|5.65894|02/25/2005||Yes|No||02/25/2005||Yes|No|02/25/2005||Yes|No||||No|No|||Prescription required|No|||No|12.89712|03/22/2022|12.71287|03/22/2022|12.1075|03/22/2022||||490|||||No|No||PFIZER/VIATRIS|No||||
eplerenone|No|No|No|No|75%|00025171002|INSPRA 25 MG TABLET|90|EA|5.65898|02/25/2005||Yes|No||02/25/2005||Yes|No|02/25/2005||Yes|No||||No|No|||Prescription required|No|||No|12.89723|03/22/2022|12.71298|03/22/2022|12.1076|03/22/2022||||491|||||No|No||PFIZER/VIATRIS|No||||
eplerenone|No|No|No|No|75%|00025172001|INSPRA 50 MG TABLET|90|EA|5.65898|02/25/2005||Yes|No||02/25/2005||Yes|No|02/25/2005||Yes|No||||No|No|||Prescription required|No|||No|12.89723|03/22/2022|12.71298|03/22/2022|12.1076|03/22/2022||||492|||||No|No||PFIZER/VIATRIS|No||||
eplerenone|No|No|No|No|75%|00025172003|INSPRA 50 MG TABLET|30|EA|5.65894|02/25/2005||Yes|No||02/25/2005||Yes|No|02/25/2005||Yes|No||||No|No|||Prescription required|No|||No|12.89712|03/22/2022|12.71287|03/22/2022|12.1075|03/22/2022||||493|||||No|No||PFIZER/VIATRIS|No||||
verapamil HCl|No|No|No|No|75%|00025189131|CALAN SR 240 MG CAPLET|100|EA|3.82403|03/01/2002|01/31/2022|Yes|No||03/01/2002|01/31/2022|Yes|No|03/01/2002|01/31/2022|Yes|No||||No|No|||Prescription required|Yes|02/23/2004|045|No|8.71523|01/12/2021|8.59073|01/12/2021|8.18165|01/12/2021|||CALCIUM CHANNEL BLOCKERS|494|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||PHARMACI/PFIZER|No||||
verapamil HCl|No|No|No|No|75%|00025190131|CALAN SR 120 MG CAPLET|100|EA|2.63762|03/01/2002|10/25/2022|Yes|No||03/01/2002|10/25/2022|Yes|No|03/01/2002|10/25/2022|Yes|No||||No|No|||Prescription required|Yes|02/23/2004|045|No|6.01132|01/12/2021|5.92544|01/12/2021|5.64328|01/12/2021|||CALCIUM CHANNEL BLOCKERS|495|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||PHARMACI/PFIZER|No||||
metronidazole|No|No|No|No|75%|00025194250|FLAGYL 375 CAPSULE|50|EA|2.64527|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|115|No|6.02876|01/04/2022|5.94263|01/04/2022|5.65965|01/04/2022|||ANTIBIOTICS: GI|496|||||No|No||PHARMACI/PFIZER|No||||
disopyramide phosphate|No|No|No|No|75%|00025273231|NORPACE CR 100 MG CAPSULE|100|EA|1.8023|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|4.10757|01/04/2022|4.04889|01/04/2022|3.85608|01/04/2022||||497|||||No|No||PHARMACI/PFIZER|No||||
disopyramide phosphate|No|No|No|No|75%|00025274231|NORPACE CR 150 MG CAPSULE|100|EA|2.13|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|4.85443|01/04/2022|4.78508|01/04/2022|4.55722|01/04/2022||||498|||||No|No||PHARMACI/PFIZER|No||||
disopyramide phosphate|No|No|No|No|75%|00025275231|NORPACE 100 MG CAPSULE|100|EA|1.98978|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|4.53485|01/04/2022|4.47006|01/04/2022|4.2572|01/04/2022||||499|||||No|No||PHARMACI/PFIZER|No||||
disopyramide phosphate|No|No|No|No|75%|00025276231|NORPACE 150 MG CAPSULE|100|EA|2.35106|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|5.35824|01/04/2022|5.2817|01/04/2022|5.03019|01/04/2022||||500|||||No|No||PHARMACI/PFIZER|No||||
verapamil HCl|No|No|No|No|75%|00025292431|CALAN SR 240 MG TABLET|100|EA|3.97698|01/07/2022||Yes|No||01/07/2022||Yes|No|01/07/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|045|No|9.06382|01/07/2022|8.93434|01/07/2022|8.50889|01/07/2022|||CALCIUM CHANNEL BLOCKERS|501|||||No|No||PFIZER US PHARM|No||||
antihemophil.FVIII,full length|No|No|No|No|75%|00026378225|KOGENATE FS 250 UNIT VIAL|1|EA|1.258|11/08/2013||Yes|No||11/08/2013||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.813|01/11/2022|1.7871|01/11/2022|1.702|01/11/2022|||HEMOPHILIA TREATMENT|502|||||No|No||BAYER,PHARM DIV|No||||
antihemophil.FVIII,full length|No|No|No|No|75%|00026378335|KOGENATE FS 500 UNIT VIAL|1|EA|1.258|11/08/2013||Yes|No||11/08/2013||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.813|01/11/2022|1.7871|01/11/2022|1.702|01/11/2022|||HEMOPHILIA TREATMENT|503|||||No|No||BAYER,PHARM DIV|No||||
antihemophil.FVIII,full length|No|No|No|No|75%|00026378555|KOGENATE FS 1,000 UNITS VIAL|1|EA|1.258|11/08/2013||Yes|No||11/08/2013||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.813|01/11/2022|1.7871|01/11/2022|1.702|01/11/2022|||HEMOPHILIA TREATMENT|504|||||No|No||BAYER,PHARM DIV|No||||
antihemophil.FVIII,full length|No|No|No|No|75%|00026378665|KOGENATE FS 2,000 UNIT VIAL|1|EA|1.258|11/08/2013||Yes|No||11/08/2013||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.813|01/11/2022|1.7871|01/11/2022|1.702|01/11/2022|||HEMOPHILIA TREATMENT|505|||||No|No||BAYER,PHARM DIV|No||||
antihemophil.FVIII,full length|No|No|No|No|75%|00026378775|KOGENATE FS 3,000 UNITS VIAL|1|EA|1.258|11/08/2013||Yes|No||11/08/2013||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.813|01/11/2022|1.7871|01/11/2022|1.702|01/11/2022|||HEMOPHILIA TREATMENT|506|||||No|No||BAYER,PHARM DIV|No||||
antihemophil.FVIII,full length|No|No|No|No|75%|00026382125|KOVALTRY 250 UNIT KIT|1|EA|1.2988|10/07/2016||Yes|No||10/07/2016||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.8718|01/11/2022|1.84506|01/11/2022|1.7572|01/11/2022|||HEMOPHILIA TREATMENT|507|||||No|No||BAYER,PHARM DIV|No||||
antihemophil.FVIII,full length|No|No|No|No|75%|00026382225|KOVALTRY 500 UNIT KIT|1|EA|1.2988|10/07/2016||Yes|No||10/07/2016||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.8718|01/11/2022|1.84506|01/11/2022|1.7572|01/11/2022|||HEMOPHILIA TREATMENT|508|||||No|No||BAYER,PHARM DIV|No||||
antihemophil.FVIII,full length|No|No|No|No|75%|00026382425|KOVALTRY 1,000 UNIT KIT|1|EA|1.2988|10/07/2016||Yes|No||10/07/2016||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.8718|01/11/2022|1.84506|01/11/2022|1.7572|01/11/2022|||HEMOPHILIA TREATMENT|509|||||No|No||BAYER,PHARM DIV|No||||
antihemophil.FVIII,full length|No|No|No|No|75%|00026382650|KOVALTRY 2,000 UNIT KIT|1|EA|1.2988|10/07/2016||Yes|No||10/07/2016||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.8718|01/11/2022|1.84506|01/11/2022|1.7572|01/11/2022|||HEMOPHILIA TREATMENT|510|||||No|No||BAYER,PHARM DIV|No||||
antihemophil.FVIII,full length|No|No|No|No|75%|00026382850|KOVALTRY 3,000 UNIT KIT|1|EA|1.2988|10/07/2016||Yes|No||10/07/2016||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.8718|01/11/2022|1.84506|01/11/2022|1.7572|01/11/2022|||HEMOPHILIA TREATMENT|511|||||No|No||BAYER,PHARM DIV|No||||
FVIII rec,B-dom delet peg-aucl|No|No|No|No|75%|00026394225|JIVI 500 UNIT VIAL|1|EA|1.632|12/07/2018||Yes|No||12/07/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.352|01/11/2022|2.3184|01/11/2022|2.208|01/11/2022|||HEMOPHILIA TREATMENT|512|||||No|No||BAYER,PHARM DIV|No||||
FVIII rec,B-dom delet peg-aucl|No|No|No|No|75%|00026394425|JIVI 1,000 UNIT VIAL|1|EA|1.632|12/07/2018||Yes|No||12/07/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.352|01/11/2022|2.3184|01/11/2022|2.208|01/11/2022|||HEMOPHILIA TREATMENT|513|||||No|No||BAYER,PHARM DIV|No||||
FVIII rec,B-dom delet peg-aucl|No|No|No|No|75%|00026394625|JIVI 2,000 UNIT VIAL|1|EA|1.632|12/07/2018||Yes|No||12/07/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.352|01/11/2022|2.3184|01/11/2022|2.208|01/11/2022|||HEMOPHILIA TREATMENT|514|||||No|No||BAYER,PHARM DIV|No||||
FVIII rec,B-dom delet peg-aucl|No|No|No|No|75%|00026394825|JIVI 3,000 UNIT VIAL|1|EA|1.632|12/07/2018||Yes|No||12/07/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.352|01/11/2022|2.3184|01/11/2022|2.208|01/11/2022|||HEMOPHILIA TREATMENT|515|||||No|No||BAYER,PHARM DIV|No||||
lipase/protease/amylase|No|No|No|No|75%|00032120370|CREON DR 3,000 UNIT CAPSULE|70|EA|.68449|08/16/2011||Yes|No||08/16/2011||Yes|No|08/16/2011||Yes|No||||No|No|||Prescription required|No||108|No|1.52764|02/01/2022|1.49097|02/01/2022|1.5009|02/01/2022|||PANCREATIC ENZYMES|516|||||No|No||ABBVIE US LLC|No||||
lipase/protease/amylase|No|No|No|No|75%|00032120601|CREON DR 6,000 UNIT CAPSULE|100|EA|.81042|08/12/2009||Yes|No||08/12/2009||Yes|No|08/12/2009||Yes|No||08/12/2009||Yes|No|||Prescription required|No||108|No|1.81316|02/01/2022|1.76964|02/01/2022|1.78142|02/01/2022|||PANCREATIC ENZYMES|517|||||No|No||ABBVIE US LLC|No||||
lipase/protease/amylase|No|No|No|No|75%|00032120607|CREON DR 6,000 UNIT CAPSULE|250|EA|.81049|08/12/2009||Yes|No||08/12/2009||Yes|No|08/12/2009||Yes|No||08/12/2009||Yes|No|||Prescription required|No||108|No|1.81316|02/01/2022|1.76964|02/01/2022|1.78142|02/01/2022|||PANCREATIC ENZYMES|518|||||No|No||ABBVIE US LLC|No||||
lipase/protease/amylase|No|No|No|No|75%|00032121201|CREON DR 12,000 UNIT CAPSULE|100|EA|1.61989|08/12/2009||Yes|No||08/12/2009||Yes|No|08/12/2009||Yes|No||08/12/2009||Yes|No|||Prescription required|No||108|No|3.60256|02/01/2022|3.51609|02/01/2022|3.53951|02/01/2022|||PANCREATIC ENZYMES|519|||||No|No||ABBVIE US LLC|No||||
lipase/protease/amylase|No|No|No|No|75%|00032121207|CREON DR 12,000 UNIT CAPSULE|250|EA|1.61987|08/12/2009||Yes|No||08/12/2009||Yes|No|08/12/2009||Yes|No||08/12/2009||Yes|No|||Prescription required|No||108|No|3.60256|02/01/2022|3.51609|02/01/2022|3.53951|02/01/2022|||PANCREATIC ENZYMES|520|||||No|No||ABBVIE US LLC|No||||
lipase/protease/amylase|No|No|No|No|75%|00032122401|CREON DR 24,000 UNIT CAPSULE|100|EA|3.21093|08/12/2009||Yes|No||08/12/2009||Yes|No|08/12/2009||Yes|No||08/12/2009||Yes|No|||Prescription required|No||108|No|7.16032|02/01/2022|6.98847|02/01/2022|7.03501|02/01/2022|||PANCREATIC ENZYMES|521|||||No|No||ABBVIE US LLC|No||||
lipase/protease/amylase|No|No|No|No|75%|00032122407|CREON DR 24,000 UNIT CAPSULE|250|EA|3.15921|08/12/2009||Yes|No||08/12/2009||Yes|No|08/12/2009||Yes|No||08/12/2009||Yes|No|||Prescription required|No||108|No|7.16032|02/01/2022|6.98847|02/01/2022|7.03501|02/01/2022|||PANCREATIC ENZYMES|522|||||No|No||ABBVIE US LLC|No||||
lipase/protease/amylase|No|No|No|No|75%|00032301613|CREON DR 36,000 UNIT CAPSULE|100|EA|4.87542|07/30/2013||Yes|No||07/30/2013||Yes|No|07/30/2013||Yes|No||07/30/2013||Yes|No|||Prescription required|No||108|No|10.87358|02/01/2022|10.61261|02/01/2022|10.68329|02/01/2022|||PANCREATIC ENZYMES|523|||||No|No||ABBVIE US LLC|No||||
lipase/protease/amylase|No|No|No|No|75%|00032301628|CREON DR 36,000 UNIT CAPSULE|250|EA|4.87482|07/30/2013||Yes|No||07/30/2013||Yes|No|07/30/2013||Yes|No||07/30/2013||Yes|No|||Prescription required|No||108|No|10.87358|02/01/2022|10.61261|02/01/2022|10.68329|02/01/2022|||PANCREATIC ENZYMES|524|||||No|No||ABBVIE US LLC|No||||
azelastine/fluticasone|No|No|No|No|75%|00037024523|DYMISTA NASAL SPRAY|23|GM|3.91879|09/28/2012||Yes|No||09/28/2012||Yes|No|09/28/2012||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|019|No|8.73946|03/29/2022|8.52971|03/29/2022|8.58651|03/29/2022|||INTRANASAL RHINITIS AGENTS|525|||||No|No||MEDA/MYLAN SPEC|No||||
felbamate|No|No|No|No|75%|00037043001|FELBATOL 400 MG TABLET|100|EA|5.90725|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||056|No|13.46304|03/22/2022|13.27071|03/22/2022|12.63877|03/22/2022|||ANTICONVULSANTS|526|||||No|No||MEDA/MYLAN SPEC|No||||
felbamate|No|No|No|No|75%|00037043101|FELBATOL 600 MG TABLET|100|EA|6.77004|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||056|No|15.09657|03/29/2022|14.73425|03/29/2022|14.83238|03/29/2022|||ANTICONVULSANTS|527|||||No|No||MEDA/MYLAN SPEC|No||||
felbamate|No|No|No|No|75%|00037044217|FELBATOL 600 MG/5 ML SUSP|946|ML|2.95921|04/18/2008||Yes|No||04/18/2008||Yes|No|04/18/2008||Yes|No||||No|No|||Prescription required|No||056|No|6.74426|03/22/2022|6.64791|03/22/2022|6.33134|03/22/2022|||ANTICONVULSANTS|528|||||No|No||MEDA/MYLAN SPEC|No||||
felbamate|No|No|No|No|75%|00037044267|FELBATOL 600 MG/5 ML SUSP|237|ML|3.06334|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||056|No|6.98156|03/22/2022|6.88183|03/22/2022|6.55412|03/22/2022|||ANTICONVULSANTS|529|||||No|No||MEDA/MYLAN SPEC|No||||
carisoprodol|No|No|No|No|90%|00037200101|SOMA 350 MG TABLET|100|EA|4.09936|09/24/2009||Yes|No||09/24/2009||Yes|No|09/24/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|116|Yes|9.34273|03/22/2022|9.20926|03/22/2022|8.77072|03/22/2022|||SKELETAL MUSCLE RELAXANTS|530|||||No|No||MEDA/MYLAN SPEC|No||||
carisoprodol|No|No|No|No|90%|00037225010|SOMA 250 MG TABLET|100|EA|2.81069|02/08/2008||Yes|No||02/08/2008||Yes|No|02/08/2008||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|116|Yes|6.40577|03/22/2022|6.31425|03/22/2022|6.01358|03/22/2022|||SKELETAL MUSCLE RELAXANTS|531|||||No|No||MEDA/MYLAN SPEC|No||||
penicillamine|No|No|No|No|75%|00037440101|DEPEN 250 MG TITRATAB|100|EA|28.94566|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|65.96919|03/22/2022|65.02677|03/22/2022|61.93026|03/22/2022||||532|||||No|No||MEDA/MYLAN SPEC|No||||
zolpidem tartrate|No|No|No|No|90%|00037601030|EDLUAR 10 MG SL TABLET|30|EA|5.62411|07/13/2009||Yes|No||07/13/2009||Yes|No|07/13/2009||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|054|Yes|12.81774|03/22/2022|12.63463|03/22/2022|12.03298|03/22/2022|||SEDATIVE HYPNOTICS|533|||||No|No||MEDA/MYLAN SPEC|No||||
zolpidem tartrate|No|No|No|No|90%|00037605030|EDLUAR 5 MG SL TABLET|30|EA|5.36138|07/13/2009||Yes|No||07/13/2009||Yes|No|07/13/2009||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|054|Yes|12.21896|09/17/2019|12.0444|09/17/2019|11.47086|09/17/2019|||SEDATIVE HYPNOTICS|534|||||No|No||MEDA/MYLAN SPEC|No||||
hydrocortisone/pramoxine|No|No|No|No|75%|00037682210|PROCTOFOAM-HC 1%-1% FOAM|10|GM|7.08511|04/08/2015||Yes|No||04/08/2015||Yes|No|04/08/2015||Yes|No||||No|No|||Prescription required|No|||No|15.77621|03/29/2022|15.39758|03/29/2022|15.50012|03/29/2022||||535|||||No|No||MEDA/MYLAN SPEC|No||||
hydrocortisone acetate|No|No|No|No|75%|00037683015|CORTIFOAM 10% AEROSOL|15|GM|11.97435|02/18/2016||Yes|No||02/18/2016||Yes|No|02/18/2016||Yes|No||||No|No|||Prescription required|No|||No|26.45131|03/29/2022|25.81647|03/29/2022|25.98841|03/29/2022||||536|||||No|No||MEDA/MYLAN SPEC|No||||
olsalazine sodium|No|No|No|No|75%|00037686010|DIPENTUM 250 MG CAPSULE|100|EA|6.11395|02/18/2016||Yes|No||02/18/2016||Yes|No|02/18/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|010|No|13.93413|03/22/2022|13.73507|03/22/2022|13.08102|03/22/2022|||ULCERATIVE COLITIS AGENTS|537|||||No|No||MEDA/MYLAN SPEC|No||||
glimepiride|No|No|No|No|75%|00039022110|AMARYL 1 MG TABLET|100|EA|.57142|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|1.30232|06/01/2016|1.28371|06/01/2016|1.22258|06/01/2016||||538|||||No|No||SANOFI-AVENTIS|No||||
glimepiride|No|No|No|No|75%|00039022210|AMARYL 2 MG TABLET|100|EA|.92609|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|2.11062|04/25/2017|2.08047|04/25/2017|1.9814|04/25/2017||||539|||||No|No||SANOFI-AVENTIS|No||||
glimepiride|No|No|No|No|75%|00039022310|AMARYL 4 MG TABLET|100|EA|1.7467|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|3.98085|07/24/2018|3.92398|07/24/2018|3.73713|07/24/2018||||540|||||No|No||SANOFI-AVENTIS|No||||
estrogens, conjugated|No|No|No|No|75%|00046074905|PREMARIN 25 MG VIAL|1|EA|146.3333|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|333.5038|01/04/2022|328.73946|01/04/2022|313.0852|01/04/2022||||541|||||No|No||WYETH/PFIZER|No||||
estrogens, conjugated|No|No|No|No|75%|00046087221|PREMARIN VAGINAL CREAM-APPL|30|GM|5.96453|07/13/2012||Yes|No||07/13/2012||Yes|No|07/13/2012||Yes|No||||No|No|||Prescription required|No|||Yes|13.2897|01/11/2022|12.97074|01/11/2022|13.05713|01/11/2022||||542|||||No|No||WYETH/PFIZER|No||||
estrogens, conjugated|No|No|No|No|75%|00046110081|PREMARIN 0.3 MG TABLET|100|EA|2.74563|03/08/2006||Yes|No||03/08/2006||Yes|No|03/08/2006||Yes|No||||No|No|||Prescription required|No|||Yes|6.10887|01/11/2022|5.96225|01/11/2022|6.00196|01/11/2022||||543|||||No|No||WYETH/PFIZER|No||||
estrogens, conjugated|No|No|No|No|75%|00046110091|PREMARIN 0.3 MG TABLET|1000|EA|2.74555|03/08/2006||Yes|No||03/08/2006||Yes|No|03/08/2006||Yes|No||||No|No|||Prescription required|No|||Yes|6.10887|01/11/2022|5.96225|01/11/2022|6.00196|01/11/2022||||544|||||No|No||WYETH/PFIZER|No||||
estrogens, conjugated|No|No|No|No|75%|00046110181|PREMARIN 0.45 MG TABLET|100|EA|2.74563|03/08/2006||Yes|No||03/08/2006||Yes|No|03/08/2006||Yes|No||||No|No|||Prescription required|No|||Yes|6.11543|01/11/2022|5.96865|01/11/2022|6.0084|01/11/2022||||545|||||No|No||WYETH/PFIZER|No||||
estrogens, conjugated|No|No|No|No|75%|00046110281|PREMARIN 0.625 MG TABLET|100|EA|2.74563|03/08/2006||Yes|No||03/08/2006||Yes|No|03/08/2006||Yes|No||||No|No|||Prescription required|No|||Yes|6.12843|01/11/2022|5.98134|01/11/2022|6.02118|01/11/2022||||546|||||No|No||WYETH/PFIZER|No||||
estrogens, conjugated|No|No|No|No|75%|00046110291|PREMARIN 0.625 MG TABLET|1000|EA|2.74555|03/08/2006||Yes|No||03/08/2006||Yes|No|03/08/2006||Yes|No||||No|No|||Prescription required|No|||Yes|6.12843|01/11/2022|5.98134|01/11/2022|6.02118|01/11/2022||||547|||||No|No||WYETH/PFIZER|No||||
estrogens, conjugated|No|No|No|No|75%|00046110381|PREMARIN 0.9 MG TABLET|100|EA|2.74563|03/08/2006||Yes|No||03/08/2006||Yes|No|03/08/2006||Yes|No||||No|No|||Prescription required|No|||Yes|6.11348|01/11/2022|5.96675|01/11/2022|6.00649|01/11/2022||||548|||||No|No||WYETH/PFIZER|No||||
estrogens, conjugated|No|No|No|No|75%|00046110481|PREMARIN 1.25 MG TABLET|100|EA|2.74563|05/31/2005||Yes|No||05/31/2005||Yes|No|05/31/2005||Yes|No||||No|No|||Prescription required|No|||Yes|6.0942|01/11/2022|5.94793|01/11/2022|5.98755|01/11/2022||||549|||||No|No||WYETH/PFIZER|No||||
estrogens, conjugated|No|No|No|No|75%|00046110491|PREMARIN 1.25 MG TABLET|1000|EA|2.74555|09/16/2004||Yes|No||09/16/2004||Yes|No|||No|No||||No|No|||Prescription required|No|||Yes|6.0942|01/11/2022|5.94793|01/11/2022|5.98755|01/11/2022||||550|||||No|No||WYETH/PFIZER|No||||
estrogen,con/m-progest acet|No|No|No|No|75%|00046110511|PREMPRO 0.3 MG-1.5 MG TABLET|28|EA|3.4337|11/13/2009||Yes|No||11/13/2009||Yes|No|11/13/2009||Yes|No||||No|No|||Prescription required|No|||Yes|7.66762|01/11/2022|7.48359|01/11/2022|7.53343|01/11/2022||||551|||||No|No||WYETH/PFIZER|No||||
estrogen,con/m-progest acet|No|No|No|No|75%|00046110611|PREMPRO 0.45-1.5 MG TABLET|28|EA|3.4337|03/18/2010||Yes|No||03/18/2010||Yes|No|03/18/2010||Yes|No||||No|No|||Prescription required|No|||Yes|7.63618|01/11/2022|7.45291|01/11/2022|7.50254|01/11/2022||||552|||||No|No||WYETH/PFIZER|No||||
estrogen,con/m-progest acet|No|No|No|No|75%|00046110711|PREMPRO 0.625-2.5 MG TABLET|28|EA|3.4337|08/29/2011||Yes|No||08/29/2011||Yes|No|08/29/2011||Yes|No||||No|No|||Prescription required|No|||Yes|7.669|01/11/2022|7.48494|01/11/2022|7.53479|01/11/2022||||553|||||No|No||WYETH/PFIZER|No||||
estrogen,con/m-progest acet|No|No|No|No|75%|00046110811|PREMPRO 0.625-5 MG TABLET|28|EA|3.4337|01/27/2014||Yes|No||01/27/2014||Yes|No|01/27/2014||Yes|No||||No|No|||Prescription required|No|||Yes|7.70551|01/11/2022|7.52057|01/11/2022|7.57066|01/11/2022||||554|||||No|No||WYETH/PFIZER|No||||
ampicillin sodium/sulbactam Na|No|No|No|No|75%|00049001383|UNASYN 1.5 GM VIAL|1|EA|3.31616|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|7.55776|01/04/2022|7.44979|01/04/2022|7.09504|01/04/2022||||555|||||No|No||PFIZER US PHARM|No||||
ampicillin sodium/sulbactam Na|No|No|No|No|75%|00049001483|UNASYN 3 GM VIAL|1|EA|6.26166|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|14.27076|01/04/2022|14.06689|01/04/2022|13.39704|01/04/2022||||556|||||No|No||PFIZER US PHARM|No||||
ziprasidone HCl|No|No|No|No|75%|00049005260|GEODON 20 MG CAPSULE|60|EA|9.10116|01/24/2020|11/08/2022|Yes|No||01/24/2020|11/08/2022|Yes|No|01/24/2020|11/08/2022|Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|20.74219|01/12/2021|20.44587|01/12/2021|19.47226|01/12/2021|||ANTIPSYCHOTICS|557|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||PFIZER/VIATRIS|No||||
ziprasidone HCl|No|No|No|No|75%|00049005460|GEODON 40 MG CAPSULE|60|EA|9.54714|06/17/2019||Yes|No||06/17/2019||Yes|No|06/17/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|21.7586|03/22/2022|21.44776|03/22/2022|20.42644|03/22/2022|||ANTIPSYCHOTICS|558|||||No|No||PFIZER/VIATRIS|No||||
ziprasidone HCl|No|No|No|No|75%|00049005660|GEODON 60 MG CAPSULE|60|EA|11.04461|03/27/2020|11/08/2022|Yes|No||03/27/2020|11/08/2022|Yes|No|03/27/2020|11/08/2022|Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|25.17145|01/12/2021|24.81186|01/12/2021|23.63034|01/12/2021|||ANTIPSYCHOTICS|559|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||PFIZER/VIATRIS|No||||
ziprasidone HCl|No|No|No|No|75%|00049005860|GEODON 80 MG CAPSULE|60|EA|11.04461|03/27/2020|11/08/2022|Yes|No||03/27/2020|11/08/2022|Yes|No|03/27/2020|11/08/2022|Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|25.17145|01/12/2021|24.81186|01/12/2021|23.63034|01/12/2021|||ANTIPSYCHOTICS|560|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||PFIZER/VIATRIS|No||||
glipizide|No|No|No|No|75%|00049017001|GLUCOTROL XL 2.5 MG TABLET|30|EA|.1677|10/11/2013||Yes|No||10/11/2013||Yes|No|10/11/2013||Yes|No||10/11/2013||Yes|No|||Prescription required|No|||Yes|.3822|02/08/2022|.37674|02/08/2022|.3588|02/08/2022||||561|||||No|No||PFIZER US PHARM|No||||
glipizide|No|No|No|No|75%|00049017807|GLUCOTROL XL 10 MG TABLET|100|EA|.3053|10/11/2013||Yes|No||10/11/2013||Yes|No|10/11/2013||Yes|No||10/11/2013||Yes|No|||Prescription required|No|||No|.6958|02/08/2022|.68586|02/08/2022|.6532|02/08/2022||||562|||||No|No||PFIZER US PHARM|No||||
glipizide|No|No|No|No|75%|00049017808|GLUCOTROL XL 10 MG TABLET|500|EA|.3053|10/11/2013||Yes|No||10/11/2013||Yes|No|10/11/2013||Yes|No||10/11/2013||Yes|No|||Prescription required|No|||No|.6958|02/08/2022|.68586|02/08/2022|.6532|02/08/2022||||563|||||No|No||PFIZER US PHARM|No||||
penicillin G potassium|No|No|No|No|75%|00049052022|PFIZERPEN 5 MILLION UNIT VIAL|1|EA|5.47003|10/26/2009||Yes|No||10/26/2009||Yes|No|10/26/2009||Yes|No||||No|No|||Prescription required|No|||No|12.46658|01/05/2021|12.28848|01/05/2021|11.70332|01/05/2021||||564|||||No|No||PFIZER/NOVAPLUS|No||||
penicillin G potassium|No|No|No|No|75%|00049052083|PFIZERPEN 5 MILLION UNIT VIAL|1|EA|5.47003|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|12.46658|01/05/2021|12.28848|01/05/2021|11.70332|01/05/2021||||565|||||No|No||PFIZER US PHARM|No||||
penicillin G potassium|No|No|No|No|75%|00049053022|PFIZERPEN 20 MILLION UNIT VIAL|1|EA|21.8784|10/26/2009||Yes|No||10/26/2009||Yes|No|10/26/2009||Yes|No||||No|No|||Prescription required|No|||No|49.8624|01/05/2021|49.15008|01/05/2021|46.8096|01/05/2021||||566|||||No|No||PFIZER/NOVAPLUS|No||||
penicillin G potassium|No|No|No|No|75%|00049053028|PFIZERPEN 20 MILLION UNIT VIAL|1|EA|21.8784|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|49.8624|01/05/2021|49.15008|01/05/2021|46.8096|01/05/2021||||567|||||No|No||PFIZER US PHARM|No||||
eletriptan hydrobromide|No|No|No|No|75%|00049233045|RELPAX 20 MG TABLET|6|EA|30.9127|02/08/2010||Yes|No||02/08/2010||Yes|No|02/08/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|021|No|70.4522|03/22/2022|69.44574|03/22/2022|66.1388|03/22/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|568|||||No|No||PFIZER/VIATRIS|No||||
eletriptan hydrobromide|No|No|No|No|75%|00049234005|RELPAX 40 MG TABLET|12|EA|30.91233|07/15/2007||Yes|No||07/15/2007||Yes|No|07/15/2007||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|021|No|69.14556|03/29/2022|67.48606|03/29/2022|67.93551|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|569|||||No|No||PFIZER/VIATRIS|No||||
eletriptan hydrobromide|No|No|No|No|75%|00049234045|RELPAX 40 MG TABLET|6|EA|30.9127|02/08/2010||Yes|No||02/08/2010||Yes|No|02/08/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|021|No|69.14556|03/29/2022|67.48606|03/29/2022|67.93551|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|570|||||No|No||PFIZER/VIATRIS|No||||
doxazosin mesylate|No|No|No|No|75%|00049275066|CARDURA 1 MG TABLET|100|EA|2.20362|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|04/28/2004|003|Yes|5.0222|01/12/2021|4.95046|01/12/2021|4.71472|01/12/2021|||BPH TREATMENTS|571|||||No|No||PFIZER/VIATRIS|No||||
doxazosin mesylate|No|No|No|No|75%|00049276066|CARDURA 2 MG TABLET|100|EA|2.20362|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|04/28/2004|003|Yes|5.0222|01/12/2021|4.95046|01/12/2021|4.71472|01/12/2021|||BPH TREATMENTS|572|||||No|No||PFIZER/VIATRIS|No||||
doxazosin mesylate|No|No|No|No|75%|00049277066|CARDURA 4 MG TABLET|100|EA|2.31262|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|04/28/2004|003|Yes|5.27063|01/12/2021|5.19534|01/12/2021|4.94794|01/12/2021|||BPH TREATMENTS|573|||||No|No||PFIZER/VIATRIS|No||||
doxazosin mesylate|No|No|No|No|75%|00049278066|CARDURA 8 MG TABLET|100|EA|2.54744|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|04/28/2004|003|No|5.80581|03/22/2022|5.72287|03/22/2022|5.45035|03/22/2022|||BPH TREATMENTS|574|||||No|No||PFIZER/VIATRIS|No||||
voriconazole|No|No|No|No|75%|00049316044|VFEND 40 MG/ML SUSPENSION|75|ML|2.93896|05/10/2005||Yes|No||05/10/2005||Yes|No|05/10/2005||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|03/29/2004|069|No|6.6981|01/04/2022|6.60241|01/04/2022|6.28801|01/04/2022|||ANTIFUNGALS: ORAL|575|||||No|No||PFIZER US PHARM|No||||
voriconazole|No|No|No|No|75%|00049317030|VFEND 50 MG TABLET|30|EA|.64012|08/16/2002||Yes|No||08/16/2002||Yes|No|08/16/2002||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|03/29/2004|069|No|1.45888|01/04/2022|1.43804|01/04/2022|1.36956|01/04/2022|||ANTIFUNGALS: ORAL|576|||||No|No||PFIZER US PHARM|No||||
voriconazole|No|No|No|No|75%|00049318030|VFEND 200 MG TABLET|30|EA|1.60117|10/09/2003||Yes|No||10/09/2003||Yes|No|10/09/2003||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|03/29/2004|069|No|3.64918|01/04/2022|3.59705|01/04/2022|3.42576|01/04/2022|||ANTIFUNGALS: ORAL|577|||||No|No||PFIZER US PHARM|No||||
voriconazole|No|No|No|No|75%|00049319028|VFEND IV 200 MG VIAL|1|EA|64.4742|08/16/2002||Yes|No||08/16/2002||Yes|No|08/16/2002||Yes|No||||No|No|||Prescription required|No|||No|146.9412|01/05/2021|144.84204|01/05/2021|137.9448|01/05/2021||||578|||||No|No||PFIZER US PHARM|No||||
fluconazole|No|No|No|No|75%|00049341030|DIFLUCAN 50 MG TABLET|30|EA|.48905|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|07/12/2005|069|No|1.11458|01/04/2022|1.09866|01/04/2022|1.04634|01/04/2022|||ANTIFUNGALS: ORAL|579|||||No|No||PFIZER US PHARM|No||||
fluconazole|No|No|No|No|75%|00049342030|DIFLUCAN 100 MG TABLET|30|EA|.4879|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|07/12/2005|069|No|1.11196|01/04/2022|1.09608|01/04/2022|1.04388|01/04/2022|||ANTIFUNGALS: ORAL|580|||||No|No||PFIZER US PHARM|No||||
fluconazole|No|No|No|No|75%|00049343030|DIFLUCAN 200 MG TABLET|30|EA|26.9147|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|07/12/2005|069|No|61.34048|01/04/2022|60.46419|01/04/2022|57.58494|01/04/2022|||ANTIFUNGALS: ORAL|581|||||No|No||PFIZER US PHARM|No||||
fluconazole|No|No|No|No|75%|00049344019|DIFLUCAN 10 MG/ML SUSPENSION|35|ML|.20922|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/12/2005|069|No|.47683|01/04/2022|.47002|01/04/2022|.44764|01/04/2022|||ANTIFUNGALS: ORAL|582|||||No|No||PFIZER US PHARM|No||||
fluconazole|No|No|No|No|75%|00049345019|DIFLUCAN 40 MG/ML SUSPENSION|35|ML|.34535|08/22/2009||Yes|No||08/22/2009||Yes|No|08/22/2009||Yes|No||||No|No|||Prescription required|Yes|07/12/2005|069|No|.78707|01/04/2022|.77583|01/04/2022|.73888|01/04/2022|||ANTIFUNGALS: ORAL|583|||||No|No||PFIZER US PHARM|No||||
fluconazole|Yes|No|No|No|75%|00049350079|DIFLUCAN 150 MG TABLET|1|EA|26.17732|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|11/01/2012||Prescription required|Yes|07/12/2005|069|No|59.65995|01/04/2022|58.80766|01/04/2022|56.0073|01/04/2022|||ANTIFUNGALS: ORAL|584|||||No|No||PFIZER US PHARM|No||||
ziprasidone mesylate|No|No|No|No|75%|00049392083|GEODON 20 MG/ML VIAL|1|EA|24.65921|11/04/2010||Yes|No||11/04/2010||Yes|No|11/04/2010||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|027|Yes|56.20006|03/22/2022|55.3972|03/22/2022|52.75924|03/22/2022|||ANTIPSYCHOTICS|585|||||No|No||PFIZER/VIATRIS|No||||
glipizide|No|No|No|No|75%|00049412066|GLUCOTROL 10 MG TABLET|100|EA|1.33218|03/01/2002|01/31/2022|Yes|No||03/01/2002|01/31/2022|Yes|No|03/01/2002|01/31/2022|Yes|No||03/01/2002|01/31/2022|Yes|No|||Prescription required|No|||No|3.03613|01/12/2021|2.99276|01/12/2021|2.85025|01/12/2021||||586|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||PFIZER US PHARM|No||||
sertraline HCl|No|No|No|No|75%|00049490030|ZOLOFT 50 MG TABLET|30|EA|5.53524|11/28/2005||Yes|No||11/28/2005||Yes|No|11/28/2005||Yes|No||||No|No|||Prescription required|Yes|01/23/2007|008|Yes|12.3778|03/29/2022|12.08073|03/29/2022|12.16118|03/29/2022|||ANTIDEPRESSANTS: SSRIs|587|||||No|No||PFIZER/VIATRIS|No||||
sertraline HCl|No|No|No|No|75%|00049490041|ZOLOFT 50 MG TABLET|100|EA|5.53551|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/23/2007|008|Yes|12.3778|03/29/2022|12.08073|03/29/2022|12.16118|03/29/2022|||ANTIDEPRESSANTS: SSRIs|588|||||No|No||PFIZER/VIATRIS|No||||
sertraline HCl|No|No|No|No|75%|00049491030|ZOLOFT 100 MG TABLET|30|EA|5.53524|11/28/2005||Yes|No||11/28/2005||Yes|No|11/28/2005||Yes|No||||No|No|||Prescription required|Yes|01/23/2007|008|No|12.29053|03/29/2022|11.99555|03/29/2022|12.07544|03/29/2022|||ANTIDEPRESSANTS: SSRIs|589|||||No|No||PFIZER/VIATRIS|No||||
sertraline HCl|No|No|No|No|75%|00049491041|ZOLOFT 100 MG TABLET|100|EA|5.53551|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/23/2007|008|No|12.29053|03/29/2022|11.99555|03/29/2022|12.07544|03/29/2022|||ANTIDEPRESSANTS: SSRIs|590|||||No|No||PFIZER/VIATRIS|No||||
sertraline HCl|No|No|No|No|75%|00049496030|ZOLOFT 25 MG TABLET|30|EA|5.53524|11/28/2005||Yes|No||11/28/2005||Yes|No|11/28/2005||Yes|No||||No|No|||Prescription required|Yes|01/23/2007|008|Yes|12.6152|03/22/2022|12.43498|03/22/2022|11.84284|03/22/2022|||ANTIDEPRESSANTS: SSRIs|591|||||No|No||PFIZER/VIATRIS|No||||
testosterone|No|No|No|No|90%|00051842530|ANDROGEL 1% (25 MG/2.5 G) PKT|2.5|GM|3.57226|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|084|No|8.14144|01/29/2019|8.02514|01/29/2019|7.64299|01/29/2019|||ANDROGENIC AGENTS|592|||||No|No||ABBVIE US LLC|No||||
testosterone|No|No|No|No|90%|00051845030|ANDROGEL 1% (50 MG/5 G) PKT|5|GM|1.83578|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|084|No|4.06934|07/27/2021|3.97167|07/27/2021|3.99812|07/27/2021|||ANDROGENIC AGENTS|593|||||No|No||ABBVIE US LLC|No||||
testosterone|No|No|No|No|90%|00051846230|ANDROGEL 1.62%(2.5G) GEL PCKT|2.5|GM|3.67145|01/11/2013||Yes|No||01/11/2013||Yes|No|01/11/2013||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|084|No|8.36749|07/27/2021|8.24795|07/27/2021|7.85519|07/27/2021|||ANDROGENIC AGENTS|594|||||No|No||ABBVIE US LLC|No||||
testosterone|No|No|No|No|90%|00051846231|ANDROGEL 1.62%(1.25G) GEL PCKT|1.25|GM|7.1443|01/11/2013||Yes|No||01/11/2013||Yes|No|01/11/2013||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|084|No|16.28236|10/29/2019|16.04976|10/29/2019|15.28548|10/29/2019|||ANDROGENIC AGENTS|595|||||No|No||ABBVIE US LLC|No||||
testosterone|No|No|No|No|90%|00051846233|ANDROGEL 1.62% GEL PUMP|75|GM|3.56074|05/23/2011||Yes|No||05/23/2011||Yes|No|05/23/2011||Yes|No||||No|No|||Prescription required|No||084|No|7.9352|03/01/2022|7.74475|03/01/2022|7.79633|03/01/2022|||ANDROGENIC AGENTS|596|||||No|No||ABBVIE US LLC|No||||
mirtazapine|No|No|No|No|75%|00052010630|REMERON 15 MG SOLTAB|30|EA|1.8275|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/10/2005|031|Yes|4.165|10/09/2018|4.1055|10/09/2018|3.91|10/09/2018|||ANTIDEPRESSANTS: OTHER|597|||||No|No||MERCK SHARP & D|No||||
mirtazapine|No|No|No|No|75%|00052010830|REMERON 30 MG SOLTAB|30|EA|1.8834|06/22/2006||Yes|No||06/22/2006||Yes|No|06/22/2006||Yes|No||||No|No|||Prescription required|Yes|01/10/2005|031|No|4.2924|10/09/2018|4.23108|10/09/2018|4.0296|10/09/2018|||ANTIDEPRESSANTS: OTHER|598|||||No|No||MERCK SHARP & D|No||||
mirtazapine|No|No|No|No|75%|00052011030|REMERON 45 MG SOLTAB|30|EA|2.0038|06/22/2006||Yes|No||06/22/2006||Yes|No|06/22/2006||Yes|No||||No|No|||Prescription required|Yes|01/10/2005|031|No|4.5668|10/09/2018|4.50156|10/09/2018|4.2872|10/09/2018|||ANTIDEPRESSANTS: OTHER|599|||||No|No||MERCK SHARP & D|No||||
etonogestrel/ethinyl estradiol|Yes|Yes|No|No|75%|00052027301|NUVARING VAGINAL RING|1|EA|69.9309|01/23/2007||Yes|No||01/23/2007||Yes|No|||No|No||||No|No|11/01/2012||Prescription required|No|||No|156.19036|12/21/2021|152.44179|12/21/2021|153.45702|12/21/2021||||600|||||No|No||MERCK SHARP & D|No|||Only covered for non-contraceptive (medical) purposes|
etonogestrel/ethinyl estradiol|Yes|Yes|No|No|75%|00052027303|NUVARING VAGINAL RING|1|EA|69.9309|01/23/2007||Yes|No||01/23/2007||Yes|No|||No|No||||No|No|11/01/2012||Prescription required|No|||No|156.19036|12/21/2021|152.44179|12/21/2021|153.45702|12/21/2021||||601|||||No|No||MERCK SHARP & D|No|||Only covered for non-contraceptive (medical) purposes|
etonogestrel|Yes|Yes|No|No|75%|00052433001|NEXPLANON 68 MG IMPLANT|1|EA|443.1752|01/07/2016||Yes|No||||No|No|||No|No||||No|No|01/07/2016||Prescription required|No|||No|1010.0272|08/24/2021|995.59824|08/24/2021|948.1888|08/24/2021||||602|||||Yes|No||MERCK SHARP & D|No||||
mirtazapine|No|No|No|No|75%|00052436401|REMERON 15 MG TABLET|30|EA|2.2962|06/09/2020||Yes|No||06/09/2020||Yes|No|06/09/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|031|Yes|5.2332|06/09/2020|5.15844|06/09/2020|4.9128|06/09/2020|||ANTIDEPRESSANTS: OTHER|603|||||No|No||MERCK SHARP & D|No||||
mirtazapine|No|No|No|No|75%|00052436501|REMERON 30 MG TABLET|30|EA|2.365|06/09/2020||Yes|No||06/09/2020||Yes|No|06/09/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|031|No|5.39|06/09/2020|5.313|06/09/2020|5.06|06/09/2020|||ANTIDEPRESSANTS: OTHER|604|||||No|No||MERCK SHARP & D|No||||
desmopressin acetate|No|No|No|No|75%|00053687100|STIMATE 1.5 MG/ML NASAL SPRAY|2.5|ML|125.904|08/06/2021||Yes|No||08/06/2021||Yes|No|08/06/2021||Yes|No||||No|No|||Prescription required|No|||No|286.944|10/03/2019|282.8448|10/03/2019|269.376|10/03/2019||||605|||||No|No||CSL BEHRING LLC|No||||
alpha-1-proteinase inhibitor|No|No|No|No|75%|00053720102|ZEMAIRA 1,000 MG VIAL|1|EA|.2279|12/02/2004||Yes|No||12/02/2004||Yes|No|12/02/2004||Yes|No||||No|No|||Prescription required|No|||No|.5194|10/13/2020|.51198|10/13/2020|.4876|10/13/2020||||606|||||No|No||CSL BEHRING LLC|No||||
calcitriol|No|No|No|No|75%|00054000713|CALCITRIOL 0.25 MCG CAPSULE|30|EA|.44017|10/23/2007||Yes|No||10/23/2007||Yes|No|10/23/2007||Yes|No||10/23/2007||Yes|No|||Prescription required|No|||No|.18695|03/29/2022|.18246|03/29/2022|.18367|03/29/2022||||607|||||No|No||WEST-WARD/HIKMA|No||||
calcitriol|No|No|No|No|75%|00054000725|CALCITRIOL 0.25 MCG CAPSULE|100|EA|.40673|10/23/2007||Yes|No||10/23/2007||Yes|No|10/23/2007||Yes|No||10/23/2007||Yes|No|||Prescription required|No|||No|.18695|03/29/2022|.18246|03/29/2022|.18367|03/29/2022||||608|||||No|No||WEST-WARD/HIKMA|No||||
flecainide acetate|No|No|No|No|75%|00054001021|FLECAINIDE ACETATE 50 MG TAB|60|EA|.24682|03/01/2004||Yes|No||03/01/2004||Yes|No|03/01/2004||Yes|No||||No|No|||Prescription required|No|||No|.15465|03/29/2022|.15093|03/29/2022|.15194|03/29/2022||||609|||||No|No||WEST-WARD/HIKMA|No||||
flecainide acetate|No|No|No|No|75%|00054001025|FLECAINIDE ACETATE 50 MG TAB|100|EA|.24682|03/01/2004||Yes|No||03/01/2004||Yes|No|03/01/2004||Yes|No||||No|No|||Prescription required|No|||No|.15465|03/29/2022|.15093|03/29/2022|.15194|03/29/2022||||610|||||No|No||WEST-WARD/HIKMA|No||||
flecainide acetate|No|No|No|No|75%|00054001121|FLECAINIDE ACETATE 100 MG TAB|60|EA|.40334|03/01/2004||Yes|No||03/01/2004||Yes|No|03/01/2004||Yes|No||||No|No|||Prescription required|No|||No|.24778|03/29/2022|.24183|03/29/2022|.24344|03/29/2022||||611|||||No|No||WEST-WARD/HIKMA|No||||
flecainide acetate|No|No|No|No|75%|00054001125|FLECAINIDE ACETATE 100 MG TAB|100|EA|.40334|03/01/2004||Yes|No||03/01/2004||Yes|No|03/01/2004||Yes|No||||No|No|||Prescription required|No|||No|.24778|03/29/2022|.24183|03/29/2022|.24344|03/29/2022||||612|||||No|No||WEST-WARD/HIKMA|No||||
flecainide acetate|No|No|No|No|75%|00054001221|FLECAINIDE ACETATE 150 MG TAB|60|EA|.55405|03/01/2004||Yes|No||03/01/2004||Yes|No|03/01/2004||Yes|No||||No|No|||Prescription required|No|||No|.41264|03/29/2022|.40273|03/29/2022|.40541|03/29/2022||||613|||||No|No||ROXANE/WEST-WAR|No||||
flecainide acetate|No|No|No|No|75%|00054001225|FLECAINIDE ACETATE 150 MG TAB|100|EA|.55405|03/01/2004||Yes|No||03/01/2004||Yes|No|03/01/2004||Yes|No||||No|No|||Prescription required|No|||No|.41264|03/29/2022|.40273|03/29/2022|.40541|03/29/2022||||614|||||No|No||WEST-WARD/HIKMA|No||||
prednisone|No|No|No|No|75%|00054001720|PREDNISONE 10 MG TABLET|100|EA|.09184|12/30/2010||Yes|No||12/30/2010||Yes|No|12/30/2010||Yes|No||12/30/2010||Yes|No|||Prescription required|No||168|Yes|.07092|03/29/2022|.06921|03/29/2022|.06967|03/29/2022|||GLUCOCORTICOIDS: ORAL|615|||||No|No||WEST-WARD/HIKMA|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00054001725|PREDNISONE 10 MG TABLET|100|EA|.0835|03/21/2005|04/30/2022|Yes|No||03/21/2005|04/30/2022|Yes|No|03/21/2005|04/30/2022|Yes|No||03/21/2005|04/30/2022|Yes|No|||Prescription required|No||168|Yes|.07092|03/29/2022|.06921|03/29/2022|.06967|03/29/2022|||GLUCOCORTICOIDS: ORAL|616|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||WEST-WARD/HIKMA|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00054001729|PREDNISONE 10 MG TABLET|500|EA|.08267|01/26/2005|09/30/2022|Yes|No||01/26/2005|09/30/2022|Yes|No|01/26/2005|09/30/2022|Yes|No||01/26/2005|09/30/2022|Yes|No|||Prescription required|No||168|Yes|.07092|03/29/2022|.06921|03/29/2022|.06967|03/29/2022|||GLUCOCORTICOIDS: ORAL|617|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||WEST-WARD/HIKMA|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00054001820|PREDNISONE 20 MG TABLET|100|EA|.09799|12/30/2010||Yes|No||12/30/2010||Yes|No|12/30/2010||Yes|No||12/30/2010||Yes|No|||Prescription required|No||168|Yes|.11229|03/29/2022|.10959|03/29/2022|.11032|03/29/2022|||GLUCOCORTICOIDS: ORAL|618|||||No|No||WEST-WARD/HIKMA|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00054001825|PREDNISONE 20 MG TABLET|100|EA|.08909|01/26/2005||Yes|No||01/26/2005||Yes|No|01/26/2005||Yes|No||01/26/2005||Yes|No|||Prescription required|No||168|Yes|.11229|03/29/2022|.10959|03/29/2022|.11032|03/29/2022|||GLUCOCORTICOIDS: ORAL|619|||||No|No||WEST-WARD/HIKMA|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00054001829|PREDNISONE 20 MG TABLET|500|EA|.0882|01/26/2005||Yes|No||01/26/2005||Yes|No|01/26/2005||Yes|No||01/26/2005||Yes|No|||Prescription required|No||168|Yes|.11229|03/29/2022|.10959|03/29/2022|.11032|03/29/2022|||GLUCOCORTICOIDS: ORAL|620|||||No|No||WEST-WARD/HIKMA|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00054001920|PREDNISONE 50 MG TABLET|100|EA|.14405|06/03/2020||Yes|No||06/03/2020||Yes|No|06/03/2020||Yes|No||06/03/2020||Yes|No|||Prescription required|No||168|Yes|.26795|03/29/2022|.26151|03/29/2022|.26326|03/29/2022|||GLUCOCORTICOIDS: ORAL|621|||||No|No||ROXANE/WEST-WAR|No||||
prednisone|No|No|No|No|75%|00054001925|PREDNISONE 50 MG TABLET|100|EA|.14|01/26/2005||Yes|No||01/26/2005||Yes|No|01/26/2005||Yes|No||01/26/2005||Yes|No|||Prescription required|No||168|Yes|.26795|03/29/2022|.26151|03/29/2022|.26326|03/29/2022|||GLUCOCORTICOIDS: ORAL|622|||||No|No||ROXANE/WEST-WAR|Yes|09/01/2020|||
lithium carbonate|No|No|No|No|75%|00054002025|LITHIUM CARBONATE ER 450 MG TB|100|EA|.18472|03/01/2004||Yes|No||03/01/2004||Yes|No|03/01/2004||Yes|No||||No|No|||Prescription required|No|||No|.16553|03/29/2022|.16155|03/29/2022|.16263|03/29/2022||||623|||||No|No||ROXANE/WEST-WAR|No||||
lithium carbonate|No|No|No|No|75%|00054002125|LITHIUM CARBONATE ER 300 MG TB|100|EA|.14349|01/12/2005||Yes|No||01/12/2005||Yes|No|01/12/2005||Yes|No||||No|No|||Prescription required|No|||No|.12646|03/29/2022|.12342|03/29/2022|.12424|03/29/2022||||624|||||No|No||ROXANE/WEST-WAR|No||||
lithium carbonate|No|No|No|No|75%|00054002129|LITHIUM CARBONATE ER 300 MG TB|500|EA|.16002|01/12/2005||Yes|No||01/12/2005||Yes|No|01/12/2005||Yes|No||||No|No|||Prescription required|No|||No|.12646|03/29/2022|.12342|03/29/2022|.12424|03/29/2022||||625|||||No|No||ROXANE/WEST-WAR|No||||
cilostazol|No|No|No|No|75%|00054002821|CILOSTAZOL 50 MG TABLET|60|EA|.13559|08/16/2005|10/31/2022|Yes|No||08/16/2005|10/31/2022|Yes|No|08/16/2005|10/31/2022|Yes|No||||No|No|||Prescription required|No|||No|.11608|03/29/2022|.11329|03/29/2022|.11404|03/29/2022||||626|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||WEST-WARD/HIKMA|No||||
cilostazol|No|No|No|No|75%|00054004421|CILOSTAZOL 100 MG TABLET|60|EA|.15365|08/16/2005|09/30/2022|Yes|No||08/16/2005|09/30/2022|Yes|No|08/16/2005|09/30/2022|Yes|No||||No|No|||Prescription required|No|||No|.13507|03/29/2022|.13182|03/29/2022|.1327|03/29/2022||||627|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ROXANE/WEST-WAR|No||||
cilostazol|No|No|No|No|75%|00054004429|CILOSTAZOL 100 MG TABLET|500|EA|.15365|08/13/2008|07/31/2022|Yes|No||08/13/2008|07/31/2022|Yes|No|08/13/2008|07/31/2022|Yes|No||||No|No|||Prescription required|No|||No|.13507|03/29/2022|.13182|03/29/2022|.1327|03/29/2022||||628|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ROXANE/WEST-WAR|No||||
ipratropium bromide|No|No|No|No|75%|00054004544|IPRATROPIUM 0.03% SPRAY|30|ML|.516|03/01/2004||Yes|No||03/01/2004||Yes|No|03/01/2004||Yes|No||||No|No|||Prescription required|Yes|07/12/2005|019|No|.75257|03/29/2022|.7345|03/29/2022|.7394|03/29/2022|||INTRANASAL RHINITIS AGENTS|629|||||No|No||ROXANE/WEST-WAR|Yes|09/01/2020|||
ipratropium bromide|No|No|No|No|75%|00054004641|IPRATROPIUM 0.06% SPRAY|15|ML|1.032|03/01/2004||Yes|No||03/01/2004||Yes|No|03/01/2004||Yes|No||||No|No|||Prescription required|Yes|07/12/2005|019|No|1.39746|03/29/2022|1.36392|03/29/2022|1.373|03/29/2022|||INTRANASAL RHINITIS AGENTS|630|||||No|No||WEST-WARD/HIKMA|Yes|09/01/2020|||
digoxin|No|No|No|No|75%|00054005746|DIGOXIN 0.05 MG/ML SOLUTION|60|ML|1.00333|02/09/2005||Yes|No||02/09/2005||Yes|No|02/09/2005||Yes|No||02/09/2005||Yes|No|||Prescription required|No|||No|1.9807|03/29/2022|1.93316|03/29/2022|1.94603|03/29/2022||||631|||||No|No||WEST-WARD/HIKMA|No||||
citalopram hydrobromide|Yes|No|No|No|75%|00054006258|CITALOPRAM HBR 10 MG/5 ML SOLN|240|ML|.14333|05/16/2006||Yes|No||05/16/2006||Yes|No|05/16/2006||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.26239|01/25/2022|.25609|01/25/2022|.25779|01/25/2022|||ANTIDEPRESSANTS: SSRIs|632|||||No|No||ROXANE/WEST-WAR|No||||
risperidone|No|No|No|No|75%|00054006344|RISPERIDONE 1 MG/ML SOLUTION|30|ML|.43|07/30/2009||Yes|No||07/30/2009||Yes|No|07/30/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.33084|03/29/2022|.32289|03/29/2022|.32505|03/29/2022|||ANTIPSYCHOTICS|633|||||No|No||ROXANE/WEST-WAR|No||||
ondansetron HCl|No|No|No|No|75%|00054006447|ONDANSETRON 4 MG/5 ML SOLUTION|50|ML|.72188|05/23/2007||Yes|No||05/23/2007||Yes|No|05/23/2007||Yes|No||||No|No|||Prescription required|No||085|No|.25985|03/29/2022|.25361|03/29/2022|.2553|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|634|||||No|No||ROXANE/WEST-WAR|No||||
torsemide|No|No|No|No|75%|00054007725|TORSEMIDE 20 MG TABLET|100|EA|.09193|10/04/2005||Yes|No||10/04/2005||Yes|No|10/04/2005||Yes|No||10/04/2005||Yes|No|||Prescription required|No|||No|.08257|03/29/2022|.08058|03/29/2022|.08112|03/29/2022||||635|||||No|No||ROXANE/WEST-WAR|No||||
torsemide|No|No|No|No|75%|00054007729|TORSEMIDE 20 MG TABLET|500|EA|.26382|10/13/2006||Yes|No||10/13/2006||Yes|No|10/13/2006||Yes|No||10/13/2006||Yes|No|||Prescription required|No|||No|.08257|03/29/2022|.08058|03/29/2022|.08112|03/29/2022||||636|||||No|No||ROXANE/WEST-WAR|No||||
balsalazide disodium|No|No|No|No|75%|00054007928|BALSALAZIDE DISODIUM 750 MG CP|280|EA|.32403|05/30/2008||Yes|No||05/30/2008||Yes|No|05/30/2008||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|010|No|.43814|03/29/2022|.42762|03/29/2022|.43047|03/29/2022|||ULCERATIVE COLITIS AGENTS|637|||||No|No||WEST-WARD/HIKMA|No||||
exemestane|No|No|No|No|75%|00054008013|EXEMESTANE 25 MG TABLET|30|EA|4.66951|06/06/2011||Yes|No||06/06/2011||Yes|No|06/06/2011||Yes|No||||No|No|||Prescription required|No||502|No|1.32315|03/29/2022|1.29139|03/29/2022|1.29999|03/29/2022|||ONCOLOGY: ORAL - BREAST|638|||||No|No||ROXANE/WEST-WAR|No||||
zaleplon|No|No|No|No|90%|00054008425|ZALEPLON 5 MG CAPSULE|100|EA|.172|07/16/2008||Yes|No||07/16/2008||Yes|No|07/16/2008||Yes|No||||No|No|||Prescription required|No||054|Yes|.1639|03/29/2022|.15996|03/29/2022|.16103|03/29/2022|||SEDATIVE HYPNOTICS|639|||||No|No||WEST-WARD/HIKMA|No||||
zaleplon|No|No|No|No|90%|00054008525|ZALEPLON 10 MG CAPSULE|100|EA|.1806|07/16/2008||Yes|No||07/16/2008||Yes|No|07/16/2008||Yes|No||||No|No|||Prescription required|No||054|Yes|.18241|03/29/2022|.17803|03/29/2022|.17921|03/29/2022|||SEDATIVE HYPNOTICS|640|||||No|No||WEST-WARD/HIKMA|No||||
calcium acetate|No|No|No|No|75%|00054008813|CALCIUM ACETATE 667 MG CAPSULE|30|EA|.35217|05/23/2014||Yes|No||05/23/2014||Yes|No|05/23/2014||Yes|No||05/23/2014||Yes|No|||Prescription required|No||052|Yes|.28113|03/29/2022|.27438|03/29/2022|.27621|03/29/2022|||PHOSPHATE BINDERS|641|||||No|No||WEST-WARD/HIKMA|No||||
calcium acetate|No|No|No|No|75%|00054008826|CALCIUM ACETATE 667 MG CAPSULE|200|EA|.24447|12/09/2008||Yes|No||12/09/2008||Yes|No|12/09/2008||Yes|No||12/09/2008||Yes|No|||Prescription required|No||052|Yes|.28113|03/29/2022|.27438|03/29/2022|.27621|03/29/2022|||PHOSPHATE BINDERS|642|||||No|No||WEST-WARD/HIKMA|No||||
perindopril erbumine|Yes|No|No|No|75%|00054011025|PERINDOPRIL ERBUMINE 2 MG TAB|100|EA|.26862|11/12/2009||Yes|No||11/12/2009||Yes|No|11/12/2009||Yes|No||||No|No|07/01/2016||Prescription required|Yes|02/10/2009|113|No|.6122|06/01/2016|.60346|06/01/2016|.57472|06/01/2016|||ANGIOTENSIN MODULATORS|643|||||No|No||WEST-WARD/HIKMA|No||||
perindopril erbumine|Yes|No|No|No|75%|00054011125|PERINDOPRIL ERBUMINE 4 MG TAB|100|EA|.28457|11/12/2009||Yes|No||11/12/2009||Yes|No|11/12/2009||Yes|No||||No|No|07/01/2016||Prescription required|Yes|02/10/2009|113|No|.48097|07/27/2021|.46942|07/27/2021|.47255|07/27/2021|||ANGIOTENSIN MODULATORS|644|||||No|No||WEST-WARD/HIKMA|No||||
losartan potassium|Yes|No|No|No|75%|00054012322|LOSARTAN POTASSIUM 25 MG TAB|90|EA|.1696|08/24/2019|06/30/2022|Yes|No||08/24/2019|06/30/2022|Yes|No|08/24/2019|06/30/2022|Yes|No||08/24/2019|06/30/2022|Yes|No|08/24/2019|06/30/2022|Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|645|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||WEST-WARD/HIKMA|No||||
galantamine HBr|No|No|No|No|75%|00054013749|GALANTAMINE 4 MG/ML ORAL SOLN|100|ML|1.28845|08/26/2009||Yes|No||08/26/2009||Yes|No|08/26/2009||Yes|No||||No|No|||Prescription required|Yes|07/22/2009|011|No|2.93647|06/01/2016|2.89452|06/01/2016|2.75668|06/01/2016|||ALZHEIMER'S AGENTS|646|||||No|No||ROXANE/WEST-WAR|No||||
acarbose|No|No|No|No|75%|00054014025|ACARBOSE 25 MG TABLET|100|EA|.19995|01/13/2009||Yes|No||01/13/2009||Yes|No|01/13/2009||Yes|No||||No|No|||Prescription required|No|||No|.17861|03/29/2022|.17432|03/29/2022|.17548|03/29/2022||||647|||||No|No||ROXANE/WEST-WAR|No||||
acarbose|No|No|No|No|75%|00054014125|ACARBOSE 50 MG TABLET|100|EA|.2193|01/13/2009||Yes|No||01/13/2009||Yes|No|01/13/2009||Yes|No||||No|No|||Prescription required|No|||No|.19141|03/29/2022|.18681|03/29/2022|.18806|03/29/2022||||648|||||No|No||ROXANE/WEST-WAR|No||||
acarbose|No|No|No|No|75%|00054014225|ACARBOSE 100 MG TABLET|100|EA|.26015|01/13/2009||Yes|No||01/13/2009||Yes|No|01/13/2009||Yes|No||||No|No|||Prescription required|No|||No|.31919|03/29/2022|.31152|03/29/2022|.3136|03/29/2022||||649|||||No|No||ROXANE/WEST-WAR|No||||
mycophenolate mofetil|No|No|No|No|75%|00054016325|MYCOPHENOLATE 250 MG CAPSULE|100|EA|.23508|09/23/2009||Yes|No||09/23/2009||Yes|No|09/23/2009||Yes|No||09/23/2009||Yes|No|||Prescription required|No||229|No|.2129|03/29/2022|.20779|03/29/2022|.20917|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|650|||||No|No||ROXANE/WEST-WAR|No||||
mycophenolate mofetil|No|No|No|No|75%|00054016329|MYCOPHENOLATE 250 MG CAPSULE|500|EA|.22332|09/23/2009||Yes|No||09/23/2009||Yes|No|09/23/2009||Yes|No||09/23/2009||Yes|No|||Prescription required|No||229|No|.2129|03/29/2022|.20779|03/29/2022|.20917|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|651|||||No|No||ROXANE/WEST-WAR|No||||
mycophenolate mofetil|No|No|No|No|75%|00054016625|MYCOPHENOLATE 500 MG TABLET|100|EA|.47304|09/23/2009||Yes|No||09/23/2009||Yes|No|09/23/2009||Yes|No||09/23/2009||Yes|No|||Prescription required|No||229|No|.30426|03/29/2022|.29695|03/29/2022|.29893|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|652|||||No|No||ROXANE/WEST-WAR|No||||
mycophenolate mofetil|No|No|No|No|75%|00054016629|MYCOPHENOLATE 500 MG TABLET|500|EA|.4494|09/23/2009||Yes|No||09/23/2009||Yes|No|09/23/2009||Yes|No||09/23/2009||Yes|No|||Prescription required|No||229|No|.30426|03/29/2022|.29695|03/29/2022|.29893|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|653|||||No|No||ROXANE/WEST-WAR|No||||
buprenorphine HCl|No|No|No|No|90%|00054017613|BUPRENORPHINE 2 MG TABLET SL|30|EA|.645|05/11/2010||Yes|No||05/11/2010||Yes|No|05/11/2010||Yes|No||||No|No|||Prescription required|No||145|Yes|.37925|03/29/2022|.37014|03/29/2022|.37261|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|654|||||No|No||WEST-WARD/HIKMA|Yes|09/01/2020|||
buprenorphine HCl|No|No|No|No|90%|00054017713|BUPRENORPHINE 8 MG TABLET SL|30|EA|.78116|05/11/2010||Yes|No||05/11/2010||Yes|No|05/11/2010||Yes|No||||No|No|||Prescription required|No||145|Yes|.77298|03/29/2022|.75442|03/29/2022|.75945|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|655|||||No|No||WEST-WARD/HIKMA|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00054018813|BUPRENORPHINE-NALOX 2-0.5MG TB|30|EA|.79636|11/07/2014||Yes|No||11/07/2014||Yes|No|11/07/2014||Yes|No||||No|No|||Prescription required|No||145|Yes|.72296|03/29/2022|.7056|03/29/2022|.7103|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|656|||||No|No||WEST-WARD/HIKMA|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00054018913|BUPRENORPHINE-NALOX 8-2 MG TAB|30|EA|.9556|11/07/2014||Yes|No||11/07/2014||Yes|No|11/07/2014||Yes|No||||No|No|||Prescription required|No||145|Yes|1.08568|03/29/2022|1.05962|03/29/2022|1.06668|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|657|||||No|No||WEST-WARD/HIKMA|Yes|09/01/2020|||
protriptyline HCl|No|No|No|No|75%|00054021025|PROTRIPTYLINE HCL 5 MG TABLET|100|EA|2.05432|01/13/2009||Yes|No||01/13/2009||Yes|No|01/13/2009||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|4.68195|03/01/2022|4.61506|03/01/2022|4.3953|03/01/2022|||ANTIDEPRESSANTS: TRICYCLIC|658|||||No|No||ROXANE/WEST-WAR|No||||
protriptyline HCl|No|No|No|No|75%|00054021125|PROTRIPTYLINE HCL 10 MG TABLET|100|EA|2.05432|01/13/2009||Yes|No||01/13/2009||Yes|No|01/13/2009||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|3.06317|01/25/2022|2.98965|01/25/2022|3.00956|01/25/2022|||ANTIDEPRESSANTS: TRICYCLIC|659|||||No|No||ROXANE/WEST-WAR|No||||
morphine sulfate|No|No|No|No|90%|00054023525|MORPHINE SULFATE IR 15 MG TAB|100|EA|.1858|08/04/2008||Yes|No||08/04/2008||Yes|No|08/04/2008||Yes|No||||No|No|||Prescription required|No||109|Yes|.29802|03/29/2022|.29086|03/29/2022|.2928|03/29/2022|||ANALGESICS: NARCOTICS SHORT|660|||||No|No||WEST-WARD/HIKMA|No||||
morphine sulfate|No|No|No|No|90%|00054023625|MORPHINE SULFATE IR 30 MG TAB|100|EA|.31617|08/04/2008||Yes|No||08/04/2008||Yes|No|08/04/2008||Yes|No||||No|No|||Prescription required|No||109|Yes|.43937|03/29/2022|.42882|03/29/2022|.43168|03/29/2022|||ANALGESICS: NARCOTICS SHORT|661|||||No|No||ROXANE/WEST-WAR|No||||
morphine sulfate|No|No|No|No|90%|00054023749|MORPHINE SULF 10 MG/5 ML SOLN|100|ML|.03917|06/26/2020||Yes|No||06/26/2020||Yes|No|06/26/2020||Yes|No||||No|No|||Prescription required|No||109|Yes|.08934|10/26/2021|.08719|10/26/2021|.08777|10/26/2021|||ANALGESICS: NARCOTICS SHORT|662|||||No|No||ROXANE/WEST-WAR|No||||
morphine sulfate|No|No|No|No|90%|00054023763|MORPHINE SULF 10 MG/5 ML SOLN|500|ML|.0198|08/04/2008||Yes|No||08/04/2008||Yes|No|08/04/2008||Yes|No||||No|No|||Prescription required|No||109|Yes|.04513|11/23/2021|.04449|11/23/2021|.04237|11/23/2021|||ANALGESICS: NARCOTICS SHORT|663|||||No|No||ROXANE/WEST-WAR|No||||
morphine sulfate|No|No|No|No|90%|00054023849|MORPHINE SULF 20 MG/5 ML SOLN|100|ML|.05577|06/26/2020||Yes|No||06/26/2020||Yes|No|06/26/2020||Yes|No||||No|No|||Prescription required|No||109|Yes|.1271|06/26/2020|.12529|06/26/2020|.11932|06/26/2020|||ANALGESICS: NARCOTICS SHORT|664|||||No|No||ROXANE/WEST-WAR|No||||
morphine sulfate|No|No|No|No|90%|00054023863|MORPHINE SULF 20 MG/5 ML SOLN|500|ML|.0304|08/04/2008||Yes|No||08/04/2008||Yes|No|08/04/2008||Yes|No||||No|No|||Prescription required|No||109|Yes|.06928|11/28/2017|.06829|11/28/2017|.06504|11/28/2017|||ANALGESICS: NARCOTICS SHORT|665|||||No|No||ROXANE/WEST-WAR|No||||
codeine sulfate|No|No|No|No|90%|00054024324|CODEINE SULFATE 15 MG TABLET|100|EA|.30917|06/08/2020||Yes|No||06/08/2020||Yes|No|06/08/2020||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|109|Yes|.69218|03/01/2022|.67556|03/01/2022|.68006|03/01/2022|||ANALGESICS: NARCOTICS SHORT|666|||||No|No||WEST-WARD/HIKMA|No||||
codeine sulfate|No|No|No|No|90%|00054024424|CODEINE SULFATE 30 MG TABLET|100|EA|.36945|06/08/2020||Yes|No||06/08/2020||Yes|No|06/08/2020||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|109|Yes|.66853|03/01/2022|.65248|03/01/2022|.65683|03/01/2022|||ANALGESICS: NARCOTICS SHORT|667|||||No|No||WEST-WARD/HIKMA|No||||
codeine sulfate|No|No|No|No|90%|00054024425|CODEINE SULFATE 30 MG TABLET|100|EA|.33329|10/26/2009||Yes|No||10/26/2009||Yes|No|10/26/2009||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|109|Yes|.66853|03/01/2022|.65248|03/01/2022|.65683|03/01/2022|||ANALGESICS: NARCOTICS SHORT|668|||||No|No||WEST-WARD/HIKMA|No||||
codeine sulfate|No|No|No|No|90%|00054024525|CODEINE SULFATE 60 MG TABLET|100|EA|.61085|11/12/2009||Yes|No||11/12/2009||Yes|No|11/12/2009||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|109|Yes|1.39218|03/29/2022|1.37229|03/29/2022|1.30695|03/29/2022|||ANALGESICS: NARCOTICS SHORT|669|||||No|No||WEST-WARD/HIKMA|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|00054025413|IRBESARTAN-HCTZ 150-12.5 MG TB|30|EA|.172|05/16/2014||Yes|No||05/16/2014||Yes|No|05/16/2014||Yes|No||05/16/2014||Yes|No|07/01/2016||Prescription required|No||113|Yes|.24959|03/29/2022|.24359|03/29/2022|.24522|03/29/2022|||ANGIOTENSIN MODULATORS|670|||||No|No||ROXANE/WEST-WAR|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|00054025422|IRBESARTAN-HCTZ 150-12.5 MG TB|90|EA|.16244|05/16/2014||Yes|No||05/16/2014||Yes|No|05/16/2014||Yes|No||05/16/2014||Yes|No|07/01/2016||Prescription required|No||113|Yes|.24959|03/29/2022|.24359|03/29/2022|.24522|03/29/2022|||ANGIOTENSIN MODULATORS|671|||||No|No||ROXANE/WEST-WAR|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|00054025513|IRBESARTAN-HCTZ 300-12.5 MG TB|30|EA|.23621|12/11/2012||Yes|No||12/11/2012||Yes|No|12/11/2012||Yes|No||12/11/2012||Yes|No|07/01/2016||Prescription required|No||113|Yes|.26247|03/29/2022|.25617|03/29/2022|.25787|03/29/2022|||ANGIOTENSIN MODULATORS|672|||||No|No||ROXANE/WEST-WAR|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|00054025522|IRBESARTAN-HCTZ 300-12.5 MG TB|90|EA|.18155|12/11/2012||Yes|No||12/11/2012||Yes|No|12/11/2012||Yes|No||12/11/2012||Yes|No|07/01/2016||Prescription required|No||113|Yes|.26247|03/29/2022|.25617|03/29/2022|.25787|03/29/2022|||ANGIOTENSIN MODULATORS|673|||||No|No||ROXANE/WEST-WAR|No||||
hydromorphone HCl|No|No|No|No|90%|00054026424|HYDROMORPHONE 4 MG TABLET|100|EA|.129|09/15/2009|03/31/2022|Yes|No||09/15/2009|03/31/2022|Yes|No|09/15/2009|03/31/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|.09714|03/29/2022|.0948|03/29/2022|.09544|03/29/2022|||ANALGESICS: NARCOTICS SHORT|674|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||WEST-WARD/HIKMA|No||||
hydromorphone HCl|No|No|No|No|90%|00054026425|HYDROMORPHONE 4 MG TABLET|100|EA|.07869|09/15/2009|03/31/2022|Yes|No||09/15/2009|03/31/2022|Yes|No|09/15/2009|03/31/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|.09714|03/29/2022|.0948|03/29/2022|.09544|03/29/2022|||ANALGESICS: NARCOTICS SHORT|675|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||WEST-WARD/HIKMA|No||||
hydromorphone HCl|No|No|No|No|90%|00054026525|HYDROMORPHONE 8 MG TABLET|100|EA|.34142|09/15/2009|02/28/2022|Yes|No||09/15/2009|02/28/2022|Yes|No|09/15/2009|02/28/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|.77812|03/15/2022|.767|03/15/2022|.73048|03/15/2022|||ANALGESICS: NARCOTICS SHORT|676|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||WEST-WARD/HIKMA|No||||
capecitabine|No|No|No|No|75%|00054027121|CAPECITABINE 150 MG TABLET|60|EA|1.1825|03/29/2017||Yes|No||03/29/2017||Yes|No|03/29/2017||Yes|No||||No|No|||Prescription required|No||502|No|2.695|08/22/2017|2.6565|08/22/2017|2.53|08/22/2017|||ONCOLOGY: ORAL - BREAST|677|||||No|No||WEST-WARD/HIKMA|No||||
capecitabine|No|No|No|No|75%|00054027223|CAPECITABINE 500 MG TABLET|120|EA|2.32916|03/29/2017||Yes|No||03/29/2017||Yes|No|03/29/2017||Yes|No||||No|No|||Prescription required|No||502|No|.61977|12/28/2021|.60489|12/28/2021|.60892|12/28/2021|||ONCOLOGY: ORAL - BREAST|678|||||No|No||WEST-WARD/HIKMA|No||||
imipramine pamoate|No|No|No|No|75%|00054027313|IMIPRAMINE PAMOATE 75 MG CAP|30|EA|5.07414|11/16/2010||Yes|No||11/16/2010||Yes|No|11/16/2010||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|5.75067|05/25/2021|5.61265|05/25/2021|5.65003|05/25/2021|||ANTIDEPRESSANTS: TRICYCLIC|679|||||No|No||ROXANE/WEST-WAR|No||||
imipramine pamoate|No|No|No|No|75%|00054027413|IMIPRAMINE PAMOATE 100 MG CAP|30|EA|5.07414|11/16/2010||Yes|No||11/16/2010||Yes|No|11/16/2010||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|4.74483|04/27/2021|4.63095|04/27/2021|4.66179|04/27/2021|||ANTIDEPRESSANTS: TRICYCLIC|680|||||No|No||ROXANE/WEST-WAR|No||||
imipramine pamoate|No|No|No|No|75%|00054027513|IMIPRAMINE PAMOATE 125 MG CAP|30|EA|5.07414|11/16/2010||Yes|No||11/16/2010||Yes|No|11/16/2010||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|11.56432|12/06/2016|11.39911|12/06/2016|10.8563|12/06/2016|||ANTIDEPRESSANTS: TRICYCLIC|681|||||No|No||ROXANE/WEST-WAR|No||||
imipramine pamoate|No|No|No|No|75%|00054027613|IMIPRAMINE PAMOATE 150 MG CAP|30|EA|5.07414|11/16/2010||Yes|No||11/16/2010||Yes|No|11/16/2010||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|11.56432|02/27/2018|11.39911|02/27/2018|10.8563|02/27/2018|||ANTIDEPRESSANTS: TRICYCLIC|682|||||No|No||ROXANE/WEST-WAR|No||||
naratriptan HCl|No|No|No|No|75%|00054027803|NARATRIPTAN HCL 1 MG TABLET|9|EA|4.70897|08/02/2010||Yes|No||08/02/2010||Yes|No|08/02/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|021|No|2.52833|03/29/2022|2.46765|03/29/2022|2.48408|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|683|||||No|No||ROXANE/WEST-WAR|No||||
naratriptan HCl|No|No|No|No|75%|00054027903|NARATRIPTAN HCL 2.5 MG TABLET|9|EA|4.70897|08/02/2010||Yes|No||08/02/2010||Yes|No|08/02/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|021|No|1.83483|03/29/2022|1.79079|03/29/2022|1.80272|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|684|||||No|No||ROXANE/WEST-WAR|No||||
alendronate sodium|No|No|No|No|75%|00054028259|ALENDRONATE SOD 70 MG/75 ML|75|ML|.39556|04/01/2021||Yes|No||04/01/2021||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|060|No|.90153|04/01/2021|.88865|04/01/2021|.84633|04/01/2021|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|685|||||No|No||WEST-WARD/HIKMA|No||||
oxymorphone HCl|No|No|No|No|90%|00054028325|OXYMORPHONE HCL 5 MG TABLET|100|EA|1.11477|12/07/2010||Yes|No||12/07/2010||Yes|No|12/07/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|109|Yes|.56292|03/01/2022|.5494|03/01/2022|.55306|03/01/2022|||ANALGESICS: NARCOTICS SHORT|686|||||No|No||ROXANE/WEST-WAR|No||||
oxymorphone HCl|No|No|No|No|90%|00054028425|OXYMORPHONE HCL 10 MG TABLET|100|EA|2.02422|12/07/2010||Yes|No||12/07/2010||Yes|No|12/07/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|109|Yes|.96999|03/29/2022|.94671|03/29/2022|.95301|03/29/2022|||ANALGESICS: NARCOTICS SHORT|687|||||No|No||ROXANE/WEST-WAR|No||||
azelastine HCl|No|No|No|No|75%|00054029399|AZELASTINE 0.1% (137 MCG) SPRY|30|ML|.258|04/07/2021||Yes|No||04/07/2021||Yes|No|04/07/2021||Yes|No||||No|No|||Prescription required|No||019|Yes|.27761|03/29/2022|.27094|03/29/2022|.27275|03/29/2022|||INTRANASAL RHINITIS AGENTS|688|||||No|No||ROXANE/WEST-WAR|No||||
alosetron HCl|No|No|No|No|75%|00054029513|ALOSETRON HCL 0.5 MG TABLET|30|EA|5.375|06/26/2015|01/31/2022|Yes|No||06/26/2015|01/31/2022|Yes|No|06/26/2015|01/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|534|Yes|12.25|02/15/2022|12.075|02/15/2022|11.5|02/15/2022|||GI MOTILITY: CHRONIC|689|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ROXANE/WEST-WAR|No||||
alosetron HCl|No|No|No|No|75%|00054029613|ALOSETRON HCL 1 MG TABLET|30|EA|8.74333|06/26/2015|06/30/2022|Yes|No||06/26/2015|06/30/2022|Yes|No|06/26/2015|06/30/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|534|Yes|8.58181|01/25/2022|8.37584|01/25/2022|8.43162|01/25/2022|||GI MOTILITY: CHRONIC|690|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ROXANE/WEST-WAR|No||||
linezolid|No|No|No|No|75%|00054031950|LINEZOLID 100 MG/5 ML SUSP|150|ML|1.92579|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||146|No|4.38902|12/17/2019|4.32632|12/17/2019|4.12031|12/17/2019|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|691|||||No|No||ROXANE/WEST-WAR|No||||
fluticasone propion/salmeterol|No|No|No|No|75%|00054032656|FLUTICASONE-SALMETEROL 100-50|60|EA|.67158|08/23/2021||Yes|No||08/23/2021||Yes|No|08/23/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|033|Yes|1.62434|03/29/2022|1.58535|03/29/2022|1.59591|03/29/2022|||GLUCOCORTICOIDS: INHALED|692|||||No|No||WEST-WARD/HIKMA|No||||
fluticasone propion/salmeterol|No|No|No|No|75%|00054032756|FLUTICASONE-SALMETEROL 250-50|60|EA|.83448|08/23/2021||Yes|No||08/23/2021||Yes|No|08/23/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|033|Yes|1.91406|03/29/2022|1.86812|03/29/2022|1.88056|03/29/2022|||GLUCOCORTICOIDS: INHALED|693|||||No|No||WEST-WARD/HIKMA|No||||
cevimeline HCl|No|No|No|No|75%|00054033425|CEVIMELINE HCL 30 MG CAPSULE|100|EA|1.11112|09/16/2013||Yes|No||09/16/2013||Yes|No|09/16/2013||Yes|No||||No|No|||Prescription required|No|||No|.81662|03/29/2022|.79702|03/29/2022|.80232|03/29/2022||||694|||||No|No||WEST-WARD/HIKMA|No||||
phenoxybenzamine HCl|No|No|No|No|75%|00054034925|PHENOXYBENZAMINE HCL 10 MG CAP|100|EA|46.43613|06/30/2017||Yes|No||06/30/2017||Yes|No|06/30/2017||Yes|No||||No|No|||Prescription required|No|||No|105.83118|06/30/2017|104.3193|06/30/2017|99.35172|06/30/2017||||695|||||No|No||WEST-WARD/HIKMA|No||||
disulfiram|No|No|No|No|75%|00054035613|DISULFIRAM 250 MG TABLET|30|EA|1.21618|10/04/2021||Yes|No||10/04/2021||Yes|No|10/04/2021||Yes|No||||No|No|||Prescription required|No|||No|1.95785|03/29/2022|1.91086|03/29/2022|1.92358|03/29/2022||||696|||||No|No||WEST-WARD/HIKMA|Yes|09/01/2020|||
disulfiram|No|No|No|No|75%|00054035625|DISULFIRAM 250 MG TABLET|100|EA|1.28312|10/04/2021||Yes|No||10/04/2021||Yes|No|10/04/2021||Yes|No||||No|No|||Prescription required|No|||No|1.95785|03/29/2022|1.91086|03/29/2022|1.92358|03/29/2022||||697|||||No|No||WEST-WARD/HIKMA|Yes|09/01/2020|||
disulfiram|No|No|No|No|75%|00054035725|DISULFIRAM 500 MG TABLET|100|EA|2.00079|10/04/2021||Yes|No||10/04/2021||Yes|No|10/04/2021||Yes|No||||No|No|||Prescription required|No|||No|4.55994|08/29/2017|4.49479|08/29/2017|4.28076|08/29/2017||||698|||||No|No||WEST-WARD/HIKMA|Yes|09/01/2020|||
cyclophosphamide|No|No|No|No|75%|00054038225|CYCLOPHOSPHAMIDE 25 MG CAPSULE|100|EA|3.22044|11/07/2014||Yes|No||11/07/2014||Yes|No|11/07/2014||Yes|No||11/07/2014||Yes|No|||Prescription required|No||502|No|7.33961|06/01/2016|7.23476|06/01/2016|6.89024|06/01/2016|||ONCOLOGY: ORAL - BREAST|699|||||No|No||WEST-WARD/HIKMA|No||||
cyclophosphamide|No|No|No|No|75%|00054038325|CYCLOPHOSPHAMIDE 50 MG CAPSULE|100|EA|5.91035|11/07/2014||Yes|No||11/07/2014||Yes|No|11/07/2014||Yes|No||11/07/2014||Yes|No|||Prescription required|No||502|No|13.4701|05/25/2021|13.27767|05/25/2021|12.6454|05/25/2021|||ONCOLOGY: ORAL - BREAST|700|||||No|No||ROXANE/WEST-WAR|No||||
hydromorphone HCl|No|No|No|No|90%|00054038663|HYDROMORPHONE 1 MG/ML SOLUTION|473|ML|.2063|05/17/2012||Yes|No||05/17/2012||Yes|No|05/17/2012||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|109|Yes|.24066|03/29/2022|.23488|03/29/2022|.23644|03/29/2022|||ANALGESICS: NARCOTICS SHORT|701|||||No|No||WEST-WARD/HIKMA|No||||
methamphetamine HCl|No|No|No|No|75%|00054038925|METHAMPHETAMINE 5 MG TABLET|100|EA|2.75569|05/05/2020||Yes|No||05/05/2020||Yes|No|05/05/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|6.82872|07/27/2021|6.66483|07/27/2021|6.70921|07/27/2021|||STIMULANTS AND RELATED AGENTS|702|||||No|No||WEST-WARD/HIKMA|No||||
oxycodone HCl|No|No|No|No|90%|00054039041|OXYCODONE HCL 5 MG/5 ML SOLN|15|ML|.30816|02/27/2015||Yes|No||02/27/2015||Yes|No|02/27/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.70232|06/01/2016|.69229|06/01/2016|.65932|06/01/2016|||ANALGESICS: NARCOTICS SHORT|703|||||No|No||ROXANE/WEST-WAR|No||||
oxycodone HCl|No|No|No|No|90%|00054039063|OXYCODONE HCL 5 MG/5 ML SOLN|500|ML|.09804|02/27/2015||Yes|No||02/27/2015||Yes|No|02/27/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.11792|03/29/2022|.11508|03/29/2022|.11585|03/29/2022|||ANALGESICS: NARCOTICS SHORT|704|||||No|No||ROXANE/WEST-WAR|No||||
methadone HCl|No|No|No|No|90%|00054039168|METHADONE 10 MG/ML ORAL CONC|1000|ML|.02193|01/21/2011||Yes|No||01/21/2011||Yes|No|01/21/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|110|Yes|.04999|06/01/2016|.04928|06/01/2016|.04693|06/01/2016|||ANALGESICS: NARCOTICS LONG|705|||||No|No||ROXANE/WEST-WAR|No||||
methadone HCl|No|No|No|No|90%|00054039268|METHADONE 10 MG/ML ORAL CONC|1000|ML|.02193|12/07/2010||Yes|No||12/07/2010||Yes|No|12/07/2010||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|110|Yes|.04999|06/01/2016|.04928|06/01/2016|.04693|06/01/2016|||ANALGESICS: NARCOTICS LONG|706|||||No|No||ROXANE/WEST-WAR|No||||
bexarotene|No|No|No|No|75%|00054039925|BEXAROTENE 75 MG CAPSULE|100|EA|25.3055|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No|||No|57.673|04/14/2021|56.8491|04/14/2021|54.142|04/14/2021||||707|||||No|No||WEST-WARD/HIKMA|No||||
desvenlafaxine succinate|No|No|No|No|75%|00054040013|DESVENLAFAXINE SUCCNT ER 50 MG|30|EA|.4568|05/08/2020||Yes|No||05/08/2020||Yes|No|05/08/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.57735|03/29/2022|.56349|03/29/2022|.56724|03/29/2022|||ANTIDEPRESSANTS: OTHER|708|||||No|No||WEST-WARD/HIKMA|No||||
desvenlafaxine succinate|No|No|No|No|75%|00054040022|DESVENLAFAXINE SUCCNT ER 50 MG|90|EA|.4568|05/08/2020||Yes|No||05/08/2020||Yes|No|05/08/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.57735|03/29/2022|.56349|03/29/2022|.56724|03/29/2022|||ANTIDEPRESSANTS: OTHER|709|||||No|No||WEST-WARD/HIKMA|No||||
desvenlafaxine succinate|No|No|No|No|75%|00054040113|DESVENLAFAXINE SUCCNT ER 100MG|30|EA|.4568|05/08/2020||Yes|No||05/08/2020||Yes|No|05/08/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.60974|03/29/2022|.5951|03/29/2022|.59906|03/29/2022|||ANTIDEPRESSANTS: OTHER|710|||||No|No||WEST-WARD/HIKMA|No||||
desvenlafaxine succinate|No|No|No|No|75%|00054040122|DESVENLAFAXINE SUCCNT ER 100MG|90|EA|.4568|05/08/2020||Yes|No||05/08/2020||Yes|No|05/08/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.60974|03/29/2022|.5951|03/29/2022|.59906|03/29/2022|||ANTIDEPRESSANTS: OTHER|711|||||No|No||WEST-WARD/HIKMA|No||||
ritonavir|No|No|No|No|75%|00054040713|RITONAVIR 100 MG TABLET|30|EA|3.19999|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|1.50357|03/29/2022|1.46748|03/29/2022|1.47725|03/29/2022|||HIV / AIDS|712|||||No|No||WEST-WARD/HIKMA|No||||
febuxostat|No|No|No|No|75%|00054041313|FEBUXOSTAT 40 MG TABLET|30|EA|2.15|04/24/2020||Yes|No||04/24/2020||Yes|No|04/24/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|231|No|.89466|03/29/2022|.87318|03/29/2022|.879|03/29/2022|||ANTIHYPERURICEMICS|713|||||No|No||WEST-WARD/HIKMA|No||||
febuxostat|No|No|No|No|75%|00054041413|FEBUXOSTAT 80 MG TABLET|30|EA|2.15|04/24/2020||Yes|No||04/24/2020||Yes|No|04/24/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|231|No|.93355|03/29/2022|.91114|03/29/2022|.91721|03/29/2022|||ANTIHYPERURICEMICS|714|||||No|No||WEST-WARD/HIKMA|No||||
ethacrynic acid|No|No|No|No|75%|00054041525|ETHACRYNIC ACID 25 MG TABLET|100|EA|4.29088|05/07/2020|03/31/2022|Yes|No||05/07/2020|03/31/2022|Yes|No|05/07/2020|03/31/2022|Yes|No||||No|No|||Prescription required|No|||No|2.34378|03/01/2022|2.28752|03/01/2022|2.30276|03/01/2022||||715|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||WEST-WARD/HIKMA|No||||
rufinamide|No|No|No|No|75%|00054042523|RUFINAMIDE 200 MG TABLET|120|EA|1.32053|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||056|No|3.00958|08/26/2021|2.96658|08/26/2021|2.82532|08/26/2021|||ANTICONVULSANTS|716|||||No|No||WEST-WARD/HIKMA|No||||
rufinamide|No|No|No|No|75%|00054042623|RUFINAMIDE 400 MG TABLET|120|EA|2.64106|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||056|No|5.73268|01/25/2022|5.59509|01/25/2022|5.63235|01/25/2022|||ANTICONVULSANTS|717|||||No|No||WEST-WARD/HIKMA|No||||
flucytosine|No|No|No|No|75%|00054042725|FLUCYTOSINE 250 MG CAPSULE|100|EA|28.23173|05/08/2020||Yes|No||05/08/2020||Yes|No|05/08/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|069|No|64.34209|05/08/2020|63.42292|05/08/2020|60.40278|05/08/2020|||ANTIFUNGALS: ORAL|718|||||No|No||WEST-WARD/HIKMA|No||||
flucytosine|No|No|No|No|75%|00054042825|FLUCYTOSINE 500 MG CAPSULE|100|EA|54.62892|05/08/2020||Yes|No||05/08/2020||Yes|No|05/08/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|069|No|124.50312|05/08/2020|122.7245|05/08/2020|116.88048|05/08/2020|||ANTIFUNGALS: ORAL|719|||||No|No||WEST-WARD/HIKMA|No||||
everolimus|No|No|No|No|75%|00054047021|EVEROLIMUS 0.25 MG TABLET|60|EA|3.40925|06/12/2020||Yes|No||06/12/2020||Yes|No|06/12/2020||Yes|No||06/12/2020||Yes|No|||Prescription required|Yes|01/30/2020|229|No|7.76993|06/12/2020|7.65893|06/12/2020|7.29422|06/12/2020|||IMMUNOSUPPRESSIVES: ORAL|720|||||No|No||WEST-WARD/HIKMA|No||||
everolimus|No|No|No|No|75%|00054047121|EVEROLIMUS 0.5 MG TABLET|60|EA|6.81857|06/12/2020||Yes|No||06/12/2020||Yes|No|06/12/2020||Yes|No||06/12/2020||Yes|No|||Prescription required|Yes|01/30/2020|229|No|15.54001|06/12/2020|15.31801|06/12/2020|14.58858|06/12/2020|||IMMUNOSUPPRESSIVES: ORAL|721|||||No|No||WEST-WARD/HIKMA|No||||
everolimus|No|No|No|No|75%|00054047221|EVEROLIMUS 0.75 MG TABLET|60|EA|10.22776|06/12/2020||Yes|No||06/12/2020||Yes|No|06/12/2020||Yes|No||06/12/2020||Yes|No|||Prescription required|Yes|01/30/2020|229|No|23.30979|06/12/2020|22.97679|06/12/2020|21.88266|06/12/2020|||IMMUNOSUPPRESSIVES: ORAL|722|||||No|No||WEST-WARD/HIKMA|No||||
dalfampridine|No|No|No|No|75%|00054047921|DALFAMPRIDINE ER 10 MG TABLET|60|EA|1.39785|06/17/2021|02/22/2022|Yes|No||06/17/2021|02/22/2022|Yes|No|06/17/2021|02/22/2022|Yes|No||||No|No|||Prescription required|No||043|No|.82047|03/29/2022|.80077|03/29/2022|.80611|03/29/2022|||MULTIPLE SCLEROSIS AGENTS|723|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||WEST-WARD/HIKMA|No||||
everolimus|No|No|No|No|75%|00054048013|EVEROLIMUS 2.5 MG TABLET|30|EA|92.01183|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||548|No|209.70138|11/23/2021|206.70564|11/23/2021|196.86252|11/23/2021|||ONCOLOGY: ORAL - RENAL CELL|724|||||No|No||WEST-WARD/HIKMA|No||||
everolimus|No|No|No|No|75%|00054048014|EVEROLIMUS 2.5 MG TABLET|28|EA|98.5841|10/02/2020|02/19/2022|Yes|No||10/02/2020|02/19/2022|Yes|No|10/02/2020|02/19/2022|Yes|No||||No|No|||Prescription required|No||548|No|224.68004|11/23/2021|221.47032|11/23/2021|210.92412|11/23/2021|||ONCOLOGY: ORAL - RENAL CELL|725|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||WEST-WARD/HIKMA|No||||
everolimus|No|No|No|No|75%|00054048113|EVEROLIMUS 5 MG TABLET|30|EA|96.24288|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No||548|No|219.34424|02/02/2022|216.21075|02/02/2022|205.915|02/02/2022|||ONCOLOGY: ORAL - RENAL CELL|726|||||No|No||WEST-WARD/HIKMA|No||||
everolimus|No|No|No|No|75%|00054048114|EVEROLIMUS 5 MG TABLET|28|EA|103.11737|10/02/2020|01/31/2023|Yes|No||10/02/2020|01/31/2023|Yes|No|10/02/2020|01/31/2023|Yes|No||||No|No|||Prescription required|No||548|No|235.01169|11/23/2021|231.65438|11/23/2021|220.62322|11/23/2021|||ONCOLOGY: ORAL - RENAL CELL|727|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||WEST-WARD/HIKMA|No||||
everolimus|No|No|No|No|75%|00054048213|EVEROLIMUS 10 MG TABLET|30|EA|96.24288|03/29/2022||Yes|No||03/29/2022||Yes|No|03/29/2022||Yes|No||||No|No|||Prescription required|No||548|No|219.34424|03/29/2022|216.21075|03/29/2022|205.915|03/29/2022|||ONCOLOGY: ORAL - RENAL CELL|728|||||No|No||WEST-WARD/HIKMA|No||||
everolimus|No|No|No|No|75%|00054049713|EVEROLIMUS 7.5 MG TABLET|30|EA|96.24288|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No||548|No|219.34424|02/02/2022|216.21075|02/02/2022|205.915|02/02/2022|||ONCOLOGY: ORAL - RENAL CELL|729|||||No|No||WEST-WARD/HIKMA|No||||
everolimus|No|No|No|No|75%|00054049714|EVEROLIMUS 7.5 MG TABLET|28|EA|103.11737|10/02/2020|12/31/2022|Yes|No||10/02/2020|12/31/2022|Yes|No|10/02/2020|12/31/2022|Yes|No||||No|No|||Prescription required|No||548|No|235.01169|11/23/2021|231.65438|11/23/2021|220.62322|11/23/2021|||ONCOLOGY: ORAL - RENAL CELL|730|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||WEST-WARD/HIKMA|No||||
icosapent ethyl|No|No|No|No|75%|00054050823|ICOSAPENT ETHYL 1 GRAM CAPSULE|120|EA|1.08166|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|055|No|2.11805|03/29/2022|2.06721|03/29/2022|2.08098|03/29/2022|||LIPOTROPICS: OTHER|731|||||No|No||WEST-WARD/HIKMA|No||||
morphine sulfate|No|No|No|No|90%|00054051741|MORPHINE SULF 100 MG/5 ML CONC|15|ML|.24624|08/27/2015||Yes|No||08/27/2015||Yes|No|08/27/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|109|Yes|.40058|03/29/2022|.39096|03/29/2022|.39356|03/29/2022|||ANALGESICS: NARCOTICS SHORT|732|||||No|No||ROXANE/WEST-WAR|No||||
morphine sulfate|No|No|No|No|90%|00054051744|MORPHINE SULF 100 MG/5 ML CONC|30|ML|.24624|08/27/2015||Yes|No||08/27/2015||Yes|No|08/27/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|109|Yes|.3028|03/29/2022|.29553|03/29/2022|.2975|03/29/2022|||ANALGESICS: NARCOTICS SHORT|733|||||No|No||ROXANE/WEST-WAR|No||||
morphine sulfate|No|No|No|No|90%|00054051750|MORPHINE SULF 100 MG/5 ML CONC|120|ML|.24628|08/27/2015||Yes|No||08/27/2015||Yes|No|08/27/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|109|Yes|.27485|03/29/2022|.26825|03/29/2022|.27004|03/29/2022|||ANALGESICS: NARCOTICS SHORT|734|||||No|No||ROXANE/WEST-WAR|No||||
bosentan|No|No|No|No|75%|00054052021|BOSENTAN 62.5 MG TABLET|60|EA|8.33598|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/26/2018|171|No|18.99828|01/07/2020|18.72687|01/03/2020|17.83512|01/03/2020|||PAH AGENTS: ORAL AND INHALED|735|||||No|No||WEST-WARD/HIKMA|No||||
bosentan|No|No|No|No|75%|00054052121|BOSENTAN 125 MG TABLET|60|EA|8.33598|01/03/2020|11/11/2022|Yes|No||01/03/2020|11/11/2022|Yes|No|01/03/2020|11/11/2022|Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/26/2018|171|No|18.99828|01/07/2020|18.72687|01/03/2020|17.83512|01/03/2020|||PAH AGENTS: ORAL AND INHALED|736|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||WEST-WARD/HIKMA|No||||
clobazam|No|No|No|No|90%|00054052625|CLOBAZAM 10 MG TABLET|100|EA|.3225|02/21/2019|01/31/2022|Yes|No||02/21/2019|01/31/2022|Yes|No|02/21/2019|01/31/2022|Yes|No||||No|No|||Prescription required|No||056|No|.735|02/15/2022|.7245|02/15/2022|.69|02/15/2022|||ANTICONVULSANTS|737|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||WEST-WARD/HIKMA|No||||
rufinamide|No|No|No|No|75%|00054052863|RUFINAMIDE 40 MG/ML SUSPENSION|460|ML|1.43991|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No||056|No|1.88512|03/01/2022|1.83987|03/01/2022|1.85213|03/01/2022|||ANTICONVULSANTS|738|||||No|No||WEST-WARD/HIKMA|No||||
droxidopa|No|No|No|No|75%|00054053222|DROXIDOPA 100 MG CAPSULE|90|EA|.59621|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No|||No|1.35881|06/03/2021|1.3394|06/03/2021|1.27562|06/03/2021||||739|||||No|No||WEST-WARD/HIKMA|No||||
droxidopa|No|No|No|No|75%|00054053322|DROXIDOPA 200 MG CAPSULE|90|EA|1.19248|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No|||No|2.71775|06/03/2021|2.67893|06/03/2021|2.55136|06/03/2021||||740|||||No|No||WEST-WARD/HIKMA|No||||
droxidopa|No|No|No|No|75%|00054053422|DROXIDOPA 300 MG CAPSULE|90|EA|1.7887|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No|||No|4.07657|06/03/2021|4.01833|06/03/2021|3.82698|06/03/2021||||741|||||No|No||WEST-WARD/HIKMA|No||||
clobazam|No|No|No|No|90%|00054056150|CLOBAZAM 2.5 MG/ML SUSPENSION|120|ML|1.88125|02/21/2019|02/28/2022|Yes|No||02/21/2019|02/28/2022|Yes|No|02/21/2019|02/28/2022|Yes|No||||No|No|||Prescription required|No||056|No|4.2875|03/15/2022|4.22625|03/15/2022|4.025|03/15/2022|||ANTICONVULSANTS|742|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||WEST-WARD/HIKMA|No||||
deferiprone|No|No|No|No|75%|00054057625|DEFERIPRONE 500 MG TABLET|100|EA|26.43674|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No|||No|60.25118|08/26/2021|59.39045|08/26/2021|56.56233|08/26/2021||||743|||||No|No||WEST-WARD/HIKMA|No||||
desvenlafaxine succinate|No|No|No|No|75%|00054060313|DESVENLAFAXINE SUCCNT ER 25 MG|30|EA|.41939|01/30/2020||Yes|No||01/30/2020||Yes|No|01/30/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.63768|03/29/2022|.62237|03/29/2022|.62652|03/29/2022|||ANTIDEPRESSANTS: OTHER|744|||||No|No||WEST-WARD/HIKMA|No||||
dicyclomine HCl|No|No|No|No|75%|00054062263|DICYCLOMINE 10 MG/5 ML SOLN|473|ML|.10333|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No|||No|.21044|03/29/2022|.20538|03/29/2022|.20675|03/29/2022||||745|||||No|No||WEST-WARD/HIKMA|No||||
methylergonovine maleate|No|No|No|No|75%|00054063905|METHYLERGONOVINE 0.2 MG TABLET|12|EA|23.12683|03/21/2019||Yes|No||03/21/2019||Yes|No|03/21/2019||Yes|No||||No|No|||Prescription required|No|||No|13.46155|05/25/2021|13.13847|05/25/2021|13.22597|05/25/2021||||746|||||No|No||WEST-WARD/HIKMA|No||||
methylergonovine maleate|No|No|No|No|75%|00054063913|METHYLERGONOVINE 0.2 MG TABLET|28|EA|23.11357|04/24/2020||Yes|No||04/24/2020||Yes|No|04/24/2020||Yes|No||||No|No|||Prescription required|No|||No|13.46155|05/25/2021|13.13847|05/25/2021|13.22597|05/25/2021||||747|||||No|No||WEST-WARD/HIKMA|No||||
methadone HCl|No|No|No|No|90%|00054070920|METHADONE HCL 5 MG TABLET|100|EA|.13222|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|110|Yes|.12051|03/29/2022|.11761|03/29/2022|.1184|03/29/2022|||ANALGESICS: NARCOTICS LONG|748|||||No|No||WEST-WARD/HIKMA|No||||
methadone HCl|No|No|No|No|90%|00054070925|METHADONE HCL 5 MG TABLET|100|EA|.09159|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|110|Yes|.12051|03/29/2022|.11761|03/29/2022|.1184|03/29/2022|||ANALGESICS: NARCOTICS LONG|749|||||No|No||WEST-WARD/HIKMA|No||||
methadone HCl|No|No|No|No|90%|00054071020|METHADONE HCL 10 MG TABLET|100|EA|.15045|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|110|Yes|.08598|03/29/2022|.08391|03/29/2022|.08447|03/29/2022|||ANALGESICS: NARCOTICS LONG|750|||||No|No||WEST-WARD/HIKMA|No||||
methadone HCl|No|No|No|No|90%|00054071025|METHADONE HCL 10 MG TABLET|100|EA|.15209|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|110|Yes|.08598|03/29/2022|.08391|03/29/2022|.08447|03/29/2022|||ANALGESICS: NARCOTICS LONG|751|||||No|No||WEST-WARD/HIKMA|No||||
albuterol sulfate|No|No|No|No|75%|00054074287|ALBUTEROL HFA 90 MCG INHALER|6.7|GM|2.30916|03/30/2022||Yes|No||03/30/2022||Yes|No|03/30/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|037|Yes|3.77137|03/30/2022|3.68085|03/30/2022|3.70537|03/30/2022|||BRONCHODILATORS: BETA AGONIST|752|||||No|No||WEST-WARD/HIKMA|No||||
lithium carbonate|No|No|No|No|75%|00054252625|LITHIUM CARBONATE 150 MG CAP|100|EA|.04803|10/18/2006||Yes|No||10/18/2006||Yes|No|10/18/2006||Yes|No||||No|No|||Prescription required|No|||No|.06953|03/29/2022|.06786|03/29/2022|.06831|03/29/2022||||753|||||No|No||WEST-WARD/HIKMA|No||||
lithium carbonate|No|No|No|No|75%|00054252725|LITHIUM CARBONATE 300 MG CAP|100|EA|.0344|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.04894|03/29/2022|.04776|03/29/2022|.04808|03/29/2022||||754|||||No|No||WEST-WARD/HIKMA|No||||
lithium carbonate|No|No|No|No|75%|00054252731|LITHIUM CARBONATE 300 MG CAP|1000|EA|.03014|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.04894|03/29/2022|.04776|03/29/2022|.04808|03/29/2022||||755|||||No|No||WEST-WARD/HIKMA|No||||
lithium carbonate|No|No|No|No|75%|00054253125|LITHIUM CARBONATE 600 MG CAP|100|EA|.13454|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.13745|03/29/2022|.13415|03/29/2022|.13504|03/29/2022||||756|||||No|No||ROXANE/WEST-WAR|No||||
alprazolam|No|No|No|No|90%|00054306844|ALPRAZOLAM INTENSOL 1 MG/ML|30|ML|1.31322|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|2.99292|06/01/2016|2.95016|06/01/2016|2.80968|06/01/2016|||ANXIOLYTICS|757|||||No|No||ROXANE/WEST-WAR|No||||
butorphanol tartrate|No|No|No|No|90%|00054309036|BUTORPHANOL 10 MG/ML SPRAY|2.5|ML|9.7008|09/15/2006||Yes|No||09/15/2006||Yes|No|09/15/2006||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|109|Yes|13.82286|03/29/2022|13.49111|03/29/2022|13.58095|03/29/2022|||ANALGESICS: NARCOTICS SHORT|758|||||No|No||ROXANE/WEST-WAR|No||||
calcium carbonate|No|No|No|No|75%|00054311763|CALCIUM CARB 1,250 MG/5 ML SUS|500|ML|.00786|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||09/01/1999||Yes|No|||Over the counter|No|||No|.01744|03/29/2022|.01702|03/29/2022|.01713|03/29/2022||||759|||||No|No||ROXANE/WEST-WAR|No||||
calcitriol|No|No|No|No|75%|00054312041|CALCITRIOL 1 MCG/ML SOLUTION|15|ML|4.10506|10/23/2007||Yes|No||10/23/2007||Yes|No|10/23/2007||Yes|No||10/23/2007||Yes|No|||Prescription required|No|||No|4.45307|03/29/2022|4.34619|03/29/2022|4.37514|03/29/2022||||760|||||No|No||ROXANE/WEST-WAR|No||||
dexamethasone|No|No|No|No|75%|00054317644|DEXAMETHASONE INTENSOL 1 MG/ML|30|ML|.3417|10/18/2006||Yes|No||10/18/2006||Yes|No|10/18/2006||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|168|Yes|.73856|03/01/2022|.72083|03/01/2022|.72563|03/01/2022|||GLUCOCORTICOIDS: ORAL|761|||||No|No||ROXANE/WEST-WAR|No||||
dexamethasone|No|No|No|No|75%|00054317757|DEXAMETHASONE 0.5 MG/5 ML LIQ|240|ML|.09128|12/30/2008||Yes|No||12/30/2008||Yes|No|12/30/2008||Yes|No||||No|No|||Prescription required|No||168|Yes|.20804|09/28/2021|.20507|09/28/2021|.1953|09/28/2021|||GLUCOCORTICOIDS: ORAL|762|||||No|No||ROXANE/WEST-WAR|No||||
dexamethasone|No|No|No|No|75%|00054317763|DEXAMETHASONE 0.5 MG/5 ML LIQ|500|ML|.0139|12/30/2008||Yes|No||12/30/2008||Yes|No|12/30/2008||Yes|No||||No|No|||Prescription required|No||168|Yes|.03169|06/26/2018|.03124|06/26/2018|.02975|06/26/2018|||GLUCOCORTICOIDS: ORAL|763|||||No|No||ROXANE/WEST-WAR|No||||
diazepam|No|No|No|No|75%|00054318544|DIAZEPAM 5 MG/ML ORAL CONC|30|ML|.45608|10/23/2007||Yes|No||10/23/2007||Yes|No|10/23/2007||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|.78996|10/26/2021|.771|10/26/2021|.77613|10/26/2021|||ANXIOLYTICS|764|||||No|No||ROXANE/WEST-WAR|No||||
diazepam|No|No|No|No|75%|00054318863|DIAZEPAM 5 MG/5 ML SOLUTION|500|ML|.04966|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.10073|03/29/2022|.09831|03/29/2022|.09896|03/29/2022|||ANXIOLYTICS|765|||||No|No||ROXANE/WEST-WAR|No||||
diphenoxylate HCl/atropine|No|No|No|No|75%|00054319446|DIPHENOXYLAT-ATROP 2.5-0.025/5|60|ML|.50166|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|1.14332|01/29/2019|1.12699|01/29/2019|1.07332|01/29/2019||||766|||||No|No||ROXANE/WEST-WAR|No||||
fluticasone propionate|No|No|No|No|75%|00054327099|FLUTICASONE PROP 50 MCG SPRAY|16|GM|.29562|03/24/2006||Yes|No||03/24/2006||Yes|No|03/24/2006||Yes|No||||No|No|||Prescription required|No||019|No|.27037|03/29/2022|.26388|03/29/2022|.26563|03/29/2022|||INTRANASAL RHINITIS AGENTS|767|||||No|No||WEST-WARD/HIKMA|No||||
furosemide|No|No|No|No|75%|00054329446|FUROSEMIDE 10 MG/ML SOLUTION|60|ML|.0483|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.10297|03/29/2022|.10049|03/29/2022|.10116|03/29/2022||||768|||||No|No||ROXANE/WEST-WAR|No||||
furosemide|No|No|No|No|75%|00054329450|FUROSEMIDE 10 MG/ML SOLUTION|120|ML|.0469|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.10297|03/29/2022|.10049|03/29/2022|.10116|03/29/2022||||769|||||No|No||ROXANE/WEST-WAR|No||||
furosemide|No|No|No|No|75%|00054329863|FUROSEMIDE 40 MG/5 ML SOLN|500|ML|.03331|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.07593|06/01/2016|.07484|06/01/2016|.07128|06/01/2016||||770|||||No|No||ROXANE/WEST-WAR|No||||
lidocaine HCl|No|No|No|No|75%|00054350049|LIDOCAINE 2% VISCOUS SOLN|100|ML|.0473|10/23/2002||Yes|No||10/23/2002||Yes|No|10/23/2002||Yes|No||||No|No|||Prescription required|No|||No|.06351|03/29/2022|.06198|03/29/2022|.06239|03/29/2022||||771|||||No|No||WEST-WARD/HIKMA|No||||
lidocaine HCl|No|No|No|No|75%|00054350547|LIDOCAINE HCL 4% SOLUTION|50|ML|.344|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.45385|03/29/2022|.44295|03/29/2022|.4459|03/29/2022||||772|||||No|No||ROXANE/WEST-WAR|No||||
lorazepam|No|No|No|No|90%|00054353244|LORAZEPAM INTENSOL 2 MG/ML|30|ML|.45221|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.59241|03/29/2022|.57819|03/29/2022|.58204|03/29/2022|||ANXIOLYTICS|773|||||No|No||ROXANE/WEST-WAR|No||||
meperidine HCl|No|No|No|No|90%|00054354563|MEPERIDINE 50 MG/5 ML SOLUTION|500|ML|.07257|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|11/17/2006|109|Yes|.1654|11/28/2017|.16304|11/28/2017|.15527|11/28/2017|||ANALGESICS: NARCOTICS SHORT|774|||||No|No||ROXANE/WEST-WAR|No||||
methadone HCl|No|No|No|No|90%|00054355344|METHADONE INTENSOL 10 MG/ML|30|ML|.29068|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|110|Yes|.66248|08/29/2017|.65301|08/29/2017|.62192|08/29/2017|||ANALGESICS: NARCOTICS LONG|775|||||No|No||ROXANE/WEST-WAR|No||||
methadone HCl|No|No|No|No|90%|00054355563|METHADONE 5 MG/5 ML SOLUTION|500|ML|.02743|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|110|Yes|.06252|12/26/2017|.06163|12/26/2017|.05869|12/26/2017|||ANALGESICS: NARCOTICS LONG|776|||||No|No||ROXANE/WEST-WAR|No||||
methadone HCl|No|No|No|No|90%|00054355663|METHADONE 10 MG/5 ML SOLUTION|500|ML|.04752|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|110|Yes|.1083|06/01/2016|.10676|06/01/2016|.10167|06/01/2016|||ANALGESICS: NARCOTICS LONG|777|||||No|No||WEST-WARD/HIKMA|No||||
naproxen|No|No|No|No|75%|00054363063|NAPROXEN 125 MG/5 ML SUSPEN|500|ML|.77093|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||06/08/2021||Yes|No|||Prescription required|Yes|01/15/2014|059|Yes|1.75702|03/02/2021|1.73192|03/02/2021|1.64944|03/02/2021|||NSAIDS|778|||||No|No||WEST-WARD/HIKMA|No||||
prednisone|No|No|No|No|75%|00054372144|PREDNISONE INTENSOL 5 MG/ML|30|ML|1.86333|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|01/15/2014|168|Yes|4.24666|08/29/2017|4.18599|08/29/2017|3.98666|08/29/2017|||GLUCOCORTICOIDS: ORAL|779|||||No|No||ROXANE/WEST-WAR|No||||
prednisone|No|No|No|No|75%|00054372250|PREDNISONE 5 MG/5 ML SOLUTION|120|ML|.28666|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|.5522|03/01/2022|.53894|03/01/2022|.54253|03/01/2022|||GLUCOCORTICOIDS: ORAL|780|||||No|No||ROXANE/WEST-WAR|No||||
prednisone|No|No|No|No|75%|00054372263|PREDNISONE 5 MG/5 ML SOLUTION|500|ML|.2666|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|.6076|08/08/2017|.59892|08/08/2017|.5704|08/08/2017|||GLUCOCORTICOIDS: ORAL|781|||||No|No||ROXANE/WEST-WAR|No||||
propranolol HCl|No|No|No|No|75%|00054372763|PROPRANOLOL 20 MG/5 ML SOLN|500|ML|.04158|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.09282|03/29/2022|.09059|03/29/2022|.09119|03/29/2022|||BETA-BLOCKERS|782|||||No|No||ROXANE/WEST-WAR|No||||
propranolol HCl|No|No|No|No|75%|00054373063|PROPRANOLOL 40 MG/5 ML SOLN|500|ML|.05924|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.13502|06/28/2016|.13309|06/28/2016|.12675|06/28/2016|||BETA-BLOCKERS|783|||||No|No||ROXANE/WEST-WAR|No||||
clotrimazole|No|No|No|No|75%|00054414622|CLOTRIMAZOLE 10 MG TROCHE|70|EA|.8509|10/03/2006||Yes|No||10/03/2006||Yes|No|10/03/2006||Yes|No||10/03/2006||Yes|No|||Prescription required|No||069|No|.42659|03/29/2022|.41635|03/29/2022|.41912|03/29/2022|||ANTIFUNGALS: ORAL|784|||||No|No||WEST-WARD/HIKMA|No||||
clotrimazole|No|No|No|No|75%|00054414623|CLOTRIMAZOLE 10 MG TROCHE|140|EA|.74721|10/03/2006||Yes|No||10/03/2006||Yes|No|10/03/2006||Yes|No||10/03/2006||Yes|No|||Prescription required|No||069|No|.42659|03/29/2022|.41635|03/29/2022|.41912|03/29/2022|||ANTIFUNGALS: ORAL|785|||||No|No||ROXANE/WEST-WAR|No||||
dexamethasone|No|No|No|No|75%|00054417925|DEXAMETHASONE 0.5 MG TABLET|100|EA|.04949|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|.10515|03/29/2022|.10262|03/29/2022|.1033|03/29/2022|||GLUCOCORTICOIDS: ORAL|786|||||No|No||ROXANE/WEST-WAR|No||||
dexamethasone|No|No|No|No|75%|00054418025|DEXAMETHASONE 0.75 MG TABLET|100|EA|.0887|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|.18206|01/25/2022|.17769|01/25/2022|.17887|01/25/2022|||GLUCOCORTICOIDS: ORAL|787|||||No|No||WEST-WARD/HIKMA|No||||
dexamethasone|No|No|No|No|75%|00054418125|DEXAMETHASONE 1 MG TABLET|100|EA|.10655|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|.23592|03/29/2022|.23025|03/29/2022|.23179|03/29/2022|||GLUCOCORTICOIDS: ORAL|788|||||No|No||ROXANE/WEST-WAR|No||||
dexamethasone|No|No|No|No|75%|00054418225|DEXAMETHASONE 1.5 MG TABLET|100|EA|.17092|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|.34387|03/29/2022|.33561|03/29/2022|.33785|03/29/2022|||GLUCOCORTICOIDS: ORAL|789|||||No|No||ROXANE/WEST-WAR|No||||
dexamethasone|No|No|No|No|75%|00054418325|DEXAMETHASONE 2 MG TABLET|100|EA|.2131|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|.46036|03/29/2022|.44931|03/29/2022|.4523|03/29/2022|||GLUCOCORTICOIDS: ORAL|790|||||No|No||WEST-WARD/HIKMA|No||||
dexamethasone|No|No|No|No|75%|00054418425|DEXAMETHASONE 4 MG TABLET|100|EA|.42621|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|.52706|03/29/2022|.51441|03/29/2022|.51783|03/29/2022|||GLUCOCORTICOIDS: ORAL|791|||||No|No||WEST-WARD/HIKMA|No||||
dexamethasone|No|No|No|No|75%|00054418625|DEXAMETHASONE 6 MG TABLET|100|EA|.63932|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|1.17981|03/29/2022|1.15149|03/29/2022|1.15916|03/29/2022|||GLUCOCORTICOIDS: ORAL|792|||||No|No||ROXANE/WEST-WAR|No||||
furosemide|No|No|No|No|75%|00054429725|FUROSEMIDE 20 MG TABLET|100|EA|.02352|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.03187|03/29/2022|.0311|03/29/2022|.03131|03/29/2022||||793|||||No|No||ROXANE/WEST-WAR|No||||
furosemide|No|No|No|No|75%|00054429731|FUROSEMIDE 20 MG TABLET|1000|EA|.01552|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.03187|03/29/2022|.0311|03/29/2022|.03131|03/29/2022||||794|||||No|No||WEST-WARD/HIKMA|No||||
furosemide|No|No|No|No|75%|00054429925|FUROSEMIDE 40 MG TABLET|100|EA|.0494|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.03326|03/29/2022|.03246|03/29/2022|.03267|03/29/2022||||795|||||No|No||ROXANE/WEST-WAR|No||||
furosemide|No|No|No|No|75%|00054429931|FUROSEMIDE 40 MG TABLET|1000|EA|.02322|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.03326|03/29/2022|.03246|03/29/2022|.03267|03/29/2022||||796|||||No|No||ROXANE/WEST-WAR|No||||
furosemide|No|No|No|No|75%|00054430125|FUROSEMIDE 80 MG TABLET|100|EA|.05512|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.06148|03/29/2022|.06|03/29/2022|.0604|03/29/2022||||797|||||No|No||WEST-WARD/HIKMA|No||||
furosemide|No|No|No|No|75%|00054430129|FUROSEMIDE 80 MG TABLET|500|EA|.03268|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.06148|03/29/2022|.06|03/29/2022|.0604|03/29/2022||||798|||||No|No||WEST-WARD/HIKMA|No||||
leucovorin calcium|No|No|No|No|75%|00054449613|LEUCOVORIN CALCIUM 5 MG TAB|30|EA|.48045|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.873|03/29/2022|.85204|03/29/2022|.85772|03/29/2022||||799|||||No|No||WEST-WARD/HIKMA|No||||
leucovorin calcium|No|No|No|No|75%|00054449625|LEUCOVORIN CALCIUM 5 MG TAB|100|EA|.46814|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.873|03/29/2022|.85204|03/29/2022|.85772|03/29/2022||||800|||||No|No||WEST-WARD/HIKMA|No||||
leucovorin calcium|No|No|No|No|75%|00054449705|LEUCOVORIN CALCIUM 10 MG TAB|12|EA|2.67925|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|5.44565|08/24/2021|5.31495|08/24/2021|5.35035|08/24/2021||||801|||||No|No||WEST-WARD/HIKMA|No||||
leucovorin calcium|No|No|No|No|75%|00054449710|LEUCOVORIN CALCIUM 10 MG TAB|24|EA|2.38183|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|5.44565|08/24/2021|5.31495|08/24/2021|5.35035|08/24/2021||||802|||||No|No||WEST-WARD/HIKMA|No||||
leucovorin calcium|No|No|No|No|75%|00054449810|LEUCOVORIN CALCIUM 15 MG TAB|24|EA|2.27685|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|5.1891|06/01/2016|5.11497|06/01/2016|4.8714|06/01/2016||||803|||||No|No||WEST-WARD/HIKMA|No||||
leucovorin calcium|No|No|No|No|75%|00054449911|LEUCOVORIN CALCIUM 25 MG TAB|25|EA|4.85814|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|5.60951|03/29/2022|5.47488|03/29/2022|5.51134|03/29/2022||||804|||||No|No||WEST-WARD/HIKMA|No||||
lithium carbonate|No|No|No|No|75%|00054452725|LITHIUM CARBONATE 300 MG TAB|100|EA|.07396|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.13413|03/29/2022|.13091|03/29/2022|.13178|03/29/2022||||805|||||No|No||ROXANE/WEST-WAR|No||||
lithium carbonate|No|No|No|No|75%|00054452731|LITHIUM CARBONATE 300 MG TAB|1000|EA|.07397|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.13413|03/29/2022|.13091|03/29/2022|.13178|03/29/2022||||806|||||No|No||ROXANE/WEST-WAR|No||||
methadone HCl|No|No|No|No|90%|00054453825|DISKETS 40 MG TABLET DISPR|100|EA|.1099|05/31/2005||Yes|No||05/31/2005||Yes|No|05/31/2005||Yes|No||||No|No|||Prescription required|No|||Yes|.25048|06/01/2016|.2469|06/01/2016|.23515|06/01/2016||||807|||||No|No||WEST-WARD/HIKMA|No||||
methotrexate sodium|No|No|No|No|75%|00054455015|METHOTREXATE 2.5 MG TABLET|36|EA|.77638|07/27/2010||Yes|No||07/27/2010||Yes|No|07/27/2010||Yes|No||||No|No|||Prescription required|No|||No|.26817|03/29/2022|.26173|03/29/2022|.26347|03/29/2022||||808|||||No|No||ROXANE/WEST-WAR|No||||
methotrexate sodium|No|No|No|No|75%|00054455025|METHOTREXATE 2.5 MG TABLET|100|EA|.75933|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.26817|03/29/2022|.26173|03/29/2022|.26347|03/29/2022||||809|||||No|No||ROXANE/WEST-WAR|No||||
methadone HCl|No|No|No|No|90%|00054457025|METHADONE HCL 5 MG TABLET|100|EA|.09159|03/01/2002|02/01/2022|Yes|No||03/01/2002|02/01/2022|Yes|No|03/01/2002|02/01/2022|Yes|No||||No|No|||Prescription required|Yes|07/28/2017|110|Yes|.12051|03/29/2022|.11761|03/29/2022|.1184|03/29/2022|||ANALGESICS: NARCOTICS LONG|810|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||WEST-WARD/HIKMA|No||||
methadone HCl|No|No|No|No|90%|00054457125|METHADONE HCL 10 MG TABLET|100|EA|.15209|10/06/2003|02/01/2022|Yes|No||10/06/2003|02/01/2022|Yes|No|10/06/2003|02/01/2022|Yes|No||||No|No|||Prescription required|Yes|07/28/2017|110|Yes|.08598|03/29/2022|.08391|03/29/2022|.08447|03/29/2022|||ANALGESICS: NARCOTICS LONG|811|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||WEST-WARD/HIKMA|No||||
mercaptopurine|No|No|No|No|75%|00054458111|MERCAPTOPURINE 50 MG TABLET|25|EA|1.3631|03/01/2004||Yes|No||03/01/2004||Yes|No|03/01/2004||Yes|No||||No|No|||Prescription required|No||173|No|.93312|03/29/2022|.91072|03/29/2022|.91679|03/29/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|812|||||No|No||ROXANE/WEST-WAR|No||||
mercaptopurine|No|No|No|No|75%|00054458127|MERCAPTOPURINE 50 MG TABLET|250|EA|1.22679|03/01/2004||Yes|No||03/01/2004||Yes|No|03/01/2004||Yes|No||||No|No|||Prescription required|No||173|No|.93312|03/29/2022|.91072|03/29/2022|.91679|03/29/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|813|||||No|No||ROXANE/WEST-WAR|No||||
prednisone|No|No|No|No|75%|00054472825|PREDNISONE 5 MG TABLET|100|EA|.07778|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|.07803|03/29/2022|.07615|03/29/2022|.07666|03/29/2022|||GLUCOCORTICOIDS: ORAL|814|||||No|No||ROXANE/WEST-WAR|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00054472831|PREDNISONE 5 MG TABLET|1000|EA|.077|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|.07803|03/29/2022|.07615|03/29/2022|.07666|03/29/2022|||GLUCOCORTICOIDS: ORAL|815|||||No|No||ROXANE/WEST-WAR|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00054474125|PREDNISONE 1 MG TABLET|100|EA|.08698|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|.08042|03/29/2022|.07848|03/29/2022|.07901|03/29/2022|||GLUCOCORTICOIDS: ORAL|816|||||No|No||WEST-WARD/HIKMA|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00054474131|PREDNISONE 1 MG TABLET|1000|EA|.08612|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|.08042|03/29/2022|.07848|03/29/2022|.07901|03/29/2022|||GLUCOCORTICOIDS: ORAL|817|||||No|No||WEST-WARD/HIKMA|No||||
prednisone|No|No|No|No|75%|00054474225|PREDNISONE 2.5 MG TABLET|100|EA|.05667|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|.09048|03/29/2022|.0883|03/29/2022|.08889|03/29/2022|||GLUCOCORTICOIDS: ORAL|818|||||No|No||ROXANE/WEST-WAR|Yes|09/01/2020|||
triazolam|No|No|No|No|90%|00054485825|TRIAZOLAM 0.125 MG TABLET|100|EA|1.2614|03/07/2019||Yes|No||03/07/2019||Yes|No|03/07/2019||Yes|No||||No|No|||Prescription required|No||054|Yes|1.52308|03/29/2022|1.48652|03/29/2022|1.49642|03/29/2022|||SEDATIVE HYPNOTICS|819|||||No|No||WEST-WARD/HIKMA|No||||
triazolam|No|No|No|No|90%|00054485925|TRIAZOLAM 0.25 MG TABLET|100|EA|1.2614|03/07/2019||Yes|No||03/07/2019||Yes|No|03/07/2019||Yes|No||||No|No|||Prescription required|No||054|Yes|1.09553|03/29/2022|1.06923|03/29/2022|1.07635|03/29/2022|||SEDATIVE HYPNOTICS|820|||||No|No||WEST-WARD/HIKMA|No||||
triazolam|No|No|No|No|90%|00054485929|TRIAZOLAM 0.25 MG TABLET|500|EA|.63071|07/01/2016||Yes|No||07/01/2016||Yes|No|07/01/2016||Yes|No||||No|No|||Prescription required|No||054|Yes|1.09553|03/29/2022|1.06923|03/29/2022|1.07635|03/29/2022|||SEDATIVE HYPNOTICS|821|||||No|No||WEST-WARD/HIKMA|No||||
clotrimazole|No|No|No|No|75%|00054814622|CLOTRIMAZOLE 10 MG TROCHE|70|EA|1.18176|01/20/2011||Yes|No||01/20/2011||Yes|No|01/20/2011||Yes|No||01/20/2011||Yes|No|||Prescription required|No||069|No|.42659|03/29/2022|.41635|03/29/2022|.41912|03/29/2022|||ANTIFUNGALS: ORAL|822|||||No|No||WEST-WARD/HIKMA|No||||
dexamethasone|No|No|No|No|75%|00054817425|DEXAMETHASONE 1 MG TABLET|100|EA|.13291|01/20/2011||Yes|No||01/20/2011||Yes|No|01/20/2011||Yes|No||01/20/2011||Yes|No|||Prescription required|No||168|Yes|.23592|03/29/2022|.23025|03/29/2022|.23179|03/29/2022|||GLUCOCORTICOIDS: ORAL|823|||||No|No||WEST-WARD/HIKMA|No||||
dexamethasone|No|No|No|No|75%|00054817525|DEXAMETHASONE 4 MG TABLET|100|EA|.43163|01/20/2011||Yes|No||01/20/2011||Yes|No|01/20/2011||Yes|No||01/20/2011||Yes|No|||Prescription required|No||168|Yes|.52706|03/29/2022|.51441|03/29/2022|.51783|03/29/2022|||GLUCOCORTICOIDS: ORAL|824|||||No|No||WEST-WARD/HIKMA|No||||
dexamethasone|No|No|No|No|75%|00054817625|DEXAMETHASONE 2 MG TABLET|100|EA|.26582|01/20/2011||Yes|No||01/20/2011||Yes|No|01/20/2011||Yes|No||01/20/2011||Yes|No|||Prescription required|No||168|Yes|.46036|03/29/2022|.44931|03/29/2022|.4523|03/29/2022|||GLUCOCORTICOIDS: ORAL|825|||||No|No||WEST-WARD/HIKMA|No||||
dexamethasone|No|No|No|No|75%|00054817925|DEXAMETHASONE 0.5 MG TABLET|100|EA|.07408|01/20/2011||Yes|No||01/20/2011||Yes|No|01/20/2011||Yes|No||01/20/2011||Yes|No|||Prescription required|No||168|Yes|.10515|03/29/2022|.10262|03/29/2022|.1033|03/29/2022|||GLUCOCORTICOIDS: ORAL|826|||||No|No||ROXANE/WEST-WAR|No||||
dexamethasone|No|No|No|No|75%|00054818025|DEXAMETHASONE 0.75 MG TABLET|100|EA|.0952|01/20/2011||Yes|No||01/20/2011||Yes|No|01/20/2011||Yes|No||01/20/2011||Yes|No|||Prescription required|No||168|Yes|.18206|01/25/2022|.17769|01/25/2022|.17887|01/25/2022|||GLUCOCORTICOIDS: ORAL|827|||||No|No||ROXANE/WEST-WAR|No||||
dexamethasone|No|No|No|No|75%|00054818125|DEXAMETHASONE 1.5 MG TABLET|100|EA|.19633|01/20/2011||Yes|No||01/20/2011||Yes|No|02/16/2001||Yes|No||01/20/2011||Yes|No|||Prescription required|No||168|Yes|.34387|03/29/2022|.33561|03/29/2022|.33785|03/29/2022|||GLUCOCORTICOIDS: ORAL|828|||||No|No||ROXANE/WEST-WAR|No||||
dexamethasone|No|No|No|No|75%|00054818325|DEXAMETHASONE 6 MG TABLET|100|EA|.67914|01/20/2011||Yes|No||01/20/2011||Yes|No|01/20/2011||Yes|No||01/20/2011||Yes|No|||Prescription required|No||168|Yes|1.17981|03/29/2022|1.15149|03/29/2022|1.15916|03/29/2022|||GLUCOCORTICOIDS: ORAL|829|||||No|No||ROXANE/WEST-WAR|No||||
furosemide|No|No|No|No|75%|00054829725|FUROSEMIDE 20 MG TABLET|100|EA|.07236|01/21/2011||Yes|No||01/21/2011||Yes|No|01/21/2011||Yes|No||01/21/2011||Yes|No|||Prescription required|No|||No|.03187|03/29/2022|.0311|03/29/2022|.03131|03/29/2022||||830|||||No|No||WEST-WARD/HIKMA|No||||
furosemide|No|No|No|No|75%|00054829925|FUROSEMIDE 40 MG TABLET|100|EA|.08114|01/21/2011||Yes|No||01/21/2011||Yes|No|01/21/2011||Yes|No||01/21/2011||Yes|No|||Prescription required|No|||No|.03326|03/29/2022|.03246|03/29/2022|.03267|03/29/2022||||831|||||No|No||WEST-WARD/HIKMA|No||||
furosemide|No|No|No|No|75%|00054830125|FUROSEMIDE 80 MG TABLET|100|EA|.16757|01/21/2011||Yes|No||01/21/2011||Yes|No|01/21/2011||Yes|No||01/21/2011||Yes|No|||Prescription required|No|||No|.06148|03/29/2022|.06|03/29/2022|.0604|03/29/2022||||832|||||No|No||WEST-WARD/HIKMA|No||||
leucovorin calcium|No|No|No|No|75%|00054849619|LEUCOVORIN CALCIUM 5 MG TAB|50|EA|.67716|01/20/2011||Yes|No||01/20/2011||Yes|No|01/20/2011||Yes|No||||No|No|||Prescription required|No|||No|.873|03/29/2022|.85204|03/29/2022|.85772|03/29/2022||||833|||||No|No||WEST-WARD/HIKMA|No||||
lithium carbonate|No|No|No|No|75%|00054852625|LITHIUM CARBONATE 150 MG CAP|100|EA|.06458|01/21/2011||Yes|No||01/21/2011||Yes|No|01/21/2011||Yes|No||||No|No|||Prescription required|No|||No|.06953|03/29/2022|.06786|03/29/2022|.06831|03/29/2022||||834|||||No|No||WEST-WARD/HIKMA|No||||
lithium carbonate|No|No|No|No|75%|00054852725|LITHIUM CARBONATE 300 MG CAP|100|EA|.07206|01/21/2011||Yes|No||01/21/2011||Yes|No|01/21/2011||Yes|No||||No|No|||Prescription required|No|||No|.04894|03/29/2022|.04776|03/29/2022|.04808|03/29/2022||||835|||||No|No||WEST-WARD/HIKMA|No||||
lithium carbonate|No|No|No|No|75%|00054852825|LITHIUM CARBONATE 300 MG TAB|100|EA|.08879|01/21/2011||Yes|No||01/21/2011||Yes|No|01/21/2011||Yes|No||||No|No|||Prescription required|No|||No|.13413|03/29/2022|.13091|03/29/2022|.13178|03/29/2022||||836|||||No|No||WEST-WARD/HIKMA|No||||
methotrexate sodium|No|No|No|No|75%|00054855025|METHOTREXATE 2.5 MG TABLET|100|EA|1.31021|01/21/2011||Yes|No||01/21/2011||Yes|No|01/21/2011||Yes|No||||No|No|||Prescription required|No|||No|.26817|03/29/2022|.26173|03/29/2022|.26347|03/29/2022||||837|||||No|No||ROXANE/WEST-WAR|No||||
methadone HCl|No|No|No|No|90%|00054855324|METHADONE HCL 5 MG TABLET|100|EA|.13222|08/06/2020|02/01/2022|Yes|No||08/06/2020|02/01/2022|Yes|No|08/06/2020|02/01/2022|Yes|No||||No|No|||Prescription required|Yes|07/27/2017|110|Yes|.12051|03/29/2022|.11761|03/29/2022|.1184|03/29/2022|||ANALGESICS: NARCOTICS LONG|838|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||WEST-WARD/HIKMA|No||||
methadone HCl|No|No|No|No|90%|00054855424|METHADONE HCL 10 MG TABLET|100|EA|.15045|08/06/2020|02/01/2022|Yes|No||08/06/2020|02/01/2022|Yes|No|08/06/2020|02/01/2022|Yes|No||||No|No|||Prescription required|Yes|07/27/2017|110|Yes|.08598|03/29/2022|.08391|03/29/2022|.08447|03/29/2022|||ANALGESICS: NARCOTICS LONG|839|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||WEST-WARD/HIKMA|No||||
prednisone|No|No|No|No|75%|00054872425|PREDNISONE 5 MG TABLET|100|EA|.08557|01/21/2011||Yes|No||01/21/2011||Yes|No|01/21/2011||Yes|No||01/21/2011||Yes|No|||Prescription required|No||168|Yes|.07803|03/29/2022|.07615|03/29/2022|.07666|03/29/2022|||GLUCOCORTICOIDS: ORAL|840|||||No|No||WEST-WARD/HIKMA|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00054873925|PREDNISONE 1 MG TABLET|100|EA|.09567|01/21/2011||Yes|No||01/21/2011||Yes|No|01/21/2011||Yes|No||01/21/2011||Yes|No|||Prescription required|No||168|Yes|.08042|03/29/2022|.07848|03/29/2022|.07901|03/29/2022|||GLUCOCORTICOIDS: ORAL|841|||||No|No||ROXANE/WEST-WAR|No||||
prednisone|No|No|No|No|75%|00054874025|PREDNISONE 2.5 MG TABLET|100|EA|.06239|01/21/2011||Yes|No||01/21/2011||Yes|No|01/21/2011||Yes|No||01/21/2011||Yes|No|||Prescription required|No||168|Yes|.09048|03/29/2022|.0883|03/29/2022|.08889|03/29/2022|||GLUCOCORTICOIDS: ORAL|842|||||No|No||WEST-WARD/HIKMA|No||||
prednisone|No|No|No|No|75%|00054981725|PREDNISONE 10 MG TABLET|100|EA|.0835|04/01/2021||Yes|No||04/01/2021||Yes|No|04/01/2021||Yes|No||04/01/2021||Yes|No|||Prescription required|No||168|Yes|.07092|03/29/2022|.06921|03/29/2022|.06967|03/29/2022|||GLUCOCORTICOIDS: ORAL|843|||||No|No||WEST-WARD/HIKMA|No||||
prednisone|No|No|No|No|75%|00054981729|PREDNISONE 10 MG TABLET|500|EA|.08267|04/01/2021||Yes|No||04/01/2021||Yes|No|04/01/2021||Yes|No||04/01/2021||Yes|No|||Prescription required|No||168|Yes|.07092|03/29/2022|.06921|03/29/2022|.06967|03/29/2022|||GLUCOCORTICOIDS: ORAL|844|||||No|No||WEST-WARD/HIKMA|No||||
prednisone|No|No|No|No|75%|00054982825|PREDNISONE 5 MG TABLET|100|EA|.07778|04/30/2021||Yes|No||04/30/2021||Yes|No|04/30/2021||Yes|No||04/30/2021||Yes|No|||Prescription required|No||168|Yes|.07803|03/29/2022|.07615|03/29/2022|.07666|03/29/2022|||GLUCOCORTICOIDS: ORAL|845|||||No|No||WEST-WARD/HIKMA|No||||
prednisone|No|No|No|No|75%|00054982831|PREDNISONE 5 MG TABLET|1000|EA|.077|04/30/2021||Yes|No||04/30/2021||Yes|No|04/30/2021||Yes|No||04/30/2021||Yes|No|||Prescription required|No||168|Yes|.07803|03/29/2022|.07615|03/29/2022|.07666|03/29/2022|||GLUCOCORTICOIDS: ORAL|846|||||No|No||WEST-WARD/HIKMA|No||||
NALTREXONE HCL|No|No|No|No|75%|00056001176|NALTREXONE HCL|100|EA|1.10299|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||No|||||||.7816|10/01/2020||847|||||No|No||DU PONT PHARMA|Yes|09/01/2020|||
efavirenz|No|No|No|No|75%|00056047030|SUSTIVA 50 MG CAPSULE|30|EA|1.63539|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|2.67114|01/10/2017|2.63298|01/10/2017|2.5076|01/10/2017|||HIV / AIDS|848|||||No|No||BMS|No||||
efavirenz|No|No|No|No|75%|00056047492|SUSTIVA 200 MG CAPSULE|90|EA|6.53746|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|10.67785|01/23/2018|10.52531|01/23/2018|10.0241|01/23/2018|||HIV / AIDS|849|||||No|No||BMS|No||||
efavirenz|No|No|No|No|75%|00056051030|SUSTIVA 600 MG TABLET|30|EA|19.61239|03/21/2002||Yes|No||03/21/2002||Yes|No|03/21/2002||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|32.03358|03/24/2020|31.57596|03/24/2020|30.07234|03/24/2020|||HIV / AIDS|850|||||No|No||BMS|No||||
nepafenac|No|No|No|No|75%|00065000203|NEVANAC 0.1% DROPTAINER|3|ML|38.93363|08/30/2005||Yes|No||08/30/2005||Yes|No|08/30/2005||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|013|No|88.73246|11/23/2021|87.46485|11/23/2021|83.29986|11/23/2021|||OPHTHALMICS: ANTI-INFLAMMATORIES|851|||||No|No||ALCON/NOVARTIS|No||||
moxifloxacin HCl|No|No|No|No|75%|00065000603|MOXEZA 0.5% EYE DROPS|3|ML|24.32366|02/23/2011|02/07/2023|Yes|No||02/23/2011|02/07/2023|Yes|No|02/23/2011|02/07/2023|Yes|No||||No|No|||Prescription required|Yes|01/28/2021|058|No|55.43532|03/23/2021|54.64339|03/23/2021|52.04132|03/23/2021|||OPHTHALMIC ANTIBIOTICS|852|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ALCON/NOVARTIS|No||||
betaxolol HCl|No|No|No|No|75%|00065024610|BETOPTIC S 0.25% EYE DROPS|10|ML|13.35279|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|088|No|29.855|01/25/2022|29.13848|01/25/2022|29.33253|01/25/2022|||OPHTHALMICS: GLAUCOMA AGENTS|853|||||No|No||ALCON/NOVARTIS|No||||
betaxolol HCl|No|No|No|No|75%|00065024615|BETOPTIC S 0.25% EYE DROPS|15|ML|13.35178|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|088|No|30.42964|01/29/2019|29.99493|01/29/2019|28.5666|01/29/2019|||OPHTHALMICS: GLAUCOMA AGENTS|854|||||No|No||ALCON/NOVARTIS|No||||
brinzolamide|No|No|No|No|75%|00065027510|AZOPT 1% EYE DROPS|10|ML|14.75889|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||088|No|32.91509|10/26/2021|32.12512|10/26/2021|32.33907|10/26/2021|||OPHTHALMICS: GLAUCOMA AGENTS|855|||||No|No||ALCON/NOVARTIS|No||||
brinzolamide|No|No|No|No|75%|00065027515|AZOPT 1% EYE DROPS|15|ML|14.7576|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||088|No|33.06742|10/26/2021|32.2738|10/26/2021|32.48874|10/26/2021|||OPHTHALMICS: GLAUCOMA AGENTS|856|||||No|No||ALCON/NOVARTIS|No||||
olopatadine HCl|No|No|No|No|75%|00065033230|PATANASE 665 MCG NASAL SPRAY|30.5|GM|4.08161|04/28/2008||Yes|No||04/28/2008||Yes|No|04/28/2008||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|019|No|9.30228|01/29/2019|9.16939|01/29/2019|8.73275|01/29/2019|||INTRANASAL RHINITIS AGENTS|857|||||No|No||ALCON/NOVARTIS|No||||
lodoxamide tromethamine|No|No|No|No|75%|00065034510|ALOMIDE 0.1% EYE DROPS|10|ML|7.35601|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|002|No|16.76486|01/29/2019|16.52536|01/29/2019|15.73844|01/29/2019|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|858|||||No|No||ALCON/NOVARTIS|No||||
cyclopentolate/phenylephrine|No|No|No|No|75%|00065035905|CYCLOMYDRIL EYE DROPS|5|ML|4.7859|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|10.9074|03/01/2022|10.75158|03/01/2022|10.2396|03/01/2022||||859|||||No|No||ALCON LABORATOR|No||||
cyclopentolate HCl|No|No|No|No|75%|00065039515|CYCLOGYL 0.5% EYE DROPS|15|ML|2.48339|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|5.65982|03/01/2022|5.57896|03/01/2022|5.3133|03/01/2022||||860|||||No|No||ALCON LABORATOR|No||||
cyclopentolate HCl|No|No|No|No|75%|00065039605|CYCLOGYL 1% EYE DROPS|5|ML|4.68786|01/02/2008||Yes|No||01/02/2008||Yes|No|01/02/2008||Yes|No||||No|No|||Prescription required|No|||No|10.68396|03/01/2022|10.53133|03/01/2022|10.02984|03/01/2022||||861|||||No|No||ALCON LABORATOR|No||||
cyclopentolate HCl|No|No|No|No|75%|00065039705|CYCLOGYL 2% EYE DROPS|5|ML|5.64074|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|12.85564|03/01/2022|12.67198|03/01/2022|12.06856|03/01/2022||||862|||||No|No||ALCON LABORATOR|No||||
cyclopentolate HCl|No|No|No|No|75%|00065039715|CYCLOGYL 2% EYE DROPS|15|ML|3.12294|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|7.1174|03/01/2022|7.01572|03/01/2022|6.68164|03/01/2022||||863|||||No|No||ALCON LABORATOR|No||||
tobramycin|No|No|No|No|75%|00065064305|TOBREX 0.3% EYE DROP|5|ML|8.77802|03/01/2002|01/20/2023|Yes|No||03/01/2002|01/20/2023|Yes|No|03/01/2002|01/20/2023|Yes|No||||No|No|||Prescription required|Yes|01/20/2011|058|No|20.00572|01/09/2018|19.71992|01/09/2018|18.78088|01/09/2018|||OPHTHALMIC ANTIBIOTICS|864|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ALCON/NOVARTIS|No||||
tobramycin|No|No|No|No|75%|00065064435|TOBREX 0.3% EYE OINTMENT|3.5|GM|26.33565|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||058|No|58.74743|06/29/2021|57.33749|06/29/2021|57.71934|06/29/2021|||OPHTHALMIC ANTIBIOTICS|865|||||No|No||ALCON/NOVARTIS|No||||
natamycin|No|No|No|No|75%|00065064515|NATACYN 5% EYE DROPS|15|ML|13.57768|03/01/2002|10/18/2022|Yes|No||03/01/2002|10/18/2022|Yes|No|03/01/2002|10/18/2022|Yes|No||||No|No|||Prescription required|Yes|01/20/2011|058|No|30.94448|08/10/2021|30.50241|08/10/2021|29.04992|08/10/2021|||OPHTHALMIC ANTIBIOTICS|866|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||NOVARTIS/EYEVAN|No||||
tobramycin/dexamethasone|No|No|No|No|75%|00065064705|TOBRADEX EYE DROPS|5|ML|13.64218|01/02/2008||Yes|No||01/02/2008||Yes|No|01/02/2008||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|036|No|30.45967|11/23/2021|29.72863|11/23/2021|29.92662|11/23/2021|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|867|||||No|No||ALCON/NOVARTIS|No||||
tobramycin/dexamethasone|No|No|No|No|75%|00065064710|TOBRADEX EYE DROPS|10|ML|13.64003|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|036|No|31.08658|01/09/2018|30.64248|01/09/2018|29.18332|01/09/2018|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|868|||||No|No||ALCON/NOVARTIS|No||||
tobramycin/dexamethasone|No|No|No|No|75%|00065064725|TOBRADEX EYE DROPS|2.5|ML|13.61896|01/02/2008||Yes|No||01/02/2008||Yes|No|01/02/2008||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|036|No|31.03856|01/09/2018|30.59515|01/09/2018|29.13824|01/09/2018|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|869|||||No|No||ALCON/NOVARTIS|No||||
tobramycin/dexamethasone|No|No|No|No|75%|00065064835|TOBRADEX EYE OINTMENT|3.5|GM|28.03722|04/27/2010|06/02/2022|Yes|No||04/27/2010|06/02/2022|Yes|No|04/27/2010|06/02/2022|Yes|No||||No|No|||Prescription required|No||036|No|62.71824|08/24/2021|61.213|08/24/2021|61.62067|08/24/2021|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|870|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ALCON/NOVARTIS|No||||
tobramycin/dexamethasone|No|No|No|No|75%|00065065205|TOBRADEX ST 0.3-0.05% EYE DROP|5|ML|19.48502|07/18/2011||Yes|No||07/18/2011||Yes|No|07/18/2011||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|036|No|45.67465|09/28/2021|44.57845|09/28/2021|44.87534|09/28/2021|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|871|||||No|No||ALCON/EYEVANCE|No||||
ciprofloxacin HCl|No|No|No|No|75%|00065065435|CILOXAN 0.3% OINTMENT|3.5|GM|26.33565|03/01/2002|01/31/2022|Yes|No||03/01/2002|01/31/2022|Yes|No|03/01/2002|01/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/12/2005|058|No|60.02079|02/15/2022|59.16335|02/15/2022|56.34605|02/15/2022|||OPHTHALMIC ANTIBIOTICS|872|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ALCON/NOVARTIS|No||||
ciprofloxacin HCl|No|No|No|No|75%|00065065605|CILOXAN 0.3% EYE DROPS|5|ML|10.39912|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/12/2005|058|No|23.70032|01/09/2018|23.36174|01/09/2018|22.24928|01/09/2018|||OPHTHALMIC ANTIBIOTICS|873|||||No|No||ALCON/NOVARTIS|No||||
olopatadine HCl|No|No|No|No|75%|00065081604|PATADAY ONCE DAILY 0.7% DROPS|2.5|ML||03/04/2021||Yes|No||||No|No|03/04/2021||Yes|No||||No|No|||Over the counter|No||002|No|6.01073|06/29/2021|5.86647|06/29/2021|5.90554|06/29/2021|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|874|||||No|No||ALCON LABORATOR|No||||
moxifloxacin HCl|No|No|No|No|75%|00065401303|VIGAMOX 0.5% EYE DROPS|3|ML|24.9572|05/05/2003|07/31/2022|Yes|No||05/05/2003|07/31/2022|Yes|No|05/05/2003|07/31/2022|Yes|No||||No|No|||Prescription required|Yes|01/31/2019|058|No|55.75278|08/24/2021|54.41471|08/24/2021|54.7771|08/24/2021|||OPHTHALMIC ANTIBIOTICS|875|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ALCON/NOVARTIS|No||||
olopatadine HCl|No|No|No|No|75%|00065815001|PATADAY ONCE DAILY 0.2% DROPS|2.5|ML||03/04/2021||Yes|No||||No|No|03/04/2021||Yes|No||||No|No|||Over the counter|Yes|01/28/2021|002|No|5.77434|06/29/2021|5.63575|06/29/2021|5.67328|06/29/2021|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|876|||||No|No||ALCON LABORATOR|No||||
ciprofloxacin/hydrocortisone|No|No|No|No|75%|00065853110|CIPRO HC OTIC SUSPENSION|10|ML|13.58241|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|051|No|30.13429|03/01/2022|29.41106|03/01/2022|29.60693|03/01/2022|||OTIC ANTIBIOTICS|877|||||No|No||ALCON/NOVARTIS|No||||
difluprednate|No|No|No|No|75%|00065924007|DUREZOL 0.05% EYE DROPS|5|ML|17.85532|09/26/2013||Yes|No||09/26/2013||Yes|No|09/26/2013||Yes|No||||No|No|||Prescription required|No||013|No|39.8427|10/26/2021|38.88647|10/26/2021|39.14545|10/26/2021|||OPHTHALMICS: ANTI-INFLAMMATORIES|878|||||No|No||ALCON/NOVARTIS|No||||
rifampin|No|No|No|No|75%|00068059701|RIFADIN IV 600 MG VIAL|1|EA|76.7808|01/27/2010||Yes|No||01/27/2010||Yes|No|01/27/2010||Yes|No||||No|No|||Prescription required|No|||No|174.9888|06/01/2016|172.48896|06/01/2016|164.2752|06/01/2016||||879|||||No|No||SANOFI-AVENTIS|No||||
rifampin|No|No|No|No|75%|00068059901|RIFADIN IV 600 MG VIAL|1|EA|76.7808|01/05/2018||Yes|No||01/05/2018||Yes|No|01/05/2018||Yes|No||||No|No|||Prescription required|No|||No|174.9888|01/05/2018|172.48896|01/05/2018|164.2752|01/05/2018||||880|||||No|No||SANOFI-AVENTIS|No||||
taliglucerase alfa|No|No|No|No|75%|00069010601|ELELYSO 200 UNITS VIAL|1|EA|360.8173|01/08/2013||Yes|No||01/08/2013||Yes|No|01/08/2013||Yes|No||||No|No|||Prescription required|No|||No|822.3278|01/04/2022|810.58026|01/04/2022|771.9812|01/04/2022||||881|||||No|No||PFIZER US PHARM|No||||
bosutinib|No|No|No|No|75%|00069013501|BOSULIF 100 MG TABLET|120|EA|62.21275|11/22/2013||Yes|No||11/22/2013||Yes|No|11/22/2013||Yes|No||||No|No|||Prescription required|No||173|No|141.78721|01/04/2022|139.76168|01/04/2022|133.10636|01/04/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|882|||||No|No||PFIZER US PHARM|No||||
bosutinib|No|No|No|No|75%|00069013601|BOSULIF 500 MG TABLET|30|EA|248.85103|11/12/2012||Yes|No||11/12/2012||Yes|No|11/12/2012||Yes|No||||No|No|||Prescription required|No||173|No|567.14886|01/04/2022|559.04673|01/04/2022|532.42546|01/04/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|883|||||No|No||PFIZER US PHARM|No||||
axitinib|No|No|No|No|75%|00069014501|INLYTA 1 MG TABLET|180|EA|42.46431|06/15/2012||Yes|No||06/15/2012||Yes|No|06/15/2012||Yes|No||||No|No|||Prescription required|No||548|No|96.77913|01/04/2022|95.39657|01/04/2022|90.85388|01/04/2022|||ONCOLOGY: ORAL - RENAL CELL|884|||||No|No||PFIZER US PHARM|No||||
axitinib|No|No|No|No|75%|00069015111|INLYTA 5 MG TABLET|60|EA|127.39294|06/15/2012||Yes|No||06/15/2012||Yes|No|06/15/2012||Yes|No||||No|No|||Prescription required|No||548|No|290.3374|01/04/2022|286.18972|01/04/2022|272.56164|01/04/2022|||ONCOLOGY: ORAL - RENAL CELL|885|||||No|No||PFIZER US PHARM|No||||
palbociclib|No|No|No|No|75%|00069018721|IBRANCE 75 MG CAPSULE|21|EA|286.13018|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||502|No|652.11065|01/04/2022|642.79479|01/04/2022|612.18551|01/04/2022|||ONCOLOGY: ORAL - BREAST|886|||||No|No||PFIZER US PHARM|No||||
palbociclib|No|No|No|No|75%|00069018821|IBRANCE 100 MG CAPSULE|21|EA|286.13018|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||502|No|652.11065|01/04/2022|642.79479|01/04/2022|612.18551|01/04/2022|||ONCOLOGY: ORAL - BREAST|887|||||No|No||PFIZER US PHARM|No||||
palbociclib|No|No|No|No|75%|00069018921|IBRANCE 125 MG CAPSULE|21|EA|286.13018|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||502|No|652.11065|01/04/2022|642.79479|01/04/2022|612.18551|01/04/2022|||ONCOLOGY: ORAL - BREAST|888|||||No|No||PFIZER US PHARM|No||||
dalteparin sodium,porcine|No|No|No|No|75%|00069019502|FRAGMIN 2,500 UNIT/0.2 ML SYR|.2|ML|60.12045|09/24/2015||Yes|No||09/24/2015||Yes|No|09/24/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|068|Yes|137.0187|01/04/2022|135.06129|01/04/2022|128.6298|01/04/2022|||ANTICOAGULANTS|889|||||No|No||PFIZER US PHARM|No||||
dalteparin sodium,porcine|No|No|No|No|75%|00069019602|FRAGMIN 5,000 UNIT/0.2 ML SYR|.2|ML|97.53905|09/24/2015||Yes|No||09/24/2015||Yes|No|09/24/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|068|Yes|222.2983|01/04/2022|219.12261|01/04/2022|208.6882|01/04/2022|||ANTICOAGULANTS|890|||||No|No||PFIZER US PHARM|No||||
dacomitinib|No|No|No|No|75%|00069019730|VIZIMPRO 15 MG TABLET|30|EA|206.72837|03/18/2019||Yes|No||03/18/2019||Yes|No|03/18/2019||Yes|No||||No|No|||Prescription required|No||551|No|471.14838|01/04/2022|464.41769|01/04/2022|442.30256|01/04/2022|||ONCOLOGY: ORAL - LUNG|891|||||No|No||PFIZER US PHARM|No||||
dalteparin sodium,porcine|No|No|No|No|75%|00069020602|FRAGMIN 7,500 UNIT/0.3 ML SYR|.3|ML|97.5498|09/24/2015||Yes|No||09/24/2015||Yes|No|09/24/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|068|Yes|222.3228|01/04/2022|219.14676|01/04/2022|208.7112|01/04/2022|||ANTICOAGULANTS|892|||||No|No||PFIZER US PHARM|No||||
dalteparin sodium,porcine|No|No|No|No|75%|00069021702|FRAGMIN 10,000 UNIT/ML SYRINGE|1|ML|39.01562|09/24/2015||Yes|No||09/24/2015||Yes|No|09/24/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|068|Yes|88.91932|01/04/2022|87.64904|01/04/2022|83.47528|01/04/2022|||ANTICOAGULANTS|893|||||No|No||PFIZER US PHARM|No||||
dalteparin sodium,porcine|No|No|No|No|75%|00069022002|FRAGMIN 12,500 UNIT/0.5 ML SYR|.5|ML|97.5455|09/24/2015||Yes|No||09/24/2015||Yes|No|09/24/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|068|Yes|222.313|01/04/2022|219.1371|01/04/2022|208.702|01/04/2022|||ANTICOAGULANTS|894|||||No|No||PFIZER US PHARM|No||||
dalteparin sodium,porcine|No|No|No|No|75%|00069022302|FRAGMIN 15,000 UNIT/0.6 ML SYR|.6|ML|97.54048|09/24/2015||Yes|No||09/24/2015||Yes|No|09/24/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|068|Yes|222.30156|01/04/2022|219.12582|01/04/2022|208.69126|01/04/2022|||ANTICOAGULANTS|895|||||No|No||PFIZER US PHARM|No||||
dalteparin sodium,porcine|No|No|No|No|75%|00069022802|FRAGMIN 18,000 UNIT/0.72 ML|.72|ML|97.54012|09/24/2015||Yes|No||09/24/2015||Yes|No|09/24/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|068|Yes|222.30075|01/04/2022|219.12502|01/04/2022|208.6905|01/04/2022|||ANTICOAGULANTS|896|||||No|No||PFIZER US PHARM|No||||
dalteparin sodium,porcine|No|No|No|No|75%|00069023201|FRAGMIN 95,000 UNIT/3.8 ML VL|3.8|ML|88.25184|09/24/2015||Yes|No||09/24/2015||Yes|No|09/24/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|068|Yes|201.1321|01/04/2022|198.25878|01/04/2022|188.81789|01/04/2022|||ANTICOAGULANTS|897|||||No|No||PFIZER US PHARM|No||||
fesoterodine fumarate|No|No|No|No|75%|00069024230|TOVIAZ ER 4 MG TABLET|30|EA|5.39721|02/24/2009||Yes|No||02/24/2009||Yes|No|02/24/2009||Yes|No||||No|No|||Prescription required|No||006|No|12.0064|01/11/2022|11.71824|01/11/2022|11.79628|01/11/2022|||BLADDER RELAXANT PREPARATIONS|898|||||No|No||PFIZER US PHARM|No||||
fesoterodine fumarate|No|No|No|No|75%|00069024430|TOVIAZ ER 8 MG TABLET|30|EA|5.39721|02/24/2009||Yes|No||02/24/2009||Yes|No|02/24/2009||Yes|No||||No|No|||Prescription required|No||006|No|12.05064|01/11/2022|11.76142|01/11/2022|11.83975|01/11/2022|||BLADDER RELAXANT PREPARATIONS|899|||||No|No||PFIZER US PHARM|No||||
palbociclib|No|No|No|No|75%|00069028403|IBRANCE 75 MG TABLET|21|EA|286.13018|04/30/2020||Yes|No||04/30/2020||Yes|No|04/30/2020||Yes|No||||No|No|||Prescription required|No||502|No|652.11065|01/04/2022|642.79479|01/04/2022|612.18551|01/04/2022|||ONCOLOGY: ORAL - BREAST|900|||||No|No||PFIZER US PHARM|No||||
talazoparib tosylate|No|No|No|No|75%|00069029630|TALZENNA 0.25 MG CAPSULE|30|EA|77.55179|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|No||502|No|176.74594|01/04/2022|174.22099|01/04/2022|165.92476|01/04/2022|||ONCOLOGY: ORAL - BREAST|901|||||No|No||PFIZER US PHARM|No||||
sildenafil citrate|No|No|No|No|75%|00069033621|REVATIO 10 MG/ML ORAL SUSP|112|ML|30.95951|01/16/2015||Yes|No||01/16/2015||Yes|No|01/16/2015||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|Yes|83.19088|03/22/2022|82.00244|03/22/2022|78.09756|03/22/2022|||PAH AGENTS: ORAL AND INHALED|902|||||No|No||PFIZER/VIATRIS|No||||
varenicline tartrate|No|No|No|No|75%|00069046856|CHANTIX 0.5 MG TABLET|56|EA|3.49873|07/14/2006|09/16/2022|Yes|No||07/14/2006|09/16/2022|Yes|No|07/14/2006|09/16/2022|Yes|No||||No|No|||Prescription required|No||040|No|7.97386|01/25/2022|7.85995|01/25/2022|7.48567|01/25/2022|||SMOKING CESSATION|903|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||PFIZER US PHARM|Yes|09/01/2020|||
varenicline tartrate|No|No|No|No|75%|00069046956|CHANTIX 1 MG TABLET|56|EA|3.6037|07/14/2006|09/16/2022|Yes|No||07/14/2006|09/16/2022|Yes|No|07/14/2006|09/16/2022|Yes|No||||No|No|||Prescription required|No||040|No|8.01002|03/15/2022|7.81777|03/15/2022|7.86984|03/15/2022|||SMOKING CESSATION|904|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||PFIZER US PHARM|Yes|09/01/2020|||
varenicline tartrate|No|No|No|No|75%|00069047103|CHANTIX STARTING MONTH BOX|53|EA|3.80768|10/02/2015|09/16/2022|Yes|No||10/02/2015|09/16/2022|Yes|No|10/02/2015|09/16/2022|Yes|No||||No|No|||Prescription required|No||040|No|8.45696|01/11/2022|8.25399|01/11/2022|8.30896|01/11/2022|||SMOKING CESSATION|905|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||PFIZER US PHARM|Yes|09/01/2020|||
palbociclib|No|No|No|No|75%|00069048603|IBRANCE 100 MG TABLET|21|EA|286.13018|04/30/2020||Yes|No||04/30/2020||Yes|No|04/30/2020||Yes|No||||No|No|||Prescription required|No||502|No|652.11065|01/04/2022|642.79479|01/04/2022|612.18551|01/04/2022|||ONCOLOGY: ORAL - BREAST|906|||||No|No||PFIZER US PHARM|No||||
tofacitinib citrate|No|No|No|No|75%|00069050130|XELJANZ XR 11 MG TABLET|30|EA|74.55727|07/17/2017||Yes|No||07/17/2017||Yes|No|07/17/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|071|Yes|168.44163|01/11/2022|164.39903|01/11/2022|165.4939|01/11/2022|||CYTOKINE AND CAM ANTAGONISTS|907|||||No|No||PFIZER US PHARM|No||||
sunitinib malate|No|No|No|No|75%|00069055038|SUTENT 12.5 MG CAPSULE|28|EA|91.6803|08/10/2006||Yes|No||08/10/2006||Yes|No|08/10/2006||Yes|No||||No|No|||Prescription required|No||548|No|205.64611|01/11/2022|200.7106|01/11/2022|202.0473|01/11/2022|||ONCOLOGY: ORAL - RENAL CELL|908|||||No|No||PFIZER US PHARM|No||||
palbociclib|No|No|No|No|75%|00069068803|IBRANCE 125 MG TABLET|21|EA|286.13018|04/30/2020||Yes|No||04/30/2020||Yes|No|04/30/2020||Yes|No||||No|No|||Prescription required|No||502|No|652.11065|01/04/2022|642.79479|01/04/2022|612.18551|01/04/2022|||ONCOLOGY: ORAL - BREAST|909|||||No|No||PFIZER US PHARM|No||||
sunitinib malate|No|No|No|No|75%|00069077038|SUTENT 25 MG CAPSULE|28|EA|183.36075|08/10/2006||Yes|No||08/10/2006||Yes|No|08/10/2006||Yes|No||||No|No|||Prescription required|No||548|No|415.22318|01/11/2022|405.25782|01/11/2022|407.95677|01/11/2022|||ONCOLOGY: ORAL - RENAL CELL|910|||||No|No||PFIZER US PHARM|No||||
sunitinib malate|No|No|No|No|75%|00069083038|SUTENT 37.5 MG CAPSULE|28|EA|275.0412|03/05/2015||Yes|No||03/05/2015||Yes|No|03/05/2015||Yes|No||||No|No|||Prescription required|No||548|No|626.83809|01/04/2022|617.88326|01/04/2022|588.46025|01/04/2022|||ONCOLOGY: ORAL - RENAL CELL|911|||||No|No||PFIZER US PHARM|No||||
doxycycline hyclate|Yes|No|No|No|75%|00069095050|VIBRAMYCIN 100 MG CAPSULE|50|EA|.39121|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|11/01/2012||Prescription required|Yes|02/02/2010|213|No|.8916|01/04/2022|.87886|01/04/2022|.83701|01/04/2022|||TETRACYCLINES|912|||||No|No||PFIZER US PHARM|No||||
doxycycline monohydrate|No|No|No|No|75%|00069097065|VIBRAMYCIN 25 MG/5 ML SUSP|60|ML|.29633|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||213|No|.67537|01/05/2021|.66572|01/05/2021|.63402|01/05/2021|||TETRACYCLINES|913|||||No|No||PFIZER US PHARM|No||||
doxycycline calcium|No|No|No|No|75%|00069097195|VIBRAMYCIN 50 MG/5 ML SYRUP|473|ML|.45895|02/09/2021||Yes|No||02/09/2021||Yes|No|02/09/2021||Yes|No||02/09/2021||Yes|No|||Prescription required|Yes|01/30/2020|213|No|1.04598|02/09/2021|1.03104|02/09/2021|.98194|02/09/2021|||TETRACYCLINES|914|||||No|No||PFIZER US PHARM|No||||
sunitinib malate|No|No|No|No|75%|00069098038|SUTENT 50 MG CAPSULE|28|EA|319.20512|08/09/2006||Yes|No||08/09/2006||Yes|No|08/09/2006||Yes|No||||No|No|||Prescription required|No||548|No|727.49075|01/04/2022|717.09802|01/04/2022|682.9505|01/04/2022|||ONCOLOGY: ORAL - RENAL CELL|915|||||No|No||PFIZER US PHARM|No||||
tofacitinib citrate|No|No|No|No|75%|00069100101|XELJANZ 5 MG TABLET|60|EA|37.27863|02/11/2013||Yes|No||02/11/2013||Yes|No|02/11/2013||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|071|Yes|84.23091|01/11/2022|82.20936|01/11/2022|82.75686|01/11/2022|||CYTOKINE AND CAM ANTAGONISTS|916|||||No|No||PFIZER US PHARM|No||||
tofacitinib citrate|No|No|No|No|75%|00069100201|XELJANZ 10 MG TABLET|60|EA|37.27863|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|071|Yes|84.96061|01/04/2022|83.74688|01/04/2022|79.75894|01/04/2022|||CYTOKINE AND CAM ANTAGONISTS|917|||||No|No||PFIZER US PHARM|No||||
tofacitinib citrate|No|No|No|No|75%|00069102902|XELJANZ 1 MG/ML SOLUTION|240|ML|7.45571|09/21/2021||Yes|No||09/21/2021||Yes|No|09/21/2021||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|071|Yes|16.99209|01/04/2022|16.74934|01/04/2022|15.95176|01/04/2022|||CYTOKINE AND CAM ANTAGONISTS|918|||||No|No||PFIZER US PHARM|No||||
nirmatrelvir/ritonavir|No|No|No|No|75%|00069108506|PAXLOVID CO-PACK (EUA)|6|EA|.0043|12/27/2021||Yes|No||12/27/2021||Yes|No|12/27/2021||Yes|No||||No|No|||Prescription required|No|||No|.0098|12/27/2021|.00966|12/27/2021|.0092|12/27/2021|.0001|12/27/2021||919|||||No|No||PFIZER US PHARM|No||||
nirmatrelvir/ritonavir|No|No|No|No|75%|00069108530|PAXLOVID CO-PACK (EUA)|30|EA|.0043|12/27/2021||Yes|No||12/27/2021||Yes|No|12/27/2021||Yes|No||||No|No|||Prescription required|No|||No|.0098|12/27/2021|.00966|12/27/2021|.0092|12/27/2021|.0001|12/27/2021||920|||||No|No||PFIZER US PHARM|No||||
talazoparib tosylate|No|No|No|No|75%|00069119530|TALZENNA 1 MG CAPSULE|30|EA|232.65522|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|No||502|No|530.23748|01/04/2022|522.66266|01/04/2022|497.77396|01/04/2022|||ONCOLOGY: ORAL - BREAST|921|||||No|No||PFIZER US PHARM|No||||
dacomitinib|No|No|No|No|75%|00069119830|VIZIMPRO 30 MG TABLET|30|EA|206.72837|03/18/2019||Yes|No||03/18/2019||Yes|No|03/18/2019||Yes|No||||No|No|||Prescription required|No||551|No|471.14838|01/04/2022|464.41769|01/04/2022|442.30256|01/04/2022|||ONCOLOGY: ORAL - LUNG|922|||||No|No||PFIZER US PHARM|No||||
epoetin alfa-epbx|No|No|No|No|75%|00069130501|RETACRIT 2,000 UNIT/ML VIAL|1|ML||10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|No||038|Yes|||||||21.61|10/07/2020|ERYTHROPOIESIS STIMULATING PROTEINS|923|||||No|No||PFIZER US PHARM|No||||
epoetin alfa-epbx|No|No|No|No|75%|00069130510|RETACRIT 2,000 UNIT/ML VIAL|1|ML|9.4858|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|No||038|Yes|21.6188|10/13/2020|21.30996|10/13/2020|20.2952|10/07/2020|||ERYTHROPOIESIS STIMULATING PROTEINS|924|||||No|No||PFIZER US PHARM|No||||
epoetin alfa-epbx|No|No|No|No|75%|00069130601|RETACRIT 3,000 UNIT/ML VIAL|1|ML||10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|No||038|Yes|||||||32.42|10/07/2020|ERYTHROPOIESIS STIMULATING PROTEINS|925|||||No|No||PFIZER US PHARM|No||||
epoetin alfa-epbx|No|No|No|No|75%|00069130610|RETACRIT 3,000 UNIT/ML VIAL|1|ML|14.2287|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|No||038|Yes|32.4282|10/07/2020|31.96494|10/07/2020|30.4428|10/07/2020|||ERYTHROPOIESIS STIMULATING PROTEINS|926|||||No|No||PFIZER US PHARM|No||||
epoetin alfa-epbx|No|No|No|No|75%|00069130701|RETACRIT 4,000 UNIT/ML VIAL|1|ML||10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|No||038|Yes|||||||43.23|10/07/2020|ERYTHROPOIESIS STIMULATING PROTEINS|927|||||No|No||PFIZER US PHARM|No||||
epoetin alfa-epbx|No|No|No|No|75%|00069130710|RETACRIT 4,000 UNIT/ML VIAL|1|ML|18.9716|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|No||038|Yes|43.2376|10/13/2020|42.61992|10/13/2020|40.5904|10/07/2020|||ERYTHROPOIESIS STIMULATING PROTEINS|928|||||No|No||PFIZER US PHARM|No||||
epoetin alfa-epbx|No|No|No|No|75%|00069130801|RETACRIT 10,000 UNIT/ML VIAL|1|ML||10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|No||038|Yes|||||||108.09|10/07/2020|ERYTHROPOIESIS STIMULATING PROTEINS|929|||||No|No||PFIZER US PHARM|No||||
epoetin alfa-epbx|No|No|No|No|75%|00069130810|RETACRIT 10,000 UNIT/ML VIAL|1|ML|47.429|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|No||038|Yes|108.094|10/07/2020|106.5498|10/13/2020|101.476|10/07/2020|||ERYTHROPOIESIS STIMULATING PROTEINS|930|||||No|No||PFIZER US PHARM|No||||
epoetin alfa-epbx|No|No|No|No|75%|00069130901|RETACRIT 40,000 UNIT/ML VIAL|1|ML||10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|No||038|Yes|||||||432.37|10/07/2020|ERYTHROPOIESIS STIMULATING PROTEINS|931|||||No|No||PFIZER US PHARM|No||||
epoetin alfa-epbx|No|No|No|No|75%|00069130904|RETACRIT 40,000 UNIT/ML VIAL|1|ML|189.716|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|No||038|Yes|432.376|10/07/2020|426.1992|10/13/2020|405.904|10/07/2020|||ERYTHROPOIESIS STIMULATING PROTEINS|932|||||No|No||PFIZER US PHARM|No||||
amlodipine besylate|No|No|No|No|75%|00069152068|NORVASC 2.5 MG TABLET|90|EA|3.24234|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|01/23/2008|045|Yes|7.38952|03/22/2022|7.28395|03/22/2022|6.9371|03/22/2022|||CALCIUM CHANNEL BLOCKERS|933|||||No|No||PFIZER/VIATRIS|No||||
amlodipine besylate|No|No|No|No|75%|00069153068|NORVASC 5 MG TABLET|90|EA|3.24234|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|01/23/2008|045|Yes|7.2439|03/29/2022|7.07004|03/29/2022|7.11713|03/29/2022|||CALCIUM CHANNEL BLOCKERS|934|||||No|No||PFIZER/VIATRIS|No||||
amlodipine besylate|No|No|No|No|75%|00069153072|NORVASC 5 MG TABLET|300|EA|3.24234|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|01/23/2008|045|Yes|7.2439|03/29/2022|7.07004|03/29/2022|7.11713|03/29/2022|||CALCIUM CHANNEL BLOCKERS|935|||||No|No||PFIZER/VIATRIS|No||||
amlodipine besylate|No|No|No|No|75%|00069154068|NORVASC 10 MG TABLET|90|EA|4.44519|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|01/23/2008|045|No|9.95998|03/29/2022|9.72094|03/29/2022|9.78568|03/29/2022|||CALCIUM CHANNEL BLOCKERS|936|||||No|No||PFIZER/VIATRIS|No||||
tafamidis meglumine|No|No|No|No|75%|00069197540|VYNDAQEL 20 MG CAPSULE|120|EA|70.14375|02/03/2020||Yes|No||02/03/2020||Yes|No|02/03/2020||Yes|No||||No|No|||Prescription required|No|||No|159.8625|01/04/2022|157.57875|01/04/2022|150.075|01/04/2022||||937|||||No|No||PFIZER US PHARM|No||||
amlodipine/atorvastatin|No|No|No|No|75%|00069215030|CADUET 5 MG-10 MG TABLET|30|EA|7.01258|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|Yes|07/22/2009|063|Yes|15.98216|03/22/2022|15.75384|03/22/2022|15.00366|03/22/2022|||LIPOTROPICS: STATINS|938|||||No|No||PFIZER/VIATRIS|No||||
amlodipine/atorvastatin|No|No|No|No|75%|00069216030|CADUET 10 MG-10 MG TABLET|30|EA|7.01258|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|Yes|07/22/2009|063|Yes|15.98216|03/22/2022|15.75384|03/22/2022|15.00366|03/22/2022|||LIPOTROPICS: STATINS|939|||||No|No||PFIZER/VIATRIS|No||||
amlodipine/atorvastatin|No|No|No|No|75%|00069217030|CADUET 5 MG-20 MG TABLET|30|EA|9.59315|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|Yes|07/22/2009|063|Yes|21.86346|03/22/2022|21.55113|03/22/2022|20.52488|03/22/2022|||LIPOTROPICS: STATINS|940|||||No|No||PFIZER/VIATRIS|No||||
amlodipine/atorvastatin|No|No|No|No|75%|00069218030|CADUET 10 MG-20 MG TABLET|30|EA|9.59315|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|Yes|07/22/2009|063|Yes|21.86346|03/22/2022|21.55113|03/22/2022|20.52488|03/22/2022|||LIPOTROPICS: STATINS|941|||||No|No||PFIZER/VIATRIS|No||||
amlodipine/atorvastatin|No|No|No|No|75%|00069219030|CADUET 5 MG-40 MG TABLET|30|EA|9.59315|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|Yes|07/22/2009|063|Yes|21.86346|03/22/2022|21.55113|03/22/2022|20.52488|03/22/2022|||LIPOTROPICS: STATINS|942|||||No|No||PFIZER/VIATRIS|No||||
amlodipine/atorvastatin|No|No|No|No|75%|00069225030|CADUET 10 MG-40 MG TABLET|30|EA|9.59315|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|Yes|07/22/2009|063|Yes|21.86346|03/22/2022|21.55113|03/22/2022|20.52488|03/22/2022|||LIPOTROPICS: STATINS|943|||||No|No||PFIZER/VIATRIS|No||||
amlodipine/atorvastatin|No|No|No|No|75%|00069226030|CADUET 5 MG-80 MG TABLET|30|EA|9.59315|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|Yes|07/22/2009|063|Yes|21.86346|03/22/2022|21.55113|03/22/2022|20.52488|03/22/2022|||LIPOTROPICS: STATINS|944|||||No|No||PFIZER/VIATRIS|No||||
amlodipine/atorvastatin|No|No|No|No|75%|00069227030|CADUET 10 MG-80 MG TABLET|30|EA|9.59315|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|Yes|07/22/2009|063|Yes|21.86346|03/22/2022|21.55113|03/22/2022|20.52488|03/22/2022|||LIPOTROPICS: STATINS|945|||||No|No||PFIZER/VIATRIS|No||||
dacomitinib|No|No|No|No|75%|00069229930|VIZIMPRO 45 MG TABLET|30|EA|206.72837|03/18/2019||Yes|No||03/18/2019||Yes|No|03/18/2019||Yes|No||||No|No|||Prescription required|No||551|No|471.14838|01/04/2022|464.41769|01/04/2022|442.30256|01/04/2022|||ONCOLOGY: ORAL - LUNG|946|||||No|No||PFIZER US PHARM|No||||
nifedipine|No|No|No|No|75%|00069265066|PROCARDIA XL 30 MG TABLET|100|EA|2.78511|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|02/23/2004|045|Yes|6.34746|01/04/2022|6.25678|01/04/2022|5.95884|01/04/2022|||CALCIUM CHANNEL BLOCKERS|947|||||No|No||PFIZER US PHARM|No||||
nifedipine|No|No|No|No|75%|00069265072|PROCARDIA XL 30 MG TABLET|300|EA|2.78515|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|02/23/2004|045|Yes|6.34755|01/04/2022|6.25687|01/04/2022|5.95893|01/04/2022|||CALCIUM CHANNEL BLOCKERS|948|||||No|No||PFIZER US PHARM|No||||
nifedipine|No|No|No|No|75%|00069266066|PROCARDIA XL 60 MG TABLET|100|EA|4.81961|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|02/23/2004|045|No|10.98423|01/04/2022|10.82731|01/04/2022|10.31172|01/04/2022|||CALCIUM CHANNEL BLOCKERS|949|||||No|No||PFIZER US PHARM|No||||
nifedipine|No|No|No|No|75%|00069266072|PROCARDIA XL 60 MG TABLET|300|EA|4.81963|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|02/23/2004|045|No|10.98429|01/04/2022|10.82737|01/04/2022|10.31178|01/04/2022|||CALCIUM CHANNEL BLOCKERS|950|||||No|No||PFIZER US PHARM|No||||
nifedipine|No|No|No|No|75%|00069267066|PROCARDIA XL 90 MG TABLET|100|EA|5.56076|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|02/23/2004|045|No|12.67336|01/04/2022|12.49231|01/04/2022|11.89744|01/04/2022|||CALCIUM CHANNEL BLOCKERS|951|||||No|No||PFIZER US PHARM|No||||
azithromycin|Yes|No|No|No|75%|00069305107|ZITHROMAX 1 GM POWDER PACKET|10|EA|53.60767|10/28/2003||Yes|No||10/28/2003||Yes|No|10/28/2003||Yes|No||10/28/2003||Yes|No|11/01/2012||Prescription required|Yes|05/25/2007|018|No|122.17562|01/04/2022|120.43025|01/04/2022|114.69548|01/04/2022|||MACROLIDES/KETOLIDES|952|||||No|No||PFIZER US PHARM|No||||
azithromycin|Yes|No|No|No|75%|00069305175|ZITHROMAX 1 GM POWDER PACKET|3|EA|10.621|10/23/2003||Yes|No||10/23/2003||Yes|No|10/23/2003||Yes|No||10/23/2003||Yes|No|11/01/2012||Prescription required|Yes|05/25/2007|018|No|24.206|01/04/2022|23.8602|01/04/2022|22.724|01/04/2022|||MACROLIDES/KETOLIDES|953|||||No|No||PFIZER US PHARM|No||||
azithromycin|Yes|No|No|No|75%|00069306075|ZITHROMAX 250 MG Z-PAK TABLET|6|EA|.92903|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|11/01/2012||Prescription required|Yes|07/18/2006|018|No|2.08064|03/01/2022|2.0307|03/01/2022|2.04422|03/01/2022|||MACROLIDES/KETOLIDES|954|||||No|No||PFIZER US PHARM|No||||
azithromycin|Yes|No|No|No|75%|00069307030|ZITHROMAX 500 MG TABLET|30|EA|1.28025|11/22/2005||Yes|No||11/22/2005||Yes|No|11/22/2005||Yes|No||11/22/2005||Yes|No|11/01/2012||Prescription required|Yes|07/18/2006|018|No|2.91778|01/04/2022|2.8761|01/04/2022|2.73914|01/04/2022|||MACROLIDES/KETOLIDES|955|||||No|No||PFIZER US PHARM|No||||
azithromycin|Yes|No|No|No|75%|00069307075|ZITHROMAX TRI-PAK 500 MG TAB|3|EA|29.96526|04/16/2004||Yes|No||04/16/2004||Yes|No|04/16/2004||Yes|No||04/16/2004||Yes|No|11/01/2012||Prescription required|Yes|07/18/2006|018|No|68.29292|01/04/2022|67.31731|01/04/2022|64.11172|01/04/2022|||MACROLIDES/KETOLIDES|956|||||No|No||PFIZER US PHARM|No||||
azithromycin|Yes|No|No|No|75%|00069307086|ZITHROMAX 500 MG TABLET|50|EA|29.96403|11/17/2005||Yes|No||11/17/2005||Yes|No|11/17/2005||Yes|No||11/17/2005||Yes|No|11/01/2012||Prescription required|Yes|07/18/2006|018|No|68.29012|01/04/2022|67.31455|01/04/2022|64.10909|01/04/2022|||MACROLIDES/KETOLIDES|957|||||No|No||PFIZER US PHARM|No||||
azithromycin|No|No|No|No|75%|00069311019|ZITHROMAX 100 MG/5 ML SUSP|15|ML|.7611|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|08/07/2010|018|No|1.7346|01/04/2022|1.70982|01/04/2022|1.6284|01/04/2022|||MACROLIDES/KETOLIDES|958|||||No|No||PFIZER US PHARM|No||||
azithromycin|No|No|No|No|75%|00069312019|ZITHROMAX 200 MG/5 ML SUSP|15|ML|1.45483|05/15/2008||Yes|No||05/15/2008||Yes|No|05/15/2008||Yes|No||05/15/2008||Yes|No|||Prescription required|Yes|08/07/2010|018|No|3.31566|01/04/2022|3.26829|01/04/2022|3.11266|01/04/2022|||MACROLIDES/KETOLIDES|959|||||No|No||PFIZER US PHARM|No||||
azithromycin|No|No|No|No|75%|00069313019|ZITHROMAX 200 MG/5 ML SUSP|22.5|ML|.96988|05/15/2008||Yes|No||05/15/2008||Yes|No|05/15/2008||Yes|No||05/15/2008||Yes|No|||Prescription required|Yes|08/07/2010|018|No|2.21043|01/04/2022|2.17886|01/04/2022|2.0751|01/04/2022|||MACROLIDES/KETOLIDES|960|||||No|No||PFIZER US PHARM|No||||
azithromycin|No|No|No|No|75%|00069314019|ZITHROMAX 200 MG/5 ML SUSP|30|ML|.38055|10/09/2003||Yes|No||10/09/2003||Yes|No|10/09/2003||Yes|No||10/09/2003||Yes|No|||Prescription required|Yes|08/07/2010|018|No|.8673|01/04/2022|.85491|01/04/2022|.8142|01/04/2022|||MACROLIDES/KETOLIDES|961|||||No|No||PFIZER US PHARM|No||||
azithromycin|No|No|No|No|75%|00069315083|ZITHROMAX I.V. 500 MG VIAL|1|EA|2.6187|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|5.9682|01/04/2022|5.88294|01/04/2022|5.6028|01/04/2022||||962|||||No|No||PFIZER US PHARM|No||||
piroxicam|No|No|No|No|75%|00069322066|FELDENE 10 MG CAPSULE|100|EA|3.47134|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|059|Yes|7.91144|01/04/2022|7.79842|01/04/2022|7.42706|01/04/2022|||NSAIDS|963|||||No|No||PFIZER US PHARM|No||||
piroxicam|No|No|No|No|75%|00069323066|FELDENE 20 MG CAPSULE|100|EA|5.94062|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|059|Yes|13.53909|01/04/2022|13.34567|01/04/2022|12.71016|01/04/2022|||NSAIDS|964|||||No|No||PFIZER US PHARM|No||||
sildenafil citrate|No|No|No|No|75%|00069419068|REVATIO 20 MG TABLET|90|EA|23.67388|09/13/2005||Yes|No||09/13/2005||Yes|No|09/13/2005||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/26/2012|171|Yes|53.95443|03/22/2022|53.18366|03/22/2022|50.6511|03/22/2022|||PAH AGENTS: ORAL AND INHALED|965|||||No|No||PFIZER/VIATRIS|No||||
prazosin HCl|No|No|No|No|75%|00069431071|MINIPRESS 1 MG CAPSULE|250|EA|.98564|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|2.24635|01/04/2022|2.21426|01/04/2022|2.10882|01/04/2022||||966|||||No|No||PFIZER US PHARM|No||||
prazosin HCl|No|No|No|No|75%|00069437071|MINIPRESS 2 MG CAPSULE|250|EA|1.37194|01/16/2004||Yes|No||01/16/2004||Yes|No|01/16/2004||Yes|No||01/16/2004||Yes|No|||Prescription required|No|||No|3.12674|01/04/2022|3.08208|01/04/2022|2.93531|01/04/2022||||967|||||No|No||PFIZER US PHARM|No||||
prazosin HCl|No|No|No|No|75%|00069438071|MINIPRESS 5 MG CAPSULE|250|EA|2.33892|01/16/2004||Yes|No||01/16/2004||Yes|No|01/16/2004||Yes|No||01/16/2004||Yes|No|||Prescription required|No|||No|5.33057|01/04/2022|5.25442|01/04/2022|5.00421|01/04/2022||||968|||||No|No||PFIZER US PHARM|No||||
hydroxyzine pamoate|No|No|No|No|75%|00069541066|VISTARIL 25 MG CAPSULE|100|EA|.07856|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|07/29/2021|574|Yes|.17904|01/04/2022|.17648|01/04/2022|.16808|01/04/2022|||ANTIHISTAMINES: FIRST GENERATION|969|||||No|No||PFIZER US PHARM|No||||
hydroxyzine pamoate|No|No|No|No|75%|00069542066|VISTARIL 50 MG CAPSULE|100|EA|1.30801|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|07/29/2021|574|Yes|2.98106|01/04/2022|2.93847|01/04/2022|2.79854|01/04/2022|||ANTIHISTAMINES: FIRST GENERATION|970|||||No|No||PFIZER US PHARM|No||||
dofetilide|No|No|No|No|75%|00069580043|TIKOSYN 125 MCG CAPSULE|40|EA|4.67098|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|10.64549|01/04/2022|10.49341|01/04/2022|9.99373|01/04/2022||||971|||||No|No||PFIZER US PHARM|No||||
dofetilide|No|No|No|No|75%|00069580060|TIKOSYN 125 MCG CAPSULE|60|EA|4.67101|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|10.64557|01/04/2022|10.49349|01/04/2022|9.9938|01/04/2022||||972|||||No|No||PFIZER US PHARM|No||||
dofetilide|No|No|No|No|75%|00069581043|TIKOSYN 250 MCG CAPSULE|40|EA|4.67098|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|10.64549|01/04/2022|10.49341|01/04/2022|9.99373|01/04/2022||||973|||||No|No||PFIZER US PHARM|No||||
dofetilide|No|No|No|No|75%|00069581060|TIKOSYN 250 MCG CAPSULE|60|EA|4.67101|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|10.64557|01/04/2022|10.49349|01/04/2022|9.9938|01/04/2022||||974|||||No|No||PFIZER US PHARM|No||||
dofetilide|No|No|No|No|75%|00069582043|TIKOSYN 500 MCG CAPSULE|40|EA|4.67098|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|10.45437|01/11/2022|10.20346|01/11/2022|10.27141|01/11/2022||||975|||||No|No||PFIZER US PHARM|No||||
dofetilide|No|No|No|No|75%|00069582060|TIKOSYN 500 MCG CAPSULE|60|EA|4.67101|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|10.45437|01/11/2022|10.20346|01/11/2022|10.27141|01/11/2022||||976|||||No|No||PFIZER US PHARM|No||||
crizotinib|No|No|No|No|75%|00069814020|XALKORI 250 MG CAPSULE|60|EA|140.53023|12/06/2011||Yes|No||12/06/2011||Yes|No|12/06/2011||Yes|No||||No|No|||Prescription required|No||551|No|320.27821|01/04/2022|315.7028|01/04/2022|300.66934|01/04/2022|||ONCOLOGY: ORAL - LUNG|977|||||No|No||PFIZER US PHARM|No||||
crizotinib|No|No|No|No|75%|00069814120|XALKORI 200 MG CAPSULE|60|EA|140.53023|12/06/2011||Yes|No||12/06/2011||Yes|No|12/06/2011||Yes|No||||No|No|||Prescription required|No||551|No|320.27821|01/04/2022|315.7028|01/04/2022|300.66934|01/04/2022|||ONCOLOGY: ORAL - LUNG|978|||||No|No||PFIZER US PHARM|No||||
tafamidis|No|No|No|No|75%|00069873030|VYNDAMAX 61 MG CAPSULE|30|EA|280.575|02/03/2020||Yes|No||02/03/2020||Yes|No|02/03/2020||Yes|No||||No|No|||Prescription required|No|||No|639.45|01/04/2022|630.315|01/04/2022|600.3|01/04/2022||||979|||||No|No||PFIZER US PHARM|No||||
phenytoin|No|No|No|No|75%|00071000724|DILANTIN 50 MG INFATAB|100|EA|.60337|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||056|No|1.34328|03/29/2022|1.31104|03/29/2022|1.31977|03/29/2022|||ANTICONVULSANTS|980|||||No|No||PFIZER/VIATRIS|No||||
atorvastatin calcium|No|No|No|No|75%|00071015523|LIPITOR 10 MG TABLET|90|EA|4.95876|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|07/29/2021|063|Yes|11.10531|03/29/2022|10.83878|03/29/2022|10.91096|03/29/2022|||LIPOTROPICS: STATINS|981|||||No|No||PFIZER/VIATRIS|No||||
atorvastatin calcium|No|No|No|No|75%|00071015623|LIPITOR 20 MG TABLET|90|EA|7.07354|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|07/29/2021|063|Yes|15.75311|10/26/2021|15.37503|10/26/2021|15.47743|10/26/2021|||LIPOTROPICS: STATINS|982|||||No|No||PFIZER/VIATRIS|No||||
atorvastatin calcium|No|No|No|No|75%|00071015723|LIPITOR 40 MG TABLET|90|EA|7.07354|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|07/29/2021|063|Yes|15.7704|10/26/2021|15.39191|10/26/2021|15.49441|10/26/2021|||LIPOTROPICS: STATINS|983|||||No|No||PFIZER/VIATRIS|No||||
atorvastatin calcium|No|No|No|No|75%|00071015823|LIPITOR 80 MG TABLET|90|EA|7.07354|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|07/29/2021|063|Yes|16.1211|01/25/2022|15.8908|01/25/2022|15.1341|01/25/2022|||LIPOTROPICS: STATINS|984|||||No|No||PFIZER/VIATRIS|No||||
quinapril/hydrochlorothiazide|No|No|No|No|75%|00071022023|ACCURETIC 20-12.5 MG TABLET|90|EA|2.03442|10/07/2002||Yes|No||10/07/2002||Yes|No|10/07/2002||Yes|No||10/07/2002||Yes|No|||Prescription required|Yes|03/23/2007|113|Yes|4.63659|01/12/2021|4.57035|01/12/2021|4.35272|01/12/2021|||ANGIOTENSIN MODULATORS|985|||||No|No||PFIZER US PHARM|No||||
quinapril/hydrochlorothiazide|No|No|No|No|75%|00071022223|ACCURETIC 10-12.5 MG TABLET|90|EA|2.03442|10/07/2002||Yes|No||10/07/2002||Yes|No|10/07/2002||Yes|No||10/07/2002||Yes|No|||Prescription required|Yes|03/23/2007|113|Yes|4.63659|01/12/2021|4.57035|01/12/2021|4.35272|01/12/2021|||ANGIOTENSIN MODULATORS|986|||||No|No||PFIZER US PHARM|No||||
quinapril/hydrochlorothiazide|No|No|No|No|75%|00071022323|ACCURETIC 20-25 MG TABLET|90|EA|2.11578|10/07/2002||Yes|No||10/07/2002||Yes|No|10/07/2002||Yes|No||10/07/2002||Yes|No|||Prescription required|Yes|03/23/2007|113|Yes|4.82203|01/04/2022|4.75314|01/04/2022|4.5268|01/04/2022|||ANGIOTENSIN MODULATORS|987|||||No|No||PFIZER US PHARM|No||||
ethosuximide|No|No|No|No|75%|00071023724|ZARONTIN 250 MG CAPSULE|100|EA|1.66246|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||056|No|3.78887|01/04/2022|3.73474|01/04/2022|3.5569|01/04/2022|||ANTICONVULSANTS|988|||||No|No||PFIZER US PHARM|No||||
phenelzine sulfate|No|No|No|No|75%|00071035060|NARDIL 15 MG TABLET|60|EA|1.08632|01/30/2007||Yes|No||01/30/2007||Yes|No|01/30/2007||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|031|No|2.4758|01/04/2022|2.44043|01/04/2022|2.32422|01/04/2022|||ANTIDEPRESSANTS: OTHER|989|||||No|No||PFIZER US PHARM|No||||
phenytoin sodium extended|No|No|No|No|75%|00071036924|DILANTIN 100 MG CAPSULE|100|EA|.64396|02/08/2008||Yes|No||02/08/2008||Yes|No|02/08/2008||Yes|No||02/08/2008||Yes|No|||Prescription required|No||056|No|1.4361|03/29/2022|1.40163|03/29/2022|1.41096|03/29/2022|||ANTICONVULSANTS|990|||||No|No||PFIZER/VIATRIS|No||||
phenytoin sodium extended|No|No|No|No|75%|00071036932|DILANTIN 100 MG CAPSULE|1000|EA|.64392|02/08/2008||Yes|No||02/08/2008||Yes|No|02/08/2008||Yes|No||02/08/2008||Yes|No|||Prescription required|No||056|No|1.4361|03/29/2022|1.40163|03/29/2022|1.41096|03/29/2022|||ANTICONVULSANTS|991|||||No|No||PFIZER/VIATRIS|No||||
gabapentin|No|No|No|No|75%|00071040124|NEURONTIN 800 MG TABLET|100|EA|6.31283|03/08/2004||Yes|No||03/08/2004||Yes|No|03/08/2004||Yes|No||03/08/2004||Yes|No|||Prescription required|Yes|07/29/2021|232|Yes|14.38738|03/22/2022|14.18184|03/22/2022|13.50652|03/22/2022|||NEUROPATHIC PAIN|992|||||No|No||PFIZER/VIATRIS|No||||
nitroglycerin|No|No|No|No|75%|00071041724|NITROSTAT 0.3 MG TABLET SL|100|EA|.28354|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.64621|03/22/2022|.63698|03/22/2022|.60664|03/22/2022||||993|||||No|No||PFIZER/VIATRIS|No||||
nitroglycerin|No|No|No|No|75%|00071041813|NITROSTAT 0.4 MG TABLET SL|25|EA|.61868|10/01/2021||Yes|No||10/01/2021||Yes|No|10/01/2021||Yes|No||10/01/2021||Yes|No|||Prescription required|No|||No|1.41002|03/22/2022|1.38988|03/22/2022|1.32369|03/22/2022||||994|||||No|No||PFIZER/VIATRIS|No||||
nitroglycerin|No|No|No|No|75%|00071041824|NITROSTAT 0.4 MG TABLET SL|100|EA|.28354|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.64621|03/22/2022|.63698|03/22/2022|.60664|03/22/2022||||995|||||No|No||PFIZER/VIATRIS|No||||
nitroglycerin|No|No|No|No|75%|00071041924|NITROSTAT 0.6 MG TABLET SL|100|EA|.28354|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.64621|03/22/2022|.63698|03/22/2022|.60664|03/22/2022||||996|||||No|No||PFIZER/VIATRIS|No||||
methsuximide|No|No|No|No|75%|00071052524|CELONTIN 300 MG KAPSEAL|100|EA|1.9159|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||056|No|4.36648|01/04/2022|4.3041|01/04/2022|4.09915|01/04/2022|||ANTICONVULSANTS|997|||||No|No||PFIZER US PHARM|No||||
quinapril HCl|No|No|No|No|75%|00071052723|ACCUPRIL 5 MG TABLET|90|EA|2.17666|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|03/23/2007|113|No|4.96076|01/04/2022|4.88989|01/04/2022|4.65704|01/04/2022|||ANGIOTENSIN MODULATORS|998|||||No|No||PFIZER US PHARM|No||||
quinapril HCl|No|No|No|No|75%|00071053023|ACCUPRIL 10 MG TABLET|90|EA|2.17666|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|03/23/2007|113|No|4.96076|01/04/2022|4.88989|01/04/2022|4.65704|01/04/2022|||ANGIOTENSIN MODULATORS|999|||||No|No||PFIZER US PHARM|No||||
quinapril HCl|No|No|No|No|75%|00071053223|ACCUPRIL 20 MG TABLET|90|EA|2.17666|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|03/23/2007|113|No|4.96076|01/04/2022|4.88989|01/04/2022|4.65704|01/04/2022|||ANGIOTENSIN MODULATORS|1000|||||No|No||PFIZER US PHARM|No||||
quinapril HCl|No|No|No|No|75%|00071053240|ACCUPRIL 20 MG TABLET|100|EA|2.09298|03/01/2002|01/31/2022|Yes|No||03/01/2002|01/31/2022|Yes|No|03/01/2002|01/31/2022|Yes|No||03/01/2002|01/31/2022|Yes|No|||Prescription required|Yes|03/23/2007|113|No|4.77005|01/12/2021|4.7019|01/12/2021|4.478|01/12/2021|||ANGIOTENSIN MODULATORS|1001|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||PFIZER US PHARM|No||||
quinapril HCl|No|No|No|No|75%|00071053523|ACCUPRIL 40 MG TABLET|90|EA|2.17666|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|03/23/2007|113|No|4.96076|01/04/2022|4.88989|01/04/2022|4.65704|01/04/2022|||ANGIOTENSIN MODULATORS|1002|||||No|No||PFIZER US PHARM|No||||
gemfibrozil|No|No|No|No|75%|00071073720|LOPID 600 MG TABLET|60|EA|.5547|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|02/23/2004|055|No|1.2642|02/08/2022|1.24614|02/08/2022|1.1868|02/08/2022|||LIPOTROPICS: OTHER|1003|||||No|No||PFIZER US PHARM|No||||
gemfibrozil|No|No|No|No|75%|00071073730|LOPID 600 MG TABLET|500|EA|.5547|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|02/23/2004|055|No|1.2642|02/08/2022|1.24614|02/08/2022|1.1868|02/08/2022|||LIPOTROPICS: OTHER|1004|||||No|No||PFIZER US PHARM|No||||
gabapentin|No|No|No|No|75%|00071080324|NEURONTIN 100 MG CAPSULE|100|EA|1.10772|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|07/29/2021|232|Yes|2.52457|03/22/2022|2.48851|03/22/2022|2.37001|03/22/2022|||NEUROPATHIC PAIN|1005|||||No|No||PFIZER/VIATRIS|No||||
gabapentin|No|No|No|No|75%|00071080524|NEURONTIN 300 MG CAPSULE|100|EA|2.76971|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|07/29/2021|232|Yes|6.14758|03/29/2022|6.00003|03/29/2022|6.03999|03/29/2022|||NEUROPATHIC PAIN|1006|||||No|No||PFIZER/VIATRIS|No||||
gabapentin|No|No|No|No|75%|00071080624|NEURONTIN 400 MG CAPSULE|100|EA|3.32269|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|07/29/2021|232|Yes|7.57265|03/22/2022|7.46447|03/22/2022|7.10902|03/22/2022|||NEUROPATHIC PAIN|1007|||||No|No||PFIZER/VIATRIS|No||||
pregabalin|No|No|No|No|90%|00071101268|LYRICA 25 MG CAPSULE|90|EA|3.87315|09/13/2005||Yes|No||09/13/2005||Yes|No|09/13/2005||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|232|No|8.82718|03/22/2022|8.70108|03/22/2022|8.28674|03/22/2022|||NEUROPATHIC PAIN|1008|||||No|No||PFIZER/VIATRIS|No||||
pregabalin|No|No|No|No|90%|00071101368|LYRICA 50 MG CAPSULE|90|EA|3.87315|09/13/2005||Yes|No||09/13/2005||Yes|No|09/13/2005||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|232|No|8.6286|03/29/2022|8.42151|03/29/2022|8.47759|03/29/2022|||NEUROPATHIC PAIN|1009|||||No|No||PFIZER/VIATRIS|No||||
pregabalin|No|No|No|No|90%|00071101468|LYRICA 75 MG CAPSULE|90|EA|3.87315|09/13/2005||Yes|No||09/13/2005||Yes|No|09/13/2005||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|232|No|8.62841|03/29/2022|8.42132|03/29/2022|8.47741|03/29/2022|||NEUROPATHIC PAIN|1010|||||No|No||PFIZER/VIATRIS|No||||
pregabalin|No|No|No|No|90%|00071101568|LYRICA 100 MG CAPSULE|90|EA|3.87315|05/29/2007||Yes|No||05/29/2007||Yes|No|05/29/2007||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|232|No|8.63574|03/29/2022|8.42848|03/29/2022|8.48461|03/29/2022|||NEUROPATHIC PAIN|1011|||||No|No||PFIZER/VIATRIS|No||||
pregabalin|No|No|No|No|90%|00071101668|LYRICA 150 MG CAPSULE|90|EA|3.87315|05/29/2007||Yes|No||05/29/2007||Yes|No|05/29/2007||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|232|No|8.61562|03/29/2022|8.40884|03/29/2022|8.46484|03/29/2022|||NEUROPATHIC PAIN|1012|||||No|No||PFIZER/VIATRIS|No||||
pregabalin|No|No|No|No|90%|00071101768|LYRICA 200 MG CAPSULE|90|EA|3.87315|05/29/2007||Yes|No||05/29/2007||Yes|No|05/29/2007||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|232|No|8.61369|03/29/2022|8.40696|03/29/2022|8.46295|03/29/2022|||NEUROPATHIC PAIN|1013|||||No|No||PFIZER/VIATRIS|No||||
pregabalin|No|No|No|No|90%|00071101868|LYRICA 300 MG CAPSULE|90|EA|3.87315|05/29/2007||Yes|No||05/29/2007||Yes|No|05/29/2007||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|232|No|8.65906|03/29/2022|8.45124|03/29/2022|8.50752|03/29/2022|||NEUROPATHIC PAIN|1014|||||No|No||PFIZER/VIATRIS|No||||
pregabalin|No|No|No|No|90%|00071101968|LYRICA 225 MG CAPSULE|90|EA|3.87315|05/29/2007||Yes|No||05/29/2007||Yes|No|05/29/2007||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|232|No|8.82718|03/22/2022|8.70108|03/22/2022|8.28674|03/22/2022|||NEUROPATHIC PAIN|1015|||||No|No||PFIZER/VIATRIS|No||||
pregabalin|No|No|No|No|90%|00071102001|LYRICA 20 MG/ML ORAL SOLUTION|473|ML|1.03175|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|232|No|2.35143|03/22/2022|2.31783|03/22/2022|2.20746|03/22/2022|||NEUROPATHIC PAIN|1016|||||No|No||PFIZER/VIATRIS|No||||
pregabalin|No|No|No|No|90%|00071102601|LYRICA CR 82.5 MG TABLET|30|EA|6.65554|07/19/2018||Yes|No||07/19/2018||Yes|No|07/19/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|232|No|15.16844|03/22/2022|14.95174|03/22/2022|14.23976|03/22/2022|||NEUROPATHIC PAIN|1017|||||No|No||PFIZER/VIATRIS|No||||
pregabalin|No|No|No|No|90%|00071102701|LYRICA CR 165 MG TABLET|30|EA|6.65554|07/19/2018||Yes|No||07/19/2018||Yes|No|07/19/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|232|No|15.16844|03/22/2022|14.95174|03/22/2022|14.23976|03/22/2022|||NEUROPATHIC PAIN|1018|||||No|No||PFIZER/VIATRIS|No||||
pregabalin|No|No|No|No|90%|00071102901|LYRICA CR 330 MG TABLET|30|EA|6.65554|07/19/2018||Yes|No||07/19/2018||Yes|No|07/19/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|232|No|15.16844|03/22/2022|14.95174|03/22/2022|14.23976|03/22/2022|||NEUROPATHIC PAIN|1019|||||No|No||PFIZER/VIATRIS|No||||
gabapentin|No|No|No|No|75%|00071201244|NEURONTIN 250 MG/5 ML SOLUTION|470|ML|.39904|07/20/2020||Yes|No||07/20/2020||Yes|No|07/20/2020||Yes|No||07/20/2020||Yes|No|||Prescription required|Yes|07/29/2021|232|Yes|.90945|01/12/2021|.89646|01/12/2021|.85377|01/12/2021|||NEUROPATHIC PAIN|1020|||||No|No||PFIZER/VIATRIS|No||||
ethosuximide|No|No|No|No|75%|00071241835|ZARONTIN 250 MG/5 ML SOLUTION|474|ML|.369|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|No||056|No|.84097|01/04/2022|.82896|01/04/2022|.78948|01/04/2022|||ANTICONVULSANTS|1021|||||No|No||PFIZER US PHARM|No||||
phenytoin sodium extended|No|No|No|No|75%|00071374066|DILANTIN 30 MG CAPSULE|100|EA|.55521|10/14/2009||Yes|No||10/14/2009||Yes|No|10/14/2009||Yes|No||10/14/2009||Yes|No|||Prescription required|No||056|No|1.23454|03/29/2022|1.20491|03/29/2022|1.21293|03/29/2022|||ANTICONVULSANTS|1022|||||No|No||PFIZER/VIATRIS|No||||
elagolix sodium|No|No|No|No|75%|00074003828|ORILISSA 150 MG TABLET|28|EA|16.0737|11/09/2018||Yes|No||11/09/2018||Yes|No|11/09/2018||Yes|No||||No|No|||Prescription required|No|||No|36.15251|02/01/2022|35.28484|02/01/2022|35.51984|02/01/2022||||1023|||||No|No||ABBVIE US LLC|No||||
elagolix sodium|No|No|No|No|75%|00074003956|ORILISSA 200 MG TABLET|56|EA|8.03685|11/09/2018||Yes|No||11/09/2018||Yes|No|11/09/2018||Yes|No||||No|No|||Prescription required|No|||No|18.11466|02/01/2022|17.6799|02/01/2022|17.79765|02/01/2022||||1024|||||No|No||ABBVIE US LLC|No||||
adalimumab|No|No|No|No|75%|00074006702|HUMIRA(CF) PEDI CROHN 80-40 MG|2|EA|2067.1777|05/30/2018||Yes|No||05/30/2018||Yes|No|05/30/2018||Yes|No||||No|No|||Prescription required|No||071|Yes|4711.2422|01/25/2022|4643.93874|01/25/2022|4422.7988|01/25/2022|||CYTOKINE AND CAM ANTAGONISTS|1025|||||No|No||ABBVIE US LLC|No||||
adalimumab|No|No|No|No|75%|00074012402|HUMIRA(CF) PEN 80 MG/0.8 ML|2|EA|2756.23335|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||071|Yes|6281.6481|01/25/2022|6191.91027|01/25/2022|5897.0574|01/25/2022|||CYTOKINE AND CAM ANTAGONISTS|1026|||||No|No||ABBVIE US LLC|No||||
adalimumab|No|No|No|No|75%|00074012403|HUMIRA(CF) PEN CRHN-UC-HS 80MG|3|EA|2756.23836|08/24/2018||Yes|No||08/24/2018||Yes|No|08/24/2018||Yes|No||||No|No|||Prescription required|No||071|Yes|6281.65952|01/25/2022|6191.92153|01/25/2022|5897.06812|01/25/2022|||CYTOKINE AND CAM ANTAGONISTS|1027|||||No|No||ABBVIE US LLC|No||||
adalimumab|No|No|No|No|75%|00074012404|HUMIRA(CF) PEN PEDI UC 80 MG|4|EA|2756.23442|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|No||071|Yes|6281.65055|01/25/2022|6191.91268|01/25/2022|5897.0597|01/25/2022|||CYTOKINE AND CAM ANTAGONISTS|1028|||||No|No||ABBVIE US LLC|No||||
adalimumab|No|No|No|No|75%|00074024302|HUMIRA(CF) 40 MG/0.4 ML SYRING|2|EA|1378.11345|05/30/2018||Yes|No||05/30/2018||Yes|No|05/30/2018||Yes|No||||No|No|||Prescription required|No||071|Yes|3123.50937|02/01/2022|3048.54514|02/01/2022|3068.84795|02/01/2022|||CYTOKINE AND CAM ANTAGONISTS|1029|||||No|No||ABBVIE US LLC|No||||
lopinavir/ritonavir|No|No|No|No|75%|00074052260|KALETRA 100-25 MG TABLET|60|EA|2.56029|01/03/2008||Yes|No||01/03/2008||Yes|No|01/03/2008||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|4.18181|01/09/2018|4.12207|01/09/2018|3.92578|01/09/2018|||HIV / AIDS|1030|||||No|No||ABBVIE US LLC|No||||
adalimumab|No|No|No|No|75%|00074055402|HUMIRA(CF) PEN 40 MG/0.4 ML|2|EA|1378.11345|05/30/2018||Yes|No||05/30/2018||Yes|No|05/30/2018||Yes|No||||No|No|||Prescription required|No||071|Yes|3121.75105|02/01/2022|3046.82902|02/01/2022|3067.1204|02/01/2022|||CYTOKINE AND CAM ANTAGONISTS|1031|||||No|No||ABBVIE US LLC|No||||
venetoclax|No|No|No|No|75%|00074056111|VENCLEXTA 10 MG TAB (10MG X 2)|2|EA|4.8332|09/19/2016||Yes|No||09/19/2016||Yes|No|09/19/2016||Yes|No||||No|No|||Prescription required|No||173|No|11.0152|01/11/2022|10.85784|01/11/2022|10.3408|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|1032|||||No|No||ABBVIE US LLC|No||||
venetoclax|No|No|No|No|75%|00074056114|VENCLEXTA 10 MG TABLET|14|EA|4.8335|09/19/2016||Yes|No||09/19/2016||Yes|No|09/19/2016||Yes|No||||No|No|||Prescription required|No||173|No|11.01589|01/11/2022|10.85852|01/11/2022|10.34145|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|1033|||||No|No||ABBVIE US LLC|No||||
venetoclax|No|No|No|No|75%|00074056607|VENCLEXTA 50 MG TABLET|7|EA|24.16784|09/20/2016||Yes|No||09/20/2016||Yes|No|09/20/2016||Yes|No||||No|No|||Prescription required|No||173|No|55.08019|01/11/2022|54.29333|01/11/2022|51.70793|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|1034|||||No|No||ABBVIE US LLC|No||||
venetoclax|No|No|No|No|75%|00074056611|VENCLEXTA 50 MG TABLET|1|EA|24.166|09/20/2016||Yes|No||09/20/2016||Yes|No|09/20/2016||Yes|No||||No|No|||Prescription required|No||173|No|55.076|01/11/2022|54.2892|01/11/2022|51.704|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|1035|||||No|No||ABBVIE US LLC|No||||
venetoclax|No|No|No|No|75%|00074057611|VENCLEXTA 100 MG TABLET|1|EA|48.332|09/20/2016||Yes|No||09/20/2016||Yes|No|09/20/2016||Yes|No||||No|No|||Prescription required|No||173|No|110.152|01/11/2022|108.5784|01/11/2022|103.408|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|1036|||||No|No||ABBVIE US LLC|No||||
venetoclax|No|No|No|No|75%|00074057622|VENCLEXTA 100 MG TABLET|120|EA|48.33561|09/20/2016||Yes|No||09/20/2016||Yes|No|09/20/2016||Yes|No||||No|No|||Prescription required|No||173|No|110.16024|01/11/2022|108.58652|01/11/2022|103.41573|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|1037|||||No|No||ABBVIE US LLC|No||||
venetoclax|No|No|No|No|75%|00074057634|VENCLEXTA 100 MG TABLET|180|EA|48.33562|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|||Prescription required|No||173|No|110.16027|01/11/2022|108.58655|01/11/2022|103.41576|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|1038|||||No|No||ABBVIE US LLC|No||||
venetoclax|No|No|No|No|75%|00074057928|VENCLEXTA STARTING PACK|42|EA|29.80698|09/20/2016||Yes|No||09/20/2016||Yes|No|09/20/2016||Yes|No||||No|No|||Prescription required|No||173|No|67.93219|01/11/2022|66.96173|01/11/2022|63.77308|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|1039|||||No|No||ABBVIE US LLC|No||||
adalimumab|No|No|No|No|75%|00074061602|HUMIRA(CF) 20 MG/0.2 ML SYRING|2|EA|1378.11345|05/30/2018||Yes|No||05/30/2018||Yes|No|05/30/2018||Yes|No||||No|No|||Prescription required|No||071|Yes|3140.8167|01/25/2022|3095.94789|01/25/2022|2948.5218|01/25/2022|||CYTOKINE AND CAM ANTAGONISTS|1040|||||No|No||ABBVIE US LLC|No||||
adalimumab|No|No|No|No|75%|00074081702|HUMIRA(CF) 10 MG/0.1 ML SYRING|2|EA|1378.11345|05/30/2018||Yes|No||05/30/2018||Yes|No|05/30/2018||Yes|No||||No|No|||Prescription required|No||071|Yes|3140.8167|01/25/2022|3095.94789|01/25/2022|2948.5218|01/25/2022|||CYTOKINE AND CAM ANTAGONISTS|1041|||||No|No||ABBVIE US LLC|No||||
elagolix/estradiol/norethindrn|No|No|No|No|75%|00074101756|ORIAHNN 300-1-0.5MG/300MG CAPS|56|EA|8.03685|09/28/2020||Yes|No||09/28/2020||Yes|No|09/28/2020||Yes|No||||No|No|||Prescription required|No|||No|18.0829|02/01/2022|17.64891|02/01/2022|17.76644|02/01/2022||||1042|||||No|No||ABBVIE US LLC|No||||
risankizumab-rzaa|No|No|No|No|75%|00074105001|SKYRIZI 150 MG/ML SYRINGE|1|ML|7857.2997|09/13/2021||Yes|No||09/13/2021||Yes|No|09/13/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|071|Yes|17907.3342|01/25/2022|17651.51514|01/25/2022|16810.9668|01/25/2022|||CYTOKINE AND CAM ANTAGONISTS|1043|||||No|No||ABBVIE US LLC|No||||
adalimumab|No|No|No|No|75%|00074153903|HUMIRA(CF) PEN PS-UV-AHS 80-40|3|EA|1837.4889|08/24/2018||Yes|No||08/24/2018||Yes|No|08/24/2018||Yes|No||||No|No|||Prescription required|No||071|Yes|4187.7654|01/25/2022|4127.94018|01/25/2022|3931.3716|01/25/2022|||CYTOKINE AND CAM ANTAGONISTS|1044|||||No|No||ABBVIE US LLC|No||||
ritonavir|No|No|No|No|75%|00074194063|NORVIR 80 MG/ML SOLUTION|240|ML|3.60049|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|5.88081|06/01/2016|5.7968|06/01/2016|5.52076|06/01/2016|||HIV / AIDS|1045|||||No|No||ABBVIE US LLC|No||||
risankizumab-rzaa|No|No|No|No|75%|00074204202|SKYRIZI 150 MG DOSE KIT-2 SYRN|1|EA|7857.2997|09/10/2019||Yes|No||09/10/2019||Yes|No|09/10/2019||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|071|Yes|17907.3342|01/25/2022|17651.51514|01/25/2022|16810.9668|01/25/2022|||CYTOKINE AND CAM ANTAGONISTS|1046|||||No|No||ABBVIE US LLC|No||||
risankizumab-rzaa|No|No|No|No|75%|00074210001|SKYRIZI 150 MG/ML PEN|1|ML|7857.2997|09/13/2021||Yes|No||09/13/2021||Yes|No|09/13/2021||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|071|Yes|17907.3342|01/25/2022|17651.51514|01/25/2022|16810.9668|01/25/2022|||CYTOKINE AND CAM ANTAGONISTS|1047|||||No|No||ABBVIE US LLC|No||||
leuprolide acetate|No|No|No|No|75%|00074210803|LUPRON DEPOT-PED 7.5 MG KIT|1|EA|804.8353|08/25/2009||Yes|No||08/25/2009||Yes|No|08/25/2009||Yes|No||||No|No|||Prescription required|No|||No|1834.2758|01/25/2022|1808.07186|01/25/2022|1721.9732|01/25/2022||||1048|||||No|No||ABBVIE US LLC|No||||
leuprolide acetate|No|No|No|No|75%|00074228203|LUPRON DEPOT-PED 11.25 MG KIT|1|EA|1461.1658|05/15/2009||Yes|No||05/15/2009||Yes|No|05/15/2009||Yes|No||||No|No|||Prescription required|No|||No|3330.0988|01/25/2022|3282.52596|01/25/2022|3126.2152|01/25/2022||||1049|||||No|No||ABBVIE US LLC|No||||
upadacitinib|No|No|No|No|75%|00074230630|RINVOQ ER 15 MG TABLET|30|EA|81.28806|12/02/2019||Yes|No||12/02/2019||Yes|No|12/02/2019||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|071|Yes|183.59415|02/01/2022|179.18789|02/01/2022|180.38125|02/01/2022|||CYTOKINE AND CAM ANTAGONISTS|1050|||||No|No||ABBVIE US LLC|No||||
leuprolide acetate|No|No|No|No|75%|00074244003|LUPRON DEPOT-PED 15 MG KIT|1|EA|1609.3266|05/15/2009||Yes|No||05/15/2009||Yes|No|05/15/2009||Yes|No||||No|No|||Prescription required|No|||No|3667.7676|01/25/2022|3615.37092|01/25/2022|3443.2104|01/25/2022||||1051|||||No|No||ABBVIE US LLC|No||||
adalimumab|No|No|No|No|75%|00074254003|HUMIRA(CF) PEDI CROHN 80MG/0.8|3|EA|2756.23836|05/30/2018||Yes|No||05/30/2018||Yes|No|05/30/2018||Yes|No||||No|No|||Prescription required|No||071|Yes|6281.65952|01/25/2022|6191.92153|01/25/2022|5897.06812|01/25/2022|||CYTOKINE AND CAM ANTAGONISTS|1052|||||No|No||ABBVIE US LLC|No||||
glecaprevir/pibrentasvir|No|No|No|No|75%|00074260028|MAVYRET 50-20 MG PELLET PACKET|28|EA|40.5447|12/07/2021||Yes|No||||No|No|12/07/2021||Yes|No||||No|No|||Prescription required|No||064|Yes|92.4042|12/07/2021|91.08414|12/07/2021|86.7468|12/07/2021|||HEPATITIS C AGENTS|1053|||||No|No||ABBVIE US LLC|No||||
glecaprevir/pibrentasvir|No|No|No|No|75%|00074262528|MAVYRET 100-40 MG TABLET|84|EA|67.57142|02/01/2018||Yes|No||||No|No|09/01/2021||Yes|No||||No|No|||Prescription required|No||064|Yes|153.99999|09/28/2021|151.79999|09/28/2021|144.57142|09/28/2021|||HEPATITIS C AGENTS|1054|||||No|No||ABBVIE US LLC|No||||
glecaprevir/pibrentasvir|No|No|No|No|75%|00074262584|MAVYRET 100-40 MG TABLET|84|EA|67.57142|12/20/2021||Yes|No||12/20/2021||Yes|No|12/20/2021||Yes|No||||No|No|||Prescription required|No||064|Yes|153.99999|12/20/2021|151.79999|12/20/2021|144.57142|12/20/2021|||HEPATITIS C AGENTS|1055|||||No|No||ABBVIE US LLC|No||||
carbidopa/levodopa|No|No|No|No|75%|00074301207|DUOPA 4.63 MG-20 MG/ML SUSPENS|100|ML|.86791|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|015|No|1.97803|06/01/2016|1.94977|06/01/2016|1.85692|06/01/2016|||ANTIPARKINSON'S AGENTS|1056|||||No|No||ABBVIE US LLC|No||||
potassium chloride|No|No|No|No|75%|00074302313|K-TAB ER 20 MEQ TABLET|100|EA|.35634|04/23/2014||Yes|No||04/23/2014||Yes|No|04/23/2014||Yes|No||||No|No|||Prescription required|No|||No|.81212|05/26/2020|.80052|05/26/2020|.7624|05/26/2020||||1057|||||No|No||ABBVIE US LLC|No||||
potassium chloride|No|No|No|No|75%|00074302353|K-TAB ER 20 MEQ TABLET|500|EA|.35634|04/23/2014|01/20/2023|Yes|No||04/23/2014|01/20/2023|Yes|No|04/23/2014|01/20/2023|Yes|No||||No|No|||Prescription required|No|||No|.81214|05/26/2020|.80054|05/26/2020|.76242|05/26/2020||||1058|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ABBVIE US LLC|No||||
potassium chloride|No|No|No|No|75%|00074305846|K-TAB ER 8 MEQ TABLET|1000|EA|.23489|07/15/2015|01/20/2023|Yes|No||07/15/2015|01/20/2023|Yes|No|07/15/2015|01/20/2023|Yes|No||||No|No|||Prescription required|No|||No|.53534|10/29/2019|.52769|10/29/2019|.50256|10/29/2019||||1059|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ABBVIE US LLC|No||||
ombita/paritap/riton/dasabuvir|No|No|No|No|75%|00074309328|VIEKIRA PAK|112|EA|106.62848|04/06/2015||Yes|No||||No|No|09/01/2021||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|064|Yes|243.01374|12/10/2019|239.54212|12/10/2019|228.13535|12/10/2019|||HEPATITIS C AGENTS|1060|||||No|No||ABBVIE US LLC|No||||
cyclosporine, modified|No|No|No|No|75%|00074310832|GENGRAF 25 MG CAPSULE|30|EA|.75307|01/21/2016||Yes|No||01/21/2016||Yes|No|01/21/2016||Yes|No||01/21/2016||Yes|No|||Prescription required|No||229|No|1.7163|11/28/2017|1.69178|11/28/2017|1.61122|11/28/2017|||IMMUNOSUPPRESSIVES: ORAL|1061|||||No|No||ABBVIE US LLC|No||||
cyclosporine, modified|No|No|No|No|75%|00074310932|GENGRAF 100 MG CAPSULE|30|EA|3.00842|02/19/2016||Yes|No||02/19/2016||Yes|No|02/19/2016||Yes|No||02/19/2016||Yes|No|||Prescription required|No||229|No|6.8564|06/01/2016|6.75845|06/01/2016|6.43662|06/01/2016|||IMMUNOSUPPRESSIVES: ORAL|1062|||||No|No||ABBVIE US LLC|No||||
fenofibric acid (choline)|No|No|No|No|75%|00074316190|TRILIPIX DR 45 MG CAPSULE|90|EA|1.29319|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|2.94729|12/25/2018|2.90518|12/25/2018|2.76684|12/25/2018|||LIPOTROPICS: OTHER|1063|||||No|No||ABBVIE US LLC|No||||
fenofibric acid (choline)|No|No|No|No|75%|00074316290|TRILIPIX DR 135 MG CAPSULE|90|EA|3.87979|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|8.84231|09/24/2019|8.71599|09/24/2019|8.30094|09/24/2019|||LIPOTROPICS: OTHER|1064|||||No|No||ABBVIE US LLC|No||||
fenofibrate nanocrystallized|No|No|No|No|75%|00074317390|TRICOR 48 MG TABLET|90|EA|.24347|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.55489|03/27/2018|.54696|03/27/2018|.52092|03/27/2018|||LIPOTROPICS: OTHER|1065|||||No|No||ABBVIE US LLC|No||||
fenofibrate nanocrystallized|No|No|No|No|75%|00074318990|TRICOR 145 MG TABLET|90|EA|.44462|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|1.01332|12/04/2018|.99884|12/04/2018|.95128|12/04/2018|||LIPOTROPICS: OTHER|1066|||||No|No||ABBVIE US LLC|No||||
niacin|No|No|No|No|75%|00074326590|NIASPAN ER 500 MG TABLET|90|EA|2.22233|02/16/2018|08/02/2022|Yes|No||02/16/2018|08/02/2022|Yes|No|02/16/2018|08/02/2022|Yes|No||||No|No|||Prescription required|Yes|12/14/2017|055|Yes|5.06485|01/26/2021|4.9925|01/26/2021|4.75476|01/26/2021|||LIPOTROPICS: OTHER|1067|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ABBVIE US LLC|No||||
niacin|No|No|No|No|75%|00074327490|NIASPAN ER 750 MG TABLET|90|EA|3.1699|05/31/2018|08/03/2022|Yes|No||05/31/2018|08/03/2022|Yes|No|05/31/2018|08/03/2022|Yes|No||||No|No|||Prescription required|Yes|07/27/2017|055|No|7.22444|05/31/2018|7.12123|05/31/2018|6.78212|05/31/2018|||LIPOTROPICS: OTHER|1068|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ABBVIE US LLC|No||||
niacin|No|No|No|No|75%|00074327590|NIASPAN ER 1,000 MG TABLET|90|EA|3.93048|02/16/2018|10/21/2022|Yes|No||02/16/2018|10/21/2022|Yes|No|02/16/2018|10/21/2022|Yes|No||||No|No|||Prescription required|Yes|12/14/2017|055|No|8.95784|02/16/2018|8.82987|02/16/2018|8.4094|02/16/2018|||LIPOTROPICS: OTHER|1069|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ABBVIE US LLC|No||||
potassium chloride|No|No|No|No|75%|00074327813|K-TAB ER 10 MEQ TABLET|100|EA|.36051|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No|||No|.82163|03/02/2020|.80989|03/02/2020|.77132|03/02/2020||||1070|||||No|No||ABBVIE US LLC|No||||
potassium chloride|No|No|No|No|75%|00074327819|K-TAB ER 10 MEQ TABLET|1000|EA|.34248|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No|||No|.78054|03/02/2020|.76939|03/02/2020|.73275|03/02/2020||||1071|||||No|No||ABBVIE US LLC|No||||
ritonavir|No|No|No|No|75%|00074333330|NORVIR 100 MG TABLET|30|EA|5.14339|02/24/2010||Yes|No||02/24/2010||Yes|No|02/24/2010||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|8.40088|03/29/2022|8.28087|03/29/2022|7.88654|03/29/2022|||HIV / AIDS|1072|||||No|No||ABBVIE US LLC|No||||
leuprolide acetate|No|No|No|No|75%|00074334603|LUPRON DEPOT 22.5 MG 3MO KIT|1|EA|2391.7245|05/15/2009||Yes|No||05/15/2009||Yes|No|05/15/2009||Yes|No||||No|No|||Prescription required|No|||No|5399.9191|02/08/2022|5270.32104|02/08/2022|5305.42051|02/08/2022||||1073|||||No|No||ABBVIE US LLC|No||||
ritonavir|No|No|No|No|75%|00074339930|NORVIR 100 MG POWDER PACKET|30|EA|5.14339|10/16/2018||Yes|No||10/16/2018||Yes|No|10/16/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|8.40088|10/16/2018|8.28087|10/16/2018|7.88654|10/16/2018|||HIV / AIDS|1074|||||No|No||ABBVIE US LLC|No||||
leuprolide acetate|No|No|No|No|75%|00074347303|LUPRON DEPOT 45 MG 6MO KIT|1|EA|4783.5307|07/08/2011||Yes|No||07/08/2011||Yes|No|07/08/2011||Yes|No||||No|No|||Prescription required|No|||No|10902.0002|01/25/2022|10746.25734|01/25/2022|10234.5308|01/25/2022||||1075|||||No|No||ABBVIE US LLC|No||||
leuprolide acetate|No|No|No|No|75%|00074364103|LUPRON DEPOT 3.75 MG KIT|1|EA|669.0241|05/15/2009||Yes|No||05/15/2009||Yes|No|05/15/2009||Yes|No||||No|No|||Prescription required|No|||No|1505.47858|02/08/2022|1469.34709|02/08/2022|1479.1327|02/08/2022||||1076|||||No|No||ABBVIE US LLC|No||||
leuprolide acetate|No|No|No|No|75%|00074364203|LUPRON DEPOT 7.5 MG KIT|1|EA|797.2458|05/15/2009||Yes|No||05/15/2009||Yes|No|05/15/2009||Yes|No||||No|No|||Prescription required|No|||No|1794.46454|02/08/2022|1751.39739|02/08/2022|1763.06141|02/08/2022||||1077|||||No|No||ABBVIE US LLC|No||||
leuprolide acetate|No|No|No|No|75%|00074366303|LUPRON DEPOT 11.25 MG 3MO KIT|1|EA|2007.0852|06/05/2009||Yes|No||06/05/2009||Yes|No|06/05/2009||Yes|No||||No|No|||Prescription required|No|||No|4546.75203|02/01/2022|4437.62998|02/01/2022|4467.18386|02/01/2022||||1078|||||No|No||ABBVIE US LLC|No||||
leuprolide acetate|No|No|No|No|75%|00074368303|LUPRON DEPOT-4 MONTH KIT|1|EA|3188.9746|05/15/2009||Yes|No||05/15/2009||Yes|No|05/15/2009||Yes|No||||No|No|||Prescription required|No|||No|7267.8956|01/25/2022|7164.06852|01/25/2022|6822.9224|01/25/2022||||1079|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074372719|SYNTHROID 137 MCG TABLET|1000|EA|.61523|07/15/2015||Yes|No||07/15/2015||Yes|No|07/15/2015||Yes|No||||No|No|||Prescription required|No|||No|1.37274|02/01/2022|1.33979|02/01/2022|1.34871|02/01/2022||||1080|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074372790|SYNTHROID 137 MCG TABLET|90|EA|.61527|04/25/2011||Yes|No||04/25/2011||Yes|No|04/25/2011||Yes|No||||No|No|||Prescription required|No|||No|1.37274|02/01/2022|1.33979|02/01/2022|1.34871|02/01/2022||||1081|||||No|No||ABBVIE US LLC|No||||
leuprolide acetate|No|No|No|No|75%|00074377903|LUPRON DEPOT-PED 11.25 MG 3MO|1|EA|4383.5103|09/01/2011||Yes|No||09/01/2011||Yes|No|09/01/2011||Yes|No||||No|No|||Prescription required|No|||No|9990.3258|01/25/2022|9847.60686|01/25/2022|9378.6732|01/25/2022||||1082|||||No|No||ABBVIE US LLC|No||||
adalimumab|No|No|No|No|75%|00074379902|HUMIRA 40 MG/0.8 ML SYRINGE|2|EA|1378.11345|10/14/2008||Yes|No||10/14/2008||Yes|No|10/14/2008||Yes|No||||No|No|||Prescription required|No||071|Yes|3121.26578|02/01/2022|3046.3554|02/01/2022|3066.64362|02/01/2022|||CYTOKINE AND CAM ANTAGONISTS|1083|||||No|No||ABBVIE US LLC|No||||
divalproex sodium|No|No|No|No|75%|00074382611|DEPAKOTE ER 250 MG TABLET|100|EA|1.44239|10/16/2007||Yes|No||10/16/2007||Yes|No|10/16/2007||Yes|No||||No|No|||Prescription required|No||056|Yes|3.0405|11/23/2021|2.96752|11/23/2021|2.98729|11/23/2021|||ANTICONVULSANTS|1084|||||No|No||ABBVIE US LLC|No||||
divalproex sodium|No|No|No|No|75%|00074382613|DEPAKOTE ER 250 MG TABLET|100|EA|1.36413|05/12/2004||Yes|No||05/12/2004||Yes|No|05/12/2004||Yes|No||||No|No|||Prescription required|No||056|Yes|3.0405|11/23/2021|2.96752|11/23/2021|2.98729|11/23/2021|||ANTICONVULSANTS|1085|||||No|No||ABBVIE US LLC|No||||
lopinavir/ritonavir|No|No|No|No|75%|00074395646|KALETRA 80 MG-20 MG/ML SOLN|160|ML|1.92025|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|3.13642|12/25/2018|3.09161|12/25/2018|2.94439|12/25/2018|||HIV / AIDS|1086|||||No|No||ABBVIE US LLC|No||||
adalimumab|No|No|No|No|75%|00074433902|HUMIRA PEN 40 MG/0.8 ML|2|EA|1378.11345|04/04/2007||Yes|No||04/04/2007||Yes|No|04/04/2007||Yes|No||||No|No|||Prescription required|No||071|Yes|3119.4745|02/01/2022|3044.60711|02/01/2022|3064.88369|02/01/2022|||CYTOKINE AND CAM ANTAGONISTS|1087|||||No|No||ABBVIE US LLC|No||||
adalimumab|No|No|No|No|75%|00074433906|HUMIRA PEN CROHN-UC-HS 40 MG|6|EA|1378.11918|01/14/2008||Yes|No||01/14/2008||Yes|No|01/14/2008||Yes|No||||No|No|||Prescription required|No||071|Yes|3115.24896|02/08/2022|3040.48298|02/08/2022|3060.7321|02/08/2022|||CYTOKINE AND CAM ANTAGONISTS|1088|||||No|No||ABBVIE US LLC|No||||
adalimumab|No|No|No|No|75%|00074433907|HUMIRA PEN PS-UV-ADOL HS 40 MG|4|EA|1378.11667|04/10/2009||Yes|No||04/10/2009||Yes|No|04/10/2009||Yes|No||||No|No|||Prescription required|No||071|Yes|3115.30346|02/08/2022|3040.53617|02/08/2022|3060.78564|02/08/2022|||CYTOKINE AND CAM ANTAGONISTS|1089|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074434119|SYNTHROID 25 MCG TABLET|1000|EA|.61525|01/21/2003||Yes|No||01/21/2003||Yes|No|01/21/2003||Yes|No||||No|No|||Prescription required|No|||No|1.37628|02/01/2022|1.34324|02/01/2022|1.35219|02/01/2022||||1090|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074434190|SYNTHROID 25 MCG TABLET|90|EA|.61527|04/25/2011||Yes|No||04/25/2011||Yes|No|04/25/2011||Yes|No||||No|No|||Prescription required|No|||No|1.37628|02/01/2022|1.34324|02/01/2022|1.35219|02/01/2022||||1091|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074455219|SYNTHROID 50 MCG TABLET|1000|EA|.615|01/21/2003||Yes|No||01/21/2003||Yes|No|01/21/2003||Yes|No||||No|No|||Prescription required|No|||No|1.3726|02/01/2022|1.33965|02/01/2022|1.34857|02/01/2022||||1092|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074455290|SYNTHROID 50 MCG TABLET|90|EA|.61499|04/25/2011||Yes|No||04/25/2011||Yes|No|04/25/2011||Yes|No||||No|No|||Prescription required|No|||No|1.3726|02/01/2022|1.33965|02/01/2022|1.34857|02/01/2022||||1093|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074518219|SYNTHROID 75 MCG TABLET|1000|EA|.61526|01/21/2003||Yes|No||01/21/2003||Yes|No|01/21/2003||Yes|No||||No|No|||Prescription required|No|||No|1.37462|02/01/2022|1.34162|02/01/2022|1.35056|02/01/2022||||1094|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074518290|SYNTHROID 75 MCG TABLET|90|EA|.61518|04/25/2011||Yes|No||04/25/2011||Yes|No|04/25/2011||Yes|No||||No|No|||Prescription required|No|||No|1.37462|02/01/2022|1.34162|02/01/2022|1.35056|02/01/2022||||1095|||||No|No||ABBVIE US LLC|No||||
divalproex sodium|No|No|No|No|75%|00074611413|DEPAKOTE DR 125 MG SPRINKLE CP|100|EA|.72807|08/11/2009||Yes|No||08/11/2009||Yes|No|08/11/2009||Yes|No||08/11/2009||Yes|No|||Prescription required|No||056|No|1.62053|10/26/2021|1.58163|10/26/2021|1.59217|10/26/2021|||ANTICONVULSANTS|1096|||||No|No||ABBVIE US LLC|No||||
divalproex sodium|No|No|No|No|75%|00074621213|DEPAKOTE DR 125 MG TABLET|100|EA|.76368|05/05/2009||Yes|No||05/05/2009||Yes|No|05/05/2009||Yes|No||05/05/2009||Yes|No|||Prescription required|No||056|No|1.74048|03/29/2022|1.71561|03/29/2022|1.63392|03/29/2022|||ANTICONVULSANTS|1097|||||No|No||ABBVIE US LLC|No||||
divalproex sodium|No|No|No|No|75%|00074621413|DEPAKOTE DR 250 MG TABLET|100|EA|1.50009|09/11/2008||Yes|No||09/11/2008||Yes|No|09/11/2008||Yes|No||09/11/2008||Yes|No|||Prescription required|No||056|No|3.3658|10/26/2021|3.28502|10/26/2021|3.30689|10/26/2021|||ANTICONVULSANTS|1098|||||No|No||ABBVIE US LLC|No||||
divalproex sodium|No|No|No|No|75%|00074621453|DEPAKOTE DR 250 MG TABLET|500|EA|1.50009|09/11/2008||Yes|No||09/11/2008||Yes|No|09/11/2008||Yes|No||09/11/2008||Yes|No|||Prescription required|No||056|No|3.3658|10/26/2021|3.28502|10/26/2021|3.30689|10/26/2021|||ANTICONVULSANTS|1099|||||No|No||ABBVIE US LLC|No||||
divalproex sodium|No|No|No|No|75%|00074621513|DEPAKOTE DR 500 MG TABLET|100|EA|2.76623|09/11/2008||Yes|No||09/11/2008||Yes|No|09/11/2008||Yes|No||09/11/2008||Yes|No|||Prescription required|No||056|No|6.15982|09/28/2021|6.01198|09/28/2021|6.05202|09/28/2021|||ANTICONVULSANTS|1100|||||No|No||ABBVIE US LLC|No||||
divalproex sodium|No|No|No|No|75%|00074621553|DEPAKOTE DR 500 MG TABLET|500|EA|2.76623|09/11/2008||Yes|No||09/11/2008||Yes|No|09/11/2008||Yes|No||09/11/2008||Yes|No|||Prescription required|No||056|No|6.15982|09/28/2021|6.01198|09/28/2021|6.05202|09/28/2021|||ANTICONVULSANTS|1101|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074659419|SYNTHROID 88 MCG TABLET|1000|EA|.61516|01/16/2003||Yes|No||01/16/2003||Yes|No|01/16/2003||Yes|No||||No|No|||Prescription required|No|||No|1.3729|02/01/2022|1.33995|02/01/2022|1.34887|02/01/2022||||1102|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074659490|SYNTHROID 88 MCG TABLET|90|EA|.61518|04/25/2011||Yes|No||04/25/2011||Yes|No|04/25/2011||Yes|No||||No|No|||Prescription required|No|||No|1.3729|02/01/2022|1.33995|02/01/2022|1.34887|02/01/2022||||1103|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074662419|SYNTHROID 100 MCG TABLET|1000|EA|.61501|01/21/2003||Yes|No||01/21/2003||Yes|No|01/21/2003||Yes|No||||No|No|||Prescription required|No|||No|1.37244|02/01/2022|1.3395|02/01/2022|1.34842|02/01/2022||||1104|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074662490|SYNTHROID 100 MCG TABLET|90|EA|.61499|04/25/2011||Yes|No||04/25/2011||Yes|No|04/25/2011||Yes|No||||No|No|||Prescription required|No|||No|1.37244|02/01/2022|1.3395|02/01/2022|1.34842|02/01/2022||||1105|||||No|No||ABBVIE US LLC|No||||
lopinavir/ritonavir|No|No|No|No|75%|00074679922|KALETRA 200-50 MG TABLET|120|EA|5.1207|11/08/2005||Yes|No||11/08/2005||Yes|No|11/08/2005||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|8.36381|03/29/2022|8.24432|03/29/2022|7.85174|03/29/2022|||HIV / AIDS|1106|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074706819|SYNTHROID 125 MCG TABLET|1000|EA|.61525|01/21/2003||Yes|No||01/21/2003||Yes|No|01/21/2003||Yes|No||||No|No|||Prescription required|No|||No|1.37154|02/01/2022|1.33862|02/01/2022|1.34753|02/01/2022||||1107|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074706890|SYNTHROID 125 MCG TABLET|90|EA|.61537|04/25/2011||Yes|No||04/25/2011||Yes|No|04/25/2011||Yes|No||||No|No|||Prescription required|No|||No|1.37154|02/01/2022|1.33862|02/01/2022|1.34753|02/01/2022||||1108|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074706919|SYNTHROID 150 MCG TABLET|1000|EA|.61528|01/21/2003||Yes|No||01/21/2003||Yes|No|01/21/2003||Yes|No||||No|No|||Prescription required|No|||No|1.3722|02/01/2022|1.33926|02/01/2022|1.34818|02/01/2022||||1109|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074706990|SYNTHROID 150 MCG TABLET|90|EA|.61537|04/25/2011||Yes|No||04/25/2011||Yes|No|04/25/2011||Yes|No||||No|No|||Prescription required|No|||No|1.3722|02/01/2022|1.33926|02/01/2022|1.34818|02/01/2022||||1110|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074707019|SYNTHROID 175 MCG TABLET|1000|EA|.61445|01/22/2003||Yes|No||01/22/2003||Yes|No|01/22/2003||Yes|No||||No|No|||Prescription required|No|||No|1.37281|02/01/2022|1.33986|02/01/2022|1.34878|02/01/2022||||1111|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074707090|SYNTHROID 175 MCG TABLET|90|EA|.61447|04/25/2011||Yes|No||04/25/2011||Yes|No|04/25/2011||Yes|No||||No|No|||Prescription required|No|||No|1.37281|02/01/2022|1.33986|02/01/2022|1.34878|02/01/2022||||1112|||||No|No||ABBVIE US LLC|No||||
divalproex sodium|No|No|No|No|75%|00074712613|DEPAKOTE ER 500 MG TABLET|100|EA|2.39952|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||056|No|5.33756|12/28/2021|5.20945|12/28/2021|5.24415|12/28/2021|||ANTICONVULSANTS|1113|||||No|No||ABBVIE US LLC|No||||
divalproex sodium|No|No|No|No|75%|00074712653|DEPAKOTE ER 500 MG TABLET|500|EA|2.39954|10/30/2003|03/30/2023|Yes|No||10/30/2003|03/30/2023|Yes|No|10/30/2003|03/30/2023|Yes|No||||No|No|||Prescription required|No||056|No|5.33756|12/28/2021|5.20945|12/28/2021|5.24415|12/28/2021|||ANTICONVULSANTS|1114|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074714819|SYNTHROID 200 MCG TABLET|1000|EA|.61518|01/22/2003||Yes|No||01/22/2003||Yes|No|01/22/2003||Yes|No||||No|No|||Prescription required|No|||No|1.37258|02/01/2022|1.33963|02/01/2022|1.34855|02/01/2022||||1115|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074714890|SYNTHROID 200 MCG TABLET|90|EA|.61527|04/25/2011||Yes|No||04/25/2011||Yes|No|04/25/2011||Yes|No||||No|No|||Prescription required|No|||No|1.37258|02/01/2022|1.33963|02/01/2022|1.34855|02/01/2022||||1116|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074714919|SYNTHROID 300 MCG TABLET|1000|EA|.61483|01/22/2003||Yes|No||01/22/2003||Yes|No|01/22/2003||Yes|No||||No|No|||Prescription required|No|||No|1.37513|02/01/2022|1.34212|02/01/2022|1.35106|02/01/2022||||1117|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074714990|SYNTHROID 300 MCG TABLET|90|EA|.61484|04/25/2011||Yes|No||04/25/2011||Yes|No|04/25/2011||Yes|No||||No|No|||Prescription required|No|||No|1.37513|02/01/2022|1.34212|02/01/2022|1.35106|02/01/2022||||1118|||||No|No||ABBVIE US LLC|No||||
cyclosporine, modified|No|No|No|No|75%|00074726950|GENGRAF 100 MG/ML SOLUTION|50|ML|3.39975|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||01/01/2011||Yes|No|||Prescription required|No||229|No|7.74827|06/01/2016|7.63758|06/01/2016|7.27388|06/01/2016|||IMMUNOSUPPRESSIVES: ORAL|1119|||||No|No||ABBVIE US LLC|No||||
potassium chloride|No|No|No|No|75%|00074780413|K-TAB ER 10 MEQ TABLET|100|EA|.36051|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.82163|11/28/2017|.80989|11/28/2017|.77132|11/28/2017||||1120|||||No|No||ABBVIE US LLC|No||||
potassium chloride|No|No|No|No|75%|00074780419|K-TAB ER 10 MEQ TABLET|1000|EA|.34248|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.78054|11/28/2017|.76939|11/28/2017|.73275|11/28/2017||||1121|||||No|No||ABBVIE US LLC|No||||
paricalcitol|No|No|No|No|75%|00074903630|ZEMPLAR 1 MCG CAPSULE|30|EA|5.59458|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|No|||No|12.75044|09/12/2019|12.56829|09/12/2019|11.9698|09/12/2019||||1122|||||No|No||ABBVIE US LLC|No||||
paricalcitol|No|No|No|No|75%|00074903730|ZEMPLAR 2 MCG CAPSULE|30|EA|11.18888|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|No|||No|25.50024|09/12/2019|25.13595|09/12/2019|23.939|09/12/2019||||1123|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074929619|SYNTHROID 112 MCG TABLET|1000|EA|.61491|01/21/2003||Yes|No||01/21/2003||Yes|No|01/21/2003||Yes|No||||No|No|||Prescription required|No|||No|1.3715|02/01/2022|1.33858|02/01/2022|1.34749|02/01/2022||||1124|||||No|No||ABBVIE US LLC|No||||
levothyroxine sodium|No|No|No|No|75%|00074929690|SYNTHROID 112 MCG TABLET|90|EA|.61499|04/25/2011||Yes|No||04/25/2011||Yes|No|04/25/2011||Yes|No||||No|No|||Prescription required|No|||No|1.3715|02/01/2022|1.33858|02/01/2022|1.34749|02/01/2022||||1125|||||No|No||ABBVIE US LLC|No||||
leuprolide acetate|No|No|No|No|75%|00074969403|LUPRON DEPOT-PED 30 MG 3MO KIT|1|EA|4827.997|09/01/2011||Yes|No||09/01/2011||Yes|No|09/01/2011||Yes|No||||No|No|||Prescription required|No|||No|11003.342|01/25/2022|10846.1514|01/25/2022|10329.668|01/25/2022||||1126|||||No|No||ABBVIE US LLC|No||||
enoxaparin sodium|No|No|No|No|75%|00075062040|LOVENOX 40 MG/0.4 ML SYRINGE|.4|ML|35.5567|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|09/17/2013|068|Yes|81.0362|06/01/2016|79.87854|06/01/2016|76.0748|06/01/2016|||ANTICOAGULANTS|1127|||||No|No||SANOFI-AVENTIS|No||||
enoxaparin sodium|No|No|No|No|75%|00075062160|LOVENOX 60 MG/0.6 ML SYRINGE|.6|ML|35.59898|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|09/17/2013|068|Yes|81.13256|06/01/2016|79.97352|06/01/2016|76.16526|06/01/2016|||ANTICOAGULANTS|1128|||||No|No||SANOFI-AVENTIS|No||||
enoxaparin sodium|No|No|No|No|75%|00075062280|LOVENOX 80 MG/0.8 ML SYRINGE|.8|ML|35.59916|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|09/17/2013|068|Yes|81.13297|06/01/2016|79.97393|06/01/2016|76.16565|06/01/2016|||ANTICOAGULANTS|1129|||||No|No||SANOFI-AVENTIS|No||||
enoxaparin sodium|No|No|No|No|75%|00075062300|LOVENOX 100 MG/ML SYRINGE|1|ML|35.59841|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|09/17/2013|068|Yes|81.13126|06/01/2016|79.97224|06/01/2016|76.16404|06/01/2016|||ANTICOAGULANTS|1130|||||No|No||SANOFI-AVENTIS|No||||
enoxaparin sodium|No|No|No|No|75%|00075062430|LOVENOX 30 MG/0.3 ML SYRINGE|.3|ML|35.55813|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|09/17/2013|068|Yes|81.03946|06/01/2016|79.88175|06/01/2016|76.07786|06/01/2016|||ANTICOAGULANTS|1131|||||No|No||SANOFI-AVENTIS|No||||
enoxaparin sodium|No|No|No|No|75%|00075062603|LOVENOX 300 MG/3 ML VIAL|3|ML|35.55813|03/12/2003||Yes|No||03/12/2003||Yes|No|03/12/2003||Yes|No||||No|No|||Prescription required|Yes|09/17/2013|068|Yes|81.03946|06/01/2016|79.88175|06/01/2016|76.07786|06/01/2016|||ANTICOAGULANTS|1132|||||No|No||SANOFI-AVENTIS|No||||
enoxaparin sodium|No|No|No|No|75%|00075291201|LOVENOX 120 MG/0.8 ML SYRINGE|.8|ML|53.41513|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|09/17/2013|068|Yes|121.73682|06/01/2016|119.99772|06/01/2016|114.28355|06/01/2016|||ANTICOAGULANTS|1133|||||No|No||SANOFI-AVENTIS|No||||
enoxaparin sodium|No|No|No|No|75%|00075291501|LOVENOX 150 MG/ML SYRINGE|1|ML|53.41589|01/26/2009||Yes|No||01/26/2009||Yes|No|01/26/2009||Yes|No||||No|No|||Prescription required|Yes|09/17/2013|068|Yes|121.73854|06/01/2016|119.99941|06/01/2016|114.28516|06/01/2016|||ANTICOAGULANTS|1134|||||No|No||SANOFI-AVENTIS|No||||
cyclosporine|No|No|No|No|75%|00078011022|SANDIMMUNE 100 MG/ML SOLN|50|ML|6.44862|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|01/15/2014|229|No|14.69686|01/14/2020|14.4869|01/14/2020|13.79705|01/14/2020|||IMMUNOSUPPRESSIVES: ORAL|1135|||||No|No||NOVARTIS|No||||
octreotide acetate|No|No|No|No|75%|00078018001|SANDOSTATIN 0.05 MG/ML AMPUL|1|ML|5.95077|11/30/2009||Yes|No||11/30/2009||Yes|No|11/30/2009||Yes|No||||No|No|||Prescription required|No|||No|13.56222|06/01/2016|13.36847|06/01/2016|12.73188|06/01/2016||||1136|||||No|No||NOVARTIS|No||||
octreotide acetate|No|No|No|No|75%|00078018101|SANDOSTATIN 0.1 MG/ML AMPUL|1|ML|11.54335|11/30/2009||Yes|No||11/30/2009||Yes|No|11/30/2009||Yes|No||||No|No|||Prescription required|No|||No|26.3081|06/01/2016|25.93227|06/01/2016|24.6974|06/01/2016||||1137|||||No|No||NOVARTIS|No||||
octreotide acetate|No|No|No|No|75%|00078018201|SANDOSTATIN 0.5 MG/ML AMPUL|1|ML|55.67554|11/30/2009||Yes|No||11/30/2009||Yes|No|11/30/2009||Yes|No||||No|No|||Prescription required|No|||No|126.88844|06/01/2016|125.07574|06/01/2016|119.11976|06/01/2016||||1138|||||No|No||NOVARTIS|No||||
cyclosporine|No|No|No|No|75%|00078024015|SANDIMMUNE 25 MG CAPSULE|30|EA|1.66381|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|01/15/2014|229|No|3.79194|01/26/2021|3.73777|01/26/2021|3.55978|01/26/2021|||IMMUNOSUPPRESSIVES: ORAL|1139|||||No|No||NOVARTIS|No||||
cyclosporine|No|No|No|No|75%|00078024115|SANDIMMUNE 100 MG CAPSULE|30|EA|6.64049|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|01/15/2014|229|No|15.13414|01/26/2021|14.91793|01/26/2021|14.20756|01/26/2021|||IMMUNOSUPPRESSIVES: ORAL|1140|||||No|No||NOVARTIS|No||||
cyclosporine, modified|No|No|No|No|75%|00078024615|NEORAL 25 MG GELATIN CAPSULE|30|EA|.96864|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||229|No|2.17413|06/29/2021|2.12195|06/29/2021|2.13608|06/29/2021|||IMMUNOSUPPRESSIVES: ORAL|1141|||||No|No||NOVARTIS|No||||
cyclosporine, modified|No|No|No|No|75%|00078024815|NEORAL 100 MG GELATIN CAPSULE|30|EA|3.87114|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||229|No|8.8226|01/26/2021|8.69656|01/26/2021|8.28244|01/26/2021|||IMMUNOSUPPRESSIVES: ORAL|1142|||||No|No||NOVARTIS|No||||
letrozole|No|No|No|No|75%|00078024915|FEMARA 2.5 MG TABLET|30|EA|10.06314|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||502|No|22.9346|12/24/2019|22.60696|12/24/2019|21.53044|12/24/2019|||ONCOLOGY: ORAL - BREAST|1143|||||No|No||NOVARTIS|No||||
cyclosporine, modified|No|No|No|No|75%|00078027422|NEORAL 100 MG/ML SOLUTION|50|ML|4.21976|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|01/15/2014|229|No|9.61713|01/14/2020|9.47974|01/14/2020|9.02832|01/14/2020|||IMMUNOSUPPRESSIVES: ORAL|1144|||||No|No||NOVARTIS|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|00078031434|DIOVAN HCT 80-12.5 MG TABLET|90|EA|3.79794|04/12/2004||Yes|No||04/12/2004||Yes|No|04/12/2004||Yes|No||04/12/2004||Yes|No|||Prescription required|Yes|07/17/2014|113|Yes|8.65579|01/28/2020|8.53213|01/28/2020|8.12584|01/28/2020|||ANGIOTENSIN MODULATORS|1145|||||No|No||NOVARTIS|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|00078031534|DIOVAN HCT 160-12.5 MG TAB|90|EA|4.13224|04/12/2004||Yes|No||04/12/2004||Yes|No|04/12/2004||Yes|No||04/12/2004||Yes|No|||Prescription required|Yes|07/17/2014|113|Yes|9.41768|03/01/2022|9.28314|03/01/2022|8.84108|03/01/2022|||ANGIOTENSIN MODULATORS|1146|||||No|No||NOVARTIS|No||||
entacapone|No|No|No|No|75%|00078032705|COMTAN 200 MG TABLET|100|EA|3.3159|03/01/2002|04/09/2022|Yes|No||03/01/2002|04/09/2022|Yes|No|03/01/2002|04/09/2022|Yes|No||||No|No|||Prescription required|Yes|07/17/2007|015|No|7.55717|01/29/2019|7.44921|01/29/2019|7.09448|01/29/2019|||ANTIPARKINSON'S AGENTS|1147|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||NOVARTIS/ALMATI|No||||
oxcarbazepine|No|No|No|No|75%|00078033705|TRILEPTAL 300 MG TABLET|100|EA|3.75265|04/16/2004||Yes|No||04/16/2004||Yes|No|04/16/2004||Yes|No||||No|No|||Prescription required|No||056|No|8.55255|03/29/2022|8.43037|03/29/2022|8.02893|03/29/2022|||ANTICONVULSANTS|1148|||||No|No||NOVARTIS|No||||
estradiol|No|No|No|No|75%|00078034542|VIVELLE-DOT 0.075 MG PATCH|8|EA|7.17562|05/13/2016||Yes|No||05/13/2016||Yes|No|05/13/2016||Yes|No||||No|No|||Prescription required|No|||Yes|16.00763|08/24/2021|15.62344|08/24/2021|15.72749|08/24/2021||||1149|||||No|No||NOVARTIS|No||||
estradiol|No|No|No|No|75%|00078034642|VIVELLE-DOT 0.1 MG PATCH|8|EA|7.17777|05/13/2016||Yes|No||05/13/2016||Yes|No|05/13/2016||Yes|No||||No|No|||Prescription required|No|||Yes|16.05125|07/27/2021|15.66602|07/27/2021|15.77035|07/27/2021||||1150|||||No|No||NOVARTIS|No||||
nateglinide|No|No|No|No|75%|00078035205|STARLIX 120 MG TABLET|100|EA|1.60768|03/01/2002|01/31/2022|Yes|No||03/01/2002|01/31/2022|Yes|No|03/01/2002|01/31/2022|Yes|No||||No|No|||Prescription required|Yes|01/20/2011|022|Yes|3.66402|01/29/2019|3.61168|01/29/2019|3.43969|01/29/2019|||HYPOGLYCEMICS: MEGLITINIDES|1151|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NOVARTIS|No||||
fluvastatin sodium|No|No|No|No|75%|00078035415|LESCOL XL 80 MG TABLET|30|EA|4.62923|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|07/17/2014|063|Yes|10.55034|01/29/2019|10.39962|01/29/2019|9.9044|01/29/2019|||LIPOTROPICS: STATINS|1152|||||No|No||NOVARTIS|No||||
oxcarbazepine|No|No|No|No|75%|00078035752|TRILEPTAL 300 MG/5 ML SUSP|250|ML|.69142|05/12/2004||Yes|No||05/12/2004||Yes|No|05/12/2004||Yes|No||||No|No|||Prescription required|No||056|No|1.54309|12/28/2021|1.50605|12/28/2021|1.51608|12/28/2021|||ANTICONVULSANTS|1153|||||No|No||NOVARTIS|No||||
valsartan|No|No|No|No|75%|00078035834|DIOVAN 80 MG TABLET|90|EA|3.37722|04/09/2004||Yes|No||04/09/2004||Yes|No|04/09/2004||Yes|No||04/09/2004||Yes|No|||Prescription required|No||113|Yes|7.49625|07/27/2021|7.31634|07/27/2021|7.36506|07/27/2021|||ANGIOTENSIN MODULATORS|1154|||||No|No||NOVARTIS|No||||
valsartan|No|No|No|No|75%|00078035934|DIOVAN 160 MG TABLET|90|EA|3.63158|02/01/2004||Yes|No||02/01/2004||Yes|No|02/01/2004||Yes|No||02/01/2004||Yes|No|||Prescription required|No||113|Yes|8.10778|03/01/2022|7.91319|03/01/2022|7.96589|03/01/2022|||ANGIOTENSIN MODULATORS|1155|||||No|No||NOVARTIS|No||||
valsartan|No|No|No|No|75%|00078036034|DIOVAN 320 MG TABLET|90|EA|4.59426|04/12/2004||Yes|No||04/12/2004||Yes|No|04/12/2004||Yes|No||04/12/2004||Yes|No|||Prescription required|No||113|Yes|10.23669|12/28/2021|9.991|12/28/2021|10.05754|12/28/2021|||ANGIOTENSIN MODULATORS|1156|||||No|No||NOVARTIS|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|00078036405|LOTREL 10-20 MG CAPSULE|100|EA|5.00833|10/08/2007||Yes|No||10/08/2007||Yes|No|10/08/2007||Yes|No||10/08/2007||Yes|No|||Prescription required|Yes|07/26/2012|017|No|11.41435|01/28/2020|11.25129|01/28/2020|10.71551|01/28/2020|||ANGIOTENSIN MODULATOR COMBINATIONS|1157|||||No|No||NOVARTIS|No||||
estradiol|No|No|No|No|75%|00078036542|VIVELLE-DOT 0.025 MG PATCH|8|EA|7.16165|11/12/2003|03/01/2022|Yes|No||11/12/2003|03/01/2022|Yes|No|11/12/2003|03/01/2022|Yes|No||||No|No|||Prescription required|No|||Yes|16.3219|11/23/2021|16.08873|11/23/2021|15.3226|11/23/2021||||1158|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||NOVARTIS|No||||
methylphenidate HCl|No|No|No|No|75%|00078037005|RITALIN LA 20 MG CAPSULE|100|EA|4.27923|08/01/2002||Yes|No||08/01/2002||Yes|No|08/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|9.75266|01/29/2019|9.61334|01/29/2019|9.15556|01/29/2019|||STIMULANTS AND RELATED AGENTS|1159|||||No|No||NOVARTIS|No||||
methylphenidate HCl|No|No|No|No|75%|00078037105|RITALIN LA 30 MG CAPSULE|100|EA|4.37666|08/01/2002||Yes|No||08/01/2002||Yes|No|08/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|9.97473|01/29/2019|9.83223|01/29/2019|9.36403|01/29/2019|||STIMULANTS AND RELATED AGENTS|1160|||||No|No||NOVARTIS|No||||
methylphenidate HCl|No|No|No|No|75%|00078037205|RITALIN LA 40 MG CAPSULE|100|EA|4.49823|08/01/2002||Yes|No||08/01/2002||Yes|No|08/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|10.25178|01/29/2019|10.10532|01/29/2019|9.62412|01/29/2019|||STIMULANTS AND RELATED AGENTS|1161|||||No|No||NOVARTIS|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|00078037905|LOTREL 10-40 MG CAPSULE|100|EA|5.51844|02/05/2008||Yes|No||02/05/2008||Yes|No|02/05/2008||Yes|No||02/05/2008||Yes|No|||Prescription required|Yes|07/26/2012|017|No|12.57692|01/22/2019|12.39725|01/22/2019|11.80691|01/22/2019|||ANGIOTENSIN MODULATOR COMBINATIONS|1162|||||No|No||NOVARTIS|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00078038005|FOCALIN 2.5 MG TABLET|100|EA|.27206|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.60864|03/01/2022|.59403|03/01/2022|.59798|03/01/2022|||STIMULANTS AND RELATED AGENTS|1163|||||No|No||NOVARTIS|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00078038105|FOCALIN 5 MG TABLET|100|EA|.38781|04/27/2004||Yes|No||04/27/2004||Yes|No|04/27/2004||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.86368|03/29/2022|.84295|03/29/2022|.84856|03/29/2022|||STIMULANTS AND RELATED AGENTS|1164|||||No|No||NOVARTIS|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00078038205|FOCALIN 10 MG TABLET|100|EA|.55775|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.2451|09/28/2021|1.21521|09/28/2021|1.22331|09/28/2021|||STIMULANTS AND RELATED AGENTS|1165|||||No|No||NOVARTIS|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|00078038334|DIOVAN HCT 160-25 MG TABLET|90|EA|4.68623|04/12/2004||Yes|No||04/12/2004||Yes|No|04/12/2004||Yes|No||04/12/2004||Yes|No|||Prescription required|Yes|07/17/2014|113|Yes|10.68025|01/22/2019|10.52768|01/22/2019|10.02636|01/22/2019|||ANGIOTENSIN MODULATORS|1166|||||No|No||NOVARTIS|No||||
mycophenolate sodium|No|No|No|No|75%|00078038566|MYFORTIC 180 MG TABLET|120|EA|2.45501|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|Yes|01/15/2014|229|No|5.59514|11/23/2021|5.51521|11/23/2021|5.25258|11/23/2021|||IMMUNOSUPPRESSIVES: ORAL|1167|||||No|No||NOVARTIS|No||||
mycophenolate sodium|No|No|No|No|75%|00078038666|MYFORTIC 360 MG TABLET|120|EA|4.90998|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|Yes|01/15/2014|229|No|11.1902|03/01/2022|11.03034|03/01/2022|10.50509|03/01/2022|||IMMUNOSUPPRESSIVES: ORAL|1168|||||No|No||NOVARTIS|No||||
imatinib mesylate|No|No|No|No|75%|00078040134|GLEEVEC 100 MG TABLET|90|EA|40.26443|03/27/2008||Yes|No||03/27/2008||Yes|No|03/27/2008||Yes|No||||No|No|||Prescription required|No||173|No|91.76545|05/29/2018|90.45452|05/29/2018|86.14716|05/29/2018|||ONCOLOGY: ORAL - HEMATOLOGIC|1169|||||No|No||NOVARTIS|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|00078040505|LOTREL 5-10 MG CAPSULE|100|EA|4.08211|07/12/2005||Yes|No||07/12/2005||Yes|No|07/12/2005||Yes|No||07/12/2005||Yes|No|||Prescription required|Yes|07/26/2012|017|No|9.30343|01/28/2020|9.17052|01/28/2020|8.73383|01/28/2020|||ANGIOTENSIN MODULATOR COMBINATIONS|1170|||||No|No||NOVARTIS|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|00078040605|LOTREL 5-20 MG CAPSULE|100|EA|4.31079|10/08/2007||Yes|No||10/08/2007||Yes|No|10/08/2007||Yes|No||10/08/2007||Yes|No|||Prescription required|Yes|07/26/2012|017|No|9.82459|01/28/2020|9.68424|01/28/2020|9.22309|01/28/2020|||ANGIOTENSIN MODULATOR COMBINATIONS|1171|||||No|No||NOVARTIS|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|00078040705|STALEVO 50 TABLET|100|EA|3.28803|08/05/2003|06/07/2022|Yes|No||08/05/2003|06/07/2022|Yes|No|08/05/2003|06/07/2022|Yes|No||||No|No|||Prescription required|Yes|07/21/2016|015|No|7.49366|01/09/2018|7.38661|01/09/2018|7.03487|01/09/2018|||ANTIPARKINSON'S AGENTS|1172|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||NOVARTIS/ALMATI|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|00078040905|STALEVO 150 TABLET|100|EA|3.28803|08/05/2003|04/09/2022|Yes|No||08/05/2003|04/09/2022|Yes|No|08/05/2003|04/09/2022|Yes|No||||No|No|||Prescription required|Yes|07/21/2016|015|No|7.49366|01/29/2019|7.38661|01/29/2019|7.03487|01/29/2019|||ANTIPARKINSON'S AGENTS|1173|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||NOVARTIS/ALMATI|No||||
everolimus|No|No|No|No|75%|00078041420|ZORTRESS 0.5 MG TABLET|60|EA|7.97492|05/28/2010||Yes|No||05/28/2010||Yes|No|05/28/2010||Yes|No||07/01/2017||Yes|No|||Prescription required|Yes|01/15/2014|229|No|18.1754|01/26/2021|17.91575|01/26/2021|17.06262|01/26/2021|||IMMUNOSUPPRESSIVES: ORAL|1174|||||No|No||NOVARTIS|No||||
everolimus|No|No|No|No|75%|00078041461|ZORTRESS 0.5 MG TABLET|1|EA|7.9894|03/11/2021||Yes|No||03/11/2021||Yes|No|03/11/2021||Yes|No||03/11/2021||Yes|No|||Prescription required|Yes|01/15/2014|229|No|18.2084|03/16/2021|17.94828|03/16/2021|17.0936|03/11/2021|||IMMUNOSUPPRESSIVES: ORAL|1175|||||No|No||NOVARTIS|No||||
everolimus|No|No|No|No|75%|00078041520|ZORTRESS 0.75 MG TABLET|60|EA|11.96231|05/28/2010||Yes|No||05/28/2010||Yes|No|05/28/2010||Yes|No||07/01/2017||Yes|No|||Prescription required|Yes|01/15/2014|229|No|27.26294|01/26/2021|26.87347|01/26/2021|25.59378|01/26/2021|||IMMUNOSUPPRESSIVES: ORAL|1176|||||No|No||NOVARTIS|No||||
everolimus|No|No|No|No|75%|00078041561|ZORTRESS 0.75 MG TABLET|1|EA|11.9755|03/11/2021||Yes|No||03/11/2021||Yes|No|03/11/2021||Yes|No||03/11/2021||Yes|No|||Prescription required|Yes|01/15/2014|229|No|27.293|03/11/2021|26.9031|03/11/2021|25.622|03/11/2021|||IMMUNOSUPPRESSIVES: ORAL|1177|||||No|No||NOVARTIS|No||||
everolimus|No|No|No|No|75%|00078041720|ZORTRESS 0.25 MG TABLET|60|EA|3.98745|05/28/2010||Yes|No||05/28/2010||Yes|No|05/28/2010||Yes|No||07/01/2017||Yes|No|||Prescription required|Yes|01/15/2014|229|No|9.08769|01/14/2020|8.95787|01/14/2020|8.5313|01/14/2020|||IMMUNOSUPPRESSIVES: ORAL|1178|||||No|No||NOVARTIS|No||||
everolimus|No|No|No|No|75%|00078041761|ZORTRESS 0.25 MG TABLET|1|EA|3.9904|03/11/2021||Yes|No||03/11/2021||Yes|No|03/11/2021||Yes|No||03/11/2021||Yes|No|||Prescription required|Yes|01/15/2014|229|No|9.0944|03/16/2021|8.96448|03/16/2021|8.5376|03/11/2021|||IMMUNOSUPPRESSIVES: ORAL|1179|||||No|No||NOVARTIS|No||||
everolimus|No|No|No|No|75%|00078042220|ZORTRESS 1 MG TABLET|60|EA|15.94984|03/11/2021||Yes|No||03/11/2021||Yes|No|03/11/2021||Yes|No||03/11/2021||Yes|No|||Prescription required|Yes|01/25/2018|229|No|36.3508|03/11/2021|35.8315|03/11/2021|34.12524|03/11/2021|||IMMUNOSUPPRESSIVES: ORAL|1180|||||No|No||NOVARTIS|No||||
everolimus|No|No|No|No|75%|00078042261|ZORTRESS 1 MG TABLET|1|EA|15.9487|03/11/2021||Yes|No||03/11/2021||Yes|No|03/11/2021||Yes|No||03/11/2021||Yes|No|||Prescription required|Yes|01/25/2018|229|No|36.3482|03/11/2021|35.82894|03/11/2021|34.1228|03/11/2021|||IMMUNOSUPPRESSIVES: ORAL|1181|||||No|No||NOVARTIS|No||||
valsartan|No|No|No|No|75%|00078042315|DIOVAN 40 MG TABLET|30|EA|2.82524|09/08/2005||Yes|No||09/08/2005||Yes|No|09/08/2005||Yes|No||09/08/2005||Yes|No|||Prescription required|No||113|Yes|6.43892|08/24/2021|6.34693|08/24/2021|6.0447|08/24/2021|||ANGIOTENSIN MODULATORS|1182|||||No|No||NOVARTIS|No||||
methylphenidate HCl|No|No|No|No|75%|00078042405|RITALIN LA 10 MG CAPSULE|100|EA|4.27923|04/21/2004||Yes|No||04/21/2004||Yes|No|04/21/2004||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|9.75266|01/29/2019|9.61334|01/29/2019|9.15556|01/29/2019|||STIMULANTS AND RELATED AGENTS|1183|||||No|No||NOVARTIS|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00078043005|FOCALIN XR 5 MG CAPSULE|100|EA|5.4542|04/20/2009||Yes|No||04/20/2009||Yes|No|04/20/2009||Yes|No||||No|No|||Prescription required|No||007|Yes|12.14304|11/23/2021|11.8516|11/23/2021|11.93053|11/23/2021|||STIMULANTS AND RELATED AGENTS|1184|||||No|No||NOVARTIS|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00078043105|FOCALIN XR 10 MG CAPSULE|100|EA|5.53496|04/20/2009||Yes|No||04/20/2009||Yes|No|04/20/2009||Yes|No||||No|No|||Prescription required|No||007|Yes|12.32649|06/29/2021|12.03065|06/29/2021|12.11077|06/29/2021|||STIMULANTS AND RELATED AGENTS|1185|||||No|No||NOVARTIS|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00078043205|FOCALIN XR 20 MG CAPSULE|100|EA|5.69203|04/20/2009||Yes|No||04/20/2009||Yes|No|04/20/2009||Yes|No||||No|No|||Prescription required|No||007|Yes|12.74228|10/26/2021|12.43646|10/26/2021|12.51929|10/26/2021|||STIMULANTS AND RELATED AGENTS|1186|||||No|No||NOVARTIS|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00078043305|FOCALIN XR 30 MG CAPSULE|100|EA|5.48323|01/14/2010||Yes|No||01/14/2010||Yes|No|01/14/2010||Yes|No||||No|No|||Prescription required|No||007|Yes|12.24705|06/29/2021|11.95312|06/29/2021|12.03272|06/29/2021|||STIMULANTS AND RELATED AGENTS|1187|||||No|No||NOVARTIS|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00078043405|FOCALIN XR 40 MG CAPSULE|100|EA|6.27585|09/30/2010||Yes|No||09/30/2010||Yes|No|09/30/2010||Yes|No||||No|No|||Prescription required|No||007|Yes|13.9639|10/26/2021|13.62876|10/26/2021|13.71953|10/26/2021|||STIMULANTS AND RELATED AGENTS|1188|||||No|No||NOVARTIS|No||||
methylphenidate HCl|No|No|No|No|75%|00078043905|RITALIN 5 MG TABLET|100|EA|.28246|10/24/2005||Yes|No||10/24/2005||Yes|No|10/24/2005||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.64376|12/28/2021|.63456|12/28/2021|.60434|12/28/2021|||STIMULANTS AND RELATED AGENTS|1189|||||No|No||NOVARTIS|No||||
methylphenidate HCl|No|No|No|No|75%|00078044005|RITALIN 10 MG TABLET|100|EA|.40269|10/24/2005||Yes|No||10/24/2005||Yes|No|10/24/2005||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.90224|07/27/2021|.88058|07/27/2021|.88645|07/27/2021|||STIMULANTS AND RELATED AGENTS|1190|||||No|No||NOVARTIS|No||||
methylphenidate HCl|No|No|No|No|75%|00078044105|RITALIN 20 MG TABLET|100|EA|.57903|10/24/2005||Yes|No||10/24/2005||Yes|No|10/24/2005||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.29756|08/24/2021|1.26641|08/24/2021|1.27485|08/24/2021|||STIMULANTS AND RELATED AGENTS|1191|||||No|No||NOVARTIS|No||||
oxcarbazepine|No|No|No|No|75%|00078045605|TRILEPTAL 150 MG TABLET|100|EA|2.05471|02/28/2006||Yes|No||02/28/2006||Yes|No|02/28/2006||Yes|No||||No|No|||Prescription required|No||056|No|4.68283|01/28/2020|4.61593|01/28/2020|4.39612|01/28/2020|||ANTICONVULSANTS|1192|||||No|No||NOVARTIS|No||||
oxcarbazepine|No|No|No|No|75%|00078045705|TRILEPTAL 600 MG TABLET|100|EA|6.89707|02/28/2006||Yes|No||02/28/2006||Yes|No|02/28/2006||Yes|No||||No|No|||Prescription required|No||056|No|15.4068|03/29/2022|15.03703|03/29/2022|15.13718|03/29/2022|||ANTICONVULSANTS|1193|||||No|No||NOVARTIS|No||||
deferoxamine mesylate|No|No|No|No|75%|00078046791|DESFERAL MESYLATE 500 MG VL|1|EA|14.6372|05/17/2007||Yes|No||05/17/2007||Yes|No|05/17/2007||Yes|No||||No|No|||Prescription required|No|||No|33.3592|06/01/2016|32.88264|06/01/2016|31.3168|06/01/2016||||1194|||||No|No||NOVARTIS|No||||
deferasirox|No|No|No|No|75%|00078046815|EXJADE 125 MG TABLET|30|EA|18.15818|07/20/2006||Yes|No||07/20/2006||Yes|No|07/20/2006||Yes|No||||No|No|||Prescription required|No|||No|41.38376|01/22/2019|40.79256|01/22/2019|38.85006|01/22/2019||||1195|||||No|No||NOVARTIS|No||||
deferasirox|No|No|No|No|75%|00078046915|EXJADE 250 MG TABLET|30|EA|36.31565|07/20/2006||Yes|No||07/20/2006||Yes|No|07/20/2006||Yes|No||||No|No|||Prescription required|No|||No|82.7659|01/22/2019|81.58353|01/22/2019|77.6986|01/22/2019||||1196|||||No|No||NOVARTIS|No||||
deferasirox|No|No|No|No|75%|00078047015|EXJADE 500 MG TABLET|30|EA|72.62986|07/11/2006||Yes|No||07/11/2006||Yes|No|07/11/2006||Yes|No||||No|No|||Prescription required|No|||No|165.52852|01/22/2019|163.16383|01/22/2019|155.39412|01/22/2019||||1197|||||No|No||NOVARTIS|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|00078047134|DIOVAN HCT 320-12.5 MG TAB|90|EA|5.23543|06/27/2006||Yes|No||06/27/2006||Yes|No|06/27/2006||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|113|Yes|11.93193|01/28/2020|11.76147|01/28/2020|11.2014|01/28/2020|||ANGIOTENSIN MODULATORS|1198|||||No|No||NOVARTIS|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|00078047234|DIOVAN HCT 320-25 MG TABLET|90|EA|5.93959|08/08/2006||Yes|No||08/08/2006||Yes|No|08/08/2006||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|113|Yes|13.53674|01/28/2020|13.34335|01/28/2020|12.70796|01/28/2020|||ANGIOTENSIN MODULATORS|1199|||||No|No||NOVARTIS|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|00078048815|EXFORGE 5-160 MG TABLET|30|EA|3.81137|10/01/2009||Yes|No||10/01/2009||Yes|No|10/01/2009||Yes|No||10/01/2009||Yes|No|||Prescription required|Yes|07/27/2017|017|Yes|8.68638|10/26/2021|8.56229|10/26/2021|8.15456|10/26/2021|||ANGIOTENSIN MODULATOR COMBINATIONS|1200|||||No|No||NOVARTIS|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|00078048915|EXFORGE 10-160 MG TABLET|30|EA|4.3235|10/01/2009||Yes|No||10/01/2009||Yes|No|10/01/2009||Yes|No||10/01/2009||Yes|No|||Prescription required|Yes|07/27/2017|017|Yes|9.85356|01/28/2020|9.7128|01/28/2020|9.25028|01/28/2020|||ANGIOTENSIN MODULATOR COMBINATIONS|1201|||||No|No||NOVARTIS|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|00078049015|EXFORGE 5-320 MG TABLET|30|EA|4.83434|10/01/2009||Yes|No||10/01/2009||Yes|No|10/01/2009||Yes|No||10/01/2009||Yes|No|||Prescription required|Yes|07/27/2017|017|Yes|11.0178|01/28/2020|10.8604|01/28/2020|10.34324|01/28/2020|||ANGIOTENSIN MODULATOR COMBINATIONS|1202|||||No|No||NOVARTIS|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|00078049115|EXFORGE 10-320 MG TABLET|30|EA|5.48866|10/01/2009||Yes|No||10/01/2009||Yes|No|10/01/2009||Yes|No||10/01/2009||Yes|No|||Prescription required|Yes|07/27/2017|017|Yes|12.50904|01/28/2020|12.33034|01/28/2020|11.74318|01/28/2020|||ANGIOTENSIN MODULATOR COMBINATIONS|1203|||||No|No||NOVARTIS|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00078049305|FOCALIN XR 15 MG CAPSULE|100|EA|5.69203|04/20/2009||Yes|No||04/20/2009||Yes|No|04/20/2009||Yes|No||||No|No|||Prescription required|No||007|Yes|12.68162|11/23/2021|12.37726|11/23/2021|12.45969|11/23/2021|||STIMULANTS AND RELATED AGENTS|1204|||||No|No||NOVARTIS|No||||
tobramycin in 0.225% sod chlor|No|No|No|No|75%|00078049471|TOBI 300 MG/5 ML SOLUTION|5|ML|11.82094|03/06/2008||Yes|No||03/06/2008||Yes|No|03/06/2008||Yes|No|Submit HHS Form 1143|||No|No|||Prescription required|Yes|07/23/2015|240|No|26.94075|03/22/2022|26.55589|03/22/2022|25.29132|03/22/2022|||ANTIBIOTICS: INHALED|1205|||||No|No||NOVARTIS/MYLAN|No||||
rivastigmine|No|No|No|No|75%|00078050115|EXELON 4.6 MG/24HR PATCH|30|EA|9.83266|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||||No|No|||Prescription required|No||011|No|22.09267|01/25/2022|21.56244|01/25/2022|21.70604|01/25/2022|||ALZHEIMER'S AGENTS|1206|||||No|No||NOVARTIS|No||||
rivastigmine|No|No|No|No|75%|00078050215|EXELON 9.5 MG/24HR PATCH|30|EA|9.83266|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||||No|No|||Prescription required|No||011|No|22.08779|06/29/2021|21.55768|06/29/2021|21.70125|06/29/2021|||ALZHEIMER'S AGENTS|1207|||||No|No||NOVARTIS|No||||
rivastigmine|No|No|No|No|75%|00078050315|EXELON 13.3 MG/24HR PATCH|30|EA|9.83266|02/07/2013||Yes|No||02/07/2013||Yes|No|02/07/2013||Yes|No||||No|No|||Prescription required|No||011|No|21.84625|05/25/2021|21.32194|05/25/2021|21.46394|05/25/2021|||ALZHEIMER'S AGENTS|1208|||||No|No||NOVARTIS|No||||
carbamazepine|No|No|No|No|75%|00078050883|TEGRETOL 100 MG/5 ML SUSP|450|ML|.15594|10/02/2008||Yes|No||10/02/2008||Yes|No|10/02/2008||Yes|No||10/02/2008||Yes|No|||Prescription required|No||056|No|.34669|07/27/2021|.33836|07/27/2021|.34062|07/27/2021|||ANTICONVULSANTS|1209|||||No|No||NOVARTIS|No||||
carbamazepine|No|No|No|No|75%|00078050905|TEGRETOL 200 MG TABLET|100|EA|1.08953|07/08/2008||Yes|No||07/08/2008||Yes|No|07/08/2008||Yes|No||07/08/2008||Yes|No|||Prescription required|No||056|No|2.43591|06/29/2021|2.37744|06/29/2021|2.39328|06/29/2021|||ANTICONVULSANTS|1210|||||No|No||NOVARTIS|No||||
carbamazepine|No|No|No|No|75%|00078051005|TEGRETOL XR 100 MG TABLET|100|EA|.5832|07/08/2008||Yes|No||07/08/2008||Yes|No|07/08/2008||Yes|No||07/08/2008||Yes|No|||Prescription required|No||056|No|1.31099|06/29/2021|1.27952|06/29/2021|1.28804|06/29/2021|||ANTICONVULSANTS|1211|||||No|No||NOVARTIS|No||||
carbamazepine|No|No|No|No|75%|00078051105|TEGRETOL XR 200 MG TABLET|100|EA|1.16401|07/08/2008||Yes|No||07/08/2008||Yes|No|07/08/2008||Yes|No||07/08/2008||Yes|No|||Prescription required|No||056|No|2.58504|10/26/2021|2.52299|10/26/2021|2.5398|10/26/2021|||ANTICONVULSANTS|1212|||||No|No||NOVARTIS|No||||
carbamazepine|No|No|No|No|75%|00078051205|TEGRETOL XR 400 MG TABLET|100|EA|2.32621|07/08/2008||Yes|No||07/08/2008||Yes|No|07/08/2008||Yes|No||07/08/2008||Yes|No|||Prescription required|No||056|No|5.19073|06/29/2021|5.06615|06/29/2021|5.09989|06/29/2021|||ANTICONVULSANTS|1213|||||No|No||NOVARTIS|No||||
nilotinib HCl|No|No|No|No|75%|00078052651|TASIGNA 200 MG CAPSULE|28|EA|64.0809|12/15/2015||Yes|No||12/15/2015||Yes|No|12/15/2015||Yes|No||||No|No|||Prescription required|No||173|No|146.04484|01/11/2022|143.95848|01/11/2022|137.10332|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|1214|||||No|No||NOVARTIS|No||||
nilotinib HCl|No|No|No|No|75%|00078052687|TASIGNA 200 MG CAPSULE|28|EA|64.08117|08/19/2008||Yes|No||08/19/2008||Yes|No|08/19/2008||Yes|No||||No|No|||Prescription required|No||173|No|146.04546|01/11/2022|143.95909|01/11/2022|137.1039|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|1215|||||No|No||NOVARTIS|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|00078052705|STALEVO 200 TABLET|100|EA|3.28803|01/03/2011|04/09/2022|Yes|No||01/03/2011|04/09/2022|Yes|No|01/03/2011|04/09/2022|Yes|No||||No|No|||Prescription required|Yes|07/21/2016|015|No|7.49366|01/29/2019|7.38661|01/29/2019|7.03487|01/29/2019|||ANTIPARKINSON'S AGENTS|1216|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||NOVARTIS/ALMATI|No||||
everolimus|No|No|No|No|75%|00078056651|AFINITOR 5 MG TABLET|28|EA|241.21018|04/06/2009||Yes|No||04/06/2009||Yes|No|04/06/2009||Yes|No||||No|No|||Prescription required|No||548|No|549.73484|01/22/2019|541.88148|01/22/2019|516.0776|01/22/2019|||ONCOLOGY: ORAL - RENAL CELL|1217|||||No|No||NOVARTIS|No||||
everolimus|No|No|No|No|75%|00078056751|AFINITOR 10 MG TABLET|28|EA|241.21018|04/06/2009||Yes|No||04/06/2009||Yes|No|04/06/2009||Yes|No||||No|No|||Prescription required|No||548|No|549.73484|01/22/2019|541.88148|01/22/2019|516.0776|01/22/2019|||ONCOLOGY: ORAL - RENAL CELL|1218|||||No|No||NOVARTIS|No||||
interferon beta-1b|No|No|No|No|75%|00078056912|EXTAVIA 0.3 MG KIT|15|EA|191.56127|01/11/2010||Yes|No||01/11/2010||Yes|No|01/11/2010||Yes|No||||No|No|||Prescription required|No||043|No|436.5815|01/22/2019|430.34462|01/22/2019|409.85202|01/22/2019|||MULTIPLE SCLEROSIS AGENTS|1219|||||No|No||NOVARTIS|No||||
nilotinib HCl|No|No|No|No|75%|00078059251|TASIGNA 150 MG CAPSULE|28|EA|64.0809|12/15/2015||Yes|No||12/15/2015||Yes|No|12/15/2015||Yes|No||||No|No|||Prescription required|No||173|No|146.04484|01/11/2022|143.95848|01/11/2022|137.10332|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|1220|||||No|No||NOVARTIS|No||||
nilotinib HCl|No|No|No|No|75%|00078059287|TASIGNA 150 MG CAPSULE|28|EA|64.08117|09/30/2010||Yes|No||09/30/2010||Yes|No|09/30/2010||Yes|No||||No|No|||Prescription required|No||173|No|146.04546|01/11/2022|143.95909|01/11/2022|137.1039|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|1221|||||No|No||NOVARTIS|No||||
everolimus|No|No|No|No|75%|00078059451|AFINITOR 2.5 MG TABLET|28|EA|230.60623|01/03/2011||Yes|No||01/03/2011||Yes|No|01/03/2011||Yes|No||||No|No|||Prescription required|No||548|No|525.56769|01/22/2019|518.05958|01/22/2019|493.39008|01/22/2019|||ONCOLOGY: ORAL - RENAL CELL|1222|||||No|No||NOVARTIS|No||||
fingolimod HCl|No|No|No|No|75%|00078060715|GILENYA 0.5 MG CAPSULE|30|EA|136.88491|06/17/2015||Yes|No||06/17/2015||Yes|No|06/17/2015||Yes|No||||No|No|||Prescription required|No||043|No|309.61805|01/18/2022|302.18721|01/18/2022|304.19973|01/18/2022|||MULTIPLE SCLEROSIS AGENTS|1223|||||No|No||NOVARTIS|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00078060805|FOCALIN XR 25 MG CAPSULE|100|EA|5.97678|10/03/2011||Yes|No||10/13/2011||Yes|No|10/03/2011||Yes|No||||No|No|||Prescription required|No||007|Yes|13.28476|07/27/2021|12.96592|07/27/2021|13.05227|07/27/2021|||STIMULANTS AND RELATED AGENTS|1224|||||No|No||NOVARTIS|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00078060905|FOCALIN XR 35 MG CAPSULE|100|EA|6.27585|10/03/2011||Yes|No||10/03/2011||Yes|No|10/03/2011||Yes|No||||No|No|||Prescription required|No||007|Yes|14.05622|09/28/2021|13.71887|09/28/2021|13.81023|09/28/2021|||STIMULANTS AND RELATED AGENTS|1225|||||No|No||NOVARTIS|No||||
everolimus|No|No|No|No|75%|00078062051|AFINITOR 7.5 MG TABLET|28|EA|241.21018|10/08/2014||Yes|No||10/08/2014||Yes|No|10/08/2014||Yes|No||||No|No|||Prescription required|No||548|No|549.73484|01/22/2019|541.88148|01/22/2019|516.0776|01/22/2019|||ONCOLOGY: ORAL - RENAL CELL|1226|||||No|No||NOVARTIS|No||||
everolimus|No|No|No|No|75%|00078062651|AFINITOR DISPERZ 2 MG TABLET|28|EA|229.45629|08/05/2013||Yes|No||08/05/2013||Yes|No|08/05/2013||Yes|No||||No|No|||Prescription required|No||548|No|522.94689|01/22/2019|515.47622|01/22/2019|490.92973|01/22/2019|||ONCOLOGY: ORAL - RENAL CELL|1227|||||No|No||NOVARTIS|No||||
everolimus|No|No|No|No|75%|00078062751|AFINITOR DISPERZ 3 MG TABLET|28|EA|231.75479|08/05/2013||Yes|No||08/05/2013||Yes|No|08/05/2013||Yes|No||||No|No|||Prescription required|No||548|No|528.18534|01/22/2019|520.63984|01/22/2019|495.84746|01/22/2019|||ONCOLOGY: ORAL - RENAL CELL|1228|||||No|No||NOVARTIS|No||||
everolimus|No|No|No|No|75%|00078062851|AFINITOR DISPERZ 5 MG TABLET|28|EA|241.21018|08/05/2013||Yes|No||08/05/2013||Yes|No|08/05/2013||Yes|No||||No|No|||Prescription required|No||548|No|549.73484|01/22/2019|541.88148|01/22/2019|516.0776|01/22/2019|||ONCOLOGY: ORAL - RENAL CELL|1229|||||No|No||NOVARTIS|No||||
pasireotide diaspartate|No|No|No|No|75%|00078063320|SIGNIFOR 0.3 MG/ML AMPULE|1|ML|104.99488|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No|||No|239.29067|09/14/2021|235.87223|09/14/2021|224.64022|09/14/2021||||1230|||||No|No||NOVARTIS/RECORD|No||||
pasireotide diaspartate|No|No|No|No|75%|00078063420|SIGNIFOR 0.6 MG/ML AMPULE|1|ML|104.99488|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|No|||No|239.29067|02/09/2022|235.87223|02/09/2022|224.64022|02/09/2022||||1231|||||No|No||NOVARTIS/RECORD|No||||
pasireotide diaspartate|No|No|No|No|75%|00078063520|SIGNIFOR 0.9 MG/ML AMPULE|1|ML|104.99488|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No|||No|239.29067|09/14/2021|235.87223|09/14/2021|224.64022|09/14/2021||||1232|||||No|No||NOVARTIS/RECORD|No||||
secukinumab|No|No|No|No|75%|00078063941|COSENTYX 300 MG DOSE-2 PENS|1|ML|1364.0417|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|071|Yes|3055.09728|03/08/2022|2981.77494|03/08/2022|3001.63307|03/08/2022|||CYTOKINE AND CAM ANTAGONISTS|1233|||||No|No||NOVARTIS|No||||
secukinumab|No|No|No|No|75%|00078063968|COSENTYX 150 MG/ML PEN INJECT|1|ML|2728.0834|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|071|Yes|6217.4924|01/11/2022|6128.67108|01/11/2022|5836.8296|01/11/2022|||CYTOKINE AND CAM ANTAGONISTS|1234|||||No|No||NOVARTIS|No||||
secukinumab|No|No|No|No|75%|00078063997|COSENTYX 150 MG/ML SYRINGE|1|ML|2728.0834|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|071|Yes|6217.4924|01/11/2022|6128.67108|01/11/2022|5836.8296|01/11/2022|||CYTOKINE AND CAM ANTAGONISTS|1235|||||No|No||NOVARTIS|No||||
secukinumab|No|No|No|No|75%|00078063998|COSENTYX 300 MG DOSE-2 SYRINGE|1|ML|1364.0417|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|071|Yes|3108.7462|01/11/2022|3064.33554|01/11/2022|2918.4148|01/11/2022|||CYTOKINE AND CAM ANTAGONISTS|1236|||||No|No||NOVARTIS|No||||
pasireotide pamoate|No|No|No|No|75%|00078064181|SIGNIFOR LAR 20 MG KIT|1|EA|6279.1008|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No|||No|14310.5088|01/18/2022|14106.07296|01/18/2022|13434.3552|01/18/2022||||1237|||||No|No||NOVARTIS/RECORD|No||||
pasireotide pamoate|No|No|No|No|75%|00078064281|SIGNIFOR LAR 40 MG KIT|1|EA|6279.1008|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No|||No|14310.5088|01/18/2022|14106.07296|01/18/2022|13434.3552|01/18/2022||||1238|||||No|No||NOVARTIS/RECORD|No||||
pasireotide pamoate|No|No|No|No|75%|00078064381|SIGNIFOR LAR 60 MG KIT|1|EA|6279.1008|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No|||No|14310.5088|01/18/2022|14106.07296|01/18/2022|13434.3552|01/18/2022||||1239|||||No|No||NOVARTIS/RECORD|No||||
imatinib mesylate|No|No|No|No|75%|00078064930|GLEEVEC 400 MG TABLET|30|EA|145.08816|03/09/2015||Yes|No||03/09/2015||Yes|No|03/09/2015||Yes|No||||No|No|||Prescription required|No||173|No|330.66604|09/28/2021|325.94224|09/28/2021|310.42118|09/28/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|1240|||||No|No||NOVARTIS|No||||
panobinostat lactate|No|No|No|No|75%|00078065006|FARYDAK 10 MG CAPSULE|6|EA|1009.24655|05/18/2015|01/31/2023|Yes|No||05/18/2015|01/31/2023|Yes|No|05/18/2015|01/31/2023|Yes|No||||No|No|||Prescription required|No||173|No|2300.1433|04/27/2021|2267.28411|04/27/2021|2159.3182|04/27/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|1241|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NOVARTIS/SECURA|No||||
panobinostat lactate|No|No|No|No|75%|00078065106|FARYDAK 15 MG CAPSULE|6|EA|1009.24655|05/18/2015|12/31/2022|Yes|No||05/18/2015|12/31/2022|Yes|No|05/18/2015|12/31/2022|Yes|No||||No|No|||Prescription required|No||173|No|2300.1433|04/27/2021|2267.28411|04/27/2021|2159.3182|04/27/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|1242|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NOVARTIS/SECURA|No||||
panobinostat lactate|No|No|No|No|75%|00078065206|FARYDAK 20 MG CAPSULE|6|EA|1009.24655|05/12/2015|12/31/2022|Yes|No||05/12/2015|12/31/2022|Yes|No|05/12/2015|12/31/2022|Yes|No||||No|No|||Prescription required|No||173|No|2300.1433|04/27/2021|2267.28411|04/27/2021|2159.3182|04/27/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|1243|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NOVARTIS/SECURA|No||||
deferasirox|No|No|No|No|75%|00078065415|JADENU 90 MG TABLET|30|EA|20.79066|06/02/2015||Yes|No||06/02/2015||Yes|No|06/02/2015||Yes|No||||No|No|||Prescription required|No|||No|41.38376|01/22/2019|40.79256|01/22/2019|38.85006|01/22/2019||||1244|||||No|No||NOVARTIS|No||||
deferasirox|No|No|No|No|75%|00078065515|JADENU 180 MG TABLET|30|EA|41.64023|06/02/2015||Yes|No||06/02/2015||Yes|No|06/02/2015||Yes|No||||No|No|||Prescription required|No|||No|82.7659|01/22/2019|81.58353|01/22/2019|77.6986|01/22/2019||||1245|||||No|No||NOVARTIS|No||||
deferasirox|No|No|No|No|75%|00078065615|JADENU 360 MG TABLET|30|EA|85.7169|06/02/2015||Yes|No||06/02/2015||Yes|No|06/02/2015||Yes|No||||No|No|||Prescription required|No|||No|165.52852|01/22/2019|163.16383|01/22/2019|155.39412|01/22/2019||||1246|||||No|No||NOVARTIS|No||||
sacubitril/valsartan|No|No|No|No|75%|00078065920|ENTRESTO 24 MG-26 MG TABLET|60|EA|4.46977|08/13/2015||Yes|No||08/13/2015||Yes|No|08/13/2015||Yes|No||||No|No|||Prescription required|No||113|Yes|9.97896|01/18/2022|9.73946|01/18/2022|9.80432|01/18/2022|||ANGIOTENSIN MODULATORS|1247|||||No|No||NOVARTIS|No||||
sacubitril/valsartan|No|No|No|No|75%|00078065967|ENTRESTO 24 MG-26 MG TABLET|180|EA|4.46982|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||113|Yes|9.97896|01/18/2022|9.73946|01/18/2022|9.80432|01/18/2022|||ANGIOTENSIN MODULATORS|1248|||||No|No||NOVARTIS|No||||
indacaterol/glycopyrrolate|No|No|No|No|75%|00078066419|UTIBRON NEOHALER 27.5-15.6 MCG|60|EA|2.6316|04/03/2017||Yes|No||04/03/2017||Yes|No|04/03/2017||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|098|Yes|5.9976|09/10/2019|5.91192|09/10/2019|5.6304|09/10/2019|||COPD AGENTS|1249|||||No|No||NOVARTIS/SUNOVI|No||||
trametinib dimethyl sulfoxide|No|No|No|No|75%|00078066615|MEKINIST 0.5 MG TABLET|30|EA|55.98485|08/12/2016||Yes|No||08/12/2016||Yes|No|08/12/2016||Yes|No||||No|No|||Prescription required|No||563|No|127.59338|01/11/2022|125.77062|01/11/2022|119.78154|01/11/2022|||ONCOLOGY: ORAL - SKIN|1250|||||No|No||NOVARTIS|No||||
trametinib dimethyl sulfoxide|No|No|No|No|75%|00078066815|MEKINIST 2 MG TABLET|30|EA|190.54489|08/12/2016||Yes|No||08/12/2016||Yes|No|08/12/2016||Yes|No||||No|No|||Prescription required|No||563|No|434.2651|01/11/2022|428.06131|01/11/2022|407.67744|01/11/2022|||ONCOLOGY: ORAL - SKIN|1251|||||No|No||NOVARTIS|No||||
pazopanib HCl|No|No|No|No|75%|00078067066|VOTRIENT 200 MG TABLET|120|EA|55.03046|09/23/2016||Yes|No||09/23/2016||Yes|No|09/23/2016||Yes|No||||No|No|||Prescription required|No||548|No|125.41827|01/11/2022|123.62658|01/11/2022|117.7396|01/11/2022|||ONCOLOGY: ORAL - RENAL CELL|1252|||||No|No||NOVARTIS|No||||
lapatinib ditosylate|No|No|No|No|75%|00078067119|TYKERB 250 MG TABLET|150|EA|23.94615|09/19/2016||Yes|No||09/19/2016||Yes|No|09/19/2016||Yes|No||||No|No|||Prescription required|No||502|No|54.57495|01/14/2020|53.79531|01/14/2020|51.23363|01/14/2020|||ONCOLOGY: ORAL - BREAST|1253|||||No|No||NOVARTIS|No||||
topotecan HCl|No|No|No|No|75%|00078067301|HYCAMTIN 1 MG CAPSULE|10|EA|172.84495|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No||551|No|393.9257|05/02/2017|388.29819|05/02/2017|369.8078|05/02/2017|||ONCOLOGY: ORAL - LUNG|1254|||||No|No||NOVARTIS|No||||
dabrafenib mesylate|No|No|No|No|75%|00078068166|TAFINLAR 75 MG CAPSULE|120|EA|43.87505|07/07/2016||Yes|No||07/07/2016||Yes|No|07/07/2016||Yes|No||||No|No|||Prescription required|No||563|No|99.9943|01/11/2022|98.56581|01/11/2022|93.8722|01/11/2022|||ONCOLOGY: ORAL - SKIN|1255|||||No|No||NOVARTIS|No||||
dabrafenib mesylate|No|No|No|No|75%|00078068266|TAFINLAR 50 MG CAPSULE|120|EA|34.04463|07/07/2016||Yes|No||07/07/2016||Yes|No|07/07/2016||Yes|No||||No|No|||Prescription required|No||563|No|77.5901|01/11/2022|76.48167|01/11/2022|72.83969|01/11/2022|||ONCOLOGY: ORAL - SKIN|1256|||||No|No||NOVARTIS|No||||
eltrombopag olamine|No|No|No|No|75%|00078068415|PROMACTA 12.5 MG TABLET|30|EA|86.50353|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No||||No|No|||Prescription required|No||235|No|197.14758|01/11/2022|194.33118|01/11/2022|185.07732|01/11/2022|||THROMBOPOIESIS STIMULATING PROTEINS|1257|||||No|No||NOVARTIS|No||||
eltrombopag olamine|No|No|No|No|75%|00078068515|PROMACTA 25 MG TABLET|30|EA|86.50353|07/27/2016||Yes|No||07/27/2016||Yes|No|07/27/2016||Yes|No||||No|No|||Prescription required|No||235|No|197.14758|01/11/2022|194.33118|01/11/2022|185.07732|01/11/2022|||THROMBOPOIESIS STIMULATING PROTEINS|1258|||||No|No||NOVARTIS|No||||
eltrombopag olamine|No|No|No|No|75%|00078068615|PROMACTA 50 MG TABLET|30|EA|156.54393|07/27/2016||Yes|No||07/27/2016||Yes|No|07/27/2016||Yes|No||||No|No|||Prescription required|No||235|No|356.77454|01/11/2022|351.67776|01/11/2022|334.9312|01/11/2022|||THROMBOPOIESIS STIMULATING PROTEINS|1259|||||No|No||NOVARTIS|No||||
eltrombopag olamine|No|No|No|No|75%|00078068715|PROMACTA 75 MG TABLET|30|EA|234.81597|05/20/2016||Yes|No||05/20/2016||Yes|No|05/20/2016||Yes|No||||No|No|||Prescription required|No||235|No|535.16198|01/11/2022|527.51681|01/11/2022|502.39696|01/11/2022|||THROMBOPOIESIS STIMULATING PROTEINS|1260|||||No|No||NOVARTIS|No||||
sacubitril/valsartan|No|No|No|No|75%|00078069620|ENTRESTO 97 MG-103 MG TABLET|60|EA|4.46977|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No||113|Yes|9.98499|01/18/2022|9.74535|01/18/2022|9.81025|01/18/2022|||ANGIOTENSIN MODULATORS|1261|||||No|No||NOVARTIS|No||||
sacubitril/valsartan|No|No|No|No|75%|00078069667|ENTRESTO 97 MG-103 MG TABLET|180|EA|4.46982|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||113|Yes|9.98499|01/18/2022|9.74535|01/18/2022|9.81025|01/18/2022|||ANGIOTENSIN MODULATORS|1262|||||No|No||NOVARTIS|No||||
eltrombopag olamine|No|No|No|No|75%|00078069761|PROMACTA 25 MG SUSPENSION PCKT|30|EA|86.50811|08/03/2021||Yes|No||08/03/2021||Yes|No|08/03/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|235|No|197.15802|01/11/2022|194.34148|01/11/2022|185.08712|01/11/2022|||THROMBOPOIESIS STIMULATING PROTEINS|1263|||||No|No||NOVARTIS|No||||
midostaurin|No|No|No|No|75%|00078069802|RYDAPT 25 MG CAPSULE|2|EA|76.64965|07/17/2017||Yes|No||07/17/2017||Yes|No|07/17/2017||Yes|No||||No|No|||Prescription required|No||173|No|174.6899|01/11/2022|172.19433|01/11/2022|163.9946|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|1264|||||No|No||NOVARTIS|No||||
midostaurin|No|No|No|No|75%|00078069899|RYDAPT 25 MG CAPSULE|56|EA|76.64772|07/17/2017||Yes|No||07/17/2017||Yes|No|07/17/2017||Yes|No||||No|No|||Prescription required|No||173|No|174.68551|01/11/2022|172.19001|01/11/2022|163.99048|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|1265|||||No|No||NOVARTIS|No||||
alpelisib|No|No|No|No|75%|00078070184|PIQRAY 200 MG DAILY DOSE|28|EA|287.51612|04/10/2020||Yes|No||04/10/2020||Yes|No|04/10/2020||Yes|No||||No|No|||Prescription required|No||502|No|655.26929|01/11/2022|645.9083|01/11/2022|615.15076|01/11/2022|||ONCOLOGY: ORAL - BREAST|1266|||||No|No||NOVARTIS|No||||
alpelisib|No|No|No|No|75%|00078070802|PIQRAY 300 MG DAILY DOSE|56|EA|143.75806|04/13/2020||Yes|No||04/13/2020||Yes|No|04/13/2020||Yes|No||||No|No|||Prescription required|No||502|No|327.63464|01/11/2022|322.95415|01/11/2022|307.57538|01/11/2022|||ONCOLOGY: ORAL - BREAST|1267|||||No|No||NOVARTIS|No||||
capmatinib hydrochloride|No|No|No|No|75%|00078070956|TABRECTA 150 MG TABLET|56|EA|76.70432|11/10/2020||Yes|No||11/10/2020||Yes|No|11/10/2020||Yes|No||||No|No|||Prescription required|No||551|No|174.81449|01/11/2022|172.31714|01/11/2022|164.11156|01/11/2022|||ONCOLOGY: ORAL - LUNG|1268|||||No|No||NOVARTIS|No||||
deferasirox|No|No|No|No|75%|00078071315|JADENU SPRINKLE 180 MG GRANULE|30|EA|36.31565|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No|||No|82.7659|01/22/2019|81.58353|01/22/2019|77.6986|01/22/2019||||1269|||||No|No||NOVARTIS|No||||
alpelisib|No|No|No|No|75%|00078071502|PIQRAY 250 MG DAILY DOSE|56|EA|143.75806|04/10/2020||Yes|No||04/10/2020||Yes|No|04/10/2020||Yes|No||||No|No|||Prescription required|No||502|No|327.63464|01/11/2022|322.95415|01/11/2022|307.57538|01/11/2022|||ONCOLOGY: ORAL - BREAST|1270|||||No|No||NOVARTIS|No||||
capmatinib hydrochloride|No|No|No|No|75%|00078071656|TABRECTA 200 MG TABLET|56|EA|76.70432|11/10/2020||Yes|No||11/10/2020||Yes|No|11/10/2020||Yes|No||||No|No|||Prescription required|No||551|No|174.81449|01/11/2022|172.31714|01/11/2022|164.11156|01/11/2022|||ONCOLOGY: ORAL - LUNG|1271|||||No|No||NOVARTIS|No||||
deferasirox|No|No|No|No|75%|00078072015|JADENU SPRINKLE 360 MG GRANULE|30|EA|72.62986|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|No|||No|165.52852|01/22/2019|163.16383|01/22/2019|155.39412|01/22/2019||||1272|||||No|No||NOVARTIS|No||||
deferasirox|No|No|No|No|75%|00078072715|JADENU SPRINKLE 90 MG GRANULE|30|EA|18.15818|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|No|||No|41.38376|01/22/2019|40.79256|01/22/2019|38.85006|01/22/2019||||1273|||||No|No||NOVARTIS|No||||
canakinumab/PF|No|No|No|No|75%|00078073461|ILARIS 150 MG/ML VIAL|1|ML|7290.2974|04/07/2017||Yes|No||04/07/2017||Yes|No|04/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|071|Yes|16615.0964|01/11/2022|16377.73788|01/11/2022|15597.8456|01/11/2022|||CYTOKINE AND CAM ANTAGONISTS|1274|||||No|No||NOVARTIS|No||||
pasireotide pamoate|No|No|No|No|75%|00078074181|SIGNIFOR LAR 30 MG KIT|1|EA|6279.1008|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No|||No|14310.5088|01/18/2022|14106.07296|01/18/2022|13434.3552|01/18/2022||||1275|||||No|No||NOVARTIS/RECORD|No||||
pasireotide pamoate|No|No|No|No|75%|00078074881|SIGNIFOR LAR 10 MG KIT|1|EA|6279.1008|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No|||No|14310.5088|01/18/2022|14106.07296|01/18/2022|13434.3552|01/18/2022||||1276|||||No|No||NOVARTIS/RECORD|No||||
sacubitril/valsartan|No|No|No|No|75%|00078077720|ENTRESTO 49 MG-51 MG TABLET|60|EA|4.46977|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No||113|Yes|9.97659|01/18/2022|9.73715|01/18/2022|9.80199|01/18/2022|||ANGIOTENSIN MODULATORS|1277|||||No|No||NOVARTIS|No||||
sacubitril/valsartan|No|No|No|No|75%|00078077767|ENTRESTO 49 MG-51 MG TABLET|180|EA|4.46982|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||113|Yes|9.97659|01/18/2022|9.73715|01/18/2022|9.80199|01/18/2022|||ANGIOTENSIN MODULATORS|1278|||||No|No||NOVARTIS|No||||
ciprofloxacin HCl/dexameth|No|No|No|No|75%|00078079975|CIPRODEX OTIC SUSPENSION|7.5|ML|14.28116|01/05/2021||Yes|No||01/05/2021||Yes|No|01/05/2021||Yes|No||||No|No|||Prescription required|No||051|No|31.79346|12/28/2021|31.03041|12/28/2021|31.23707|12/28/2021|||OTIC ANTIBIOTICS|1279|||||No|No||NOVARTIS|No||||
octreotide acetate,mi-spheres|No|No|No|No|75%|00078081881|SANDOSTATIN LAR DEPOT 20 MG KT|1|EA|1833.8382|02/16/2017||Yes|No||02/16/2017||Yes|No|02/16/2017||Yes|No||||No|No|||Prescription required|No|||No|4179.4452|01/22/2019|4119.73884|01/22/2019|3923.5608|01/22/2019||||1280|||||No|No||NOVARTIS|No||||
octreotide acetate,mi-spheres|No|No|No|No|75%|00078082581|SANDOSTATIN LAR DEPOT 30 MG KT|1|EA|2746.0402|02/16/2017||Yes|No||02/16/2017||Yes|No|02/16/2017||Yes|No||||No|No|||Prescription required|No|||No|6258.4172|01/22/2019|6169.01124|01/22/2019|5875.2488|01/22/2019||||1281|||||No|No||NOVARTIS|No||||
ribociclib succinate|No|No|No|No|75%|00078086001|KISQALI 200 MG DAILY DOSE|21|EA|124.18645|05/15/2017||Yes|No||05/15/2017||Yes|No|05/15/2017||Yes|No||||No|No|||Prescription required|No||502|No|283.02959|01/11/2022|278.98631|01/11/2022|265.70125|01/11/2022|||ONCOLOGY: ORAL - BREAST|1282|||||No|No||NOVARTIS|No||||
ribociclib succinate|No|No|No|No|75%|00078086742|KISQALI 400 MG DAILY DOSE|42|EA|124.18686|05/15/2017||Yes|No||05/15/2017||Yes|No|05/15/2017||Yes|No||||No|No|||Prescription required|No||502|No|283.03052|01/11/2022|278.98723|01/11/2022|265.70212|01/11/2022|||ONCOLOGY: ORAL - BREAST|1283|||||No|No||NOVARTIS|No||||
ribociclib succinate|No|No|No|No|75%|00078087463|KISQALI 600 MG DAILY DOSE|63|EA|103.48905|05/15/2017||Yes|No||05/15/2017||Yes|No|05/15/2017||Yes|No||||No|No|||Prescription required|No||502|No|235.85877|01/11/2022|232.48936|01/11/2022|221.41844|01/11/2022|||ONCOLOGY: ORAL - BREAST|1284|||||No|No||NOVARTIS|No||||
brinzolamide/brimonidine tart|No|No|No|No|75%|00078090438|SIMBRINZA 1%-0.2% EYE DROPS|8|ML|10.2512|02/08/2021||Yes|No||02/08/2021||Yes|No|02/08/2021||Yes|No||||No|No|||Prescription required|No||088|No|22.88625|01/11/2022|22.33698|01/11/2022|22.48574|01/11/2022|||OPHTHALMICS: GLAUCOMA AGENTS|1285|||||No|No||ALCON LABORATOR|No||||
ribociclib succinate/letrozole|No|No|No|No|75%|00078090961|KISQALI FEMARA 200 MG CO-PACK|49|EA|53.22276|07/10/2017||Yes|No||07/10/2017||Yes|No|07/10/2017||Yes|No||||No|No|||Prescription required|No||502|No|121.29839|01/11/2022|119.56555|01/11/2022|113.87196|01/11/2022|||ONCOLOGY: ORAL - BREAST|1286|||||No|No||NOVARTIS|No||||
lifitegrast|No|No|No|No|75%|00078091112|XIIDRA 5% EYE DROPS|60|EA|4.54187|12/09/2020||Yes|No||12/09/2020||Yes|No|12/09/2020||Yes|No||||No|No|||Prescription required|No||086|No|10.13623|01/18/2022|9.89296|01/18/2022|9.95884|01/18/2022|||OPHTHALMICS: ANTI-INFLAMMATORY/IMMUNOMODULATOR|1287|||||No|No||NOVARTIS|No||||
ribociclib succinate/letrozole|No|No|No|No|75%|00078091661|KISQALI FEMARA 400 MG CO-PACK|70|EA|74.51212|07/10/2017||Yes|No||07/10/2017||Yes|No|07/10/2017||Yes|No||||No|No|||Prescription required|No||502|No|169.81832|01/11/2022|167.39234|01/11/2022|159.42128|01/11/2022|||ONCOLOGY: ORAL - BREAST|1288|||||No|No||NOVARTIS|No||||
ribociclib succinate/letrozole|No|No|No|No|75%|00078092361|KISQALI FEMARA 600 MG CO-PACK|91|EA|71.64626|07/10/2017||Yes|No||07/10/2017||Yes|No|07/10/2017||Yes|No||||No|No|||Prescription required|No||502|No|163.28684|01/11/2022|160.95417|01/11/2022|153.28969|01/11/2022|||ONCOLOGY: ORAL - BREAST|1289|||||No|No||NOVARTIS|No||||
eltrombopag olamine|No|No|No|No|75%|00078097261|PROMACTA 12.5 MG SUSPEN PACKET|30|EA|86.50353|04/02/2019||Yes|No||04/02/2019||Yes|No|04/02/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|235|No|197.14758|01/11/2022|194.33118|01/11/2022|185.07732|01/11/2022|||THROMBOPOIESIS STIMULATING PROTEINS|1290|||||No|No||NOVARTIS|No||||
siponimod|No|No|No|No|75%|00078097912|MAYZENT 0.25MG START-2MG MAINT|12|EA|30.31715|04/10/2020||Yes|No||04/10/2020||Yes|No|04/10/2020||Yes|No||||No|No|||Prescription required|No||043|No|69.0949|01/11/2022|68.10783|01/11/2022|64.8646|01/11/2022|||MULTIPLE SCLEROSIS AGENTS|1291|||||No|No||NOVARTIS|No||||
siponimod|No|No|No|No|75%|00078097950|MAYZENT 0.25 MG TABLET|28|EA|30.3173|04/10/2020||Yes|No||04/10/2020||Yes|No|04/10/2020||Yes|No||||No|No|||Prescription required|No||043|No|69.09524|01/11/2022|68.10816|01/11/2022|64.86492|01/11/2022|||MULTIPLE SCLEROSIS AGENTS|1292|||||No|No||NOVARTIS|No||||
siponimod|No|No|No|No|75%|00078098615|MAYZENT 2 MG TABLET|30|EA|121.26903|04/10/2020||Yes|No||04/10/2020||Yes|No|04/10/2020||Yes|No||||No|No|||Prescription required|No||043|No|276.38058|01/11/2022|272.43228|01/11/2022|259.45932|01/11/2022|||MULTIPLE SCLEROSIS AGENTS|1293|||||No|No||NOVARTIS|No||||
ofatumumab|No|No|No|No|75%|00078100768|KESIMPTA 20 MG/0.4 ML PEN|.4|ML|8041.4085|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|No||043|No|18326.931|01/11/2022|18065.1177|01/11/2022|17204.874|01/11/2022|||MULTIPLE SCLEROSIS AGENTS|1294|||||No|No||NOVARTIS|No||||
betamethasone/propylene glyc|No|No|No|No|75%|00085057502|DIPROLENE 0.05% OINTMENT|15|GM|2.5929|04/28/2006||Yes|No||04/28/2006||Yes|No|04/28/2006||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|120|No|5.9094|06/13/2017|5.82498|06/13/2017|5.5476|06/13/2017|||STEROIDS: TOPICAL HIGH|1295|||||No|No||MERCK SHARP & D|No||||
betamethasone/propylene glyc|No|No|No|No|75%|00085057505|DIPROLENE 0.05% OINTMENT|50|GM|1.7415|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|120|No|3.969|06/13/2017|3.9123|06/13/2017|3.726|06/13/2017|||STEROIDS: TOPICAL HIGH|1296|||||No|No||MERCK SHARP & D|No||||
albuterol sulfate|No|No|No|No|75%|00085113204|PROVENTIL HFA 90 MCG INHALER|6.7|GM|5.117|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|||Prescription required|No||037|Yes|11.45406|09/28/2021|11.17916|09/28/2021|11.25361|09/28/2021|||BRONCHODILATORS: BETA AGONIST|1297|||||No|No||MERCK SHARP & D|No||||
interferon alfa-2b,recomb.|No|No|No|No|75%|00085113301|INTRON A 25 MILLION UNIT/2.5ML|3.2|ML|132.89687|12/05/2008|02/22/2022|Yes|No||12/05/2008|02/22/2022|Yes|No|12/05/2008|02/22/2022|Yes|No||||No|No|||Prescription required|No|||No|302.88125|01/16/2018|298.55437|01/16/2018|284.3375|01/16/2018||||1298|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MERCK SHARP & D|No||||
interferon alfa-2b,recomb.|No|No|No|No|75%|00085116801|INTRON A 18 MILLION UNIT/3 ML|3.8|ML|80.57747|12/05/2008|02/22/2022|Yes|No||12/05/2008|02/22/2022|Yes|No|12/05/2008|02/22/2022|Yes|No||||No|No|||Prescription required|No|||No|183.64168|01/16/2018|181.01822|01/16/2018|172.39831|01/16/2018||||1299|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MERCK SHARP & D|No||||
desloratadine|No|No|No|No|75%|00085126401|CLARINEX 5 MG TABLET|100|EA|3.139|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|030|Yes|7.154|06/13/2017|7.0518|06/13/2017|6.716|06/13/2017|||ANTIHISTAMINES: MINIMALLY SEDATING|1300|||||No|No||MERCK SHARP & D|No||||
mometasone furoate|No|No|No|No|75%|00085128801|NASONEX 50 MCG NASAL SPRAY|17|GM|6.3597|01/11/2005|02/22/2022|Yes|No||01/11/2005|02/22/2022|Yes|No|01/11/2005|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|07/27/2017|019|No|14.4942|03/29/2022|14.28714|03/29/2022|13.6068|03/29/2022|||INTRANASAL RHINITIS AGENTS|1301|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MERCK SHARP & D|No||||
posaconazole|No|No|No|No|75%|00085132801|NOXAFIL 40 MG/ML SUSPENSION|105|ML|5.8953|08/17/2009||Yes|No||08/17/2009||Yes|No|08/17/2009||Yes|No||||No|No|||Prescription required|Yes|07/18/2006|069|No|13.4358|01/28/2020|13.24386|01/28/2020|12.6132|01/28/2020|||ANTIFUNGALS: ORAL|1302|||||No|No||MERCK SHARP & D|No||||
mometasone furoate|No|No|No|No|75%|00085134101|ASMANEX TWISTHALR 220 MCG #120|1|EA|138.503|08/31/2005||Yes|No||08/31/2005||Yes|No|08/31/2005||Yes|No||||No|No|||Prescription required|No||033|Yes|324.89512|01/25/2022|317.09763|01/25/2022|319.20945|01/25/2022|||GLUCOCORTICOIDS: INHALED|1303|||||No|No||MERCK SHARP & D|Yes|09/01/2020|||
mometasone furoate|No|No|No|No|75%|00085134102|ASMANEX TWISTHALER 220 MCG #60|1|EA|96.6554|08/31/2005||Yes|No||08/31/2005||Yes|No|08/31/2005||Yes|No||||No|No|||Prescription required|No||033|Yes|225.91994|01/25/2022|220.49786|01/25/2022|221.96634|01/25/2022|||GLUCOCORTICOIDS: INHALED|1304|||||No|No||MERCK SHARP & D|Yes|09/01/2020|||
mometasone furoate|No|No|No|No|75%|00085134107|ASMANEX TWISTHALER 220 MCG #30|1|EA|82.3665|10/21/2013||Yes|No||10/21/2013||Yes|No|10/21/2013||Yes|No||||No|No|||Prescription required|No||033|Yes|192.46528|01/25/2022|187.84611|01/25/2022|189.09713|01/25/2022|||GLUCOCORTICOIDS: INHALED|1305|||||No|No||MERCK SHARP & D|Yes|09/01/2020|||
temozolomide|No|No|No|No|75%|00085136603|TEMODAR 100 MG CAPSULE|5|EA|195.908|01/25/2013||Yes|No||01/25/2013||Yes|No|01/25/2013||Yes|No||||No|No|||Prescription required|No||239|No|446.488|01/16/2018|440.1096|01/16/2018|419.152|01/16/2018|||ONCOLOGY: ORAL - OTHER|1306|||||No|No||MERCK SHARP & D|No||||
temozolomide|No|No|No|No|75%|00085136604|TEMODAR 100 MG CAPSULE|14|EA|195.908|01/25/2013||Yes|No||01/25/2013||Yes|No|01/25/2013||Yes|No||||No|No|||Prescription required|No||239|No|446.488|01/16/2018|440.1096|01/16/2018|419.152|01/16/2018|||ONCOLOGY: ORAL - OTHER|1307|||||No|No||MERCK SHARP & D|No||||
temozolomide|No|No|No|No|75%|00085141702|TEMODAR 250 MG CAPSULE|5|EA|489.77|01/25/2013||Yes|No||01/25/2013||Yes|No|01/25/2013||Yes|No||||No|No|||Prescription required|No||239|No|1116.22|01/29/2019|1100.274|01/29/2019|1047.88|01/29/2019|||ONCOLOGY: ORAL - OTHER|1308|||||No|No||MERCK SHARP & D|No||||
temozolomide|No|No|No|No|75%|00085142504|TEMODAR 140 MG CAPSULE|14|EA|274.2712|01/25/2013||Yes|No||01/25/2013||Yes|No|01/25/2013||Yes|No||||No|No|||Prescription required|No||239|No|625.0832|01/16/2018|616.15344|01/16/2018|586.8128|01/16/2018|||ONCOLOGY: ORAL - OTHER|1309|||||No|No||MERCK SHARP & D|No||||
temozolomide|No|No|No|No|75%|00085143003|TEMODAR 180 MG CAPSULE|5|EA|352.6344|01/25/2013||Yes|No||01/25/2013||Yes|No|01/25/2013||Yes|No||||No|No|||Prescription required|No||239|No|803.6784|01/16/2018|792.19728|01/16/2018|754.4736|01/16/2018|||ONCOLOGY: ORAL - OTHER|1310|||||No|No||MERCK SHARP & D|No||||
mometasone furoate|No|No|No|No|75%|00085146102|ASMANEX TWISTHALER 110 MCG #30|1|EA|76.2777|10/07/2008||Yes|No||10/07/2008||Yes|No|10/07/2008||Yes|No||||No|No|||Prescription required|No||033|Yes|178.63736|01/25/2022|174.35006|01/25/2022|175.5112|01/25/2022|||GLUCOCORTICOIDS: INHALED|1311|||||No|No||MERCK SHARP & D|Yes|09/01/2020|||
mometasone furoate|No|No|No|No|75%|00085222201|ASMANEX HFA 50 MCG INHALER|13|GM|5.86751|07/01/2020||Yes|No||07/01/2020||Yes|No|07/01/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|033|No|13.66992|01/25/2022|13.34184|01/25/2022|13.43069|01/25/2022|||GLUCOCORTICOIDS: INHALED|1312|||||No|No||MERCK SHARP & D|No||||
mometasone/formoterol|No|No|No|No|75%|00085222301|DULERA 50 MCG-5 MCG INHALER|13|GM|10.2985|06/30/2020||Yes|No||06/30/2020||Yes|No|06/30/2020||Yes|No||||No|No|||Prescription required|No||033|Yes|24.15861|01/25/2022|23.5788|01/25/2022|23.73583|01/25/2022|||GLUCOCORTICOIDS: INHALED|1313|||||No|No||MERCK SHARP & D|No||||
betamethasone acetate,sod phos|No|No|No|No|75%|00085432001|CELESTONE SOLUSPAN 30 MG/5 ML|5|ML|3.2164|06/16/2017||Yes|No||06/16/2017||Yes|No|06/16/2017||Yes|No||||No|No|||Prescription required|No|||No|7.3304|12/28/2021|7.22568|12/28/2021|6.8816|12/28/2021||||1314|||||No|No||MERCK SHARP & D|No||||
posaconazole|No|No|No|No|75%|00085432402|NOXAFIL DR 100 MG TABLET|60|EA|29.4679|12/09/2013||Yes|No||12/09/2013||Yes|No|12/09/2013||Yes|No||||No|No|||Prescription required|No||069|No|67.1594|07/28/2020|66.19998|07/28/2020|63.0476|07/28/2020|||ANTIFUNGALS: ORAL|1315|||||No|No||MERCK SHARP & D|No||||
mometasone furoate|No|No|No|No|75%|00085433301|ASMANEX HFA 100 MCG INHALER|13|GM|6.3296|07/17/2019||Yes|No||07/17/2019||Yes|No|07/17/2019||Yes|No||07/17/2019||Yes|No|||Prescription required|Yes|07/23/2015|033|Yes|14.84625|01/25/2022|14.48994|01/25/2022|14.58644|01/25/2022|||GLUCOCORTICOIDS: INHALED|1316|||||No|No||MERCK SHARP & D|No||||
mometasone furoate|No|No|No|No|75%|00085433401|ASMANEX HFA 200 MCG INHALER|13|GM|7.439|07/19/2019||Yes|No||07/19/2019||Yes|No|07/19/2019||Yes|No||07/19/2019||Yes|No|||Prescription required|Yes|07/23/2015|033|Yes|17.4282|01/25/2022|17.00992|01/25/2022|17.1232|01/25/2022|||GLUCOCORTICOIDS: INHALED|1317|||||No|No||MERCK SHARP & D|No||||
mometasone/formoterol|No|No|No|No|75%|00085461001|DULERA 200 MCG-5 MCG INHALER|13|GM|10.2985|08/17/2010||Yes|No||08/17/2010||Yes|No|08/17/2010||Yes|No||||No|No|||Prescription required|No||033|Yes|24.11624|01/25/2022|23.53745|01/25/2022|23.6942|01/25/2022|||GLUCOCORTICOIDS: INHALED|1318|||||No|No||MERCK SHARP & D|No||||
mometasone/formoterol|No|No|No|No|75%|00085720601|DULERA 100 MCG-5 MCG INHALER|13|GM|10.2985|08/17/2010||Yes|No||08/17/2010||Yes|No|08/17/2010||Yes|No||||No|No|||Prescription required|No||033|Yes|24.20081|01/25/2022|23.61999|01/25/2022|23.77729|01/25/2022|||GLUCOCORTICOIDS: INHALED|1319|||||No|No||MERCK SHARP & D|No||||
pediatric multivitamin no.192|No|No|No|No|75%|00087040203|POLY-VI-SOL 250MCG-50MG/ML DRP|50|ML|.06131|04/10/2019||Yes|No||||No|No|04/10/2019||Yes|No||||No|No|||Over the counter|No|||No|.13974|06/01/2016|.13775|06/01/2016|.13119|06/01/2016||||1320|||||No|No||MJ NUTRITIONAL|No||||
pedi mv no.189/ferrous sulfate|No|No|No|No|75%|00087040501|POLY-VI-SOL WITH IRON DROPS|50|ML|.06131|04/10/2019||Yes|No||||No|No|04/10/2019||Yes|No||||No|No|||Over the counter|No|||No|.13974|06/01/2016|.13775|06/01/2016|.13119|06/01/2016||||1321|||||No|No||MJ NUTRITIONAL|No||||
rifapentine|No|No|No|No|75%|00088210224|PRIFTIN 150 MG TABLET|24|EA|1.8945|07/06/2018||Yes|No||07/06/2018||Yes|No|07/06/2018||Yes|No||||No|No|||Prescription required|No|||No|4.2328|01/18/2022|4.13121|01/18/2022|4.15872|01/18/2022||||1322|||||No|No||SANOFI-AVENTIS|No||||
leflunomide|No|No|No|No|75%|00088216030|ARAVA 10 MG TABLET|30|EA|20.43976|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|46.58364|01/11/2022|45.91816|01/11/2022|43.73158|01/11/2022||||1323|||||No|No||SANOFI-AVENTIS|No||||
leflunomide|No|No|No|No|75%|00088216130|ARAVA 20 MG TABLET|30|EA|20.43976|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|46.58364|01/11/2022|45.91816|01/11/2022|43.73158|01/11/2022||||1324|||||No|No||SANOFI-AVENTIS|No||||
insulin glargine,hum.rec.anlog|No|No|No|No|75%|00088221905|LANTUS SOLOSTAR 100 UNIT/ML|3|ML|12.19222|09/30/2010||Yes|No||09/30/2010||Yes|No|09/30/2010||Yes|No||07/01/2013||Yes|No|||Prescription required|No||029|No|27.23698|06/29/2021|26.58329|06/29/2021|26.76033|06/29/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|1325|||||No|No||SANOFI-AVENTIS|No||||
insulin glargine,hum.rec.anlog|Yes|No|No|No|75%|00088222033|LANTUS 100 UNIT/ML VIAL|10|ML|12.19308|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No||029|No|27.22308|06/29/2021|26.56972|06/29/2021|26.74667|06/29/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|1326|||||No|No||SANOFI-AVENTIS|No||||
insulin glulisine|Yes|No|No|No|75%|00088250033|APIDRA 100 UNIT/ML VIAL|10|ML|12.20985|02/01/2006||Yes|No||02/01/2006||Yes|No|02/01/2006||Yes|No||02/01/2006||Yes|No|04/08/2020||Prescription required|Yes|09/18/2020|029|No|27.18143|07/27/2021|26.52907|07/27/2021|26.70575|07/27/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|1327|||||No|No||SANOFI-AVENTIS|No||||
insulin glulisine|Yes|No|No|No|75%|00088250205|APIDRA SOLOSTAR 100 UNIT/ML|3|ML|15.72424|04/08/2009||Yes|No||04/08/2009||Yes|No|04/08/2009||Yes|No||04/08/2009||Yes|No|04/08/2020||Prescription required|Yes|09/18/2020|029|No|34.95289|12/28/2021|34.11402|12/28/2021|34.34121|12/28/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|1328|||||No|No||SANOFI-AVENTIS|No||||
insulin glargine,hum.rec.anlog|No|No|No|No|75%|00088502005|LANTUS SOLOSTAR 100 UNIT/ML|3|ML|12.19222|01/05/2018||Yes|No||01/05/2018||Yes|No|01/05/2018||Yes|No||01/05/2018||Yes|No|||Prescription required|No||029|No|27.23698|06/29/2021|26.58329|06/29/2021|26.76033|06/29/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|1329|||||No|No||SANOFI-AVENTIS|No||||
insulin glargine,hum.rec.anlog|No|No|No|No|75%|00088502101|LANTUS 100 UNIT/ML VIAL|10|ML|12.19308|01/05/2018||Yes|No||01/05/2018||Yes|No|01/05/2018||Yes|No||01/05/2018||Yes|No|||Prescription required|No||029|No|27.22308|06/29/2021|26.56972|06/29/2021|26.74667|06/29/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|1330|||||No|No||SANOFI-AVENTIS|No||||
tolterodine tartrate|No|No|No|No|75%|00093001006|TOLTERODINE TARTRATE 1 MG TAB|60|EA|1.13835|05/13/2016||Yes|No||05/13/2016||Yes|No|05/13/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|006|No|.65955|03/29/2022|.64372|03/29/2022|.648|03/29/2022|||BLADDER RELAXANT PREPARATIONS|1331|||||No|No||TEVA USA|No||||
moexipril HCl|No|No|No|No|75%|00093001701|MOEXIPRIL HCL 7.5 MG TABLET|100|EA|.38829|05/02/2007||Yes|No||05/02/2007||Yes|No|05/02/2007||Yes|No||05/02/2007||Yes|No|||Prescription required|Yes|03/23/2007|113|No|.75532|07/27/2021|.73719|07/27/2021|.7421|07/27/2021|||ANGIOTENSIN MODULATORS|1332|||||No|No||TEVA USA|No||||
tolterodine tartrate|No|No|No|No|75%|00093001805|TOLTERODINE TARTRATE 2 MG TAB|500|EA|1.16838|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|006|No|.55522|03/29/2022|.54189|03/29/2022|.5455|03/29/2022|||BLADDER RELAXANT PREPARATIONS|1333|||||No|No||TEVA USA|No||||
tolterodine tartrate|No|No|No|No|75%|00093001806|TOLTERODINE TARTRATE 2 MG TAB|60|EA|1.16837|08/16/2016||Yes|No||08/16/2016||Yes|No|08/16/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|006|No|.55522|03/29/2022|.54189|03/29/2022|.5455|03/29/2022|||BLADDER RELAXANT PREPARATIONS|1334|||||No|No||TEVA USA|No||||
acetaminophen with codeine|No|No|No|No|90%|00093005001|ACETAMINOPHEN-COD #2 TABLET|100|EA|.07451|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.11854|03/29/2022|.11569|03/29/2022|.11646|03/29/2022|||ANALGESICS: NARCOTICS SHORT|1335|||||No|No||TEVA USA|No||||
carvedilol|No|No|No|No|75%|00093005101|CARVEDILOL 3.125 MG TABLET|100|EA|.0258|02/08/2008||Yes|No||02/08/2008||Yes|No|02/08/2008||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.01877|03/29/2022|.01831|03/29/2022|.01844|03/29/2022|||BETA-BLOCKERS|1336|||||No|No||TEVA USA|No||||
carvedilol|No|No|No|No|75%|00093005105|CARVEDILOL 3.125 MG TABLET|500|EA|.02515|11/15/2011||Yes|No||11/15/2011||Yes|No|11/15/2011||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.01877|03/29/2022|.01831|03/29/2022|.01844|03/29/2022|||BETA-BLOCKERS|1337|||||No|No||TEVA USA|No||||
buspirone HCl|No|No|No|No|75%|00093005301|BUSPIRONE HCL 5 MG TABLET|100|EA|.02214|01/28/2011||Yes|No||01/28/2011||Yes|No|01/28/2011||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|1338|||||No|No||TEVA USA|No||||
buspirone HCl|No|No|No|No|75%|00093005401|BUSPIRONE HCL 10 MG TABLET|100|EA|.0304|01/28/2011||Yes|No||01/28/2011||Yes|No|01/28/2011||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|1339|||||No|No||TEVA USA|No||||
tramadol HCl|No|No|No|No|90%|00093005801|TRAMADOL HCL 50 MG TABLET|100|EA|.02021|06/24/2004||Yes|No||06/24/2004||Yes|No|06/24/2004||Yes|No||||No|No|||Prescription required|No||109|Yes|.02459|03/29/2022|.02399|03/29/2022|.02415|03/29/2022|||ANALGESICS: NARCOTICS SHORT|1340|||||No|No||TEVA USA|No||||
tramadol HCl|No|No|No|No|90%|00093005805|TRAMADOL HCL 50 MG TABLET|500|EA|.01978|06/21/2002||Yes|No||06/21/2002||Yes|No|06/21/2002||Yes|No||||No|No|||Prescription required|No||109|Yes|.02459|03/29/2022|.02399|03/29/2022|.02415|03/29/2022|||ANALGESICS: NARCOTICS SHORT|1341|||||No|No||TEVA USA|No||||
rabeprazole sodium|No|No|No|No|75%|00093006456|RABEPRAZOLE SOD DR 20 MG TAB|30|EA|.345|04/15/2014|01/25/2022|Yes|No||04/15/2014|01/25/2022|Yes|No|04/15/2014|01/25/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.78628|02/15/2022|.77505|02/15/2022|.73814|02/15/2022|||PROTON PUMP INHIBITORS|1342|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TEVA USA|No||||
zolpidem tartrate|No|No|No|No|90%|00093007301|ZOLPIDEM TARTRATE 5 MG TABLET|100|EA|.01982|05/02/2007||Yes|No||05/02/2007||Yes|No|05/02/2007||Yes|No||||No|No|||Prescription required|No||054|Yes|.03056|03/29/2022|.02982|03/29/2022|.03002|03/29/2022|||SEDATIVE HYPNOTICS|1343|||||No|No||TEVA USA|No||||
zolpidem tartrate|No|No|No|No|90%|00093007401|ZOLPIDEM TARTRATE 10 MG TABLET|100|EA|.01982|05/02/2007||Yes|No||05/02/2007||Yes|No|05/02/2007||Yes|No||||No|No|||Prescription required|No||054|Yes|.0301|03/29/2022|.02937|03/29/2022|.02957|03/29/2022|||SEDATIVE HYPNOTICS|1344|||||No|No||TEVA USA|No||||
carbamazepine|No|No|No|No|75%|00093009001|EPITOL 200 MG TABLET|100|EA|.55009|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||056|No|.20856|03/29/2022|.20355|03/29/2022|.20491|03/29/2022|||ANTICONVULSANTS|1345|||||No|No||TEVA USA|No||||
carbamazepine|No|No|No|No|75%|00093010901|CARBAMAZEPINE 200 MG TABLET|100|EA|.55009|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||056|No|.20856|03/29/2022|.20355|03/29/2022|.20491|03/29/2022|||ANTICONVULSANTS|1346|||||No|No||TEVA USA|No||||
carbamazepine|No|No|No|No|75%|00093010910|CARBAMAZEPINE 200 MG TABLET|1000|EA|.5336|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||056|No|.20856|03/29/2022|.20355|03/29/2022|.20491|03/29/2022|||ANTICONVULSANTS|1347|||||No|No||TEVA USA|No||||
carvedilol|No|No|No|No|75%|00093013501|CARVEDILOL 6.25 MG TABLET|100|EA|.0258|02/08/2008||Yes|No||02/08/2008||Yes|No|02/08/2008||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.02069|03/29/2022|.02019|03/29/2022|.02032|03/29/2022|||BETA-BLOCKERS|1348|||||No|No||TEVA USA|No||||
carvedilol|No|No|No|No|75%|00093013505|CARVEDILOL 6.25 MG TABLET|500|EA|.02515|11/15/2011||Yes|No||11/15/2011||Yes|No|11/15/2011||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.02069|03/29/2022|.02019|03/29/2022|.02032|03/29/2022|||BETA-BLOCKERS|1349|||||No|No||TEVA USA|No||||
acetaminophen with codeine|No|No|No|No|90%|00093015001|ACETAMINOPHEN-COD #3 TABLET|100|EA|.0774|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.10921|03/29/2022|.10658|03/29/2022|.10729|03/29/2022|||ANALGESICS: NARCOTICS SHORT|1350|||||No|No||TEVA USA|No||||
acetaminophen with codeine|No|No|No|No|90%|00093015010|ACETAMINOPHEN-COD #3 TABLET|1000|EA|.06966|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.10921|03/29/2022|.10658|03/29/2022|.10729|03/29/2022|||ANALGESICS: NARCOTICS SHORT|1351|||||No|No||TEVA USA|No||||
fluocinonide|No|No|No|No|75%|00093026215|FLUOCINONIDE 0.05% CREAM|15|GM|1.04461|01/03/2008||Yes|No||01/03/2008||Yes|No|01/03/2008||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.69804|03/29/2022|.68128|03/29/2022|.68582|03/29/2022|||STEROIDS: TOPICAL HIGH|1352|||||No|No||TEVA USA|No||||
fluocinonide|No|No|No|No|75%|00093026230|FLUOCINONIDE 0.05% CREAM|30|GM|1.04461|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.62146|03/29/2022|.60654|03/29/2022|.61058|03/29/2022|||STEROIDS: TOPICAL HIGH|1353|||||No|No||TEVA USA|No||||
fluocinonide|No|No|No|No|75%|00093026292|FLUOCINONIDE 0.05% CREAM|60|GM|1.04453|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.55445|03/29/2022|.54114|03/29/2022|.54474|03/29/2022|||STEROIDS: TOPICAL HIGH|1354|||||No|No||TEVA USA|No||||
fluocinonide/emollient base|No|No|No|No|75%|00093026315|FLUOCINONIDE-E 0.05% CREAM|15|GM|1.10452|08/11/2008||Yes|No||08/11/2008||Yes|No|08/11/2008||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|1.34778|08/24/2021|1.31543|08/24/2021|1.32419|08/24/2021|||STEROIDS: TOPICAL HIGH|1355|||||No|No||TEVA USA|No||||
fluocinonide/emollient base|No|No|No|No|75%|00093026330|FLUOCINONIDE-E 0.05% CREAM|30|GM|1.10452|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|2.51728|03/01/2022|2.48132|03/01/2022|2.36316|03/01/2022|||STEROIDS: TOPICAL HIGH|1356|||||No|No||TEVA USA|No||||
fluocinonide/emollient base|No|No|No|No|75%|00093026392|FLUOCINONIDE-E 0.05% CREAM|60|GM|1.10452|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.77317|03/01/2022|.75461|03/01/2022|.75963|03/01/2022|||STEROIDS: TOPICAL HIGH|1357|||||No|No||TEVA USA|No||||
fluocinonide|No|No|No|No|75%|00093026415|FLUOCINONIDE 0.05% OINTMENT|15|GM|1.62253|01/03/2008||Yes|No||01/03/2008||Yes|No|01/03/2008||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|120|No|.57506|03/29/2022|.56125|03/29/2022|.56499|03/29/2022|||STEROIDS: TOPICAL HIGH|1358|||||No|No||TEVA USA|No||||
fluocinonide|No|No|No|No|75%|00093026430|FLUOCINONIDE 0.05% OINTMENT|30|GM|1.62253|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|120|No|.36243|03/29/2022|.35373|03/29/2022|.35608|03/29/2022|||STEROIDS: TOPICAL HIGH|1359|||||No|No||TEVA USA|No||||
fluocinonide|No|No|No|No|75%|00093026492|FLUOCINONIDE 0.05% OINTMENT|60|GM|1.62253|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|120|No|.32783|03/29/2022|.31996|03/29/2022|.32209|03/29/2022|||STEROIDS: TOPICAL HIGH|1360|||||No|No||TEVA USA|No||||
clemastine fumarate|No|No|No|No|75%|00093030801|CLEMASTINE FUM 2.68 MG TAB|100|EA|.26655|01/31/2018||Yes|No||01/31/2018||Yes|No|01/31/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|574|Yes|.6075|03/29/2022|.59882|03/29/2022|.5703|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|1361|||||No|No||TEVA USA|No||||
loperamide HCl|No|No|No|No|75%|00093031101|LOPERAMIDE 2 MG CAPSULE|100|EA|.15798|||No|No||||No|No|||No|No||09/01/1999||Yes|No|||Prescription required|No|||No|.28168|03/29/2022|.27491|03/29/2022|.27675|03/29/2022||||1362|||||No|No||TEVA USA|No||||
loperamide HCl|No|No|No|No|75%|00093031105|LOPERAMIDE 2 MG CAPSULE|500|EA|.15797|||No|No||||No|No|||No|No||09/01/1999||Yes|No|||Prescription required|No|||No|.28168|03/29/2022|.27491|03/29/2022|.27675|03/29/2022||||1363|||||No|No||TEVA USA|No||||
ketorolac tromethamine|No|No|No|No|75%|00093031401|KETOROLAC 10 MG TABLET|100|EA|.46371|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|059|Yes|.74409|03/29/2022|.72623|03/29/2022|.73106|03/29/2022|||NSAIDS|1364|||||No|No||TEVA USA|No||||
diltiazem HCl|No|No|No|No|75%|00093031801|DILTIAZEM 30 MG TABLET|100|EA|.06445|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||045|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||CALCIUM CHANNEL BLOCKERS|1365|||||No|No||TEVA USA|No||||
diltiazem HCl|No|No|No|No|75%|00093031805|DILTIAZEM 30 MG TABLET|500|EA|.06332|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||045|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||CALCIUM CHANNEL BLOCKERS|1366|||||No|No||TEVA USA|No||||
diltiazem HCl|No|No|No|No|75%|00093031901|DILTIAZEM 60 MG TABLET|100|EA|.10105|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||045|No|.18408|03/29/2022|.17966|03/29/2022|.18085|03/29/2022|||CALCIUM CHANNEL BLOCKERS|1367|||||No|No||TEVA USA|No||||
diltiazem HCl|No|No|No|No|75%|00093031905|DILTIAZEM 60 MG TABLET|500|EA|.09927|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||045|No|.18408|03/29/2022|.17966|03/29/2022|.18085|03/29/2022|||CALCIUM CHANNEL BLOCKERS|1368|||||No|No||TEVA USA|No||||
diltiazem HCl|No|No|No|No|75%|00093032001|DILTIAZEM 90 MG TABLET|100|EA|.13815|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||045|No|.24252|03/29/2022|.23669|03/29/2022|.23827|03/29/2022|||CALCIUM CHANNEL BLOCKERS|1369|||||No|No||TEVA USA|No||||
diltiazem HCl|No|No|No|No|75%|00093032101|DILTIAZEM 120 MG TABLET|100|EA|.18601|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||045|No|.30465|03/29/2022|.29733|03/29/2022|.29931|03/29/2022|||CALCIUM CHANNEL BLOCKERS|1370|||||No|No||TEVA USA|No||||
acetaminophen with codeine|No|No|No|No|90%|00093035001|ACETAMINOPHEN-COD #4 TABLET|100|EA|.1204|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.22352|03/29/2022|.21815|03/29/2022|.2196|03/29/2022|||ANALGESICS: NARCOTICS SHORT|1371|||||No|No||TEVA USA|No||||
acetaminophen with codeine|No|No|No|No|90%|00093035005|ACETAMINOPHEN-COD #4 TABLET|500|EA|.11678|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.22352|03/29/2022|.21815|03/29/2022|.2196|03/29/2022|||ANALGESICS: NARCOTICS SHORT|1372|||||No|No||TEVA USA|No||||
acetaminophen with codeine|No|No|No|No|90%|00093035010|ACETAMINOPHEN-COD #4 TABLET|1000|EA|.11438|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.22352|03/29/2022|.21815|03/29/2022|.2196|03/29/2022|||ANALGESICS: NARCOTICS SHORT|1373|||||No|No||TEVA USA|No||||
lovastatin|Yes|No|No|No|75%|00093057610|LOVASTATIN 20 MG TABLET|1000|EA|.08797|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.04992|03/29/2022|.04872|03/29/2022|.04904|03/29/2022|||LIPOTROPICS: STATINS|1374|||||No|No||TEVA USA|No||||
flurbiprofen|No|No|No|No|75%|00093071101|FLURBIPROFEN 100 MG TABLET|100|EA|.18438|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.40311|03/29/2022|.39343|03/29/2022|.39605|03/29/2022|||NSAIDS|1375|||||No|No||TEVA USA|No||||
flurbiprofen|No|No|No|No|75%|00093071105|FLURBIPROFEN 100 MG TABLET|500|EA|.1806|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.40311|03/29/2022|.39343|03/29/2022|.39605|03/29/2022|||NSAIDS|1376|||||No|No||TEVA USA|No||||
atenolol|No|No|No|No|75%|00093075201|ATENOLOL 50 MG TABLET|100|EA|.01492|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.02861|03/29/2022|.02792|03/29/2022|.0281|03/29/2022|||BETA-BLOCKERS|1377|||||No|No||TEVA USA|No||||
atenolol|No|No|No|No|75%|00093075210|ATENOLOL 50 MG TABLET|1000|EA|.01417|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.02861|03/29/2022|.02792|03/29/2022|.0281|03/29/2022|||BETA-BLOCKERS|1378|||||No|No||TEVA USA|No||||
atenolol|No|No|No|No|75%|00093075301|ATENOLOL 100 MG TABLET|100|EA|.02623|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.04816|03/29/2022|.047|03/29/2022|.04731|03/29/2022|||BETA-BLOCKERS|1379|||||No|No||TEVA USA|No||||
atenolol|No|No|No|No|75%|00093075305|ATENOLOL 100 MG TABLET|500|EA|.02557|02/08/2008||Yes|No||02/08/2008||Yes|No|02/08/2008||Yes|No||02/08/2008||Yes|No|||Prescription required|No||070|No|.04816|03/29/2022|.047|03/29/2022|.04731|03/29/2022|||BETA-BLOCKERS|1380|||||No|No||TEVA USA|No||||
diflunisal|No|No|No|No|75%|00093075501|DIFLUNISAL 500 MG TABLET|100|EA|.71079|03/01/2002|06/30/2022|Yes|No||03/01/2002|06/30/2022|Yes|No|03/01/2002|06/30/2022|Yes|No||03/01/2002|06/30/2022|Yes|No|||Prescription required|Yes|01/23/2013|059|Yes|.92195|03/29/2022|.89982|03/29/2022|.90581|03/29/2022|||NSAIDS|1381|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||TEVA USA|No||||
diflunisal|No|No|No|No|75%|00093075505|DIFLUNISAL 500 MG TABLET|500|EA|.69302|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|01/23/2013|059|Yes|.92195|03/29/2022|.89982|03/29/2022|.90581|03/29/2022|||NSAIDS|1382|||||No|No||TEVA USA|No||||
piroxicam|No|No|No|No|75%|00093075601|PIROXICAM 10 MG CAPSULE|100|EA|.48435|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.25876|03/01/2022|.25254|03/01/2022|.25423|03/01/2022|||NSAIDS|1383|||||No|No||TEVA USA|No||||
piroxicam|No|No|No|No|75%|00093075701|PIROXICAM 20 MG CAPSULE|100|EA|.90781|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.40758|03/29/2022|.39779|03/29/2022|.40044|03/29/2022|||NSAIDS|1384|||||No|No||TEVA USA|No||||
piroxicam|No|No|No|No|75%|00093075705|PIROXICAM 20 MG CAPSULE|500|EA|.88972|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.40758|03/29/2022|.39779|03/29/2022|.40044|03/29/2022|||NSAIDS|1385|||||No|No||TEVA USA|No||||
pravastatin sodium|Yes|No|No|No|75%|00093077198|PRAVASTATIN SODIUM 10 MG TAB|90|EA|.20735|04/27/2006||Yes|No||04/27/2006||Yes|No|04/27/2006||Yes|No||04/27/2006||Yes|No|07/01/2016||Prescription required|No||063|Yes|.07144|03/29/2022|.06972|03/29/2022|.07018|03/29/2022|||LIPOTROPICS: STATINS|1386|||||No|No||TEVA USA|No||||
carbamazepine|No|No|No|No|75%|00093077801|CARBAMAZEPINE 100 MG TAB CHEW|100|EA|.22652|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||056|No|.29391|03/29/2022|.28685|03/29/2022|.28876|03/29/2022|||ANTICONVULSANTS|1387|||||No|No||TEVA USA|No||||
atenolol|No|No|No|No|75%|00093078701|ATENOLOL 25 MG TABLET|100|EA|.01466|12/07/2004||Yes|No||12/07/2004||Yes|No|12/07/2004||Yes|No||12/07/2004||Yes|No|||Prescription required|No||070|No|.02437|03/29/2022|.02378|03/29/2022|.02394|03/29/2022|||BETA-BLOCKERS|1388|||||No|No||TEVA USA|No||||
atenolol|No|No|No|No|75%|00093078710|ATENOLOL 25 MG TABLET|1000|EA|.01393|12/07/2004||Yes|No||12/07/2004||Yes|No|12/07/2004||Yes|No||12/07/2004||Yes|No|||Prescription required|No||070|No|.02437|03/29/2022|.02378|03/29/2022|.02394|03/29/2022|||BETA-BLOCKERS|1389|||||No|No||TEVA USA|No||||
fluoxetine HCl|No|No|No|No|75%|00093080701|FLUOXETINE HCL 20 MG TABLET|100|EA|.17341|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|No||008|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||ANTIDEPRESSANTS: SSRIs|1390|||||No|No||TEVA USA|No||||
fluoxetine HCl|No|No|No|No|75%|00093080756|FLUOXETINE HCL 20 MG TABLET|30|EA|.17343|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|No||008|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||ANTIDEPRESSANTS: SSRIs|1391|||||No|No||TEVA USA|No||||
nortriptyline HCl|No|No|No|No|75%|00093081001|NORTRIPTYLINE HCL 10 MG CAP|100|EA|.08376|05/12/2011||Yes|No||05/12/2011||Yes|No|05/12/2011||Yes|No||||No|No|||Prescription required|No||215|No|.07187|03/29/2022|.07014|03/29/2022|.07061|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|1392|||||No|No||TEVA USA|No||||
nortriptyline HCl|No|No|No|No|75%|00093081101|NORTRIPTYLINE HCL 25 MG CAP|100|EA|.11438|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.09534|03/29/2022|.09305|03/29/2022|.09367|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|1393|||||No|No||TEVA USA|No||||
nortriptyline HCl|No|No|No|No|75%|00093081105|NORTRIPTYLINE HCL 25 MG CAP|500|EA|.11152|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.09534|03/29/2022|.09305|03/29/2022|.09367|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|1394|||||No|No||TEVA USA|No||||
nortriptyline HCl|No|No|No|No|75%|00093081201|NORTRIPTYLINE HCL 50 MG CAP|100|EA|.14013|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.12931|03/29/2022|.1262|03/29/2022|.12704|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|1395|||||No|No||TEVA USA|No||||
nortriptyline HCl|No|No|No|No|75%|00093081205|NORTRIPTYLINE HCL 50 MG CAP|500|EA|.1366|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.12931|03/29/2022|.1262|03/29/2022|.12704|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|1396|||||No|No||TEVA USA|No||||
nortriptyline HCl|No|No|No|No|75%|00093081301|NORTRIPTYLINE HCL 75 MG CAP|100|EA|.19405|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.17543|03/29/2022|.17121|03/29/2022|.17235|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|1397|||||No|No||TEVA USA|No||||
nortriptyline HCl|No|No|No|No|75%|00093081305|NORTRIPTYLINE HCL 75 MG CAP|500|EA|.18921|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.17543|03/29/2022|.17121|03/29/2022|.17235|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|1398|||||No|No||TEVA USA|No||||
clonazepam|No|No|No|No|75%|00093083201|CLONAZEPAM 0.5 MG TABLET|100|EA|.0129|05/30/2019|03/31/2022|Yes|No||05/30/2019|03/31/2022|Yes|No|05/30/2019|03/31/2022|Yes|No||||No|No|||Prescription required|No||056|Yes|.02441|03/29/2022|.02382|03/29/2022|.02398|03/29/2022|||ANTICONVULSANTS|1399|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||TEVA USA|No||||
oxaprozin|No|No|No|No|75%|00093092401|OXAPROZIN 600 MG TABLET|100|EA|1.26041|05/15/2003||Yes|No||05/15/2003||Yes|No|05/15/2003||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.63712|03/29/2022|.62182|03/29/2022|.62597|03/29/2022|||NSAIDS|1400|||||No|No||TEVA USA|No||||
oxaprozin|No|No|No|No|75%|00093092405|OXAPROZIN 600 MG TABLET|500|EA|1.2289|05/15/2003||Yes|No||05/15/2003||Yes|No|05/15/2003||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.63712|03/29/2022|.62182|03/29/2022|.62597|03/29/2022|||NSAIDS|1401|||||No|No||TEVA USA|No||||
lovastatin|Yes|No|No|No|75%|00093092606|LOVASTATIN 10 MG TABLET|60|EA|.09001|02/16/2016||Yes|No||02/16/2016||Yes|No|02/16/2016||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.0534|03/29/2022|.05211|03/29/2022|.05246|03/29/2022|||LIPOTROPICS: STATINS|1402|||||No|No||TEVA USA|No||||
lovastatin|Yes|No|No|No|75%|00093092610|LOVASTATIN 10 MG TABLET|1000|EA|.08562|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.0534|03/29/2022|.05211|03/29/2022|.05246|03/29/2022|||LIPOTROPICS: STATINS|1403|||||No|No||TEVA USA|No||||
lovastatin|Yes|No|No|No|75%|00093092810|LOVASTATIN 40 MG TABLET|1000|EA|.14143|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.0616|03/29/2022|.06012|03/29/2022|.06052|03/29/2022|||LIPOTROPICS: STATINS|1404|||||No|No||TEVA USA|No||||
diclofenac potassium|No|No|No|No|75%|00093094801|DICLOFENAC POT 50 MG TABLET|100|EA|.44969|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||059|Yes|.33951|03/29/2022|.33136|03/29/2022|.33356|03/29/2022|||NSAIDS|1405|||||No|No||TEVA USA|No||||
diclofenac potassium|No|No|No|No|75%|00093094805|DICLOFENAC POT 50 MG TABLET|500|EA|.44969|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||059|Yes|.33951|03/29/2022|.33136|03/29/2022|.33356|03/29/2022|||NSAIDS|1406|||||No|No||TEVA USA|No||||
nystatin|No|No|No|No|75%|00093098301|NYSTATIN 500,000 UNIT ORAL TAB|100|EA|.43129|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||069|No|.33632|03/29/2022|.32824|03/29/2022|.33043|03/29/2022|||ANTIFUNGALS: ORAL|1407|||||No|No||TEVA USA|No||||
buspirone HCl|No|No|No|No|75%|00093100301|BUSPIRONE HCL 15 MG TABLET|100|EA|.03771|12/14/2010||Yes|No||12/14/2010||Yes|No|12/14/2010||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|1408|||||No|No||TEVA USA|No||||
buspirone HCl|No|No|No|No|75%|00093100305|BUSPIRONE HCL 15 MG TABLET|500|EA|.03713|12/14/2010||Yes|No||12/14/2010||Yes|No|12/14/2010||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|1409|||||No|No||TEVA USA|No||||
naproxen|No|No|No|No|75%|00093100501|NAPROXEN DR 375 MG TABLET|100|EA|.29025|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||07/01/2012||Yes|No|||Prescription required|No||059|Yes|.40508|01/25/2022|.39535|01/25/2022|.39799|01/25/2022|||NSAIDS|1410|||||No|No||TEVA USA|No||||
naproxen|No|No|No|No|75%|00093100505|NAPROXEN DR 375 MG TABLET|500|EA|.27574|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||07/01/2012||Yes|No|||Prescription required|No||059|Yes|.40508|01/25/2022|.39535|01/25/2022|.39799|01/25/2022|||NSAIDS|1411|||||No|No||TEVA USA|No||||
naproxen|No|No|No|No|75%|00093100601|NAPROXEN DR 500 MG TABLET|100|EA|.37895|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||07/01/2012||Yes|No|||Prescription required|No||059|Yes|3.24464|03/29/2022|3.16676|03/29/2022|3.18785|03/29/2022|||NSAIDS|1412|||||No|No||TEVA USA|No||||
naproxen|No|No|No|No|75%|00093100605|NAPROXEN DR 500 MG TABLET|500|EA|.35998|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||07/01/2012||Yes|No|||Prescription required|No||059|Yes|3.24464|03/29/2022|3.16676|03/29/2022|3.18785|03/29/2022|||NSAIDS|1413|||||No|No||TEVA USA|No||||
mupirocin|No|No|No|No|75%|00093101042|MUPIROCIN 2% OINTMENT|22|GM|.62662|11/14/2003||Yes|No||11/14/2003||Yes|No|11/14/2003||Yes|No||||No|No|||Prescription required|No||114|No|.18067|03/29/2022|.17633|03/29/2022|.1775|03/29/2022|||ANTIBIOTICS: TOPICAL|1414|||||No|No||TEVA USA|No||||
nefazodone HCl|No|No|No|No|75%|00093102406|NEFAZODONE HCL 100 MG TABLET|60|EA|.58945|09/22/2003||Yes|No||09/22/2003||Yes|No|09/22/2003||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|031|No|1.34341|01/11/2022|1.32422|01/11/2022|1.26116|01/11/2022|||ANTIDEPRESSANTS: OTHER|1415|||||No|No||TEVA USA|No||||
nefazodone HCl|No|No|No|No|75%|00093102506|NEFAZODONE HCL 200 MG TABLET|60|EA|.6485|09/22/2003||Yes|No||09/22/2003||Yes|No|09/22/2003||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|031|No|1.47799|01/11/2022|1.45688|01/11/2022|1.3875|01/11/2022|||ANTIDEPRESSANTS: OTHER|1416|||||No|No||TEVA USA|No||||
nefazodone HCl|No|No|No|No|75%|00093102606|NEFAZODONE HCL 250 MG TABLET|60|EA|.67774|09/22/2003||Yes|No||09/22/2003||Yes|No|09/22/2003||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|031|No|1.54463|01/11/2022|1.52257|01/11/2022|1.45006|01/11/2022|||ANTIDEPRESSANTS: OTHER|1417|||||No|No||TEVA USA|No||||
sotalol HCl|No|No|No|No|75%|00093106001|SOTALOL 120 MG TABLET|100|EA|.16125|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.10056|03/29/2022|.09814|03/29/2022|.0988|03/29/2022|||BETA-BLOCKERS|1418|||||No|No||TEVA USA|No||||
sotalol HCl|No|No|No|No|75%|00093106101|SOTALOL 80 MG TABLET|100|EA|.1204|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.07746|03/29/2022|.0756|03/29/2022|.0761|03/29/2022|||BETA-BLOCKERS|1419|||||No|No||TEVA USA|No||||
sotalol HCl|No|No|No|No|75%|00093106201|SOTALOL 160 MG TABLET|100|EA|.20425|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.16372|03/29/2022|.15979|03/29/2022|.16085|03/29/2022|||BETA-BLOCKERS|1420|||||No|No||TEVA USA|No||||
sotalol HCl|No|No|No|No|75%|00093106301|SOTALOL 240 MG TABLET|100|EA|.28294|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.64484|06/28/2016|.63562|06/28/2016|.60536|06/28/2016|||BETA-BLOCKERS|1421|||||No|No||TEVA USA|No||||
cefprozil|No|No|No|No|75%|00093107701|CEFPROZIL 250 MG TABLET|100|EA|.58329|05/17/2006||Yes|No||05/17/2006||Yes|No|05/17/2006||Yes|No||||No|No|||Prescription required|No||046|No|.65626|11/23/2021|.6405|11/23/2021|.64477|11/23/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1422|||||No|No||TEVA USA|No||||
cefprozil|No|No|No|No|75%|00093107853|CEFPROZIL 500 MG TABLET|50|EA|1.20159|12/29/2005||Yes|No||12/29/2005||Yes|No|12/29/2005||Yes|No||||No|No|||Prescription required|No||046|No|1.02667|03/29/2022|1.00202|03/29/2022|1.0087|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1423|||||No|No||TEVA USA|No||||
cefaclor|No|No|No|No|75%|00093108701|CEFACLOR ER 500 MG TABLET|100|EA|5.52081|09/10/2002||Yes|No||09/10/2002||Yes|No|09/10/2002||Yes|No||09/10/2002||Yes|No|||Prescription required|Yes|01/25/2012|046|No|12.58231|06/01/2016|12.40257|06/01/2016|11.81197|06/01/2016|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1424|||||No|No||TEVA USA|No||||
etodolac|No|No|No|No|75%|00093111801|ETODOLAC ER 600 MG TABLET|100|EA|1.12629|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|2.56691|06/29/2021|2.53024|06/29/2021|2.40975|06/29/2021|||NSAIDS|1425|||||No|No||TEVA USA|No||||
etodolac|No|No|No|No|75%|00093112201|ETODOLAC ER 400 MG TABLET|100|EA|.99803|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|1.74706|03/01/2022|1.70513|03/01/2022|1.71648|03/01/2022|||NSAIDS|1426|||||No|No||TEVA USA|No||||
abiraterone acetate|No|No|No|No|75%|00093112589|ABIRATERONE ACETATE 250 MG TAB|120|EA|12.53951|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||550|No|28.57842|09/28/2021|28.17016|09/28/2021|26.82872|09/28/2021|||ONCOLOGY: ORAL - PROSTATE|1427|||||No|No||TEVA USA|No||||
acitretin|No|No|No|No|75%|00093113556|ACITRETIN 10 MG CAPSULE|30|EA|5.36668|04/22/2014||Yes|No||04/22/2014||Yes|No|04/22/2014||Yes|No||||No|No|||Prescription required|No|||No|7.81961|03/29/2022|7.63193|03/29/2022|7.68276|03/29/2022||||1428|||||No|No||TEVA USA|No||||
acitretin|No|No|No|No|75%|00093113656|ACITRETIN 25 MG CAPSULE|30|EA|6.61497|04/22/2014||Yes|No||04/22/2014||Yes|No|04/22/2014||Yes|No||||No|No|||Prescription required|No|||No|10.86025|03/29/2022|10.5996|03/29/2022|10.67019|03/29/2022||||1429|||||No|No||TEVA USA|No||||
acitretin|No|No|No|No|75%|00093113856|ACITRETIN 17.5 MG CAPSULE|30|EA|8.26875|04/22/2014||Yes|No||04/22/2014||Yes|No|04/22/2014||Yes|No||||No|No|||Prescription required|No|||No|18.84506|03/29/2022|18.57585|03/29/2022|17.69128|03/29/2022||||1430|||||No|No||TEVA USA|No||||
penicillin V potassium|No|No|No|No|75%|00093117201|PENICILLIN VK 250 MG TABLET|100|EA|.08264|12/07/2006||Yes|No||12/07/2006||Yes|No|12/07/2006||Yes|No||12/07/2006||Yes|No|||Prescription required|No||209|No|.0637|03/29/2022|.06217|03/29/2022|.06258|03/29/2022|||PENICILLINS|1431|||||No|No||TEVA USA|No||||
penicillin V potassium|No|No|No|No|75%|00093117210|PENICILLIN VK 250 MG TABLET|1000|EA|.0785|12/08/2006||Yes|No||12/08/2006||Yes|No|12/08/2006||Yes|No||12/08/2006||Yes|No|||Prescription required|No||209|No|.0637|03/29/2022|.06217|03/29/2022|.06258|03/29/2022|||PENICILLINS|1432|||||No|No||TEVA USA|No||||
penicillin V potassium|No|No|No|No|75%|00093117410|PENICILLIN VK 500 MG TABLET|1000|EA|.13342|12/07/2006||Yes|No||12/07/2006||Yes|No|12/07/2006||Yes|No||12/07/2006||Yes|No|||Prescription required|No||209|No|.10026|03/29/2022|.09785|03/29/2022|.0985|03/29/2022|||PENICILLINS|1433|||||No|No||TEVA USA|No||||
neomycin sulfate|No|No|No|No|75%|00093117701|NEOMYCIN 500 MG TABLET|100|EA|.43791|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||115|No|.8474|03/29/2022|.82706|03/29/2022|.83257|03/29/2022|||ANTIBIOTICS: GI|1434|||||No|No||TEVA USA|No||||
warfarin sodium|No|No|No|No|75%|00093171201|WARFARIN SODIUM 1 MG TABLET|100|EA|.09374|02/18/2016||Yes|No||02/18/2016||Yes|No|02/18/2016||Yes|No||02/18/2016||Yes|No|||Prescription required|No||068|Yes|.08991|03/29/2022|.08775|03/29/2022|.08833|03/29/2022|||ANTICOAGULANTS|1435|||||No|No||TEVA USA|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|00093171210|WARFARIN SODIUM 1 MG TABLET|1000|EA|.09093|02/18/2016||Yes|No||02/18/2016||Yes|No|02/18/2016||Yes|No||02/18/2016||Yes|No|||Prescription required|No||068|Yes|.08991|03/29/2022|.08775|03/29/2022|.08833|03/29/2022|||ANTICOAGULANTS|1436|||||No|No||TEVA USA|No||||
warfarin sodium|No|No|No|No|75%|00093171301|WARFARIN SODIUM 2 MG TABLET|100|EA|.09786|09/17/2015||Yes|No||09/17/2015||Yes|No|09/17/2015||Yes|No||09/17/2015||Yes|No|||Prescription required|No||068|Yes|.09104|03/29/2022|.08885|03/29/2022|.08944|03/29/2022|||ANTICOAGULANTS|1437|||||No|No||TEVA USA|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|00093171310|WARFARIN SODIUM 2 MG TABLET|1000|EA|.09493|09/17/2015||Yes|No||09/17/2015||Yes|No|09/17/2015||Yes|No||09/17/2015||Yes|No|||Prescription required|No||068|Yes|.09104|03/29/2022|.08885|03/29/2022|.08944|03/29/2022|||ANTICOAGULANTS|1438|||||No|No||TEVA USA|No||||
warfarin sodium|No|No|No|No|75%|00093171401|WARFARIN SODIUM 2.5 MG TABLET|100|EA|.10096|09/17/2015||Yes|No||09/17/2015||Yes|No|09/17/2015||Yes|No||09/17/2015||Yes|No|||Prescription required|No||068|Yes|.09348|03/29/2022|.09123|03/29/2022|.09184|03/29/2022|||ANTICOAGULANTS|1439|||||No|No||TEVA USA|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|00093171410|WARFARIN SODIUM 2.5 MG TABLET|1000|EA|.0979|09/17/2015||Yes|No||09/17/2015||Yes|No|09/17/2015||Yes|No||09/17/2015||Yes|No|||Prescription required|No||068|Yes|.09348|03/29/2022|.09123|03/29/2022|.09184|03/29/2022|||ANTICOAGULANTS|1440|||||No|No||TEVA USA|No||||
warfarin sodium|No|No|No|No|75%|00093171501|WARFARIN SODIUM 3 MG TABLET|100|EA|.10139|09/17/2015||Yes|No||09/17/2015||Yes|No|09/17/2015||Yes|No||09/17/2015||Yes|No|||Prescription required|No||068|Yes|.09211|03/29/2022|.08989|03/29/2022|.09049|03/29/2022|||ANTICOAGULANTS|1441|||||No|No||TEVA USA|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|00093171601|WARFARIN SODIUM 4 MG TABLET|100|EA|.10169|09/17/2015||Yes|No||09/17/2015||Yes|No|09/17/2015||Yes|No||09/17/2015||Yes|No|||Prescription required|No||068|Yes|.09432|03/29/2022|.09205|03/29/2022|.09266|03/29/2022|||ANTICOAGULANTS|1442|||||No|No||TEVA USA|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|00093171610|WARFARIN SODIUM 4 MG TABLET|1000|EA|.09861|09/17/2015||Yes|No||09/17/2015||Yes|No|09/17/2015||Yes|No||09/17/2015||Yes|No|||Prescription required|No||068|Yes|.09432|03/29/2022|.09205|03/29/2022|.09266|03/29/2022|||ANTICOAGULANTS|1443|||||No|No||TEVA USA|No||||
warfarin sodium|No|No|No|No|75%|00093171801|WARFARIN SODIUM 6 MG TABLET|100|EA|.14512|09/17/2015||Yes|No||09/17/2015||Yes|No|09/17/2015||Yes|No||09/17/2015||Yes|No|||Prescription required|No||068|Yes|.13556|03/29/2022|.1323|03/29/2022|.13318|03/29/2022|||ANTICOAGULANTS|1444|||||No|No||TEVA USA|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|00093172001|WARFARIN SODIUM 10 MG TABLET|100|EA|.15656|09/17/2015||Yes|No||09/17/2015||Yes|No|09/17/2015||Yes|No||09/17/2015||Yes|No|||Prescription required|No||068|Yes|.12691|03/29/2022|.12386|03/29/2022|.12468|03/29/2022|||ANTICOAGULANTS|1445|||||No|No||TEVA USA|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|00093172101|WARFARIN SODIUM 5 MG TABLET|100|EA|.10229|09/17/2015||Yes|No||09/17/2015||Yes|No|09/17/2015||Yes|No||09/17/2015||Yes|No|||Prescription required|No||068|Yes|.10902|03/29/2022|.1064|03/29/2022|.10711|03/29/2022|||ANTICOAGULANTS|1446|||||No|No||TEVA USA|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|00093172110|WARFARIN SODIUM 5 MG TABLET|1000|EA|.09923|09/17/2015||Yes|No||09/17/2015||Yes|No|09/17/2015||Yes|No||09/17/2015||Yes|No|||Prescription required|No||068|Yes|.10902|03/29/2022|.1064|03/29/2022|.10711|03/29/2022|||ANTICOAGULANTS|1447|||||No|No||TEVA USA|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|00093172301|WARFARIN SODIUM 7.5 MG TABLET|100|EA|.1505|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||12/10/2018||Yes|No|||Prescription required|No||068|Yes|.11896|03/29/2022|.1161|03/29/2022|.11687|03/29/2022|||ANTICOAGULANTS|1448|||||No|No||TEVA USA|Yes|09/01/2020|||
cyclobenzaprine HCl|No|No|No|No|75%|00093192006|CYCLOBENZAPRINE ER 15 MG CAP|60|EA|2.92034|06/29/2021||Yes|No||06/29/2021||Yes|No|06/29/2021||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|Yes|6.65567|06/29/2021|6.56058|06/29/2021|6.24818|06/29/2021|||SKELETAL MUSCLE RELAXANTS|1449|||||No|No||TEVA USA|No||||
cyclobenzaprine HCl|No|No|No|No|75%|00093192106|CYCLOBENZAPRINE ER 30 MG CAP|60|EA|2.92034|06/29/2021||Yes|No||06/29/2021||Yes|No|06/29/2021||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|Yes|6.65567|06/29/2021|6.56058|06/29/2021|6.24818|06/29/2021|||SKELETAL MUSCLE RELAXANTS|1450|||||No|No||TEVA USA|No||||
sumatriptan succinate|No|No|No|No|75%|00093201312|SUMATRIPTAN 4 MG/0.5 ML INJECT|.5|ML|77.0904|06/14/2017||Yes|No||06/14/2017||Yes|No|06/14/2017||Yes|No||||No|No|||Prescription required|No||021|No|129.29|03/01/2022|126.18704|03/01/2022|127.02742|03/01/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|1451|||||No|No||TEVA USA|No||||
sumatriptan succinate|No|No|No|No|75%|00093201412|SUMATRIPTAN 6 MG/0.5 ML INJECT|.5|ML|77.0904|06/14/2017||Yes|No||06/14/2017||Yes|No|06/14/2017||Yes|No||||No|No|||Prescription required|No||021|No|76.75855|03/29/2022|74.91634|03/29/2022|75.41527|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|1452|||||No|No||TEVA USA|No||||
azithromycin|No|No|No|No|75%|00093202623|AZITHROMYCIN 200 MG/5 ML SUSP|15|ML|.74992|01/27/2011||Yes|No||01/27/2011||Yes|No|01/27/2011||Yes|No||07/01/2012||Yes|No|||Prescription required|No||018|No|.46232|03/29/2022|.45122|03/29/2022|.45422|03/29/2022|||MACROLIDES/KETOLIDES|1453|||||No|No||TEVA USA|No||||
azithromycin|No|No|No|No|75%|00093202631|AZITHROMYCIN 200 MG/5 ML SUSP|30|ML|.37496|01/27/2011||Yes|No||01/27/2011||Yes|No|01/27/2011||Yes|No||07/01/2012||Yes|No|||Prescription required|No||018|No|.28375|03/29/2022|.27694|03/29/2022|.27878|03/29/2022|||MACROLIDES/KETOLIDES|1454|||||No|No||TEVA USA|No||||
azithromycin|No|No|No|No|75%|00093202694|AZITHROMYCIN 200 MG/5 ML SUSP|22.5|ML|.49994|03/08/2011||Yes|No||03/08/2011||Yes|No|03/08/2011||Yes|No||07/01/2012||Yes|No|||Prescription required|No||018|No|.35562|03/29/2022|.34708|03/29/2022|.34939|03/29/2022|||MACROLIDES/KETOLIDES|1455|||||No|No||TEVA USA|No||||
azithromycin|No|No|No|No|75%|00093202723|AZITHROMYCIN 100 MG/5 ML SUSP|15|ML|.74992|01/27/2011||Yes|No||01/27/2011||Yes|No|01/27/2011||Yes|No||07/01/2012||Yes|No|||Prescription required|No||018|No|.56328|03/29/2022|.54976|03/29/2022|.55342|03/29/2022|||MACROLIDES/KETOLIDES|1456|||||No|No||TEVA USA|No||||
quetiapine fumarate|No|No|No|No|75%|00093206301|QUETIAPINE FUMARATE 25 MG TAB|100|EA|.07998|04/28/2014||Yes|No||04/28/2014||Yes|No|04/28/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.03239|03/29/2022|.03161|03/29/2022|.03182|03/29/2022|||ANTIPSYCHOTICS|1457|||||No|No||TEVA USA|No||||
cilostazol|No|No|No|No|75%|00093206406|CILOSTAZOL 100 MG TABLET|60|EA|.15687|02/28/2013||Yes|No||02/28/2013||Yes|No|02/28/2013||Yes|No||||No|No|||Prescription required|No|||No|.13507|03/29/2022|.13182|03/29/2022|.1327|03/29/2022||||1458|||||No|No||TEVA USA|No||||
cilostazol|No|No|No|No|75%|00093206506|CILOSTAZOL 50 MG TABLET|60|EA|.13688|06/06/2012||Yes|No||06/06/2012||Yes|No|06/06/2012||Yes|No||||No|No|||Prescription required|No|||No|.11608|03/29/2022|.11329|03/29/2022|.11404|03/29/2022||||1459|||||No|No||TEVA USA|No||||
doxazosin mesylate|No|No|No|No|75%|00093206701|DOXAZOSIN MESYLATE 8 MG TAB|100|EA|.31957|02/18/2015||Yes|No||02/18/2015||Yes|No|02/18/2015||Yes|No||02/18/2015||Yes|No|||Prescription required|No||003|No|.12737|03/29/2022|.12431|03/29/2022|.12514|03/29/2022|||BPH TREATMENTS|1460|||||No|No||TEVA USA|No||||
doxazosin mesylate|No|No|No|No|75%|00093206801|DOXAZOSIN MESYLATE 4 MG TAB|100|EA|.30431|10/28/2014||Yes|No||10/28/2014||Yes|No|10/28/2014||Yes|No||10/28/2014||Yes|No|||Prescription required|No||003|Yes|.10379|03/29/2022|.10129|03/29/2022|.10197|03/29/2022|||BPH TREATMENTS|1461|||||No|No||TEVA USA|No||||
doxazosin mesylate|No|No|No|No|75%|00093206901|DOXAZOSIN MESYLATE 2 MG TAB|100|EA|.28994|10/28/2014||Yes|No||10/28/2014||Yes|No|10/28/2014||Yes|No||10/28/2014||Yes|No|||Prescription required|No||003|Yes|.085|03/29/2022|.08296|03/29/2022|.08351|03/29/2022|||BPH TREATMENTS|1462|||||No|No||TEVA USA|No||||
doxazosin mesylate|No|No|No|No|75%|00093207001|DOXAZOSIN MESYLATE 1 MG TAB|100|EA|.28994|10/28/2014||Yes|No||10/28/2014||Yes|No|10/28/2014||Yes|No||10/28/2014||Yes|No|||Prescription required|No||003|Yes|.09392|03/29/2022|.09166|03/29/2022|.09227|03/29/2022|||BPH TREATMENTS|1463|||||No|No||TEVA USA|No||||
norgestimate-ethinyl estradiol|Yes|Yes|No|No|75%|00093214062|TRI-LO-SPRINTEC TABLET|28|EA|.18018|04/27/2016||Yes|No||04/27/2016||Yes|No|04/27/2016||Yes|No|Refer to program requirements|||No|No|04/27/2016||Prescription required|No|||No|.16464|03/29/2022|.16068|03/29/2022|.16175|03/29/2022||||1464|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
naloxone HCl|No|No|No|No|75%|00093216568|NALOXONE HCL 4 MG NASAL SPRAY|2|EA|23.22|03/29/2022||Yes|No||03/29/2022||Yes|No|03/29/2022||Yes|No||||No|No|||Prescription required|No||145|No|43.81|03/29/2022|42.75856|03/29/2022|43.04332|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|1465|||||No|No||TEVA USA|No||||
liothyronine sodium|No|No|No|No|75%|00093217801|LIOTHYRONINE SOD 25 MCG TAB|100|EA|.3102|07/09/2021||Yes|No||07/09/2021||Yes|No|07/09/2021||Yes|No||||No|No|||Prescription required|No|||No|.55764|03/29/2022|.54425|03/29/2022|.54788|03/29/2022||||1466|||||No|No||TEVA USA|No||||
liothyronine sodium|No|No|No|No|75%|00093217901|LIOTHYRONINE SOD 5 MCG TAB|100|EA|.23615|07/09/2021||Yes|No||07/09/2021||Yes|No|07/09/2021||Yes|No||||No|No|||Prescription required|No|||No|.37734|03/29/2022|.36828|03/29/2022|.37073|03/29/2022||||1467|||||No|No||TEVA USA|No||||
liothyronine sodium|No|No|No|No|75%|00093218001|LIOTHYRONINE SOD 50 MCG TAB|100|EA|.4739|07/09/2021||Yes|No||07/09/2021||Yes|No|07/09/2021||Yes|No||||No|No|||Prescription required|No|||No|.67729|01/25/2022|.66103|01/25/2022|.66543|01/25/2022||||1468|||||No|No||TEVA USA|No||||
metoclopramide HCl|No|No|No|No|75%|00093220301|METOCLOPRAMIDE 10 MG TABLET|100|EA|.03139|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||085|No|.05083|03/29/2022|.04961|03/29/2022|.04994|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|1469|||||No|No||TEVA USA|No||||
metoclopramide HCl|No|No|No|No|75%|00093220305|METOCLOPRAMIDE 10 MG TABLET|500|EA|.02999|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||085|No|.05083|03/29/2022|.04961|03/29/2022|.04994|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|1470|||||No|No||TEVA USA|No||||
metoclopramide HCl|No|No|No|No|75%|00093220310|METOCLOPRAMIDE 10 MG TABLET|1000|EA|.02863|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||085|No|.05083|03/29/2022|.04961|03/29/2022|.04994|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|1471|||||No|No||TEVA USA|No||||
metoclopramide HCl|No|No|No|No|75%|00093220401|METOCLOPRAMIDE 5 MG TABLET|100|EA|.03096|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||085|No|.04524|03/29/2022|.04415|03/29/2022|.04444|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|1472|||||No|No||TEVA USA|No||||
metoclopramide HCl|No|No|No|No|75%|00093220405|METOCLOPRAMIDE 5 MG TABLET|500|EA|.02717|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||085|No|.04524|03/29/2022|.04415|03/29/2022|.04444|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|1473|||||No|No||TEVA USA|No||||
sucralfate|No|No|No|No|75%|00093221001|SUCRALFATE 1 GM TABLET|100|EA|.11627|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.19448|03/29/2022|.18981|03/29/2022|.19107|03/29/2022||||1474|||||No|No||TEVA USA|No||||
sucralfate|No|No|No|No|75%|00093221005|SUCRALFATE 1 GM TABLET|500|EA|.1025|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.19448|03/29/2022|.18981|03/29/2022|.19107|03/29/2022||||1475|||||No|No||TEVA USA|No||||
cephalexin|No|No|No|No|75%|00093223801|CEPHALEXIN 250 MG TABLET|100|EA|.53418|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|01/15/2014|046|No|1.21745|06/01/2016|1.20006|06/01/2016|1.14291|06/01/2016|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1476|||||No|No||TEVA USA|No||||
cephalexin|No|No|No|No|75%|00093224001|CEPHALEXIN 500 MG TABLET|100|EA|1.06816|04/18/2006||Yes|No||04/18/2006||Yes|No|04/18/2006||Yes|No||04/18/2006||Yes|No|||Prescription required|Yes|01/15/2014|046|No|2.43441|06/01/2016|2.39964|06/01/2016|2.28537|06/01/2016|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1477|||||No|No||TEVA USA|No||||
amoxicillin|No|No|No|No|75%|00093226301|AMOXICILLIN 500 MG TABLET|100|EA|.16064|04/19/2006||Yes|No||04/19/2006||Yes|No|04/19/2006||Yes|No||04/19/2006||Yes|No|||Prescription required|No||209|No|.12149|03/29/2022|.11857|03/29/2022|.11936|03/29/2022|||PENICILLINS|1478|||||No|No||TEVA USA|No||||
amoxicillin|No|No|No|No|75%|00093226401|AMOXICILLIN 875 MG TABLET|100|EA|.28126|04/18/2006||Yes|No||04/18/2006||Yes|No|04/18/2006||Yes|No||04/18/2006||Yes|No|||Prescription required|No||209|No|.1448|03/29/2022|.14132|03/29/2022|.14226|03/29/2022|||PENICILLINS|1479|||||No|No||TEVA USA|No||||
amoxicillin|No|No|No|No|75%|00093226701|AMOXICILLIN 125 MG TAB CHEW|100|EA|.08595|04/18/2006||Yes|No||04/18/2006||Yes|No|04/18/2006||Yes|No||04/18/2006||Yes|No|||Prescription required|No||209|No|.1959|06/01/2016|.1931|06/01/2016|.1839|06/01/2016|||PENICILLINS|1480|||||No|No||TEVA USA|No||||
amoxicillin|No|No|No|No|75%|00093226801|AMOXICILLIN 250 MG TAB CHEW|100|EA|.12891|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||209|No|.26285|03/01/2022|.25654|03/01/2022|.25825|03/01/2022|||PENICILLINS|1481|||||No|No||TEVA USA|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00093227034|AMOX-CLAV 200-28.5 MG TAB CHEW|20|EA|.91224|04/21/2005||Yes|No||04/21/2005||Yes|No|04/21/2005||Yes|No||04/21/2005||Yes|No|||Prescription required|Yes|01/23/2013|046|No|2.07907|06/01/2016|2.04936|06/01/2016|1.95178|06/01/2016|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1482|||||No|No||TEVA USA|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00093227234|AMOX-CLAV 400-57 MG TAB CHEW|20|EA|1.73849|02/15/2005||Yes|No||02/15/2005||Yes|No|02/15/2005||Yes|No||02/15/2005||Yes|No|||Prescription required|Yes|01/23/2013|046|No|3.1527|03/29/2022|3.07703|03/29/2022|3.09752|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1483|||||No|No||TEVA USA|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00093227434|AMOX-CLAV 500-125 MG TABLET|20|EA|.60651|11/07/2002||Yes|No||11/07/2002||Yes|No|11/07/2002||Yes|No||11/07/2002||Yes|No|||Prescription required|No||046|No|.31268|03/29/2022|.30517|03/29/2022|.3072|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1484|||||No|No||TEVA USA|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00093227534|AMOX-CLAV 875-125 MG TABLET|20|EA|.72584|11/01/2002||Yes|No||11/01/2002||Yes|No|11/01/2002||Yes|No||11/01/2002||Yes|No|||Prescription required|No||046|No|.32484|03/29/2022|.31704|03/29/2022|.31915|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1485|||||No|No||TEVA USA|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00093227773|AMOX-CLAV 200-28.5 MG/5 ML SUS|100|ML|.05955|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|No||046|No|.05885|03/29/2022|.05743|03/29/2022|.05782|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1486|||||No|No||TEVA USA|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00093227973|AMOX-CLAV 400-57 MG/5 ML SUSP|100|ML|.22252|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|No||046|No|.07681|03/29/2022|.07496|03/29/2022|.07546|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1487|||||No|No||TEVA USA|No||||
hydroxychloroquine sulfate|No|No|No|No|75%|00093240101|HYDROXYCHLOROQUINE 200 MG TAB|100|EA|1.4061|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|No|||No|.23831|03/29/2022|.23259|03/29/2022|.23413|03/29/2022||||1488|||||No|No||TEVA USA|No||||
quinine sulfate|No|No|No|No|75%|00093300256|QUININE SULFATE 324 MG CAPSULE|30|EA|2.43294|10/22/2012||Yes|No||10/22/2012||Yes|No|10/22/2012||Yes|No||10/22/2012||Yes|No|||Prescription required|No|||No|1.35758|03/29/2022|1.32499|03/29/2022|1.33382|03/29/2022||||1489|||||No|No||TEVA USA|No||||
lansoprazole|No|No|No|No|75%|00093300893|LANSOPRAZOLE ODT 15 MG TABLET|100|EA|5.14052|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|Yes|03/22/2018|047|No|6.08156|03/29/2022|5.9356|03/29/2022|5.97513|03/29/2022|||PROTON PUMP INHIBITORS|1490|||||No|No||TEVA USA|No||||
lansoprazole|No|No|No|No|75%|00093300993|LANSOPRAZOLE ODT 30 MG TABLET|100|EA|5.14052|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|Yes|03/22/2018|047|No|5.52111|03/29/2022|5.3886|03/29/2022|5.42449|03/29/2022|||PROTON PUMP INHIBITORS|1491|||||No|No||TEVA USA|No||||
rasagiline mesylate|No|No|No|No|75%|00093306056|RASAGILINE MESYLATE 0.5 MG TAB|30|EA|5.91207|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|015|No|4.5286|03/29/2022|4.41991|03/29/2022|4.44934|03/29/2022|||ANTIPARKINSON'S AGENTS|1492|||||No|No||TEVA USA|No||||
rasagiline mesylate|No|No|No|No|75%|00093306156|RASAGILINE MESYLATE 1 MG TAB|30|EA|5.91207|04/26/2017||Yes|No||04/26/2017||Yes|No|04/26/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|015|No|1.78642|03/29/2022|1.74354|03/29/2022|1.75515|03/29/2022|||ANTIPARKINSON'S AGENTS|1493|||||No|No||TEVA USA|No||||
clozapine|No|No|No|No|75%|00093308684|CLOZAPINE ODT 150 MG TABLET|48|EA|7.42341|10/16/2015|08/31/2022|Yes|No||10/16/2015|08/31/2022|Yes|No|10/16/2015|08/31/2022|Yes|No||||No|No|||Prescription required|Yes|01/22/2015|027|Yes|16.91847|06/01/2016|16.67678|06/01/2016|15.88265|06/01/2016|||ANTIPSYCHOTICS|1494|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||TEVA USA|No||||
armodafinil|No|No|No|No|90%|00093309056|ARMODAFINIL 50 MG TABLET|30|EA|.18762|03/02/2017||Yes|No||03/02/2017||Yes|No|03/02/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.28825|03/29/2022|.28133|03/29/2022|.2832|03/29/2022|||STIMULANTS AND RELATED AGENTS|1495|||||No|No||TEVA USA|No||||
armodafinil|No|No|No|No|90%|00093309256|ARMODAFINIL 150 MG TABLET|30|EA|.56473|03/02/2017||Yes|No||03/02/2017||Yes|No|03/02/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.83403|03/29/2022|.81401|03/29/2022|.81943|03/29/2022|||STIMULANTS AND RELATED AGENTS|1496|||||No|No||TEVA USA|No||||
armodafinil|No|No|No|No|90%|00093309356|ARMODAFINIL 200 MG TABLET|30|EA|.56473|03/02/2017||Yes|No||03/02/2017||Yes|No|03/02/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.63792|03/29/2022|.6226|03/29/2022|.62675|03/29/2022|||STIMULANTS AND RELATED AGENTS|1497|||||No|No||TEVA USA|No||||
armodafinil|No|No|No|No|90%|00093309456|ARMODAFINIL 250 MG TABLET|30|EA|.56473|03/02/2017||Yes|No||03/02/2017||Yes|No|03/02/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.10963|03/29/2022|1.08299|03/29/2022|1.09021|03/29/2022|||STIMULANTS AND RELATED AGENTS|1498|||||No|No||TEVA USA|No||||
risedronate sodium|No|No|No|No|75%|00093309829|RISEDRONATE SODIUM 35 MG TAB|12|EA|21.31115|07/31/2015||Yes|No||07/31/2015||Yes|No|07/31/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|060|No|2.85532|03/29/2022|2.78679|03/29/2022|2.80535|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|1499|||||No|No||TEVA USA|No||||
risedronate sodium|No|No|No|No|75%|00093309844|RISEDRONATE SODIUM 35 MG TAB|4|EA|21.31187|07/31/2015||Yes|No||07/31/2015||Yes|No|07/31/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|060|No|2.85532|03/29/2022|2.78679|03/29/2022|2.80535|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|1500|||||No|No||TEVA USA|No||||
risedronate sodium|No|No|No|No|75%|00093309956|RISEDRONATE SODIUM 5 MG TABLET|30|EA|3.0464|07/31/2015||Yes|No||07/31/2015||Yes|No|07/31/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|060|No|6.94296|06/01/2016|6.84378|06/01/2016|6.51788|06/01/2016|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|1501|||||No|No||TEVA USA|No||||
risedronate sodium|No|No|No|No|75%|00093310056|RISEDRONATE SODIUM 30 MG TAB|30|EA|21.31108|07/31/2015||Yes|No||07/31/2015||Yes|No|07/31/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|060|No|48.56944|06/01/2016|47.87559|06/01/2016|45.5958|06/01/2016|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|1502|||||No|No||TEVA USA|No||||
amoxicillin|No|No|No|No|75%|00093310701|AMOXICILLIN 250 MG CAPSULE|100|EA|.05121|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||209|No|.06288|03/29/2022|.06137|03/29/2022|.06177|03/29/2022|||PENICILLINS|1503|||||No|No||TEVA USA|No||||
amoxicillin|No|No|No|No|75%|00093310705|AMOXICILLIN 250 MG CAPSULE|500|EA|.04533|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||209|No|.06288|03/29/2022|.06137|03/29/2022|.06177|03/29/2022|||PENICILLINS|1504|||||No|No||TEVA USA|No||||
amoxicillin|No|No|No|No|75%|00093310905|AMOXICILLIN 500 MG CAPSULE|500|EA|.07159|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||209|No|.07054|03/29/2022|.06884|03/29/2022|.0693|03/29/2022|||PENICILLINS|1505|||||No|No||TEVA USA|No||||
amoxicillin|No|No|No|No|75%|00093310953|AMOXICILLIN 500 MG CAPSULE|50|EA|.07972|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||209|No|.07054|03/29/2022|.06884|03/29/2022|.0693|03/29/2022|||PENICILLINS|1506|||||No|No||TEVA USA|No||||
norethindrone ac-eth estradiol|No|No|No|No|75%|00093312242|JINTELI 1 MG-5 MCG TABLET|28|EA|1.00758|03/04/2011||Yes|No||03/04/2011||Yes|No|03/04/2011||Yes|No||||No|No|||Prescription required|No|||Yes|1.33067|03/29/2022|1.29873|03/29/2022|1.30738|03/29/2022||||1507|||||No|No||TEVA USA|No||||
norethindrone ac-eth estradiol|No|No|No|No|75%|00093312298|JINTELI 1 MG-5 MCG TABLET|90|EA|1.00739|03/04/2011||Yes|No||03/04/2011||Yes|No|03/04/2011||Yes|No||||No|No|||Prescription required|No|||Yes|1.33067|03/29/2022|1.29873|03/29/2022|1.30738|03/29/2022||||1508|||||No|No||TEVA USA|No||||
dicloxacillin sodium|No|No|No|No|75%|00093312301|DICLOXACILLIN 250 MG CAPSULE|100|EA|.26935|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||209|No|.61387|10/26/2021|.6051|10/26/2021|.57628|10/26/2021|||PENICILLINS|1509|||||No|No||TEVA USA|No||||
dicloxacillin sodium|No|No|No|No|75%|00093312501|DICLOXACILLIN 500 MG CAPSULE|100|EA|.53874|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||209|No|1.09839|03/29/2022|1.07202|03/29/2022|1.07916|03/29/2022|||PENICILLINS|1510|||||No|No||TEVA USA|No||||
disopyramide phosphate|No|No|No|No|75%|00093312701|DISOPYRAMIDE 100 MG CAPSULE|100|EA|.85699|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|1.56742|10/26/2021|1.5298|10/26/2021|1.53999|10/26/2021||||1511|||||No|No||TEVA USA|No||||
disopyramide phosphate|No|No|No|No|75%|00093312901|DISOPYRAMIDE 150 MG CAPSULE|100|EA|.96616|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|1.43662|12/28/2021|1.40214|12/28/2021|1.41147|12/28/2021||||1512|||||No|No||TEVA USA|No||||
imiquimod|No|No|No|No|75%|00093313331|IMIQUIMOD 3.75% CREAM PUMP|7.5|GM|61.03592|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||||No|No|||Prescription required|No|||Yes|139.10512|12/30/2020|137.1179|12/30/2020|130.58848|12/30/2020||||1513|||||No|No||TEVA USA|No||||
L-norgest/e.estradiol-e.estrad|Yes|Yes|No|No|75%|00093313482|CAMRESE 0.15-0.03-0.01 MG TAB|91|EA|.8629|08/05/2011||Yes|No||08/05/2011||Yes|No|08/05/2011||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.54912|03/29/2022|.53594|03/29/2022|.53951|03/29/2022||||1514|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
cephalexin|No|No|No|No|75%|00093314501|CEPHALEXIN 250 MG CAPSULE|100|EA|.05676|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||046|No|.09013|03/29/2022|.08796|03/29/2022|.08855|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1515|||||No|No||TEVA USA|No||||
cephalexin|No|No|No|No|75%|00093314505|CEPHALEXIN 250 MG CAPSULE|500|EA|.05418|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||046|No|.09013|03/29/2022|.08796|03/29/2022|.08855|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1516|||||No|No||TEVA USA|No||||
cephalexin|No|No|No|No|75%|00093314701|CEPHALEXIN 500 MG CAPSULE|100|EA|.09374|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||046|No|.12151|03/29/2022|.11859|03/29/2022|.11938|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1517|||||No|No||TEVA USA|No||||
cephalexin|No|No|No|No|75%|00093314705|CEPHALEXIN 500 MG CAPSULE|500|EA|.08858|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||046|No|.12151|03/29/2022|.11859|03/29/2022|.11938|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1518|||||No|No||TEVA USA|No||||
cefdinir|No|No|No|No|75%|00093316006|CEFDINIR 300 MG CAPSULE|60|EA|1.64933|05/14/2007||Yes|No||05/14/2007||Yes|No|05/14/2007||Yes|No||||No|No|||Prescription required|No||046|No|.46443|03/29/2022|.45328|03/29/2022|.4563|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1519|||||No|No||TEVA USA|No||||
albuterol sulfate|No|No|No|No|75%|00093317431|ALBUTEROL HFA 90 MCG INHALER|8.5|GM|1.82016|04/17/2020||Yes|No||04/17/2020||Yes|No|04/17/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|037|Yes|3.10102|03/29/2022|3.02659|03/29/2022|3.04675|03/29/2022|||BRONCHODILATORS: BETA AGONIST|1520|||||No|No||TEVA USA|No||||
cefadroxil|No|No|No|No|75%|00093319601|CEFADROXIL 500 MG CAPSULE|100|EA|.2279|05/16/2007||Yes|No||05/16/2007||Yes|No|05/16/2007||Yes|No||05/16/2007||Yes|No|||Prescription required|No||046|No|.20994|03/29/2022|.2049|03/29/2022|.20626|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1521|||||No|No||TEVA USA|No||||
cefadroxil|No|No|No|No|75%|00093319653|CEFADROXIL 500 MG CAPSULE|50|EA|.25585|11/01/2008||Yes|No||11/01/2008||Yes|No|11/01/2008||Yes|No||11/01/2008||Yes|No|||Prescription required|No||046|No|.20994|03/29/2022|.2049|03/29/2022|.20626|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1522|||||No|No||TEVA USA|No||||
clonazepam|No|No|No|No|75%|00093321201|CLONAZEPAM 1 MG TABLET|100|EA|.01806|01/30/2020||Yes|No||01/30/2020||Yes|No|01/30/2020||Yes|No||01/30/2020||Yes|No|||Prescription required|No||056|Yes|.0296|03/29/2022|.02888|03/29/2022|.02908|03/29/2022|||ANTICONVULSANTS|1523|||||No|No||TEVA USA|No||||
clonazepam|No|No|No|No|75%|00093321301|CLONAZEPAM 2 MG TABLET|100|EA|.02666|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||02/02/2021||Yes|No|||Prescription required|No||056|Yes|.03734|03/29/2022|.03644|03/29/2022|.03668|03/29/2022|||ANTICONVULSANTS|1524|||||No|No||TEVA USA|No||||
clonazepam|No|No|No|No|75%|00093321305|CLONAZEPAM 2 MG TABLET|500|EA|.02666|01/30/2020||Yes|No||01/30/2020||Yes|No|01/30/2020||Yes|No||01/30/2020||Yes|No|||Prescription required|No||056|Yes|.03734|03/29/2022|.03644|03/29/2022|.03668|03/29/2022|||ANTICONVULSANTS|1525|||||No|No||TEVA USA|No||||
ketoconazole|No|No|No|No|75%|00093321915|KETOCONAZOLE 2% CREAM|15|GM|.70864|02/01/2021||Yes|No||02/01/2021||Yes|No|02/01/2021||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|.53088|03/29/2022|.51813|03/29/2022|.52158|03/29/2022|||ANTIFUNGALS: TOPICAL|1526|||||No|No||TEVA USA|No||||
ketoconazole|No|No|No|No|75%|00093321930|KETOCONAZOLE 2% CREAM|30|GM|.59755|02/01/2021||Yes|No||02/01/2021||Yes|No|02/01/2021||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|.43567|03/29/2022|.42521|03/29/2022|.42804|03/29/2022|||ANTIFUNGALS: TOPICAL|1527|||||No|No||TEVA USA|No||||
ketoconazole|No|No|No|No|75%|00093321992|KETOCONAZOLE 2% CREAM|60|GM|.45365|02/01/2021||Yes|No||02/01/2021||Yes|No|02/01/2021||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|.36478|03/29/2022|.35602|03/29/2022|.35839|03/29/2022|||ANTIFUNGALS: TOPICAL|1528|||||No|No||TEVA USA|No||||
estradiol|No|No|No|No|75%|00093322308|ESTRADIOL 10 MCG VAGINAL INSRT|8|EA|8.34092|11/28/2017||Yes|No||11/28/2017||Yes|No|11/28/2017||Yes|No||||No|No|||Prescription required|No|||Yes|7.83958|03/29/2022|7.65143|03/29/2022|7.70238|03/29/2022||||1529|||||No|No||TEVA USA|No||||
estradiol|No|No|No|No|75%|00093322397|ESTRADIOL 10 MCG VAGINAL INSRT|18|EA|8.34128|11/28/2017||Yes|No||11/28/2017||Yes|No|11/28/2017||Yes|No||||No|No|||Prescription required|No|||Yes|7.83958|03/29/2022|7.65143|03/29/2022|7.70238|03/29/2022||||1530|||||No|No||TEVA USA|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|00093324101|BISOPROLOL-HCTZ 2.5-6.25 MG TB|100|EA|.28964|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||02/03/2021||Yes|No|||Prescription required|No||070|Yes|.36234|03/29/2022|.35364|03/29/2022|.35599|03/29/2022|||BETA-BLOCKERS|1531|||||No|No||TEVA USA|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|00093324201|BISOPROLOL-HCTZ 5-6.25 MG TAB|100|EA|.28964|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||02/03/2021||Yes|No|||Prescription required|No||070|Yes|.33991|03/29/2022|.33175|03/29/2022|.33396|03/29/2022|||BETA-BLOCKERS|1532|||||No|No||TEVA USA|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|00093324356|BISOPROLOL-HCTZ 10-6.25 MG TAB|30|EA|.28967|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||02/03/2021||Yes|No|||Prescription required|No||070|Yes|.33843|03/29/2022|.3303|03/29/2022|.3325|03/29/2022|||BETA-BLOCKERS|1533|||||No|No||TEVA USA|No||||
desogestrel-ethinyl estradiol|Yes|Yes|No|No|75%|00093330416|RECLIPSEN 28 DAY TABLET|28|EA|.3139|08/24/2017||Yes|No||08/24/2017||Yes|No|08/24/2017||Yes|No|Refer to program requirements|||No|No|08/24/2017||Prescription required|No|||No|.18364|03/29/2022|.17923|03/29/2022|.18042|03/29/2022||||1534|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
tadalafil|No|No|No|No|75%|00093333406|ALYQ 20 MG TABLET|60|EA|.40527|08/07/2020||Yes|No||08/07/2020||Yes|No|08/07/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/26/2018|171|Yes|.68104|03/29/2022|.66469|03/29/2022|.66912|03/29/2022|||PAH AGENTS: ORAL AND INHALED|1535|||||No|No||TEVA USA|No||||
cyclobenzaprine HCl|No|No|No|No|75%|00093342001|CYCLOBENZAPRINE 5 MG TABLET|100|EA|.07254|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|No||116|Yes|.02938|03/29/2022|.02867|03/29/2022|.02886|03/29/2022|||SKELETAL MUSCLE RELAXANTS|1536|||||No|No||TEVA USA|No||||
cyclobenzaprine HCl|No|No|No|No|75%|00093342101|CYCLOBENZAPRINE 7.5 MG TABLET|100|EA|1.65369|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|No||116|Yes|1.21617|03/29/2022|1.18698|03/29/2022|1.19488|03/29/2022|||SKELETAL MUSCLE RELAXANTS|1537|||||No|No||TEVA USA|No||||
cyclobenzaprine HCl|No|No|No|No|75%|00093342201|CYCLOBENZAPRINE 10 MG TABLET|100|EA|.03053|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|1538|||||No|No||TEVA USA|No||||
cyclobenzaprine HCl|No|No|No|No|75%|00093342205|CYCLOBENZAPRINE 10 MG TABLET|500|EA|.029|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|1539|||||No|No||TEVA USA|No||||
cyclobenzaprine HCl|No|No|No|No|75%|00093342210|CYCLOBENZAPRINE 10 MG TABLET|1000|EA|.029|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|1540|||||No|No||TEVA USA|No||||
lorazepam|No|No|No|No|90%|00093342505|LORAZEPAM 0.5 MG TABLET|500|EA|.01876|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|No||090|Yes|.03794|03/28/2022|.03702|03/28/2022|.03727|03/28/2022|||ANXIOLYTICS|1541|||||No|No||TEVA USA|No||||
lorazepam|No|No|No|No|90%|00093342510|LORAZEPAM 0.5 MG TABLET|1000|EA|.0182|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|No||090|Yes|.03794|03/28/2022|.03702|03/28/2022|.03727|03/28/2022|||ANXIOLYTICS|1542|||||No|No||TEVA USA|No||||
lorazepam|No|No|No|No|90%|00093342601|LORAZEPAM 1 MG TABLET|100|EA|.02128|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|No||090|Yes|.04593|03/28/2022|.04482|03/28/2022|.04512|03/28/2022|||ANXIOLYTICS|1543|||||No|No||TEVA USA|No||||
lorazepam|No|No|No|No|90%|00093342701|LORAZEPAM 2 MG TABLET|100|EA|.03311|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No||090|Yes|.06696|03/29/2022|.06535|03/29/2022|.06578|03/29/2022|||ANXIOLYTICS|1544|||||No|No||TEVA USA|No||||
lorazepam|No|No|No|No|90%|00093342705|LORAZEPAM 2 MG TABLET|500|EA|.03309|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No||090|Yes|.06696|03/29/2022|.06535|03/29/2022|.06578|03/29/2022|||ANXIOLYTICS|1545|||||No|No||TEVA USA|No||||
lorazepam|No|No|No|No|90%|00093342710|LORAZEPAM 2 MG TABLET|1000|EA|.03209|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No||090|Yes|.06696|03/29/2022|.06535|03/29/2022|.06578|03/29/2022|||ANXIOLYTICS|1546|||||No|No||TEVA USA|No||||
deferasirox|No|No|No|No|75%|00093351656|DEFERASIROX 180 MG TABLET|30|EA|31.37667|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|No|||No|71.50962|02/16/2022|70.48805|02/16/2022|67.13148|02/16/2022||||1547|||||No|No||TEVA USA|No||||
estradiol|No|No|No|No|75%|00093354143|ESTRADIOL 0.01% CREAM|42.5|GM|2.7525|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No|||Yes|.87976|03/29/2022|.85864|03/29/2022|.86436|03/29/2022||||1548|||||No|No||TEVA USA|No||||
atomoxetine HCl|No|No|No|No|75%|00093354256|ATOMOXETINE HCL 10 MG CAPSULE|30|EA|1.59143|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.20613|03/29/2022|1.17718|03/29/2022|1.18502|03/29/2022|||STIMULANTS AND RELATED AGENTS|1549|||||No|No||TEVA USA|No||||
atomoxetine HCl|No|No|No|No|75%|00093354356|ATOMOXETINE HCL 18 MG CAPSULE|30|EA|1.59143|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.0614|03/29/2022|1.03592|03/29/2022|1.04282|03/29/2022|||STIMULANTS AND RELATED AGENTS|1550|||||No|No||TEVA USA|No||||
atomoxetine HCl|No|No|No|No|75%|00093354456|ATOMOXETINE HCL 25 MG CAPSULE|30|EA|1.59143|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.05569|03/29/2022|1.03035|03/29/2022|1.03721|03/29/2022|||STIMULANTS AND RELATED AGENTS|1551|||||No|No||TEVA USA|No||||
atomoxetine HCl|No|No|No|No|75%|00093354556|ATOMOXETINE HCL 40 MG CAPSULE|30|EA|1.72903|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.0462|03/29/2022|1.02109|03/29/2022|1.02789|03/29/2022|||STIMULANTS AND RELATED AGENTS|1552|||||No|No||TEVA USA|No||||
atomoxetine HCl|No|No|No|No|75%|00093354656|ATOMOXETINE HCL 60 MG CAPSULE|30|EA|1.72903|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.16565|03/29/2022|1.13767|03/29/2022|1.14525|03/29/2022|||STIMULANTS AND RELATED AGENTS|1553|||||No|No||TEVA USA|No||||
atomoxetine HCl|No|No|No|No|75%|00093354756|ATOMOXETINE HCL 80 MG CAPSULE|30|EA|1.86548|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.40838|03/29/2022|1.37457|03/29/2022|1.38373|03/29/2022|||STIMULANTS AND RELATED AGENTS|1554|||||No|No||TEVA USA|No||||
atomoxetine HCl|No|No|No|No|75%|00093354856|ATOMOXETINE HCL 100 MG CAPSULE|30|EA|1.86548|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.76872|03/29/2022|1.72627|03/29/2022|1.73776|03/29/2022|||STIMULANTS AND RELATED AGENTS|1555|||||No|No||TEVA USA|No||||
peg3350/sod sul/NaCl/KCl/asb/C|No|No|No|No|75%|00093356026|PEG3350 100-7.5-2.691-1.01-5.9|1|EA|41.624|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||02/03/2021||Yes|No|||Prescription required|No|||No|83.08|03/29/2022|81.08608|03/29/2022|81.6261|03/29/2022||||1556|||||No|No||TEVA USA|No||||
fluticasone propion/salmeterol|No|No|No|No|75%|00093360782|FLUTICASONE-SALMETEROL 55-14|1|EA|50.31|07/06/2018||Yes|No||07/06/2018||Yes|No|07/06/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|033|Yes|84.75833|12/28/2021|82.72413|12/28/2021|83.27505|12/28/2021|||GLUCOCORTICOIDS: INHALED|1557|||||No|No||TEVA USA|No||||
fluticasone propion/salmeterol|No|No|No|No|75%|00093360882|FLUTICASONE-SALMETEROL 113-14|1|EA|50.31|07/06/2018||Yes|No||07/06/2018||Yes|No|07/06/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|033|Yes|84.582|03/29/2022|82.55203|03/29/2022|83.10181|03/29/2022|||GLUCOCORTICOIDS: INHALED|1558|||||No|No||TEVA USA|No||||
fluticasone propion/salmeterol|No|No|No|No|75%|00093360982|FLUTICASONE-SALMETEROL 232-14|1|EA|50.31|07/06/2018||Yes|No||07/06/2018||Yes|No|07/06/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|033|Yes|87.02417|03/29/2022|84.93558|03/29/2022|85.50124|03/29/2022|||GLUCOCORTICOIDS: INHALED|1559|||||No|No||TEVA USA|No||||
acyclovir|No|No|No|No|75%|00093363020|ACYCLOVIR 5% CREAM|5|GM|62.73442|08/31/2020||Yes|No||08/31/2020||Yes|No|08/31/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|123|No|36.3578|03/29/2022|35.48521|03/29/2022|35.72153|03/29/2022|||ANTIVIRALS: TOPICAL|1560|||||No|No||TEVA USA|No||||
methylergonovine maleate|No|No|No|No|75%|00093365522|METHYLERGONOVINE 0.2 MG TABLET|12|EA|8.5441|06/06/2019||Yes|No||06/06/2019||Yes|No|06/06/2019||Yes|No||||No|No|||Prescription required|No|||No|13.46155|05/25/2021|13.13847|05/25/2021|13.22597|05/25/2021||||1561|||||No|No||TEVA USA|No||||
methylergonovine maleate|No|No|No|No|75%|00093365528|METHYLERGONOVINE 0.2 MG TABLET|28|EA|8.53933|06/06/2019||Yes|No||06/06/2019||Yes|No|06/06/2019||Yes|No||||No|No|||Prescription required|No|||No|13.46155|05/25/2021|13.13847|05/25/2021|13.22597|05/25/2021||||1562|||||No|No||TEVA USA|No||||
buprenorphine|No|No|No|No|90%|00093365640|BUPRENORPHINE 5 MCG/HR PATCH|4|EA|22.77065|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|35.41903|03/29/2022|34.56897|03/29/2022|34.79919|03/29/2022|||ANALGESICS: NARCOTICS LONG|1563|||||No|No||TEVA USA|No||||
buprenorphine|No|No|No|No|90%|00093365740|BUPRENORPHINE 10 MCG/HR PATCH|4|EA|34.15597|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|66.68301|03/29/2022|65.08261|03/29/2022|65.51605|03/29/2022|||ANALGESICS: NARCOTICS LONG|1564|||||No|No||TEVA USA|No||||
buprenorphine|No|No|No|No|90%|00093365840|BUPRENORPHINE 15 MCG/HR PATCH|4|EA|49.2694|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|99.0625|03/29/2022|96.685|03/29/2022|97.3289|03/29/2022|||ANALGESICS: NARCOTICS LONG|1565|||||No|No||TEVA USA|No||||
buprenorphine|No|No|No|No|90%|00093365940|BUPRENORPHINE 20 MCG/HR PATCH|4|EA|60.46875|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|115.06922|03/29/2022|112.30755|03/29/2022|113.0555|03/29/2022|||ANALGESICS: NARCOTICS LONG|1566|||||No|No||TEVA USA|No||||
diclofenac epolamine|No|No|No|No|75%|00093372755|DICLOFENAC EPOLAMINE 1.3% PTCH|30|EA|4.61877|10/29/2020||Yes|No||10/29/2020||Yes|No|10/29/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|5.77341|03/29/2022|5.63484|03/29/2022|5.67237|03/29/2022|||NSAIDS|1567|||||No|No||TEVA USA|No||||
tobramycin|No|No|No|No|75%|00093375028|TOBRAMYCIN 300 MG/4 ML AMPULE|4|ML|10.25937|01/27/2021||Yes|No||01/27/2021||Yes|No|01/27/2021||Yes|No|Submit HHS Form 1143|||No|No|||Prescription required|Yes|07/25/2019|240|No|23.38182|01/27/2021|23.0478|01/27/2021|21.95028|01/27/2021|||ANTIBIOTICS: INHALED|1568|||||No|No||TEVA USA|No||||
tobramycin|No|No|No|No|75%|00093375063|TOBRAMYCIN 300 MG/4 ML AMPULE|4|ML|10.25937|01/27/2021||Yes|No||01/27/2021||Yes|No|01/27/2021||Yes|No|Submit HHS Form 1143|||No|No|||Prescription required|Yes|07/25/2019|240|No|23.38182|01/27/2021|23.0478|01/27/2021|21.95028|01/27/2021|||ANTIBIOTICS: INHALED|1569|||||No|No||TEVA USA|No||||
ethinyl estradiol/drospirenone|No|Yes|No|No|75%|00093400062|VESTURA 3 MG-0.02 MG TABLET|28|EA|.86998|07/09/2021||Yes|No||07/09/2021||Yes|No|07/09/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.36582|03/29/2022|.35704|03/29/2022|.35941|03/29/2022||||1570|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
cefadroxil|No|No|No|No|75%|00093405953|CEFADROXIL 1 GM TABLET|50|EA|2.1156|05/21/2007||Yes|No||05/21/2007||Yes|No|05/21/2007||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|046|No|4.8216|06/01/2016|4.75272|06/01/2016|4.5264|06/01/2016|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1571|||||No|No||TEVA USA|No||||
formoterol fumarate|No|No|No|No|75%|00093406106|FORMOTEROL 20 MCG/2 ML NEB VL|2|ML|3.45357|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|037|Yes|6.84467|03/29/2022|6.68039|03/29/2022|6.72488|03/29/2022|||BRONCHODILATORS: BETA AGONIST|1572|||||No|No||TEVA USA|No||||
formoterol fumarate|No|No|No|No|75%|00093406130|FORMOTEROL 20 MCG/2 ML NEB VL|2|ML|3.45361|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|037|Yes|6.91211|02/10/2022|6.74621|02/10/2022|6.79114|02/10/2022|||BRONCHODILATORS: BETA AGONIST|1573|||||No|No||TEVA USA|No||||
prazosin HCl|No|No|No|No|75%|00093406701|PRAZOSIN 1 MG CAPSULE|100|EA|.23103|04/10/2007||Yes|No||04/10/2007||Yes|No|04/10/2007||Yes|No||04/10/2007||Yes|No|||Prescription required|No|||No|.1999|03/29/2022|.1951|03/29/2022|.1964|03/29/2022||||1574|||||No|No||TEVA USA|No||||
prazosin HCl|No|No|No|No|75%|00093406710|PRAZOSIN 1 MG CAPSULE|1000|EA|.23103|04/10/2007||Yes|No||04/10/2007||Yes|No|04/10/2007||Yes|No||04/10/2007||Yes|No|||Prescription required|No|||No|.1999|03/29/2022|.1951|03/29/2022|.1964|03/29/2022||||1575|||||No|No||TEVA USA|No||||
prazosin HCl|No|No|No|No|75%|00093406801|PRAZOSIN 2 MG CAPSULE|100|EA|.34116|04/10/2007||Yes|No||04/10/2007||Yes|No|04/10/2007||Yes|No||04/10/2007||Yes|No|||Prescription required|No|||No|.29873|03/29/2022|.29156|03/29/2022|.2935|03/29/2022||||1576|||||No|No||TEVA USA|No||||
prazosin HCl|No|No|No|No|75%|00093406810|PRAZOSIN 2 MG CAPSULE|1000|EA|.34114|04/10/2007||Yes|No||04/10/2007||Yes|No|04/10/2007||Yes|No||04/10/2007||Yes|No|||Prescription required|No|||No|.29873|03/29/2022|.29156|03/29/2022|.2935|03/29/2022||||1577|||||No|No||TEVA USA|No||||
prazosin HCl|No|No|No|No|75%|00093406901|PRAZOSIN 5 MG CAPSULE|100|EA|.56317|04/10/2007||Yes|No||04/10/2007||Yes|No|04/10/2007||Yes|No||04/10/2007||Yes|No|||Prescription required|No|||No|.53856|03/29/2022|.52563|03/29/2022|.52913|03/29/2022||||1578|||||No|No||TEVA USA|No||||
prazosin HCl|No|No|No|No|75%|00093406905|PRAZOSIN 5 MG CAPSULE|500|EA|.56317|04/10/2007||Yes|No||04/10/2007||Yes|No|04/10/2007||Yes|No||04/10/2007||Yes|No|||Prescription required|No|||No|.53856|03/29/2022|.52563|03/29/2022|.52913|03/29/2022||||1579|||||No|No||TEVA USA|No||||
prazosin HCl|No|No|No|No|75%|00093406952|PRAZOSIN 5 MG CAPSULE|250|EA|.56314|04/10/2007||Yes|No||04/10/2007||Yes|No|04/10/2007||Yes|No||04/10/2007||Yes|No|||Prescription required|No|||No|.53856|03/29/2022|.52563|03/29/2022|.52913|03/29/2022||||1580|||||No|No||TEVA USA|No||||
tobramycin in 0.225% sod chlor|No|No|No|No|75%|00093408563|TOBRAMYCIN 300 MG/5 ML AMPULE|5|ML|8.8595|12/13/2013||Yes|No||12/13/2013||Yes|No|12/13/2013||Yes|No|Submit HHS Form 1143|||No|No|||Prescription required|Yes|07/29/2021|240|No|3.76543|05/25/2021|3.67505|05/25/2021|3.69953|05/25/2021|||ANTIBIOTICS: INHALED|1581|||||No|No||TEVA USA|No||||
penicillin V potassium|No|No|No|No|75%|00093412573|PENICILLIN VK 125 MG/5 ML SOLN|100|ML|.03134|12/07/2006||Yes|No||12/07/2006||Yes|No|12/07/2006||Yes|No||12/07/2006||Yes|No|||Prescription required|No||209|No|.07144|01/26/2021|.07042|01/26/2021|.06706|01/26/2021|||PENICILLINS|1582|||||No|No||TEVA USA|No||||
penicillin V potassium|No|No|No|No|75%|00093412574|PENICILLIN VK 125 MG/5 ML SOLN|200|ML|.02298|12/07/2006||Yes|No||12/07/2006||Yes|No|12/07/2006||Yes|No||12/07/2006||Yes|No|||Prescription required|No||209|No|.05238|09/24/2019|.05163|09/24/2019|.04917|09/24/2019|||PENICILLINS|1583|||||No|No||TEVA USA|No||||
penicillin V potassium|No|No|No|No|75%|00093412773|PENICILLIN VK 250 MG/5 ML SOLN|100|ML|.03517|12/07/2006||Yes|No||12/07/2006||Yes|No|12/07/2006||Yes|No||12/07/2006||Yes|No|||Prescription required|No||209|No|.05716|03/29/2022|.05578|03/29/2022|.05615|03/29/2022|||PENICILLINS|1584|||||No|No||TEVA USA|No||||
penicillin V potassium|No|No|No|No|75%|00093412774|PENICILLIN VK 250 MG/5 ML SOLN|200|ML|.02547|12/07/2006||Yes|No||12/07/2006||Yes|No|12/07/2006||Yes|No||12/07/2006||Yes|No|||Prescription required|No||209|No|.04862|03/29/2022|.04745|03/29/2022|.04776|03/29/2022|||PENICILLINS|1585|||||No|No||TEVA USA|No||||
cefdinir|No|No|No|No|75%|00093413664|CEFDINIR 125 MG/5 ML SUSP|60|ML|.27419|05/11/2007||Yes|No||05/11/2007||Yes|No|05/11/2007||Yes|No||||No|No|||Prescription required|No||046|No|.15822|03/29/2022|.15442|03/29/2022|.15545|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1586|||||No|No||TEVA USA|No||||
cefdinir|No|No|No|No|75%|00093413673|CEFDINIR 125 MG/5 ML SUSP|100|ML|.26053|05/12/2008||Yes|No||05/12/2008||Yes|No|05/12/2008||Yes|No||||No|No|||Prescription required|No||046|No|.11292|03/29/2022|.1102|03/29/2022|.11094|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1587|||||No|No||TEVA USA|No||||
cefdinir|No|No|No|No|75%|00093413764|CEFDINIR 250 MG/5 ML SUSP|60|ML|.5347|05/12/2008||Yes|No||05/12/2008||Yes|No|05/12/2008||Yes|No||||No|No|||Prescription required|No||046|No|.18029|03/29/2022|.17596|03/29/2022|.17713|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1588|||||No|No||TEVA USA|No||||
cefdinir|No|No|No|No|75%|00093413773|CEFDINIR 250 MG/5 ML SUSP|100|ML|.50813|05/11/2007||Yes|No||05/11/2007||Yes|No|05/11/2007||Yes|No||||No|No|||Prescription required|No||046|No|.18689|03/29/2022|.1824|03/29/2022|.18361|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1589|||||No|No||TEVA USA|No||||
levalbuterol HCl|No|No|No|No|75%|00093414556|LEVALBUTEROL 0.31 MG/3 ML SOL|3|ML|.76888|01/18/2019||Yes|No||01/18/2019||Yes|No|01/18/2019||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|.33735|03/01/2022|.32925|03/01/2022|.33144|03/01/2022|||BRONCHODILATORS: BETA AGONIST|1590|||||No|No||TEVA USA|No||||
levalbuterol HCl|No|No|No|No|75%|00093414656|LEVALBUTEROL 0.63 MG/3 ML SOL|3|ML|.76888|03/07/2019||Yes|No||03/07/2019||Yes|No|03/07/2019||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|.37606|03/29/2022|.36703|03/29/2022|.36947|03/29/2022|||BRONCHODILATORS: BETA AGONIST|1591|||||No|No||TEVA USA|No||||
levalbuterol HCl|No|No|No|No|75%|00093414756|LEVALBUTEROL CONC 1.25 MG/0.5|1|EA|2.3048|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|5.2528|03/29/2022|5.17776|03/29/2022|4.9312|03/29/2022|||BRONCHODILATORS: BETA AGONIST|1592|||||No|No||TEVA USA|No||||
levalbuterol HCl|No|No|No|No|75%|00093414856|LEVALBUTEROL 1.25 MG/3 ML SOL|3|ML|.76888|01/18/2019||Yes|No||01/18/2019||Yes|No|01/18/2019||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|.33214|03/29/2022|.32416|03/29/2022|.32632|03/29/2022|||BRONCHODILATORS: BETA AGONIST|1593|||||No|No||TEVA USA|No||||
amoxicillin|No|No|No|No|75%|00093415573|AMOXICILLIN 250 MG/5 ML SUSP|100|ML|.01599|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||209|No|.01967|03/29/2022|.01919|03/29/2022|.01932|03/29/2022|||PENICILLINS|1594|||||No|No||TEVA USA|No||||
amoxicillin|No|No|No|No|75%|00093415579|AMOXICILLIN 250 MG/5 ML SUSP|80|ML|.01741|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||209|No|.02476|03/29/2022|.02416|03/29/2022|.02432|03/29/2022|||PENICILLINS|1595|||||No|No||TEVA USA|No||||
amoxicillin|No|No|No|No|75%|00093415580|AMOXICILLIN 250 MG/5 ML SUSP|150|ML|.01498|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||209|No|.01799|03/29/2022|.01755|03/29/2022|.01767|03/29/2022|||PENICILLINS|1596|||||No|No||TEVA USA|No||||
amoxicillin|No|No|No|No|75%|00093416073|AMOXICILLIN 200 MG/5 ML SUSP|100|ML|.03134|04/18/2006||Yes|No||04/18/2006||Yes|No|04/18/2006||Yes|No||04/18/2006||Yes|No|||Prescription required|No||209|No|.03312|03/29/2022|.03232|03/29/2022|.03254|03/29/2022|||PENICILLINS|1597|||||No|No||TEVA USA|No||||
amoxicillin|No|No|No|No|75%|00093416076|AMOXICILLIN 200 MG/5 ML SUSP|50|ML|.0313|04/18/2006||Yes|No||04/18/2006||Yes|No|04/18/2006||Yes|No||04/18/2006||Yes|No|||Prescription required|No||209|No|.02949|11/23/2021|.02878|11/23/2021|.02897|11/23/2021|||PENICILLINS|1598|||||No|No||TEVA USA|No||||
amoxicillin|No|No|No|No|75%|00093416078|AMOXICILLIN 200 MG/5 ML SUSP|75|ML|.0321|04/18/2006||Yes|No||04/18/2006||Yes|No|04/18/2006||Yes|No||04/18/2006||Yes|No|||Prescription required|No||209|No|.032|01/25/2022|.03123|01/25/2022|.03144|01/25/2022|||PENICILLINS|1599|||||No|No||TEVA USA|No||||
amoxicillin|No|No|No|No|75%|00093416173|AMOXICILLIN 400 MG/5 ML SUSP|100|ML|.03375|04/18/2006||Yes|No||04/18/2006||Yes|No|04/18/2006||Yes|No||04/18/2006||Yes|No|||Prescription required|No||209|No|.02289|03/29/2022|.02234|03/29/2022|.02248|03/29/2022|||PENICILLINS|1600|||||No|No||TEVA USA|No||||
amoxicillin|No|No|No|No|75%|00093416176|AMOXICILLIN 400 MG/5 ML SUSP|50|ML|.03379|04/18/2006||Yes|No||04/18/2006||Yes|No|04/18/2006||Yes|No||04/18/2006||Yes|No|||Prescription required|No||209|No|.03376|03/29/2022|.03294|03/29/2022|.03316|03/29/2022|||PENICILLINS|1601|||||No|No||TEVA USA|No||||
amoxicillin|No|No|No|No|75%|00093416178|AMOXICILLIN 400 MG/5 ML SUSP|75|ML|.03302|04/18/2006||Yes|No||04/18/2006||Yes|No|04/18/2006||Yes|No||04/18/2006||Yes|No|||Prescription required|No||209|No|.02457|03/29/2022|.02398|03/29/2022|.02414|03/29/2022|||PENICILLINS|1602|||||No|No||TEVA USA|No||||
cephalexin|No|No|No|No|75%|00093417573|CEPHALEXIN 125 MG/5 ML SUSP|100|ML|.0817|04/18/2006||Yes|No||04/18/2006||Yes|No|04/18/2006||Yes|No||04/18/2006||Yes|No|||Prescription required|No||046|No|.0819|03/29/2022|.07993|03/29/2022|.08046|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1603|||||No|No||TEVA USA|No||||
cephalexin|No|No|No|No|75%|00093417574|CEPHALEXIN 125 MG/5 ML SUSP|200|ML|.0688|04/18/2006||Yes|No||04/18/2006||Yes|No|04/18/2006||Yes|No||04/18/2006||Yes|No|||Prescription required|No||046|No|.0415|10/26/2021|.0405|10/26/2021|.04077|10/26/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1604|||||No|No||TEVA USA|No||||
cephalexin|No|No|No|No|75%|00093417773|CEPHALEXIN 250 MG/5 ML SUSP|100|ML|.0989|04/18/2006||Yes|No||04/18/2006||Yes|No|04/18/2006||Yes|No||04/18/2006||Yes|No|||Prescription required|No||046|No|.09997|03/29/2022|.09757|03/29/2022|.09822|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1605|||||No|No||TEVA USA|No||||
cephalexin|No|No|No|No|75%|00093417774|CEPHALEXIN 250 MG/5 ML SUSP|200|ML|.08815|04/18/2006||Yes|No||04/18/2006||Yes|No|04/18/2006||Yes|No||04/18/2006||Yes|No|||Prescription required|No||046|No|.07683|03/29/2022|.07498|03/29/2022|.07548|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1606|||||No|No||TEVA USA|No||||
clozapine|No|No|No|No|75%|00093435901|CLOZAPINE 25 MG TABLET|100|EA|.38265|03/03/2011||Yes|No||03/03/2011||Yes|No|03/03/2011||Yes|No||||No|No|||Prescription required|No||027|Yes|.26318|03/29/2022|.25686|03/29/2022|.25857|03/29/2022|||ANTIPSYCHOTICS|1607|||||No|No||TEVA USA|No||||
clozapine|No|No|No|No|75%|00093435905|CLOZAPINE 25 MG TABLET|500|EA|.37117|02/08/2008||Yes|No||02/08/2008||Yes|No|02/08/2008||Yes|No||||No|No|||Prescription required|No||027|Yes|.26318|03/29/2022|.25686|03/29/2022|.25857|03/29/2022|||ANTIPSYCHOTICS|1608|||||No|No||TEVA USA|No||||
clozapine|No|No|No|No|75%|00093435993|CLOZAPINE 25 MG TABLET|100|EA|.28057|01/14/2008||Yes|No||01/14/2008||Yes|No|01/14/2008||Yes|No||||No|No|||Prescription required|No||027|Yes|.26318|03/29/2022|.25686|03/29/2022|.25857|03/29/2022|||ANTIPSYCHOTICS|1609|||||No|No||TEVA USA|No||||
clozapine|No|No|No|No|75%|00093440401|CLOZAPINE 50 MG TABLET|100|EA|.5676|04/10/2007||Yes|No||04/10/2007||Yes|No|04/10/2007||Yes|No||||No|No|||Prescription required|No||027|Yes|.51896|03/29/2022|.5065|03/29/2022|.50987|03/29/2022|||ANTIPSYCHOTICS|1610|||||No|No||TEVA USA|No||||
clozapine|No|No|No|No|75%|00093440405|CLOZAPINE 50 MG TABLET|500|EA|.5676|04/10/2007||Yes|No||04/10/2007||Yes|No|04/10/2007||Yes|No||||No|No|||Prescription required|No||027|Yes|.51896|03/29/2022|.5065|03/29/2022|.50987|03/29/2022|||ANTIPSYCHOTICS|1611|||||No|No||TEVA USA|No||||
clozapine|No|No|No|No|75%|00093440505|CLOZAPINE 200 MG TABLET|500|EA|1.82989|06/05/2007||Yes|No||06/05/2007||Yes|No|06/05/2007||Yes|No||||No|No|||Prescription required|No||027|Yes|1.46893|03/29/2022|1.43367|03/29/2022|1.44322|03/29/2022|||ANTIPSYCHOTICS|1612|||||No|No||TEVA USA|No||||
clozapine|No|No|No|No|75%|00093440593|CLOZAPINE 200 MG TABLET|100|EA|1.4233|08/23/2007||Yes|No||08/23/2007||Yes|No|08/23/2007||Yes|No||||No|No|||Prescription required|No||027|Yes|1.46893|03/29/2022|1.43367|03/29/2022|1.44322|03/29/2022|||ANTIPSYCHOTICS|1613|||||No|No||TEVA USA|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|00093500256|OLMSRTN-AMLDPN-HCTZ 40-10-25MG|30|EA|1.67843|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.46963|03/29/2022|1.43435|03/29/2022|1.44391|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|1614|||||No|No||TEVA USA|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|00093500356|OLMSRTN-AMLDPN-HCTZ 40-10-12.5|30|EA|1.67843|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.55605|03/29/2022|1.5187|03/29/2022|1.52881|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|1615|||||No|No||TEVA USA|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|00093500456|OLMSRTN-AMLDPN-HCTZ 40-5-25 MG|30|EA|1.67843|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.32536|03/29/2022|1.29355|03/29/2022|1.30216|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|1616|||||No|No||TEVA USA|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|00093500556|OLMSRTN-AMLDPN-HCTZ 20-5-12.5|30|EA|1.3287|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.26872|03/29/2022|1.23827|03/29/2022|1.24651|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|1617|||||No|No||TEVA USA|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|00093500656|OLMSRTN-AMLDPN-HCTZ 40-5-12.5|30|EA|1.67843|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.52605|03/29/2022|1.48942|03/29/2022|1.49934|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|1618|||||No|No||TEVA USA|No||||
tiagabine HCl|No|No|No|No|75%|00093503056|TIAGABINE HCL 2 MG TABLET|30|EA|2.72949|08/16/2016||Yes|No||08/16/2016||Yes|No|08/16/2016||Yes|No||||No|No|||Prescription required|No||056|No|6.2207|06/29/2021|6.13183|06/29/2021|5.83984|06/29/2021|||ANTICONVULSANTS|1619|||||No|No||TEVA USA|No||||
tiagabine HCl|No|No|No|No|75%|00093503156|TIAGABINE HCL 4 MG TABLET|30|EA|2.72949|11/06/2017||Yes|No||11/06/2017||Yes|No|11/06/2017||Yes|No||||No|No|||Prescription required|No||056|No|3.73471|03/29/2022|3.64507|03/29/2022|3.66935|03/29/2022|||ANTICONVULSANTS|1620|||||No|No||TEVA USA|No||||
disulfiram|No|No|No|No|75%|00093503501|DISULFIRAM 250 MG TABLET|100|EA|1.40343|05/06/2011||Yes|No||05/06/2011||Yes|No|05/06/2011||Yes|No||||No|No|||Prescription required|No|||No|3.19852|12/14/2021|3.15283|12/14/2021|3.00269|12/14/2021||||1621|||||No|No||TEVA USA|Yes|09/01/2020|||
disulfiram|No|No|No|No|75%|00093503601|DISULFIRAM 500 MG TABLET|100|EA|2.24541|08/02/2011||Yes|No||08/02/2011||Yes|No|08/02/2011||Yes|No||||No|No|||Prescription required|No|||No|5.11746|08/29/2017|5.04435|08/29/2017|4.80414|08/29/2017||||1622|||||No|No||TEVA USA|Yes|09/01/2020|||
dexmethylphenidate HCl|No|No|No|No|75%|00093504501|DEXMETHYLPHENIDATE ER 25 MG CP|100|EA|3.35232|12/19/2017||Yes|No||12/19/2017||Yes|No|12/19/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.83308|03/29/2022|1.78908|03/29/2022|1.801|03/29/2022|||STIMULANTS AND RELATED AGENTS|1623|||||No|No||TEVA USA|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00093504601|DEXMETHYLPHENIDATE ER 35 MG CP|100|EA|3.52006|12/19/2017||Yes|No||12/19/2017||Yes|No|12/19/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|2.40563|01/25/2022|2.34789|01/25/2022|2.36353|01/25/2022|||STIMULANTS AND RELATED AGENTS|1624|||||No|No||TEVA USA|No||||
atorvastatin calcium|No|No|No|No|75%|00093505698|ATORVASTATIN 10 MG TABLET|90|EA|.05479|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||09/07/2017||Yes|No|||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|1625|||||No|No||TEVA USA|No||||
atorvastatin calcium|No|No|No|No|75%|00093505798|ATORVASTATIN 80 MG TABLET|90|EA|.0782|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||09/07/2017||Yes|No|||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|1626|||||No|No||TEVA USA|No||||
atorvastatin calcium|No|No|No|No|75%|00093505898|ATORVASTATIN 40 MG TABLET|90|EA|.0782|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||09/07/2017||Yes|No|||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|1627|||||No|No||TEVA USA|No||||
atorvastatin calcium|No|No|No|No|75%|00093505998|ATORVASTATIN 20 MG TABLET|90|EA|.0782|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||09/07/2017||Yes|No|||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|1628|||||No|No||TEVA USA|No||||
hydroxyzine HCl|No|No|No|No|75%|00093506001|HYDROXYZINE HCL 10 MG TABLET|100|EA|.0731|10/14/2013||Yes|No||10/14/2013||Yes|No|10/14/2013||Yes|No||10/14/2013||Yes|No|||Prescription required|No||574|Yes|.03952|03/29/2022|.03857|03/29/2022|.03882|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|1629|||||No|No||TEVA USA|No||||
hydroxyzine HCl|No|No|No|No|75%|00093506005|HYDROXYZINE HCL 10 MG TABLET|500|EA|.06708|05/24/2013||Yes|No||05/24/2013||Yes|No|05/24/2013||Yes|No||05/24/2013||Yes|No|||Prescription required|No||574|Yes|.03952|03/29/2022|.03857|03/29/2022|.03882|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|1630|||||No|No||TEVA USA|No||||
hydroxyzine HCl|No|No|No|No|75%|00093506101|HYDROXYZINE HCL 25 MG TABLET|100|EA|.17393|02/28/2013||Yes|No||02/28/2013||Yes|No|02/28/2013||Yes|No||02/28/2013||Yes|No|||Prescription required|No||574|Yes|.06757|03/29/2022|.06594|03/29/2022|.06638|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|1631|||||No|No||TEVA USA|No||||
hydroxyzine HCl|No|No|No|No|75%|00093506105|HYDROXYZINE HCL 25 MG TABLET|500|EA|.16967|02/28/2013||Yes|No||02/28/2013||Yes|No|02/28/2013||Yes|No||02/28/2013||Yes|No|||Prescription required|No||574|Yes|.06757|03/29/2022|.06594|03/29/2022|.06638|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|1632|||||No|No||TEVA USA|No||||
hydroxyzine HCl|No|No|No|No|75%|00093506110|HYDROXYZINE HCL 25 MG TABLET|1000|EA|.16544|02/28/2013||Yes|No||02/28/2013||Yes|No|02/28/2013||Yes|No||02/28/2013||Yes|No|||Prescription required|No||574|Yes|.06757|03/29/2022|.06594|03/29/2022|.06638|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|1633|||||No|No||TEVA USA|No||||
hydroxyzine HCl|No|No|No|No|75%|00093506201|HYDROXYZINE HCL 50 MG TABLET|100|EA|.1333|05/24/2013||Yes|No||05/24/2013||Yes|No|05/24/2013||Yes|No||05/24/2013||Yes|No|||Prescription required|No||574|Yes|.09594|03/29/2022|.09363|03/29/2022|.09426|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|1634|||||No|No||TEVA USA|No||||
hydroxyzine HCl|No|No|No|No|75%|00093506205|HYDROXYZINE HCL 50 MG TABLET|500|EA|.20695|02/28/2013||Yes|No||02/28/2013||Yes|No|02/28/2013||Yes|No||02/28/2013||Yes|No|||Prescription required|No||574|Yes|.09594|03/29/2022|.09363|03/29/2022|.09426|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|1635|||||No|No||TEVA USA|No||||
moexipril HCl|No|No|No|No|75%|00093515001|MOEXIPRIL HCL 15 MG TABLET|100|EA|.40678|04/21/2009||Yes|No||04/21/2009||Yes|No|04/21/2009||Yes|No||04/21/2009||Yes|No|||Prescription required|Yes|03/23/2007|113|No|.79767|03/29/2022|.77852|03/29/2022|.78371|03/29/2022|||ANGIOTENSIN MODULATORS|1636|||||No|No||TEVA USA|No||||
buspirone HCl|No|No|No|No|75%|00093520005|BUSPIRONE HCL 30 MG TABLET|500|EA|.81264|03/30/2004||Yes|No||03/30/2004||Yes|No|03/30/2004||Yes|No||||No|No|||Prescription required|No||090|No|.17728|03/29/2022|.17302|03/29/2022|.17417|03/29/2022|||ANXIOLYTICS|1637|||||No|No||TEVA USA|No||||
buspirone HCl|No|No|No|No|75%|00093520006|BUSPIRONE HCL 30 MG TABLET|60|EA|.81262|03/30/2004||Yes|No||03/30/2004||Yes|No|03/30/2004||Yes|No||||No|No|||Prescription required|No||090|No|.17728|03/29/2022|.17302|03/29/2022|.17417|03/29/2022|||ANXIOLYTICS|1638|||||No|No||TEVA USA|No||||
efavirenz/emtricit/tenofovr df|No|No|No|No|75%|00093523456|EFAVIR-EMTRI-TENOF 600-200-300|30|EA|4.8|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|4.79678|12/28/2021|4.68165|12/28/2021|4.71283|12/28/2021|||HIV / AIDS|1639|||||No|No||TEVA USA|No||||
olanzapine|No|No|No|No|75%|00093524565|OLANZAPINE ODT 5 MG TABLET|30|EA|.76769|03/08/2012||Yes|No||03/08/2012||Yes|No|03/08/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.59218|03/29/2022|.57796|03/29/2022|.58181|03/29/2022|||ANTIPSYCHOTICS|1640|||||No|No||TEVA USA|No||||
olanzapine|No|No|No|No|75%|00093524665|OLANZAPINE ODT 10 MG TABLET|30|EA|1.12774|03/08/2012||Yes|No||03/08/2012||Yes|No|03/08/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.58062|03/29/2022|.56668|03/29/2022|.57045|03/29/2022|||ANTIPSYCHOTICS|1641|||||No|No||TEVA USA|No||||
olanzapine|No|No|No|No|75%|00093524765|OLANZAPINE ODT 15 MG TABLET|30|EA|1.66295|03/08/2012||Yes|No||03/08/2012||Yes|No|03/08/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.85386|03/29/2022|.83336|03/29/2022|.83891|03/29/2022|||ANTIPSYCHOTICS|1642|||||No|No||TEVA USA|No||||
olanzapine|No|No|No|No|75%|00093524865|OLANZAPINE ODT 20 MG TABLET|30|EA|2.19816|03/08/2012||Yes|No||03/08/2012||Yes|No|03/08/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|1.09|03/29/2022|1.06384|03/29/2022|1.07092|03/29/2022|||ANTIPSYCHOTICS|1643|||||No|No||TEVA USA|No||||
almotriptan malate|No|No|No|No|75%|00093526018|ALMOTRIPTAN MALATE 6.25 MG TAB|6|EA|14.43366|08/17/2015||Yes|No||08/17/2015||Yes|No|08/17/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|021|No|32.89532|11/28/2017|32.42539|11/28/2017|30.88132|11/28/2017|||ANTIMIGRAINE AGENTS: TRIPTANS|1644|||||No|No||TEVA USA|No||||
almotriptan malate|No|No|No|No|75%|00093526129|ALMOTRIPTAN MALATE 12.5 MG TAB|12|EA|14.43617|08/17/2015||Yes|No||08/17/2015||Yes|No|08/17/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|021|No|22.10833|03/29/2022|21.57773|03/29/2022|21.72143|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|1645|||||No|No||TEVA USA|No||||
fluoxetine HCl|No|No|No|No|75%|00093526256|FLUOXETINE HCL 60 MG TABLET|30|EA|.64041|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|008|No|1.06507|03/29/2022|1.0395|03/29/2022|1.04643|03/29/2022|||ANTIDEPRESSANTS: SSRIs|1646|||||No|No||TEVA USA|No||||
solifenacin succinate|No|No|No|No|75%|00093526356|SOLIFENACIN 5 MG TABLET|30|EA|.23506|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|Yes|.23024|03/29/2022|.22471|03/29/2022|.22621|03/29/2022|||BLADDER RELAXANT PREPARATIONS|1647|||||No|No||TEVA USA|No||||
solifenacin succinate|No|No|No|No|75%|00093526456|SOLIFENACIN 10 MG TABLET|30|EA|.23506|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|No|.26101|03/29/2022|.25474|03/29/2022|.25644|03/29/2022|||BLADDER RELAXANT PREPARATIONS|1648|||||No|No||TEVA USA|No||||
methylphenidate HCl|No|No|No|No|75%|00093529201|METHYLPHENIDATE CD 50 MG CAP|100|EA|1.6521|01/31/2017||Yes|No||01/31/2017||Yes|No|01/31/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|007|Yes|2.6246|01/25/2022|2.5616|01/25/2022|2.57866|01/25/2022|||STIMULANTS AND RELATED AGENTS|1649|||||No|No||TEVA USA|No||||
methylphenidate HCl|No|No|No|No|75%|00093529301|METHYLPHENIDATE CD 60 MG CAP|100|EA|1.6521|01/31/2017||Yes|No||01/31/2017||Yes|No|01/31/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|007|Yes|1.91295|03/08/2022|1.86703|03/08/2022|1.87947|03/08/2022|||STIMULANTS AND RELATED AGENTS|1650|||||No|No||TEVA USA|No||||
methylphenidate HCl|No|No|No|No|75%|00093529501|METHYLPHENIDATE CD 10 MG CAP|100|EA|1.2221|10/22/2012||Yes|No||10/22/2012||Yes|No|10/22/2012||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|007|Yes|1.31759|03/29/2022|1.28596|03/29/2022|1.29453|03/29/2022|||STIMULANTS AND RELATED AGENTS|1651|||||No|No||TEVA USA|No||||
methylphenidate HCl|No|No|No|No|75%|00093529601|METHYLPHENIDATE CD 20 MG CAP|100|EA|1.2221|10/22/2012||Yes|No||10/22/2012||Yes|No|10/22/2012||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|007|Yes|1.42341|03/29/2022|1.38924|03/29/2022|1.3985|03/29/2022|||STIMULANTS AND RELATED AGENTS|1652|||||No|No||TEVA USA|No||||
methylphenidate HCl|No|No|No|No|75%|00093529701|METHYLPHENIDATE CD 30 MG CAP|100|EA|1.2221|10/22/2012||Yes|No||10/22/2012||Yes|No|10/22/2012||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|007|Yes|1.42159|03/29/2022|1.38747|03/29/2022|1.39671|03/29/2022|||STIMULANTS AND RELATED AGENTS|1653|||||No|No||TEVA USA|No||||
methylphenidate HCl|No|No|No|No|75%|00093529801|METHYLPHENIDATE CD 40 MG CAP|100|EA|1.61589|01/31/2017||Yes|No||01/31/2017||Yes|No|01/31/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|007|Yes|1.70323|03/29/2022|1.66235|03/29/2022|1.67342|03/29/2022|||STIMULANTS AND RELATED AGENTS|1654|||||No|No||TEVA USA|No||||
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|00093532862|JUNEL FE 24 TABLET|28|EA|.82503|02/10/2017||Yes|No||02/10/2017||Yes|No|02/10/2017||Yes|No|Refer to program requirements|||No|No|02/10/2017||Prescription required|No|||No|.56858|03/29/2022|.55493|03/29/2022|.55862|03/29/2022||||1655|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
methylphenidate HCl|No|No|No|No|75%|00093534601|METHYLPHENIDATE LA 20 MG CAP|100|EA|1.6988|07/27/2012||Yes|No||07/27/2012||Yes|No|07/27/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.22563|03/29/2022|1.19621|03/29/2022|1.20418|03/29/2022|||STIMULANTS AND RELATED AGENTS|1656|||||No|No||TEVA USA|No||||
methylphenidate HCl|No|No|No|No|75%|00093534701|METHYLPHENIDATE LA 30 MG CAP|100|EA|1.73745|07/27/2012||Yes|No||07/27/2012||Yes|No|07/27/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.80098|03/29/2022|1.75775|03/29/2022|1.76946|03/29/2022|||STIMULANTS AND RELATED AGENTS|1657|||||No|No||TEVA USA|No||||
methylphenidate HCl|No|No|No|No|75%|00093534801|METHYLPHENIDATE LA 40 MG CAP|100|EA|1.78574|07/27/2012||Yes|No||07/27/2012||Yes|No|07/27/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.62914|03/29/2022|1.59004|03/29/2022|1.60063|03/29/2022|||STIMULANTS AND RELATED AGENTS|1658|||||No|No||TEVA USA|No||||
acamprosate calcium|No|No|No|No|75%|00093535286|ACAMPROSATE CALC DR 333 MG TAB|180|EA|.60441|06/24/2016||Yes|No||06/24/2016||Yes|No|06/24/2016||Yes|No||||No|No|||Prescription required|No|||No|.6071|03/29/2022|.59252|03/29/2022|.59647|03/29/2022||||1659|||||No|No||TEVA USA|Yes|09/01/2020|||
clozapine|No|No|No|No|75%|00093537601|CLOZAPINE ODT 150 MG TABLET|100|EA|7.42317|02/09/2021||Yes|No||02/09/2021||Yes|No|02/09/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|027|Yes|16.91793|02/09/2021|16.67625|02/09/2021|15.88214|02/09/2021|||ANTIPSYCHOTICS|1660|||||No|No||TEVA USA|No||||
clozapine|No|No|No|No|75%|00093537701|CLOZAPINE ODT 200 MG TABLET|100|EA|9.89761|02/09/2021||Yes|No||02/09/2021||Yes|No|02/09/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|027|Yes|22.55734|02/09/2021|22.23509|02/09/2021|21.17628|02/09/2021|||ANTIPSYCHOTICS|1661|||||No|No||TEVA USA|No||||
clozapine|No|No|No|No|75%|00093541601|CLOZAPINE ODT 12.5 MG TABLET|100|EA|.76626|11/09/2018||Yes|No||11/09/2018||Yes|No|11/09/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|1.74636|11/09/2018|1.72141|11/09/2018|1.63944|11/09/2018|||ANTIPSYCHOTICS|1662|||||No|No||TEVA USA|No||||
clozapine|No|No|No|No|75%|00093541701|CLOZAPINE ODT 25 MG TABLET|100|EA|1.03096|11/14/2017||Yes|No||11/14/2017||Yes|No|11/14/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|027|Yes|2.34964|11/14/2017|2.31608|11/14/2017|2.20579|11/14/2017|||ANTIPSYCHOTICS|1663|||||No|No||TEVA USA|No||||
clozapine|No|No|No|No|75%|00093541784|CLOZAPINE ODT 25 MG TABLET|48|EA|1.03119|11/14/2017||Yes|No||11/14/2017||Yes|No|11/14/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|027|Yes|2.35015|11/14/2017|2.31658|11/14/2017|2.20627|11/14/2017|||ANTIPSYCHOTICS|1664|||||No|No||TEVA USA|No||||
clozapine|No|No|No|No|75%|00093541901|CLOZAPINE ODT 100 MG TABLET|100|EA|2.81207|11/14/2017||Yes|No||11/14/2017||Yes|No|11/14/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|027|Yes|6.4089|03/29/2022|6.31735|03/29/2022|6.01652|03/29/2022|||ANTIPSYCHOTICS|1665|||||No|No||TEVA USA|No||||
clozapine|No|No|No|No|75%|00093541984|CLOZAPINE ODT 100 MG TABLET|48|EA|2.8122|11/14/2017||Yes|No||11/14/2017||Yes|No|11/14/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|027|Yes|6.4092|03/29/2022|6.31764|03/29/2022|6.0168|03/29/2022|||ANTIPSYCHOTICS|1666|||||No|No||TEVA USA|No||||
cabergoline|No|No|No|No|75%|00093542088|CABERGOLINE 0.5 MG TABLET|8|EA|6.9875|03/16/2007||Yes|No||03/16/2007||Yes|No|03/16/2007||Yes|No||||No|No|||Prescription required|No|||No|2.46183|03/29/2022|2.40274|03/29/2022|2.41874|03/29/2022||||1667|||||No|No||TEVA USA|No||||
ethinyl estradiol/drospirenone|Yes|Yes|No|No|75%|00093542362|GIANVI 3 MG-0.02 MG TABLET|28|EA|.86998|02/21/2017|03/02/2022|Yes|No||02/21/2017|03/02/2022|Yes|No|02/21/2017|03/02/2022|Yes|No|Refer to program requirements|||No|No|02/21/2017|03/02/2022|Prescription required|No|||No|.36582|03/29/2022|.35704|03/29/2022|.35941|03/29/2022||||1668|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
estradiol/norethindrone acet|No|No|No|No|75%|00093545528|MIMVEY 1-0.5 MG TABLET|28|EA|1.75117|06/18/2010||Yes|No||06/18/2010||Yes|No|06/18/2010||Yes|No||||No|No|||Prescription required|No|||Yes|1.11831|03/29/2022|1.09147|03/29/2022|1.09873|03/29/2022||||1669|||||No|No||TEVA USA|No||||
estradiol/norethindrone acet|No|No|No|No|75%|00093545542|MIMVEY 1-0.5 MG TABLET|28|EA|1.75117|06/18/2010||Yes|No||06/18/2010||Yes|No|06/18/2010||Yes|No||||No|No|||Prescription required|No|||Yes|1.11831|03/29/2022|1.09147|03/29/2022|1.09873|03/29/2022||||1670|||||No|No||TEVA USA|No||||
olanzapine/fluoxetine HCl|No|No|No|No|75%|00093550356|OLANZAPINE-FLUOXETINE 3-25 MG|30|EA|3.41635|12/06/2013||Yes|No||12/06/2013||Yes|No|12/06/2013||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|027|Yes|5.27433|03/29/2022|5.14774|03/29/2022|5.18202|03/29/2022|||ANTIPSYCHOTICS|1671|||||No|No||TEVA USA|No||||
olanzapine/fluoxetine HCl|No|No|No|No|75%|00093550456|OLANZAPINE-FLUOXETINE 6-25 MG|30|EA|4.98198|07/13/2012||Yes|No||07/13/2012||Yes|No|07/13/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|027|Yes|5.76547|03/29/2022|5.62709|03/29/2022|5.66457|03/29/2022|||ANTIPSYCHOTICS|1672|||||No|No||TEVA USA|No||||
olanzapine/fluoxetine HCl|No|No|No|No|75%|00093550556|OLANZAPINE-FLUOXETINE 6-50 MG|30|EA|4.98198|07/13/2012||Yes|No||07/13/2012||Yes|No|07/13/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|027|Yes|5.947|01/25/2022|5.80427|01/25/2022|5.84292|01/25/2022|||ANTIPSYCHOTICS|1673|||||No|No||TEVA USA|No||||
olanzapine/fluoxetine HCl|No|No|No|No|75%|00093550656|OLANZAPINE-FLUOXETINE 12-25 MG|30|EA|7.50837|07/13/2012||Yes|No||07/13/2012||Yes|No|07/13/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|027|Yes|17.1121|12/24/2019|16.86764|12/24/2019|16.06442|12/24/2019|||ANTIPSYCHOTICS|1674|||||No|No||TEVA USA|No||||
olanzapine/fluoxetine HCl|No|No|No|No|75%|00093550756|OLANZAPINE-FLUOXETINE 12-50 MG|30|EA|7.50837|07/13/2012||Yes|No||07/13/2012||Yes|No|07/13/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|027|Yes|17.1121|06/25/2019|16.86764|06/25/2019|16.06442|06/25/2019|||ANTIPSYCHOTICS|1675|||||No|No||TEVA USA|No||||
sildenafil citrate|No|No|No|No|75%|00093551798|SILDENAFIL 20 MG TABLET|90|EA|.3792|07/18/2013||Yes|No||07/18/2013||Yes|No|07/18/2013||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|Yes|.09246|03/29/2022|.09024|03/29/2022|.09084|03/29/2022|||PAH AGENTS: ORAL AND INHALED|1676|||||No|No||TEVA USA|No||||
atazanavir sulfate|No|No|No|No|75%|00093552606|ATAZANAVIR SULFATE 150 MG CAP|60|EA|3.16059|03/22/2018||Yes|No||03/22/2018||Yes|No|03/22/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|5.1623|03/02/2021|5.08855|03/02/2021|4.84624|03/02/2021|||HIV / AIDS|1677|||||No|No||TEVA USA|No||||
atazanavir sulfate|No|No|No|No|75%|00093552706|ATAZANAVIR SULFATE 200 MG CAP|60|EA|3.16059|03/22/2018||Yes|No||03/22/2018||Yes|No|03/22/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|5.1623|03/02/2021|5.08855|03/02/2021|4.84624|03/02/2021|||HIV / AIDS|1678|||||No|No||TEVA USA|No||||
atazanavir sulfate|No|No|No|No|75%|00093552856|ATAZANAVIR SULFATE 300 MG CAP|30|EA|6.32119|03/22/2018||Yes|No||03/22/2018||Yes|No|03/22/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|5.91006|05/25/2021|5.76821|05/25/2021|5.80663|05/25/2021|||HIV / AIDS|1679|||||No|No||TEVA USA|No||||
eszopiclone|No|No|No|No|90%|00093553756|ESZOPICLONE 1 MG TABLET|30|EA|.30243|05/05/2014||Yes|No||05/05/2014||Yes|No|05/05/2014||Yes|No||||No|No|||Prescription required|No||054|Yes|.19753|03/29/2022|.19278|03/29/2022|.19407|03/29/2022|||SEDATIVE HYPNOTICS|1680|||||No|No||TEVA USA|No||||
eszopiclone|No|No|No|No|90%|00093553801|ESZOPICLONE 2 MG TABLET|100|EA|.30229|05/05/2014||Yes|No||05/05/2014||Yes|No|05/05/2014||Yes|No||||No|No|||Prescription required|No||054|Yes|.25375|03/29/2022|.24766|03/29/2022|.2493|03/29/2022|||SEDATIVE HYPNOTICS|1681|||||No|No||TEVA USA|No||||
eszopiclone|No|No|No|No|90%|00093553901|ESZOPICLONE 3 MG TABLET|100|EA|.30229|05/05/2014||Yes|No||05/05/2014||Yes|No|05/05/2014||Yes|No||||No|No|||Prescription required|No||054|Yes|.14316|03/29/2022|.13972|03/29/2022|.14065|03/29/2022|||SEDATIVE HYPNOTICS|1682|||||No|No||TEVA USA|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00093555001|DEXMETHYLPHENIDATE ER 5 MG CAP|100|EA|2.68474|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.46405|03/29/2022|1.42891|03/29/2022|1.43842|03/29/2022|||STIMULANTS AND RELATED AGENTS|1683|||||No|No||TEVA USA|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00093555101|DEXMETHYLPHENIDATE ER 10 MG CP|100|EA|3.12936|02/27/2015||Yes|No||02/27/2015||Yes|No|02/27/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.21716|03/29/2022|1.18794|03/29/2022|1.19585|03/29/2022|||STIMULANTS AND RELATED AGENTS|1684|||||No|No||TEVA USA|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00093555201|DEXMETHYLPHENIDATE ER 15 MG CP|100|EA|2.38929|09/29/2014||Yes|No||09/29/2014||Yes|No|09/29/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.90155|03/29/2022|.87991|03/29/2022|.88577|03/29/2022|||STIMULANTS AND RELATED AGENTS|1685|||||No|No||TEVA USA|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00093555301|DEXMETHYLPHENIDATE ER 20 MG CP|100|EA|3.2182|07/31/2015||Yes|No||07/31/2015||Yes|No|07/31/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.47249|03/29/2022|1.43715|03/29/2022|1.44672|03/29/2022|||STIMULANTS AND RELATED AGENTS|1686|||||No|No||TEVA USA|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00093555401|DEXMETHYLPHENIDATE ER 30 MG CP|100|EA|2.3017|10/01/2014||Yes|No||10/01/2014||Yes|No|10/01/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|2.05596|03/29/2022|2.00661|03/29/2022|2.01998|03/29/2022|||STIMULANTS AND RELATED AGENTS|1687|||||No|No||TEVA USA|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00093556201|DEXMETHYLPHENIDATE ER 40 MG CP|100|EA|2.80996|04/15/2014||Yes|No||04/15/2014||Yes|No|04/15/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|2.72731|03/29/2022|2.66185|03/29/2022|2.67958|03/29/2022|||STIMULANTS AND RELATED AGENTS|1688|||||No|No||TEVA USA|No||||
erythromycin base|No|No|No|No|75%|00093557101|ERYTHROMYCIN 250 MG FILMTAB|100|EA|2.84423|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||08/30/2021||Yes|No|||Prescription required|Yes|01/28/2021|018|No|7.84358|03/29/2022|7.65533|03/29/2022|7.70631|03/29/2022|||MACROLIDES/KETOLIDES|1689|||||No|No||TEVA USA|No||||
erythromycin base|No|No|No|No|75%|00093557156|ERYTHROMYCIN 250 MG FILMTAB|30|EA|2.8443|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||08/30/2021||Yes|No|||Prescription required|Yes|01/28/2021|018|No|7.84358|03/29/2022|7.65533|03/29/2022|7.70631|03/29/2022|||MACROLIDES/KETOLIDES|1690|||||No|No||TEVA USA|No||||
erythromycin base|No|No|No|No|75%|00093557201|ERYTHROMYCIN 500 MG FILMTAB|100|EA|4.28753|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||08/30/2021||Yes|No|||Prescription required|Yes|01/28/2021|018|No|13.22133|08/30/2021|12.90401|08/30/2021|12.98995|08/30/2021|||MACROLIDES/KETOLIDES|1691|||||No|No||TEVA USA|No||||
erythromycin base|No|No|No|No|75%|00093557256|ERYTHROMYCIN 500 MG FILMTAB|30|EA|4.28753|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||08/30/2021||Yes|No|||Prescription required|Yes|01/28/2021|018|No|13.22133|08/30/2021|12.90401|08/30/2021|12.98995|08/30/2021|||MACROLIDES/KETOLIDES|1692|||||No|No||TEVA USA|No||||
oxycodone HCl|No|No|No|No|90%|00093573101|OXYCODONE HCL ER 10 MG TABLET|100|EA|1.04004|02/22/2016||Yes|No||02/22/2016||Yes|No|02/22/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|110|Yes|2.46132|09/28/2021|2.40224|09/28/2021|2.41824|09/28/2021|||ANALGESICS: NARCOTICS LONG|1693|||||No|No||TEVA USA|No||||
oxycodone HCl|No|No|No|No|90%|00093573201|OXYCODONE HCL ER 20 MG TABLET|100|EA|1.93955|02/22/2016||Yes|No||02/22/2016||Yes|No|02/22/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|110|Yes|4.05047|08/24/2021|3.95325|08/24/2021|3.97958|08/24/2021|||ANALGESICS: NARCOTICS LONG|1694|||||No|No||TEVA USA|No||||
oxycodone HCl|No|No|No|No|90%|00093573301|OXYCODONE HCL ER 40 MG TABLET|100|EA|3.32179|02/22/2016||Yes|No||02/22/2016||Yes|No|02/22/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|110|Yes|5.67023|11/23/2021|5.53414|11/23/2021|5.571|11/23/2021|||ANALGESICS: NARCOTICS LONG|1695|||||No|No||TEVA USA|No||||
oxycodone HCl|No|No|No|No|90%|00093573401|OXYCODONE HCL ER 80 MG TABLET|100|EA|5.79644|02/22/2016||Yes|No||02/22/2016||Yes|No|02/22/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|110|Yes|10.68078|12/28/2021|10.42444|12/28/2021|10.49386|12/28/2021|||ANALGESICS: NARCOTICS LONG|1696|||||No|No||TEVA USA|No||||
cyclosporine, modified|No|No|No|No|75%|00093574065|CYCLOSPORINE MODIFIED 25 MG|30|EA|.47285|09/17/2015|06/08/2022|Yes|No||09/17/2015|06/08/2022|Yes|No|09/17/2015|06/08/2022|Yes|No||09/17/2015|06/08/2022|Yes|No|||Prescription required|No||229|No|.55875|03/29/2022|.54534|03/29/2022|.54897|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|1697|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||TEVA USA|No||||
cyclosporine, modified|No|No|No|No|75%|00093574165|CYCLOSPORINE MODIFIED 50 MG|30|EA|.94528|02/18/2016|06/08/2022|Yes|No||02/18/2016|06/08/2022|Yes|No|02/18/2016|06/08/2022|Yes|No||02/18/2016|06/08/2022|Yes|No|||Prescription required|Yes|01/22/2015|229|No|1.26409|03/29/2022|1.23375|03/29/2022|1.24196|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|1698|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||TEVA USA|No||||
cyclosporine, modified|No|No|No|No|75%|00093574265|CYCLOSPORINE MODIFIED 100 MG|30|EA|1.89056|02/18/2016|06/08/2022|Yes|No||02/18/2016|06/08/2022|Yes|No|02/18/2016|06/08/2022|Yes|No||02/18/2016|06/08/2022|Yes|No|||Prescription required|No||229|No|1.49497|03/29/2022|1.45909|03/29/2022|1.4688|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|1699|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||TEVA USA|No||||
mesalamine|No|No|No|No|75%|00093590786|MESALAMINE DR 400 MG CAPSULE|180|EA|1.4413|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|010|No|2.07243|03/29/2022|2.02269|03/29/2022|2.03616|03/29/2022|||ULCERATIVE COLITIS AGENTS|1700|||||No|No||TEVA USA|No||||
arformoterol tartrate|No|No|No|No|75%|00093595506|ARFORMOTEROL 15 MCG/2 ML SOLN|2|ML|1.37929|03/29/2022||Yes|No||03/29/2022||Yes|No|03/29/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|037|Yes|3.32444|03/29/2022|3.24465|03/29/2022|3.26626|03/29/2022|||BRONCHODILATORS: BETA AGONIST|1701|||||No|No||TEVA USA|No||||
arformoterol tartrate|No|No|No|No|75%|00093595556|ARFORMOTEROL 15 MCG/2 ML SOLN|2|ML|1.37929|03/29/2022||Yes|No||03/29/2022||Yes|No|03/29/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|037|Yes|3.35685|03/29/2022|3.27628|03/29/2022|3.2981|03/29/2022|||BRONCHODILATORS: BETA AGONIST|1702|||||No|No||TEVA USA|No||||
guanfacine HCl|No|No|No|No|75%|00093596001|GUANFACINE HCL ER 1 MG TABLET|100|EA|.31579|07/31/2015|02/28/2022|Yes|No||07/31/2015|02/28/2022|Yes|No|07/31/2015|02/28/2022|Yes|No||07/31/2015|02/28/2022|Yes|No|||Prescription required|No||007|Yes|.71971|03/15/2022|.70943|03/15/2022|.67564|03/15/2022|||STIMULANTS AND RELATED AGENTS|1703|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||TEVA USA|No||||
guanfacine HCl|No|No|No|No|75%|00093596101|GUANFACINE HCL ER 2 MG TABLET|100|EA|.31579|07/31/2015|02/28/2022|Yes|No||07/31/2015|02/28/2022|Yes|No|07/31/2015|02/28/2022|Yes|No||07/31/2015|02/28/2022|Yes|No|||Prescription required|No||007|Yes|.71971|03/15/2022|.70943|03/15/2022|.67564|03/15/2022|||STIMULANTS AND RELATED AGENTS|1704|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||TEVA USA|No||||
epinephrine|No|No|No|No|75%|00093598527|EPINEPHRINE 0.15 MG AUTO-INJCT|2|EA|64.5|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|Yes|11/01/2021|238|No|136.43818|03/29/2022|133.16366|03/29/2022|134.05051|03/29/2022|||EPINEPHRINE: SELF-INJECTED|1705|||||No|No||TEVA USA|No||||
epinephrine|No|No|No|No|75%|00093598627|EPINEPHRINE 0.3 MG AUTO-INJECT|2|EA|64.5|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|Yes|11/01/2021|238|No|139.88297|03/29/2022|136.52577|03/29/2022|137.43501|03/29/2022|||EPINEPHRINE: SELF-INJECTED|1706|||||No|No||TEVA USA|No||||
L-norgest/e.estradiol-e.estrad|Yes|Yes|No|No|75%|00093603182|RIVELSA TABLET|91|EA|1.57079|06/05/2018||Yes|No||06/26/2018||Yes|No|06/05/2018||Yes|No|Refer to program requirements|||No|No|06/05/2018||Prescription required|No|||No|3.57995|06/05/2018|3.52881|06/05/2018|3.36077|06/05/2018||||1707|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
L-norgest/e.estradiol-e.estrad|Yes|Yes|No|No|75%|00093614882|CAMRESE LO TABLET|91|EA|1.01517|12/12/2011||Yes|No||12/12/2011||Yes|No|12/12/2011||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.32321|03/01/2022|.31545|03/01/2022|.31755|03/01/2022||||1708|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
adapalene/benzoyl peroxide|No|No|No|No|75%|00093630345|ADAPALENE-BNZYL PEROX 0.3-2.5%|45|GM|5.03281|03/29/2022||Yes|No||03/29/2022||Yes|No|03/29/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|11.47013|03/29/2022|11.30627|03/29/2022|10.76788|03/29/2022|||ACNE AGENTS: TOPICAL|1709|||||No|No||TEVA USA|No||||
esomeprazole magnesium|No|No|No|No|75%|00093645056|ESOMEPRAZOLE MAG DR 20 MG CAP|30|EA|4.76926|03/26/2015||Yes|No||03/26/2015||Yes|No|03/26/2015||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|1710|||||No|No||TEVA USA|No||||
esomeprazole magnesium|No|No|No|No|75%|00093645098|ESOMEPRAZOLE MAG DR 20 MG CAP|90|EA|.21987|03/26/2015||Yes|No||03/26/2015||Yes|No|03/26/2015||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|1711|||||No|No||TEVA USA|No||||
esomeprazole magnesium|No|No|No|No|75%|00093645156|ESOMEPRAZOLE MAG DR 40 MG CAP|30|EA|.21987|03/26/2015||Yes|No||03/26/2015||Yes|No|03/26/2015||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|1712|||||No|No||TEVA USA|No||||
esomeprazole magnesium|No|No|No|No|75%|00093645198|ESOMEPRAZOLE MAG DR 40 MG CAP|90|EA|.21987|03/26/2015||Yes|No||03/26/2015||Yes|No|03/26/2015||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|1713|||||No|No||TEVA USA|No||||
budesonide|No|No|No|No|75%|00093681555|BUDESONIDE 0.25 MG/2 ML SUSP|2|ML|1.61923|02/01/2021||Yes|No||02/01/2021||Yes|No|02/01/2021||Yes|No||||No|No|||Prescription required|No||033|Yes|.8321|03/29/2022|.81212|03/29/2022|.81753|03/29/2022|||GLUCOCORTICOIDS: INHALED|1714|||||No|No||TEVA USA|No||||
budesonide|No|No|No|No|75%|00093681573|BUDESONIDE 0.25 MG/2 ML SUSP|2|ML|1.61923|11/24/2010||Yes|No||11/24/2010||Yes|No|11/24/2010||Yes|No||||No|No|||Prescription required|No||033|Yes|.8321|03/29/2022|.81212|03/29/2022|.81753|03/29/2022|||GLUCOCORTICOIDS: INHALED|1715|||||No|No||TEVA USA|Yes|09/01/2020|||
budesonide|No|No|No|No|75%|00093681655|BUDESONIDE 0.5 MG/2 ML SUSP|2|ML|1.90561|02/01/2021||Yes|No||02/01/2021||Yes|No|02/01/2021||Yes|No||||No|No|||Prescription required|No||033|Yes|.57313|03/29/2022|.55937|03/29/2022|.5631|03/29/2022|||GLUCOCORTICOIDS: INHALED|1716|||||No|No||TEVA USA|No||||
budesonide|No|No|No|No|75%|00093681673|BUDESONIDE 0.5 MG/2 ML SUSP|2|ML|1.90561|05/12/2009||Yes|No||05/12/2009||Yes|No|05/12/2009||Yes|No||||No|No|||Prescription required|No||033|Yes|.57313|03/29/2022|.55937|03/29/2022|.5631|03/29/2022|||GLUCOCORTICOIDS: INHALED|1717|||||No|No||TEVA USA|Yes|09/01/2020|||
budesonide|No|No|No|No|75%|00093681773|BUDESONIDE 1 MG/2 ML INH SUSP|2|ML|3.96976|06/13/2016||Yes|No||06/13/2016||Yes|No|06/13/2016||Yes|No||||No|No|||Prescription required|No||033|Yes|3.95849|03/29/2022|3.86348|03/29/2022|3.88921|03/29/2022|||GLUCOCORTICOIDS: INHALED|1718|||||No|No||TEVA USA|No||||
nefazodone HCl|No|No|No|No|75%|00093711306|NEFAZODONE HCL 150 MG TABLET|60|EA|.61877|09/22/2003||Yes|No||09/22/2003||Yes|No|09/22/2003||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|031|No|1.41022|01/11/2022|1.39007|01/11/2022|1.32388|01/11/2022|||ANTIDEPRESSANTS: OTHER|1719|||||No|No||TEVA USA|No||||
tolterodine tartrate|No|No|No|No|75%|00093716305|TOLTERODINE TART ER 2 MG CAP|500|EA|2.76419|06/07/2017||Yes|No||06/07/2017||Yes|No|06/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|006|Yes|1.20249|03/29/2022|1.17363|03/29/2022|1.18144|03/29/2022|||BLADDER RELAXANT PREPARATIONS|1720|||||No|No||TEVA USA|No||||
tolterodine tartrate|No|No|No|No|75%|00093716356|TOLTERODINE TART ER 2 MG CAP|30|EA|2.76432|06/06/2017||Yes|No||06/06/2017||Yes|No|06/06/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|006|Yes|1.20249|03/29/2022|1.17363|03/29/2022|1.18144|03/29/2022|||BLADDER RELAXANT PREPARATIONS|1721|||||No|No||TEVA USA|No||||
tolterodine tartrate|No|No|No|No|75%|00093716398|TOLTERODINE TART ER 2 MG CAP|90|EA|2.76422|06/06/2017||Yes|No||06/06/2017||Yes|No|06/06/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|006|Yes|1.20249|03/29/2022|1.17363|03/29/2022|1.18144|03/29/2022|||BLADDER RELAXANT PREPARATIONS|1722|||||No|No||TEVA USA|No||||
tolterodine tartrate|No|No|No|No|75%|00093716405|TOLTERODINE TART ER 4 MG CAP|500|EA|2.76419|06/07/2017||Yes|No||06/07/2017||Yes|No|06/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|006|No|1.14537|03/29/2022|1.11788|03/29/2022|1.12532|03/29/2022|||BLADDER RELAXANT PREPARATIONS|1723|||||No|No||TEVA USA|No||||
tolterodine tartrate|No|No|No|No|75%|00093716456|TOLTERODINE TART ER 4 MG CAP|30|EA|2.76432|06/07/2017||Yes|No||06/07/2017||Yes|No|06/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|006|No|1.14537|03/29/2022|1.11788|03/29/2022|1.12532|03/29/2022|||BLADDER RELAXANT PREPARATIONS|1724|||||No|No||TEVA USA|No||||
tolterodine tartrate|No|No|No|No|75%|00093716498|TOLTERODINE TART ER 4 MG CAP|90|EA|2.76422|06/07/2017||Yes|No||06/07/2017||Yes|No|06/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|006|No|1.14537|03/29/2022|1.11788|03/29/2022|1.12532|03/29/2022|||BLADDER RELAXANT PREPARATIONS|1725|||||No|No||TEVA USA|No||||
celecoxib|No|No|No|No|75%|00093716501|CELECOXIB 100 MG CAPSULE|100|EA|.51737|01/05/2015||Yes|No||01/05/2015||Yes|No|01/05/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|1726|||||No|No||TEVA USA|No||||
celecoxib|No|No|No|No|75%|00093716505|CELECOXIB 100 MG CAPSULE|500|EA|.51737|01/05/2015||Yes|No||01/05/2015||Yes|No|01/05/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|1727|||||No|No||TEVA USA|No||||
celecoxib|No|No|No|No|75%|00093716601|CELECOXIB 200 MG CAPSULE|100|EA|.85686|01/05/2015||Yes|No||01/05/2015||Yes|No|01/05/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|1728|||||No|No||TEVA USA|No||||
celecoxib|No|No|No|No|75%|00093716605|CELECOXIB 200 MG CAPSULE|500|EA|.85686|01/05/2015||Yes|No||01/05/2015||Yes|No|01/05/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|1729|||||No|No||TEVA USA|No||||
celecoxib|No|No|No|No|75%|00093717006|CELECOXIB 400 MG CAPSULE|60|EA|1.32031|01/05/2015||Yes|No||01/05/2015||Yes|No|01/05/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.73632|03/29/2022|.71864|03/29/2022|.72343|03/29/2022|||NSAIDS|1730|||||No|No||TEVA USA|No||||
etodolac|No|No|No|No|75%|00093717201|ETODOLAC ER 500 MG TABLET|100|EA|1.0602|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|1.39968|03/29/2022|1.36608|03/29/2022|1.37518|03/29/2022|||NSAIDS|1731|||||No|No||TEVA USA|No||||
nefazodone HCl|No|No|No|No|75%|00093717801|NEFAZODONE HCL 50 MG TABLET|100|EA|.55994|09/22/2003||Yes|No||09/22/2003||Yes|No|09/22/2003||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|031|No|1.27615|01/11/2022|1.25792|01/11/2022|1.19802|01/11/2022|||ANTIDEPRESSANTS: OTHER|1732|||||No|No||TEVA USA|No||||
fluoxetine HCl|Yes|No|No|No|75%|00093718801|FLUOXETINE HCL 10 MG TABLET|100|EA|.14804|01/02/2020||Yes|No||01/02/2020||Yes|No|01/02/2020||Yes|No||||No|No|03/20/2020||Prescription required|No||008|No|.24078|03/29/2022|.235|03/29/2022|.23656|03/29/2022|||ANTIDEPRESSANTS: SSRIs|1733|||||No|No||TEVA USA|No||||
fluoxetine HCl|No|No|No|No|75%|00093718810|FLUOXETINE HCL 10 MG TABLET|1000|EA|.14804|07/10/2014||Yes|No||07/10/2014||Yes|No|07/10/2014||Yes|No||||No|No|||Prescription required|No||008|No|.24078|03/29/2022|.235|03/29/2022|.23656|03/29/2022|||ANTIDEPRESSANTS: SSRIs|1734|||||No|No||TEVA USA|No||||
fluoxetine HCl|No|No|No|No|75%|00093718856|FLUOXETINE HCL 10 MG TABLET|30|EA|.14806|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||008|No|.24078|03/29/2022|.235|03/29/2022|.23656|03/29/2022|||ANTIDEPRESSANTS: SSRIs|1735|||||No|No||TEVA USA|No||||
fluoxetine HCl|Yes|No|No|No|75%|00093719801|FLUOXETINE HCL 40 MG CAPSULE|100|EA|.33325|06/18/2009||Yes|No||06/18/2009||Yes|No|06/18/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|1736|||||No|No||TEVA USA|No||||
fluoxetine HCl|Yes|No|No|No|75%|00093719805|FLUOXETINE HCL 40 MG CAPSULE|500|EA|.63317|10/02/2008||Yes|No||10/02/2008||Yes|No|10/02/2008||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|1737|||||No|No||TEVA USA|No||||
fluoxetine HCl|Yes|No|No|No|75%|00093719856|FLUOXETINE HCL 40 MG CAPSULE|30|EA|.33325|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|1738|||||No|No||TEVA USA|No||||
pravastatin sodium|Yes|No|No|No|75%|00093720110|PRAVASTATIN SODIUM 20 MG TAB|1000|EA|.21074|01/09/2007||Yes|No||01/09/2007||Yes|No|01/09/2007||Yes|No||01/09/2007||Yes|No|07/01/2016||Prescription required|No||063|Yes|.05771|03/29/2022|.05632|03/29/2022|.0567|03/29/2022|||LIPOTROPICS: STATINS|1739|||||No|No||TEVA USA|No||||
pravastatin sodium|Yes|No|No|No|75%|00093720198|PRAVASTATIN SODIUM 20 MG TAB|90|EA|.21074|01/09/2007||Yes|No||01/09/2007||Yes|No|01/09/2007||Yes|No||01/09/2007||Yes|No|07/01/2016||Prescription required|No||063|Yes|.05771|03/29/2022|.05632|03/29/2022|.0567|03/29/2022|||LIPOTROPICS: STATINS|1740|||||No|No||TEVA USA|No||||
pravastatin sodium|Yes|No|No|No|75%|00093720210|PRAVASTATIN SODIUM 40 MG TAB|1000|EA|.30926|01/09/2007||Yes|No||01/09/2007||Yes|No|01/09/2007||Yes|No||01/09/2007||Yes|No|07/01/2016||Prescription required|No||063|Yes|.08966|03/29/2022|.0875|03/29/2022|.08809|03/29/2022|||LIPOTROPICS: STATINS|1741|||||No|No||TEVA USA|No||||
pravastatin sodium|Yes|No|No|No|75%|00093720298|PRAVASTATIN SODIUM 40 MG TAB|90|EA|.30926|01/09/2007||Yes|No||01/09/2007||Yes|No|01/09/2007||Yes|No||01/09/2007||Yes|No|07/01/2016||Prescription required|No||063|Yes|.08966|03/29/2022|.0875|03/29/2022|.08809|03/29/2022|||LIPOTROPICS: STATINS|1742|||||No|No||TEVA USA|No||||
pravastatin sodium|Yes|No|No|No|75%|00093727010|PRAVASTATIN SODIUM 80 MG TAB|1000|EA|.30926|05/12/2009||Yes|No||05/12/2009||Yes|No|05/12/2009||Yes|No||05/12/2009||Yes|No|07/01/2016||Prescription required|No||063|Yes|.14996|03/29/2022|.14636|03/29/2022|.14733|03/29/2022|||LIPOTROPICS: STATINS|1743|||||No|No||TEVA USA|No||||
pravastatin sodium|Yes|No|No|No|75%|00093727098|PRAVASTATIN SODIUM 80 MG TAB|90|EA|.30926|05/12/2009||Yes|No||05/12/2009||Yes|No|05/12/2009||Yes|No||05/12/2009||Yes|No|07/01/2016||Prescription required|No||063|Yes|.14996|03/29/2022|.14636|03/29/2022|.14733|03/29/2022|||LIPOTROPICS: STATINS|1744|||||No|No||TEVA USA|No||||
pioglitazone HCl|No|No|No|No|75%|00093727105|PIOGLITAZONE HCL 15 MG TABLET|500|EA|.12089|05/22/2015||Yes|No||05/22/2015||Yes|No|05/22/2015||Yes|No||05/22/2015||Yes|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|1745|||||No|No||TEVA USA|No||||
pioglitazone HCl|No|No|No|No|75%|00093727156|PIOGLITAZONE HCL 15 MG TABLET|30|EA|.12083|09/18/2015||Yes|No||09/18/2015||Yes|No|09/18/2015||Yes|No||09/18/2015||Yes|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|1746|||||No|No||TEVA USA|No||||
pioglitazone HCl|No|No|No|No|75%|00093727198|PIOGLITAZONE HCL 15 MG TABLET|90|EA|.12087|09/18/2015||Yes|No||09/18/2015||Yes|No|09/18/2015||Yes|No||09/18/2015||Yes|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|1747|||||No|No||TEVA USA|No||||
pioglitazone HCl|No|No|No|No|75%|00093727205|PIOGLITAZONE HCL 30 MG TABLET|500|EA|.18476|05/22/2015||Yes|No||05/22/2015||Yes|No|05/22/2015||Yes|No||05/22/2015||Yes|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|1748|||||No|No||TEVA USA|No||||
pioglitazone HCl|No|No|No|No|75%|00093727256|PIOGLITAZONE HCL 30 MG TABLET|30|EA|.18475|09/18/2015||Yes|No||09/18/2015||Yes|No|09/18/2015||Yes|No||09/18/2015||Yes|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|1749|||||No|No||TEVA USA|No||||
pioglitazone HCl|No|No|No|No|75%|00093727298|PIOGLITAZONE HCL 30 MG TABLET|90|EA|.18475|09/18/2015||Yes|No||09/18/2015||Yes|No|09/18/2015||Yes|No||09/18/2015||Yes|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|1750|||||No|No||TEVA USA|No||||
pioglitazone HCl|No|No|No|No|75%|00093727305|PIOGLITAZONE HCL 45 MG TABLET|500|EA|.2004|02/02/2018||Yes|No||02/02/2018||Yes|No|02/02/2018||Yes|No||02/02/2018||Yes|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|1751|||||No|No||TEVA USA|No||||
pioglitazone HCl|No|No|No|No|75%|00093727356|PIOGLITAZONE HCL 45 MG TABLET|30|EA|.20038|02/18/2016||Yes|No||02/18/2016||Yes|No|02/18/2016||Yes|No||02/18/2016||Yes|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|1752|||||No|No||TEVA USA|No||||
pioglitazone HCl|No|No|No|No|75%|00093727398|PIOGLITAZONE HCL 45 MG TABLET|90|EA|.20042|09/18/2015||Yes|No||09/18/2015||Yes|No|09/18/2015||Yes|No||09/18/2015||Yes|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|1753|||||No|No||TEVA USA|No||||
raloxifene HCl|No|No|No|No|75%|00093729001|RALOXIFENE HCL 60 MG TABLET|100|EA|1.66732|05/05/2014||Yes|No||05/05/2014||Yes|No|05/05/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|060|Yes|.36315|03/29/2022|.35443|03/29/2022|.35679|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|1754|||||No|No||TEVA USA|No||||
raloxifene HCl|No|No|No|No|75%|00093729056|RALOXIFENE HCL 60 MG TABLET|30|EA|1.66266|05/05/2014||Yes|No||05/05/2014||Yes|No|05/05/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|060|Yes|.36315|03/29/2022|.35443|03/29/2022|.35679|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|1755|||||No|No||TEVA USA|No||||
carvedilol|No|No|No|No|75%|00093729501|CARVEDILOL 12.5 MG TABLET|100|EA|.0258|02/08/2008||Yes|No||02/08/2008||Yes|No|02/08/2008||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.02277|03/29/2022|.02222|03/29/2022|.02237|03/29/2022|||BETA-BLOCKERS|1756|||||No|No||TEVA USA|No||||
carvedilol|No|No|No|No|75%|00093729505|CARVEDILOL 12.5 MG TABLET|500|EA|.02515|11/15/2011||Yes|No||11/15/2011||Yes|No|11/15/2011||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.02277|03/29/2022|.02222|03/29/2022|.02237|03/29/2022|||BETA-BLOCKERS|1757|||||No|No||TEVA USA|No||||
carvedilol|No|No|No|No|75%|00093729601|CARVEDILOL 25 MG TABLET|100|EA|.0258|02/08/2008||Yes|No||02/08/2008||Yes|No|02/08/2008||Yes|No||02/08/2008||Yes|No|||Prescription required|No||070|No|.03449|03/29/2022|.03366|03/29/2022|.03388|03/29/2022|||BETA-BLOCKERS|1758|||||No|No||TEVA USA|No||||
carvedilol|No|No|No|No|75%|00093729605|CARVEDILOL 25 MG TABLET|500|EA|.02515|09/15/2010||Yes|No||09/15/2010||Yes|No|09/15/2010||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.03449|03/29/2022|.03366|03/29/2022|.03388|03/29/2022|||BETA-BLOCKERS|1759|||||No|No||TEVA USA|No||||
celecoxib|No|No|No|No|75%|00093730606|CELECOXIB 50 MG CAPSULE|60|EA|.25083|01/05/2015||Yes|No||01/05/2015||Yes|No|01/05/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.1386|03/29/2022|.13527|03/29/2022|.13617|03/29/2022|||NSAIDS|1760|||||No|No||TEVA USA|No||||
clopidogrel bisulfate|No|No|No|No|75%|00093731405|CLOPIDOGREL 75 MG TABLET|500|EA|.07163|06/05/2012||Yes|No||06/05/2012||Yes|No|06/05/2012||Yes|No||06/05/2012||Yes|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|1761|||||No|No||TEVA USA|No||||
clopidogrel bisulfate|No|No|No|No|75%|00093731456|CLOPIDOGREL 75 MG TABLET|30|EA|.07166|06/05/2012||Yes|No||06/05/2012||Yes|No|06/05/2012||Yes|No||06/05/2012||Yes|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|1762|||||No|No||TEVA USA|No||||
mycophenolate mofetil|No|No|No|No|75%|00093733401|MYCOPHENOLATE 250 MG CAPSULE|100|EA|.27627|09/23/2009||Yes|No||09/23/2009||Yes|No|09/23/2009||Yes|No||09/23/2009||Yes|No|||Prescription required|No||229|No|.2129|03/29/2022|.20779|03/29/2022|.20917|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|1763|||||No|No||TEVA USA|No||||
mycophenolate mofetil|No|No|No|No|75%|00093733405|MYCOPHENOLATE 250 MG CAPSULE|500|EA|.27627|09/23/2009||Yes|No||09/23/2009||Yes|No|09/23/2009||Yes|No||09/23/2009||Yes|No|||Prescription required|No||229|No|.2129|03/29/2022|.20779|03/29/2022|.20917|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|1764|||||No|No||TEVA USA|No||||
lansoprazole|No|No|No|No|75%|00093735056|LANSOPRAZOLE DR 15 MG CAPSULE|30|EA|.80983|07/02/2010||Yes|No||07/02/2010||Yes|No|07/02/2010||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|Yes|.24898|03/29/2022|.243|03/29/2022|.24462|03/29/2022|||PROTON PUMP INHIBITORS|1765|||||No|No||TEVA USA|No||||
lansoprazole|No|No|No|No|75%|00093735156|LANSOPRAZOLE DR 30 MG CAPSULE|30|EA|.80983|07/02/2010||Yes|No||07/02/2010||Yes|No|07/02/2010||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.12249|03/29/2022|.11955|03/29/2022|.12034|03/29/2022|||PROTON PUMP INHIBITORS|1766|||||No|No||TEVA USA|No||||
calcitriol|No|No|No|No|75%|00093735201|CALCITRIOL 0.25 MCG CAPSULE|100|EA|.41086|08/14/2018||Yes|No||08/14/2018||Yes|No|08/14/2018||Yes|No||08/14/2018||Yes|No|||Prescription required|No|||No|.18695|03/29/2022|.18246|03/29/2022|.18367|03/29/2022||||1767|||||No|No||TEVA USA|No||||
calcitriol|No|No|No|No|75%|00093735301|CALCITRIOL 0.5 MCG CAPSULE|100|EA|.65691|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No||11/21/2016||Yes|No|||Prescription required|No|||No|.32158|03/29/2022|.31386|03/29/2022|.31595|03/29/2022||||1768|||||No|No||TEVA USA|No||||
finasteride|No|No|No|No|75%|00093735505|FINASTERIDE 5 MG TABLET|500|EA|.23056|04/01/2008||Yes|No||04/01/2008||Yes|No|04/01/2008||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|1769|||||No|No||TEVA USA|No||||
finasteride|No|No|No|No|75%|00093735556|FINASTERIDE 5 MG TABLET|30|EA|.258|02/22/2007||Yes|No||02/22/2007||Yes|No|02/22/2007||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|1770|||||No|No||TEVA USA|No||||
finasteride|No|No|No|No|75%|00093735598|FINASTERIDE 5 MG TABLET|90|EA|.2365|04/10/2007||Yes|No||04/10/2007||Yes|No|04/10/2007||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|1771|||||No|No||TEVA USA|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|00093736710|LOSARTAN-HCTZ 50-12.5 MG TAB|1000|EA|.05917|05/03/2010||Yes|No||05/03/2010||Yes|No|05/03/2010||Yes|No||05/03/2010||Yes|No|07/01/2016||Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|1772|||||No|No||TEVA USA|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|00093736756|LOSARTAN-HCTZ 50-12.5 MG TAB|30|EA|.05948|05/03/2010||Yes|No||05/03/2010||Yes|No|05/03/2010||Yes|No||05/03/2010||Yes|No|07/01/2016||Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|1773|||||No|No||TEVA USA|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|00093736798|LOSARTAN-HCTZ 50-12.5 MG TAB|90|EA|.05928|05/03/2010||Yes|No||05/03/2010||Yes|No|05/03/2010||Yes|No||05/03/2010||Yes|No|07/01/2016||Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|1774|||||No|No||TEVA USA|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|00093736810|LOSARTAN-HCTZ 100-25 MG TAB|1000|EA|.0806|06/02/2010||Yes|No||06/02/2010||Yes|No|06/02/2010||Yes|No||06/02/2010||Yes|No|||Prescription required|No||113|Yes|.21077|03/01/2022|.20571|03/01/2022|.20708|03/01/2022|||ANGIOTENSIN MODULATORS|1775|||||No|No||TEVA USA|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|00093736856|LOSARTAN-HCTZ 100-25 MG TAB|30|EA|.08084|05/03/2010||Yes|No||05/03/2010||Yes|No|05/03/2010||Yes|No||05/03/2010||Yes|No|||Prescription required|No||113|Yes|.21077|03/01/2022|.20571|03/01/2022|.20708|03/01/2022|||ANGIOTENSIN MODULATORS|1776|||||No|No||TEVA USA|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|00093736898|LOSARTAN-HCTZ 100-25 MG TAB|90|EA|.08069|05/03/2010||Yes|No||05/03/2010||Yes|No|05/03/2010||Yes|No||05/03/2010||Yes|No|||Prescription required|No||113|Yes|.21077|03/01/2022|.20571|03/01/2022|.20708|03/01/2022|||ANGIOTENSIN MODULATORS|1777|||||No|No||TEVA USA|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|00093736910|LOSARTAN-HCTZ 100-12.5 MG TAB|1000|EA|.0806|05/03/2010||Yes|No||05/03/2010||Yes|No|05/03/2010||Yes|No||05/03/2010||Yes|No|07/01/2016||Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|1778|||||No|No||TEVA USA|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|00093736956|LOSARTAN-HCTZ 100-12.5 MG TAB|30|EA|.08084|05/03/2010||Yes|No||05/03/2010||Yes|No|05/03/2010||Yes|No||05/03/2010||Yes|No|07/01/2016||Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|1779|||||No|No||TEVA USA|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|00093736998|LOSARTAN-HCTZ 100-12.5 MG TAB|90|EA|.08069|05/03/2010||Yes|No||05/03/2010||Yes|No|05/03/2010||Yes|No||05/03/2010||Yes|No|07/01/2016||Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|1780|||||No|No||TEVA USA|No||||
venlafaxine HCl|No|No|No|No|75%|00093738456|VENLAFAXINE HCL ER 37.5 MG CAP|30|EA|.10965|07/09/2010||Yes|No||07/09/2010||Yes|No|07/09/2010||Yes|No||||No|No|||Prescription required|No||031|Yes|.11725|03/29/2022|.11443|03/29/2022|.11519|03/29/2022|||ANTIDEPRESSANTS: OTHER|1781|||||No|No||TEVA USA|No||||
venlafaxine HCl|No|No|No|No|75%|00093738498|VENLAFAXINE HCL ER 37.5 MG CAP|90|EA|.10052|07/09/2010||Yes|No||07/09/2010||Yes|No|07/09/2010||Yes|No||||No|No|||Prescription required|No||031|Yes|.11725|03/29/2022|.11443|03/29/2022|.11519|03/29/2022|||ANTIDEPRESSANTS: OTHER|1782|||||No|No||TEVA USA|No||||
venlafaxine HCl|No|No|No|No|75%|00093738556|VENLAFAXINE HCL ER 75 MG CAP|30|EA|.13272|07/09/2010||Yes|No||07/09/2010||Yes|No|07/09/2010||Yes|No||||No|No|||Prescription required|No||031|Yes|.12722|03/29/2022|.12416|03/29/2022|.12499|03/29/2022|||ANTIDEPRESSANTS: OTHER|1783|||||No|No||TEVA USA|No||||
venlafaxine HCl|No|No|No|No|75%|00093738598|VENLAFAXINE HCL ER 75 MG CAP|90|EA|.12264|07/09/2010||Yes|No||07/09/2010||Yes|No|07/09/2010||Yes|No||||No|No|||Prescription required|No||031|Yes|.12722|03/29/2022|.12416|03/29/2022|.12499|03/29/2022|||ANTIDEPRESSANTS: OTHER|1784|||||No|No||TEVA USA|No||||
venlafaxine HCl|No|No|No|No|75%|00093738656|VENLAFAXINE HCL ER 150 MG CAP|30|EA|.19235|07/09/2010||Yes|No||07/09/2010||Yes|No|07/09/2010||Yes|No||||No|No|||Prescription required|No||031|No|.16516|03/29/2022|.16119|03/29/2022|.16226|03/29/2022|||ANTIDEPRESSANTS: OTHER|1785|||||No|No||TEVA USA|No||||
venlafaxine HCl|No|No|No|No|75%|00093738698|VENLAFAXINE HCL ER 150 MG CAP|90|EA|.15842|07/09/2010||Yes|No||07/09/2010||Yes|No|07/09/2010||Yes|No||||No|No|||Prescription required|No||031|No|.16516|03/29/2022|.16119|03/29/2022|.16226|03/29/2022|||ANTIDEPRESSANTS: OTHER|1786|||||No|No||TEVA USA|No||||
moxifloxacin HCl|No|No|No|No|75%|00093738756|MOXIFLOXACIN HCL 400 MG TABLET|30|EA|9.3654|03/25/2014||Yes|No||03/25/2014||Yes|No|03/25/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|028|No|1.23895|03/29/2022|1.20921|03/29/2022|1.21726|03/29/2022|||FLUOROQUINOLONES: ORAL|1787|||||No|No||TEVA USA|No||||
niacin|No|No|No|No|75%|00093739286|NIACIN ER 500 MG TABLET|180|EA|1.45745|04/22/2014||Yes|No||04/22/2014||Yes|No|04/22/2014||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|Yes|.21332|03/29/2022|.2082|03/29/2022|.20958|03/29/2022|||LIPOTROPICS: OTHER|1788|||||No|No||TEVA USA|No||||
niacin|No|No|No|No|75%|00093739386|NIACIN ER 750 MG TABLET|180|EA|2.07885|04/22/2014||Yes|No||04/22/2014||Yes|No|04/22/2014||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.52604|03/29/2022|.51341|03/29/2022|.51683|03/29/2022|||LIPOTROPICS: OTHER|1789|||||No|No||TEVA USA|No||||
niacin|No|No|No|No|75%|00093739398|NIACIN ER 750 MG TABLET|90|EA|2.07885|04/22/2014||Yes|No||04/22/2014||Yes|No|04/22/2014||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.52604|03/29/2022|.51341|03/29/2022|.51683|03/29/2022|||LIPOTROPICS: OTHER|1790|||||No|No||TEVA USA|No||||
niacin|No|No|No|No|75%|00093739486|NIACIN ER 1,000 MG TABLET|180|EA|2.5777|04/22/2014||Yes|No||04/22/2014||Yes|No|04/22/2014||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.4737|03/29/2022|.46233|03/29/2022|.46541|03/29/2022|||LIPOTROPICS: OTHER|1791|||||No|No||TEVA USA|No||||
niacin|No|No|No|No|75%|00093739498|NIACIN ER 1,000 MG TABLET|90|EA|2.5777|04/22/2014||Yes|No||04/22/2014||Yes|No|04/22/2014||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.4737|03/29/2022|.46233|03/29/2022|.46541|03/29/2022|||LIPOTROPICS: OTHER|1792|||||No|No||TEVA USA|No||||
fluvastatin sodium|No|No|No|No|75%|00093744201|FLUVASTATIN SODIUM 20 MG CAP|100|EA|1.71871|07/25/2012||Yes|No||07/25/2012||Yes|No|07/25/2012||Yes|No||07/25/2012||Yes|No|||Prescription required|Yes|07/29/2021|063|Yes|3.616|10/26/2021|3.52921|10/26/2021|3.55272|10/26/2021|||LIPOTROPICS: STATINS|1793|||||No|No||TEVA USA|No||||
fluvastatin sodium|No|No|No|No|75%|00093744256|FLUVASTATIN SODIUM 20 MG CAP|30|EA|1.71871|07/25/2012||Yes|No||07/25/2012||Yes|No|07/25/2012||Yes|No||07/25/2012||Yes|No|||Prescription required|Yes|07/29/2021|063|Yes|3.616|10/26/2021|3.52921|10/26/2021|3.55272|10/26/2021|||LIPOTROPICS: STATINS|1794|||||No|No||TEVA USA|No||||
fluvastatin sodium|No|No|No|No|75%|00093744301|FLUVASTATIN SODIUM 40 MG CAP|100|EA|1.71871|07/25/2012||Yes|No||07/25/2012||Yes|No|07/25/2012||Yes|No||07/25/2012||Yes|No|||Prescription required|Yes|07/29/2021|063|Yes|3.76547|11/23/2021|3.67509|11/23/2021|3.69957|11/23/2021|||LIPOTROPICS: STATINS|1795|||||No|No||TEVA USA|No||||
fluvastatin sodium|No|No|No|No|75%|00093744356|FLUVASTATIN SODIUM 40 MG CAP|30|EA|1.71871|07/25/2012||Yes|No||07/25/2012||Yes|No|07/25/2012||Yes|No||07/25/2012||Yes|No|||Prescription required|Yes|07/29/2021|063|Yes|3.76547|11/23/2021|3.67509|11/23/2021|3.69957|11/23/2021|||LIPOTROPICS: STATINS|1796|||||No|No||TEVA USA|No||||
fluvastatin sodium|No|No|No|No|75%|00093744601|FLUVASTATIN ER 80 MG TABLET|100|EA|2.78265|10/05/2016||Yes|No||10/05/2016||Yes|No|10/05/2016||Yes|No||10/05/2016||Yes|No|||Prescription required|Yes|07/23/2015|063|Yes|3.96093|01/25/2022|3.86586|01/25/2022|3.89161|01/25/2022|||LIPOTROPICS: STATINS|1797|||||No|No||TEVA USA|No||||
fluvastatin sodium|No|No|No|No|75%|00093744656|FLUVASTATIN ER 80 MG TABLET|30|EA|2.78253|10/05/2016||Yes|No||10/05/2016||Yes|No|10/05/2016||Yes|No||10/05/2016||Yes|No|||Prescription required|Yes|07/23/2015|063|Yes|3.96093|01/25/2022|3.86586|01/25/2022|3.89161|01/25/2022|||LIPOTROPICS: STATINS|1798|||||No|No||TEVA USA|No||||
glipizide/metformin HCl|Yes|No|No|No|75%|00093745501|GLIPIZIDE-METFORMIN 2.5-250 MG|100|EA|.26733|10/31/2005||Yes|No||10/31/2005||Yes|No|10/31/2005||Yes|No||||No|No|07/01/2016||Prescription required|Yes|01/26/2017|012|No|.60926|11/26/2019|.60056|11/26/2019|.57196|11/26/2019|||HYPOGLYCEMICS: METFORMINS|1799|||||No|No||TEVA USA|No||||
glipizide/metformin HCl|Yes|No|No|No|75%|00093745601|GLIPIZIDE-METFORMIN 2.5-500 MG|100|EA|.31893|10/31/2005||Yes|No||10/31/2005||Yes|No|10/31/2005||Yes|No||||No|No|07/01/2016||Prescription required|Yes|01/26/2017|012|No|.33272|03/29/2022|.32473|03/29/2022|.32689|03/29/2022|||HYPOGLYCEMICS: METFORMINS|1800|||||No|No||TEVA USA|No||||
glipizide/metformin HCl|Yes|No|No|No|75%|00093745701|GLIPIZIDE-METFORMIN 5-500 MG|100|EA|.31893|10/31/2005||Yes|No||10/31/2005||Yes|No|||No|No||||No|No|07/01/2016||Prescription required|Yes|01/26/2017|012|No|.24767|03/29/2022|.24172|03/29/2022|.24333|03/29/2022|||HYPOGLYCEMICS: METFORMINS|1801|||||No|No||TEVA USA|No||||
rizatriptan benzoate|No|No|No|No|75%|00093747119|RIZATRIPTAN 5 MG TABLET|1|EA|.645|04/15/2014||Yes|No||04/15/2014||Yes|No|04/15/2014||Yes|No||||No|No|||Prescription required|No||021|No|.64991|03/29/2022|.63431|03/29/2022|.63853|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|1802|||||No|No||TEVA USA|No||||
rizatriptan benzoate|No|No|No|No|75%|00093747143|RIZATRIPTAN 5 MG TABLET|18|EA|.64332|04/15/2014||Yes|No||04/15/2014||Yes|No|04/15/2014||Yes|No||||No|No|||Prescription required|No||021|No|.64991|03/29/2022|.63431|03/29/2022|.63853|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|1803|||||No|No||TEVA USA|No||||
rizatriptan benzoate|No|No|No|No|75%|00093747219|RIZATRIPTAN 10 MG TABLET|1|EA|.645|04/15/2014||Yes|No||04/15/2014||Yes|No|04/15/2014||Yes|No||||No|No|||Prescription required|No||021|No|.50927|03/29/2022|.49704|03/29/2022|.50035|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|1804|||||No|No||TEVA USA|No||||
rizatriptan benzoate|No|No|No|No|75%|00093747243|RIZATRIPTAN 10 MG TABLET|18|EA|.64332|04/15/2014||Yes|No||04/15/2014||Yes|No|04/15/2014||Yes|No||||No|No|||Prescription required|No||021|No|.50927|03/29/2022|.49704|03/29/2022|.50035|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|1805|||||No|No||TEVA USA|No||||
capecitabine|No|No|No|No|75%|00093747306|CAPECITABINE 150 MG TABLET|60|EA|.5246|03/31/2014||Yes|No||03/31/2014||Yes|No|03/31/2014||Yes|No||||No|No|||Prescription required|No||502|No|1.1956|03/02/2021|1.17852|03/02/2021|1.1224|03/02/2021|||ONCOLOGY: ORAL - BREAST|1806|||||No|No||TEVA USA|No||||
capecitabine|No|No|No|No|75%|00093747489|CAPECITABINE 500 MG TABLET|120|EA|.73995|09/12/2014||Yes|No||09/12/2014||Yes|No|09/12/2014||Yes|No||||No|No|||Prescription required|No||502|No|.61977|12/28/2021|.60489|12/28/2021|.60892|12/28/2021|||ONCOLOGY: ORAL - BREAST|1807|||||No|No||TEVA USA|No||||
montelukast sodium|No|No|No|No|75%|00093748756|MONTELUKAST SOD 4 MG GRANULES|30|EA|1.30533|03/22/2018||Yes|No||03/22/2018||Yes|No|03/22/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|042|Yes|1.25796|03/29/2022|1.22776|03/29/2022|1.23594|03/29/2022|||LEUKOTRIENE MODIFIERS|1808|||||No|No||TEVA USA|No||||
anastrozole|No|No|No|No|75%|00093753656|ANASTROZOLE 1 MG TABLET|30|EA|.13932|07/09/2010||Yes|No||07/09/2010||Yes|No|07/09/2010||Yes|No||||No|No|||Prescription required|No||502|No|.11251|03/29/2022|.1098|03/29/2022|.11054|03/29/2022|||ONCOLOGY: ORAL - BREAST|1809|||||No|No||TEVA USA|No||||
emtricitabine/tenofovir (TDF)|No|No|No|No|75%|00093760756|EMTRICITABINE-TENOFV 200-300MG|30|EA|29.10799|05/18/2021|01/20/2022|Yes|No||05/18/2021|01/20/2022|Yes|No|05/18/2021|01/20/2022|Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.70347|03/29/2022|.68658|03/29/2022|.69115|03/29/2022|||HIV / AIDS|1810|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TEVA USA|No||||
letrozole|No|No|No|No|75%|00093762056|LETROZOLE 2.5 MG TABLET|30|EA|.15766|06/16/2011||Yes|No||06/16/2011||Yes|No|06/16/2011||Yes|No||||No|No|||Prescription required|No||502|No|.1337|03/29/2022|.13049|03/29/2022|.13136|03/29/2022|||ONCOLOGY: ORAL - BREAST|1811|||||No|No||TEVA USA|No||||
imatinib mesylate|No|No|No|No|75%|00093762998|IMATINIB MESYLATE 100 MG TAB|90|EA|.52173|12/16/2016||Yes|No||12/16/2016||Yes|No|12/16/2016||Yes|No||||No|No|||Prescription required|No||173|No|1.18906|07/27/2021|1.17207|07/27/2021|1.11626|07/27/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|1812|||||No|No||TEVA USA|No||||
imatinib mesylate|No|No|No|No|75%|00093763056|IMATINIB MESYLATE 400 MG TAB|30|EA|1.87996|12/16/2016||Yes|No||12/16/2016||Yes|No|12/16/2016||Yes|No||||No|No|||Prescription required|No||173|No|2.86988|03/01/2022|2.801|03/01/2022|2.81965|03/01/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|1813|||||No|No||TEVA USA|No||||
erlotinib HCl|No|No|No|No|75%|00093766356|ERLOTINIB HCL 100 MG TABLET|30|EA|92.53342|03/19/2021||Yes|No||03/19/2021||Yes|No|03/19/2021||Yes|No||||No|No|||Prescription required|No||551|No|210.89012|03/19/2021|207.8774|03/19/2021|197.97848|03/19/2021|||ONCOLOGY: ORAL - LUNG|1814|||||No|No||TEVA USA|No||||
erlotinib HCl|No|No|No|No|75%|00093766456|ERLOTINIB HCL 150 MG TABLET|30|EA|104.66214|03/19/2021||Yes|No||03/19/2021||Yes|No|03/19/2021||Yes|No||||No|No|||Prescription required|No||551|No|238.53232|03/19/2021|235.12471|03/19/2021|223.9283|03/19/2021|||ONCOLOGY: ORAL - LUNG|1815|||||No|No||TEVA USA|No||||
etonogestrel/ethinyl estradiol|No|Yes|No|No|75%|00093767902|ETONOGESTREL-EE VAGINAL RING|1|EA|60.42216|06/07/2021||Yes|No||06/23/2021||Yes|No|06/07/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|92.38101|03/29/2022|90.16386|03/29/2022|90.76434|03/29/2022||||1816|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
olopatadine HCl|No|No|No|No|75%|00093768432|OLOPATADINE HCL 0.2% EYE DROP|2.5|ML|4.62852|10/13/2017|03/31/2022|Yes|No||10/13/2017|03/31/2022|Yes|No|10/13/2017|03/31/2022|Yes|No||||No|No|||Prescription required|Yes|01/26/2017|002|No|9.7075|01/25/2022|9.47452|01/25/2022|9.53761|01/25/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|1817|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||TEVA USA|No||||
levocetirizine dihydrochloride|No|No|No|No|75%|00093770198|LEVOCETIRIZINE 5 MG TABLET|90|EA|.14333|09/16/2011||Yes|No||09/16/2011||Yes|No|09/16/2011||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|030|Yes|.08234|03/29/2022|.08036|03/29/2022|.08089|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|1818|||||No|No||TEVA USA|No||||
emtricitabine/tenofovir (TDF)|No|No|No|No|75%|00093770456|EMTRICITABINE-TENOFV 200-300MG|30|EA|.6|05/26/2021||Yes|No||05/26/2021||Yes|No|05/26/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.70347|03/29/2022|.68658|03/29/2022|.69115|03/29/2022|||HIV / AIDS|1819|||||No|No||TEVA USA|No||||
everolimus|No|No|No|No|75%|00093776624|EVEROLIMUS 2.5 MG TABLET|28|EA|98.5841|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||||No|No|||Prescription required|No||548|No|224.68004|12/30/2020|221.47032|12/30/2020|210.92412|12/30/2020|||ONCOLOGY: ORAL - RENAL CELL|1820|||||No|No||TEVA USA|No||||
everolimus|No|No|No|No|75%|00093776724|EVEROLIMUS 5 MG TABLET|28|EA|103.11737|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||||No|No|||Prescription required|No||548|No|235.01169|12/30/2020|231.65438|12/30/2020|220.62322|12/30/2020|||ONCOLOGY: ORAL - RENAL CELL|1821|||||No|No||TEVA USA|No||||
everolimus|No|No|No|No|75%|00093776824|EVEROLIMUS 7.5 MG TABLET|28|EA|103.11737|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||||No|No|||Prescription required|No||548|No|235.01169|12/30/2020|231.65438|12/30/2020|220.62322|12/30/2020|||ONCOLOGY: ORAL - RENAL CELL|1822|||||No|No||TEVA USA|No||||
risedronate sodium|No|No|No|No|75%|00093777113|RISEDRONATE SODIUM 150 MG TAB|3|EA|64.23196|03/01/2017||Yes|No||03/01/2017||Yes|No|03/01/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|060|No|20.52701|03/29/2022|20.03436|03/29/2022|20.16778|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|1823|||||No|No||TEVA USA|No||||
risedronate sodium|No|No|No|No|75%|00093777179|RISEDRONATE SODIUM 150 MG TAB|1|EA|64.2334|03/16/2017||Yes|No||03/16/2017||Yes|No|03/16/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|060|No|20.52701|03/29/2022|20.03436|03/29/2022|20.16778|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|1824|||||No|No||TEVA USA|No||||
clozapine|No|No|No|No|75%|00093777201|CLOZAPINE 100 MG TABLET|100|EA|.99325|11/04/2009||Yes|No||11/04/2009||Yes|No|11/04/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.60868|03/29/2022|.59407|03/29/2022|.59802|03/29/2022|||ANTIPSYCHOTICS|1825|||||No|No||TEVA USA|No||||
clozapine|No|No|No|No|75%|00093777205|CLOZAPINE 100 MG TABLET|500|EA|.9631|11/04/2009||Yes|No||11/04/2009||Yes|No|11/04/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.60868|03/29/2022|.59407|03/29/2022|.59802|03/29/2022|||ANTIPSYCHOTICS|1826|||||No|No||TEVA USA|No||||
clozapine|No|No|No|No|75%|00093777293|CLOZAPINE 100 MG TABLET|100|EA|.71165|06/03/2010||Yes|No||06/03/2010||Yes|No|06/03/2010||Yes|No||||No|No|||Prescription required|No||027|Yes|.60868|03/29/2022|.59407|03/29/2022|.59802|03/29/2022|||ANTIPSYCHOTICS|1827|||||No|No||TEVA USA|No||||
fentanyl citrate|No|No|No|No|90%|00093786565|FENTANYL CITRATE OTFC 200 MCG|30|EA|5.23955|09/14/2016||Yes|No||09/14/2016||Yes|No|09/14/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|109|Yes|11.9413|09/14/2016|11.77071|09/14/2016|11.2102|09/14/2016|||ANALGESICS: NARCOTICS SHORT|1828|||||No|No||TEVA USA|No||||
fentanyl citrate|No|No|No|No|90%|00093786665|FENTANYL CITRATE OTFC 400 MCG|30|EA|6.63819|09/14/2016||Yes|No||09/14/2016||Yes|No|09/14/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|109|Yes|15.1289|05/23/2017|14.91277|05/23/2017|14.20264|05/23/2017|||ANALGESICS: NARCOTICS SHORT|1829|||||No|No||TEVA USA|No||||
fentanyl citrate|No|No|No|No|90%|00093786765|FENTANYL CITRATE OTFC 600 MCG|30|EA|8.13072|09/14/2016||Yes|No||09/14/2016||Yes|No|09/14/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|109|Yes|18.53048|09/20/2016|18.26576|09/20/2016|17.39596|09/20/2016|||ANALGESICS: NARCOTICS SHORT|1830|||||No|No||TEVA USA|No||||
fentanyl citrate|No|No|No|No|90%|00093786865|FENTANYL CITRATE OTFC 800 MCG|30|EA|9.63372|09/14/2016||Yes|No||09/14/2016||Yes|No|09/14/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|109|Yes|21.95592|11/28/2017|21.64226|11/28/2017|20.61168|11/28/2017|||ANALGESICS: NARCOTICS SHORT|1831|||||No|No||TEVA USA|No||||
fentanyl citrate|No|No|No|No|90%|00093786965|FENTANYL CIT OTFC 1,200 MCG|30|EA|12.52489|09/14/2016||Yes|No||09/14/2016||Yes|No|09/14/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|109|Yes|28.5451|01/24/2017|28.13731|01/24/2017|26.79744|01/24/2017|||ANALGESICS: NARCOTICS SHORT|1832|||||No|No||TEVA USA|No||||
fentanyl citrate|No|No|No|No|90%|00093787065|FENTANYL CIT OTFC 1,600 MCG|30|EA|15.44732|09/14/2016||Yes|No||09/14/2016||Yes|No|09/14/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|109|Yes|35.20552|09/14/2016|34.70258|09/14/2016|33.05008|09/14/2016|||ANALGESICS: NARCOTICS SHORT|1833|||||No|No||TEVA USA|No||||
tiopronin|No|No|No|No|75%|00093790901|TIOPRONIN 100 MG TABLET|100|EA|10.48026|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No|||No|23.88524|08/30/2021|23.54402|08/30/2021|22.42288|08/30/2021||||1834|||||No|No||TEVA USA|No||||
glyburide,micronized|Yes|No|No|No|75%|00093803401|GLYBURIDE MICRO 1.5 MG TAB|100|EA|.06536|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.14896|10/25/2016|.14683|10/25/2016|.13984|10/25/2016||||1835|||||No|No||TEVA USA|No||||
glyburide,micronized|Yes|No|No|No|75%|00093803501|GLYBURIDE MICRO 3 MG TABLET|100|EA|.08363|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.19061|11/23/2021|.18788|11/23/2021|.17894|11/23/2021||||1836|||||No|No||TEVA USA|No||||
glyburide,micronized|Yes|No|No|No|75%|00093803505|GLYBURIDE MICRO 3 MG TABLET|500|EA|.07942|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.181|11/23/2021|.17842|11/23/2021|.16992|11/23/2021||||1837|||||No|No||TEVA USA|No||||
glyburide,micronized|Yes|No|No|No|75%|00093803601|GLYBURIDE MICRO 6 MG TABLET|100|EA|.23069|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.18063|01/25/2022|.17629|01/25/2022|.17746|01/25/2022||||1838|||||No|No||TEVA USA|No||||
tiagabine HCl|No|No|No|No|75%|00093807256|TIAGABINE HCL 12 MG TABLET|30|EA|3.75232|06/25/2018||Yes|No||06/25/2018||Yes|No|06/25/2018||Yes|No||||No|No|||Prescription required|No||056|No|8.5518|06/25/2018|8.42963|06/25/2018|8.02822|06/25/2018|||ANTICONVULSANTS|1839|||||No|No||TEVA USA|No||||
ethynodiol d-ethinyl estradiol|Yes|Yes|No|No|75%|00093807316|KELNOR 1-50 TABLET|28|EA|.37988|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No|Refer to program requirements|||No|No|06/04/2018||Prescription required|No|||No|.61349|01/25/2022|.59876|01/25/2022|.60275|01/25/2022||||1840|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
tiagabine HCl|No|No|No|No|75%|00093807656|TIAGABINE HCL 16 MG TABLET|30|EA|4.91404|06/25/2018||Yes|No||06/25/2018||Yes|No|06/25/2018||Yes|No||||No|No|||Prescription required|No||056|No|11.19944|06/25/2018|11.03944|06/25/2018|10.51376|06/25/2018|||ANTICONVULSANTS|1841|||||No|No||TEVA USA|No||||
famciclovir|No|No|No|No|75%|00093811756|FAMCICLOVIR 125 MG TABLET|30|EA|.63611|02/08/2008||Yes|No||02/08/2008||Yes|No|02/08/2008||Yes|No||||No|No|||Prescription required|No||025|No|.30813|10/26/2021|.30073|10/26/2021|.30273|10/26/2021|||ANTIVIRALS: ORAL|1842|||||No|No||TEVA USA|No||||
famciclovir|Yes|No|No|No|75%|00093811856|FAMCICLOVIR 250 MG TABLET|30|EA|.69158|02/08/2008||Yes|No||02/08/2008||Yes|No|02/08/2008||Yes|No||||No|No|11/01/2012||Prescription required|No||025|No|.49235|03/29/2022|.48053|03/29/2022|.48373|03/29/2022|||ANTIVIRALS: ORAL|1843|||||No|No||TEVA USA|No||||
famciclovir|No|No|No|No|75%|00093811956|FAMCICLOVIR 500 MG TABLET|30|EA|1.38875|02/08/2008||Yes|No||02/08/2008||Yes|No|02/08/2008||Yes|No||||No|No|||Prescription required|No||025|No|.88904|03/29/2022|.8677|03/29/2022|.87348|03/29/2022|||ANTIVIRALS: ORAL|1844|||||No|No||TEVA USA|No||||
quetiapine fumarate|No|No|No|No|75%|00093816201|QUETIAPINE FUMARATE 100 MG TAB|100|EA|.29485|04/17/2012||Yes|No||04/17/2012||Yes|No|04/17/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.05826|03/29/2022|.05686|03/29/2022|.05724|03/29/2022|||ANTIPSYCHOTICS|1845|||||No|No||TEVA USA|No||||
quetiapine fumarate|No|No|No|No|75%|00093816301|QUETIAPINE FUMARATE 200 MG TAB|100|EA|.55629|04/17/2012||Yes|No||04/17/2012||Yes|No|04/17/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.10261|03/29/2022|.10014|03/29/2022|.10081|03/29/2022|||ANTIPSYCHOTICS|1846|||||No|No||TEVA USA|No||||
quetiapine fumarate|No|No|No|No|75%|00093816401|QUETIAPINE FUMARATE 300 MG TAB|100|EA|.72936|04/17/2012||Yes|No||04/17/2012||Yes|No|04/17/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.13964|03/29/2022|.13628|03/29/2022|.13719|03/29/2022|||ANTIPSYCHOTICS|1847|||||No|No||TEVA USA|No||||
quetiapine fumarate|No|No|No|No|75%|00093816501|QUETIAPINE FUMARATE 400 MG TAB|100|EA|.8572|04/17/2012||Yes|No||04/17/2012||Yes|No|04/17/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.17858|03/29/2022|.17429|03/29/2022|.17545|03/29/2022|||ANTIPSYCHOTICS|1848|||||No|No||TEVA USA|No||||
quetiapine fumarate|No|No|No|No|75%|00093816601|QUETIAPINE FUMARATE 50 MG TAB|100|EA|.28238|04/17/2012||Yes|No||04/17/2012||Yes|No|04/17/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.04283|03/29/2022|.0418|03/29/2022|.04208|03/29/2022|||ANTIPSYCHOTICS|1849|||||No|No||TEVA USA|No||||
oseltamivir phosphate|No|No|No|No|75%|00093818064|OSELTAMIVIR 6 MG/ML SUSPENSION|60|ML|.49636|11/20/2019||Yes|No||11/20/2019||Yes|No|11/20/2019||Yes|No||||No|No|||Prescription required|No||025|No|.51688|03/29/2022|.50447|03/29/2022|.50783|03/29/2022|||ANTIVIRALS: ORAL|1850|||||No|No||TEVA USA|No||||
cimetidine|No|No|No|No|75%|00093819201|CIMETIDINE 300 MG TABLET|100|EA|.15888|02/02/2018||Yes|No||02/02/2018||Yes|No|02/02/2018||Yes|No||||No|No|||Prescription required|No|||No|.2727|03/29/2022|.26615|03/29/2022|.26792|03/29/2022||||1851|||||No|No||TEVA USA|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|00093823256|IRBESARTAN-HCTZ 300-12.5 MG TB|30|EA|.19192|03/18/2014||Yes|No||03/18/2014||Yes|No|03/18/2014||Yes|No||03/18/2014||Yes|No|07/01/2016||Prescription required|No||113|Yes|.26247|03/29/2022|.25617|03/29/2022|.25787|03/29/2022|||ANGIOTENSIN MODULATORS|1852|||||No|No||TEVA USA|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|00093823298|IRBESARTAN-HCTZ 300-12.5 MG TB|90|EA|.18561|03/18/2014||Yes|No||03/18/2014||Yes|No|03/18/2014||Yes|No||03/18/2014||Yes|No|07/01/2016||Prescription required|No||113|Yes|.26247|03/29/2022|.25617|03/29/2022|.25787|03/29/2022|||ANGIOTENSIN MODULATORS|1853|||||No|No||TEVA USA|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|00093823856|IRBESARTAN-HCTZ 150-12.5 MG TB|30|EA|.1548|05/24/2013||Yes|No||05/24/2013||Yes|No|05/24/2013||Yes|No||05/24/2013||Yes|No|07/01/2016||Prescription required|No||113|Yes|.24959|03/29/2022|.24359|03/29/2022|.24522|03/29/2022|||ANGIOTENSIN MODULATORS|1854|||||No|No||TEVA USA|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|00093823898|IRBESARTAN-HCTZ 150-12.5 MG TB|90|EA|.15064|05/24/2013||Yes|No||05/24/2013||Yes|No|05/24/2013||Yes|No||05/24/2013||Yes|No|07/01/2016||Prescription required|No||113|Yes|.24959|03/29/2022|.24359|03/29/2022|.24522|03/29/2022|||ANGIOTENSIN MODULATORS|1855|||||No|No||TEVA USA|No||||
cimetidine|No|No|No|No|75%|00093830501|CIMETIDINE 800 MG TABLET|100|EA|.49617|03/08/2011||Yes|No||03/08/2011||Yes|No|03/08/2011||Yes|No||03/08/2011||Yes|No|||Prescription required|No|||No|.91984|03/29/2022|.89776|03/29/2022|.90374|03/29/2022||||1856|||||No|No||TEVA USA|No||||
eletriptan hydrobromide|No|No|No|No|75%|00093831018|ELETRIPTAN HBR 20 MG TABLET|6|EA|7.92848|11/28/2017||Yes|No||11/28/2017||Yes|No|11/28/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|021|No|6.78979|03/29/2022|6.62683|03/29/2022|6.67096|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|1857|||||No|No||TEVA USA|No||||
eletriptan hydrobromide|No|No|No|No|75%|00093831118|ELETRIPTAN HBR 40 MG TABLET|6|EA|7.92848|11/28/2017||Yes|No||11/28/2017||Yes|No|11/28/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|021|No|3.20664|03/29/2022|3.12968|03/29/2022|3.15052|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|1858|||||No|No||TEVA USA|No||||
glyburide|Yes|No|No|No|75%|00093834201|GLYBURIDE 1.25 MG TABLET|100|EA|.05448|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.0711|03/29/2022|.06939|03/29/2022|.06985|03/29/2022||||1859|||||No|No||TEVA USA|No||||
glyburide|Yes|No|No|No|75%|00093834301|GLYBURIDE 2.5 MG TABLET|100|EA|.0688|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.07275|03/29/2022|.071|03/29/2022|.07147|03/29/2022||||1860|||||No|No||TEVA USA|No||||
glyburide|Yes|No|No|No|75%|00093834305|GLYBURIDE 2.5 MG TABLET|500|EA|.06708|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.07275|03/29/2022|.071|03/29/2022|.07147|03/29/2022||||1861|||||No|No||TEVA USA|No||||
glyburide|Yes|No|No|No|75%|00093834310|GLYBURIDE 2.5 MG TABLET|1000|EA|.06536|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.07275|03/29/2022|.071|03/29/2022|.07147|03/29/2022||||1862|||||No|No||TEVA USA|No||||
glyburide|Yes|No|No|No|75%|00093834401|GLYBURIDE 5 MG TABLET|100|EA|.1118|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.09415|03/29/2022|.09189|03/29/2022|.0925|03/29/2022||||1863|||||No|No||TEVA USA|No||||
glyburide|Yes|No|No|No|75%|00093834405|GLYBURIDE 5 MG TABLET|500|EA|.11667|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.09415|03/29/2022|.09189|03/29/2022|.0925|03/29/2022||||1864|||||No|No||TEVA USA|No||||
glyburide|Yes|No|No|No|75%|00093834410|GLYBURIDE 5 MG TABLET|1000|EA|.10374|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.09415|03/29/2022|.09189|03/29/2022|.0925|03/29/2022||||1865|||||No|No||TEVA USA|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00093867574|AMOX-CLAV 600-42.9 MG/5 ML SUS|200|ML|.15563|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|No||046|No|.06244|03/29/2022|.06094|03/29/2022|.06134|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1866|||||No|No||TEVA USA|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00093867575|AMOX-CLAV 600-42.9 MG/5 ML SUS|125|ML|.15858|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|No||046|No|.06559|03/29/2022|.06401|03/29/2022|.06444|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1867|||||No|No||TEVA USA|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00093867578|AMOX-CLAV 600-42.9 MG/5 ML SUS|75|ML|.16505|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|No||046|No|.08577|03/29/2022|.08371|03/29/2022|.08426|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|1868|||||No|No||TEVA USA|No||||
mexiletine HCl|No|No|No|No|75%|00093873901|MEXILETINE 150 MG CAPSULE|100|EA|.55611|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.76273|03/29/2022|.74442|03/29/2022|.74938|03/29/2022||||1869|||||No|No||TEVA USA|No||||
mexiletine HCl|No|No|No|No|75%|00093874001|MEXILETINE 200 MG CAPSULE|100|EA|.6763|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.85196|03/29/2022|.83151|03/29/2022|.83705|03/29/2022||||1870|||||No|No||TEVA USA|No||||
mexiletine HCl|No|No|No|No|75%|00093874101|MEXILETINE 250 MG CAPSULE|100|EA|.7921|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|1.80525|01/25/2022|1.77946|01/25/2022|1.69473|01/25/2022||||1871|||||No|No||TEVA USA|No||||
cyclosporine, modified|No|No|No|No|75%|00093901865|CYCLOSPORINE MODIFIED 25 MG|30|EA|.47285|07/20/2021||Yes|No||07/20/2021||Yes|No|07/20/2021||Yes|No||07/20/2021||Yes|No|||Prescription required|No||229|No|.55875|03/29/2022|.54534|03/29/2022|.54897|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|1872|||||No|No||TEVA USA|No||||
cyclosporine, modified|No|No|No|No|75%|00093901965|CYCLOSPORINE MODIFIED 50 MG|30|EA|.94528|07/20/2021||Yes|No||07/20/2021||Yes|No|07/20/2021||Yes|No||07/20/2021||Yes|No|||Prescription required|Yes|01/28/2021|229|No|1.26409|03/29/2022|1.23375|03/29/2022|1.24196|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|1873|||||No|No||TEVA USA|No||||
cyclosporine, modified|No|No|No|No|75%|00093902065|CYCLOSPORINE MODIFIED 100 MG|30|EA|1.89056|07/20/2021||Yes|No||07/20/2021||Yes|No|07/20/2021||Yes|No||07/20/2021||Yes|No|||Prescription required|No||229|No|1.49497|03/29/2022|1.45909|03/29/2022|1.4688|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|1874|||||No|No||TEVA USA|No||||
venlafaxine HCl|No|No|No|No|75%|00093914701|VENLAFAXINE HCL 25 MG TABLET|100|EA|.13373|06/24/2020||Yes|No||06/24/2020||Yes|No|06/24/2020||Yes|No||||No|No|||Prescription required|No||031|No|.11374|03/29/2022|.11101|03/29/2022|.11174|03/29/2022|||ANTIDEPRESSANTS: OTHER|1875|||||No|No||TEVA USA|No||||
venlafaxine HCl|No|No|No|No|75%|00093914801|VENLAFAXINE HCL 37.5 MG TABLET|100|EA|.13781|06/24/2020||Yes|No||06/24/2020||Yes|No|06/24/2020||Yes|No||||No|No|||Prescription required|No||031|Yes|.11453|03/29/2022|.11178|03/29/2022|.11252|03/29/2022|||ANTIDEPRESSANTS: OTHER|1876|||||No|No||TEVA USA|No||||
venlafaxine HCl|No|No|No|No|75%|00093914901|VENLAFAXINE HCL 50 MG TABLET|100|EA|.1419|06/24/2020||Yes|No||06/24/2020||Yes|No|06/24/2020||Yes|No||||No|No|||Prescription required|No||031|No|.12769|03/29/2022|.12462|03/29/2022|.12545|03/29/2022|||ANTIDEPRESSANTS: OTHER|1877|||||No|No||TEVA USA|No||||
venlafaxine HCl|No|No|No|No|75%|00093915701|VENLAFAXINE HCL 75 MG TABLET|100|EA|.1505|06/24/2020||Yes|No||06/24/2020||Yes|No|06/24/2020||Yes|No||||No|No|||Prescription required|No||031|No|.10828|03/29/2022|.10568|03/29/2022|.10638|03/29/2022|||ANTIDEPRESSANTS: OTHER|1878|||||No|No||TEVA USA|No||||
venlafaxine HCl|No|No|No|No|75%|00093916301|VENLAFAXINE HCL 100 MG TABLET|100|EA|.15953|06/24/2020||Yes|No||06/24/2020||Yes|No|06/24/2020||Yes|No||||No|No|||Prescription required|No||031|No|.13788|03/29/2022|.13457|03/29/2022|.13546|03/29/2022|||ANTIDEPRESSANTS: OTHER|1879|||||No|No||TEVA USA|No||||
dimethyl fumarate|No|No|No|No|75%|00093921841|DIMETHYL FUMARATE DR 120 MG CP|14|EA|2.36653|12/30/2020|08/16/2022|Yes|No||12/30/2020|08/16/2022|Yes|No|12/30/2020|08/16/2022|Yes|No||||No|No|||Prescription required|No||043|No|6.92871|10/26/2021|6.76242|10/26/2021|6.80745|10/26/2021|||MULTIPLE SCLEROSIS AGENTS|1880|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TEVA USA|No||||
dimethyl fumarate|No|No|No|No|75%|00093921906|DIMETHYL FUMARATE DR 240 MG CP|60|EA|2.3665|12/30/2020|08/16/2022|Yes|No||12/30/2020|08/16/2022|Yes|No|12/30/2020|08/16/2022|Yes|No||||No|No|||Prescription required|No||043|No|3.05522|11/23/2021|2.98189|11/23/2021|3.00175|11/23/2021|||MULTIPLE SCLEROSIS AGENTS|1881|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TEVA USA|No||||
diflunisal|No|No|No|No|75%|00093922201|DIFLUNISAL 500 MG TABLET|100|EA|.71079|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||02/16/2022||Yes|No|||Prescription required|Yes|01/28/2021|059|Yes|.92195|03/29/2022|.89982|03/29/2022|.90581|03/29/2022|||NSAIDS|1882|||||No|No||TEVA USA|No||||
diflunisal|No|No|No|No|75%|00093922206|DIFLUNISAL 500 MG TABLET|60|EA|.71079|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||02/16/2022||Yes|No|||Prescription required|Yes|01/28/2021|059|Yes|.92195|03/29/2022|.89982|03/29/2022|.90581|03/29/2022|||NSAIDS|1883|||||No|No||TEVA USA|No||||
mesalamine|No|No|No|No|75%|00093922489|MESALAMINE ER 0.375 GRAM CAP|120|EA|1.35499|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|010|No|1.86918|03/29/2022|1.82431|03/29/2022|1.83646|03/29/2022|||ULCERATIVE COLITIS AGENTS|1884|||||No|No||TEVA USA|No||||
glyburide|Yes|No|No|No|75%|00093936401|GLYBURIDE 5 MG TABLET|100|EA|.13738|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.09415|03/29/2022|.09189|03/29/2022|.0925|03/29/2022||||1885|||||No|No||TEVA USA|No||||
glyburide|Yes|No|No|No|75%|00093936405|GLYBURIDE 5 MG TABLET|500|EA|.13394|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.09415|03/29/2022|.09189|03/29/2022|.0925|03/29/2022||||1886|||||No|No||TEVA USA|No||||
glyburide|Yes|No|No|No|75%|00093936410|GLYBURIDE 5 MG TABLET|1000|EA|.1305|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.09415|03/29/2022|.09189|03/29/2022|.0925|03/29/2022||||1887|||||No|No||TEVA USA|No||||
glyburide|Yes|No|No|No|75%|00093943301|GLYBURIDE 2.5 MG TABLET|100|EA|.08879|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.07275|03/29/2022|.071|03/29/2022|.07147|03/29/2022||||1888|||||No|No||TEVA USA|No||||
glyburide|Yes|No|No|No|75%|00093943305|GLYBURIDE 2.5 MG TABLET|500|EA|.08655|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.07275|03/29/2022|.071|03/29/2022|.07147|03/29/2022||||1889|||||No|No||TEVA USA|No||||
glyburide|Yes|No|No|No|75%|00093947753|GLYBURIDE 1.25 MG TABLET|50|EA|.08772|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.0711|03/29/2022|.06939|03/29/2022|.06985|03/29/2022||||1890|||||No|No||TEVA USA|No||||
butalbital/acetaminophen|No|No|No|No|75%|00095300001|BUPAP 50 MG-300 MG TABLET|100|EA|5.79941|08/23/2013||Yes|No||08/23/2013||Yes|No|08/23/2013||Yes|No||||No|No|||Prescription required|No|||No|13.21726|12/04/2018|13.02844|12/04/2018|12.40804|12/04/2018||||1891|||||No|No||BAUSCH HEALTH U|No||||
ibuprofen|No|No|No|No|75%|00113005705|GS INF IBUPROFEN 50 MG/1.25 ML|15|ML|.11524|04/22/2009||Yes|No||||No|No|04/22/2009||Yes|No||||No|No|||Over the counter|No||059|Yes|.24939|03/29/2022|.2434|03/29/2022|.24502|03/29/2022|||NSAIDS|1892|||||No|No||PERRIGO/GOODSEN|No||||
famotidine|No|No|No|No|75%|00113014165|GS ACID REDUCER 10 MG TABLET|30|EA|.10334|05/06/2020||Yes|No||||No|No|05/06/2020||Yes|No||||No|No|||Over the counter|No|||No|.09993|03/29/2022|.09753|03/29/2022|.09818|03/29/2022||||1893|||||No|No||PERRIGO/GOODSEN|No||||
ibuprofen|No|No|No|No|75%|00113016626|GS CHILD IBUPROFEN 100 MG/5 ML|120|ML|.01694|04/22/2009||Yes|No||||No|No|04/22/2009||Yes|No||||No|No|||Over the counter|No||059|Yes|.03078|03/29/2022|.03004|03/29/2022|.03024|03/29/2022|||NSAIDS|1894|||||No|No||PERRIGO/GOODSEN|No||||
polyethylene glycol 3350|No|No|No|No|75%|00113030602|GS CLEARLAX POWDER|238|GM|.01434|03/29/2019||Yes|No||||No|No|03/29/2019||Yes|No||||No|No|||Over the counter|No|||No|.02672|03/29/2022|.02607|03/29/2022|.02625|03/29/2022||||1895|||||No|No||PERRIGO/GOODSEN|No||||
polyethylene glycol 3350|No|No|No|No|75%|00113030603|GS CLEARLAX POWDER|510|GM|.01269|03/29/2019||Yes|No||||No|No|03/29/2019||Yes|No||||No|No|||Over the counter|No|||No|.02124|03/29/2022|.02073|03/29/2022|.02086|03/29/2022||||1896|||||No|No||PERRIGO/GOODSEN|No||||
mag hydrox/aluminum hyd/simeth|No|No|No|No|75%|00113035740|GS ANTACID PLUS ANTI-GAS LIQ|355|ML|.00484|04/22/2009||Yes|No||||No|No|04/22/2009||Yes|No||||No|No|||Over the counter|No|||No|.00773|03/29/2022|.00754|03/29/2022|.00759|03/29/2022||||1897|||||No|No||PERRIGO/GOODSEN|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|00113057826|GS TUSSIN DM LIQUID|118|ML|.01453|04/22/2009||Yes|No||||No|No|04/22/2009||Yes|No||||No|No|||Over the counter|No||184|Yes|.01774|03/29/2022|.01731|03/29/2022|.01742|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|1898|||||No|No||PERRIGO/GOODSEN|No||||
ibuprofen|No|No|No|No|75%|00113060471|GS IBUPROFEN 200 MG TABLET|50|EA|.04325|04/22/2009||Yes|No||||No|No|04/22/2009||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|1899|||||No|No||PERRIGO/GOODSEN|No||||
ibuprofen|No|No|No|No|75%|00113060478|GS IBUPROFEN 200 MG TABLET|100|EA|.03276|04/22/2009||Yes|No||||No|No|04/22/2009||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|1900|||||No|No||PERRIGO/GOODSEN|No||||
ibuprofen|No|No|No|No|75%|00113060490|GS IBUPROFEN 200 MG TABLET|500|EA|.00614|04/22/2009||Yes|No||||No|No|04/22/2009||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|1901|||||No|No||PERRIGO/GOODSEN|No||||
loratadine|No|No|No|No|75%|00113061239|GS ALLERGY RELIEF 10 MG TABLET|30|EA|.24037|06/20/2007||Yes|No||||No|No|06/20/2007||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|1902|||||No|No||PERRIGO/GOODSEN|No||||
loratadine|No|No|No|No|75%|00113061265|GS ALLERGY RELIEF 10 MG TABLET|30|EA|.24037|01/31/2005||Yes|No||||No|No|01/31/2005||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|1903|||||No|No||PERRIGO/GOODSEN|No||||
ibuprofen|No|No|No|No|75%|00113066026|GS CHILD IBUPROFEN 100 MG/5 ML|120|ML|.01694|04/22/2009||Yes|No||||No|No|04/22/2009||Yes|No||||No|No|||Over the counter|No||059|Yes|.03078|03/29/2022|.03004|03/29/2022|.03024|03/29/2022|||NSAIDS|1904|||||No|No||PERRIGO/GOODSEN|No||||
nicotine polacrilex|No|No|No|No|75%|00113073402|GS NICOTINE 2 MG MINI LOZENGE|81|EA|.16063|01/05/2021||Yes|No||||No|No|01/05/2021||Yes|No||||No|No|||Over the counter|No||040|No|.4117|11/23/2021|.40181|11/23/2021|.40449|11/23/2021|||SMOKING CESSATION|1905|||||No|No||PERRIGO/GOODSEN|No||||
simethicone|No|No|No|No|75%|00113088210|GS SIMETHICONE 20 MG/0.3 ML|30|ML|.02221|04/22/2009||Yes|No||||No|No|04/22/2009||Yes|No||||No|No|||Over the counter|No|||No|.0916|03/29/2022|.0894|03/29/2022|.08999|03/29/2022||||1906|||||No|No||PERRIGO/GOODSEN|No||||
ibuprofen|No|No|No|No|75%|00113089726|GS CHILD IBUPROFEN 100 MG/5 ML|120|ML|.01694|04/22/2009||Yes|No||||No|No|04/22/2009||Yes|No||||No|No|||Over the counter|No||059|Yes|.03078|03/29/2022|.03004|03/29/2022|.03024|03/29/2022|||NSAIDS|1907|||||No|No||PERRIGO/GOODSEN|No||||
ibuprofen|No|No|No|No|75%|00113089734|GS CHILD IBUPROFEN 100 MG/5 ML|240|ML|.01336|06/23/2009||Yes|No||||No|No|06/23/2009||Yes|No||||No|No|||Over the counter|No||059|Yes|.02479|03/29/2022|.02419|03/29/2022|.02435|03/29/2022|||NSAIDS|1908|||||No|No||PERRIGO/GOODSEN|No||||
omeprazole|No|No|No|No|75%|00113091555|GS OMEPRAZOLE DR 20 MG TABLET|42|EA|.20783|05/18/2009||Yes|No||||No|No|05/18/2009||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.45914|03/29/2022|.44812|03/29/2022|.4511|03/29/2022|||PROTON PUMP INHIBITORS|1909|||||No|No||PERRIGO/GOODSEN|No||||
fenofibrate,micronized|No|No|No|No|75%|00115051101|FENOFIBRATE 67 MG CAPSULE|100|EA|.06923|05/22/2009|07/26/2022|Yes|No||05/22/2009|07/26/2022|Yes|No|05/22/2009|07/26/2022|Yes|No||||No|No|||Prescription required|No||055|No|.15038|03/29/2022|.14677|03/29/2022|.14774|03/29/2022|||LIPOTROPICS: OTHER|1910|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
fenofibrate,micronized|No|No|No|No|75%|00115052201|FENOFIBRATE 134 MG CAPSULE|100|EA|.09137|05/22/2009|02/03/2023|Yes|No||05/22/2009|02/03/2023|Yes|No|05/22/2009|02/03/2023|Yes|No||||No|No|||Prescription required|No||055|No|.17604|03/29/2022|.17181|03/29/2022|.17295|03/29/2022|||LIPOTROPICS: OTHER|1911|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
fenofibrate,micronized|No|No|No|No|75%|00115052202|FENOFIBRATE 134 MG CAPSULE|500|EA|.09137|10/14/2013|02/03/2023|Yes|No||10/14/2013|02/03/2023|Yes|No|10/14/2013|02/03/2023|Yes|No||||No|No|||Prescription required|No||055|No|.17604|03/29/2022|.17181|03/29/2022|.17295|03/29/2022|||LIPOTROPICS: OTHER|1912|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
fenofibrate,micronized|No|No|No|No|75%|00115053301|FENOFIBRATE 200 MG CAPSULE|100|EA|.15652|05/22/2009|11/19/2022|Yes|No||05/22/2009|11/19/2022|Yes|No|05/22/2009|11/19/2022|Yes|No||||No|No|||Prescription required|No||055|No|.22993|03/29/2022|.22441|03/29/2022|.2259|03/29/2022|||LIPOTROPICS: OTHER|1913|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
baclofen|No|No|No|No|75%|00115101001|BACLOFEN 10 MG TABLET|100|EA|.02816|09/27/2021||Yes|No||09/27/2021||Yes|No|09/27/2021||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|1914|||||No|No||AMNEAL PHARMACE|No||||
baclofen|No|No|No|No|75%|00115101003|BACLOFEN 10 MG TABLET|1000|EA|.02817|12/15/2021||Yes|No||12/15/2021||Yes|No|12/15/2021||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|1915|||||No|No||AMNEAL PHARMACE|No||||
baclofen|No|No|No|No|75%|00115101101|BACLOFEN 5 MG TABLET|100|EA|.31875|12/20/2021||Yes|No||12/20/2021||Yes|No|12/20/2021||Yes|No||||No|No|||Prescription required|No||116|No|.53855|03/29/2022|.52562|03/29/2022|.52912|03/29/2022|||SKELETAL MUSCLE RELAXANTS|1916|||||No|No||AMNEAL PHARMACE|No||||
baclofen|No|No|No|No|75%|00115101201|BACLOFEN 20 MG TABLET|100|EA|.04102|09/27/2021||Yes|No||09/27/2021||Yes|No|09/27/2021||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|1917|||||No|No||AMNEAL PHARMACE|No||||
baclofen|No|No|No|No|75%|00115101203|BACLOFEN 20 MG TABLET|1000|EA|.04099|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|1918|||||No|No||AMNEAL PHARMACE|No||||
dipyridamole|No|No|No|No|75%|00115107001|DIPYRIDAMOLE 25 MG TABLET|100|EA|.32073|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|Yes|07/17/2007|004|No|1.06294|03/29/2022|1.03742|03/29/2022|1.04433|03/29/2022|||PLATELET AGGREGATION INHIBITORS|1919|||||No|No||AMNEAL PHARMACE|No||||
dipyridamole|No|No|No|No|75%|00115107101|DIPYRIDAMOLE 50 MG TABLET|100|EA|.51664|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|Yes|07/17/2007|004|No|1.35098|03/29/2022|1.31855|03/29/2022|1.32733|03/29/2022|||PLATELET AGGREGATION INHIBITORS|1920|||||No|No||AMNEAL PHARMACE|No||||
dipyridamole|No|No|No|No|75%|00115107201|DIPYRIDAMOLE 75 MG TABLET|100|EA|.69126|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|Yes|07/17/2007|004|No|1.57544|10/19/2021|1.55294|10/19/2021|1.47899|10/19/2021|||PLATELET AGGREGATION INHIBITORS|1921|||||No|No||AMNEAL PHARMACE|No||||
morphine sulfate|No|No|No|No|90%|00115127701|MORPHINE SULFATE ER 20 MG CAP|100|EA|1.79869|03/10/2017|10/29/2022|Yes|No||03/10/2017|10/29/2022|Yes|No|03/10/2017|10/29/2022|Yes|No||||No|No|||Prescription required|Yes|07/21/2016|110|Yes|3.39578|03/01/2022|3.31428|03/01/2022|3.33635|03/01/2022|||ANALGESICS: NARCOTICS LONG|1922|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
morphine sulfate|No|No|No|No|90%|00115127801|MORPHINE SULFATE ER 30 MG CAP|100|EA|1.95637|03/10/2017|02/22/2022|Yes|No||03/10/2017|02/22/2022|Yes|No|03/10/2017|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|07/21/2016|110|Yes|4.4587|03/29/2022|4.39501|03/29/2022|4.18572|03/29/2022|||ANALGESICS: NARCOTICS LONG|1923|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMNEAL PHARMACE|No||||
morphine sulfate|No|No|No|No|90%|00115127901|MORPHINE SULFATE ER 50 MG CAP|100|EA|2.24976|03/10/2017|02/22/2022|Yes|No||03/10/2017|02/22/2022|Yes|No|03/10/2017|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|07/21/2016|110|Yes|5.12736|03/29/2022|5.05411|03/29/2022|4.81344|03/29/2022|||ANALGESICS: NARCOTICS LONG|1924|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMNEAL PHARMACE|No||||
morphine sulfate|No|No|No|No|90%|00115128001|MORPHINE SULFATE ER 60 MG CAP|100|EA|2.58722|03/10/2017|02/22/2022|Yes|No||03/10/2017|02/22/2022|Yes|No|03/10/2017|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|07/21/2016|110|Yes|5.89646|10/26/2021|5.81222|10/26/2021|5.53545|10/26/2021|||ANALGESICS: NARCOTICS LONG|1925|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMNEAL PHARMACE|No||||
morphine sulfate|No|No|No|No|90%|00115128101|MORPHINE SULFATE ER 80 MG CAP|100|EA|2.97534|03/10/2017|02/22/2022|Yes|No||03/10/2017|02/22/2022|Yes|No|03/10/2017|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|07/21/2016|110|Yes|6.78101|08/25/2020|6.68414|08/25/2020|6.36584|08/25/2020|||ANALGESICS: NARCOTICS LONG|1926|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMNEAL PHARMACE|No||||
morphine sulfate|No|No|No|No|90%|00115128201|MORPHINE SULFATE ER 100 MG CAP|100|EA|3.42163|03/10/2017|02/22/2022|Yes|No||03/10/2017|02/22/2022|Yes|No|03/10/2017|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|07/21/2016|110|Yes|7.79815|08/25/2020|7.68675|08/25/2020|7.32071|08/25/2020|||ANALGESICS: NARCOTICS LONG|1927|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMNEAL PHARMACE|No||||
colesevelam HCl|No|No|No|No|75%|00115132019|COLESEVELAM 625 MG TABLET|180|EA|.47777|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|055|No|.48654|03/29/2022|.47486|03/29/2022|.47802|03/29/2022|||LIPOTROPICS: OTHER|1928|||||No|No||AMNEAL PHARMACE|No||||
doxycycline monohydrate|No|No|No|No|75%|00115132713|DOXYCYCLINE MONO 150 MG CAP|60|EA|7.82055|06/01/2011||Yes|No||06/01/2011||Yes|No|06/01/2011||Yes|No||06/01/2011||Yes|No|||Prescription required|Yes|01/20/2011|213|No|17.82358|06/01/2016|17.56896|06/01/2016|16.73234|06/01/2016|||TETRACYCLINES|1929|||||No|No||AMNEAL PHARMACE|No||||
sevelamer carbonate|No|No|No|No|75%|00115136529|SEVELAMER 0.8 GM POWDER PACKET|90|EA|.8361|12/20/2021||Yes|No||12/20/2021||Yes|No|12/20/2021||Yes|No||12/20/2021||Yes|No|||Prescription required|Yes|07/29/2021|052|Yes|1.90555|01/25/2022|1.87832|01/25/2022|1.78888|01/25/2022|||PHOSPHATE BINDERS|1930|||||No|No||AMNEAL PHARMACE|No||||
sevelamer carbonate|No|No|No|No|75%|00115136629|SEVELAMER 2.4 GM POWDER PACKET|90|EA|.8361|12/20/2021||Yes|No||12/20/2021||Yes|No|12/20/2021||Yes|No||12/20/2021||Yes|No|||Prescription required|Yes|07/29/2021|052|Yes|6.45324|12/20/2021|6.29836|12/20/2021|6.3403|12/20/2021|||PHOSPHATE BINDERS|1931|||||No|No||AMNEAL PHARMACE|No||||
pyridostigmine bromide|No|No|No|No|75%|00115140408|PYRIDOSTIGMINE ER 180 MG TAB|30|EA|6.93375|10/15/2015||Yes|No||10/15/2015||Yes|No|10/15/2015||Yes|No||||No|No|||Prescription required|No|||No|5.45827|03/29/2022|5.32727|03/29/2022|5.36275|03/29/2022||||1932|||||No|No||AMNEAL PHARMACE|No||||
methyltestosterone|No|No|No|No|90%|00115140801|METHYLTESTOSTERONE 10 MG CAP|100|EA|26.71968|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|No|||No|60.89602|05/18/2021|60.02608|05/18/2021|57.16769|05/18/2021||||1933|||||No|No||AMNEAL PHARMACE|No||||
cyclobenzaprine HCl|No|No|No|No|75%|00115143613|CYCLOBENZAPRINE ER 15 MG CAP|60|EA|2.92034|06/05/2019||Yes|No||06/05/2019||Yes|No|06/05/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|Yes|6.65567|12/29/2020|6.56058|12/29/2020|6.24818|12/29/2020|||SKELETAL MUSCLE RELAXANTS|1934|||||No|No||AMNEAL PHARMACE|No||||
cyclobenzaprine HCl|No|No|No|No|75%|00115143713|CYCLOBENZAPRINE ER 30 MG CAP|60|EA|2.92034|06/05/2019||Yes|No||06/05/2019||Yes|No|06/05/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|Yes|6.65567|12/29/2020|6.56058|12/29/2020|6.24818|12/29/2020|||SKELETAL MUSCLE RELAXANTS|1935|||||No|No||AMNEAL PHARMACE|No||||
lidocaine/prilocaine|No|No|No|No|75%|00115146845|LIDOCAINE-PRILOCAINE CREAM|30|GM|.24366|11/16/2012|04/27/2022|Yes|No||11/16/2012|04/27/2022|Yes|No|11/16/2012|04/27/2022|Yes|No||||No|No|||Prescription required|No|||No|.45426|03/29/2022|.44335|03/29/2022|.44631|03/29/2022||||1936|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
lidocaine/prilocaine|No|No|No|No|75%|00115146860|LIDOCAINE-PRILOCAINE CREAM|5|GM|.51858|01/03/2013|09/22/2022|Yes|No||01/03/2013|09/22/2022|Yes|No|01/03/2013|09/22/2022|Yes|No||||No|No|||Prescription required|No|||No|1.24616|03/01/2022|1.21625|03/01/2022|1.22435|03/01/2022||||1937|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
metronidazole|No|No|No|No|75%|00115147446|METRONIDAZOLE TOPICAL 0.75% GL|45|GM|.93644|11/01/2012||Yes|No||11/01/2012||Yes|No|11/01/2012||Yes|No||||No|No|||Prescription required|No||221|No|.54113|03/29/2022|.52814|03/29/2022|.53166|03/29/2022|||ROSACEA AGENTS: TOPICAL|1938|||||No|No||AMNEAL PHARMACE|No||||
calcipotriene|No|No|No|No|75%|00115147555|CALCIPOTRIENE 0.005% SOLUTION|60|ML|1.34711|11/01/2012|03/26/2022|Yes|No||11/01/2012|03/26/2022|Yes|No|11/01/2012|03/26/2022|Yes|No||||No|No|||Prescription required|No|||No|.84564|03/29/2022|.82534|03/29/2022|.83084|03/29/2022||||1939|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
morphine sulfate|No|No|No|No|90%|00115147901|MORPHINE SULFATE ER 40 MG CAP|100|EA|6.0851|12/06/2018|02/22/2022|Yes|No||12/06/2018|02/22/2022|Yes|No|12/06/2018|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|13.86837|12/06/2018|13.67025|12/06/2018|13.01928|12/06/2018|||ANALGESICS: NARCOTICS LONG|1940|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMNEAL PHARMACE|No||||
diclofenac sodium|No|No|No|No|75%|00115148361|DICLOFENAC SODIUM 3% GEL|100|GM|.39977|01/21/2014||Yes|No||01/21/2014||Yes|No|01/21/2014||Yes|No||||No|No|||Prescription required|No|||Yes|.41138|03/29/2022|.4015|03/29/2022|.40418|03/29/2022||||1941|||||No|No||AMNEAL PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00115148601|DEXTROAMP-AMPHET ER 5 MG CAP|100|EA|.3225|12/27/2016||Yes|No||12/27/2016||Yes|No|12/27/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.59233|03/29/2022|.57811|03/29/2022|.58196|03/29/2022|||STIMULANTS AND RELATED AGENTS|1942|||||No|No||AMNEAL PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00115148701|DEXTROAMP-AMPHET ER 10 MG CAP|100|EA|.3225|12/27/2016||Yes|No||12/27/2016||Yes|No|12/27/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.53198|03/29/2022|.51921|03/29/2022|.52267|03/29/2022|||STIMULANTS AND RELATED AGENTS|1943|||||No|No||AMNEAL PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00115148801|DEXTROAMP-AMPHET ER 15 MG CAP|100|EA|.3225|12/27/2016||Yes|No||12/27/2016||Yes|No|12/27/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55636|03/29/2022|.543|03/29/2022|.54662|03/29/2022|||STIMULANTS AND RELATED AGENTS|1944|||||No|No||AMNEAL PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00115148901|DEXTROAMP-AMPHET ER 20 MG CAP|100|EA|.3225|12/27/2016||Yes|No||12/27/2016||Yes|No|12/27/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.58746|03/29/2022|.57336|03/29/2022|.57717|03/29/2022|||STIMULANTS AND RELATED AGENTS|1945|||||No|No||AMNEAL PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00115149001|DEXTROAMP-AMPHET ER 25 MG CAP|100|EA|.3225|07/07/2016||Yes|No||07/07/2016||Yes|No|07/07/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.54687|03/29/2022|.53374|03/29/2022|.53729|03/29/2022|||STIMULANTS AND RELATED AGENTS|1946|||||No|No||AMNEAL PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00115149101|DEXTROAMP-AMPHET ER 30 MG CAP|100|EA|.3225|07/07/2016||Yes|No||07/07/2016||Yes|No|07/07/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.61484|03/29/2022|.60008|03/29/2022|.60408|03/29/2022|||STIMULANTS AND RELATED AGENTS|1947|||||No|No||AMNEAL PHARMACE|No||||
naftifine HCl|No|No|No|No|75%|00115151048|NAFTIFINE HCL 1% GEL|90|GM|1.80652|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|4.11719|03/03/2020|4.05837|03/03/2020|3.86512|03/03/2020|||ANTIFUNGALS: TOPICAL|1948|||||No|No||AMNEAL PHARMACE|No||||
naftifine HCl|No|No|No|No|75%|00115151058|NAFTIFINE HCL 1% GEL|60|GM|2.70978|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|6.17579|03/03/2020|6.08756|03/03/2020|5.79768|03/03/2020|||ANTIFUNGALS: TOPICAL|1949|||||No|No||AMNEAL PHARMACE|No||||
naftifine HCl|No|No|No|No|75%|00115151063|NAFTIFINE HCL 1% GEL|40|GM|4.06468|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|9.26369|03/03/2020|9.13135|03/03/2020|8.69653|03/03/2020|||ANTIFUNGALS: TOPICAL|1950|||||No|No||AMNEAL PHARMACE|No||||
naftifine HCl|No|No|No|No|75%|00115151246|NAFTIFINE HCL 2% CREAM|45|GM|3.0549|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|061|No|3.76396|09/28/2021|3.67362|09/28/2021|3.69809|09/28/2021|||ANTIFUNGALS: TOPICAL|1951|||||No|No||AMNEAL PHARMACE|No||||
naftifine HCl|No|No|No|No|75%|00115151258|NAFTIFINE HCL 2% CREAM|60|GM|3.0616|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|061|No|1.1856|01/25/2022|1.15714|01/25/2022|1.16485|01/25/2022|||ANTIFUNGALS: TOPICAL|1952|||||No|No||AMNEAL PHARMACE|No||||
fenofibrate|No|No|No|No|75%|00115152210|FENOFIBRATE 40 MG TABLET|90|EA|3.59412|06/13/2017||Yes|No||06/13/2017||Yes|No|06/13/2017||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|055|No|8.19127|06/13/2017|8.07425|06/13/2017|7.68976|06/13/2017|||LIPOTROPICS: OTHER|1953|||||No|No||AMNEAL PHARMACE|No||||
fenofibrate|No|No|No|No|75%|00115152310|FENOFIBRATE 120 MG TABLET|90|EA|10.78243|06/14/2017||Yes|No||06/14/2017||Yes|No|06/14/2017||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|055|No|10.5118|03/29/2022|10.25951|03/29/2022|10.32784|03/29/2022|||LIPOTROPICS: OTHER|1954|||||No|No||AMNEAL PHARMACE|No||||
fenofibric acid (choline)|No|No|No|No|75%|00115155410|FENOFIBRIC ACID DR 45 MG CAP|90|EA|.14333|05/29/2018||Yes|No||05/29/2018||Yes|No|05/29/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|055|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||LIPOTROPICS: OTHER|1955|||||No|No||AMNEAL PHARMACE|No||||
fenofibric acid (choline)|No|No|No|No|75%|00115155510|FENOFIBRIC ACID DR 135 MG CAP|90|EA|.35833|11/17/2017||Yes|No||11/17/2017||Yes|No|11/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|055|No|.69218|03/29/2022|.67556|03/29/2022|.68006|03/29/2022|||LIPOTROPICS: OTHER|1956|||||No|No||AMNEAL PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|00115155601|OXYCODONE HCL ER 10 MG TABLET|100|EA|1.04004|12/06/2016|02/09/2023|Yes|No||12/06/2016|02/09/2023|Yes|No|12/06/2016|02/09/2023|Yes|No||||No|No|||Prescription required|Yes|07/23/2015|110|Yes|2.46132|09/28/2021|2.40224|09/28/2021|2.41824|09/28/2021|||ANALGESICS: NARCOTICS LONG|1957|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|00115155701|OXYCODONE HCL ER 15 MG TABLET|100|EA|1.66358|07/07/2016|02/09/2023|Yes|No||07/07/2016|02/09/2023|Yes|No|07/07/2016|02/09/2023|Yes|No||||No|No|||Prescription required|Yes|07/23/2015|110|Yes|3.79142|08/27/2019|3.73726|08/27/2019|3.55929|08/27/2019|||ANALGESICS: NARCOTICS LONG|1958|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|00115155801|OXYCODONE HCL ER 20 MG TABLET|100|EA|1.93955|07/07/2016|02/09/2023|Yes|No||07/07/2016|02/09/2023|Yes|No|07/07/2016|02/09/2023|Yes|No||||No|No|||Prescription required|Yes|07/23/2015|110|Yes|4.05047|08/24/2021|3.95325|08/24/2021|3.97958|08/24/2021|||ANALGESICS: NARCOTICS LONG|1959|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|00115155901|OXYCODONE HCL ER 30 MG TABLET|100|EA|2.93083|07/07/2016|02/09/2023|Yes|No||07/07/2016|02/09/2023|Yes|No|07/07/2016|02/09/2023|Yes|No||||No|No|||Prescription required|Yes|07/23/2015|110|Yes|6.67958|09/24/2019|6.58415|09/24/2019|6.27062|09/24/2019|||ANALGESICS: NARCOTICS LONG|1960|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|00115156001|OXYCODONE HCL ER 40 MG TABLET|100|EA|3.32179|07/07/2016|02/09/2023|Yes|No||07/07/2016|02/09/2023|Yes|No|07/07/2016|02/09/2023|Yes|No||||No|No|||Prescription required|Yes|07/23/2015|110|Yes|5.67023|11/23/2021|5.53414|11/23/2021|5.571|11/23/2021|||ANALGESICS: NARCOTICS LONG|1961|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|00115156101|OXYCODONE HCL ER 60 MG TABLET|100|EA|5.10981|07/18/2016|02/09/2023|Yes|No||07/18/2016|02/09/2023|Yes|No|07/18/2016|02/09/2023|Yes|No||||No|No|||Prescription required|Yes|07/23/2015|110|Yes|11.64563|08/27/2019|11.47926|08/27/2019|10.93263|08/27/2019|||ANALGESICS: NARCOTICS LONG|1962|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|00115156201|OXYCODONE HCL ER 80 MG TABLET|100|EA|5.79644|07/18/2016|02/09/2023|Yes|No||07/18/2016|02/09/2023|Yes|No|07/18/2016|02/09/2023|Yes|No||||No|No|||Prescription required|Yes|07/23/2015|110|Yes|10.68078|12/28/2021|10.42444|12/28/2021|10.49386|12/28/2021|||ANALGESICS: NARCOTICS LONG|1963|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
azelaic acid|No|No|No|No|75%|00115162456|AZELAIC ACID 15% GEL|50|GM|1.29|02/26/2019|01/25/2023|Yes|No||02/26/2019|01/25/2023|Yes|No|02/26/2019|01/25/2023|Yes|No||||No|No|||Prescription required|Yes|01/28/2021|221|No|1.03233|03/29/2022|1.00755|03/29/2022|1.01426|03/29/2022|||ROSACEA AGENTS: TOPICAL|1964|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
nitrofurantoin macrocrystal|No|No|No|No|75%|00115164301|NITROFURANTOIN MCR 50 MG CAP|100|EA|.3225|05/25/2017||Yes|No||05/25/2017||Yes|No|05/25/2017||Yes|No||||No|No|||Prescription required|No|||No|.39225|03/29/2022|.38283|03/29/2022|.38538|03/29/2022||||1965|||||No|No||AMNEAL PHARMACE|No||||
nitrofurantoin macrocrystal|No|No|No|No|75%|00115164501|NITROFURANTOIN MCR 100 MG CAP|100|EA|.5332|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||05/16/2017||Yes|No|||Prescription required|No|||No|.47756|03/29/2022|.46609|03/29/2022|.4692|03/29/2022||||1966|||||No|No||AMNEAL PHARMACE|No||||
propranolol HCl|No|No|No|No|75%|00115165901|PROPRANOLOL 10 MG TABLET|100|EA|.06888|02/23/2017||Yes|No||02/23/2017||Yes|No|02/23/2017||Yes|No||02/23/2017||Yes|No|||Prescription required|No||070|No|.06946|03/29/2022|.06779|03/29/2022|.06824|03/29/2022|||BETA-BLOCKERS|1967|||||No|No||AMNEAL PHARMACE|No||||
propranolol HCl|No|No|No|No|75%|00115165903|PROPRANOLOL 10 MG TABLET|1000|EA|.06888|02/23/2017||Yes|No||02/23/2017||Yes|No|02/23/2017||Yes|No||02/23/2017||Yes|No|||Prescription required|No||070|No|.06946|03/29/2022|.06779|03/29/2022|.06824|03/29/2022|||BETA-BLOCKERS|1968|||||No|No||AMNEAL PHARMACE|No||||
propranolol HCl|No|No|No|No|75%|00115166001|PROPRANOLOL 20 MG TABLET|100|EA|.08591|02/23/2017||Yes|No||02/23/2017||Yes|No|02/23/2017||Yes|No||02/23/2017||Yes|No|||Prescription required|No||070|No|.08469|03/29/2022|.08265|03/29/2022|.0832|03/29/2022|||BETA-BLOCKERS|1969|||||No|No||AMNEAL PHARMACE|No||||
propranolol HCl|No|No|No|No|75%|00115166003|PROPRANOLOL 20 MG TABLET|1000|EA|.08591|03/03/2017||Yes|No||03/03/2017||Yes|No|03/03/2017||Yes|No||03/03/2017||Yes|No|||Prescription required|No||070|No|.08469|03/29/2022|.08265|03/29/2022|.0832|03/29/2022|||BETA-BLOCKERS|1970|||||No|No||AMNEAL PHARMACE|No||||
propranolol HCl|No|No|No|No|75%|00115166101|PROPRANOLOL 40 MG TABLET|100|EA|.10913|02/23/2017||Yes|No||02/23/2017||Yes|No|02/23/2017||Yes|No||02/23/2017||Yes|No|||Prescription required|No||070|No|.11538|03/29/2022|.11261|03/29/2022|.11336|03/29/2022|||BETA-BLOCKERS|1971|||||No|No||AMNEAL PHARMACE|No||||
propranolol HCl|No|No|No|No|75%|00115166103|PROPRANOLOL 40 MG TABLET|1000|EA|.10913|02/23/2017||Yes|No||02/23/2017||Yes|No|02/23/2017||Yes|No||02/23/2017||Yes|No|||Prescription required|No||070|No|.11538|03/29/2022|.11261|03/29/2022|.11336|03/29/2022|||BETA-BLOCKERS|1972|||||No|No||AMNEAL PHARMACE|No||||
propranolol HCl|No|No|No|No|75%|00115166201|PROPRANOLOL 80 MG TABLET|100|EA|.1637|05/24/2017||Yes|No||05/24/2017||Yes|No|05/24/2017||Yes|No||05/24/2017||Yes|No|||Prescription required|No||070|No|.21823|03/29/2022|.21299|03/29/2022|.21441|03/29/2022|||BETA-BLOCKERS|1973|||||No|No||AMNEAL PHARMACE|No||||
propranolol HCl|No|No|No|No|75%|00115166202|PROPRANOLOL 80 MG TABLET|500|EA|.1637|02/23/2017||Yes|No||02/23/2017||Yes|No|02/23/2017||Yes|No||02/23/2017||Yes|No|||Prescription required|No||070|No|.21823|03/29/2022|.21299|03/29/2022|.21441|03/29/2022|||BETA-BLOCKERS|1974|||||No|No||AMNEAL PHARMACE|No||||
budesonide|No|No|No|No|75%|00115168774|BUDESONIDE 0.25 MG/2 ML SUSP|2|ML|.60916|05/29/2018||Yes|No||05/29/2018||Yes|No|05/29/2018||Yes|No||||No|No|||Prescription required|No||033|Yes|.8321|03/29/2022|.81212|03/29/2022|.81753|03/29/2022|||GLUCOCORTICOIDS: INHALED|1975|||||No|No||AMNEAL PHARMACE|No||||
budesonide|No|No|No|No|75%|00115168974|BUDESONIDE 0.5 MG/2 ML SUSP|2|ML|.64141|05/29/2018||Yes|No||05/29/2018||Yes|No|05/29/2018||Yes|No||||No|No|||Prescription required|No||033|Yes|.57313|03/29/2022|.55937|03/29/2022|.5631|03/29/2022|||GLUCOCORTICOIDS: INHALED|1976|||||No|No||AMNEAL PHARMACE|Yes|09/01/2020|||
propranolol HCl|No|No|No|No|75%|00115169301|PROPRANOLOL 60 MG TABLET|100|EA|.30302|05/23/2017||Yes|No||05/23/2017||Yes|No|05/23/2017||Yes|No||05/23/2017||Yes|No|||Prescription required|No||070|No|.35485|03/29/2022|.34633|03/29/2022|.34864|03/29/2022|||BETA-BLOCKERS|1977|||||No|No||AMNEAL PHARMACE|No||||
epinephrine|No|No|No|No|75%|00115169449|EPINEPHRINE 0.3 MG AUTO-INJECT|2|EA|64.5|06/01/2017||Yes|No||06/01/2017||Yes|No|06/01/2017||Yes|No||||No|No|||Prescription required|Yes|11/01/2021|238|No|120.96197|03/29/2022|118.05888|03/29/2022|118.84513|03/29/2022|||EPINEPHRINE: SELF-INJECTED|1978|||||No|No||AMNEAL PHARMACE|No||||
epinephrine|No|No|No|No|75%|00115169549|EPINEPHRINE 0.15 MG AUTO-INJCT|2|EA|64.5|06/01/2017||Yes|No||06/01/2017||Yes|No|06/01/2017||Yes|No||||No|No|||Prescription required|Yes|11/01/2021|238|No|125.20143|03/29/2022|122.19659|03/29/2022|123.0104|03/29/2022|||EPINEPHRINE: SELF-INJECTED|1979|||||No|No||AMNEAL PHARMACE|No||||
hydrocortisone|No|No|No|No|75%|00115169606|HYDROCORTISONE 5 MG TABLET|50|EA|.12151|03/29/2021||Yes|No||03/29/2021||Yes|No|03/29/2021||Yes|No||||No|No|||Prescription required|No||168|Yes|.21144|03/29/2022|.20636|03/29/2022|.20773|03/29/2022|||GLUCOCORTICOIDS: ORAL|1980|||||No|No||AMNEAL PHARMACE|No||||
hydrocortisone|No|No|No|No|75%|00115169701|HYDROCORTISONE 10 MG TABLET|100|EA|.20532|04/08/2021||Yes|No||04/08/2021||Yes|No|03/29/2021||Yes|No||||No|No|||Prescription required|No||168|Yes|.28946|03/29/2022|.28251|03/29/2022|.28439|03/29/2022|||GLUCOCORTICOIDS: ORAL|1981|||||No|No||AMNEAL PHARMACE|No||||
hydrocortisone|No|No|No|No|75%|00115170001|HYDROCORTISONE 20 MG TABLET|100|EA|.38949|06/24/2021||Yes|No||06/24/2021||Yes|No|06/24/2021||Yes|No||||No|No|||Prescription required|No||168|Yes|.46844|03/29/2022|.45719|03/29/2022|.46024|03/29/2022|||GLUCOCORTICOIDS: ORAL|1982|||||No|No||AMNEAL PHARMACE|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00115170901|DEXMETHYLPHENIDATE ER 25 MG CP|100|EA|1.39956|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.83308|03/29/2022|1.78908|03/29/2022|1.801|03/29/2022|||STIMULANTS AND RELATED AGENTS|1983|||||No|No||AMNEAL PHARMACE|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00115171001|DEXMETHYLPHENIDATE ER 35 MG CP|100|EA|1.61456|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|2.40563|01/25/2022|2.34789|01/25/2022|2.36353|01/25/2022|||STIMULANTS AND RELATED AGENTS|1984|||||No|No||AMNEAL PHARMACE|No||||
griseofulvin ultramicrosize|No|No|No|No|75%|00115172401|GRISEOFULVIN ULTRA 125 MG TAB|100|EA|1.71527|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|069|No|3.90922|07/23/2019|3.85337|07/23/2019|3.66988|07/23/2019|||ANTIFUNGALS: ORAL|1985|||||No|No||AMNEAL PHARMACE|No||||
griseofulvin ultramicrosize|No|No|No|No|75%|00115172501|GRISEOFULVIN ULTRA 250 MG TAB|100|EA|2.19257|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|069|No|4.20728|03/29/2022|4.1063|03/29/2022|4.13365|03/29/2022|||ANTIFUNGALS: ORAL|1986|||||No|No||AMNEAL PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|00115173601|METHYLPHENIDATE ER(CD) 10MG CP|100|EA|.73327|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|1.31759|03/29/2022|1.28596|03/29/2022|1.29453|03/29/2022|||STIMULANTS AND RELATED AGENTS|1987|||||No|No||AMNEAL PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|00115173701|METHYLPHENIDATE ER(CD) 20MG CP|100|EA|.73327|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|1.42341|03/29/2022|1.38924|03/29/2022|1.3985|03/29/2022|||STIMULANTS AND RELATED AGENTS|1988|||||No|No||AMNEAL PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|00115173801|METHYLPHENIDATE ER(CD) 30MG CP|100|EA|.73327|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|1.42159|03/29/2022|1.38747|03/29/2022|1.39671|03/29/2022|||STIMULANTS AND RELATED AGENTS|1989|||||No|No||AMNEAL PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|00115173901|METHYLPHENIDATE ER(CD) 40MG CP|100|EA|.96952|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|1.70323|03/29/2022|1.66235|03/29/2022|1.67342|03/29/2022|||STIMULANTS AND RELATED AGENTS|1990|||||No|No||AMNEAL PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|00115174001|METHYLPHENIDATE ER(CD) 50MG CP|100|EA|.99123|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|2.6246|01/25/2022|2.5616|01/25/2022|2.57866|01/25/2022|||STIMULANTS AND RELATED AGENTS|1991|||||No|No||AMNEAL PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|00115174101|METHYLPHENIDATE ER(CD) 60MG CP|100|EA|.99123|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|1.91295|03/08/2022|1.86703|03/08/2022|1.87947|03/08/2022|||STIMULANTS AND RELATED AGENTS|1992|||||No|No||AMNEAL PHARMACE|No||||
metaxalone|No|No|No|No|75%|00115174501|METAXALONE 400 MG TABLET|100|EA|2.20293|09/24/2018||Yes|No||09/24/2018||Yes|No|09/24/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|116|Yes|5.02063|10/27/2020|4.94891|10/27/2020|4.71325|10/27/2020|||SKELETAL MUSCLE RELAXANTS|1993|||||No|No||AMNEAL PHARMACE|No||||
metaxalone|No|No|No|No|75%|00115174801|METAXALONE 800 MG TABLET|100|EA|.645|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|116|Yes|.52754|03/29/2022|.51487|03/29/2022|.5183|03/29/2022|||SKELETAL MUSCLE RELAXANTS|1994|||||No|No||AMNEAL PHARMACE|No||||
acitretin|No|No|No|No|75%|00115175008|ACITRETIN 10 MG CAPSULE|30|EA|5.36668|11/17/2017||Yes|No||11/17/2017||Yes|No|11/17/2017||Yes|No||||No|No|||Prescription required|No|||No|7.81961|03/29/2022|7.63193|03/29/2022|7.68276|03/29/2022||||1995|||||No|No||AMNEAL PHARMACE|No||||
acitretin|No|No|No|No|75%|00115175108|ACITRETIN 17.5 MG CAPSULE|30|EA|8.26875|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No|||No|18.84506|04/07/2020|18.57585|04/07/2020|17.69128|04/07/2020||||1996|||||No|No||AMNEAL PHARMACE|No||||
acitretin|No|No|No|No|75%|00115175308|ACITRETIN 25 MG CAPSULE|30|EA|6.61497|05/29/2018||Yes|No||05/29/2018||Yes|No|05/29/2018||Yes|No||||No|No|||Prescription required|No|||No|10.86025|03/29/2022|10.5996|03/29/2022|10.67019|03/29/2022||||1997|||||No|No||AMNEAL PHARMACE|No||||
cyproheptadine HCl|No|No|No|No|75%|00115175701|CYPROHEPTADINE 4 MG TABLET|100|EA|.0387|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No||||No|No|||Prescription required|No||574|Yes|.09783|03/29/2022|.09548|03/29/2022|.09611|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|1998|||||No|No||AMNEAL PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|00115180001|METHYLPHENIDATE 5 MG TABLET|100|EA|.04321|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|.1394|03/29/2022|.13605|03/29/2022|.13696|03/29/2022|||STIMULANTS AND RELATED AGENTS|1999|||||No|No||AMNEAL PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|00115180101|METHYLPHENIDATE 10 MG TABLET|100|EA|.05762|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|.15766|03/29/2022|.15387|03/29/2022|.1549|03/29/2022|||STIMULANTS AND RELATED AGENTS|2000|||||No|No||AMNEAL PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|00115180201|METHYLPHENIDATE 20 MG TABLET|100|EA|.06626|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|.22814|03/29/2022|.22266|03/29/2022|.22414|03/29/2022|||STIMULANTS AND RELATED AGENTS|2001|||||No|No||AMNEAL PHARMACE|No||||
hydroxyzine pamoate|No|No|No|No|75%|00115180301|HYDROXYZINE PAM 25 MG CAP|100|EA|.05676|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||11/27/2018||Yes|No|||Prescription required|No||574|Yes|.06792|03/29/2022|.06628|03/29/2022|.06673|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|2002|||||No|No||AMNEAL PHARMACE|No||||
hydroxyzine pamoate|No|No|No|No|75%|00115180302|HYDROXYZINE PAM 25 MG CAP|500|EA|.05392|05/25/2018||Yes|No||05/25/2018||Yes|No|05/25/2018||Yes|No||05/25/2018||Yes|No|||Prescription required|No||574|Yes|.06792|03/29/2022|.06628|03/29/2022|.06673|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|2003|||||No|No||AMNEAL PHARMACE|No||||
hydroxyzine pamoate|No|No|No|No|75%|00115180401|HYDROXYZINE PAM 50 MG CAP|100|EA|.07009|06/06/2018||Yes|No||06/06/2018||Yes|No|06/06/2018||Yes|No||06/06/2018||Yes|No|||Prescription required|No||574|Yes|.09227|03/29/2022|.09005|03/29/2022|.09065|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|2004|||||No|No||AMNEAL PHARMACE|No||||
hydroxyzine pamoate|No|No|No|No|75%|00115180402|HYDROXYZINE PAM 50 MG CAP|500|EA|.06658|12/06/2019||Yes|No||12/06/2019||Yes|No|12/06/2019||Yes|No||12/06/2019||Yes|No|||Prescription required|No||574|Yes|.09227|03/29/2022|.09005|03/29/2022|.09065|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|2005|||||No|No||AMNEAL PHARMACE|No||||
rimantadine HCl|No|No|No|No|75%|00115191101|RIMANTADINE HCL 100 MG TABLET|100|EA|.97786|12/29/2004||Yes|No||12/29/2004||Yes|No|12/29/2004||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|025|No|2.22861|06/01/2016|2.19678|06/01/2016|2.09217|06/01/2016|||ANTIVIRALS: ORAL|2006|||||No|No||AMNEAL PHARMACE|No||||
orphenadrine citrate|No|No|No|No|75%|00115201101|ORPHENADRINE ER 100 MG TABLET|100|EA|.42355|03/29/2005||Yes|No||03/29/2005||Yes|No|||No|No||||No|No|||Prescription required|Yes|01/25/2012|116|Yes|.33346|03/29/2022|.32545|03/29/2022|.32762|03/29/2022|||SKELETAL MUSCLE RELAXANTS|2007|||||No|No||AMNEAL PHARMACE|No||||
orphenadrine citrate|No|No|No|No|75%|00115201102|ORPHENADRINE ER 100 MG TABLET|500|EA|.42355|03/29/2005||Yes|No||03/29/2005||Yes|No|||No|No||||No|No|||Prescription required|Yes|01/25/2012|116|Yes|.33346|03/29/2022|.32545|03/29/2022|.32762|03/29/2022|||SKELETAL MUSCLE RELAXANTS|2008|||||No|No||AMNEAL PHARMACE|No||||
colestipol HCl|No|No|No|No|75%|00115214216|COLESTIPOL HCL 1 GM TABLET|120|EA|.44354|12/20/2021||Yes|No||12/20/2021||Yes|No|12/20/2021||Yes|No||||No|No|||Prescription required|No||055|No|.78231|03/29/2022|.76353|03/29/2022|.76861|03/29/2022|||LIPOTROPICS: OTHER|2009|||||No|No||AMNEAL PHARMACE|No||||
terbutaline sulfate|No|No|No|No|75%|00115262201|TERBUTALINE SULFATE 5 MG TAB|100|EA|1.462|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|037|No|3.332|10/06/2020|3.2844|10/06/2020|3.128|10/06/2020|||BRONCHODILATORS: BETA AGONIST|2010|||||No|No||AMNEAL PHARMACE|Yes|09/01/2020|||
pyridostigmine bromide|No|No|No|No|75%|00115351101|PYRIDOSTIGMINE BR 60 MG TABLET|100|EA|.35088|12/21/2007||Yes|No||12/21/2007||Yes|No|12/21/2007||Yes|No||||No|No|||Prescription required|No|||No|.31425|03/29/2022|.3067|03/29/2022|.30875|03/29/2022||||2011|||||No|No||AMNEAL PHARMACE|No||||
midodrine HCl|No|No|No|No|75%|00115423301|MIDODRINE HCL 10 MG TABLET|100|EA|1.60673|09/11/2009||Yes|No||09/11/2009||Yes|No|09/11/2009||Yes|No||09/11/2009||Yes|No|||Prescription required|No|||No|.40773|03/29/2022|.39794|03/29/2022|.40059|03/29/2022||||2012|||||No|No||AMNEAL PHARMACE|No||||
dantrolene sodium|No|No|No|No|75%|00115441101|DANTROLENE SODIUM 25 MG CAP|100|EA|.34817|05/05/2006||Yes|No||05/05/2006||Yes|No|05/05/2006||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|116|No|.43377|03/29/2022|.42335|03/29/2022|.42617|03/29/2022|||SKELETAL MUSCLE RELAXANTS|2013|||||No|No||AMNEAL PHARMACE|No||||
dantrolene sodium|No|No|No|No|75%|00115442201|DANTROLENE SODIUM 50 MG CAP|100|EA|.56269|05/05/2006||Yes|No||05/05/2006||Yes|No|05/05/2006||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|116|No|.99541|03/01/2022|.97152|03/01/2022|.97799|03/01/2022|||SKELETAL MUSCLE RELAXANTS|2014|||||No|No||AMNEAL PHARMACE|No||||
dantrolene sodium|No|No|No|No|75%|00115443301|DANTROLENE SODIUM 100 MG CAP|100|EA|.70563|05/05/2006||Yes|No||05/05/2006||Yes|No|05/05/2006||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|116|No|.85614|03/01/2022|.83559|03/01/2022|.84115|03/01/2022|||SKELETAL MUSCLE RELAXANTS|2015|||||No|No||AMNEAL PHARMACE|No||||
colestipol HCl|No|No|No|No|75%|00115521116|COLESTIPOL HCL 1 GM TABLET|120|EA|.44354|05/04/2007||Yes|No||05/04/2007||Yes|No|05/04/2007||Yes|No||||No|No|||Prescription required|No||055|No|.78231|03/29/2022|.76353|03/29/2022|.76861|03/29/2022|||LIPOTROPICS: OTHER|2016|||||No|No||AMNEAL PHARMACE|No||||
colestipol HCl|No|No|No|No|75%|00115521218|COLESTIPOL HCL GRANULES PACKET|30|EA|1.35206|05/22/2009||Yes|No||05/22/2009||Yes|No|05/22/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|055|No|2.28193|03/01/2022|2.22716|03/01/2022|2.24199|03/01/2022|||LIPOTROPICS: OTHER|2017|||||No|No||AMNEAL PHARMACE|No||||
colestipol HCl|No|No|No|No|75%|00115521229|COLESTIPOL HCL GRANULES PACKET|90|EA|1.35177|05/22/2009||Yes|No||05/22/2009||Yes|No|05/22/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|055|No|2.28193|03/01/2022|2.22716|03/01/2022|2.24199|03/01/2022|||LIPOTROPICS: OTHER|2018|||||No|No||AMNEAL PHARMACE|No||||
colestipol HCl|No|No|No|No|75%|00115521302|COLESTIPOL HCL GRANULES|500|GM|.16099|05/22/2009||Yes|No||05/22/2009||Yes|No|05/22/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|055|No|.36691|06/01/2016|.36167|06/01/2016|.34444|06/01/2016|||LIPOTROPICS: OTHER|2019|||||No|No||AMNEAL PHARMACE|No||||
nadolol/bendroflumethiazide|No|No|No|No|75%|00115532201|NADOLOL-BENDROFLU 80-5 MG TAB|100|EA|2.11396|08/23/2007||Yes|No||08/23/2007||Yes|No|08/23/2007||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|070|Yes|4.81787|06/01/2016|4.74904|06/01/2016|4.5229|06/01/2016|||BETA-BLOCKERS|2020|||||No|No||AMNEAL PHARMACE|No||||
fenofibrate|No|No|No|No|75%|00115551110|FENOFIBRATE 54 MG TABLET|90|EA|.09149|09/03/2008||Yes|No||09/03/2008||Yes|No|09/03/2008||Yes|No||||No|No|||Prescription required|No||055|No|.1459|03/29/2022|.14239|03/29/2022|.14334|03/29/2022|||LIPOTROPICS: OTHER|2021|||||No|No||AMNEAL PHARMACE|No||||
fenofibrate|No|No|No|No|75%|00115552202|FENOFIBRATE 160 MG TABLET|500|EA|.16722|05/19/2011||Yes|No||05/19/2011||Yes|No|05/19/2011||Yes|No||||No|No|||Prescription required|No||055|No|.1612|03/29/2022|.15733|03/29/2022|.15837|03/29/2022|||LIPOTROPICS: OTHER|2022|||||No|No||AMNEAL PHARMACE|No||||
fenofibrate|No|No|No|No|75%|00115552210|FENOFIBRATE 160 MG TABLET|90|EA|.16721|09/03/2008||Yes|No||09/03/2008||Yes|No|09/03/2008||Yes|No||||No|No|||Prescription required|No||055|No|.1612|03/29/2022|.15733|03/29/2022|.15837|03/29/2022|||LIPOTROPICS: OTHER|2023|||||No|No||AMNEAL PHARMACE|No||||
pilocarpine HCl|No|No|No|No|75%|00115592201|PILOCARPINE HCL 5 MG TABLET|100|EA|.258|05/22/2009||Yes|No||05/22/2009||Yes|No|05/22/2009||Yes|No||||No|No|||Prescription required|No|||No|.27963|03/29/2022|.27291|03/29/2022|.27473|03/29/2022||||2024|||||No|No||AMNEAL PHARMACE|No||||
bupropion HCl|Yes|No|No|No|75%|00115681110|BUPROPION HCL XL 150 MG TABLET|90|EA|.07644|12/12/2008|01/27/2022|Yes|No||12/12/2008|01/27/2022|Yes|No|12/12/2008|01/27/2022|Yes|No||||No|No|07/01/2016|01/27/2022|Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|2025|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
fludrocortisone acetate|No|No|No|No|75%|00115703301|FLUDROCORTISONE 0.1 MG TABLET|100|EA|.25357|06/12/2002||Yes|No||06/12/2002||Yes|No|06/12/2002||Yes|No||||No|No|||Prescription required|No|||No|.51987|03/29/2022|.50739|03/29/2022|.51077|03/29/2022||||2026|||||No|No||AMNEAL PHARMACE|No||||
fludrocortisone acetate|No|No|No|No|75%|00115703302|FLUDROCORTISONE 0.1 MG TABLET|500|EA|.25341|05/22/2009||Yes|No||05/22/2009||Yes|No|05/22/2009||Yes|No||||No|No|||Prescription required|No|||No|.51987|03/29/2022|.50739|03/29/2022|.51077|03/29/2022||||2027|||||No|No||AMNEAL PHARMACE|No||||
methyltestosterone|No|No|No|No|90%|00115703701|METHITEST 10 MG TABLET|100|EA|26.71968|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|60.89602|05/18/2021|60.02608|05/18/2021|57.16769|05/18/2021||||2028|||||No|No||AMNEAL PHARMACE|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00115991801|DEXMETHYLPHENIDATE ER 5 MG CAP|100|EA|.96956|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.46405|03/29/2022|1.42891|03/29/2022|1.43842|03/29/2022|||STIMULANTS AND RELATED AGENTS|2029|||||No|No||AMNEAL PHARMACE|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00115991901|DEXMETHYLPHENIDATE ER 10 MG CP|100|EA|1.07706|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.21716|03/29/2022|1.18794|03/29/2022|1.19585|03/29/2022|||STIMULANTS AND RELATED AGENTS|2030|||||No|No||AMNEAL PHARMACE|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00115992001|DEXMETHYLPHENIDATE ER 15 MG CP|100|EA|1.18456|05/25/2018||Yes|No||05/25/2018||Yes|No|05/25/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.90155|03/29/2022|.87991|03/29/2022|.88577|03/29/2022|||STIMULANTS AND RELATED AGENTS|2031|||||No|No||AMNEAL PHARMACE|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00115992101|DEXMETHYLPHENIDATE ER 20 MG CP|100|EA|1.29206|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.47249|03/29/2022|1.43715|03/29/2022|1.44672|03/29/2022|||STIMULANTS AND RELATED AGENTS|2032|||||No|No||AMNEAL PHARMACE|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00115992201|DEXMETHYLPHENIDATE ER 30 MG CP|100|EA|1.50706|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|2.05596|03/29/2022|2.00661|03/29/2022|2.01998|03/29/2022|||STIMULANTS AND RELATED AGENTS|2033|||||No|No||AMNEAL PHARMACE|No||||
dextroamphetamine sulfate|No|No|No|No|75%|00115992710|DEXTROAMPHETAMINE ER 5 MG CAP|90|EA|1.25397|10/17/2019|12/01/2022|Yes|No||10/17/2019|12/01/2022|Yes|No|10/17/2019|12/01/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.09277|03/29/2022|1.06654|03/29/2022|1.07364|03/29/2022|||STIMULANTS AND RELATED AGENTS|2034|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
dextroamphetamine sulfate|No|No|No|No|75%|00115992810|DEXTROAMPHETAMINE ER 10 MG CAP|90|EA|1.56639|10/17/2019|12/01/2022|Yes|No||10/17/2019|12/01/2022|Yes|No|10/17/2019|12/01/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.19348|03/29/2022|1.16483|03/29/2022|1.17259|03/29/2022|||STIMULANTS AND RELATED AGENTS|2035|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
dextroamphetamine sulfate|No|No|No|No|75%|00115992910|DEXTROAMPHETAMINE ER 15 MG CAP|90|EA|1.99729|10/17/2019|10/14/2022|Yes|No||10/17/2019|10/14/2022|Yes|No|10/17/2019|10/14/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.81061|03/29/2022|1.76715|03/29/2022|1.77892|03/29/2022|||STIMULANTS AND RELATED AGENTS|2036|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
levalbuterol HCl|No|No|No|No|75%|00115993078|LEVALBUTEROL 0.31 MG/3 ML SOL|3|ML|.172|03/19/2018||Yes|No||03/19/2018||Yes|No|03/19/2018||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|.392|03/23/2021|.3864|03/23/2021|.368|03/23/2021|||BRONCHODILATORS: BETA AGONIST|2037|||||No|No||AMNEAL PHARMACE|No||||
levalbuterol HCl|No|No|No|No|75%|00115993178|LEVALBUTEROL 0.63 MG/3 ML SOL|3|ML|.172|03/19/2018||Yes|No||03/19/2018||Yes|No|03/19/2018||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|.3279|03/29/2022|.32003|03/29/2022|.32216|03/29/2022|||BRONCHODILATORS: BETA AGONIST|2038|||||No|No||AMNEAL PHARMACE|No||||
levalbuterol HCl|No|No|No|No|75%|00115993278|LEVALBUTEROL 1.25 MG/3 ML SOL|3|ML|.172|03/19/2018||Yes|No||03/19/2018||Yes|No|03/19/2018||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|.31144|03/29/2022|.30396|03/29/2022|.30598|03/29/2022|||BRONCHODILATORS: BETA AGONIST|2039|||||No|No||AMNEAL PHARMACE|Yes|09/01/2020|||
minocycline HCl|No|No|No|No|75%|00115993508|MINOCYCLINE ER 65 MG TABLET|30|EA|3.225|05/23/2018||Yes|No||05/23/2018||Yes|No|05/23/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|7.35|08/25/2020|7.245|08/25/2020|6.9|08/25/2020|||TETRACYCLINES|2040|||||No|No||AMNEAL PHARMACE|No||||
minocycline HCl|No|No|No|No|75%|00115993608|MINOCYCLINE ER 115 MG TABLET|30|EA|3.225|05/23/2018||Yes|No||05/23/2018||Yes|No|05/23/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|7.35|08/25/2020|7.245|08/25/2020|6.9|08/25/2020|||TETRACYCLINES|2041|||||No|No||AMNEAL PHARMACE|No||||
lamotrigine|No|No|No|No|75%|00115993908|LAMOTRIGINE ODT 25 MG TABLET|30|EA|3.05343|10/17/2019|11/15/2022|Yes|No||10/17/2019|11/15/2022|Yes|No|10/17/2019|11/15/2022|Yes|No||||No|No|||Prescription required|No||056|No|3.83184|03/01/2022|3.73987|03/01/2022|3.76478|03/01/2022|||ANTICONVULSANTS|2042|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
lamotrigine|No|No|No|No|75%|00115994008|LAMOTRIGINE ODT 50 MG TABLET|30|EA|3.27043|10/17/2019|11/15/2022|Yes|No||10/17/2019|11/15/2022|Yes|No|10/17/2019|11/15/2022|Yes|No||||No|No|||Prescription required|No||056|No|3.24575|03/29/2022|3.16785|03/29/2022|3.18894|03/29/2022|||ANTICONVULSANTS|2043|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
lamotrigine|No|No|No|No|75%|00115994108|LAMOTRIGINE ODT 100 MG TABLET|30|EA|3.4873|10/17/2019|11/15/2022|Yes|No||10/17/2019|11/15/2022|Yes|No|10/17/2019|11/15/2022|Yes|No||||No|No|||Prescription required|No||056|No|4.72113|03/29/2022|4.60782|03/29/2022|4.63851|03/29/2022|||ANTICONVULSANTS|2044|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
lamotrigine|No|No|No|No|75%|00115994208|LAMOTRIGINE ODT 200 MG TABLET|30|EA|4.16139|10/17/2019|11/15/2022|Yes|No||10/17/2019|11/15/2022|Yes|No|10/17/2019|11/15/2022|Yes|No||||No|No|||Prescription required|No||056|No|4.09893|03/01/2022|4.00055|03/01/2022|4.02719|03/01/2022|||ANTICONVULSANTS|2045|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
chlorhexidine gluconate|No|No|No|No|75%|00116200116|CHLORHEXIDINE 0.12% RINSE|473|ML|.00249|09/27/2007||Yes|No||09/27/2007||Yes|No|09/27/2007||Yes|No||||No|No|||Prescription required|No|||No|.00532|03/29/2022|.00519|03/29/2022|.00522|03/29/2022||||2046|||||No|No||XTTRIUM LABS.|No||||
acetaminophen with codeine|No|No|No|No|90%|00121050404|ACETAMINOP-CODEINE 120-12 MG/5|118|ML|.01019|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.01998|03/29/2022|.0195|03/29/2022|.01963|03/29/2022|||ANALGESICS: NARCOTICS SHORT|2047|||||No|No||PHARM ASSOC INC|No||||
acetaminophen with codeine|No|No|No|No|90%|00121050416|ACETAMINOP-CODEINE 120-12 MG/5|473|ML|.00722|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.01517|03/29/2022|.0148|03/29/2022|.0149|03/29/2022|||ANALGESICS: NARCOTICS SHORT|2048|||||No|No||PHARM ASSOC INC|No||||
metoclopramide HCl|No|No|No|No|75%|00121057616|METOCLOPRAMIDE 5 MG/5 ML SOLN|473|ML|.02681|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||085|No|.03918|03/29/2022|.03823|03/29/2022|.03849|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|2049|||||No|No||PHARM ASSOC INC|No||||
lactulose|No|No|No|No|75%|00121057716|LACTULOSE 10 GM/15 ML SOLUTION|473|ML|.00704|12/28/2006|01/31/2022|Yes|No||12/28/2006|01/31/2022|Yes|No|12/28/2006|01/31/2022|Yes|No||||No|No|||Prescription required|No|||No|.01605|02/15/2022|.01582|02/15/2022|.01506|02/15/2022||||2050|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||PHARM ASSOC INC|No||||
haloperidol lactate|No|No|No|No|75%|00121058104|HALOPERIDOL LAC 2 MG/ML CONC|120|ML|.0989|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.21566|03/29/2022|.21048|03/29/2022|.21188|03/29/2022|||ANTIPSYCHOTICS|2051|||||No|No||PHARM ASSOC INC|Yes|09/01/2020|||
citric acid/sodium citrate|No|No|No|No|75%|00121059516|SOD CITRATE-CITRIC ACID SOLN|473|ML|.01272|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Over the counter|No|||No|.02471|03/29/2022|.02411|03/29/2022|.02427|03/29/2022||||2052|||||No|No||PHARM ASSOC INC|No||||
amantadine HCl|No|No|No|No|75%|00121064616|AMANTADINE 50 MG/5 ML SOLUTION|473|ML|.01636|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||015|No|.02319|03/29/2022|.02263|03/29/2022|.02278|03/29/2022|||ANTIPARKINSON'S AGENTS|2053|||||No|No||PHARM ASSOC INC|No||||
fluphenazine HCl|No|No|No|No|75%|00121065304|FLUPHENAZINE 5 MG/ML CONC|120|ML|1.1243|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|2.56236|02/08/2022|2.52576|02/08/2022|2.40548|02/08/2022|||ANTIPSYCHOTICS|2054|||||No|No||PHARM ASSOC INC|No||||
fluphenazine HCl|No|No|No|No|75%|00121065402|FLUPHENAZINE 2.5 MG/5 ML ELIX|60|ML|.22925|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.52249|02/08/2022|.51503|02/08/2022|.4905|02/08/2022|||ANTIPSYCHOTICS|2055|||||No|No||PHARM ASSOC INC|No||||
trihexyphenidyl HCl|No|No|No|No|75%|00121065816|TRIHEXYPHENIDYL 2 MG/5 ML SOLN|473|ML|.03876|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||015|No|.08835|08/24/2021|.08709|08/24/2021|.08294|08/24/2021|||ANTIPARKINSON'S AGENTS|2056|||||No|No||PHARM ASSOC INC|No||||
ethosuximide|No|No|No|No|75%|00121067016|ETHOSUXIMIDE 250 MG/5 ML SOLN|473|ML|.0512|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||056|No|.15831|03/01/2022|.15451|03/01/2022|.15553|03/01/2022|||ANTICONVULSANTS|2057|||||No|No||PHARM ASSOC INC|No||||
valproic acid (as sodium salt)|No|No|No|No|75%|00121067516|VALPROIC ACID 250 MG/5 ML SOLN|473|ML|.01136|03/10/2006||Yes|No||03/10/2006||Yes|No|03/10/2006||Yes|No||||No|No|||Prescription required|No||056|No|.01872|03/29/2022|.01827|03/29/2022|.01839|03/29/2022|||ANTICONVULSANTS|2058|||||No|No||PHARM ASSOC INC|No||||
potassium citrate/citric acid|No|No|No|No|75%|00121067616|POTASSIUM CIT-CITRIC ACID SOLN|473|ML|.03236|02/11/2014||Yes|No||||No|No|02/11/2014||Yes|No||||No|No|||Over the counter|No|||No|.06815|03/29/2022|.06651|03/29/2022|.06695|03/29/2022||||2059|||||No|No||PHARM ASSOC INC|No||||
sod/pot/K cit/sod cit/cit acid|No|No|No|No|75%|00121067716|TRICITRATES ORAL SOLUTION|473|ML|.01805|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Over the counter|No|||No|.04114|03/01/2022|.04055|03/01/2022|.03862|03/01/2022||||2060|||||No|No||PHARM ASSOC INC|No||||
nortriptyline HCl|No|No|No|No|75%|00121067816|NORTRIPTYLINE 10 MG/5 ML SOLN|473|ML|.17259|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.39336|02/08/2022|.38774|02/08/2022|.36927|02/08/2022|||ANTIDEPRESSANTS: TRICYCLIC|2061|||||No|No||PHARM ASSOC INC|No||||
fluoxetine HCl|No|No|No|No|75%|00121072104|FLUOXETINE 20 MG/5 ML SOLUTION|120|ML|.17966|12/28/2006||Yes|No||12/28/2006||Yes|No|12/28/2006||Yes|No||||No|No|||Prescription required|No||008|No|.3776|03/29/2022|.36853|03/29/2022|.37099|03/29/2022|||ANTIDEPRESSANTS: SSRIs|2062|||||No|No||PHARM ASSOC INC|No||||
prednisolone sodium phosphate|No|No|No|No|75%|00121075908|PREDNISOLONE 15 MG/5 ML SOLN|237|ML|.07211|12/15/2006||Yes|No||12/15/2006||Yes|No|12/15/2006||Yes|No||||No|No|||Prescription required|No||168|Yes|.11167|03/29/2022|.10898|03/29/2022|.10971|03/29/2022|||GLUCOCORTICOIDS: ORAL|2063|||||No|No||PHARM ASSOC INC|No||||
calcium carbonate|No|No|No|No|75%|00121076616|CALCIUM CARB 1,250 MG/5 ML SUS|473|ML|.00886|10/10/2014||Yes|No||||No|No|10/10/2014||Yes|No||||No|No|||Over the counter|No|||No|.0145|03/29/2022|.01415|03/29/2022|.01424|03/29/2022||||2064|||||No|No||PHARM ASSOC INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00121077204|HYDROCODONE-ACETAMN 7.5-325/15|118|ML|.10968|09/02/2014||Yes|No||09/02/2014||Yes|No|09/02/2014||Yes|No||||No|No|||Prescription required|No||109|Yes|.21467|05/25/2021|.20951|05/25/2021|.21091|05/25/2021|||ANALGESICS: NARCOTICS SHORT|2065|||||No|No||PHARM ASSOC INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00121077216|HYDROCODONE-ACETAMN 7.5-325/15|473|ML|.04071|09/02/2014||Yes|No||09/02/2014||Yes|No|09/02/2014||Yes|No||||No|No|||Prescription required|No||109|Yes|.08003|03/29/2022|.0781|03/29/2022|.07862|03/29/2022|||ANALGESICS: NARCOTICS SHORT|2066|||||No|No||PHARM ASSOC INC|No||||
prednisolone sodium phosphate|No|No|No|No|75%|00121077308|PREDNISOLONE 10 MG/5 ML SOLN|237|ML|1.07018|10/03/2017||Yes|No||10/03/2017||Yes|No|10/03/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|168|Yes|2.43903|10/03/2017|2.40419|10/03/2017|2.2897|10/03/2017|||GLUCOCORTICOIDS: ORAL|2067|||||No|No||PHARM ASSOC INC|No||||
codeine phosphate/guaifenesin|No|No|No|No|90%|00121077504|GUAIFEN-CODEINE 100-10 MG/5 ML|118|ML|.03902|11/06/2006||Yes|No||04/15/2011||Yes|No|11/06/2006||Yes|No||||No|No|||Prescription required|No||183|Yes|.05917|03/29/2022|.05774|03/29/2022|.05813|03/29/2022|||COUGH AND COLD: NARCOTIC|2068|||||No|No||PHARM ASSOC INC|No||||
codeine phosphate/guaifenesin|No|No|No|No|90%|00121077508|GUAIFEN-CODEINE 100-10 MG/5 ML|237|ML|.03771|11/19/2018||Yes|No||||No|No|11/19/2018||Yes|No||||No|No|||Over the counter|No||183|Yes|.04679|03/29/2022|.04566|03/29/2022|.04597|03/29/2022|||COUGH AND COLD: NARCOTIC|2069|||||No|No||PHARM ASSOC INC|No||||
codeine phosphate/guaifenesin|No|No|No|No|90%|00121077516|GUAIFEN-CODEINE 100-10 MG/5 ML|473|ML|.01948|11/06/2006||Yes|No||04/15/2011||Yes|No|11/06/2006||Yes|No||||No|No|||Prescription required|No||183|Yes|.02734|03/29/2022|.02668|03/29/2022|.02686|03/29/2022|||COUGH AND COLD: NARCOTIC|2070|||||No|No||PHARM ASSOC INC|No||||
prednisolone sodium phosphate|No|No|No|No|75%|00121077708|PREDNISOLONE 20 MG/5 ML SOLN|237|ML|1.52076|10/03/2017||Yes|No||10/03/2017||Yes|No|10/03/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|168|Yes|3.46592|10/03/2017|3.41641|10/03/2017|3.25372|10/03/2017|||GLUCOCORTICOIDS: ORAL|2071|||||No|No||PHARM ASSOC INC|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|00121085416|SULFATRIM PEDIATRIC SUSPENSION|473|ML|.03422|12/04/2018||Yes|No||12/04/2018||Yes|No|12/04/2018||Yes|No||||No|No|||Prescription required|No|||No|.05588|03/29/2022|.05453|03/29/2022|.0549|03/29/2022||||2072|||||No|No||PHARM ASSOC INC|No||||
nystatin|No|No|No|No|75%|00121086802|NYSTATIN 100,000 UNIT/ML SUSP|60|ML|.086|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|No||069|No|.14005|03/29/2022|.13668|03/29/2022|.13759|03/29/2022|||ANTIFUNGALS: ORAL|2073|||||No|No||PHARM ASSOC INC|No||||
nystatin|No|No|No|No|75%|00121086816|NYSTATIN 100,000 UNIT/ML SUSP|473|ML|.02885|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|No||069|No|.04529|03/29/2022|.0442|03/29/2022|.04449|03/29/2022|||ANTIFUNGALS: ORAL|2074|||||No|No||PHARM ASSOC INC|No||||
lactulose|No|No|No|No|75%|00121087316|LACTULOSE 10 GM/15 ML SOLUTION|473|ML|.00704|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|No|||No|.01519|03/29/2022|.01482|03/29/2022|.01492|03/29/2022||||2075|||||No|No||PHARM ASSOC INC|No||||
lactulose|No|No|No|No|75%|00121087332|LACTULOSE 10 GM/15 ML SOLUTION|946|ML|.00635|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|No|||No|.0141|03/29/2022|.01376|03/29/2022|.01385|03/29/2022||||2076|||||No|No||PHARM ASSOC INC|No||||
chlorhexidine gluconate|No|No|No|No|75%|00121089316|CHLORHEXIDINE 0.12% RINSE|473|ML|.00463|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|No|||No|.00532|03/29/2022|.00519|03/29/2022|.00522|03/29/2022||||2077|||||No|No||PHARM ASSOC INC|No||||
potassium chloride|No|No|No|No|75%|00121168016|POTASSIUM CL 10% (20 MEQ/15ML)|473|ML|.05045|09/27/2019||Yes|No||09/27/2019||Yes|No|09/27/2019||Yes|No||||No|No|||Prescription required|No|||No|.13625|03/29/2022|.13298|03/29/2022|.13386|03/29/2022||||2078|||||No|No||PHARM ASSOC INC|No||||
lacosamide|No|No|No|No|75%|00131247735|VIMPAT 50 MG TABLET|60|EA|4.57627|06/01/2009||Yes|No||06/01/2009||Yes|No|06/01/2009||Yes|No||||No|No|||Prescription required|No||056|No|10.22739|01/18/2022|9.98193|01/18/2022|10.04841|01/18/2022|||ANTICONVULSANTS|2079|||||No|No||UCB PHARMA|No||||
lacosamide|No|No|No|No|75%|00131247760|VIMPAT 50 MG TABLET|60|EA|5.03436|12/04/2012||Yes|No||12/04/2012||Yes|No|12/04/2012||Yes|No||||No|No|||Prescription required|No||056|No|10.22739|01/18/2022|9.98193|01/18/2022|10.04841|01/18/2022|||ANTICONVULSANTS|2080|||||No|No||UCB PHARMA|No||||
lacosamide|No|No|No|No|75%|00131247835|VIMPAT 100 MG TABLET|60|EA|7.15455|06/01/2009||Yes|No||06/01/2009||Yes|No|06/01/2009||Yes|No||||No|No|||Prescription required|No||056|No|15.95217|01/18/2022|15.56931|01/18/2022|15.673|01/18/2022|||ANTICONVULSANTS|2081|||||No|No||UCB PHARMA|No||||
lacosamide|No|No|No|No|75%|00131247860|VIMPAT 100 MG TABLET|60|EA|7.87064|12/04/2012||Yes|No||12/04/2012||Yes|No|12/04/2012||Yes|No||||No|No|||Prescription required|No||056|No|15.95217|01/18/2022|15.56931|01/18/2022|15.673|01/18/2022|||ANTICONVULSANTS|2082|||||No|No||UCB PHARMA|No||||
lacosamide|No|No|No|No|75%|00131247935|VIMPAT 150 MG TABLET|60|EA|7.57724|06/01/2009||Yes|No||06/01/2009||Yes|No|06/01/2009||Yes|No||||No|No|||Prescription required|No||056|No|16.89365|01/18/2022|16.4882|01/18/2022|16.59801|01/18/2022|||ANTICONVULSANTS|2083|||||No|No||UCB PHARMA|No||||
lacosamide|No|No|No|No|75%|00131247960|VIMPAT 150 MG TABLET|60|EA|8.3354|12/04/2012||Yes|No||12/04/2012||Yes|No|12/04/2012||Yes|No||||No|No|||Prescription required|No||056|No|16.89365|01/18/2022|16.4882|01/18/2022|16.59801|01/18/2022|||ANTICONVULSANTS|2084|||||No|No||UCB PHARMA|No||||
lacosamide|No|No|No|No|75%|00131248035|VIMPAT 200 MG TABLET|60|EA|7.57932|06/01/2009||Yes|No||06/01/2009||Yes|No|06/01/2009||Yes|No||||No|No|||Prescription required|No||056|No|16.89584|01/18/2022|16.49033|01/18/2022|16.60016|01/18/2022|||ANTICONVULSANTS|2085|||||No|No||UCB PHARMA|No||||
lacosamide|No|No|No|No|75%|00131248060|VIMPAT 200 MG TABLET|60|EA|8.33813|12/04/2012||Yes|No||12/04/2012||Yes|No|12/04/2012||Yes|No||||No|No|||Prescription required|No||056|No|16.89584|01/18/2022|16.49033|01/18/2022|16.60016|01/18/2022|||ANTICONVULSANTS|2086|||||No|No||UCB PHARMA|No||||
lacosamide|No|No|No|No|75%|00131541072|VIMPAT 10 MG/ML SOLUTION|200|ML|.88797|09/16/2020||Yes|No||09/16/2020||Yes|No|09/16/2020||Yes|No||||No|No|||Prescription required|No||056|No|1.98325|01/18/2022|1.93565|01/18/2022|1.94854|01/18/2022|||ANTICONVULSANTS|2087|||||No|No||UCB PHARMA|No||||
sodium phosphate,mono-dibasic|No|No|No|No|75%|00132020220|FLEET PEDIA-LAX ENEMA|66|ML|.00813|09/07/2015||Yes|No||||No|No|09/07/2015||Yes|No||||No|No|||Over the counter|No|||No|.01855|11/24/2020|.01828|11/24/2020|.01741|11/24/2020||||2088|||||No|No||FLEET,C.B. CO.|No||||
captopril|Yes|No|No|No|75%|00143117101|CAPTOPRIL 12.5 MG TABLET|100|EA|.4355|09/08/2003||Yes|No||09/08/2003||Yes|No|09/08/2003||Yes|No||09/08/2003||Yes|No|07/01/2016||Prescription required|Yes|07/26/2018|113|No|.58889|03/29/2022|.57475|03/29/2022|.57858|03/29/2022|||ANGIOTENSIN MODULATORS|2089|||||No|No||WEST-WARD/HIKMA|No||||
captopril|Yes|No|No|No|75%|00143117110|CAPTOPRIL 12.5 MG TABLET|1000|EA|.43553|10/29/2003||Yes|No||10/29/2003||Yes|No|10/29/2003||Yes|No||10/29/2003||Yes|No|07/01/2016||Prescription required|Yes|07/26/2018|113|No|.58889|03/29/2022|.57475|03/29/2022|.57858|03/29/2022|||ANGIOTENSIN MODULATORS|2090|||||No|No||WEST-WARD/HIKMA|No||||
captopril|Yes|No|No|No|75%|00143117201|CAPTOPRIL 25 MG TABLET|100|EA|.46663|09/08/2003||Yes|No||09/08/2003||Yes|No|09/08/2003||Yes|No||09/08/2003||Yes|No|07/01/2016||Prescription required|Yes|07/26/2018|113|No|.40459|03/29/2022|.39487|03/29/2022|.3975|03/29/2022|||ANGIOTENSIN MODULATORS|2091|||||No|No||WEST-WARD/HIKMA|No||||
captopril|Yes|No|No|No|75%|00143117210|CAPTOPRIL 25 MG TABLET|1000|EA|.4666|09/08/2003||Yes|No||09/08/2003||Yes|No|09/08/2003||Yes|No||09/08/2003||Yes|No|07/01/2016||Prescription required|Yes|07/26/2018|113|No|.40459|03/29/2022|.39487|03/29/2022|.3975|03/29/2022|||ANGIOTENSIN MODULATORS|2092|||||No|No||WEST-WARD/HIKMA|No||||
captopril|Yes|No|No|No|75%|00143117301|CAPTOPRIL 50 MG TABLET|100|EA|.8102|09/08/2003||Yes|No||09/08/2003||Yes|No|09/08/2003||Yes|No||09/08/2003||Yes|No|07/01/2016||Prescription required|Yes|07/26/2018|113|No|1.25965|03/29/2022|1.22941|03/29/2022|1.2376|03/29/2022|||ANGIOTENSIN MODULATORS|2093|||||No|No||WEST-WARD/HIKMA|No||||
captopril|Yes|No|No|No|75%|00143117310|CAPTOPRIL 50 MG TABLET|1000|EA|.81018|09/08/2003||Yes|No||09/08/2003||Yes|No|09/08/2003||Yes|No||09/08/2003||Yes|No|07/01/2016||Prescription required|Yes|07/26/2018|113|No|1.25965|03/29/2022|1.22941|03/29/2022|1.2376|03/29/2022|||ANGIOTENSIN MODULATORS|2094|||||No|No||WEST-WARD/HIKMA|No||||
captopril|Yes|No|No|No|75%|00143117401|CAPTOPRIL 100 MG TABLET|100|EA|1.06386|09/08/2003||Yes|No||09/08/2003||Yes|No|09/08/2003||Yes|No||09/08/2003||Yes|No|07/01/2016||Prescription required|Yes|07/26/2018|113|No|1.37792|03/29/2022|1.34484|03/29/2022|1.3538|03/29/2022|||ANGIOTENSIN MODULATORS|2095|||||No|No||WEST-WARD/HIKMA|No||||
dicyclomine HCl|No|No|No|No|75%|00143122701|DICYCLOMINE 20 MG TABLET|100|EA|.11932|11/28/2015||Yes|No||11/28/2015||Yes|No|11/28/2015||Yes|No||||No|No|||Prescription required|No|||No|.17279|03/29/2022|.16864|03/29/2022|.16976|03/29/2022||||2096|||||No|No||WEST-WARD/HIKMA|No||||
dicyclomine HCl|No|No|No|No|75%|00143122710|DICYCLOMINE 20 MG TABLET|1000|EA|.10965|11/28/2015||Yes|No||11/28/2015||Yes|No|11/28/2015||Yes|No||||No|No|||Prescription required|No|||No|.17279|03/29/2022|.16864|03/29/2022|.16976|03/29/2022||||2097|||||No|No||WEST-WARD/HIKMA|No||||
digoxin|No|No|No|No|75%|00143124001|DIGOXIN 125 MCG TABLET|100|EA|.50955|05/01/2008||Yes|No||05/01/2008||Yes|No|05/01/2008||Yes|No||05/01/2008||Yes|No|||Prescription required|No|||No|.25031|03/29/2022|.2443|03/29/2022|.24592|03/29/2022||||2098|||||No|No||WEST-WARD/HIKMA|No||||
digoxin|No|No|No|No|75%|00143124010|DIGOXIN 125 MCG TABLET|1000|EA|.42548|05/01/2008||Yes|No||05/01/2008||Yes|No|05/01/2008||Yes|No||05/01/2008||Yes|No|||Prescription required|No|||No|.25031|03/29/2022|.2443|03/29/2022|.24592|03/29/2022||||2099|||||No|No||WEST-WARD/HIKMA|Yes|09/01/2020|||
digoxin|No|No|No|No|75%|00143124101|DIGOXIN 250 MCG TABLET|100|EA|.50955|05/01/2008||Yes|No||05/01/2008||Yes|No|05/01/2008||Yes|No||05/01/2008||Yes|No|||Prescription required|No|||No|.22254|03/29/2022|.21719|03/29/2022|.21864|03/29/2022||||2100|||||No|No||WEST-WARD/HIKMA|Yes|09/01/2020|||
digoxin|No|No|No|No|75%|00143124110|DIGOXIN 250 MCG TABLET|1000|EA|.42548|05/01/2008||Yes|No||05/01/2008||Yes|No|05/01/2008||Yes|No||05/01/2008||Yes|No|||Prescription required|No|||No|.22254|03/29/2022|.21719|03/29/2022|.21864|03/29/2022||||2101|||||No|No||WEST-WARD/HIKMA|Yes|09/01/2020|||
PHENOBARBITAL|No|No|No|No|75%|00143144510|PHENOBARBITAL 15 MG TABLET|1000|EA||09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||09/07/2015||Yes|No|||Prescription required|No|||No|.04696|06/01/2016|.04629|06/01/2016|.04408|06/01/2016||||2102|||||No|No||WEST-WARD,INC.|No||||
phenobarbital|No|No|No|No|75%|00143145501|PHENOBARBITAL 60 MG TABLET|100|EA|.1892|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||02/15/2022||Yes|No|||Prescription required|No||056|No|.29898|03/29/2022|.2918|03/29/2022|.29374|03/29/2022|||ANTICONVULSANTS|2103|||||No|No||WEST-WARD/HIKMA|No||||
phenobarbital|No|No|No|No|75%|00143145505|PHENOBARBITAL 60 MG TABLET|500|EA|.0946|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||09/07/2015||Yes|No|||Prescription required|No||056|No|.29898|03/29/2022|.2918|03/29/2022|.29374|03/29/2022|||ANTICONVULSANTS|2104|||||No|No||WEST-WARD/HIKMA|No||||
PHENOBARBITAL|No|No|No|No|75%|00143145510|PHENOBARBITAL 60 MG TABLET|1000|EA||09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||09/07/2015||Yes|No|||Prescription required|No|||No|.07337|06/01/2016|.07232|06/01/2016|.06888|06/01/2016||||2105|||||No|No||WEST-WARD,INC.|No||||
phenobarbital|No|No|No|No|75%|00143145801|PHENOBARBITAL 100 MG TABLET|100|EA|.2666|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||09/07/2015||Yes|No|||Prescription required|No||056|No|.39079|03/29/2022|.38141|03/29/2022|.38395|03/29/2022|||ANTICONVULSANTS|2106|||||No|No||WEST-WARD/HIKMA|No||||
phenobarbital|No|No|No|No|75%|00143145805|PHENOBARBITAL 100 MG TABLET|500|EA|.1333|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||09/07/2015||Yes|No|||Prescription required|No||056|No|.39079|03/29/2022|.38141|03/29/2022|.38395|03/29/2022|||ANTICONVULSANTS|2107|||||No|No||WEST-WARD/HIKMA|No||||
PHENOBARBITAL|No|No|No|No|75%|00143145810|PHENOBARBITAL 100 MG TABLET|1000|EA||09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||09/07/2015||Yes|No|||Prescription required|No|||No|.10272|06/01/2016|.10125|06/01/2016|.09643|06/01/2016||||2108|||||No|No||WEST-WARD,INC.|No||||
phenobarbital|No|No|No|No|75%|00143149501|PHENOBARBITAL 15 MG TABLET|100|EA|.1204|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||02/15/2022||Yes|No|||Prescription required|No||056|No|.13719|03/29/2022|.13389|03/29/2022|.13478|03/29/2022|||ANTICONVULSANTS|2109|||||No|No||WEST-WARD/HIKMA|No||||
phenobarbital|No|No|No|No|75%|00143149505|PHENOBARBITAL 15 MG TABLET|500|EA|.0602|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||02/15/2022||Yes|No|||Prescription required|No||056|No|.13719|03/29/2022|.13389|03/29/2022|.13478|03/29/2022|||ANTICONVULSANTS|2110|||||No|No||WEST-WARD/HIKMA|No||||
phenobarbital|No|No|No|No|75%|00143150001|PHENOBARBITAL 30 MG TABLET|100|EA|.15136|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||10/01/2020||Yes|No|||Prescription required|No||056|No|.19822|03/29/2022|.19346|03/29/2022|.19475|03/29/2022|||ANTICONVULSANTS|2111|||||No|No||WEST-WARD/HIKMA|No||||
phenobarbital|No|No|No|No|75%|00143150005|PHENOBARBITAL 30 MG TABLET|500|EA|.07568|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||02/15/2022||Yes|No|||Prescription required|No||056|No|.19822|03/29/2022|.19346|03/29/2022|.19475|03/29/2022|||ANTICONVULSANTS|2112|||||No|No||WEST-WARD/HIKMA|No||||
isosorbide dinitrate|No|No|No|No|75%|00143176901|ISOSORBIDE DINITRATE 5 MG TAB|100|EA|.22587|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.32336|03/29/2022|.31559|03/29/2022|.3177|03/29/2022||||2113|||||No|No||WEST-WARD/HIKMA|No||||
isosorbide dinitrate|No|No|No|No|75%|00143177101|ISOSORBIDE DINITRATE 10 MG TAB|100|EA|.24849|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.34234|03/29/2022|.33412|03/29/2022|.33634|03/29/2022||||2114|||||No|No||WEST-WARD/HIKMA|No||||
isosorbide dinitrate|No|No|No|No|75%|00143177201|ISOSORBIDE DINITRATE 20 MG TAB|100|EA|.27335|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.30675|03/29/2022|.29938|03/29/2022|.30138|03/29/2022||||2115|||||No|No||WEST-WARD/HIKMA|No||||
doxycycline hyclate|Yes|No|No|No|75%|00143211205|DOXYCYCLINE HYCLATE 100 MG TAB|500|EA|.516|09/08/2003||Yes|No||09/08/2003||Yes|No|09/08/2003||Yes|No||09/08/2003||Yes|No|11/01/2012||Prescription required|Yes|01/22/2015|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|2116|||||No|No||WEST-WARD/HIKMA|No||||
doxycycline hyclate|Yes|No|No|No|75%|00143211250|DOXYCYCLINE HYCLATE 100 MG TAB|50|EA|.516|09/08/2003||Yes|No||09/08/2003||Yes|No|09/08/2003||Yes|No||09/08/2003||Yes|No|11/01/2012||Prescription required|Yes|01/22/2015|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|2117|||||No|No||WEST-WARD/HIKMA|No||||
colchicine|No|No|No|No|75%|00143301801|COLCHICINE 0.6 MG CAPSULE|100|EA|2.24541|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||05/12/2015||Yes|No|||Prescription required|Yes|01/22/2015|231|No|4.58611|03/29/2022|4.47604|03/29/2022|4.50585|03/29/2022|||ANTIHYPERURICEMICS|2118|||||No|No||WEST-WARD/HIKMA|No||||
colchicine|No|No|No|No|75%|00143301810|COLCHICINE 0.6 MG CAPSULE|1000|EA|2.24547|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||05/12/2015||Yes|No|||Prescription required|Yes|01/22/2015|231|No|4.58611|03/29/2022|4.47604|03/29/2022|4.50585|03/29/2022|||ANTIHYPERURICEMICS|2119|||||No|No||WEST-WARD/HIKMA|No||||
colchicine|No|No|No|No|75%|00143301830|COLCHICINE 0.6 MG CAPSULE|30|EA|2.24546|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||04/11/2019||Yes|No|||Prescription required|Yes|07/26/2018|231|No|4.58611|03/29/2022|4.47604|03/29/2022|4.50585|03/29/2022|||ANTIHYPERURICEMICS|2120|||||No|No||WEST-WARD/HIKMA|No||||
dicyclomine HCl|No|No|No|No|75%|00143312601|DICYCLOMINE 10 MG CAPSULE|100|EA|.08578|09/09/2016||Yes|No||09/09/2016||Yes|No|09/09/2016||Yes|No||||No|No|||Prescription required|No|||No|.10786|03/29/2022|.10527|03/29/2022|.10597|03/29/2022||||2121|||||No|No||WEST-WARD/HIKMA|No||||
dicyclomine HCl|No|No|No|No|75%|00143312610|DICYCLOMINE 10 MG CAPSULE|1000|EA|.07933|09/09/2016||Yes|No||09/09/2016||Yes|No|09/09/2016||Yes|No||||No|No|||Prescription required|No|||No|.10786|03/29/2022|.10527|03/29/2022|.10597|03/29/2022||||2122|||||No|No||WEST-WARD/HIKMA|No||||
doxycycline hyclate|No|No|No|No|75%|00143314150|DOXYCYCLINE HYCLATE 50 MG CAP|50|EA|.516|03/01/2002|01/31/2022|Yes|No||03/01/2002|01/31/2022|Yes|No|03/01/2002|01/31/2022|Yes|No||03/01/2002|01/31/2022|Yes|No|||Prescription required|No||213|No|1.176|02/15/2022|1.1592|02/15/2022|1.104|02/15/2022|||TETRACYCLINES|2123|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||WEST-WARD/HIKMA|No||||
doxycycline hyclate|Yes|No|No|No|75%|00143314250|DOXYCYCLINE HYCLATE 100 MG CAP|50|EA|.516|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|11/01/2012||Prescription required|No||213|No|.14255|03/29/2022|.13912|03/29/2022|.14005|03/29/2022|||TETRACYCLINES|2124|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00143924920|AMOX-CLAV 875-125 MG TABLET|20|EA|.5074|04/24/2020||Yes|No||04/24/2020||Yes|No|04/24/2020||Yes|No||04/24/2020||Yes|No|||Prescription required|No||046|No|.32484|03/29/2022|.31704|03/29/2022|.31915|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|2125|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin|No|No|No|No|75%|00143928501|AMOXICILLIN 875 MG TABLET|100|EA|.18748|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No||12/03/2018||Yes|No|||Prescription required|No||209|No|.1448|03/29/2022|.14132|03/29/2022|.14226|03/29/2022|||PENICILLINS|2126|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin|No|No|No|No|75%|00143928520|AMOXICILLIN 875 MG TABLET|20|EA|.20425|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No||12/03/2018||Yes|No|||Prescription required|No||209|No|.1448|03/29/2022|.14132|03/29/2022|.14226|03/29/2022|||PENICILLINS|2127|||||No|No||WEST-WARD/HIKMA|No||||
abiraterone acetate|No|No|No|No|75%|00143959721|ABIRATERONE ACETATE 250 MG TAB|120|EA|2.15|03/04/2019||Yes|No||03/04/2019||Yes|No|03/04/2019||Yes|No||||No|No|||Prescription required|No||550|No|4.9|09/28/2021|4.83|09/28/2021|4.6|09/28/2021|||ONCOLOGY: ORAL - PROSTATE|2128|||||No|No||WEST-WARD/HIKMA|No||||
glycopyrrolate|No|No|No|No|75%|00143967910|GLYCOPYRROLATE 4 MG/20 ML VIAL|20|ML|2.58|05/23/2014||Yes|No||05/23/2014||Yes|No|05/23/2014||Yes|No||||No|No|||Prescription required|No|||No|5.88|07/03/2018|5.796|07/03/2018|5.52|07/03/2018||||2129|||||No|No||WEST-WARD/HIKMA|No||||
glycopyrrolate|No|No|No|No|75%|00143968025|GLYCOPYRROLATE 1 MG/5 ML VIAL|5|ML|2.58|05/23/2014||Yes|No||05/23/2014||Yes|No|05/23/2014||Yes|No||||No|No|||Prescription required|No|||No|5.88|07/03/2018|5.796|07/03/2018|5.52|07/03/2018||||2130|||||No|No||WEST-WARD/HIKMA|No||||
glycopyrrolate|No|No|No|No|75%|00143968125|GLYCOPYRROLATE 0.4 MG/2 ML VL|2|ML|3.01|05/23/2014||Yes|No||05/23/2014||Yes|No|05/23/2014||Yes|No||||No|No|||Prescription required|No|||No|6.86|07/03/2018|6.762|07/03/2018|6.44|07/03/2018||||2131|||||No|No||WEST-WARD/HIKMA|No||||
glycopyrrolate|No|No|No|No|75%|00143968225|GLYCOPYRROLATE 0.2 MG/ML VIAL|1|ML|3.01|05/23/2014||Yes|No||05/23/2014||Yes|No|05/23/2014||Yes|No||||No|No|||Prescription required|No|||No|6.86|07/03/2018|6.762|07/03/2018|6.44|07/03/2018||||2132|||||No|No||WEST-WARD/HIKMA|No||||
milrinone lactate|No|No|No|No|75%|00143970801|MILRINONE LACT 50 MG/50 ML VL|50|ML|.344|07/24/2012||Yes|No||07/24/2012||Yes|No|07/24/2012||Yes|No||||No|No|||Prescription required|No|||No|.784|06/01/2016|.7728|06/01/2016|.736|06/01/2016||||2133|||||No|No||WEST-WARD/HIKMA|No||||
milrinone lactate|No|No|No|No|75%|00143970910|MILRINONE LACT 20 MG/20 ML VL|20|ML|.19737|08/06/2012||Yes|No||08/06/2012||Yes|No|08/06/2012||Yes|No||||No|No|||Prescription required|No|||No|.44982|06/01/2016|.44339|06/01/2016|.42228|06/01/2016||||2134|||||No|No||WEST-WARD/HIKMA|No||||
milrinone lactate|No|No|No|No|75%|00143971010|MILRINONE LACT 10 MG/10 ML VL|10|ML|.26875|08/03/2012||Yes|No||08/03/2012||Yes|No|08/03/2012||Yes|No||||No|No|||Prescription required|No|||No|.6125|06/01/2016|.60375|06/01/2016|.575|06/01/2016||||2135|||||No|No||WEST-WARD/HIKMA|No||||
milrinone lactate/D5W|No|No|No|No|75%|00143971810|MILRINONE-D5W 40 MG/200 ML|200|ML|.06858|08/06/2012||Yes|No||08/06/2012||Yes|No|08/06/2012||Yes|No||||No|No|||Prescription required|No|||No|.15631|06/01/2016|.15407|06/01/2016|.14674|06/01/2016||||2136|||||No|No||WEST-WARD/HIKMA|No||||
milrinone lactate/D5W|No|No|No|No|75%|00143971910|MILRINONE-D5W 20 MG/100 ML|100|ML|.06536|08/06/2012||Yes|No||08/06/2012||Yes|No|08/06/2012||Yes|No||||No|No|||Prescription required|No|||No|.14896|06/01/2016|.14683|06/01/2016|.13984|06/01/2016||||2137|||||No|No||WEST-WARD/HIKMA|No||||
levofloxacin in dextrose 5 %|No|No|No|No|75%|00143972001|LEVOFLOXACIN 750 MG/150 ML-D5W|150|ML||03/14/2012||Yes|No||03/14/2012||Yes|No|03/14/2012||Yes|No||||No|No|||Prescription required|No|||No|||||||.04244|06/01/2016||2138|||||No|No||WEST-WARD/HIKMA|No||||
levofloxacin in dextrose 5 %|No|No|No|No|75%|00143972101|LEVOFLOXACIN 500 MG/100 ML-D5W|100|ML||03/14/2012||Yes|No||03/14/2012||Yes|No|03/14/2012||Yes|No||||No|No|||Prescription required|No|||No|||||||.06239|06/01/2016||2139|||||No|No||WEST-WARD/HIKMA|No||||
levofloxacin in dextrose 5 %|No|No|No|No|75%|00143972201|LEVOFLOXACIN 250 MG/50 ML-D5W|50|ML||03/14/2012||Yes|No||03/14/2012||Yes|No|03/14/2012||Yes|No||||No|No|||Prescription required|No|||No|||||||.1224|06/01/2016||2140|||||No|No||WEST-WARD/HIKMA|No||||
progesterone|No|No|No|No|75%|00143972501|PROGESTERONE 500 MG/10 ML VIAL|10|ML|1.46329|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||No|2.019|03/29/2022|1.97054|03/29/2022|1.98366|03/29/2022||||2141|||||No|No||WEST-WARD/HIKMA|No||||
benztropine mesylate|No|No|No|No|75%|00143972905|BENZTROPINE 2 MG/2 ML AMPULE|2|ML|12.9|11/15/2009||Yes|No||11/15/2009||Yes|No|11/15/2009||Yes|No||||No|No|||Prescription required|No|||No|29.4|06/01/2016|28.98|06/01/2016|27.6|06/01/2016||||2142|||||No|No||WEST-WARD/HIKMA|No||||
valproic acid (as sodium salt)|No|No|No|No|75%|00143978510|VALPROATE SOD 500 MG/5 ML VL|5|ML|1.48668|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|No|||No|3.38825|09/18/2020|3.33984|09/18/2020|3.1808|09/18/2020||||2143|||||No|No||WEST-WARD/HIKMA|No||||
doxycycline hyclate|No|No|No|No|75%|00143980250|DOXYCYCLINE HYCLATE 50 MG CAP|50|EA|.516|04/01/2021||Yes|No||04/01/2021||Yes|No|04/01/2021||Yes|No||04/01/2021||Yes|No|||Prescription required|No||213|No|.2526|03/29/2022|.24653|03/29/2022|.24817|03/29/2022|||TETRACYCLINES|2144|||||No|No||WEST-WARD/HIKMA|No||||
doxycycline hyclate|Yes|No|No|No|75%|00143980305|DOXYCYCLINE HYCLATE 100 MG CAP|500|EA|.516|06/25/2020||Yes|No||06/25/2020||Yes|No|06/25/2020||Yes|No||06/25/2020||Yes|No|09/21/2020||Prescription required|No||213|No|.14255|03/29/2022|.13912|03/29/2022|.14005|03/29/2022|||TETRACYCLINES|2145|||||No|No||WEST-WARD/HIKMA|No||||
doxycycline hyclate|Yes|No|No|No|75%|00143980350|DOXYCYCLINE HYCLATE 100 MG CAP|50|EA|.516|06/25/2020||Yes|No||06/25/2020||Yes|No|06/25/2020||Yes|No||06/25/2020||Yes|No|09/21/2020||Prescription required|No||213|No|.14255|03/29/2022|.13912|03/29/2022|.14005|03/29/2022|||TETRACYCLINES|2146|||||No|No||WEST-WARD/HIKMA|No||||
penicillin V potassium|No|No|No|No|75%|00143983601|PENICILLIN VK 500 MG TABLET|100|EA|.08587|04/20/2020||Yes|No||04/20/2020||Yes|No|04/20/2020||Yes|No||04/20/2020||Yes|No|||Prescription required|No||209|No|.10026|03/29/2022|.09785|03/29/2022|.0985|03/29/2022|||PENICILLINS|2147|||||No|No||WEST-WARD/HIKMA|No||||
penicillin V potassium|No|No|No|No|75%|00143983610|PENICILLIN VK 500 MG TABLET|1000|EA|.04761|04/20/2020||Yes|No||04/20/2020||Yes|No|04/20/2020||Yes|No||04/20/2020||Yes|No|||Prescription required|No||209|No|.10026|03/29/2022|.09785|03/29/2022|.0985|03/29/2022|||PENICILLINS|2148|||||No|No||WEST-WARD/HIKMA|No||||
penicillin V potassium|No|No|No|No|75%|00143983701|PENICILLIN VK 250 MG TABLET|100|EA|.03483|04/20/2020||Yes|No||04/20/2020||Yes|No|04/20/2020||Yes|No||04/20/2020||Yes|No|||Prescription required|No||209|No|.0637|03/29/2022|.06217|03/29/2022|.06258|03/29/2022|||PENICILLINS|2149|||||No|No||WEST-WARD/HIKMA|No||||
penicillin V potassium|No|No|No|No|75%|00143983710|PENICILLIN VK 250 MG TABLET|1000|EA|.03483|04/20/2020||Yes|No||04/20/2020||Yes|No|04/20/2020||Yes|No||04/20/2020||Yes|No|||Prescription required|No||209|No|.0637|03/29/2022|.06217|03/29/2022|.06258|03/29/2022|||PENICILLINS|2150|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00143985316|AMOX-CLAV 600-42.9 MG/5 ML SUS|125|ML|.0602|04/01/2008||Yes|No||04/01/2008||Yes|No|04/01/2008||Yes|No||04/01/2008||Yes|No|||Prescription required|No||046|No|.06559|03/29/2022|.06401|03/29/2022|.06444|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|2151|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00143985324|AMOX-CLAV 600-42.9 MG/5 ML SUS|200|ML|.086|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||02/21/2020||Yes|No|||Prescription required|No||046|No|.06244|03/29/2022|.06094|03/29/2022|.06134|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|2152|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00143985375|AMOX-CLAV 600-42.9 MG/5 ML SUS|75|ML|.0817|04/01/2008||Yes|No||04/01/2008||Yes|No|04/01/2008||Yes|No||04/01/2008||Yes|No|||Prescription required|No||046|No|.08577|03/29/2022|.08371|03/29/2022|.08426|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|2153|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin|No|No|No|No|75%|00143988601|AMOXICILLIN 200 MG/5 ML SUSP|100|ML|.02618|09/05/2006||Yes|No||09/05/2006||Yes|No|09/05/2006||Yes|No||09/05/2006||Yes|No|||Prescription required|No||209|No|.03312|03/29/2022|.03232|03/29/2022|.03254|03/29/2022|||PENICILLINS|2154|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin|No|No|No|No|75%|00143988650|AMOXICILLIN 200 MG/5 ML SUSP|50|ML|.02631|09/05/2006||Yes|No||09/05/2006||Yes|No|09/05/2006||Yes|No||09/05/2006||Yes|No|||Prescription required|No||209|No|.02949|11/23/2021|.02878|11/23/2021|.02897|11/23/2021|||PENICILLINS|2155|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin|No|No|No|No|75%|00143988675|AMOXICILLIN 200 MG/5 ML SUSP|75|ML|.02614|09/05/2006||Yes|No||09/05/2006||Yes|No|09/05/2006||Yes|No||09/05/2006||Yes|No|||Prescription required|No||209|No|.032|01/25/2022|.03123|01/25/2022|.03144|01/25/2022|||PENICILLINS|2156|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin|No|No|No|No|75%|00143988701|AMOXICILLIN 400 MG/5 ML SUSP|100|ML|.02812|05/06/2009||Yes|No||05/06/2009||Yes|No|05/06/2009||Yes|No||05/06/2009||Yes|No|||Prescription required|No||209|No|.02289|03/29/2022|.02234|03/29/2022|.02248|03/29/2022|||PENICILLINS|2157|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin|No|No|No|No|75%|00143988750|AMOXICILLIN 400 MG/5 ML SUSP|50|ML|.02812|09/05/2006||Yes|No||09/05/2006||Yes|No|09/05/2006||Yes|No||09/05/2006||Yes|No|||Prescription required|No||209|No|.03376|03/29/2022|.03294|03/29/2022|.03316|03/29/2022|||PENICILLINS|2158|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin|No|No|No|No|75%|00143988775|AMOXICILLIN 400 MG/5 ML SUSP|75|ML|.02803|10/27/2009||Yes|No||10/27/2009||Yes|No|10/27/2009||Yes|No||10/27/2009||Yes|No|||Prescription required|No||209|No|.02457|03/29/2022|.02398|03/29/2022|.02414|03/29/2022|||PENICILLINS|2159|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin|No|No|No|No|75%|00143988801|AMOXICILLIN 125 MG/5 ML SUSP|100|ML|.0101|09/05/2006||Yes|No||09/05/2006||Yes|No|09/05/2006||Yes|No||09/05/2006||Yes|No|||Prescription required|No||209|No|.02009|03/29/2022|.0196|03/29/2022|.01973|03/29/2022|||PENICILLINS|2160|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin|No|No|No|No|75%|00143988815|AMOXICILLIN 125 MG/5 ML SUSP|150|ML|.00874|01/13/2012||Yes|No||01/13/2012||Yes|No|01/13/2012||Yes|No||01/13/2012||Yes|No|||Prescription required|No||209|No|.01643|03/29/2022|.01603|03/29/2022|.01614|03/29/2022|||PENICILLINS|2161|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin|No|No|No|No|75%|00143988880|AMOXICILLIN 125 MG/5 ML SUSP|80|ML|.01021|09/05/2006||Yes|No||09/05/2006||Yes|No|09/05/2006||Yes|No||09/05/2006||Yes|No|||Prescription required|No||209|No|.01904|03/29/2022|.01858|03/29/2022|.0187|03/29/2022|||PENICILLINS|2162|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin|No|No|No|No|75%|00143988901|AMOXICILLIN 250 MG/5 ML SUSP|100|ML|.01268|09/05/2006||Yes|No||09/05/2006||Yes|No|09/05/2006||Yes|No||09/05/2006||Yes|No|||Prescription required|No||209|No|.01967|03/29/2022|.01919|03/29/2022|.01932|03/29/2022|||PENICILLINS|2163|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin|No|No|No|No|75%|00143988915|AMOXICILLIN 250 MG/5 ML SUSP|150|ML|.01333|10/06/2009||Yes|No||10/06/2009||Yes|No|10/06/2009||Yes|No||10/06/2009||Yes|No|||Prescription required|No||209|No|.01799|03/29/2022|.01755|03/29/2022|.01767|03/29/2022|||PENICILLINS|2164|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin|No|No|No|No|75%|00143988980|AMOXICILLIN 250 MG/5 ML SUSP|80|ML|.01397|09/05/2006||Yes|No||09/05/2006||Yes|No|09/05/2006||Yes|No||09/05/2006||Yes|No|||Prescription required|No||209|No|.02476|03/29/2022|.02416|03/29/2022|.02432|03/29/2022|||PENICILLINS|2165|||||No|No||WEST-WARD/HIKMA|No||||
cefazolin sodium|No|No|No|No|75%|00143992390|CEFAZOLIN 500 MG VIAL|1|EA|.86086|08/20/2007||Yes|No||08/20/2007||Yes|No|08/20/2007||Yes|No||||No|No|||Prescription required|No|||No|1.96196|11/06/2018|1.93393|11/06/2018|1.84184|11/06/2018||||2166|||||No|No||WEST-WARD/HIKMA|No||||
cefazolin sodium|No|No|No|No|75%|00143992490|CEFAZOLIN 1 GM VIAL|1|EA|.58806|08/20/2007||Yes|No||08/20/2007||Yes|No|08/20/2007||Yes|No||||No|No|||Prescription required|No|||No|1.34024|11/06/2018|1.3211|11/06/2018|1.25819|11/06/2018||||2167|||||No|No||WEST-WARD/HIKMA|No||||
ciprofloxacin HCl|Yes|No|No|No|75%|00143992701|CIPROFLOXACIN HCL 250 MG TAB|100|EA|.06235|07/27/2004||Yes|No||07/27/2004||Yes|No|07/27/2004||Yes|No||07/27/2004||Yes|No|07/01/2016||Prescription required|No||028|No|.09397|03/29/2022|.09171|03/29/2022|.09232|03/29/2022|||FLUOROQUINOLONES: ORAL|2168|||||No|No||WEST-WARD/HIKMA|No||||
ciprofloxacin HCl|No|No|No|No|75%|00143992801|CIPROFLOXACIN HCL 500 MG TAB|100|EA|.0903|07/27/2004||Yes|No||07/27/2004||Yes|No|07/27/2004||Yes|No||07/27/2004||Yes|No|||Prescription required|No||028|No|.13565|03/29/2022|.13239|03/29/2022|.13327|03/29/2022|||FLUOROQUINOLONES: ORAL|2169|||||No|No||WEST-WARD/HIKMA|No||||
ciprofloxacin HCl|No|No|No|No|75%|00143992950|CIPROFLOXACIN HCL 750 MG TAB|50|EA|.1376|07/27/2004||Yes|No||07/27/2004||Yes|No|07/27/2004||Yes|No||07/27/2004||Yes|No|||Prescription required|No||028|No|.288|03/29/2022|.28108|03/29/2022|.28296|03/29/2022|||FLUOROQUINOLONES: ORAL|2170|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin|No|No|No|No|75%|00143993905|AMOXICILLIN 500 MG CAPSULE|500|EA|.06475|02/08/2008||Yes|No||02/08/2008||Yes|No|02/08/2008||Yes|No||05/21/2007||Yes|No|||Prescription required|No||209|No|.07054|03/29/2022|.06884|03/29/2022|.0693|03/29/2022|||PENICILLINS|2171|||||No|No||WEST-WARD/HIKMA|No||||
cefuroxime sodium|No|No|No|No|75%|00143997790|CEFUROXIME SOD 1.5 GM VIAL|1|EA||04/18/2005||Yes|No||04/18/2005||Yes|No|04/18/2005||Yes|No||||No|No|||Prescription required|No|||No|||||||4.41|06/01/2016||2172|||||No|No||WEST-WARD/HIKMA|No||||
cefuroxime sodium|No|No|No|No|75%|00143997922|CEFUROXIME SOD 750 MG VIAL|1|EA|1.2568|09/10/2008||Yes|No||09/10/2008||Yes|No|09/10/2008||Yes|No||||No|No|||Prescription required|No|||No|2.86434|04/23/2019|2.82342|04/23/2019|2.68897|04/23/2019||||2173|||||No|No||WEST-WARD/HIKMA|No||||
cefuroxime sodium|No|No|No|No|75%|00143997990|CEFUROXIME SOD 750 MG VIAL|1|EA||04/18/2005||Yes|No||04/18/2005||Yes|No|04/18/2005||Yes|No||||No|No|||Prescription required|No|||No|||||||2.205|06/01/2016||2174|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00143998101|AMOX-CLAV 200-28.5 MG/5 ML SUS|100|ML|.04644|08/01/2006||Yes|No||08/01/2006||Yes|No|08/01/2006||Yes|No||08/01/2006||Yes|No|||Prescription required|No||046|No|.05885|03/29/2022|.05743|03/29/2022|.05782|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|2175|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00143998150|AMOX-CLAV 200-28.5 MG/5 ML SUS|50|ML|.0743|08/01/2006||Yes|No||08/01/2006||Yes|No|08/01/2006||Yes|No||08/01/2006||Yes|No|||Prescription required|No||046|No|.16934|10/27/2020|.16692|10/27/2020|.15897|10/27/2020|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|2176|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00143998175|AMOX-CLAV 200-28.5 MG/5 ML SUS|75|ML|.05274|08/01/2006||Yes|No||08/01/2006||Yes|No|08/01/2006||Yes|No||08/01/2006||Yes|No|||Prescription required|No||046|No|.1202|03/23/2021|.11848|03/23/2021|.11284|03/23/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|2177|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00143998201|AMOX-CLAV 400-57 MG/5 ML SUSP|100|ML|.06278|08/01/2006||Yes|No||08/01/2006||Yes|No|08/01/2006||Yes|No||08/01/2006||Yes|No|||Prescription required|No||046|No|.07681|03/29/2022|.07496|03/29/2022|.07546|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|2178|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00143998250|AMOX-CLAV 400-57 MG/5 ML SUSP|50|ML|.09288|08/01/2006||Yes|No||08/01/2006||Yes|No|08/01/2006||Yes|No||08/01/2006||Yes|No|||Prescription required|No||046|No|.0974|03/29/2022|.09506|03/29/2022|.09569|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|2179|||||No|No||WEST-WARD/HIKMA|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00143998275|AMOX-CLAV 400-57 MG/5 ML SUSP|75|ML|.06593|08/01/2006||Yes|No||08/01/2006||Yes|No|08/01/2006||Yes|No||08/01/2006||Yes|No|||Prescription required|No||046|No|.0795|03/29/2022|.07759|03/29/2022|.0781|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|2180|||||No|No||WEST-WARD/HIKMA|No||||
cefazolin sodium|No|No|No|No|75%|00143998391|CEFAZOLIN 10 GM VIAL|1|EA||01/26/2005||Yes|No||01/26/2005||Yes|No|01/26/2005||Yes|No||||No|No|||Prescription required|No|||No|||||||16.8|06/01/2016||2181|||||No|No||WEST-WARD/HIKMA|No||||
acitretin|No|No|No|No|75%|00145009025|SORIATANE 10 MG CAPSULE|30|EA|18.89162|12/18/2009|11/11/2022|Yes|No||12/18/2009|11/11/2022|Yes|No|12/18/2009|11/11/2022|Yes|No||||No|No|||Prescription required|No|||No|43.05532|01/23/2018|42.44024|01/23/2018|40.41928|01/23/2018||||2182|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||STIEFEL LABS.|No||||
acitretin|No|No|No|No|75%|00145009125|SORIATANE 25 MG CAPSULE|30|EA|23.28593|12/18/2009|11/11/2022|Yes|No||12/18/2009|11/11/2022|Yes|No|12/18/2009|11/11/2022|Yes|No||||No|No|||Prescription required|No|||No|53.07026|01/23/2018|52.31211|01/23/2018|49.82106|01/23/2018||||2183|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||STIEFEL LABS.|No||||
triamcinolone acetonide|No|No|No|No|75%|00168000215|TRIAMCINOLONE 0.5% CREAM|15|GM|.26516|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||120|No|.24378|03/29/2022|.23792|03/29/2022|.23951|03/29/2022|||STEROIDS: TOPICAL HIGH|2184|||||No|No||FOUGERA/SANDOZ|No||||
triamcinolone acetonide|No|No|No|No|75%|00168000315|TRIAMCINOLONE 0.025% CREAM|15|GM|.10664|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||120|No|.15373|03/29/2022|.15004|03/29/2022|.15103|03/29/2022|||STEROIDS: TOPICAL HIGH|2185|||||No|No||FOUGERA/SANDOZ|No||||
triamcinolone acetonide|No|No|No|No|75%|00168000380|TRIAMCINOLONE 0.025% CREAM|80|GM|.04993|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||120|No|.05651|03/29/2022|.05515|03/29/2022|.05552|03/29/2022|||STEROIDS: TOPICAL HIGH|2186|||||No|No||FOUGERA/SANDOZ|No||||
triamcinolone acetonide|No|No|No|No|75%|00168000415|TRIAMCINOLONE 0.1% CREAM|15|GM|.086|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||120|No|.13878|03/29/2022|.13544|03/29/2022|.13635|03/29/2022|||STEROIDS: TOPICAL HIGH|2187|||||No|No||FOUGERA/SANDOZ|No||||
triamcinolone acetonide|No|No|No|No|75%|00168000416|TRIAMCINOLONE 0.1% CREAM|453.6|GM|.01895|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||120|No|.02624|03/29/2022|.02561|03/29/2022|.02578|03/29/2022|||STEROIDS: TOPICAL HIGH|2188|||||No|No||FOUGERA/SANDOZ|No||||
triamcinolone acetonide|No|No|No|No|75%|00168000480|TRIAMCINOLONE 0.1% CREAM|80|GM|.03762|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||120|No|.05241|03/29/2022|.05115|03/29/2022|.05149|03/29/2022|||STEROIDS: TOPICAL HIGH|2189|||||No|No||FOUGERA/SANDOZ|No||||
triamcinolone acetonide|No|No|No|No|75%|00168000580|TRIAMCINOLONE 0.025% OINT|80|GM|.04993|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||120|No|.07753|03/29/2022|.07566|03/29/2022|.07617|03/29/2022|||STEROIDS: TOPICAL HIGH|2190|||||No|No||FOUGERA/SANDOZ|No||||
triamcinolone acetonide|No|No|No|No|75%|00168000615|TRIAMCINOLONE 0.1% OINTMENT|15|GM|.1333|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||120|No|.14436|03/29/2022|.14089|03/29/2022|.14183|03/29/2022|||STEROIDS: TOPICAL HIGH|2191|||||No|No||FOUGERA/SANDOZ|No||||
triamcinolone acetonide|No|No|No|No|75%|00168000616|TRIAMCINOLONE 0.1% OINTMENT|453.6|GM|.02369|04/24/2009||Yes|No||04/24/2009||Yes|No|04/24/2009||Yes|No||||No|No|||Prescription required|No||120|No|.0434|11/23/2021|.04235|11/23/2021|.04264|11/23/2021|||STEROIDS: TOPICAL HIGH|2192|||||No|No||FOUGERA/SANDOZ|No||||
triamcinolone acetonide|No|No|No|No|75%|00168000680|TRIAMCINOLONE 0.1% OINTMENT|80|GM|.06245|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||120|No|.06224|03/29/2022|.06074|03/29/2022|.06115|03/29/2022|||STEROIDS: TOPICAL HIGH|2193|||||No|No||FOUGERA/SANDOZ|No||||
nystatin|No|No|No|No|75%|00168000715|NYSTATIN 100,000 UNIT/GM OINT|15|GM|.40133|03/16/2013||Yes|No||03/16/2013||Yes|No|03/16/2013||Yes|No||||No|No|||Prescription required|No||061|No|.33338|03/29/2022|.32537|03/29/2022|.32754|03/29/2022|||ANTIFUNGALS: TOPICAL|2194|||||No|No||FOUGERA/SANDOZ|No||||
nystatin|No|No|No|No|75%|00168000730|NYSTATIN 100,000 UNIT/GM OINT|30|GM|.301|03/16/2013||Yes|No||03/16/2013||Yes|No|03/16/2013||Yes|No||||No|No|||Prescription required|No||061|No|.27525|03/29/2022|.26864|03/29/2022|.27043|03/29/2022|||ANTIFUNGALS: TOPICAL|2195|||||No|No||FOUGERA/SANDOZ|No||||
hydrocortisone|No|No|No|No|75%|00168001516|HYDROCORTISONE 1% CREAM|453.6|GM|.05687|03/19/2008||Yes|No||03/19/2008||Yes|No|03/19/2008||Yes|No||||No|No|||Prescription required|No||118|No|.12962|06/01/2016|.12777|06/01/2016|.12168|06/01/2016|||STEROIDS: TOPICAL LOW|2196|||||No|No||FOUGERA/SANDOZ|No||||
hydrocortisone|No|No|No|No|75%|00168001531|HYDROCORTISONE 1% CREAM|28.35|GM|.091|03/19/2008||Yes|No||03/19/2008||Yes|No|03/19/2008||Yes|No||||No|No|||Prescription required|No||118|No|.07811|03/01/2022|.07623|03/01/2022|.07674|03/01/2022|||STEROIDS: TOPICAL LOW|2197|||||No|No||FOUGERA/SANDOZ|No||||
hydrocortisone|No|No|No|No|75%|00168002016|HYDROCORTISONE 1% OINTMENT|453.6|GM|.05687|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||118|No|.12962|06/01/2016|.12777|06/01/2016|.12168|06/01/2016|||STEROIDS: TOPICAL LOW|2198|||||No|No||FOUGERA/SANDOZ|No||||
hydrocortisone|No|No|No|No|75%|00168002031|HYDROCORTISONE 1% OINTMENT|28.35|GM|.091|03/19/2008||Yes|No||03/19/2008||Yes|No|03/19/2008||Yes|No||||No|No|||Prescription required|No||118|No|.15581|03/01/2022|.15207|03/01/2022|.15308|03/01/2022|||STEROIDS: TOPICAL LOW|2199|||||No|No||FOUGERA/SANDOZ|No||||
betamethasone valerate|No|No|No|No|75%|00168003315|BETAMETHASONE VALER 0.1% OINTM|15|GM|.4664|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||120|No|.7916|03/29/2022|.7726|03/29/2022|.77774|03/29/2022|||STEROIDS: TOPICAL HIGH|2200|||||No|No||SANDOZ|No||||
betamethasone valerate|No|No|No|No|75%|00168003346|BETAMETHASONE VALER 0.1% OINTM|45|GM|.31743|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||120|No|.63691|03/29/2022|.62162|03/29/2022|.62576|03/29/2022|||STEROIDS: TOPICAL HIGH|2201|||||No|No||SANDOZ|No||||
betamethasone valerate|No|No|No|No|75%|00168004015|BETAMETHASONE VA 0.1% CREAM|15|GM|.64156|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||120|No|.68343|03/29/2022|.66702|03/29/2022|.67146|03/29/2022|||STEROIDS: TOPICAL HIGH|2202|||||No|No||FOUGERA/SANDOZ|No||||
betamethasone valerate|No|No|No|No|75%|00168004046|BETAMETHASONE VA 0.1% CREAM|45|GM|.43649|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||120|No|.43211|03/29/2022|.42173|03/29/2022|.42454|03/29/2022|||STEROIDS: TOPICAL HIGH|2203|||||No|No||FOUGERA/SANDOZ|No||||
betamethasone valerate|No|No|No|No|75%|00168004160|BETAMETHASONE VA 0.1% LOTION|60|ML|.43|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|120|No|.62369|03/29/2022|.60872|03/29/2022|.61277|03/29/2022|||STEROIDS: TOPICAL HIGH|2204|||||No|No||FOUGERA/SANDOZ|No||||
nystatin|No|No|No|No|75%|00168005415|NYSTATIN 100,000 UNIT/GM CREAM|15|GM|.40133|01/06/2004|02/22/2022|Yes|No||01/06/2004|02/22/2022|Yes|No|01/06/2004|02/22/2022|Yes|No||||No|No|||Prescription required|No||061|No|.91466|03/29/2022|.90159|03/29/2022|.85866|03/29/2022|||ANTIFUNGALS: TOPICAL|2205|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SANDOZ|No||||
nystatin|No|No|No|No|75%|00168005430|NYSTATIN 100,000 UNIT/GM CREAM|30|GM|.301|01/06/2004|02/22/2022|Yes|No||01/06/2004|02/22/2022|Yes|No|01/06/2004|02/22/2022|Yes|No||||No|No|||Prescription required|No||061|No|.686|03/29/2022|.6762|03/29/2022|.644|03/29/2022|||ANTIFUNGALS: TOPICAL|2206|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SANDOZ|No||||
betamethasone dipropionate|No|No|No|No|75%|00168005515|BETAMETHASONE DP 0.05% CRM|15|GM|1.21145|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|1.02286|03/29/2022|.99831|03/29/2022|1.00495|03/29/2022|||STEROIDS: TOPICAL HIGH|2207|||||No|No||FOUGERA/SANDOZ|No||||
betamethasone dipropionate|No|No|No|No|75%|00168005546|BETAMETHASONE DP 0.05% CRM|45|GM|.80763|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|.64604|03/29/2022|.63053|03/29/2022|.63473|03/29/2022|||STEROIDS: TOPICAL HIGH|2208|||||No|No||FOUGERA/SANDOZ|No||||
betamethasone dipropionate|No|No|No|No|75%|00168005615|BETAMETHASONE DP 0.05% OINT|15|GM|1.41011|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|1.65429|03/29/2022|1.61458|03/29/2022|1.62533|03/29/2022|||STEROIDS: TOPICAL HIGH|2209|||||No|No||FOUGERA/SANDOZ|No||||
betamethasone dipropionate|No|No|No|No|75%|00168005646|BETAMETHASONE DP 0.05% OINT|45|GM|.94007|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|1.30454|03/29/2022|1.27323|03/29/2022|1.28171|03/29/2022|||STEROIDS: TOPICAL HIGH|2210|||||No|No||FOUGERA/SANDOZ|No||||
betamethasone dipropionate|No|No|No|No|75%|00168005760|BETAMETHASONE DP 0.05% LOT|60|ML|.28659|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||120|No|.41157|03/29/2022|.40169|03/29/2022|.40436|03/29/2022|||STEROIDS: TOPICAL HIGH|2211|||||No|No||FOUGERA/SANDOZ|No||||
fluocinolone acetonide|No|No|No|No|75%|00168005960|FLUOCINOLONE 0.01% SOLUTION|60|ML|.23936|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|119|No|.3936|03/29/2022|.38415|03/29/2022|.38671|03/29/2022|||STEROIDS: TOPICAL MEDIUM|2212|||||No|No||FOUGERA/SANDOZ|No||||
fluocinolone acetonide|No|No|No|No|75%|00168006415|FLUOCINOLONE 0.025% OINTMENT|15|GM|.80668|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|119|No|1.17785|03/29/2022|1.14958|03/29/2022|1.15723|03/29/2022|||STEROIDS: TOPICAL MEDIUM|2213|||||No|No||SANDOZ|No||||
fluocinolone acetonide|No|No|No|No|75%|00168006460|FLUOCINOLONE 0.025% OINTMENT|60|GM|.60479|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|119|No|.92023|03/29/2022|.89814|03/29/2022|.90412|03/29/2022|||STEROIDS: TOPICAL MEDIUM|2214|||||No|No||SANDOZ|No||||
hydrocortisone|No|No|No|No|75%|00168008016|HYDROCORTISONE 2.5% CREAM|453.6|GM|.05687|03/19/2008||Yes|No||03/19/2008||Yes|No|03/19/2008||Yes|No||||No|No|||Prescription required|No||118|No|.11903|03/29/2022|.11617|03/29/2022|.11694|03/29/2022|||STEROIDS: TOPICAL LOW|2215|||||No|No||FOUGERA/SANDOZ|No||||
hydrocortisone|No|No|No|No|75%|00168008031|HYDROCORTISONE 2.5% CREAM|30|GM|.0473|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||118|No|.08752|03/29/2022|.08541|03/29/2022|.08598|03/29/2022|||STEROIDS: TOPICAL LOW|2216|||||No|No||FOUGERA/SANDOZ|No||||
nystatin/triamcin|No|No|No|No|75%|00168008115|NYSTATIN-TRIAMCINOLONE CREAM|15|GM|1.92525|12/11/2014|02/22/2022|Yes|No||12/11/2014|02/22/2022|Yes|No|12/11/2014|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|01/15/2014|061|No|4.38778|03/29/2022|4.3251|03/29/2022|4.11914|03/29/2022|||ANTIFUNGALS: TOPICAL|2217|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SANDOZ|No||||
nystatin/triamcin|No|No|No|No|75%|00168008130|NYSTATIN-TRIAMCINOLONE CREAM|30|GM|1.37184|12/11/2014|02/22/2022|Yes|No||12/11/2014|02/22/2022|Yes|No|12/11/2014|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|01/15/2014|061|No|3.12652|03/29/2022|3.08185|03/29/2022|2.9351|03/29/2022|||ANTIFUNGALS: TOPICAL|2218|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SANDOZ|No||||
nystatin/triamcin|No|No|No|No|75%|00168008160|NYSTATIN-TRIAMCINOLONE CREAM|60|GM|.97724|12/11/2014|02/22/2022|Yes|No||12/11/2014|02/22/2022|Yes|No|12/11/2014|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|01/15/2014|061|No|2.2272|03/29/2022|2.19538|03/29/2022|2.09084|03/29/2022|||ANTIFUNGALS: TOPICAL|2219|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SANDOZ|No||||
nystatin/triamcin|No|No|No|No|75%|00168008915|NYSTATIN-TRIAMCINOLONE OINTM|15|GM|1.43046|12/11/2014||Yes|No||12/11/2014||Yes|No|12/11/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|061|No|.4296|03/29/2022|.41928|03/29/2022|.42208|03/29/2022|||ANTIFUNGALS: TOPICAL|2220|||||No|No||SANDOZ|No||||
nystatin/triamcin|No|No|No|No|75%|00168008930|NYSTATIN-TRIAMCINOLONE OINTM|30|GM|1.02125|12/11/2014||Yes|No||12/11/2014||Yes|No|12/11/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|061|No|.33412|03/29/2022|.3261|03/29/2022|.32827|03/29/2022|||ANTIFUNGALS: TOPICAL|2221|||||No|No||SANDOZ|No||||
nystatin/triamcin|No|No|No|No|75%|00168008960|NYSTATIN-TRIAMCINOLONE OINTM|60|GM|.7439|12/11/2014||Yes|No||12/11/2014||Yes|No|12/11/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|061|No|.24511|03/29/2022|.23922|03/29/2022|.24082|03/29/2022|||ANTIFUNGALS: TOPICAL|2222|||||No|No||SANDOZ|No||||
ketoconazole|No|No|No|No|75%|00168009915|KETOCONAZOLE 2% CREAM|15|GM|.43|06/18/2004||Yes|No||06/18/2004||Yes|No|06/18/2004||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|.53088|03/29/2022|.51813|03/29/2022|.52158|03/29/2022|||ANTIFUNGALS: TOPICAL|2223|||||No|No||FOUGERA/SANDOZ|No||||
ketoconazole|No|No|No|No|75%|00168009930|KETOCONAZOLE 2% CREAM|30|GM|.35833|06/18/2004||Yes|No||06/18/2004||Yes|No|06/18/2004||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|.43567|03/29/2022|.42521|03/29/2022|.42804|03/29/2022|||ANTIFUNGALS: TOPICAL|2224|||||No|No||FOUGERA/SANDOZ|No||||
ketoconazole|No|No|No|No|75%|00168009960|KETOCONAZOLE 2% CREAM|60|GM|.26875|06/18/2004||Yes|No||06/18/2004||Yes|No|06/18/2004||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|.36478|03/29/2022|.35602|03/29/2022|.35839|03/29/2022|||ANTIFUNGALS: TOPICAL|2225|||||No|No||FOUGERA/SANDOZ|No||||
fluocinonide|No|No|No|No|75%|00168013460|FLUOCINONIDE 0.05% SOLUTION|60|ML|.28666|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|120|No|.3579|03/29/2022|.34931|03/29/2022|.35163|03/29/2022|||STEROIDS: TOPICAL HIGH|2226|||||No|No||FOUGERA/SANDOZ|No||||
hydrocortisone|No|No|No|No|75%|00168014616|HYDROCORTISONE 2.5% OINTMENT|453.6|GM|.05687|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||118|No|.12962|06/01/2016|.12777|06/01/2016|.12168|06/01/2016|||STEROIDS: TOPICAL LOW|2227|||||No|No||FOUGERA/SANDOZ|No||||
hydrocortisone|No|No|No|No|75%|00168014630|HYDROCORTISONE 2.5% OINTMENT|28.35|GM|.05005|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||118|No|.10662|03/29/2022|.10406|03/29/2022|.10475|03/29/2022|||STEROIDS: TOPICAL LOW|2228|||||No|No||FOUGERA/SANDOZ|No||||
clobetasol propionate|No|No|No|No|75%|00168016215|CLOBETASOL 0.05% OINTMENT|15|GM|1.10854|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||121|No|.35914|03/29/2022|.35052|03/29/2022|.35285|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|2229|||||No|No||FOUGERA/SANDOZ|No||||
clobetasol propionate|No|No|No|No|75%|00168016230|CLOBETASOL 0.05% OINTMENT|30|GM|.9417|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||121|No|.3756|03/29/2022|.36658|03/29/2022|.36902|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|2230|||||No|No||FOUGERA/SANDOZ|No||||
clobetasol propionate|No|No|No|No|75%|00168016246|CLOBETASOL 0.05% OINTMENT|45|GM|.99148|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||121|No|.36764|03/29/2022|.35881|03/29/2022|.3612|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|2231|||||No|No||FOUGERA/SANDOZ|No||||
clobetasol propionate|No|No|No|No|75%|00168016260|CLOBETASOL 0.05% OINTMENT|60|GM|.93374|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||121|No|.32004|03/29/2022|.31235|03/29/2022|.31443|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|2232|||||No|No||FOUGERA/SANDOZ|No||||
clobetasol propionate|No|No|No|No|75%|00168016315|CLOBETASOL 0.05% CREAM|15|GM|.46325|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||121|No|.42879|03/29/2022|.41849|03/29/2022|.42128|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|2233|||||No|No||FOUGERA/SANDOZ|No||||
clobetasol propionate|No|No|No|No|75%|00168016330|CLOBETASOL 0.05% CREAM|30|GM|.46311|09/23/2009||Yes|No||09/23/2009||Yes|No|09/23/2009||Yes|No||||No|No|||Prescription required|No||121|No|.34489|03/29/2022|.33661|03/29/2022|.33885|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|2234|||||No|No||FOUGERA/SANDOZ|No||||
clobetasol propionate|No|No|No|No|75%|00168016346|CLOBETASOL 0.05% CREAM|45|GM|.46315|09/23/2009||Yes|No||09/23/2009||Yes|No|09/23/2009||Yes|No||||No|No|||Prescription required|No||121|No|.31467|03/29/2022|.30711|03/29/2022|.30916|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|2235|||||No|No||FOUGERA/SANDOZ|No||||
clobetasol propionate|No|No|No|No|75%|00168016360|CLOBETASOL 0.05% CREAM|60|GM|.41444|09/23/2009||Yes|No||09/23/2009||Yes|No|09/23/2009||Yes|No||||No|No|||Prescription required|No||121|No|.33784|03/29/2022|.32973|03/29/2022|.33192|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|2236|||||No|No||FOUGERA/SANDOZ|No||||
clindamycin phosphate|No|No|No|No|75%|00168020130|CLINDAMYCIN PH 1% SOLUTION|30|ML|.26516|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||||No|No|||Prescription required|No||104|No|.23242|03/29/2022|.22684|03/29/2022|.22835|03/29/2022|||ACNE AGENTS: TOPICAL|2237|||||No|No||FOUGERA/SANDOZ|No||||
clindamycin phosphate|No|No|No|No|75%|00168020160|CLINDAMYCIN PH 1% SOLUTION|60|ML|.258|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||104|No|.19863|03/29/2022|.19386|03/29/2022|.19515|03/29/2022|||ACNE AGENTS: TOPICAL|2238|||||No|No||FOUGERA/SANDOZ|No||||
clindamycin phosphate|No|No|No|No|75%|00168020230|CLINDAMYCIN PH 1% GEL|30|GM|1.18852|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||104|No|.67613|03/29/2022|.6599|03/29/2022|.66429|03/29/2022|||ACNE AGENTS: TOPICAL|2239|||||No|No||SANDOZ|No||||
clindamycin phosphate|No|No|No|No|75%|00168020260|CLINDAMYCIN PH 1% GEL|60|GM|1.07041|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||104|No|.47333|03/29/2022|.46197|03/29/2022|.46504|03/29/2022|||ACNE AGENTS: TOPICAL|2240|||||No|No||SANDOZ|No||||
clindamycin phosphate|No|No|No|No|75%|00168020360|CLINDAMYCIN PHOSP 1% LOTION|60|ML|.82689|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|104|No|.74671|03/29/2022|.72878|03/29/2022|.73364|03/29/2022|||ACNE AGENTS: TOPICAL|2241|||||No|No||FOUGERA/SANDOZ|No||||
lidocaine|No|No|No|No|75%|00168020437|LIDOCAINE 5% OINTMENT|35.44|GM|2.91196|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No|||No|.18796|03/29/2022|.18344|03/29/2022|.18467|03/29/2022||||2242|||||No|No||FOUGERA/SANDOZ|No||||
clotrimazole/betamethasone dip|No|No|No|No|75%|00168025815|CLOTRIMAZOLE-BETAMETHASONE CRM|15|GM|.48332|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||061|No|.25272|03/29/2022|.24665|03/29/2022|.24829|03/29/2022|||ANTIFUNGALS: TOPICAL|2243|||||No|No||FOUGERA/SANDOZ|No||||
clotrimazole/betamethasone dip|No|No|No|No|75%|00168025846|CLOTRIMAZOLE-BETAMETHASONE CRM|45|GM|.34686|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||061|No|.17393|03/29/2022|.16975|03/29/2022|.17088|03/29/2022|||ANTIFUNGALS: TOPICAL|2244|||||No|No||FOUGERA/SANDOZ|No||||
alclometasone dipropionate|No|No|No|No|75%|00168026315|ALCLOMETASONE DIPRO 0.05% CRM|15|GM|1.10252|05/21/2008||Yes|No||05/21/2008||Yes|No|05/21/2008||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|118|No|1.384|03/29/2022|1.35078|03/29/2022|1.35978|03/29/2022|||STEROIDS: TOPICAL LOW|2245|||||No|No||FOUGERA/SANDOZ|No||||
alclometasone dipropionate|No|No|No|No|75%|00168026345|ALCLOMETASONE DIPRO 0.05% CRM|45|GM|.74542|05/21/2008||Yes|No||05/21/2008||Yes|No|05/21/2008||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|118|No|.64662|03/29/2022|.6311|03/29/2022|.6353|03/29/2022|||STEROIDS: TOPICAL LOW|2246|||||No|No||FOUGERA/SANDOZ|No||||
alclometasone dipropionate|No|No|No|No|75%|00168026360|ALCLOMETASONE DIPRO 0.05% CRM|60|GM|.64829|05/21/2008||Yes|No||05/21/2008||Yes|No|05/21/2008||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|118|No|.81209|03/29/2022|.79259|03/29/2022|.79787|03/29/2022|||STEROIDS: TOPICAL LOW|2247|||||No|No||FOUGERA/SANDOZ|No||||
alclometasone dipropionate|No|No|No|No|75%|00168026415|ALCLOMETASONE DIPR 0.05% OINT|15|GM|.47787|04/21/2008||Yes|No||04/21/2008||Yes|No|04/21/2008||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|118|No|1.05408|03/29/2022|1.02878|03/29/2022|1.03563|03/29/2022|||STEROIDS: TOPICAL LOW|2248|||||No|No||FOUGERA/SANDOZ|No||||
alclometasone dipropionate|No|No|No|No|75%|00168026445|ALCLOMETASONE DIPR 0.05% OINT|45|GM|.23745|04/21/2008||Yes|No||04/21/2008||Yes|No|04/21/2008||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|118|No|.54117|03/29/2022|.53344|03/29/2022|.50804|03/29/2022|||STEROIDS: TOPICAL LOW|2249|||||No|No||FOUGERA/SANDOZ|No||||
alclometasone dipropionate|No|No|No|No|75%|00168026460|ALCLOMETASONE DIPR 0.05% OINT|60|GM|.22553|04/21/2008||Yes|No||04/21/2008||Yes|No|04/21/2008||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|118|No|.51401|06/29/2021|.50666|06/29/2021|.48254|06/29/2021|||STEROIDS: TOPICAL LOW|2250|||||No|No||FOUGERA/SANDOZ|No||||
betamethasone/propylene glyc|No|No|No|No|75%|00168026515|BETAMETHASONE DP AUG 0.05% CRM|15|GM|.60888|01/04/2008||Yes|No||01/04/2008||Yes|No|01/04/2008||Yes|No||||No|No|||Prescription required|No||120|No|.24003|03/29/2022|.23426|03/29/2022|.23582|03/29/2022|||STEROIDS: TOPICAL HIGH|2251|||||No|No||FOUGERA/SANDOZ|No||||
betamethasone/propylene glyc|No|No|No|No|75%|00168026550|BETAMETHASONE DP AUG 0.05% CRM|50|GM|.4085|01/26/2004||Yes|No||01/26/2004||Yes|No|01/26/2004||Yes|No||||No|No|||Prescription required|No||120|No|.14968|03/29/2022|.14608|03/29/2022|.14706|03/29/2022|||STEROIDS: TOPICAL HIGH|2252|||||No|No||FOUGERA/SANDOZ|No||||
betamethasone/propylene glyc|No|No|No|No|75%|00168026730|BETAMETHASONE DP AUG 0.05% LOT|30|ML|.65675|08/10/2009||Yes|No||08/10/2009||Yes|No|08/10/2009||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|.90128|03/01/2022|.87964|03/01/2022|.8855|03/01/2022|||STEROIDS: TOPICAL HIGH|2253|||||No|No||FOUGERA/SANDOZ|No||||
betamethasone/propylene glyc|No|No|No|No|75%|00168026760|BETAMETHASONE DP AUG 0.05% LOT|60|ML|.64721|08/10/2009||Yes|No||08/10/2009||Yes|No|08/10/2009||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|.75016|03/29/2022|.73215|03/29/2022|.73703|03/29/2022|||STEROIDS: TOPICAL HIGH|2254|||||No|No||FOUGERA/SANDOZ|No||||
betamethasone/propylene glyc|No|No|No|No|75%|00168026815|BETAMETHASONE DP AUG 0.05% OIN|15|GM|1.14466|04/28/2006||Yes|No||04/28/2006||Yes|No|04/28/2006||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|1.24083|03/29/2022|1.21105|03/29/2022|1.21911|03/29/2022|||STEROIDS: TOPICAL HIGH|2255|||||No|No||SANDOZ|No||||
betamethasone/propylene glyc|No|No|No|No|75%|00168026850|BETAMETHASONE DP AUG 0.05% OIN|50|GM|.76918|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|1.07205|03/29/2022|1.04632|03/29/2022|1.05328|03/29/2022|||STEROIDS: TOPICAL HIGH|2256|||||No|No||SANDOZ|No||||
clobetasol propionate|No|No|No|No|75%|00168026950|CLOBETASOL 0.05% SOLUTION|50|ML|.86|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||121|No|.35501|03/29/2022|.34648|03/29/2022|.34879|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|2257|||||No|No||FOUGERA/SANDOZ|No||||
mometasone furoate|No|No|No|No|75%|00168027115|MOMETASONE FUROATE 0.1% OINT|15|GM|.44003|10/21/2008|02/22/2022|Yes|No||10/21/2008|02/22/2022|Yes|No|10/21/2008|02/22/2022|Yes|No||||No|No|||Prescription required|No||119|No|1.00286|03/29/2022|.98853|03/29/2022|.94146|03/29/2022|||STEROIDS: TOPICAL MEDIUM|2258|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||FOUGERA/SANDOZ|No||||
mometasone furoate|No|No|No|No|75%|00168027146|MOMETASONE FUROATE 0.1% OINT|45|GM|.26755|03/15/2007|02/22/2022|Yes|No||03/15/2007|02/22/2022|Yes|No|03/15/2007|02/22/2022|Yes|No||||No|No|||Prescription required|No||119|No|.60977|03/29/2022|.60106|03/29/2022|.57244|03/29/2022|||STEROIDS: TOPICAL MEDIUM|2259|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||FOUGERA/SANDOZ|No||||
metronidazole|No|No|No|No|75%|00168027545|METRONIDAZOLE TOPICAL 0.75% GL|45|GM|1.30605|03/19/2009|02/22/2022|Yes|No||03/19/2009|02/22/2022|Yes|No|03/19/2009|02/22/2022|Yes|No||||No|No|||Prescription required|No||221|No|2.97658|03/29/2022|2.93406|03/29/2022|2.79434|03/29/2022|||ROSACEA AGENTS: TOPICAL|2260|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||FOUGERA/SANDOZ|No||||
clindamycin phosphate|Yes|No|No|No|75%|00168027740|CLINDAMYCIN 2% VAGINAL CREAM|40|GM|1.12079|04/15/2010||Yes|No||04/15/2010||Yes|No|04/15/2010||Yes|No||||No|No|11/01/2012||Prescription required|Yes|01/30/2020|124|No|1.72408|03/29/2022|1.6827|03/29/2022|1.6939|03/29/2022|||ANTIBIOTICS: VAGINAL|2261|||||No|No||FOUGERA/SANDOZ|No||||
amcinonide|No|No|No|No|75%|00168027815|AMCINONIDE 0.1% CREAM|15|GM|3.612|01/26/2004||Yes|No||01/26/2004||Yes|No|01/26/2004||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|8.232|06/01/2016|8.1144|06/01/2016|7.728|06/01/2016|||STEROIDS: TOPICAL HIGH|2262|||||No|No||FOUGERA/SANDOZ|No||||
amcinonide|No|No|No|No|75%|00168027830|AMCINONIDE 0.1% CREAM|30|GM|2.709|01/26/2004||Yes|No||01/26/2004||Yes|No|01/26/2004||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|6.174|08/23/2016|6.0858|08/23/2016|5.796|08/23/2016|||STEROIDS: TOPICAL HIGH|2263|||||No|No||FOUGERA/SANDOZ|No||||
amcinonide|No|No|No|No|75%|00168027860|AMCINONIDE 0.1% CREAM|60|GM|2.322|01/26/2004||Yes|No||01/26/2004||Yes|No|01/26/2004||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|5.292|06/01/2016|5.2164|06/01/2016|4.968|06/01/2016|||STEROIDS: TOPICAL HIGH|2264|||||No|No||FOUGERA/SANDOZ|No||||
amcinonide|No|No|No|No|75%|00168028060|AMCINONIDE 0.1% LOTION|60|ML|1.94532|01/26/2004|02/22/2022|Yes|No||01/26/2004|02/22/2022|Yes|No|01/26/2004|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|4.43352|06/01/2016|4.37018|06/01/2016|4.16208|06/01/2016|||STEROIDS: TOPICAL HIGH|2265|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||FOUGERA/SANDOZ|No||||
clobetasol propionate|No|No|No|No|75%|00168029315|CLOBETASOL 0.05% GEL|15|GM|1.02684|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||121|No|1.023|03/01/2022|.99844|03/01/2022|1.00509|03/01/2022|||STEROIDS: TOPICAL VERY HIGH|2266|||||No|No||FOUGERA/SANDOZ|No||||
clobetasol propionate|No|No|No|No|75%|00168029330|CLOBETASOL 0.05% GEL|30|GM|.93009|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||121|No|1.27828|03/29/2022|1.2476|03/29/2022|1.25591|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|2267|||||No|No||FOUGERA/SANDOZ|No||||
clobetasol propionate|No|No|No|No|75%|00168029360|CLOBETASOL 0.05% GEL|60|GM|.89074|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||121|No|.91682|03/29/2022|.89481|03/29/2022|.90077|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|2268|||||No|No||FOUGERA/SANDOZ|No||||
clobetasol propionate/emoll|No|No|No|No|75%|00168030115|CLOBETASOL EMOLLIENT 0.05% CRM|15|GM|.7095|09/23/2009||Yes|No||09/23/2009||Yes|No|09/23/2009||Yes|No||||No|No|||Prescription required|No||121|No|1.21527|03/29/2022|1.1861|03/29/2022|1.194|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|2269|||||No|No||FOUGERA/SANDOZ|No||||
clobetasol propionate/emoll|No|No|No|No|75%|00168030130|CLOBETASOL EMOLLIENT 0.05% CRM|30|GM|.7095|01/06/2004||Yes|No||01/06/2004||Yes|No|01/06/2004||Yes|No||||No|No|||Prescription required|No||121|No|.6904|03/29/2022|.67383|03/29/2022|.67831|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|2270|||||No|No||FOUGERA/SANDOZ|No||||
clobetasol propionate/emoll|No|No|No|No|75%|00168030160|CLOBETASOL EMOLLIENT 0.05% CRM|60|GM|.7095|09/23/2009||Yes|No||09/23/2009||Yes|No|09/23/2009||Yes|No||||No|No|||Prescription required|No||121|No|.73304|03/29/2022|.71544|03/29/2022|.72021|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|2271|||||No|No||FOUGERA/SANDOZ|No||||
metronidazole|No|No|No|No|75%|00168032346|METRONIDAZOLE 0.75% CREAM|45|GM|.68178|12/02/2005||Yes|No||12/02/2005||Yes|No|12/02/2005||Yes|No||||No|No|||Prescription required|No||221|No|.99332|03/29/2022|.96948|03/29/2022|.97593|03/29/2022|||ROSACEA AGENTS: TOPICAL|2272|||||No|No||FOUGERA/SANDOZ|No||||
fluticasone propionate|No|No|No|No|75%|00168033215|FLUTICASONE PROP 0.05% CREAM|15|GM|.45465|01/04/2008||Yes|No||01/04/2008||Yes|No|01/04/2008||Yes|No||||No|No|||Prescription required|No||119|No|.30287|03/29/2022|.2956|03/29/2022|.29756|03/29/2022|||STEROIDS: TOPICAL MEDIUM|2273|||||No|No||FOUGERA/SANDOZ|No||||
fluticasone propionate|No|No|No|No|75%|00168033230|FLUTICASONE PROP 0.05% CREAM|30|GM|.3503|06/18/2004||Yes|No||06/18/2004||Yes|No|06/18/2004||Yes|No||||No|No|||Prescription required|No||119|No|.3165|03/29/2022|.3089|03/29/2022|.31096|03/29/2022|||STEROIDS: TOPICAL MEDIUM|2274|||||No|No||FOUGERA/SANDOZ|No||||
fluticasone propionate|No|No|No|No|75%|00168033260|FLUTICASONE PROP 0.05% CREAM|60|GM|.27612|06/18/2004||Yes|No||06/18/2004||Yes|No|06/18/2004||Yes|No||||No|No|||Prescription required|No||119|No|.23471|03/29/2022|.22907|03/29/2022|.2306|03/29/2022|||STEROIDS: TOPICAL MEDIUM|2275|||||No|No||FOUGERA/SANDOZ|No||||
terconazole|No|No|No|No|75%|00168034720|TERCONAZOLE 0.8% CREAM|20|GM|.84344|04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No||||No|No|||Prescription required|No|||No|1.2859|03/29/2022|1.25503|03/29/2022|1.26339|03/29/2022||||2276|||||No|No||FOUGERA|No||||
mupirocin|No|No|No|No|75%|00168035222|MUPIROCIN 2% OINTMENT|22|GM|.63033|02/13/2009||Yes|No||02/13/2009||Yes|No|02/13/2009||Yes|No||||No|No|||Prescription required|No||114|No|.18067|03/29/2022|.17633|03/29/2022|.1775|03/29/2022|||ANTIBIOTICS: TOPICAL|2277|||||No|No||FOUGERA/SANDOZ|No||||
halobetasol propionate|No|No|No|No|75%|00168035550|HALOBETASOL PROP 0.05% CREAM|50|GM|.78991|06/23/2005||Yes|No||06/23/2005||Yes|No|06/23/2005||Yes|No||||No|No|||Prescription required|No||121|No|.62002|03/29/2022|.60513|03/29/2022|.60916|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|2278|||||No|No||FOUGERA/SANDOZ|No||||
lidocaine/prilocaine|No|No|No|No|75%|00168035730|LIDOCAINE-PRILOCAINE CREAM|30|GM|.21614|01/26/2004||Yes|No||01/26/2004||Yes|No|01/26/2004||Yes|No||||No|No|||Prescription required|No|||No|.45426|03/29/2022|.44335|03/29/2022|.44631|03/29/2022||||2279|||||No|No||FOUGERA/SANDOZ|No||||
lidocaine/prilocaine|No|No|No|No|75%|00168035755|LIDOCAINE-PRILOCAINE CREAM|5|GM|.7107|03/30/2022||Yes|No||03/30/2022||Yes|No|03/30/2022||Yes|No||||No|No|||Prescription required|No|||No|1.24616|03/30/2022|1.21625|03/30/2022|1.22435|03/30/2022||||2280|||||No|No||FOUGERA/SANDOZ|No||||
oxiconazole nitrate|No|No|No|No|75%|00168035830|OXICONAZOLE NITRATE 1% CREAM|30|GM|7.04899|06/29/2016||Yes|No||06/29/2016||Yes|No|06/29/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|061|No|16.06514|05/25/2021|15.83563|05/25/2021|15.08156|05/25/2021|||ANTIFUNGALS: TOPICAL|2281|||||No|No||FOUGERA/SANDOZ|No||||
oxiconazole nitrate|No|No|No|No|75%|00168035860|OXICONAZOLE NITRATE 1% CREAM|60|GM|3.57616|06/29/2016||Yes|No||06/29/2016||Yes|No|06/29/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|061|No|8.15032|09/28/2021|8.03389|09/28/2021|7.65132|09/28/2021|||ANTIFUNGALS: TOPICAL|2282|||||No|No||FOUGERA/SANDOZ|No||||
oxiconazole nitrate|No|No|No|No|75%|00168035890|OXICONAZOLE NITRATE 1% CREAM|90|GM|3.57449|06/29/2016||Yes|No||06/29/2016||Yes|No|06/29/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|061|No|8.14651|10/29/2019|8.03013|10/29/2019|7.64774|10/29/2019|||ANTIFUNGALS: TOPICAL|2283|||||No|No||FOUGERA/SANDOZ|No||||
clotrimazole/betamethasone dip|No|No|No|No|75%|00168037030|CLOTRIMAZOLE-BETAMETHASONE LOT|30|ML|1.77446|03/19/2009||Yes|No||03/19/2009||Yes|No|03/19/2009||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|061|No|2.80479|03/29/2022|2.73747|03/29/2022|2.7557|03/29/2022|||ANTIFUNGALS: TOPICAL|2284|||||No|No||FOUGERA/SANDOZ|No||||
metronidazole|No|No|No|No|75%|00168038360|METRONIDAZOLE 0.75% LOTION|59|ML|.52474|03/19/2009||Yes|No||03/19/2009||Yes|No|03/19/2009||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|221|No|2.21171|03/29/2022|2.15862|03/29/2022|2.173|03/29/2022|||ROSACEA AGENTS: TOPICAL|2285|||||No|No||FOUGERA/SANDOZ|No||||
prednicarbate|No|No|No|No|75%|00168041015|PREDNICARBATE 0.1% OINTMENT|15|GM|.71666|03/19/2009||Yes|No||03/19/2009||Yes|No|03/19/2009||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|119|No|1.63332|06/01/2016|1.60999|06/01/2016|1.53332|06/01/2016|||STEROIDS: TOPICAL MEDIUM|2286|||||No|No||FOUGERA/SANDOZ|No||||
prednicarbate|No|No|No|No|75%|00168041060|PREDNICARBATE 0.1% OINTMENT|60|GM|.44067|03/19/2009||Yes|No||03/19/2009||Yes|No|03/19/2009||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|119|No|1.00433|06/01/2016|.98998|06/01/2016|.94284|06/01/2016|||STEROIDS: TOPICAL MEDIUM|2287|||||No|No||FOUGERA/SANDOZ|No||||
tacrolimus|No|No|No|No|75%|00168041630|TACROLIMUS 0.1% OINTMENT|30|GM|1.94116|10/07/2016||Yes|No||10/07/2016||Yes|No|10/07/2016||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|034|Yes|2.17788|03/29/2022|2.12561|03/29/2022|2.13976|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|2288|||||No|No||FOUGERA/SANDOZ|No||||
tacrolimus|No|No|No|No|75%|00168041660|TACROLIMUS 0.1% OINTMENT|60|GM|1.94123|10/07/2016||Yes|No||10/07/2016||Yes|No|10/07/2016||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|034|Yes|2.14182|03/29/2022|2.09041|03/29/2022|2.10433|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|2289|||||No|No||FOUGERA/SANDOZ|No||||
tacrolimus|No|No|No|No|75%|00168041699|TACROLIMUS 0.1% OINTMENT|100|GM|1.94119|02/19/2015||Yes|No||02/19/2015||Yes|No|02/19/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|034|Yes|1.89468|03/29/2022|1.8492|03/29/2022|1.86152|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|2290|||||No|No||FOUGERA/SANDOZ|No||||
tacrolimus|No|No|No|No|75%|00168041730|TACROLIMUS 0.03% OINTMENT|30|GM|1.94116|05/21/2015||Yes|No||05/21/2015||Yes|No|05/21/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|034|Yes|2.05819|03/29/2022|2.00879|03/29/2022|2.02217|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|2291|||||No|No||FOUGERA/SANDOZ|No||||
tacrolimus|No|No|No|No|75%|00168041760|TACROLIMUS 0.03% OINTMENT|60|GM|1.94123|02/19/2015||Yes|No||02/19/2015||Yes|No|02/19/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|034|Yes|1.50147|03/01/2022|1.46543|03/01/2022|1.47519|03/01/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|2292|||||No|No||FOUGERA/SANDOZ|No||||
tacrolimus|No|No|No|No|75%|00168041799|TACROLIMUS 0.03% OINTMENT|100|GM|1.94119|02/19/2015||Yes|No||02/19/2015||Yes|No|02/19/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|034|Yes|1.71892|03/01/2022|1.67766|03/01/2022|1.68883|03/01/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|2293|||||No|No||FOUGERA/SANDOZ|No||||
adapalene|No|No|No|No|75%|00168042446|ADAPALENE 0.1% CREAM|45|GM|2.25386|08/02/2010||Yes|No||08/02/2010||Yes|No|08/02/2010||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|3.17233|03/29/2022|3.09619|03/29/2022|3.11681|03/29/2022|||ACNE AGENTS: TOPICAL|2294|||||No|No||FOUGERA/SANDOZ|No||||
fluocinonide|No|No|No|No|75%|00168045730|FLUOCINONIDE 0.1% CREAM|30|GM|.25083|06/06/2016|02/22/2022|Yes|No||06/06/2016|02/22/2022|Yes|No|06/06/2016|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.57166|03/29/2022|.56349|03/29/2022|.53666|03/29/2022|||STEROIDS: TOPICAL HIGH|2295|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||FOUGERA/SANDOZ|No||||
fluocinonide|No|No|No|No|75%|00168045760|FLUOCINONIDE 0.1% CREAM|60|GM|.25083|06/06/2016|02/22/2022|Yes|No||06/06/2016|02/22/2022|Yes|No|06/06/2016|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.57166|03/29/2022|.56349|03/29/2022|.53666|03/29/2022|||STEROIDS: TOPICAL HIGH|2296|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||FOUGERA/SANDOZ|No||||
acyclovir|No|No|No|No|75%|00168082515|ACYCLOVIR 5% OINTMENT|15|GM|9.14581|04/28/2017|02/22/2022|Yes|No||04/28/2017|02/22/2022|Yes|No|04/28/2017|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|20.84394|03/29/2022|20.54617|03/29/2022|19.56778|03/29/2022|||ANTIVIRALS: TOPICAL|2297|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||FOUGERA/SANDOZ|No||||
acyclovir|No|No|No|No|75%|00168082530|ACYCLOVIR 5% OINTMENT|30|GM|9.14567|05/22/2017|02/22/2022|Yes|No||05/22/2017|02/22/2022|Yes|No|05/22/2017|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|20.84362|03/29/2022|20.54585|03/29/2022|19.56748|03/29/2022|||ANTIVIRALS: TOPICAL|2298|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||FOUGERA/SANDOZ|No||||
insulin regular, human|Yes|No|No|No|75%|00169183311|NOVOLIN R 100 UNIT/ML VIAL|10|ML|5.9211|03/01/2002||Yes|No||12/17/2014||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Over the counter|No||029|No|13.24005|06/29/2021|12.92228|06/29/2021|13.00834|06/29/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2299|||||No|No||NOVO NORDISK|No||||
insulin NPH human isophane|Yes|No|No|No|75%|00169183411|NOVOLIN N 100 UNIT/ML VIAL|10|ML|5.9211|10/01/2002||Yes|No||12/17/2014||Yes|No|10/01/2002||Yes|No||10/01/2002||Yes|No|07/01/2016||Over the counter|No||029|No|13.22853|06/29/2021|12.91104|06/29/2021|12.99703|06/29/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2300|||||No|No||NOVO NORDISK|No||||
insulin NPH hum/reg insulin hm|Yes|No|No|No|75%|00169183711|NOVOLIN 70-30 100 UNIT/ML VIAL|10|ML|5.9211|03/01/2002||Yes|No||12/17/2014||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Over the counter|Yes|09/18/2020|029|No|13.25119|06/29/2021|12.93316|06/29/2021|13.01929|06/29/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2301|||||No|No||NOVO NORDISK|No||||
insulin aspart|No|No|No|No|75%|00169210011|RELION NOVOLOG 100 UNIT/ML VL|10|ML|12.44248|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||09/30/2021||Yes|No|||Prescription required|No||029|No|28.35728|09/30/2021|27.95217|09/30/2021|26.62112|09/30/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2302|||||No|No||NOVO NORDISK-WA|No||||
insulin aspart|No|No|No|No|75%|00169210125|RELION NOVOLOG U-100 FLEXPEN|3|ML|16.01979|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||09/30/2021||Yes|No|||Prescription required|No||029|No|36.51022|09/30/2021|35.98864|09/30/2021|34.2749|09/30/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2303|||||No|No||NOVO NORDISK-WA|No||||
insulin aspart prot/insuln asp|No|No|No|No|75%|00169220011|RELION NOVOLOG MIX 70-30 VIAL|10|ML|12.90516|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||02/02/2022||Yes|No|||Prescription required|No||029|No|29.41176|02/02/2022|28.99159|02/02/2022|27.61104|02/02/2022|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2304|||||No|No||NOVO NORDISK-WA|No||||
insulin aspart prot/insuln asp|No|No|No|No|75%|00169220125|RELION NOVOLOG MIX 70-30 FLXPN|3|ML|16.01979|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||02/02/2022||Yes|No|||Prescription required|No||029|No|36.51022|02/02/2022|35.98864|02/02/2022|34.2749|02/02/2022|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2305|||||No|No||NOVO NORDISK-WA|No||||
insulin degludec|Yes|No|No|No|75%|00169255013|TRESIBA FLEXTOUCH 200 UNIT/ML|3|ML|29.1497|10/23/2015||Yes|No||10/23/2015||Yes|No|10/23/2015||Yes|No||10/23/2015||Yes|No|04/08/2020||Prescription required|Yes|09/18/2020|029|No|65.09407|06/29/2021|63.53181|06/29/2021|63.95492|06/29/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2306|||||No|No||NOVO NORDISK|No||||
insulin degludec|Yes|No|No|No|75%|00169266015|TRESIBA FLEXTOUCH 100 UNIT/ML|3|ML|14.57499|10/23/2015||Yes|No||10/23/2015||Yes|No|10/23/2015||Yes|No||10/23/2015||Yes|No|04/08/2020||Prescription required|Yes|09/18/2020|029|No|32.55311|06/29/2021|31.77183|06/29/2021|31.98343|06/29/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2307|||||No|No||NOVO NORDISK|No||||
insulin degludec|Yes|No|No|No|75%|00169266211|TRESIBA 100 UNIT/ML VIAL|10|ML|14.57485|02/05/2019||Yes|No||02/05/2019||Yes|No|02/05/2019||Yes|No||02/05/2019||Yes|No|07/22/2019||Prescription required|Yes|09/18/2020|029|No|32.573|12/28/2021|31.79124|12/28/2021|32.00297|12/28/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2308|||||No|No||NOVO NORDISK|No||||
insulin degludec/liraglutide|No|No|No|No|75%|00169291115|XULTOPHY 100 UNIT-3.6MG/ML PEN|3|ML|33.81892|08/15/2017||Yes|No||08/15/2017||Yes|No|08/15/2017||Yes|No||08/15/2017||Yes|No|||Prescription required|Yes|07/27/2017|111|Yes|75.69017|01/18/2022|73.8736|01/18/2022|74.36559|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2309|||||No|No||NOVO NORDISK|No||||
insulin regular, human|Yes|No|No|No|75%|00169300315|NOVOLIN R 100 UNIT/ML FLEXPEN|3|ML|7.4605|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||03/17/2020||Yes|No|06/19/2020||Over the counter|Yes|07/25/2019|029|No|16.70813|07/27/2021|16.30713|07/27/2021|16.41573|07/27/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2310|||||No|No||NOVO NORDISK|No||||
insulin NPH human isophane|Yes|No|No|No|75%|00169300415|NOVOLIN N 100 UNIT/ML FLEXPEN|3|ML|7.4605|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||03/17/2020||Yes|No|06/19/2020||Over the counter|Yes|07/25/2019|029|No|16.65825|06/29/2021|16.25845|06/29/2021|16.36673|06/29/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2311|||||No|No||NOVO NORDISK|No||||
insulin NPH hum/reg insulin hm|Yes|No|No|No|75%|00169300715|NOVOLIN 70-30 FLEXPEN|3|ML|7.4605|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||02/25/2019||Yes|No|07/22/2019||Over the counter|Yes|09/18/2020|029|No|16.71803|07/27/2021|16.31679|07/27/2021|16.42546|07/27/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2312|||||No|No||NOVO NORDISK|No||||
insulin aspart (niacinamide)|Yes|No|No|No|75%|00169320111|FIASP 100 UNIT/ML VIAL|10|ML|12.44248|07/06/2018||Yes|No||07/06/2018||Yes|No|07/06/2018||Yes|No||07/06/2018||Yes|No|07/22/2019||Prescription required|Yes|09/18/2020|029|No|27.85486|12/28/2021|27.18634|12/28/2021|27.36739|12/28/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2313|||||No|No||NOVO NORDISK|No||||
insulin aspart (niacinamide)|Yes|No|No|No|75%|00169320415|FIASP 100 UNIT/ML FLEXTOUCH|3|ML|16.01979|07/06/2018||Yes|No||07/06/2018||Yes|No|07/06/2018||Yes|No||07/06/2018||Yes|No|07/22/2019||Prescription required|Yes|09/18/2020|029|No|35.76888|12/28/2021|34.91042|12/28/2021|35.14292|12/28/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2314|||||No|No||NOVO NORDISK|No||||
insulin aspart (niacinamide)|Yes|No|No|No|75%|00169320515|FIASP PENFILL 100 UNIT/ML CART|3|ML|15.40747|02/27/2020||Yes|No||02/27/2020||Yes|No|02/27/2020||Yes|No||02/27/2020||Yes|No|03/20/2020||Prescription required|Yes|07/30/2020|029|No|35.1147|02/27/2020|34.61306|02/27/2020|32.96482|02/27/2020|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2315|||||No|No||NOVO NORDISK|No||||
insulin aspart|No|No|No|No|75%|00169330312|NOVOLOG PENFILL 100 UNIT/ML|3|ML|15.40747|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||029|No|34.48144|03/01/2022|33.65388|03/01/2022|33.87801|03/01/2022|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2316|||||No|No||NOVO NORDISK|No||||
insulin aspart prot/insuln asp|Yes|No|No|No|75%|00169368512|NOVOLOG MIX 70-30 VIAL|10|ML|12.90516|01/01/2004||Yes|No||01/01/2004||Yes|No|01/01/2004||Yes|No||01/01/2004||Yes|No|07/01/2016||Prescription required|No||029|No|28.90748|09/28/2021|28.2137|09/28/2021|28.40159|09/28/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2317|||||No|No||NOVO NORDISK|No||||
insulin detemir|No|No|No|No|75%|00169368712|LEVEMIR 100 UNIT/ML VIAL|10|ML|13.25002|03/15/2007||Yes|No||03/15/2007||Yes|No|03/15/2007||Yes|No||03/15/2007||Yes|No|||Prescription required|No||029|No|29.55227|06/29/2021|28.84301|06/29/2021|29.0351|06/29/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2318|||||No|No||NOVO NORDISK|No||||
insulin aspart prot/insuln asp|No|No|No|No|75%|00169369619|NOVOLOG MIX 70-30 FLEXPEN|3|ML|16.01979|09/02/2004||Yes|No||09/02/2004||Yes|No|09/02/2004||Yes|No||09/02/2004||Yes|No|||Prescription required|No||029|No|35.85673|09/28/2021|34.99616|09/28/2021|35.22923|09/28/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2319|||||No|No||NOVO NORDISK|No||||
liraglutide|No|No|No|No|75%|00169406012|VICTOZA 2-PAK 18 MG/3 ML PEN|3|ML|50.8647|02/23/2010||Yes|No||02/23/2010||Yes|No|02/23/2010||Yes|No||11/01/2016||Yes|No|||Prescription required|No||111|Yes|113.58682|01/18/2022|110.86073|01/18/2022|111.59905|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2320|||||No|No||NOVO NORDISK|No||||
liraglutide|No|No|No|No|75%|00169406013|VICTOZA 3-PAK 18 MG/3 ML PEN|3|ML|50.8647|02/23/2010||Yes|No||02/23/2010||Yes|No|02/23/2010||Yes|No||11/01/2016||Yes|No|||Prescription required|No||111|Yes|113.5164|01/18/2022|110.792|01/18/2022|111.52986|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2321|||||No|No||NOVO NORDISK|No||||
semaglutide|No|No|No|No|75%|00169413013|OZEMPIC 1 MG/DOSE (4 MG/3 ML)|3|ML|127.86193|05/11/2021||Yes|No||05/11/2021||Yes|No|05/11/2021||Yes|No||05/11/2021||Yes|No|||Prescription required|Yes|01/28/2021|111|Yes|287.00972|01/18/2022|280.12148|01/18/2022|281.98704|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2322|||||No|No||NOVO NORDISK|No||||
semaglutide|No|No|No|No|75%|00169413212|OZEMPIC 0.25-0.5 MG/DOSE PEN|1.5|ML|255.72386|07/06/2018||Yes|No||07/06/2018||Yes|No|07/06/2018||Yes|No||07/06/2018||Yes|No|||Prescription required|Yes|07/26/2018|111|Yes|571.53331|01/18/2022|557.81651|01/18/2022|561.53147|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2323|||||No|No||NOVO NORDISK|No||||
semaglutide|No|No|No|No|75%|00169413602|OZEMPIC 1 MG/DOSE (2 MG/1.5ML)|1.5|ML|127.86193|07/06/2018|01/01/2023|Yes|No||07/06/2018|01/01/2023|Yes|No|07/06/2018|01/01/2023|Yes|No||07/06/2018|01/01/2023|Yes|No|||Prescription required|Yes|07/26/2018|111|Yes|285.23404|01/18/2022|278.38842|01/18/2022|280.24244|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2324|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||NOVO NORDISK|No||||
semaglutide|No|No|No|No|75%|00169430313|RYBELSUS 3 MG TABLET|30|EA|12.78619|03/30/2020||Yes|No||03/30/2020||Yes|No|03/30/2020||Yes|No||03/30/2020||Yes|No|||Prescription required|Yes|07/30/2020|111|Yes|28.53399|01/18/2022|27.84917|01/18/2022|28.03464|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2325|||||No|No||NOVO NORDISK|No||||
semaglutide|No|No|No|No|75%|00169430330|RYBELSUS 3 MG TABLET|30|EA|12.78619|02/07/2022||Yes|No||02/07/2022||Yes|No|02/07/2022||Yes|No||02/07/2022||Yes|No|||Prescription required|Yes|07/29/2021|111|Yes|28.53399|03/29/2022|27.84917|03/29/2022|28.03464|03/29/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2326|||||No|No||NOVO NORDISK|No||||
semaglutide|No|No|No|No|75%|00169430713|RYBELSUS 7 MG TABLET|30|EA|12.78619|03/30/2020||Yes|No||03/30/2020||Yes|No|03/30/2020||Yes|No||03/30/2020||Yes|No|||Prescription required|Yes|07/30/2020|111|Yes|28.62399|01/18/2022|27.93701|01/18/2022|28.12307|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2327|||||No|No||NOVO NORDISK|No||||
semaglutide|No|No|No|No|75%|00169430730|RYBELSUS 7 MG TABLET|30|EA|12.78619|02/07/2022||Yes|No||02/07/2022||Yes|No|02/07/2022||Yes|No||02/07/2022||Yes|No|||Prescription required|Yes|07/29/2021|111|Yes|28.62399|03/29/2022|27.93701|03/29/2022|28.12307|03/29/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2328|||||No|No||NOVO NORDISK|No||||
semaglutide|No|No|No|No|75%|00169431413|RYBELSUS 14 MG TABLET|30|EA|12.78619|03/30/2020||Yes|No||03/30/2020||Yes|No|03/30/2020||Yes|No||03/30/2020||Yes|No|||Prescription required|Yes|07/30/2020|111|Yes|28.60036|01/18/2022|27.91395|01/18/2022|28.09985|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2329|||||No|No||NOVO NORDISK|No||||
semaglutide|No|No|No|No|75%|00169431430|RYBELSUS 14 MG TABLET|30|EA|12.78619|02/07/2022||Yes|No||02/07/2022||Yes|No|02/07/2022||Yes|No||02/07/2022||Yes|No|||Prescription required|Yes|07/29/2021|111|Yes|28.60036|03/29/2022|27.91395|03/29/2022|28.09985|03/29/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2330|||||No|No||NOVO NORDISK|No||||
estradiol|No|No|No|No|75%|00169517603|VAGIFEM 10 MCG VAGINAL TAB|8|EA|9.1461|02/22/2010||Yes|No||02/22/2010||Yes|No|02/22/2010||Yes|No||||No|No|||Prescription required|No|||Yes|20.39337|03/01/2022|19.90392|03/01/2022|20.03648|03/01/2022||||2331|||||No|No||NOVO NORDISK|No||||
estradiol|No|No|No|No|75%|00169517604|VAGIFEM 10 MCG VAGINAL TAB|18|EA|9.1461|02/22/2010||Yes|No||02/22/2010||Yes|No|02/22/2010||Yes|No||||No|No|||Prescription required|No|||Yes|20.39337|03/01/2022|19.90392|03/01/2022|20.03648|03/01/2022||||2332|||||No|No||NOVO NORDISK|No||||
insulin aspart|No|No|No|No|75%|00169633910|NOVOLOG 100 UNIT/ML FLEXPEN|3|ML|16.01979|05/05/2004||Yes|No||05/05/2004||Yes|No|05/05/2004||Yes|No||05/05/2004||Yes|No|||Prescription required|No||029|No|35.83585|09/28/2021|34.97578|09/28/2021|35.20872|09/28/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2333|||||No|No||NOVO NORDISK|No||||
insulin detemir|No|No|No|No|75%|00169643810|LEVEMIR FLEXTOUCH 100 UNIT/ML|3|ML|13.25002|06/19/2014||Yes|No||06/19/2014||Yes|No|06/19/2014||Yes|No||06/19/2014||Yes|No|||Prescription required|No||029|No|29.59702|06/29/2021|28.88669|06/29/2021|29.07907|06/29/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2334|||||No|No||NOVO NORDISK|No||||
factor XIII A-subunit,recomb|No|No|No|No|75%|00169701301|TRETTEN 2,500 UNIT VIAL|1|EA|11.458|03/25/2014||Yes|No||03/25/2014||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|16.513|01/11/2022|16.2771|01/11/2022|15.502|01/11/2022|||HEMOPHILIA TREATMENT|2335|||||No|No||NOVO NORDISK|No||||
glucagon|No|No|No|No|75%|00169706515|GLUCAGEN 1 MG HYPOKIT|1|EA|126.0115|09/05/2006||Yes|No||09/05/2006||Yes|No|09/05/2006||Yes|No||||No|No|||Prescription required|No||583|No|270.32378|12/21/2021|263.836|12/21/2021|265.59311|12/21/2021|||GLUCAGON AGENTS|2336|||||No|No||NOVO NORDISK|No||||
coagulation factor VIIa,recomb|No|No|No|No|75%|00169720101|NOVOSEVEN RT 1 MG VIAL|1|EA|1.6864|05/22/2013||Yes|No||05/22/2013||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.4304|01/11/2022|2.39568|01/11/2022|2.2816|01/11/2022|||HEMOPHILIA TREATMENT|2337|||||No|No||NOVO NORDISK|No||||
coagulation factor VIIa,recomb|No|No|No|No|75%|00169720201|NOVOSEVEN RT 2 MG VIAL|1|EA|1.6864|05/22/2013||Yes|No||05/22/2013||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.4304|01/11/2022|2.39568|01/11/2022|2.2816|01/11/2022|||HEMOPHILIA TREATMENT|2338|||||No|No||NOVO NORDISK|No||||
coagulation factor VIIa,recomb|No|No|No|No|75%|00169720501|NOVOSEVEN RT 5 MG VIAL|1|EA|1.6864|05/22/2013||Yes|No||05/22/2013||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.4304|01/11/2022|2.39568|01/11/2022|2.2816|01/11/2022|||HEMOPHILIA TREATMENT|2339|||||No|No||NOVO NORDISK|No||||
coagulation factor VIIa,recomb|No|No|No|No|75%|00169720801|NOVOSEVEN RT 8 MG VIAL|1|EA|1.6864|05/22/2013||Yes|No||05/22/2013||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.4304|01/11/2022|2.39568|01/11/2022|2.2816|01/11/2022|||HEMOPHILIA TREATMENT|2340|||||No|No||NOVO NORDISK|No||||
insulin aspart|Yes|No|No|No|75%|00169750111|NOVOLOG 100 UNIT/ML VIAL|10|ML|12.44248|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No||029|No|27.83693|09/28/2021|27.16884|09/28/2021|27.34978|09/28/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|2341|||||No|No||NOVO NORDISK|No||||
somatropin|No|No|No|No|75%|00169770321|NORDITROPIN FLEXPRO 30 MG/3 ML|3|ML|630.122|05/20/2015||Yes|No||05/20/2015||Yes|No|05/20/2015||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|No||014|Yes|1436.092|01/11/2022|1415.5764|01/11/2022|1348.168|01/11/2022|||GROWTH HORMONE|2342|||||No|No||NOVO NORDISK|No||||
somatropin|No|No|No|No|75%|00169770421|NORDITROPIN FLEXPRO 5 MG/1.5|1.5|ML|210.04066|04/15/2010||Yes|No||04/15/2010||Yes|No|04/15/2010||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|No||014|Yes|465.3|03/29/2022|454.1328|03/29/2022|457.15725|03/29/2022|||GROWTH HORMONE|2343|||||No|No||NOVO NORDISK|No||||
somatropin|No|No|No|No|75%|00169770521|NORDITROPIN FLEXPRO 10 MG/1.5|1.5|ML|420.08133|04/15/2010||Yes|No||04/15/2010||Yes|No|04/15/2010||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|No||014|Yes|945.57412|01/18/2022|922.88034|01/18/2022|929.02657|01/18/2022|||GROWTH HORMONE|2344|||||No|No||NOVO NORDISK|No||||
somatropin|No|No|No|No|75%|00169770821|NORDITROPIN FLEXPRO 15 MG/1.5|1.5|ML|630.122|04/15/2010||Yes|No||04/15/2010||Yes|No|04/15/2010||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|No||014|Yes|1436.092|01/11/2022|1415.5764|01/11/2022|1348.168|01/11/2022|||GROWTH HORMONE|2345|||||No|No||NOVO NORDISK|No||||
antihemoph.FVIII,B-dom truncat|No|No|No|No|75%|00169781001|NOVOEIGHT 1,000 UNIT VIAL|1|EA|1.36|05/20/2015||Yes|No||05/20/2015||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.96|01/11/2022|1.932|01/11/2022|1.84|01/11/2022|||HEMOPHILIA TREATMENT|2346|||||No|No||NOVO NORDISK|No||||
antihemoph.FVIII,B-dom truncat|No|No|No|No|75%|00169781501|NOVOEIGHT 1,500 UNIT VIAL|1|EA|1.36|05/20/2015||Yes|No||05/20/2015||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.96|01/11/2022|1.932|01/11/2022|1.84|01/11/2022|||HEMOPHILIA TREATMENT|2347|||||No|No||NOVO NORDISK|No||||
antihemoph.FVIII,B-dom truncat|No|No|No|No|75%|00169782001|NOVOEIGHT 2,000 UNIT VIAL|1|EA|1.36|05/20/2015||Yes|No||05/20/2015||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.96|01/11/2022|1.932|01/11/2022|1.84|01/11/2022|||HEMOPHILIA TREATMENT|2348|||||No|No||NOVO NORDISK|No||||
antihemoph.FVIII,B-dom truncat|No|No|No|No|75%|00169782501|NOVOEIGHT 250 UNIT VIAL|1|EA|1.36|05/20/2015||Yes|No||05/20/2015||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.96|01/11/2022|1.932|01/11/2022|1.84|01/11/2022|||HEMOPHILIA TREATMENT|2349|||||No|No||NOVO NORDISK|No||||
antihemoph.FVIII,B-dom truncat|No|No|No|No|75%|00169783001|NOVOEIGHT 3,000 UNIT VIAL|1|EA|1.36|05/20/2015||Yes|No||05/20/2015||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.96|01/11/2022|1.932|01/11/2022|1.84|01/11/2022|||HEMOPHILIA TREATMENT|2350|||||No|No||NOVO NORDISK|No||||
antihemoph.FVIII,B-dom truncat|No|No|No|No|75%|00169785001|NOVOEIGHT 500 UNIT VIAL|1|EA|1.36|05/20/2015||Yes|No||05/20/2015||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.96|01/11/2022|1.932|01/11/2022|1.84|01/11/2022|||HEMOPHILIA TREATMENT|2351|||||No|No||NOVO NORDISK|No||||
factor IX human rec,pegylated|No|No|No|No|75%|00169790101|REBINYN 1,000 UNIT VIAL|1|EA|3.0668|06/22/2018||Yes|No||06/22/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|4.4198|01/11/2022|4.35666|01/11/2022|4.1492|01/11/2022|||HEMOPHILIA TREATMENT|2352|||||No|No||NOVO NORDISK|No||||
factor IX human rec,pegylated|No|No|No|No|75%|00169790201|REBINYN 2,000 UNIT VIAL|1|EA|3.0668|06/22/2018||Yes|No||06/22/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|4.4198|01/11/2022|4.35666|01/11/2022|4.1492|01/11/2022|||HEMOPHILIA TREATMENT|2353|||||No|No||NOVO NORDISK|No||||
factor IX human rec,pegylated|No|No|No|No|75%|00169790501|REBINYN 500 UNIT VIAL|1|EA|3.0668|06/22/2018||Yes|No||06/22/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|4.4198|01/11/2022|4.35666|01/11/2022|4.1492|01/11/2022|||HEMOPHILIA TREATMENT|2354|||||No|No||NOVO NORDISK|No||||
FVIII rec,B-dom trunc peg-exei|No|No|No|No|75%|00169810001|ESPEROCT 1,000 UNIT VIAL|1|EA|1.6116|03/09/2020||Yes|No||03/09/2020||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.3226|01/11/2022|2.28942|01/11/2022|2.1804|01/11/2022|||HEMOPHILIA TREATMENT|2355|||||No|No||NOVO NORDISK|No||||
FVIII rec,B-dom trunc peg-exei|No|No|No|No|75%|00169815001|ESPEROCT 1,500 UNIT VIAL|1|EA|1.6116|03/09/2020||Yes|No||03/09/2020||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.3226|01/11/2022|2.28942|01/11/2022|2.1804|01/11/2022|||HEMOPHILIA TREATMENT|2356|||||No|No||NOVO NORDISK|No||||
FVIII rec,B-dom trunc peg-exei|No|No|No|No|75%|00169820001|ESPEROCT 2,000 UNIT VIAL|1|EA|1.6116|03/09/2020||Yes|No||03/09/2020||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.3226|01/11/2022|2.28942|01/11/2022|2.1804|01/11/2022|||HEMOPHILIA TREATMENT|2357|||||No|No||NOVO NORDISK|No||||
FVIII rec,B-dom trunc peg-exei|No|No|No|No|75%|00169830001|ESPEROCT 3,000 UNIT VIAL|1|EA|1.6116|03/09/2020||Yes|No||03/09/2020||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.3226|01/11/2022|2.28942|01/11/2022|2.1804|01/11/2022|||HEMOPHILIA TREATMENT|2358|||||No|No||NOVO NORDISK|No||||
FVIII rec,B-dom trunc peg-exei|No|No|No|No|75%|00169850001|ESPEROCT 500 UNIT VIAL|1|EA|1.6116|03/09/2020||Yes|No||03/09/2020||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.3226|01/11/2022|2.28942|01/11/2022|2.1804|01/11/2022|||HEMOPHILIA TREATMENT|2359|||||No|No||NOVO NORDISK|No||||
hydrochlorothiazide|Yes|No|No|No|75%|00172208360|HYDROCHLOROTHIAZIDE 25 MG TAB|100|EA|.01823|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||Yes|.01337|03/29/2022|.01304|03/29/2022|.01313|03/29/2022||||2360|||||No|No||TEVA USA|No||||
hydrochlorothiazide|Yes|No|No|No|75%|00172208380|HYDROCHLOROTHIAZIDE 25 MG TAB|1000|EA|.01768|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||Yes|.01337|03/29/2022|.01304|03/29/2022|.01313|03/29/2022||||2361|||||No|No||TEVA USA|No||||
hydrochlorothiazide|Yes|No|No|No|75%|00172208960|HYDROCHLOROTHIAZIDE 50 MG TAB|100|EA|.03504|08/15/2002||Yes|No||08/15/2002||Yes|No|08/15/2002||Yes|No||08/15/2002||Yes|No|07/01/2016||Prescription required|No|||Yes|.02959|03/29/2022|.02887|03/29/2022|.02907|03/29/2022||||2362|||||No|No||TEVA USA|No||||
hydrochlorothiazide|Yes|No|No|No|75%|00172208980|HYDROCHLOROTHIAZIDE 50 MG TAB|1000|EA|.03373|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||Yes|.02959|03/29/2022|.02887|03/29/2022|.02907|03/29/2022||||2363|||||No|No||TEVA USA|No||||
lisinopril|Yes|No|No|No|75%|00172376170|LISINOPRIL 40 MG TABLET|500|EA|.0524|07/24/2002||Yes|No||07/24/2002||Yes|No|07/24/2002||Yes|No||07/24/2002||Yes|No|07/01/2016||Prescription required|No||113|No|.04778|03/29/2022|.04663|03/29/2022|.04694|03/29/2022|||ANGIOTENSIN MODULATORS|2364|||||No|No||TEVA USA|No||||
lisinopril|Yes|No|No|No|75%|00172376260|LISINOPRIL 30 MG TABLET|100|EA|.05009|07/24/2002||Yes|No||07/24/2002||Yes|No|07/24/2002||Yes|No||07/24/2002||Yes|No|07/01/2016||Prescription required|No||113|No|.05487|03/29/2022|.05355|03/29/2022|.0539|03/29/2022|||ANGIOTENSIN MODULATORS|2365|||||No|No||TEVA USA|No||||
diazepam|No|No|No|No|75%|00172392560|DIAZEPAM 2 MG TABLET|100|EA|.01285|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02435|03/29/2022|.02376|03/29/2022|.02392|03/29/2022|||ANXIOLYTICS|2366|||||No|No||TEVA USA|Yes|09/01/2020|||
diazepam|No|No|No|No|75%|00172392570|DIAZEPAM 2 MG TABLET|500|EA|.01203|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02435|03/29/2022|.02376|03/29/2022|.02392|03/29/2022|||ANXIOLYTICS|2367|||||No|No||TEVA USA|Yes|09/01/2020|||
diazepam|No|No|No|No|75%|00172392660|DIAZEPAM 5 MG TABLET|100|EA|.02059|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02374|03/29/2022|.02317|03/29/2022|.02332|03/29/2022|||ANXIOLYTICS|2368|||||No|No||TEVA USA|Yes|09/01/2020|||
diazepam|No|No|No|No|75%|00172392670|DIAZEPAM 5 MG TABLET|500|EA|.01896|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02374|03/29/2022|.02317|03/29/2022|.02332|03/29/2022|||ANXIOLYTICS|2369|||||No|No||TEVA USA|Yes|09/01/2020|||
diazepam|No|No|No|No|75%|00172392680|DIAZEPAM 5 MG TABLET|1000|EA|.01201|04/28/2011||Yes|No||04/28/2011||Yes|No|04/28/2011||Yes|No||||No|No|||Prescription required|No||090|Yes|.02374|03/29/2022|.02317|03/29/2022|.02332|03/29/2022|||ANXIOLYTICS|2370|||||No|No||TEVA USA|Yes|09/01/2020|||
diazepam|No|No|No|No|75%|00172392760|DIAZEPAM 10 MG TABLET|100|EA|.03977|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANXIOLYTICS|2371|||||No|No||TEVA USA|Yes|09/01/2020|||
diazepam|No|No|No|No|75%|00172392770|DIAZEPAM 10 MG TABLET|500|EA|.03877|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANXIOLYTICS|2372|||||No|No||TEVA USA|Yes|09/01/2020|||
diazepam|No|No|No|No|75%|00172392780|DIAZEPAM 10 MG TABLET|1000|EA|.01561|04/01/2011||Yes|No||04/01/2011||Yes|No|04/01/2011||Yes|No||||No|No|||Prescription required|No||090|Yes|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANXIOLYTICS|2373|||||No|No||TEVA USA|Yes|09/01/2020|||
baclofen|No|No|No|No|75%|00172409660|BACLOFEN 10 MG TABLET|100|EA|.12869|07/13/2010||Yes|No||07/13/2010||Yes|No|07/13/2010||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|2374|||||No|No||TEVA USA|No||||
baclofen|No|No|No|No|75%|00172409680|BACLOFEN 10 MG TABLET|1000|EA|.12867|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|2375|||||No|No||TEVA USA|No||||
baclofen|No|No|No|No|75%|00172409760|BACLOFEN 20 MG TABLET|100|EA|.21242|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|2376|||||No|No||TEVA USA|No||||
baclofen|No|No|No|No|75%|00172409780|BACLOFEN 20 MG TABLET|1000|EA|.21242|05/09/2012||Yes|No||09/01/2020||Yes|No|09/01/2020||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|2377|||||No|No||TEVA USA|No||||
anagrelide HCl|No|No|No|No|75%|00172524060|ANAGRELIDE HCL 1 MG CAPSULE|100|EA|.77013|06/28/2010||Yes|No||06/28/2010||Yes|No|06/28/2010||Yes|No||||No|No|||Prescription required|No|||No|1.75518|10/27/2020|1.7301|10/27/2020|1.64772|10/27/2020||||2378|||||No|No||TEVA USA|No||||
anagrelide HCl|No|No|No|No|75%|00172524160|ANAGRELIDE HCL 0.5 MG CAPSULE|100|EA|.35814|06/28/2010||Yes|No||06/28/2010||Yes|No|06/28/2010||Yes|No||||No|No|||Prescription required|No|||No|.73936|03/01/2022|.72161|03/01/2022|.72642|03/01/2022||||2379|||||No|No||TEVA USA|No||||
fluconazole|No|No|No|No|75%|00172541046|FLUCONAZOLE 50 MG TABLET|30|EA|.28666|11/10/2008|06/30/2022|Yes|No||11/10/2008|06/30/2022|Yes|No|11/10/2008|06/30/2022|Yes|No||11/10/2008|06/30/2022|Yes|No|||Prescription required|No||069|No|.43933|03/29/2022|.42878|03/29/2022|.43164|03/29/2022|||ANTIFUNGALS: ORAL|2380|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||TEVA USA|No||||
fluconazole|No|No|No|No|75%|00172541146|FLUCONAZOLE 100 MG TABLET|30|EA|.43|11/10/2008|06/30/2022|Yes|No||11/10/2008|06/30/2022|Yes|No|11/10/2008|06/30/2022|Yes|No||11/10/2008|06/30/2022|Yes|No|||Prescription required|No||069|No|.34281|03/29/2022|.33458|03/29/2022|.33681|03/29/2022|||ANTIFUNGALS: ORAL|2381|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||TEVA USA|No||||
fluconazole|No|No|No|No|75%|00172541160|FLUCONAZOLE 100 MG TABLET|100|EA|.43|11/10/2008|06/30/2022|Yes|No||11/10/2008|06/30/2022|Yes|No|11/10/2008|06/30/2022|Yes|No||11/10/2008|06/30/2022|Yes|No|||Prescription required|No||069|No|.34281|03/29/2022|.33458|03/29/2022|.33681|03/29/2022|||ANTIFUNGALS: ORAL|2382|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||TEVA USA|No||||
fluconazole|Yes|No|No|No|75%|00172541211|FLUCONAZOLE 150 MG TABLET|1|EA|1.204|11/10/2008|06/30/2022|Yes|No||11/10/2008|06/30/2022|Yes|No|11/10/2008|06/30/2022|Yes|No||11/10/2008|06/30/2022|Yes|No|11/01/2012|06/30/2022|Prescription required|No||069|No|.74933|03/29/2022|.73134|03/29/2022|.73621|03/29/2022|||ANTIFUNGALS: ORAL|2383|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||TEVA USA|No||||
fluconazole|No|No|No|No|75%|00172541346|FLUCONAZOLE 200 MG TABLET|30|EA|.57333|11/10/2008|06/30/2022|Yes|No||11/10/2008|06/30/2022|Yes|No|11/10/2008|06/30/2022|Yes|No||11/10/2008|06/30/2022|Yes|No|||Prescription required|No||069|No|.52936|03/29/2022|.51665|03/29/2022|.52009|03/29/2022|||ANTIFUNGALS: ORAL|2384|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||TEVA USA|No||||
famotidine|No|No|No|No|75%|00172572860|FAMOTIDINE 20 MG TABLET|100|EA|.0602|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.03262|03/29/2022|.03183|03/29/2022|.03204|03/29/2022||||2385|||||No|No||TEVA USA|No||||
famotidine|No|No|No|No|75%|00172572870|FAMOTIDINE 20 MG TABLET|500|EA|.0602|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.03262|03/29/2022|.03183|03/29/2022|.03204|03/29/2022||||2386|||||No|No||TEVA USA|No||||
famotidine|No|No|No|No|75%|00172572880|FAMOTIDINE 20 MG TABLET|1000|EA|.0602|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.03262|03/29/2022|.03183|03/29/2022|.03204|03/29/2022||||2387|||||No|No||TEVA USA|No||||
famotidine|No|No|No|No|75%|00172572960|FAMOTIDINE 40 MG TABLET|100|EA|.1204|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.06888|03/29/2022|.06722|03/29/2022|.06767|03/29/2022||||2388|||||No|No||TEVA USA|No||||
famotidine|No|No|No|No|75%|00172572970|FAMOTIDINE 40 MG TABLET|500|EA|.1204|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.06888|03/29/2022|.06722|03/29/2022|.06767|03/29/2022||||2389|||||No|No||TEVA USA|No||||
cyclosporine, modified|No|No|No|No|75%|00172731320|CYCLOSPORINE MODIFIED 100MG/ML|50|ML|2.02779|03/08/2006||Yes|No||03/08/2006||Yes|No|03/08/2006||Yes|No||03/08/2006||Yes|No|||Prescription required|No||229|No|4.62148|07/28/2020|4.55546|07/28/2020|4.33853|07/28/2020|||IMMUNOSUPPRESSIVES: ORAL|2390|||||No|No||TEVA USA|No||||
bupropion HCl|No|No|No|No|75%|00173013555|WELLBUTRIN SR 150 MG TABLET|60|EA|3.28684|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|031|No|7.49095|02/01/2022|7.38393|02/01/2022|7.03232|02/01/2022|||ANTIDEPRESSANTS: OTHER|2391|||||No|No||GLAXOSMITHKLINE|No||||
beclomethasone dipropionate|No|No|No|No|75%|00173038879|BECONASE AQ 0.042% SPRAY|25|GM|5.04579|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|019|No|11.19764|11/23/2021|10.92889|11/23/2021|11.00168|11/23/2021|||INTRANASAL RHINITIS AGENTS|2392|||||No|No||GLAXOSMITHKLINE|No||||
sumatriptan succinate|No|No|No|No|75%|00173047800|IMITREX 6 MG/0.5 ML CARTRIDGES|1|ML|181.6965|06/22/2009||Yes|No||06/22/2009||Yes|No|06/22/2009||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|021|No|409.31943|02/08/2022|399.49576|02/08/2022|402.15633|02/08/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|2393|||||No|No||GLAXOSMITHKLINE|No||||
sumatriptan succinate|No|No|No|No|75%|00173047900|IMITREX 6 MG/0.5 ML PEN INJECT|1|ML|191.8445|06/26/2009||Yes|No||06/26/2009||Yes|No|06/26/2009||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|021|No|437.227|02/01/2022|430.9809|02/01/2022|410.458|02/01/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|2394|||||No|No||GLAXOSMITHKLINE|No||||
epoprostenol sodium (glycine)|No|No|No|No|75%|00173051700|FLOLAN 0.5 MG VIAL|1|EA|8.0367|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|18.3162|06/01/2016|18.05454|06/01/2016|17.1948|06/01/2016||||2395|||||No|No||GLAXOSMITHKLINE|No||||
epoprostenol sodium (glycine)|No|No|No|No|75%|00173051900|FLOLAN 1.5 MG VIAL|1|EA|19.4102|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|44.2372|06/01/2016|43.60524|06/01/2016|41.5288|06/01/2016||||2396|||||No|No||GLAXOSMITHKLINE|No||||
salmeterol xinafoate|No|No|No|No|75%|00173052100|SEREVENT DISKUS 50 MCG|60|EA|3.03479|10/10/2003||Yes|No||10/10/2003||Yes|No|10/10/2003||Yes|No||||No|No|||Prescription required|Yes|07/17/2007|037|Yes|6.78572|02/08/2022|6.62286|02/08/2022|6.66696|02/08/2022|||BRONCHODILATORS: BETA AGONIST|2397|||||No|No||GLAXOSMITHKLINE|No||||
sumatriptan|No|No|No|No|75%|00173052300|IMITREX 20 MG NASAL SPRAY|6|EA|38.3044|03/25/2009||Yes|No||03/25/2009||Yes|No|03/25/2009||Yes|No||||No|No|||Prescription required|No||021|No|86.69219|02/08/2022|84.61157|02/08/2022|85.17507|02/08/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|2398|||||No|No||GLAXOSMITHKLINE|No||||
sumatriptan|No|No|No|No|75%|00173052400|IMITREX 5 MG NASAL SPRAY|6|EA|38.3044|08/13/2007||Yes|No||08/13/2007||Yes|No|08/13/2007||Yes|No||||No|No|||Prescription required|No||021|No|84.39895|02/08/2022|82.37337|02/08/2022|82.92196|02/08/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|2399|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173052600|LAMICTAL 5 MG DISPER TABLET|100|EA|6.14938|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||056|No|14.01488|02/01/2022|13.81466|02/01/2022|13.15682|02/01/2022|||ANTICONVULSANTS|2400|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173052700|LAMICTAL 25 MG DISPER TABLET|100|EA|6.60153|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||056|No|14.66134|02/08/2022|14.30946|02/08/2022|14.40476|02/08/2022|||ANTICONVULSANTS|2401|||||No|No||GLAXOSMITHKLINE|No||||
atovaquone|No|No|No|No|75%|00173054700|MEPRON 750 MG/5 ML SUSPENSION|5|ML|3.97865|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|6.49846|01/28/2020|6.40563|01/28/2020|6.1006|01/28/2020||||2402|||||No|No||GLAXOSMITHKLINE|No||||
naratriptan HCl|No|No|No|No|75%|00173056100|AMERGE 1 MG TABLET|9|EA|24.32844|09/26/2006||Yes|No||09/26/2006||Yes|No|09/26/2006||Yes|No||||No|No|||Prescription required|Yes|01/23/2008|021|No|55.44621|01/10/2017|54.65412|01/10/2017|52.05154|01/10/2017|||ANTIMIGRAINE AGENTS: TRIPTANS|2403|||||No|No||GLAXOSMITHKLINE|No||||
naratriptan HCl|No|No|No|No|75%|00173056200|AMERGE 2.5 MG TABLET|9|EA|24.32844|07/06/2009||Yes|No||07/06/2009||Yes|No|07/06/2009||Yes|No||||No|No|||Prescription required|Yes|01/23/2008|021|No|55.44621|01/23/2018|54.65412|01/23/2018|52.05154|01/23/2018|||ANTIMIGRAINE AGENTS: TRIPTANS|2404|||||No|No||GLAXOSMITHKLINE|No||||
valacyclovir HCl|Yes|No|No|No|75%|00173056504|VALTREX 1 GM CAPLET|30|EA|9.80944|03/08/2006||Yes|No||03/08/2006||Yes|No|03/08/2006||Yes|No||||No|No|11/01/2012||Prescription required|Yes|05/02/2016|025|No|22.3564|02/01/2022|22.03702|02/01/2022|20.98764|02/01/2022|||ANTIVIRALS: ORAL|2405|||||No|No||GLAXOSMITHKLINE|No||||
valacyclovir HCl|Yes|No|No|No|75%|00173056510|VALTREX 1 GM CAPLET|90|EA|9.80959|02/22/2007||Yes|No||02/22/2007||Yes|No|02/22/2007||Yes|No||||No|No|11/01/2012||Prescription required|Yes|05/02/2016|025|No|22.35674|02/01/2022|22.03735|02/01/2022|20.98796|02/01/2022|||ANTIVIRALS: ORAL|2406|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173059402|LAMICTAL TB START KIT (ORANGE)|49|EA|6.48448|01/11/2005||Yes|No||01/11/2005||Yes|No|01/11/2005||Yes|No||||No|No|||Prescription required|No||056|No|14.77859|02/01/2022|14.56747|02/01/2022|13.87378|02/01/2022|||ANTICONVULSANTS|2407|||||No|No||GLAXOSMITHKLINE|No||||
fluticasone propionate|No|No|No|No|75%|00173060002|FLOVENT 50 MCG DISKUS|60|EA|1.3899|07/02/2007||Yes|No||07/02/2007||Yes|No|07/02/2007||Yes|No||||No|No|||Prescription required|Yes|09/18/2020|033|Yes|3.10634|02/08/2022|3.03178|02/08/2022|3.05197|02/08/2022|||GLUCOCORTICOIDS: INHALED|2408|||||No|No||GLAXOSMITHKLINE|Yes|09/01/2020|||
fluticasone propionate|No|No|No|No|75%|00173060102|FLOVENT 250 MCG DISKUS|60|EA|1.96244|07/29/2009||Yes|No||07/29/2009||Yes|No|07/29/2009||Yes|No||||No|No|||Prescription required|Yes|09/18/2020|033|Yes|4.37945|02/08/2022|4.27434|02/08/2022|4.3028|02/08/2022|||GLUCOCORTICOIDS: INHALED|2409|||||No|No||GLAXOSMITHKLINE|No||||
fluticasone propionate|No|No|No|No|75%|00173060202|FLOVENT 100 MCG DISKUS|60|EA|1.46587|07/29/2009||Yes|No||07/29/2009||Yes|No|07/29/2009||Yes|No||||No|No|||Prescription required|Yes|09/18/2020|033|Yes|3.27324|02/08/2022|3.19468|02/08/2022|3.21595|02/08/2022|||GLUCOCORTICOIDS: INHALED|2410|||||No|No||GLAXOSMITHKLINE|Yes|09/01/2020|||
lamotrigine|No|No|No|No|75%|00173063302|LAMICTAL 25 MG TABLET|100|EA|6.35531|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||056|No|14.18492|02/08/2022|13.84448|02/08/2022|13.93668|02/08/2022|||ANTICONVULSANTS|2411|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173063310|LAMICTAL TAB START KIT (BLUE)|35|EA|6.35552|06/14/2009||Yes|No||06/14/2009||Yes|No|06/14/2009||Yes|No||||No|No|||Prescription required|No||056|No|14.48467|02/01/2022|14.27775|02/01/2022|13.59785|02/01/2022|||ANTICONVULSANTS|2412|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173064255|LAMICTAL 100 MG TABLET|100|EA|7.25934|05/12/2004||Yes|No||05/12/2004||Yes|No|05/12/2004||Yes|No||||No|No|||Prescription required|No||056|No|16.20508|02/08/2022|15.81615|02/08/2022|15.92149|02/08/2022|||ANTICONVULSANTS|2413|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173064360|LAMICTAL 150 MG TABLET|60|EA|7.95643|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||056|No|17.81875|02/08/2022|17.3911|02/08/2022|17.50692|02/08/2022|||ANTICONVULSANTS|2414|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173064460|LAMICTAL 200 MG TABLET|60|EA|8.66141|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||056|No|19.3628|02/08/2022|18.89809|02/08/2022|19.02395|02/08/2022|||ANTICONVULSANTS|2415|||||No|No||GLAXOSMITHKLINE|No||||
lamivudine|No|No|No|No|75%|00173066200|EPIVIR HBV 100 MG TABLET|60|EA|9.7563|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|15.93529|01/10/2017|15.70764|01/10/2017|14.95966|01/10/2017||||2416|||||No|No||GLAXOSMITHKLINE|No||||
lamivudine|No|No|No|No|75%|00173066300|EPIVIR HBV 25 MG/5 ML SOLN|240|ML|.4878|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.79674|01/10/2017|.78535|01/10/2017|.74796|01/10/2017||||2417|||||No|No||GLAXOSMITHKLINE|No||||
atovaquone|No|No|No|No|75%|00173066518|MEPRON 750 MG/5 ML SUSPENSION|210|ML|4.30285|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|7.02799|01/28/2020|6.92759|01/28/2020|6.5977|01/28/2020||||2418|||||No|No||GLAXOSMITHKLINE|No||||
atovaquone/proguanil HCl|No|No|No|No|75%|00173067501|MALARONE 250-100 MG TABLET|100|EA|2.89381|04/29/2009||Yes|No||04/29/2009||Yes|No|04/29/2009||Yes|No||||No|No|||Prescription required|No|||No|6.5952|06/01/2016|6.50098|06/01/2016|6.19141|06/01/2016||||2419|||||No|No||GLAXOSMITHKLINE|No||||
atovaquone/proguanil HCl|No|No|No|No|75%|00173067502|MALARONE 250-100 MG TABLET|24|EA|2.95266|04/29/2009||Yes|No||04/29/2009||Yes|No|04/29/2009||Yes|No||||No|No|||Prescription required|No|||No|6.72932|06/01/2016|6.63319|06/01/2016|6.31732|06/01/2016||||2420|||||No|No||GLAXOSMITHKLINE|No||||
atovaquone/proguanil HCl|No|No|No|No|75%|00173067601|MALARONE 62.5-25 MG PED TAB|100|EA|1.07035|04/29/2009||Yes|No||04/29/2009||Yes|No|04/29/2009||Yes|No||||No|No|||Prescription required|No|||No|2.43941|06/01/2016|2.40456|06/01/2016|2.29006|06/01/2016||||2421|||||No|No||GLAXOSMITHKLINE|No||||
zanamivir|No|No|No|No|75%|00173068101|RELENZA 5 MG DISKHALER|20|EA|1.2685|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|025|No|2.891|03/26/2019|2.8497|03/26/2019|2.714|03/26/2019|||ANTIVIRALS: ORAL|2422|||||No|No||GLAXOSMITHKLINE|No||||
albuterol sulfate|No|No|No|No|75%|00173068220|VENTOLIN HFA 90 MCG INHALER|18|GM|1.36214|07/14/2006||Yes|No||07/14/2006||Yes|No|07/14/2006||Yes|No||||No|No|||Prescription required|No||037|Yes|3.04135|02/08/2022|2.96835|02/08/2022|2.98812|02/08/2022|||BRONCHODILATORS: BETA AGONIST|2423|||||No|No||GLAXOSMITHKLINE|No||||
albuterol sulfate|No|No|No|No|75%|00173068224|VENTOLIN HFA 90 MCG INHALER|8|GM|1.2212|04/10/2020||Yes|No||04/10/2020||Yes|No|04/10/2020||Yes|No||||No|No|||Prescription required|No||037|Yes|2.7141|02/08/2022|2.64896|02/08/2022|2.6666|02/08/2022|||BRONCHODILATORS: BETA AGONIST|2424|||||No|No||GLAXOSMITHKLINE|No||||
fluticasone propion/salmeterol|No|No|No|No|75%|00173069500|ADVAIR 100-50 DISKUS|60|EA|2.27218|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||033|Yes|5.06842|03/01/2022|4.94677|03/01/2022|4.97972|03/01/2022|||GLUCOCORTICOIDS: INHALED|2425|||||No|No||GLAXOSMITHKLINE|Yes|09/01/2020|||
fluticasone propion/salmeterol|No|No|No|No|75%|00173069600|ADVAIR 250-50 DISKUS|60|EA|2.82316|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||033|Yes|6.30036|03/01/2022|6.14915|03/01/2022|6.1901|03/01/2022|||GLUCOCORTICOIDS: INHALED|2426|||||No|No||GLAXOSMITHKLINE|Yes|09/01/2020|||
fluticasone propion/salmeterol|No|No|No|No|75%|00173069700|ADVAIR 500-50 DISKUS|60|EA|3.71305|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||033|Yes|8.27356|03/01/2022|8.07499|03/01/2022|8.12877|03/01/2022|||GLUCOCORTICOIDS: INHALED|2427|||||No|No||GLAXOSMITHKLINE|Yes|09/01/2020|||
dutasteride|No|No|No|No|75%|00173071204|AVODART 0.5 MG SOFTGEL|90|EA|3.26546|08/16/2005||Yes|No||08/16/2005||Yes|No|08/16/2005||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|003|No|7.26442|10/05/2021|7.09007|10/05/2021|7.13729|10/05/2021|||BPH TREATMENTS|2428|||||No|No||GSK/ WOODWARD P|No||||
dutasteride|No|No|No|No|75%|00173071215|AVODART 0.5 MG SOFTGEL|30|EA|3.26599|09/09/2003||Yes|No||09/09/2003||Yes|No|09/09/2003||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|003|No|7.26442|10/05/2021|7.09007|10/05/2021|7.13729|10/05/2021|||BPH TREATMENTS|2429|||||No|No||GSK/ WOODWARD P|No||||
fluticasone propion/salmeterol|No|No|No|No|75%|00173071520|ADVAIR HFA 45-21 MCG INHALER|12|GM|11.70173|12/18/2008||Yes|No||12/18/2008||Yes|No|12/18/2008||Yes|No||||No|No|||Prescription required|No||033|Yes|26.13214|10/26/2021|25.50496|10/26/2021|25.67482|10/26/2021|||GLUCOCORTICOIDS: INHALED|2430|||||No|No||GLAXOSMITHKLINE|Yes|09/01/2020|||
fluticasone propion/salmeterol|No|No|No|No|75%|00173071522|ADVAIR HFA 45-21 MCG INHALER|8|GM|11.76265|01/14/2010||Yes|No||01/14/2010||Yes|No|01/14/2010||Yes|No||||No|No|||Prescription required|No||033|Yes|26.8079|01/12/2021|26.42493|01/12/2021|25.1666|01/12/2021|||GLUCOCORTICOIDS: INHALED|2431|||||No|No||GLAXOSMITHKLINE|Yes|09/01/2020|||
fluticasone propion/salmeterol|No|No|No|No|75%|00173071620|ADVAIR HFA 115-21 MCG INHALER|12|GM|14.53937|12/18/2008||Yes|No||12/18/2008||Yes|No|12/18/2008||Yes|No||||No|No|||Prescription required|No||033|Yes|32.47032|10/26/2021|31.69103|10/26/2021|31.90208|10/26/2021|||GLUCOCORTICOIDS: INHALED|2432|||||No|No||GLAXOSMITHKLINE|Yes|09/01/2020|||
fluticasone propion/salmeterol|No|No|No|No|75%|00173071622|ADVAIR HFA 115-21 MCG INHALER|8|GM|11.76265|01/14/2010||Yes|No||01/14/2010||Yes|No|01/14/2010||Yes|No||||No|No|||Prescription required|No||033|Yes|26.38175|06/29/2021|25.74858|06/29/2021|25.92006|06/29/2021|||GLUCOCORTICOIDS: INHALED|2433|||||No|No||GLAXOSMITHKLINE|Yes|09/01/2020|||
fluticasone propion/salmeterol|No|No|No|No|75%|00173071720|ADVAIR HFA 230-21 MCG INHALER|12|GM|19.1221|08/27/2010||Yes|No||08/27/2010||Yes|No|08/27/2010||Yes|No||||No|No|||Prescription required|No||033|Yes|42.64112|10/26/2021|41.61773|10/26/2021|41.8949|10/26/2021|||GLUCOCORTICOIDS: INHALED|2434|||||No|No||GLAXOSMITHKLINE|Yes|09/01/2020|||
fluticasone propion/salmeterol|No|No|No|No|75%|00173071722|ADVAIR HFA 230-21 MCG INHALER|8|GM|17.4451|01/14/2010||Yes|No||01/14/2010||Yes|No|01/14/2010||Yes|No||||No|No|||Prescription required|No||033|Yes|39.7586|01/12/2021|39.19062|01/12/2021|37.3244|01/12/2021|||GLUCOCORTICOIDS: INHALED|2435|||||No|No||GLAXOSMITHKLINE|No||||
fluticasone propionate|No|No|No|No|75%|00173071820|FLOVENT HFA 44 MCG INHALER|10.6|GM|8.29737|05/04/2007||Yes|No||05/04/2007||Yes|No|05/04/2007||Yes|No||||No|No|||Prescription required|No||033|Yes|18.53668|02/08/2022|18.09179|02/08/2022|18.21228|02/08/2022|||GLUCOCORTICOIDS: INHALED|2436|||||No|No||GLAXOSMITHKLINE|Yes|09/01/2020|||
fluticasone propionate|No|No|No|No|75%|00173071920|FLOVENT HFA 110 MCG INHALER|12|GM|9.81223|03/13/2007||Yes|No||03/13/2007||Yes|No|03/13/2007||Yes|No||||No|No|||Prescription required|No||033|Yes|21.88307|02/08/2022|21.35787|02/08/2022|21.50011|02/08/2022|||GLUCOCORTICOIDS: INHALED|2437|||||No|No||GLAXOSMITHKLINE|Yes|09/01/2020|||
fluticasone propionate|No|No|No|No|75%|00173072020|FLOVENT HFA 220 MCG INHALER|12|GM|15.24098|05/16/2007||Yes|No||05/16/2007||Yes|No|05/16/2007||Yes|No||||No|No|||Prescription required|No||033|Yes|34.00346|02/08/2022|33.18737|02/08/2022|33.40839|02/08/2022|||GLUCOCORTICOIDS: INHALED|2438|||||No|No||GLAXOSMITHKLINE|Yes|09/01/2020|||
bupropion HCl|No|No|No|No|75%|00173072200|WELLBUTRIN SR 200 MG TABLET|60|EA|6.10356|06/25/2002||Yes|No||06/25/2002||Yes|No|06/25/2002||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|031|No|13.91044|02/01/2022|13.71172|02/01/2022|13.05878|02/01/2022|||ANTIDEPRESSANTS: OTHER|2439|||||No|No||GLAXOSMITHKLINE|No||||
sumatriptan succinate|No|No|No|No|75%|00173073500|IMITREX 25 MG TABLET|9|EA|14.07915|01/05/2004||Yes|No||01/05/2004||Yes|No|01/05/2004||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|32.08737|02/01/2022|31.62898|02/01/2022|30.12284|02/01/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|2440|||||No|No||GLAXOSMITHKLINE|No||||
sumatriptan succinate|No|No|No|No|75%|00173073601|IMITREX 50 MG TABLET|9|EA|30.69005|01/05/2004||Yes|No||01/05/2004||Yes|No|01/05/2004||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|68.87375|02/08/2022|67.22078|02/08/2022|67.66845|02/08/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|2441|||||No|No||GLAXOSMITHKLINE|No||||
sumatriptan succinate|No|No|No|No|75%|00173073701|IMITREX 100 MG TABLET|9|EA|30.69005|07/23/2009||Yes|No||07/23/2009||Yes|No|07/23/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|68.67425|02/08/2022|67.02606|02/08/2022|67.47245|02/08/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|2442|||||No|No||GLAXOSMITHKLINE|No||||
sumatriptan succinate|No|No|No|No|75%|00173073900|IMITREX 4 MG/0.5 ML PEN INJECT|1|ML|191.8445|06/22/2010||Yes|No||06/22/2010||Yes|No|06/22/2010||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|021|No|437.227|02/01/2022|430.9809|02/01/2022|410.458|02/01/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|2443|||||No|No||GLAXOSMITHKLINE|No||||
sumatriptan succinate|No|No|No|No|75%|00173073902|IMITREX 4 MG/0.5 ML CARTRIDGES|1|ML|181.6965|09/28/2010||Yes|No||09/28/2010||Yes|No|09/28/2010||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|021|No|414.099|02/01/2022|408.1833|02/01/2022|388.746|02/01/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|2444|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173075400|LAMICTAL XR 25 MG TABLET|30|EA|5.58971|06/28/2009||Yes|No||06/28/2009||Yes|No|06/28/2009||Yes|No||||No|No|||Prescription required|No||056|No|12.73934|02/01/2022|12.55735|02/01/2022|11.95938|02/01/2022|||ANTICONVULSANTS|2445|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173075500|LAMICTAL XR 50 MG TABLET|30|EA|11.17813|06/28/2009||Yes|No||06/28/2009||Yes|No|06/28/2009||Yes|No||||No|No|||Prescription required|No||056|No|24.90114|02/08/2022|24.30351|02/08/2022|24.46537|02/08/2022|||ANTICONVULSANTS|2446|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173075600|LAMICTAL XR 100 MG TABLET|30|EA|11.97363|06/28/2009||Yes|No||06/28/2009||Yes|No|06/28/2009||Yes|No||||No|No|||Prescription required|No||056|No|26.68768|02/08/2022|26.04717|02/08/2022|26.22064|02/08/2022|||ANTICONVULSANTS|2447|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173075700|LAMICTAL XR 200 MG TABLET|30|EA|12.76827|06/28/2009||Yes|No||06/28/2009||Yes|No|06/28/2009||Yes|No||||No|No|||Prescription required|No||056|No|28.56191|02/08/2022|27.87642|02/08/2022|28.06207|02/08/2022|||ANTICONVULSANTS|2448|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173075800|LAMICTAL XR START KIT (BLUE)|28|EA|6.98688|06/28/2009||Yes|No||06/28/2009||Yes|No|06/28/2009||Yes|No||||No|No|||Prescription required|No||056|No|15.92359|02/01/2022|15.69611|02/01/2022|14.94868|02/01/2022|||ANTICONVULSANTS|2449|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173075900|LAMICTAL XR START KIT (GREEN)|35|EA|15.96762|06/28/2009||Yes|No||06/28/2009||Yes|No|06/28/2009||Yes|No||||No|No|||Prescription required|No||056|No|36.39132|02/01/2022|35.87144|02/01/2022|34.16328|02/01/2022|||ANTICONVULSANTS|2450|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173076000|LAMICTAL XR START KIT (ORANGE)|35|EA|7.98424|06/28/2009||Yes|No||06/28/2009||Yes|No|06/28/2009||Yes|No||||No|No|||Prescription required|No||056|No|18.19664|02/01/2022|17.93668|02/01/2022|17.08256|02/01/2022|||ANTICONVULSANTS|2451|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173076100|LAMICTAL XR 300 MG TABLET|30|EA|19.15291|04/14/2011||Yes|No||04/14/2011||Yes|No|04/14/2011||Yes|No||||No|No|||Prescription required|No||056|No|42.907|02/08/2022|41.87723|02/08/2022|42.15612|02/08/2022|||ANTICONVULSANTS|2452|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173077202|LAMICTAL ODT 25 MG TABLET|30|EA|5.34647|06/17/2009||Yes|No||06/17/2009||Yes|No|06/17/2009||Yes|No||||No|No|||Prescription required|No||056|No|12.18498|02/01/2022|12.01091|02/01/2022|11.43896|02/01/2022|||ANTICONVULSANTS|2453|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173077402|LAMICTAL ODT 50 MG TABLET|30|EA|5.72674|06/17/2009||Yes|No||06/17/2009||Yes|No|06/17/2009||Yes|No||||No|No|||Prescription required|No||056|No|12.75303|02/08/2022|12.44695|02/08/2022|12.52985|02/08/2022|||ANTICONVULSANTS|2454|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173077602|LAMICTAL ODT 100 MG TABLET|30|EA|6.10614|06/17/2009||Yes|No||06/17/2009||Yes|No|06/17/2009||Yes|No||||No|No|||Prescription required|No||056|No|13.57951|02/08/2022|13.2536|02/08/2022|13.34186|02/08/2022|||ANTICONVULSANTS|2455|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173077702|LAMICTAL ODT 200 MG TABLET|30|EA|7.28663|06/18/2009||Yes|No||06/18/2009||Yes|No|06/18/2009||Yes|No||||No|No|||Prescription required|No||056|No|16.25626|02/08/2022|15.8661|02/08/2022|15.97177|02/08/2022|||ANTICONVULSANTS|2456|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173077800|LAMICTAL ODT START KT (ORANGE)|35|EA|7.6368|06/17/2009||Yes|No||06/17/2009||Yes|No|06/17/2009||Yes|No||||No|No|||Prescription required|No||056|No|17.4048|02/01/2022|17.15616|02/01/2022|16.3392|02/01/2022|||ANTICONVULSANTS|2457|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173077900|LAMICTAL ODT START KIT (BLUE)|28|EA|6.68266|06/17/2009||Yes|No||06/17/2009||Yes|No|06/17/2009||Yes|No||||No|No|||Prescription required|No||056|No|15.23024|02/01/2022|15.01267|02/01/2022|14.29778|02/01/2022|||ANTICONVULSANTS|2458|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173078000|LAMICTAL ODT START KIT (GREEN)|56|EA|9.54569|06/17/2009||Yes|No||06/17/2009||Yes|No|06/17/2009||Yes|No||||No|No|||Prescription required|No||056|No|21.75529|02/01/2022|21.4445|02/01/2022|20.42333|02/01/2022|||ANTICONVULSANTS|2459|||||No|No||GLAXOSMITHKLINE|No||||
lamotrigine|No|No|No|No|75%|00173078100|LAMICTAL XR 250 MG TABLET|30|EA|17.41184|03/08/2012||Yes|No||03/08/2012||Yes|No|03/08/2012||Yes|No||||No|No|||Prescription required|No||056|No|39.6828|02/01/2022|39.1159|02/01/2022|37.25324|02/01/2022|||ANTICONVULSANTS|2460|||||No|No||GLAXOSMITHKLINE|No||||
dutasteride/tamsulosin HCl|No|No|No|No|75%|00173080913|JALYN 0.5-0.4 MG CAPSULE|30|EA|3.26599|07/16/2010||Yes|No||07/16/2010||Yes|No|07/16/2010||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|003|No|7.29468|10/05/2021|7.1196|10/05/2021|7.16702|10/05/2021|||BPH TREATMENTS|2461|||||No|No||GSK/ WOODWARD P|No||||
dutasteride/tamsulosin HCl|No|No|No|No|75%|00173080959|JALYN 0.5-0.4 MG CAPSULE|90|EA|3.26546|07/16/2010||Yes|No||07/16/2010||Yes|No|07/16/2010||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|003|No|7.29468|10/05/2021|7.1196|10/05/2021|7.16702|10/05/2021|||BPH TREATMENTS|2462|||||No|No||GSK/ WOODWARD P|No||||
lamotrigine|No|No|No|No|75%|00173081728|LAMICTAL TAB START KIT (GREEN)|98|EA|6.48435|05/05/2011||Yes|No||05/05/2011||Yes|No|05/05/2011||Yes|No||||No|No|||Prescription required|No||056|No|14.77829|02/01/2022|14.56717|02/01/2022|13.87349|02/01/2022|||ANTICONVULSANTS|2463|||||No|No||GLAXOSMITHKLINE|No||||
fluticasone/vilanterol|No|No|No|No|75%|00173085910|BREO ELLIPTA 100-25 MCG INH|60|EA|2.75085|10/25/2013||Yes|No||10/25/2013||Yes|No|10/25/2013||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|033|Yes|6.14119|02/08/2022|5.9938|02/08/2022|6.03371|02/08/2022|||GLUCOCORTICOIDS: INHALED|2464|||||No|No||GLAXOSMITHKLINE|No||||
fluticasone/vilanterol|No|No|No|No|75%|00173085914|BREO ELLIPTA 100-25 MCG INH|28|EA|2.27086|10/25/2013||Yes|No||10/25/2013||Yes|No|10/25/2013||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|033|Yes|5.0888|02/08/2022|4.96666|02/08/2022|4.99974|02/08/2022|||GLUCOCORTICOIDS: INHALED|2465|||||No|No||GLAXOSMITHKLINE|No||||
umeclidinium brm/vilanterol tr|No|No|No|No|75%|00173086910|ANORO ELLIPTA 62.5-25 MCG INH|60|EA|3.20765|06/30/2014||Yes|No||06/30/2014||Yes|No|06/30/2014||Yes|No||||No|No|||Prescription required|No||098|Yes|7.15984|02/08/2022|6.988|02/08/2022|7.03454|02/08/2022|||COPD AGENTS|2466|||||No|No||GLAXOSMITHKLINE|No||||
umeclidinium bromide|No|No|No|No|75%|00173087310|INCRUSE ELLIPTA 62.5 MCG INH|30|EA|5.07543|03/18/2015||Yes|No||03/18/2015||Yes|No|03/18/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|098|No|11.31807|10/26/2021|11.04643|10/26/2021|11.12|10/26/2021|||COPD AGENTS|2467|||||No|No||GLAXOSMITHKLINE|No||||
fluticasone furoate|No|No|No|No|75%|00173087410|ARNUITY ELLIPTA 100 MCG INH|30|EA|2.71831|03/18/2015||Yes|No||03/18/2015||Yes|No|03/18/2015||Yes|No||||No|No|||Prescription required|Yes|09/18/2020|033|Yes|6.07369|02/08/2022|5.92792|02/08/2022|5.9674|02/08/2022|||GLUCOCORTICOIDS: INHALED|2468|||||No|No||GLAXOSMITHKLINE|No||||
fluticasone furoate|No|No|No|No|75%|00173087610|ARNUITY ELLIPTA 200 MCG INH|30|EA|3.63937|03/18/2015||Yes|No||03/18/2015||Yes|No|03/18/2015||Yes|No||||No|No|||Prescription required|Yes|09/18/2020|033|Yes|8.11518|02/08/2022|7.92041|02/08/2022|7.97316|02/08/2022|||GLUCOCORTICOIDS: INHALED|2469|||||No|No||GLAXOSMITHKLINE|No||||
fluticasone/vilanterol|No|No|No|No|75%|00173088210|BREO ELLIPTA 200-25 MCG INH|60|EA|2.75085|07/16/2015||Yes|No||07/16/2015||Yes|No|07/16/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|033|Yes|6.13798|02/08/2022|5.99066|02/08/2022|6.03056|02/08/2022|||GLUCOCORTICOIDS: INHALED|2470|||||No|No||GLAXOSMITHKLINE|No||||
fluticasone/umeclidin/vilanter|No|No|No|No|75%|00173088710|TRELEGY ELLIPTA 100-62.5-25|60|EA|4.44276|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|033|Yes|9.93144|02/08/2022|9.69308|02/08/2022|9.75763|02/08/2022|||GLUCOCORTICOIDS: INHALED|2471|||||No|No||GLAXOSMITHKLINE|No||||
fluticasone/umeclidin/vilanter|No|No|No|No|75%|00173088714|TRELEGY ELLIPTA 100-62.5-25|28|EA|4.43667|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|033|Yes|9.95537|02/08/2022|9.71644|02/08/2022|9.78115|02/08/2022|||GLUCOCORTICOIDS: INHALED|2472|||||No|No||GLAXOSMITHKLINE|No||||
fluticasone furoate|No|No|No|No|75%|00173088810|ARNUITY ELLIPTA 50 MCG INH|30|EA|2.71831|11/07/2018||Yes|No||11/07/2018||Yes|No|11/07/2018||Yes|No||||No|No|||Prescription required|Yes|09/18/2020|033|Yes|6.07735|02/08/2022|5.93149|02/08/2022|5.97099|02/08/2022|||GLUCOCORTICOIDS: INHALED|2473|||||No|No||GLAXOSMITHKLINE|No||||
tafenoquine succinate|No|No|No|No|75%|00173088939|KRINTAFEL 150 MG TABLET|2|EA|6.88|06/03/2019||Yes|No||06/03/2019||Yes|No|06/03/2019||Yes|No||||No|No|||Prescription required|No|||No|15.68|06/03/2019|15.456|06/03/2019|14.72|06/03/2019||||2474|||||No|No||GLAXOSMITHKLINE|No||||
mepolizumab|No|No|No|No|75%|00173089201|NUCALA 100 MG/ML AUTO-INJECTOR|1|ML|1429.8962|02/04/2020||Yes|No||02/04/2020||Yes|No|02/04/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|206|Yes|3258.8332|02/01/2022|3212.27844|02/01/2022|3059.3128|02/01/2022|||IMMUNOMODULATORS: ASTHMA|2475|||||No|No||GLAXOSMITHKLINE|No||||
mepolizumab|No|No|No|No|75%|00173089242|NUCALA 100 MG/ML SYRINGE|1|ML|1429.8962|02/04/2020||Yes|No||02/04/2020||Yes|No|02/04/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|206|Yes|3258.8332|02/01/2022|3212.27844|02/01/2022|3059.3128|02/01/2022|||IMMUNOMODULATORS: ASTHMA|2476|||||No|No||GLAXOSMITHKLINE|No||||
fluticasone/umeclidin/vilanter|No|No|No|No|75%|00173089310|TRELEGY ELLIPTA 200-62.5-25|60|EA|4.44276|04/26/2021||Yes|No||04/26/2021||Yes|No|04/26/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|033|Yes|9.94643|02/08/2022|9.70771|02/08/2022|9.77236|02/08/2022|||GLUCOCORTICOIDS: INHALED|2477|||||No|No||GLAXOSMITHKLINE|No||||
fluticasone/umeclidin/vilanter|No|No|No|No|75%|00173089314|TRELEGY ELLIPTA 200-62.5-25|28|EA|4.43667|04/26/2021||Yes|No||04/26/2021||Yes|No|04/26/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|033|Yes|9.85088|02/08/2022|9.61445|02/08/2022|9.67848|02/08/2022|||GLUCOCORTICOIDS: INHALED|2478|||||No|No||GLAXOSMITHKLINE|No||||
valacyclovir HCl|No|No|No|No|75%|00173093308|VALTREX 500 MG CAPLET|30|EA|5.60533|02/21/2003||Yes|No||02/21/2003||Yes|No|02/21/2003||Yes|No||||No|No|||Prescription required|Yes|05/02/2016|025|No|12.54369|02/08/2022|12.24264|02/08/2022|12.32417|02/08/2022|||ANTIVIRALS: ORAL|2479|||||No|No||GLAXOSMITHKLINE|No||||
valacyclovir HCl|No|No|No|No|75%|00173093310|VALTREX 500 MG CAPLET|90|EA|5.60485|02/22/2007||Yes|No||02/22/2007||Yes|No|02/22/2007||Yes|No||||No|No|||Prescription required|Yes|05/02/2016|025|No|12.54369|02/08/2022|12.24264|02/08/2022|12.32417|02/08/2022|||ANTIVIRALS: ORAL|2480|||||No|No||GLAXOSMITHKLINE|No||||
valacyclovir HCl|No|No|No|No|75%|00173093356|VALTREX 500 MG CAPLET|100|EA|5.73|06/07/2006||Yes|No||06/07/2006||Yes|No|06/07/2006||Yes|No||||No|No|||Prescription required|Yes|05/02/2016|025|No|12.54369|02/08/2022|12.24264|02/08/2022|12.32417|02/08/2022|||ANTIVIRALS: ORAL|2481|||||No|No||GLAXOSMITHKLINE|No||||
bupropion HCl|No|No|No|No|75%|00173094755|WELLBUTRIN SR 100 MG TABLET|60|EA|3.06676|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|031|No|6.98936|02/01/2022|6.88951|02/01/2022|6.56144|02/01/2022|||ANTIDEPRESSANTS: OTHER|2482|||||No|No||GLAXOSMITHKLINE|No||||
iron carb,gl/FA/B12/C/docusate|No|No|No|No|75%|00178008990|FERRALET 90 TABLET|90|EA|.97504|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Over the counter|No||506|No|2.16864|06/23/2020|2.11659|06/23/2020|2.13068|06/23/2020|||IRON: ORAL|2483|||||No|No||MISSION PHARM.|No||||
zinc oxide|No|No|No|No|75%|00178033002|DR. SMITH'S DIAPER 10% OINTMNT|56.7|GM|.02168|03/24/2010||Yes|No||||No|No|03/24/2010||Yes|No||||No|No|||Over the counter|No|||No|.04943|01/26/2021|.04872|01/26/2021|.0464|01/26/2021||||2484|||||No|No||MISSION PHARM.|No||||
zinc oxide|No|No|No|No|75%|00178033003|DR. SMITH'S DIAPER 10% OINTMNT|85|GM|.02114|11/02/2010||Yes|No||||No|No|11/02/2010||Yes|No||||No|No|||Over the counter|No|||No|.04818|08/29/2017|.04749|08/29/2017|.04523|08/29/2017||||2485|||||No|No||MISSION PHARM.|No||||
zinc oxide|No|No|No|No|75%|00178034003|DR. SMITH'S DIAPER RASH SPRAY|100|GM|.02829|11/05/2014||Yes|No||||No|No|11/05/2014||Yes|No||||No|No|||Over the counter|No|||No|.06448|01/28/2020|.06356|01/28/2020|.06053|01/28/2020||||2486|||||No|No||MISSION PHARM.|No||||
hydrocortisone|No|No|No|No|75%|00178045501|TEXACORT 2.5% SOLUTION|30|ML|2.92729|06/06/2012||Yes|No||06/06/2012||Yes|No|06/06/2012||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|118|No|6.6715|10/06/2020|6.57619|10/06/2020|6.26304|10/06/2020|||STEROIDS: TOPICAL LOW|2487|||||No|No||MISSION PHARM.|No||||
acetohydroxamic acid|No|No|No|No|75%|00178050001|LITHOSTAT 250 MG TABLET|100|EA|8.53335|01/04/2005||Yes|No||01/04/2005||Yes|No|01/04/2005||Yes|No||||No|No|||Prescription required|No|||No|19.4481|10/06/2020|19.17027|10/06/2020|18.2574|10/06/2020||||2488|||||No|No||MISSION PHARM.|No||||
prednisolone sodium phosphate|No|No|No|No|75%|00178058208|PREDNISOLONE SOD PH 25 MG/5 ML|237|ML|.53203|11/20/2012|01/31/2022|Yes|No||11/20/2012|01/31/2022|Yes|No|11/20/2012|01/31/2022|Yes|No||||No|No|||Prescription required|No||168|No|1.21254|02/25/2020|1.19522|02/25/2020|1.1383|02/25/2020|||GLUCOCORTICOIDS: ORAL|2489|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MISSION PHARM.|No||||
potassium citrate|No|No|No|No|75%|00178060001|UROCIT-K SR 5 MEQ TABLET|100|EA|.65626|01/04/2005||Yes|No||01/04/2005||Yes|No|01/04/2005||Yes|No||||No|No|||Prescription required|No|||No|1.49567|06/01/2016|1.4743|06/01/2016|1.4041|06/01/2016||||2490|||||No|No||MISSION PHARM.|No||||
potassium citrate|No|No|No|No|75%|00178061001|UROCIT-K SR 10 MEQ TABLET|100|EA|.91981|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|2.09631|06/01/2016|2.06637|06/01/2016|1.96797|06/01/2016||||2491|||||No|No||MISSION PHARM.|No||||
potassium citrate|No|No|No|No|75%|00178061501|UROCIT-K ER 15 MEQ TABLET|100|EA|1.56607|02/24/2010||Yes|No||02/24/2010||Yes|No|02/24/2010||Yes|No||||No|No|||Prescription required|No|||No|3.56918|06/01/2016|3.5182|06/01/2016|3.35066|06/01/2016||||2492|||||No|No||MISSION PHARM.|No||||
PNV59/iron,carb,fum/FA/dss/dha|No|No|No|No|75%|00178079630|CITRANATAL HARMONY CAPSULE|30|EA|1.73863|05/15/2014||Yes|No||05/15/2014||Yes|No|05/15/2014||Yes|No||||No|No|||Prescription required|No||243|No|3.8871|10/29/2019|3.7938|10/29/2019|3.81907|10/29/2019|||PRENATAL VITAMINS|2493|||||No|No||MISSION PHARM.|No||||
iron carb,gl/FA/B12/C/docusate|No|No|No|No|75%|00178081330|CITRANATAL BLOOM TABLET|30|EA|1.78679|02/27/2018||Yes|No||02/27/2018||Yes|No|02/27/2018||Yes|No||||No|No|||Prescription required|Yes|04/26/2020|506|No|3.96789|10/29/2019|3.87266|10/29/2019|3.89845|10/29/2019|||IRON: ORAL|2494|||||No|No||MISSION PHARM.|No||||
PNV72/iron,gluc/folic/dss/dha|No|No|No|No|75%|00178082130|CITRANATAL 90 DHA COMBO PACK|60|EA|.89762|05/15/2014||Yes|No||05/15/2014||Yes|No|05/15/2014||Yes|No||||No|No|||Prescription required|No||243|No|2.00336|10/29/2019|1.95527|10/29/2019|1.9683|10/29/2019|||PRENATAL VITAMINS|2495|||||No|No||MISSION PHARM.|No||||
prenatal 48/iron/folic acid/B6|No|No|No|No|75%|00178083230|CITRANATAL B-CALM COMBO PACK|90|EA|.52335|12/21/2012||Yes|No||12/21/2012||Yes|No|12/21/2012||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|1.19276|01/05/2021|1.17572|01/05/2021|1.11974|01/05/2021|||PRENATAL VITAMINS|2496|||||No|No||MISSION PHARM.|No||||
prenatal81/iron/folic/docusate|No|No|No|No|75%|00178085890|CITRANATAL RX TABLET|90|EA|1.19816|02/27/2018|09/30/2022|Yes|No||02/27/2018|09/30/2022|Yes|No|02/27/2018|09/30/2022|Yes|No||||No|No|||Prescription required|No||243|No|2.68312|10/29/2019|2.61872|10/29/2019|2.63616|10/29/2019|||PRENATAL VITAMINS|2497|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MISSION PHARM.|No||||
PNV73/iron,gluc/folic/dss/dha|No|No|No|No|75%|00178089130|CITRANATAL ASSURE COMBO PACK|60|EA|.86651|05/29/2014||Yes|No||05/29/2014||Yes|No|05/29/2014||Yes|No||||No|No|||Prescription required|No||243|No|1.94141|10/29/2019|1.89481|10/29/2019|1.90743|10/29/2019|||PRENATAL VITAMINS|2498|||||No|No||MISSION PHARM.|No||||
PNV 76/iron,gluc/folic/dss/dha|No|No|No|No|75%|00178089430|CITRANATAL DHA PACK|60|EA|.82674|02/27/2018|10/31/2023|Yes|No||02/27/2018|10/31/2023|Yes|No|02/27/2018|10/31/2023|Yes|No||||No|No|||Prescription required|Yes|07/30/2020|243|No|1.846|06/23/2020|1.80169|06/23/2020|1.81369|06/23/2020|||PRENATAL VITAMINS|2499|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MISSION PHARM.|No||||
tiopronin|No|No|No|No|75%|00178090001|THIOLA 100 MG TABLET|100|EA|12.12995|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|27.64501|06/01/2016|27.25008|06/01/2016|25.95246|06/01/2016||||2500|||||No|No||RETROPHIN, INC.|No||||
tiopronin|No|No|No|No|75%|00178090190|THIOLA EC 300 MG TABLET|90|EA|36.38984|11/20/2019||Yes|No||11/20/2019||Yes|No|11/20/2019||Yes|No||||No|No|||Prescription required|No|||No|82.93499|11/20/2019|81.75021|11/20/2019|77.85734|11/20/2019||||2501|||||No|No||RETROPHIN, INC.|No||||
tiopronin|No|No|No|No|75%|00178090201|THIOLA EC 100 MG TABLET|300|EA|12.12995|11/20/2019||Yes|No||11/20/2019||Yes|No|11/20/2019||Yes|No||||No|No|||Prescription required|No|||No|27.64501|11/20/2019|27.25008|11/20/2019|25.95246|11/20/2019||||2502|||||No|No||RETROPHIN, INC.|No||||
labetalol HCl|No|No|No|No|75%|00185001001|LABETALOL HCL 100 MG TABLET|100|EA|.17647|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.12868|03/29/2022|.12559|03/29/2022|.12642|03/29/2022|||BETA-BLOCKERS|2503|||||No|No||SANDOZ|No||||
labetalol HCl|No|No|No|No|75%|00185001005|LABETALOL HCL 100 MG TABLET|500|EA|.16743|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.12868|03/29/2022|.12559|03/29/2022|.12642|03/29/2022|||BETA-BLOCKERS|2504|||||No|No||SANDOZ|No||||
orphenadrine citrate|No|No|No|No|75%|00185002201|ORPHENADRINE ER 100 MG TABLET|100|EA|.40226|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|116|Yes|.33346|03/29/2022|.32545|03/29/2022|.32762|03/29/2022|||SKELETAL MUSCLE RELAXANTS|2505|||||No|No||SANDOZ|No||||
orphenadrine citrate|No|No|No|No|75%|00185002210|ORPHENADRINE ER 100 MG TABLET|1000|EA|.39019|03/01/2002|02/11/2022|Yes|No||03/01/2002|02/11/2022|Yes|No|03/01/2002|02/11/2022|Yes|No||||No|No|||Prescription required|Yes|01/25/2012|116|Yes|.33346|03/29/2022|.32545|03/29/2022|.32762|03/29/2022|||SKELETAL MUSCLE RELAXANTS|2506|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||SANDOZ|No||||
naltrexone HCl|No|No|No|No|75%|00185003901|NALTREXONE 50 MG TABLET|100|EA|1.10299|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||145|No|.75734|03/29/2022|.73916|03/29/2022|.74408|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|2507|||||No|No||SANDOZ|Yes|09/01/2020|||
metolazone|No|No|No|No|75%|00185005501|METOLAZONE 5 MG TABLET|100|EA|.81033|08/24/2004||Yes|No||08/24/2004||Yes|No|08/24/2004||Yes|No||08/24/2004||Yes|No|||Prescription required|No|||No|.77158|03/29/2022|.75306|03/29/2022|.75807|03/29/2022||||2508|||||No|No||SANDOZ|No||||
labetalol HCl|No|No|No|No|75%|00185011701|LABETALOL HCL 200 MG TABLET|100|EA|.25038|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.17218|03/29/2022|.16804|03/29/2022|.16916|03/29/2022|||BETA-BLOCKERS|2509|||||No|No||SANDOZ|No||||
labetalol HCl|No|No|No|No|75%|00185011705|LABETALOL HCL 200 MG TABLET|500|EA|.2379|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.17218|03/29/2022|.16804|03/29/2022|.16916|03/29/2022|||BETA-BLOCKERS|2510|||||No|No||SANDOZ|No||||
labetalol HCl|No|No|No|No|75%|00185011801|LABETALOL HCL 300 MG TABLET|100|EA|.33307|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.21583|03/29/2022|.21065|03/29/2022|.21205|03/29/2022|||BETA-BLOCKERS|2511|||||No|No||SANDOZ|No||||
labetalol HCl|No|No|No|No|75%|00185011805|LABETALOL HCL 300 MG TABLET|500|EA|.33308|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.21583|03/29/2022|.21065|03/29/2022|.21205|03/29/2022|||BETA-BLOCKERS|2512|||||No|No||SANDOZ|No||||
nitrofurantoin monohyd/m-cryst|No|No|No|No|75%|00185012201|NITROFURANTOIN MONO-MCR 100 MG|100|EA|.67269|06/02/2005||Yes|No||06/02/2005||Yes|No|06/02/2005||Yes|No||06/02/2005||Yes|No|||Prescription required|No|||No|.48495|03/29/2022|.47331|03/29/2022|.47646|03/29/2022||||2513|||||No|No||SANDOZ|No||||
nitrofurantoin monohyd/m-cryst|No|No|No|No|75%|00185012210|NITROFURANTOIN MONO-MCR 100 MG|1000|EA|.67269|10/07/2016||Yes|No||10/07/2016||Yes|No|10/07/2016||Yes|No||10/07/2016||Yes|No|||Prescription required|No|||No|.48495|03/29/2022|.47331|03/29/2022|.47646|03/29/2022||||2514|||||No|No||SANDOZ|No||||
bumetanide|No|No|No|No|75%|00185012801|BUMETANIDE 0.5 MG TABLET|100|EA|.1935|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.20616|03/29/2022|.20121|03/29/2022|.20255|03/29/2022||||2515|||||No|No||SANDOZ|No||||
bumetanide|No|No|No|No|75%|00185012805|BUMETANIDE 0.5 MG TABLET|500|EA|.1935|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.20616|03/29/2022|.20121|03/29/2022|.20255|03/29/2022||||2516|||||No|No||SANDOZ|No||||
bumetanide|No|No|No|No|75%|00185012901|BUMETANIDE 1 MG TABLET|100|EA|.19504|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.21417|03/29/2022|.20902|03/29/2022|.21042|03/29/2022||||2517|||||No|No||SANDOZ|No||||
bumetanide|No|No|No|No|75%|00185012905|BUMETANIDE 1 MG TABLET|500|EA|.19504|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.21417|03/29/2022|.20902|03/29/2022|.21042|03/29/2022||||2518|||||No|No||SANDOZ|No||||
bumetanide|No|No|No|No|75%|00185013001|BUMETANIDE 2 MG TABLET|100|EA|.36184|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.40198|03/29/2022|.39233|03/29/2022|.39494|03/29/2022||||2519|||||No|No||SANDOZ|No||||
bumetanide|No|No|No|No|75%|00185013005|BUMETANIDE 2 MG TABLET|500|EA|.36184|05/11/2003||Yes|No||05/11/2003||Yes|No|05/11/2003||Yes|No||05/11/2003||Yes|No|||Prescription required|No|||No|.40198|03/29/2022|.39233|03/29/2022|.39494|03/29/2022||||2520|||||No|No||SANDOZ|No||||
oxaprozin|No|No|No|No|75%|00185014101|OXAPROZIN 600 MG TABLET|100|EA|.6302|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.63712|03/29/2022|.62182|03/29/2022|.62597|03/29/2022|||NSAIDS|2521|||||No|No||SANDOZ|No||||
benazepril/hydrochlorothiazide|No|No|No|No|75%|00185021101|BENAZEPRIL-HCTZ 20-12.5 MG TAB|100|EA|.38472|05/20/2004||Yes|No||05/20/2004||Yes|No|05/20/2004||Yes|No||05/20/2004||Yes|No|||Prescription required|Yes|07/27/2017|113|Yes|.60233|03/29/2022|.58787|03/29/2022|.59178|03/29/2022|||ANGIOTENSIN MODULATORS|2522|||||No|No||SANDOZ|No||||
benazepril/hydrochlorothiazide|No|No|No|No|75%|00185023601|BENAZEPRIL-HCTZ 5-6.25 MG TAB|100|EA|.38472|06/04/2015||Yes|No||06/04/2015||Yes|No|06/04/2015||Yes|No||06/04/2015||Yes|No|||Prescription required|Yes|07/27/2017|113|Yes|.8768|06/08/2021|.86428|06/08/2021|.82312|06/08/2021|||ANGIOTENSIN MODULATORS|2523|||||No|No||SANDOZ|No||||
benazepril/hydrochlorothiazide|No|No|No|No|75%|00185027701|BENAZEPRIL-HCTZ 20-25 MG TAB|100|EA|.38472|05/20/2004||Yes|No||05/20/2004||Yes|No|05/20/2004||Yes|No||05/20/2004||Yes|No|||Prescription required|Yes|07/27/2017|113|Yes|.5345|03/29/2022|.52167|03/29/2022|.52514|03/29/2022|||ANGIOTENSIN MODULATORS|2524|||||No|No||SANDOZ|No||||
benazepril/hydrochlorothiazide|No|No|No|No|75%|00185032501|BENAZEPRIL-HCTZ 10-12.5 MG TAB|100|EA|.38472|12/03/2014||Yes|No||12/03/2014||Yes|No|12/03/2014||Yes|No||12/03/2014||Yes|No|||Prescription required|Yes|07/27/2017|113|Yes|.40705|03/29/2022|.39728|03/29/2022|.39992|03/29/2022|||ANGIOTENSIN MODULATORS|2525|||||No|No||SANDOZ|No||||
bupropion HCl|Yes|No|No|No|75%|00185041001|BUPROPION HCL SR 100 MG TABLET|100|EA|.19315|06/17/2010||Yes|No||06/17/2010||Yes|No|06/17/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.11271|03/29/2022|.11|03/29/2022|.11073|03/29/2022|||ANTIDEPRESSANTS: OTHER|2526|||||No|No||SANDOZ|No||||
bupropion HCl|Yes|No|No|No|75%|00185041005|BUPROPION HCL SR 100 MG TABLET|500|EA|.19313|02/24/2004||Yes|No||02/24/2004||Yes|No|02/24/2004||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.11271|03/29/2022|.11|03/29/2022|.11073|03/29/2022|||ANTIDEPRESSANTS: OTHER|2527|||||No|No||SANDOZ|No||||
bupropion HCl|Yes|No|No|No|75%|00185041060|BUPROPION HCL SR 100 MG TABLET|60|EA|.29053|02/24/2004||Yes|No||02/24/2004||Yes|No|02/24/2004||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.11271|03/29/2022|.11|03/29/2022|.11073|03/29/2022|||ANTIDEPRESSANTS: OTHER|2528|||||No|No||SANDOZ|No||||
bupropion HCl|Yes|No|No|No|75%|00185041501|BUPROPION HCL SR 150 MG TABLET|100|EA|.1935|08/23/2011||Yes|No||08/23/2011||Yes|No|08/23/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.10128|03/29/2022|.09884|03/29/2022|.0995|03/29/2022|||ANTIDEPRESSANTS: OTHER|2529|||||No|No||SANDOZ|No||||
bupropion HCl|Yes|No|No|No|75%|00185041505|BUPROPION HCL SR 150 MG TABLET|500|EA|.1935|03/30/2004||Yes|No||03/30/2004||Yes|No|03/30/2004||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.10128|03/29/2022|.09884|03/29/2022|.0995|03/29/2022|||ANTIDEPRESSANTS: OTHER|2530|||||No|No||SANDOZ|No||||
bupropion HCl|No|No|No|No|75%|00185041552|BUPROPION HCL SR 150 MG TABLET|250|EA|.1935|10/11/2016||Yes|No||10/11/2016||Yes|No|10/11/2016||Yes|No||||No|No|||Prescription required|No||031|No|.10128|03/29/2022|.09884|03/29/2022|.0995|03/29/2022|||ANTIDEPRESSANTS: OTHER|2531|||||No|No||SANDOZ|No||||
bupropion HCl|Yes|No|No|No|75%|00185041560|BUPROPION HCL SR 150 MG TABLET|60|EA|.1935|03/30/2004||Yes|No||03/30/2004||Yes|No|03/30/2004||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.10128|03/29/2022|.09884|03/29/2022|.0995|03/29/2022|||ANTIDEPRESSANTS: OTHER|2532|||||No|No||SANDOZ|No||||
metaxalone|No|No|No|No|75%|00185044801|METAXALONE 800 MG TABLET|100|EA|1.75259|02/26/2016||Yes|No||02/26/2016||Yes|No|02/26/2016||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|116|Yes|.52754|03/29/2022|.51487|03/29/2022|.5183|03/29/2022|||SKELETAL MUSCLE RELAXANTS|2533|||||No|No||SANDOZ|No||||
hydroxyzine pamoate|No|No|No|No|75%|00185061501|HYDROXYZINE PAM 50 MG CAP|100|EA|.04506|03/01/2002|09/13/2022|Yes|No||03/01/2002|09/13/2022|Yes|No|03/01/2002|09/13/2022|Yes|No||03/01/2002|09/13/2022|Yes|No|||Prescription required|No||574|Yes|.09227|03/29/2022|.09005|03/29/2022|.09065|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|2534|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||SANDOZ|No||||
hydroxyzine pamoate|No|No|No|No|75%|00185061505|HYDROXYZINE PAM 50 MG CAP|500|EA|.04371|03/01/2002|09/13/2022|Yes|No||03/01/2002|09/13/2022|Yes|No|03/01/2002|09/13/2022|Yes|No||03/01/2002|09/13/2022|Yes|No|||Prescription required|No||574|Yes|.09227|03/29/2022|.09005|03/29/2022|.09065|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|2535|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||SANDOZ|No||||
hydroxyzine pamoate|No|No|No|No|75%|00185067401|HYDROXYZINE PAM 25 MG CAP|100|EA|.03298|10/23/2014||Yes|No||10/23/2014||Yes|No|10/23/2014||Yes|No||10/23/2014||Yes|No|||Prescription required|No||574|Yes|.06792|03/29/2022|.06628|03/29/2022|.06673|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|2536|||||No|No||SANDOZ|No||||
hydroxyzine pamoate|No|No|No|No|75%|00185067405|HYDROXYZINE PAM 25 MG CAP|500|EA|.03199|10/23/2014||Yes|No||10/23/2014||Yes|No|10/23/2014||Yes|No||10/23/2014||Yes|No|||Prescription required|No||574|Yes|.06792|03/29/2022|.06628|03/29/2022|.06673|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|2537|||||No|No||SANDOZ|No||||
etodolac|No|No|No|No|75%|00185067501|ETODOLAC 400 MG TABLET|100|EA|.45537|10/07/2016||Yes|No||10/07/2016||Yes|No|10/07/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|.33513|03/29/2022|.32708|03/29/2022|.32926|03/29/2022|||NSAIDS|2538|||||No|No||SANDOZ|No||||
etodolac|No|No|No|No|75%|00185067510|ETODOLAC 400 MG TABLET|1000|EA|.42347|06/09/2016||Yes|No||06/09/2016||Yes|No|06/09/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|.33513|03/29/2022|.32708|03/29/2022|.32926|03/29/2022|||NSAIDS|2539|||||No|No||SANDOZ|No||||
hydroxyzine pamoate|No|No|No|No|75%|00185067601|HYDROXYZINE PAM 50 MG CAP|100|EA|.04506|02/01/2022||Yes|No||02/01/2022||Yes|No|02/01/2022||Yes|No||02/01/2022||Yes|No|||Prescription required|No||574|Yes|.09227|03/29/2022|.09005|03/29/2022|.09065|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|2540|||||No|No||SANDOZ|No||||
hydroxyzine pamoate|No|No|No|No|75%|00185067605|HYDROXYZINE PAM 50 MG CAP|500|EA|.04371|02/01/2022||Yes|No||02/01/2022||Yes|No|02/01/2022||Yes|No||02/01/2022||Yes|No|||Prescription required|No||574|Yes|.09227|03/29/2022|.09005|03/29/2022|.09065|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|2541|||||No|No||SANDOZ|No||||
etodolac|No|No|No|No|75%|00185068701|ETODOLAC 500 MG TABLET|100|EA|.48375|07/06/2015||Yes|No||07/06/2015||Yes|No|07/06/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|.34546|03/29/2022|.33716|03/29/2022|.33941|03/29/2022|||NSAIDS|2542|||||No|No||SANDOZ|No||||
sulfadiazine|No|No|No|No|75%|00185075701|SULFADIAZINE 500 MG TABLET|100|EA|1.73629|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|3.95714|09/18/2018|3.90061|09/18/2018|3.71486|09/18/2018||||2543|||||No|No||SANDOZ|No||||
rifampin|No|No|No|No|75%|00185079901|RIFAMPIN 300 MG CAPSULE|100|EA|1.57956|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.95898|03/29/2022|.93596|03/29/2022|.94219|03/29/2022||||2544|||||No|No||SANDOZ|No||||
rifampin|No|No|No|No|75%|00185079905|RIFAMPIN 300 MG CAPSULE|500|EA|1.57954|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.95898|03/29/2022|.93596|03/29/2022|.94219|03/29/2022||||2545|||||No|No||SANDOZ|No||||
rifampin|No|No|No|No|75%|00185079930|RIFAMPIN 300 MG CAPSULE|30|EA|1.57953|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.95898|03/29/2022|.93596|03/29/2022|.94219|03/29/2022||||2546|||||No|No||SANDOZ|No||||
rifampin|No|No|No|No|75%|00185079960|RIFAMPIN 300 MG CAPSULE|60|EA|1.57953|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.95898|03/29/2022|.93596|03/29/2022|.94219|03/29/2022||||2547|||||No|No||SANDOZ|No||||
rifampin|No|No|No|No|75%|00185080101|RIFAMPIN 150 MG CAPSULE|100|EA|1.1152|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.77852|03/29/2022|.75983|03/29/2022|.76489|03/29/2022||||2548|||||No|No||SANDOZ|No||||
rifampin|No|No|No|No|75%|00185080130|RIFAMPIN 150 MG CAPSULE|30|EA|1.11527|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.77852|03/29/2022|.75983|03/29/2022|.76489|03/29/2022||||2549|||||No|No||SANDOZ|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00185083101|DEXTROAMP-AMPHETAMINE 5 MG TAB|100|EA|.1603|10/07/2016|12/08/2022|Yes|No||10/07/2016|12/08/2022|Yes|No|10/07/2016|12/08/2022|Yes|No||||No|No|||Prescription required|No||007|Yes|.21985|03/29/2022|.21457|03/29/2022|.216|03/29/2022|||STIMULANTS AND RELATED AGENTS|2550|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||SANDOZ|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00185084201|DEXTROAMP-AMPHETAMIN 10 MG TAB|100|EA|.1603|10/07/2016||Yes|No||10/07/2016||Yes|No|10/07/2016||Yes|No||||No|No|||Prescription required|No||007|Yes|.24071|03/29/2022|.23493|03/29/2022|.23649|03/29/2022|||STIMULANTS AND RELATED AGENTS|2551|||||No|No||SANDOZ|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00185085301|DEXTROAMP-AMPHETAMIN 20 MG TAB|100|EA|.1603|10/07/2016||Yes|No||10/07/2016||Yes|No|10/07/2016||Yes|No||||No|No|||Prescription required|No||007|Yes|.31357|03/29/2022|.30604|03/29/2022|.30808|03/29/2022|||STIMULANTS AND RELATED AGENTS|2552|||||No|No||SANDOZ|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00185086401|DEXTROAMP-AMPHETAMIN 30 MG TAB|100|EA|.1603|10/07/2016|11/16/2022|Yes|No||10/07/2016|11/16/2022|Yes|No|10/07/2016|11/16/2022|Yes|No||||No|No|||Prescription required|No||007|Yes|.30925|03/29/2022|.30182|03/29/2022|.30383|03/29/2022|||STIMULANTS AND RELATED AGENTS|2553|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||SANDOZ|No||||
cholestyramine/aspartame|No|No|No|No|75%|00185093997|CHOLESTYRAMINE LIGHT POWDER|239.4|GM|.1145|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||055|No|.23643|01/25/2022|.23075|01/25/2022|.23229|01/25/2022|||LIPOTROPICS: OTHER|2554|||||No|No||SANDOZ|No||||
cholestyramine/aspartame|No|No|No|No|75%|00185093998|CHOLESTYRAMINE LIGHT PACKET|60|EA|.88171|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||055|No|1.2151|03/29/2022|1.18593|03/29/2022|1.19383|03/29/2022|||LIPOTROPICS: OTHER|2555|||||No|No||SANDOZ|No||||
cholestyramine (with sugar)|No|No|No|No|75%|00185094097|CHOLESTYRAMINE POWDER|378|GM|.11932|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||055|No|.14958|03/29/2022|.14599|03/29/2022|.14696|03/29/2022|||LIPOTROPICS: OTHER|2556|||||No|No||SANDOZ|No||||
cholestyramine (with sugar)|No|No|No|No|75%|00185094098|CHOLESTYRAMINE PACKET|60|EA|.88171|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||055|No|1.02853|03/29/2022|1.00384|03/29/2022|1.01053|03/29/2022|||LIPOTROPICS: OTHER|2557|||||No|No||SANDOZ|No||||
quinidine sulfate|No|No|No|No|75%|00185104701|QUINIDINE SULFATE 300 MG TAB|100|EA|.19633|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.44746|06/27/2017|.44107|06/27/2017|.42007|06/27/2017||||2558|||||No|No||SANDOZ|No||||
quinidine sulfate|No|No|No|No|75%|00185104710|QUINIDINE SULFATE 300 MG TAB|1000|EA|.18259|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.41614|06/27/2017|.4102|06/27/2017|.39066|06/27/2017||||2559|||||No|No||SANDOZ|No||||
bupropion HCl|Yes|No|No|No|75%|00185111160|BUPROPION HCL SR 200 MG TABLET|60|EA|.58716|07/07/2005||Yes|No||07/07/2005||Yes|No|07/07/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.16014|03/29/2022|.15629|03/29/2022|.15733|03/29/2022|||ANTIDEPRESSANTS: OTHER|2560|||||No|No||SANDOZ|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00185209801|DEXTROAMP-AMPHETAMINE 5 MG TAB|100|EA|.1603|03/30/2022||Yes|No||03/30/2022||Yes|No|03/30/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.36534|03/30/2022|.36012|03/30/2022|.34297|03/30/2022|||STIMULANTS AND RELATED AGENTS|2561|||||No|No||SANDOZ|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00185209901|DEXTROAMP-AMPHETAMIN 30 MG TAB|100|EA|.1603|03/30/2022||Yes|No||03/30/2022||Yes|No|03/30/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.36534|03/30/2022|.36012|03/30/2022|.34297|03/30/2022|||STIMULANTS AND RELATED AGENTS|2562|||||No|No||SANDOZ|No||||
quinidine sulfate|No|No|No|No|75%|00185434601|QUINIDINE SULFATE 200 MG TAB|100|EA|.10599|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.1705|12/28/2021|.1664|12/28/2021|.16751|12/28/2021||||2563|||||No|No||SANDOZ|No||||
metolazone|No|No|No|No|75%|00185505001|METOLAZONE 2.5 MG TABLET|100|EA|.71315|08/24/2004||Yes|No||08/24/2004||Yes|No|08/24/2004||Yes|No||08/24/2004||Yes|No|||Prescription required|No|||No|.75368|03/29/2022|.73559|03/29/2022|.74049|03/29/2022||||2564|||||No|No||SANDOZ|No||||
eplerenone|No|No|No|No|75%|00185536809|EPLERENONE 25 MG TABLET|90|EA|1.49281|04/06/2010||Yes|No||04/06/2010||Yes|No|04/06/2010||Yes|No||||No|No|||Prescription required|No|||No|.73164|03/29/2022|.71408|03/29/2022|.71883|03/29/2022||||2565|||||No|No||SANDOZ|No||||
eplerenone|No|No|No|No|75%|00185536830|EPLERENONE 25 MG TABLET|30|EA|1.49267|04/06/2010||Yes|No||04/06/2010||Yes|No|04/06/2010||Yes|No||||No|No|||Prescription required|No|||No|.73164|03/29/2022|.71408|03/29/2022|.71883|03/29/2022||||2566|||||No|No||SANDOZ|No||||
eplerenone|No|No|No|No|75%|00185536909|EPLERENONE 50 MG TABLET|90|EA|1.49281|04/06/2010||Yes|No||04/06/2010||Yes|No|04/06/2010||Yes|No||||No|No|||Prescription required|No|||No|.85922|03/29/2022|.83859|03/29/2022|.84418|03/29/2022||||2567|||||No|No||SANDOZ|No||||
eplerenone|No|No|No|No|75%|00185536930|EPLERENONE 50 MG TABLET|30|EA|1.49281|04/06/2010||Yes|No||04/06/2010||Yes|No|04/06/2010||Yes|No||||No|No|||Prescription required|No|||No|.85922|03/29/2022|.83859|03/29/2022|.84418|03/29/2022||||2568|||||No|No||SANDOZ|No||||
metolazone|No|No|No|No|75%|00185560001|METOLAZONE 10 MG TABLET|100|EA|.97046|08/24/2004||Yes|No||08/24/2004||Yes|No|08/24/2004||Yes|No||08/24/2004||Yes|No|||Prescription required|No|||No|1.18747|03/01/2022|1.15897|03/01/2022|1.16668|03/01/2022||||2569|||||No|No||SANDOZ|No||||
budesonide/formoterol fumarate|No|No|No|No|75%|00186037020|SYMBICORT 160-4.5 MCG INHALER|10.2|GM|15.98166|06/25/2007||Yes|No||06/25/2007||Yes|No|06/25/2007||Yes|No||||No|No|||Prescription required|No||033|Yes|35.6911|01/18/2022|34.83451|01/18/2022|35.0665|01/18/2022|||GLUCOCORTICOIDS: INHALED|2570|||||No|No||ASTRAZENECA|No||||
budesonide/formoterol fumarate|No|No|No|No|75%|00186037220|SYMBICORT 80-4.5 MCG INHALER|10.2|GM|13.98174|06/25/2007||Yes|No||06/25/2007||Yes|No|06/25/2007||Yes|No||||No|No|||Prescription required|No||033|Yes|31.17623|01/18/2022|30.428|01/18/2022|30.63064|01/18/2022|||GLUCOCORTICOIDS: INHALED|2571|||||No|No||ASTRAZENECA|No||||
esomeprazole magnesium|No|No|No|No|75%|00186038230|ESOMEPRAZOLE MAG DR 20 MG CAP|30|EA|.3665|01/25/2018|02/01/2022|Yes|No||01/25/2018|02/01/2022|Yes|No|01/25/2018|02/01/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|Yes|.83528|02/15/2022|.82335|02/15/2022|.78414|02/15/2022|||PROTON PUMP INHIBITORS|2572|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ASTRAZENECA LP/|No||||
esomeprazole magnesium|No|No|No|No|75%|00186038290|ESOMEPRAZOLE MAG DR 20 MG CAP|90|EA|.3665|01/25/2018||Yes|No||01/25/2018||Yes|No|01/25/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|2573|||||No|No||ASTRAZENECA LP/|No||||
esomeprazole magnesium|No|No|No|No|75%|00186038430|ESOMEPRAZOLE MAG DR 40 MG CAP|30|EA|.3665|01/25/2018||Yes|No||01/25/2018||Yes|No|01/25/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|2574|||||No|No||ASTRAZENECA LP/|No||||
esomeprazole magnesium|No|No|No|No|75%|00186038490|ESOMEPRAZOLE MAG DR 40 MG CAP|90|EA|.3665|01/25/2018||Yes|No||01/25/2018||Yes|No|01/25/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|2575|||||No|No||ASTRAZENECA LP/|No||||
ticagrelor|No|No|No|No|75%|00186077660|BRILINTA 60 MG TABLET|60|EA|3.04805|07/13/2016||Yes|No||07/13/2016||Yes|No|07/13/2016||Yes|No||||No|No|||Prescription required|No||004|No|6.80617|01/18/2022|6.64282|01/18/2022|6.68706|01/18/2022|||PLATELET AGGREGATION INHIBITORS|2576|||||No|No||ASTRAZENECA|No||||
ticagrelor|No|No|No|No|75%|00186077760|BRILINTA 90 MG TABLET|60|EA|3.04805|09/05/2011||Yes|No||09/05/2011||Yes|No|09/05/2011||Yes|No||||No|No|||Prescription required|No||004|No|6.79483|01/18/2022|6.63175|01/18/2022|6.67592|01/18/2022|||PLATELET AGGREGATION INHIBITORS|2577|||||No|No||ASTRAZENECA|No||||
budesonide|No|No|No|No|75%|00186091612|PULMICORT 180 MCG FLEXHALER|1|EA|110.4627|06/07/2007||Yes|No||06/07/2007||Yes|No|06/07/2007||Yes|No||||No|No|||Prescription required|Yes|09/18/2020|033|Yes|246.32443|12/21/2021|240.41264|12/21/2021|242.01375|12/21/2021|||GLUCOCORTICOIDS: INHALED|2578|||||No|No||ASTRAZENECA|No||||
budesonide|No|No|No|No|75%|00186091706|PULMICORT 90 MCG FLEXHALER|1|EA|82.4912|05/02/2007||Yes|No||05/02/2007||Yes|No|05/02/2007||Yes|No||||No|No|||Prescription required|Yes|09/18/2020|033|Yes|184.12821|12/21/2021|179.70913|12/21/2021|180.90596|12/21/2021|||GLUCOCORTICOIDS: INHALED|2579|||||No|No||ASTRAZENECA|No||||
budesonide|No|No|No|No|75%|00186198804|PULMICORT 0.25 MG/2 ML RESPUL|2|ML|1.87379|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|033|Yes|4.2705|03/01/2022|4.20949|03/01/2022|4.00904|03/01/2022|||GLUCOCORTICOIDS: INHALED|2580|||||No|No||ASTRAZENECA|No||||
budesonide|No|No|No|No|75%|00186198904|PULMICORT 0.5 MG/2 ML RESPULE|2|ML|2.20532|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|033|Yes|4.92456|10/26/2021|4.80637|10/26/2021|4.83838|10/26/2021|||GLUCOCORTICOIDS: INHALED|2581|||||No|No||ASTRAZENECA|No||||
budesonide|No|No|No|No|75%|00186199004|PULMICORT 1 MG/2 ML RESPULE|2|ML|4.41094|10/25/2007||Yes|No||10/25/2007||Yes|No|10/25/2007||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|033|Yes|10.05284|07/28/2020|9.90922|07/28/2020|9.43736|07/28/2020|||GLUCOCORTICOIDS: INHALED|2582|||||No|No||ASTRAZENECA|No||||
esomeprazole magnesium|No|No|No|No|75%|00186401001|NEXIUM DR 10 MG PACKET|30|EA|4.11768|08/31/2009||Yes|No||08/31/2009||Yes|No|08/31/2009||Yes|No||||No|No|||Prescription required|No||047|No|9.25637|03/01/2022|9.03421|03/01/2022|9.09438|03/01/2022|||PROTON PUMP INHIBITORS|2583|||||No|No||ASTRAZENECA|No||||
esomeprazole magnesium|No|No|No|No|75%|00186402001|NEXIUM DR 20 MG PACKET|30|EA|4.11768|08/31/2009||Yes|No||08/31/2009||Yes|No|08/31/2009||Yes|No||||No|No|||Prescription required|No||047|No|9.21621|12/28/2021|8.99502|12/28/2021|9.05492|12/28/2021|||PROTON PUMP INHIBITORS|2584|||||No|No||ASTRAZENECA|No||||
esomeprazole magnesium|No|No|No|No|75%|00186402501|NEXIUM DR 2.5 MG PACKET|30|EA|4.11768|08/06/2014||Yes|No||08/06/2014||Yes|No|08/06/2014||Yes|No||||No|No|||Prescription required|No||047|No|9.16613|03/01/2022|8.94614|03/01/2022|9.00572|03/01/2022|||PROTON PUMP INHIBITORS|2585|||||No|No||ASTRAZENECA|No||||
esomeprazole magnesium|No|No|No|No|75%|00186404001|NEXIUM DR 40 MG PACKET|30|EA|4.11768|08/31/2009||Yes|No||08/31/2009||Yes|No|08/31/2009||Yes|No||||No|No|||Prescription required|No||047|No|9.13473|09/28/2021|8.91549|09/28/2021|8.97487|09/28/2021|||PROTON PUMP INHIBITORS|2586|||||No|No||ASTRAZENECA|No||||
esomeprazole magnesium|No|No|No|No|75%|00186405001|NEXIUM DR 5 MG PACKET|30|EA|4.11768|08/06/2014||Yes|No||08/06/2014||Yes|No|08/06/2014||Yes|No||||No|No|||Prescription required|No||047|No|9.20087|12/28/2021|8.98004|12/28/2021|9.03985|12/28/2021|||PROTON PUMP INHIBITORS|2587|||||No|No||ASTRAZENECA|No||||
esomeprazole magnesium|No|No|No|No|75%|00186502031|NEXIUM DR 20 MG CAPSULE|30|EA|3.94611|08/31/2009||Yes|No||08/31/2009||Yes|No|08/31/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|Yes|8.825|12/28/2021|8.6132|12/28/2021|8.67056|12/28/2021|||PROTON PUMP INHIBITORS|2588|||||No|No||ASTRAZENECA|No||||
esomeprazole magnesium|No|No|No|No|75%|00186502054|NEXIUM DR 20 MG CAPSULE|90|EA|3.94591|08/31/2009||Yes|No||08/31/2009||Yes|No|08/31/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|Yes|8.825|12/28/2021|8.6132|12/28/2021|8.67056|12/28/2021|||PROTON PUMP INHIBITORS|2589|||||No|No||ASTRAZENECA|No||||
esomeprazole magnesium|No|No|No|No|75%|00186504031|NEXIUM DR 40 MG CAPSULE|30|EA|3.94611|08/31/2009||Yes|No||08/31/2009||Yes|No|08/31/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|8.80528|10/26/2021|8.59395|10/26/2021|8.65118|10/26/2021|||PROTON PUMP INHIBITORS|2590|||||No|No||ASTRAZENECA|No||||
esomeprazole magnesium|No|No|No|No|75%|00186504054|NEXIUM DR 40 MG CAPSULE|90|EA|3.94591|08/31/2009||Yes|No||08/31/2009||Yes|No|08/31/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|8.80528|10/26/2021|8.59395|10/26/2021|8.65118|10/26/2021|||PROTON PUMP INHIBITORS|2591|||||No|No||ASTRAZENECA|No||||
halobetasol propionate|No|No|No|No|75%|00187000201|BRYHALI 0.01% LOTION|100|GM|2.04856|03/04/2019||Yes|No||03/04/2019||Yes|No|03/04/2019||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|121|No|4.5513|01/18/2022|4.44206|01/18/2022|4.47165|01/18/2022|||STEROIDS: TOPICAL VERY HIGH|2592|||||No|No||BAUSCH HEALTH U|No||||
halobetasol propionate|No|No|No|No|75%|00187000260|BRYHALI 0.01% LOTION|60|GM|2.04852|03/04/2019||Yes|No||03/04/2019||Yes|No|03/04/2019||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|121|No|4.57243|01/18/2022|4.46269|01/18/2022|4.49241|01/18/2022|||STEROIDS: TOPICAL VERY HIGH|2593|||||No|No||BAUSCH HEALTH U|No||||
brodalumab|No|No|No|No|75%|00187000402|SILIQ 210 MG/1.5 ML SYRINGE|1.5|ML|619.47663|07/09/2018||Yes|No||07/09/2018||Yes|No|07/09/2018||Yes|No||||No|No|||Prescription required|Yes|02/01/2018|071|Yes|1411.83046|01/11/2022|1391.66145|01/11/2022|1325.39186|01/11/2022|||CYTOKINE AND CAM ANTAGONISTS|2594|||||No|No||BAUSCH HEALTH U|No||||
tretinoin|No|No|No|No|75%|00187000520|ALTRENO 0.05% LOTION|20|GM|1.075|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|104|No|2.45|03/03/2020|2.415|03/03/2020|2.3|03/03/2020|||ACNE AGENTS: TOPICAL|2595|||||No|No||BAUSCH HEALTH U|No||||
tretinoin|No|No|No|No|75%|00187000545|ALTRENO 0.05% LOTION|45|GM|1.09888|05/16/2019||Yes|No||05/16/2019||Yes|No|05/16/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|104|No|2.44419|09/28/2021|2.38552|09/28/2021|2.40141|09/28/2021|||ACNE AGENTS: TOPICAL|2596|||||No|No||BAUSCH HEALTH U|No||||
enalapril maleate|No|No|No|No|75%|00187014090|VASOTEC 2.5 MG TABLET|90|EA|6.93604|01/15/2013||Yes|No||01/15/2013||Yes|No|01/15/2013||Yes|No||01/15/2013||Yes|No|||Prescription required|Yes|07/26/2012|113|No|15.80772|01/11/2022|15.58189|01/11/2022|14.8399|01/11/2022|||ANGIOTENSIN MODULATORS|2597|||||No|No||BAUSCH HEALTH U|No||||
enalapril/hydrochlorothiazide|No|No|No|No|75%|00187014601|VASERETIC 10-25 MG TABLET|100|EA|5.60505|01/15/2013||Yes|No||01/15/2013||Yes|No|01/15/2013||Yes|No||01/15/2013||Yes|No|||Prescription required|Yes|07/27/2011|113|Yes|12.7743|06/01/2016|12.59181|06/01/2016|11.9922|06/01/2016|||ANGIOTENSIN MODULATORS|2598|||||No|No||BAUSCH HEALTH U|No||||
dihydroergotamine mesylate|No|No|No|No|75%|00187024503|MIGRANAL NASAL SPRAY|1|ML|205.48248|03/30/2009||Yes|No||03/30/2009||Yes|No|03/30/2009||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|537|No|468.30892|01/26/2021|461.61879|01/26/2021|439.63695|01/26/2021|||ANTIMIGRAINE AGENTS: OTHER|2599|||||No|No||BAUSCH HEALTH U|No||||
selegiline HCl|No|No|No|No|75%|00187045302|ZELAPAR 1.25 MG ODT TABLET|60|EA|37.48316|09/21/2006||Yes|No||09/21/2006||Yes|No|09/21/2006||Yes|No||||No|No|||Prescription required|Yes|07/17/2007|015|No|85.42675|01/11/2022|84.20637|01/11/2022|80.19654|01/11/2022|||ANTIPARKINSON'S AGENTS|2600|||||No|No||BAUSCH HEALTH U|No||||
halobetasol propion/tazarotene|No|No|No|No|75%|00187065301|DUOBRII 0.01%-0.045% LOTION|100|GM|3.98597|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|||Prescription required|No|||No|8.92212|01/18/2022|8.70798|01/18/2022|8.76598|01/18/2022||||2601|||||No|No||BAUSCH HEALTH U|No||||
diazepam|No|No|No|No|75%|00187065820|DIASTAT ACUDIAL 5-7.5-10 MG KT|1|EA|150.8225|10/17/2005||Yes|No||10/17/2005||Yes|No|10/17/2005||Yes|No||||No|No|||Prescription required|No||056|Yes|336.01857|12/21/2021|327.95412|12/21/2021|330.13824|12/21/2021|||ANTICONVULSANTS|2602|||||No|No||BAUSCH HEALTH U|No||||
diazepam|No|No|No|No|75%|00187065920|DIASTAT ACUDIAL 12.5-15-20 MG|1|EA|150.8225|10/17/2005||Yes|No||10/17/2005||Yes|No|10/17/2005||Yes|No||||No|No|||Prescription required|No||056|Yes|343.735|01/26/2021|338.8245|01/26/2021|322.69|01/26/2021|||ANTICONVULSANTS|2603|||||No|No||BAUSCH HEALTH U|No||||
bupropion HCl|No|No|No|No|75%|00187073030|WELLBUTRIN XL 150 MG TABLET|30|EA|24.52677|01/15/2013||Yes|No||01/15/2013||Yes|No|01/15/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|031|Yes|54.8349|01/18/2022|53.51886|01/18/2022|53.87528|01/18/2022|||ANTIDEPRESSANTS: OTHER|2604|||||No|No||BAUSCH HEALTH U|No||||
bupropion HCl|No|No|No|No|75%|00187073090|WELLBUTRIN XL 150 MG TABLET|90|EA|24.52824|01/15/2013||Yes|No||01/15/2013||Yes|No|01/15/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|031|Yes|54.8349|01/18/2022|53.51886|01/18/2022|53.87528|01/18/2022|||ANTIDEPRESSANTS: OTHER|2605|||||No|No||BAUSCH HEALTH U|No||||
bupropion HCl|No|No|No|No|75%|00187073130|WELLBUTRIN XL 300 MG TABLET|30|EA|32.37627|01/15/2013||Yes|No||01/15/2013||Yes|No|01/15/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|031|No|71.95396|01/18/2022|70.22706|01/18/2022|70.69476|01/18/2022|||ANTIDEPRESSANTS: OTHER|2606|||||No|No||BAUSCH HEALTH U|No||||
diltiazem HCl|No|No|No|No|75%|00187077247|CARDIZEM 60 MG TABLET|100|EA|4.31702|01/15/2013||Yes|No||01/15/2013||Yes|No|01/15/2013||Yes|No||01/15/2013||Yes|No|||Prescription required|Yes|07/27/2011|045|No|9.8388|06/01/2016|9.69825|06/01/2016|9.23643|06/01/2016|||CALCIUM CHANNEL BLOCKERS|2607|||||No|No||BAUSCH HEALTH U|No||||
diltiazem HCl|No|No|No|No|75%|00187079247|CARDIZEM 120 MG TABLET|100|EA|7.9467|01/15/2013||Yes|No||01/15/2013||Yes|No|01/15/2013||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|045|No|18.11108|06/01/2016|17.85235|06/01/2016|17.00224|06/01/2016|||CALCIUM CHANNEL BLOCKERS|2608|||||No|No||BAUSCH HEALTH U|No||||
diltiazem HCl|No|No|No|No|75%|00187079530|CARDIZEM CD 120 MG CAPSULE|30|EA|12.23493|01/15/2013||Yes|No||01/15/2013||Yes|No|01/15/2013||Yes|No||01/15/2013||Yes|No|||Prescription required|Yes|07/27/2011|045|No|27.88426|01/11/2022|27.48591|01/11/2022|26.17706|01/11/2022|||CALCIUM CHANNEL BLOCKERS|2609|||||No|No||BAUSCH HEALTH U|No||||
diltiazem HCl|No|No|No|No|75%|00187079630|CARDIZEM CD 180 MG CAPSULE|30|EA|15.43327|01/15/2013||Yes|No||01/15/2013||Yes|No|01/15/2013||Yes|No||01/15/2013||Yes|No|||Prescription required|Yes|07/27/2011|045|No|35.1735|01/11/2022|34.67102|01/11/2022|33.02002|01/11/2022|||CALCIUM CHANNEL BLOCKERS|2610|||||No|No||BAUSCH HEALTH U|No||||
diltiazem HCl|No|No|No|No|75%|00187079642|CARDIZEM CD 180 MG CAPSULE|90|EA|14.73151|01/15/2013||Yes|No||01/15/2013||Yes|No|01/15/2013||Yes|No||01/15/2013||Yes|No|||Prescription required|Yes|07/27/2011|045|No|33.57414|01/11/2022|33.09451|01/11/2022|31.51858|01/11/2022|||CALCIUM CHANNEL BLOCKERS|2611|||||No|No||BAUSCH HEALTH U|No||||
diltiazem HCl|No|No|No|No|75%|00187079730|CARDIZEM CD 240 MG CAPSULE|30|EA|20.92294|01/15/2013||Yes|No||01/15/2013||Yes|No|01/15/2013||Yes|No||01/15/2013||Yes|No|||Prescription required|Yes|07/27/2011|045|No|47.68484|01/11/2022|47.00362|01/11/2022|44.76536|01/11/2022|||CALCIUM CHANNEL BLOCKERS|2612|||||No|No||BAUSCH HEALTH U|No||||
diltiazem HCl|No|No|No|No|75%|00187079742|CARDIZEM CD 240 MG CAPSULE|90|EA|20.89823|01/15/2013||Yes|No||01/15/2013||Yes|No|01/15/2013||Yes|No||01/15/2013||Yes|No|||Prescription required|Yes|07/27/2011|045|No|47.62853|01/11/2022|46.94813|01/11/2022|44.7125|01/11/2022|||CALCIUM CHANNEL BLOCKERS|2613|||||No|No||BAUSCH HEALTH U|No||||
diltiazem HCl|No|No|No|No|75%|00187079830|CARDIZEM CD 300 MG CAPSULE|30|EA|27.40633|07/13/2012||Yes|No||07/13/2012||Yes|No|07/13/2012||Yes|No||07/13/2012||Yes|No|||Prescription required|Yes|07/27/2011|045|No|62.46094|01/11/2022|61.56864|01/11/2022|58.6368|01/11/2022|||CALCIUM CHANNEL BLOCKERS|2614|||||No|No||BAUSCH HEALTH U|No||||
diltiazem HCl|No|No|No|No|75%|00187079942|CARDIZEM CD 360 MG CAPSULE|90|EA|39.98613|01/15/2013||Yes|No||01/15/2013||Yes|No|01/15/2013||Yes|No||01/15/2013||Yes|No|||Prescription required|Yes|07/27/2011|045|No|91.13118|01/11/2022|89.8293|01/11/2022|85.55172|01/11/2022|||CALCIUM CHANNEL BLOCKERS|2615|||||No|No||BAUSCH HEALTH U|No||||
tolcapone|No|No|No|No|75%|00187093801|TASMAR 100 MG TABLET|90|EA|50.97157|03/01/2005||Yes|No||03/01/2005||Yes|No|||No|No||||No|No|||Prescription required|Yes|06/09/2004|015|No|116.16777|01/17/2017|114.50823|01/17/2017|109.05546|01/17/2017|||ANTIPARKINSON'S AGENTS|2616|||||No|No||BAUSCH HEALTH U|No||||
acyclovir|No|No|No|No|75%|00187099395|ZOVIRAX 5% OINTMENT|30|GM|2.15|11/12/2012||Yes|No||11/12/2012||Yes|No|11/12/2012||Yes|No||||No|No|||Prescription required|No||123|No|4.9|12/22/2020|4.83|12/22/2020|4.6|12/22/2020|||ANTIVIRALS: TOPICAL|2617|||||No|No||BAUSCH HEALTH U|No||||
acyclovir|No|No|No|No|75%|00187099445|ZOVIRAX 5% CREAM|5|GM|17.2|11/12/2012||Yes|No||11/12/2012||Yes|No|11/12/2012||Yes|No||||No|No|||Prescription required|No||123|No|38.24|12/28/2021|37.32224|12/28/2021|37.5708|12/28/2021|||ANTIVIRALS: TOPICAL|2618|||||No|No||BAUSCH HEALTH U|No||||
phytonadione (vit K1)|No|No|No|No|75%|00187170405|MEPHYTON 5 MG TABLET|100|EA|25.26684|09/05/2013||Yes|No||09/05/2013||Yes|No|09/05/2013||Yes|No||||No|No|||Prescription required|No|||No|57.58489|05/28/2019|56.76225|05/28/2019|54.05929|05/28/2019||||2619|||||No|No||BAUSCH HEALTH U|No||||
diltiazem HCl|No|No|No|No|75%|00187204690|CARDIZEM LA 180 MG TABLET|90|EA|1.72817|11/30/2015||Yes|No||11/30/2015||Yes|No|11/30/2015||Yes|No||11/30/2015||Yes|No|||Prescription required|Yes|01/22/2015|045|No|3.93862|06/01/2016|3.88235|06/01/2016|3.69748|06/01/2016|||CALCIUM CHANNEL BLOCKERS|2620|||||No|No||BAUSCH HEALTH U|No||||
tazarotene|No|No|No|No|75%|00187209845|ARAZLO 0.045% LOTION|45|GM|4.558|10/26/2020||Yes|No||10/26/2020||Yes|No|10/26/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|10.08775|01/18/2022|9.84564|01/18/2022|9.91121|01/18/2022|||ACNE AGENTS: TOPICAL|2621|||||No|No||BAUSCH HEALTH U|No||||
trientine HCl|No|No|No|No|75%|00187212010|SYPRINE 250 MG CAPSULE|100|EA|91.44724|11/30/2015||Yes|No||11/30/2015||Yes|No|11/30/2015||Yes|No||||No|No|||Prescription required|No|||No|208.41464|06/01/2016|205.43728|06/01/2016|195.65456|06/01/2016||||2622|||||No|No||BAUSCH HEALTH U|No||||
pyridostigmine bromide|No|No|No|No|75%|00187301030|MESTINON 60 MG TABLET|100|EA|7.95998|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|18.14136|01/11/2022|17.8822|01/11/2022|17.03067|01/11/2022||||2623|||||No|No||BAUSCH HEALTH U|No||||
pyridostigmine bromide|No|No|No|No|75%|00187301220|MESTINON 60 MG/5 ML SOLUTION|473|ML|1.3669|07/10/2002||Yes|No||07/10/2002||Yes|No|07/10/2002||Yes|No||||No|No|||Prescription required|No|||No|3.11527|01/11/2022|3.07076|01/11/2022|2.92454|01/11/2022||||2624|||||No|No||BAUSCH HEALTH U|No||||
pyridostigmine bromide|No|No|No|No|75%|00187301330|MESTINON 180 MG TIMESPAN|30|EA|15.09773|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|34.40878|01/11/2022|33.91722|01/11/2022|32.30212|01/11/2022||||2625|||||No|No||BAUSCH HEALTH U|No||||
fluorouracil|No|No|No|No|75%|00187320447|EFUDEX 5% CREAM|40|GM|.645|04/13/2009||Yes|No||04/13/2009||Yes|No|||No|No||||No|No|||Prescription required|No|||No|1.47|03/23/2021|1.449|03/23/2021|1.38|03/23/2021||||2626|||||No|No||BAUSCH HEALTH U|No||||
flucytosine|No|No|No|No|75%|00187355410|ANCOBON 250 MG CAPSULE|100|EA|33.04279|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|069|No|75.30682|06/01/2016|74.23101|06/01/2016|70.6962|06/01/2016|||ANTIFUNGALS: ORAL|2627|||||No|No||BAUSCH HEALTH U|No||||
flucytosine|No|No|No|No|75%|00187355510|ANCOBON 500 MG CAPSULE|100|EA|63.93833|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|069|No|145.71992|06/01/2016|143.63821|06/01/2016|136.79829|06/01/2016|||ANTIFUNGALS: ORAL|2628|||||No|No||BAUSCH HEALTH U|No||||
pimecrolimus|No|No|No|No|75%|00187510001|ELIDEL 1% CREAM|30|GM|4.28638|01/12/2012||Yes|No||01/12/2012||Yes|No|01/12/2012||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|034|Yes|9.5953|06/29/2021|9.36501|06/29/2021|9.42738|06/29/2021|||IMMUNOMODULATORS: ATOPIC DERMATITIS|2629|||||No|No||BAUSCH HEALTH U|No||||
pimecrolimus|No|No|No|No|75%|00187510102|ELIDEL 1% CREAM|60|GM|4.28645|01/12/2012||Yes|No||01/12/2012||Yes|No|01/12/2012||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|034|Yes|9.54986|03/29/2022|9.32066|03/29/2022|9.38273|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|2630|||||No|No||BAUSCH HEALTH U|No||||
pimecrolimus|No|No|No|No|75%|00187510203|ELIDEL 1% CREAM|100|GM|4.28636|01/12/2012||Yes|No||01/12/2012||Yes|No|01/12/2012||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|034|Yes|9.57793|12/28/2021|9.34805|12/28/2021|9.41031|12/28/2021|||IMMUNOMODULATORS: ATOPIC DERMATITIS|2631|||||No|No||BAUSCH HEALTH U|No||||
acyclovir/hydrocortisone|No|No|No|No|75%|00187510401|XERESE 5%-1% CREAM|5|GM|105.67594|01/15/2013||Yes|No||01/15/2013||Yes|No|01/15/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|123|No|240.84284|01/16/2018|237.40222|01/16/2018|226.09736|01/16/2018|||ANTIVIRALS: TOPICAL|2632|||||No|No||BAUSCH HEALTH U|No||||
tretinoin microspheres|No|No|No|No|75%|00187514650|RETIN-A MICRO PUMP 0.06% GEL|50|GM|7.83743|02/20/2019||Yes|No||02/20/2019||Yes|No|02/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|104|No|17.43233|11/23/2021|17.01395|11/23/2021|17.12726|11/23/2021|||ACNE AGENTS: TOPICAL|2633|||||No|No||BAUSCH HEALTH U|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|00187519025|BENZACLIN GEL|25|GM|4.40887|08/15/2013|01/28/2023|Yes|No||08/15/2013|01/28/2023|Yes|No|08/15/2013|01/28/2023|Yes|No||||No|No|||Prescription required|Yes|07/17/2014|104|No|10.04813|05/29/2018|9.90459|05/29/2018|9.43294|05/29/2018|||ACNE AGENTS: TOPICAL|2634|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BAUSCH HEALTH U|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|00187519035|BENZACLIN GEL 35G PUMP|35|GM|4.4102|08/15/2013|01/28/2023|Yes|No||08/15/2013|01/28/2023|Yes|No|08/15/2013|01/28/2023|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|104|No|10.05115|08/29/2017|9.90756|08/29/2017|9.43577|08/29/2017|||ACNE AGENTS: TOPICAL|2635|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BAUSCH HEALTH U|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|00187519050|BENZACLIN GEL 50G PUMP|50|GM|3.76155|08/15/2013|01/28/2023|Yes|No||08/15/2013|01/28/2023|Yes|No|08/15/2013|01/28/2023|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|104|No|8.57284|03/26/2019|8.45037|03/26/2019|8.04797|03/26/2019|||ACNE AGENTS: TOPICAL|2636|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BAUSCH HEALTH U|No||||
efinaconazole|No|No|No|No|75%|00187540004|JUBLIA 10% TOPICAL SOLUTION|4|ML|73.3408|12/16/2016||Yes|No||12/16/2016||Yes|No|12/16/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|061|No|163.84031|01/18/2022|159.90814|01/18/2022|160.9731|01/18/2022|||ANTIFUNGALS: TOPICAL|2637|||||No|No||BAUSCH HEALTH U|No||||
bexarotene|No|No|No|No|75%|00187552675|TARGRETIN 75 MG CAPSULE|100|EA|106.96073|04/25/2014||Yes|No||04/25/2014||Yes|No|04/25/2014||Yes|No||||No|No|||Prescription required|No|||No|243.77098|06/01/2016|240.28853|06/01/2016|228.84622|06/01/2016||||2638|||||No|No||BAUSCH HEALTH U|No||||
bupropion HBr|No|No|No|No|75%|00187581030|APLENZIN ER 174 MG TABLET|30|EA|24.84196|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|031|No|55.47849|01/18/2022|54.147|01/18/2022|54.50761|01/18/2022|||ANTIDEPRESSANTS: OTHER|2639|||||No|No||BAUSCH HEALTH U|No||||
bupropion HBr|No|No|No|No|75%|00187581130|APLENZIN ER 348 MG TABLET|30|EA|32.74794|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|031|No|72.80553|01/18/2022|71.05819|01/18/2022|71.53143|01/18/2022|||ANTIDEPRESSANTS: OTHER|2640|||||No|No||BAUSCH HEALTH U|No||||
bupropion HBr|No|No|No|No|75%|00187581230|APLENZIN ER 522 MG TABLET|30|EA|74.52459|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|031|No|166.52061|01/18/2022|162.52411|01/18/2022|163.60649|01/18/2022|||ANTIDEPRESSANTS: OTHER|2641|||||No|No||BAUSCH HEALTH U|No||||
hyoscyamine sulfate|No|No|No|No|75%|00225029515|ANASPAZ 0.125 MG TABLET ODT|100|EA|.1075|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|.20067|03/29/2022|.19585|03/29/2022|.19715|03/29/2022||||2642|||||No|No||B.F ASCHER & CO|No||||
hyoscyamine sulfate|No|No|No|No|75%|00225029520|ANASPAZ 0.125 MG TABLET ODT|500|EA|.10535|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|.20067|03/29/2022|.19585|03/29/2022|.19715|03/29/2022||||2643|||||No|No||B.F ASCHER & CO|No||||
lamotrigine|No|No|No|No|75%|00228141003|LAMOTRIGINE ER 25 MG TABLET|30|EA|2.08564|06/28/2016||Yes|No||06/28/2016||Yes|No|06/28/2016||Yes|No||||No|No|||Prescription required|No||056|No|1.20872|03/01/2022|1.17971|03/01/2022|1.18756|03/01/2022|||ANTICONVULSANTS|2644|||||No|No||ACTAVIS/TEVA|No||||
lamotrigine|No|No|No|No|75%|00228142203|LAMOTRIGINE ER 100 MG TABLET|30|EA|4.4677|06/28/2016||Yes|No||06/28/2016||Yes|No|06/28/2016||Yes|No||||No|No|||Prescription required|No||056|No|1.51472|03/29/2022|1.47836|03/29/2022|1.48821|03/29/2022|||ANTICONVULSANTS|2645|||||No|No||ACTAVIS/TEVA|No||||
lamotrigine|No|No|No|No|75%|00228143503|LAMOTRIGINE ER 50 MG TABLET|30|EA|4.17085|06/28/2016||Yes|No||06/28/2016||Yes|No|06/28/2016||Yes|No||||No|No|||Prescription required|No||056|No|1.67529|03/29/2022|1.63508|03/29/2022|1.64597|03/29/2022|||ANTICONVULSANTS|2646|||||No|No||ACTAVIS/TEVA|No||||
lamotrigine|No|No|No|No|75%|00228145303|LAMOTRIGINE ER 200 MG TABLET|30|EA|4.76425|06/28/2016||Yes|No||06/28/2016||Yes|No|06/28/2016||Yes|No||||No|No|||Prescription required|No||056|No|1.69753|03/29/2022|1.65678|03/29/2022|1.66782|03/29/2022|||ANTICONVULSANTS|2647|||||No|No||ACTAVIS/TEVA|No||||
lamotrigine|No|No|No|No|75%|00228158003|LAMOTRIGINE ER 300 MG TABLET|30|EA|7.1466|06/28/2016||Yes|No||06/28/2016||Yes|No|06/28/2016||Yes|No||||No|No|||Prescription required|No||056|No|4.96792|03/29/2022|4.84868|03/29/2022|4.88098|03/29/2022|||ANTICONVULSANTS|2648|||||No|No||ACTAVIS/TEVA|No||||
lamotrigine|No|No|No|No|75%|00228163803|LAMOTRIGINE ER 250 MG TABLET|30|EA|5.23654|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No||056|No|5.54243|03/29/2022|5.40941|03/29/2022|5.44543|03/29/2022|||ANTICONVULSANTS|2649|||||No|No||ACTAVIS/TEVA|No||||
alprazolam|No|No|No|No|90%|00228202710|ALPRAZOLAM 0.25 MG TABLET|100|EA|.02064|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02093|03/29/2022|.02042|03/29/2022|.02056|03/29/2022|||ANXIOLYTICS|2650|||||No|No||ACTAVIS/TEVA|No||||
alprazolam|No|No|No|No|90%|00228202750|ALPRAZOLAM 0.25 MG TABLET|500|EA|.02064|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02093|03/29/2022|.02042|03/29/2022|.02056|03/29/2022|||ANXIOLYTICS|2651|||||No|No||ACTAVIS/TEVA|No||||
alprazolam|No|No|No|No|90%|00228202796|ALPRAZOLAM 0.25 MG TABLET|1000|EA|.02064|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02093|03/29/2022|.02042|03/29/2022|.02056|03/29/2022|||ANXIOLYTICS|2652|||||No|No||ACTAVIS/TEVA|No||||
alprazolam|No|No|No|No|90%|00228202910|ALPRAZOLAM 0.5 MG TABLET|100|EA|.02107|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.0228|03/29/2022|.02225|03/29/2022|.0224|03/29/2022|||ANXIOLYTICS|2653|||||No|No||ACTAVIS/TEVA|No||||
alprazolam|No|No|No|No|90%|00228202950|ALPRAZOLAM 0.5 MG TABLET|500|EA|.02119|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.0228|03/29/2022|.02225|03/29/2022|.0224|03/29/2022|||ANXIOLYTICS|2654|||||No|No||ACTAVIS/TEVA|No||||
alprazolam|No|No|No|No|90%|00228202996|ALPRAZOLAM 0.5 MG TABLET|1000|EA|.02119|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.0228|03/29/2022|.02225|03/29/2022|.0224|03/29/2022|||ANXIOLYTICS|2655|||||No|No||ACTAVIS/TEVA|No||||
alprazolam|No|No|No|No|90%|00228203110|ALPRAZOLAM 1 MG TABLET|100|EA|.02623|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02503|03/29/2022|.02442|03/29/2022|.02459|03/29/2022|||ANXIOLYTICS|2656|||||No|No||ACTAVIS/TEVA|No||||
alprazolam|No|No|No|No|90%|00228203150|ALPRAZOLAM 1 MG TABLET|500|EA|.0258|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02503|03/29/2022|.02442|03/29/2022|.02459|03/29/2022|||ANXIOLYTICS|2657|||||No|No||ACTAVIS/TEVA|No||||
alprazolam|No|No|No|No|90%|00228203196|ALPRAZOLAM 1 MG TABLET|1000|EA|.0258|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02503|03/29/2022|.02442|03/29/2022|.02459|03/29/2022|||ANXIOLYTICS|2658|||||No|No||ACTAVIS/TEVA|No||||
alprazolam|No|No|No|No|90%|00228203910|ALPRAZOLAM 2 MG TABLET|100|EA|.06708|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.0533|03/29/2022|.05202|03/29/2022|.05236|03/29/2022|||ANXIOLYTICS|2659|||||No|No||ACTAVIS/TEVA|No||||
oxazepam|No|No|No|No|90%|00228206710|OXAZEPAM 10 MG CAPSULE|100|EA|.4128|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|.8772|03/29/2022|.85614|03/29/2022|.86184|03/29/2022|||ANXIOLYTICS|2660|||||No|No||ACTAVIS/TEVA|No||||
oxazepam|No|No|No|No|90%|00228206910|OXAZEPAM 15 MG CAPSULE|100|EA|.5212|11/29/2016||Yes|No||11/29/2016||Yes|No|11/29/2016||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|090|Yes|1.06313|03/29/2022|1.03761|03/29/2022|1.04452|03/29/2022|||ANXIOLYTICS|2661|||||No|No||ACTAVIS/TEVA|No||||
oxazepam|No|No|No|No|90%|00228207310|OXAZEPAM 30 MG CAPSULE|100|EA|.75387|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|1.71813|08/24/2021|1.69359|08/24/2021|1.61294|08/24/2021|||ANXIOLYTICS|2662|||||No|No||ACTAVIS/TEVA|No||||
temazepam|No|No|No|No|90%|00228207610|TEMAZEPAM 15 MG CAPSULE|100|EA|.03913|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||054|Yes|.07712|03/29/2022|.07526|03/29/2022|.07577|03/29/2022|||SEDATIVE HYPNOTICS|2663|||||No|No||ACTAVIS/TEVA|No||||
temazepam|No|No|No|No|90%|00228207650|TEMAZEPAM 15 MG CAPSULE|500|EA|.03753|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||054|Yes|.07712|03/29/2022|.07526|03/29/2022|.07577|03/29/2022|||SEDATIVE HYPNOTICS|2664|||||No|No||ACTAVIS/TEVA|No||||
temazepam|No|No|No|No|90%|00228207710|TEMAZEPAM 30 MG CAPSULE|100|EA|.05009|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||054|Yes|.10046|03/29/2022|.09804|03/29/2022|.0987|03/29/2022|||SEDATIVE HYPNOTICS|2665|||||No|No||ACTAVIS/TEVA|No||||
temazepam|No|No|No|No|90%|00228207750|TEMAZEPAM 30 MG CAPSULE|500|EA|.04807|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||054|Yes|.10046|03/29/2022|.09804|03/29/2022|.0987|03/29/2022|||SEDATIVE HYPNOTICS|2666|||||No|No||ACTAVIS/TEVA|No||||
clonidine HCl|No|No|No|No|75%|00228212710|CLONIDINE HCL 0.1 MG TABLET|100|EA|.01823|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||166|No|.03029|03/29/2022|.02956|03/29/2022|.02975|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|2667|||||No|No||ACTAVIS/TEVA|No||||
clonidine HCl|No|No|No|No|75%|00228212750|CLONIDINE HCL 0.1 MG TABLET|500|EA|.01823|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||166|No|.03029|03/29/2022|.02956|03/29/2022|.02975|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|2668|||||No|No||ACTAVIS/TEVA|No||||
clonidine HCl|No|No|No|No|75%|00228212810|CLONIDINE HCL 0.2 MG TABLET|100|EA|.02494|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||166|No|.0396|03/29/2022|.03864|03/29/2022|.0389|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|2669|||||No|No||ACTAVIS/TEVA|No||||
clonidine HCl|No|No|No|No|75%|00228212850|CLONIDINE HCL 0.2 MG TABLET|500|EA|.02494|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||166|No|.0396|03/29/2022|.03864|03/29/2022|.0389|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|2670|||||No|No||ACTAVIS/TEVA|No||||
clonidine HCl|No|No|No|No|75%|00228212910|CLONIDINE HCL 0.3 MG TABLET|100|EA|.02777|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||166|No|.03883|03/29/2022|.03789|03/29/2022|.03815|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|2671|||||No|No||ACTAVIS/TEVA|No||||
propylthiouracil|No|No|No|No|75%|00228234810|PROPYLTHIOURACIL 50 MG TABLET|100|EA|.3225|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|.52222|03/29/2022|.50968|03/29/2022|.51308|03/29/2022||||2672|||||No|No||ACTAVIS/TEVA|No||||
nifedipine|No|No|No|No|75%|00228249710|NIFEDIPINE 10 MG CAPSULE|100|EA|.36747|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|01/15/2014|045|No|.40848|03/29/2022|.39867|03/29/2022|.40133|03/29/2022|||CALCIUM CHANNEL BLOCKERS|2673|||||No|No||ACTAVIS/TEVA|No||||
nifedipine|No|No|No|No|75%|00228253010|NIFEDIPINE 20 MG CAPSULE|100|EA|.79214|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|01/15/2014|045|No|1.80535|11/24/2020|1.77956|11/24/2020|1.69482|11/24/2020|||CALCIUM CHANNEL BLOCKERS|2674|||||No|No||ACTAVIS/TEVA|No||||
carbidopa/levodopa|No|No|No|No|75%|00228253810|CARBIDOPA-LEVODOPA 10-100 TAB|100|EA|.09558|03/01/2002|01/18/2023|Yes|No||03/01/2002|01/18/2023|Yes|No|03/01/2002|01/18/2023|Yes|No||||No|No|||Prescription required|No||015|No|.14195|03/29/2022|.13854|03/29/2022|.13946|03/29/2022|||ANTIPARKINSON'S AGENTS|2675|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ACTAVIS/TEVA|No||||
carbidopa/levodopa|No|No|No|No|75%|00228253850|CARBIDOPA-LEVODOPA 10-100 TAB|500|EA|.09367|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||015|No|.14195|03/29/2022|.13854|03/29/2022|.13946|03/29/2022|||ANTIPARKINSON'S AGENTS|2676|||||No|No||ACTAVIS/TEVA|No||||
carbidopa/levodopa|No|No|No|No|75%|00228253910|CARBIDOPA-LEVODOPA 25-100 TAB|100|EA|.10857|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||015|No|.11418|03/29/2022|.11143|03/29/2022|.11218|03/29/2022|||ANTIPARKINSON'S AGENTS|2677|||||No|No||ACTAVIS/TEVA|No||||
carbidopa/levodopa|No|No|No|No|75%|00228253950|CARBIDOPA-LEVODOPA 25-100 TAB|500|EA|.10638|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||015|No|.11418|03/29/2022|.11143|03/29/2022|.11218|03/29/2022|||ANTIPARKINSON'S AGENTS|2678|||||No|No||ACTAVIS/TEVA|No||||
carbidopa/levodopa|No|No|No|No|75%|00228253996|CARBIDOPA-LEVODOPA 25-100 TAB|1000|EA|.10638|03/01/2002|01/18/2023|Yes|No||03/01/2002|01/18/2023|Yes|No|03/01/2002|01/18/2023|Yes|No||||No|No|||Prescription required|No||015|No|.11418|03/29/2022|.11143|03/29/2022|.11218|03/29/2022|||ANTIPARKINSON'S AGENTS|2679|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ACTAVIS/TEVA|No||||
carbidopa/levodopa|No|No|No|No|75%|00228254010|CARBIDOPA-LEVODOPA 25-250 TAB|100|EA|.12538|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||015|No|.1493|03/29/2022|.14571|03/29/2022|.14668|03/29/2022|||ANTIPARKINSON'S AGENTS|2680|||||No|No||ACTAVIS/TEVA|No||||
carbidopa/levodopa|No|No|No|No|75%|00228254050|CARBIDOPA-LEVODOPA 25-250 TAB|500|EA|.1191|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||015|No|.1493|03/29/2022|.14571|03/29/2022|.14668|03/29/2022|||ANTIPARKINSON'S AGENTS|2681|||||No|No||ACTAVIS/TEVA|No||||
carbidopa/levodopa|No|No|No|No|75%|00228254096|CARBIDOPA-LEVODOPA 25-250 TAB|1000|EA|.1191|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||015|No|.1493|03/29/2022|.14571|03/29/2022|.14668|03/29/2022|||ANTIPARKINSON'S AGENTS|2682|||||No|No||ACTAVIS/TEVA|No||||
diclofenac sodium|No|No|No|No|75%|00228255006|DICLOFENAC SOD EC 50 MG TAB|60|EA|.13609|04/17/2007||Yes|No||04/17/2007||Yes|No|04/17/2007||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.10202|03/29/2022|.09957|03/29/2022|.10023|03/29/2022|||NSAIDS|2683|||||No|No||ACTAVIS/TEVA|No||||
diclofenac sodium|No|No|No|No|75%|00228255011|DICLOFENAC SOD EC 50 MG TAB|100|EA|.13609|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.10202|03/29/2022|.09957|03/29/2022|.10023|03/29/2022|||NSAIDS|2684|||||No|No||ACTAVIS/TEVA|No||||
diclofenac sodium|No|No|No|No|75%|00228255096|DICLOFENAC SOD EC 50 MG TAB|1000|EA|.13201|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.10202|03/29/2022|.09957|03/29/2022|.10023|03/29/2022|||NSAIDS|2685|||||No|No||ACTAVIS/TEVA|No||||
diclofenac sodium|No|No|No|No|75%|00228255106|DICLOFENAC SOD EC 75 MG TAB|60|EA|.1677|07/01/2009||Yes|No||07/01/2009||Yes|No|07/01/2009||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.09618|03/29/2022|.09387|03/29/2022|.09449|03/29/2022|||NSAIDS|2686|||||No|No||ACTAVIS/TEVA|No||||
diclofenac sodium|No|No|No|No|75%|00228255111|DICLOFENAC SOD EC 75 MG TAB|100|EA|.1677|03/03/2004||Yes|No||03/03/2004||Yes|No|03/03/2004||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.09618|03/29/2022|.09387|03/29/2022|.09449|03/29/2022|||NSAIDS|2687|||||No|No||ACTAVIS/TEVA|No||||
diclofenac sodium|No|No|No|No|75%|00228255196|DICLOFENAC SOD EC 75 MG TAB|1000|EA|.16266|07/01/2009||Yes|No||07/01/2009||Yes|No|07/01/2009||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.09618|03/29/2022|.09387|03/29/2022|.09449|03/29/2022|||NSAIDS|2688|||||No|No||ACTAVIS/TEVA|No||||
indapamide|No|No|No|No|75%|00228257111|INDAPAMIDE 2.5 MG TABLET|100|EA|.1806|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.15208|03/29/2022|.14843|03/29/2022|.14941|03/29/2022||||2689|||||No|No||ACTAVIS/TEVA|No||||
indapamide|No|No|No|No|75%|00228257196|INDAPAMIDE 2.5 MG TABLET|1000|EA|.17028|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.15208|03/29/2022|.14843|03/29/2022|.14941|03/29/2022||||2690|||||No|No||ACTAVIS/TEVA|No||||
indapamide|No|No|No|No|75%|00228259711|INDAPAMIDE 1.25 MG TABLET|100|EA|.13691|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.12482|03/29/2022|.12182|03/29/2022|.12263|03/29/2022||||2691|||||No|No||ACTAVIS/TEVA|No||||
indapamide|No|No|No|No|75%|00228259796|INDAPAMIDE 1.25 MG TABLET|1000|EA|.13417|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.12482|03/29/2022|.12182|03/29/2022|.12263|03/29/2022||||2692|||||No|No||ACTAVIS/TEVA|No||||
isosorbide mononitrate|No|No|No|No|75%|00228262011|ISOSORBIDE MONONIT 20 MG TAB|100|EA|.21887|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.23897|03/29/2022|.23323|03/29/2022|.23478|03/29/2022||||2693|||||No|No||ACTAVIS/TEVA|No||||
isosorbide mononitrate|No|No|No|No|75%|00228263111|ISOSORBIDE MONONIT 10 MG TAB|100|EA|.21018|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.20493|03/29/2022|.20001|03/29/2022|.20134|03/29/2022||||2694|||||No|No||ACTAVIS/TEVA|No||||
gabapentin|No|No|No|No|75%|00228263611|GABAPENTIN 600 MG TABLET|100|EA|.27915|12/15/2004||Yes|No||12/15/2004||Yes|No|12/15/2004||Yes|No||07/01/2012||Yes|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|2695|||||No|No||ACTAVIS/TEVA|No||||
gabapentin|No|No|No|No|75%|00228263650|GABAPENTIN 600 MG TABLET|500|EA|.27915|12/15/2004||Yes|No||12/15/2004||Yes|No|12/15/2004||Yes|No||07/01/2012||Yes|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|2696|||||No|No||ACTAVIS/TEVA|No||||
gabapentin|No|No|No|No|75%|00228263711|GABAPENTIN 800 MG TABLET|100|EA|.33699|12/15/2004||Yes|No||12/15/2004||Yes|No|12/15/2004||Yes|No||07/01/2012||Yes|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|2697|||||No|No||ACTAVIS/TEVA|No||||
gabapentin|No|No|No|No|75%|00228263750|GABAPENTIN 800 MG TABLET|500|EA|.33699|12/15/2004||Yes|No||12/15/2004||Yes|No|12/15/2004||Yes|No||07/01/2012||Yes|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|2698|||||No|No||ACTAVIS/TEVA|No||||
glyburide/metformin HCl|Yes|No|No|No|75%|00228275111|GLYBURID-METFORMIN 1.25-250 MG|100|EA|.04226|07/06/2005||Yes|No||07/06/2005||Yes|No|07/06/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.09633|02/25/2020|.09495|02/25/2020|.09043|02/25/2020|||HYPOGLYCEMICS: METFORMINS|2699|||||No|No||ACTAVIS/TEVA|No||||
glyburide/metformin HCl|Yes|No|No|No|75%|00228275211|GLYBURIDE-METFORMIN 2.5-500 MG|100|EA|.04321|07/06/2005||Yes|No||07/06/2005||Yes|No|07/06/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.05324|03/29/2022|.05196|03/29/2022|.0523|03/29/2022|||HYPOGLYCEMICS: METFORMINS|2700|||||No|No||ACTAVIS/TEVA|No||||
glyburide/metformin HCl|Yes|No|No|No|75%|00228275250|GLYBURIDE-METFORMIN 2.5-500 MG|500|EA|.04321|05/09/2008||Yes|No||05/09/2008||Yes|No|05/09/2008||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.05324|03/29/2022|.05196|03/29/2022|.0523|03/29/2022|||HYPOGLYCEMICS: METFORMINS|2701|||||No|No||ACTAVIS/TEVA|No||||
glyburide/metformin HCl|Yes|No|No|No|75%|00228275311|GLYBURIDE-METFORMIN 5-500 MG|100|EA|.04321|07/06/2005||Yes|No||07/06/2005||Yes|No|07/06/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.05734|03/29/2022|.05596|03/29/2022|.05633|03/29/2022|||HYPOGLYCEMICS: METFORMINS|2702|||||No|No||ACTAVIS/TEVA|No||||
glyburide/metformin HCl|Yes|No|No|No|75%|00228275350|GLYBURIDE-METFORMIN 5-500 MG|500|EA|.04321|05/09/2008||Yes|No||05/09/2008||Yes|No|05/09/2008||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.05734|03/29/2022|.05596|03/29/2022|.05633|03/29/2022|||HYPOGLYCEMICS: METFORMINS|2703|||||No|No||ACTAVIS/TEVA|No||||
propranolol HCl|No|No|No|No|75%|00228277811|PROPRANOLOL ER 60 MG CAPSULE|100|EA|.72321|09/26/2007||Yes|No||09/26/2007||Yes|No|09/26/2007||Yes|No||09/26/2007||Yes|No|||Prescription required|Yes|07/28/2010|070|No|.32013|03/29/2022|.31244|03/29/2022|.31452|03/29/2022|||BETA-BLOCKERS|2704|||||No|No||ACTAVIS/TEVA|No||||
propranolol HCl|No|No|No|No|75%|00228277911|PROPRANOLOL ER 80 MG CAPSULE|100|EA|.84469|09/26/2007||Yes|No||09/26/2007||Yes|No|09/26/2007||Yes|No||09/26/2007||Yes|No|||Prescription required|Yes|07/28/2010|070|No|.35912|03/29/2022|.3505|03/29/2022|.35283|03/29/2022|||BETA-BLOCKERS|2705|||||No|No||ACTAVIS/TEVA|No||||
propranolol HCl|No|No|No|No|75%|00228278011|PROPRANOLOL ER 120 MG CAPSULE|100|EA|1.04782|09/26/2007||Yes|No||09/26/2007||Yes|No|09/26/2007||Yes|No||09/26/2007||Yes|No|||Prescription required|Yes|07/28/2010|070|No|.4314|03/29/2022|.42104|03/29/2022|.42385|03/29/2022|||BETA-BLOCKERS|2706|||||No|No||ACTAVIS/TEVA|No||||
propranolol HCl|No|No|No|No|75%|00228278111|PROPRANOLOL ER 160 MG CAPSULE|100|EA|1.37182|09/26/2007||Yes|No||09/26/2007||Yes|No|09/26/2007||Yes|No||09/26/2007||Yes|No|||Prescription required|Yes|07/28/2010|070|No|.61078|03/29/2022|.59612|03/29/2022|.60009|03/29/2022|||BETA-BLOCKERS|2707|||||No|No||ACTAVIS/TEVA|No||||
pilocarpine HCl|No|No|No|No|75%|00228280111|PILOCARPINE HCL 5 MG TABLET|100|EA|.51535|01/07/2005||Yes|No||01/07/2005||Yes|No|01/07/2005||Yes|No||||No|No|||Prescription required|No|||No|.27963|03/29/2022|.27291|03/29/2022|.27473|03/29/2022||||2708|||||No|No||ACTAVIS/TEVA|No||||
hydrochlorothiazide|No|No|No|No|75%|00228282011|HYDROCHLOROTHIAZIDE 12.5 MG TB|100|EA|.1204|03/02/2007||Yes|No||03/02/2007||Yes|No|03/02/2007||Yes|No||01/01/2012||Yes|No|||Prescription required|No|||Yes|.05169|03/29/2022|.05044|03/29/2022|.05078|03/29/2022||||2709|||||No|No||ACTAVIS/TEVA|No||||
pilocarpine HCl|No|No|No|No|75%|00228283711|PILOCARPINE HCL 7.5 MG TABLET|100|EA|.55685|09/08/2006||Yes|No||09/08/2006||Yes|No|09/08/2006||Yes|No||||No|No|||Prescription required|No|||No|.89289|03/29/2022|.87146|03/29/2022|.87726|03/29/2022||||2710|||||No|No||ACTAVIS/TEVA|No||||
fluvoxamine maleate|No|No|No|No|75%|00228284803|FLUVOXAMINE ER 100 MG CAPSULE|30|EA|3.24392|12/16/2014||Yes|No||12/16/2014||Yes|No|12/16/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|008|No|6.5592|03/29/2022|6.40177|03/29/2022|6.44441|03/29/2022|||ANTIDEPRESSANTS: SSRIs|2711|||||No|No||ACTAVIS/TEVA|No||||
fluvoxamine maleate|No|No|No|No|75%|00228284903|FLUVOXAMINE ER 150 MG CAPSULE|30|EA|3.48128|12/16/2014||Yes|No||12/16/2014||Yes|No|12/16/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|008|No|7.00339|03/29/2022|6.8353|03/29/2022|6.88083|03/29/2022|||ANTIDEPRESSANTS: SSRIs|2712|||||No|No||ACTAVIS/TEVA|No||||
guanfacine HCl|No|No|No|No|75%|00228285011|GUANFACINE HCL ER 1 MG TABLET|100|EA|.31579|01/13/2015||Yes|No||01/13/2015||Yes|No|01/13/2015||Yes|No||01/13/2015||Yes|No|||Prescription required|No||007|Yes|.25553|03/29/2022|.24939|03/29/2022|.25105|03/29/2022|||STIMULANTS AND RELATED AGENTS|2713|||||No|No||ACTAVIS/TEVA|No||||
guanfacine HCl|No|No|No|No|75%|00228285111|GUANFACINE HCL ER 2 MG TABLET|100|EA|.31579|01/13/2015||Yes|No||01/13/2015||Yes|No|01/13/2015||Yes|No||01/13/2015||Yes|No|||Prescription required|No||007|Yes|.28237|03/29/2022|.27559|03/29/2022|.27742|03/29/2022|||STIMULANTS AND RELATED AGENTS|2714|||||No|No||ACTAVIS/TEVA|No||||
guanfacine HCl|No|No|No|No|75%|00228285311|GUANFACINE HCL ER 3 MG TABLET|100|EA|.31579|01/13/2015||Yes|No||01/13/2015||Yes|No|01/13/2015||Yes|No||01/13/2015||Yes|No|||Prescription required|No||007|Yes|.28|03/29/2022|.27328|03/29/2022|.2751|03/29/2022|||STIMULANTS AND RELATED AGENTS|2715|||||No|No||ACTAVIS/TEVA|No||||
guanfacine HCl|No|No|No|No|75%|00228285511|GUANFACINE HCL ER 4 MG TABLET|100|EA|.31579|01/13/2015||Yes|No||01/13/2015||Yes|No|01/13/2015||Yes|No||01/13/2015||Yes|No|||Prescription required|No||007|Yes|.25313|03/29/2022|.24705|03/29/2022|.2487|03/29/2022|||STIMULANTS AND RELATED AGENTS|2716|||||No|No||ACTAVIS/TEVA|No||||
pregabalin|No|No|No|No|90%|00228285609|PREGABALIN 25 MG CAPSULE|90|EA|.05971|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|No||232|No|.0795|03/29/2022|.07759|03/29/2022|.0781|03/29/2022|||NEUROPATHIC PAIN|2717|||||No|No||TEVA USA|No||||
pregabalin|No|No|No|No|90%|00228285709|PREGABALIN 50 MG CAPSULE|90|EA|.05971|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|No||232|No|.09128|03/29/2022|.08908|03/29/2022|.08968|03/29/2022|||NEUROPATHIC PAIN|2718|||||No|No||TEVA USA|No||||
pregabalin|No|No|No|No|90%|00228285809|PREGABALIN 75 MG CAPSULE|90|EA|.05971|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|No||232|No|.08098|03/29/2022|.07903|03/29/2022|.07956|03/29/2022|||NEUROPATHIC PAIN|2719|||||No|No||TEVA USA|No||||
pregabalin|No|No|No|No|90%|00228285909|PREGABALIN 100 MG CAPSULE|90|EA|.05971|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|No||232|No|.08763|03/29/2022|.08552|03/29/2022|.08609|03/29/2022|||NEUROPATHIC PAIN|2720|||||No|No||TEVA USA|No||||
pregabalin|No|No|No|No|90%|00228286009|PREGABALIN 150 MG CAPSULE|90|EA|.06688|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|No||232|No|.10646|03/29/2022|.1039|03/29/2022|.10459|03/29/2022|||NEUROPATHIC PAIN|2721|||||No|No||TEVA USA|No||||
pregabalin|No|No|No|No|90%|00228286109|PREGABALIN 200 MG CAPSULE|90|EA|.07166|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|No||232|No|.11395|03/29/2022|.11121|03/29/2022|.11195|03/29/2022|||NEUROPATHIC PAIN|2722|||||No|No||TEVA USA|No||||
pregabalin|No|No|No|No|90%|00228286209|PREGABALIN 225 MG CAPSULE|90|EA|.07644|05/26/2021||Yes|No||05/26/2021||Yes|No|05/26/2021||Yes|No||||No|No|||Prescription required|No||232|No|.12393|03/29/2022|.12095|03/29/2022|.12176|03/29/2022|||NEUROPATHIC PAIN|2723|||||No|No||TEVA USA|No||||
pregabalin|No|No|No|No|90%|00228286309|PREGABALIN 300 MG CAPSULE|90|EA|.08121|05/25/2021||Yes|No||05/25/2021||Yes|No|05/25/2021||Yes|No||||No|No|||Prescription required|No||232|No|.12181|03/29/2022|.11888|03/29/2022|.11967|03/29/2022|||NEUROPATHIC PAIN|2724|||||No|No||TEVA USA|No||||
duloxetine HCl|No|No|No|No|75%|00228289006|DULOXETINE HCL DR 20 MG CAP|60|EA|.54825|02/18/2014||Yes|No||02/18/2014||Yes|No|02/18/2014||Yes|No||||No|No|||Prescription required|No||232|No|.13163|03/29/2022|.12847|03/29/2022|.12932|03/29/2022|||NEUROPATHIC PAIN|2725|||||No|No||ACTAVIS/TEVA|No||||
duloxetine HCl|No|No|No|No|75%|00228289103|DULOXETINE HCL DR 30 MG CAP|30|EA|.5848|02/18/2014||Yes|No||02/18/2014||Yes|No|02/18/2014||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|2726|||||No|No||ACTAVIS/TEVA|No||||
duloxetine HCl|No|No|No|No|75%|00228289150|DULOXETINE HCL DR 30 MG CAP|500|EA|.5848|02/05/2015||Yes|No||02/05/2015||Yes|No|02/05/2015||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|2727|||||No|No||ACTAVIS/TEVA|No||||
duloxetine HCl|No|No|No|No|75%|00228289203|DULOXETINE HCL DR 60 MG CAP|30|EA|.5848|02/18/2014||Yes|No||02/18/2014||Yes|No|02/18/2014||Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|2728|||||No|No||ACTAVIS/TEVA|No||||
duloxetine HCl|No|No|No|No|75%|00228289296|DULOXETINE HCL DR 60 MG CAP|1000|EA|.5848|02/05/2015||Yes|No||02/05/2015||Yes|No|02/05/2015||Yes|No||02/05/2015||Yes|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|2729|||||No|No||ACTAVIS/TEVA|No||||
doxycycline hyclate|No|No|No|No|75%|00228289506|DOXYCYCLINE HYC DR 75 MG TAB|60|EA|3.51711|02/18/2014||Yes|No||02/18/2014||Yes|No|02/18/2014||Yes|No||02/18/2014||Yes|No|||Prescription required|Yes|01/25/2012|213|No|8.01574|06/01/2016|7.90123|06/01/2016|7.52498|06/01/2016|||TETRACYCLINES|2730|||||No|No||ACTAVIS/TEVA|No||||
doxycycline hyclate|Yes|No|No|No|75%|00228289611|DOXYCYCLINE HYC DR 100 MG TAB|100|EA|4.52304|02/18/2014||Yes|No||02/18/2014||Yes|No|02/18/2014||Yes|No||02/18/2014||Yes|No|02/18/2014||Prescription required|Yes|01/25/2012|213|No|10.30832|09/24/2019|10.16106|09/24/2019|9.6772|09/24/2019|||TETRACYCLINES|2731|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|00228291809|DILTIAZEM 24H ER(CD) 360 MG CP|90|EA|2.11239|02/18/2014||Yes|No||02/18/2014||Yes|No|02/18/2014||Yes|No||02/18/2014||Yes|No|||Prescription required|No||045|No|1.70196|03/29/2022|1.66111|03/29/2022|1.67217|03/29/2022|||CALCIUM CHANNEL BLOCKERS|2732|||||No|No||ACTAVIS/TEVA|No||||
tamsulosin HCl|No|No|No|No|75%|00228299611|TAMSULOSIN HCL 0.4 MG CAPSULE|100|EA|.215|01/23/2012||Yes|No||01/23/2012||Yes|No|01/23/2012||Yes|No||||No|No|||Prescription required|No||003|No|.06447|03/29/2022|.06292|03/29/2022|.06334|03/29/2022|||BPH TREATMENTS|2733|||||No|No||ACTAVIS/TEVA|No||||
tamsulosin HCl|No|No|No|No|75%|00228299650|TAMSULOSIN HCL 0.4 MG CAPSULE|500|EA|.215|01/23/2012||Yes|No||01/23/2012||Yes|No|01/23/2012||Yes|No||||No|No|||Prescription required|No||003|No|.06447|03/29/2022|.06292|03/29/2022|.06334|03/29/2022|||BPH TREATMENTS|2734|||||No|No||ACTAVIS/TEVA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00228305911|DEXTROAMP-AMPHET ER 10 MG CAP|100|EA|1.67141|07/24/2012||Yes|No||07/24/2012||Yes|No|07/24/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.53198|03/29/2022|.51921|03/29/2022|.52267|03/29/2022|||STIMULANTS AND RELATED AGENTS|2735|||||No|No||ACTAVIS/TEVA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00228306011|DEXTROAMP-AMPHET ER 20 MG CAP|100|EA|1.67141|07/24/2012||Yes|No||07/24/2012||Yes|No|07/24/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.58746|03/29/2022|.57336|03/29/2022|.57717|03/29/2022|||STIMULANTS AND RELATED AGENTS|2736|||||No|No||ACTAVIS/TEVA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00228306111|DEXTROAMP-AMPHET ER 30 MG CAP|100|EA|1.67141|07/24/2012||Yes|No||07/24/2012||Yes|No|07/24/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.61484|03/29/2022|.60008|03/29/2022|.60408|03/29/2022|||STIMULANTS AND RELATED AGENTS|2737|||||No|No||ACTAVIS/TEVA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00228306211|DEXTROAMP-AMPHET ER 5 MG CAP|100|EA|1.67141|07/24/2012||Yes|No||07/24/2012||Yes|No|07/24/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.59233|03/29/2022|.57811|03/29/2022|.58196|03/29/2022|||STIMULANTS AND RELATED AGENTS|2738|||||No|No||ACTAVIS/TEVA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00228306311|DEXTROAMP-AMPHET ER 15 MG CAP|100|EA|1.67141|07/24/2012||Yes|No||07/24/2012||Yes|No|07/24/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55636|03/29/2022|.543|03/29/2022|.54662|03/29/2022|||STIMULANTS AND RELATED AGENTS|2739|||||No|No||ACTAVIS/TEVA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00228306411|DEXTROAMP-AMPHET ER 25 MG CAP|100|EA|1.67141|07/24/2012||Yes|No||07/24/2012||Yes|No|07/24/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.54687|03/29/2022|.53374|03/29/2022|.53729|03/29/2022|||STIMULANTS AND RELATED AGENTS|2740|||||No|No||ACTAVIS/TEVA|No||||
alprazolam|No|No|No|No|90%|00228308306|ALPRAZOLAM ER 0.5 MG TABLET|60|EA|.30938|02/21/2007||Yes|No||02/21/2007||Yes|No|02/21/2007||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|.20761|03/29/2022|.20262|03/29/2022|.20397|03/29/2022|||ANXIOLYTICS|2741|||||No|No||ACTAVIS/TEVA|No||||
alprazolam|No|No|No|No|90%|00228308406|ALPRAZOLAM ER 1 MG TABLET|60|EA|.41344|02/21/2007||Yes|No||02/21/2007||Yes|No|02/21/2007||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|.20127|03/29/2022|.19643|03/29/2022|.19774|03/29/2022|||ANXIOLYTICS|2742|||||No|No||ACTAVIS/TEVA|No||||
alprazolam|No|No|No|No|90%|00228308606|ALPRAZOLAM ER 3 MG TABLET|60|EA|.79657|02/21/2007||Yes|No||02/21/2007||Yes|No|02/21/2007||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|.2755|03/29/2022|.26888|03/29/2022|.27067|03/29/2022|||ANXIOLYTICS|2743|||||No|No||ACTAVIS/TEVA|No||||
alprazolam|No|No|No|No|90%|00228308706|ALPRAZOLAM ER 2 MG TABLET|60|EA|.49722|02/21/2007||Yes|No||02/21/2007||Yes|No|02/21/2007||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|.3342|03/29/2022|.32617|03/29/2022|.32835|03/29/2022|||ANXIOLYTICS|2744|||||No|No||ACTAVIS/TEVA|No||||
morphine sulfate|No|No|No|No|90%|00228309011|MORPHINE SULFATE ER 30 MG CAP|100|EA|1.97099|09/12/2014||Yes|No||09/12/2014||Yes|No|09/12/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|4.49202|11/28/2017|4.42785|11/28/2017|4.217|11/28/2017|||ANALGESICS: NARCOTICS LONG|2745|||||No|No||ACTAVIS/TEVA|No||||
morphine sulfate|No|No|No|No|90%|00228309111|MORPHINE SULFATE ER 60 MG CAP|100|EA|3.82743|09/12/2014||Yes|No||09/12/2014||Yes|No|09/12/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|8.72298|07/25/2017|8.59836|07/25/2017|8.18892|07/25/2017|||ANALGESICS: NARCOTICS LONG|2746|||||No|No||ACTAVIS/TEVA|No||||
morphine sulfate|No|No|No|No|90%|00228309211|MORPHINE SULFATE ER 90 MG CAP|100|EA|5.75486|09/12/2014||Yes|No||09/12/2014||Yes|No|09/12/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|13.11573|08/29/2017|12.92836|08/29/2017|12.31272|08/29/2017|||ANALGESICS: NARCOTICS LONG|2747|||||No|No||ACTAVIS/TEVA|No||||
morphine sulfate|No|No|No|No|90%|00228309311|MORPHINE SULFATE ER 120 MG CAP|100|EA|6.79013|09/12/2014||Yes|No||09/12/2014||Yes|No|09/12/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|15.47518|01/23/2018|15.2541|01/23/2018|14.52772|01/23/2018|||ANALGESICS: NARCOTICS LONG|2748|||||No|No||ACTAVIS/TEVA|No||||
morphine sulfate|No|No|No|No|90%|00228311611|MORPHINE SULFATE ER 45 MG CAP|100|EA|2.92245|09/12/2014||Yes|No||09/12/2014||Yes|No|09/12/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|6.66047|06/01/2016|6.56532|06/01/2016|6.25268|06/01/2016|||ANALGESICS: NARCOTICS LONG|2749|||||No|No||ACTAVIS/TEVA|No||||
morphine sulfate|No|No|No|No|90%|00228311711|MORPHINE SULFATE ER 75 MG CAP|100|EA|4.87069|09/12/2014||Yes|No||09/12/2014||Yes|No|09/12/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|11.10065|06/01/2016|10.94207|06/01/2016|10.42102|06/01/2016|||ANALGESICS: NARCOTICS LONG|2750|||||No|No||ACTAVIS/TEVA|No||||
buprenorphine HCl|No|No|No|No|90%|00228315303|BUPRENORPHINE 8 MG TABLET SL|30|EA|1.99692|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||145|Yes|.77298|03/29/2022|.75442|03/29/2022|.75945|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|2751|||||No|No||ACTAVIS/TEVA|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00228315403|BUPRENORPHINE-NALOX 2-0.5MG TB|30|EA|2.00251|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|.72296|03/29/2022|.7056|03/29/2022|.7103|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|2752|||||No|No||ACTAVIS/TEVA|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00228315503|BUPRENORPHINE-NALOX 8-2 MG TAB|30|EA|3.58892|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|1.08568|03/29/2022|1.05962|03/29/2022|1.06668|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|2753|||||No|No||ACTAVIS/TEVA|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00228315567|BUPRENORPHINE-NALOX 8-2 MG TAB|15|EA||10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|1.08568|03/29/2022|1.05962|03/29/2022|1.06668|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|2754|||||No|No||ACTAVIS/TEVA|Yes|09/01/2020|||
buprenorphine HCl|No|No|No|No|90%|00228315603|BUPRENORPHINE 2 MG TABLET SL|30|EA|1.06812|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||145|Yes|.37925|03/29/2022|.37014|03/29/2022|.37261|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|2755|||||No|No||ACTAVIS/TEVA|Yes|09/01/2020|||
doxepin HCl|No|No|No|No|75%|00228331503|DOXEPIN HCL 3 MG TABLET|30|EA|5.6221|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|054|No|9.6007|03/29/2022|9.37028|03/29/2022|9.43268|03/29/2022|||SEDATIVE HYPNOTICS|2756|||||No|No||TEVA USA|No||||
doxepin HCl|No|No|No|No|75%|00228331603|DOXEPIN HCL 6 MG TABLET|30|EA|5.6221|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|054|No|8.13342|03/29/2022|7.93821|03/29/2022|7.99108|03/29/2022|||SEDATIVE HYPNOTICS|2757|||||No|No||TEVA USA|No||||
morphine sulfate|No|No|No|No|90%|00228350106|MORPHINE SULFATE ER 10 MG CAP|60|EA|1.62783|02/10/2015||Yes|No||02/10/2015||Yes|No|02/10/2015||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|2.57285|03/29/2022|2.5111|03/29/2022|2.52782|03/29/2022|||ANALGESICS: NARCOTICS LONG|2758|||||No|No||ACTAVIS/TEVA|No||||
morphine sulfate|No|No|No|No|90%|00228350206|MORPHINE SULFATE ER 20 MG CAP|60|EA|1.79869|02/10/2015||Yes|No||02/10/2015||Yes|No|02/10/2015||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|3.39578|03/01/2022|3.31428|03/01/2022|3.33635|03/01/2022|||ANALGESICS: NARCOTICS LONG|2759|||||No|No||ACTAVIS/TEVA|No||||
morphine sulfate|No|No|No|No|90%|00228350306|MORPHINE SULFATE ER 30 MG CAP|60|EA|1.95635|02/10/2015||Yes|No||02/10/2015||Yes|No|02/10/2015||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|2.89795|03/29/2022|2.82839|03/29/2022|2.84723|03/29/2022|||ANALGESICS: NARCOTICS LONG|2760|||||No|No||ACTAVIS/TEVA|No||||
morphine sulfate|No|No|No|No|90%|00228350406|MORPHINE SULFATE ER 50 MG CAP|60|EA|3.26921|02/10/2015||Yes|No||02/10/2015||Yes|No|02/10/2015||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|1.57696|09/28/2021|1.53911|09/28/2021|1.54936|09/28/2021|||ANALGESICS: NARCOTICS LONG|2761|||||No|No||ACTAVIS/TEVA|No||||
morphine sulfate|No|No|No|No|90%|00228350506|MORPHINE SULFATE ER 60 MG CAP|60|EA|3.91263|02/10/2015||Yes|No||02/10/2015||Yes|No|02/10/2015||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|8.91717|10/26/2021|8.78978|10/26/2021|8.37122|10/26/2021|||ANALGESICS: NARCOTICS LONG|2762|||||No|No||ACTAVIS/TEVA|No||||
morphine sulfate|No|No|No|No|90%|00228350606|MORPHINE SULFATE ER 80 MG CAP|60|EA|5.21252|02/10/2015||Yes|No||02/10/2015||Yes|No|02/10/2015||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|11.87971|10/23/2018|11.71|10/23/2018|11.15238|10/23/2018|||ANALGESICS: NARCOTICS LONG|2763|||||No|No||ACTAVIS/TEVA|No||||
morphine sulfate|No|No|No|No|90%|00228350706|MORPHINE SULFATE ER 100 MG CAP|60|EA|6.53858|02/10/2015||Yes|No||02/10/2015||Yes|No|02/10/2015||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|14.90188|09/24/2019|14.68899|09/24/2019|13.98952|09/24/2019|||ANALGESICS: NARCOTICS LONG|2764|||||No|No||ACTAVIS/TEVA|No||||
ropinirole HCl|No|No|No|No|75%|00228364003|ROPINIROLE HCL ER 6 MG TABLET|30|EA|2.77995|07/03/2012||Yes|No||07/03/2012||Yes|No|07/03/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|2.547|03/29/2022|2.48587|03/29/2022|2.50242|03/29/2022|||ANTIPARKINSON'S AGENTS|2765|||||No|No||ACTAVIS/TEVA|No||||
ropinirole HCl|No|No|No|No|75%|00228365803|ROPINIROLE HCL ER 2 MG TABLET|30|EA|.92665|07/03/2012||Yes|No||07/03/2012||Yes|No|07/03/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|.59483|03/29/2022|.58055|03/29/2022|.58442|03/29/2022|||ANTIPARKINSON'S AGENTS|2766|||||No|No||ACTAVIS/TEVA|No||||
ropinirole HCl|No|No|No|No|75%|00228365809|ROPINIROLE HCL ER 2 MG TABLET|90|EA|.92665|07/03/2012||Yes|No||07/03/2012||Yes|No|07/03/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|.59483|03/29/2022|.58055|03/29/2022|.58442|03/29/2022|||ANTIPARKINSON'S AGENTS|2767|||||No|No||ACTAVIS/TEVA|No||||
ropinirole HCl|No|No|No|No|75%|00228365903|ROPINIROLE HCL ER 4 MG TABLET|30|EA|1.8533|07/03/2012||Yes|No||07/03/2012||Yes|No|07/03/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|1.04346|03/29/2022|1.01841|03/29/2022|1.02519|03/29/2022|||ANTIPARKINSON'S AGENTS|2768|||||No|No||ACTAVIS/TEVA|No||||
ropinirole HCl|No|No|No|No|75%|00228365909|ROPINIROLE HCL ER 4 MG TABLET|90|EA|1.85334|07/03/2012||Yes|No||07/03/2012||Yes|No|07/03/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|1.04346|03/29/2022|1.01841|03/29/2022|1.02519|03/29/2022|||ANTIPARKINSON'S AGENTS|2769|||||No|No||ACTAVIS/TEVA|No||||
ropinirole HCl|No|No|No|No|75%|00228366003|ROPINIROLE HCL ER 8 MG TABLET|30|EA|2.77995|07/03/2012||Yes|No||07/03/2012||Yes|No|07/03/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|1.52194|03/29/2022|1.48541|03/29/2022|1.4953|03/29/2022|||ANTIPARKINSON'S AGENTS|2770|||||No|No||ACTAVIS/TEVA|No||||
ropinirole HCl|No|No|No|No|75%|00228366009|ROPINIROLE HCL ER 8 MG TABLET|90|EA|2.77999|07/03/2012||Yes|No||07/03/2012||Yes|No|07/03/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|1.52194|03/29/2022|1.48541|03/29/2022|1.4953|03/29/2022|||ANTIPARKINSON'S AGENTS|2771|||||No|No||ACTAVIS/TEVA|No||||
ropinirole HCl|No|No|No|No|75%|00228366103|ROPINIROLE HCL ER 12 MG TABLET|30|EA|4.63339|07/03/2012||Yes|No||07/03/2012||Yes|No|07/03/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|2.53667|09/28/2021|2.47578|09/28/2021|2.49227|09/28/2021|||ANTIPARKINSON'S AGENTS|2772|||||No|No||ACTAVIS/TEVA|No||||
alprazolam|No|No|No|No|90%|00228401911|ALPRAZOLAM ODT 0.25 MG TAB|100|EA|.46397|06/13/2016||Yes|No||06/13/2016||Yes|No|06/13/2016||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|1.05742|11/29/2016|1.04231|11/29/2016|.99268|11/29/2016|||ANXIOLYTICS|2773|||||No|No||ACTAVIS/TEVA|No||||
alprazolam|No|No|No|No|90%|00228402211|ALPRAZOLAM ODT 0.5 MG TAB|100|EA|.57809|06/14/2016||Yes|No||06/14/2016||Yes|No|06/14/2016||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|1.31751|05/25/2021|1.29869|05/25/2021|1.23684|05/25/2021|||ANXIOLYTICS|2774|||||No|No||ACTAVIS/TEVA|No||||
alprazolam|No|No|No|No|90%|00228402411|ALPRAZOLAM ODT 1 MG TAB|100|EA|.77129|06/14/2016||Yes|No||06/14/2016||Yes|No|06/14/2016||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|1.75782|11/28/2017|1.73271|11/28/2017|1.6502|11/28/2017|||ANXIOLYTICS|2775|||||No|No||ACTAVIS/TEVA|No||||
alprazolam|No|No|No|No|90%|00228402511|ALPRAZOLAM ODT 2 MG TAB|100|EA|1.31141|06/14/2016||Yes|No||06/14/2016||Yes|No|06/14/2016||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|2.9888|06/14/2016|2.9461|06/14/2016|2.80581|06/14/2016|||ANXIOLYTICS|2776|||||No|No||ACTAVIS/TEVA|No||||
clonidine HCl|No|No|No|No|75%|00228424106|CLONIDINE HCL ER 0.1 MG TABLET|60|EA|1.43333|06/17/2015||Yes|No||06/17/2015||Yes|No|06/17/2015||Yes|No||06/17/2015||Yes|No|||Prescription required|Yes|07/29/2021|007|Yes|.52051|03/29/2022|.50801|03/29/2022|.5114|03/29/2022|||STIMULANTS AND RELATED AGENTS|2777|||||No|No||ACTAVIS/TEVA|No||||
morphine sulfate|No|No|No|No|90%|00228427011|MORPHINE SULF ER 15 MG TABLET|100|EA|.28822|11/12/2015||Yes|No||11/12/2015||Yes|No|11/12/2015||Yes|No||||No|No|||Prescription required|No||110|Yes|.19105|03/29/2022|.18646|03/29/2022|.1877|03/29/2022|||ANALGESICS: NARCOTICS LONG|2778|||||No|No||ACTAVIS/TEVA|No||||
morphine sulfate|No|No|No|No|90%|00228427111|MORPHINE SULF ER 30 MG TABLET|100|EA|.54769|11/12/2015||Yes|No||11/12/2015||Yes|No|11/12/2015||Yes|No||||No|No|||Prescription required|No||110|Yes|.34621|03/29/2022|.3379|03/29/2022|.34015|03/29/2022|||ANALGESICS: NARCOTICS LONG|2779|||||No|No||ACTAVIS/TEVA|No||||
morphine sulfate|No|No|No|No|90%|00228431111|MORPHINE SULF ER 60 MG TABLET|100|EA|1.06872|11/12/2015||Yes|No||11/12/2015||Yes|No|11/12/2015||Yes|No||||No|No|||Prescription required|No||110|Yes|.55429|03/29/2022|.54098|03/29/2022|.54458|03/29/2022|||ANALGESICS: NARCOTICS LONG|2780|||||No|No||ACTAVIS/TEVA|No||||
morphine sulfate|No|No|No|No|90%|00228432311|MORPHINE SULF ER 100 MG TABLET|100|EA|1.58231|11/12/2015||Yes|No||11/12/2015||Yes|No|11/12/2015||Yes|No||||No|No|||Prescription required|No||110|Yes|1.04927|03/29/2022|1.02408|03/29/2022|1.0309|03/29/2022|||ANALGESICS: NARCOTICS LONG|2781|||||No|No||ACTAVIS/TEVA|No||||
morphine sulfate|No|No|No|No|90%|00228434711|MORPHINE SULF ER 200 MG TABLET|100|EA|2.89777|11/12/2015||Yes|No||11/12/2015||Yes|No|11/12/2015||Yes|No||||No|No|||Prescription required|No||110|Yes|2.54414|07/27/2021|2.48308|07/27/2021|2.49961|07/27/2021|||ANALGESICS: NARCOTICS LONG|2782|||||No|No||ACTAVIS/TEVA|No||||
sotalol HCl|No|No|No|No|75%|00245001201|SORINE 80 MG TABLET|100|EA|.68606|01/04/2017||Yes|No||01/04/2017||Yes|No|01/04/2017||Yes|No||||No|No|||Prescription required|No||070|No|.07746|03/29/2022|.0756|03/29/2022|.0761|03/29/2022|||BETA-BLOCKERS|2783|||||No|No||UPSHER-SMITH LA|No||||
sotalol HCl|No|No|No|No|75%|00245001301|SORINE 120 MG TABLET|100|EA|.91091|01/04/2017||Yes|No||01/04/2017||Yes|No|01/04/2017||Yes|No||||No|No|||Prescription required|No||070|No|.10056|03/29/2022|.09814|03/29/2022|.0988|03/29/2022|||BETA-BLOCKERS|2784|||||No|No||UPSHER-SMITH LA|No||||
sotalol HCl|No|No|No|No|75%|00245001401|SORINE 160 MG TABLET|100|EA|1.13593|01/04/2017||Yes|No||01/04/2017||Yes|No|01/04/2017||Yes|No||||No|No|||Prescription required|No||070|No|.16372|03/29/2022|.15979|03/29/2022|.16085|03/29/2022|||BETA-BLOCKERS|2785|||||No|No||UPSHER-SMITH LA|No||||
sotalol HCl|No|No|No|No|75%|00245001501|SORINE 240 MG TABLET|100|EA|1.59607|01/04/2017||Yes|No||01/04/2017||Yes|No|01/04/2017||Yes|No||||No|No|||Prescription required|No||070|No|3.63756|01/04/2017|3.58559|01/04/2017|3.41485|01/04/2017|||BETA-BLOCKERS|2786|||||No|No||UPSHER-SMITH LA|No||||
cholestyramine/aspartame|No|No|No|No|75%|00245003623|PREVALITE POWDER|231|GM|.11866|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||055|No|.21025|03/29/2022|.2052|03/29/2022|.20657|03/29/2022|||LIPOTROPICS: OTHER|2787|||||No|No||UPSHER-SMITH LA|No||||
cholestyramine/aspartame|No|No|No|No|75%|00245003642|PREVALITE PACKET|42|EA|.88354|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||055|No|1.2151|03/29/2022|1.18593|03/29/2022|1.19383|03/29/2022|||LIPOTROPICS: OTHER|2788|||||No|No||UPSHER-SMITH LA|No||||
cholestyramine/aspartame|No|No|No|No|75%|00245003660|PREVALITE PACKET|60|EA|.88171|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||055|No|1.2151|03/29/2022|1.18593|03/29/2022|1.19383|03/29/2022|||LIPOTROPICS: OTHER|2789|||||No|No||UPSHER-SMITH LA|No||||
potassium citrate|No|No|No|No|75%|00245007011|POTASSIUM CITRATE ER 5 MEQ TAB|100|EA|.43395|07/11/2008||Yes|No||07/11/2008||Yes|No|07/11/2008||Yes|No||07/11/2008||Yes|No|||Prescription required|No|||No|.46644|03/29/2022|.45524|03/29/2022|.45827|03/29/2022||||2790|||||No|No||UPSHER-SMITH LA|No||||
potassium citrate|No|No|No|No|75%|00245007111|POTASSIUM CITRATE ER 10 MEQ TB|100|EA|.60823|07/11/2008||Yes|No||07/11/2008||Yes|No|07/11/2008||Yes|No||07/11/2008||Yes|No|||Prescription required|No|||No|.30433|03/29/2022|.29702|03/29/2022|.299|03/29/2022||||2791|||||No|No||UPSHER-SMITH LA|No||||
ferrous sulfate|No|No|No|No|75%|00245010801|FERROUS SULF EC 325 MG TABLET|100|EA|.25877|||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|.58976|07/07/2020|.58133|07/07/2020|.55365|07/07/2020||||2792|||||No|No||UPSHER-SMITH LA|No||||
ferrous sulfate|No|No|No|No|75%|00245010810|FERROUS SULF EC 325 MG TABLET|1000|EA|.12381|||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|.28219|07/07/2020|.27815|07/07/2020|.26491|07/07/2020||||2793|||||No|No||UPSHER-SMITH LA|No||||
ferrous sulfate|No|No|No|No|75%|00245010811|FERROUS SULF EC 325 MG TABLET|100|EA|.13738|||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|.31311|07/07/2020|.30863|07/07/2020|.29394|07/07/2020||||2794|||||No|No||UPSHER-SMITH LA|No||||
ferrous sulfate|No|No|No|No|75%|00245010889|FERROUS SULF EC 325 MG TABLET|1|EA|.258|||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|.588|07/07/2020|.5796|07/07/2020|.552|07/07/2020||||2795|||||No|No||UPSHER-SMITH LA|No||||
amiodarone HCl|No|No|No|No|75%|00245014401|PACERONE 100 MG TABLET|100|EA|1.19841|07/15/2004||Yes|No||07/15/2004||Yes|No|07/15/2004||Yes|No||||No|No|||Prescription required|No|||No|1.15068|10/19/2021|1.12306|10/19/2021|1.13054|10/19/2021||||2796|||||No|No||UPSHER-SMITH LA|No||||
amiodarone HCl|No|No|No|No|75%|00245014430|PACERONE 100 MG TABLET|30|EA|1.19841|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||||No|No|||Prescription required|No|||No|1.15068|10/19/2021|1.12306|10/19/2021|1.13054|10/19/2021||||2797|||||No|No||UPSHER-SMITH LA|No||||
amiodarone HCl|No|No|No|No|75%|00245014501|PACERONE 400 MG TABLET|100|EA|2.69205|09/06/2016|01/22/2022|Yes|No||09/06/2016|01/22/2022|Yes|No|09/06/2016|01/22/2022|Yes|No||||No|No|||Prescription required|No|||No|6.13538|01/28/2020|6.04773|01/28/2020|5.75975|01/28/2020||||2798|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||UPSHER-SMITH LA|No||||
amiodarone HCl|No|No|No|No|75%|00245014530|PACERONE 400 MG TABLET|30|EA|2.69638|03/01/2002|01/22/2022|Yes|No||03/01/2002|01/22/2022|Yes|No|03/01/2002|01/22/2022|Yes|No||||No|No|||Prescription required|No|||No|6.14524|01/28/2020|6.05745|01/28/2020|5.769|01/28/2020||||2799|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||UPSHER-SMITH LA|No||||
amiodarone HCl|No|No|No|No|75%|00245014701|PACERONE 200 MG TABLET|100|EA|.16034|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.11264|03/29/2022|.10993|03/29/2022|.11066|03/29/2022||||2800|||||No|No||UPSHER-SMITH LA|No||||
amiodarone HCl|No|No|No|No|75%|00245014715|PACERONE 200 MG TABLET|500|EA|.11653|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.11264|03/29/2022|.10993|03/29/2022|.11066|03/29/2022||||2801|||||No|No||UPSHER-SMITH LA|No||||
amiodarone HCl|No|No|No|No|75%|00245014760|PACERONE 200 MG TABLET|60|EA|.11896|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.11264|03/29/2022|.10993|03/29/2022|.11066|03/29/2022||||2802|||||No|No||UPSHER-SMITH LA|No||||
amiodarone HCl|No|No|No|No|75%|00245014790|PACERONE 200 MG TABLET|90|EA|.11891|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||||No|No|||Prescription required|No|||No|.11264|03/29/2022|.10993|03/29/2022|.11066|03/29/2022||||2803|||||No|No||UPSHER-SMITH LA|No||||
midodrine HCl|No|No|No|No|75%|00245021111|MIDODRINE HCL 2.5 MG TABLET|100|EA|.22415|05/21/2008||Yes|No||05/21/2008||Yes|No|05/21/2008||Yes|No||05/21/2008||Yes|No|||Prescription required|No|||No|.20233|03/29/2022|.19747|03/29/2022|.19878|03/29/2022||||2804|||||No|No||UPSHER-SMITH LA|No||||
midodrine HCl|No|No|No|No|75%|00245021201|MIDODRINE HCL 5 MG TABLET|100|EA|1.29602|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||09/06/2016||Yes|No|||Prescription required|No|||No|.26381|03/29/2022|.25747|03/29/2022|.25919|03/29/2022||||2805|||||No|No||UPSHER-SMITH LA|No||||
midodrine HCl|No|No|No|No|75%|00245021211|MIDODRINE HCL 5 MG TABLET|100|EA|.3154|05/21/2008||Yes|No||05/21/2008||Yes|No|05/21/2008||Yes|No||05/21/2008||Yes|No|||Prescription required|No|||No|.26381|03/29/2022|.25747|03/29/2022|.25919|03/29/2022||||2806|||||No|No||UPSHER-SMITH LA|No||||
midodrine HCl|No|No|No|No|75%|00245021311|MIDODRINE HCL 10 MG TABLET|100|EA|.53904|05/21/2008||Yes|No||05/21/2008||Yes|No|05/21/2008||Yes|No||05/21/2008||Yes|No|||Prescription required|No|||No|.40773|03/29/2022|.39794|03/29/2022|.40059|03/29/2022||||2807|||||No|No||UPSHER-SMITH LA|No||||
oxandrolone|No|No|No|No|90%|00245027111|OXANDROLONE 2.5 MG TABLET|100|EA|1.19398|04/15/2008||Yes|No||04/15/2008||Yes|No|04/15/2008||Yes|No||||No|No|||Prescription required|No|||No|2.72116|02/19/2019|2.68229|02/19/2019|2.55456|02/19/2019||||2808|||||No|No||UPSHER-SMITH LA|No||||
oxandrolone|No|No|No|No|90%|00245027206|OXANDROLONE 10 MG TABLET|60|EA|4.05038|04/15/2008||Yes|No||04/15/2008||Yes|No|04/15/2008||Yes|No||||No|No|||Prescription required|No|||No|9.23111|02/19/2019|9.09923|02/19/2019|8.66594|02/19/2019||||2809|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00245036001|KLOR-CON 20 MEQ PACKET|100|EA|3.10064|07/19/2018||Yes|No||07/19/2018||Yes|No|07/19/2018||Yes|No||07/19/2018||Yes|No|||Prescription required|No|||No|3.17362|10/26/2021|3.09745|10/26/2021|3.11808|10/26/2021||||2810|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00245036030|KLOR-CON 20 MEQ PACKET|30|EA|3.2637|07/19/2018||Yes|No||07/19/2018||Yes|No|07/19/2018||Yes|No||07/19/2018||Yes|No|||Prescription required|No|||No|3.17362|10/26/2021|3.09745|10/26/2021|3.11808|10/26/2021||||2811|||||No|No||UPSHER-SMITH LA|No||||
cholestyramine (with sugar)|No|No|No|No|75%|00245053637|CHOLESTYRAMINE POWDER|378|GM|.11932|03/08/2012||Yes|No||03/08/2012||Yes|No|03/08/2012||Yes|No||03/08/2012||Yes|No|||Prescription required|No||055|No|.14958|03/29/2022|.14599|03/29/2022|.14696|03/29/2022|||LIPOTROPICS: OTHER|2812|||||No|No||UPSHER-SMITH LA|No||||
cholestyramine (with sugar)|No|No|No|No|75%|00245053660|CHOLESTYRAMINE PACKET|60|EA|.88171|04/04/2014||Yes|No||04/04/2014||Yes|No|04/04/2014||Yes|No||04/04/2014||Yes|No|||Prescription required|No||055|No|1.02853|03/29/2022|1.00384|03/29/2022|1.01053|03/29/2022|||LIPOTROPICS: OTHER|2813|||||No|No||UPSHER-SMITH LA|No||||
vigabatrin|No|No|No|No|75%|00245055650|VIGADRONE 500 MG POWDER PACKET|50|EA|40.33778|12/07/2018||Yes|No||12/07/2018||Yes|No|12/07/2018||Yes|No||||No|No|||Prescription required|No||056|No|91.93262|12/07/2018|90.6193|12/07/2018|86.30409|12/07/2018|||ANTICONVULSANTS|2814|||||No|No||UPSHER-SMITH LA|No||||
sumatriptan|No|No|No|No|75%|00245081261|TOSYMRA 10 MG NASAL SPRAY|6|EA|41.925|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|95.55|02/23/2022|94.185|02/23/2022|89.7|02/23/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|2815|||||No|No||UPSHER-SMITH LA|No||||
metronidazole|Yes|No|No|No|75%|00245086070|VANDAZOLE VAGINAL 0.75% GEL|70|GM|.75108|11/13/2008||Yes|No||11/13/2008||Yes|No|11/13/2008||Yes|No||||No|No|11/01/2012||Prescription required|Yes|02/10/2009|124|No|.76524|03/29/2022|.74687|03/29/2022|.75184|03/29/2022|||ANTIBIOTICS: VAGINAL|2816|||||No|No||UPSHER-SMITH LA|No||||
testosterone|No|No|No|No|90%|00245087105|VOGELXO 50 MG/5 GRAM GEL|5|GM|1.27749|06/18/2015||Yes|No||06/18/2015||Yes|No|06/18/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|084|No|2.91151|06/01/2016|2.86991|06/01/2016|2.73325|06/01/2016|||ANDROGENIC AGENTS|2817|||||No|No||UPSHER-SMITH LA|No||||
testosterone|No|No|No|No|90%|00245087135|VOGELXO 50 MG/5 GRAM GEL PACKT|5|GM|1.27577|06/18/2015||Yes|No||06/18/2015||Yes|No|06/18/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|084|No|2.90759|06/01/2016|2.86605|06/01/2016|2.72957|06/01/2016|||ANDROGENIC AGENTS|2818|||||No|No||UPSHER-SMITH LA|No||||
testosterone|No|No|No|No|90%|00245087242|VOGELXO 12.5 MG/1.25 GRAM PUMP|75|GM|1.27577|06/18/2015||Yes|No||06/18/2015||Yes|No|06/18/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|084|No|2.90759|06/01/2016|2.86605|06/01/2016|2.72957|06/01/2016|||ANDROGENIC AGENTS|2819|||||No|No||UPSHER-SMITH LA|No||||
topiramate|No|No|No|No|75%|00245107130|QUDEXY XR 25 MG CAPSULE|30|EA|3.85452|11/13/2014||Yes|No||11/13/2014||Yes|No|11/13/2014||Yes|No||||No|No|||Prescription required|No||056|No|8.78472|02/02/2021|8.65922|02/02/2021|8.24688|02/02/2021|||ANTICONVULSANTS|2820|||||No|No||UPSHER-SMITH LA|No||||
topiramate|No|No|No|No|75%|00245107230|QUDEXY XR 50 MG CAPSULE|30|EA|5.02096|11/13/2014||Yes|No||11/13/2014||Yes|No|11/13/2014||Yes|No||||No|No|||Prescription required|No||056|No|11.44312|03/29/2022|11.27965|03/29/2022|10.74252|03/29/2022|||ANTICONVULSANTS|2821|||||No|No||UPSHER-SMITH LA|No||||
topiramate|No|No|No|No|75%|00245107330|QUDEXY XR 200 MG CAPSULE|30|EA|13.60821|11/13/2014||Yes|No||11/13/2014||Yes|No|11/13/2014||Yes|No||||No|No|||Prescription required|No||056|No|31.01406|02/02/2021|30.571|02/02/2021|29.11524|02/02/2021|||ANTICONVULSANTS|2822|||||No|No||UPSHER-SMITH LA|No||||
topiramate|No|No|No|No|75%|00245107430|QUDEXY XR 100 MG CAPSULE|30|EA|9.9479|11/13/2014||Yes|No||11/13/2014||Yes|No|11/13/2014||Yes|No||||No|No|||Prescription required|No||056|No|22.67196|03/29/2022|22.34808|03/29/2022|21.28388|03/29/2022|||ANTICONVULSANTS|2823|||||No|No||UPSHER-SMITH LA|No||||
topiramate|No|No|No|No|75%|00245107530|QUDEXY XR 150 MG CAPSULE|30|EA|12.23636|11/13/2014||Yes|No||11/13/2014||Yes|No|11/13/2014||Yes|No||||No|No|||Prescription required|No||056|No|27.88752|02/02/2021|27.48913|02/02/2021|26.18012|02/02/2021|||ANTICONVULSANTS|2824|||||No|No||UPSHER-SMITH LA|No||||
amiodarone HCl|No|No|No|No|75%|00245164501|PACERONE 400 MG TABLET|100|EA|1.72|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|No|||No|3.92|09/30/2021|3.864|09/30/2021|3.68|09/30/2021||||2825|||||No|No||UPSHER-SMITH LA|No||||
amiodarone HCl|No|No|No|No|75%|00245164530|PACERONE 400 MG TABLET|30|EA|1.43333|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|No|||No|3.26666|09/30/2021|3.21999|09/30/2021|3.06666|09/30/2021||||2826|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00245531501|KLOR-CON 8 MEQ TABLET|100|EA|.20885|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||12/09/2019||Yes|No|||Prescription required|No|||No|.47598|12/09/2019|.46918|12/09/2019|.44684|12/09/2019||||2827|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00245531511|KLOR-CON 8 MEQ TABLET|100|EA|.18451|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||12/09/2019||Yes|No|||Prescription required|No|||No|.42051|12/09/2019|.41451|12/09/2019|.39477|12/09/2019||||2828|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00245531515|KLOR-CON 8 MEQ TABLET|500|EA|.18451|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||12/09/2019||Yes|No|||Prescription required|No|||No|.42051|12/09/2019|.41451|12/09/2019|.39477|12/09/2019||||2829|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00245531601|KLOR-CON 10 MEQ TABLET|100|EA|.21689|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||12/09/2019||Yes|No|||Prescription required|No|||No|.26965|06/29/2021|.26317|06/29/2021|.26493|06/29/2021||||2830|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00245531611|KLOR-CON 10 MEQ TABLET|100|EA|.19423|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||12/09/2019||Yes|No|||Prescription required|No|||No|.26965|06/29/2021|.26317|06/29/2021|.26493|06/29/2021||||2831|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00245531615|KLOR-CON 10 MEQ TABLET|500|EA|.19423|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||12/09/2019||Yes|No|||Prescription required|No|||No|.26965|06/29/2021|.26317|06/29/2021|.26493|06/29/2021||||2832|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00245531701|KLOR-CON M10 TABLET|100|EA|.21254|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||12/09/2019||Yes|No|||Prescription required|No|||No|.48441|12/28/2021|.47749|12/28/2021|.45475|12/28/2021||||2833|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00245531710|KLOR-CON M10 TABLET|1000|EA|.205|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||12/09/2019||Yes|No|||Prescription required|No|||No|.46722|12/28/2021|.46055|12/28/2021|.43861|12/28/2021||||2834|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00245531711|KLOR-CON M10 TABLET|100|EA|.20502|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||12/09/2019||Yes|No|||Prescription required|No|||No|.46726|12/28/2021|.46058|12/28/2021|.43865|12/28/2021||||2835|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00245531790|KLOR-CON M10 TABLET|90|EA|.20501|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||12/09/2019||Yes|No|||Prescription required|No|||No|.46723|12/28/2021|.46055|12/28/2021|.43862|12/28/2021||||2836|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00245531801|KLOR-CON M15 TABLET|100|EA|.36532|12/06/2019||Yes|No||12/06/2019||Yes|No|12/06/2019||Yes|No||12/06/2019||Yes|No|||Prescription required|No|||No|.8326|12/24/2019|.82071|12/24/2019|.78163|12/24/2019||||2837|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00245531811|KLOR-CON M15 TABLET|100|EA|.34142|12/06/2019||Yes|No||12/06/2019||Yes|No|12/06/2019||Yes|No||12/06/2019||Yes|No|||Prescription required|No|||No|.77812|12/24/2019|.767|12/24/2019|.73048|12/24/2019||||2838|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00245531901|KLOR-CON M20 TABLET|100|EA|.23387|12/06/2019||Yes|No||12/06/2019||Yes|No|12/06/2019||Yes|No||12/06/2019||Yes|No|||Prescription required|No|||No|.25243|09/28/2021|.24637|09/28/2021|.24801|09/28/2021||||2839|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00245531910|KLOR-CON M20 TABLET|1000|EA|.21582|12/06/2019||Yes|No||12/06/2019||Yes|No|12/06/2019||Yes|No||12/06/2019||Yes|No|||Prescription required|No|||No|.25243|09/28/2021|.24637|09/28/2021|.24801|09/28/2021||||2840|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00245531911|KLOR-CON M20 TABLET|100|EA|.21581|12/06/2019||Yes|No||12/06/2019||Yes|No|12/06/2019||Yes|No||12/06/2019||Yes|No|||Prescription required|No|||No|.25243|09/28/2021|.24637|09/28/2021|.24801|09/28/2021||||2841|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00245531915|KLOR-CON M20 TABLET|500|EA|.21582|12/06/2019||Yes|No||12/06/2019||Yes|No|12/06/2019||Yes|No||12/06/2019||Yes|No|||Prescription required|No|||No|.25243|09/28/2021|.24637|09/28/2021|.24801|09/28/2021||||2842|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00245531990|KLOR-CON M20 TABLET|90|EA|.2158|12/06/2019||Yes|No||12/06/2019||Yes|No|12/06/2019||Yes|No||12/06/2019||Yes|No|||Prescription required|No|||No|.25243|09/28/2021|.24637|09/28/2021|.24801|09/28/2021||||2843|||||No|No||UPSHER-SMITH LA|No||||
potassium bicarbonate/cit ac|No|No|No|No|75%|00245532601|KLOR-CON-EF 25 MEQ TAB EFF|100|EA|.54012|10/12/2020||Yes|No||10/12/2020||Yes|No|10/12/2020||Yes|No||10/12/2020||Yes|No|||Prescription required|No|||No|1.16893|03/29/2022|1.14087|03/29/2022|1.14847|03/29/2022||||2844|||||No|No||UPSHER-SMITH LA|No||||
potassium bicarbonate/cit ac|No|No|No|No|75%|00245532630|KLOR-CON-EF 25 MEQ TAB EFF|30|EA|.54051|10/12/2020||Yes|No||10/12/2020||Yes|No|10/12/2020||Yes|No||10/12/2020||Yes|No|||Prescription required|No|||No|1.16893|03/29/2022|1.14087|03/29/2022|1.14847|03/29/2022||||2845|||||No|No||UPSHER-SMITH LA|No||||
albuterol sulfate|No|No|No|No|75%|00254100752|ALBUTEROL HFA 90 MCG INHALER|6.7|GM|2.30916|09/09/2019||Yes|No||09/09/2019||Yes|No|09/09/2019||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|3.77137|03/29/2022|3.68085|03/29/2022|3.70537|03/29/2022|||BRONCHODILATORS: BETA AGONIST|2846|||||No|No||PAR PHARM.|No||||
diazoxide|No|No|No|No|75%|00254101019|DIAZOXIDE 50 MG/ML ORAL SUSP|30|ML|3.94912|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|583|No|8.55475|03/08/2022|8.34943|03/08/2022|8.40504|03/08/2022|||GLUCAGON AGENTS|2847|||||No|No||PAR PHARM.|No||||
sucralfate|No|No|No|No|75%|00254101196|SUCRALFATE 1 GM/10 ML SUSP|420|ML|.17997|06/30/2020||Yes|No||06/30/2020||Yes|No|06/30/2020||Yes|No||||No|No|||Prescription required|No|||No|.34621|03/29/2022|.3379|03/29/2022|.34015|03/29/2022||||2848|||||No|No||PAR PHARM.|No||||
erythromycin ethylsuccinate|No|No|No|No|75%|00254102047|ERYTHROMYCIN 200 MG/5 ML SUSP|100|ML|1.39461|03/09/2020|11/30/2022|Yes|No||03/09/2020|11/30/2022|Yes|No|03/09/2020|11/30/2022|Yes|No||||No|No|||Prescription required|Yes|03/09/2018|018|No|1.82351|03/29/2022|1.77974|03/29/2022|1.79159|03/29/2022|||MACROLIDES/KETOLIDES|2849|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||PAR PHARM.|No||||
erythromycin ethylsuccinate|No|No|No|No|75%|00254102147|ERYTHROMYCIN 400 MG/5 ML SUSP|100|ML|2.4553|09/01/2020|10/31/2022|Yes|No||09/01/2020|10/31/2022|Yes|No|09/01/2020|10/31/2022|Yes|No||||No|No|||Prescription required|Yes|03/09/2018|018|No|3.08133|03/29/2022|3.00737|03/29/2022|3.0274|03/29/2022|||MACROLIDES/KETOLIDES|2850|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||PAR PHARM.|No||||
penicillamine|No|No|No|No|75%|00254200001|PENICILLAMINE 250 MG TABLET|100|EA|20.00755|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No|||No|45.59861|05/21/2020|44.9472|05/21/2020|42.80686|05/21/2020||||2851|||||No|No||PAR PHARM.|No||||
colchicine|No|No|No|No|75%|00254200801|COLCHICINE 0.6 MG TABLET|100|EA|2.41384|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|231|No|.64179|03/29/2022|.62638|03/29/2022|.63055|03/29/2022|||ANTIHYPERURICEMICS|2852|||||No|No||PAR PHARM.|No||||
colchicine|No|No|No|No|75%|00254200811|COLCHICINE 0.6 MG TABLET|30|EA|2.41387|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|231|No|.64179|03/29/2022|.62638|03/29/2022|.63055|03/29/2022|||ANTIHYPERURICEMICS|2853|||||No|No||PAR PHARM.|No||||
posaconazole|No|No|No|No|75%|00254204502|POSACONAZOLE DR 100 MG TABLET|60|EA|23.57432|12/20/2019||Yes|No||12/20/2019||Yes|No|12/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|069|No|22.47154|03/29/2022|21.93222|03/29/2022|22.07828|03/29/2022|||ANTIFUNGALS: ORAL|2854|||||No|No||PAR PHARM.|No||||
nitisinone|No|No|No|No|75%|00254302002|NITISINONE 2 MG CAPSULE|60|EA|31.24315|05/11/2020||Yes|No||05/11/2020||Yes|No|05/11/2020||Yes|No||||No|No|||Prescription required|No|||Yes|71.20533|05/11/2020|70.18811|05/11/2020|66.84582|05/11/2020||||2855|||||No|No||PAR PHARM.|No||||
nitisinone|No|No|No|No|75%|00254302102|NITISINONE 5 MG CAPSULE|60|EA|78.10741|05/11/2020||Yes|No||05/11/2020||Yes|No|05/11/2020||Yes|No||||No|No|||Prescription required|No|||Yes|178.01225|05/11/2020|175.46922|05/11/2020|167.11354|05/11/2020||||2856|||||No|No||PAR PHARM.|No||||
nitisinone|No|No|No|No|75%|00254302202|NITISINONE 10 MG CAPSULE|60|EA|156.21505|05/11/2020||Yes|No||05/11/2020||Yes|No|05/11/2020||Yes|No||||No|No|||Prescription required|No|||Yes|356.02501|05/11/2020|350.93894|05/11/2020|334.22756|05/11/2020||||2857|||||No|No||PAR PHARM.|No||||
lubiprostone|No|No|No|No|75%|00254302802|LUBIPROSTONE 8 MCG CAPSULE|60|EA|2.12764|10/04/2021||Yes|No||10/04/2021||Yes|No|10/04/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|534|Yes|4.64232|03/29/2022|4.5309|03/29/2022|4.56107|03/29/2022|||GI MOTILITY: CHRONIC|2858|||||No|No||PAR PHARM.|No||||
lubiprostone|No|No|No|No|75%|00254302902|LUBIPROSTONE 24 MCG CAPSULE|60|EA|2.12764|10/04/2021||Yes|No||10/04/2021||Yes|No|10/04/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|534|Yes|4.48947|03/29/2022|4.38172|03/29/2022|4.4109|03/29/2022|||GI MOTILITY: CHRONIC|2859|||||No|No||PAR PHARM.|No||||
glycopyrrolate|No|No|No|No|75%|00259050116|CUVPOSA 1 MG/5 ML SOLUTION|473|ML|.63783|04/16/2013||Yes|No||04/16/2013||Yes|No|04/16/2013||Yes|No||||No|No|||Prescription required|No|||No|1.01499|07/27/2021|.99063|07/27/2021|.99722|07/27/2021||||2860|||||No|No||MERZ|No||||
dextrose 5 % in water|No|No|No|No|75%|00264151032|DEXTROSE 5%-WATER IV SOLN|100|ML|.00976|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.02224|06/30/2020|.02192|06/30/2020|.02088|06/30/2020||||2861|||||No|No||B.BRAUN|No||||
0.9 % sodium chloride|No|No|No|No|75%|00264180031|SODIUM CHLORIDE 0.9% SOLUTION|50|ML|.01952|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.04449|06/30/2020|.04385|06/30/2020|.04176|06/30/2020||||2862|||||No|No||B.BRAUN|No||||
0.9 % sodium chloride|No|No|No|No|75%|00264180032|SODIUM CHLORIDE 0.9% SOLUTION|100|ML|.00976|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.02224|06/30/2020|.02192|06/30/2020|.02088|06/30/2020||||2863|||||No|No||B.BRAUN|No||||
sodium/pot/mag/calc/chlor/acet|No|No|No|No|75%|00264194320|HYPERLYTE CR VIAL|250|ML|.03279|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|.07473|06/30/2020|.07366|06/30/2020|.07015|06/30/2020||||2864|||||No|No||B.BRAUN|No||||
water for irrigation,sterile|No|No|No|No|75%|00264210100|STERILE WATER FOR IRRIGATION|1000|ML|.00134|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00305|06/30/2020|.00301|06/30/2020|.00287|06/30/2020||||2865|||||No|No||B.BRAUN|No||||
water for irrigation,sterile|No|No|No|No|75%|00264210110|STERILE WATER FOR IRRIGATION|500|ML|.00237|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00541|06/30/2020|.00534|06/30/2020|.00508|06/30/2020||||2866|||||No|No||B.BRAUN|No||||
water for irrigation,sterile|No|No|No|No|75%|00264210150|STERILE WATER FOR IRRIGATION|2000|ML|.00078|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00179|07/02/2019|.00176|07/02/2019|.00168|07/02/2019||||2867|||||No|No||B.BRAUN|No||||
sodium chloride irrig solution|No|No|No|No|75%|00264220100|SODIUM CHLORIDE 0.9% IRRIG.|1000|ML|.00146|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00333|06/30/2020|.00328|06/30/2020|.00312|06/30/2020||||2868|||||No|No||B.BRAUN|No||||
sodium chloride irrig solution|No|No|No|No|75%|00264220110|SODIUM CHLORIDE 0.9% IRRIG.|500|ML|.00249|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00569|06/30/2020|.00561|06/30/2020|.00534|06/30/2020||||2869|||||No|No||B.BRAUN|No||||
sodium chloride irrig solution|No|No|No|No|75%|00264220150|SODIUM CHLORIDE 0.9% IRRIG.|2000|ML|.00091|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00207|06/30/2020|.00204|06/30/2020|.00195|06/30/2020||||2870|||||No|No||B.BRAUN|No||||
Ringer's solution,lactated|No|No|No|No|75%|00264220300|LACTATED RINGERS IRRIGATION|1000|ML|.00135|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00309|02/19/2019|.00305|02/19/2019|.0029|02/19/2019||||2871|||||No|No||B.BRAUN|No||||
physiological irrig soln no.1|No|No|No|No|75%|00264220500|PHYSIOLYTE IRRIGATION SOLN|1000|ML|.00123|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00281|02/19/2019|.00277|02/19/2019|.00264|02/19/2019||||2872|||||No|No||B.BRAUN|No||||
acetic acid|No|No|No|No|75%|00264230400|ACETIC ACID 0.25% IRRIG SOLN|1000|ML|.00179|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00408|06/30/2020|.00402|06/30/2020|.00383|06/30/2020||||2873|||||No|No||B.BRAUN|No||||
acetic acid|No|No|No|No|75%|00264230410|ACETIC ACID 0.25% IRRIG SOLN|500|ML|.00368|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.0084|06/30/2020|.00828|06/30/2020|.00789|06/30/2020||||2874|||||No|No||B.BRAUN|No||||
dextrose 5 % in water|No|No|No|No|75%|00264751000|DEXTROSE 5%-WATER IV SOLN|1000|ML|.00158|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00361|06/30/2020|.00356|06/30/2020|.00339|06/30/2020||||2875|||||No|No||B.BRAUN|No||||
dextrose 5 % in water|No|No|No|No|75%|00264751010|DEXTROSE 5%-WATER IV SOLN|500|ML|.00266|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00607|06/30/2020|.00598|06/30/2020|.0057|06/30/2020||||2876|||||No|No||B.BRAUN|No||||
dextrose 5 % in water|No|No|No|No|75%|00264751020|DEXTROSE 5%-WATER IV SOLN|250|ML|.0049|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.01118|06/30/2020|.01102|06/30/2020|.01049|06/30/2020||||2877|||||No|No||B.BRAUN|No||||
dextrose 10 % in water|No|No|No|No|75%|00264752000|DEXTROSE 10%-WATER IV SOLUTION|1000|ML|.00132|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00301|06/30/2020|.00297|06/30/2020|.00283|06/30/2020||||2878|||||No|No||B.BRAUN|No||||
dextrose 10 % in water|No|No|No|No|75%|00264752010|DEXTROSE 10%-WATER IV SOLUTION|500|ML|.00238|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00543|06/30/2020|.00536|06/30/2020|.0051|06/30/2020||||2879|||||No|No||B.BRAUN|No||||
dextrose 10 % in water|No|No|No|No|75%|00264752020|DEXTROSE 10%-WATER IV SOLUTION|250|ML|.00365|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00833|02/19/2019|.00821|02/19/2019|.00782|02/19/2019||||2880|||||No|No||B.BRAUN|No||||
dextrose 5 % and 0.9 % NaCl|No|No|No|No|75%|00264761000|DEXTROSE 5%-0.9% NACL IV SOLN|1000|ML|.00122|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00279|06/30/2020|.00275|06/30/2020|.00262|06/30/2020||||2881|||||No|No||B.BRAUN|No||||
dextrose 5 % and 0.9 % NaCl|No|No|No|No|75%|00264761010|DEXTROSE 5%-0.9% NACL IV SOLN|500|ML|.0025|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.0057|06/30/2020|.00562|06/30/2020|.00535|06/30/2020||||2882|||||No|No||B.BRAUN|No||||
dextrose 5 %-0.45 % sod chlord|No|No|No|No|75%|00264761200|DEXTROSE 5%-0.45% NACL IV SOLN|1000|ML|.0012|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00274|06/30/2020|.0027|06/30/2020|.00257|06/30/2020||||2883|||||No|No||B.BRAUN|No||||
dextrose 5 %-0.45 % sod chlord|No|No|No|No|75%|00264761210|DEXTROSE 5%-0.45% NACL IV SOLN|500|ML|.0024|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00548|06/30/2020|.0054|06/30/2020|.00515|06/30/2020||||2884|||||No|No||B.BRAUN|No||||
dextrose 5 %-0.2 % sod chlorid|No|No|No|No|75%|00264761600|DEXTROSE 5%-0.2% NACL IV SOLN|1000|ML|.00141|03/01/2002||Yes|No||03/01/2002||Yes|No|||No|No||||No|No|||Prescription required|No|||No|.00323|06/30/2020|.00318|06/30/2020|.00303|06/30/2020||||2885|||||No|No||B.BRAUN|No||||
dextrose 5 %-0.2 % sod chlorid|No|No|No|No|75%|00264761610|DEXTROSE 5%-0.2% NACL IV SOLN|500|ML|.00183|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00418|02/19/2019|.00412|02/19/2019|.00392|02/19/2019||||2886|||||No|No||B.BRAUN|No||||
dextrose 5 %-0.2 % sod chlorid|No|No|No|No|75%|00264761620|DEXTROSE 5%-0.2% NACL IV SOLN|250|ML|.00365|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00833|02/19/2019|.00821|02/19/2019|.00782|02/19/2019||||2887|||||No|No||B.BRAUN|No||||
dextrose 10 % and 0.45 % NaCl|No|No|No|No|75%|00264762200|DEXTROSE 10%-0.45% NACL IV SOL|1000|ML|.00313|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00713|06/30/2020|.00703|06/30/2020|.00669|06/30/2020||||2888|||||No|No||B.BRAUN|No||||
dextrose 10 % and 0.2 % NaCl|No|No|No|No|75%|00264762320|DEXTROSE 10%-0.2% NACL IV SOLN|250|ML|.00536|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.01223|06/30/2020|.01205|06/30/2020|.01148|06/30/2020||||2889|||||No|No||B.BRAUN|No||||
potassium chloride in D5W|No|No|No|No|75%|00264762500|KCL 20 MEQ/L IN D5W SOLUTION|1000|ML|.00168|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00383|06/30/2020|.00377|06/30/2020|.00359|06/30/2020||||2890|||||No|No||B.BRAUN|No||||
potassium chloride/D5-0.45NaCl|No|No|No|No|75%|00264763400|D5%-1/2NS-KCL 10 MEQ/L IV SOL|1000|ML|.00215|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00491|06/30/2020|.00484|06/30/2020|.00461|06/30/2020||||2891|||||No|No||B.BRAUN|No||||
potassium chloride/D5-0.45NaCl|No|No|No|No|75%|00264763500|KCL 20 MEQ IN D5W-0.45% NACL|1000|ML|.00133|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00303|06/30/2020|.00299|06/30/2020|.00285|06/30/2020||||2892|||||No|No||B.BRAUN|No||||
potassium chloride/D5-0.45NaCl|No|No|No|No|75%|00264763600|D5%-1/2NS-KCL 30 MEQ/L IV SOL|1000|ML|.00126|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00289|02/19/2019|.00284|02/19/2019|.00271|02/19/2019||||2893|||||No|No||B.BRAUN|No||||
potassium chloride/D5-0.45NaCl|No|No|No|No|75%|00264763800|D5%-1/2NS-KCL 40 MEQ/L IV SOL|1000|ML|.00216|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00492|06/30/2020|.00485|06/30/2020|.00462|06/30/2020||||2894|||||No|No||B.BRAUN|No||||
potassium chloride/D5-0.2%NaCl|No|No|No|No|75%|00264764500|KCL 20 MEQ IN D5W-0.2% NACL|1000|ML|.00206|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.0047|06/30/2020|.00463|06/30/2020|.00441|06/30/2020||||2895|||||No|No||B.BRAUN|No||||
potassium chloride/D5-0.9%NaCl|No|No|No|No|75%|00264765200|KCL 20 MEQ IN D5W-NS|1000|ML|.00153|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00348|06/30/2020|.00343|06/30/2020|.00327|06/30/2020||||2896|||||No|No||B.BRAUN|No||||
Ringer's solution,lactated|No|No|No|No|75%|00264775000|LACTATED RINGERS INJECTION|1000|ML|.00108|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00247|07/02/2019|.00244|07/02/2019|.00232|07/02/2019||||2897|||||No|No||B.BRAUN|No||||
Ringer's solution,lactated|No|No|No|No|75%|00264775010|LACTATED RINGERS INJECTION|500|ML|.00239|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00546|07/02/2019|.00539|07/02/2019|.00513|07/02/2019||||2898|||||No|No||B.BRAUN|No||||
Ringer's solution,lactated|No|No|No|No|75%|00264775020|LACTATED RINGERS INJECTION|250|ML|.00485|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.01107|06/30/2020|.01091|06/30/2020|.01039|06/30/2020||||2899|||||No|No||B.BRAUN|No||||
dextrose 5%-lactated ringers|No|No|No|No|75%|00264775100|DEXTROSE 5%-LR IV SOLUTION|1000|ML|.00122|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.0028|06/30/2020|.00276|06/30/2020|.00263|06/30/2020||||2900|||||No|No||B.BRAUN|No||||
dextrose 5%-lactated ringers|No|No|No|No|75%|00264775110|DEXTROSE 5%-LR IV SOLUTION|500|ML|.00268|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00612|06/30/2020|.00603|06/30/2020|.00575|06/30/2020||||2901|||||No|No||B.BRAUN|No||||
0.9 % sodium chloride|No|No|No|No|75%|00264780000|SODIUM CHLORIDE 0.9% SOL-EXCEL|1000|ML|.00105|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.0024|07/02/2019|.00236|07/02/2019|.00225|07/02/2019||||2902|||||No|No||B.BRAUN|No||||
0.9 % sodium chloride|No|No|No|No|75%|00264780009|SODIUM CHLORIDE 0.9% SOLUTION|1000|ML|.00112|04/03/2018||Yes|No||||No|No|04/03/2018||Yes|No||||No|No|||Prescription required|No|||No|.00256|04/03/2018|.00253|04/03/2018|.00241|04/03/2018||||2903|||||No|No||B.BRAUN|No||||
0.9 % sodium chloride|No|No|No|No|75%|00264780010|SODIUM CHLORIDE 0.9% SOL-EXCEL|500|ML|.00242|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00552|06/30/2020|.00544|06/30/2020|.00518|06/30/2020||||2904|||||No|No||B.BRAUN|No||||
0.9 % sodium chloride|No|No|No|No|75%|00264780020|SODIUM CHLORIDE 0.9% SOL-EXCEL|250|ML|.00412|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00939|06/30/2020|.00926|06/30/2020|.00882|06/30/2020||||2905|||||No|No||B.BRAUN|No||||
sodium chloride 0.45 %|No|No|No|No|75%|00264780200|SALINE 0.45% SOLN-EXCEL CON|1000|ML|.00122|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.0028|06/30/2020|.00276|06/30/2020|.00263|06/30/2020||||2906|||||No|No||B.BRAUN|No||||
sodium chloride 0.45 %|No|No|No|No|75%|00264780210|SALINE 0.45% SOLN-EXCEL CON|500|ML|.00251|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00573|06/30/2020|.00565|06/30/2020|.00538|06/30/2020||||2907|||||No|No||B.BRAUN|No||||
water for injection,sterile|No|No|No|No|75%|00264785000|STERILE WATER FOR INJECTION|1000|ML|.00149|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.0034|06/30/2020|.00335|06/30/2020|.00319|06/30/2020||||2908|||||No|No||B.BRAUN|No||||
water for injection,sterile|No|No|No|No|75%|00264785020|STERILE WATER FOR INJECTION|250|ML|.00377|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00859|02/19/2019|.00847|02/19/2019|.00806|02/19/2019||||2909|||||No|No||B.BRAUN|No||||
heparin sodium,porcine/D5W|No|No|No|No|75%|00264957710|HEPARIN 25,000 UNIT/500 ML-D5W|500|ML|.01268|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.02891|06/30/2020|.0285|06/30/2020|.02714|06/30/2020||||2910|||||No|No||B.BRAUN|No||||
lidocaine HCl/dextrose 5 %/PF|No|No|No|No|75%|00264959410|LIDOCAINE 0.4% IN D5W SOLN|500|ML|.0067|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.01528|06/30/2020|.01506|06/30/2020|.01435|06/30/2020||||2911|||||No|No||B.BRAUN|No||||
lidocaine HCl/dextrose 5 %/PF|No|No|No|No|75%|00264959820|LIDOCAINE 0.8% IN D5W SOLN|250|ML|.01219|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.0278|06/30/2020|.0274|06/30/2020|.0261|06/30/2020||||2912|||||No|No||B.BRAUN|No||||
heparin sodium,porcine/NS/PF|No|No|No|No|75%|00264987210|HEPARIN 1,000 UNIT/500 ML-NS|500|ML|.00329|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.0075|06/30/2020|.00739|06/30/2020|.00704|06/30/2020||||2913|||||No|No||B.BRAUN|No||||
nitroglycerin|No|No|No|No|75%|00281032608|NITRO-BID 2% OINTMENT|1|GM|.94769|12/11/2015||Yes|No||12/11/2015||Yes|No|12/11/2015||Yes|No||||No|No|||Prescription required|No|||No|2.15987|06/19/2018|2.12901|06/19/2018|2.02763|06/19/2018||||2914|||||No|No||SANDOZ|No||||
nitroglycerin|No|No|No|No|75%|00281032630|NITRO-BID 2% OINTMENT|30|GM|.48833|10/12/2016||Yes|No||10/12/2016||Yes|No|10/12/2016||Yes|No||||No|No|||Prescription required|No|||No|1.12708|07/27/2021|1.10003|07/27/2021|1.10735|07/27/2021||||2915|||||No|No||SANDOZ|No||||
nitroglycerin|No|No|No|No|75%|00281032660|NITRO-BID 2% OINTMENT|60|GM|.48833|10/12/2016||Yes|No||10/12/2016||Yes|No|10/12/2016||Yes|No||||No|No|||Prescription required|No|||No|1.0982|08/24/2021|1.07184|08/24/2021|1.07898|08/24/2021||||2916|||||No|No||SANDOZ|No||||
calcitriol|No|No|No|No|75%|00299201210|VECTICAL 3 MCG/G OINTMENT|100|GM|3.90676|04/22/2009||Yes|No||04/22/2009||Yes|No|04/22/2009||Yes|No||||No|No|||Prescription required|No|||No|8.90379|04/25/2017|8.77659|04/25/2017|8.35866|04/25/2017||||2917|||||No|No||GALDERMA LABORA|No||||
metronidazole|No|No|No|No|75%|00299382060|METROGEL TOPICAL 1% GEL|60|GM|2.69788|05/02/2006||Yes|No||05/02/2006||Yes|No|05/02/2006||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|221|No|6.04829|05/25/2021|5.90313|05/25/2021|5.94244|05/25/2021|||ROSACEA AGENTS: TOPICAL|2918|||||No|No||GALDERMA LABORA|No||||
doxycycline monohydrate|No|No|No|No|75%|00299382230|ORACEA 40 MG CAPSULE|30|EA|11.65013|10/21/2008||Yes|No||10/21/2008||Yes|No|10/21/2008||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|213|No|26.02625|01/25/2022|25.40162|01/25/2022|25.57079|01/25/2022|||TETRACYCLINES|2919|||||No|No||GALDERMA LABORA|No||||
metronidazole|No|No|No|No|75%|00299383645|METROCREAM 0.75% CREAM|45|GM|5.97604|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|221|No|13.61981|06/01/2016|13.42524|06/01/2016|12.78594|06/01/2016|||ROSACEA AGENTS: TOPICAL|2920|||||No|No||GALDERMA LABORA|No||||
clobetasol propionate|No|No|No|No|75%|00299384902|CLOBEX 0.05% SPRAY|59|ML|3.22463|04/26/2007||Yes|No||04/26/2007||Yes|No|04/26/2007||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|121|No|7.34916|07/26/2016|7.24417|07/26/2016|6.89921|07/26/2016|||STEROIDS: TOPICAL VERY HIGH|2921|||||No|No||GALDERMA LABORA|No||||
clobetasol propionate|No|No|No|No|75%|00299384904|CLOBEX 0.05% SPRAY|125|ML|3.00948|04/04/2007||Yes|No||04/04/2007||Yes|No|04/04/2007||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|121|No|6.85882|07/25/2017|6.76084|07/25/2017|6.43889|07/25/2017|||STEROIDS: TOPICAL VERY HIGH|2922|||||No|No||GALDERMA LABORA|No||||
adapalene/benzoyl peroxide|No|No|No|No|75%|00299590645|EPIDUO FORTE 0.3-2.5% GEL PUMP|45|GM|5.82506|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|104|No|13.02624|01/25/2022|12.71361|01/25/2022|12.79828|01/25/2022|||ACNE AGENTS: TOPICAL|2923|||||No|No||GALDERMA LABORA|No||||
adapalene|No|No|No|No|75%|00299591202|DIFFERIN 0.1% LOTION|59|ML|3.53438|05/03/2010||Yes|No||05/03/2010||Yes|No|05/03/2010||Yes|No||||No|No|||Prescription required|Yes|04/01/2012|104|No|8.0551|04/25/2017|7.94002|04/25/2017|7.56193|04/25/2017|||ACNE AGENTS: TOPICAL|2924|||||No|No||GALDERMA LABORA|No||||
adapalene|No|No|No|No|75%|00299591545|DIFFERIN 0.1% CREAM|45|GM|5.05584|04/29/2002||Yes|No||04/29/2002||Yes|No|04/29/2002||Yes|No||||No|No|||Prescription required|Yes|04/01/2012|104|No|11.21791|11/23/2021|10.94868|11/23/2021|11.02159|11/23/2021|||ACNE AGENTS: TOPICAL|2925|||||No|No||GALDERMA LABORA|No||||
adapalene|No|No|No|No|75%|00299591825|DIFFERIN 0.3% GEL PUMP|45|GM|5.24647|06/13/2012||Yes|No||06/13/2012||Yes|No|06/13/2012||Yes|No||||No|No|||Prescription required|Yes|04/01/2012|104|No|11.63308|03/01/2022|11.35388|03/01/2022|11.4295|03/01/2022|||ACNE AGENTS: TOPICAL|2926|||||No|No||GALDERMA LABORA|No||||
fluocinolone/tretinoin/h-quin|No|No|No|No|75%|00299595030|TRI-LUMA CREAM|30|GM|3.18916|02/03/2004||Yes|No||02/03/2004||Yes|No|02/03/2004||Yes|No||||No|No|||Prescription required|No|||No|7.08524|01/04/2022|6.91519|01/04/2022|6.96124|01/04/2022||||2927|||||No|No||GALDERMA LABORA|No||||
brimonidine tartrate|No|No|No|No|75%|00299598035|MIRVASO 0.33% GEL PUMP|30|GM|7.90053|12/21/2016||Yes|No||12/21/2016||Yes|No|12/21/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|221|No|17.61123|04/20/2021|17.18856|04/20/2021|17.30303|04/20/2021|||ROSACEA AGENTS: TOPICAL|2928|||||No|No||GALDERMA LABORA|No||||
roflumilast|No|No|No|No|75%|00310008828|DALIRESP 250 MCG TABLET|28|EA|5.99619|09/24/2018||Yes|No||09/24/2018||Yes|No|09/24/2018||Yes|No||||No|No|||Prescription required|Yes|03/22/2018|098|No|13.35195|01/18/2022|13.0315|01/18/2022|13.11829|01/18/2022|||COPD AGENTS|2929|||||No|No||ASTRAZENECA|No||||
roflumilast|No|No|No|No|75%|00310008839|DALIRESP 250 MCG TABLET|20|EA|5.99484|09/24/2018||Yes|No||09/24/2018||Yes|No|09/24/2018||Yes|No||||No|No|||Prescription required|Yes|03/22/2018|098|No|13.35195|01/18/2022|13.0315|01/18/2022|13.11829|01/18/2022|||COPD AGENTS|2930|||||No|No||ASTRAZENECA|No||||
roflumilast|No|No|No|No|75%|00310009530|DALIRESP 500 MCG TABLET|30|EA|5.9962|09/03/2015||Yes|No||09/03/2015||Yes|No|09/03/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|098|No|13.36963|01/18/2022|13.04875|01/18/2022|13.13566|01/18/2022|||COPD AGENTS|2931|||||No|No||ASTRAZENECA|No||||
roflumilast|No|No|No|No|75%|00310009590|DALIRESP 500 MCG TABLET|90|EA|5.99629|09/03/2015||Yes|No||09/03/2015||Yes|No|09/03/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|098|No|13.36963|01/18/2022|13.04875|01/18/2022|13.13566|01/18/2022|||COPD AGENTS|2932|||||No|No||ASTRAZENECA|No||||
quetiapine fumarate|No|No|No|No|75%|00310027110|SEROQUEL 100 MG TABLET|100|EA|2.86681|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|027|Yes|6.53366|07/25/2017|6.44032|07/25/2017|6.13364|07/25/2017|||ANTIPSYCHOTICS|2933|||||No|No||ASTRAZENECA|No||||
quetiapine fumarate|No|No|No|No|75%|00310027210|SEROQUEL 200 MG TABLET|100|EA|5.40832|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|027|Yes|12.32595|01/29/2019|12.14986|01/29/2019|11.5713|01/29/2019|||ANTIPSYCHOTICS|2934|||||No|No||ASTRAZENECA|No||||
quetiapine fumarate|No|No|No|No|75%|00310027460|SEROQUEL 300 MG TABLET|60|EA|7.09127|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|027|Yes|16.1615|02/28/2017|15.93062|02/28/2017|15.17202|02/28/2017|||ANTIPSYCHOTICS|2935|||||No|No||ASTRAZENECA|No||||
quetiapine fumarate|No|No|No|No|75%|00310027510|SEROQUEL 25 MG TABLET|100|EA|1.67059|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|027|Yes|3.80739|02/28/2017|3.753|02/28/2017|3.57429|02/28/2017|||ANTIPSYCHOTICS|2936|||||No|No||ASTRAZENECA|No||||
quetiapine fumarate|No|No|No|No|75%|00310027810|SEROQUEL 50 MG TABLET|100|EA|2.7452|07/13/2006||Yes|No||07/13/2006||Yes|No|07/13/2006||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|027|Yes|6.25651|06/01/2016|6.16713|06/01/2016|5.87346|06/01/2016|||ANTIPSYCHOTICS|2937|||||No|No||ASTRAZENECA|No||||
quetiapine fumarate|No|No|No|No|75%|00310027910|SEROQUEL 400 MG TABLET|100|EA|8.33383|07/13/2006||Yes|No||07/13/2006||Yes|No|07/13/2006||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|027|Yes|18.99338|05/23/2017|18.72204|05/23/2017|17.83052|05/23/2017|||ANTIPSYCHOTICS|2938|||||No|No||ASTRAZENECA|No||||
quetiapine fumarate|No|No|No|No|75%|00310028060|SEROQUEL XR 50 MG TABLET|60|EA|3.53116|02/18/2009||Yes|No||02/18/2009||Yes|No|02/18/2009||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|027|Yes|8.04776|05/28/2019|7.93279|05/28/2019|7.55504|05/28/2019|||ANTIPSYCHOTICS|2939|||||No|No||ASTRAZENECA|No||||
quetiapine fumarate|No|No|No|No|75%|00310028160|SEROQUEL XR 150 MG TABLET|60|EA|6.34078|02/19/2009||Yes|No||02/19/2009||Yes|No|02/19/2009||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|027|Yes|14.45108|08/24/2021|14.24463|08/24/2021|13.56632|08/24/2021|||ANTIPSYCHOTICS|2940|||||No|No||ASTRAZENECA|No||||
quetiapine fumarate|No|No|No|No|75%|00310028260|SEROQUEL XR 200 MG TABLET|60|EA|6.9789|07/24/2007||Yes|No||07/24/2007||Yes|No|07/24/2007||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|027|Yes|15.9054|12/24/2019|15.67818|12/24/2019|14.9316|12/24/2019|||ANTIPSYCHOTICS|2941|||||No|No||ASTRAZENECA|No||||
quetiapine fumarate|No|No|No|No|75%|00310028360|SEROQUEL XR 300 MG TABLET|60|EA|9.15025|07/24/2007||Yes|No||07/24/2007||Yes|No|07/24/2007||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|027|Yes|20.85406|09/29/2020|20.55615|09/29/2020|19.57728|09/29/2020|||ANTIPSYCHOTICS|2942|||||No|No||ASTRAZENECA|No||||
quetiapine fumarate|No|No|No|No|75%|00310028460|SEROQUEL XR 400 MG TABLET|60|EA|10.75387|07/24/2007||Yes|No||07/24/2007||Yes|No|07/24/2007||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|027|Yes|24.50882|11/23/2021|24.15869|11/23/2021|23.00828|11/23/2021|||ANTIPSYCHOTICS|2943|||||No|No||ASTRAZENECA|No||||
gefitinib|No|No|No|No|75%|00310048230|IRESSA 250 MG TABLET|30|EA|111.64061|06/13/2003||Yes|No||06/13/2003||Yes|No|06/13/2003||Yes|No||||No|No|||Prescription required|No||551|No|254.43674|04/09/2019|250.80193|04/09/2019|238.85898|04/09/2019|||ONCOLOGY: ORAL - LUNG|2944|||||No|No||ASTRAZENECA|No||||
acalabrutinib|No|No|No|No|75%|00310051260|CALQUENCE 100 MG CAPSULE|60|EA|102.30388|07/06/2018||Yes|No||07/06/2018||Yes|No|07/06/2018||Yes|No||||No|No|||Prescription required|No||173|No|233.15768|01/11/2022|229.82685|01/11/2022|218.88272|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|2945|||||No|No||ASTRAZENECA|No||||
selumetinib/vitamin E TPGS|No|No|No|No|75%|00310061028|KOSELUGO 10 MG CAPSULE|28|EA|33.81274|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|No||239|No|77.06159|10/12/2021|75.96071|10/12/2021|72.34353|10/12/2021|||ONCOLOGY: ORAL - OTHER|2946|||||No|No||ASTRAZENECA|No||||
selumetinib/vitamin E TPGS|No|No|No|No|75%|00310061060|KOSELUGO 10 MG CAPSULE|60|EA|33.8119|06/12/2020||Yes|No||06/12/2020||Yes|No|06/12/2020||Yes|No||||No|No|||Prescription required|No||239|No|77.05968|10/12/2021|75.95883|10/12/2021|72.34174|10/12/2021|||ONCOLOGY: ORAL - OTHER|2947|||||No|No||ASTRAZENECA|No||||
selumetinib/vitamin E TPGS|No|No|No|No|75%|00310062528|KOSELUGO 25 MG CAPSULE|28|EA|84.5297|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|No||239|No|192.64909|10/12/2021|189.89696|10/12/2021|180.85425|10/12/2021|||ONCOLOGY: ORAL - OTHER|2948|||||No|No||ASTRAZENECA|No||||
selumetinib/vitamin E TPGS|No|No|No|No|75%|00310062560|KOSELUGO 25 MG CAPSULE|60|EA|84.52975|06/15/2020||Yes|No||06/15/2020||Yes|No|06/15/2020||Yes|No||||No|No|||Prescription required|No||239|No|192.64921|10/12/2021|189.89708|10/12/2021|180.85436|10/12/2021|||ONCOLOGY: ORAL - OTHER|2949|||||No|No||ASTRAZENECA|No||||
olaparib|No|No|No|No|75%|00310066812|LYNPARZA 100 MG TABLET|120|EA|53.32845|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|No||239|No|121.53926|01/11/2022|119.80299|01/11/2022|114.09808|01/11/2022|||ONCOLOGY: ORAL - OTHER|2950|||||No|No||ASTRAZENECA|No||||
olaparib|No|No|No|No|75%|00310066860|LYNPARZA 100 MG TABLET|60|EA|53.32845|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|No||239|No|121.53926|01/11/2022|119.80299|01/11/2022|114.09808|01/11/2022|||ONCOLOGY: ORAL - OTHER|2951|||||No|No||ASTRAZENECA|No||||
olaparib|No|No|No|No|75%|00310067912|LYNPARZA 150 MG TABLET|120|EA|53.32845|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|No||239|No|121.53926|01/11/2022|119.80299|01/11/2022|114.09808|01/11/2022|||ONCOLOGY: ORAL - OTHER|2952|||||No|No||ASTRAZENECA|No||||
olaparib|No|No|No|No|75%|00310067960|LYNPARZA 150 MG TABLET|60|EA|53.32845|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|No||239|No|121.53926|01/11/2022|119.80299|01/11/2022|114.09808|01/11/2022|||ONCOLOGY: ORAL - OTHER|2953|||||No|No||ASTRAZENECA|No||||
rosuvastatin calcium|No|No|No|No|75%|00310075190|CRESTOR 10 MG TABLET|90|EA|3.96383|05/01/2008||Yes|No||05/01/2008||Yes|No|05/01/2008||Yes|No||05/01/2008||Yes|No|||Prescription required|Yes|07/26/2012|063|Yes|8.851|03/01/2022|8.63857|03/01/2022|8.6961|03/01/2022|||LIPOTROPICS: STATINS|2954|||||No|No||ASTRAZENECA|No||||
rosuvastatin calcium|No|No|No|No|75%|00310075290|CRESTOR 20 MG TABLET|90|EA|3.96383|05/01/2008|01/24/2023|Yes|No||05/01/2008|01/24/2023|Yes|No|05/01/2008|01/24/2023|Yes|No||05/01/2008|01/24/2023|Yes|No|||Prescription required|Yes|07/26/2012|063|Yes|8.85078|03/01/2022|8.63836|03/01/2022|8.69589|03/01/2022|||LIPOTROPICS: STATINS|2955|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||ASTRAZENECA|No||||
rosuvastatin calcium|No|No|No|No|75%|00310075430|CRESTOR 40 MG TABLET|30|EA|3.96402|05/01/2008|01/24/2023|Yes|No||05/01/2008|01/24/2023|Yes|No|05/01/2008|01/24/2023|Yes|No||05/01/2008|01/24/2023|Yes|No|||Prescription required|Yes|07/26/2012|063|Yes|8.85048|03/01/2022|8.63806|03/01/2022|8.69559|03/01/2022|||LIPOTROPICS: STATINS|2956|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||ASTRAZENECA|No||||
rosuvastatin calcium|No|No|No|No|75%|00310075590|CRESTOR 5 MG TABLET|90|EA|3.96383|05/01/2008||Yes|No||05/01/2008||Yes|No|05/01/2008||Yes|No||05/01/2008||Yes|No|||Prescription required|Yes|07/26/2012|063|Yes|8.85982|03/01/2022|8.64718|03/01/2022|8.70477|03/01/2022|||LIPOTROPICS: STATINS|2957|||||No|No||ASTRAZENECA|No||||
sodium zirconium cyclosilicate|No|No|No|No|75%|00310110530|LOKELMA 5 GRAM POWDER PACKET|30|EA|10.45803|05/16/2019||Yes|No||05/16/2019||Yes|No|05/16/2019||Yes|No||||No|No|||Prescription required|No|||No|23.29152|01/18/2022|22.73252|01/18/2022|22.88391|01/18/2022||||2958|||||No|No||ASTRAZENECA|No||||
sodium zirconium cyclosilicate|No|No|No|No|75%|00310110539|LOKELMA 5 GRAM POWDER PACKET|11|EA|10.4576|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|No|||No|23.29152|01/18/2022|22.73252|01/18/2022|22.88391|01/18/2022||||2959|||||No|No||ASTRAZENECA|No||||
sodium zirconium cyclosilicate|No|No|No|No|75%|00310111030|LOKELMA 10 GRAM POWDER PACKET|30|EA|10.45803|05/16/2019||Yes|No||05/16/2019||Yes|No|05/16/2019||Yes|No||||No|No|||Prescription required|No|||No|23.28063|01/18/2022|22.72189|01/18/2022|22.87321|01/18/2022||||2960|||||No|No||ASTRAZENECA|No||||
sodium zirconium cyclosilicate|No|No|No|No|75%|00310111039|LOKELMA 10 GRAM POWDER PACKET|11|EA|10.4576|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|No|||No|23.28063|01/18/2022|22.72189|01/18/2022|22.87321|01/18/2022||||2961|||||No|No||ASTRAZENECA|No||||
osimertinib mesylate|No|No|No|No|75%|00310134930|TAGRISSO 40 MG TABLET|30|EA|217.98807|12/27/2016||Yes|No||12/27/2016||Yes|No|12/27/2016||Yes|No||||No|No|||Prescription required|No||551|No|496.81002|07/14/2020|489.71273|07/14/2020|466.39308|07/14/2020|||ONCOLOGY: ORAL - LUNG|2962|||||No|No||ASTRAZENECA|No||||
osimertinib mesylate|No|No|No|No|75%|00310135030|TAGRISSO 80 MG TABLET|30|EA|217.98807|12/27/2016||Yes|No||12/27/2016||Yes|No|12/27/2016||Yes|No||||No|No|||Prescription required|No||551|No|496.81002|07/14/2020|489.71273|07/14/2020|466.39308|07/14/2020|||ONCOLOGY: ORAL - LUNG|2963|||||No|No||ASTRAZENECA|No||||
benralizumab|No|No|No|No|75%|00310183030|FASENRA PEN 30 MG/ML|1|ML|2300.8784|02/27/2020||Yes|No||02/27/2020||Yes|No|02/27/2020||Yes|No||||No|No|||Prescription required|No||206|Yes|5243.8624|01/11/2022|5168.95008|01/11/2022|4922.8096|01/11/2022|||IMMUNOMODULATORS: ASTHMA|2964|||||No|No||ASTRAZENECA|No||||
glycopyrrolate/formoterol fum|No|No|No|No|75%|00310460012|BEVESPI AEROSPHERE INHALER|10.7|GM|16.35486|04/12/2017||Yes|No||04/12/2017||Yes|No|04/12/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|098|Yes|36.51643|01/18/2022|35.64003|01/18/2022|35.87739|01/18/2022|||COPD AGENTS|2965|||||No|No||ASTRAZENECA|No||||
glycopyrrolate/formoterol fum|No|No|No|No|75%|00310460039|BEVESPI AEROSPHERE INHALER|5.9|GM|15.87865|02/01/2018|02/22/2022|Yes|No||02/01/2018|02/22/2022|Yes|No|02/01/2018|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|098|Yes|36.18856|01/25/2022|35.67158|01/25/2022|33.97294|01/25/2022|||COPD AGENTS|2966|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ASTRAZENECA|No||||
budesonide/glycopyr/formoterol|No|No|No|No|75%|00310461612|BREZTRI AEROSPHERE INHALER|10.7|GM|24.43806|02/24/2021||Yes|No||02/24/2021||Yes|No|02/24/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|033|Yes|54.65261|01/18/2022|53.34094|01/18/2022|53.69618|01/18/2022|||GLUCOCORTICOIDS: INHALED|2967|||||No|No||ASTRAZENECA|No||||
budesonide/glycopyr/formoterol|No|No|No|No|75%|00310461639|BREZTRI AEROSPHERE INHALER|5.9|GM|24.4393|02/24/2021||Yes|No||02/24/2021||Yes|No|02/24/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|033|Yes|54.7899|01/18/2022|53.47494|01/18/2022|53.83107|01/18/2022|||GLUCOCORTICOIDS: INHALED|2968|||||No|No||ASTRAZENECA|No||||
saxagliptin HCl|No|No|No|No|75%|00310610030|ONGLYZA 2.5 MG TABLET|30|EA|6.75028|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||||No|No|||Prescription required|No||111|Yes|15.06876|01/18/2022|14.7071|01/18/2022|14.80505|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2969|||||No|No||ASTRAZENECA|No||||
saxagliptin HCl|No|No|No|No|75%|00310610090|ONGLYZA 2.5 MG TABLET|90|EA|6.75008|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||||No|No|||Prescription required|No||111|Yes|15.06876|01/18/2022|14.7071|01/18/2022|14.80505|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2970|||||No|No||ASTRAZENECA|No||||
saxagliptin HCl|No|No|No|No|75%|00310610530|ONGLYZA 5 MG TABLET|30|EA|6.75028|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||||No|No|||Prescription required|No||111|Yes|15.06531|01/18/2022|14.70374|01/18/2022|14.80166|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2971|||||No|No||ASTRAZENECA|No||||
saxagliptin HCl|No|No|No|No|75%|00310610590|ONGLYZA 5 MG TABLET|90|EA|6.75008|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||||No|No|||Prescription required|No||111|Yes|15.06531|01/18/2022|14.70374|01/18/2022|14.80166|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2972|||||No|No||ASTRAZENECA|No||||
saxagliptin HCl/metformin HCl|No|No|No|No|75%|00310612560|KOMBIGLYZE XR 2.5-1,000 MG TAB|60|EA|3.37513|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||||No|No|||Prescription required|No||111|Yes|7.51085|01/18/2022|7.33058|01/18/2022|7.37941|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2973|||||No|No||ASTRAZENECA|No||||
saxagliptin HCl/metformin HCl|No|No|No|No|75%|00310613530|KOMBIGLYZE XR 5-500 MG TABLET|30|EA|6.75028|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||||No|No|||Prescription required|No||111|Yes|15.02914|01/18/2022|14.66844|01/18/2022|14.76613|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2974|||||No|No||ASTRAZENECA|No||||
saxagliptin HCl/metformin HCl|No|No|No|No|75%|00310614530|KOMBIGLYZE XR 5-1,000 MG TAB|30|EA|6.75028|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||||No|No|||Prescription required|No||111|Yes|15.05865|01/18/2022|14.69724|01/18/2022|14.79512|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2975|||||No|No||ASTRAZENECA|No||||
dapagliflozin propanediol|No|No|No|No|75%|00310620530|FARXIGA 5 MG TABLET|30|EA|7.86656|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||||No|No|||Prescription required|No||535|No|17.56041|01/18/2022|17.13896|01/18/2022|17.2531|01/18/2022|||HYPOGLYCEMICS: SGLT2|2976|||||No|No||ASTRAZENECA|No||||
dapagliflozin propanediol|No|No|No|No|75%|00310621030|FARXIGA 10 MG TABLET|30|EA|7.86656|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||||No|No|||Prescription required|No||535|No|17.56127|01/18/2022|17.13979|01/18/2022|17.25394|01/18/2022|||HYPOGLYCEMICS: SGLT2|2977|||||No|No||ASTRAZENECA|No||||
dapagliflozin/metformin HCl|No|No|No|No|75%|00310625030|XIGDUO XR 5 MG-500 MG TABLET|30|EA|7.86656|01/09/2015||Yes|No||01/09/2015||Yes|No|01/09/2015||Yes|No||||No|No|||Prescription required|No||535|No|17.49987|01/18/2022|17.07987|01/18/2022|17.19362|01/18/2022|||HYPOGLYCEMICS: SGLT2|2978|||||No|No||ASTRAZENECA|No||||
dapagliflozin/metformin HCl|No|No|No|No|75%|00310626060|XIGDUO XR 5 MG-1,000 MG TABLET|60|EA|3.93327|01/09/2015||Yes|No||01/09/2015||Yes|No|01/09/2015||Yes|No||||No|No|||Prescription required|No||535|No|8.79891|01/18/2022|8.58773|01/18/2022|8.64492|01/18/2022|||HYPOGLYCEMICS: SGLT2|2979|||||No|No||ASTRAZENECA|No||||
dapagliflozin/metformin HCl|No|No|No|No|75%|00310627030|XIGDUO XR 10 MG-500 MG TABLET|30|EA|7.86656|01/09/2015||Yes|No||01/09/2015||Yes|No|01/09/2015||Yes|No||||No|No|||Prescription required|No||535|No|17.61056|01/18/2022|17.1879|01/18/2022|17.30237|01/18/2022|||HYPOGLYCEMICS: SGLT2|2980|||||No|No||ASTRAZENECA|No||||
dapagliflozin/metformin HCl|No|No|No|No|75%|00310628030|XIGDUO XR 10 MG-1,000 MG TAB|30|EA|7.86656|01/09/2015||Yes|No||01/09/2015||Yes|No|01/09/2015||Yes|No||||No|No|||Prescription required|No||535|No|17.56788|01/18/2022|17.14625|01/18/2022|17.26044|01/18/2022|||HYPOGLYCEMICS: SGLT2|2981|||||No|No||ASTRAZENECA|No||||
exenatide|No|No|No|No|75%|00310651201|BYETTA 5 MCG DOSE PEN INJ|1.2|ML|287.08233|02/10/2015||Yes|No||02/10/2015||Yes|No|02/10/2015||Yes|No||||No|No|||Prescription required|No||111|Yes|641.26534|01/18/2022|625.87497|01/18/2022|630.04319|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2982|||||No|No||ASTRAZENECA|No||||
exenatide|No|No|No|No|75%|00310652401|BYETTA 10 MCG DOSE PEN INJ|2.4|ML|143.54116|02/10/2015||Yes|No||02/10/2015||Yes|No|02/10/2015||Yes|No||||No|No|||Prescription required|No||111|Yes|320.91807|01/18/2022|313.21603|01/18/2022|315.302|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2983|||||No|No||ASTRAZENECA|No||||
exenatide microspheres|No|No|No|No|75%|00310653004|BYDUREON 2 MG PEN INJECT|4|EA|81.40222|10/17/2014|03/10/2022|Yes|No||10/17/2014|03/10/2022|Yes|No|10/17/2014|03/10/2022|Yes|No||||No|No|||Prescription required|No||111|Yes|181.56561|01/25/2022|177.20803|01/25/2022|178.38821|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2984|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ASTRAZENECA|No||||
exenatide microspheres|No|No|No|No|75%|00310654004|BYDUREON BCISE 2 MG AUTOINJECT|.85|ML|98.64073|07/10/2018||Yes|No||07/10/2018||Yes|No|07/10/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|111|Yes|220.25095|01/18/2022|214.96492|01/18/2022|216.39655|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2985|||||No|No||ASTRAZENECA|No||||
pramlintide acetate|No|No|No|No|75%|00310661502|SYMLINPEN 60 PEN INJECTOR|1.5|ML|139.95783|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||||No|No|||Prescription required|No||111|Yes|318.97366|01/11/2022|314.41689|01/11/2022|299.44466|01/11/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2986|||||No|No||ASTRAZENECA|No||||
pramlintide acetate|No|No|No|No|75%|00310662702|SYMLINPEN 120 PEN INJECTOR|2.7|ML|92.33373|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||||No|No|||Prescription required|No||111|Yes|210.43502|01/11/2022|207.42881|01/11/2022|197.55125|01/11/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2987|||||No|No||ASTRAZENECA|No||||
dapagliflozin/saxagliptin HCl|No|No|No|No|75%|00310678030|QTERN 10 MG-5 MG TABLET|30|EA|7.86656|07/09/2018||Yes|No||07/09/2018||Yes|No|07/09/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|111|Yes|17.46343|01/18/2022|17.0443|01/18/2022|17.15781|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|2988|||||No|No||ASTRAZENECA|No||||
budesonide/formoterol fumarate|No|No|No|No|75%|00310737020|BUDESONIDE-FORMOTEROL 160-4.5|10.2|GM|10.54174|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|033|Yes|23.22654|03/29/2022|22.6691|03/29/2022|22.82007|03/29/2022|||GLUCOCORTICOIDS: INHALED|2989|||||No|No||ASTRAZENECA/PRA|No||||
budesonide/formoterol fumarate|No|No|No|No|75%|00310737220|BUDESONIDE-FORMOTEROL 80-4.5|10.2|GM|9.22265|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|033|Yes|20.30307|03/29/2022|19.81579|03/29/2022|19.94776|03/29/2022|||GLUCOCORTICOIDS: INHALED|2990|||||No|No||ASTRAZENECA/PRA|No||||
water for irrigation,sterile|No|No|No|No|75%|00338000344|STERILE WATER FOR IRRIGATION|1000|ML|.00305|03/11/2004||Yes|No||03/11/2004||Yes|No|03/11/2004||Yes|No||||No|No|||Prescription required|No|||No|.00696|04/06/2021|.00686|04/06/2021|.00654|04/06/2021||||2991|||||No|No||BAXTER HEALTHCA|No||||
water for irrigation,sterile|No|No|No|No|75%|00338000346|STERILE WATER FOR IRRIGATION|2000|ML|.00218|03/11/2004||Yes|No||03/11/2004||Yes|No|03/11/2004||Yes|No||||No|No|||Prescription required|No|||No|.00498|04/06/2021|.00491|04/06/2021|.00468|04/06/2021||||2992|||||No|No||BAXTER HEALTHCA|No||||
water for irrigation,sterile|No|No|No|No|75%|00338000347|STERILE WATER FOR IRRIGATION|3000|ML|.00211|03/07/2005||Yes|No||03/07/2005||Yes|No|03/07/2005||Yes|No||||No|No|||Prescription required|No|||No|.00482|04/06/2021|.00475|04/06/2021|.00452|04/06/2021||||2993|||||No|No||BAXTER HEALTHCA|No||||
water for irrigation,sterile|No|No|No|No|75%|00338000404|STERILE WATER FOR IRRIGATION|1000|ML|.00139|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00318|04/06/2021|.00313|04/06/2021|.00299|04/06/2021||||2994|||||No|No||BAXTER HEALTHCA|No||||
water for injection,sterile|No|No|No|No|75%|00338001304|STERILE WATER FOR INJECTION|1000|ML|.00348|03/07/2005||Yes|No||03/07/2005||Yes|No|03/07/2005||Yes|No||||No|No|||Prescription required|No|||No|.00794|04/06/2021|.00783|04/06/2021|.00746|04/06/2021||||2995|||||No|No||BAXTER HEALTHCA|No||||
water for injection,sterile|No|No|No|No|75%|00338001329|STERILE WATER FOR INJECTION|5000|ML|.00159|03/07/2005||Yes|No||03/07/2005||Yes|No|03/07/2005||Yes|No||||No|No|||Prescription required|No|||No|.00364|04/06/2021|.00359|04/06/2021|.00342|04/06/2021||||2996|||||No|No||BAXTER HEALTHCA|No||||
dextrose 5 % in water|No|No|No|No|75%|00338001704|DEXTROSE 5%-WATER IV SOLN|1000|ML|.00199|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00455|04/06/2021|.00449|04/06/2021|.00427|04/06/2021||||2997|||||No|No||BAXTER HEALTHCA|No||||
dextrose 5 % in water|No|No|No|No|75%|00338001711|DEXTROSE 5%-WATER IV SOLN|50|ML|.02004|||No|No||||No|No|03/08/2005||Yes|No||||No|No|||Prescription required|No|||No|.04568|04/06/2021|.04503|04/06/2021|.04289|04/06/2021||||2998|||||No|No||BAXTER HEALTHCA|No||||
dextrose 5 % in water|No|No|No|No|75%|00338001718|DEXTROSE 5%-WATER IV SOLN|100|ML|.00998|03/20/2007||Yes|No||03/20/2007||Yes|No|03/20/2007||Yes|No||||No|No|||Prescription required|No|||No|.02275|04/06/2021|.02243|04/06/2021|.02136|04/06/2021||||2999|||||No|No||BAXTER HEALTHCA|No||||
dextrose 5 % in water|No|No|No|No|75%|00338001731|DEXTROSE 5%-WATER IV SOLN|50|ML|.01857|08/24/2006||Yes|No||08/24/2006||Yes|No|08/24/2006||Yes|No||||No|No|||Prescription required|No|||No|.04233|03/01/2022|.04173|03/01/2022|.03974|03/01/2022||||3000|||||No|No||BAXTER HEALTHCA|No||||
dextrose 5 % in water|No|No|No|No|75%|00338001738|DEXTROSE 5%-WATER IV SOLN|100|ML|.00928|03/20/2007||Yes|No||03/20/2007||Yes|No|03/20/2007||Yes|No||||No|No|||Prescription required|No|||No|.02116|04/06/2021|.02086|04/06/2021|.01987|04/06/2021||||3001|||||No|No||BAXTER HEALTHCA|No||||
dextrose 5 % in water|No|No|No|No|75%|00338001741|DEXTROSE 5%-WATER IV SOLN|50|ML|.02151|03/20/2007||Yes|No||03/20/2007||Yes|No|03/20/2007||Yes|No||||No|No|||Prescription required|No|||No|.04902|03/01/2022|.04832|03/01/2022|.04602|03/01/2022||||3002|||||No|No||BAXTER HEALTHCA|No||||
dextrose 5 % in water|No|No|No|No|75%|00338001748|DEXTROSE 5%-WATER IV SOLN|100|ML|.01065|||No|No||||No|No|09/01/1999||Yes|No||||No|No|||Prescription required|No|||No|.02428|04/06/2021|.02393|04/06/2021|.02279|04/06/2021||||3003|||||No|No||BAXTER HEALTHCA|No||||
sodium chloride 0.45 %|No|No|No|No|75%|00338004303|SODIUM CHLORIDE 0.45% SOLN|500|ML|.00371|10/28/2014||Yes|No||10/28/2014||Yes|No|10/28/2014||Yes|No||||No|No|||Prescription required|No|||No|.00846|04/06/2021|.00834|04/06/2021|.00794|04/06/2021||||3004|||||No|No||BAXTER HEALTHCA|No||||
sodium chloride 0.45 %|No|No|No|No|75%|00338004304|SODIUM CHLORIDE 0.45% SOLN|1000|ML|.00226|10/28/2014||Yes|No||10/28/2014||Yes|No|10/28/2014||Yes|No||||No|No|||Prescription required|No|||No|.00515|04/06/2021|.00508|04/06/2021|.00483|04/06/2021||||3005|||||No|No||BAXTER HEALTHCA|No||||
sodium chloride irrig solution|No|No|No|No|75%|00338004804|SODIUM CHLORIDE 0.9% IRRIG.|1000|ML|.00158|12/05/2005||Yes|No||12/05/2005||Yes|No|12/05/2005||Yes|No||||No|No|||Prescription required|No|||No|.0036|04/06/2021|.00355|04/06/2021|.00338|04/06/2021||||3006|||||No|No||BAXTER HEALTHCA|No||||
0.9 % sodium chloride|No|No|No|No|75%|00338004902|SODIUM CHLORIDE 0.9% SOLUTION|250|ML|.0062|02/29/2008||Yes|No||02/29/2008||Yes|No|02/29/2008||Yes|No||||No|No|||Prescription required|No|||No|.01414|04/06/2021|.01393|04/06/2021|.01327|04/06/2021||||3007|||||No|No||BAXTER HEALTHCA|No||||
0.9 % sodium chloride|No|No|No|No|75%|00338004903|SODIUM CHLORIDE 0.9% SOLUTION|500|ML|.00332|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00757|03/01/2022|.00746|03/01/2022|.00711|03/01/2022||||3008|||||No|No||BAXTER HEALTHCA|No||||
0.9 % sodium chloride|No|No|No|No|75%|00338004904|SODIUM CHLORIDE 0.9% SOLUTION|1000|ML|.00193|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00441|04/06/2021|.00435|04/06/2021|.00414|04/06/2021||||3009|||||No|No||BAXTER HEALTHCA|No||||
0.9 % sodium chloride|No|No|No|No|75%|00338004911|SODIUM CHLORIDE 0.9% SOLUTION|50|ML|.01909|02/29/2008||Yes|No||02/29/2008||Yes|No|02/29/2008||Yes|No||||No|No|||Prescription required|No|||No|.04351|04/06/2021|.04289|04/06/2021|.04084|04/06/2021||||3010|||||No|No||BAXTER HEALTHCA|No||||
0.9 % sodium chloride|No|No|No|No|75%|00338004938|SODIUM CHLORIDE 0.9% SOLUTION|100|ML|.00928|02/29/2008||Yes|No||02/29/2008||Yes|No|02/29/2008||Yes|No||||No|No|||Prescription required|No|||No|.02116|04/06/2021|.02086|04/06/2021|.01987|04/06/2021||||3011|||||No|No||BAXTER HEALTHCA|No||||
dextrose 5 %-0.45 % sod chlord|No|No|No|No|75%|00338008504|DEXTROSE 5%-0.45% NACL IV SOLN|1000|ML|.00212|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00485|04/06/2021|.00478|04/06/2021|.00455|04/06/2021||||3012|||||No|No||BAXTER HEALTHCA|No||||
dextrose 5 % and 0.9 % NaCl|No|No|No|No|75%|00338008904|DEXTROSE 5%-0.9% NACL IV SOLN|1000|ML|.00202|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00461|04/06/2021|.00454|04/06/2021|.00433|04/06/2021||||3013|||||No|No||BAXTER HEALTHCA|No||||
Ringer's solution,lactated|No|No|No|No|75%|00338011704|LACTATED RINGERS INJECTION|1000|ML|.00203|03/31/2005||Yes|No||03/31/2005||Yes|No|03/31/2005||Yes|No||||No|No|||Prescription required|No|||No|.00463|04/06/2021|.00456|04/06/2021|.00435|04/06/2021||||3014|||||No|No||BAXTER HEALTHCA|No||||
lidocaine HCl/dextrose 5 %/PF|No|No|No|No|75%|00338040903|LIDOCAINE 0.4% IN D5W SOLN|500|ML|.00536|03/31/2005||Yes|No||03/31/2005||Yes|No|03/31/2005||Yes|No||||No|No|||Prescription required|No|||No|.01222|04/06/2021|.01204|04/06/2021|.01147|04/06/2021||||3015|||||No|No||BAXTER HEALTHCA|No||||
gentamicin in NaCl, iso-osm|No|No|No|No|75%|00338050348|ISOTON GENTAMICIN 80 MG/100 ML|100|ML|.01573|12/09/2003||Yes|No||12/09/2003||Yes|No|12/09/2003||Yes|No||||No|No|||Prescription required|No|||No|.03586|04/06/2021|.03535|04/06/2021|.03367|04/06/2021||||3016|||||No|No||BAXTER HEALTHCA|No||||
gentamicin in NaCl, iso-osm|No|No|No|No|75%|00338050548|ISO GENTAMICIN 100 MG/100 ML|100|ML|.01685|12/10/2003||Yes|No||12/10/2003||Yes|No|12/10/2003||Yes|No||||No|No|||Prescription required|No|||No|.03841|04/06/2021|.03786|04/06/2021|.03606|04/06/2021||||3017|||||No|No||BAXTER HEALTHCA|No||||
gentamicin in NaCl, iso-osm|No|No|No|No|75%|00338050741|ISOTON GENTAMICIN 60 MG/50 ML|50|ML|.03019|12/10/2003||Yes|No||12/10/2003||Yes|No|12/10/2003||Yes|No||||No|No|||Prescription required|No|||No|.0688|04/06/2021|.06782|04/06/2021|.06459|04/06/2021||||3018|||||No|No||BAXTER HEALTHCA|No||||
gentamicin in NaCl, iso-osm|No|No|No|No|75%|00338050748|ISO GENTAMICIN 120 MG/100 ML|100|ML|.01642|12/10/2003||Yes|No||12/10/2003||Yes|No|12/10/2003||Yes|No||||No|No|||Prescription required|No|||No|.03742|03/01/2022|.03689|03/01/2022|.03513|03/01/2022||||3019|||||No|No||BAXTER HEALTHCA|No||||
gentamicin in NaCl, iso-osm|No|No|No|No|75%|00338050941|ISOTON GENTAMICIN 80 MG/50 ML|50|ML|.0321|12/10/2003||Yes|No||12/10/2003||Yes|No|12/10/2003||Yes|No||||No|No|||Prescription required|No|||No|.07316|04/06/2021|.07212|04/06/2021|.06868|04/06/2021||||3020|||||No|No||BAXTER HEALTHCA|No||||
gentamicin in NaCl, iso-osm|No|No|No|No|75%|00338051141|ISOTON GENTAMICIN 100 MG/50 ML|50|ML|.03274|12/10/2003||Yes|No||12/10/2003||Yes|No|12/10/2003||Yes|No||||No|No|||Prescription required|No|||No|.07462|04/06/2021|.07356|04/06/2021|.07005|04/06/2021||||3021|||||No|No||BAXTER HEALTHCA|No||||
0.9 % sodium chloride|No|No|No|No|75%|00338055311|SODIUM CHLORIDE 0.9% SOLUTION|50|ML|.04573|08/24/2006||Yes|No||08/24/2006||Yes|No|||No|No||||No|No|||Prescription required|No|||No|.10422|04/06/2021|.10273|04/06/2021|.09784|04/06/2021||||3022|||||No|No||BAXTER HEALTHCA|No||||
0.9 % sodium chloride|No|No|No|No|75%|00338055318|SODIUM CHLORIDE 0.9% SOLUTION|100|ML|.02286|09/15/2010||Yes|No||09/15/2010||Yes|No|||No|No||||No|No|||Prescription required|No|||No|.0521|04/06/2021|.05136|04/06/2021|.04891|04/06/2021||||3023|||||No|No||BAXTER HEALTHCA|No||||
potassium chloride-0.45% NaCl|No|No|No|No|75%|00338070434|POTASSIUM CL 20 MEQ-0.45% NACL|1000|ML|.00285|06/15/2005||Yes|No||06/15/2005||Yes|No|06/15/2005||Yes|No||||No|No|||Prescription required|No|||No|.00649|04/06/2021|.0064|04/06/2021|.00609|04/06/2021||||3024|||||No|No||BAXTER HEALTHCA|No||||
dextrose 70 % in water|No|No|No|No|75%|00338071906|DEXTROSE 70%-WATER IV SOLN|2000|ML|.00387|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.00882|04/06/2021|.00869|04/06/2021|.00828|04/06/2021||||3025|||||No|No||BAXTER HEALTHCA|No||||
oxacillin in dextrose(iso-osm)|No|No|No|No|75%|00338101541|OXACILLIN 2 GM/ 50 ML INJ|50|ML|.21009|06/19/2008||Yes|No||06/19/2008||Yes|No|06/19/2008||Yes|No||||No|No|||Prescription required|No|||No|.47882|02/05/2019|.47198|02/05/2019|.44951|02/05/2019||||3026|||||No|No||BAXTER HEALTHCA|No||||
nafcillin in dextrose,iso-osm|No|No|No|No|75%|00338101741|NAFCILLIN 1 GM/ 50 ML INJ|50|ML|.14599|06/19/2008||Yes|No||06/19/2008||Yes|No|06/19/2008||Yes|No||||No|No|||Prescription required|No|||No|.33272|02/05/2019|.32797|02/05/2019|.31235|02/05/2019||||3027|||||No|No||BAXTER HEALTHCA|No||||
nafcillin in dextrose,iso-osm|No|No|No|No|75%|00338101948|NAFCILLIN 2 GM/ 100 ML INJ|100|ML|.10504|06/19/2008||Yes|No||06/19/2008||Yes|No|06/19/2008||Yes|No||||No|No|||Prescription required|No|||No|.23941|02/05/2019|.23599|02/05/2019|.22475|02/05/2019||||3028|||||No|No||BAXTER HEALTHCA|No||||
pen G pot/dextrose-water|No|No|No|No|75%|00338102141|PEN G K 1 MILLION UNIT/50 ML|50|ML|.08536|03/31/2005||Yes|No||03/31/2005||Yes|No|03/31/2005||Yes|No||||No|No|||Prescription required|No|||No|.19454|02/05/2019|.19177|02/05/2019|.18263|02/05/2019||||3029|||||No|No||BAXTER HEALTHCA|No||||
pen G pot/dextrose-water|No|No|No|No|75%|00338102341|PEN G K 2 MILLION UNIT/50 ML|50|ML|.08883|03/31/2005||Yes|No||03/31/2005||Yes|No|03/31/2005||Yes|No||||No|No|||Prescription required|No|||No|.20246|02/05/2019|.19957|02/05/2019|.19007|02/05/2019||||3030|||||No|No||BAXTER HEALTHCA|No||||
pen G pot/dextrose-water|No|No|No|No|75%|00338102541|PEN G K 3 MILLION UNIT/50 ML|50|ML|.09223|03/31/2005||Yes|No||03/31/2005||Yes|No|03/31/2005||Yes|No||||No|No|||Prescription required|No|||No|.21021|02/05/2019|.2072|02/05/2019|.19734|02/05/2019||||3031|||||No|No||BAXTER HEALTHCA|No||||
metronidazole/sodium chloride|No|No|No|No|75%|00338105548|METRONIDAZOLE 500 MG/100 ML|100|ML|.00985|11/18/2003||Yes|No||11/18/2003||Yes|No|11/18/2003||Yes|No||||No|No|||Prescription required|No|||No|.02245|01/02/2018|.02213|01/02/2018|.02107|01/02/2018||||3032|||||No|No||BAXTER HEALTHCA|No||||
dobutamine HCl in dextrose 5 %|No|No|No|No|75%|00338107302|DOBUTAMINE 250 MG/250 ML-D5W|250|ML|.03542|08/09/2013||Yes|No||08/09/2013||Yes|No|08/09/2013||Yes|No||||No|No|||Prescription required|No|||No|.08073|04/06/2021|.07957|04/06/2021|.07578|04/06/2021||||3033|||||No|No||BAXTER HEALTHCA|No||||
dobutamine HCl in dextrose 5 %|No|No|No|No|75%|00338107502|DOBUTAMINE 500 MG/250 ML D5W|250|ML|.06421|08/09/2013||Yes|No||08/09/2013||Yes|No|08/09/2013||Yes|No||||No|No|||Prescription required|No|||No|.14634|04/06/2021|.14425|04/06/2021|.13738|04/06/2021||||3034|||||No|No||BAXTER HEALTHCA|No||||
dobutamine HCl in dextrose 5 %|No|No|No|No|75%|00338107702|DOBUTAMINE 1,000 MG/250 ML D5W|250|ML|.04611|08/09/2013||Yes|No||08/09/2013||Yes|No|08/09/2013||Yes|No||||No|No|||Prescription required|No|||No|.1051|04/06/2021|.1036|04/06/2021|.09867|04/06/2021||||3035|||||No|No||BAXTER HEALTHCA|No||||
cefepime in iso-osm dextrose|No|No|No|No|75%|00338130141|CEFEPIME 1 GM INJECTION|50|ML|.23199|10/15/2008||Yes|No||10/15/2008||Yes|No|10/15/2008||Yes|No||||No|No|||Prescription required|No|||No|.52873|03/01/2022|.52118|03/01/2022|.49636|03/01/2022||||3036|||||No|No||BAXTER HEALTHCA|No||||
cefepime in iso-osm dextrose|No|No|No|No|75%|00338130148|CEFEPIME 2 GM INJECTION|100|ML|.18309|10/15/2008||Yes|No||10/15/2008||Yes|No|10/15/2008||Yes|No||||No|No|||Prescription required|No|||No|.41728|06/01/2016|.41132|06/01/2016|.39173|06/01/2016||||3037|||||No|No||BAXTER HEALTHCA|No||||
cefazolin sodium/dextrose,iso|No|No|No|No|75%|00338350341|CEFAZOLIN 1 G/50 ML-DEXTROSE|50|ML|.04527|07/07/2008||Yes|No||07/07/2008||Yes|No|07/07/2008||Yes|No||||No|No|||Prescription required|No|||No|.10317|02/05/2019|.1017|02/05/2019|.09685|02/05/2019||||3038|||||No|No||BAXTER HEALTHCA|No||||
vancomycin HCl in 5 % dextrose|No|No|No|No|75%|00338355148|VANCOMYCIN-D5W 500 MG/100 ML|100|ML|.03334|06/19/2008||Yes|No||06/19/2008||Yes|No|06/19/2008||Yes|No||||No|No|||Prescription required|No|||No|.07599|02/05/2019|.07491|02/05/2019|.07134|02/05/2019||||3039|||||No|No||BAXTER HEALTHCA|No||||
vancomycin HCl in 5 % dextrose|No|No|No|No|75%|00338355248|VANCOMYCIN HCL 1G/200 ML BAG|200|ML|.0582|06/19/2008||Yes|No||06/19/2008||Yes|No|06/19/2008||Yes|No||||No|No|||Prescription required|No|||No|.13264|02/05/2019|.13074|02/05/2019|.12452|02/05/2019||||3040|||||No|No||BAXTER HEALTHCA|No||||
vancomycin HCl in 5 % dextrose|No|No|No|No|75%|00338358048|VANCOMYCIN 750 MG/150 ML BAG|150|ML|.03462|05/15/2011||Yes|No||05/15/2011||Yes|No|05/15/2011||Yes|No||||No|No|||Prescription required|No|||No|.07891|06/01/2016|.07779|06/01/2016|.07408|06/01/2016||||3041|||||No|No||BAXTER HEALTHCA|No||||
ceftriaxone in is-osm dextrose|No|No|No|No|75%|00338500241|CEFTRIAXONE 1 GM PIGGYBACK|50|ML|.12203|06/19/2008||Yes|No||06/19/2008||Yes|No|06/19/2008||Yes|No||||No|No|||Prescription required|No|||No|.27812|02/05/2019|.27415|02/05/2019|.26109|02/05/2019||||3042|||||No|No||BAXTER HEALTHCA|No||||
ceftriaxone in is-osm dextrose|No|No|No|No|75%|00338500341|CEFTRIAXONE 2 GM PIGGYBACK|50|ML|.28904|06/19/2008||Yes|No||06/19/2008||Yes|No|06/19/2008||Yes|No||||No|No|||Prescription required|No|||No|.65875|06/01/2016|.64934|06/01/2016|.61842|06/01/2016||||3043|||||No|No||BAXTER HEALTHCA|No||||
famotidine in NaCl,iso-osm/PF|No|No|No|No|75%|00338519741|FAMOTIDINE 20 MG PIGGYBACK|50|ML|.04415|11/18/2003||Yes|No||11/18/2003||Yes|No|11/18/2003||Yes|No||||No|No|||Prescription required|No|||No|.10062|04/06/2021|.09918|04/06/2021|.09446|04/06/2021||||3044|||||No|No||BAXTER HEALTHCA|No||||
milrinone lactate/D5W|No|No|No|No|75%|00338601048|MILRINONE-D5W 20 MG/100 ML|100|ML|.1329|11/18/2003||Yes|No||11/18/2003||Yes|No|11/18/2003||Yes|No||||No|No|||Prescription required|No|||No|.30288|04/06/2021|.29856|04/06/2021|.28434|04/06/2021||||3045|||||No|No||BAXTER HEALTHCA|No||||
milrinone lactate/D5W|No|No|No|No|75%|00338601137|MILRINONE-D5W 40 MG/200 ML|200|ML|.13752|11/18/2003||Yes|No||11/18/2003||Yes|No|11/18/2003||Yes|No||||No|No|||Prescription required|No|||No|.31343|04/06/2021|.30895|04/06/2021|.29424|04/06/2021||||3046|||||No|No||BAXTER HEALTHCA|No||||
fluconazole in NaCL,iso-osm|No|No|No|No|75%|00338604537|FLUCONAZOLE-NACL 400 MG/200 ML|200|ML|.04474|03/04/2005||Yes|No||03/04/2005||Yes|No|03/04/2005||Yes|No||||No|No|||Prescription required|No|||No|.10197|01/02/2018|.10052|01/02/2018|.09573|01/02/2018||||3047|||||No|No||BAXTER HEALTHCA|No||||
fluconazole in NaCL,iso-osm|No|No|No|No|75%|00338604648|FLUCONAZOLE-NACL 200 MG/100 ML|100|ML|.08024|03/04/2005||Yes|No||03/04/2005||Yes|No|03/04/2005||Yes|No||||No|No|||Prescription required|No|||No|.18287|12/13/2016|.18026|12/13/2016|.17168|12/13/2016||||3048|||||No|No||BAXTER HEALTHCA|No||||
methotrexate sodium|No|No|No|No|75%|00378001401|METHOTREXATE 2.5 MG TABLET|100|EA|1.01243|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.26817|03/29/2022|.26173|03/29/2022|.26347|03/29/2022||||3049|||||No|No||MYLAN|No||||
metoprolol tartrate|No|No|No|No|75%|00378001801|METOPROLOL TARTRATE 25 MG TAB|100|EA|.02064|01/18/2005||Yes|No||01/18/2005||Yes|No|01/18/2005||Yes|No||01/18/2005||Yes|No|||Prescription required|No||070|No|.01777|03/29/2022|.01734|03/29/2022|.01745|03/29/2022|||BETA-BLOCKERS|3050|||||No|No||MYLAN|No||||
metoprolol tartrate|No|No|No|No|75%|00378001805|METOPROLOL TARTRATE 25 MG TAB|500|EA|.0196|06/25/2008||Yes|No||06/25/2008||Yes|No|06/25/2008||Yes|No||06/25/2008||Yes|No|||Prescription required|No||070|No|.01777|03/29/2022|.01734|03/29/2022|.01745|03/29/2022|||BETA-BLOCKERS|3051|||||No|No||MYLAN|No||||
nadolol|No|No|No|No|75%|00378002801|NADOLOL 20 MG TABLET|100|EA|.66349|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|07/17/2014|070|No|.34023|03/29/2022|.33206|03/29/2022|.33427|03/29/2022|||BETA-BLOCKERS|3052|||||No|No||MYLAN|No||||
clorazepate dipotassium|No|No|No|No|90%|00378003001|CLORAZEPATE 3.75 MG TABLET|100|EA|.42785|03/01/2002|12/01/2022|Yes|No||03/01/2002|12/01/2022|Yes|No|03/01/2002|12/01/2022|Yes|No||||No|No|||Prescription required|No||090|Yes|.92083|12/28/2021|.89873|12/28/2021|.90471|12/28/2021|||ANXIOLYTICS|3053|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||MYLAN/AUROBINDO|No||||
clorazepate dipotassium|No|No|No|No|90%|00378003005|CLORAZEPATE 3.75 MG TABLET|500|EA|.42785|03/01/2002|12/01/2022|Yes|No||03/01/2002|12/01/2022|Yes|No|03/01/2002|12/01/2022|Yes|No||||No|No|||Prescription required|No||090|Yes|.92083|12/28/2021|.89873|12/28/2021|.90471|12/28/2021|||ANXIOLYTICS|3054|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||MYLAN/AUROBINDO|No||||
metoprolol tartrate|No|No|No|No|75%|00378003201|METOPROLOL TARTRATE 50 MG TAB|100|EA|.02107|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.02252|03/29/2022|.02197|03/29/2022|.02212|03/29/2022|||BETA-BLOCKERS|3055|||||No|No||MYLAN|No||||
metoprolol tartrate|No|No|No|No|75%|00378003210|METOPROLOL TARTRATE 50 MG TAB|1000|EA|.01827|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.02252|03/29/2022|.02197|03/29/2022|.02212|03/29/2022|||BETA-BLOCKERS|3056|||||No|No||MYLAN|No||||
clorazepate dipotassium|No|No|No|No|90%|00378004001|CLORAZEPATE 7.5 MG TABLET|100|EA|.5992|03/01/2002|01/01/2023|Yes|No||03/01/2002|01/01/2023|Yes|No|03/01/2002|01/01/2023|Yes|No||||No|No|||Prescription required|No||090|Yes|1.5386|01/25/2022|1.50167|01/25/2022|1.51167|01/25/2022|||ANXIOLYTICS|3057|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||MYLAN/AUROBINDO|Yes|09/01/2020|||
clorazepate dipotassium|No|No|No|No|90%|00378004005|CLORAZEPATE 7.5 MG TABLET|500|EA|.5992|03/01/2002|01/01/2023|Yes|No||03/01/2002|01/01/2023|Yes|No|03/01/2002|01/01/2023|Yes|No||||No|No|||Prescription required|No||090|Yes|1.5386|01/25/2022|1.50167|01/25/2022|1.51167|01/25/2022|||ANXIOLYTICS|3058|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||MYLAN/AUROBINDO|No||||
perphenazine/amitriptyline HCl|No|No|No|No|75%|00378004201|PERPHEN-AMITRIP 4 MG-10 MG TAB|100|EA|.55405|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|1.26273|06/01/2016|1.24469|06/01/2016|1.18542|06/01/2016|||ANTIPSYCHOTICS|3059|||||No|No||MYLAN|No||||
metoprolol tartrate|No|No|No|No|75%|00378004701|METOPROLOL TARTRATE 100 MG TAB|100|EA|.03117|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.03443|03/29/2022|.0336|03/29/2022|.03382|03/29/2022|||BETA-BLOCKERS|3060|||||No|No||MYLAN|No||||
metoprolol tartrate|No|No|No|No|75%|00378004710|METOPROLOL TARTRATE 100 MG TAB|1000|EA|.02687|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.03443|03/29/2022|.0336|03/29/2022|.03382|03/29/2022|||BETA-BLOCKERS|3061|||||No|No||MYLAN|No||||
pindolol|No|No|No|No|75%|00378005201|PINDOLOL 5 MG TABLET|100|EA|.45399|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|07/26/2012|070|No|.74858|03/29/2022|.73061|03/29/2022|.73547|03/29/2022|||BETA-BLOCKERS|3062|||||No|No||MYLAN|No||||
cimetidine|No|No|No|No|75%|00378005301|CIMETIDINE 200 MG TABLET|100|EA|.15286|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.3448|03/29/2022|.33652|03/29/2022|.33876|03/29/2022||||3063|||||No|No||MYLAN|No||||
timolol maleate|No|No|No|No|75%|00378005501|TIMOLOL MALEATE 5 MG TABLET|100|EA|.47355|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|070|No|1.07927|10/24/2017|1.06385|10/24/2017|1.01319|10/24/2017|||BETA-BLOCKERS|3064|||||No|No||MYLAN|No||||
clorazepate dipotassium|No|No|No|No|90%|00378007001|CLORAZEPATE 15 MG TABLET|100|EA|.98491|03/01/2002|01/01/2023|Yes|No||03/01/2002|01/01/2023|Yes|No|03/01/2002|01/01/2023|Yes|No||||No|No|||Prescription required|No||090|Yes|2.854|01/25/2022|2.7855|01/25/2022|2.80405|01/25/2022|||ANXIOLYTICS|3065|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||MYLAN/AUROBINDO|Yes|09/01/2020|||
perphenazine/amitriptyline HCl|No|No|No|No|75%|00378007301|PERPHEN-AMITRIP 4 MG-50 MG TAB|100|EA|1.13365|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|2.58367|06/01/2016|2.54676|06/01/2016|2.42548|06/01/2016|||ANTIPSYCHOTICS|3066|||||No|No||MYLAN|No||||
carbidopa/levodopa|No|No|No|No|75%|00378007801|CARBIDOPA-LEVODOPA 10-100 TAB|100|EA|.11244|06/25/2020||Yes|No||06/25/2020||Yes|No|06/25/2020||Yes|No||||No|No|||Prescription required|No||015|No|.14195|03/29/2022|.13854|03/29/2022|.13946|03/29/2022|||ANTIPARKINSON'S AGENTS|3067|||||No|No||MYLAN|No||||
carbidopa/levodopa|No|No|No|No|75%|00378008501|CARBIDOPA-LEVODOPA 25-100 TAB|100|EA|.12771|02/09/2014||Yes|No||02/09/2014||Yes|No|02/09/2014||Yes|No||||No|No|||Prescription required|No||015|No|.11418|03/29/2022|.11143|03/29/2022|.11218|03/29/2022|||ANTIPARKINSON'S AGENTS|3068|||||No|No||MYLAN|No||||
carbidopa/levodopa|No|No|No|No|75%|00378008801|CARBIDOPA-LEVO ER 25-100 TAB|100|EA|.29708|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||015|No|.21193|03/29/2022|.20684|03/29/2022|.20822|03/29/2022|||ANTIPARKINSON'S AGENTS|3069|||||No|No||MYLAN|No||||
carbidopa/levodopa|No|No|No|No|75%|00378009401|CARBIDOPA-LEVO ER 50-200 TAB|100|EA|.60423|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||015|No|.29671|03/29/2022|.28958|03/29/2022|.29151|03/29/2022|||ANTIPARKINSON'S AGENTS|3070|||||No|No||MYLAN|No||||
pindolol|No|No|No|No|75%|00378012701|PINDOLOL 10 MG TABLET|100|EA|.61859|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|07/26/2012|070|No|1.40982|06/29/2021|1.38968|06/29/2021|1.32351|06/29/2021|||BETA-BLOCKERS|3071|||||No|No||MYLAN|No||||
allopurinol|No|No|No|No|75%|00378013701|ALLOPURINOL 100 MG TABLET|100|EA|.12199|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|3072|||||No|No||MYLAN|No||||
allopurinol|No|No|No|No|75%|00378013710|ALLOPURINOL 100 MG TABLET|1000|EA|.12199|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|3073|||||No|No||MYLAN|No||||
tamoxifen citrate|No|No|No|No|75%|00378014491|TAMOXIFEN 10 MG TABLET|60|EA|.16375|03/04/2003||Yes|No||03/04/2003||Yes|No|03/04/2003||Yes|No||||No|No|||Prescription required|No||502|No|.21342|03/29/2022|.20829|03/29/2022|.20968|03/29/2022|||ONCOLOGY: ORAL - BREAST|3074|||||No|No||MYLAN|No||||
doxycycline hyclate|Yes|No|No|No|75%|00378016705|DOXYCYCLINE HYCLATE 100 MG TAB|500|EA|.946|11/09/2015|02/28/2022|Yes|No||11/09/2015|02/28/2022|Yes|No|11/09/2015|02/28/2022|Yes|No||11/09/2015|02/28/2022|Yes|No|11/09/2015|02/28/2022|Prescription required|Yes|11/17/2016|213|No|2.156|03/15/2022|2.1252|03/15/2022|2.024|03/15/2022|||TETRACYCLINES|3075|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||MYLAN|No||||
allopurinol|No|No|No|No|75%|00378018101|ALLOPURINOL 300 MG TABLET|100|EA|.24514|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|3076|||||No|No||MYLAN|No||||
allopurinol|No|No|No|No|75%|00378018105|ALLOPURINOL 300 MG TABLET|500|EA|.24512|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|3077|||||No|No||MYLAN|No||||
propranolol HCl|No|No|No|No|75%|00378018201|PROPRANOLOL 10 MG TABLET|100|EA|.12267|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.06946|03/29/2022|.06779|03/29/2022|.06824|03/29/2022|||BETA-BLOCKERS|3078|||||No|No||MYLAN|No||||
propranolol HCl|No|No|No|No|75%|00378018210|PROPRANOLOL 10 MG TABLET|1000|EA|.12268|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.06946|03/29/2022|.06779|03/29/2022|.06824|03/29/2022|||BETA-BLOCKERS|3079|||||No|No||MYLAN|No||||
propranolol HCl|No|No|No|No|75%|00378018301|PROPRANOLOL 20 MG TABLET|100|EA|.15338|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.08469|03/29/2022|.08265|03/29/2022|.0832|03/29/2022|||BETA-BLOCKERS|3080|||||No|No||MYLAN|No||||
propranolol HCl|No|No|No|No|75%|00378018310|PROPRANOLOL 20 MG TABLET|1000|EA|.15335|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.08469|03/29/2022|.08265|03/29/2022|.0832|03/29/2022|||BETA-BLOCKERS|3081|||||No|No||MYLAN|No||||
propranolol HCl|No|No|No|No|75%|00378018401|PROPRANOLOL 40 MG TABLET|100|EA|.21547|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.11538|03/29/2022|.11261|03/29/2022|.11336|03/29/2022|||BETA-BLOCKERS|3082|||||No|No||MYLAN|No||||
propranolol HCl|No|No|No|No|75%|00378018410|PROPRANOLOL 40 MG TABLET|1000|EA|.21548|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.11538|03/29/2022|.11261|03/29/2022|.11336|03/29/2022|||BETA-BLOCKERS|3083|||||No|No||MYLAN|No||||
propranolol HCl|No|No|No|No|75%|00378018501|PROPRANOLOL 80 MG TABLET|100|EA|.29154|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.21823|03/29/2022|.21299|03/29/2022|.21441|03/29/2022|||BETA-BLOCKERS|3084|||||No|No||MYLAN|No||||
propranolol HCl|No|No|No|No|75%|00378018505|PROPRANOLOL 80 MG TABLET|500|EA|.29152|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.21823|03/29/2022|.21299|03/29/2022|.21441|03/29/2022|||BETA-BLOCKERS|3085|||||No|No||MYLAN|No||||
propranolol HCl|No|No|No|No|75%|00378018701|PROPRANOLOL 60 MG TABLET|100|EA|.38295|05/17/2011||Yes|No||05/17/2011||Yes|No|05/17/2011||Yes|No||||No|No|||Prescription required|No||070|No|.35485|03/29/2022|.34633|03/29/2022|.34864|03/29/2022|||BETA-BLOCKERS|3086|||||No|No||MYLAN|No||||
furosemide|No|No|No|No|75%|00378020801|FUROSEMIDE 20 MG TABLET|100|EA|.0215|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.03187|03/29/2022|.0311|03/29/2022|.03131|03/29/2022||||3087|||||No|No||MYLAN|No||||
furosemide|No|No|No|No|75%|00378020810|FUROSEMIDE 20 MG TABLET|1000|EA|.01936|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.03187|03/29/2022|.0311|03/29/2022|.03131|03/29/2022||||3088|||||No|No||MYLAN|No||||
amitriptyline/chlordiazepoxide|No|No|No|No|75%|00378021101|CHLORDIAZEPO-AMITRIPTYL 5-12.5|100|EA|.5273|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|1.20177|04/28/2020|1.1846|04/28/2020|1.12819|04/28/2020||||3089|||||No|No||MYLAN|No||||
amitriptyline/chlordiazepoxide|No|No|No|No|75%|00378021105|CHLORDIAZEPO-AMITRIPTYL 5-12.5|500|EA|.52729|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|1.20173|04/28/2020|1.18456|04/28/2020|1.12815|04/28/2020||||3090|||||No|No||MYLAN|No||||
chlorthalidone|No|No|No|No|75%|00378021301|CHLORTHALIDONE 50 MG TABLET|100|EA|.512|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.3607|03/29/2022|.35204|03/29/2022|.35438|03/29/2022||||3091|||||No|No||MYLAN|No||||
chlorthalidone|No|No|No|No|75%|00378021310|CHLORTHALIDONE 50 MG TABLET|1000|EA|.51192|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.3607|03/29/2022|.35204|03/29/2022|.35438|03/29/2022||||3092|||||No|No||MYLAN|No||||
haloperidol|No|No|No|No|75%|00378021401|HALOPERIDOL 2 MG TABLET|100|EA|.2174|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.43109|03/29/2022|.42074|03/29/2022|.42354|03/29/2022|||ANTIPSYCHOTICS|3093|||||No|No||MYLAN|Yes|09/01/2020|||
haloperidol|No|No|No|No|75%|00378021410|HALOPERIDOL 2 MG TABLET|1000|EA|.21739|08/23/2009||Yes|No||08/23/2009||Yes|No|08/23/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.43109|03/29/2022|.42074|03/29/2022|.42354|03/29/2022|||ANTIPSYCHOTICS|3094|||||No|No||MYLAN|No||||
furosemide|No|No|No|No|75%|00378021601|FUROSEMIDE 40 MG TABLET|100|EA|.02223|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.03326|03/29/2022|.03246|03/29/2022|.03267|03/29/2022||||3095|||||No|No||MYLAN|No||||
furosemide|No|No|No|No|75%|00378021610|FUROSEMIDE 40 MG TABLET|1000|EA|.01999|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.03326|03/29/2022|.03246|03/29/2022|.03267|03/29/2022||||3096|||||No|No||MYLAN|No||||
atenolol|No|No|No|No|75%|00378021801|ATENOLOL 25 MG TABLET|100|EA|.02795|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.02437|03/29/2022|.02378|03/29/2022|.02394|03/29/2022|||BETA-BLOCKERS|3097|||||No|No||MYLAN|No||||
atenolol|No|No|No|No|75%|00378021810|ATENOLOL 25 MG TABLET|1000|EA|.02655|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.02437|03/29/2022|.02378|03/29/2022|.02394|03/29/2022|||BETA-BLOCKERS|3098|||||No|No||MYLAN|No||||
timolol maleate|No|No|No|No|75%|00378022101|TIMOLOL MALEATE 10 MG TABLET|100|EA|.58583|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|070|No|1.33515|12/26/2017|1.31607|12/26/2017|1.2534|12/26/2017|||BETA-BLOCKERS|3099|||||No|No||MYLAN|No||||
chlorthalidone|No|No|No|No|75%|00378022201|CHLORTHALIDONE 25 MG TABLET|100|EA|.41516|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.16117|03/29/2022|.1573|03/29/2022|.15834|03/29/2022||||3100|||||No|No||MYLAN|No||||
chlorthalidone|No|No|No|No|75%|00378022210|CHLORTHALIDONE 25 MG TABLET|1000|EA|.41513|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.16117|03/29/2022|.1573|03/29/2022|.15834|03/29/2022||||3101|||||No|No||MYLAN|No||||
atenolol|No|No|No|No|75%|00378023101|ATENOLOL 50 MG TABLET|100|EA|.03031|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.02861|03/29/2022|.02792|03/29/2022|.0281|03/29/2022|||BETA-BLOCKERS|3102|||||No|No||MYLAN|No||||
atenolol|No|No|No|No|75%|00378023110|ATENOLOL 50 MG TABLET|1000|EA|.02881|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.02861|03/29/2022|.02792|03/29/2022|.0281|03/29/2022|||BETA-BLOCKERS|3103|||||No|No||MYLAN|No||||
furosemide|No|No|No|No|75%|00378023201|FUROSEMIDE 80 MG TABLET|100|EA|.0325|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.06148|03/29/2022|.06|03/29/2022|.0604|03/29/2022||||3104|||||No|No||MYLAN|No||||
spironolactone|No|No|No|No|75%|00378024301|SPIRONOLACTONE 50 MG TABLET|100|EA|.1833|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.12042|03/29/2022|.11752|03/29/2022|.11831|03/29/2022||||3105|||||No|No||MYLAN|No||||
albuterol sulfate|No|No|No|No|75%|00378025501|ALBUTEROL SULFATE 2 MG TAB|100|EA|2.02104|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|037|No|.67057|07/27/2021|.65447|07/27/2021|.65883|07/27/2021|||BRONCHODILATORS: BETA AGONIST|3106|||||No|No||MYLAN|Yes|09/01/2020|||
haloperidol|No|No|No|No|75%|00378025701|HALOPERIDOL 1 MG TABLET|100|EA|.15871|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.34011|03/29/2022|.33194|03/29/2022|.33415|03/29/2022|||ANTIPSYCHOTICS|3107|||||No|No||MYLAN|Yes|09/01/2020|||
haloperidol|No|No|No|No|75%|00378025710|HALOPERIDOL 1 MG TABLET|1000|EA|.1587|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.34011|03/29/2022|.33194|03/29/2022|.33415|03/29/2022|||ANTIPSYCHOTICS|3108|||||No|No||MYLAN|No||||
diazepam|No|No|No|No|75%|00378027101|DIAZEPAM 2 MG TABLET|100|EA|.01376|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02435|03/29/2022|.02376|03/29/2022|.02392|03/29/2022|||ANXIOLYTICS|3109|||||No|No||MYLAN|No||||
diazepam|No|No|No|No|75%|00378027105|DIAZEPAM 2 MG TABLET|500|EA|.01225|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02435|03/29/2022|.02376|03/29/2022|.02392|03/29/2022|||ANXIOLYTICS|3110|||||No|No||MYLAN|Yes|09/01/2020|||
tamoxifen citrate|No|No|No|No|75%|00378027493|TAMOXIFEN 20 MG TABLET|30|EA|.32751|03/04/2003||Yes|No||03/04/2003||Yes|No|03/04/2003||Yes|No||||No|No|||Prescription required|No||502|No|.42352|03/29/2022|.41335|03/29/2022|.4161|03/29/2022|||ONCOLOGY: ORAL - BREAST|3111|||||No|No||MYLAN|No||||
amitriptyline/chlordiazepoxide|No|No|No|No|75%|00378027701|CHLORDIAZEPOX-AMITRIPTYL 10-25|100|EA|.74398|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|1.69559|05/26/2020|1.67137|05/26/2020|1.59178|05/26/2020||||3112|||||No|No||MYLAN|No||||
amitriptyline/chlordiazepoxide|No|No|No|No|75%|00378027705|CHLORDIAZEPOX-AMITRIPTYL 10-25|500|EA|.74398|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|1.69559|05/26/2020|1.67137|05/26/2020|1.59178|05/26/2020||||3113|||||No|No||MYLAN|No||||
cimetidine|No|No|No|No|75%|00378031701|CIMETIDINE 300 MG TABLET|100|EA|.15888|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.2727|03/29/2022|.26615|03/29/2022|.26792|03/29/2022||||3114|||||No|No||MYLAN|No||||
haloperidol|No|No|No|No|75%|00378032701|HALOPERIDOL 5 MG TABLET|100|EA|.35217|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.44921|03/29/2022|.43842|03/29/2022|.44134|03/29/2022|||ANTIPSYCHOTICS|3115|||||No|No||MYLAN|Yes|09/01/2020|||
haloperidol|No|No|No|No|75%|00378032710|HALOPERIDOL 5 MG TABLET|1000|EA|.35217|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.44921|03/29/2022|.43842|03/29/2022|.44134|03/29/2022|||ANTIPSYCHOTICS|3116|||||No|No||MYLAN|Yes|09/01/2020|||
perphenazine/amitriptyline HCl|No|No|No|No|75%|00378033001|PERPHEN-AMITRIP 2 MG-10 MG TAB|100|EA|.4951|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|1.12837|11/28/2017|1.11225|11/28/2017|1.05928|11/28/2017|||ANTIPSYCHOTICS|3117|||||No|No||MYLAN|No||||
perphenazine/amitriptyline HCl|No|No|No|No|75%|00378033005|PERPHEN-AMITRIP 2 MG-10 MG TAB|500|EA|.49516|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|1.1285|11/28/2017|1.11238|11/28/2017|1.05941|11/28/2017|||ANTIPSYCHOTICS|3118|||||No|No||MYLAN|No||||
haloperidol|No|No|No|No|75%|00378033401|HALOPERIDOL 10 MG TABLET|100|EA|.64766|03/26/2010||Yes|No||03/26/2010||Yes|No|03/26/2010||Yes|No||||No|No|||Prescription required|No||027|Yes|.48134|03/29/2022|.46978|03/29/2022|.47291|03/29/2022|||ANTIPSYCHOTICS|3119|||||No|No||MYLAN|Yes|09/01/2020|||
haloperidol|No|No|No|No|75%|00378033501|HALOPERIDOL 20 MG TABLET|100|EA|1.2448|03/26/2010||Yes|No||03/26/2010||Yes|No|03/26/2010||Yes|No||||No|No|||Prescription required|No||027|Yes|.97837|03/29/2022|.95488|03/29/2022|.96124|03/29/2022|||ANTIPSYCHOTICS|3120|||||No|No||MYLAN|Yes|09/01/2020|||
diazepam|No|No|No|No|75%|00378034501|DIAZEPAM 5 MG TABLET|100|EA|.0215|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02374|03/29/2022|.02317|03/29/2022|.02332|03/29/2022|||ANXIOLYTICS|3121|||||No|No||MYLAN|No||||
diazepam|No|No|No|No|75%|00378034505|DIAZEPAM 5 MG TABLET|500|EA|.0193|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02374|03/29/2022|.02317|03/29/2022|.02332|03/29/2022|||ANXIOLYTICS|3122|||||No|No||MYLAN|Yes|09/01/2020|||
haloperidol|No|No|No|No|75%|00378035101|HALOPERIDOL 0.5 MG TABLET|100|EA|.11197|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.24816|03/29/2022|.2422|03/29/2022|.24381|03/29/2022|||ANTIPSYCHOTICS|3123|||||No|No||MYLAN|Yes|09/01/2020|||
haloperidol|No|No|No|No|75%|00378035110|HALOPERIDOL 0.5 MG TABLET|1000|EA|.11197|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.24816|03/29/2022|.2422|03/29/2022|.24381|03/29/2022|||ANTIPSYCHOTICS|3124|||||No|No||MYLAN|Yes|09/01/2020|||
cimetidine|No|No|No|No|75%|00378037201|CIMETIDINE 400 MG TABLET|100|EA|.2583|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.55647|03/29/2022|.54311|03/29/2022|.54673|03/29/2022||||3125|||||No|No||MYLAN|No||||
hydroxychloroquine sulfate|No|No|No|No|75%|00378037301|HYDROXYCHLOROQUINE 200 MG TAB|100|EA|1.79648|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.23831|03/29/2022|.23259|03/29/2022|.23413|03/29/2022||||3126|||||No|No||MYLAN|No||||
dimethyl fumarate|No|No|No|No|75%|00378039614|DIMETHYL FUMARATE DR 120 MG CP|14|EA|2.39571|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||043|No|6.92871|10/26/2021|6.76242|10/26/2021|6.80745|10/26/2021|||MULTIPLE SCLEROSIS AGENTS|3127|||||No|No||MYLAN|No||||
dimethyl fumarate|No|No|No|No|75%|00378039991|DIMETHYL FUMARATE DR 240 MG CP|60|EA|1.68416|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||043|No|3.05522|11/23/2021|2.98189|11/23/2021|3.00175|11/23/2021|||MULTIPLE SCLEROSIS AGENTS|3128|||||No|No||MYLAN|No||||
spironolact/hydrochlorothiazid|No|No|No|No|75%|00378040301|SPIRONOLACTONE-HCTZ 25-25 TAB|100|EA|.52847|05/04/2020||Yes|No||05/04/2020||Yes|No|05/04/2020||Yes|No||||No|No|||Prescription required|No|||Yes|.6635|03/29/2022|.64757|03/29/2022|.65188|03/29/2022||||3129|||||No|No||MYLAN|No||||
diphenoxylate HCl/atropine|No|No|No|No|75%|00378041501|DIPHENOXYLATE-ATROP 2.5-0.025|100|EA|.301|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.22711|03/29/2022|.22165|03/29/2022|.22313|03/29/2022||||3130|||||No|No||MYLAN|No||||
diphenoxylate HCl/atropine|No|No|No|No|75%|00378041510|DIPHENOXYLATE-ATROP 2.5-0.025|1000|EA|.301|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.22711|03/29/2022|.22165|03/29/2022|.22313|03/29/2022||||3131|||||No|No||MYLAN|No||||
diphenoxylate HCl/atropine|No|No|No|No|75%|00378041577|DIPHENOXYLATE-ATROP 2.5-0.025|90|EA|.301|02/03/2010||Yes|No||02/03/2010||Yes|No|02/03/2010||Yes|No||02/03/2010||Yes|No|||Prescription required|No|||No|.22711|03/29/2022|.22165|03/29/2022|.22313|03/29/2022||||3132|||||No|No||MYLAN|No||||
metoprolol/hydrochlorothiazide|No|No|No|No|75%|00378042401|METOPROLOL-HCTZ 50-25 MG TAB|100|EA|.48215|03/15/2007||Yes|No||03/15/2007||Yes|No|03/15/2007||Yes|No||03/15/2007||Yes|No|||Prescription required|Yes|07/24/2013|070|Yes|1.02132|03/01/2022|.9968|03/01/2022|1.00344|03/01/2022|||BETA-BLOCKERS|3133|||||No|No||MYLAN|No||||
metoprolol/hydrochlorothiazide|No|No|No|No|75%|00378043401|METOPROLOL-HCTZ 100-25 MG TAB|100|EA|.75361|03/15/2007||Yes|No||03/15/2007||Yes|No|03/15/2007||Yes|No||03/15/2007||Yes|No|||Prescription required|Yes|07/24/2013|070|Yes|1.54164|12/28/2021|1.50464|12/28/2021|1.51466|12/28/2021|||BETA-BLOCKERS|3134|||||No|No||MYLAN|No||||
spironolactone|No|No|No|No|75%|00378043701|SPIRONOLACTONE 100 MG TABLET|100|EA|.33002|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.2048|03/29/2022|.19988|03/29/2022|.20121|03/29/2022||||3135|||||No|No||MYLAN|No||||
perphenazine/amitriptyline HCl|No|No|No|No|75%|00378044201|PERPHEN-AMITRIP 2 MG-25 MG TAB|100|EA|.63042|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|1.43677|01/23/2018|1.41625|01/23/2018|1.34881|01/23/2018|||ANTIPSYCHOTICS|3136|||||No|No||MYLAN|No||||
perphenazine/amitriptyline HCl|No|No|No|No|75%|00378044205|PERPHEN-AMITRIP 2 MG-25 MG TAB|500|EA|.63041|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|1.43675|01/23/2018|1.41623|01/23/2018|1.34879|01/23/2018|||ANTIPSYCHOTICS|3137|||||No|No||MYLAN|No||||
metoprolol/hydrochlorothiazide|No|No|No|No|75%|00378044501|METOPROLOL-HCTZ 100-50 MG TAB|100|EA|.79911|03/15/2007||Yes|No||03/15/2007||Yes|No|03/15/2007||Yes|No||03/15/2007||Yes|No|||Prescription required|Yes|07/24/2013|070|Yes|1.82123|06/01/2016|1.79521|06/01/2016|1.70972|06/01/2016|||BETA-BLOCKERS|3138|||||No|No||MYLAN|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|00378046001|MAXZIDE 75 MG-50 MG TABLET|100|EA|1.46165|12/30/2009||Yes|No||12/30/2009||Yes|No|12/30/2009||Yes|No||||No|No|||Prescription required|No|||Yes|3.33121|06/01/2016|3.28362|06/01/2016|3.12726|06/01/2016||||3139|||||No|No||MYLAN|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|00378046401|MAXZIDE 37.5 MG-25 MG TABLET|100|EA|.65175|02/03/2010||Yes|No||02/03/2010||Yes|No|02/03/2010||Yes|No||||No|No|||Prescription required|No|||Yes|1.48538|05/23/2017|1.46416|05/23/2017|1.39444|05/23/2017||||3140|||||No|No||MYLAN|No||||
divalproex sodium|No|No|No|No|75%|00378047201|DIVALPROEX SOD ER 250 MG TAB|100|EA|.215|03/12/2009||Yes|No||03/12/2009||Yes|No|03/12/2009||Yes|No||03/12/2009||Yes|No|||Prescription required|No||056|Yes|.17839|03/29/2022|.1741|03/29/2022|.17526|03/29/2022|||ANTICONVULSANTS|3141|||||No|No||MYLAN|No||||
divalproex sodium|No|No|No|No|75%|00378047205|DIVALPROEX SOD ER 250 MG TAB|500|EA|.215|03/12/2009||Yes|No||03/12/2009||Yes|No|03/12/2009||Yes|No||03/12/2009||Yes|No|||Prescription required|No||056|Yes|.17839|03/29/2022|.1741|03/29/2022|.17526|03/29/2022|||ANTICONVULSANTS|3142|||||No|No||MYLAN|No||||
divalproex sodium|No|No|No|No|75%|00378047277|DIVALPROEX SOD ER 250 MG TAB|90|EA|.215|05/06/2010|06/30/2022|Yes|No||05/06/2010|06/30/2022|Yes|No|05/06/2010|06/30/2022|Yes|No||05/06/2010|06/30/2022|Yes|No|||Prescription required|No||056|Yes|.17839|03/29/2022|.1741|03/29/2022|.17526|03/29/2022|||ANTICONVULSANTS|3143|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||MYLAN|No||||
divalproex sodium|No|No|No|No|75%|00378047301|DIVALPROEX SOD ER 500 MG TAB|100|EA|.43|03/12/2009||Yes|No||03/12/2009||Yes|No|03/12/2009||Yes|No||03/12/2009||Yes|No|||Prescription required|No||056|No|.21008|03/29/2022|.20503|03/29/2022|.2064|03/29/2022|||ANTICONVULSANTS|3144|||||No|No||MYLAN|No||||
divalproex sodium|No|No|No|No|75%|00378047305|DIVALPROEX SOD ER 500 MG TAB|500|EA|.43|03/12/2009||Yes|No||03/12/2009||Yes|No|03/12/2009||Yes|No||03/12/2009||Yes|No|||Prescription required|No||056|No|.21008|03/29/2022|.20503|03/29/2022|.2064|03/29/2022|||ANTICONVULSANTS|3145|||||No|No||MYLAN|No||||
divalproex sodium|No|No|No|No|75%|00378047377|DIVALPROEX SOD ER 500 MG TAB|90|EA|.43|05/06/2010|09/30/2022|Yes|No||05/06/2010|09/30/2022|Yes|No|05/06/2010|09/30/2022|Yes|No||05/06/2010|09/30/2022|Yes|No|||Prescription required|No||056|No|.21008|03/29/2022|.20503|03/29/2022|.2064|03/29/2022|||ANTICONVULSANTS|3146|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||MYLAN|No||||
diazepam|No|No|No|No|75%|00378047701|DIAZEPAM 10 MG TABLET|100|EA|.04106|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANXIOLYTICS|3147|||||No|No||MYLAN|No||||
diazepam|No|No|No|No|75%|00378047705|DIAZEPAM 10 MG TABLET|500|EA|.03904|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANXIOLYTICS|3148|||||No|No||MYLAN|Yes|09/01/2020|||
dalfampridine|No|No|No|No|75%|00378050991|DALFAMPRIDINE ER 10 MG TABLET|60|EA|16.64952|12/03/2018|05/31/2022|Yes|No||12/03/2018|05/31/2022|Yes|No|12/03/2018|05/31/2022|Yes|No||||No|No|||Prescription required|No||043|No|.82047|03/29/2022|.80077|03/29/2022|.80611|03/29/2022|||MULTIPLE SCLEROSIS AGENTS|3149|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN|No||||
cimetidine|No|No|No|No|75%|00378054101|CIMETIDINE 800 MG TABLET|100|EA|.49617|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.91984|03/29/2022|.89776|03/29/2022|.90374|03/29/2022||||3150|||||No|No||MYLAN|No||||
albuterol sulfate|No|No|No|No|75%|00378057201|ALBUTEROL SULFATE 4 MG TAB|100|EA|2.02104|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|037|No|1.0884|03/01/2022|1.06227|03/01/2022|1.06935|03/01/2022|||BRONCHODILATORS: BETA AGONIST|3151|||||No|No||MYLAN|Yes|09/01/2020|||
perphenazine/amitriptyline HCl|No|No|No|No|75%|00378057401|PERPHEN-AMITRIP 4 MG-25 MG TAB|100|EA|.68662|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|1.56486|12/26/2017|1.5425|12/26/2017|1.46905|12/26/2017|||ANTIPSYCHOTICS|3152|||||No|No||MYLAN|No||||
perphenazine/amitriptyline HCl|No|No|No|No|75%|00378057405|PERPHEN-AMITRIP 4 MG-25 MG TAB|500|EA|.68654|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|1.56468|12/26/2017|1.54233|12/26/2017|1.46889|12/26/2017|||ANTIPSYCHOTICS|3153|||||No|No||MYLAN|No||||
amiloride/hydrochlorothiazide|No|No|No|No|75%|00378057701|AMILORIDE HCL-HCTZ 5-50 MG TAB|100|EA|.1744|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|.41068|03/29/2022|.40082|03/29/2022|.40349|03/29/2022||||3154|||||No|No||MYLAN|No||||
amiloride/hydrochlorothiazide|No|No|No|No|75%|00378057705|AMILORIDE HCL-HCTZ 5-50 MG TAB|500|EA|.1744|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|.41068|03/29/2022|.40082|03/29/2022|.40349|03/29/2022||||3155|||||No|No||MYLAN|No||||
thioridazine HCl|No|No|No|No|75%|00378061201|THIORIDAZINE 10 MG TABLET|100|EA|.20485|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.46687|08/27/2019|.4602|08/27/2019|.43828|08/27/2019|||ANTIPSYCHOTICS|3156|||||No|No||MYLAN|No||||
thioridazine HCl|No|No|No|No|75%|00378061401|THIORIDAZINE 25 MG TABLET|100|EA|.28818|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.65679|11/23/2021|.64741|11/23/2021|.61658|11/23/2021|||ANTIPSYCHOTICS|3157|||||No|No||MYLAN|No||||
thioridazine HCl|No|No|No|No|75%|00378061601|THIORIDAZINE 50 MG TABLET|100|EA|.36038|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.82133|10/27/2020|.8096|10/27/2020|.77105|10/27/2020|||ANTIPSYCHOTICS|3158|||||No|No||MYLAN|No||||
thioridazine HCl|No|No|No|No|75%|00378061801|THIORIDAZINE 100 MG TABLET|100|EA|.41039|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.93531|01/29/2019|.92195|01/29/2019|.87804|01/29/2019|||ANTIPSYCHOTICS|3159|||||No|No||MYLAN|No||||
prednisone|No|No|No|No|75%|00378064001|PREDNISONE 5 MG TABLET|100|EA|.07|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||06/04/2019||Yes|No|||Prescription required|No||168|Yes|.07803|03/29/2022|.07615|03/29/2022|.07666|03/29/2022|||GLUCOCORTICOIDS: ORAL|3160|||||No|No||MYLAN|No||||
prednisone|No|No|No|No|75%|00378064010|PREDNISONE 5 MG TABLET|1000|EA|.0693|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||06/04/2019||Yes|No|||Prescription required|No||168|Yes|.07803|03/29/2022|.07615|03/29/2022|.07666|03/29/2022|||GLUCOCORTICOIDS: ORAL|3161|||||No|No||MYLAN|No||||
prednisone|No|No|No|No|75%|00378064101|PREDNISONE 10 MG TABLET|100|EA|.07516|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||01/03/2020||Yes|No|||Prescription required|No||168|Yes|.07092|03/29/2022|.06921|03/29/2022|.06967|03/29/2022|||GLUCOCORTICOIDS: ORAL|3162|||||No|No||MYLAN|No||||
prednisone|No|No|No|No|75%|00378064110|PREDNISONE 10 MG TABLET|1000|EA|.0744|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||01/03/2020||Yes|No|||Prescription required|No||168|Yes|.07092|03/29/2022|.06921|03/29/2022|.06967|03/29/2022|||GLUCOCORTICOIDS: ORAL|3163|||||No|No||MYLAN|No||||
prednisone|No|No|No|No|75%|00378064201|PREDNISONE 20 MG TABLET|100|EA|.08019|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||12/30/2020||Yes|No|||Prescription required|No||168|Yes|.11229|03/29/2022|.10959|03/29/2022|.11032|03/29/2022|||GLUCOCORTICOIDS: ORAL|3164|||||No|No||MYLAN|No||||
prednisone|No|No|No|No|75%|00378064205|PREDNISONE 20 MG TABLET|500|EA|.07937|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||12/30/2020||Yes|No|||Prescription required|No||168|Yes|.11229|03/29/2022|.10959|03/29/2022|.11032|03/29/2022|||GLUCOCORTICOIDS: ORAL|3165|||||No|No||MYLAN|No||||
prednisone|No|No|No|No|75%|00378064210|PREDNISONE 20 MG TABLET|1000|EA|.07541|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||12/30/2020||Yes|No|||Prescription required|No||168|Yes|.11229|03/29/2022|.10959|03/29/2022|.11032|03/29/2022|||GLUCOCORTICOIDS: ORAL|3166|||||No|No||MYLAN|No||||
timolol maleate|No|No|No|No|75%|00378071501|TIMOLOL MALEATE 20 MG TABLET|100|EA|1.08084|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|070|No|2.46332|06/01/2016|2.42813|06/01/2016|2.31251|06/01/2016|||BETA-BLOCKERS|3167|||||No|No||MYLAN|No||||
atenolol|No|No|No|No|75%|00378075701|ATENOLOL 100 MG TABLET|100|EA|.05568|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.04816|03/29/2022|.047|03/29/2022|.04731|03/29/2022|||BETA-BLOCKERS|3168|||||No|No||MYLAN|No||||
atenolol|No|No|No|No|75%|00378075710|ATENOLOL 100 MG TABLET|1000|EA|.05291|06/02/2005||Yes|No||06/02/2005||Yes|No|06/02/2005||Yes|No||06/02/2005||Yes|No|||Prescription required|No||070|No|.04816|03/29/2022|.047|03/29/2022|.04731|03/29/2022|||BETA-BLOCKERS|3169|||||No|No||MYLAN|No||||
fexofenadine HCl|No|No|No|No|75%|00378078191|FEXOFENADINE HCL 60 MG TABLET|60|EA|.31425|07/18/2016|02/28/2022|Yes|No||||No|No|07/18/2016|02/28/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.71621|03/15/2022|.70598|03/15/2022|.67236|03/15/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|3170|No Longer Rebatable||No Longer Rebatable||No|No||MYLAN|No||||
fexofenadine HCl|No|No|No|No|75%|00378078293|FEXOFENADINE HCL 180 MG TABLET|30|EA|.54509|07/18/2016|02/28/2022|Yes|No||||No|No|07/18/2016|02/28/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|1.2423|03/15/2022|1.22455|03/15/2022|1.16624|03/15/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|3171|No Longer Rebatable||No Longer Rebatable||No|No||MYLAN|No||||
hydrochlorothiazide|Yes|No|No|No|75%|00378081001|HYDROCHLOROTHIAZIDE 12.5 MG CP|100|EA|.0344|03/01/2002|07/31/2022|Yes|No||03/01/2002|07/31/2022|Yes|No|03/01/2002|07/31/2022|Yes|No||01/01/2012|07/31/2022|Yes|No|07/01/2016|07/31/2022|Prescription required|No|||Yes|.03333|03/29/2022|.03253|03/29/2022|.03274|03/29/2022||||3172|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||MYLAN|No||||
hydrochlorothiazide|Yes|No|No|No|75%|00378081005|HYDROCHLOROTHIAZIDE 12.5 MG CP|500|EA|.0344|06/20/2018|07/31/2022|Yes|No||06/20/2018|07/31/2022|Yes|No|06/20/2018|07/31/2022|Yes|No||06/20/2018|07/31/2022|Yes|No|06/20/2018|07/31/2022|Prescription required|No|||Yes|.03333|03/29/2022|.03253|03/29/2022|.03274|03/29/2022||||3173|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||MYLAN|No||||
clozapine|No|No|No|No|75%|00378082501|CLOZAPINE 25 MG TABLET|100|EA|.36175|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.26318|03/29/2022|.25686|03/29/2022|.25857|03/29/2022|||ANTIPSYCHOTICS|3174|||||No|No||MYLAN|No||||
clozapine|No|No|No|No|75%|00378086001|CLOZAPINE 100 MG TABLET|100|EA|.93843|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.60868|03/29/2022|.59407|03/29/2022|.59802|03/29/2022|||ANTIPSYCHOTICS|3175|||||No|No||MYLAN|No||||
clozapine|No|No|No|No|75%|00378086005|CLOZAPINE 100 MG TABLET|500|EA|.89442|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.60868|03/29/2022|.59407|03/29/2022|.59802|03/29/2022|||ANTIPSYCHOTICS|3176|||||No|No||MYLAN|No||||
clonidine|No|No|No|No|75%|00378087199|CLONIDINE 0.1 MG/DAY PATCH|4|EA|11.39392|07/20/2010||Yes|No||07/20/2010||Yes|No|07/20/2010||Yes|No||01/01/2012||Yes|No|||Prescription required|Yes|07/29/2021|166|No|8.1002|03/29/2022|7.90579|03/29/2022|7.95844|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|3177|||||No|No||MYLAN|No||||
clonidine|No|No|No|No|75%|00378087299|CLONIDINE 0.2 MG/DAY PATCH|4|EA|19.18337|07/20/2010||Yes|No||07/20/2010||Yes|No|07/20/2010||Yes|No||01/01/2012||Yes|No|||Prescription required|Yes|07/29/2021|166|No|12.62203|03/29/2022|12.3191|03/29/2022|12.40114|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|3178|||||No|No||MYLAN|No||||
clonidine|No|No|No|No|75%|00378087399|CLONIDINE 0.3 MG/DAY PATCH|4|EA|26.6127|07/20/2010||Yes|No||07/20/2010||Yes|No|07/20/2010||Yes|No||01/01/2012||Yes|No|||Prescription required|Yes|07/29/2021|166|No|15.82856|03/29/2022|15.44867|03/29/2022|15.55156|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|3179|||||No|No||MYLAN|No||||
buprenorphine HCl|No|No|No|No|90%|00378092393|BUPRENORPHINE 2 MG TABLET SL|30|EA|.22933|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|.52266|11/12/2019|.51519|11/12/2019|.49066|11/12/2019|||OPIATE DEPENDENCE TREATMENTS|3180|||||No|No||MYLAN|Yes|09/01/2020|||
buprenorphine HCl|No|No|No|No|90%|00378092493|BUPRENORPHINE 8 MG TABLET SL|30|EA|.71666|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|1.63332|11/12/2019|1.60999|11/12/2019|1.53332|11/12/2019|||OPIATE DEPENDENCE TREATMENTS|3181|||||No|No||MYLAN|Yes|09/01/2020|||
clozapine|No|No|No|No|75%|00378097201|CLOZAPINE 50 MG TABLET|100|EA|.5676|05/03/2010||Yes|No||05/03/2010||Yes|No|05/03/2010||Yes|No||||No|No|||Prescription required|No||027|Yes|.51896|03/29/2022|.5065|03/29/2022|.50987|03/29/2022|||ANTIPSYCHOTICS|3182|||||No|No||MYLAN|No||||
clozapine|No|No|No|No|75%|00378097301|CLOZAPINE 200 MG TABLET|100|EA|1.88718|05/03/2010||Yes|No||05/03/2010||Yes|No|05/03/2010||Yes|No||||No|No|||Prescription required|No||027|Yes|1.46893|03/29/2022|1.43367|03/29/2022|1.44322|03/29/2022|||ANTIPSYCHOTICS|3183|||||No|No||MYLAN|No||||
thiothixene|No|No|No|No|75%|00378100101|THIOTHIXENE 1 MG CAPSULE|100|EA|.40867|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.93139|06/25/2019|.91808|06/25/2019|.87436|06/25/2019|||ANTIPSYCHOTICS|3184|||||No|No||MYLAN|No||||
azathioprine|No|No|No|No|75%|00378100501|AZATHIOPRINE 50 MG TABLET|100|EA|.20059|01/25/2010||Yes|No||01/25/2010||Yes|No|01/25/2010||Yes|No||02/28/2011||Yes|No|||Prescription required|No||229|No|.24374|03/29/2022|.23789|03/29/2022|.23947|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|3185|||||No|No||MYLAN|No||||
nicardipine HCl|Yes|No|No|No|75%|00378102005|NICARDIPINE 20 MG CAPSULE|500|EA|.7494|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|Yes|01/28/2016|045|No|1.70794|04/28/2020|1.68354|04/28/2020|1.60337|04/28/2020|||CALCIUM CHANNEL BLOCKERS|3186|||||No|No||MYLAN|No||||
nicardipine HCl|Yes|No|No|No|75%|00378102077|NICARDIPINE 20 MG CAPSULE|90|EA|.76678|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|Yes|01/28/2016|045|No|1.74755|04/28/2020|1.72259|04/28/2020|1.64056|04/28/2020|||CALCIUM CHANNEL BLOCKERS|3187|||||No|No||MYLAN|No||||
eplerenone|No|No|No|No|75%|00378103077|EPLERENONE 25 MG TABLET|90|EA|.60175|06/06/2018||Yes|No||06/06/2018||Yes|No|06/06/2018||Yes|No||||No|No|||Prescription required|No|||No|.73164|03/29/2022|.71408|03/29/2022|.71883|03/29/2022||||3188|||||No|No||MYLAN/PRASCO LA|No||||
eplerenone|No|No|No|No|75%|00378103093|EPLERENONE 25 MG TABLET|30|EA|.60171|06/06/2018||Yes|No||06/06/2018||Yes|No|06/06/2018||Yes|No||||No|No|||Prescription required|No|||No|.73164|03/29/2022|.71408|03/29/2022|.71883|03/29/2022||||3189|||||No|No||MYLAN/PRASCO LA|No||||
eplerenone|No|No|No|No|75%|00378103177|EPLERENONE 50 MG TABLET|90|EA|.60175|06/06/2018||Yes|No||06/06/2018||Yes|No|06/06/2018||Yes|No||||No|No|||Prescription required|No|||No|.85922|03/29/2022|.83859|03/29/2022|.84418|03/29/2022||||3190|||||No|No||MYLAN/PRASCO LA|No||||
eplerenone|No|No|No|No|75%|00378103193|EPLERENONE 50 MG TABLET|30|EA|.60185|06/06/2018||Yes|No||06/06/2018||Yes|No|06/06/2018||Yes|No||||No|No|||Prescription required|No|||No|.85922|03/29/2022|.83859|03/29/2022|.84418|03/29/2022||||3191|||||No|No||MYLAN/PRASCO LA|No||||
doxepin HCl|No|No|No|No|75%|00378104901|DOXEPIN 10 MG CAPSULE|100|EA|.20141|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.22181|03/29/2022|.21648|03/29/2022|.21792|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|3192|||||No|No||MYLAN|No||||
doxepin HCl|No|No|No|No|75%|00378104910|DOXEPIN 10 MG CAPSULE|1000|EA|.20139|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.22181|03/29/2022|.21648|03/29/2022|.21792|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|3193|||||No|No||MYLAN|No||||
telmisartan/amlodipine|No|No|No|No|75%|00378107593|TELMISARTAN-AMLODIPINE 40-5 MG|30|EA|1.78306|05/29/2015||Yes|No||05/29/2015||Yes|No|05/29/2015||Yes|No||05/29/2015||Yes|No|||Prescription required|Yes|07/17/2014|017|Yes|4.06372|06/01/2016|4.00567|06/01/2016|3.81492|06/01/2016|||ANGIOTENSIN MODULATOR COMBINATIONS|3194|||||No|No||MYLAN|No||||
telmisartan/amlodipine|No|No|No|No|75%|00378107693|TELMISARTAN-AMLODIPINE 40-10|30|EA|1.78306|05/29/2015||Yes|No||05/29/2015||Yes|No|05/29/2015||Yes|No||05/29/2015||Yes|No|||Prescription required|Yes|07/17/2014|017|Yes|4.06372|06/01/2016|4.00567|06/01/2016|3.81492|06/01/2016|||ANGIOTENSIN MODULATOR COMBINATIONS|3195|||||No|No||MYLAN|No||||
telmisartan/amlodipine|No|No|No|No|75%|00378107793|TELMISARTAN-AMLODIPINE 80-5 MG|30|EA|1.78306|05/29/2015||Yes|No||05/29/2015||Yes|No|05/29/2015||Yes|No||05/29/2015||Yes|No|||Prescription required|Yes|07/17/2014|017|Yes|4.06372|08/25/2020|4.00567|08/25/2020|3.81492|08/25/2020|||ANGIOTENSIN MODULATOR COMBINATIONS|3196|||||No|No||MYLAN|No||||
telmisartan/amlodipine|No|No|No|No|75%|00378107893|TELMISARTAN-AMLODIPINE 80-10|30|EA|1.78306|05/29/2015||Yes|No||05/29/2015||Yes|No|05/29/2015||Yes|No||05/29/2015||Yes|No|||Prescription required|Yes|07/17/2014|017|Yes|4.06372|06/01/2016|4.00567|06/01/2016|3.81492|06/01/2016|||ANGIOTENSIN MODULATOR COMBINATIONS|3197|||||No|No||MYLAN|No||||
colchicine|No|No|No|No|75%|00378108601|COLCHICINE 0.6 MG TABLET|100|EA|.86903|07/21/2020||Yes|No||07/21/2020||Yes|No|07/21/2020||Yes|No||07/21/2020||Yes|No|||Prescription required|Yes|07/25/2019|231|No|.64179|03/29/2022|.62638|03/29/2022|.63055|03/29/2022|||ANTIHYPERURICEMICS|3198|||||No|No||MYLAN|No||||
colchicine|No|No|No|No|75%|00378108693|COLCHICINE 0.6 MG TABLET|30|EA|.86917|07/21/2020||Yes|No||07/21/2020||Yes|No|07/21/2020||Yes|No||07/21/2020||Yes|No|||Prescription required|Yes|07/25/2019|231|No|.64179|03/29/2022|.62638|03/29/2022|.63055|03/29/2022|||ANTIHYPERURICEMICS|3199|||||No|No||MYLAN|No||||
prazosin HCl|No|No|No|No|75%|00378110101|PRAZOSIN 1 MG CAPSULE|100|EA|.23103|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.1999|03/29/2022|.1951|03/29/2022|.1964|03/29/2022||||3200|||||No|No||MYLAN|No||||
prazosin HCl|No|No|No|No|75%|00378110110|PRAZOSIN 1 MG CAPSULE|1000|EA|.23103|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.1999|03/29/2022|.1951|03/29/2022|.1964|03/29/2022||||3201|||||No|No||MYLAN|No||||
glipizide|Yes|No|No|No|75%|00378110501|GLIPIZIDE 5 MG TABLET|100|EA|.0273|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.03474|03/29/2022|.0339|03/29/2022|.03413|03/29/2022||||3202|||||No|No||MYLAN|No||||
glipizide|Yes|No|No|No|75%|00378110505|GLIPIZIDE 5 MG TABLET|500|EA|.0258|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.03474|03/29/2022|.0339|03/29/2022|.03413|03/29/2022||||3203|||||No|No||MYLAN|No||||
glipizide|Yes|No|No|No|75%|00378111001|GLIPIZIDE 10 MG TABLET|100|EA|.03999|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.04827|03/29/2022|.04711|03/29/2022|.04742|03/29/2022||||3204|||||No|No||MYLAN|No||||
glipizide|Yes|No|No|No|75%|00378111005|GLIPIZIDE 10 MG TABLET|500|EA|.03784|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.04827|03/29/2022|.04711|03/29/2022|.04742|03/29/2022||||3205|||||No|No||MYLAN|No||||
nadolol|No|No|No|No|75%|00378113201|NADOLOL 80 MG TABLET|100|EA|1.06648|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|07/17/2014|070|No|.57501|03/29/2022|.5612|03/29/2022|.56494|03/29/2022|||BETA-BLOCKERS|3206|||||No|No||MYLAN|No||||
carbidopa/levodopa|No|No|No|No|75%|00378113301|CARBIDOPA-LEVODOPA 25-250 TAB|100|EA|.14749|02/09/2014||Yes|No||02/09/2014||Yes|No|02/09/2014||Yes|No||||No|No|||Prescription required|No||015|No|.1493|03/29/2022|.14571|03/29/2022|.14668|03/29/2022|||ANTIPARKINSON'S AGENTS|3207|||||No|No||MYLAN|No||||
ketorolac tromethamine|No|No|No|No|75%|00378113401|KETOROLAC 10 MG TABLET|100|EA|.77916|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|059|Yes|.74409|03/29/2022|.72623|03/29/2022|.73106|03/29/2022|||NSAIDS|3208|||||No|No||MYLAN|No||||
buspirone HCl|No|No|No|No|75%|00378114001|BUSPIRONE HCL 5 MG TABLET|100|EA|.03418|03/26/2002||Yes|No||03/26/2002||Yes|No|03/26/2002||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|3209|||||No|No||MYLAN|No||||
buspirone HCl|No|No|No|No|75%|00378114005|BUSPIRONE HCL 5 MG TABLET|500|EA|.03418|03/26/2002||Yes|No||03/26/2002||Yes|No|03/26/2002||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|3210|||||No|No||MYLAN|No||||
buspirone HCl|No|No|No|No|75%|00378114501|BUSPIRONE HCL 7.5 MG TABLET|100|EA|.19543|11/04/2013||Yes|No||11/04/2013||Yes|No|11/04/2013||Yes|No||||No|No|||Prescription required|No||090|No|.22186|03/29/2022|.21653|03/29/2022|.21797|03/29/2022|||ANXIOLYTICS|3211|||||No|No||MYLAN|No||||
buspirone HCl|No|No|No|No|75%|00378115001|BUSPIRONE HCL 10 MG TABLET|100|EA|.04687|03/26/2002||Yes|No||03/26/2002||Yes|No|03/26/2002||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|3212|||||No|No||MYLAN|No||||
buspirone HCl|No|No|No|No|75%|00378115005|BUSPIRONE HCL 10 MG TABLET|500|EA|.04687|03/26/2002||Yes|No||03/26/2002||Yes|No|03/26/2002||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|3213|||||No|No||MYLAN|No||||
buspirone HCl|No|No|No|No|75%|00378116580|BUSPIRONE HCL 15 MG TABLET|180|EA|.05733|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|3214|||||No|No||MYLAN|No||||
buspirone HCl|No|No|No|No|75%|00378116591|BUSPIRONE HCL 15 MG TABLET|60|EA|.05733|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|3215|||||No|No||MYLAN|No||||
nadolol|No|No|No|No|75%|00378117101|NADOLOL 40 MG TABLET|100|EA|.77627|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|07/17/2014|070|No|.40202|03/29/2022|.39237|03/29/2022|.39498|03/29/2022|||BETA-BLOCKERS|3216|||||No|No||MYLAN|No||||
nadolol|No|No|No|No|75%|00378117110|NADOLOL 40 MG TABLET|1000|EA|.77627|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|07/17/2014|070|No|.40202|03/29/2022|.39237|03/29/2022|.39498|03/29/2022|||BETA-BLOCKERS|3217|||||No|No||MYLAN|No||||
buspirone HCl|No|No|No|No|75%|00378117591|BUSPIRONE HCL 30 MG TABLET|60|EA|.62514|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|No|.17728|03/29/2022|.17302|03/29/2022|.17417|03/29/2022|||ANXIOLYTICS|3218|||||No|No||MYLAN|No||||
acebutolol HCl|No|No|No|No|75%|00378120001|ACEBUTOLOL 200 MG CAPSULE|100|EA|.13222|03/01/2002|02/22/2022|Yes|No||03/01/2002|02/22/2022|Yes|No|03/01/2002|02/22/2022|Yes|No||03/01/2002|02/22/2022|Yes|No|||Prescription required|No||070|No|.30135|03/29/2022|.29704|03/29/2022|.2829|03/29/2022|||BETA-BLOCKERS|3219|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||MYLAN|No||||
rasagiline mesylate|No|No|No|No|75%|00378127093|RASAGILINE MESYLATE 0.5 MG TAB|30|EA|5.91207|02/28/2018||Yes|No||02/28/2018||Yes|No|02/28/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|015|No|4.5286|03/29/2022|4.41991|03/29/2022|4.44934|03/29/2022|||ANTIPARKINSON'S AGENTS|3220|||||No|No||MYLAN|No||||
rasagiline mesylate|No|No|No|No|75%|00378127193|RASAGILINE MESYLATE 1 MG TAB|30|EA|5.91207|02/28/2018||Yes|No||02/28/2018||Yes|No|02/28/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|015|No|1.78642|03/29/2022|1.74354|03/29/2022|1.75515|03/29/2022|||ANTIPARKINSON'S AGENTS|3221|||||No|No||MYLAN|No||||
lithium carbonate|No|No|No|No|75%|00378130001|LITHIUM CARBONATE ER 300 MG TB|100|EA|.14349|07/19/2012||Yes|No||07/19/2012||Yes|No|07/19/2012||Yes|No||||No|No|||Prescription required|No|||No|.12646|03/29/2022|.12342|03/29/2022|.12424|03/29/2022||||3222|||||No|No||MYLAN|No||||
lithium carbonate|No|No|No|No|75%|00378130005|LITHIUM CARBONATE ER 300 MG TB|500|EA|.14349|07/19/2012||Yes|No||07/19/2012||Yes|No|07/19/2012||Yes|No||||No|No|||Prescription required|No|||No|.12646|03/29/2022|.12342|03/29/2022|.12424|03/29/2022||||3223|||||No|No||MYLAN|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|00378135201|TRIAMTERENE-HCTZ 37.5-25 MG TB|100|EA|.1182|03/01/2002|02/22/2022|Yes|No||03/01/2002|02/22/2022|Yes|No|03/01/2002|02/22/2022|Yes|No||||No|No|||Prescription required|No|||Yes|.2694|03/29/2022|.26555|03/29/2022|.2529|03/29/2022||||3224|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|00378135205|TRIAMTERENE-HCTZ 37.5-25 MG TB|500|EA|.11674|03/01/2002|08/31/2022|Yes|No||03/01/2002|08/31/2022|Yes|No|03/01/2002|08/31/2022|Yes|No||||No|No|||Prescription required|No|||Yes|.09986|03/29/2022|.09746|03/29/2022|.09811|03/29/2022||||3225|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|00378135501|TRIAMTERENE-HCTZ 75-50 MG TAB|100|EA|.12121|03/01/2002|08/31/2022|Yes|No||03/01/2002|08/31/2022|Yes|No|03/01/2002|08/31/2022|Yes|No||||No|No|||Prescription required|No|||Yes|.1312|03/29/2022|.12805|03/29/2022|.1289|03/29/2022||||3226|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|00378135505|TRIAMTERENE-HCTZ 75-50 MG TAB|500|EA|.11756|03/01/2002|03/31/2022|Yes|No||03/01/2002|03/31/2022|Yes|No|03/01/2002|03/31/2022|Yes|No||||No|No|||Prescription required|No|||Yes|.1312|03/29/2022|.12805|03/29/2022|.1289|03/29/2022||||3227|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN|No||||
mesalamine|No|No|No|No|75%|00378137578|MESALAMINE ER 0.375 GRAM CAP|120|EA|1.57816|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|010|No|1.86918|03/29/2022|1.82431|03/29/2022|1.83646|03/29/2022|||ULCERATIVE COLITIS AGENTS|3228|||||No|No||MYLAN|No||||
acebutolol HCl|No|No|No|No|75%|00378140001|ACEBUTOLOL 400 MG CAPSULE|100|EA|.19242|03/01/2002|02/22/2022|Yes|No||03/01/2002|02/22/2022|Yes|No|03/01/2002|02/22/2022|Yes|No||03/01/2002|02/22/2022|Yes|No|||Prescription required|No||070|No|.43855|03/29/2022|.43228|03/29/2022|.4117|03/29/2022|||BETA-BLOCKERS|3229|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||MYLAN|No||||
rizatriptan benzoate|No|No|No|No|75%|00378140496|RIZATRIPTAN 10 MG TABLET|12|EA|1.3484|06/29/2018||Yes|No||06/29/2018||Yes|No|06/29/2018||Yes|No||||No|No|||Prescription required|No||021|No|.50927|03/29/2022|.49704|03/29/2022|.50035|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|3230|||||No|No||MYLAN|No||||
nicardipine HCl|Yes|No|No|No|75%|00378143005|NICARDIPINE 30 MG CAPSULE|500|EA|1.07297|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|Yes|01/28/2016|045|No|2.44537|10/29/2019|2.41044|10/29/2019|2.29565|10/29/2019|||CALCIUM CHANNEL BLOCKERS|3231|||||No|No||MYLAN|No||||
nicardipine HCl|Yes|No|No|No|75%|00378143077|NICARDIPINE 30 MG CAPSULE|90|EA|1.09822|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|Yes|01/28/2016|045|No|2.50292|10/29/2019|2.46716|10/29/2019|2.34968|10/29/2019|||CALCIUM CHANNEL BLOCKERS|3232|||||No|No||MYLAN|No||||
lithium carbonate|No|No|No|No|75%|00378145001|LITHIUM CARBONATE ER 450 MG TB|100|EA|.16615|08/30/2012||Yes|No||08/30/2012||Yes|No|08/30/2012||Yes|No||||No|No|||Prescription required|No|||No|.16553|03/29/2022|.16155|03/29/2022|.16263|03/29/2022||||3233|||||No|No||MYLAN|No||||
phenytoin sodium extended|No|No|No|No|75%|00378156001|PHENYTOIN SOD EXT 100 MG CAP|100|EA|.22024|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||056|No|.15598|03/29/2022|.15223|03/29/2022|.15325|03/29/2022|||ANTICONVULSANTS|3234|||||No|No||MYLAN|No||||
phenytoin sodium extended|No|No|No|No|75%|00378156010|PHENYTOIN SOD EXT 100 MG CAP|1000|EA|.22027|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||056|No|.15598|03/29/2022|.15223|03/29/2022|.15325|03/29/2022|||ANTICONVULSANTS|3235|||||No|No||MYLAN|No||||
dicyclomine HCl|No|No|No|No|75%|00378161001|DICYCLOMINE 10 MG CAPSULE|100|EA|.03504|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.10786|03/29/2022|.10527|03/29/2022|.10597|03/29/2022||||3236|||||No|No||MYLAN|No||||
dicyclomine HCl|No|No|No|No|75%|00378161005|DICYCLOMINE 10 MG CAPSULE|500|EA|.03397|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.10786|03/29/2022|.10527|03/29/2022|.10597|03/29/2022||||3237|||||No|No||MYLAN|No||||
voriconazole|No|No|No|No|75%|00378162693|VORICONAZOLE 50 MG TABLET|30|EA|4.03383|12/12/2011||Yes|No||12/12/2011||Yes|No|12/12/2011||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|01/20/2011|069|No|9.19338|01/24/2017|9.06204|01/24/2017|8.63052|01/24/2017|||ANTIFUNGALS: ORAL|3238|||||No|No||MYLAN|No||||
voriconazole|No|No|No|No|75%|00378164093|VORICONAZOLE 200 MG TABLET|30|EA|16.1356|12/12/2011||Yes|No||12/12/2011||Yes|No|12/12/2011||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|01/20/2011|069|No|2.07998|03/29/2022|2.03006|03/29/2022|2.04358|03/29/2022|||ANTIFUNGALS: ORAL|3239|||||No|No||MYLAN|No||||
sildenafil citrate|No|No|No|No|75%|00378165777|SILDENAFIL 20 MG TABLET|90|EA|.043|01/25/2013||Yes|No||01/25/2013||Yes|No|01/25/2013||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|Yes|.09246|03/29/2022|.09024|03/29/2022|.09084|03/29/2022|||PAH AGENTS: ORAL AND INHALED|3240|||||No|No||MYLAN|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|00378172193|AMLODIPINE-VALSARTAN 5-160 MG|30|EA|.25456|07/17/2015||Yes|No||07/17/2015||Yes|No|07/17/2015||Yes|No||07/17/2015||Yes|No|||Prescription required|No||017|Yes|.43208|03/29/2022|.42171|03/29/2022|.42451|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|3241|||||No|No||MYLAN|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|00378172293|AMLODIPINE-VALSARTAN 10-160 MG|30|EA|.28867|07/17/2015||Yes|No||07/17/2015||Yes|No|07/17/2015||Yes|No||07/17/2015||Yes|No|||Prescription required|No||017|Yes|.53459|03/29/2022|.52175|03/29/2022|.52523|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|3242|||||No|No||MYLAN|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|00378172393|AMLODIPINE-VALSARTAN 5-320 MG|30|EA|.32278|07/17/2015||Yes|No||07/17/2015||Yes|No|07/17/2015||Yes|No||07/17/2015||Yes|No|||Prescription required|No||017|Yes|.57359|03/29/2022|.55982|03/29/2022|.56355|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|3243|||||No|No||MYLAN|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|00378172493|AMLODIPINE-VALSARTAN 10-320 MG|30|EA|.3665|07/17/2015||Yes|No||07/17/2015||Yes|No|07/17/2015||Yes|No||07/17/2015||Yes|No|||Prescription required|No||017|Yes|.73857|03/29/2022|.72084|03/29/2022|.72564|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|3244|||||No|No||MYLAN|No||||
ursodiol|No|No|No|No|75%|00378173001|URSODIOL 300 MG CAPSULE|100|EA|1.0965|02/16/2014|01/31/2023|Yes|No||02/16/2014|01/31/2023|Yes|No|02/16/2014|01/31/2023|Yes|No||||No|No|||Prescription required|Yes|03/09/2018|198|No|.60006|03/29/2022|.58565|03/29/2022|.58955|03/29/2022|||BILE SALTS|3245|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN|No||||
levothyroxine sodium|No|No|No|No|75%|00378180010|LEVOTHYROXINE 25 MCG TABLET|1000|EA|.15656|12/20/2007||Yes|No||12/20/2007||Yes|No|12/20/2007||Yes|No||||No|No|||Prescription required|No|||No|.11852|03/29/2022|.11567|03/29/2022|.11644|03/29/2022||||3246|||||No|No||MYLAN|No||||
levothyroxine sodium|No|No|No|No|75%|00378180310|LEVOTHYROXINE 50 MCG TABLET|1000|EA|.17773|07/11/2005||Yes|No||07/11/2005||Yes|No|07/11/2005||Yes|No||||No|No|||Prescription required|No|||No|.14288|03/29/2022|.13945|03/29/2022|.14037|03/29/2022||||3247|||||No|No||MYLAN|No||||
levothyroxine sodium|No|No|No|No|75%|00378180377|LEVOTHYROXINE 50 MCG TABLET|90|EA|.17773|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|No|||No|.14288|03/29/2022|.13945|03/29/2022|.14037|03/29/2022||||3248|||||No|No||MYLAN|No||||
levothyroxine sodium|No|No|No|No|75%|00378180510|LEVOTHYROXINE 75 MCG TABLET|1000|EA|.1964|07/11/2005||Yes|No||07/11/2005||Yes|No|07/11/2005||Yes|No||||No|No|||Prescription required|No|||No|.15545|03/29/2022|.15171|03/29/2022|.15272|03/29/2022||||3249|||||No|No||MYLAN|No||||
levothyroxine sodium|No|No|No|No|75%|00378180577|LEVOTHYROXINE 75 MCG TABLET|90|EA|.19641|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|No|||No|.15545|03/29/2022|.15171|03/29/2022|.15272|03/29/2022||||3250|||||No|No||MYLAN|No||||
levothyroxine sodium|No|No|No|No|75%|00378180710|LEVOTHYROXINE 88 MCG TABLET|1000|EA|.19979|10/18/2007||Yes|No||10/18/2007||Yes|No|10/18/2007||Yes|No||||No|No|||Prescription required|No|||No|.16198|03/29/2022|.15809|03/29/2022|.15914|03/29/2022||||3251|||||No|No||MYLAN|No||||
levothyroxine sodium|No|No|No|No|75%|00378180777|LEVOTHYROXINE 88 MCG TABLET|90|EA|.19975|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|No|||No|.16198|03/29/2022|.15809|03/29/2022|.15914|03/29/2022||||3252|||||No|No||MYLAN|No||||
levothyroxine sodium|No|No|No|No|75%|00378180910|LEVOTHYROXINE 100 MCG TABLET|1000|EA|.20133|07/11/2005||Yes|No||07/11/2005||Yes|No|07/11/2005||Yes|No||||No|No|||Prescription required|No|||No|.17286|03/29/2022|.16871|03/29/2022|.16983|03/29/2022||||3253|||||No|No||MYLAN|No||||
levothyroxine sodium|No|No|No|No|75%|00378180977|LEVOTHYROXINE 100 MCG TABLET|90|EA|.20133|06/07/2018||Yes|No||06/07/2018||Yes|No|06/07/2018||Yes|No||||No|No|||Prescription required|No|||No|.17286|03/29/2022|.16871|03/29/2022|.16983|03/29/2022||||3254|||||No|No||MYLAN|No||||
levothyroxine sodium|No|No|No|No|75%|00378181110|LEVOTHYROXINE 112 MCG TABLET|1000|EA|.23281|01/14/2008||Yes|No||01/14/2008||Yes|No|01/14/2008||Yes|No||||No|No|||Prescription required|No|||No|.1546|03/29/2022|.15088|03/29/2022|.15189|03/29/2022||||3255|||||No|No||MYLAN|No||||
levothyroxine sodium|No|No|No|No|75%|00378181177|LEVOTHYROXINE 112 MCG TABLET|90|EA|.23281|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|No|||No|.1546|03/29/2022|.15088|03/29/2022|.15189|03/29/2022||||3256|||||No|No||MYLAN|No||||
levothyroxine sodium|No|No|No|No|75%|00378181310|LEVOTHYROXINE 125 MCG TABLET|1000|EA|.23603|07/11/2005||Yes|No||07/11/2005||Yes|No|07/11/2005||Yes|No||||No|No|||Prescription required|No|||No|.18894|03/29/2022|.1844|03/29/2022|.18563|03/29/2022||||3257|||||No|No||MYLAN|No||||
levothyroxine sodium|No|No|No|No|75%|00378181377|LEVOTHYROXINE 125 MCG TABLET|90|EA|.23601|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||||No|No|||Prescription required|No|||No|.18894|03/29/2022|.1844|03/29/2022|.18563|03/29/2022||||3258|||||No|No||MYLAN|No||||
levothyroxine sodium|No|No|No|No|75%|00378181510|LEVOTHYROXINE 150 MCG TABLET|1000|EA|.24291|07/11/2005||Yes|No||07/11/2005||Yes|No|07/11/2005||Yes|No||||No|No|||Prescription required|No|||No|.21406|03/29/2022|.20892|03/29/2022|.21031|03/29/2022||||3259|||||No|No||MYLAN|No||||
levothyroxine sodium|No|No|No|No|75%|00378181577|LEVOTHYROXINE 150 MCG TABLET|90|EA|.24295|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|No|||No|.21406|03/29/2022|.20892|03/29/2022|.21031|03/29/2022||||3260|||||No|No||MYLAN|No||||
levothyroxine sodium|No|No|No|No|75%|00378181710|LEVOTHYROXINE 175 MCG TABLET|1000|EA|.28874|08/23/2007||Yes|No||08/23/2007||Yes|No|08/23/2007||Yes|No||||No|No|||Prescription required|No|||No|.2247|03/29/2022|.2193|03/29/2022|.22076|03/29/2022||||3261|||||No|No||MYLAN|No||||
levothyroxine sodium|No|No|No|No|75%|00378181777|LEVOTHYROXINE 175 MCG TABLET|90|EA|.28876|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||||No|No|||Prescription required|No|||No|.2247|03/29/2022|.2193|03/29/2022|.22076|03/29/2022||||3262|||||No|No||MYLAN|No||||
levothyroxine sodium|No|No|No|No|75%|00378181910|LEVOTHYROXINE 200 MCG TABLET|1000|EA|.28932|07/11/2005||Yes|No||07/11/2005||Yes|No|07/11/2005||Yes|No||||No|No|||Prescription required|No|||No|.2307|03/29/2022|.22516|03/29/2022|.22666|03/29/2022||||3263|||||No|No||MYLAN|No||||
levothyroxine sodium|No|No|No|No|75%|00378181977|LEVOTHYROXINE 200 MCG TABLET|90|EA|.28929|12/12/2018||Yes|No||12/12/2018||Yes|No|12/12/2018||Yes|No||||No|No|||Prescription required|No|||No|.2307|03/29/2022|.22516|03/29/2022|.22666|03/29/2022||||3264|||||No|No||MYLAN|No||||
levothyroxine sodium|No|No|No|No|75%|00378182177|LEVOTHYROXINE 300 MCG TABLET|90|EA|.37347|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||||No|No|||Prescription required|No|||No|.17616|03/29/2022|.17193|03/29/2022|.17307|03/29/2022||||3265|||||No|No||MYLAN|No||||
levothyroxine sodium|No|No|No|No|75%|00378182310|LEVOTHYROXINE 137 MCG TABLET|1000|EA|.23932|02/26/2008||Yes|No||02/26/2008||Yes|No|02/26/2008||Yes|No||||No|No|||Prescription required|No|||No|.22748|03/29/2022|.22202|03/29/2022|.22349|03/29/2022||||3266|||||No|No||MYLAN|No||||
levothyroxine sodium|No|No|No|No|75%|00378182377|LEVOTHYROXINE 137 MCG TABLET|90|EA|.23931|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|No|||No|.22748|03/29/2022|.22202|03/29/2022|.22349|03/29/2022||||3267|||||No|No||MYLAN|No||||
midodrine HCl|No|No|No|No|75%|00378190101|MIDODRINE HCL 2.5 MG TABLET|100|EA|.34873|07/26/2004||Yes|No||07/26/2004||Yes|No|07/26/2004||Yes|No||07/26/2004||Yes|No|||Prescription required|No|||No|.20233|03/29/2022|.19747|03/29/2022|.19878|03/29/2022||||3268|||||No|No||MYLAN|No||||
midodrine HCl|No|No|No|No|75%|00378190201|MIDODRINE HCL 5 MG TABLET|100|EA|.70176|07/26/2004||Yes|No||07/26/2004||Yes|No|07/26/2004||Yes|No||07/26/2004||Yes|No|||Prescription required|No|||No|.26381|03/29/2022|.25747|03/29/2022|.25919|03/29/2022||||3269|||||No|No||MYLAN|No||||
midodrine HCl|No|No|No|No|75%|00378190301|MIDODRINE HCL 10 MG TABLET|100|EA|1.40373|03/09/2004||Yes|No||03/09/2004||Yes|No|03/09/2004||Yes|No||03/09/2004||Yes|No|||Prescription required|No|||No|.40773|03/29/2022|.39794|03/29/2022|.40059|03/29/2022||||3270|||||No|No||MYLAN|No||||
thiothixene|No|No|No|No|75%|00378200201|THIOTHIXENE 2 MG CAPSULE|100|EA|.5402|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|1.23117|08/06/2019|1.21358|08/06/2019|1.15579|08/06/2019|||ANTIPSYCHOTICS|3271|||||No|No||MYLAN|No||||
tacrolimus|No|No|No|No|75%|00378204501|TACROLIMUS 0.5 MG CAPSULE (IR)|100|EA|.20141|04/01/2011||Yes|No||04/01/2011||Yes|No|04/01/2011||Yes|No||01/01/2011||Yes|No|||Prescription required|No||229|No|.26138|03/29/2022|.2551|03/29/2022|.2568|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|3272|||||No|No||MYLAN|No||||
tacrolimus|No|No|No|No|75%|00378204601|TACROLIMUS 1 MG CAPSULE (IR)|100|EA|.40282|04/04/2011||Yes|No||04/04/2011||Yes|No|04/04/2011||Yes|No||01/01/2011||Yes|No|||Prescription required|No||229|No|.35645|03/29/2022|.34789|03/29/2022|.35021|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|3273|||||No|No||MYLAN|No||||
tacrolimus|No|No|No|No|75%|00378204701|TACROLIMUS 5 MG CAPSULE (IR)|100|EA|2.0142|04/04/2011||Yes|No||04/04/2011||Yes|No|04/04/2011||Yes|No||01/01/2011||Yes|No|||Prescription required|No||229|No|2.05753|03/29/2022|2.00814|03/29/2022|2.02152|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|3274|||||No|No||MYLAN|No||||
nisoldipine|No|No|No|No|75%|00378209601|NISOLDIPINE ER 8.5 MG TABLET|100|EA|1.9807|03/10/2011||Yes|No||03/10/2011||Yes|No|03/10/2011||Yes|No||03/10/2011||Yes|No|||Prescription required|Yes|07/29/2021|045|No|3.32904|04/27/2021|3.24914|04/27/2021|3.27078|04/27/2021|||CALCIUM CHANNEL BLOCKERS|3275|||||No|No||MYLAN|No||||
nisoldipine|No|No|No|No|75%|00378209701|NISOLDIPINE ER 17 MG TABLET|100|EA|2.48247|03/10/2011||Yes|No||03/10/2011||Yes|No|03/10/2011||Yes|No||03/10/2011||Yes|No|||Prescription required|Yes|07/29/2021|045|No|5.65773|10/26/2021|5.57691|10/26/2021|5.31134|10/26/2021|||CALCIUM CHANNEL BLOCKERS|3276|||||No|No||MYLAN|No||||
nisoldipine|No|No|No|No|75%|00378209801|NISOLDIPINE ER 25.5 MG TABLET|100|EA|2.70732|03/10/2011||Yes|No||03/10/2011||Yes|No|03/10/2011||Yes|No||03/10/2011||Yes|No|||Prescription required|Yes|07/29/2021|045|No|6.17017|06/01/2016|6.08203|06/01/2016|5.79241|06/01/2016|||CALCIUM CHANNEL BLOCKERS|3277|||||No|No||MYLAN|No||||
nisoldipine|No|No|No|No|75%|00378209901|NISOLDIPINE ER 34 MG TABLET|100|EA|2.70732|03/10/2011||Yes|No||03/10/2011||Yes|No|03/10/2011||Yes|No||03/10/2011||Yes|No|||Prescription required|Yes|07/29/2021|045|No|5.37038|08/24/2021|5.24149|08/24/2021|5.27639|08/24/2021|||CALCIUM CHANNEL BLOCKERS|3278|||||No|No||MYLAN|No||||
loperamide HCl|No|No|No|No|75%|00378210001|LOPERAMIDE 2 MG CAPSULE|100|EA|.15798|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.28168|03/29/2022|.27491|03/29/2022|.27675|03/29/2022||||3279|||||No|No||MYLAN|No||||
loperamide HCl|No|No|No|No|75%|00378210005|LOPERAMIDE 2 MG CAPSULE|500|EA|.15797|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.28168|03/29/2022|.27491|03/29/2022|.27675|03/29/2022||||3280|||||No|No||MYLAN|No||||
spironolactone|No|No|No|No|75%|00378214601|SPIRONOLACTONE 25 MG TABLET|100|EA|.06884|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||3281|||||No|No||MYLAN|No||||
spironolactone|No|No|No|No|75%|00378214605|SPIRONOLACTONE 25 MG TABLET|500|EA|.06884|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||3282|||||No|No||MYLAN|No||||
meclofenamate sodium|No|No|No|No|75%|00378215001|MECLOFENAMATE 50 MG CAPSULE|100|EA|1.43387|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|3.2679|06/01/2016|3.22122|06/01/2016|3.06783|06/01/2016|||NSAIDS|3283|||||No|No||MYLAN|No||||
efavirenz|No|No|No|No|75%|00378223393|EFAVIRENZ 600 MG TABLET|30|EA|17.88639|03/23/2018|01/31/2023|Yes|No||03/23/2018|01/31/2023|Yes|No|03/23/2018|01/31/2023|Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|5.43893|08/24/2021|5.30839|08/24/2021|5.34374|08/24/2021|||HIV / AIDS|3284|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN|No||||
imatinib mesylate|No|No|No|No|75%|00378224577|IMATINIB MESYLATE 100 MG TAB|90|EA|1.46601|03/19/2018||Yes|No||03/19/2018||Yes|No|03/19/2018||Yes|No||||No|No|||Prescription required|No||173|No|3.34114|07/27/2021|3.29341|07/27/2021|3.13658|07/27/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|3285|||||No|No||MYLAN|No||||
imatinib mesylate|No|No|No|No|75%|00378224693|IMATINIB MESYLATE 400 MG TAB|30|EA|5.28255|03/19/2018||Yes|No||03/19/2018||Yes|No|03/19/2018||Yes|No||||No|No|||Prescription required|No||173|No|2.86988|03/01/2022|2.801|03/01/2022|2.81965|03/01/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|3286|||||No|No||MYLAN|No||||
mycophenolate mofetil|No|No|No|No|75%|00378225001|MYCOPHENOLATE 250 MG CAPSULE|100|EA|.18894|08/01/2009||Yes|No||08/01/2009||Yes|No|08/01/2009||Yes|No||08/01/2009||Yes|No|||Prescription required|No||229|No|.2129|03/29/2022|.20779|03/29/2022|.20917|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|3287|||||No|No||MYLAN|No||||
mycophenolate mofetil|No|No|No|No|75%|00378225005|MYCOPHENOLATE 250 MG CAPSULE|500|EA|.18922|08/01/2009||Yes|No||08/01/2009||Yes|No|08/01/2009||Yes|No||08/01/2009||Yes|No|||Prescription required|No||229|No|.2129|03/29/2022|.20779|03/29/2022|.20917|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|3288|||||No|No||MYLAN|No||||
prazosin HCl|No|No|No|No|75%|00378230201|PRAZOSIN 2 MG CAPSULE|100|EA|.34116|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.29873|03/29/2022|.29156|03/29/2022|.2935|03/29/2022||||3289|||||No|No||MYLAN|No||||
prazosin HCl|No|No|No|No|75%|00378230210|PRAZOSIN 2 MG CAPSULE|1000|EA|.34114|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.29873|03/29/2022|.29156|03/29/2022|.2935|03/29/2022||||3290|||||No|No||MYLAN|No||||
esomeprazole magnesium|No|No|No|No|75%|00378235093|ESOMEPRAZOLE MAG DR 20 MG CAP|30|EA|.36277|09/21/2015||Yes|No||09/21/2015||Yes|No|09/21/2015||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|3291|||||No|No||MYLAN|No||||
esomeprazole magnesium|No|No|No|No|75%|00378235193|ESOMEPRAZOLE MAG DR 40 MG CAP|30|EA|.36277|09/21/2015||Yes|No||09/21/2015||Yes|No|09/21/2015||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|3292|||||No|No||MYLAN|No||||
trifluoperazine HCl|No|No|No|No|75%|00378240101|TRIFLUOPERAZINE 1 MG TABLET|100|EA|.2632|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.59985|06/25/2019|.59128|06/25/2019|.56313|06/25/2019|||ANTIPSYCHOTICS|3293|||||No|No||MYLAN|No||||
trifluoperazine HCl|No|No|No|No|75%|00378240201|TRIFLUOPERAZINE 2 MG TABLET|100|EA|.38786|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.88396|09/24/2019|.87133|09/24/2019|.82984|09/24/2019|||ANTIPSYCHOTICS|3294|||||No|No||MYLAN|No||||
trifluoperazine HCl|No|No|No|No|75%|00378240501|TRIFLUOPERAZINE 5 MG TABLET|100|EA|.48852|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.87564|11/23/2021|.85462|11/23/2021|.86031|11/23/2021|||ANTIPSYCHOTICS|3295|||||No|No||MYLAN|No||||
trifluoperazine HCl|No|No|No|No|75%|00378241001|TRIFLUOPERAZINE 10 MG TABLET|100|EA|.73637|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|1.67825|08/27/2019|1.65427|08/27/2019|1.5755|08/27/2019|||ANTIPSYCHOTICS|3296|||||No|No||MYLAN|No||||
diclofenac potassium|No|No|No|No|75%|00378247401|DICLOFENAC POT 50 MG TABLET|100|EA|.44969|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||059|Yes|.33951|03/29/2022|.33136|03/29/2022|.33356|03/29/2022|||NSAIDS|3297|||||No|No||MYLAN/ARCHIS PH|No||||
capecitabine|No|No|No|No|75%|00378251191|CAPECITABINE 150 MG TABLET|60|EA|1.32583|05/29/2015||Yes|No||05/29/2015||Yes|No|05/29/2015||Yes|No||||No|No|||Prescription required|No||502|No|3.02166|05/21/2019|2.97849|05/21/2019|2.83666|05/21/2019|||ONCOLOGY: ORAL - BREAST|3298|||||No|No||MYLAN|No||||
capecitabine|No|No|No|No|75%|00378251278|CAPECITABINE 500 MG TABLET|120|EA|3.51166|05/29/2015||Yes|No||05/29/2015||Yes|No|05/29/2015||Yes|No||||No|No|||Prescription required|No||502|No|.61977|12/28/2021|.60489|12/28/2021|.60892|12/28/2021|||ONCOLOGY: ORAL - BREAST|3299|||||No|No||MYLAN|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|00378253701|TRIAMTERENE-HCTZ 37.5-25 MG CP|100|EA|.09782|03/01/2002|05/31/2022|Yes|No||03/01/2002|05/31/2022|Yes|No|03/01/2002|05/31/2022|Yes|No||||No|No|||Prescription required|No|||Yes|.14661|03/29/2022|.14309|03/29/2022|.14404|03/29/2022||||3300|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|00378253710|TRIAMTERENE-HCTZ 37.5-25 MG CP|1000|EA|.0949|03/01/2002|05/31/2022|Yes|No||03/01/2002|05/31/2022|Yes|No|03/01/2002|05/31/2022|Yes|No||||No|No|||Prescription required|No|||Yes|.14661|03/29/2022|.14309|03/29/2022|.14404|03/29/2022||||3301|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN|No||||
phenytoin sodium extended|No|No|No|No|75%|00378267001|PHENYTEK 200 MG CAPSULE|100|EA|.62676|08/24/2009||Yes|No||08/24/2009||Yes|No|08/24/2009||Yes|No||08/24/2009||Yes|No|||Prescription required|No||056|No|1.42844|12/25/2018|1.40804|12/25/2018|1.34099|12/25/2018|||ANTICONVULSANTS|3302|||||No|No||MYLAN|No||||
telmisartan|Yes|No|No|No|75%|00378292093|TELMISARTAN 20 MG TABLET|30|EA|.46096|10/09/2014||Yes|No||10/09/2014||Yes|No|10/09/2014||Yes|No||10/09/2014||Yes|No|07/01/2016||Prescription required|Yes|07/17/2014|113|Yes|.30407|03/29/2022|.29677|03/29/2022|.29874|03/29/2022|||ANGIOTENSIN MODULATORS|3303|||||No|No||MYLAN|No||||
meclofenamate sodium|No|No|No|No|75%|00378300001|MECLOFENAMATE 100 MG CAPSULE|100|EA|2.66178|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|6.06639|06/01/2016|5.97973|06/01/2016|5.69498|06/01/2016|||NSAIDS|3304|||||No|No||MYLAN|No||||
candesartan/hydrochlorothiazid|No|No|No|No|75%|00378300177|CANDESARTAN-HCTZ 16-12.5 MG TB|90|EA|1.62372|11/04/2013||Yes|No||11/04/2013||Yes|No|11/04/2013||Yes|No||11/04/2013||Yes|No|||Prescription required|Yes|07/29/2021|113|Yes|1.48228|03/29/2022|1.4467|03/29/2022|1.45634|03/29/2022|||ANGIOTENSIN MODULATORS|3305|||||No|No||MYLAN|No||||
candesartan/hydrochlorothiazid|No|No|No|No|75%|00378300205|CANDESARTAN-HCTZ 32-12.5 MG TB|500|EA|1.65603|11/04/2013|04/30/2022|Yes|No||11/04/2013|04/30/2022|Yes|No|11/04/2013|04/30/2022|Yes|No||11/04/2013|04/30/2022|Yes|No|||Prescription required|Yes|07/29/2021|113|Yes|1.84933|03/29/2022|1.80494|03/29/2022|1.81696|03/29/2022|||ANGIOTENSIN MODULATORS|3306|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||MYLAN|No||||
candesartan/hydrochlorothiazid|No|No|No|No|75%|00378300277|CANDESARTAN-HCTZ 32-12.5 MG TB|90|EA|1.65602|11/04/2013||Yes|No||11/04/2013||Yes|No|11/04/2013||Yes|No||11/04/2013||Yes|No|||Prescription required|Yes|07/29/2021|113|Yes|1.84933|03/29/2022|1.80494|03/29/2022|1.81696|03/29/2022|||ANGIOTENSIN MODULATORS|3307|||||No|No||MYLAN|No||||
candesartan/hydrochlorothiazid|No|No|No|No|75%|00378300377|CANDESARTAN-HCTZ 32-25 MG TAB|90|EA|1.79257|11/04/2013||Yes|No||11/04/2013||Yes|No|11/04/2013||Yes|No||11/04/2013||Yes|No|||Prescription required|Yes|07/29/2021|113|Yes|1.84688|03/29/2022|1.80255|03/29/2022|1.81455|03/29/2022|||ANGIOTENSIN MODULATORS|3308|||||No|No||MYLAN|No||||
thiothixene|No|No|No|No|75%|00378300501|THIOTHIXENE 5 MG CAPSULE|100|EA|.81923|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|1.86709|08/06/2019|1.84042|08/06/2019|1.75278|08/06/2019|||ANTIPSYCHOTICS|3309|||||No|No||MYLAN|No||||
captopril|Yes|No|No|No|75%|00378300701|CAPTOPRIL 12.5 MG TABLET|100|EA|.4355|03/01/2002|06/30/2023|Yes|No||03/01/2002|06/30/2023|Yes|No|03/01/2002|06/30/2023|Yes|No||03/01/2002|06/30/2023|Yes|No|07/01/2016|06/30/2023|Prescription required|Yes|07/26/2018|113|No|.58889|03/29/2022|.57475|03/29/2022|.57858|03/29/2022|||ANGIOTENSIN MODULATORS|3310|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||MYLAN|No||||
captopril|Yes|No|No|No|75%|00378300710|CAPTOPRIL 12.5 MG TABLET|1000|EA|.43553|03/01/2002|06/30/2023|Yes|No||03/01/2002|06/30/2023|Yes|No|03/01/2002|06/30/2023|Yes|No||03/01/2002|06/30/2023|Yes|No|07/01/2016|06/30/2023|Prescription required|Yes|07/26/2018|113|No|.58889|03/29/2022|.57475|03/29/2022|.57858|03/29/2022|||ANGIOTENSIN MODULATORS|3311|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||MYLAN|No||||
captopril|Yes|No|No|No|75%|00378301201|CAPTOPRIL 25 MG TABLET|100|EA|.46663|03/01/2002|10/31/2022|Yes|No||03/01/2002|10/31/2022|Yes|No|03/01/2002|10/31/2022|Yes|No||03/01/2002|10/31/2022|Yes|No|07/01/2016|10/31/2022|Prescription required|Yes|07/26/2018|113|No|.40459|03/29/2022|.39487|03/29/2022|.3975|03/29/2022|||ANGIOTENSIN MODULATORS|3312|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||MYLAN|No||||
captopril|Yes|No|No|No|75%|00378301210|CAPTOPRIL 25 MG TABLET|1000|EA|.4666|03/01/2002|10/31/2022|Yes|No||03/01/2002|10/31/2022|Yes|No|03/01/2002|10/31/2022|Yes|No||03/01/2002|10/31/2022|Yes|No|07/01/2016|10/31/2022|Prescription required|Yes|07/26/2018|113|No|.40459|03/29/2022|.39487|03/29/2022|.3975|03/29/2022|||ANGIOTENSIN MODULATORS|3313|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||MYLAN|No||||
captopril|Yes|No|No|No|75%|00378301701|CAPTOPRIL 50 MG TABLET|100|EA|.8102|03/01/2002|10/31/2022|Yes|No||03/01/2002|10/31/2022|Yes|No|03/01/2002|10/31/2022|Yes|No||03/01/2002|10/31/2022|Yes|No|07/01/2016|10/31/2022|Prescription required|Yes|07/26/2018|113|No|1.25965|03/29/2022|1.22941|03/29/2022|1.2376|03/29/2022|||ANGIOTENSIN MODULATORS|3314|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||MYLAN|No||||
captopril|Yes|No|No|No|75%|00378301710|CAPTOPRIL 50 MG TABLET|1000|EA|.81018|03/01/2002|10/31/2022|Yes|No||03/01/2002|10/31/2022|Yes|No|03/01/2002|10/31/2022|Yes|No||03/01/2002|10/31/2022|Yes|No|07/01/2016|10/31/2022|Prescription required|Yes|07/26/2018|113|No|1.25965|03/29/2022|1.22941|03/29/2022|1.2376|03/29/2022|||ANGIOTENSIN MODULATORS|3315|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||MYLAN|No||||
captopril|Yes|No|No|No|75%|00378302201|CAPTOPRIL 100 MG TABLET|100|EA|1.06386|03/01/2002|10/31/2022|Yes|No||03/01/2002|10/31/2022|Yes|No|03/01/2002|10/31/2022|Yes|No||03/01/2002|10/31/2022|Yes|No|07/01/2016|10/31/2022|Prescription required|Yes|07/26/2018|113|No|1.37792|03/29/2022|1.34484|03/29/2022|1.3538|03/29/2022|||ANGIOTENSIN MODULATORS|3316|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||MYLAN|No||||
clomipramine HCl|No|No|No|No|75%|00378302501|CLOMIPRAMINE 25 MG CAPSULE|100|EA|3.86716|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|1.31238|03/29/2022|1.28088|03/29/2022|1.28941|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|3317|||||No|No||MYLAN|No||||
clomipramine HCl|No|No|No|No|75%|00378305001|CLOMIPRAMINE 50 MG CAPSULE|100|EA|3.86716|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.80238|03/29/2022|.78312|03/29/2022|.78833|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|3318|||||No|No||MYLAN|No||||
fenofibrate nanocrystallized|No|No|No|No|75%|00378306577|FENOFIBRATE 48 MG TABLET|90|EA|.15331|02/09/2014||Yes|No||02/09/2014||Yes|No|02/09/2014||Yes|No||||No|No|||Prescription required|No||055|No|.11999|03/29/2022|.11711|03/29/2022|.11789|03/29/2022|||LIPOTROPICS: OTHER|3319|||||No|No||MYLAN|No||||
fenofibrate nanocrystallized|No|No|No|No|75%|00378306605|FENOFIBRATE 145 MG TABLET|500|EA|.28007|02/09/2014||Yes|No||02/09/2014||Yes|No|02/09/2014||Yes|No||||No|No|||Prescription required|No||055|No|.16424|03/29/2022|.16029|03/29/2022|.16136|03/29/2022|||LIPOTROPICS: OTHER|3320|||||No|No||MYLAN|No||||
fenofibrate nanocrystallized|No|No|No|No|75%|00378306677|FENOFIBRATE 145 MG TABLET|90|EA|.28007|02/09/2014||Yes|No||02/09/2014||Yes|No|02/09/2014||Yes|No||||No|No|||Prescription required|No||055|No|.16424|03/29/2022|.16029|03/29/2022|.16136|03/29/2022|||LIPOTROPICS: OTHER|3321|||||No|No||MYLAN|No||||
clomipramine HCl|No|No|No|No|75%|00378307501|CLOMIPRAMINE 75 MG CAPSULE|100|EA|3.86716|09/07/2010||Yes|No||09/07/2010||Yes|No|09/07/2010||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.95054|03/29/2022|.92772|03/29/2022|.9339|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|3322|||||No|No||MYLAN|No||||
everolimus|No|No|No|No|75%|00378309685|EVEROLIMUS 2.5 MG TABLET|28|EA|98.5841|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||548|No|224.68004|02/03/2021|221.47032|02/03/2021|210.92412|02/03/2021|||ONCOLOGY: ORAL - RENAL CELL|3323|||||No|No||MYLAN|No||||
everolimus|No|No|No|No|75%|00378309785|EVEROLIMUS 5 MG TABLET|28|EA|103.11737|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||548|No|235.01169|02/03/2021|231.65438|02/03/2021|220.62322|02/03/2021|||ONCOLOGY: ORAL - RENAL CELL|3324|||||No|No||MYLAN|No||||
everolimus|No|No|No|No|75%|00378309885|EVEROLIMUS 7.5 MG TABLET|28|EA|103.11737|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||548|No|235.01169|02/03/2021|231.65438|02/03/2021|220.62322|02/03/2021|||ONCOLOGY: ORAL - RENAL CELL|3325|||||No|No||MYLAN|No||||
doxepin HCl|No|No|No|No|75%|00378312501|DOXEPIN 25 MG CAPSULE|100|EA|.265|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.30005|03/29/2022|.29284|03/29/2022|.29479|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|3326|||||No|No||MYLAN|No||||
doxepin HCl|No|No|No|No|75%|00378312510|DOXEPIN 25 MG CAPSULE|1000|EA|.26509|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.30005|03/29/2022|.29284|03/29/2022|.29479|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|3327|||||No|No||MYLAN|No||||
frovatriptan succinate|No|No|No|No|75%|00378314085|FROVATRIPTAN SUCC 2.5 MG TAB|9|EA|23.04704|07/03/2017||Yes|No||07/03/2017||Yes|No|07/03/2017||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|021|No|12.36667|03/29/2022|12.06986|03/29/2022|12.15025|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|3328|||||No|No||MYLAN|No||||
prazosin HCl|No|No|No|No|75%|00378320501|PRAZOSIN 5 MG CAPSULE|100|EA|.56317|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.53856|03/29/2022|.52563|03/29/2022|.52913|03/29/2022||||3329|||||No|No||MYLAN|No||||
prazosin HCl|No|No|No|No|75%|00378320525|PRAZOSIN 5 MG CAPSULE|250|EA|.56314|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.53856|03/29/2022|.52563|03/29/2022|.52913|03/29/2022||||3330|||||No|No||MYLAN|No||||
candesartan cilexetil|Yes|No|No|No|75%|00378322477|CANDESARTAN CILEXETIL 4 MG TAB|90|EA|.54466|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||05/21/2020||Yes|No|06/19/2020||Prescription required|Yes|07/29/2021|113|Yes|.89|03/29/2022|.86864|03/29/2022|.87442|03/29/2022|||ANGIOTENSIN MODULATORS|3331|||||No|No||MYLAN|No||||
candesartan cilexetil|Yes|No|No|No|75%|00378322493|CANDESARTAN CILEXETIL 4 MG TAB|30|EA|.54466|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||05/21/2020||Yes|No|06/19/2020||Prescription required|Yes|07/29/2021|113|Yes|.89|03/29/2022|.86864|03/29/2022|.87442|03/29/2022|||ANGIOTENSIN MODULATORS|3332|||||No|No||MYLAN|No||||
candesartan cilexetil|Yes|No|No|No|75%|00378322577|CANDESARTAN CILEXETIL 8 MG TAB|90|EA|.57333|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||05/21/2020||Yes|No|06/19/2020||Prescription required|Yes|07/29/2021|113|Yes|.78972|03/29/2022|.77076|03/29/2022|.77589|03/29/2022|||ANGIOTENSIN MODULATORS|3333|||||No|No||MYLAN|No||||
candesartan cilexetil|Yes|No|No|No|75%|00378322593|CANDESARTAN CILEXETIL 8 MG TAB|30|EA|.57333|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||05/21/2020||Yes|No|06/19/2020||Prescription required|Yes|07/29/2021|113|Yes|.78972|03/29/2022|.77076|03/29/2022|.77589|03/29/2022|||ANGIOTENSIN MODULATORS|3334|||||No|No||MYLAN|No||||
candesartan cilexetil|Yes|No|No|No|75%|00378323177|CANDESARTAN CILEXETIL 16 MG TB|90|EA|.44433|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||05/21/2020||Yes|No|06/19/2020||Prescription required|Yes|07/29/2021|113|Yes|.72757|03/29/2022|.7101|03/29/2022|.71483|03/29/2022|||ANGIOTENSIN MODULATORS|3335|||||No|No||MYLAN|No||||
candesartan cilexetil|Yes|No|No|No|75%|00378323193|CANDESARTAN CILEXETIL 16 MG TB|30|EA|.44433|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||05/21/2020||Yes|No|06/19/2020||Prescription required|Yes|07/29/2021|113|Yes|.72757|03/29/2022|.7101|03/29/2022|.71483|03/29/2022|||ANGIOTENSIN MODULATORS|3336|||||No|No||MYLAN|No||||
candesartan cilexetil|Yes|No|No|No|75%|00378323277|CANDESARTAN CILEXETIL 32 MG TB|90|EA|.731|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||05/21/2020||Yes|No|06/19/2020||Prescription required|Yes|07/29/2021|113|Yes|1.10475|03/29/2022|1.07823|03/29/2022|1.08541|03/29/2022|||ANGIOTENSIN MODULATORS|3337|||||No|No||MYLAN|No||||
candesartan cilexetil|Yes|No|No|No|75%|00378323293|CANDESARTAN CILEXETIL 32 MG TB|30|EA|.731|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||05/21/2020||Yes|No|06/19/2020||Prescription required|Yes|07/29/2021|113|Yes|1.10475|03/29/2022|1.07823|03/29/2022|1.08541|03/29/2022|||ANGIOTENSIN MODULATORS|3338|||||No|No||MYLAN|No||||
etoposide|No|No|No|No|75%|00378326694|ETOPOSIDE 50 MG CAPSULE|20|EA|32.39147|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|73.82242|06/01/2016|72.76781|06/01/2016|69.30268|06/01/2016||||3339|||||No|No||MYLAN|No||||
norelgestromin/ethin.estradiol|Yes|Yes|No|No|75%|00378334053|XULANE 150-35 MCG/DAY PATCH|3|EA|17.50816|09/10/2014||Yes|No||09/10/2014||Yes|No|09/10/2014||Yes|No|Refer to program requirements|||No|No|09/10/2014||Prescription required|No|||No|39.90232|05/01/2018|39.33229|05/01/2018|37.45932|05/01/2018||||3340|||||No|No||MYLAN|No|||Only covered for non-contraceptive (medical) purposes|
estradiol|No|No|No|No|75%|00378334999|ESTRADIOL 0.025 MG PATCH(1/WK)|4|EA|7.98295|04/11/2005||Yes|No||04/11/2005||Yes|No|04/11/2005||Yes|No||||No|No|||Prescription required|No|||Yes|13.22429|03/29/2022|12.9069|03/29/2022|12.99286|03/29/2022||||3341|||||No|No||MYLAN|No||||
estradiol|No|No|No|No|75%|00378335099|ESTRADIOL 0.05 MG PATCH (1/WK)|4|EA|7.98295|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|12.19224|03/29/2022|11.89962|03/29/2022|11.97887|03/29/2022||||3342|||||No|No||MYLAN|No||||
estradiol|No|No|No|No|75%|00378335199|ESTRADIOL 0.075 MG PATCH(1/WK)|4|EA|7.98295|04/11/2005||Yes|No||04/11/2005||Yes|No|04/11/2005||Yes|No||||No|No|||Prescription required|No|||Yes|12.236|03/29/2022|11.94233|03/29/2022|12.02187|03/29/2022||||3343|||||No|No||MYLAN|No||||
estradiol|No|No|No|No|75%|00378335299|ESTRADIOL 0.1 MG PATCH (1/WK)|4|EA|7.98295|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|12.90538|03/29/2022|12.59565|03/29/2022|12.67953|03/29/2022||||3344|||||No|No||MYLAN|No||||
estradiol|No|No|No|No|75%|00378336099|ESTRADIOL 0.0375MG PATCH(1/WK)|4|EA|7.98295|09/28/2006||Yes|No||09/28/2006||Yes|No|09/28/2006||Yes|No||||No|No|||Prescription required|No|||Yes|15.03859|03/29/2022|14.67766|03/29/2022|14.77541|03/29/2022||||3345|||||No|No||MYLAN|No||||
estradiol|No|No|No|No|75%|00378336199|ESTRADIOL 0.06 MG PATCH (1/WK)|4|EA|7.98295|09/28/2006||Yes|No||09/28/2006||Yes|No|09/28/2006||Yes|No||||No|No|||Prescription required|No|||Yes|15.72469|03/01/2022|15.34729|03/01/2022|15.4495|03/01/2022||||3346|||||No|No||MYLAN|No||||
armodafinil|No|No|No|No|90%|00378343193|ARMODAFINIL 50 MG TABLET|30|EA|2.49873|06/21/2017||Yes|No||06/21/2017||Yes|No|06/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.28825|03/29/2022|.28133|03/29/2022|.2832|03/29/2022|||STIMULANTS AND RELATED AGENTS|3347|||||No|No||MYLAN|No||||
armodafinil|No|No|No|No|90%|00378343293|ARMODAFINIL 150 MG TABLET|30|EA|7.52113|06/21/2017||Yes|No||06/21/2017||Yes|No|06/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.83403|03/29/2022|.81401|03/29/2022|.81943|03/29/2022|||STIMULANTS AND RELATED AGENTS|3348|||||No|No||MYLAN|No||||
armodafinil|No|No|No|No|90%|00378343393|ARMODAFINIL 250 MG TABLET|30|EA|7.52113|06/21/2017||Yes|No||06/21/2017||Yes|No|06/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.10963|03/29/2022|1.08299|03/29/2022|1.09021|03/29/2022|||STIMULANTS AND RELATED AGENTS|3349|||||No|No||MYLAN|No||||
azelastine/fluticasone|No|No|No|No|75%|00378345823|AZELASTIN-FLUTIC 137-50MCG SPR|23|GM|3.19396|09/22/2020||Yes|No||09/22/2020||Yes|No|09/22/2020||Yes|No||||No|No|||Prescription required|Yes|04/26/2020|019|No|4.21868|03/29/2022|4.11743|03/29/2022|4.14485|03/29/2022|||INTRANASAL RHINITIS AGENTS|3350|||||No|No||MYLAN|No||||
mirtazapine|No|No|No|No|75%|00378351501|MIRTAZAPINE 15 MG TABLET|100|EA|.08681|12/12/2018||Yes|No||12/12/2018||Yes|No|12/12/2018||Yes|No||||No|No|||Prescription required|No||031|Yes|.08357|03/29/2022|.08156|03/29/2022|.0821|03/29/2022|||ANTIDEPRESSANTS: OTHER|3351|||||No|No||MYLAN|No||||
mirtazapine|No|No|No|No|75%|00378351593|MIRTAZAPINE 15 MG TABLET|30|EA|.12756|07/14/2003||Yes|No||07/14/2003||Yes|No|07/14/2003||Yes|No||||No|No|||Prescription required|No||031|Yes|.08357|03/29/2022|.08156|03/29/2022|.0821|03/29/2022|||ANTIDEPRESSANTS: OTHER|3352|||||No|No||MYLAN|No||||
fosamprenavir calcium|No|No|No|No|75%|00378352091|FOSAMPRENAVIR 700 MG TABLET|60|EA|9.99889|02/28/2018||Yes|No||02/28/2018||Yes|No|02/28/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|16.33153|02/28/2018|16.09822|02/28/2018|15.33164|02/28/2018|||HIV / AIDS|3353|||||No|No||MYLAN|No||||
mirtazapine|No|No|No|No|75%|00378353001|MIRTAZAPINE 30 MG TABLET|100|EA|.12117|12/12/2018||Yes|No||12/12/2018||Yes|No|12/12/2018||Yes|No||||No|No|||Prescription required|No||031|No|.09806|03/29/2022|.0957|03/29/2022|.09634|03/29/2022|||ANTIDEPRESSANTS: OTHER|3354|||||No|No||MYLAN|No||||
mirtazapine|No|No|No|No|75%|00378353093|MIRTAZAPINE 30 MG TABLET|30|EA|.16125|07/14/2003||Yes|No||07/14/2003||Yes|No|07/14/2003||Yes|No||||No|No|||Prescription required|No||031|No|.09806|03/29/2022|.0957|03/29/2022|.09634|03/29/2022|||ANTIDEPRESSANTS: OTHER|3355|||||No|No||MYLAN|No||||
mirtazapine|No|No|No|No|75%|00378354501|MIRTAZAPINE 45 MG TABLET|100|EA|.1532|12/12/2018||Yes|No||12/12/2018||Yes|No|12/12/2018||Yes|No||||No|No|||Prescription required|No||031|No|.13324|03/29/2022|.13004|03/29/2022|.1309|03/29/2022|||ANTIDEPRESSANTS: OTHER|3356|||||No|No||MYLAN|No||||
mirtazapine|No|No|No|No|75%|00378354593|MIRTAZAPINE 45 MG TABLET|30|EA|.18275|07/14/2003||Yes|No||07/14/2003||Yes|No|07/14/2003||Yes|No||||No|No|||Prescription required|No||031|No|.13324|03/29/2022|.13004|03/29/2022|.1309|03/29/2022|||ANTIDEPRESSANTS: OTHER|3357|||||No|No||MYLAN|No||||
mercaptopurine|No|No|No|No|75%|00378354725|MERCAPTOPURINE 50 MG TABLET|250|EA|1.22679|07/13/2005||Yes|No||07/13/2005||Yes|No|07/13/2005||Yes|No||||No|No|||Prescription required|No||173|No|.93312|03/29/2022|.91072|03/29/2022|.91679|03/29/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|3358|||||No|No||MYLAN|No||||
mercaptopurine|No|No|No|No|75%|00378354752|MERCAPTOPURINE 50 MG TABLET|25|EA|1.3631|07/13/2005||Yes|No||07/13/2005||Yes|No|07/13/2005||Yes|No||||No|No|||Prescription required|No||173|No|.93312|03/29/2022|.91072|03/29/2022|.91679|03/29/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|3359|||||No|No||MYLAN|No||||
carvedilol|No|No|No|No|75%|00378363101|CARVEDILOL 3.125 MG TABLET|100|EA|.03414|09/07/2007||Yes|No||09/07/2007||Yes|No|09/07/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.01877|03/29/2022|.01831|03/29/2022|.01844|03/29/2022|||BETA-BLOCKERS|3360|||||No|No||MYLAN|No||||
carvedilol|No|No|No|No|75%|00378363105|CARVEDILOL 3.125 MG TABLET|500|EA|.03414|09/07/2007||Yes|No||09/07/2007||Yes|No|09/07/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.01877|03/29/2022|.01831|03/29/2022|.01844|03/29/2022|||BETA-BLOCKERS|3361|||||No|No||MYLAN|No||||
carvedilol|No|No|No|No|75%|00378363201|CARVEDILOL 6.25 MG TABLET|100|EA|.03414|09/07/2007||Yes|No||09/07/2007||Yes|No|09/07/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.02069|03/29/2022|.02019|03/29/2022|.02032|03/29/2022|||BETA-BLOCKERS|3362|||||No|No||MYLAN|No||||
carvedilol|No|No|No|No|75%|00378363205|CARVEDILOL 6.25 MG TABLET|500|EA|.03414|09/07/2007||Yes|No||09/07/2007||Yes|No|09/07/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.02069|03/29/2022|.02019|03/29/2022|.02032|03/29/2022|||BETA-BLOCKERS|3363|||||No|No||MYLAN|No||||
carvedilol|No|No|No|No|75%|00378363301|CARVEDILOL 12.5 MG TABLET|100|EA|.03414|09/07/2007||Yes|No||09/07/2007||Yes|No|09/07/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.02277|03/29/2022|.02222|03/29/2022|.02237|03/29/2022|||BETA-BLOCKERS|3364|||||No|No||MYLAN|No||||
carvedilol|No|No|No|No|75%|00378363305|CARVEDILOL 12.5 MG TABLET|500|EA|.03414|09/07/2007||Yes|No||09/07/2007||Yes|No|09/07/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.02277|03/29/2022|.02222|03/29/2022|.02237|03/29/2022|||BETA-BLOCKERS|3365|||||No|No||MYLAN|No||||
carvedilol|No|No|No|No|75%|00378363401|CARVEDILOL 25 MG TABLET|100|EA|.03414|09/07/2007||Yes|No||09/07/2007||Yes|No|09/07/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.03449|03/29/2022|.03366|03/29/2022|.03388|03/29/2022|||BETA-BLOCKERS|3366|||||No|No||MYLAN|No||||
carvedilol|No|No|No|No|75%|00378363405|CARVEDILOL 25 MG TABLET|500|EA|.03414|09/07/2007||Yes|No||09/07/2007||Yes|No|09/07/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.03449|03/29/2022|.03366|03/29/2022|.03388|03/29/2022|||BETA-BLOCKERS|3367|||||No|No||MYLAN|No||||
cetirizine HCl|No|No|No|No|75%|00378363501|CETIRIZINE HCL 5 MG TABLET|100|EA|.05719|02/14/2008||Yes|No||||No|No|02/14/2008||Yes|No||||No|No|||Over the counter|No||030|Yes|.04838|03/29/2022|.04721|03/29/2022|.04753|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|3368|||||No|No||MYLAN|No||||
cetirizine HCl|No|No|No|No|75%|00378363701|CETIRIZINE HCL 10 MG TABLET|100|EA|.05719|02/13/2008||Yes|No||||No|No|02/13/2008||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|3369|||||No|No||MYLAN|No||||
cetirizine HCl|No|No|No|No|75%|00378363705|CETIRIZINE HCL 10 MG TABLET|500|EA|.0543|02/13/2008||Yes|No||||No|No|02/13/2008||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|3370|||||No|No||MYLAN|No||||
phenytoin sodium extended|No|No|No|No|75%|00378375001|PHENYTEK 300 MG CAPSULE|100|EA|.93916|08/26/2009||Yes|No||08/26/2009||Yes|No|08/26/2009||Yes|No||08/26/2009||Yes|No|||Prescription required|No||056|No|2.14041|12/25/2018|2.10984|12/25/2018|2.00937|12/25/2018|||ANTICONVULSANTS|3371|||||No|No||MYLAN|No||||
phenytoin sodium extended|No|No|No|No|75%|00378375093|PHENYTEK 300 MG CAPSULE|30|EA|.93912|08/24/2009||Yes|No||08/24/2009||Yes|No|08/24/2009||Yes|No||08/24/2009||Yes|No|||Prescription required|No||056|No|2.14032|12/25/2018|2.10974|12/25/2018|2.00928|12/25/2018|||ANTICONVULSANTS|3372|||||No|No||MYLAN|No||||
febuxostat|No|No|No|No|75%|00378392593|FEBUXOSTAT 40 MG TABLET|30|EA|1.08804|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|231|No|.89466|03/29/2022|.87318|03/29/2022|.879|03/29/2022|||ANTIHYPERURICEMICS|3373|||||No|No||MYLAN|No||||
febuxostat|No|No|No|No|75%|00378392693|FEBUXOSTAT 80 MG TABLET|30|EA|1.08804|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|231|No|.93355|03/29/2022|.91114|03/29/2022|.91721|03/29/2022|||ANTIHYPERURICEMICS|3374|||||No|No||MYLAN|No||||
atorvastatin calcium|No|No|No|No|75%|00378395005|ATORVASTATIN 10 MG TABLET|500|EA|.09106|07/05/2017||Yes|No||07/05/2017||Yes|No|07/05/2017||Yes|No||07/05/2017||Yes|No|||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|3375|||||No|No||MYLAN|No||||
atorvastatin calcium|Yes|No|No|No|75%|00378395077|ATORVASTATIN 10 MG TABLET|90|EA|.09106|04/22/2020||Yes|No||04/22/2020||Yes|No|04/22/2020||Yes|No||04/22/2020||Yes|No|06/19/2020||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|3376|||||No|No||MYLAN|No||||
atorvastatin calcium|Yes|No|No|No|75%|00378395105|ATORVASTATIN 20 MG TABLET|500|EA|.12961|02/21/2019||Yes|No||02/21/2019||Yes|No|02/21/2019||Yes|No||02/21/2019||Yes|No|07/22/2019||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|3377|||||No|No||MYLAN|No||||
atorvastatin calcium|Yes|No|No|No|75%|00378395177|ATORVASTATIN 20 MG TABLET|90|EA|.12961|04/22/2020||Yes|No||04/22/2020||Yes|No|04/22/2020||Yes|No||04/22/2020||Yes|No|06/19/2020||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|3378|||||No|No||MYLAN|No||||
atorvastatin calcium|No|No|No|No|75%|00378395205|ATORVASTATIN 40 MG TABLET|500|EA|.12961|07/05/2017||Yes|No||07/05/2017||Yes|No|07/05/2017||Yes|No||07/05/2017||Yes|No|||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|3379|||||No|No||MYLAN|No||||
atorvastatin calcium|Yes|No|No|No|75%|00378395277|ATORVASTATIN 40 MG TABLET|90|EA|.12961|04/22/2020||Yes|No||04/22/2020||Yes|No|04/22/2020||Yes|No||04/22/2020||Yes|No|06/19/2020||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|3380|||||No|No||MYLAN|No||||
atorvastatin calcium|Yes|No|No|No|75%|00378395305|ATORVASTATIN 80 MG TABLET|500|EA|.12961|02/21/2019||Yes|No||02/21/2019||Yes|No|02/21/2019||Yes|No||02/21/2019||Yes|No|07/22/2019||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|3381|||||No|No||MYLAN|No||||
atorvastatin calcium|Yes|No|No|No|75%|00378395377|ATORVASTATIN 80 MG TABLET|90|EA|.12961|04/22/2020||Yes|No||04/22/2020||Yes|No|04/22/2020||Yes|No||04/22/2020||Yes|No|06/19/2020||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|3382|||||No|No||MYLAN|No||||
paliperidone|No|No|No|No|75%|00378397893|PALIPERIDONE ER 1.5 MG TABLET|30|EA|10.51335|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|027|Yes|4.83706|03/29/2022|4.72097|03/29/2022|4.75241|03/29/2022|||ANTIPSYCHOTICS|3383|||||No|No||MYLAN/ARCHIS PH|No||||
paliperidone|No|No|No|No|75%|00378397993|PALIPERIDONE ER 3 MG TABLET|30|EA|10.51335|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|027|Yes|6.18339|03/29/2022|6.03498|03/29/2022|6.07518|03/29/2022|||ANTIPSYCHOTICS|3384|||||No|No||MYLAN/ARCHIS PH|No||||
paliperidone|No|No|No|No|75%|00378398093|PALIPERIDONE ER 6 MG TABLET|30|EA|10.51335|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|027|Yes|5.21133|03/29/2022|5.08625|03/29/2022|5.12013|03/29/2022|||ANTIPSYCHOTICS|3385|||||No|No||MYLAN/ARCHIS PH|No||||
paliperidone|No|No|No|No|75%|00378398193|PALIPERIDONE ER 9 MG TABLET|30|EA|15.76996|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|027|Yes|7.23268|03/29/2022|7.05909|03/29/2022|7.1061|03/29/2022|||ANTIPSYCHOTICS|3386|||||No|No||MYLAN/ARCHIS PH|No||||
nevirapine|No|No|No|No|75%|00378405091|NEVIRAPINE 200 MG TABLET|60|EA|.10219|07/02/2012||Yes|No||07/20/2012||Yes|No|07/02/2012||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.16692|10/27/2020|.16453|10/27/2020|.1567|10/27/2020|||HIV / AIDS|3387|||||No|No||MYLAN|No||||
abacavir sulfate|No|No|No|No|75%|00378410591|ABACAVIR 300 MG TABLET|60|EA|4.8213|07/19/2012||Yes|No||07/19/2012||Yes|No|07/19/2012||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.69669|03/29/2022|.67996|03/29/2022|.68449|03/29/2022|||HIV / AIDS|3388|||||No|No||MYLAN|No||||
riluzole|No|No|No|No|75%|00378414591|RILUZOLE 50 MG TABLET|60|EA|1.21073|10/09/2014||Yes|No||10/09/2014||Yes|No|10/09/2014||Yes|No||||No|No|||Prescription required|No|||No|.46908|03/01/2022|.45782|03/01/2022|.46087|03/01/2022||||3389|||||No|No||MYLAN|No||||
tramadol HCl|No|No|No|No|90%|00378415101|TRAMADOL HCL 50 MG TABLET|100|EA|.02021|07/19/2002||Yes|No||07/19/2002||Yes|No|07/19/2002||Yes|No||||No|No|||Prescription required|No||109|Yes|.02459|03/29/2022|.02399|03/29/2022|.02415|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3390|||||No|No||MYLAN|No||||
tramadol HCl|No|No|No|No|90%|00378415105|TRAMADOL HCL 50 MG TABLET|500|EA|.01978|07/19/2002||Yes|No||07/19/2002||Yes|No|07/19/2002||Yes|No||||No|No|||Prescription required|No||109|Yes|.02459|03/29/2022|.02399|03/29/2022|.02415|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3391|||||No|No||MYLAN|No||||
tramadol HCl|No|No|No|No|90%|00378415293|TRAMADOL HCL ER 100 MG TABLET|30|EA|.81728|06/22/2017|08/31/2022|Yes|No||06/22/2017|08/31/2022|Yes|No|06/22/2017|08/31/2022|Yes|No||||No|No|||Prescription required|No||110|Yes|.97069|03/29/2022|.94739|03/29/2022|.9537|03/29/2022|||ANALGESICS: NARCOTICS LONG|3392|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN|No||||
tramadol HCl|No|No|No|No|90%|00378415393|TRAMADOL HCL ER 200 MG TABLET|30|EA|1.3426|06/22/2017|04/30/2022|Yes|No||06/22/2017|04/30/2022|Yes|No|06/22/2017|04/30/2022|Yes|No||||No|No|||Prescription required|No||110|Yes|1.59713|03/29/2022|1.55879|03/29/2022|1.56918|03/29/2022|||ANALGESICS: NARCOTICS LONG|3393|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN|No||||
atovaquone/proguanil HCl|No|No|No|No|75%|00378416201|ATOVAQUONE-PROGUANIL 250-100|100|EA|2.45972|10/09/2014||Yes|No||10/09/2014||Yes|No|10/09/2014||Yes|No||||No|No|||Prescription required|No|||No|2.47536|03/29/2022|2.41595|03/29/2022|2.43204|03/29/2022||||3394|||||No|No||MYLAN|No||||
mycophenolate sodium|No|No|No|No|75%|00378420178|MYCOPHENOLIC ACID DR 180 MG TB|120|EA|1.57165|08/05/2014||Yes|No||08/05/2014||Yes|No|08/05/2014||Yes|No||08/05/2014||Yes|No|||Prescription required|Yes|01/15/2014|229|No|.54568|03/29/2022|.53258|03/29/2022|.53613|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|3395|||||No|No||MYLAN/ARCHIS PH|No||||
mycophenolate sodium|No|No|No|No|75%|00378420278|MYCOPHENOLIC ACID DR 360 MG TB|120|EA|3.1433|08/05/2014||Yes|No||08/05/2014||Yes|No|08/05/2014||Yes|No||08/05/2014||Yes|No|||Prescription required|Yes|01/15/2014|229|No|.56705|03/29/2022|.55344|03/29/2022|.55712|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|3396|||||No|No||MYLAN/ARCHIS PH|No||||
doxepin HCl|No|No|No|No|75%|00378425001|DOXEPIN 50 MG CAPSULE|100|EA|.37969|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.41139|03/29/2022|.40151|03/29/2022|.40419|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|3397|||||No|No||MYLAN|No||||
doxepin HCl|No|No|No|No|75%|00378425010|DOXEPIN 50 MG CAPSULE|1000|EA|.37969|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.41139|03/29/2022|.40151|03/29/2022|.40419|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|3398|||||No|No||MYLAN|No||||
ambrisentan|No|No|No|No|75%|00378427093|AMBRISENTAN 5 MG TABLET|30|EA|16.51257|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|No|37.6333|09/11/2019|37.09568|09/11/2019|35.32922|09/11/2019|||PAH AGENTS: ORAL AND INHALED|3399|||||No|No||MYLAN|No||||
ambrisentan|No|No|No|No|75%|00378427193|AMBRISENTAN 10 MG TABLET|30|EA|16.51257|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|No|37.6333|09/11/2019|37.09568|09/11/2019|35.32922|09/11/2019|||PAH AGENTS: ORAL AND INHALED|3400|||||No|No||MYLAN|No||||
valacyclovir HCl|No|No|No|No|75%|00378427577|VALACYCLOVIR HCL 500 MG TABLET|90|EA|.16721|06/07/2010||Yes|No||06/07/2010||Yes|No|06/07/2010||Yes|No||07/01/2012||Yes|No|||Prescription required|No||025|No|.29328|03/29/2022|.28624|03/29/2022|.28814|03/29/2022|||ANTIVIRALS: ORAL|3401|||||No|No||MYLAN|No||||
valacyclovir HCl|No|No|No|No|75%|00378427593|VALACYCLOVIR HCL 500 MG TABLET|30|EA|.172|06/07/2010||Yes|No||06/07/2010||Yes|No|06/07/2010||Yes|No||07/01/2012||Yes|No|||Prescription required|No||025|No|.29328|03/29/2022|.28624|03/29/2022|.28814|03/29/2022|||ANTIVIRALS: ORAL|3402|||||No|No||MYLAN|No||||
valacyclovir HCl|Yes|No|No|No|75%|00378427677|VALACYCLOVIR HCL 1 GRAM TABLET|90|EA|.26277|06/07/2010||Yes|No||06/07/2010||Yes|No|06/07/2010||Yes|No||07/01/2012||Yes|No|11/01/2012||Prescription required|No||025|No|.5737|03/29/2022|.55993|03/29/2022|.56366|03/29/2022|||ANTIVIRALS: ORAL|3403|||||No|No||MYLAN|No||||
valacyclovir HCl|Yes|No|No|No|75%|00378427693|VALACYCLOVIR HCL 1 GRAM TABLET|30|EA|.27233|06/07/2010||Yes|No||06/07/2010||Yes|No|06/07/2010||Yes|No||07/01/2012||Yes|No|11/01/2012||Prescription required|No||025|No|.5737|03/29/2022|.55993|03/29/2022|.56366|03/29/2022|||ANTIVIRALS: ORAL|3404|||||No|No||MYLAN|No||||
eletriptan hydrobromide|No|No|No|No|75%|00378428785|ELETRIPTAN HBR 20 MG TABLET|6|EA|5.1385|06/08/2018||Yes|No||06/08/2018||Yes|No|06/08/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|021|No|6.78979|03/29/2022|6.62683|03/29/2022|6.67096|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|3405|||||No|No||MYLAN|No||||
eletriptan hydrobromide|No|No|No|No|75%|00378428808|ELETRIPTAN HBR 40 MG TABLET|12|EA|5.1385|06/08/2018||Yes|No||06/08/2018||Yes|No|06/08/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|021|No|3.20664|03/29/2022|3.12968|03/29/2022|3.15052|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|3406|||||No|No||MYLAN|No||||
eletriptan hydrobromide|No|No|No|No|75%|00378428885|ELETRIPTAN HBR 40 MG TABLET|6|EA|5.1385|06/08/2018||Yes|No||06/08/2018||Yes|No|06/08/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|021|No|3.20664|03/29/2022|3.12968|03/29/2022|3.15052|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|3407|||||No|No||MYLAN|No||||
fenofibrate|No|No|No|No|75%|00378439077|FENOFIBRATE 40 MG TABLET|90|EA|3.59412|07/03/2017||Yes|No||07/03/2017||Yes|No|07/03/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|8.19127|07/03/2017|8.07425|07/03/2017|7.68976|07/03/2017|||LIPOTROPICS: OTHER|3408|||||No|No||MYLAN|No||||
fenofibrate|No|No|No|No|75%|00378439177|FENOFIBRATE 120 MG TABLET|90|EA|10.78243|07/03/2017||Yes|No||07/03/2017||Yes|No|07/03/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|10.5118|03/29/2022|10.25951|03/29/2022|10.32784|03/29/2022|||LIPOTROPICS: OTHER|3409|||||No|No||MYLAN|No||||
flurazepam HCl|No|No|No|No|90%|00378441501|FLURAZEPAM 15 MG CAPSULE|100|EA|.21452|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||054|Yes|.48892|12/24/2019|.48193|12/24/2019|.45898|12/24/2019|||SEDATIVE HYPNOTICS|3410|||||No|No||MYLAN|No||||
flurazepam HCl|No|No|No|No|90%|00378443001|FLURAZEPAM 30 MG CAPSULE|100|EA|.25855|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||054|Yes|.58927|07/27/2021|.58085|07/27/2021|.55319|07/27/2021|||SEDATIVE HYPNOTICS|3411|||||No|No||MYLAN|No||||
mycophenolate mofetil|No|No|No|No|75%|00378447201|MYCOPHENOLATE 500 MG TABLET|100|EA|.38983|08/01/2009||Yes|No||08/01/2009||Yes|No|08/01/2009||Yes|No||08/01/2009||Yes|No|||Prescription required|No||229|No|.30426|03/29/2022|.29695|03/29/2022|.29893|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|3412|||||No|No||MYLAN|No||||
mycophenolate mofetil|No|No|No|No|75%|00378447205|MYCOPHENOLATE 500 MG TABLET|500|EA|.38984|08/01/2009||Yes|No||08/01/2009||Yes|No|08/01/2009||Yes|No||08/01/2009||Yes|No|||Prescription required|No||229|No|.30426|03/29/2022|.29695|03/29/2022|.29893|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|3413|||||No|No||MYLAN|No||||
budesonide|No|No|No|No|75%|00378450093|BUDESONIDE ER 9 MG TABLET|30|EA|22.20262|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|010|No|33.23257|03/29/2022|32.43498|03/29/2022|32.651|03/29/2022|||ULCERATIVE COLITIS AGENTS|3414|||||No|No||MYLAN|No||||
amlodipine/atorvastatin|No|No|No|No|75%|00378451493|AMLODIPINE-ATORVAST 5-20 MG|30|EA|3.22371|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||04/11/2019||Yes|No|||Prescription required|Yes|07/24/2013|063|Yes|2.6682|03/29/2022|2.60416|03/29/2022|2.6215|03/29/2022|||LIPOTROPICS: STATINS|3415|||||No|No||MYLAN|No||||
amlodipine/atorvastatin|No|No|No|No|75%|00378451593|AMLODIPINE-ATORVAST 5-40 MG|30|EA|3.22371|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||04/11/2019||Yes|No|||Prescription required|Yes|07/17/2014|063|Yes|3.582|03/01/2022|3.49603|03/01/2022|3.51931|03/01/2022|||LIPOTROPICS: STATINS|3416|||||No|No||MYLAN|No||||
amlodipine/atorvastatin|No|No|No|No|75%|00378451793|AMLODIPINE-ATORVAST 10-10 MG|30|EA|2.35625|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||04/11/2019||Yes|No|||Prescription required|Yes|07/17/2014|063|Yes|2.18539|03/29/2022|2.13294|03/29/2022|2.14714|03/29/2022|||LIPOTROPICS: STATINS|3417|||||No|No||MYLAN|No||||
amlodipine/atorvastatin|No|No|No|No|75%|00378451893|AMLODIPINE-ATORVAST 10-20 MG|30|EA|3.22371|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||04/11/2019||Yes|No|||Prescription required|Yes|07/24/2013|063|Yes|1.70393|03/29/2022|1.66303|03/29/2022|1.67411|03/29/2022|||LIPOTROPICS: STATINS|3418|||||No|No||MYLAN|No||||
amlodipine/atorvastatin|No|No|No|No|75%|00378451993|AMLODIPINE-ATORVAST 10-40 MG|30|EA|3.22371|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||04/11/2019||Yes|No|||Prescription required|Yes|07/24/2013|063|Yes|2.04729|03/29/2022|1.99815|03/29/2022|2.01146|03/29/2022|||LIPOTROPICS: STATINS|3419|||||No|No||MYLAN|No||||
potassium chloride|No|No|No|No|75%|00378456005|POTASSIUM CL ER 8 MEQ TABLET|500|EA|.1845|08/01/2017||Yes|No||08/01/2017||Yes|No|08/01/2017||Yes|No||08/01/2017||Yes|No|||Prescription required|No|||No|.17696|03/29/2022|.17271|03/29/2022|.17386|03/29/2022||||3420|||||No|No||MYLAN|No||||
potassium chloride|No|No|No|No|75%|00378456077|POTASSIUM CL ER 8 MEQ TABLET|90|EA|.18451|07/25/2017||Yes|No||07/25/2017||Yes|No|07/25/2017||Yes|No||07/25/2017||Yes|No|||Prescription required|No|||No|.17696|03/29/2022|.17271|03/29/2022|.17386|03/29/2022||||3421|||||No|No||MYLAN|No||||
potassium chloride|No|No|No|No|75%|00378456105|POTASSIUM CL ER 10 MEQ TABLET|500|EA|.19422|10/01/2017||Yes|No||10/01/2017||Yes|No|10/01/2017||Yes|No||10/01/2017||Yes|No|||Prescription required|No|||No|.13824|03/29/2022|.13492|03/29/2022|.13582|03/29/2022||||3422|||||No|No||MYLAN|No||||
potassium chloride|No|No|No|No|75%|00378456177|POTASSIUM CL ER 10 MEQ TABLET|90|EA|.19421|10/01/2017||Yes|No||10/01/2017||Yes|No|10/01/2017||Yes|No||10/01/2017||Yes|No|||Prescription required|No|||No|.13824|03/29/2022|.13492|03/29/2022|.13582|03/29/2022||||3423|||||No|No||MYLAN|No||||
metoprolol succinate|No|No|No|No|75%|00378459510|METOPROLOL SUCC ER 25 MG TAB|1000|EA|.32225|07/01/2017||Yes|No||07/01/2017||Yes|No|07/01/2017||Yes|No||07/01/2017||Yes|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|3424|||||No|No||MYLAN|No||||
metoprolol succinate|No|No|No|No|75%|00378459577|METOPROLOL SUCC ER 25 MG TAB|90|EA|.32225|07/01/2017||Yes|No||07/01/2017||Yes|No|07/01/2017||Yes|No||07/01/2017||Yes|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|3425|||||No|No||MYLAN|No||||
metoprolol succinate|No|No|No|No|75%|00378459610|METOPROLOL SUCC ER 50 MG TAB|1000|EA|.32225|07/01/2017||Yes|No||07/01/2017||Yes|No|07/01/2017||Yes|No||07/01/2017||Yes|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|3426|||||No|No||MYLAN|No||||
metoprolol succinate|No|No|No|No|75%|00378459677|METOPROLOL SUCC ER 50 MG TAB|90|EA|.32225|07/01/2017||Yes|No||07/01/2017||Yes|No|07/01/2017||Yes|No||07/01/2017||Yes|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|3427|||||No|No||MYLAN|No||||
metoprolol succinate|No|No|No|No|75%|00378459710|METOPROLOL SUCC ER 100 MG TAB|1000|EA|.53807|07/01/2017||Yes|No||07/01/2017||Yes|No|07/01/2017||Yes|No||07/01/2017||Yes|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|3428|||||No|No||MYLAN|No||||
metoprolol succinate|No|No|No|No|75%|00378459777|METOPROLOL SUCC ER 100 MG TAB|90|EA|.53807|07/01/2017||Yes|No||07/01/2017||Yes|No|07/01/2017||Yes|No||07/01/2017||Yes|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|3429|||||No|No||MYLAN|No||||
metoprolol succinate|No|No|No|No|75%|00378459805|METOPROLOL SUCC ER 200 MG TAB|500|EA|.85607|07/01/2017||Yes|No||07/01/2017||Yes|No|07/01/2017||Yes|No||07/01/2017||Yes|No|||Prescription required|No||070|No|.25385|03/29/2022|.24775|03/29/2022|.2494|03/29/2022|||BETA-BLOCKERS|3430|||||No|No||MYLAN|No||||
metoprolol succinate|No|No|No|No|75%|00378459877|METOPROLOL SUCC ER 200 MG TAB|90|EA|.85607|07/01/2017||Yes|No||07/01/2017||Yes|No|07/01/2017||Yes|No||07/01/2017||Yes|No|||Prescription required|No||070|No|.25385|03/29/2022|.24775|03/29/2022|.2494|03/29/2022|||BETA-BLOCKERS|3431|||||No|No||MYLAN|No||||
estradiol|No|No|No|No|75%|00378461926|ESTRADIOL 0.025 MG PATCH(2/WK)|8|EA|7.65615|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No|||Yes|9.33155|03/29/2022|9.10759|03/29/2022|9.16824|03/29/2022||||3432|||||No|No||MYLAN|No||||
estradiol|No|No|No|No|75%|00378462026|ESTRADIOL 0.0375MG PATCH(2/WK)|8|EA|7.65615|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No|||Yes|10.33407|03/29/2022|10.08605|03/29/2022|10.15322|03/29/2022||||3433|||||No|No||MYLAN|No||||
estradiol|No|No|No|No|75%|00378462126|ESTRADIOL 0.05 MG PATCH (2/WK)|8|EA|7.65615|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No|||Yes|9.27983|03/29/2022|9.05711|03/29/2022|9.11743|03/29/2022||||3434|||||No|No||MYLAN|No||||
estradiol|No|No|No|No|75%|00378462226|ESTRADIOL 0.075 MG PATCH(2/WK)|8|EA|7.65615|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No|||Yes|8.4725|03/29/2022|8.26916|03/29/2022|8.32423|03/29/2022||||3435|||||No|No||MYLAN|No||||
estradiol|No|No|No|No|75%|00378462326|ESTRADIOL 0.1 MG PATCH (2/WK)|8|EA|7.65615|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No|||Yes|8.48083|03/29/2022|8.27729|03/29/2022|8.33241|03/29/2022||||3436|||||No|No||MYLAN|No||||
estradiol|No|No|No|No|75%|00378464026|ESTRADIOL 0.1 MG PATCH (2/WK)|8|EA|3.90547|06/26/2015||Yes|No||06/26/2015||Yes|No|06/26/2015||Yes|No||||No|No|||Prescription required|No|||Yes|8.48083|03/29/2022|8.27729|03/29/2022|8.33241|03/29/2022||||3437|||||No|No||MYLAN|No||||
estradiol|No|No|No|No|75%|00378464126|ESTRADIOL 0.075 MG PATCH(2/WK)|8|EA|3.90386|06/26/2015||Yes|No||06/26/2015||Yes|No|06/26/2015||Yes|No||||No|No|||Prescription required|No|||Yes|8.4725|03/29/2022|8.26916|03/29/2022|8.32423|03/29/2022||||3438|||||No|No||MYLAN|No||||
estradiol|No|No|No|No|75%|00378464226|ESTRADIOL 0.05 MG PATCH (2/WK)|8|EA|3.89956|06/26/2015||Yes|No||06/26/2015||Yes|No|06/26/2015||Yes|No||||No|No|||Prescription required|No|||Yes|9.27983|03/29/2022|9.05711|03/29/2022|9.11743|03/29/2022||||3439|||||No|No||MYLAN|No||||
estradiol|No|No|No|No|75%|00378464326|ESTRADIOL 0.0375MG PATCH(2/WK)|8|EA|3.89687|06/26/2015||Yes|No||06/26/2015||Yes|No|06/26/2015||Yes|No||||No|No|||Prescription required|No|||Yes|10.33407|03/29/2022|10.08605|03/29/2022|10.15322|03/29/2022||||3440|||||No|No||MYLAN|No||||
estradiol|No|No|No|No|75%|00378464426|ESTRADIOL 0.025 MG PATCH(2/WK)|8|EA|3.89687|06/26/2015||Yes|No||06/26/2015||Yes|No|06/26/2015||Yes|No||||No|No|||Prescription required|No|||Yes|9.33155|03/29/2022|9.10759|03/29/2022|9.16824|03/29/2022||||3441|||||No|No||MYLAN|No||||
doxepin HCl|No|No|No|No|75%|00378481093|DOXEPIN HCL 3 MG TABLET|30|EA|5.61594|05/19/2020|01/05/2022|Yes|No||05/19/2020|01/05/2022|Yes|No|05/19/2020|01/05/2022|Yes|No||||No|No|||Prescription required|Yes|07/25/2019|054|No|9.6007|03/29/2022|9.37028|03/29/2022|9.43268|03/29/2022|||SEDATIVE HYPNOTICS|3442|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||MYLAN|No||||
doxepin HCl|No|No|No|No|75%|00378481193|DOXEPIN HCL 6 MG TABLET|30|EA|5.61594|05/19/2020|01/05/2022|Yes|No||05/19/2020|01/05/2022|Yes|No|05/19/2020|01/05/2022|Yes|No||||No|No|||Prescription required|Yes|07/25/2019|054|No|8.13342|03/29/2022|7.93821|03/29/2022|7.99108|03/29/2022|||SEDATIVE HYPNOTICS|3443|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||MYLAN|No||||
nevirapine|No|No|No|No|75%|00378489093|NEVIRAPINE ER 400 MG TABLET|30|EA|4.92|06/26/2015||Yes|No||06/26/2015||Yes|No|06/26/2015||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|8.036|08/24/2021|7.9212|08/24/2021|7.544|08/24/2021|||HIV / AIDS|3444|||||No|No||MYLAN|No||||
exemestane|No|No|No|No|75%|00378500193|EXEMESTANE 25 MG TABLET|30|EA|1.64589|06/29/2018||Yes|No||06/29/2018||Yes|No|06/29/2018||Yes|No||||No|No|||Prescription required|No||502|No|1.32315|03/29/2022|1.29139|03/29/2022|1.29999|03/29/2022|||ONCOLOGY: ORAL - BREAST|3445|||||No|No||MYLAN|No||||
thiothixene|No|No|No|No|75%|00378501001|THIOTHIXENE 10 MG CAPSULE|100|EA|1.15493|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|2.63218|01/29/2019|2.59457|01/29/2019|2.47102|01/29/2019|||ANTIPSYCHOTICS|3446|||||No|No||MYLAN|No||||
carbidopa/levodopa|No|No|No|No|75%|00378505201|CARBIDOPA-LEVO 25-100 MG ODT|100|EA|.37749|03/11/2009|10/31/2022|Yes|No||03/11/2009|10/31/2022|Yes|No|03/11/2009|10/31/2022|Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|.65376|12/28/2021|.63806|12/28/2021|.64231|12/28/2021|||ANTIPARKINSON'S AGENTS|3447|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN|No||||
itraconazole|No|No|No|No|75%|00378510093|ITRACONAZOLE 100 MG CAPSULE|30|EA|5.40925|09/26/2012|06/30/2023|Yes|No||09/26/2012|06/30/2023|Yes|No|09/26/2012|06/30/2023|Yes|No||09/26/2012|06/30/2023|Yes|No|||Prescription required|Yes|01/25/2012|069|No|.85195|03/29/2022|.8315|03/29/2022|.83704|03/29/2022|||ANTIFUNGALS: ORAL|3448|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||MYLAN|No||||
prochlorperazine maleate|No|No|No|No|75%|00378510501|PROCHLORPERAZINE 5 MG TABLET|100|EA|.1376|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||085|No|.2903|03/29/2022|.28333|03/29/2022|.28521|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|3449|||||No|No||MYLAN|No||||
prochlorperazine maleate|No|No|No|No|75%|00378511001|PROCHLORPERAZINE 10 MG TAB|100|EA|.2064|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||085|No|.39111|03/29/2022|.38172|03/29/2022|.38426|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|3450|||||No|No||MYLAN|No||||
prasugrel HCl|No|No|No|No|75%|00378518593|PRASUGREL 5 MG TABLET|30|EA|.43|06/05/2018||Yes|No||06/05/2018||Yes|No|06/05/2018||Yes|No||||No|No|||Prescription required|No||004|No|.53487|03/29/2022|.52203|03/29/2022|.5255|03/29/2022|||PLATELET AGGREGATION INHIBITORS|3451|||||No|No||MYLAN|No||||
prasugrel HCl|No|No|No|No|75%|00378518693|PRASUGREL 10 MG TABLET|30|EA|.43|06/05/2018||Yes|No||06/05/2018||Yes|No|06/05/2018||Yes|No||||No|No|||Prescription required|No||004|No|.35104|03/29/2022|.34261|03/29/2022|.34489|03/29/2022|||PLATELET AGGREGATION INHIBITORS|3452|||||No|No||MYLAN|No||||
eszopiclone|No|No|No|No|90%|00378527001|ESZOPICLONE 1 MG TABLET|100|EA|.30229|09/10/2014||Yes|No||09/10/2014||Yes|No|09/10/2014||Yes|No||||No|No|||Prescription required|No||054|Yes|.19753|03/29/2022|.19278|03/29/2022|.19407|03/29/2022|||SEDATIVE HYPNOTICS|3453|||||No|No||MYLAN|No||||
eszopiclone|No|No|No|No|90%|00378527101|ESZOPICLONE 2 MG TABLET|100|EA|.30229|09/10/2014||Yes|No||09/10/2014||Yes|No|09/10/2014||Yes|No||||No|No|||Prescription required|No||054|Yes|.25375|03/29/2022|.24766|03/29/2022|.2493|03/29/2022|||SEDATIVE HYPNOTICS|3454|||||No|No||MYLAN|No||||
eszopiclone|No|No|No|No|90%|00378527201|ESZOPICLONE 3 MG TABLET|100|EA|.30229|09/10/2014||Yes|No||09/10/2014||Yes|No|09/10/2014||Yes|No||||No|No|||Prescription required|No||054|Yes|.14316|03/29/2022|.13972|03/29/2022|.14065|03/29/2022|||SEDATIVE HYPNOTICS|3455|||||No|No||MYLAN|No||||
perphenazine|No|No|No|No|75%|00378535001|PERPHENAZINE 2 MG TABLET|100|EA|.19517|06/05/2018|02/28/2022|Yes|No||06/05/2018|02/28/2022|Yes|No|06/05/2018|02/28/2022|Yes|No||||No|No|||Prescription required|No||027|Yes|.44482|03/15/2022|.43846|03/15/2022|.41758|03/15/2022|||ANTIPSYCHOTICS|3456|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN|No||||
perphenazine|No|No|No|No|75%|00378535101|PERPHENAZINE 4 MG TABLET|100|EA|.26715|06/05/2018|02/28/2022|Yes|No||06/05/2018|02/28/2022|Yes|No|06/05/2018|02/28/2022|Yes|No||||No|No|||Prescription required|No||027|Yes|.60887|03/15/2022|.60017|03/15/2022|.57159|03/15/2022|||ANTIPSYCHOTICS|3457|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN|No||||
doxepin HCl|No|No|No|No|75%|00378537501|DOXEPIN 75 MG CAPSULE|100|EA|.58376|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.56944|03/29/2022|.55577|03/29/2022|.55947|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|3458|||||No|No||MYLAN|No||||
doxepin HCl|No|No|No|No|75%|00378537510|DOXEPIN 75 MG CAPSULE|1000|EA|.58376|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.56944|03/29/2022|.55577|03/29/2022|.55947|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|3459|||||No|No||MYLAN|No||||
moxifloxacin HCl|No|No|No|No|75%|00378543035|MOXIFLOXACIN 0.5% EYE DROPS|3|ML|4.87333|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|058|No|3.97371|03/29/2022|3.87834|03/29/2022|3.90417|03/29/2022|||OPHTHALMIC ANTIBIOTICS|3460|||||No|No||MYLAN|No||||
ropinirole HCl|No|No|No|No|75%|00378550101|ROPINIROLE HCL 1 MG TABLET|100|EA|.2165|08/26/2008||Yes|No||08/26/2008||Yes|No|08/26/2008||Yes|No||||No|No|||Prescription required|No||015|No|.05246|03/29/2022|.0512|03/29/2022|.05154|03/29/2022|||ANTIPARKINSON'S AGENTS|3461|||||No|No||MYLAN|No||||
ropinirole HCl|No|No|No|No|75%|00378550201|ROPINIROLE HCL 2 MG TABLET|100|EA|.2165|08/26/2008||Yes|No||08/26/2008||Yes|No|08/26/2008||Yes|No||||No|No|||Prescription required|No||015|No|.06367|03/29/2022|.06214|03/29/2022|.06255|03/29/2022|||ANTIPARKINSON'S AGENTS|3462|||||No|No||MYLAN|No||||
ropinirole HCl|No|No|No|No|75%|00378550301|ROPINIROLE HCL 3 MG TABLET|100|EA|.22454|08/26/2008||Yes|No||08/26/2008||Yes|No|08/26/2008||Yes|No||||No|No|||Prescription required|No||015|No|.10196|03/29/2022|.09951|03/29/2022|.10017|03/29/2022|||ANTIPARKINSON'S AGENTS|3463|||||No|No||MYLAN|No||||
ropinirole HCl|No|No|No|No|75%|00378550401|ROPINIROLE HCL 4 MG TABLET|100|EA|.22454|08/26/2008||Yes|No||08/26/2008||Yes|No|08/26/2008||Yes|No||||No|No|||Prescription required|No||015|No|.08517|03/29/2022|.08312|03/29/2022|.08367|03/29/2022|||ANTIPARKINSON'S AGENTS|3464|||||No|No||MYLAN|No||||
ropinirole HCl|No|No|No|No|75%|00378550501|ROPINIROLE HCL 5 MG TABLET|100|EA|.22454|08/26/2008||Yes|No||08/26/2008||Yes|No|08/26/2008||Yes|No||||No|No|||Prescription required|No||015|No|.08598|03/29/2022|.08391|03/29/2022|.08447|03/29/2022|||ANTIPARKINSON'S AGENTS|3465|||||No|No||MYLAN|No||||
olanzapine|No|No|No|No|75%|00378551093|OLANZAPINE ODT 5 MG TABLET|30|EA|.36793|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.59218|03/29/2022|.57796|03/29/2022|.58181|03/29/2022|||ANTIPSYCHOTICS|3466|||||No|No||MYLAN|No||||
olanzapine|No|No|No|No|75%|00378551193|OLANZAPINE ODT 10 MG TABLET|30|EA|.54051|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.58062|03/29/2022|.56668|03/29/2022|.57045|03/29/2022|||ANTIPSYCHOTICS|3467|||||No|No||MYLAN|No||||
olanzapine|No|No|No|No|75%|00378551293|OLANZAPINE ODT 15 MG TABLET|30|EA|.79707|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.85386|03/29/2022|.83336|03/29/2022|.83891|03/29/2022|||ANTIPSYCHOTICS|3468|||||No|No||MYLAN|No||||
olanzapine|No|No|No|No|75%|00378551393|OLANZAPINE ODT 20 MG TABLET|30|EA|1.05378|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|1.09|03/29/2022|1.06384|03/29/2022|1.07092|03/29/2022|||ANTIPSYCHOTICS|3469|||||No|No||MYLAN|No||||
ropinirole HCl|No|No|No|No|75%|00378552501|ROPINIROLE HCL 0.25 MG TABLET|100|EA|.2165|08/26/2008||Yes|No||08/26/2008||Yes|No|08/26/2008||Yes|No||||No|No|||Prescription required|No||015|No|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIPARKINSON'S AGENTS|3470|||||No|No||MYLAN|No||||
ropinirole HCl|No|No|No|No|75%|00378555001|ROPINIROLE HCL 0.5 MG TABLET|100|EA|.2165|08/26/2008||Yes|No||08/26/2008||Yes|No|08/26/2008||Yes|No||||No|No|||Prescription required|No||015|No|.04899|03/29/2022|.04781|03/29/2022|.04813|03/29/2022|||ANTIPARKINSON'S AGENTS|3471|||||No|No||MYLAN|No||||
levetiracetam|No|No|No|No|75%|00378561305|LEVETIRACETAM 250 MG TABLET|500|EA|.1656|02/09/2009||Yes|No||02/09/2009||Yes|No|02/09/2009||Yes|No||||No|No|||Prescription required|No||056|No|.08073|03/29/2022|.07879|03/29/2022|.07931|03/29/2022|||ANTICONVULSANTS|3472|||||No|No||MYLAN|No||||
levetiracetam|No|No|No|No|75%|00378561505|LEVETIRACETAM 500 MG TABLET|500|EA|.20266|02/09/2009||Yes|No||02/09/2009||Yes|No|02/09/2009||Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|3473|||||No|No||MYLAN|No||||
levetiracetam|No|No|No|No|75%|00378561578|LEVETIRACETAM 500 MG TABLET|120|EA|.21334|02/09/2009||Yes|No||02/09/2009||Yes|No|02/09/2009||Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|3474|||||No|No||MYLAN|No||||
levetiracetam|No|No|No|No|75%|00378561705|LEVETIRACETAM 750 MG TABLET|500|EA|.27145|02/09/2009||Yes|No||02/09/2009||Yes|No|02/09/2009||Yes|No||||No|No|||Prescription required|No||056|No|.15853|03/29/2022|.15472|03/29/2022|.15575|03/29/2022|||ANTICONVULSANTS|3475|||||No|No||MYLAN|No||||
levetiracetam|No|No|No|No|75%|00378561778|LEVETIRACETAM 750 MG TABLET|120|EA|.28573|02/09/2009||Yes|No||02/09/2009||Yes|No|02/09/2009||Yes|No||||No|No|||Prescription required|No||056|No|.15853|03/29/2022|.15472|03/29/2022|.15575|03/29/2022|||ANTICONVULSANTS|3476|||||No|No||MYLAN|No||||
sumatriptan succinate|No|No|No|No|75%|00378563059|SUMATRIPTAN SUCC 25 MG TABLET|9|EA|.44671|09/02/2009||Yes|No||09/02/2009||Yes|No|09/02/2009||Yes|No||||No|No|||Prescription required|No||021|No|.55768|03/29/2022|.54429|03/29/2022|.54792|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|3477|||||No|No||MYLAN|No||||
sumatriptan succinate|No|No|No|No|75%|00378563159|SUMATRIPTAN SUCC 50 MG TABLET|9|EA|.44671|09/02/2009||Yes|No||09/02/2009||Yes|No|09/02/2009||Yes|No||||No|No|||Prescription required|No||021|No|.52829|03/29/2022|.51561|03/29/2022|.51904|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|3478|||||No|No||MYLAN|No||||
sumatriptan succinate|No|No|No|No|75%|00378563259|SUMATRIPTAN SUCC 100 MG TABLET|9|EA|.44671|09/02/2009||Yes|No||09/02/2009||Yes|No|09/02/2009||Yes|No||||No|No|||Prescription required|No||021|No|.54919|03/29/2022|.536|03/29/2022|.53957|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|3479|||||No|No||MYLAN|No||||
valsartan|Yes|No|No|No|75%|00378580793|VALSARTAN 40 MG TABLET|30|EA|.11466|03/11/2015||Yes|No||03/11/2015||Yes|No|03/11/2015||Yes|No||03/11/2015||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.1945|03/29/2022|.18983|03/29/2022|.19109|03/29/2022|||ANGIOTENSIN MODULATORS|3480|||||No|No||MYLAN|No||||
valsartan|Yes|No|No|No|75%|00378581377|VALSARTAN 80 MG TABLET|90|EA|.14333|03/11/2015||Yes|No||03/11/2015||Yes|No|03/11/2015||Yes|No||03/11/2015||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.21024|03/29/2022|.20519|03/29/2022|.20656|03/29/2022|||ANGIOTENSIN MODULATORS|3481|||||No|No||MYLAN|No||||
valsartan|Yes|No|No|No|75%|00378581477|VALSARTAN 160 MG TABLET|90|EA|.1911|03/11/2015||Yes|No||03/11/2015||Yes|No|03/11/2015||Yes|No||03/11/2015||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.23007|03/29/2022|.22454|03/29/2022|.22604|03/29/2022|||ANGIOTENSIN MODULATORS|3482|||||No|No||MYLAN|No||||
valsartan|Yes|No|No|No|75%|00378581577|VALSARTAN 320 MG TABLET|90|EA|.23888|03/11/2015||Yes|No||03/11/2015||Yes|No|03/11/2015||Yes|No||03/11/2015||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.31156|03/29/2022|.30408|03/29/2022|.3061|03/29/2022|||ANGIOTENSIN MODULATORS|3483|||||No|No||MYLAN|No||||
metformin HCl|No|No|No|No|75%|00378600191|METFORMIN ER 1,000 MG OSM-TAB|60|EA|6.967|07/03/2017||Yes|No||07/03/2017||Yes|No|07/03/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|012|No|1.48331|03/29/2022|1.44771|03/29/2022|1.45735|03/29/2022|||HYPOGLYCEMICS: METFORMINS|3484|||||No|No||MYLAN|No||||
metformin HCl|No|No|No|No|75%|00378600291|METFORMIN ER 500 MG OSMOTIC TB|60|EA|3.82606|07/03/2017||Yes|No||07/03/2017||Yes|No|07/03/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|012|No|.70527|01/25/2022|.68834|01/25/2022|.69292|01/25/2022|||HYPOGLYCEMICS: METFORMINS|3485|||||No|No||MYLAN|No||||
diltiazem HCl|No|No|No|No|75%|00378606001|DILTIAZEM 12HR ER 60 MG CAP|100|EA|1.09125|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||045|No|2.24166|03/29/2022|2.18786|03/29/2022|2.20243|03/29/2022|||CALCIUM CHANNEL BLOCKERS|3486|||||No|No||MYLAN|No||||
diltiazem HCl|No|No|No|No|75%|00378609001|DILTIAZEM 12HR ER 90 MG CAP|100|EA|1.24682|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||045|No|2.28512|11/23/2021|2.23027|11/23/2021|2.24513|11/23/2021|||CALCIUM CHANNEL BLOCKERS|3487|||||No|No||MYLAN|No||||
diltiazem HCl|No|No|No|No|75%|00378612001|DILTIAZEM 12HR ER 120 MG CAP|100|EA|1.6254|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||045|No|3.09075|03/29/2022|3.01657|03/29/2022|3.03666|03/29/2022|||CALCIUM CHANNEL BLOCKERS|3488|||||No|No||MYLAN|No||||
tretinoin|No|No|No|No|75%|00378614044|AVITA 0.025% GEL|20|GM|1.84362|09/15/2010||Yes|No||09/15/2010||Yes|No|||No|No||||No|No|||Prescription required|Yes|01/25/2012|104|No|4.20175|06/01/2016|4.14172|06/01/2016|3.9445|06/01/2016|||ACNE AGENTS: TOPICAL|3489|||||No|No||MYLAN|No||||
tretinoin|No|No|No|No|75%|00378614045|AVITA 0.025% GEL|45|GM|1.84364|09/15/2010||Yes|No||09/15/2010||Yes|No|||No|No||||No|No|||Prescription required|Yes|01/25/2012|104|No|4.20179|09/08/2020|4.14177|09/08/2020|3.94454|09/08/2020|||ACNE AGENTS: TOPICAL|3490|||||No|No||MYLAN|No||||
tretinoin|No|No|No|No|75%|00378614144|AVITA 0.025% CREAM|20|GM|1.84362|09/07/2006||Yes|No||09/07/2006||Yes|No|||No|No||||No|No|||Prescription required|Yes|01/25/2012|104|No|4.20175|06/01/2016|4.14172|06/01/2016|3.9445|06/01/2016|||ACNE AGENTS: TOPICAL|3491|||||No|No||MYLAN|No||||
tretinoin|No|No|No|No|75%|00378614145|AVITA 0.025% CREAM|45|GM|1.84364|02/14/2007||Yes|No||02/14/2007||Yes|No|||No|No||||No|No|||Prescription required|Yes|01/25/2012|104|No|4.20179|05/22/2018|4.14177|05/22/2018|3.94454|05/22/2018|||ACNE AGENTS: TOPICAL|3492|||||No|No||MYLAN|No||||
butenafine HCl|No|No|No|No|75%|00378615146|MENTAX 1% CREAM|15|GM|2.81134|02/27/2007||Yes|No||02/27/2007||Yes|No|02/27/2007||Yes|No||||No|No|||Prescription required|Yes|07/18/2006|061|No|6.40724|01/09/2018|6.3157|01/09/2018|6.01496|01/09/2018|||ANTIFUNGALS: TOPICAL|3493|||||No|No||MYLAN|No||||
butenafine HCl|No|No|No|No|75%|00378615149|MENTAX 1% CREAM|30|GM|2.81091|10/09/2006||Yes|No||10/09/2006||Yes|No|10/09/2006||Yes|No||||No|No|||Prescription required|Yes|07/06/2006|061|No|6.40626|01/09/2018|6.31474|01/09/2018|6.01404|01/09/2018|||ANTIFUNGALS: TOPICAL|3494|||||No|No||MYLAN|No||||
digoxin|No|No|No|No|75%|00378615501|DIGITEK 125 MCG TABLET|100|EA|.50955|07/29/2015||Yes|No||07/29/2015||Yes|No|07/29/2015||Yes|No||||No|No|||Prescription required|No|||No|.25031|03/29/2022|.2443|03/29/2022|.24592|03/29/2022||||3495|||||No|No||MYLAN|No||||
digoxin|No|No|No|No|75%|00378615510|DIGITEK 125 MCG TABLET|1000|EA|.42548|07/29/2015||Yes|No||07/29/2015||Yes|No|07/29/2015||Yes|No||||No|No|||Prescription required|No|||No|.25031|03/29/2022|.2443|03/29/2022|.24592|03/29/2022||||3496|||||No|No||MYLAN|No||||
digoxin|No|No|No|No|75%|00378615601|DIGITEK 250 MCG TABLET|100|EA|.50955|07/29/2015||Yes|No||07/29/2015||Yes|No|07/29/2015||Yes|No||||No|No|||Prescription required|No|||No|.22254|03/29/2022|.21719|03/29/2022|.21864|03/29/2022||||3497|||||No|No||MYLAN|No||||
metolazone|No|No|No|No|75%|00378617201|METOLAZONE 2.5 MG TABLET|100|EA|.77589|01/18/2005||Yes|No||01/18/2005||Yes|No|01/18/2005||Yes|No||01/18/2005||Yes|No|||Prescription required|No|||No|.75368|03/29/2022|.73559|03/29/2022|.74049|03/29/2022||||3498|||||No|No||MYLAN|No||||
metolazone|No|No|No|No|75%|00378617301|METOLAZONE 5 MG TABLET|100|EA|.88162|12/07/2004||Yes|No||12/07/2004||Yes|No|12/07/2004||Yes|No||12/07/2004||Yes|No|||Prescription required|No|||No|.77158|03/29/2022|.75306|03/29/2022|.75807|03/29/2022||||3499|||||No|No||MYLAN|No||||
metolazone|No|No|No|No|75%|00378617401|METOLAZONE 10 MG TABLET|100|EA|1.05586|12/07/2004||Yes|No||12/07/2004||Yes|No|12/07/2004||Yes|No||12/07/2004||Yes|No|||Prescription required|No|||No|1.18747|03/01/2022|1.15897|03/01/2022|1.16668|03/01/2022||||3500|||||No|No||MYLAN|No||||
citalopram hydrobromide|Yes|No|No|No|75%|00378623101|CITALOPRAM HBR 10 MG TABLET|100|EA|.03126|09/28/2011||Yes|No||09/28/2011||Yes|No|09/28/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02682|03/29/2022|.02617|03/29/2022|.02635|03/29/2022|||ANTIDEPRESSANTS: SSRIs|3501|||||No|No||MYLAN|No||||
citalopram hydrobromide|Yes|No|No|No|75%|00378623105|CITALOPRAM HBR 10 MG TABLET|500|EA|.03125|09/28/2011||Yes|No||09/28/2011||Yes|No|09/28/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02682|03/29/2022|.02617|03/29/2022|.02635|03/29/2022|||ANTIDEPRESSANTS: SSRIs|3502|||||No|No||MYLAN|No||||
citalopram hydrobromide|Yes|No|No|No|75%|00378623201|CITALOPRAM HBR 20 MG TABLET|100|EA|.03491|09/28/2011||Yes|No||09/28/2011||Yes|No|09/28/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02946|03/29/2022|.02875|03/29/2022|.02894|03/29/2022|||ANTIDEPRESSANTS: SSRIs|3503|||||No|No||MYLAN|No||||
citalopram hydrobromide|Yes|No|No|No|75%|00378623205|CITALOPRAM HBR 20 MG TABLET|500|EA|.03492|09/28/2011||Yes|No||09/28/2011||Yes|No|09/28/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02946|03/29/2022|.02875|03/29/2022|.02894|03/29/2022|||ANTIDEPRESSANTS: SSRIs|3504|||||No|No||MYLAN|No||||
citalopram hydrobromide|Yes|No|No|No|75%|00378623301|CITALOPRAM HBR 40 MG TABLET|100|EA|.04321|09/28/2011||Yes|No||09/28/2011||Yes|No|09/28/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03726|03/29/2022|.03636|03/29/2022|.0366|03/29/2022|||ANTIDEPRESSANTS: SSRIs|3505|||||No|No||MYLAN|No||||
citalopram hydrobromide|Yes|No|No|No|75%|00378623305|CITALOPRAM HBR 40 MG TABLET|500|EA|.04322|09/28/2011||Yes|No||09/28/2011||Yes|No|09/28/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03726|03/29/2022|.03636|03/29/2022|.0366|03/29/2022|||ANTIDEPRESSANTS: SSRIs|3506|||||No|No||MYLAN|No||||
verapamil HCl|No|No|No|No|75%|00378632001|VERAPAMIL ER 120 MG CAPSULE|100|EA|.62543|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||045|No|1.14665|03/29/2022|1.11913|03/29/2022|1.12658|03/29/2022|||CALCIUM CHANNEL BLOCKERS|3507|||||No|No||MYLAN|No||||
valsartan/hydrochlorothiazide|Yes|No|No|No|75%|00378632177|VALSARTAN-HCTZ 80-12.5 MG TAB|90|EA|.51809|09/27/2012||Yes|No||09/27/2012||Yes|No|09/27/2012||Yes|No||09/27/2012||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.29054|03/29/2022|.28356|03/29/2022|.28545|03/29/2022|||ANGIOTENSIN MODULATORS|3508|||||No|No||MYLAN|No||||
valsartan/hydrochlorothiazide|Yes|No|No|No|75%|00378632277|VALSARTAN-HCTZ 160-12.5 MG TAB|90|EA|.56367|09/27/2012||Yes|No||09/27/2012||Yes|No|09/27/2012||Yes|No||09/27/2012||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.28742|03/29/2022|.28052|03/29/2022|.28239|03/29/2022|||ANGIOTENSIN MODULATORS|3509|||||No|No||MYLAN|No||||
valsartan/hydrochlorothiazide|Yes|No|No|No|75%|00378632377|VALSARTAN-HCTZ 160-25 MG TAB|90|EA|.63926|09/27/2012||Yes|No||09/27/2012||Yes|No|09/27/2012||Yes|No||09/27/2012||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.29583|03/29/2022|.28873|03/29/2022|.29065|03/29/2022|||ANGIOTENSIN MODULATORS|3510|||||No|No||MYLAN|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|00378632477|VALSARTAN-HCTZ 320-12.5 MG TAB|90|EA|.71417|09/27/2012||Yes|No||09/27/2012||Yes|No|09/27/2012||Yes|No||09/27/2012||Yes|No|||Prescription required|Yes|07/29/2021|113|Yes|.41056|03/29/2022|.4007|03/29/2022|.40337|03/29/2022|||ANGIOTENSIN MODULATORS|3511|||||No|No||MYLAN|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|00378632577|VALSARTAN-HCTZ 320-25 MG TAB|90|EA|.81026|09/27/2012||Yes|No||09/27/2012||Yes|No|09/27/2012||Yes|No||09/27/2012||Yes|No|||Prescription required|Yes|07/29/2021|113|Yes|.3994|03/29/2022|.38981|03/29/2022|.39241|03/29/2022|||ANGIOTENSIN MODULATORS|3512|||||No|No||MYLAN|No||||
acamprosate calcium|No|No|No|No|75%|00378633380|ACAMPROSATE CALC DR 333 MG TAB|180|EA|.35319|05/29/2015||Yes|No||05/29/2015||Yes|No|05/29/2015||Yes|No||||No|No|||Prescription required|No|||No|.6071|03/29/2022|.59252|03/29/2022|.59647|03/29/2022||||3513|||||No|No||MYLAN|Yes|09/01/2020|||
verapamil HCl|No|No|No|No|75%|00378638001|VERAPAMIL ER 180 MG CAPSULE|100|EA|.65501|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||045|No|1.23808|03/29/2022|1.20836|03/29/2022|1.21641|03/29/2022|||CALCIUM CHANNEL BLOCKERS|3514|||||No|No||MYLAN|No||||
doxepin HCl|No|No|No|No|75%|00378641001|DOXEPIN 100 MG CAPSULE|100|EA|.63597|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.67991|03/29/2022|.66359|03/29/2022|.66801|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|3515|||||No|No||MYLAN|No||||
doxepin HCl|No|No|No|No|75%|00378641010|DOXEPIN 100 MG CAPSULE|1000|EA|.63594|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.67991|03/29/2022|.66359|03/29/2022|.66801|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|3516|||||No|No||MYLAN|No||||
verapamil HCl|No|No|No|No|75%|00378644001|VERAPAMIL ER 240 MG CAPSULE|100|EA|.73921|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||045|No|1.40763|03/29/2022|1.37384|03/29/2022|1.38299|03/29/2022|||CALCIUM CHANNEL BLOCKERS|3517|||||No|No||MYLAN|No||||
scopolamine|No|No|No|No|75%|00378647044|SCOPOLAMINE 1 MG/3 DAY PATCH|24|EA|7.90321|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|085|No|11.10069|03/29/2022|10.83427|03/29/2022|10.90642|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|3518|||||No|No||MYLAN|No||||
scopolamine|No|No|No|No|75%|00378647097|SCOPOLAMINE 1 MG/3 DAY PATCH|10|EA|7.90297|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|085|No|11.10069|03/29/2022|10.83427|03/29/2022|10.90642|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|3519|||||No|No||MYLAN|No||||
scopolamine|No|No|No|No|75%|00378647099|SCOPOLAMINE 1 MG/3 DAY PATCH|4|EA|6.9488|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|085|No|11.10069|03/29/2022|10.83427|03/29/2022|10.90642|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|3520|||||No|No||MYLAN|No||||
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|00378655053|LEVONOR-ETH ESTRAD 0.15-0.03|28|EA|.07883|12/02/2016||Yes|No||12/02/2016||Yes|No|12/02/2016||Yes|No|Refer to program requirements|||No|No|12/02/2016||Prescription required|No|||No|.17306|03/29/2022|.1689|03/29/2022|.17003|03/29/2022||||3521|||||No|No||MYLAN|No|||Only covered for non-contraceptive (medical) purposes|
isotretinoin|No|No|No|No|75%|00378661193|AMNESTEEM 10 MG CAPSULE|30|EA|2.15716|12/01/2016||Yes|No||12/01/2016||Yes|No|12/01/2016||Yes|No||||No|No|||Prescription required|No||144|No|2.44307|03/29/2022|2.38443|03/29/2022|2.40031|03/29/2022|||ACNE AGENTS: ORAL|3522|||||No|No||MYLAN|No||||
isotretinoin|No|No|No|No|75%|00378661293|AMNESTEEM 20 MG CAPSULE|30|EA|2.5585|06/01/2017||Yes|No||06/01/2017||Yes|No|06/01/2017||Yes|No||||No|No|||Prescription required|No||144|No|2.5524|03/29/2022|2.49114|03/29/2022|2.50773|03/29/2022|||ACNE AGENTS: ORAL|3523|||||No|No||MYLAN|No||||
isotretinoin|No|No|No|No|75%|00378661493|AMNESTEEM 40 MG CAPSULE|30|EA|2.97244|05/01/2017||Yes|No||05/01/2017||Yes|No|05/01/2017||Yes|No||||No|No|||Prescription required|No||144|No|3.38467|03/29/2022|3.30343|03/29/2022|3.32543|03/29/2022|||ACNE AGENTS: ORAL|3524|||||No|No||MYLAN|No||||
pantoprazole sodium|No|No|No|No|75%|00378668877|PANTOPRAZOLE SOD DR 20 MG TAB|90|EA|.04816|01/27/2011||Yes|No||01/27/2011||Yes|No|01/27/2011||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|Yes|.05306|03/29/2022|.05178|03/29/2022|.05213|03/29/2022|||PROTON PUMP INHIBITORS|3525|||||No|No||MYLAN|No||||
pantoprazole sodium|No|No|No|No|75%|00378668899|PANTOPRAZOLE SOD DR 20 MG TAB|90|EA|.04816|06/12/2020|01/31/2023|Yes|No||06/12/2020|01/31/2023|Yes|No|06/12/2020|01/31/2023|Yes|No||06/12/2020|01/31/2023|Yes|No|||Prescription required|No||047|Yes|.05306|03/29/2022|.05178|03/29/2022|.05213|03/29/2022|||PROTON PUMP INHIBITORS|3526|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||MYLAN|No||||
pantoprazole sodium|No|No|No|No|75%|00378668910|PANTOPRAZOLE SOD DR 40 MG TAB|1000|EA|.04575|01/27/2011||Yes|No||01/27/2011||Yes|No|01/27/2011||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|No|.05828|03/29/2022|.05688|03/29/2022|.05726|03/29/2022|||PROTON PUMP INHIBITORS|3527|||||No|No||MYLAN|No||||
pantoprazole sodium|No|No|No|No|75%|00378668977|PANTOPRAZOLE SOD DR 40 MG TAB|90|EA|.04816|01/27/2011||Yes|No||01/27/2011||Yes|No|01/27/2011||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|No|.05828|03/29/2022|.05688|03/29/2022|.05726|03/29/2022|||PROTON PUMP INHIBITORS|3528|||||No|No||MYLAN|No||||
pantoprazole sodium|No|No|No|No|75%|00378668999|PANTOPRAZOLE SOD DR 40 MG TAB|90|EA|.04816|06/12/2020|12/31/2022|Yes|No||06/12/2020|12/31/2022|Yes|No|06/12/2020|12/31/2022|Yes|No||06/12/2020|12/31/2022|Yes|No|||Prescription required|No||047|No|.05828|03/29/2022|.05688|03/29/2022|.05726|03/29/2022|||PROTON PUMP INHIBITORS|3529|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||MYLAN|No||||
abiraterone acetate|No|No|No|No|75%|00378692078|ABIRATERONE ACETATE 250 MG TAB|120|EA|6.09166|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No||550|No|13.88332|09/28/2021|13.68499|09/28/2021|13.03332|09/28/2021|||ONCOLOGY: ORAL - PROSTATE|3530|||||No|No||MYLAN|No||||
abiraterone acetate|No|No|No|No|75%|00378692191|ABIRATERONE 500 MG TABLET|60|EA|67.33749|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No||550|No|153.46685|04/14/2021|151.27446|04/14/2021|144.07092|04/14/2021|||ONCOLOGY: ORAL - PROSTATE|3531|||||No|No||MYLAN|No||||
bexarotene|No|No|No|No|75%|00378695501|BEXAROTENE 75 MG CAPSULE|100|EA|25.3055|11/15/2016||Yes|No||11/15/2016||Yes|No|11/15/2016||Yes|No||||No|No|||Prescription required|No|||No|57.673|01/19/2021|56.8491|01/19/2021|54.142|01/19/2021||||3532|||||No|No||MYLAN|No||||
glatiramer acetate|No|No|No|No|75%|00378696093|GLATIRAMER 20 MG/ML SYRINGE|1|ML|27.95|02/05/2018||Yes|No||02/05/2018||Yes|No|02/05/2018||Yes|No||||No|No|||Prescription required|No||043|No|63.7|08/24/2021|62.79|08/24/2021|59.8|08/24/2021|||MULTIPLE SCLEROSIS AGENTS|3533|||||No|No||MYLAN|No||||
glatiramer acetate|No|No|No|No|75%|00378696112|GLATIRAMER 40 MG/ML SYRINGE|1|ML|69.875|02/06/2018||Yes|No||02/06/2018||Yes|No|02/06/2018||Yes|No||||No|No|||Prescription required|No||043|No|127.69067|01/25/2022|124.62609|01/25/2022|125.45608|01/25/2022|||MULTIPLE SCLEROSIS AGENTS|3534|||||No|No||MYLAN|No||||
lansoprazole|No|No|No|No|75%|00378698188|LANSOPRAZOLE ODT 15 MG TABLET|100|EA|3.87967|02/01/2019||Yes|No||02/01/2019||Yes|No|02/01/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|047|No|6.08156|03/29/2022|5.9356|03/29/2022|5.97513|03/29/2022|||PROTON PUMP INHIBITORS|3535|||||No|No||MYLAN|No||||
lansoprazole|No|No|No|No|75%|00378698288|LANSOPRAZOLE ODT 30 MG TABLET|100|EA|3.87967|02/01/2019||Yes|No||02/01/2019||Yes|No|02/01/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|047|No|5.52111|03/29/2022|5.3886|03/29/2022|5.42449|03/29/2022|||PROTON PUMP INHIBITORS|3536|||||No|No||MYLAN|No||||
albuterol sulfate|No|No|No|No|75%|00378699152|ALBUTEROL SUL 0.63 MG/3 ML SOL|3|ML|.19063|11/17/2009||Yes|No||11/17/2009||Yes|No|11/17/2009||Yes|No||||No|No|||Prescription required|No||037|Yes|.20231|03/29/2022|.19745|03/29/2022|.19876|03/29/2022|||BRONCHODILATORS: BETA AGONIST|3537|||||No|No||MYLAN|Yes|09/01/2020|||
albuterol sulfate|No|No|No|No|75%|00378699252|ALBUTEROL SUL 1.25 MG/3 ML SOL|3|ML|.19063|11/17/2009||Yes|No||11/17/2009||Yes|No|11/17/2009||Yes|No||||No|No|||Prescription required|No||037|Yes|.212|03/29/2022|.20691|03/29/2022|.20829|03/29/2022|||BRONCHODILATORS: BETA AGONIST|3538|||||No|No||MYLAN|Yes|09/01/2020|||
levalbuterol HCl|No|No|No|No|75%|00378699393|LEVALBUTEROL CONC 1.25 MG/0.5|1|EA|2.30451|09/02/2009||Yes|No||09/02/2009||Yes|No|09/02/2009||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|5.25214|03/29/2022|5.17711|03/29/2022|4.93058|03/29/2022|||BRONCHODILATORS: BETA AGONIST|3539|||||No|No||MYLAN|No||||
paroxetine HCl|No|No|No|No|75%|00378700110|PAROXETINE HCL 10 MG TABLET|1000|EA|.04902|08/26/2008||Yes|No||08/26/2008||Yes|No|08/26/2008||Yes|No||||No|No|||Prescription required|No||008|Yes|.075|03/29/2022|.0732|03/29/2022|.07368|03/29/2022|||ANTIDEPRESSANTS: SSRIs|3540|||||No|No||MYLAN|No||||
paroxetine HCl|No|No|No|No|75%|00378700193|PAROXETINE HCL 10 MG TABLET|30|EA|.04902|08/26/2008||Yes|No||08/26/2008||Yes|No|08/26/2008||Yes|No||||No|No|||Prescription required|No||008|Yes|.075|03/29/2022|.0732|03/29/2022|.07368|03/29/2022|||ANTIDEPRESSANTS: SSRIs|3541|||||No|No||MYLAN|No||||
paroxetine HCl|No|No|No|No|75%|00378700210|PAROXETINE HCL 20 MG TABLET|1000|EA|.05962|08/26/2008||Yes|No||08/26/2008||Yes|No|08/26/2008||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|3542|||||No|No||MYLAN|No||||
paroxetine HCl|No|No|No|No|75%|00378700293|PAROXETINE HCL 20 MG TABLET|30|EA|.05962|08/26/2008||Yes|No||08/26/2008||Yes|No|08/26/2008||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|3543|||||No|No||MYLAN|No||||
paroxetine HCl|No|No|No|No|75%|00378700310|PAROXETINE HCL 30 MG TABLET|1000|EA|.08284|08/26/2008||Yes|No||08/26/2008||Yes|No|08/26/2008||Yes|No||||No|No|||Prescription required|No||008|No|.13236|03/29/2022|.12918|03/29/2022|.13004|03/29/2022|||ANTIDEPRESSANTS: SSRIs|3544|||||No|No||MYLAN|No||||
paroxetine HCl|No|No|No|No|75%|00378700393|PAROXETINE HCL 30 MG TABLET|30|EA|.08284|08/26/2008||Yes|No||08/26/2008||Yes|No|08/26/2008||Yes|No||||No|No|||Prescription required|No||008|No|.13236|03/29/2022|.12918|03/29/2022|.13004|03/29/2022|||ANTIDEPRESSANTS: SSRIs|3545|||||No|No||MYLAN|No||||
paroxetine HCl|No|No|No|No|75%|00378700410|PAROXETINE HCL 40 MG TABLET|1000|EA|.08624|08/26/2008||Yes|No||08/26/2008||Yes|No|08/26/2008||Yes|No||||No|No|||Prescription required|No||008|No|.13005|03/29/2022|.12692|03/29/2022|.12777|03/29/2022|||ANTIDEPRESSANTS: SSRIs|3546|||||No|No||MYLAN|No||||
paroxetine HCl|No|No|No|No|75%|00378700493|PAROXETINE HCL 40 MG TABLET|30|EA|.08772|08/26/2008||Yes|No||08/26/2008||Yes|No|08/26/2008||Yes|No||||No|No|||Prescription required|No||008|No|.13005|03/29/2022|.12692|03/29/2022|.12777|03/29/2022|||ANTIDEPRESSANTS: SSRIs|3547|||||No|No||MYLAN|No||||
ketoconazole|No|No|No|No|75%|00378700701|KETOCONAZOLE 2% FOAM|100|GM|2.97052|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|6.77003|02/26/2019|6.67332|02/26/2019|6.35554|02/26/2019|||ANTIFUNGALS: TOPICAL|3548|||||No|No||MYLAN|No||||
ketoconazole|No|No|No|No|75%|00378700750|KETOCONAZOLE 2% FOAM|50|GM|5.07658|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|11.56988|02/26/2019|11.40459|02/26/2019|10.86152|02/26/2019|||ANTIFUNGALS: TOPICAL|3549|||||No|No||MYLAN|No||||
acitretin|No|No|No|No|75%|00378702093|ACITRETIN 10 MG CAPSULE|30|EA|5.36668|09/15/2016||Yes|No||09/15/2016||Yes|No|09/15/2016||Yes|No||||No|No|||Prescription required|No|||No|7.81961|03/29/2022|7.63193|03/29/2022|7.68276|03/29/2022||||3550|||||No|No||MYLAN|No||||
acitretin|No|No|No|No|75%|00378702393|ACITRETIN 25 MG CAPSULE|30|EA|6.61497|09/15/2016||Yes|No||09/15/2016||Yes|No|09/15/2016||Yes|No||||No|No|||Prescription required|No|||No|10.86025|03/29/2022|10.5996|03/29/2022|10.67019|03/29/2022||||3551|||||No|No||MYLAN|No||||
bromocriptine mesylate|No|No|No|No|75%|00378709601|BROMOCRIPTINE 5 MG CAPSULE|100|EA|3.20276|09/15/2009||Yes|No||09/15/2009||Yes|No|09/15/2009||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|4.49386|11/23/2021|4.386|11/23/2021|4.41521|11/23/2021|||ANTIPARKINSON'S AGENTS|3552|||||No|No||MYLAN|Yes|09/01/2020|||
bromocriptine mesylate|No|No|No|No|75%|00378709693|BROMOCRIPTINE 5 MG CAPSULE|30|EA|3.20278|04/14/2005||Yes|No||04/14/2005||Yes|No|04/14/2005||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|4.49386|11/23/2021|4.386|11/23/2021|4.41521|11/23/2021|||ANTIPARKINSON'S AGENTS|3553|||||No|No||MYLAN|Yes|09/01/2020|||
fenofibrate|No|No|No|No|75%|00378710077|FENOFIBRATE 54 MG TABLET|90|EA|.27247|01/11/2010||Yes|No||01/11/2010||Yes|No|01/11/2010||Yes|No||||No|No|||Prescription required|No||055|No|.1459|03/29/2022|.14239|03/29/2022|.14334|03/29/2022|||LIPOTROPICS: OTHER|3554|||||No|No||MYLAN|No||||
fenofibrate|No|No|No|No|75%|00378710177|FENOFIBRATE 160 MG TABLET|90|EA|.81747|01/11/2010||Yes|No||01/11/2010||Yes|No|01/11/2010||Yes|No||||No|No|||Prescription required|No||055|No|.1612|03/29/2022|.15733|03/29/2022|.15837|03/29/2022|||LIPOTROPICS: OTHER|3555|||||No|No||MYLAN|No||||
erlotinib HCl|No|No|No|No|75%|00378713193|ERLOTINIB HCL 25 MG TABLET|30|EA|35.561|09/18/2019||Yes|No||09/18/2019||Yes|No|09/18/2019||Yes|No||||No|No|||Prescription required|No||551|No|81.046|09/18/2019|79.8882|09/18/2019|76.084|09/18/2019|||ONCOLOGY: ORAL - LUNG|3556|||||No|No||MYLAN|No||||
erlotinib HCl|No|No|No|No|75%|00378713293|ERLOTINIB HCL 100 MG TABLET|30|EA|97.67421|09/18/2019||Yes|No||09/18/2019||Yes|No|09/18/2019||Yes|No||||No|No|||Prescription required|No||551|No|222.60634|09/18/2019|219.42625|09/18/2019|208.97738|09/18/2019|||ONCOLOGY: ORAL - LUNG|3557|||||No|No||MYLAN|No||||
erlotinib HCl|No|No|No|No|75%|00378713393|ERLOTINIB HCL 150 MG TABLET|30|EA|110.47674|09/18/2019||Yes|No||09/18/2019||Yes|No|09/18/2019||Yes|No||||No|No|||Prescription required|No||551|No|251.7842|09/18/2019|248.18728|09/18/2019|236.36884|09/18/2019|||ONCOLOGY: ORAL - LUNG|3558|||||No|No||MYLAN|No||||
budesonide|No|No|No|No|75%|00378715501|BUDESONIDE DR 3 MG CAPSULE|100|EA|1.9135|10/05/2011||Yes|No||10/05/2011||Yes|No|10/05/2011||Yes|No||||No|No|||Prescription required|No||168|Yes|.86544|03/29/2022|.84466|03/29/2022|.85029|03/29/2022|||GLUCOCORTICOIDS: ORAL|3559|||||No|No||MYLAN|No||||
metformin HCl|Yes|No|No|No|75%|00378718505|METFORMIN HCL 500 MG TABLET|500|EA|.01255|06/15/2010||Yes|No||06/15/2010||Yes|No|06/15/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|3560|||||No|No||MYLAN|No||||
metformin HCl|Yes|No|No|No|75%|00378718605|METFORMIN HCL 850 MG TABLET|500|EA|.01742|06/15/2010||Yes|No||06/15/2010||Yes|No|06/15/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|3561|||||No|No||MYLAN|No||||
metformin HCl|Yes|No|No|No|75%|00378718705|METFORMIN HCL 1,000 MG TABLET|500|EA|.01984|06/15/2010||Yes|No||06/15/2010||Yes|No|06/15/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|3562|||||No|No||MYLAN|No||||
norethindrone|Yes|Yes|No|No|75%|00378727253|NORETHINDRONE 0.35 MG TABLET|28|EA|.05738|01/04/2017||Yes|No||01/04/2017||Yes|No|01/04/2017||Yes|No|Refer to program requirements|||No|No|01/04/2017||Prescription required|No|||No|.16123|03/29/2022|.15736|03/29/2022|.1584|03/29/2022||||3563|||||No|No||MYLAN|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone ac-eth estradiol|Yes|Yes|No|No|75%|00378728053|NORETHIND-ETH ESTRAD 1-0.02 MG|21|EA|.14244|02/09/2015||Yes|No||02/09/2015||Yes|No|02/09/2015||Yes|No|Refer to program requirements|||No|No|02/09/2015||Prescription required|No|||No|.29153|03/29/2022|.28453|03/29/2022|.28642|03/29/2022||||3564|||||No|No||MYLAN|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|00378728153|LEVONOR-ETH ESTRAD 0.15-0.03|91|EA|.25963|11/09/2015||Yes|No||11/09/2015||Yes|No|11/09/2015||Yes|No|Refer to program requirements|||No|No|11/09/2015||Prescription required|No|||No|.17533|03/29/2022|.17112|03/29/2022|.17226|03/29/2022||||3565|||||No|No||MYLAN|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|00378728353|NORETH-EE-FE 1-0.02(21)-75 TAB|28|EA|.10683|02/09/2015||Yes|No||02/09/2015||Yes|No|02/09/2015||Yes|No|Refer to program requirements|||No|No|02/09/2015||Prescription required|No|||No|.20374|03/29/2022|.19885|03/29/2022|.20017|03/29/2022||||3566|||||No|No||MYLAN|No|||Only covered for non-contraceptive (medical) purposes|
L-norgest/e.estradiol-e.estrad|Yes|Yes|No|No|75%|00378728490|LEVONOR-E ESTRAD 0.1-0.02-0.01|91|EA|.18007|05/05/2020||Yes|No||05/05/2020||Yes|No|05/05/2020||Yes|No|Refer to program requirements|||No|No|06/19/2020||Prescription required|No|||No|.32321|03/01/2022|.31545|03/01/2022|.31755|03/01/2022||||3567|||||No|No||MYLAN|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|00378728753|LEVONOR-ETH ESTRAD 0.1-0.02 MG|28|EA|.13109|02/09/2015||Yes|No||02/09/2015||Yes|No|02/09/2015||Yes|No|Refer to program requirements|||No|No|02/09/2015||Prescription required|No|||No|.21292|03/29/2022|.2078|03/29/2022|.20919|03/29/2022||||3568|||||No|No||MYLAN|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone acetate|No|No|No|No|75%|00378729189|NORETHINDRONE 5 MG TABLET|50|EA|.79722|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No|||No|.58431|03/29/2022|.57028|03/29/2022|.57408|03/29/2022||||3569|||||No|No||MYLAN|No||||
norethindrone|Yes|Yes|No|No|75%|00378729253|NORETHINDRONE 0.35 MG TABLET|28|EA|.05738|10/09/2014||Yes|No||10/09/2014||Yes|No|10/09/2014||Yes|No|Refer to program requirements|||No|No|10/09/2014||Prescription required|No|||No|.16123|03/29/2022|.15736|03/29/2022|.1584|03/29/2022||||3570|||||No|No||MYLAN|No|||Only covered for non-contraceptive (medical) purposes|
estradiol/norethindrone acet|No|No|No|No|75%|00378729453|ESTRADIOL-NORETH 0.5-0.1 MG TB|28|EA|.24827|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|No|||Yes|1.2896|03/29/2022|1.25864|03/29/2022|1.26703|03/29/2022||||3571|||||No|No||MYLAN|No||||
estradiol/norethindrone acet|No|No|No|No|75%|00378729553|ESTRADIOL-NORETH 1-0.5 MG TAB|28|EA|.22579|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|No|||Yes|1.11831|03/29/2022|1.09147|03/29/2022|1.09873|03/29/2022||||3572|||||No|No||MYLAN|No||||
desog-e.estradiol/e.estradiol|Yes|Yes|No|No|75%|00378729653|DESOGESTR-ETH ESTRAD ETH ESTRA|28|EA|.25349|02/09/2015||Yes|No||02/09/2015||Yes|No|02/09/2015||Yes|No|Refer to program requirements|||No|No|02/09/2015||Prescription required|No|||No|.21935|03/29/2022|.21408|03/29/2022|.21551|03/29/2022||||3573|||||No|No||MYLAN|No|||Only covered for non-contraceptive (medical) purposes|
noreth-ethinyl estradiol/iron|Yes|Yes|No|No|75%|00378729753|NORET-ESTR-FE 0.4-0.035(21)-75|28|EA|.36954|10/16/2017||Yes|No||10/16/2017||Yes|No|10/16/2017||Yes|No|Refer to program requirements|||No|No|10/16/2017||Prescription required|No|||No|.84221|10/23/2018|.83018|10/23/2018|.79064|10/23/2018||||3574|||||No|No||MYLAN|No|||Only covered for non-contraceptive (medical) purposes|
ethinyl estradiol/drospirenone|Yes|Yes|No|No|75%|00378729953|DROSPIRENONE-EE 3-0.02 MG TAB|28|EA|.28999|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No|Refer to program requirements|||No|No|07/22/2019||Prescription required|No|||No|.36582|03/29/2022|.35704|03/29/2022|.35941|03/29/2022||||3575|||||No|No||MYLAN|No|||Only covered for non-contraceptive (medical) purposes|
ethinyl estradiol/drospirenone|Yes|Yes|No|No|75%|00378730053|DROSPIRENONE-EE 3-0.03 MG TAB|28|EA|.26276|11/10/2015||Yes|No||11/10/2015||Yes|No|11/10/2015||Yes|No|Refer to program requirements|||No|No|11/10/2015||Prescription required|No|||No|.2455|03/29/2022|.2396|03/29/2022|.2412|03/29/2022||||3576|||||No|No||MYLAN|No|||Only covered for non-contraceptive (medical) purposes|
noreth-ethinyl estradiol/iron|Yes|Yes|No|No|75%|00378730853|NORETHIN-ESTRA-FE 0.8-0.025 MG|28|EA|1.4988|07/17/2015||Yes|No||07/17/2015||Yes|No|07/17/2015||Yes|No|Refer to program requirements|||No|No|07/17/2015||Prescription required|No|||No|1.76123|03/29/2022|1.71896|03/29/2022|1.7304|03/29/2022||||3577|||||No|No||MYLAN|No|||Only covered for non-contraceptive (medical) purposes|
L-norgest/e.estradiol-e.estrad|Yes|Yes|No|No|75%|00378731685|LEVONORG 0.15MG-EE 20-25-30MCG|91|EA|1.57077|06/26/2018||Yes|No||06/26/2018||Yes|No|06/26/2018||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|3.5799|06/26/2018|3.52875|06/26/2018|3.36072|06/26/2018||||3578|||||No|No||MYLAN|No|||Only covered for non-contraceptive (medical) purposes|
mesalamine|No|No|No|No|75%|00378740178|MESALAMINE DR 1.2 GM TABLET|120|EA|.95635|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|010|No|2.75392|03/29/2022|2.68782|03/29/2022|2.70572|03/29/2022|||ULCERATIVE COLITIS AGENTS|3579|||||No|No||MYLAN|No||||
ondansetron|No|No|No|No|75%|00378773293|ONDANSETRON ODT 4 MG TABLET|30|EA|.26301|06/28/2007||Yes|No||06/28/2007||Yes|No|06/28/2007||Yes|No||||No|No|||Prescription required|No||085|No|.24125|03/29/2022|.23546|03/29/2022|.23702|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|3580|||||No|No||MYLAN|No||||
ondansetron|No|No|No|No|75%|00378773493|ONDANSETRON ODT 8 MG TABLET|30|EA|.36335|06/28/2007||Yes|No||06/28/2007||Yes|No|06/28/2007||Yes|No||||No|No|||Prescription required|No||085|No|.24386|03/29/2022|.238|03/29/2022|.23959|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|3581|||||No|No||MYLAN|No||||
ondansetron|No|No|No|No|75%|00378773497|ONDANSETRON ODT 8 MG TABLET|10|EA|.36335|06/28/2007||Yes|No||06/28/2007||Yes|No|06/28/2007||Yes|No||||No|No|||Prescription required|No||085|No|.24386|03/29/2022|.238|03/29/2022|.23959|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|3582|||||No|No||MYLAN|No||||
lansoprazole|No|No|No|No|75%|00378801593|LANSOPRAZOLE DR 15 MG CAPSULE|30|EA|.43|12/18/2009||Yes|No||12/18/2009||Yes|No|12/18/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|Yes|.24898|03/29/2022|.243|03/29/2022|.24462|03/29/2022|||PROTON PUMP INHIBITORS|3583|||||No|No||MYLAN|No||||
fluvastatin sodium|No|No|No|No|75%|00378802077|FLUVASTATIN SODIUM 20 MG CAP|90|EA|1.71928|05/14/2012||Yes|No||05/14/2012||Yes|No|05/14/2012||Yes|No||05/14/2012||Yes|No|||Prescription required|Yes|07/29/2021|063|Yes|3.616|10/26/2021|3.52921|10/26/2021|3.55272|10/26/2021|||LIPOTROPICS: STATINS|3584|||||No|No||MYLAN|No||||
fluvastatin sodium|No|No|No|No|75%|00378802093|FLUVASTATIN SODIUM 20 MG CAP|30|EA|1.72215|05/14/2012||Yes|No||05/14/2012||Yes|No|05/14/2012||Yes|No||05/14/2012||Yes|No|||Prescription required|Yes|07/29/2021|063|Yes|3.616|10/26/2021|3.52921|10/26/2021|3.55272|10/26/2021|||LIPOTROPICS: STATINS|3585|||||No|No||MYLAN|No||||
fluvastatin sodium|No|No|No|No|75%|00378802177|FLUVASTATIN SODIUM 40 MG CAP|90|EA|1.71928|05/14/2012||Yes|No||05/14/2012||Yes|No|05/14/2012||Yes|No||05/14/2012||Yes|No|||Prescription required|Yes|07/29/2021|063|Yes|3.76547|11/23/2021|3.67509|11/23/2021|3.69957|11/23/2021|||LIPOTROPICS: STATINS|3586|||||No|No||MYLAN|No||||
fluvastatin sodium|No|No|No|No|75%|00378802193|FLUVASTATIN SODIUM 40 MG CAP|30|EA|1.72215|05/14/2012||Yes|No||05/14/2012||Yes|No|05/14/2012||Yes|No||05/14/2012||Yes|No|||Prescription required|Yes|07/29/2021|063|Yes|3.76547|11/23/2021|3.67509|11/23/2021|3.69957|11/23/2021|||LIPOTROPICS: STATINS|3587|||||No|No||MYLAN|No||||
lansoprazole|No|No|No|No|75%|00378803005|LANSOPRAZOLE DR 30 MG CAPSULE|500|EA|.43|11/16/2009||Yes|No||11/16/2009||Yes|No|11/16/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.12249|03/29/2022|.11955|03/29/2022|.12034|03/29/2022|||PROTON PUMP INHIBITORS|3588|||||No|No||MYLAN|No||||
lansoprazole|No|No|No|No|75%|00378803077|LANSOPRAZOLE DR 30 MG CAPSULE|90|EA|.43|11/16/2009||Yes|No||11/16/2009||Yes|No|11/16/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.12249|03/29/2022|.11955|03/29/2022|.12034|03/29/2022|||PROTON PUMP INHIBITORS|3589|||||No|No||MYLAN|No||||
lansoprazole|No|No|No|No|75%|00378803093|LANSOPRAZOLE DR 30 MG CAPSULE|30|EA|.43|10/29/2010||Yes|No||10/29/2010||Yes|No|10/29/2010||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.12249|03/29/2022|.11955|03/29/2022|.12034|03/29/2022|||PROTON PUMP INHIBITORS|3590|||||No|No||MYLAN|No||||
clobazam|No|No|No|No|90%|00378804321|CLOBAZAM 2.5 MG/ML SUSPENSION|120|ML|.28666|01/03/2019||Yes|No||01/03/2019||Yes|No|01/03/2019||Yes|No||||No|No|||Prescription required|No||056|No|.50176|03/29/2022|.48971|03/29/2022|.49297|03/29/2022|||ANTICONVULSANTS|3591|||||No|No||MYLAN|No||||
clobetasol propionate/emoll|No|No|No|No|75%|00378805501|CLOBETASOL EMULSION 0.05% FOAM|100|GM|2.29607|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|121|No|2.90918|03/01/2022|2.83935|03/01/2022|2.85826|03/01/2022|||STEROIDS: TOPICAL VERY HIGH|3592|||||No|No||MYLAN|No||||
halcinonide|No|No|No|No|75%|00378805649|HALCINONIDE 0.1% CREAM|30|GM|5.60161|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|12.76646|12/24/2019|12.58408|12/17/2019|11.98484|12/17/2019|||STEROIDS: TOPICAL HIGH|3593|||||No|No||MYLAN|No||||
halcinonide|No|No|No|No|75%|00378805660|HALCINONIDE 0.1% CREAM|60|GM|4.76289|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|10.85497|12/17/2019|10.69989|12/17/2019|10.19038|12/17/2019|||STEROIDS: TOPICAL HIGH|3594|||||No|No||MYLAN|No||||
erythromycin base in ethanol|No|No|No|No|75%|00378807560|ERYGEL 2% GEL|60|GM|1.79639|09/05/2019||Yes|No||09/05/2019||Yes|No|09/05/2019||Yes|No||||No|No|||Prescription required|No||104|No|4.0941|09/05/2019|4.03561|09/05/2019|3.84344|09/05/2019|||ACNE AGENTS: TOPICAL|3595|||||No|No||MYLAN|No||||
erythromycin base in ethanol|No|No|No|No|75%|00378807593|ERYGEL 2% GEL|30|GM|2.50489|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|No||104|No|5.70882|01/03/2020|5.62726|01/03/2020|5.3593|01/03/2020|||ACNE AGENTS: TOPICAL|3596|||||No|No||MYLAN|No||||
tretinoin|No|No|No|No|75%|00378808220|TRETINOIN 0.025% CREAM|20|GM|1.79976|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No||||No|No|||Prescription required|No||104|No|2.13963|03/29/2022|2.08827|03/29/2022|2.10218|03/29/2022|||ACNE AGENTS: TOPICAL|3597|||||No|No||MYLAN|No||||
tretinoin|No|No|No|No|75%|00378808245|TRETINOIN 0.025% CREAM|45|GM|1.51455|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No||||No|No|||Prescription required|No||104|No|1.91452|03/29/2022|1.86857|03/29/2022|1.88101|03/29/2022|||ACNE AGENTS: TOPICAL|3598|||||No|No||MYLAN|No||||
tretinoin|No|No|No|No|75%|00378808320|TRETINOIN 0.05% CREAM|20|GM|2.01842|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No||||No|No|||Prescription required|No||104|No|2.20699|03/29/2022|2.15402|03/29/2022|2.16836|03/29/2022|||ACNE AGENTS: TOPICAL|3599|||||No|No||MYLAN|No||||
tretinoin|No|No|No|No|75%|00378808420|TRETINOIN 0.1% CREAM|20|GM|2.35575|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No||||No|No|||Prescription required|No||104|No|2.48726|03/29/2022|2.42756|03/29/2022|2.44373|03/29/2022|||ACNE AGENTS: TOPICAL|3600|||||No|No||MYLAN|No||||
tretinoin|No|No|No|No|75%|00378808445|TRETINOIN 0.1% CREAM|45|GM|1.9606|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No||||No|No|||Prescription required|No||104|No|2.33901|03/29/2022|2.28287|03/29/2022|2.29807|03/29/2022|||ACNE AGENTS: TOPICAL|3601|||||No|No||MYLAN|No||||
tretinoin|No|No|No|No|75%|00378808515|TRETINOIN 0.01% GEL|15|GM|1.90576|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|No||104|No|3.65059|03/29/2022|3.56297|03/29/2022|3.5867|03/29/2022|||ACNE AGENTS: TOPICAL|3602|||||No|No||MYLAN|No||||
tretinoin|No|No|No|No|75%|00378808545|TRETINOIN 0.01% GEL|45|GM|1.49964|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No||||No|No|||Prescription required|No||104|No|2.47886|03/29/2022|2.41936|03/29/2022|2.43547|03/29/2022|||ACNE AGENTS: TOPICAL|3603|||||No|No||MYLAN|No||||
tretinoin|No|No|No|No|75%|00378808615|TRETINOIN 0.025% GEL|15|GM|1.92267|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No||||No|No|||Prescription required|No||104|No|3.76373|03/29/2022|3.6734|03/29/2022|3.69786|03/29/2022|||ACNE AGENTS: TOPICAL|3604|||||No|No||MYLAN|No||||
tretinoin|No|No|No|No|75%|00378808645|TRETINOIN 0.025% GEL|45|GM|1.51178|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No||||No|No|||Prescription required|No||104|No|2.81852|03/29/2022|2.75087|03/29/2022|2.76919|03/29/2022|||ACNE AGENTS: TOPICAL|3605|||||No|No||MYLAN|No||||
tretinoin|No|No|No|No|75%|00378809045|TRETINOIN 0.05% GEL|45|GM|2.68701|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|104|No|4.28857|03/01/2022|4.18564|03/01/2022|4.21352|03/01/2022|||ACNE AGENTS: TOPICAL|3606|||||No|No||MYLAN|No||||
tretinoin microspheres|No|No|No|No|75%|00378809220|TRETINOIN GEL MICRO 0.04% TUBE|20|GM|5.37564|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|12.25147|01/29/2020|12.07644|01/29/2020|11.50138|01/29/2020|||ACNE AGENTS: TOPICAL|3607|||||No|No||MYLAN|No||||
tretinoin microspheres|No|No|No|No|75%|00378809245|TRETINOIN GEL MICRO 0.04% TUBE|45|GM|4.31662|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|9.83788|09/28/2021|9.69734|09/28/2021|9.23556|09/28/2021|||ACNE AGENTS: TOPICAL|3608|||||No|No||MYLAN|No||||
tretinoin microspheres|No|No|No|No|75%|00378809250|TRETINOIN GEL MICRO 0.04% PUMP|50|GM|4.51465|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|10.28921|01/29/2020|10.14222|01/29/2020|9.65926|01/29/2020|||ACNE AGENTS: TOPICAL|3609|||||No|No||MYLAN|No||||
tretinoin microspheres|No|No|No|No|75%|00378809345|TRETINOIN GEL MICRO 0.1% TUBE|45|GM|4.31662|05/04/2020||Yes|No||05/04/2020||Yes|No|05/04/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|7.63538|03/29/2022|7.45213|03/29/2022|7.50176|03/29/2022|||ACNE AGENTS: TOPICAL|3610|||||No|No||MYLAN|No||||
doxepin HCl|No|No|No|No|75%|00378811745|DOXEPIN 5% CREAM|45|GM|5.75177|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|No|||No|13.10869|12/28/2021|12.92142|12/28/2021|12.30612|12/28/2021||||3611|||||No|No||MYLAN|No||||
doxepin HCl|No|No|No|No|75%|00378812330|ZONALON 5% CREAM|30|GM|8.49565|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|No|||No|19.36218|02/27/2019|19.08558|02/27/2019|18.17674|02/27/2019||||3612|||||No|No||MYLAN|No||||
doxepin HCl|No|No|No|No|75%|00378812345|ZONALON 5% CREAM|45|GM|6.39075|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|No|||No|14.56497|02/27/2019|14.3569|02/27/2019|13.67324|02/27/2019||||3613|||||No|No||MYLAN|No||||
clindamycin phosphate|No|No|No|No|75%|00378813401|EVOCLIN 1% FOAM|100|GM|2.91036|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|104|No|6.63293|01/03/2020|6.53817|01/03/2020|6.22683|01/03/2020|||ACNE AGENTS: TOPICAL|3614|||||No|No||MYLAN|No||||
clindamycin phosphate|No|No|No|No|75%|00378813450|EVOCLIN 1% FOAM|50|GM|4.09781|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|104|No|9.3392|01/03/2020|9.20578|01/03/2020|8.76741|01/03/2020|||ACNE AGENTS: TOPICAL|3615|||||No|No||MYLAN|No||||
ketoconazole|No|No|No|No|75%|00378813601|EXTINA 2% FOAM|100|GM|3.95015|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|9.00267|05/23/2019|8.87406|05/23/2019|8.45148|05/23/2019|||ANTIFUNGALS: TOPICAL|3616|||||No|No||MYLAN|No||||
ketoconazole|No|No|No|No|75%|00378813650|EXTINA 2% FOAM|50|GM|6.75074|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|15.38541|05/23/2019|15.16562|05/23/2019|14.44344|05/23/2019|||ANTIFUNGALS: TOPICAL|3617|||||No|No||MYLAN|No||||
clobetasol propionate/emoll|No|No|No|No|75%|00378814701|OLUX-E 0.05% FOAM|100|GM|3.95015|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|121|No|9.00267|05/22/2019|8.87406|05/22/2019|8.45148|05/22/2019|||STEROIDS: TOPICAL VERY HIGH|3618|||||No|No||MYLAN|No||||
clobetasol propionate/emoll|No|No|No|No|75%|00378814750|OLUX-E 0.05% FOAM|50|GM|4.61243|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|121|No|10.51206|02/21/2020|10.36189|02/21/2020|9.86847|02/21/2020|||STEROIDS: TOPICAL VERY HIGH|3619|||||No|No||MYLAN|No||||
methylphenidate HCl|No|No|No|No|75%|00378815501|METHYLPHENIDATE ER 18 MG TAB|100|EA|2.59668|06/05/2018||Yes|No||06/05/2018||Yes|No|06/05/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.56499|03/29/2022|.55143|03/29/2022|.5551|03/29/2022|||STIMULANTS AND RELATED AGENTS|3620|||||No|No||MYLAN|No||||
methylphenidate HCl|No|No|No|No|75%|00378815601|METHYLPHENIDATE ER 27 MG TAB|100|EA|2.6617|06/05/2018||Yes|No||06/05/2018||Yes|No|06/05/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.90623|03/29/2022|.88448|03/29/2022|.89037|03/29/2022|||STIMULANTS AND RELATED AGENTS|3621|||||No|No||MYLAN|No||||
methylphenidate HCl|No|No|No|No|75%|00378815701|METHYLPHENIDATE ER 36 MG TAB|100|EA|2.74546|06/05/2018||Yes|No||06/05/2018||Yes|No|06/05/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.76999|03/29/2022|.75151|03/29/2022|.75651|03/29/2022|||STIMULANTS AND RELATED AGENTS|3622|||||No|No||MYLAN|No||||
methylphenidate HCl|No|No|No|No|75%|00378815801|METHYLPHENIDATE ER 54 MG TAB|100|EA|2.98738|06/05/2018||Yes|No||06/05/2018||Yes|No|06/05/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.87218|03/29/2022|.85124|03/29/2022|.85691|03/29/2022|||STIMULANTS AND RELATED AGENTS|3623|||||No|No||MYLAN|No||||
clobetasol propionate|No|No|No|No|75%|00378816701|CLOBETASOL PROP 0.05% FOAM|100|GM|2.29607|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|121|No|.7435|03/29/2022|.72565|03/29/2022|.73048|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|3624|||||No|No||MYLAN|No||||
clobetasol propionate|No|No|No|No|75%|00378816750|CLOBETASOL PROP 0.05% FOAM|50|GM|2.51378|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|121|No|.53203|03/29/2022|.51926|03/29/2022|.52271|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|3625|||||No|No||MYLAN|No||||
betamethasone valerate|No|No|No|No|75%|00378818050|BETAMETHASONE VALER 0.12% FOAM|50|GM|2.24924|02/28/2018||Yes|No||02/28/2018||Yes|No|02/28/2018||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|119|No|2.1912|03/01/2022|2.13861|03/01/2022|2.15285|03/01/2022|||STEROIDS: TOPICAL MEDIUM|3626|||||No|No||MYLAN|No||||
betamethasone valerate|No|No|No|No|75%|00378818099|BETAMETHASONE VALER 0.12% FOAM|100|GM|2.09315|02/28/2018||Yes|No||02/28/2018||Yes|No|02/28/2018||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|119|No|.8923|06/29/2021|.87088|06/29/2021|.87668|06/29/2021|||STEROIDS: TOPICAL MEDIUM|3627|||||No|No||MYLAN|No||||
clobetasol propionate|No|No|No|No|75%|00378818201|OLUX 0.05% FOAM|100|GM|3.95015|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|121|No|9.00267|02/26/2019|8.87406|02/26/2019|8.45148|02/26/2019|||STEROIDS: TOPICAL VERY HIGH|3628|||||No|No||MYLAN|No||||
clobetasol propionate|No|No|No|No|75%|00378818250|OLUX 0.05% FOAM|50|GM|4.61243|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|121|No|10.51206|01/03/2020|10.36189|01/03/2020|9.86847|01/03/2020|||STEROIDS: TOPICAL VERY HIGH|3629|||||No|No||MYLAN|No||||
betamethasone valerate|No|No|No|No|75%|00378818701|LUXIQ 0.12% FOAM|100|GM|2.77866|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|6.33276|03/05/2019|6.24229|02/26/2019|5.94504|02/26/2019|||STEROIDS: TOPICAL MEDIUM|3630|||||No|No||MYLAN|No||||
betamethasone valerate|No|No|No|No|75%|00378818750|LUXIQ 0.12% FOAM|50|GM|3.85082|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|8.77629|02/26/2019|8.65091|02/26/2019|8.23896|02/26/2019|||STEROIDS: TOPICAL MEDIUM|3631|||||No|No||MYLAN|No||||
ketoprofen|No|No|No|No|75%|00378820001|KETOPROFEN ER 200 MG CAPSULE|100|EA|3.72053|09/17/2003||Yes|No||09/17/2003||Yes|No|09/17/2003||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|8.47935|03/27/2018|8.35821|03/27/2018|7.9602|03/27/2018|||NSAIDS|3632|||||No|No||MYLAN|No||||
erythromycin base in ethanol|No|No|No|No|75%|00378821260|ERYTHROMYCIN 2% GEL|60|GM|1.40939|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No||104|No|.79832|03/29/2022|.77916|03/29/2022|.78434|03/29/2022|||ACNE AGENTS: TOPICAL|3633|||||No|No||MYLAN|No||||
erythromycin base in ethanol|No|No|No|No|75%|00378821293|ERYTHROMYCIN 2% GEL|30|GM|1.96524|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No||104|No|.72375|03/29/2022|.70638|03/29/2022|.71108|03/29/2022|||ACNE AGENTS: TOPICAL|3634|||||No|No||MYLAN|No||||
miconazole nitrate/zinc ox/pet|No|No|No|No|75%|00378822250|MICONAZOLE-ZINC-PETRO 0.25-15%|50|GM|4.32924|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|9.86664|02/25/2019|9.72568|02/25/2019|9.26256|02/25/2019|||ANTIFUNGALS: TOPICAL|3635|||||No|No||MYLAN|No||||
albuterol sulfate|No|No|No|No|75%|00378827052|ALBUTEROL SUL 2.5 MG/3 ML SOLN|3|ML|.02293|04/03/2013||Yes|No||04/03/2013||Yes|No|04/03/2013||Yes|No||||No|No|||Prescription required|No||037|Yes|.04199|03/29/2022|.04098|03/29/2022|.04125|03/29/2022|||BRONCHODILATORS: BETA AGONIST|3636|||||No|No||MYLAN|Yes|09/01/2020|||
carbidopa/levodopa/entacapone|No|No|No|No|75%|00378830201|CARBIDOPA-LEVODOPA 100 MG-ENTA|100|EA|1.29025|09/13/2014|04/30/2022|Yes|No||09/13/2014|04/30/2022|Yes|No|09/13/2014|04/30/2022|Yes|No||||No|No|||Prescription required|No||015|No|.96003|03/01/2022|.93698|03/01/2022|.94322|03/01/2022|||ANTIPARKINSON'S AGENTS|3637|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|00378830301|CARBIDOPA-LEVODOPA 125 MG-ENTA|100|EA|1.29025|09/13/2014|02/28/2022|Yes|No||09/13/2014|02/28/2022|Yes|No|09/13/2014|02/28/2022|Yes|No||||No|No|||Prescription required|No||015|No|2.94058|03/15/2022|2.89857|03/15/2022|2.76055|03/15/2022|||ANTIPARKINSON'S AGENTS|3638|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|00378830501|CARBIDOPA-LEVODOPA 200 MG-ENTA|100|EA|1.29025|09/13/2014|06/30/2022|Yes|No||09/13/2014|06/30/2022|Yes|No|09/13/2014|06/30/2022|Yes|No||||No|No|||Prescription required|No||015|No|.96506|03/29/2022|.94189|03/29/2022|.94817|03/29/2022|||ANTIPARKINSON'S AGENTS|3639|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|00378868854|CLINDAMYCIN-BENZOYL PEROX 1-5%|50|GM|1.29|09/01/2009||Yes|No||09/01/2009||Yes|No|09/01/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|.80914|03/29/2022|.78972|03/29/2022|.79498|03/29/2022|||ACNE AGENTS: TOPICAL|3640|||||No|No||MYLAN|No||||
acyclovir|No|No|No|No|75%|00378870006|ACYCLOVIR 5% OINTMENT|15|GM|2.15|11/04/2013||Yes|No||11/04/2013||Yes|No|11/04/2013||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.36934|03/29/2022|1.33647|03/29/2022|1.34537|03/29/2022|||ANTIVIRALS: TOPICAL|3641|||||No|No||MYLAN|No||||
acyclovir|No|No|No|No|75%|00378871273|ACYCLOVIR 200 MG/5 ML SUSP|473|ML|.32378|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||02/25/2019||Yes|No|||Prescription required|No||025|No|.2948|03/29/2022|.28772|03/29/2022|.28964|03/29/2022|||ANTIVIRALS: ORAL|3642|||||No|No||MYLAN|No||||
diclofenac sodium|No|No|No|No|75%|00378875006|DICLOFENAC SODIUM 1% GEL|100|GM|.16537|09/11/2019|09/30/2022|Yes|No||09/11/2019|09/30/2022|Yes|No|09/11/2019|09/30/2022|Yes|No||||No|No|||Prescription required|No||059|Yes|.08846|03/29/2022|.08633|03/29/2022|.08691|03/29/2022|||NSAIDS|3643|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN|No||||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00378876516|BUPRENORPHINE-NALOX 2-0.5MG FM|1|EA|1.76027|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|2.34845|03/29/2022|2.29208|03/29/2022|2.30735|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|3644|||||No|No||MYLAN|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00378876593|BUPRENORPHINE-NALOX 2-0.5MG FM|30|EA|.95718|09/22/2020||Yes|No||09/22/2020||Yes|No|09/22/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|2.34845|03/29/2022|2.29208|03/29/2022|2.30735|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|3645|||||No|No||MYLAN|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00378876616|BUPRENORPHINE-NALOX 4-1MG FILM|1|EA|3.15333|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|4.75054|03/29/2022|4.63652|03/29/2022|4.6674|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|3646|||||No|No||MYLAN|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00378876693|BUPRENORPHINE-NALOX 4-1MG FILM|30|EA|1.71484|09/22/2020||Yes|No||09/22/2020||Yes|No|09/22/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|4.75054|03/29/2022|4.63652|03/29/2022|4.6674|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|3647|||||No|No||MYLAN|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00378876716|BUPRENORPHINE-NALOX 8-2MG FILM|1|EA|3.15333|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|3.26802|03/29/2022|3.18958|03/29/2022|3.21082|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|3648|||||No|No||MYLAN|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00378876793|BUPRENORPHINE-NALOX 8-2MG FILM|30|EA|1.71484|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|||Prescription required|No||145|Yes|3.26802|03/29/2022|3.18958|03/29/2022|3.21082|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|3649|||||No|No||MYLAN|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00378876816|BUPRENORPHINE-NALOX 12-3MG FLM|1|EA|6.30652|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|6.93269|03/29/2022|6.7663|03/29/2022|6.81136|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|3650|||||No|No||MYLAN|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00378876893|BUPRENORPHINE-NALOX 12-3MG FLM|30|EA|3.42953|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|||Prescription required|No||145|Yes|6.93269|03/29/2022|6.7663|03/29/2022|6.81136|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|3651|||||No|No||MYLAN|Yes|09/01/2020|||
estradiol|No|No|No|No|75%|00378877035|ESTRADIOL 0.01% CREAM|42.5|GM|2.51089|02/28/2018||Yes|No||02/28/2018||Yes|No|02/28/2018||Yes|No||||No|No|||Prescription required|No|||Yes|.87976|03/29/2022|.85864|03/29/2022|.86436|03/29/2022||||3652|||||No|No||MYLAN|No||||
cysteamine bitartrate|No|No|No|No|75%|00378904005|CYSTAGON 50 MG CAPSULE|500|EA|.11438|06/26/2002||Yes|No||06/26/2002||Yes|No|06/26/2002||Yes|No||||No|No|||Prescription required|No|||No|.26068|06/01/2016|.25695|06/01/2016|.24472|06/01/2016||||3653|||||No|No||MYLAN|No||||
cysteamine bitartrate|No|No|No|No|75%|00378904505|CYSTAGON 150 MG CAPSULE|500|EA|.33333|06/26/2002||Yes|No||06/26/2002||Yes|No|06/26/2002||Yes|No||||No|No|||Prescription required|No|||No|.75969|06/01/2016|.74884|06/01/2016|.71318|06/01/2016||||3654|||||No|No||MYLAN|No||||
lidocaine|No|No|No|No|75%|00378905593|LIDOCAINE 5% PATCH|30|EA|3.53474|10/05/2016||Yes|No||10/05/2016||Yes|No|10/05/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|232|No|2.00634|03/29/2022|1.95818|03/29/2022|1.97122|03/29/2022|||NEUROPATHIC PAIN|3655|||||No|No||MYLAN|No||||
rivastigmine|No|No|No|No|75%|00378907093|RIVASTIGMINE 4.6 MG/24HR PATCH|30|EA|1.29014|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|011|No|2.88542|03/29/2022|2.81616|03/29/2022|2.83492|03/29/2022|||ALZHEIMER'S AGENTS|3656|||||No|No||MYLAN|No||||
rivastigmine|No|No|No|No|75%|00378907193|RIVASTIGMINE 9.5 MG/24HR PATCH|30|EA|1.29014|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|011|No|2.83898|03/29/2022|2.77084|03/29/2022|2.78929|03/29/2022|||ALZHEIMER'S AGENTS|3657|||||No|No||MYLAN|No||||
rivastigmine|No|No|No|No|75%|00378907293|RIVASTIGMINE 13.3 MG/24HR PTCH|30|EA|1.29014|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|011|No|3.24254|03/29/2022|3.16471|03/29/2022|3.18579|03/29/2022|||ALZHEIMER'S AGENTS|3658|||||No|No||MYLAN|No||||
entacapone|No|No|No|No|75%|00378908001|ENTACAPONE 200 MG TABLET|100|EA|1.36043|10/09/2014||Yes|No||10/09/2014||Yes|No|10/09/2014||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|015|No|.43301|03/29/2022|.42261|03/29/2022|.42543|03/29/2022|||ANTIPARKINSON'S AGENTS|3659|||||No|No||MYLAN|No||||
nitroglycerin|No|No|No|No|75%|00378910293|NITROGLYCERIN 0.1 MG/HR PATCH|30|EA|.26273|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.50793|03/29/2022|.49573|03/29/2022|.49904|03/29/2022||||3660|||||No|No||MYLAN|No||||
nitroglycerin|No|No|No|No|75%|00378910493|NITROGLYCERIN 0.2 MG/HR PATCH|30|EA|.30372|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.5028|03/29/2022|.49073|03/29/2022|.494|03/29/2022||||3661|||||No|No||MYLAN|No||||
nitroglycerin|No|No|No|No|75%|00378911293|NITROGLYCERIN 0.4 MG/HR PATCH|30|EA|.35102|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.59249|03/29/2022|.57827|03/29/2022|.58212|03/29/2022||||3662|||||No|No||MYLAN|No||||
nitroglycerin|No|No|No|No|75%|00378911693|NITROGLYCERIN 0.6 MG/HR PATCH|30|EA|.44576|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.68113|09/28/2021|.66478|09/28/2021|.66921|09/28/2021||||3663|||||No|No||MYLAN|No||||
fentanyl|No|No|No|No|90%|00378911998|FENTANYL 12 MCG/HR PATCH|5|EA|6.98406|07/29/2010||Yes|No||07/29/2010||Yes|No|07/29/2010||Yes|No||||No|No|||Prescription required|No||110|Yes|8.30578|03/29/2022|8.10644|03/29/2022|8.16042|03/29/2022|||ANALGESICS: NARCOTICS LONG|3664|||||No|No||MYLAN|No||||
fentanyl|No|No|No|No|90%|00378912198|FENTANYL 25 MCG/HR PATCH|5|EA|3.0659|07/29/2010||Yes|No||07/29/2010||Yes|No|07/29/2010||Yes|No||||No|No|||Prescription required|No||110|Yes|3.10308|03/29/2022|3.0286|03/29/2022|3.04877|03/29/2022|||ANALGESICS: NARCOTICS LONG|3665|||||No|No||MYLAN|No||||
fentanyl|No|No|No|No|90%|00378912298|FENTANYL 50 MCG/HR PATCH|5|EA|5.44638|07/29/2010||Yes|No||07/29/2010||Yes|No|07/29/2010||Yes|No||||No|No|||Prescription required|No||110|Yes|5.19805|03/29/2022|5.07329|03/29/2022|5.10708|03/29/2022|||ANALGESICS: NARCOTICS LONG|3666|||||No|No||MYLAN|No||||
fentanyl|No|No|No|No|90%|00378912398|FENTANYL 75 MCG/HR PATCH|5|EA|8.6086|07/29/2010||Yes|No||07/29/2010||Yes|No|07/29/2010||Yes|No||||No|No|||Prescription required|No||110|Yes|7.86615|03/29/2022|7.67736|03/29/2022|7.72849|03/29/2022|||ANALGESICS: NARCOTICS LONG|3667|||||No|No||MYLAN|No||||
fentanyl|No|No|No|No|90%|00378912498|FENTANYL 100 MCG/HR PATCH|5|EA|11.84994|09/28/2009||Yes|No||09/28/2009||Yes|No|09/28/2009||Yes|No||||No|No|||Prescription required|No||110|Yes|9.14035|03/29/2022|8.92098|03/29/2022|8.98039|03/29/2022|||ANALGESICS: NARCOTICS LONG|3668|||||No|No||MYLAN|No||||
fentanyl|No|No|No|No|90%|00378912598|FENTANYL 37.5 MCG/HR PATCH|5|EA|18.25522|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|42.59071|03/29/2022|41.56853|03/29/2022|41.84537|03/29/2022|||ANALGESICS: NARCOTICS LONG|3669|||||No|No||MYLAN|No||||
fentanyl|No|No|No|No|90%|00378912698|FENTANYL 62.5 MCG/HR PATCH|5|EA|26.52584|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|60.45424|06/01/2016|59.5906|06/01/2016|56.75296|06/01/2016|||ANALGESICS: NARCOTICS LONG|3670|||||No|No||MYLAN|No||||
fentanyl|No|No|No|No|90%|00378912798|FENTANYL 87.5 MCG/HR PATCH|5|EA|36.1157|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|82.3102|06/01/2016|81.13434|06/01/2016|77.2708|06/01/2016|||ANALGESICS: NARCOTICS LONG|3671|||||No|No||MYLAN|No||||
mesalamine|No|No|No|No|75%|00378923093|MESALAMINE 1,000 MG SUPP|30|EA|6.8433|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||010|No|2.81018|03/29/2022|2.74273|03/29/2022|2.761|03/29/2022|||ULCERATIVE COLITIS AGENTS|3672|||||No|No||MYLAN|No||||
fluticasone propion/salmeterol|No|No|No|No|75%|00378932032|WIXELA 100-50 INHUB|60|EA|.67158|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|033|Yes|1.62434|03/29/2022|1.58535|03/29/2022|1.59591|03/29/2022|||GLUCOCORTICOIDS: INHALED|3673|||||No|No||MYLAN|No||||
fluticasone propion/salmeterol|No|No|No|No|75%|00378932132|WIXELA 250-50 INHUB|60|EA|.83448|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|033|Yes|1.91406|03/29/2022|1.86812|03/29/2022|1.88056|03/29/2022|||GLUCOCORTICOIDS: INHALED|3674|||||No|No||MYLAN|No||||
fluticasone propion/salmeterol|No|No|No|No|75%|00378932232|WIXELA 500-50 INHUB|60|EA|1.0975|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|033|Yes|3.44519|03/29/2022|3.3625|03/29/2022|3.38489|03/29/2022|||GLUCOCORTICOIDS: INHALED|3675|||||No|No||MYLAN|No||||
travoprost|No|No|No|No|75%|00378965132|TRAVOPROST 0.004% EYE DROP|2.5|ML|27.29296|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|088|No|36.32982|03/29/2022|35.4579|03/29/2022|35.69404|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|3676|||||No|No||MYLAN|No||||
travoprost|No|No|No|No|75%|00378965150|TRAVOPROST 0.004% EYE DROP|5|ML|27.2921|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|088|No|32.8|03/29/2022|32.0128|03/29/2022|32.226|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|3677|||||No|No||MYLAN|No||||
levalbuterol HCl|No|No|No|No|75%|00378969052|LEVALBUTEROL 0.31 MG/3 ML SOL|3|ML|.40012|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|.91191|03/23/2021|.89889|03/23/2021|.85608|03/23/2021|||BRONCHODILATORS: BETA AGONIST|3678|||||No|No||MYLAN|No||||
levalbuterol HCl|No|No|No|No|75%|00378969152|LEVALBUTEROL 0.63 MG/3 ML SOL|3|ML|.40012|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|.3279|03/29/2022|.32003|03/29/2022|.32216|03/29/2022|||BRONCHODILATORS: BETA AGONIST|3679|||||No|No||MYLAN|No||||
levalbuterol HCl|No|No|No|No|75%|00378969252|LEVALBUTEROL 1.25 MG/3 ML SOL|3|ML|.40012|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|.31144|03/29/2022|.30396|03/29/2022|.30598|03/29/2022|||BRONCHODILATORS: BETA AGONIST|3680|||||No|No||MYLAN|Yes|09/01/2020|||
miconazole nitrate/zinc ox/pet|No|No|No|No|75%|00378973050|VUSION OINTMENT|50|GM|5.01629|06/12/2020||Yes|No||06/12/2020||Yes|No|06/12/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|061|No|11.43248|06/12/2020|11.26916|06/12/2020|10.73253|06/12/2020|||ANTIFUNGALS: TOPICAL|3681|||||No|No||MYLAN|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00406012301|HYDROCODONE-ACETAMIN 5-325 MG|100|EA|.14035|09/22/2014||Yes|No||09/22/2014||Yes|No|09/22/2014||Yes|No||09/22/2014||Yes|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3682|||||No|No||MALLINCKRODT PH|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00406012305|HYDROCODONE-ACETAMIN 5-325 MG|500|EA|.14035|09/22/2014||Yes|No||09/22/2014||Yes|No|09/22/2014||Yes|No||09/22/2014||Yes|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3683|||||No|No||MALLINCKRODT PH|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00406012310|HYDROCODONE-ACETAMIN 5-325 MG|1000|EA|.14035|11/18/2016||Yes|No||11/18/2016||Yes|No|11/18/2016||Yes|No||||No|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3684|||||No|No||MALLINCKRODT PH|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00406012362|HYDROCODONE-ACETAMIN 5-325 MG|100|EA|.18932|09/22/2014||Yes|No||09/22/2014||Yes|No|09/22/2014||Yes|No||09/22/2014||Yes|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3685|||||No|No||SPECGX LLC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00406012401|HYDROCODONE-ACETAMIN 7.5-325|100|EA|.15669|09/22/2014||Yes|No||09/22/2014||Yes|No|09/22/2014||Yes|No||09/22/2014||Yes|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3686|||||No|No||MALLINCKRODT PH|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00406012405|HYDROCODONE-ACETAMIN 7.5-325|500|EA|.15669|09/22/2014||Yes|No||09/22/2014||Yes|No|09/22/2014||Yes|No||09/22/2014||Yes|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3687|||||No|No||MALLINCKRODT PH|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00406012410|HYDROCODONE-ACETAMIN 7.5-325|1000|EA|.15669|11/18/2016||Yes|No||11/18/2016||Yes|No|11/18/2016||Yes|No||||No|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3688|||||No|No||MALLINCKRODT PH|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00406012462|HYDROCODONE-ACETAMIN 7.5-325|100|EA|.2088|09/22/2014||Yes|No||09/22/2014||Yes|No|09/22/2014||Yes|No||09/22/2014||Yes|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3689|||||No|No||MALLINCKRODT PH|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00406012501|HYDROCODONE-ACETAMIN 10-325 MG|100|EA|.156|09/22/2014||Yes|No||09/22/2014||Yes|No|09/22/2014||Yes|No||09/22/2014||Yes|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3690|||||No|No||MALLINCKRODT PH|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00406012505|HYDROCODONE-ACETAMIN 10-325 MG|500|EA|.156|09/22/2014||Yes|No||09/22/2014||Yes|No|09/22/2014||Yes|No||09/22/2014||Yes|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3691|||||No|No||MALLINCKRODT PH|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00406012510|HYDROCODONE-ACETAMIN 10-325 MG|1000|EA|.156|11/18/2016||Yes|No||11/18/2016||Yes|No|11/18/2016||Yes|No||||No|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3692|||||No|No||MALLINCKRODT PH|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00406012562|HYDROCODONE-ACETAMIN 10-325 MG|100|EA|.21242|09/22/2014||Yes|No||09/22/2014||Yes|No|09/22/2014||Yes|No||09/22/2014||Yes|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3693|||||No|No||MALLINCKRODT PH|No||||
methylphenidate HCl|No|No|No|No|75%|00406012701|METHYLPHENIDATE ER 27 MG TAB|100|EA|1.72|05/03/2013||Yes|No||05/03/2013||Yes|No|05/03/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.90623|03/29/2022|.88448|03/29/2022|.89037|03/29/2022|||STIMULANTS AND RELATED AGENTS|3694|||||No|No||MALLINCKRODT PH|No||||
methylphenidate HCl|No|No|No|No|75%|00406013601|METHYLPHENIDATE ER 36 MG TAB|100|EA|1.7845|05/03/2013||Yes|No||05/03/2013||Yes|No|05/03/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.76999|03/29/2022|.75151|03/29/2022|.75651|03/29/2022|||STIMULANTS AND RELATED AGENTS|3695|||||No|No||MALLINCKRODT PH|No||||
methylphenidate HCl|No|No|No|No|75%|00406015401|METHYLPHENIDATE ER 54 MG TAB|100|EA|1.935|05/03/2013||Yes|No||05/03/2013||Yes|No|05/03/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.87218|03/29/2022|.85124|03/29/2022|.85691|03/29/2022|||STIMULANTS AND RELATED AGENTS|3696|||||No|No||MALLINCKRODT PH|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00406037601|HYDROCODONE-ACETAMIN 5-300 MG|100|EA|.21242|09/05/2017||Yes|No||09/05/2017||Yes|No|09/05/2017||Yes|No||||No|No|||Prescription required|No||109|Yes|.19231|03/29/2022|.18769|03/29/2022|.18894|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3697|||||No|No||MALLINCKRODT PH|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00406037605|HYDROCODONE-ACETAMIN 5-300 MG|500|EA|.21242|09/05/2017||Yes|No||09/05/2017||Yes|No|09/05/2017||Yes|No||||No|No|||Prescription required|No||109|Yes|.19231|03/29/2022|.18769|03/29/2022|.18894|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3698|||||No|No||MALLINCKRODT PH|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00406037701|HYDROCODONE-ACETAMIN 7.5-300|100|EA|.21242|09/05/2017||Yes|No||09/05/2017||Yes|No|09/05/2017||Yes|No||||No|No|||Prescription required|No||109|Yes|.2429|03/29/2022|.23707|03/29/2022|.23864|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3699|||||No|No||MALLINCKRODT PH|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00406037705|HYDROCODONE-ACETAMIN 7.5-300|500|EA|.21242|09/05/2017||Yes|No||09/05/2017||Yes|No|09/05/2017||Yes|No||||No|No|||Prescription required|No||109|Yes|.2429|03/29/2022|.23707|03/29/2022|.23864|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3700|||||No|No||MALLINCKRODT PH|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00406037801|HYDROCODONE-ACETAMIN 10-300 MG|100|EA|.21242|09/05/2017||Yes|No||09/05/2017||Yes|No|09/05/2017||Yes|No||||No|No|||Prescription required|No||109|Yes|.34815|03/29/2022|.33979|03/29/2022|.34205|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3701|||||No|No||MALLINCKRODT PH|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00406037805|HYDROCODONE-ACETAMIN 10-300 MG|500|EA|.21242|09/05/2017||Yes|No||09/05/2017||Yes|No|09/05/2017||Yes|No||||No|No|||Prescription required|No||109|Yes|.34815|03/29/2022|.33979|03/29/2022|.34205|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3702|||||No|No||MALLINCKRODT PH|No||||
acetaminophen with codeine|No|No|No|No|90%|00406048301|ACETAMINOPHEN-COD #2 TABLET|100|EA|.05981|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.11854|03/29/2022|.11569|03/29/2022|.11646|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3703|||||No|No||MALLINCKRODT PH|No||||
acetaminophen with codeine|No|No|No|No|90%|00406048401|ACETAMINOPHEN-COD #3 TABLET|100|EA|.06235|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.10921|03/29/2022|.10658|03/29/2022|.10729|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3704|||||No|No||MALLINCKRODT PH|No||||
acetaminophen with codeine|No|No|No|No|90%|00406048410|ACETAMINOPHEN-COD #3 TABLET|1000|EA|.05921|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.10921|03/29/2022|.10658|03/29/2022|.10729|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3705|||||No|No||MALLINCKRODT PH|No||||
acetaminophen with codeine|No|No|No|No|90%|00406048462|ACETAMINOPHEN-COD #3 TABLET|100|EA|.05787|03/27/2002||Yes|No||03/27/2002||Yes|No|03/27/2002||Yes|No||03/27/2002||Yes|No|||Prescription required|No||109|Yes|.10921|03/29/2022|.10658|03/29/2022|.10729|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3706|||||No|No||MALLINCKRODT PH|No||||
acetaminophen with codeine|No|No|No|No|90%|00406048501|ACETAMINOPHEN-COD #4 TABLET|100|EA|.12418|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.22352|03/29/2022|.21815|03/29/2022|.2196|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3707|||||No|No||MALLINCKRODT PH|No||||
acetaminophen with codeine|No|No|No|No|90%|00406048505|ACETAMINOPHEN-COD #4 TABLET|500|EA|.11798|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.22352|03/29/2022|.21815|03/29/2022|.2196|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3708|||||No|No||MALLINCKRODT PH|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|00406051201|OXYCODONE-ACETAMINOPHEN 5-325|100|EA|.07671|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.09091|03/29/2022|.08872|03/29/2022|.08931|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3709|||||No|No||MALLINCKRODT PH|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|00406051205|OXYCODONE-ACETAMINOPHEN 5-325|500|EA|.07672|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.09091|03/29/2022|.08872|03/29/2022|.08931|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3710|||||No|No||MALLINCKRODT PH|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|00406052201|OXYCODONE-ACETAMINOPHN 7.5-325|100|EA|.21242|11/12/2004||Yes|No||11/12/2004||Yes|No|11/12/2004||Yes|No||11/12/2004||Yes|No|||Prescription required|No||109|Yes|.14032|03/29/2022|.13695|03/29/2022|.13786|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3711|||||No|No||MALLINCKRODT PH|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|00406052205|OXYCODONE-ACETAMINOPHN 7.5-325|500|EA|.21242|06/06/2016||Yes|No||06/06/2016||Yes|No|06/06/2016||Yes|No||||No|No|||Prescription required|No||109|Yes|.14032|03/29/2022|.13695|03/29/2022|.13786|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3712|||||No|No||MALLINCKRODT PH|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|00406052301|OXYCODONE-ACETAMINOPHEN 10-325|100|EA|.21242|11/12/2004||Yes|No||11/12/2004||Yes|No|11/12/2004||Yes|No||11/12/2004||Yes|No|||Prescription required|No||109|Yes|.19233|03/29/2022|.18771|03/29/2022|.18896|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3713|||||No|No||MALLINCKRODT PH|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|00406052305|OXYCODONE-ACETAMINOPHEN 10-325|500|EA|.21242|06/06/2016||Yes|No||06/06/2016||Yes|No|06/06/2016||Yes|No||||No|No|||Prescription required|No||109|Yes|.19233|03/29/2022|.18771|03/29/2022|.18896|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3714|||||No|No||MALLINCKRODT PH|No||||
methadone HCl|No|No|No|No|90%|00406052710|METHADOSE 10 MG/ML ORAL CONC|1000|ML|.03363|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/28/2017|110|Yes|.07665|06/01/2016|.07556|06/01/2016|.07196|06/01/2016|||ANALGESICS: NARCOTICS LONG|3715|||||No|No||MALLINCKRODT PH|No||||
methadone HCl|No|No|No|No|90%|00406054034|METHADOSE 40 MG TABLET DISPR|100|EA|.11051|04/02/2002||Yes|No||04/02/2002||Yes|No|04/02/2002||Yes|No||||No|No|||Prescription required|Yes|07/28/2017|110|Yes|.25186|06/01/2016|.24826|06/01/2016|.23644|06/01/2016|||ANALGESICS: NARCOTICS LONG|3716|||||No|No||MALLINCKRODT PH|No||||
oxycodone HCl|No|No|No|No|90%|00406055201|OXYCODONE HCL (IR) 5 MG TABLET|100|EA|.08587|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||109|Yes|.0685|03/29/2022|.06685|03/29/2022|.0673|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3717|||||No|No||MALLINCKRODT PH|No||||
methylphenidate HCl|No|No|No|No|75%|00406114201|METHYLPHENIDATE 5 MG TABLET|100|EA|.08471|08/11/2011||Yes|No||08/11/2011||Yes|No|08/11/2011||Yes|No||||No|No|||Prescription required|No||007|Yes|.1394|03/29/2022|.13605|03/29/2022|.13696|03/29/2022|||STIMULANTS AND RELATED AGENTS|3718|||||No|No||MALLINCKRODT PH|No||||
methylphenidate HCl|No|No|No|No|75%|00406114401|METHYLPHENIDATE 10 MG TABLET|100|EA|.12074|08/24/2011||Yes|No||08/24/2011||Yes|No|08/24/2011||Yes|No||||No|No|||Prescription required|No||007|Yes|.15766|03/29/2022|.15387|03/29/2022|.1549|03/29/2022|||STIMULANTS AND RELATED AGENTS|3719|||||No|No||MALLINCKRODT PH|No||||
methylphenidate HCl|No|No|No|No|75%|00406114601|METHYLPHENIDATE 20 MG TABLET|100|EA|.17341|08/24/2011||Yes|No||08/24/2011||Yes|No|08/24/2011||Yes|No||||No|No|||Prescription required|No||007|Yes|.22814|03/29/2022|.22266|03/29/2022|.22414|03/29/2022|||STIMULANTS AND RELATED AGENTS|3720|||||No|No||MALLINCKRODT PH|No||||
naltrexone HCl|No|No|No|No|75%|00406117001|NALTREXONE 50 MG TABLET|100|EA|.645|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||145|No|.75734|03/29/2022|.73916|03/29/2022|.74408|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|3721|||||No|No||MALLINCKRODT PH|Yes|09/01/2020|||
naltrexone HCl|No|No|No|No|75%|00406117003|NALTREXONE 50 MG TABLET|30|EA|.645|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||145|No|.75734|03/29/2022|.73916|03/29/2022|.74408|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|3722|||||No|No||MALLINCKRODT PH|Yes|09/01/2020|||
methylphenidate HCl|No|No|No|No|75%|00406144501|METHYLPHENIDATE ER 10 MG TAB|100|EA|.4515|08/24/2011||Yes|No||08/24/2011||Yes|No|08/24/2011||Yes|No||||No|No|||Prescription required|Yes|02/08/2018|007|Yes|.37583|03/29/2022|.36681|03/29/2022|.36925|03/29/2022|||STIMULANTS AND RELATED AGENTS|3723|||||No|No||MALLINCKRODT PH|No||||
methylphenidate HCl|No|No|No|No|75%|00406147301|METHYLPHENIDATE ER 20 MG TAB|100|EA|.4945|08/24/2011||Yes|No||08/24/2011||Yes|No|08/24/2011||Yes|No||||No|No|||Prescription required|Yes|02/08/2018|007|Yes|.50044|03/29/2022|.48842|03/29/2022|.49168|03/29/2022|||STIMULANTS AND RELATED AGENTS|3724|||||No|No||MALLINCKRODT PH|No||||
methylphenidate HCl|No|No|No|No|75%|00406181001|METHYLPHENIDATE ER(CD) 10MG CP|100|EA|1.2255|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|007|Yes|1.31759|03/29/2022|1.28596|03/29/2022|1.29453|03/29/2022|||STIMULANTS AND RELATED AGENTS|3725|||||No|No||MALLINCKRODT PH|No||||
methylphenidate HCl|No|No|No|No|75%|00406182001|METHYLPHENIDATE ER(CD) 20MG CP|100|EA|1.2255|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|007|Yes|1.42341|03/29/2022|1.38924|03/29/2022|1.3985|03/29/2022|||STIMULANTS AND RELATED AGENTS|3726|||||No|No||MALLINCKRODT PH|No||||
methylphenidate HCl|No|No|No|No|75%|00406183001|METHYLPHENIDATE ER(CD) 30MG CP|100|EA|1.2255|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|007|Yes|1.42159|03/29/2022|1.38747|03/29/2022|1.39671|03/29/2022|||STIMULANTS AND RELATED AGENTS|3727|||||No|No||MALLINCKRODT PH|No||||
methylphenidate HCl|No|No|No|No|75%|00406184001|METHYLPHENIDATE ER(CD) 40MG CP|100|EA|1.29|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|007|Yes|1.70323|03/29/2022|1.66235|03/29/2022|1.67342|03/29/2022|||STIMULANTS AND RELATED AGENTS|3728|||||No|No||MALLINCKRODT PH|No||||
methylphenidate HCl|No|No|No|No|75%|00406185001|METHYLPHENIDATE ER(CD) 50MG CP|100|EA|1.548|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|007|Yes|2.6246|01/25/2022|2.5616|01/25/2022|2.57866|01/25/2022|||STIMULANTS AND RELATED AGENTS|3729|||||No|No||MALLINCKRODT PH|No||||
methylphenidate HCl|No|No|No|No|75%|00406186001|METHYLPHENIDATE ER(CD) 60MG CP|100|EA|1.548|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|007|Yes|1.91295|03/08/2022|1.86703|03/08/2022|1.87947|03/08/2022|||STIMULANTS AND RELATED AGENTS|3730|||||No|No||MALLINCKRODT PH|No||||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00406192303|BUPRENORPHINE-NALOX 2-0.5MG TB|30|EA|2.00394|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|.72296|03/29/2022|.7056|03/29/2022|.7103|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|3731|||||No|No||MALLINCKRODT PH|Yes|09/01/2020|||
methadone HCl|No|No|No|No|90%|00406254001|METHADONE 40 MG TABLET DISPR|100|EA|.11352|08/31/2005||Yes|No||08/31/2005||Yes|No|08/31/2005||Yes|No||||No|No|||Prescription required|Yes|07/28/2017|110|Yes|.25872|06/01/2016|.25502|06/01/2016|.24288|06/01/2016|||ANALGESICS: NARCOTICS LONG|3732|||||No|No||MALLINCKRODT PH|No||||
hydromorphone HCl|No|No|No|No|90%|00406324301|HYDROMORPHONE 2 MG TABLET|100|EA|.0626|08/12/2009||Yes|No||08/12/2009||Yes|No|08/12/2009||Yes|No||||No|No|||Prescription required|No||109|Yes|.0744|03/29/2022|.07261|03/29/2022|.07309|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3733|||||No|No||MALLINCKRODT PH|No||||
hydromorphone HCl|No|No|No|No|90%|00406324401|HYDROMORPHONE 4 MG TABLET|100|EA|.07327|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||109|Yes|.09714|03/29/2022|.0948|03/29/2022|.09544|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3734|||||No|No||MALLINCKRODT PH|No||||
hydromorphone HCl|No|No|No|No|90%|00406324901|HYDROMORPHONE 8 MG TABLET|100|EA|.21242|06/26/2006||Yes|No||06/26/2006||Yes|No|06/26/2006||Yes|No||||No|No|||Prescription required|No||109|Yes|.27467|03/29/2022|.26807|03/29/2022|.26986|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3735|||||No|No||MALLINCKRODT PH|No||||
methadone HCl|No|No|No|No|90%|00406575501|METHADONE HCL 5 MG TABLET|100|EA|.09159|02/28/2005||Yes|No||02/28/2005||Yes|No|02/28/2005||Yes|No||||No|No|||Prescription required|Yes|07/28/2017|110|Yes|.12051|03/29/2022|.11761|03/29/2022|.1184|03/29/2022|||ANALGESICS: NARCOTICS LONG|3736|||||No|No||MALLINCKRODT PH|Yes|09/01/2020|||
methadone HCl|No|No|No|No|90%|00406577101|METHADONE HCL 10 MG TABLET|100|EA|.15209|02/28/2005||Yes|No||02/28/2005||Yes|No|02/28/2005||Yes|No||||No|No|||Prescription required|Yes|07/28/2017|110|Yes|.08598|03/29/2022|.08391|03/29/2022|.08447|03/29/2022|||ANALGESICS: NARCOTICS LONG|3737|||||No|No||MALLINCKRODT PH|No||||
morphine sulfate|No|No|No|No|90%|00406800312|MORPHINE SULF 100 MG/5 ML CONC|120|ML|.2408|06/25/2009||Yes|No||06/25/2009||Yes|No|06/25/2009||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|109|Yes|.27485|03/29/2022|.26825|03/29/2022|.27004|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3738|||||No|No||MALLINCKRODT PH|No||||
morphine sulfate|No|No|No|No|90%|00406800315|MORPHINE SULF 100 MG/5 ML CONC|15|ML|.258|06/25/2009||Yes|No||06/25/2009||Yes|No|06/25/2009||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|109|Yes|.40058|03/29/2022|.39096|03/29/2022|.39356|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3739|||||No|No||MALLINCKRODT PH|No||||
morphine sulfate|No|No|No|No|90%|00406800324|MORPHINE SULF 100 MG/5 ML CONC|240|ML|.17943|06/25/2009||Yes|No||06/25/2009||Yes|No|06/25/2009||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|109|Yes|.40894|06/01/2016|.4031|06/01/2016|.3839|06/01/2016|||ANALGESICS: NARCOTICS SHORT|3740|||||No|No||MALLINCKRODT PH|No||||
morphine sulfate|No|No|No|No|90%|00406800330|MORPHINE SULF 100 MG/5 ML CONC|30|ML|.2365|06/25/2009||Yes|No||06/25/2009||Yes|No|06/25/2009||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|109|Yes|.3028|03/29/2022|.29553|03/29/2022|.2975|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3741|||||No|No||MALLINCKRODT PH|No||||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00406800503|BUPRENORPHINE-NALOX 2-0.5MG TB|30|EA|.57333|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|.72296|03/29/2022|.7056|03/29/2022|.7103|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|3742|||||No|No||MALLINCKRODT PH|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00406802003|BUPRENORPHINE-NALOX 8-2 MG TAB|30|EA|.688|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|1.08568|03/29/2022|1.05962|03/29/2022|1.06668|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|3743|||||No|No||MALLINCKRODT PH|Yes|09/01/2020|||
morphine sulfate|No|No|No|No|90%|00406831501|MORPHINE SULF ER 15 MG TABLET|100|EA|.28822|08/13/2003||Yes|No||08/13/2003||Yes|No|08/13/2003||Yes|No||||No|No|||Prescription required|No||110|Yes|.19105|03/29/2022|.18646|03/29/2022|.1877|03/29/2022|||ANALGESICS: NARCOTICS LONG|3744|||||No|No||MALLINCKRODT PH|No||||
morphine sulfate|No|No|No|No|90%|00406832001|MORPHINE SULF ER 200 MG TABLET|100|EA|2.89777|08/13/2003||Yes|No||08/13/2003||Yes|No|08/13/2003||Yes|No||||No|No|||Prescription required|No||110|Yes|2.54414|07/27/2021|2.48308|07/27/2021|2.49961|07/27/2021|||ANALGESICS: NARCOTICS LONG|3745|||||No|No||MALLINCKRODT PH|No||||
morphine sulfate|No|No|No|No|90%|00406833001|MORPHINE SULF ER 30 MG TABLET|100|EA|.54769|08/13/2003||Yes|No||08/13/2003||Yes|No|08/13/2003||Yes|No||||No|No|||Prescription required|No||110|Yes|.34621|03/29/2022|.3379|03/29/2022|.34015|03/29/2022|||ANALGESICS: NARCOTICS LONG|3746|||||No|No||MALLINCKRODT PH|No||||
morphine sulfate|No|No|No|No|90%|00406838001|MORPHINE SULF ER 60 MG TABLET|100|EA|1.06872|08/13/2003||Yes|No||08/13/2003||Yes|No|08/13/2003||Yes|No||||No|No|||Prescription required|No||110|Yes|.55429|03/29/2022|.54098|03/29/2022|.54458|03/29/2022|||ANALGESICS: NARCOTICS LONG|3747|||||No|No||MALLINCKRODT PH|No||||
morphine sulfate|No|No|No|No|90%|00406839001|MORPHINE SULF ER 100 MG TABLET|100|EA|1.58231|08/13/2003||Yes|No||08/13/2003||Yes|No|08/13/2003||Yes|No||||No|No|||Prescription required|No||110|Yes|1.04927|03/29/2022|1.02408|03/29/2022|1.0309|03/29/2022|||ANALGESICS: NARCOTICS LONG|3748|||||No|No||MALLINCKRODT PH|No||||
oxycodone HCl|No|No|No|No|90%|00406851501|OXYCODONE HCL (IR) 15 MG TAB|100|EA|.13695|08/16/2004||Yes|No||08/16/2004||Yes|No|08/16/2004||Yes|No||||No|No|||Prescription required|No||109|Yes|.15895|03/29/2022|.15513|03/29/2022|.15616|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3749|||||No|No||MALLINCKRODT PH|No||||
oxycodone HCl|No|No|No|No|90%|00406851562|OXYCODONE HCL (IR) 15 MG TAB|100|EA|.42548|07/22/2015||Yes|No||07/22/2015||Yes|No|07/22/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.15895|03/29/2022|.15513|03/29/2022|.15616|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3750|||||No|No||MALLINCKRODT PH|No||||
oxycodone HCl|No|No|No|No|90%|00406853001|OXYCODONE HCL (IR) 30 MG TAB|100|EA|.21242|08/16/2004||Yes|No||08/16/2004||Yes|No|08/16/2004||Yes|No||||No|No|||Prescription required|No||109|Yes|.2615|03/29/2022|.25522|03/29/2022|.25692|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3751|||||No|No||MALLINCKRODT PH|No||||
oxycodone HCl|No|No|No|No|90%|00406853062|OXYCODONE HCL (IR) 30 MG TAB|100|EA|.66435|07/22/2015||Yes|No||07/22/2015||Yes|No|07/22/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.2615|03/29/2022|.25522|03/29/2022|.25692|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3752|||||No|No||MALLINCKRODT PH|No||||
oxycodone HCl|No|No|No|No|90%|00406855605|OXYCODONE HCL 5 MG/5 ML SOLN|500|ML|.05332|08/13/2019||Yes|No||08/13/2019||Yes|No|08/13/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.11792|03/29/2022|.11508|03/29/2022|.11585|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3753|||||No|No||MALLINCKRODT PH|No||||
oxycodone HCl|No|No|No|No|90%|00406855730|OXYCODONE HCL 100 MG/5 ML CONC|30|ML|1.57666|08/13/2019||Yes|No||08/13/2019||Yes|No|08/13/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|109|Yes|3.65933|03/29/2022|3.5715|03/29/2022|3.59529|03/29/2022|||ANALGESICS: NARCOTICS SHORT|3754|||||No|No||MALLINCKRODT PH|No||||
methadone HCl|No|No|No|No|90%|00406872510|METHADOSE 10 MG/ML ORAL CONC|1000|ML|.03363|05/28/2002||Yes|No||05/28/2002||Yes|No|05/28/2002||Yes|No||||No|No|||Prescription required|Yes|07/28/2017|110|Yes|.07665|06/01/2016|.07556|06/01/2016|.07196|06/01/2016|||ANALGESICS: NARCOTICS LONG|3755|||||No|No||MALLINCKRODT PH|No||||
clomipramine HCl|No|No|No|No|75%|00406880601|CLOMIPRAMINE 25 MG CAPSULE|100|EA|.645|08/06/2015||Yes|No||08/06/2015||Yes|No|08/06/2015||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|1.31238|03/29/2022|1.28088|03/29/2022|1.28941|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|3756|||||No|No||MALLINCKRODT PH|No||||
clomipramine HCl|No|No|No|No|75%|00406880701|CLOMIPRAMINE 50 MG CAPSULE|100|EA|.645|08/06/2015||Yes|No||08/06/2015||Yes|No|08/06/2015||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.80238|03/29/2022|.78312|03/29/2022|.78833|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|3757|||||No|No||MALLINCKRODT PH|No||||
clomipramine HCl|No|No|No|No|75%|00406880801|CLOMIPRAMINE 75 MG CAPSULE|100|EA|.645|08/06/2015||Yes|No||08/06/2015||Yes|No|08/06/2015||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.95054|03/29/2022|.92772|03/29/2022|.9339|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|3758|||||No|No||MALLINCKRODT PH|No||||
dextroamphetamine sulfate|No|No|No|No|75%|00406895801|DEXTROAMPHETAMINE 5 MG TAB|100|EA|.5934|02/16/2016||Yes|No||02/16/2016||Yes|No|02/16/2016||Yes|No||||No|No|||Prescription required|No||007|Yes|.24678|03/29/2022|.24085|03/29/2022|.24246|03/29/2022|||STIMULANTS AND RELATED AGENTS|3759|||||No|No||MALLINCKRODT PH|No||||
dextroamphetamine sulfate|No|No|No|No|75%|00406895901|DEXTROAMPHETAMINE 10 MG TAB|100|EA|.6106|02/16/2016||Yes|No||02/16/2016||Yes|No|02/16/2016||Yes|No||||No|No|||Prescription required|No||007|Yes|.30046|03/29/2022|.29324|03/29/2022|.2952|03/29/2022|||STIMULANTS AND RELATED AGENTS|3760|||||No|No||MALLINCKRODT PH|No||||
dextroamphetamine sulfate|No|No|No|No|75%|00406896001|DEXTROAMPHETAMINE ER 5 MG CAP|100|EA|1.25396|02/10/2016||Yes|No||02/10/2016||Yes|No|02/10/2016||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|007|Yes|1.09277|03/29/2022|1.06654|03/29/2022|1.07364|03/29/2022|||STIMULANTS AND RELATED AGENTS|3761|||||No|No||MALLINCKRODT PH|No||||
dextroamphetamine sulfate|No|No|No|No|75%|00406896101|DEXTROAMPHETAMINE ER 10 MG CAP|100|EA|1.5664|02/10/2016||Yes|No||02/10/2016||Yes|No|02/10/2016||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|007|Yes|1.19348|03/29/2022|1.16483|03/29/2022|1.17259|03/29/2022|||STIMULANTS AND RELATED AGENTS|3762|||||No|No||MALLINCKRODT PH|No||||
dextroamphetamine sulfate|No|No|No|No|75%|00406896201|DEXTROAMPHETAMINE ER 15 MG CAP|100|EA|1.9973|02/10/2016||Yes|No||02/10/2016||Yes|No|02/10/2016||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|007|Yes|1.81061|03/29/2022|1.76715|03/29/2022|1.77892|03/29/2022|||STIMULANTS AND RELATED AGENTS|3763|||||No|No||MALLINCKRODT PH|No||||
fentanyl|No|No|No|No|90%|00406900076|FENTANYL 100 MCG/HR PATCH|5|EA|11.84994|03/02/2011||Yes|No||03/02/2011||Yes|No|03/02/2011||Yes|No||||No|No|||Prescription required|No||110|Yes|9.14035|03/29/2022|8.92098|03/29/2022|8.98039|03/29/2022|||ANALGESICS: NARCOTICS LONG|3764|||||No|No||MALLINCKRODT PH|No||||
fentanyl|No|No|No|No|90%|00406901276|FENTANYL 12 MCG/HR PATCH|5|EA|6.98406|07/07/2015||Yes|No||07/07/2015||Yes|No|07/07/2015||Yes|No||||No|No|||Prescription required|No||110|Yes|8.30578|03/29/2022|8.10644|03/29/2022|8.16042|03/29/2022|||ANALGESICS: NARCOTICS LONG|3765|||||No|No||MALLINCKRODT PH|No||||
fentanyl|No|No|No|No|90%|00406902576|FENTANYL 25 MCG/HR PATCH|5|EA|3.0659|03/02/2011||Yes|No||03/02/2011||Yes|No|03/02/2011||Yes|No||||No|No|||Prescription required|No||110|Yes|3.10308|03/29/2022|3.0286|03/29/2022|3.04877|03/29/2022|||ANALGESICS: NARCOTICS LONG|3766|||||No|No||MALLINCKRODT PH|No||||
fentanyl|No|No|No|No|90%|00406905076|FENTANYL 50 MCG/HR PATCH|5|EA|5.44638|03/02/2011||Yes|No||03/02/2011||Yes|No|03/02/2011||Yes|No||||No|No|||Prescription required|No||110|Yes|5.19805|03/29/2022|5.07329|03/29/2022|5.10708|03/29/2022|||ANALGESICS: NARCOTICS LONG|3767|||||No|No||MALLINCKRODT PH|No||||
fentanyl|No|No|No|No|90%|00406907576|FENTANYL 75 MCG/HR PATCH|5|EA|8.6086|03/02/2011||Yes|No||03/02/2011||Yes|No|03/02/2011||Yes|No||||No|No|||Prescription required|No||110|Yes|7.86615|03/29/2022|7.67736|03/29/2022|7.72849|03/29/2022|||ANALGESICS: NARCOTICS LONG|3768|||||No|No||MALLINCKRODT PH|No||||
fentanyl citrate|No|No|No|No|90%|00406920230|FENTANYL CITRATE OTFC 200 MCG|30|EA|5.23955|03/26/2010||Yes|No||03/26/2010||Yes|No|03/26/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|109|Yes|11.9413|06/01/2016|11.77071|06/01/2016|11.2102|06/01/2016|||ANALGESICS: NARCOTICS SHORT|3769|||||No|No||MALLINCKRODT PH|No||||
fentanyl citrate|No|No|No|No|90%|00406920430|FENTANYL CITRATE OTFC 400 MCG|30|EA|6.63819|03/26/2010||Yes|No||03/26/2010||Yes|No|03/26/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|109|Yes|15.1289|05/23/2017|14.91277|05/23/2017|14.20264|05/23/2017|||ANALGESICS: NARCOTICS SHORT|3770|||||No|No||MALLINCKRODT PH|No||||
fentanyl citrate|No|No|No|No|90%|00406920630|FENTANYL CITRATE OTFC 600 MCG|30|EA|8.13072|03/26/2010||Yes|No||03/26/2010||Yes|No|03/26/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|109|Yes|18.53048|06/01/2016|18.26576|06/01/2016|17.39596|06/01/2016|||ANALGESICS: NARCOTICS SHORT|3771|||||No|No||MALLINCKRODT PH|No||||
fentanyl citrate|No|No|No|No|90%|00406920830|FENTANYL CITRATE OTFC 800 MCG|30|EA|9.63372|03/26/2010||Yes|No||03/26/2010||Yes|No|03/26/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|109|Yes|21.95592|11/28/2017|21.64226|11/28/2017|20.61168|11/28/2017|||ANALGESICS: NARCOTICS SHORT|3772|||||No|No||MALLINCKRODT PH|No||||
fentanyl citrate|No|No|No|No|90%|00406921230|FENTANYL CIT OTFC 1,200 MCG|30|EA|12.52489|03/26/2010||Yes|No||03/26/2010||Yes|No|03/26/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|109|Yes|28.5451|01/24/2017|28.13731|01/24/2017|26.79744|01/24/2017|||ANALGESICS: NARCOTICS SHORT|3773|||||No|No||MALLINCKRODT PH|No||||
fentanyl citrate|No|No|No|No|90%|00406921630|FENTANYL CIT OTFC 1,600 MCG|30|EA|15.44732|03/26/2010||Yes|No||03/26/2010||Yes|No|03/26/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|109|Yes|35.20552|06/01/2016|34.70258|06/01/2016|33.05008|06/01/2016|||ANALGESICS: NARCOTICS SHORT|3774|||||No|No||MALLINCKRODT PH|No||||
clomipramine HCl|No|No|No|No|75%|00406990603|ANAFRANIL 25 MG CAPSULE|30|EA|15.17914|09/07/2006||Yes|No||09/07/2006||Yes|No|09/07/2006||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|34.59432|03/07/2017|34.10011|03/07/2017|32.4763|03/07/2017|||ANTIDEPRESSANTS: TRICYCLIC|3775|||||No|No||MALLINCKRODT PH|No||||
clomipramine HCl|No|No|No|No|75%|00406990703|ANAFRANIL 50 MG CAPSULE|30|EA|15.46552|09/07/2006||Yes|No||09/07/2006||Yes|No|09/07/2006||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|35.247|03/07/2017|34.74347|03/07/2017|33.08902|03/07/2017|||ANTIDEPRESSANTS: TRICYCLIC|3776|||||No|No||MALLINCKRODT PH|No||||
clomipramine HCl|No|No|No|No|75%|00406990803|ANAFRANIL 75 MG CAPSULE|30|EA|15.75176|09/07/2006||Yes|No||09/07/2006||Yes|No|09/07/2006||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|35.89936|03/07/2017|35.38651|03/07/2017|33.70144|03/07/2017|||ANTIDEPRESSANTS: TRICYCLIC|3777|||||No|No||MALLINCKRODT PH|No||||
nortriptyline HCl|No|No|No|No|75%|00406991003|PAMELOR 10 MG CAPSULE|30|EA|16.89713|02/11/2008||Yes|No||02/11/2008||Yes|No|02/11/2008||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|38.50974|03/07/2017|37.9596|03/07/2017|36.152|03/07/2017|||ANTIDEPRESSANTS: TRICYCLIC|3778|||||No|No||MALLINCKRODT PH|No||||
nortriptyline HCl|No|No|No|No|75%|00406991103|PAMELOR 25 MG CAPSULE|30|EA|17.23497|02/11/2008||Yes|No||02/11/2008||Yes|No|02/11/2008||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|39.2797|03/07/2017|38.71856|03/07/2017|36.87482|03/07/2017|||ANTIDEPRESSANTS: TRICYCLIC|3779|||||No|No||MALLINCKRODT PH|No||||
nortriptyline HCl|No|No|No|No|75%|00406991203|PAMELOR 50 MG CAPSULE|30|EA|17.57309|02/11/2008||Yes|No||02/11/2008||Yes|No|02/11/2008||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|40.0503|03/07/2017|39.47815|03/07/2017|37.59824|03/07/2017|||ANTIDEPRESSANTS: TRICYCLIC|3780|||||No|No||MALLINCKRODT PH|No||||
nortriptyline HCl|No|No|No|No|75%|00406991303|PAMELOR 75 MG CAPSULE|30|EA|17.91107|10/21/2008||Yes|No||10/21/2008||Yes|No|10/21/2008||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|40.82058|03/07/2017|40.23743|03/07/2017|38.32136|03/07/2017|||ANTIDEPRESSANTS: TRICYCLIC|3781|||||No|No||MALLINCKRODT PH|No||||
temazepam|No|No|No|No|90%|00406991403|RESTORIL 22.5 MG CAPSULE|30|EA|13.805|01/20/2005||Yes|No||01/20/2005||Yes|No|01/20/2005||Yes|No||||No|No|||Prescription required|Yes|06/09/2004|054|Yes|31.46256|03/14/2017|31.0131|03/14/2017|29.53628|03/14/2017|||SEDATIVE HYPNOTICS|3782|||||No|No||MALLINCKRODT PH|No||||
temazepam|No|No|No|No|90%|00406991501|RESTORIL 7.5 MG CAPSULE|100|EA|12.68637|08/02/2002||Yes|No||08/02/2002||Yes|No|08/02/2002||Yes|No||||No|No|||Prescription required|Yes|06/09/2004|054|Yes|28.91313|03/07/2017|28.50009|03/07/2017|27.14294|03/07/2017|||SEDATIVE HYPNOTICS|3783|||||No|No||MALLINCKRODT PH|No||||
temazepam|No|No|No|No|90%|00406991503|RESTORIL 7.5 MG CAPSULE|30|EA|12.68629|02/09/2009||Yes|No||02/09/2009||Yes|No|02/09/2009||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|054|Yes|28.91294|03/07/2017|28.49989|03/07/2017|27.14276|03/07/2017|||SEDATIVE HYPNOTICS|3784|||||No|No||MALLINCKRODT PH|No||||
temazepam|No|No|No|No|90%|00406991601|RESTORIL 15 MG CAPSULE|100|EA|13.42524|12/18/2002||Yes|No||12/18/2002||Yes|No|12/18/2002||Yes|No||||No|No|||Prescription required|Yes|06/09/2004|054|Yes|30.59707|03/14/2017|30.15996|03/14/2017|28.72378|03/14/2017|||SEDATIVE HYPNOTICS|3785|||||No|No||MALLINCKRODT PH|No||||
temazepam|No|No|No|No|90%|00406991701|RESTORIL 30 MG CAPSULE|100|EA|14.19219|04/23/2002||Yes|No||04/23/2002||Yes|No|04/23/2002||Yes|No||||No|No|||Prescription required|Yes|06/09/2004|054|Yes|32.34499|03/07/2017|31.88292|03/07/2017|30.36469|03/07/2017|||SEDATIVE HYPNOTICS|3786|||||No|No||MALLINCKRODT PH|No||||
temazepam|No|No|No|No|90%|00406995903|TEMAZEPAM 22.5 MG CAPSULE|30|EA|.93166|07/09/2008||Yes|No||07/09/2008||Yes|No|07/09/2008||Yes|No||||No|No|||Prescription required|Yes|07/28/2010|054|Yes|2.70743|03/29/2022|2.64245|03/29/2022|2.66004|03/29/2022|||SEDATIVE HYPNOTICS|3787|||||No|No||MALLINCKRODT PH|No||||
temazepam|No|No|No|No|90%|00406996001|TEMAZEPAM 7.5 MG CAPSULE|100|EA|1.1438|03/11/2009||Yes|No||03/11/2009||Yes|No|03/11/2009||Yes|No||||No|No|||Prescription required|Yes|07/28/2010|054|Yes|1.39989|03/29/2022|1.36629|03/29/2022|1.37539|03/29/2022|||SEDATIVE HYPNOTICS|3788|||||No|No||MALLINCKRODT PH|No||||
morphine sulfate|No|No|No|No|90%|00409113403|MORPHINE SULFATE 50 MG/ML VIAL|20|ML|.27649|09/07/2015||Yes|No||09/07/2015||Yes|No|||No|No||||No|No|||Prescription required|No|||Yes|.63014|01/04/2022|.62113|01/04/2022|.59156|01/04/2022||||3789|||||No|No||HOSPIRA/PFIZER|No||||
morphine sulfate|No|No|No|No|90%|00409113405|MORPHINE SULFATE 50 MG/ML VIAL|50|ML|.23486|09/07/2015||Yes|No||09/07/2015||Yes|No|||No|No||||No|No|||Prescription required|No|||Yes|.53527|01/04/2022|.52762|01/04/2022|.5025|01/04/2022||||3790|||||No|No||HOSPIRA/PFIZER|No||||
meperidine HCl|No|No|No|No|90%|00409118130|DEMEROL 50 MG/ML VIAL|30|ML|1.16472|09/25/2006||Yes|No||09/25/2006||Yes|No|09/25/2006||Yes|No||||No|No|||Prescription required|No|||Yes|2.65448|01/04/2022|2.61656|01/04/2022|2.49196|01/04/2022||||3791|||||No|No||HOSPIRA/PFIZER|No||||
gentamicin sulfate|No|No|No|No|75%|00409120703|GENTAMICIN 80 MG/2 ML VIAL|2|ML|.24226|10/07/2005||Yes|No||10/07/2005||Yes|No|||No|No||||No|No|||Prescription required|No|||No|.69103|08/24/2021|.67444|08/24/2021|.67893|08/24/2021||||3792|||||No|No||HOSPIRA/PFIZER|No||||
naloxone HCl|No|No|No|No|75%|00409121501|NALOXONE 0.4 MG/ML VIAL|1|ML|6.8069|03/26/2015||Yes|No||03/26/2015||Yes|No|03/26/2015||Yes|No||||No|No|||Prescription required|No||145|No|15.5134|03/29/2022|15.29178|03/29/2022|14.5636|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|3793|||||No|Yes|12.56|HOSPIRA/PFIZER|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|00409121521|NALOXONE 0.4 MG/ML VIAL|1|ML|6.8069|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|||||||15.5134|10/01/2020|OPIATE DEPENDENCE TREATMENTS|3794|||||No|No||HOSPIRA/PFIZER|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|00409121525|NALOXONE 0.4 MG/ML VIAL|1|ML|6.7037|03/26/2015||Yes|No||03/26/2015||Yes|No|03/26/2015||Yes|No||||No|No|||Prescription required|No||145|No|15.2782|12/14/2021|15.05994|12/14/2021|14.3428|12/14/2021|||OPIATE DEPENDENCE TREATMENTS|3795|||||No|Yes|12.56|HOSPIRA-NOVAPLU|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|00409121901|NALOXONE 4 MG/10 ML VIAL|10|ML|5.10582|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|11.63652|10/01/2020|11.47028|10/01/2020|10.92408|10/01/2020|||OPIATE DEPENDENCE TREATMENTS|3796|||||No|No||HOSPIRA/PFIZER|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|00409121925|NALOXONE 4 MG/10 ML VIAL|10|ML|5.02928|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|11.46208|12/14/2021|11.29833|12/14/2021|10.76032|12/14/2021|||OPIATE DEPENDENCE TREATMENTS|3797|||||No|No||HOSPIRA-NOVAPLU|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|00409121930|NALOXONE 4 MG/10 ML VIAL|10|ML|4.945|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|||||||||OPIATE DEPENDENCE TREATMENTS|3798|||||No|No||HOSPIRA-NOVAPLU|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|00409121941|NALOXONE 4 MG/10 ML VIAL|10|ML|4.945|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|||||||||OPIATE DEPENDENCE TREATMENTS|3799|||||No|No||HOSPIRA/PFIZER|Yes|09/01/2020|||
nalbuphine HCl|No|No|No|No|90%|00409146301|NALBUPHINE 10 MG/ML AMPUL|1|ML|1.58068|05/10/2005||Yes|No||05/10/2005||Yes|No|05/10/2005||Yes|No||||No|No|||Prescription required|No|||Yes|3.60248|01/04/2022|3.55101|01/04/2022|3.38192|01/04/2022||||3800|||||No|No||HOSPIRA/PFIZER|No||||
nalbuphine HCl|No|No|No|No|90%|00409146701|NALBUPHINE 200 MG/10 ML VIAL|10|ML|2.27753|10/11/2005||Yes|No||10/11/2005||Yes|No|||No|No||||No|No|||Prescription required|No|||Yes|5.19066|01/04/2022|5.11651|01/04/2022|4.87287|01/04/2022||||3801|||||No|No||HOSPIRA/PFIZER|No||||
naloxone HCl|No|No|No|No|75%|00409178203|NALOXONE 0.4 MG/ML CARPUJECT|1|ML|6.6392|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|||||||15.1312|10/01/2020|OPIATE DEPENDENCE TREATMENTS|3802|||||No|No||HOSPIRA/PFIZER|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|00409178269|NALOXONE 0.4 MG/ML CARPUJECT|1|ML|6.6392|03/26/2015||Yes|No||03/26/2015||Yes|No|03/26/2015||Yes|No||||No|No|||Prescription required|No||145|No|15.1312|12/26/2017|14.91504|12/26/2017|14.2048|12/26/2017|||OPIATE DEPENDENCE TREATMENTS|3803|||||No|Yes|12.56|HOSPIRA/PFIZER|Yes|09/01/2020|||
morphine sulfate|No|No|No|No|90%|00409189001|MORPHINE 2 MG/ML CARPUJECT|1|ML|.91547|11/12/2012||Yes|No||11/12/2012||Yes|No|11/12/2012||Yes|No||||No|No|||Prescription required|No|||Yes|2.08642|01/04/2022|2.05661|01/04/2022|1.95868|01/04/2022||||3804|||||No|No||HOSPIRA/PFIZER|No||||
morphine sulfate|No|No|No|No|90%|00409189101|MORPHINE 4 MG/ML CARPUJECT|1|ML|.83678|11/12/2012||Yes|No||11/12/2012||Yes|No|11/12/2012||Yes|No||||No|No|||Prescription required|No|||Yes|1.90708|01/04/2022|1.87983|01/04/2022|1.79032|01/04/2022||||3805|||||No|No||HOSPIRA/PFIZER|No||||
morphine sulfate|No|No|No|No|90%|00409189201|MORPHINE 8 MG/ML CARPUJECT|1|ML|.82044|03/06/2013||Yes|No||03/05/2013||Yes|No|03/05/2013||Yes|No||||No|No|||Prescription required|No|||Yes|1.86984|01/04/2022|1.84312|01/04/2022|1.75536|01/04/2022||||3806|||||No|No||HOSPIRA/PFIZER|No||||
morphine sulfate|No|No|No|No|90%|00409189301|MORPHINE 10 MG/ML CARPUJECT|1|ML|.82044|11/12/2012||Yes|No||11/12/2012||Yes|No|11/12/2012||Yes|No||||No|No|||Prescription required|No|||Yes|1.86984|01/04/2022|1.84312|01/04/2022|1.75536|01/04/2022||||3807|||||No|No||HOSPIRA/PFIZER|No||||
bacteriostatic sodium chloride|No|No|No|No|75%|00409196607|BACTERIOSTATIC SALINE VIAL|30|ML|.01615|05/04/2005||Yes|Yes||05/04/2005||Yes|Yes|05/04/2005||Yes|Yes||||No|No|||Prescription required|No|||No|.0368|01/04/2022|.03628|01/04/2022|.03455|01/04/2022||||3808|||||No|No||HOSPIRA/PFIZER|No||||
deferoxamine mesylate|No|No|No|No|75%|00409233725|DEFEROXAMINE 2 GRAM VIAL|1|EA|13.78365|10/12/2005||Yes|No||10/12/2005||Yes|No|||No|No||||No|No|||Prescription required|No|||No|31.4139|01/04/2022|30.96513|01/04/2022|29.4906|01/04/2022||||3809|||||No|No||HOSPIRA/PFIZER|No||||
dobutamine HCl|No|No|No|No|75%|00409234401|DOBUTAMINE 250 MG/20 ML VIAL|20|ML|.12857|08/31/2010||Yes|No||08/31/2010||Yes|No|08/31/2010||Yes|No||||No|No|||Prescription required|No|||No|.29302|01/04/2022|.28883|01/04/2022|.27508|01/04/2022||||3810|||||No|No||HOSPIRA/PFIZER|No||||
dobutamine HCl|No|No|No|No|75%|00409234402|DOBUTAMINE 250 MG/20 ML VIAL|20|ML|.1211|08/31/2010||Yes|No||08/31/2010||Yes|No|08/31/2010||Yes|No||||No|No|||Prescription required|No|||No|.27601|01/04/2022|.27207|01/04/2022|.25911|01/04/2022||||3811|||||No|No||HOSPIRA/PFIZER|No||||
milrinone lactate/D5W|No|No|No|No|75%|00409277602|MILRINONE-D5W 40 MG/200 ML|200|ML|.06891|11/30/2011||Yes|No||11/30/2011||Yes|No|11/30/2011||Yes|No||||No|No|||Prescription required|No|||No|.15706|01/04/2022|.15482|01/04/2022|.14744|01/04/2022||||3812|||||No|No||HOSPIRA/PFIZER|No||||
milrinone lactate/D5W|No|No|No|No|75%|00409277623|MILRINONE-D5W 20 MG/100 ML|100|ML|.06892|11/30/2011||Yes|No||11/30/2011||Yes|No|11/30/2011||Yes|No||||No|No|||Prescription required|No|||No|.15707|01/04/2022|.15483|01/04/2022|.14745|01/04/2022||||3813|||||No|No||HOSPIRA/PFIZER|No||||
diazepam|No|No|No|No|75%|00409321312|DIAZEPAM 50 MG/10 ML VIAL|10|ML|1.74175|06/06/2013||Yes|No||06/06/2013||Yes|No|06/06/2013||Yes|No||||No|No|||Prescription required|No|||Yes|3.96958|01/04/2022|3.91287|01/04/2022|3.72655|01/04/2022||||3814|||||No|No||HOSPIRA/PFIZER|No||||
acetylcysteine|No|No|No|No|75%|00409330703|ACETYLCYSTEINE 10% VIAL|30|ML|.16578|08/23/2011||Yes|No||08/23/2011||Yes|No|08/23/2011||Yes|No||||No|No|||Prescription required|No|||No|.44878|05/25/2021|.438|05/25/2021|.44092|05/25/2021||||3815|||||No|No||HOSPIRA/PFIZER|No||||
acetylcysteine|No|No|No|No|75%|00409330803|ACETYLCYSTEINE 20% VIAL|30|ML|.15546|08/23/2011||Yes|No||08/23/2011||Yes|No|08/23/2011||Yes|No||||No|No|||Prescription required|No|||No|.36236|07/27/2021|.35366|07/27/2021|.35601|07/27/2021||||3816|||||No|No||HOSPIRA/PFIZER|No||||
piperacillin sodium/tazobactam|No|No|No|No|75%|00409338302|PIPERACIL-TAZOBACT 2.25 GM VL|1|EA|2.9971|08/25/2011||Yes|No||08/25/2011||Yes|No|08/25/2011||Yes|No||||No|No|||Prescription required|No|||No|6.8306|01/04/2022|6.73302|01/04/2022|6.4124|01/04/2022||||3817|||||No|No||HOSPIRA/PFIZER|No||||
piperacillin sodium/tazobactam|No|No|No|No|75%|00409338513|PIPERACIL-TAZOBACT 3.375 GM VL|1|EA|4.49651|08/25/2011||Yes|No||08/25/2011||Yes|No|08/25/2011||Yes|No||||No|No|||Prescription required|No|||No|10.24786|01/04/2022|10.10146|01/04/2022|9.62044|01/04/2022||||3818|||||No|No||HOSPIRA/PFIZER|No||||
piperacillin sodium/tazobactam|No|No|No|No|75%|00409339004|PIPERACIL-TAZOBACT 4.5 GM VIAL|1|EA|5.99463|08/25/2011||Yes|No||08/25/2011||Yes|No|08/25/2011||Yes|No||||No|No|||Prescription required|No|||No|13.66218|01/04/2022|13.467|01/04/2022|12.82572|01/04/2022||||3819|||||No|No||HOSPIRA/PFIZER|No||||
tobramycin sulfate|No|No|No|No|75%|00409357801|TOBRAMYCIN 80 MG/2 ML VIAL|2|ML|.53027|10/06/2005||Yes|No||10/06/2005||Yes|No|||No|No||||No|No|||Prescription required|No|||No|.84952|08/24/2021|.82913|08/24/2021|.83465|08/24/2021||||3820|||||No|No||HOSPIRA/PFIZER|No||||
ketorolac tromethamine|No|No|No|No|75%|00409379601|KETOROLAC 60 MG/2 ML VIAL|2|ML|.68266|10/21/2009||Yes|No||10/21/2009||Yes|No|10/21/2009||Yes|No||||No|No|||Prescription required|No|||Yes|.93756|03/29/2022|.91505|03/29/2022|.92115|03/29/2022||||3821|||||No|No||HOSPIRA/PFIZER|No||||
water for inj.,bacteriostatic|No|No|No|No|75%|00409397703|BACTERIOSTATIC WATER VIAL|30|ML|.02136|10/12/2005||Yes|No||10/12/2005||Yes|No|||No|No||||No|No|||Prescription required|No|||No|.04869|01/04/2022|.048|01/04/2022|.04571|01/04/2022||||3822|||||No|No||HOSPIRA/PFIZER|No||||
lidocaine HCl|No|No|No|No|75%|00409427601|LIDOCAINE HCL 1% VIAL|20|ML|.03099|10/11/2005||Yes|No||10/11/2005||Yes|No|||No|No||||No|No|||Prescription required|No|||No|.06061|06/29/2021|.05915|06/29/2021|.05954|06/29/2021||||3823|||||No|No||HOSPIRA/PFIZER|No||||
lidocaine HCl/PF|No|No|No|No|75%|00409427902|LIDOCAINE HCL 1% VIAL|30|ML|.04266|10/11/2005||Yes|No||10/11/2005||Yes|No|||No|No||||No|No|||Prescription required|No|||No|.09723|01/04/2022|.09584|01/04/2022|.09128|01/04/2022||||3824|||||No|No||HOSPIRA/PFIZER|No||||
vancomycin HCl|No|No|No|No|75%|00409433201|VANCOMYCIN 500 MG VIAL|1|EA|3.50923|05/21/2014||Yes|No||05/21/2014||Yes|No|05/21/2014||Yes|No||||No|No|||Prescription required|No|||No|7.99778|01/04/2022|7.88352|01/04/2022|7.50812|01/04/2022||||3825|||||No|No||HOSPIRA/PFIZER|No||||
ciprofloxacin in 5 % dextrose|No|No|No|No|75%|00409477702|CIPROFLOXACIN 400 MG/200ML-D5W|200|ML|.00643|10/14/2011||Yes|No||10/14/2011||Yes|No|10/14/2011||Yes|No||||No|No|||Prescription required|No|||No|.01467|01/04/2022|.01446|01/04/2022|.01377|01/04/2022||||3826|||||No|No||HOSPIRA/PFIZER|No||||
ciprofloxacin in 5 % dextrose|No|No|No|No|75%|00409477723|CIPROFLOXACIN 200 MG/100ML-D5W|100|ML|.01043|10/14/2011||Yes|No||10/14/2011||Yes|No|10/14/2011||Yes|No||||No|No|||Prescription required|No|||No|.02377|01/04/2022|.02343|01/04/2022|.02231|01/04/2022||||3827|||||No|No||HOSPIRA/PFIZER|No||||
water for injection,sterile|No|No|No|No|75%|00409488720|WATER FOR INJECTION VIAL|20|ML|.02804|10/23/2006||Yes|No||10/23/2006||Yes|No|||No|No||||No|No|||Prescription required|No|||No|.06391|01/04/2022|.063|01/04/2022|.06|01/04/2022||||3828|||||No|No||HOSPIRA/PFIZER|No||||
water for injection,sterile|No|No|No|No|75%|00409488750|WATER FOR INJECTION VIAL|50|ML|.02042|10/06/2005||Yes|No||10/06/2005||Yes|No|||No|No||||No|No|||Prescription required|No|||No|.04655|01/04/2022|.04589|01/04/2022|.0437|01/04/2022||||3829|||||No|No||HOSPIRA/PFIZER|No||||
0.9 % sodium chloride|No|No|No|No|75%|00409488810|SODIUM CHLORIDE 0.9% VIAL|10|ML|.03971|03/28/2008||Yes|No||03/28/2008||Yes|No|03/28/2008||Yes|No||||No|No|||Prescription required|No|||No|.06721|01/25/2022|.06559|01/25/2022|.06603|01/25/2022||||3830|||||No|No||HOSPIRA/PFIZER|No||||
0.9 % sodium chloride|No|No|No|No|75%|00409488820|SODIUM CHLORIDE 0.9% VIAL|20|ML|.0275|03/28/2008||Yes|No||03/28/2008||Yes|No|03/28/2008||Yes|No||||No|No|||Prescription required|No|||No|.06268|01/04/2022|.06178|01/04/2022|.05884|01/04/2022||||3831|||||No|No||HOSPIRA/PFIZER|No||||
ceftazidime|No|No|No|No|75%|00409508216|TAZICEF 1 GRAM VIAL|1|EA|1.83334|10/23/2006||Yes|No||10/23/2006||Yes|No|10/23/2006||Yes|No||||No|No|||Prescription required|No|||No|4.17832|01/04/2022|4.11863|01/04/2022|3.92251|01/04/2022||||3832|||||No|No||HOSPIRA/PFIZER|No||||
ceftazidime|No|No|No|No|75%|00409508411|TAZICEF 2 GRAM VIAL|1|EA|4.10736|10/23/2006||Yes|No||10/23/2006||Yes|No|10/23/2006||Yes|No||||No|No|||Prescription required|No|||No|9.36096|01/04/2022|9.22723|01/04/2022|8.78784|01/04/2022||||3833|||||No|No||HOSPIRA/PFIZER|No||||
ceftazidime|No|No|No|No|75%|00409508611|TAZICEF 6 GRAM VIAL|1|EA|13.14252|10/23/2006||Yes|No||10/23/2006||Yes|No|10/23/2006||Yes|No||||No|No|||Prescription required|No|||No|29.95272|01/04/2022|29.52482|01/04/2022|28.11888|01/04/2022||||3834|||||No|No||HOSPIRA/PFIZER|No||||
aminophylline|No|No|No|No|75%|00409592201|AMINOPHYLLINE 500 MG/20 ML VL|20|ML|.19027|10/12/2005||Yes|No||10/12/2005||Yes|No|||No|No||||No|No|||Prescription required|No|||Yes|.43365|01/04/2022|.42745|01/04/2022|.4071|01/04/2022||||3835|||||No|No||HOSPIRA/PFIZER|No||||
furosemide|No|No|No|No|75%|00409610204|FUROSEMIDE 40 MG/4 ML VIAL|4|ML|.31536|10/24/2006||Yes|No||10/24/2006||Yes|No|||No|No||||No|No|||Prescription required|No|||No|.71873|01/04/2022|.70846|01/04/2022|.67472|01/04/2022||||3836|||||No|No||HOSPIRA/PFIZER|No||||
erythromycin lactobionate|No|No|No|No|75%|00409647644|ERYTHROCIN 500 MG ADDVAN VIAL|1|EA|36.35005|10/24/2006||Yes|No||10/24/2006||Yes|No|10/24/2006||Yes|No||||No|No|||Prescription required|No|||No|82.8443|01/04/2022|81.66081|01/04/2022|77.7722|01/04/2022||||3837|||||No|No||HOSPIRA/PFIZER|No||||
erythromycin lactobionate|No|No|No|No|75%|00409648201|ERYTHROCIN LACT 500 MG VIAL|1|EA|35.52746|10/06/2005||Yes|No||10/06/2005||Yes|No|||No|No||||No|No|||Prescription required|No|||No|80.96956|01/04/2022|79.81285|01/04/2022|76.01224|01/04/2022||||3838|||||No|No||HOSPIRA/PFIZER|No||||
vancomycin HCl|No|No|No|No|75%|00409650901|VANCOMYCIN HCL 5 GM VIAL|1|EA|38.8118|10/24/2008||Yes|No||10/24/2008||Yes|No|10/24/2008||Yes|No||||No|No|||Prescription required|No|||No|88.4548|01/04/2022|87.19116|01/04/2022|83.0392|01/04/2022||||3839|||||No|No||HOSPIRA/PFIZER|No||||
vancomycin HCl|No|No|No|No|75%|00409653101|VANCOMYCIN 750 MG ADD-VAN VIAL|1|EA|4.78805|05/21/2014||Yes|No||05/21/2014||Yes|No|05/21/2014||Yes|No||||No|No|||Prescription required|No|||No|10.9123|01/04/2022|10.75641|01/04/2022|10.2442|01/04/2022||||3840|||||No|No||HOSPIRA/PFIZER|No||||
vancomycin HCl|No|No|No|No|75%|00409653102|VANCOMYCIN HCL 750 MG VIAL|1|EA|4.22905|08/25/2011||Yes|No||08/25/2011||Yes|No|08/25/2011||Yes|No||||No|No|||Prescription required|No|||No|9.6383|01/04/2022|9.50061|01/04/2022|9.0482|01/04/2022||||3841|||||No|No||HOSPIRA/PFIZER|No||||
vancomycin HCl|No|No|No|No|75%|00409653301|VANCOMYCIN 1 GM VIAL|1|EA|6.9316|10/24/2006|02/22/2022|Yes|No||10/24/2006|02/22/2022|Yes|No|||No|No||||No|No|||Prescription required|No|||No|15.7976|02/23/2021|15.57192|02/23/2021|14.8304|02/23/2021||||3842|No Longer Rebatable|No Longer Rebatable|||No|No||HOSPIRA/PFIZER|No||||
vancomycin HCl|No|No|No|No|75%|00409653401|VANCOMYCIN 500 MG ADD-VAN VIAL|1|EA|4.6655|10/06/2005||Yes|No||10/06/2005||Yes|No|||No|No||||No|No|||Prescription required|No|||No|10.633|01/04/2022|10.4811|01/04/2022|9.982|01/04/2022||||3843|||||No|No||HOSPIRA/PFIZER|No||||
vancomycin HCl|No|No|No|No|75%|00409653501|VANCOMYCIN 1 GM ADD-VAN VIAL|1|EA|9.01323|10/12/2005||Yes|No||10/12/2005||Yes|No|||No|No||||No|No|||Prescription required|No|||No|20.54178|01/04/2022|20.24832|01/04/2022|19.28412|01/04/2022||||3844|||||No|No||HOSPIRA/PFIZER|No||||
sodium bicarbonate|No|No|No|No|75%|00409662502|SODIUM BICARBONATE 8.4% VIAL|50|ML|.08374|09/07/2015|10/25/2022|Yes|No||09/07/2015|10/25/2022|Yes|No|09/07/2015|10/25/2022|Yes|No||||No|No|||Prescription required|No|||No|.19086|06/29/2021|.18813|06/29/2021|.17917|06/29/2021||||3845|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||HOSPIRA/PFIZER|No||||
sodium bicarbonate|No|No|No|No|75%|00409662514|SODIUM BICARBONATE 8.4% VIAL|50|ML|.08458|06/15/2021||Yes|No||06/15/2021||Yes|No|06/15/2021||Yes|No||||No|No|||Prescription required|No|||No|.19277|01/04/2022|.19002|01/04/2022|.18097|01/04/2022||||3846|||||No|No||HOSPIRA/PFIZER|No||||
potassium chloride|No|No|No|No|75%|00409665106|POTASSIUM CL 20 MEQ/10 ML CONC|10|ML|.14183|10/24/2006||Yes|No||10/24/2006||Yes|No|10/24/2006||Yes|No||||No|No|||Prescription required|No|||No|.32324|01/04/2022|.31862|01/04/2022|.30345|01/04/2022||||3847|||||No|No||HOSPIRA/PFIZER|No||||
potassium chloride|No|No|No|No|75%|00409665305|POTASSIUM CL 40 MEQ/20 ML CONC|20|ML|.0986|04/21/2010||Yes|No||04/21/2010||Yes|No|||No|No||||No|No|||Prescription required|No|||No|.22473|01/04/2022|.22152|01/04/2022|.21097|01/04/2022||||3848|||||No|No||HOSPIRA/PFIZER|No||||
lorazepam|No|No|No|No|90%|00409677802|LORAZEPAM 2 MG/ML VIAL|1|ML|.73315|10/12/2006||Yes|No||10/12/2006||Yes|No|10/12/2006||Yes|No||||No|No|||Prescription required|No|||Yes|1.6709|01/04/2022|1.64703|01/04/2022|1.5686|01/04/2022||||3849|||||No|No||HOSPIRA/PFIZER|No||||
lorazepam|No|No|No|No|90%|00409678002|LORAZEPAM 20 MG/10 ML VIAL|10|ML|.32237|10/24/2006|02/22/2022|Yes|No||10/24/2006|02/22/2022|Yes|No|10/24/2006|02/22/2022|Yes|No||||No|No|||Prescription required|No|||Yes|.7347|01/05/2021|.72421|01/05/2021|.68972|01/05/2021||||3850|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||HOSPIRA/PFIZER|No||||
dextrose 5 % in water|No|No|No|No|75%|00409710002|DEXTROSE 5%-WATER IV SOLN|250|ML|.00621|10/12/2005||Yes|No||10/12/2005||Yes|No|||No|No||||No|No|||Prescription required|No|||No|.01417|01/04/2022|.01396|01/04/2022|.0133|01/04/2022||||3851|||||No|No||HOSPIRA/PFIZER|No||||
dextrose 5 % in water|No|No|No|No|75%|00409710067|DEXTROSE 5%-WATER IV SOLN|100|ML|.01171|10/12/2005||Yes|No||10/12/2005||Yes|No|||No|No||||No|No|||Prescription required|No|||No|.0267|01/04/2022|.02632|01/04/2022|.02507|01/04/2022||||3852|||||No|No||HOSPIRA/PFIZER|No||||
0.9 % sodium chloride|No|No|No|No|75%|00409710102|SODIUM CHLORIDE 0.9% SOLN|250|ML|.00625|10/12/2005||Yes|No||10/12/2005||Yes|No|||No|No||||No|No|||Prescription required|No|||No|.01425|01/04/2022|.01405|01/04/2022|.01338|01/04/2022||||3853|||||No|No||HOSPIRA/PFIZER|No||||
ceftriaxone sodium|No|No|No|No|75%|00409733201|CEFTRIAXONE 1 GM VIAL|1|EA|.65489|03/31/2009||Yes|No||03/31/2009||Yes|No|03/31/2009||Yes|No||||No|No|||Prescription required|No|||No|1.6715|03/29/2022|1.63138|03/29/2022|1.64224|03/29/2022||||3854|||||No|No||HOSPIRA/PFIZER|No||||
ceftriaxone sodium|No|No|No|No|75%|00409733410|CEFTRIAXONE 10 GM VIAL|1|EA|7.4476|09/22/2005||Yes|No||09/22/2005||Yes|No|09/22/2005||Yes|No||||No|No|||Prescription required|No|||No|16.9736|01/04/2022|16.73112|01/04/2022|15.9344|01/04/2022||||3855|||||No|No||HOSPIRA/PFIZER|No||||
ceftriaxone sodium|No|No|No|No|75%|00409733503|CEFTRIAXONE 2 GM VIAL|1|EA|1.24399|03/31/2009||Yes|No||03/31/2009||Yes|No|03/31/2009||Yes|No||||No|No|||Prescription required|No|||No|2.83514|01/04/2022|2.79463|01/04/2022|2.66156|01/04/2022||||3856|||||No|No||HOSPIRA/PFIZER|No||||
ceftriaxone sodium|Yes|No|No|No|75%|00409733701|CEFTRIAXONE 250 MG VIAL|1|EA|.32766|10/13/2005||Yes|No||10/13/2005||Yes|No|10/13/2005||Yes|No||||No|No|11/01/2012||Prescription required|No|||No|.74676|01/04/2022|.73609|01/04/2022|.70104|01/04/2022||||3857|||||No|No||HOSPIRA/PFIZER|No||||
ceftriaxone sodium|Yes|No|No|No|75%|00409733801|CEFTRIAXONE 500 MG VIAL|1|EA|.41495|10/13/2005||Yes|No||10/13/2005||Yes|No|10/13/2005||Yes|No||||No|No|03/10/2021||Prescription required|No|||No|1.2765|03/29/2022|1.24586|03/29/2022|1.25416|03/29/2022||||3858|||||No|No||HOSPIRA/PFIZER|No||||
phytonadione (vit K1)|No|No|No|No|75%|00409915801|VITAMIN K-1  10 MG/ML AMPUL|1|ML|21.05589|10/12/2005||Yes|No||10/12/2005||Yes|No|||No|No||||No|No|||Prescription required|No|||No|47.98785|01/04/2022|47.30231|01/04/2022|45.04982|01/04/2022||||3859|||||No|No||HOSPIRA/PFIZER|No||||
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|00430000531|ESTROSTEP FE-28 TABLET|28|EA|2.8921|05/14/2015|03/31/2022|Yes|No||05/14/2015|03/31/2022|Yes|No|05/14/2015|03/31/2022|Yes|No|Refer to program requirements|||No|No|05/14/2015|03/31/2022|Prescription required|No|||No|6.59131|01/09/2018|6.49715|01/09/2018|6.18776|01/09/2018||||3860|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ACTAVIS/ALLERGA|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|00430042014|LO LOESTRIN FE 1-10 TABLET|28|EA|2.50167|01/20/2011||Yes|No||01/20/2011||Yes|No|01/30/2015||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|5.58406|02/08/2022|5.45004|02/08/2022|5.48633|02/08/2022||||3861|||||No|No||ACTAVIS/ALLERGA|No|||Only covered for non-contraceptive (medical) purposes|
risedronate sodium|No|No|No|No|75%|00430047203|ACTONEL 35 MG TABLET|4|EA|36.65535|11/17/2011||Yes|No||11/17/2011||Yes|No|11/17/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|060|No|83.5401|08/24/2021|82.34667|08/24/2021|78.4254|08/24/2021|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|3862|||||No|No||ACTAVIS/ALLERGA|No||||
risedronate sodium|No|No|No|No|75%|00430047801|ACTONEL 150 MG TABLET|1|EA|158.8119|11/17/2011||Yes|No||11/17/2011||Yes|No|11/17/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|060|No|361.9434|01/28/2020|356.77278|01/28/2020|339.7836|01/28/2020|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|3863|||||No|No||ACTAVIS/ALLERGA|No||||
risedronate sodium|No|No|No|No|75%|00430047802|ACTONEL 150 MG TABLET|3|EA|158.81333|10/31/2011||Yes|No||10/31/2011||Yes|No|10/31/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|060|No|361.94666|01/28/2020|356.77599|01/28/2020|339.78666|01/28/2020|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|3864|||||No|No||ACTAVIS/ALLERGA|No||||
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|00430054050|MINASTRIN 24 FE CHEWABLE TAB|28|EA|2.72782|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No|Refer to program requirements|||No|No|05/12/2015||Prescription required|No|||No|6.2169|10/26/2021|6.12809|10/26/2021|5.83627|10/26/2021||||3865|||||No|No||ACTAVIS/ALLERGA|No|||Only covered for non-contraceptive (medical) purposes|
estradiol|No|No|No|No|75%|00430072024|ESTRACE 0.5 MG TABLET|100|EA|2.34393|05/18/2006||Yes|No||05/18/2006||Yes|No|05/18/2006||Yes|No||||No|No|||Prescription required|No|||Yes|5.34198|01/28/2020|5.26566|01/28/2020|5.01492|01/28/2020||||3866|||||No|No||ACTAVIS/ALLERGA|No||||
estradiol|No|No|No|No|75%|00430072124|ESTRACE 1 MG TABLET|100|EA|2.34393|06/18/2007||Yes|No||06/18/2007||Yes|No|06/18/2007||Yes|No||||No|No|||Prescription required|No|||Yes|5.34198|01/28/2020|5.26566|01/28/2020|5.01492|01/28/2020||||3867|||||No|No||ACTAVIS/ALLERGA|No||||
estradiol|No|No|No|No|75%|00430072224|ESTRACE 2 MG TABLET|100|EA|3.00866|02/23/2007||Yes|No||02/23/2007||Yes|No|02/23/2007||Yes|No||||No|No|||Prescription required|No|||Yes|6.85696|01/28/2020|6.759|01/28/2020|6.43714|01/28/2020||||3868|||||No|No||ACTAVIS/ALLERGA|No||||
risedronate sodium|No|No|No|No|75%|00430097903|ATELVIA DR 35 MG TABLET|4|EA|28.6552|01/27/2011||Yes|No||01/27/2011||Yes|No|01/27/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|060|No|65.3072|01/28/2020|64.37424|01/28/2020|61.3088|01/28/2020|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|3869|||||No|No||ACTAVIS/ALLERGA|No||||
estradiol|No|No|No|No|75%|00430375414|ESTRACE 0.01% CREAM|42.5|GM|3.48836|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|7.81572|06/29/2021|7.62814|06/29/2021|7.67894|06/29/2021||||3870|||||No|No||ACTAVIS/ALLERGA|No||||
ceftaroline fosamil acetate|No|No|No|No|75%|00456040010|TEFLARO 400 MG VIAL|1|EA|95.63372|03/02/2011||Yes|No||03/02/2011||Yes|No|03/02/2011||Yes|No||||No|No|||Prescription required|No|||No|217.95592|02/01/2022|214.84226|02/01/2022|204.61168|02/01/2022||||3871|||||No|No||ALLERGAN INC.|No||||
thyroid,pork|No|No|No|No|75%|00456045701|ARMOUR THYROID 15 MG TABLET|100|EA|.31974|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|.71212|02/08/2022|.69502|02/08/2022|.69965|02/08/2022||||3872|||||No|No||FOREST/ALLERGAN|No||||
thyroid,pork|No|No|No|No|75%|00456045801|ARMOUR THYROID 30 MG TABLET|100|EA|.37543|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|.83787|02/08/2022|.81776|02/08/2022|.8232|02/08/2022||||3873|||||No|No||FOREST/ALLERGAN|No||||
thyroid,pork|No|No|No|No|75%|00456045901|ARMOUR THYROID 60 MG TABLET|100|EA|.4171|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|.93012|02/08/2022|.90779|02/08/2022|.91384|02/08/2022||||3874|||||No|No||FOREST/ALLERGAN|No||||
thyroid,pork|No|No|No|No|75%|00456046001|ARMOUR THYROID 90 MG TABLET|100|EA|.65342|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|1.45786|02/08/2022|1.42287|02/08/2022|1.43234|02/08/2022||||3875|||||No|No||FOREST/ALLERGAN|No||||
thyroid,pork|No|No|No|No|75%|00456046101|ARMOUR THYROID 120 MG TABLET|100|EA|.76471|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|1.70351|02/08/2022|1.66262|02/08/2022|1.67369|02/08/2022||||3876|||||No|No||FOREST/ALLERGAN|No||||
thyroid,pork|No|No|No|No|75%|00456046201|ARMOUR THYROID 180 MG TABLET|100|EA|.57237|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|1.27889|02/08/2022|1.24819|02/08/2022|1.2565|02/08/2022||||3877|||||No|No||FOREST/ALLERGAN|No||||
thyroid,pork|No|No|No|No|75%|00456046301|ARMOUR THYROID 240 MG TABLET|100|EA|.69496|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|1.54251|02/08/2022|1.50548|02/08/2022|1.51551|02/08/2022||||3878|||||No|No||FOREST/ALLERGAN|No||||
thyroid,pork|No|No|No|No|75%|00456046401|ARMOUR THYROID 300 MG TABLET|100|EA|.81755|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|1.81294|02/08/2022|1.76942|02/08/2022|1.78121|02/08/2022||||3879|||||No|No||FOREST/ALLERGAN|No||||
ceftaroline fosamil acetate|No|No|No|No|75%|00456060010|TEFLARO 600 MG VIAL|1|EA|95.63372|03/02/2011||Yes|No||03/02/2011||Yes|No|03/02/2011||Yes|No||||No|No|||Prescription required|No|||No|217.95592|02/01/2022|214.84226|02/01/2022|204.61168|02/01/2022||||3880|||||No|No||ALLERGAN INC.|No||||
vilazodone HCl|No|No|No|No|75%|00456111030|VIIBRYD 10 MG TABLET|30|EA|4.51715|06/03/2011||Yes|No||06/03/2011||Yes|No|06/03/2011||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|031|No|10.07013|02/08/2022|9.82844|02/08/2022|9.8939|02/08/2022|||ANTIDEPRESSANTS: OTHER|3881|||||No|No||ALLERGAN INC.|No||||
vilazodone HCl|No|No|No|No|75%|00456112030|VIIBRYD 20 MG TABLET|30|EA|4.51715|06/03/2011||Yes|No||06/03/2011||Yes|No|06/03/2011||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|031|No|10.07991|02/08/2022|9.83799|02/08/2022|9.90351|02/08/2022|||ANTIDEPRESSANTS: OTHER|3882|||||No|No||ALLERGAN INC.|No||||
vilazodone HCl|No|No|No|No|75%|00456114030|VIIBRYD 40 MG TABLET|30|EA|4.51715|06/03/2011||Yes|No||06/03/2011||Yes|No|06/03/2011||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|031|No|10.08857|02/08/2022|9.84644|02/08/2022|9.91202|02/08/2022|||ANTIDEPRESSANTS: OTHER|3883|||||No|No||ALLERGAN INC.|No||||
linaclotide|No|No|No|No|75%|00456120130|LINZESS 145 MCG CAPSULE|30|EA|7.03236|12/03/2012||Yes|No||12/03/2012||Yes|No|12/03/2012||Yes|No||||No|No|||Prescription required|No||534|Yes|15.70923|02/08/2022|15.3322|02/08/2022|15.43431|02/08/2022|||GI MOTILITY: CHRONIC|3884|||||No|No||ALLERGAN INC.|No||||
linaclotide|No|No|No|No|75%|00456120230|LINZESS 290 MCG CAPSULE|30|EA|7.03236|12/03/2012||Yes|No||12/03/2012||Yes|No|12/03/2012||Yes|No||||No|No|||Prescription required|No||534|Yes|15.69154|02/08/2022|15.31494|02/08/2022|15.41693|02/08/2022|||GI MOTILITY: CHRONIC|3885|||||No|No||ALLERGAN INC.|No||||
linaclotide|No|No|No|No|75%|00456120330|LINZESS 72 MCG CAPSULE|30|EA|7.03236|05/01/2017||Yes|No||05/01/2017||Yes|No|05/01/2017||Yes|No||||No|No|||Prescription required|No||534|Yes|15.69667|02/08/2022|15.31994|02/08/2022|15.42197|02/08/2022|||GI MOTILITY: CHRONIC|3886|||||No|No||ALLERGAN INC.|No||||
memantine HCl/donepezil HCl|No|No|No|No|75%|00456120730|NAMZARIC 7 MG-10 MG CAPSULE|30|EA|7.67664|12/28/2016||Yes|No||12/28/2016||Yes|No|12/28/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|011|No|17.14592|02/08/2022|16.73441|02/08/2022|16.84586|02/08/2022|||ALZHEIMER'S AGENTS|3887|||||No|No||ALLERGAN INC.|No||||
memantine HCl/donepezil HCl|No|No|No|No|75%|00456121430|NAMZARIC 14 MG-10 MG CAPSULE|30|EA|7.67664|05/07/2015||Yes|No||05/07/2015||Yes|No|05/07/2015||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|011|No|17.175|02/08/2022|16.7628|02/08/2022|16.87443|02/08/2022|||ALZHEIMER'S AGENTS|3888|||||No|No||ALLERGAN INC.|No||||
memantine HCl/donepezil HCl|No|No|No|No|75%|00456122130|NAMZARIC 21 MG-10 MG CAPSULE|30|EA|7.67664|12/28/2016||Yes|No||12/28/2016||Yes|No|12/28/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|011|No|17.14196|02/08/2022|16.73055|02/08/2022|16.84197|02/08/2022|||ALZHEIMER'S AGENTS|3889|||||No|No||ALLERGAN INC.|No||||
memantine HCl/donepezil HCl|No|No|No|No|75%|00456122830|NAMZARIC 28 MG-10 MG CAPSULE|30|EA|7.67664|05/07/2015||Yes|No||05/07/2015||Yes|No|05/07/2015||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|011|No|17.18783|02/08/2022|16.77532|02/08/2022|16.88704|02/08/2022|||ALZHEIMER'S AGENTS|3890|||||No|No||ALLERGAN INC.|No||||
memantine HCl/donepezil HCl|No|No|No|No|75%|00456122929|NAMZARIC TITRATION PACK|28|EA|7.67657|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|011|No|17.49545|02/01/2022|17.24551|02/01/2022|16.4243|02/01/2022|||ALZHEIMER'S AGENTS|3891|||||No|No||ALLERGAN INC.|No||||
nebivolol HCl|No|No|No|No|75%|00456140230|BYSTOLIC 2.5 MG TABLET|30|EA|2.37675|01/24/2008||Yes|No||01/24/2008||Yes|No|01/24/2008||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|070|No|5.30529|02/08/2022|5.17796|02/08/2022|5.21244|02/08/2022|||BETA-BLOCKERS|3892|||||No|No||FOREST/ALLERGAN|No||||
nebivolol HCl|No|No|No|No|75%|00456140530|BYSTOLIC 5 MG TABLET|30|EA|2.37675|01/24/2008||Yes|No||01/24/2008||Yes|No|01/24/2008||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|070|No|5.29978|02/08/2022|5.17258|02/08/2022|5.20703|02/08/2022|||BETA-BLOCKERS|3893|||||No|No||FOREST/ALLERGAN|No||||
nebivolol HCl|No|No|No|No|75%|00456140563|BYSTOLIC 5 MG TABLET|100|EA|2.42184|01/24/2008|08/31/2023|Yes|No||01/24/2008|08/31/2023|Yes|No|01/24/2008|08/31/2023|Yes|No||||No|No|||Prescription required|Yes|07/26/2012|070|No|5.29978|02/08/2022|5.17258|02/08/2022|5.20703|02/08/2022|||BETA-BLOCKERS|3894|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||FOREST/ALLERGAN|No||||
nebivolol HCl|No|No|No|No|75%|00456140590|BYSTOLIC 5 MG TABLET|90|EA|2.3767|05/14/2015||Yes|No||05/14/2015||Yes|No|05/14/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|070|No|5.29978|02/08/2022|5.17258|02/08/2022|5.20703|02/08/2022|||BETA-BLOCKERS|3895|||||No|No||FOREST/ALLERGAN|No||||
nebivolol HCl|No|No|No|No|75%|00456141030|BYSTOLIC 10 MG TABLET|30|EA|2.37675|01/24/2008||Yes|No||01/24/2008||Yes|No|01/24/2008||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|070|No|5.30307|02/08/2022|5.17579|02/08/2022|5.21026|02/08/2022|||BETA-BLOCKERS|3896|||||No|No||FOREST/ALLERGAN|No||||
nebivolol HCl|No|No|No|No|75%|00456141090|BYSTOLIC 10 MG TABLET|90|EA|2.3767|05/14/2015||Yes|No||05/14/2015||Yes|No|05/14/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|070|No|5.30307|02/08/2022|5.17579|02/08/2022|5.21026|02/08/2022|||BETA-BLOCKERS|3897|||||No|No||FOREST/ALLERGAN|No||||
nebivolol HCl|No|No|No|No|75%|00456142030|BYSTOLIC 20 MG TABLET|30|EA|2.37675|03/31/2010||Yes|No||03/31/2010||Yes|No|03/31/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|070|No|5.30783|02/08/2022|5.18044|02/08/2022|5.21494|02/08/2022|||BETA-BLOCKERS|3898|||||No|No||FOREST/ALLERGAN|No||||
milnacipran HCl|No|No|No|No|75%|00456150055|SAVELLA TITRATION PACK|55|EA|3.16862|06/18/2009||Yes|No||06/18/2009||Yes|No|06/18/2009||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|232|No|7.04249|02/08/2022|6.87347|02/08/2022|6.91924|02/08/2022|||NEUROPATHIC PAIN|3899|||||No|No||ALLERGAN INC.|No||||
milnacipran HCl|No|No|No|No|75%|00456151060|SAVELLA 100 MG TABLET|60|EA|3.16859|06/18/2009||Yes|No||06/18/2009||Yes|No|06/18/2009||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|232|No|7.06911|02/08/2022|6.89945|02/08/2022|6.9454|02/08/2022|||NEUROPATHIC PAIN|3900|||||No|No||ALLERGAN INC.|No||||
milnacipran HCl|No|No|No|No|75%|00456151260|SAVELLA 12.5 MG TABLET|60|EA|3.16859|06/18/2009||Yes|No||06/18/2009||Yes|No|06/18/2009||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|232|No|7.00635|02/08/2022|6.83819|02/08/2022|6.88373|02/08/2022|||NEUROPATHIC PAIN|3901|||||No|No||ALLERGAN INC.|No||||
milnacipran HCl|No|No|No|No|75%|00456152560|SAVELLA 25 MG TABLET|60|EA|3.16859|06/18/2009||Yes|No||06/18/2009||Yes|No|06/18/2009||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|232|No|7.08106|02/08/2022|6.91111|02/08/2022|6.95714|02/08/2022|||NEUROPATHIC PAIN|3902|||||No|No||ALLERGAN INC.|No||||
milnacipran HCl|No|No|No|No|75%|00456155060|SAVELLA 50 MG TABLET|60|EA|3.16859|06/18/2009||Yes|No||06/18/2009||Yes|No|06/18/2009||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|232|No|7.06693|02/08/2022|6.89732|02/08/2022|6.94325|02/08/2022|||NEUROPATHIC PAIN|3903|||||No|No||ALLERGAN INC.|No||||
escitalopram oxalate|No|No|No|No|75%|00456200501|LEXAPRO 5 MG TABLET|100|EA|5.4625|02/05/2004||Yes|No||02/05/2004||Yes|No|02/05/2004||Yes|No||||No|No|||Prescription required|Yes|09/17/2013|008|Yes|12.39297|02/08/2022|12.09553|02/08/2022|12.17609|02/08/2022|||ANTIDEPRESSANTS: SSRIs|3904|||||No|No||FOREST/ALLERGAN|No||||
escitalopram oxalate|No|No|No|No|75%|00456201001|LEXAPRO 10 MG TABLET|100|EA|5.7113|09/06/2002||Yes|No||09/06/2002||Yes|No|09/06/2002||Yes|No||||No|No|||Prescription required|Yes|09/17/2013|008|Yes|12.68383|02/08/2022|12.37941|02/08/2022|12.46186|02/08/2022|||ANTIDEPRESSANTS: SSRIs|3905|||||No|No||FOREST/ALLERGAN|No||||
escitalopram oxalate|No|No|No|No|75%|00456202001|LEXAPRO 20 MG TABLET|100|EA|5.95975|09/06/2002||Yes|No||09/06/2002||Yes|No|09/06/2002||Yes|No||||No|No|||Prescription required|Yes|09/17/2013|008|No|13.3107|02/08/2022|12.99124|02/08/2022|13.07776|02/08/2022|||ANTIDEPRESSANTS: SSRIs|3906|||||No|No||FOREST/ALLERGAN|No||||
levomilnacipran HCl|No|No|No|No|75%|00456220228|FETZIMA 20-40 MG TITRATION PAK|28|EA|6.51772|11/08/2013||Yes|No||11/08/2013||Yes|No|11/08/2013||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|031|No|14.6273|02/08/2022|14.27624|02/08/2022|14.37132|02/08/2022|||ANTIDEPRESSANTS: OTHER|3907|||||No|No||FOREST/ALLERGAN|No||||
levomilnacipran HCl|No|No|No|No|75%|00456221230|FETZIMA ER 120 MG CAPSULE|30|EA|6.51751|11/08/2013||Yes|No||11/08/2013||Yes|No|11/08/2013||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|031|No|14.5552|02/08/2022|14.20587|02/08/2022|14.30048|02/08/2022|||ANTIDEPRESSANTS: OTHER|3908|||||No|No||FOREST/ALLERGAN|No||||
levomilnacipran HCl|No|No|No|No|75%|00456222030|FETZIMA ER 20 MG CAPSULE|30|EA|6.51751|11/08/2013||Yes|No||11/08/2013||Yes|No|11/08/2013||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|031|No|14.4556|02/08/2022|14.10866|02/08/2022|14.20262|02/08/2022|||ANTIDEPRESSANTS: OTHER|3909|||||No|No||FOREST/ALLERGAN|No||||
levomilnacipran HCl|No|No|No|No|75%|00456224030|FETZIMA ER 40 MG CAPSULE|30|EA|6.51751|11/08/2013||Yes|No||11/08/2013||Yes|No|11/08/2013||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|031|No|14.49791|02/08/2022|14.14996|02/08/2022|14.24419|02/08/2022|||ANTIDEPRESSANTS: OTHER|3910|||||No|No||FOREST/ALLERGAN|No||||
levomilnacipran HCl|No|No|No|No|75%|00456228030|FETZIMA ER 80 MG CAPSULE|30|EA|6.51751|11/08/2013||Yes|No||11/08/2013||Yes|No|11/08/2013||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|031|No|14.52081|02/08/2022|14.17231|02/08/2022|14.26669|02/08/2022|||ANTIDEPRESSANTS: OTHER|3911|||||No|No||FOREST/ALLERGAN|No||||
asenapine maleate|No|No|No|No|75%|00456240260|SAPHRIS 2.5 MG TAB SUBLINGUAL|60|EA|8.6058|05/07/2015||Yes|No||05/07/2015||Yes|No|05/07/2015||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|027|Yes|19.227|03/29/2022|18.76555|03/29/2022|18.89052|03/29/2022|||ANTIPSYCHOTICS|3912|||||No|No||FOREST/ALLERGAN|No||||
asenapine maleate|No|No|No|No|75%|00456240560|SAPHRIS 5 MG TAB SUBLINGUAL|60|EA|8.6058|12/22/2014||Yes|No||12/22/2014||Yes|No|12/22/2014||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|027|Yes|19.1429|03/01/2022|18.68347|03/01/2022|18.80789|03/01/2022|||ANTIPSYCHOTICS|3913|||||No|No||FOREST/ALLERGAN|No||||
asenapine maleate|No|No|No|No|75%|00456241060|SAPHRIS 10 MG TAB SUBLINGUAL|60|EA|8.6058|12/22/2014||Yes|No||12/22/2014||Yes|No|12/22/2014||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|027|Yes|19.20123|12/28/2021|18.7404|12/28/2021|18.8652|12/28/2021|||ANTIPSYCHOTICS|3914|||||No|No||FOREST/ALLERGAN|No||||
memantine HCl|No|No|No|No|75%|00456320014|NAMENDA 5-10 MG TITRATION PK|49|EA|3.18664|08/16/2015||Yes|No||08/17/2015||Yes|No|08/16/2015||Yes|No||||No|No|||Prescription required|Yes|10/01/2015|011|No|7.26259|01/29/2019|7.15884|01/29/2019|6.81794|01/29/2019|||ALZHEIMER'S AGENTS|3915|||||No|No||FOREST/ALLERGAN|No||||
memantine HCl|No|No|No|No|75%|00456320560|NAMENDA 5 MG TABLET|60|EA|3.18737|08/16/2015|02/29/2024|Yes|No||08/16/2015|02/29/2024|Yes|No|08/16/2015|02/29/2024|Yes|No||||No|No|||Prescription required|Yes|10/01/2015|011|No|7.26425|01/29/2019|7.16047|01/29/2019|6.8195|01/29/2019|||ALZHEIMER'S AGENTS|3916|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||FOREST/ALLERGAN|No||||
memantine HCl|No|No|No|No|75%|00456321060|NAMENDA 10 MG TABLET|60|EA|3.18737|08/16/2015|01/31/2024|Yes|No||08/16/2015|01/31/2024|Yes|No|08/16/2015|01/31/2024|Yes|No||||No|No|||Prescription required|Yes|10/01/2015|011|No|7.26425|01/29/2019|7.16047|01/29/2019|6.8195|01/29/2019|||ALZHEIMER'S AGENTS|3917|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||FOREST/ALLERGAN|No||||
memantine HCl|No|No|No|No|75%|00456340733|NAMENDA XR 7 MG CAPSULE|30|EA|6.6617|05/13/2013||Yes|No||05/13/2013||Yes|No|05/13/2013||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|011|No|15.18248|01/28/2020|14.96559|01/28/2020|14.25294|01/28/2020|||ALZHEIMER'S AGENTS|3918|||||No|No||FOREST/ALLERGAN|No||||
memantine HCl|No|No|No|No|75%|00456341433|NAMENDA XR 14 MG CAPSULE|30|EA|6.6617|05/13/2013||Yes|No||05/13/2013||Yes|No|05/13/2013||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|011|No|15.18248|01/28/2020|14.96559|01/28/2020|14.25294|01/28/2020|||ALZHEIMER'S AGENTS|3919|||||No|No||FOREST/ALLERGAN|No||||
memantine HCl|No|No|No|No|75%|00456341490|NAMENDA XR 14 MG CAPSULE|90|EA|6.66174|05/13/2013||Yes|No||05/13/2013||Yes|No|05/13/2013||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|011|No|15.18259|01/28/2020|14.96569|01/28/2020|14.25304|01/28/2020|||ALZHEIMER'S AGENTS|3920|||||No|No||FOREST/ALLERGAN|No||||
memantine HCl|No|No|No|No|75%|00456342133|NAMENDA XR 21 MG CAPSULE|30|EA|6.6617|05/13/2013||Yes|No||05/13/2013||Yes|No|05/13/2013||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|011|No|15.18248|01/28/2020|14.96559|01/28/2020|14.25294|01/28/2020|||ALZHEIMER'S AGENTS|3921|||||No|No||FOREST/ALLERGAN|No||||
memantine HCl|No|No|No|No|75%|00456342833|NAMENDA XR 28 MG CAPSULE|30|EA|6.6617|05/13/2013||Yes|No||05/13/2013||Yes|No|05/13/2013||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|011|No|15.18248|10/26/2021|14.96559|10/26/2021|14.25294|10/26/2021|||ALZHEIMER'S AGENTS|3922|||||No|No||FOREST/ALLERGAN|No||||
memantine HCl|No|No|No|No|75%|00456342890|NAMENDA XR 28 MG CAPSULE|90|EA|6.66174|05/13/2013||Yes|No||05/13/2013||Yes|No|05/13/2013||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|011|No|15.18259|10/26/2021|14.96569|10/26/2021|14.25304|10/26/2021|||ALZHEIMER'S AGENTS|3923|||||No|No||FOREST/ALLERGAN|No||||
citalopram hydrobromide|No|No|No|No|75%|00456401001|CELEXA 10 MG TABLET|100|EA|3.90315|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|008|Yes|8.89555|01/28/2020|8.76847|01/28/2020|8.35093|01/28/2020|||ANTIDEPRESSANTS: SSRIs|3924|||||No|No||FOREST/ALLERGAN|No||||
citalopram hydrobromide|No|No|No|No|75%|00456402001|CELEXA 20 MG TABLET|100|EA|4.06823|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|008|Yes|9.27178|01/28/2020|9.13932|01/28/2020|8.70412|01/28/2020|||ANTIDEPRESSANTS: SSRIs|3925|||||No|No||FOREST/ALLERGAN|No||||
citalopram hydrobromide|No|No|No|No|75%|00456404001|CELEXA 40 MG TABLET|100|EA|4.24534|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|008|No|9.67544|01/28/2020|9.53722|01/28/2020|9.08306|01/28/2020|||ANTIDEPRESSANTS: SSRIs|3926|||||No|No||FOREST/ALLERGAN|No||||
fosfomycin tromethamine|No|No|No|No|75%|00456430001|MONUROL 3 GM SACHET|1|EA|39.2461|05/14/2015||Yes|No||05/14/2015||Yes|No|05/14/2015||Yes|No||||No|No|||Prescription required|No|||No|87.345|08/24/2021|85.24872|08/24/2021|85.81646|08/24/2021||||3927|||||No|No||ALLERGAN INC.|No||||
enzalutamide|No|No|No|No|75%|00469012599|XTANDI 40 MG CAPSULE|120|EA|46.58322|06/24/2013||Yes|No||06/24/2013||Yes|No|06/24/2013||Yes|No||||No|No|||Prescription required|No||550|No|106.16641|01/18/2022|104.64975|01/18/2022|99.66643|01/18/2022|||ONCOLOGY: ORAL - PROSTATE|3928|||||No|No||ASTELLAS PHARMA|No||||
isavuconazonium sulfate|No|No|No|No|75%|00469042099|CRESEMBA 372 MG VIAL|1|EA|147.9286|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|No|||No|337.1396|01/18/2022|332.32332|01/18/2022|316.4984|01/18/2022||||3929|||||No|No||ASTELLAS PHARMA|No||||
isavuconazonium sulfate|No|No|No|No|75%|00469052014|CRESEMBA 186 MG CAPSULE|14|EA|43.41587|07/13/2016||Yes|No||07/13/2016||Yes|No|07/13/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|069|No|96.88836|01/25/2022|94.56303|01/25/2022|95.19281|01/25/2022|||ANTIFUNGALS: ORAL|3930|||||No|No||ASTELLAS PHARMA|No||||
tacrolimus|No|No|No|No|75%|00469060773|PROGRAF 0.5 MG CAPSULE|100|EA|1.4147|03/20/2002||Yes|No||03/20/2002||Yes|No|03/20/2002||Yes|No||03/20/2002||Yes|No|||Prescription required|Yes|01/27/2022|229|No|3.17025|01/25/2022|3.09416|01/25/2022|3.11477|01/25/2022|||IMMUNOSUPPRESSIVES: ORAL|3931|||||No|No||ASTELLAS PHARMA|No||||
tacrolimus|No|No|No|No|75%|00469061773|PROGRAF 1 MG CAPSULE|100|EA|2.8294|12/17/2009||Yes|No||12/17/2009||Yes|No|12/17/2009||Yes|No||12/17/2009||Yes|No|||Prescription required|Yes|01/27/2022|229|No|6.34642|01/25/2022|6.1941|01/25/2022|6.23535|01/25/2022|||IMMUNOSUPPRESSIVES: ORAL|3932|||||No|No||ASTELLAS PHARMA|No||||
enzalutamide|No|No|No|No|75%|00469062599|XTANDI 40 MG TABLET|120|EA|46.58322|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|No||550|No|106.16641|01/18/2022|104.64975|01/18/2022|99.66643|01/18/2022|||ONCOLOGY: ORAL - PROSTATE|3933|||||No|No||ASTELLAS PHARMA|No||||
tacrolimus|No|No|No|No|75%|00469064773|ASTAGRAF XL 0.5 MG CAPSULE|30|EA|1.10438|09/17/2013||Yes|No||09/17/2013||Yes|No|09/17/2013||Yes|No||09/17/2013||Yes|No|||Prescription required|Yes|01/15/2014|229|No|2.51696|01/18/2022|2.481|01/18/2022|2.36286|01/18/2022|||IMMUNOSUPPRESSIVES: ORAL|3934|||||No|No||ASTELLAS PHARMA|No||||
tacrolimus|No|No|No|No|75%|00469065773|PROGRAF 5 MG CAPSULE|100|EA|14.147|12/17/2009||Yes|No||12/17/2009||Yes|No|12/17/2009||Yes|No||12/17/2009||Yes|No|||Prescription required|Yes|01/27/2022|229|No|32.242|01/18/2022|31.7814|01/18/2022|30.268|01/18/2022|||IMMUNOSUPPRESSIVES: ORAL|3935|||||No|No||ASTELLAS PHARMA|No||||
tacrolimus|No|No|No|No|75%|00469067773|ASTAGRAF XL 1 MG CAPSULE|30|EA|2.20891|09/17/2013||Yes|No||09/17/2013||Yes|No|09/17/2013||Yes|No||09/17/2013||Yes|No|||Prescription required|Yes|01/15/2014|229|No|4.96137|01/25/2022|4.84229|01/25/2022|4.87454|01/25/2022|||IMMUNOSUPPRESSIVES: ORAL|3936|||||No|No||ASTELLAS PHARMA|No||||
tacrolimus|No|No|No|No|75%|00469068773|ASTAGRAF XL 5 MG CAPSULE|30|EA|11.04469|09/17/2013||Yes|No||09/17/2013||Yes|No|09/17/2013||Yes|No||09/17/2013||Yes|No|||Prescription required|Yes|01/15/2014|229|No|25.17162|01/18/2022|24.81202|01/18/2022|23.6305|01/18/2022|||IMMUNOSUPPRESSIVES: ORAL|3937|||||No|No||ASTELLAS PHARMA|No||||
enzalutamide|No|No|No|No|75%|00469072560|XTANDI 80 MG TABLET|60|EA|93.16644|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|No||550|No|212.33283|01/18/2022|209.29951|01/18/2022|199.33286|01/18/2022|||ONCOLOGY: ORAL - PROSTATE|3938|||||No|No||ASTELLAS PHARMA|No||||
tacrolimus|No|No|No|No|75%|00469123050|PROGRAF 0.2 MG GRANULE PACKET|50|EA|2.236|05/31/2019||Yes|No||05/31/2019||Yes|No|05/31/2019||Yes|No||05/31/2019||Yes|No|||Prescription required|Yes|01/27/2022|229|No|5.096|05/31/2019|5.0232|05/31/2019|4.784|05/31/2019|||IMMUNOSUPPRESSIVES: ORAL|3939|||||No|No||ASTELLAS PHARMA|No||||
tacrolimus|No|No|No|No|75%|00469133050|PROGRAF 1 MG GRANULE PACKET|50|EA|3.33723|05/31/2019||Yes|No||05/31/2019||Yes|No|05/31/2019||Yes|No||05/31/2019||Yes|No|||Prescription required|Yes|01/27/2022|229|No|7.60578|05/31/2019|7.49712|05/31/2019|7.14012|05/31/2019|||IMMUNOSUPPRESSIVES: ORAL|3940|||||No|No||ASTELLAS PHARMA|No||||
gilteritinib fumarate|No|No|No|No|75%|00469142590|XOSPATA 40 MG TABLET|90|EA|123.12065|04/01/2019||Yes|No||04/01/2019||Yes|No|04/01/2019||Yes|No||||No|No|||Prescription required|No||173|No|280.60056|01/18/2022|276.59198|01/18/2022|263.42094|01/18/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|3941|||||No|No||ASTELLAS PHARMA|No||||
mirabegron|No|No|No|No|75%|00469260130|MYRBETRIQ ER 25 MG TABLET|30|EA|6.15917|06/24/2013||Yes|No||06/24/2013||Yes|No|06/24/2013||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|006|No|13.74473|01/25/2022|13.41485|01/25/2022|13.50419|01/25/2022|||BLADDER RELAXANT PREPARATIONS|3942|||||No|No||ASTELLAS PHARMA|No||||
mirabegron|No|No|No|No|75%|00469260190|MYRBETRIQ ER 25 MG TABLET|90|EA|6.15912|06/24/2013||Yes|No||06/24/2013||Yes|No|06/24/2013||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|006|No|13.74473|01/25/2022|13.41485|01/25/2022|13.50419|01/25/2022|||BLADDER RELAXANT PREPARATIONS|3943|||||No|No||ASTELLAS PHARMA|No||||
mirabegron|No|No|No|No|75%|00469260230|MYRBETRIQ ER 50 MG TABLET|30|EA|6.15917|06/24/2013||Yes|No||06/26/2013||Yes|No|06/24/2013||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|006|No|13.73581|01/25/2022|13.40615|01/25/2022|13.49543|01/25/2022|||BLADDER RELAXANT PREPARATIONS|3944|||||No|No||ASTELLAS PHARMA|No||||
mirabegron|No|No|No|No|75%|00469260290|MYRBETRIQ ER 50 MG TABLET|90|EA|6.15912|06/24/2013||Yes|No||06/24/2013||Yes|No|06/24/2013||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|006|No|13.73581|01/25/2022|13.40615|01/25/2022|13.49543|01/25/2022|||BLADDER RELAXANT PREPARATIONS|3945|||||No|No||ASTELLAS PHARMA|No||||
amphotericin B liposome|No|No|No|No|75%|00469305130|AMBISOME 50 MG VIAL|1|EA|121.7115|10/10/2003||Yes|No||10/10/2003||Yes|No|10/10/2003||Yes|No||||No|No|||Prescription required|No|||No|277.389|01/18/2022|273.4263|01/18/2022|260.406|01/18/2022||||3946|||||No|No||ASTELLAS PHARMA|No||||
micafungin sodium|No|No|No|No|75%|00469325010|MYCAMINE 50 MG VIAL|1|EA|40.205|12/01/2007||Yes|No||12/01/2007||Yes|No|12/01/2007||Yes|No||||No|No|||Prescription required|No|||No|91.63|06/01/2016|90.321|06/01/2016|86.02|06/01/2016||||3947|||||No|No||ASTELLAS PHARMA|No||||
griseofulvin, microsize|No|No|No|No|75%|00472001304|GRISEOFULVIN 125 MG/5 ML SUSP|120|ML|.1735|12/07/2007||Yes|No||12/07/2007||Yes|No|12/07/2007||Yes|No||||No|No|||Prescription required|No||069|No|.28513|03/29/2022|.27828|03/29/2022|.28014|03/29/2022|||ANTIFUNGALS: ORAL|3948|||||No|No||ACTAVIS/TEVA|No||||
acyclovir|No|No|No|No|75%|00472008216|ACYCLOVIR 200 MG/5 ML SUSP|473|ML|.32378|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||025|No|.2948|03/29/2022|.28772|03/29/2022|.28964|03/29/2022|||ANTIVIRALS: ORAL|3949|||||No|No||ACTAVIS/TEVA|No||||
tretinoin|No|No|No|No|75%|00472011720|TRETINOIN 0.025% CREAM|20|GM|1.79955|01/08/2003||Yes|No||01/08/2003||Yes|No|01/01/2012||Yes|No||||No|No|||Prescription required|No||104|No|2.13963|03/29/2022|2.08827|03/29/2022|2.10218|03/29/2022|||ACNE AGENTS: TOPICAL|3950|||||No|No||ACTAVIS/TEVA|No||||
tretinoin|No|No|No|No|75%|00472011745|TRETINOIN 0.025% CREAM|45|GM|1.51446|08/01/2004||Yes|No||08/01/2004||Yes|No|01/01/2012||Yes|No||||No|No|||Prescription required|No||104|No|1.91452|03/29/2022|1.86857|03/29/2022|1.88101|03/29/2022|||ACNE AGENTS: TOPICAL|3951|||||No|No||ACTAVIS/TEVA|No||||
adapalene|No|No|No|No|75%|00472012645|ADAPALENE 0.3% GEL|45|GM|2.3649|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|.91902|03/29/2022|.89696|03/29/2022|.90293|03/29/2022|||ACNE AGENTS: TOPICAL|3952|||||No|No||ACTAVIS/TEVA|No||||
nystatin/triamcin|No|No|No|No|75%|00472015060|NYSTATIN-TRIAMCINOLONE CREAM|60|GM|1.30318|09/24/2015||Yes|No||09/24/2015||Yes|No|09/24/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|061|No|.35965|03/29/2022|.35101|03/29/2022|.35335|03/29/2022|||ANTIFUNGALS: TOPICAL|3953|||||No|No||ACTAVIS/TEVA|No||||
nystatin/triamcin|No|No|No|No|75%|00472015560|NYSTATIN-TRIAMCINOLONE OINTM|60|GM|1.30318|07/15/2015||Yes|No||07/15/2015||Yes|No|07/15/2015||Yes|No||||No|No|||Prescription required|Yes|08/01/2015|061|No|.24511|03/29/2022|.23922|03/29/2022|.24082|03/29/2022|||ANTIFUNGALS: TOPICAL|3954|||||No|No||ACTAVIS/TEVA|No||||
nystatin|No|No|No|No|75%|00472016615|NYSTATIN 100,000 UNIT/GM OINT|15|GM|.40133|02/24/2012||Yes|No||02/24/2012||Yes|No|02/24/2012||Yes|No||02/24/2012||Yes|No|||Prescription required|No||061|No|.33338|03/29/2022|.32537|03/29/2022|.32754|03/29/2022|||ANTIFUNGALS: TOPICAL|3955|||||No|No||ACTAVIS/TEVA|No||||
nystatin|No|No|No|No|75%|00472016630|NYSTATIN 100,000 UNIT/GM OINT|30|GM|.301|02/24/2012||Yes|No||02/24/2012||Yes|No|02/24/2012||Yes|No||02/24/2012||Yes|No|||Prescription required|No||061|No|.27525|03/29/2022|.26864|03/29/2022|.27043|03/29/2022|||ANTIFUNGALS: TOPICAL|3956|||||No|No||ACTAVIS/TEVA|No||||
levetiracetam|No|No|No|No|75%|00472023516|LEVETIRACETAM 100 MG/ML SOLN|473|ML|.05454|04/21/2009||Yes|No||04/21/2009||Yes|No|04/21/2009||Yes|No||||No|No|||Prescription required|No||056|No|.03146|03/29/2022|.0307|03/29/2022|.0309|03/29/2022|||ANTICONVULSANTS|3957|||||No|No||ACTAVIS/TEVA|No||||
permethrin|No|No|No|No|75%|00472024260|PERMETHRIN 5% CREAM|60|GM|.7095|10/14/2005||Yes|No||10/14/2005||Yes|No|10/14/2005||Yes|No||||No|No|||Prescription required|No||122|No|.34397|03/29/2022|.33571|03/29/2022|.33795|03/29/2022|||ANTIPARASITICS: TOPICAL|3958|||||No|No||ACTAVIS/TEVA|No||||
hydrocortisone|No|No|No|No|75%|00472032126|HYDROCORTISONE 1% CREAM|28.4|GM|.0816|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||118|No|.13774|03/29/2022|.13443|03/29/2022|.13532|03/29/2022|||STEROIDS: TOPICAL LOW|3959|||||No|No||ACTAVIS/TEVA|No||||
hydrocortisone|No|No|No|No|75%|00472033720|HYDROCORTISONE 2.5% CREAM|20|GM|.10578|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||118|No|.14813|03/29/2022|.14457|03/29/2022|.14553|03/29/2022|||STEROIDS: TOPICAL LOW|3960|||||No|No||ACTAVIS/TEVA|No||||
hydrocortisone|No|No|No|No|75%|00472033730|HYDROCORTISONE 2.5% CREAM|30|GM|.09316|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||118|No|.08752|03/29/2022|.08541|03/29/2022|.08598|03/29/2022|||STEROIDS: TOPICAL LOW|3961|||||No|No||ACTAVIS/TEVA|No||||
betamethasone valerate|No|No|No|No|75%|00472037015|BETAMETHASONE VA 0.1% CREAM|15|GM|.64156|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||120|No|.68343|03/29/2022|.66702|03/29/2022|.67146|03/29/2022|||STEROIDS: TOPICAL HIGH|3962|||||No|No||ACTAVIS/TEVA|No||||
betamethasone valerate|No|No|No|No|75%|00472037045|BETAMETHASONE VA 0.1% CREAM|45|GM|.43649|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||120|No|.43211|03/29/2022|.42173|03/29/2022|.42454|03/29/2022|||STEROIDS: TOPICAL HIGH|3963|||||No|No||ACTAVIS/TEVA|No||||
betamethasone valerate|No|No|No|No|75%|00472037115|BETAMETHASONE VALER 0.1% OINTM|15|GM|.4664|03/25/2004||Yes|No||03/25/2004||Yes|No|03/25/2004||Yes|No||||No|No|||Prescription required|No||120|No|.7916|03/29/2022|.7726|03/29/2022|.77774|03/29/2022|||STEROIDS: TOPICAL HIGH|3964|||||No|No||ACTAVIS/TEVA|No||||
betamethasone valerate|No|No|No|No|75%|00472037145|BETAMETHASONE VALER 0.1% OINTM|45|GM|.31743|03/25/2004||Yes|No||03/25/2004||Yes|No|03/25/2004||Yes|No||||No|No|||Prescription required|No||120|No|.63691|03/29/2022|.62162|03/29/2022|.62576|03/29/2022|||STEROIDS: TOPICAL HIGH|3965|||||No|No||ACTAVIS/TEVA|No||||
clotrimazole/betamethasone dip|No|No|No|No|75%|00472037915|CLOTRIMAZOLE-BETAMETHASONE CRM|15|GM|.2901|03/02/2004||Yes|No||03/02/2004||Yes|No|03/02/2004||Yes|No||||No|No|||Prescription required|No||061|No|.25272|03/29/2022|.24665|03/29/2022|.24829|03/29/2022|||ANTIFUNGALS: TOPICAL|3966|||||No|No||ACTAVIS/TEVA|No||||
clotrimazole/betamethasone dip|No|No|No|No|75%|00472037945|CLOTRIMAZOLE-BETAMETHASONE CRM|45|GM|.20812|03/02/2004||Yes|No||03/02/2004||Yes|No|03/02/2004||Yes|No||||No|No|||Prescription required|No||061|No|.17393|03/29/2022|.16975|03/29/2022|.17088|03/29/2022|||ANTIFUNGALS: TOPICAL|3967|||||No|No||ACTAVIS/TEVA|No||||
betamethasone dipropionate|No|No|No|No|75%|00472038015|BETAMETHASONE DP 0.05% CRM|15|GM|.9288|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|1.02286|03/29/2022|.99831|03/29/2022|1.00495|03/29/2022|||STEROIDS: TOPICAL HIGH|3968|||||No|No||ACTAVIS/TEVA|No||||
betamethasone dipropionate|No|No|No|No|75%|00472038045|BETAMETHASONE DP 0.05% CRM|45|GM|.6192|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|.64604|03/29/2022|.63053|03/29/2022|.63473|03/29/2022|||STEROIDS: TOPICAL HIGH|3969|||||No|No||ACTAVIS/TEVA|No||||
betamethasone dipropionate|No|No|No|No|75%|00472038115|BETAMETHASONE DP 0.05% OINT|15|GM|1.12631|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|1.65429|03/29/2022|1.61458|03/29/2022|1.62533|03/29/2022|||STEROIDS: TOPICAL HIGH|3970|||||No|No||ACTAVIS/TEVA|No||||
betamethasone dipropionate|No|No|No|No|75%|00472038145|BETAMETHASONE DP 0.05% OINT|45|GM|.75584|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|1.30454|03/29/2022|1.27323|03/29/2022|1.28171|03/29/2022|||STEROIDS: TOPICAL HIGH|3971|||||No|No||ACTAVIS/TEVA|No||||
betamethasone/propylene glyc|No|No|No|No|75%|00472038215|BETAMETHASONE DP AUG 0.05% OIN|15|GM|1.51532|04/28/2006||Yes|No||04/28/2006||Yes|No|04/28/2006||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|1.24083|03/29/2022|1.21105|03/29/2022|1.21911|03/29/2022|||STEROIDS: TOPICAL HIGH|3972|||||No|No||ACTAVIS/TEVA|No||||
betamethasone/propylene glyc|No|No|No|No|75%|00472038245|BETAMETHASONE DP AUG 0.05% OIN|45|GM|1.01689|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|1.35853|03/29/2022|1.32592|03/29/2022|1.33475|03/29/2022|||STEROIDS: TOPICAL HIGH|3973|||||No|No||ACTAVIS/TEVA|No||||
clobetasol propionate|No|No|No|No|75%|00472040015|CLOBETASOL 0.05% CREAM|15|GM|2.94062|04/01/2015|09/30/2022|Yes|No||04/01/2015|09/30/2022|Yes|No|04/01/2015|09/30/2022|Yes|No||||No|No|||Prescription required|No||121|No|.42879|03/29/2022|.41849|03/29/2022|.42128|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|3974|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ACTAVIS/TEVA|No||||
clobetasol propionate|No|No|No|No|75%|00472040030|CLOBETASOL 0.05% CREAM|30|GM|2.94062|04/01/2015|09/30/2022|Yes|No||04/01/2015|09/30/2022|Yes|No|04/01/2015|09/30/2022|Yes|No||||No|No|||Prescription required|No||121|No|.34489|03/29/2022|.33661|03/29/2022|.33885|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|3975|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ACTAVIS/TEVA|No||||
clobetasol propionate|No|No|No|No|75%|00472040045|CLOBETASOL 0.05% CREAM|45|GM|2.94071|04/01/2015|09/30/2022|Yes|No||04/01/2015|09/30/2022|Yes|No|04/01/2015|09/30/2022|Yes|No||||No|No|||Prescription required|No||121|No|.31467|03/29/2022|.30711|03/29/2022|.30916|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|3976|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ACTAVIS/TEVA|No||||
clobetasol propionate|No|No|No|No|75%|00472040060|CLOBETASOL 0.05% CREAM|60|GM|2.63138|08/31/2015|09/30/2022|Yes|No||08/31/2015|09/30/2022|Yes|No|08/31/2015|09/30/2022|Yes|No||||No|No|||Prescription required|No||121|No|.33784|03/29/2022|.32973|03/29/2022|.33192|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|3977|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ACTAVIS/TEVA|No||||
clobetasol propionate|No|No|No|No|75%|00472040250|CLOBETASOL 0.05% SOLUTION|50|ML|1.41943|09/07/2015|09/30/2022|Yes|No||09/07/2015|09/30/2022|Yes|No|09/07/2015|09/30/2022|Yes|No||||No|No|||Prescription required|No||121|No|.35501|03/29/2022|.34648|03/29/2022|.34879|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|3978|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ACTAVIS/TEVA|No||||
clobetasol propionate|No|No|No|No|75%|00472040394|CLOBETASOL 0.05% SHAMPOO|118|ML|1.10626|08/10/2016||Yes|No||08/10/2016||Yes|No|08/10/2016||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|121|No|.54041|03/29/2022|.52744|03/29/2022|.53095|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|3979|||||No|No||ACTAVIS/TEVA|No||||
clobetasol propionate|No|No|No|No|75%|00472040492|CLOBETASOL 0.05% TOPICAL LOTN|59|ML|1.65928|03/13/2012||Yes|No||03/13/2012||Yes|No|03/13/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|121|No|.88758|03/29/2022|.86627|03/29/2022|.87204|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|3980|||||No|No||ACTAVIS/TEVA|No||||
clobetasol propionate|No|No|No|No|75%|00472040494|CLOBETASOL 0.05% TOPICAL LOTN|118|ML|1.5176|03/13/2012||Yes|No||03/13/2012||Yes|No|03/13/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|121|No|1.12678|03/29/2022|1.09973|03/29/2022|1.10706|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|3981|||||No|No||ACTAVIS/TEVA|No||||
desoximetasone|No|No|No|No|75%|00472047815|DESOXIMETASONE 0.25% CREAM|15|GM|1.25302|06/24/2016||Yes|No||06/24/2016||Yes|No|06/24/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.62238|03/29/2022|.60744|03/29/2022|.61148|03/29/2022|||STEROIDS: TOPICAL HIGH|3982|||||No|No||ACTAVIS/TEVA|No||||
desoximetasone|No|No|No|No|75%|00472047860|DESOXIMETASONE 0.25% CREAM|60|GM|1.07091|06/24/2016||Yes|No||06/24/2016||Yes|No|06/24/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.41664|03/29/2022|.40664|03/29/2022|.40934|03/29/2022|||STEROIDS: TOPICAL HIGH|3983|||||No|No||ACTAVIS/TEVA|No||||
desoximetasone|No|No|No|No|75%|00472047915|DESOXIMETASONE 0.25% OINTMENT|15|GM|1.00104|03/01/2017||Yes|No||03/01/2017||Yes|No|03/01/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.658|03/29/2022|.6422|03/29/2022|.64648|03/29/2022|||STEROIDS: TOPICAL HIGH|3984|||||No|No||ACTAVIS/TEVA|No||||
desoximetasone|No|No|No|No|75%|00472047960|DESOXIMETASONE 0.25% OINTMENT|60|GM|.83097|03/01/2017||Yes|No||03/01/2017||Yes|No|03/01/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.39246|03/29/2022|.38304|03/29/2022|.38559|03/29/2022|||STEROIDS: TOPICAL HIGH|3985|||||No|No||ACTAVIS/TEVA|No||||
desonide|No|No|No|No|75%|00472080302|DESONIDE 0.05% LOTION|59|ML|1.72641|02/23/2012||Yes|No||02/23/2012||Yes|No|02/23/2012||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|118|No|1.36873|03/01/2022|1.33588|03/01/2022|1.34477|03/01/2022|||STEROIDS: TOPICAL LOW|3986|||||No|No||ACTAVIS/TEVA|No||||
desonide|No|No|No|No|75%|00472080304|DESONIDE 0.05% LOTION|118|ML|1.27808|02/23/2012||Yes|No||02/23/2012||Yes|No|02/23/2012||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|118|No|1.43647|03/01/2022|1.40199|03/01/2022|1.41133|03/01/2022|||STEROIDS: TOPICAL LOW|3987|||||No|No||ACTAVIS/TEVA|No||||
desonide|No|No|No|No|75%|00472080415|DESONIDE 0.05% CREAM|15|GM|1.84126|08/23/2013||Yes|No||08/23/2013||Yes|No|08/23/2013||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|118|No|.68707|03/29/2022|.67058|03/29/2022|.67504|03/29/2022|||STEROIDS: TOPICAL LOW|3988|||||No|No||ACTAVIS/TEVA|No||||
desonide|No|No|No|No|75%|00472080460|DESONIDE 0.05% CREAM|60|GM|1.84118|08/23/2013||Yes|No||08/23/2013||Yes|No|08/23/2013||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|118|No|.61157|03/29/2022|.59689|03/29/2022|.60086|03/29/2022|||STEROIDS: TOPICAL LOW|3989|||||No|No||ACTAVIS/TEVA|No||||
albuterol sulfate|No|No|No|No|75%|00472082516|ALBUTEROL SULF 2 MG/5 ML SYRUP|473|ML|.02239|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|No||037|No|.03624|03/29/2022|.03537|03/29/2022|.0356|03/29/2022|||BRONCHODILATORS: BETA AGONIST|3990|||||No|No||ACTAVIS/TEVA|Yes|09/01/2020|||
fluocinonide|No|No|No|No|75%|00472082902|FLUOCINONIDE 0.05% SOLUTION|60|ML|.4153|09/03/2013|04/30/2022|Yes|No||09/03/2013|04/30/2022|Yes|No|09/03/2013|04/30/2022|Yes|No||||No|No|||Prescription required|Yes|01/15/2014|120|No|.3579|03/29/2022|.34931|03/29/2022|.35163|03/29/2022|||STEROIDS: TOPICAL HIGH|3991|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ACTAVIS/TEVA|No||||
hydrocodone bit/homatrop me-br|No|No|No|No|90%|00472103016|HYDROMET 5 MG-1.5 MG/5 ML SOLN|473|ML|.06358|04/23/2008||Yes|No||04/23/2008||Yes|No|04/23/2008||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|183|Yes|.1071|03/29/2022|.10452|03/29/2022|.10522|03/29/2022|||COUGH AND COLD: NARCOTIC|3992|||||No|No||ACTAVIS/TEVA|No||||
miconazole nitrate|Yes|No|No|No|75%|00472173803|MICONAZOLE 3 200 MG VAG SUPP|3|EA|6.27943|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|11/01/2012||Prescription required|No|||No|14.31126|06/26/2018|14.10681|06/26/2018|13.43506|06/26/2018||||3993|||||No|No||ACTAVIS/TEVA|No||||
diclofenac sodium|No|No|No|No|75%|00472178310|DICLOFENAC SODIUM 3% GEL|100|GM|.39977|08/22/2016||Yes|No||08/22/2016||Yes|No|08/22/2016||Yes|No||||No|No|||Prescription required|No|||Yes|.41138|03/29/2022|.4015|03/29/2022|.40418|03/29/2022||||3994|||||No|No||ACTAVIS/TEVA|No||||
clindamycin/tretinoin|No|No|No|No|75%|00472179030|CLINDA-TRETINOIN 1.2%-0.025%|30|GM|4.54495|09/15/2016||Yes|No||09/15/2016||Yes|No|09/15/2016||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|104|No|10.35826|10/29/2019|10.21029|10/29/2019|9.72408|10/29/2019|||ACNE AGENTS: TOPICAL|3995|||||No|No||ACTAVIS/TEVA|No||||
clindamycin/tretinoin|No|No|No|No|75%|00472179060|CLINDA-TRETINOIN 1.2%-0.025%|60|GM|4.37238|09/15/2016||Yes|No||09/15/2016||Yes|No|09/15/2016||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|104|No|9.96496|06/25/2019|9.8226|06/25/2019|9.35486|06/25/2019|||ACNE AGENTS: TOPICAL|3996|||||No|No||ACTAVIS/TEVA|No||||
mesalamine|No|No|No|No|75%|00472191530|MESALAMINE 1,000 MG SUPP|30|EA|1.8983|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No||010|No|2.81018|03/29/2022|2.74273|03/29/2022|2.761|03/29/2022|||ULCERATIVE COLITIS AGENTS|3997|||||No|No||ACTAVIS/TEVA|No||||
nitrofurantoin|No|No|No|No|75%|00472199208|NITROFURANTOIN 25 MG/5 ML SUSP|230|ML|.88757|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No|||No|2.02284|04/30/2019|1.99394|04/30/2019|1.89899|04/30/2019||||3998|||||No|No||ACTAVIS/TEVA|No||||
ibuprofen|No|No|No|No|75%|00472200294|IBUPROFEN 100 MG/5 ML SUSP|118|ML|.0344|10/19/2018||Yes|No||10/19/2018||Yes|No|10/19/2018||Yes|No||||No|No|||Prescription required|No||059|Yes|.0784|12/29/2020|.07728|12/29/2020|.0736|12/29/2020|||NSAIDS|3999|||||No|No||ACTAVIS/TEVA|No||||
acetaminophen|No|No|No|No|75%|00485005708|ED-APAP 160 MG/5 ML LIQUID|236|ML|.01098|04/28/2005||Yes|No||||No|No|04/28/2005||Yes|No||||No|No|||Over the counter|No|||No|.02503|02/08/2022|.02468|02/08/2022|.0235|02/08/2022||||4000|||||No|No||EDWARDS PHARM.|No||||
dexchlorpheniram/phenylephrine|No|No|No|No|75%|00485008001|RYMED TABLET|100|EA|.08045|05/25/2010||Yes|No||||No|No|05/25/2010||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|.18335|02/08/2022|.18073|02/08/2022|.17213|02/08/2022|||COUGH AND COLD: COLD|4001|||||No|No||EDWARDS PHARM.|No||||
hyoscyamine sulfate|No|No|No|No|75%|00485008201|ED-SPAZ 0.125 MG ODT|100|EA|.1505|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|.20067|03/29/2022|.19585|03/29/2022|.19715|03/29/2022||||4002|||||No|No||EDWARDS PHARM.|No||||
chlorpheniramine maleate|No|No|No|No|75%|00485009816|ED CHLORPED JR SYRUP|473|ML|.01667|06/21/2012||Yes|No||||No|No|06/21/2012||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|574|Yes|.03801|02/08/2022|.03747|02/08/2022|.03568|02/08/2022|||ANTIHISTAMINES: FIRST GENERATION|4003|||||No|No||EDWARDS PHARM.|No||||
methenam/sod phos/mblue/hyoscy|No|No|No|No|75%|00485015101|UROGESIC-BLUE TABLET|100|EA|1.81537|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|4.0532|03/29/2022|3.95592|03/29/2022|3.98226|03/29/2022||||4004|||||No|No||EDWARDS PHARM.|No||||
chlorpheniramine/phenylephrine|No|No|No|No|75%|00485015516|ED A-HIST LIQUID|473|ML|.01721|01/09/2012||Yes|No||||No|No|01/09/2012||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|.04063|11/23/2021|.03965|11/23/2021|.03991|11/23/2021|||COUGH AND COLD: COLD|4005|||||No|No||EDWARDS PHARM.|No||||
chlorpheniramine/phenyleph/DM|No|No|No|No|75%|00485017116|ED-A-HIST DM LIQUID|473|ML|.02408|06/20/2012||Yes|No||||No|No|06/20/2012||Yes|No||||No|No|||Over the counter|No||184|Yes|.06812|03/29/2022|.06648|03/29/2022|.06692|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|4006|||||No|No||EDWARDS PHARM.|No||||
brompheniramine/phenylephrine|No|No|No|No|75%|00485020216|RYNEX PE LIQUID|473|ML|.01667|06/30/2011||Yes|No||||No|No|06/30/2011||Yes|No||||No|No|||Over the counter|No||182|Yes|.03801|02/08/2022|.03747|02/08/2022|.03568|02/08/2022|||COUGH AND COLD: COLD|4007|||||No|No||EDWARDS PHARM.|No||||
brompheniram/phenylephrine/DM|No|No|No|No|75%|00485020404|RYNEX DM LIQUID|118|ML|.02583|10/28/2014||Yes|No||||No|No|10/28/2014||Yes|No||||No|No|||Over the counter|No||184|Yes|.01623|03/29/2022|.01584|03/29/2022|.01594|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|4008|||||No|No||EDWARDS PHARM.|No||||
brompheniram/phenylephrine/DM|No|No|No|No|75%|00485020416|RYNEX DM LIQUID|473|ML|.01575|06/30/2011||Yes|No||||No|No|06/30/2011||Yes|No||||No|No|||Over the counter|No||184|Yes|.03893|03/29/2022|.03799|03/29/2022|.03824|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|4009|||||No|No||EDWARDS PHARM.|No||||
brompheniramin/pseudoephedrine|No|No|No|No|75%|00485020616|RYNEX PSE LIQUID|473|ML|.01773|06/30/2011||Yes|No||||No|No|06/30/2011||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|.04041|02/08/2022|.03983|02/08/2022|.03794|02/08/2022|||COUGH AND COLD: COLD|4010|||||No|No||EDWARDS PHARM.|No||||
guaifenesin/phenylephrine HCl|No|No|No|No|75%|00485020816|ED BRON GP LIQUID|473|ML|.01773|03/21/2011||Yes|No||||No|No|03/21/2011||Yes|No||||No|No|||Over the counter|No||182|Yes|.04041|02/08/2022|.03983|02/08/2022|.03794|02/08/2022|||COUGH AND COLD: COLD|4011|||||No|No||EDWARDS PHARM.|No||||
chlorpheniramine/phenyleph/DM|No|No|No|No|75%|00485024001|ED A-HIST DM TABLET|100|EA|.15596|02/04/2015||Yes|No||||No|No|02/04/2015||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.35544|02/08/2022|.35036|02/08/2022|.33368|02/08/2022|||COUGH AND COLD: NON-NARCOTIC|4012|||||No|No||EDWARDS PHARM.|No||||
chlorpheniramine/phenylephrine|No|No|No|No|75%|00485025401|ED-A-HIST 4 MG-10 MG TABLET|100|EA|.07946|02/07/2013||Yes|No||||No|No|02/07/2013||Yes|No||||No|No|||Over the counter|No||182|Yes|.1811|02/08/2022|.17851|02/08/2022|.17001|02/08/2022|||COUGH AND COLD: COLD|4013|||||No|No||EDWARDS PHARM.|No||||
potassium phosphate,monobasic|No|No|No|No|75%|00486111101|K-PHOS ORIGINAL TABLET|100|EA|.20855|||No|No||09/07/2015||Yes|No|||No|No||||No|No|||Prescription required|No|||No|.46838|10/26/2021|.45713|10/26/2021|.46018|10/26/2021||||4014|||||No|No||BEACH PRODUCTS|No||||
potassium phosphate,monobasic|No|No|No|No|75%|00486111105|K-PHOS ORIGINAL TABLET|500|EA|.19087|||No|No||09/09/2015||Yes|No|||No|No||||No|No|||Prescription required|No|||No|.46838|10/26/2021|.45713|10/26/2021|.46018|10/26/2021||||4015|||||No|No||BEACH PRODUCTS|No||||
sod phos di, mono/K phos mono|No|No|No|No|75%|00486112501|K-PHOS NEUTRAL TABLET|100|EA|.29132|||No|No||09/09/2015||Yes|No|||No|No||||No|No|||Over the counter|No|||No|.22689|03/29/2022|.22144|03/29/2022|.22291|03/29/2022||||4016|||||No|No||BEACH PRODUCTS|No||||
ipratropium/albuterol sulfate|No|No|No|No|75%|00487020101|IPRAT-ALBUT 0.5-3(2.5) MG/3 ML|3|ML|.07166|08/12/2008||Yes|No||08/12/2008||Yes|No|08/12/2008||Yes|No||||No|No|||Prescription required|No||098|Yes|.07201|03/29/2022|.07028|03/29/2022|.07074|03/29/2022|||COPD AGENTS|4017|||||No|No||NEPHRON CORP|Yes|09/01/2020|||
ipratropium/albuterol sulfate|No|No|No|No|75%|00487020103|IPRAT-ALBUT 0.5-3(2.5) MG/3 ML|3|ML|.043|10/21/2008||Yes|No||10/21/2008||Yes|No|10/21/2008||Yes|No||||No|No|||Prescription required|No||098|Yes|.07201|03/29/2022|.07028|03/29/2022|.07074|03/29/2022|||COPD AGENTS|4018|||||No|No||NEPHRON CORP|Yes|09/01/2020|||
ipratropium/albuterol sulfate|No|No|No|No|75%|00487020160|IPRAT-ALBUT 0.5-3(2.5) MG/3 ML|3|ML|.043|04/29/2008||Yes|No||04/29/2008||Yes|No|04/29/2008||Yes|No||||No|No|||Prescription required|No||098|Yes|.06072|03/29/2022|.05926|03/29/2022|.05965|03/29/2022|||COPD AGENTS|4019|||||No|No||NEPHRON CORP|Yes|09/01/2020|||
albuterol sulfate|No|No|No|No|75%|00487030101|ALBUTEROL SUL 0.63 MG/3 ML SOL|3|ML|.19034|10/24/2011||Yes|No||10/24/2011||Yes|No|10/24/2011||Yes|No||||No|No|||Prescription required|No||037|Yes|.27861|03/29/2022|.27192|03/29/2022|.27373|03/29/2022|||BRONCHODILATORS: BETA AGONIST|4020|||||No|No||NEPHRON CORP|Yes|09/01/2020|||
racepinephrine HCl|No|No|No|No|75%|00487590199|S2 RACEPINEPHRINE 2.25% SOLN|1|EA|.516|10/24/2007||Yes|No||||No|No|10/24/2007||Yes|No||||No|No|||Over the counter|No|||No|1.176|06/01/2016|1.1592|06/01/2016|1.104|06/01/2016||||4021|||||No|No||NEPHRON CORP|No||||
albuterol sulfate|No|No|No|No|75%|00487950101|ALBUTEROL SUL 2.5 MG/3 ML SOLN|3|ML|.02866|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||037|Yes|.04903|03/29/2022|.04785|03/29/2022|.04817|03/29/2022|||BRONCHODILATORS: BETA AGONIST|4022|||||No|No||NEPHRON CORP|Yes|09/01/2020|||
albuterol sulfate|No|No|No|No|75%|00487950103|ALBUTEROL SUL 2.5 MG/3 ML SOLN|3|ML|.02293|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||037|Yes|.04903|03/29/2022|.04785|03/29/2022|.04817|03/29/2022|||BRONCHODILATORS: BETA AGONIST|4023|||||No|No||NEPHRON CORP|Yes|09/01/2020|||
albuterol sulfate|No|No|No|No|75%|00487950125|ALBUTEROL SUL 2.5 MG/3 ML SOLN|3|ML|.02293|08/09/2005||Yes|No||08/09/2005||Yes|No|08/09/2005||Yes|No||||No|No|||Prescription required|No||037|Yes|.04199|03/29/2022|.04098|03/29/2022|.04125|03/29/2022|||BRONCHODILATORS: BETA AGONIST|4024|||||No|No||NEPHRON CORP|Yes|09/01/2020|||
albuterol sulfate|No|No|No|No|75%|00487950160|ALBUTEROL SUL 2.5 MG/3 ML SOLN|3|ML|.02293|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||037|Yes|.04406|03/29/2022|.043|03/29/2022|.04328|03/29/2022|||BRONCHODILATORS: BETA AGONIST|4025|||||No|No||NEPHRON CORP|Yes|09/01/2020|||
ipratropium bromide|No|No|No|No|75%|00487980101|IPRATROPIUM BR 0.02% SOLN|2.5|ML|.03612|04/29/2008||Yes|No||04/29/2008||Yes|No|04/29/2008||Yes|No||||No|No|||Prescription required|No||098|No|.05788|03/29/2022|.05649|03/29/2022|.05686|03/29/2022|||COPD AGENTS|4026|||||No|No||NEPHRON CORP|Yes|09/01/2020|||
ipratropium bromide|No|No|No|No|75%|00487980125|IPRATROPIUM BR 0.02% SOLN|2.5|ML|.03164|08/09/2005||Yes|No||08/09/2005||Yes|No|08/09/2005||Yes|No||||No|No|||Prescription required|No||098|No|.05484|03/29/2022|.05352|03/29/2022|.05388|03/29/2022|||COPD AGENTS|4027|||||No|No||NEPHRON CORP|Yes|09/01/2020|||
ipratropium bromide|No|No|No|No|75%|00487980130|IPRATROPIUM BR 0.02% SOLN|2.5|ML|.03164|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||098|No|.05788|03/29/2022|.05649|03/29/2022|.05686|03/29/2022|||COPD AGENTS|4028|||||No|No||NEPHRON CORP|No||||
ipratropium bromide|No|No|No|No|75%|00487980160|IPRATROPIUM BR 0.02% SOLN|2.5|ML|.03164|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||098|No|.0599|03/29/2022|.05846|03/29/2022|.05885|03/29/2022|||COPD AGENTS|4029|||||No|No||NEPHRON CORP|Yes|09/01/2020|||
albuterol sulfate|No|No|No|No|75%|00487990130|ALBUTEROL 2.5 MG/0.5 ML SOL|1|EA|.1634|08/16/2007||Yes|No||08/16/2007||Yes|No|08/16/2007||Yes|No||||No|No|||Prescription required|No||037|Yes|.36515|03/29/2022|.35638|03/29/2022|.35875|03/29/2022|||BRONCHODILATORS: BETA AGONIST|4030|||||No|No||NEPHRON CORP|Yes|09/01/2020|||
albuterol sulfate|No|No|No|No|75%|00487990401|ALBUTEROL SUL 1.25 MG/3 ML SOL|3|ML|.19034|02/21/2006||Yes|No||02/21/2006||Yes|No|02/21/2006||Yes|No||||No|No|||Prescription required|No||037|Yes|.29643|03/29/2022|.28931|03/29/2022|.29124|03/29/2022|||BRONCHODILATORS: BETA AGONIST|4031|||||No|No||NEPHRON CORP|Yes|09/01/2020|||
albuterol sulfate|No|No|No|No|75%|00487990425|ALBUTEROL SUL 1.25 MG/3 ML SOL|3|ML|.19034|04/29/2008||Yes|No||04/29/2008||Yes|No|04/29/2008||Yes|No||||No|No|||Prescription required|No||037|Yes|.212|03/29/2022|.20691|03/29/2022|.20829|03/29/2022|||BRONCHODILATORS: BETA AGONIST|4032|||||No|No||NEPHRON CORP|Yes|09/01/2020|||
cyanocobalamin (vitamin B-12)|No|No|No|No|75%|00517003125|CYANOCOBALAMIN 1,000 MCG/ML VL|1|ML|3.0057|01/09/2015||Yes|No||01/09/2015||Yes|No|01/09/2015||Yes|No||||No|No|||Prescription required|No|||No|2.89168|03/29/2022|2.82227|03/29/2022|2.84107|03/29/2022||||4033|||||No|No||AMER. REGENT|No||||
cyanocobalamin (vitamin B-12)|No|No|No|No|75%|00517003225|CYANOCOBALAMIN 10,000 MCG/10ML|10|ML|1.8705|01/09/2015||Yes|No||01/09/2015||Yes|No|01/09/2015||Yes|No||||No|No|||Prescription required|No|||No|4.263|08/25/2020|4.2021|08/25/2020|4.002|08/25/2020||||4034|||||No|No||AMER. REGENT|No||||
estradiol valerate|No|No|No|No|75%|00517042001|ESTRADIOL VALERATE 100 MG/5 ML|5|ML|11.49992|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||Yes|21.8262|03/29/2022|21.30237|03/29/2022|21.44424|03/29/2022||||4035|||||No|No||AMER. REGENT|No||||
estradiol valerate|No|No|No|No|75%|00517044001|ESTRADIOL VALERATE 200 MG/5 ML|5|ML|19.0791|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||Yes|33.70342|11/02/2021|32.89453|11/02/2021|33.11361|11/02/2021||||4036|||||No|No||AMER. REGENT|No||||
betamethasone acetate,sod phos|No|No|No|No|75%|00517072001|BETAMETHASONE SP-AC 30 MG/5 ML|5|ML|4.50726|06/14/2017||Yes|No||06/14/2017||Yes|No|06/14/2017||Yes|No||||No|No|||Prescription required|No|||No|8.9316|08/24/2021|8.71724|08/24/2021|8.77529|08/24/2021||||4037|||||No|No||AMER. REGENT|No||||
hydroxyprogesterone caproat/PF|No|No|No|No|75%|00517176701|HYDROXYPROGEST 250 MG/ML VIAL|1|ML|293.4965|08/13/2018||Yes|No||08/13/2018||Yes|No|08/13/2018||Yes|No||||No|No|||Prescription required|Yes|09/28/2017|151|Yes|668.899|08/21/2018|659.3433|08/21/2018|627.946|08/13/2018|||PROGESTATIONAL AGENTS|4038|||||No|No||AMER. REGENT|No||||
hydroxyzine HCl|No|No|No|No|75%|00517420125|HYDROXYZINE 25 MG/ML VIAL|1|ML|9.5073|12/19/2011||Yes|No||12/19/2011||Yes|No|12/19/2011||Yes|No||||No|No|||Prescription required|No|||Yes|21.6678|02/08/2022|21.35826|02/08/2022|20.3412|02/08/2022||||4039|||||No|No||AMER. REGENT|No||||
glycopyrrolate|No|No|No|No|75%|00517460125|GLYCOPYRROLATE 0.2 MG/ML VIAL|1|ML|5.59|01/15/2004||Yes|No||01/15/2004||Yes|No|01/15/2004||Yes|No||||No|No|||Prescription required|No|||No|12.74|06/01/2016|12.558|06/01/2016|11.96|06/01/2016||||4040|||||No|No||AMER. REGENT|No||||
glycopyrrolate|No|No|No|No|75%|00517460225|GLYCOPYRROLATE 0.2 MG/ML VIAL|2|ML|4.945|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|11.27|06/01/2016|11.109|06/01/2016|10.58|06/01/2016||||4041|||||No|No||AMER. REGENT|No||||
glycopyrrolate|No|No|No|No|75%|00517460525|GLYCOPYRROLATE 0.2 MG/ML VIAL|5|ML|3.784|05/12/2004||Yes|No||05/12/2004||Yes|No|05/12/2004||Yes|No||||No|No|||Prescription required|No|||No|8.624|06/01/2016|8.5008|06/01/2016|8.096|06/01/2016||||4042|||||No|No||AMER. REGENT|No||||
glycopyrrolate|No|No|No|No|75%|00517462025|GLYCOPYRROLATE 0.2 MG/ML VIAL|20|ML|2.74812|04/27/2004||Yes|No||04/27/2004||Yes|No|04/27/2004||Yes|No||||No|No|||Prescription required|No|||No|6.26316|06/01/2016|6.17368|06/01/2016|5.8797|06/01/2016||||4043|||||No|No||AMER. REGENT|No||||
acetylcysteine|No|No|No|No|75%|00517750425|ACETYLCYSTEINE 10% VIAL|4|ML|.89117|03/16/2012||Yes|No||03/16/2012||Yes|No|03/16/2012||Yes|No||||No|No|||Prescription required|No|||No|2.03105|02/08/2022|2.00203|02/08/2022|1.9067|02/08/2022||||4044|||||No|No||AMER. REGENT|No||||
acetylcysteine|No|No|No|No|75%|00517760425|ACETYLCYSTEINE 20% VIAL|4|ML|1.28978|03/16/2012||Yes|No||03/16/2012||Yes|No|03/16/2012||Yes|No||||No|No|||Prescription required|No|||No|1.80328|03/29/2022|1.76|03/29/2022|1.77172|03/29/2022||||4045|||||No|No||AMER. REGENT|No||||
dicyclomine HCl|No|No|No|No|75%|00527058601|DICYCLOMINE 10 MG CAPSULE|100|EA|.08578|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.10786|03/29/2022|.10527|03/29/2022|.10597|03/29/2022||||4046|||||No|No||LANNETT CO. INC|No||||
dicyclomine HCl|No|No|No|No|75%|00527058610|DICYCLOMINE 10 MG CAPSULE|1000|EA|.07933|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.10786|03/29/2022|.10527|03/29/2022|.10597|03/29/2022||||4047|||||No|No||LANNETT CO. INC|No||||
acetazolamide|No|No|No|No|75%|00527105001|ACETAZOLAMIDE 250 MG TABLET|100|EA|.42991|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.25723|03/29/2022|.25105|03/29/2022|.25272|03/29/2022||||4048|||||No|No||LANNETT CO. INC|No||||
primidone|No|No|No|No|75%|00527123101|PRIMIDONE 250 MG TABLET|100|EA|.29128|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||056|No|.31086|03/29/2022|.30339|03/29/2022|.30541|03/29/2022|||ANTICONVULSANTS|4049|||||No|No||LANNETT CO. INC|No||||
primidone|No|No|No|No|75%|00527123110|PRIMIDONE 250 MG TABLET|1000|EA|.24759|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||056|No|.31086|03/29/2022|.30339|03/29/2022|.30541|03/29/2022|||ANTICONVULSANTS|4050|||||No|No||LANNETT CO. INC|No||||
dicyclomine HCl|No|No|No|No|75%|00527128201|DICYCLOMINE 20 MG TABLET|100|EA|.07757|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.17279|03/29/2022|.16864|03/29/2022|.16976|03/29/2022||||4051|||||No|No||LANNETT CO. INC|No||||
dicyclomine HCl|No|No|No|No|75%|00527128210|DICYCLOMINE 20 MG TABLET|1000|EA|.07756|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.17279|03/29/2022|.16864|03/29/2022|.16976|03/29/2022||||4052|||||No|No||LANNETT CO. INC|No||||
primidone|No|No|No|No|75%|00527130101|PRIMIDONE 50 MG TABLET|100|EA|.16082|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||056|No|.16327|03/29/2022|.15935|03/29/2022|.16041|03/29/2022|||ANTICONVULSANTS|4053|||||No|No||LANNETT CO. INC|No||||
primidone|No|No|No|No|75%|00527130105|PRIMIDONE 50 MG TABLET|500|EA|.15501|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||056|No|.16327|03/29/2022|.15935|03/29/2022|.16041|03/29/2022|||ANTICONVULSANTS|4054|||||No|No||LANNETT CO. INC|No||||
terbutaline sulfate|No|No|No|No|75%|00527131101|TERBUTALINE SULFATE 5 MG TAB|100|EA|2.28618|03/05/2007||Yes|No||03/05/2007||Yes|No|03/05/2007||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|037|No|5.21036|06/28/2016|5.13593|06/28/2016|4.89136|06/28/2016|||BRONCHODILATORS: BETA AGONIST|4055|||||No|No||LANNETT CO. INC|Yes|09/01/2020|||
codeine/butalbital/ASA/caffein|No|No|No|No|90%|00527131201|BUTALBITAL COMP-CODEINE #3 CAP|100|EA|.94251|03/19/2002||Yes|No||03/19/2002||Yes|No|03/19/2002||Yes|No||03/19/2002||Yes|No|||Prescription required|Yes|07/17/2014|109|Yes|1.16307|03/29/2022|1.13515|03/29/2022|1.14271|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4056|||||No|No||LANNETT CO. INC|No||||
pilocarpine HCl|No|No|No|No|75%|00527131301|PILOCARPINE HCL 5 MG TABLET|100|EA|.17552|08/18/2008||Yes|No||08/18/2008||Yes|No|08/18/2008||Yes|No||||No|No|||Prescription required|No|||No|.27963|03/29/2022|.27291|03/29/2022|.27473|03/29/2022||||4057|||||No|No||LANNETT CO. INC|No||||
rifampin|No|No|No|No|75%|00527131501|RIFAMPIN 300 MG CAPSULE|100|EA|.57405|08/18/2008||Yes|No||08/18/2008||Yes|No|08/18/2008||Yes|No||||No|No|||Prescription required|No|||No|.95898|03/29/2022|.93596|03/29/2022|.94219|03/29/2022||||4058|||||No|No||LANNETT CO. INC|No||||
rifampin|No|No|No|No|75%|00527131530|RIFAMPIN 300 MG CAPSULE|30|EA|.6235|08/18/2008||Yes|No||08/18/2008||Yes|No|08/18/2008||Yes|No||||No|No|||Prescription required|No|||No|.95898|03/29/2022|.93596|03/29/2022|.94219|03/29/2022||||4059|||||No|No||LANNETT CO. INC|No||||
terbutaline sulfate|No|No|No|No|75%|00527131801|TERBUTALINE SULFATE 2.5 MG TAB|100|EA|1.87196|03/05/2007||Yes|No||03/05/2007||Yes|No|03/05/2007||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|037|No|4.26633|04/24/2018|4.20538|04/24/2018|4.00512|04/24/2018|||BRONCHODILATORS: BETA AGONIST|4060|||||No|No||LANNETT CO. INC|Yes|09/01/2020|||
digoxin|No|No|No|No|75%|00527132401|DIGOX 125 MCG TABLET|100|EA|.50955|12/23/2002||Yes|No||12/23/2002||Yes|No|12/23/2002||Yes|No||12/23/2002||Yes|No|||Prescription required|No|||No|.25031|03/29/2022|.2443|03/29/2022|.24592|03/29/2022||||4061|||||No|No||LANNETT CO. INC|No||||
digoxin|No|No|No|No|75%|00527132410|DIGOX 125 MCG TABLET|1000|EA|.42548|12/23/2002||Yes|No||12/23/2002||Yes|No|12/23/2002||Yes|No||12/23/2002||Yes|No|||Prescription required|No|||No|.25031|03/29/2022|.2443|03/29/2022|.24592|03/29/2022||||4062|||||No|No||LANNETT CO. INC|No||||
digoxin|No|No|No|No|75%|00527132501|DIGOX 250 MCG TABLET|100|EA|.50955|12/23/2002||Yes|No||12/23/2002||Yes|No|12/23/2002||Yes|No||12/23/2002||Yes|No|||Prescription required|No|||No|.22254|03/29/2022|.21719|03/29/2022|.21864|03/29/2022||||4063|||||No|No||LANNETT CO. INC|No||||
digoxin|No|No|No|No|75%|00527132510|DIGOX 250 MCG TABLET|1000|EA|.42548|12/23/2002||Yes|No||12/23/2002||Yes|No|12/23/2002||Yes|No||12/23/2002||Yes|No|||Prescription required|No|||No|.22254|03/29/2022|.21719|03/29/2022|.21864|03/29/2022||||4064|||||No|No||LANNETT CO. INC|No||||
ursodiol|No|No|No|No|75%|00527132601|URSODIOL 300 MG CAPSULE|100|EA|.5375|01/23/2009||Yes|No||01/23/2009||Yes|No|01/23/2009||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|198|No|.60006|03/29/2022|.58565|03/29/2022|.58955|03/29/2022|||BILE SALTS|4065|||||No|No||LANNETT CO. INC|No||||
bethanechol chloride|No|No|No|No|75%|00527132901|BETHANECHOL 50 MG TABLET|100|EA|.49407|09/11/2008||Yes|No||09/11/2008||Yes|No|09/11/2008||Yes|No||||No|No|||Prescription required|No|||No|.48885|03/01/2022|.47711|03/01/2022|.48029|03/01/2022||||4066|||||No|No||LANNETT CO. INC|No||||
baclofen|No|No|No|No|75%|00527133001|BACLOFEN 10 MG TABLET|100|EA|.02833|09/11/2008||Yes|No||09/11/2008||Yes|No|09/11/2008||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4067|||||No|No||LANNETT CO. INC|No||||
baclofen|No|No|No|No|75%|00527133010|BACLOFEN 10 MG TABLET|1000|EA|.02775|09/11/2008||Yes|No||09/11/2008||Yes|No|09/11/2008||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4068|||||No|No||LANNETT CO. INC|No||||
doxycycline monohydrate|No|No|No|No|75%|00527133501|DOXYCYCLINE MONO 50 MG TABLET|100|EA|.15789|09/11/2008||Yes|No||09/11/2008||Yes|No|09/11/2008||Yes|No||09/11/2008||Yes|No|||Prescription required|Yes|01/15/2014|213|No|.26397|03/29/2022|.25763|03/29/2022|.25935|03/29/2022|||TETRACYCLINES|4069|||||No|No||LANNETT CO. INC|No||||
doxycycline hyclate|No|No|No|No|75%|00527133601|DOXYCYCLINE HYCLATE 20 MG TAB|100|EA|.16318|08/18/2008||Yes|No||08/18/2008||Yes|No|08/18/2008||Yes|No||08/18/2008||Yes|No|||Prescription required|Yes|01/22/2015|213|No|.15838|03/29/2022|.15457|03/29/2022|.1556|03/29/2022|||TETRACYCLINES|4070|||||No|No||LANNETT CO. INC|No||||
baclofen|No|No|No|No|75%|00527133701|BACLOFEN 20 MG TABLET|100|EA|.05129|09/11/2008||Yes|No||09/11/2008||Yes|No|09/11/2008||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4071|||||No|No||LANNETT CO. INC|No||||
baclofen|No|No|No|No|75%|00527133705|BACLOFEN 20 MG TABLET|500|EA|.05129|09/11/2008||Yes|No||09/11/2008||Yes|No|09/11/2008||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4072|||||No|No||LANNETT CO. INC|No||||
doxycycline monohydrate|Yes|No|No|No|75%|00527133825|DOXYCYCLINE MONO 100 MG TABLET|250|EA|.15707|09/11/2008||Yes|No||09/11/2008||Yes|No|09/11/2008||Yes|No||09/11/2008||Yes|No|11/01/2012||Prescription required|Yes|01/15/2014|213|No|.32436|03/29/2022|.31657|03/29/2022|.31868|03/29/2022|||TETRACYCLINES|4073|||||No|No||LANNETT CO. INC|No||||
doxycycline monohydrate|Yes|No|No|No|75%|00527133850|DOXYCYCLINE MONO 100 MG TABLET|50|EA|.23099|09/11/2008||Yes|No||09/11/2008||Yes|No|09/11/2008||Yes|No||09/11/2008||Yes|No|11/01/2012||Prescription required|Yes|01/15/2014|213|No|.32436|03/29/2022|.31657|03/29/2022|.31868|03/29/2022|||TETRACYCLINES|4074|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527134110|LEVOTHYROXINE 25 MCG TABLET|1000|EA|.15656|07/14/2003||Yes|No||07/14/2003||Yes|No|07/14/2003||Yes|No||||No|No|||Prescription required|No|||No|.11852|03/29/2022|.11567|03/29/2022|.11644|03/29/2022||||4075|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527134201|LEVOTHYROXINE 50 MCG TABLET|100|EA|.17771|04/28/2003||Yes|No||04/28/2003||Yes|No|04/28/2003||Yes|No||||No|No|||Prescription required|No|||No|.14288|03/29/2022|.13945|03/29/2022|.14037|03/29/2022||||4076|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527134210|LEVOTHYROXINE 50 MCG TABLET|1000|EA|.17773|04/28/2003||Yes|No||04/28/2003||Yes|No|04/28/2003||Yes|No||||No|No|||Prescription required|No|||No|.14288|03/29/2022|.13945|03/29/2022|.14037|03/29/2022||||4077|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527134310|LEVOTHYROXINE 75 MCG TABLET|1000|EA|.1964|04/28/2003||Yes|No||04/28/2003||Yes|No|04/28/2003||Yes|No||||No|No|||Prescription required|No|||No|.15545|03/29/2022|.15171|03/29/2022|.15272|03/29/2022||||4078|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527134401|LEVOTHYROXINE 88 MCG TABLET|100|EA|.19977|07/14/2003||Yes|No||07/14/2003||Yes|No|07/14/2003||Yes|No||||No|No|||Prescription required|No|||No|.16198|03/29/2022|.15809|03/29/2022|.15914|03/29/2022||||4079|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527134410|LEVOTHYROXINE 88 MCG TABLET|1000|EA|.19979|07/14/2003||Yes|No||07/14/2003||Yes|No|07/14/2003||Yes|No||||No|No|||Prescription required|No|||No|.16198|03/29/2022|.15809|03/29/2022|.15914|03/29/2022||||4080|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527134601|LEVOTHYROXINE 112 MCG TABLET|100|EA|.2328|07/14/2003||Yes|No||07/14/2003||Yes|No|07/14/2003||Yes|No||||No|No|||Prescription required|No|||No|.1546|03/29/2022|.15088|03/29/2022|.15189|03/29/2022||||4081|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527134610|LEVOTHYROXINE 112 MCG TABLET|1000|EA|.23281|07/14/2003||Yes|No||07/14/2003||Yes|No|07/14/2003||Yes|No||||No|No|||Prescription required|No|||No|.1546|03/29/2022|.15088|03/29/2022|.15189|03/29/2022||||4082|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527134710|LEVOTHYROXINE 125 MCG TABLET|1000|EA|.23603|04/28/2003||Yes|No||04/28/2003||Yes|No|04/28/2003||Yes|No||||No|No|||Prescription required|No|||No|.18894|03/29/2022|.1844|03/29/2022|.18563|03/29/2022||||4083|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527134901|LEVOTHYROXINE 150 MCG TABLET|100|EA|.24295|04/28/2003||Yes|No||04/28/2003||Yes|No|04/28/2003||Yes|No||||No|No|||Prescription required|No|||No|.21406|03/29/2022|.20892|03/29/2022|.21031|03/29/2022||||4084|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527134910|LEVOTHYROXINE 150 MCG TABLET|1000|EA|.24291|04/28/2003||Yes|No||04/28/2003||Yes|No|04/28/2003||Yes|No||||No|No|||Prescription required|No|||No|.21406|03/29/2022|.20892|03/29/2022|.21031|03/29/2022||||4085|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527135001|LEVOTHYROXINE 175 MCG TABLET|100|EA|.28874|07/14/2003||Yes|No||07/14/2003||Yes|No|07/14/2003||Yes|No||||No|No|||Prescription required|No|||No|.2247|03/29/2022|.2193|03/29/2022|.22076|03/29/2022||||4086|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527135010|LEVOTHYROXINE 175 MCG TABLET|1000|EA|.28874|07/14/2003||Yes|No||07/14/2003||Yes|No|07/14/2003||Yes|No||||No|No|||Prescription required|No|||No|.2247|03/29/2022|.2193|03/29/2022|.22076|03/29/2022||||4087|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527135101|LEVOTHYROXINE 200 MCG TABLET|100|EA|.2893|07/14/2003||Yes|No||07/14/2003||Yes|No|07/14/2003||Yes|No||||No|No|||Prescription required|No|||No|.2307|03/29/2022|.22516|03/29/2022|.22666|03/29/2022||||4088|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527135110|LEVOTHYROXINE 200 MCG TABLET|1000|EA|.28932|07/14/2003||Yes|No||07/14/2003||Yes|No|07/14/2003||Yes|No||||No|No|||Prescription required|No|||No|.2307|03/29/2022|.22516|03/29/2022|.22666|03/29/2022||||4089|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527135201|LEVOTHYROXINE 300 MCG TABLET|100|EA|.37345|07/14/2003||Yes|No||07/14/2003||Yes|No|07/14/2003||Yes|No||||No|No|||Prescription required|No|||No|.17616|03/29/2022|.17193|03/29/2022|.17307|03/29/2022||||4090|||||No|No||LANNETT CO. INC|No||||
hydromorphone HCl|No|No|No|No|90%|00527135301|HYDROMORPHONE 2 MG TABLET|100|EA|.05998|03/01/2010||Yes|No||03/01/2010||Yes|No|03/01/2010||Yes|No||||No|No|||Prescription required|No||109|Yes|.0744|03/29/2022|.07261|03/29/2022|.07309|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4091|||||No|No||LANNETT CO. INC|No||||
hydromorphone HCl|No|No|No|No|90%|00527135401|HYDROMORPHONE 4 MG TABLET|100|EA|.07955|03/01/2010||Yes|No||03/01/2010||Yes|No|03/01/2010||Yes|No||||No|No|||Prescription required|No||109|Yes|.09714|03/29/2022|.0948|03/29/2022|.09544|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4092|||||No|No||LANNETT CO. INC|No||||
hydromorphone HCl|No|No|No|No|90%|00527135501|HYDROMORPHONE 8 MG TABLET|100|EA|.2924|03/01/2010||Yes|No||03/01/2010||Yes|No|03/01/2010||Yes|No||||No|No|||Prescription required|No||109|Yes|.27467|03/29/2022|.26807|03/29/2022|.26986|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4093|||||No|No||LANNETT CO. INC|No||||
probenecid|Yes|No|No|No|75%|00527136701|PROBENECID 500 MG TABLET|100|EA|.8664|08/18/2008||Yes|No||08/18/2008||Yes|No|08/18/2008||Yes|No||||No|No|11/01/2012||Prescription required|No||231|No|.94759|03/29/2022|.92484|03/29/2022|.931|03/29/2022|||ANTIHYPERURICEMICS|4094|||||No|No||LANNETT CO. INC|No||||
danazol|No|No|No|No|75%|00527136801|DANAZOL 100 MG CAPSULE|100|EA|1.63744|08/18/2008||Yes|No||08/18/2008||Yes|No|08/18/2008||Yes|No||||No|No|||Prescription required|No|||No|3.73184|06/01/2016|3.67852|06/01/2016|3.50336|06/01/2016||||4095|||||No|No||LANNETT CO. INC|No||||
danazol|No|No|No|No|75%|00527136901|DANAZOL 200 MG CAPSULE|100|EA|2.7283|08/18/2008||Yes|No||08/18/2008||Yes|No|08/18/2008||Yes|No||||No|No|||Prescription required|No|||No|6.218|11/24/2020|6.12917|11/24/2020|5.8373|11/24/2020||||4096|||||No|No||LANNETT CO. INC|No||||
danazol|No|No|No|No|75%|00527136906|DANAZOL 200 MG CAPSULE|60|EA|3.09442|08/18/2008||Yes|No||08/18/2008||Yes|No|08/18/2008||Yes|No||||No|No|||Prescription required|No|||No|7.0524|11/24/2020|6.95165|11/24/2020|6.62062|11/24/2020||||4097|||||No|No||LANNETT CO. INC|No||||
danazol|No|No|No|No|75%|00527139201|DANAZOL 50 MG CAPSULE|100|EA|1.09116|08/18/2008||Yes|No||08/18/2008||Yes|No|08/18/2008||Yes|No||||No|No|||Prescription required|No|||No|2.48684|06/01/2016|2.45132|06/01/2016|2.33459|06/01/2016||||4098|||||No|No||LANNETT CO. INC|No||||
rifampin|No|No|No|No|75%|00527139301|RIFAMPIN 150 MG CAPSULE|100|EA|.3578|08/18/2008||Yes|No||08/18/2008||Yes|No|08/18/2008||Yes|No||||No|No|||Prescription required|No|||No|.77852|03/29/2022|.75983|03/29/2022|.76489|03/29/2022||||4099|||||No|No||LANNETT CO. INC|No||||
rifampin|No|No|No|No|75%|00527139330|RIFAMPIN 150 MG CAPSULE|30|EA|.42469|10/24/2008||Yes|No||10/24/2008||Yes|No|10/24/2008||Yes|No||||No|No|||Prescription required|No|||No|.77852|03/29/2022|.75983|03/29/2022|.76489|03/29/2022||||4100|||||No|No||LANNETT CO. INC|No||||
loxapine succinate|No|No|No|No|75%|00527139401|LOXAPINE 5 MG CAPSULE|100|EA|.23512|12/20/2011||Yes|No||12/20/2011||Yes|No|12/20/2011||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|027|Yes|.48716|01/25/2022|.47546|01/25/2022|.47863|01/25/2022|||ANTIPSYCHOTICS|4101|||||No|No||LANNETT CO. INC|No||||
loxapine succinate|No|No|No|No|75%|00527139501|LOXAPINE 10 MG CAPSULE|100|EA|.30917|12/20/2011||Yes|No||12/20/2011||Yes|No|12/20/2011||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|027|Yes|.55828|01/25/2022|.54488|01/25/2022|.54851|01/25/2022|||ANTIPSYCHOTICS|4102|||||No|No||LANNETT CO. INC|No||||
loxapine succinate|No|No|No|No|75%|00527139601|LOXAPINE 25 MG CAPSULE|100|EA|.47029|12/20/2011||Yes|No||12/20/2011||Yes|No|12/20/2011||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|027|Yes|.84036|01/25/2022|.82019|01/25/2022|.82565|01/25/2022|||ANTIPSYCHOTICS|4103|||||No|No||LANNETT CO. INC|No||||
loxapine succinate|No|No|No|No|75%|00527139701|LOXAPINE 50 MG CAPSULE|100|EA|.62685|12/20/2011||Yes|No||12/20/2011||Yes|No|12/20/2011||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|027|Yes|1.01035|10/26/2021|.9861|10/26/2021|.99266|10/26/2021|||ANTIPSYCHOTICS|4104|||||No|No||LANNETT CO. INC|No||||
pilocarpine HCl|No|No|No|No|75%|00527140701|PILOCARPINE HCL 7.5 MG TABLET|100|EA|.2798|08/15/2009||Yes|No||08/15/2009||Yes|No|08/15/2009||Yes|No||||No|No|||Prescription required|No|||No|.89289|03/29/2022|.87146|03/29/2022|.87726|03/29/2022||||4105|||||No|No||LANNETT CO. INC|No||||
metaxalone|No|No|No|No|75%|00527143501|METAXALONE 800 MG TABLET|100|EA|.258|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|116|Yes|.52754|03/29/2022|.51487|03/29/2022|.5183|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4106|||||No|No||LANNETT CO. INC|No||||
dronabinol|No|No|No|No|75%|00527145006|DRONABINOL 2.5 MG CAPSULE|60|EA|.72562|08/28/2019||Yes|No||08/28/2019||Yes|No|08/28/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|085|No|1.39891|03/29/2022|1.36533|03/29/2022|1.37442|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|4107|||||No|No||LANNETT CO. INC|No||||
dronabinol|No|No|No|No|75%|00527145106|DRONABINOL 5 MG CAPSULE|60|EA|1.51223|08/28/2019||Yes|No||08/28/2019||Yes|No|08/28/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|085|No|2.55851|03/29/2022|2.4971|03/29/2022|2.51373|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|4108|||||No|No||LANNETT CO. INC|No||||
dronabinol|No|No|No|No|75%|00527145206|DRONABINOL 10 MG CAPSULE|60|EA|2.32479|08/28/2019||Yes|No||08/28/2019||Yes|No|08/28/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|085|No|3.9278|03/29/2022|3.83353|03/29/2022|3.85906|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|4109|||||No|No||LANNETT CO. INC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00527150037|DEXTROAMP-AMPHETAMINE 5 MG TAB|100|EA|.09619|01/05/2021||Yes|No||01/05/2021||Yes|No|01/05/2021||Yes|No||||No|No|||Prescription required|No||007|Yes|.21985|03/29/2022|.21457|03/29/2022|.216|03/29/2022|||STIMULANTS AND RELATED AGENTS|4110|||||No|No||LANNETT CO. INC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00527150137|DEXTROAMP-AMPHETAM 7.5 MG TAB|100|EA|.09619|01/05/2021||Yes|No||01/05/2021||Yes|No|01/05/2021||Yes|No||||No|No|||Prescription required|No||007|Yes|.45915|03/29/2022|.44813|03/29/2022|.45111|03/29/2022|||STIMULANTS AND RELATED AGENTS|4111|||||No|No||LANNETT CO. INC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00527150237|DEXTROAMP-AMPHETAMIN 10 MG TAB|100|EA|.09619|01/05/2021||Yes|No||01/05/2021||Yes|No|01/05/2021||Yes|No||||No|No|||Prescription required|No||007|Yes|.24071|03/29/2022|.23493|03/29/2022|.23649|03/29/2022|||STIMULANTS AND RELATED AGENTS|4112|||||No|No||LANNETT CO. INC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00527150337|DEXTROAMP-AMPHETAM 12.5 MG TAB|100|EA|.09619|01/05/2021||Yes|No||01/05/2021||Yes|No|01/05/2021||Yes|No||||No|No|||Prescription required|No||007|Yes|.65907|03/01/2022|.64325|03/01/2022|.64753|03/01/2022|||STIMULANTS AND RELATED AGENTS|4113|||||No|No||LANNETT CO. INC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00527150437|DEXTROAMP-AMPHETAMIN 15 MG TAB|100|EA|.09619|01/05/2021||Yes|No||01/05/2021||Yes|No|01/05/2021||Yes|No||||No|No|||Prescription required|No||007|Yes|.25605|03/29/2022|.2499|03/29/2022|.25156|03/29/2022|||STIMULANTS AND RELATED AGENTS|4114|||||No|No||LANNETT CO. INC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00527150537|DEXTROAMP-AMPHETAMIN 20 MG TAB|100|EA|.09619|01/05/2021||Yes|No||01/05/2021||Yes|No|01/05/2021||Yes|No||||No|No|||Prescription required|No||007|Yes|.31357|03/29/2022|.30604|03/29/2022|.30808|03/29/2022|||STIMULANTS AND RELATED AGENTS|4115|||||No|No||LANNETT CO. INC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00527150637|DEXTROAMP-AMPHETAMIN 30 MG TAB|100|EA|.09619|01/05/2021||Yes|No||01/05/2021||Yes|No|01/05/2021||Yes|No||||No|No|||Prescription required|No||007|Yes|.30925|03/29/2022|.30182|03/29/2022|.30383|03/29/2022|||STIMULANTS AND RELATED AGENTS|4116|||||No|No||LANNETT CO. INC|No||||
doxycycline monohydrate|No|No|No|No|75%|00527153501|DOXYCYCLINE MONO 75 MG TABLET|100|EA|.69973|09/11/2008||Yes|No||09/11/2008||Yes|No|09/11/2008||Yes|No||09/11/2008||Yes|No|||Prescription required|Yes|01/15/2014|213|No|1.59475|06/01/2016|1.57197|06/01/2016|1.49711|06/01/2016|||TETRACYCLINES|4117|||||No|No||LANNETT CO. INC|No||||
doxycycline monohydrate|No|No|No|No|75%|00527153730|DOXYCYCLINE MONO 150 MG TABLET|30|EA|2.91124|09/11/2008||Yes|No||09/11/2008||Yes|No|09/11/2008||Yes|No||09/11/2008||Yes|No|||Prescription required|Yes|01/15/2014|213|No|6.63492|03/27/2018|6.54013|03/27/2018|6.2287|03/27/2018|||TETRACYCLINES|4118|||||No|No||LANNETT CO. INC|No||||
butalbital/aspirin/caffeine|No|No|No|No|90%|00527155201|BUTALBITAL-ASPIRIN-CAFFEINE CP|100|EA|.47085|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.92415|03/29/2022|.90197|03/29/2022|.90797|03/29/2022||||4119|||||No|No||LANNETT CO. INC|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|00527163201|TRIAMTERENE-HCTZ 37.5-25 MG CP|100|EA|.09782|12/20/2011||Yes|No||12/20/2011||Yes|No|12/20/2011||Yes|No||||No|No|||Prescription required|No|||Yes|.14661|03/29/2022|.14309|03/29/2022|.14404|03/29/2022||||4120|||||No|No||LANNETT CO. INC|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|00527163210|TRIAMTERENE-HCTZ 37.5-25 MG CP|1000|EA|.0949|12/20/2011||Yes|No||12/20/2011||Yes|No|12/20/2011||Yes|No||||No|No|||Prescription required|No|||Yes|.14661|03/29/2022|.14309|03/29/2022|.14404|03/29/2022||||4121|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527163801|LEVOTHYROXINE 137 MCG TABLET|100|EA|.23929|08/18/2008||Yes|No||08/18/2008||Yes|No|08/18/2008||Yes|No||||No|No|||Prescription required|No|||No|.22748|03/29/2022|.22202|03/29/2022|.22349|03/29/2022||||4122|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527163810|LEVOTHYROXINE 137 MCG TABLET|1000|EA|.23932|08/18/2008||Yes|No||08/18/2008||Yes|No|08/18/2008||Yes|No||||No|No|||Prescription required|No|||No|.22748|03/29/2022|.22202|03/29/2022|.22349|03/29/2022||||4123|||||No|No||LANNETT CO. INC|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|00527169501|BUTALB-ACETAMIN-CAFF 50-325-40|100|EA|.11416|08/14/2014||Yes|No||08/14/2014||Yes|No|08/14/2014||Yes|No||||No|No|||Prescription required|No|||No|.18524|03/29/2022|.18079|03/29/2022|.18199|03/29/2022||||4124|||||No|No||LANNETT CO. INC|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|00527169505|BUTALB-ACETAMIN-CAFF 50-325-40|500|EA|.11352|08/14/2014||Yes|No||08/14/2014||Yes|No|08/14/2014||Yes|No||||No|No|||Prescription required|No|||No|.18524|03/29/2022|.18079|03/29/2022|.18199|03/29/2022||||4125|||||No|No||LANNETT CO. INC|No||||
fluphenazine HCl|No|No|No|No|75%|00527178801|FLUPHENAZINE 1 MG TABLET|100|EA|.64448|12/20/2011||Yes|No||12/20/2011||Yes|No|12/20/2011||Yes|No||||No|No|||Prescription required|No||027|Yes|1.56797|01/25/2022|1.53033|01/25/2022|1.54053|01/25/2022|||ANTIPSYCHOTICS|4126|||||No|No||LANNETT CO. INC|No||||
fluphenazine HCl|No|No|No|No|75%|00527178901|FLUPHENAZINE 2.5 MG TABLET|100|EA|.99772|12/20/2011||Yes|No||12/20/2011||Yes|No|12/20/2011||Yes|No||||No|No|||Prescription required|No||027|Yes|2.3014|01/25/2022|2.24616|01/25/2022|2.26112|01/25/2022|||ANTIPSYCHOTICS|4127|||||No|No||LANNETT CO. INC|No||||
fluphenazine HCl|No|No|No|No|75%|00527179001|FLUPHENAZINE 5 MG TABLET|100|EA|1.34989|12/20/2011||Yes|No||12/20/2011||Yes|No|12/20/2011||Yes|No||||No|No|||Prescription required|No||027|Yes|2.98385|03/29/2022|2.91223|03/29/2022|2.93163|03/29/2022|||ANTIPSYCHOTICS|4128|||||No|No||LANNETT CO. INC|No||||
fluphenazine HCl|No|No|No|No|75%|00527179005|FLUPHENAZINE 5 MG TABLET|500|EA|2.4536|12/20/2011||Yes|No||12/20/2011||Yes|No|12/20/2011||Yes|No||||No|No|||Prescription required|No||027|Yes|2.98385|03/29/2022|2.91223|03/29/2022|2.93163|03/29/2022|||ANTIPSYCHOTICS|4129|||||No|No||LANNETT CO. INC|No||||
fluphenazine HCl|No|No|No|No|75%|00527179101|FLUPHENAZINE 10 MG TABLET|100|EA|1.70194|12/20/2011||Yes|No||12/20/2011||Yes|No|12/20/2011||Yes|No||||No|No|||Prescription required|No||027|Yes|3.52974|03/29/2022|3.44502|03/29/2022|3.46796|03/29/2022|||ANTIPSYCHOTICS|4130|||||No|No||LANNETT CO. INC|No||||
fluphenazine HCl|No|No|No|No|75%|00527179105|FLUPHENAZINE 10 MG TABLET|500|EA|3.09396|12/20/2011||Yes|No||12/20/2011||Yes|No|12/20/2011||Yes|No||||No|No|||Prescription required|No||027|Yes|3.52974|03/29/2022|3.44502|03/29/2022|3.46796|03/29/2022|||ANTIPSYCHOTICS|4131|||||No|No||LANNETT CO. INC|No||||
sumatriptan|No|No|No|No|75%|00527181843|SUMATRIPTAN 5 MG NASAL SPRAY|6|EA|25.93043|04/20/2020||Yes|No||04/20/2020||Yes|No|04/20/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|021|No|34.775|03/29/2022|33.9404|03/29/2022|34.16643|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|4132|||||No|No||LANNETT CO. INC|No||||
entacapone|No|No|No|No|75%|00527183037|ENTACAPONE 200 MG TABLET|100|EA|.387|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|015|No|.43301|03/29/2022|.42261|03/29/2022|.42543|03/29/2022|||ANTIPARKINSON'S AGENTS|4133|||||No|No||LANNETT CO. INC|No||||
sumatriptan|No|No|No|No|75%|00527185943|SUMATRIPTAN 20 MG NASAL SPRAY|6|EA|25.93043|04/20/2020||Yes|No||04/20/2020||Yes|No|04/20/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|021|No|23.30855|03/29/2022|22.74914|03/29/2022|22.90065|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|4134|||||No|No||LANNETT CO. INC|No||||
clarithromycin|No|No|No|No|75%|00527193106|CLARITHROMYCIN 250 MG TABLET|60|EA|.40312|05/01/2020||Yes|No||05/01/2020||Yes|No|05/01/2020||Yes|No||||No|No|||Prescription required|No||018|No|.54294|03/29/2022|.5299|03/29/2022|.53343|03/29/2022|||MACROLIDES/KETOLIDES|4135|||||No|No||LANNETT CO. INC|No||||
clarithromycin|No|No|No|No|75%|00527193206|CLARITHROMYCIN 500 MG TABLET|60|EA|.40312|05/01/2020||Yes|No||05/01/2020||Yes|No|05/01/2020||Yes|No||||No|No|||Prescription required|No||018|No|.44307|03/29/2022|.43243|03/29/2022|.43531|03/29/2022|||MACROLIDES/KETOLIDES|4136|||||No|No||LANNETT CO. INC|No||||
levofloxacin|No|No|No|No|75%|00527194866|LEVOFLOXACIN 25 MG/ML SOLUTION|100|ML|.48013|06/26/2020||Yes|No||06/26/2020||Yes|No|06/26/2020||Yes|No||06/26/2020||Yes|No|||Prescription required|Yes|07/29/2021|028|No|1.10746|09/28/2021|1.08088|09/28/2021|1.08807|09/28/2021|||FLUOROQUINOLONES: ORAL|4137|||||No|No||LANNETT CO. INC|No||||
levofloxacin|No|No|No|No|75%|00527194868|LEVOFLOXACIN 25 MG/ML SOLUTION|200|ML|.48013|06/26/2020||Yes|No||06/26/2020||Yes|No|06/26/2020||Yes|No||06/26/2020||Yes|No|||Prescription required|Yes|07/29/2021|028|No|1.09426|06/26/2020|1.07863|06/26/2020|1.02727|06/26/2020|||FLUOROQUINOLONES: ORAL|4138|||||No|No||LANNETT CO. INC|No||||
levofloxacin|No|No|No|No|75%|00527194870|LEVOFLOXACIN 25 MG/ML SOLUTION|480|ML|.47532|06/26/2020||Yes|No||06/26/2020||Yes|No|06/26/2020||Yes|No||06/26/2020||Yes|No|||Prescription required|Yes|07/29/2021|028|No|1.0833|06/26/2020|1.06782|06/26/2020|1.01697|06/26/2020|||FLUOROQUINOLONES: ORAL|4139|||||No|No||LANNETT CO. INC|No||||
cyproheptadine HCl|No|No|No|No|75%|00527194947|CYPROHEPTADINE 2 MG/5 ML SYRUP|473|ML|.04634|01/12/2022||Yes|No||01/12/2022||Yes|No|01/12/2022||Yes|No||||No|No|||Prescription required|No||574|Yes|.06009|03/29/2022|.05864|03/29/2022|.05903|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|4140|||||No|No||LANNETT CO. INC|No||||
posaconazole|No|No|No|No|75%|00527213335|POSACONAZOLE DR 100 MG TABLET|60|EA|10.60845|11/22/2021||Yes|No||11/22/2021||Yes|No|11/22/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|069|No|22.47154|03/29/2022|21.93222|03/29/2022|22.07828|03/29/2022|||ANTIFUNGALS: ORAL|4141|||||No|No||LANNETT CO. INC|No||||
diclofenac sodium|No|No|No|No|75%|00527217037|DICLOFENAC SOD ER 100 MG TAB|100|EA|.96728|01/30/2020||Yes|No||01/30/2020||Yes|No|01/30/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|1.0568|03/29/2022|1.03143|03/29/2022|1.0383|03/29/2022|||NSAIDS|4142|||||No|No||LANNETT CO. INC|No||||
metoprolol succinate|No|No|No|No|75%|00527260037|METOPROLOL SUCC ER 25 MG TAB|100|EA|.10741|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||05/18/2018||Yes|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|4143|||||No|No||LANNETT CO. INC|No||||
metoprolol succinate|No|No|No|No|75%|00527260043|METOPROLOL SUCC ER 25 MG TAB|1000|EA|.10096|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||05/18/2018||Yes|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|4144|||||No|No||LANNETT CO. INC|No||||
metoprolol succinate|No|No|No|No|75%|00527260137|METOPROLOL SUCC ER 50 MG TAB|100|EA|.10741|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||05/18/2018||Yes|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|4145|||||No|No||LANNETT CO. INC|No||||
metoprolol succinate|No|No|No|No|75%|00527260143|METOPROLOL SUCC ER 50 MG TAB|1000|EA|.10096|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||05/18/2018||Yes|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|4146|||||No|No||LANNETT CO. INC|No||||
metoprolol succinate|No|No|No|No|75%|00527260237|METOPROLOL SUCC ER 100 MG TAB|100|EA|.16017|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||05/18/2018||Yes|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|4147|||||No|No||LANNETT CO. INC|No||||
metoprolol succinate|No|No|No|No|75%|00527260243|METOPROLOL SUCC ER 100 MG TAB|1000|EA|.15376|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||05/18/2018||Yes|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|4148|||||No|No||LANNETT CO. INC|No||||
metoprolol succinate|No|No|No|No|75%|00527260337|METOPROLOL SUCC ER 200 MG TAB|100|EA|.25787|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||05/18/2018||Yes|No|||Prescription required|No||070|No|.25385|03/29/2022|.24775|03/29/2022|.2494|03/29/2022|||BETA-BLOCKERS|4149|||||No|No||LANNETT CO. INC|No||||
metoprolol succinate|No|No|No|No|75%|00527260343|METOPROLOL SUCC ER 200 MG TAB|1000|EA|.24755|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||05/18/2018||Yes|No|||Prescription required|No||070|No|.25385|03/29/2022|.24775|03/29/2022|.2494|03/29/2022|||BETA-BLOCKERS|4150|||||No|No||LANNETT CO. INC|No||||
prednisone|No|No|No|No|75%|00527293037|PREDNISONE 1 MG TABLET|100|EA|.08698|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||03/06/2020||Yes|No|||Prescription required|No||168|Yes|.08042|03/29/2022|.07848|03/29/2022|.07901|03/29/2022|||GLUCOCORTICOIDS: ORAL|4151|||||No|No||LANNETT CO. INC|No||||
prednisone|No|No|No|No|75%|00527293043|PREDNISONE 1 MG TABLET|1000|EA|.08351|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||03/06/2020||Yes|No|||Prescription required|No||168|Yes|.08042|03/29/2022|.07848|03/29/2022|.07901|03/29/2022|||GLUCOCORTICOIDS: ORAL|4152|||||No|No||LANNETT CO. INC|No||||
prednisone|No|No|No|No|75%|00527293137|PREDNISONE 2.5 MG TABLET|100|EA|.05667|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||03/06/2020||Yes|No|||Prescription required|No||168|Yes|.09048|03/29/2022|.0883|03/29/2022|.08889|03/29/2022|||GLUCOCORTICOIDS: ORAL|4153|||||No|No||LANNETT CO. INC|No||||
prednisone|No|No|No|No|75%|00527293237|PREDNISONE 5 MG TABLET|100|EA|.0666|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||03/06/2020||Yes|No|||Prescription required|No||168|Yes|.07803|03/29/2022|.07615|03/29/2022|.07666|03/29/2022|||GLUCOCORTICOIDS: ORAL|4154|||||No|No||LANNETT CO. INC|No||||
prednisone|No|No|No|No|75%|00527293243|PREDNISONE 5 MG TABLET|1000|EA|.06394|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||03/06/2020||Yes|No|||Prescription required|No||168|Yes|.07803|03/29/2022|.07615|03/29/2022|.07666|03/29/2022|||GLUCOCORTICOIDS: ORAL|4155|||||No|No||LANNETT CO. INC|No||||
prednisone|No|No|No|No|75%|00527293337|PREDNISONE 10 MG TABLET|100|EA|.07507|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||03/06/2020||Yes|No|||Prescription required|No||168|Yes|.07092|03/29/2022|.06921|03/29/2022|.06967|03/29/2022|||GLUCOCORTICOIDS: ORAL|4156|||||No|No||LANNETT CO. INC|No||||
prednisone|No|No|No|No|75%|00527293341|PREDNISONE 10 MG TABLET|500|EA|.07357|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||03/06/2020||Yes|No|||Prescription required|No||168|Yes|.07092|03/29/2022|.06921|03/29/2022|.06967|03/29/2022|||GLUCOCORTICOIDS: ORAL|4157|||||No|No||LANNETT CO. INC|No||||
prednisone|No|No|No|No|75%|00527293437|PREDNISONE 20 MG TABLET|100|EA|.08019|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||03/06/2020||Yes|No|||Prescription required|No||168|Yes|.11229|03/29/2022|.10959|03/29/2022|.11032|03/29/2022|||GLUCOCORTICOIDS: ORAL|4158|||||No|No||LANNETT CO. INC|No||||
prednisone|No|No|No|No|75%|00527293441|PREDNISONE 20 MG TABLET|500|EA|.07859|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||03/06/2020||Yes|No|||Prescription required|No||168|Yes|.11229|03/29/2022|.10959|03/29/2022|.11032|03/29/2022|||GLUCOCORTICOIDS: ORAL|4159|||||No|No||LANNETT CO. INC|No||||
prednisone|No|No|No|No|75%|00527293537|PREDNISONE 50 MG TABLET|100|EA|.14|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||03/06/2020||Yes|No|||Prescription required|No||168|Yes|.26795|03/29/2022|.26151|03/29/2022|.26326|03/29/2022|||GLUCOCORTICOIDS: ORAL|4160|||||No|No||LANNETT CO. INC|No||||
dantrolene sodium|No|No|No|No|75%|00527321937|DANTROLENE SODIUM 25 MG CAP|100|EA|.27799|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|No|.43377|03/29/2022|.42335|03/29/2022|.42617|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4161|||||No|No||LANNETT CO. INC|No||||
dantrolene sodium|No|No|No|No|75%|00527322037|DANTROLENE SODIUM 50 MG CAP|100|EA|.44973|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|No|.99541|03/01/2022|.97152|03/01/2022|.97799|03/01/2022|||SKELETAL MUSCLE RELAXANTS|4162|||||No|No||LANNETT CO. INC|No||||
dantrolene sodium|No|No|No|No|75%|00527322137|DANTROLENE SODIUM 100 MG CAP|100|EA|.56394|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|No|.85614|03/01/2022|.83559|03/01/2022|.84115|03/01/2022|||SKELETAL MUSCLE RELAXANTS|4163|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527328043|LEVOTHYROXINE 25 MCG TABLET|1000|EA|.04097|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|No|||No|.11852|03/29/2022|.11567|03/29/2022|.11644|03/29/2022||||4164|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527328046|LEVOTHYROXINE 25 MCG TABLET|90|EA|.0418|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|No|||No|.11852|03/29/2022|.11567|03/29/2022|.11644|03/29/2022||||4165|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527328143|LEVOTHYROXINE 50 MCG TABLET|1000|EA|.04267|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|No|||No|.14288|03/29/2022|.13945|03/29/2022|.14037|03/29/2022||||4166|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527328146|LEVOTHYROXINE 50 MCG TABLET|90|EA|.04352|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|No|||No|.14288|03/29/2022|.13945|03/29/2022|.14037|03/29/2022||||4167|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527328243|LEVOTHYROXINE 75 MCG TABLET|1000|EA|.04362|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|No|||No|.15545|03/29/2022|.15171|03/29/2022|.15272|03/29/2022||||4168|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527328246|LEVOTHYROXINE 75 MCG TABLET|90|EA|.04452|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|No|||No|.15545|03/29/2022|.15171|03/29/2022|.15272|03/29/2022||||4169|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527328346|LEVOTHYROXINE 88 MCG TABLET|90|EA|.04419|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|No|||No|.16198|03/29/2022|.15809|03/29/2022|.15914|03/29/2022||||4170|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527328443|LEVOTHYROXINE 100 MCG TABLET|1000|EA|.04549|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|No|||No|.17286|03/29/2022|.16871|03/29/2022|.16983|03/29/2022||||4171|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527328446|LEVOTHYROXINE 100 MCG TABLET|90|EA|.04644|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|No|||No|.17286|03/29/2022|.16871|03/29/2022|.16983|03/29/2022||||4172|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527328546|LEVOTHYROXINE 112 MCG TABLET|90|EA|.04968|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|No|||No|.1546|03/29/2022|.15088|03/29/2022|.15189|03/29/2022||||4173|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527328643|LEVOTHYROXINE 125 MCG TABLET|1000|EA|.05611|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|No|||No|.18894|03/29/2022|.1844|03/29/2022|.18563|03/29/2022||||4174|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527328646|LEVOTHYROXINE 125 MCG TABLET|90|EA|.05723|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|No|||No|.18894|03/29/2022|.1844|03/29/2022|.18563|03/29/2022||||4175|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527328746|LEVOTHYROXINE 137 MCG TABLET|90|EA|.06311|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|No|||No|.22748|03/29/2022|.22202|03/29/2022|.22349|03/29/2022||||4176|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527328843|LEVOTHYROXINE 150 MCG TABLET|1000|EA|.04604|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|No|||No|.21406|03/29/2022|.20892|03/29/2022|.21031|03/29/2022||||4177|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527328846|LEVOTHYROXINE 150 MCG TABLET|90|EA|.04701|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|No|||No|.21406|03/29/2022|.20892|03/29/2022|.21031|03/29/2022||||4178|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527328946|LEVOTHYROXINE 175 MCG TABLET|90|EA|.07018|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|No|||No|.2247|03/29/2022|.2193|03/29/2022|.22076|03/29/2022||||4179|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527329046|LEVOTHYROXINE 200 MCG TABLET|90|EA|.061|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|No|||No|.2307|03/29/2022|.22516|03/29/2022|.22666|03/29/2022||||4180|||||No|No||LANNETT CO. INC|No||||
levothyroxine sodium|No|No|No|No|75%|00527329146|LEVOTHYROXINE 300 MCG TABLET|90|EA|.08274|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|No|||No|.17616|03/29/2022|.17193|03/29/2022|.17307|03/29/2022||||4181|||||No|No||LANNETT CO. INC|No||||
methylphenidate HCl|No|No|No|No|75%|00527331037|METHYLPHENIDATE ER 18 MG TAB|100|EA|.32219|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.56499|03/29/2022|.55143|03/29/2022|.5551|03/29/2022|||STIMULANTS AND RELATED AGENTS|4182|||||No|No||LANNETT CO. INC|No||||
methylphenidate HCl|No|No|No|No|75%|00527331137|METHYLPHENIDATE ER 27 MG TAB|100|EA|.33024|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.90623|03/29/2022|.88448|03/29/2022|.89037|03/29/2022|||STIMULANTS AND RELATED AGENTS|4183|||||No|No||LANNETT CO. INC|No||||
methylphenidate HCl|No|No|No|No|75%|00527331237|METHYLPHENIDATE ER 36 MG TAB|100|EA|.34064|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.76999|03/29/2022|.75151|03/29/2022|.75651|03/29/2022|||STIMULANTS AND RELATED AGENTS|4184|||||No|No||LANNETT CO. INC|No||||
methylphenidate HCl|No|No|No|No|75%|00527331337|METHYLPHENIDATE ER 54 MG TAB|100|EA|.37066|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.87218|03/29/2022|.85124|03/29/2022|.85691|03/29/2022|||STIMULANTS AND RELATED AGENTS|4185|||||No|No||LANNETT CO. INC|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|00527409537|BUTALB-ACETAMIN-CAFF 50-300-40|100|EA|.72111|06/26/2020||Yes|No||06/26/2020||Yes|No|06/26/2020||Yes|No||||No|No|||Prescription required|No|||No|.69452|03/29/2022|.67785|03/29/2022|.68236|03/29/2022||||4186|||||No|No||LANNETT CO. INC|No||||
propranolol HCl|No|No|No|No|75%|00527411637|PROPRANOLOL ER 60 MG CAPSULE|100|EA|.08707|10/28/2021||Yes|No||10/28/2021||Yes|No|10/28/2021||Yes|No||10/28/2021||Yes|No|||Prescription required|Yes|07/26/2018|070|No|.32013|03/29/2022|.31244|03/29/2022|.31452|03/29/2022|||BETA-BLOCKERS|4187|||||No|No||LANNETT CO. INC|No||||
propranolol HCl|No|No|No|No|75%|00527411737|PROPRANOLOL ER 80 MG CAPSULE|100|EA|.09675|10/28/2021||Yes|No||10/28/2021||Yes|No|10/28/2021||Yes|No||10/28/2021||Yes|No|||Prescription required|Yes|07/26/2018|070|No|.35912|03/29/2022|.3505|03/29/2022|.35283|03/29/2022|||BETA-BLOCKERS|4188|||||No|No||LANNETT CO. INC|No||||
propranolol HCl|No|No|No|No|75%|00527411837|PROPRANOLOL ER 120 MG CAPSULE|100|EA|.1161|10/28/2021||Yes|No||10/28/2021||Yes|No|10/28/2021||Yes|No||10/28/2021||Yes|No|||Prescription required|Yes|07/26/2018|070|No|.4314|03/29/2022|.42104|03/29/2022|.42385|03/29/2022|||BETA-BLOCKERS|4189|||||No|No||LANNETT CO. INC|No||||
propranolol HCl|No|No|No|No|75%|00527411937|PROPRANOLOL ER 160 MG CAPSULE|100|EA|.1548|10/28/2021||Yes|No||10/28/2021||Yes|No|10/28/2021||Yes|No||10/28/2021||Yes|No|||Prescription required|Yes|07/26/2018|070|No|.61078|03/29/2022|.59612|03/29/2022|.60009|03/29/2022|||BETA-BLOCKERS|4190|||||No|No||LANNETT CO. INC|No||||
methylphenidate HCl|No|No|No|No|75%|00527457937|METHYLPHENIDATE CD 10 MG CAP|100|EA|.61107|06/23/2020||Yes|No||06/23/2020||Yes|No|06/23/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|1.31759|03/29/2022|1.28596|03/29/2022|1.29453|03/29/2022|||STIMULANTS AND RELATED AGENTS|4191|||||No|No||LANNETT CO. INC|No||||
methylphenidate HCl|No|No|No|No|75%|00527458037|METHYLPHENIDATE CD 20 MG CAP|100|EA|.61107|06/23/2020||Yes|No||06/23/2020||Yes|No|06/23/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|1.42341|03/29/2022|1.38924|03/29/2022|1.3985|03/29/2022|||STIMULANTS AND RELATED AGENTS|4192|||||No|No||LANNETT CO. INC|No||||
methylphenidate HCl|No|No|No|No|75%|00527458137|METHYLPHENIDATE CD 30 MG CAP|100|EA|.61107|06/23/2020||Yes|No||06/23/2020||Yes|No|06/23/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|1.42159|03/29/2022|1.38747|03/29/2022|1.39671|03/29/2022|||STIMULANTS AND RELATED AGENTS|4193|||||No|No||LANNETT CO. INC|No||||
methylphenidate HCl|No|No|No|No|75%|00527458237|METHYLPHENIDATE CD 40 MG CAP|100|EA|.80797|06/23/2020||Yes|No||06/23/2020||Yes|No|06/23/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|1.70323|03/29/2022|1.66235|03/29/2022|1.67342|03/29/2022|||STIMULANTS AND RELATED AGENTS|4194|||||No|No||LANNETT CO. INC|No||||
methylphenidate HCl|No|No|No|No|75%|00527458337|METHYLPHENIDATE CD 50 MG CAP|100|EA|.82607|06/23/2020||Yes|No||06/23/2020||Yes|No|06/23/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|2.6246|01/25/2022|2.5616|01/25/2022|2.57866|01/25/2022|||STIMULANTS AND RELATED AGENTS|4195|||||No|No||LANNETT CO. INC|No||||
methylphenidate HCl|No|No|No|No|75%|00527458437|METHYLPHENIDATE CD 60 MG CAP|100|EA|.82607|06/23/2020||Yes|No||06/23/2020||Yes|No|06/23/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|1.91295|03/08/2022|1.86703|03/08/2022|1.87947|03/08/2022|||STIMULANTS AND RELATED AGENTS|4196|||||No|No||LANNETT CO. INC|No||||
nystatin|No|No|No|No|75%|00527512162|NYSTATIN 100,000 UNIT/ML SUSP|60|ML|.07883|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||05/18/2021||Yes|No|||Prescription required|No||069|No|.14005|03/29/2022|.13668|03/29/2022|.13759|03/29/2022|||ANTIFUNGALS: ORAL|4197|||||No|No||LANNETT CO. INC|No||||
nystatin|No|No|No|No|75%|00527512170|NYSTATIN 100,000 UNIT/ML SUSP|473|ML|.02727|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||05/18/2021||Yes|No|||Prescription required|No||069|No|.04529|03/29/2022|.0442|03/29/2022|.04449|03/29/2022|||ANTIFUNGALS: ORAL|4198|||||No|No||LANNETT CO. INC|No||||
brompheniramine/pseudoephed/DM|No|No|No|No|75%|00527530264|BROMPHEN-PSE-DM 2-30-10 MG/5ML|118|ML|.03643|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|No||184|Yes|.0774|03/29/2022|.07554|03/29/2022|.07604|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|4199|||||No|No||LANNETT CO. INC|No||||
brompheniramine/pseudoephed/DM|No|No|No|No|75%|00527530270|BROMPHEN-PSE-DM 2-30-10 MG/5ML|473|ML|.03181|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|No||184|Yes|.06501|03/29/2022|.06344|03/29/2022|.06387|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|4200|||||No|No||LANNETT CO. INC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00527551037|DEXTROAMP-AMPHET ER 5 MG CAP|100|EA|.215|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.59233|03/29/2022|.57811|03/29/2022|.58196|03/29/2022|||STIMULANTS AND RELATED AGENTS|4201|||||No|No||LANNETT CO. INC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00527551137|DEXTROAMP-AMPHET ER 10 MG CAP|100|EA|.215|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.53198|03/29/2022|.51921|03/29/2022|.52267|03/29/2022|||STIMULANTS AND RELATED AGENTS|4202|||||No|No||LANNETT CO. INC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00527551237|DEXTROAMP-AMPHET ER 15 MG CAP|100|EA|.215|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55636|03/29/2022|.543|03/29/2022|.54662|03/29/2022|||STIMULANTS AND RELATED AGENTS|4203|||||No|No||LANNETT CO. INC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00527551337|DEXTROAMP-AMPHET ER 20 MG CAP|100|EA|.215|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.58746|03/29/2022|.57336|03/29/2022|.57717|03/29/2022|||STIMULANTS AND RELATED AGENTS|4204|||||No|No||LANNETT CO. INC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00527551437|DEXTROAMP-AMPHET ER 25 MG CAP|100|EA|.215|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.54687|03/29/2022|.53374|03/29/2022|.53729|03/29/2022|||STIMULANTS AND RELATED AGENTS|4205|||||No|No||LANNETT CO. INC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00527551537|DEXTROAMP-AMPHET ER 30 MG CAP|100|EA|.215|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.61484|03/29/2022|.60008|03/29/2022|.60408|03/29/2022|||STIMULANTS AND RELATED AGENTS|4206|||||No|No||LANNETT CO. INC|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00527810637|DEXMETHYLPHENIDATE ER 5 MG CAP|100|EA|.51987|08/19/2019||Yes|No||08/19/2019||Yes|No|08/19/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.46405|03/29/2022|1.42891|03/29/2022|1.43842|03/29/2022|||STIMULANTS AND RELATED AGENTS|4207|||||No|No||LANNETT CO. INC|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00527810737|DEXMETHYLPHENIDATE ER 10 MG CP|100|EA|.55147|08/19/2019||Yes|No||08/19/2019||Yes|No|08/19/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.21716|03/29/2022|1.18794|03/29/2022|1.19585|03/29/2022|||STIMULANTS AND RELATED AGENTS|4208|||||No|No||LANNETT CO. INC|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00527810837|DEXMETHYLPHENIDATE ER 15 MG CP|100|EA|.31871|08/19/2019||Yes|No||08/19/2019||Yes|No|08/19/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.90155|03/29/2022|.87991|03/29/2022|.88577|03/29/2022|||STIMULANTS AND RELATED AGENTS|4209|||||No|No||LANNETT CO. INC|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00527810937|DEXMETHYLPHENIDATE ER 20 MG CP|100|EA|.66439|08/19/2019||Yes|No||08/19/2019||Yes|No|08/19/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.47249|03/29/2022|1.43715|03/29/2022|1.44672|03/29/2022|||STIMULANTS AND RELATED AGENTS|4210|||||No|No||LANNETT CO. INC|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00527811037|DEXMETHYLPHENIDATE ER 25 MG CP|100|EA|.64801|08/19/2019||Yes|No||08/19/2019||Yes|No|08/19/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.83308|03/29/2022|1.78908|03/29/2022|1.801|03/29/2022|||STIMULANTS AND RELATED AGENTS|4211|||||No|No||LANNETT CO. INC|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00527811137|DEXMETHYLPHENIDATE ER 30 MG CP|100|EA|.47196|08/19/2019||Yes|No||08/19/2019||Yes|No|08/19/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|2.05596|03/29/2022|2.00661|03/29/2022|2.01998|03/29/2022|||STIMULANTS AND RELATED AGENTS|4212|||||No|No||LANNETT CO. INC|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00527811237|DEXMETHYLPHENIDATE ER 35 MG CP|100|EA|.68043|08/19/2019||Yes|No||08/19/2019||Yes|No|08/19/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|2.40563|01/25/2022|2.34789|01/25/2022|2.36353|01/25/2022|||STIMULANTS AND RELATED AGENTS|4213|||||No|No||LANNETT CO. INC|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00527811337|DEXMETHYLPHENIDATE ER 40 MG CP|100|EA|.56953|08/19/2019||Yes|No||08/19/2019||Yes|No|08/19/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|2.72731|03/29/2022|2.66185|03/29/2022|2.67958|03/29/2022|||STIMULANTS AND RELATED AGENTS|4214|||||No|No||LANNETT CO. INC|No||||
mag hydrox/aluminum hyd/simeth|No|No|No|No|75%|00536001583|ALMACONE-2 LIQUID|355|ML|.00342|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No|||No|.00902|03/29/2022|.0088|03/29/2022|.00886|03/29/2022||||4215|||||No|No||RUGBY|No||||
aluminum hydroxide|No|No|No|No|75%|00536009185|ALUMINUM HYDROXIDE GEL|473|ML|.00459|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||09/01/1999||Yes|No|||Over the counter|No|||No|.01047|06/29/2021|.01032|06/29/2021|.00983|06/29/2021||||4216|||||No|No||RUGBY|No||||
chlorpheniramine maleate|No|No|No|No|75%|00536100601|ALLER-CHLOR 4 MG TABLET|100|EA|.01552|02/10/2015||Yes|No||||No|No|02/10/2015||Yes|No||||No|No|||Over the counter|No||574|Yes|.01452|03/29/2022|.01417|03/29/2022|.01426|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|4217|||||No|No||RUGBY|No||||
chlorpheniramine maleate|No|No|No|No|75%|00536100610|ALLER-CHLOR 4 MG TABLET|1000|EA|.00467|02/10/2015||Yes|No||||No|No|02/10/2015||Yes|No||||No|No|||Over the counter|No||574|Yes|.01452|03/29/2022|.01417|03/29/2022|.01426|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|4218|||||No|No||RUGBY|No||||
calcium carbonate|No|No|No|No|75%|00536100715|CAL-GEST 500 MG TABLET CHEW|150|EA|.00748|12/02/2014||Yes|No||||No|No|12/02/2014||Yes|No||||No|No|||Over the counter|No|||No|.01526|03/29/2022|.01489|03/29/2022|.01499|03/29/2022||||4219|||||No|No||RUGBY|No||||
diphenhydramine HCl|No|No|No|No|75%|00536101001|DIPHENHIST 25 MG CAPSULE|100|EA|.01732|11/07/2016||Yes|No||||No|No|11/07/2016||Yes|No||||No|No|||Over the counter|No||574|Yes|.03464|03/29/2022|.0338|03/29/2022|.03403|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|4220|||||No|No||RUGBY|No||||
meclizine HCl|No|No|No|No|75%|00536101810|TRAVEL SICKNESS 25 MG TAB CHEW|1000|EA|.01176|12/04/2014|01/19/2022|Yes|No||||No|No|12/04/2014|01/19/2022|Yes|No||12/04/2014|01/19/2022|Yes|No|||Over the counter|No||085|Yes|.03332|12/28/2021|.03252|12/28/2021|.03273|12/28/2021|||ANTIEMETIC/ANTIVERTIGO AGENTS|4221|Discontinued by Manufacturer||Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||RUGBY|No||||
bismuth subsalicylate|No|No|No|No|75%|00536102107|PEPTIC RELIEF 262 MG CHEW TAB|30|EA|.02651|05/12/2015|07/29/2022|Yes|No||||No|No|05/12/2015|07/29/2022|Yes|No||||No|No|||Over the counter|No|||No|.08173|03/29/2022|.07976|03/29/2022|.08029|03/29/2022||||4222|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||RUGBY|No||||
sodium bicarbonate|No|No|No|No|75%|00536104610|SODIUM BICARB 325 MG TABLET|1000|EA|.00651|04/24/2015||Yes|No||||No|No|04/24/2015||Yes|No||||No|No|||Over the counter|No|||No|.01484|12/28/2021|.01463|12/28/2021|.01393|12/28/2021||||4223|||||No|No||RUGBY|No||||
sodium bicarbonate|No|No|No|No|75%|00536104710|SODIUM BICARB 650 MG TABLET|1000|EA|.00698|07/21/2015||Yes|No||||No|No|07/21/2015||Yes|No||||No|No|||Over the counter|No|||No|.01539|03/29/2022|.01502|03/29/2022|.01512|03/29/2022||||4224|||||No|No||RUGBY|No||||
calcium carbonate|No|No|No|No|75%|00536104815|CALCIUM ANTACID 500 MG CHW TAB|150|EA|.00484|05/12/2015||Yes|No||||No|No|05/12/2015||Yes|No||||No|No|||Over the counter|No|||No|.01526|03/29/2022|.01489|03/29/2022|.01499|03/29/2022||||4225|||||No|No||RUGBY|No||||
polyethylene glycol 3350|No|No|No|No|75%|00536105224|POLYETHYLENE GLYCOL 3350 POWD|238|GM|.00955|09/03/2015||Yes|No||||No|No|09/03/2015||Yes|No||09/03/2015||Yes|No|||Over the counter|No|||No|.02672|03/29/2022|.02607|03/29/2022|.02625|03/29/2022||||4226|||||No|No||RUGBY|No||||
polyethylene glycol 3350|No|No|No|No|75%|00536105227|POLYETHYLENE GLYCOL 3350 POWD|510|GM|.00847|04/24/2015||Yes|No||||No|No|04/24/2015||Yes|No||04/24/2015||Yes|No|||Over the counter|No|||No|.02124|03/29/2022|.02073|03/29/2022|.02086|03/29/2022||||4227|||||No|No||RUGBY|No||||
polyethylene glycol 3350|No|No|No|No|75%|00536105284|POLYETHYLENE GLYCOL 3350 POWD|850|GM|.00737|04/24/2015||Yes|No||||No|No|04/24/2015||Yes|No||04/24/2015||Yes|No|||Over the counter|No|||No|.01681|06/01/2016|.01657|06/01/2016|.01578|06/01/2016||||4228|||||No|No||RUGBY|No||||
aspirin|No|No|No|No|75%|00536105429|ASPIRIN 325 MG TABLET|100|EA|.00455|07/20/2015||Yes|No||||No|No|07/20/2015||Yes|No||||No|No|||Over the counter|No|||No|.01006|03/29/2022|.00981|03/29/2022|.00988|03/29/2022||||4229|||||No|No||RUGBY|No||||
benzoyl peroxide|No|No|No|No|75%|00536105525|ACNE MEDICATION 5% GEL|60|GM|.08256|11/24/2020||Yes|No||||No|No|11/24/2020||Yes|No||||No|No|||Over the counter|No|||No|.22386|03/01/2022|.21848|03/01/2022|.21994|03/01/2022||||4230|||||No|No||RUGBY|No||||
benzoyl peroxide|No|No|No|No|75%|00536105556|ACNE MEDICATION 5% GEL|42.5|GM|.03642|04/24/2015||Yes|No||||No|No|04/24/2015||Yes|No||||No|No|||Over the counter|No|||No|.06491|03/29/2022|.06335|03/29/2022|.06377|03/29/2022||||4231|||||No|No||RUGBY|No||||
benzoyl peroxide|No|No|No|No|75%|00536105625|ACNE MEDICATION 10% GEL|60|GM|.08277|09/18/2020||Yes|No||||No|No|09/18/2020||Yes|No||||No|No|||Over the counter|No|||No|.2248|11/23/2021|.2194|11/23/2021|.22086|11/23/2021||||4232|||||No|No||RUGBY|No||||
benzoyl peroxide|No|No|No|No|75%|00536105656|ACNE MEDICATION 10% GEL|42.5|GM|.03854|04/24/2015||Yes|No||||No|No|04/24/2015||Yes|No||||No|No|||Over the counter|No|||No|.09027|01/25/2022|.0881|01/25/2022|.08869|01/25/2022||||4233|||||No|No||RUGBY|No||||
benzoyl peroxide|No|No|No|No|75%|00536105775|ACNE MEDICATION 5% LOTION|29.5|ML|.02929|11/07/2016||Yes|No||||No|No|11/07/2016||Yes|No||||No|No|||Over the counter|No|||No|.06563|12/28/2021|.06405|12/28/2021|.06448|12/28/2021||||4234|||||No|No||RUGBY|No||||
benzoyl peroxide|No|No|No|No|75%|00536105875|ACNE MEDICATION 10% LOTION|29.5|ML|.03352|04/24/2015||Yes|No||||No|No|04/24/2015||Yes|No||||No|No|||Over the counter|No|||No|.0764|03/23/2021|.0753|03/23/2021|.07172|03/23/2021||||4235|||||No|No||RUGBY|No||||
menthol|No|No|No|No|75%|00536106139|BLUE 2% GEL|226.8|GM|.00473|04/24/2015||Yes|No||||No|No|04/24/2015||Yes|No||||No|No|||Over the counter|No|||No|.01529|03/29/2022|.01492|03/29/2022|.01502|03/29/2022||||4236|||||No|No||RUGBY|No||||
docusate sodium|No|No|No|No|75%|00536106210|STOOL SOFTENER 100 MG SOFTGEL|1000|EA|.00847|06/06/2016|02/17/2022|Yes|No||||No|No|06/06/2016|02/17/2022|Yes|No||06/06/2016|02/17/2022|Yes|No|||Over the counter|No|||No|.02114|03/29/2022|.02063|03/29/2022|.02077|03/29/2022||||4237|Discontinued by Manufacturer||Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||RUGBY|No||||
docusate sodium|No|No|No|No|75%|00536106229|STOOL SOFTENER 100 MG SOFTGEL|100|EA|.01612|06/06/2016|04/14/2022|Yes|No||||No|No|06/06/2016|04/14/2022|Yes|No||06/06/2016|04/14/2022|Yes|No|||Over the counter|No|||No|.02114|03/29/2022|.02063|03/29/2022|.02077|03/29/2022||||4238|Discontinued by Manufacturer||Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||RUGBY|No||||
docusate calcium|No|No|No|No|75%|00536106505|STOOL SOFTENER 240 MG SOFTGEL|500|EA|.02228|09/03/2015|02/04/2022|Yes|No||||No|No|09/03/2015|02/04/2022|Yes|No||||No|No|||Over the counter|No|||No|.06192|03/29/2022|.06043|03/29/2022|.06083|03/29/2022||||4239|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||RUGBY|No||||
dextromethorphan HBr|No|No|No|No|75%|00536106834|ROBAFEN COUGH 15 MG LIQUIDGEL|20|EA|.05052|07/21/2015|01/06/2022|Yes|No||||No|No|07/21/2015|01/06/2022|Yes|No||||No|No|||Over the counter|No||184|Yes|.11515|03/23/2021|.1135|03/23/2021|.1081|03/23/2021|||COUGH AND COLD: NON-NARCOTIC|4240|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||RUGBY|No||||
naproxen sodium|No|No|No|No|75%|00536109301|ALL DAY RELIEF 220 MG CAPLET|100|EA|.02661|11/23/2015||Yes|No||||No|No|11/23/2015||Yes|No||||No|No|||Over the counter|No||059|Yes|.0581|03/29/2022|.0567|03/29/2022|.05708|03/29/2022|||NSAIDS|4241|||||No|No||RUGBY|No||||
naproxen sodium|No|No|No|No|75%|00536109306|ALL DAY RELIEF 220 MG CAPLET|50|EA|.02795|11/23/2015||Yes|No||||No|No|11/23/2015||Yes|No||||No|No|||Over the counter|No||059|Yes|.0581|03/29/2022|.0567|03/29/2022|.05708|03/29/2022|||NSAIDS|4242|||||No|No||RUGBY|No||||
naproxen sodium|No|No|No|No|75%|00536109401|ALL DAY RELIEF 220 MG TABLET|100|EA|.02661|06/24/2016||Yes|No||||No|No|06/24/2016||Yes|No||||No|No|||Over the counter|No||059|Yes|.0581|03/29/2022|.0567|03/29/2022|.05708|03/29/2022|||NSAIDS|4243|||||No|No||RUGBY|No||||
methyl salicylate/menthol|No|No|No|No|75%|00536110145|PAIN RELIEVING 1%-15% CREAM|85|GM|.02195|12/22/2016||Yes|No||||No|No|12/22/2016||Yes|No||||No|No|||Over the counter|No|||No|.04922|12/28/2021|.04803|12/28/2021|.04835|12/28/2021||||4244|||||No|No||RUGBY|No||||
nicotine|No|No|No|No|75%|00536110688|NICOTINE 7 MG/24HR PATCH|14|EA|.73683|09/21/2016||Yes|No||||No|No|09/21/2016||Yes|No||||No|No|||Over the counter|No||040|No|1.78989|03/29/2022|1.74693|03/29/2022|1.75856|03/29/2022|||SMOKING CESSATION|4245|||||No|No||RUGBY|Yes|09/01/2020|||
nicotine|No|No|No|No|75%|00536110788|NICOTINE 14 MG/24HR PATCH|14|EA|.73683|09/21/2016||Yes|No||||No|No|09/21/2016||Yes|No||||No|No|||Over the counter|No||040|No|1.68083|03/29/2022|1.64049|03/29/2022|1.65141|03/29/2022|||SMOKING CESSATION|4246|||||No|No||RUGBY|Yes|09/01/2020|||
budesonide|No|No|No|No|75%|00536111248|BUDESONIDE 32 MCG NASAL SPRAY|8.43|ML|.82786|12/16/2016||Yes|No||||No|No|12/16/2016||Yes|No||||No|No|||Over the counter|Yes|07/21/2016|019|No|1.90218|03/29/2022|1.85652|03/29/2022|1.86889|03/29/2022|||INTRANASAL RHINITIS AGENTS|4247|||||No|No||RUGBY|Yes|09/01/2020|||
miconazole nitrate|No|No|No|No|75%|00536113428|MICONAZOLE 2% TOPICAL CREAM|30|GM|.06292|03/07/2018||Yes|No||||No|No|03/07/2018||Yes|No||||No|No|||Over the counter|No||061|No|.09559|03/29/2022|.09329|03/29/2022|.09391|03/29/2022|||ANTIFUNGALS: TOPICAL|4248|||||No|No||RUGBY|No||||
levonorgestrel|No|Yes|No|No|75%|00536114263|LEVONORGESTREL 1.5 MG TABLET|1|EA|3.2422|02/28/2019||Yes|No||||No|No|||No|No||||No|No|||Over the counter|No|||No|10.215|03/29/2022|9.96984|03/29/2022|10.03623|03/29/2022||||4249|||||No|No||RUGBY|No||||
petrolatum,white|No|No|No|No|75%|00536114398|PETROLATUM 42% OINTMENT|454|GM|.01157|01/23/2019||Yes|Yes||||No|No|01/23/2019||Yes|Yes||||No|No|||Over the counter|No|||No|.02637|01/23/2019|.02599|01/23/2019|.02475|01/23/2019||||4250|||||No|No||RUGBY|No||||
ibuprofen|No|No|No|No|75%|00536114730|IBUPROFEN 200 MG SOFTGEL|80|EA|.02547|01/09/2019||Yes|No||||No|No|01/09/2019||Yes|No||||No|No|||Over the counter|No||059|Yes|.07198|03/29/2022|.07025|03/29/2022|.07072|03/29/2022|||NSAIDS|4251|||||No|No||RUGBY|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|00536116134|MUCUS RLF DM ER 600-30 MG TAB|20|EA|.22596|02/28/2019||Yes|No||||No|No|02/28/2019||Yes|No||||No|No|||Over the counter|No||184|Yes|.49455|03/29/2022|.48268|03/29/2022|.48589|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|4252|||||No|No||RUGBY|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|00536116137|MUCUS RLF DM ER 600-30 MG TAB|40|EA|.21779|12/20/2019||Yes|No||||No|No|12/20/2019||Yes|No||||No|No|||Over the counter|No||184|Yes|.49455|03/29/2022|.48268|03/29/2022|.48589|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|4253|||||No|No||RUGBY|No||||
guaifenesin|No|No|No|No|75%|00536116361|MUCUS RELIEF ER 600 MG TABLET|100|EA|.20523|02/28/2019||Yes|No||||No|No|02/28/2019||Yes|No||||No|No|||Over the counter|No||182|Yes|.34047|03/29/2022|.33229|03/29/2022|.33451|03/29/2022|||COUGH AND COLD: COLD|4254|||||No|No||RUGBY|No||||
bacitracin zinc/polymyxin B|No|No|No|No|75%|00536117420|DOUBLE ANTIBIOTIC OINTMENT|14|GM|.12193|12/20/2019|01/26/2022|Yes|No||||No|No|12/20/2019|01/26/2022|Yes|No||||No|No|||Over the counter|No|||No|.27789|12/20/2019|.27392|12/20/2019|.26088|12/20/2019||||4255|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||RUGBY|No||||
clotrimazole|No|No|No|No|75%|00536118170|CLOTRIMAZOLE 1% SOLUTION|10|ML|1.29215|06/10/2019||Yes|No||||No|No|06/10/2019||Yes|No||06/10/2019||Yes|No|||Over the counter|No||061|No|2.75313|03/29/2022|2.68705|03/29/2022|2.70495|03/29/2022|||ANTIFUNGALS: TOPICAL|4256|||||No|No||RUGBY|No||||
guaifenesin|No|No|No|No|75%|00536118297|MUCUS-CHEST CONG 200 MG/10 ML|118|ML|.00645|06/10/2019||Yes|No||||No|No|06/10/2019||Yes|No||||No|No|||Over the counter|No||182|Yes|.01581|03/29/2022|.01543|03/29/2022|.01553|03/29/2022|||COUGH AND COLD: COLD|4257|||||No|No||RUGBY|No||||
fluticasone propionate|No|No|No|No|75%|00536118365|FLUTICASONE PROP 50 MCG SPRAY|15.8|ML|.46102|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|||Over the counter|Yes|07/26/2018|019|No|.82699|03/29/2022|.80714|03/29/2022|.81251|03/29/2022|||INTRANASAL RHINITIS AGENTS|4258|||||No|No||RUGBY|No||||
fluticasone propionate|No|No|No|No|75%|00536118399|FLUTICASONE PROP 50 MCG SPRAY|9.9|ML|.43|06/11/2019||Yes|No||||No|No|06/11/2019||Yes|No||||No|No|||Over the counter|Yes|07/26/2018|019|No|.93163|03/29/2022|.90927|03/29/2022|.91532|03/29/2022|||INTRANASAL RHINITIS AGENTS|4259|||||No|No||RUGBY|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|00536118497|COUGH DM SYRUP|118|ML|.00754|02/28/2019||Yes|No||||No|No|02/28/2019||Yes|No||||No|No|||Over the counter|No||184|Yes|.01774|03/29/2022|.01731|03/29/2022|.01742|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|4260|||||No|No||RUGBY|No||||
phenylephrine HCl/cocoa butter|No|No|No|No|75%|00536118612|HEMORRHOIDAL SUPPOSITORIES|12|EA|.086|03/04/2019||Yes|No||||No|No|03/04/2019||Yes|No||||No|No|||Over the counter|No|||No|.18615|03/29/2022|.18168|03/29/2022|.18289|03/29/2022||||4261|||||No|No||RUGBY|No||||
guaifenesin/pseudoephedrne HCl|No|No|No|No|75%|00536120521|MUCUS RELIEF D ER 600-60 MG TB|18|EA|.18967|06/10/2019|02/28/2022|Yes|No||||No|No|06/10/2019|02/28/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|.43228|03/15/2022|.42611|03/15/2022|.40582|03/15/2022|||COUGH AND COLD: COLD|4262|No Longer Rebatable||No Longer Rebatable||No|No||RUGBY|No||||
guaifenesin/pseudoephedrne HCl|No|No|No|No|75%|00536120536|MUCUS RELIEF D ER 600-60 MG TB|36|EA|.16363|06/10/2019|02/28/2022|Yes|No||||No|No|06/10/2019|02/28/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|.37293|03/15/2022|.36761|03/15/2022|.3501|03/15/2022|||COUGH AND COLD: COLD|4263|No Longer Rebatable||No Longer Rebatable||No|No||RUGBY|No||||
calcium carbonate|No|No|No|No|75%|00536120610|CALCIUM CARBONATE 648 MG TAB|1000|EA|.00368|||No|No||||No|No|||No|No||09/19/2019||Yes|No|||Over the counter|No|||No|.0084|09/19/2019|.00828|09/19/2019|.00789|09/19/2019||||4264|||||No|No||RUGBY|No||||
simethicone|No|No|No|No|75%|00536120704|GAS RELIEF (SIMETH) 80 MG CHEW|100|EA|.01715|09/19/2019|02/28/2022|Yes|No||||No|No|09/19/2019|02/28/2022|Yes|No||||No|No|||Over the counter|No|||No|.0391|03/15/2022|.03854|03/15/2022|.0367|03/15/2022||||4265|No Longer Rebatable||No Longer Rebatable||No|No||RUGBY|No||||
dibucaine|No|No|No|No|75%|00536121195|DIBUCAINE 1% OINTMENT|28|GM|.0754|12/20/2019||Yes|No||||No|No|12/20/2019||Yes|No||||No|No|||Over the counter|No|||No|.15853|03/29/2022|.15472|03/29/2022|.15575|03/29/2022||||4266|||||No|No||RUGBY|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|00536121388|MUCUS RLF DM MAX ER 1200-60 MG|14|EA|.33417|02/28/2019||Yes|No||||No|No|02/28/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.54375|03/29/2022|.5307|03/29/2022|.53423|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|4267|||||No|No||RUGBY|No||||
diphenhydramine HCl|No|No|No|No|75%|00536121429|DIPHENHYDRAMINE 25 MG TABLET|100|EA|.01732|09/19/2019||Yes|No||||No|No|09/19/2019||Yes|No||09/19/2019||Yes|No|||Over the counter|No||574|Yes|.03535|03/29/2022|.0345|03/29/2022|.03473|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|4268|||||No|No||RUGBY|No||||
tetrahydrozoline HCl|No|No|No|No|75%|00536121794|EYE DROPS 0.05%|15|ML|.04529|12/20/2019||Yes|No||||No|No|12/20/2019||Yes|No||||No|No|||Over the counter|No|||No|.10218|03/29/2022|.09972|03/29/2022|.10039|03/29/2022||||4269|||||No|No||RUGBY|No||||
propylene glycol/peg 400|No|No|No|No|75%|00536121994|LUBRICATING EYE DROP|15|ML|.17658|09/20/2019||Yes|No||||No|No|09/20/2019||Yes|No||||No|No|||Over the counter|No|||No|.31839|03/29/2022|.31074|03/29/2022|.31281|03/29/2022||||4270|||||No|No||RUGBY|No||||
simethicone|No|No|No|No|75%|00536122308|GAS RELIEF 125 MG CHEW TABLET|60|EA|.03554|09/18/2020||Yes|No||||No|No|09/18/2020||Yes|No||||No|No|||Over the counter|No|||No|.09994|03/01/2022|.09754|03/01/2022|.09819|03/01/2022||||4271|||||No|No||RUGBY|No||||
calcium carbonate|No|No|No|No|75%|00536122522|CALCIUM ANTACID 750 MG TB CHEW|96|EA|.00936|12/20/2019||Yes|No||||No|No|12/20/2019||Yes|No||12/20/2019||Yes|No|||Over the counter|No|||No|.02533|03/29/2022|.02472|03/29/2022|.02488|03/29/2022||||4272|||||No|No||RUGBY|No||||
calcium carbonate|No|No|No|No|75%|00536122922|ANTACID EX-STR 750 MG TAB CHEW|96|EA|.00936|03/03/2020||Yes|No||||No|No|03/03/2020||Yes|No||||No|No|||Over the counter|No|||No|.02533|03/29/2022|.02472|03/29/2022|.02488|03/29/2022||||4273|||||No|No||RUGBY|No||||
lansoprazole|No|No|No|No|75%|00536123613|LANSOPRAZOLE DR 15 MG CAPSULE|14|EA|.17455|03/03/2020|06/01/2022|Yes|No||||No|No|03/03/2020|06/01/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.43525|03/29/2022|.4248|03/29/2022|.42763|03/29/2022|||PROTON PUMP INHIBITORS|4274|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||RUGBY|No||||
lansoprazole|No|No|No|No|75%|00536123688|LANSOPRAZOLE DR 15 MG CAPSULE|14|EA|.23803|06/15/2020|03/31/2022|Yes|No||||No|No|06/15/2020|03/31/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.43525|03/29/2022|.4248|03/29/2022|.42763|03/29/2022|||PROTON PUMP INHIBITORS|4275|No Longer Rebatable||No Longer Rebatable||No|No||RUGBY|No||||
nicotine polacrilex|No|No|No|No|75%|00536123981|NICOTINE 2 MG MINI LOZENGE|81|EA|.18123|03/04/2020||Yes|No||||No|No|03/04/2020||Yes|No||||No|No|||Over the counter|No||040|No|.4117|11/23/2021|.40181|11/23/2021|.40449|11/23/2021|||SMOKING CESSATION|4276|||||No|No||RUGBY|No||||
nicotine polacrilex|No|No|No|No|75%|00536124181|NICOTINE 4 MG MINI LOZENGE|81|EA|.18123|03/04/2020||Yes|No||||No|No|03/04/2020||Yes|No||||No|No|||Over the counter|No||040|No|.3724|03/29/2022|.36346|03/29/2022|.36588|03/29/2022|||SMOKING CESSATION|4277|||||No|No||RUGBY|No||||
fexofenadine/pseudoephedrine|No|No|No|No|75%|00536124207|FEXOFENADINE-PSE ER 60-120 TAB|30|EA|.31361|06/15/2020||Yes|No||||No|No|06/15/2020||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.58518|03/01/2022|.57113|03/01/2022|.57493|03/01/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|4278|||||No|No||RUGBY|No||||
ketotifen fumarate|No|No|No|No|75%|00536125240|EYE ITCH RELIEF 0.025% DROPS|5|ML|.9116|04/15/2021||Yes|No||||No|No|04/15/2021||Yes|No||||No|No|||Over the counter|Yes|01/30/2020|002|No|1.3642|03/29/2022|1.33145|03/29/2022|1.34032|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|4279|||||No|No||RUGBY|No||||
sodium chloride|No|No|No|No|75%|00536125391|SODIUM CHLORIDE 5% EYE OINT|3.5|GM|1.24822|04/15/2021||Yes|No||||No|No|04/15/2021||Yes|No||||No|No|||Over the counter|No|||No|3.10166|10/26/2021|3.02722|10/26/2021|3.04738|10/26/2021||||4280|||||No|No||RUGBY|No||||
sodium chloride|No|No|No|No|75%|00536125494|SODIUM CHLORIDE 5% OPHTH SOLN|15|ML|.11696|12/11/2020||Yes|No||||No|No|12/11/2020||Yes|No||||No|No|||Over the counter|No|||No|.58738|03/29/2022|.57328|03/29/2022|.5771|03/29/2022||||4281|||||No|No||RUGBY|No||||
bacitracin|No|No|No|No|75%|00536125628|BACITRACIN 500 UNIT/GM OINTMNT|30|GM|.02909|12/11/2020||Yes|No||||No|No|12/11/2020||Yes|No||||No|No|||Over the counter|No||114|No|.06713|01/25/2022|.06551|01/25/2022|.06595|01/25/2022|||ANTIBIOTICS: TOPICAL|4282|||||No|No||RUGBY|No||||
triprolidine HCl|No|No|No|No|75%|00536125775|TRIPROLIDINE 0.938 MG/ML DROPS|30|ML|.32092|06/16/2020||Yes|No||||No|No|06/16/2020||Yes|No||||No|No|||Over the counter|Yes|01/30/2020|574|Yes|.49773|03/29/2022|.48578|03/29/2022|.48901|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|4283|||||No|No||RUGBY|No||||
triprolidine HCl|No|No|No|No|75%|00536125859|TRIPROLIDINE 2.5 MG/5 ML LIQ|237|ML|.07687|09/18/2020|09/16/2022|Yes|No||||No|No|09/18/2020|09/16/2022|Yes|No||||No|No|||Over the counter|Yes|01/30/2020|574|Yes|.17519|09/18/2020|.17269|09/18/2020|.16446|09/18/2020|||ANTIHISTAMINES: FIRST GENERATION|4284|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||RUGBY|No||||
benzoyl peroxide|No|No|No|No|75%|00536125963|BENZOYL PEROXIDE 5% WASH|148|ML|.01536|09/21/2020||Yes|No||||No|No|09/21/2020||Yes|No||||No|No|||Over the counter|No|||No|.03502|09/21/2020|.03452|09/21/2020|.03288|09/21/2020||||4285|||||No|No||RUGBY|No||||
benzoyl peroxide|No|No|No|No|75%|00536126163|BENZOYL PEROXIDE 10% WASH|148|ML|.021|09/21/2020||Yes|No||||No|No|09/21/2020||Yes|No||||No|No|||Over the counter|No|||No|.04787|09/21/2020|.04718|09/21/2020|.04494|09/21/2020||||4286|||||No|No||RUGBY|No||||
bacitracin zinc|No|No|No|No|75%|00536126328|BACITRACIN ZN 500 UNIT/GM OINT|28|GM|.03808|02/04/2021||Yes|No||||No|No|02/04/2021||Yes|No||02/04/2021||Yes|No|||Over the counter|No||114|No|.07647|03/29/2022|.07463|03/29/2022|.07513|03/29/2022|||ANTIBIOTICS: TOPICAL|4287|||||No|No||RUGBY|No||||
clotrimazole|No|No|No|No|75%|00536126526|CLOTRIMAZOLE 1% TOPICAL CREAM|45|GM|.02178|12/11/2020||Yes|No||||No|No|12/11/2020||Yes|No||||No|No|||Over the counter|No||061|No|.04762|03/29/2022|.04647|03/29/2022|.04678|03/29/2022|||ANTIFUNGALS: TOPICAL|4288|||||No|No||RUGBY|No||||
pramoxine HCl/zinc acetate|No|No|No|No|75%|00536126958|CALDYPHEN CLEAR LOTION|177|ML|.00651|12/11/2020||Yes|No||||No|No|12/11/2020||Yes|No||||No|No|||Over the counter|No|||No|.01439|03/29/2022|.01404|03/29/2022|.01413|03/29/2022||||4289|||||No|No||RUGBY|No||||
clotrimazole|No|No|No|No|75%|00536127211|ANTIFUNGAL 1% TOPICAL CREAM|14|GM|.03777|05/18/2021||Yes|No||||No|No|05/18/2021||Yes|No||||No|No|||Over the counter|No||061|No|.08609|05/18/2021|.08486|05/18/2021|.08082|05/18/2021|||ANTIFUNGALS: TOPICAL|4290|||||No|No||RUGBY|No||||
clotrimazole|No|No|No|No|75%|00536127222|ANTIFUNGAL 1% TOPICAL CREAM|28|GM|.03102|12/11/2020||Yes|No||||No|No|12/11/2020||Yes|No||||No|No|||Over the counter|No||061|No|.07286|03/29/2022|.07111|03/29/2022|.07158|03/29/2022|||ANTIFUNGALS: TOPICAL|4291|||||No|No||RUGBY|No||||
cetirizine HCl/pseudoephedrine|No|No|No|No|75%|00536127912|CETIRIZINE-PSE ER 5-120 MG TAB|12|EA|.34937|05/18/2021||Yes|No||||No|No|05/18/2021||Yes|No||||No|No|||Over the counter|Yes|12/01/2021|030|Yes|.59854|03/29/2022|.58417|03/29/2022|.58806|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|4292|||||No|No||RUGBY|No||||
cetirizine HCl/pseudoephedrine|No|No|No|No|75%|00536127935|CETIRIZINE-PSE ER 5-120 MG TAB|24|EA|.28308|05/18/2021||Yes|No||||No|No|05/18/2021||Yes|No||||No|No|||Over the counter|Yes|12/01/2021|030|Yes|.59854|03/29/2022|.58417|03/29/2022|.58806|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|4293|||||No|No||RUGBY|No||||
dextran 70/hypromellose|No|No|No|No|75%|00536128294|LUBRICATING TEARS 0.1-0.3% DRP|15|ML|.13358|11/22/2021||Yes|No||||No|No|11/22/2021||Yes|No||||No|No|||Over the counter|No|||No|.30444|11/22/2021|.30009|11/22/2021|.2858|11/22/2021||||4294|||||No|No||RUGBY|No||||
bismuth subsalicylate|No|No|No|No|75%|00536128636|STOMACH RLF 525 MG/30 ML SUSP|237|ML|.00473|12/11/2020||Yes|No||||No|No|12/11/2020||Yes|No||||No|No|||Over the counter|No|||No|.01036|03/29/2022|.01011|03/29/2022|.01017|03/29/2022||||4295|||||No|No||RUGBY|No||||
bismuth subsalicylate|No|No|No|No|75%|00536128736|STOMACH RELIEF 525 MG/15 ML|237|ML|.0039|12/11/2020||Yes|No||||No|No|12/11/2020||Yes|No||||No|No|||Over the counter|No|||No|.01156|03/29/2022|.01128|03/29/2022|.01135|03/29/2022||||4296|||||No|No||RUGBY|No||||
phenyleph/mineral oil/petrolat|No|No|No|No|75%|00536128806|HEMORRHOIDAL OINTMENT|57|GM|.01848|12/11/2020||Yes|No||||No|No|12/11/2020||Yes|No||||No|No|||Over the counter|No|||No|.0437|03/29/2022|.04265|03/29/2022|.04293|03/29/2022||||4297|||||No|No||RUGBY|No||||
phenylephrine HCl/acetaminophn|No|No|No|No|75%|00536128935|SINUS CONGESTION-PAIN CAPLET|24|EA|.02561|12/11/2020||Yes|No||||No|No|12/11/2020||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|No|.06294|03/29/2022|.06142|03/29/2022|.06183|03/29/2022|||COUGH AND COLD: COLD|4298|||||No|No||RUGBY|No||||
phenylephrine HCl|No|No|No|No|75%|00536129136|PHENYLEPHRINE 10 MG TABLET|36|EA|.01552|04/15/2021||Yes|No||||No|No|04/15/2021||Yes|No||||No|No|||Over the counter|No|||No|.05129|03/29/2022|.05005|03/29/2022|.05039|03/29/2022||||4299|||||No|No||RUGBY|No||||
mag hydrox/aluminum hyd/simeth|No|No|No|No|75%|00536129383|ANTACID-ANTIGAS LIQUID|355|ML|.00439|04/15/2021||Yes|No||||No|No|04/15/2021||Yes|No||||No|No|||Over the counter|No|||No|.00773|03/29/2022|.00754|03/29/2022|.00759|03/29/2022||||4300|||||No|No||RUGBY|No||||
diclofenac sodium|No|No|No|No|75%|00536129431|DICLOFENAC SODIUM 1% GEL|150|GM|.05461|05/18/2021||Yes|No||||No|No|05/18/2021||Yes|No||||No|No|||Over the counter|No||059|Yes|.12446|05/18/2021|.12268|05/18/2021|.11684|05/18/2021|||NSAIDS|4301|||||No|No||RUGBY|No||||
diclofenac sodium|No|No|No|No|75%|00536129434|DICLOFENAC SODIUM 1% GEL|50|GM|.07593|05/18/2021||Yes|No||||No|No|05/18/2021||Yes|No||||No|No|||Over the counter|No||059|Yes|.10472|03/29/2022|.1022|03/29/2022|.10288|03/29/2022|||NSAIDS|4302|||||No|No||RUGBY|No||||
diclofenac sodium|No|No|No|No|75%|00536129497|DICLOFENAC SODIUM 1% GEL|100|GM|.05486|04/15/2021||Yes|No||||No|No|04/15/2021||Yes|No||||No|No|||Over the counter|No||059|Yes|.09419|03/29/2022|.09192|03/29/2022|.09254|03/29/2022|||NSAIDS|4303|||||No|No||RUGBY|No||||
meclizine HCl|No|No|No|No|75%|00536129701|MECLIZINE 12.5 MG CAPLET|100|EA|.01285|12/11/2020||Yes|No||||No|No|12/11/2020||Yes|No||||No|No|||Over the counter|No||085|Yes|.02958|03/29/2022|.02887|03/29/2022|.02906|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|4304|||||No|No||RUGBY|No||||
meclizine HCl|No|No|No|No|75%|00536129710|MECLIZINE 12.5 MG CAPLET|1000|EA|.01142|04/15/2021||Yes|No||||No|No|04/15/2021||Yes|No||||No|No|||Over the counter|No||085|Yes|.02958|03/29/2022|.02887|03/29/2022|.02906|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|4305|||||No|No||RUGBY|No||||
famotidine|No|No|No|No|75%|00536129801|FAMOTIDINE 20 MG TABLET|100|EA|.04368|12/11/2020||Yes|No||||No|No|12/11/2020||Yes|No||12/11/2020||Yes|No|||Over the counter|No|||No|.14581|03/29/2022|.14231|03/29/2022|.14325|03/29/2022||||4306|||||No|No||RUGBY|No||||
meclizine HCl|No|No|No|No|75%|00536129910|MECLIZINE 25 MG TABLET CHEW|1000|EA|.01176|04/15/2021||Yes|No||||No|No|04/15/2021||Yes|No||||No|No|||Over the counter|No||085|Yes|.03332|12/28/2021|.03252|12/28/2021|.03273|12/28/2021|||ANTIEMETIC/ANTIVERTIGO AGENTS|4307|||||No|No||RUGBY|No||||
simethicone|No|No|No|No|75%|00536130375|INFANTS' SIMETHICONE DROPS|30|ML|.02666|05/18/2021||Yes|No||||No|No|05/18/2021||Yes|No||||No|No|||Over the counter|No|||No|.0916|03/29/2022|.0894|03/29/2022|.08999|03/29/2022||||4308|||||No|No||RUGBY|No||||
simethicone|No|No|No|No|75%|00536130608|SIMETHICONE 180 MG SOFTGEL|60|EA|.02644|05/18/2021||Yes|No||||No|No|05/18/2021||Yes|No||||No|No|||Over the counter|No|||No|.05902|03/29/2022|.0576|03/29/2022|.05798|03/29/2022||||4309|||||No|No||RUGBY|No||||
olopatadine HCl|No|No|No|No|75%|00536130723|OLOPATADINE HCL 0.2% EYE DROP|2.5|ML|2.40628|05/18/2021||Yes|No||||No|No|05/18/2021||Yes|No||||No|No|||Over the counter|Yes|01/28/2021|002|No|3.64128|03/29/2022|3.55388|03/29/2022|3.57755|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|4310|||||No|No||RUGBY|No||||
olopatadine HCl|No|No|No|No|75%|00536130840|OLOPATADINE HCL 0.1% EYE DROPS|5|ML|1.30806|05/18/2021||Yes|No||||No|No|05/18/2021||Yes|No||||No|No|||Over the counter|Yes|01/28/2021|002|No|1.29385|03/29/2022|1.26279|03/29/2022|1.2712|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|4311|||||No|No||RUGBY|No||||
guaifenesin|No|No|No|No|75%|00536131108|CHEST CONGEST RLF 400 MG TAB|60|EA|.02142|08/30/2021||Yes|No||||No|No|08/30/2021||Yes|No||||No|No|||Over the counter|No||182|Yes|.06856|03/29/2022|.06691|03/29/2022|.06736|03/29/2022|||COUGH AND COLD: COLD|4312|||||No|No||RUGBY|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|00536131385|CHEST CONGESTION RELIEF DM LIQ|473|ML|.00465|04/15/2021||Yes|No||||No|No|04/15/2021||Yes|No||||No|No|||Over the counter|No||184|Yes|.01007|03/29/2022|.00982|03/29/2022|.00989|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|4313|||||No|No||RUGBY|No||||
guaifenesin|No|No|No|No|75%|00536131485|CHEST CONGESTION RELIEF SOLN|473|ML|.00399|04/15/2021||Yes|No||||No|No|04/15/2021||Yes|No||||No|No|||Over the counter|No||182|Yes|.00969|03/29/2022|.00945|03/29/2022|.00952|03/29/2022|||COUGH AND COLD: COLD|4314|||||No|No||RUGBY|No||||
mag hydrox/aluminum hyd/simeth|No|No|No|No|75%|00536131783|ANTACID-ANTIGAS LIQUID|355|ML|.0038|05/18/2021||Yes|No||||No|No|05/18/2021||Yes|No||||No|No|||Over the counter|No|||No|.00773|03/29/2022|.00754|03/29/2022|.00759|03/29/2022||||4315|||||No|No||RUGBY|No||||
mag hydrox/aluminum hyd/simeth|No|No|No|No|75%|00536131883|ANTACID ANTI-GAS LIQUID|355|ML|.00313|05/18/2021||Yes|No||||No|No|05/18/2021||Yes|No||||No|No|||Over the counter|No|||No|.00902|03/29/2022|.0088|03/29/2022|.00886|03/29/2022||||4316|||||No|No||RUGBY|No||||
omeprazole magnesium|No|No|No|No|75%|00536132213|OMEPRAZOLE MAG DR 20 MG TABLET|42|EA|.22933|05/18/2021||Yes|No||||No|No|05/18/2021||Yes|No||05/18/2021||Yes|No|||Over the counter|Yes|12/01/2021|047|No|.50629|03/29/2022|.49413|03/29/2022|.49742|03/29/2022|||PROTON PUMP INHIBITORS|4317|||||No|No||RUGBY|No||||
omeprazole magnesium|No|No|No|No|75%|00536132271|OMEPRAZOLE MAG DR 20 MG TABLET|28|EA|.25339|05/18/2021||Yes|No||||No|No|05/18/2021||Yes|No||||No|No|||Over the counter|Yes|12/01/2021|047|No|.50629|03/29/2022|.49413|03/29/2022|.49742|03/29/2022|||PROTON PUMP INHIBITORS|4318|||||No|No||RUGBY|No||||
omeprazole magnesium|No|No|No|No|75%|00536132288|OMEPRAZOLE MAG DR 20 MG TABLET|14|EA|.29025|05/18/2021||Yes|No||||No|No|05/18/2021||Yes|No||05/18/2021||Yes|No|||Over the counter|Yes|12/01/2021|047|No|.50629|03/29/2022|.49413|03/29/2022|.49742|03/29/2022|||PROTON PUMP INHIBITORS|4319|||||No|No||RUGBY|No||||
dextromethorphan HBr|No|No|No|No|75%|00536132334|DEXTROMETHORPHAN 15 MG LIQ GEL|20|EA|.05052|05/18/2021||Yes|No||||No|No|05/18/2021||Yes|No||||No|No|||Over the counter|No||184|Yes|.11515|05/25/2021|.1135|05/18/2021|.1081|05/18/2021|||COUGH AND COLD: NON-NARCOTIC|4320|||||No|No||RUGBY|No||||
lansoprazole|No|No|No|No|75%|00536132413|LANSOPRAZOLE DR 15 MG CAPSULE|14|EA|.17455|08/30/2021||Yes|No||||No|No|08/30/2021||Yes|No||||No|No|||Over the counter|Yes|12/01/2021|047|Yes|.43525|03/29/2022|.4248|03/29/2022|.42763|03/29/2022|||PROTON PUMP INHIBITORS|4321|||||No|No||RUGBY|No||||
lansoprazole|No|No|No|No|75%|00536132488|LANSOPRAZOLE DR 15 MG CAPSULE|14|EA|.23803|08/30/2021||Yes|No||||No|No|08/30/2021||Yes|No||||No|No|||Over the counter|Yes|12/01/2021|047|Yes|.43525|03/29/2022|.4248|03/29/2022|.42763|03/29/2022|||PROTON PUMP INHIBITORS|4322|||||No|No||RUGBY|No||||
nicotine polacrilex|No|No|No|No|75%|00536136206|NICOTINE 2 MG CHEWING GUM|50|EA|.13777|11/15/2008||Yes|No||||No|No|11/15/2008||Yes|No||||No|No|||Over the counter|No||040|No|.22992|03/29/2022|.2244|03/29/2022|.22589|03/29/2022|||SMOKING CESSATION|4323|||||No|No||RUGBY|No||||
nicotine polacrilex|No|No|No|No|75%|00536136223|NICOTINE 2 MG CHEWING GUM|110|EA|.09084|11/15/2008||Yes|No||||No|No|11/15/2008||Yes|No||||No|No|||Over the counter|No||040|No|.22992|03/29/2022|.2244|03/29/2022|.22589|03/29/2022|||SMOKING CESSATION|4324|||||No|No||RUGBY|Yes|09/01/2020|||
nicotine polacrilex|No|No|No|No|75%|00536137206|NICOTINE 4 MG CHEWING GUM|50|EA|.16649|11/15/2008||Yes|No||||No|No|11/15/2008||Yes|No||||No|No|||Over the counter|No||040|No|.27548|03/29/2022|.26886|03/29/2022|.27065|03/29/2022|||SMOKING CESSATION|4325|||||No|No||RUGBY|No||||
nicotine polacrilex|No|No|No|No|75%|00536137223|NICOTINE 4 MG CHEWING GUM|110|EA|.12301|11/15/2008||Yes|No||||No|No|11/15/2008||Yes|No||||No|No|||Over the counter|No||040|No|.27548|03/29/2022|.26886|03/29/2022|.27065|03/29/2022|||SMOKING CESSATION|4326|||||No|No||RUGBY|No||||
simethicone|No|No|No|No|75%|00536222075|GAS RELIEF 20 MG/0.3 ML DROPS|30|ML|.06392|09/01/1999|01/28/2022|Yes|No||||No|No|09/01/1999|01/28/2022|Yes|No||||No|No|||Over the counter|No|||No|.0916|03/29/2022|.0894|03/29/2022|.08999|03/29/2022||||4327|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||RUGBY|No||||
magnesium hydroxide|No|No|No|No|75%|00536247085|MILK OF MAGNESIA SUSPENSION|473|ML|.00247|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No|||No|.00547|03/29/2022|.00533|03/29/2022|.00537|03/29/2022||||4328|||||No|No||RUGBY|No||||
capsaicin|No|No|No|No|75%|00536252525|CAPSAICIN 0.025% CREAM|60|GM|.0498|03/02/2017||Yes|No||||No|No|03/02/2017||Yes|No||||No|No|||Over the counter|No||232|No|.10178|03/29/2022|.09933|03/29/2022|.09999|03/29/2022|||NEUROPATHIC PAIN|4329|||||No|No||RUGBY|No||||
nicotine polacrilex|No|No|No|No|75%|00536302906|NICOTINE 2 MG CHEWING GUM|50|EA|.13777|06/22/2010||Yes|No||||No|No|06/22/2010||Yes|No||||No|No|||Over the counter|No||040|No|.22992|03/29/2022|.2244|03/29/2022|.22589|03/29/2022|||SMOKING CESSATION|4330|||||No|No||RUGBY|Yes|09/01/2020|||
nicotine polacrilex|No|No|No|No|75%|00536302923|NICOTINE 2 MG CHEWING GUM|110|EA|.09084|06/22/2010||Yes|No||||No|No|06/22/2010||Yes|No||||No|No|||Over the counter|No||040|No|.22992|03/29/2022|.2244|03/29/2022|.22589|03/29/2022|||SMOKING CESSATION|4331|||||No|No||RUGBY|Yes|09/01/2020|||
nicotine polacrilex|No|No|No|No|75%|00536303023|NICOTINE 4 MG CHEWING GUM|110|EA|.12301|06/22/2010||Yes|No||||No|No|06/22/2010||Yes|No||||No|No|||Over the counter|No||040|No|.27548|03/29/2022|.26886|03/29/2022|.27065|03/29/2022|||SMOKING CESSATION|4332|||||No|No||RUGBY|No||||
simethicone|No|No|No|No|75%|00536360408|SIMETHICONE 180 MG SOFTGEL|60|EA|.01741|05/29/2012|02/25/2022|Yes|No||||No|No|05/29/2012|02/25/2022|Yes|No||||No|No|||Over the counter|No|||No|.05902|03/29/2022|.0576|03/29/2022|.05798|03/29/2022||||4333|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||RUGBY|No||||
calcium polycarbophil|No|No|No|No|75%|00536430605|FIBER-LAX CAPTABS|500|EA|.02303|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No|||No|.06299|03/29/2022|.06147|03/29/2022|.06188|03/29/2022||||4334|||||No|No||RUGBY|No||||
calcium polycarbophil|No|No|No|No|75%|00536430608|FIBER-LAX CAPTABS|60|EA|.02988|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No|||No|.06299|03/29/2022|.06147|03/29/2022|.06188|03/29/2022||||4335|||||No|No||RUGBY|No||||
calcium polycarbophil|No|No|No|No|75%|00536430611|FIBER-LAX CAPTABS|90|EA|.02699|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No|||No|.06299|03/29/2022|.06147|03/29/2022|.06188|03/29/2022||||4336|||||No|No||RUGBY|No||||
multivit,calc,mins/iron/folic|No|No|No|No|75%|00536466110|THEREMS-M TABLET|1000|EA|.01118|||No|No||||No|No|||No|No||08/04/2015||Yes|No|||Over the counter|No|||No|.02548|07/07/2020|.02512|07/07/2020|.02392|07/07/2020||||4337|||||No|No||RUGBY|No||||
multivit,calc,mins/iron/folic|No|No|No|No|75%|00536466138|THEREMS-M TABLET|130|EA|.01541|||No|No||||No|No|||No|No||08/04/2015|04/08/2022|Yes|No|||Over the counter|No|||No|.03512|07/07/2020|.03462|07/07/2020|.03297|07/07/2020||||4338||||Discontinued by Manufacturer|No|No||RUGBY|No||||
multivit with iron,minerals|No|No|No|No|75%|00536475011|UNICOMPLEX-M TABLET|90|EA|.01361|||No|No||||No|No|||No|No||08/04/2015|04/22/2022|Yes|No|||Over the counter|No|||No|.03102|07/07/2020|.03058|07/07/2020|.02912|07/07/2020||||4339||||Discontinued by Manufacturer|No|No||RUGBY|No||||
tolnaftate|No|No|No|No|75%|00536515026|ANTI-FUNGAL 1% POWDER|45|GM|.02044|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||09/01/1999||Yes|No|||Over the counter|No||061|No|.04329|09/28/2021|.04225|09/28/2021|.04253|09/28/2021|||ANTIFUNGALS: TOPICAL|4340|||||No|No||RUGBY|No||||
zinc oxide|No|No|No|No|75%|00536570025|ZINC OXIDE 20% OINTMENT|60|GM|.02156|01/09/2019|03/31/2024|Yes|No||||No|No|01/09/2019|03/31/2024|Yes|No||||No|No|||Over the counter|No|||No|.04915|10/26/2021|.04845|10/26/2021|.04614|10/26/2021||||4341|No Longer Rebatable||No Longer Rebatable||No|No||RUGBY|No||||
zinc oxide|No|No|No|No|75%|00536570028|ZINC OXIDE 20% OINTMENT|30|GM|.02952|02/28/2019|07/27/2022|Yes|No||||No|No|02/28/2019|07/27/2022|Yes|No||||No|No|||Over the counter|No|||No|.06373|07/27/2021|.0622|07/27/2021|.06261|07/27/2021||||4342|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||RUGBY|No||||
zinc oxide|No|No|No|No|75%|00536570098|ZINC OXIDE 20% OINTMENT|454|GM|.00702|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No|||No|.01539|01/25/2022|.01502|01/25/2022|.01512|01/25/2022||||4343|||||No|No||RUGBY|No||||
nicotine|No|No|No|No|75%|00536589453|NICOTINE 7 MG/24HR PATCH|7|EA|.85692|10/05/2017||Yes|No||||No|No|10/05/2017||Yes|No||||No|No|||Over the counter|No||040|No|1.78989|03/29/2022|1.74693|03/29/2022|1.75856|03/29/2022|||SMOKING CESSATION|4344|||||No|No||RUGBY|Yes|09/01/2020|||
nicotine|No|No|No|No|75%|00536589488|NICOTINE 7 MG/24HR PATCH|14|EA|.73683|03/19/2009||Yes|No||||No|No|03/19/2009||Yes|No||||No|No|||Over the counter|No||040|No|1.78989|03/29/2022|1.74693|03/29/2022|1.75856|03/29/2022|||SMOKING CESSATION|4345|||||No|No||RUGBY|Yes|09/01/2020|||
nicotine|No|No|No|No|75%|00536589553|NICOTINE 14 MG/24HR PATCH|7|EA|.85692|10/05/2017||Yes|No||||No|No|10/05/2017||Yes|No||||No|No|||Over the counter|No||040|No|1.68083|03/29/2022|1.64049|03/29/2022|1.65141|03/29/2022|||SMOKING CESSATION|4346|||||No|No||RUGBY|Yes|09/01/2020|||
nicotine|No|No|No|No|75%|00536589571|NICOTINE 14 MG/24HR PATCH|28|EA|.76708|06/16/2020||Yes|No||||No|No|06/16/2020||Yes|No||||No|No|||Over the counter|No||040|No|1.68083|03/29/2022|1.64049|03/29/2022|1.65141|03/29/2022|||SMOKING CESSATION|4347|||||No|No||RUGBY|No||||
nicotine|No|No|No|No|75%|00536589588|NICOTINE 14 MG/24HR PATCH|14|EA|.73683|03/19/2009||Yes|No||||No|No|03/19/2009||Yes|No||||No|No|||Over the counter|No||040|No|1.68083|03/29/2022|1.64049|03/29/2022|1.65141|03/29/2022|||SMOKING CESSATION|4348|||||No|No||RUGBY|Yes|09/01/2020|||
nicotine|No|No|No|No|75%|00536589653|NICOTINE 21 MG/24HR PATCH|7|EA|.85692|10/05/2017||Yes|No||||No|No|10/05/2017||Yes|No||||No|No|||Over the counter|No||040|No|1.70855|03/29/2022|1.66754|03/29/2022|1.67865|03/29/2022|||SMOKING CESSATION|4349|||||No|No||RUGBY|Yes|09/01/2020|||
nicotine|No|No|No|No|75%|00536589671|NICOTINE 21 MG/24HR PATCH|28|EA|.76708|10/05/2017||Yes|No||||No|No|10/05/2017||Yes|No||||No|No|||Over the counter|No||040|No|1.70855|03/29/2022|1.66754|03/29/2022|1.67865|03/29/2022|||SMOKING CESSATION|4350|||||No|No||RUGBY|Yes|09/01/2020|||
nicotine|No|No|No|No|75%|00536589688|NICOTINE 21 MG/24HR PATCH|14|EA|.73683|03/19/2009||Yes|No||||No|No|03/19/2009||Yes|No||||No|No|||Over the counter|No||040|No|1.70855|03/29/2022|1.66754|03/29/2022|1.67865|03/29/2022|||SMOKING CESSATION|4351|||||No|No||RUGBY|Yes|09/01/2020|||
folic acid/vit B complex and C|No|No|No|No|75%|00536730001|NEPHRO-VITE TABLET|100|EA|.05078|||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|||||||.13618|06/07/2016||4352|||||No|No||RUGBY|No||||
enoxaparin sodium|No|No|No|No|75%|00548560100|ENOXAPARIN 30 MG/0.3 ML SYR|.3|ML|6.45|02/23/2018||Yes|No||02/23/2018||Yes|No|02/23/2018||Yes|No||||No|No|||Prescription required|No||068|Yes|12.85641|03/29/2022|12.54785|03/29/2022|12.63142|03/29/2022|||ANTICOAGULANTS|4353|||||No|No||AMPHASTAR PHARM|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|00548560200|ENOXAPARIN 40 MG/0.4 ML SYR|.4|ML|6.45|02/23/2018||Yes|No||02/23/2018||Yes|No|02/23/2018||Yes|No||||No|No|||Prescription required|No||068|Yes|11.94818|03/29/2022|11.66142|03/29/2022|11.73908|03/29/2022|||ANTICOAGULANTS|4354|||||No|No||AMPHASTAR PHARM|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|00548560300|ENOXAPARIN 60 MG/0.6 ML SYR|.6|ML|6.45|02/26/2018||Yes|No||02/26/2018||Yes|No|02/26/2018||Yes|No||||No|No|||Prescription required|No||068|Yes|11.41069|03/29/2022|11.13683|03/29/2022|11.211|03/29/2022|||ANTICOAGULANTS|4355|||||No|No||AMPHASTAR PHARM|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|00548560400|ENOXAPARIN 80 MG/0.8 ML SYR|.8|ML|6.45|02/26/2018||Yes|No||02/26/2018||Yes|No|02/26/2018||Yes|No||||No|No|||Prescription required|No||068|Yes|12.0025|03/29/2022|11.71444|03/29/2022|11.79245|03/29/2022|||ANTICOAGULANTS|4356|||||No|No||AMPHASTAR PHARM|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|00548560500|ENOXAPARIN 100 MG/ML SYRINGE|1|ML|6.45|02/26/2018||Yes|No||02/26/2018||Yes|No|02/26/2018||Yes|No||||No|No|||Prescription required|No||068|Yes|11.81296|03/29/2022|11.52944|03/29/2022|11.60623|03/29/2022|||ANTICOAGULANTS|4357|||||No|No||AMPHASTAR PHARM|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|00548560600|ENOXAPARIN 120 MG/0.8 ML SYR|.8|ML|9.675|02/26/2018||Yes|No||02/26/2018||Yes|No|02/26/2018||Yes|No||||No|No|||Prescription required|No||068|Yes|15.335|03/29/2022|14.96696|03/29/2022|15.06663|03/29/2022|||ANTICOAGULANTS|4358|||||No|No||AMPHASTAR PHARM|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|00548560700|ENOXAPARIN 150 MG/ML SYRINGE|1|ML|9.675|02/26/2018||Yes|No||02/26/2018||Yes|No|02/26/2018||Yes|No||||No|No|||Prescription required|No||068|Yes|15.18|03/29/2022|14.81568|03/29/2022|14.91435|03/29/2022|||ANTICOAGULANTS|4359|||||No|No||AMPHASTAR PHARM|Yes|09/01/2020|||
glucagon|No|No|No|No|75%|00548585000|GLUCAGON 1 MG EMERGENCY KIT|1|EA|120.4|07/22/2021||Yes|No||07/22/2021||Yes|No|07/22/2021||Yes|No||||No|No|||Prescription required|No||583|No|208.81357|03/29/2022|203.80204|03/29/2022|205.15933|03/29/2022|||GLUCAGON AGENTS|4360|||||No|No||AMPHASTAR PHARM|No||||
chlordiazepoxide HCl|No|No|No|No|90%|00555003302|CHLORDIAZEPOXIDE 10 MG CAPSULE|100|EA|.06338|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.1176|03/29/2022|.11477|03/29/2022|.11554|03/29/2022|||ANXIOLYTICS|4361|||||No|No||TEVA USA|Yes|09/01/2020|||
chlordiazepoxide HCl|No|No|No|No|90%|00555003305|CHLORDIAZEPOXIDE 10 MG CAPSULE|1000|EA|.04304|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.1176|03/29/2022|.11477|03/29/2022|.11554|03/29/2022|||ANXIOLYTICS|4362|||||No|No||TEVA USA|No||||
isoniazid|No|No|No|No|75%|00555006602|ISONIAZID 100 MG TABLET|100|EA|.05065|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.11544|10/24/2017|.11379|10/24/2017|.10837|10/24/2017||||4363|||||No|No||TEVA USA|No||||
isoniazid|No|No|No|No|75%|00555007101|ISONIAZID 300 MG TABLET|30|EA|.17415|04/07/2003||Yes|No||04/07/2003||Yes|No|04/07/2003||Yes|No||||No|No|||Prescription required|No|||No|.18105|03/29/2022|.1767|03/29/2022|.17788|03/29/2022||||4364|||||No|No||TEVA USA|No||||
isoniazid|No|No|No|No|75%|00555007102|ISONIAZID 300 MG TABLET|100|EA|.10642|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.18105|03/29/2022|.1767|03/29/2022|.17788|03/29/2022||||4365|||||No|No||TEVA USA|No||||
clonazepam|No|No|No|No|75%|00555009496|CLONAZEPAM 0.125 MG DIS TAB|60|EA|.40211|10/07/2005||Yes|No||10/07/2005||Yes|No|10/07/2005||Yes|No||10/07/2005||Yes|No|||Prescription required|No||056|Yes|.69971|03/29/2022|.68291|03/29/2022|.68746|03/29/2022|||ANTICONVULSANTS|4366|||||No|No||TEVA USA|No||||
clonazepam|No|No|No|No|75%|00555009596|CLONAZEPAM 0.25 MG ODT|60|EA|.40211|10/07/2005||Yes|No||10/07/2005||Yes|No|10/07/2005||Yes|No||10/07/2005||Yes|No|||Prescription required|No||056|Yes|.70247|03/29/2022|.68561|03/29/2022|.69017|03/29/2022|||ANTICONVULSANTS|4367|||||No|No||TEVA USA|No||||
clonazepam|No|No|No|No|75%|00555009696|CLONAZEPAM 0.5 MG DIS TABLET|60|EA|.40147|10/07/2005||Yes|No||10/07/2005||Yes|No|10/07/2005||Yes|No||10/07/2005||Yes|No|||Prescription required|No||056|Yes|.67976|03/29/2022|.66344|03/29/2022|.66786|03/29/2022|||ANTICONVULSANTS|4368|||||No|No||TEVA USA|No||||
clonazepam|No|No|No|No|75%|00555009796|CLONAZEPAM 1 MG DIS TABLET|60|EA|.45881|10/07/2005||Yes|No||10/07/2005||Yes|No|10/07/2005||Yes|No||10/07/2005||Yes|No|||Prescription required|No||056|Yes|.76385|03/29/2022|.74551|03/29/2022|.75048|03/29/2022|||ANTICONVULSANTS|4369|||||No|No||TEVA USA|No||||
clonazepam|No|No|No|No|75%|00555009896|CLONAZEPAM 2 MG ODT|60|EA|.63568|10/07/2005||Yes|No||10/07/2005||Yes|No|10/07/2005||Yes|No||10/07/2005||Yes|No|||Prescription required|No||056|Yes|1.00233|01/25/2022|.97827|01/25/2022|.98478|01/25/2022|||ANTICONVULSANTS|4370|||||No|No||TEVA USA|No||||
chlordiazepoxide HCl|No|No|No|No|90%|00555015802|CHLORDIAZEPOXIDE 5 MG CAPSULE|100|EA|.08221|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.17737|03/29/2022|.17311|03/29/2022|.17426|03/29/2022|||ANXIOLYTICS|4371|||||No|No||TEVA USA|No||||
chlordiazepoxide HCl|No|No|No|No|90%|00555015804|CHLORDIAZEPOXIDE 5 MG CAPSULE|500|EA|.07361|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.17737|03/29/2022|.17311|03/29/2022|.17426|03/29/2022|||ANXIOLYTICS|4372|||||No|No||TEVA USA|No||||
chlordiazepoxide HCl|No|No|No|No|90%|00555015902|CHLORDIAZEPOXIDE 25 MG CAPSULE|100|EA|.07146|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.13592|03/29/2022|.13265|03/29/2022|.13354|03/29/2022|||ANXIOLYTICS|4373|||||No|No||TEVA USA|Yes|09/01/2020|||
chlordiazepoxide HCl|No|No|No|No|90%|00555015904|CHLORDIAZEPOXIDE 25 MG CAPSULE|500|EA|.06009|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.13592|03/29/2022|.13265|03/29/2022|.13354|03/29/2022|||ANXIOLYTICS|4374|||||No|No||TEVA USA|No||||
mefloquine HCl|No|No|No|No|75%|00555017178|MEFLOQUINE HCL 250 MG TABLET|25|EA|3.1519|06/05/2009||Yes|No||06/05/2009||Yes|No|06/05/2009||Yes|No||||No|No|||Prescription required|No|||No|4.12154|03/29/2022|4.02262|03/29/2022|4.04941|03/29/2022||||4375|||||No|No||TEVA USA|No||||
norethindrone acetate|No|No|No|No|75%|00555021110|NORETHINDRONE 5 MG TABLET|50|EA|.79722|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.58431|03/29/2022|.57028|03/29/2022|.57408|03/29/2022||||4376|||||No|No||TEVA USA|No||||
hydroxyzine pamoate|No|No|No|No|75%|00555030202|HYDROXYZINE PAM 50 MG CAP|100|EA|.08561|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||574|Yes|.09227|03/29/2022|.09005|03/29/2022|.09065|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|4377|||||No|No||TEVA USA|No||||
hydroxyzine pamoate|No|No|No|No|75%|00555030204|HYDROXYZINE PAM 50 MG CAP|500|EA|.08348|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||574|Yes|.09227|03/29/2022|.09005|03/29/2022|.09065|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|4378|||||No|No||TEVA USA|No||||
hydroxyzine pamoate|No|No|No|No|75%|00555032302|HYDROXYZINE PAM 25 MG CAP|100|EA|.06265|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||574|Yes|.06792|03/29/2022|.06628|03/29/2022|.06673|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|4379|||||No|No||TEVA USA|No||||
hydroxyzine pamoate|No|No|No|No|75%|00555032304|HYDROXYZINE PAM 25 MG CAP|500|EA|.06109|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||574|Yes|.06792|03/29/2022|.06628|03/29/2022|.06673|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|4380|||||No|No||TEVA USA|No||||
hydroxyzine pamoate|No|No|No|No|75%|00555032402|HYDROXYZINE PAM 100 MG CAP|100|EA|.20459|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||574|Yes|.46596|03/29/2022|.45477|03/29/2022|.4578|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|4381|||||No|No||TEVA USA|No||||
amiloride/hydrochlorothiazide|No|No|No|No|75%|00555048302|AMILORIDE HCL-HCTZ 5-50 MG TAB|100|EA|.20055|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|.41068|03/29/2022|.40082|03/29/2022|.40349|03/29/2022||||4382|||||No|No||TEVA USA|No||||
amiloride/hydrochlorothiazide|No|No|No|No|75%|00555048305|AMILORIDE HCL-HCTZ 5-50 MG TAB|1000|EA|.20056|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|.41068|03/29/2022|.40082|03/29/2022|.40349|03/29/2022||||4383|||||No|No||TEVA USA|No||||
leucovorin calcium|No|No|No|No|75%|00555048401|LEUCOVORIN CALCIUM 5 MG TAB|30|EA|.50166|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.873|03/29/2022|.85204|03/29/2022|.85772|03/29/2022||||4384|||||No|No||TEVA USA|No||||
leucovorin calcium|No|No|No|No|75%|00555048402|LEUCOVORIN CALCIUM 5 MG TAB|100|EA|.516|03/01/2002||Yes|No||03/01/2002||Yes|No|||No|No||||No|No|||Prescription required|No|||No|.873|03/29/2022|.85204|03/29/2022|.85772|03/29/2022||||4385|||||No|No||TEVA USA|No||||
leucovorin calcium|No|No|No|No|75%|00555048527|LEUCOVORIN CALCIUM 25 MG TAB|25|EA|3.84471|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|5.60951|03/29/2022|5.47488|03/29/2022|5.51134|03/29/2022||||4386|||||No|No||TEVA USA|No||||
methotrexate sodium|No|No|No|No|75%|00555057202|METHOTREXATE 2.5 MG TABLET|100|EA|1.01243|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.26817|03/29/2022|.26173|03/29/2022|.26347|03/29/2022||||4387|||||No|No||TEVA USA|No||||
methotrexate sodium|No|No|No|No|75%|00555057235|METHOTREXATE 2.5 MG TABLET|36|EA|1.19802|07/27/2010||Yes|No||07/27/2010||Yes|No|07/27/2010||Yes|No||||No|No|||Prescription required|No|||No|.26817|03/29/2022|.26173|03/29/2022|.26347|03/29/2022||||4388|||||No|No||TEVA USA|No||||
megestrol acetate|No|No|No|No|75%|00555060602|MEGESTROL 20 MG TABLET|100|EA|.15501|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||197|No|.14744|03/29/2022|.1439|03/29/2022|.14485|03/29/2022|||PROGESTINS FOR CACHEXIA|4389|||||No|No||TEVA USA|No||||
megestrol acetate|No|No|No|No|75%|00555060702|MEGESTROL 40 MG TABLET|100|EA|.30014|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||197|No|.19837|03/29/2022|.1936|03/29/2022|.19489|03/29/2022|||PROGESTINS FOR CACHEXIA|4390|||||No|No||TEVA USA|No||||
danazol|No|No|No|No|75%|00555063302|DANAZOL 50 MG CAPSULE|100|EA|1.09116|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|2.48684|06/01/2016|2.45132|06/01/2016|2.33459|06/01/2016||||4391|||||No|No||TEVA USA|No||||
danazol|No|No|No|No|75%|00555063402|DANAZOL 100 MG CAPSULE|100|EA|1.63744|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|3.73184|06/01/2016|3.67852|06/01/2016|3.50336|06/01/2016||||4392|||||No|No||TEVA USA|No||||
danazol|No|No|No|No|75%|00555063502|DANAZOL 200 MG CAPSULE|100|EA|2.7283|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|6.218|11/24/2020|6.12917|11/24/2020|5.8373|11/24/2020||||4393|||||No|No||TEVA USA|No||||
danazol|No|No|No|No|75%|00555063509|DANAZOL 200 MG CAPSULE|60|EA|3.09442|10/23/2008||Yes|No||10/23/2008||Yes|No|10/23/2008||Yes|No||||No|No|||Prescription required|No|||No|7.0524|11/24/2020|6.95165|11/24/2020|6.62062|11/24/2020||||4394|||||No|No||TEVA USA|No||||
trazodone HCl|No|No|No|No|75%|00555071102|TRAZODONE 300 MG TABLET|100|EA|1.40055|03/29/2022||Yes|No||03/29/2022||Yes|No|03/29/2022||Yes|No||||No|No|||Prescription required|No||031|No|1.52238|03/29/2022|1.48584|03/29/2022|1.49573|03/29/2022|||ANTIDEPRESSANTS: OTHER|4395|||||No|No||TEVA USA|No||||
trazodone HCl|No|No|No|No|75%|00555073302|TRAZODONE 300 MG TABLET|100|EA|1.40055|03/01/2002|10/31/2022|Yes|No||03/01/2002|10/31/2022|Yes|No|03/01/2002|10/31/2022|Yes|No||||No|No|||Prescription required|No||031|No|1.52238|03/29/2022|1.48584|03/29/2022|1.49573|03/29/2022|||ANTIDEPRESSANTS: OTHER|4396|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||TEVA USA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00555077502|DEXTROAMP-AMPHETAM 7.5 MG TAB|100|EA|.37233|08/07/2003||Yes|No||08/07/2003||Yes|No|08/07/2003||Yes|No||||No|No|||Prescription required|No||007|Yes|.45915|03/29/2022|.44813|03/29/2022|.45111|03/29/2022|||STIMULANTS AND RELATED AGENTS|4397|||||No|No||TEVA USA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00555077602|DEXTROAMP-AMPHETAM 12.5 MG TAB|100|EA|.37233|08/07/2003||Yes|No||08/07/2003||Yes|No|08/07/2003||Yes|No||||No|No|||Prescription required|No||007|Yes|.65907|03/01/2022|.64325|03/01/2022|.64753|03/01/2022|||STIMULANTS AND RELATED AGENTS|4398|||||No|No||TEVA USA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00555077702|DEXTROAMP-AMPHETAMIN 15 MG TAB|100|EA|.37233|08/07/2003||Yes|No||08/07/2003||Yes|No|08/07/2003||Yes|No||||No|No|||Prescription required|No||007|Yes|.25605|03/29/2022|.2499|03/29/2022|.25156|03/29/2022|||STIMULANTS AND RELATED AGENTS|4399|||||No|No||TEVA USA|No||||
medroxyprogesterone acetate|No|No|No|No|75%|00555077902|MEDROXYPROGESTERONE 10 MG TAB|100|EA|.11399|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.14545|03/29/2022|.14195|03/29/2022|.1429|03/29/2022||||4400|||||No|No||TEVA USA|No||||
medroxyprogesterone acetate|No|No|No|No|75%|00555077904|MEDROXYPROGESTERONE 10 MG TAB|500|EA|.11057|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.14545|03/29/2022|.14195|03/29/2022|.1429|03/29/2022||||4401|||||No|No||TEVA USA|No||||
tretinoin|No|No|No|No|75%|00555080802|TRETINOIN 10 MG CAPSULE|100|EA|11.5642|04/14/2008||Yes|No||04/14/2008||Yes|No|04/14/2008||Yes|No||||No|No|||Prescription required|No||173|No|26.35563|06/01/2016|25.97912|06/01/2016|24.74202|06/01/2016|||ONCOLOGY: ORAL - HEMATOLOGIC|4402|||||No|No||TEVA USA|No||||
medroxyprogesterone acetate|No|No|No|No|75%|00555087202|MEDROXYPROGESTERONE 2.5 MG TAB|100|EA|.06097|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.10866|03/29/2022|.10605|03/29/2022|.10675|03/29/2022||||4403|||||No|No||TEVA USA|No||||
medroxyprogesterone acetate|No|No|No|No|75%|00555087204|MEDROXYPROGESTERONE 2.5 MG TAB|500|EA|.05914|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.10866|03/29/2022|.10605|03/29/2022|.10675|03/29/2022||||4404|||||No|No||TEVA USA|No||||
medroxyprogesterone acetate|No|No|No|No|75%|00555087302|MEDROXYPROGESTERONE 5 MG TAB|100|EA|.09214|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.13379|03/29/2022|.13057|03/29/2022|.13144|03/29/2022||||4405|||||No|No||TEVA USA|No||||
medroxyprogesterone acetate|No|No|No|No|75%|00555087304|MEDROXYPROGESTERONE 5 MG TAB|500|EA|.08938|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.13379|03/29/2022|.13057|03/29/2022|.13144|03/29/2022||||4406|||||No|No||TEVA USA|No||||
hydroxyurea|No|No|No|No|75%|00555088202|HYDROXYUREA 500 MG CAPSULE|100|EA|.50714|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||580|No|.26887|03/29/2022|.26241|03/29/2022|.26416|03/29/2022|||SICKLE CELL ANEMIA TREATMENTS|4407|||||No|No||TEVA USA|No||||
estradiol|No|No|No|No|75%|00555088602|ESTRADIOL 1 MG TABLET|100|EA|.13218|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|.09546|03/29/2022|.09316|03/29/2022|.09378|03/29/2022||||4408|||||No|No||TEVA USA|No||||
estradiol|No|No|No|No|75%|00555088604|ESTRADIOL 1 MG TABLET|500|EA|.13212|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|.09546|03/29/2022|.09316|03/29/2022|.09378|03/29/2022||||4409|||||No|No||TEVA USA|No||||
estradiol|No|No|No|No|75%|00555088702|ESTRADIOL 2 MG TABLET|100|EA|.17346|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|.13189|03/29/2022|.12872|03/29/2022|.12958|03/29/2022||||4410|||||No|No||TEVA USA|No||||
estradiol|No|No|No|No|75%|00555088704|ESTRADIOL 2 MG TABLET|500|EA|.17356|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|.13189|03/29/2022|.12872|03/29/2022|.12958|03/29/2022||||4411|||||No|No||TEVA USA|No||||
estradiol|No|No|No|No|75%|00555089902|ESTRADIOL 0.5 MG TABLET|100|EA|.11584|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|.08676|03/29/2022|.08467|03/29/2022|.08524|03/29/2022||||4412|||||No|No||TEVA USA|No||||
dextroamphetamine sulfate|No|No|No|No|75%|00555095202|DEXTROAMPHETAMINE 5 MG TAB|100|EA|.645|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||007|Yes|.24678|03/29/2022|.24085|03/29/2022|.24246|03/29/2022|||STIMULANTS AND RELATED AGENTS|4413|||||No|No||TEVA USA|No||||
dextroamphetamine sulfate|No|No|No|No|75%|00555095302|DEXTROAMPHETAMINE 10 MG TAB|100|EA|.731|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||007|Yes|.30046|03/29/2022|.29324|03/29/2022|.2952|03/29/2022|||STIMULANTS AND RELATED AGENTS|4414|||||No|No||TEVA USA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00555097102|DEXTROAMP-AMPHETAMINE 5 MG TAB|100|EA|.37233|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||007|Yes|.21985|03/29/2022|.21457|03/29/2022|.216|03/29/2022|||STIMULANTS AND RELATED AGENTS|4415|||||No|No||TEVA USA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00555097202|DEXTROAMP-AMPHETAMIN 10 MG TAB|100|EA|.37233|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||007|Yes|.24071|03/29/2022|.23493|03/29/2022|.23649|03/29/2022|||STIMULANTS AND RELATED AGENTS|4416|||||No|No||TEVA USA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00555097302|DEXTROAMP-AMPHETAMIN 20 MG TAB|100|EA|.37233|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||007|Yes|.31357|03/29/2022|.30604|03/29/2022|.30808|03/29/2022|||STIMULANTS AND RELATED AGENTS|4417|||||No|No||TEVA USA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00555097402|DEXTROAMP-AMPHETAMIN 30 MG TAB|100|EA|.37233|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||007|Yes|.30925|03/29/2022|.30182|03/29/2022|.30383|03/29/2022|||STIMULANTS AND RELATED AGENTS|4418|||||No|No||TEVA USA|No||||
fludrocortisone acetate|No|No|No|No|75%|00555099702|FLUDROCORTISONE 0.1 MG TABLET|100|EA|.23598|03/15/2005||Yes|No||03/15/2005||Yes|No|03/15/2005||Yes|No||||No|No|||Prescription required|No|||No|.51987|03/29/2022|.50739|03/29/2022|.51077|03/29/2022||||4419|||||No|No||TEVA USA|No||||
isotretinoin|No|No|No|No|75%|00555105456|CLARAVIS 10 MG CAPSULE|100|EA|5.08642|03/29/2006||Yes|No||03/29/2006||Yes|No|01/01/2011||Yes|No||||No|No|||Prescription required|No||144|No|2.44307|03/29/2022|2.38443|03/29/2022|2.40031|03/29/2022|||ACNE AGENTS: ORAL|4420|||||No|No||TEVA USA|No||||
isotretinoin|No|No|No|No|75%|00555105486|CLARAVIS 10 MG CAPSULE|30|EA|5.18823|03/29/2006||Yes|No||03/29/2006||Yes|No|01/01/2011||Yes|No||||No|No|||Prescription required|No||144|No|2.44307|03/29/2022|2.38443|03/29/2022|2.40031|03/29/2022|||ACNE AGENTS: ORAL|4421|||||No|No||TEVA USA|No||||
isotretinoin|No|No|No|No|75%|00555105556|CLARAVIS 20 MG CAPSULE|100|EA|6.03165|03/29/2006||Yes|No||03/29/2006||Yes|No|01/01/2011||Yes|No||||No|No|||Prescription required|No||144|No|2.5524|03/29/2022|2.49114|03/29/2022|2.50773|03/29/2022|||ACNE AGENTS: ORAL|4422|||||No|No||TEVA USA|No||||
isotretinoin|No|No|No|No|75%|00555105586|CLARAVIS 20 MG CAPSULE|30|EA|6.15258|03/29/2006||Yes|No||03/29/2006||Yes|No|01/01/2011||Yes|No||||No|No|||Prescription required|No||144|No|2.5524|03/29/2022|2.49114|03/29/2022|2.50773|03/29/2022|||ACNE AGENTS: ORAL|4423|||||No|No||TEVA USA|No||||
isotretinoin|No|No|No|No|75%|00555105686|CLARAVIS 30 MG CAPSULE|30|EA|6.36672|08/01/2006||Yes|No||08/01/2006||Yes|No|01/01/2011||Yes|No||||No|No|||Prescription required|No||144|No|3.30978|03/29/2022|3.23034|03/29/2022|3.25185|03/29/2022|||ACNE AGENTS: ORAL|4424|||||No|No||TEVA USA|No||||
isotretinoin|No|No|No|No|75%|00555105756|CLARAVIS 40 MG CAPSULE|100|EA|7.00749|03/29/2006||Yes|No||03/29/2006||Yes|No|01/01/2011||Yes|No||||No|No|||Prescription required|No||144|No|3.38467|03/29/2022|3.30343|03/29/2022|3.32543|03/29/2022|||ACNE AGENTS: ORAL|4425|||||No|No||TEVA USA|No||||
isotretinoin|No|No|No|No|75%|00555105786|CLARAVIS 40 MG CAPSULE|30|EA|7.14774|03/29/2006||Yes|No||03/29/2006||Yes|No|01/01/2011||Yes|No||||No|No|||Prescription required|No||144|No|3.38467|03/29/2022|3.30343|03/29/2022|3.32543|03/29/2022|||ACNE AGENTS: ORAL|4426|||||No|No||TEVA USA|No||||
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|00555900867|NORTREL 0.5-35-28 TABLET|28|EA|.33334|09/11/2008||Yes|No||09/11/2008||Yes|No|09/11/2008||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.626|03/29/2022|.61097|03/29/2022|.61504|03/29/2022||||4427|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|00555900942|NORTREL 1-35 21 TABLET|21|EA|.40733|09/11/2008||Yes|No||09/11/2008||Yes|No|09/11/2008||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.53608|03/01/2022|.52321|03/01/2022|.52669|03/01/2022||||4428|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|00555901058|NORTREL 1-35 28 TABLET|28|EA|.30547|01/01/2006||Yes|No||01/01/2006||Yes|No|01/01/2006||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.34259|03/29/2022|.33436|03/29/2022|.33659|03/29/2022||||4429|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|00555901258|NORTREL 7-7-7-28 TABLET|28|EA|.3336|01/01/2006||Yes|No||01/01/2006||Yes|No|01/01/2006||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.43221|03/29/2022|.42183|03/29/2022|.42464|03/29/2022||||4430|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|00555901467|LESSINA-28 TABLET|28|EA|.3616|11/08/2005||Yes|No||11/08/2005||Yes|No|11/08/2005||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.21292|03/29/2022|.2078|03/29/2022|.20919|03/29/2022||||4431|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
norgestimate-ethinyl estradiol|Yes|Yes|No|No|75%|00555901658|SPRINTEC 28 DAY TABLET|28|EA|.3336|01/01/2006||Yes|No||01/01/2006||Yes|No|09/10/2015||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.1742|03/29/2022|.17001|03/29/2022|.17115|03/29/2022||||4432|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
norgestimate-ethinyl estradiol|Yes|Yes|No|No|75%|00555901858|TRI-SPRINTEC TABLET|28|EA|.37724|01/01/2007||Yes|No||01/01/2007||Yes|No|01/01/2007||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.1602|03/29/2022|.15635|03/29/2022|.15739|03/29/2022||||4433|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|00555902058|PORTIA-28 TABLET|28|EA|.35605|01/01/2006||Yes|No||01/01/2006||Yes|No|06/16/2014||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.17306|03/29/2022|.1689|03/29/2022|.17003|03/29/2022||||4434|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone ac-eth estradiol|Yes|Yes|No|No|75%|00555902542|JUNEL 1 MG-20 MCG TABLET|21|EA|.4401|08/01/2007||Yes|No||08/01/2007||Yes|No|08/01/2007||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.29153|03/29/2022|.28453|03/29/2022|.28642|03/29/2022||||4435|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|00555902658|JUNEL FE 1 MG-20 MCG TABLET|28|EA|.33004|01/01/2006||Yes|No||01/01/2006||Yes|No|01/01/2006||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.20374|03/29/2022|.19885|03/29/2022|.20017|03/29/2022||||4436|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone ac-eth estradiol|Yes|Yes|No|No|75%|00555902742|JUNEL 1.5 MG-30 MCG TABLET|21|EA|.4401|06/09/2006||Yes|No||06/09/2006||Yes|No|06/09/2006||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.56037|03/29/2022|.54692|03/29/2022|.55056|03/29/2022||||4437|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|00555902858|JUNEL FE 1.5 MG-30 MCG TABLET|28|EA|.33004|01/01/2006||Yes|No||01/01/2006||Yes|No|01/01/2006||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.28591|03/29/2022|.27904|03/29/2022|.2809|03/29/2022||||4438|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|00555903270|TRI-LEGEST FE-28 DAY TABLET|28|EA|.63191|01/23/2008||Yes|No||01/23/2008||Yes|No|01/23/2008||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|1.27715|03/29/2022|1.24649|03/29/2022|1.25479|03/29/2022||||4439|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|00555903458|BALZIVA 28 TABLET|28|EA|.49575|02/05/2007||Yes|No||02/05/2007||Yes|No|02/05/2007||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.44932|03/29/2022|.43853|03/29/2022|.44145|03/29/2022||||4440|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
desogestrel-ethinyl estradiol|Yes|Yes|No|No|75%|00555904358|APRI 28 DAY TABLET|28|EA|.31586|01/01/2006||Yes|No||01/01/2006||Yes|No|01/01/2006||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.18364|03/29/2022|.17923|03/29/2022|.18042|03/29/2022||||4441|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|00555904558|AVIANE-28 TABLET|28|EA|.36393|01/01/2006||Yes|No||01/01/2006||Yes|No|01/01/2006||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.21292|03/29/2022|.2078|03/29/2022|.20919|03/29/2022||||4442|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|00555904758|ENPRESSE-28 TABLET|28|EA|.3164|01/01/2006||Yes|No||01/01/2006||Yes|No|01/01/2006||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.4402|03/29/2022|.42963|03/29/2022|.43249|03/29/2022||||4443|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
norgestrel-ethinyl estradiol|Yes|Yes|No|No|75%|00555904958|CRYSELLE-28 TABLET|28|EA|.35137|01/01/2006||Yes|No||01/01/2006||Yes|No|01/01/2006||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.39526|03/29/2022|.38577|03/29/2022|.38834|03/29/2022||||4444|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
desog-e.estradiol/e.estradiol|Yes|Yes|No|No|75%|00555905058|KARIVA 28 DAY TABLET|28|EA|.66299|01/01/2006||Yes|No||01/01/2006||Yes|No|01/01/2006||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.21935|03/29/2022|.21408|03/29/2022|.21551|03/29/2022||||4445|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
desogestrel-ethinyl estradiol|Yes|Yes|No|No|75%|00555905167|VELIVET 28 DAY TABLET|28|EA|.37199|01/01/2006||Yes|No||01/01/2006||Yes|No|01/01/2006||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.60615|03/29/2022|.5916|03/29/2022|.59554|03/29/2022||||4446|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
ethynodiol d-ethinyl estradiol|Yes|Yes|No|No|75%|00555906458|KELNOR 1-35 28 TABLET|28|EA|.34056|03/26/2008||Yes|No||03/26/2008||Yes|No|03/26/2008||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.41215|03/29/2022|.40225|03/29/2022|.40493|03/29/2022||||4447|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|00555906667|ARANELLE 28 TABLET|28|EA|.43506|08/15/2006||Yes|No||08/15/2006||Yes|No|08/15/2006||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.60269|03/01/2022|.58822|03/01/2022|.59214|03/01/2022||||4448|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|00555912366|JOLESSA 0.15 MG-0.03 MG TABLET|91|EA|.54663|10/09/2006||Yes|No||10/09/2006||Yes|No|10/09/2006||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.17533|03/29/2022|.17112|03/29/2022|.17226|03/29/2022||||4449|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
ethinyl estradiol/drospirenone|Yes|Yes|No|No|75%|00555913167|OCELLA 3 MG-0.03 MG TABLET|28|EA|.84786|04/06/2009||Yes|No||04/06/2009||Yes|No|04/06/2009||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.2455|03/29/2022|.2396|03/29/2022|.2412|03/29/2022||||4450|||||No|No||TEVA USA|No|||Only covered for non-contraceptive (medical) purposes|
bromocriptine mesylate|No|No|No|No|75%|00574010601|BROMOCRIPTINE 2.5 MG TABLET|100|EA|1.29159|10/15/2008||Yes|No||10/15/2008||Yes|No|10/15/2008||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|1.4796|03/29/2022|1.44408|03/29/2022|1.4537|03/29/2022|||ANTIPARKINSON'S AGENTS|4451|||||No|No||PERRIGO/PADAGIS|Yes|09/01/2020|||
bromocriptine mesylate|No|No|No|No|75%|00574010603|BROMOCRIPTINE 2.5 MG TABLET|30|EA|1.42315|10/15/2008||Yes|No||10/15/2008||Yes|No|10/15/2008||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|1.4796|03/29/2022|1.44408|03/29/2022|1.4537|03/29/2022|||ANTIPARKINSON'S AGENTS|4452|||||No|No||PERRIGO/PADAGIS|Yes|09/01/2020|||
clotrimazole|No|No|No|No|75%|00574010714|CLOTRIMAZOLE 10 MG TROCHE|140|EA|.50227|12/14/2005||Yes|No||12/14/2005||Yes|No|12/14/2005||Yes|No||12/14/2005||Yes|No|||Prescription required|No||069|No|.42659|03/29/2022|.41635|03/29/2022|.41912|03/29/2022|||ANTIFUNGALS: ORAL|4453|||||No|No||PERRIGO/PADAGIS|No||||
clotrimazole|No|No|No|No|75%|00574010770|CLOTRIMAZOLE 10 MG TROCHE|70|EA|.55304|12/14/2005||Yes|No||12/14/2005||Yes|No|12/14/2005||Yes|No||12/14/2005||Yes|No|||Prescription required|No||069|No|.42659|03/29/2022|.41635|03/29/2022|.41912|03/29/2022|||ANTIFUNGALS: ORAL|4454|||||No|No||PERRIGO/PADAGIS|No||||
flavoxate HCl|No|No|No|No|75%|00574011501|FLAVOXATE HCL 100 MG TABLET|100|EA|.47644|01/24/2005||Yes|No||01/24/2005||Yes|No|01/24/2005||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|006|No|.75886|03/29/2022|.74064|03/29/2022|.74557|03/29/2022|||BLADDER RELAXANT PREPARATIONS|4455|||||No|No||PERRIGO/PADAGIS|No||||
trospium chloride|No|No|No|No|75%|00574011830|TROSPIUM CHLORIDE ER 60 MG CAP|30|EA|2.31741|06/10/2013||Yes|No||06/10/2013||Yes|No|06/10/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|006|No|3.47514|03/29/2022|3.39173|03/29/2022|3.41432|03/29/2022|||BLADDER RELAXANT PREPARATIONS|4456|||||No|No||PERRIGO/PADAGIS|No||||
charcoal/sorbitol solution|No|No|No|No|75%|00574012008|ACTIDOSE 50 GM LIQUID|240|ML|.03389|09/07/2015||Yes|No||||No|No|09/07/2015||Yes|No||||No|No|||Over the counter|No|||No|.07725|06/01/2016|.07614|06/01/2016|.07252|06/01/2016||||4457|||||No|No||PERRIGO/PADAGIS|No||||
clindamycin palmitate HCl|No|No|No|No|75%|00574012901|CLINDAMYCIN (PEDI) 75 MG/5 ML|100|ML|.10509|10/24/2019||Yes|No||10/24/2019||Yes|No|10/24/2019||Yes|No||||No|No|||Prescription required|No||146|No|.19356|03/29/2022|.18891|03/29/2022|.19017|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|4458|||||No|No||PERRIGO CO.|No||||
trospium chloride|No|No|No|No|75%|00574014560|TROSPIUM CHLORIDE 20 MG TABLET|60|EA|.3412|12/02/2010||Yes|No||12/02/2010||Yes|No|12/02/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|006|No|.42162|03/29/2022|.4115|03/29/2022|.41424|03/29/2022|||BLADDER RELAXANT PREPARATIONS|4459|||||No|No||PERRIGO/PADAGIS|No||||
tavaborole|No|No|No|No|75%|00574015710|TAVABOROLE 5% TOPICAL SOLUTION|10|ML|3.87|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|061|No|12.67867|08/24/2021|12.37438|08/24/2021|12.45679|08/24/2021|||ANTIFUNGALS: TOPICAL|4460|||||No|No||PERRIGO/PADAGIS|No||||
potassium chloride|No|No|No|No|75%|00574018101|POTASSIUM CL ER 10 MEQ CAPSULE|100|EA|.34142|11/09/2011||Yes|No||11/09/2011||Yes|No|11/09/2011||Yes|No||11/09/2011||Yes|No|||Prescription required|No|||No|.15494|03/29/2022|.15122|03/29/2022|.15222|03/29/2022||||4461|||||No|No||PERRIGO CO.|No||||
potassium chloride|No|No|No|No|75%|00574018105|POTASSIUM CL ER 10 MEQ CAPSULE|500|EA|.32434|11/09/2011||Yes|No||11/09/2011||Yes|No|11/09/2011||Yes|No||11/09/2011||Yes|No|||Prescription required|No|||No|.15494|03/29/2022|.15122|03/29/2022|.15222|03/29/2022||||4462|||||No|No||PERRIGO CO.|No||||
benazepril/hydrochlorothiazide|Yes|No|No|No|75%|00574022701|BENAZEPRIL-HCTZ 10-12.5 MG TAB|100|EA|.38472|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||09/06/2019||Yes|No|01/15/2020||Prescription required|Yes|07/26/2018|113|Yes|.40705|03/29/2022|.39728|03/29/2022|.39992|03/29/2022|||ANGIOTENSIN MODULATORS|4463|||||No|No||PERRIGO CO.|No||||
benazepril/hydrochlorothiazide|Yes|No|No|No|75%|00574022801|BENAZEPRIL-HCTZ 20-25 MG TAB|100|EA|.38472|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||09/06/2019||Yes|No|01/15/2020||Prescription required|Yes|07/26/2018|113|Yes|.5345|03/29/2022|.52167|03/29/2022|.52514|03/29/2022|||ANGIOTENSIN MODULATORS|4464|||||No|No||PERRIGO CO.|No||||
benazepril/hydrochlorothiazide|Yes|No|No|No|75%|00574022901|BENAZEPRIL-HCTZ 20-12.5 MG TAB|100|EA|.38472|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||09/06/2019||Yes|No|01/15/2020||Prescription required|Yes|07/26/2018|113|Yes|.60233|03/29/2022|.58787|03/29/2022|.59178|03/29/2022|||ANGIOTENSIN MODULATORS|4465|||||No|No||PERRIGO CO.|No||||
repaglinide|Yes|No|No|No|75%|00574024001|REPAGLINIDE 0.5 MG TABLET|100|EA|.086|08/30/2013||Yes|No||08/30/2013||Yes|No|08/30/2013||Yes|No||08/30/2013||Yes|No|07/01/2016||Prescription required|No||022|Yes|.11854|03/29/2022|.11569|03/29/2022|.11646|03/29/2022|||HYPOGLYCEMICS: MEGLITINIDES|4466|||||No|No||PERRIGO/PADAGIS|No||||
repaglinide|Yes|No|No|No|75%|00574024101|REPAGLINIDE 1 MG TABLET|100|EA|.086|02/06/2014||Yes|No||02/06/2014||Yes|No|02/06/2014||Yes|No||02/06/2014||Yes|No|07/01/2016||Prescription required|No||022|Yes|.12359|03/29/2022|.12062|03/29/2022|.12142|03/29/2022|||HYPOGLYCEMICS: MEGLITINIDES|4467|||||No|No||PERRIGO/PADAGIS|No||||
repaglinide|Yes|No|No|No|75%|00574024201|REPAGLINIDE 2 MG TABLET|100|EA|.086|02/16/2014||Yes|No||02/16/2014||Yes|No|02/16/2014||Yes|No||02/16/2014||Yes|No|07/01/2016||Prescription required|No||022|Yes|.12502|03/29/2022|.12201|03/29/2022|.12283|03/29/2022|||HYPOGLYCEMICS: MEGLITINIDES|4468|||||No|No||PERRIGO/PADAGIS|No||||
potassium chloride|No|No|No|No|75%|00574027401|POTASSIUM CL ER 8 MEQ TABLET|100|EA|.18451|03/28/2016||Yes|No||03/28/2016||Yes|No|03/28/2016||Yes|No||||No|No|||Prescription required|No|||No|.17696|03/29/2022|.17271|03/29/2022|.17386|03/29/2022||||4469|||||No|No||PERRIGO/PADAGIS|No||||
potassium chloride|No|No|No|No|75%|00574027405|POTASSIUM CL ER 8 MEQ TABLET|500|EA|.1845|03/28/2016||Yes|No||03/28/2016||Yes|No|03/28/2016||Yes|No||||No|No|||Prescription required|No|||No|.17696|03/29/2022|.17271|03/29/2022|.17386|03/29/2022||||4470|||||No|No||PERRIGO/PADAGIS|No||||
potassium chloride|No|No|No|No|75%|00574027501|POTASSIUM CL ER 10 MEQ TABLET|100|EA|.19423|12/22/2015||Yes|No||12/22/2015||Yes|No|12/22/2015||Yes|No||12/22/2015||Yes|No|||Prescription required|No|||No|.13824|03/29/2022|.13492|03/29/2022|.13582|03/29/2022||||4471|||||No|No||PERRIGO/PADAGIS|No||||
potassium chloride|No|No|No|No|75%|00574027505|POTASSIUM CL ER 10 MEQ TABLET|500|EA|.19422|12/22/2015||Yes|No||12/22/2015||Yes|No|12/22/2015||Yes|No||12/22/2015||Yes|No|||Prescription required|No|||No|.13824|03/29/2022|.13492|03/29/2022|.13582|03/29/2022||||4472|||||No|No||PERRIGO/PADAGIS|No||||
potassium chloride|No|No|No|No|75%|00574027511|POTASSIUM CL ER 10 MEQ TABLET|100|EA|.13983|08/23/2016||Yes|No||08/23/2016||Yes|No|08/23/2016||Yes|No||08/23/2016||Yes|No|||Prescription required|No|||No|.13824|03/29/2022|.13492|03/29/2022|.13582|03/29/2022||||4473|||||No|No||PERRIGO/PADAGIS|No||||
paroxetine mesylate|No|No|No|No|75%|00574027930|PAROXETINE MESYLATE 7.5 MG CAP|30|EA|2.36328|01/25/2018||Yes|No||01/25/2018||Yes|No|01/25/2018||Yes|No||||No|No|||Prescription required|Yes|10/12/2017|008|No|4.51495|03/29/2022|4.40659|03/29/2022|4.43593|03/29/2022|||ANTIDEPRESSANTS: SSRIs|4474|||||No|No||PERRIGO/PADAGIS|No||||
amiloride HCl|No|No|No|No|75%|00574029201|AMILORIDE HCL 5 MG TABLET|100|EA|.09567|04/13/2009||Yes|No||04/13/2009||Yes|No|04/13/2009||Yes|No||04/13/2009||Yes|No|||Prescription required|No|||No|.19533|03/29/2022|.19064|03/29/2022|.19191|03/29/2022||||4475|||||No|No||PERRIGO/PADAGIS|No||||
carbomer/polysorbates|No|No|No|No|75%|00574030716|SUSPENDOL-S LIQUID|473|ML|.01363|09/07/2015||Yes|Yes||||No|No|09/07/2015||Yes|Yes||||No|No|||Over the counter|No|||No|.03107|06/01/2016|.03063|06/01/2016|.02917|06/01/2016||||4476|||||No|No||PERRIGO CO.|No||||
ferrous gluconate|No|No|No|No|75%|00574050811|FERROUS GLUCONATE 324 MG TAB|100|EA|.03784|||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|.08624|07/07/2020|.085|07/07/2020|.08096|07/07/2020||||4477|||||No|No||PERRIGO/PADAGIS|No||||
ferrous sulfate|No|No|No|No|75%|00574060801|FERROUS SULF EC 324 MG TABLET|100|EA|.02064|||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|.04704|07/07/2020|.04636|07/07/2020|.04416|07/07/2020||||4478|||||No|No||PERRIGO/PADAGIS|No||||
ferrous sulfate|No|No|No|No|75%|00574060811|FERROUS SULF EC 324 MG TABLET|100|EA|.03784|||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|.08624|07/07/2020|.085|07/07/2020|.08096|07/07/2020||||4479|||||No|No||PERRIGO/PADAGIS|No||||
podofilox|No|No|No|No|75%|00574061105|PODOFILOX 0.5% TOPICAL SOLN|3.5|ML|10.6296|03/27/2002||Yes|No||03/27/2002||Yes|No|03/27/2002||Yes|No||||No|No|||Prescription required|No|||No|15.44|03/29/2022|15.06944|03/29/2022|15.1698|03/29/2022||||4480|||||No|No||PERRIGO/PADAGIS|No||||
methazolamide|No|No|No|No|75%|00574079001|METHAZOLAMIDE 25 MG TABLET|100|EA|.989|06/21/2018||Yes|No||06/21/2018||Yes|No|06/21/2018||Yes|No||||No|No|||Prescription required|No|||No|2.09477|03/01/2022|2.04449|03/01/2022|2.05811|03/01/2022||||4481|||||No|No||PERRIGO/PADAGIS|No||||
methazolamide|No|No|No|No|75%|00574079101|METHAZOLAMIDE 50 MG TABLET|100|EA|1.978|06/21/2018||Yes|No||06/21/2018||Yes|No|06/21/2018||Yes|No||||No|No|||Prescription required|No|||No|4.4571|03/29/2022|4.35012|03/29/2022|4.3791|03/29/2022||||4482|||||No|No||PERRIGO/PADAGIS|No||||
pilocarpine HCl|No|No|No|No|75%|00574079201|PILOCARPINE HCL 5 MG TABLET|100|EA|.17552|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No|||No|.27963|03/29/2022|.27291|03/29/2022|.27473|03/29/2022||||4483|||||No|No||PERRIGO/PADAGIS|No||||
acetylcysteine|No|No|No|No|75%|00574080530|ACETYLCYSTEINE 6 GRAM/30 ML VL|30|ML|2.69466|01/04/2013||Yes|No||01/04/2013||Yes|No|01/04/2013||Yes|No||||No|No|||Prescription required|No|||No|6.14132|06/01/2016|6.05359|06/01/2016|5.76532|06/01/2016||||4484|||||No|No||PERRIGO/PADAGIS|No||||
testosterone cypionate|No|No|No|No|90%|00574082001|TESTOSTERONE CYP 200 MG/ML|1|ML|7.9722|06/08/2015||Yes|No||06/08/2015||Yes|No|06/08/2015||Yes|No||||No|No|||Prescription required|No|||No|15.53502|03/29/2022|15.16217|03/29/2022|15.26315|03/29/2022||||4485|||||No|No||PERRIGO/PADAGIS|No||||
testosterone cypionate|No|No|No|No|90%|00574082010|TESTOSTERONE CYP 200 MG/ML|10|ML|3.48773|12/28/2007||Yes|No||12/28/2007||Yes|No|12/28/2007||Yes|No||||No|No|||Prescription required|No|||No|3.11913|03/29/2022|3.04427|03/29/2022|3.06454|03/29/2022||||4486|||||No|No||PERRIGO/PADAGIS|No||||
testosterone cypionate|No|No|No|No|90%|00574082701|TESTOSTERONE CYP 200 MG/ML|1|ML|7.9722|09/05/2019||Yes|No||09/05/2019||Yes|No|09/05/2019||Yes|No||||No|No|||Prescription required|No|||No|15.53502|03/29/2022|15.16217|03/29/2022|15.26315|03/29/2022||||4487|||||No|No||PERRIGO/PADAGIS|No||||
testosterone cypionate|No|No|No|No|90%|00574082710|TESTOSTERON CYP 2,000 MG/10 ML|10|ML|3.48773|06/10/2020||Yes|No||06/10/2020||Yes|No|06/10/2020||Yes|No||||No|No|||Prescription required|No|||No|3.11913|03/29/2022|3.04427|03/29/2022|3.06454|03/29/2022||||4488|||||No|No||PERRIGO/PADAGIS|No||||
dihydroergotamine mesylate|No|No|No|No|75%|00574085005|DIHYDROERGOTAMINE 1 MG/ML AMP|1|ML|56.4805|09/16/2003||Yes|No||09/16/2003||Yes|No|09/16/2003||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|537|No|128.723|04/24/2018|126.8841|04/24/2018|120.842|04/24/2018|||ANTIMIGRAINE AGENTS: OTHER|4489|||||No|No||PERRIGO CO.|No||||
dihydroergotamine mesylate|No|No|No|No|75%|00574085010|DIHYDROERGOTAMINE 1 MG/ML AMP|1|ML|53.65669|01/31/2005||Yes|No||01/31/2005||Yes|No|01/31/2005||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|537|No|122.28734|06/27/2017|120.54037|06/27/2017|114.80036|06/27/2017|||ANTIMIGRAINE AGENTS: OTHER|4490|||||No|No||PERRIGO/PADAGIS|No||||
estradiol valerate|No|No|No|No|75%|00574087005|ESTRADIOL VALERATE 100 MG/5 ML|5|ML|9.92784|04/01/2010|02/28/2022|Yes|No||04/01/2010|02/28/2022|Yes|No|04/01/2010|02/28/2022|Yes|No||||No|No|||Prescription required|No|||Yes|22.62624|03/15/2022|22.303|03/15/2022|21.24096|03/15/2022||||4491|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||PERRIGO/PADAGIS|No||||
estradiol valerate|No|No|No|No|75%|00574087205|ESTRADIOL VALERATE 200 MG/5 ML|5|ML|16.46986|06/01/2010|01/31/2022|Yes|No||06/01/2010|01/31/2022|Yes|No|06/01/2010|01/31/2022|Yes|No||||No|No|||Prescription required|No|||Yes|37.53596|02/15/2022|36.99973|02/15/2022|35.23784|02/15/2022||||4492|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||PERRIGO/PADAGIS|No||||
brompheniramine/pseudoephed/DM|No|No|No|No|75%|00574110404|BROMPHEN-PSE-DM 2-30-10 MG/5ML|118|ML|.08034|03/30/2015||Yes|No||03/30/2015||Yes|No|03/30/2015||Yes|No||||No|No|||Prescription required|No||184|Yes|.0774|03/29/2022|.07554|03/29/2022|.07604|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|4493|||||No|No||PERRIGO/PADAGIS|No||||
brompheniramine/pseudoephed/DM|No|No|No|No|75%|00574110416|BROMPHEN-PSE-DM 2-30-10 MG/5ML|473|ML|.08007|03/30/2015||Yes|No||03/30/2015||Yes|No|03/30/2015||Yes|No||||No|No|||Prescription required|No||184|Yes|.06501|03/29/2022|.06344|03/29/2022|.06387|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|4494|||||No|No||PERRIGO/PADAGIS|No||||
nystatin|No|No|No|No|75%|00574200802|NYSTOP 100,000 UNIT/GM POWDER|60|GM|.49665|01/19/2005||Yes|No||01/19/2005||Yes|No|01/19/2005||Yes|No||||No|No|||Prescription required|No||061|No|.2597|03/29/2022|.25346|03/29/2022|.25515|03/29/2022|||ANTIFUNGALS: TOPICAL|4495|||||No|No||PERRIGO CO.|No||||
nystatin|No|No|No|No|75%|00574200815|NYSTOP 100,000 UNIT/GM POWDER|15|GM|.55613|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||061|No|.35016|03/29/2022|.34175|03/29/2022|.34403|03/29/2022|||ANTIFUNGALS: TOPICAL|4496|||||No|No||PERRIGO CO.|No||||
nystatin|No|No|No|No|75%|00574200830|NYSTOP 100,000 UNIT/GM POWDER|30|GM|.55627|08/06/2002||Yes|No||08/06/2002||Yes|No|08/06/2002||Yes|No||08/06/2002||Yes|No|||Prescription required|No||061|No|.30897|03/29/2022|.30155|03/29/2022|.30356|03/29/2022|||ANTIFUNGALS: TOPICAL|4497|||||No|No||PERRIGO CO.|No||||
ciclopirox|No|No|No|No|75%|00574206101|CICLOPIROX 0.77% GEL|100|GM|.83385|10/16/2013||Yes|No||10/16/2013||Yes|No|10/16/2013||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|061|No|.5644|03/29/2022|.55085|03/29/2022|.55452|03/29/2022|||ANTIFUNGALS: TOPICAL|4498|||||No|No||PERRIGO/PADAGIS|No||||
ciclopirox|No|No|No|No|75%|00574206130|CICLOPIROX 0.77% GEL|30|GM|.92507|10/16/2013||Yes|No||10/16/2013||Yes|No|10/16/2013||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|061|No|.698|03/29/2022|.68124|03/29/2022|.68578|03/29/2022|||ANTIFUNGALS: TOPICAL|4499|||||No|No||PERRIGO/PADAGIS|No||||
ciclopirox|No|No|No|No|75%|00574206145|CICLOPIROX 0.77% GEL|45|GM|.92526|10/16/2013||Yes|No||10/16/2013||Yes|No|10/16/2013||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|061|No|.72022|03/29/2022|.70293|03/29/2022|.70761|03/29/2022|||ANTIFUNGALS: TOPICAL|4500|||||No|No||PERRIGO/PADAGIS|No||||
estradiol|No|No|No|No|75%|00574206727|EVAMIST 1.53 MG/SPRAY|8.1|ML|6.83275|01/11/2016||Yes|No||01/11/2016||Yes|No|01/11/2016||Yes|No||||No|No|||Prescription required|No|||Yes|15.23907|06/29/2021|14.87333|06/29/2021|14.97238|06/29/2021||||4501|||||No|No||PERRIGO/PADAGIS|No||||
ivermectin|No|No|No|No|75%|00574210745|IVERMECTIN 1% CREAM|45|GM|4.74136|12/01/2021||Yes|No||12/01/2021||Yes|No|12/01/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|221|No|6.39081|03/29/2022|6.23743|03/29/2022|6.27897|03/29/2022|||ROSACEA AGENTS: TOPICAL|4502|||||No|No||PERRIGO/PADAGIS|No||||
tretinoin|No|No|No|No|75%|00574220120|TRETINOIN 0.1% CREAM|20|GM|2.35554|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||||No|No|||Prescription required|No||104|No|2.48726|03/29/2022|2.42756|03/29/2022|2.44373|03/29/2022|||ACNE AGENTS: TOPICAL|4503|||||No|No||PERRIGO/PADAGIS|No||||
tretinoin|No|No|No|No|75%|00574220145|TRETINOIN 0.1% CREAM|45|GM|1.96051|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||||No|No|||Prescription required|No||104|No|2.33901|03/29/2022|2.28287|03/29/2022|2.29807|03/29/2022|||ACNE AGENTS: TOPICAL|4504|||||No|No||PERRIGO/PADAGIS|No||||
tretinoin|No|No|No|No|75%|00574220520|TRETINOIN 0.05% CREAM|20|GM|2.0182|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||||No|No|||Prescription required|No||104|No|2.20699|03/29/2022|2.15402|03/29/2022|2.16836|03/29/2022|||ACNE AGENTS: TOPICAL|4505|||||No|No||PERRIGO/PADAGIS|No||||
tretinoin|No|No|No|No|75%|00574220545|TRETINOIN 0.05% CREAM|45|GM|1.68234|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||||No|No|||Prescription required|No||104|No|1.78965|03/29/2022|1.74669|03/29/2022|1.75833|03/29/2022|||ACNE AGENTS: TOPICAL|4506|||||No|No||PERRIGO/PADAGIS|No||||
tretinoin|No|No|No|No|75%|00574222520|TRETINOIN 0.025% CREAM|20|GM|1.79955|11/14/2017||Yes|No||11/14/2017||Yes|No|11/14/2017||Yes|No||||No|No|||Prescription required|No||104|No|2.13963|03/29/2022|2.08827|03/29/2022|2.10218|03/29/2022|||ACNE AGENTS: TOPICAL|4507|||||No|No||PERRIGO/PADAGIS|No||||
tretinoin|No|No|No|No|75%|00574222545|TRETINOIN 0.025% CREAM|45|GM|1.51446|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||||No|No|||Prescription required|No||104|No|1.91452|03/29/2022|1.86857|03/29/2022|1.88101|03/29/2022|||ACNE AGENTS: TOPICAL|4508|||||No|No||PERRIGO/PADAGIS|No||||
tretinoin|No|No|No|No|75%|00574230115|TRETINOIN 0.01% GEL|15|GM|1.90547|11/17/2020||Yes|No||11/17/2020||Yes|No|11/17/2020||Yes|No||||No|No|||Prescription required|No||104|No|3.65059|03/29/2022|3.56297|03/29/2022|3.5867|03/29/2022|||ACNE AGENTS: TOPICAL|4509|||||No|No||PERRIGO/PADAGIS|No||||
tretinoin|No|No|No|No|75%|00574230145|TRETINOIN 0.01% GEL|45|GM|1.49955|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||||No|No|||Prescription required|No||104|No|2.47886|03/29/2022|2.41936|03/29/2022|2.43547|03/29/2022|||ACNE AGENTS: TOPICAL|4510|||||No|No||PERRIGO/PADAGIS|No||||
tretinoin|No|No|No|No|75%|00574232515|TRETINOIN 0.025% GEL|15|GM|1.92238|05/18/2017||Yes|No||05/18/2017||Yes|No|05/18/2017||Yes|No||||No|No|||Prescription required|No||104|No|3.76373|03/29/2022|3.6734|03/29/2022|3.69786|03/29/2022|||ACNE AGENTS: TOPICAL|4511|||||No|No||PERRIGO/PADAGIS|No||||
tretinoin|No|No|No|No|75%|00574232545|TRETINOIN 0.025% GEL|45|GM|1.51168|02/16/2018||Yes|No||02/16/2018||Yes|No|02/16/2018||Yes|No||||No|No|||Prescription required|No||104|No|2.81852|03/29/2022|2.75087|03/29/2022|2.76919|03/29/2022|||ACNE AGENTS: TOPICAL|4512|||||No|No||PERRIGO/PADAGIS|No||||
bacitracin/polymyxin B sulfate|No|No|No|No|75%|00574402135|POLYCIN EYE OINTMENT|3.5|GM|2.6746|02/18/2015||Yes|No||02/18/2015||Yes|No|02/18/2015||Yes|No||||No|No|||Prescription required|No||058|No|3.21333|03/29/2022|3.13621|03/29/2022|3.15709|03/29/2022|||OPHTHALMIC ANTIBIOTICS|4513|||||No|No||PERRIGO/PADAGIS|No||||
bacitracin|No|No|No|No|75%|00574402235|BACITRACIN 500 UNIT/GM OPHTH|3.5|GM|12.126|11/07/2014||Yes|No||11/07/2014||Yes|No|11/07/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|058|No|26.05748|08/24/2021|25.4321|08/24/2021|25.60147|08/24/2021|||OPHTHALMIC ANTIBIOTICS|4514|||||No|No||PERRIGO CO.|No||||
erythromycin base|No|No|No|No|75%|00574402435|ERYTHROMYCIN 0.5% EYE OINTMENT|3.5|GM|1.83917|06/19/2014||Yes|No||06/19/2014||Yes|No|06/19/2014||Yes|No||||No|No|||Prescription required|No||058|No|2.75102|03/29/2022|2.68499|03/29/2022|2.70287|03/29/2022|||OPHTHALMIC ANTIBIOTICS|4515|||||No|No||PERRIGO/PADAGIS|No||||
erythromycin base|No|No|No|No|75%|00574402439|ERYTHROMYCIN 0.5% EYE OINTMENT|3.5|GM|1.83917|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|No||058|No|4.19159|09/20/2019|4.13171|09/20/2019|3.93496|09/20/2019|||OPHTHALMIC ANTIBIOTICS|4516|||||No|No||PERRIGO/PADAGIS|No||||
erythromycin base|No|No|No|No|75%|00574402450|ERYTHROMYCIN 0.5% EYE OINTMENT|1|GM|3.11595|06/24/2014||Yes|No||06/24/2014||Yes|No|06/24/2014||Yes|No||||No|No|||Prescription required|No||058|No|7.10147|03/24/2020|7.00002|03/24/2020|6.66668|03/24/2020|||OPHTHALMIC ANTIBIOTICS|4517|||||No|No||PERRIGO/PADAGIS|No||||
neomycin/bacit/p-myx/hydrocort|No|No|No|No|75%|00574414435|NEO-POLYCIN HC EYE OINTMENT|3.5|GM|6.1404|09/17/2015||Yes|No||09/17/2015||Yes|No|09/17/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|036|No|8.46571|04/27/2021|8.26253|04/27/2021|8.31756|04/27/2021|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|4518|||||No|No||PERRIGO CO.|No||||
neomycin/polymyxin B/dexametha|No|No|No|No|75%|00574416035|NEOMYC-POLYM-DEXAMET EYE OINTM|3.5|GM|1.55168|11/07/2014||Yes|No||11/07/2014||Yes|No|11/07/2014||Yes|No||||No|No|||Prescription required|No||036|No|3.06312|03/29/2022|2.9896|03/29/2022|3.00951|03/29/2022|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|4519|||||No|No||PERRIGO CO.|No||||
sulfacetamide sodium|No|No|No|No|75%|00574419035|SULFACETAMIDE 10% EYE OINTMENT|3.5|GM|6.7424|10/03/2014||Yes|No||10/03/2014||Yes|No|10/03/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|058|No|15.3664|06/28/2016|15.14688|06/28/2016|14.4256|06/28/2016|||OPHTHALMIC ANTIBIOTICS|4520|||||No|No||PERRIGO/PADAGIS|No||||
neomycin/bacitracin/polymyxinB|No|No|No|No|75%|00574425035|NEO-POLYCIN EYE OINTMENT|3.5|GM|5.37868|09/17/2015||Yes|No||09/17/2015||Yes|No|09/17/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|058|No|6.36143|03/29/2022|6.20875|03/29/2022|6.2501|03/29/2022|||OPHTHALMIC ANTIBIOTICS|4521|||||No|No||PERRIGO CO.|No||||
opium/belladonna alkaloids|No|No|No|No|90%|00574704012|BELLADONNA-OPIUM 16.2-60 SUPP|12|EA|11.50751|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||Yes|26.22642|08/29/2017|25.85176|08/29/2017|24.62072|08/29/2017||||4522|||||No|No||PERRIGO CO.|No||||
opium/belladonna alkaloids|No|No|No|No|90%|00574704512|BELLADONNA-OPIUM 16.2-30 SUPP|12|EA|9.46608|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||Yes|21.57387|07/28/2020|21.26567|07/28/2020|20.25302|07/28/2020||||4523|||||No|No||PERRIGO CO.|No||||
bisacodyl|No|No|No|No|75%|00574705012|BISACODYL 10 MG SUPPOSITORY|12|EA|.15193|11/24/2020||Yes|No||||No|No|11/24/2020||Yes|No||||No|No|||Over the counter|No|||No|.28634|03/29/2022|.27946|03/29/2022|.28132|03/29/2022||||4524|||||No|No||PERRIGO/PADAGIS|No||||
hydromorphone HCl|No|No|No|No|90%|00574722406|HYDROMORPHONE 3 MG SUPPOS|6|EA|4.21973|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|109|Yes|9.61706|07/25/2017|9.47967|07/25/2017|9.02826|07/25/2017|||ANALGESICS: NARCOTICS SHORT|4525|||||No|No||PERRIGO/PADAGIS|No||||
prochlorperazine|No|No|No|No|75%|00574722612|COMPRO 25 MG SUPPOSITORY|12|EA|3.74637|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|01/15/2014|085|No|6.24106|03/29/2022|6.09127|03/29/2022|6.13184|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|4526|||||No|No||PERRIGO/PADAGIS|No||||
budesonide|No|No|No|No|75%|00574985010|ENTOCORT EC 3 MG CAPSULE|100|EA|9.89653|02/17/2017|01/31/2022|Yes|No||02/17/2017|01/31/2022|Yes|No|02/17/2017|01/31/2022|Yes|No||||No|No|||Prescription required|Yes|01/28/2016|168|Yes|22.55489|02/17/2017|22.23268|02/17/2017|21.17398|02/17/2017|||GLUCOCORTICOIDS: ORAL|4527|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||PERRIGO/PADAGIS|No||||
budesonide|No|No|No|No|75%|00574985510|BUDESONIDE DR 3 MG CAPSULE|100|EA|.95675|09/06/2018||Yes|No||09/06/2018||Yes|No|09/06/2018||Yes|No||||No|No|||Prescription required|No||168|Yes|.86544|03/29/2022|.84466|03/29/2022|.85029|03/29/2022|||GLUCOCORTICOIDS: ORAL|4528|||||No|No||PERRIGO/PADAGIS|No||||
diazoxide|No|No|No|No|75%|00575620030|PROGLYCEM 50 MG/ML ORAL SUSP|30|ML|5.4008|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||583|No|12.3088|01/11/2022|12.13296|01/11/2022|11.5552|01/11/2022|||GLUCAGON AGENTS|4529|||||No|No||TEVA SPECIALTY|No||||
lorazepam|No|No|No|No|90%|00591024001|LORAZEPAM 0.5 MG TABLET|100|EA|.01874|08/19/2002|12/28/2022|Yes|No||08/19/2002|12/28/2022|Yes|No|08/19/2002|12/28/2022|Yes|No||||No|No|||Prescription required|No||090|Yes|.03794|03/29/2022|.03702|03/29/2022|.03727|03/29/2022|||ANXIOLYTICS|4530|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ACTAVIS/TEVA|No||||
lorazepam|No|No|No|No|90%|00591024005|LORAZEPAM 0.5 MG TABLET|500|EA|.01876|04/26/2002|11/05/2022|Yes|No||04/26/2002|11/05/2022|Yes|No|04/26/2002|11/05/2022|Yes|No||||No|No|||Prescription required|No||090|Yes|.03794|03/29/2022|.03702|03/29/2022|.03727|03/29/2022|||ANXIOLYTICS|4531|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ACTAVIS/TEVA|No||||
lorazepam|No|No|No|No|90%|00591024010|LORAZEPAM 0.5 MG TABLET|1000|EA|.0182|04/10/2002|10/11/2022|Yes|No||04/10/2002|10/11/2022|Yes|No|04/10/2002|10/11/2022|Yes|No||||No|No|||Prescription required|No||090|Yes|.03794|03/29/2022|.03702|03/29/2022|.03727|03/29/2022|||ANXIOLYTICS|4532|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ACTAVIS/TEVA|No||||
lorazepam|No|No|No|No|90%|00591024101|LORAZEPAM 1 MG TABLET|100|EA|.02128|05/29/2002|12/09/2022|Yes|No||05/29/2002|12/09/2022|Yes|No|05/29/2002|12/09/2022|Yes|No||||No|No|||Prescription required|No||090|Yes|.04593|03/29/2022|.04482|03/29/2022|.04512|03/29/2022|||ANXIOLYTICS|4533|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ACTAVIS/TEVA|No||||
lorazepam|No|No|No|No|90%|00591024105|LORAZEPAM 1 MG TABLET|500|EA|.0213|07/16/2002|01/11/2023|Yes|No||07/16/2002|01/11/2023|Yes|No|07/16/2002|01/11/2023|Yes|No||||No|No|||Prescription required|No||090|Yes|.04593|03/29/2022|.04482|03/29/2022|.04512|03/29/2022|||ANXIOLYTICS|4534|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ACTAVIS/TEVA|No||||
lorazepam|No|No|No|No|90%|00591024110|LORAZEPAM 1 MG TABLET|1000|EA|.02066|06/14/2002|12/28/2022|Yes|No||06/14/2002|12/28/2022|Yes|No|06/14/2002|12/28/2022|Yes|No||||No|No|||Prescription required|No||090|Yes|.04593|03/29/2022|.04482|03/29/2022|.04512|03/29/2022|||ANXIOLYTICS|4535|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ACTAVIS/TEVA|No||||
lorazepam|No|No|No|No|90%|00591024201|LORAZEPAM 2 MG TABLET|100|EA|.03311|04/10/2002|07/20/2022|Yes|No||04/10/2002|07/20/2022|Yes|No|04/10/2002|07/20/2022|Yes|No||||No|No|||Prescription required|No||090|Yes|.06696|03/29/2022|.06535|03/29/2022|.06578|03/29/2022|||ANXIOLYTICS|4536|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ACTAVIS/TEVA|No||||
lorazepam|No|No|No|No|90%|00591024205|LORAZEPAM 2 MG TABLET|500|EA|.03309|05/29/2002|07/20/2022|Yes|No||05/29/2002|07/20/2022|Yes|No|05/29/2002|07/20/2022|Yes|No||||No|No|||Prescription required|No||090|Yes|.06696|03/29/2022|.06535|03/29/2022|.06578|03/29/2022|||ANXIOLYTICS|4537|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ACTAVIS/TEVA|No||||
lorazepam|No|No|No|No|90%|00591024210|LORAZEPAM 2 MG TABLET|1000|EA|.03209|08/19/2002|07/20/2022|Yes|No||08/19/2002|07/20/2022|Yes|No|08/19/2002|07/20/2022|Yes|No||||No|No|||Prescription required|No||090|Yes|.06696|03/29/2022|.06535|03/29/2022|.06578|03/29/2022|||ANXIOLYTICS|4538|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ACTAVIS/TEVA|No||||
verapamil HCl|Yes|No|No|No|75%|00591034301|VERAPAMIL 80 MG TABLET|100|EA|.02214|08/19/2002||Yes|No||08/19/2002||Yes|No|08/19/2002||Yes|No||08/19/2002||Yes|No|07/01/2016||Prescription required|No||045|No|.05252|03/29/2022|.05125|03/29/2022|.0516|03/29/2022|||CALCIUM CHANNEL BLOCKERS|4539|||||No|No||ACTAVIS/TEVA|No||||
verapamil HCl|Yes|No|No|No|75%|00591034305|VERAPAMIL 80 MG TABLET|500|EA|.02078|07/12/2005||Yes|No||07/12/2005||Yes|No|07/12/2005||Yes|No||07/12/2005||Yes|No|07/01/2016||Prescription required|No||045|No|.05252|03/29/2022|.05125|03/29/2022|.0516|03/29/2022|||CALCIUM CHANNEL BLOCKERS|4540|||||No|No||ACTAVIS/TEVA|No||||
verapamil HCl|Yes|No|No|No|75%|00591034310|VERAPAMIL 80 MG TABLET|1000|EA|.02018|07/17/2002||Yes|No||07/17/2002||Yes|No|07/17/2002||Yes|No||07/17/2002||Yes|No|07/01/2016||Prescription required|No||045|No|.05252|03/29/2022|.05125|03/29/2022|.0516|03/29/2022|||CALCIUM CHANNEL BLOCKERS|4541|||||No|No||ACTAVIS/TEVA|No||||
verapamil HCl|No|No|No|No|75%|00591034501|VERAPAMIL 120 MG TABLET|100|EA|.03289|09/25/2002||Yes|No||09/25/2002||Yes|No|09/25/2002||Yes|No||09/25/2002||Yes|No|||Prescription required|No||045|No|.07071|03/29/2022|.06901|03/29/2022|.06947|03/29/2022|||CALCIUM CHANNEL BLOCKERS|4542|||||No|No||ACTAVIS/TEVA|No||||
verapamil HCl|No|No|No|No|75%|00591034505|VERAPAMIL 120 MG TABLET|500|EA|.0312|11/06/2002||Yes|No||11/06/2002||Yes|No|11/06/2002||Yes|No||11/06/2002||Yes|No|||Prescription required|No||045|No|.07071|03/29/2022|.06901|03/29/2022|.06947|03/29/2022|||CALCIUM CHANNEL BLOCKERS|4543|||||No|No||ACTAVIS/TEVA|No||||
verapamil HCl|No|No|No|No|75%|00591034510|VERAPAMIL 120 MG TABLET|1000|EA|.02952|11/19/2003||Yes|No||11/19/2003||Yes|No|11/19/2003||Yes|No||11/19/2003||Yes|No|||Prescription required|No||045|No|.07071|03/29/2022|.06901|03/29/2022|.06947|03/29/2022|||CALCIUM CHANNEL BLOCKERS|4544|||||No|No||ACTAVIS/TEVA|No||||
hydrochlorothiazide|Yes|No|No|No|75%|00591034701|HYDROCHLOROTHIAZIDE 12.5 MG CP|100|EA|.0344|08/02/2002||Yes|No||08/02/2002||Yes|No|08/02/2002||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No|||Yes|.03333|03/29/2022|.03253|03/29/2022|.03274|03/29/2022||||4545|||||No|No||ACTAVIS/TEVA|No||||
hydrochlorothiazide|Yes|No|No|No|75%|00591034705|HYDROCHLOROTHIAZIDE 12.5 MG CP|500|EA|.03268|04/30/2004||Yes|No||04/30/2004||Yes|No|04/30/2004||Yes|No||04/30/2004||Yes|No|07/01/2016||Prescription required|No|||Yes|.03333|03/29/2022|.03253|03/29/2022|.03274|03/29/2022||||4546|||||No|No||ACTAVIS/TEVA|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|00591034801|TRIAMTERENE-HCTZ 75-50 MG TAB|100|EA|.12121|03/20/2002||Yes|No||03/20/2002||Yes|No|03/20/2002||Yes|No||||No|No|||Prescription required|No|||Yes|.1312|03/29/2022|.12805|03/29/2022|.1289|03/29/2022||||4547|||||No|No||ACTAVIS/TEVA|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|00591034805|TRIAMTERENE-HCTZ 75-50 MG TAB|500|EA|.11756|07/17/2002||Yes|No||07/17/2002||Yes|No|07/17/2002||Yes|No||||No|No|||Prescription required|No|||Yes|.1312|03/29/2022|.12805|03/29/2022|.1289|03/29/2022||||4548|||||No|No||ACTAVIS/TEVA|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|00591034810|TRIAMTERENE-HCTZ 75-50 MG TAB|1000|EA|.11756|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|.1312|03/29/2022|.12805|03/29/2022|.1289|03/29/2022||||4549|||||No|No||ACTAVIS/TEVA|No||||
loxapine succinate|No|No|No|No|75%|00591036901|LOXAPINE 5 MG CAPSULE|100|EA|.23512|02/12/2003||Yes|No||02/12/2003||Yes|No|02/12/2003||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|027|Yes|.48716|01/25/2022|.47546|01/25/2022|.47863|01/25/2022|||ANTIPSYCHOTICS|4550|||||No|No||ACTAVIS/TEVA|No||||
loxapine succinate|No|No|No|No|75%|00591037001|LOXAPINE 10 MG CAPSULE|100|EA|.30917|09/25/2002||Yes|No||09/25/2002||Yes|No|09/25/2002||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|027|Yes|.55828|01/25/2022|.54488|01/25/2022|.54851|01/25/2022|||ANTIPSYCHOTICS|4551|||||No|No||ACTAVIS/TEVA|No||||
loxapine succinate|No|No|No|No|75%|00591037101|LOXAPINE 25 MG CAPSULE|100|EA|.47029|09/25/2002||Yes|No||09/25/2002||Yes|No|09/25/2002||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|027|Yes|.84036|01/25/2022|.82019|01/25/2022|.82565|01/25/2022|||ANTIPSYCHOTICS|4552|||||No|No||ACTAVIS/TEVA|No||||
loxapine succinate|No|No|No|No|75%|00591037201|LOXAPINE 50 MG CAPSULE|100|EA|.62685|09/25/2002||Yes|No||09/25/2002||Yes|No|09/25/2002||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|027|Yes|1.01035|10/26/2021|.9861|10/26/2021|.99266|10/26/2021|||ANTIPSYCHOTICS|4553|||||No|No||ACTAVIS/TEVA|No||||
pentazocine HCl/naloxone HCl|No|No|No|No|90%|00591039501|PENTAZOCINE-NALOXONE TABLET|100|EA|.88666|05/29/2002||Yes|No||05/29/2002||Yes|No|05/29/2002||Yes|No||05/29/2002||Yes|No|||Prescription required|Yes|07/17/2014|109|Yes|1.88962|03/01/2022|1.84426|03/01/2022|1.85655|03/01/2022|||ANALGESICS: NARCOTICS SHORT|4554|||||No|No||ACTAVIS/TEVA|No||||
diclofenac sodium/misoprostol|No|No|No|No|75%|00591039719|DICLOFENAC-MISOPROST 50-0.2 MG|90|EA|1.1534|02/18/2016||Yes|No||02/18/2016||Yes|No|02/18/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|1.41801|03/29/2022|1.38397|03/29/2022|1.39319|03/29/2022|||NSAIDS|4555|||||No|No||ACTAVIS/TEVA|No||||
diclofenac sodium/misoprostol|No|No|No|No|75%|00591039760|DICLOFENAC-MISOPROST 50-0.2 MG|60|EA|1.1534|02/28/2013||Yes|No||02/28/2013||Yes|No|02/28/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|1.41801|03/29/2022|1.38397|03/29/2022|1.39319|03/29/2022|||NSAIDS|4556|||||No|No||ACTAVIS/TEVA|No||||
diclofenac sodium/misoprostol|No|No|No|No|75%|00591039860|DICLOFENAC-MISOPROST 75-0.2 MG|60|EA|1.1534|02/28/2013||Yes|No||02/28/2013||Yes|No|02/28/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|1.61285|03/29/2022|1.57414|03/29/2022|1.58462|03/29/2022|||NSAIDS|4557|||||No|No||ACTAVIS/TEVA|No||||
verapamil HCl|No|No|No|No|75%|00591040401|VERAPAMIL 40 MG TABLET|100|EA|.06656|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||045|No|.13868|03/29/2022|.13535|03/29/2022|.13625|03/29/2022|||CALCIUM CHANNEL BLOCKERS|4558|||||No|No||ACTAVIS/TEVA|No||||
lisinopril|Yes|No|No|No|75%|00591040501|LISINOPRIL 2.5 MG TABLET|100|EA|.01053|07/19/2002||Yes|No||07/19/2002||Yes|No|07/19/2002||Yes|No||07/19/2002||Yes|No|07/01/2016||Prescription required|No||113|No|.01617|03/29/2022|.01578|03/29/2022|.01588|03/29/2022|||ANGIOTENSIN MODULATORS|4559|||||No|No||ACTAVIS/TEVA|No||||
lisinopril|Yes|No|No|No|75%|00591040505|LISINOPRIL 2.5 MG TABLET|500|EA|.01053|11/07/2002||Yes|No||11/07/2002||Yes|No|11/07/2002||Yes|No||11/07/2002||Yes|No|07/01/2016||Prescription required|No||113|No|.01617|03/29/2022|.01578|03/29/2022|.01588|03/29/2022|||ANGIOTENSIN MODULATORS|4560|||||No|No||ACTAVIS/TEVA|No||||
lisinopril|Yes|No|No|No|75%|00591040601|LISINOPRIL 5 MG TABLET|100|EA|.01384|07/19/2002||Yes|No||07/19/2002||Yes|No|07/19/2002||Yes|No||07/19/2002||Yes|No|07/01/2016||Prescription required|No||113|No|.01549|03/29/2022|.01511|03/29/2022|.01521|03/29/2022|||ANGIOTENSIN MODULATORS|4561|||||No|No||ACTAVIS/TEVA|No||||
lisinopril|Yes|No|No|No|75%|00591040610|LISINOPRIL 5 MG TABLET|1000|EA|.01316|11/07/2002||Yes|No||11/07/2002||Yes|No|11/07/2002||Yes|No||11/07/2002||Yes|No|07/01/2016||Prescription required|No||113|No|.01549|03/29/2022|.01511|03/29/2022|.01521|03/29/2022|||ANGIOTENSIN MODULATORS|4562|||||No|No||ACTAVIS/TEVA|No||||
lisinopril|Yes|No|No|No|75%|00591040701|LISINOPRIL 10 MG TABLET|100|EA|.01947|07/19/2002||Yes|No||07/19/2002||Yes|No|07/19/2002||Yes|No||07/19/2002||Yes|No|07/01/2016||Prescription required|No||113|No|.01914|03/29/2022|.01868|03/29/2022|.0188|03/29/2022|||ANGIOTENSIN MODULATORS|4563|||||No|No||ACTAVIS/TEVA|No||||
lisinopril|Yes|No|No|No|75%|00591040710|LISINOPRIL 10 MG TABLET|1000|EA|.0185|11/07/2002||Yes|No||11/07/2002||Yes|No|11/07/2002||Yes|No||11/07/2002||Yes|No|07/01/2016||Prescription required|No||113|No|.01914|03/29/2022|.01868|03/29/2022|.0188|03/29/2022|||ANGIOTENSIN MODULATORS|4564|||||No|No||ACTAVIS/TEVA|No||||
lisinopril|Yes|No|No|No|75%|00591040801|LISINOPRIL 20 MG TABLET|100|EA|.02919|07/19/2002||Yes|No||07/19/2002||Yes|No|07/19/2002||Yes|No||07/19/2002||Yes|No|07/01/2016||Prescription required|No||113|No|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANGIOTENSIN MODULATORS|4565|||||No|No||ACTAVIS/TEVA|No||||
lisinopril|Yes|No|No|No|75%|00591040810|LISINOPRIL 20 MG TABLET|1000|EA|.02772|11/07/2002||Yes|No||11/07/2002||Yes|No|11/07/2002||Yes|No||11/07/2002||Yes|No|07/01/2016||Prescription required|No||113|No|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANGIOTENSIN MODULATORS|4566|||||No|No||ACTAVIS/TEVA|No||||
lisinopril|Yes|No|No|No|75%|00591040901|LISINOPRIL 40 MG TABLET|100|EA|.05263|07/19/2002||Yes|No||07/19/2002||Yes|No|07/19/2002||Yes|No||07/19/2002||Yes|No|07/01/2016||Prescription required|No||113|No|.04778|03/29/2022|.04663|03/29/2022|.04694|03/29/2022|||ANGIOTENSIN MODULATORS|4567|||||No|No||ACTAVIS/TEVA|No||||
lisinopril|Yes|No|No|No|75%|00591040905|LISINOPRIL 40 MG TABLET|500|EA|.05263|11/07/2002||Yes|No||11/07/2002||Yes|No|11/07/2002||Yes|No||11/07/2002||Yes|No|07/01/2016||Prescription required|No||113|No|.04778|03/29/2022|.04663|03/29/2022|.04694|03/29/2022|||ANGIOTENSIN MODULATORS|4568|||||No|No||ACTAVIS/TEVA|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|00591042401|TRIAMTERENE-HCTZ 37.5-25 MG TB|100|EA|.1182|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|.09986|03/29/2022|.09746|03/29/2022|.09811|03/29/2022||||4569|||||No|No||ACTAVIS/TEVA|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|00591042405|TRIAMTERENE-HCTZ 37.5-25 MG TB|500|EA|.11674|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|.09986|03/29/2022|.09746|03/29/2022|.09811|03/29/2022||||4570|||||No|No||ACTAVIS/TEVA|No||||
guanfacine HCl|No|No|No|No|75%|00591044401|GUANFACINE 1 MG TABLET|100|EA|.08772|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||166|No|.50477|03/29/2022|.49265|03/29/2022|.49593|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|4571|||||No|No||ACTAVIS/TEVA|No||||
guanfacine HCl|No|No|No|No|75%|00591045301|GUANFACINE 2 MG TABLET|100|EA|.12298|04/10/2002||Yes|No||04/10/2002||Yes|No|04/10/2002||Yes|No||04/10/2002||Yes|No|||Prescription required|No||166|No|.72297|03/29/2022|.70561|03/29/2022|.71031|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|4572|||||No|No||ACTAVIS/TEVA|No||||
glipizide|Yes|No|No|No|75%|00591046001|GLIPIZIDE 5 MG TABLET|100|EA|.019|04/26/2002||Yes|No||04/26/2002||Yes|No|04/26/2002||Yes|No||04/26/2002||Yes|No|07/01/2016||Prescription required|No|||No|.03474|03/29/2022|.0339|03/29/2022|.03413|03/29/2022||||4573|||||No|No||ACTAVIS/TEVA|No||||
glipizide|Yes|No|No|No|75%|00591046005|GLIPIZIDE 5 MG TABLET|500|EA|.01855|03/06/2002||Yes|No||03/06/2002||Yes|No|03/06/2002||Yes|No||03/06/2002||Yes|No|07/01/2016||Prescription required|No|||No|.03474|03/29/2022|.0339|03/29/2022|.03413|03/29/2022||||4574|||||No|No||ACTAVIS/TEVA|No||||
glipizide|Yes|No|No|No|75%|00591046010|GLIPIZIDE 5 MG TABLET|1000|EA|.01805|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.03474|03/29/2022|.0339|03/29/2022|.03413|03/29/2022||||4575|||||No|No||ACTAVIS/TEVA|No||||
glipizide|Yes|No|No|No|75%|00591046101|GLIPIZIDE 10 MG TABLET|100|EA|.02687|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.04827|03/29/2022|.04711|03/29/2022|.04742|03/29/2022||||4576|||||No|No||ACTAVIS/TEVA|No||||
glipizide|Yes|No|No|No|75%|00591046105|GLIPIZIDE 10 MG TABLET|500|EA|.02623|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.04827|03/29/2022|.04711|03/29/2022|.04742|03/29/2022||||4577|||||No|No||ACTAVIS/TEVA|No||||
glipizide|Yes|No|No|No|75%|00591046110|GLIPIZIDE 10 MG TABLET|1000|EA|.0258|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.04827|03/29/2022|.04711|03/29/2022|.04742|03/29/2022||||4578|||||No|No||ACTAVIS/TEVA|No||||
propafenone HCl|No|No|No|No|75%|00591058201|PROPAFENONE HCL 150 MG TABLET|100|EA|.16567|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.14292|03/29/2022|.13948|03/29/2022|.14041|03/29/2022||||4579|||||No|No||ACTAVIS/TEVA|No||||
propafenone HCl|No|No|No|No|75%|00591058301|PROPAFENONE HCL 225 MG TAB|100|EA|.21783|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.20774|03/29/2022|.20275|03/29/2022|.2041|03/29/2022||||4580|||||No|No||ACTAVIS/TEVA|No||||
labetalol HCl|No|No|No|No|75%|00591060501|LABETALOL HCL 100 MG TABLET|100|EA|.17647|10/02/2002||Yes|No||10/02/2002||Yes|No|10/02/2002||Yes|No||10/02/2002||Yes|No|||Prescription required|No||070|No|.12868|03/29/2022|.12559|03/29/2022|.12642|03/29/2022|||BETA-BLOCKERS|4581|||||No|No||ACTAVIS/TEVA|No||||
labetalol HCl|No|No|No|No|75%|00591060505|LABETALOL HCL 100 MG TABLET|500|EA|.16743|08/19/2002||Yes|No||08/19/2002||Yes|No|08/19/2002||Yes|No||08/19/2002||Yes|No|||Prescription required|No||070|No|.12868|03/29/2022|.12559|03/29/2022|.12642|03/29/2022|||BETA-BLOCKERS|4582|||||No|No||ACTAVIS/TEVA|No||||
labetalol HCl|No|No|No|No|75%|00591060601|LABETALOL HCL 200 MG TABLET|100|EA|.25038|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.17218|03/29/2022|.16804|03/29/2022|.16916|03/29/2022|||BETA-BLOCKERS|4583|||||No|No||ACTAVIS/TEVA|No||||
labetalol HCl|No|No|No|No|75%|00591060605|LABETALOL HCL 200 MG TABLET|500|EA|.2379|03/06/2002||Yes|No||03/06/2002||Yes|No|03/06/2002||Yes|No||03/06/2002||Yes|No|||Prescription required|No||070|No|.17218|03/29/2022|.16804|03/29/2022|.16916|03/29/2022|||BETA-BLOCKERS|4584|||||No|No||ACTAVIS/TEVA|No||||
labetalol HCl|No|No|No|No|75%|00591060701|LABETALOL HCL 300 MG TABLET|100|EA|.33307|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.21583|03/29/2022|.21065|03/29/2022|.21205|03/29/2022|||BETA-BLOCKERS|4585|||||No|No||ACTAVIS/TEVA|No||||
estazolam|No|No|No|No|90%|00591074401|ESTAZOLAM 1 MG TABLET|100|EA|.23194|12/17/2002||Yes|No||12/17/2002||Yes|No|12/17/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|054|Yes|2.24434|12/28/2021|2.19047|12/28/2021|2.20506|12/28/2021|||SEDATIVE HYPNOTICS|4586|||||No|No||ACTAVIS/TEVA|No||||
estazolam|No|No|No|No|90%|00591074501|ESTAZOLAM 2 MG TABLET|100|EA|.25838|06/25/2002||Yes|No||06/25/2002||Yes|No|06/25/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|054|Yes|3.59229|07/27/2021|3.50607|07/27/2021|3.52942|07/27/2021|||SEDATIVE HYPNOTICS|4587|||||No|No||ACTAVIS/TEVA|No||||
dicyclomine HCl|No|No|No|No|75%|00591079401|DICYCLOMINE 10 MG CAPSULE|100|EA|.08578|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.10786|03/29/2022|.10527|03/29/2022|.10597|03/29/2022||||4588|||||No|No||ACTAVIS/TEVA|No||||
dicyclomine HCl|No|No|No|No|75%|00591079410|DICYCLOMINE 10 MG CAPSULE|1000|EA|.07933|07/25/2002||Yes|No||07/25/2002||Yes|No|07/25/2002||Yes|No||||No|No|||Prescription required|No|||No|.10786|03/29/2022|.10527|03/29/2022|.10597|03/29/2022||||4589|||||No|No||ACTAVIS/TEVA|No||||
dicyclomine HCl|No|No|No|No|75%|00591079501|DICYCLOMINE 20 MG TABLET|100|EA|.11932|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.17279|03/29/2022|.16864|03/29/2022|.16976|03/29/2022||||4590|||||No|No||ACTAVIS/TEVA|No||||
dicyclomine HCl|No|No|No|No|75%|00591079510|DICYCLOMINE 20 MG TABLET|1000|EA|.10965|07/21/2005||Yes|No||07/21/2005||Yes|No|07/21/2005||Yes|No||||No|No|||Prescription required|No|||No|.17279|03/29/2022|.16864|03/29/2022|.16976|03/29/2022||||4591|||||No|No||ACTAVIS/TEVA|No||||
sulfasalazine|No|No|No|No|75%|00591079601|SULFASALAZINE 500 MG TABLET|100|EA|.08019|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||010|No|.1775|03/29/2022|.17324|03/29/2022|.17439|03/29/2022|||ULCERATIVE COLITIS AGENTS|4592|||||No|No||ACTAVIS/TEVA|No||||
sulfasalazine|No|No|No|No|75%|00591079605|SULFASALAZINE 500 MG TABLET|500|EA|.08019|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||010|No|.1775|03/29/2022|.17324|03/29/2022|.17439|03/29/2022|||ULCERATIVE COLITIS AGENTS|4593|||||No|No||ACTAVIS/TEVA|No||||
sulfasalazine|No|No|No|No|75%|00591079610|SULFASALAZINE 500 MG TABLET|1000|EA|.08019|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||010|No|.1775|03/29/2022|.17324|03/29/2022|.17439|03/29/2022|||ULCERATIVE COLITIS AGENTS|4594|||||No|No||ACTAVIS/TEVA|No||||
glipizide|No|No|No|No|75%|00591084401|GLIPIZIDE ER 5 MG TABLET|100|EA|.1247|03/11/2004||Yes|No||03/11/2004||Yes|No|03/11/2004||Yes|No||03/11/2004||Yes|No|||Prescription required|No|||Yes|.11105|03/29/2022|.10838|03/29/2022|.1091|03/29/2022||||4595|||||No|No||ACTAVIS/TEVA|No||||
glipizide|No|No|No|No|75%|00591084410|GLIPIZIDE ER 5 MG TABLET|1000|EA|.11846|04/21/2005||Yes|No||04/21/2005||Yes|No|04/21/2005||Yes|No||04/21/2005||Yes|No|||Prescription required|No|||Yes|.11105|03/29/2022|.10838|03/29/2022|.1091|03/29/2022||||4596|||||No|No||ACTAVIS/TEVA|No||||
glipizide|Yes|No|No|No|75%|00591084501|GLIPIZIDE ER 10 MG TABLET|100|EA|.24617|03/11/2004||Yes|No||03/11/2004||Yes|No|03/11/2004||Yes|No||03/11/2004||Yes|No|07/01/2016||Prescription required|No|||No|.184|03/29/2022|.17958|03/29/2022|.18078|03/29/2022||||4597|||||No|No||ACTAVIS/TEVA|No||||
glipizide|Yes|No|No|No|75%|00591084510|GLIPIZIDE ER 10 MG TABLET|1000|EA|.23386|04/21/2005||Yes|No||04/21/2005||Yes|No|04/21/2005||Yes|No||04/21/2005||Yes|No|07/01/2016||Prescription required|No|||No|.184|03/29/2022|.17958|03/29/2022|.18078|03/29/2022||||4598|||||No|No||ACTAVIS/TEVA|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|00591086001|LISINOPRIL-HCTZ 10-12.5 MG TAB|100|EA|.06682|03/31/2008||Yes|No||03/31/2008||Yes|No|03/31/2008||Yes|No||03/31/2008||Yes|No|||Prescription required|No||113|Yes|.03674|03/29/2022|.03585|03/29/2022|.03609|03/29/2022|||ANGIOTENSIN MODULATORS|4599|||||No|No||ACTAVIS/TEVA|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|00591086005|LISINOPRIL-HCTZ 10-12.5 MG TAB|500|EA|.06348|05/11/2009||Yes|No||05/11/2009||Yes|No|05/11/2009||Yes|No||||No|No|||Prescription required|No||113|Yes|.03674|03/29/2022|.03585|03/29/2022|.03609|03/29/2022|||ANGIOTENSIN MODULATORS|4600|||||No|No||ACTAVIS/TEVA|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|00591086101|LISINOPRIL-HCTZ 20-12.5 MG TAB|100|EA|.07232|03/11/2003||Yes|No||03/11/2003||Yes|No|03/11/2003||Yes|No||03/11/2003||Yes|No|||Prescription required|No||113|Yes|.04909|03/29/2022|.04791|03/29/2022|.04823|03/29/2022|||ANGIOTENSIN MODULATORS|4601|||||No|No||ACTAVIS/TEVA|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|00591086105|LISINOPRIL-HCTZ 20-12.5 MG TAB|500|EA|.06869|03/11/2003||Yes|No||03/11/2003||Yes|No|03/11/2003||Yes|No||03/11/2003||Yes|No|||Prescription required|No||113|Yes|.04909|03/29/2022|.04791|03/29/2022|.04823|03/29/2022|||ANGIOTENSIN MODULATORS|4602|||||No|No||ACTAVIS/TEVA|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|00591086201|LISINOPRIL-HCTZ 20-25 MG TAB|100|EA|.07322|03/11/2003||Yes|No||03/11/2003||Yes|No|03/11/2003||Yes|No||03/11/2003||Yes|No|||Prescription required|No||113|Yes|.04948|03/29/2022|.04829|03/29/2022|.04861|03/29/2022|||ANGIOTENSIN MODULATORS|4603|||||No|No||ACTAVIS/TEVA|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|00591086205|LISINOPRIL-HCTZ 20-25 MG TAB|500|EA|.06955|03/11/2003||Yes|No||03/11/2003||Yes|No|03/11/2003||Yes|No||03/11/2003||Yes|No|||Prescription required|No||113|Yes|.04948|03/29/2022|.04829|03/29/2022|.04861|03/29/2022|||ANGIOTENSIN MODULATORS|4604|||||No|No||ACTAVIS/TEVA|No||||
lisinopril|Yes|No|No|No|75%|00591088501|LISINOPRIL 30 MG TABLET|100|EA|.04674|03/11/2009||Yes|No||03/11/2009||Yes|No|03/11/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.05487|03/29/2022|.05355|03/29/2022|.0539|03/29/2022|||ANGIOTENSIN MODULATORS|4605|||||No|No||ACTAVIS/TEVA|No||||
glipizide|Yes|No|No|No|75%|00591090030|GLIPIZIDE ER 2.5 MG TABLET|30|EA|.12441|08/20/2012||Yes|No||08/20/2012||Yes|No|08/20/2012||Yes|No||08/20/2012||Yes|No|07/01/2016||Prescription required|No|||Yes|.12809|03/29/2022|.12501|03/29/2022|.12584|03/29/2022||||4606|||||No|No||ACTAVIS/TEVA|No||||
acyclovir|No|No|No|No|75%|00591115930|ACYCLOVIR 5% OINTMENT|30|GM|9.17333|09/15/2014||Yes|No||09/15/2014||Yes|No|09/15/2014||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.03754|03/29/2022|1.01263|03/29/2022|1.01938|03/29/2022|||ANTIVIRALS: TOPICAL|4607|||||No|No||ACTAVIS/TEVA|No||||
lidocaine/prilocaine|No|No|No|No|75%|00591207030|LIDOCAINE-PRILOCAINE CREAM|30|GM|.60916|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No|||No|.45426|03/29/2022|.44335|03/29/2022|.44631|03/29/2022||||4608|||||No|No||ACTAVIS/TEVA|No||||
testosterone|No|No|No|No|90%|00591211481|TESTOSTERONE 30 MG/1.5 ML PUMP|90|ML|1.77541|12/13/2017||Yes|No||12/13/2017||Yes|No|12/13/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|084|No|.95473|03/29/2022|.93181|03/29/2022|.93802|03/29/2022|||ANDROGENIC AGENTS|4609|||||No|No||ACTAVIS/TEVA|No||||
brinzolamide|No|No|No|No|75%|00591212712|BRINZOLAMIDE 1% EYE DROPS|15|ML|12.75064|07/09/2021||Yes|No||07/09/2021||Yes|No|07/09/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|088|No|27.27858|03/29/2022|26.62389|03/29/2022|26.8012|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|4610|||||No|No||TEVA USA|No||||
brinzolamide|No|No|No|No|75%|00591212779|BRINZOLAMIDE 1% EYE DROPS|10|ML|12.75165|07/09/2021||Yes|No||07/09/2021||Yes|No|07/09/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|088|No|26.8459|03/29/2022|26.20159|03/29/2022|26.37609|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|4611|||||No|No||TEVA USA|No||||
azelaic acid|No|No|No|No|75%|00591213155|AZELAIC ACID 15% GEL|50|GM|1.60243|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|221|No|1.03233|03/29/2022|1.00755|03/29/2022|1.01426|03/29/2022|||ROSACEA AGENTS: TOPICAL|4612|||||No|No||ACTAVIS/TEVA|No||||
doxylamine succinate/vit B6|No|No|No|No|75%|00591213201|DOXYLAMINE-PYRIDOXINE 10-10 MG|100|EA|2.54861|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|085|No|2.71034|03/29/2022|2.64529|03/29/2022|2.6629|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|4613|||||No|No||ACTAVIS/TEVA|No||||
ciclopirox|No|No|No|No|75%|00591215990|CICLOPIROX 1% SHAMPOO|120|ML|.4224|04/23/2013||Yes|No||04/23/2013||Yes|No|||No|No||||No|No|||Prescription required|Yes|01/25/2012|061|No|.28181|03/29/2022|.27504|03/29/2022|.27687|03/29/2022|||ANTIFUNGALS: TOPICAL|4614|||||No|No||ACTAVIS/TEVA|No||||
ramelteon|No|No|No|No|75%|00591219101|RAMELTEON 8 MG TABLET|100|EA|2.22482|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|054|Yes|1.10393|03/29/2022|1.07743|03/29/2022|1.08461|03/29/2022|||SEDATIVE HYPNOTICS|4615|||||No|No||TEVA USA|No||||
ramelteon|No|No|No|No|75%|00591219130|RAMELTEON 8 MG TABLET|30|EA|2.22496|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|054|Yes|1.10393|03/29/2022|1.07743|03/29/2022|1.08461|03/29/2022|||SEDATIVE HYPNOTICS|4616|||||No|No||TEVA USA|No||||
mesalamine|No|No|No|No|75%|00591224522|MESALAMINE DR 1.2 GM TABLET|120|EA|2.98254|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|010|No|2.75392|03/29/2022|2.68782|03/29/2022|2.70572|03/29/2022|||ULCERATIVE COLITIS AGENTS|4617|||||No|No||ACTAVIS/TEVA|No||||
propafenone HCl|No|No|No|No|75%|00591228560|PROPAFENONE HCL ER 225 MG CAP|60|EA|2.51413|10/19/2015||Yes|No||10/19/2015||Yes|No|10/19/2015||Yes|No||||No|No|||Prescription required|No|||No|1.23841|03/29/2022|1.20868|03/29/2022|1.21673|03/29/2022||||4618|||||No|No||ACTAVIS/TEVA|No||||
propafenone HCl|No|No|No|No|75%|00591228660|PROPAFENONE HCL ER 325 MG CAP|60|EA|3.18507|10/19/2015||Yes|No||10/19/2015||Yes|No|10/19/2015||Yes|No||||No|No|||Prescription required|No|||No|2.24387|03/29/2022|2.19001|03/29/2022|2.2046|03/29/2022||||4619|||||No|No||ACTAVIS/TEVA|No||||
propafenone HCl|No|No|No|No|75%|00591228760|PROPAFENONE HCL ER 425 MG CAP|60|EA|3.18507|10/19/2015||Yes|No||10/19/2015||Yes|No|10/19/2015||Yes|No||||No|No|||Prescription required|No|||No|7.25901|03/23/2021|7.15531|03/23/2021|6.81458|03/23/2021||||4620|||||No|No||ACTAVIS/TEVA|No||||
metaxalone|No|No|No|No|75%|00591234101|METAXALONE 800 MG TABLET|100|EA|.86283|10/30/2017||Yes|No||10/30/2017||Yes|No|10/30/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|116|Yes|.52754|03/29/2022|.51487|03/29/2022|.5183|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4621|||||No|No||ACTAVIS/TEVA|No||||
testosterone|No|No|No|No|90%|00591236360|TESTOSTERONE 10 MG GEL PUMP|60|GM|2.56452|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|084|No|5.26742|03/29/2022|5.141|03/29/2022|5.17524|03/29/2022|||ANDROGENIC AGENTS|4622|||||No|No||ACTAVIS/TEVA|No||||
ambrisentan|No|No|No|No|75%|00591240530|AMBRISENTAN 5 MG TABLET|30|EA|39.65761|08/07/2020||Yes|No||08/07/2020||Yes|No|08/07/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|No|90.38246|08/07/2020|89.09128|08/07/2020|84.84884|08/07/2020|||PAH AGENTS: ORAL AND INHALED|4623|||||No|No||ACTAVIS/TEVA|No||||
ambrisentan|No|No|No|No|75%|00591240630|AMBRISENTAN 10 MG TABLET|30|EA|39.65761|08/07/2020||Yes|No||08/07/2020||Yes|No|08/07/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|No|90.38246|08/07/2020|89.09128|08/07/2020|84.84884|08/07/2020|||PAH AGENTS: ORAL AND INHALED|4624|||||No|No||ACTAVIS/TEVA|No||||
metformin HCl|No|No|No|No|75%|00591241101|METFORMIN ER 500 MG GASTRC-TB|100|EA|6.9445|01/03/2018||Yes|No||01/03/2018||Yes|No|01/03/2018||Yes|No||||No|No|||Prescription required|No||012|No|2.40128|03/29/2022|2.34364|03/29/2022|2.35925|03/29/2022|||HYPOGLYCEMICS: METFORMINS|4625|||||No|No||ACTAVIS/TEVA|No||||
metformin HCl|No|No|No|No|75%|00591241219|METFORMIN ER 1,000 MG GASTR-TB|90|EA|12.54166|01/03/2018||Yes|No||01/03/2018||Yes|No|01/03/2018||Yes|No||||No|No|||Prescription required|No||012|No|6.02577|03/29/2022|5.88115|03/29/2022|5.92031|03/29/2022|||HYPOGLYCEMICS: METFORMINS|4626|||||No|No||ACTAVIS/TEVA|No||||
isotretinoin|No|No|No|No|75%|00591243315|ISOTRETINOIN 10 MG CAPSULE|30|EA|10.9445|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No||144|No|24.884|08/30/2021|24.28678|08/30/2021|24.44853|08/30/2021|||ACNE AGENTS: ORAL|4627|||||No|No||TEVA USA|No||||
isotretinoin|No|No|No|No|75%|00591243415|ISOTRETINOIN 20 MG CAPSULE|30|EA|10.9445|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No||144|No|24.80699|08/30/2021|24.21162|08/30/2021|24.37286|08/30/2021|||ACNE AGENTS: ORAL|4628|||||No|No||TEVA USA|No||||
isotretinoin|No|No|No|No|75%|00591243515|ISOTRETINOIN 30 MG CAPSULE|30|EA|11.77569|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No||144|No|26.6923|08/30/2021|26.05168|08/30/2021|26.22518|08/30/2021|||ACNE AGENTS: ORAL|4629|||||No|No||TEVA USA|No||||
isotretinoin|No|No|No|No|75%|00591243615|ISOTRETINOIN 40 MG CAPSULE|30|EA|11.77569|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No||144|No|26.7665|08/30/2021|26.1241|08/30/2021|26.29808|08/30/2021|||ACNE AGENTS: ORAL|4630|||||No|No||TEVA USA|No||||
isotretinoin|No|No|No|No|75%|00591245115|ISOTRETINOIN 25 MG CAPSULE|30|EA|11.77569|09/09/2021||Yes|No||09/09/2021||Yes|No|09/09/2021||Yes|No||||No|No|||Prescription required|No||144|No|26.83762|09/09/2021|26.45422|09/09/2021|25.1945|09/09/2021|||ACNE AGENTS: ORAL|4631|||||No|No||TEVA USA|No||||
desmopressin acetate|No|No|No|No|75%|00591246401|DESMOPRESSIN ACETATE 0.1 MG TB|100|EA|1.63645|11/22/2011||Yes|No||11/22/2011||Yes|No|11/22/2011||Yes|No||||No|No|||Prescription required|No|||Yes|.41734|03/29/2022|.40732|03/29/2022|.41003|03/29/2022||||4632|||||No|No||ACTAVIS/TEVA|No||||
desmopressin acetate|No|No|No|No|75%|00591246501|DESMOPRESSIN ACETATE 0.2 MG TB|100|EA|2.3576|10/31/2011||Yes|No||10/31/2011||Yes|No|10/31/2011||Yes|No||||No|No|||Prescription required|No|||Yes|.446|03/29/2022|.43529|03/29/2022|.43819|03/29/2022||||4633|||||No|No||ACTAVIS/TEVA|No||||
tamoxifen citrate|No|No|No|No|75%|00591247218|TAMOXIFEN 10 MG TABLET|180|EA|.16375|04/04/2012||Yes|No||04/04/2012||Yes|No|04/04/2012||Yes|No||||No|No|||Prescription required|No||502|No|.21342|03/29/2022|.20829|03/29/2022|.20968|03/29/2022|||ONCOLOGY: ORAL - BREAST|4634|||||No|No||ACTAVIS/TEVA|No||||
tamoxifen citrate|No|No|No|No|75%|00591247260|TAMOXIFEN 10 MG TABLET|60|EA|.16375|08/24/2012||Yes|No||08/24/2012||Yes|No|08/24/2012||Yes|No||||No|No|||Prescription required|No||502|No|.21342|03/29/2022|.20829|03/29/2022|.20968|03/29/2022|||ONCOLOGY: ORAL - BREAST|4635|||||No|No||ACTAVIS/TEVA|No||||
tamoxifen citrate|No|No|No|No|75%|00591247330|TAMOXIFEN 20 MG TABLET|30|EA|.32751|10/31/2011||Yes|No||10/31/2011||Yes|No|10/31/2011||Yes|No||||No|No|||Prescription required|No||502|No|.42352|03/29/2022|.41335|03/29/2022|.4161|03/29/2022|||ONCOLOGY: ORAL - BREAST|4636|||||No|No||ACTAVIS/TEVA|No||||
tetracycline HCl|No|No|No|No|75%|00591247401|TETRACYCLINE 250 MG CAPSULE|100|EA|2.709|08/19/2016||Yes|No||08/19/2016||Yes|No|08/19/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|213|No|.9651|03/01/2022|.94193|03/01/2022|.94821|03/01/2022|||TETRACYCLINES|4637|||||No|No||ACTAVIS/TEVA|No||||
tetracycline HCl|No|No|No|No|75%|00591247501|TETRACYCLINE 500 MG CAPSULE|100|EA|5.418|08/19/2016||Yes|No||08/19/2016||Yes|No|08/19/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|213|No|1.54692|03/29/2022|1.50979|03/29/2022|1.51984|03/29/2022|||TETRACYCLINES|4638|||||No|No||ACTAVIS/TEVA|No||||
isotretinoin|No|No|No|No|75%|00591250115|ISOTRETINOIN 35 MG CAPSULE|30|EA|11.77569|09/09/2021||Yes|No||09/09/2021||Yes|No|09/09/2021||Yes|No||||No|No|||Prescription required|No||144|No|26.83762|09/09/2021|26.45422|09/09/2021|25.1945|09/09/2021|||ACNE AGENTS: ORAL|4639|||||No|No||TEVA USA|No||||
budesonide|No|No|No|No|75%|00591251030|BUDESONIDE ER 9 MG TABLET|30|EA|22.20262|12/07/2018||Yes|No||12/07/2018||Yes|No|12/07/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|010|No|33.23257|03/29/2022|32.43498|03/29/2022|32.651|03/29/2022|||ULCERATIVE COLITIS AGENTS|4640|||||No|No||ACTAVIS/TEVA|No||||
bosentan|No|No|No|No|75%|00591251160|BOSENTAN 62.5 MG TABLET|60|EA|9.503|08/17/2020||Yes|No||08/17/2020||Yes|No|08/17/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/25/2019|171|No|21.658|08/17/2020|21.3486|08/17/2020|20.332|08/17/2020|||PAH AGENTS: ORAL AND INHALED|4641|||||No|No||ACTAVIS/TEVA|No||||
bosentan|No|No|No|No|75%|00591251260|BOSENTAN 125 MG TABLET|60|EA|9.503|08/17/2020||Yes|No||08/17/2020||Yes|No|08/17/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/25/2019|171|No|21.658|08/17/2020|21.3486|08/17/2020|20.332|08/17/2020|||PAH AGENTS: ORAL AND INHALED|4642|||||No|No||ACTAVIS/TEVA|No||||
chlorzoxazone|No|No|No|No|75%|00591252001|CHLORZOXAZONE 500 MG TABLET|100|EA|.12044|10/31/2011||Yes|No||10/31/2011||Yes|No|10/31/2011||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|116|Yes|.26503|03/29/2022|.25866|03/29/2022|.26039|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4643|||||No|No||ACTAVIS/TEVA|No||||
chlorzoxazone|No|No|No|No|75%|00591252005|CHLORZOXAZONE 500 MG TABLET|500|EA|.11444|12/14/2011||Yes|No||12/14/2011||Yes|No|12/14/2011||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|116|Yes|.26503|03/29/2022|.25866|03/29/2022|.26039|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4644|||||No|No||ACTAVIS/TEVA|No||||
colchicine|No|No|No|No|75%|00591256201|COLCHICINE 0.6 MG TABLET|100|EA|.35247|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||05/18/2021||Yes|No|||Prescription required|Yes|07/30/2020|231|No|.64179|03/29/2022|.62638|03/29/2022|.63055|03/29/2022|||ANTIHYPERURICEMICS|4645|||||No|No||TEVA USA|No||||
colchicine|No|No|No|No|75%|00591256230|COLCHICINE 0.6 MG TABLET|30|EA|.35245|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||05/18/2021||Yes|No|||Prescription required|Yes|07/30/2020|231|No|.64179|03/29/2022|.62638|03/29/2022|.63055|03/29/2022|||ANTIHYPERURICEMICS|4646|||||No|No||TEVA USA|No||||
valganciclovir HCl|No|No|No|No|75%|00591257920|VALGANCICLOVIR HCL 50 MG/ML|88|ML|3.91035|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|01/26/2017|136|No|8.91198|11/17/2016|8.78466|11/17/2016|8.36635|11/17/2016|||ANTIVIRALS: GENERAL|4647|||||No|No||ACTAVIS/TEVA|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|00591264001|BUTALB-ACETAMIN-CAFF 50-300-40|100|EA|1.05225|03/31/2014||Yes|No||03/31/2014||Yes|No|03/31/2014||Yes|No||||No|No|||Prescription required|No|||No|.69452|03/29/2022|.67785|03/29/2022|.68236|03/29/2022||||4648|||||No|No||ACTAVIS/TEVA|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|00591264005|BUTALB-ACETAMIN-CAFF 50-300-40|500|EA|1.05226|03/24/2014||Yes|No||03/24/2014||Yes|No|03/24/2014||Yes|No||||No|No|||Prescription required|No|||No|.69452|03/29/2022|.67785|03/29/2022|.68236|03/29/2022||||4649|||||No|No||ACTAVIS/TEVA|No||||
butalbit/acetamin/caff/codeine|No|No|No|No|90%|00591264101|BUTALB-ACETAMIN-CAF-COD 50-300|100|EA|2.61336|03/24/2014||Yes|No||03/24/2014||Yes|No|03/24/2014||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|109|Yes|5.95604|12/24/2019|5.87096|12/24/2019|5.59139|12/24/2019|||ANALGESICS: NARCOTICS SHORT|4650|||||No|No||ACTAVIS/TEVA|No||||
potassium citrate|No|No|No|No|75%|00591268201|POTASSIUM CITRATE ER 5 MEQ TAB|100|EA|.22441|11/09/2018||Yes|No||11/09/2018||Yes|No|11/09/2018||Yes|No||||No|No|||Prescription required|No|||No|.46644|03/29/2022|.45524|03/29/2022|.45827|03/29/2022||||4651|||||No|No||ACTAVIS/TEVA|No||||
oxycodone HCl|No|No|No|No|90%|00591269301|OXYCODONE HCL ER 40 MG TABLET|100|EA|2.87751|01/13/2015||Yes|No||01/13/2015||Yes|No|01/13/2015||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|5.67023|11/23/2021|5.53414|11/23/2021|5.571|11/23/2021|||ANALGESICS: NARCOTICS LONG|4652|||||No|No||ACTAVIS/TEVA|No||||
oxycodone HCl|No|No|No|No|90%|00591270801|OXYCODONE HCL ER 80 MG TABLET|100|EA|5.41116|01/13/2015||Yes|No||01/13/2015||Yes|No|01/13/2015||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|10.68078|12/28/2021|10.42444|12/28/2021|10.49386|12/28/2021|||ANALGESICS: NARCOTICS LONG|4653|||||No|No||ACTAVIS/TEVA|No||||
albendazole|No|No|No|No|75%|00591271202|ALBENDAZOLE 200 MG TABLET|2|EA|41.63475|08/07/2020||Yes|No||08/07/2020||Yes|No|08/07/2020||Yes|No||||No|No|||Prescription required|No|||No|16.91042|03/29/2022|16.50456|03/29/2022|16.61448|03/29/2022||||4654|||||No|No||TEVA USA|No||||
metformin HCl|No|No|No|No|75%|00591271960|METFORMIN ER 500 MG OSMOTIC TB|60|EA|3.12423|04/24/2012||Yes|No||04/24/2012||Yes|No|04/24/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|012|No|.70527|01/25/2022|.68834|01/25/2022|.69292|01/25/2022|||HYPOGLYCEMICS: METFORMINS|4655|||||No|No||ACTAVIS/TEVA|No||||
metformin HCl|No|No|No|No|75%|00591272060|METFORMIN ER 1,000 MG OSM-TAB|60|EA|5.89429|04/24/2012||Yes|No||04/24/2012||Yes|No|04/24/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|012|No|1.48331|03/29/2022|1.44771|03/29/2022|1.45735|03/29/2022|||HYPOGLYCEMICS: METFORMINS|4656|||||No|No||ACTAVIS/TEVA|No||||
potassium citrate|No|No|No|No|75%|00591272901|POTASSIUM CITRATE ER 10 MEQ TB|100|EA|.22441|11/09/2018||Yes|No||11/09/2018||Yes|No|11/09/2018||Yes|No||11/09/2018||Yes|No|||Prescription required|No|||No|.30433|03/29/2022|.29702|03/29/2022|.299|03/29/2022||||4657|||||No|No||ACTAVIS/TEVA|No||||
potassium citrate|No|No|No|No|75%|00591274201|POTASSIUM CITRATE ER 15 MEQ TB|100|EA|.5356|11/09/2018||Yes|No||11/09/2018||Yes|No|11/09/2018||Yes|No||11/09/2018||Yes|No|||Prescription required|No|||No|.5925|03/29/2022|.57828|03/29/2022|.58213|03/29/2022||||4658|||||No|No||ACTAVIS/TEVA|No||||
tizanidine HCl|No|No|No|No|75%|00591278886|TIZANIDINE HCL 2 MG CAPSULE|150|EA|.93275|02/14/2012||Yes|No||02/14/2012||Yes|No|02/14/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|116|No|.0903|03/29/2022|.08813|03/29/2022|.08871|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4659|||||No|No||ACTAVIS/TEVA|No||||
tizanidine HCl|No|No|No|No|75%|00591278986|TIZANIDINE HCL 4 MG CAPSULE|150|EA|1.18226|02/14/2012||Yes|No||02/14/2012||Yes|No|02/14/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|116|No|.15367|03/29/2022|.14998|03/29/2022|.15098|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4660|||||No|No||ACTAVIS/TEVA|No||||
tizanidine HCl|No|No|No|No|75%|00591279086|TIZANIDINE HCL 6 MG CAPSULE|150|EA|1.77328|02/14/2012||Yes|No||02/14/2012||Yes|No|02/14/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|116|No|.27523|03/29/2022|.26862|03/29/2022|.27041|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4661|||||No|No||ACTAVIS/TEVA|No||||
clarithromycin|No|No|No|No|75%|00591280560|CLARITHROMYCIN ER 500 MG TAB|60|EA|3.07908|06/16/2015||Yes|No||06/16/2015||Yes|No|06/16/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|018|No|3.72397|10/26/2021|3.63459|10/26/2021|3.6588|10/26/2021|||MACROLIDES/KETOLIDES|4662|||||No|No||ACTAVIS/TEVA|No||||
bexarotene|No|No|No|No|75%|00591283201|BEXAROTENE 75 MG CAPSULE|100|EA|12.19351|03/29/2022||Yes|No||03/29/2022||Yes|No|03/29/2022||Yes|No||||No|No|||Prescription required|No|||No|27.78985|03/29/2022|27.39286|03/29/2022|26.08844|03/29/2022||||4663|||||No|No||TEVA USA|No||||
verapamil HCl|No|No|No|No|75%|00591288001|VERAPAMIL SR 120 MG CAPSULE|100|EA|.62565|02/12/2003||Yes|No||02/12/2003||Yes|No|02/12/2003||Yes|No||02/12/2003||Yes|No|||Prescription required|No||045|No|1.14665|03/29/2022|1.11913|03/29/2022|1.12658|03/29/2022|||CALCIUM CHANNEL BLOCKERS|4664|||||No|No||ACTAVIS/TEVA|No||||
verapamil HCl|No|No|No|No|75%|00591288201|VERAPAMIL SR 180 MG CAPSULE|100|EA|.65523|02/12/2003||Yes|No||02/12/2003||Yes|No|02/12/2003||Yes|No||02/12/2003||Yes|No|||Prescription required|No||045|No|1.23808|03/29/2022|1.20836|03/29/2022|1.21641|03/29/2022|||CALCIUM CHANNEL BLOCKERS|4665|||||No|No||ACTAVIS/TEVA|No||||
verapamil HCl|No|No|No|No|75%|00591288401|VERAPAMIL SR 240 MG CAPSULE|100|EA|.73942|02/12/2003||Yes|No||02/12/2003||Yes|No|02/12/2003||Yes|No||02/12/2003||Yes|No|||Prescription required|No||045|No|1.40763|03/29/2022|1.37384|03/29/2022|1.38299|03/29/2022|||CALCIUM CHANNEL BLOCKERS|4666|||||No|No||ACTAVIS/TEVA|No||||
verapamil HCl|No|No|No|No|75%|00591288601|VERAPAMIL SR 360 MG CAPSULE|100|EA|2.28437|08/19/2002||Yes|No||08/19/2002||Yes|No|08/19/2002||Yes|No||08/19/2002||Yes|No|||Prescription required|Yes|01/23/2013|045|No|5.05802|03/29/2022|4.93662|03/29/2022|4.9695|03/29/2022|||CALCIUM CHANNEL BLOCKERS|4667|||||No|No||ACTAVIS/TEVA|No||||
testosterone|No|No|No|No|90%|00591292102|TESTOSTERONE 12.5 MG/1.25 GRAM|75|GM|1.07407|09/16/2016||Yes|No||09/16/2016||Yes|No|09/16/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|084|No|1.27336|03/29/2022|1.24279|03/29/2022|1.25107|03/29/2022|||ANDROGENIC AGENTS|4668|||||No|No||ACTAVIS/TEVA|No||||
testosterone|No|No|No|No|90%|00591292418|TESTOSTERONE 1.62% GEL PUMP|75|GM|.5074|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|084|No|.65888|03/29/2022|.64306|03/29/2022|.64734|03/29/2022|||ANDROGENIC AGENTS|4669|||||No|No||ACTAVIS/TEVA|No||||
testosterone|No|No|No|No|90%|00591292530|TESTOSTERONE 1.62%(1.25 G) PKT|1.25|GM|6.17215|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|084|No|6.91737|03/29/2022|6.75135|03/29/2022|6.79631|03/29/2022|||ANDROGENIC AGENTS|4670|||||No|No||TEVA USA|No||||
testosterone|No|No|No|No|90%|00591292630|TESTOSTERONE 1.62% (2.5 G) PKT|2.5|GM|3.17276|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|084|No|2.67717|03/29/2022|2.61291|03/29/2022|2.63031|03/29/2022|||ANDROGENIC AGENTS|4671|||||No|No||TEVA USA|No||||
levalbuterol tartrate|No|No|No|No|75%|00591292754|LEVALBUTEROL TAR HFA 45MCG INH|15|GM|1.69018|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|3.72735|03/29/2022|3.63789|03/29/2022|3.66212|03/29/2022|||BRONCHODILATORS: BETA AGONIST|4672|||||No|No||ACTAVIS/TEVA|Yes|09/01/2020|||
pimecrolimus|No|No|No|No|75%|00591294430|PIMECROLIMUS 1% CREAM|30|GM|3.49375|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|034|Yes|5.06554|03/29/2022|4.94396|03/29/2022|4.97689|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|4673|||||No|No||ACTAVIS/TEVA|No||||
pimecrolimus|No|No|No|No|75%|00591294460|PIMECROLIMUS 1% CREAM|60|GM|3.49381|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|034|Yes|4.49404|03/29/2022|4.38618|03/29/2022|4.41539|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|4674|||||No|No||ACTAVIS/TEVA|No||||
pimecrolimus|No|No|No|No|75%|00591294487|PIMECROLIMUS 1% CREAM|100|GM|3.49379|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|034|Yes|4.27357|03/29/2022|4.171|03/29/2022|4.19878|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|4675|||||No|No||ACTAVIS/TEVA|No||||
ursodiol|No|No|No|No|75%|00591299801|URSODIOL 250 MG TABLET|100|EA|.92273|01/13/2015||Yes|No||01/13/2015||Yes|No|01/13/2015||Yes|No||||No|No|||Prescription required|No||198|No|.5902|03/29/2022|.57603|03/29/2022|.57987|03/29/2022|||BILE SALTS|4676|||||No|No||ACTAVIS/TEVA|No||||
ursodiol|No|No|No|No|75%|00591300501|URSODIOL 500 MG TABLET|100|EA|1.63516|01/13/2015||Yes|No||01/13/2015||Yes|No|01/13/2015||Yes|No||||No|No|||Prescription required|No||198|No|.95342|03/29/2022|.93053|03/29/2022|.93673|03/29/2022|||BILE SALTS|4677|||||No|No||ACTAVIS/TEVA|No||||
progesterone|No|No|No|No|75%|00591312879|PROGESTERONE 500 MG/10 ML VIAL|10|ML|1.333|07/12/2005||Yes|No||07/12/2005||Yes|No|07/12/2005||Yes|No||||No|No|||Prescription required|No|||No|2.019|03/29/2022|1.97054|03/29/2022|1.98366|03/29/2022||||4678|||||No|No||ACTAVIS/TEVA|No||||
nizatidine|No|No|No|No|75%|00591313760|NIZATIDINE 150 MG CAPSULE|60|EA|.41243|07/19/2002||Yes|No||07/19/2002||Yes|No|07/19/2002||Yes|No||07/19/2002||Yes|No|||Prescription required|No|||No|.93997|02/23/2021|.92654|02/23/2021|.88242|02/23/2021||||4679|||||No|No||ACTAVIS/TEVA|No||||
nizatidine|No|No|No|No|75%|00591313830|NIZATIDINE 300 MG CAPSULE|30|EA|.40993|07/19/2002||Yes|No||07/19/2002||Yes|No|07/19/2002||Yes|No||07/19/2002||Yes|No|||Prescription required|No|||No|.93426|12/29/2020|.92091|12/29/2020|.87706|12/29/2020||||4680|||||No|No||ACTAVIS/TEVA|No||||
minocycline HCl|No|No|No|No|75%|00591315301|MINOCYCLINE 75 MG CAPSULE|100|EA|.27563|10/26/2002||Yes|No||10/26/2002||Yes|No|10/26/2002||Yes|No||||No|No|||Prescription required|No||213|No|.36632|10/26/2021|.35752|10/26/2021|.3599|10/26/2021|||TETRACYCLINES|4681|||||No|No||ACTAVIS/TEVA|No||||
ursodiol|No|No|No|No|75%|00591315901|URSODIOL 300 MG CAPSULE|100|EA|.43924|07/14/2003||Yes|No||07/14/2003||Yes|No|07/14/2003||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|198|No|.60006|03/29/2022|.58565|03/29/2022|.58955|03/29/2022|||BILE SALTS|4682|||||No|No||ACTAVIS/TEVA|No||||
podofilox|No|No|No|No|75%|00591320413|PODOFILOX 0.5% TOPICAL SOLN|3.5|ML|9.77697|08/08/2003||Yes|No||08/08/2003||Yes|No|08/08/2003||Yes|No||||No|No|||Prescription required|No|||No|15.44|03/29/2022|15.06944|03/29/2022|15.1698|03/29/2022||||4683|||||No|No||ACTAVIS/TEVA|No||||
testosterone|No|No|No|No|90%|00591321630|TESTOSTERONE 1% (25MG/2.5G) PK|2.5|GM|2.09008|09/16/2016||Yes|No||09/16/2016||Yes|No|09/16/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|084|No|2.59223|03/29/2022|2.53001|03/29/2022|2.54686|03/29/2022|||ANDROGENIC AGENTS|4684|||||No|No||ACTAVIS/TEVA|No||||
testosterone|No|No|No|No|90%|00591321730|TESTOSTERONE 1% (50 MG/5 G) PK|5|GM|1.07407|09/16/2016||Yes|No||09/16/2016||Yes|No|09/16/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|084|No|1.10779|03/29/2022|1.0812|03/29/2022|1.0884|03/29/2022|||ANDROGENIC AGENTS|4685|||||No|No||ACTAVIS/TEVA|No||||
butalbital/aspirin/caffeine|No|No|No|No|90%|00591321901|BUTALBITAL-ASPIRIN-CAFFEINE CP|100|EA|.47085|09/23/2003||Yes|No||09/23/2003||Yes|No|09/23/2003||Yes|No||||No|No|||Prescription required|No|||No|.92415|03/29/2022|.90197|03/29/2022|.90797|03/29/2022||||4686|||||No|No||ACTAVIS/TEVA|No||||
butalbit/acetamin/caff/codeine|No|No|No|No|90%|00591322001|BUTALB-ACETAMIN-CAF-COD 50-325|100|EA|.46762|09/23/2003||Yes|No||09/23/2003||Yes|No|09/23/2003||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|109|Yes|.68873|03/29/2022|.6722|03/29/2022|.67667|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4687|||||No|No||ACTAVIS/TEVA|No||||
testosterone enanthate|No|No|No|No|90%|00591322126|TESTOSTERONE ENAN 200 MG/ML|5|ML|5.84456|03/16/2004||Yes|No||03/16/2004||Yes|No|03/16/2004||Yes|No||||No|No|||Prescription required|No|||No|13.36533|03/29/2022|13.04456|03/29/2022|13.13143|03/29/2022||||4688|||||No|No||ACTAVIS/TEVA|No||||
cyclobenzaprine HCl|No|No|No|No|75%|00591325601|CYCLOBENZAPRINE 5 MG TABLET|100|EA|.07254|02/22/2006|05/31/2022|Yes|No||02/22/2006|05/31/2022|Yes|No|02/22/2006|05/31/2022|Yes|No||||No|No|||Prescription required|No||116|Yes|.02938|03/29/2022|.02867|03/29/2022|.02886|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4689|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ACTAVIS/TEVA|No||||
cyclobenzaprine HCl|No|No|No|No|75%|00591333001|CYCLOBENZAPRINE 7.5 MG TABLET|100|EA|1.65369|11/17/2016|07/20/2022|Yes|No||11/17/2016|07/20/2022|Yes|No|11/17/2016|07/20/2022|Yes|No||||No|No|||Prescription required|No||116|Yes|1.21617|03/29/2022|1.18698|03/29/2022|1.19488|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4690|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ACTAVIS/TEVA|No||||
bupropion HCl|Yes|No|No|No|75%|00591333105|BUPROPION HCL XL 150 MG TABLET|500|EA|.56115|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No||||No|No|11/21/2016||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|4691|||||No|No||ACTAVIS/TEVA|No||||
bupropion HCl|Yes|No|No|No|75%|00591333119|BUPROPION HCL XL 150 MG TABLET|90|EA|.56115|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No||||No|No|11/22/2016||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|4692|||||No|No||ACTAVIS/TEVA|No||||
bupropion HCl|Yes|No|No|No|75%|00591333130|BUPROPION HCL XL 150 MG TABLET|30|EA|.56115|03/05/2009||Yes|No||03/05/2009||Yes|No|03/05/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|4693|||||No|No||ACTAVIS/TEVA|No||||
nateglinide|Yes|No|No|No|75%|00591335401|NATEGLINIDE 60 MG TABLET|100|EA|.5083|05/24/2011||Yes|No||05/24/2011||Yes|No|05/24/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||022|Yes|.3103|03/29/2022|.30285|03/29/2022|.30486|03/29/2022|||HYPOGLYCEMICS: MEGLITINIDES|4694|||||No|No||ACTAVIS/TEVA|No||||
nateglinide|Yes|No|No|No|75%|00591335501|NATEGLINIDE 120 MG TABLET|100|EA|.52812|05/24/2011||Yes|No||05/24/2011||Yes|No|05/24/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||022|Yes|.33379|03/29/2022|.32577|03/29/2022|.32794|03/29/2022|||HYPOGLYCEMICS: MEGLITINIDES|4695|||||No|No||ACTAVIS/TEVA|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|00591336901|BUTALB-ACETAMIN-CAFF 50-325-40|100|EA|.28702|01/09/2008||Yes|No||01/09/2008||Yes|No|01/09/2008||Yes|No||||No|No|||Prescription required|No|||No|.18524|03/29/2022|.18079|03/29/2022|.18199|03/29/2022||||4696|||||No|No||ACTAVIS/TEVA|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|00591336905|BUTALB-ACETAMIN-CAFF 50-325-40|500|EA|.26879|01/28/2008||Yes|No||01/28/2008||Yes|No|01/28/2008||Yes|No||||No|No|||Prescription required|No|||No|.18524|03/29/2022|.18079|03/29/2022|.18199|03/29/2022||||4697|||||No|No||ACTAVIS/TEVA|No||||
albuterol sulfate|No|No|No|No|75%|00591346753|ALBUTEROL SUL 0.63 MG/3 ML SOL|3|ML|.19034|11/17/2007||Yes|No||11/17/2007||Yes|No|11/17/2007||Yes|No||||No|No|||Prescription required|No||037|Yes|.20231|03/29/2022|.19745|03/29/2022|.19876|03/29/2022|||BRONCHODILATORS: BETA AGONIST|4698|||||No|No||ACTAVIS/TEVA|Yes|09/01/2020|||
albuterol sulfate|No|No|No|No|75%|00591346853|ALBUTEROL SUL 1.25 MG/3 ML SOL|3|ML|.19034|10/03/2007||Yes|No||10/03/2007||Yes|No|10/03/2007||Yes|No||||No|No|||Prescription required|No||037|Yes|.212|03/29/2022|.20691|03/29/2022|.20829|03/29/2022|||BRONCHODILATORS: BETA AGONIST|4699|||||No|No||ACTAVIS/TEVA|Yes|09/01/2020|||
galantamine HBr|No|No|No|No|75%|00591349630|GALANTAMINE ER 8 MG CAPSULE|30|EA|1.97054|03/05/2009||Yes|No||03/05/2009||Yes|No|03/05/2009||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|011|No|1.1683|03/29/2022|1.14026|03/29/2022|1.14785|03/29/2022|||ALZHEIMER'S AGENTS|4700|||||No|No||ACTAVIS/TEVA|No||||
galantamine HBr|No|No|No|No|75%|00591349730|GALANTAMINE ER 16 MG CAPSULE|30|EA|1.97054|03/05/2009||Yes|No||03/05/2009||Yes|No|03/05/2009||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|011|No|1.23595|03/29/2022|1.20628|03/29/2022|1.21432|03/29/2022|||ALZHEIMER'S AGENTS|4701|||||No|No||ACTAVIS/TEVA|No||||
galantamine HBr|No|No|No|No|75%|00591349830|GALANTAMINE ER 24 MG CAPSULE|30|EA|1.97054|03/05/2009||Yes|No||03/05/2009||Yes|No|03/05/2009||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|011|No|1.24993|03/29/2022|1.21993|03/29/2022|1.22805|03/29/2022|||ALZHEIMER'S AGENTS|4702|||||No|No||ACTAVIS/TEVA|No||||
clonidine|No|No|No|No|75%|00591350804|CLONIDINE 0.1 MG/DAY PATCH|4|EA|11.39392|09/12/2014||Yes|No||09/12/2014||Yes|No|09/12/2014||Yes|No||09/12/2014||Yes|No|||Prescription required|Yes|07/29/2021|166|No|8.1002|03/29/2022|7.90579|03/29/2022|7.95844|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|4703|||||No|No||ACTAVIS/TEVA|No||||
clonidine|No|No|No|No|75%|00591350904|CLONIDINE 0.2 MG/DAY PATCH|4|EA|19.18337|09/12/2014||Yes|No||09/12/2014||Yes|No|09/12/2014||Yes|No||09/12/2014||Yes|No|||Prescription required|Yes|07/29/2021|166|No|12.62203|03/29/2022|12.3191|03/29/2022|12.40114|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|4704|||||No|No||ACTAVIS/TEVA|No||||
clonidine|No|No|No|No|75%|00591351004|CLONIDINE 0.3 MG/DAY PATCH|4|EA|26.6127|09/12/2014||Yes|No||09/12/2014||Yes|No|09/12/2014||Yes|No||09/12/2014||Yes|No|||Prescription required|Yes|07/29/2021|166|No|15.82856|03/29/2022|15.44867|03/29/2022|15.55156|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|4705|||||No|No||ACTAVIS/TEVA|No||||
testosterone|No|No|No|No|90%|00591352430|TESTOSTERONE 50 MG/5 GRAM GEL|5|GM|.83394|02/02/2018||Yes|No||02/02/2018||Yes|No|02/02/2018||Yes|No||||No|No|||Prescription required|Yes|11/03/2017|084|No|1.04613|03/29/2022|1.02102|03/29/2022|1.02782|03/29/2022|||ANDROGENIC AGENTS|4706|||||No|No||ACTAVIS/TEVA|No||||
lidocaine|No|No|No|No|75%|00591352530|LIDOCAINE 5% PATCH|30|EA|1.28799|09/17/2013||Yes|No||09/17/2013||Yes|No|09/17/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|232|No|2.00634|03/29/2022|1.95818|03/29/2022|1.97122|03/29/2022|||NEUROPATHIC PAIN|4707|||||No|No||ACTAVIS/TEVA|No||||
bupropion HCl|Yes|No|No|No|75%|00591354005|BUPROPION HCL SR 100 MG TABLET|500|EA|.10622|11/02/2010||Yes|No||11/02/2010||Yes|No|11/02/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.11271|03/29/2022|.11|03/29/2022|.11073|03/29/2022|||ANTIDEPRESSANTS: OTHER|4708|||||No|No||ACTAVIS/TEVA|No||||
bupropion HCl|Yes|No|No|No|75%|00591354060|BUPROPION HCL SR 100 MG TABLET|60|EA|.10621|08/04/2009||Yes|No||08/04/2009||Yes|No|08/04/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.11271|03/29/2022|.11|03/29/2022|.11073|03/29/2022|||ANTIDEPRESSANTS: OTHER|4709|||||No|No||ACTAVIS/TEVA|No||||
bupropion HCl|Yes|No|No|No|75%|00591354105|BUPROPION HCL SR 150 MG TABLET|500|EA|.1161|11/02/2010||Yes|No||11/02/2010||Yes|No|11/02/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.10128|03/29/2022|.09884|03/29/2022|.0995|03/29/2022|||ANTIDEPRESSANTS: OTHER|4710|||||No|No||ACTAVIS/TEVA|No||||
bupropion HCl|Yes|No|No|No|75%|00591354125|BUPROPION HCL SR 150 MG TABLET|250|EA|.1161|08/04/2009||Yes|No||08/04/2009||Yes|No|08/04/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.10128|03/29/2022|.09884|03/29/2022|.0995|03/29/2022|||ANTIDEPRESSANTS: OTHER|4711|||||No|No||ACTAVIS/TEVA|No||||
bupropion HCl|Yes|No|No|No|75%|00591354160|BUPROPION HCL SR 150 MG TABLET|60|EA|.1161|08/04/2009||Yes|No||08/04/2009||Yes|No|08/04/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.10128|03/29/2022|.09884|03/29/2022|.0995|03/29/2022|||ANTIDEPRESSANTS: OTHER|4712|||||No|No||ACTAVIS/TEVA|No||||
bupropion HCl|Yes|No|No|No|75%|00591354260|BUPROPION HCL SR 200 MG TABLET|60|EA|.26423|08/04/2009||Yes|No||08/04/2009||Yes|No|08/04/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.16014|03/29/2022|.15629|03/29/2022|.15733|03/29/2022|||ANTIDEPRESSANTS: OTHER|4713|||||No|No||ACTAVIS/TEVA|No||||
bupropion HCl|No|No|No|No|75%|00591354360|BUPROPION HCL SR 150 MG TABLET|60|EA|.1935|08/04/2009||Yes|No||08/04/2009||Yes|No|08/04/2009||Yes|No||||No|No|||Prescription required|No||040|No|.31361|03/29/2022|.30608|03/29/2022|.30812|03/29/2022|||SMOKING CESSATION|4714|||||No|No||ACTAVIS/TEVA|No||||
bupropion HCl|No|No|No|No|75%|00591354376|BUPROPION HCL SR 150 MG TABLET|60|EA|.1935|08/15/2016||Yes|No||08/15/2016||Yes|No|08/15/2016||Yes|No||||No|No|||Prescription required|No||040|No|.31361|03/29/2022|.30608|03/29/2022|.30812|03/29/2022|||SMOKING CESSATION|4715|||||No|No||ACTAVIS/TEVA|No||||
codeine/butalbital/ASA/caffein|No|No|No|No|90%|00591354601|BUTALBITAL COMP-CODEINE #3 CAP|100|EA|.94251|02/11/2008||Yes|No||02/11/2008||Yes|No|02/11/2008||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|109|Yes|1.16307|03/29/2022|1.13515|03/29/2022|1.14271|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4716|||||No|No||ACTAVIS/TEVA|No||||
codeine/butalbital/ASA/caffein|No|No|No|No|90%|00591354605|BUTALBITAL COMP-CODEINE #3 CAP|500|EA|.94251|08/29/2007||Yes|No||08/29/2007||Yes|No|08/29/2007||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|109|Yes|1.16307|03/29/2022|1.13515|03/29/2022|1.14271|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4717|||||No|No||ACTAVIS/TEVA|No||||
trospium chloride|No|No|No|No|75%|00591363630|TROSPIUM CHLORIDE ER 60 MG CAP|30|EA|2.31741|10/22/2012||Yes|No||10/22/2012||Yes|No|10/22/2012||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|006|No|3.47514|03/29/2022|3.39173|03/29/2022|3.41432|03/29/2022|||BLADDER RELAXANT PREPARATIONS|4718|||||No|No||ACTAVIS/TEVA|No||||
nitrofurantoin monohyd/m-cryst|No|No|No|No|75%|00591365801|NITROFURANTOIN MONO-MCR 100 MG|100|EA|1.10269|11/19/2015||Yes|No||11/19/2015||Yes|No|11/19/2015||Yes|No||||No|No|||Prescription required|No|||No|.48495|03/29/2022|.47331|03/29/2022|.47646|03/29/2022||||4719|||||No|No||ACTAVIS/TEVA|No||||
desvenlafaxine succinate|No|No|No|No|75%|00591365930|DESVENLAFAXINE SUCCNT ER 50 MG|30|EA|.41939|06/06/2017||Yes|No||06/06/2017||Yes|No|06/06/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.57735|03/29/2022|.56349|03/29/2022|.56724|03/29/2022|||ANTIDEPRESSANTS: OTHER|4720|||||No|No||ACTAVIS/TEVA|No||||
desvenlafaxine succinate|No|No|No|No|75%|00591366030|DESVENLAFAXINE SUCCNT ER 100MG|30|EA|.41939|06/06/2017||Yes|No||06/06/2017||Yes|No|06/06/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.60974|03/29/2022|.5951|03/29/2022|.59906|03/29/2022|||ANTIDEPRESSANTS: OTHER|4721|||||No|No||ACTAVIS/TEVA|No||||
nabumetone|No|No|No|No|75%|00591367001|NABUMETONE 500 MG TABLET|100|EA|.19565|07/25/2011||Yes|No||07/25/2011||Yes|No|07/25/2011||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.17691|03/29/2022|.17266|03/29/2022|.17381|03/29/2022|||NSAIDS|4722|||||No|No||ACTAVIS/TEVA|No||||
nabumetone|No|No|No|No|75%|00591367005|NABUMETONE 500 MG TABLET|500|EA|.19173|07/25/2011||Yes|No||07/25/2011||Yes|No|07/25/2011||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.17691|03/29/2022|.17266|03/29/2022|.17381|03/29/2022|||NSAIDS|4723|||||No|No||ACTAVIS/TEVA|No||||
nabumetone|No|No|No|No|75%|00591367101|NABUMETONE 750 MG TABLET|100|EA|.21736|07/25/2011||Yes|No||07/25/2011||Yes|No|07/25/2011||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.2074|03/29/2022|.20242|03/29/2022|.20377|03/29/2022|||NSAIDS|4724|||||No|No||ACTAVIS/TEVA|No||||
nabumetone|No|No|No|No|75%|00591367105|NABUMETONE 750 MG TABLET|500|EA|.21302|07/25/2011||Yes|No||07/25/2011||Yes|No|07/25/2011||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.2074|03/29/2022|.20242|03/29/2022|.20377|03/29/2022|||NSAIDS|4725|||||No|No||ACTAVIS/TEVA|No||||
nitrofurantoin macrocrystal|No|No|No|No|75%|00591368401|NITROFURANTOIN MCR 25 MG CAP|100|EA|2.5198|10/02/2015||Yes|No||10/02/2015||Yes|No|10/02/2015||Yes|No||10/02/2015||Yes|No|||Prescription required|No|||No|4.58426|08/24/2021|4.47423|08/24/2021|4.50403|08/24/2021||||4726|||||No|No||ACTAVIS/TEVA|No||||
nitrofurantoin macrocrystal|Yes|No|No|No|75%|00591368501|NITROFURANTOIN MCR 50 MG CAP|100|EA|.59469|10/02/2015||Yes|No||10/02/2015||Yes|No|10/02/2015||Yes|No||10/02/2015||Yes|No|07/01/2016||Prescription required|No|||No|.39225|03/29/2022|.38283|03/29/2022|.38538|03/29/2022||||4727|||||No|No||ACTAVIS/TEVA|No||||
nitrofurantoin macrocrystal|No|No|No|No|75%|00591368601|NITROFURANTOIN MCR 100 MG CAP|100|EA|1.00998|10/02/2015||Yes|No||10/02/2015||Yes|No|10/02/2015||Yes|No||10/02/2015||Yes|No|||Prescription required|No|||No|.47756|03/29/2022|.46609|03/29/2022|.4692|03/29/2022||||4728|||||No|No||ACTAVIS/TEVA|No||||
paliperidone|No|No|No|No|75%|00591369230|PALIPERIDONE ER 1.5 MG TABLET|30|EA|10.52496|09/25/2015||Yes|No||09/25/2015||Yes|No|09/25/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|027|Yes|4.83706|03/29/2022|4.72097|03/29/2022|4.75241|03/29/2022|||ANTIPSYCHOTICS|4729|||||No|No||ACTAVIS/TEVA|No||||
paliperidone|No|No|No|No|75%|00591369319|PALIPERIDONE ER 3 MG TABLET|90|EA|10.52501|09/25/2015||Yes|No||09/25/2015||Yes|No|09/25/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|027|Yes|6.18339|03/29/2022|6.03498|03/29/2022|6.07518|03/29/2022|||ANTIPSYCHOTICS|4730|||||No|No||ACTAVIS/TEVA|No||||
paliperidone|No|No|No|No|75%|00591369330|PALIPERIDONE ER 3 MG TABLET|30|EA|10.52496|09/25/2015||Yes|No||09/25/2015||Yes|No|09/25/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|027|Yes|6.18339|03/29/2022|6.03498|03/29/2022|6.07518|03/29/2022|||ANTIPSYCHOTICS|4731|||||No|No||ACTAVIS/TEVA|No||||
paliperidone|No|No|No|No|75%|00591369419|PALIPERIDONE ER 6 MG TABLET|90|EA|10.52501|09/25/2015||Yes|No||09/25/2015||Yes|No|09/25/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|027|Yes|5.21133|03/29/2022|5.08625|03/29/2022|5.12013|03/29/2022|||ANTIPSYCHOTICS|4732|||||No|No||ACTAVIS/TEVA|No||||
paliperidone|No|No|No|No|75%|00591369430|PALIPERIDONE ER 6 MG TABLET|30|EA|10.52496|09/25/2015||Yes|No||09/25/2015||Yes|No|09/25/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|027|Yes|5.21133|03/29/2022|5.08625|03/29/2022|5.12013|03/29/2022|||ANTIPSYCHOTICS|4733|||||No|No||ACTAVIS/TEVA|No||||
paliperidone|No|No|No|No|75%|00591369519|PALIPERIDONE ER 9 MG TABLET|90|EA|15.78749|09/25/2015||Yes|No||09/25/2015||Yes|No|09/25/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|027|Yes|7.23268|03/29/2022|7.05909|03/29/2022|7.1061|03/29/2022|||ANTIPSYCHOTICS|4734|||||No|No||ACTAVIS/TEVA|No||||
paliperidone|No|No|No|No|75%|00591369530|PALIPERIDONE ER 9 MG TABLET|30|EA|15.78745|09/25/2015||Yes|No||09/25/2015||Yes|No|09/25/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|027|Yes|7.23268|03/29/2022|7.05909|03/29/2022|7.1061|03/29/2022|||ANTIPSYCHOTICS|4735|||||No|No||ACTAVIS/TEVA|No||||
ezetimibe|No|No|No|No|75%|00591371305|EZETIMIBE 10 MG TABLET|500|EA|.1943|11/14/2017||Yes|No||11/14/2017||Yes|No|11/14/2017||Yes|No||||No|No|||Prescription required|Yes|09/21/2017|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|4736|||||No|No||ACTAVIS/TEVA|No||||
ezetimibe|No|No|No|No|75%|00591371319|EZETIMIBE 10 MG TABLET|90|EA|.1943|10/12/2017||Yes|No||10/12/2017||Yes|No|10/12/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|4737|||||No|No||ACTAVIS/TEVA|No||||
ezetimibe|No|No|No|No|75%|00591371330|EZETIMIBE 10 MG TABLET|30|EA|.19436|10/12/2017||Yes|No||10/12/2017||Yes|No|10/12/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|4738|||||No|No||ACTAVIS/TEVA|No||||
tranexamic acid|No|No|No|No|75%|00591372030|TRANEXAMIC ACID 650 MG TABLET|30|EA|2.83968|02/28/2013||Yes|No||02/28/2013||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No|||No|1.67932|03/29/2022|1.63901|03/29/2022|1.64993|03/29/2022||||4739|||||No|No||ACTAVIS/TEVA|No||||
solifenacin succinate|No|No|No|No|75%|00591379519|SOLIFENACIN 5 MG TABLET|90|EA|.23601|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|Yes|.23024|03/29/2022|.22471|03/29/2022|.22621|03/29/2022|||BLADDER RELAXANT PREPARATIONS|4740|||||No|No||TEVA USA|No||||
solifenacin succinate|No|No|No|No|75%|00591379619|SOLIFENACIN 10 MG TABLET|90|EA|.23601|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|No|.26101|03/29/2022|.25474|03/29/2022|.25644|03/29/2022|||BLADDER RELAXANT PREPARATIONS|4741|||||No|No||TEVA USA|No||||
ipratropium bromide|No|No|No|No|75%|00591379830|IPRATROPIUM BR 0.02% SOLN|2.5|ML|.0258|07/29/2011|04/30/2022|Yes|No||07/29/2011|04/30/2022|Yes|No|07/29/2011|04/30/2022|Yes|No||||No|No|||Prescription required|No||098|No|.05788|03/29/2022|.05649|03/29/2022|.05686|03/29/2022|||COPD AGENTS|4742|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ACTAVIS/TEVA|Yes|09/01/2020|||
ipratropium bromide|No|No|No|No|75%|00591379860|IPRATROPIUM BR 0.02% SOLN|2.5|ML|.0258|08/23/2011|01/31/2022|Yes|No||08/23/2011|01/31/2022|Yes|No|08/23/2011|01/31/2022|Yes|No||||No|No|||Prescription required|No||098|No|.0588|02/15/2022|.05796|02/15/2022|.0552|02/15/2022|||COPD AGENTS|4743|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ACTAVIS/TEVA|Yes|09/01/2020|||
ipratropium bromide|No|No|No|No|75%|00591379883|IPRATROPIUM BR 0.02% SOLN|2.5|ML|.0258|12/14/2011|04/30/2022|Yes|No||12/14/2011|04/30/2022|Yes|No|12/14/2011|04/30/2022|Yes|No||||No|No|||Prescription required|No||098|No|.05484|03/29/2022|.05352|03/29/2022|.05388|03/29/2022|||COPD AGENTS|4744|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ACTAVIS/TEVA|No||||
vigabatrin|No|No|No|No|75%|00591385101|VIGABATRIN 500 MG TABLET|100|EA|49.39539|07/27/2020||Yes|No||07/27/2020||Yes|No|07/27/2020||Yes|No||||No|No|||Prescription required|No||056|No|112.57554|07/27/2020|110.96731|07/27/2020|105.68316|07/27/2020|||ANTICONVULSANTS|4745|||||No|No||ACTAVIS/TEVA|No||||
methylphenidate HCl|No|No|No|No|75%|00591385419|METHYLPHENIDATE ER 10 MG CAP|90|EA|3.09729|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|007|Yes|7.05894|12/14/2020|6.95809|12/14/2020|6.62676|12/14/2020|||STIMULANTS AND RELATED AGENTS|4746|||||No|No||TEVA USA|No||||
methylphenidate HCl|No|No|No|No|75%|00591386219|METHYLPHENIDATE ER 15 MG CAP|90|EA|3.09729|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|007|Yes|7.05894|12/14/2020|6.95809|12/14/2020|6.62676|12/14/2020|||STIMULANTS AND RELATED AGENTS|4747|||||No|No||TEVA USA|No||||
methylphenidate HCl|No|No|No|No|75%|00591386919|METHYLPHENIDATE ER 20 MG CAP|90|EA|3.09729|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|007|Yes|7.05894|12/14/2020|6.95809|12/14/2020|6.62676|12/14/2020|||STIMULANTS AND RELATED AGENTS|4748|||||No|No||TEVA USA|No||||
memantine HCl|No|No|No|No|75%|00591387044|MEMANTINE HCL 5 MG TABLET|100|EA|.17918|10/03/2016||Yes|No||10/03/2016||Yes|No|10/03/2016||Yes|No||||No|No|||Prescription required|No||011|No|.08825|03/29/2022|.08613|03/29/2022|.0867|03/29/2022|||ALZHEIMER'S AGENTS|4749|||||No|No||ACTAVIS/TEVA|No||||
memantine HCl|No|No|No|No|75%|00591387060|MEMANTINE HCL 5 MG TABLET|60|EA|.17916|07/14/2015||Yes|No||07/14/2015||Yes|No|07/14/2015||Yes|No||||No|No|||Prescription required|No||011|No|.08825|03/29/2022|.08613|03/29/2022|.0867|03/29/2022|||ALZHEIMER'S AGENTS|4750|||||No|No||ACTAVIS/TEVA|No||||
methylphenidate HCl|No|No|No|No|75%|00591387319|METHYLPHENIDATE ER 30 MG CAP|90|EA|3.09729|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|007|Yes|7.05894|12/14/2020|6.95809|12/14/2020|6.62676|12/14/2020|||STIMULANTS AND RELATED AGENTS|4751|||||No|No||TEVA USA|No||||
memantine HCl|No|No|No|No|75%|00591387544|MEMANTINE HCL 10 MG TABLET|100|EA|.17918|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|4752|||||No|No||ACTAVIS/TEVA|No||||
memantine HCl|No|No|No|No|75%|00591387560|MEMANTINE HCL 10 MG TABLET|60|EA|.17916|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|4753|||||No|No||ACTAVIS/TEVA|No||||
methylphenidate HCl|No|No|No|No|75%|00591389119|METHYLPHENIDATE ER 40 MG CAP|90|EA|3.09729|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|007|Yes|7.05894|12/14/2020|6.95809|12/14/2020|6.62676|12/14/2020|||STIMULANTS AND RELATED AGENTS|4754|||||No|No||TEVA USA|No||||
methylphenidate HCl|No|No|No|No|75%|00591389519|METHYLPHENIDATE ER 50 MG CAP|90|EA|3.09729|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|007|Yes|7.05894|12/14/2020|6.95809|12/14/2020|6.62676|12/14/2020|||STIMULANTS AND RELATED AGENTS|4755|||||No|No||TEVA USA|No||||
memantine HCl|No|No|No|No|75%|00591390087|MEMANTINE 5-10 MG TITRATION PK|49|EA|.17919|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|Yes|02/01/2018|011|No|.3718|03/29/2022|.36287|03/29/2022|.36529|03/29/2022|||ALZHEIMER'S AGENTS|4756|||||No|No||ACTAVIS/TEVA|No||||
methylphenidate HCl|No|No|No|No|75%|00591390219|METHYLPHENIDATE ER 60 MG CAP|90|EA|3.09729|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|007|Yes|7.05894|12/14/2020|6.95809|12/14/2020|6.62676|12/14/2020|||STIMULANTS AND RELATED AGENTS|4757|||||No|No||TEVA USA|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|00591391668|CLIND PH-BENZOYL PERO 1.2-2.5%|50|GM|4.07837|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|104|No|1.96427|03/29/2022|1.91712|03/29/2022|1.92989|03/29/2022|||ACNE AGENTS: TOPICAL|4758|||||No|No||ACTAVIS/TEVA|No||||
vigabatrin|No|No|No|No|75%|00591395550|VIGABATRIN 500 MG POWDER PACKT|50|EA|14.32536|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||||No|No|||Prescription required|No||056|No|32.6485|12/30/2020|32.18209|12/30/2020|30.64961|12/30/2020|||ANTICONVULSANTS|4759|||||No|No||TEVA USA|No||||
celecoxib|No|No|No|No|75%|00591398260|CELECOXIB 50 MG CAPSULE|60|EA|.7431|02/18/2016||Yes|No||02/18/2016||Yes|No|02/18/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|.1386|03/29/2022|.13527|03/29/2022|.13617|03/29/2022|||NSAIDS|4760|||||No|No||ACTAVIS/TEVA|No||||
celecoxib|No|No|No|No|75%|00591398301|CELECOXIB 100 MG CAPSULE|100|EA|1.58996|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|4761|||||No|No||ACTAVIS/TEVA|No||||
celecoxib|No|No|No|No|75%|00591398305|CELECOXIB 100 MG CAPSULE|500|EA|1.59001|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|4762|||||No|No||ACTAVIS/TEVA|No||||
celecoxib|No|No|No|No|75%|00591398401|CELECOXIB 200 MG CAPSULE|100|EA|2.60795|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|4763|||||No|No||ACTAVIS/TEVA|No||||
celecoxib|No|No|No|No|75%|00591398405|CELECOXIB 200 MG CAPSULE|500|EA|2.60798|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|4764|||||No|No||ACTAVIS/TEVA|No||||
valproic acid|No|No|No|No|75%|00591401201|VALPROIC ACID 250 MG CAPSULE|100|EA|.172|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||056|No|.23326|03/29/2022|.22766|03/29/2022|.22917|03/29/2022|||ANTICONVULSANTS|4765|||||No|No||ACTAVIS/TEVA|No||||
clobetasol propionate|No|No|No|No|75%|00591403946|CLOBETASOL PROP 0.05% SPRAY|59|ML|2.39874|09/02/2015||Yes|No||09/02/2015||Yes|No|09/02/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|121|No|.72856|01/25/2022|.71107|01/25/2022|.71581|01/25/2022|||STEROIDS: TOPICAL VERY HIGH|4766|||||No|No||ACTAVIS/TEVA|No||||
clobetasol propionate|No|No|No|No|75%|00591403974|CLOBETASOL PROP 0.05% SPRAY|125|ML|2.03699|09/02/2015||Yes|No||09/02/2015||Yes|No|09/02/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|121|No|.7112|03/29/2022|.69413|03/29/2022|.69875|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|4767|||||No|No||ACTAVIS/TEVA|No||||
sildenafil citrate|No|No|No|No|75%|00591405094|SILDENAFIL 10 MG/ML ORAL SUSP|112|ML|3.78157|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/30/2020|171|Yes|8.61848|10/13/2020|8.49536|10/13/2020|8.09082|10/13/2020|||PAH AGENTS: ORAL AND INHALED|4768|||||No|No||TEVA USA|No||||
ivermectin|No|No|No|No|75%|00591405289|IVERMECTIN 1% CREAM|45|GM|3.78476|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|221|No|6.39081|03/29/2022|6.23743|03/29/2022|6.27897|03/29/2022|||ROSACEA AGENTS: TOPICAL|4769|||||No|No||TEVA USA|No||||
desvenlafaxine succinate|No|No|No|No|75%|00591406030|DESVENLAFAXINE SUCCNT ER 25 MG|30|EA|.41939|06/06/2017||Yes|No||06/06/2017||Yes|No|06/06/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.63768|03/29/2022|.62237|03/29/2022|.62652|03/29/2022|||ANTIDEPRESSANTS: OTHER|4770|||||No|No||ACTAVIS/TEVA|No||||
perphenazine|No|No|No|No|75%|00591410101|PERPHENAZINE 2 MG TABLET|100|EA|.19517|10/12/2017||Yes|No||10/12/2017||Yes|No|10/12/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.31906|03/29/2022|.3114|03/29/2022|.31347|03/29/2022|||ANTIPSYCHOTICS|4771|||||No|No||ACTAVIS/TEVA|No||||
perphenazine|No|No|No|No|75%|00591410201|PERPHENAZINE 4 MG TABLET|100|EA|.26715|10/12/2017||Yes|No||10/12/2017||Yes|No|10/12/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.32485|03/29/2022|.31705|03/29/2022|.31916|03/29/2022|||ANTIPSYCHOTICS|4772|||||No|No||ACTAVIS/TEVA|No||||
perphenazine|No|No|No|No|75%|00591410301|PERPHENAZINE 8 MG TABLET|100|EA|.32404|10/12/2017||Yes|No||10/12/2017||Yes|No|10/12/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.48127|03/29/2022|.46971|03/29/2022|.47284|03/29/2022|||ANTIPSYCHOTICS|4773|||||No|No||ACTAVIS/TEVA|No||||
perphenazine|No|No|No|No|75%|00591410401|PERPHENAZINE 16 MG TABLET|100|EA|.43593|10/12/2017||Yes|No||10/12/2017||Yes|No|10/12/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.69746|03/29/2022|.68072|03/29/2022|.68525|03/29/2022|||ANTIPSYCHOTICS|4774|||||No|No||ACTAVIS/TEVA|No||||
testosterone cypionate|No|No|No|No|90%|00591412879|TESTOSTERON CYP 2,000 MG/10 ML|10|ML|3.48773|05/14/2015||Yes|No||05/14/2015||Yes|No|05/14/2015||Yes|No||||No|No|||Prescription required|No|||No|3.11913|03/29/2022|3.04427|03/29/2022|3.06454|03/29/2022||||4775|||||No|No||ACTAVIS/TEVA|No||||
penicillamine|No|No|No|No|75%|00591417101|PENICILLAMINE 250 MG CAPSULE|100|EA|97.29605|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|No|||No|221.7445|02/02/2021|218.57672|02/02/2021|208.1683|02/02/2021||||4776|||||No|No||ACTAVIS/TEVA|No||||
doxycycline hyclate|No|No|No|No|75%|00591455022|DOXYCYCLINE HYC DR 50 MG TAB|120|EA|4.06565|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||02/02/2021||Yes|No|||Prescription required|Yes|07/25/2019|213|No|7.12484|05/25/2021|6.95384|05/25/2021|7.00015|05/25/2021|||TETRACYCLINES|4777|||||No|No||TEVA USA|No||||
doxycycline hyclate|No|No|No|No|75%|00591457560|DOXYCYCLINE HYC DR 200 MG TAB|60|EA|10.75264|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||02/02/2021||Yes|No|||Prescription required|Yes|07/25/2019|213|No|24.50603|02/02/2021|24.15595|02/02/2021|23.00566|02/02/2021|||TETRACYCLINES|4778|||||No|No||TEVA USA|No||||
trientine HCl|No|No|No|No|75%|00591491001|TRIENTINE HCL 250 MG CAPSULE|100|EA|79.01043|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No|||No|180.07029|05/21/2018|177.49786|05/21/2018|169.04558|05/21/2018||||4779|||||No|No||ACTAVIS/TEVA|No||||
amantadine HCl|No|No|No|No|75%|00591492001|AMANTADINE 100 MG TABLET|100|EA|.68722|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No||015|No|.71929|03/29/2022|.70202|03/29/2022|.7067|03/29/2022|||ANTIPARKINSON'S AGENTS|4780|||||No|No||ACTAVIS/TEVA|No||||
amantadine HCl|No|No|No|No|75%|00591492005|AMANTADINE 100 MG TABLET|500|EA|.68724|09/27/2018||Yes|No||09/27/2018||Yes|No|09/27/2018||Yes|No||||No|No|||Prescription required|No||015|No|.71929|03/29/2022|.70202|03/29/2022|.7067|03/29/2022|||ANTIPARKINSON'S AGENTS|4781|||||No|No||ACTAVIS/TEVA|No||||
prednisone|No|No|No|No|75%|00591505201|PREDNISONE 5 MG TABLET|100|EA|.07778|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|.07803|03/29/2022|.07615|03/29/2022|.07666|03/29/2022|||GLUCOCORTICOIDS: ORAL|4782|||||No|No||ACTAVIS/TEVA|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00591505210|PREDNISONE 5 MG TABLET|1000|EA|.077|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|.07803|03/29/2022|.07615|03/29/2022|.07666|03/29/2022|||GLUCOCORTICOIDS: ORAL|4783|||||No|No||ACTAVIS/TEVA|Yes|09/01/2020|||
promethazine HCl|No|No|No|No|75%|00591530701|PROMETHAZINE 25 MG TABLET|100|EA|.16331|03/21/2003||Yes|No||03/21/2003||Yes|No|03/21/2003||Yes|No||03/21/2003||Yes|No|||Prescription required|No||085|Yes|.05271|03/29/2022|.05144|03/29/2022|.05178|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|4784|||||No|No||ACTAVIS/TEVA|No||||
promethazine HCl|No|No|No|No|75%|00591530710|PROMETHAZINE 25 MG TABLET|1000|EA|.15514|04/25/2002||Yes|No||04/25/2002||Yes|No|04/25/2002||Yes|No||04/25/2002||Yes|No|||Prescription required|No||085|Yes|.05271|03/29/2022|.05144|03/29/2022|.05178|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|4785|||||No|No||ACTAVIS/TEVA|No||||
promethazine HCl|No|No|No|No|75%|00591531901|PROMETHAZINE 50 MG TABLET|100|EA|.25034|03/24/2003||Yes|No||03/24/2003||Yes|No|03/24/2003||Yes|No||03/24/2003||Yes|No|||Prescription required|No||085|Yes|.09825|03/29/2022|.09589|03/29/2022|.09653|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|4786|||||No|No||ACTAVIS/TEVA|No||||
primidone|No|No|No|No|75%|00591532101|PRIMIDONE 250 MG TABLET|100|EA|.15557|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||056|No|.31086|03/29/2022|.30339|03/29/2022|.30541|03/29/2022|||ANTICONVULSANTS|4787|||||No|No||ACTAVIS/TEVA|No||||
probenecid/colchicine|No|No|No|No|75%|00591532501|PROBENECID-COLCHICINE TABLET|100|EA|.34679|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||231|No|1.11456|03/29/2022|1.08781|03/29/2022|1.09505|03/29/2022|||ANTIHYPERURICEMICS|4788|||||No|No||ACTAVIS/TEVA|No||||
trihexyphenidyl HCl|No|No|No|No|75%|00591533501|TRIHEXYPHENIDYL 2 MG TABLET|100|EA|.06467|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||015|No|.06083|03/29/2022|.05937|03/29/2022|.05976|03/29/2022|||ANTIPARKINSON'S AGENTS|4789|||||No|No||ACTAVIS/TEVA|No||||
trihexyphenidyl HCl|No|No|No|No|75%|00591533510|TRIHEXYPHENIDYL 2 MG TABLET|1000|EA|.0501|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||015|No|.06083|03/29/2022|.05937|03/29/2022|.05976|03/29/2022|||ANTIPARKINSON'S AGENTS|4790|||||No|No||ACTAVIS/TEVA|No||||
trihexyphenidyl HCl|No|No|No|No|75%|00591533701|TRIHEXYPHENIDYL 5 MG TABLET|100|EA|.1305|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||015|No|.10848|03/29/2022|.10587|03/29/2022|.10658|03/29/2022|||ANTIPARKINSON'S AGENTS|4791|||||No|No||ACTAVIS/TEVA|No||||
trihexyphenidyl HCl|No|No|No|No|75%|00591533710|TRIHEXYPHENIDYL 5 MG TABLET|1000|EA|.11751|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||015|No|.10848|03/29/2022|.10587|03/29/2022|.10658|03/29/2022|||ANTIPARKINSON'S AGENTS|4792|||||No|No||ACTAVIS/TEVA|No||||
probenecid|Yes|No|No|No|75%|00591534701|PROBENECID 500 MG TABLET|100|EA|.25559|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|11/01/2012||Prescription required|No||231|No|.94759|03/29/2022|.92484|03/29/2022|.931|03/29/2022|||ANTIHYPERURICEMICS|4793|||||No|No||ACTAVIS/TEVA|No||||
probenecid|Yes|No|No|No|75%|00591534710|PROBENECID 500 MG TABLET|1000|EA|.24281|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|11/01/2012||Prescription required|No||231|No|.94759|03/29/2022|.92484|03/29/2022|.931|03/29/2022|||ANTIHYPERURICEMICS|4794|||||No|No||ACTAVIS/TEVA|No||||
prednisone|No|No|No|No|75%|00591544201|PREDNISONE 10 MG TABLET|100|EA|.0835|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|.07092|03/29/2022|.06921|03/29/2022|.06967|03/29/2022|||GLUCOCORTICOIDS: ORAL|4795|||||No|No||ACTAVIS/TEVA|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00591544205|PREDNISONE 10 MG TABLET|500|EA|.08267|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|.07092|03/29/2022|.06921|03/29/2022|.06967|03/29/2022|||GLUCOCORTICOIDS: ORAL|4796|||||No|No||ACTAVIS/TEVA|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00591544210|PREDNISONE 10 MG TABLET|1000|EA|.08019|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|.07092|03/29/2022|.06921|03/29/2022|.06967|03/29/2022|||GLUCOCORTICOIDS: ORAL|4797|||||No|No||ACTAVIS/TEVA|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00591544301|PREDNISONE 20 MG TABLET|100|EA|.08909|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|.11229|03/29/2022|.10959|03/29/2022|.11032|03/29/2022|||GLUCOCORTICOIDS: ORAL|4798|||||No|No||ACTAVIS/TEVA|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00591544305|PREDNISONE 20 MG TABLET|500|EA|.0882|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|.11229|03/29/2022|.10959|03/29/2022|.11032|03/29/2022|||GLUCOCORTICOIDS: ORAL|4799|||||No|No||ACTAVIS/TEVA|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00591544310|PREDNISONE 20 MG TABLET|1000|EA|.08555|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|.11229|03/29/2022|.10959|03/29/2022|.11032|03/29/2022|||GLUCOCORTICOIDS: ORAL|4800|||||No|No||ACTAVIS/TEVA|Yes|09/01/2020|||
carisoprodol|No|No|No|No|90%|00591551301|CARISOPRODOL 350 MG TABLET|100|EA|.04179|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4801|||||No|No||ACTAVIS/TEVA|No||||
carisoprodol|No|No|No|No|90%|00591551305|CARISOPRODOL 350 MG TABLET|500|EA|.0397|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4802|||||No|No||ACTAVIS/TEVA|No||||
carisoprodol|No|No|No|No|90%|00591551310|CARISOPRODOL 350 MG TABLET|1000|EA|.03769|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4803|||||No|No||ACTAVIS/TEVA|No||||
allopurinol|No|No|No|No|75%|00591554301|ALLOPURINOL 100 MG TABLET|100|EA|.13506|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|4804|||||No|No||ACTAVIS/TEVA|No||||
allopurinol|No|No|No|No|75%|00591554310|ALLOPURINOL 100 MG TABLET|1000|EA|.12198|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|4805|||||No|No||ACTAVIS/TEVA|No||||
allopurinol|No|No|No|No|75%|00591554401|ALLOPURINOL 300 MG TABLET|100|EA|.25812|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|4806|||||No|No||ACTAVIS/TEVA|No||||
allopurinol|No|No|No|No|75%|00591554405|ALLOPURINOL 300 MG TABLET|500|EA|.24512|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|4807|||||No|No||ACTAVIS/TEVA|No||||
doxycycline hyclate|Yes|No|No|No|75%|00591555305|DOXYCYCLINE HYCLATE 100 MG TAB|500|EA|1.17605|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|11/01/2012||Prescription required|Yes|01/22/2015|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|4808|||||No|No||ACTAVIS/TEVA|No||||
doxycycline hyclate|Yes|No|No|No|75%|00591555350|DOXYCYCLINE HYCLATE 100 MG TAB|50|EA|1.17605|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|11/01/2012||Prescription required|Yes|01/22/2015|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|4809|||||No|No||ACTAVIS/TEVA|No||||
propranolol HCl|No|No|No|No|75%|00591555401|PROPRANOLOL 10 MG TABLET|100|EA|.11829|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.06946|03/29/2022|.06779|03/29/2022|.06824|03/29/2022|||BETA-BLOCKERS|4810|||||No|No||ACTAVIS/TEVA|No||||
propranolol HCl|No|No|No|No|75%|00591555410|PROPRANOLOL 10 MG TABLET|1000|EA|.11238|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.06946|03/29/2022|.06779|03/29/2022|.06824|03/29/2022|||BETA-BLOCKERS|4811|||||No|No||ACTAVIS/TEVA|No||||
propranolol HCl|No|No|No|No|75%|00591555501|PROPRANOLOL 20 MG TABLET|100|EA|.14787|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.08469|03/29/2022|.08265|03/29/2022|.0832|03/29/2022|||BETA-BLOCKERS|4812|||||No|No||ACTAVIS/TEVA|No||||
propranolol HCl|No|No|No|No|75%|00591555510|PROPRANOLOL 20 MG TABLET|1000|EA|.14048|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.08469|03/29/2022|.08265|03/29/2022|.0832|03/29/2022|||BETA-BLOCKERS|4813|||||No|No||ACTAVIS/TEVA|No||||
propranolol HCl|No|No|No|No|75%|00591555601|PROPRANOLOL 40 MG TABLET|100|EA|.20777|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.11538|03/29/2022|.11261|03/29/2022|.11336|03/29/2022|||BETA-BLOCKERS|4814|||||No|No||ACTAVIS/TEVA|No||||
propranolol HCl|No|No|No|No|75%|00591555610|PROPRANOLOL 40 MG TABLET|1000|EA|.19738|04/26/2002||Yes|No||04/26/2002||Yes|No|04/26/2002||Yes|No||04/26/2002||Yes|No|||Prescription required|No||070|No|.11538|03/29/2022|.11261|03/29/2022|.11336|03/29/2022|||BETA-BLOCKERS|4815|||||No|No||ACTAVIS/TEVA|No||||
propranolol HCl|No|No|No|No|75%|00591555701|PROPRANOLOL 80 MG TABLET|100|EA|.26027|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||070|No|.21823|03/29/2022|.21299|03/29/2022|.21441|03/29/2022|||BETA-BLOCKERS|4816|||||No|No||ACTAVIS/TEVA|No||||
propranolol HCl|No|No|No|No|75%|00591555705|PROPRANOLOL 80 MG TABLET|500|EA|.24726|07/21/2005||Yes|No||07/21/2005||Yes|No|07/21/2005||Yes|No||||No|No|||Prescription required|No||070|No|.21823|03/29/2022|.21299|03/29/2022|.21441|03/29/2022|||BETA-BLOCKERS|4817|||||No|No||ACTAVIS/TEVA|No||||
tranylcypromine sulfate|No|No|No|No|75%|00591559001|TRANYLCYPROMINE SULF 10 MG TAB|100|EA|1.161|10/07/2016||Yes|No||||No|No|||No|No||||No|No|||Prescription required|Yes|07/23/2015|031|No|1.32918|03/29/2022|1.29727|03/29/2022|1.30591|03/29/2022|||ANTIDEPRESSANTS: OTHER|4818|||||No|No||ACTAVIS/TEVA|No||||
minoxidil|No|No|No|No|75%|00591564201|MINOXIDIL 2.5 MG TABLET|100|EA|.09085|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.14809|03/29/2022|.14453|03/29/2022|.14549|03/29/2022||||4819|||||No|No||ACTAVIS/TEVA|No||||
minoxidil|No|No|No|No|75%|00591564205|MINOXIDIL 2.5 MG TABLET|500|EA|.08631|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.14809|03/29/2022|.14453|03/29/2022|.14549|03/29/2022||||4820|||||No|No||ACTAVIS/TEVA|No||||
minoxidil|No|No|No|No|75%|00591564301|MINOXIDIL 10 MG TABLET|100|EA|.19964|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.26052|03/29/2022|.25426|03/29/2022|.25596|03/29/2022||||4821|||||No|No||ACTAVIS/TEVA|No||||
minoxidil|No|No|No|No|75%|00591564305|MINOXIDIL 10 MG TABLET|500|EA|.18966|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.26052|03/29/2022|.25426|03/29/2022|.25596|03/29/2022||||4822|||||No|No||ACTAVIS/TEVA|No||||
cyclobenzaprine HCl|No|No|No|No|75%|00591565801|CYCLOBENZAPRINE 10 MG TABLET|100|EA|.03053|03/01/2002|07/20/2022|Yes|No||03/01/2002|07/20/2022|Yes|No|03/01/2002|07/20/2022|Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4823|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ACTAVIS/TEVA|No||||
cyclobenzaprine HCl|No|No|No|No|75%|00591565805|CYCLOBENZAPRINE 10 MG TABLET|500|EA|.029|03/01/2002|07/20/2022|Yes|No||03/01/2002|07/20/2022|Yes|No|03/01/2002|07/20/2022|Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4824|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ACTAVIS/TEVA|No||||
cyclobenzaprine HCl|No|No|No|No|75%|00591565810|CYCLOBENZAPRINE 10 MG TABLET|1000|EA|.029|03/01/2002|07/20/2022|Yes|No||03/01/2002|07/20/2022|Yes|No|03/01/2002|07/20/2022|Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4825|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ACTAVIS/TEVA|No||||
sulindac|No|No|No|No|75%|00591566001|SULINDAC 200 MG TABLET|100|EA|.12293|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.24702|03/29/2022|.24109|03/29/2022|.24269|03/29/2022|||NSAIDS|4826|||||No|No||ACTAVIS/TEVA|No||||
sulindac|No|No|No|No|75%|00591566005|SULINDAC 200 MG TABLET|500|EA|.1219|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.24702|03/29/2022|.24109|03/29/2022|.24269|03/29/2022|||NSAIDS|4827|||||No|No||ACTAVIS/TEVA|No||||
sulindac|No|No|No|No|75%|00591566101|SULINDAC 150 MG TABLET|100|EA|.09507|11/07/2002||Yes|No||11/07/2002||Yes|No|11/07/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.17191|03/29/2022|.16778|03/29/2022|.1689|03/29/2022|||NSAIDS|4828|||||No|No||ACTAVIS/TEVA|No||||
sulindac|No|No|No|No|75%|00591566105|SULINDAC 150 MG TABLET|500|EA|.09392|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.17191|03/29/2022|.16778|03/29/2022|.1689|03/29/2022|||NSAIDS|4829|||||No|No||ACTAVIS/TEVA|No||||
minocycline HCl|No|No|No|No|75%|00591569401|MINOCYCLINE 50 MG CAPSULE|100|EA|.11395|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||213|No|.20366|03/29/2022|.19877|03/29/2022|.20009|03/29/2022|||TETRACYCLINES|4830|||||No|No||ACTAVIS/TEVA|No||||
minocycline HCl|No|No|No|No|75%|00591569460|MINOCYCLINE 50 MG CAPSULE|60|EA|.11395|08/15/2016||Yes|No||08/15/2016||Yes|No|08/15/2016||Yes|No||08/15/2016||Yes|No|||Prescription required|No||213|No|.20366|03/29/2022|.19877|03/29/2022|.20009|03/29/2022|||TETRACYCLINES|4831|||||No|No||ACTAVIS/TEVA|No||||
minocycline HCl|No|No|No|No|75%|00591569550|MINOCYCLINE 100 MG CAPSULE|50|EA|.23951|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||213|No|.38664|03/29/2022|.37736|03/29/2022|.37987|03/29/2022|||TETRACYCLINES|4832|||||No|No||ACTAVIS/TEVA|No||||
clindamycin HCl|No|No|No|No|75%|00591570801|CLINDAMYCIN HCL 150 MG CAPSULE|100|EA|.0617|03/01/2002|05/31/2022|Yes|No||03/01/2002|05/31/2022|Yes|No|03/01/2002|05/31/2022|Yes|No||03/01/2002|05/31/2022|Yes|No|||Prescription required|No||146|No|.12382|03/29/2022|.12084|03/29/2022|.12165|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|4833|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||ACTAVIS/TEVA|No||||
amoxapine|No|No|No|No|75%|00591571301|AMOXAPINE 25 MG TABLET|100|EA|.23938|07/29/2003||Yes|No||07/29/2003||Yes|No|07/29/2003||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.54556|05/08/2018|.53777|05/08/2018|.51216|05/08/2018|||ANTIDEPRESSANTS: TRICYCLIC|4834|||||No|No||ACTAVIS/TEVA|No||||
amoxapine|No|No|No|No|75%|00591571401|AMOXAPINE 50 MG TABLET|100|EA|.36859|07/16/2002||Yes|No||07/16/2002||Yes|No|07/16/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.84005|05/08/2018|.82805|05/08/2018|.78862|05/08/2018|||ANTIDEPRESSANTS: TRICYCLIC|4835|||||No|No||ACTAVIS/TEVA|No||||
amoxapine|No|No|No|No|75%|00591571501|AMOXAPINE 100 MG TABLET|100|EA|.63184|07/17/2002||Yes|No||07/17/2002||Yes|No|07/17/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|1.44001|05/08/2018|1.41944|05/08/2018|1.35184|05/08/2018|||ANTIDEPRESSANTS: TRICYCLIC|4836|||||No|No||ACTAVIS/TEVA|No||||
amoxapine|No|No|No|No|75%|00591571630|AMOXAPINE 150 MG TABLET|30|EA|1.05135|09/09/2002||Yes|No||09/09/2002||Yes|No|09/09/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|2.3961|12/15/2020|2.36187|12/15/2020|2.2494|12/15/2020|||ANTIDEPRESSANTS: TRICYCLIC|4837|||||No|No||ACTAVIS/TEVA|No||||
atenolol/chlorthalidone|No|No|No|No|75%|00591578201|ATENOLOL-CHLORTHALIDONE 50-25|100|EA|.24037|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||070|Yes|.37465|03/29/2022|.36565|03/29/2022|.36809|03/29/2022|||BETA-BLOCKERS|4838|||||No|No||ACTAVIS/TEVA|No||||
atenolol/chlorthalidone|No|No|No|No|75%|00591578301|ATENOLOL-CHLORTHALIDONE 100-25|100|EA|.33759|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||070|Yes|.47415|03/29/2022|.46277|03/29/2022|.46585|03/29/2022|||BETA-BLOCKERS|4839|||||No|No||ACTAVIS/TEVA|No||||
doxycycline hyclate|No|No|No|No|75%|00591610060|DOXYCYCLINE HYCLATE 75 MG TAB|60|EA|10.73071|07/06/2018||Yes|No||07/06/2018||Yes|No|07/06/2018||Yes|No||07/06/2018||Yes|No|||Prescription required|Yes|09/14/2017|213|No|24.45605|07/06/2018|24.10668|07/06/2018|22.95874|07/06/2018|||TETRACYCLINES|4840|||||No|No||ACTAVIS/TEVA|No||||
doxycycline hyclate|No|No|No|No|75%|00591612560|DOXYCYCLINE HYCLATE 150 MG TAB|60|EA|10.73071|07/06/2018||Yes|No||07/06/2018||Yes|No|07/06/2018||Yes|No||07/06/2018||Yes|No|||Prescription required|Yes|09/14/2017|213|No|24.45605|03/24/2020|24.10668|03/24/2020|22.95874|03/24/2020|||TETRACYCLINES|4841|||||No|No||ACTAVIS/TEVA|No||||
tipranavir|No|No|No|No|75%|00597000302|APTIVUS 250 MG CAPSULE|120|EA|9.59029|11/20/2009||Yes|No||11/20/2009||Yes|No|11/20/2009||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|15.36293|01/25/2022|14.99421|01/25/2022|15.09407|01/25/2022|||HIV / AIDS|4842|||||No|No||BOEHRINGER ING.|No||||
clonidine HCl|No|No|No|No|75%|00597000601|CATAPRES 0.1 MG TABLET|100|EA|1.16775|03/01/2002|01/13/2022|Yes|No||03/01/2002|01/13/2022|Yes|No|03/01/2002|01/13/2022|Yes|No||03/01/2002|01/13/2022|Yes|No|||Prescription required|Yes|01/15/2014|166|No|2.66138|01/08/2019|2.62336|01/08/2019|2.49844|01/08/2019|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|4843|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||BOEHRINGER ING.|No||||
clonidine HCl|No|No|No|No|75%|00597000701|CATAPRES 0.2 MG TABLET|100|EA|1.78656|03/01/2002|01/13/2022|Yes|No||03/01/2002|01/13/2022|Yes|No|03/01/2002|01/13/2022|Yes|No||03/01/2002|01/13/2022|Yes|No|||Prescription required|Yes|01/15/2014|166|No|4.0717|01/28/2020|4.01353|01/28/2020|3.82241|01/28/2020|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|4844|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||BOEHRINGER ING.|No||||
clonidine HCl|No|No|No|No|75%|00597001101|CATAPRES 0.3 MG TABLET|100|EA|2.24189|03/01/2002|01/13/2022|Yes|No||03/01/2002|01/13/2022|Yes|No|03/01/2002|01/13/2022|Yes|No||03/01/2002|01/13/2022|Yes|No|||Prescription required|Yes|01/15/2014|166|No|5.10942|01/08/2019|5.03643|01/08/2019|4.7966|01/08/2019|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|4845|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||BOEHRINGER ING.|No||||
ipratropium/albuterol sulfate|No|No|No|No|75%|00597002402|COMBIVENT RESPIMAT 20-100 MCG|4|GM|49.58437|10/04/2012||Yes|No||10/04/2012||Yes|No|10/04/2012||Yes|No||||No|No|||Prescription required|No||098|Yes|110.54701|01/25/2022|107.89388|01/25/2022|108.61243|01/25/2022|||COPD AGENTS|4846|||||No|No||BOEHRINGER ING.|No||||
meloxicam|No|No|No|No|75%|00597002901|MOBIC 7.5 MG TABLET|100|EA|4.16033|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/12/2005|059|Yes|9.51708|01/25/2022|9.28867|01/25/2022|9.35053|01/25/2022|||NSAIDS|4847|||||No|No||BOEHRINGER ING.|No||||
meloxicam|No|No|No|No|75%|00597003001|MOBIC 15 MG TABLET|100|EA|6.36142|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/12/2005|059|Yes|14.19463|01/25/2022|13.85395|01/25/2022|13.94622|01/25/2022|||NSAIDS|4848|||||No|No||BOEHRINGER ING.|No||||
clonidine|No|No|No|No|75%|00597003134|CATAPRES-TTS 1 PATCH|4|EA|31.2008|09/01/2020|10/31/2022|Yes|No||09/01/2020|10/31/2022|Yes|No|09/01/2020|10/31/2022|Yes|No||09/01/2020|10/31/2022|Yes|No|||Prescription required|No||166|No|69.83917|03/01/2022|68.16302|03/01/2022|68.61698|03/01/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|4849|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||BOEHRINGER ING.|No||||
clonidine|No|No|No|No|75%|00597003234|CATAPRES-TTS 2 PATCH|4|EA|52.53632|10/01/2020|10/31/2022|Yes|No||10/01/2020|10/31/2022|Yes|No|10/01/2020|10/31/2022|Yes|No||10/01/2020|10/31/2022|Yes|No|||Prescription required|No||166|No|119.73395|01/05/2021|118.02346|01/05/2021|112.4033|01/05/2021|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|4850|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||BOEHRINGER ING.|No||||
clonidine|No|No|No|No|75%|00597003334|CATAPRES-TTS 3 PATCH|4|EA|72.87747|10/01/2020|10/31/2022|Yes|No||10/01/2020|10/31/2022|Yes|No|10/01/2020|10/31/2022|Yes|No||10/01/2020|10/31/2022|Yes|No|||Prescription required|No||166|No|163.21417|12/21/2021|159.29702|12/21/2021|160.35792|12/21/2021|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|4851|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||BOEHRINGER ING.|No||||
telmisartan|No|No|No|No|75%|00597003937|MICARDIS 20 MG TABLET|30|EA|2.01025|10/27/2009||Yes|No||10/27/2009||Yes|No|10/27/2009||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|113|Yes|4.5815|01/18/2022|4.51605|01/18/2022|4.301|01/18/2022|||ANGIOTENSIN MODULATORS|4852|||||No|No||BOEHRINGER ING.|No||||
telmisartan|No|No|No|No|75%|00597004037|MICARDIS 40 MG TABLET|30|EA|2.01025|12/02/2004||Yes|No||12/02/2004||Yes|No|12/02/2004||Yes|No||12/02/2004||Yes|No|||Prescription required|Yes|07/26/2012|113|Yes|4.5815|01/18/2022|4.51605|01/18/2022|4.301|01/18/2022|||ANGIOTENSIN MODULATORS|4853|||||No|No||BOEHRINGER ING.|No||||
telmisartan|No|No|No|No|75%|00597004137|MICARDIS 80 MG TABLET|30|EA|2.01025|12/02/2004||Yes|No||12/02/2004||Yes|No|12/02/2004||Yes|No||12/02/2004||Yes|No|||Prescription required|Yes|07/26/2012|113|Yes|4.48414|01/25/2022|4.37652|01/25/2022|4.40566|01/25/2022|||ANGIOTENSIN MODULATORS|4854|||||No|No||BOEHRINGER ING.|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|00597004237|MICARDIS HCT 80-25 MG TABLET|30|EA|2.01025|12/02/2004||Yes|No||12/02/2004||Yes|No|12/02/2004||Yes|No||12/02/2004||Yes|No|||Prescription required|Yes|07/26/2012|113|Yes|4.5815|01/18/2022|4.51605|01/18/2022|4.301|01/18/2022|||ANGIOTENSIN MODULATORS|4855|||||No|No||BOEHRINGER ING.|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|00597004337|MICARDIS HCT 40-12.5 MG TABLET|30|EA|2.01025|12/02/2004||Yes|No||12/02/2004||Yes|No|12/02/2004||Yes|No||12/02/2004||Yes|No|||Prescription required|Yes|07/26/2012|113|Yes|4.5815|01/18/2022|4.51605|01/18/2022|4.301|01/18/2022|||ANGIOTENSIN MODULATORS|4856|||||No|No||BOEHRINGER ING.|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|00597004437|MICARDIS HCT 80-12.5 MG TABLET|30|EA|2.01025|12/02/2004||Yes|No||12/02/2004||Yes|No|12/02/2004||Yes|No||12/02/2004||Yes|No|||Prescription required|Yes|07/26/2012|113|Yes|4.5815|01/18/2022|4.51605|01/18/2022|4.301|01/18/2022|||ANGIOTENSIN MODULATORS|4857|||||No|No||BOEHRINGER ING.|No||||
nevirapine|No|No|No|No|75%|00597004724|VIRAMUNE 50 MG/5 ML SUSP|240|ML|.49057|03/01/2002|10/07/2022|Yes|No||03/01/2002|10/07/2022|Yes|No|03/01/2002|10/07/2022|Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.80126|01/08/2019|.78982|01/08/2019|.75221|01/08/2019|||HIV / AIDS|4858|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BOEHRINGER ING.|No||||
glucagon|No|No|No|No|75%|00597005345|GLUCAGEN DIAGNOSTIC 1 MG VIAL|1|EA|73.788|07/16/2015||Yes|No||07/16/2015||Yes|No|07/16/2015||Yes|No||||No|No|||Prescription required|No|||No|168.168|02/28/2017|165.7656|02/28/2017|157.872|02/28/2017||||4859|||||No|No||BOEHRINGER ING.|No||||
tiotropium bromide|No|No|No|No|75%|00597007541|SPIRIVA 18 MCG CP-HANDIHALER|30|EA|7.12538|05/24/2007||Yes|No||05/24/2007||Yes|No|05/24/2007||Yes|No||||No|No|||Prescription required|No||098|No|15.91813|01/25/2022|15.53609|01/25/2022|15.63956|01/25/2022|||COPD AGENTS|4860|||||No|No||BOEHRINGER ING.|No||||
tiotropium bromide|No|No|No|No|75%|00597007547|SPIRIVA 18 MCG CP-HANDIHALER|90|EA|7.12538|05/21/2007||Yes|No||05/21/2007||Yes|No|05/21/2007||Yes|No||||No|No|||Prescription required|No||098|No|15.86436|01/25/2022|15.48361|01/25/2022|15.58673|01/25/2022|||COPD AGENTS|4861|||||No|No||BOEHRINGER ING.|No||||
ipratropium bromide|No|No|No|No|75%|00597008717|ATROVENT 17 MCG HFA INHALER|12.9|GM|14.83199|07/28/2005||Yes|No||07/28/2005||Yes|No|07/28/2005||Yes|No||||No|No|||Prescription required|No||098|No|33.0613|01/25/2022|32.26782|01/25/2022|32.48272|01/25/2022|||COPD AGENTS|4862|||||No|No||BOEHRINGER ING.|No||||
tiotropium bromide|No|No|No|No|75%|00597010051|SPIRIVA RESPIMAT 2.5 MCG INH|4|GM|8.0625|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|098|No|18.375|07/21/2020|18.1125|07/21/2020|17.25|07/21/2020|||COPD AGENTS|4863|||||No|No||BOEHRINGER ING.|No||||
tiotropium bromide|No|No|No|No|75%|00597010061|SPIRIVA RESPIMAT 2.5 MCG INH|4|GM|53.4404|11/09/2014||Yes|No||11/09/2014||Yes|No|11/09/2014||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|098|No|119.14205|01/25/2022|116.28264|01/25/2022|117.05706|01/25/2022|||COPD AGENTS|4864|||||No|No||BOEHRINGER ING.|No||||
pramipexole di-HCl|No|No|No|No|75%|00597010930|MIRAPEX ER 0.375 MG TABLET|30|EA|9.82464|04/12/2010||Yes|No||04/12/2010||Yes|No|04/12/2010||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|22.10387|01/25/2022|21.57337|01/25/2022|21.71705|01/25/2022|||ANTIPARKINSON'S AGENTS|4865|||||No|No||BOEHRINGER ING.|No||||
pramipexole di-HCl|No|No|No|No|75%|00597011330|MIRAPEX ER 1.5 MG TABLET|30|EA|9.82464|04/12/2010||Yes|No||04/12/2010||Yes|No|04/12/2010||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|21.99553|01/25/2022|21.46763|01/25/2022|21.6106|01/25/2022|||ANTIPARKINSON'S AGENTS|4866|||||No|No||BOEHRINGER ING.|No||||
pramipexole di-HCl|No|No|No|No|75%|00597011530|MIRAPEX ER 3 MG TABLET|30|EA|9.82464|04/12/2010||Yes|No||04/12/2010||Yes|No|04/12/2010||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|21.97588|01/25/2022|21.44845|01/25/2022|21.5913|01/25/2022|||ANTIPARKINSON'S AGENTS|4867|||||No|No||BOEHRINGER ING.|No||||
pramipexole di-HCl|No|No|No|No|75%|00597011630|MIRAPEX ER 4.5 MG TABLET|30|EA|9.82464|04/12/2010||Yes|No||04/12/2010||Yes|No|04/12/2010||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|22.07664|01/25/2022|21.5468|01/25/2022|21.69029|01/25/2022|||ANTIPARKINSON'S AGENTS|4868|||||No|No||BOEHRINGER ING.|No||||
nevirapine|No|No|No|No|75%|00597012330|VIRAMUNE XR 400 MG TABLET|30|EA|16.80639|06/16/2011||Yes|No||06/16/2011||Yes|No|06/16/2011||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|27.45044|01/28/2020|27.05829|01/28/2020|25.7698|01/28/2020|||HIV / AIDS|4869|||||No|No||BOEHRINGER ING.|No||||
afatinib dimaleate|No|No|No|No|75%|00597013730|GILOTRIF 30 MG TABLET|30|EA|150.29532|10/14/2013||Yes|No||10/14/2013||Yes|No|10/14/2013||Yes|No||||No|No|||Prescription required|No||551|No|342.53352|01/18/2022|337.64018|01/18/2022|321.56208|01/18/2022|||ONCOLOGY: ORAL - LUNG|4870|||||No|No||BOEHRINGER ING.|No||||
afatinib dimaleate|No|No|No|No|75%|00597013830|GILOTRIF 40 MG TABLET|30|EA|150.29532|10/14/2013||Yes|No||10/14/2013||Yes|No|10/14/2013||Yes|No||||No|No|||Prescription required|No||551|No|342.53352|01/18/2022|337.64018|01/18/2022|321.56208|01/18/2022|||ONCOLOGY: ORAL - LUNG|4871|||||No|No||BOEHRINGER ING.|No||||
linagliptin|No|No|No|No|75%|00597014030|TRADJENTA 5 MG TABLET|30|EA|7.23661|06/16/2011||Yes|No||06/16/2011||Yes|No|06/16/2011||Yes|No||06/16/2011||Yes|No|||Prescription required|No||111|Yes|16.15348|01/25/2022|15.76579|01/25/2022|15.87079|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4872|||||No|No||BOEHRINGER ING.|No||||
linagliptin|No|No|No|No|75%|00597014090|TRADJENTA 5 MG TABLET|90|EA|7.23661|06/16/2011||Yes|No||06/16/2011||Yes|No|06/16/2011||Yes|No||06/16/2011||Yes|No|||Prescription required|No||111|Yes|16.15348|01/25/2022|15.76579|01/25/2022|15.87079|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4873|||||No|No||BOEHRINGER ING.|No||||
afatinib dimaleate|No|No|No|No|75%|00597014130|GILOTRIF 20 MG TABLET|30|EA|150.29532|10/14/2013||Yes|No||10/14/2013||Yes|No|10/14/2013||Yes|No||||No|No|||Prescription required|No||551|No|342.53352|01/18/2022|337.64018|01/18/2022|321.56208|01/18/2022|||ONCOLOGY: ORAL - LUNG|4874|||||No|No||BOEHRINGER ING.|No||||
nintedanib esylate|No|No|No|No|75%|00597014360|OFEV 100 MG CAPSULE|60|EA|82.83333|11/09/2014||Yes|No||11/09/2014||Yes|No|11/09/2014||Yes|No||||No|No|||Prescription required|No|||No|188.78294|01/18/2022|186.08604|01/18/2022|177.2248|01/18/2022||||4875|||||No|No||BOEHRINGER ING.|No||||
nintedanib esylate|No|No|No|No|75%|00597014560|OFEV 150 MG CAPSULE|60|EA|82.83333|11/09/2014||Yes|No||11/09/2014||Yes|No|11/09/2014||Yes|No||||No|No|||Prescription required|No|||No|188.78294|01/18/2022|186.08604|01/18/2022|177.2248|01/18/2022||||4876|||||No|No||BOEHRINGER ING.|No||||
linagliptin/metformin HCl|No|No|No|No|75%|00597014618|JENTADUETO 2.5 MG-500 MG TAB|180|EA|3.6183|04/17/2019||Yes|No||04/17/2019||Yes|No|04/17/2019||Yes|No||||No|No|||Prescription required|No||111|Yes|8.08432|01/25/2022|7.89029|01/25/2022|7.94284|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4877|||||No|No||BOEHRINGER ING.|No||||
linagliptin/metformin HCl|No|No|No|No|75%|00597014660|JENTADUETO 2.5 MG-500 MG TAB|60|EA|3.6183|03/14/2012||Yes|No||03/14/2012||Yes|No|03/14/2012||Yes|No||||No|No|||Prescription required|No||111|Yes|8.08432|01/25/2022|7.89029|01/25/2022|7.94284|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4878|||||No|No||BOEHRINGER ING.|No||||
linagliptin/metformin HCl|No|No|No|No|75%|00597014718|JENTADUETO 2.5 MG-850 MG TAB|180|EA|3.6183|04/17/2019||Yes|No||04/17/2019||Yes|No|04/17/2019||Yes|No||||No|No|||Prescription required|No||111|Yes|8.03042|01/25/2022|7.83768|01/25/2022|7.88988|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4879|||||No|No||BOEHRINGER ING.|No||||
linagliptin/metformin HCl|No|No|No|No|75%|00597014760|JENTADUETO 2.5 MG-850 MG TAB|60|EA|3.6183|03/14/2012||Yes|No||03/14/2012||Yes|No|03/14/2012||Yes|No||||No|No|||Prescription required|No||111|Yes|8.03042|01/25/2022|7.83768|01/25/2022|7.88988|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4880|||||No|No||BOEHRINGER ING.|No||||
linagliptin/metformin HCl|No|No|No|No|75%|00597014818|JENTADUETO 2.5 MG-1000 MG TAB|180|EA|3.6183|04/17/2019||Yes|No||04/17/2019||Yes|No|04/17/2019||Yes|No||||No|No|||Prescription required|No||111|Yes|8.11984|01/25/2022|7.92496|01/25/2022|7.97774|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4881|||||No|No||BOEHRINGER ING.|No||||
linagliptin/metformin HCl|No|No|No|No|75%|00597014860|JENTADUETO 2.5 MG-1000 MG TAB|60|EA|3.6183|03/14/2012||Yes|No||03/14/2012||Yes|No|03/14/2012||Yes|No||||No|No|||Prescription required|No||111|Yes|8.11984|01/25/2022|7.92496|01/25/2022|7.97774|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4882|||||No|No||BOEHRINGER ING.|No||||
empagliflozin|No|No|No|No|75%|00597015230|JARDIANCE 10 MG TABLET|30|EA|8.17688|09/07/2014||Yes|No||09/07/2014||Yes|No|09/07/2014||Yes|No||||No|No|||Prescription required|No||535|No|18.23463|01/25/2022|17.79699|01/25/2022|17.91552|01/25/2022|||HYPOGLYCEMICS: SGLT2|4883|||||No|No||BOEHRINGER ING.|No||||
empagliflozin|No|No|No|No|75%|00597015237|JARDIANCE 10 MG TABLET|30|EA|8.17688|11/19/2015||Yes|No||11/19/2015||Yes|No|11/19/2015||Yes|No||||No|No|||Prescription required|No||535|No|18.23463|01/25/2022|17.79699|01/25/2022|17.91552|01/25/2022|||HYPOGLYCEMICS: SGLT2|4884|||||No|No||BOEHRINGER ING.|No||||
empagliflozin|No|No|No|No|75%|00597015290|JARDIANCE 10 MG TABLET|90|EA|8.17688|09/07/2014||Yes|No||09/07/2014||Yes|No|09/07/2014||Yes|No||||No|No|||Prescription required|No||535|No|18.23463|01/25/2022|17.79699|01/25/2022|17.91552|01/25/2022|||HYPOGLYCEMICS: SGLT2|4885|||||No|No||BOEHRINGER ING.|No||||
empagliflozin|No|No|No|No|75%|00597015330|JARDIANCE 25 MG TABLET|30|EA|8.17688|09/07/2014||Yes|No||09/07/2014||Yes|No|09/07/2014||Yes|No||||No|No|||Prescription required|No||535|No|18.23551|01/25/2022|17.79785|01/25/2022|17.91638|01/25/2022|||HYPOGLYCEMICS: SGLT2|4886|||||No|No||BOEHRINGER ING.|No||||
empagliflozin|No|No|No|No|75%|00597015337|JARDIANCE 25 MG TABLET|30|EA|8.17688|11/19/2015||Yes|No||11/19/2015||Yes|No|11/19/2015||Yes|No||||No|No|||Prescription required|No||535|No|18.23551|01/25/2022|17.79785|01/25/2022|17.91638|01/25/2022|||HYPOGLYCEMICS: SGLT2|4887|||||No|No||BOEHRINGER ING.|No||||
empagliflozin|No|No|No|No|75%|00597015390|JARDIANCE 25 MG TABLET|90|EA|8.17688|09/07/2014||Yes|No||09/07/2014||Yes|No|09/07/2014||Yes|No||||No|No|||Prescription required|No||535|No|18.23551|01/25/2022|17.79785|01/25/2022|17.91638|01/25/2022|||HYPOGLYCEMICS: SGLT2|4888|||||No|No||BOEHRINGER ING.|No||||
tiotropium Br/olodaterol HCl|No|No|No|No|75%|00597015561|STIOLTO RESPIMAT INHAL SPRAY|4|GM|49.0114|06/30/2015||Yes|No||06/30/2015||Yes|No|06/30/2015||Yes|No||||No|No|||Prescription required|No||098|Yes|109.38692|01/25/2022|106.76163|01/25/2022|107.47264|01/25/2022|||COPD AGENTS|4889|||||No|No||BOEHRINGER ING.|No||||
tiotropium Br/olodaterol HCl|No|No|No|No|75%|00597015570|STIOLTO RESPIMAT INHAL SPRAY|4|GM|8.0625|01/02/2020||Yes|No||01/02/2020||Yes|No|01/02/2020||Yes|No||||No|No|||Prescription required|No||098|Yes|18.375|01/02/2020|18.1125|01/02/2020|17.25|01/02/2020|||COPD AGENTS|4890|||||No|No||BOEHRINGER ING.|No||||
tiotropium bromide|No|No|No|No|75%|00597016061|SPIRIVA RESPIMAT 1.25 MCG INH|4|GM|53.4404|10/30/2015||Yes|No||10/30/2015||Yes|No|10/30/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|098|No|119.27974|01/25/2022|116.41702|01/25/2022|117.19234|01/25/2022|||COPD AGENTS|4891|||||No|No||BOEHRINGER ING.|No||||
empagliflozin/linagliptin|No|No|No|No|75%|00597016430|GLYXAMBI 25 MG-5 MG TABLET|30|EA|8.17688|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||111|Yes|18.25471|01/25/2022|17.81659|01/25/2022|17.93525|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4892|||||No|No||BOEHRINGER ING.|No||||
empagliflozin/linagliptin|No|No|No|No|75%|00597016490|GLYXAMBI 25 MG-5 MG TABLET|90|EA|8.17688|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||111|Yes|18.25471|01/25/2022|17.81659|01/25/2022|17.93525|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4893|||||No|No||BOEHRINGER ING.|No||||
empagliflozin/metformin HCl|No|No|No|No|75%|00597016818|SYNJARDY 12.5-1,000 MG TABLET|180|EA|4.08844|07/20/2016||Yes|No||07/20/2016||Yes|No|07/20/2016||Yes|No||||No|No|||Prescription required|No||535|No|9.10368|01/25/2022|8.88519|01/25/2022|8.94436|01/25/2022|||HYPOGLYCEMICS: SGLT2|4894|||||No|No||BOEHRINGER ING.|No||||
empagliflozin/metformin HCl|No|No|No|No|75%|00597016860|SYNJARDY 12.5-1,000 MG TABLET|60|EA|4.08844|07/20/2016||Yes|No||07/20/2016||Yes|No|07/20/2016||Yes|No||||No|No|||Prescription required|No||535|No|9.10368|01/25/2022|8.88519|01/25/2022|8.94436|01/25/2022|||HYPOGLYCEMICS: SGLT2|4895|||||No|No||BOEHRINGER ING.|No||||
empagliflozin/metformin HCl|No|No|No|No|75%|00597017518|SYNJARDY 5-1,000 MG TABLET|180|EA|4.08844|07/20/2016||Yes|No||07/20/2016||Yes|No|07/20/2016||Yes|No||||No|No|||Prescription required|No||535|No|9.13515|01/25/2022|8.9159|01/25/2022|8.97528|01/25/2022|||HYPOGLYCEMICS: SGLT2|4896|||||No|No||BOEHRINGER ING.|No||||
empagliflozin/metformin HCl|No|No|No|No|75%|00597017560|SYNJARDY 5-1,000 MG TABLET|60|EA|4.08844|07/20/2016||Yes|No||07/20/2016||Yes|No|07/20/2016||Yes|No||||No|No|||Prescription required|No||535|No|9.13515|01/25/2022|8.9159|01/25/2022|8.97528|01/25/2022|||HYPOGLYCEMICS: SGLT2|4897|||||No|No||BOEHRINGER ING.|No||||
empagliflozin/metformin HCl|No|No|No|No|75%|00597018018|SYNJARDY 12.5-500 MG TABLET|180|EA|4.08844|07/20/2016||Yes|No||07/20/2016||Yes|No|07/20/2016||Yes|No||||No|No|||Prescription required|No||535|No|9.13049|01/25/2022|8.91135|01/25/2022|8.9707|01/25/2022|||HYPOGLYCEMICS: SGLT2|4898|||||No|No||BOEHRINGER ING.|No||||
empagliflozin/metformin HCl|No|No|No|No|75%|00597018060|SYNJARDY 12.5-500 MG TABLET|60|EA|4.08844|07/20/2016||Yes|No||07/20/2016||Yes|No|07/20/2016||Yes|No||||No|No|||Prescription required|No||535|No|9.13049|01/25/2022|8.91135|01/25/2022|8.9707|01/25/2022|||HYPOGLYCEMICS: SGLT2|4899|||||No|No||BOEHRINGER ING.|No||||
empagliflozin/linagliptin|No|No|No|No|75%|00597018230|GLYXAMBI 10 MG-5 MG TABLET|30|EA|8.17688|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||111|Yes|18.23392|01/25/2022|17.7963|01/25/2022|17.91482|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4900|||||No|No||BOEHRINGER ING.|No||||
empagliflozin/linagliptin|No|No|No|No|75%|00597018239|GLYXAMBI 10 MG-5 MG TABLET|30|EA|8.17688|07/21/2016||Yes|No||07/21/2016||Yes|No|07/21/2016||Yes|No||||No|No|||Prescription required|No||111|Yes|18.23392|01/25/2022|17.7963|01/25/2022|17.91482|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4901|||||No|No||BOEHRINGER ING.|No||||
empagliflozin/linagliptin|No|No|No|No|75%|00597018290|GLYXAMBI 10 MG-5 MG TABLET|90|EA|8.17688|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||111|Yes|18.23392|01/25/2022|17.7963|01/25/2022|17.91482|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4902|||||No|No||BOEHRINGER ING.|No||||
olodaterol HCl|No|No|No|No|75%|00597019261|STRIVERDI RESPIMAT INHAL SPRAY|4|GM|26.10745|09/07/2014||Yes|No||09/07/2014||Yes|No|09/07/2014||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|037|Yes|57.85997|01/25/2022|56.47133|01/25/2022|56.84742|01/25/2022|||BRONCHODILATORS: BETA AGONIST|4903|||||No|No||BOEHRINGER ING.|No||||
glucagon|No|No|No|No|75%|00597026010|GLUCAGEN DIAGNOSTIC 1 MG VIAL|1|EA|73.788|07/16/2015||Yes|No||07/16/2015||Yes|No|07/16/2015||Yes|No||||No|No|||Prescription required|No|||No|168.168|02/28/2017|165.7656|02/28/2017|157.872|02/28/2017||||4904|||||No|No||BOEHRINGER ING.|No||||
linagliptin/metformin HCl|No|No|No|No|75%|00597027073|JENTADUETO XR 2.5 MG-1,000 MG|60|EA|3.6183|02/24/2017||Yes|No||02/24/2017||Yes|No|02/24/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|111|Yes|8.07963|01/25/2022|7.88571|01/25/2022|7.93823|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4905|||||No|No||BOEHRINGER ING.|No||||
linagliptin/metformin HCl|No|No|No|No|75%|00597027094|JENTADUETO XR 2.5 MG-1,000 MG|180|EA|3.6183|02/24/2017||Yes|No||02/24/2017||Yes|No|02/24/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|111|Yes|8.07963|01/25/2022|7.88571|01/25/2022|7.93823|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4906|||||No|No||BOEHRINGER ING.|No||||
linagliptin/metformin HCl|No|No|No|No|75%|00597027533|JENTADUETO XR 5 MG-1,000 MG TB|30|EA|7.23661|02/24/2017||Yes|No||02/24/2017||Yes|No|02/24/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|111|Yes|16.13203|01/25/2022|15.74486|01/25/2022|15.84971|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4907|||||No|No||BOEHRINGER ING.|No||||
linagliptin/metformin HCl|No|No|No|No|75%|00597027581|JENTADUETO XR 5 MG-1,000 MG TB|90|EA|7.23661|02/24/2017||Yes|No||02/24/2017||Yes|No|02/24/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|111|Yes|16.13203|01/25/2022|15.74486|01/25/2022|15.84971|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4908|||||No|No||BOEHRINGER ING.|No||||
empagliflozin/metformin HCl|No|No|No|No|75%|00597028073|SYNJARDY XR 10-1,000 MG TABLET|30|EA|8.17688|01/04/2018||Yes|No||01/04/2018||Yes|No|01/04/2018||Yes|No||||No|No|||Prescription required|Yes|02/01/2018|535|No|18.21337|01/25/2022|17.77624|01/25/2022|17.89463|01/25/2022|||HYPOGLYCEMICS: SGLT2|4909|||||No|No||BOEHRINGER ING.|No||||
empagliflozin/metformin HCl|No|No|No|No|75%|00597028090|SYNJARDY XR 10-1,000 MG TABLET|90|EA|8.17688|01/04/2018||Yes|No||01/04/2018||Yes|No|01/04/2018||Yes|No||||No|No|||Prescription required|Yes|02/01/2018|535|No|18.21337|01/25/2022|17.77624|01/25/2022|17.89463|01/25/2022|||HYPOGLYCEMICS: SGLT2|4910|||||No|No||BOEHRINGER ING.|No||||
pramipexole di-HCl|No|No|No|No|75%|00597028530|MIRAPEX ER 0.75 MG TABLET|30|EA|9.82464|04/12/2010||Yes|No||04/12/2010||Yes|No|04/12/2010||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|21.9612|01/25/2022|21.43413|01/25/2022|21.57687|01/25/2022|||ANTIPARKINSON'S AGENTS|4911|||||No|No||BOEHRINGER ING.|No||||
empagliflozin/metformin HCl|No|No|No|No|75%|00597029059|SYNJARDY XR 5-1,000 MG TABLET|180|EA|4.08844|01/04/2018||Yes|No||01/04/2018||Yes|No|01/04/2018||Yes|No||||No|No|||Prescription required|Yes|02/01/2018|535|No|9.11943|01/25/2022|8.90056|01/25/2022|8.95983|01/25/2022|||HYPOGLYCEMICS: SGLT2|4912|||||No|No||BOEHRINGER ING.|No||||
empagliflozin/metformin HCl|No|No|No|No|75%|00597029074|SYNJARDY XR 5-1,000 MG TABLET|60|EA|4.08844|01/04/2018||Yes|No||01/04/2018||Yes|No|01/04/2018||Yes|No||||No|No|||Prescription required|Yes|02/01/2018|535|No|9.11943|01/25/2022|8.90056|01/25/2022|8.95983|01/25/2022|||HYPOGLYCEMICS: SGLT2|4913|||||No|No||BOEHRINGER ING.|No||||
empagliflozin/metformin HCl|No|No|No|No|75%|00597029578|SYNJARDY XR 25-1,000 MG TABLET|90|EA|8.17688|01/04/2018||Yes|No||01/04/2018||Yes|No|01/04/2018||Yes|No||||No|No|||Prescription required|Yes|02/01/2018|535|No|18.23747|01/25/2022|17.79977|01/25/2022|17.91831|01/25/2022|||HYPOGLYCEMICS: SGLT2|4914|||||No|No||BOEHRINGER ING.|No||||
empagliflozin/metformin HCl|No|No|No|No|75%|00597029588|SYNJARDY XR 25-1,000 MG TABLET|30|EA|8.17688|01/04/2018||Yes|No||01/04/2018||Yes|No|01/04/2018||Yes|No||||No|No|||Prescription required|Yes|02/01/2018|535|No|18.23747|01/25/2022|17.79977|01/25/2022|17.91831|01/25/2022|||HYPOGLYCEMICS: SGLT2|4915|||||No|No||BOEHRINGER ING.|No||||
empagliflozin/metformin HCl|No|No|No|No|75%|00597030045|SYNJARDY XR 12.5-1,000 MG TAB|60|EA|4.08844|01/04/2018||Yes|No||01/04/2018||Yes|No|01/04/2018||Yes|No||||No|No|||Prescription required|Yes|02/01/2018|535|No|9.11406|01/25/2022|8.89532|01/25/2022|8.95456|01/25/2022|||HYPOGLYCEMICS: SGLT2|4916|||||No|No||BOEHRINGER ING.|No||||
empagliflozin/metformin HCl|No|No|No|No|75%|00597030093|SYNJARDY XR 12.5-1,000 MG TAB|180|EA|4.08844|01/04/2018||Yes|No||01/04/2018||Yes|No|01/04/2018||Yes|No||||No|No|||Prescription required|Yes|02/01/2018|535|No|9.11406|01/25/2022|8.89532|01/25/2022|8.95456|01/25/2022|||HYPOGLYCEMICS: SGLT2|4917|||||No|No||BOEHRINGER ING.|No||||
dabigatran etexilate mesylate|No|No|No|No|75%|00597035509|PRADAXA 75 MG CAPSULE|60|EA|3.55466|03/21/2018||Yes|No||03/21/2018||Yes|No|03/21/2018||Yes|No||||No|No|||Prescription required|No||068|Yes|7.92488|01/25/2022|7.73468|01/25/2022|7.78619|01/25/2022|||ANTICOAGULANTS|4918|||||No|No||BOEHRINGER ING.|No||||
dabigatran etexilate mesylate|No|No|No|No|75%|00597035556|PRADAXA 75 MG CAPSULE|60|EA|3.55466|03/21/2018||Yes|No||03/21/2018||Yes|No|03/21/2018||Yes|No||||No|No|||Prescription required|No||068|Yes|7.92488|01/25/2022|7.73468|01/25/2022|7.78619|01/25/2022|||ANTICOAGULANTS|4919|||||No|No||BOEHRINGER ING.|No||||
dabigatran etexilate mesylate|No|No|No|No|75%|00597036055|PRADAXA 150 MG CAPSULE|60|EA|3.55466|03/21/2018||Yes|No||03/21/2018||Yes|No|03/21/2018||Yes|No||||No|No|||Prescription required|No||068|Yes|7.92376|01/25/2022|7.73358|01/25/2022|7.78509|01/25/2022|||ANTICOAGULANTS|4920|||||No|No||BOEHRINGER ING.|No||||
dabigatran etexilate mesylate|No|No|No|No|75%|00597036082|PRADAXA 150 MG CAPSULE|60|EA|3.55466|03/21/2018||Yes|No||03/21/2018||Yes|No|03/21/2018||Yes|No||||No|No|||Prescription required|No||068|Yes|7.92376|01/25/2022|7.73358|01/25/2022|7.78509|01/25/2022|||ANTICOAGULANTS|4921|||||No|No||BOEHRINGER ING.|No||||
empaglifloz/linaglip/metformin|No|No|No|No|75%|00597038013|TRIJARDY XR 10-5-1,000 MG TAB|30|EA|8.17688|11/16/2020||Yes|No||11/16/2020||Yes|No|11/16/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|111|No|18.2174|01/25/2022|17.78018|01/25/2022|17.89859|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4922|||||No|No||BOEHRINGER ING.|No||||
empaglifloz/linaglip/metformin|No|No|No|No|75%|00597038068|TRIJARDY XR 10-5-1,000 MG TAB|90|EA|8.17688|11/16/2020||Yes|No||11/16/2020||Yes|No|11/16/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|111|No|18.2174|01/25/2022|17.78018|01/25/2022|17.89859|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4923|||||No|No||BOEHRINGER ING.|No||||
empaglifloz/linaglip/metformin|No|No|No|No|75%|00597038577|TRIJARDY XR 12.5-2.5-1,000 MG|60|EA|4.08844|11/16/2020||Yes|No||11/16/2020||Yes|No|11/16/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|111|No|9.16814|01/25/2022|8.9481|01/25/2022|9.00769|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4924|||||No|No||BOEHRINGER ING.|No||||
empaglifloz/linaglip/metformin|No|No|No|No|75%|00597038586|TRIJARDY XR 12.5-2.5-1,000 MG|180|EA|4.08844|11/16/2020||Yes|No||11/16/2020||Yes|No|11/16/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|111|No|9.16814|01/25/2022|8.9481|01/25/2022|9.00769|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4925|||||No|No||BOEHRINGER ING.|No||||
empaglifloz/linaglip/metformin|No|No|No|No|75%|00597039013|TRIJARDY XR 25-5-1,000 MG TAB|90|EA|8.17688|11/16/2020||Yes|No||11/16/2020||Yes|No|11/16/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|111|No|18.14669|01/25/2022|17.71116|01/25/2022|17.82912|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4926|||||No|No||BOEHRINGER ING.|No||||
empaglifloz/linaglip/metformin|No|No|No|No|75%|00597039071|TRIJARDY XR 25-5-1,000 MG TAB|30|EA|8.17688|11/16/2020||Yes|No||11/16/2020||Yes|No|11/16/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|111|No|18.14669|01/25/2022|17.71116|01/25/2022|17.82912|01/25/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4927|||||No|No||BOEHRINGER ING.|No||||
empaglifloz/linaglip/metformin|No|No|No|No|75%|00597039523|TRIJARDY XR 5-2.5-1,000 MG TAB|180|EA|4.08844|11/16/2020||Yes|No||11/16/2020||Yes|No|11/16/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|111|No|9.31784|01/18/2022|9.18472|01/18/2022|8.74736|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4928|||||No|No||BOEHRINGER ING.|No||||
empaglifloz/linaglip/metformin|No|No|No|No|75%|00597039582|TRIJARDY XR 5-2.5-1,000 MG TAB|60|EA|4.08844|11/16/2020||Yes|No||11/16/2020||Yes|No|11/16/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|111|No|9.31784|01/18/2022|9.18472|01/18/2022|8.74736|01/18/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|4929|||||No|No||BOEHRINGER ING.|No||||
magnesium oxide|No|No|No|No|75%|00603020922|MAGNESIUM OXIDE 400 MG TABLET|120|EA|.01451|06/23/2005||Yes|No||||No|No|06/23/2005||Yes|No||06/23/2005||Yes|No|||Over the counter|No|||No|.03856|03/29/2022|.03763|03/29/2022|.03788|03/29/2022||||4930|||||No|No||QUALITEST/PAR P|No||||
magnesium oxide|No|No|No|No|75%|00603021321|MAGNESIUM OXIDE 420 MG TABLET|100|EA|.01741|||No|No||||No|No|||No|No||11/20/2009||Yes|No|||Over the counter|No|||No|||||||.4536|06/07/2016||4931|||||No|No||QUALITEST/PAR P|No||||
dicyclomine HCl|No|No|No|No|75%|00603116158|DICYCLOMINE 10 MG/5 ML SOLN|473|ML|.10333|07/28/2005||Yes|No||07/28/2005||Yes|No|07/28/2005||Yes|No||||No|No|||Prescription required|No|||No|.21044|03/29/2022|.20538|03/29/2022|.20675|03/29/2022||||4932|||||No|No||QUALITEST/PAR P|No||||
phenobarbital|No|No|No|No|75%|00603150858|PHENOBARBITAL 20 MG/5 ML ELIX|473|ML|.06496|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No||056|No|.09847|03/29/2022|.0961|03/29/2022|.09674|03/29/2022|||ANTICONVULSANTS|4933|||||No|No||QUALITEST|No||||
potassium chloride|No|No|No|No|75%|00603154258|POTASSIUM CL 10% (20 MEQ/15ML)|473|ML|.16818|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No|||No|.13625|03/29/2022|.13298|03/29/2022|.13386|03/29/2022||||4934|||||No|No||QUALITEST/PAR P|No||||
potassium chloride|No|No|No|No|75%|00603154358|POTASSIUM CL 20% (40 MEQ/15ML)|473|ML|.33636|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No|||No|.44086|03/01/2022|.43027|03/01/2022|.43314|03/01/2022||||4935|||||No|No||QUALITEST/PAR P|No||||
potassium chloride|No|No|No|No|75%|00603155404|POTASSIUM CL 20 MEQ PACKET|100|EA|3.10064|03/08/2017||Yes|No||03/08/2017||Yes|No|03/08/2017||Yes|No||||No|No|||Prescription required|No|||No|2.51484|03/29/2022|2.45448|03/29/2022|2.47083|03/29/2022||||4936|||||No|No||QUALITEST/PAR P|No||||
potassium chloride|No|No|No|No|75%|00603155416|POTASSIUM CL 20 MEQ PACKET|30|EA|3.2637|03/08/2017||Yes|No||03/08/2017||Yes|No|03/08/2017||Yes|No||||No|No|||Prescription required|No|||No|2.51484|03/29/2022|2.45448|03/29/2022|2.47083|03/29/2022||||4937|||||No|No||QUALITEST/PAR P|No||||
lidocaine|No|No|No|No|75%|00603188016|LIDOCAINE 5% PATCH|30|EA|3.21984|05/15/2014||Yes|No||05/15/2014||Yes|No|05/15/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|232|No|2.00634|03/29/2022|1.95818|03/29/2022|1.97122|03/29/2022|||NEUROPATHIC PAIN|4938|||||No|No||QUALITEST/PAR P|No||||
allopurinol|No|No|No|No|75%|00603211521|ALLOPURINOL 100 MG TABLET|100|EA|.13506|08/19/2003||Yes|No||08/19/2003||Yes|No|08/19/2003||Yes|No||08/19/2003||Yes|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|4939|||||No|No||QUALITEST/PAR P|No||||
allopurinol|No|No|No|No|75%|00603211532|ALLOPURINOL 100 MG TABLET|1000|EA|.12198|08/19/2003||Yes|No||08/19/2003||Yes|No|08/19/2003||Yes|No||08/19/2003||Yes|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|4940|||||No|No||QUALITEST/PAR P|No||||
allopurinol|No|No|No|No|75%|00603211621|ALLOPURINOL 300 MG TABLET|100|EA|.25812|08/19/2003||Yes|No||08/19/2003||Yes|No|08/19/2003||Yes|No||08/19/2003||Yes|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|4941|||||No|No||QUALITEST/PAR P|No||||
allopurinol|No|No|No|No|75%|00603211628|ALLOPURINOL 300 MG TABLET|500|EA|.24512|08/19/2003||Yes|No||08/19/2003||Yes|No|08/19/2003||Yes|No||08/19/2003||Yes|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|4942|||||No|No||QUALITEST/PAR P|No||||
allopurinol|No|No|No|No|75%|00603211632|ALLOPURINOL 300 MG TABLET|1000|EA|.23285|04/12/2004||Yes|No||04/12/2004||Yes|No|04/12/2004||Yes|No||||No|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|4943|||||No|No||QUALITEST/PAR P|No||||
amitriptyline HCl|No|No|No|No|75%|00603221221|AMITRIPTYLINE HCL 10 MG TAB|100|EA|.06153|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||215|No|.04811|03/29/2022|.04695|03/29/2022|.04726|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|4944|||||No|No||QUALITEST/PAR P|No||||
amitriptyline HCl|No|No|No|No|75%|00603221232|AMITRIPTYLINE HCL 10 MG TAB|1000|EA|.05835|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||215|No|.04811|03/29/2022|.04695|03/29/2022|.04726|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|4945|||||No|No||QUALITEST/PAR P|No||||
amitriptyline HCl|No|No|No|No|75%|00603221321|AMITRIPTYLINE HCL 25 MG TAB|100|EA|.12306|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||215|No|.07343|03/29/2022|.07166|03/29/2022|.07214|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|4946|||||No|No||QUALITEST/PAR P|No||||
amitriptyline HCl|No|No|No|No|75%|00603221332|AMITRIPTYLINE HCL 25 MG TAB|1000|EA|.11671|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||215|No|.07343|03/29/2022|.07166|03/29/2022|.07214|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|4947|||||No|No||QUALITEST/PAR P|No||||
amitriptyline HCl|No|No|No|No|75%|00603221421|AMITRIPTYLINE HCL 50 MG TAB|100|EA|.24574|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||215|No|.14797|03/29/2022|.14441|03/29/2022|.14538|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|4948|||||No|No||QUALITEST/PAR P|No||||
amitriptyline HCl|No|No|No|No|75%|00603221432|AMITRIPTYLINE HCL 50 MG TAB|1000|EA|.20425|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||215|No|.14797|03/29/2022|.14441|03/29/2022|.14538|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|4949|||||No|No||QUALITEST/PAR P|No||||
amitriptyline HCl|No|No|No|No|75%|00603221521|AMITRIPTYLINE HCL 75 MG TAB|100|EA|.36919|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||215|No|.26194|03/29/2022|.25565|03/29/2022|.25735|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|4950|||||No|No||QUALITEST/PAR P|No||||
amitriptyline HCl|No|No|No|No|75%|00603221621|AMITRIPTYLINE HCL 100 MG TAB|100|EA|.49149|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||215|No|.30607|03/29/2022|.29872|03/29/2022|.30071|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|4951|||||No|No||QUALITEST/PAR P|No||||
amitriptyline HCl|No|No|No|No|75%|00603221721|AMITRIPTYLINE HCL 150 MG TAB|100|EA|.73723|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||215|No|.58201|03/29/2022|.56804|03/29/2022|.57182|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|4952|||||No|No||QUALITEST/PAR P|No||||
acetaminophen with codeine|No|No|No|No|90%|00603233721|ACETAMINOPHEN-COD #2 TABLET|100|EA|.18111|03/01/2002|01/31/2023|Yes|No||03/01/2002|01/31/2023|Yes|No|03/01/2002|01/31/2023|Yes|No||03/01/2002|01/31/2023|Yes|No|||Prescription required|No||109|Yes|.11854|03/29/2022|.11569|03/29/2022|.11646|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4953|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||QUALITEST/PAR P|No||||
acetaminophen with codeine|No|No|No|No|90%|00603233821|ACETAMINOPHEN-COD #3 TABLET|100|EA|.18111|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.10921|03/29/2022|.10658|03/29/2022|.10729|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4954|||||No|No||QUALITEST/PAR P|No||||
acetaminophen with codeine|No|No|No|No|90%|00603233832|ACETAMINOPHEN-COD #3 TABLET|1000|EA|.17202|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.10921|03/29/2022|.10658|03/29/2022|.10729|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4955|||||No|No||QUALITEST/PAR P|No||||
acetaminophen with codeine|No|No|No|No|90%|00603233921|ACETAMINOPHEN-COD #4 TABLET|100|EA|.35604|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.22352|03/29/2022|.21815|03/29/2022|.2196|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4956|||||No|No||QUALITEST/PAR P|No||||
acetaminophen with codeine|No|No|No|No|90%|00603233928|ACETAMINOPHEN-COD #4 TABLET|500|EA|.32043|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.22352|03/29/2022|.21815|03/29/2022|.2196|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4957|||||No|No||QUALITEST/PAR P|No||||
baclofen|No|No|No|No|75%|00603240621|BACLOFEN 10 MG TABLET|100|EA|.0774|03/07/2017||Yes|No||03/07/2017||Yes|No|03/07/2017||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4958|||||No|No||QUALITEST/PAR P|No||||
baclofen|No|No|No|No|75%|00603240628|BACLOFEN 10 MG TABLET|500|EA|.07507|03/07/2017||Yes|No||03/07/2017||Yes|No|03/07/2017||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4959|||||No|No||QUALITEST/PAR P|No||||
baclofen|No|No|No|No|75%|00603240632|BACLOFEN 10 MG TABLET|1000|EA|.08092|03/07/2017||Yes|No||03/07/2017||Yes|No|03/07/2017||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4960|||||No|No||QUALITEST/PAR P|No||||
baclofen|No|No|No|No|75%|00603240721|BACLOFEN 20 MG TABLET|100|EA|.1548|03/07/2017||Yes|No||03/07/2017||Yes|No|03/07/2017||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4961|||||No|No||QUALITEST/PAR P|No||||
baclofen|No|No|No|No|75%|00603240728|BACLOFEN 20 MG TABLET|500|EA|.14706|03/07/2017||Yes|No||03/07/2017||Yes|No|03/07/2017||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4962|||||No|No||QUALITEST/PAR P|No||||
baclofen|No|No|No|No|75%|00603240732|BACLOFEN 20 MG TABLET|1000|EA|.1397|03/07/2017||Yes|No||03/07/2017||Yes|No|03/07/2017||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|4963|||||No|No||QUALITEST/PAR P|No||||
benztropine mesylate|No|No|No|No|75%|00603243721|BENZTROPINE MES 0.5 MG TAB|100|EA|.05959|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|No||015|No|.08426|03/29/2022|.08223|03/29/2022|.08278|03/29/2022|||ANTIPARKINSON'S AGENTS|4964|||||No|No||QUALITEST/PAR P|No||||
benztropine mesylate|No|No|No|No|75%|00603243732|BENZTROPINE MES 0.5 MG TAB|1000|EA|.05634|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|No||015|No|.08426|03/29/2022|.08223|03/29/2022|.08278|03/29/2022|||ANTIPARKINSON'S AGENTS|4965|||||No|No||QUALITEST/PAR P|No||||
benztropine mesylate|No|No|No|No|75%|00603243821|BENZTROPINE MES 1 MG TABLET|100|EA|.06888|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|No||015|No|.08541|03/29/2022|.08336|03/29/2022|.08391|03/29/2022|||ANTIPARKINSON'S AGENTS|4966|||||No|No||QUALITEST/PAR P|No||||
benztropine mesylate|No|No|No|No|75%|00603243832|BENZTROPINE MES 1 MG TABLET|1000|EA|.06544|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|No||015|No|.08541|03/29/2022|.08336|03/29/2022|.08391|03/29/2022|||ANTIPARKINSON'S AGENTS|4967|||||No|No||QUALITEST/PAR P|No||||
benztropine mesylate|No|No|No|No|75%|00603243921|BENZTROPINE MES 2 MG TABLET|100|EA|.08784|11/13/2017||Yes|No||11/13/2017||Yes|No|11/13/2017||Yes|No||||No|No|||Prescription required|No||015|No|.12012|03/29/2022|.11723|03/29/2022|.11801|03/29/2022|||ANTIPARKINSON'S AGENTS|4968|||||No|No||QUALITEST/PAR P|No||||
benztropine mesylate|No|No|No|No|75%|00603243932|BENZTROPINE MES 2 MG TABLET|1000|EA|.08343|11/13/2017||Yes|No||11/13/2017||Yes|No|11/13/2017||Yes|No||||No|No|||Prescription required|No||015|No|.12012|03/29/2022|.11723|03/29/2022|.11801|03/29/2022|||ANTIPARKINSON'S AGENTS|4969|||||No|No||QUALITEST/PAR P|No||||
butalbital/acetaminophen|No|No|No|No|75%|00603254021|BUTALBITAL-ACETAMINOPHN 50-325|100|EA|.53754|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.8699|03/29/2022|.84902|03/29/2022|.85467|03/29/2022||||4970|||||No|No||QUALITEST/PAR P|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|00603254421|BUTALB-ACETAMIN-CAFF 50-325-40|100|EA|.48297|08/17/2004||Yes|No||08/17/2004||Yes|No|08/17/2004||Yes|No||||No|No|||Prescription required|No|||No|.18524|03/29/2022|.18079|03/29/2022|.18199|03/29/2022||||4971|||||No|No||QUALITEST/PAR P|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|00603254428|BUTALB-ACETAMIN-CAFF 50-325-40|500|EA|.45867|01/18/2005||Yes|No||01/18/2005||Yes|No|||No|No||||No|No|||Prescription required|No|||No|.18524|03/29/2022|.18079|03/29/2022|.18199|03/29/2022||||4972|||||No|No||QUALITEST/PAR P|No||||
butalbit/acetamin/caff/codeine|No|No|No|No|90%|00603255321|BUTALB-ACETAMIN-CAF-COD 50-325|100|EA|.49149|05/13/2002||Yes|No||05/13/2002||Yes|No|05/13/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|109|Yes|.68873|03/29/2022|.6722|03/29/2022|.67667|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4973|||||No|No||QUALITEST/PAR P|No||||
felodipine|Yes|No|No|No|75%|00603358121|FELODIPINE ER 2.5 MG TABLET|100|EA|.23994|04/09/2012||Yes|No||04/09/2012||Yes|No|04/09/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.25478|03/29/2022|.24866|03/29/2022|.25032|03/29/2022|||CALCIUM CHANNEL BLOCKERS|4974|||||No|No||QUALITEST/PAR P|No||||
felodipine|Yes|No|No|No|75%|00603358128|FELODIPINE ER 2.5 MG TABLET|500|EA|.22794|04/09/2012||Yes|No||04/09/2012||Yes|No|04/09/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.25478|03/29/2022|.24866|03/29/2022|.25032|03/29/2022|||CALCIUM CHANNEL BLOCKERS|4975|||||No|No||QUALITEST/PAR P|No||||
felodipine|Yes|No|No|No|75%|00603358221|FELODIPINE ER 5 MG TABLET|100|EA|.24071|04/09/2012||Yes|No||04/09/2012||Yes|No|04/09/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.17388|03/29/2022|.1697|03/29/2022|.17083|03/29/2022|||CALCIUM CHANNEL BLOCKERS|4976|||||No|No||QUALITEST/PAR P|No||||
felodipine|Yes|No|No|No|75%|00603358228|FELODIPINE ER 5 MG TABLET|500|EA|.22871|04/09/2012||Yes|No||04/09/2012||Yes|No|04/09/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.17388|03/29/2022|.1697|03/29/2022|.17083|03/29/2022|||CALCIUM CHANNEL BLOCKERS|4977|||||No|No||QUALITEST/PAR P|No||||
felodipine|Yes|No|No|No|75%|00603358321|FELODIPINE ER 10 MG TABLET|100|EA|.34984|04/09/2012||Yes|No||04/09/2012||Yes|No|04/09/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||045|No|.22814|03/29/2022|.22266|03/29/2022|.22414|03/29/2022|||CALCIUM CHANNEL BLOCKERS|4978|||||No|No||QUALITEST/PAR P|No||||
felodipine|Yes|No|No|No|75%|00603358328|FELODIPINE ER 10 MG TABLET|500|EA|.33235|04/09/2012||Yes|No||04/09/2012||Yes|No|04/09/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||045|No|.22814|03/29/2022|.22266|03/29/2022|.22414|03/29/2022|||CALCIUM CHANNEL BLOCKERS|4979|||||No|No||QUALITEST/PAR P|No||||
hydrocodone/ibuprofen|No|No|No|No|90%|00603358421|HYDROCODONE-IBUPROFEN 5-200 MG|100|EA|1.22679|03/09/2018|01/04/2023|Yes|No||03/09/2018|01/04/2023|Yes|No|03/09/2018|01/04/2023|Yes|No||||No|No|||Prescription required|No||109|Yes|2.79594|08/29/2017|2.75599|08/29/2017|2.62476|08/29/2017|||ANALGESICS: NARCOTICS SHORT|4980|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||QUALITEST/PAR P|No||||
hydrocodone/ibuprofen|No|No|No|No|90%|00603358621|HYDROCODONE-IBUPROFEN 10-200|100|EA|1.618|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|3.42647|03/01/2022|3.34423|03/01/2022|3.3665|03/01/2022|||ANALGESICS: NARCOTICS SHORT|4981|||||No|No||QUALITEST/PAR P|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00603388728|HYDROCODONE-ACETAMIN 10-325 MG|500|EA|.1887|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4982|||||No|No||QUALITEST/PAR P|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00603388732|HYDROCODONE-ACETAMIN 10-325 MG|1000|EA|.17925|10/15/2003||Yes|No||10/15/2003||Yes|No|10/15/2003||Yes|No||10/15/2003||Yes|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4983|||||No|No||QUALITEST/PAR P|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00603389028|HYDROCODONE-ACETAMIN 5-325 MG|500|EA|.16462|06/24/2009||Yes|No||06/24/2009||Yes|No|06/24/2009||Yes|No||06/24/2009||Yes|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4984|||||No|No||QUALITEST/PAR P|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00603389032|HYDROCODONE-ACETAMIN 5-325 MG|1000|EA|.15638|05/19/2011||Yes|No||05/19/2011||Yes|No|05/19/2011||Yes|No||05/19/2011||Yes|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4985|||||No|No||QUALITEST/PAR P|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00603389128|HYDROCODONE-ACETAMIN 7.5-325|500|EA|.1798|06/22/2009||Yes|No||06/22/2009||Yes|No|06/22/2009||Yes|No||06/22/2009||Yes|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4986|||||No|No||QUALITEST/PAR P|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|00603389132|HYDROCODONE-ACETAMIN 7.5-325|1000|EA|.17082|05/19/2011||Yes|No||05/19/2011||Yes|No|05/19/2011||Yes|No||05/19/2011||Yes|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4987|||||No|No||QUALITEST/PAR P|No||||
hydrocodone/ibuprofen|No|No|No|No|90%|00603389721|HYDROCODONE-IBUPROFEN 7.5-200|100|EA|.17608|11/29/2006||Yes|No||11/29/2006||Yes|No|11/29/2006||Yes|No||||No|No|||Prescription required|No||109|Yes|.19819|03/29/2022|.19343|03/29/2022|.19472|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4988|||||No|No||QUALITEST/PAR P|No||||
hydrocodone/ibuprofen|No|No|No|No|90%|00603389728|HYDROCODONE-IBUPROFEN 7.5-200|500|EA|.17241|05/15/2008|11/30/2022|Yes|No||05/15/2008|11/30/2022|Yes|No|05/15/2008|11/30/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|.19819|03/29/2022|.19343|03/29/2022|.19472|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4989|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||QUALITEST/PAR P|No||||
methylprednisolone|No|No|No|No|75%|00603459315|METHYLPREDNISOLONE 4 MG DOSEPK|21|EA|.4902|07/06/2006||Yes|No||07/06/2006||Yes|No|07/06/2006||Yes|No||07/06/2006||Yes|No|||Prescription required|No||168|Yes|.17447|03/29/2022|.17028|03/29/2022|.17141|03/29/2022|||GLUCOCORTICOIDS: ORAL|4990|||||No|No||PAR PHARM.|No||||
methylprednisolone|No|No|No|No|75%|00603459321|METHYLPREDNISOLONE 4 MG TABLET|100|EA|.49149|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|01/15/2014|168|Yes|.21195|03/29/2022|.20686|03/29/2022|.20824|03/29/2022|||GLUCOCORTICOIDS: ORAL|4991|||||No|No||PAR PHARM.|No||||
oxybutynin chloride|No|No|No|No|75%|00603497521|OXYBUTYNIN 5 MG TABLET|100|EA|.20898|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|4992|||||No|No||PAR PHARM.|No||||
oxybutynin chloride|No|No|No|No|75%|00603497528|OXYBUTYNIN 5 MG TABLET|500|EA|.19853|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|4993|||||No|No||PAR PHARM.|No||||
oxybutynin chloride|No|No|No|No|75%|00603497532|OXYBUTYNIN 5 MG TABLET|1000|EA|.18862|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|4994|||||No|No||PAR PHARM.|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|00603497821|OXYCODONE-ACETAMINOPHN 2.5-325|100|EA|.70085|01/16/2014|10/31/2022|Yes|No||01/16/2014|10/31/2022|Yes|No|01/16/2014|10/31/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|1.39948|03/29/2022|1.36589|03/29/2022|1.37498|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4995|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||PAR PHARM.|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|00603497921|OXYCODONE-ACETAMINOPHN 7.5-325|100|EA|.31463|01/16/2014|10/31/2022|Yes|No||01/16/2014|10/31/2022|Yes|No|01/16/2014|10/31/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|.14032|03/29/2022|.13695|03/29/2022|.13786|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4996|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||QUALITEST/PAR P|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|00603497928|OXYCODONE-ACETAMINOPHN 7.5-325|500|EA|.31463|01/16/2014|10/31/2022|Yes|No||01/16/2014|10/31/2022|Yes|No|01/16/2014|10/31/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|.14032|03/29/2022|.13695|03/29/2022|.13786|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4997|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||QUALITEST/PAR P|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|00603498221|OXYCODONE-ACETAMINOPHEN 10-325|100|EA|.3572|01/16/2014|10/31/2022|Yes|No||01/16/2014|10/31/2022|Yes|No|01/16/2014|10/31/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|.19233|03/29/2022|.18771|03/29/2022|.18896|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4998|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||QUALITEST/PAR P|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|00603498228|OXYCODONE-ACETAMINOPHEN 10-325|500|EA|.3572|01/16/2014|10/31/2022|Yes|No||01/16/2014|10/31/2022|Yes|No|01/16/2014|10/31/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|.19233|03/29/2022|.18771|03/29/2022|.18896|03/29/2022|||ANALGESICS: NARCOTICS SHORT|4999|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||QUALITEST/PAR P|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|00603499821|OXYCODONE-ACETAMINOPHEN 5-325|100|EA|.09481|03/01/2002|11/30/2022|Yes|No||03/01/2002|11/30/2022|Yes|No|03/01/2002|11/30/2022|Yes|No||03/01/2002|11/30/2022|Yes|No|||Prescription required|No||109|Yes|.09091|03/29/2022|.08872|03/29/2022|.08931|03/29/2022|||ANALGESICS: NARCOTICS SHORT|5000|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||QUALITEST/PAR P|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|00603499828|OXYCODONE-ACETAMINOPHEN 5-325|500|EA|.08947|03/01/2002|11/30/2022|Yes|No||03/01/2002|11/30/2022|Yes|No|03/01/2002|11/30/2022|Yes|No||03/01/2002|11/30/2022|Yes|No|||Prescription required|No||109|Yes|.09091|03/29/2022|.08872|03/29/2022|.08931|03/29/2022|||ANALGESICS: NARCOTICS SHORT|5001|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||QUALITEST/PAR P|No||||
perphenazine|No|No|No|No|75%|00603506021|PERPHENAZINE 2 MG TABLET|100|EA|.40054|08/23/2012||Yes|No||08/23/2012||Yes|No|08/23/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.31906|03/29/2022|.3114|03/29/2022|.31347|03/29/2022|||ANTIPSYCHOTICS|5002|||||No|No||QUALITEST/PAR P|No||||
perphenazine|No|No|No|No|75%|00603506121|PERPHENAZINE 4 MG TABLET|100|EA|.54799|05/07/2012||Yes|No||05/07/2012||Yes|No|05/07/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.32485|03/29/2022|.31705|03/29/2022|.31916|03/29/2022|||ANTIPSYCHOTICS|5003|||||No|No||QUALITEST/PAR P|No||||
perphenazine|No|No|No|No|75%|00603506128|PERPHENAZINE 4 MG TABLET|500|EA|.52059|05/07/2012||Yes|No||05/07/2012||Yes|No|05/07/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.32485|03/29/2022|.31705|03/29/2022|.31916|03/29/2022|||ANTIPSYCHOTICS|5004|||||No|No||QUALITEST/PAR P|No||||
perphenazine|No|No|No|No|75%|00603506221|PERPHENAZINE 8 MG TABLET|100|EA|.6637|05/21/2012||Yes|No||05/21/2012||Yes|No|05/21/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.48127|03/29/2022|.46971|03/29/2022|.47284|03/29/2022|||ANTIPSYCHOTICS|5005|||||No|No||QUALITEST/PAR P|No||||
perphenazine|No|No|No|No|75%|00603506228|PERPHENAZINE 8 MG TABLET|500|EA|.6305|05/21/2012||Yes|No||05/21/2012||Yes|No|05/21/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.48127|03/29/2022|.46971|03/29/2022|.47284|03/29/2022|||ANTIPSYCHOTICS|5006|||||No|No||QUALITEST/PAR P|No||||
perphenazine|No|No|No|No|75%|00603506321|PERPHENAZINE 16 MG TABLET|100|EA|.89435|05/21/2012||Yes|No||05/21/2012||Yes|No|05/21/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.69746|03/29/2022|.68072|03/29/2022|.68525|03/29/2022|||ANTIPSYCHOTICS|5007|||||No|No||QUALITEST/PAR P|No||||
phenobarbital|No|No|No|No|75%|00603516521|PHENOBARBITAL 16.2 MG TABLET|100|EA|.18382|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No||056|No|.22712|03/29/2022|.22166|03/29/2022|.22314|03/29/2022|||ANTICONVULSANTS|5008|||||No|No||QUALITEST/PAR P|No||||
phenobarbital|No|No|No|No|75%|00603516532|PHENOBARBITAL 16.2 MG TABLET|1000|EA|.17542|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No||056|No|.22712|03/29/2022|.22166|03/29/2022|.22314|03/29/2022|||ANTICONVULSANTS|5009|||||No|No||QUALITEST/PAR P|No||||
phenobarbital|No|No|No|No|75%|00603516621|PHENOBARBITAL 32.4 MG TABLET|100|EA|.2322|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||09/07/2015||Yes|No|||Prescription required|No||056|No|.30495|03/29/2022|.29763|03/29/2022|.29961|03/29/2022|||ANTICONVULSANTS|5010|||||No|No||QUALITEST/PAR P|No||||
phenobarbital|No|No|No|No|75%|00603516632|PHENOBARBITAL 32.4 MG TABLET|1000|EA|.22059|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||09/07/2015||Yes|No|||Prescription required|No||056|No|.30495|03/29/2022|.29763|03/29/2022|.29961|03/29/2022|||ANTICONVULSANTS|5011|||||No|No||QUALITEST/PAR P|No||||
phenobarbital|No|No|No|No|75%|00603516721|PHENOBARBITAL 64.8 MG TABLET|100|EA|.29025|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||09/07/2015||Yes|No|||Prescription required|No||056|No|.38211|03/29/2022|.37293|03/29/2022|.37542|03/29/2022|||ANTICONVULSANTS|5012|||||No|No||QUALITEST/PAR P|No||||
phenobarbital|No|No|No|No|75%|00603516732|PHENOBARBITAL 64.8 MG TABLET|1000|EA|.27589|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||09/07/2015||Yes|No|||Prescription required|No||056|No|.38211|03/29/2022|.37293|03/29/2022|.37542|03/29/2022|||ANTICONVULSANTS|5013|||||No|No||QUALITEST/PAR P|No||||
phenobarbital|No|No|No|No|75%|00603516821|PHENOBARBITAL 97.2 MG TABLET|100|EA|.40944|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No||056|No|.45635|03/29/2022|.44539|03/29/2022|.44836|03/29/2022|||ANTICONVULSANTS|5014|||||No|No||QUALITEST/PAR P|No||||
phenobarbital|No|No|No|No|75%|00603516832|PHENOBARBITAL 97.2 MG TABLET|1000|EA|.38878|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No||056|No|.45635|03/29/2022|.44539|03/29/2022|.44836|03/29/2022|||ANTICONVULSANTS|5015|||||No|No||QUALITEST/PAR P|No||||
prednisone|No|No|No|No|75%|00603533521|PREDNISONE 1 MG TABLET|100|EA|.08707|05/31/2005||Yes|No||05/31/2005||Yes|No|05/31/2005||Yes|No||||No|No|||Prescription required|No||168|Yes|.08042|03/29/2022|.07848|03/29/2022|.07901|03/29/2022|||GLUCOCORTICOIDS: ORAL|5016|||||No|No||QUALITEST/PAR P|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00603533532|PREDNISONE 1 MG TABLET|1000|EA|.08274|05/31/2005||Yes|No||05/31/2005||Yes|No|05/31/2005||Yes|No||||No|No|||Prescription required|No||168|Yes|.08042|03/29/2022|.07848|03/29/2022|.07901|03/29/2022|||GLUCOCORTICOIDS: ORAL|5017|||||No|No||QUALITEST/PAR P|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00603533621|PREDNISONE 2.5 MG TABLET|100|EA|.05688|05/31/2005||Yes|No||05/31/2005||Yes|No|05/31/2005||Yes|No||||No|No|||Prescription required|No||168|Yes|.09048|03/29/2022|.0883|03/29/2022|.08889|03/29/2022|||GLUCOCORTICOIDS: ORAL|5018|||||No|No||QUALITEST/PAR P|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00603533715|PREDNISONE 5 MG TAB DOSE PACK|21|EA|.27642|04/07/2017||Yes|No||04/07/2017||Yes|No|04/07/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|168|Yes|.39414|03/29/2022|.38468|03/29/2022|.38724|03/29/2022|||GLUCOCORTICOIDS: ORAL|5019|||||No|No||QUALITEST/PAR P|No||||
prednisone|No|No|No|No|75%|00603533721|PREDNISONE 5 MG TABLET|100|EA|.07004|02/12/2003||Yes|No||02/12/2003||Yes|No|02/12/2003||Yes|No||02/12/2003||Yes|No|||Prescription required|No||168|Yes|.07803|03/29/2022|.07615|03/29/2022|.07666|03/29/2022|||GLUCOCORTICOIDS: ORAL|5020|||||No|No||QUALITEST/PAR P|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00603533731|PREDNISONE 5 MG TAB DOSE PACK|48|EA|.19995|04/07/2017||Yes|No||04/07/2017||Yes|No|04/07/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|168|Yes|.39414|03/29/2022|.38468|03/29/2022|.38724|03/29/2022|||GLUCOCORTICOIDS: ORAL|5021|||||No|No||QUALITEST/PAR P|No||||
prednisone|No|No|No|No|75%|00603533732|PREDNISONE 5 MG TABLET|1000|EA|.06931|02/12/2003||Yes|No||02/12/2003||Yes|No|02/12/2003||Yes|No||02/12/2003||Yes|No|||Prescription required|No||168|Yes|.07803|03/29/2022|.07615|03/29/2022|.07666|03/29/2022|||GLUCOCORTICOIDS: ORAL|5022|||||No|No||QUALITEST/PAR P|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00603533815|PREDNISONE 10 MG TAB DOSE PACK|21|EA|.4773|04/07/2017||Yes|No||04/07/2017||Yes|No|04/07/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|168|Yes|.66148|03/29/2022|.6456|03/29/2022|.6499|03/29/2022|||GLUCOCORTICOIDS: ORAL|5023|||||No|No||QUALITEST/PAR P|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00603533821|PREDNISONE 10 MG TABLET|100|EA|.07507|02/18/2003||Yes|No||02/18/2003||Yes|No|02/18/2003||Yes|No||02/18/2003||Yes|No|||Prescription required|No||168|Yes|.07092|03/29/2022|.06921|03/29/2022|.06967|03/29/2022|||GLUCOCORTICOIDS: ORAL|5024|||||No|No||QUALITEST/PAR P|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00603533828|PREDNISONE 10 MG TABLET|500|EA|.07507|10/21/2003||Yes|No||10/21/2003||Yes|No|10/21/2003||Yes|No||||No|No|||Prescription required|No||168|Yes|.07092|03/29/2022|.06921|03/29/2022|.06967|03/29/2022|||GLUCOCORTICOIDS: ORAL|5025|||||No|No||QUALITEST/PAR P|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00603533831|PREDNISONE 10 MG TAB DOSE PACK|48|EA|.2967|04/07/2017||Yes|No||04/07/2017||Yes|No|04/07/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|168|Yes|.66148|03/29/2022|.6456|03/29/2022|.6499|03/29/2022|||GLUCOCORTICOIDS: ORAL|5026|||||No|No||QUALITEST/PAR P|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00603533832|PREDNISONE 10 MG TABLET|1000|EA|.07442|02/18/2003||Yes|No||02/18/2003||Yes|No|02/18/2003||Yes|No||02/18/2003||Yes|No|||Prescription required|No||168|Yes|.07092|03/29/2022|.06921|03/29/2022|.06967|03/29/2022|||GLUCOCORTICOIDS: ORAL|5027|||||No|No||QUALITEST/PAR P|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00603533921|PREDNISONE 20 MG TABLET|100|EA|.08901|09/17/2003||Yes|No||09/17/2003||Yes|No|09/17/2003||Yes|No||||No|No|||Prescription required|No||168|Yes|.11229|03/29/2022|.10959|03/29/2022|.11032|03/29/2022|||GLUCOCORTICOIDS: ORAL|5028|||||No|No||QUALITEST/PAR P|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00603533928|PREDNISONE 20 MG TABLET|500|EA|.08823|09/17/2003||Yes|No||09/17/2003||Yes|No|09/17/2003||Yes|No||||No|No|||Prescription required|No||168|Yes|.11229|03/29/2022|.10959|03/29/2022|.11032|03/29/2022|||GLUCOCORTICOIDS: ORAL|5029|||||No|No||QUALITEST/PAR P|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|00603533932|PREDNISONE 20 MG TABLET|1000|EA|.08556|09/17/2003||Yes|No||09/17/2003||Yes|No|09/17/2003||Yes|No||||No|No|||Prescription required|No||168|Yes|.11229|03/29/2022|.10959|03/29/2022|.11032|03/29/2022|||GLUCOCORTICOIDS: ORAL|5030|||||No|No||QUALITEST/PAR P|Yes|09/01/2020|||
propafenone HCl|No|No|No|No|75%|00603544821|PROPAFENONE HCL 150 MG TABLET|100|EA|.10023|05/31/2005||Yes|No||05/31/2005||Yes|No|05/31/2005||Yes|No||||No|No|||Prescription required|No|||No|.14292|03/29/2022|.13948|03/29/2022|.14041|03/29/2022||||5031|||||No|No||QUALITEST/PAR P|No||||
propafenone HCl|No|No|No|No|75%|00603544825|PROPAFENONE HCL 150 MG TABLET|300|EA|.0972|05/31/2005||Yes|No||05/31/2005||Yes|No|05/31/2005||Yes|No||||No|No|||Prescription required|No|||No|.14292|03/29/2022|.13948|03/29/2022|.14041|03/29/2022||||5032|||||No|No||QUALITEST/PAR P|No||||
propafenone HCl|No|No|No|No|75%|00603544921|PROPAFENONE HCL 225 MG TAB|100|EA|.16524|05/31/2005||Yes|No||05/31/2005||Yes|No|05/31/2005||Yes|No||||No|No|||Prescription required|No|||No|.20774|03/29/2022|.20275|03/29/2022|.2041|03/29/2022||||5033|||||No|No||QUALITEST/PAR P|No||||
propafenone HCl|No|No|No|No|75%|00603544925|PROPAFENONE HCL 225 MG TAB|300|EA|.15686|08/23/2012||Yes|No||08/23/2012||Yes|No|08/23/2012||Yes|No||||No|No|||Prescription required|No|||No|.20774|03/29/2022|.20275|03/29/2022|.2041|03/29/2022||||5034|||||No|No||QUALITEST/PAR P|No||||
propafenone HCl|No|No|No|No|75%|00603545021|PROPAFENONE HCL 300 MG TAB|100|EA|.46384|05/31/2005||Yes|No||05/31/2005||Yes|No|05/31/2005||Yes|No||||No|No|||Prescription required|No|||No|.57288|01/25/2022|.55913|01/25/2022|.56285|01/25/2022||||5035|||||No|No||QUALITEST/PAR P|No||||
propranolol HCl|No|No|No|No|75%|00603548221|PROPRANOLOL 10 MG TABLET|100|EA|.06888|07/02/2010||Yes|No||07/02/2010||Yes|No|07/02/2010||Yes|No||||No|No|||Prescription required|No||070|No|.06946|03/29/2022|.06779|03/29/2022|.06824|03/29/2022|||BETA-BLOCKERS|5036|||||No|No||QUALITEST/PAR P|No||||
propranolol HCl|No|No|No|No|75%|00603548232|PROPRANOLOL 10 MG TABLET|1000|EA|.06888|07/02/2010||Yes|No||07/02/2010||Yes|No|07/02/2010||Yes|No||||No|No|||Prescription required|No||070|No|.06946|03/29/2022|.06779|03/29/2022|.06824|03/29/2022|||BETA-BLOCKERS|5037|||||No|No||QUALITEST/PAR P|No||||
propranolol HCl|No|No|No|No|75%|00603548321|PROPRANOLOL 20 MG TABLET|100|EA|.08591|07/02/2010||Yes|No||07/02/2010||Yes|No|07/02/2010||Yes|No||||No|No|||Prescription required|No||070|No|.08469|03/29/2022|.08265|03/29/2022|.0832|03/29/2022|||BETA-BLOCKERS|5038|||||No|No||QUALITEST/PAR P|No||||
propranolol HCl|No|No|No|No|75%|00603548332|PROPRANOLOL 20 MG TABLET|1000|EA|.08599|07/02/2010||Yes|No||07/02/2010||Yes|No|07/02/2010||Yes|No||||No|No|||Prescription required|No||070|No|.08469|03/29/2022|.08265|03/29/2022|.0832|03/29/2022|||BETA-BLOCKERS|5039|||||No|No||QUALITEST/PAR P|No||||
propranolol HCl|No|No|No|No|75%|00603548421|PROPRANOLOL 40 MG TABLET|100|EA|.10913|07/02/2010||Yes|No||07/02/2010||Yes|No|07/02/2010||Yes|No||||No|No|||Prescription required|No||070|No|.11538|03/29/2022|.11261|03/29/2022|.11336|03/29/2022|||BETA-BLOCKERS|5040|||||No|No||QUALITEST/PAR P|No||||
propranolol HCl|No|No|No|No|75%|00603548432|PROPRANOLOL 40 MG TABLET|1000|EA|.10913|07/02/2010||Yes|No||07/02/2010||Yes|No|07/02/2010||Yes|No||||No|No|||Prescription required|No||070|No|.11538|03/29/2022|.11261|03/29/2022|.11336|03/29/2022|||BETA-BLOCKERS|5041|||||No|No||QUALITEST/PAR P|No||||
propranolol HCl|No|No|No|No|75%|00603548521|PROPRANOLOL 60 MG TABLET|100|EA|.30302|09/01/2010||Yes|No||09/01/2010||Yes|No|09/01/2010||Yes|No||||No|No|||Prescription required|No||070|No|.35485|03/29/2022|.34633|03/29/2022|.34864|03/29/2022|||BETA-BLOCKERS|5042|||||No|No||QUALITEST/PAR P|No||||
propranolol HCl|No|No|No|No|75%|00603548621|PROPRANOLOL 80 MG TABLET|100|EA|.1637|09/01/2010||Yes|No||09/01/2010||Yes|No|09/01/2010||Yes|No||||No|No|||Prescription required|No||070|No|.21823|03/29/2022|.21299|03/29/2022|.21441|03/29/2022|||BETA-BLOCKERS|5043|||||No|No||QUALITEST/PAR P|No||||
propranolol HCl|No|No|No|No|75%|00603548628|PROPRANOLOL 80 MG TABLET|500|EA|.16254|09/01/2010||Yes|No||09/01/2010||Yes|No|09/01/2010||Yes|No||||No|No|||Prescription required|No||070|No|.21823|03/29/2022|.21299|03/29/2022|.21441|03/29/2022|||BETA-BLOCKERS|5044|||||No|No||QUALITEST/PAR P|No||||
valganciclovir HCl|No|No|No|No|75%|00603633020|VALGANCICLOVIR 450 MG TABLET|60|EA|7.23539|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|136|No|2.64507|03/29/2022|2.58158|03/29/2022|2.59878|03/29/2022|||ANTIVIRALS: GENERAL|5045|||||No|No||QUALITEST/PAR P|No||||
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|00603752117|CYCLAFEM 1-35-28 TABLET|28|EA|.30545|01/01/2011||Yes|No||01/01/2011||Yes|No|01/01/2011||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.34259|03/29/2022|.33436|03/29/2022|.33659|03/29/2022||||5046|||||No|No||QUALITEST/PAR P|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|00603752149|CYCLAFEM 1-35-28 TABLET|28|EA|.32157|01/01/2011||Yes|No||01/01/2011||Yes|No|01/01/2011||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.34259|03/29/2022|.33436|03/29/2022|.33659|03/29/2022||||5047|||||No|No||QUALITEST/PAR P|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|00603752517|CYCLAFEM 7-7-7-28 TABLET|28|EA|.33355|01/01/2011||Yes|No||01/01/2011||Yes|No|01/01/2011||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.43221|03/29/2022|.42183|03/29/2022|.42464|03/29/2022||||5048|||||No|No||QUALITEST/PAR P|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|00603752549|CYCLAFEM 7-7-7-28 TABLET|28|EA|.33355|01/01/2011||Yes|No||01/01/2011||Yes|No|01/01/2011||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.43221|03/29/2022|.42183|03/29/2022|.42464|03/29/2022||||5049|||||No|No||QUALITEST/PAR P|No|||Only covered for non-contraceptive (medical) purposes|
testosterone|No|No|No|No|90%|00603783188|TESTOSTERONE 10 MG GEL PUMP|60|GM|2.44584|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|084|No|5.26742|03/29/2022|5.141|03/29/2022|5.17524|03/29/2022|||ANDROGENIC AGENTS|5050|||||No|No||QUALITEST/PAR P|No||||
phenobarbital sodium|No|No|No|No|75%|00641047625|PHENOBARBITAL 65 MG/ML VIAL|1|ML|10.3114|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|23.5004|03/24/2020|23.16468|03/24/2020|22.0616|03/24/2020||||5051|||||No|No||WEST-WARD/HIKMA|No||||
phenobarbital sodium|No|No|No|No|75%|00641047725|PHENOBARBITAL 130 MG/ML VIAL|1|ML|26.76165|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|60.99167|03/24/2020|60.12036|03/24/2020|57.25748|03/24/2020||||5052|||||No|No||WEST-WARD/HIKMA|No||||
phenytoin sodium|No|No|No|No|75%|00641049325|PHENYTOIN 50 MG/ML VIAL|2|ML|.29867|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.68069|03/02/2021|.67097|03/02/2021|.63902|03/02/2021||||5053|||||No|No||WEST-WARD/HIKMA|No||||
promethazine HCl|No|No|No|No|75%|00641092821|PROMETHAZINE 25 MG/ML VIAL|1|ML|.3698|10/05/2010||Yes|No||10/05/2010||Yes|No|10/05/2010||Yes|No||||No|No|||Prescription required|No|||Yes|||||||.8428|10/03/2016||5054|||||No|No||WEST-WARD/HIKMA|No||||
promethazine HCl|No|No|No|No|75%|00641092825|PROMETHAZINE 25 MG/ML VIAL|1|ML|.79464|10/05/2010||Yes|No||10/05/2010||Yes|No|10/05/2010||Yes|No||||No|No|||Prescription required|No|||Yes|1.81104|03/29/2022|1.78516|03/29/2022|1.70016|03/29/2022||||5055|||||No|No||WEST-WARD/HIKMA|No||||
promethazine HCl|No|No|No|No|75%|00641092921|PROMETHAZINE 50 MG/ML VIAL|1|ML|.7955|10/05/2010||Yes|No||10/05/2010||Yes|No|10/05/2010||Yes|No||||No|No|||Prescription required|No|||Yes|||||||1.813|11/01/2017||5056|||||No|No||WEST-WARD/HIKMA|No||||
promethazine HCl|No|No|No|No|75%|00641092925|PROMETHAZINE 50 MG/ML VIAL|1|ML|1.6536|10/05/2010||Yes|No||10/05/2010||Yes|No|10/05/2010||Yes|No||||No|No|||Prescription required|No|||Yes|3.76868|11/06/2018|3.71484|11/06/2018|3.53795|11/06/2018||||5057|||||No|No||WEST-WARD/HIKMA|No||||
promethazine HCl|No|No|No|No|75%|00641094931|PROMETHAZINE 50 MG/ML AMPUL|1|ML|.7955|10/05/2010||Yes|No||10/05/2010||Yes|No|10/05/2010||Yes|No||||No|No|||Prescription required|No|||Yes|||||||1.813|06/06/2017||5058|||||No|No||WEST-WARD,INC./|No||||
promethazine HCl|No|No|No|No|75%|00641094935|PROMETHAZINE 50 MG/ML AMPUL|1|ML|1.0817|10/05/2010||Yes|No||10/05/2010||Yes|No|10/05/2010||Yes|No||||No|No|||Prescription required|No|||Yes|2.46528|12/14/2021|2.43006|12/14/2021|2.31435|12/14/2021||||5059|||||No|No||WEST-WARD,INC./|No||||
chlorpromazine HCl|No|No|No|No|75%|00641139835|CHLORPROMAZINE 25 MG/ML AMP|2|ML|7.11693|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|16.21998|03/24/2020|15.98826|03/24/2020|15.22692|03/24/2020|||ANTIPSYCHOTICS|5060|||||No|No||WEST-WARD/HIKMA|No||||
promethazine HCl|No|No|No|No|75%|00641149535|PROMETHAZINE 25 MG/ML AMPUL|1|ML|.79464|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|1.78064|09/28/2021|1.7379|09/28/2021|1.74947|09/28/2021||||5061|||||No|No||WEST-WARD/HIKMA|No||||
promethazine HCl|No|No|No|No|75%|00641149635|PROMETHAZINE 50 MG/ML AMPUL|1|ML|1.1137|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|2.5382|11/06/2018|2.50194|11/06/2018|2.3828|11/06/2018||||5062|||||No|No||WEST-WARD/HIKMA|No||||
meperidine HCl/PF|No|No|No|No|90%|00641605225|MEPERIDINE 25 MG/ML VIAL|1|ML|1.09065|02/24/2012||Yes|No||02/24/2012||Yes|No|02/24/2012||Yes|No||||No|No|||Prescription required|No|||Yes|2.48567|03/24/2020|2.45016|03/24/2020|2.33348|03/24/2020||||5063|||||No|No||WEST-WARD/HIKMA|No||||
meperidine HCl/PF|No|No|No|No|90%|00641605325|MEPERIDINE 50 MG/ML VIAL|1|ML|1.13606|02/24/2012||Yes|No||02/24/2012||Yes|No|02/24/2012||Yes|No||||No|No|||Prescription required|No|||Yes|2.58916|03/24/2020|2.55217|03/24/2020|2.43064|03/24/2020||||5064|||||No|No||WEST-WARD/HIKMA|No||||
meperidine HCl/PF|No|No|No|No|90%|00641605425|MEPERIDINE 100 MG/ML VIAL|1|ML|1.2451|02/24/2012||Yes|No||02/24/2012||Yes|No|02/24/2012||Yes|No||||No|No|||Prescription required|No|||Yes|2.83768|03/24/2020|2.79714|03/24/2020|2.66395|03/24/2020||||5065|||||No|No||WEST-WARD/HIKMA|No||||
ondansetron HCl/PF|No|No|No|No|75%|00641607825|ONDANSETRON HCL 4 MG/2 ML VIAL|2|ML|.20425|02/24/2012||Yes|No||02/24/2012||Yes|No|02/24/2012||Yes|No||||No|No|||Prescription required|No|||No|.18088|01/25/2022|.17653|01/25/2022|.17771|01/25/2022||||5066|||||No|No||WEST-WARD/HIKMA|No||||
ondansetron HCl/PF|No|No|No|No|75%|00641608025|ONDANSETRON HCL 4 MG/2 ML VIAL|2|ML|.129|02/24/2012||Yes|No||02/24/2012||Yes|No|02/24/2012||Yes|No||||No|No|||Prescription required|No|||No|.18088|01/25/2022|.17653|01/25/2022|.17771|01/25/2022||||5067|||||No|No||WEST-WARD/HIKMA|No||||
promethazine HCl|No|No|No|No|75%|00641608425|PHENERGAN 25 MG/ML VIAL|1|ML|1.44996|02/24/2012||Yes|No||02/24/2012||Yes|No|02/24/2012||Yes|No||||No|No|||Prescription required|No|||Yes|3.30456|01/08/2019|3.25735|01/08/2019|3.10224|01/08/2019||||5068|||||No|No||WEST-WARD/HIKMA|No||||
naloxone HCl|No|No|No|No|75%|00641613201|NALOXONE 0.4 MG/ML VIAL|1|ML|6.7037|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|||||||15.2782|10/01/2020|OPIATE DEPENDENCE TREATMENTS|5069|||||No|No||WEST-WARD/HIKMA|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|00641613225|NALOXONE 0.4 MG/ML VIAL|1|ML|4.3|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|9.8|10/01/2020|9.66|10/01/2020|9.2|10/01/2020|||OPIATE DEPENDENCE TREATMENTS|5070|||||No|No||WEST-WARD/HIKMA|Yes|09/01/2020|||
octreotide acetate|No|No|No|No|75%|00641617410|OCTREOTIDE ACET 50 MCG/ML VIAL|1|ML|1.935|06/11/2019||Yes|No||06/11/2019||Yes|No|06/11/2019||Yes|No||||No|No|||Prescription required|No|||No|4.41|06/11/2019|4.347|06/18/2019|4.14|06/11/2019||||5071|||||No|No||WEST-WARD/HIKMA|No||||
prenatal 26/iron ps/folic/dha|No|No|No|No|75%|00642007030|VITAFOL-ONE CAPSULE|30|EA|1.78005|06/30/2011||Yes|No||06/30/2011||Yes|No|06/30/2011||Yes|No||||No|No|||Over the counter|No||243|No|3.96086|01/04/2022|3.86579|01/04/2022|3.89154|01/04/2022|||PRENATAL VITAMINS|5072|||||No|No||EXELTIS USA, IN|No||||
prenatal vit 33/iron/folic/dha|No|No|No|No|75%|00642007530|SELECT-OB + DHA PACK|60|EA|.89002|04/14/2010||Yes|No||04/14/2010||Yes|No|04/14/2010||Yes|No||||No|No|||Over the counter|No||243|No|2.02843|01/04/2022|1.99945|01/04/2022|1.90424|01/04/2022|||PRENATAL VITAMINS|5073|||||No|No||EXELTIS USA, IN|No||||
prenatal vit 10/iron/folic/dha|No|No|No|No|75%|00642007630|VITAFOL-OB+DHA COMBO PACK|60|EA|.95388|10/07/2014||Yes|No||10/07/2014||Yes|No|10/07/2014||Yes|No||||No|No|||Over the counter|No||243|No|2.17396|01/04/2022|2.1429|01/04/2022|2.04086|01/04/2022|||PRENATAL VITAMINS|5074|||||No|No||EXELTIS USA, IN|No||||
prenatal vit128/iron/folic acd|No|No|No|No|75%|00642007790|SELECT-OB CHEWABLE CAPLET|90|EA|.71489|02/25/2008||Yes|No||02/25/2008||Yes|No|02/25/2008||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|1.62929|06/01/2016|1.60602|06/01/2016|1.52954|06/01/2016|||PRENATAL VITAMINS|5075|||||No|No||EXELTIS USA, IN|No||||
prenatal vit 10/iron fum/folic|No|No|No|No|75%|00642007912|VITAFOL-OB CAPLET|100|EA|1.67837|02/25/2008||Yes|No||02/25/2008||Yes|No|02/25/2008||Yes|No||||No|No|||Over the counter|No||243|No|3.82513|01/04/2022|3.77049|01/04/2022|3.59094|01/04/2022|||PRENATAL VITAMINS|5076|||||No|No||EXELTIS USA, IN|No||||
PNV 67/iron ps/folate no.1/dha|No|No|No|No|75%|00642009330|VITAFOL ULTRA SOFTGEL|30|EA|1.80557|09/06/2013||Yes|No||09/06/2013||Yes|No|09/06/2013||Yes|No||||No|No|||Over the counter|No||243|No|4.01927|01/04/2022|3.9228|01/04/2022|3.94893|01/04/2022|||PRENATAL VITAMINS|5077|||||No|No||EXELTIS USA, IN|No||||
prenatal no.75/iron/folate no1|No|No|No|No|75%|00642009430|VITAFOL NANO TABLET|30|EA|1.78005|06/09/2015||Yes|No||06/09/2015||Yes|No|06/09/2015||Yes|No||||No|No|||Over the counter|No||243|No|4.05686|01/04/2022|3.99891|01/04/2022|3.80848|01/04/2022|||PRENATAL VITAMINS|5078|||||No|No||EXELTIS USA, IN|No||||
PNV 112/iron/folic/om3/dha/epa|No|No|No|No|75%|00642012590|VITAFOL GUMMIES|90|EA|.60558|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Over the counter|No||243|No|1.35165|01/04/2022|1.31921|01/04/2022|1.32799|01/04/2022|||PRENATAL VITAMINS|5079|||||No|No||EXELTIS USA, IN|No||||
benznidazole|No|No|No|No|75%|00642746410|BENZNIDAZOLE 100 MG TABLET|100|EA|1.29|01/08/2019||Yes|No||01/08/2019||Yes|No|01/08/2019||Yes|No||||No|No|||Prescription required|No|||No|2.94|01/09/2019|2.898|01/15/2019|2.76|01/09/2019||||5080|||||No|No||EXELTIS USA, IN|No||||
metronidazole|No|No|No|No|75%|00642746605|NUVESSA VAGINAL 1.3% GEL|5|GM|15.83776|09/18/2018||Yes|No||09/18/2018||Yes|No|09/18/2018||Yes|No||||No|No|||Prescription required|No||124|No|35.45382|03/01/2022|34.60292|03/01/2022|34.83337|03/01/2022|||ANTIBIOTICS: VAGINAL|5081|||||No|No||EXELTIS USA, IN|No||||
drospirenone|Yes|Yes|No|No|75%|00642747001|SLYND 4 MG TABLET|28|EA|2.97928|12/13/2019||Yes|No||||No|No|12/13/2019||Yes|No|Refer to program requirements|||No|No|03/20/2020||Prescription required|No|||No|6.6454|10/26/2021|6.48591|10/26/2021|6.5291|10/26/2021||||5082|||||No|No||EXELTIS USA, IN|No||||
hydromorphone HCl/PF|No|No|No|No|90%|00703001801|HYDROMORPHONE 10 MG/ML VIAL|50|ML|.8901|03/08/2011||Yes|No||03/08/2011||Yes|No|03/08/2011||Yes|No||||No|No|||Prescription required|No|||Yes|2.0286|06/01/2016|1.99962|06/01/2016|1.9044|06/01/2016||||5083|||||No|No||TEVA PARENTERAL|No||||
methylprednisolone acetate|No|No|No|No|75%|00703003101|METHYLPREDNISOLONE 40 MG/ML VL|1|ML|3.741|07/14/2006||Yes|No||07/14/2006||Yes|No|07/14/2006||Yes|No||||No|No|||Prescription required|No|||No|8.69667|03/29/2022|8.48794|03/29/2022|8.54447|03/29/2022||||5084|||||No|No||TEVA PARENTERAL|No||||
methylprednisolone acetate|No|No|No|No|75%|00703003104|METHYLPREDNISOLONE 40 MG/ML VL|1|ML|3.741|07/14/2006||Yes|No||07/14/2006||Yes|No|07/14/2006||Yes|No||||No|No|||Prescription required|No|||No|8.526|12/12/2017|8.4042|12/12/2017|8.004|12/12/2017||||5085|||||No|No||TEVA PARENTERAL|No||||
methylprednisolone acetate|No|No|No|No|75%|00703004301|METHYLPREDNISOLONE 200 MG/5 ML|5|ML|3.0745|11/02/2006||Yes|No||11/02/2006||Yes|No|11/02/2006||Yes|No||||No|No|||Prescription required|No|||No|7.007|12/12/2017|6.9069|12/12/2017|6.578|12/12/2017||||5086|||||No|No||TEVA PARENTERAL|No||||
methylprednisolone acetate|No|No|No|No|75%|00703004501|METHYLPREDNISOLONE 400 MG/10ML|10|ML|3.0745|11/02/2006||Yes|No||11/02/2006||Yes|No|11/02/2006||Yes|No||||No|No|||Prescription required|No|||No|7.007|12/12/2017|6.9069|12/12/2017|6.578|12/12/2017||||5087|||||No|No||TEVA PARENTERAL|No||||
methylprednisolone acetate|No|No|No|No|75%|00703005101|METHYLPREDNISOLONE 80 MG/ML VL|1|ML|6.149|07/14/2006||Yes|No||07/14/2006||Yes|No|07/14/2006||Yes|No||||No|No|||Prescription required|No|||No|14.014|12/12/2017|13.8138|12/12/2017|13.156|12/12/2017||||5088|||||No|No||TEVA PARENTERAL|No||||
methylprednisolone acetate|No|No|No|No|75%|00703005104|METHYLPREDNISOLONE 80 MG/ML VL|1|ML|6.149|07/14/2006||Yes|No||07/14/2006||Yes|No|07/14/2006||Yes|No||||No|No|||Prescription required|No|||No|14.014|12/12/2017|13.8138|12/12/2017|13.156|12/12/2017||||5089|||||No|No||TEVA PARENTERAL|No||||
methylprednisolone acetate|No|No|No|No|75%|00703006301|METHYLPREDNISOLONE 400 MG/5 ML|5|ML|6.149|11/02/2006||Yes|No||11/02/2006||Yes|No|11/02/2006||Yes|No||||No|No|||Prescription required|No|||No|14.014|12/12/2017|13.8138|12/12/2017|13.156|12/12/2017||||5090|||||No|No||TEVA PARENTERAL|No||||
hydromorphone HCl/PF|No|No|No|No|90%|00703011003|HYDROMORPHONE 10 MG/ML VIAL|1|ML|1.5007|03/08/2011||Yes|No||03/08/2011||Yes|No|03/08/2011||Yes|No||||No|No|||Prescription required|No|||Yes|3.4202|07/12/2016|3.37134|07/12/2016|3.2108|07/12/2016||||5091|||||No|No||TEVA PARENTERAL|No||||
hydromorphone HCl/PF|No|No|No|No|90%|00703011303|HYDROMORPHONE 50 MG/5 ML VIAL|5|ML|.81012|03/08/2011||Yes|No||03/08/2011||Yes|No|03/08/2011||Yes|No||||No|No|||Prescription required|No|||Yes|1.84632|06/01/2016|1.81994|06/01/2016|1.73328|06/01/2016||||5092|||||No|No||TEVA PARENTERAL|No||||
daptomycin|No|No|No|No|75%|00703012501|DAPTOMYCIN 500 MG VIAL|1|EA|45.15|03/07/2017|11/30/2022|Yes|No||03/07/2017|11/30/2022|Yes|No|03/07/2017|11/30/2022|Yes|No||||No|No|||Prescription required|No|||No|102.9|03/02/2021|101.43|03/02/2021|96.6|03/02/2021||||5093|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||TEVA PARENTERAL|No||||
treprostinil sodium|No|No|No|No|75%|00703066601|TREPROSTINIL 20 MG/20 ML VIAL|20|ML|26.00747|03/05/2020||Yes|No||03/05/2020||Yes|No|03/05/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|59.27285|03/05/2020|58.42609|03/05/2020|55.6439|03/05/2020||||5094|||||No|No||TEVA PARENTERAL|No||||
treprostinil sodium|No|No|No|No|75%|00703067601|TREPROSTINIL 50 MG/20 ML VIAL|20|ML|65.01901|03/05/2020||Yes|No||03/05/2020||Yes|No|03/05/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|148.18286|03/05/2020|146.06596|03/05/2020|139.11044|03/05/2020||||5095|||||No|No||TEVA PARENTERAL|No||||
treprostinil sodium|No|No|No|No|75%|00703068601|TREPROSTINIL 100 MG/20 ML VIAL|20|ML|130.0378|03/05/2020||Yes|No||03/05/2020||Yes|No|03/05/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|296.36523|03/05/2020|292.13144|03/05/2020|278.22042|03/05/2020||||5096|||||No|No||TEVA PARENTERAL|No||||
treprostinil sodium|No|No|No|No|75%|00703069601|TREPROSTINIL 200 MG/20 ML VIAL|20|ML|260.07561|03/05/2020||Yes|No||03/05/2020||Yes|No|03/05/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|592.73046|03/05/2020|584.26288|03/05/2020|556.44084|03/05/2020||||5097|||||No|No||TEVA PARENTERAL|No||||
epoprostenol sodium (glycine)|No|No|No|No|75%|00703198501|EPOPROSTENOL SODIUM 0.5 MG VL|1|EA|6.966|05/12/2009||Yes|No||05/12/2009||Yes|No|05/12/2009||Yes|No||||No|No|||Prescription required|No|||No|15.876|06/01/2016|15.6492|06/01/2016|14.904|06/01/2016||||5098|||||No|No||TEVA PARENTERAL|No||||
epoprostenol sodium (glycine)|No|No|No|No|75%|00703199501|EPOPROSTENOL SODIUM 1.5 MG VL|1|EA|16.8216|05/12/2009||Yes|No||05/12/2009||Yes|No|05/12/2009||Yes|No||||No|No|||Prescription required|No|||No|38.3376|06/01/2016|37.78992|06/01/2016|35.9904|06/01/2016||||5099|||||No|No||TEVA PARENTERAL|No||||
octreotide acetate|No|No|No|No|75%|00703330104|OCTREOTIDE ACET 0.05 MG/ML VL|1|ML|1.935|09/13/2006||Yes|No||09/13/2006||Yes|No|09/13/2006||Yes|No||||No|No|||Prescription required|No|||No|4.41|08/02/2016|4.347|08/02/2016|4.14|08/02/2016||||5100|||||No|No||TEVA PARENTERAL|No||||
octreotide acetate|No|No|No|No|75%|00703331104|OCTREOTIDE ACET 100 MCG/ML VL|1|ML|2.795|09/13/2006||Yes|No||09/13/2006||Yes|No|09/13/2006||Yes|No||||No|No|||Prescription required|No|||No|6.37|06/01/2016|6.279|06/01/2016|5.98|06/01/2016||||5101|||||No|No||TEVA PARENTERAL|No||||
octreotide acetate|No|No|No|No|75%|00703332104|OCTREOTIDE ACET 500 MCG/ML VL|1|ML|15.05|09/13/2006||Yes|No||09/13/2006||Yes|No|09/13/2006||Yes|No||||No|No|||Prescription required|No|||No|34.3|06/01/2016|33.81|06/01/2016|32.2|06/01/2016||||5102|||||No|No||TEVA PARENTERAL|No||||
octreotide acetate|No|No|No|No|75%|00703333301|OCTREOTIDE ACET 200 MCG/ML VL|5|ML|5.848|11/30/2009||Yes|No||11/30/2009||Yes|No|11/30/2009||Yes|No||||No|No|||Prescription required|No|||No|13.328|01/26/2021|13.1376|01/26/2021|12.512|01/26/2021||||5103|||||No|No||TEVA PARENTERAL|No||||
octreotide acetate|No|No|No|No|75%|00703334301|OCTREOTIDE 1,000 MCG/ML VIAL|5|ML|20.64|11/30/2009||Yes|No||11/30/2009||Yes|No|11/30/2009||Yes|No||||No|No|||Prescription required|No|||No|47.04|11/28/2017|46.368|11/28/2017|44.16|11/28/2017||||5104|||||No|No||TEVA PARENTERAL|No||||
methotrexate sodium/PF|No|No|No|No|75%|00703367101|METHOTREXATE 50 MG/2 ML VIAL|2|ML|2.22525|01/17/2020||Yes|No||01/17/2020||Yes|No|01/17/2020||Yes|No||||No|No|||Prescription required|No|||No|1.55875|03/29/2022|1.52134|03/29/2022|1.53147|03/29/2022||||5105|||||No|No||TEVA PARENTERAL|No||||
methotrexate sodium/PF|No|No|No|No|75%|00703367501|METHOTREXATE 250 MG/10 ML VIAL|10|ML|.38829|08/29/2012||Yes|No||08/29/2012||Yes|No|08/29/2012||Yes|No||||No|No|||Prescription required|No|||No|.88494|03/23/2021|.87229|03/23/2021|.83076|03/23/2021||||5106|||||No|No||TEVA PARENTERAL|No||||
methotrexate sodium/PF|No|No|No|No|75%|00703367801|METHOTREXATE 1 GRAM/40 ML VIAL|40|ML|.35743|08/29/2012||Yes|No||08/29/2012||Yes|No|08/29/2012||Yes|No||||No|No|||Prescription required|No|||No|.81462|06/01/2016|.80298|06/01/2016|.76475|06/01/2016||||5107|||||No|No||TEVA PARENTERAL|No||||
methotrexate sodium/PF|No|No|No|No|75%|00703367881|METHOTREXATE 1 GRAM/40 ML VIAL|40|ML|.35743|04/27/2016||Yes|No||04/27/2016||Yes|No|04/27/2016||Yes|No||||No|No|||Prescription required|No|||No|.81462|06/01/2016|.80298|06/01/2016|.76475|06/01/2016||||5108|||||No|No||TEVA PARENTERAL|No||||
metoclopramide HCl|No|No|No|No|75%|00703450201|METOCLOPRAMIDE 10 MG/2 ML VIAL|2|ML|.1935|03/06/2014||Yes|No||03/06/2014||Yes|No|03/06/2014||Yes|No||||No|No|||Prescription required|No|||No|||||||.441|08/01/2018||5109|||||No|No||TEVA PARENTERAL|No||||
metoclopramide HCl|No|No|No|No|75%|00703450204|METOCLOPRAMIDE 10 MG/2 ML VIAL|2|ML|.72076|03/06/2014||Yes|No||03/06/2014||Yes|No|03/06/2014||Yes|No||||No|No|||Prescription required|No|||No|1.64267|04/10/2018|1.6192|04/10/2018|1.5421|04/10/2018||||5110|||||No|No||TEVA PARENTERAL|No||||
mitoxantrone HCl|No|No|No|No|75%|00703468001|MITOXANTRONE 25 MG/12.5 ML VL|12.5|ML|9.30829|06/26/2006||Yes|No||06/26/2006||Yes|No|06/26/2006||Yes|No||||No|No|||Prescription required|No|||No|21.21425|06/01/2016|20.91119|06/01/2016|19.91542|06/01/2016||||5111|||||No|No||TEVA PARENTERAL|No||||
mitoxantrone HCl|No|No|No|No|75%|00703468501|MITOXANTRONE 20 MG/10 ML VIAL|10|ML|7.31|06/26/2006||Yes|No||06/26/2006||Yes|No|06/26/2006||Yes|No||||No|No|||Prescription required|No|||No|16.66|11/26/2019|16.422|11/26/2019|15.64|11/26/2019||||5112|||||No|No||TEVA PARENTERAL|No||||
mitoxantrone HCl|No|No|No|No|75%|00703468601|MITOXANTRONE 30 MG/15 ML VIAL|15|ML|9.78049|06/26/2006||Yes|No||06/26/2006||Yes|No|06/26/2006||Yes|No||||No|No|||Prescription required|No|||No|22.29042|06/01/2016|21.97198|06/01/2016|20.9257|06/01/2016||||5113|||||No|No||TEVA PARENTERAL|No||||
desmopressin acetate|No|No|No|No|75%|00703505103|DESMOPRESSIN AC 4 MCG/ML VIAL|1|ML|25.5936|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|58.3296|06/25/2019|57.49632|06/25/2019|54.7584|06/25/2019||||5114|||||No|No||TEVA PARENTERAL|No||||
desmopressin acetate|No|No|No|No|75%|00703505401|DESMOPRESSIN 40 MCG/10 ML VIAL|10|ML|25.5936|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|58.3296|06/25/2019|57.49632|06/25/2019|54.7584|06/25/2019||||5115|||||No|No||TEVA PARENTERAL|No||||
medroxyprogesterone acetate|Yes|Yes|No|No|75%|00703680101|MEDROXYPROGESTERONE 150 MG/ML|1|ML|19.35|02/19/2013||Yes|No||||No|No|02/19/2013||Yes|No|Refer to program requirements|||No|No|02/19/2013||Prescription required|No|||No|31.14606|03/29/2022|30.39855|03/29/2022|30.601|03/29/2022||||5116|||||No|No||TEVA PARENTERAL|No||||
medroxyprogesterone acetate|Yes|Yes|No|No|75%|00703680104|MEDROXYPROGESTERONE 150 MG/ML|1|ML|19.35|02/19/2013||Yes|No||||No|No|02/19/2013||Yes|No|Refer to program requirements|||No|No|02/19/2013||Prescription required|No|||No|30.77229|09/28/2021|30.03375|09/28/2021|30.23377|09/28/2021||||5117|||||No|No||TEVA PARENTERAL|No||||
haloperidol lactate|No|No|No|No|75%|00703704501|HALOPERIDOL LAC 5 MG/ML VIAL|10|ML|2.623|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|027|Yes|5.978|06/01/2016|5.8926|06/01/2016|5.612|06/01/2016|||ANTIPSYCHOTICS|5118|||||No|No||TEVA PARENTERAL|No||||
haloperidol decanoate|No|No|No|No|75%|00703712103|HALOPERIDOL DEC 50 MG/ML VIAL|1|ML|10.234|04/24/2020||Yes|No||04/24/2020||Yes|No|04/24/2020||Yes|No||||No|No|||Prescription required|No||027|No|17.60088|09/28/2021|17.17845|09/28/2021|17.29286|09/28/2021|||ANTIPSYCHOTICS|5119|||||No|No||TEVA PARENTERAL|No||||
haloperidol decanoate|No|No|No|No|75%|00703713103|HALOPERIDOL DEC 100 MG/ML VIAL|1|ML|18.791|04/24/2020||Yes|No||04/24/2020||Yes|No|04/24/2020||Yes|No||||No|No|||Prescription required|No||027|No|42.826|04/24/2020|42.2142|04/24/2020|40.204|04/24/2020|||ANTIPSYCHOTICS|5120|||||No|No||TEVA PARENTERAL|No||||
haloperidol decanoate|No|No|No|No|75%|00703713301|HALOPERIDOL DEC 100 MG/ML VIAL|5|ML|18.8082|04/24/2020||Yes|No||04/24/2020||Yes|No|04/24/2020||Yes|No||||No|No|||Prescription required|No||027|No|29.246|03/29/2022|28.54409|03/29/2022|28.73419|03/29/2022|||ANTIPSYCHOTICS|5121|||||No|No||TEVA USA|No||||
granisetron HCl|No|No|No|No|75%|00703797103|GRANISETRON HCL 1 MG/ML VIAL|1|ML|8.17|01/11/2008||Yes|No||01/11/2008||Yes|No|01/11/2008||Yes|No||||No|No|||Prescription required|No|||Yes|18.62|06/01/2016|18.354|06/01/2016|17.48|06/01/2016||||5122|||||No|No||TEVA PARENTERAL|No||||
granisetron HCl|No|No|No|No|75%|00703797301|GRANISETRON HCL 4 MG/4 ML VIAL|4|ML|7.525|05/12/2009||Yes|No||05/12/2009||Yes|No|05/12/2009||Yes|No||||No|No|||Prescription required|No|||Yes|17.15|06/01/2016|16.905|06/01/2016|16.1|06/01/2016||||5123|||||No|No||TEVA PARENTERAL|No||||
enoxaparin sodium|No|No|No|No|75%|00703851021|ENOXAPARIN 150 MG/ML SYRINGE|1|ML|28.38|05/12/2015|12/20/2022|Yes|No||05/12/2015|12/20/2022|Yes|No|05/12/2015|12/20/2022|Yes|No||||No|No|||Prescription required|No||068|Yes|||||||64.68|11/27/2018|ANTICOAGULANTS|5124|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TEVA PARENTERAL|No||||
enoxaparin sodium|No|No|No|No|75%|00703851023|ENOXAPARIN 150 MG/ML SYRINGE|1|ML|12.8183|05/12/2015|12/20/2022|Yes|No||05/12/2015|12/20/2022|Yes|No|05/12/2015|12/20/2022|Yes|No||||No|No|||Prescription required|No||068|Yes|15.18|03/29/2022|14.81568|03/29/2022|14.91435|03/29/2022|||ANTICOAGULANTS|5125|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TEVA PARENTERAL|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|00703853023|ENOXAPARIN 30 MG/0.3 ML SYR|.3|ML|8.557|02/04/2015|12/20/2022|Yes|No||02/04/2015|12/20/2022|Yes|No|02/04/2015|12/20/2022|Yes|No||||No|No|||Prescription required|No||068|Yes|12.85641|03/29/2022|12.54785|03/29/2022|12.63142|03/29/2022|||ANTICOAGULANTS|5126|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TEVA PARENTERAL|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|00703854023|ENOXAPARIN 40 MG/0.4 ML SYR|.4|ML|8.5355|02/04/2015|12/20/2022|Yes|No||02/04/2015|12/20/2022|Yes|No|02/04/2015|12/20/2022|Yes|No||||No|No|||Prescription required|No||068|Yes|11.94818|03/29/2022|11.66142|03/29/2022|11.73908|03/29/2022|||ANTICOAGULANTS|5127|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TEVA PARENTERAL|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|00703856023|ENOXAPARIN 60 MG/0.6 ML SYR|.6|ML|8.54983|02/04/2015|05/31/2022|Yes|No||02/04/2015|05/31/2022|Yes|No|02/04/2015|05/31/2022|Yes|No||||No|No|||Prescription required|No||068|Yes|11.41069|03/29/2022|11.13683|03/29/2022|11.211|03/29/2022|||ANTICOAGULANTS|5128|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||TEVA PARENTERAL|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|00703858021|ENOXAPARIN 100 MG/ML SYRINGE|1|ML|18.92|05/12/2015|10/31/2022|Yes|No||05/12/2015|10/31/2022|Yes|No|05/12/2015|10/31/2022|Yes|No||||No|No|||Prescription required|No||068|Yes|||||||43.12|11/27/2018|ANTICOAGULANTS|5129|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||TEVA PARENTERAL|No||||
enoxaparin sodium|No|No|No|No|75%|00703858023|ENOXAPARIN 100 MG/ML SYRINGE|1|ML|8.5484|05/12/2015|10/31/2022|Yes|No||05/12/2015|10/31/2022|Yes|No|05/12/2015|10/31/2022|Yes|No||||No|No|||Prescription required|No||068|Yes|11.81296|03/29/2022|11.52944|03/29/2022|11.60623|03/29/2022|||ANTICOAGULANTS|5130|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||TEVA PARENTERAL|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|00703861023|ENOXAPARIN 120 MG/0.8 ML SYR|.8|ML|12.81937|02/04/2015|09/30/2022|Yes|No||02/04/2015|09/30/2022|Yes|No|02/04/2015|09/30/2022|Yes|No||||No|No|||Prescription required|No||068|Yes|15.335|03/29/2022|14.96696|03/29/2022|15.06663|03/29/2022|||ANTICOAGULANTS|5131|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||TEVA PARENTERAL|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|00703868023|ENOXAPARIN 80 MG/0.8 ML SYR|.8|ML|8.54625|02/04/2015|09/30/2022|Yes|No||02/04/2015|09/30/2022|Yes|No|02/04/2015|09/30/2022|Yes|No||||No|No|||Prescription required|No||068|Yes|12.0025|03/29/2022|11.71444|03/29/2022|11.79245|03/29/2022|||ANTICOAGULANTS|5132|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||TEVA PARENTERAL|Yes|09/01/2020|||
amikacin sulfate|No|No|No|No|75%|00703903203|AMIKACIN SULF 500 MG/2 ML VIAL|2|ML|2.63482|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|6.00495|06/01/2016|5.91916|06/01/2016|5.6373|06/01/2016||||5133|||||No|No||TEVA PARENTERAL|No||||
amikacin sulfate|No|No|No|No|75%|00703904003|AMIKACIN SULF 1 GRAM/4 ML VIAL|4|ML|2.63482|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|6.00495|06/01/2016|5.91916|06/01/2016|5.6373|06/01/2016||||5134|||||No|No||TEVA PARENTERAL|No||||
linezolid in dextrose 5%|No|No|No|No|75%|00703906033|LINEZOLID 600 MG/300 ML-D5W|300|ML|.08958|02/27/2015||Yes|No||02/27/2015||Yes|No|02/27/2015||Yes|No||||No|No|||Prescription required|No||146|No|.20416|06/01/2016|.20124|06/01/2016|.19166|06/01/2016|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|5135|||||No|No||TEVA PARENTERAL|No||||
nafcillin sodium|No|No|No|No|75%|00703909503|NAFCILLIN 1 GM VIAL|1|EA|5.0095|03/26/2015||Yes|No||03/26/2015||Yes|No|03/26/2015||Yes|No||||No|No|||Prescription required|No|||No|11.417|06/01/2016|11.2539|06/01/2016|10.718|06/01/2016||||5136|||||No|No||TEVA USA|No||||
nafcillin sodium|No|No|No|No|75%|00703910503|NAFCILLIN 2 GM VIAL|1|EA|9.718|03/26/2015||Yes|No||03/26/2015||Yes|No|03/26/2015||Yes|No||||No|No|||Prescription required|No|||No|22.148|06/01/2016|21.8316|06/01/2016|20.792|06/01/2016||||5137|||||No|No||TEVA USA|No||||
diluent for epoprostenol(glyc)|No|No|No|No|75%|00703925809|DILUENT FOR EPOPROSTENOL VIAL|50|ML|.10113|05/12/2009||Yes|Yes||05/12/2009||Yes|Yes|05/12/2009||Yes|Yes||||No|No|||Prescription required|No|||No|.23049|06/01/2016|.2272|06/01/2016|.21638|06/01/2016||||5138|||||No|No||TEVA PARENTERAL|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|00703950303|SULFAMETHOXAZOLE-TMP IV VIAL|5|ML|.5393|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|1.22911|06/01/2016|1.21155|06/01/2016|1.15386|06/01/2016||||5139|||||No|No||TEVA PARENTERAL|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|00703952601|SULFAMETHOXAZOLE-TMP IV VIAL|30|ML|.53922|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|1.22892|06/01/2016|1.21136|06/01/2016|1.15368|06/01/2016||||5140|||||No|No||TEVA PARENTERAL|No||||
promethazine HCl|No|No|No|No|75%|00713013212|PROMETHEGAN 50 MG SUPPOSITORY|12|EA|11.53403|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|01/15/2014|085|Yes|26.28686|01/29/2019|25.91133|01/29/2019|24.67746|01/29/2019|||ANTIEMETIC/ANTIVERTIGO AGENTS|5141|||||No|No||COSETTE PHARMAC|No||||
prochlorperazine|No|No|No|No|75%|00713013512|PROCHLORPERAZINE 25 MG SUPP|12|EA|3.74637|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|01/15/2014|085|No|6.24106|03/29/2022|6.09127|03/29/2022|6.13184|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|5142|||||No|No||COSETTE PHARMAC|No||||
fluocinolone acetonide|No|No|No|No|75%|00713022315|FLUOCINOLONE 0.01% CREAM|15|GM|1.07328|04/23/2014||Yes|No||04/23/2014||Yes|No|04/23/2014||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|119|No|1.83933|09/28/2021|1.79518|09/28/2021|1.80714|09/28/2021|||STEROIDS: TOPICAL MEDIUM|5143|||||No|No||COSETTE PHARMAC|No||||
fluocinolone acetonide|No|No|No|No|75%|00713022360|FLUOCINOLONE 0.01% CREAM|60|GM|.80029|04/23/2014||Yes|No||04/23/2014||Yes|No|04/23/2014||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|119|No|1.17667|03/01/2022|1.14842|03/01/2022|1.15607|03/01/2022|||STEROIDS: TOPICAL MEDIUM|5144|||||No|No||COSETTE PHARMAC|No||||
fluocinolone acetonide|No|No|No|No|75%|00713022415|FLUOCINOLONE 0.025% OINTMENT|15|GM|.81098|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|119|No|1.17785|03/29/2022|1.14958|03/29/2022|1.15723|03/29/2022|||STEROIDS: TOPICAL MEDIUM|5145|||||No|No||COSETTE PHARMAC|No||||
fluocinolone acetonide|No|No|No|No|75%|00713022460|FLUOCINOLONE 0.025% OINTMENT|60|GM|.60579|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|119|No|.92023|03/29/2022|.89814|03/29/2022|.90412|03/29/2022|||STEROIDS: TOPICAL MEDIUM|5146|||||No|No||COSETTE PHARMAC|No||||
triamcinolone acetonide|No|No|No|No|75%|00713022515|TRIAMCINOLONE 0.1% CREAM|15|GM|.09288|03/28/2016||Yes|No||03/28/2016||Yes|No|03/28/2016||Yes|No||||No|No|||Prescription required|No||120|No|.13878|03/29/2022|.13544|03/29/2022|.13635|03/29/2022|||STEROIDS: TOPICAL HIGH|5147|||||No|No||COSETTE PHARMAC|No||||
triamcinolone acetonide|No|No|No|No|75%|00713022531|TRIAMCINOLONE 0.1% CREAM|30|GM|.05762|12/02/2016||Yes|No||12/02/2016||Yes|No|12/02/2016||Yes|No||||No|No|||Prescription required|No||120|No|.14475|03/29/2022|.14127|03/29/2022|.14221|03/29/2022|||STEROIDS: TOPICAL HIGH|5148|||||No|No||COSETTE PHARMAC|No||||
triamcinolone acetonide|No|No|No|No|75%|00713022580|TRIAMCINOLONE 0.1% CREAM|80|GM|.03197|03/28/2016||Yes|No||03/28/2016||Yes|No|03/28/2016||Yes|No||||No|No|||Prescription required|No||120|No|.05241|03/29/2022|.05115|03/29/2022|.05149|03/29/2022|||STEROIDS: TOPICAL HIGH|5149|||||No|No||COSETTE PHARMAC|No||||
triamcinolone acetonide|No|No|No|No|75%|00713022615|TRIAMCINOLONE 0.025% CREAM|15|GM|.09087|04/19/2017||Yes|No||04/19/2017||Yes|No|04/19/2017||Yes|No||||No|No|||Prescription required|No||120|No|.15373|03/29/2022|.15004|03/29/2022|.15103|03/29/2022|||STEROIDS: TOPICAL HIGH|5150|||||No|No||COSETTE PHARMAC|No||||
triamcinolone acetonide|No|No|No|No|75%|00713022680|TRIAMCINOLONE 0.025% CREAM|80|GM|.03875|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|No||120|No|.05651|03/29/2022|.05515|03/29/2022|.05552|03/29/2022|||STEROIDS: TOPICAL HIGH|5151|||||No|No||COSETTE PHARMAC|No||||
triamcinolone acetonide|No|No|No|No|75%|00713022815|TRIAMCINOLONE 0.1% OINTMENT|15|GM|.1138|08/23/2016||Yes|No||08/23/2016||Yes|No|08/23/2016||Yes|No||||No|No|||Prescription required|No||120|No|.14436|03/29/2022|.14089|03/29/2022|.14183|03/29/2022|||STEROIDS: TOPICAL HIGH|5152|||||No|No||COSETTE PHARMAC|No||||
triamcinolone acetonide|No|No|No|No|75%|00713022880|TRIAMCINOLONE 0.1% OINTMENT|80|GM|.04859|08/23/2016||Yes|No||08/23/2016||Yes|No|08/23/2016||Yes|No||||No|No|||Prescription required|No||120|No|.06224|03/29/2022|.06074|03/29/2022|.06115|03/29/2022|||STEROIDS: TOPICAL HIGH|5153|||||No|No||COSETTE PHARMAC|No||||
triamcinolone acetonide|No|No|No|No|75%|00713022915|TRIAMCINOLONE 0.025% OINT|15|GM|.088|04/19/2017||Yes|No||04/19/2017||Yes|No|04/19/2017||Yes|No||||No|No|||Prescription required|No||120|No|.2641|03/29/2022|.25776|03/29/2022|.25947|03/29/2022|||STEROIDS: TOPICAL HIGH|5154|||||No|No||COSETTE PHARMAC|No||||
triamcinolone acetonide|No|No|No|No|75%|00713022980|TRIAMCINOLONE 0.025% OINT|80|GM|.04117|04/19/2017||Yes|No||04/19/2017||Yes|No|04/19/2017||Yes|No||||No|No|||Prescription required|No||120|No|.07753|03/29/2022|.07566|03/29/2022|.07617|03/29/2022|||STEROIDS: TOPICAL HIGH|5155|||||No|No||COSETTE PHARMAC|No||||
neomycin/bacitracin/polymyxinB|No|No|No|No|75%|00713026831|TRIPLE ANTIBIOTIC OINTMENT|28.4|GM|.04178|08/25/2014||Yes|No||||No|No|08/25/2014||Yes|No||||No|No|||Over the counter|No||114|No|.09275|03/29/2022|.09052|03/29/2022|.09112|03/29/2022|||ANTIBIOTICS: TOPICAL|5156|||||No|No||COSETTE PHARMAC|No||||
bacitracin|No|No|No|No|75%|00713028031|BACITRACIN 500 UNIT/GM OINTMNT|28.4|GM|.03345|10/19/2010||Yes|No||||No|No|10/19/2010||Yes|No||||No|No|||Over the counter|No||114|No|.07743|03/29/2022|.07557|03/29/2022|.07607|03/29/2022|||ANTIBIOTICS: TOPICAL|5157|||||No|No||COSETTE PHARMAC|No||||
ciclopirox|No|No|No|No|75%|00713031788|CICLOPIROX 8% SOLUTION|6.6|ML|2.08484|10/07/2009|11/02/2022|Yes|No||10/07/2009|11/02/2022|Yes|No|10/07/2009|11/02/2022|Yes|No||||No|No|||Prescription required|Yes|01/25/2012|061|No|1.90189|03/29/2022|1.85624|03/29/2022|1.8686|03/29/2022|||ANTIFUNGALS: TOPICAL|5158|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||COSETTE PHARMAC|No||||
calcipotriene|No|No|No|No|75%|00713031853|CALCIPOTRIENE 0.005% SOLUTION|60|ML|1.6125|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|No|||No|.84564|03/29/2022|.82534|03/29/2022|.83084|03/29/2022||||5159|||||No|No||COSETTE PHARMAC|No||||
betamethasone valerate|No|No|No|No|75%|00713032615|BETAMETHASONE VA 0.1% CREAM|15|GM|.51313|11/27/2017||Yes|No||11/27/2017||Yes|No|11/27/2017||Yes|No||||No|No|||Prescription required|No||120|No|.68343|03/29/2022|.66702|03/29/2022|.67146|03/29/2022|||STEROIDS: TOPICAL HIGH|5160|||||No|No||COSETTE PHARMAC|No||||
betamethasone valerate|No|No|No|No|75%|00713032637|BETAMETHASONE VA 0.1% CREAM|45|GM|.34916|11/27/2017||Yes|No||11/27/2017||Yes|No|11/27/2017||Yes|No||||No|No|||Prescription required|No||120|No|.43211|03/29/2022|.42173|03/29/2022|.42454|03/29/2022|||STEROIDS: TOPICAL HIGH|5161|||||No|No||COSETTE PHARMAC|No||||
betamethasone valerate|No|No|No|No|75%|00713032715|BETAMETHASONE VALER 0.1% OINTM|15|GM|.4664|03/10/2017||Yes|No||03/10/2017||Yes|No|03/10/2017||Yes|No||||No|No|||Prescription required|No||120|No|.7916|03/29/2022|.7726|03/29/2022|.77774|03/29/2022|||STEROIDS: TOPICAL HIGH|5162|||||No|No||COSETTE PHARMAC|No||||
betamethasone valerate|No|No|No|No|75%|00713032737|BETAMETHASONE VALER 0.1% OINTM|45|GM|.31743|03/10/2017||Yes|No||03/10/2017||Yes|No|03/10/2017||Yes|No||||No|No|||Prescription required|No||120|No|.63691|03/29/2022|.62162|03/29/2022|.62576|03/29/2022|||STEROIDS: TOPICAL HIGH|5163|||||No|No||COSETTE PHARMAC|No||||
halobetasol propionate|No|No|No|No|75%|00713033915|HALOBETASOL PROP 0.05% OINTMNT|15|GM|1.8252|08/15/2018||Yes|No||08/15/2018||Yes|No|08/15/2018||Yes|No||||No|No|||Prescription required|No||121|No|1.65592|03/29/2022|1.61617|03/29/2022|1.62694|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|5164|||||No|No||COSETTE PHARMAC|No||||
halobetasol propionate|No|No|No|No|75%|00713033986|HALOBETASOL PROP 0.05% OINTMNT|50|GM|1.31648|08/15/2018||Yes|No||08/15/2018||Yes|No|08/15/2018||Yes|No||||No|No|||Prescription required|No||121|No|.74705|03/29/2022|.72912|03/29/2022|.73397|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|5165|||||No|No||COSETTE PHARMAC|No||||
promethazine HCl|No|No|No|No|75%|00713052612|PROMETHEGAN 25 MG SUPPOSITORY|12|EA|4.19142|06/28/2002||Yes|No||06/28/2002||Yes|No|06/28/2002||Yes|No||06/28/2002||Yes|No|||Prescription required|Yes|01/22/2015|085|Yes|4.199|03/29/2022|4.09822|03/29/2022|4.12551|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|5166|||||No|No||COSETTE PHARMAC|No||||
promethazine HCl|No|No|No|No|75%|00713053612|PROMETHEGAN 12.5 MG SUPPOS|12|EA|4.19142|07/08/2003||Yes|No||07/08/2003||Yes|No|07/08/2003||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|085|Yes|4.318|03/29/2022|4.21436|03/29/2022|4.24243|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|5167|||||No|No||COSETTE PHARMAC|No||||
terconazole|Yes|No|No|No|75%|00713055273|TERCONAZOLE 80 MG SUPPOSITORY|3|EA|11.70173|10/06/2015||Yes|No||10/06/2015||Yes|No|10/06/2015||Yes|No||||No|No|10/06/2015||Prescription required|No|||No|18.08733|03/29/2022|17.65323|03/29/2022|17.7708|03/29/2022||||5168|||||No|No||COSETTE PHARMAC|No||||
doxycycline monohydrate|No|No|No|No|75%|00713055401|DOXYCYCLINE MONO 75 MG CAPSULE|100|EA|5.60204|02/19/2019||Yes|No||02/19/2019||Yes|No|02/19/2019||Yes|No||02/19/2019||Yes|No|||Prescription required|Yes|03/09/2018|213|No|12.76744|02/19/2019|12.58504|02/19/2019|11.98576|02/19/2019|||TETRACYCLINES|5169|||||No|No||COSETTE PHARMAC|No||||
doxycycline monohydrate|Yes|No|No|No|75%|00713055550|DOXYCYCLINE MONO 100 MG CAP|50|EA|.35905|02/19/2019||Yes|No||02/19/2019||Yes|No|02/19/2019||Yes|No||02/19/2019||Yes|No|07/22/2019||Prescription required|No||213|No|.25496|03/29/2022|.24884|03/29/2022|.25049|03/29/2022|||TETRACYCLINES|5170|||||No|No||COSETTE PHARMAC|No||||
doxycycline monohydrate|Yes|No|No|No|75%|00713055593|DOXYCYCLINE MONO 100 MG CAP|250|EA|.34391|10/12/2018||Yes|No||10/12/2018||Yes|No|10/12/2018||Yes|No||||No|No|07/22/2019||Prescription required|No||213|No|.25496|03/29/2022|.24884|03/29/2022|.25049|03/29/2022|||TETRACYCLINES|5171|||||No|No||COSETTE PHARMAC|No||||
neomycn/bacitrc/polymyx/pramox|No|No|No|No|75%|00713062231|TRIPLE ANTIBIOTIC PLUS OINTMNT|28.4|GM|.05435|08/25/2014||Yes|No||||No|No|08/25/2014||Yes|No||||No|No|||Over the counter|No||114|No|.13594|03/29/2022|.13267|03/29/2022|.13356|03/29/2022|||ANTIBIOTICS: TOPICAL|5172|||||No|No||COSETTE PHARMAC|No||||
acyclovir|No|No|No|No|75%|00713063015|ACYCLOVIR 5% OINTMENT|15|GM|1.72|05/04/2018|08/13/2022|Yes|No||05/04/2018|08/13/2022|Yes|No|05/04/2018|08/13/2022|Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.36934|03/29/2022|1.33647|03/29/2022|1.34537|03/29/2022|||ANTIVIRALS: TOPICAL|5173|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||COSETTE PHARMAC|No||||
acyclovir|No|No|No|No|75%|00713063031|ACYCLOVIR 5% OINTMENT|30|GM|1.72|05/04/2018|08/13/2022|Yes|No||05/04/2018|08/13/2022|Yes|No|05/04/2018|08/13/2022|Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.03754|03/29/2022|1.01263|03/29/2022|1.01938|03/29/2022|||ANTIVIRALS: TOPICAL|5174|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||COSETTE PHARMAC|No||||
fluticasone propionate|No|No|No|No|75%|00713063115|FLUTICASONE PROP 0.05% CREAM|15|GM|.41337|10/07/2009||Yes|No||10/07/2009||Yes|No|10/07/2009||Yes|No||||No|No|||Prescription required|No||119|No|.30287|03/29/2022|.2956|03/29/2022|.29756|03/29/2022|||STEROIDS: TOPICAL MEDIUM|5175|||||No|No||COSETTE PHARMAC|No||||
fluticasone propionate|No|No|No|No|75%|00713063131|FLUTICASONE PROP 0.05% CREAM|30|GM|.31848|10/07/2009||Yes|No||10/07/2009||Yes|No|10/07/2009||Yes|No||||No|No|||Prescription required|No||119|No|.3165|03/29/2022|.3089|03/29/2022|.31096|03/29/2022|||STEROIDS: TOPICAL MEDIUM|5176|||||No|No||COSETTE PHARMAC|No||||
fluticasone propionate|No|No|No|No|75%|00713063160|FLUTICASONE PROP 0.05% CREAM|60|GM|.25104|10/07/2009||Yes|No||10/07/2009||Yes|No|10/07/2009||Yes|No||||No|No|||Prescription required|No||119|No|.23471|03/29/2022|.22907|03/29/2022|.2306|03/29/2022|||STEROIDS: TOPICAL MEDIUM|5177|||||No|No||COSETTE PHARMAC|No||||
fluticasone propionate|No|No|No|No|75%|00713063215|FLUTICASONE PROP 0.005% OINT|15|GM|.41423|10/07/2009||Yes|No||10/07/2009||Yes|No|10/07/2009||Yes|No||||No|No|||Prescription required|No||119|No|.59685|03/29/2022|.58252|03/29/2022|.5864|03/29/2022|||STEROIDS: TOPICAL MEDIUM|5178|||||No|No||COSETTE PHARMAC|No||||
fluticasone propionate|No|No|No|No|75%|00713063231|FLUTICASONE PROP 0.005% OINT|30|GM|.31891|10/07/2009||Yes|No||10/07/2009||Yes|No|10/07/2009||Yes|No||||No|No|||Prescription required|No||119|No|.41904|03/29/2022|.40898|03/29/2022|.4117|03/29/2022|||STEROIDS: TOPICAL MEDIUM|5179|||||No|No||COSETTE PHARMAC|No||||
fluticasone propionate|No|No|No|No|75%|00713063260|FLUTICASONE PROP 0.005% OINT|60|GM|.2519|10/07/2009||Yes|No||10/07/2009||Yes|No|10/07/2009||Yes|No||||No|No|||Prescription required|No||119|No|.49215|03/29/2022|.48033|03/29/2022|.48353|03/29/2022|||STEROIDS: TOPICAL MEDIUM|5180|||||No|No||COSETTE PHARMAC|No||||
metronidazole|No|No|No|No|75%|00713063337|METRONIDAZOLE 0.75% CREAM|45|GM|1.45836|10/07/2009||Yes|No||10/07/2009||Yes|No|10/07/2009||Yes|No||||No|No|||Prescription required|No||221|No|.99332|03/29/2022|.96948|03/29/2022|.97593|03/29/2022|||ROSACEA AGENTS: TOPICAL|5181|||||No|No||COSETTE PHARMAC|No||||
mometasone furoate|No|No|No|No|75%|00713063415|MOMETASONE FUROATE 0.1% CREAM|15|GM|.50166|10/07/2009||Yes|No||10/07/2009||Yes|No|10/07/2009||Yes|No||||No|No|||Prescription required|No||119|No|.51132|03/29/2022|.49904|03/29/2022|.50237|03/29/2022|||STEROIDS: TOPICAL MEDIUM|5182|||||No|No||COSETTE PHARMAC|No||||
mometasone furoate|No|No|No|No|75%|00713063437|MOMETASONE FUROATE 0.1% CREAM|45|GM|.28666|10/07/2009||Yes|No||10/07/2009||Yes|No|10/07/2009||Yes|No||||No|No|||Prescription required|No||119|No|.32851|03/29/2022|.32062|03/29/2022|.32276|03/29/2022|||STEROIDS: TOPICAL MEDIUM|5183|||||No|No||COSETTE PHARMAC|No||||
mometasone furoate|No|No|No|No|75%|00713063515|MOMETASONE FUROATE 0.1% OINT|15|GM|.344|10/21/2008||Yes|No||10/21/2008||Yes|No|10/21/2008||Yes|No||||No|No|||Prescription required|No||119|No|.28576|03/29/2022|.2789|03/29/2022|.28075|03/29/2022|||STEROIDS: TOPICAL MEDIUM|5184|||||No|No||COSETTE PHARMAC|No||||
mometasone furoate|No|No|No|No|75%|00713063537|MOMETASONE FUROATE 0.1% OINT|45|GM|.20066|07/24/2008||Yes|No||07/24/2008||Yes|No|07/24/2008||Yes|No||||No|No|||Prescription required|No||119|No|.17309|03/29/2022|.16893|03/29/2022|.17006|03/29/2022|||STEROIDS: TOPICAL MEDIUM|5185|||||No|No||COSETTE PHARMAC|No||||
metronidazole|No|No|No|No|75%|00713063737|METRONIDAZOLE TOPICAL 0.75% GL|45|GM|.93644|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|No||221|No|.54113|03/29/2022|.52814|03/29/2022|.53166|03/29/2022|||ROSACEA AGENTS: TOPICAL|5186|||||No|No||COSETTE PHARMAC|No||||
ciclopirox olamine|No|No|No|No|75%|00713063815|CICLOPIROX 0.77% CREAM|15|GM|.4406|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|061|No|.22046|03/29/2022|.21516|03/29/2022|.2166|03/29/2022|||ANTIFUNGALS: TOPICAL|5187|||||No|No||COSETTE PHARMAC|No||||
ciclopirox olamine|No|No|No|No|75%|00713063818|CICLOPIROX 0.77% CREAM|90|GM|.30983|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|061|No|.11129|03/29/2022|.10861|03/29/2022|.10934|03/29/2022|||ANTIFUNGALS: TOPICAL|5188|||||No|No||COSETTE PHARMAC|No||||
ciclopirox olamine|No|No|No|No|75%|00713063831|CICLOPIROX 0.77% CREAM|30|GM|.38814|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|061|No|.18222|03/29/2022|.17784|03/29/2022|.17903|03/29/2022|||ANTIFUNGALS: TOPICAL|5189|||||No|No||COSETTE PHARMAC|No||||
halobetasol propionate|No|No|No|No|75%|00713064015|HALOBETASOL PROP 0.05% CREAM|15|GM|1.8252|10/07/2009||Yes|No||10/07/2009||Yes|No|10/07/2009||Yes|No||||No|No|||Prescription required|No||121|No|.76044|03/29/2022|.74218|03/29/2022|.74713|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|5190|||||No|No||COSETTE PHARMAC|No||||
halobetasol propionate|No|No|No|No|75%|00713064086|HALOBETASOL PROP 0.05% CREAM|50|GM|1.31648|10/07/2009||Yes|No||10/07/2009||Yes|No|10/07/2009||Yes|No||||No|No|||Prescription required|No||121|No|.62002|03/29/2022|.60513|03/29/2022|.60916|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|5191|||||No|No||COSETTE PHARMAC|No||||
triamcinolone acetonide|No|No|No|No|75%|00713065540|TRIAMCINOLONE 0.1% PASTE|5|GM|5.54442|09/18/2017||Yes|No||09/18/2017||Yes|No|09/18/2017||Yes|No||||No|No|||Prescription required|No|||No|5.24075|03/29/2022|5.11497|03/29/2022|5.14903|03/29/2022||||5192|||||No|No||COSETTE PHARMAC|No||||
clobetasol propionate|No|No|No|No|75%|00713065615|CLOBETASOL 0.05% OINTMENT|15|GM|.688|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No||||No|No|||Prescription required|No||121|No|.35914|03/29/2022|.35052|03/29/2022|.35285|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|5193|||||No|No||COSETTE PHARMAC|No||||
clobetasol propionate|No|No|No|No|75%|00713065631|CLOBETASOL 0.05% OINTMENT|30|GM|.57921|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No||||No|No|||Prescription required|No||121|No|.3756|03/29/2022|.36658|03/29/2022|.36902|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|5194|||||No|No||COSETTE PHARMAC|No||||
clobetasol propionate|No|No|No|No|75%|00713065637|CLOBETASOL 0.05% OINTMENT|45|GM|.57915|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No||||No|No|||Prescription required|No||121|No|.36764|03/29/2022|.35881|03/29/2022|.3612|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|5195|||||No|No||COSETTE PHARMAC|No||||
clobetasol propionate|No|No|No|No|75%|00713065660|CLOBETASOL 0.05% OINTMENT|60|GM|.57906|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No||||No|No|||Prescription required|No||121|No|.32004|03/29/2022|.31235|03/29/2022|.31443|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|5196|||||No|No||COSETTE PHARMAC|No||||
desonide|No|No|No|No|75%|00713066115|DESONIDE 0.05% CREAM|15|GM|.58938|09/13/2015||Yes|No||09/13/2015||Yes|No|09/13/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|118|No|.68707|03/29/2022|.67058|03/29/2022|.67504|03/29/2022|||STEROIDS: TOPICAL LOW|5197|||||No|No||COSETTE PHARMAC|No||||
desonide|No|No|No|No|75%|00713066160|DESONIDE 0.05% CREAM|60|GM|.58945|09/13/2015||Yes|No||09/13/2015||Yes|No|09/13/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|118|No|.61157|03/29/2022|.59689|03/29/2022|.60086|03/29/2022|||STEROIDS: TOPICAL LOW|5198|||||No|No||COSETTE PHARMAC|No||||
fluocinonide/emollient base|No|No|No|No|75%|00713066415|FLUOCINONIDE-E 0.05% CREAM|15|GM|.80496|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|1.34778|08/24/2021|1.31543|08/24/2021|1.32419|08/24/2021|||STEROIDS: TOPICAL HIGH|5199|||||No|No||COSETTE PHARMAC|No||||
fluocinonide/emollient base|No|No|No|No|75%|00713066431|FLUOCINONIDE-E 0.05% CREAM|30|GM|.78905|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|1.7983|03/01/2022|1.77261|03/01/2022|1.6882|03/01/2022|||STEROIDS: TOPICAL HIGH|5200|||||No|No||COSETTE PHARMAC|No||||
fluocinonide/emollient base|No|No|No|No|75%|00713066460|FLUOCINONIDE-E 0.05% CREAM|60|GM|.78109|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|.77317|03/01/2022|.75461|03/01/2022|.75963|03/01/2022|||STEROIDS: TOPICAL HIGH|5201|||||No|No||COSETTE PHARMAC|No||||
hydrocortisone valerate|No|No|No|No|75%|00713066815|HYDROCORTISONE VAL 0.2% CREAM|15|GM|1.06066|03/13/2015||Yes|No||03/13/2015||Yes|No|03/13/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|119|No|.67989|03/29/2022|.66357|03/29/2022|.66799|03/29/2022|||STEROIDS: TOPICAL MEDIUM|5202|||||No|No||COSETTE PHARMAC|No||||
hydrocortisone valerate|No|No|No|No|75%|00713066837|HYDROCORTISONE VAL 0.2% CREAM|45|GM|.6899|03/13/2015||Yes|No||03/13/2015||Yes|No|03/13/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|119|No|.56991|03/29/2022|.55623|03/29/2022|.55993|03/29/2022|||STEROIDS: TOPICAL MEDIUM|5203|||||No|No||COSETTE PHARMAC|No||||
hydrocortisone valerate|No|No|No|No|75%|00713066860|HYDROCORTISONE VAL 0.2% CREAM|60|GM|.62242|03/13/2015||Yes|No||03/13/2015||Yes|No|03/13/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|119|No|.61899|03/01/2022|.60413|03/01/2022|.60815|03/01/2022|||STEROIDS: TOPICAL MEDIUM|5204|||||No|No||COSETTE PHARMAC|No||||
hydrocortisone valerate|No|No|No|No|75%|00713066915|HYDROCORTISONE VAL 0.2% OINTMT|15|GM|2.25664|08/04/2016||Yes|No||08/04/2016||Yes|No|08/04/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|119|No|3.63773|08/24/2021|3.55042|08/24/2021|3.57406|08/24/2021|||STEROIDS: TOPICAL MEDIUM|5205|||||No|No||COSETTE PHARMAC|No||||
hydrocortisone valerate|No|No|No|No|75%|00713066937|HYDROCORTISONE VAL 0.2% OINTMT|45|GM|1.51646|09/19/2017||Yes|No||09/19/2017||Yes|No|09/19/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|119|No|2.25168|03/01/2022|2.19763|03/01/2022|2.21227|03/01/2022|||STEROIDS: TOPICAL MEDIUM|5206|||||No|No||COSETTE PHARMAC|No||||
hydrocortisone valerate|No|No|No|No|75%|00713066960|HYDROCORTISONE VAL 0.2% OINTMT|60|GM|1.36804|08/04/2016||Yes|No||08/04/2016||Yes|No|08/04/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|119|No|3.11787|10/23/2018|3.07332|10/23/2018|2.92698|10/23/2018|||STEROIDS: TOPICAL MEDIUM|5207|||||No|No||COSETTE PHARMAC|No||||
tazarotene|No|No|No|No|75%|00713067031|TAZAROTENE 0.1% CREAM|30|GM|3.10775|05/22/2018||Yes|No||05/22/2018||Yes|No|05/22/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|104|No|2.38122|03/29/2022|2.32407|03/29/2022|2.33954|03/29/2022|||ACNE AGENTS: TOPICAL|5208|||||No|No||COSETTE PHARMAC|No||||
tazarotene|No|No|No|No|75%|00713067060|TAZAROTENE 0.1% CREAM|60|GM|3.10724|05/22/2018||Yes|No||05/22/2018||Yes|No|05/22/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|104|No|3.41533|03/01/2022|3.33336|03/01/2022|3.35556|03/01/2022|||ACNE AGENTS: TOPICAL|5209|||||No|No||COSETTE PHARMAC|No||||
triamcinolone acetonide|No|No|No|No|75%|00713067653|TRIAMCINOLONE 0.1% LOTION|60|ML|.13401|02/08/2016||Yes|No||02/08/2016||Yes|No|02/08/2016||Yes|No||||No|No|||Prescription required|No||120|No|.34078|03/29/2022|.3326|03/29/2022|.33481|03/29/2022|||STEROIDS: TOPICAL HIGH|5210|||||No|No||COSETTE PHARMAC|No||||
nystatin|No|No|No|No|75%|00713067815|NYSTATIN 100,000 UNIT/GM CREAM|15|GM|.37238|02/08/2016||Yes|No||02/08/2016||Yes|No|02/08/2016||Yes|No||02/08/2016||Yes|No|||Prescription required|No||061|No|.26748|03/29/2022|.26106|03/29/2022|.26279|03/29/2022|||ANTIFUNGALS: TOPICAL|5211|||||No|No||COSETTE PHARMAC|No||||
nystatin|No|No|No|No|75%|00713067831|NYSTATIN 100,000 UNIT/GM CREAM|30|GM|.28652|02/08/2016||Yes|No||02/08/2016||Yes|No|02/08/2016||Yes|No||02/08/2016||Yes|No|||Prescription required|No||061|No|.16163|03/29/2022|.15775|03/29/2022|.1588|03/29/2022|||ANTIFUNGALS: TOPICAL|5212|||||No|No||COSETTE PHARMAC|No||||
gentamicin sulfate|No|No|No|No|75%|00713068215|GENTAMICIN 0.1% OINTMENT|15|GM|1.13233|05/22/2018||Yes|No||05/22/2018||Yes|No|05/22/2018||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|114|No|1.4736|03/29/2022|1.43823|03/29/2022|1.44781|03/29/2022|||ANTIBIOTICS: TOPICAL|5213|||||No|No||COSETTE PHARMAC|No||||
gentamicin sulfate|No|No|No|No|75%|00713068231|GENTAMICIN 0.1% OINTMENT|30|GM|1.13233|05/22/2018||Yes|No||05/22/2018||Yes|No|05/22/2018||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|114|No|1.09757|03/29/2022|1.07122|03/29/2022|1.07836|03/29/2022|||ANTIBIOTICS: TOPICAL|5214|||||No|No||COSETTE PHARMAC|No||||
gentamicin sulfate|No|No|No|No|75%|00713068315|GENTAMICIN 0.1% CREAM|15|GM|1.13233|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|114|No|1.45337|03/29/2022|1.41848|03/29/2022|1.42793|03/29/2022|||ANTIBIOTICS: TOPICAL|5215|||||No|No||COSETTE PHARMAC|No||||
gentamicin sulfate|No|No|No|No|75%|00713068331|GENTAMICIN 0.1% CREAM|30|GM|1.13233|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|114|No|1.27926|03/29/2022|1.24855|03/29/2022|1.25687|03/29/2022|||ANTIBIOTICS: TOPICAL|5216|||||No|No||COSETTE PHARMAC|No||||
nystatin|No|No|No|No|75%|00713068615|NYSTATIN 100,000 UNIT/GM OINT|15|GM|.40133|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||02/28/2019||Yes|No|||Prescription required|No||061|No|.33338|03/29/2022|.32537|03/29/2022|.32754|03/29/2022|||ANTIFUNGALS: TOPICAL|5217|||||No|No||COSETTE PHARMAC|No||||
nystatin|No|No|No|No|75%|00713068631|NYSTATIN 100,000 UNIT/GM OINT|30|GM|.301|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||02/28/2019||Yes|No|||Prescription required|No||061|No|.27525|03/29/2022|.26864|03/29/2022|.27043|03/29/2022|||ANTIFUNGALS: TOPICAL|5218|||||No|No||COSETTE PHARMAC|No||||
mometasone furoate|No|No|No|No|75%|00713070153|MOMETASONE FUROATE 0.1% SOLN|60|ML|.258|01/29/2021|09/15/2022|Yes|No||01/29/2021|09/15/2022|Yes|No|01/29/2021|09/15/2022|Yes|No||||No|No|||Prescription required|No||119|No|.29151|03/29/2022|.28451|03/29/2022|.2864|03/29/2022|||STEROIDS: TOPICAL MEDIUM|5219|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||COSETTE PHARMAC|No||||
mometasone furoate|No|No|No|No|75%|00713070185|MOMETASONE FUROATE 0.1% SOLN|30|ML|.26875|01/29/2021||Yes|No||01/29/2021||Yes|No|01/29/2021||Yes|No||||No|No|||Prescription required|No||119|No|.36456|03/29/2022|.35581|03/29/2022|.35818|03/29/2022|||STEROIDS: TOPICAL MEDIUM|5220|||||No|No||COSETTE PHARMAC|No||||
fluocinolone acetonide|No|No|No|No|75%|00713070915|FLUOCINOLONE 0.025% CREAM|15|GM|.8385|01/29/2021||Yes|No||01/29/2021||Yes|No|01/29/2021||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|1.52527|03/29/2022|1.48866|03/29/2022|1.49857|03/29/2022|||STEROIDS: TOPICAL MEDIUM|5221|||||No|No||COSETTE PHARMAC|No||||
fluocinolone acetonide|No|No|No|No|75%|00713070960|FLUOCINOLONE 0.025% CREAM|60|GM|.60737|01/29/2021||Yes|No||01/29/2021||Yes|No|01/29/2021||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|1.09723|12/28/2021|1.07089|12/28/2021|1.07802|12/28/2021|||STEROIDS: TOPICAL MEDIUM|5222|||||No|No||COSETTE PHARMAC|No||||
betamethasone dipropionate|No|No|No|No|75%|00713080753|BETAMETHASONE DP 0.05% LOT|60|ML|.27233|08/16/2017||Yes|No||08/16/2017||Yes|No|08/16/2017||Yes|No||||No|No|||Prescription required|No||120|No|.41157|03/29/2022|.40169|03/29/2022|.40436|03/29/2022|||STEROIDS: TOPICAL HIGH|5223|||||No|No||COSETTE PHARMAC|No||||
fluoxetine HCl|No|No|No|No|75%|00777310402|PROZAC 10 MG PULVULE|100|EA|7.2326|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|008|No|16.4836|01/11/2022|16.24812|01/11/2022|15.4744|01/11/2022|||ANTIDEPRESSANTS: SSRIs|5224|||||No|No||DISTA LABS|No||||
fluoxetine HCl|No|No|No|No|75%|00777310502|PROZAC 20 MG PULVULE|100|EA|7.4347|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|008|No|16.55128|01/18/2022|16.15404|01/18/2022|16.26163|01/18/2022|||ANTIDEPRESSANTS: SSRIs|5225|||||No|No||DISTA LABS|No||||
fluoxetine HCl|No|No|No|No|75%|00777310530|PROZAC 20 MG PULVULE|30|EA|7.4347|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|008|No|16.55128|01/18/2022|16.15404|01/18/2022|16.26163|01/18/2022|||ANTIDEPRESSANTS: SSRIs|5226|||||No|No||DISTA LABS|No||||
fluoxetine HCl|No|No|No|No|75%|00777310730|PROZAC 40 MG PULVULE|30|EA|14.8694|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|008|No|33.24175|01/18/2022|32.44394|01/18/2022|32.66001|01/18/2022|||ANTIDEPRESSANTS: SSRIs|5227|||||No|No||DISTA LABS|No||||
alprazolam|No|No|No|No|90%|00781106101|ALPRAZOLAM 0.25 MG TABLET|100|EA|.01436|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02093|03/29/2022|.02042|03/29/2022|.02056|03/29/2022|||ANXIOLYTICS|5228|||||No|No||SANDOZ|No||||
alprazolam|No|No|No|No|90%|00781106105|ALPRAZOLAM 0.25 MG TABLET|500|EA|.01406|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02093|03/29/2022|.02042|03/29/2022|.02056|03/29/2022|||ANXIOLYTICS|5229|||||No|No||SANDOZ|No||||
alprazolam|No|No|No|No|90%|00781106110|ALPRAZOLAM 0.25 MG TABLET|1000|EA|.01378|07/17/2006||Yes|No||07/17/2006||Yes|No|07/17/2006||Yes|No||||No|No|||Prescription required|No||090|Yes|.02093|03/29/2022|.02042|03/29/2022|.02056|03/29/2022|||ANXIOLYTICS|5230|||||No|No||SANDOZ|No||||
alprazolam|No|No|No|No|90%|00781107701|ALPRAZOLAM 0.5 MG TABLET|100|EA|.01831|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.0228|03/29/2022|.02225|03/29/2022|.0224|03/29/2022|||ANXIOLYTICS|5231|||||No|No||SANDOZ|No||||
alprazolam|No|No|No|No|90%|00781107705|ALPRAZOLAM 0.5 MG TABLET|500|EA|.01796|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.0228|03/29/2022|.02225|03/29/2022|.0224|03/29/2022|||ANXIOLYTICS|5232|||||No|No||SANDOZ|No||||
alprazolam|No|No|No|No|90%|00781107710|ALPRAZOLAM 0.5 MG TABLET|1000|EA|.0176|07/17/2006||Yes|No||07/17/2006||Yes|No|07/17/2006||Yes|No||||No|No|||Prescription required|No||090|Yes|.0228|03/29/2022|.02225|03/29/2022|.0224|03/29/2022|||ANXIOLYTICS|5233|||||No|No||SANDOZ|No||||
alprazolam|No|No|No|No|90%|00781107901|ALPRAZOLAM 1 MG TABLET|100|EA|.02033|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02503|03/29/2022|.02442|03/29/2022|.02459|03/29/2022|||ANXIOLYTICS|5234|||||No|No||SANDOZ|No||||
alprazolam|No|No|No|No|90%|00781107905|ALPRAZOLAM 1 MG TABLET|500|EA|.01991|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02503|03/29/2022|.02442|03/29/2022|.02459|03/29/2022|||ANXIOLYTICS|5235|||||No|No||SANDOZ|No||||
alprazolam|No|No|No|No|90%|00781107910|ALPRAZOLAM 1 MG TABLET|1000|EA|.01952|01/05/2006||Yes|No||01/05/2006||Yes|No|01/05/2006||Yes|No||||No|No|||Prescription required|No||090|Yes|.02503|03/29/2022|.02442|03/29/2022|.02459|03/29/2022|||ANXIOLYTICS|5236|||||No|No||SANDOZ|No||||
alprazolam|No|No|No|No|90%|00781108901|ALPRAZOLAM 2 MG TABLET|100|EA|.04755|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.0533|03/29/2022|.05202|03/29/2022|.05236|03/29/2022|||ANXIOLYTICS|5237|||||No|No||SANDOZ|No||||
alprazolam|No|No|No|No|90%|00781108905|ALPRAZOLAM 2 MG TABLET|500|EA|.04659|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.0533|03/29/2022|.05202|03/29/2022|.05236|03/29/2022|||ANXIOLYTICS|5238|||||No|No||SANDOZ|No||||
penicillin V potassium|No|No|No|No|75%|00781120501|PENICILLIN VK 250 MG TABLET|100|EA|.23615|03/01/2002|05/31/2022|Yes|No||03/01/2002|05/31/2022|Yes|No|03/01/2002|05/31/2022|Yes|No||03/01/2002|05/31/2022|Yes|No|||Prescription required|No||209|No|.0637|03/29/2022|.06217|03/29/2022|.06258|03/29/2022|||PENICILLINS|5239|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||SANDOZ|No||||
penicillin V potassium|No|No|No|No|75%|00781120510|PENICILLIN VK 250 MG TABLET|1000|EA|.22431|03/01/2002|05/05/2022|Yes|No||03/01/2002|05/05/2022|Yes|No|03/01/2002|05/05/2022|Yes|No||03/01/2002|05/05/2022|Yes|No|||Prescription required|No||209|No|.0637|03/29/2022|.06217|03/29/2022|.06258|03/29/2022|||PENICILLINS|5240|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||SANDOZ|No||||
amitriptyline HCl|No|No|No|No|75%|00781148601|AMITRIPTYLINE HCL 10 MG TAB|100|EA|.06153|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||215|No|.04811|03/29/2022|.04695|03/29/2022|.04726|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|5241|||||No|No||SANDOZ|No||||
amitriptyline HCl|No|No|No|No|75%|00781148610|AMITRIPTYLINE HCL 10 MG TAB|1000|EA|.05835|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||215|No|.04811|03/29/2022|.04695|03/29/2022|.04726|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|5242|||||No|No||SANDOZ|No||||
amitriptyline HCl|No|No|No|No|75%|00781148701|AMITRIPTYLINE HCL 25 MG TAB|100|EA|.12306|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||215|No|.07343|03/29/2022|.07166|03/29/2022|.07214|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|5243|||||No|No||SANDOZ|No||||
amitriptyline HCl|No|No|No|No|75%|00781148710|AMITRIPTYLINE HCL 25 MG TAB|1000|EA|.11671|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||215|No|.07343|03/29/2022|.07166|03/29/2022|.07214|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|5244|||||No|No||SANDOZ|No||||
amitriptyline HCl|No|No|No|No|75%|00781148801|AMITRIPTYLINE HCL 50 MG TAB|100|EA|.24574|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||215|No|.14797|03/29/2022|.14441|03/29/2022|.14538|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|5245|||||No|No||SANDOZ|No||||
amitriptyline HCl|No|No|No|No|75%|00781148810|AMITRIPTYLINE HCL 50 MG TAB|1000|EA|.20425|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||215|No|.14797|03/29/2022|.14441|03/29/2022|.14538|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|5246|||||No|No||SANDOZ|No||||
amitriptyline HCl|No|No|No|No|75%|00781148901|AMITRIPTYLINE HCL 75 MG TAB|100|EA|.36919|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||215|No|.26194|03/29/2022|.25565|03/29/2022|.25735|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|5247|||||No|No||SANDOZ|No||||
amitriptyline HCl|No|No|No|No|75%|00781149001|AMITRIPTYLINE HCL 100 MG TAB|100|EA|.49149|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||215|No|.30607|03/29/2022|.29872|03/29/2022|.30071|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|5248|||||No|No||SANDOZ|No||||
amitriptyline HCl|No|No|No|No|75%|00781149101|AMITRIPTYLINE HCL 150 MG TAB|100|EA|.73723|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||215|No|.58201|03/29/2022|.56804|03/29/2022|.57182|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|5249|||||No|No||SANDOZ|No||||
potassium chloride|No|No|No|No|75%|00781151610|POTASSIUM CL ER 8 MEQ TABLET|1000|EA|.1845|02/03/2005||Yes|No||02/03/2005||Yes|No|02/03/2005||Yes|No||04/01/2011||Yes|No|||Prescription required|No|||No|.17696|03/29/2022|.17271|03/29/2022|.17386|03/29/2022||||5250|||||No|No||SANDOZ|No||||
potassium chloride|No|No|No|No|75%|00781152601|POTASSIUM CL ER 10 MEQ TABLET|100|EA|.19423|11/05/2002|01/15/2022|Yes|No||11/05/2002|01/15/2022|Yes|No|11/05/2002|01/15/2022|Yes|No||11/05/2002|01/15/2022|Yes|No|||Prescription required|No|||No|.44266|03/15/2022|.43634|03/15/2022|.41556|03/15/2022||||5251|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||SANDOZ|No||||
potassium chloride|No|No|No|No|75%|00781152610|POTASSIUM CL ER 10 MEQ TABLET|1000|EA|.19421|11/05/2002|01/15/2022|Yes|No||11/05/2002|01/15/2022|Yes|No|11/05/2002|01/15/2022|Yes|No||11/05/2002|01/15/2022|Yes|No|||Prescription required|No|||No|.44263|03/15/2022|.43631|03/15/2022|.41553|03/15/2022||||5252|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||SANDOZ|No||||
isosorbide dinitrate|No|No|No|No|75%|00781155601|ISOSORBIDE DINITRATE 10 MG TAB|100|EA|.37272|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.34234|03/29/2022|.33412|03/29/2022|.33634|03/29/2022||||5253|||||No|No||SANDOZ|No||||
isosorbide dinitrate|No|No|No|No|75%|00781155610|ISOSORBIDE DINITRATE 10 MG TAB|1000|EA|.37274|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.34234|03/29/2022|.33412|03/29/2022|.33634|03/29/2022||||5254|||||No|No||SANDOZ|No||||
isosorbide dinitrate|No|No|No|No|75%|00781163501|ISOSORBIDE DINITRATE 5 MG TAB|100|EA|.33884|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.32336|03/29/2022|.31559|03/29/2022|.3177|03/29/2022||||5255|||||No|No||SANDOZ|No||||
isosorbide dinitrate|No|No|No|No|75%|00781163510|ISOSORBIDE DINITRATE 5 MG TAB|1000|EA|.33885|10/11/2016||Yes|No||10/11/2016||Yes|No|10/11/2016||Yes|No||||No|No|||Prescription required|No|||No|.32336|03/29/2022|.31559|03/29/2022|.3177|03/29/2022||||5256|||||No|No||SANDOZ|No||||
penicillin V potassium|No|No|No|No|75%|00781165501|PENICILLIN VK 500 MG TABLET|100|EA|.40127|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||209|No|.10026|03/29/2022|.09785|03/29/2022|.0985|03/29/2022|||PENICILLINS|5257|||||No|No||SANDOZ|No||||
penicillin V potassium|No|No|No|No|75%|00781165510|PENICILLIN VK 500 MG TABLET|1000|EA|.38122|03/01/2002|05/05/2022|Yes|No||03/01/2002|05/05/2022|Yes|No|03/01/2002|05/05/2022|Yes|No||03/01/2002|05/05/2022|Yes|No|||Prescription required|No||209|No|.10026|03/29/2022|.09785|03/29/2022|.0985|03/29/2022|||PENICILLINS|5258|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||SANDOZ|No||||
isosorbide dinitrate|No|No|No|No|75%|00781169501|ISOSORBIDE DINITRATE 20 MG TAB|100|EA|.41|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.30675|03/29/2022|.29938|03/29/2022|.30138|03/29/2022||||5259|||||No|No||SANDOZ|No||||
isosorbide dinitrate|No|No|No|No|75%|00781169510|ISOSORBIDE DINITRATE 20 MG TAB|1000|EA|.41001|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.30675|03/29/2022|.29938|03/29/2022|.30138|03/29/2022||||5260|||||No|No||SANDOZ|No||||
imipramine HCl|No|No|No|No|75%|00781176201|IMIPRAMINE HCL 10 MG TABLET|100|EA|.11085|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.08862|03/29/2022|.08649|03/29/2022|.08706|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|5261|||||No|No||SANDOZ|No||||
imipramine HCl|No|No|No|No|75%|00781176401|IMIPRAMINE HCL 25 MG TABLET|100|EA|.14809|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.0831|03/29/2022|.0811|03/29/2022|.08164|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|5262|||||No|No||SANDOZ|No||||
imipramine HCl|No|No|No|No|75%|00781176410|IMIPRAMINE HCL 25 MG TABLET|1000|EA|.14068|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.0831|03/29/2022|.0811|03/29/2022|.08164|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|5263|||||No|No||SANDOZ|No||||
imipramine HCl|No|No|No|No|75%|00781176601|IMIPRAMINE HCL 50 MG TABLET|100|EA|.22011|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.13692|03/29/2022|.13363|03/29/2022|.13452|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|5264|||||No|No||SANDOZ|No||||
imipramine HCl|No|No|No|No|75%|00781176610|IMIPRAMINE HCL 50 MG TABLET|1000|EA|.20911|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.13692|03/29/2022|.13363|03/29/2022|.13452|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|5265|||||No|No||SANDOZ|No||||
promethazine HCl|No|No|No|No|75%|00781183001|PROMETHAZINE 25 MG TABLET|100|EA|.0301|10/14/2004||Yes|No||10/14/2004||Yes|No|10/14/2004||Yes|No||10/14/2004||Yes|No|||Prescription required|No||085|Yes|.05271|03/29/2022|.05144|03/29/2022|.05178|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|5266|||||No|No||SANDOZ|No||||
promethazine HCl|No|No|No|No|75%|00781183010|PROMETHAZINE 25 MG TABLET|1000|EA|.0301|09/01/2005||Yes|No||09/01/2005||Yes|No|09/01/2005||Yes|No||04/01/2011||Yes|No|||Prescription required|No||085|Yes|.05271|03/29/2022|.05144|03/29/2022|.05178|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|5267|||||No|No||SANDOZ|No||||
promethazine HCl|No|No|No|No|75%|00781183201|PROMETHAZINE 50 MG TABLET|100|EA|.06192|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||085|Yes|.09825|03/29/2022|.09589|03/29/2022|.09653|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|5268|||||No|No||SANDOZ|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00781185220|AMOX-CLAV 875-125 MG TABLET|20|EA|.48783|02/02/2005||Yes|No||02/02/2005||Yes|No|02/02/2005||Yes|No||04/01/2011||Yes|No|||Prescription required|No||046|No|.32484|03/29/2022|.31704|03/29/2022|.31915|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|5269|||||No|No||SANDOZ|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00781187431|AMOX-CLAV 250-125 MG TABLET|30|EA|1.42846|06/05/2006||Yes|No||06/05/2006||Yes|No|06/05/2006||Yes|No||04/01/2011||Yes|No|||Prescription required|No||046|No|2.34666|03/29/2022|2.29034|03/29/2022|2.30559|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|5270|||||No|No||SANDOZ|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00781194339|AMOX-CLAV ER 1,000-62.5 MG TAB|40|EA|2.63901|02/10/2011||Yes|No||02/10/2011||Yes|No|02/10/2011||Yes|No||02/10/2011||Yes|No|||Prescription required|Yes|01/28/2021|046|No|5.42252|03/29/2022|5.29237|03/29/2022|5.32762|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|5271|||||No|No||SANDOZ|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00781194382|AMOX-CLAV ER 1,000-62.5 MG TAB|28|EA|2.63912|02/10/2011||Yes|No||02/10/2011||Yes|No|02/10/2011||Yes|No||02/10/2011||Yes|No|||Prescription required|Yes|01/28/2021|046|No|5.42252|03/29/2022|5.29237|03/29/2022|5.32762|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|5272|||||No|No||SANDOZ|No||||
clarithromycin|No|No|No|No|75%|00781196160|CLARITHROMYCIN 250 MG TABLET|60|EA|.42017|03/16/2006||Yes|No||03/16/2006||Yes|No|03/16/2006||Yes|No||||No|No|||Prescription required|No||018|No|.54294|03/29/2022|.5299|03/29/2022|.53343|03/29/2022|||MACROLIDES/KETOLIDES|5273|||||No|No||SANDOZ|No||||
clarithromycin|No|No|No|No|75%|00781196260|CLARITHROMYCIN 500 MG TABLET|60|EA|.42017|03/16/2006||Yes|No||03/16/2006||Yes|No|03/16/2006||Yes|No||||No|No|||Prescription required|No||018|No|.44307|03/29/2022|.43243|03/29/2022|.43531|03/29/2022|||MACROLIDES/KETOLIDES|5274|||||No|No||SANDOZ|No||||
amoxicillin|No|No|No|No|75%|00781202001|AMOXICILLIN 250 MG CAPSULE|100|EA|.04923|04/19/2004||Yes|No||04/19/2004||Yes|No|04/19/2004||Yes|No||04/01/2011||Yes|No|||Prescription required|No||209|No|.06288|03/29/2022|.06137|03/29/2022|.06177|03/29/2022|||PENICILLINS|5275|||||No|No||SANDOZ|No||||
amoxicillin|No|No|No|No|75%|00781202005|AMOXICILLIN 250 MG CAPSULE|500|EA|.04358|04/19/2004||Yes|No||04/19/2004||Yes|No|04/19/2004||Yes|No||04/19/2004||Yes|No|||Prescription required|No||209|No|.06288|03/29/2022|.06137|03/29/2022|.06177|03/29/2022|||PENICILLINS|5276|||||No|No||SANDOZ|No||||
clomipramine HCl|No|No|No|No|75%|00781202701|CLOMIPRAMINE 25 MG CAPSULE|100|EA|2.90043|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|1.31238|03/29/2022|1.28088|03/29/2022|1.28941|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|5277|||||No|No||SANDOZ|No||||
clomipramine HCl|No|No|No|No|75%|00781203701|CLOMIPRAMINE 50 MG CAPSULE|100|EA|2.90043|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.80238|03/29/2022|.78312|03/29/2022|.78833|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|5278|||||No|No||SANDOZ|No||||
mycophenolate mofetil|No|No|No|No|75%|00781206701|MYCOPHENOLATE 250 MG CAPSULE|100|EA|.23508|04/13/2010||Yes|No||04/13/2010||Yes|No|04/13/2010||Yes|No||04/01/2011||Yes|No|||Prescription required|No||229|No|.2129|03/29/2022|.20779|03/29/2022|.20917|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|5279|||||No|No||SANDOZ|No||||
mycophenolate mofetil|No|No|No|No|75%|00781206705|MYCOPHENOLATE 250 MG CAPSULE|500|EA|.22332|04/13/2010||Yes|No||04/13/2010||Yes|No|04/13/2010||Yes|No||04/01/2011||Yes|No|||Prescription required|No||229|No|.2129|03/29/2022|.20779|03/29/2022|.20917|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|5280|||||No|No||SANDOZ|No||||
mycophenolate mofetil|No|No|No|No|75%|00781206789|MYCOPHENOLATE 250 MG CAPSULE|120|EA|.23508|05/04/2010||Yes|No||05/04/2010||Yes|No|05/04/2010||Yes|No||04/01/2011||Yes|No|||Prescription required|No||229|No|.2129|03/29/2022|.20779|03/29/2022|.20917|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|5281|||||No|No||SANDOZ|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|00781207401|TRIAMTERENE-HCTZ 37.5-25 MG CP|100|EA|.0912|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|.14661|03/29/2022|.14309|03/29/2022|.14404|03/29/2022||||5282|||||No|No||SANDOZ|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|00781207410|TRIAMTERENE-HCTZ 37.5-25 MG CP|1000|EA|.0877|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|.14661|03/29/2022|.14309|03/29/2022|.14404|03/29/2022||||5283|||||No|No||SANDOZ|No||||
tamsulosin HCl|No|No|No|No|75%|00781207601|TAMSULOSIN HCL 0.4 MG CAPSULE|100|EA|.215|06/10/2010||Yes|No||06/10/2010||Yes|No|06/10/2010||Yes|No||||No|No|||Prescription required|No||003|No|.06447|03/29/2022|.06292|03/29/2022|.06334|03/29/2022|||BPH TREATMENTS|5284|||||No|No||SANDOZ|No||||
calcium acetate|No|No|No|No|75%|00781208102|CALCIUM ACETATE 667 MG GELCAP|200|EA|.27163|03/20/2013||Yes|No||03/20/2013||Yes|No|03/20/2013||Yes|No||03/20/2013||Yes|No|||Prescription required|No||052|Yes|.28113|03/29/2022|.27438|03/29/2022|.27621|03/29/2022|||PHOSPHATE BINDERS|5285|||||No|No||SANDOZ|No||||
tacrolimus|No|No|No|No|75%|00781210201|TACROLIMUS 0.5 MG CAPSULE (IR)|100|EA|.19874|12/17/2009||Yes|No||12/17/2009||Yes|No|12/17/2009||Yes|No||03/07/2011||Yes|No|||Prescription required|No||229|No|.26138|03/29/2022|.2551|03/29/2022|.2568|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|5286|||||No|No||SANDOZ|No||||
tacrolimus|No|No|No|No|75%|00781210301|TACROLIMUS 1 MG CAPSULE (IR)|100|EA|.39431|11/02/2009||Yes|No||11/02/2009||Yes|No|11/02/2009||Yes|No||03/07/2011||Yes|No|||Prescription required|No||229|No|.35645|03/29/2022|.34789|03/29/2022|.35021|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|5287|||||No|No||SANDOZ|No||||
tacrolimus|No|No|No|No|75%|00781210401|TACROLIMUS 5 MG CAPSULE (IR)|100|EA|1.9365|11/02/2009||Yes|No||11/02/2009||Yes|No|11/02/2009||Yes|No||03/07/2011||Yes|No|||Prescription required|No||229|No|2.05753|03/29/2022|2.00814|03/29/2022|2.02152|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|5288|||||No|No||SANDOZ|No||||
ampicillin trihydrate|No|No|No|No|75%|00781214501|AMPICILLIN 500 MG CAPSULE|100|EA|.22265|05/01/2004||Yes|No||05/01/2004||Yes|No|05/01/2004||Yes|No||04/01/2011||Yes|No|||Prescription required|No||209|No|.47312|03/29/2022|.46176|03/29/2022|.46484|03/29/2022|||PENICILLINS|5289|||||No|No||SANDOZ|No||||
ampicillin trihydrate|No|No|No|No|75%|00781214505|AMPICILLIN 500 MG CAPSULE|500|EA|.21706|10/11/2016||Yes|No||10/11/2016||Yes|No|10/11/2016||Yes|No||10/11/2016||Yes|No|||Prescription required|No||209|No|.47312|03/29/2022|.46176|03/29/2022|.46484|03/29/2022|||PENICILLINS|5290|||||No|No||SANDOZ|No||||
ziprasidone HCl|No|No|No|No|75%|00781216460|ZIPRASIDONE HCL 20 MG CAPSULE|60|EA|.215|03/14/2013||Yes|No||03/14/2013||Yes|No|03/14/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|.27381|03/29/2022|.26723|03/29/2022|.26901|03/29/2022|||ANTIPSYCHOTICS|5291|||||No|No||SANDOZ|No||||
ziprasidone HCl|No|No|No|No|75%|00781216660|ZIPRASIDONE HCL 40 MG CAPSULE|60|EA|.215|03/14/2013||Yes|No||03/14/2013||Yes|No|03/14/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|.29914|03/29/2022|.29196|03/29/2022|.2939|03/29/2022|||ANTIPSYCHOTICS|5292|||||No|No||SANDOZ|No||||
ziprasidone HCl|No|No|No|No|75%|00781216760|ZIPRASIDONE HCL 60 MG CAPSULE|60|EA|.25083|03/14/2013||Yes|No||03/14/2013||Yes|No|03/14/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|.38441|03/29/2022|.37518|03/29/2022|.37768|03/29/2022|||ANTIPSYCHOTICS|5293|||||No|No||SANDOZ|No||||
ziprasidone HCl|No|No|No|No|75%|00781216860|ZIPRASIDONE HCL 80 MG CAPSULE|60|EA|.25083|03/14/2013||Yes|No||03/14/2013||Yes|No|03/14/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|.42395|03/29/2022|.41377|03/29/2022|.41653|03/29/2022|||ANTIPSYCHOTICS|5294|||||No|No||SANDOZ|No||||
cefdinir|No|No|No|No|75%|00781217660|CEFDINIR 300 MG CAPSULE|60|EA|.35833|05/10/2007|08/06/2022|Yes|No||05/10/2007|08/06/2022|Yes|No|05/10/2007|08/06/2022|Yes|No||||No|No|||Prescription required|No||046|No|.46443|03/29/2022|.45328|03/29/2022|.4563|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|5295|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||SANDOZ|No||||
omeprazole|No|No|No|No|75%|00781223401|OMEPRAZOLE DR 40 MG CAPSULE|100|EA|.0516|05/31/2011||Yes|No||05/31/2011||Yes|No|05/31/2011||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|5296|||||No|No||SANDOZ|No||||
omeprazole|No|No|No|No|75%|00781223410|OMEPRAZOLE DR 40 MG CAPSULE|1000|EA|.0516|05/31/2011||Yes|No||05/31/2011||Yes|No|05/31/2011||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|5297|||||No|No||SANDOZ|No||||
omeprazole|No|No|No|No|75%|00781223431|OMEPRAZOLE DR 40 MG CAPSULE|30|EA|.0516|05/31/2011||Yes|No||05/31/2011||Yes|No|05/31/2011||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|5298|||||No|No||SANDOZ|No||||
dicloxacillin sodium|No|No|No|No|75%|00781224801|DICLOXACILLIN 250 MG CAPSULE|100|EA|.12887|11/02/2004||Yes|No||11/02/2004||Yes|No|||No|No||04/01/2011||Yes|No|||Prescription required|No||209|No|.2937|10/26/2021|.28951|10/26/2021|.27572|10/26/2021|||PENICILLINS|5299|||||No|No||SANDOZ|No||||
dicloxacillin sodium|No|No|No|No|75%|00781225801|DICLOXACILLIN 500 MG CAPSULE|100|EA|.25774|05/01/2004||Yes|No||05/01/2004||Yes|No|05/01/2004||Yes|No||04/01/2011||Yes|No|||Prescription required|No||209|No|1.09839|03/29/2022|1.07202|03/29/2022|1.07916|03/29/2022|||PENICILLINS|5300|||||No|No||SANDOZ|No||||
aprepitant|No|No|No|No|75%|00781232106|APREPITANT 40 MG CAPSULE|1|EA|37.8185|04/12/2017||Yes|No||04/12/2017||Yes|No|04/12/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|085|Yes|60.95057|01/25/2022|59.48775|01/25/2022|59.88393|01/25/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|5301|||||No|No||SANDOZ|No||||
aprepitant|No|No|No|No|75%|00781232151|APREPITANT 40 MG CAPSULE|5|EA|37.81764|04/12/2017||Yes|No||04/12/2017||Yes|No|04/12/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|085|Yes|60.95057|01/25/2022|59.48775|01/25/2022|59.88393|01/25/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|5302|||||No|No||SANDOZ|No||||
aprepitant|No|No|No|No|75%|00781232246|APREPITANT 80 MG CAPSULE|2|EA|70.10075|04/12/2017||Yes|No||04/12/2017||Yes|No|04/12/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|085|Yes|130.01571|12/21/2021|126.89533|12/21/2021|127.74043|12/21/2021|||ANTIEMETIC/ANTIVERTIGO AGENTS|5303|||||No|No||SANDOZ|No||||
aprepitant|No|No|No|No|75%|00781232268|APREPITANT 80 MG CAPSULE|6|EA|70.09358|04/12/2017||Yes|No||04/12/2017||Yes|No|04/12/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|085|Yes|130.01571|12/21/2021|126.89533|12/21/2021|127.74043|12/21/2021|||ANTIEMETIC/ANTIVERTIGO AGENTS|5304|||||No|No||SANDOZ|No||||
aprepitant|No|No|No|No|75%|00781232368|APREPITANT 125 MG CAPSULE|6|EA|109.52458|04/12/2017||Yes|No||04/12/2017||Yes|No|04/12/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|085|Yes|249.61416|04/12/2017|246.04824|04/12/2017|234.33166|04/12/2017|||ANTIEMETIC/ANTIVERTIGO AGENTS|5305|||||No|No||SANDOZ|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00781232901|DEXTROAMP-AMPHET ER 5 MG CAP|100|EA|.473|11/30/2016||Yes|No||11/30/2016||Yes|No|11/30/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.59233|03/29/2022|.57811|03/29/2022|.58196|03/29/2022|||STIMULANTS AND RELATED AGENTS|5306|||||No|No||SANDOZ|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00781233501|DEXTROAMP-AMPHET ER 10 MG CAP|100|EA|.473|11/30/2016||Yes|No||11/30/2016||Yes|No|11/30/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.53198|03/29/2022|.51921|03/29/2022|.52267|03/29/2022|||STIMULANTS AND RELATED AGENTS|5307|||||No|No||SANDOZ|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00781234301|DEXTROAMP-AMPHET ER 15 MG CAP|100|EA|.473|11/30/2016||Yes|No||11/30/2016||Yes|No|11/30/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55636|03/29/2022|.543|03/29/2022|.54662|03/29/2022|||STIMULANTS AND RELATED AGENTS|5308|||||No|No||SANDOZ|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00781235201|DEXTROAMP-AMPHET ER 20 MG CAP|100|EA|.473|11/30/2016||Yes|No||11/30/2016||Yes|No|11/30/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.58746|03/29/2022|.57336|03/29/2022|.57717|03/29/2022|||STIMULANTS AND RELATED AGENTS|5309|||||No|No||SANDOZ|No||||
methylphenidate HCl|No|No|No|No|75%|00781236101|METHYLPHENIDATE ER(LA) 10MG CP|100|EA|3.53356|05/15/2018||Yes|No||05/15/2018||Yes|No|05/15/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|5.98466|03/29/2022|5.84102|03/29/2022|5.87992|03/29/2022|||STIMULANTS AND RELATED AGENTS|5310|||||No|No||SANDOZ|No||||
methylphenidate HCl|No|No|No|No|75%|00781236201|METHYLPHENIDATE ER(LA) 20MG CP|100|EA|1.95194|01/19/2016||Yes|No||01/19/2016||Yes|No|01/19/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.22563|03/29/2022|1.19621|03/29/2022|1.20418|03/29/2022|||STIMULANTS AND RELATED AGENTS|5311|||||No|No||SANDOZ|No||||
methylphenidate HCl|No|No|No|No|75%|00781236301|METHYLPHENIDATE ER(LA) 30MG CP|100|EA|1.99636|01/19/2016||Yes|No||01/19/2016||Yes|No|01/19/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.80098|03/29/2022|1.75775|03/29/2022|1.76946|03/29/2022|||STIMULANTS AND RELATED AGENTS|5312|||||No|No||SANDOZ|No||||
methylphenidate HCl|No|No|No|No|75%|00781236401|METHYLPHENIDATE ER(LA) 40MG CP|100|EA|2.05183|01/19/2016||Yes|No||01/19/2016||Yes|No|01/19/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.62914|03/29/2022|1.59004|03/29/2022|1.60063|03/29/2022|||STIMULANTS AND RELATED AGENTS|5313|||||No|No||SANDOZ|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00781236801|DEXTROAMP-AMPHET ER 25 MG CAP|100|EA|.473|11/30/2016||Yes|No||11/30/2016||Yes|No|11/30/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.54687|03/29/2022|.53374|03/29/2022|.53729|03/29/2022|||STIMULANTS AND RELATED AGENTS|5314|||||No|No||SANDOZ|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|00781237101|DEXTROAMP-AMPHET ER 30 MG CAP|100|EA|.473|11/30/2016||Yes|No||11/30/2016||Yes|No|11/30/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.61484|03/29/2022|.60008|03/29/2022|.60408|03/29/2022|||STIMULANTS AND RELATED AGENTS|5315|||||No|No||SANDOZ|No||||
amoxicillin|No|No|No|No|75%|00781261301|AMOXICILLIN 500 MG CAPSULE|100|EA|.07662|04/19/2004||Yes|No||04/19/2004||Yes|No|04/19/2004||Yes|No||04/01/2011||Yes|No|||Prescription required|No||209|No|.07054|03/29/2022|.06884|03/29/2022|.0693|03/29/2022|||PENICILLINS|5316|||||No|No||SANDOZ|No||||
amoxicillin|No|No|No|No|75%|00781261305|AMOXICILLIN 500 MG CAPSULE|500|EA|.06884|08/25/2004||Yes|No||08/25/2004||Yes|No|08/25/2004||Yes|No||08/25/2004||Yes|No|||Prescription required|No||209|No|.07054|03/29/2022|.06884|03/29/2022|.0693|03/29/2022|||PENICILLINS|5317|||||No|No||SANDOZ|No||||
amoxicillin|No|No|No|No|75%|00781261376|AMOXICILLIN 500 MG CAPSULE|30|EA|.06884|10/11/2016||Yes|No||10/11/2016||Yes|No|10/11/2016||Yes|No||10/11/2016||Yes|No|||Prescription required|No||209|No|.07054|03/29/2022|.06884|03/29/2022|.0693|03/29/2022|||PENICILLINS|5318|||||No|No||SANDOZ|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00781268201|DEXMETHYLPHENIDATE ER 5 MG CAP|100|EA|2.79659|02/23/2015||Yes|No||02/23/2015||Yes|No|02/23/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.46405|03/29/2022|1.42891|03/29/2022|1.43842|03/29/2022|||STIMULANTS AND RELATED AGENTS|5319|||||No|No||SANDOZ|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00781268301|DEXMETHYLPHENIDATE ER 10 MG CP|100|EA|3.25978|06/01/2015||Yes|No||06/01/2015||Yes|No|06/01/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.21716|03/29/2022|1.18794|03/29/2022|1.19585|03/29/2022|||STIMULANTS AND RELATED AGENTS|5320|||||No|No||SANDOZ|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00781268401|DEXMETHYLPHENIDATE ER 15 MG CP|100|EA|2.65095|06/10/2014||Yes|No||06/10/2014||Yes|No|06/10/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.90155|03/29/2022|.87991|03/29/2022|.88577|03/29/2022|||STIMULANTS AND RELATED AGENTS|5321|||||No|No||SANDOZ|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00781268501|DEXMETHYLPHENIDATE ER 20 MG CP|100|EA|3.35232|09/08/2015||Yes|No||09/08/2015||Yes|No|09/08/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.47249|03/29/2022|1.43715|03/29/2022|1.44672|03/29/2022|||STIMULANTS AND RELATED AGENTS|5322|||||No|No||SANDOZ|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00781268601|DEXMETHYLPHENIDATE ER 25 MG CP|100|EA|1.39956|08/14/2019|04/30/2022|Yes|No||08/14/2019|04/30/2022|Yes|No|08/14/2019|04/30/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.83308|03/29/2022|1.78908|03/29/2022|1.801|03/29/2022|||STIMULANTS AND RELATED AGENTS|5323|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SANDOZ|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00781268701|DEXMETHYLPHENIDATE ER 30 MG CP|100|EA|2.45241|09/29/2014||Yes|No||09/29/2014||Yes|No|09/29/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|2.05596|03/29/2022|2.00661|03/29/2022|2.01998|03/29/2022|||STIMULANTS AND RELATED AGENTS|5324|||||No|No||SANDOZ|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00781268801|DEXMETHYLPHENIDATE ER 35 MG CP|100|EA|1.61456|08/14/2019||Yes|No||08/14/2019||Yes|No|08/14/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|2.40563|01/25/2022|2.34789|01/25/2022|2.36353|01/25/2022|||STIMULANTS AND RELATED AGENTS|5325|||||No|No||SANDOZ|No||||
dexmethylphenidate HCl|No|No|No|No|75%|00781268901|DEXMETHYLPHENIDATE ER 40 MG CP|100|EA|2.92705|11/04/2014|07/31/2022|Yes|No||11/04/2014|07/31/2022|Yes|No|11/04/2014|07/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|2.72731|03/29/2022|2.66185|03/29/2022|2.67958|03/29/2022|||STIMULANTS AND RELATED AGENTS|5326|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SANDOZ|No||||
temozolomide|No|No|No|No|75%|00781269344|TEMOZOLOMIDE 100 MG CAPSULE|14|EA|34.5806|12/06/2013|01/06/2022|Yes|No||12/06/2013|01/06/2022|Yes|No|12/06/2013|01/06/2022|Yes|No||||No|No|||Prescription required|No||239|No|78.8116|11/28/2017|77.68572|11/28/2017|73.9864|11/28/2017|||ONCOLOGY: ORAL - OTHER|5327|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||SANDOZ|No||||
temozolomide|No|No|No|No|75%|00781269375|TEMOZOLOMIDE 100 MG CAPSULE|5|EA|34.57974|12/06/2013|01/06/2022|Yes|No||12/06/2013|01/06/2022|Yes|No|12/06/2013|01/06/2022|Yes|No||||No|No|||Prescription required|No||239|No|78.80964|11/28/2017|77.68378|11/28/2017|73.98456|11/28/2017|||ONCOLOGY: ORAL - OTHER|5328|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||SANDOZ|No||||
temozolomide|No|No|No|No|75%|00781269444|TEMOZOLOMIDE 140 MG CAPSULE|14|EA|48.41247|12/06/2013|01/06/2022|Yes|No||12/06/2013|01/06/2022|Yes|No|12/06/2013|01/06/2022|Yes|No||||No|No|||Prescription required|No||239|No|13.83623|07/27/2021|13.50416|07/27/2021|13.59409|07/27/2021|||ONCOLOGY: ORAL - OTHER|5329|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||SANDOZ|No||||
temozolomide|No|No|No|No|75%|00781269475|TEMOZOLOMIDE 140 MG CAPSULE|5|EA|48.41284|12/06/2013|01/06/2022|Yes|No||12/06/2013|01/06/2022|Yes|No|12/06/2013|01/06/2022|Yes|No||||No|No|||Prescription required|No||239|No|13.83623|07/27/2021|13.50416|07/27/2021|13.59409|07/27/2021|||ONCOLOGY: ORAL - OTHER|5330|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||SANDOZ|No||||
temozolomide|No|No|No|No|75%|00781269544|TEMOZOLOMIDE 180 MG CAPSULE|14|EA|62.24465|12/06/2013|01/06/2022|Yes|No||12/06/2013|01/06/2022|Yes|No|12/06/2013|01/06/2022|Yes|No||||No|No|||Prescription required|No||239|No|141.8599|06/13/2017|139.83333|06/13/2017|133.1746|06/13/2017|||ONCOLOGY: ORAL - OTHER|5331|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||SANDOZ|No||||
temozolomide|No|No|No|No|75%|00781269575|TEMOZOLOMIDE 180 MG CAPSULE|5|EA|62.24422|12/06/2013|01/06/2022|Yes|No||12/06/2013|01/06/2022|Yes|No|12/06/2013|01/06/2022|Yes|No||||No|No|||Prescription required|No||239|No|141.85892|06/13/2017|139.83236|06/13/2017|133.17368|06/13/2017|||ONCOLOGY: ORAL - OTHER|5332|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||SANDOZ|No||||
temozolomide|No|No|No|No|75%|00781269675|TEMOZOLOMIDE 250 MG CAPSULE|5|EA|86.47386|11/19/2014|01/06/2022|Yes|No||11/19/2014|01/06/2022|Yes|No|11/19/2014|01/06/2022|Yes|No||||No|No|||Prescription required|No||239|No|197.07996|06/13/2017|194.26453|06/13/2017|185.01384|06/13/2017|||ONCOLOGY: ORAL - OTHER|5333|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||SANDOZ|No||||
omeprazole|No|No|No|No|75%|00781285901|OMEPRAZOLE DR 10 MG CAPSULE|100|EA|.0516|02/23/2021||Yes|No||02/23/2021||Yes|No|02/23/2021||Yes|No||02/23/2021||Yes|No|||Prescription required|No||047|Yes|.09084|03/29/2022|.08865|03/29/2022|.08925|03/29/2022|||PROTON PUMP INHIBITORS|5334|||||No|No||SANDOZ|No||||
omeprazole|No|No|No|No|75%|00781285910|OMEPRAZOLE DR 10 MG CAPSULE|1000|EA|.0516|02/23/2021||Yes|No||02/23/2021||Yes|No|02/23/2021||Yes|No||02/23/2021||Yes|No|||Prescription required|No||047|Yes|.09084|03/29/2022|.08865|03/29/2022|.08925|03/29/2022|||PROTON PUMP INHIBITORS|5335|||||No|No||SANDOZ|No||||
omeprazole|No|No|No|No|75%|00781285931|OMEPRAZOLE DR 10 MG CAPSULE|30|EA|.0516|02/23/2021||Yes|No||02/23/2021||Yes|No|02/23/2021||Yes|No||02/23/2021||Yes|No|||Prescription required|No||047|Yes|.09084|03/29/2022|.08865|03/29/2022|.08925|03/29/2022|||PROTON PUMP INHIBITORS|5336|||||No|No||SANDOZ|No||||
omeprazole|No|No|No|No|75%|00781286810|OMEPRAZOLE DR 20 MG CAPSULE|1000|EA|.0516|09/23/2019||Yes|No||09/23/2019||Yes|No|09/23/2019||Yes|No||09/23/2019||Yes|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|5337|||||No|No||SANDOZ|No||||
omeprazole|No|No|No|No|75%|00781286831|OMEPRAZOLE DR 20 MG CAPSULE|30|EA|.0516|09/23/2019||Yes|No||09/23/2019||Yes|No|09/23/2019||Yes|No||09/23/2019||Yes|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|5338|||||No|No||SANDOZ|No||||
omeprazole|No|No|No|No|75%|00781286892|OMEPRAZOLE DR 20 MG CAPSULE|90|EA|.0516|09/23/2019||Yes|No||09/23/2019||Yes|No|09/23/2019||Yes|No||09/23/2019||Yes|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|5339|||||No|No||SANDOZ|No||||
meropenem|No|No|No|No|75%|00781300095|MEROPENEM IV 500 MG VIAL|1|EA|3.9431|06/15/2017||Yes|No||06/15/2017||Yes|No|06/15/2017||Yes|No||||No|No|||Prescription required|No|||No|8.9866|09/14/2021|8.85822|09/14/2021|8.4364|09/14/2021||||5340|||||No|No||SANDOZ|No||||
somatropin|No|No|No|No|75%|00781300107|OMNITROPE 5 MG/1.5 ML CRTG|1.5|ML|179.2326|10/08/2010||Yes|No||10/08/2010||Yes|No|10/08/2010||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|Yes|07/29/2021|014|Yes|408.4836|05/07/2019|402.64812|05/07/2019|383.4744|05/07/2019|||GROWTH HORMONE|5341|||||No|No||SANDOZ|No||||
somatropin|No|No|No|No|75%|00781300407|OMNITROPE 10 MG/1.5 ML CRTG|1.5|ML|358.4652|06/26/2012||Yes|No||06/26/2012||Yes|No|06/26/2012||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|Yes|07/29/2021|014|Yes|816.9672|05/07/2019|805.29624|05/07/2019|766.9488|05/07/2019|||GROWTH HORMONE|5342|||||No|No||SANDOZ|No||||
meropenem|No|No|No|No|75%|00781309895|MEROPENEM IV 1 GM VIAL|1|EA|7.8862|06/15/2017||Yes|No||06/15/2017||Yes|No|06/15/2017||Yes|No||||No|No|||Prescription required|No|||No|17.9732|09/14/2021|17.71644|09/14/2021|16.8728|09/14/2021||||5343|||||No|No||SANDOZ|No||||
nafcillin sodium|No|No|No|No|75%|00781312595|NAFCILLIN 2 GM VIAL|1|EA|9.74337|02/03/2005|05/31/2022|Yes|No||02/03/2005|05/31/2022|Yes|No|02/03/2005|05/31/2022|Yes|No||||No|No|||Prescription required|No|||No|22.20582|06/01/2016|21.88859|06/01/2016|20.84628|06/01/2016||||5344|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SANDOZ|No||||
nafcillin sodium|No|No|No|No|75%|00781312695|NAFCILLIN 10 GM BULK VIAL|1|EA|47.73903|02/03/2005|05/31/2022|Yes|No||02/03/2005|05/31/2022|Yes|No|02/03/2005|05/31/2022|Yes|No||||No|No|||Prescription required|No|||No|108.80058|06/01/2016|107.24628|06/01/2016|102.13932|06/01/2016||||5345|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SANDOZ|No||||
olanzapine|No|No|No|No|75%|00781315972|OLANZAPINE 10 MG VIAL|1|EA|9.9932|06/26/2012||Yes|No||06/26/2012||Yes|No|06/26/2012||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|027|Yes|22.7752|09/14/2021|22.44984|09/14/2021|21.3808|09/14/2021|||ANTIPSYCHOTICS|5346|||||No|No||SANDOZ|No||||
piperacillin sodium/tazobactam|No|No|No|No|75%|00781318094|PIPERACIL-TAZOBACT 40.5 GRAM|1|EA|29.541|03/29/2022||Yes|No||03/29/2022||Yes|No|03/29/2022||Yes|No||||No|No|||Prescription required|No|||No|67.326|03/29/2022|66.3642|03/29/2022|63.204|03/29/2022||||5347|||||No|No||SANDOZ|No||||
ceftriaxone sodium|No|No|No|No|75%|00781320785|CEFTRIAXONE 500 MG VIAL|1|EA|.9202|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||||No|No|||Prescription required|No|||No|2.0972|01/31/2022|2.06724|01/31/2022|1.9688|01/31/2022||||5348|||||No|No||SANDOZ|No||||
ceftriaxone sodium|Yes|No|No|No|75%|00781320795|CEFTRIAXONE 500 MG VIAL|1|EA|.91934|08/05/2005||Yes|No||08/05/2005||Yes|No|08/05/2005||Yes|No||||No|No|03/10/2021||Prescription required|No|||No|1.2765|03/29/2022|1.24586|03/29/2022|1.25416|03/29/2022||||5349|||||No|No||SANDOZ|No||||
ceftriaxone sodium|No|No|No|No|75%|00781320895|CEFTRIAXONE 1 GM VIAL|1|EA|1.50457|08/05/2005||Yes|No||08/05/2005||Yes|No|08/05/2005||Yes|No||||No|No|||Prescription required|No|||No|1.6715|03/29/2022|1.63138|03/29/2022|1.64224|03/29/2022||||5350|||||No|No||SANDOZ|No||||
ceftriaxone sodium|No|No|No|No|75%|00781320995|CEFTRIAXONE 2 GM VIAL|1|EA|2.87756|08/05/2005||Yes|No||08/05/2005||Yes|No|08/05/2005||Yes|No||||No|No|||Prescription required|No|||No|6.55816|08/17/2021|6.46447|08/17/2021|6.15664|08/17/2021||||5351|||||No|No||SANDOZ|No||||
ceftriaxone sodium|No|No|No|No|75%|00781321046|CEFTRIAXONE 10 GM VIAL|1|EA|14.3878|08/05/2005||Yes|No||08/05/2005||Yes|No|08/05/2005||Yes|No||||No|No|||Prescription required|No|||No|32.7908|08/17/2021|32.32236|08/17/2021|30.7832|08/17/2021||||5352|||||No|No||SANDOZ|No||||
pantoprazole sodium|No|No|No|No|75%|00781323295|PANTOPRAZOLE SODIUM 40 MG VIAL|1|EA|2.107|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||10/01/2020||Yes|No|||Prescription required|No|||No|4.802|10/01/2020|4.7334|10/01/2020|4.508|10/01/2020||||5353|||||No|No||SANDOZ|No||||
glatiramer acetate|No|No|No|No|75%|00781323434|GLATOPA 20 MG/ML SYRINGE|1|ML|21.5|01/11/2017||Yes|No||01/11/2017||Yes|No|01/11/2017||Yes|No||||No|No|||Prescription required|No||043|No|49|08/24/2021|48.3|08/24/2021|46|08/24/2021|||MULTIPLE SCLEROSIS AGENTS|5354|||||No|No||SANDOZ|No||||
enoxaparin sodium|No|No|No|No|75%|00781323863|ENOXAPARIN 30 MG/0.3 ML SYR|.3|ML|9.60046|05/26/2021||Yes|No||05/26/2021||Yes|No|05/26/2021||Yes|No||||No|No|||Prescription required|No||068|Yes|12.85641|03/29/2022|12.54785|03/29/2022|12.63142|03/29/2022|||ANTICOAGULANTS|5355|||||No|No||SANDOZ|No||||
enoxaparin sodium|No|No|No|No|75%|00781324664|ENOXAPARIN 40 MG/0.4 ML SYR|.4|ML|9.60082|05/26/2021||Yes|No||05/26/2021||Yes|No|05/26/2021||Yes|No||||No|No|||Prescription required|No||068|Yes|11.94818|03/29/2022|11.66142|03/29/2022|11.73908|03/29/2022|||ANTICOAGULANTS|5356|||||No|No||SANDOZ|No||||
glatiramer acetate|No|No|No|No|75%|00781325089|GLATOPA 40 MG/ML SYRINGE|1|ML|53.75|06/06/2018||Yes|No||06/06/2018||Yes|No|06/06/2018||Yes|No||||No|No|||Prescription required|No||043|No|127.69067|01/25/2022|124.62609|01/25/2022|125.45608|01/25/2022|||MULTIPLE SCLEROSIS AGENTS|5357|||||No|No||SANDOZ|No||||
azacitidine|No|No|No|No|75%|00781325394|AZACITIDINE 100 MG VIAL|1|EA|93.697|12/20/2013||Yes|No||12/20/2013||Yes|No|12/20/2013||Yes|No||||No|No|||Prescription required|No|||No|213.542|08/17/2021|210.4914|08/17/2021|200.468|08/17/2021||||5358|||||No|No||SANDOZ|No||||
enoxaparin sodium|No|No|No|No|75%|00781325666|ENOXAPARIN 60 MG/0.6 ML SYR|.6|ML|9.61193|05/26/2021||Yes|No||05/26/2021||Yes|No|05/26/2021||Yes|No||||No|No|||Prescription required|No||068|Yes|11.41069|03/29/2022|11.13683|03/29/2022|11.211|03/29/2022|||ANTICOAGULANTS|5359|||||No|No||SANDOZ|No||||
enoxaparin sodium|No|No|No|No|75%|00781326268|ENOXAPARIN 80 MG/0.8 ML SYR|.8|ML|9.61157|05/26/2021||Yes|No||05/26/2021||Yes|No|05/26/2021||Yes|No||||No|No|||Prescription required|No||068|Yes|12.0025|03/29/2022|11.71444|03/29/2022|11.79245|03/29/2022|||ANTICOAGULANTS|5360|||||No|No||SANDOZ|No||||
enoxaparin sodium|No|No|No|No|75%|00781326869|ENOXAPARIN 100 MG/ML SYRINGE|1|ML|9.61136|05/26/2021||Yes|No||05/26/2021||Yes|No|05/26/2021||Yes|No||||No|No|||Prescription required|No||068|Yes|11.81296|03/29/2022|11.52944|03/29/2022|11.60623|03/29/2022|||ANTICOAGULANTS|5361|||||No|No||SANDOZ|No||||
daptomycin|No|No|No|No|75%|00781329570|DAPTOMYCIN 500 MG VIAL|1|EA|55.9|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No|||No|127.4|12/15/2020|125.58|12/11/2020|119.6|12/11/2020||||5362|||||No|No||SANDOZ|No||||
enoxaparin sodium|No|No|No|No|75%|00781329868|ENOXAPARIN 120 MG/0.8 ML SYR|.8|ML|14.4222|05/26/2021||Yes|No||05/26/2021||Yes|No|05/26/2021||Yes|No||||No|No|||Prescription required|No||068|Yes|15.335|03/29/2022|14.96696|03/29/2022|15.06663|03/29/2022|||ANTICOAGULANTS|5363|||||No|No||SANDOZ|No||||
enoxaparin sodium|No|No|No|No|75%|00781329969|ENOXAPARIN 150 MG/ML SYRINGE|1|ML|14.4222|05/25/2021||Yes|No||05/25/2021||Yes|No|05/25/2021||Yes|No||||No|No|||Prescription required|No||068|Yes|15.18|03/29/2022|14.81568|03/29/2022|14.91435|03/29/2022|||ANTICOAGULANTS|5364|||||No|No||SANDOZ|No||||
oxaliplatin|No|No|No|No|75%|00781331570|OXALIPLATIN 50 MG/10 ML VIAL|10|ML|1.29|06/10/2015||Yes|No||06/10/2015||Yes|No|06/10/2015||Yes|No||||No|No|||Prescription required|No|||No|2.94|09/14/2021|2.898|09/14/2021|2.76|09/14/2021||||5365|||||No|No||SANDOZ|No||||
oxaliplatin|No|No|No|No|75%|00781331780|OXALIPLATIN 100 MG/20 ML VIAL|20|ML|1.29|06/10/2015||Yes|No||06/10/2015||Yes|No|06/10/2015||Yes|No||||No|No|||Prescription required|No|||No|2.94|09/14/2021|2.898|09/14/2021|2.76|09/14/2021||||5366|||||No|No||SANDOZ|No||||
ampicillin sodium|No|No|No|No|75%|00781340095|AMPICILLIN 125 MG VIAL|1|EA|1.43663|03/30/2005||Yes|No||03/30/2005||Yes|No|||No|No||||No|No|||Prescription required|No|||No|3.27418|08/17/2021|3.2274|08/17/2021|3.07372|08/17/2021||||5367|||||No|No||SANDOZ|No||||
ampicillin sodium|No|No|No|No|75%|00781340295|AMPICILLIN 250 MG VIAL|1|EA|1.15154|01/09/2006||Yes|No||01/09/2006||Yes|No|01/09/2006||Yes|No||||No|No|||Prescription required|No|||No|2.62444|08/17/2021|2.58694|08/17/2021|2.46376|08/17/2021||||5368|||||No|No||SANDOZ|No||||
ampicillin sodium|No|No|No|No|75%|00781340495|AMPICILLIN 1 GM VIAL|1|EA|2.37618|01/09/2006||Yes|No||01/09/2006||Yes|No|01/09/2006||Yes|No||||No|No|||Prescription required|No|||No|5.41548|08/17/2021|5.33811|08/17/2021|5.08392|08/17/2021||||5369|||||No|No||SANDOZ|No||||
ampicillin sodium|No|No|No|No|75%|00781340795|AMPICILLIN 500 MG VIAL|1|EA|1.21217|01/09/2006||Yes|No||01/09/2006||Yes|No|01/09/2006||Yes|No||||No|No|||Prescription required|No|||No|2.76262|08/17/2021|2.72315|08/17/2021|2.59348|08/17/2021||||5370|||||No|No||SANDOZ|No||||
ampicillin sodium|No|No|No|No|75%|00781340895|AMPICILLIN 2 GM VIAL|1|EA|3.05429|01/09/2006||Yes|No||01/09/2006||Yes|No|01/09/2006||Yes|No||||No|No|||Prescription required|No|||No|6.96094|08/17/2021|6.86149|08/17/2021|6.53476|08/17/2021||||5371|||||No|No||SANDOZ|No||||
ampicillin sodium|No|No|No|No|75%|00781340995|AMPICILLIN 10 GM VIAL|1|EA|29.65925|03/19/2008||Yes|No||03/19/2008||Yes|No|03/19/2008||Yes|No||||No|No|||Prescription required|No|||No|67.5955|08/17/2021|66.62985|08/17/2021|63.457|08/17/2021||||5372|||||No|No||SANDOZ|No||||
voriconazole|No|No|No|No|75%|00781341694|VORICONAZOLE 200 MG VIAL|1|EA|31.4932|06/15/2012||Yes|No||06/15/2012||Yes|No|06/15/2012||Yes|No||09/01/2021||Yes|No|||Prescription required|No|||No|71.7752|06/08/2021|70.74984|06/08/2021|67.3808|06/08/2021||||5373|||||No|No||SANDOZ|No||||
treprostinil sodium|No|No|No|No|75%|00781342080|TREPROSTINIL 20 MG/20 ML VIAL|20|ML|24.63878|06/05/2019||Yes|No||06/05/2019||Yes|No|06/05/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|56.15351|06/05/2019|55.35131|06/05/2019|52.71554|06/05/2019||||5374|||||No|No||SANDOZ|No||||
treprostinil sodium|No|No|No|No|75%|00781342580|TREPROSTINIL 50 MG/20 ML VIAL|20|ML|61.59685|06/07/2019||Yes|No||06/07/2019||Yes|No|06/07/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|140.38353|06/07/2019|138.37805|06/07/2019|131.78862|06/07/2019||||5375|||||No|No||SANDOZ|No||||
treprostinil sodium|No|No|No|No|75%|00781342780|TREPROSTINIL 100 MG/20 ML VIAL|20|ML|123.19371|06/07/2019||Yes|No||06/07/2019||Yes|No|06/07/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|280.76706|06/07/2019|276.7561|06/07/2019|263.57724|06/07/2019||||5376|||||No|No||SANDOZ|No||||
treprostinil sodium|No|No|No|No|75%|00781343080|TREPROSTINIL 200 MG/20 ML VIAL|20|ML|246.38742|06/07/2019||Yes|No||06/07/2019||Yes|No|06/07/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|561.53412|06/07/2019|553.5122|06/07/2019|527.15448|06/07/2019||||5377|||||No|No||SANDOZ|No||||
linezolid in dextrose 5%|No|No|No|No|75%|00781343395|LINEZOLID 600 MG/300 ML-D5W|300|ML|.0617|10/13/2016||Yes|No||10/13/2016||Yes|No|10/13/2016||Yes|No||||No|No|||Prescription required|No||146|No|.14063|06/08/2021|.13862|06/08/2021|.13202|06/08/2021|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|5378|||||No|No||SANDOZ|No||||
fondaparinux sodium|No|No|No|No|75%|00781344312|FONDAPARINUX 2.5 MG/0.5 ML SYR|.5|ML|34.7354|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|068|Yes|79.1644|04/20/2021|78.03348|04/20/2021|74.3176|04/20/2021|||ANTICOAGULANTS|5379|||||No|No||SANDOZ|No||||
fondaparinux sodium|No|No|No|No|75%|00781344395|FONDAPARINUX 2.5 MG/0.5 ML SYR|.5|ML|20.21|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|068|Yes|46.06|04/20/2021|45.402|04/20/2021|43.24|04/20/2021|||ANTICOAGULANTS|5380|||||No|No||SANDOZ|No||||
cefazolin sodium|No|No|No|No|75%|00781345095|CEFAZOLIN 500 MG VIAL|1|EA|.90429|01/03/2007||Yes|No||01/03/2007||Yes|No|01/03/2007||Yes|No||||No|No|||Prescription required|No|||No|2.06094|08/17/2021|2.03149|08/17/2021|1.93476|08/17/2021||||5381|||||No|No||SANDOZ|No||||
cefazolin sodium|No|No|No|No|75%|00781345196|CEFAZOLIN 1 GM VIAL|1|EA|.645|01/03/2007||Yes|No||01/03/2007||Yes|No|01/03/2007||Yes|No||||No|No|||Prescription required|No|||No|1.47|08/17/2021|1.449|08/17/2021|1.38|08/17/2021||||5382|||||No|No||SANDOZ|No||||
cefazolin sodium|No|No|No|No|75%|00781345295|CEFAZOLIN 10 GM VIAL|1|EA|5.16|01/03/2007||Yes|No||01/03/2007||Yes|No|01/03/2007||Yes|No||||No|No|||Prescription required|No|||No|11.76|08/17/2021|11.592|08/17/2021|11.04|08/17/2021||||5383|||||No|No||SANDOZ|No||||
fondaparinux sodium|No|No|No|No|75%|00781345412|FONDAPARINUX 5 MG/0.4 ML SYR|.4|ML|102.1895|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|068|Yes|232.897|04/20/2021|229.5699|04/20/2021|218.638|04/20/2021|||ANTICOAGULANTS|5384|||||No|No||SANDOZ|No||||
fondaparinux sodium|No|No|No|No|75%|00781345495|FONDAPARINUX 5 MG/0.4 ML SYR|.4|ML|59.4475|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|068|Yes|135.485|04/27/2021|133.5495|04/20/2021|127.19|04/20/2021|||ANTICOAGULANTS|5385|||||No|No||SANDOZ|No||||
fondaparinux sodium|No|No|No|No|75%|00781346512|FONDAPARINUX 7.5 MG/0.6 ML SYR|.6|ML|68.12633|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|068|Yes|155.26466|04/20/2021|153.04659|04/20/2021|145.75866|04/20/2021|||ANTICOAGULANTS|5386|||||No|No||SANDOZ|No||||
fondaparinux sodium|No|No|No|No|75%|00781346595|FONDAPARINUX 7.5 MG/0.6 ML SYR|.6|ML|39.63166|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|068|Yes|57.45472|12/28/2021|56.0758|12/28/2021|56.44926|12/28/2021|||ANTICOAGULANTS|5387|||||No|No||SANDOZ|No||||
fondaparinux sodium|No|No|No|No|75%|00781347612|FONDAPARINUX 10 MG/0.8 ML SYR|.8|ML|51.09475|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|068|Yes|116.4485|04/20/2021|114.78495|04/20/2021|109.319|04/20/2021|||ANTICOAGULANTS|5388|||||No|No||SANDOZ|No||||
fondaparinux sodium|No|No|No|No|75%|00781347695|FONDAPARINUX 10 MG/0.8 ML SYR|.8|ML|29.72375|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|068|Yes|67.7425|04/27/2021|66.77475|04/20/2021|63.595|04/20/2021|||ANTICOAGULANTS|5389|||||No|No||SANDOZ|No||||
leuprolide acetate|No|No|No|No|75%|00781400332|LEUPROLIDE 2WK 14 MG/2.8 ML KT|1|EA|306.504|02/29/2016||Yes|No||02/29/2016||Yes|No|02/29/2016||Yes|No||||No|No|||Prescription required|No|||No|698.544|07/26/2016|688.5648|07/26/2016|655.776|07/26/2016||||5390|||||No|No||SANDOZ|No||||
somatropin|No|No|No|No|75%|00781400436|OMNITROPE 5.8 MG VIAL|1|EA|135.46935|01/30/2007||Yes|No||01/30/2007||Yes|No|01/30/2007||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|Yes|07/29/2021|014|Yes|308.7441|04/10/2018|304.33347|04/10/2018|289.8414|04/10/2018|||GROWTH HORMONE|5391|||||No|No||SANDOZ|No||||
lansoprazole/amoxiciln/clarith|No|No|No|No|75%|00781405442|LANSOPRAZOL-AMOXICIL-CLARITHRO|112|EA|2.44143|08/25/2014||Yes|No||08/25/2014||Yes|No|08/25/2014||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|001|No|5.33188|09/28/2021|5.20391|09/28/2021|5.23857|09/28/2021|||H. PYLORI TREATMENT|5392|||||No|No||SANDOZ|No||||
aprepitant|No|No|No|No|75%|00781406336|APREPITANT 125-80-80 MG PACK|3|EA|82.7019|04/12/2017||Yes|No||04/12/2017||Yes|No|04/12/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|085|Yes|144.5|10/26/2021|141.032|10/26/2021|141.97125|10/26/2021|||ANTIEMETIC/ANTIVERTIGO AGENTS|5393|||||No|No||SANDOZ|No||||
drospir/eth estra/levomefol Ca|Yes|Yes|No|No|75%|00781407515|DROSP-EE-LEVOMEF 3-0.02-0.451|28|EA|2.08089|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No|Refer to program requirements|||No|No|02/21/2017||Prescription required|No|||No|4.52845|03/29/2022|4.41976|03/29/2022|4.4492|03/29/2022||||5394|||||No|No||SANDOZ|No|||Only covered for non-contraceptive (medical) purposes|
drospir/eth estra/levomefol Ca|Yes|Yes|No|No|75%|00781410315|DROSP-EE-LEVOMEF 3-0.03-0.451|28|EA|2.28677|06/11/2018||Yes|No||06/11/2018||Yes|No|06/11/2018||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|5.21172|09/28/2021|5.13727|09/28/2021|4.89264|09/28/2021||||5395|||||No|No||SANDOZ|No|||Only covered for non-contraceptive (medical) purposes|
methylprednisolone|No|No|No|No|75%|00781502201|METHYLPREDNISOLONE 4 MG TABLET|100|EA|.49166|07/06/2006||Yes|No||07/06/2006||Yes|No|07/06/2006||Yes|No||04/01/2011||Yes|No|||Prescription required|Yes|01/15/2014|168|Yes|.21195|03/29/2022|.20686|03/29/2022|.20824|03/29/2022|||GLUCOCORTICOIDS: ORAL|5396|||||No|No||SANDOZ|No||||
methylprednisolone|No|No|No|No|75%|00781502207|METHYLPREDNISOLONE 4 MG DOSEPK|21|EA|.49163|07/06/2006||Yes|No||07/06/2006||Yes|No|07/06/2006||Yes|No||04/01/2011||Yes|No|||Prescription required|No||168|Yes|.17447|03/29/2022|.17028|03/29/2022|.17141|03/29/2022|||GLUCOCORTICOIDS: ORAL|5397|||||No|No||SANDOZ|No||||
amoxicillin|No|No|No|No|75%|00781506001|AMOXICILLIN 500 MG TABLET|100|EA|.15007|05/04/2006||Yes|No||05/04/2006||Yes|No|05/04/2006||Yes|No||04/01/2011||Yes|No|||Prescription required|No||209|No|.11847|09/28/2021|.11562|09/28/2021|.11639|09/28/2021|||PENICILLINS|5398|||||No|No||SANDOZ|No||||
amoxicillin|No|No|No|No|75%|00781506020|AMOXICILLIN 500 MG TABLET|20|EA|.15845|05/04/2006||Yes|No||05/04/2006||Yes|No|05/04/2006||Yes|No||04/01/2011||Yes|No|||Prescription required|No||209|No|.12149|03/29/2022|.11857|03/29/2022|.11936|03/29/2022|||PENICILLINS|5399|||||No|No||SANDOZ|No||||
amoxicillin|No|No|No|No|75%|00781506101|AMOXICILLIN 875 MG TABLET|100|EA|.18748|05/04/2006||Yes|No||05/04/2006||Yes|No|05/04/2006||Yes|No||04/01/2011||Yes|No|||Prescription required|No||209|No|.1448|03/29/2022|.14132|03/29/2022|.14226|03/29/2022|||PENICILLINS|5400|||||No|No||SANDOZ|No||||
amoxicillin|No|No|No|No|75%|00781506120|AMOXICILLIN 875 MG TABLET|20|EA|.20425|05/04/2006||Yes|No||05/04/2006||Yes|No|05/04/2006||Yes|No||04/01/2011||Yes|No|||Prescription required|No||209|No|.1448|03/29/2022|.14132|03/29/2022|.14226|03/29/2022|||PENICILLINS|5401|||||No|No||SANDOZ|No||||
mycophenolate mofetil|No|No|No|No|75%|00781517501|MYCOPHENOLATE 500 MG TABLET|100|EA|.47304|05/04/2010||Yes|No||05/04/2010||Yes|No|05/04/2010||Yes|No||04/01/2011||Yes|No|||Prescription required|No||229|No|.30426|03/29/2022|.29695|03/29/2022|.29893|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|5402|||||No|No||SANDOZ|No||||
mycophenolate mofetil|No|No|No|No|75%|00781517505|MYCOPHENOLATE 500 MG TABLET|500|EA|.4494|05/04/2010||Yes|No||05/04/2010||Yes|No|05/04/2010||Yes|No||04/01/2011||Yes|No|||Prescription required|No||229|No|.30426|03/29/2022|.29695|03/29/2022|.29893|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|5403|||||No|No||SANDOZ|No||||
valacyclovir HCl|No|No|No|No|75%|00781520831|VALACYCLOVIR HCL 500 MG TABLET|30|EA|1.24399|06/14/2010||Yes|No||06/14/2010||Yes|No|06/14/2010||Yes|No||07/01/2012||Yes|No|||Prescription required|No||025|No|.29328|03/29/2022|.28624|03/29/2022|.28814|03/29/2022|||ANTIVIRALS: ORAL|5404|||||No|No||SANDOZ|No||||
valacyclovir HCl|No|No|No|No|75%|00781520892|VALACYCLOVIR HCL 500 MG TABLET|90|EA|1.11957|06/14/2010||Yes|No||06/14/2010||Yes|No|06/14/2010||Yes|No||07/01/2012||Yes|No|||Prescription required|No||025|No|.29328|03/29/2022|.28624|03/29/2022|.28814|03/29/2022|||ANTIVIRALS: ORAL|5405|||||No|No||SANDOZ|No||||
valacyclovir HCl|Yes|No|No|No|75%|00781520931|VALACYCLOVIR HCL 1 GRAM TABLET|30|EA|2.32415|06/14/2010||Yes|No||06/14/2010||Yes|No|06/14/2010||Yes|No||07/01/2012||Yes|No|11/01/2012||Prescription required|No||025|No|.5737|03/29/2022|.55993|03/29/2022|.56366|03/29/2022|||ANTIVIRALS: ORAL|5406|||||No|No||SANDOZ|No||||
valacyclovir HCl|Yes|No|No|No|75%|00781520992|VALACYCLOVIR HCL 1 GRAM TABLET|90|EA|1.95888|06/14/2010||Yes|No||06/14/2010||Yes|No|06/14/2010||Yes|No||07/01/2012||Yes|No|11/01/2012||Prescription required|No||025|No|.5737|03/29/2022|.55993|03/29/2022|.56366|03/29/2022|||ANTIVIRALS: ORAL|5407|||||No|No||SANDOZ|No||||
carvedilol|No|No|No|No|75%|00781522101|CARVEDILOL 3.125 MG TABLET|100|EA|.0215|09/17/2007||Yes|No||09/17/2007||Yes|No|09/17/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.01877|03/29/2022|.01831|03/29/2022|.01844|03/29/2022|||BETA-BLOCKERS|5408|||||No|No||SANDOZ|No||||
carvedilol|No|No|No|No|75%|00781522201|CARVEDILOL 6.25 MG TABLET|100|EA|.0215|09/17/2007||Yes|No||09/17/2007||Yes|No|09/17/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.02069|03/29/2022|.02019|03/29/2022|.02032|03/29/2022|||BETA-BLOCKERS|5409|||||No|No||SANDOZ|No||||
carvedilol|No|No|No|No|75%|00781522301|CARVEDILOL 12.5 MG TABLET|100|EA|.0215|09/17/2007||Yes|No||09/17/2007||Yes|No|09/17/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.02277|03/29/2022|.02222|03/29/2022|.02237|03/29/2022|||BETA-BLOCKERS|5410|||||No|No||SANDOZ|No||||
carvedilol|No|No|No|No|75%|00781522401|CARVEDILOL 25 MG TABLET|100|EA|.0215|10/16/2007||Yes|No||10/16/2007||Yes|No|10/16/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.03449|03/29/2022|.03366|03/29/2022|.03388|03/29/2022|||BETA-BLOCKERS|5411|||||No|No||SANDOZ|No||||
zolpidem tartrate|No|No|No|No|90%|00781531501|ZOLPIDEM TART ER 6.25 MG TAB|100|EA|.3225|04/03/2012||Yes|No||04/03/2012||Yes|No|04/03/2012||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|054|Yes|.20271|03/29/2022|.19784|03/29/2022|.19916|03/29/2022|||SEDATIVE HYPNOTICS|5412|||||No|No||SANDOZ|No||||
zolpidem tartrate|No|No|No|No|90%|00781531601|ZOLPIDEM TART ER 12.5 MG TAB|100|EA|.3225|04/03/2012||Yes|No||04/03/2012||Yes|No|04/03/2012||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|054|Yes|.24181|03/29/2022|.236|03/29/2022|.23757|03/29/2022|||SEDATIVE HYPNOTICS|5413|||||No|No||SANDOZ|No||||
zolpidem tartrate|No|No|No|No|90%|00781531701|ZOLPIDEM TARTRATE 5 MG TABLET|100|EA|.0301|05/18/2007||Yes|No||05/18/2007||Yes|No|05/18/2007||Yes|No||||No|No|||Prescription required|No||054|Yes|.03056|03/29/2022|.02982|03/29/2022|.03002|03/29/2022|||SEDATIVE HYPNOTICS|5414|||||No|No||SANDOZ|No||||
zolpidem tartrate|No|No|No|No|90%|00781531710|ZOLPIDEM TARTRATE 5 MG TABLET|1000|EA|.0301|05/18/2007||Yes|No||05/18/2007||Yes|No|05/18/2007||Yes|No||||No|No|||Prescription required|No||054|Yes|.03056|03/29/2022|.02982|03/29/2022|.03002|03/29/2022|||SEDATIVE HYPNOTICS|5415|||||No|No||SANDOZ|No||||
zolpidem tartrate|No|No|No|No|90%|00781531801|ZOLPIDEM TARTRATE 10 MG TABLET|100|EA|.0301|04/23/2007||Yes|No||04/23/2007||Yes|No|04/23/2007||Yes|No||||No|No|||Prescription required|No||054|Yes|.0301|03/29/2022|.02937|03/29/2022|.02957|03/29/2022|||SEDATIVE HYPNOTICS|5416|||||No|No||SANDOZ|No||||
zolpidem tartrate|No|No|No|No|90%|00781531810|ZOLPIDEM TARTRATE 10 MG TABLET|1000|EA|.0301|04/23/2007||Yes|No||04/23/2007||Yes|No|04/23/2007||Yes|No||||No|No|||Prescription required|No||054|Yes|.0301|03/29/2022|.02937|03/29/2022|.02957|03/29/2022|||SEDATIVE HYPNOTICS|5417|||||No|No||SANDOZ|No||||
bromocriptine mesylate|No|No|No|No|75%|00781532501|BROMOCRIPTINE 2.5 MG TABLET|100|EA|2.15025|11/03/2008||Yes|No||11/03/2008||Yes|No|11/03/2008||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|1.4796|03/29/2022|1.44408|03/29/2022|1.4537|03/29/2022|||ANTIPARKINSON'S AGENTS|5418|||||No|No||SANDOZ|Yes|09/01/2020|||
bromocriptine mesylate|No|No|No|No|75%|00781532531|BROMOCRIPTINE 2.5 MG TABLET|30|EA|2.1563|11/03/2008||Yes|No||11/03/2008||Yes|No|11/03/2008||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|1.4796|03/29/2022|1.44408|03/29/2022|1.4537|03/29/2022|||ANTIPARKINSON'S AGENTS|5419|||||No|No||SANDOZ|Yes|09/01/2020|||
quetiapine fumarate|No|No|No|No|75%|00781534201|QUETIAPINE FUMARATE 50 MG TAB|100|EA|.18146|12/20/2013||Yes|No||12/20/2013||Yes|No|12/20/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|.04283|03/29/2022|.0418|03/29/2022|.04208|03/29/2022|||ANTIPSYCHOTICS|5420|||||No|No||SANDOZ|No||||
quetiapine fumarate|No|No|No|No|75%|00781534301|QUETIAPINE FUMARATE 25 MG TAB|100|EA|.11042|12/20/2013||Yes|No||12/20/2013||Yes|No|12/20/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|.03239|03/29/2022|.03161|03/29/2022|.03182|03/29/2022|||ANTIPSYCHOTICS|5421|||||No|No||SANDOZ|No||||
quetiapine fumarate|No|No|No|No|75%|00781534401|QUETIAPINE FUMARATE 100 MG TAB|100|EA|.18954|12/20/2013||Yes|No||12/20/2013||Yes|No|12/20/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|.05826|03/29/2022|.05686|03/29/2022|.05724|03/29/2022|||ANTIPSYCHOTICS|5422|||||No|No||SANDOZ|No||||
quetiapine fumarate|No|No|No|No|75%|00781534601|QUETIAPINE FUMARATE 200 MG TAB|100|EA|.35754|12/20/2013||Yes|No||12/20/2013||Yes|No|12/20/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|.10261|03/29/2022|.10014|03/29/2022|.10081|03/29/2022|||ANTIPSYCHOTICS|5423|||||No|No||SANDOZ|No||||
quetiapine fumarate|No|No|No|No|75%|00781534701|QUETIAPINE FUMARATE 300 MG TAB|100|EA|.46882|12/20/2013||Yes|No||12/20/2013||Yes|No|12/20/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|.13964|03/29/2022|.13628|03/29/2022|.13719|03/29/2022|||ANTIPSYCHOTICS|5424|||||No|No||SANDOZ|No||||
quetiapine fumarate|No|No|No|No|75%|00781534801|QUETIAPINE FUMARATE 400 MG TAB|100|EA|.54235|12/20/2013||Yes|No||12/20/2013||Yes|No|12/20/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|.17858|03/29/2022|.17429|03/29/2022|.17545|03/29/2022|||ANTIPSYCHOTICS|5425|||||No|No||SANDOZ|No||||
atorvastatin calcium|Yes|No|No|No|75%|00781538192|ATORVASTATIN 10 MG TABLET|90|EA|.10152|05/29/2012||Yes|No||05/29/2012||Yes|No|05/29/2012||Yes|No||05/29/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|5426|||||No|No||SANDOZ|No||||
atorvastatin calcium|Yes|No|No|No|75%|00781538292|ATORVASTATIN 20 MG TABLET|90|EA|.14481|05/29/2012||Yes|No||05/29/2012||Yes|No|05/29/2012||Yes|No||05/29/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|5427|||||No|No||SANDOZ|No||||
atorvastatin calcium|Yes|No|No|No|75%|00781538492|ATORVASTATIN 40 MG TABLET|90|EA|.14481|05/29/2012||Yes|No||05/29/2012||Yes|No|05/29/2012||Yes|No||05/29/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|5428|||||No|No||SANDOZ|No||||
minocycline HCl|No|No|No|No|75%|00781538531|MINOCYCLINE ER 45 MG TABLET|30|EA|2.86666|11/15/2012||Yes|No||11/15/2012||Yes|No|11/15/2012||Yes|No||11/15/2012||Yes|No|||Prescription required|Yes|02/02/2010|213|No|6.53332|10/12/2021|6.43999|10/12/2021|6.13332|10/12/2021|||TETRACYCLINES|5429|||||No|No||SANDOZ|No||||
minocycline HCl|No|No|No|No|75%|00781538631|MINOCYCLINE ER 90 MG TABLET|30|EA|2.86666|11/15/2012||Yes|No||11/15/2012||Yes|No|11/15/2012||Yes|No||11/15/2012||Yes|No|||Prescription required|Yes|02/02/2010|213|No|6.53332|10/12/2021|6.43999|10/12/2021|6.13332|10/12/2021|||TETRACYCLINES|5430|||||No|No||SANDOZ|No||||
minocycline HCl|No|No|No|No|75%|00781538731|MINOCYCLINE ER 135 MG TABLET|30|EA|2.86666|11/15/2012||Yes|No||11/15/2012||Yes|No|11/15/2012||Yes|No||11/15/2012||Yes|No|||Prescription required|Yes|02/02/2010|213|No|6.53332|10/12/2021|6.43999|10/12/2021|6.13332|10/12/2021|||TETRACYCLINES|5431|||||No|No||SANDOZ|No||||
atorvastatin calcium|Yes|No|No|No|75%|00781538892|ATORVASTATIN 80 MG TABLET|90|EA|.14481|05/29/2012||Yes|No||05/29/2012||Yes|No|05/29/2012||Yes|No||05/29/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|5432|||||No|No||SANDOZ|No||||
rosuvastatin calcium|No|No|No|No|75%|00781540092|ROSUVASTATIN CALCIUM 5 MG TAB|90|EA|.11944|11/28/2016||Yes|No||11/28/2016||Yes|No|11/28/2016||Yes|No||11/28/2016||Yes|No|||Prescription required|No||063|Yes|.06753|03/29/2022|.0659|03/29/2022|.06634|03/29/2022|||LIPOTROPICS: STATINS|5433|||||No|No||SANDOZ|No||||
rosuvastatin calcium|No|No|No|No|75%|00781540192|ROSUVASTATIN CALCIUM 10 MG TAB|90|EA|.11944|11/28/2016||Yes|No||11/28/2016||Yes|No|11/28/2016||Yes|No||11/28/2016||Yes|No|||Prescription required|No||063|Yes|.05981|03/29/2022|.05837|03/29/2022|.05876|03/29/2022|||LIPOTROPICS: STATINS|5434|||||No|No||SANDOZ|No||||
rosuvastatin calcium|No|No|No|No|75%|00781540292|ROSUVASTATIN CALCIUM 20 MG TAB|90|EA|.11944|11/28/2016||Yes|No||11/28/2016||Yes|No|11/28/2016||Yes|No||11/28/2016||Yes|No|||Prescription required|No||063|Yes|.07822|03/29/2022|.07634|03/29/2022|.07685|03/29/2022|||LIPOTROPICS: STATINS|5435|||||No|No||SANDOZ|No||||
rosuvastatin calcium|No|No|No|No|75%|00781540331|ROSUVASTATIN CALCIUM 40 MG TAB|30|EA|.11939|11/28/2016||Yes|No||11/28/2016||Yes|No|11/28/2016||Yes|No||11/28/2016||Yes|No|||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|5436|||||No|No||SANDOZ|No||||
pioglitazone HCl|No|No|No|No|75%|00781542010|PIOGLITAZONE HCL 15 MG TABLET|1000|EA|.15735|12/18/2014||Yes|No||12/18/2014||Yes|No|12/18/2014||Yes|No||12/18/2014||Yes|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|5437|||||No|No||SANDOZ|No||||
pioglitazone HCl|No|No|No|No|75%|00781542031|PIOGLITAZONE HCL 15 MG TABLET|30|EA|.15738|12/18/2014||Yes|No||12/18/2014||Yes|No|12/18/2014||Yes|No||12/18/2014||Yes|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|5438|||||No|No||SANDOZ|No||||
pioglitazone HCl|No|No|No|No|75%|00781542092|PIOGLITAZONE HCL 15 MG TABLET|90|EA|.15738|12/18/2014||Yes|No||12/18/2014||Yes|No|12/18/2014||Yes|No||12/18/2014||Yes|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|5439|||||No|No||SANDOZ|No||||
pioglitazone HCl|No|No|No|No|75%|00781542110|PIOGLITAZONE HCL 30 MG TABLET|1000|EA|.24037|12/18/2014||Yes|No||12/18/2014||Yes|No|12/18/2014||Yes|No||12/18/2014||Yes|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|5440|||||No|No||SANDOZ|No||||
pioglitazone HCl|No|No|No|No|75%|00781542131|PIOGLITAZONE HCL 30 MG TABLET|30|EA|.24051|12/18/2014||Yes|No||12/18/2014||Yes|No|12/18/2014||Yes|No||12/18/2014||Yes|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|5441|||||No|No||SANDOZ|No||||
pioglitazone HCl|No|No|No|No|75%|00781542192|PIOGLITAZONE HCL 30 MG TABLET|90|EA|.24051|12/18/2014||Yes|No||12/18/2014||Yes|No|12/18/2014||Yes|No||12/18/2014||Yes|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|5442|||||No|No||SANDOZ|No||||
pioglitazone HCl|No|No|No|No|75%|00781542210|PIOGLITAZONE HCL 45 MG TABLET|1000|EA|.26101|12/18/2014||Yes|No||12/18/2014||Yes|No|12/18/2014||Yes|No||12/18/2014||Yes|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|5443|||||No|No||SANDOZ|No||||
pioglitazone HCl|No|No|No|No|75%|00781542231|PIOGLITAZONE HCL 45 MG TABLET|30|EA|.26086|12/18/2014||Yes|No||12/18/2014||Yes|No|12/18/2014||Yes|No||12/18/2014||Yes|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|5444|||||No|No||SANDOZ|No||||
pioglitazone HCl|No|No|No|No|75%|00781542292|PIOGLITAZONE HCL 45 MG TABLET|90|EA|.26091|12/18/2014||Yes|No||12/18/2014||Yes|No|12/18/2014||Yes|No||12/18/2014||Yes|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|5445|||||No|No||SANDOZ|No||||
cefpodoxime proxetil|No|No|No|No|75%|00781543820|CEFPODOXIME 100 MG TABLET|20|EA|2.3177|04/15/2010||Yes|No||04/15/2010||Yes|No|04/15/2010||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|046|No|2.53516|03/29/2022|2.47431|03/29/2022|2.49079|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|5446|||||No|No||SANDOZ|No||||
cefpodoxime proxetil|No|No|No|No|75%|00781543901|CEFPODOXIME 200 MG TABLET|100|EA|2.90916|04/15/2010||Yes|No||04/15/2010||Yes|No|04/15/2010||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|046|No|3.01774|03/29/2022|2.94531|03/29/2022|2.96492|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|5447|||||No|No||SANDOZ|No||||
cefpodoxime proxetil|No|No|No|No|75%|00781543920|CEFPODOXIME 200 MG TABLET|20|EA|2.90916|04/15/2010||Yes|No||04/15/2010||Yes|No|04/15/2010||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|046|No|3.01774|03/29/2022|2.94531|03/29/2022|2.96492|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|5448|||||No|No||SANDOZ|No||||
griseofulvin, microsize|No|No|No|No|75%|00781551501|GRISEOFULVIN MICRO 500 MG TAB|100|EA|3.21665|12/20/2013||Yes|No||12/20/2013||Yes|No|12/20/2013||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|069|No|7.20637|12/28/2021|7.03341|12/28/2021|7.08025|12/28/2021|||ANTIFUNGALS: ORAL|5449|||||No|No||SANDOZ|No||||
bupropion HCl|Yes|No|No|No|75%|00781552810|BUPROPION HCL XL 150 MG TABLET|1000|EA|.17916|05/25/2018||Yes|No||05/25/2018||Yes|No|05/25/2018||Yes|No||||No|No|05/25/2018||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|5450|||||No|No||SANDOZ|No||||
bupropion HCl|Yes|No|No|No|75%|00781552831|BUPROPION HCL XL 150 MG TABLET|30|EA|.17916|05/25/2018||Yes|No||05/25/2018||Yes|No|05/25/2018||Yes|No||||No|No|05/25/2018||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|5451|||||No|No||SANDOZ|No||||
bupropion HCl|Yes|No|No|No|75%|00781552910|BUPROPION HCL XL 300 MG TABLET|1000|EA|.1892|05/25/2018||Yes|No||05/25/2018||Yes|No|05/25/2018||Yes|No||||No|No|05/25/2018||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|5452|||||No|No||SANDOZ|No||||
bupropion HCl|Yes|No|No|No|75%|00781552931|BUPROPION HCL XL 300 MG TABLET|30|EA|.1892|05/25/2018||Yes|No||05/25/2018||Yes|No|05/25/2018||Yes|No||||No|No|05/25/2018||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|5453|||||No|No||SANDOZ|No||||
montelukast sodium|No|No|No|No|75%|00781555431|MONTELUKAST SOD 4 MG TAB CHEW|30|EA|.3225|08/13/2012||Yes|No||08/13/2012||Yes|No|08/13/2012||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|5454|||||No|No||SANDOZ|No||||
montelukast sodium|No|No|No|No|75%|00781555492|MONTELUKAST SOD 4 MG TAB CHEW|90|EA|.3225|08/13/2012||Yes|No||08/13/2012||Yes|No|08/13/2012||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|5455|||||No|No||SANDOZ|No||||
montelukast sodium|No|No|No|No|75%|00781555592|MONTELUKAST SOD 5 MG TAB CHEW|90|EA|.3225|08/13/2012||Yes|No||08/13/2012||Yes|No|08/13/2012||Yes|No||||No|No|||Prescription required|No||042|Yes|.08451|03/29/2022|.08248|03/29/2022|.08303|03/29/2022|||LEUKOTRIENE MODIFIERS|5456|||||No|No||SANDOZ|No||||
entacapone|No|No|No|No|75%|00781557801|ENTACAPONE 200 MG TABLET|100|EA|1.3588|11/21/2014||Yes|No||11/21/2014||Yes|No|11/21/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|015|No|.43301|03/29/2022|.42261|03/29/2022|.42543|03/29/2022|||ANTIPARKINSON'S AGENTS|5457|||||No|No||SANDOZ|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|00781561301|CARBIDOPA-LEVODOPA 50 MG-ENTA|100|EA|1.29025|08/25/2014||Yes|No||08/25/2014||Yes|No|08/25/2014||Yes|No||||No|No|||Prescription required|No||015|No|2.94058|10/29/2019|2.89857|10/29/2019|2.76055|10/29/2019|||ANTIPARKINSON'S AGENTS|5458|||||No|No||SANDOZ|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|00781562501|CARBIDOPA-LEVODOPA 75 MG-ENTA|100|EA|1.29025|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|||Prescription required|No||015|No|2.94058|08/24/2021|2.89857|08/24/2021|2.76055|08/24/2021|||ANTIPARKINSON'S AGENTS|5459|||||No|No||SANDOZ|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|00781563701|CARBIDOPA-LEVODOPA 100 MG-ENTA|100|EA|1.29025|08/25/2014||Yes|No||08/25/2014||Yes|No|08/25/2014||Yes|No||||No|No|||Prescription required|No||015|No|.96003|03/01/2022|.93698|03/01/2022|.94322|03/01/2022|||ANTIPARKINSON'S AGENTS|5460|||||No|No||SANDOZ|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|00781564101|CARBIDOPA-LEVODOPA 125 MG-ENTA|100|EA|1.29025|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|||Prescription required|No||015|No|.9119|07/27/2021|.89001|07/27/2021|.89594|07/27/2021|||ANTIPARKINSON'S AGENTS|5461|||||No|No||SANDOZ|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|00781564331|AMLODIPINE-VALSARTAN 10-320 MG|30|EA|.74633|06/10/2015|02/22/2022|Yes|No||06/10/2015|02/22/2022|Yes|No|06/10/2015|02/22/2022|Yes|No||06/10/2015|02/22/2022|Yes|No|||Prescription required|No||017|Yes|1.70094|03/29/2022|1.67664|03/29/2022|1.5968|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|5462|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||SANDOZ|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|00781565401|CARBIDOPA-LEVODOPA 150 MG-ENTA|100|EA|1.29025|08/25/2014||Yes|No||08/25/2014||Yes|No|08/25/2014||Yes|No||||No|No|||Prescription required|No||015|No|1.0904|05/25/2021|1.06423|05/25/2021|1.07131|05/25/2021|||ANTIPARKINSON'S AGENTS|5463|||||No|No||SANDOZ|No||||
voriconazole|No|No|No|No|75%|00781566731|VORICONAZOLE 50 MG TABLET|30|EA|1.37915|02/03/2012||Yes|No||02/03/2012||Yes|No|02/03/2012||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/27/2011|069|No|3.14318|01/26/2021|3.09828|01/26/2021|2.95074|01/26/2021|||ANTIFUNGALS: ORAL|5464|||||No|No||SANDOZ|No||||
voriconazole|No|No|No|No|75%|00781566831|VORICONAZOLE 200 MG TABLET|30|EA|3.98853|02/03/2012||Yes|No||02/03/2012||Yes|No|02/03/2012||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/27/2011|069|No|2.07998|03/29/2022|2.03006|03/29/2022|2.04358|03/29/2022|||ANTIFUNGALS: ORAL|5465|||||No|No||SANDOZ|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|00781566901|CARBIDOPA-LEVODOPA 200 MG-ENTA|100|EA|1.29025|11/04/2014||Yes|No||11/04/2014||Yes|No|11/04/2014||Yes|No||||No|No|||Prescription required|No||015|No|.96506|03/29/2022|.94189|03/29/2022|.94817|03/29/2022|||ANTIPARKINSON'S AGENTS|5466|||||No|No||SANDOZ|No||||
ezetimibe|No|No|No|No|75%|00781569005|EZETIMIBE 10 MG TABLET|500|EA|.1247|01/03/2018||Yes|No||01/03/2018||Yes|No|01/03/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|5467|||||No|No||SANDOZ|No||||
ezetimibe|No|No|No|No|75%|00781569031|EZETIMIBE 10 MG TABLET|30|EA|.1247|01/03/2018||Yes|No||01/03/2018||Yes|No|01/03/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|5468|||||No|No||SANDOZ|No||||
ezetimibe|No|No|No|No|75%|00781569092|EZETIMIBE 10 MG TABLET|90|EA|.1247|01/03/2018||Yes|No||01/03/2018||Yes|No|01/03/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|5469|||||No|No||SANDOZ|No||||
potassium chloride|No|No|No|No|75%|00781571010|POTASSIUM CL ER 10 MEQ TABLET|1000|EA|.205|08/12/2009||Yes|No||08/12/2009||Yes|No|08/12/2009||Yes|No||04/01/2011||Yes|No|||Prescription required|No|||No|.18432|03/29/2022|.17989|03/29/2022|.18109|03/29/2022||||5470|||||No|No||SANDOZ|No||||
levofloxacin|Yes|No|No|No|75%|00781579050|LEVOFLOXACIN 250 MG TABLET|50|EA|.25327|02/14/2012|02/22/2022|Yes|No||02/14/2012|02/22/2022|Yes|No|02/14/2012|02/22/2022|Yes|No||02/14/2012|02/22/2022|Yes|No|07/01/2016|02/22/2022|Prescription required|No||028|No|.57722|03/29/2022|.56897|03/29/2022|.54188|03/29/2022|||FLUOROQUINOLONES: ORAL|5471|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||SANDOZ|No||||
levofloxacin|No|No|No|No|75%|00781579150|LEVOFLOXACIN 500 MG TABLET|50|EA|.29025|02/14/2012|02/22/2022|Yes|No||02/14/2012|02/22/2022|Yes|No|02/14/2012|02/22/2022|Yes|No||02/14/2012|02/22/2022|Yes|No|||Prescription required|No||028|No|.6615|03/29/2022|.65205|03/29/2022|.621|03/29/2022|||FLUOROQUINOLONES: ORAL|5472|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||SANDOZ|No||||
levofloxacin|No|No|No|No|75%|00781579220|LEVOFLOXACIN 750 MG TABLET|20|EA|.54352|02/14/2012|02/22/2022|Yes|No||02/14/2012|02/22/2022|Yes|No|02/14/2012|02/22/2022|Yes|No||02/14/2012|02/22/2022|Yes|No|||Prescription required|No||028|No|1.23872|03/29/2022|1.22102|03/29/2022|1.16288|03/29/2022|||FLUOROQUINOLONES: ORAL|5473|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||SANDOZ|No||||
levofloxacin|No|No|No|No|75%|00781579250|LEVOFLOXACIN 750 MG TABLET|50|EA|.5436|02/14/2012|02/22/2022|Yes|No||02/14/2012|02/22/2022|Yes|No|02/14/2012|02/22/2022|Yes|No||02/14/2012|02/22/2022|Yes|No|||Prescription required|No||028|No|1.23891|03/29/2022|1.22121|03/29/2022|1.16306|03/29/2022|||FLUOROQUINOLONES: ORAL|5474|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||SANDOZ|No||||
griseofulvin ultramicrosize|No|No|No|No|75%|00781582701|GRISEOFULVIN ULTRA 125 MG TAB|100|EA|1.71527|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|069|No|3.90922|09/18/2020|3.85337|09/18/2020|3.66988|09/18/2020|||ANTIFUNGALS: ORAL|5475|||||No|No||SANDOZ|No||||
griseofulvin ultramicrosize|No|No|No|No|75%|00781582801|GRISEOFULVIN ULTRA 250 MG TAB|100|EA|2.19257|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|069|No|4.20728|03/29/2022|4.1063|03/29/2022|4.13365|03/29/2022|||ANTIFUNGALS: ORAL|5476|||||No|No||SANDOZ|No||||
chlorpromazine HCl|No|No|No|No|75%|00781591301|CHLORPROMAZINE 10 MG TABLET|100|EA|1.47911|05/07/2015||Yes|No||05/07/2015||Yes|No|05/07/2015||Yes|No||05/07/2015||Yes|No|||Prescription required|No||027|Yes|1.29919|10/26/2021|1.268|10/26/2021|1.27645|10/26/2021|||ANTIPSYCHOTICS|5477|||||No|No||SANDOZ|No||||
chlorpromazine HCl|No|No|No|No|75%|00781591401|CHLORPROMAZINE 25 MG TABLET|100|EA|2.11302|02/13/2012||Yes|No||02/13/2012||Yes|No|02/13/2012||Yes|No||02/13/2012||Yes|No|||Prescription required|No||027|Yes|1.39549|03/29/2022|1.36199|03/29/2022|1.37106|03/29/2022|||ANTIPSYCHOTICS|5478|||||No|No||SANDOZ|No||||
chlorpromazine HCl|No|No|No|No|75%|00781591501|CHLORPROMAZINE 50 MG TABLET|100|EA|3.01107|02/13/2012||Yes|No||02/13/2012||Yes|No|02/13/2012||Yes|No||02/13/2012||Yes|No|||Prescription required|No||027|Yes|1.74791|03/29/2022|1.70596|03/29/2022|1.71732|03/29/2022|||ANTIPSYCHOTICS|5479|||||No|No||SANDOZ|No||||
chlorpromazine HCl|No|No|No|No|75%|00781591601|CHLORPROMAZINE 100 MG TABLET|100|EA|4.30154|05/07/2015||Yes|No||05/07/2015||Yes|No|05/07/2015||Yes|No||05/07/2015||Yes|No|||Prescription required|No||027|Yes|2.03394|03/29/2022|1.98512|03/29/2022|1.99834|03/29/2022|||ANTIPSYCHOTICS|5480|||||No|No||SANDOZ|No||||
chlorpromazine HCl|No|No|No|No|75%|00781591701|CHLORPROMAZINE 200 MG TABLET|100|EA|6.14495|05/07/2015||Yes|No||05/07/2015||Yes|No|05/07/2015||Yes|No||05/07/2015||Yes|No|||Prescription required|No||027|Yes|4.21034|03/01/2022|4.10929|03/01/2022|4.13665|03/01/2022|||ANTIPSYCHOTICS|5481|||||No|No||SANDOZ|No||||
carbamazepine|No|No|No|No|75%|00781598701|CARBAMAZEPINE ER 200 MG TABLET|100|EA|.715|04/09/2012||Yes|No||04/09/2012||Yes|No|04/09/2012||Yes|No||04/09/2012||Yes|No|||Prescription required|No||056|No|.8262|03/29/2022|.80637|03/29/2022|.81174|03/29/2022|||ANTICONVULSANTS|5482|||||No|No||SANDOZ|No||||
carbamazepine|No|No|No|No|75%|00781598801|CARBAMAZEPINE ER 400 MG TABLET|100|EA|1.42897|04/09/2012||Yes|No||04/09/2012||Yes|No|04/09/2012||Yes|No||04/09/2012||Yes|No|||Prescription required|No||056|No|1.58237|03/29/2022|1.54439|03/29/2022|1.55467|03/29/2022|||ANTICONVULSANTS|5483|||||No|No||SANDOZ|No||||
hydroxychloroquine sulfate|No|No|No|No|75%|00781599401|HYDROXYCHLOROQUINE 200 MG TAB|100|EA|.3655|05/30/2018||Yes|No||05/30/2018||Yes|No|05/30/2018||Yes|No||||No|No|||Prescription required|No|||No|.23831|03/29/2022|.23259|03/29/2022|.23413|03/29/2022||||5484|||||No|No||SANDOZ|No||||
hydroxychloroquine sulfate|No|No|No|No|75%|00781599405|HYDROXYCHLOROQUINE 200 MG TAB|500|EA|.3655|05/30/2018||Yes|No||05/30/2018||Yes|No|05/30/2018||Yes|No||||No|No|||Prescription required|No|||No|.23831|03/29/2022|.23259|03/29/2022|.23413|03/29/2022||||5485|||||No|No||SANDOZ|No||||
difluprednate|No|No|No|No|75%|00781600078|DIFLUPREDNATE 0.05% EYE DROP|5|ML|15.23232|02/01/2022||Yes|No||02/01/2022||Yes|No|02/01/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|013|No|31.84694|03/29/2022|31.08261|03/29/2022|31.28961|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|5486|||||No|No||SANDOZ|No||||
brinzolamide|No|No|No|No|75%|00781601470|BRINZOLAMIDE 1% EYE DROPS|10|ML|12.59083|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|088|No|26.8459|03/29/2022|26.20159|03/29/2022|26.37609|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|5487|||||No|No||SANDOZ|No||||
brinzolamide|No|No|No|No|75%|00781601485|BRINZOLAMIDE 1% EYE DROPS|15|ML|12.58925|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|088|No|27.27858|03/29/2022|26.62389|03/29/2022|26.8012|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|5488|||||No|No||SANDOZ|No||||
clarithromycin|No|No|No|No|75%|00781602246|CLARITHROMYCIN 125 MG/5 ML SUS|100|ML|.46809|09/18/2007||Yes|No||09/18/2007||Yes|No|09/18/2007||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|018|No|1.06682|07/23/2019|1.05158|07/23/2019|1.00151|07/23/2019|||MACROLIDES/KETOLIDES|5489|||||No|No||SANDOZ|No||||
clarithromycin|No|No|No|No|75%|00781602252|CLARITHROMYCIN 125 MG/5 ML SUS|50|ML|.50636|11/11/2008||Yes|No||11/11/2008||Yes|No|11/11/2008||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|018|No|1.15404|07/16/2019|1.13756|07/16/2019|1.08339|07/16/2019|||MACROLIDES/KETOLIDES|5490|||||No|No||SANDOZ|No||||
clarithromycin|No|No|No|No|75%|00781602346|CLARITHROMYCIN 250 MG/5 ML SUS|100|ML|.68288|01/22/2009||Yes|No||01/22/2009||Yes|No|01/22/2009||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|018|No|1.1646|03/29/2022|1.13664|03/29/2022|1.14421|03/29/2022|||MACROLIDES/KETOLIDES|5491|||||No|No||SANDOZ|No||||
clarithromycin|No|No|No|No|75%|00781602352|CLARITHROMYCIN 250 MG/5 ML SUS|50|ML|.73719|09/18/2007||Yes|No||09/18/2007||Yes|No|09/18/2007||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|018|No|1.68011|02/23/2021|1.65611|02/23/2021|1.57724|02/23/2021|||MACROLIDES/KETOLIDES|5492|||||No|No||SANDOZ|No||||
amoxicillin|No|No|No|No|75%|00781603946|AMOXICILLIN 125 MG/5 ML SUSP|100|ML|.01234|01/12/2006||Yes|No||01/12/2006||Yes|No|01/12/2006||Yes|No||04/01/2011||Yes|No|||Prescription required|No||209|No|.02009|03/29/2022|.0196|03/29/2022|.01973|03/29/2022|||PENICILLINS|5493|||||No|No||SANDOZ|No||||
amoxicillin|No|No|No|No|75%|00781603955|AMOXICILLIN 125 MG/5 ML SUSP|150|ML|.0108|01/12/2006||Yes|No||01/12/2006||Yes|No|01/12/2006||Yes|No||04/01/2011||Yes|No|||Prescription required|No||209|No|.01643|03/29/2022|.01603|03/29/2022|.01614|03/29/2022|||PENICILLINS|5494|||||No|No||SANDOZ|No||||
amoxicillin|No|No|No|No|75%|00781603958|AMOXICILLIN 125 MG/5 ML SUSP|80|ML|.01295|01/12/2006||Yes|No||01/12/2006||Yes|No|01/12/2006||Yes|No||04/01/2011||Yes|No|||Prescription required|No||209|No|.01904|03/29/2022|.01858|03/29/2022|.0187|03/29/2022|||PENICILLINS|5495|||||No|No||SANDOZ|No||||
amoxicillin|No|No|No|No|75%|00781604146|AMOXICILLIN 250 MG/5 ML SUSP|100|ML|.01539|09/21/2005||Yes|No||09/21/2005||Yes|No|||No|No||04/01/2011||Yes|No|||Prescription required|No||209|No|.01967|03/29/2022|.01919|03/29/2022|.01932|03/29/2022|||PENICILLINS|5496|||||No|No||SANDOZ|No||||
amoxicillin|No|No|No|No|75%|00781604155|AMOXICILLIN 250 MG/5 ML SUSP|150|ML|.01441|05/19/2009||Yes|No||05/19/2009||Yes|No|05/19/2009||Yes|No||04/01/2011||Yes|No|||Prescription required|No||209|No|.01799|03/29/2022|.01755|03/29/2022|.01767|03/29/2022|||PENICILLINS|5497|||||No|No||SANDOZ|No||||
amoxicillin|No|No|No|No|75%|00781604158|AMOXICILLIN 250 MG/5 ML SUSP|80|ML|.01677|09/13/2005||Yes|No||09/13/2005||Yes|No|||No|No||04/01/2011||Yes|No|||Prescription required|No||209|No|.02476|03/29/2022|.02416|03/29/2022|.02432|03/29/2022|||PENICILLINS|5498|||||No|No||SANDOZ|No||||
cefdinir|No|No|No|No|75%|00781607746|CEFDINIR 125 MG/5 ML SUSP|100|ML|.17862|05/12/2008||Yes|No||05/12/2008||Yes|No|05/12/2008||Yes|No||||No|No|||Prescription required|No||046|No|.11292|03/29/2022|.1102|03/29/2022|.11094|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|5499|||||No|No||SANDOZ|No||||
cefdinir|No|No|No|No|75%|00781607761|CEFDINIR 125 MG/5 ML SUSP|60|ML|.18898|05/10/2007||Yes|No||05/10/2007||Yes|No|05/10/2007||Yes|No||||No|No|||Prescription required|No||046|No|.15822|03/29/2022|.15442|03/29/2022|.15545|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|5500|||||No|No||SANDOZ|No||||
cefdinir|No|No|No|No|75%|00781607846|CEFDINIR 250 MG/5 ML SUSP|100|ML|.37491|05/10/2007||Yes|No||05/10/2007||Yes|No|05/10/2007||Yes|No||||No|No|||Prescription required|No||046|No|.18689|03/29/2022|.1824|03/29/2022|.18361|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|5501|||||No|No||SANDOZ|No||||
cefdinir|No|No|No|No|75%|00781607861|CEFDINIR 250 MG/5 ML SUSP|60|ML|.37868|05/12/2008||Yes|No||05/12/2008||Yes|No|05/12/2008||Yes|No||||No|No|||Prescription required|No||046|No|.18029|03/29/2022|.17596|03/29/2022|.17713|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|5502|||||No|No||SANDOZ|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00781610246|AMOX-CLAV 200-28.5 MG/5 ML SUS|100|ML|.04644|10/07/2016||Yes|No||10/07/2016||Yes|No|10/07/2016||Yes|No||||No|No|||Prescription required|No||046|No|.05885|03/29/2022|.05743|03/29/2022|.05782|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|5503|||||No|No||SANDOZ|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00781610446|AMOX-CLAV 400-57 MG/5 ML SUSP|100|ML|.06278|08/16/2016||Yes|No||08/16/2016||Yes|No|08/16/2016||Yes|No||||No|No|||Prescription required|No||046|No|.07681|03/29/2022|.07496|03/29/2022|.07546|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|5504|||||No|No||SANDOZ|No||||
penicillin G potassium|No|No|No|No|75%|00781613595|PENICILLIN GK 5 MILLION UNIT|1|EA|15.05|12/18/2002||Yes|No||12/18/2002||Yes|No|12/18/2002||Yes|No||||No|No|||Prescription required|No|||No|34.3|06/01/2016|33.81|06/01/2016|32.2|06/01/2016||||5505|||||No|No||SANDOZ|No||||
penicillin G potassium|No|No|No|No|75%|00781613694|PENICILLIN GK 20 MILLION UNIT|1|EA|57.19|12/18/2002||Yes|No||12/18/2002||Yes|No|12/18/2002||Yes|No||||No|No|||Prescription required|No|||No|130.34|06/01/2016|128.478|06/01/2016|122.36|06/01/2016||||5506|||||No|No||SANDOZ|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00781613948|AMOX-CLAV 600-42.9 MG/5 ML SUS|200|ML|.129|08/17/2007||Yes|No||08/17/2007||Yes|No|08/17/2007||Yes|No||04/01/2011||Yes|No|||Prescription required|No||046|No|.06244|03/29/2022|.06094|03/29/2022|.06134|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|5507|||||No|No||SANDOZ|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00781613954|AMOX-CLAV 600-42.9 MG/5 ML SUS|125|ML|.129|08/17/2007||Yes|No||08/17/2007||Yes|No|08/17/2007||Yes|No||04/01/2011||Yes|No|||Prescription required|No||046|No|.06559|03/29/2022|.06401|03/29/2022|.06444|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|5508|||||No|No||SANDOZ|No||||
amoxicillin/potassium clav|No|No|No|No|75%|00781613957|AMOX-CLAV 600-42.9 MG/5 ML SUS|75|ML|.129|08/17/2007||Yes|No||08/17/2007||Yes|No|08/17/2007||Yes|No||04/01/2011||Yes|No|||Prescription required|No||046|No|.08577|03/29/2022|.08371|03/29/2022|.08426|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|5509|||||No|No||SANDOZ|No||||
penicillin G sodium|No|No|No|No|75%|00781615395|PENICILLIN G NA 5 MILLION UNIT|1|EA|19.81354|01/23/2003||Yes|No||01/23/2003||Yes|No|01/23/2003||Yes|No||||No|No|||Prescription required|No|||No|45.15644|06/01/2016|44.51134|06/01/2016|42.39176|06/01/2016||||5510|||||No|No||SANDOZ|No||||
amoxicillin|No|No|No|No|75%|00781615646|AMOXICILLIN 200 MG/5 ML SUSP|100|ML|.0258|03/22/2010||Yes|No||03/22/2010||Yes|No|03/22/2010||Yes|No||04/01/2011||Yes|No|||Prescription required|No||209|No|.03312|03/29/2022|.03232|03/29/2022|.03254|03/29/2022|||PENICILLINS|5511|||||No|No||SANDOZ|No||||
amoxicillin|No|No|No|No|75%|00781615652|AMOXICILLIN 200 MG/5 ML SUSP|50|ML|.02588|04/20/2010||Yes|No||04/20/2010||Yes|No|04/20/2010||Yes|No||04/01/2011||Yes|No|||Prescription required|No||209|No|.02949|11/23/2021|.02878|11/23/2021|.02897|11/23/2021|||PENICILLINS|5512|||||No|No||SANDOZ|No||||
amoxicillin|No|No|No|No|75%|00781615657|AMOXICILLIN 200 MG/5 ML SUSP|75|ML|.02573|04/20/2010||Yes|No||04/20/2010||Yes|No|04/20/2010||Yes|No||04/01/2011||Yes|No|||Prescription required|No||209|No|.032|01/25/2022|.03123|01/25/2022|.03144|01/25/2022|||PENICILLINS|5513|||||No|No||SANDOZ|No||||
amoxicillin|No|No|No|No|75%|00781615746|AMOXICILLIN 400 MG/5 ML SUSP|100|ML|.02769|03/22/2010||Yes|No||03/22/2010||Yes|No|03/22/2010||Yes|No||04/01/2011||Yes|No|||Prescription required|No||209|No|.02289|03/29/2022|.02234|03/29/2022|.02248|03/29/2022|||PENICILLINS|5514|||||No|No||SANDOZ|No||||
amoxicillin|No|No|No|No|75%|00781615752|AMOXICILLIN 400 MG/5 ML SUSP|50|ML|.02769|07/23/2010||Yes|No||07/23/2010||Yes|No|07/23/2010||Yes|No||04/01/2011||Yes|No|||Prescription required|No||209|No|.03376|03/29/2022|.03294|03/29/2022|.03316|03/29/2022|||PENICILLINS|5515|||||No|No||SANDOZ|No||||
amoxicillin|No|No|No|No|75%|00781615757|AMOXICILLIN 400 MG/5 ML SUSP|75|ML|.02763|04/20/2010||Yes|No||04/20/2010||Yes|No|04/20/2010||Yes|No||04/01/2011||Yes|No|||Prescription required|No||209|No|.02457|03/29/2022|.02398|03/29/2022|.02414|03/29/2022|||PENICILLINS|5516|||||No|No||SANDOZ|No||||
travoprost|No|No|No|No|75%|00781618556|TRAVOPROST 0.004% EYE DROP|2.5|ML|28.46256|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|088|No|36.32982|03/29/2022|35.4579|03/29/2022|35.69404|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|5517|||||No|No||SANDOZ|No||||
travoprost|No|No|No|No|75%|00781618575|TRAVOPROST 0.004% EYE DROP|5|ML|28.4617|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|088|No|32.8|03/29/2022|32.0128|03/29/2022|32.226|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|5518|||||No|No||SANDOZ|No||||
ciprofloxacin HCl/dexameth|No|No|No|No|75%|00781618667|CIPROFLOX-DEXAMETH OTIC SUSP|7.5|ML|12.85298|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|051|No|19.45133|03/29/2022|18.98449|03/29/2022|19.11093|03/29/2022|||OTIC ANTIBIOTICS|5519|||||No|No||SANDOZ|No||||
oxcarbazepine|No|No|No|No|75%|00781627043|OXCARBAZEPINE 300 MG/5 ML SUSP|250|ML|.28455|05/21/2015||Yes|No||05/21/2015||Yes|No|05/21/2015||Yes|No||||No|No|||Prescription required|No||056|No|.34245|03/29/2022|.33423|03/29/2022|.33645|03/29/2022|||ANTICONVULSANTS|5520|||||No|No||SANDOZ|No||||
sumatriptan|No|No|No|No|75%|00781652386|SUMATRIPTAN 20 MG NASAL SPRAY|6|EA|21.15671|03/08/2010|01/31/2022|Yes|No||03/08/2010|01/31/2022|Yes|No|03/08/2010|01/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|021|No|48.21762|02/15/2022|47.5288|02/15/2022|45.26552|02/15/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|5521|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SANDOZ|No||||
sumatriptan|No|No|No|No|75%|00781652486|SUMATRIPTAN 5 MG NASAL SPRAY|6|EA|21.15671|03/08/2010|01/31/2022|Yes|No||03/08/2010|01/31/2022|Yes|No|03/08/2010|01/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|021|No|48.21762|02/15/2022|47.5288|02/15/2022|45.26552|02/15/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|5522|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SANDOZ|No||||
erythromycin/benzoyl peroxide|No|No|No|No|75%|00781705449|ERYTHROMYCIN-BENZOYL GEL|23.3|GM|3.06185|04/07/2004||Yes|No||04/07/2004||Yes|No|04/07/2004||Yes|No||||No|No|||Prescription required|No||104|No|1.71854|03/29/2022|1.67729|03/29/2022|1.68846|03/29/2022|||ACNE AGENTS: TOPICAL|5523|||||No|No||SANDOZ|No||||
metronidazole|Yes|No|No|No|75%|00781707787|METRONIDAZOLE VAGINAL 0.75% GL|70|GM|.75108|11/28/2006||Yes|No||11/28/2006||Yes|No|11/28/2006||Yes|No||||No|No|11/01/2012||Prescription required|Yes|01/28/2021|124|No|.55819|03/29/2022|.54479|03/29/2022|.54842|03/29/2022|||ANTIBIOTICS: VAGINAL|5524|||||No|No||SANDOZ|No||||
metronidazole|No|No|No|No|75%|00781708035|METRONIDAZOLE TOPICAL 1% GEL|60|GM|1.11276|12/20/2013||Yes|No||12/20/2013||Yes|No|12/20/2013||Yes|No||||No|No|||Prescription required|No||221|No|1.2961|03/29/2022|1.26499|03/29/2022|1.27341|03/29/2022|||ROSACEA AGENTS: TOPICAL|5525|||||No|No||SANDOZ|No||||
metronidazole|No|No|No|No|75%|00781708055|METRONIDAZOLE TOP 1% GEL PUMP|55|GM|1.21392|12/20/2013||Yes|No||12/20/2013||Yes|No|12/20/2013||Yes|No||||No|No|||Prescription required|No||221|No|1.15772|03/29/2022|1.12993|03/29/2022|1.13745|03/29/2022|||ROSACEA AGENTS: TOPICAL|5526|||||No|No||SANDOZ|No||||
mesalamine|No|No|No|No|75%|00781708833|MESALAMINE 1,000 MG SUPP|30|EA|6.66084|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No||||No|No|||Prescription required|No||010|No|2.81018|03/29/2022|2.74273|03/29/2022|2.761|03/29/2022|||ULCERATIVE COLITIS AGENTS|5527|||||No|No||SANDOZ|No||||
erythromycin/benzoyl peroxide|No|No|No|No|75%|00781709459|ERYTHROMYCIN-BENZOYL GEL|46.6|GM|3.06194|04/04/2012||Yes|No||04/04/2012||Yes|No|04/04/2012||Yes|No||||No|No|||Prescription required|No||104|No|1.12609|03/29/2022|1.09906|03/29/2022|1.10638|03/29/2022|||ACNE AGENTS: TOPICAL|5528|||||No|No||SANDOZ|No||||
estradiol|No|No|No|No|75%|00781710454|ESTRADIOL 0.1 MG PATCH (1/WK)|4|EA|7.98295|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||||No|No|||Prescription required|No|||Yes|12.90538|03/29/2022|12.59565|03/29/2022|12.67953|03/29/2022||||5529|||||No|No||SANDOZ|No||||
calcipotriene|No|No|No|No|75%|00781711735|CALCIPOTRIENE 0.005% CREAM|60|GM|2.53327|08/14/2012||Yes|No||08/14/2012||Yes|No|08/14/2012||Yes|No||||No|No|||Prescription required|No|||No|1.06701|03/29/2022|1.0414|03/29/2022|1.04833|03/29/2022||||5530|||||No|No||SANDOZ|No||||
calcipotriene|No|No|No|No|75%|00781711783|CALCIPOTRIENE 0.005% CREAM|120|GM|2.42211|08/14/2012||Yes|No||08/14/2012||Yes|No|08/14/2012||Yes|No||||No|No|||Prescription required|No|||No|1.10109|03/29/2022|1.07466|03/29/2022|1.08182|03/29/2022||||5531|||||No|No||SANDOZ|No||||
estradiol|No|No|No|No|75%|00781711954|ESTRADIOL 0.025 MG PATCH(1/WK)|4|EA|7.98295|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||||No|No|||Prescription required|No|||Yes|13.22429|03/29/2022|12.9069|03/29/2022|12.99286|03/29/2022||||5532|||||No|No||SANDOZ|No||||
estradiol|No|No|No|No|75%|00781712254|ESTRADIOL 0.0375MG PATCH(1/WK)|4|EA|7.98295|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||||No|No|||Prescription required|No|||Yes|15.03859|03/29/2022|14.67766|03/29/2022|14.77541|03/29/2022||||5533|||||No|No||SANDOZ|No||||
estradiol|No|No|No|No|75%|00781712983|ESTRADIOL 0.025 MG PATCH(2/WK)|8|EA|4.6741|10/12/2016||Yes|No||10/12/2016||Yes|No|10/12/2016||Yes|No||||No|No|||Prescription required|No|||Yes|9.33155|03/29/2022|9.10759|03/29/2022|9.16824|03/29/2022||||5534|||||No|No||SANDOZ|No||||
estradiol|No|No|No|No|75%|00781713354|ESTRADIOL 0.05 MG PATCH (1/WK)|4|EA|7.98295|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||||No|No|||Prescription required|No|||Yes|12.19224|03/29/2022|11.89962|03/29/2022|11.97887|03/29/2022||||5535|||||No|No||SANDOZ|No||||
estradiol|No|No|No|No|75%|00781713454|ESTRADIOL 0.06 MG PATCH (1/WK)|4|EA|7.98295|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||||No|No|||Prescription required|No|||Yes|15.72469|03/01/2022|15.34729|03/01/2022|15.4495|03/01/2022||||5536|||||No|No||SANDOZ|No||||
moxifloxacin HCl|No|No|No|No|75%|00781713593|MOXIFLOXACIN 0.5% EYE DROPS|3|ML|5.01666|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|058|No|3.97371|03/29/2022|3.87834|03/29/2022|3.90417|03/29/2022|||OPHTHALMIC ANTIBIOTICS|5537|||||No|No||SANDOZ|No||||
estradiol|No|No|No|No|75%|00781713654|ESTRADIOL 0.075 MG PATCH(1/WK)|4|EA|7.98295|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||||No|No|||Prescription required|No|||Yes|12.236|03/29/2022|11.94233|03/29/2022|12.02187|03/29/2022||||5538|||||No|No||SANDOZ|No||||
clobetasol propionate|No|No|No|No|75%|00781713704|CLOBETASOL 0.05% SHAMPOO|118|ML|1.17131|10/05/2016|04/30/2022|Yes|No||10/05/2016|04/30/2022|Yes|No|10/05/2016|04/30/2022|Yes|No||||No|No|||Prescription required|Yes|01/25/2012|121|No|.54041|03/29/2022|.52744|03/29/2022|.53095|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|5539|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SANDOZ|No||||
estradiol|No|No|No|No|75%|00781713883|ESTRADIOL 0.0375MG PATCH(2/WK)|8|EA|4.6741|11/08/2016||Yes|No||11/08/2016||Yes|No|11/08/2016||Yes|No||||No|No|||Prescription required|No|||Yes|10.33407|03/29/2022|10.08605|03/29/2022|10.15322|03/29/2022||||5540|||||No|No||SANDOZ|No||||
adapalene|No|No|No|No|75%|00781714219|ADAPALENE 0.3% GEL|45|GM|2.36758|08/25/2014||Yes|No||08/25/2014||Yes|No|08/25/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|.91902|03/29/2022|.89696|03/29/2022|.90293|03/29/2022|||ACNE AGENTS: TOPICAL|5541|||||No|No||SANDOZ|No||||
adapalene|No|No|No|No|75%|00781714270|ADAPALENE 0.3% GEL PUMP|45|GM|2.3649|02/17/2016||Yes|No||02/17/2016||Yes|No|02/17/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|104|No|3.35906|03/01/2022|3.27844|03/01/2022|3.30027|03/01/2022|||ACNE AGENTS: TOPICAL|5542|||||No|No||SANDOZ|No||||
estradiol|No|No|No|No|75%|00781714483|ESTRADIOL 0.05 MG PATCH (2/WK)|8|EA|4.67625|11/08/2016||Yes|No||11/08/2016||Yes|No|11/08/2016||Yes|No||||No|No|||Prescription required|No|||Yes|9.27983|03/29/2022|9.05711|03/29/2022|9.11743|03/29/2022||||5543|||||No|No||SANDOZ|No||||
estradiol|No|No|No|No|75%|00781715683|ESTRADIOL 0.075 MG PATCH(2/WK)|8|EA|4.68323|11/08/2016||Yes|No||11/08/2016||Yes|No|11/08/2016||Yes|No||||No|No|||Prescription required|No|||Yes|8.4725|03/29/2022|8.26916|03/29/2022|8.32423|03/29/2022||||5544|||||No|No||SANDOZ|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|00781716119|CLIND PH-BENZOYL PEROX 1.2-5%|45|GM|.56616|05/01/2017||Yes|No||05/01/2017||Yes|No|05/01/2017||Yes|No||||No|No|||Prescription required|No||104|No|.73339|03/29/2022|.71578|03/29/2022|.72055|03/29/2022|||ACNE AGENTS: TOPICAL|5545|||||No|No||SANDOZ|No||||
calcipotriene/betamethasone|No|No|No|No|75%|00781716535|CALCIPOTRIENE-BETAMETH DP OINT|60|GM|4.71172|06/19/2014||Yes|No||06/19/2014||Yes|No|06/19/2014||Yes|No||||No|No|||Prescription required|No|||No|5.20664|03/29/2022|5.08168|03/29/2022|5.11552|03/29/2022||||5546|||||No|No||SANDOZ|No||||
calcipotriene/betamethasone|No|No|No|No|75%|00781716595|CALCIPOTRIENE-BETAMETH DP OINT|100|GM|4.16412|06/19/2014||Yes|No||06/19/2014||Yes|No|06/19/2014||Yes|No||||No|No|||Prescription required|No|||No|3.63452|03/29/2022|3.54729|03/29/2022|3.57091|03/29/2022||||5547|||||No|No||SANDOZ|No||||
estradiol|No|No|No|No|75%|00781716783|ESTRADIOL 0.1 MG PATCH (2/WK)|8|EA|4.68323|11/08/2016||Yes|No||11/08/2016||Yes|No|11/08/2016||Yes|No||||No|No|||Prescription required|No|||Yes|8.48083|03/29/2022|8.27729|03/29/2022|8.33241|03/29/2022||||5548|||||No|No||SANDOZ|No||||
tobramycin in 0.225% sod chlor|No|No|No|No|75%|00781717156|TOBRAMYCIN 300 MG/5 ML AMPULE|5|ML|5.53471|09/02/2014||Yes|No||09/02/2014||Yes|No|09/02/2014||Yes|No|Submit HHS Form 1143|||No|No|||Prescription required|Yes|07/29/2021|240|No|3.76543|05/25/2021|3.67505|05/25/2021|3.69953|05/25/2021|||ANTIBIOTICS: INHALED|5549|||||No|No||SANDOZ|No||||
naloxone HCl|No|No|No|No|75%|00781717612|NALOXONE HCL 4 MG NASAL SPRAY|2|EA|24.1875|03/30/2022||Yes|No||03/30/2022||Yes|No|03/30/2022||Yes|No||||No|No|||Prescription required|No||145|No|55.125|03/30/2022|54.3375|03/30/2022|51.75|03/30/2022|||OPIATE DEPENDENCE TREATMENTS|5550|||||No|No||SANDOZ|No||||
adapalene/benzoyl peroxide|No|No|No|No|75%|00781718270|ADAPALENE-BNZYL PEROX 0.1-2.5%|45|GM|.95555|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|104|No|.76371|03/29/2022|.74538|03/29/2022|.75034|03/29/2022|||ACNE AGENTS: TOPICAL|5551|||||No|No||SANDOZ|No||||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00781721606|BUPRENORPHINE-NALOX 2-0.5MG FM|1|EA|1.76027|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|||||||2.61599|10/01/2020|OPIATE DEPENDENCE TREATMENTS|5552|||||No|No||SANDOZ|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00781721664|BUPRENORPHINE-NALOX 2-0.5MG FM|30|EA|1.76027|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|No||145|Yes|4.01178|05/11/2021|3.95447|05/11/2021|3.76616|05/11/2021|||OPIATE DEPENDENCE TREATMENTS|5553|||||No|No||SANDOZ|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00781722706|BUPRENORPHINE-NALOX 4-1MG FILM|1|EA|3.15333|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|||||||4.68422|10/01/2020|OPIATE DEPENDENCE TREATMENTS|5554|||||No|No||SANDOZ|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00781722764|BUPRENORPHINE-NALOX 4-1MG FILM|30|EA|3.15333|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|No||145|Yes|7.18666|02/09/2021|7.08399|02/09/2021|6.74666|02/09/2021|||OPIATE DEPENDENCE TREATMENTS|5555|||||No|No||SANDOZ|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00781723806|BUPRENORPHINE-NALOX 8-2MG FILM|1|EA|3.15333|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|||||||3.98028|10/01/2020|OPIATE DEPENDENCE TREATMENTS|5556|||||No|No||SANDOZ|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00781723864|BUPRENORPHINE-NALOX 8-2MG FILM|30|EA|3.15333|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|No||145|Yes|7.18666|05/11/2021|7.08399|05/11/2021|6.74666|05/11/2021|||OPIATE DEPENDENCE TREATMENTS|5557|||||No|No||SANDOZ|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00781724906|BUPRENORPHINE-NALOX 12-3MG FLM|1|EA|6.30652|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|||||||8.50806|10/01/2020|OPIATE DEPENDENCE TREATMENTS|5558|||||No|No||SANDOZ|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00781724964|BUPRENORPHINE-NALOX 12-3MG FLM|30|EA|6.30652|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|No||145|Yes|14.373|03/09/2021|14.16767|03/09/2021|13.49302|03/09/2021|||OPIATE DEPENDENCE TREATMENTS|5559|||||No|No||SANDOZ|Yes|09/01/2020|||
clindamycin phos/benzoyl perox|No|No|No|No|75%|00781726368|CLINDAMYCIN-BENZOYL PEROX 1-5%|25|GM|2.92658|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|.996|03/29/2022|.97209|03/29/2022|.97857|03/29/2022|||ACNE AGENTS: TOPICAL|5560|||||No|No||SANDOZ|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|00781728750|CLINDAMYCIN-BENZOYL PEROX 1-5%|50|GM|2.9264|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|.80914|03/29/2022|.78972|03/29/2022|.79498|03/29/2022|||ACNE AGENTS: TOPICAL|5561|||||No|No||SANDOZ|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|00781729146|CLINDAMYCIN-BNZ PEROX 1-5% PMP|50|GM|3.3896|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|Yes|09/28/2017|104|No|1.67707|03/29/2022|1.63682|03/29/2022|1.64772|03/29/2022|||ACNE AGENTS: TOPICAL|5562|||||No|No||SANDOZ|No||||
albuterol sulfate|No|No|No|No|75%|00781729685|ALBUTEROL HFA 90 MCG INHALER|6.7|GM|2.30916|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|037|Yes|3.77137|03/29/2022|3.68085|03/29/2022|3.70537|03/29/2022|||BRONCHODILATORS: BETA AGONIST|5563|||||No|No||SANDOZ|No||||
rivastigmine|No|No|No|No|75%|00781730431|RIVASTIGMINE 4.6 MG/24HR PATCH|30|EA|5.81245|02/22/2016||Yes|No||02/22/2016||Yes|No|02/22/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|011|No|2.88542|03/29/2022|2.81616|03/29/2022|2.83492|03/29/2022|||ALZHEIMER'S AGENTS|5564|||||No|No||SANDOZ|No||||
rivastigmine|No|No|No|No|75%|00781730931|RIVASTIGMINE 9.5 MG/24HR PATCH|30|EA|5.81245|02/22/2016||Yes|No||02/22/2016||Yes|No|02/22/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|011|No|2.83898|03/29/2022|2.77084|03/29/2022|2.78929|03/29/2022|||ALZHEIMER'S AGENTS|5565|||||No|No||SANDOZ|No||||
rivastigmine|No|No|No|No|75%|00781731331|RIVASTIGMINE 13.3 MG/24HR PTCH|30|EA|5.81245|02/22/2016||Yes|No||02/22/2016||Yes|No|02/22/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|011|No|3.24254|03/29/2022|3.16471|03/29/2022|3.18579|03/29/2022|||ALZHEIMER'S AGENTS|5566|||||No|No||SANDOZ|No||||
budesonide|No|No|No|No|75%|00781751587|BUDESONIDE 0.25 MG/2 ML SUSP|2|ML|.60916|09/29/2015||Yes|No||09/29/2015||Yes|No|09/29/2015||Yes|No||||No|No|||Prescription required|No||033|Yes|.8321|03/29/2022|.81212|03/29/2022|.81753|03/29/2022|||GLUCOCORTICOIDS: INHALED|5567|||||No|No||SANDOZ|No||||
budesonide|No|No|No|No|75%|00781751687|BUDESONIDE 0.5 MG/2 ML SUSP|2|ML|2.69886|09/29/2015||Yes|No||09/29/2015||Yes|No|09/29/2015||Yes|No||||No|No|||Prescription required|No||033|Yes|.57313|03/29/2022|.55937|03/29/2022|.5631|03/29/2022|||GLUCOCORTICOIDS: INHALED|5568|||||No|No||SANDOZ|Yes|09/01/2020|||
budesonide|No|No|No|No|75%|00781751787|BUDESONIDE 1 MG/2 ML INH SUSP|2|ML|2.15|09/29/2015||Yes|No||09/29/2015||Yes|No|09/29/2015||Yes|No||||No|No|||Prescription required|No||033|Yes|3.95849|03/29/2022|3.86348|03/29/2022|3.88921|03/29/2022|||GLUCOCORTICOIDS: INHALED|5569|||||No|No||SANDOZ|Yes|09/01/2020|||
clobazam|No|No|No|No|90%|00781801301|CLOBAZAM 10 MG TABLET|100|EA|.258|01/03/2019||Yes|No||01/03/2019||Yes|No|01/03/2019||Yes|No||||No|No|||Prescription required|No||056|No|.37729|03/29/2022|.36823|03/29/2022|.37068|03/29/2022|||ANTICONVULSANTS|5570|||||No|No||SANDOZ|No||||
clobazam|No|No|No|No|90%|00781801401|CLOBAZAM 20 MG TABLET|100|EA|.516|01/03/2019||Yes|No||01/03/2019||Yes|No|01/03/2019||Yes|No||||No|No|||Prescription required|No||056|No|.71967|03/29/2022|.70239|03/29/2022|.70707|03/29/2022|||ANTICONVULSANTS|5571|||||No|No||SANDOZ|No||||
carbamazepine|No|No|No|No|75%|00781801601|CARBAMAZEPINE ER 100 MG TABLET|100|EA|.3937|10/12/2018||Yes|No||10/12/2018||Yes|No|10/12/2018||Yes|No||||No|No|||Prescription required|No||056|No|.53596|03/29/2022|.52309|03/29/2022|.52658|03/29/2022|||ANTICONVULSANTS|5572|||||No|No||SANDOZ|No||||
fluvastatin sodium|No|No|No|No|75%|00781801701|FLUVASTATIN ER 80 MG TABLET|100|EA|3.01425|06/27/2018||Yes|No||06/27/2018||Yes|No|06/27/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|063|Yes|3.96093|01/25/2022|3.86586|01/25/2022|3.89161|01/25/2022|||LIPOTROPICS: STATINS|5573|||||No|No||SANDOZ|No||||
fluvastatin sodium|No|No|No|No|75%|00781801731|FLUVASTATIN ER 80 MG TABLET|30|EA|3.01415|06/27/2018||Yes|No||06/27/2018||Yes|No|06/27/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|063|Yes|3.96093|01/25/2022|3.86586|01/25/2022|3.89161|01/25/2022|||LIPOTROPICS: STATINS|5574|||||No|No||SANDOZ|No||||
trifluoperazine HCl|No|No|No|No|75%|00781802801|TRIFLUOPERAZINE 1 MG TABLET|100|EA|.2632|05/07/2019||Yes|No||05/07/2019||Yes|No|05/07/2019||Yes|No||||No|No|||Prescription required|No||027|Yes|.59985|06/25/2019|.59128|06/25/2019|.56313|06/25/2019|||ANTIPSYCHOTICS|5575|||||No|No||SANDOZ|No||||
armodafinil|No|No|No|No|90%|00781802931|ARMODAFINIL 50 MG TABLET|30|EA|.18762|05/01/2017||Yes|No||05/01/2017||Yes|No|05/01/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.28825|03/29/2022|.28133|03/29/2022|.2832|03/29/2022|||STIMULANTS AND RELATED AGENTS|5576|||||No|No||SANDOZ|No||||
trifluoperazine HCl|No|No|No|No|75%|00781803201|TRIFLUOPERAZINE 2 MG TABLET|100|EA|.38786|05/07/2019||Yes|No||05/07/2019||Yes|No|05/07/2019||Yes|No||||No|No|||Prescription required|No||027|Yes|.88396|09/24/2019|.87133|09/24/2019|.82984|09/24/2019|||ANTIPSYCHOTICS|5577|||||No|No||SANDOZ|No||||
trifluoperazine HCl|No|No|No|No|75%|00781803401|TRIFLUOPERAZINE 5 MG TABLET|100|EA|.48852|05/07/2019||Yes|No||05/07/2019||Yes|No|05/07/2019||Yes|No||||No|No|||Prescription required|No||027|Yes|.87564|11/23/2021|.85462|11/23/2021|.86031|11/23/2021|||ANTIPSYCHOTICS|5578|||||No|No||SANDOZ|No||||
trifluoperazine HCl|No|No|No|No|75%|00781803601|TRIFLUOPERAZINE 10 MG TABLET|100|EA|.73637|05/07/2019||Yes|No||05/07/2019||Yes|No|05/07/2019||Yes|No||||No|No|||Prescription required|No||027|Yes|1.67825|08/27/2019|1.65427|08/27/2019|1.5755|08/27/2019|||ANTIPSYCHOTICS|5579|||||No|No||SANDOZ|No||||
armodafinil|No|No|No|No|90%|00781803731|ARMODAFINIL 150 MG TABLET|30|EA|.56473|05/01/2017||Yes|No||05/01/2017||Yes|No|05/01/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.83403|03/29/2022|.81401|03/29/2022|.81943|03/29/2022|||STIMULANTS AND RELATED AGENTS|5580|||||No|No||SANDOZ|No||||
armodafinil|No|No|No|No|90%|00781804531|ARMODAFINIL 200 MG TABLET|30|EA|.56473|05/01/2017||Yes|No||05/01/2017||Yes|No|05/01/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.63792|03/29/2022|.6226|03/29/2022|.62675|03/29/2022|||STIMULANTS AND RELATED AGENTS|5581|||||No|No||SANDOZ|No||||
perphenazine|No|No|No|No|75%|00781804601|PERPHENAZINE 2 MG TABLET|100|EA|.14637|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.31906|03/29/2022|.3114|03/29/2022|.31347|03/29/2022|||ANTIPSYCHOTICS|5582|||||No|No||SANDOZ|No||||
perphenazine|No|No|No|No|75%|00781804701|PERPHENAZINE 4 MG TABLET|100|EA|.20038|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.32485|03/29/2022|.31705|03/29/2022|.31916|03/29/2022|||ANTIPSYCHOTICS|5583|||||No|No||SANDOZ|No||||
perphenazine|No|No|No|No|75%|00781804801|PERPHENAZINE 8 MG TABLET|100|EA|.24303|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.48127|03/29/2022|.46971|03/29/2022|.47284|03/29/2022|||ANTIPSYCHOTICS|5584|||||No|No||SANDOZ|No||||
perphenazine|No|No|No|No|75%|00781804901|PERPHENAZINE 16 MG TABLET|100|EA|.32697|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.69746|03/29/2022|.68072|03/29/2022|.68525|03/29/2022|||ANTIPSYCHOTICS|5585|||||No|No||SANDOZ|No||||
captopril|No|No|No|No|75%|00781805201|CAPTOPRIL 12.5 MG TABLET|100|EA|.344|12/08/2016||Yes|No||12/08/2016||Yes|No|12/08/2016||Yes|No||12/08/2016||Yes|No|||Prescription required|Yes|07/26/2018|113|No|.58889|03/29/2022|.57475|03/29/2022|.57858|03/29/2022|||ANGIOTENSIN MODULATORS|5586|||||No|No||SANDOZ|No||||
armodafinil|No|No|No|No|90%|00781805331|ARMODAFINIL 250 MG TABLET|30|EA|.56473|05/01/2017||Yes|No||05/01/2017||Yes|No|05/01/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.10963|03/29/2022|1.08299|03/29/2022|1.09021|03/29/2022|||STIMULANTS AND RELATED AGENTS|5587|||||No|No||SANDOZ|No||||
captopril|No|No|No|No|75%|00781806101|CAPTOPRIL 25 MG TABLET|100|EA|.3655|12/08/2016||Yes|No||12/08/2016||Yes|No|12/08/2016||Yes|No||12/08/2016||Yes|No|||Prescription required|Yes|07/26/2018|113|No|.40459|03/29/2022|.39487|03/29/2022|.3975|03/29/2022|||ANGIOTENSIN MODULATORS|5588|||||No|No||SANDOZ|No||||
captopril|No|No|No|No|75%|00781806110|CAPTOPRIL 25 MG TABLET|1000|EA|.3655|04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No||04/21/2021||Yes|No|||Prescription required|Yes|07/26/2018|113|No|.40459|03/29/2022|.39487|03/29/2022|.3975|03/29/2022|||ANGIOTENSIN MODULATORS|5589|||||No|No||SANDOZ|No||||
captopril|No|No|No|No|75%|00781807501|CAPTOPRIL 50 MG TABLET|100|EA|.602|12/08/2016||Yes|No||12/08/2016||Yes|No|12/08/2016||Yes|No||12/08/2016||Yes|No|||Prescription required|Yes|07/26/2018|113|No|1.25965|03/29/2022|1.22941|03/29/2022|1.2376|03/29/2022|||ANGIOTENSIN MODULATORS|5590|||||No|No||SANDOZ|No||||
captopril|No|No|No|No|75%|00781807510|CAPTOPRIL 50 MG TABLET|1000|EA|.602|04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No||04/21/2021||Yes|No|||Prescription required|Yes|07/26/2018|113|No|1.25965|03/29/2022|1.22941|03/29/2022|1.2376|03/29/2022|||ANGIOTENSIN MODULATORS|5591|||||No|No||SANDOZ|No||||
captopril|No|No|No|No|75%|00781808001|CAPTOPRIL 100 MG TABLET|100|EA|.774|12/08/2016||Yes|No||12/08/2016||Yes|No|12/08/2016||Yes|No||12/08/2016||Yes|No|||Prescription required|Yes|07/26/2018|113|No|1.37792|03/29/2022|1.34484|03/29/2022|1.3538|03/29/2022|||ANGIOTENSIN MODULATORS|5592|||||No|No||SANDOZ|No||||
azithromycin|Yes|No|No|No|75%|00781808926|AZITHROMYCIN 250 MG TABLET|6|EA|.93166|04/07/2020||Yes|No||04/07/2020||Yes|No|04/07/2020||Yes|No||04/07/2020||Yes|No|06/19/2020||Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|5593|||||No|No||SANDOZ|No||||
azithromycin|Yes|No|No|No|75%|00781808931|AZITHROMYCIN 250 MG TABLET|30|EA|.93166|04/07/2020||Yes|No||04/07/2020||Yes|No|04/07/2020||Yes|No||04/07/2020||Yes|No|06/19/2020||Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|5594|||||No|No||SANDOZ|No||||
azithromycin|No|No|No|No|75%|00781809003|AZITHROMYCIN 500 MG TABLET|3|EA|1.86333|09/03/2020||Yes|No||09/03/2020||Yes|No|09/03/2020||Yes|No||09/03/2020||Yes|No|||Prescription required|No||018|No|.82092|03/29/2022|.80121|03/29/2022|.80655|03/29/2022|||MACROLIDES/KETOLIDES|5595|||||No|No||SANDOZ|No||||
azithromycin|No|No|No|No|75%|00781809031|AZITHROMYCIN 500 MG TABLET|30|EA|1.86333|09/03/2020||Yes|No||09/03/2020||Yes|No|09/03/2020||Yes|No||09/03/2020||Yes|No|||Prescription required|No||018|No|.82092|03/29/2022|.80121|03/29/2022|.80655|03/29/2022|||MACROLIDES/KETOLIDES|5596|||||No|No||SANDOZ|No||||
azithromycin|No|No|No|No|75%|00781809131|AZITHROMYCIN 600 MG TABLET|30|EA|2.88358|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||09/22/2021||Yes|No|||Prescription required|No||018|No|1.08173|09/22/2021|1.05576|09/22/2021|1.06279|09/22/2021|||MACROLIDES/KETOLIDES|5597|||||No|No||SANDOZ|No||||
desipramine HCl|No|No|No|No|75%|00781897201|DESIPRAMINE 25 MG TABLET|100|EA|.62694|01/02/2019||Yes|No||01/02/2019||Yes|No|01/02/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.4119|03/01/2022|.40201|03/01/2022|.40469|03/01/2022|||ANTIDEPRESSANTS: TRICYCLIC|5598|||||No|No||SANDOZ|No||||
desipramine HCl|No|No|No|No|75%|00781897301|DESIPRAMINE 50 MG TABLET|100|EA|1.18017|01/02/2019||Yes|No||01/02/2019||Yes|No|01/02/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.3099|01/25/2022|.30246|01/25/2022|.30447|01/25/2022|||ANTIDEPRESSANTS: TRICYCLIC|5599|||||No|No||SANDOZ|No||||
desipramine HCl|No|No|No|No|75%|00781897401|DESIPRAMINE 75 MG TABLET|100|EA|1.50216|01/02/2019||Yes|No||01/02/2019||Yes|No|01/02/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|3.42353|01/02/2019|3.37462|01/02/2019|3.21392|01/02/2019|||ANTIDEPRESSANTS: TRICYCLIC|5600|||||No|No||SANDOZ|No||||
desipramine HCl|No|No|No|No|75%|00781897501|DESIPRAMINE 100 MG TABLET|100|EA|1.97391|01/02/2019||Yes|No||01/02/2019||Yes|No|01/02/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|4.49869|10/29/2019|4.43442|10/29/2019|4.22326|10/29/2019|||ANTIDEPRESSANTS: TRICYCLIC|5601|||||No|No||SANDOZ|No||||
desipramine HCl|No|No|No|No|75%|00781897650|DESIPRAMINE 150 MG TABLET|50|EA|2.8601|01/02/2019||Yes|No||01/02/2019||Yes|No|01/02/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|6.51837|03/24/2020|6.42525|03/24/2020|6.11928|03/24/2020|||ANTIDEPRESSANTS: TRICYCLIC|5602|||||No|No||SANDOZ|No||||
olanzapine|No|No|No|No|75%|00781910572|OLANZAPINE 10 MG VIAL|1|EA|14.276|06/02/2016||Yes|No||06/02/2016||Yes|No|06/02/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|027|Yes|32.536|05/26/2020|32.0712|05/26/2020|30.544|05/26/2020|||ANTIPSYCHOTICS|5603|||||No|No||SANDOZ/PREMIER|No||||
piperacillin sodium/tazobactam|No|No|No|No|75%|00781921395|PIPERACIL-TAZOBACT 3.375 GM VL|1|EA|4.429|12/04/2018||Yes|No||12/04/2018||Yes|No|12/04/2018||Yes|No||||No|No|||Prescription required|No|||No|10.094|12/04/2018|9.9498|12/04/2018|9.476|12/04/2018||||5604|||||No|No||SANDOZ/NOVAPLUS|No||||
ampicillin sodium|No|No|No|No|75%|00781924295|AMPICILLIN 250 MG VIAL|1|EA|1.43964|02/17/2016||Yes|No||02/17/2016||Yes|No|02/17/2016||Yes|No||||No|No|||Prescription required|No|||No|3.28104|06/01/2016|3.23416|06/01/2016|3.08016|06/01/2016||||5605|||||No|No||SANDOZ/PREMIER|No||||
ampicillin sodium|No|No|No|No|75%|00781925095|AMPICILLIN 500 MG VIAL|1|EA|1.51532|02/17/2016||Yes|No||02/17/2016||Yes|No|02/17/2016||Yes|No||||No|No|||Prescription required|No|||No|3.45352|06/01/2016|3.40418|06/01/2016|3.24208|06/01/2016||||5606|||||No|No||SANDOZ/PREMIER|No||||
ampicillin sodium|No|No|No|No|75%|00781926195|AMPICILLIN 1 GM VIAL|1|EA|2.97044|02/17/2016||Yes|No||02/17/2016||Yes|No|02/17/2016||Yes|No||||No|No|||Prescription required|No|||No|6.76984|06/01/2016|6.67312|06/01/2016|6.35536|06/01/2016||||5607|||||No|No||SANDOZ/PREMIER|No||||
ampicillin sodium|No|No|No|No|75%|00781927395|AMPICILLIN 2 GM VIAL|1|EA|5.76286|02/17/2016||Yes|No||02/17/2016||Yes|No|02/17/2016||Yes|No||||No|No|||Prescription required|No|||No|13.13396|06/01/2016|12.94633|06/01/2016|12.32984|06/01/2016||||5608|||||No|No||SANDOZ/PREMIER|No||||
oxybutynin chloride|No|No|No|No|75%|00832003800|OXYBUTYNIN 5 MG TABLET|100|EA|.05224|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|5609|||||No|No||UPSHER SMITH LA|No||||
oxybutynin chloride|No|No|No|No|75%|00832003810|OXYBUTYNIN 5 MG TABLET|1000|EA|.05224|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|5610|||||No|No||UPSHER SMITH LA|No||||
oxybutynin chloride|No|No|No|No|75%|00832003850|OXYBUTYNIN 5 MG TABLET|500|EA|.05224|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|5611|||||No|No||UPSHER SMITH LA|No||||
amantadine HCl|No|No|No|No|75%|00832011100|AMANTADINE 100 MG TABLET|100|EA|.68722|01/29/2004||Yes|No||01/29/2004||Yes|No|01/29/2004||Yes|No||||No|No|||Prescription required|No||015|No|.71929|03/29/2022|.70202|03/29/2022|.7067|03/29/2022|||ANTIPARKINSON'S AGENTS|5612|||||No|No||UPSHER SMITH LA|No||||
amantadine HCl|No|No|No|No|75%|00832011150|AMANTADINE 100 MG TABLET|500|EA|.68724|01/29/2004||Yes|No||01/29/2004||Yes|No|01/29/2004||Yes|No||||No|No|||Prescription required|No||015|No|.71929|03/29/2022|.70202|03/29/2022|.7067|03/29/2022|||ANTIPARKINSON'S AGENTS|5613|||||No|No||UPSHER SMITH LA|No||||
morphine sulfate|No|No|No|No|90%|00832022500|MORPHINE SULFATE ER 10 MG CAP|100|EA|1.62785|11/27/2013||Yes|No||11/27/2013||Yes|No|11/27/2013||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|2.57285|03/29/2022|2.5111|03/29/2022|2.52782|03/29/2022|||ANALGESICS: NARCOTICS LONG|5614|||||No|No||UPSHER SMITH LA|No||||
morphine sulfate|No|No|No|No|90%|00832022600|MORPHINE SULFATE ER 20 MG CAP|100|EA|1.79873|11/27/2013||Yes|No||11/27/2013||Yes|No|11/27/2013||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|3.39578|03/01/2022|3.31428|03/01/2022|3.33635|03/01/2022|||ANALGESICS: NARCOTICS LONG|5615|||||No|No||UPSHER SMITH LA|No||||
morphine sulfate|No|No|No|No|90%|00832022700|MORPHINE SULFATE ER 30 MG CAP|100|EA|1.95632|11/27/2013||Yes|No||11/27/2013||Yes|No|11/27/2013||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|2.89795|03/29/2022|2.82839|03/29/2022|2.84723|03/29/2022|||ANALGESICS: NARCOTICS LONG|5616|||||No|No||UPSHER SMITH LA|No||||
morphine sulfate|No|No|No|No|90%|00832022800|MORPHINE SULFATE ER 50 MG CAP|100|EA|2.24976|11/27/2013||Yes|No||11/27/2013||Yes|No|11/27/2013||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|1.57696|09/28/2021|1.53911|09/28/2021|1.54936|09/28/2021|||ANALGESICS: NARCOTICS LONG|5617|||||No|No||UPSHER SMITH LA|No||||
morphine sulfate|No|No|No|No|90%|00832022900|MORPHINE SULFATE ER 60 MG CAP|100|EA|2.58722|11/27/2013||Yes|No||11/27/2013||Yes|No|11/27/2013||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|5.89646|10/26/2021|5.81222|10/26/2021|5.53545|10/26/2021|||ANALGESICS: NARCOTICS LONG|5618|||||No|No||UPSHER SMITH LA|No||||
morphine sulfate|No|No|No|No|90%|00832023000|MORPHINE SULFATE ER 80 MG CAP|100|EA|2.97534|11/27/2013||Yes|No||11/27/2013||Yes|No|11/27/2013||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|6.78101|02/18/2020|6.68414|02/18/2020|6.36584|02/18/2020|||ANALGESICS: NARCOTICS LONG|5619|||||No|No||UPSHER SMITH LA|No||||
morphine sulfate|No|No|No|No|90%|00832023300|MORPHINE SULFATE ER 100 MG CAP|100|EA|3.42163|11/27/2013||Yes|No||11/27/2013||Yes|No|11/27/2013||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|7.79815|02/18/2020|7.68675|02/18/2020|7.32071|02/18/2020|||ANALGESICS: NARCOTICS LONG|5620|||||No|No||UPSHER SMITH LA|No||||
morphine sulfate|No|No|No|No|90%|00832027311|MORPHINE SULFATE IR 15 MG TAB|100|EA|.17651|10/21/2021||Yes|No||10/21/2021||Yes|No|10/21/2021||Yes|No||||No|No|||Prescription required|No||109|Yes|.29802|03/29/2022|.29086|03/29/2022|.2928|03/29/2022|||ANALGESICS: NARCOTICS SHORT|5621|||||No|No||UPSHER SMITH LA|No||||
morphine sulfate|No|No|No|No|90%|00832027411|MORPHINE SULFATE IR 30 MG TAB|100|EA|.30035|10/21/2021||Yes|No||10/21/2021||Yes|No|10/21/2021||Yes|No||||No|No|||Prescription required|No||109|Yes|.43937|03/29/2022|.42882|03/29/2022|.43168|03/29/2022|||ANALGESICS: NARCOTICS SHORT|5622|||||No|No||UPSHER SMITH LA|No||||
bexarotene|No|No|No|No|75%|00832028500|BEXAROTENE 75 MG CAPSULE|100|EA|12.97804|03/04/2019||Yes|No||03/04/2019||Yes|No|03/04/2019||Yes|No||||No|No|||Prescription required|No|||No|29.57787|10/12/2021|29.15532|10/12/2021|27.76698|10/12/2021||||5623|||||No|No||UPSHER-SMITH LA|No||||
chlorpromazine HCl|No|No|No|No|75%|00832030000|CHLORPROMAZINE 10 MG TABLET|100|EA|1.13778|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|||Prescription required|No||027|Yes|1.29919|10/26/2021|1.268|10/26/2021|1.27645|10/26/2021|||ANTIPSYCHOTICS|5624|||||No|No||UPSHER SMITH LA|No||||
chlorpromazine HCl|No|No|No|No|75%|00832030100|CHLORPROMAZINE 25 MG TABLET|100|EA|1.6254|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|||Prescription required|No||027|Yes|1.39549|03/29/2022|1.36199|03/29/2022|1.37106|03/29/2022|||ANTIPSYCHOTICS|5625|||||No|No||UPSHER SMITH LA|No||||
chlorpromazine HCl|No|No|No|No|75%|00832030110|CHLORPROMAZINE 25 MG TABLET|1000|EA|1.6254|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||027|Yes|1.39549|03/29/2022|1.36199|03/29/2022|1.37106|03/29/2022|||ANTIPSYCHOTICS|5626|||||No|No||UPSHER SMITH LA|No||||
chlorpromazine HCl|No|No|No|No|75%|00832030200|CHLORPROMAZINE 50 MG TABLET|100|EA|2.31619|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|||Prescription required|No||027|Yes|1.74791|03/29/2022|1.70596|03/29/2022|1.71732|03/29/2022|||ANTIPSYCHOTICS|5627|||||No|No||UPSHER SMITH LA|No||||
chlorpromazine HCl|No|No|No|No|75%|00832030210|CHLORPROMAZINE 50 MG TABLET|1000|EA|2.31619|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|||Prescription required|No||027|Yes|1.74791|03/29/2022|1.70596|03/29/2022|1.71732|03/29/2022|||ANTIPSYCHOTICS|5628|Not Specified|Not Specified|Not Specified||No|No||UPSHER SMITH LA|No||||
chlorpromazine HCl|No|No|No|No|75%|00832030300|CHLORPROMAZINE 100 MG TABLET|100|EA|3.30889|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||027|Yes|2.03394|03/29/2022|1.98512|03/29/2022|1.99834|03/29/2022|||ANTIPSYCHOTICS|5629|||||No|No||UPSHER SMITH LA|No||||
chlorpromazine HCl|No|No|No|No|75%|00832030310|CHLORPROMAZINE 100 MG TABLET|1000|EA|3.30891|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||027|Yes|2.03394|03/29/2022|1.98512|03/29/2022|1.99834|03/29/2022|||ANTIPSYCHOTICS|5630|||||No|No||UPSHER SMITH LA|No||||
chlorpromazine HCl|No|No|No|No|75%|00832030400|CHLORPROMAZINE 200 MG TABLET|100|EA|4.7269|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|||Prescription required|No||027|Yes|4.21034|03/01/2022|4.10929|03/01/2022|4.13665|03/01/2022|||ANTIPSYCHOTICS|5631|||||No|No||UPSHER SMITH LA|No||||
chlorpromazine HCl|No|No|No|No|75%|00832030410|CHLORPROMAZINE 200 MG TABLET|1000|EA|4.72687|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|||Prescription required|No||027|Yes|4.21034|03/01/2022|4.10929|03/01/2022|4.13665|03/01/2022|||ANTIPSYCHOTICS|5632|||||No|No||UPSHER SMITH LA|No||||
valproic acid|No|No|No|No|75%|00832031011|VALPROIC ACID 250 MG CAPSULE|100|EA|.18812|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||056|No|.23326|03/29/2022|.22766|03/29/2022|.22917|03/29/2022|||ANTICONVULSANTS|5633|||||No|No||UPSHER SMITH LA|No||||
doxazosin mesylate|No|No|No|No|75%|00832035611|DOXAZOSIN MESYLATE 1 MG TAB|100|EA|.18287|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||11/29/2018||Yes|No|||Prescription required|No||003|Yes|.09392|03/29/2022|.09166|03/29/2022|.09227|03/29/2022|||BPH TREATMENTS|5634|||||No|No||UPSHER-SMITH LA|No||||
doxazosin mesylate|No|No|No|No|75%|00832035711|DOXAZOSIN MESYLATE 2 MG TAB|100|EA|.18287|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||11/29/2018||Yes|No|||Prescription required|No||003|Yes|.085|03/29/2022|.08296|03/29/2022|.08351|03/29/2022|||BPH TREATMENTS|5635|||||No|No||UPSHER-SMITH LA|No||||
fluoxetine HCl|Yes|No|No|No|75%|00832040211|FLUOXETINE HCL 10 MG TABLET|100|EA|.28904|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||008|No|.24078|03/29/2022|.235|03/29/2022|.23656|03/29/2022|||ANTIDEPRESSANTS: SSRIs|5636|||||No|No||UPSHER-SMITH LA|No||||
fluoxetine HCl|Yes|No|No|No|75%|00832040230|FLUOXETINE HCL 10 MG TABLET|30|EA|.28896|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||008|No|.24078|03/29/2022|.235|03/29/2022|.23656|03/29/2022|||ANTIDEPRESSANTS: SSRIs|5637|||||No|No||UPSHER-SMITH LA|No||||
fluoxetine HCl|Yes|No|No|No|75%|00832040311|FLUOXETINE HCL 20 MG TABLET|100|EA|.28904|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||008|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||ANTIDEPRESSANTS: SSRIs|5638|||||No|No||UPSHER-SMITH LA|No||||
fluoxetine HCl|Yes|No|No|No|75%|00832040330|FLUOXETINE HCL 20 MG TABLET|30|EA|.28896|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||008|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||ANTIDEPRESSANTS: SSRIs|5639|||||No|No||UPSHER-SMITH LA|No||||
nystatin|No|No|No|No|75%|00832046515|NYAMYC 100,000 UNIT/GM POWDER|15|GM|.31246|05/19/2010||Yes|No||05/19/2010||Yes|No|05/19/2010||Yes|No||||No|No|||Prescription required|No||061|No|.35016|03/29/2022|.34175|03/29/2022|.34403|03/29/2022|||ANTIFUNGALS: TOPICAL|5640|||||No|No||UPSHER SMITH LA|No||||
nystatin|No|No|No|No|75%|00832046530|NYAMYC 100,000 UNIT/GM POWDER|30|GM|.30573|05/18/2010||Yes|No||05/18/2010||Yes|No|05/18/2010||Yes|No||||No|No|||Prescription required|No||061|No|.30897|03/29/2022|.30155|03/29/2022|.30356|03/29/2022|||ANTIFUNGALS: TOPICAL|5641|||||No|No||UPSHER SMITH LA|No||||
nystatin|No|No|No|No|75%|00832046560|NYAMYC 100,000 UNIT/GM POWDER|60|GM|.27225|05/18/2010||Yes|No||05/18/2010||Yes|No|05/18/2010||Yes|No||||No|No|||Prescription required|No||061|No|.2597|03/29/2022|.25346|03/29/2022|.25515|03/29/2022|||ANTIFUNGALS: TOPICAL|5642|||||No|No||UPSHER SMITH LA|No||||
bethanechol chloride|No|No|No|No|75%|00832051000|BETHANECHOL 5 MG TABLET|100|EA|.10354|05/21/2008||Yes|No||05/21/2008||Yes|No|05/21/2008||Yes|No||||No|No|||Prescription required|No|||No|.20616|03/01/2022|.20121|03/01/2022|.20255|03/01/2022||||5643|||||No|No||UPSHER SMITH LA|No||||
bethanechol chloride|No|No|No|No|75%|00832051100|BETHANECHOL 10 MG TABLET|100|EA|.13652|05/21/2008||Yes|No||05/21/2008||Yes|No|05/21/2008||Yes|No||||No|No|||Prescription required|No|||No|.22911|03/29/2022|.22361|03/29/2022|.2251|03/29/2022||||5644|||||No|No||UPSHER SMITH LA|No||||
bethanechol chloride|No|No|No|No|75%|00832051101|BETHANECHOL 10 MG TABLET|100|EA|.273|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||||No|No|||Prescription required|No|||No|.22911|03/29/2022|.22361|03/29/2022|.2251|03/29/2022||||5645|||||No|No||UPSHER SMITH LA|No||||
bethanechol chloride|No|No|No|No|75%|00832051200|BETHANECHOL 25 MG TABLET|100|EA|.19642|01/28/2008||Yes|No||01/28/2008||Yes|No|01/28/2008||Yes|No||||No|No|||Prescription required|No|||No|.29586|03/29/2022|.28875|03/29/2022|.29068|03/29/2022||||5646|||||No|No||UPSHER SMITH LA|No||||
bethanechol chloride|No|No|No|No|75%|00832051201|BETHANECHOL 25 MG TABLET|100|EA|.39284|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||||No|No|||Prescription required|No|||No|.29586|03/29/2022|.28875|03/29/2022|.29068|03/29/2022||||5647|||||No|No||UPSHER SMITH LA|No||||
bethanechol chloride|No|No|No|No|75%|00832051300|BETHANECHOL 50 MG TABLET|100|EA|.32465|05/21/2008||Yes|No||05/21/2008||Yes|No|05/21/2008||Yes|No||||No|No|||Prescription required|No|||No|.48885|03/01/2022|.47711|03/01/2022|.48029|03/01/2022||||5648|||||No|No||UPSHER SMITH LA|No||||
bethanechol chloride|No|No|No|No|75%|00832051301|BETHANECHOL 50 MG TABLET|100|EA|.6493|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||||No|No|||Prescription required|No|||No|.48885|03/01/2022|.47711|03/01/2022|.48029|03/01/2022||||5649|||||No|No||UPSHER SMITH LA|No||||
bumetanide|No|No|No|No|75%|00832054011|BUMETANIDE 0.5 MG TABLET|100|EA|.24682|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||02/03/2021||Yes|No|||Prescription required|No|||No|.20616|03/29/2022|.20121|03/29/2022|.20255|03/29/2022||||5650|||||No|No||UPSHER-SMITH LA|No||||
bumetanide|No|No|No|No|75%|00832054111|BUMETANIDE 1 MG TABLET|100|EA|.24682|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||02/03/2021||Yes|No|||Prescription required|No|||No|.21417|03/29/2022|.20902|03/29/2022|.21042|03/29/2022||||5651|||||No|No||UPSHER-SMITH LA|No||||
bumetanide|No|No|No|No|75%|00832054211|BUMETANIDE 2 MG TABLET|100|EA|.46354|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||02/03/2021||Yes|No|||Prescription required|No|||No|.40198|03/29/2022|.39233|03/29/2022|.39494|03/29/2022||||5652|||||No|No||UPSHER-SMITH LA|No||||
clobazam|No|No|No|No|90%|00832058011|CLOBAZAM 10 MG TABLET|100|EA|.31454|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|||Prescription required|No||056|No|.37729|03/29/2022|.36823|03/29/2022|.37068|03/29/2022|||ANTICONVULSANTS|5653|||||No|No||UPSHER-SMITH LA|No||||
clobazam|No|No|No|No|90%|00832058111|CLOBAZAM 20 MG TABLET|100|EA|.62909|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|||Prescription required|No||056|No|.71967|03/29/2022|.70239|03/29/2022|.70707|03/29/2022|||ANTICONVULSANTS|5654|||||No|No||UPSHER-SMITH LA|No||||
clobazam|No|No|No|No|90%|00832058525|CLOBAZAM 2.5 MG/ML SUSPENSION|120|ML|.28666|03/04/2019||Yes|No||03/04/2019||Yes|No|03/04/2019||Yes|No||||No|No|||Prescription required|No||056|No|.50176|03/29/2022|.48971|03/29/2022|.49297|03/29/2022|||ANTICONVULSANTS|5655|||||No|No||UPSHER-SMITH LA|No||||
diphenoxylate HCl/atropine|No|No|No|No|75%|00832059010|DIPHENOXYLATE-ATROP 2.5-0.025|1000|EA|.21285|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||02/26/2019||Yes|No|||Prescription required|No|||No|.22711|03/29/2022|.22165|03/29/2022|.22313|03/29/2022||||5656|||||No|No||UPSHER-SMITH LA|No||||
diphenoxylate HCl/atropine|No|No|No|No|75%|00832059011|DIPHENOXYLATE-ATROP 2.5-0.025|100|EA|.21285|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||02/26/2019||Yes|No|||Prescription required|No|||No|.22711|03/29/2022|.22165|03/29/2022|.22313|03/29/2022||||5657|||||No|No||UPSHER-SMITH LA|No||||
exemestane|No|No|No|No|75%|00832059530|EXEMESTANE 25 MG TABLET|30|EA|1.43333|02/07/2018||Yes|No||02/07/2018||Yes|No|02/07/2018||Yes|No||||No|No|||Prescription required|No||502|No|1.32315|03/29/2022|1.29139|03/29/2022|1.29999|03/29/2022|||ONCOLOGY: ORAL - BREAST|5658|||||No|No||UPSHER-SMITH LA|No||||
clomipramine HCl|No|No|No|No|75%|00832063011|CLOMIPRAMINE 25 MG CAPSULE|100|EA|1.95293|09/19/2017||Yes|No||09/19/2017||Yes|No|09/19/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|1.31238|03/29/2022|1.28088|03/29/2022|1.28941|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|5659|||||No|No||UPSHER SMITH LA|No||||
clomipramine HCl|No|No|No|No|75%|00832063111|CLOMIPRAMINE 50 MG CAPSULE|100|EA|1.95293|09/19/2017||Yes|No||09/19/2017||Yes|No|09/19/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.80238|03/29/2022|.78312|03/29/2022|.78833|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|5660|||||No|No||UPSHER SMITH LA|No||||
clomipramine HCl|No|No|No|No|75%|00832063211|CLOMIPRAMINE 75 MG CAPSULE|100|EA|1.95293|09/19/2017||Yes|No||09/19/2017||Yes|No|09/19/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.95054|03/29/2022|.92772|03/29/2022|.9339|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|5661|||||No|No||UPSHER SMITH LA|No||||
propafenone HCl|No|No|No|No|75%|00832074060|PROPAFENONE HCL ER 225 MG CAP|60|EA|.94284|02/11/2021||Yes|No||02/11/2021||Yes|No|02/11/2021||Yes|No||||No|No|||Prescription required|No|||No|1.23841|03/29/2022|1.20868|03/29/2022|1.21673|03/29/2022||||5662|||||No|No||UPSHER-SMITH LA|No||||
propafenone HCl|No|No|No|No|75%|00832074160|PROPAFENONE HCL ER 325 MG CAP|60|EA|1.19439|02/11/2021||Yes|No||02/11/2021||Yes|No|02/11/2021||Yes|No||||No|No|||Prescription required|No|||No|2.24387|03/29/2022|2.19001|03/29/2022|2.2046|03/29/2022||||5663|||||No|No||UPSHER-SMITH LA|No||||
propafenone HCl|No|No|No|No|75%|00832074260|PROPAFENONE HCL ER 425 MG CAP|60|EA|1.19439|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|No|||No|2.7221|03/23/2021|2.68321|03/23/2021|2.55544|03/23/2021||||5664|||||No|No||UPSHER-SMITH LA|No||||
clonidine HCl|No|No|No|No|75%|00832077760|CLONIDINE HCL ER 0.1 MG TABLET|60|EA|.3225|05/21/2020|01/22/2022|Yes|No||05/21/2020|01/22/2022|Yes|No|05/21/2020|01/22/2022|Yes|No||05/21/2020|01/22/2022|Yes|No|||Prescription required|Yes|07/29/2021|007|Yes|.52051|03/29/2022|.50801|03/29/2022|.5114|03/29/2022|||STIMULANTS AND RELATED AGENTS|5665|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||UPSHER-SMITH LA|No||||
amantadine HCl|No|No|No|No|75%|00832101500|AMANTADINE 100 MG CAPSULE|100|EA|.34649|01/05/2021||Yes|No||01/05/2021||Yes|No|01/05/2021||Yes|No||||No|No|||Prescription required|No||015|No|.2857|03/29/2022|.27884|03/29/2022|.2807|03/29/2022|||ANTIPARKINSON'S AGENTS|5666|||||No|No||UPSHER SMITH LA|No||||
amantadine HCl|No|No|No|No|75%|00832101550|AMANTADINE 100 MG CAPSULE|500|EA|.34656|01/05/2021||Yes|No||01/05/2021||Yes|No|01/05/2021||Yes|No||||No|No|||Prescription required|No||015|No|.2857|03/29/2022|.27884|03/29/2022|.2807|03/29/2022|||ANTIPARKINSON'S AGENTS|5667|||||No|No||UPSHER SMITH LA|No||||
topiramate|No|No|No|No|75%|00832107130|TOPIRAMATE ER 25 MG CAPSULE|30|EA|3.1433|11/13/2014||Yes|No||11/13/2014||Yes|No|11/13/2014||Yes|No||||No|No|||Prescription required|No||056|No|7.1638|05/25/2021|7.06146|05/25/2021|6.7252|05/25/2021|||ANTICONVULSANTS|5668|||||No|No||UPSHER SMITH LA|No||||
topiramate|No|No|No|No|75%|00832107230|TOPIRAMATE ER 50 MG CAPSULE|30|EA|4.09431|11/13/2014||Yes|No||11/13/2014||Yes|No|11/13/2014||Yes|No||||No|No|||Prescription required|No||056|No|8.67793|01/25/2022|8.46965|01/25/2022|8.52606|01/25/2022|||ANTICONVULSANTS|5669|||||No|No||UPSHER SMITH LA|No||||
topiramate|No|No|No|No|75%|00832107330|TOPIRAMATE ER 200 MG CAPSULE|30|EA|11.09686|11/13/2014||Yes|No||11/13/2014||Yes|No|11/13/2014||Yes|No||||No|No|||Prescription required|No||056|No|24.30273|10/26/2021|23.71946|10/26/2021|23.87743|10/26/2021|||ANTICONVULSANTS|5670|||||No|No||UPSHER SMITH LA|No||||
topiramate|No|No|No|No|75%|00832107430|TOPIRAMATE ER 100 MG CAPSULE|30|EA|8.1118|11/13/2014||Yes|No||11/13/2014||Yes|No|11/13/2014||Yes|No||||No|No|||Prescription required|No||056|No|17.264|03/29/2022|16.84966|03/29/2022|16.96188|03/29/2022|||ANTICONVULSANTS|5671|||||No|No||UPSHER SMITH LA|No||||
topiramate|No|No|No|No|75%|00832107530|TOPIRAMATE ER 150 MG CAPSULE|30|EA|9.97772|11/13/2014||Yes|No||11/13/2014||Yes|No|11/13/2014||Yes|No||||No|No|||Prescription required|No||056|No|22.73992|05/25/2021|22.41506|05/25/2021|21.34768|05/25/2021|||ANTICONVULSANTS|5672|||||No|No||UPSHER SMITH LA|No||||
memantine HCl|No|No|No|No|75%|00832111260|MEMANTINE HCL 5 MG TABLET|60|EA|.07869|12/06/2016||Yes|No||12/06/2016||Yes|No|12/06/2016||Yes|No||||No|No|||Prescription required|No||011|No|.08825|03/29/2022|.08613|03/29/2022|.0867|03/29/2022|||ALZHEIMER'S AGENTS|5673|||||No|No||UPSHER SMITH LA|No||||
memantine HCl|No|No|No|No|75%|00832111360|MEMANTINE HCL 10 MG TABLET|60|EA|.07869|12/06/2016||Yes|No||12/06/2016||Yes|No|12/06/2016||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|5674|||||No|No||UPSHER SMITH LA|No||||
testosterone|No|No|No|No|90%|00832112005|TESTOSTERONE 50 MG/5 GRAM GEL|5|GM|.88783|06/18/2015||Yes|No||06/18/2015||Yes|No|06/18/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|084|No|1.04613|03/29/2022|1.02102|03/29/2022|1.02782|03/29/2022|||ANDROGENIC AGENTS|5675|||||No|No||UPSHER SMITH LA|No||||
testosterone|No|No|No|No|90%|00832112035|TESTOSTERONE 50 MG/5 GRAM PKT|5|GM|.88783|06/18/2015||Yes|No||06/18/2015||Yes|No|06/18/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|084|No|1.10779|03/29/2022|1.0812|03/29/2022|1.0884|03/29/2022|||ANDROGENIC AGENTS|5676|||||No|No||UPSHER SMITH LA|No||||
testosterone|No|No|No|No|90%|00832112142|TESTOSTERONE 12.5 MG/1.25 GRAM|75|GM|.88783|06/18/2015||Yes|No||06/18/2015||Yes|No|06/18/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|084|No|1.27336|03/29/2022|1.24279|03/29/2022|1.25107|03/29/2022|||ANDROGENIC AGENTS|5677|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121100|JANTOVEN 1 MG TABLET|100|EA|.15944|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|No||068|Yes|.08991|03/29/2022|.08775|03/29/2022|.08833|03/29/2022|||ANTICOAGULANTS|5678|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121101|JANTOVEN 1 MG TABLET|100|EA|.15944|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||09/06/2016||Yes|No|||Prescription required|No||068|Yes|.08991|03/29/2022|.08775|03/29/2022|.08833|03/29/2022|||ANTICOAGULANTS|5679|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121110|JANTOVEN 1 MG TABLET|1000|EA|.15144|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|No||068|Yes|.08991|03/29/2022|.08775|03/29/2022|.08833|03/29/2022|||ANTICOAGULANTS|5680|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121200|JANTOVEN 2 MG TABLET|100|EA|.16331|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|No||068|Yes|.09104|03/29/2022|.08885|03/29/2022|.08944|03/29/2022|||ANTICOAGULANTS|5681|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121201|JANTOVEN 2 MG TABLET|100|EA|.16331|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||09/06/2016||Yes|No|||Prescription required|No||068|Yes|.09104|03/29/2022|.08885|03/29/2022|.08944|03/29/2022|||ANTICOAGULANTS|5682|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121210|JANTOVEN 2 MG TABLET|1000|EA|.15514|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|No||068|Yes|.09104|03/29/2022|.08885|03/29/2022|.08944|03/29/2022|||ANTICOAGULANTS|5683|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121300|JANTOVEN 2.5 MG TABLET|100|EA|.16722|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|No||068|Yes|.09348|03/29/2022|.09123|03/29/2022|.09184|03/29/2022|||ANTICOAGULANTS|5684|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121301|JANTOVEN 2.5 MG TABLET|100|EA|.16722|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||09/06/2016||Yes|No|||Prescription required|No||068|Yes|.09348|03/29/2022|.09123|03/29/2022|.09184|03/29/2022|||ANTICOAGULANTS|5685|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121310|JANTOVEN 2.5 MG TABLET|1000|EA|.15883|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|No||068|Yes|.09348|03/29/2022|.09123|03/29/2022|.09184|03/29/2022|||ANTICOAGULANTS|5686|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121400|JANTOVEN 3 MG TABLET|100|EA|.17109|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|No||068|Yes|.09211|03/29/2022|.08989|03/29/2022|.09049|03/29/2022|||ANTICOAGULANTS|5687|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121401|JANTOVEN 3 MG TABLET|100|EA|.17109|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||09/06/2016||Yes|No|||Prescription required|No||068|Yes|.09211|03/29/2022|.08989|03/29/2022|.09049|03/29/2022|||ANTICOAGULANTS|5688|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121410|JANTOVEN 3 MG TABLET|1000|EA|.16253|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|No||068|Yes|.09211|03/29/2022|.08989|03/29/2022|.09049|03/29/2022|||ANTICOAGULANTS|5689|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121500|JANTOVEN 4 MG TABLET|100|EA|.17109|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|No||068|Yes|.09432|03/29/2022|.09205|03/29/2022|.09266|03/29/2022|||ANTICOAGULANTS|5690|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121501|JANTOVEN 4 MG TABLET|100|EA|.17109|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||09/06/2016||Yes|No|||Prescription required|No||068|Yes|.09432|03/29/2022|.09205|03/29/2022|.09266|03/29/2022|||ANTICOAGULANTS|5691|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121510|JANTOVEN 4 MG TABLET|1000|EA|.16253|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|No||068|Yes|.09432|03/29/2022|.09205|03/29/2022|.09266|03/29/2022|||ANTICOAGULANTS|5692|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121600|JANTOVEN 5 MG TABLET|100|EA|.17496|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|No||068|Yes|.10902|03/29/2022|.1064|03/29/2022|.10711|03/29/2022|||ANTICOAGULANTS|5693|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121601|JANTOVEN 5 MG TABLET|100|EA|.17496|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||09/06/2016||Yes|No|||Prescription required|No||068|Yes|.10902|03/29/2022|.1064|03/29/2022|.10711|03/29/2022|||ANTICOAGULANTS|5694|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121610|JANTOVEN 5 MG TABLET|1000|EA|.16622|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|No||068|Yes|.10902|03/29/2022|.1064|03/29/2022|.10711|03/29/2022|||ANTICOAGULANTS|5695|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121700|JANTOVEN 6 MG TABLET|100|EA|.24105|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|No||068|Yes|.13556|03/29/2022|.1323|03/29/2022|.13318|03/29/2022|||ANTICOAGULANTS|5696|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121701|JANTOVEN 6 MG TABLET|100|EA|.24105|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||09/06/2016||Yes|No|||Prescription required|No||068|Yes|.13556|03/29/2022|.1323|03/29/2022|.13318|03/29/2022|||ANTICOAGULANTS|5697|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121710|JANTOVEN 6 MG TABLET|1000|EA|.22901|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|No||068|Yes|.13556|03/29/2022|.1323|03/29/2022|.13318|03/29/2022|||ANTICOAGULANTS|5698|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121800|JANTOVEN 7.5 MG TABLET|100|EA|.24888|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|No||068|Yes|.11896|03/29/2022|.1161|03/29/2022|.11687|03/29/2022|||ANTICOAGULANTS|5699|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121801|JANTOVEN 7.5 MG TABLET|100|EA|.24888|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||09/06/2016||Yes|No|||Prescription required|No||068|Yes|.11896|03/29/2022|.1161|03/29/2022|.11687|03/29/2022|||ANTICOAGULANTS|5700|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121850|JANTOVEN 7.5 MG TABLET|500|EA|.24138|02/01/2005|08/02/2022|Yes|No||02/01/2005|08/02/2022|Yes|No|02/01/2005|08/02/2022|Yes|No||02/01/2005|08/02/2022|Yes|No|||Prescription required|No||068|Yes|.11896|03/29/2022|.1161|03/29/2022|.11687|03/29/2022|||ANTICOAGULANTS|5701|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121900|JANTOVEN 10 MG TABLET|100|EA|.26053|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|No||068|Yes|.12691|03/29/2022|.12386|03/29/2022|.12468|03/29/2022|||ANTICOAGULANTS|5702|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121901|JANTOVEN 10 MG TABLET|100|EA|.26053|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||09/06/2016||Yes|No|||Prescription required|No||068|Yes|.12691|03/29/2022|.12386|03/29/2022|.12468|03/29/2022|||ANTICOAGULANTS|5703|||||No|No||UPSHER SMITH LA|No||||
warfarin sodium|No|No|No|No|75%|00832121950|JANTOVEN 10 MG TABLET|500|EA|.2527|02/01/2005|08/02/2022|Yes|No||02/01/2005|08/02/2022|Yes|No|02/01/2005|08/02/2022|Yes|No||02/01/2005|08/02/2022|Yes|No|||Prescription required|No||068|Yes|.12691|03/29/2022|.12386|03/29/2022|.12468|03/29/2022|||ANTICOAGULANTS|5704|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||UPSHER SMITH LA|No||||
doxazosin mesylate|No|No|No|No|75%|00832135811|DOXAZOSIN MESYLATE 4 MG TAB|100|EA|.20609|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No||003|Yes|.10379|03/29/2022|.10129|03/29/2022|.10197|03/29/2022|||BPH TREATMENTS|5705|||||No|No||UPSHER-SMITH LA|No||||
doxazosin mesylate|No|No|No|No|75%|00832135911|DOXAZOSIN MESYLATE 8 MG TAB|100|EA|.20644|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|No||003|No|.12737|03/29/2022|.12431|03/29/2022|.12514|03/29/2022|||BPH TREATMENTS|5706|||||No|No||UPSHER-SMITH LA|No||||
moxifloxacin HCl|No|No|No|No|75%|00832141003|MOXIFLOXACIN 0.5% EYE DROPS|3|ML|3.6679|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|058|No|3.97371|03/29/2022|3.87834|03/29/2022|3.90417|03/29/2022|||OPHTHALMIC ANTIBIOTICS|5707|||||No|No||UPSHER-SMITH LA|No||||
haloperidol|No|No|No|No|75%|00832151011|HALOPERIDOL 0.5 MG TABLET|100|EA|.11197|06/26/2020||Yes|No||06/26/2020||Yes|No|06/26/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.24816|03/29/2022|.2422|03/29/2022|.24381|03/29/2022|||ANTIPSYCHOTICS|5708|||||No|No||UPSHER-SMITH LA|No||||
haloperidol|No|No|No|No|75%|00832152011|HALOPERIDOL 1 MG TABLET|100|EA|.15871|06/26/2020||Yes|No||06/26/2020||Yes|No|06/26/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.34011|03/29/2022|.33194|03/29/2022|.33415|03/29/2022|||ANTIPSYCHOTICS|5709|||||No|No||UPSHER-SMITH LA|No||||
haloperidol|No|No|No|No|75%|00832153011|HALOPERIDOL 2 MG TABLET|100|EA|.2174|02/11/2021||Yes|No||02/11/2021||Yes|No|02/11/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.43109|03/29/2022|.42074|03/29/2022|.42354|03/29/2022|||ANTIPSYCHOTICS|5710|||||No|No||UPSHER-SMITH LA|No||||
haloperidol|No|No|No|No|75%|00832154011|HALOPERIDOL 5 MG TABLET|100|EA|.24763|06/26/2020||Yes|No||06/26/2020||Yes|No|06/26/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.44921|03/29/2022|.43842|03/29/2022|.44134|03/29/2022|||ANTIPSYCHOTICS|5711|||||No|No||UPSHER-SMITH LA|No||||
haloperidol|No|No|No|No|75%|00832155011|HALOPERIDOL 10 MG TABLET|100|EA|.27945|06/26/2020||Yes|No||06/26/2020||Yes|No|06/26/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.48134|03/29/2022|.46978|03/29/2022|.47291|03/29/2022|||ANTIPSYCHOTICS|5712|||||No|No||UPSHER-SMITH LA|No||||
haloperidol|No|No|No|No|75%|00832156011|HALOPERIDOL 20 MG TABLET|100|EA|.55895|06/30/2020||Yes|No||06/30/2020||Yes|No|06/30/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.97837|03/29/2022|.95488|03/29/2022|.96124|03/29/2022|||ANTIPSYCHOTICS|5713|||||No|No||UPSHER-SMITH LA|No||||
fluvoxamine maleate|No|No|No|No|75%|00832167011|FLUVOXAMINE MALEATE 25 MG TAB|100|EA|.215|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No||008|No|.2817|03/29/2022|.27493|03/29/2022|.27677|03/29/2022|||ANTIDEPRESSANTS: SSRIs|5714|||||No|No||UPSHER-SMITH LA|No||||
fluvoxamine maleate|No|No|No|No|75%|00832167111|FLUVOXAMINE MALEATE 50 MG TAB|100|EA|.2365|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No||008|No|.34583|03/29/2022|.33753|03/29/2022|.33977|03/29/2022|||ANTIDEPRESSANTS: SSRIs|5715|||||No|No||UPSHER-SMITH LA|No||||
fluvoxamine maleate|No|No|No|No|75%|00832167211|FLUVOXAMINE MALEATE 100 MG TAB|100|EA|.258|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No||008|No|.33359|03/29/2022|.32558|03/29/2022|.32775|03/29/2022|||ANTIDEPRESSANTS: SSRIs|5716|||||No|No||UPSHER-SMITH LA|No||||
ethacrynic acid|No|No|No|No|75%|00832169011|ETHACRYNIC ACID 25 MG TABLET|100|EA|1.075|02/11/2021||Yes|No||02/11/2021||Yes|No|02/11/2021||Yes|No||||No|No|||Prescription required|No|||No|2.34378|03/01/2022|2.28752|03/01/2022|2.30276|03/01/2022||||5717|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00832532210|POTASSIUM CL ER 8 MEQ TABLET|1000|EA|.1845|12/06/2019||Yes|No||12/06/2019||Yes|No|12/06/2019||Yes|No||12/06/2019||Yes|No|||Prescription required|No|||No|.17696|03/29/2022|.17271|03/29/2022|.17386|03/29/2022||||5718|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00832532211|POTASSIUM CL ER 8 MEQ TABLET|100|EA|.18451|12/06/2019||Yes|No||12/06/2019||Yes|No|12/06/2019||Yes|No||12/06/2019||Yes|No|||Prescription required|No|||No|.17696|03/29/2022|.17271|03/29/2022|.17386|03/29/2022||||5719|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00832532310|POTASSIUM CL ER 10 MEQ TABLET|1000|EA|.19421|12/09/2020||Yes|No||12/09/2020||Yes|No|12/09/2020||Yes|No||12/09/2020||Yes|No|||Prescription required|No|||No|.13824|03/29/2022|.13492|03/29/2022|.13582|03/29/2022||||5720|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00832532311|POTASSIUM CL ER 10 MEQ TABLET|100|EA|.19423|12/09/2020||Yes|No||12/09/2020||Yes|No|12/09/2020||Yes|No||12/09/2020||Yes|No|||Prescription required|No|||No|.13824|03/29/2022|.13492|03/29/2022|.13582|03/29/2022||||5721|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00832532410|POTASSIUM CL ER 10 MEQ TABLET|1000|EA|.205|10/25/2019||Yes|No||10/25/2019||Yes|No|10/25/2019||Yes|No||10/25/2019||Yes|No|||Prescription required|No|||No|.18432|03/29/2022|.17989|03/29/2022|.18109|03/29/2022||||5722|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00832532411|POTASSIUM CL ER 10 MEQ TABLET|100|EA|.20502|10/25/2019||Yes|No||10/25/2019||Yes|No|10/25/2019||Yes|No||10/25/2019||Yes|No|||Prescription required|No|||No|.18432|03/29/2022|.17989|03/29/2022|.18109|03/29/2022||||5723|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00832532510|POTASSIUM CL ER 20 MEQ TABLET|1000|EA|.21579|12/06/2019||Yes|No||12/06/2019||Yes|No|12/06/2019||Yes|No||12/06/2019||Yes|No|||Prescription required|No|||No|.19104|03/29/2022|.18645|03/29/2022|.18769|03/29/2022||||5724|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00832532511|POTASSIUM CL ER 20 MEQ TABLET|100|EA|.21581|12/06/2019||Yes|No||12/06/2019||Yes|No|12/06/2019||Yes|No||12/06/2019||Yes|No|||Prescription required|No|||No|.19104|03/29/2022|.18645|03/29/2022|.18769|03/29/2022||||5725|||||No|No||UPSHER-SMITH LA|No||||
potassium chloride|No|No|No|No|75%|00832532515|POTASSIUM CL ER 20 MEQ TABLET|500|EA|.21579|12/06/2019||Yes|No||12/06/2019||Yes|No|12/06/2019||Yes|No||12/06/2019||Yes|No|||Prescription required|No|||No|.19104|03/29/2022|.18645|03/29/2022|.18769|03/29/2022||||5726|||||No|No||UPSHER-SMITH LA|No||||
divalproex sodium|No|No|No|No|75%|00832712211|DIVALPROEX SOD DR 125 MG TAB|100|EA|.03857|02/18/2015||Yes|No||02/18/2015||Yes|No|02/18/2015||Yes|No||02/18/2015||Yes|No|||Prescription required|No||056|No|.06035|03/29/2022|.0589|03/29/2022|.05929|03/29/2022|||ANTICONVULSANTS|5727|||||No|No||UPSHER SMITH LA|No||||
divalproex sodium|No|No|No|No|75%|00832712215|DIVALPROEX SOD DR 125 MG TAB|500|EA|.03857|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||09/06/2016||Yes|No|||Prescription required|No||056|No|.06035|03/29/2022|.0589|03/29/2022|.05929|03/29/2022|||ANTICONVULSANTS|5728|||||No|No||UPSHER SMITH LA|No||||
divalproex sodium|No|No|No|No|75%|00832712301|DIVALPROEX SOD DR 250 MG TAB|100|EA|.09399|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||09/06/2016||Yes|No|||Prescription required|No||056|No|.07754|03/29/2022|.07567|03/29/2022|.07618|03/29/2022|||ANTICONVULSANTS|5729|||||No|No||UPSHER SMITH LA|No||||
divalproex sodium|No|No|No|No|75%|00832712311|DIVALPROEX SOD DR 250 MG TAB|100|EA|.07576|02/18/2015||Yes|No||02/18/2015||Yes|No|02/18/2015||Yes|No||02/18/2015||Yes|No|||Prescription required|No||056|No|.07754|03/29/2022|.07567|03/29/2022|.07618|03/29/2022|||ANTICONVULSANTS|5730|||||No|No||UPSHER SMITH LA|No||||
divalproex sodium|No|No|No|No|75%|00832712315|DIVALPROEX SOD DR 250 MG TAB|500|EA|.07577|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||09/06/2016||Yes|No|||Prescription required|No||056|No|.07754|03/29/2022|.07567|03/29/2022|.07618|03/29/2022|||ANTICONVULSANTS|5731|||||No|No||UPSHER SMITH LA|No||||
divalproex sodium|No|No|No|No|75%|00832712401|DIVALPROEX SOD DR 500 MG TAB|100|EA|.12444|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||09/06/2016||Yes|No|||Prescription required|No||056|No|.13473|03/29/2022|.13149|03/29/2022|.13237|03/29/2022|||ANTICONVULSANTS|5732|||||No|No||UPSHER SMITH LA|No||||
divalproex sodium|No|No|No|No|75%|00832712411|DIVALPROEX SOD DR 500 MG TAB|100|EA|.13975|02/18/2015||Yes|No||02/18/2015||Yes|No|02/18/2015||Yes|No||02/18/2015||Yes|No|||Prescription required|No||056|No|.13473|03/29/2022|.13149|03/29/2022|.13237|03/29/2022|||ANTICONVULSANTS|5733|||||No|No||UPSHER SMITH LA|No||||
divalproex sodium|No|No|No|No|75%|00832712415|DIVALPROEX SOD DR 500 MG TAB|500|EA|.13973|02/18/2015||Yes|No||02/18/2015||Yes|No|02/18/2015||Yes|No||02/18/2015||Yes|No|||Prescription required|No||056|No|.13473|03/29/2022|.13149|03/29/2022|.13237|03/29/2022|||ANTICONVULSANTS|5734|||||No|No||UPSHER SMITH LA|No||||
miconazole nitrate|No|No|No|No|75%|00884029301|FUNGOID 2% TINCTURE|29.57|ML|.25171|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|Yes|01/25/2012|061|No|.57368|05/25/2021|.56548|05/25/2021|.53855|05/25/2021|||ANTIFUNGALS: TOPICAL|5735|||||No|No||BAUSCH HEALTH U|No||||
chlorpheniramine maleate|No|No|No|No|75%|00904001280|ALLERGY 4 MG TABLET|1000|EA|.00198|04/22/2003||Yes|No||||No|No|04/22/2003||Yes|No||||No|No|||Over the counter|No||574|Yes|.01452|03/29/2022|.01417|03/29/2022|.01426|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|5736|||||No|No||MAJOR PHARMACEU|No||||
phosphorated carbo(dext-fruct)|No|No|No|No|75%|00904004920|FORMULA EM SOLUTION|118|ML|.00695|09/01/1999|04/13/2022|Yes|No||||No|No|09/01/1999|04/13/2022|Yes|No||||No|No|||Over the counter|No||085|No|.02106|03/29/2022|.02055|03/29/2022|.02069|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|5737|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||MAJOR PHARMACEU|No||||
triprolidine/pseudoephedrine|No|No|No|No|75%|00904025024|APRODINE TABLET|24|EA|.02311|04/22/2003||Yes|No||||No|No|04/22/2003||Yes|No||||No|No|||Over the counter|No||182|Yes|.04999|01/25/2022|.04879|01/25/2022|.04911|01/25/2022|||COUGH AND COLD: COLD|5738|||||No|No||MAJOR PHARMACEU|No||||
triprolidine/pseudoephedrine|No|No|No|No|75%|00904025059|APRODINE TABLET|100|EA|.01582|04/22/2003||Yes|No||||No|No|04/22/2003||Yes|No||||No|No|||Over the counter|No||182|Yes|.04999|01/25/2022|.04879|01/25/2022|.04911|01/25/2022|||COUGH AND COLD: COLD|5739|||||No|No||MAJOR PHARMACEU|No||||
multivitamin,stress formula|No|No|No|No|75%|00904026252|STRESS FORMULA TABLET|60|EA|.01784|||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|.04067|07/07/2020|.04008|07/07/2020|.03818|07/07/2020||||5740|||||No|No||MAJOR PHARMACEU|No||||
doxycycline hyclate|Yes|No|No|No|75%|00904042804|DOXYCYCLINE HYCLATE 100 MG CAP|30|EA|.91934|12/20/2019||Yes|No||12/20/2019||Yes|No|12/20/2019||Yes|No||12/20/2019||Yes|No|03/20/2020||Prescription required|No||213|No|.14255|03/29/2022|.13912|03/29/2022|.14005|03/29/2022|||TETRACYCLINES|5741|||||No|No||MAJOR PHARMACEU|No||||
doxycycline hyclate|Yes|No|No|No|75%|00904043004|DOXYCYCLINE HYCLATE 100 MG TAB|30|EA|1.55932|11/03/2014||Yes|No||11/03/2014||Yes|No|11/03/2014||Yes|No||11/03/2014||Yes|No|11/03/2014||Prescription required|Yes|01/22/2015|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|5742|||||No|No||MAJOR PHARMACEU|No||||
doxycycline hyclate|Yes|No|No|No|75%|00904043006|DOXYCYCLINE HYCLATE 100 MG TAB|50|EA|.93955|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Prescription required|Yes|11/23/2017|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|5743|||||No|No||MAJOR PHARMACEU|No||||
multivitamin with iron|No|No|No|No|75%|00904053670|CHILD CHEW + IRON TAB CHEW|250|EA|.00775|||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|.01767|07/07/2020|.01742|07/07/2020|.01659|07/07/2020||||5744|||||No|No||MAJOR PHARMACEU|No||||
tolnaftate|No|No|No|No|75%|00904072236|ANTIFUNGAL 1% CREAM|14.18|GM|.04184|09/01/1999|10/31/2023|Yes|No||||No|No|09/01/1999|10/31/2023|Yes|No||09/01/1999|10/31/2023|Yes|No|||Over the counter|No||061|No|.09688|01/25/2022|.09455|01/25/2022|.09518|01/25/2022|||ANTIFUNGALS: TOPICAL|5745|No Longer Rebatable||No Longer Rebatable|No Longer Rebatable|No|No||MAJOR PHARMACEU|No||||
tolnaftate|No|No|No|No|75%|00904072645|TOLNAFTATE 1% POWDER|45|GM|.02522|04/22/2003||Yes|No||||No|No|04/22/2003||Yes|No||||No|No|||Over the counter|No||061|No|.04329|09/28/2021|.04225|09/28/2021|.04253|09/28/2021|||ANTIFUNGALS: TOPICAL|5746|||||No|No||MAJOR PHARMACEU|No||||
neomycin/bacitracin/polymyxinB|No|No|No|No|75%|00904073431|TRIPLE ANTIBIOTIC OINTMENT|28|GM|.0324|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||09/01/1999||Yes|No|||Over the counter|No||114|No|.09281|03/29/2022|.09058|03/29/2022|.09118|03/29/2022|||ANTIBIOTICS: TOPICAL|5747|||||No|No||MAJOR PHARMACEU|No||||
magnesium hydroxide|No|No|No|No|75%|00904078816|MILK OF MAGNESIA SUSPENSION|473|ML||03/31/2022||Yes|No||||No|No|03/31/2022||Yes|No||||No|No|||Over the counter|No|||No|.00547|03/29/2022|.00533|03/29/2022|.00537|03/29/2022||||5748|||||No|No||MAJOR PHARMACEU|No||||
povidone-iodine|No|No|No|No|75%|00904110231|POVIDONE-IODINE 10% OINTMENT|28.35|GM|.02275|09/01/1999|05/12/2022|Yes|No||||No|No|09/01/1999|05/12/2022|Yes|No||||No|No|||Over the counter|No|||No|.05185|05/25/2021|.05111|05/25/2021|.04867|05/25/2021||||5749|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||MAJOR PHARMACEU|No||||
povidone-iodine|No|No|No|No|75%|00904110309|POVIDONE-IODINE 10% SOLUTION|236|ML|.004|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No|||No|.01357|03/29/2022|.01324|03/29/2022|.01333|03/29/2022||||5750|||||No|No||MAJOR PHARMACEU|No||||
bismuth subsalicylate|No|No|No|No|75%|00904131309|BISMATROL 525 MG/30 ML SUSP|236|ML|.00475|08/26/2008|03/10/2022|Yes|No||||No|No|08/26/2008|03/10/2022|Yes|No||||No|No|||Over the counter|No|||No|.01082|11/23/2021|.01067|11/23/2021|.01016|11/23/2021||||5751|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||MAJOR PHARMACEU|No||||
bismuth subsalicylate|No|No|No|No|75%|00904131409|BISMATROL 525 MG/15 ML SUSP|236|ML|.00391|09/01/1999|03/31/2022|Yes|No||||No|No|09/01/1999|03/31/2022|Yes|No||||No|No|||Over the counter|No|||No|.00892|11/23/2021|.0088|11/23/2021|.00838|11/23/2021||||5752|No Longer Rebatable||No Longer Rebatable||No|No||MAJOR PHARMACEU|No||||
bismuth subsalicylate|No|No|No|No|75%|00904131546|BISMATROL TABLET CHEW|30|EA|.02465|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No|||No|.08173|03/29/2022|.07976|03/29/2022|.08029|03/29/2022||||5753|||||No|No||MAJOR PHARMACEU|No||||
metronidazole|Yes|No|No|No|75%|00904145361|METRONIDAZOLE 250 MG TABLET|100|EA|.17324|05/01/2012|05/31/2023|Yes|No||05/01/2012|05/31/2023|Yes|No|05/01/2012|05/31/2023|Yes|No||05/01/2012|05/31/2023|Yes|No|11/01/2012|05/31/2023|Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|5754|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||MAJOR PHARMACEU|No||||
calcium carbonate/vitamin D3|No|No|No|No|75%|00904188260|CALCIUM 250-VIT D3 125 TABLET|100|EA|.00546|||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|.01244|07/07/2020|.01226|07/07/2020|.01168|07/07/2020||||5755|||||No|No||MAJOR PHARMACEU|No||||
calcium carbonate|No|No|No|No|75%|00904188361|OYSTER SHELL CALCIUM 500 MG TB|100|EA|.01414|||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|.03224|07/07/2020|.03178|07/07/2020|.03026|07/07/2020||||5756|||||No|No||MAJOR PHARMACEU|No||||
calcium carbonate|No|No|No|No|75%|00904188372|OYSTER SHELL CALCIUM 500 MG TB|300|EA|.00573|||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|.01306|07/07/2020|.01287|07/07/2020|.01226|07/07/2020||||5757|||||No|No||MAJOR PHARMACEU|No||||
acetaminophen|No|No|No|No|75%|00904198760|MAPAP 500 MG CAPSULE|100|EA|.01586|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No|||No|.03586|03/29/2022|.03499|03/29/2022|.03523|03/29/2022||||5758|||||No|No||MAJOR PHARMACEU|No||||
ferrous gluconate|No|No|No|No|75%|00904213761|FERROUS GLUCONATE 324 MG TAB|100|EA|.01371|||No|No||||No|No|||No|No||08/19/2013|02/16/2022|Yes|No|||Over the counter|No|||No|.03126|07/07/2020|.03081|07/07/2020|.02934|07/07/2020||||5759||||Discontinued by Manufacturer|No|No||MAJOR PHARMACEU|No||||
calcium polycarbophil|No|No|No|No|75%|00904250091|FIBER TABLET|90|EA|.02264|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No|||No|.06299|03/29/2022|.06147|03/29/2022|.06188|03/29/2022||||5760|||||No|No||MAJOR PHARMACEU|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|00904272561|SULFAMETHOXAZOLE-TMP DS TABLET|100|EA|.08023|09/19/2017||Yes|No||09/19/2017||Yes|No|09/19/2017||Yes|No||||No|No|||Prescription required|No|||No|.06566|03/29/2022|.06408|03/29/2022|.06451|03/29/2022||||5761|||||No|No||MAJOR PHARMACEU|No||||
calcium carbonate/vitamin D3|No|No|No|No|75%|00904323393|CALCIUM 600-VIT D3 400 TABLET|180|EA|.00659|||No|No||||No|No|||No|No||08/19/2013|01/15/2022|Yes|No|||Over the counter|No|||No|.01502|07/07/2020|.0148|07/07/2020|.0141|07/07/2020||||5762||||Discontinued by Manufacturer|No|No||MAJOR PHARMACEU|No||||
carbamazepine|No|No|No|No|75%|00904385461|CARBAMAZEPINE 100 MG TAB CHEW|100|EA|.21994|09/19/2006||Yes|No||09/19/2006||Yes|No|09/19/2006||Yes|No||09/19/2006||Yes|No|||Prescription required|No||056|No|.29391|03/29/2022|.28685|03/29/2022|.28876|03/29/2022|||ANTICONVULSANTS|5763|||||No|No||MAJOR PHARMACEU|No||||
aspirin|No|No|No|No|75%|00904404073|ASPIRIN 81 MG CHEWABLE TABLET|36|EA|.00835|04/22/2003||Yes|No||||No|No|||No|No||||No|No|||Over the counter|No|||No|.02682|03/29/2022|.02617|03/29/2022|.02635|03/29/2022||||5764|||||No|No||MAJOR PHARMACEU|No||||
cyanocobalamin (vitamin B-12)|No|No|No|No|75%|00904421813|VITAMIN B-12 250 MCG TABLET|130|EA|.00585|||No|No||||No|No|||No|No||08/19/2013|01/22/2022|Yes|No|||Over the counter|No|||No|.01333|07/07/2020|.01314|07/07/2020|.01252|07/07/2020||||5765||||Discontinued by Manufacturer|No|No||MAJOR PHARMACEU|No||||
magnesium oxide|No|No|No|No|75%|00904423960|MAGNESIUM OXIDE 500 MG TABLET|100|EA|.00825|||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|.01881|07/07/2020|.01854|07/07/2020|.01766|07/07/2020||||5766|||||No|No||MAJOR PHARMACEU|No||||
multivitamin,ther and minerals|No|No|No|No|75%|00904504260|VITAMIN AND MINERALS TABLET|100|EA|.01238|||No|No||||No|No|||No|No||08/19/2013|03/31/2022|Yes|No|||Over the counter|No|||No|.02822|07/07/2020|.02782|07/07/2020|.02649|07/07/2020||||5767||||Discontinued by Manufacturer|No|No||MAJOR PHARMACEU|No||||
captopril|No|No|No|No|75%|00904504561|CAPTOPRIL 12.5 MG TABLET|100|EA|.60737|09/07/2015|06/23/2022|Yes|No||09/07/2015|06/23/2022|Yes|No|09/07/2015|06/23/2022|Yes|No||09/07/2015|06/23/2022|Yes|No|||Prescription required|Yes|07/26/2018|113|No|.58889|03/29/2022|.57475|03/29/2022|.57858|03/29/2022|||ANGIOTENSIN MODULATORS|5768|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||MAJOR PHARMACEU|No||||
captopril|No|No|No|No|75%|00904504661|CAPTOPRIL 25 MG TABLET|100|EA|.64392|11/25/2003|04/21/2022|Yes|No||11/25/2003|04/21/2022|Yes|No|11/25/2003|04/21/2022|Yes|No||11/25/2003|04/21/2022|Yes|No|||Prescription required|Yes|07/26/2018|113|No|.40459|03/29/2022|.39487|03/29/2022|.3975|03/29/2022|||ANGIOTENSIN MODULATORS|5769|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||MAJOR PHARMACEU|No||||
pseudoephedrine HCl|No|No|No|No|75%|00904505359|SUDOGEST 30 MG TABLET|100|EA|.00907|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No|||No|.05204|03/29/2022|.05079|03/29/2022|.05112|03/29/2022||||5770|||||No|No||MAJOR PHARMACEU|No||||
simethicone|No|No|No|No|75%|00904506860|MI-ACID GAS 80 MG TAB CHEW|100|EA|.00817|09/01/1999|02/28/2024|Yes|No||||No|No|09/01/1999|02/28/2024|Yes|No||||No|No|||Over the counter|No|||No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022||||5771|No Longer Rebatable||No Longer Rebatable||No|No||MAJOR PHARMACEU|No||||
rifampin|No|No|No|No|75%|00904528261|RIFAMPIN 300 MG CAPSULE|100|EA|.47536|09/14/2017||Yes|No||09/14/2017||Yes|No|09/14/2017||Yes|No||||No|No|||Prescription required|No|||No|.95898|03/29/2022|.93596|03/29/2022|.94219|03/29/2022||||5772|||||No|No||MAJOR PHARMACEU|No||||
diphenhydramine HCl|No|No|No|No|75%|00904530624|BANOPHEN 25 MG CAPSULE|24|EA|.01522|09/09/2019||Yes|No||||No|No|09/09/2019||Yes|No||09/09/2019||Yes|No|||Over the counter|No||574|Yes|.03464|03/29/2022|.0338|03/29/2022|.03403|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|5773|||||No|No||MAJOR PHARMACEU|No||||
diphenhydramine HCl|No|No|No|No|75%|00904530660|BANOPHEN 25 MG CAPSULE|100|EA|.00881|01/15/2019||Yes|No||||No|No|01/15/2019||Yes|No||01/15/2019||Yes|No|||Over the counter|No||574|Yes|.03464|03/29/2022|.0338|03/29/2022|.03403|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|5774|||||No|No||MAJOR PHARMACEU|No||||
diphenhydramine HCl|No|No|No|No|75%|00904530680|BANOPHEN 25 MG CAPSULE|1000|EA|.00534|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||09/01/1999||Yes|No|||Over the counter|No||574|Yes|.03464|03/29/2022|.0338|03/29/2022|.03403|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|5775|||||No|No||MAJOR PHARMACEU|No||||
diphenhydramine HCl|No|No|No|No|75%|00904530780|BANOPHEN 50 MG CAPSULE|1000|EA|.00577|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||09/01/1999||Yes|No|||Over the counter|No||574|Yes|.02024|03/29/2022|.01975|03/29/2022|.01988|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|5776|||||No|No||MAJOR PHARMACEU|No||||
ibuprofen|No|No|No|No|75%|00904530909|CHILDREN IBUPROFEN 100 MG/5 ML|240|ML|.01049|03/28/2013||Yes|No||||No|No|03/28/2013||Yes|No||||No|No|||Over the counter|No||059|Yes|.02479|03/29/2022|.02419|03/29/2022|.02435|03/29/2022|||NSAIDS|5777|||||No|No||MAJOR PHARMACEU|No||||
ibuprofen|No|No|No|No|75%|00904530920|CHILDREN IBUPROFEN 100 MG/5 ML|120|ML|.01451|03/14/2003||Yes|No||||No|No|03/14/2003||Yes|No||||No|No|||Over the counter|No||059|Yes|.03078|03/29/2022|.03004|03/29/2022|.03024|03/29/2022|||NSAIDS|5778|||||No|No||MAJOR PHARMACEU|No||||
chlorpheniramine/pseudoephed|No|No|No|No|75%|00904535196|SUDOGEST SINUS AND ALLERGY TAB|48|EA|.01836|08/16/2010||Yes|No||||No|No|08/16/2010||Yes|No||||No|No|||Over the counter|No||182|Yes|.05341|10/26/2021|.05212|10/26/2021|.05247|10/26/2021|||COUGH AND COLD: COLD|5779|||||No|No||MAJOR PHARMACEU|No||||
pentoxifylline|No|No|No|No|75%|00904544861|PENTOXIFYLLINE ER 400 MG TAB|100|EA|.10827|05/01/2012||Yes|No||05/01/2012||Yes|No|05/01/2012||Yes|No||||No|No|||Prescription required|No|||No|.26964|03/29/2022|.26316|03/29/2022|.26492|03/29/2022||||5780|||||No|No||MAJOR PHARMACEU|No||||
multivit,calc,mins/iron/folic|No|No|No|No|75%|00904549213|THERA-M TABLET|130|EA|.01197|||No|No||||No|No|||No|No||08/04/2015|01/04/2022|Yes|No|||Over the counter|No|||No|.02728|07/07/2020|.02689|07/07/2020|.02561|07/07/2020||||5781||||Discontinued by Manufacturer|No|No||MAJOR PHARMACEU|No||||
multivit,calc,mins/iron/folic|No|No|No|No|75%|00904549261|THERA M PLUS TABLET|100|EA|.01917|||No|No||||No|No|||No|No||08/04/2015||Yes|No|||Over the counter|No|||No|.0437|07/07/2020|.04308|07/07/2020|.04103|07/07/2020||||5782|||||No|No||MAJOR PHARMACEU|No||||
multivit,calc,mins/iron/folic|No|No|No|No|75%|00904549280|THERA-M TABLET|1000|EA|.01058|||No|No||||No|No|||No|No||08/04/2015||Yes|No|||Over the counter|No|||No|.02411|07/07/2020|.02377|07/07/2020|.02264|07/07/2020||||5783|||||No|No||MAJOR PHARMACEU|No||||
enalapril maleate|Yes|No|No|No|75%|00904550261|ENALAPRIL MALEATE 5 MG TABLET|100|EA|.20528|03/22/2004||Yes|No||03/22/2004||Yes|No|03/22/2004||Yes|No||03/22/2004||Yes|No|07/01/2016||Prescription required|No||113|No|.15947|03/29/2022|.15564|03/29/2022|.15667|03/29/2022|||ANGIOTENSIN MODULATORS|5784|||||No|No||MAJOR PHARMACEU|No||||
doxazosin mesylate|No|No|No|No|75%|00904552261|DOXAZOSIN MESYLATE 1 MG TAB|100|EA|.36442|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||02/21/2017||Yes|No|||Prescription required|No||003|Yes|.09392|03/29/2022|.09166|03/29/2022|.09227|03/29/2022|||BPH TREATMENTS|5785|||||No|No||MAJOR PHARMACEU|No||||
doxazosin mesylate|No|No|No|No|75%|00904552361|DOXAZOSIN MESYLATE 2 MG TAB|100|EA|.34756|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||02/21/2017||Yes|No|||Prescription required|No||003|Yes|.085|03/29/2022|.08296|03/29/2022|.08351|03/29/2022|||BPH TREATMENTS|5786|||||No|No||MAJOR PHARMACEU|No||||
doxazosin mesylate|No|No|No|No|75%|00904552461|DOXAZOSIN MESYLATE 4 MG TAB|100|EA|.36765|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||02/21/2017||Yes|No|||Prescription required|No||003|Yes|.10379|03/29/2022|.10129|03/29/2022|.10197|03/29/2022|||BPH TREATMENTS|5787|||||No|No||MAJOR PHARMACEU|No||||
ibuprofen|No|No|No|No|75%|00904557720|CHILDREN IBUPROFEN 100 MG/5 ML|120|ML|.01451|03/14/2003||Yes|No||||No|No|03/14/2003||Yes|No||03/14/2003||Yes|No|||Over the counter|No||059|Yes|.03078|03/29/2022|.03004|03/29/2022|.03024|03/29/2022|||NSAIDS|5788|||||No|No||MAJOR PHARMACEU|No||||
paroxetine HCl|No|No|No|No|75%|00904567661|PAROXETINE HCL 10 MG TABLET|100|EA|.344|05/01/2012||Yes|No||05/01/2012||Yes|No|05/01/2012||Yes|No||||No|No|||Prescription required|No||008|Yes|.075|03/29/2022|.0732|03/29/2022|.07368|03/29/2022|||ANTIDEPRESSANTS: SSRIs|5789|||||No|No||MAJOR PHARMACEU|No||||
paroxetine HCl|No|No|No|No|75%|00904567761|PAROXETINE HCL 20 MG TABLET|100|EA|.1075|02/01/2012||Yes|No||02/01/2012||Yes|No|02/01/2012||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|5790|||||No|No||MAJOR PHARMACEU|No||||
mag hydrox/aluminum hyd/simeth|No|No|No|No|75%|00904572514|MINTOX MAXIMUM STRENGTH SUSP|355|ML|.00282|12/04/2010||Yes|No||||No|No|12/04/2010||Yes|No||||No|No|||Over the counter|No|||No|.00902|03/29/2022|.0088|03/29/2022|.00886|03/29/2022||||5791|||||No|No||MAJOR PHARMACEU|No||||
acetaminophen|No|No|No|No|75%|00904576960|MAPAP ARTHRITIS ER 650 MG CPLT|100|EA|.02683|01/26/2006||Yes|No||||No|No|01/26/2006||Yes|No||||No|No|||Over the counter|No|||No|.06737|03/29/2022|.06575|03/29/2022|.06619|03/29/2022||||5792|||||No|No||MAJOR PHARMACEU|No||||
d-methorphan/PE/acetaminophen|No|No|No|No|75%|00904578624|MAPAP COLD FORMULA CAPLET|24|EA|.03278|01/16/2007||Yes|No||||No|No|01/16/2007||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.07472|02/23/2021|.07365|02/23/2021|.07015|02/23/2021|||COUGH AND COLD: NON-NARCOTIC|5793|||||No|No||MAJOR PHARMACEU|No||||
acyclovir|Yes|No|No|No|75%|00904578961|ACYCLOVIR 200 MG CAPSULE|100|EA|.05787|11/18/2013||Yes|No||11/18/2013||Yes|No|11/18/2013||Yes|No||11/09/2016||Yes|No|11/18/2013||Prescription required|No||025|No|.11267|03/29/2022|.10996|03/29/2022|.11069|03/29/2022|||ANTIVIRALS: ORAL|5794|||||No|No||MAJOR PHARMACEU|No||||
acyclovir|Yes|No|No|No|75%|00904579061|ACYCLOVIR 400 MG TABLET|100|EA|.17419|11/18/2013||Yes|No||11/18/2013||Yes|No|11/18/2013||Yes|No||11/18/2013||Yes|No|11/18/2013||Prescription required|No||025|No|.0985|03/29/2022|.09613|03/29/2022|.09677|03/29/2022|||ANTIVIRALS: ORAL|5795|||||No|No||MAJOR PHARMACEU|No||||
acetaminophen|No|No|No|No|75%|00904579146|CHILDREN'S MAPAP 80 MG TAB CHW|30|EA|.02881|03/20/2007||Yes|No||||No|No|03/20/2007||Yes|No||||No|No|||Over the counter|No|||No|.06314|03/29/2022|.06162|03/29/2022|.06203|03/29/2022||||5796|||||No|No||MAJOR PHARMACEU|No||||
guaifenesin/phenylephrine HCl|No|No|No|No|75%|00904579252|MUCUS RELIEF SINUS TABLET|60|EA|.0283|04/12/2007|04/03/2022|Yes|No||||No|No|04/12/2007|04/03/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|.08704|03/29/2022|.08495|03/29/2022|.08551|03/29/2022|||COUGH AND COLD: COLD|5797|No Longer Rebatable||No Longer Rebatable||No|No||MAJOR PHARMACEU|No||||
loratadine/pseudoephedrine|No|No|No|No|75%|00904583315|LORATADINE-D 24HR TABLET|10|EA|.32336|03/11/2008||Yes|No||||No|No|03/11/2008||Yes|No||||No|No|||Over the counter|Yes|01/31/2019|030|Yes|.51383|03/29/2022|.50149|03/29/2022|.50483|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|5798|||||No|No||MAJOR PHARMACEU|No||||
loratadine/pseudoephedrine|No|No|No|No|75%|00904583348|LORATADINE-D 24HR TABLET|15|EA|.29813|03/11/2008||Yes|No||||No|No|03/11/2008||Yes|No||||No|No|||Over the counter|Yes|01/31/2019|030|Yes|.51383|03/29/2022|.50149|03/29/2022|.50483|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|5799|||||No|No||MAJOR PHARMACEU|No||||
acetaminophen|No|No|No|No|75%|00904584709|MAPAP 500 MG/15 ML LIQUID|237|ML|.0056|04/16/2014||Yes|No||||No|No|04/16/2014||Yes|No||||No|No|||Over the counter|No|||No|.01289|03/29/2022|.01258|03/29/2022|.01266|03/29/2022||||5800|||||No|No||MAJOR PHARMACEU|No||||
ibuprofen|No|No|No|No|75%|00904585340|IBUPROFEN 400 MG TABLET|500|EA|.02412|07/26/2013||Yes|No||07/26/2013||Yes|No|07/26/2013||Yes|No||07/26/2013||Yes|No|||Prescription required|No||059|Yes|.04934|03/29/2022|.04815|03/29/2022|.04847|03/29/2022|||NSAIDS|5801|||||No|No||MAJOR PHARMACEU|No||||
ibuprofen|No|No|No|No|75%|00904585360|IBUPROFEN 400 MG TABLET|100|EA|.0258|01/14/2014||Yes|No||01/14/2014||Yes|No|01/14/2014||Yes|No||01/14/2014||Yes|No|||Prescription required|No||059|Yes|.04934|03/29/2022|.04815|03/29/2022|.04847|03/29/2022|||NSAIDS|5802|||||No|No||MAJOR PHARMACEU|No||||
ibuprofen|No|No|No|No|75%|00904585440|IBUPROFEN 600 MG TABLET|500|EA|.03322|07/26/2013||Yes|No||07/26/2013||Yes|No|07/26/2013||Yes|No||07/26/2013||Yes|No|||Prescription required|No||059|Yes|.06063|03/29/2022|.05917|03/29/2022|.05956|03/29/2022|||NSAIDS|5803|||||No|No||MAJOR PHARMACEU|No||||
ibuprofen|No|No|No|No|75%|00904585461|IBUPROFEN 600 MG TABLET|100|EA|.03672|05/14/2008||Yes|No||05/14/2008||Yes|No|05/14/2008||Yes|No||05/14/2008||Yes|No|||Prescription required|No||059|Yes|.06063|03/29/2022|.05917|03/29/2022|.05956|03/29/2022|||NSAIDS|5804|||||No|No||MAJOR PHARMACEU|No||||
ibuprofen|No|No|No|No|75%|00904585540|IBUPROFEN 800 MG TABLET|500|EA|.03927|07/26/2013||Yes|No||07/26/2013||Yes|No|07/26/2013||Yes|No||07/26/2013||Yes|No|||Prescription required|No||059|Yes|.07481|03/29/2022|.07301|03/29/2022|.0735|03/29/2022|||NSAIDS|5805|||||No|No||MAJOR PHARMACEU|No||||
ibuprofen|No|No|No|No|75%|00904585560|IBUPROFEN 800 MG TABLET|100|EA|.05276|07/26/2013||Yes|No||07/26/2013||Yes|No|07/26/2013||Yes|No||07/26/2013||Yes|No|||Prescription required|No||059|Yes|.07481|03/29/2022|.07301|03/29/2022|.0735|03/29/2022|||NSAIDS|5806|||||No|No||MAJOR PHARMACEU|No||||
ibuprofen|No|No|No|No|75%|00904585561|IBUPROFEN 800 MG TABLET|100|EA|.03212|05/14/2008||Yes|No||05/14/2008||Yes|No|05/14/2008||Yes|No||05/14/2008||Yes|No|||Prescription required|No||059|Yes|.07481|03/29/2022|.07301|03/29/2022|.0735|03/29/2022|||NSAIDS|5807|||||No|No||MAJOR PHARMACEU|No||||
pravastatin sodium|Yes|No|No|No|75%|00904589161|PRAVASTATIN SODIUM 10 MG TAB|100|EA|.16894|09/18/2012||Yes|No||09/18/2012||Yes|No|09/18/2012||Yes|No||09/18/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.07144|03/29/2022|.06972|03/29/2022|.07018|03/29/2022|||LIPOTROPICS: STATINS|5808|||||No|No||MAJOR PHARMACEU|No||||
pravastatin sodium|Yes|No|No|No|75%|00904589261|PRAVASTATIN SODIUM 20 MG TAB|100|EA|.24226|06/05/2012||Yes|No||06/05/2012||Yes|No|06/05/2012||Yes|No||06/05/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.05771|03/29/2022|.05632|03/29/2022|.0567|03/29/2022|||LIPOTROPICS: STATINS|5809|||||No|No||MAJOR PHARMACEU|No||||
pravastatin sodium|Yes|No|No|No|75%|00904589361|PRAVASTATIN SODIUM 40 MG TAB|100|EA|.30517|09/18/2012||Yes|No||09/18/2012||Yes|No|09/18/2012||Yes|No||09/18/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.08966|03/29/2022|.0875|03/29/2022|.08809|03/29/2022|||LIPOTROPICS: STATINS|5810|||||No|No||MAJOR PHARMACEU|No||||
simethicone|No|No|No|No|75%|00904589430|INF GAS REL 20 MG/0.3 ML DROP|30|ML|.02666|12/12/2008|04/06/2022|Yes|No||||No|No|12/12/2008|04/06/2022|Yes|No||||No|No|||Over the counter|No|||No|.0916|03/29/2022|.0894|03/29/2022|.08999|03/29/2022||||5811|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||MAJOR PHARMACEU|No||||
digoxin|No|No|No|No|75%|00904592161|DIGOXIN 125 MCG TABLET|100|EA|.57955|04/02/2015||Yes|No||04/02/2015||Yes|No|04/02/2015||Yes|No||04/02/2015||Yes|No|||Prescription required|No|||No|.25031|03/29/2022|.2443|03/29/2022|.24592|03/29/2022||||5812|||||No|No||MAJOR PHARMACEU|No||||
digoxin|No|No|No|No|75%|00904592261|DIGOXIN 250 MCG TABLET|100|EA|.57955|04/02/2015||Yes|No||04/02/2015||Yes|No|04/02/2015||Yes|No||04/02/2015||Yes|No|||Prescription required|No|||No|.22254|03/29/2022|.21719|03/29/2022|.21864|03/29/2022||||5813|||||No|No||MAJOR PHARMACEU|No||||
clindamycin HCl|No|No|No|No|75%|00904595961|CLINDAMYCIN HCL 150 MG CAPSULE|100|EA|.14185|09/03/2010||Yes|No||09/03/2010||Yes|No|09/03/2010||Yes|No||09/03/2010||Yes|No|||Prescription required|No||146|No|.12382|03/29/2022|.12084|03/29/2022|.12165|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|5814|||||No|No||MAJOR PHARMACEU|No||||
lorazepam|No|No|No|No|90%|00904600760|LORAZEPAM 0.5 MG TABLET|100|EA|.02373|09/03/2010||Yes|No||09/03/2010||Yes|No|09/03/2010||Yes|No||||No|No|||Prescription required|No||090|Yes|.03794|03/29/2022|.03702|03/29/2022|.03727|03/29/2022|||ANXIOLYTICS|5815|||||No|No||MAJOR PHARMACEU|No||||
lorazepam|No|No|No|No|90%|00904600761|LORAZEPAM 0.5 MG TABLET|100|EA|.03186|09/21/2016||Yes|No||09/21/2016||Yes|No|09/21/2016||Yes|No||||No|No|||Prescription required|No||090|Yes|.03794|03/29/2022|.03702|03/29/2022|.03727|03/29/2022|||ANXIOLYTICS|5816|||||No|No||MAJOR PHARMACEU|No||||
lorazepam|No|No|No|No|90%|00904600860|LORAZEPAM 1 MG TABLET|100|EA|.02554|09/03/2010||Yes|No||09/03/2010||Yes|No|09/03/2010||Yes|No||||No|No|||Prescription required|No||090|Yes|.04593|03/29/2022|.04482|03/29/2022|.04512|03/29/2022|||ANXIOLYTICS|5817|||||No|No||MAJOR PHARMACEU|No||||
lorazepam|No|No|No|No|90%|00904600861|LORAZEPAM 1 MG TABLET|100|EA|.03698|09/21/2016||Yes|No||09/21/2016||Yes|No|09/21/2016||Yes|No||||No|No|||Prescription required|No||090|Yes|.04593|03/29/2022|.04482|03/29/2022|.04512|03/29/2022|||ANXIOLYTICS|5818|||||No|No||MAJOR PHARMACEU|No||||
lorazepam|No|No|No|No|90%|00904600960|LORAZEPAM 2 MG TABLET|100|EA|.03263|09/03/2010||Yes|No||09/03/2010||Yes|No|09/03/2010||Yes|No||||No|No|||Prescription required|No||090|Yes|.06696|03/29/2022|.06535|03/29/2022|.06578|03/29/2022|||ANXIOLYTICS|5819|||||No|No||MAJOR PHARMACEU|No||||
lorazepam|No|No|No|No|90%|00904600961|LORAZEPAM 2 MG TABLET|100|EA|.04334|03/16/2017||Yes|No||03/16/2017||Yes|No|03/16/2017||Yes|No||||No|No|||Prescription required|No||090|Yes|.06696|03/29/2022|.06535|03/29/2022|.06578|03/29/2022|||ANXIOLYTICS|5820|||||No|No||MAJOR PHARMACEU|No||||
bicalutamide|No|No|No|No|75%|00904601946|BICALUTAMIDE 50 MG TABLET|30|EA|.12398|08/18/2010||Yes|No||08/18/2010||Yes|No|08/18/2010||Yes|No||||No|No|||Prescription required|No||550|No|.3381|03/29/2022|.32998|03/29/2022|.33218|03/29/2022|||ONCOLOGY: ORAL - PROSTATE|5821|||||No|No||MAJOR PHARMACEU|No||||
levetiracetam|No|No|No|No|75%|00904605161|LEVETIRACETAM 250 MG TABLET|100|EA|.07946|01/31/2014|09/01/2022|Yes|No||01/31/2014|09/01/2022|Yes|No|01/31/2014|09/01/2022|Yes|No||||No|No|||Prescription required|No||056|No|.08073|03/29/2022|.07879|03/29/2022|.07931|03/29/2022|||ANTICONVULSANTS|5822|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||MAJOR PHARMACEU|No||||
levetiracetam|No|No|No|No|75%|00904605261|LEVETIRACETAM 500 MG TABLET|100|EA|.09004|04/17/2012|08/23/2022|Yes|No||04/17/2012|08/23/2022|Yes|No|04/17/2012|08/23/2022|Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|5823|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||MAJOR PHARMACEU|No||||
levetiracetam|No|No|No|No|75%|00904605361|LEVETIRACETAM 750 MG TABLET|100|EA|.1219|11/18/2013|05/31/2023|Yes|No||11/18/2013|05/31/2023|Yes|No|11/18/2013|05/31/2023|Yes|No||||No|No|||Prescription required|No||056|No|.15853|03/29/2022|.15472|03/29/2022|.15575|03/29/2022|||ANTICONVULSANTS|5824|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MAJOR PHARMACEU|No||||
zolpidem tartrate|No|No|No|No|90%|00904608261|ZOLPIDEM TARTRATE 5 MG TABLET|100|EA|.03736|09/03/2010||Yes|No||09/03/2010||Yes|No|09/03/2010||Yes|No||||No|No|||Prescription required|No||054|Yes|.03056|03/29/2022|.02982|03/29/2022|.03002|03/29/2022|||SEDATIVE HYPNOTICS|5825|||||No|No||MAJOR PHARMACEU|No||||
citalopram hydrobromide|Yes|No|No|No|75%|00904608461|CITALOPRAM HBR 10 MG TABLET|100|EA|.02412|09/03/2010||Yes|No||09/03/2010||Yes|No|09/03/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02682|03/29/2022|.02617|03/29/2022|.02635|03/29/2022|||ANTIDEPRESSANTS: SSRIs|5826|||||No|No||MAJOR PHARMACEU|No||||
citalopram hydrobromide|Yes|No|No|No|75%|00904608561|CITALOPRAM HBR 20 MG TABLET|100|EA|.02605|09/03/2010||Yes|No||09/03/2010||Yes|No|09/03/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02946|03/29/2022|.02875|03/29/2022|.02894|03/29/2022|||ANTIDEPRESSANTS: SSRIs|5827|||||No|No||MAJOR PHARMACEU|No||||
carbamazepine|No|No|No|No|75%|00904617250|CARBAMAZEPINE 200 MG TABLET|2000|EA|.0989|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||10/09/2017||Yes|No|||Prescription required|No||056|No|.20856|03/29/2022|.20355|03/29/2022|.20491|03/29/2022|||ANTICONVULSANTS|5828|||||No|No||MAJOR PHARMACEU|No||||
carbamazepine|No|No|No|No|75%|00904617261|CARBAMAZEPINE 200 MG TABLET|100|EA|.38506|04/24/2012||Yes|No||04/24/2012||Yes|No|04/24/2012||Yes|No||04/24/2012||Yes|No|||Prescription required|No||056|No|.20856|03/29/2022|.20355|03/29/2022|.20491|03/29/2022|||ANTICONVULSANTS|5829|||||No|No||MAJOR PHARMACEU|No||||
bethanechol chloride|No|No|No|No|75%|00904617861|BETHANECHOL 25 MG TABLET|100|EA|.34584|01/09/2019||Yes|No||01/09/2019||Yes|No|01/09/2019||Yes|No||||No|No|||Prescription required|No|||No|.29586|03/29/2022|.28875|03/29/2022|.29068|03/29/2022||||5830|||||No|No||MAJOR PHARMACEU|No||||
phenytoin sodium extended|No|No|No|No|75%|00904618761|PHENYTOIN SOD EXT 100 MG CAP|100|EA|.26242|03/16/2017||Yes|No||03/16/2017||Yes|No|03/16/2017||Yes|No||03/16/2017||Yes|No|||Prescription required|No||056|No|.15598|03/29/2022|.15223|03/29/2022|.15325|03/29/2022|||ANTICONVULSANTS|5831|||||No|No||MAJOR PHARMACEU|No||||
anastrozole|No|No|No|No|75%|00904619546|ANASTROZOLE 1 MG TABLET|30|EA|.06851|04/24/2012||Yes|No||04/24/2012||Yes|No|04/24/2012||Yes|No||||No|No|||Prescription required|No||502|No|.11251|03/29/2022|.1098|03/29/2022|.11054|03/29/2022|||ONCOLOGY: ORAL - BREAST|5832|||||No|No||MAJOR PHARMACEU|No||||
sulindac|No|No|No|No|75%|00904621640|SULINDAC 150 MG TABLET|500|EA|.05937|04/24/2012||Yes|No||04/24/2012||Yes|No|04/24/2012||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.17191|03/29/2022|.16778|03/29/2022|.1689|03/29/2022|||NSAIDS|5833|||||No|No||MAJOR PHARMACEU|No||||
sulindac|No|No|No|No|75%|00904621740|SULINDAC 200 MG TABLET|500|EA|.08152|04/24/2012||Yes|No||04/24/2012||Yes|No|04/24/2012||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.24702|03/29/2022|.24109|03/29/2022|.24269|03/29/2022|||NSAIDS|5834|||||No|No||MAJOR PHARMACEU|No||||
ursodiol|No|No|No|No|75%|00904622106|URSODIOL 300 MG CAPSULE|50|EA|3.21855|12/04/2017||Yes|No||12/04/2017||Yes|No|12/04/2017||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|198|No|.60006|03/29/2022|.58565|03/29/2022|.58955|03/29/2022|||BILE SALTS|5835|||||No|No||MAJOR PHARMACEU|No||||
ursodiol|No|No|No|No|75%|00904622161|URSODIOL 300 MG CAPSULE|100|EA|1.88877|12/04/2017||Yes|No||12/04/2017||Yes|No|12/04/2017||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|198|No|.60006|03/29/2022|.58565|03/29/2022|.58955|03/29/2022|||BILE SALTS|5836|||||No|No||MAJOR PHARMACEU|No||||
carbidopa/levodopa|No|No|No|No|75%|00904623761|CARBIDOPA-LEVODOPA 25-100 TAB|100|EA|.08101|04/24/2012||Yes|No||04/24/2012||Yes|No|04/24/2012||Yes|No||||No|No|||Prescription required|No||015|No|.11418|03/29/2022|.11143|03/29/2022|.11218|03/29/2022|||ANTIPARKINSON'S AGENTS|5837|||||No|No||MAJOR PHARMACEU|No||||
carbidopa/levodopa|No|No|No|No|75%|00904623861|CARBIDOPA-LEVODOPA 25-250 TAB|100|EA|.10629|04/24/2012||Yes|No||04/24/2012||Yes|No|04/24/2012||Yes|No||||No|No|||Prescription required|No||015|No|.1493|03/29/2022|.14571|03/29/2022|.14668|03/29/2022|||ANTIPARKINSON'S AGENTS|5838|||||No|No||MAJOR PHARMACEU|No||||
ziprasidone HCl|No|No|No|No|75%|00904626908|ZIPRASIDONE HCL 20 MG CAPSULE|40|EA|2.07475|05/01/2012||Yes|No||05/01/2012||Yes|No|05/01/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.27381|03/29/2022|.26723|03/29/2022|.26901|03/29/2022|||ANTIPSYCHOTICS|5839|||||No|No||MAJOR PHARMACEU|No||||
ziprasidone HCl|No|No|No|No|75%|00904627008|ZIPRASIDONE HCL 40 MG CAPSULE|40|EA|2.07475|05/01/2012||Yes|No||05/01/2012||Yes|No|05/01/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.29914|03/29/2022|.29196|03/29/2022|.2939|03/29/2022|||ANTIPSYCHOTICS|5840|||||No|No||MAJOR PHARMACEU|No||||
ziprasidone HCl|No|No|No|No|75%|00904627108|ZIPRASIDONE HCL 60 MG CAPSULE|40|EA|2.494|05/01/2012||Yes|No||05/01/2012||Yes|No|05/01/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.38441|03/29/2022|.37518|03/29/2022|.37768|03/29/2022|||ANTIPSYCHOTICS|5841|||||No|No||MAJOR PHARMACEU|No||||
ziprasidone HCl|No|No|No|No|75%|00904627208|ZIPRASIDONE HCL 80 MG CAPSULE|40|EA|2.494|05/01/2012||Yes|No||05/01/2012||Yes|No|05/01/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.42395|03/29/2022|.41377|03/29/2022|.41653|03/29/2022|||ANTIPSYCHOTICS|5842|||||No|No||MAJOR PHARMACEU|No||||
olanzapine|No|No|No|No|75%|00904628361|OLANZAPINE 2.5 MG TABLET|100|EA|.14847|07/26/2012||Yes|No||07/26/2012||Yes|No|07/26/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.08915|03/29/2022|.08701|03/29/2022|.08758|03/29/2022|||ANTIPSYCHOTICS|5843|||||No|No||MAJOR PHARMACEU|No||||
olanzapine|No|No|No|No|75%|00904628606|OLANZAPINE 15 MG TABLET|50|EA|.31063|07/26/2012||Yes|No||07/26/2012||Yes|No|07/26/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.15007|03/29/2022|.14646|03/29/2022|.14744|03/29/2022|||ANTIPSYCHOTICS|5844|||||No|No||MAJOR PHARMACEU|No||||
olanzapine|No|No|No|No|75%|00904628661|OLANZAPINE 15 MG TABLET|100|EA|.26316|12/13/2016||Yes|No||12/13/2016||Yes|No|12/13/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.15007|03/29/2022|.14646|03/29/2022|.14744|03/29/2022|||ANTIPSYCHOTICS|5845|||||No|No||MAJOR PHARMACEU|No||||
olanzapine|No|No|No|No|75%|00904628706|OLANZAPINE 20 MG TABLET|50|EA|.40359|07/26/2012||Yes|No||07/26/2012||Yes|No|07/26/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.18048|03/29/2022|.17614|03/29/2022|.17732|03/29/2022|||ANTIPSYCHOTICS|5846|||||No|No||MAJOR PHARMACEU|No||||
olanzapine|No|No|No|No|75%|00904628761|OLANZAPINE 20 MG TABLET|100|EA|.34197|12/13/2016||Yes|No||12/13/2016||Yes|No|12/13/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.18048|03/29/2022|.17614|03/29/2022|.17732|03/29/2022|||ANTIPSYCHOTICS|5847|||||No|No||MAJOR PHARMACEU|No||||
atorvastatin calcium|Yes|No|No|No|75%|00904629061|ATORVASTATIN 10 MG TABLET|100|EA|.10556|07/26/2012||Yes|No||11/09/2012||Yes|No|07/26/2012||Yes|No||07/26/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|5848|||||No|No||MAJOR PHARMACEU|No||||
atorvastatin calcium|Yes|No|No|No|75%|00904629161|ATORVASTATIN 20 MG TABLET|100|EA|.12973|07/26/2012||Yes|No||07/26/2012||Yes|No|07/26/2012||Yes|No||07/26/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|5849|||||No|No||MAJOR PHARMACEU|No||||
atorvastatin calcium|Yes|No|No|No|75%|00904629261|ATORVASTATIN 40 MG TABLET|100|EA|.13674|02/09/2015||Yes|No||02/09/2015||Yes|No|02/09/2015||Yes|No||02/09/2015||Yes|No|07/01/2016||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|5850|||||No|No||MAJOR PHARMACEU|No||||
atorvastatin calcium|Yes|No|No|No|75%|00904629304|ATORVASTATIN 80 MG TABLET|30|EA|.18604|02/09/2015||Yes|No||02/09/2015||Yes|No|02/09/2015||Yes|No||02/09/2015||Yes|No|07/01/2016||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|5851|||||No|No||MAJOR PHARMACEU|No||||
clopidogrel bisulfate|No|No|No|No|75%|00904629461|CLOPIDOGREL 75 MG TABLET|100|EA|.10126|11/12/2012||Yes|No||11/12/2012||Yes|No|11/12/2012||Yes|No||11/12/2012||Yes|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|5852|||||No|No||MAJOR PHARMACEU|No||||
carvedilol|No|No|No|No|75%|00904630061|CARVEDILOL 3.125 MG TABLET|100|EA|.03551|04/22/2013||Yes|No||04/22/2013||Yes|No|04/22/2013||Yes|No||04/22/2013||Yes|No|||Prescription required|No||070|No|.01877|03/29/2022|.01831|03/29/2022|.01844|03/29/2022|||BETA-BLOCKERS|5853|||||No|No||MAJOR PHARMACEU|No||||
carvedilol|No|No|No|No|75%|00904630161|CARVEDILOL 6.25 MG TABLET|100|EA|.03551|04/22/2013||Yes|No||04/22/2013||Yes|No|04/22/2013||Yes|No||04/22/2013||Yes|No|||Prescription required|No||070|No|.02069|03/29/2022|.02019|03/29/2022|.02032|03/29/2022|||BETA-BLOCKERS|5854|||||No|No||MAJOR PHARMACEU|No||||
carvedilol|No|No|No|No|75%|00904630261|CARVEDILOL 12.5 MG TABLET|100|EA|.03551|04/22/2013||Yes|No||04/22/2013||Yes|No|04/22/2013||Yes|No||04/22/2013||Yes|No|||Prescription required|No||070|No|.02277|03/29/2022|.02222|03/29/2022|.02237|03/29/2022|||BETA-BLOCKERS|5855|||||No|No||MAJOR PHARMACEU|No||||
carvedilol|No|No|No|No|75%|00904630361|CARVEDILOL 25 MG TABLET|100|EA|.03551|04/22/2013||Yes|No||04/22/2013||Yes|No|04/22/2013||Yes|No||04/22/2013||Yes|No|||Prescription required|No||070|No|.03449|03/29/2022|.03366|03/29/2022|.03388|03/29/2022|||BETA-BLOCKERS|5856|||||No|No||MAJOR PHARMACEU|No||||
dextromethorphan polistirex|No|No|No|No|75%|00904631256|COUGH DM ER 30 MG/5 ML SUSP|89|ML|.02632|11/18/2013||Yes|No||||No|No|11/18/2013||Yes|No||||No|No|||Over the counter|No||184|Yes|.05873|03/29/2022|.05732|03/29/2022|.0577|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|5857|||||No|No||MAJOR PHARMACEU|No||||
sodium phosphate,mono-dibasic|No|No|No|No|75%|00904632078|ENEMA READY TO USE|133|ML|.00329|04/16/2014||Yes|No||||No|No|04/16/2014||Yes|No||||No|No|||Over the counter|No|||No|.0064|03/29/2022|.00624|03/29/2022|.00628|03/29/2022||||5858|||||No|No||MAJOR PHARMACEU|No||||
metoprolol succinate|No|No|No|No|75%|00904632261|METOPROLOL SUCC ER 25 MG TAB|100|EA|.37637|08/11/2014||Yes|No||08/11/2014||Yes|No|08/11/2014||Yes|No||08/11/2014||Yes|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|5859|||||No|No||MAJOR PHARMACEU|No||||
metoprolol succinate|No|No|No|No|75%|00904632361|METOPROLOL SUCC ER 50 MG TAB|100|EA|.45076|11/18/2013||Yes|No||11/18/2013||Yes|No|11/18/2013||Yes|No||11/18/2013||Yes|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|5860|||||No|No||MAJOR PHARMACEU|No||||
metoprolol succinate|No|No|No|No|75%|00904632461|METOPROLOL SUCC ER 100 MG TAB|100|EA|.52326|05/16/2014||Yes|No||05/16/2014||Yes|No|05/16/2014||Yes|No||05/16/2014||Yes|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|5861|||||No|No||MAJOR PHARMACEU|No||||
carboxymethylcellulose sodium|No|No|No|No|75%|00904632946|LUBRICATING PLUS 0.5% EYE DRPS|30|EA|.10119|08/12/2014||Yes|No||||No|No|08/12/2014||Yes|No||||No|No|||Over the counter|No|||No|.18927|03/29/2022|.18472|03/29/2022|.18595|03/29/2022||||5862|||||No|No||MAJOR PHARMACEU|No||||
carboxymethylcellulose sodium|No|No|No|No|75%|00904632951|LUBRICATING PLUS 0.5% EYE DRPS|50|EA|.09442|08/12/2014||Yes|No||||No|No|08/12/2014||Yes|No||||No|No|||Over the counter|No|||No|.2152|06/01/2016|.21213|06/01/2016|.20203|06/01/2016||||5863|||||No|No||MAJOR PHARMACEU|No||||
pseudoephedrine HCl|No|No|No|No|75%|00904633724|SUDOGEST 30 MG TABLET|24|EA|.01898|06/10/2019||Yes|No||||No|No|06/10/2019||Yes|No||||No|No|||Over the counter|No|||No|.05204|03/29/2022|.05079|03/29/2022|.05112|03/29/2022||||5864|||||No|No||MAJOR PHARMACEU|No||||
levofloxacin|Yes|No|No|No|75%|00904635161|LEVOFLOXACIN 250 MG TABLET|100|EA|.09472|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||01/31/2014||Yes|No|07/01/2016||Prescription required|No||028|No|.15969|03/29/2022|.15585|03/29/2022|.15689|03/29/2022|||FLUOROQUINOLONES: ORAL|5865|||||No|No||MAJOR PHARMACEU|No||||
levofloxacin|No|No|No|No|75%|00904635261|LEVOFLOXACIN 500 MG TABLET|100|EA|.10427|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||01/31/2014||Yes|No|||Prescription required|No||028|No|.19821|03/29/2022|.19345|03/29/2022|.19474|03/29/2022|||FLUOROQUINOLONES: ORAL|5866|||||No|No||MAJOR PHARMACEU|No||||
levofloxacin|No|No|No|No|75%|00904635361|LEVOFLOXACIN 750 MG TABLET|100|EA|.18877|05/16/2014||Yes|No||05/16/2014||Yes|No|05/16/2014||Yes|No||05/16/2014||Yes|No|||Prescription required|No||028|No|.38345|03/29/2022|.37424|03/29/2022|.37673|03/29/2022|||FLUOROQUINOLONES: ORAL|5867|||||No|No||MAJOR PHARMACEU|No||||
risperidone|No|No|No|No|75%|00904635761|RISPERIDONE 0.25 MG TABLET|100|EA|.0712|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.04339|03/29/2022|.04234|03/29/2022|.04263|03/29/2022|||ANTIPSYCHOTICS|5868|||||No|No||MAJOR PHARMACEU|No||||
risperidone|No|No|No|No|75%|00904635861|RISPERIDONE 0.5 MG TABLET|100|EA|.08475|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.04564|03/29/2022|.04454|03/29/2022|.04484|03/29/2022|||ANTIPSYCHOTICS|5869|||||No|No||MAJOR PHARMACEU|No||||
risperidone|No|No|No|No|75%|00904635961|RISPERIDONE 1 MG TABLET|100|EA|.074|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.05646|03/29/2022|.0551|03/29/2022|.05547|03/29/2022|||ANTIPSYCHOTICS|5870|||||No|No||MAJOR PHARMACEU|No||||
risperidone|No|No|No|No|75%|00904636061|RISPERIDONE 2 MG TABLET|100|EA|.08066|05/16/2014||Yes|No||05/16/2014||Yes|No|05/16/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.061|03/29/2022|.05953|03/29/2022|.05993|03/29/2022|||ANTIPSYCHOTICS|5871|||||No|No||MAJOR PHARMACEU|No||||
risperidone|No|No|No|No|75%|00904636161|RISPERIDONE 3 MG TABLET|100|EA|.08638|05/16/2014||Yes|No||05/16/2014||Yes|No|05/16/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.07183|03/29/2022|.0701|03/29/2022|.07057|03/29/2022|||ANTIPSYCHOTICS|5872|||||No|No||MAJOR PHARMACEU|No||||
risperidone|No|No|No|No|75%|00904636261|RISPERIDONE 4 MG TABLET|100|EA|.09623|05/16/2014||Yes|No||05/16/2014||Yes|No|05/16/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.10538|03/29/2022|.10285|03/29/2022|.10353|03/29/2022|||ANTIPSYCHOTICS|5873|||||No|No||MAJOR PHARMACEU|No||||
divalproex sodium|No|No|No|No|75%|00904636345|DIVALPROEX SOD ER 250 MG TAB|80|EA|.65418|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||02/04/2015||Yes|No|||Prescription required|No||056|Yes|.17839|03/29/2022|.1741|03/29/2022|.17526|03/29/2022|||ANTICONVULSANTS|5874|||||No|No||MAJOR PHARMACEU|No||||
divalproex sodium|No|No|No|No|75%|00904636361|DIVALPROEX SOD ER 250 MG TAB|100|EA|.55577|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||03/07/2018||Yes|No|||Prescription required|No||056|Yes|.17839|03/29/2022|.1741|03/29/2022|.17526|03/29/2022|||ANTICONVULSANTS|5875|||||No|No||MAJOR PHARMACEU|No||||
divalproex sodium|No|No|No|No|75%|00904636445|DIVALPROEX SOD ER 500 MG TAB|80|EA|1.08429|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||02/04/2015||Yes|No|||Prescription required|No||056|No|.21008|03/29/2022|.20503|03/29/2022|.2064|03/29/2022|||ANTICONVULSANTS|5876|||||No|No||MAJOR PHARMACEU|No||||
amlodipine besylate|Yes|No|No|No|75%|00904636961|AMLODIPINE BESYLATE 2.5 MG TAB|100|EA|.05972|05/08/2014||Yes|No||05/08/2014||Yes|No|05/08/2014||Yes|No||05/08/2014||Yes|No|07/01/2016||Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|5877|||||No|No||MAJOR PHARMACEU|No||||
amlodipine besylate|Yes|No|No|No|75%|00904637061|AMLODIPINE BESYLATE 5 MG TAB|100|EA|.03414|05/08/2014||Yes|No||05/08/2014||Yes|No|05/08/2014||Yes|No||05/08/2014||Yes|No|07/01/2016||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|5878|||||No|No||MAJOR PHARMACEU|No||||
amlodipine besylate|Yes|No|No|No|75%|00904637161|AMLODIPINE BESYLATE 10 MG TAB|100|EA|.04682|05/08/2014||Yes|No||05/08/2014||Yes|No|05/08/2014||Yes|No||05/08/2014||Yes|No|07/01/2016||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|5879|||||No|No||MAJOR PHARMACEU|No||||
ropinirole HCl|No|No|No|No|75%|00904637361|ROPINIROLE HCL 0.25 MG TABLET|100|EA|.21143|02/09/2015||Yes|No||02/09/2015||Yes|No|02/09/2015||Yes|No||||No|No|||Prescription required|No||015|No|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIPARKINSON'S AGENTS|5880|||||No|No||MAJOR PHARMACEU|No||||
ropinirole HCl|No|No|No|No|75%|00904637461|ROPINIROLE HCL 1 MG TABLET|100|EA|.24368|02/09/2015||Yes|No||02/09/2015||Yes|No|02/09/2015||Yes|No||||No|No|||Prescription required|No||015|No|.05246|03/29/2022|.0512|03/29/2022|.05154|03/29/2022|||ANTIPARKINSON'S AGENTS|5881|||||No|No||MAJOR PHARMACEU|No||||
olanzapine|No|No|No|No|75%|00904637661|OLANZAPINE 10 MG TABLET|100|EA|.20618|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.12613|03/29/2022|.1231|03/29/2022|.12392|03/29/2022|||ANTIPSYCHOTICS|5882|||||No|No||MAJOR PHARMACEU|No||||
olanzapine|No|No|No|No|75%|00904637761|OLANZAPINE 5 MG TABLET|100|EA|.15518|10/24/2014||Yes|No||10/24/2014||Yes|No|10/24/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.09455|03/29/2022|.09228|03/29/2022|.09289|03/29/2022|||ANTIPSYCHOTICS|5883|||||No|No||MAJOR PHARMACEU|No||||
ciprofloxacin HCl|No|No|No|No|75%|00904637861|CIPROFLOXACIN HCL 500 MG TAB|100|EA|.12448|10/01/2016|09/07/2022|Yes|No||10/01/2016|09/07/2022|Yes|No|10/01/2016|09/07/2022|Yes|No||10/01/2016|09/07/2022|Yes|No|||Prescription required|No||028|No|.13565|03/29/2022|.13239|03/29/2022|.13327|03/29/2022|||FLUOROQUINOLONES: ORAL|5884|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||MAJOR PHARMACEU|No||||
tamsulosin HCl|No|No|No|No|75%|00904640161|TAMSULOSIN HCL 0.4 MG CAPSULE|100|EA|.19113|04/23/2015||Yes|No||04/23/2015||Yes|No|04/23/2015||Yes|No||||No|No|||Prescription required|No||003|No|.06447|03/29/2022|.06292|03/29/2022|.06334|03/29/2022|||BPH TREATMENTS|5885|||||No|No||MAJOR PHARMACEU|No||||
tamsulosin HCl|No|No|No|No|75%|00904640180|TAMSULOSIN HCL 0.4 MG CAPSULE|1000|EA|.02382|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|No||003|No|.06447|03/29/2022|.06292|03/29/2022|.06334|03/29/2022|||BPH TREATMENTS|5886|||||No|No||MAJOR PHARMACEU|No||||
tamsulosin HCl|No|No|No|No|75%|00904640189|TAMSULOSIN HCL 0.4 MG CAPSULE|90|EA|.02383|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|No||003|No|.06447|03/29/2022|.06292|03/29/2022|.06334|03/29/2022|||BPH TREATMENTS|5887|||||No|No||MAJOR PHARMACEU|No||||
ferrous gluconate|No|No|No|No|75%|00904640360|FERATE 27 MG TABLET|100|EA|.00692|||No|No||||No|No|||No|No||06/10/2014||Yes|No|||Over the counter|No|||No|.01577|07/07/2020|.01555|07/07/2020|.01481|07/07/2020||||5888|||||No|No||MAJOR PHARMACEU|No||||
moxifloxacin HCl|No|No|No|No|75%|00904640606|MOXIFLOXACIN HCL 400 MG TABLET|50|EA|4.58749|08/11/2014||Yes|No||08/11/2014||Yes|No|08/11/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|028|No|1.23895|03/29/2022|1.20921|03/29/2022|1.21726|03/29/2022|||FLUOROQUINOLONES: ORAL|5889|||||No|No||MAJOR PHARMACEU|No||||
bisacodyl|No|No|No|No|75%|00904640761|BISACODYL EC 5 MG TABLET|100|EA|.01169|04/23/2015||Yes|No||||No|No|04/23/2015||Yes|No||||No|No|||Over the counter|No|||No|.03778|03/29/2022|.03687|03/29/2022|.03711|03/29/2022||||5890|||||No|No||MAJOR PHARMACEU|No||||
calcium carbonate|No|No|No|No|75%|00904641292|CALCIUM ANTACID 500 MG CHW TAB|150|EA|.00484|02/12/2015||Yes|No||||No|No|02/12/2015||Yes|No||||No|No|||Over the counter|No|||No|.01526|03/29/2022|.01489|03/29/2022|.01499|03/29/2022||||5891|||||No|No||MAJOR PHARMACEU|No||||
tizanidine HCl|No|No|No|No|75%|00904641861|TIZANIDINE HCL 4 MG TABLET|100|EA|.22609|02/09/2015||Yes|No||02/09/2015||Yes|No|02/09/2015||Yes|No||||No|No|||Prescription required|No||116|No|.05014|03/29/2022|.04893|03/29/2022|.04926|03/29/2022|||SKELETAL MUSCLE RELAXANTS|5892|||||No|No||MAJOR PHARMACEU|No||||
escitalopram oxalate|Yes|No|No|No|75%|00904642661|ESCITALOPRAM 10 MG TABLET|100|EA|.06591|02/09/2015||Yes|No||02/09/2015||Yes|No|02/09/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIDEPRESSANTS: SSRIs|5893|||||No|No||MAJOR PHARMACEU|No||||
escitalopram oxalate|Yes|No|No|No|75%|00904642761|ESCITALOPRAM 20 MG TABLET|100|EA|.07731|02/09/2015||Yes|No||02/09/2015||Yes|No|02/09/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.07845|03/29/2022|.07656|03/29/2022|.07707|03/29/2022|||ANTIDEPRESSANTS: SSRIs|5894|||||No|No||MAJOR PHARMACEU|No||||
temazepam|No|No|No|No|90%|00904643604|TEMAZEPAM 7.5 MG CAPSULE|30|EA|1.50643|07/27/2015||Yes|No||07/27/2015||Yes|No|07/27/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|054|Yes|1.39989|03/29/2022|1.36629|03/29/2022|1.37539|03/29/2022|||SEDATIVE HYPNOTICS|5895|||||No|No||MAJOR PHARMACEU|No||||
hydralazine HCl|No|No|No|No|75%|00904644061|HYDRALAZINE 10 MG TABLET|100|EA|.0451|01/29/2016||Yes|No||01/29/2016||Yes|No|01/29/2016||Yes|No||01/29/2016||Yes|No|||Prescription required|No|||No|.03439|03/29/2022|.03356|03/29/2022|.03378|03/29/2022||||5896|||||No|No||MAJOR PHARMACEU|No||||
hydralazine HCl|No|No|No|No|75%|00904644161|HYDRALAZINE 25 MG TABLET|100|EA|.05366|01/29/2016||Yes|No||01/29/2016||Yes|No|01/29/2016||Yes|No||01/29/2016||Yes|No|||Prescription required|No|||No|.04116|03/29/2022|.04017|03/29/2022|.04043|03/29/2022||||5897|||||No|No||MAJOR PHARMACEU|No||||
hydralazine HCl|No|No|No|No|75%|00904644261|HYDRALAZINE 50 MG TABLET|100|EA|.05921|01/29/2016||Yes|No||01/29/2016||Yes|No|01/29/2016||Yes|No||01/29/2016||Yes|No|||Prescription required|No|||No|.0521|03/29/2022|.05084|03/29/2022|.05118|03/29/2022||||5898|||||No|No||MAJOR PHARMACEU|No||||
hydralazine HCl|No|No|No|No|75%|00904644361|HYDRALAZINE 100 MG TABLET|100|EA|.10049|01/29/2016||Yes|No||01/29/2016||Yes|No|01/29/2016||Yes|No||01/29/2016||Yes|No|||Prescription required|No|||No|.0869|03/29/2022|.08481|03/29/2022|.08537|03/29/2022||||5899|||||No|No||MAJOR PHARMACEU|No||||
isosorbide mononitrate|No|No|No|No|75%|00904644961|ISOSORBIDE MONONIT ER 30 MG TB|100|EA|.16352|04/23/2015||Yes|No||04/23/2015||Yes|No|04/23/2015||Yes|No||||No|No|||Prescription required|No|||No|.09715|03/29/2022|.09481|03/29/2022|.09544|03/29/2022||||5900|||||No|No||MAJOR PHARMACEU|No||||
isosorbide mononitrate|No|No|No|No|75%|00904645061|ISOSORBIDE MONONIT ER 60 MG TB|100|EA|.1775|04/23/2015||Yes|No||04/23/2015||Yes|No|04/23/2015||Yes|No||||No|No|||Prescription required|No|||No|.12753|03/29/2022|.12446|03/29/2022|.12529|03/29/2022||||5901|||||No|No||MAJOR PHARMACEU|No||||
duloxetine HCl|No|No|No|No|75%|00904645204|DULOXETINE HCL DR 20 MG CAP|30|EA|.62593|12/14/2016|03/31/2022|Yes|No||12/14/2016|03/31/2022|Yes|No|12/14/2016|03/31/2022|Yes|No||||No|No|||Prescription required|No||232|No|.13163|03/29/2022|.12847|03/29/2022|.12932|03/29/2022|||NEUROPATHIC PAIN|5902|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MAJOR PHARMACEU|No||||
duloxetine HCl|No|No|No|No|75%|00904645261|DULOXETINE HCL DR 20 MG CAP|100|EA|.68976|01/29/2016|03/31/2022|Yes|No||01/29/2016|03/31/2022|Yes|No|01/29/2016|03/31/2022|Yes|No||||No|No|||Prescription required|No||232|No|.13163|03/29/2022|.12847|03/29/2022|.12932|03/29/2022|||NEUROPATHIC PAIN|5903|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MAJOR PHARMACEU|No||||
duloxetine HCl|No|No|No|No|75%|00904645361|DULOXETINE HCL DR 30 MG CAP|100|EA|.61739|07/28/2016|07/15/2022|Yes|No||07/28/2016|07/15/2022|Yes|No|07/28/2016|07/15/2022|Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|5904|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||MAJOR PHARMACEU|No||||
duloxetine HCl|No|No|No|No|75%|00904645461|DULOXETINE HCL DR 60 MG CAP|100|EA|.61739|09/26/2016|07/15/2022|Yes|No||09/26/2016|07/15/2022|Yes|No|09/26/2016|07/15/2022|Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|5905|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||MAJOR PHARMACEU|No||||
docusate sodium|No|No|No|No|75%|00904645561|DOK 100 MG SOFTGEL|100|EA|.01324|01/29/2016|06/17/2022|Yes|No||||No|No|01/29/2016|06/17/2022|Yes|No||||No|No|||Over the counter|No|||No|.02114|03/29/2022|.02063|03/29/2022|.02077|03/29/2022||||5906|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||MAJOR PHARMACEU|No||||
promethazine HCl|No|No|No|No|75%|00904646161|PROMETHAZINE 25 MG TABLET|100|EA|.0497|04/23/2015||Yes|No||04/23/2015||Yes|No|04/23/2015||Yes|No||04/23/2015||Yes|No|||Prescription required|No||085|Yes|.05271|03/29/2022|.05144|03/29/2022|.05178|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|5907|||||No|No||MAJOR PHARMACEU|No||||
brompheniram/phenylephrine/DM|No|No|No|No|75%|00904646320|DIMAPHEN DM ELIXIR|118|ML|.00637|06/06/2016||Yes|No||||No|No|06/06/2016||Yes|No||||No|No|||Over the counter|No||184|Yes|.01623|03/29/2022|.01584|03/29/2022|.01594|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|5908|||||No|No||MAJOR PHARMACEU|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|00904646420|ROBAFEN DM CGH-CHEST CONG SYRP|118|ML|.00484|11/09/2016||Yes|No||||No|No|11/09/2016||Yes|No||||No|No|||Over the counter|No||184|Yes|.01774|03/29/2022|.01731|03/29/2022|.01742|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|5909|||||No|No||MAJOR PHARMACEU|No||||
DM/acetaminophen/doxylamine|No|No|No|No|75%|00904646509|ALL-NITE COLD-FLU RELIEF LIQ|237|ML|.00533|09/26/2016||Yes|No||||No|No|09/26/2016||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|No|.01407|03/29/2022|.01373|03/29/2022|.01382|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|5910|||||No|No||MAJOR PHARMACEU|No||||
clopidogrel bisulfate|No|No|No|No|75%|00904646707|CLOPIDOGREL 300 MG TABLET|30|EA|5.71312|07/27/2015||Yes|No||07/27/2015||Yes|No|07/27/2015||Yes|No||07/27/2015||Yes|No|||Prescription required|No||004|No|13.0206|06/01/2016|12.83459|06/01/2016|12.22342|06/01/2016|||PLATELET AGGREGATION INHIBITORS|5911|||||No|No||MAJOR PHARMACEU|No||||
venlafaxine HCl|No|No|No|No|75%|00904646861|VENLAFAXINE HCL ER 37.5 MG CAP|100|EA|.22076|12/05/2017||Yes|No||12/05/2017||Yes|No|12/05/2017||Yes|No||||No|No|||Prescription required|No||031|Yes|.11725|03/29/2022|.11443|03/29/2022|.11519|03/29/2022|||ANTIDEPRESSANTS: OTHER|5912|||||No|No||MAJOR PHARMACEU|No||||
venlafaxine HCl|No|No|No|No|75%|00904646961|VENLAFAXINE HCL ER 75 MG CAP|100|EA|.22458|12/05/2017||Yes|No||12/05/2017||Yes|No|12/05/2017||Yes|No||||No|No|||Prescription required|No||031|Yes|.12722|03/29/2022|.12416|03/29/2022|.12499|03/29/2022|||ANTIDEPRESSANTS: OTHER|5913|||||No|No||MAJOR PHARMACEU|No||||
venlafaxine HCl|No|No|No|No|75%|00904647061|VENLAFAXINE HCL ER 150 MG CAP|100|EA|.25146|12/05/2017||Yes|No||12/05/2017||Yes|No|12/05/2017||Yes|No||||No|No|||Prescription required|No||031|No|.16516|03/29/2022|.16119|03/29/2022|.16226|03/29/2022|||ANTIDEPRESSANTS: OTHER|5914|||||No|No||MAJOR PHARMACEU|No||||
voriconazole|No|No|No|No|75%|00904647104|VORICONAZOLE 200 MG TABLET|30|EA|9.96095|||No|No||||No|No|||No|No||09/01/2021||Yes|No|||Prescription required|No|||No|22.7017|12/14/2021|22.37739|12/14/2021|21.3118|12/14/2021||||5915|||||No|No||MAJOR PHARMACEU|No||||
pantoprazole sodium|No|No|No|No|75%|00904647461|PANTOPRAZOLE SOD DR 40 MG TAB|100|EA|.12878|07/27/2015||Yes|No||07/27/2015||Yes|No|07/27/2015||Yes|No||||No|No|||Prescription required|No||047|No|.05828|03/29/2022|.05688|03/29/2022|.05726|03/29/2022|||PROTON PUMP INHIBITORS|5916|||||No|No||MAJOR PHARMACEU|No||||
baclofen|No|No|No|No|75%|00904647561|BACLOFEN 10 MG TABLET|100|EA|.18141|06/07/2016||Yes|No||06/07/2016||Yes|No|06/07/2016||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|5917|||||No|No||MAJOR PHARMACEU|No||||
baclofen|No|No|No|No|75%|00904647661|BACLOFEN 20 MG TABLET|100|EA|.28625|06/07/2016||Yes|No||06/07/2016||Yes|No|06/07/2016||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|5918|||||No|No||MAJOR PHARMACEU|No||||
donepezil HCl|No|No|No|No|75%|00904647761|DONEPEZIL HCL 5 MG TABLET|100|EA|.05852|01/09/2019||Yes|No||01/09/2019||Yes|No|01/09/2019||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|5919|||||No|No||MAJOR PHARMACEU|No||||
donepezil HCl|No|No|No|No|75%|00904647861|DONEPEZIL HCL 10 MG TABLET|100|EA|.05852|01/09/2019||Yes|No||01/09/2019||Yes|No|01/09/2019||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|5920|||||No|No||MAJOR PHARMACEU|No||||
mineral oil/petrolatum,white|No|No|No|No|75%|00904648838|LUBRIFRESH PM EYE OINTMENT|3.5|GM|.5074|06/02/2019||Yes|No||||No|No|06/02/2019||Yes|No||||No|No|||Over the counter|No|||No|1.8847|03/29/2022|1.83946|03/29/2022|1.85171|03/29/2022||||5921|||||No|No||MAJOR PHARMACEU|No||||
fluconazole|No|No|No|No|75%|00904650061|FLUCONAZOLE 100 MG TABLET|100|EA|.6087|06/07/2016||Yes|No||06/07/2016||Yes|No|06/07/2016||Yes|No||06/07/2016||Yes|No|||Prescription required|No||069|No|.34281|03/29/2022|.33458|03/29/2022|.33681|03/29/2022|||ANTIFUNGALS: ORAL|5922|||||No|No||MAJOR PHARMACEU|No||||
fluconazole|No|No|No|No|75%|00904650161|FLUCONAZOLE 200 MG TABLET|100|EA|.87672|06/07/2016||Yes|No||06/07/2016||Yes|No|06/07/2016||Yes|No||06/07/2016||Yes|No|||Prescription required|No||069|No|.52936|03/29/2022|.51665|03/29/2022|.52009|03/29/2022|||ANTIFUNGALS: ORAL|5923|||||No|No||MAJOR PHARMACEU|No||||
celecoxib|No|No|No|No|75%|00904650261|CELECOXIB 100 MG CAPSULE|100|EA|.51866|06/07/2016||Yes|No||06/07/2016||Yes|No|06/07/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|5924|||||No|No||MAJOR PHARMACEU|No||||
celecoxib|No|No|No|No|75%|00904650361|CELECOXIB 200 MG CAPSULE|100|EA|.85686|06/07/2016||Yes|No||06/07/2016||Yes|No|06/07/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|5925|||||No|No||MAJOR PHARMACEU|No||||
memantine HCl|No|No|No|No|75%|00904650506|MEMANTINE HCL 5 MG TABLET|50|EA|.17535|01/14/2019||Yes|No||01/14/2019||Yes|No|01/14/2019||Yes|No||||No|No|||Prescription required|No||011|No|.08825|03/29/2022|.08613|03/29/2022|.0867|03/29/2022|||ALZHEIMER'S AGENTS|5926|||||No|No||MAJOR PHARMACEU|No||||
memantine HCl|No|No|No|No|75%|00904650561|MEMANTINE HCL 5 MG TABLET|100|EA|.18545|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|No||011|No|.08825|03/29/2022|.08613|03/29/2022|.0867|03/29/2022|||ALZHEIMER'S AGENTS|5927|||||No|No||MAJOR PHARMACEU|No||||
memantine HCl|No|No|No|No|75%|00904650606|MEMANTINE HCL 10 MG TABLET|50|EA|.19332|01/14/2019||Yes|No||01/14/2019||Yes|No|01/14/2019||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|5928|||||No|No||MAJOR PHARMACEU|No||||
memantine HCl|No|No|No|No|75%|00904650661|MEMANTINE HCL 10 MG TABLET|100|EA|.18545|07/07/2016||Yes|No||07/07/2016||Yes|No|07/07/2016||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|5929|||||No|No||MAJOR PHARMACEU|No||||
aripiprazole|No|No|No|No|75%|00904650904|ARIPIPRAZOLE 2 MG TABLET|30|EA|10.39166|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|5930|||||No|No||MAJOR PHARMACEU|No||||
aripiprazole|No|No|No|No|75%|00904651006|ARIPIPRAZOLE 5 MG TABLET|50|EA|3.59884|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|5931|||||No|No||MAJOR PHARMACEU|No||||
aripiprazole|No|No|No|No|75%|00904651061|ARIPIPRAZOLE 5 MG TABLET|100|EA|9.62125|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|5932|||||No|No||MAJOR PHARMACEU|No||||
aripiprazole|No|No|No|No|75%|00904651106|ARIPIPRAZOLE 10 MG TABLET|50|EA|3.59884|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|5933|||||No|No||MAJOR PHARMACEU|No||||
aripiprazole|No|No|No|No|75%|00904651161|ARIPIPRAZOLE 10 MG TABLET|100|EA|9.62125|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|5934|||||No|No||MAJOR PHARMACEU|No||||
aripiprazole|No|No|No|No|75%|00904651204|ARIPIPRAZOLE 15 MG TABLET|30|EA|10.39166|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|5935|||||No|No||MAJOR PHARMACEU|No||||
aripiprazole|No|No|No|No|75%|00904651304|ARIPIPRAZOLE 20 MG TABLET|30|EA|13.70625|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|5936|||||No|No||MAJOR PHARMACEU|No||||
aripiprazole|No|No|No|No|75%|00904651404|ARIPIPRAZOLE 30 MG TABLET|30|EA|13.70625|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|5937|||||No|No||MAJOR PHARMACEU|No||||
meclizine HCl|No|No|No|No|75%|00904651661|MECLIZINE 12.5 MG TABLET|100|EA|.18834|07/28/2016||Yes|No||07/28/2016||Yes|No|07/28/2016||Yes|No||||No|No|||Prescription required|No||085|Yes|.08309|03/29/2022|.08109|03/29/2022|.08163|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|5938|||||No|No||MAJOR PHARMACEU|No||||
meclizine HCl|No|No|No|No|75%|00904651761|MECLIZINE 25 MG TABLET|100|EA|.19878|06/08/2016||Yes|No||06/08/2016||Yes|No|06/08/2016||Yes|No||06/08/2016||Yes|No|||Prescription required|No||085|Yes|.11433|03/29/2022|.11158|03/29/2022|.11232|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|5939|||||No|No||MAJOR PHARMACEU|No||||
mirtazapine|No|No|No|No|75%|00904651961|MIRTAZAPINE 15 MG TABLET|100|EA|.06665|07/28/2016||Yes|No||07/28/2016||Yes|No|07/28/2016||Yes|No||||No|No|||Prescription required|No||031|Yes|.08357|03/29/2022|.08156|03/29/2022|.0821|03/29/2022|||ANTIDEPRESSANTS: OTHER|5940|||||No|No||MAJOR PHARMACEU|No||||
sennosides|No|No|No|No|75%|00904652261|SENNA-LAX 8.6 MG TABLET|100|EA|.01505|09/26/2016||Yes|No||||No|No|09/26/2016||Yes|No||||No|No|||Over the counter|No|||No|.02428|03/29/2022|.02369|03/29/2022|.02385|03/29/2022||||5941|||||No|No||MAJOR PHARMACEU|No||||
methadone HCl|No|No|No|No|90%|00904653061|METHADONE HCL 10 MG TABLET|100|EA|.1093|12/14/2016||Yes|No||12/14/2016||Yes|No|12/14/2016||Yes|No||||No|No|||Prescription required|Yes|07/28/2017|110|Yes|.08598|03/29/2022|.08391|03/29/2022|.08447|03/29/2022|||ANALGESICS: NARCOTICS LONG|5942|||||No|No||MAJOR PHARMACEU|No||||
guaifen/dextromethorphan/PE|No|No|No|No|75%|00904653720|ROBAFEN CF LIQUID|118|ML|.00754|07/28/2016||Yes|No||||No|No|07/28/2016||Yes|No||||No|No|||Over the counter|No||184|Yes|.01816|03/29/2022|.01772|03/29/2022|.01784|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|5943|||||No|No||MAJOR PHARMACEU|No||||
propranolol HCl|No|No|No|No|75%|00904655061|PROPRANOLOL 10 MG TABLET|100|EA|.10079|12/15/2016||Yes|No||12/15/2016||Yes|No|12/15/2016||Yes|No||12/15/2016||Yes|No|||Prescription required|No||070|No|.06946|03/29/2022|.06779|03/29/2022|.06824|03/29/2022|||BETA-BLOCKERS|5944|||||No|No||MAJOR PHARMACEU|No||||
ondansetron HCl|No|No|No|No|75%|00904655161|ONDANSETRON HCL 4 MG TABLET|100|EA|.21306|09/23/2016||Yes|No||09/23/2016||Yes|No|09/23/2016||Yes|No||||No|No|||Prescription required|No||085|No|.06763|03/29/2022|.066|03/29/2022|.06644|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|5945|||||No|No||MAJOR PHARMACEU|No||||
ondansetron HCl|No|No|No|No|75%|00904655261|ONDANSETRON HCL 8 MG TABLET|100|EA|.27085|09/23/2016||Yes|No||09/23/2016||Yes|No|09/23/2016||Yes|No||||No|No|||Prescription required|No||085|No|.09975|03/29/2022|.09735|03/29/2022|.098|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|5946|||||No|No||MAJOR PHARMACEU|No||||
linezolid|No|No|No|No|75%|00904655304|LINEZOLID 600 MG TABLET|30|EA|2.66184|07/28/2016||Yes|No||07/28/2016||Yes|No|07/28/2016||Yes|No||||No|No|||Prescription required|No||146|No|2.07915|03/29/2022|2.02925|03/29/2022|2.04276|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|5947|||||No|No||MAJOR PHARMACEU|No||||
morphine sulfate|No|No|No|No|90%|00904655761|MORPHINE SULF ER 15 MG TABLET|100|EA|.492|06/08/2017||Yes|No||06/08/2017||Yes|No|06/08/2017||Yes|No||||No|No|||Prescription required|No||110|Yes|.19105|03/29/2022|.18646|03/29/2022|.1877|03/29/2022|||ANALGESICS: NARCOTICS LONG|5948|||||No|No||MAJOR PHARMACEU|No||||
morphine sulfate|No|No|No|No|90%|00904655861|MORPHINE SULF ER 30 MG TABLET|100|EA|.53793|06/08/2017||Yes|No||06/08/2017||Yes|No|06/08/2017||Yes|No||||No|No|||Prescription required|No||110|Yes|.34621|03/29/2022|.3379|03/29/2022|.34015|03/29/2022|||ANALGESICS: NARCOTICS LONG|5949|||||No|No||MAJOR PHARMACEU|No||||
morphine sulfate|No|No|No|No|90%|00904655961|MORPHINE SULF ER 60 MG TABLET|100|EA|1.21522|06/08/2017||Yes|No||06/08/2017||Yes|No|06/08/2017||Yes|No||||No|No|||Prescription required|No||110|Yes|.55429|03/29/2022|.54098|03/29/2022|.54458|03/29/2022|||ANALGESICS: NARCOTICS LONG|5950|||||No|No||MAJOR PHARMACEU|No||||
morphine sulfate|No|No|No|No|90%|00904656061|MORPHINE SULF ER 100 MG TABLET|100|EA|1.50702|06/08/2017||Yes|No||06/08/2017||Yes|No|06/08/2017||Yes|No||||No|No|||Prescription required|No||110|Yes|1.04927|03/29/2022|1.02408|03/29/2022|1.0309|03/29/2022|||ANALGESICS: NARCOTICS LONG|5951|||||No|No||MAJOR PHARMACEU|No||||
benzonatate|No|No|No|No|75%|00904656460|BENZONATATE 100 MG CAPSULE|100|EA|.0838|07/29/2016||Yes|No||07/29/2016||Yes|No|07/29/2016||Yes|No||||No|No|||Prescription required|No||184|Yes|.09389|03/29/2022|.09163|03/29/2022|.09224|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|5952|||||No|No||MAJOR PHARMACEU|No||||
benzonatate|No|No|No|No|75%|00904656461|BENZONATATE 100 MG CAPSULE|100|EA|.21259|01/17/2019||Yes|No||01/17/2019||Yes|No|01/17/2019||Yes|No||||No|No|||Prescription required|No||184|Yes|.09389|03/29/2022|.09163|03/29/2022|.09224|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|5953|||||No|No||MAJOR PHARMACEU|No||||
valacyclovir HCl|No|No|No|No|75%|00904656507|VALACYCLOVIR HCL 500 MG TABLET|30|EA|1.42258|12/05/2017||Yes|No||12/05/2017||Yes|No|12/05/2017||Yes|No||12/05/2017||Yes|No|||Prescription required|No||025|No|.29328|03/29/2022|.28624|03/29/2022|.28814|03/29/2022|||ANTIVIRALS: ORAL|5954|||||No|No||MAJOR PHARMACEU|No||||
valacyclovir HCl|No|No|No|No|75%|00904656561|VALACYCLOVIR HCL 500 MG TABLET|100|EA|1.04752|06/08/2017||Yes|No||06/08/2017||Yes|No|06/08/2017||Yes|No||06/08/2017||Yes|No|||Prescription required|No||025|No|.29328|03/29/2022|.28624|03/29/2022|.28814|03/29/2022|||ANTIVIRALS: ORAL|5955|||||No|No||MAJOR PHARMACEU|No||||
oxybutynin chloride|No|No|No|No|75%|00904657004|OXYBUTYNIN CL ER 5 MG TABLET|30|EA|1.47475|01/17/2019||Yes|No||01/17/2019||Yes|No|01/17/2019||Yes|No||||No|No|||Prescription required|No||006|Yes|.15279|03/29/2022|.14912|03/29/2022|.15011|03/29/2022|||BLADDER RELAXANT PREPARATIONS|5956|||||No|No||MAJOR PHARMACEU|No||||
oxybutynin chloride|No|No|No|No|75%|00904657006|OXYBUTYNIN CL ER 5 MG TABLET|50|EA|1.20357|03/30/2017||Yes|No||03/30/2017||Yes|No|03/30/2017||Yes|No||||No|No|||Prescription required|No||006|Yes|.15279|03/29/2022|.14912|03/29/2022|.15011|03/29/2022|||BLADDER RELAXANT PREPARATIONS|5957|||||No|No||MAJOR PHARMACEU|No||||
oxybutynin chloride|No|No|No|No|75%|00904657061|OXYBUTYNIN CL ER 5 MG TABLET|100|EA|.9847|03/30/2017||Yes|No||03/30/2017||Yes|No|03/30/2017||Yes|No||||No|No|||Prescription required|No||006|Yes|.15279|03/29/2022|.14912|03/29/2022|.15011|03/29/2022|||BLADDER RELAXANT PREPARATIONS|5958|||||No|No||MAJOR PHARMACEU|No||||
allopurinol|No|No|No|No|75%|00904657261|ALLOPURINOL 300 MG TABLET|100|EA|.28986|06/12/2017||Yes|No||06/12/2017||Yes|No|06/12/2017||Yes|No||06/12/2017||Yes|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|5959|||||No|No||MAJOR PHARMACEU|No||||
bupropion HCl|No|No|No|No|75%|00904657304|BUPROPION HCL XL 300 MG TABLET|30|EA|1.00118|05/18/2017||Yes|No||05/18/2017||Yes|No|05/18/2017||Yes|No||||No|No|||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|5960|||||No|No||MAJOR PHARMACEU|No||||
esomeprazole magnesium|No|No|No|No|75%|00904658168|ESOMEPRAZOLE MAG DR 40 MG CAP|60|EA|2.7932|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|5961|||||No|No||MAJOR PHARMACEU|No||||
lamivudine|No|No|No|No|75%|00904658304|LAMIVUDINE 150 MG TABLET|30|EA|4.6188|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.96758|11/23/2021|.94435|11/23/2021|.95064|11/23/2021|||HIV / AIDS|5962|||||No|No||MAJOR PHARMACEU|No||||
bupropion HCl|No|No|No|No|75%|00904658561|BUPROPION HCL SR 150 MG TABLET|100|EA|.25202|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|No||031|No|.10128|03/29/2022|.09884|03/29/2022|.0995|03/29/2022|||ANTIDEPRESSANTS: OTHER|5963|||||No|No||MAJOR PHARMACEU|No||||
tolterodine tartrate|No|No|No|No|75%|00904659204|TOLTERODINE TART ER 2 MG CAP|30|EA|4.8567|06/12/2017||Yes|No||06/12/2017||Yes|No|06/12/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|006|Yes|1.20249|03/29/2022|1.17363|03/29/2022|1.18144|03/29/2022|||BLADDER RELAXANT PREPARATIONS|5964|||||No|No||MAJOR PHARMACEU|No||||
tolterodine tartrate|No|No|No|No|75%|00904659304|TOLTERODINE TART ER 4 MG CAP|30|EA|5.08059|06/12/2017||Yes|No||06/12/2017||Yes|No|06/12/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|006|No|1.14537|03/29/2022|1.11788|03/29/2022|1.12532|03/29/2022|||BLADDER RELAXANT PREPARATIONS|5965|||||No|No||MAJOR PHARMACEU|No||||
voriconazole|No|No|No|No|75%|00904659604|VORICONAZOLE 50 MG TABLET|30|EA|3.48171|06/13/2017||Yes|No||06/13/2017||Yes|No|06/13/2017||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|01/26/2017|069|No|7.93506|06/20/2017|7.8217|06/13/2017|7.44924|06/13/2017|||ANTIFUNGALS: ORAL|5966|||||No|No||MAJOR PHARMACEU|No||||
perphenazine|No|No|No|No|75%|00904659961|PERPHENAZINE 2 MG TABLET|100|EA|.64392|01/07/2019||Yes|No||01/07/2019||Yes|No|01/07/2019||Yes|No||||No|No|||Prescription required|No||027|Yes|.31906|03/29/2022|.3114|03/29/2022|.31347|03/29/2022|||ANTIPSYCHOTICS|5967|||||No|No||MAJOR PHARMACEU|No||||
perphenazine|No|No|No|No|75%|00904660061|PERPHENAZINE 4 MG TABLET|100|EA|.64177|03/20/2018||Yes|No||03/20/2018||Yes|No|03/20/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.32485|03/29/2022|.31705|03/29/2022|.31916|03/29/2022|||ANTIPSYCHOTICS|5968|||||No|No||MAJOR PHARMACEU|No||||
perphenazine|No|No|No|No|75%|00904660161|PERPHENAZINE 8 MG TABLET|100|EA|.77249|03/20/2018||Yes|No||03/20/2018||Yes|No|03/20/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.48127|03/29/2022|.46971|03/29/2022|.47284|03/29/2022|||ANTIPSYCHOTICS|5969|||||No|No||MAJOR PHARMACEU|No||||
hydroxyzine HCl|No|No|No|No|75%|00904661761|HYDROXYZINE HCL 25 MG TABLET|100|EA|.10887|01/14/2019||Yes|No||01/14/2019||Yes|No|01/14/2019||Yes|No||01/14/2019||Yes|No|||Prescription required|No||574|Yes|.06757|03/29/2022|.06594|03/29/2022|.06638|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|5970|||||No|No||MAJOR PHARMACEU|No||||
hydroxyzine HCl|No|No|No|No|75%|00904661861|HYDROXYZINE HCL 50 MG TABLET|100|EA|.1465|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||02/28/2019||Yes|No|||Prescription required|No||574|Yes|.09594|03/29/2022|.09363|03/29/2022|.09426|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|5971|||||No|No||MAJOR PHARMACEU|No||||
isosorbide dinitrate|No|No|No|No|75%|00904661961|ISOSORBIDE DINITRATE 10 MG TAB|100|EA|.26208|01/07/2019||Yes|No||01/07/2019||Yes|No|01/07/2019||Yes|No||||No|No|||Prescription required|No|||No|.34234|03/29/2022|.33412|03/29/2022|.33634|03/29/2022||||5972|||||No|No||MAJOR PHARMACEU|No||||
isosorbide dinitrate|No|No|No|No|75%|00904662061|ISOSORBIDE DINITRATE 20 MG TAB|100|EA|.30637|01/07/2019||Yes|No||01/07/2019||Yes|No|01/07/2019||Yes|No||||No|No|||Prescription required|No|||No|.30675|03/29/2022|.29938|03/29/2022|.30138|03/29/2022||||5973|||||No|No||MAJOR PHARMACEU|No||||
imatinib mesylate|No|No|No|No|75%|00904662104|IMATINIB MESYLATE 400 MG TAB|30|EA|66.38426|11/26/2019||Yes|No||11/26/2019||Yes|No|11/26/2019||Yes|No||||No|No|||Prescription required|No||173|No|2.86988|03/01/2022|2.801|03/01/2022|2.81965|03/01/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|5974|||||No|No||MAJOR PHARMACEU|No||||
tacrolimus|No|No|No|No|75%|00904662361|TACROLIMUS 0.5 MG CAPSULE (IR)|100|EA|.55766|06/13/2017||Yes|No||06/13/2017||Yes|No|06/13/2017||Yes|No||06/13/2017||Yes|No|||Prescription required|No||229|No|.26138|03/29/2022|.2551|03/29/2022|.2568|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|5975|||||No|No||MAJOR PHARMACEU|No||||
tacrolimus|No|No|No|No|75%|00904662461|TACROLIMUS 5 MG CAPSULE (IR)|100|EA|4.37168|06/13/2017||Yes|No||06/13/2017||Yes|No|06/13/2017||Yes|No||06/13/2017||Yes|No|||Prescription required|No||229|No|2.05753|03/29/2022|2.00814|03/29/2022|2.02152|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|5976|||||No|No||MAJOR PHARMACEU|No||||
carbamide peroxide|No|No|No|No|75%|00904662735|EAR DROPS 6.5%|15|ML|.04156|11/15/2017||Yes|No||||No|No|11/15/2017||Yes|No||||No|No|||Over the counter|No|||No|.12463|03/29/2022|.12163|03/29/2022|.12244|03/29/2022||||5977|||||No|No||MAJOR PHARMACEU|No||||
amantadine HCl|No|No|No|No|75%|00904663061|AMANTADINE 100 MG CAPSULE|100|EA|.7712|06/13/2017|01/31/2022|Yes|No||06/13/2017|01/31/2022|Yes|No|06/13/2017|01/31/2022|Yes|No||||No|No|||Prescription required|No||015|No|1.75763|02/15/2022|1.73252|02/15/2022|1.65002|02/15/2022|||ANTIPARKINSON'S AGENTS|5978|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MAJOR PHARMACEU|No||||
bupropion HCl|Yes|No|No|No|75%|00904663561|BUPROPION HCL 75 MG TABLET|100|EA|.51978|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|07/22/2019||Prescription required|No||031|No|.12417|03/29/2022|.12118|03/29/2022|.12199|03/29/2022|||ANTIDEPRESSANTS: OTHER|5979|||||No|No||MAJOR PHARMACEU|No||||
bupropion HCl|Yes|No|No|No|75%|00904663661|BUPROPION HCL 100 MG TABLET|100|EA|.70446|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|07/22/2019||Prescription required|No||031|No|.14759|03/29/2022|.14404|03/29/2022|.145|03/29/2022|||ANTIDEPRESSANTS: OTHER|5980|||||No|No||MAJOR PHARMACEU|No||||
glipizide|No|No|No|No|75%|00904663761|GLIPIZIDE 5 MG TABLET|100|EA|.14379|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||10/09/2017||Yes|No|||Prescription required|No|||No|.03474|03/29/2022|.0339|03/29/2022|.03413|03/29/2022||||5981|||||No|No||MAJOR PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|00904663861|QUETIAPINE FUMARATE 25 MG TAB|100|EA|.1247|12/06/2017||Yes|No||12/06/2017||Yes|No|12/06/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.03239|03/29/2022|.03161|03/29/2022|.03182|03/29/2022|||ANTIPSYCHOTICS|5982|||||No|No||MAJOR PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|00904663961|QUETIAPINE FUMARATE 50 MG TAB|100|EA|.2021|01/07/2019||Yes|No||01/07/2019||Yes|No|01/07/2019||Yes|No||||No|No|||Prescription required|No||027|Yes|.04283|03/29/2022|.0418|03/29/2022|.04208|03/29/2022|||ANTIPSYCHOTICS|5983|||||No|No||MAJOR PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|00904664061|QUETIAPINE FUMARATE 100 MG TAB|100|EA|.2021|12/06/2017||Yes|No||12/06/2017||Yes|No|12/06/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.05826|03/29/2022|.05686|03/29/2022|.05724|03/29/2022|||ANTIPSYCHOTICS|5984|||||No|No||MAJOR PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|00904664161|QUETIAPINE FUMARATE 200 MG TAB|100|EA|.4085|12/06/2017||Yes|No||12/06/2017||Yes|No|12/06/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.10261|03/29/2022|.10014|03/29/2022|.10081|03/29/2022|||ANTIPSYCHOTICS|5985|||||No|No||MAJOR PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|00904664261|QUETIAPINE FUMARATE 300 MG TAB|100|EA|.19375|12/06/2017||Yes|No||12/06/2017||Yes|No|12/06/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.13964|03/29/2022|.13628|03/29/2022|.13719|03/29/2022|||ANTIPSYCHOTICS|5986|||||No|No||MAJOR PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|00904664361|QUETIAPINE FUMARATE 400 MG TAB|100|EA|.602|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.17858|03/29/2022|.17429|03/29/2022|.17545|03/29/2022|||ANTIPSYCHOTICS|5987|||||No|No||MAJOR PHARMACEU|No||||
aripiprazole|No|No|No|No|75%|00904665640|ARIPIPRAZOLE 5 MG TABLET|500|EA|.16318|12/06/2017||Yes|No||12/06/2017||Yes|No|12/06/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|5988|||||No|No||MAJOR PHARMACEU|No||||
benzonatate|No|No|No|No|75%|00904665760|BENZONATATE 100 MG CAPSULE|100|EA|.10027|12/06/2017|02/24/2022|Yes|No||12/06/2017|02/24/2022|Yes|No|12/06/2017|02/24/2022|Yes|No||||No|No|||Prescription required|No||184|Yes|.09389|03/29/2022|.09163|03/29/2022|.09224|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|5989|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||MAJOR PHARMACEU|No||||
lansoprazole|No|No|No|No|75%|00904666245|LANSOPRAZOLE DR 30 MG CAPSULE|80|EA|.79963|01/15/2019||Yes|No||01/15/2019||Yes|No|01/15/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.12249|03/29/2022|.11955|03/29/2022|.12034|03/29/2022|||PROTON PUMP INHIBITORS|5990|||||No|No||MAJOR PHARMACEU|No||||
ezetimibe|No|No|No|No|75%|00904666404|EZETIMIBE 10 MG TABLET|30|EA|4.73358|01/07/2019|03/16/2022|Yes|No||01/07/2019|03/16/2022|Yes|No|01/07/2019|03/16/2022|Yes|No||||No|No|||Prescription required|Yes|07/27/2017|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|5991|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||MAJOR PHARMACEU|No||||
gabapentin|No|No|No|No|75%|00904666561|GABAPENTIN 100 MG CAPSULE|100|EA|.05031|01/17/2019||Yes|No||01/17/2019||Yes|No|01/17/2019||Yes|No||01/17/2019||Yes|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|5992|||||No|No||MAJOR PHARMACEU|No||||
gabapentin|No|No|No|No|75%|00904666661|GABAPENTIN 300 MG CAPSULE|100|EA|.07013|01/17/2019||Yes|No||01/17/2019||Yes|No|01/17/2019||Yes|No||01/17/2019||Yes|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|5993|||||No|No||MAJOR PHARMACEU|No||||
gabapentin|No|No|No|No|75%|00904666761|GABAPENTIN 400 MG CAPSULE|100|EA|.08823|01/17/2019||Yes|No||01/17/2019||Yes|No|01/17/2019||Yes|No||01/17/2019||Yes|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|5994|||||No|No||MAJOR PHARMACEU|No||||
sildenafil citrate|No|No|No|No|75%|00904667104|SILDENAFIL 20 MG TABLET|30|EA|.49951|01/07/2019||Yes|No||01/07/2019||Yes|No|01/07/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|Yes|.09246|03/29/2022|.09024|03/29/2022|.09084|03/29/2022|||PAH AGENTS: ORAL AND INHALED|5995|||||No|No||MAJOR PHARMACEU|No||||
oxycodone HCl|No|No|No|No|90%|00904667840|OXYCODONE HCL 5 MG/5 ML SOLN|500|ML|.03427|01/14/2019||Yes|No||01/14/2019||Yes|No|01/14/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.11792|03/29/2022|.11508|03/29/2022|.11585|03/29/2022|||ANALGESICS: NARCOTICS SHORT|5996|||||No|No||MAJOR PHARMACEU|No||||
metformin HCl|Yes|No|No|No|75%|00904668961|METFORMIN HCL 500 MG TABLET|100|EA|.02747|01/15/2019|09/20/2022|Yes|No||01/15/2019|09/20/2022|Yes|No|01/15/2019|09/20/2022|Yes|No||||No|No|01/15/2019|09/20/2022|Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|5997|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||MAJOR PHARMACEU|No||||
metformin HCl|Yes|No|No|No|75%|00904669061|METFORMIN HCL 850 MG TABLET|100|EA|.08926|01/15/2019|08/05/2022|Yes|No||01/15/2019|08/05/2022|Yes|No|01/15/2019|08/05/2022|Yes|No||||No|No|07/22/2019|08/05/2022|Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|5998|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||MAJOR PHARMACEU|No||||
mag hydrox/aluminum hyd/simeth|No|No|No|No|75%|00904670060|MINTOX PLUS TABLET CHEWABLE|100|EA|.0107|01/09/2019||Yes|No||||No|No|01/09/2019||Yes|No||||No|No|||Over the counter|No|||No|.02326|06/29/2021|.0227|06/29/2021|.02285|06/29/2021||||5999|||||No|No||MAJOR PHARMACEU|No||||
leucovorin calcium|No|No|No|No|75%|00904670310|LEUCOVORIN CALCIUM 25 MG TAB|20|EA|4.05855|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|||Prescription required|No|||No|5.60951|03/29/2022|5.47488|03/29/2022|5.51134|03/29/2022||||6000|||||No|No||MAJOR PHARMACEU|No||||
propranolol HCl|No|No|No|No|75%|00904670561|PROPRANOLOL 20 MG TABLET|100|EA|.47992|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||02/28/2019||Yes|No|||Prescription required|No||070|No|.08469|03/29/2022|.08265|03/29/2022|.0832|03/29/2022|||BETA-BLOCKERS|6001|||||No|No||MAJOR PHARMACEU|No||||
glycopyrrolate|No|No|No|No|75%|00904670961|GLYCOPYRROLATE 1 MG TABLET|100|EA|.46556|12/20/2019||Yes|No||12/20/2019||Yes|No|12/20/2019||Yes|No||||No|No|||Prescription required|No|||No|.10136|03/29/2022|.09892|03/29/2022|.09958|03/29/2022||||6002|||||No|No||MAJOR PHARMACEU|No||||
fexofenadine HCl|No|No|No|No|75%|00904671110|FEXOFENADINE HCL 180 MG TABLET|15|EA|.26574|01/15/2019||Yes|No||||No|No|01/15/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.28782|03/29/2022|.28091|03/29/2022|.28278|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|6003|||||No|No||MAJOR PHARMACEU|No||||
fexofenadine HCl|No|No|No|No|75%|00904671146|FEXOFENADINE HCL 180 MG TABLET|30|EA|.1892|01/15/2019||Yes|No||||No|No|01/15/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.28782|03/29/2022|.28091|03/29/2022|.28278|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|6004|||||No|No||MAJOR PHARMACEU|No||||
cetirizine HCl|No|No|No|No|75%|00904671740|CETIRIZINE HCL 10 MG TABLET|500|EA|.0159|02/28/2019||Yes|No||||No|No|02/28/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|6005|||||No|No||MAJOR PHARMACEU|No||||
cetirizine HCl|No|No|No|No|75%|00904671741|CETIRIZINE HCL 10 MG TABLET|14|EA|.0562|01/17/2019||Yes|No||||No|No|01/17/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|6006|||||No|No||MAJOR PHARMACEU|No||||
cetirizine HCl|No|No|No|No|75%|00904671743|CETIRIZINE HCL 10 MG TABLET|45|EA|.04347|02/28/2019||Yes|No||||No|No|02/28/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|6007|||||No|No||MAJOR PHARMACEU|No||||
cetirizine HCl|No|No|No|No|75%|00904671746|CETIRIZINE HCL 10 MG TABLET|30|EA|.03898|01/17/2019||Yes|No||||No|No|01/17/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|6008|||||No|No||MAJOR PHARMACEU|No||||
cetirizine HCl|No|No|No|No|75%|00904671760|CETIRIZINE HCL 10 MG TABLET|100|EA|.01913|02/28/2019||Yes|No||||No|No|02/28/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|6009|||||No|No||MAJOR PHARMACEU|No||||
cetirizine HCl|No|No|No|No|75%|00904671761|CETIRIZINE HCL 10 MG TABLET|100|EA|.05482|02/28/2019||Yes|No||||No|No|02/28/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|6010|||||No|No||MAJOR PHARMACEU|No||||
cetirizine HCl|No|No|No|No|75%|00904671772|CETIRIZINE HCL 10 MG TABLET|300|EA|.02537|01/17/2019||Yes|No||||No|No|01/17/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|6011|||||No|No||MAJOR PHARMACEU|No||||
cetirizine HCl|No|No|No|No|75%|00904671786|CETIRIZINE HCL 10 MG TABLET|90|EA|.02441|02/13/2019||Yes|No||||No|No|02/13/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|6012|||||No|No||MAJOR PHARMACEU|No||||
guaifenesin|No|No|No|No|75%|00904671839|MUCUS RELIEF ER 600 MG TABLET|100|EA|.38274|06/11/2019||Yes|No||||No|No|06/11/2019||Yes|No||||No|No|||Over the counter|No||182|Yes|.34047|03/29/2022|.33229|03/29/2022|.33451|03/29/2022|||COUGH AND COLD: COLD|6013|||||No|No||MAJOR PHARMACEU|No||||
pseudoephedrine HCl|No|No|No|No|75%|00904672760|SUDOGEST 30 MG TABLET|100|EA|.00907|03/03/2020||Yes|No||||No|No|03/03/2020||Yes|No||||No|No|||Over the counter|No|||No|.05204|03/29/2022|.05079|03/29/2022|.05112|03/29/2022||||6014|||||No|No||MAJOR PHARMACEU|No||||
pseudoephedrine HCl|No|No|No|No|75%|00904672846|SUDOGEST 60 MG TABLET|30|EA|.02522|12/20/2019||Yes|No||||No|No|12/20/2019||Yes|No||||No|No|||Over the counter|No|||No|.04554|03/29/2022|.04444|03/29/2022|.04474|03/29/2022||||6015|||||No|No||MAJOR PHARMACEU|No||||
memantine HCl|No|No|No|No|75%|00904673461|MEMANTINE HCL ER 7 MG CAPSULE|100|EA|1.11524|12/20/2019||Yes|No||12/20/2019||Yes|No|12/20/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|011|No|.73424|03/29/2022|.71661|03/29/2022|.72139|03/29/2022|||ALZHEIMER'S AGENTS|6016|||||No|No||MAJOR PHARMACEU|No||||
memantine HCl|No|No|No|No|75%|00904673561|MEMANTINE HCL ER 28 MG CAPSULE|100|EA|1.29825|09/19/2019||Yes|No||09/19/2019||Yes|No|09/19/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|011|No|1.08689|03/29/2022|1.0608|03/29/2022|1.06786|03/29/2022|||ALZHEIMER'S AGENTS|6017|||||No|No||MAJOR PHARMACEU|No||||
memantine HCl|No|No|No|No|75%|00904673761|MEMANTINE HCL ER 21 MG CAPSULE|100|EA|1.23917|12/20/2019||Yes|No||12/20/2019||Yes|No|12/20/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|011|No|.91098|03/29/2022|.88911|03/29/2022|.89503|03/29/2022|||ALZHEIMER'S AGENTS|6018|||||No|No||MAJOR PHARMACEU|No||||
dronabinol|No|No|No|No|75%|00904674561|DRONABINOL 2.5 MG CAPSULE|100|EA|2.0311|02/28/2019|08/09/2022|Yes|No||02/28/2019|08/09/2022|Yes|No|02/28/2019|08/09/2022|Yes|No||||No|No|||Prescription required|Yes|03/09/2018|085|No|1.39891|03/29/2022|1.36533|03/29/2022|1.37442|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|6019|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||MAJOR PHARMACEU|No||||
ibuprofen|No|No|No|No|75%|00904674724|IBUPROFEN 200 MG TABLET|24|EA|.01755|09/20/2019||Yes|No||||No|No|09/20/2019||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|6020|||||No|No||MAJOR PHARMACEU|No||||
ibuprofen|No|No|No|No|75%|00904674740|IBUPROFEN 200 MG TABLET|500|EA|.00638|09/20/2019||Yes|No||||No|No|09/20/2019||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|6021|||||No|No||MAJOR PHARMACEU|No||||
ibuprofen|No|No|No|No|75%|00904674751|IBUPROFEN 200 MG TABLET|50|EA|.01083|06/10/2019||Yes|No||||No|No|06/10/2019||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|6022|||||No|No||MAJOR PHARMACEU|No||||
ibuprofen|No|No|No|No|75%|00904674759|IBUPROFEN 200 MG TABLET|100|EA|.00894|12/20/2019||Yes|No||||No|No|12/20/2019||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|6023|||||No|No||MAJOR PHARMACEU|No||||
ibuprofen|No|No|No|No|75%|00904674770|IBUPROFEN 200 MG TABLET|250|EA|.00761|09/20/2019||Yes|No||||No|No|09/20/2019||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|6024|||||No|No||MAJOR PHARMACEU|No||||
ibuprofen|No|No|No|No|75%|00904674780|IBUPROFEN 200 MG TABLET|1000|EA|.00518|06/10/2019||Yes|No||||No|No|06/10/2019||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|6025|||||No|No||MAJOR PHARMACEU|No||||
bisacodyl|No|No|No|No|75%|00904674880|BISACODYL EC 5 MG TABLET|1000|EA|.00256|07/28/2021||Yes|No||||No|No|07/28/2021||Yes|No||||No|No|||Over the counter|No|||No|.03778|03/29/2022|.03687|03/29/2022|.03711|03/29/2022||||6026|||||No|No||MAJOR PHARMACEU|No||||
aspirin|No|No|No|No|75%|00904675180|ASPIRIN EC 81 MG TABLET|1000|EA|.00258|07/28/2021||Yes|No||||No|No|07/28/2021||Yes|No||||No|No|||Over the counter|No|||No|.01442|03/29/2022|.01407|03/29/2022|.01416|03/29/2022||||6027|||||No|No||MAJOR PHARMACEU|No||||
phenylephrine HCl|No|No|No|No|75%|00904675349|SUDOGEST PE 10 MG TABLET|18|EA|.0191|03/03/2020|02/24/2022|Yes|No||||No|No|03/03/2020|02/24/2022|Yes|No||||No|No|||Over the counter|No|||No|.04355|03/15/2022|.04292|03/15/2022|.04088|03/15/2022||||6028|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||MAJOR PHARMACEU|No||||
pseudoephedrine HCl|No|No|No|No|75%|00904675415|SUDOGEST 12 HOUR 120 MG CAPLET|10|EA|.1677|09/20/2019||Yes|No||||No|No|09/20/2019||Yes|No||||No|No|||Over the counter|No|||No|.31485|03/29/2022|.30729|03/29/2022|.30934|03/29/2022||||6029|||||No|No||MAJOR PHARMACEU|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|00904675859|ROBAFEN DM COUGH LIQUID|237|ML|.00371|06/11/2019||Yes|No||||No|No|06/11/2019||Yes|No||||No|No|||Over the counter|No||184|Yes|.01037|03/29/2022|.01012|03/29/2022|.01018|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|6030|||||No|No||MAJOR PHARMACEU|No||||
oxymetazoline HCl|No|No|No|No|75%|00904676130|NASAL DECONGESTANT 0.05% SPRAY|30|ML|.02293|03/04/2019||Yes|No||||No|No|03/04/2019||Yes|No||||No|No|||Over the counter|No||182|Yes|.07205|03/29/2022|.07032|03/29/2022|.07078|03/29/2022|||COUGH AND COLD: COLD|6031|||||No|No||MAJOR PHARMACEU|No||||
guaifenesin|No|No|No|No|75%|00904676320|ROBAFEN 200 MG/10 ML SYRUP|118|ML|.00338|03/04/2019||Yes|No||||No|No|03/04/2019||Yes|No||||No|No|||Over the counter|No||182|Yes|.01581|03/29/2022|.01543|03/29/2022|.01553|03/29/2022|||COUGH AND COLD: COLD|6032|||||No|No||MAJOR PHARMACEU|No||||
cetirizine HCl|No|No|No|No|75%|00904676520|CHILD CETIRIZINE HCL 1 MG/ML|118|ML|.01763|03/04/2019||Yes|No||||No|No|03/04/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.03462|03/29/2022|.03378|03/29/2022|.03401|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|6033|||||No|No||MAJOR PHARMACEU|No||||
loratadine|No|No|No|No|75%|00904676720|CHILD LORATADINE 5 MG/5 ML SOL|120|ML|.01741|12/20/2019||Yes|No||||No|No|12/20/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.04114|03/29/2022|.04015|03/29/2022|.04042|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|6034|||||No|No||MAJOR PHARMACEU|No||||
dimenhydrinate|No|No|No|No|75%|00904677212|DRIMINATE 50 MG TABLET|12|EA|.02328|09/20/2019||Yes|No||||No|No|09/20/2019||Yes|No||||No|No|||Over the counter|No||085|No|.05446|03/29/2022|.05315|03/29/2022|.0535|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|6035|||||No|No||MAJOR PHARMACEU|No||||
rosuvastatin calcium|Yes|No|No|No|75%|00904677861|ROSUVASTATIN CALCIUM 5 MG TAB|100|EA|.4303|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||02/28/2019||Yes|No|06/18/2019||Prescription required|No||063|Yes|.06753|03/29/2022|.0659|03/29/2022|.06634|03/29/2022|||LIPOTROPICS: STATINS|6036|||||No|No||MAJOR PHARMACEU|No||||
rosuvastatin calcium|Yes|No|No|No|75%|00904678061|ROSUVASTATIN CALCIUM 20 MG TAB|100|EA|.53036|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||02/28/2019||Yes|No|06/18/2019||Prescription required|No||063|Yes|.07822|03/29/2022|.07634|03/29/2022|.07685|03/29/2022|||LIPOTROPICS: STATINS|6037|||||No|No||MAJOR PHARMACEU|No||||
aspirin|No|No|No|No|75%|00904678370|ASPIRIN EC 81 MG TABLET|250|EA|.00426|06/11/2019||Yes|No||06/11/2019||Yes|No|06/11/2019||Yes|No||||No|No|||Over the counter|No|||No|.01442|03/29/2022|.01407|03/29/2022|.01416|03/29/2022||||6038|||||No|No||MAJOR PHARMACEU|No||||
benztropine mesylate|No|No|No|No|75%|00904678861|BENZTROPINE MES 0.5 MG TAB|100|EA|.19023|12/20/2019||Yes|No||12/20/2019||Yes|No|12/20/2019||Yes|No||||No|No|||Prescription required|No||015|No|.08426|03/29/2022|.08223|03/29/2022|.08278|03/29/2022|||ANTIPARKINSON'S AGENTS|6039|||||No|No||MAJOR PHARMACEU|No||||
benztropine mesylate|No|No|No|No|75%|00904678961|BENZTROPINE MES 2 MG TABLET|100|EA|.25081|12/20/2019||Yes|No||12/20/2019||Yes|No|12/20/2019||Yes|No||||No|No|||Prescription required|No||015|No|.12012|03/29/2022|.11723|03/29/2022|.11801|03/29/2022|||ANTIPARKINSON'S AGENTS|6040|||||No|No||MAJOR PHARMACEU|No||||
aspirin|No|No|No|No|75%|00904679480|ASPIRIN 81 MG CHEWABLE TABLET|1000|EA|.00369|02/28/2019||Yes|No||||No|No|02/28/2019||Yes|No||||No|No|||Over the counter|No|||No|.02682|03/29/2022|.02617|03/29/2022|.02635|03/29/2022||||6041|||||No|No||MAJOR PHARMACEU|No||||
aspirin|No|No|No|No|75%|00904679489|ASPIRIN 81 MG CHEWABLE TABLET|90|EA|.00688|02/28/2019||Yes|No||||No|No|02/28/2019||Yes|No||||No|No|||Over the counter|No|||No|.02682|03/29/2022|.02617|03/29/2022|.02635|03/29/2022||||6042|||||No|No||MAJOR PHARMACEU|No||||
valganciclovir HCl|No|No|No|No|75%|00904679604|VALGANCICLOVIR 450 MG TABLET|30|EA|19.80006|01/15/2019||Yes|No||01/15/2019||Yes|No|01/15/2019||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|136|No|2.64507|03/29/2022|2.58158|03/29/2022|2.59878|03/29/2022|||ANTIVIRALS: GENERAL|6043|||||No|No||MAJOR PHARMACEU|No||||
valganciclovir HCl|No|No|No|No|75%|00904679610|VALGANCICLOVIR 450 MG TABLET|20|EA|19.92018|01/15/2019||Yes|No||01/15/2019||Yes|No|01/15/2019||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|136|No|2.64507|03/29/2022|2.58158|03/29/2022|2.59878|03/29/2022|||ANTIVIRALS: GENERAL|6044|||||No|No||MAJOR PHARMACEU|No||||
lisinopril|Yes|No|No|No|75%|00904679761|LISINOPRIL 5 MG TABLET|100|EA|.02777|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||02/28/2019||Yes|No|06/18/2019||Prescription required|No||113|No|.01549|03/29/2022|.01511|03/29/2022|.01521|03/29/2022|||ANGIOTENSIN MODULATORS|6045|||||No|No||MAJOR PHARMACEU|No||||
lisinopril|Yes|No|No|No|75%|00904679861|LISINOPRIL 10 MG TABLET|100|EA|.02291|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||02/28/2019||Yes|No|06/18/2019||Prescription required|No||113|No|.01914|03/29/2022|.01868|03/29/2022|.0188|03/29/2022|||ANGIOTENSIN MODULATORS|6046|||||No|No||MAJOR PHARMACEU|No||||
lisinopril|Yes|No|No|No|75%|00904679961|LISINOPRIL 20 MG TABLET|100|EA|.02928|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||02/28/2019||Yes|No|06/18/2019||Prescription required|No||113|No|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANGIOTENSIN MODULATORS|6047|||||No|No||MAJOR PHARMACEU|No||||
lisinopril|Yes|No|No|No|75%|00904680061|LISINOPRIL 40 MG TABLET|100|EA|.05981|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||02/28/2019||Yes|No|06/18/2019||Prescription required|No||113|No|.04778|03/29/2022|.04663|03/29/2022|.04694|03/29/2022|||ANGIOTENSIN MODULATORS|6048|||||No|No||MAJOR PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|00904680361|QUETIAPINE ER 200 MG TABLET|100|EA|.47089|11/26/2019||Yes|No||11/26/2019||Yes|No|11/26/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|.25825|03/29/2022|.25205|03/29/2022|.25373|03/29/2022|||ANTIPSYCHOTICS|6049|||||No|No||MAJOR PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|00904680561|QUETIAPINE ER 400 MG TABLET|100|EA|.94819|11/26/2019||Yes|No||11/26/2019||Yes|No|11/26/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|.42833|03/29/2022|.41805|03/29/2022|.42083|03/29/2022|||ANTIPSYCHOTICS|6050|||||No|No||MAJOR PHARMACEU|No||||
montelukast sodium|No|No|No|No|75%|00904680861|MONTELUKAST SOD 10 MG TABLET|100|EA|.14202|06/11/2019||Yes|No||06/11/2019||Yes|No|06/11/2019||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|6051|||||No|No||MAJOR PHARMACEU|No||||
guaifenesin|No|No|No|No|75%|00904681552|MUCUS RELIEF 400 MG TABLET|60|EA|.02142|03/04/2019|06/07/2022|Yes|No||||No|No|03/04/2019|06/07/2022|Yes|No||||No|No|||Over the counter|No||182|Yes|.06856|03/29/2022|.06691|03/29/2022|.06736|03/29/2022|||COUGH AND COLD: COLD|6052|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||MAJOR PHARMACEU|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|00904681646|MUCUS RELIEF DM 20-400 MG TAB|30|EA|.03253|09/06/2019|03/31/2022|Yes|No||||No|No|09/06/2019|03/31/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.07712|03/29/2022|.07526|03/29/2022|.07577|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|6053|No Longer Rebatable||No Longer Rebatable||No|No||MAJOR PHARMACEU|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|00904681652|MUCUS RELIEF DM 20-400 MG TAB|60|EA|.02572|06/11/2019|08/17/2022|Yes|No||||No|No|06/11/2019|08/17/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.07712|03/29/2022|.07526|03/29/2022|.07577|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|6054|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||MAJOR PHARMACEU|No||||
witch hazel|No|No|No|No|75%|00904682960|MEDI-PADS 50%|100|EA|.01763|09/23/2019||Yes|No||||No|No|09/23/2019||Yes|No||||No|No|||Over the counter|No|||No|.0373|03/29/2022|.0364|03/29/2022|.03664|03/29/2022||||6055|||||No|No||MAJOR PHARMACEU|No||||
metaxalone|No|No|No|No|75%|00904683106|METAXALONE 800 MG TABLET|50|EA|2.25646|11/27/2019||Yes|No||11/27/2019||Yes|No|11/27/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|116|Yes|.52754|03/29/2022|.51487|03/29/2022|.5183|03/29/2022|||SKELETAL MUSCLE RELAXANTS|6056|||||No|No||MAJOR PHARMACEU|No||||
flucytosine|No|No|No|No|75%|00904683407|FLUCYTOSINE 250 MG CAPSULE|30|EA|35.97523|12/20/2019||Yes|No||12/20/2019||Yes|No|12/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|069|No|81.99006|12/20/2019|80.81877|12/20/2019|76.97026|12/20/2019|||ANTIFUNGALS: ORAL|6057|||||No|No||MAJOR PHARMACEU|No||||
flucytosine|No|No|No|No|75%|00904683507|FLUCYTOSINE 500 MG CAPSULE|30|EA|68.85002|12/20/2019||Yes|No||12/20/2019||Yes|No|12/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|069|No|156.914|12/20/2019|154.67237|12/20/2019|147.30702|12/20/2019|||ANTIFUNGALS: ORAL|6058|||||No|No||MAJOR PHARMACEU|No||||
loperamide HCl|No|No|No|No|75%|00904683620|LOPERAMIDE 1 MG/7.5 ML SOLN|120|ML|.01307|09/20/2019||Yes|No||||No|No|09/20/2019||Yes|No||09/20/2019||Yes|No|||Over the counter|No|||No|.02593|03/29/2022|.0253|03/29/2022|.02547|03/29/2022||||6059|||||No|No||MAJOR PHARMACEU|No||||
loratadine|No|No|No|No|75%|00904685207|LORATADINE 10 MG TABLET|30|EA|.0301|12/20/2019||Yes|No||||No|No|12/20/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|6060|||||No|No||MAJOR PHARMACEU|No||||
loratadine|No|No|No|No|75%|00904685260|LORATADINE 10 MG TABLET|100|EA|.02416|06/11/2019||Yes|No||||No|No|06/11/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|6061|||||No|No||MAJOR PHARMACEU|No||||
loratadine|No|No|No|No|75%|00904685261|LORATADINE 10 MG TABLET|100|EA|.10294|03/04/2019||Yes|No||||No|No|03/04/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|6062|||||No|No||MAJOR PHARMACEU|No||||
loratadine|No|No|No|No|75%|00904685272|LORATADINE 10 MG TABLET|300|EA|.01576|12/20/2019||Yes|No||||No|No|12/20/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|6063|||||No|No||MAJOR PHARMACEU|No||||
loratadine|No|No|No|No|75%|00904685289|LORATADINE 10 MG TABLET|90|EA|.02503|12/20/2019||Yes|No||||No|No|12/20/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|6064|||||No|No||MAJOR PHARMACEU|No||||
tretinoin|No|No|No|No|75%|00904686704|TRETINOIN 10 MG CAPSULE|30|EA|13.75684|12/20/2019||Yes|No||12/20/2019||Yes|No|12/20/2019||Yes|No||||No|No|||Prescription required|No||173|No|31.3528|12/20/2019|30.9049|12/20/2019|29.43324|12/20/2019|||ONCOLOGY: ORAL - HEMATOLOGIC|6065|||||No|No||MAJOR PHARMACEU|No||||
tretinoin|No|No|No|No|75%|00904686760|TRETINOIN 10 MG CAPSULE|100|EA|13.34939|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|No||173|No|30.42419|09/18/2020|29.98956|09/18/2020|28.56149|09/18/2020|||ONCOLOGY: ORAL - HEMATOLOGIC|6066|||||No|No||MAJOR PHARMACEU|No||||
acetaminophen|No|No|No|No|75%|00904688365|ACETAMINOPHEN ER 650 MG CAPLET|400|EA|.03405|03/03/2020||Yes|No||||No|No|03/03/2020||Yes|No||||No|No|||Over the counter|No|||No|.06737|03/29/2022|.06575|03/29/2022|.06619|03/29/2022||||6067|||||No|No||MAJOR PHARMACEU|No||||
pseudoephedrine HCl|No|No|No|No|75%|00904690706|PSEUDOEPHEDRINE 60 MG TABLET|50|EA|.02468|12/20/2019||Yes|No||||No|No|12/20/2019||Yes|No||||No|No|||Over the counter|No|||No|.04554|03/29/2022|.04444|03/29/2022|.04474|03/29/2022||||6068|||||No|No||MAJOR PHARMACEU|No||||
atomoxetine HCl|No|No|No|No|75%|00904690804|ATOMOXETINE HCL 40 MG CAPSULE|30|EA|2.72175|11/27/2019||Yes|No||11/27/2019||Yes|No|11/27/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|1.0462|03/29/2022|1.02109|03/29/2022|1.02789|03/29/2022|||STIMULANTS AND RELATED AGENTS|6069|||||No|No||MAJOR PHARMACEU|No||||
polyethylene glycol 3350|No|No|No|No|75%|00904693126|POLYETHYLENE GLYCOL 3350 POWD|14|EA|.66957|12/10/2020||Yes|No||||No|No|12/10/2020||Yes|No||12/10/2020||Yes|No|||Over the counter|No|||No|1.51205|03/29/2022|1.47576|03/29/2022|1.48558|03/29/2022||||6070|||||No|No||MAJOR PHARMACEU|No||||
polyethylene glycol 3350|No|No|No|No|75%|00904693176|POLYETHYLENE GLYCOL 3350 POWD|30|EA|.59827|06/11/2020||Yes|No||||No|No|06/11/2020||Yes|No||06/11/2020||Yes|No|||Over the counter|No|||No|1.51205|03/29/2022|1.47576|03/29/2022|1.48558|03/29/2022||||6071|||||No|No||MAJOR PHARMACEU|No||||
polyethylene glycol 3350|No|No|No|No|75%|00904693181|POLYETHYLENE GLYCOL 3350 POWD|100|EA|.66972|06/11/2020||Yes|No||||No|No|06/11/2020||Yes|No||06/11/2020||Yes|No|||Over the counter|No|||No|1.51205|03/29/2022|1.47576|03/29/2022|1.48558|03/29/2022||||6072|||||No|No||MAJOR PHARMACEU|No||||
fexofenadine HCl|No|No|No|No|75%|00904697940|FEXOFENADINE HCL 60 MG TABLET|500|EA|.05892|03/03/2020|07/07/2022|Yes|No||||No|No|03/03/2020|07/07/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.15058|03/29/2022|.14696|03/29/2022|.14794|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|6073|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||MAJOR PHARMACEU|No||||
fexofenadine HCl|No|No|No|No|75%|00904697960|FEXOFENADINE HCL 60 MG TABLET|100|EA|.05766|03/03/2020|05/04/2022|Yes|No||||No|No|03/03/2020|05/04/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.15058|03/29/2022|.14696|03/29/2022|.14794|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|6074|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||MAJOR PHARMACEU|No||||
diphenhydramine HCl|No|No|No|No|75%|00904698516|DIPHENHYDRAMINE 12.5 MG/5 ML|473|ML|.00426|03/03/2020||Yes|No||||No|No|03/03/2020||Yes|No||03/03/2020||Yes|No|||Over the counter|No||574|Yes|.02458|03/29/2022|.02399|03/29/2022|.02414|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|6075|||||No|No||MAJOR PHARMACEU|No||||
diphenhydramine HCl|No|No|No|No|75%|00904698520|DIPHENHYDRAMINE 12.5 MG/5 ML|118|ML|.0087|06/16/2020||Yes|No||||No|No|06/16/2020||Yes|No||06/16/2020||Yes|No|||Over the counter|No||574|Yes|.01468|03/29/2022|.01432|03/29/2022|.01442|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|6076|||||No|No||MAJOR PHARMACEU|No||||
guaifenesin|No|No|No|No|75%|00904698640|MUCUS RELIEF ER 600 MG TABLET|500|EA|.11471|03/03/2020||Yes|No||||No|No|03/03/2020||Yes|No||||No|No|||Over the counter|No||182|Yes|.34047|03/29/2022|.33229|03/29/2022|.33451|03/29/2022|||COUGH AND COLD: COLD|6077|||||No|No||MAJOR PHARMACEU|No||||
simethicone|No|No|No|No|75%|00904699446|GAS RELIEF 125 MG SOFTGEL|30|EA|.02852|09/18/2020||Yes|No||||No|No|09/18/2020||Yes|No||||No|No|||Over the counter|No|||No|.06683|03/29/2022|.06522|03/29/2022|.06566|03/29/2022||||6078|||||No|No||MAJOR PHARMACEU|No||||
d-methorphan/PE/acetaminophen|No|No|No|No|75%|00904699544|DAYTIME COLD-FLU RELIEF SFTGL|16|EA|.07417|06/16/2020||Yes|No||||No|No|06/16/2020||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.16805|03/29/2022|.16401|03/29/2022|.1651|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|6079|||||No|No||MAJOR PHARMACEU|No||||
DM/acetaminophen/doxylamine|No|No|No|No|75%|00904699644|NIGHTTIME COLD-FLU RLF SFTGL|16|EA|.0602|12/03/2020||Yes|No||||No|No|12/03/2020||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.1281|03/29/2022|.12502|03/29/2022|.12585|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|6080|||||No|No||MAJOR PHARMACEU|No||||
docusate calcium|No|No|No|No|75%|00904699780|DOCUSATE CAL 240 MG SOFTGEL|1000|EA|.02109|08/18/2021||Yes|No||||No|No|08/18/2021||Yes|No||||No|No|||Over the counter|No|||No|.06192|03/29/2022|.06043|03/29/2022|.06083|03/29/2022||||6081|||||No|No||MAJOR PHARMACEU|No||||
docusate sodium|No|No|No|No|75%|00904699880|DOCUSATE SODIUM 100 MG SOFTGEL|1000|EA|.00573|07/28/2021||Yes|No||||No|No|07/28/2021||Yes|No||||No|No|||Over the counter|No|||No|.02114|03/29/2022|.02063|03/29/2022|.02077|03/29/2022||||6082|||||No|No||MAJOR PHARMACEU|No||||
oxymetazoline HCl|No|No|No|No|75%|00904700635|NASAL DECONGESTANT 0.05% SPRAY|15|ML|.04472|05/08/2020||Yes|No||||No|No|05/08/2020||Yes|No||||No|No|||Over the counter|No||182|Yes|.09747|11/23/2021|.09513|11/23/2021|.09576|11/23/2021|||COUGH AND COLD: COLD|6083|||||No|No||MAJOR PHARMACEU|No||||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00904700906|BUPRENORPHINE-NALOX 2-0.5MG TB|50|EA|1.33076|07/12/2021||Yes|No||07/12/2021||Yes|No|07/12/2021||Yes|No||||No|No|||Prescription required|No||145|Yes|.72296|03/29/2022|.7056|03/29/2022|.7103|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|6084|||||No|No||MAJOR PHARMACEU|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|00904701006|BUPRENORPHINE-NALOX 8-2 MG TAB|50|EA|1.71355|03/15/2021||Yes|No||03/15/2021||Yes|No|03/15/2021||Yes|No||||No|No|||Prescription required|No||145|Yes|1.08568|03/29/2022|1.05962|03/29/2022|1.06668|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|6085|||||No|No||MAJOR PHARMACEU|Yes|09/01/2020|||
bacitracin zinc|No|No|No|No|75%|00904702367|BACITRACIN ZN 500 UNIT/GM OINT|144|EA|.04664|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||02/04/2021||Yes|No|||Over the counter|Yes|01/30/2020|114|No|.1063|02/04/2021|.10478|02/04/2021|.09979|02/04/2021|||ANTIBIOTICS: TOPICAL|6086|||||No|No||MAJOR PHARMACEU|No||||
naltrexone HCl|No|No|No|No|75%|00904703604|NALTREXONE 50 MG TABLET|30|EA|.7674|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|.75734|03/29/2022|.73916|03/29/2022|.74408|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|6087|||||No|No||MAJOR PHARMACEU|Yes|09/01/2020|||
amantadine HCl|No|No|No|No|75%|00904704240|AMANTADINE 100 MG CAPSULE|500|EA|.42544|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|No||015|No|.2857|03/29/2022|.27884|03/29/2022|.2807|03/29/2022|||ANTIPARKINSON'S AGENTS|6088|||||No|No||MAJOR PHARMACEU|No||||
amantadine HCl|No|No|No|No|75%|00904704259|AMANTADINE 100 MG CAPSULE|100|EA|.42535|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|No||015|No|.2857|03/29/2022|.27884|03/29/2022|.2807|03/29/2022|||ANTIPARKINSON'S AGENTS|6089|||||No|No||MAJOR PHARMACEU|No||||
fexofenadine HCl|No|No|No|No|75%|00904705040|FEXOFENADINE HCL 180 MG TABLET|500|EA|.06837|06/17/2020||Yes|No||||No|No|06/17/2020||Yes|No||||No|No|||Over the counter|Yes|12/01/2021|030|Yes|.28782|03/29/2022|.28091|03/29/2022|.28278|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|6090|||||No|No||MAJOR PHARMACEU|No||||
fexofenadine HCl|No|No|No|No|75%|00904705060|FEXOFENADINE HCL 180 MG TABLET|100|EA|.05886|06/17/2020||Yes|No||||No|No|06/17/2020||Yes|No||||No|No|||Over the counter|Yes|12/01/2021|030|Yes|.28782|03/29/2022|.28091|03/29/2022|.28278|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|6091|||||No|No||MAJOR PHARMACEU|No||||
trospium chloride|No|No|No|No|75%|00904705952|TROSPIUM CHLORIDE 20 MG TABLET|60|EA|.17816|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|No|.42162|03/29/2022|.4115|03/29/2022|.41424|03/29/2022|||BLADDER RELAXANT PREPARATIONS|6092|||||No|No||MAJOR PHARMACEU|No||||
ciprofloxacin HCl|No|No|No|No|75%|00904708395|CIPROFLOXACIN HCL 500 MG TAB|20|EA|.11459|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||028|No|.13565|03/29/2022|.13239|03/29/2022|.13327|03/29/2022|||FLUOROQUINOLONES: ORAL|6093|||||No|No||MAJOR PHARMACEU|No||||
ferrous sulfate|No|No|No|No|75%|00904759060|FEROSUL 325 MG TABLET|100|EA|.00442|||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|.01009|07/07/2020|.00994|07/07/2020|.00947|07/07/2020||||6094|||||No|No||MAJOR PHARMACEU|No||||
ferrous sulfate|No|No|No|No|75%|00904759080|FEROSUL 325 MG TABLET|1000|EA|.00295|||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|.00674|07/07/2020|.00664|07/07/2020|.00632|07/07/2020||||6095|||||No|No||MAJOR PHARMACEU|No||||
ferrous sulfate|No|No|No|No|75%|00904759082|FEROSUL 325 MG TABLET|100|EA|.00528|||No|No||||No|No|||No|No||08/19/2013|04/05/2022|Yes|No|||Over the counter|No|||No|.01205|07/07/2020|.01188|07/07/2020|.01131|07/07/2020||||6096||||Discontinued by Manufacturer|No|No||MAJOR PHARMACEU|No||||
ferrous sulfate|No|No|No|No|75%|00904759160|FEROSUL 325 MG TABLET|100|EA|.00399|||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|.00911|07/07/2020|.00898|07/07/2020|.00855|07/07/2020||||6097|||||No|No||MAJOR PHARMACEU|No||||
ferrous sulfate|No|No|No|No|75%|00904759161|FERROUS SULFATE 325 MG TABLET|100|EA|.01195|||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|.02724|07/07/2020|.02685|07/07/2020|.02557|07/07/2020||||6098|||||No|No||MAJOR PHARMACEU|No||||
ferrous sulfate|No|No|No|No|75%|00904759180|FEROSUL 325 MG TABLET|1000|EA|.00334|||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|.00761|07/07/2020|.0075|07/07/2020|.00714|07/07/2020||||6099|||||No|No||MAJOR PHARMACEU|No||||
ferrous sulfate|No|No|No|No|75%|00904759182|FEROSUL 325 MG TABLET|100|EA|.00533|||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|.01215|07/07/2020|.01197|07/07/2020|.0114|07/07/2020||||6100|||||No|No||MAJOR PHARMACEU|No||||
hydrocortisone/aloe vera|No|No|No|No|75%|00904762331|HYDROCORTISONE-ALOE 1% CREAM|28|GM|.02211|09/01/1999|01/31/2022|Yes|No||||No|No|09/01/1999|01/31/2022|Yes|No||||No|No|||Over the counter|No||118|No|.05039|02/15/2022|.04967|02/15/2022|.0473|02/15/2022|||STEROIDS: TOPICAL LOW|6101|No Longer Rebatable||No Longer Rebatable||No|No||MAJOR PHARMACEU|No||||
loperamide HCl|No|No|No|No|75%|00904772512|ANTI-DIARRHEAL 2 MG CAPLET|12|EA|.04443|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||09/01/1999||Yes|No|||Over the counter|No|||No|.14456|03/29/2022|.14109|03/29/2022|.14203|03/29/2022||||6102|||||No|No||MAJOR PHARMACEU|No||||
mag carb/aluminum hydrox/algin|No|No|No|No|75%|00904772714|ACID GONE ANTACID LIQUID|355|ML|.00442|04/22/2003||Yes|No||||No|No|04/22/2003||Yes|No||||No|No|||Over the counter|No|||No|.01018|03/29/2022|.00993|03/29/2022|.01|03/29/2022||||6103|||||No|No||MAJOR PHARMACEU|No||||
clotrimazole|No|No|No|No|75%|00904782231|CLOTRIMAZOLE 1% TOPICAL CREAM|28.35|GM|.02608|09/01/1999|01/08/2022|Yes|No||||No|No|09/01/1999|01/08/2022|Yes|No||09/01/1999|01/08/2022|Yes|No|||Over the counter|No||061|No|.05945|10/26/2021|.0586|10/26/2021|.05581|10/26/2021|||ANTIFUNGALS: TOPICAL|6104|Discontinued by Manufacturer||Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||MAJOR PHARMACEU|No||||
clotrimazole|No|No|No|No|75%|00904782236|CLOTRIMAZOLE 1% TOPICAL CREAM|14.17|GM|.03732|04/21/2009|01/14/2022|Yes|No||||No|No|04/21/2009|01/14/2022|Yes|No||04/21/2009|01/14/2022|Yes|No|||Over the counter|No||061|No|.08506|12/28/2021|.08384|12/28/2021|.07985|12/28/2021|||ANTIFUNGALS: TOPICAL|6105|Discontinued by Manufacturer||Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||MAJOR PHARMACEU|No||||
ibuprofen|No|No|No|No|75%|00904791251|IBUPROFEN 200 MG CAPLET|50|EA|.0098|10/21/2003||Yes|No||||No|No|10/21/2003||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|6106|||||No|No||MAJOR PHARMACEU|No||||
ibuprofen|No|No|No|No|75%|00904791451|IBU-200 200 MG TABLET|50|EA|.02158|10/21/2003|08/11/2022|Yes|No||||No|No|10/21/2003|08/11/2022|Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|6107|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||MAJOR PHARMACEU|No||||
ibuprofen|No|No|No|No|75%|00904791459|IBU-200 200 MG TABLET|100|EA|.01775|10/21/2003||Yes|No||||No|No|10/21/2003||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|6108|||||No|No||MAJOR PHARMACEU|No||||
bacitracin zinc|No|No|No|No|75%|00904880467|BACITRACIN ZN 500 UNIT/GM OINT|144|EA|.0587|12/10/2020||Yes|No||||No|No|12/10/2020||Yes|No||12/10/2020||Yes|No|||Over the counter|Yes|01/30/2020|114|No|.13378|12/10/2020|.13187|12/10/2020|.12559|12/10/2020|||ANTIBIOTICS: TOPICAL|6109|||||No|No||MAJOR PHARMACEU|No||||
neomycin/bacitracin/polymyxinB|No|No|No|No|75%|00904880567|TRIPLE ANTIBIOTIC OINTMENT PKT|144|EA|.05664|04/15/2021||Yes|No||||No|No|04/15/2021||Yes|No||||No|No|||Over the counter|No||114|No|.12909|04/15/2021|.12725|04/15/2021|.12119|04/15/2021|||ANTIBIOTICS: TOPICAL|6110|||||No|No||MAJOR PHARMACEU|No||||
IgG/hyaluronidase,recombinant|No|No|No|No|75%|00944251002|HYQVIA 2.5 GM-200 UNIT PACK|26.25|ML|9.0947|09/19/2014||Yes|No||09/19/2014||Yes|No|09/19/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|20.72746|01/11/2022|20.43135|01/11/2022|19.45843|01/11/2022|||IMMUNE GLOBULINS|6111|||||No|No||BAXALTA US INC.|No||||
IgG/hyaluronidase,recombinant|No|No|No|No|75%|00944251102|HYQVIA 5 GM-400 UNIT PACK|52.5|ML|9.0947|09/19/2014||Yes|No||09/19/2014||Yes|No|09/19/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|20.72746|01/11/2022|20.43135|01/11/2022|19.45843|01/11/2022|||IMMUNE GLOBULINS|6112|||||No|No||BAXALTA US INC.|No||||
IgG/hyaluronidase,recombinant|No|No|No|No|75%|00944251202|HYQVIA 10 GM-800 UNIT PACK|105|ML|9.0947|09/19/2014||Yes|No||09/19/2014||Yes|No|09/19/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|20.72746|01/11/2022|20.43135|01/11/2022|19.45843|01/11/2022|||IMMUNE GLOBULINS|6113|||||No|No||BAXALTA US INC.|No||||
IgG/hyaluronidase,recombinant|No|No|No|No|75%|00944251302|HYQVIA 20 GM-1,600 UNIT PACK|210|ML|9.0947|09/19/2014||Yes|No||09/19/2014||Yes|No|09/19/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|20.72746|01/11/2022|20.43135|01/11/2022|19.45843|01/11/2022|||IMMUNE GLOBULINS|6114|||||No|No||BAXALTA US INC.|No||||
IgG/hyaluronidase,recombinant|No|No|No|No|75%|00944251402|HYQVIA 30 GM-2,400 UNIT PACK|315|ML|9.0947|09/19/2014||Yes|No||09/19/2014||Yes|No|09/19/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|20.72746|01/11/2022|20.43135|01/11/2022|19.45843|01/11/2022|||IMMUNE GLOBULINS|6115|||||No|No||BAXALTA US INC.|No||||
immun glob G(IgG)/gly/IgA ov50|No|No|No|No|75%|00944270002|GAMMAGARD LIQUID 10% VIAL|10|ML|6.67532|09/01/2005||Yes|No||09/01/2005||Yes|No|09/01/2005||Yes|No||||No|No|||Prescription required|No||023|No|15.21352|01/11/2022|14.99618|01/11/2022|14.28208|01/11/2022|||IMMUNE GLOBULINS|6116|||||No|No||BAXALTA US INC.|No||||
immun glob G(IgG)/gly/IgA ov50|No|No|No|No|75%|00944270003|GAMMAGARD LIQUID 10% VIAL|25|ML|6.67532|09/01/2005||Yes|No||09/01/2005||Yes|No|09/01/2005||Yes|No||||No|No|||Prescription required|No||023|No|15.21352|01/11/2022|14.99618|01/11/2022|14.28208|01/11/2022|||IMMUNE GLOBULINS|6117|||||No|No||BAXALTA US INC.|No||||
immun glob G(IgG)/gly/IgA ov50|No|No|No|No|75%|00944270004|GAMMAGARD LIQUID 10% VIAL|50|ML|6.67532|09/01/2005||Yes|No||09/01/2005||Yes|No|09/01/2005||Yes|No||||No|No|||Prescription required|No||023|No|15.21352|01/11/2022|14.99618|01/11/2022|14.28208|01/11/2022|||IMMUNE GLOBULINS|6118|||||No|No||BAXALTA US INC.|No||||
immun glob G(IgG)/gly/IgA ov50|No|No|No|No|75%|00944270005|GAMMAGARD LIQUID 10% VIAL|100|ML|6.67532|09/01/2005||Yes|No||09/01/2005||Yes|No|09/01/2005||Yes|No||||No|No|||Prescription required|No||023|No|15.21352|01/11/2022|14.99618|01/11/2022|14.28208|01/11/2022|||IMMUNE GLOBULINS|6119|||||No|No||BAXALTA US INC.|No||||
immun glob G(IgG)/gly/IgA ov50|No|No|No|No|75%|00944270006|GAMMAGARD LIQUID 10% VIAL|200|ML|6.67532|09/01/2005||Yes|No||09/01/2005||Yes|No|09/01/2005||Yes|No||||No|No|||Prescription required|No||023|No|15.21352|01/11/2022|14.99618|01/11/2022|14.28208|01/11/2022|||IMMUNE GLOBULINS|6120|||||No|No||BAXALTA US INC.|No||||
immun glob G(IgG)/gly/IgA ov50|No|No|No|No|75%|00944270007|GAMMAGARD LIQUID 10% VIAL|300|ML|6.67532|02/23/2011||Yes|No||02/23/2011||Yes|No|02/23/2011||Yes|No||||No|No|||Prescription required|No||023|No|15.21352|01/11/2022|14.99618|01/11/2022|14.28208|01/11/2022|||IMMUNE GLOBULINS|6121|||||No|No||BAXALTA US INC.|No||||
alpha-1-proteinase inhibitor|No|No|No|No|75%|00944281401|ARALAST NP 500 MG VIAL|1|EA|.2537|09/15/2014||Yes|No||09/15/2014||Yes|No|09/15/2014||Yes|No||||No|No|||Prescription required|No|||No|.5782|01/11/2022|.56994|01/11/2022|.5428|01/11/2022||||6122|||||No|No||BAXALTA US INC.|No||||
alpha-1-proteinase inhibitor|No|No|No|No|75%|00944281501|ARALAST NP 1,000 MG VIAL|1|EA|.2537|09/15/2014||Yes|No||09/15/2014||Yes|No|09/15/2014||Yes|No||||No|No|||Prescription required|No|||No|.5782|01/11/2022|.56994|01/11/2022|.5428|01/11/2022||||6123|||||No|No||BAXALTA US INC.|No||||
antihemophilic factor, hum rec|No|No|No|No|75%|00944284110|RECOMBINATE 220-400 UNIT VIAL|1|EA|1.2172|02/07/2011||Yes|No||02/07/2011||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.7542|01/11/2022|1.72914|01/11/2022|1.6468|01/11/2022|||HEMOPHILIA TREATMENT|6124|||||No|No||BAXALTA US INC.|No||||
antihemophilic factor, hum rec|No|No|No|No|75%|00944284210|RECOMBINATE 401-800 UNIT VIAL|1|EA|1.2172|02/07/2011||Yes|No||02/07/2011||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.7542|01/11/2022|1.72914|01/11/2022|1.6468|01/11/2022|||HEMOPHILIA TREATMENT|6125|||||No|No||BAXALTA US INC.|No||||
antihemophilic factor, hum rec|No|No|No|No|75%|00944284310|RECOMBINATE 801-1,240 UNIT VL|1|EA|1.2172|02/07/2011||Yes|No||02/07/2011||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.7542|01/11/2022|1.72914|01/11/2022|1.6468|01/11/2022|||HEMOPHILIA TREATMENT|6126|||||No|No||BAXALTA US INC.|No||||
antihemophilic factor, hum rec|No|No|No|No|75%|00944284410|RECOMBINATE 1,241-1,800 UNIT V|1|EA|1.2172|02/07/2011||Yes|No||02/07/2011||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.7542|01/11/2022|1.72914|01/11/2022|1.6468|01/11/2022|||HEMOPHILIA TREATMENT|6127|||||No|No||BAXALTA US INC.|No||||
antihemophilic factor, hum rec|No|No|No|No|75%|00944284510|RECOMBINATE 1,801-2,400 UNIT V|1|EA|1.2172|02/07/2011||Yes|No||02/07/2011||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.7542|01/11/2022|1.72914|01/11/2022|1.6468|01/11/2022|||HEMOPHILIA TREATMENT|6128|||||No|No||BAXALTA US INC.|No||||
immun glob G(IgG)/gly/IgA ov50|No|No|No|No|75%|00944285001|CUVITRU 1 GRAM/5 ML VIAL|5|ML|17.34448|02/15/2017||Yes|No||02/15/2017||Yes|No|02/15/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|023|No|39.52928|01/11/2022|38.96457|01/11/2022|37.10912|01/11/2022|||IMMUNE GLOBULINS|6129|||||No|No||SHIRE/TAKEDA PH|No||||
immun glob G(IgG)/gly/IgA ov50|No|No|No|No|75%|00944285003|CUVITRU 2 GRAM/10 ML VIAL|10|ML|17.34448|02/15/2017||Yes|No||02/15/2017||Yes|No|02/15/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|023|No|39.52928|01/11/2022|38.96457|01/11/2022|37.10912|01/11/2022|||IMMUNE GLOBULINS|6130|||||No|No||SHIRE/TAKEDA PH|No||||
immun glob G(IgG)/gly/IgA ov50|No|No|No|No|75%|00944285005|CUVITRU 4 GRAM/20 ML VIAL|20|ML|17.34448|02/15/2017||Yes|No||02/15/2017||Yes|No|02/15/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|023|No|39.52928|01/11/2022|38.96457|01/11/2022|37.10912|01/11/2022|||IMMUNE GLOBULINS|6131|||||No|No||SHIRE/TAKEDA PH|No||||
immun glob G(IgG)/gly/IgA ov50|No|No|No|No|75%|00944285007|CUVITRU 8 GRAM/ 40 ML VIAL|40|ML|17.34448|02/15/2017||Yes|No||02/15/2017||Yes|No|02/15/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|023|No|39.52928|01/11/2022|38.96457|01/11/2022|37.10912|01/11/2022|||IMMUNE GLOBULINS|6132|||||No|No||SHIRE/TAKEDA PH|No||||
immun glob G(IgG)/gly/IgA ov50|No|No|No|No|75%|00944285009|CUVITRU 10 GRAM/50 ML VIAL|50|ML|17.34448|02/14/2020||Yes|No||02/14/2020||Yes|No|02/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|023|No|39.52928|01/11/2022|38.96457|01/11/2022|37.10912|01/11/2022|||IMMUNE GLOBULINS|6133|||||No|No||SHIRE/TAKEDA PH|No||||
alpha-1-proteinase inhibitor|No|No|No|No|75%|00944288401|GLASSIA 1 GM/50 ML VIAL|1|EA|.258|10/11/2010||Yes|No||10/11/2010||Yes|No|10/11/2010||Yes|No||||No|No|||Prescription required|No|||No|.588|01/11/2022|.5796|01/11/2022|.552|01/11/2022||||6134|||||No|No||BAXALTA US INC.|No||||
factor IX human recombinant|No|No|No|No|75%|00944302602|RIXUBIS 250 UNIT NOMINAL|1|EA|1.156|06/28/2013||Yes|No||06/28/2013||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.666|01/11/2022|1.6422|01/11/2022|1.564|01/11/2022|||HEMOPHILIA TREATMENT|6135|||||No|No||BAXALTA US INC.|No||||
factor IX human recombinant|No|No|No|No|75%|00944302802|RIXUBIS 500 UNIT NOMINAL|1|EA|1.156|06/28/2013||Yes|No||06/28/2013||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.666|01/11/2022|1.6422|01/11/2022|1.564|01/11/2022|||HEMOPHILIA TREATMENT|6136|||||No|No||BAXALTA US INC.|No||||
factor IX human recombinant|No|No|No|No|75%|00944303002|RIXUBIS 1,000 UNIT NOMINAL|1|EA|1.156|06/28/2013||Yes|No||06/28/2013||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.666|01/11/2022|1.6422|01/11/2022|1.564|01/11/2022|||HEMOPHILIA TREATMENT|6137|||||No|No||BAXALTA US INC.|No||||
factor IX human recombinant|No|No|No|No|75%|00944303202|RIXUBIS 2,000 UNIT NOMINAL|1|EA|1.156|06/28/2013||Yes|No||06/28/2013||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.666|01/11/2022|1.6422|01/11/2022|1.564|01/11/2022|||HEMOPHILIA TREATMENT|6138|||||No|No||BAXALTA US INC.|No||||
factor IX human recombinant|No|No|No|No|75%|00944303402|RIXUBIS 3,000 UNIT NOMINAL|1|EA|1.156|06/28/2013||Yes|No||06/28/2013||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.666|01/11/2022|1.6422|01/11/2022|1.564|01/11/2022|||HEMOPHILIA TREATMENT|6139|||||No|No||BAXALTA US INC.|No||||
antihemophil.FVIII,full length|No|No|No|No|75%|00944304510|ADVATE 1,801-2,400 UNIT VIAL|1|EA|1.2172|07/03/2014||Yes|No||07/03/2014||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.7542|01/11/2022|1.72914|01/11/2022|1.6468|01/11/2022|||HEMOPHILIA TREATMENT|6140|||||No|No||BAXALTA US INC.|No||||
antihemophil.FVIII,full length|No|No|No|No|75%|00944304610|ADVATE 2,401-3,600 UNIT VIAL|1|EA|1.2172|07/03/2014||Yes|No||07/03/2014||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.7542|01/11/2022|1.72914|01/11/2022|1.6468|01/11/2022|||HEMOPHILIA TREATMENT|6141|||||No|No||BAXALTA US INC.|No||||
antihemophil.FVIII,full length|No|No|No|No|75%|00944304710|ADVATE 3,601-4,800 UNIT VIAL|1|EA|1.2172|07/03/2014||Yes|No||07/03/2014||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.7542|01/11/2022|1.72914|01/11/2022|1.6468|01/11/2022|||HEMOPHILIA TREATMENT|6142|||||No|No||BAXALTA US INC.|No||||
antihemophil.FVIII,full length|No|No|No|No|75%|00944305102|ADVATE 200-400 UNIT VIAL|1|EA|1.2172|07/03/2014||Yes|No||07/03/2014||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.7542|01/11/2022|1.72914|01/11/2022|1.6468|01/11/2022|||HEMOPHILIA TREATMENT|6143|||||No|No||BAXALTA US INC.|No||||
antihemophil.FVIII,full length|No|No|No|No|75%|00944305202|ADVATE 401-800 UNIT VIAL|1|EA|1.2172|07/03/2014||Yes|No||07/03/2014||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.7542|01/11/2022|1.72914|01/11/2022|1.6468|01/11/2022|||HEMOPHILIA TREATMENT|6144|||||No|No||BAXALTA US INC.|No||||
antihemophil.FVIII,full length|No|No|No|No|75%|00944305302|ADVATE 801-1,200 UNIT VIAL|1|EA|1.2172|07/03/2014||Yes|No||07/03/2014||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.7542|01/11/2022|1.72914|01/11/2022|1.6468|01/11/2022|||HEMOPHILIA TREATMENT|6145|||||No|No||BAXALTA US INC.|No||||
antihemophil.FVIII,full length|No|No|No|No|75%|00944305402|ADVATE 1,201-1,800 UNIT VIAL|1|EA|1.2172|07/03/2014||Yes|No||07/03/2014||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.7542|01/11/2022|1.72914|01/11/2022|1.6468|01/11/2022|||HEMOPHILIA TREATMENT|6146|||||No|No||BAXALTA US INC.|No||||
antihemophilic factor, human|No|No|No|No|75%|00944394002|HEMOFIL M 250 UNIT NOMINAL|1|EA|1.02|10/15/2013||Yes|No||10/15/2013||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.47|01/11/2022|1.449|01/11/2022|1.38|01/11/2022|||HEMOPHILIA TREATMENT|6147|||||No|No||BAXALTA US INC.|No||||
antihemophilic factor, human|No|No|No|No|75%|00944394202|HEMOFIL M 500 UNIT NOMINAL|1|EA|1.02|10/15/2013||Yes|No||10/15/2013||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.47|01/11/2022|1.449|01/11/2022|1.38|01/11/2022|||HEMOPHILIA TREATMENT|6148|||||No|No||BAXALTA US INC.|No||||
antihemophilic factor, human|No|No|No|No|75%|00944394402|HEMOFIL M 1,000 UNIT NOMINAL|1|EA|1.02|10/15/2013||Yes|No||10/15/2013||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.47|01/11/2022|1.449|01/11/2022|1.38|01/11/2022|||HEMOPHILIA TREATMENT|6149|||||No|No||BAXALTA US INC.|No||||
antihemophilic factor, human|No|No|No|No|75%|00944394602|HEMOFIL M 1,700 UNIT NOMINAL|1|EA|1.02|10/15/2013||Yes|No||10/15/2013||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.47|01/11/2022|1.449|01/11/2022|1.38|01/11/2022|||HEMOPHILIA TREATMENT|6150|||||No|No||BAXALTA US INC.|No||||
protein C, human|No|No|No|No|75%|00944417910|CEPROTIN 800-1,200 UNIT VIAL|1|EA|.645|09/07/2015||Yes|No||09/07/2015||Yes|No|||No|No||||No|No|||Prescription required|No|||Yes|1.47|06/01/2016|1.449|06/01/2016|1.38|06/01/2016||||6151|||||No|No||BAXALTA US INC.|No||||
antihemo.FVIII,full length peg|No|No|No|No|75%|00944462201|ADYNOVATE 200-400 UNIT VIAL|1|EA|1.5572|11/09/2016||Yes|No||11/09/2016||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.2442|01/11/2022|2.21214|01/11/2022|2.1068|01/11/2022|||HEMOPHILIA TREATMENT|6152|||||No|No||BAXALTA US INC.|No||||
antihemo.FVIII,full length peg|No|No|No|No|75%|00944462301|ADYNOVATE 401-800 UNIT VIAL|1|EA|1.5572|11/09/2016||Yes|No||11/09/2016||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.2442|01/11/2022|2.21214|01/11/2022|2.1068|01/11/2022|||HEMOPHILIA TREATMENT|6153|||||No|No||BAXALTA US INC.|No||||
antihemo.FVIII,full length peg|No|No|No|No|75%|00944462401|ADYNOVATE 801-1,250 UNIT VIAL|1|EA|1.5572|11/09/2016||Yes|No||11/09/2016||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.2442|01/11/2022|2.21214|01/11/2022|2.1068|01/11/2022|||HEMOPHILIA TREATMENT|6154|||||No|No||BAXALTA US INC.|No||||
antihemo.FVIII,full length peg|No|No|No|No|75%|00944462501|ADYNOVATE 1,251-2,500 UNIT VL|1|EA|1.5572|11/09/2016||Yes|No||11/09/2016||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.2442|01/11/2022|2.21214|01/11/2022|2.1068|01/11/2022|||HEMOPHILIA TREATMENT|6155|||||No|No||BAXALTA US INC.|No||||
antihemo.FVIII,full length peg|No|No|No|No|75%|00944462601|ADYNOVATE 750 UNIT VIAL|1|EA|1.5572|02/21/2017||Yes|No||02/21/2017||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.2442|01/11/2022|2.21214|01/11/2022|2.1068|01/11/2022|||HEMOPHILIA TREATMENT|6156|||||No|No||BAXALTA US INC.|No||||
antihemo.FVIII,full length peg|No|No|No|No|75%|00944462701|ADYNOVATE 1,500 UNIT VIAL|1|EA|1.5572|02/21/2017||Yes|No||02/21/2017||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.2442|01/11/2022|2.21214|01/11/2022|2.1068|01/11/2022|||HEMOPHILIA TREATMENT|6157|||||No|No||BAXALTA US INC.|No||||
antihemo.FVIII,full length peg|No|No|No|No|75%|00944462801|ADYNOVATE 3,000 UNIT VIAL|1|EA|1.5572|05/15/2017||Yes|No||05/15/2017||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.2442|01/11/2022|2.21214|01/11/2022|2.1068|01/11/2022|||HEMOPHILIA TREATMENT|6158|||||No|No||BAXALTA US INC.|No||||
von Willebrand factor|No|No|No|No|75%|00944755102|VONVENDI 650 UNIT VIAL|1|EA|1.3464|12/29/2016||Yes|No||12/29/2016||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.9404|12/29/2016|1.91268|12/29/2016|1.8216|12/29/2016|||HEMOPHILIA TREATMENT|6159|||||No|No||BAXALTA US INC.|No||||
von Willebrand factor|No|No|No|No|75%|00944755302|VONVENDI 1,300 UNIT VIAL|1|EA|1.3464|12/29/2016||Yes|No||12/29/2016||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.9404|12/29/2016|1.91268|12/29/2016|1.8216|12/29/2016|||HEMOPHILIA TREATMENT|6160|||||No|No||BAXALTA US INC.|No||||
enoxaparin sodium|No|No|No|No|75%|00955100310|ENOXAPARIN 30 MG/0.3 ML SYR|.3|ML|9.19483|07/22/2013||Yes|No||07/22/2013||Yes|No|07/22/2013||Yes|No||||No|No|||Prescription required|No||068|Yes|12.85641|03/29/2022|12.54785|03/29/2022|12.63142|03/29/2022|||ANTICOAGULANTS|6161|||||No|No||WINTHROP US|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|00955100410|ENOXAPARIN 40 MG/0.4 ML SYR|.4|ML|9.17942|07/22/2013||Yes|No||07/22/2013||Yes|No|07/22/2013||Yes|No||||No|No|||Prescription required|No||068|Yes|11.94818|03/29/2022|11.66142|03/29/2022|11.73908|03/29/2022|||ANTICOAGULANTS|6162|||||No|No||WINTHROP US|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|00955100610|ENOXAPARIN 60 MG/0.6 ML SYR|.6|ML|9.18981|07/22/2013||Yes|No||07/22/2013||Yes|No|07/22/2013||Yes|No||||No|No|||Prescription required|No||068|Yes|11.41069|03/29/2022|11.13683|03/29/2022|11.211|03/29/2022|||ANTICOAGULANTS|6163|||||No|No||WINTHROP US|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|00955100810|ENOXAPARIN 80 MG/0.8 ML SYR|.8|ML|9.18748|07/22/2013||Yes|No||07/22/2013||Yes|No|07/22/2013||Yes|No||||No|No|||Prescription required|No||068|Yes|12.0025|03/29/2022|11.71444|03/29/2022|11.79245|03/29/2022|||ANTICOAGULANTS|6164|||||No|No||WINTHROP US|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|00955101010|ENOXAPARIN 100 MG/ML SYRINGE|1|ML|9.1891|07/22/2013||Yes|No||07/22/2013||Yes|No|07/22/2013||Yes|No||||No|No|||Prescription required|No||068|Yes|11.81296|03/29/2022|11.52944|03/29/2022|11.60623|03/29/2022|||ANTICOAGULANTS|6165|||||No|No||WINTHROP US|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|00955101210|ENOXAPARIN 120 MG/0.8 ML SYR|.8|ML|13.78096|07/22/2013||Yes|No||07/22/2013||Yes|No|07/22/2013||Yes|No||||No|No|||Prescription required|No||068|Yes|15.335|03/29/2022|14.96696|03/29/2022|15.06663|03/29/2022|||ANTICOAGULANTS|6166|||||No|No||WINTHROP US|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|00955101510|ENOXAPARIN 150 MG/ML SYRINGE|1|ML|13.7815|07/22/2013||Yes|No||07/22/2013||Yes|No|07/22/2013||Yes|No||||No|No|||Prescription required|No||068|Yes|15.18|03/29/2022|14.81568|03/29/2022|14.91435|03/29/2022|||ANTICOAGULANTS|6167|||||No|No||WINTHROP US|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|00955101601|ENOXAPARIN 300 MG/3 ML VIAL|3|ML|9.19483|11/13/2013||Yes|No||11/13/2013||Yes|No|11/13/2013||Yes|No||||No|No|||Prescription required|No||068|Yes|20.95566|01/25/2022|20.65629|01/25/2022|19.67266|01/25/2022|||ANTICOAGULANTS|6168|||||No|No||WINTHROP US|Yes|09/01/2020|||
irbesartan|No|No|No|No|75%|00955104090|IRBESARTAN 75 MG TABLET|90|EA|.15685|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.21751|03/29/2022|.21228|03/29/2022|.2137|03/29/2022|||ANGIOTENSIN MODULATORS|6169|||||No|No||WINTHROP US|No||||
irbesartan|No|No|No|No|75%|00955104190|IRBESARTAN 150 MG TABLET|90|EA|.16512|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.20852|03/29/2022|.20351|03/29/2022|.20487|03/29/2022|||ANGIOTENSIN MODULATORS|6170|||||No|No||WINTHROP US|No||||
irbesartan|No|No|No|No|75%|00955104290|IRBESARTAN 300 MG TABLET|90|EA|.19846|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.32541|03/29/2022|.3176|03/29/2022|.31971|03/29/2022|||ANGIOTENSIN MODULATORS|6171|||||No|No||WINTHROP US|No||||
irbesartan/hydrochlorothiazide|No|No|No|No|75%|00955104590|IRBESARTAN-HCTZ 150-12.5 MG TB|90|EA|.2396|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.24959|03/29/2022|.24359|03/29/2022|.24522|03/29/2022|||ANGIOTENSIN MODULATORS|6172|||||No|No||WINTHROP US|No||||
irbesartan/hydrochlorothiazide|No|No|No|No|75%|00955104690|IRBESARTAN-HCTZ 300-12.5 MG TB|90|EA|.26105|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.26247|03/29/2022|.25617|03/29/2022|.25787|03/29/2022|||ANGIOTENSIN MODULATORS|6173|||||No|No||WINTHROP US|No||||
sevelamer HCl|No|No|No|No|75%|00955104818|SEVELAMER HCL 800 MG TABLET|180|EA|2.58|06/05/2019||Yes|No||06/05/2019||Yes|No|06/05/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|052|Yes|4.51707|12/28/2021|4.40866|12/28/2021|4.43802|12/28/2021|||PHOSPHATE BINDERS|6174|||||No|No||WINTHROP US|No||||
sevelamer carbonate|No|No|No|No|75%|00955105027|SEVELAMER CARBONATE 800 MG TAB|270|EA|.73186|02/02/2018||Yes|No||02/02/2018||Yes|No|02/02/2018||Yes|No||||No|No|||Prescription required|Yes|11/03/2017|052|Yes|.27122|03/29/2022|.26471|03/29/2022|.26647|03/29/2022|||PHOSPHATE BINDERS|6175|||||No|No||WINTHROP US|No||||
sevelamer carbonate|No|No|No|No|75%|00955105290|SEVELAMER 0.8 GM POWDER PACKET|90|EA|4.06588|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|052|Yes|9.26643|01/25/2022|9.13406|01/25/2022|8.6991|01/25/2022|||PHOSPHATE BINDERS|6176|||||No|No||WINTHROP US|No||||
sevelamer carbonate|No|No|No|No|75%|00955105490|SEVELAMER 2.4 GM POWDER PACKET|90|EA|4.06588|12/29/2020||Yes|No||12/29/2020||Yes|No|12/29/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|052|Yes|6.45324|08/24/2021|6.29836|08/24/2021|6.3403|08/24/2021|||PHOSPHATE BINDERS|6177|||||No|No||WINTHROP US|No||||
zolpidem tartrate|No|No|No|No|90%|00955170210|ZOLPIDEM TART ER 6.25 MG TAB|100|EA|.5762|06/11/2012||Yes|No||06/11/2012||Yes|No|06/11/2012||Yes|No||||No|No|||Prescription required|Yes|07/28/2010|054|Yes|.20271|03/29/2022|.19784|03/29/2022|.19916|03/29/2022|||SEDATIVE HYPNOTICS|6178|||||No|No||WINTHROP US|No||||
zolpidem tartrate|No|No|No|No|90%|00955170310|ZOLPIDEM TART ER 12.5 MG TAB|100|EA|.5762|06/11/2012||Yes|No||06/11/2012||Yes|No|06/11/2012||Yes|No||||No|No|||Prescription required|Yes|07/28/2010|054|Yes|.24181|03/29/2022|.236|03/29/2022|.23757|03/29/2022|||SEDATIVE HYPNOTICS|6179|||||No|No||WINTHROP US|No||||
doxercalciferol|No|No|No|No|75%|00955172050|DOXERCALCIFEROL 0.5 MCG CAP|50|EA|2.58|09/06/2017||Yes|No||09/06/2017||Yes|No|09/06/2017||Yes|No||||No|No|||Prescription required|No|||No|5.88|09/06/2017|5.796|09/12/2017|5.52|09/06/2017||||6180|||||No|No||WINTHROP US|No||||
doxercalciferol|No|No|No|No|75%|00955172150|DOXERCALCIFEROL 1 MCG CAPSULE|50|EA|5.16|09/06/2017||Yes|No||09/06/2017||Yes|No|09/06/2017||Yes|No||||No|No|||Prescription required|No|||No|11.76|09/06/2017|11.592|09/12/2017|11.04|09/06/2017||||6181|||||No|No||WINTHROP US|No||||
doxercalciferol|No|No|No|No|75%|00955172250|DOXERCALCIFEROL 2.5 MCG CAP|50|EA|5.977|09/06/2017||Yes|No||09/06/2017||Yes|No|09/06/2017||Yes|No||||No|No|||Prescription required|No|||No|13.622|09/06/2017|13.4274|09/06/2017|12.788|09/06/2017||||6182|||||No|No||WINTHROP US|No||||
leflunomide|No|No|No|No|75%|00955173530|LEFLUNOMIDE 10 MG TABLET|30|EA|2.15|10/01/2015|08/05/2022|Yes|No||10/01/2015|08/05/2022|Yes|No|10/01/2015|08/05/2022|Yes|No||||No|No|||Prescription required|No|||No|.80538|03/29/2022|.78605|03/29/2022|.79128|03/29/2022||||6183|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||WINTHROP US|No||||
leflunomide|No|No|No|No|75%|00955173730|LEFLUNOMIDE 20 MG TABLET|30|EA|2.15|10/01/2015||Yes|No||10/01/2015||Yes|No|10/01/2015||Yes|No||||No|No|||Prescription required|No|||No|.61902|03/29/2022|.60416|03/29/2022|.60818|03/29/2022||||6184|||||No|No||WINTHROP US|No||||
sodium chloride irrig solution|No|No|No|No|75%|00990613803|SODIUM CHLORIDE 0.9% IRRIG.|500|ML|.00451|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.01029|02/03/2022|.01014|02/03/2022|.00966|02/03/2022||||6185|||||No|No||ICU MEDICAL INC|No||||
sodium chloride irrig solution|No|No|No|No|75%|00990613822|SODIUM CHLORIDE 0.9% IRRIG.|250|ML|.00903|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.02058|02/03/2022|.02028|02/03/2022|.01932|02/03/2022||||6186|||||No|No||ICU MEDICAL INC|No||||
water for irrigation,sterile|No|No|No|No|75%|00990613903|STERILE WATER FOR IRRIGATION|500|ML|.00451|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.01029|02/03/2022|.01014|02/03/2022|.00966|02/03/2022||||6187|||||No|No||ICU MEDICAL INC|No||||
water for irrigation,sterile|No|No|No|No|75%|00990613922|STERILE WATER FOR IRRIGATION|250|ML|.00903|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.02058|02/03/2022|.02028|02/03/2022|.01932|02/03/2022||||6188|||||No|No||ICU MEDICAL INC|No||||
physiological irrig soln no.1|No|No|No|No|75%|00990614109|PHYSIOSOL IRRIGATION SOLN|1000|ML|.00225|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00514|02/03/2022|.00507|02/03/2022|.00483|02/03/2022||||6189|||||No|No||ICU MEDICAL INC|No||||
acetic acid|No|No|No|No|75%|00990614309|ACETIC ACID 0.25% IRRIG SOLN|1000|ML|.00225|01/25/2022||Yes|No||01/25/2022||Yes|No|01/25/2022||Yes|No||||No|No|||Prescription required|No|||No|.00514|01/25/2022|.00507|01/25/2022|.00483|01/25/2022||||6190|||||No|No||ICU MEDICAL INC|No||||
acetic acid|No|No|No|No|75%|00990614322|ACETIC ACID 0.25% IRRIG SOLN|250|ML|.00903|01/25/2022||Yes|No||01/25/2022||Yes|No|01/25/2022||Yes|No||||No|No|||Prescription required|No|||No|.02058|01/25/2022|.02028|01/25/2022|.01932|01/25/2022||||6191|||||No|No||ICU MEDICAL INC|No||||
potassium chloride in water|No|No|No|No|75%|00990707426|POTASSIUM CL 10 MEQ/100 ML SOL|100|ML|.02094|03/03/2022||Yes|No||03/03/2022||Yes|No|03/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.04772|03/03/2022|.04704|03/03/2022|.0448|03/03/2022||||6192|||||No|No||ICU MEDICAL INC|No||||
potassium chloride in water|No|No|No|No|75%|00990707526|POTASSIUM CL 20 MEQ/100 ML SOL|100|ML|.01143|03/03/2022||Yes|No||03/03/2022||Yes|No|03/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.02606|03/03/2022|.02569|03/03/2022|.02447|03/03/2022||||6193|||||No|No||ICU MEDICAL INC|No||||
potassium chloride in water|No|No|No|No|75%|00990707714|POTASSIUM CL 20 MEQ/50 ML SOL|50|ML|.04308|03/03/2022||Yes|No||03/03/2022||Yes|No|03/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.09819|03/03/2022|.09679|03/03/2022|.09218|03/03/2022||||6194|||||No|No||ICU MEDICAL INC|No||||
potassium chloride in water|No|No|No|No|75%|00990707726|POTASSIUM CL 40 MEQ/100 ML SOL|100|ML|.02197|03/03/2022||Yes|No||03/03/2022||Yes|No|03/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.05007|03/03/2022|.04936|03/03/2022|.04701|03/03/2022||||6195|||||No|No||ICU MEDICAL INC|No||||
potassium chloride/D5-0.9%NaCl|No|No|No|No|75%|00990710709|KCL 20 MEQ IN D5W-NS|1000|ML|.00305|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00696|02/03/2022|.00686|02/03/2022|.00654|02/03/2022||||6196|||||No|No||ICU MEDICAL INC|No||||
potassium chloride/D5-0.9%NaCl|No|No|No|No|75%|00990710909|KCL 40 MEQ IN D5W-NACL 0.9%|1000|ML|.00343|03/03/2022||Yes|No||03/03/2022||Yes|No|03/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00782|03/03/2022|.0077|03/03/2022|.00734|03/03/2022||||6197|||||No|No||ICU MEDICAL INC|No||||
potassium chloride in LR-D5|No|No|No|No|75%|00990711109|KCL 20 MEQ IN D5W-LACT RINGER|1000|ML|.00376|03/03/2022||Yes|No||03/03/2022||Yes|No|03/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00857|03/03/2022|.00845|03/03/2022|.00805|03/03/2022||||6198|||||No|No||ICU MEDICAL INC|No||||
potassium chloride in 0.9%NaCl|No|No|No|No|75%|00990711509|POTASSIUM CL 20 MEQ/1,000ML-NS|1000|ML|.00294|03/03/2022||Yes|No||03/03/2022||Yes|No|03/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00672|03/03/2022|.00662|03/03/2022|.00631|03/03/2022||||6199|||||No|No||ICU MEDICAL INC|No||||
potassium chloride in 0.9%NaCl|No|No|No|No|75%|00990711609|POTASSIUM CL 40 MEQ/1,000ML-NS|1000|ML|.00368|03/03/2022||Yes|No||03/03/2022||Yes|No|03/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.0084|03/03/2022|.00828|03/03/2022|.00789|03/03/2022||||6200|||||No|No||ICU MEDICAL INC|No||||
water for injection,sterile|No|No|No|No|75%|00990711807|STERILE WATER FOR INJECTION|2000|ML|.00112|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|No|||No|.00256|02/09/2022|.00253|02/09/2022|.00241|02/09/2022||||6201|||||No|No||ICU MEDICAL INC|No||||
dextrose 70 % in water|No|No|No|No|75%|00990712007|DEXTROSE 70%-WATER IV SOLN|2000|ML|.00399|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00911|02/03/2022|.00898|02/03/2022|.00855|02/03/2022||||6202|||||No|No||ICU MEDICAL INC|No||||
sodium chloride irrig solution|No|No|No|No|75%|00990713809|SODIUM CHLORIDE 0.9% IRRIG|1000|ML|.00225|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00514|02/03/2022|.00507|02/03/2022|.00483|02/03/2022||||6203|||||No|No||ICU MEDICAL INC|No||||
sodium chloride irrig solution|No|No|No|No|75%|00990713836|SODIUM CHLORIDE 0.9% IRRIG.|1500|ML|.0015|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00343|02/03/2022|.00338|02/03/2022|.00322|02/03/2022||||6204|||||No|No||ICU MEDICAL INC|No||||
water for irrigation,sterile|No|No|No|No|75%|00990713909|STERILE WATER FOR IRRIGATION|1000|ML|.00225|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00514|02/03/2022|.00507|02/03/2022|.00483|02/03/2022||||6205|||||No|No||ICU MEDICAL INC|No||||
water for irrigation,sterile|No|No|No|No|75%|00990713936|STERILE WATER FOR IRRIGATION|1500|ML|.0015|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00343|02/03/2022|.00338|02/03/2022|.00322|02/03/2022||||6206|||||No|No||ICU MEDICAL INC|No||||
sodium chloride 0.45 %|No|No|No|No|75%|00990773036|SODIUM CHLORIDE 0.45% SOLN|50|ML|.02451|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|.05586|02/02/2022|.05506|02/02/2022|.05244|02/02/2022||||6207|||||No|No||ICU MEDICAL INC|No||||
sodium chloride 0.45 %|No|No|No|No|75%|00990773037|SODIUM CHLORIDE 0.45% SOLN|100|ML|.00152|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|.00347|02/02/2022|.00342|02/02/2022|.00326|02/02/2022||||6208|||||No|No||ICU MEDICAL INC|No||||
Ringer's solution,lactated|No|No|No|No|75%|00990782808|LACTATED RINGERS IRRIGATION|3000|ML|.00179|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|.00409|02/02/2022|.00403|02/02/2022|.00384|02/02/2022||||6209|||||No|No||ICU MEDICAL INC|No||||
potassium chloride/D5-0.2%NaCl|No|No|No|No|75%|00990790109|KCL 20 MEQ IN D5W-0.225% NACL|1000|ML|.00313|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|.00713|02/02/2022|.00703|02/02/2022|.00669|02/02/2022||||6210|||||No|No||ICU MEDICAL INC|No||||
potassium chloride/D5-0.45NaCl|No|No|No|No|75%|00990790203|KCL 10 MEQ/500ML-D5W-0.45%NACL|500|ML|.00701|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|.01599|02/02/2022|.01576|02/02/2022|.01501|02/02/2022||||6211|||||No|No||ICU MEDICAL INC|No||||
potassium chloride/D5-0.45NaCl|No|No|No|No|75%|00990790209|KCL 20 MEQ IN D5W-0.45% NACL|1000|ML|.00304|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|.00692|02/02/2022|.00682|02/02/2022|.0065|02/02/2022||||6212|||||No|No||ICU MEDICAL INC|No||||
potassium chloride/D5-0.45NaCl|No|No|No|No|75%|00990790309|D5%-1/2NS-KCL 30 MEQ/L IV SOL|1000|ML|.00311|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.0071|02/03/2022|.007|02/03/2022|.00667|02/03/2022||||6213|||||No|No||ICU MEDICAL INC|No||||
potassium chloride/D5-0.45NaCl|No|No|No|No|75%|00990790409|D5%-1/2NS-KCL 40 MEQ/L IV SOL|1000|ML|.00304|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00692|02/03/2022|.00682|02/03/2022|.0065|02/03/2022||||6214|||||No|No||ICU MEDICAL INC|No||||
potassium chloride in D5W|No|No|No|No|75%|00990790509|KCL 20 MEQ/L IN D5W SOLUTION|1000|ML|.00313|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00713|02/03/2022|.00703|02/03/2022|.00669|02/03/2022||||6215|||||No|No||ICU MEDICAL INC|No||||
dextrose 70 % in water|No|No|No|No|75%|00990791819|DEXTROSE 70%-WATER IV SOLN|500|ML|.01077|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.02455|02/03/2022|.0242|02/03/2022|.02305|02/03/2022||||6216|||||No|No||ICU MEDICAL INC|No||||
dextrose 5 % in water|No|No|No|No|75%|00990792202|DEXTROSE 5%-WATER IV SOLN|250|ML|.00903|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.02058|02/03/2022|.02028|02/03/2022|.01932|02/03/2022||||6217|||||No|No||ICU MEDICAL INC|No||||
dextrose 5 % in water|No|No|No|No|75%|00990792203|DEXTROSE 5%-WATER IV SOLN|500|ML|.00451|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.01029|02/03/2022|.01014|02/03/2022|.00966|02/03/2022||||6218|||||No|No||ICU MEDICAL INC|No||||
dextrose 5 % in water|No|No|No|No|75%|00990792209|DEXTROSE 5%-WATER IV SOLN|1000|ML|.00225|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00514|02/03/2022|.00507|02/03/2022|.00483|02/03/2022||||6219|||||No|No||ICU MEDICAL INC|No||||
dextrose 5 % in water|No|No|No|No|75%|00990792225|DEXTROSE 5%-WATER IV SOLN|250|ML|.00903|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.02058|02/03/2022|.02028|02/03/2022|.01932|02/03/2022||||6220|||||No|No||ICU MEDICAL INC|No||||
dextrose 5 % in water|No|No|No|No|75%|00990792255|DEXTROSE 5%-WATER IV SOLN|500|ML|.00451|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.01029|02/03/2022|.01014|02/03/2022|.00966|02/03/2022||||6221|||||No|No||ICU MEDICAL INC|No||||
dextrose 5 % in water|No|No|No|No|75%|00990792261|DEXTROSE 5%-WATER IV SOLN|150|ML|.01505|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.0343|02/03/2022|.03381|02/03/2022|.0322|02/03/2022||||6222|||||No|No||ICU MEDICAL INC|No||||
dextrose 5 % in water|No|No|No|No|75%|00990792306|DEXTROSE 5%-WATER IV SOLN|50|ML|.04515|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.1029|02/08/2022|.10143|02/08/2022|.0966|02/03/2022||||6223|||||No|No||ICU MEDICAL INC|No||||
dextrose 5 % in water|No|No|No|No|75%|00990792311|DEXTROSE 5%-WATER IV SOLN|100|ML|.02257|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.05145|02/08/2022|.05071|02/03/2022|.0483|02/03/2022||||6224|||||No|No||ICU MEDICAL INC|No||||
dextrose 5 % in water|No|No|No|No|75%|00990792313|DEXTROSE 5%-WATER IV SOLN|50|ML|.01917|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.0437|02/03/2022|.04308|02/03/2022|.04103|02/03/2022||||6225|||||No|No||ICU MEDICAL INC|No||||
dextrose 5 % in water|No|No|No|No|75%|00990792320|DEXTROSE 5%-WATER IV SOLN|25|ML|.03835|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.08741|02/03/2022|.08616|02/03/2022|.08206|02/03/2022||||6226|||||No|No||ICU MEDICAL INC|No||||
dextrose 5 % in water|No|No|No|No|75%|00990792323|DEXTROSE 5%-WATER IV SOLN|100|ML|.00928|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.02116|02/03/2022|.02086|02/03/2022|.01987|02/03/2022||||6227|||||No|No||ICU MEDICAL INC|No||||
dextrose 5 % in water|No|No|No|No|75%|00990792336|DEXTROSE 5%-WATER IV SOLN|50|ML|.01831|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.04174|02/03/2022|.04115|02/03/2022|.03919|02/03/2022||||6228|||||No|No||ICU MEDICAL INC|No||||
dextrose 5 % in water|No|No|No|No|75%|00990792337|DEXTROSE 5%-WATER IV SOLN|100|ML|.00903|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.02058|02/03/2022|.02028|02/03/2022|.01932|02/03/2022||||6229|||||No|No||ICU MEDICAL INC|No||||
dextrose 5 %-0.2 % sod chlorid|No|No|No|No|75%|00990792402|DEXTROSE 5%-0.225% NACL IV SOL|250|ML|.00903|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.02058|02/03/2022|.02028|02/03/2022|.01932|02/03/2022||||6230|||||No|No||ICU MEDICAL INC|No||||
dextrose 5 %-0.2 % sod chlorid|No|No|No|No|75%|00990792403|DEXTROSE 5%-0.225% NACL IV SOL|500|ML|.00451|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.01029|02/03/2022|.01014|02/03/2022|.00966|02/03/2022||||6231|||||No|No||ICU MEDICAL INC|No||||
dextrose 5 %-0.2 % sod chlorid|No|No|No|No|75%|00990792409|DEXTROSE 5%-0.225% NACL IV SOL|1000|ML|.00225|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00514|02/03/2022|.00507|02/03/2022|.00483|02/03/2022||||6232|||||No|No||ICU MEDICAL INC|No||||
dextrose 5 % and 0.3 % NaCl|No|No|No|No|75%|00990792503|DEXTROSE 5%-0.3% NACL IV SOLN|500|ML|.00451|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||No|.01029|02/23/2022|.01014|02/23/2022|.00966|02/23/2022||||6233|||||No|No||ICU MEDICAL INC|No||||
dextrose 5 % and 0.3 % NaCl|No|No|No|No|75%|00990792509|DEXTROSE 5%-0.3% NACL IV SOLN|1000|ML|.00225|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||No|.00514|02/23/2022|.00507|02/23/2022|.00483|02/23/2022||||6234|||||No|No||ICU MEDICAL INC|No||||
dextrose 5 %-0.45 % sod chlord|No|No|No|No|75%|00990792602|DEXTROSE 5%-0.45% NACL IV SOLN|250|ML|.00903|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.02058|02/03/2022|.02028|02/03/2022|.01932|02/03/2022||||6235|||||No|No||ICU MEDICAL INC|No||||
dextrose 5 %-0.45 % sod chlord|No|No|No|No|75%|00990792603|DEXTROSE 5%-0.45% NACL IV SOLN|500|ML|.00451|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.01029|02/03/2022|.01014|02/03/2022|.00966|02/03/2022||||6236|||||No|No||ICU MEDICAL INC|No||||
dextrose 5%-lactated ringers|No|No|No|No|75%|00990792903|DEXTROSE 5%-LR IV SOLUTION|500|ML|.00451|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No|||No|.01029|02/15/2022|.01014|02/15/2022|.00966|02/15/2022||||6237|||||No|No||ICU MEDICAL INC|No||||
dextrose 5%-lactated ringers|No|No|No|No|75%|00990792909|DEXTROSE 5%-LR IV SOLUTION|1000|ML|.00225|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|No|||No|.00514|02/09/2022|.00507|02/09/2022|.00483|02/09/2022||||6238|||||No|No||ICU MEDICAL INC|No||||
dextrose 10 % in water|No|No|No|No|75%|00990793002|DEXTROSE 10%-WATER IV SOLUTION|250|ML|.00903|02/18/2022||Yes|No||02/18/2022||Yes|No|02/18/2022||Yes|No||||No|No|||Prescription required|No|||No|.02058|02/18/2022|.02028|02/18/2022|.01932|02/18/2022||||6239|||||No|No||ICU MEDICAL INC|No||||
dextrose 10 % in water|No|No|No|No|75%|00990793003|DEXTROSE 10%-WATER IV SOLUTION|500|ML|.00451|02/18/2022||Yes|No||02/18/2022||Yes|No|02/18/2022||Yes|No||||No|No|||Prescription required|No|||No|.01029|02/18/2022|.01014|02/18/2022|.00966|02/18/2022||||6240|||||No|No||ICU MEDICAL INC|No||||
dextrose 10 % in water|No|No|No|No|75%|00990793009|DEXTROSE 10%-WATER IV SOLUTION|1000|ML|.00225|02/18/2022||Yes|No||02/18/2022||Yes|No|02/18/2022||Yes|No||||No|No|||Prescription required|No|||No|.00514|02/18/2022|.00507|02/18/2022|.00483|02/18/2022||||6241|||||No|No||ICU MEDICAL INC|No||||
dextrose 20 % in water|No|No|No|No|75%|00990793519|DEXTROSE 20%-WATER IV SOLN|500|ML|.00981|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||No|.02236|02/23/2022|.02204|02/23/2022|.02099|02/23/2022||||6242|||||No|No||ICU MEDICAL INC|No||||
dextrose 50 % in water|No|No|No|No|75%|00990793619|DEXTROSE 50%-WATER IV SOLN|500|ML|.01041|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||No|.02374|02/23/2022|.0234|02/23/2022|.02229|02/23/2022||||6243|||||No|No||ICU MEDICAL INC|No||||
dextrose 40 % in water|No|No|No|No|75%|00990793719|DEXTROSE 40%-WATER IV SOLN|500|ML|.01024|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||No|.02334|02/23/2022|.02301|02/23/2022|.02191|02/23/2022||||6244|||||No|No||ICU MEDICAL INC|No||||
dextrose 10 % in water|No|No|No|No|75%|00990793819|DEXTROSE 10%-WATER IV SOLUTION|500|ML|.00451|02/18/2022||Yes|No||02/18/2022||Yes|No|02/18/2022||Yes|No||||No|No|||Prescription required|No|||No|.01029|02/18/2022|.01014|02/18/2022|.00966|02/18/2022||||6245|||||No|No||ICU MEDICAL INC|No||||
dextrose 5 % and 0.9 % NaCl|No|No|No|No|75%|00990794109|DEXTROSE 5%-0.9% NACL IV SOLN|1000|ML|.00225|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00514|02/03/2022|.00507|02/03/2022|.00483|02/03/2022||||6246|||||No|No||ICU MEDICAL INC|No||||
Ringer's solution,lactated|No|No|No|No|75%|00990795302|LACTATED RINGERS INJECTION|250|ML|.00903|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.02058|02/03/2022|.02028|02/03/2022|.01932|02/03/2022||||6247|||||No|No||ICU MEDICAL INC|No||||
Ringer's solution,lactated|No|No|No|No|75%|00990795303|LACTATED RINGERS INJECTION|500|ML|.00451|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.01029|02/03/2022|.01014|02/03/2022|.00966|02/03/2022||||6248|||||No|No||ICU MEDICAL INC|No||||
Ringer's solution,lactated|No|No|No|No|75%|00990795309|LACTATED RINGERS INJECTION|1000|ML|.00225|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00514|02/03/2022|.00507|02/03/2022|.00483|02/03/2022||||6249|||||No|No||ICU MEDICAL INC|No||||
sodium chloride irrig solution|No|No|No|No|75%|00990797205|SODIUM CHLORIDE 0.9% IRRIG.|1000|ML|.00185|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00422|02/03/2022|.00416|02/03/2022|.00396|02/03/2022||||6250|||||No|No||ICU MEDICAL INC|No||||
sodium chloride irrig solution|No|No|No|No|75%|00990797207|SODIUM CHLORIDE 0.9% IRRIG.|2000|ML|.0015|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00342|02/03/2022|.00337|02/03/2022|.00321|02/03/2022||||6251|||||No|No||ICU MEDICAL INC|No||||
sodium chloride irrig solution|No|No|No|No|75%|00990797208|SODIUM CHLORIDE 0.9% IRRIG.|3000|ML|.00117|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00268|02/03/2022|.00264|02/03/2022|.00252|02/03/2022||||6252|||||No|No||ICU MEDICAL INC|No||||
water for irrigation,sterile|No|No|No|No|75%|00990797305|STERILE WATER FOR IRRIGATION|1000|ML|.00184|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00419|02/03/2022|.00413|02/03/2022|.00393|02/03/2022||||6253|||||No|No||ICU MEDICAL INC|No||||
water for irrigation,sterile|No|No|No|No|75%|00990797307|STERILE WATER FOR IRRIGATION|2000|ML|.0023|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00524|02/03/2022|.00516|02/03/2022|.00492|02/03/2022||||6254|||||No|No||ICU MEDICAL INC|No||||
water for irrigation,sterile|No|No|No|No|75%|00990797308|STERILE WATER FOR IRRIGATION|3000|ML|.00153|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00349|02/03/2022|.00344|02/03/2022|.00328|02/03/2022||||6255|||||No|No||ICU MEDICAL INC|No||||
Ringer's solution|No|No|No|No|75%|00990798209|RINGER'S IV SOLUTION|1000|ML|.00225|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||No|.00514|02/23/2022|.00507|02/23/2022|.00483|02/23/2022||||6256|||||No|No||ICU MEDICAL INC|No||||
0.9 % sodium chloride|No|No|No|No|75%|00990798302|SODIUM CHLORIDE 0.9% SOLUTION|250|ML|.00903|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|.02058|02/02/2022|.02028|02/02/2022|.01932|02/02/2022||||6257|||||No|No||ICU MEDICAL INC|No||||
0.9 % sodium chloride|No|No|No|No|75%|00990798303|SODIUM CHLORIDE 0.9% SOLUTION|500|ML|.00451|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|.01029|02/02/2022|.01014|02/02/2022|.00966|02/02/2022||||6258|||||No|No||ICU MEDICAL INC|No||||
0.9 % sodium chloride|No|No|No|No|75%|00990798309|SODIUM CHLORIDE 0.9% SOLUTION|1000|ML|.00225|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|.00514|02/02/2022|.00507|02/02/2022|.00483|02/02/2022||||6259|||||No|No||ICU MEDICAL INC|No||||
0.9 % sodium chloride|No|No|No|No|75%|00990798355|SODIUM CHLORIDE 0.9% SOLUTION|500|ML|.00451|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|.01029|02/02/2022|.01014|02/02/2022|.00966|02/02/2022||||6260|||||No|No||ICU MEDICAL INC|No||||
0.9 % sodium chloride|No|No|No|No|75%|00990798361|SODIUM CHLORIDE 0.9% SOLUTION|150|ML|.01505|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|.0343|02/02/2022|.03381|02/02/2022|.0322|02/02/2022||||6261|||||No|No||ICU MEDICAL INC|No||||
0.9 % sodium chloride|No|No|No|No|75%|00990798413|SODIUM CHLORIDE 0.9% SOLUTION|50|ML|.02115|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|.04821|02/02/2022|.04752|02/02/2022|.04526|02/02/2022||||6262|||||No|No||ICU MEDICAL INC|No||||
0.9 % sodium chloride|No|No|No|No|75%|00990798420|SODIUM CHLORIDE 0.9% SOLUTION|25|ML|.03818|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|.08702|02/02/2022|.08578|02/02/2022|.08169|02/02/2022||||6263|||||No|No||ICU MEDICAL INC|No||||
0.9 % sodium chloride|No|No|No|No|75%|00990798423|SODIUM CHLORIDE 0.9% SOLUTION|100|ML|.01001|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|.02283|02/02/2022|.0225|02/02/2022|.02143|02/02/2022||||6264|||||No|No||ICU MEDICAL INC|No||||
0.9 % sodium chloride|No|No|No|No|75%|00990798436|SODIUM CHLORIDE 0.9% SOLUTION|50|ML|.01247|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|.02842|02/02/2022|.02801|02/02/2022|.02668|02/02/2022||||6265|||||No|No||ICU MEDICAL INC|No||||
0.9 % sodium chloride|No|No|No|No|75%|00990798437|SODIUM CHLORIDE 0.9% SOLUTION|100|ML|.00825|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|.01881|02/02/2022|.01854|02/02/2022|.01766|02/02/2022||||6266|||||No|No||ICU MEDICAL INC|No||||
sodium chloride 0.45 %|No|No|No|No|75%|00990798502|SODIUM CHLORIDE 0.45% SOLN|250|ML|.00903|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.02058|02/03/2022|.02028|02/03/2022|.01932|02/03/2022||||6267|||||No|No||ICU MEDICAL INC|No||||
sodium chloride 0.45 %|No|No|No|No|75%|00990798503|SODIUM CHLORIDE 0.45% SOLN|500|ML|.00451|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.01029|02/03/2022|.01014|02/03/2022|.00966|02/03/2022||||6268|||||No|No||ICU MEDICAL INC|No||||
sodium chloride 0.45 %|No|No|No|No|75%|00990798509|SODIUM CHLORIDE 0.45% SOLN|1000|ML|.00225|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00514|02/03/2022|.00507|02/03/2022|.00483|02/03/2022||||6269|||||No|No||ICU MEDICAL INC|No||||
water for injection,sterile|No|No|No|No|75%|00990799009|STERILE WATER FOR INJECTION|1000|ML|.00225|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00514|02/03/2022|.00507|02/03/2022|.00483|02/03/2022||||6270|||||No|No||ICU MEDICAL INC|No||||
potassium chloride/D5-0.45NaCl|No|No|No|No|75%|00990799309|D5%-1/2NS-KCL 10 MEQ/L IV SOL|1000|ML|.00304|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00692|02/03/2022|.00682|02/03/2022|.0065|02/03/2022||||6271|||||No|No||ICU MEDICAL INC|No||||
dextrose 30 % in water|No|No|No|No|75%|00990800415|DEXTROSE 30%-WATER IV SOLN|500|ML|.01002|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||No|.02285|02/23/2022|.02252|02/23/2022|.02145|02/23/2022||||6272|||||No|No||ICU MEDICAL INC|No||||
potassium chloride-0.45% NaCl|No|No|No|No|75%|00990925739|POTASSIUM CL 20 MEQ-0.45% NACL|1000|ML|.00294|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No|||No|.00672|02/03/2022|.00662|02/03/2022|.00631|02/03/2022||||6273|||||No|No||ICU MEDICAL INC|No||||
pilocarpine HCl|No|No|No|No|75%|00998020315|ISOPTO CARPINE 1% EYE DROPS|15|ML|2.66743|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||088|No|6.07926|01/09/2018|5.99241|01/09/2018|5.70706|01/09/2018|||OPHTHALMICS: GLAUCOMA AGENTS|6274|||||No|No||ALCON/NOVARTIS|No||||
pilocarpine HCl|No|No|No|No|75%|00998020415|ISOPTO CARPINE 2% EYE DROPS|15|ML|2.7282|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||088|No|6.21776|01/09/2018|6.12894|01/09/2018|5.83708|01/09/2018|||OPHTHALMICS: GLAUCOMA AGENTS|6275|||||No|No||ALCON/NOVARTIS|No||||
pilocarpine HCl|No|No|No|No|75%|00998020615|ISOPTO CARPINE 4% EYE DROPS|15|ML|2.85864|03/01/2002|05/31/2022|Yes|No||03/01/2002|05/31/2022|Yes|No|03/01/2002|05/31/2022|Yes|No||||No|No|||Prescription required|No||088|No|6.51504|01/09/2018|6.42196|01/09/2018|6.11616|01/09/2018|||OPHTHALMICS: GLAUCOMA AGENTS|6276|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ALCON/NOVARTIS|No||||
tropicamide|No|No|No|No|75%|00998035515|MYDRIACYL 1% EYE DROPS|15|ML|2.73365|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|6.23018|03/01/2022|6.14118|03/01/2022|5.84874|03/01/2022||||6277|||||No|No||ALCON LABORATOR|No||||
hypromellose|No|No|No|No|75%|00998040815|ISOPTO TEARS 0.5% EYE DROPS|15|ML|.74103|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No|||No|||||||1.84067|02/15/2022||6278|||||No|No||ALCON CONSUMER|No||||
dexamethasone|No|No|No|No|75%|00998061505|MAXIDEX 0.1% EYE DROPS|5|ML|6.48526|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|013|No|14.78036|12/28/2021|14.56921|12/28/2021|13.87544|12/28/2021|||OPHTHALMICS: ANTI-INFLAMMATORIES|6279|||||No|No||ALCON/NOVARTIS|No||||
neomycin/polymyxin B/dexametha|No|No|No|No|75%|00998063006|MAXITROL EYE DROPS|5|ML|9.72058|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|036|No|22.15388|03/23/2021|21.83739|03/23/2021|20.79752|03/23/2021|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|6280|||||No|No||ALCON/NOVARTIS|No||||
COVID-19 antigen test|Yes|No|No|No|75%|08337000158|INTELISWAB COVID-19 HOME TEST|2|EA|.0043|01/03/2022||Yes|No||01/03/2022||Yes|No|01/03/2022||Yes|No||01/03/2022||Yes|No|01/03/2022||Over the counter|No|||No||||||||||6281|||||No|No||ORASURE TECHNOL|No||||
lancing device|No|No|Yes|No|75%|08470027401|AUTOLET PLUS LANCING DEVICE|1|EA|1.4835|||No|No||||No|No|||No|No||08/27/2013||Yes|No|||Over the counter|No|||No|3.381|07/07/2020|3.3327|07/07/2020|3.174|07/07/2020||||6282|||||No|No||OWEN MUMFORD US|No||||
scopolamine|No|No|No|No|75%|10019055303|TRANSDERM-SCOP 1 MG/3 DAY PTCH|10|EA|9.15728|02/16/2017||Yes|No||02/16/2017||Yes|No|02/16/2017||Yes|No||||No|No|||Prescription required|Yes|04/02/2018|085|No|20.54383|03/29/2022|20.05077|03/29/2022|20.18431|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|6283|||||No|No||BAXTER HEALTHCA|No||||
scopolamine|No|No|No|No|75%|10019055304|TRANSDERM-SCOP 1 MG/3 DAY PTCH|24|EA|9.15738|02/16/2017||Yes|No||02/16/2017||Yes|No|02/16/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|085|No|20.54383|03/29/2022|20.05077|03/29/2022|20.18431|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|6284|||||No|No||BAXTER HEALTHCA|No||||
mesna|No|No|No|No|75%|10019095301|MESNA 1 GRAM/10 ML VIAL|10|ML|1.075|05/20/2011||Yes|No||05/20/2011||Yes|No|05/20/2011||Yes|No||||No|No|||Prescription required|No|||No|2.45|08/17/2021|2.415|08/17/2021|2.3|08/17/2021||||6285|||||No|No||BAXTER HEALTHCA|No||||
cyclophosphamide|No|No|No|No|75%|10019098201|CYCLOPHOSPHAMIDE 25 MG TABLET|100|EA|1.26678|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No||502|No|2.88708|08/25/2021|2.84583|08/25/2021|2.71032|08/25/2021|||ONCOLOGY: ORAL - BREAST|6286|||||No|No||BAXTER HEALTHCA|No||||
cyclophosphamide|No|No|No|No|75%|10019098401|CYCLOPHOSPHAMIDE 50 MG TABLET|100|EA|1.81025|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No||502|No|4.1257|08/25/2021|4.06676|08/25/2021|3.8731|08/25/2021|||ONCOLOGY: ORAL - BREAST|6287|||||No|No||BAXTER HEALTHCA|No||||
clobazam|No|No|No|No|90%|10094020560|SYMPAZAN 5 MG FILM|60|EA|6.5102|03/11/2019||Yes|No||03/11/2019||Yes|No|03/11/2019||Yes|No||||No|No|||Prescription required|No||056|No|14.8372|01/04/2022|14.62524|01/04/2022|13.9288|01/04/2022|||ANTICONVULSANTS|6288|||||No|No||AQUESTIVE THERA|No||||
clobazam|No|No|No|No|90%|10094021060|SYMPAZAN 10 MG FILM|60|EA|13.0204|03/11/2019||Yes|No||03/11/2019||Yes|No|03/11/2019||Yes|No||||No|No|||Prescription required|No||056|No|29.6744|01/04/2022|29.25048|01/04/2022|27.8576|01/04/2022|||ANTICONVULSANTS|6289|||||No|No||AQUESTIVE THERA|No||||
clobazam|No|No|No|No|90%|10094022060|SYMPAZAN 20 MG FILM|60|EA|26.0408|03/11/2019||Yes|No||03/11/2019||Yes|No|03/11/2019||Yes|No||||No|No|||Prescription required|No||056|No|59.3488|01/04/2022|58.50096|01/04/2022|55.7152|01/04/2022|||ANTICONVULSANTS|6290|||||No|No||AQUESTIVE THERA|No||||
deferiprone|No|No|No|No|75%|10122010010|FERRIPROX 500 MG TABLET|100|EA|32.88928|01/14/2022||Yes|No||01/14/2022||Yes|No|01/14/2022||Yes|No||||No|No|||Prescription required|No|||No|74.95696|01/14/2022|73.88615|01/14/2022|70.36776|01/14/2022||||6291|||||No|No||CHIESI USA, INC|No||||
deferiprone|No|No|No|No|75%|10122010150|FERRIPROX 100 MG/ML SOLUTION|500|ML|6.57785|06/23/2021||Yes|No||06/23/2021||Yes|No|06/23/2021||Yes|No||||No|No|||Prescription required|No|||Yes|14.99139|01/11/2022|14.77723|01/11/2022|14.07355|01/11/2022||||6292|||||No|No||CHIESI USA, INC|No||||
deferiprone|No|No|No|No|75%|10122010305|FERRIPROX 1,000 MG TAB(3X/DAY)|50|EA|65.77856|10/25/2021||Yes|No||10/25/2021||Yes|No|10/25/2021||Yes|No||||No|No|||Prescription required|No|||No|149.91393|01/11/2022|147.7723|01/11/2022|140.73552|01/11/2022||||6293|||||No|No||CHIESI USA, INC|No||||
deferiprone|No|No|No|No|75%|10122010401|FERRIPROX 1,000 MG TAB(2X/DAY)|50|EA|83.77457|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|No|||No|190.9281|01/11/2022|188.20056|01/11/2022|179.23863|01/11/2022||||6294|||||No|No||CHIESI USA, INC|No||||
mannitol|No|No|No|No|75%|10122021204|BRONCHITOL 40 MG INHALE CAP|10|EA|2.67374|06/10/2021||Yes|No||06/10/2021||Yes|No|06/10/2021||Yes|No||||No|No|||Prescription required|No|||No|6.09364|06/10/2021|6.00658|06/10/2021|5.72056|06/10/2021||||6295|||||No|No||CHIESI USA, INC|No||||
mannitol|No|No|No|No|75%|10122021214|BRONCHITOL 40 MG INHALE CAP|140|EA|2.67367|06/10/2021||Yes|No||06/10/2021||Yes|No|06/10/2021||Yes|No||||No|No|||Prescription required|No|||No|6.09349|06/10/2021|6.00644|06/10/2021|5.72042|06/10/2021||||6296|||||No|No||CHIESI USA, INC|No||||
mannitol|No|No|No|No|75%|10122021256|BRONCHITOL 40 MG INHALE CAP|560|EA|2.67367|06/10/2021||Yes|No||06/10/2021||Yes|No|06/10/2021||Yes|No||||No|No|||Prescription required|No|||No|6.09349|06/10/2021|6.00644|06/10/2021|5.72042|06/10/2021||||6297|||||No|No||CHIESI USA, INC|No||||
tobramycin|No|No|No|No|75%|10122082028|BETHKIS 300 MG/4 ML AMPULE|4|ML|11.87445|11/14/2014||Yes|No||11/14/2014||Yes|No|11/14/2014||Yes|No|Submit HHS Form 1143|||No|No|||Prescription required|No||240|No|27.0627|01/15/2019|26.67609|01/15/2019|25.4058|01/15/2019|||ANTIBIOTICS: INHALED|6298|||||No|No||CHIESI USA, INC|No||||
tobramycin|No|No|No|No|75%|10122082056|BETHKIS 300 MG/4 ML AMPULE|4|ML|13.06812|10/03/2013||Yes|No||10/03/2013||Yes|No|10/03/2013||Yes|No|Submit HHS Form 1143|||No|No|||Prescription required|No||240|No|27.06265|08/13/2019|26.67604|08/13/2019|25.40575|08/13/2019|||ANTIBIOTICS: INHALED|6299|||||No|No||CHIESI USA, INC|No||||
dalfampridine|No|No|No|No|75%|10144042760|AMPYRA ER 10 MG TABLET|60|EA|25.21311|03/08/2010||Yes|No||03/08/2010||Yes|No|03/08/2010||Yes|No||||No|No|||Prescription required|No||043|No|57.46245|01/04/2022|56.64156|01/04/2022|53.94434|01/04/2022|||MULTIPLE SCLEROSIS AGENTS|6300|||||No|No||ACORDA THERAPEU|No||||
itraconazole|No|No|No|No|75%|10147015001|ITRACONAZOLE 10 MG/ML SOLUTION|150|ML|.82923|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|069|No|1.88989|11/23/2021|1.86289|11/23/2021|1.77418|11/23/2021|||ANTIFUNGALS: ORAL|6301|||||No|No||PATRIOT PHARMAC|No||||
methylphenidate HCl|No|No|No|No|75%|10147068501|METHYLPHENIDATE ER 18 MG TAB|100|EA|3.34733|04/25/2019||Yes|No||04/25/2019||Yes|No|04/25/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.56499|03/29/2022|.55143|03/29/2022|.5551|03/29/2022|||STIMULANTS AND RELATED AGENTS|6302|||||No|No||PATRIOT PHARMAC|No||||
methylphenidate HCl|No|No|No|No|75%|10147068601|METHYLPHENIDATE ER 36 MG TAB|100|EA|3.53924|04/25/2019||Yes|No||04/25/2019||Yes|No|04/25/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.76999|03/29/2022|.75151|03/29/2022|.75651|03/29/2022|||STIMULANTS AND RELATED AGENTS|6303|||||No|No||PATRIOT PHARMAC|No||||
methylphenidate HCl|No|No|No|No|75%|10147068701|METHYLPHENIDATE ER 54 MG TAB|100|EA|3.85103|04/25/2019||Yes|No||04/25/2019||Yes|No|04/25/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.87218|03/29/2022|.85124|03/29/2022|.85691|03/29/2022|||STIMULANTS AND RELATED AGENTS|6304|||||No|No||PATRIOT PHARMAC|No||||
methylphenidate HCl|No|No|No|No|75%|10147068801|METHYLPHENIDATE ER 27 MG TAB|100|EA|3.43118|04/25/2019||Yes|No||04/25/2019||Yes|No|04/25/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.90623|03/29/2022|.88448|03/29/2022|.89037|03/29/2022|||STIMULANTS AND RELATED AGENTS|6305|||||No|No||PATRIOT PHARMAC|No||||
galantamine HBr|No|No|No|No|75%|10147089103|GALANTAMINE ER 8 MG CAPSULE|30|EA|2.18726|10/24/2008||Yes|No||10/24/2008||Yes|No|10/24/2008||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|011|No|1.1683|03/29/2022|1.14026|03/29/2022|1.14785|03/29/2022|||ALZHEIMER'S AGENTS|6306|||||No|No||PATRIOT PHARMAC|No||||
galantamine HBr|No|No|No|No|75%|10147089203|GALANTAMINE ER 16 MG CAPSULE|30|EA|2.18726|10/24/2008||Yes|No||10/24/2008||Yes|No|10/24/2008||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|011|No|1.23595|03/29/2022|1.20628|03/29/2022|1.21432|03/29/2022|||ALZHEIMER'S AGENTS|6307|||||No|No||PATRIOT PHARMAC|No||||
galantamine HBr|No|No|No|No|75%|10147089303|GALANTAMINE ER 24 MG CAPSULE|30|EA|2.18726|10/24/2008||Yes|No||10/24/2008||Yes|No|10/24/2008||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|011|No|1.24993|03/29/2022|1.21993|03/29/2022|1.22805|03/29/2022|||ALZHEIMER'S AGENTS|6308|||||No|No||PATRIOT PHARMAC|No||||
haloperidol lactate|No|No|No|No|75%|10147091101|HALOPERIDOL LAC 5 MG/ML AMPUL|1|ML|2.6402|08/30/2011||Yes|No||08/30/2011||Yes|No|08/30/2011||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|027|Yes|6.0172|04/11/2017|5.93124|04/11/2017|5.6488|04/11/2017|||ANTIPSYCHOTICS|6309|||||No|No||PATRIOT PHARMAC|No||||
haloperidol decanoate|No|No|No|No|75%|10147092103|HALOPERIDOL DECAN 50 MG/ML AMP|1|ML|11.1327|08/30/2011||Yes|No||08/30/2011||Yes|No|08/30/2011||Yes|No||||No|No|||Prescription required|No||027|No|21.21556|03/01/2022|20.70638|03/01/2022|20.84428|03/01/2022|||ANTIPSYCHOTICS|6310|||||No|No||PATRIOT PHARMAC|No||||
haloperidol decanoate|No|No|No|No|75%|10147092205|HALOPERIDOL DEC 100 MG/ML AMP|1|ML|21.2205|08/30/2011||Yes|No||08/30/2011||Yes|No|08/30/2011||Yes|No||||No|No|||Prescription required|No||027|No|33.234|03/29/2022|32.43638|03/29/2022|32.6524|03/29/2022|||ANTIPSYCHOTICS|6311|||||No|No||PATRIOT PHARMAC|Yes|09/01/2020|||
paliperidone|No|No|No|No|75%|10147095103|PALIPERIDONE ER 1.5 MG TABLET|30|EA|4.73487|11/10/2015||Yes|No||11/10/2015||Yes|No|11/10/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|027|Yes|4.83706|03/29/2022|4.72097|03/29/2022|4.75241|03/29/2022|||ANTIPSYCHOTICS|6312|||||No|No||PATRIOT PHARMAC|No||||
paliperidone|No|No|No|No|75%|10147095203|PALIPERIDONE ER 3 MG TABLET|30|EA|4.73487|11/10/2015||Yes|No||11/10/2015||Yes|No|11/10/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|027|Yes|6.18339|03/29/2022|6.03498|03/29/2022|6.07518|03/29/2022|||ANTIPSYCHOTICS|6313|||||No|No||PATRIOT PHARMAC|No||||
paliperidone|No|No|No|No|75%|10147095303|PALIPERIDONE ER 6 MG TABLET|30|EA|4.73487|11/10/2015||Yes|No||11/10/2015||Yes|No|11/10/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|027|Yes|5.21133|03/29/2022|5.08625|03/29/2022|5.12013|03/29/2022|||ANTIPSYCHOTICS|6314|||||No|No||PATRIOT PHARMAC|No||||
paliperidone|No|No|No|No|75%|10147095403|PALIPERIDONE ER 9 MG TABLET|30|EA|7.10216|11/10/2015||Yes|No||11/10/2015||Yes|No|11/10/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|027|Yes|7.23268|03/29/2022|7.05909|03/29/2022|7.1061|03/29/2022|||ANTIPSYCHOTICS|6315|||||No|No||PATRIOT PHARMAC|No||||
itraconazole|No|No|No|No|75%|10147170003|ITRACONAZOLE 100 MG CAPSULE|30|EA|3.19146|08/05/2005||Yes|No||08/05/2005||Yes|No|||No|No||||No|No|||Prescription required|Yes|03/29/2004|069|No|.85195|03/29/2022|.8315|03/29/2022|.83704|03/29/2022|||ANTIFUNGALS: ORAL|6316|||||No|No||PATRIOT PHARMAC|No||||
itraconazole|No|No|No|No|75%|10147170007|ITRACONAZOLE 100 MG CAPSULE|28|EA|3.20042|09/30/2005|12/31/2022|Yes|No||09/30/2005|12/31/2022|Yes|No|||No|No||||No|No|||Prescription required|Yes|07/12/2005|069|No|.85195|03/29/2022|.8315|03/29/2022|.83704|03/29/2022|||ANTIFUNGALS: ORAL|6317|Discontinued by Manufacturer|Discontinued by Manufacturer|||No|No||PATRIOT PHARMAC|No||||
hydrocortisone probutate|No|No|No|No|75%|10337015380|PANDEL 0.1% CREAM|80|GM|6.2846|11/07/2016|01/31/2023|Yes|No||11/07/2016|01/31/2023|Yes|No|11/07/2016|01/31/2023|Yes|No||||No|No|||Prescription required|Yes|01/22/2015|119|No|14.32306|03/22/2022|14.11844|03/22/2022|13.44614|03/22/2022|||STEROIDS: TOPICAL MEDIUM|6318|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||PHARMADERM/SAND|No||||
clobetasol propionate|No|No|No|No|75%|10337016215|TEMOVATE 0.05% OINTMENT|15|GM|4.58838|01/08/2015|02/22/2022|Yes|No||01/08/2015|02/22/2022|Yes|No|01/08/2015|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|07/26/2012|121|No|10.45724|06/01/2016|10.30785|06/01/2016|9.817|06/01/2016|||STEROIDS: TOPICAL VERY HIGH|6319|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SANDOZ|No||||
oxiconazole nitrate|No|No|No|No|75%|10337035830|OXISTAT 1% CREAM|30|GM|9.22006|07/29/2013||Yes|No||07/29/2013||Yes|No|07/29/2013||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|061|No|21.01316|12/25/2018|20.71297|12/25/2018|19.72664|12/25/2018|||ANTIFUNGALS: TOPICAL|6320|||||No|No||SANDOZ|No||||
oxiconazole nitrate|No|No|No|No|75%|10337035860|OXISTAT 1% CREAM|60|GM|4.6776|07/29/2013||Yes|No||07/29/2013||Yes|No|07/29/2013||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|061|No|10.66059|12/25/2018|10.5083|12/25/2018|10.0079|12/25/2018|||ANTIFUNGALS: TOPICAL|6321|||||No|No||SANDOZ|No||||
oxiconazole nitrate|No|No|No|No|75%|10337035890|OXISTAT 1% CREAM|90|GM|4.67548|02/17/2011||Yes|No||02/17/2011||Yes|No|02/17/2011||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|061|No|10.65575|01/09/2018|10.50353|01/09/2018|10.00336|01/09/2018|||ANTIFUNGALS: TOPICAL|6322|||||No|No||SANDOZ|No||||
oxiconazole nitrate|No|No|No|No|75%|10337035930|OXISTAT 1% LOTION|30|ML|10.04981|01/09/2015|04/30/2022|Yes|No||01/09/2015|04/30/2022|Yes|No|01/09/2015|04/30/2022|Yes|No||||No|No|||Prescription required|Yes|01/25/2012|061|No|22.90422|03/22/2022|22.57702|03/22/2022|21.50192|03/22/2022|||ANTIFUNGALS: TOPICAL|6323|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SANDOZ|No||||
oxiconazole nitrate|No|No|No|No|75%|10337035960|OXISTAT 1% LOTION|60|ML|5.09528|01/09/2015||Yes|No||01/09/2015||Yes|No|01/09/2015||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|061|No|11.61251|03/22/2022|11.44661|03/22/2022|10.90154|03/22/2022|||ANTIFUNGALS: TOPICAL|6324|||||No|No||SANDOZ|No||||
diflorasone diacet/emollient|No|No|No|No|75%|10337039530|APEXICON E 0.05% CREAM|30|GM|8.7955|01/12/2015|07/31/2022|Yes|No||01/12/2015|07/31/2022|Yes|No|01/12/2015|07/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/26/2012|121|No|20.04556|03/22/2022|19.7592|03/22/2022|18.81828|03/22/2022|||STEROIDS: TOPICAL VERY HIGH|6325|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SANDOZ|No||||
diflorasone diacet/emollient|No|No|No|No|75%|10337039560|APEXICON E 0.05% CREAM|60|GM|8.79141|01/12/2015|07/31/2022|Yes|No||01/12/2015|07/31/2022|Yes|No|01/12/2015|07/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/26/2012|121|No|20.03625|03/22/2022|19.75002|03/22/2022|18.80954|03/22/2022|||STEROIDS: TOPICAL VERY HIGH|6326|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SANDOZ|No||||
sinecatechins|No|No|No|No|75%|10337045003|VEREGEN 15% OINTMENT|30|GM|20.88223|07/02/2013|10/31/2022|Yes|No||07/02/2013|10/31/2022|Yes|No|07/02/2013|10/31/2022|Yes|No||||No|No|||Prescription required|No|||No|47.59206|03/22/2022|46.91217|03/22/2022|44.67826|03/22/2022||||6327|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||DOAK DERM.|No||||
tavaborole|No|No|No|No|75%|10337090510|KERYDIN 5% TOPICAL SOLUTION|10|ML|64.96655|08/17/2016|06/30/2022|Yes|No||08/17/2016|06/30/2022|Yes|No|08/17/2016|06/30/2022|Yes|No||||No|No|||Prescription required|Yes|01/22/2015|061|No|148.0633|11/23/2021|145.94811|11/23/2021|138.9982|11/23/2021|||ANTIFUNGALS: TOPICAL|6328|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||PHARMADERM/SAND|No||||
bupropion HCl|Yes|No|No|No|75%|10370010103|BUPROPION HCL XL 150 MG TABLET|30|EA|.35833|12/16/2008||Yes|No||12/16/2008||Yes|No|12/16/2008||Yes|No||||No|No|07/01/2016||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|6329|||||No|No||PAR PHARM.|No||||
bupropion HCl|Yes|No|No|No|75%|10370010150|BUPROPION HCL XL 150 MG TABLET|500|EA|.35833|12/16/2008||Yes|No||12/16/2008||Yes|No|12/16/2008||Yes|No||||No|No|07/01/2016||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|6330|||||No|No||PAR PHARM.|No||||
bupropion HCl|Yes|No|No|No|75%|10370010203|BUPROPION HCL XL 300 MG TABLET|30|EA|.43|08/04/2007||Yes|No||08/04/2007||Yes|No|08/04/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|6331|||||No|No||PAR PHARM.|No||||
bupropion HCl|Yes|No|No|No|75%|10370010250|BUPROPION HCL XL 300 MG TABLET|500|EA|.43|08/04/2007||Yes|No||08/04/2007||Yes|No|08/04/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|6332|||||No|No||PAR PHARM.|No||||
zolpidem tartrate|No|No|No|No|90%|10370011610|ZOLPIDEM TART ER 12.5 MG TAB|100|EA|.3225|12/21/2010||Yes|No||12/21/2010||Yes|No|12/21/2010||Yes|No||||No|No|||Prescription required|Yes|07/28/2010|054|Yes|.24181|03/29/2022|.236|03/29/2022|.23757|03/29/2022|||SEDATIVE HYPNOTICS|6333|||||No|No||PAR PHARM.|No||||
zolpidem tartrate|No|No|No|No|90%|10370011710|ZOLPIDEM TART ER 6.25 MG TAB|100|EA|.3225|05/13/2011||Yes|No||05/13/2011||Yes|No|05/13/2011||Yes|No||||No|No|||Prescription required|Yes|07/28/2010|054|Yes|.20271|03/29/2022|.19784|03/29/2022|.19916|03/29/2022|||SEDATIVE HYPNOTICS|6334|||||No|No||PAR PHARM.|No||||
fluvoxamine maleate|No|No|No|No|75%|10370017511|FLUVOXAMINE ER 100 MG CAPSULE|30|EA|3.24392|05/03/2013||Yes|No||05/03/2013||Yes|No|05/03/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|008|No|6.5592|03/29/2022|6.40177|03/29/2022|6.44441|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6335|||||No|No||PAR PHARM.|No||||
fluvoxamine maleate|No|No|No|No|75%|10370017611|FLUVOXAMINE ER 150 MG CAPSULE|30|EA|3.48128|05/03/2013||Yes|No||05/03/2013||Yes|No|05/03/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|008|No|7.00339|03/29/2022|6.8353|03/29/2022|6.88083|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6336|||||No|No||PAR PHARM.|No||||
tramadol HCl|No|No|No|No|90%|10370022111|TRAMADOL ER 100 MG TABLET|30|EA|1.49941|08/16/2012|01/31/2023|Yes|No||08/16/2012|01/31/2023|Yes|No|08/16/2012|01/31/2023|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|3.41726|03/01/2022|3.36844|03/01/2022|3.20804|03/01/2022|||ANALGESICS: NARCOTICS LONG|6337|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||PAR PHARM.|No||||
tramadol HCl|No|No|No|No|90%|10370022211|TRAMADOL ER 200 MG TABLET|30|EA|2.47952|08/16/2012|01/31/2023|Yes|No||08/16/2012|01/31/2023|Yes|No|08/16/2012|01/31/2023|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|2.388|06/29/2021|2.33068|06/29/2021|2.34621|06/29/2021|||ANALGESICS: NARCOTICS LONG|6338|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||PAR PHARM.|No||||
tramadol HCl|No|No|No|No|90%|10370022311|TRAMADOL ER 300 MG TABLET|30|EA|3.45963|08/16/2012|01/31/2023|Yes|No||08/16/2012|01/31/2023|Yes|No|08/16/2012|01/31/2023|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|7.88474|07/27/2021|7.7721|07/27/2021|7.402|07/27/2021|||ANALGESICS: NARCOTICS LONG|6339|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||PAR PHARM.|No||||
pramipexole di-HCl|No|No|No|No|75%|10370025111|PRAMIPEXOLE ER 0.375 MG TABLET|30|EA|4.22833|11/10/2021||Yes|No||11/10/2021||Yes|No|11/10/2021||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|015|No|9.63666|04/13/2021|9.49899|04/13/2021|9.04666|04/13/2021|||ANTIPARKINSON'S AGENTS|6340|||||No|No||PAR PHARM.|No||||
pramipexole di-HCl|No|No|No|No|75%|10370025211|PRAMIPEXOLE ER 0.75 MG TABLET|30|EA|4.22833|11/10/2021||Yes|No||11/10/2021||Yes|No|11/10/2021||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|015|No|9.63666|04/13/2021|9.49899|04/13/2021|9.04666|04/13/2021|||ANTIPARKINSON'S AGENTS|6341|||||No|No||PAR PHARM.|No||||
pramipexole di-HCl|No|No|No|No|75%|10370025311|PRAMIPEXOLE ER 1.5 MG TABLET|30|EA|5.1405|09/15/2015||Yes|No||09/15/2015||Yes|No|09/15/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|015|No|5.85567|03/01/2022|5.71513|03/01/2022|5.75319|03/01/2022|||ANTIPARKINSON'S AGENTS|6342|||||No|No||PAR PHARM.|No||||
pramipexole di-HCl|No|No|No|No|75%|10370025411|PRAMIPEXOLE ER 3 MG TABLET|30|EA|5.1405|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|015|No|11.71556|04/27/2021|11.5482|04/27/2021|10.99828|04/27/2021|||ANTIPARKINSON'S AGENTS|6343|||||No|No||PAR PHARM.|No||||
clonidine HCl|No|No|No|No|75%|10370025702|CLONIDINE HCL ER 0.1 MG TABLET|60|EA|1.43333|11/25/2013||Yes|No||11/25/2013||Yes|No|11/25/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.52051|03/29/2022|.50801|03/29/2022|.5114|03/29/2022|||STIMULANTS AND RELATED AGENTS|6344|||||No|No||PAR PHARM.|No||||
tretinoin|No|No|No|No|75%|10370026801|TRETINOIN 10 MG CAPSULE|100|EA|11.5642|03/18/2013||Yes|No||03/18/2013||Yes|No|03/18/2013||Yes|No||||No|No|||Prescription required|No||173|No|26.35563|06/01/2016|25.97912|06/01/2016|24.74202|06/01/2016|||ONCOLOGY: ORAL - HEMATOLOGIC|6345|||||No|No||PAR PHARM.|No||||
dutasteride/tamsulosin HCl|No|No|No|No|75%|10370028009|DUTASTERIDE-TAMSULOSIN 0.5-0.4|90|EA|1.92701|01/03/2017||Yes|No||01/03/2017||Yes|No|01/03/2017||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|003|No|2.12378|03/29/2022|2.0728|03/29/2022|2.08661|03/29/2022|||BPH TREATMENTS|6346|||||No|No||PAR PHARM.|No||||
dutasteride/tamsulosin HCl|No|No|No|No|75%|10370028011|DUTASTERIDE-TAMSULOSIN 0.5-0.4|30|EA|1.92726|01/03/2017||Yes|No||01/03/2017||Yes|No|01/03/2017||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|003|No|2.12378|03/29/2022|2.0728|03/29/2022|2.08661|03/29/2022|||BPH TREATMENTS|6347|||||No|No||PAR PHARM.|No||||
pramipexole di-HCl|No|No|No|No|75%|10370030511|PRAMIPEXOLE ER 2.25 MG TABLET|30|EA|5.1405|03/30/2017||Yes|No||03/30/2017||Yes|No|03/30/2017||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|015|No|11.71556|03/30/2017|11.5482|03/30/2017|10.99828|03/30/2017|||ANTIPARKINSON'S AGENTS|6348|||||No|No||PAR PHARM.|No||||
pramipexole di-HCl|No|No|No|No|75%|10370030611|PRAMIPEXOLE ER 3.75 MG TABLET|30|EA|5.64934|03/30/2017||Yes|No||03/30/2017||Yes|No|03/30/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|015|No|12.87524|03/30/2017|12.6913|03/30/2017|12.08696|03/30/2017|||ANTIPARKINSON'S AGENTS|6349|||||No|No||PAR PHARM.|No||||
memantine HCl|No|No|No|No|75%|10370034611|MEMANTINE HCL ER 7 MG CAPSULE|30|EA|1.6426|06/21/2018||Yes|No||06/21/2018||Yes|No|06/21/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|011|No|.73424|03/29/2022|.71661|03/29/2022|.72139|03/29/2022|||ALZHEIMER'S AGENTS|6350|||||No|No||PAR PHARM.|No||||
memantine HCl|No|No|No|No|75%|10370034709|MEMANTINE HCL ER 14 MG CAPSULE|90|EA|1.6426|06/21/2018||Yes|No||06/21/2018||Yes|No|06/21/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|011|No|.96952|03/29/2022|.94625|03/29/2022|.95255|03/29/2022|||ALZHEIMER'S AGENTS|6351|||||No|No||PAR PHARM.|No||||
memantine HCl|No|No|No|No|75%|10370034711|MEMANTINE HCL ER 14 MG CAPSULE|30|EA|1.6426|06/21/2018||Yes|No||06/21/2018||Yes|No|06/21/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|011|No|.96952|03/29/2022|.94625|03/29/2022|.95255|03/29/2022|||ALZHEIMER'S AGENTS|6352|||||No|No||PAR PHARM.|No||||
memantine HCl|No|No|No|No|75%|10370034811|MEMANTINE HCL ER 21 MG CAPSULE|30|EA|1.6426|06/21/2018||Yes|No||06/21/2018||Yes|No|06/21/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|011|No|.91098|03/29/2022|.88911|03/29/2022|.89503|03/29/2022|||ALZHEIMER'S AGENTS|6353|||||No|No||PAR PHARM.|No||||
memantine HCl|No|No|No|No|75%|10370034909|MEMANTINE HCL ER 28 MG CAPSULE|90|EA|1.6426|06/21/2018||Yes|No||06/21/2018||Yes|No|06/21/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|011|No|1.08689|03/29/2022|1.0608|03/29/2022|1.06786|03/29/2022|||ALZHEIMER'S AGENTS|6354|||||No|No||PAR PHARM.|No||||
memantine HCl|No|No|No|No|75%|10370034911|MEMANTINE HCL ER 28 MG CAPSULE|30|EA|1.6426|06/21/2018||Yes|No||06/21/2018||Yes|No|06/21/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|011|No|1.08689|03/29/2022|1.0608|03/29/2022|1.06786|03/29/2022|||ALZHEIMER'S AGENTS|6355|||||No|No||PAR PHARM.|No||||
glipizide|No|No|No|No|75%|10370074501|GLIPIZIDE ER 5 MG TABLET|100|EA|.1247|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No|||Yes|.11105|03/29/2022|.10838|03/29/2022|.1091|03/29/2022||||6356|||||No|No||PAR PHARM.|No||||
glipizide|No|No|No|No|75%|10370074601|GLIPIZIDE ER 10 MG TABLET|100|EA|.24617|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No|||No|.184|03/29/2022|.17958|03/29/2022|.18078|03/29/2022||||6357|||||No|No||PAR PHARM.|No||||
diltiazem HCl|No|No|No|No|75%|10370082905|DILTIAZEM 24H ER(CD) 120 MG CP|500|EA|.32644|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||02/17/2017||Yes|No|||Prescription required|No||045|No|.17507|03/29/2022|.17086|03/29/2022|.172|03/29/2022|||CALCIUM CHANNEL BLOCKERS|6358|||||No|No||PAR PHARM.|No||||
diltiazem HCl|No|No|No|No|75%|10370082909|DILTIAZEM 24H ER(CD) 120 MG CP|90|EA|.3331|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||02/17/2017||Yes|No|||Prescription required|No||045|No|.17507|03/29/2022|.17086|03/29/2022|.172|03/29/2022|||CALCIUM CHANNEL BLOCKERS|6359|||||No|No||PAR PHARM.|No||||
diltiazem HCl|No|No|No|No|75%|10370082911|DILTIAZEM 24H ER(CD) 120 MG CP|30|EA|.34256|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||08/25/2017||Yes|No|||Prescription required|No||045|No|.17507|03/29/2022|.17086|03/29/2022|.172|03/29/2022|||CALCIUM CHANNEL BLOCKERS|6360|||||No|No||PAR PHARM.|No||||
diltiazem HCl|No|No|No|No|75%|10370083005|DILTIAZEM 24H ER(CD) 180 MG CP|500|EA|.39405|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||05/16/2017||Yes|No|||Prescription required|No||045|No|.21189|03/29/2022|.2068|03/29/2022|.20818|03/29/2022|||CALCIUM CHANNEL BLOCKERS|6361|||||No|No||PAR PHARM.|No||||
diltiazem HCl|No|No|No|No|75%|10370083009|DILTIAZEM 24H ER(CD) 180 MG CP|90|EA|.40209|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||08/25/2017||Yes|No|||Prescription required|No||045|No|.21189|03/29/2022|.2068|03/29/2022|.20818|03/29/2022|||CALCIUM CHANNEL BLOCKERS|6362|||||No|No||PAR PHARM.|No||||
diltiazem HCl|No|No|No|No|75%|10370083011|DILTIAZEM 24H ER(CD) 180 MG CP|30|EA|.41423|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||02/17/2017||Yes|No|||Prescription required|No||045|No|.21189|03/29/2022|.2068|03/29/2022|.20818|03/29/2022|||CALCIUM CHANNEL BLOCKERS|6363|||||No|No||PAR PHARM.|No||||
diltiazem HCl|No|No|No|No|75%|10370083111|DILTIAZEM 24H ER(CD) 240 MG CP|30|EA|.58766|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No||045|No|.29728|03/29/2022|.29014|03/29/2022|.29207|03/29/2022|||CALCIUM CHANNEL BLOCKERS|6364|||||No|No||PAR PHARM.|No||||
diltiazem HCl|No|No|No|No|75%|10370083211|DILTIAZEM 24H ER(CD) 300 MG CP|30|EA|.7611|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No||045|No|.34265|03/29/2022|.33442|03/29/2022|.33665|03/29/2022|||CALCIUM CHANNEL BLOCKERS|6365|||||No|No||PAR PHARM.|No||||
multivit-mins 25/folic acid/D3|No|No|No|No|75%|10542000909|DIALYVITE SUPREME D TABLET|90|EA|.11557|||No|No||||No|No|||No|No||07/12/2011||Yes|No|||Over the counter|No|||No|||||||.27407|06/07/2016||6366|||||No|No||HILLESTAD PHARM|No||||
folic acid/vit B complex and C|No|No|No|No|75%|10542001010|DIALYVITE TABLET|100|EA|.05409|||No|No||||No|No|||No|No||09/01/1999||Yes|No|||Over the counter|No|||No|||||||.08866|06/07/2016||6367|||||No|No||HILLESTAD PHARM|No||||
multivit-mins no.11/folic acid|No|No|No|No|75%|10542001109|DIALYVITE 5000 TABLET|90|EA|.18619|||No|No||||No|No|||No|No||06/17/2011||Yes|No|||Over the counter|No|||No|.42434|07/07/2020|.41827|07/07/2020|.39836|07/07/2020||||6368|||||No|No||HILLESTAD PHARM|No||||
B complex 11/folic/C/biot/zinc|No|No|No|No|75%|10542001210|DIALYVITE WITH ZINC TABLET|100|EA|.05908|||No|No||||No|No|||No|No||09/15/2004||Yes|No|||Over the counter|No|||No|||||||.09886|06/07/2016||6369|||||No|No||HILLESTAD PHARM|No||||
folic acid/B cplx/C/selen/zinc|No|No|No|No|75%|10542001409|DIALYVITE 3,000 TABLET|90|EA|.1117|||No|No||||No|No|||No|No||09/15/2004||Yes|No|||Over the counter|No|||No|||||||.2261|06/07/2016||6370|||||No|No||HILLESTAD PHARM|No||||
folic acid/vit B complex and C|No|No|No|No|75%|10542007010|DIALYVITE 800 TABLET|100|EA|.03474|||No|No||||No|No|||No|No||09/15/2004||Yes|No|||Over the counter|No|||No|||||||.0714|06/07/2016||6371|||||No|No||HILLESTAD PHARM|No||||
ferrous fum/folic acid/Bcomp,C|No|No|No|No|75%|10542007510|DIALYVITE 800 WITH IRON TAB|100|EA|.0396|||No|No||||No|No|||No|No||09/15/2004||Yes|No|||Over the counter|No|||No|||||||.0816|06/07/2016||6372|||||No|No||HILLESTAD PHARM|No||||
peg3350/sod sulf,bicarb,Cl/KCl|No|No|No|No|75%|10572010001|PEG-3350 AND ELECTROLYTES SOLN|4000|ML|.00147|08/28/2009||Yes|No||08/28/2009||Yes|No|08/28/2009||Yes|No||||No|No|||Prescription required|No|||No|.00317|03/29/2022|.00309|03/29/2022|.00311|03/29/2022||||6373|||||No|No||AFFORDABLE PHAR|No||||
peg3350/sod sulf,bicarb,Cl/KCl|No|No|No|No|75%|10572010101|PEG-3350 AND ELECTROLYTES SOLN|4000|ML|.00147|08/28/2009|04/23/2022|Yes|No||08/28/2009|04/23/2022|Yes|No|08/28/2009|04/23/2022|Yes|No||||No|No|||Prescription required|No|||No|.00317|03/29/2022|.00309|03/29/2022|.00311|03/29/2022||||6374|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AFFORDABLE PHAR|No||||
crotamiton|No|No|No|No|75%|10631009160|EURAX 10% CREAM|60|GM|3.62576|02/23/2009||Yes|No||02/23/2009||Yes|No|02/23/2009||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|122|No|8.26336|01/23/2018|8.14531|01/23/2018|7.75744|01/23/2018|||ANTIPARASITICS: TOPICAL|6375|||||No|No||RANBAXY/SUN PHA|No||||
crotamiton|No|No|No|No|75%|10631009216|EURAX 10% LOTION|454|GM|1.96133|02/23/2009||Yes|No||02/23/2009||Yes|No|02/23/2009||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|122|No|4.47002|01/03/2017|4.40616|01/03/2017|4.19635|01/03/2017|||ANTIPARASITICS: TOPICAL|6376|||||No|No||RANBAXY/SUN PHA|No||||
crotamiton|No|No|No|No|75%|10631009260|EURAX 10% LOTION|60|GM|3.62547|02/23/2009||Yes|No||02/23/2009||Yes|No|02/23/2009||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|122|No|8.2627|01/03/2017|8.14466|01/03/2017|7.75682|01/03/2017|||ANTIPARASITICS: TOPICAL|6377|||||No|No||RANBAXY/SUN PHA|No||||
halcinonide|No|No|No|No|75%|10631009430|HALOG 0.1% CREAM|60|GM|5.51876|03/10/2010||Yes|No||03/10/2010||Yes|No|03/10/2010||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|120|No|12.57764|01/23/2018|12.39796|01/23/2018|11.80758|01/23/2018|||STEROIDS: TOPICAL HIGH|6378|||||No|No||SUN PHARMACEUTI|No||||
halcinonide|No|No|No|No|75%|10631009630|HALOG 0.1% OINTMENT|60|GM|5.51876|03/04/2010||Yes|No||03/04/2010||Yes|No|03/04/2010||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|120|No|12.57764|01/23/2018|12.39796|01/23/2018|11.80758|01/23/2018|||STEROIDS: TOPICAL HIGH|6379|||||No|No||SUN PHARMACEUTI|No||||
isotretinoin|No|No|No|No|75%|10631011531|ABSORICA 10 MG CAPSULE|30|EA|16.00073|01/09/2013||Yes|No||01/09/2013||Yes|No|01/09/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|144|No|36.46678|04/06/2021|35.94582|04/06/2021|34.23412|04/06/2021|||ACNE AGENTS: ORAL|6380|||||No|No||SUN PHARMACEUTI|No||||
isotretinoin|No|No|No|No|75%|10631011631|ABSORICA 20 MG CAPSULE|30|EA|16.00073|01/09/2013||Yes|No||01/09/2013||Yes|No|01/09/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|144|No|36.46678|04/06/2021|35.94582|04/06/2021|34.23412|04/06/2021|||ACNE AGENTS: ORAL|6381|||||No|No||SUN PHARMACEUTI|No||||
isotretinoin|No|No|No|No|75%|10631011731|ABSORICA 30 MG CAPSULE|30|EA|17.21591|01/09/2013||Yes|No||01/09/2013||Yes|No|01/09/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|144|No|38.43532|04/06/2021|37.51287|04/06/2021|37.7627|04/06/2021|||ACNE AGENTS: ORAL|6382|||||No|No||SUN PHARMACEUTI|No||||
isotretinoin|No|No|No|No|75%|10631011831|ABSORICA 40 MG CAPSULE|30|EA|17.21591|01/09/2013||Yes|No||01/09/2013||Yes|No|01/09/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|144|No|38.14314|04/06/2021|37.2277|04/06/2021|37.47563|04/06/2021|||ACNE AGENTS: ORAL|6383|||||No|No||SUN PHARMACEUTI|No||||
metformin HCl|No|No|No|No|75%|10631020601|RIOMET 500 MG/5 ML SOLUTION|118|ML|.60451|05/23/2008||Yes|No||05/23/2008||Yes|No|05/23/2008||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|012|No|1.37772|03/06/2018|1.35804|03/06/2018|1.29337|03/06/2018|||HYPOGLYCEMICS: METFORMINS|6384|||||No|No||SUN PHARMACEUTI|No||||
metformin HCl|No|No|No|No|75%|10631020602|RIOMET 500 MG/5 ML SOLUTION|473|ML|.60472|05/23/2008||Yes|No||05/23/2008||Yes|No|05/23/2008||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|012|No|1.37821|12/29/2020|1.35852|12/29/2020|1.29383|12/29/2020|||HYPOGLYCEMICS: METFORMINS|6385|||||No|No||SUN PHARMACEUTI|No||||
hydrocortisone|No|No|No|No|75%|10631040701|PROCTOSOL-HC 2.5% CREAM|28.35|GM|1.06172|10/10/2005||Yes|No||10/10/2005||Yes|No|||No|No||||No|No|||Prescription required|No||118|No|2.41974|04/27/2021|2.38517|04/27/2021|2.27159|04/27/2021|||STEROIDS: TOPICAL LOW|6386|||||No|No||RANBAXY/SUN PHA|No||||
promethazine HCl|No|No|No|No|75%|10702000201|PROMETHAZINE 12.5 MG TABLET|100|EA|.0258|08/01/2007||Yes|No||08/01/2007||Yes|No|08/01/2007||Yes|No||||No|No|||Prescription required|No||085|Yes|.05281|03/29/2022|.05154|03/29/2022|.05188|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|6387|||||No|No||KVK-TECH, INC.|No||||
promethazine HCl|No|No|No|No|75%|10702000301|PROMETHAZINE 25 MG TABLET|100|EA|.02042|02/09/2007||Yes|No||02/09/2007||Yes|No|02/09/2007||Yes|No||||No|No|||Prescription required|No||085|Yes|.05271|03/29/2022|.05144|03/29/2022|.05178|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|6388|||||No|No||KVK-TECH, INC.|No||||
promethazine HCl|No|No|No|No|75%|10702000310|PROMETHAZINE 25 MG TABLET|1000|EA|.02042|02/09/2007||Yes|No||02/09/2007||Yes|No|02/09/2007||Yes|No||||No|No|||Prescription required|No||085|Yes|.05271|03/29/2022|.05144|03/29/2022|.05178|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|6389|||||No|No||KVK-TECH, INC.|No||||
promethazine HCl|No|No|No|No|75%|10702000401|PROMETHAZINE 50 MG TABLET|100|EA|.0387|02/09/2007||Yes|No||02/09/2007||Yes|No|02/09/2007||Yes|No||||No|No|||Prescription required|No||085|Yes|.09825|03/29/2022|.09589|03/29/2022|.09653|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|6390|||||No|No||KVK-TECH, INC.|No||||
cyclobenzaprine HCl|No|No|No|No|75%|10702000601|CYCLOBENZAPRINE 5 MG TABLET|100|EA|.02021|05/03/2013||Yes|No||05/03/2013||Yes|No|05/03/2013||Yes|No||||No|No|||Prescription required|No||116|Yes|.02938|03/29/2022|.02867|03/29/2022|.02886|03/29/2022|||SKELETAL MUSCLE RELAXANTS|6391|||||No|No||KVK-TECH, INC.|No||||
cyclobenzaprine HCl|No|No|No|No|75%|10702000610|CYCLOBENZAPRINE 5 MG TABLET|1000|EA|.01623|05/03/2013||Yes|No||05/03/2013||Yes|No|05/03/2013||Yes|No||||No|No|||Prescription required|No||116|Yes|.02938|03/29/2022|.02867|03/29/2022|.02886|03/29/2022|||SKELETAL MUSCLE RELAXANTS|6392|||||No|No||KVK-TECH, INC.|No||||
cyclobenzaprine HCl|No|No|No|No|75%|10702000650|CYCLOBENZAPRINE 5 MG TABLET|500|EA|.02094|05/03/2013||Yes|No||05/03/2013||Yes|No|05/03/2013||Yes|No||||No|No|||Prescription required|No||116|Yes|.02938|03/29/2022|.02867|03/29/2022|.02886|03/29/2022|||SKELETAL MUSCLE RELAXANTS|6393|||||No|No||KVK-TECH, INC.|No||||
cyclobenzaprine HCl|No|No|No|No|75%|10702000701|CYCLOBENZAPRINE 10 MG TABLET|100|EA|.01913|05/03/2013||Yes|No||05/03/2013||Yes|No|05/03/2013||Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|6394|||||No|No||KVK-TECH, INC.|No||||
cyclobenzaprine HCl|No|No|No|No|75%|10702000710|CYCLOBENZAPRINE 10 MG TABLET|1000|EA|.01541|05/03/2013||Yes|No||05/03/2013||Yes|No|05/03/2013||Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|6395|||||No|No||KVK-TECH, INC.|No||||
cyclobenzaprine HCl|No|No|No|No|75%|10702000750|CYCLOBENZAPRINE 10 MG TABLET|500|EA|.01462|05/03/2013||Yes|No||05/03/2013||Yes|No|05/03/2013||Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|6396|||||No|No||KVK-TECH, INC.|No||||
oxycodone HCl|No|No|No|No|90%|10702000801|OXYCODONE HCL (IR) 15 MG TAB|100|EA|.0645|09/18/2009||Yes|No||09/18/2009||Yes|No|09/18/2009||Yes|No||||No|No|||Prescription required|No||109|Yes|.15895|03/29/2022|.15513|03/29/2022|.15616|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6397|||||No|No||KVK-TECH, INC.|No||||
oxycodone HCl|No|No|No|No|90%|10702000850|OXYCODONE HCL (IR) 15 MG TAB|500|EA|.08047|10/29/2015||Yes|No||10/29/2015||Yes|No|10/29/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.15895|03/29/2022|.15513|03/29/2022|.15616|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6398|||||No|No||KVK-TECH, INC.|No||||
oxycodone HCl|No|No|No|No|90%|10702000901|OXYCODONE HCL (IR) 30 MG TAB|100|EA|.1419|09/18/2009||Yes|No||09/18/2009||Yes|No|09/18/2009||Yes|No||||No|No|||Prescription required|No||109|Yes|.2615|03/29/2022|.25522|03/29/2022|.25692|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6399|||||No|No||KVK-TECH, INC.|No||||
oxycodone HCl|No|No|No|No|90%|10702000950|OXYCODONE HCL (IR) 30 MG TAB|500|EA|.15247|10/29/2015||Yes|No||10/29/2015||Yes|No|10/29/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.2615|03/29/2022|.25522|03/29/2022|.25692|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6400|||||No|No||KVK-TECH, INC.|No||||
hydroxyzine HCl|No|No|No|No|75%|10702001001|HYDROXYZINE HCL 10 MG TABLET|100|EA|.0344|08/01/2007||Yes|No||08/01/2007||Yes|No|08/01/2007||Yes|No||||No|No|||Prescription required|No||574|Yes|.03952|03/29/2022|.03857|03/29/2022|.03882|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|6401|||||No|No||KVK-TECH, INC.|No||||
hydroxyzine HCl|No|No|No|No|75%|10702001050|HYDROXYZINE HCL 10 MG TABLET|500|EA|.03397|08/01/2007||Yes|No||08/01/2007||Yes|No|08/01/2007||Yes|No||||No|No|||Prescription required|No||574|Yes|.03952|03/29/2022|.03857|03/29/2022|.03882|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|6402|||||No|No||KVK-TECH, INC.|No||||
hydroxyzine HCl|No|No|No|No|75%|10702001101|HYDROXYZINE HCL 25 MG TABLET|100|EA|.04257|08/01/2007||Yes|No||08/01/2007||Yes|No|08/01/2007||Yes|No||||No|No|||Prescription required|No||574|Yes|.06757|03/29/2022|.06594|03/29/2022|.06638|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|6403|||||No|No||KVK-TECH, INC.|No||||
hydroxyzine HCl|No|No|No|No|75%|10702001110|HYDROXYZINE HCL 25 MG TABLET|1000|EA|.03835|08/01/2007||Yes|No||08/01/2007||Yes|No|08/01/2007||Yes|No||||No|No|||Prescription required|No||574|Yes|.06757|03/29/2022|.06594|03/29/2022|.06638|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|6404|||||No|No||KVK-TECH, INC.|No||||
hydroxyzine HCl|No|No|No|No|75%|10702001150|HYDROXYZINE HCL 25 MG TABLET|500|EA|.04024|08/01/2007||Yes|No||08/01/2007||Yes|No|08/01/2007||Yes|No||||No|No|||Prescription required|No||574|Yes|.06757|03/29/2022|.06594|03/29/2022|.06638|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|6405|||||No|No||KVK-TECH, INC.|No||||
hydroxyzine HCl|No|No|No|No|75%|10702001201|HYDROXYZINE HCL 50 MG TABLET|100|EA|.06149|08/01/2007||Yes|No||08/01/2007||Yes|No|08/01/2007||Yes|No||||No|No|||Prescription required|No||574|Yes|.09594|03/29/2022|.09363|03/29/2022|.09426|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|6406|||||No|No||KVK-TECH, INC.|No||||
hydroxyzine HCl|No|No|No|No|75%|10702001210|HYDROXYZINE HCL 50 MG TABLET|1000|EA|.05553|08/01/2007||Yes|No||08/01/2007||Yes|No|08/01/2007||Yes|No||||No|No|||Prescription required|No||574|Yes|.09594|03/29/2022|.09363|03/29/2022|.09426|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|6407|||||No|No||KVK-TECH, INC.|No||||
hydroxyzine HCl|No|No|No|No|75%|10702001250|HYDROXYZINE HCL 50 MG TABLET|500|EA|.05921|08/01/2007||Yes|No||08/01/2007||Yes|No|08/01/2007||Yes|No||||No|No|||Prescription required|No||574|Yes|.09594|03/29/2022|.09363|03/29/2022|.09426|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|6408|||||No|No||KVK-TECH, INC.|No||||
betaxolol HCl|No|No|No|No|75%|10702001301|BETAXOLOL 10 MG TABLET|100|EA|.31003|08/12/2008||Yes|No||08/12/2008||Yes|No|08/12/2008||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|070|No|.52457|01/25/2022|.51198|01/25/2022|.51539|01/25/2022|||BETA-BLOCKERS|6409|||||No|No||KVK-TECH, INC.|No||||
betaxolol HCl|No|No|No|No|75%|10702001401|BETAXOLOL 20 MG TABLET|100|EA|.56545|08/12/2008||Yes|No||08/12/2008||Yes|No|08/12/2008||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|070|No|1.2887|06/01/2016|1.27029|06/01/2016|1.2098|06/01/2016|||BETA-BLOCKERS|6410|||||No|No||KVK-TECH, INC.|No||||
indomethacin|No|No|No|No|75%|10702001601|INDOMETHACIN ER 75 MG CAPSULE|100|EA|.1274|04/16/2009|02/22/2022|Yes|No||04/16/2009|02/22/2022|Yes|No|04/16/2009|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.23098|03/29/2022|.22543|03/29/2022|.22693|03/29/2022|||NSAIDS|6411|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||KVK-TECH, INC.|No||||
oxycodone HCl|No|No|No|No|90%|10702001801|OXYCODONE HCL (IR) 5 MG TABLET|100|EA|.03655|09/18/2009||Yes|No||09/18/2009||Yes|No|09/18/2009||Yes|No||||No|No|||Prescription required|No||109|Yes|.0685|03/29/2022|.06685|03/29/2022|.0673|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6412|||||No|No||KVK-TECH, INC.|No||||
oxycodone HCl|No|No|No|No|90%|10702001850|OXYCODONE HCL (IR) 5 MG TABLET|500|EA|.03655|10/29/2015||Yes|No||10/29/2015||Yes|No|10/29/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.0685|03/29/2022|.06685|03/29/2022|.0673|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6413|||||No|No||KVK-TECH, INC.|No||||
oxycodone HCl|No|No|No|No|90%|10702002301|OXYCODONE HCL (IR) 5 MG CAP|100|EA|.21495|10/09/2015||Yes|No||10/09/2015||Yes|No|10/09/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|109|Yes|.28013|03/29/2022|.2734|03/29/2022|.27522|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6414|||||No|No||KVK-TECH, INC.|No||||
sodium polystyrene sulfonate|No|No|No|No|75%|10702003645|SODIUM POLYSTYRENE SULF POWDER|454|GM|.06487|04/24/2009||Yes|No||04/24/2009||Yes|No|04/24/2009||Yes|No||||No|No|||Prescription required|No|||No|.09856|03/29/2022|.09619|03/29/2022|.09683|03/29/2022||||6415|||||No|No||KVK-TECH, INC.|No||||
hydrocodone bit/homatrop me-br|No|No|No|No|90%|10702005501|HYDROCODONE-HOMATROPINE 5-1.5|100|EA|.4945|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|183|Yes|.88201|03/29/2022|.86084|03/29/2022|.86657|03/29/2022|||COUGH AND COLD: NARCOTIC|6416|||||No|No||KVK-TECH, INC.|No||||
hydrocodone bit/homatrop me-br|No|No|No|No|90%|10702005503|HYDROCODONE-HOMATROPINE 5-1.5|30|EA|.50166|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|183|Yes|.88201|03/29/2022|.86084|03/29/2022|.86657|03/29/2022|||COUGH AND COLD: NARCOTIC|6417|||||No|No||KVK-TECH, INC.|No||||
oxycodone HCl|No|No|No|No|90%|10702005601|OXYCODONE HCL (IR) 10 MG TAB|100|EA|.06235|09/18/2009||Yes|No||09/18/2009||Yes|No|09/18/2009||Yes|No||||No|No|||Prescription required|No||109|Yes|.12568|03/29/2022|.12266|03/29/2022|.12348|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6418|||||No|No||KVK-TECH, INC.|No||||
oxycodone HCl|No|No|No|No|90%|10702005650|OXYCODONE HCL (IR) 10 MG TAB|500|EA|.0688|10/29/2015||Yes|No||10/29/2015||Yes|No|10/29/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.12568|03/29/2022|.12266|03/29/2022|.12348|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6419|||||No|No||KVK-TECH, INC.|No||||
oxycodone HCl|No|No|No|No|90%|10702005701|OXYCODONE HCL (IR) 20 MG TAB|100|EA|.11825|09/18/2009||Yes|No||09/18/2009||Yes|No|09/18/2009||Yes|No||||No|No|||Prescription required|No||109|Yes|.23193|03/29/2022|.22636|03/29/2022|.22787|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6420|||||No|No||KVK-TECH, INC.|No||||
oxycodone HCl|No|No|No|No|90%|10702005750|OXYCODONE HCL (IR) 20 MG TAB|500|EA|.12706|10/29/2015||Yes|No||10/29/2015||Yes|No|10/29/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.23193|03/29/2022|.22636|03/29/2022|.22787|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6421|||||No|No||KVK-TECH, INC.|No||||
dextroamphetamine sulfate|No|No|No|No|75%|10702006501|DEXTROAMPHETAMINE 5 MG TAB|100|EA|.2064|11/30/2015||Yes|No||11/30/2015||Yes|No|11/30/2015||Yes|No||||No|No|||Prescription required|No||007|Yes|.24678|03/29/2022|.24085|03/29/2022|.24246|03/29/2022|||STIMULANTS AND RELATED AGENTS|6422|||||No|No||KVK-TECH, INC.|No||||
dextroamphetamine sulfate|No|No|No|No|75%|10702006601|DEXTROAMPHETAMINE 10 MG TAB|100|EA|.2236|11/30/2015||Yes|No||11/30/2015||Yes|No|11/30/2015||Yes|No||||No|No|||Prescription required|No||007|Yes|.30046|03/29/2022|.29324|03/29/2022|.2952|03/29/2022|||STIMULANTS AND RELATED AGENTS|6423|||||No|No||KVK-TECH, INC.|No||||
oxymorphone HCl|No|No|No|No|90%|10702007001|OXYMORPHONE HCL 5 MG TABLET|100|EA|.4343|10/22/2013||Yes|No||10/22/2013||Yes|No|10/22/2013||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|109|Yes|.56292|03/01/2022|.5494|03/01/2022|.55306|03/01/2022|||ANALGESICS: NARCOTICS SHORT|6424|||||No|No||KVK-TECH, INC.|No||||
oxymorphone HCl|No|No|No|No|90%|10702007006|OXYMORPHONE HCL 5 MG TABLET|60|EA|.14856|01/30/2020||Yes|No||01/30/2020||Yes|No|01/30/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|109|Yes|.56292|03/01/2022|.5494|03/01/2022|.55306|03/01/2022|||ANALGESICS: NARCOTICS SHORT|6425|||||No|No||KVK-TECH, INC.|No||||
oxymorphone HCl|No|No|No|No|90%|10702007101|OXYMORPHONE HCL 10 MG TABLET|100|EA|.731|10/22/2013||Yes|No||10/22/2013||Yes|No|10/22/2013||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|109|Yes|.96999|03/29/2022|.94671|03/29/2022|.95301|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6426|||||No|No||KVK-TECH, INC.|No||||
oxymorphone HCl|No|No|No|No|90%|10702007106|OXYMORPHONE HCL 10 MG TABLET|60|EA|.1515|01/30/2020||Yes|No||01/30/2020||Yes|No|01/30/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|109|Yes|.96999|03/29/2022|.94671|03/29/2022|.95301|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6427|||||No|No||KVK-TECH, INC.|No||||
methylphenidate HCl|No|No|No|No|75%|10702007501|METHYLPHENIDATE ER 10 MG TAB|100|EA|.23839|11/04/2015||Yes|No||11/04/2015||Yes|No|11/04/2015||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|007|Yes|.37583|03/29/2022|.36681|03/29/2022|.36925|03/29/2022|||STIMULANTS AND RELATED AGENTS|6428|||||No|No||KVK-TECH, INC.|No||||
methylphenidate HCl|No|No|No|No|75%|10702007601|METHYLPHENIDATE ER 20 MG TAB|100|EA|.24557|11/04/2015||Yes|No||11/04/2015||Yes|No|11/04/2015||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|007|Yes|.50044|03/29/2022|.48842|03/29/2022|.49168|03/29/2022|||STIMULANTS AND RELATED AGENTS|6429|||||No|No||KVK-TECH, INC.|No||||
methylphenidate HCl|No|No|No|No|75%|10702010001|METHYLPHENIDATE 5 MG TABLET|100|EA|.04515|11/10/2017||Yes|No||11/10/2017||Yes|No|11/10/2017||Yes|No||||No|No|||Prescription required|No||007|Yes|.1394|03/29/2022|.13605|03/29/2022|.13696|03/29/2022|||STIMULANTS AND RELATED AGENTS|6430|||||No|No||KVK-TECH, INC.|No||||
methylphenidate HCl|No|No|No|No|75%|10702010101|METHYLPHENIDATE 10 MG TABLET|100|EA|.06235|11/10/2017||Yes|No||11/10/2017||Yes|No|11/10/2017||Yes|No||||No|No|||Prescription required|No||007|Yes|.15766|03/29/2022|.15387|03/29/2022|.1549|03/29/2022|||STIMULANTS AND RELATED AGENTS|6431|||||No|No||KVK-TECH, INC.|No||||
methylphenidate HCl|No|No|No|No|75%|10702010201|METHYLPHENIDATE 20 MG TABLET|100|EA|.086|11/10/2017||Yes|No||11/10/2017||Yes|No|11/10/2017||Yes|No||||No|No|||Prescription required|No||007|Yes|.22814|03/29/2022|.22266|03/29/2022|.22414|03/29/2022|||STIMULANTS AND RELATED AGENTS|6432|||||No|No||KVK-TECH, INC.|No||||
dexmethylphenidate HCl|No|No|No|No|75%|10702010601|DEXMETHYLPHENIDATE 2.5 MG TAB|100|EA|.06665|12/15/2015||Yes|No||12/15/2015||Yes|No|12/15/2015||Yes|No||||No|No|||Prescription required|No||007|Yes|.13596|03/29/2022|.13269|03/29/2022|.13358|03/29/2022|||STIMULANTS AND RELATED AGENTS|6433|||||No|No||KVK-TECH, INC.|No||||
dexmethylphenidate HCl|No|No|No|No|75%|10702010701|DEXMETHYLPHENIDATE 5 MG TAB|100|EA|.08062|12/15/2015||Yes|No||12/15/2015||Yes|No|12/15/2015||Yes|No||||No|No|||Prescription required|No||007|Yes|.16938|03/29/2022|.16531|03/29/2022|.16641|03/29/2022|||STIMULANTS AND RELATED AGENTS|6434|||||No|No||KVK-TECH, INC.|No||||
dexmethylphenidate HCl|No|No|No|No|75%|10702010801|DEXMETHYLPHENIDATE 10 MG TAB|100|EA|.10212|12/15/2015||Yes|No||12/15/2015||Yes|No|12/15/2015||Yes|No||||No|No|||Prescription required|No||007|Yes|.29016|03/29/2022|.28319|03/29/2022|.28508|03/29/2022|||STIMULANTS AND RELATED AGENTS|6435|||||No|No||KVK-TECH, INC.|No||||
hydrocodone bit/homatrop me-br|No|No|No|No|90%|10702015016|HYDROCODONE-HOMATROPINE SOLN|473|ML|.0359|11/22/2017||Yes|No||11/22/2017||Yes|No|11/22/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|183|Yes|.1071|03/29/2022|.10452|03/29/2022|.10522|03/29/2022|||COUGH AND COLD: NARCOTIC|6436|||||No|No||KVK-TECH, INC.|No||||
methylphenidate HCl|No|No|No|No|75%|10702016350|METHYLPHENIDATE 5 MG/5 ML SOLN|500|ML|.0602|11/22/2017||Yes|No||11/22/2017||Yes|No|11/22/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.15581|03/29/2022|.15207|03/29/2022|.15308|03/29/2022|||STIMULANTS AND RELATED AGENTS|6437|||||No|No||KVK-TECH, INC.|No||||
methylphenidate HCl|No|No|No|No|75%|10702016450|METHYLPHENIDATE 10 MG/5 ML SOL|500|ML|.086|11/22/2017||Yes|No||11/22/2017||Yes|No|11/22/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.17579|03/29/2022|.17157|03/29/2022|.17271|03/29/2022|||STIMULANTS AND RELATED AGENTS|6438|||||No|No||KVK-TECH, INC.|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|10702018401|OXYCODONE-ACETAMINOPHN 2.5-325|100|EA|.70085|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|1.39948|03/29/2022|1.36589|03/29/2022|1.37498|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6439|||||No|No||KVK-TECH, INC.|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|10702018701|OXYCODONE-ACETAMINOPHEN 10-325|100|EA|.16383|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.19233|03/29/2022|.18771|03/29/2022|.18896|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6440|||||No|No||KVK-TECH, INC.|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|10702018750|OXYCODONE-ACETAMINOPHEN 10-325|500|EA|.16383|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.19233|03/29/2022|.18771|03/29/2022|.18896|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6441|||||No|No||KVK-TECH, INC.|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|10702019001|HYDROCODONE-ACETAMIN 7.5-325|100|EA|.06523|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||05/31/2018||Yes|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6442|||||No|No||KVK-TECH, INC.|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|10702019010|HYDROCODONE-ACETAMIN 7.5-325|1000|EA|.03907|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||05/31/2018||Yes|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6443|||||No|No||KVK-TECH, INC.|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|10702019050|HYDROCODONE-ACETAMIN 7.5-325|500|EA|.06403|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||05/31/2018||Yes|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6444|||||No|No||KVK-TECH, INC.|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|10702019101|HYDROCODONE-ACETAMIN 10-325 MG|100|EA|.07658|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||05/31/2018||Yes|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6445|||||No|No||KVK-TECH, INC.|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|10702019201|HYDROCODONE-ACETAMIN 5-300 MG|100|EA|.16834|12/29/2020||Yes|No||12/29/2020||Yes|No|12/29/2020||Yes|No||||No|No|||Prescription required|No||109|Yes|.19231|03/29/2022|.18769|03/29/2022|.18894|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6446|||||No|No||KVK-TECH, INC.|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|10702019301|HYDROCODONE-ACETAMIN 7.5-300|100|EA|.19995|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|No||109|Yes|.2429|03/29/2022|.23707|03/29/2022|.23864|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6447|||||No|No||KVK-TECH, INC.|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|10702019401|HYDROCODONE-ACETAMIN 10-300 MG|100|EA|.21478|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|No||109|Yes|.34815|03/29/2022|.33979|03/29/2022|.34205|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6448|||||No|No||KVK-TECH, INC.|No||||
oxybutynin chloride|No|No|No|No|75%|10702020101|OXYBUTYNIN 5 MG TABLET|100|EA|.03784|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|6449|||||No|No||KVK-TECH, INC.|No||||
oxybutynin chloride|No|No|No|No|75%|10702020110|OXYBUTYNIN 5 MG TABLET|1000|EA|.03655|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|6450|||||No|No||KVK-TECH, INC.|No||||
oxybutynin chloride|No|No|No|No|75%|10702020150|OXYBUTYNIN 5 MG TABLET|500|EA|.03698|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|6451|||||No|No||KVK-TECH, INC.|No||||
atovaquone|No|No|No|No|75%|10702022321|ATOVAQUONE 750 MG/5 ML SUSP|210|ML|1.15714|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|1.13871|03/29/2022|1.11138|03/29/2022|1.11878|03/29/2022||||6452|||||No|No||KVK-TECH, INC.|No||||
ursodiol|No|No|No|No|75%|10702023701|URSODIOL 300 MG CAPSULE|100|EA|.3397|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|198|No|.60006|03/29/2022|.58565|03/29/2022|.58955|03/29/2022|||BILE SALTS|6453|||||No|No||KVK-TECH, INC.|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|10702025301|BUTALB-ACETAMIN-CAFF 50-325-40|100|EA|.08815|12/29/2020||Yes|No||12/29/2020||Yes|No|12/29/2020||Yes|No||||No|No|||Prescription required|No|||No|.18524|03/29/2022|.18079|03/29/2022|.18199|03/29/2022||||6454|||||No|No||KVK-TECH, INC.|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|10702025350|BUTALB-ACETAMIN-CAFF 50-325-40|500|EA|.08686|12/29/2020||Yes|No||12/29/2020||Yes|No|12/29/2020||Yes|No||||No|No|||Prescription required|No|||No|.18524|03/29/2022|.18079|03/29/2022|.18199|03/29/2022||||6455|||||No|No||KVK-TECH, INC.|No||||
benzhydrocodone/acetaminophen|No|No|No|No|75%|10702034301|BENZHYDROCOD-ACETAMIN 4.08-325|100|EA|.1032|03/30/2020||Yes|No||03/30/2020||Yes|No|03/30/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|109|Yes|.2352|03/30/2020|.23184|03/30/2020|.2208|03/30/2020|||ANALGESICS: NARCOTICS SHORT|6456|||||No|No||KVK-TECH, INC.|No||||
benzhydrocodone/acetaminophen|No|No|No|No|75%|10702034401|BENZHYDROCOD-ACETAMIN 6.12-325|100|EA|.1118|03/30/2020||Yes|No||03/30/2020||Yes|No|03/30/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|109|Yes|.2548|03/30/2020|.25116|03/30/2020|.2392|03/30/2020|||ANALGESICS: NARCOTICS SHORT|6457|||||No|No||KVK-TECH, INC.|No||||
benzhydrocodone/acetaminophen|No|No|No|No|75%|10702034501|BENZHYDROCOD-ACETAMIN 8.16-325|100|EA|.1204|03/30/2020||Yes|No||03/30/2020||Yes|No|03/30/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|109|Yes|.2744|03/30/2020|.27048|03/30/2020|.2576|03/30/2020|||ANALGESICS: NARCOTICS SHORT|6458|||||No|No||KVK-TECH, INC.|No||||
lidocaine/tetracaine|No|No|No|No|75%|10885000201|SYNERA PATCH|1|EA|7.2885|07/01/2014||Yes|No||07/01/2014||Yes|No|07/01/2014||Yes|No||||No|No|||Prescription required|No|||No|16.611|10/02/2018|16.3737|10/02/2018|15.594|10/02/2018||||6459|||||No|No||GALEN US INCORP|No||||
lidocaine/tetracaine|No|No|No|No|75%|10885000210|SYNERA PATCH|10|EA|7.2885|07/01/2014||Yes|No||07/01/2014||Yes|No|07/01/2014||Yes|No||||No|No|||Prescription required|No|||No|16.611|10/02/2018|16.3737|10/02/2018|15.594|10/02/2018||||6460|||||No|No||GALEN US INCORP|No||||
sodium fluoride/potassium nit|No|No|No|No|75%|11527070442|SODIUM FLUORIDE SENSTV 5000PPM|100|ML|.05663|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||No|.12654|03/29/2022|.1235|03/29/2022|.12432|03/29/2022||||6461|||||No|No||SHEFFIELD PHARM|No||||
fluoride (sodium)|No|No|No|No|75%|11527073044|SODIUM FLUORIDE 5000 PPM PASTE|100|ML|.05663|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||No|.12026|03/29/2022|.11737|03/29/2022|.11815|03/29/2022||||6462|||||No|No||SHEFFIELD PHARM|No||||
sodium fluoride/potassium nit|No|No|No|No|75%|11527074534|SOD FLUORIDE ENAM PROT 5000PPM|100|ML|.05663|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No|||No|.12654|03/29/2022|.1235|03/29/2022|.12432|03/29/2022||||6463|||||No|No||SHEFFIELD PHARM|No||||
fluoride (sodium)|No|No|No|No|75%|11527075043|SODIUM FLUORIDE 5000 PPM PASTE|100|ML|.05663|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||No|.12026|03/29/2022|.11737|03/29/2022|.11815|03/29/2022||||6464|||||No|No||SHEFFIELD PHARM|No||||
fluoride (sodium)|No|No|No|No|75%|11527075534|SODIUM FLUORIDE 5000 DRY MOUTH|100|ML|.05663|08/02/2021||Yes|No||08/02/2021||Yes|No|08/02/2021||Yes|No||||No|No|||Prescription required|No|||No|.12026|03/29/2022|.11737|03/29/2022|.11815|03/29/2022||||6465|||||No|No||SHEFFIELD PHARM|No||||
folic acid|No|No|No|No|75%|11534016501|FOLIC ACID 1 MG TABLET|100|EA|.0258|05/05/2017||Yes|No||05/05/2017||Yes|No|05/05/2017||Yes|No||||No|No|||Prescription required|No|||No|.02568|03/29/2022|.02506|03/29/2022|.02523|03/29/2022||||6466|||||No|No||SUNRISE PHARMAC|No||||
folic acid|No|No|No|No|75%|11534016503|FOLIC ACID 1 MG TABLET|1000|EA|.00903|05/05/2017||Yes|No||05/05/2017||Yes|No|05/05/2017||Yes|No||||No|No|||Prescription required|No|||No|.02568|03/29/2022|.02506|03/29/2022|.02523|03/29/2022||||6467|||||No|No||SUNRISE PHARMAC|No||||
sodium polystyrene sulfonate|No|No|No|No|75%|11534016615|SODIUM POLYSTYRENE SULF POWDER|15|GM|.35804|12/17/2020||Yes|No||12/17/2020||Yes|No|12/17/2020||Yes|No||||No|No|||Prescription required|No|||No|.816|02/15/2022|.80434|02/15/2022|.76604|02/15/2022||||6468|||||No|No||SUNRISE PHARMAC|No||||
sodium polystyrene sulfonate|No|No|No|No|75%|11534016616|SODIUM POLYSTYRENE SULF POWDER|15|GM|.35833|03/19/2021||Yes|No||03/19/2021||Yes|No|03/19/2021||Yes|No||||No|No|||Prescription required|No|||No|.5292|08/24/2021|.51649|08/24/2021|.51993|08/24/2021||||6469|||||No|No||SUNRISE PHARMAC|No||||
sodium polystyrene sulfonate|No|No|No|No|75%|11534016644|SODIUM POLYSTYRENE SULF POWDER|454|GM|.12453|09/27/2017||Yes|No||09/27/2017||Yes|No|09/27/2017||Yes|No||||No|No|||Prescription required|No|||No|.09856|03/29/2022|.09619|03/29/2022|.09683|03/29/2022||||6470|||||No|No||SUNRISE PHARMAC|No||||
polyethylene glycol 3350|No|No|No|No|75%|11534018028|POLYETHYLENE GLYCOL 3350 POWD|238|GM|.01311|05/18/2018||Yes|No||||No|No|05/18/2018||Yes|No||||No|No|||Over the counter|No|||No|.02672|03/29/2022|.02607|03/29/2022|.02625|03/29/2022||||6471|||||No|No||SUNRISE PHARMAC|No||||
polyethylene glycol 3350|No|No|No|No|75%|11534018050|POLYETHYLENE GLYCOL 3350 POWD|510|GM|.01194|04/23/2019||Yes|No||||No|No|04/23/2019||Yes|No||||No|No|||Over the counter|No|||No|.02124|03/29/2022|.02073|03/29/2022|.02086|03/29/2022||||6472|||||No|No||SUNRISE PHARMAC|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|11534018701|BUTALB-ACETAMIN-CAFF 50-300-40|100|EA|.72111|09/27/2017||Yes|No||09/27/2017||Yes|No|09/27/2017||Yes|No||||No|No|||Prescription required|No|||No|.69452|03/29/2022|.67785|03/29/2022|.68236|03/29/2022||||6473|||||No|No||SUNRISE PHARMAC|No||||
dextroamphetamine sulfate|No|No|No|No|75%|11534018801|DEXTROAMPHETAMINE 5 MG TAB|100|EA|.5934|01/12/2022||Yes|No||01/12/2022||Yes|No|01/12/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.24678|03/29/2022|.24085|03/29/2022|.24246|03/29/2022|||STIMULANTS AND RELATED AGENTS|6474|||||No|No||SUNRISE PHARMAC|No||||
dextroamphetamine sulfate|No|No|No|No|75%|11534018901|DEXTROAMPHETAMINE 10 MG TAB|100|EA|.6106|10/28/2021||Yes|No||10/28/2021||Yes|No|10/28/2021||Yes|No||||No|No|||Prescription required|No||007|Yes|.30046|03/29/2022|.29324|03/29/2022|.2952|03/29/2022|||STIMULANTS AND RELATED AGENTS|6475|||||No|No||SUNRISE PHARMAC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|11534019001|DEXTROAMP-AMPHETAMINE 5 MG TAB|100|EA|.37233|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|No||007|Yes|.21985|03/29/2022|.21457|03/29/2022|.216|03/29/2022|||STIMULANTS AND RELATED AGENTS|6476|||||No|No||SUNRISE PHARMAC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|11534019101|DEXTROAMP-AMPHETAM 7.5 MG TAB|100|EA|.37233|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|No||007|Yes|.45915|03/29/2022|.44813|03/29/2022|.45111|03/29/2022|||STIMULANTS AND RELATED AGENTS|6477|||||No|No||SUNRISE PHARMAC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|11534019201|DEXTROAMP-AMPHETAMIN 10 MG TAB|100|EA|.37233|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|No||007|Yes|.24071|03/29/2022|.23493|03/29/2022|.23649|03/29/2022|||STIMULANTS AND RELATED AGENTS|6478|||||No|No||SUNRISE PHARMAC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|11534019301|DEXTROAMP-AMPHETAM 12.5 MG TAB|100|EA|.37233|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|No||007|Yes|.65907|03/01/2022|.64325|03/01/2022|.64753|03/01/2022|||STIMULANTS AND RELATED AGENTS|6479|||||No|No||SUNRISE PHARMAC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|11534019401|DEXTROAMP-AMPHETAMIN 15 MG TAB|100|EA|.37233|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|No||007|Yes|.25605|03/29/2022|.2499|03/29/2022|.25156|03/29/2022|||STIMULANTS AND RELATED AGENTS|6480|||||No|No||SUNRISE PHARMAC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|11534019501|DEXTROAMP-AMPHETAMIN 20 MG TAB|100|EA|.37233|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|No||007|Yes|.31357|03/29/2022|.30604|03/29/2022|.30808|03/29/2022|||STIMULANTS AND RELATED AGENTS|6481|||||No|No||SUNRISE PHARMAC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|11534019601|DEXTROAMP-AMPHETAMIN 30 MG TAB|100|EA|.37233|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|No||007|Yes|.30925|03/29/2022|.30182|03/29/2022|.30383|03/29/2022|||STIMULANTS AND RELATED AGENTS|6482|||||No|No||SUNRISE PHARMAC|No||||
chlordiazepoxide/clidinium Br|No|No|No|No|75%|11534019701|CHLORDIAZEPOXIDE-CLIDINIUM CAP|100|EA|.6407|12/17/2020||Yes|No||12/17/2020||Yes|No|12/17/2020||Yes|No||||No|No|||Prescription required|No|||Yes|.95937|03/29/2022|.93634|03/29/2022|.94258|03/29/2022||||6483|||||No|No||SUNRISE PHARMAC|No||||
multivitamin with iron|No|No|No|No|75%|11845000001|DAILY MULTI VITAMIN-IRON TAB|100|EA||||No|No||||No|No|||No|No||09/01/1999||Yes|No|||Over the counter|No|||No|||||||.02255|09/01/1999||6484|||||No|No||MASON DISTRIB.|No||||
B-complex with vitamin C|No|No|No|No|75%|11845053501|VITAMIN B COMPLEX-VIT C CAP|100|EA||||No|No||||No|No|||No|No||09/01/1999||Yes|No|||Over the counter|No|||No|||||||.0177|09/01/1999||6485|||||No|No||MASON DISTRIB.|No||||
cyanocobalamin (vitamin B-12)|No|No|No|No|75%|11845057401|VITAMIN B-12 100 MCG TABLET|100|EA||||No|No||||No|No|||No|No||09/01/1999||Yes|No|||Over the counter|No|||No|||||||.01362|09/01/1999||6486|||||No|No||MASON DISTRIB.|No||||
magnesium gluconate|No|No|No|No|75%|11845061701|MAGNESIUM GLUC 550 MG TABLET|100|EA||||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|||||||.05393|08/19/2013||6487|||||No|No||MASON DISTRIB.|No||||
zinc gluconate|No|No|No|No|75%|11845069101|ZINC GLUCONATE 50 MG TABLET|100|EA||||No|No||||No|No|||No|No||09/01/1999||Yes|No|||Over the counter|No|||No|||||||.04602|09/01/1999||6488|||||No|No||MASON DISTRIB.|No||||
multivitamin with minerals|No|No|No|No|75%|11845095505|DAILY MULTIVIT-MINERALS TAB|60|EA||||No|No||||No|No|||No|No||09/01/1999||Yes|No|||Over the counter|No|||No|||||||.02849|09/01/1999||6489|||||No|No||MASON DISTRIB.|No||||
COVID-19 antigen test|Yes|No|No|No|75%|11877001129|BINAXNOW COVID-19 AG CARD|1|EA|.0043|01/03/2022||Yes|No||01/03/2022||Yes|No|01/03/2022||Yes|No||01/03/2022||Yes|No|01/03/2022||Prescription required|No|||No|.0098|12/24/2021|.00966|12/24/2021|.0092|12/24/2021||||6490|||||No|No||ALERE/ABBOTT DI|No||||
COVID-19 antigen test|Yes|No|No|No|75%|11877001133|BINAXNOW COVD AG CARD HOME TST|1|EA||01/03/2022||Yes|No||01/03/2022||Yes|No|01/03/2022||Yes|No||01/03/2022||Yes|No|01/03/2022||Prescription required|No|||No||||||||||6491|||||No|No||ALERE/ABBOTT DI|No||||
COVID-19 antigen test|Yes|No|No|No|75%|11877001140|BINAXNOW COVID-19 AG SELF TEST|2|EA|3.44|01/03/2022||Yes|No||01/03/2022||Yes|No|01/03/2022||Yes|No||01/03/2022||Yes|No|01/03/2022||Over the counter|No|||No|7.84|01/25/2022|7.728|01/25/2022|7.36|01/25/2022||||6492|||||No|No||ALERE/ABBOTT DI|No||||
sulfacetamide sodium|No|No|No|No|75%|11980001105|BLEPH-10 10% EYE DROPS|5|ML|12.00904|10/30/2010|06/30/2022|Yes|No||10/30/2010|06/30/2022|Yes|No|10/30/2010|06/30/2022|Yes|No||||No|No|||Prescription required|Yes|01/20/2011|058|No|27.36944|01/12/2021|26.97844|01/12/2021|25.69376|01/12/2021|||OPHTHALMIC ANTIBIOTICS|6493|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ALLERGAN INC.|No||||
sulfacetamide/prednisolone|No|No|No|No|75%|11980002205|BLEPHAMIDE EYE DROPS|5|ML|13.7944|03/01/2002|04/30/2022|Yes|No||03/01/2002|04/30/2022|Yes|No|03/01/2002|04/30/2022|Yes|No||||No|No|||Prescription required|Yes|01/27/2022|036|No|31.4384|01/25/2022|30.98928|01/25/2022|29.5136|01/25/2022|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|6494|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ALLERGAN INC.|No||||
sulfacetamide/prednisolone|No|No|No|No|75%|11980002210|BLEPHAMIDE EYE DROPS|10|ML|13.79483|03/01/2002|05/31/2022|Yes|No||03/01/2002|05/31/2022|Yes|No|03/01/2002|05/31/2022|Yes|No||||No|No|||Prescription required|Yes|01/27/2022|036|No|31.43938|01/25/2022|30.99024|01/25/2022|29.51452|01/25/2022|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|6495|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ALLERGAN INC.|No||||
prednisolone acetate|No|No|No|No|75%|11980017405|PRED MILD 0.12% EYE DROPS|5|ML|13.7944|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|013|No|31.4384|01/25/2022|30.98928|01/25/2022|29.5136|01/25/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|6496|||||No|No||ALLERGAN INC.|No||||
prednisolone acetate|No|No|No|No|75%|11980017410|PRED MILD 0.12% EYE DROPS|10|ML|13.79483|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|013|No|31.43938|01/25/2022|30.99024|01/25/2022|29.51452|01/25/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|6497|||||No|No||ALLERGAN INC.|No||||
prednisolone acetate|No|No|No|No|75%|11980018005|PRED FORTE 1% EYE DROPS|5|ML|13.7944|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|013|No|30.77371|03/01/2022|30.03514|03/01/2022|30.23517|03/01/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|6498|||||No|No||ALLERGAN INC.|No||||
prednisolone acetate|No|No|No|No|75%|11980018010|PRED FORTE 1% EYE DROPS|10|ML|13.79483|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|013|No|31.43938|01/25/2022|30.99024|01/25/2022|29.51452|01/25/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|6499|||||No|No||ALLERGAN INC.|No||||
prednisolone acetate|No|No|No|No|75%|11980018015|PRED FORTE 1% EYE DROPS|15|ML|13.7944|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|013|No|31.4384|01/12/2021|30.98928|01/12/2021|29.5136|01/12/2021|||OPHTHALMICS: ANTI-INFLAMMATORIES|6500|||||No|No||ALLERGAN INC.|No||||
fluorometholone|No|No|No|No|75%|11980021105|FML LIQUIFILM 0.1% EYE DROP|5|ML|14.48412|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|013|No|33.01032|01/25/2022|32.53874|01/25/2022|30.98928|01/25/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|6501|||||No|No||ALLERGAN INC.|No||||
fluorometholone|No|No|No|No|75%|11980021110|FML LIQUIFILM 0.1% EYE DROP|10|ML|14.48455|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|013|No|33.0113|01/25/2022|32.53971|01/25/2022|30.9902|01/25/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|6502|||||No|No||ALLERGAN INC.|No||||
fluorometholone|No|No|No|No|75%|11980022805|FML FORTE 0.25% EYE DROPS|5|ML|14.48412|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|013|No|32.36775|10/26/2021|31.59092|10/26/2021|31.80131|10/26/2021|||OPHTHALMICS: ANTI-INFLAMMATORIES|6503|||||No|No||ALLERGAN INC.|No||||
fluorometholone|No|No|No|No|75%|11980022810|FML FORTE 0.25% EYE DROPS|10|ML|14.48455|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|013|No|33.0113|01/25/2022|32.53971|01/25/2022|30.9902|01/25/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|6504|||||No|No||ALLERGAN INC.|No||||
ofloxacin|No|No|No|No|75%|11980077905|OCUFLOX 0.3% EYE DROPS|5|ML|10.66916|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/28/2004|058|No|24.31576|01/12/2021|23.96839|01/12/2021|22.82704|01/12/2021|||OPHTHALMIC ANTIBIOTICS|6505|||||No|No||ALLERGAN INC.|No||||
risperidone|No|No|No|No|75%|12496009001|PERSERIS ER 90 MG SYRINGE KIT|1|EA|851.1979|02/15/2019||Yes|No||02/15/2019||Yes|No|02/15/2019||Yes|No||||No|No|||Prescription required|No||027|Yes|1939.9394|02/22/2022|1912.22598|02/22/2022|1821.1676|02/22/2022|||ANTIPSYCHOTICS|6506|||||No|Yes|12.56|INDIVIOR INC.|No||||
risperidone|No|No|No|No|75%|12496012001|PERSERIS ER 120 MG SYRINGE KIT|1|EA|1134.9377|02/15/2019||Yes|No||02/15/2019||Yes|No|02/15/2019||Yes|No||||No|No|||Prescription required|No||027|Yes|2586.6022|02/22/2022|2549.65074|02/22/2022|2428.2388|02/22/2022|||ANTIPSYCHOTICS|6507|||||No|Yes|12.56|INDIVIOR INC.|No||||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|12496120201|SUBOXONE 2 MG-0.5 MG SL FILM|1|EA|2.1543|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|4.79875|07/27/2021|4.68358|07/27/2021|4.71477|07/27/2021|||OPIATE DEPENDENCE TREATMENTS|6508|||||No|No||INDIVIOR INC.|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|12496120203|SUBOXONE 2 MG-0.5 MG SL FILM|30|EA|2.1543|10/15/2010||Yes|No||10/15/2010||Yes|No|10/15/2010||Yes|No||||No|No|||Prescription required|No||145|Yes|4.79875|07/27/2021|4.68358|07/27/2021|4.71477|07/27/2021|||OPIATE DEPENDENCE TREATMENTS|6509|||||No|No||INDIVIOR INC.|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|12496120401|SUBOXONE 4 MG-1 MG SL FILM|1|EA|3.8614|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|8.61591|07/27/2021|8.40912|07/27/2021|8.46513|07/27/2021|||OPIATE DEPENDENCE TREATMENTS|6510|||||No|No||INDIVIOR INC.|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|12496120403|SUBOXONE 4 MG-1 MG SL FILM|30|EA|3.8614|12/19/2012||Yes|No||12/19/2012||Yes|No|12/19/2012||Yes|No||||No|No|||Prescription required|No||145|Yes|8.61591|07/27/2021|8.40912|07/27/2021|8.46513|07/27/2021|||OPIATE DEPENDENCE TREATMENTS|6511|||||No|No||INDIVIOR INC.|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|12496120801|SUBOXONE 8 MG-2 MG SL FILM|1|EA|3.8614|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|8.62198|07/27/2021|8.41505|07/27/2021|8.47109|07/27/2021|||OPIATE DEPENDENCE TREATMENTS|6512|||||No|No||INDIVIOR INC.|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|12496120803|SUBOXONE 8 MG-2 MG SL FILM|30|EA|3.8614|10/15/2010||Yes|No||10/15/2010||Yes|No|10/15/2010||Yes|No||||No|No|||Prescription required|No||145|Yes|8.62198|07/27/2021|8.41505|07/27/2021|8.47109|07/27/2021|||OPIATE DEPENDENCE TREATMENTS|6513|Not Specified|Not Specified|Not Specified||No|No||INDIVIOR INC.|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|12496121201|SUBOXONE 12 MG-3 MG SL FILM|1|EA|7.7228|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|17.24329|07/27/2021|16.82945|07/27/2021|16.94153|07/27/2021|||OPIATE DEPENDENCE TREATMENTS|6514|||||No|No||INDIVIOR INC.|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|12496121203|SUBOXONE 12 MG-3 MG SL FILM|30|EA|7.7228|12/19/2012||Yes|No||12/19/2012||Yes|No|12/19/2012||Yes|No||||No|No|||Prescription required|No||145|Yes|17.24329|07/27/2021|16.82945|07/27/2021|16.94153|07/27/2021|||OPIATE DEPENDENCE TREATMENTS|6515|||||No|No||INDIVIOR INC.|Yes|09/01/2020|||
dexbromphen/pseudoeph/chlophed|No|No|No|No|75%|12830076216|CHLO TUSS LIQUID|473|ML|.03631|10/25/2013||Yes|No||||No|No|10/25/2013||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.08277|01/26/2021|.08158|01/26/2021|.0777|01/26/2021|||COUGH AND COLD: NON-NARCOTIC|6516|||||No|No||R.A.MC NEIL CO.|No||||
dexbromphen/pseudoephedrine/DM|No|No|No|No|75%|12830081616|M-END DMX LIQUID|473|ML|.02722|12/19/2011||Yes|No||||No|No|12/19/2011||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.06204|11/23/2021|.06115|11/23/2021|.05824|11/23/2021|||COUGH AND COLD: NON-NARCOTIC|6517|||||No|No||R.A.MC NEIL CO.|No||||
mirtazapine|No|No|No|No|75%|13107000105|MIRTAZAPINE 7.5 MG TABLET|500|EA|.56545|12/27/2013||Yes|No||12/27/2013||Yes|No|12/27/2013||Yes|No||||No|No|||Prescription required|No||031|Yes|.74916|03/29/2022|.73118|03/29/2022|.73604|03/29/2022|||ANTIDEPRESSANTS: OTHER|6518|||||No|No||AUROBINDO PHARM|No||||
mirtazapine|No|No|No|No|75%|13107000130|MIRTAZAPINE 7.5 MG TABLET|30|EA|.91561|12/27/2013||Yes|No||12/27/2013||Yes|No|12/27/2013||Yes|No||||No|No|||Prescription required|No||031|Yes|.74916|03/29/2022|.73118|03/29/2022|.73604|03/29/2022|||ANTIDEPRESSANTS: OTHER|6519|||||No|No||AUROBINDO PHARM|No||||
mirtazapine|No|No|No|No|75%|13107000305|MIRTAZAPINE 30 MG TABLET|500|EA|.14512|07/01/2009||Yes|No||07/01/2009||Yes|No|07/01/2009||Yes|No||||No|No|||Prescription required|No||031|No|.09806|03/29/2022|.0957|03/29/2022|.09634|03/29/2022|||ANTIDEPRESSANTS: OTHER|6520|||||No|No||AUROBINDO PHARM|No||||
mirtazapine|No|No|No|No|75%|13107000330|MIRTAZAPINE 30 MG TABLET|30|EA|.16125|07/01/2009||Yes|No||07/01/2009||Yes|No|07/01/2009||Yes|No||||No|No|||Prescription required|No||031|No|.09806|03/29/2022|.0957|03/29/2022|.09634|03/29/2022|||ANTIDEPRESSANTS: OTHER|6521|||||No|No||AUROBINDO PHARM|No||||
mirtazapine|No|No|No|No|75%|13107000334|MIRTAZAPINE 30 MG TABLET|30|EA|.16125|12/31/2010||Yes|No||12/31/2010||Yes|No|12/31/2010||Yes|No||||No|No|||Prescription required|No||031|No|.09806|03/29/2022|.0957|03/29/2022|.09634|03/29/2022|||ANTIDEPRESSANTS: OTHER|6522|||||No|No||AUROBINDO PHARM|No||||
hydrocodone/ibuprofen|No|No|No|No|90%|13107000401|HYDROCODONE-IBUPROFEN 7.5-200|100|EA|.17608|10/04/2017||Yes|No||10/04/2017||Yes|No|10/04/2017||Yes|No||||No|No|||Prescription required|No||109|Yes|.19819|03/29/2022|.19343|03/29/2022|.19472|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6523|||||No|No||AUROBINDO PHARM|No||||
citalopram hydrobromide|Yes|No|No|No|75%|13107000501|CITALOPRAM HBR 10 MG TABLET|100|EA|.04798|07/01/2009||Yes|No||07/01/2009||Yes|No|07/01/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02682|03/29/2022|.02617|03/29/2022|.02635|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6524|||||No|No||AUROBINDO PHARM|No||||
citalopram hydrobromide|Yes|No|No|No|75%|13107000505|CITALOPRAM HBR 10 MG TABLET|500|EA|.04558|07/01/2009||Yes|No||07/01/2009||Yes|No|07/01/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02682|03/29/2022|.02617|03/29/2022|.02635|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6525|||||No|No||AUROBINDO PHARM|No||||
citalopram hydrobromide|Yes|No|No|No|75%|13107000601|CITALOPRAM HBR 20 MG TABLET|100|EA|.04945|07/01/2009||Yes|No||07/01/2009||Yes|No|07/01/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02946|03/29/2022|.02875|03/29/2022|.02894|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6526|||||No|No||AUROBINDO PHARM|No||||
citalopram hydrobromide|Yes|No|No|No|75%|13107000605|CITALOPRAM HBR 20 MG TABLET|500|EA|.04698|07/01/2009||Yes|No||07/01/2009||Yes|No|07/01/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02946|03/29/2022|.02875|03/29/2022|.02894|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6527|||||No|No||AUROBINDO PHARM|No||||
citalopram hydrobromide|Yes|No|No|No|75%|13107000701|CITALOPRAM HBR 40 MG TABLET|100|EA|.05035|07/01/2009||Yes|No||07/01/2009||Yes|No|07/01/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03726|03/29/2022|.03636|03/29/2022|.0366|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6528|||||No|No||AUROBINDO PHARM|No||||
citalopram hydrobromide|Yes|No|No|No|75%|13107000705|CITALOPRAM HBR 40 MG TABLET|500|EA|.04783|07/01/2009||Yes|No||07/01/2009||Yes|No|07/01/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03726|03/29/2022|.03636|03/29/2022|.0366|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6529|||||No|No||AUROBINDO PHARM|No||||
glycopyrrolate|No|No|No|No|75%|13107001401|GLYCOPYRROLATE 1 MG TABLET|100|EA|.18653|08/21/2015||Yes|No||08/21/2015||Yes|No|08/21/2015||Yes|No||||No|No|||Prescription required|No|||No|.10136|03/29/2022|.09892|03/29/2022|.09958|03/29/2022||||6530|||||No|No||AUROBINDO PHARM|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|13107001901|HYDROCODONE-ACETAMIN 5-325 MG|100|EA|.16447|08/08/2012||Yes|No||08/08/2012||Yes|No|08/08/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6531|||||No|No||AUROBINDO PHARM|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|13107001905|HYDROCODONE-ACETAMIN 5-325 MG|500|EA|.16464|08/08/2012||Yes|No||08/08/2012||Yes|No|08/08/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6532|||||No|No||AUROBINDO PHARM|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|13107002001|HYDROCODONE-ACETAMIN 7.5-325|100|EA|.18167|08/08/2012||Yes|No||08/08/2012||Yes|No|08/08/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6533|||||No|No||AUROBINDO PHARM|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|13107002005|HYDROCODONE-ACETAMIN 7.5-325|500|EA|.17978|08/08/2012||Yes|No||08/08/2012||Yes|No|08/08/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6534|||||No|No||AUROBINDO PHARM|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|13107002101|HYDROCODONE-ACETAMIN 10-325 MG|100|EA|.18726|08/08/2012||Yes|No||08/08/2012||Yes|No|08/08/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6535|||||No|No||AUROBINDO PHARM|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|13107002105|HYDROCODONE-ACETAMIN 10-325 MG|500|EA|.18864|08/08/2012||Yes|No||08/08/2012||Yes|No|08/08/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6536|||||No|No||AUROBINDO PHARM|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|13107002199|HYDROCODONE-ACETAMIN 10-325 MG|1000|EA|.18393|10/02/2012||Yes|No||10/02/2012||Yes|No|10/02/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6537|||||No|No||AUROBINDO PHARM|No||||
mirtazapine|No|No|No|No|75%|13107003105|MIRTAZAPINE 15 MG TABLET|500|EA|.11481|07/01/2009||Yes|No||07/01/2009||Yes|No|07/01/2009||Yes|No||||No|No|||Prescription required|No||031|Yes|.08357|03/29/2022|.08156|03/29/2022|.0821|03/29/2022|||ANTIDEPRESSANTS: OTHER|6538|||||No|No||AUROBINDO PHARM|No||||
mirtazapine|No|No|No|No|75%|13107003130|MIRTAZAPINE 15 MG TABLET|30|EA|.12756|10/07/2009||Yes|No||10/07/2009||Yes|No|10/07/2009||Yes|No||||No|No|||Prescription required|No||031|Yes|.08357|03/29/2022|.08156|03/29/2022|.0821|03/29/2022|||ANTIDEPRESSANTS: OTHER|6539|||||No|No||AUROBINDO PHARM|No||||
mirtazapine|No|No|No|No|75%|13107003134|MIRTAZAPINE 15 MG TABLET|30|EA|.12756|12/03/2010||Yes|No||12/03/2010||Yes|No|12/03/2010||Yes|No||||No|No|||Prescription required|No||031|Yes|.08357|03/29/2022|.08156|03/29/2022|.0821|03/29/2022|||ANTIDEPRESSANTS: OTHER|6540|||||No|No||AUROBINDO PHARM|No||||
mirtazapine|No|No|No|No|75%|13107003205|MIRTAZAPINE 45 MG TABLET|500|EA|.16447|07/01/2009||Yes|No||07/01/2009||Yes|No|07/01/2009||Yes|No||||No|No|||Prescription required|No||031|No|.13324|03/29/2022|.13004|03/29/2022|.1309|03/29/2022|||ANTIDEPRESSANTS: OTHER|6541|||||No|No||AUROBINDO PHARM|No||||
mirtazapine|No|No|No|No|75%|13107003234|MIRTAZAPINE 45 MG TABLET|30|EA|.18275|12/10/2010||Yes|No||12/10/2010||Yes|No|12/10/2010||Yes|No||||No|No|||Prescription required|No||031|No|.13324|03/29/2022|.13004|03/29/2022|.1309|03/29/2022|||ANTIDEPRESSANTS: OTHER|6542|||||No|No||AUROBINDO PHARM|No||||
dextroamphetamine sulfate|No|No|No|No|75%|13107003501|DEXTROAMPHETAMINE 5 MG TAB|100|EA|.18468|12/20/2013||Yes|No||12/20/2013||Yes|No|12/20/2013||Yes|No||||No|No|||Prescription required|No||007|Yes|.24678|03/29/2022|.24085|03/29/2022|.24246|03/29/2022|||STIMULANTS AND RELATED AGENTS|6543|||||No|No||AUROBINDO PHARM|No||||
dextroamphetamine sulfate|No|No|No|No|75%|13107003601|DEXTROAMPHETAMINE 10 MG TAB|100|EA|.18468|12/20/2013||Yes|No||12/20/2013||Yes|No|12/20/2013||Yes|No||||No|No|||Prescription required|No||007|Yes|.30046|03/29/2022|.29324|03/29/2022|.2952|03/29/2022|||STIMULANTS AND RELATED AGENTS|6544|||||No|No||AUROBINDO PHARM|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|13107004401|OXYCODONE-ACETAMINOPHEN 5-325|100|EA|.0433|04/22/2014||Yes|No||04/22/2014||Yes|No|04/22/2014||Yes|No||04/01/2015||Yes|No|||Prescription required|No||109|Yes|.09091|03/29/2022|.08872|03/29/2022|.08931|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6545|||||No|No||AUROBINDO PHARM|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|13107004405|OXYCODONE-ACETAMINOPHEN 5-325|500|EA|.0433|04/22/2014||Yes|No||04/22/2014||Yes|No|04/22/2014||Yes|No||04/01/2015||Yes|No|||Prescription required|No||109|Yes|.09091|03/29/2022|.08872|03/29/2022|.08931|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6546|||||No|No||AUROBINDO PHARM|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|13107004501|OXYCODONE-ACETAMINOPHN 7.5-325|100|EA|.06497|04/22/2014||Yes|No||04/22/2014||Yes|No|04/22/2014||Yes|No||04/01/2015||Yes|No|||Prescription required|No||109|Yes|.14032|03/29/2022|.13695|03/29/2022|.13786|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6547|||||No|No||AUROBINDO PHARM|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|13107004505|OXYCODONE-ACETAMINOPHN 7.5-325|500|EA|.06497|04/03/2017||Yes|No||04/03/2017||Yes|No|04/03/2017||Yes|No||04/03/2017||Yes|No|||Prescription required|No||109|Yes|.14032|03/29/2022|.13695|03/29/2022|.13786|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6548|||||No|No||AUROBINDO PHARM|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|13107004601|OXYCODONE-ACETAMINOPHEN 10-325|100|EA|.0866|04/22/2014||Yes|No||04/22/2014||Yes|No|04/22/2014||Yes|No||04/01/2015||Yes|No|||Prescription required|No||109|Yes|.19233|03/29/2022|.18771|03/29/2022|.18896|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6549|||||No|No||AUROBINDO PHARM|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|13107004605|OXYCODONE-ACETAMINOPHEN 10-325|500|EA|.0866|04/03/2017||Yes|No||04/03/2017||Yes|No|04/03/2017||Yes|No||04/03/2017||Yes|No|||Prescription required|No||109|Yes|.19233|03/29/2022|.18771|03/29/2022|.18896|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6550|||||No|No||AUROBINDO PHARM|No||||
oxycodone HCl|No|No|No|No|90%|13107005501|OXYCODONE HCL (IR) 5 MG TABLET|100|EA|.05332|02/13/2014||Yes|No||02/13/2014||Yes|No|02/13/2014||Yes|No||||No|No|||Prescription required|No||109|Yes|.0685|03/29/2022|.06685|03/29/2022|.0673|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6551|||||No|No||AUROBINDO PHARM|No||||
oxycodone HCl|No|No|No|No|90%|13107005601|OXYCODONE HCL (IR) 15 MG TAB|100|EA|.06622|10/16/2020||Yes|No||10/16/2020||Yes|No|10/16/2020||Yes|No||||No|No|||Prescription required|No||109|Yes|.15895|03/29/2022|.15513|03/29/2022|.15616|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6552|||||No|No||AUROBINDO PHARM|No||||
oxycodone HCl|No|No|No|No|90%|13107005701|OXYCODONE HCL (IR) 30 MG TAB|100|EA|.1204|02/13/2014||Yes|No||02/13/2014||Yes|No|02/13/2014||Yes|No||||No|No|||Prescription required|No||109|Yes|.2615|03/29/2022|.25522|03/29/2022|.25692|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6553|||||No|No||AUROBINDO PHARM|No||||
acetaminophen with codeine|No|No|No|No|90%|13107005801|ACETAMINOPHEN-COD #2 TABLET|100|EA|.07451|08/12/2014||Yes|No||08/12/2014||Yes|No|08/12/2014||Yes|No||04/01/2015||Yes|No|||Prescription required|No||109|Yes|.11854|03/29/2022|.11569|03/29/2022|.11646|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6554|||||No|No||AUROBINDO PHARM|No||||
acetaminophen with codeine|No|No|No|No|90%|13107005901|ACETAMINOPHEN-COD #3 TABLET|100|EA|.0774|08/12/2014||Yes|No||08/12/2014||Yes|No|08/12/2014||Yes|No||04/01/2015||Yes|No|||Prescription required|No||109|Yes|.10921|03/29/2022|.10658|03/29/2022|.10729|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6555|||||No|No||AUROBINDO PHARM|No||||
acetaminophen with codeine|No|No|No|No|90%|13107005999|ACETAMINOPHEN-COD #3 TABLET|1000|EA|.06966|08/12/2014||Yes|No||08/12/2014||Yes|No|08/12/2014||Yes|No||04/01/2015||Yes|No|||Prescription required|No||109|Yes|.10921|03/29/2022|.10658|03/29/2022|.10729|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6556|||||No|No||AUROBINDO PHARM|No||||
acetaminophen with codeine|No|No|No|No|90%|13107006001|ACETAMINOPHEN-COD #4 TABLET|100|EA|.1204|08/12/2014||Yes|No||08/12/2014||Yes|No|08/12/2014||Yes|No||04/01/2015||Yes|No|||Prescription required|No||109|Yes|.22352|03/29/2022|.21815|03/29/2022|.2196|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6557|||||No|No||AUROBINDO PHARM|No||||
acetaminophen with codeine|No|No|No|No|90%|13107006005|ACETAMINOPHEN-COD #4 TABLET|500|EA|.11678|08/12/2014||Yes|No||08/12/2014||Yes|No|08/12/2014||Yes|No||04/01/2015||Yes|No|||Prescription required|No||109|Yes|.22352|03/29/2022|.21815|03/29/2022|.2196|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6558|||||No|No||AUROBINDO PHARM|No||||
acetaminophen with codeine|No|No|No|No|90%|13107006099|ACETAMINOPHEN-COD #4 TABLET|1000|EA|.11438|08/12/2014||Yes|No||08/12/2014||Yes|No|08/12/2014||Yes|No||04/01/2015||Yes|No|||Prescription required|No||109|Yes|.22352|03/29/2022|.21815|03/29/2022|.2196|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6559|||||No|No||AUROBINDO PHARM|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|13107006801|DEXTROAMP-AMPHETAMINE 5 MG TAB|100|EA|.1603|08/05/2014||Yes|No||08/05/2014||Yes|No|08/05/2014||Yes|No||||No|No|||Prescription required|No||007|Yes|.21985|03/29/2022|.21457|03/29/2022|.216|03/29/2022|||STIMULANTS AND RELATED AGENTS|6560|||||No|No||AUROBINDO PHARM|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|13107007001|DEXTROAMP-AMPHETAMIN 10 MG TAB|100|EA|.1603|08/05/2014||Yes|No||08/05/2014||Yes|No|08/05/2014||Yes|No||||No|No|||Prescription required|No||007|Yes|.24071|03/29/2022|.23493|03/29/2022|.23649|03/29/2022|||STIMULANTS AND RELATED AGENTS|6561|||||No|No||AUROBINDO PHARM|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|13107007201|DEXTROAMP-AMPHETAMIN 15 MG TAB|100|EA|.1603|08/05/2014||Yes|No||08/05/2014||Yes|No|08/05/2014||Yes|No||||No|No|||Prescription required|No||007|Yes|.25605|03/29/2022|.2499|03/29/2022|.25156|03/29/2022|||STIMULANTS AND RELATED AGENTS|6562|||||No|No||AUROBINDO PHARM|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|13107007301|DEXTROAMP-AMPHETAMIN 20 MG TAB|100|EA|.1603|08/05/2014||Yes|No||08/05/2014||Yes|No|08/05/2014||Yes|No||||No|No|||Prescription required|No||007|Yes|.31357|03/29/2022|.30604|03/29/2022|.30808|03/29/2022|||STIMULANTS AND RELATED AGENTS|6563|||||No|No||AUROBINDO PHARM|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|13107007401|DEXTROAMP-AMPHETAMIN 30 MG TAB|100|EA|.1603|08/05/2014||Yes|No||08/05/2014||Yes|No|08/05/2014||Yes|No||||No|No|||Prescription required|No||007|Yes|.30925|03/29/2022|.30182|03/29/2022|.30383|03/29/2022|||STIMULANTS AND RELATED AGENTS|6564|||||No|No||AUROBINDO PHARM|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|13107007501|BUTALB-ACETAMIN-CAFF 50-325-40|100|EA|1.65601|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|No|||No|3.38611|03/01/2022|3.30484|03/01/2022|3.32685|03/01/2022||||6565|||||No|No||AUROBINDO PHARM|No||||
ciprofloxacin HCl|No|No|No|No|75%|13107007701|CIPROFLOXACIN HCL 500 MG TAB|100|EA|.13115|10/21/2009||Yes|No||10/21/2009||Yes|No|10/21/2009||Yes|No||04/01/2015||Yes|No|||Prescription required|No||028|No|.13565|03/29/2022|.13239|03/29/2022|.13327|03/29/2022|||FLUOROQUINOLONES: ORAL|6566|||||No|No||AUROBINDO PHARM|No||||
lorazepam|No|No|No|No|90%|13107008301|LORAZEPAM 0.5 MG TABLET|100|EA|.03225|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No||090|Yes|.03794|03/29/2022|.03702|03/29/2022|.03727|03/29/2022|||ANXIOLYTICS|6567|||||No|No||AUROBINDO PHARM|No||||
lorazepam|No|No|No|No|90%|13107008305|LORAZEPAM 0.5 MG TABLET|500|EA|.03225|08/24/2020||Yes|No||08/24/2020||Yes|No|08/24/2020||Yes|No||||No|No|||Prescription required|No||090|Yes|.03794|03/29/2022|.03702|03/29/2022|.03727|03/29/2022|||ANXIOLYTICS|6568|||||No|No||AUROBINDO PHARM|No||||
lorazepam|No|No|No|No|90%|13107008401|LORAZEPAM 1 MG TABLET|100|EA|.03547|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No||090|Yes|.04593|03/29/2022|.04482|03/29/2022|.04512|03/29/2022|||ANXIOLYTICS|6569|||||No|No||AUROBINDO PHARM|No||||
lorazepam|No|No|No|No|90%|13107008405|LORAZEPAM 1 MG TABLET|500|EA|.03547|08/24/2020||Yes|No||08/24/2020||Yes|No|08/24/2020||Yes|No||||No|No|||Prescription required|No||090|Yes|.04593|03/29/2022|.04482|03/29/2022|.04512|03/29/2022|||ANXIOLYTICS|6570|||||No|No||AUROBINDO PHARM|No||||
lorazepam|No|No|No|No|90%|13107008499|LORAZEPAM 1 MG TABLET|1000|EA|.0346|03/04/2022||Yes|No||03/04/2022||Yes|No|03/04/2022||Yes|No||||No|No|||Prescription required|No||090|Yes|.04593|03/29/2022|.04482|03/29/2022|.04512|03/29/2022|||ANXIOLYTICS|6571|||||No|No||AUROBINDO PHARM|No||||
lorazepam|No|No|No|No|90%|13107008501|LORAZEPAM 2 MG TABLET|100|EA|.05052|08/24/2020||Yes|No||08/24/2020||Yes|No|08/24/2020||Yes|No||||No|No|||Prescription required|No||090|Yes|.06696|03/29/2022|.06535|03/29/2022|.06578|03/29/2022|||ANXIOLYTICS|6572|||||No|No||AUROBINDO PHARM|No||||
methadone HCl|No|No|No|No|90%|13107008801|METHADONE HCL 5 MG TABLET|100|EA|.09159|12/28/2017||Yes|No||12/28/2017||Yes|No|12/28/2017||Yes|No||||No|No|||Prescription required|Yes|07/28/2017|110|Yes|.12051|03/29/2022|.11761|03/29/2022|.1184|03/29/2022|||ANALGESICS: NARCOTICS LONG|6573|||||No|No||AUROBINDO PHARM|No||||
methadone HCl|No|No|No|No|90%|13107008901|METHADONE HCL 10 MG TABLET|100|EA|.15209|12/28/2017||Yes|No||12/28/2017||Yes|No|12/28/2017||Yes|No||||No|No|||Prescription required|Yes|07/28/2017|110|Yes|.08598|03/29/2022|.08391|03/29/2022|.08447|03/29/2022|||ANALGESICS: NARCOTICS LONG|6574|||||No|No||AUROBINDO PHARM|Yes|09/01/2020|||
oxymorphone HCl|No|No|No|No|90%|13107010301|OXYMORPHONE HCL 5 MG TABLET|100|EA|.3655|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|109|Yes|.56292|03/01/2022|.5494|03/01/2022|.55306|03/01/2022|||ANALGESICS: NARCOTICS SHORT|6575|||||No|No||AUROBINDO PHARM|No||||
oxymorphone HCl|No|No|No|No|90%|13107010401|OXYMORPHONE HCL 10 MG TABLET|100|EA|.602|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|109|Yes|.96999|03/29/2022|.94671|03/29/2022|.95301|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6576|||||No|No||AUROBINDO PHARM|No||||
hydromorphone HCl|No|No|No|No|90%|13107010701|HYDROMORPHONE 2 MG TABLET|100|EA|.0626|11/22/2016||Yes|No||11/22/2016||Yes|No|11/22/2016||Yes|No||||No|No|||Prescription required|No||109|Yes|.0744|03/29/2022|.07261|03/29/2022|.07309|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6577|||||No|No||AUROBINDO PHARM|No||||
hydromorphone HCl|No|No|No|No|90%|13107010801|HYDROMORPHONE 4 MG TABLET|100|EA|.07327|11/22/2016||Yes|No||11/22/2016||Yes|No|11/22/2016||Yes|No||||No|No|||Prescription required|No||109|Yes|.09714|03/29/2022|.0948|03/29/2022|.09544|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6578|||||No|No||AUROBINDO PHARM|No||||
hydromorphone HCl|No|No|No|No|90%|13107010901|HYDROMORPHONE 8 MG TABLET|100|EA|.41783|11/22/2016||Yes|No||11/22/2016||Yes|No|11/22/2016||Yes|No||||No|No|||Prescription required|No||109|Yes|.27467|03/29/2022|.26807|03/29/2022|.26986|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6579|||||No|No||AUROBINDO PHARM|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|13107011530|OMEPRAZOLE-BICARB 20-1,100 CAP|30|EA|4.77844|02/24/2017||Yes|No||02/24/2017||Yes|No|02/24/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|1.11633|03/29/2022|1.08953|03/29/2022|1.09679|03/29/2022|||PROTON PUMP INHIBITORS|6580|||||No|No||AUROBINDO PHARM|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|13107011630|OMEPRAZOLE-BICARB 40-1,100 CAP|30|EA|4.77844|02/24/2017||Yes|No||02/24/2017||Yes|No|02/24/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|1.14084|03/29/2022|1.11345|03/29/2022|1.12087|03/29/2022|||PROTON PUMP INHIBITORS|6581|||||No|No||AUROBINDO PHARM|No||||
paroxetine HCl|No|No|No|No|75%|13107015405|PAROXETINE HCL 10 MG TABLET|500|EA|.09326|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No||008|Yes|.075|03/29/2022|.0732|03/29/2022|.07368|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6582|||||No|No||AUROBINDO PHARM|No||||
paroxetine HCl|No|No|No|No|75%|13107015430|PAROXETINE HCL 10 MG TABLET|30|EA|.09818|08/01/2011||Yes|No||08/01/2011||Yes|No|08/01/2011||Yes|No||||No|No|||Prescription required|No||008|Yes|.075|03/29/2022|.0732|03/29/2022|.07368|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6583|||||No|No||AUROBINDO PHARM|No||||
paroxetine HCl|No|No|No|No|75%|13107015490|PAROXETINE HCL 10 MG TABLET|90|EA|.09818|12/02/2014||Yes|No||12/02/2014||Yes|No|12/02/2014||Yes|No||||No|No|||Prescription required|No||008|Yes|.075|03/29/2022|.0732|03/29/2022|.07368|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6584|||||No|No||AUROBINDO PHARM|No||||
paroxetine HCl|No|No|No|No|75%|13107015505|PAROXETINE HCL 20 MG TABLET|500|EA|.09735|11/16/2009||Yes|No||11/16/2009||Yes|No|11/16/2009||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6585|||||No|No||AUROBINDO PHARM|No||||
paroxetine HCl|No|No|No|No|75%|13107015530|PAROXETINE HCL 20 MG TABLET|30|EA|.10248|01/12/2010||Yes|No||01/12/2010||Yes|No|01/12/2010||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6586|||||No|No||AUROBINDO PHARM|No||||
paroxetine HCl|No|No|No|No|75%|13107015590|PAROXETINE HCL 20 MG TABLET|90|EA|.10248|12/02/2014||Yes|No||12/02/2014||Yes|No|12/02/2014||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6587|||||No|No||AUROBINDO PHARM|No||||
paroxetine HCl|No|No|No|No|75%|13107015599|PAROXETINE HCL 20 MG TABLET|1000|EA|.0559|11/16/2009||Yes|No||11/16/2009||Yes|No|11/16/2009||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6588|||||No|No||AUROBINDO PHARM|No||||
paroxetine HCl|No|No|No|No|75%|13107015605|PAROXETINE HCL 30 MG TABLET|500|EA|.11438|12/14/2011||Yes|No||12/14/2011||Yes|No|12/14/2011||Yes|No||||No|No|||Prescription required|No||008|No|.13236|03/29/2022|.12918|03/29/2022|.13004|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6589|||||No|No||AUROBINDO PHARM|No||||
paroxetine HCl|No|No|No|No|75%|13107015630|PAROXETINE HCL 30 MG TABLET|30|EA|.1204|07/05/2011||Yes|No||07/05/2011||Yes|No|07/05/2011||Yes|No||||No|No|||Prescription required|No||008|No|.13236|03/29/2022|.12918|03/29/2022|.13004|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6590|||||No|No||AUROBINDO PHARM|No||||
paroxetine HCl|No|No|No|No|75%|13107015690|PAROXETINE HCL 30 MG TABLET|90|EA|.1204|12/02/2014||Yes|No||12/02/2014||Yes|No|12/02/2014||Yes|No||||No|No|||Prescription required|No||008|No|.13236|03/29/2022|.12918|03/29/2022|.13004|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6591|||||No|No||AUROBINDO PHARM|No||||
paroxetine HCl|No|No|No|No|75%|13107015699|PAROXETINE HCL 30 MG TABLET|1000|EA|.10836|07/05/2011||Yes|No||07/05/2011||Yes|No|07/05/2011||Yes|No||||No|No|||Prescription required|No||008|No|.13236|03/29/2022|.12918|03/29/2022|.13004|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6592|||||No|No||AUROBINDO PHARM|No||||
paroxetine HCl|No|No|No|No|75%|13107015705|PAROXETINE HCL 40 MG TABLET|500|EA|.13274|12/14/2011||Yes|No||12/14/2011||Yes|No|12/14/2011||Yes|No||||No|No|||Prescription required|No||008|No|.13005|03/29/2022|.12692|03/29/2022|.12777|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6593|||||No|No||AUROBINDO PHARM|No||||
paroxetine HCl|No|No|No|No|75%|13107015730|PAROXETINE HCL 40 MG TABLET|30|EA|.13975|07/05/2011||Yes|No||07/05/2011||Yes|No|07/05/2011||Yes|No||||No|No|||Prescription required|No||008|No|.13005|03/29/2022|.12692|03/29/2022|.12777|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6594|||||No|No||AUROBINDO PHARM|No||||
paroxetine HCl|No|No|No|No|75%|13107015790|PAROXETINE HCL 40 MG TABLET|90|EA|.13975|12/02/2014||Yes|No||12/02/2014||Yes|No|12/02/2014||Yes|No||||No|No|||Prescription required|No||008|No|.13005|03/29/2022|.12692|03/29/2022|.12777|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6595|||||No|No||AUROBINDO PHARM|No||||
paroxetine HCl|No|No|No|No|75%|13107015799|PAROXETINE HCL 40 MG TABLET|1000|EA|.12577|07/05/2011||Yes|No||07/05/2011||Yes|No|07/05/2011||Yes|No||||No|No|||Prescription required|No||008|No|.13005|03/29/2022|.12692|03/29/2022|.12777|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6596|||||No|No||AUROBINDO PHARM|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|13107021101|HYDROCODONE-ACETAMIN 5-300 MG|100|EA|.3225|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||12/09/2019||Yes|No|||Prescription required|No||109|Yes|.19231|03/29/2022|.18769|03/29/2022|.18894|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6597|||||No|No||AUROBINDO PHARM|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|13107021105|HYDROCODONE-ACETAMIN 5-300 MG|500|EA|.30637|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||12/09/2019||Yes|No|||Prescription required|No||109|Yes|.19231|03/29/2022|.18769|03/29/2022|.18894|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6598|||||No|No||AUROBINDO PHARM|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|13107021201|HYDROCODONE-ACETAMIN 7.5-300|100|EA|.43|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||12/09/2019||Yes|No|||Prescription required|No||109|Yes|.2429|03/29/2022|.23707|03/29/2022|.23864|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6599|||||No|No||AUROBINDO PHARM|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|13107021205|HYDROCODONE-ACETAMIN 7.5-300|500|EA|.4085|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||12/09/2019||Yes|No|||Prescription required|No||109|Yes|.2429|03/29/2022|.23707|03/29/2022|.23864|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6600|||||No|No||AUROBINDO PHARM|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|13107021301|HYDROCODONE-ACETAMIN 10-300 MG|100|EA|.5332|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||12/09/2019||Yes|No|||Prescription required|No||109|Yes|.34815|03/29/2022|.33979|03/29/2022|.34205|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6601|||||No|No||AUROBINDO PHARM|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|13107021305|HYDROCODONE-ACETAMIN 10-300 MG|500|EA|.50654|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||12/09/2019||Yes|No|||Prescription required|No||109|Yes|.34815|03/29/2022|.33979|03/29/2022|.34205|03/29/2022|||ANALGESICS: NARCOTICS SHORT|6602|||||No|No||AUROBINDO PHARM|No||||
clorazepate dipotassium|No|No|No|No|90%|13107031901|CLORAZEPATE 3.75 MG TABLET|100|EA|.42785|03/04/2022||Yes|No||03/04/2022||Yes|No|03/04/2022||Yes|No||||No|No|||Prescription required|No||090|Yes|.92083|03/29/2022|.89873|03/29/2022|.90471|03/29/2022|||ANXIOLYTICS|6603|||||No|No||AUROBINDO PHARM|No||||
clorazepate dipotassium|No|No|No|No|90%|13107031905|CLORAZEPATE 3.75 MG TABLET|500|EA|.42785|03/04/2022||Yes|No||03/04/2022||Yes|No|03/04/2022||Yes|No||||No|No|||Prescription required|No||090|Yes|.92083|03/29/2022|.89873|03/29/2022|.90471|03/29/2022|||ANXIOLYTICS|6604|||||No|No||AUROBINDO PHARM|No||||
clorazepate dipotassium|No|No|No|No|90%|13107032001|CLORAZEPATE 7.5 MG TABLET|100|EA|.5992|03/04/2022||Yes|No||03/04/2022||Yes|No|03/04/2022||Yes|No||||No|No|||Prescription required|No||090|Yes|1.5386|03/29/2022|1.50167|03/29/2022|1.51167|03/29/2022|||ANXIOLYTICS|6605|||||No|No||AUROBINDO PHARM|No||||
diazoxide|No|No|No|No|75%|13517010030|DIAZOXIDE 50 MG/ML ORAL SUSP|30|ML|4.43788|04/03/2020||Yes|No||04/03/2020||Yes|No|04/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|583|No|8.55475|03/08/2022|8.34943|03/08/2022|8.40504|03/08/2022|||GLUCAGON AGENTS|6606|||||No|No||E5 PHARMA|No||||
phenobarbital|No|No|No|No|75%|13517010716|PHENOBARBITAL 20 MG/5 ML ELIX|473|ML|.06264|08/27/2018||Yes|No||08/27/2018||Yes|No|08/27/2018||Yes|No||||No|No|||Prescription required|No||056|No|.09847|03/29/2022|.0961|03/29/2022|.09674|03/29/2022|||ANTICONVULSANTS|6607|||||No|No||E5 PHARMA|No||||
phenobarbital|No|No|No|No|75%|13517011001|PHENOBARBITAL 16.2 MG TABLET|100|EA|.18253|01/08/2018||Yes|No||01/08/2018||Yes|No|01/08/2018||Yes|No||||No|No|||Prescription required|No||056|No|.22712|03/29/2022|.22166|03/29/2022|.22314|03/29/2022|||ANTICONVULSANTS|6608|||||No|No||E5 PHARMA|No||||
phenobarbital|No|No|No|No|75%|13517011010|PHENOBARBITAL 16.2 MG TABLET|1000|EA|.17419|01/08/2018||Yes|No||01/08/2018||Yes|No|01/08/2018||Yes|No||||No|No|||Prescription required|No||056|No|.22712|03/29/2022|.22166|03/29/2022|.22314|03/29/2022|||ANTICONVULSANTS|6609|||||No|No||E5 PHARMA|No||||
phenobarbital|No|No|No|No|75%|13517011101|PHENOBARBITAL 32.4 MG TABLET|100|EA|.23056|01/08/2018||Yes|No||01/08/2018||Yes|No|01/08/2018||Yes|No||||No|No|||Prescription required|No||056|No|.30495|03/29/2022|.29763|03/29/2022|.29961|03/29/2022|||ANTICONVULSANTS|6610|||||No|No||E5 PHARMA|No||||
phenobarbital|No|No|No|No|75%|13517011110|PHENOBARBITAL 32.4 MG TABLET|1000|EA|.21904|01/08/2018||Yes|No||01/08/2018||Yes|No|01/08/2018||Yes|No||||No|No|||Prescription required|No||056|No|.30495|03/29/2022|.29763|03/29/2022|.29961|03/29/2022|||ANTICONVULSANTS|6611|||||No|No||E5 PHARMA|No||||
phenobarbital|No|No|No|No|75%|13517011201|PHENOBARBITAL 64.8 MG TABLET|100|EA|.28822|01/08/2018||Yes|No||01/08/2018||Yes|No|01/08/2018||Yes|No||||No|No|||Prescription required|No||056|No|.38211|03/29/2022|.37293|03/29/2022|.37542|03/29/2022|||ANTICONVULSANTS|6612|||||No|No||E5 PHARMA|No||||
phenobarbital|No|No|No|No|75%|13517011210|PHENOBARBITAL 64.8 MG TABLET|1000|EA|.27395|01/08/2018||Yes|No||01/08/2018||Yes|No|01/08/2018||Yes|No||||No|No|||Prescription required|No||056|No|.38211|03/29/2022|.37293|03/29/2022|.37542|03/29/2022|||ANTICONVULSANTS|6613|||||No|No||E5 PHARMA|No||||
phenobarbital|No|No|No|No|75%|13517011301|PHENOBARBITAL 97.2 MG TABLET|100|EA|.4066|01/08/2018||Yes|No||01/08/2018||Yes|No|01/08/2018||Yes|No||||No|No|||Prescription required|No||056|No|.45635|03/29/2022|.44539|03/29/2022|.44836|03/29/2022|||ANTICONVULSANTS|6614|||||No|No||E5 PHARMA|No||||
phenobarbital|No|No|No|No|75%|13517011310|PHENOBARBITAL 97.2 MG TABLET|1000|EA|.38605|01/08/2018||Yes|No||01/08/2018||Yes|No|01/08/2018||Yes|No||||No|No|||Prescription required|No||056|No|.45635|03/29/2022|.44539|03/29/2022|.44836|03/29/2022|||ANTICONVULSANTS|6615|||||No|No||E5 PHARMA|No||||
phenobarbital|No|No|No|No|75%|13517075501|PHENOBARBITAL 15 MG TABLET|100|EA|.1204|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No||056|No|.13719|03/29/2022|.13389|03/29/2022|.13478|03/29/2022|||ANTICONVULSANTS|6616|||||No|No||E5 PHARMA|No||||
phenobarbital|No|No|No|No|75%|13517075505|PHENOBARBITAL 15 MG TABLET|500|EA|.10836|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No||056|No|.13719|03/29/2022|.13389|03/29/2022|.13478|03/29/2022|||ANTICONVULSANTS|6617|||||No|No||E5 PHARMA|No||||
phenobarbital|No|No|No|No|75%|13517075601|PHENOBARBITAL 30 MG TABLET|100|EA|.15136|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No||056|No|.19822|03/29/2022|.19346|03/29/2022|.19475|03/29/2022|||ANTICONVULSANTS|6618|||||No|No||E5 PHARMA|No||||
phenobarbital|No|No|No|No|75%|13517075605|PHENOBARBITAL 30 MG TABLET|500|EA|.13622|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No||056|No|.19822|03/29/2022|.19346|03/29/2022|.19475|03/29/2022|||ANTICONVULSANTS|6619|||||No|No||E5 PHARMA|No||||
phenobarbital|No|No|No|No|75%|13517075701|PHENOBARBITAL 60 MG TABLET|100|EA|.1892|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No||056|No|.29898|03/29/2022|.2918|03/29/2022|.29374|03/29/2022|||ANTICONVULSANTS|6620|||||No|No||E5 PHARMA|No||||
phenobarbital|No|No|No|No|75%|13517075705|PHENOBARBITAL 60 MG TABLET|500|EA|.17028|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No||056|No|.29898|03/29/2022|.2918|03/29/2022|.29374|03/29/2022|||ANTICONVULSANTS|6621|||||No|No||E5 PHARMA|No||||
phenobarbital|No|No|No|No|75%|13517075801|PHENOBARBITAL 100 MG TABLET|100|EA|.2666|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No||056|No|.39079|03/29/2022|.38141|03/29/2022|.38395|03/29/2022|||ANTICONVULSANTS|6622|||||No|No||E5 PHARMA|No||||
phenobarbital|No|No|No|No|75%|13517075805|PHENOBARBITAL 100 MG TABLET|500|EA|.23994|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No||056|No|.39079|03/29/2022|.38141|03/29/2022|.38395|03/29/2022|||ANTICONVULSANTS|6623|||||No|No||E5 PHARMA|No||||
alpha-1-proteinase inhibitor|No|No|No|No|75%|13533070501|PROLASTIN C 1,000 MG/20 ML VL|1|EA|.2279|07/17/2018||Yes|No||07/17/2018||Yes|No|07/17/2018||Yes|No||||No|No|||Prescription required|No|||No|.5194|01/04/2022|.51198|01/04/2022|.4876|01/04/2022||||6624|||||No|No||GRIFOLS THERAPE|No||||
immune globul G/gly/IgA avg 46|No|No|No|No|75%|13533080012|GAMUNEX-C 1 GRAM/10 ML VIAL|10|ML|5.59516|01/31/2011||Yes|No||01/31/2011||Yes|No|01/31/2011||Yes|No||||No|No|||Prescription required|No||023|No|12.75176|02/02/2021|12.56959|02/02/2021|11.97104|02/02/2021|||IMMUNE GLOBULINS|6625|||||No|No||GRIFOLS THERAPE|No||||
immune globul G/gly/IgA avg 46|No|No|No|No|75%|13533080015|GAMUNEX-C 2.5 GRAM/25 ML VIAL|25|ML|5.59516|01/31/2011||Yes|No||01/31/2011||Yes|No|01/31/2011||Yes|No||||No|No|||Prescription required|No||023|No|12.75176|02/02/2021|12.56959|02/02/2021|11.97104|02/02/2021|||IMMUNE GLOBULINS|6626|||||No|No||GRIFOLS THERAPE|No||||
immune globul G/gly/IgA avg 46|No|No|No|No|75%|13533080020|GAMUNEX-C 5 GRAM/50 ML VIAL|50|ML|5.59516|01/31/2011||Yes|No||01/31/2011||Yes|No|01/31/2011||Yes|No||||No|No|||Prescription required|No||023|No|12.75176|02/02/2021|12.56959|02/02/2021|11.97104|02/02/2021|||IMMUNE GLOBULINS|6627|||||No|No||GRIFOLS THERAPE|No||||
immune globul G/gly/IgA avg 46|No|No|No|No|75%|13533080024|GAMUNEX-C 20 GRAM/200 ML VIAL|200|ML|5.59516|01/31/2011||Yes|No||01/31/2011||Yes|No|01/31/2011||Yes|No||||No|No|||Prescription required|No||023|No|12.75176|02/02/2021|12.56959|02/02/2021|11.97104|02/02/2021|||IMMUNE GLOBULINS|6628|||||No|No||GRIFOLS THERAPE|No||||
immune globul G/gly/IgA avg 46|No|No|No|No|75%|13533080040|GAMUNEX-C 40 GRAM/400 ML VIAL|400|ML|5.59516|10/21/2014||Yes|No||10/21/2014||Yes|No|10/21/2014||Yes|No||||No|No|||Prescription required|No||023|No|12.75176|02/02/2021|12.56959|02/02/2021|11.97104|02/02/2021|||IMMUNE GLOBULINS|6629|||||No|No||GRIFOLS THERAPE|No||||
immune globul G/gly/IgA avg 46|No|No|No|No|75%|13533080071|GAMUNEX-C 10 GRAM/100 ML VIAL|100|ML|5.59516|01/31/2011||Yes|No||01/31/2011||Yes|No|01/31/2011||Yes|No||||No|No|||Prescription required|No||023|No|12.75176|02/02/2021|12.56959|02/02/2021|11.97104|02/02/2021|||IMMUNE GLOBULINS|6630|||||No|No||GRIFOLS THERAPE|No||||
immune globulin,gamma(IgG)klhw|No|No|No|No|75%|13533081005|XEMBIFY 20% (1 G/5 ML) VIAL|5|ML|14.9296|03/05/2020||Yes|No||03/05/2020||Yes|No|03/05/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|023|No|34.0256|08/03/2021|33.53952|08/03/2021|31.9424|08/03/2021|||IMMUNE GLOBULINS|6631|||||No|No||GRIFOLS THERAPE|No||||
immune globulin,gamma(IgG)klhw|No|No|No|No|75%|13533081010|XEMBIFY 20% (2 G/10 ML) VIAL|10|ML|14.9296|03/05/2020||Yes|No||03/05/2020||Yes|No|03/05/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|023|No|34.0256|08/03/2021|33.53952|08/03/2021|31.9424|08/03/2021|||IMMUNE GLOBULINS|6632|||||No|No||GRIFOLS THERAPE|No||||
immune globulin,gamma(IgG)klhw|No|No|No|No|75%|13533081020|XEMBIFY 20% (4 G/20 ML) VIAL|20|ML|14.9296|03/05/2020||Yes|No||03/05/2020||Yes|No|03/05/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|023|No|34.0256|08/03/2021|33.53952|08/03/2021|31.9424|08/03/2021|||IMMUNE GLOBULINS|6633|||||No|No||GRIFOLS THERAPE|No||||
immune globulin,gamma(IgG)klhw|No|No|No|No|75%|13533081050|XEMBIFY 20% (10 G/50 ML) VIAL|50|ML|14.9296|03/05/2020||Yes|No||03/05/2020||Yes|No|03/05/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|023|No|34.0256|08/03/2021|33.53952|08/03/2021|31.9424|08/03/2021|||IMMUNE GLOBULINS|6634|||||No|No||GRIFOLS THERAPE|No||||
tretinoin|No|No|No|No|75%|13548007045|ATRALIN 0.05% GEL|45|GM|5.37414|09/08/2008||Yes|No||09/08/2008||Yes|No|09/08/2008||Yes|No||||No|No|||Prescription required|Yes|07/22/2008|104|No|12.24804|12/26/2017|12.07306|12/26/2017|11.49816|12/26/2017|||ACNE AGENTS: TOPICAL|6635|||||No|No||BAUSCH HEALTH U|No||||
zolpidem tartrate|No|No|No|No|90%|13668000701|ZOLPIDEM TARTRATE 5 MG TABLET|100|EA|.0387|05/01/2008||Yes|No||05/01/2008||Yes|No|05/01/2008||Yes|No||||No|No|||Prescription required|No||054|Yes|.03056|03/29/2022|.02982|03/29/2022|.03002|03/29/2022|||SEDATIVE HYPNOTICS|6636|||||No|No||TORRENT PHARMAC|No||||
zolpidem tartrate|No|No|No|No|90%|13668000705|ZOLPIDEM TARTRATE 5 MG TABLET|500|EA|.0387|05/01/2008||Yes|No||05/01/2008||Yes|No|05/01/2008||Yes|No||||No|No|||Prescription required|No||054|Yes|.03056|03/29/2022|.02982|03/29/2022|.03002|03/29/2022|||SEDATIVE HYPNOTICS|6637|||||No|No||TORRENT PHARMAC|No||||
zolpidem tartrate|No|No|No|No|90%|13668000710|ZOLPIDEM TARTRATE 5 MG TABLET|1000|EA|.0387|05/01/2008||Yes|No||05/01/2008||Yes|No|05/01/2008||Yes|No||||No|No|||Prescription required|No||054|Yes|.03056|03/29/2022|.02982|03/29/2022|.03002|03/29/2022|||SEDATIVE HYPNOTICS|6638|||||No|No||TORRENT PHARMAC|No||||
zolpidem tartrate|No|No|No|No|90%|13668000801|ZOLPIDEM TARTRATE 10 MG TABLET|100|EA|.0387|05/01/2008||Yes|No||05/01/2008||Yes|No|05/01/2008||Yes|No||||No|No|||Prescription required|No||054|Yes|.0301|03/29/2022|.02937|03/29/2022|.02957|03/29/2022|||SEDATIVE HYPNOTICS|6639|||||No|No||TORRENT PHARMAC|No||||
zolpidem tartrate|No|No|No|No|90%|13668000805|ZOLPIDEM TARTRATE 10 MG TABLET|500|EA|.0387|05/01/2008||Yes|No||05/01/2008||Yes|No|05/01/2008||Yes|No||||No|No|||Prescription required|No||054|Yes|.0301|03/29/2022|.02937|03/29/2022|.02957|03/29/2022|||SEDATIVE HYPNOTICS|6640|||||No|No||TORRENT PHARMAC|No||||
zolpidem tartrate|No|No|No|No|90%|13668000810|ZOLPIDEM TARTRATE 10 MG TABLET|1000|EA|.0387|05/01/2008||Yes|No||05/01/2008||Yes|No|05/01/2008||Yes|No||||No|No|||Prescription required|No||054|Yes|.0301|03/29/2022|.02937|03/29/2022|.02957|03/29/2022|||SEDATIVE HYPNOTICS|6641|||||No|No||TORRENT PHARMAC|No||||
citalopram hydrobromide|Yes|No|No|No|75%|13668000901|CITALOPRAM HBR 10 MG TABLET|100|EA|.02438|11/08/2007||Yes|No||11/08/2007||Yes|No|11/08/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02682|03/29/2022|.02617|03/29/2022|.02635|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6642|||||No|No||TORRENT PHARMAC|No||||
citalopram hydrobromide|Yes|No|No|No|75%|13668000905|CITALOPRAM HBR 10 MG TABLET|500|EA|.02334|11/08/2007||Yes|No||11/08/2007||Yes|No|11/08/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02682|03/29/2022|.02617|03/29/2022|.02635|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6643|||||No|No||TORRENT PHARMAC|No||||
citalopram hydrobromide|Yes|No|No|No|75%|13668000909|CITALOPRAM HBR 10 MG TABLET|9990|EA|.02334|03/12/2009||Yes|No||03/12/2009||Yes|No|03/12/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02682|03/29/2022|.02617|03/29/2022|.02635|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6644|||||No|No||TORRENT PHARMAC|No||||
citalopram hydrobromide|Yes|No|No|No|75%|13668001001|CITALOPRAM HBR 20 MG TABLET|100|EA|.02171|11/08/2007||Yes|No||11/08/2007||Yes|No|11/08/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02946|03/29/2022|.02875|03/29/2022|.02894|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6645|||||No|No||TORRENT PHARMAC|No||||
citalopram hydrobromide|Yes|No|No|No|75%|13668001005|CITALOPRAM HBR 20 MG TABLET|500|EA|.023|11/08/2007||Yes|No||11/08/2007||Yes|No|11/08/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02946|03/29/2022|.02875|03/29/2022|.02894|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6646|||||No|No||TORRENT PHARMAC|No||||
citalopram hydrobromide|Yes|No|No|No|75%|13668001006|CITALOPRAM HBR 20 MG TABLET|5600|EA|.023|03/12/2009||Yes|No||03/12/2009||Yes|No|03/12/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02946|03/29/2022|.02875|03/29/2022|.02894|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6647|||||No|No||TORRENT PHARMAC|No||||
citalopram hydrobromide|Yes|No|No|No|75%|13668001101|CITALOPRAM HBR 40 MG TABLET|100|EA|.02438|11/08/2007||Yes|No||11/08/2007||Yes|No|11/08/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03726|03/29/2022|.03636|03/29/2022|.0366|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6648|||||No|No||TORRENT PHARMAC|No||||
citalopram hydrobromide|Yes|No|No|No|75%|13668001105|CITALOPRAM HBR 40 MG TABLET|500|EA|.023|11/08/2007||Yes|No||11/08/2007||Yes|No|11/08/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03726|03/29/2022|.03636|03/29/2022|.0366|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6649|||||No|No||TORRENT PHARMAC|No||||
citalopram hydrobromide|Yes|No|No|No|75%|13668001108|CITALOPRAM HBR 40 MG TABLET|2800|EA|.023|03/12/2009||Yes|No||03/12/2009||Yes|No|03/12/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03726|03/29/2022|.03636|03/29/2022|.0366|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6650|||||No|No||TORRENT PHARMAC|No||||
levetiracetam|No|No|No|No|75%|13668001405|LEVETIRACETAM 250 MG TABLET|500|EA|.05375|02/19/2009||Yes|No||02/19/2009||Yes|No|02/19/2009||Yes|No||||No|No|||Prescription required|No||056|No|.08073|03/29/2022|.07879|03/29/2022|.07931|03/29/2022|||ANTICONVULSANTS|6651|||||No|No||TORRENT PHARMAC|No||||
levetiracetam|No|No|No|No|75%|13668001412|LEVETIRACETAM 250 MG TABLET|120|EA|.05375|02/19/2009||Yes|No||02/19/2009||Yes|No|02/19/2009||Yes|No||||No|No|||Prescription required|No||056|No|.08073|03/29/2022|.07879|03/29/2022|.07931|03/29/2022|||ANTICONVULSANTS|6652|||||No|No||TORRENT PHARMAC|No||||
levetiracetam|No|No|No|No|75%|13668001425|LEVETIRACETAM 250 MG TABLET|250|EA|.05375|02/19/2009||Yes|No||02/19/2009||Yes|No|02/19/2009||Yes|No||||No|No|||Prescription required|No||056|No|.08073|03/29/2022|.07879|03/29/2022|.07931|03/29/2022|||ANTICONVULSANTS|6653|||||No|No||TORRENT PHARMAC|No||||
levetiracetam|No|No|No|No|75%|13668001505|LEVETIRACETAM 500 MG TABLET|500|EA|.1075|02/19/2009||Yes|No||02/19/2009||Yes|No|02/19/2009||Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|6654|||||No|No||TORRENT PHARMAC|No||||
levetiracetam|No|No|No|No|75%|13668001512|LEVETIRACETAM 500 MG TABLET|120|EA|.1075|02/19/2009||Yes|No||02/19/2009||Yes|No|02/19/2009||Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|6655|||||No|No||TORRENT PHARMAC|No||||
levetiracetam|No|No|No|No|75%|13668001525|LEVETIRACETAM 500 MG TABLET|250|EA|.1075|02/19/2009||Yes|No||02/19/2009||Yes|No|02/19/2009||Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|6656|||||No|No||TORRENT PHARMAC|No||||
levetiracetam|No|No|No|No|75%|13668001605|LEVETIRACETAM 750 MG TABLET|500|EA|.14333|02/19/2009||Yes|No||02/19/2009||Yes|No|02/19/2009||Yes|No||||No|No|||Prescription required|No||056|No|.15853|03/29/2022|.15472|03/29/2022|.15575|03/29/2022|||ANTICONVULSANTS|6657|||||No|No||TORRENT PHARMAC|No||||
levetiracetam|No|No|No|No|75%|13668001612|LEVETIRACETAM 750 MG TABLET|120|EA|.14333|02/19/2009||Yes|No||02/19/2009||Yes|No|02/19/2009||Yes|No||||No|No|||Prescription required|No||056|No|.15853|03/29/2022|.15472|03/29/2022|.15575|03/29/2022|||ANTICONVULSANTS|6658|||||No|No||TORRENT PHARMAC|No||||
levetiracetam|No|No|No|No|75%|13668001625|LEVETIRACETAM 750 MG TABLET|250|EA|.14332|02/19/2009||Yes|No||02/19/2009||Yes|No|02/19/2009||Yes|No||||No|No|||Prescription required|No||056|No|.15853|03/29/2022|.15472|03/29/2022|.15575|03/29/2022|||ANTICONVULSANTS|6659|||||No|No||TORRENT PHARMAC|No||||
levetiracetam|No|No|No|No|75%|13668001705|LEVETIRACETAM 1,000 MG TABLET|500|EA|.3225|02/19/2009||Yes|No||02/19/2009||Yes|No|02/19/2009||Yes|No||||No|No|||Prescription required|No||056|No|.22789|03/29/2022|.22242|03/29/2022|.2239|03/29/2022|||ANTICONVULSANTS|6660|||||No|No||TORRENT PHARMAC|No||||
levetiracetam|No|No|No|No|75%|13668001712|LEVETIRACETAM 1,000 MG TABLET|120|EA|.3225|02/19/2009||Yes|No||02/19/2009||Yes|No|02/19/2009||Yes|No||||No|No|||Prescription required|No||056|No|.22789|03/29/2022|.22242|03/29/2022|.2239|03/29/2022|||ANTICONVULSANTS|6661|||||No|No||TORRENT PHARMAC|No||||
levetiracetam|No|No|No|No|75%|13668001760|LEVETIRACETAM 1,000 MG TABLET|60|EA|.3225|02/19/2009||Yes|No||02/19/2009||Yes|No|02/19/2009||Yes|No||||No|No|||Prescription required|No||056|No|.22789|03/29/2022|.22242|03/29/2022|.2239|03/29/2022|||ANTICONVULSANTS|6662|||||No|No||TORRENT PHARMAC|No||||
venlafaxine HCl|No|No|No|No|75%|13668001830|VENLAFAXINE HCL ER 37.5 MG CAP|30|EA|.215|06/02/2011||Yes|No||06/02/2011||Yes|No|06/02/2011||Yes|No||||No|No|||Prescription required|No||031|Yes|.11725|03/29/2022|.11443|03/29/2022|.11519|03/29/2022|||ANTIDEPRESSANTS: OTHER|6663|||||No|No||TORRENT PHARMAC|No||||
venlafaxine HCl|No|No|No|No|75%|13668001930|VENLAFAXINE HCL ER 75 MG CAP|30|EA|.215|06/02/2011||Yes|No||06/02/2011||Yes|No|06/02/2011||Yes|No||||No|No|||Prescription required|No||031|Yes|.12722|03/29/2022|.12416|03/29/2022|.12499|03/29/2022|||ANTIDEPRESSANTS: OTHER|6664|||||No|No||TORRENT PHARMAC|No||||
venlafaxine HCl|No|No|No|No|75%|13668001990|VENLAFAXINE HCL ER 75 MG CAP|90|EA|.215|06/02/2011||Yes|No||06/02/2011||Yes|No|06/02/2011||Yes|No||||No|No|||Prescription required|No||031|Yes|.12722|03/29/2022|.12416|03/29/2022|.12499|03/29/2022|||ANTIDEPRESSANTS: OTHER|6665|||||No|No||TORRENT PHARMAC|No||||
venlafaxine HCl|No|No|No|No|75%|13668002030|VENLAFAXINE HCL ER 150 MG CAP|30|EA|.215|06/02/2011||Yes|No||06/02/2011||Yes|No|06/02/2011||Yes|No||||No|No|||Prescription required|No||031|No|.16516|03/29/2022|.16119|03/29/2022|.16226|03/29/2022|||ANTIDEPRESSANTS: OTHER|6666|||||No|No||TORRENT PHARMAC|No||||
venlafaxine HCl|No|No|No|No|75%|13668002090|VENLAFAXINE HCL ER 150 MG CAP|90|EA|.215|06/02/2011||Yes|No||06/02/2011||Yes|No|06/02/2011||Yes|No||||No|No|||Prescription required|No||031|No|.16516|03/29/2022|.16119|03/29/2022|.16226|03/29/2022|||ANTIDEPRESSANTS: OTHER|6667|||||No|No||TORRENT PHARMAC|No||||
alfuzosin HCl|No|No|No|No|75%|13668002101|ALFUZOSIN HCL ER 10 MG TABLET|100|EA|.172|03/16/2011||Yes|No||03/16/2011||Yes|No|03/16/2011||Yes|No||||No|No|||Prescription required|No||003|No|.12775|03/29/2022|.12468|03/29/2022|.12551|03/29/2022|||BPH TREATMENTS|6668|||||No|No||TORRENT PHARMAC|No||||
alfuzosin HCl|No|No|No|No|75%|13668002105|ALFUZOSIN HCL ER 10 MG TABLET|500|EA|.172|03/16/2011||Yes|No||03/16/2011||Yes|No|03/16/2011||Yes|No||||No|No|||Prescription required|No||003|No|.12775|03/29/2022|.12468|03/29/2022|.12551|03/29/2022|||BPH TREATMENTS|6669|||||No|No||TORRENT PHARMAC|No||||
topiramate|No|No|No|No|75%|13668003105|TOPIRAMATE 25 MG TABLET|500|EA|.04945|03/27/2009||Yes|No||03/27/2009||Yes|No|03/27/2009||Yes|No||||No|No|||Prescription required|No||056|No|.03423|03/29/2022|.0334|03/29/2022|.03363|03/29/2022|||ANTICONVULSANTS|6670|||||No|No||TORRENT PHARMAC|No||||
topiramate|No|No|No|No|75%|13668003160|TOPIRAMATE 25 MG TABLET|60|EA|.04945|03/27/2009||Yes|No||03/27/2009||Yes|No|03/27/2009||Yes|No||||No|No|||Prescription required|No||056|No|.03423|03/29/2022|.0334|03/29/2022|.03363|03/29/2022|||ANTICONVULSANTS|6671|||||No|No||TORRENT PHARMAC|No||||
topiramate|No|No|No|No|75%|13668003205|TOPIRAMATE 50 MG TABLET|500|EA|.0989|03/27/2009||Yes|No||03/27/2009||Yes|No|03/27/2009||Yes|No||||No|No|||Prescription required|No||056|No|.04588|03/29/2022|.04477|03/29/2022|.04507|03/29/2022|||ANTICONVULSANTS|6672|||||No|No||TORRENT PHARMAC|No||||
topiramate|No|No|No|No|75%|13668003230|TOPIRAMATE 50 MG TABLET|30|EA|.0989|03/27/2009||Yes|No||03/27/2009||Yes|No|03/27/2009||Yes|No||||No|No|||Prescription required|No||056|No|.04588|03/29/2022|.04477|03/29/2022|.04507|03/29/2022|||ANTICONVULSANTS|6673|||||No|No||TORRENT PHARMAC|No||||
topiramate|No|No|No|No|75%|13668003260|TOPIRAMATE 50 MG TABLET|60|EA|.0989|03/27/2009||Yes|No||03/27/2009||Yes|No|03/27/2009||Yes|No||||No|No|||Prescription required|No||056|No|.04588|03/29/2022|.04477|03/29/2022|.04507|03/29/2022|||ANTICONVULSANTS|6674|||||No|No||TORRENT PHARMAC|No||||
topiramate|No|No|No|No|75%|13668003305|TOPIRAMATE 100 MG TABLET|500|EA|.13465|03/27/2009||Yes|No||03/27/2009||Yes|No|03/27/2009||Yes|No||||No|No|||Prescription required|No||056|No|.06953|03/29/2022|.06786|03/29/2022|.06831|03/29/2022|||ANTICONVULSANTS|6675|||||No|No||TORRENT PHARMAC|No||||
topiramate|No|No|No|No|75%|13668003360|TOPIRAMATE 100 MG TABLET|60|EA|.13473|03/27/2009||Yes|No||03/27/2009||Yes|No|03/27/2009||Yes|No||||No|No|||Prescription required|No||056|No|.06953|03/29/2022|.06786|03/29/2022|.06831|03/29/2022|||ANTICONVULSANTS|6676|||||No|No||TORRENT PHARMAC|No||||
topiramate|No|No|No|No|75%|13668003405|TOPIRAMATE 200 MG TABLET|500|EA|.15766|03/27/2009||Yes|No||03/27/2009||Yes|No|03/27/2009||Yes|No||||No|No|||Prescription required|No||056|No|.12326|03/29/2022|.1203|03/29/2022|.1211|03/29/2022|||ANTICONVULSANTS|6677|||||No|No||TORRENT PHARMAC|No||||
topiramate|No|No|No|No|75%|13668003460|TOPIRAMATE 200 MG TABLET|60|EA|.15766|03/27/2009||Yes|No||03/27/2009||Yes|No|03/27/2009||Yes|No||||No|No|||Prescription required|No||056|No|.12326|03/29/2022|.1203|03/29/2022|.1211|03/29/2022|||ANTICONVULSANTS|6678|||||No|No||TORRENT PHARMAC|No||||
risperidone|No|No|No|No|75%|13668003505|RISPERIDONE 0.25 MG TABLET|500|EA|.05106|09/29/2009||Yes|No||09/29/2009||Yes|No|09/29/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.04339|03/29/2022|.04234|03/29/2022|.04263|03/29/2022|||ANTIPSYCHOTICS|6679|||||No|No||TORRENT PHARMAC|No||||
risperidone|No|No|No|No|75%|13668003560|RISPERIDONE 0.25 MG TABLET|60|EA|.05109|02/20/2009||Yes|No||02/20/2009||Yes|No|02/20/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.04339|03/29/2022|.04234|03/29/2022|.04263|03/29/2022|||ANTIPSYCHOTICS|6680|||||No|No||TORRENT PHARMAC|No||||
risperidone|No|No|No|No|75%|13668003605|RISPERIDONE 0.5 MG TABLET|500|EA|.05412|09/29/2009||Yes|No||09/29/2009||Yes|No|09/29/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.04564|03/29/2022|.04454|03/29/2022|.04484|03/29/2022|||ANTIPSYCHOTICS|6681|||||No|No||TORRENT PHARMAC|No||||
risperidone|No|No|No|No|75%|13668003660|RISPERIDONE 0.5 MG TABLET|60|EA|.0541|02/20/2009||Yes|No||02/20/2009||Yes|No|02/20/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.04564|03/29/2022|.04454|03/29/2022|.04484|03/29/2022|||ANTIPSYCHOTICS|6682|||||No|No||TORRENT PHARMAC|No||||
risperidone|No|No|No|No|75%|13668003705|RISPERIDONE 1 MG TABLET|500|EA|.06287|02/20/2009||Yes|No||02/20/2009||Yes|No|02/20/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.05646|03/29/2022|.0551|03/29/2022|.05547|03/29/2022|||ANTIPSYCHOTICS|6683|||||No|No||TORRENT PHARMAC|No||||
risperidone|No|No|No|No|75%|13668003760|RISPERIDONE 1 MG TABLET|60|EA|.06284|02/20/2009||Yes|No||02/20/2009||Yes|No|02/20/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.05646|03/29/2022|.0551|03/29/2022|.05547|03/29/2022|||ANTIPSYCHOTICS|6684|||||No|No||TORRENT PHARMAC|No||||
risperidone|No|No|No|No|75%|13668003805|RISPERIDONE 2 MG TABLET|500|EA|.06332|02/20/2009||Yes|No||02/20/2009||Yes|No|02/20/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.061|03/29/2022|.05953|03/29/2022|.05993|03/29/2022|||ANTIPSYCHOTICS|6685|||||No|No||TORRENT PHARMAC|No||||
risperidone|No|No|No|No|75%|13668003860|RISPERIDONE 2 MG TABLET|60|EA|.06335|02/20/2009||Yes|No||02/20/2009||Yes|No|02/20/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.061|03/29/2022|.05953|03/29/2022|.05993|03/29/2022|||ANTIPSYCHOTICS|6686|||||No|No||TORRENT PHARMAC|No||||
risperidone|No|No|No|No|75%|13668003905|RISPERIDONE 3 MG TABLET|500|EA|.06484|02/20/2009||Yes|No||02/20/2009||Yes|No|02/20/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.07183|03/29/2022|.0701|03/29/2022|.07057|03/29/2022|||ANTIPSYCHOTICS|6687|||||No|No||TORRENT PHARMAC|No||||
risperidone|No|No|No|No|75%|13668003960|RISPERIDONE 3 MG TABLET|60|EA|.06485|02/20/2009||Yes|No||02/20/2009||Yes|No|02/20/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.07183|03/29/2022|.0701|03/29/2022|.07057|03/29/2022|||ANTIPSYCHOTICS|6688|||||No|No||TORRENT PHARMAC|No||||
risperidone|No|No|No|No|75%|13668004005|RISPERIDONE 4 MG TABLET|500|EA|.07288|09/29/2009||Yes|No||09/29/2009||Yes|No|09/29/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.10538|03/29/2022|.10285|03/29/2022|.10353|03/29/2022|||ANTIPSYCHOTICS|6689|||||No|No||TORRENT PHARMAC|No||||
risperidone|No|No|No|No|75%|13668004060|RISPERIDONE 4 MG TABLET|60|EA|.07288|09/29/2009||Yes|No||09/29/2009||Yes|No|09/29/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.10538|03/29/2022|.10285|03/29/2022|.10353|03/29/2022|||ANTIPSYCHOTICS|6690|||||No|No||TORRENT PHARMAC|No||||
lamotrigine|No|No|No|No|75%|13668004501|LAMOTRIGINE 25 MG TABLET|100|EA|.0258|02/19/2009||Yes|No||02/19/2009||Yes|No|02/19/2009||Yes|No||||No|No|||Prescription required|No||056|No|.03514|03/29/2022|.03429|03/29/2022|.03452|03/29/2022|||ANTICONVULSANTS|6691|||||No|No||TORRENT PHARMAC|No||||
lamotrigine|No|No|No|No|75%|13668004505|LAMOTRIGINE 25 MG TABLET|500|EA|.0258|02/19/2009||Yes|No||02/19/2009||Yes|No|02/19/2009||Yes|No||||No|No|||Prescription required|No||056|No|.03514|03/29/2022|.03429|03/29/2022|.03452|03/29/2022|||ANTICONVULSANTS|6692|||||No|No||TORRENT PHARMAC|No||||
lamotrigine|No|No|No|No|75%|13668004701|LAMOTRIGINE 100 MG TABLET|100|EA|.0301|02/19/2009||Yes|No||02/19/2009||Yes|No|02/19/2009||Yes|No||||No|No|||Prescription required|No||056|No|.06403|03/29/2022|.06249|03/29/2022|.0629|03/29/2022|||ANTICONVULSANTS|6693|||||No|No||TORRENT PHARMAC|No||||
lamotrigine|No|No|No|No|75%|13668004705|LAMOTRIGINE 100 MG TABLET|500|EA|.0301|02/19/2009||Yes|No||02/19/2009||Yes|No|02/19/2009||Yes|No||||No|No|||Prescription required|No||056|No|.06403|03/29/2022|.06249|03/29/2022|.0629|03/29/2022|||ANTICONVULSANTS|6694|||||No|No||TORRENT PHARMAC|No||||
lamotrigine|No|No|No|No|75%|13668004805|LAMOTRIGINE 150 MG TABLET|500|EA|.03769|02/19/2009||Yes|No||02/19/2009||Yes|No|02/19/2009||Yes|No||||No|No|||Prescription required|No||056|No|.0888|03/29/2022|.08666|03/29/2022|.08724|03/29/2022|||ANTICONVULSANTS|6695|||||No|No||TORRENT PHARMAC|No||||
lamotrigine|No|No|No|No|75%|13668004860|LAMOTRIGINE 150 MG TABLET|60|EA|.03769|02/19/2009||Yes|No||02/19/2009||Yes|No|02/19/2009||Yes|No||||No|No|||Prescription required|No||056|No|.0888|03/29/2022|.08666|03/29/2022|.08724|03/29/2022|||ANTICONVULSANTS|6696|||||No|No||TORRENT PHARMAC|No||||
lamotrigine|No|No|No|No|75%|13668004905|LAMOTRIGINE 200 MG TABLET|500|EA|.0602|02/19/2009||Yes|No||02/19/2009||Yes|No|02/19/2009||Yes|No||||No|No|||Prescription required|No||056|No|.10103|03/29/2022|.0986|03/29/2022|.09926|03/29/2022|||ANTICONVULSANTS|6697|||||No|No||TORRENT PHARMAC|No||||
lamotrigine|No|No|No|No|75%|13668004960|LAMOTRIGINE 200 MG TABLET|60|EA|.0602|02/19/2009||Yes|No||02/19/2009||Yes|No|02/19/2009||Yes|No||||No|No|||Prescription required|No||056|No|.10103|03/29/2022|.0986|03/29/2022|.09926|03/29/2022|||ANTICONVULSANTS|6698|||||No|No||TORRENT PHARMAC|No||||
valsartan|Yes|No|No|No|75%|13668006730|VALSARTAN 40 MG TABLET|30|EA|.13946|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.1945|03/29/2022|.18983|03/29/2022|.19109|03/29/2022|||ANGIOTENSIN MODULATORS|6699|||||No|No||TORRENT PHARMAC|No||||
valsartan|Yes|No|No|No|75%|13668006890|VALSARTAN 80 MG TABLET|90|EA|.16674|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.21024|03/29/2022|.20519|03/29/2022|.20656|03/29/2022|||ANGIOTENSIN MODULATORS|6700|||||No|No||TORRENT PHARMAC|No||||
valsartan|Yes|No|No|No|75%|13668006990|VALSARTAN 160 MG TABLET|90|EA|.17935|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.23007|03/29/2022|.22454|03/29/2022|.22604|03/29/2022|||ANGIOTENSIN MODULATORS|6701|||||No|No||TORRENT PHARMAC|No||||
valsartan|Yes|No|No|No|75%|13668007090|VALSARTAN 320 MG TABLET|90|EA|.22684|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.31156|03/29/2022|.30408|03/29/2022|.3061|03/29/2022|||ANGIOTENSIN MODULATORS|6702|||||No|No||TORRENT PHARMAC|No||||
montelukast sodium|No|No|No|No|75%|13668007905|MONTELUKAST SOD 4 MG TAB CHEW|500|EA|.3225|08/07/2012||Yes|No||08/07/2012||Yes|No|08/07/2012||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|6703|||||No|No||TORRENT PHARMAC|No||||
montelukast sodium|No|No|No|No|75%|13668007930|MONTELUKAST SOD 4 MG TAB CHEW|30|EA|.3225|08/07/2012||Yes|No||08/07/2012||Yes|No|08/07/2012||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|6704|||||No|No||TORRENT PHARMAC|No||||
montelukast sodium|No|No|No|No|75%|13668007990|MONTELUKAST SOD 4 MG TAB CHEW|90|EA|.3225|08/07/2012||Yes|No||08/07/2012||Yes|No|08/07/2012||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|6705|||||No|No||TORRENT PHARMAC|No||||
montelukast sodium|No|No|No|No|75%|13668008005|MONTELUKAST SOD 5 MG TAB CHEW|500|EA|.3225|08/07/2012||Yes|No||08/07/2012||Yes|No|08/07/2012||Yes|No||||No|No|||Prescription required|No||042|Yes|.08451|03/29/2022|.08248|03/29/2022|.08303|03/29/2022|||LEUKOTRIENE MODIFIERS|6706|||||No|No||TORRENT PHARMAC|No||||
montelukast sodium|No|No|No|No|75%|13668008030|MONTELUKAST SOD 5 MG TAB CHEW|30|EA|.3225|08/07/2012||Yes|No||08/07/2012||Yes|No|08/07/2012||Yes|No||||No|No|||Prescription required|No||042|Yes|.08451|03/29/2022|.08248|03/29/2022|.08303|03/29/2022|||LEUKOTRIENE MODIFIERS|6707|||||No|No||TORRENT PHARMAC|No||||
montelukast sodium|No|No|No|No|75%|13668008090|MONTELUKAST SOD 5 MG TAB CHEW|90|EA|.3225|08/07/2012||Yes|No||08/07/2012||Yes|No|08/07/2012||Yes|No||||No|No|||Prescription required|No||042|Yes|.08451|03/29/2022|.08248|03/29/2022|.08303|03/29/2022|||LEUKOTRIENE MODIFIERS|6708|||||No|No||TORRENT PHARMAC|No||||
montelukast sodium|No|No|No|No|75%|13668008190|MONTELUKAST SOD 10 MG TABLET|90|EA|.3225|08/07/2012||Yes|No||08/07/2012||Yes|No|08/07/2012||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|6709|||||No|No||TORRENT PHARMAC|Yes|09/01/2020|||
levofloxacin|Yes|No|No|No|75%|13668008201|LEVOFLOXACIN 250 MG TABLET|100|EA|.172|09/08/2011||Yes|No||09/08/2011||Yes|No|09/08/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||028|No|.15969|03/29/2022|.15585|03/29/2022|.15689|03/29/2022|||FLUOROQUINOLONES: ORAL|6710|||||No|No||TORRENT PHARMAC|No||||
levofloxacin|Yes|No|No|No|75%|13668008250|LEVOFLOXACIN 250 MG TABLET|50|EA|.172|09/08/2011||Yes|No||09/08/2011||Yes|No|09/08/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||028|No|.15969|03/29/2022|.15585|03/29/2022|.15689|03/29/2022|||FLUOROQUINOLONES: ORAL|6711|||||No|No||TORRENT PHARMAC|No||||
levofloxacin|No|No|No|No|75%|13668008301|LEVOFLOXACIN 500 MG TABLET|100|EA|.258|09/08/2011||Yes|No||09/08/2011||Yes|No|09/08/2011||Yes|No||||No|No|||Prescription required|No||028|No|.19821|03/29/2022|.19345|03/29/2022|.19474|03/29/2022|||FLUOROQUINOLONES: ORAL|6712|||||No|No||TORRENT PHARMAC|No||||
levofloxacin|No|No|No|No|75%|13668008350|LEVOFLOXACIN 500 MG TABLET|50|EA|.258|09/08/2011||Yes|No||09/08/2011||Yes|No|09/08/2011||Yes|No||||No|No|||Prescription required|No||028|No|.19821|03/29/2022|.19345|03/29/2022|.19474|03/29/2022|||FLUOROQUINOLONES: ORAL|6713|||||No|No||TORRENT PHARMAC|No||||
levofloxacin|No|No|No|No|75%|13668008401|LEVOFLOXACIN 750 MG TABLET|100|EA|.43|09/08/2011||Yes|No||09/08/2011||Yes|No|09/08/2011||Yes|No||||No|No|||Prescription required|No||028|No|.38345|03/29/2022|.37424|03/29/2022|.37673|03/29/2022|||FLUOROQUINOLONES: ORAL|6714|||||No|No||TORRENT PHARMAC|No||||
levofloxacin|No|No|No|No|75%|13668008421|LEVOFLOXACIN 750 MG TABLET|20|EA|.43|09/08/2011||Yes|No||09/08/2011||Yes|No|09/08/2011||Yes|No||||No|No|||Prescription required|No||028|No|.38345|03/29/2022|.37424|03/29/2022|.37673|03/29/2022|||FLUOROQUINOLONES: ORAL|6715|||||No|No||TORRENT PHARMAC|No||||
olanzapine|No|No|No|No|75%|13668008630|OLANZAPINE ODT 5 MG TABLET|30|EA|1.0535|10/26/2011||Yes|No||10/26/2011||Yes|No|10/26/2011||Yes|No||||No|No|||Prescription required|No||027|Yes|.59218|03/29/2022|.57796|03/29/2022|.58181|03/29/2022|||ANTIPSYCHOTICS|6716|||||No|No||TORRENT PHARMAC|No||||
olanzapine|No|No|No|No|75%|13668008830|OLANZAPINE ODT 10 MG TABLET|30|EA|1.55516|10/26/2011||Yes|No||10/26/2011||Yes|No|10/26/2011||Yes|No||||No|No|||Prescription required|No||027|Yes|.58062|03/29/2022|.56668|03/29/2022|.57045|03/29/2022|||ANTIPSYCHOTICS|6717|||||No|No||TORRENT PHARMAC|No||||
olanzapine|No|No|No|No|75%|13668008930|OLANZAPINE ODT 15 MG TABLET|30|EA|2.28258|10/26/2011||Yes|No||10/26/2011||Yes|No|10/26/2011||Yes|No||||No|No|||Prescription required|No||027|Yes|.85386|03/29/2022|.83336|03/29/2022|.83891|03/29/2022|||ANTIPSYCHOTICS|6718|||||No|No||TORRENT PHARMAC|No||||
olanzapine|No|No|No|No|75%|13668009030|OLANZAPINE ODT 20 MG TABLET|30|EA|3.01|10/26/2011||Yes|No||10/26/2011||Yes|No|10/26/2011||Yes|No||||No|No|||Prescription required|No||027|Yes|1.09|03/29/2022|1.06384|03/29/2022|1.07092|03/29/2022|||ANTIPSYCHOTICS|6719|||||No|No||TORRENT PHARMAC|No||||
pramipexole di-HCl|No|No|No|No|75%|13668009105|PRAMIPEXOLE 0.125 MG TABLET|500|EA|.0633|03/16/2011||Yes|No||03/16/2011||Yes|No|03/16/2011||Yes|No||||No|No|||Prescription required|No||015|No|.05408|03/29/2022|.05278|03/29/2022|.05313|03/29/2022|||ANTIPARKINSON'S AGENTS|6720|||||No|No||TORRENT PHARMAC|No||||
pramipexole di-HCl|No|No|No|No|75%|13668009190|PRAMIPEXOLE 0.125 MG TABLET|90|EA|.0633|03/16/2011||Yes|No||03/16/2011||Yes|No|03/16/2011||Yes|No||||No|No|||Prescription required|No||015|No|.05408|03/29/2022|.05278|03/29/2022|.05313|03/29/2022|||ANTIPARKINSON'S AGENTS|6721|||||No|No||TORRENT PHARMAC|No||||
pramipexole di-HCl|No|No|No|No|75%|13668009205|PRAMIPEXOLE 0.25 MG TABLET|500|EA|.0633|03/16/2011||Yes|No||03/16/2011||Yes|No|03/16/2011||Yes|No||||No|No|||Prescription required|No||015|No|.05102|03/29/2022|.04979|03/29/2022|.05012|03/29/2022|||ANTIPARKINSON'S AGENTS|6722|||||No|No||TORRENT PHARMAC|No||||
pramipexole di-HCl|No|No|No|No|75%|13668009290|PRAMIPEXOLE 0.25 MG TABLET|90|EA|.0633|03/16/2011||Yes|No||03/16/2011||Yes|No|03/16/2011||Yes|No||||No|No|||Prescription required|No||015|No|.05102|03/29/2022|.04979|03/29/2022|.05012|03/29/2022|||ANTIPARKINSON'S AGENTS|6723|||||No|No||TORRENT PHARMAC|No||||
pramipexole di-HCl|No|No|No|No|75%|13668009305|PRAMIPEXOLE 0.5 MG TABLET|500|EA|.0633|03/16/2011||Yes|No||03/16/2011||Yes|No|03/16/2011||Yes|No||||No|No|||Prescription required|No||015|No|.05616|03/29/2022|.05481|03/29/2022|.05517|03/29/2022|||ANTIPARKINSON'S AGENTS|6724|||||No|No||TORRENT PHARMAC|No||||
pramipexole di-HCl|No|No|No|No|75%|13668009390|PRAMIPEXOLE 0.5 MG TABLET|90|EA|.0633|03/16/2011||Yes|No||03/16/2011||Yes|No|03/16/2011||Yes|No||||No|No|||Prescription required|No||015|No|.05616|03/29/2022|.05481|03/29/2022|.05517|03/29/2022|||ANTIPARKINSON'S AGENTS|6725|||||No|No||TORRENT PHARMAC|No||||
pramipexole di-HCl|No|No|No|No|75%|13668009405|PRAMIPEXOLE 1 MG TABLET|500|EA|.0633|03/16/2011||Yes|No||03/16/2011||Yes|No|03/16/2011||Yes|No||||No|No|||Prescription required|No||015|No|.06615|03/29/2022|.06456|03/29/2022|.06499|03/29/2022|||ANTIPARKINSON'S AGENTS|6726|||||No|No||TORRENT PHARMAC|No||||
pramipexole di-HCl|No|No|No|No|75%|13668009490|PRAMIPEXOLE 1 MG TABLET|90|EA|.0633|03/16/2011||Yes|No||03/16/2011||Yes|No|03/16/2011||Yes|No||||No|No|||Prescription required|No||015|No|.06615|03/29/2022|.06456|03/29/2022|.06499|03/29/2022|||ANTIPARKINSON'S AGENTS|6727|||||No|No||TORRENT PHARMAC|No||||
pramipexole di-HCl|No|No|No|No|75%|13668009505|PRAMIPEXOLE 1.5 MG TABLET|500|EA|.0633|03/16/2011||Yes|No||03/16/2011||Yes|No|03/16/2011||Yes|No||||No|No|||Prescription required|No||015|No|.07545|03/29/2022|.07363|03/29/2022|.07412|03/29/2022|||ANTIPARKINSON'S AGENTS|6728|||||No|No||TORRENT PHARMAC|No||||
pramipexole di-HCl|No|No|No|No|75%|13668009590|PRAMIPEXOLE 1.5 MG TABLET|90|EA|.0633|03/16/2011||Yes|No||03/16/2011||Yes|No|03/16/2011||Yes|No||||No|No|||Prescription required|No||015|No|.07545|03/29/2022|.07363|03/29/2022|.07412|03/29/2022|||ANTIPARKINSON'S AGENTS|6729|||||No|No||TORRENT PHARMAC|No||||
pantoprazole sodium|No|No|No|No|75%|13668009605|PANTOPRAZOLE SOD DR 20 MG TAB|500|EA|.086|09/08/2011||Yes|No||09/08/2011||Yes|No|09/08/2011||Yes|No||||No|No|||Prescription required|No||047|Yes|.05306|03/29/2022|.05178|03/29/2022|.05213|03/29/2022|||PROTON PUMP INHIBITORS|6730|||||No|No||TORRENT PHARMAC|No||||
pantoprazole sodium|No|No|No|No|75%|13668009690|PANTOPRAZOLE SOD DR 20 MG TAB|90|EA|.086|11/09/2018||Yes|No||11/09/2018||Yes|No|11/09/2018||Yes|No||||No|No|||Prescription required|No||047|Yes|.05306|03/29/2022|.05178|03/29/2022|.05213|03/29/2022|||PROTON PUMP INHIBITORS|6731|||||No|No||TORRENT PHARMAC|No||||
donepezil HCl|No|No|No|No|75%|13668010210|DONEPEZIL HCL 5 MG TABLET|1000|EA|.0645|06/02/2011||Yes|No||06/02/2011||Yes|No|06/02/2011||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|6732|||||No|No||TORRENT PHARMAC|No||||
donepezil HCl|No|No|No|No|75%|13668010230|DONEPEZIL HCL 5 MG TABLET|30|EA|.0645|06/02/2011||Yes|No||06/02/2011||Yes|No|06/02/2011||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|6733|||||No|No||TORRENT PHARMAC|No||||
donepezil HCl|No|No|No|No|75%|13668010240|DONEPEZIL HCL 5 MG TABLET|4000|EA|.0645|06/02/2011||Yes|No||06/02/2011||Yes|No|06/02/2011||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|6734|||||No|No||TORRENT PHARMAC|No||||
donepezil HCl|No|No|No|No|75%|13668010290|DONEPEZIL HCL 5 MG TABLET|90|EA|.0645|06/02/2011||Yes|No||06/02/2011||Yes|No|06/02/2011||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|6735|||||No|No||TORRENT PHARMAC|No||||
donepezil HCl|No|No|No|No|75%|13668010310|DONEPEZIL HCL 10 MG TABLET|1000|EA|.0645|06/02/2011||Yes|No||06/02/2011||Yes|No|06/02/2011||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|6736|||||No|No||TORRENT PHARMAC|No||||
donepezil HCl|No|No|No|No|75%|13668010326|DONEPEZIL HCL 10 MG TABLET|2650|EA|.0645|06/02/2011||Yes|No||06/02/2011||Yes|No|06/02/2011||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|6737|||||No|No||TORRENT PHARMAC|No||||
donepezil HCl|No|No|No|No|75%|13668010330|DONEPEZIL HCL 10 MG TABLET|30|EA|.0645|06/02/2011||Yes|No||06/02/2011||Yes|No|06/02/2011||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|6738|||||No|No||TORRENT PHARMAC|No||||
donepezil HCl|No|No|No|No|75%|13668010390|DONEPEZIL HCL 10 MG TABLET|90|EA|.0645|06/02/2011||Yes|No||06/02/2011||Yes|No|06/02/2011||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|6739|||||No|No||TORRENT PHARMAC|No||||
isosorbide mononitrate|No|No|No|No|75%|13668010401|ISOSORBIDE MONONIT ER 30 MG TB|100|EA|.172|01/19/2011||Yes|No||01/19/2011||Yes|No|01/19/2011||Yes|No||||No|No|||Prescription required|No|||No|.09715|03/29/2022|.09481|03/29/2022|.09544|03/29/2022||||6740|||||No|No||TORRENT PHARMAC|No||||
isosorbide mononitrate|No|No|No|No|75%|13668010410|ISOSORBIDE MONONIT ER 30 MG TB|1000|EA|.1505|02/18/2014||Yes|No||02/18/2014||Yes|No|02/18/2014||Yes|No||||No|No|||Prescription required|No|||No|.09715|03/29/2022|.09481|03/29/2022|.09544|03/29/2022||||6741|||||No|No||TORRENT PHARMAC|No||||
isosorbide mononitrate|No|No|No|No|75%|13668010501|ISOSORBIDE MONONIT ER 60 MG TB|100|EA|.301|01/19/2011||Yes|No||01/19/2011||Yes|No|01/19/2011||Yes|No||||No|No|||Prescription required|No|||No|.12753|03/29/2022|.12446|03/29/2022|.12529|03/29/2022||||6742|||||No|No||TORRENT PHARMAC|No||||
isosorbide mononitrate|No|No|No|No|75%|13668010510|ISOSORBIDE MONONIT ER 60 MG TB|1000|EA|.258|02/18/2014||Yes|No||02/18/2014||Yes|No|02/18/2014||Yes|No||||No|No|||Prescription required|No|||No|.12753|03/29/2022|.12446|03/29/2022|.12529|03/29/2022||||6743|||||No|No||TORRENT PHARMAC|No||||
isosorbide mononitrate|No|No|No|No|75%|13668010601|ISOSORBIDE MONONIT ER 120 MG|100|EA|.4515|01/19/2011||Yes|No||01/19/2011||Yes|No|01/19/2011||Yes|No||||No|No|||Prescription required|No|||No|.25435|03/29/2022|.24824|03/29/2022|.24989|03/29/2022||||6744|||||No|No||TORRENT PHARMAC|No||||
rabeprazole sodium|No|No|No|No|75%|13668010705|RABEPRAZOLE SOD DR 20 MG TAB|500|EA|.43|04/30/2014||Yes|No||04/30/2014||Yes|No|04/30/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.24287|03/29/2022|.23704|03/29/2022|.23861|03/29/2022|||PROTON PUMP INHIBITORS|6745|||||No|No||TORRENT PHARMAC|No||||
rabeprazole sodium|No|No|No|No|75%|13668010730|RABEPRAZOLE SOD DR 20 MG TAB|30|EA|.43|04/30/2014||Yes|No||04/30/2014||Yes|No|04/30/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.24287|03/29/2022|.23704|03/29/2022|.23861|03/29/2022|||PROTON PUMP INHIBITORS|6746|||||No|No||TORRENT PHARMAC|No||||
rabeprazole sodium|No|No|No|No|75%|13668010790|RABEPRAZOLE SOD DR 20 MG TAB|90|EA|.43|04/30/2014||Yes|No||04/30/2014||Yes|No|04/30/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.24287|03/29/2022|.23704|03/29/2022|.23861|03/29/2022|||PROTON PUMP INHIBITORS|6747|||||No|No||TORRENT PHARMAC|No||||
duloxetine HCl|No|No|No|No|75%|13668010960|DULOXETINE HCL DR 20 MG CAP|60|EA|.55728|05/08/2014||Yes|No||05/08/2014||Yes|No|05/08/2014||Yes|No||||No|No|||Prescription required|No||232|No|.13163|03/29/2022|.12847|03/29/2022|.12932|03/29/2022|||NEUROPATHIC PAIN|6748|||||No|No||TORRENT PHARMAC|No||||
duloxetine HCl|No|No|No|No|75%|13668011005|DULOXETINE HCL DR 30 MG CAP|500|EA|.62522|05/08/2014||Yes|No||05/08/2014||Yes|No|05/08/2014||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|6749|||||No|No||TORRENT PHARMAC|No||||
duloxetine HCl|No|No|No|No|75%|13668011030|DULOXETINE HCL DR 30 MG CAP|30|EA|.62522|05/08/2014||Yes|No||05/08/2014||Yes|No|05/08/2014||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|6750|||||No|No||TORRENT PHARMAC|No||||
duloxetine HCl|No|No|No|No|75%|13668011105|DULOXETINE HCL DR 60 MG CAP|500|EA|.62522|05/08/2014||Yes|No||05/08/2014||Yes|No|05/08/2014||Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|6751|||||No|No||TORRENT PHARMAC|No||||
duloxetine HCl|No|No|No|No|75%|13668011130|DULOXETINE HCL DR 60 MG CAP|30|EA|.62522|05/08/2014||Yes|No||05/08/2014||Yes|No|05/08/2014||Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|6752|||||No|No||TORRENT PHARMAC|No||||
losartan potassium|Yes|No|No|No|75%|13668011310|LOSARTAN POTASSIUM 25 MG TAB|1000|EA|.0602|03/16/2011||Yes|No||03/16/2011||Yes|No|03/16/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|6753|||||No|No||TORRENT PHARMAC|No||||
losartan potassium|Yes|No|No|No|75%|13668011390|LOSARTAN POTASSIUM 25 MG TAB|90|EA|.0602|03/16/2011||Yes|No||03/16/2011||Yes|No|03/16/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|6754|||||No|No||TORRENT PHARMAC|No||||
losartan potassium|Yes|No|No|No|75%|13668011510|LOSARTAN POTASSIUM 100 MG TAB|1000|EA|.1118|04/06/2011||Yes|No||04/06/2011||Yes|No|04/06/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|6755|||||No|No||TORRENT PHARMAC|No||||
losartan potassium|Yes|No|No|No|75%|13668011530|LOSARTAN POTASSIUM 100 MG TAB|30|EA|.1118|04/06/2011||Yes|No||04/06/2011||Yes|No|04/06/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|6756|||||No|No||TORRENT PHARMAC|No||||
losartan potassium|Yes|No|No|No|75%|13668011590|LOSARTAN POTASSIUM 100 MG TAB|90|EA|.1118|04/06/2011||Yes|No||04/06/2011||Yes|No|04/06/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|6757|||||No|No||TORRENT PHARMAC|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|13668011610|LOSARTAN-HCTZ 50-12.5 MG TAB|1000|EA|.0903|03/16/2011||Yes|No||03/16/2011||Yes|No|03/16/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|6758|||||No|No||TORRENT PHARMAC|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|13668011630|LOSARTAN-HCTZ 50-12.5 MG TAB|30|EA|.0903|03/16/2011||Yes|No||03/16/2011||Yes|No|03/16/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|6759|||||No|No||TORRENT PHARMAC|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|13668011690|LOSARTAN-HCTZ 50-12.5 MG TAB|90|EA|.0903|03/16/2011||Yes|No||03/16/2011||Yes|No|03/16/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|6760|||||No|No||TORRENT PHARMAC|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|13668011710|LOSARTAN-HCTZ 100-12.5 MG TAB|1000|EA|.1247|10/11/2010||Yes|No||10/11/2010||Yes|No|10/11/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|6761|||||No|No||TORRENT PHARMAC|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|13668011730|LOSARTAN-HCTZ 100-12.5 MG TAB|30|EA|.1247|10/11/2010||Yes|No||10/11/2010||Yes|No|10/11/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|6762|||||No|No||TORRENT PHARMAC|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|13668011790|LOSARTAN-HCTZ 100-12.5 MG TAB|90|EA|.1247|10/11/2010||Yes|No||10/11/2010||Yes|No|10/11/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|6763|||||No|No||TORRENT PHARMAC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|13668011810|LOSARTAN-HCTZ 100-25 MG TAB|1000|EA|.1247|03/16/2011||Yes|No||03/16/2011||Yes|No|03/16/2011||Yes|No||||No|No|||Prescription required|No||113|Yes|.21077|03/01/2022|.20571|03/01/2022|.20708|03/01/2022|||ANGIOTENSIN MODULATORS|6764|||||No|No||TORRENT PHARMAC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|13668011830|LOSARTAN-HCTZ 100-25 MG TAB|30|EA|.1247|03/16/2011||Yes|No||03/16/2011||Yes|No|03/16/2011||Yes|No||||No|No|||Prescription required|No||113|Yes|.21077|03/01/2022|.20571|03/01/2022|.20708|03/01/2022|||ANGIOTENSIN MODULATORS|6765|||||No|No||TORRENT PHARMAC|No||||
pioglitazone HCl|No|No|No|No|75%|13668011905|PIOGLITAZONE HCL 30 MG TABLET|500|EA|.18476|02/13/2013||Yes|No||02/13/2013||Yes|No|02/13/2013||Yes|No||||No|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|6766|||||No|No||TORRENT PHARMAC|No||||
pioglitazone HCl|No|No|No|No|75%|13668011930|PIOGLITAZONE HCL 30 MG TABLET|30|EA|.18475|02/13/2013||Yes|No||02/13/2013||Yes|No|02/13/2013||Yes|No||||No|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|6767|||||No|No||TORRENT PHARMAC|No||||
pioglitazone HCl|No|No|No|No|75%|13668011990|PIOGLITAZONE HCL 30 MG TABLET|90|EA|.18475|02/13/2013||Yes|No||02/13/2013||Yes|No|02/13/2013||Yes|No||||No|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|6768|||||No|No||TORRENT PHARMAC|No||||
pioglitazone HCl|No|No|No|No|75%|13668012005|PIOGLITAZONE HCL 45 MG TABLET|500|EA|.2004|02/13/2013||Yes|No||02/13/2013||Yes|No|02/13/2013||Yes|No||||No|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|6769|||||No|No||TORRENT PHARMAC|No||||
pioglitazone HCl|No|No|No|No|75%|13668012030|PIOGLITAZONE HCL 45 MG TABLET|30|EA|.20038|02/13/2013||Yes|No||02/13/2013||Yes|No|02/13/2013||Yes|No||||No|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|6770|||||No|No||TORRENT PHARMAC|No||||
pioglitazone HCl|No|No|No|No|75%|13668012090|PIOGLITAZONE HCL 45 MG TABLET|90|EA|.20042|02/13/2013||Yes|No||02/13/2013||Yes|No|02/13/2013||Yes|No||||No|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|6771|||||No|No||TORRENT PHARMAC|No||||
felodipine|Yes|No|No|No|75%|13668013201|FELODIPINE ER 2.5 MG TABLET|100|EA|.16331|12/01/2011||Yes|No||12/01/2011||Yes|No|12/01/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.25478|03/29/2022|.24866|03/29/2022|.25032|03/29/2022|||CALCIUM CHANNEL BLOCKERS|6772|||||No|No||TORRENT PHARMAC|No||||
felodipine|Yes|No|No|No|75%|13668013210|FELODIPINE ER 2.5 MG TABLET|1000|EA|.15513|12/01/2011||Yes|No||12/01/2011||Yes|No|12/01/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.25478|03/29/2022|.24866|03/29/2022|.25032|03/29/2022|||CALCIUM CHANNEL BLOCKERS|6773|||||No|No||TORRENT PHARMAC|No||||
felodipine|Yes|No|No|No|75%|13668013301|FELODIPINE ER 5 MG TABLET|100|EA|.16331|12/01/2011||Yes|No||12/01/2011||Yes|No|12/01/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.17388|03/29/2022|.1697|03/29/2022|.17083|03/29/2022|||CALCIUM CHANNEL BLOCKERS|6774|||||No|No||TORRENT PHARMAC|No||||
felodipine|Yes|No|No|No|75%|13668013310|FELODIPINE ER 5 MG TABLET|1000|EA|.15513|12/01/2011||Yes|No||12/01/2011||Yes|No|12/01/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.17388|03/29/2022|.1697|03/29/2022|.17083|03/29/2022|||CALCIUM CHANNEL BLOCKERS|6775|||||No|No||TORRENT PHARMAC|No||||
felodipine|Yes|No|No|No|75%|13668013401|FELODIPINE ER 10 MG TABLET|100|EA|.29343|12/01/2011||Yes|No||12/01/2011||Yes|No|12/01/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||045|No|.22814|03/29/2022|.22266|03/29/2022|.22414|03/29/2022|||CALCIUM CHANNEL BLOCKERS|6776|||||No|No||TORRENT PHARMAC|No||||
felodipine|Yes|No|No|No|75%|13668013410|FELODIPINE ER 10 MG TABLET|1000|EA|.27877|12/01/2011||Yes|No||12/01/2011||Yes|No|12/01/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||045|No|.22814|03/29/2022|.22266|03/29/2022|.22414|03/29/2022|||CALCIUM CHANNEL BLOCKERS|6777|||||No|No||TORRENT PHARMAC|No||||
escitalopram oxalate|Yes|No|No|No|75%|13668013501|ESCITALOPRAM 5 MG TABLET|100|EA|.0645|09/12/2012||Yes|No||09/12/2012||Yes|No|09/12/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.0462|03/29/2022|.04509|03/29/2022|.04539|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6778|||||No|No||TORRENT PHARMAC|No||||
escitalopram oxalate|Yes|No|No|No|75%|13668013505|ESCITALOPRAM 5 MG TABLET|500|EA|.0645|09/12/2012||Yes|No||09/12/2012||Yes|No|09/12/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.0462|03/29/2022|.04509|03/29/2022|.04539|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6779|||||No|No||TORRENT PHARMAC|No||||
escitalopram oxalate|Yes|No|No|No|75%|13668013510|ESCITALOPRAM 5 MG TABLET|1000|EA|.0645|03/03/2014||Yes|No||03/03/2014||Yes|No|03/03/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.0462|03/29/2022|.04509|03/29/2022|.04539|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6780|||||No|No||TORRENT PHARMAC|No||||
escitalopram oxalate|Yes|No|No|No|75%|13668013601|ESCITALOPRAM 10 MG TABLET|100|EA|.0688|09/12/2012||Yes|No||09/12/2012||Yes|No|09/12/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6781|||||No|No||TORRENT PHARMAC|No||||
escitalopram oxalate|Yes|No|No|No|75%|13668013605|ESCITALOPRAM 10 MG TABLET|500|EA|.0688|09/12/2012||Yes|No||09/12/2012||Yes|No|09/12/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6782|||||No|No||TORRENT PHARMAC|No||||
escitalopram oxalate|Yes|No|No|No|75%|13668013610|ESCITALOPRAM 10 MG TABLET|1000|EA|.0688|03/03/2014||Yes|No||03/03/2014||Yes|No|03/03/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6783|||||No|No||TORRENT PHARMAC|No||||
escitalopram oxalate|Yes|No|No|No|75%|13668013701|ESCITALOPRAM 20 MG TABLET|100|EA|.0731|09/12/2012||Yes|No||09/12/2012||Yes|No|09/12/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.07845|03/29/2022|.07656|03/29/2022|.07707|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6784|||||No|No||TORRENT PHARMAC|No||||
escitalopram oxalate|Yes|No|No|No|75%|13668013705|ESCITALOPRAM 20 MG TABLET|500|EA|.0731|09/12/2012||Yes|No||09/12/2012||Yes|No|09/12/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.07845|03/29/2022|.07656|03/29/2022|.07707|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6785|||||No|No||TORRENT PHARMAC|No||||
escitalopram oxalate|Yes|No|No|No|75%|13668013710|ESCITALOPRAM 20 MG TABLET|1000|EA|.0731|03/03/2014||Yes|No||03/03/2014||Yes|No|03/03/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.07845|03/29/2022|.07656|03/29/2022|.07707|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6786|||||No|No||TORRENT PHARMAC|No||||
pioglitazone HCl|No|No|No|No|75%|13668014005|PIOGLITAZONE HCL 15 MG TABLET|500|EA|.12089|02/13/2013||Yes|No||02/13/2013||Yes|No|02/13/2013||Yes|No||||No|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|6787|||||No|No||TORRENT PHARMAC|No||||
pioglitazone HCl|No|No|No|No|75%|13668014030|PIOGLITAZONE HCL 15 MG TABLET|30|EA|.12083|02/13/2013||Yes|No||02/13/2013||Yes|No|02/13/2013||Yes|No||||No|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|6788|||||No|No||TORRENT PHARMAC|No||||
pioglitazone HCl|No|No|No|No|75%|13668014090|PIOGLITAZONE HCL 15 MG TABLET|90|EA|.12087|02/13/2013||Yes|No||02/13/2013||Yes|No|02/13/2013||Yes|No||||No|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|6789|||||No|No||TORRENT PHARMAC|No||||
clopidogrel bisulfate|No|No|No|No|75%|13668014105|CLOPIDOGREL 75 MG TABLET|500|EA|.07163|05/17/2012||Yes|No||05/17/2012||Yes|No|05/17/2012||Yes|No||||No|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|6790|||||No|No||TORRENT PHARMAC|Yes|09/01/2020|||
clopidogrel bisulfate|No|No|No|No|75%|13668014130|CLOPIDOGREL 75 MG TABLET|30|EA|.07166|05/17/2012||Yes|No||05/17/2012||Yes|No|05/17/2012||Yes|No||||No|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|6791|||||No|No||TORRENT PHARMAC|No||||
clopidogrel bisulfate|No|No|No|No|75%|13668014190|CLOPIDOGREL 75 MG TABLET|90|EA|.07166|05/17/2012||Yes|No||05/17/2012||Yes|No|05/17/2012||Yes|No||||No|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|6792|||||No|No||TORRENT PHARMAC|No||||
esomeprazole magnesium|No|No|No|No|75%|13668015410|ESOMEPRAZOLE MAG DR 20 MG CAP|1000|EA|1.6124|10/26/2015||Yes|No||10/26/2015||Yes|No|10/26/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|6793|||||No|No||TORRENT PHARMAC|No||||
esomeprazole magnesium|No|No|No|No|75%|13668015430|ESOMEPRAZOLE MAG DR 20 MG CAP|30|EA|1.6125|10/26/2015||Yes|No||10/26/2015||Yes|No|10/26/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|6794|||||No|No||TORRENT PHARMAC|No||||
esomeprazole magnesium|No|No|No|No|75%|13668015490|ESOMEPRAZOLE MAG DR 20 MG CAP|90|EA|1.6124|10/26/2015||Yes|No||10/26/2015||Yes|No|10/26/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|6795|||||No|No||TORRENT PHARMAC|No||||
esomeprazole magnesium|No|No|No|No|75%|13668015510|ESOMEPRAZOLE MAG DR 40 MG CAP|1000|EA|1.6124|10/26/2015||Yes|No||10/26/2015||Yes|No|10/26/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|6796|||||No|No||TORRENT PHARMAC|No||||
esomeprazole magnesium|No|No|No|No|75%|13668015530|ESOMEPRAZOLE MAG DR 40 MG CAP|30|EA|1.6125|10/26/2015||Yes|No||10/26/2015||Yes|No|10/26/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|6797|||||No|No||TORRENT PHARMAC|No||||
esomeprazole magnesium|No|No|No|No|75%|13668015590|ESOMEPRAZOLE MAG DR 40 MG CAP|90|EA|1.6124|10/26/2015||Yes|No||10/26/2015||Yes|No|10/26/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|6798|||||No|No||TORRENT PHARMAC|No||||
telmisartan|Yes|No|No|No|75%|13668015630|TELMISARTAN 20 MG TABLET|30|EA|.35976|10/01/2014||Yes|No||10/01/2014||Yes|No|10/01/2014||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/17/2014|113|Yes|.30407|03/29/2022|.29677|03/29/2022|.29874|03/29/2022|||ANGIOTENSIN MODULATORS|6799|||||No|No||TORRENT PHARMAC|No||||
telmisartan|Yes|No|No|No|75%|13668015730|TELMISARTAN 40 MG TABLET|30|EA|.35976|10/01/2014||Yes|No||10/01/2014||Yes|No|10/01/2014||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/17/2014|113|Yes|.35861|03/29/2022|.35|03/29/2022|.35233|03/29/2022|||ANGIOTENSIN MODULATORS|6800|||||No|No||TORRENT PHARMAC|No||||
telmisartan|Yes|No|No|No|75%|13668015830|TELMISARTAN 80 MG TABLET|30|EA|.35976|10/01/2014||Yes|No||10/01/2014||Yes|No|10/01/2014||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/17/2014|113|Yes|.33958|03/29/2022|.33143|03/29/2022|.33363|03/29/2022|||ANGIOTENSIN MODULATORS|6801|||||No|No||TORRENT PHARMAC|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|13668015930|TELMISARTAN-HCTZ 40-12.5 MG TB|30|EA|1.73433|07/15/2014||Yes|No||07/15/2014||Yes|No|07/15/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|113|Yes|1.13569|03/29/2022|1.10843|03/29/2022|1.11581|03/29/2022|||ANGIOTENSIN MODULATORS|6802|||||No|No||TORRENT PHARMAC|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|13668016030|TELMISARTAN-HCTZ 80-12.5 MG TB|30|EA|1.73433|07/15/2014||Yes|No||07/15/2014||Yes|No|07/15/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|113|Yes|.94301|03/29/2022|.92037|03/29/2022|.9265|03/29/2022|||ANGIOTENSIN MODULATORS|6803|||||No|No||TORRENT PHARMAC|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|13668016130|TELMISARTAN-HCTZ 80-25 MG TAB|30|EA|1.73433|07/15/2014||Yes|No||07/15/2014||Yes|No|07/15/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|113|Yes|1.29965|03/29/2022|1.26845|03/29/2022|1.2769|03/29/2022|||ANGIOTENSIN MODULATORS|6804|||||No|No||TORRENT PHARMAC|No||||
olanzapine|No|No|No|No|75%|13668016630|OLANZAPINE 2.5 MG TABLET|30|EA|.08456|08/24/2016||Yes|No||08/24/2016||Yes|No|08/24/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.08915|03/29/2022|.08701|03/29/2022|.08758|03/29/2022|||ANTIPSYCHOTICS|6805|||||No|No||TORRENT PHARMAC|No||||
olanzapine|No|No|No|No|75%|13668016730|OLANZAPINE 5 MG TABLET|30|EA|.09961|08/24/2016||Yes|No||08/24/2016||Yes|No|08/24/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.09455|03/29/2022|.09228|03/29/2022|.09289|03/29/2022|||ANTIPSYCHOTICS|6806|||||No|No||TORRENT PHARMAC|No||||
olanzapine|No|No|No|No|75%|13668016830|OLANZAPINE 7.5 MG TABLET|30|EA|.12111|08/24/2016||Yes|No||08/24/2016||Yes|No|08/24/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.11617|03/29/2022|.11338|03/29/2022|.11413|03/29/2022|||ANTIPSYCHOTICS|6807|||||No|No||TORRENT PHARMAC|No||||
olanzapine|No|No|No|No|75%|13668016930|OLANZAPINE 10 MG TABLET|30|EA|.14978|08/24/2016||Yes|No||08/24/2016||Yes|No|08/24/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.12613|03/29/2022|.1231|03/29/2022|.12392|03/29/2022|||ANTIPSYCHOTICS|6808|||||No|No||TORRENT PHARMAC|No||||
olanzapine|No|No|No|No|75%|13668017030|OLANZAPINE 15 MG TABLET|30|EA|.22503|08/24/2016||Yes|No||08/24/2016||Yes|No|08/24/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.15007|03/29/2022|.14646|03/29/2022|.14744|03/29/2022|||ANTIPSYCHOTICS|6809|||||No|No||TORRENT PHARMAC|No||||
olanzapine|No|No|No|No|75%|13668017130|OLANZAPINE 20 MG TABLET|30|EA|.30028|08/24/2016||Yes|No||08/24/2016||Yes|No|08/24/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.18048|03/29/2022|.17614|03/29/2022|.17732|03/29/2022|||ANTIPSYCHOTICS|6810|||||No|No||TORRENT PHARMAC|No||||
rosuvastatin calcium|Yes|No|No|No|75%|13668017905|ROSUVASTATIN CALCIUM 5 MG TAB|500|EA|.11944|01/02/2020||Yes|No||01/02/2020||Yes|No|01/02/2020||Yes|No||||No|No|03/20/2020||Prescription required|No||063|Yes|.06753|03/29/2022|.0659|03/29/2022|.06634|03/29/2022|||LIPOTROPICS: STATINS|6811|||||No|No||TORRENT PHARMAC|No||||
rosuvastatin calcium|No|No|No|No|75%|13668017990|ROSUVASTATIN CALCIUM 5 MG TAB|90|EA|.11944|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|No||063|Yes|.06753|03/29/2022|.0659|03/29/2022|.06634|03/29/2022|||LIPOTROPICS: STATINS|6812|||||No|No||TORRENT PHARMAC|No||||
rosuvastatin calcium|No|No|No|No|75%|13668018090|ROSUVASTATIN CALCIUM 10 MG TAB|90|EA|.11944|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|No||063|Yes|.05981|03/29/2022|.05837|03/29/2022|.05876|03/29/2022|||LIPOTROPICS: STATINS|6813|||||No|No||TORRENT PHARMAC|No||||
rosuvastatin calcium|No|No|No|No|75%|13668018190|ROSUVASTATIN CALCIUM 20 MG TAB|90|EA|.11944|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|No||063|Yes|.07822|03/29/2022|.07634|03/29/2022|.07685|03/29/2022|||LIPOTROPICS: STATINS|6814|||||No|No||TORRENT PHARMAC|No||||
rosuvastatin calcium|Yes|No|No|No|75%|13668018205|ROSUVASTATIN CALCIUM 40 MG TAB|500|EA|.11944|01/02/2020||Yes|No||01/02/2020||Yes|No|01/02/2020||Yes|No||||No|No|03/20/2020||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|6815|||||No|No||TORRENT PHARMAC|No||||
rosuvastatin calcium|No|No|No|No|75%|13668018230|ROSUVASTATIN CALCIUM 40 MG TAB|30|EA|.11939|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|6816|||||No|No||TORRENT PHARMAC|No||||
pramipexole di-HCl|No|No|No|No|75%|13668018405|PRAMIPEXOLE 0.75 MG TABLET|500|EA|.0633|03/16/2011||Yes|No||03/16/2011||Yes|No|03/16/2011||Yes|No||||No|No|||Prescription required|No||015|No|.07926|03/29/2022|.07735|03/29/2022|.07787|03/29/2022|||ANTIPARKINSON'S AGENTS|6817|||||No|No||TORRENT PHARMAC|No||||
pramipexole di-HCl|No|No|No|No|75%|13668018490|PRAMIPEXOLE 0.75 MG TABLET|90|EA|.0633|03/16/2011||Yes|No||03/16/2011||Yes|No|03/16/2011||Yes|No||||No|No|||Prescription required|No||015|No|.07926|03/29/2022|.07735|03/29/2022|.07787|03/29/2022|||ANTIPARKINSON'S AGENTS|6818|||||No|No||TORRENT PHARMAC|No||||
sildenafil citrate|No|No|No|No|75%|13668018590|SILDENAFIL 20 MG TABLET|90|EA|.30434|01/28/2013||Yes|No||01/28/2013||Yes|No|01/28/2013||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|Yes|.09246|03/29/2022|.09024|03/29/2022|.09084|03/29/2022|||PAH AGENTS: ORAL AND INHALED|6819|||||No|No||TORRENT PHARMAC|No||||
tolterodine tartrate|No|No|No|No|75%|13668018905|TOLTERODINE TART ER 2 MG CAP|500|EA|1.93278|08/20/2015||Yes|No||08/20/2015||Yes|No|08/20/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|006|Yes|1.20249|03/29/2022|1.17363|03/29/2022|1.18144|03/29/2022|||BLADDER RELAXANT PREPARATIONS|6820|||||No|No||TORRENT PHARMAC|No||||
tolterodine tartrate|No|No|No|No|75%|13668018930|TOLTERODINE TART ER 2 MG CAP|30|EA|1.93285|08/20/2015||Yes|No||08/20/2015||Yes|No|08/20/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|006|Yes|1.20249|03/29/2022|1.17363|03/29/2022|1.18144|03/29/2022|||BLADDER RELAXANT PREPARATIONS|6821|||||No|No||TORRENT PHARMAC|No||||
tolterodine tartrate|No|No|No|No|75%|13668018990|TOLTERODINE TART ER 2 MG CAP|90|EA|1.93279|08/20/2015||Yes|No||08/20/2015||Yes|No|08/20/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|006|Yes|1.20249|03/29/2022|1.17363|03/29/2022|1.18144|03/29/2022|||BLADDER RELAXANT PREPARATIONS|6822|||||No|No||TORRENT PHARMAC|No||||
tolterodine tartrate|No|No|No|No|75%|13668019005|TOLTERODINE TART ER 4 MG CAP|500|EA|1.93278|08/20/2015||Yes|No||08/20/2015||Yes|No|08/20/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|006|No|1.14537|03/29/2022|1.11788|03/29/2022|1.12532|03/29/2022|||BLADDER RELAXANT PREPARATIONS|6823|||||No|No||TORRENT PHARMAC|No||||
tolterodine tartrate|No|No|No|No|75%|13668019030|TOLTERODINE TART ER 4 MG CAP|30|EA|1.93285|08/20/2015||Yes|No||08/20/2015||Yes|No|08/20/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|006|No|1.14537|03/29/2022|1.11788|03/29/2022|1.12532|03/29/2022|||BLADDER RELAXANT PREPARATIONS|6824|||||No|No||TORRENT PHARMAC|No||||
tolterodine tartrate|No|No|No|No|75%|13668019090|TOLTERODINE TART ER 4 MG CAP|90|EA|1.93279|08/20/2015||Yes|No||08/20/2015||Yes|No|08/20/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|006|No|1.14537|03/29/2022|1.11788|03/29/2022|1.12532|03/29/2022|||BLADDER RELAXANT PREPARATIONS|6825|||||No|No||TORRENT PHARMAC|No||||
moxifloxacin HCl|No|No|No|No|75%|13668020130|MOXIFLOXACIN HCL 400 MG TABLET|30|EA|3.87|07/15/2014||Yes|No||07/15/2014||Yes|No|07/15/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|028|No|1.23895|03/29/2022|1.20921|03/29/2022|1.21726|03/29/2022|||FLUOROQUINOLONES: ORAL|6826|||||No|No||TORRENT PHARMAC|No||||
darifenacin hydrobromide|No|No|No|No|75%|13668020230|DARIFENACIN ER 7.5 MG TABLET|30|EA|1.40896|02/20/2018||Yes|No||02/20/2018||Yes|No|02/20/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|006|Yes|1.71519|03/29/2022|1.67402|03/29/2022|1.68517|03/29/2022|||BLADDER RELAXANT PREPARATIONS|6827|||||No|No||TORRENT PHARMAC|No||||
darifenacin hydrobromide|No|No|No|No|75%|13668020290|DARIFENACIN ER 7.5 MG TABLET|90|EA|1.40896|02/20/2018||Yes|No||02/20/2018||Yes|No|02/20/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|006|Yes|1.71519|03/29/2022|1.67402|03/29/2022|1.68517|03/29/2022|||BLADDER RELAXANT PREPARATIONS|6828|||||No|No||TORRENT PHARMAC|No||||
darifenacin hydrobromide|No|No|No|No|75%|13668020330|DARIFENACIN ER 15 MG TABLET|30|EA|1.40896|02/20/2018||Yes|No||02/20/2018||Yes|No|02/20/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|006|No|2.08753|03/29/2022|2.03742|03/29/2022|2.05099|03/29/2022|||BLADDER RELAXANT PREPARATIONS|6829|||||No|No||TORRENT PHARMAC|No||||
darifenacin hydrobromide|No|No|No|No|75%|13668020390|DARIFENACIN ER 15 MG TABLET|90|EA|1.40896|02/20/2018||Yes|No||02/20/2018||Yes|No|02/20/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|006|No|2.08753|03/29/2022|2.03742|03/29/2022|2.05099|03/29/2022|||BLADDER RELAXANT PREPARATIONS|6830|||||No|No||TORRENT PHARMAC|No||||
aripiprazole|No|No|No|No|75%|13668021630|ARIPIPRAZOLE 2 MG TABLET|30|EA|.63926|04/29/2015||Yes|No||04/29/2015||Yes|No|04/29/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|6831|||||No|No||TORRENT PHARMAC|No||||
aripiprazole|No|No|No|No|75%|13668021690|ARIPIPRAZOLE 2 MG TABLET|90|EA|.63926|04/29/2015||Yes|No||04/29/2015||Yes|No|04/29/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|6832|||||No|No||TORRENT PHARMAC|No||||
aripiprazole|No|No|No|No|75%|13668021730|ARIPIPRAZOLE 5 MG TABLET|30|EA|.63926|04/29/2015||Yes|No||04/29/2015||Yes|No|04/29/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|6833|||||No|No||TORRENT PHARMAC|No||||
aripiprazole|No|No|No|No|75%|13668021790|ARIPIPRAZOLE 5 MG TABLET|90|EA|.63926|04/29/2015||Yes|No||04/29/2015||Yes|No|04/29/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|6834|||||No|No||TORRENT PHARMAC|No||||
aripiprazole|No|No|No|No|75%|13668021830|ARIPIPRAZOLE 10 MG TABLET|30|EA|.63926|04/29/2015||Yes|No||04/29/2015||Yes|No|04/29/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|6835|||||No|No||TORRENT PHARMAC|No||||
aripiprazole|No|No|No|No|75%|13668021890|ARIPIPRAZOLE 10 MG TABLET|90|EA|.63926|04/29/2015||Yes|No||04/29/2015||Yes|No|04/29/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|6836|||||No|No||TORRENT PHARMAC|No||||
aripiprazole|No|No|No|No|75%|13668021930|ARIPIPRAZOLE 15 MG TABLET|30|EA|.63926|04/29/2015||Yes|No||04/29/2015||Yes|No|04/29/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|6837|||||No|No||TORRENT PHARMAC|No||||
aripiprazole|No|No|No|No|75%|13668021990|ARIPIPRAZOLE 15 MG TABLET|90|EA|.63926|04/29/2015||Yes|No||04/29/2015||Yes|No|04/29/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|6838|||||No|No||TORRENT PHARMAC|No||||
aripiprazole|No|No|No|No|75%|13668022030|ARIPIPRAZOLE 20 MG TABLET|30|EA|.72311|04/29/2015||Yes|No||04/29/2015||Yes|No|04/29/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|6839|||||No|No||TORRENT PHARMAC|No||||
aripiprazole|No|No|No|No|75%|13668022090|ARIPIPRAZOLE 20 MG TABLET|90|EA|.72311|04/29/2015||Yes|No||04/29/2015||Yes|No|04/29/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|6840|||||No|No||TORRENT PHARMAC|No||||
aripiprazole|No|No|No|No|75%|13668022130|ARIPIPRAZOLE 30 MG TABLET|30|EA|.72311|04/29/2015||Yes|No||04/29/2015||Yes|No|04/29/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|6841|||||No|No||TORRENT PHARMAC|No||||
aripiprazole|No|No|No|No|75%|13668022190|ARIPIPRAZOLE 30 MG TABLET|90|EA|.72311|04/29/2015||Yes|No||04/29/2015||Yes|No|04/29/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|6842|||||No|No||TORRENT PHARMAC|No||||
memantine HCl|No|No|No|No|75%|13668022260|MEMANTINE HCL 5 MG TABLET|60|EA|.1573|12/16/2015||Yes|No||12/16/2015||Yes|No|12/16/2015||Yes|No||||No|No|||Prescription required|No||011|No|.08825|03/29/2022|.08613|03/29/2022|.0867|03/29/2022|||ALZHEIMER'S AGENTS|6843|||||No|No||TORRENT PHARMAC|No||||
memantine HCl|No|No|No|No|75%|13668022360|MEMANTINE HCL 10 MG TABLET|60|EA|.1573|12/16/2015||Yes|No||12/16/2015||Yes|No|12/16/2015||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|6844|||||No|No||TORRENT PHARMAC|No||||
olmesartan medoxomil|No|No|No|No|75%|13668024830|OLMESARTAN MEDOXOMIL 5 MG TAB|30|EA|.1075|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.07425|03/29/2022|.07246|03/29/2022|.07295|03/29/2022|||ANGIOTENSIN MODULATORS|6845|||||No|No||TORRENT PHARMAC|No||||
olmesartan medoxomil|No|No|No|No|75%|13668024890|OLMESARTAN MEDOXOMIL 5 MG TAB|90|EA|.1075|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.07425|03/29/2022|.07246|03/29/2022|.07295|03/29/2022|||ANGIOTENSIN MODULATORS|6846|||||No|No||TORRENT PHARMAC|No||||
olmesartan medoxomil|No|No|No|No|75%|13668024930|OLMESARTAN MEDOXOMIL 20 MG TAB|30|EA|.129|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.1002|03/29/2022|.09779|03/29/2022|.09844|03/29/2022|||ANGIOTENSIN MODULATORS|6847|||||No|No||TORRENT PHARMAC|No||||
olmesartan medoxomil|No|No|No|No|75%|13668024990|OLMESARTAN MEDOXOMIL 20 MG TAB|90|EA|.11944|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.1002|03/29/2022|.09779|03/29/2022|.09844|03/29/2022|||ANGIOTENSIN MODULATORS|6848|||||No|No||TORRENT PHARMAC|No||||
olmesartan medoxomil|No|No|No|No|75%|13668025030|OLMESARTAN MEDOXOMIL 40 MG TAB|30|EA|.172|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.15714|03/29/2022|.15336|03/29/2022|.15439|03/29/2022|||ANGIOTENSIN MODULATORS|6849|||||No|No||TORRENT PHARMAC|No||||
olmesartan medoxomil|No|No|No|No|75%|13668025090|OLMESARTAN MEDOXOMIL 40 MG TAB|90|EA|.16721|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.15714|03/29/2022|.15336|03/29/2022|.15439|03/29/2022|||ANGIOTENSIN MODULATORS|6850|||||No|No||TORRENT PHARMAC|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|13668025130|OLMESARTAN-HCTZ 20-12.5 MG TAB|30|EA|.53993|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.22565|03/29/2022|.22023|03/29/2022|.2217|03/29/2022|||ANGIOTENSIN MODULATORS|6851|||||No|No||TORRENT PHARMAC|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|13668025190|OLMESARTAN-HCTZ 20-12.5 MG TAB|90|EA|.53998|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.22565|03/29/2022|.22023|03/29/2022|.2217|03/29/2022|||ANGIOTENSIN MODULATORS|6852|||||No|No||TORRENT PHARMAC|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|13668025230|OLMESARTAN-HCTZ 40-12.5 MG TAB|30|EA|.75063|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.29168|03/29/2022|.28467|03/29/2022|.28657|03/29/2022|||ANGIOTENSIN MODULATORS|6853|||||No|No||TORRENT PHARMAC|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|13668025290|OLMESARTAN-HCTZ 40-12.5 MG TAB|90|EA|.75058|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.29168|03/29/2022|.28467|03/29/2022|.28657|03/29/2022|||ANGIOTENSIN MODULATORS|6854|||||No|No||TORRENT PHARMAC|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|13668025330|OLMESARTAN-HCTZ 40-25 MG TAB|30|EA|.75063|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.29227|03/29/2022|.28525|03/29/2022|.28715|03/29/2022|||ANGIOTENSIN MODULATORS|6855|||||No|No||TORRENT PHARMAC|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|13668025390|OLMESARTAN-HCTZ 40-25 MG TAB|90|EA|.75058|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.29227|03/29/2022|.28525|03/29/2022|.28715|03/29/2022|||ANGIOTENSIN MODULATORS|6856|||||No|No||TORRENT PHARMAC|No||||
carbamazepine|No|No|No|No|75%|13668026801|CARBAMAZEPINE 200 MG TABLET|100|EA|.55009|10/26/2009||Yes|No||10/26/2009||Yes|No|10/26/2009||Yes|No||||No|No|||Prescription required|No||056|No|.20856|03/29/2022|.20355|03/29/2022|.20491|03/29/2022|||ANTICONVULSANTS|6857|||||No|No||TORRENT PHARMAC|No||||
carbamazepine|No|No|No|No|75%|13668026805|CARBAMAZEPINE 200 MG TABLET|500|EA|.55009|10/26/2009||Yes|No||10/26/2009||Yes|No|10/26/2009||Yes|No||||No|No|||Prescription required|No||056|No|.20856|03/29/2022|.20355|03/29/2022|.20491|03/29/2022|||ANTICONVULSANTS|6858|||||No|No||TORRENT PHARMAC|No||||
carbamazepine|No|No|No|No|75%|13668026810|CARBAMAZEPINE 200 MG TABLET|1000|EA|.55009|10/26/2009||Yes|No||10/26/2009||Yes|No|10/26/2009||Yes|No||||No|No|||Prescription required|No||056|No|.20856|03/29/2022|.20355|03/29/2022|.20491|03/29/2022|||ANTICONVULSANTS|6859|||||No|No||TORRENT PHARMAC|No||||
carbamazepine|No|No|No|No|75%|13668027101|CARBAMAZEPINE 100 MG TAB CHEW|100|EA|.22652|10/26/2009||Yes|No||10/26/2009||Yes|No|10/26/2009||Yes|No||||No|No|||Prescription required|No||056|No|.29391|03/29/2022|.28685|03/29/2022|.28876|03/29/2022|||ANTICONVULSANTS|6860|||||No|No||TORRENT PHARMAC|No||||
carbamazepine|No|No|No|No|75%|13668027105|CARBAMAZEPINE 100 MG TAB CHEW|500|EA|.22652|10/26/2009||Yes|No||10/26/2009||Yes|No|10/26/2009||Yes|No||||No|No|||Prescription required|No||056|No|.29391|03/29/2022|.28685|03/29/2022|.28876|03/29/2022|||ANTICONVULSANTS|6861|||||No|No||TORRENT PHARMAC|No||||
levetiracetam|No|No|No|No|75%|13668027260|LEVETIRACETAM ER 500 MG TABLET|60|EA|.6905|03/12/2012||Yes|No||03/12/2012||Yes|No|03/12/2012||Yes|No||||No|No|||Prescription required|No||056|No|.22713|03/29/2022|.22167|03/29/2022|.22315|03/29/2022|||ANTICONVULSANTS|6862|||||No|No||TORRENT PHARMAC|No||||
pioglitazone HCl/metformin HCl|No|No|No|No|75%|13668028033|PIOGLITAZONE-METFORMIN 15-500|180|EA|1.37477|02/13/2013||Yes|No||02/13/2013||Yes|No|02/13/2013||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|009|Yes|.53323|03/29/2022|.52043|03/29/2022|.52389|03/29/2022|||HYPOGLYCEMICS: TZD|6863|||||No|No||TORRENT PHARMAC|No||||
pioglitazone HCl/metformin HCl|No|No|No|No|75%|13668028060|PIOGLITAZONE-METFORMIN 15-500|60|EA|1.37485|02/13/2013||Yes|No||02/13/2013||Yes|No|02/13/2013||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|009|Yes|.53323|03/29/2022|.52043|03/29/2022|.52389|03/29/2022|||HYPOGLYCEMICS: TZD|6864|||||No|No||TORRENT PHARMAC|No||||
pioglitazone HCl/metformin HCl|No|No|No|No|75%|13668028133|PIOGLITAZONE-METFORMIN 15-850|180|EA|1.37477|02/13/2013||Yes|No||02/13/2013||Yes|No|02/13/2013||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|009|Yes|.44962|03/29/2022|.43882|03/29/2022|.44175|03/29/2022|||HYPOGLYCEMICS: TZD|6865|||||No|No||TORRENT PHARMAC|No||||
pioglitazone HCl/metformin HCl|No|No|No|No|75%|13668028160|PIOGLITAZONE-METFORMIN 15-850|60|EA|1.37485|02/13/2013||Yes|No||02/13/2013||Yes|No|02/13/2013||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|009|Yes|.44962|03/29/2022|.43882|03/29/2022|.44175|03/29/2022|||HYPOGLYCEMICS: TZD|6866|||||No|No||TORRENT PHARMAC|No||||
levetiracetam|No|No|No|No|75%|13668030060|LEVETIRACETAM ER 750 MG TABLET|60|EA|1.03687|03/12/2012||Yes|No||03/12/2012||Yes|No|03/12/2012||Yes|No||||No|No|||Prescription required|No||056|No|.36799|03/29/2022|.35915|03/29/2022|.36155|03/29/2022|||ANTICONVULSANTS|6867|||||No|No||TORRENT PHARMAC|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|13668031130|AMLODIPINE-OLMESARTAN 10-40 MG|30|EA|.85168|09/27/2017||Yes|No||09/27/2017||Yes|No|09/27/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.41757|03/29/2022|.40754|03/29/2022|.41026|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|6868|||||No|No||TORRENT PHARMAC|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|13668031190|AMLODIPINE-OLMESARTAN 10-40 MG|90|EA|.85168|09/27/2017||Yes|No||09/27/2017||Yes|No|09/27/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.41757|03/29/2022|.40754|03/29/2022|.41026|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|6869|||||No|No||TORRENT PHARMAC|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|13668031230|AMLODIPINE-OLMESARTAN 10-20 MG|30|EA|.67424|09/27/2017||Yes|No||09/27/2017||Yes|No|09/27/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.43528|03/29/2022|.42483|03/29/2022|.42766|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|6870|||||No|No||TORRENT PHARMAC|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|13668031290|AMLODIPINE-OLMESARTAN 10-20 MG|90|EA|.67428|09/27/2017||Yes|No||09/27/2017||Yes|No|09/27/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.43528|03/29/2022|.42483|03/29/2022|.42766|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|6871|||||No|No||TORRENT PHARMAC|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|13668031330|AMLODIPINE-OLMESARTAN 5-40 MG|30|EA|.85168|09/27/2017||Yes|No||09/27/2017||Yes|No|09/27/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.47518|03/29/2022|.46377|03/29/2022|.46686|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|6872|||||No|No||TORRENT PHARMAC|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|13668031390|AMLODIPINE-OLMESARTAN 5-40 MG|90|EA|.85168|09/27/2017||Yes|No||09/27/2017||Yes|No|09/27/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.47518|03/29/2022|.46377|03/29/2022|.46686|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|6873|||||No|No||TORRENT PHARMAC|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|13668032430|AMLODIPINE-OLMESARTAN 5-20 MG|30|EA|.67424|09/27/2017||Yes|No||09/27/2017||Yes|No|09/27/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.41945|03/29/2022|.40938|03/29/2022|.4121|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|6874|||||No|No||TORRENT PHARMAC|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|13668032490|AMLODIPINE-OLMESARTAN 5-20 MG|90|EA|.67428|09/27/2017||Yes|No||09/27/2017||Yes|No|09/27/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.41945|03/29/2022|.40938|03/29/2022|.4121|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|6875|||||No|No||TORRENT PHARMAC|No||||
trazodone HCl|No|No|No|No|75%|13668033001|TRAZODONE 50 MG TABLET|100|EA|.02859|09/15/2014||Yes|No||09/15/2014||Yes|No|09/15/2014||Yes|No||||No|No|||Prescription required|No||031|No|.03855|03/29/2022|.03762|03/29/2022|.03787|03/29/2022|||ANTIDEPRESSANTS: OTHER|6876|||||No|No||TORRENT PHARMAC|No||||
trazodone HCl|No|No|No|No|75%|13668033005|TRAZODONE 50 MG TABLET|500|EA|.02614|09/15/2014||Yes|No||09/15/2014||Yes|No|09/15/2014||Yes|No||||No|No|||Prescription required|No||031|No|.03855|03/29/2022|.03762|03/29/2022|.03787|03/29/2022|||ANTIDEPRESSANTS: OTHER|6877|||||No|No||TORRENT PHARMAC|No||||
trazodone HCl|No|No|No|No|75%|13668033101|TRAZODONE 100 MG TABLET|100|EA|.0531|09/15/2014||Yes|No||09/15/2014||Yes|No|09/15/2014||Yes|No||||No|No|||Prescription required|No||031|No|.07015|03/29/2022|.06846|03/29/2022|.06892|03/29/2022|||ANTIDEPRESSANTS: OTHER|6878|||||No|No||TORRENT PHARMAC|No||||
trazodone HCl|No|No|No|No|75%|13668033105|TRAZODONE 100 MG TABLET|500|EA|.04983|09/15/2014||Yes|No||09/15/2014||Yes|No|09/15/2014||Yes|No||||No|No|||Prescription required|No||031|No|.07015|03/29/2022|.06846|03/29/2022|.06892|03/29/2022|||ANTIDEPRESSANTS: OTHER|6879|||||No|No||TORRENT PHARMAC|No||||
trazodone HCl|No|No|No|No|75%|13668033201|TRAZODONE 150 MG TABLET|100|EA|.15523|09/15/2014||Yes|No||09/15/2014||Yes|No|09/15/2014||Yes|No||||No|No|||Prescription required|No||031|No|.1311|03/29/2022|.12795|03/29/2022|.1288|03/29/2022|||ANTIDEPRESSANTS: OTHER|6880|||||No|No||TORRENT PHARMAC|No||||
trazodone HCl|No|No|No|No|75%|13668033205|TRAZODONE 150 MG TABLET|500|EA|.14706|09/15/2014||Yes|No||09/15/2014||Yes|No|09/15/2014||Yes|No||||No|No|||Prescription required|No||031|No|.1311|03/29/2022|.12795|03/29/2022|.1288|03/29/2022|||ANTIDEPRESSANTS: OTHER|6881|||||No|No||TORRENT PHARMAC|No||||
trazodone HCl|No|No|No|No|75%|13668033301|TRAZODONE 300 MG TABLET|100|EA|1.40055|09/15/2014||Yes|No||09/15/2014||Yes|No|09/15/2014||Yes|No||||No|No|||Prescription required|No||031|No|1.52238|03/29/2022|1.48584|03/29/2022|1.49573|03/29/2022|||ANTIDEPRESSANTS: OTHER|6882|||||No|No||TORRENT PHARMAC|No||||
lamotrigine|No|No|No|No|75%|13668033930|LAMOTRIGINE ER 25 MG TABLET|30|EA|.65646|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|||Prescription required|No||056|No|1.20872|03/01/2022|1.17971|03/01/2022|1.18756|03/01/2022|||ANTICONVULSANTS|6883|||||No|No||TORRENT PHARMAC|No||||
lamotrigine|No|No|No|No|75%|13668034030|LAMOTRIGINE ER 50 MG TABLET|30|EA|.688|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|||Prescription required|No||056|No|1.67529|03/29/2022|1.63508|03/29/2022|1.64597|03/29/2022|||ANTICONVULSANTS|6884|||||No|No||TORRENT PHARMAC|No||||
lamotrigine|No|No|No|No|75%|13668034130|LAMOTRIGINE ER 100 MG TABLET|30|EA|1.1524|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|||Prescription required|No||056|No|1.51472|03/29/2022|1.47836|03/29/2022|1.48821|03/29/2022|||ANTICONVULSANTS|6885|||||No|No||TORRENT PHARMAC|No||||
lamotrigine|No|No|No|No|75%|13668034230|LAMOTRIGINE ER 200 MG TABLET|30|EA|1.23195|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|||Prescription required|No||056|No|1.69753|03/29/2022|1.65678|03/29/2022|1.66782|03/29/2022|||ANTICONVULSANTS|6886|||||No|No||TORRENT PHARMAC|No||||
telmisartan/amlodipine|No|No|No|No|75%|13668034330|TELMISARTAN-AMLODIPINE 80-10|30|EA|1.86333|01/09/2014||Yes|No||01/09/2014||Yes|No|01/09/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|017|Yes|4.24666|06/01/2016|4.18599|06/01/2016|3.98666|06/01/2016|||ANGIOTENSIN MODULATOR COMBINATIONS|6887|||||No|No||TORRENT PHARMAC|No||||
telmisartan/amlodipine|No|No|No|No|75%|13668034430|TELMISARTAN-AMLODIPINE 80-5 MG|30|EA|1.86333|01/09/2014||Yes|No||01/09/2014||Yes|No|01/09/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|017|Yes|4.24666|08/25/2020|4.18599|08/25/2020|3.98666|08/25/2020|||ANGIOTENSIN MODULATOR COMBINATIONS|6888|||||No|No||TORRENT PHARMAC|No||||
telmisartan/amlodipine|No|No|No|No|75%|13668034530|TELMISARTAN-AMLODIPINE 40-10|30|EA|1.86333|01/09/2014||Yes|No||01/09/2014||Yes|No|01/09/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|017|Yes|4.24666|06/01/2016|4.18599|06/01/2016|3.98666|06/01/2016|||ANGIOTENSIN MODULATOR COMBINATIONS|6889|||||No|No||TORRENT PHARMAC|No||||
telmisartan/amlodipine|No|No|No|No|75%|13668034630|TELMISARTAN-AMLODIPINE 40-5 MG|30|EA|1.86333|01/09/2014||Yes|No||01/09/2014||Yes|No|01/09/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|017|Yes|4.24666|06/01/2016|4.18599|06/01/2016|3.98666|06/01/2016|||ANGIOTENSIN MODULATOR COMBINATIONS|6890|||||No|No||TORRENT PHARMAC|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|13668038230|OLMSRTN-AMLDPN-HCTZ 40-10-25MG|30|EA|1.67843|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|017|Yes|1.46963|03/29/2022|1.43435|03/29/2022|1.44391|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|6891|||||No|No||TORRENT PHARMAC|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|13668038530|OLMSRTN-AMLDPN-HCTZ 40-5-25 MG|30|EA|1.67843|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|017|Yes|1.32536|03/29/2022|1.29355|03/29/2022|1.30216|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|6892|||||No|No||TORRENT PHARMAC|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|13668038630|OLMSRTN-AMLDPN-HCTZ 40-5-12.5|30|EA|1.67843|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|017|Yes|1.52605|03/29/2022|1.48942|03/29/2022|1.49934|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|6893|||||No|No||TORRENT PHARMAC|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|13668039730|OLMSRTN-AMLDPN-HCTZ 20-5-12.5|30|EA|1.3287|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|017|Yes|1.26872|03/29/2022|1.23827|03/29/2022|1.24651|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|6894|||||No|No||TORRENT PHARMAC|No||||
losartan potassium|Yes|No|No|No|75%|13668040910|LOSARTAN POTASSIUM 50 MG TAB|1000|EA|.086|08/31/2011||Yes|No||08/31/2011||Yes|No|08/31/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|6895|||||No|No||TORRENT PHARMAC|No||||
losartan potassium|Yes|No|No|No|75%|13668040930|LOSARTAN POTASSIUM 50 MG TAB|30|EA|.086|08/31/2011||Yes|No||08/31/2011||Yes|No|08/31/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|6896|||||No|No||TORRENT PHARMAC|No||||
losartan potassium|Yes|No|No|No|75%|13668040990|LOSARTAN POTASSIUM 50 MG TAB|90|EA|.086|08/31/2011||Yes|No||08/31/2011||Yes|No|08/31/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|6897|||||No|No||TORRENT PHARMAC|No||||
pantoprazole sodium|No|No|No|No|75%|13668042905|PANTOPRAZOLE SOD DR 40 MG TAB|500|EA|.086|04/27/2012||Yes|No||04/27/2012||Yes|No|04/27/2012||Yes|No||||No|No|||Prescription required|No||047|No|.05828|03/29/2022|.05688|03/29/2022|.05726|03/29/2022|||PROTON PUMP INHIBITORS|6898|||||No|No||TORRENT PHARMAC|No||||
pantoprazole sodium|No|No|No|No|75%|13668042930|PANTOPRAZOLE SOD DR 40 MG TAB|30|EA|.086|04/27/2012||Yes|No||04/27/2012||Yes|No|04/27/2012||Yes|No||||No|No|||Prescription required|No||047|No|.05828|03/29/2022|.05688|03/29/2022|.05726|03/29/2022|||PROTON PUMP INHIBITORS|6899|||||No|No||TORRENT PHARMAC|No||||
pantoprazole sodium|No|No|No|No|75%|13668042990|PANTOPRAZOLE SOD DR 40 MG TAB|90|EA|.086|04/27/2012||Yes|No||04/27/2012||Yes|No|04/27/2012||Yes|No||||No|No|||Prescription required|No||047|No|.05828|03/29/2022|.05688|03/29/2022|.05726|03/29/2022|||PROTON PUMP INHIBITORS|6900|||||No|No||TORRENT PHARMAC|No||||
bupropion HCl|Yes|No|No|No|75%|13668043060|BUPROPION HCL SR 100 MG TABLET|60|EA|.10176|05/20/2015||Yes|No||05/20/2015||Yes|No|05/20/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.11271|03/29/2022|.11|03/29/2022|.11073|03/29/2022|||ANTIDEPRESSANTS: OTHER|6901|||||No|No||TORRENT PHARMAC|No||||
bupropion HCl|Yes|No|No|No|75%|13668043125|BUPROPION HCL SR 150 MG TABLET|250|EA|.1161|05/20/2015||Yes|No||05/20/2015||Yes|No|05/20/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.10128|03/29/2022|.09884|03/29/2022|.0995|03/29/2022|||ANTIDEPRESSANTS: OTHER|6902|||||No|No||TORRENT PHARMAC|No||||
bupropion HCl|Yes|No|No|No|75%|13668043160|BUPROPION HCL SR 150 MG TABLET|60|EA|.1161|05/20/2015||Yes|No||05/20/2015||Yes|No|05/20/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.10128|03/29/2022|.09884|03/29/2022|.0995|03/29/2022|||ANTIDEPRESSANTS: OTHER|6903|||||No|No||TORRENT PHARMAC|No||||
bupropion HCl|Yes|No|No|No|75%|13668043260|BUPROPION HCL SR 200 MG TABLET|60|EA|.3225|05/20/2015||Yes|No||05/20/2015||Yes|No|05/20/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.16014|03/29/2022|.15629|03/29/2022|.15733|03/29/2022|||ANTIDEPRESSANTS: OTHER|6904|||||No|No||TORRENT PHARMAC|No||||
fenofibrate,micronized|No|No|No|No|75%|13668043801|FENOFIBRATE 200 MG CAPSULE|100|EA|.28453|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||055|No|.22993|03/29/2022|.22441|03/29/2022|.2259|03/29/2022|||LIPOTROPICS: OTHER|6905|||||No|No||TORRENT PHARMAC|No||||
fenofibrate,micronized|No|No|No|No|75%|13668043901|FENOFIBRATE 134 MG CAPSULE|100|EA|.16013|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||055|No|.17604|03/29/2022|.17181|03/29/2022|.17295|03/29/2022|||LIPOTROPICS: OTHER|6906|||||No|No||TORRENT PHARMAC|No||||
fenofibrate,micronized|No|No|No|No|75%|13668044001|FENOFIBRATE 67 MG CAPSULE|100|EA|.09567|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||055|No|.15038|03/29/2022|.14677|03/29/2022|.14774|03/29/2022|||LIPOTROPICS: OTHER|6907|||||No|No||TORRENT PHARMAC|No||||
celecoxib|No|No|No|No|75%|13668044101|CELECOXIB 100 MG CAPSULE|100|EA|.129|09/20/2017||Yes|No||09/20/2017||Yes|No|09/20/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|6908|||||No|No||TORRENT PHARMAC|No||||
fluoxetine HCl|No|No|No|No|75%|13668044330|FLUOXETINE HCL 10 MG TABLET|30|EA|5.59|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No||008|No|.24078|03/29/2022|.235|03/29/2022|.23656|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6909|||||No|No||TORRENT PHARMAC|No||||
fluoxetine HCl|No|No|No|No|75%|13668044391|FLUOXETINE HCL 10 MG TABLET|28|EA|5.98928|09/06/2017||Yes|No||09/06/2017||Yes|No|09/06/2017||Yes|No||||No|No|||Prescription required|No||008|No|.24078|03/29/2022|.235|03/29/2022|.23656|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6910|||||No|No||TORRENT PHARMAC|No||||
anagrelide HCl|No|No|No|No|75%|13668045301|ANAGRELIDE HCL 0.5 MG CAPSULE|100|EA|.35814|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|||Prescription required|No|||No|.73936|03/01/2022|.72161|03/01/2022|.72642|03/01/2022||||6911|||||No|No||TORRENT PHARMAC|No||||
anagrelide HCl|No|No|No|No|75%|13668046201|ANAGRELIDE HCL 1 MG CAPSULE|100|EA|.77013|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|||Prescription required|No|||No|1.75518|10/27/2020|1.7301|10/27/2020|1.64772|10/27/2020||||6912|||||No|No||TORRENT PHARMAC|No||||
itraconazole|No|No|No|No|75%|13668046330|ITRACONAZOLE 100 MG CAPSULE|30|EA|.71666|09/04/2019||Yes|No||09/04/2019||Yes|No|09/04/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|069|No|.85195|03/29/2022|.8315|03/29/2022|.83704|03/29/2022|||ANTIFUNGALS: ORAL|6913|||||No|No||TORRENT PHARMAC|No||||
fluoxetine HCl|No|No|No|No|75%|13668047330|FLUOXETINE HCL 20 MG TABLET|30|EA|5.59|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No||008|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6914|||||No|No||TORRENT PHARMAC|No||||
fluoxetine HCl|No|No|No|No|75%|13668047391|FLUOXETINE HCL 20 MG TABLET|28|EA|5.98928|09/06/2017||Yes|No||09/06/2017||Yes|No|09/06/2017||Yes|No||||No|No|||Prescription required|No||008|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||ANTIDEPRESSANTS: SSRIs|6915|||||No|No||TORRENT PHARMAC|No||||
minocycline HCl|No|No|No|No|75%|13668048201|MINOCYCLINE 50 MG CAPSULE|100|EA|.14598|08/16/2016||Yes|No||08/16/2016||Yes|No|08/16/2016||Yes|No||||No|No|||Prescription required|No||213|No|.20366|03/29/2022|.19877|03/29/2022|.20009|03/29/2022|||TETRACYCLINES|6916|||||No|No||TORRENT PHARMAC|No||||
minocycline HCl|No|No|No|No|75%|13668048301|MINOCYCLINE 75 MG CAPSULE|100|EA|.2687|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||||No|No|||Prescription required|No||213|No|.36632|10/26/2021|.35752|10/26/2021|.3599|10/26/2021|||TETRACYCLINES|6917|||||No|No||TORRENT PHARMAC|No||||
minocycline HCl|No|No|No|No|75%|13668048405|MINOCYCLINE 100 MG CAPSULE|500|EA|.27732|08/16/2016||Yes|No||08/16/2016||Yes|No|08/16/2016||Yes|No||||No|No|||Prescription required|No||213|No|.38664|03/29/2022|.37736|03/29/2022|.37987|03/29/2022|||TETRACYCLINES|6918|||||No|No||TORRENT PHARMAC|No||||
minocycline HCl|No|No|No|No|75%|13668048450|MINOCYCLINE 100 MG CAPSULE|50|EA|.29197|12/07/2016||Yes|No||12/07/2016||Yes|No|12/07/2016||Yes|No||||No|No|||Prescription required|No||213|No|.38664|03/29/2022|.37736|03/29/2022|.37987|03/29/2022|||TETRACYCLINES|6919|||||No|No||TORRENT PHARMAC|No||||
minocycline HCl|No|No|No|No|75%|13668048501|MINOCYCLINE HCL 50 MG TABLET|100|EA|.97476|12/08/2016||Yes|No||12/08/2016||Yes|No|12/08/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|213|No|1.57315|03/01/2022|1.53539|03/01/2022|1.54561|03/01/2022|||TETRACYCLINES|6920|||||No|No||TORRENT PHARMAC|No||||
minocycline HCl|No|No|No|No|75%|13668048601|MINOCYCLINE HCL 75 MG TABLET|100|EA|1.02503|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|213|No|2.33612|08/25/2017|2.30275|08/25/2017|2.19309|08/25/2017|||TETRACYCLINES|6921|||||No|No||TORRENT PHARMAC|No||||
minocycline HCl|No|No|No|No|75%|13668048750|MINOCYCLINE HCL 100 MG TABLET|50|EA|1.70839|08/16/2016||Yes|No||08/16/2016||Yes|No|08/16/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|213|No|1.59602|01/25/2022|1.55771|01/25/2022|1.56808|01/25/2022|||TETRACYCLINES|6922|||||No|No||TORRENT PHARMAC|No||||
acyclovir|No|No|No|No|75%|13668051501|ACYCLOVIR 5% OINTMENT|15|GM|1.00333|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.36934|03/29/2022|1.33647|03/29/2022|1.34537|03/29/2022|||ANTIVIRALS: TOPICAL|6923|||||No|No||TORRENT PHARMAC|No||||
acyclovir|No|No|No|No|75%|13668051502|ACYCLOVIR 5% OINTMENT|30|GM|.86|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.03754|03/29/2022|1.01263|03/29/2022|1.01938|03/29/2022|||ANTIVIRALS: TOPICAL|6924|||||No|No||TORRENT PHARMAC|No||||
montelukast sodium|No|No|No|No|75%|13668053194|MONTELUKAST SOD 4 MG GRANULES|30|EA|1.935|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|042|Yes|1.25796|03/29/2022|1.22776|03/29/2022|1.23594|03/29/2022|||LEUKOTRIENE MODIFIERS|6925|||||No|No||TORRENT PHARMAC|No||||
nystatin|No|No|No|No|75%|13668053401|NYSTATIN 100,000 UNIT/GM OINT|15|GM|.344|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|||Prescription required|No||061|No|.33338|03/29/2022|.32537|03/29/2022|.32754|03/29/2022|||ANTIFUNGALS: TOPICAL|6926|||||No|No||TORRENT PHARMAC|No||||
lactulose|No|No|No|No|75%|13668057410|LACTULOSE 10 GM/15 ML SOLUTION|473|ML|.0064|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|No|||No|.01452|03/29/2022|.01417|03/29/2022|.01426|03/29/2022||||6927|||||No|No||TORRENT PHARMAC|No||||
hydrocodone bit/homatrop me-br|No|No|No|No|90%|13668057710|HYDROCODONE-HOMATROPINE SOLN|473|ML|.06354|09/05/2019||Yes|No||09/05/2019||Yes|No|09/05/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|183|Yes|.1071|03/29/2022|.10452|03/29/2022|.10522|03/29/2022|||COUGH AND COLD: NARCOTIC|6928|||||No|No||TORRENT PHARMAC|No||||
lactulose|No|No|No|No|75%|13668058010|LACTULOSE 10 GM/15 ML SOLUTION|473|ML|.01227|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|No|||No|.01519|03/29/2022|.01482|03/29/2022|.01492|03/29/2022||||6929|||||No|No||TORRENT PHARMAC|No||||
lactulose|No|No|No|No|75%|13668058012|LACTULOSE 10 GM/15 ML SOLUTION|946|ML|.01251|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|No|||No|.0141|03/29/2022|.01376|03/29/2022|.01385|03/29/2022||||6930|||||No|No||TORRENT PHARMAC|No||||
tadalafil|No|No|No|No|75%|13668058130|TADALAFIL 20 MG TABLET|30|EA|.645|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/26/2018|171|Yes|.68104|03/29/2022|.66469|03/29/2022|.66912|03/29/2022|||PAH AGENTS: ORAL AND INHALED|6931|||||No|No||TORRENT PHARMAC|No||||
risperidone|No|No|No|No|75%|13668058906|RISPERIDONE 1 MG/ML SOLUTION|30|ML|.43|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.33084|03/29/2022|.32289|03/29/2022|.32505|03/29/2022|||ANTIPSYCHOTICS|6932|||||No|No||TORRENT PHARMAC|No||||
nystatin|No|No|No|No|75%|13668059501|NYSTATIN 100,000 UNIT/GM CREAM|15|GM|.24997|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||061|No|.26748|03/29/2022|.26106|03/29/2022|.26279|03/29/2022|||ANTIFUNGALS: TOPICAL|6933|||||No|No||TORRENT PHARMAC|No||||
nystatin|No|No|No|No|75%|13668059502|NYSTATIN 100,000 UNIT/GM CREAM|30|GM|.18733|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||061|No|.16163|03/29/2022|.15775|03/29/2022|.1588|03/29/2022|||ANTIFUNGALS: TOPICAL|6934|||||No|No||TORRENT PHARMAC|No||||
cetirizine HCl|No|No|No|No|75%|13668059607|CETIRIZINE HCL 1 MG/ML SOLN|120|ML|.01451|01/29/2019||Yes|No||01/29/2019||Yes|No|01/29/2019||Yes|No||||No|No|||Prescription required|No||030|Yes|.02395|03/29/2022|.02337|03/29/2022|.02353|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|6935|||||No|No||TORRENT PHARMAC|No||||
erythromycin base|No|No|No|No|75%|13668060601|ERYTHROMYCIN 250 MG FILMTAB|100|EA|4.52747|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|018|No|7.84358|03/29/2022|7.65533|03/29/2022|7.70631|03/29/2022|||MACROLIDES/KETOLIDES|6936|||||No|No||TORRENT PHARMAC|No||||
erythromycin base|No|No|No|No|75%|13668060701|ERYTHROMYCIN 500 MG FILMTAB|100|EA|6.09279|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|018|No|13.22133|05/25/2021|12.90401|05/25/2021|12.98995|05/25/2021|||MACROLIDES/KETOLIDES|6937|||||No|No||TORRENT PHARMAC|No||||
prenatal vit27,calcium/iron/FA|No|No|No|No|75%|13811000710|TRINATAL RX 1 TABLET|100|EA|.09167|03/31/2009||Yes|No||03/31/2009||Yes|No|03/31/2009||Yes|No||||No|No|||Over the counter|No||243|No|.20893|01/11/2022|.20595|01/11/2022|.19614|01/11/2022|||PRENATAL VITAMINS|6938|||||No|No||TRIGEN LABORATO|No||||
PNV cmb 52/iron/FA/omega-3/dha|No|No|No|No|75%|13811001030|COMPLETE NATAL DHA|60|EA|.14999|03/31/2009||Yes|No||03/31/2009||Yes|No|03/31/2009||Yes|No||||No|No|||Over the counter|No||243|No|.31817|04/27/2021|.31053|04/27/2021|.3126|04/27/2021|||PRENATAL VITAMINS|6939|||||No|No||TRIGEN LABORATO|No||||
iron/folic acid/B12/C/docusate|No|No|No|No|75%|13811001290|FERRAPLUS 90 TABLET|90|EA|.21681|03/31/2009||Yes|No||03/31/2009||Yes|No|03/31/2009||Yes|No||||No|No|||Over the counter|Yes|02/01/2018|506|No|.49413|11/28/2017|.48707|11/28/2017|.46388|11/28/2017|||IRON: ORAL|6940|||||No|No||TRIGEN LABORATO|No||||
prenatal vit 14/iron fum/folic|No|No|No|No|75%|13811001490|COMPLETENATE TABLET CHEW|90|EA|.23759|03/31/2009||Yes|No||03/31/2009||Yes|No|03/31/2009||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|.54149|06/01/2016|.53376|06/01/2016|.50834|06/01/2016|||PRENATAL VITAMINS|6941|||||No|No||TRIGEN LABORATO|No||||
multivit-min69/iron/folic acid|No|No|No|No|75%|13811002710|ELITE-OB CAPLET|100|EA|.45498|09/18/2008||Yes|No||09/18/2008||Yes|No|09/18/2008||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|1.03693|01/11/2022|1.02212|01/11/2022|.97345|01/11/2022|||PRENATAL VITAMINS|6942|||||No|No||TRIGEN LABORATO|No||||
iron bg,ps/vitC/B12/FA/calcium|No|No|No|No|75%|13811004210|TARON FORTE CAPSULE|100|EA|.23903|11/30/2009||Yes|No||11/30/2009||Yes|No|11/30/2009||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|506|No|.54478|01/11/2022|.53699|01/11/2022|.51142|01/11/2022|||IRON: ORAL|6943|||||No|No||TRIGEN LABORATO|Yes|09/01/2020|||
mvn-min 74/iron fum/iron/FA|No|No|No|No|75%|13811053530|FOLIVANE-OB CAPSULE|30|EA|.26158|07/09/2010||Yes|No||07/09/2010||Yes|No|07/09/2010||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|.59616|08/24/2021|.58764|08/24/2021|.55966|08/24/2021|||PRENATAL VITAMINS|6944|||||No|No||TRIGEN LABORATO|No||||
mvn-min75/iron/iron ps/om3/dha|No|No|No|No|75%|13811053630|TARON-C DHA CAPSULE|30|EA|.32766|01/20/2011||Yes|No||01/20/2011||Yes|No|01/20/2011||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|.68405|07/27/2021|.66763|07/27/2021|.67207|07/27/2021|||PRENATAL VITAMINS|6945|||||No|No||TRIGEN LABORATO|Yes|09/01/2020|||
multivit 47/iron/folate 1/dha|No|No|No|No|75%|13811058030|ZATEAN-PN DHA CAPSULE|30|EA|.63339|01/25/2011||Yes|No||01/25/2011||Yes|No|01/25/2011||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|1.18814|03/29/2022|1.15962|03/29/2022|1.16734|03/29/2022|||PRENATAL VITAMINS|6946|||||No|No||TRIGEN LABORATO|No||||
mv-mins 71/iron/folic no.1/dha|No|No|No|No|75%|13811058230|ZATEAN-PN PLUS SOFTGEL|30|EA|.67581|01/25/2011||Yes|No||01/25/2011||Yes|No|01/25/2011||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|1.54022|04/25/2017|1.51822|04/25/2017|1.44592|04/25/2017|||PRENATAL VITAMINS|6947|||||No|No||TRIGEN LABORATO|No||||
tramadol HCl|No|No|No|No|90%|13811068930|TRAMADOL HCL ER 100 MG CAPSULE|30|EA|3.29093|07/22/2015||Yes|No||07/22/2015||Yes|No|07/22/2015||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|7.50026|06/01/2016|7.39311|06/01/2016|7.04106|06/01/2016|||ANALGESICS: NARCOTICS LONG|6948|||||No|No||TRIGEN LABORATO|No||||
tramadol HCl|No|No|No|No|90%|13811069030|TRAMADOL HCL ER 200 MG CAPSULE|30|EA|4.31261|07/22/2015||Yes|No||07/22/2015||Yes|No|07/22/2015||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|9.82874|06/01/2016|9.68833|06/01/2016|9.22698|06/01/2016|||ANALGESICS: NARCOTICS LONG|6949|||||No|No||TRIGEN LABORATO|No||||
tramadol HCl|No|No|No|No|90%|13811069130|TRAMADOL HCL ER 300 MG CAPSULE|30|EA|5.96524|07/22/2015||Yes|No||07/22/2015||Yes|No|07/22/2015||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|13.5952|06/01/2016|13.40098|06/01/2016|12.76284|06/01/2016|||ANALGESICS: NARCOTICS LONG|6950|||||No|No||TRIGEN LABORATO|No||||
hydromorphone HCl|No|No|No|No|90%|13811070110|HYDROMORPHONE HCL ER 8 MG TAB|100|EA|3.31035|02/16/2017||Yes|No||02/16/2017||Yes|No|02/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|110|Yes|7.54453|06/25/2019|7.43675|06/25/2019|7.08262|06/25/2019|||ANALGESICS: NARCOTICS LONG|6951|||||No|No||TRIGEN LABORATO|No||||
hydromorphone HCl|No|No|No|No|90%|13811070210|HYDROMORPHONE HCL ER 12 MG TAB|100|EA|4.94762|02/16/2017||Yes|No||02/16/2017||Yes|No|02/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|110|Yes|11.27597|12/24/2019|11.11489|12/24/2019|10.58561|12/24/2019|||ANALGESICS: NARCOTICS LONG|6952|||||No|No||TRIGEN LABORATO|No||||
hydromorphone HCl|No|No|No|No|90%|13811070310|HYDROMORPHONE HCL ER 16 MG TAB|100|EA|6.5968|02/16/2017||Yes|No||02/16/2017||Yes|No|02/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|110|Yes|15.03457|06/23/2020|14.81979|06/23/2020|14.11408|06/23/2020|||ANALGESICS: NARCOTICS LONG|6953|||||No|No||TRIGEN LABORATO|No||||
hydromorphone HCl|No|No|No|No|90%|13811070410|HYDROMORPHONE HCL ER 32 MG TAB|100|EA|8.7247|11/22/2017||Yes|No||11/22/2017||Yes|No|11/22/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|110|Yes|19.8842|03/26/2019|19.60014|03/26/2019|18.6668|03/26/2019|||ANALGESICS: NARCOTICS LONG|6954|||||No|No||TRIGEN LABORATO|No||||
methylphenidate HCl|No|No|No|No|75%|13811070610|METHYLPHENIDATE ER 18 MG TAB|100|EA|.31084|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.56499|03/29/2022|.55143|03/29/2022|.5551|03/29/2022|||STIMULANTS AND RELATED AGENTS|6955|||||No|No||TRIGEN LABORATO|No||||
methylphenidate HCl|No|No|No|No|75%|13811070710|METHYLPHENIDATE ER 27 MG TAB|100|EA|.32138|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.90623|03/29/2022|.88448|03/29/2022|.89037|03/29/2022|||STIMULANTS AND RELATED AGENTS|6956|||||No|No||TRIGEN LABORATO|No||||
methylphenidate HCl|No|No|No|No|75%|13811070810|METHYLPHENIDATE ER 36 MG TAB|100|EA|.33484|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.76999|03/29/2022|.75151|03/29/2022|.75651|03/29/2022|||STIMULANTS AND RELATED AGENTS|6957|||||No|No||TRIGEN LABORATO|No||||
methylphenidate HCl|No|No|No|No|75%|13811070910|METHYLPHENIDATE ER 54 MG TAB|100|EA|.37384|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.87218|03/29/2022|.85124|03/29/2022|.85691|03/29/2022|||STIMULANTS AND RELATED AGENTS|6958|||||No|No||TRIGEN LABORATO|No||||
methylphenidate HCl|No|No|No|No|75%|13811071030|METHYLPHENIDATE ER 72 MG TAB|30|EA|8.17215|08/29/2019||Yes|No||08/29/2019||Yes|No|08/29/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|No|16.19347|03/01/2022|15.80482|03/01/2022|15.91008|03/01/2022|||STIMULANTS AND RELATED AGENTS|6959|||||No|No||TRIGEN LABORATO|No||||
gabapentin|No|No|No|No|75%|13913000419|GRALISE ER 300 MG TABLET|90|EA|4.01055|06/29/2016|02/15/2022|Yes|No||06/29/2016|02/15/2022|Yes|No|06/29/2016|02/15/2022|Yes|No||||No|No|||Prescription required|Yes|07/24/2013|232|Yes|9.208|08/24/2021|8.987|08/24/2021|9.04686|08/24/2021|||NEUROPATHIC PAIN|6960|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ASSERTIO/ALMATI|No||||
gabapentin|No|No|No|No|75%|13913000519|GRALISE ER 600 MG TABLET|90|EA|4.01055|10/24/2011|02/15/2022|Yes|No||10/24/2011|02/15/2022|Yes|No|10/24/2011|02/15/2022|Yes|No||||No|No|||Prescription required|Yes|07/24/2013|232|Yes|9.19569|06/29/2021|8.97499|06/29/2021|9.03476|06/29/2021|||NEUROPATHIC PAIN|6961|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ASSERTIO/ALMATI|No||||
diclofenac potassium|No|No|No|No|75%|13913001203|CAMBIA 50 MG POWDER PACKET|9|EA|42.37745|12/08/2016||Yes|No||12/08/2016||Yes|No|12/08/2016||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|537|No|94.43488|02/15/2022|92.16844|02/15/2022|92.78226|02/15/2022|||ANTIMIGRAINE AGENTS: OTHER|6962|||||No|No||ASSERTIO THERAP|No||||
PNV no.118/iron fumarate/FA|No|No|No|No|75%|13925011701|SE-NATAL 19 CHEWABLE TABLET|100|EA|.25073|08/03/2009||Yes|No||08/03/2009||Yes|No|08/03/2009||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|.43952|09/28/2021|.42897|09/28/2021|.43182|09/28/2021|||PRENATAL VITAMINS|6963|||||No|No||SETON PHARMACEU|No||||
iron fm,ps no.1/folic/mv no.18|No|No|No|No|75%|13925011890|SE-TAN PLUS CAPSULE|90|EA|.18083|01/14/2010||Yes|No||01/14/2010||Yes|No|01/14/2010||Yes|No||||No|No|||Over the counter|No||506|No|.41213|07/23/2019|.40625|07/23/2019|.3869|07/23/2019|||IRON: ORAL|6964|||||No|No||SETON PHARMACEU|No||||
prednisolone sodium phosphate|No|No|No|No|75%|13925016604|PREDNISOLONE 5 MG/5 ML SOLN|120|ML|.28111|06/12/2020||Yes|No||06/12/2020||Yes|No|06/12/2020||Yes|No||||No|No|||Prescription required|No||168|Yes|.59232|03/29/2022|.5781|03/29/2022|.58195|03/29/2022|||GLUCOCORTICOIDS: ORAL|6965|||||No|No||SETON PHARMACEU|No||||
oxybutynin chloride|No|No|No|No|75%|14539065301|OXYBUTYNIN 5 MG TABLET|100|EA|.10105|06/17/2020||Yes|No||06/17/2020||Yes|No|06/17/2020||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|6966|||||No|No||HERITAGE PHARMA|No||||
oxybutynin chloride|No|No|No|No|75%|14539065305|OXYBUTYNIN 5 MG TABLET|500|EA|.0989|06/17/2020||Yes|No||06/17/2020||Yes|No|06/17/2020||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|6967|||||No|No||HERITAGE PHARMA|No||||
oxybutynin chloride|No|No|No|No|75%|14539065310|OXYBUTYNIN 5 MG TABLET|1000|EA|.09675|06/17/2020||Yes|No||06/17/2020||Yes|No|06/17/2020||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|6968|||||No|No||HERITAGE PHARMA|No||||
diflunisal|No|No|No|No|75%|14539067301|DIFLUNISAL 500 MG TABLET|100|EA|.71079|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.92195|03/29/2022|.89982|03/29/2022|.90581|03/29/2022|||NSAIDS|6969|||||No|No||HERITAGE PHARMA|No||||
diflunisal|No|No|No|No|75%|14539067306|DIFLUNISAL 500 MG TABLET|60|EA|.71079|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.92195|03/29/2022|.89982|03/29/2022|.90581|03/29/2022|||NSAIDS|6970|||||No|No||HERITAGE PHARMA|No||||
hydroxyzine pamoate|No|No|No|No|75%|14539067401|HYDROXYZINE PAM 25 MG CAP|100|EA|.03298|06/17/2020||Yes|No||06/17/2020||Yes|No|06/17/2020||Yes|No||||No|No|||Prescription required|No||574|Yes|.06792|03/29/2022|.06628|03/29/2022|.06673|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|6971|||||No|No||HERITAGE PHARMA|No||||
hydroxyzine pamoate|No|No|No|No|75%|14539067405|HYDROXYZINE PAM 25 MG CAP|500|EA|.03199|06/17/2020||Yes|No||06/17/2020||Yes|No|06/17/2020||Yes|No||||No|No|||Prescription required|No||574|Yes|.06792|03/29/2022|.06628|03/29/2022|.06673|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|6972|||||No|No||HERITAGE PHARMA|No||||
hydroxyzine pamoate|No|No|No|No|75%|14539067501|HYDROXYZINE PAM 50 MG CAP|100|EA|.04506|06/17/2020||Yes|No||06/17/2020||Yes|No|06/17/2020||Yes|No||||No|No|||Prescription required|No||574|Yes|.09227|03/29/2022|.09005|03/29/2022|.09065|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|6973|||||No|No||HERITAGE PHARMA|No||||
hydroxyzine pamoate|No|No|No|No|75%|14539067505|HYDROXYZINE PAM 50 MG CAP|500|EA|.04371|06/17/2020||Yes|No||06/17/2020||Yes|No|06/17/2020||Yes|No||||No|No|||Prescription required|No||574|Yes|.09227|03/29/2022|.09005|03/29/2022|.09065|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|6974|||||No|No||HERITAGE PHARMA|No||||
bumetanide|No|No|No|No|75%|14539070001|BUMETANIDE 0.5 MG TABLET|100|EA|.1935|06/30/2020||Yes|No||06/30/2020||Yes|No|06/30/2020||Yes|No||||No|No|||Prescription required|No|||No|.20616|03/29/2022|.20121|03/29/2022|.20255|03/29/2022||||6975|||||No|No||HERITAGE PHARMA|No||||
bumetanide|No|No|No|No|75%|14539070101|BUMETANIDE 1 MG TABLET|100|EA|.1935|06/30/2020||Yes|No||06/30/2020||Yes|No|06/30/2020||Yes|No||||No|No|||Prescription required|No|||No|.21417|03/29/2022|.20902|03/29/2022|.21042|03/29/2022||||6976|||||No|No||HERITAGE PHARMA|No||||
bumetanide|Yes|No|No|No|75%|14539070201|BUMETANIDE 2 MG TABLET|100|EA|.3655|06/30/2020||Yes|No||06/30/2020||Yes|No|06/30/2020||Yes|No||||No|No|06/30/2020||Prescription required|No|||No|.40198|03/29/2022|.39233|03/29/2022|.39494|03/29/2022||||6977|||||No|No||HERITAGE PHARMA|No||||
COVID-19 antigen test|Yes|No|No|No|75%|14613033937|QUICKVUE SARS ANTIGEN TEST|1|EA||01/03/2022||Yes|No||01/03/2022||Yes|No|01/03/2022||Yes|No||01/03/2022||Yes|No|01/03/2022||Prescription required|No|||No||||||||||6978|||||No|No||QUIDEL CORPORAT|No||||
COVID-19 antigen test|Yes|No|No|No|75%|14613033972|QUICKVUE AT-HOME COVID-19 TEST|2|EA||01/03/2022||Yes|No||01/03/2022||Yes|No|01/03/2022||Yes|No||01/03/2022||Yes|No|01/03/2022||Over the counter|No|||No||||||||||6979|||||No|No||QUIDEL CORPORAT|No||||
mecasermin|No|No|No|No|75%|15054104005|INCRELEX 40 MG/4 ML VIAL|4|ML|605.1175|01/24/2008||Yes|No||01/24/2008||Yes|No|||No|No||||No|No|||Prescription required|No|||Yes|1379.105|01/04/2022|1359.4035|01/04/2022|1294.67|01/04/2022||||6980|||||No|No||IPSEN BIOPHARMA|No||||
lanreotide acetate|No|No|No|No|75%|15054106004|SOMATULINE DEPOT 60 MG/0.2 ML|.2|ML|13089.2|10/21/2019||Yes|No||10/21/2019||Yes|No|10/21/2019||Yes|No||||No|No|||Prescription required|No|||No|29831.2|01/04/2022|29405.04|01/04/2022|28004.8|01/04/2022||||6981|||||No|No||IPSEN BIOPHARMA|No||||
lanreotide acetate|No|No|No|No|75%|15054109004|SOMATULINE DEPOT 90 MG/0.3 ML|.3|ML|11621.46666|10/21/2019||Yes|No||10/21/2019||Yes|No|10/21/2019||Yes|No||||No|No|||Prescription required|No|||No|26486.13332|01/04/2022|26107.75999|01/04/2022|24864.53332|01/04/2022||||6982|||||No|No||IPSEN BIOPHARMA|No||||
lanreotide acetate|No|No|No|No|75%|15054112004|SOMATULINE DEPOT 120 MG/0.5 ML|.5|ML|8223.32|10/21/2019||Yes|No||10/21/2019||Yes|No|10/21/2019||Yes|No||||No|No|||Prescription required|No|||No|18741.52|01/04/2022|18473.784|01/04/2022|17594.08|01/04/2022||||6983|||||No|No||IPSEN BIOPHARMA|No||||
pedi multivit no.83 w-fluoride|No|No|No|No|75%|15370010050|QUFLORA PED 0.25 MG/ML DROP|50|ML|1.49399|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|3.40491|10/06/2020|3.35627|10/06/2020|3.19644|10/06/2020|||PEDIATRIC VITAMIN PREPARATIONS|6984|||||No|No||CARWIN ASSOCIAT|No||||
pedi multivit 84 with fluoride|No|No|No|No|75%|15370010150|QUFLORA PED 0.5 MG/ML DROP|50|ML|1.16005|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|2.64384|07/09/2019|2.60607|07/09/2019|2.48197|07/09/2019|||PEDIATRIC VITAMIN PREPARATIONS|6985|||||No|No||CARWIN ASSOCIAT|No||||
ped multivit 151/iron/fluoride|No|No|No|No|75%|15370010250|QUFLORA FE PED 0.25 MG/ML DROP|50|ML|.94591|10/17/2017||Yes|No||10/17/2017||Yes|No|10/17/2017||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|2.1558|10/17/2017|2.125|10/17/2017|2.02381|10/17/2017|||PEDIATRIC VITAMIN PREPARATIONS|6986|||||No|No||CARWIN ASSOCIAT|No||||
pedi multivit no.63 w-fluoride|No|No|No|No|75%|15370010330|QUFLORA PED 0.25 MG CHEW TAB|30|EA|3.442|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|7.84456|10/06/2020|7.7325|10/06/2020|7.36428|10/06/2020|||PEDIATRIC VITAMIN PREPARATIONS|6987|||||No|No||CARWIN ASSOCIAT|No||||
pedi multivit no.63 w-fluoride|No|No|No|No|75%|15370010430|QUFLORA PED 0.5 MG CHEW TAB|30|EA|3.442|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|7.84456|10/06/2020|7.7325|10/06/2020|7.36428|10/06/2020|||PEDIATRIC VITAMIN PREPARATIONS|6988|||||No|No||CARWIN ASSOCIAT|No||||
pedi multivit no.63 w-fluoride|No|No|No|No|75%|15370010530|QUFLORA PED 1 MG CHEW TAB|30|EA|3.442|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|7.84456|10/06/2020|7.7325|10/06/2020|7.36428|10/06/2020|||PEDIATRIC VITAMIN PREPARATIONS|6989|||||No|No||CARWIN ASSOCIAT|No||||
ped multivit 142/iron/fluoride|No|No|No|No|75%|15370012030|QUFLORA FE 0.25 MG CHEW TABLET|30|EA|2.76217|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|6.29518|04/24/2018|6.20525|04/24/2018|5.90976|04/24/2018|||PEDIATRIC VITAMIN PREPARATIONS|6990|||||No|No||CARWIN ASSOCIAT|No||||
carbinoxamine maleate|No|No|No|No|75%|15370013010|RYVENT 6 MG TABLET|100|EA|2.86048|08/31/2017||Yes|No||08/31/2017||Yes|No|08/31/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|574|Yes|6.4075|03/22/2022|6.25372|03/22/2022|6.29536|03/22/2022|||ANTIHISTAMINES: FIRST GENERATION|6991|||||No|No||CARWIN ASSOCIAT|No||||
glycopyrrolate|No|No|No|No|75%|15370016010|GLYCATE 1.5 MG TABLET|100|EA|2.34547|10/18/2018|08/05/2022|Yes|No||10/18/2018|08/05/2022|Yes|No|10/18/2018|08/05/2022|Yes|No||||No|No|||Prescription required|No|||No|5.3455|04/06/2021|5.26914|04/06/2021|5.01823|04/06/2021||||6992|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||CARWIN ASSOCIAT|No||||
nabumetone|No|No|No|No|75%|15370017030|RELAFEN DS 1,000 MG TABLET|30|EA|20.94014|03/09/2020||Yes|No||03/09/2020||Yes|No|03/09/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|059|Yes|47.72404|03/15/2022|47.04226|03/15/2022|44.80216|03/15/2022|||NSAIDS|6993|||||No|No||CARWIN ASSOCIAT|No||||
pedi multivit no.157/fluoride|No|No|No|No|75%|15370021060|QUFLORA 0.125 MG GUMMIES|60|EA|1.26125|12/11/2017||Yes|No||12/11/2017||Yes|No|12/11/2017||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|2.87449|12/11/2017|2.83343|12/11/2017|2.6985|12/11/2017|||PEDIATRIC VITAMIN PREPARATIONS|6994|||||No|No||CARWIN ASSOCIAT|No||||
prenatal 93/iron/folate 9/dha|No|No|No|No|75%|15370025030|TRISTART DHA SOFTGEL|30|EA|3.39485|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|7.59822|03/22/2022|7.41586|03/22/2022|7.46525|03/22/2022|||PRENATAL VITAMINS|6995|||||No|No||CARWIN ASSOCIAT|No||||
efavirenz/emtricit/tenofovr df|No|No|No|No|75%|15584010101|ATRIPLA TABLET|30|EA|59.89419|07/13/2006||Yes|No||07/13/2006||Yes|No|07/13/2006||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|96.839|12/28/2021|94.51486|12/28/2021|95.14431|12/28/2021|||HIV / AIDS|6996|||||No|No||GILEAD SCIENCES|No||||
ciprofloxacin HCl|Yes|No|No|No|75%|16252051401|CIPROFLOXACIN HCL 250 MG TAB|100|EA|.31609|05/01/2007||Yes|No||05/01/2007||Yes|No|05/01/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||028|No|.09397|03/29/2022|.09171|03/29/2022|.09232|03/29/2022|||FLUOROQUINOLONES: ORAL|6997|||||No|No||ACTAVIS/TEVA|No||||
ciprofloxacin HCl|No|No|No|No|75%|16252051501|CIPROFLOXACIN HCL 500 MG TAB|100|EA|.36997|05/01/2007||Yes|No||05/01/2007||Yes|No|05/01/2007||Yes|No||||No|No|||Prescription required|No||028|No|.13565|03/29/2022|.13239|03/29/2022|.13327|03/29/2022|||FLUOROQUINOLONES: ORAL|6998|||||No|No||ACTAVIS/TEVA|No||||
ciprofloxacin HCl|No|No|No|No|75%|16252051605|CIPROFLOXACIN HCL 750 MG TAB|50|EA|.77064|05/01/2007||Yes|No||05/01/2007||Yes|No|05/01/2007||Yes|No||||No|No|||Prescription required|No||028|No|.288|03/29/2022|.28108|03/29/2022|.28296|03/29/2022|||FLUOROQUINOLONES: ORAL|6999|||||No|No||ACTAVIS/TEVA|No||||
isradipine|Yes|No|No|No|75%|16252053901|ISRADIPINE 2.5 MG CAPSULE|100|EA|.62049|06/14/2007||Yes|No||06/14/2007||Yes|No|06/14/2007||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/18/2006|045|No|1.41414|01/18/2022|1.39393|01/18/2022|1.32756|01/18/2022|||CALCIUM CHANNEL BLOCKERS|7000|||||No|No||ACTAVIS/TEVA|No||||
isradipine|Yes|No|No|No|75%|16252054001|ISRADIPINE 5 MG CAPSULE|100|EA|.9073|06/14/2007||Yes|No||06/14/2007||Yes|No|06/14/2007||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/18/2006|045|No|2.0678|01/18/2022|2.03826|01/18/2022|1.9412|01/18/2022|||CALCIUM CHANNEL BLOCKERS|7001|||||No|No||ACTAVIS/TEVA|No||||
tolterodine tartrate|No|No|No|No|75%|16571012606|TOLTERODINE TARTRATE 1 MG TAB|60|EA|.35825|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|No|.65955|03/29/2022|.64372|03/29/2022|.648|03/29/2022|||BLADDER RELAXANT PREPARATIONS|7002|||||No|No||RISING PHARM|No||||
tolterodine tartrate|No|No|No|No|75%|16571012706|TOLTERODINE TARTRATE 2 MG TAB|60|EA|.35825|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|No|.55522|03/29/2022|.54189|03/29/2022|.5455|03/29/2022|||BLADDER RELAXANT PREPARATIONS|7003|||||No|No||RISING PHARM|No||||
diclofenac sodium|No|No|No|No|75%|16571020106|DICLOFENAC SOD EC 75 MG TAB|60|EA|.12183|10/15/2009||Yes|No||10/15/2009||Yes|No|10/15/2009||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.09618|03/29/2022|.09387|03/29/2022|.09449|03/29/2022|||NSAIDS|7004|||||No|No||RISING PHARM|No||||
diclofenac sodium|No|No|No|No|75%|16571020110|DICLOFENAC SOD EC 75 MG TAB|100|EA|.1161|08/21/2008||Yes|No||08/21/2008||Yes|No|08/21/2008||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.09618|03/29/2022|.09387|03/29/2022|.09449|03/29/2022|||NSAIDS|7005|||||No|No||RISING PHARM|No||||
diclofenac sodium|No|No|No|No|75%|16571020111|DICLOFENAC SOD EC 75 MG TAB|1000|EA|.1075|07/01/2009||Yes|No||07/01/2009||Yes|No|07/01/2009||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.09618|03/29/2022|.09387|03/29/2022|.09449|03/29/2022|||NSAIDS|7006|||||No|No||RISING PHARM|No||||
diclofenac sodium|No|No|No|No|75%|16571020150|DICLOFENAC SOD EC 75 MG TAB|500|EA|.1075|10/15/2009||Yes|No||10/15/2009||Yes|No|10/15/2009||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.09618|03/29/2022|.09387|03/29/2022|.09449|03/29/2022|||NSAIDS|7007|||||No|No||RISING PHARM|No||||
diclofenac sodium|No|No|No|No|75%|16571020206|DICLOFENAC SOD EC 50 MG TAB|60|EA|.11825|04/15/2011||Yes|No||04/15/2011||Yes|No|04/15/2011||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.10202|03/29/2022|.09957|03/29/2022|.10023|03/29/2022|||NSAIDS|7008|||||No|No||RISING PHARM|No||||
diclofenac sodium|No|No|No|No|75%|16571020210|DICLOFENAC SOD EC 50 MG TAB|100|EA|.10535|04/06/2011||Yes|No||04/06/2011||Yes|No|04/06/2011||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.10202|03/29/2022|.09957|03/29/2022|.10023|03/29/2022|||NSAIDS|7009|||||No|No||RISING PHARM|No||||
diclofenac sodium|No|No|No|No|75%|16571020211|DICLOFENAC SOD EC 50 MG TAB|1000|EA|.0989|04/15/2011||Yes|No||04/15/2011||Yes|No|04/15/2011||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.10202|03/29/2022|.09957|03/29/2022|.10023|03/29/2022|||NSAIDS|7010|||||No|No||RISING PHARM|No||||
diclofenac sodium|No|No|No|No|75%|16571020310|DICLOFENAC SOD EC 25 MG TAB|100|EA|.45769|04/06/2011||Yes|No||04/06/2011||Yes|No|04/06/2011||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.86294|03/29/2022|.84222|03/29/2022|.84783|03/29/2022|||NSAIDS|7011|||||No|No||RISING PHARM|No||||
cetirizine HCl|No|No|No|No|75%|16571040110|CETIRIZINE HCL 5 MG TABLET|100|EA|.05719|04/14/2010||Yes|No||||No|No|04/14/2010||Yes|No||||No|No|||Over the counter|No||030|Yes|.04838|03/29/2022|.04721|03/29/2022|.04753|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|7012|||||No|No||RISING PHARM|No||||
cetirizine HCl|No|No|No|No|75%|16571040210|CETIRIZINE HCL 10 MG TABLET|100|EA|.05719|04/14/2010||Yes|No||||No|No|04/14/2010||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|7013|||||No|No||RISING PHARM|No||||
cetirizine HCl|No|No|No|No|75%|16571040250|CETIRIZINE HCL 10 MG TABLET|500|EA|.0543|11/19/2012||Yes|No||||No|No|11/19/2012||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|7014|||||No|No||RISING PHARM|No||||
ciprofloxacin HCl|Yes|No|No|No|75%|16571041110|CIPROFLOXACIN HCL 250 MG TAB|100|EA|.07568|12/29/2009|03/31/2022|Yes|No||12/29/2009|03/31/2022|Yes|No|12/29/2009|03/31/2022|Yes|No||||No|No|07/01/2016|03/31/2022|Prescription required|No||028|No|.09397|03/29/2022|.09171|03/29/2022|.09232|03/29/2022|||FLUOROQUINOLONES: ORAL|7015|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||RISING PHARM|No||||
ciprofloxacin HCl|No|No|No|No|75%|16571041210|CIPROFLOXACIN HCL 500 MG TAB|100|EA|.0903|12/29/2009|09/30/2022|Yes|No||12/29/2009|09/30/2022|Yes|No|12/29/2009|09/30/2022|Yes|No||||No|No|||Prescription required|No||028|No|.13565|03/29/2022|.13239|03/29/2022|.13327|03/29/2022|||FLUOROQUINOLONES: ORAL|7016|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||RISING PHARM|No||||
ciprofloxacin HCl|No|No|No|No|75%|16571041250|CIPROFLOXACIN HCL 500 MG TAB|500|EA|.0903|07/30/2013|04/30/2024|Yes|No||07/30/2013|04/30/2024|Yes|No|07/30/2013|04/30/2024|Yes|No||||No|No|||Prescription required|No||028|No|.13565|03/29/2022|.13239|03/29/2022|.13327|03/29/2022|||FLUOROQUINOLONES: ORAL|7017|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||RISING PHARM|No||||
ciprofloxacin HCl|No|No|No|No|75%|16571041305|CIPROFLOXACIN HCL 750 MG TAB|50|EA|.215|12/29/2009|09/30/2022|Yes|No||12/29/2009|09/30/2022|Yes|No|12/29/2009|09/30/2022|Yes|No||||No|No|||Prescription required|No||028|No|.288|03/29/2022|.28108|03/29/2022|.28296|03/29/2022|||FLUOROQUINOLONES: ORAL|7018|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||RISING PHARM|No||||
cromolyn sodium|No|No|No|No|75%|16571060096|CROMOLYN 100 MG/5 ML ORAL CONC|5|ML|.26875|12/12/2011||Yes|No||12/12/2011||Yes|No|12/12/2011||Yes|No||||No|No|||Prescription required|No|||No|.44235|03/29/2022|.43173|03/29/2022|.4346|03/29/2022||||7019|||||No|No||RISING PHARM|No||||
cevimeline HCl|No|No|No|No|75%|16571065710|CEVIMELINE HCL 30 MG CAPSULE|100|EA|.92222|06/06/2014||Yes|No||06/06/2014||Yes|No|06/06/2014||Yes|No||||No|No|||Prescription required|No|||No|.81662|03/29/2022|.79702|03/29/2022|.80232|03/29/2022||||7020|||||No|No||RISING PHARM|No||||
selegiline HCl|No|No|No|No|75%|16571065906|SELEGILINE HCL 5 MG CAPSULE|60|EA|.72025|08/11/2020||Yes|No||08/11/2020||Yes|No|08/11/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|015|No|1.0776|03/29/2022|1.05173|03/29/2022|1.05874|03/29/2022|||ANTIPARKINSON'S AGENTS|7021|||||No|No||RISING PHARM|No||||
meclizine HCl|No|No|No|No|75%|16571066001|MECLIZINE 12.5 MG TABLET|100|EA|.11137|10/04/2021||Yes|No||10/04/2021||Yes|No|10/04/2021||Yes|No||||No|No|||Prescription required|No||085|Yes|.08309|03/29/2022|.08109|03/29/2022|.08163|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|7022|||||No|No||RISING PHARM|No||||
meclizine HCl|No|No|No|No|75%|16571066050|MECLIZINE 12.5 MG TABLET|500|EA|.11137|10/04/2021||Yes|No||10/04/2021||Yes|No|10/04/2021||Yes|No||||No|No|||Prescription required|No||085|Yes|.08309|03/29/2022|.08109|03/29/2022|.08163|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|7023|||||No|No||RISING PHARM|No||||
meclizine HCl|No|No|No|No|75%|16571066101|MECLIZINE 25 MG TABLET|100|EA|.13738|10/04/2021||Yes|No||10/04/2021||Yes|No|10/04/2021||Yes|No||||No|No|||Prescription required|No||085|Yes|.11433|03/29/2022|.11158|03/29/2022|.11232|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|7024|||||No|No||RISING PHARM|No||||
meclizine HCl|No|No|No|No|75%|16571066110|MECLIZINE 25 MG TABLET|1000|EA|.13738|10/04/2021||Yes|No||10/04/2021||Yes|No|10/04/2021||Yes|No||||No|No|||Prescription required|No||085|Yes|.11433|03/29/2022|.11158|03/29/2022|.11232|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|7025|||||No|No||RISING PHARM|No||||
metronidazole|No|No|No|No|75%|16571066401|METRONIDAZOLE 500 MG TABLET|100|EA|.21908|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|No||115|No|.15479|03/29/2022|.15107|03/29/2022|.15208|03/29/2022|||ANTIBIOTICS: GI|7026|||||No|No||RISING PHARM|No||||
metronidazole|No|No|No|No|75%|16571066450|METRONIDAZOLE 500 MG TABLET|500|EA|.20814|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|No||115|No|.15479|03/29/2022|.15107|03/29/2022|.15208|03/29/2022|||ANTIBIOTICS: GI|7027|||||No|No||RISING PHARM|No||||
metronidazole|No|No|No|No|75%|16571066501|METRONIDAZOLE 250 MG TABLET|100|EA|.13059|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|7028|||||No|No||RISING PHARM|No||||
metronidazole|No|No|No|No|75%|16571066550|METRONIDAZOLE 250 MG TABLET|500|EA|.12407|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|7029|||||No|No||RISING PHARM|No||||
carbamazepine|No|No|No|No|75%|16571068001|CARBAMAZEPINE ER 100 MG TABLET|100|EA|.3937|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No||056|No|.53596|03/29/2022|.52309|03/29/2022|.52658|03/29/2022|||ANTICONVULSANTS|7030|||||No|No||RISING PHARM|No||||
carbamazepine|No|No|No|No|75%|16571068101|CARBAMAZEPINE ER 200 MG TABLET|100|EA|.715|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No||056|No|.8262|03/29/2022|.80637|03/29/2022|.81174|03/29/2022|||ANTICONVULSANTS|7031|||||No|No||RISING PHARM|No||||
carbamazepine|No|No|No|No|75%|16571068201|CARBAMAZEPINE ER 400 MG TABLET|100|EA|1.42897|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No||056|No|1.58237|03/29/2022|1.54439|03/29/2022|1.55467|03/29/2022|||ANTICONVULSANTS|7032|||||No|No||RISING PHARM|No||||
hydroxychloroquine sulfate|No|No|No|No|75%|16571068701|HYDROXYCHLOROQUINE 200 MG TAB|100|EA|.3655|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|No|||No|.23831|03/29/2022|.23259|03/29/2022|.23413|03/29/2022||||7033|||||No|No||RISING PHARM|No||||
hydroxychloroquine sulfate|No|No|No|No|75%|16571068750|HYDROXYCHLOROQUINE 200 MG TAB|500|EA|.3655|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|No|||No|.23831|03/29/2022|.23259|03/29/2022|.23413|03/29/2022||||7034|||||No|No||RISING PHARM|No||||
azithromycin|No|No|No|No|75%|16571069503|AZITHROMYCIN 250 MG TABLET|30|EA|.60486|09/29/2020|03/31/2022|Yes|No||09/29/2020|03/31/2022|Yes|No|09/29/2020|03/31/2022|Yes|No||||No|No|||Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|7035|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||RISING PHARM|No||||
azithromycin|No|No|No|No|75%|16571069581|AZITHROMYCIN 250 MG TABLET|6|EA|.60486|09/29/2020|03/31/2022|Yes|No||09/29/2020|03/31/2022|Yes|No|09/29/2020|03/31/2022|Yes|No||||No|No|||Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|7036|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||RISING PHARM|No||||
azithromycin|No|No|No|No|75%|16571069603|AZITHROMYCIN 500 MG TABLET|30|EA|.77973|09/29/2020|02/28/2022|Yes|No||09/29/2020|02/28/2022|Yes|No|09/29/2020|02/28/2022|Yes|No||||No|No|||Prescription required|No||018|No|1.77706|03/15/2022|1.75167|03/15/2022|1.66826|03/15/2022|||MACROLIDES/KETOLIDES|7037|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||RISING PHARM|No||||
lansoprazole|No|No|No|No|75%|16571069703|LANSOPRAZOLE DR 15 MG CAPSULE|30|EA|.14032|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|Yes|.24898|03/29/2022|.243|03/29/2022|.24462|03/29/2022|||PROTON PUMP INHIBITORS|7038|||||No|No||RISING PHARM|No||||
lansoprazole|No|No|No|No|75%|16571069803|LANSOPRAZOLE DR 30 MG CAPSULE|30|EA|.1472|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|No|.12249|03/29/2022|.11955|03/29/2022|.12034|03/29/2022|||PROTON PUMP INHIBITORS|7039|||||No|No||RISING PHARM|No||||
lansoprazole|No|No|No|No|75%|16571069809|LANSOPRAZOLE DR 30 MG CAPSULE|90|EA|.1472|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|No|.12249|03/29/2022|.11955|03/29/2022|.12034|03/29/2022|||PROTON PUMP INHIBITORS|7040|||||No|No||RISING PHARM|No||||
lansoprazole|No|No|No|No|75%|16571069850|LANSOPRAZOLE DR 30 MG CAPSULE|500|EA|.1472|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|No|.12249|03/29/2022|.11955|03/29/2022|.12034|03/29/2022|||PROTON PUMP INHIBITORS|7041|||||No|No||RISING PHARM|No||||
topiramate|No|No|No|No|75%|16571070506|TOPIRAMATE 25 MG TABLET|60|EA|.02866|02/17/2022||Yes|No||02/17/2022||Yes|No|02/17/2022||Yes|No||||No|No|||Prescription required|No||056|No|.03423|03/29/2022|.0334|03/29/2022|.03363|03/29/2022|||ANTICONVULSANTS|7042|||||No|No||RISING PHARM|No||||
topiramate|No|No|No|No|75%|16571070606|TOPIRAMATE 50 MG TABLET|60|EA|.03905|02/17/2022||Yes|No||02/17/2022||Yes|No|02/17/2022||Yes|No||||No|No|||Prescription required|No||056|No|.04588|03/29/2022|.04477|03/29/2022|.04507|03/29/2022|||ANTICONVULSANTS|7043|||||No|No||RISING PHARM|No||||
topiramate|No|No|No|No|75%|16571070706|TOPIRAMATE 100 MG TABLET|60|EA|.05016|02/17/2022||Yes|No||02/17/2022||Yes|No|02/17/2022||Yes|No||||No|No|||Prescription required|No||056|No|.06953|03/29/2022|.06786|03/29/2022|.06831|03/29/2022|||ANTICONVULSANTS|7044|||||No|No||RISING PHARM|No||||
topiramate|No|No|No|No|75%|16571070806|TOPIRAMATE 200 MG TABLET|60|EA|.0645|02/17/2022||Yes|No||02/17/2022||Yes|No|02/17/2022||Yes|No||||No|No|||Prescription required|No||056|No|.12326|03/29/2022|.1203|03/29/2022|.1211|03/29/2022|||ANTICONVULSANTS|7045|||||No|No||RISING PHARM|No||||
mafenide acetate|No|No|No|No|75%|16571072348|SULFAMYLON 8.5% CREAM|453.6|GM|.43405|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|No|||No|.98924|08/24/2021|.9751|08/24/2021|.92867|08/24/2021||||7046|||||No|No||RISING PHARM|No||||
mafenide acetate|No|No|No|No|75%|16571072360|SULFAMYLON 8.5% CREAM|56.7|GM|.50393|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|No|||No|1.14851|08/24/2021|1.1321|08/24/2021|1.07819|08/24/2021||||7047|||||No|No||RISING PHARM|No||||
nitrofurantoin|No|No|No|No|75%|16571074024|NITROFURANTOIN 25 MG/5 ML SUSP|230|ML|4.1093|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|No|||No|9.36538|05/18/2021|9.23159|05/18/2021|8.79199|05/18/2021||||7048|||||No|No||RISING PHARM|No||||
glycopyrrolate|No|No|No|No|75%|16571074309|GLYCOPYRROLATE 1 MG TABLET|90|EA|.05699|02/17/2022||Yes|No||02/17/2022||Yes|No|02/17/2022||Yes|No||||No|No|||Prescription required|No|||No|.10136|03/29/2022|.09892|03/29/2022|.09958|03/29/2022||||7049|||||No|No||RISING PHARM|No||||
glycopyrrolate|No|No|No|No|75%|16571074409|GLYCOPYRROLATE 2 MG TABLET|90|EA|.10228|02/17/2022||Yes|No||02/17/2022||Yes|No|02/17/2022||Yes|No||||No|No|||Prescription required|No|||No|.22028|03/29/2022|.21499|03/29/2022|.21642|03/29/2022||||7050|||||No|No||RISING PHARM|No||||
donepezil HCl|No|No|No|No|75%|16571077803|DONEPEZIL HCL 5 MG TABLET|30|EA|.043|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|7051|||||No|No||RISING PHARM|No||||
donepezil HCl|No|No|No|No|75%|16571077809|DONEPEZIL HCL 5 MG TABLET|90|EA|.043|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|7052|||||No|No||RISING PHARM|No||||
donepezil HCl|No|No|No|No|75%|16571077810|DONEPEZIL HCL 5 MG TABLET|1000|EA|.0344|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|7053|||||No|No||RISING PHARM|No||||
donepezil HCl|No|No|No|No|75%|16571077850|DONEPEZIL HCL 5 MG TABLET|500|EA|.0344|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|7054|||||No|No||RISING PHARM|No||||
donepezil HCl|No|No|No|No|75%|16571077903|DONEPEZIL HCL 10 MG TABLET|30|EA|.05016|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|7055|||||No|No||RISING PHARM|No||||
donepezil HCl|No|No|No|No|75%|16571077909|DONEPEZIL HCL 10 MG TABLET|90|EA|.05016|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|7056|||||No|No||RISING PHARM|No||||
donepezil HCl|No|No|No|No|75%|16571077910|DONEPEZIL HCL 10 MG TABLET|1000|EA|.04085|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|7057|||||No|No||RISING PHARM|No||||
donepezil HCl|No|No|No|No|75%|16571077950|DONEPEZIL HCL 10 MG TABLET|500|EA|.043|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|7058|||||No|No||RISING PHARM|No||||
carisoprodol|No|No|No|No|90%|16571078001|CARISOPRODOL 250 MG TABLET|100|EA|1.13722|02/17/2022||Yes|No||02/17/2022||Yes|No|02/17/2022||Yes|No||||No|No|||Prescription required|No||116|Yes|1.00427|03/29/2022|.98016|03/29/2022|.98669|03/29/2022|||SKELETAL MUSCLE RELAXANTS|7059|||||No|No||RISING PHARM|No||||
carisoprodol|No|No|No|No|90%|16571078101|CARISOPRODOL 350 MG TABLET|100|EA|.043|02/17/2022||Yes|No||02/17/2022||Yes|No|02/17/2022||Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|7060|||||No|No||RISING PHARM|No||||
carisoprodol|No|No|No|No|90%|16571078110|CARISOPRODOL 350 MG TABLET|1000|EA|.0215|02/17/2022||Yes|No||02/17/2022||Yes|No|02/17/2022||Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|7061|||||No|No||RISING PHARM|No||||
carisoprodol|No|No|No|No|90%|16571078150|CARISOPRODOL 350 MG TABLET|500|EA|.0215|02/17/2022||Yes|No||02/17/2022||Yes|No|02/17/2022||Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|7062|||||No|No||RISING PHARM|No||||
cyclobenzaprine HCl|No|No|No|No|75%|16571078201|CYCLOBENZAPRINE 5 MG TABLET|100|EA|.0172|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|No||116|Yes|.02938|03/29/2022|.02867|03/29/2022|.02886|03/29/2022|||SKELETAL MUSCLE RELAXANTS|7063|||||No|No||RISING PHARM|No||||
cyclobenzaprine HCl|No|No|No|No|75%|16571078210|CYCLOBENZAPRINE 5 MG TABLET|1000|EA|.0172|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|No||116|Yes|.02938|03/29/2022|.02867|03/29/2022|.02886|03/29/2022|||SKELETAL MUSCLE RELAXANTS|7064|||||No|No||RISING PHARM|No||||
cyclobenzaprine HCl|No|No|No|No|75%|16571078250|CYCLOBENZAPRINE 5 MG TABLET|500|EA|.0172|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|No||116|Yes|.02938|03/29/2022|.02867|03/29/2022|.02886|03/29/2022|||SKELETAL MUSCLE RELAXANTS|7065|||||No|No||RISING PHARM|No||||
cyclobenzaprine HCl|No|No|No|No|75%|16571078301|CYCLOBENZAPRINE 10 MG TABLET|100|EA|.01935|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|7066|||||No|No||RISING PHARM|No||||
cyclobenzaprine HCl|No|No|No|No|75%|16571078310|CYCLOBENZAPRINE 10 MG TABLET|1000|EA|.01935|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|7067|||||No|No||RISING PHARM|No||||
cyclobenzaprine HCl|No|No|No|No|75%|16571078350|CYCLOBENZAPRINE 10 MG TABLET|500|EA|.01935|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|7068|||||No|No||RISING PHARM|No||||
gemfibrozil|No|No|No|No|75%|16571078406|GEMFIBROZIL 600 MG TABLET|60|EA|.07467|03/09/2022||Yes|No||03/09/2022||Yes|No|03/09/2022||Yes|No||||No|No|||Prescription required|No||055|No|.10518|03/29/2022|.10265|03/29/2022|.10333|03/29/2022|||LIPOTROPICS: OTHER|7069|||||No|No||RISING PHARM|No||||
gemfibrozil|No|No|No|No|75%|16571078450|GEMFIBROZIL 600 MG TABLET|500|EA|.05142|03/09/2022||Yes|No||03/09/2022||Yes|No|03/09/2022||Yes|No||||No|No|||Prescription required|No||055|No|.10518|03/29/2022|.10265|03/29/2022|.10333|03/29/2022|||LIPOTROPICS: OTHER|7070|||||No|No||RISING PHARM|No||||
lamotrigine|No|No|No|No|75%|16571078501|LAMOTRIGINE 5 MG DISPER TABLET|100|EA|.129|12/16/2021||Yes|No||12/16/2021||Yes|No|12/16/2021||Yes|No||||No|No|||Prescription required|No||056|No|.28106|12/28/2021|.27431|12/28/2021|.27614|12/28/2021|||ANTICONVULSANTS|7071|||||No|No||RISING PHARM|No||||
lamotrigine|No|No|No|No|75%|16571078601|LAMOTRIGINE 25 MG DISPER TAB|100|EA|.13545|12/16/2021||Yes|No||12/16/2021||Yes|No|12/16/2021||Yes|No||||No|No|||Prescription required|No||056|No|.29045|03/29/2022|.28347|03/29/2022|.28536|03/29/2022|||ANTICONVULSANTS|7072|||||No|No||RISING PHARM|No||||
fluphenazine HCl|No|No|No|No|75%|16714000201|FLUPHENAZINE 1 MG TABLET|100|EA|.99149|09/28/2021||Yes|No||09/28/2021||Yes|No|09/28/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|1.56797|01/25/2022|1.53033|01/25/2022|1.54053|01/25/2022|||ANTIPSYCHOTICS|7073|||||No|No||NORTHSTAR RX LL|No||||
fluphenazine HCl|No|No|No|No|75%|16714000301|FLUPHENAZINE 2.5 MG TABLET|100|EA|1.53497|09/28/2021||Yes|No||09/28/2021||Yes|No|09/28/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|2.3014|01/25/2022|2.24616|01/25/2022|2.26112|01/25/2022|||ANTIPSYCHOTICS|7074|||||No|No||NORTHSTAR RX LL|No||||
fluphenazine HCl|No|No|No|No|75%|16714000401|FLUPHENAZINE 5 MG TABLET|100|EA|2.07677|09/28/2021||Yes|No||09/28/2021||Yes|No|09/28/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|2.98385|03/29/2022|2.91223|03/29/2022|2.93163|03/29/2022|||ANTIPSYCHOTICS|7075|||||No|No||NORTHSTAR RX LL|No||||
fluphenazine HCl|No|No|No|No|75%|16714000501|FLUPHENAZINE 10 MG TABLET|100|EA|2.61839|09/28/2021||Yes|No||09/28/2021||Yes|No|09/28/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|3.52974|03/29/2022|3.44502|03/29/2022|3.46796|03/29/2022|||ANTIPSYCHOTICS|7076|||||No|No||NORTHSTAR RX LL|No||||
enoxaparin sodium|No|No|No|No|75%|16714000610|ENOXAPARIN 30 MG/0.3 ML SYR|.3|ML|8.31333|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|No||068|Yes|12.85641|03/29/2022|12.54785|03/29/2022|12.63142|03/29/2022|||ANTICOAGULANTS|7077|||||No|No||NORTHSTAR RX LL|No||||
isosorbide dinitrate|No|No|No|No|75%|16714000701|ISOSORBIDE DINITRATE 5 MG TAB|100|EA|.30194|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No|||No|.32336|03/29/2022|.31559|03/29/2022|.3177|03/29/2022||||7078|||||No|No||NORTHSTAR RX LL|No||||
isosorbide dinitrate|No|No|No|No|75%|16714000801|ISOSORBIDE DINITRATE 10 MG TAB|100|EA|.33798|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No|||No|.34234|03/29/2022|.33412|03/29/2022|.33634|03/29/2022||||7079|||||No|No||NORTHSTAR RX LL|No||||
isosorbide dinitrate|No|No|No|No|75%|16714000901|ISOSORBIDE DINITRATE 20 MG TAB|100|EA|.37758|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No|||No|.30675|03/29/2022|.29938|03/29/2022|.30138|03/29/2022||||7080|||||No|No||NORTHSTAR RX LL|No||||
isosorbide dinitrate|No|No|No|No|75%|16714001001|ISOSORBIDE DINITRATE 30 MG TAB|100|EA|.44853|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No|||No|.46251|03/29/2022|.4514|03/29/2022|.45441|03/29/2022||||7081|||||No|No||NORTHSTAR RX LL|No||||
amoxicillin/potassium clav|No|No|No|No|75%|16714001401|AMOX-CLAV 875-125 MG TABLET|20|EA|.38979|03/04/2021||Yes|No||03/04/2021||Yes|No|03/04/2021||Yes|No||||No|No|||Prescription required|No||046|No|.32484|03/29/2022|.31704|03/29/2022|.31915|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7082|||||No|No||NORTHSTAR RX LL|No||||
desmopressin acetate|No|No|No|No|75%|16714001501|DESMOPRESSIN 40 MCG/10 ML VIAL|10|ML|22.39354|03/05/2021||Yes|No||03/05/2021||Yes|No|03/05/2021||Yes|No||||No|No|||Prescription required|No|||Yes|51.03644|03/05/2021|50.30734|03/05/2021|47.91176|03/05/2021||||7083|||||No|No||NORTHSTAR RX LL|No||||
enoxaparin sodium|No|No|No|No|75%|16714001610|ENOXAPARIN 40 MG/0.4 ML SYR|.4|ML|8.385|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|No||068|Yes|11.94818|03/29/2022|11.66142|03/29/2022|11.73908|03/29/2022|||ANTICOAGULANTS|7084|||||No|No||NORTHSTAR RX LL|No||||
budesonide|No|No|No|No|75%|16714001830|BUDESONIDE 0.25 MG/2 ML SUSP|2|ML|1.3044|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No||033|Yes|.8321|03/29/2022|.81212|03/29/2022|.81753|03/29/2022|||GLUCOCORTICOIDS: INHALED|7085|||||No|No||NORTHSTAR RX LL|No||||
budesonide|No|No|No|No|75%|16714001930|BUDESONIDE 0.5 MG/2 ML SUSP|2|ML|1.36926|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No||033|Yes|.57313|03/29/2022|.55937|03/29/2022|.5631|03/29/2022|||GLUCOCORTICOIDS: INHALED|7086|||||No|No||NORTHSTAR RX LL|No||||
budesonide|No|No|No|No|75%|16714002030|BUDESONIDE 1 MG/2 ML INH SUSP|2|ML|3.36696|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No||033|Yes|3.95849|03/29/2022|3.86348|03/29/2022|3.88921|03/29/2022|||GLUCOCORTICOIDS: INHALED|7087|||||No|No||NORTHSTAR RX LL|No||||
enoxaparin sodium|No|No|No|No|75%|16714002610|ENOXAPARIN 60 MG/0.6 ML SYR|.6|ML|8.45666|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|No||068|Yes|11.41069|03/29/2022|11.13683|03/29/2022|11.211|03/29/2022|||ANTICOAGULANTS|7088|||||No|No||NORTHSTAR RX LL|No||||
irinotecan HCl|No|No|No|No|75%|16714002701|IRINOTECAN HCL 40 MG/2 ML VIAL|2|ML|3.1648|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No|||No|7.2128|03/17/2021|7.10976|03/17/2021|6.7712|03/17/2021||||7089|||||No|No||NORTHSTAR RX LL|No||||
medroxyprogesterone acetate|No|Yes|No|No|75%|16714002801|MEDROXYPROGESTERONE 150 MG/ML|1|ML|26.3934|03/22/2022||Yes|No||||No|No|03/22/2022||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|31.14606|03/29/2022|30.39855|03/29/2022|30.601|03/29/2022||||7090|||||No|No||NORTHSTAR RX LL|No||||
levetiracetam|No|No|No|No|75%|16714003501|LEVETIRACETAM 500 MG TABLET|120|EA|.12218|09/20/2021||Yes|No||09/20/2021||Yes|No|09/20/2021||Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|7091|||||No|No||NORTHSTAR RX LL|No||||
levetiracetam|No|No|No|No|75%|16714003502|LEVETIRACETAM 500 MG TABLET|500|EA|.15616|09/20/2021||Yes|No||09/20/2021||Yes|No|09/20/2021||Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|7092|||||No|No||NORTHSTAR RX LL|No||||
enoxaparin sodium|No|No|No|No|75%|16714003610|ENOXAPARIN 80 MG/0.8 ML SYR|.8|ML|8.4925|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|No||068|Yes|12.0025|03/29/2022|11.71444|03/29/2022|11.79245|03/29/2022|||ANTICOAGULANTS|7093|||||No|No||NORTHSTAR RX LL|No||||
venlafaxine HCl|No|No|No|No|75%|16714003801|VENLAFAXINE HCL ER 225 MG TAB|30|EA|3.80234|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|031|No|3.46235|03/29/2022|3.37925|03/29/2022|3.40175|03/29/2022|||ANTIDEPRESSANTS: OTHER|7094|||||No|No||NORTHSTAR RX LL|No||||
venlafaxine HCl|No|No|No|No|75%|16714003802|VENLAFAXINE HCL ER 225 MG TAB|90|EA|3.01229|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|031|No|3.46235|03/29/2022|3.37925|03/29/2022|3.40175|03/29/2022|||ANTIDEPRESSANTS: OTHER|7095|||||No|No||NORTHSTAR RX LL|No||||
colchicine|No|No|No|No|75%|16714003901|COLCHICINE 0.6 MG TABLET|30|EA|2.81936|06/16/2021||Yes|No||06/16/2021||Yes|No|06/16/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|231|No|.64179|03/29/2022|.62638|03/29/2022|.63055|03/29/2022|||ANTIHYPERURICEMICS|7096|||||No|No||NORTHSTAR RX LL|No||||
colchicine|No|No|No|No|75%|16714003902|COLCHICINE 0.6 MG TABLET|100|EA|2.2108|06/16/2021||Yes|No||06/16/2021||Yes|No|06/16/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|231|No|.64179|03/29/2022|.62638|03/29/2022|.63055|03/29/2022|||ANTIHYPERURICEMICS|7097|||||No|No||NORTHSTAR RX LL|No||||
allopurinol|No|No|No|No|75%|16714004107|ALLOPURINOL 100 MG TABLET|30|EA|.06765|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|7098|||||No|No||NORTHSTAR RX LL|No||||
allopurinol|No|No|No|No|75%|16714004110|ALLOPURINOL 100 MG TABLET|100|EA|.06768|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|7099|||||No|No||NORTHSTAR RX LL|No||||
allopurinol|No|No|No|No|75%|16714004112|ALLOPURINOL 100 MG TABLET|1000|EA|.09215|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|7100|||||No|No||NORTHSTAR RX LL|No||||
allopurinol|No|No|No|No|75%|16714004210|ALLOPURINOL 300 MG TABLET|100|EA|.16701|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|7101|||||No|No||NORTHSTAR RX LL|No||||
allopurinol|No|No|No|No|75%|16714004211|ALLOPURINOL 300 MG TABLET|500|EA|.12779|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|7102|||||No|No||NORTHSTAR RX LL|No||||
venlafaxine HCl|No|No|No|No|75%|16714004301|VENLAFAXINE HCL ER 37.5 MG CAP|90|EA|.13606|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|No||031|Yes|.11725|03/29/2022|.11443|03/29/2022|.11519|03/29/2022|||ANTIDEPRESSANTS: OTHER|7103|||||No|No||NORTHSTAR RX LL|No||||
venlafaxine HCl|No|No|No|No|75%|16714004302|VENLAFAXINE HCL ER 37.5 MG CAP|1000|EA|.10529|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No||031|Yes|.11725|03/29/2022|.11443|03/29/2022|.11519|03/29/2022|||ANTIDEPRESSANTS: OTHER|7104|||||No|No||NORTHSTAR RX LL|No||||
venlafaxine HCl|No|No|No|No|75%|16714004401|VENLAFAXINE HCL ER 75 MG CAP|90|EA|.15742|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No||031|Yes|.12722|03/29/2022|.12416|03/29/2022|.12499|03/29/2022|||ANTIDEPRESSANTS: OTHER|7105|||||No|No||NORTHSTAR RX LL|No||||
venlafaxine HCl|No|No|No|No|75%|16714004402|VENLAFAXINE HCL ER 75 MG CAP|1000|EA|.13369|03/17/2022||Yes|No||03/17/2022||Yes|No|03/17/2022||Yes|No||||No|No|||Prescription required|No||031|Yes|.12722|03/29/2022|.12416|03/29/2022|.12499|03/29/2022|||ANTIDEPRESSANTS: OTHER|7106|||||No|No||NORTHSTAR RX LL|No||||
venlafaxine HCl|No|No|No|No|75%|16714004501|VENLAFAXINE HCL ER 150 MG CAP|90|EA|.19258|12/28/2021||Yes|No||12/28/2021||Yes|No|12/28/2021||Yes|No||||No|No|||Prescription required|No||031|No|.16516|03/29/2022|.16119|03/29/2022|.16226|03/29/2022|||ANTIDEPRESSANTS: OTHER|7107|||||No|No||NORTHSTAR RX LL|No||||
enoxaparin sodium|No|No|No|No|75%|16714004610|ENOXAPARIN 100 MG/ML SYRINGE|1|ML|8.299|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|No||068|Yes|11.81296|03/29/2022|11.52944|03/29/2022|11.60623|03/29/2022|||ANTICOAGULANTS|7108|||||No|No||NORTHSTAR RX LL|No||||
chlorpromazine HCl|No|No|No|No|75%|16714004701|CHLORPROMAZINE 10 MG TABLET|100|EA|1.17123|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|1.29919|10/26/2021|1.268|10/26/2021|1.27645|10/26/2021|||ANTIPSYCHOTICS|7109|||||No|No||NORTHSTAR RX LL|No||||
chlorpromazine HCl|No|No|No|No|75%|16714004801|CHLORPROMAZINE 25 MG TABLET|100|EA|1.67786|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|1.39549|03/29/2022|1.36199|03/29/2022|1.37106|03/29/2022|||ANTIPSYCHOTICS|7110|||||No|No||NORTHSTAR RX LL|No||||
chlorpromazine HCl|No|No|No|No|75%|16714004901|CHLORPROMAZINE 50 MG TABLET|100|EA|2.38912|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|1.74791|03/29/2022|1.70596|03/29/2022|1.71732|03/29/2022|||ANTIPSYCHOTICS|7111|||||No|No||NORTHSTAR RX LL|No||||
chlorpromazine HCl|No|No|No|No|75%|16714005001|CHLORPROMAZINE 100 MG TABLET|100|EA|3.39639|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|2.03394|03/29/2022|1.98512|03/29/2022|1.99834|03/29/2022|||ANTIPSYCHOTICS|7112|||||No|No||NORTHSTAR RX LL|No||||
chlorpromazine HCl|No|No|No|No|75%|16714005101|CHLORPROMAZINE 200 MG TABLET|100|EA|4.8476|12/21/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|4.21034|03/01/2022|4.10929|03/01/2022|4.13665|03/01/2022|||ANTIPSYCHOTICS|7113|||||No|No||NORTHSTAR RX LL|No||||
mupirocin calcium|No|No|No|No|75%|16714005501|MUPIROCIN 2% CREAM|15|GM|5.62239|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|114|No|7.17255|03/29/2022|7.0004|03/29/2022|7.04703|03/29/2022|||ANTIBIOTICS: TOPICAL|7114|||||No|No||NORTHSTAR RX LL|No||||
mupirocin calcium|No|No|No|No|75%|16714005502|MUPIROCIN 2% CREAM|30|GM|4.76511|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|114|No|4.87374|03/29/2022|4.75677|03/29/2022|4.78844|03/29/2022|||ANTIBIOTICS: TOPICAL|7115|||||No|No||NORTHSTAR RX LL|No||||
enoxaparin sodium|No|No|No|No|75%|16714005610|ENOXAPARIN 120 MG/0.8 ML SYR|.8|ML|12.73875|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|No||068|Yes|15.335|03/29/2022|14.96696|03/29/2022|15.06663|03/29/2022|||ANTICOAGULANTS|7116|||||No|No||NORTHSTAR RX LL|No||||
febuxostat|No|No|No|No|75%|16714005901|FEBUXOSTAT 40 MG TABLET|30|EA|1.7693|12/28/2021||Yes|No||12/28/2021||Yes|No|12/28/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|231|No|.89466|03/29/2022|.87318|03/29/2022|.879|03/29/2022|||ANTIHYPERURICEMICS|7117|||||No|No||NORTHSTAR RX LL|No||||
febuxostat|No|No|No|No|75%|16714006001|FEBUXOSTAT 80 MG TABLET|30|EA|1.75511|12/28/2021||Yes|No||12/28/2021||Yes|No|12/28/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|231|No|.93355|03/29/2022|.91114|03/29/2022|.91721|03/29/2022|||ANTIHYPERURICEMICS|7118|||||No|No||NORTHSTAR RX LL|No||||
carbamazepine|No|No|No|No|75%|16714006301|CARBAMAZEPINE ER 100 MG TABLET|100|EA|.3937|09/28/2021||Yes|No||09/28/2021||Yes|No|09/28/2021||Yes|No||||No|No|||Prescription required|No||056|No|.53596|03/29/2022|.52309|03/29/2022|.52658|03/29/2022|||ANTICONVULSANTS|7119|||||No|No||NORTHSTAR RX LL|No||||
carbamazepine|No|No|No|No|75%|16714006401|CARBAMAZEPINE ER 200 MG TABLET|100|EA|.5599|09/28/2021||Yes|No||09/28/2021||Yes|No|09/28/2021||Yes|No||||No|No|||Prescription required|No||056|No|.8262|03/29/2022|.80637|03/29/2022|.81174|03/29/2022|||ANTICONVULSANTS|7120|||||No|No||NORTHSTAR RX LL|No||||
carbamazepine|No|No|No|No|75%|16714006501|CARBAMAZEPINE ER 400 MG TABLET|100|EA|1.12032|09/28/2021||Yes|No||09/28/2021||Yes|No|09/28/2021||Yes|No||||No|No|||Prescription required|No||056|No|1.58237|03/29/2022|1.54439|03/29/2022|1.55467|03/29/2022|||ANTICONVULSANTS|7121|||||No|No||NORTHSTAR RX LL|No||||
enoxaparin sodium|No|No|No|No|75%|16714006610|ENOXAPARIN 150 MG/ML SYRINGE|1|ML|12.599|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|No||068|Yes|15.18|03/29/2022|14.81568|03/29/2022|14.91435|03/29/2022|||ANTICOAGULANTS|7122|||||No|No||NORTHSTAR RX LL|No||||
carbidopa|No|No|No|No|75%|16714006701|CARBIDOPA 25 MG TABLET|100|EA|3.80154|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|015|No|1.9005|03/29/2022|1.85488|03/29/2022|1.86724|03/29/2022|||ANTIPARKINSON'S AGENTS|7123|||||No|No||NORTHSTAR RX LL|No||||
baclofen|No|No|No|No|75%|16714007104|BACLOFEN 10 MG TABLET|100|EA|.06665|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|7124|||||No|No||NORTHSTAR RX LL|No||||
baclofen|No|No|No|No|75%|16714007106|BACLOFEN 10 MG TABLET|1000|EA|.09702|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|7125|||||No|No||NORTHSTAR RX LL|No||||
baclofen|No|No|No|No|75%|16714007204|BACLOFEN 20 MG TABLET|100|EA|.11524|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|7126|||||No|No||NORTHSTAR RX LL|No||||
baclofen|No|No|No|No|75%|16714007205|BACLOFEN 20 MG TABLET|500|EA|.21081|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|7127|||||No|No||NORTHSTAR RX LL|No||||
cinacalcet HCl|No|No|No|No|75%|16714007801|CINACALCET HCL 30 MG TABLET|30|EA|4.93453|03/04/2021|06/30/2023|Yes|No||03/04/2021|06/30/2023|Yes|No|03/04/2021|06/30/2023|Yes|No||||No|No|||Prescription required|No|||No|.75588|03/29/2022|.73773|03/29/2022|.74265|03/29/2022||||7128|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
cinacalcet HCl|No|No|No|No|75%|16714007901|CINACALCET HCL 60 MG TABLET|30|EA|7.56398|03/04/2021|08/31/2022|Yes|No||03/04/2021|08/31/2022|Yes|No|03/04/2021|08/31/2022|Yes|No||||No|No|||Prescription required|No|||No|1.7407|03/29/2022|1.69892|03/29/2022|1.71023|03/29/2022||||7129|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
cinacalcet HCl|No|No|No|No|75%|16714008001|CINACALCET HCL 90 MG TABLET|30|EA|9.36783|03/04/2021||Yes|No||03/04/2021||Yes|No|03/04/2021||Yes|No||||No|No|||Prescription required|No|||No|3.64673|03/29/2022|3.5592|03/29/2022|3.58291|03/29/2022||||7130|||||No|No||NORTHSTAR RX LL|No||||
hydroxyzine HCl|No|No|No|No|75%|16714008110|HYDROXYZINE HCL 10 MG TABLET|100|EA|.04562|09/29/2014||Yes|No||09/29/2014||Yes|No|09/29/2014||Yes|No||||No|No|||Prescription required|No||574|Yes|.03952|03/29/2022|.03857|03/29/2022|.03882|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|7131|||||No|No||NORTHSTAR RX LL|No||||
hydroxyzine HCl|No|No|No|No|75%|16714008111|HYDROXYZINE HCL 10 MG TABLET|500|EA|.03739|09/29/2014||Yes|No||09/29/2014||Yes|No|09/29/2014||Yes|No||||No|No|||Prescription required|No||574|Yes|.03952|03/29/2022|.03857|03/29/2022|.03882|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|7132|||||No|No||NORTHSTAR RX LL|No||||
hydroxyzine HCl|No|No|No|No|75%|16714008210|HYDROXYZINE HCL 25 MG TABLET|100|EA|.07834|09/29/2014||Yes|No||09/29/2014||Yes|No|09/29/2014||Yes|No||||No|No|||Prescription required|No||574|Yes|.06757|03/29/2022|.06594|03/29/2022|.06638|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|7133|||||No|No||NORTHSTAR RX LL|No||||
hydroxyzine HCl|No|No|No|No|75%|16714008211|HYDROXYZINE HCL 25 MG TABLET|500|EA|.04029|09/29/2014||Yes|No||09/29/2014||Yes|No|09/29/2014||Yes|No||||No|No|||Prescription required|No||574|Yes|.06757|03/29/2022|.06594|03/29/2022|.06638|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|7134|||||No|No||NORTHSTAR RX LL|No||||
hydroxyzine HCl|No|No|No|No|75%|16714008212|HYDROXYZINE HCL 25 MG TABLET|1000|EA|.07052|09/29/2014||Yes|No||09/29/2014||Yes|No|09/29/2014||Yes|No||||No|No|||Prescription required|No||574|Yes|.06757|03/29/2022|.06594|03/29/2022|.06638|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|7135|||||No|No||NORTHSTAR RX LL|No||||
hydroxyzine HCl|No|No|No|No|75%|16714008310|HYDROXYZINE HCL 50 MG TABLET|100|EA|.07972|09/29/2014||Yes|No||09/29/2014||Yes|No|09/29/2014||Yes|No||||No|No|||Prescription required|No||574|Yes|.09594|03/29/2022|.09363|03/29/2022|.09426|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|7136|||||No|No||NORTHSTAR RX LL|No||||
hydroxyzine HCl|No|No|No|No|75%|16714008311|HYDROXYZINE HCL 50 MG TABLET|500|EA|.07426|09/29/2014||Yes|No||09/29/2014||Yes|No|09/29/2014||Yes|No||||No|No|||Prescription required|No||574|Yes|.09594|03/29/2022|.09363|03/29/2022|.09426|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|7137|||||No|No||NORTHSTAR RX LL|No||||
spironolactone|No|No|No|No|75%|16714008401|SPIRONOLACTONE 25 MG TABLET|100|EA|.05061|06/21/2021||Yes|No||06/21/2021||Yes|No|06/21/2021||Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||7138|||||No|No||NORTHSTAR RX LL|No||||
spironolactone|No|No|No|No|75%|16714008402|SPIRONOLACTONE 25 MG TABLET|500|EA|.05666|06/17/2021||Yes|No||06/17/2021||Yes|No|06/17/2021||Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||7139|||||No|No||NORTHSTAR RX LL|No||||
spironolactone|No|No|No|No|75%|16714008403|SPIRONOLACTONE 25 MG TABLET|1000|EA|.05275|06/17/2021||Yes|No||06/17/2021||Yes|No|06/17/2021||Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||7140|||||No|No||NORTHSTAR RX LL|No||||
spironolactone|No|No|No|No|75%|16714008501|SPIRONOLACTONE 50 MG TABLET|100|EA|.1508|06/17/2021||Yes|No||06/17/2021||Yes|No|06/17/2021||Yes|No||||No|No|||Prescription required|No|||No|.12042|03/29/2022|.11752|03/29/2022|.11831|03/29/2022||||7141|||||No|No||NORTHSTAR RX LL|No||||
spironolactone|No|No|No|No|75%|16714008502|SPIRONOLACTONE 50 MG TABLET|500|EA|.15245|06/17/2021||Yes|No||06/17/2021||Yes|No|06/17/2021||Yes|No||||No|No|||Prescription required|No|||No|.12042|03/29/2022|.11752|03/29/2022|.11831|03/29/2022||||7142|||||No|No||NORTHSTAR RX LL|No||||
spironolactone|No|No|No|No|75%|16714008601|SPIRONOLACTONE 100 MG TABLET|30|EA|.20554|06/21/2021||Yes|No||06/21/2021||Yes|No|06/21/2021||Yes|No||||No|No|||Prescription required|No|||No|.2048|03/29/2022|.19988|03/29/2022|.20121|03/29/2022||||7143|||||No|No||NORTHSTAR RX LL|No||||
spironolactone|No|No|No|No|75%|16714008602|SPIRONOLACTONE 100 MG TABLET|60|EA|.20546|06/21/2021||Yes|No||06/21/2021||Yes|No|06/21/2021||Yes|No||||No|No|||Prescription required|No|||No|.2048|03/29/2022|.19988|03/29/2022|.20121|03/29/2022||||7144|||||No|No||NORTHSTAR RX LL|No||||
spironolactone|No|No|No|No|75%|16714008603|SPIRONOLACTONE 100 MG TABLET|100|EA|.26758|06/21/2021||Yes|No||06/21/2021||Yes|No|06/21/2021||Yes|No||||No|No|||Prescription required|No|||No|.2048|03/29/2022|.19988|03/29/2022|.20121|03/29/2022||||7145|||||No|No||NORTHSTAR RX LL|No||||
spironolactone|No|No|No|No|75%|16714008604|SPIRONOLACTONE 100 MG TABLET|500|EA|.23023|06/17/2021||Yes|No||06/17/2021||Yes|No|06/17/2021||Yes|No||||No|No|||Prescription required|No|||No|.2048|03/29/2022|.19988|03/29/2022|.20121|03/29/2022||||7146|||||No|No||NORTHSTAR RX LL|No||||
clobazam|No|No|No|No|90%|16714008701|CLOBAZAM 2.5 MG/ML SUSPENSION|120|ML|.5371|02/24/2021||Yes|No||02/24/2021||Yes|No|02/24/2021||Yes|No||||No|No|||Prescription required|No||056|No|.50176|03/29/2022|.48971|03/29/2022|.49297|03/29/2022|||ANTICONVULSANTS|7147|||||No|No||NORTHSTAR RX LL|No||||
levalbuterol HCl|No|No|No|No|75%|16714009425|LEVALBUTEROL 0.31 MG/3 ML SOL|3|ML|.18077|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|037|Yes|.41199|03/23/2021|.4061|03/23/2021|.38676|03/23/2021|||BRONCHODILATORS: BETA AGONIST|7148|||||No|No||NORTHSTAR RX LL|No||||
levalbuterol HCl|No|No|No|No|75%|16714009430|LEVALBUTEROL 0.31 MG/3 ML SOL|3|ML|.76888|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|037|Yes|.33735|03/01/2022|.32925|03/01/2022|.33144|03/01/2022|||BRONCHODILATORS: BETA AGONIST|7149|||||No|No||NORTHSTAR RX LL|No||||
levalbuterol HCl|No|No|No|No|75%|16714009525|LEVALBUTEROL 0.63 MG/3 ML SOL|3|ML|.24429|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|037|Yes|.3279|03/29/2022|.32003|03/29/2022|.32216|03/29/2022|||BRONCHODILATORS: BETA AGONIST|7150|||||No|No||NORTHSTAR RX LL|No||||
levalbuterol HCl|No|No|No|No|75%|16714009625|LEVALBUTEROL 1.25 MG/3 ML SOL|3|ML|.172|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|037|Yes|.31144|03/29/2022|.30396|03/29/2022|.30598|03/29/2022|||BRONCHODILATORS: BETA AGONIST|7151|||||No|No||NORTHSTAR RX LL|No||||
lidocaine HCl|No|No|No|No|75%|16714009701|LIDOCAINE 2% VISCOUS SOLN|100|ML|.04652|09/28/2021||Yes|No||09/28/2021||Yes|No|09/28/2021||Yes|No||||No|No|||Prescription required|No|||No|.06351|03/29/2022|.06198|03/29/2022|.06239|03/29/2022||||7152|||||No|No||NORTHSTAR RX LL|No||||
tacrolimus|No|No|No|No|75%|16714009801|TACROLIMUS 0.5 MG CAPSULE (IR)|100|EA|.35552|09/20/2021||Yes|No||09/20/2021||Yes|No|09/20/2021||Yes|No||||No|No|||Prescription required|No||229|No|.26138|03/29/2022|.2551|03/29/2022|.2568|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|7153|||||No|No||NORTHSTAR RX LL|No||||
tacrolimus|No|No|No|No|75%|16714009901|TACROLIMUS 1 MG CAPSULE (IR)|100|EA|.65519|09/20/2021||Yes|No||09/20/2021||Yes|No|09/20/2021||Yes|No||||No|No|||Prescription required|No||229|No|.35645|03/29/2022|.34789|03/29/2022|.35021|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|7154|||||No|No||NORTHSTAR RX LL|No||||
tacrolimus|No|No|No|No|75%|16714010001|TACROLIMUS 5 MG CAPSULE (IR)|100|EA|3.35292|09/20/2021||Yes|No||09/20/2021||Yes|No|09/20/2021||Yes|No||||No|No|||Prescription required|No||229|No|2.05753|03/29/2022|2.00814|03/29/2022|2.02152|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|7155|||||No|No||NORTHSTAR RX LL|No||||
gemfibrozil|No|No|No|No|75%|16714010102|GEMFIBROZIL 600 MG TABLET|60|EA|.07689|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||055|No|.10518|03/29/2022|.10265|03/29/2022|.10333|03/29/2022|||LIPOTROPICS: OTHER|7156|||||No|No||NORTHSTAR RX LL|No||||
gemfibrozil|No|No|No|No|75%|16714010105|GEMFIBROZIL 600 MG TABLET|500|EA|.05065|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||055|No|.10518|03/29/2022|.10265|03/29/2022|.10333|03/29/2022|||LIPOTROPICS: OTHER|7157|||||No|No||NORTHSTAR RX LL|No||||
hydroxychloroquine sulfate|No|No|No|No|75%|16714011001|HYDROXYCHLOROQUINE 200 MG TAB|100|EA|.5399|03/24/2020||Yes|No||03/24/2020||Yes|No|03/24/2020||Yes|No||||No|No|||Prescription required|No|||No|.23831|03/29/2022|.23259|03/29/2022|.23413|03/29/2022||||7158|||||No|No||NORTHSTAR RX LL|No||||
fluoxetine HCl|Yes|No|No|No|75%|16714011201|FLUOXETINE HCL 10 MG TABLET|30|EA|.48862|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||008|No|.24078|03/29/2022|.235|03/29/2022|.23656|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7159|||||No|No||NORTHSTAR RX LL|No||||
fluoxetine HCl|Yes|No|No|No|75%|16714011202|FLUOXETINE HCL 10 MG TABLET|100|EA|.47734|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||008|No|.24078|03/29/2022|.235|03/29/2022|.23656|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7160|||||No|No||NORTHSTAR RX LL|No||||
fluoxetine HCl|Yes|No|No|No|75%|16714011301|FLUOXETINE HCL 20 MG TABLET|30|EA|.63582|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||008|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7161|||||No|No||NORTHSTAR RX LL|No||||
fluoxetine HCl|Yes|No|No|No|75%|16714011302|FLUOXETINE HCL 20 MG TABLET|100|EA|.43391|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||008|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7162|||||No|No||NORTHSTAR RX LL|No||||
fluoxetine HCl|Yes|No|No|No|75%|16714011401|FLUOXETINE HCL 60 MG TABLET|30|EA|1.59085|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|06/19/2020||Prescription required|Yes|07/30/2020|008|No|1.06507|03/29/2022|1.0395|03/29/2022|1.04643|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7163|||||No|No||NORTHSTAR RX LL|No||||
rivastigmine|No|No|No|No|75%|16714011502|RIVASTIGMINE 4.6 MG/24HR PATCH|30|EA|4.51414|09/28/2020||Yes|No||09/28/2020||Yes|No|09/28/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|011|No|2.88542|03/29/2022|2.81616|03/29/2022|2.83492|03/29/2022|||ALZHEIMER'S AGENTS|7164|||||No|No||NORTHSTAR RX LL|No||||
rivastigmine|No|No|No|No|75%|16714011602|RIVASTIGMINE 9.5 MG/24HR PATCH|30|EA|4.38241|09/28/2020||Yes|No||09/28/2020||Yes|No|09/28/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|011|No|2.83898|03/29/2022|2.77084|03/29/2022|2.78929|03/29/2022|||ALZHEIMER'S AGENTS|7165|||||No|No||NORTHSTAR RX LL|No||||
rivastigmine|No|No|No|No|75%|16714011702|RIVASTIGMINE 13.3 MG/24HR PTCH|30|EA|4.38327|09/28/2020||Yes|No||09/28/2020||Yes|No|09/28/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|011|No|3.24254|03/29/2022|3.16471|03/29/2022|3.18579|03/29/2022|||ALZHEIMER'S AGENTS|7166|||||No|No||NORTHSTAR RX LL|No||||
tobramycin in 0.225% sod chlor|No|No|No|No|75%|16714011903|TOBRAMYCIN 300 MG/5 ML AMPULE|5|ML|6.01414|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No|Submit HHS Form 1143|||No|No|||Prescription required|Yes|12/01/2021|240|No|3.76543|05/25/2021|3.67505|05/25/2021|3.69953|05/25/2021|||ANTIBIOTICS: INHALED|7167|||||No|No||NORTHSTAR RX LL|No||||
pilocarpine HCl|No|No|No|No|75%|16714012101|PILOCARPINE HCL 5 MG TABLET|100|EA|.42471|06/17/2021||Yes|No||06/17/2021||Yes|No|06/17/2021||Yes|No||||No|No|||Prescription required|No|||No|.27963|03/29/2022|.27291|03/29/2022|.27473|03/29/2022||||7168|||||No|No||NORTHSTAR RX LL|No||||
pilocarpine HCl|No|No|No|No|75%|16714012201|PILOCARPINE HCL 7.5 MG TABLET|100|EA|.53289|06/21/2021||Yes|No||06/21/2021||Yes|No|06/21/2021||Yes|No||||No|No|||Prescription required|No|||No|.89289|03/29/2022|.87146|03/29/2022|.87726|03/29/2022||||7169|||||No|No||NORTHSTAR RX LL|No||||
omeprazole|No|No|No|No|75%|16714012301|OMEPRAZOLE DR 40 MG CAPSULE|30|EA|.24323|11/13/2020||Yes|No||11/13/2020||Yes|No|11/13/2020||Yes|No||||No|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|7170|||||No|No||NORTHSTAR RX LL|No||||
omeprazole|No|No|No|No|75%|16714012302|OMEPRAZOLE DR 40 MG CAPSULE|100|EA|.18821|11/13/2020||Yes|No||11/13/2020||Yes|No|11/13/2020||Yes|No||||No|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|7171|||||No|No||NORTHSTAR RX LL|No||||
omeprazole|No|No|No|No|75%|16714012303|OMEPRAZOLE DR 40 MG CAPSULE|500|EA|.13629|11/13/2020||Yes|No||11/13/2020||Yes|No|11/13/2020||Yes|No||||No|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|7172|||||No|No||NORTHSTAR RX LL|No||||
methylphenidate HCl|No|No|No|No|75%|16714012701|METHYLPHENIDATE ER 54 MG TAB|100|EA|2.29409|05/20/2020|02/22/2022|Yes|No||05/20/2020|02/22/2022|Yes|No|05/20/2020|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|5.22839|03/29/2022|5.1537|03/29/2022|4.90829|03/29/2022|||STIMULANTS AND RELATED AGENTS|7173|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
chlorthalidone|No|No|No|No|75%|16714012801|CHLORTHALIDONE 25 MG TABLET|100|EA|.40269|10/16/2020||Yes|No||10/16/2020||Yes|No|10/16/2020||Yes|No||||No|No|||Prescription required|No|||No|.16117|03/29/2022|.1573|03/29/2022|.15834|03/29/2022||||7174|||||No|No||NORTHSTAR RX LL|No||||
chlorthalidone|No|No|No|No|75%|16714012901|CHLORTHALIDONE 50 MG TABLET|100|EA|.49849|10/16/2020||Yes|No||10/16/2020||Yes|No|10/16/2020||Yes|No||||No|No|||Prescription required|No|||No|.3607|03/29/2022|.35204|03/29/2022|.35438|03/29/2022||||7175|||||No|No||NORTHSTAR RX LL|No||||
triamcinolone acetonide|No|No|No|No|75%|16714013001|TRIAMCINOLONE ACET 40 MG/ML VL|1|ML||06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No|||No|7|01/25/2022|6.832|01/25/2022|6.8775|01/25/2022||||7176|||||No|No||NORTHSTAR RX LL|No||||
triamcinolone acetonide|No|No|No|No|75%|16714013025|TRIAMCINOLONE ACET 40 MG/ML VL|1|ML|3.655|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No|||No|8.33|07/06/2021|8.211|07/06/2021|7.82|07/06/2021||||7177|||||No|No||NORTHSTAR RX LL|No||||
irinotecan HCl|No|No|No|No|75%|16714013101|IRINOTECAN HCL 100 MG/5 ML VL|5|ML|2.18182|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No|||No|4.97252|03/23/2021|4.90148|03/17/2021|4.66808|03/17/2021||||7178|||||No|No||NORTHSTAR RX LL|No||||
doxepin HCl|No|No|No|No|75%|16714013201|DOXEPIN 10 MG CAPSULE|100|EA|.19698|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No||215|No|.22181|03/29/2022|.21648|03/29/2022|.21792|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7179|||||No|No||NORTHSTAR RX LL|No||||
doxepin HCl|No|No|No|No|75%|16714013301|DOXEPIN 25 MG CAPSULE|100|EA|.2564|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No||215|No|.30005|03/29/2022|.29284|03/29/2022|.29479|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7180|||||No|No||NORTHSTAR RX LL|No||||
doxepin HCl|No|No|No|No|75%|16714013401|DOXEPIN 50 MG CAPSULE|100|EA|.37066|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No||215|No|.41139|03/29/2022|.40151|03/29/2022|.40419|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7181|||||No|No||NORTHSTAR RX LL|No||||
doxepin HCl|No|No|No|No|75%|16714013501|DOXEPIN 75 MG CAPSULE|100|EA|.56966|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No||215|No|.56944|03/29/2022|.55577|03/29/2022|.55947|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7182|||||No|No||NORTHSTAR RX LL|No||||
doxepin HCl|No|No|No|No|75%|16714013601|DOXEPIN 100 MG CAPSULE|100|EA|.62272|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No||215|No|.67991|03/29/2022|.66359|03/29/2022|.66801|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7183|||||No|No||NORTHSTAR RX LL|No||||
triamcinolone acetonide|No|No|No|No|75%|16714014001|TRIAMCINOLONE ACET 200 MG/5 ML|5|ML|3.8958|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No|||No|8.8788|06/02/2021|8.75196|06/02/2021|8.3352|06/02/2021||||7184|||||No|No||NORTHSTAR RX LL|No||||
aripiprazole|No|No|No|No|75%|16714014101|ARIPIPRAZOLE 2 MG TABLET|30|EA|.516|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|7185|||||No|No||NORTHSTAR RX LL|No||||
aripiprazole|No|No|No|No|75%|16714014201|ARIPIPRAZOLE 5 MG TABLET|30|EA|.51499|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|7186|||||No|No||NORTHSTAR RX LL|No||||
aripiprazole|No|No|No|No|75%|16714014301|ARIPIPRAZOLE 10 MG TABLET|30|EA|.50625|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|7187|||||No|No||NORTHSTAR RX LL|No||||
aripiprazole|No|No|No|No|75%|16714014401|ARIPIPRAZOLE 15 MG TABLET|30|EA|.49564|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|7188|||||No|No||NORTHSTAR RX LL|No||||
aripiprazole|No|No|No|No|75%|16714014501|ARIPIPRAZOLE 20 MG TABLET|30|EA|.59125|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|7189|||||No|No||NORTHSTAR RX LL|No||||
aripiprazole|No|No|No|No|75%|16714014601|ARIPIPRAZOLE 30 MG TABLET|30|EA|.5504|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|7190|||||No|No||NORTHSTAR RX LL|No||||
triamcinolone acetonide|No|No|No|No|75%|16714015001|TRIAMCINOLONE ACET 400 MG/10ML|10|ML|2.90895|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No|||No|6.6297|06/02/2021|6.53499|06/02/2021|6.2238|06/02/2021||||7191|||||No|No||NORTHSTAR RX LL|No||||
norethindrone-e.estradiol-iron|No|Yes|No|No|75%|16714015503|NORETH-EE-FE 1-0.02(24)-75 CAP|28|EA|1.80876|12/16/2021||Yes|No||12/16/2021||Yes|No|12/16/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|2.32077|03/29/2022|2.26507|03/29/2022|2.28015|03/29/2022||||7192|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
posaconazole|No|No|No|No|75%|16714015601|POSACONAZOLE DR 100 MG TABLET|60|EA|18.23923|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|069|No|22.47154|03/29/2022|21.93222|03/29/2022|22.07828|03/29/2022|||ANTIFUNGALS: ORAL|7193|||||No|No||NORTHSTAR RX LL|No||||
progesterone, micronized|No|No|No|No|75%|16714015701|PROGESTERONE 100 MG CAPSULE|100|EA|.21667|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|No|||No|.25967|03/29/2022|.25343|03/29/2022|.25512|03/29/2022||||7194|||||No|No||NORTHSTAR RX LL|No||||
progesterone, micronized|No|No|No|No|75%|16714015801|PROGESTERONE 200 MG CAPSULE|100|EA|.38622|12/28/2021||Yes|No||12/28/2021||Yes|No|12/28/2021||Yes|No||||No|No|||Prescription required|No|||No|.48257|03/29/2022|.47098|03/29/2022|.47412|03/29/2022||||7195|||||No|No||NORTHSTAR RX LL|No||||
ondansetron HCl|No|No|No|No|75%|16714015901|ONDANSETRON HCL 4 MG TABLET|30|EA|.11939|03/15/2022||Yes|No||03/15/2022||Yes|No|03/15/2022||Yes|No||||No|No|||Prescription required|No||085|No|.06763|03/29/2022|.066|03/29/2022|.06644|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|7196|||||No|No||NORTHSTAR RX LL|No||||
ondansetron HCl|No|No|No|No|75%|16714016001|ONDANSETRON HCL 8 MG TABLET|30|EA|.13631|03/15/2022||Yes|No||03/15/2022||Yes|No|03/15/2022||Yes|No||||No|No|||Prescription required|No||085|No|.09975|03/29/2022|.09735|03/29/2022|.098|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|7197|||||No|No||NORTHSTAR RX LL|No||||
clindamycin phosphate|No|No|No|No|75%|16714016101|CLINDAMYCIN PH 1% GEL|30|GM|.99115|03/17/2022||Yes|No||03/17/2022||Yes|No|03/17/2022||Yes|No||||No|No|||Prescription required|No||104|No|.67613|03/29/2022|.6599|03/29/2022|.66429|03/29/2022|||ACNE AGENTS: TOPICAL|7198|||||No|No||NORTHSTAR RX LL|No||||
liothyronine sodium|No|No|No|No|75%|16714016601|LIOTHYRONINE SOD 5 MCG TAB|100|EA|.33178|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|No|||No|.37734|03/29/2022|.36828|03/29/2022|.37073|03/29/2022||||7199|||||No|No||NORTHSTAR RX LL|No||||
liothyronine sodium|No|No|No|No|75%|16714016701|LIOTHYRONINE SOD 25 MCG TAB|100|EA|.42978|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|No|||No|.55764|03/29/2022|.54425|03/29/2022|.54788|03/29/2022||||7200|||||No|No||NORTHSTAR RX LL|No||||
liothyronine sodium|No|No|No|No|75%|16714016801|LIOTHYRONINE SOD 50 MCG TAB|100|EA|.61537|12/28/2021||Yes|No||12/28/2021||Yes|No|12/28/2021||Yes|No||||No|No|||Prescription required|No|||No|.67729|01/25/2022|.66103|01/25/2022|.66543|01/25/2022||||7201|||||No|No||NORTHSTAR RX LL|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|16714017001|BUTALB-ACETAMIN-CAFF 50-300-40|100|EA|.75477|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No|||No|.69452|03/29/2022|.67785|03/29/2022|.68236|03/29/2022||||7202|||||No|No||NORTHSTAR RX LL|No||||
tizanidine HCl|No|No|No|No|75%|16714017101|TIZANIDINE HCL 2 MG TABLET|150|EA|.05833|03/22/2022||Yes|No||03/22/2022||Yes|No|03/22/2022||Yes|No||||No|No|||Prescription required|No||116|No|.06018|03/29/2022|.05873|03/29/2022|.05912|03/29/2022|||SKELETAL MUSCLE RELAXANTS|7203|||||No|No||NORTHSTAR RX LL|No||||
tizanidine HCl|No|No|No|No|75%|16714017201|TIZANIDINE HCL 4 MG TABLET|150|EA|.06799|03/22/2022||Yes|No||03/22/2022||Yes|No|03/22/2022||Yes|No||||No|No|||Prescription required|No||116|No|.05014|03/29/2022|.04893|03/29/2022|.04926|03/29/2022|||SKELETAL MUSCLE RELAXANTS|7204|||||No|No||NORTHSTAR RX LL|No||||
tizanidine HCl|No|No|No|No|75%|16714017202|TIZANIDINE HCL 4 MG TABLET|1000|EA|.06663|03/22/2022||Yes|No||03/22/2022||Yes|No|03/22/2022||Yes|No||||No|No|||Prescription required|No||116|No|.05014|03/29/2022|.04893|03/29/2022|.04926|03/29/2022|||SKELETAL MUSCLE RELAXANTS|7205|||||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|No|No|No|No|75%|16714017301|ATORVASTATIN 10 MG TABLET|90|EA|.08408|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|7206|||||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|No|No|No|No|75%|16714017302|ATORVASTATIN 10 MG TABLET|500|EA|.05479|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|7207|||||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|No|No|No|No|75%|16714017303|ATORVASTATIN 10 MG TABLET|1000|EA|.09204|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|7208|||||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|No|No|No|No|75%|16714017401|ATORVASTATIN 20 MG TABLET|90|EA|.1192|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|7209|||||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|No|No|No|No|75%|16714017402|ATORVASTATIN 20 MG TABLET|500|EA|.07412|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|7210|||||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|No|No|No|No|75%|16714017403|ATORVASTATIN 20 MG TABLET|1000|EA|.13634|12/28/2021||Yes|No||12/28/2021||Yes|No|12/28/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|7211|||||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|No|No|No|No|75%|16714017501|ATORVASTATIN 40 MG TABLET|90|EA|.12083|12/28/2021||Yes|No||12/28/2021||Yes|No|12/28/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|7212|||||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|No|No|No|No|75%|16714017502|ATORVASTATIN 40 MG TABLET|500|EA|.07757|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|7213|||||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|No|No|No|No|75%|16714017503|ATORVASTATIN 40 MG TABLET|1000|EA|.12263|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|7214|||||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|No|No|No|No|75%|16714017601|ATORVASTATIN 80 MG TABLET|90|EA|.12068|12/28/2021||Yes|No||12/28/2021||Yes|No|12/28/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|7215|||||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|No|No|No|No|75%|16714017602|ATORVASTATIN 80 MG TABLET|500|EA|.09216|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|7216|||||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|No|No|No|No|75%|16714017603|ATORVASTATIN 80 MG TABLET|1000|EA|.12961|03/17/2022||Yes|No||03/17/2022||Yes|No|03/17/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|7217|||||No|No||NORTHSTAR RX LL|No||||
ondansetron|No|No|No|No|75%|16714020030|ONDANSETRON ODT 4 MG TABLET|30|EA|.24094|03/15/2022||Yes|No||03/15/2022||Yes|No|03/15/2022||Yes|No||||No|No|||Prescription required|No||085|No|.24125|03/29/2022|.23546|03/29/2022|.23702|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|7218|||||No|No||NORTHSTAR RX LL|No||||
ondansetron|No|No|No|No|75%|16714020110|ONDANSETRON ODT 8 MG TABLET|10|EA|.27219|03/17/2022||Yes|No||03/17/2022||Yes|No|03/17/2022||Yes|No||||No|No|||Prescription required|No||085|No|.24386|03/29/2022|.238|03/29/2022|.23959|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|7219|||||No|No||NORTHSTAR RX LL|No||||
ondansetron|No|No|No|No|75%|16714020130|ONDANSETRON ODT 8 MG TABLET|30|EA|.32837|03/17/2022||Yes|No||03/17/2022||Yes|No|03/17/2022||Yes|No||||No|No|||Prescription required|No||085|No|.24386|03/29/2022|.238|03/29/2022|.23959|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|7220|||||No|No||NORTHSTAR RX LL|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|16714022401|LOSARTAN-HCTZ 100-12.5 MG TAB|30|EA|.1181|01/01/2021|07/31/2022|Yes|No||01/01/2021|07/31/2022|Yes|No|01/01/2021|07/31/2022|Yes|No||||No|No|01/01/2021|07/31/2022|Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|7221|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|16714022402|LOSARTAN-HCTZ 100-12.5 MG TAB|90|EA|.09526|01/01/2021|07/31/2022|Yes|No||01/01/2021|07/31/2022|Yes|No|01/01/2021|07/31/2022|Yes|No||||No|No|01/01/2021|07/31/2022|Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|7222|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|16714022501|LOSARTAN-HCTZ 100-25 MG TAB|30|EA|.11882|01/01/2021|06/30/2022|Yes|No||01/01/2021|06/30/2022|Yes|No|01/01/2021|06/30/2022|Yes|No||||No|No|||Prescription required|No||113|Yes|.21077|03/01/2022|.20571|03/01/2022|.20708|03/01/2022|||ANGIOTENSIN MODULATORS|7223|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|16714022502|LOSARTAN-HCTZ 100-25 MG TAB|90|EA|.09684|01/01/2021|06/30/2022|Yes|No||01/01/2021|06/30/2022|Yes|No|01/01/2021|06/30/2022|Yes|No||||No|No|||Prescription required|No||113|Yes|.21077|03/01/2022|.20571|03/01/2022|.20708|03/01/2022|||ANGIOTENSIN MODULATORS|7224|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|16714022504|LOSARTAN-HCTZ 100-25 MG TAB|1000|EA|.11623|01/01/2021|07/31/2022|Yes|No||01/01/2021|07/31/2022|Yes|No|01/01/2021|07/31/2022|Yes|No||||No|No|||Prescription required|No||113|Yes|.21077|03/01/2022|.20571|03/01/2022|.20708|03/01/2022|||ANGIOTENSIN MODULATORS|7225|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|16714022601|LOSARTAN-HCTZ 50-12.5 MG TAB|30|EA|.08729|01/01/2021|03/31/2022|Yes|No||01/01/2021|03/31/2022|Yes|No|01/01/2021|03/31/2022|Yes|No||||No|No|01/01/2021|03/31/2022|Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|7226|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|16714022602|LOSARTAN-HCTZ 50-12.5 MG TAB|90|EA|.08872|01/01/2021|07/31/2022|Yes|No||01/01/2021|07/31/2022|Yes|No|01/01/2021|07/31/2022|Yes|No||||No|No|01/01/2021|07/31/2022|Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|7227|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|16714022604|LOSARTAN-HCTZ 50-12.5 MG TAB|1000|EA|.08544|01/01/2021|06/30/2022|Yes|No||01/01/2021|06/30/2022|Yes|No|01/01/2021|06/30/2022|Yes|No||||No|No|01/01/2021|06/30/2022|Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|7228|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
carvedilol phosphate|No|No|No|No|75%|16714022701|CARVEDILOL ER 10 MG CAPSULE|30|EA|3.40201|03/22/2022||Yes|No||03/22/2022||Yes|No|03/22/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|Yes|6.70929|03/29/2022|6.54826|03/29/2022|6.59187|03/29/2022|||BETA-BLOCKERS|7229|||||No|No||NORTHSTAR RX LL|No||||
carvedilol phosphate|No|No|No|No|75%|16714022801|CARVEDILOL ER 20 MG CAPSULE|30|EA|3.39728|03/22/2022||Yes|No||03/22/2022||Yes|No|03/22/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|Yes|6.10173|03/29/2022|5.95528|03/29/2022|5.99494|03/29/2022|||BETA-BLOCKERS|7230|||||No|No||NORTHSTAR RX LL|No||||
carvedilol phosphate|No|No|No|No|75%|16714022901|CARVEDILOL ER 40 MG CAPSULE|30|EA|3.37263|03/22/2022||Yes|No||03/22/2022||Yes|No|03/22/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|Yes|5.77365|03/29/2022|5.63508|03/29/2022|5.67261|03/29/2022|||BETA-BLOCKERS|7231|||||No|No||NORTHSTAR RX LL|No||||
carvedilol phosphate|No|No|No|No|75%|16714023001|CARVEDILOL ER 80 MG CAPSULE|30|EA|3.37134|03/22/2022||Yes|No||03/22/2022||Yes|No|03/22/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|6.50208|03/29/2022|6.34603|03/29/2022|6.38829|03/29/2022|||BETA-BLOCKERS|7232|||||No|No||NORTHSTAR RX LL|No||||
penicillin V potassium|No|No|No|No|75%|16714023401|PENICILLIN VK 250 MG TABLET|100|EA|.08668|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||209|No|.0637|03/29/2022|.06217|03/29/2022|.06258|03/29/2022|||PENICILLINS|7233|||||No|No||NORTHSTAR RX LL|No||||
penicillin V potassium|No|No|No|No|75%|16714023402|PENICILLIN VK 250 MG TABLET|1000|EA|.21614|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||209|No|.0637|03/29/2022|.06217|03/29/2022|.06258|03/29/2022|||PENICILLINS|7234|||||No|No||NORTHSTAR RX LL|No||||
penicillin V potassium|No|No|No|No|75%|16714023501|PENICILLIN VK 500 MG TABLET|100|EA|.26333|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||209|No|.10026|03/29/2022|.09785|03/29/2022|.0985|03/29/2022|||PENICILLINS|7235|||||No|No||NORTHSTAR RX LL|No||||
penicillin V potassium|No|No|No|No|75%|16714023502|PENICILLIN VK 500 MG TABLET|1000|EA|.36332|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||209|No|.10026|03/29/2022|.09785|03/29/2022|.0985|03/29/2022|||PENICILLINS|7236|||||No|No||NORTHSTAR RX LL|No||||
famotidine|No|No|No|No|75%|16714024401|FAMOTIDINE 40 MG/5 ML SUSP|50|ML|.8514|03/17/2022||Yes|No||03/17/2022||Yes|No|03/17/2022||Yes|No||||No|No|||Prescription required|No|||No|.81888|03/29/2022|.79922|03/29/2022|.80454|03/29/2022||||7237|||||No|No||NORTHSTAR RX LL|No||||
amoxicillin/potassium clav|No|No|No|No|75%|16714029201|AMOX-CLAV 200-28.5 MG/5 ML SUS|50|ML|.0743|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.16934|10/27/2020|.16692|10/27/2020|.15897|10/27/2020|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7238|||||No|No||NORTHSTAR RX LL|No||||
amoxicillin/potassium clav|No|No|No|No|75%|16714029202|AMOX-CLAV 200-28.5 MG/5 ML SUS|75|ML|.05274|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.1202|03/23/2021|.11848|03/23/2021|.11284|03/23/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7239|||||No|No||NORTHSTAR RX LL|No||||
amoxicillin/potassium clav|No|No|No|No|75%|16714029203|AMOX-CLAV 200-28.5 MG/5 ML SUS|100|ML|.04648|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.05885|03/29/2022|.05743|03/29/2022|.05782|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7240|||||No|No||NORTHSTAR RX LL|No||||
amoxicillin/potassium clav|No|No|No|No|75%|16714029301|AMOX-CLAV 400-57 MG/5 ML SUSP|50|ML|.09288|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.0974|03/29/2022|.09506|03/29/2022|.09569|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7241|||||No|No||NORTHSTAR RX LL|No||||
amoxicillin/potassium clav|No|No|No|No|75%|16714029302|AMOX-CLAV 400-57 MG/5 ML SUSP|75|ML|.06593|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.0795|03/29/2022|.07759|03/29/2022|.0781|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7242|||||No|No||NORTHSTAR RX LL|No||||
amoxicillin/potassium clav|No|No|No|No|75%|16714029303|AMOX-CLAV 400-57 MG/5 ML SUSP|100|ML|.08397|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.07681|03/29/2022|.07496|03/29/2022|.07546|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7243|||||No|No||NORTHSTAR RX LL|No||||
amoxicillin/potassium clav|No|No|No|No|75%|16714029401|AMOX-CLAV 600-42.9 MG/5 ML SUS|75|ML|.09367|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.08577|03/29/2022|.08371|03/29/2022|.08426|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7244|||||No|No||NORTHSTAR RX LL|No||||
amoxicillin/potassium clav|No|No|No|No|75%|16714029402|AMOX-CLAV 600-42.9 MG/5 ML SUS|125|ML|.08565|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.06559|03/29/2022|.06401|03/29/2022|.06444|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7245|||||No|No||NORTHSTAR RX LL|No||||
amoxicillin/potassium clav|No|No|No|No|75%|16714029403|AMOX-CLAV 600-42.9 MG/5 ML SUS|200|ML|.10158|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.06244|03/29/2022|.06094|03/29/2022|.06134|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7246|||||No|No||NORTHSTAR RX LL|No||||
amoxicillin|No|No|No|No|75%|16714029801|AMOXICILLIN 250 MG CAPSULE|100|EA|.02193|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||209|No|.06288|03/29/2022|.06137|03/29/2022|.06177|03/29/2022|||PENICILLINS|7247|||||No|No||NORTHSTAR RX LL|No||||
amoxicillin|No|No|No|No|75%|16714029802|AMOXICILLIN 250 MG CAPSULE|500|EA|.02711|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||209|No|.06288|03/29/2022|.06137|03/29/2022|.06177|03/29/2022|||PENICILLINS|7248|||||No|No||NORTHSTAR RX LL|No||||
amoxicillin|No|No|No|No|75%|16714029902|AMOXICILLIN 500 MG CAPSULE|50|EA|.07972|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||209|No|.07054|03/29/2022|.06884|03/29/2022|.0693|03/29/2022|||PENICILLINS|7249|||||No|No||NORTHSTAR RX LL|No||||
amoxicillin|No|No|No|No|75%|16714029903|AMOXICILLIN 500 MG CAPSULE|100|EA|.03878|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||209|No|.07054|03/29/2022|.06884|03/29/2022|.0693|03/29/2022|||PENICILLINS|7250|||||No|No||NORTHSTAR RX LL|No||||
amoxicillin|No|No|No|No|75%|16714029904|AMOXICILLIN 500 MG CAPSULE|500|EA|.063|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||209|No|.07054|03/29/2022|.06884|03/29/2022|.0693|03/29/2022|||PENICILLINS|7251|||||No|No||NORTHSTAR RX LL|No||||
gabapentin|No|No|No|No|75%|16714033001|GABAPENTIN 600 MG TABLET|100|EA|.11197|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|7252|||||No|No||NORTHSTAR RX LL|No||||
gabapentin|No|No|No|No|75%|16714033002|GABAPENTIN 600 MG TABLET|500|EA|.12297|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|7253|||||No|No||NORTHSTAR RX LL|No||||
gabapentin|No|No|No|No|75%|16714033201|GABAPENTIN 800 MG TABLET|100|EA|.12491|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|7254|||||No|No||NORTHSTAR RX LL|No||||
gabapentin|No|No|No|No|75%|16714033202|GABAPENTIN 800 MG TABLET|500|EA|.13107|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|7255|||||No|No||NORTHSTAR RX LL|No||||
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|16714034001|LEVONEST-28 TABLET|28|EA|.31651|09/01/2012||Yes|No||09/01/2012||Yes|No|09/01/2012||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.4402|03/29/2022|.42963|03/29/2022|.43249|03/29/2022||||7256|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|16714034004|LEVONEST-28 TABLET|28|EA|.31643|09/01/2012||Yes|No||09/01/2012||Yes|No|09/01/2012||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.4402|03/29/2022|.42963|03/29/2022|.43249|03/29/2022||||7257|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|16714034601|DASETTA 7/7/7-28 TABLET|28|EA|.38223|09/01/2012||Yes|No||09/01/2012||Yes|No|09/01/2012||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.43221|03/29/2022|.42183|03/29/2022|.42464|03/29/2022||||7258|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|16714034604|DASETTA 7/7/7-28 TABLET|28|EA|.35997|09/01/2012||Yes|No||09/01/2012||Yes|No|09/01/2012||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.43221|03/29/2022|.42183|03/29/2022|.42464|03/29/2022||||7259|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|16714034701|PHILITH 0.4-0.035 MG TABLET|28|EA|.49572|07/01/2012||Yes|No||07/01/2012||Yes|No|07/01/2012||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.44932|03/29/2022|.43853|03/29/2022|.44145|03/29/2022||||7260|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|16714034704|PHILITH 0.4-0.035 MG TABLET|28|EA|.49424|07/01/2012||Yes|No||07/01/2012||Yes|No|07/01/2012||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.44932|03/29/2022|.43853|03/29/2022|.44145|03/29/2022||||7261|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|16714034801|DASETTA 1-35-28 TABLET|28|EA|.33939|09/01/2012||Yes|No||09/01/2012||Yes|No|09/01/2012||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.34259|03/29/2022|.33436|03/29/2022|.33659|03/29/2022||||7262|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|16714034804|DASETTA 1-35-28 TABLET|28|EA|.30547|09/01/2012||Yes|No||09/01/2012||Yes|No|09/01/2012||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.34259|03/29/2022|.33436|03/29/2022|.33659|03/29/2022||||7263|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
fluoxetine HCl|Yes|No|No|No|75%|16714035101|FLUOXETINE HCL 10 MG CAPSULE|30|EA|.02393|01/01/2021|10/31/2022|Yes|No||01/01/2021|10/31/2022|Yes|No|01/01/2021|10/31/2022|Yes|No||||No|No|01/01/2021|10/31/2022|Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7264|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
fluoxetine HCl|Yes|No|No|No|75%|16714035201|FLUOXETINE HCL 20 MG CAPSULE|30|EA|.02436|01/01/2021|10/31/2022|Yes|No||01/01/2021|10/31/2022|Yes|No|01/01/2021|10/31/2022|Yes|No||||No|No|01/01/2021|10/31/2022|Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7265|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
levetiracetam|No|No|No|No|75%|16714035401|LEVETIRACETAM 250 MG TABLET|120|EA|.10574|08/01/2012||Yes|No||08/01/2012||Yes|No|08/01/2012||Yes|No||||No|No|||Prescription required|No||056|No|.08073|03/29/2022|.07879|03/29/2022|.07931|03/29/2022|||ANTICONVULSANTS|7266|||||No|No||NORTHSTAR RX LL|No||||
levetiracetam|No|No|No|No|75%|16714035402|LEVETIRACETAM 250 MG TABLET|500|EA|.14231|08/01/2012||Yes|No||08/01/2012||Yes|No|08/01/2012||Yes|No||||No|No|||Prescription required|No||056|No|.08073|03/29/2022|.07879|03/29/2022|.07931|03/29/2022|||ANTICONVULSANTS|7267|||||No|No||NORTHSTAR RX LL|No||||
levetiracetam|No|No|No|No|75%|16714035501|LEVETIRACETAM 500 MG TABLET|120|EA|.12218|08/01/2012|08/31/2024|Yes|No||08/01/2012|08/31/2024|Yes|No|08/01/2012|08/31/2024|Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|7268|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
levetiracetam|No|No|No|No|75%|16714035502|LEVETIRACETAM 500 MG TABLET|500|EA|.15616|08/01/2012|02/28/2025|Yes|No||08/01/2012|02/28/2025|Yes|No|08/01/2012|02/28/2025|Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|7269|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
levetiracetam|No|No|No|No|75%|16714035601|LEVETIRACETAM 750 MG TABLET|120|EA|.15992|08/01/2012||Yes|No||08/01/2012||Yes|No|08/01/2012||Yes|No||||No|No|||Prescription required|No||056|No|.15853|03/29/2022|.15472|03/29/2022|.15575|03/29/2022|||ANTICONVULSANTS|7270|||||No|No||NORTHSTAR RX LL|No||||
levetiracetam|No|No|No|No|75%|16714035602|LEVETIRACETAM 750 MG TABLET|500|EA|.23369|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||056|No|.15853|03/29/2022|.15472|03/29/2022|.15575|03/29/2022|||ANTICONVULSANTS|7271|||||No|No||NORTHSTAR RX LL|No||||
levetiracetam|No|No|No|No|75%|16714035701|LEVETIRACETAM 1,000 MG TABLET|60|EA|.32815|08/01/2012||Yes|No||08/01/2012||Yes|No|08/01/2012||Yes|No||||No|No|||Prescription required|No||056|No|.22789|03/29/2022|.22242|03/29/2022|.2239|03/29/2022|||ANTICONVULSANTS|7272|||||No|No||NORTHSTAR RX LL|No||||
levetiracetam|No|No|No|No|75%|16714035801|LEVETIRACETAM 100 MG/ML SOLN|473|ML|.0435|09/01/2012||Yes|No||09/01/2012||Yes|No|09/01/2012||Yes|No||||No|No|||Prescription required|No||056|No|.03146|03/29/2022|.0307|03/29/2022|.0309|03/29/2022|||ANTICONVULSANTS|7273|||||No|No||NORTHSTAR RX LL|No||||
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|16714035901|FALMINA-28 TABLET|28|EA|.36288|07/16/2013||Yes|No||07/16/2013||Yes|No|07/16/2013||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.21292|03/29/2022|.2078|03/29/2022|.20919|03/29/2022||||7274|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|16714035903|FALMINA-28 TABLET|28|EA|.35664|07/01/2013||Yes|No||07/01/2013||Yes|No|07/01/2013||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.21292|03/29/2022|.2078|03/29/2022|.20919|03/29/2022||||7275|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|16714035904|FALMINA-28 TABLET|28|EA|.36393|10/26/2012||Yes|No||10/26/2012||Yes|No|10/26/2012||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.21292|03/29/2022|.2078|03/29/2022|.20919|03/29/2022||||7276|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norgestimate-ethinyl estradiol|Yes|Yes|No|No|75%|16714036001|MONO-LINYAH 28 TABLET|28|EA|.32495|05/03/2013||Yes|No||05/03/2013||Yes|No|05/03/2013||Yes|No|Refer to program requirements|||No|No|05/03/2013||Prescription required|No|||No|.1742|03/29/2022|.17001|03/29/2022|.17115|03/29/2022||||7277|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norgestimate-ethinyl estradiol|Yes|Yes|No|No|75%|16714036004|MONO-LINYAH 28 TABLET|28|EA|.32487|01/01/2013||Yes|No||01/01/2013||Yes|No|01/01/2013||Yes|No|Refer to program requirements|||No|No|01/01/2013||Prescription required|No|||No|.1742|03/29/2022|.17001|03/29/2022|.17115|03/29/2022||||7278|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norgestimate-ethinyl estradiol|Yes|Yes|No|No|75%|16714036301|TRI-LINYAH TABLET|28|EA|.36365|05/03/2013||Yes|No||05/03/2013||Yes|No|05/03/2013||Yes|No|Refer to program requirements|||No|No|05/03/2013||Prescription required|No|||No|.1602|03/29/2022|.15635|03/29/2022|.15739|03/29/2022||||7279|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norgestimate-ethinyl estradiol|Yes|Yes|No|No|75%|16714036304|TRI-LINYAH TABLET|28|EA|.3636|04/18/2013||Yes|No||04/18/2013||Yes|No|04/18/2013||Yes|No|Refer to program requirements|||No|No|04/18/2013||Prescription required|No|||No|.1602|03/29/2022|.15635|03/29/2022|.15739|03/29/2022||||7280|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norgestrel-ethinyl estradiol|Yes|Yes|No|No|75%|16714036501|ELINEST-28 TABLET|28|EA|.35152|05/03/2013||Yes|No||05/03/2013||Yes|No|05/03/2013||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.39526|03/29/2022|.38577|03/29/2022|.38834|03/29/2022||||7281|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norgestrel-ethinyl estradiol|Yes|Yes|No|No|75%|16714036504|ELINEST-28 TABLET|28|EA|.35139|04/18/2013||Yes|No||04/18/2013||Yes|No|04/18/2013||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.39526|03/29/2022|.38577|03/29/2022|.38834|03/29/2022||||7282|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|16714036603|SETLAKIN 0.15 MG-0.03 MG TAB|91|EA|.27753|06/01/2016||Yes|No||||No|No|06/01/2016||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.17533|03/29/2022|.17112|03/29/2022|.17226|03/29/2022||||7283|||||No|No||NORTHSTAR RX LL|No||||
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|16714037001|WERA 0.5/0.035 MG 28 TABLET|28|EA|.3334|09/01/2012||Yes|No||09/01/2012||Yes|No|09/01/2012||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.626|03/29/2022|.61097|03/29/2022|.61504|03/29/2022||||7284|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|16714037003|WERA 0.5/0.035 MG 28 TABLET|28|EA|.33334|09/01/2012||Yes|No||09/01/2012||Yes|No|09/01/2012||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.626|03/29/2022|.61097|03/29/2022|.61504|03/29/2022||||7285|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
cefadroxil|No|No|No|No|75%|16714038801|CEFADROXIL 500 MG CAPSULE|50|EA|.25189|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.20994|03/29/2022|.2049|03/29/2022|.20626|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7286|||||No|No||NORTHSTAR RX LL|No||||
cefadroxil|No|No|No|No|75%|16714038802|CEFADROXIL 500 MG CAPSULE|100|EA|.22682|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.20994|03/29/2022|.2049|03/29/2022|.20626|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7287|||||No|No||NORTHSTAR RX LL|No||||
cefadroxil|No|No|No|No|75%|16714038901|CEFADROXIL 250 MG/5 ML SUSP|100|ML|.20915|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.1834|09/28/2021|.17899|09/28/2021|.18019|09/28/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7288|||||No|No||NORTHSTAR RX LL|No||||
cefadroxil|No|No|No|No|75%|16714039001|CEFADROXIL 500 MG/5 ML SUSP|75|ML|.28953|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.65986|11/23/2021|.65043|11/23/2021|.61946|11/23/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7289|||||No|No||NORTHSTAR RX LL|No||||
cefadroxil|No|No|No|No|75%|16714039002|CEFADROXIL 500 MG/5 ML SUSP|100|ML|.28956|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.25492|01/25/2022|.2488|01/25/2022|.25045|01/25/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7290|||||No|No||NORTHSTAR RX LL|No||||
cefdinir|No|No|No|No|75%|16714039101|CEFDINIR 300 MG CAPSULE|30|EA|.66291|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.46443|03/29/2022|.45328|03/29/2022|.4563|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7291|||||No|No||NORTHSTAR RX LL|No||||
cefdinir|No|No|No|No|75%|16714039102|CEFDINIR 300 MG CAPSULE|60|EA|.66284|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.46443|03/29/2022|.45328|03/29/2022|.4563|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7292|||||No|No||NORTHSTAR RX LL|No||||
cefdinir|No|No|No|No|75%|16714039201|CEFDINIR 125 MG/5 ML SUSP|60|ML|.20374|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.15822|03/29/2022|.15442|03/29/2022|.15545|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7293|||||No|No||NORTHSTAR RX LL|No||||
cefdinir|No|No|No|No|75%|16714039202|CEFDINIR 125 MG/5 ML SUSP|100|ML|.15471|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.11292|03/29/2022|.1102|03/29/2022|.11094|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7294|||||No|No||NORTHSTAR RX LL|No||||
cefdinir|No|No|No|No|75%|16714039301|CEFDINIR 250 MG/5 ML SUSP|60|ML|.28988|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.18029|03/29/2022|.17596|03/29/2022|.17713|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7295|||||No|No||NORTHSTAR RX LL|No||||
cefdinir|No|No|No|No|75%|16714039302|CEFDINIR 250 MG/5 ML SUSP|100|ML|.26982|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.18689|03/29/2022|.1824|03/29/2022|.18361|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7296|||||No|No||NORTHSTAR RX LL|No||||
cefpodoxime proxetil|No|No|No|No|75%|16714039401|CEFPODOXIME 100 MG TABLET|20|EA|2.3177|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|046|No|2.53516|03/29/2022|2.47431|03/29/2022|2.49079|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7297|||||No|No||NORTHSTAR RX LL|No||||
cefpodoxime proxetil|No|No|No|No|75%|16714039501|CEFPODOXIME 200 MG TABLET|20|EA|2.90916|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|046|No|3.01774|03/29/2022|2.94531|03/29/2022|2.96492|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7298|||||No|No||NORTHSTAR RX LL|No||||
cefprozil|No|No|No|No|75%|16714039601|CEFPROZIL 125 MG/5 ML SUSP|50|ML|.1351|09/26/2016||Yes|No||09/26/2016||Yes|No|09/26/2016||Yes|No||||No|No|||Prescription required|No||046|No|.23632|01/25/2022|.23064|01/25/2022|.23218|01/25/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7299|||||No|No||NORTHSTAR RX LL|No||||
cefprozil|No|No|No|No|75%|16714039602|CEFPROZIL 125 MG/5 ML SUSP|75|ML|.13335|09/26/2016||Yes|No||09/26/2016||Yes|No|09/26/2016||Yes|No||||No|No|||Prescription required|No||046|No|.30392|03/21/2017|.29958|03/21/2017|.28531|03/21/2017|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7300|||||No|No||NORTHSTAR RX LL|No||||
cefprozil|No|No|No|No|75%|16714039603|CEFPROZIL 125 MG/5 ML SUSP|100|ML|.12981|09/26/2016||Yes|No||09/26/2016||Yes|No|09/26/2016||Yes|No||||No|No|||Prescription required|No||046|No|.09872|03/01/2022|.09635|03/01/2022|.09699|03/01/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7301|||||No|No||NORTHSTAR RX LL|No||||
cefprozil|No|No|No|No|75%|16714039701|CEFPROZIL 250 MG/5 ML SUSP|50|ML|.25129|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.3239|03/01/2022|.31612|03/01/2022|.31823|03/01/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7302|||||No|No||NORTHSTAR RX LL|No||||
cefprozil|No|No|No|No|75%|16714039702|CEFPROZIL 250 MG/5 ML SUSP|75|ML|.24446|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.22915|03/29/2022|.22365|03/29/2022|.22513|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7303|||||No|No||NORTHSTAR RX LL|No||||
cefprozil|No|No|No|No|75%|16714039703|CEFPROZIL 250 MG/5 ML SUSP|100|ML|.23551|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.21431|03/29/2022|.20916|03/29/2022|.21055|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7304|||||No|No||NORTHSTAR RX LL|No||||
cefprozil|No|No|No|No|75%|16714039801|CEFPROZIL 250 MG TABLET|100|EA|.96277|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.65626|11/23/2021|.6405|11/23/2021|.64477|11/23/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7305|||||No|No||NORTHSTAR RX LL|No||||
cefprozil|No|No|No|No|75%|16714039901|CEFPROZIL 500 MG TABLET|50|EA|2.03063|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|1.02667|03/29/2022|1.00202|03/29/2022|1.0087|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7306|||||No|No||NORTHSTAR RX LL|No||||
cefuroxime axetil|No|No|No|No|75%|16714040001|CEFUROXIME AXETIL 250 MG TAB|20|EA|.72756|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.36264|03/29/2022|.35393|03/29/2022|.35629|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7307|||||No|No||NORTHSTAR RX LL|No||||
cefuroxime axetil|No|No|No|No|75%|16714040002|CEFUROXIME AXETIL 250 MG TAB|60|EA|.69215|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.36264|03/29/2022|.35393|03/29/2022|.35629|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7308|||||No|No||NORTHSTAR RX LL|No||||
cefuroxime axetil|No|No|No|No|75%|16714040101|CEFUROXIME AXETIL 500 MG TAB|20|EA|1.42287|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.56985|03/29/2022|.55617|03/29/2022|.55987|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7309|||||No|No||NORTHSTAR RX LL|No||||
cefuroxime axetil|No|No|No|No|75%|16714040102|CEFUROXIME AXETIL 500 MG TAB|60|EA|1.35643|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||046|No|.56985|03/29/2022|.55617|03/29/2022|.55987|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7310|||||No|No||NORTHSTAR RX LL|No||||
cefpodoxime proxetil|No|No|No|No|75%|16714040201|CEFPODOXIME 50 MG/5 ML SUSP|50|ML|.29644|09/26/2016||Yes|No||09/26/2016||Yes|No|09/26/2016||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|046|No|.67561|03/21/2017|.66596|03/21/2017|.63424|03/21/2017|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7311|||||No|No||NORTHSTAR RX LL|No||||
cefpodoxime proxetil|No|No|No|No|75%|16714040202|CEFPODOXIME 50 MG/5 ML SUSP|100|ML|.29639|09/26/2016||Yes|No||09/26/2016||Yes|No|09/26/2016||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|046|No|.67551|06/01/2016|.66586|06/01/2016|.63415|06/01/2016|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7312|||||No|No||NORTHSTAR RX LL|No||||
cefpodoxime proxetil|No|No|No|No|75%|16714040301|CEFPODOXIME 100 MG/5 ML SUSP|50|ML|.59279|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|046|No|1.35102|06/01/2016|1.33172|06/01/2016|1.26831|06/01/2016|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7313|||||No|No||NORTHSTAR RX LL|No||||
cefpodoxime proxetil|No|No|No|No|75%|16714040302|CEFPODOXIME 100 MG/5 ML SUSP|100|ML|.56398|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|046|No|1.28536|02/27/2018|1.267|02/27/2018|1.20667|02/27/2018|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7314|||||No|No||NORTHSTAR RX LL|No||||
desog-e.estradiol/e.estradiol|Yes|Yes|No|No|75%|16714040401|PIMTREA 28 DAY TABLET|28|EA|.66296|10/07/2013||Yes|No||10/07/2013||Yes|No|10/07/2013||Yes|No|Refer to program requirements|||No|No|10/07/2013||Prescription required|No|||No|.21935|03/29/2022|.21408|03/29/2022|.21551|03/29/2022||||7315|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
desog-e.estradiol/e.estradiol|Yes|Yes|No|No|75%|16714040404|PIMTREA 28 DAY TABLET|28|EA|.66299|10/07/2013||Yes|No||10/07/2013||Yes|No|10/07/2013||Yes|No|Refer to program requirements|||No|No|10/07/2013||Prescription required|No|||No|.21935|03/29/2022|.21408|03/29/2022|.21551|03/29/2022||||7316|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|16714040501|LARIN FE 1.5-30 TABLET|28|EA|.33002|10/14/2013||Yes|No||10/14/2013||Yes|No|10/14/2013||Yes|No|Refer to program requirements|||No|No|10/14/2013||Prescription required|No|||No|.28591|03/29/2022|.27904|03/29/2022|.2809|03/29/2022||||7317|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|16714040504|LARIN FE 1.5-30 TABLET|28|EA|.33004|10/14/2013||Yes|No||10/14/2013||Yes|No|10/14/2013||Yes|No|Refer to program requirements|||No|No|10/14/2013||Prescription required|No|||No|.28591|03/29/2022|.27904|03/29/2022|.2809|03/29/2022||||7318|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|16714040601|LARIN FE 1-20 TABLET|28|EA|.33002|10/14/2013||Yes|No||10/14/2013||Yes|No|10/14/2013||Yes|No|Refer to program requirements|||No|No|10/14/2013||Prescription required|No|||No|.20374|03/29/2022|.19885|03/29/2022|.20017|03/29/2022||||7319|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|16714040604|LARIN FE 1-20 TABLET|28|EA|.33004|10/14/2013||Yes|No||10/14/2013||Yes|No|10/14/2013||Yes|No|Refer to program requirements|||No|No|10/14/2013||Prescription required|No|||No|.20374|03/29/2022|.19885|03/29/2022|.20017|03/29/2022||||7320|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone ac-eth estradiol|Yes|Yes|No|No|75%|16714040701|LARIN 1.5 MG-30 MCG TABLET|21|EA|.44003|10/07/2014||Yes|No||10/07/2014||Yes|No|10/07/2014||Yes|No|Refer to program requirements|||No|No|10/07/2014||Prescription required|No|||No|.56037|03/29/2022|.54692|03/29/2022|.55056|03/29/2022||||7321|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone ac-eth estradiol|Yes|Yes|No|No|75%|16714040703|LARIN 1.5 MG-30 MCG TABLET|21|EA|.4401|10/07/2014||Yes|No||10/07/2014||Yes|No|10/07/2014||Yes|No|Refer to program requirements|||No|No|10/07/2014||Prescription required|No|||No|.56037|03/29/2022|.54692|03/29/2022|.55056|03/29/2022||||7322|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone ac-eth estradiol|Yes|Yes|No|No|75%|16714040801|LARIN 21 1-20 TABLET|21|EA|.44023|10/10/2014||Yes|No||10/10/2014||Yes|No|10/10/2014||Yes|No|Refer to program requirements|||No|No|10/10/2014||Prescription required|No|||No|.29153|03/29/2022|.28453|03/29/2022|.28642|03/29/2022||||7323|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone ac-eth estradiol|Yes|Yes|No|No|75%|16714040803|LARIN 21 1-20 TABLET|21|EA|.2169|10/10/2014||Yes|No||10/10/2014||Yes|No|10/10/2014||Yes|No|Refer to program requirements|||No|No|10/10/2014||Prescription required|No|||No|.29153|03/29/2022|.28453|03/29/2022|.28642|03/29/2022||||7324|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|16714041601|LARIN 24 FE 1 MG-20 MCG TABLET|28|EA|1.10003|07/21/2016||Yes|No||07/21/2016||Yes|No|07/21/2016||Yes|No|Refer to program requirements|||No|No|07/21/2016||Prescription required|No|||No|.56858|03/29/2022|.55493|03/29/2022|.55862|03/29/2022||||7325|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|16714041603|LARIN 24 FE 1 MG-20 MCG TABLET|28|EA|.68451|07/21/2016||Yes|No||07/21/2016||Yes|No|07/21/2016||Yes|No|Refer to program requirements|||No|No|07/21/2016||Prescription required|No|||No|.56858|03/29/2022|.55493|03/29/2022|.55862|03/29/2022||||7326|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
nitrofurantoin monohyd/m-cryst|No|No|No|No|75%|16714043901|NITROFURANTOIN MONO-MCR 100 MG|100|EA|.67613|11/07/2014||Yes|No||11/07/2014||Yes|No|11/07/2014||Yes|No||||No|No|||Prescription required|No|||No|.48495|03/29/2022|.47331|03/29/2022|.47646|03/29/2022||||7327|||||No|No||NORTHSTAR RX LL|No||||
norethindrone|Yes|Yes|No|No|75%|16714044001|DEBLITANE 0.35 MG TABLET|28|EA|.38223|10/21/2014||Yes|No||10/21/2014||Yes|No|10/21/2014||Yes|No|Refer to program requirements|||No|No|10/21/2014||Prescription required|No|||No|.16123|03/29/2022|.15736|03/29/2022|.1584|03/29/2022||||7328|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone|Yes|Yes|No|No|75%|16714044004|DEBLITANE 0.35 MG TABLET|28|EA|.38216|10/21/2014||Yes|No||10/21/2014||Yes|No|10/21/2014||Yes|No|Refer to program requirements|||No|No|10/21/2014||Prescription required|No|||No|.16123|03/29/2022|.15736|03/29/2022|.1584|03/29/2022||||7329|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone|Yes|Yes|No|No|75%|16714044101|SHAROBEL 0.35 MG TABLET|28|EA|.38223|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No|Refer to program requirements|||No|No|11/17/2014||Prescription required|No|||No|.16123|03/29/2022|.15736|03/29/2022|.1584|03/29/2022||||7330|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone|Yes|Yes|No|No|75%|16714044104|SHAROBEL 0.35 MG TABLET|28|EA|.38216|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No|Refer to program requirements|||No|No|11/17/2014||Prescription required|No|||No|.16123|03/29/2022|.15736|03/29/2022|.1584|03/29/2022||||7331|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
enalapril maleate|Yes|No|No|No|75%|16714044201|ENALAPRIL MALEATE 2.5 MG TAB|100|EA|.16821|11/10/2015||Yes|No||11/10/2015||Yes|No|11/10/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.11585|03/29/2022|.11306|03/29/2022|.11382|03/29/2022|||ANGIOTENSIN MODULATORS|7332|||||No|No||NORTHSTAR RX LL|No||||
enalapril maleate|Yes|No|No|No|75%|16714044202|ENALAPRIL MALEATE 2.5 MG TAB|1000|EA|.17737|11/10/2015||Yes|No||11/10/2015||Yes|No|11/10/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.11585|03/29/2022|.11306|03/29/2022|.11382|03/29/2022|||ANGIOTENSIN MODULATORS|7333|||||No|No||NORTHSTAR RX LL|No||||
enalapril maleate|Yes|No|No|No|75%|16714044301|ENALAPRIL MALEATE 5 MG TABLET|100|EA|.21315|11/10/2015||Yes|No||11/10/2015||Yes|No|11/10/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.15947|03/29/2022|.15564|03/29/2022|.15667|03/29/2022|||ANGIOTENSIN MODULATORS|7334|||||No|No||NORTHSTAR RX LL|No||||
enalapril maleate|Yes|No|No|No|75%|16714044302|ENALAPRIL MALEATE 5 MG TABLET|1000|EA|.19675|11/10/2015||Yes|No||11/10/2015||Yes|No|11/10/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.15947|03/29/2022|.15564|03/29/2022|.15667|03/29/2022|||ANGIOTENSIN MODULATORS|7335|||||No|No||NORTHSTAR RX LL|No||||
enalapril maleate|Yes|No|No|No|75%|16714044401|ENALAPRIL MALEATE 10 MG TAB|100|EA|.21977|11/10/2015||Yes|No||11/10/2015||Yes|No|11/10/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.11378|03/29/2022|.11104|03/29/2022|.11178|03/29/2022|||ANGIOTENSIN MODULATORS|7336|||||No|No||NORTHSTAR RX LL|No||||
enalapril maleate|Yes|No|No|No|75%|16714044402|ENALAPRIL MALEATE 10 MG TAB|1000|EA|.20689|11/10/2015||Yes|No||11/10/2015||Yes|No|11/10/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.11378|03/29/2022|.11104|03/29/2022|.11178|03/29/2022|||ANGIOTENSIN MODULATORS|7337|||||No|No||NORTHSTAR RX LL|No||||
enalapril maleate|Yes|No|No|No|75%|16714044501|ENALAPRIL MALEATE 20 MG TAB|100|EA|.31347|11/10/2015||Yes|No||11/10/2015||Yes|No|11/10/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.14625|03/29/2022|.14274|03/29/2022|.14369|03/29/2022|||ANGIOTENSIN MODULATORS|7338|||||No|No||NORTHSTAR RX LL|No||||
enalapril maleate|Yes|No|No|No|75%|16714044502|ENALAPRIL MALEATE 20 MG TAB|1000|EA|.29607|11/10/2015||Yes|No||11/10/2015||Yes|No|11/10/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.14625|03/29/2022|.14274|03/29/2022|.14369|03/29/2022|||ANGIOTENSIN MODULATORS|7339|||||No|No||NORTHSTAR RX LL|No||||
amitriptyline HCl|No|No|No|No|75%|16714044601|AMITRIPTYLINE HCL 10 MG TAB|100|EA|.06153|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||215|No|.04811|03/29/2022|.04695|03/29/2022|.04726|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7340|||||No|No||NORTHSTAR RX LL|No||||
amitriptyline HCl|No|No|No|No|75%|16714044602|AMITRIPTYLINE HCL 10 MG TAB|1000|EA|.05878|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||215|No|.04811|03/29/2022|.04695|03/29/2022|.04726|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7341|||||No|No||NORTHSTAR RX LL|No||||
amitriptyline HCl|No|No|No|No|75%|16714044701|AMITRIPTYLINE HCL 25 MG TAB|100|EA|.12306|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||215|No|.07343|03/29/2022|.07166|03/29/2022|.07214|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7342|||||No|No||NORTHSTAR RX LL|No||||
amitriptyline HCl|No|No|No|No|75%|16714044702|AMITRIPTYLINE HCL 25 MG TAB|1000|EA|.12115|05/12/2015|02/28/2023|Yes|No||05/12/2015|02/28/2023|Yes|No|05/12/2015|02/28/2023|Yes|No||||No|No|||Prescription required|No||215|No|.07343|03/29/2022|.07166|03/29/2022|.07214|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7343|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
amitriptyline HCl|No|No|No|No|75%|16714044801|AMITRIPTYLINE HCL 50 MG TAB|100|EA|.24574|05/12/2015|05/31/2024|Yes|No||05/12/2015|05/31/2024|Yes|No|05/12/2015|05/31/2024|Yes|No||||No|No|||Prescription required|No||215|No|.14797|03/29/2022|.14441|03/29/2022|.14538|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7344|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
amitriptyline HCl|No|No|No|No|75%|16714044802|AMITRIPTYLINE HCL 50 MG TAB|1000|EA|.23264|01/01/2021|05/31/2024|Yes|No||01/01/2021|05/31/2024|Yes|No|01/01/2021|05/31/2024|Yes|No||||No|No|||Prescription required|No||215|No|.14797|03/29/2022|.14441|03/29/2022|.14538|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7345|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
amitriptyline HCl|No|No|No|No|75%|16714044901|AMITRIPTYLINE HCL 75 MG TAB|100|EA|.36919|05/12/2015|10/31/2023|Yes|No||05/12/2015|10/31/2023|Yes|No|05/12/2015|10/31/2023|Yes|No||||No|No|||Prescription required|No||215|No|.26194|03/29/2022|.25565|03/29/2022|.25735|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7346|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
amitriptyline HCl|No|No|No|No|75%|16714045001|AMITRIPTYLINE HCL 100 MG TAB|100|EA|.49149|05/12/2015|05/31/2024|Yes|No||05/12/2015|05/31/2024|Yes|No|05/12/2015|05/31/2024|Yes|No||||No|No|||Prescription required|No||215|No|.30607|03/29/2022|.29872|03/29/2022|.30071|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7347|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
amitriptyline HCl|No|No|No|No|75%|16714045101|AMITRIPTYLINE HCL 150 MG TAB|100|EA|.73714|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||215|No|.58201|03/29/2022|.56804|03/29/2022|.57182|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7348|||||No|No||NORTHSTAR RX LL|No||||
quetiapine fumarate|No|No|No|No|75%|16714045201|QUETIAPINE FUMARATE 25 MG TAB|100|EA|.07748|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.03239|03/29/2022|.03161|03/29/2022|.03182|03/29/2022|||ANTIPSYCHOTICS|7349|||||No|No||NORTHSTAR RX LL|No||||
quetiapine fumarate|No|No|No|No|75%|16714045202|QUETIAPINE FUMARATE 25 MG TAB|1000|EA|.06529|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.03239|03/29/2022|.03161|03/29/2022|.03182|03/29/2022|||ANTIPSYCHOTICS|7350|||||No|No||NORTHSTAR RX LL|No||||
quetiapine fumarate|No|No|No|No|75%|16714045301|QUETIAPINE FUMARATE 50 MG TAB|100|EA|.15897|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.04283|03/29/2022|.0418|03/29/2022|.04208|03/29/2022|||ANTIPSYCHOTICS|7351|||||No|No||NORTHSTAR RX LL|No||||
quetiapine fumarate|No|No|No|No|75%|16714045302|QUETIAPINE FUMARATE 50 MG TAB|1000|EA|.09729|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.04283|03/29/2022|.0418|03/29/2022|.04208|03/29/2022|||ANTIPSYCHOTICS|7352|||||No|No||NORTHSTAR RX LL|No||||
quetiapine fumarate|No|No|No|No|75%|16714045401|QUETIAPINE FUMARATE 100 MG TAB|100|EA|.12216|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.05826|03/29/2022|.05686|03/29/2022|.05724|03/29/2022|||ANTIPSYCHOTICS|7353|||||No|No||NORTHSTAR RX LL|No||||
quetiapine fumarate|No|No|No|No|75%|16714045402|QUETIAPINE FUMARATE 100 MG TAB|1000|EA|.10669|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.05826|03/29/2022|.05686|03/29/2022|.05724|03/29/2022|||ANTIPSYCHOTICS|7354|||||No|No||NORTHSTAR RX LL|No||||
quetiapine fumarate|No|No|No|No|75%|16714045501|QUETIAPINE FUMARATE 200 MG TAB|100|EA|.27773|06/21/2021||Yes|No||06/21/2021||Yes|No|06/21/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.10261|03/29/2022|.10014|03/29/2022|.10081|03/29/2022|||ANTIPSYCHOTICS|7355|||||No|No||NORTHSTAR RX LL|No||||
quetiapine fumarate|No|No|No|No|75%|16714045601|QUETIAPINE FUMARATE 300 MG TAB|100|EA|.57663|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.13964|03/29/2022|.13628|03/29/2022|.13719|03/29/2022|||ANTIPSYCHOTICS|7356|||||No|No||NORTHSTAR RX LL|No||||
quetiapine fumarate|No|No|No|No|75%|16714045701|QUETIAPINE FUMARATE 400 MG TAB|100|EA|.40015|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.17858|03/29/2022|.17429|03/29/2022|.17545|03/29/2022|||ANTIPSYCHOTICS|7357|||||No|No||NORTHSTAR RX LL|No||||
desogestrel-ethinyl estradiol|Yes|Yes|No|No|75%|16714046404|JULEBER 28 DAY TABLET|28|EA|.31499|10/19/2015||Yes|No||10/19/2015||Yes|No|10/19/2015||Yes|No|Refer to program requirements|||No|No|10/19/2015||Prescription required|No|||No|.18364|03/29/2022|.17923|03/29/2022|.18042|03/29/2022||||7358|||||No|No||NORTHSTAR RX LL|No|||Only covered for non-contraceptive (medical) purposes|
capecitabine|No|No|No|No|75%|16714046701|CAPECITABINE 150 MG TABLET|60|EA|2.59863|03/28/2016||Yes|No||03/28/2016||Yes|No|03/28/2016||Yes|No||||No|No|||Prescription required|No||502|No|5.92246|11/07/2017|5.83785|11/07/2017|5.55986|11/07/2017|||ONCOLOGY: ORAL - BREAST|7359|||||No|No||NORTHSTAR RX LL|No||||
capecitabine|No|No|No|No|75%|16714046801|CAPECITABINE 500 MG TABLET|120|EA|6.61518|03/28/2016||Yes|No||03/28/2016||Yes|No|03/28/2016||Yes|No||||No|No|||Prescription required|No||502|No|.61977|12/28/2021|.60489|12/28/2021|.60892|12/28/2021|||ONCOLOGY: ORAL - BREAST|7360|||||No|No||NORTHSTAR RX LL|No||||
amoxicillin/potassium clav|No|No|No|No|75%|16714047601|AMOX-CLAV 250-125 MG TABLET|30|EA|2.04063|11/30/2015||Yes|No||11/30/2015||Yes|No|11/30/2015||Yes|No||||No|No|||Prescription required|No||046|No|2.34666|03/29/2022|2.29034|03/29/2022|2.30559|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7361|||||No|No||NORTHSTAR RX LL|No||||
amoxicillin/potassium clav|No|No|No|No|75%|16714047701|AMOX-CLAV 500-125 MG TABLET|20|EA|.27756|03/04/2021||Yes|No||03/04/2021||Yes|No|03/04/2021||Yes|No||||No|No|||Prescription required|No||046|No|.31268|03/29/2022|.30517|03/29/2022|.3072|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7362|||||No|No||NORTHSTAR RX LL|No||||
amoxicillin/potassium clav|No|No|No|No|75%|16714047801|AMOX-CLAV 875-125 MG TABLET|20|EA|.38979|09/15/2016|04/30/2022|Yes|No||09/15/2016|04/30/2022|Yes|No|09/15/2016|04/30/2022|Yes|No||||No|No|||Prescription required|No||046|No|.32484|03/29/2022|.31704|03/29/2022|.31915|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7363|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
amoxicillin/potassium clav|No|No|No|No|75%|16714047802|AMOX-CLAV 875-125 MG TABLET|100|EA|.64736|11/30/2015||Yes|No||11/30/2015||Yes|No|11/30/2015||Yes|No||||No|No|||Prescription required|No||046|No|.32484|03/29/2022|.31704|03/29/2022|.31915|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7364|||||No|No||NORTHSTAR RX LL|No||||
clindamycin palmitate HCl|No|No|No|No|75%|16714048301|CLINDAMYCIN (PEDI) 75 MG/5 ML|100|ML|.2039|06/22/2016||Yes|No||06/22/2016||Yes|No|06/22/2016||Yes|No||||No|No|||Prescription required|No||146|No|.19356|03/29/2022|.18891|03/29/2022|.19017|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|7365|||||No|No||NORTHSTAR RX LL|No||||
divalproex sodium|No|No|No|No|75%|16714048401|DIVALPROEX SOD ER 250 MG TAB|100|EA|.16348|06/22/2016||Yes|No||06/22/2016||Yes|No|06/22/2016||Yes|No||||No|No|||Prescription required|No||056|Yes|.17839|03/29/2022|.1741|03/29/2022|.17526|03/29/2022|||ANTICONVULSANTS|7366|||||No|No||NORTHSTAR RX LL|No||||
divalproex sodium|No|No|No|No|75%|16714048402|DIVALPROEX SOD ER 250 MG TAB|500|EA|.19045|06/17/2021||Yes|No||06/17/2021||Yes|No|06/17/2021||Yes|No||||No|No|||Prescription required|No||056|Yes|.17839|03/29/2022|.1741|03/29/2022|.17526|03/29/2022|||ANTICONVULSANTS|7367|||||No|No||NORTHSTAR RX LL|No||||
divalproex sodium|No|No|No|No|75%|16714048501|DIVALPROEX SOD ER 500 MG TAB|100|EA|.24127|06/22/2016||Yes|No||06/22/2016||Yes|No|06/22/2016||Yes|No||||No|No|||Prescription required|No||056|No|.21008|03/29/2022|.20503|03/29/2022|.2064|03/29/2022|||ANTICONVULSANTS|7368|||||No|No||NORTHSTAR RX LL|No||||
divalproex sodium|No|No|No|No|75%|16714048502|DIVALPROEX SOD ER 500 MG TAB|500|EA|.22218|06/22/2016||Yes|No||06/22/2016||Yes|No|06/22/2016||Yes|No||||No|No|||Prescription required|No||056|No|.21008|03/29/2022|.20503|03/29/2022|.2064|03/29/2022|||ANTICONVULSANTS|7369|||||No|No||NORTHSTAR RX LL|No||||
amoxicillin/potassium clav|No|No|No|No|75%|16714049401|AMOX-CLAV 500-125 MG TABLET|20|EA|.27756|06/30/2016|04/30/2022|Yes|No||06/30/2016|04/30/2022|Yes|No|06/30/2016|04/30/2022|Yes|No||||No|No|||Prescription required|No||046|No|.31268|03/29/2022|.30517|03/29/2022|.3072|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7370|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
clotrimazole/betamethasone dip|No|No|No|No|75%|16714049601|CLOTRIMAZOLE-BETAMETHASONE CRM|15|GM|.62808|02/15/2017||Yes|No||02/15/2017||Yes|No|02/15/2017||Yes|No||||No|No|||Prescription required|No||061|No|.25272|03/29/2022|.24665|03/29/2022|.24829|03/29/2022|||ANTIFUNGALS: TOPICAL|7371|||||No|No||NORTHSTAR RX LL|No||||
clotrimazole/betamethasone dip|No|No|No|No|75%|16714049602|CLOTRIMAZOLE-BETAMETHASONE CRM|45|GM|.37868|02/15/2017||Yes|No||02/15/2017||Yes|No|02/15/2017||Yes|No||||No|No|||Prescription required|No||061|No|.17393|03/29/2022|.16975|03/29/2022|.17088|03/29/2022|||ANTIFUNGALS: TOPICAL|7372|||||No|No||NORTHSTAR RX LL|No||||
etodolac|No|No|No|No|75%|16714049701|ETODOLAC ER 400 MG TABLET|60|EA|1.01795|02/15/2017||Yes|No||02/15/2017||Yes|No|02/15/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|1.74706|03/01/2022|1.70513|03/01/2022|1.71648|03/01/2022|||NSAIDS|7373|||||No|No||NORTHSTAR RX LL|No||||
etodolac|No|No|No|No|75%|16714049702|ETODOLAC ER 400 MG TABLET|100|EA|.99437|02/15/2017||Yes|No||02/15/2017||Yes|No|02/15/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|1.74706|03/01/2022|1.70513|03/01/2022|1.71648|03/01/2022|||NSAIDS|7374|||||No|No||NORTHSTAR RX LL|No||||
etodolac|No|No|No|No|75%|16714049801|ETODOLAC ER 500 MG TABLET|60|EA|1.08145|02/15/2017||Yes|No||02/15/2017||Yes|No|02/15/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|1.39968|03/29/2022|1.36608|03/29/2022|1.37518|03/29/2022|||NSAIDS|7375|||||No|No||NORTHSTAR RX LL|No||||
etodolac|No|No|No|No|75%|16714049802|ETODOLAC ER 500 MG TABLET|100|EA|1.05749|02/15/2017||Yes|No||02/15/2017||Yes|No|02/15/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|1.39968|03/29/2022|1.36608|03/29/2022|1.37518|03/29/2022|||NSAIDS|7376|||||No|No||NORTHSTAR RX LL|No||||
etodolac|No|No|No|No|75%|16714049901|ETODOLAC ER 600 MG TABLET|60|EA|1.14881|02/15/2017||Yes|No||02/15/2017||Yes|No|02/15/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|2.61822|06/29/2021|2.58082|06/29/2021|2.45792|06/29/2021|||NSAIDS|7377|||||No|No||NORTHSTAR RX LL|No||||
etodolac|No|No|No|No|75%|16714049902|ETODOLAC ER 600 MG TABLET|100|EA|1.12629|02/15/2017||Yes|No||02/15/2017||Yes|No|02/15/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|2.56691|06/29/2021|2.53024|06/29/2021|2.40975|06/29/2021|||NSAIDS|7378|||||No|No||NORTHSTAR RX LL|No||||
fluocinonide|No|No|No|No|75%|16714050201|FLUOCINONIDE 0.05% OINTMENT|15|GM|1.59329|03/07/2017|04/30/2022|Yes|No||03/07/2017|04/30/2022|Yes|No|03/07/2017|04/30/2022|Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.57506|03/29/2022|.56125|03/29/2022|.56499|03/29/2022|||STEROIDS: TOPICAL HIGH|7379|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
fluocinonide|No|No|No|No|75%|16714050202|FLUOCINONIDE 0.05% OINTMENT|30|GM|1.59343|03/07/2017|04/30/2022|Yes|No||03/07/2017|04/30/2022|Yes|No|03/07/2017|04/30/2022|Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.36243|03/29/2022|.35373|03/29/2022|.35608|03/29/2022|||STEROIDS: TOPICAL HIGH|7380|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
fluocinonide|No|No|No|No|75%|16714050203|FLUOCINONIDE 0.05% OINTMENT|60|GM|1.5667|03/07/2017|04/30/2022|Yes|No||03/07/2017|04/30/2022|Yes|No|03/07/2017|04/30/2022|Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.32783|03/29/2022|.31996|03/29/2022|.32209|03/29/2022|||STEROIDS: TOPICAL HIGH|7381|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
carisoprodol|No|No|No|No|90%|16714051001|CARISOPRODOL 350 MG TABLET|100|EA|.04067|06/15/2021|02/29/2024|Yes|No||06/15/2021|02/29/2024|Yes|No|06/15/2021|02/29/2024|Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|7382|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
digoxin|No|No|No|No|75%|16714059001|DIGOXIN 0.125 MG TABLET|100|EA|.50955|02/15/2017||Yes|No||02/15/2017||Yes|No|02/15/2017||Yes|No||||No|No|||Prescription required|No|||No|.25031|03/29/2022|.2443|03/29/2022|.24592|03/29/2022||||7383|||||No|No||NORTHSTAR RX LL|Yes|09/01/2020|||
digoxin|No|No|No|No|75%|16714059002|DIGOXIN 0.125 MG TABLET|1000|EA|.42548|02/15/2017||Yes|No||02/15/2017||Yes|No|02/15/2017||Yes|No||||No|No|||Prescription required|No|||No|.25031|03/29/2022|.2443|03/29/2022|.24592|03/29/2022||||7384|||||No|No||NORTHSTAR RX LL|No||||
digoxin|No|No|No|No|75%|16714059101|DIGOXIN 0.25 MG TABLET|100|EA|.50955|02/15/2017||Yes|No||02/15/2017||Yes|No|02/15/2017||Yes|No||||No|No|||Prescription required|No|||No|.22254|03/29/2022|.21719|03/29/2022|.21864|03/29/2022||||7385|||||No|No||NORTHSTAR RX LL|No||||
digoxin|No|No|No|No|75%|16714059102|DIGOXIN 0.25 MG TABLET|1000|EA|.42548|02/15/2017||Yes|No||02/15/2017||Yes|No|02/15/2017||Yes|No||||No|No|||Prescription required|No|||No|.22254|03/29/2022|.21719|03/29/2022|.21864|03/29/2022||||7386|||||No|No||NORTHSTAR RX LL|No||||
sertraline HCl|Yes|No|No|No|75%|16714060102|SERTRALINE 20 MG/ML ORAL CONC|60|ML|.40068|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||008|No|.67787|03/29/2022|.6616|03/29/2022|.666|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7387|||||No|No||NORTHSTAR RX LL|No||||
sertraline HCl|Yes|No|No|No|75%|16714061101|SERTRALINE HCL 25 MG TABLET|30|EA|.06507|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||008|Yes|.05057|03/29/2022|.04935|03/29/2022|.04968|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7388|||||No|No||NORTHSTAR RX LL|No||||
sertraline HCl|Yes|No|No|No|75%|16714061104|SERTRALINE HCL 25 MG TABLET|100|EA|.05293|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||008|Yes|.05057|03/29/2022|.04935|03/29/2022|.04968|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7389|||||No|No||NORTHSTAR RX LL|No||||
sertraline HCl|Yes|No|No|No|75%|16714061105|SERTRALINE HCL 25 MG TABLET|500|EA|.03231|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||008|Yes|.05057|03/29/2022|.04935|03/29/2022|.04968|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7390|||||No|No||NORTHSTAR RX LL|No||||
sertraline HCl|Yes|No|No|No|75%|16714061106|SERTRALINE HCL 25 MG TABLET|1000|EA|.03231|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||008|Yes|.05057|03/29/2022|.04935|03/29/2022|.04968|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7391|||||No|No||NORTHSTAR RX LL|No||||
sertraline HCl|Yes|No|No|No|75%|16714061201|SERTRALINE HCL 50 MG TABLET|30|EA|.06134|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||008|Yes|.04281|03/29/2022|.04178|03/29/2022|.04206|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7392|||||No|No||NORTHSTAR RX LL|No||||
sertraline HCl|Yes|No|No|No|75%|16714061204|SERTRALINE HCL 50 MG TABLET|100|EA|.05688|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||008|Yes|.04281|03/29/2022|.04178|03/29/2022|.04206|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7393|||||No|No||NORTHSTAR RX LL|No||||
sertraline HCl|Yes|No|No|No|75%|16714061205|SERTRALINE HCL 50 MG TABLET|500|EA|.04637|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||008|Yes|.04281|03/29/2022|.04178|03/29/2022|.04206|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7394|||||No|No||NORTHSTAR RX LL|No||||
sertraline HCl|Yes|No|No|No|75%|16714061206|SERTRALINE HCL 50 MG TABLET|1000|EA|.04638|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||008|Yes|.04281|03/29/2022|.04178|03/29/2022|.04206|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7395|||||No|No||NORTHSTAR RX LL|No||||
sertraline HCl|Yes|No|No|No|75%|16714061301|SERTRALINE HCL 100 MG TABLET|30|EA|.04873|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7396|||||No|No||NORTHSTAR RX LL|No||||
sertraline HCl|Yes|No|No|No|75%|16714061304|SERTRALINE HCL 100 MG TABLET|100|EA|.04966|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7397|||||No|No||NORTHSTAR RX LL|No||||
sertraline HCl|Yes|No|No|No|75%|16714061305|SERTRALINE HCL 100 MG TABLET|500|EA|.05437|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7398|||||No|No||NORTHSTAR RX LL|No||||
sertraline HCl|Yes|No|No|No|75%|16714061306|SERTRALINE HCL 100 MG TABLET|1000|EA|.05437|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7399|||||No|No||NORTHSTAR RX LL|No||||
famciclovir|No|No|No|No|75%|16714061401|FAMCICLOVIR 125 MG TABLET|30|EA|.29125|05/17/2017|03/31/2022|Yes|No||05/17/2017|03/31/2022|Yes|No|05/17/2017|03/31/2022|Yes|No||||No|No|||Prescription required|No||025|No|.30813|10/26/2021|.30073|10/26/2021|.30273|10/26/2021|||ANTIVIRALS: ORAL|7400|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
famciclovir|Yes|No|No|No|75%|16714061501|FAMCICLOVIR 250 MG TABLET|30|EA|.56745|05/17/2017|03/31/2022|Yes|No||05/17/2017|03/31/2022|Yes|No|05/17/2017|03/31/2022|Yes|No||||No|No|05/17/2017|03/31/2022|Prescription required|No||025|No|.49235|03/29/2022|.48053|03/29/2022|.48373|03/29/2022|||ANTIVIRALS: ORAL|7401|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
famciclovir|No|No|No|No|75%|16714061601|FAMCICLOVIR 500 MG TABLET|30|EA|1.16501|05/17/2017|03/31/2022|Yes|No||05/17/2017|03/31/2022|Yes|No|05/17/2017|03/31/2022|Yes|No||||No|No|||Prescription required|No||025|No|.88904|03/29/2022|.8677|03/29/2022|.87348|03/29/2022|||ANTIVIRALS: ORAL|7402|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
zolpidem tartrate|No|No|No|No|90%|16714062101|ZOLPIDEM TARTRATE 5 MG TABLET|100|EA|.02494|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||054|Yes|.03056|03/29/2022|.02982|03/29/2022|.03002|03/29/2022|||SEDATIVE HYPNOTICS|7403|||||No|No||NORTHSTAR RX LL|No||||
zolpidem tartrate|No|No|No|No|90%|16714062102|ZOLPIDEM TARTRATE 5 MG TABLET|500|EA|.03479|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||054|Yes|.03056|03/29/2022|.02982|03/29/2022|.03002|03/29/2022|||SEDATIVE HYPNOTICS|7404|||||No|No||NORTHSTAR RX LL|No||||
zolpidem tartrate|No|No|No|No|90%|16714062201|ZOLPIDEM TARTRATE 10 MG TABLET|100|EA|.02395|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||054|Yes|.0301|03/29/2022|.02937|03/29/2022|.02957|03/29/2022|||SEDATIVE HYPNOTICS|7405|||||No|No||NORTHSTAR RX LL|No||||
zolpidem tartrate|No|No|No|No|90%|16714062202|ZOLPIDEM TARTRATE 10 MG TABLET|500|EA|.0354|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||054|Yes|.0301|03/29/2022|.02937|03/29/2022|.02957|03/29/2022|||SEDATIVE HYPNOTICS|7406|||||No|No||NORTHSTAR RX LL|No||||
lamotrigine|No|No|No|No|75%|16714062301|LAMOTRIGINE ER 25 MG TABLET|30|EA|2.15028|11/14/2017||Yes|No||11/14/2017||Yes|No|11/14/2017||Yes|No||||No|No|||Prescription required|No||056|No|1.20872|03/01/2022|1.17971|03/01/2022|1.18756|03/01/2022|||ANTICONVULSANTS|7407|||||No|No||NORTHSTAR RX LL|No||||
lamotrigine|No|No|No|No|75%|16714062401|LAMOTRIGINE ER 50 MG TABLET|30|EA|4.31347|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|No||056|No|1.67529|03/29/2022|1.63508|03/29/2022|1.64597|03/29/2022|||ANTICONVULSANTS|7408|||||No|No||NORTHSTAR RX LL|No||||
lamotrigine|No|No|No|No|75%|16714062501|LAMOTRIGINE ER 100 MG TABLET|30|EA|4.58867|06/21/2021||Yes|No||06/21/2021||Yes|No|06/21/2021||Yes|No||||No|No|||Prescription required|No||056|No|1.51472|03/29/2022|1.47836|03/29/2022|1.48821|03/29/2022|||ANTICONVULSANTS|7409|||||No|No||NORTHSTAR RX LL|No||||
lamotrigine|No|No|No|No|75%|16714062601|LAMOTRIGINE ER 200 MG TABLET|30|EA|4.94285|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|No||056|No|1.69753|03/29/2022|1.65678|03/29/2022|1.66782|03/29/2022|||ANTICONVULSANTS|7410|||||No|No||NORTHSTAR RX LL|No||||
lamotrigine|No|No|No|No|75%|16714062701|LAMOTRIGINE ER 300 MG TABLET|30|EA|7.75146|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|No||056|No|4.96792|03/29/2022|4.84868|03/29/2022|4.88098|03/29/2022|||ANTICONVULSANTS|7411|||||No|No||NORTHSTAR RX LL|No||||
alendronate sodium|No|No|No|No|75%|16714063101|ALENDRONATE SODIUM 10 MG TAB|30|EA|.14333|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||060|No|.14279|03/29/2022|.13936|03/29/2022|.14029|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|7412|||||No|No||NORTHSTAR RX LL|No||||
alendronate sodium|No|No|No|No|75%|16714063102|ALENDRONATE SODIUM 10 MG TAB|100|EA|.15639|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||060|No|.14279|03/29/2022|.13936|03/29/2022|.14029|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|7413|||||No|No||NORTHSTAR RX LL|No||||
alendronate sodium|No|No|No|No|75%|16714063201|ALENDRONATE SODIUM 35 MG TAB|4|EA|.55792|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||060|No|.34811|03/29/2022|.33975|03/29/2022|.34201|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|7414|||||No|No||NORTHSTAR RX LL|No||||
alendronate sodium|No|No|No|No|75%|16714063202|ALENDRONATE SODIUM 35 MG TAB|20|EA|.37582|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||060|No|.34811|03/29/2022|.33975|03/29/2022|.34201|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|7415|||||No|No||NORTHSTAR RX LL|No||||
alendronate sodium|No|No|No|No|75%|16714063301|ALENDRONATE SODIUM 70 MG TAB|4|EA|.48375|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||060|No|.29635|03/29/2022|.28923|03/29/2022|.29116|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|7416|||||No|No||NORTHSTAR RX LL|No||||
alendronate sodium|No|No|No|No|75%|16714063302|ALENDRONATE SODIUM 70 MG TAB|20|EA|.37302|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||060|No|.29635|03/29/2022|.28923|03/29/2022|.29116|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|7417|||||No|No||NORTHSTAR RX LL|No||||
ciprofloxacin HCl|Yes|No|No|No|75%|16714065102|CIPROFLOXACIN HCL 250 MG TAB|100|EA|.078|01/01/2021|02/28/2023|Yes|No||01/01/2021|02/28/2023|Yes|No|01/01/2021|02/28/2023|Yes|No||||No|No|01/01/2021|02/28/2023|Prescription required|No||028|No|.09397|03/29/2022|.09171|03/29/2022|.09232|03/29/2022|||FLUOROQUINOLONES: ORAL|7418|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
ciprofloxacin HCl|No|No|No|No|75%|16714065202|CIPROFLOXACIN HCL 500 MG TAB|100|EA|.10496|01/01/2021|08/31/2023|Yes|No||01/01/2021|08/31/2023|Yes|No|01/01/2021|08/31/2023|Yes|No||||No|No|||Prescription required|No||028|No|.13565|03/29/2022|.13239|03/29/2022|.13327|03/29/2022|||FLUOROQUINOLONES: ORAL|7419|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
ciprofloxacin HCl|No|No|No|No|75%|16714065204|CIPROFLOXACIN HCL 500 MG TAB|500|EA|.0901|01/01/2021|03/31/2023|Yes|No||01/01/2021|03/31/2023|Yes|No|01/01/2021|03/31/2023|Yes|No||||No|No|||Prescription required|No||028|No|.13565|03/29/2022|.13239|03/29/2022|.13327|03/29/2022|||FLUOROQUINOLONES: ORAL|7420|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
ciprofloxacin HCl|No|No|No|No|75%|16714065301|CIPROFLOXACIN HCL 750 MG TAB|50|EA|.29773|01/01/2021|10/31/2022|Yes|No||01/01/2021|10/31/2022|Yes|No|01/01/2021|10/31/2022|Yes|No||||No|No|||Prescription required|No||028|No|.288|03/29/2022|.28108|03/29/2022|.28296|03/29/2022|||FLUOROQUINOLONES: ORAL|7421|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
venlafaxine HCl|No|No|No|No|75%|16714065501|VENLAFAXINE HCL 25 MG TABLET|100|EA|.1523|05/17/2017|05/31/2024|Yes|No||05/17/2017|05/31/2024|Yes|No|05/17/2017|05/31/2024|Yes|No||||No|No|||Prescription required|No||031|No|.11374|03/29/2022|.11101|03/29/2022|.11174|03/29/2022|||ANTIDEPRESSANTS: OTHER|7422|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
venlafaxine HCl|No|No|No|No|75%|16714065601|VENLAFAXINE HCL 37.5 MG TABLET|100|EA|.12379|12/20/2017||Yes|No||12/20/2017||Yes|No|12/20/2017||Yes|No||||No|No|||Prescription required|No||031|Yes|.11453|03/29/2022|.11178|03/29/2022|.11252|03/29/2022|||ANTIDEPRESSANTS: OTHER|7423|||||No|No||NORTHSTAR RX LL|No||||
venlafaxine HCl|No|No|No|No|75%|16714065701|VENLAFAXINE HCL 50 MG TABLET|100|EA|.14594|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|No||031|No|.12769|03/29/2022|.12462|03/29/2022|.12545|03/29/2022|||ANTIDEPRESSANTS: OTHER|7424|||||No|No||NORTHSTAR RX LL|No||||
venlafaxine HCl|No|No|No|No|75%|16714065801|VENLAFAXINE HCL 75 MG TABLET|100|EA|.15376|12/20/2017||Yes|No||12/20/2017||Yes|No|12/20/2017||Yes|No||||No|No|||Prescription required|No||031|No|.10828|03/29/2022|.10568|03/29/2022|.10638|03/29/2022|||ANTIDEPRESSANTS: OTHER|7425|||||No|No||NORTHSTAR RX LL|No||||
venlafaxine HCl|No|No|No|No|75%|16714065901|VENLAFAXINE HCL 100 MG TABLET|100|EA|.18068|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|No||031|No|.13788|03/29/2022|.13457|03/29/2022|.13546|03/29/2022|||ANTIDEPRESSANTS: OTHER|7426|||||No|No||NORTHSTAR RX LL|No||||
gabapentin|No|No|No|No|75%|16714066101|GABAPENTIN 100 MG CAPSULE|100|EA|.04076|03/18/2010||Yes|No||03/18/2010||Yes|No|03/18/2010||Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|7427|||||No|No||NORTHSTAR RX LL|No||||
gabapentin|No|No|No|No|75%|16714066102|GABAPENTIN 100 MG CAPSULE|500|EA|.03332|03/18/2010||Yes|No||03/18/2010||Yes|No|03/18/2010||Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|7428|||||No|No||NORTHSTAR RX LL|No||||
gabapentin|No|No|No|No|75%|16714066201|GABAPENTIN 300 MG CAPSULE|100|EA|.05508|03/18/2010||Yes|No||03/18/2010||Yes|No|03/18/2010||Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|7429|||||No|No||NORTHSTAR RX LL|No||||
gabapentin|No|No|No|No|75%|16714066202|GABAPENTIN 300 MG CAPSULE|500|EA|.06382|03/18/2010||Yes|No||03/18/2010||Yes|No|03/18/2010||Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|7430|||||No|No||NORTHSTAR RX LL|No||||
gabapentin|No|No|No|No|75%|16714066302|GABAPENTIN 400 MG CAPSULE|500|EA|.05536|03/18/2010||Yes|No||03/18/2010||Yes|No|03/18/2010||Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|7431|||||No|No||NORTHSTAR RX LL|No||||
ondansetron HCl|No|No|No|No|75%|16714067102|ONDANSETRON 4 MG/5 ML SOLUTION|50|ML|.6081|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No||085|No|.25985|03/29/2022|.25361|03/29/2022|.2553|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|7432|||||No|No||NORTHSTAR RX LL|No||||
simvastatin|Yes|No|No|No|75%|16714068101|SIMVASTATIN 5 MG TABLET|30|EA|.04285|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||063|Yes|.03036|03/29/2022|.02963|03/29/2022|.02982|03/29/2022|||LIPOTROPICS: STATINS|7433|||||No|No||NORTHSTAR RX LL|No||||
simvastatin|Yes|No|No|No|75%|16714068102|SIMVASTATIN 5 MG TABLET|90|EA|.04902|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||063|Yes|.03036|03/29/2022|.02963|03/29/2022|.02982|03/29/2022|||LIPOTROPICS: STATINS|7434|||||No|No||NORTHSTAR RX LL|No||||
simvastatin|Yes|No|No|No|75%|16714068201|SIMVASTATIN 10 MG TABLET|30|EA|.04085|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||063|Yes|.02909|03/29/2022|.02839|03/29/2022|.02858|03/29/2022|||LIPOTROPICS: STATINS|7435|||||No|No||NORTHSTAR RX LL|No||||
simvastatin|Yes|No|No|No|75%|16714068202|SIMVASTATIN 10 MG TABLET|90|EA|.04581|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||063|Yes|.02909|03/29/2022|.02839|03/29/2022|.02858|03/29/2022|||LIPOTROPICS: STATINS|7436|||||No|No||NORTHSTAR RX LL|No||||
simvastatin|Yes|No|No|No|75%|16714068203|SIMVASTATIN 10 MG TABLET|1000|EA|.04214|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||063|Yes|.02909|03/29/2022|.02839|03/29/2022|.02858|03/29/2022|||LIPOTROPICS: STATINS|7437|||||No|No||NORTHSTAR RX LL|No||||
simvastatin|Yes|No|No|No|75%|16714068301|SIMVASTATIN 20 MG TABLET|30|EA|.04443|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||063|Yes|.02604|03/29/2022|.02541|03/29/2022|.02558|03/29/2022|||LIPOTROPICS: STATINS|7438|||||No|No||NORTHSTAR RX LL|No||||
simvastatin|Yes|No|No|No|75%|16714068302|SIMVASTATIN 20 MG TABLET|90|EA|.04945|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||063|Yes|.02604|03/29/2022|.02541|03/29/2022|.02558|03/29/2022|||LIPOTROPICS: STATINS|7439|||||No|No||NORTHSTAR RX LL|No||||
simvastatin|Yes|No|No|No|75%|16714068303|SIMVASTATIN 20 MG TABLET|1000|EA|.0381|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||063|Yes|.02604|03/29/2022|.02541|03/29/2022|.02558|03/29/2022|||LIPOTROPICS: STATINS|7440|||||No|No||NORTHSTAR RX LL|No||||
simvastatin|Yes|No|No|No|75%|16714068401|SIMVASTATIN 40 MG TABLET|30|EA|.04773|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||063|Yes|.04431|03/29/2022|.04324|03/29/2022|.04353|03/29/2022|||LIPOTROPICS: STATINS|7441|||||No|No||NORTHSTAR RX LL|No||||
simvastatin|Yes|No|No|No|75%|16714068402|SIMVASTATIN 40 MG TABLET|90|EA|.05828|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||063|Yes|.04431|03/29/2022|.04324|03/29/2022|.04353|03/29/2022|||LIPOTROPICS: STATINS|7442|||||No|No||NORTHSTAR RX LL|No||||
simvastatin|Yes|No|No|No|75%|16714068403|SIMVASTATIN 40 MG TABLET|1000|EA|.04651|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||063|Yes|.04431|03/29/2022|.04324|03/29/2022|.04353|03/29/2022|||LIPOTROPICS: STATINS|7443|||||No|No||NORTHSTAR RX LL|No||||
simvastatin|Yes|No|No|No|75%|16714068501|SIMVASTATIN 80 MG TABLET|30|EA|.05389|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||063|Yes|.09322|03/29/2022|.09098|03/29/2022|.09158|03/29/2022|||LIPOTROPICS: STATINS|7444|||||No|No||NORTHSTAR RX LL|No||||
simvastatin|Yes|No|No|No|75%|16714068502|SIMVASTATIN 80 MG TABLET|90|EA|.05752|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||063|Yes|.09322|03/29/2022|.09098|03/29/2022|.09158|03/29/2022|||LIPOTROPICS: STATINS|7445|||||No|No||NORTHSTAR RX LL|No||||
simvastatin|Yes|No|No|No|75%|16714068503|SIMVASTATIN 80 MG TABLET|1000|EA|.05141|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||063|Yes|.09322|03/29/2022|.09098|03/29/2022|.09158|03/29/2022|||LIPOTROPICS: STATINS|7446|||||No|No||NORTHSTAR RX LL|No||||
fluconazole|No|No|No|No|75%|16714069101|FLUCONAZOLE 100 MG TABLET|30|EA|.47672|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||069|No|.34281|03/29/2022|.33458|03/29/2022|.33681|03/29/2022|||ANTIFUNGALS: ORAL|7447|||||No|No||NORTHSTAR RX LL|No||||
fluconazole|No|No|No|No|75%|16714069102|FLUCONAZOLE 100 MG TABLET|100|EA|.52322|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||069|No|.34281|03/29/2022|.33458|03/29/2022|.33681|03/29/2022|||ANTIFUNGALS: ORAL|7448|||||No|No||NORTHSTAR RX LL|No||||
fluconazole|Yes|No|No|No|75%|16714069210|FLUCONAZOLE 150 MG TABLET|1|EA|14.1857|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||069|No|.74933|03/29/2022|.73134|03/29/2022|.73621|03/29/2022|||ANTIFUNGALS: ORAL|7449|||||No|No||NORTHSTAR RX LL|No||||
fluconazole|Yes|No|No|No|75%|16714069211|FLUCONAZOLE 150 MG TABLET|1|EA|1.18213|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||069|No|.74933|03/29/2022|.73134|03/29/2022|.73621|03/29/2022|||ANTIFUNGALS: ORAL|7450|||||No|No||NORTHSTAR RX LL|No||||
fluconazole|No|No|No|No|75%|16714069301|FLUCONAZOLE 200 MG TABLET|30|EA|.79019|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||069|No|.52936|03/29/2022|.51665|03/29/2022|.52009|03/29/2022|||ANTIFUNGALS: ORAL|7451|||||No|No||NORTHSTAR RX LL|No||||
fluconazole|No|No|No|No|75%|16714069302|FLUCONAZOLE 200 MG TABLET|100|EA|1.14539|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||069|No|.52936|03/29/2022|.51665|03/29/2022|.52009|03/29/2022|||ANTIFUNGALS: ORAL|7452|||||No|No||NORTHSTAR RX LL|No||||
fluconazole|No|No|No|No|75%|16714069401|FLUCONAZOLE 50 MG TABLET|30|EA|.33769|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||069|No|.43933|03/29/2022|.42878|03/29/2022|.43164|03/29/2022|||ANTIFUNGALS: ORAL|7453|||||No|No||NORTHSTAR RX LL|No||||
fluconazole|No|No|No|No|75%|16714069501|FLUCONAZOLE 10 MG/ML SUSP|35|ML|.30358|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||069|No|.28361|03/29/2022|.2768|03/29/2022|.27864|03/29/2022|||ANTIFUNGALS: ORAL|7454|||||No|No||NORTHSTAR RX LL|No||||
fluconazole|No|No|No|No|75%|16714069601|FLUCONAZOLE 40 MG/ML SUSP|35|ML|.7009|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||069|No|.56233|03/29/2022|.54883|03/29/2022|.55248|03/29/2022|||ANTIFUNGALS: ORAL|7455|||||No|No||NORTHSTAR RX LL|No||||
valacyclovir HCl|Yes|No|No|No|75%|16714069701|VALACYCLOVIR HCL 1 GRAM TABLET|30|EA|.56014|01/01/2021|08/31/2023|Yes|No||01/01/2021|08/31/2023|Yes|No|01/01/2021|08/31/2023|Yes|No||||No|No|01/01/2021|08/31/2023|Prescription required|No||025|No|.5737|03/29/2022|.55993|03/29/2022|.56366|03/29/2022|||ANTIVIRALS: ORAL|7456|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
valacyclovir HCl|Yes|No|No|No|75%|16714069703|VALACYCLOVIR HCL 1 GRAM TABLET|90|EA|.55169|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|01/01/2021||Prescription required|No||025|No|.5737|03/29/2022|.55993|03/29/2022|.56366|03/29/2022|||ANTIVIRALS: ORAL|7457|||||No|No||NORTHSTAR RX LL|No||||
valacyclovir HCl|No|No|No|No|75%|16714069801|VALACYCLOVIR HCL 500 MG TABLET|30|EA|.34887|01/01/2021|10/31/2023|Yes|No||01/01/2021|10/31/2023|Yes|No|01/01/2021|10/31/2023|Yes|No||||No|No|||Prescription required|No||025|No|.29328|03/29/2022|.28624|03/29/2022|.28814|03/29/2022|||ANTIVIRALS: ORAL|7458|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
valacyclovir HCl|No|No|No|No|75%|16714069803|VALACYCLOVIR HCL 500 MG TABLET|90|EA|.3191|01/01/2021||Yes|No||01/01/2021||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No||025|No|.29328|03/29/2022|.28624|03/29/2022|.28814|03/29/2022|||ANTIVIRALS: ORAL|7459|||||No|No||NORTHSTAR RX LL|No||||
lamotrigine|No|No|No|No|75%|16714070001|LAMOTRIGINE 25 MG TABLET|100|EA|.04704|12/20/2017||Yes|No||12/20/2017||Yes|No|12/20/2017||Yes|No||||No|No|||Prescription required|No||056|No|.03514|03/29/2022|.03429|03/29/2022|.03452|03/29/2022|||ANTICONVULSANTS|7460|||||No|No||NORTHSTAR RX LL|No||||
lamotrigine|No|No|No|No|75%|16714070101|LAMOTRIGINE 100 MG TABLET|100|EA|.05061|12/20/2017||Yes|No||12/20/2017||Yes|No|12/20/2017||Yes|No||||No|No|||Prescription required|No||056|No|.06403|03/29/2022|.06249|03/29/2022|.0629|03/29/2022|||ANTICONVULSANTS|7461|||||No|No||NORTHSTAR RX LL|No||||
lamotrigine|No|No|No|No|75%|16714070201|LAMOTRIGINE 150 MG TABLET|60|EA|.07546|12/20/2017||Yes|No||12/20/2017||Yes|No|12/20/2017||Yes|No||||No|No|||Prescription required|No||056|No|.0888|03/29/2022|.08666|03/29/2022|.08724|03/29/2022|||ANTICONVULSANTS|7462|||||No|No||NORTHSTAR RX LL|No||||
lamotrigine|No|No|No|No|75%|16714070301|LAMOTRIGINE 200 MG TABLET|60|EA|.09008|12/20/2017||Yes|No||12/20/2017||Yes|No|12/20/2017||Yes|No||||No|No|||Prescription required|No||056|No|.10103|03/29/2022|.0986|03/29/2022|.09926|03/29/2022|||ANTICONVULSANTS|7463|||||No|No||NORTHSTAR RX LL|No||||
imatinib mesylate|No|No|No|No|75%|16714070401|IMATINIB MESYLATE 100 MG TAB|90|EA|18.83787|05/21/2018|02/28/2023|Yes|No||05/21/2018|02/28/2023|Yes|No|05/21/2018|02/28/2023|Yes|No||||No|No|||Prescription required|No||173|No|42.93282|07/27/2021|42.31949|07/27/2021|40.30428|07/27/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|7464|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
imatinib mesylate|No|No|No|No|75%|16714070501|IMATINIB MESYLATE 400 MG TAB|30|EA|33.76417|05/21/2018|01/31/2023|Yes|No||05/21/2018|01/31/2023|Yes|No|05/21/2018|01/31/2023|Yes|No||||No|No|||Prescription required|No||173|No|2.86988|03/01/2022|2.801|03/01/2022|2.81965|03/01/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|7465|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
tamsulosin HCl|No|No|No|No|75%|16714071301|TAMSULOSIN HCL 0.4 MG CAPSULE|100|EA|.14052|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|No||003|No|.06447|03/29/2022|.06292|03/29/2022|.06334|03/29/2022|||BPH TREATMENTS|7466|||||No|No||NORTHSTAR RX LL|No||||
tamsulosin HCl|No|No|No|No|75%|16714071302|TAMSULOSIN HCL 0.4 MG CAPSULE|500|EA|.12958|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|No||003|No|.06447|03/29/2022|.06292|03/29/2022|.06334|03/29/2022|||BPH TREATMENTS|7467|||||No|No||NORTHSTAR RX LL|No||||
omeprazole|No|No|No|No|75%|16714071401|OMEPRAZOLE DR 10 MG CAPSULE|30|EA|.3364|11/13/2020||Yes|No||11/13/2020||Yes|No|11/13/2020||Yes|No||||No|No|||Prescription required|No||047|Yes|.09084|03/29/2022|.08865|03/29/2022|.08925|03/29/2022|||PROTON PUMP INHIBITORS|7468|||||No|No||NORTHSTAR RX LL|No||||
omeprazole|No|No|No|No|75%|16714071501|OMEPRAZOLE DR 20 MG CAPSULE|30|EA|.16196|11/13/2020||Yes|No||11/13/2020||Yes|No|11/13/2020||Yes|No||||No|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|7469|||||No|No||NORTHSTAR RX LL|No||||
omeprazole|No|No|No|No|75%|16714071502|OMEPRAZOLE DR 20 MG CAPSULE|100|EA|.15316|11/13/2020||Yes|No||11/13/2020||Yes|No|11/13/2020||Yes|No||||No|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|7470|||||No|No||NORTHSTAR RX LL|No||||
omeprazole|No|No|No|No|75%|16714071503|OMEPRAZOLE DR 20 MG CAPSULE|1000|EA|.11492|11/13/2020||Yes|No||11/13/2020||Yes|No|11/13/2020||Yes|No||||No|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|7471|||||No|No||NORTHSTAR RX LL|No||||
entecavir|No|No|No|No|75%|16714071701|ENTECAVIR 0.5 MG TABLET|30|EA|4.09861|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No|||No|.89227|03/29/2022|.87085|03/29/2022|.87665|03/29/2022||||7472|||||No|No||NORTHSTAR RX LL|No||||
entecavir|No|No|No|No|75%|16714071801|ENTECAVIR 1 MG TABLET|30|EA|6.34852|05/21/2018||Yes|No||05/21/2018||Yes|No|||No|No||||No|No|||Prescription required|No|||No|1.06461|03/29/2022|1.03905|03/29/2022|1.04597|03/29/2022||||7473|||||No|No||NORTHSTAR RX LL|No||||
fluoxetine HCl|No|No|No|No|75%|16714072002|FLUOXETINE HCL 10 MG CAPSULE|100|EA|.03483|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7474|||||No|No||NORTHSTAR RX LL|No||||
fluoxetine HCl|No|No|No|No|75%|16714072003|FLUOXETINE HCL 10 MG CAPSULE|1000|EA|.02189|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7475|||||No|No||NORTHSTAR RX LL|No||||
fluoxetine HCl|No|No|No|No|75%|16714072102|FLUOXETINE HCL 20 MG CAPSULE|100|EA|.02889|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7476|||||No|No||NORTHSTAR RX LL|No||||
fluoxetine HCl|No|No|No|No|75%|16714072103|FLUOXETINE HCL 20 MG CAPSULE|1000|EA|.01689|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7477|||||No|No||NORTHSTAR RX LL|No||||
fluoxetine HCl|No|No|No|No|75%|16714072202|FLUOXETINE HCL 40 MG CAPSULE|100|EA|.23667|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7478|||||No|No||NORTHSTAR RX LL|No||||
fluoxetine HCl|No|No|No|No|75%|16714072203|FLUOXETINE HCL 40 MG CAPSULE|500|EA|.06085|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7479|||||No|No||NORTHSTAR RX LL|No||||
desonide|No|No|No|No|75%|16714072901|DESONIDE 0.05% CREAM|15|GM|1.034|06/17/2021||Yes|No||06/17/2021||Yes|No|06/17/2021||Yes|No||||No|No|||Prescription required|Yes|11/03/2017|118|No|.68707|03/29/2022|.67058|03/29/2022|.67504|03/29/2022|||STEROIDS: TOPICAL LOW|7480|||||No|No||NORTHSTAR RX LL|No||||
desonide|No|No|No|No|75%|16714072902|DESONIDE 0.05% CREAM|60|GM|1.16171|06/18/2021||Yes|No||06/18/2021||Yes|No|06/18/2021||Yes|No||||No|No|||Prescription required|Yes|11/03/2017|118|No|.61157|03/29/2022|.59689|03/29/2022|.60086|03/29/2022|||STEROIDS: TOPICAL LOW|7481|||||No|No||NORTHSTAR RX LL|No||||
clobetasol propionate|No|No|No|No|75%|16714073001|CLOBETASOL 0.05% CREAM|15|GM|2.04966|02/07/2018|12/31/2022|Yes|No||02/07/2018|12/31/2022|Yes|No|02/07/2018|12/31/2022|Yes|No||||No|No|||Prescription required|No||121|No|.42879|03/29/2022|.41849|03/29/2022|.42128|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|7482|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
clobetasol propionate|No|No|No|No|75%|16714073002|CLOBETASOL 0.05% CREAM|30|GM|1.8983|02/07/2018|11/30/2022|Yes|No||02/07/2018|11/30/2022|Yes|No|02/07/2018|11/30/2022|Yes|No||||No|No|||Prescription required|No||121|No|.34489|03/29/2022|.33661|03/29/2022|.33885|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|7483|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
clobetasol propionate|No|No|No|No|75%|16714073003|CLOBETASOL 0.05% CREAM|45|GM|2.03743|02/07/2018|09/30/2022|Yes|No||02/07/2018|09/30/2022|Yes|No|||No|No||||No|No|||Prescription required|No||121|No|.31467|03/29/2022|.30711|03/29/2022|.30916|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|7484|No Longer Rebatable|No Longer Rebatable|||No|No||NORTHSTAR RX LL|No||||
celecoxib|No|No|No|No|75%|16714073101|CELECOXIB 50 MG CAPSULE|60|EA|.23327|02/07/2018||Yes|No||02/07/2018||Yes|No|02/07/2018||Yes|No||||No|No|||Prescription required|Yes|12/14/2017|059|Yes|.1386|03/29/2022|.13527|03/29/2022|.13617|03/29/2022|||NSAIDS|7485|||||No|No||NORTHSTAR RX LL|No||||
celecoxib|No|No|No|No|75%|16714073201|CELECOXIB 100 MG CAPSULE|100|EA|.42501|02/07/2018||Yes|No||02/07/2018||Yes|No|02/07/2018||Yes|No||||No|No|||Prescription required|Yes|12/14/2017|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|7486|||||No|No||NORTHSTAR RX LL|No||||
celecoxib|No|No|No|No|75%|16714073202|CELECOXIB 100 MG CAPSULE|500|EA|.18607|02/07/2018||Yes|No||02/07/2018||Yes|No|02/07/2018||Yes|No||||No|No|||Prescription required|Yes|12/14/2017|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|7487|||||No|No||NORTHSTAR RX LL|No||||
celecoxib|No|No|No|No|75%|16714073301|CELECOXIB 200 MG CAPSULE|100|EA|.7036|02/07/2018||Yes|No||02/07/2018||Yes|No|02/07/2018||Yes|No||||No|No|||Prescription required|Yes|12/14/2017|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|7488|||||No|No||NORTHSTAR RX LL|No||||
celecoxib|No|No|No|No|75%|16714073302|CELECOXIB 200 MG CAPSULE|500|EA|.40942|02/07/2018||Yes|No||02/07/2018||Yes|No|02/07/2018||Yes|No||||No|No|||Prescription required|Yes|12/14/2017|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|7489|||||No|No||NORTHSTAR RX LL|No||||
celecoxib|No|No|No|No|75%|16714073401|CELECOXIB 400 MG CAPSULE|60|EA|1.05098|02/07/2018||Yes|No||02/07/2018||Yes|No|02/07/2018||Yes|No||||No|No|||Prescription required|Yes|12/14/2017|059|Yes|.73632|03/29/2022|.71864|03/29/2022|.72343|03/29/2022|||NSAIDS|7490|||||No|No||NORTHSTAR RX LL|No||||
fenofibrate,micronized|No|No|No|No|75%|16714073902|FENOFIBRATE 67 MG CAPSULE|100|EA|.31798|11/20/2017|01/31/2023|Yes|No||11/20/2017|01/31/2023|Yes|No|11/20/2017|01/31/2023|Yes|No||||No|No|||Prescription required|No||055|No|.15038|03/29/2022|.14677|03/29/2022|.14774|03/29/2022|||LIPOTROPICS: OTHER|7491|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
fenofibrate,micronized|No|No|No|No|75%|16714074002|FENOFIBRATE 134 MG CAPSULE|100|EA|.58965|11/20/2017|10/31/2022|Yes|No||11/20/2017|10/31/2022|Yes|No|||No|No||||No|No|||Prescription required|No||055|No|.17604|03/29/2022|.17181|03/29/2022|.17295|03/29/2022|||LIPOTROPICS: OTHER|7492|No Longer Rebatable|No Longer Rebatable|||No|No||NORTHSTAR RX LL|No||||
fenofibrate,micronized|No|No|No|No|75%|16714074102|FENOFIBRATE 200 MG CAPSULE|100|EA|.94836|11/20/2017|12/31/2022|Yes|No||11/20/2017|12/31/2022|Yes|No|11/20/2017|12/31/2022|Yes|No||||No|No|||Prescription required|No||055|No|.22993|03/29/2022|.22441|03/29/2022|.2259|03/29/2022|||LIPOTROPICS: OTHER|7493|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
itraconazole|No|No|No|No|75%|16714074302|ITRACONAZOLE 100 MG CAPSULE|30|EA|2.01598|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|069|No|.85195|03/29/2022|.8315|03/29/2022|.83704|03/29/2022|||ANTIFUNGALS: ORAL|7494|||||No|No||NORTHSTAR RX LL|No||||
omeprazole|No|No|No|No|75%|16714074802|OMEPRAZOLE DR 40 MG CAPSULE|100|EA|.18821|06/17/2021|02/22/2022|Yes|No||06/17/2021|02/22/2022|Yes|No|06/17/2021|02/22/2022|Yes|No||||No|No|||Prescription required|No||047|No|.42894|02/15/2022|.42281|02/15/2022|.40268|02/15/2022|||PROTON PUMP INHIBITORS|7495|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
hydroxychloroquine sulfate|No|No|No|No|75%|16714075301|HYDROXYCHLOROQUINE 200 MG TAB|100|EA|.5399|08/27/2018|10/31/2022|Yes|No||08/27/2018|10/31/2022|Yes|No|08/27/2018|10/31/2022|Yes|No||||No|No|||Prescription required|No|||No|.23831|03/29/2022|.23259|03/29/2022|.23413|03/29/2022||||7496|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
atomoxetine HCl|No|No|No|No|75%|16714075501|ATOMOXETINE HCL 10 MG CAPSULE|30|EA|1.68674|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.20613|03/29/2022|1.17718|03/29/2022|1.18502|03/29/2022|||STIMULANTS AND RELATED AGENTS|7497|||||No|No||NORTHSTAR RX LL|No||||
atomoxetine HCl|No|No|No|No|75%|16714075601|ATOMOXETINE HCL 18 MG CAPSULE|30|EA|1.62869|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.0614|03/29/2022|1.03592|03/29/2022|1.04282|03/29/2022|||STIMULANTS AND RELATED AGENTS|7498|||||No|No||NORTHSTAR RX LL|No||||
atomoxetine HCl|No|No|No|No|75%|16714075701|ATOMOXETINE HCL 25 MG CAPSULE|30|EA|1.62611|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.05569|03/29/2022|1.03035|03/29/2022|1.03721|03/29/2022|||STIMULANTS AND RELATED AGENTS|7499|||||No|No||NORTHSTAR RX LL|No||||
atomoxetine HCl|No|No|No|No|75%|16714075801|ATOMOXETINE HCL 40 MG CAPSULE|30|EA|1.75225|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.0462|03/29/2022|1.02109|03/29/2022|1.02789|03/29/2022|||STIMULANTS AND RELATED AGENTS|7500|||||No|No||NORTHSTAR RX LL|No||||
atomoxetine HCl|No|No|No|No|75%|16714075901|ATOMOXETINE HCL 60 MG CAPSULE|30|EA|1.75712|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.16565|03/29/2022|1.13767|03/29/2022|1.14525|03/29/2022|||STIMULANTS AND RELATED AGENTS|7501|||||No|No||NORTHSTAR RX LL|No||||
atomoxetine HCl|No|No|No|No|75%|16714076001|ATOMOXETINE HCL 80 MG CAPSULE|30|EA|1.89429|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.40838|03/29/2022|1.37457|03/29/2022|1.38373|03/29/2022|||STIMULANTS AND RELATED AGENTS|7502|||||No|No||NORTHSTAR RX LL|No||||
atomoxetine HCl|No|No|No|No|75%|16714076101|ATOMOXETINE HCL 100 MG CAPSULE|30|EA|1.90246|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|No||007|Yes|1.76872|03/29/2022|1.72627|03/29/2022|1.73776|03/29/2022|||STIMULANTS AND RELATED AGENTS|7503|||||No|No||NORTHSTAR RX LL|No||||
calcipotriene|No|No|No|No|75%|16714076301|CALCIPOTRIENE 0.005% CREAM|60|GM|1.9016|02/21/2019||Yes|No||02/21/2019||Yes|No|02/21/2019||Yes|No||||No|No|||Prescription required|No|||No|1.06701|03/29/2022|1.0414|03/29/2022|1.04833|03/29/2022||||7504|||||No|No||NORTHSTAR RX LL|No||||
calcipotriene|No|No|No|No|75%|16714076302|CALCIPOTRIENE 0.005% CREAM|120|GM|1.74092|02/21/2019||Yes|No||02/21/2019||Yes|No|02/21/2019||Yes|No||||No|No|||Prescription required|No|||No|1.10109|03/29/2022|1.07466|03/29/2022|1.08182|03/29/2022||||7505|||||No|No||NORTHSTAR RX LL|No||||
valganciclovir HCl|No|No|No|No|75%|16714076501|VALGANCICLOVIR 450 MG TABLET|60|EA|6.00659|08/28/2018|08/31/2022|Yes|No||08/28/2018|08/31/2022|Yes|No|08/28/2018|08/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|136|No|2.64507|03/29/2022|2.58158|03/29/2022|2.59878|03/29/2022|||ANTIVIRALS: GENERAL|7506|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
cefixime|No|No|No|No|75%|16714076601|CEFIXIME 100 MG/5 ML SUSP|50|ML|1.42596|08/27/2018||Yes|No||08/27/2018||Yes|No|08/27/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|046|No|3.24987|08/27/2019|3.20344|08/27/2019|3.0509|08/27/2019|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7507|||||No|No||NORTHSTAR RX LL|No||||
cefixime|No|No|No|No|75%|16714076701|CEFIXIME 200 MG/5 ML SUSP|50|ML|2.82725|08/27/2018||Yes|No||08/27/2018||Yes|No|08/27/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|046|No|6.4435|10/29/2019|6.35145|10/29/2019|6.049|10/29/2019|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7508|||||No|No||NORTHSTAR RX LL|No||||
cefixime|No|No|No|No|75%|16714076702|CEFIXIME 200 MG/5 ML SUSP|75|ML|2.90043|08/27/2018||Yes|No||08/27/2018||Yes|No|08/27/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|046|No|6.61029|01/29/2019|6.51586|01/29/2019|6.20558|01/29/2019|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|7509|||||No|No||NORTHSTAR RX LL|No||||
nystatin|No|No|No|No|75%|16714076901|NYSTATIN 100,000 UNIT/GM POWD|15|GM|.49736|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|No||061|No|.35016|03/29/2022|.34175|03/29/2022|.34403|03/29/2022|||ANTIFUNGALS: TOPICAL|7510|||||No|No||NORTHSTAR RX LL|No||||
nystatin|No|No|No|No|75%|16714076902|NYSTATIN 100,000 UNIT/GM POWD|30|GM|.50682|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|No||061|No|.30897|03/29/2022|.30155|03/29/2022|.30356|03/29/2022|||ANTIFUNGALS: TOPICAL|7511|||||No|No||NORTHSTAR RX LL|No||||
nystatin|No|No|No|No|75%|16714076903|NYSTATIN 100,000 UNIT/GM POWD|60|GM|.38771|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|No||061|No|.2597|03/29/2022|.25346|03/29/2022|.25515|03/29/2022|||ANTIFUNGALS: TOPICAL|7512|||||No|No||NORTHSTAR RX LL|No||||
rasagiline mesylate|No|No|No|No|75%|16714077001|RASAGILINE MESYLATE 0.5 MG TAB|30|EA|5.88311|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|015|No|4.5286|03/29/2022|4.41991|03/29/2022|4.44934|03/29/2022|||ANTIPARKINSON'S AGENTS|7513|||||No|No||NORTHSTAR RX LL|No||||
rasagiline mesylate|No|No|No|No|75%|16714077101|RASAGILINE MESYLATE 1 MG TAB|30|EA|5.85989|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|015|No|1.78642|03/29/2022|1.74354|03/29/2022|1.75515|03/29/2022|||ANTIPARKINSON'S AGENTS|7514|||||No|No||NORTHSTAR RX LL|No||||
felbamate|No|No|No|No|75%|16714077501|FELBAMATE 600 MG/5 ML SUSP|237|ML|.9283|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||||No|No|||Prescription required|No||056|No|2.11568|11/27/2018|2.08545|11/27/2018|1.98615|11/27/2018|||ANTICONVULSANTS|7515|||||No|No||NORTHSTAR RX LL|No||||
felbamate|No|No|No|No|75%|16714077502|FELBAMATE 600 MG/5 ML SUSP|473|ML|.89871|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||||No|No|||Prescription required|No||056|No|2.04823|11/27/2018|2.01897|11/27/2018|1.92283|11/27/2018|||ANTICONVULSANTS|7516|||||No|No||NORTHSTAR RX LL|No||||
ezetimibe/simvastatin|No|No|No|No|75%|16714077801|EZETIMIBE-SIMVASTATIN 10-10 MG|30|EA|1.22249|02/25/2020||Yes|No||02/25/2020||Yes|No|02/25/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|063|Yes|.75312|03/29/2022|.73504|03/29/2022|.73994|03/29/2022|||LIPOTROPICS: STATINS|7517|||||No|No||NORTHSTAR RX LL|No||||
ezetimibe/simvastatin|No|No|No|No|75%|16714077802|EZETIMIBE-SIMVASTATIN 10-10 MG|90|EA|1.40681|02/25/2020||Yes|No||02/25/2020||Yes|No|02/25/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|063|Yes|.75312|03/29/2022|.73504|03/29/2022|.73994|03/29/2022|||LIPOTROPICS: STATINS|7518|||||No|No||NORTHSTAR RX LL|No||||
ezetimibe/simvastatin|No|No|No|No|75%|16714077901|EZETIMIBE-SIMVASTATIN 10-20 MG|30|EA|1.18465|02/25/2020||Yes|No||02/25/2020||Yes|No|02/25/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|063|Yes|.74268|03/29/2022|.72485|03/29/2022|.72968|03/29/2022|||LIPOTROPICS: STATINS|7519|||||No|No||NORTHSTAR RX LL|No||||
ezetimibe/simvastatin|No|No|No|No|75%|16714077902|EZETIMIBE-SIMVASTATIN 10-20 MG|90|EA|1.42444|02/25/2020||Yes|No||02/25/2020||Yes|No|02/25/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|063|Yes|.74268|03/29/2022|.72485|03/29/2022|.72968|03/29/2022|||LIPOTROPICS: STATINS|7520|||||No|No||NORTHSTAR RX LL|No||||
ezetimibe/simvastatin|No|No|No|No|75%|16714078001|EZETIMIBE-SIMVASTATIN 10-40 MG|30|EA|1.15885|02/25/2020||Yes|No||02/25/2020||Yes|No|02/25/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|063|Yes|.99233|03/29/2022|.96851|03/29/2022|.97496|03/29/2022|||LIPOTROPICS: STATINS|7521|||||No|No||NORTHSTAR RX LL|No||||
ezetimibe/simvastatin|No|No|No|No|75%|16714078002|EZETIMIBE-SIMVASTATIN 10-40 MG|90|EA|1.24843|02/25/2020||Yes|No||02/25/2020||Yes|No|02/25/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|063|Yes|.99233|03/29/2022|.96851|03/29/2022|.97496|03/29/2022|||LIPOTROPICS: STATINS|7522|||||No|No||NORTHSTAR RX LL|No||||
ezetimibe/simvastatin|No|No|No|No|75%|16714078101|EZETIMIBE-SIMVASTATIN 10-80 MG|30|EA|1.20328|02/25/2020||Yes|No||02/25/2020||Yes|No|02/25/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|063|Yes|.47172|03/29/2022|.46039|03/29/2022|.46346|03/29/2022|||LIPOTROPICS: STATINS|7523|||||No|No||NORTHSTAR RX LL|No||||
ezetimibe/simvastatin|No|No|No|No|75%|16714078102|EZETIMIBE-SIMVASTATIN 10-80 MG|90|EA|1.16773|02/25/2020||Yes|No||02/25/2020||Yes|No|02/25/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|063|Yes|.47172|03/29/2022|.46039|03/29/2022|.46346|03/29/2022|||LIPOTROPICS: STATINS|7524|||||No|No||NORTHSTAR RX LL|No||||
clobetasol propionate|No|No|No|No|75%|16714078201|CLOBETASOL 0.05% OINTMENT|15|GM|1.87623|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||121|No|.35914|03/29/2022|.35052|03/29/2022|.35285|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|7525|||||No|No||NORTHSTAR RX LL|No||||
clobetasol propionate|No|No|No|No|75%|16714078202|CLOBETASOL 0.05% OINTMENT|30|GM|1.5199|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||121|No|.3756|03/29/2022|.36658|03/29/2022|.36902|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|7526|||||No|No||NORTHSTAR RX LL|No||||
clobetasol propionate|No|No|No|No|75%|16714078203|CLOBETASOL 0.05% OINTMENT|45|GM|1.65014|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||121|No|.36764|03/29/2022|.35881|03/29/2022|.3612|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|7527|||||No|No||NORTHSTAR RX LL|No||||
clobetasol propionate|No|No|No|No|75%|16714078204|CLOBETASOL 0.05% OINTMENT|60|GM|1.49302|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||121|No|.32004|03/29/2022|.31235|03/29/2022|.31443|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|7528|||||No|No||NORTHSTAR RX LL|No||||
aripiprazole|No|No|No|No|75%|16714078301|ARIPIPRAZOLE 2 MG TABLET|30|EA|.516|11/28/2018|07/31/2022|Yes|No||11/28/2018|07/31/2022|Yes|No|11/28/2018|07/31/2022|Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|7529|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
aripiprazole|No|No|No|No|75%|16714078401|ARIPIPRAZOLE 5 MG TABLET|30|EA|.51499|11/28/2018|08/31/2022|Yes|No||11/28/2018|08/31/2022|Yes|No|11/28/2018|08/31/2022|Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|7530|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
aripiprazole|No|No|No|No|75%|16714078501|ARIPIPRAZOLE 10 MG TABLET|30|EA|.50625|11/28/2018|10/31/2023|Yes|No||11/28/2018|10/31/2023|Yes|No|11/28/2018|10/31/2023|Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|7531|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
aripiprazole|No|No|No|No|75%|16714078601|ARIPIPRAZOLE 15 MG TABLET|30|EA|.49564|11/28/2018|05/31/2022|Yes|No||11/28/2018|05/31/2022|Yes|No|11/28/2018|05/31/2022|Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|7532|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
aripiprazole|No|No|No|No|75%|16714078701|ARIPIPRAZOLE 20 MG TABLET|30|EA|.59125|11/28/2018|05/31/2022|Yes|No||11/28/2018|05/31/2022|Yes|No|11/28/2018|05/31/2022|Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|7533|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
aripiprazole|No|No|No|No|75%|16714078801|ARIPIPRAZOLE 30 MG TABLET|30|EA|.5504|11/28/2018|08/31/2022|Yes|No||11/28/2018|08/31/2022|Yes|No|11/28/2018|08/31/2022|Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|7534|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
terbinafine HCl|No|No|No|No|75%|16714079501|TERBINAFINE HCL 250 MG TABLET|30|EA|.11438|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||||No|No|||Prescription required|No||069|No|.15711|03/29/2022|.15333|03/29/2022|.15436|03/29/2022|||ANTIFUNGALS: ORAL|7535|||||No|No||NORTHSTAR RX LL|No||||
terbinafine HCl|No|No|No|No|75%|16714079502|TERBINAFINE HCL 250 MG TABLET|100|EA|.0912|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||||No|No|||Prescription required|No||069|No|.15711|03/29/2022|.15333|03/29/2022|.15436|03/29/2022|||ANTIFUNGALS: ORAL|7536|||||No|No||NORTHSTAR RX LL|No||||
sumatriptan succinate|No|No|No|No|75%|16714079601|SUMATRIPTAN SUCC 25 MG TABLET|9|EA|.76205|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||021|No|.55768|03/29/2022|.54429|03/29/2022|.54792|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|7537|||||No|No||NORTHSTAR RX LL|No||||
sumatriptan succinate|No|No|No|No|75%|16714079701|SUMATRIPTAN SUCC 50 MG TABLET|9|EA|.76205|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||021|No|.52829|03/29/2022|.51561|03/29/2022|.51904|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|7538|||||No|No||NORTHSTAR RX LL|No||||
sumatriptan succinate|No|No|No|No|75%|16714079801|SUMATRIPTAN SUCC 100 MG TABLET|9|EA|.76205|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||021|No|.54919|03/29/2022|.536|03/29/2022|.53957|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|7539|||||No|No||NORTHSTAR RX LL|No||||
cetirizine HCl|No|No|No|No|75%|16714079901|CETIRIZINE HCL 10 MG TABLET|30|EA|.16354|02/06/2019||Yes|No||||No|No|02/06/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|7540|||||No|No||NORTHSTAR RX LL|No||||
cetirizine HCl|No|No|No|No|75%|16714079902|CETIRIZINE HCL 10 MG TABLET|100|EA|.05585|11/28/2018||Yes|No||||No|No|11/28/2018||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|7541|||||No|No||NORTHSTAR RX LL|No||||
cetirizine HCl|No|No|No|No|75%|16714079903|CETIRIZINE HCL 10 MG TABLET|300|EA|.05082|11/28/2018||Yes|No||||No|No|11/28/2018||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|7542|||||No|No||NORTHSTAR RX LL|No||||
cetirizine HCl|No|No|No|No|75%|16714079904|CETIRIZINE HCL 10 MG TABLET|500|EA|.03895|02/06/2019||Yes|No||||No|No|02/06/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|7543|||||No|No||NORTHSTAR RX LL|No||||
chlorthalidone|Yes|No|No|No|75%|16714080001|CHLORTHALIDONE 25 MG TABLET|100|EA|.40269|11/27/2018|12/31/2022|Yes|No||11/27/2018|12/31/2022|Yes|No|11/27/2018|12/31/2022|Yes|No||||No|No|06/18/2019|12/31/2022|Prescription required|No|||No|.16117|03/29/2022|.1573|03/29/2022|.15834|03/29/2022||||7544|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
chlorthalidone|Yes|No|No|No|75%|16714080101|CHLORTHALIDONE 50 MG TABLET|100|EA|.49849|11/27/2018|08/31/2022|Yes|No||11/27/2018|08/31/2022|Yes|No|11/27/2018|08/31/2022|Yes|No||||No|No|06/18/2019|08/31/2022|Prescription required|No|||No|.3607|03/29/2022|.35204|03/29/2022|.35438|03/29/2022||||7545|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|16714080201|DEXTROAMP-AMPHETAMINE 5 MG TAB|100|EA|.28487|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|.21985|03/29/2022|.21457|03/29/2022|.216|03/29/2022|||STIMULANTS AND RELATED AGENTS|7546|||||No|No||NORTHSTAR RX LL|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|16714080301|DEXTROAMP-AMPHETAM 7.5 MG TAB|100|EA|.37775|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|.45915|03/29/2022|.44813|03/29/2022|.45111|03/29/2022|||STIMULANTS AND RELATED AGENTS|7547|||||No|No||NORTHSTAR RX LL|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|16714080401|DEXTROAMP-AMPHETAMIN 10 MG TAB|100|EA|.29807|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|.24071|03/29/2022|.23493|03/29/2022|.23649|03/29/2022|||STIMULANTS AND RELATED AGENTS|7548|||||No|No||NORTHSTAR RX LL|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|16714080501|DEXTROAMP-AMPHETAM 12.5 MG TAB|100|EA|.39237|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|.65907|03/01/2022|.64325|03/01/2022|.64753|03/01/2022|||STIMULANTS AND RELATED AGENTS|7549|||||No|No||NORTHSTAR RX LL|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|16714080601|DEXTROAMP-AMPHETAMIN 15 MG TAB|100|EA|.3022|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|.25605|03/29/2022|.2499|03/29/2022|.25156|03/29/2022|||STIMULANTS AND RELATED AGENTS|7550|||||No|No||NORTHSTAR RX LL|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|16714080701|DEXTROAMP-AMPHETAMIN 20 MG TAB|100|EA|.31566|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|.31357|03/29/2022|.30604|03/29/2022|.30808|03/29/2022|||STIMULANTS AND RELATED AGENTS|7551|||||No|No||NORTHSTAR RX LL|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|16714080801|DEXTROAMP-AMPHETAMIN 30 MG TAB|100|EA|.332|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|.30925|03/29/2022|.30182|03/29/2022|.30383|03/29/2022|||STIMULANTS AND RELATED AGENTS|7552|||||No|No||NORTHSTAR RX LL|No||||
levonorgestrel|No|Yes|No|No|75%|16714080901|NEW DAY 1.5 MG TABLET|1|EA|11.5842|11/29/2018||Yes|No||||No|No|||No|No||||No|No|||Over the counter|No|||No|10.215|03/29/2022|9.96984|03/29/2022|10.03623|03/29/2022||||7553|||||No|No||NORTHSTAR RX LL|No||||
ezetimibe|No|No|No|No|75%|16714081301|EZETIMIBE 10 MG TABLET|30|EA|.38198|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|7554|||||No|No||NORTHSTAR RX LL|No||||
ezetimibe|No|No|No|No|75%|16714081302|EZETIMIBE 10 MG TABLET|90|EA|.13697|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|7555|||||No|No||NORTHSTAR RX LL|No||||
ezetimibe|No|No|No|No|75%|16714081303|EZETIMIBE 10 MG TABLET|500|EA|.14609|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|7556|||||No|No||NORTHSTAR RX LL|No||||
sevelamer carbonate|No|No|No|No|75%|16714081401|SEVELAMER CARBONATE 800 MG TAB|270|EA|.90231|06/17/2021||Yes|No||06/17/2021||Yes|No|06/17/2021||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|052|Yes|.27122|03/29/2022|.26471|03/29/2022|.26647|03/29/2022|||PHOSPHATE BINDERS|7557|||||No|No||NORTHSTAR RX LL|No||||
zoledronic acid|No|No|No|No|75%|16714081501|ZOLEDRONIC ACID 4 MG/5 ML VIAL|5|ML|8.66708|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|No|||No|19.75288|05/28/2019|19.47069|05/22/2019|18.54352|05/22/2019||||7558|||||No|No||NORTHSTAR RX LL|No||||
bicalutamide|No|No|No|No|75%|16714081601|BICALUTAMIDE 50 MG TABLET|30|EA|.30343|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|No||550|No|.3381|03/29/2022|.32998|03/29/2022|.33218|03/29/2022|||ONCOLOGY: ORAL - PROSTATE|7559|||||No|No||NORTHSTAR RX LL|No||||
bicalutamide|No|No|No|No|75%|16714081602|BICALUTAMIDE 50 MG TABLET|100|EA|.30297|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|No||550|No|.3381|03/29/2022|.32998|03/29/2022|.33218|03/29/2022|||ONCOLOGY: ORAL - PROSTATE|7560|||||No|No||NORTHSTAR RX LL|No||||
oseltamivir phosphate|No|No|No|No|75%|16714081701|OSELTAMIVIR PHOS 30 MG CAPSULE|10|EA|3.86914|05/22/2019|02/22/2022|Yes|No||05/22/2019|02/22/2022|Yes|No|05/22/2019|02/22/2022|Yes|No||||No|No|||Prescription required|No||025|No|8.81804|03/29/2022|8.69206|03/29/2022|8.27816|03/29/2022|||ANTIVIRALS: ORAL|7561|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
oseltamivir phosphate|No|No|No|No|75%|16714081801|OSELTAMIVIR PHOS 45 MG CAPSULE|10|EA|3.74573|05/22/2019|02/22/2022|Yes|No||05/22/2019|02/22/2022|Yes|No|05/22/2019|02/22/2022|Yes|No||||No|No|||Prescription required|No||025|No|8.53678|03/29/2022|8.41482|03/29/2022|8.01412|03/29/2022|||ANTIVIRALS: ORAL|7562|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
tenofovir disoproxil fumarate|No|No|No|No|75%|16714082001|TENOFOVIR DISOP FUM 300 MG TB|30|EA|1.3512|09/05/2019||Yes|No||09/05/2019||Yes|No|09/05/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.62458|03/29/2022|.60959|03/29/2022|.61364|03/29/2022|||HIV / AIDS|7563|||||No|No||NORTHSTAR RX LL|No||||
methylphenidate HCl|No|No|No|No|75%|16714082101|METHYLPHENIDATE 5 MG TABLET|100|EA|.1382|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|.1394|03/29/2022|.13605|03/29/2022|.13696|03/29/2022|||STIMULANTS AND RELATED AGENTS|7564|||||No|No||NORTHSTAR RX LL|No||||
methylphenidate HCl|No|No|No|No|75%|16714082201|METHYLPHENIDATE 10 MG TABLET|100|EA|.18696|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|.15766|03/29/2022|.15387|03/29/2022|.1549|03/29/2022|||STIMULANTS AND RELATED AGENTS|7565|||||No|No||NORTHSTAR RX LL|No||||
methylphenidate HCl|No|No|No|No|75%|16714082301|METHYLPHENIDATE 20 MG TABLET|100|EA|.25099|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|.22814|03/29/2022|.22266|03/29/2022|.22414|03/29/2022|||STIMULANTS AND RELATED AGENTS|7566|||||No|No||NORTHSTAR RX LL|No||||
propafenone HCl|No|No|No|No|75%|16714082501|PROPAFENONE HCL ER 225 MG CAP|60|EA|2.28029|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No|||No|1.23841|03/29/2022|1.20868|03/29/2022|1.21673|03/29/2022||||7567|||||No|No||NORTHSTAR RX LL|No||||
propafenone HCl|No|No|No|No|75%|16714082601|PROPAFENONE HCL ER 325 MG CAP|60|EA|2.78683|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No|||No|2.24387|03/29/2022|2.19001|03/29/2022|2.2046|03/29/2022||||7568|||||No|No||NORTHSTAR RX LL|No||||
propafenone HCl|No|No|No|No|75%|16714082701|PROPAFENONE HCL ER 425 MG CAP|60|EA|2.90228|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No|||No|6.61451|03/23/2021|6.52001|03/23/2021|6.20954|03/23/2021||||7569|||||No|No||NORTHSTAR RX LL|No||||
desonide|No|No|No|No|75%|16714082801|DESONIDE 0.05% OINTMENT|15|GM|.9695|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|118|No|.83836|03/29/2022|.81823|03/29/2022|.82368|03/29/2022|||STEROIDS: TOPICAL LOW|7570|||||No|No||NORTHSTAR RX LL|No||||
desonide|No|No|No|No|75%|16714082802|DESONIDE 0.05% OINTMENT|60|GM|1.02741|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|118|No|.63751|03/29/2022|.6222|03/29/2022|.62635|03/29/2022|||STEROIDS: TOPICAL LOW|7571|||||No|No||NORTHSTAR RX LL|No||||
budesonide|No|No|No|No|75%|16714082901|BUDESONIDE DR 3 MG CAPSULE|100|EA|1.34727|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||168|Yes|.86544|03/29/2022|.84466|03/29/2022|.85029|03/29/2022|||GLUCOCORTICOIDS: ORAL|7572|||||No|No||NORTHSTAR RX LL|No||||
mesalamine|No|No|No|No|75%|16714083001|MESALAMINE DR 1.2 GM TABLET|120|EA|2.06206|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|010|No|2.75392|03/29/2022|2.68782|03/29/2022|2.70572|03/29/2022|||ULCERATIVE COLITIS AGENTS|7573|||||No|No||NORTHSTAR RX LL|No||||
bumetanide|No|No|No|No|75%|16714083101|BUMETANIDE 0.5 MG TABLET|100|EA|.36459|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|No|||No|.20616|03/29/2022|.20121|03/29/2022|.20255|03/29/2022||||7574|||||No|No||NORTHSTAR RX LL|No||||
bumetanide|No|No|No|No|75%|16714083201|BUMETANIDE 1 MG TABLET|100|EA|.36717|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|No|||No|.21417|03/29/2022|.20902|03/29/2022|.21042|03/29/2022||||7575|||||No|No||NORTHSTAR RX LL|No||||
bumetanide|No|No|No|No|75%|16714083202|BUMETANIDE 1 MG TABLET|500|EA|.36897|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|No|||No|.21417|03/29/2022|.20902|03/29/2022|.21042|03/29/2022||||7576|||||No|No||NORTHSTAR RX LL|No||||
bumetanide|No|No|No|No|75%|16714083301|BUMETANIDE 2 MG TABLET|100|EA|.68275|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|No|||No|.40198|03/29/2022|.39233|03/29/2022|.39494|03/29/2022||||7577|||||No|No||NORTHSTAR RX LL|No||||
bumetanide|No|No|No|No|75%|16714083302|BUMETANIDE 2 MG TABLET|500|EA|.67872|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|No|||No|.40198|03/29/2022|.39233|03/29/2022|.39494|03/29/2022||||7578|||||No|No||NORTHSTAR RX LL|No||||
ziprasidone HCl|No|No|No|No|75%|16714083501|ZIPRASIDONE HCL 20 MG CAPSULE|60|EA|.58007|06/17/2021||Yes|No||06/17/2021||Yes|No|06/17/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.27381|03/29/2022|.26723|03/29/2022|.26901|03/29/2022|||ANTIPSYCHOTICS|7579|||||No|No||NORTHSTAR RX LL|No||||
ziprasidone HCl|No|No|No|No|75%|16714083601|ZIPRASIDONE HCL 40 MG CAPSULE|60|EA|.3665|06/17/2021||Yes|No||06/17/2021||Yes|No|06/17/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.29914|03/29/2022|.29196|03/29/2022|.2939|03/29/2022|||ANTIPSYCHOTICS|7580|||||No|No||NORTHSTAR RX LL|No||||
ziprasidone HCl|No|No|No|No|75%|16714083701|ZIPRASIDONE HCL 60 MG CAPSULE|60|EA|.41853|06/17/2021||Yes|No||06/17/2021||Yes|No|06/17/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.38441|03/29/2022|.37518|03/29/2022|.37768|03/29/2022|||ANTIPSYCHOTICS|7581|||||No|No||NORTHSTAR RX LL|No||||
ziprasidone HCl|No|No|No|No|75%|16714083801|ZIPRASIDONE HCL 80 MG CAPSULE|60|EA|.41587|06/17/2021||Yes|No||06/17/2021||Yes|No|06/17/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.42395|03/29/2022|.41377|03/29/2022|.41653|03/29/2022|||ANTIPSYCHOTICS|7582|||||No|No||NORTHSTAR RX LL|No||||
dofetilide|No|No|No|No|75%|16714084001|DOFETILIDE 125 MCG CAPSULE|60|EA|2.30873|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No|||No|1.27252|03/29/2022|1.24197|03/29/2022|1.25025|03/29/2022||||7583|||||No|No||NORTHSTAR RX LL|No||||
dofetilide|No|No|No|No|75%|16714084101|DOFETILIDE 250 MCG CAPSULE|60|EA|2.3488|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No|||No|.89477|03/29/2022|.87329|03/29/2022|.87911|03/29/2022||||7584|||||No|No||NORTHSTAR RX LL|No||||
dofetilide|No|No|No|No|75%|16714084201|DOFETILIDE 500 MCG CAPSULE|60|EA|2.39825|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No|||No|.90796|03/29/2022|.88616|03/29/2022|.89207|03/29/2022||||7585|||||No|No||NORTHSTAR RX LL|No||||
amiodarone HCl|No|No|No|No|75%|16714084301|AMIODARONE HCL 100 MG TABLET|30|EA|1.19841|05/20/2019|05/31/2023|Yes|No||05/20/2019|05/31/2023|Yes|No|05/20/2019|05/31/2023|Yes|No||||No|No|||Prescription required|No|||No|1.5888|03/29/2022|1.55066|03/29/2022|1.56099|03/29/2022||||7586|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
amiodarone HCl|No|No|No|No|75%|16714084401|AMIODARONE HCL 200 MG TABLET|60|EA|.13029|05/20/2019|05/31/2023|Yes|No||05/20/2019|05/31/2023|Yes|No|05/20/2019|05/31/2023|Yes|No||||No|No|||Prescription required|No|||No|.12373|03/29/2022|.12076|03/29/2022|.12156|03/29/2022||||7587|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
amiodarone HCl|No|No|No|No|75%|16714084402|AMIODARONE HCL 200 MG TABLET|500|EA|.11374|05/20/2019|05/31/2023|Yes|No||05/20/2019|05/31/2023|Yes|No|05/20/2019|05/31/2023|Yes|No||||No|No|||Prescription required|No|||No|.12373|03/29/2022|.12076|03/29/2022|.12156|03/29/2022||||7588|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
amiodarone HCl|No|No|No|No|75%|16714084501|AMIODARONE HCL 400 MG TABLET|30|EA|1.67456|05/20/2019|07/31/2023|Yes|No||05/20/2019|07/31/2023|Yes|No|05/20/2019|07/31/2023|Yes|No||||No|No|||Prescription required|No|||No|3.05628|03/29/2022|2.98292|03/29/2022|3.00279|03/29/2022||||7589|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
clomipramine HCl|No|No|No|No|75%|16714084901|CLOMIPRAMINE 25 MG CAPSULE|30|EA|2.93561|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|1.31238|03/29/2022|1.28088|03/29/2022|1.28941|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7590|||||No|No||NORTHSTAR RX LL|No||||
clomipramine HCl|No|No|No|No|75%|16714084902|CLOMIPRAMINE 25 MG CAPSULE|90|EA|2.90044|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|1.31238|03/29/2022|1.28088|03/29/2022|1.28941|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7591|||||No|No||NORTHSTAR RX LL|No||||
clomipramine HCl|No|No|No|No|75%|16714084903|CLOMIPRAMINE 25 MG CAPSULE|100|EA|2.8644|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|1.31238|03/29/2022|1.28088|03/29/2022|1.28941|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7592|||||No|No||NORTHSTAR RX LL|No||||
clomipramine HCl|No|No|No|No|75%|16714085001|CLOMIPRAMINE 50 MG CAPSULE|30|EA|3.96847|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.80238|03/29/2022|.78312|03/29/2022|.78833|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7593|||||No|No||NORTHSTAR RX LL|No||||
clomipramine HCl|No|No|No|No|75%|16714085002|CLOMIPRAMINE 50 MG CAPSULE|90|EA|2.90044|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.80238|03/29/2022|.78312|03/29/2022|.78833|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7594|||||No|No||NORTHSTAR RX LL|No||||
clomipramine HCl|No|No|No|No|75%|16714085003|CLOMIPRAMINE 50 MG CAPSULE|100|EA|2.88861|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.80238|03/29/2022|.78312|03/29/2022|.78833|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7595|||||No|No||NORTHSTAR RX LL|No||||
clomipramine HCl|No|No|No|No|75%|16714085101|CLOMIPRAMINE 75 MG CAPSULE|30|EA|2.89719|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.95054|03/29/2022|.92772|03/29/2022|.9339|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7596|||||No|No||NORTHSTAR RX LL|No||||
clomipramine HCl|No|No|No|No|75%|16714085102|CLOMIPRAMINE 75 MG CAPSULE|90|EA|2.90044|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.95054|03/29/2022|.92772|03/29/2022|.9339|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7597|||||No|No||NORTHSTAR RX LL|No||||
clomipramine HCl|No|No|No|No|75%|16714085103|CLOMIPRAMINE 75 MG CAPSULE|100|EA|3.08684|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.95054|03/29/2022|.92772|03/29/2022|.9339|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7598|||||No|No||NORTHSTAR RX LL|No||||
metoprolol succinate|No|No|No|No|75%|16714085201|METOPROLOL SUCC ER 25 MG TAB|100|EA|.28079|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|7599|||||No|No||NORTHSTAR RX LL|No||||
metoprolol succinate|No|No|No|No|75%|16714085202|METOPROLOL SUCC ER 25 MG TAB|500|EA|.22431|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|7600|||||No|No||NORTHSTAR RX LL|No||||
metoprolol succinate|No|No|No|No|75%|16714085203|METOPROLOL SUCC ER 25 MG TAB|1000|EA|.31127|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|7601|||||No|No||NORTHSTAR RX LL|No||||
metoprolol succinate|No|No|No|No|75%|16714085301|METOPROLOL SUCC ER 50 MG TAB|100|EA|.28251|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|7602|||||No|No||NORTHSTAR RX LL|No||||
metoprolol succinate|No|No|No|No|75%|16714085302|METOPROLOL SUCC ER 50 MG TAB|500|EA|.22237|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|7603|||||No|No||NORTHSTAR RX LL|No||||
metoprolol succinate|No|No|No|No|75%|16714085303|METOPROLOL SUCC ER 50 MG TAB|1000|EA|.31251|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|7604|||||No|No||NORTHSTAR RX LL|No||||
metoprolol succinate|No|No|No|No|75%|16714085401|METOPROLOL SUCC ER 100 MG TAB|100|EA|.42729|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|7605|||||No|No||NORTHSTAR RX LL|No||||
metoprolol succinate|No|No|No|No|75%|16714085402|METOPROLOL SUCC ER 100 MG TAB|500|EA|.33011|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|7606|||||No|No||NORTHSTAR RX LL|No||||
metoprolol succinate|No|No|No|No|75%|16714085403|METOPROLOL SUCC ER 100 MG TAB|1000|EA|.46816|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|7607|||||No|No||NORTHSTAR RX LL|No||||
metoprolol succinate|No|No|No|No|75%|16714085501|METOPROLOL SUCC ER 200 MG TAB|100|EA|.6794|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||070|No|.25385|03/29/2022|.24775|03/29/2022|.2494|03/29/2022|||BETA-BLOCKERS|7608|||||No|No||NORTHSTAR RX LL|No||||
metoprolol succinate|No|No|No|No|75%|16714085502|METOPROLOL SUCC ER 200 MG TAB|500|EA|.51637|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||070|No|.25385|03/29/2022|.24775|03/29/2022|.2494|03/29/2022|||BETA-BLOCKERS|7609|||||No|No||NORTHSTAR RX LL|No||||
atazanavir sulfate|No|No|No|No|75%|16714086001|ATAZANAVIR SULFATE 150 MG CAP|60|EA|7.85929|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|12.83685|06/30/2020|12.65346|06/30/2020|12.05092|06/30/2020|||HIV / AIDS|7610|||||No|No||NORTHSTAR RX LL|No||||
atazanavir sulfate|No|No|No|No|75%|16714086101|ATAZANAVIR SULFATE 200 MG CAP|60|EA|7.9968|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|13.06144|02/23/2021|12.87484|02/23/2021|12.26176|02/23/2021|||HIV / AIDS|7611|||||No|No||NORTHSTAR RX LL|No||||
atazanavir sulfate|No|No|No|No|75%|16714086201|ATAZANAVIR SULFATE 300 MG CAP|30|EA|20.361|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|5.91006|05/25/2021|5.76821|05/25/2021|5.80663|05/25/2021|||HIV / AIDS|7612|||||No|No||NORTHSTAR RX LL|No||||
paliperidone|No|No|No|No|75%|16714086601|PALIPERIDONE ER 1.5 MG TABLET|30|EA|10.93518|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|4.83706|03/29/2022|4.72097|03/29/2022|4.75241|03/29/2022|||ANTIPSYCHOTICS|7613|||||No|No||NORTHSTAR RX LL|No||||
paliperidone|No|No|No|No|75%|16714086701|PALIPERIDONE ER 3 MG TABLET|30|EA|10.81349|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|6.18339|03/29/2022|6.03498|03/29/2022|6.07518|03/29/2022|||ANTIPSYCHOTICS|7614|||||No|No||NORTHSTAR RX LL|No||||
paliperidone|No|No|No|No|75%|16714086801|PALIPERIDONE ER 6 MG TABLET|30|EA|10.81636|09/04/2019||Yes|No||09/04/2019||Yes|No|09/04/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|5.21133|03/29/2022|5.08625|03/29/2022|5.12013|03/29/2022|||ANTIPSYCHOTICS|7615|||||No|No||NORTHSTAR RX LL|No||||
paliperidone|No|No|No|No|75%|16714086901|PALIPERIDONE ER 9 MG TABLET|30|EA|16.2249|09/04/2019||Yes|No||09/04/2019||Yes|No|09/04/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|7.23268|03/29/2022|7.05909|03/29/2022|7.1061|03/29/2022|||ANTIPSYCHOTICS|7616|||||No|No||NORTHSTAR RX LL|No||||
risedronate sodium|No|No|No|No|75%|16714087002|RISEDRONATE SOD DR 35 MG TAB|4|EA|18.44162|02/25/2020||Yes|No||02/25/2020||Yes|No|02/25/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|060|No|29.533|03/29/2022|28.8242|03/29/2022|29.01617|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|7617|||||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|Yes|No|No|No|75%|16714087401|ATORVASTATIN 10 MG TABLET|90|EA|.08408|09/20/2019|02/28/2023|Yes|No||09/20/2019|02/28/2023|Yes|No|09/20/2019|02/28/2023|Yes|No||||No|No|01/15/2020|02/28/2023|Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|7618|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|Yes|No|No|No|75%|16714087402|ATORVASTATIN 10 MG TABLET|500|EA|.05479|09/20/2019|02/28/2023|Yes|No||09/20/2019|02/28/2023|Yes|No|09/20/2019|02/28/2023|Yes|No||||No|No|01/15/2020|02/28/2023|Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|7619|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|Yes|No|No|No|75%|16714087403|ATORVASTATIN 10 MG TABLET|1000|EA|.09204|09/20/2019|04/30/2023|Yes|No||09/20/2019|04/30/2023|Yes|No|09/20/2019|04/30/2023|Yes|No||||No|No|01/15/2020|04/30/2023|Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|7620|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|Yes|No|No|No|75%|16714087501|ATORVASTATIN 20 MG TABLET|90|EA|.1192|09/20/2019|02/28/2023|Yes|No||09/20/2019|02/28/2023|Yes|No|09/20/2019|02/28/2023|Yes|No||||No|No|01/15/2020|02/28/2023|Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|7621|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|Yes|No|No|No|75%|16714087502|ATORVASTATIN 20 MG TABLET|500|EA|.07412|09/20/2019|03/31/2023|Yes|No||09/20/2019|03/31/2023|Yes|No|09/20/2019|03/31/2023|Yes|No||||No|No|01/15/2020|03/31/2023|Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|7622|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|Yes|No|No|No|75%|16714087503|ATORVASTATIN 20 MG TABLET|1000|EA|.13634|09/20/2019|03/31/2023|Yes|No||09/20/2019|03/31/2023|Yes|No|09/20/2019|03/31/2023|Yes|No||||No|No|01/15/2020|03/31/2023|Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|7623|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|Yes|No|No|No|75%|16714087601|ATORVASTATIN 40 MG TABLET|90|EA|.12083|09/20/2019|03/31/2023|Yes|No||09/20/2019|03/31/2023|Yes|No|09/20/2019|03/31/2023|Yes|No||||No|No|01/15/2020|03/31/2023|Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|7624|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|Yes|No|No|No|75%|16714087602|ATORVASTATIN 40 MG TABLET|500|EA|.07757|09/20/2019|04/30/2023|Yes|No||09/20/2019|04/30/2023|Yes|No|09/20/2019|04/30/2023|Yes|No||||No|No|01/15/2020|04/30/2023|Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|7625|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|Yes|No|No|No|75%|16714087603|ATORVASTATIN 40 MG TABLET|1000|EA|.12263|09/20/2019|03/31/2023|Yes|No||09/20/2019|03/31/2023|Yes|No|09/20/2019|03/31/2023|Yes|No||||No|No|01/15/2020|03/31/2023|Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|7626|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|Yes|No|No|No|75%|16714087701|ATORVASTATIN 80 MG TABLET|90|EA|.12068|09/20/2019|03/31/2023|Yes|No||09/20/2019|03/31/2023|Yes|No|09/20/2019|03/31/2023|Yes|No||||No|No|01/15/2020|03/31/2023|Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|7627|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|Yes|No|No|No|75%|16714087702|ATORVASTATIN 80 MG TABLET|500|EA|.09216|09/20/2019|03/31/2023|Yes|No||09/20/2019|03/31/2023|Yes|No|09/20/2019|03/31/2023|Yes|No||||No|No|01/15/2020|03/31/2023|Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|7628|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
atorvastatin calcium|Yes|No|No|No|75%|16714087703|ATORVASTATIN 80 MG TABLET|1000|EA|.12961|09/20/2019|03/31/2023|Yes|No||09/20/2019|03/31/2023|Yes|No|09/20/2019|03/31/2023|Yes|No||||No|No|01/15/2020|03/31/2023|Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|7629|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
lidocaine|No|No|No|No|75%|16714087801|LIDOCAINE 5% OINTMENT|35.44|GM|.78355|09/05/2019||Yes|No||09/05/2019||Yes|No|09/05/2019||Yes|No||||No|No|||Prescription required|No|||No|.18796|03/29/2022|.18344|03/29/2022|.18467|03/29/2022||||7630|||||No|No||NORTHSTAR RX LL|No||||
lidocaine|No|No|No|No|75%|16714087802|LIDOCAINE 5% OINTMENT|50|GM|.78913|09/05/2019||Yes|No||09/05/2019||Yes|No|09/05/2019||Yes|No||||No|No|||Prescription required|No|||No|.22969|03/29/2022|.22417|03/29/2022|.22567|03/29/2022||||7631|||||No|No||NORTHSTAR RX LL|No||||
desmopressin acetate|No|No|No|No|75%|16714088301|DESMOPRESSIN ACETATE 0.1 MG TB|100|EA|.39233|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||||No|No|||Prescription required|No|||Yes|.41734|03/29/2022|.40732|03/29/2022|.41003|03/29/2022||||7632|||||No|No||NORTHSTAR RX LL|No||||
desmopressin acetate|No|No|No|No|75%|16714088401|DESMOPRESSIN ACETATE 0.2 MG TB|100|EA|.45102|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||||No|No|||Prescription required|No|||Yes|.446|03/29/2022|.43529|03/29/2022|.43819|03/29/2022||||7633|||||No|No||NORTHSTAR RX LL|No||||
acyclovir|No|No|No|No|75%|16714088501|ACYCLOVIR 5% OINTMENT|15|GM|5.25632|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.36934|03/29/2022|1.33647|03/29/2022|1.34537|03/29/2022|||ANTIVIRALS: TOPICAL|7634|||||No|No||NORTHSTAR RX LL|No||||
acyclovir|No|No|No|No|75%|16714088502|ACYCLOVIR 5% OINTMENT|30|GM|5.05938|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.03754|03/29/2022|1.01263|03/29/2022|1.01938|03/29/2022|||ANTIVIRALS: TOPICAL|7635|||||No|No||NORTHSTAR RX LL|No||||
clobazam|No|No|No|No|90%|16714088701|CLOBAZAM 10 MG TABLET|100|EA|.75344|09/04/2019||Yes|No||09/04/2019||Yes|No|09/04/2019||Yes|No||||No|No|||Prescription required|No||056|No|.37729|03/29/2022|.36823|03/29/2022|.37068|03/29/2022|||ANTICONVULSANTS|7636|||||No|No||NORTHSTAR RX LL|No||||
clobazam|No|No|No|No|90%|16714088801|CLOBAZAM 20 MG TABLET|100|EA|1.50684|09/04/2019||Yes|No||09/04/2019||Yes|No|09/04/2019||Yes|No||||No|No|||Prescription required|No||056|No|.71967|03/29/2022|.70239|03/29/2022|.70707|03/29/2022|||ANTICONVULSANTS|7637|||||No|No||NORTHSTAR RX LL|No||||
ertapenem sodium|No|No|No|No|75%|16714088910|ERTAPENEM 1 GRAM VIAL|1|EA|45.63676|03/22/2022||Yes|No||03/22/2022||Yes|No|03/22/2022||Yes|No||||No|No|||Prescription required|No|||No|104.00936|03/22/2022|102.52351|03/22/2022|97.64144|03/22/2022||||7638|||||No|No||NORTHSTAR RX LL|No||||
sumatriptan succ/naproxen sod|No|No|No|No|75%|16714089101|SUMATRIPTAN-NAPROXEN 85-500 MG|9|EA|29.186|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|021|Yes|22.04755|03/29/2022|21.5184|03/29/2022|21.66171|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|7639|||||No|No||NORTHSTAR RX LL|No||||
daptomycin|No|No|No|No|75%|16714089201|DAPTOMYCIN 500 MG VIAL|1|EA|176.2183|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No|||No|401.6138|12/24/2019|395.87646|12/16/2019|377.0252|12/16/2019||||7640|||||No|No||NORTHSTAR RX LL|No||||
lamotrigine|No|No|No|No|75%|16714089301|LAMOTRIGINE ER 250 MG TABLET|30|EA|5.86821|05/28/2019||Yes|No||05/28/2019||Yes|No|05/28/2019||Yes|No||||No|No|||Prescription required|No||056|No|5.54243|03/29/2022|5.40941|03/29/2022|5.44543|03/29/2022|||ANTICONVULSANTS|7641|||||No|No||NORTHSTAR RX LL|No||||
glipizide|No|No|No|No|75%|16714089401|GLIPIZIDE ER 2.5 MG TABLET|30|EA|.09617|06/17/2021||Yes|No||06/17/2021||Yes|No|06/17/2021||Yes|No||||No|No|||Prescription required|No|||Yes|.12809|03/29/2022|.12501|03/29/2022|.12584|03/29/2022||||7642|||||No|No||NORTHSTAR RX LL|No||||
glipizide|No|No|No|No|75%|16714089501|GLIPIZIDE ER 5 MG TABLET|100|EA|.08139|06/17/2021||Yes|No||06/17/2021||Yes|No|06/17/2021||Yes|No||||No|No|||Prescription required|No|||Yes|.11105|03/29/2022|.10838|03/29/2022|.1091|03/29/2022||||7643|||||No|No||NORTHSTAR RX LL|No||||
glipizide|No|No|No|No|75%|16714089502|GLIPIZIDE ER 5 MG TABLET|500|EA|.06561|06/17/2021||Yes|No||06/17/2021||Yes|No|06/17/2021||Yes|No||||No|No|||Prescription required|No|||Yes|.11105|03/29/2022|.10838|03/29/2022|.1091|03/29/2022||||7644|||||No|No||NORTHSTAR RX LL|No||||
glipizide|No|No|No|No|75%|16714089601|GLIPIZIDE ER 10 MG TABLET|100|EA|.16576|06/17/2021||Yes|No||06/17/2021||Yes|No|06/17/2021||Yes|No||||No|No|||Prescription required|No|||No|.184|03/29/2022|.17958|03/29/2022|.18078|03/29/2022||||7645|||||No|No||NORTHSTAR RX LL|No||||
glipizide|No|No|No|No|75%|16714089602|GLIPIZIDE ER 10 MG TABLET|500|EA|.18886|06/17/2021||Yes|No||06/17/2021||Yes|No|06/17/2021||Yes|No||||No|No|||Prescription required|No|||No|.184|03/29/2022|.17958|03/29/2022|.18078|03/29/2022||||7646|||||No|No||NORTHSTAR RX LL|No||||
permethrin|No|No|No|No|75%|16714089701|PERMETHRIN 5% CREAM|60|GM|.7095|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|||Prescription required|No||122|No|.34397|03/29/2022|.33571|03/29/2022|.33795|03/29/2022|||ANTIPARASITICS: TOPICAL|7647|||||No|No||NORTHSTAR RX LL|No||||
loratadine|No|No|No|No|75%|16714089801|LORATADINE 10 MG TABLET|30|EA|.0344|09/05/2019||Yes|No||||No|No|09/05/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|7648|||||No|No||NORTHSTAR RX LL|No||||
loratadine|No|No|No|No|75%|16714089802|LORATADINE 10 MG TABLET|100|EA|.03607|09/05/2019||Yes|No||||No|No|09/05/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|7649|||||No|No||NORTHSTAR RX LL|No||||
loratadine|No|No|No|No|75%|16714089803|LORATADINE 10 MG TABLET|300|EA|.01651|09/05/2019||Yes|No||||No|No|09/05/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|7650|||||No|No||NORTHSTAR RX LL|No||||
fexofenadine HCl|No|No|No|No|75%|16714089901|FEXOFENADINE HCL 180 MG TABLET|30|EA|.20697|02/21/2020||Yes|No||||No|No|02/21/2020||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.28782|03/29/2022|.28091|03/29/2022|.28278|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|7651|||||No|No||NORTHSTAR RX LL|No||||
fexofenadine HCl|No|No|No|No|75%|16714089902|FEXOFENADINE HCL 180 MG TABLET|100|EA|.13235|02/21/2020||Yes|No||||No|No|02/21/2020||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.28782|03/29/2022|.28091|03/29/2022|.28278|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|7652|||||No|No||NORTHSTAR RX LL|No||||
atovaquone|No|No|No|No|75%|16714090001|ATOVAQUONE 750 MG/5 ML SUSP|210|ML|2.07365|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|1.13871|03/29/2022|1.11138|03/29/2022|1.11878|03/29/2022||||7653|||||No|No||NORTHSTAR RX LL|No||||
venlafaxine HCl|No|No|No|No|75%|16714090301|VENLAFAXINE HCL ER 37.5 MG TAB|30|EA|2.21521|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|031|Yes|1.96254|10/26/2021|1.91543|10/26/2021|1.92819|10/26/2021|||ANTIDEPRESSANTS: OTHER|7654|||||No|No||NORTHSTAR RX LL|No||||
venlafaxine HCl|No|No|No|No|75%|16714090302|VENLAFAXINE HCL ER 37.5 MG TAB|90|EA|2.22204|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|031|Yes|1.96254|10/26/2021|1.91543|10/26/2021|1.92819|10/26/2021|||ANTIDEPRESSANTS: OTHER|7655|||||No|No||NORTHSTAR RX LL|No||||
venlafaxine HCl|No|No|No|No|75%|16714090401|VENLAFAXINE HCL ER 75 MG TAB|30|EA|2.48024|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|031|Yes|1.5965|03/29/2022|1.55818|03/29/2022|1.56856|03/29/2022|||ANTIDEPRESSANTS: OTHER|7656|||||No|No||NORTHSTAR RX LL|No||||
venlafaxine HCl|No|No|No|No|75%|16714090402|VENLAFAXINE HCL ER 75 MG TAB|90|EA|2.50088|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|031|Yes|1.5965|03/29/2022|1.55818|03/29/2022|1.56856|03/29/2022|||ANTIDEPRESSANTS: OTHER|7657|||||No|No||NORTHSTAR RX LL|No||||
venlafaxine HCl|No|No|No|No|75%|16714090501|VENLAFAXINE HCL ER 150 MG TAB|30|EA|2.70255|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|031|No|2.65947|03/29/2022|2.59564|03/29/2022|2.61292|03/29/2022|||ANTIDEPRESSANTS: OTHER|7658|||||No|No||NORTHSTAR RX LL|No||||
venlafaxine HCl|No|No|No|No|75%|16714090502|VENLAFAXINE HCL ER 150 MG TAB|90|EA|2.70484|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|031|No|2.65947|03/29/2022|2.59564|03/29/2022|2.61292|03/29/2022|||ANTIDEPRESSANTS: OTHER|7659|||||No|No||NORTHSTAR RX LL|No||||
glycopyrrolate|No|No|No|No|75%|16714090625|GLYCOPYRROLATE 0.2 MG/ML VIAL|1|ML|3.72689|03/02/2020|07/31/2023|Yes|No||03/02/2020|07/31/2023|Yes|No|03/02/2020|07/31/2023|Yes|No||||No|No|||Prescription required|No|||No|8.49385|03/02/2020|8.37251|03/02/2020|7.97382|03/02/2020||||7660|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
albendazole|No|No|No|No|75%|16714090701|ALBENDAZOLE 200 MG TABLET|2|EA|82.2074|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No|||No|16.91042|03/29/2022|16.50456|03/29/2022|16.61448|03/29/2022||||7661|||||No|No||NORTHSTAR RX LL|No||||
albendazole|No|No|No|No|75%|16714090702|ALBENDAZOLE 200 MG TABLET|2|EA|82.20525|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No|||No|16.91042|03/29/2022|16.50456|03/29/2022|16.61448|03/29/2022||||7662|||||No|No||NORTHSTAR RX LL|No||||
pramipexole di-HCl|No|No|No|No|75%|16714091601|PRAMIPEXOLE ER 0.375 MG TABLET|30|EA|4.61805|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|015|No|10.52486|03/24/2020|10.37451|03/24/2020|9.88048|03/24/2020|||ANTIPARKINSON'S AGENTS|7663|||||No|No||NORTHSTAR RX LL|No||||
pramipexole di-HCl|No|No|No|No|75%|16714091701|PRAMIPEXOLE ER 0.75 MG TABLET|30|EA|4.99803|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|015|No|11.39086|12/11/2019|11.22813|12/11/2019|10.69346|12/11/2019|||ANTIPARKINSON'S AGENTS|7664|||||No|No||NORTHSTAR RX LL|No||||
pramipexole di-HCl|No|No|No|No|75%|16714091801|PRAMIPEXOLE ER 1.5 MG TABLET|30|EA|4.88996|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|015|No|5.85567|03/01/2022|5.71513|03/01/2022|5.75319|03/01/2022|||ANTIPARKINSON'S AGENTS|7665|||||No|No||NORTHSTAR RX LL|No||||
pramipexole di-HCl|No|No|No|No|75%|16714091901|PRAMIPEXOLE ER 2.25 MG TABLET|30|EA|4.25169|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|015|No|9.6899|12/11/2019|9.55147|12/11/2019|9.09664|12/11/2019|||ANTIPARKINSON'S AGENTS|7666|||||No|No||NORTHSTAR RX LL|No||||
pramipexole di-HCl|No|No|No|No|75%|16714092001|PRAMIPEXOLE ER 3 MG TABLET|30|EA|5.02627|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|015|No|11.45522|04/27/2021|11.29157|04/27/2021|10.75388|04/27/2021|||ANTIPARKINSON'S AGENTS|7667|||||No|No||NORTHSTAR RX LL|No||||
pramipexole di-HCl|No|No|No|No|75%|16714092201|PRAMIPEXOLE ER 4.5 MG TABLET|30|EA|4.58337|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|015|No|10.44582|12/11/2019|10.29659|12/11/2019|9.80628|12/11/2019|||ANTIPARKINSON'S AGENTS|7668|||||No|No||NORTHSTAR RX LL|No||||
azacitidine|No|No|No|No|75%|16714092701|AZACITIDINE 100 MG VIAL|1|EA|116.3021|12/12/2019|09/30/2023|Yes|No||12/12/2019|09/30/2023|Yes|No|12/12/2019|09/30/2023|Yes|No||||No|No|||Prescription required|No|||No|265.0606|12/12/2019|261.27402|12/12/2019|248.8324|12/12/2019||||7669|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
atenolol/chlorthalidone|No|No|No|No|75%|16714093601|ATENOLOL-CHLORTHALIDONE 50-25|100|EA|.24221|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||070|Yes|.37465|03/29/2022|.36565|03/29/2022|.36809|03/29/2022|||BETA-BLOCKERS|7670|||||No|No||NORTHSTAR RX LL|No||||
atenolol/chlorthalidone|No|No|No|No|75%|16714093701|ATENOLOL-CHLORTHALIDONE 100-25|100|EA|.35161|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|||Prescription required|No||070|Yes|.47415|03/29/2022|.46277|03/29/2022|.46585|03/29/2022|||BETA-BLOCKERS|7671|||||No|No||NORTHSTAR RX LL|No||||
metformin HCl|Yes|No|No|No|75%|16714093901|METFORMIN ER 1,000 MG GASTR-TB|90|EA|45.22003|05/18/2020|02/28/2022|Yes|No||05/18/2020|02/28/2022|Yes|No|05/18/2020|02/28/2022|Yes|No||||No|No|06/19/2020|02/28/2022|Prescription required|No||012|No|103.05962|03/15/2022|101.58734|03/15/2022|96.74984|03/15/2022|||HYPOGLYCEMICS: METFORMINS|7672|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|16714094801|DEXTROAMP-AMPHETAMINE 5 MG TAB|100|EA|.28487|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|.21985|03/29/2022|.21457|03/29/2022|.216|03/29/2022|||STIMULANTS AND RELATED AGENTS|7673|||||No|No||NORTHSTAR RX LL|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|16714094901|DEXTROAMP-AMPHETAM 7.5 MG TAB|100|EA|.37775|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|.45915|03/29/2022|.44813|03/29/2022|.45111|03/29/2022|||STIMULANTS AND RELATED AGENTS|7674|||||No|No||NORTHSTAR RX LL|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|16714095001|DEXTROAMP-AMPHETAMIN 10 MG TAB|100|EA|.29807|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|.24071|03/29/2022|.23493|03/29/2022|.23649|03/29/2022|||STIMULANTS AND RELATED AGENTS|7675|||||No|No||NORTHSTAR RX LL|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|16714095101|DEXTROAMP-AMPHETAM 12.5 MG TAB|100|EA|.39237|06/18/2021||Yes|No||06/18/2021||Yes|No|06/18/2021||Yes|No||||No|No|||Prescription required|No||007|Yes|.65907|03/01/2022|.64325|03/01/2022|.64753|03/01/2022|||STIMULANTS AND RELATED AGENTS|7676|||||No|No||NORTHSTAR RX LL|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|16714095201|DEXTROAMP-AMPHETAMIN 15 MG TAB|100|EA|.3022|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|.25605|03/29/2022|.2499|03/29/2022|.25156|03/29/2022|||STIMULANTS AND RELATED AGENTS|7677|||||No|No||NORTHSTAR RX LL|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|16714095301|DEXTROAMP-AMPHETAMIN 20 MG TAB|100|EA|.31566|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|.31357|03/29/2022|.30604|03/29/2022|.30808|03/29/2022|||STIMULANTS AND RELATED AGENTS|7678|||||No|No||NORTHSTAR RX LL|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|16714095401|DEXTROAMP-AMPHETAMIN 30 MG TAB|100|EA|.332|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|.30925|03/29/2022|.30182|03/29/2022|.30383|03/29/2022|||STIMULANTS AND RELATED AGENTS|7679|||||No|No||NORTHSTAR RX LL|No||||
ketoconazole|No|No|No|No|75%|16714095501|KETOCONAZOLE 2% CREAM|15|GM|.68972|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|.53088|03/29/2022|.51813|03/29/2022|.52158|03/29/2022|||ANTIFUNGALS: TOPICAL|7680|||||No|No||NORTHSTAR RX LL|No||||
ketoconazole|No|No|No|No|75%|16714095502|KETOCONAZOLE 2% CREAM|30|GM|.58107|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|.43567|03/29/2022|.42521|03/29/2022|.42804|03/29/2022|||ANTIFUNGALS: TOPICAL|7681|||||No|No||NORTHSTAR RX LL|No||||
ketoconazole|No|No|No|No|75%|16714095503|KETOCONAZOLE 2% CREAM|60|GM|.43637|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|.36478|03/29/2022|.35602|03/29/2022|.35839|03/29/2022|||ANTIFUNGALS: TOPICAL|7682|||||No|No||NORTHSTAR RX LL|No||||
dapsone|No|No|No|No|75%|16714095601|DAPSONE 5% GEL|60|GM|2.93324|02/05/2020||Yes|No||02/05/2020||Yes|No|02/05/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|104|No|3.1867|03/29/2022|3.11021|03/29/2022|3.13093|03/29/2022|||ACNE AGENTS: TOPICAL|7683|||||No|No||NORTHSTAR RX LL|No||||
dapsone|No|No|No|No|75%|16714095602|DAPSONE 5% GEL|90|GM|2.53465|02/05/2020||Yes|No||02/05/2020||Yes|No|02/05/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|104|No|2.65305|03/29/2022|2.58937|03/29/2022|2.60662|03/29/2022|||ACNE AGENTS: TOPICAL|7684|||||No|No||NORTHSTAR RX LL|No||||
abiraterone acetate|No|No|No|No|75%|16714096301|ABIRATERONE ACETATE 250 MG TAB|120|EA|1.20729|03/04/2021||Yes|No||03/04/2021||Yes|No|03/04/2021||Yes|No||||No|No|||Prescription required|No||550|No|2.7515|09/28/2021|2.71219|09/28/2021|2.58304|09/28/2021|||ONCOLOGY: ORAL - PROSTATE|7685|||||No|No||NORTHSTAR RX LL|No||||
aspirin/dipyridamole|No|No|No|No|75%|16714096401|ASPIRIN-DIPYRIDAM ER 25-200 MG|60|EA|2.12684|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|No||004|No|.78047|03/29/2022|.76173|03/29/2022|.76681|03/29/2022|||PLATELET AGGREGATION INHIBITORS|7686|||||No|No||NORTHSTAR RX LL|No||||
testosterone|No|No|No|No|90%|16714096701|TESTOSTERONE 1.62% GEL PUMP|75|GM|1.1462|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|084|No|.65888|03/29/2022|.64306|03/29/2022|.64734|03/29/2022|||ANDROGENIC AGENTS|7687|||||No|No||NORTHSTAR RX LL|No||||
phytonadione (vit K1)|No|No|No|No|75%|16714097301|PHYTONADIONE 5 MG TABLET|100|EA|23.04331|06/21/2021||Yes|No||06/21/2021||Yes|No|06/21/2021||Yes|No||||No|No|||Prescription required|No|||No|52.51731|07/27/2021|51.76707|07/27/2021|49.30197|07/27/2021||||7688|||||No|No||NORTHSTAR RX LL|No||||
mometasone furoate|No|No|No|No|75%|16714097401|MOMETASONE FUROATE 0.1% CREAM|15|GM|.50166|05/18/2020||Yes|No||05/18/2020||Yes|No|05/18/2020||Yes|No||||No|No|||Prescription required|No||119|No|.51132|03/29/2022|.49904|03/29/2022|.50237|03/29/2022|||STEROIDS: TOPICAL MEDIUM|7689|||||No|No||NORTHSTAR RX LL|No||||
mometasone furoate|No|No|No|No|75%|16714097402|MOMETASONE FUROATE 0.1% CREAM|45|GM|.28666|05/18/2020||Yes|No||05/18/2020||Yes|No|05/18/2020||Yes|No||||No|No|||Prescription required|No||119|No|.32851|03/29/2022|.32062|03/29/2022|.32276|03/29/2022|||STEROIDS: TOPICAL MEDIUM|7690|||||No|No||NORTHSTAR RX LL|No||||
diclofenac sodium|No|No|No|No|75%|16714097601|DICLOFENAC SODIUM 1% GEL|100|GM|.18189|05/20/2020|07/31/2022|Yes|No||05/20/2020|07/31/2022|Yes|No|05/20/2020|07/31/2022|Yes|No||||No|No|||Prescription required|No||059|Yes|.08846|03/29/2022|.08633|03/29/2022|.08691|03/29/2022|||NSAIDS|7691|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
esomeprazole magnesium|No|No|No|No|75%|16714097901|ESOMEPRAZOLE MAG DR 20 MG CAP|30|EA|.51786|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|7692|||||No|No||NORTHSTAR RX LL|No||||
esomeprazole magnesium|No|No|No|No|75%|16714097902|ESOMEPRAZOLE MAG DR 20 MG CAP|90|EA|1.17251|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|7693|||||No|No||NORTHSTAR RX LL|No||||
esomeprazole magnesium|No|No|No|No|75%|16714098001|ESOMEPRAZOLE MAG DR 40 MG CAP|30|EA|.49134|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|7694|||||No|No||NORTHSTAR RX LL|No||||
esomeprazole magnesium|No|No|No|No|75%|16714098002|ESOMEPRAZOLE MAG DR 40 MG CAP|90|EA|.90204|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|7695|||||No|No||NORTHSTAR RX LL|No||||
medroxyprogesterone acetate|No|Yes|No|No|75%|16714098101|MEDROXYPROGESTERONE 150 MG/ML|1|ML|26.3934|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|31.14606|03/29/2022|30.39855|03/29/2022|30.601|03/29/2022||||7696|||||No|No||NORTHSTAR RX LL|No||||
medroxyprogesterone acetate|No|Yes|No|No|75%|16714098102|MEDROXYPROGESTERONE 150 MG/ML|1|ML|24.25337|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|30.77229|09/28/2021|30.03375|09/28/2021|30.23377|09/28/2021||||7697|||||No|No||NORTHSTAR RX LL|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|16714098425|CLINDAMYCIN-BENZOYL PEROX 1-5%|25|GM|1.58515|09/28/2020||Yes|No||09/28/2020||Yes|No|09/28/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|.996|03/29/2022|.97209|03/29/2022|.97857|03/29/2022|||ACNE AGENTS: TOPICAL|7698|||||No|No||NORTHSTAR RX LL|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|16714098450|CLINDAMYCIN-BENZOYL PEROX 1-5%|50|GM|1.29713|09/28/2020||Yes|No||09/28/2020||Yes|No|09/28/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|.80914|03/29/2022|.78972|03/29/2022|.79498|03/29/2022|||ACNE AGENTS: TOPICAL|7699|||||No|No||NORTHSTAR RX LL|No||||
rosuvastatin calcium|Yes|No|No|No|75%|16714098801|ROSUVASTATIN CALCIUM 5 MG TAB|90|EA|.08819|05/18/2020||Yes|No||05/18/2020||Yes|No|05/18/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||063|Yes|.06753|03/29/2022|.0659|03/29/2022|.06634|03/29/2022|||LIPOTROPICS: STATINS|7700|||||No|No||NORTHSTAR RX LL|No||||
rosuvastatin calcium|Yes|No|No|No|75%|16714098901|ROSUVASTATIN CALCIUM 10 MG TAB|90|EA|.08633|05/18/2020||Yes|No||05/18/2020||Yes|No|05/18/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||063|Yes|.05981|03/29/2022|.05837|03/29/2022|.05876|03/29/2022|||LIPOTROPICS: STATINS|7701|||||No|No||NORTHSTAR RX LL|No||||
rosuvastatin calcium|Yes|No|No|No|75%|16714099001|ROSUVASTATIN CALCIUM 20 MG TAB|90|EA|.08537|05/18/2020||Yes|No||05/18/2020||Yes|No|05/18/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||063|Yes|.07822|03/29/2022|.07634|03/29/2022|.07685|03/29/2022|||LIPOTROPICS: STATINS|7702|||||No|No||NORTHSTAR RX LL|No||||
rosuvastatin calcium|Yes|No|No|No|75%|16714099101|ROSUVASTATIN CALCIUM 40 MG TAB|30|EA|.08743|05/18/2020||Yes|No||05/18/2020||Yes|No|05/18/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|7703|||||No|No||NORTHSTAR RX LL|No||||
clobetasol propionate|No|No|No|No|75%|16714099201|CLOBETASOL 0.05% CREAM|15|GM|2.04966|12/11/2020|03/31/2023|Yes|No||12/11/2020|03/31/2023|Yes|No|12/11/2020|03/31/2023|Yes|No||||No|No|||Prescription required|No||121|No|.42879|03/29/2022|.41849|03/29/2022|.42128|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|7704|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
clobetasol propionate|No|No|No|No|75%|16714099202|CLOBETASOL 0.05% CREAM|30|GM|1.8983|12/11/2020|01/31/2023|Yes|No||12/11/2020|01/31/2023|Yes|No|12/11/2020|01/31/2023|Yes|No||||No|No|||Prescription required|No||121|No|.34489|03/29/2022|.33661|03/29/2022|.33885|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|7705|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
clobetasol propionate|No|No|No|No|75%|16714099203|CLOBETASOL 0.05% CREAM|45|GM|2.03743|12/11/2020|12/31/2022|Yes|No||12/11/2020|12/31/2022|Yes|No|12/11/2020|12/31/2022|Yes|No||||No|No|||Prescription required|No||121|No|.31467|03/29/2022|.30711|03/29/2022|.30916|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|7706|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
clobetasol propionate|No|No|No|No|75%|16714099204|CLOBETASOL 0.05% CREAM|60|GM|1.83588|12/11/2020|03/31/2023|Yes|No||12/11/2020|03/31/2023|Yes|No|12/11/2020|03/31/2023|Yes|No||||No|No|||Prescription required|No||121|No|.33784|03/29/2022|.32973|03/29/2022|.33192|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|7707|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
deferasirox|No|No|No|No|75%|16714099301|DEFERASIROX 90 MG TABLET|30|EA|3.69599|12/11/2020|02/28/2022|Yes|No||12/11/2020|02/28/2022|Yes|No|12/11/2020|02/28/2022|Yes|No||||No|No|||Prescription required|No|||No|8.42342|12/11/2020|8.30308|12/11/2020|7.9077|12/11/2020||||7708|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
deferasirox|No|No|No|No|75%|16714099401|DEFERASIROX 180 MG TABLET|30|EA|16.19509|03/04/2021|07/31/2022|Yes|No||03/04/2021|07/31/2022|Yes|No|03/04/2021|07/31/2022|Yes|No||||No|No|||Prescription required|No|||No|36.90974|03/04/2021|36.38245|03/04/2021|34.64996|03/04/2021||||7709|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
deferasirox|No|No|No|No|75%|16714099501|DEFERASIROX 360 MG TABLET|30|EA|21.72517|12/11/2020|03/31/2022|Yes|No||12/11/2020|03/31/2022|Yes|No|12/11/2020|03/31/2022|Yes|No||||No|No|||Prescription required|No|||No|49.51318|12/11/2020|48.80585|12/11/2020|46.48176|12/11/2020||||7710|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
betamethasone dipropionate|No|No|No|No|75%|16714099601|BETAMETHASONE DP 0.05% CRM|15|GM|1.04146|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|120|No|1.02286|03/29/2022|.99831|03/29/2022|1.00495|03/29/2022|||STEROIDS: TOPICAL HIGH|7711|||||No|No||NORTHSTAR RX LL|No||||
betamethasone dipropionate|No|No|No|No|75%|16714099602|BETAMETHASONE DP 0.05% CRM|45|GM|.69325|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|120|No|.64604|03/29/2022|.63053|03/29/2022|.63473|03/29/2022|||STEROIDS: TOPICAL HIGH|7712|||||No|No||NORTHSTAR RX LL|No||||
glycopyrrolate|No|No|No|No|75%|16714099825|GLYCOPYRROLATE 0.4 MG/2 ML VL|2|ML|3.19386|03/02/2020|01/31/2023|Yes|No||03/02/2020|01/31/2023|Yes|No|03/02/2020|01/31/2023|Yes|No||||No|No|||Prescription required|No|||No|7.27904|03/02/2020|7.17506|03/02/2020|6.83339|03/02/2020||||7713|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
medroxyprogesterone acetate|No|Yes|No|No|75%|16714099901|MEDROXYPROGESTERONE 150 MG/ML|1|ML|35.9437|12/11/2020||Yes|No||||No|No|12/11/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|35.94375|03/01/2022|35.0811|03/01/2022|35.31473|03/01/2022||||7714|||||No|No||NORTHSTAR RX LL|No||||
glimepiride|Yes|No|No|No|75%|16729000101|GLIMEPIRIDE 1 MG TABLET|100|EA|.03844|04/24/2009||Yes|No||04/24/2009||Yes|No|04/24/2009||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.03361|03/29/2022|.0328|03/29/2022|.03302|03/29/2022||||7715|||||No|No||ACCORD HEALTHCA|No||||
glimepiride|Yes|No|No|No|75%|16729000116|GLIMEPIRIDE 1 MG TABLET|500|EA|.03844|01/28/2019||Yes|No||01/28/2019||Yes|No|01/28/2019||Yes|No||||No|No|06/18/2019||Prescription required|No|||No|.03361|03/29/2022|.0328|03/29/2022|.03302|03/29/2022||||7716|||||No|No||ACCORD HEALTHCA|No||||
glimepiride|Yes|No|No|No|75%|16729000201|GLIMEPIRIDE 2 MG TABLET|100|EA|.0623|04/28/2009||Yes|No||04/28/2009||Yes|No|04/28/2009||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.03979|03/29/2022|.03883|03/29/2022|.03909|03/29/2022||||7717|||||No|No||ACCORD HEALTHCA|No||||
glimepiride|Yes|No|No|No|75%|16729000216|GLIMEPIRIDE 2 MG TABLET|500|EA|.0623|01/28/2019||Yes|No||01/28/2019||Yes|No|01/28/2019||Yes|No||||No|No|06/18/2019||Prescription required|No|||No|.03979|03/29/2022|.03883|03/29/2022|.03909|03/29/2022||||7718|||||No|No||ACCORD HEALTHCA|No||||
glimepiride|Yes|No|No|No|75%|16729000301|GLIMEPIRIDE 4 MG TABLET|100|EA|.11751|04/28/2009||Yes|No||04/28/2009||Yes|No|04/28/2009||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.04419|03/29/2022|.04312|03/29/2022|.04341|03/29/2022||||7719|||||No|No||ACCORD HEALTHCA|No||||
glimepiride|Yes|No|No|No|75%|16729000316|GLIMEPIRIDE 4 MG TABLET|500|EA|.11751|01/28/2019||Yes|No||01/28/2019||Yes|No|01/28/2019||Yes|No||||No|No|06/18/2019||Prescription required|No|||No|.04419|03/29/2022|.04312|03/29/2022|.04341|03/29/2022||||7720|||||No|No||ACCORD HEALTHCA|No||||
simvastatin|Yes|No|No|No|75%|16729000415|SIMVASTATIN 10 MG TABLET|90|EA|.03225|04/24/2009||Yes|No||04/24/2009||Yes|No|04/24/2009||Yes|No||10/07/2013||Yes|No|07/01/2016||Prescription required|No||063|Yes|.02909|03/29/2022|.02839|03/29/2022|.02858|03/29/2022|||LIPOTROPICS: STATINS|7721|||||No|No||ACCORD HEALTHCA|No||||
simvastatin|Yes|No|No|No|75%|16729000417|SIMVASTATIN 10 MG TABLET|1000|EA|.03225|04/24/2009||Yes|No||04/24/2009||Yes|No|04/24/2009||Yes|No||10/07/2013||Yes|No|07/01/2016||Prescription required|No||063|Yes|.02909|03/29/2022|.02839|03/29/2022|.02858|03/29/2022|||LIPOTROPICS: STATINS|7722|||||No|No||ACCORD HEALTHCA|No||||
simvastatin|Yes|No|No|No|75%|16729000515|SIMVASTATIN 20 MG TABLET|90|EA|.03526|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Prescription required|No||063|Yes|.02604|03/29/2022|.02541|03/29/2022|.02558|03/29/2022|||LIPOTROPICS: STATINS|7723|||||No|No||ACCORD HEALTHCA|No||||
simvastatin|Yes|No|No|No|75%|16729000517|SIMVASTATIN 20 MG TABLET|1000|EA|.03526|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Prescription required|No||063|Yes|.02604|03/29/2022|.02541|03/29/2022|.02558|03/29/2022|||LIPOTROPICS: STATINS|7724|||||No|No||ACCORD HEALTHCA|No||||
simvastatin|Yes|No|No|No|75%|16729000615|SIMVASTATIN 40 MG TABLET|90|EA|.04601|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Prescription required|No||063|Yes|.04431|03/29/2022|.04324|03/29/2022|.04353|03/29/2022|||LIPOTROPICS: STATINS|7725|||||No|No||ACCORD HEALTHCA|No||||
simvastatin|Yes|No|No|No|75%|16729000617|SIMVASTATIN 40 MG TABLET|1000|EA|.04601|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Prescription required|No||063|Yes|.04431|03/29/2022|.04324|03/29/2022|.04353|03/29/2022|||LIPOTROPICS: STATINS|7726|||||No|No||ACCORD HEALTHCA|No||||
simvastatin|Yes|No|No|No|75%|16729000715|SIMVASTATIN 80 MG TABLET|90|EA|.05203|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Prescription required|No||063|Yes|.09322|03/29/2022|.09098|03/29/2022|.09158|03/29/2022|||LIPOTROPICS: STATINS|7727|||||No|No||ACCORD HEALTHCA|No||||
simvastatin|Yes|No|No|No|75%|16729000717|SIMVASTATIN 80 MG TABLET|1000|EA|.05203|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Prescription required|No||063|Yes|.09322|03/29/2022|.09098|03/29/2022|.09158|03/29/2022|||LIPOTROPICS: STATINS|7728|||||No|No||ACCORD HEALTHCA|No||||
pravastatin sodium|No|No|No|No|75%|16729000815|PRAVASTATIN SODIUM 10 MG TAB|90|EA|.1106|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||05/22/2017||Yes|No|||Prescription required|No||063|Yes|.07144|03/29/2022|.06972|03/29/2022|.07018|03/29/2022|||LIPOTROPICS: STATINS|7729|||||No|No||ACCORD HEALTHCA|No||||
pravastatin sodium|No|No|No|No|75%|16729000816|PRAVASTATIN SODIUM 10 MG TAB|500|EA|.1106|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||05/22/2017||Yes|No|||Prescription required|No||063|Yes|.07144|03/29/2022|.06972|03/29/2022|.07018|03/29/2022|||LIPOTROPICS: STATINS|7730|||||No|No||ACCORD HEALTHCA|No||||
pravastatin sodium|No|No|No|No|75%|16729000915|PRAVASTATIN SODIUM 20 MG TAB|90|EA|.11237|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||05/22/2017||Yes|No|||Prescription required|No||063|Yes|.05771|03/29/2022|.05632|03/29/2022|.0567|03/29/2022|||LIPOTROPICS: STATINS|7731|||||No|No||ACCORD HEALTHCA|No||||
pravastatin sodium|No|No|No|No|75%|16729000916|PRAVASTATIN SODIUM 20 MG TAB|500|EA|.11237|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||05/22/2017||Yes|No|||Prescription required|No||063|Yes|.05771|03/29/2022|.05632|03/29/2022|.0567|03/29/2022|||LIPOTROPICS: STATINS|7732|||||No|No||ACCORD HEALTHCA|No||||
pravastatin sodium|No|No|No|No|75%|16729000917|PRAVASTATIN SODIUM 20 MG TAB|1000|EA|.11237|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||05/22/2017||Yes|No|||Prescription required|No||063|Yes|.05771|03/29/2022|.05632|03/29/2022|.0567|03/29/2022|||LIPOTROPICS: STATINS|7733|||||No|No||ACCORD HEALTHCA|No||||
pravastatin sodium|No|No|No|No|75%|16729001015|PRAVASTATIN SODIUM 40 MG TAB|90|EA|.16492|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||05/22/2017||Yes|No|||Prescription required|No||063|Yes|.08966|03/29/2022|.0875|03/29/2022|.08809|03/29/2022|||LIPOTROPICS: STATINS|7734|||||No|No||ACCORD HEALTHCA|No||||
pravastatin sodium|No|No|No|No|75%|16729001016|PRAVASTATIN SODIUM 40 MG TAB|500|EA|.16493|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||05/22/2017||Yes|No|||Prescription required|No||063|Yes|.08966|03/29/2022|.0875|03/29/2022|.08809|03/29/2022|||LIPOTROPICS: STATINS|7735|||||No|No||ACCORD HEALTHCA|No||||
pravastatin sodium|No|No|No|No|75%|16729001017|PRAVASTATIN SODIUM 40 MG TAB|1000|EA|.16493|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||05/22/2017||Yes|No|||Prescription required|No||063|Yes|.08966|03/29/2022|.0875|03/29/2022|.08809|03/29/2022|||LIPOTROPICS: STATINS|7736|||||No|No||ACCORD HEALTHCA|No||||
pravastatin sodium|No|No|No|No|75%|16729001115|PRAVASTATIN SODIUM 80 MG TAB|90|EA|.16492|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||05/22/2017||Yes|No|||Prescription required|No||063|Yes|.14996|03/29/2022|.14636|03/29/2022|.14733|03/29/2022|||LIPOTROPICS: STATINS|7737|||||No|No||ACCORD HEALTHCA|No||||
pravastatin sodium|No|No|No|No|75%|16729001116|PRAVASTATIN SODIUM 80 MG TAB|500|EA|.16493|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||05/22/2017||Yes|No|||Prescription required|No||063|Yes|.14996|03/29/2022|.14636|03/29/2022|.14733|03/29/2022|||LIPOTROPICS: STATINS|7738|||||No|No||ACCORD HEALTHCA|No||||
mycophenolate mofetil|No|No|No|No|75%|16729001901|MYCOPHENOLATE 500 MG TABLET|100|EA|.31175|05/11/2009||Yes|No||05/11/2009||Yes|No|05/11/2009||Yes|No||10/01/2013||Yes|No|||Prescription required|No||229|No|.30426|03/29/2022|.29695|03/29/2022|.29893|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|7739|||||No|No||ACCORD HEALTHCA|No||||
mycophenolate mofetil|No|No|No|No|75%|16729001916|MYCOPHENOLATE 500 MG TABLET|500|EA|.31175|05/11/2009||Yes|No||05/11/2009||Yes|No|05/11/2009||Yes|No||10/01/2013||Yes|No|||Prescription required|No||229|No|.30426|03/29/2022|.29695|03/29/2022|.29893|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|7740|||||No|No||ACCORD HEALTHCA|No||||
pioglitazone HCl|No|No|No|No|75%|16729002010|PIOGLITAZONE HCL 15 MG TABLET|30|EA|.05733|02/25/2013||Yes|No||02/25/2013||Yes|No|02/25/2013||Yes|No||02/25/2013||Yes|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|7741|||||No|No||ACCORD HEALTHCA|No||||
pioglitazone HCl|No|No|No|No|75%|16729002015|PIOGLITAZONE HCL 15 MG TABLET|90|EA|.05733|02/25/2013||Yes|No||02/25/2013||Yes|No|02/25/2013||Yes|No||02/25/2013||Yes|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|7742|||||No|No||ACCORD HEALTHCA|No||||
pioglitazone HCl|No|No|No|No|75%|16729002016|PIOGLITAZONE HCL 15 MG TABLET|500|EA|.05733|02/25/2013||Yes|No||02/25/2013||Yes|No|02/25/2013||Yes|No||02/25/2013||Yes|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|7743|||||No|No||ACCORD HEALTHCA|No||||
pioglitazone HCl|No|No|No|No|75%|16729002110|PIOGLITAZONE HCL 30 MG TABLET|30|EA|.07883|02/25/2013||Yes|No||02/25/2013||Yes|No|02/25/2013||Yes|No||02/25/2013||Yes|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|7744|||||No|No||ACCORD HEALTHCA|No||||
pioglitazone HCl|No|No|No|No|75%|16729002115|PIOGLITAZONE HCL 30 MG TABLET|90|EA|.07883|02/25/2013||Yes|No||02/25/2013||Yes|No|02/25/2013||Yes|No||02/25/2013||Yes|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|7745|||||No|No||ACCORD HEALTHCA|No||||
pioglitazone HCl|No|No|No|No|75%|16729002116|PIOGLITAZONE HCL 30 MG TABLET|500|EA|.07883|02/25/2013||Yes|No||02/25/2013||Yes|No|02/25/2013||Yes|No||02/25/2013||Yes|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|7746|||||No|No||ACCORD HEALTHCA|No||||
pioglitazone HCl|No|No|No|No|75%|16729002210|PIOGLITAZONE HCL 45 MG TABLET|30|EA|.08241|02/25/2013||Yes|No||02/25/2013||Yes|No|02/25/2013||Yes|No||02/25/2013||Yes|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|7747|||||No|No||ACCORD HEALTHCA|No||||
pioglitazone HCl|No|No|No|No|75%|16729002215|PIOGLITAZONE HCL 45 MG TABLET|90|EA|.08241|02/25/2013||Yes|No||02/25/2013||Yes|No|02/25/2013||Yes|No||02/25/2013||Yes|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|7748|||||No|No||ACCORD HEALTHCA|No||||
pioglitazone HCl|No|No|No|No|75%|16729002216|PIOGLITAZONE HCL 45 MG TABLET|500|EA|.08242|02/25/2013||Yes|No||02/25/2013||Yes|No|02/25/2013||Yes|No||02/25/2013||Yes|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|7749|||||No|No||ACCORD HEALTHCA|No||||
bicalutamide|No|No|No|No|75%|16729002301|BICALUTAMIDE 50 MG TABLET|100|EA|.32606|07/10/2009||Yes|No||07/10/2009||Yes|No|07/10/2009||Yes|No||||No|No|||Prescription required|No||550|No|.3381|03/29/2022|.32998|03/29/2022|.33218|03/29/2022|||ONCOLOGY: ORAL - PROSTATE|7750|||||No|No||ACCORD HEALTHCA|No||||
bicalutamide|No|No|No|No|75%|16729002310|BICALUTAMIDE 50 MG TABLET|30|EA|.32608|07/10/2009||Yes|No||07/10/2009||Yes|No|07/10/2009||Yes|No||||No|No|||Prescription required|No||550|No|.3381|03/29/2022|.32998|03/29/2022|.33218|03/29/2022|||ONCOLOGY: ORAL - PROSTATE|7751|||||No|No||ACCORD HEALTHCA|No||||
methyldopa|No|No|No|No|75%|16729003001|METHYLDOPA 250 MG TABLET|100|EA|.04945|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||10/13/2014||Yes|No|||Prescription required|No||166|No|.1127|02/23/2021|.11109|02/23/2021|.1058|02/23/2021|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|7752|||||No|No||ACCORD HEALTHCA|No||||
methyldopa|No|No|No|No|75%|16729003016|METHYLDOPA 250 MG TABLET|500|EA|.04599|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||10/13/2014||Yes|No|||Prescription required|No||166|No|.10482|02/23/2021|.10332|02/23/2021|.0984|02/23/2021|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|7753|||||No|No||ACCORD HEALTHCA|No||||
methyldopa|No|No|No|No|75%|16729003101|METHYLDOPA 500 MG TABLET|100|EA|.09008|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||10/13/2014||Yes|No|||Prescription required|No||166|No|.20531|01/26/2021|.20237|01/26/2021|.19274|01/26/2021|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|7754|||||No|No||ACCORD HEALTHCA|No||||
methyldopa|No|No|No|No|75%|16729003116|METHYLDOPA 500 MG TABLET|500|EA|.08426|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||10/13/2014||Yes|No|||Prescription required|No||166|No|.19204|01/26/2021|.18929|01/26/2021|.18028|01/26/2021|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|7755|||||No|No||ACCORD HEALTHCA|No||||
letrozole|No|No|No|No|75%|16729003410|LETROZOLE 2.5 MG TABLET|30|EA|.129|06/22/2011||Yes|No||06/22/2011||Yes|No|06/22/2011||Yes|No||||No|No|||Prescription required|No||502|No|.1337|03/29/2022|.13049|03/29/2022|.13136|03/29/2022|||ONCOLOGY: ORAL - BREAST|7756|||||No|No||ACCORD HEALTHCA|No||||
anastrozole|No|No|No|No|75%|16729003510|ANASTROZOLE 1 MG TABLET|30|EA|.215|03/30/2011||Yes|No||03/30/2011||Yes|No|03/30/2011||Yes|No||||No|No|||Prescription required|No||502|No|.11251|03/29/2022|.1098|03/29/2022|.11054|03/29/2022|||ONCOLOGY: ORAL - BREAST|7757|||||No|No||ACCORD HEALTHCA|No||||
anastrozole|No|No|No|No|75%|16729003515|ANASTROZOLE 1 MG TABLET|90|EA|.215|11/15/2011||Yes|No||11/15/2011||Yes|No|11/15/2011||Yes|No||||No|No|||Prescription required|No||502|No|.11251|03/29/2022|.1098|03/29/2022|.11054|03/29/2022|||ONCOLOGY: ORAL - BREAST|7758|||||No|No||ACCORD HEALTHCA|No||||
anastrozole|No|No|No|No|75%|16729003516|ANASTROZOLE 1 MG TABLET|500|EA|.215|11/15/2011||Yes|No||11/15/2011||Yes|No|11/15/2011||Yes|No||||No|No|||Prescription required|No||502|No|.11251|03/29/2022|.1098|03/29/2022|.11054|03/29/2022|||ONCOLOGY: ORAL - BREAST|7759|||||No|No||ACCORD HEALTHCA|No||||
tacrolimus|No|No|No|No|75%|16729004101|TACROLIMUS 0.5 MG CAPSULE (IR)|100|EA|.15858|10/03/2011||Yes|No||10/03/2011||Yes|No|10/03/2011||Yes|No||10/01/2013||Yes|No|||Prescription required|No||229|No|.26138|03/29/2022|.2551|03/29/2022|.2568|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|7760|||||No|No||ACCORD HEALTHCA|No||||
tacrolimus|No|No|No|No|75%|16729004201|TACROLIMUS 1 MG CAPSULE (IR)|100|EA|.3108|10/03/2011||Yes|No||10/03/2011||Yes|No|10/03/2011||Yes|No||10/01/2013||Yes|No|||Prescription required|No||229|No|.35645|03/29/2022|.34789|03/29/2022|.35021|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|7761|||||No|No||ACCORD HEALTHCA|No||||
tacrolimus|No|No|No|No|75%|16729004301|TACROLIMUS 5 MG CAPSULE (IR)|100|EA|1.48414|10/03/2011||Yes|No||10/03/2011||Yes|No|10/03/2011||Yes|No||10/01/2013||Yes|No|||Prescription required|No||229|No|2.05753|03/29/2022|2.00814|03/29/2022|2.02152|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|7762|||||No|No||ACCORD HEALTHCA|No||||
atorvastatin calcium|Yes|No|No|No|75%|16729004417|ATORVASTATIN 10 MG TABLET|1000|EA|.05494|01/25/2019||Yes|No||01/25/2019||Yes|No|01/25/2019||Yes|No||01/25/2019||Yes|No|06/18/2019||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|7763|||||No|No||ACCORD HEALTHCA|No||||
atorvastatin calcium|Yes|No|No|No|75%|16729004517|ATORVASTATIN 20 MG TABLET|1000|EA|.06855|01/25/2019||Yes|No||01/25/2019||Yes|No|01/25/2019||Yes|No||01/25/2019||Yes|No|06/18/2019||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|7764|||||No|No||ACCORD HEALTHCA|No||||
atorvastatin calcium|Yes|No|No|No|75%|16729004617|ATORVASTATIN 40 MG TABLET|1000|EA|.07591|01/25/2019||Yes|No||01/25/2019||Yes|No|01/25/2019||Yes|No||01/25/2019||Yes|No|06/18/2019||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|7765|||||No|No||ACCORD HEALTHCA|No||||
atorvastatin calcium|Yes|No|No|No|75%|16729004716|ATORVASTATIN 80 MG TABLET|500|EA|.07811|01/25/2019||Yes|No||01/25/2019||Yes|No|01/25/2019||Yes|No||01/25/2019||Yes|No|06/18/2019||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|7766|||||No|No||ACCORD HEALTHCA|No||||
temozolomide|No|No|No|No|75%|16729004853|TEMOZOLOMIDE 5 MG CAPSULE|5|EA|1.28312|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No||239|No|2.92432|07/16/2019|2.88254|07/16/2019|2.74528|07/16/2019|||ONCOLOGY: ORAL - OTHER|7767|||||No|No||ACCORD HEALTHCA|No||||
temozolomide|No|No|No|No|75%|16729004854|TEMOZOLOMIDE 5 MG CAPSULE|14|EA|1.14134|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No||239|No|2.60119|07/16/2019|2.56403|07/16/2019|2.44193|07/16/2019|||ONCOLOGY: ORAL - OTHER|7768|||||No|No||ACCORD HEALTHCA|No||||
temozolomide|No|No|No|No|75%|16729004953|TEMOZOLOMIDE 20 MG CAPSULE|5|EA|2.6359|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No||239|No|6.0074|07/16/2019|5.92158|07/16/2019|5.6396|07/16/2019|||ONCOLOGY: ORAL - OTHER|7769|||||No|No||ACCORD HEALTHCA|No||||
temozolomide|No|No|No|No|75%|16729004954|TEMOZOLOMIDE 20 MG CAPSULE|14|EA|3.35768|12/21/2017||Yes|No||12/21/2017||Yes|No|12/21/2017||Yes|No||||No|No|||Prescription required|No||239|No|7.65239|07/16/2019|7.54307|07/16/2019|7.18388|07/16/2019|||ONCOLOGY: ORAL - OTHER|7770|||||No|No||ACCORD HEALTHCA|No||||
temozolomide|No|No|No|No|75%|16729005053|TEMOZOLOMIDE 100 MG CAPSULE|5|EA|14.85306|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No||239|No|33.85116|07/16/2019|33.36757|07/16/2019|31.77864|07/16/2019|||ONCOLOGY: ORAL - OTHER|7771|||||No|No||ACCORD HEALTHCA|No||||
temozolomide|No|No|No|No|75%|16729005054|TEMOZOLOMIDE 100 MG CAPSULE|14|EA|14.93052|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No||239|No|34.02769|07/16/2019|33.54158|07/16/2019|31.94436|07/16/2019|||ONCOLOGY: ORAL - OTHER|7772|||||No|No||ACCORD HEALTHCA|No||||
temozolomide|No|No|No|No|75%|16729005153|TEMOZOLOMIDE 250 MG CAPSULE|5|EA|38.786|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No||239|No|88.396|07/16/2019|87.1332|07/16/2019|82.984|07/16/2019|||ONCOLOGY: ORAL - OTHER|7773|||||No|No||ACCORD HEALTHCA|No||||
capecitabine|No|No|No|No|75%|16729007212|CAPECITABINE 150 MG TABLET|60|EA|.22245|09/23/2015||Yes|No||09/23/2015||Yes|No|09/23/2015||Yes|No||||No|No|||Prescription required|No||502|No|.50698|10/15/2019|.49974|10/15/2019|.47594|10/15/2019|||ONCOLOGY: ORAL - BREAST|7774|||||No|No||ACCORD HEALTHCA|No||||
capecitabine|No|No|No|No|75%|16729007329|CAPECITABINE 500 MG TABLET|120|EA|.43817|09/23/2015||Yes|No||09/23/2015||Yes|No|09/23/2015||Yes|No||||No|No|||Prescription required|No||502|No|.61977|12/28/2021|.60489|12/28/2021|.60892|12/28/2021|||ONCOLOGY: ORAL - BREAST|7775|||||No|No||ACCORD HEALTHCA|No||||
carbidopa/levodopa|No|No|No|No|75%|16729007901|CARBIDOPA-LEVO ER 50-200 TAB|100|EA|.54395|10/29/2013||Yes|No||10/29/2013||Yes|No|10/29/2013||Yes|No||||No|No|||Prescription required|No||015|No|.29671|03/29/2022|.28958|03/29/2022|.29151|03/29/2022|||ANTIPARKINSON'S AGENTS|7776|||||No|No||ACCORD HEALTHCA|No||||
carbidopa/levodopa|No|No|No|No|75%|16729007917|CARBIDOPA-LEVO ER 50-200 TAB|1000|EA|.54395|10/29/2013||Yes|No||10/29/2013||Yes|No|10/29/2013||Yes|No||||No|No|||Prescription required|No||015|No|.29671|03/29/2022|.28958|03/29/2022|.29151|03/29/2022|||ANTIPARKINSON'S AGENTS|7777|||||No|No||ACCORD HEALTHCA|No||||
naltrexone HCl|No|No|No|No|75%|16729008101|NALTREXONE 50 MG TABLET|100|EA|.86|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||145|No|.75734|03/29/2022|.73916|03/29/2022|.74408|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|7778|||||No|No||ACCORD HEALTHCA|Yes|09/01/2020|||
naltrexone HCl|No|No|No|No|75%|16729008110|NALTREXONE 50 MG TABLET|30|EA|.86|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||145|No|.75734|03/29/2022|.73916|03/29/2022|.74408|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|7779|||||No|No||ACCORD HEALTHCA|Yes|09/01/2020|||
finasteride|No|No|No|No|75%|16729008910|FINASTERIDE 1 MG TABLET|30|EA|.03583|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||||No|No|||Prescription required|No|||No|.04818|03/29/2022|.04702|03/29/2022|.04733|03/29/2022||||7780|||||No|No||ACCORD HEALTHCA|No||||
finasteride|No|No|No|No|75%|16729008915|FINASTERIDE 1 MG TABLET|90|EA|.03583|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||||No|No|||Prescription required|No|||No|.04818|03/29/2022|.04702|03/29/2022|.04733|03/29/2022||||7781|||||No|No||ACCORD HEALTHCA|No||||
finasteride|No|No|No|No|75%|16729009001|FINASTERIDE 5 MG TABLET|100|EA|.06591|11/16/2011||Yes|No||11/16/2011||Yes|No|11/16/2011||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|7782|||||No|No||ACCORD HEALTHCA|No||||
finasteride|No|No|No|No|75%|16729009010|FINASTERIDE 5 MG TABLET|30|EA|.06593|03/30/2011||Yes|No||03/30/2011||Yes|No|03/30/2011||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|7783|||||No|No||ACCORD HEALTHCA|No||||
finasteride|No|No|No|No|75%|16729009015|FINASTERIDE 5 MG TABLET|90|EA|.06593|11/16/2011||Yes|No||11/16/2011||Yes|No|11/16/2011||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|7784|||||No|No||ACCORD HEALTHCA|No||||
finasteride|No|No|No|No|75%|16729009016|FINASTERIDE 5 MG TABLET|500|EA|.06593|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|7785|||||No|No||ACCORD HEALTHCA|No||||
mycophenolate mofetil|No|No|No|No|75%|16729009401|MYCOPHENOLATE 250 MG CAPSULE|100|EA|.17092|05/11/2009||Yes|No||05/11/2009||Yes|No|05/11/2009||Yes|No||10/01/2013||Yes|No|||Prescription required|No||229|No|.2129|03/29/2022|.20779|03/29/2022|.20917|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|7786|||||No|No||ACCORD HEALTHCA|No||||
mycophenolate mofetil|No|No|No|No|75%|16729009416|MYCOPHENOLATE 250 MG CAPSULE|500|EA|.17092|05/11/2009||Yes|No||05/11/2009||Yes|No|05/11/2009||Yes|No||10/01/2013||Yes|No|||Prescription required|No||229|No|.2129|03/29/2022|.20779|03/29/2022|.20917|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|7787|||||No|No||ACCORD HEALTHCA|No||||
quetiapine fumarate|No|No|No|No|75%|16729009512|QUETIAPINE ER 200 MG TABLET|60|EA|.20066|09/20/2017||Yes|No||09/20/2017||Yes|No|09/20/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|027|Yes|.25825|03/29/2022|.25205|03/29/2022|.25373|03/29/2022|||ANTIPSYCHOTICS|7788|||||No|No||ACCORD HEALTHCA|No||||
quetiapine fumarate|No|No|No|No|75%|16729009612|QUETIAPINE ER 300 MG TABLET|60|EA|.22933|09/20/2017||Yes|No||09/20/2017||Yes|No|09/20/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|027|Yes|.35477|03/29/2022|.34625|03/29/2022|.34856|03/29/2022|||ANTIPSYCHOTICS|7789|||||No|No||ACCORD HEALTHCA|No||||
quetiapine fumarate|No|No|No|No|75%|16729009712|QUETIAPINE ER 400 MG TABLET|60|EA|.25083|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|027|Yes|.42833|03/29/2022|.41805|03/29/2022|.42083|03/29/2022|||ANTIPSYCHOTICS|7790|||||No|No||ACCORD HEALTHCA|No||||
mitomycin|No|No|No|No|75%|16729010811|MITOMYCIN 20 MG VIAL|1|EA|271.7514|05/12/2009||Yes|No||05/12/2009||Yes|No|05/12/2009||Yes|No||||No|No|||Prescription required|No|||No|619.3404|06/01/2016|610.49268|06/01/2016|581.4216|06/01/2016||||7791|||||No|No||ACCORD HEALTHCA|No||||
quetiapine fumarate|No|No|No|No|75%|16729010912|QUETIAPINE ER 150 MG TABLET|60|EA|.17916|09/20/2017||Yes|No||09/20/2017||Yes|No|09/20/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|027|Yes|.25256|03/29/2022|.24649|03/29/2022|.24814|03/29/2022|||ANTIPSYCHOTICS|7792|||||No|No||ACCORD HEALTHCA|No||||
mitomycin|No|No|No|No|75%|16729011505|MITOMYCIN 5 MG VIAL|1|EA|104.6061|07/09/2009||Yes|No||07/09/2009||Yes|No|07/09/2009||Yes|No||||No|No|||Prescription required|No|||No|238.4046|06/01/2016|234.99882|06/01/2016|223.8084|06/01/2016||||7793|||||No|No||ACCORD HEALTHCA|No||||
montelukast sodium|No|No|No|No|75%|16729011910|MONTELUKAST SOD 10 MG TABLET|30|EA|.0344|12/09/2013||Yes|No||12/09/2013||Yes|No|12/09/2013||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|7794|||||No|No||ACCORD HEALTHCA|Yes|09/01/2020|||
montelukast sodium|No|No|No|No|75%|16729011915|MONTELUKAST SOD 10 MG TABLET|90|EA|.0344|12/09/2013||Yes|No||12/09/2013||Yes|No|12/09/2013||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|7795|||||No|No||ACCORD HEALTHCA|Yes|09/01/2020|||
montelukast sodium|No|No|No|No|75%|16729011917|MONTELUKAST SOD 10 MG TABLET|1000|EA|.0344|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|7796|||||No|No||ACCORD HEALTHCA|No||||
temozolomide|No|No|No|No|75%|16729012953|TEMOZOLOMIDE 140 MG CAPSULE|5|EA|22.3987|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No||239|No|13.83623|07/27/2021|13.50416|07/27/2021|13.59409|07/27/2021|||ONCOLOGY: ORAL - OTHER|7797|||||No|No||ACCORD HEALTHCA|No||||
temozolomide|No|No|No|No|75%|16729012954|TEMOZOLOMIDE 140 MG CAPSULE|14|EA|21.04112|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No||239|No|13.83623|07/27/2021|13.50416|07/27/2021|13.59409|07/27/2021|||ONCOLOGY: ORAL - OTHER|7798|||||No|No||ACCORD HEALTHCA|No||||
temozolomide|No|No|No|No|75%|16729013053|TEMOZOLOMIDE 180 MG CAPSULE|5|EA|28.11512|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No||239|No|64.07632|07/16/2019|63.16094|07/16/2019|60.15328|07/16/2019|||ONCOLOGY: ORAL - OTHER|7799|||||No|No||ACCORD HEALTHCA|No||||
temozolomide|No|No|No|No|75%|16729013054|TEMOZOLOMIDE 180 MG CAPSULE|14|EA|27.9073|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No||239|No|63.60269|07/16/2019|62.69408|07/16/2019|59.70865|07/16/2019|||ONCOLOGY: ORAL - OTHER|7800|||||No|No||ACCORD HEALTHCA|No||||
quetiapine fumarate|No|No|No|No|75%|16729013212|QUETIAPINE ER 50 MG TABLET|60|EA|.05876|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|Yes|12/21/2017|027|Yes|.13845|03/29/2022|.13512|03/29/2022|.13602|03/29/2022|||ANTIPSYCHOTICS|7801|||||No|No||ACCORD HEALTHCA|No||||
allopurinol|No|No|No|No|75%|16729013401|ALLOPURINOL 100 MG TABLET|100|EA|.0473|05/27/2015||Yes|No||05/27/2015||Yes|No|05/27/2015||Yes|No||05/27/2015||Yes|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|7802|||||No|No||ACCORD HEALTHCA|No||||
allopurinol|No|No|No|No|75%|16729013501|ALLOPURINOL 300 MG TABLET|100|EA|.0903|05/27/2015||Yes|No||05/27/2015||Yes|No|05/27/2015||Yes|No||05/27/2015||Yes|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|7803|||||No|No||ACCORD HEALTHCA|No||||
allopurinol|No|No|No|No|75%|16729013516|ALLOPURINOL 300 MG TABLET|500|EA|.0903|05/27/2015||Yes|No||05/27/2015||Yes|No|05/27/2015||Yes|No||05/27/2015||Yes|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|7804|||||No|No||ACCORD HEALTHCA|No||||
clonazepam|No|No|No|No|75%|16729013600|CLONAZEPAM 0.5 MG TABLET|100|EA|.0172|04/05/2011||Yes|No||04/05/2011||Yes|No|04/05/2011||Yes|No||10/01/2013||Yes|No|||Prescription required|No||056|Yes|.02441|03/29/2022|.02382|03/29/2022|.02398|03/29/2022|||ANTICONVULSANTS|7805|||||No|No||ACCORD HEALTHCA|No||||
clonazepam|No|No|No|No|75%|16729013616|CLONAZEPAM 0.5 MG TABLET|500|EA|.01548|11/16/2011||Yes|No||11/16/2011||Yes|No|11/16/2011||Yes|No||10/01/2013||Yes|No|||Prescription required|No||056|Yes|.02441|03/29/2022|.02382|03/29/2022|.02398|03/29/2022|||ANTICONVULSANTS|7806|||||No|No||ACCORD HEALTHCA|No||||
clonazepam|No|No|No|No|75%|16729013700|CLONAZEPAM 1 MG TABLET|100|EA|.01827|04/05/2011||Yes|No||04/05/2011||Yes|No|04/05/2011||Yes|No||10/01/2013||Yes|No|||Prescription required|No||056|Yes|.0296|03/29/2022|.02888|03/29/2022|.02908|03/29/2022|||ANTICONVULSANTS|7807|||||No|No||ACCORD HEALTHCA|No||||
clonazepam|No|No|No|No|75%|16729013716|CLONAZEPAM 1 MG TABLET|500|EA|.01644|11/16/2011||Yes|No||11/16/2011||Yes|No|11/16/2011||Yes|No||10/01/2013||Yes|No|||Prescription required|No||056|Yes|.0296|03/29/2022|.02888|03/29/2022|.02908|03/29/2022|||ANTICONVULSANTS|7808|||||No|No||ACCORD HEALTHCA|No||||
clonazepam|No|No|No|No|75%|16729013800|CLONAZEPAM 2 MG TABLET|100|EA|.02687|04/05/2011||Yes|No||04/05/2011||Yes|No|04/05/2011||Yes|No||10/01/2013||Yes|No|||Prescription required|No||056|Yes|.03734|03/29/2022|.03644|03/29/2022|.03668|03/29/2022|||ANTICONVULSANTS|7809|||||No|No||ACCORD HEALTHCA|No||||
clonazepam|No|No|No|No|75%|16729013816|CLONAZEPAM 2 MG TABLET|500|EA|.02418|11/16/2011||Yes|No||11/16/2011||Yes|No|11/16/2011||Yes|No||10/01/2013||Yes|No|||Prescription required|No||056|Yes|.03734|03/29/2022|.03644|03/29/2022|.03668|03/29/2022|||ANTICONVULSANTS|7810|||||No|No||ACCORD HEALTHCA|No||||
clozapine|No|No|No|No|75%|16729014101|CLOZAPINE 25 MG TABLET|100|EA|.2795|09/05/2017||Yes|No||09/05/2017||Yes|No|09/05/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.26318|03/29/2022|.25686|03/29/2022|.25857|03/29/2022|||ANTIPSYCHOTICS|7811|||||No|No||ACCORD HEALTHCA|No||||
clozapine|No|No|No|No|75%|16729014116|CLOZAPINE 25 MG TABLET|500|EA|.2795|09/05/2017||Yes|No||09/05/2017||Yes|No|09/05/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.26318|03/29/2022|.25686|03/29/2022|.25857|03/29/2022|||ANTIPSYCHOTICS|7812|||||No|No||ACCORD HEALTHCA|No||||
clozapine|No|No|No|No|75%|16729014201|CLOZAPINE 100 MG TABLET|100|EA|.7095|09/05/2017||Yes|No||09/05/2017||Yes|No|09/05/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.60868|03/29/2022|.59407|03/29/2022|.59802|03/29/2022|||ANTIPSYCHOTICS|7813|||||No|No||ACCORD HEALTHCA|No||||
clozapine|No|No|No|No|75%|16729014216|CLOZAPINE 100 MG TABLET|500|EA|.7095|09/05/2017||Yes|No||09/05/2017||Yes|No|09/05/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.60868|03/29/2022|.59407|03/29/2022|.59802|03/29/2022|||ANTIPSYCHOTICS|7814|||||No|No||ACCORD HEALTHCA|No||||
quetiapine fumarate|No|No|No|No|75%|16729014501|QUETIAPINE FUMARATE 25 MG TAB|100|EA|.02171|04/10/2012||Yes|No||04/10/2012||Yes|No|04/10/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.03239|03/29/2022|.03161|03/29/2022|.03182|03/29/2022|||ANTIPSYCHOTICS|7815|||||No|No||ACCORD HEALTHCA|No||||
quetiapine fumarate|No|No|No|No|75%|16729014517|QUETIAPINE FUMARATE 25 MG TAB|1000|EA|.02171|04/10/2012||Yes|No||04/10/2012||Yes|No|04/10/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.03239|03/29/2022|.03161|03/29/2022|.03182|03/29/2022|||ANTIPSYCHOTICS|7816|||||No|No||ACCORD HEALTHCA|No||||
quetiapine fumarate|No|No|No|No|75%|16729014601|QUETIAPINE FUMARATE 50 MG TAB|100|EA|.03259|04/10/2012||Yes|No||04/10/2012||Yes|No|04/10/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.04283|03/29/2022|.0418|03/29/2022|.04208|03/29/2022|||ANTIPSYCHOTICS|7817|||||No|No||ACCORD HEALTHCA|No||||
quetiapine fumarate|No|No|No|No|75%|16729014617|QUETIAPINE FUMARATE 50 MG TAB|1000|EA|.03259|04/10/2012||Yes|No||04/10/2012||Yes|No|04/10/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.04283|03/29/2022|.0418|03/29/2022|.04208|03/29/2022|||ANTIPSYCHOTICS|7818|||||No|No||ACCORD HEALTHCA|No||||
quetiapine fumarate|No|No|No|No|75%|16729014701|QUETIAPINE FUMARATE 100 MG TAB|100|EA|.0516|04/10/2012||Yes|No||04/10/2012||Yes|No|04/10/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.05826|03/29/2022|.05686|03/29/2022|.05724|03/29/2022|||ANTIPSYCHOTICS|7819|||||No|No||ACCORD HEALTHCA|No||||
quetiapine fumarate|No|No|No|No|75%|16729014717|QUETIAPINE FUMARATE 100 MG TAB|1000|EA|.0516|04/10/2012||Yes|No||04/10/2012||Yes|No|04/10/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.05826|03/29/2022|.05686|03/29/2022|.05724|03/29/2022|||ANTIPSYCHOTICS|7820|||||No|No||ACCORD HEALTHCA|No||||
quetiapine fumarate|No|No|No|No|75%|16729014801|QUETIAPINE FUMARATE 200 MG TAB|100|EA|.07529|08/13/2015||Yes|No||08/13/2015||Yes|No|08/13/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.10261|03/29/2022|.10014|03/29/2022|.10081|03/29/2022|||ANTIPSYCHOTICS|7821|||||No|No||ACCORD HEALTHCA|No||||
quetiapine fumarate|No|No|No|No|75%|16729014817|QUETIAPINE FUMARATE 200 MG TAB|1000|EA|.07529|04/10/2012||Yes|No||04/10/2012||Yes|No|04/10/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.10261|03/29/2022|.10014|03/29/2022|.10081|03/29/2022|||ANTIPSYCHOTICS|7822|||||No|No||ACCORD HEALTHCA|No||||
quetiapine fumarate|No|No|No|No|75%|16729014912|QUETIAPINE FUMARATE 300 MG TAB|60|EA|.1085|04/10/2012||Yes|No||04/10/2012||Yes|No|04/10/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.13964|03/29/2022|.13628|03/29/2022|.13719|03/29/2022|||ANTIPSYCHOTICS|7823|||||No|No||ACCORD HEALTHCA|No||||
quetiapine fumarate|No|No|No|No|75%|16729014917|QUETIAPINE FUMARATE 300 MG TAB|1000|EA|.1085|04/10/2012||Yes|No||04/10/2012||Yes|No|04/10/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.13964|03/29/2022|.13628|03/29/2022|.13719|03/29/2022|||ANTIPSYCHOTICS|7824|||||No|No||ACCORD HEALTHCA|No||||
quetiapine fumarate|No|No|No|No|75%|16729015001|QUETIAPINE FUMARATE 400 MG TAB|100|EA|.13381|08/13/2015||Yes|No||08/13/2015||Yes|No|08/13/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.17858|03/29/2022|.17429|03/29/2022|.17545|03/29/2022|||ANTIPSYCHOTICS|7825|||||No|No||ACCORD HEALTHCA|No||||
quetiapine fumarate|No|No|No|No|75%|16729015016|QUETIAPINE FUMARATE 400 MG TAB|500|EA|.13381|04/10/2012||Yes|No||04/10/2012||Yes|No|04/10/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.17858|03/29/2022|.17429|03/29/2022|.17545|03/29/2022|||ANTIPSYCHOTICS|7826|||||No|No||ACCORD HEALTHCA|No||||
simvastatin|Yes|No|No|No|75%|16729015615|SIMVASTATIN 5 MG TABLET|90|EA|.01161|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Prescription required|No||063|Yes|.03036|03/29/2022|.02963|03/29/2022|.02982|03/29/2022|||LIPOTROPICS: STATINS|7827|||||No|No||ACCORD HEALTHCA|No||||
escitalopram oxalate|Yes|No|No|No|75%|16729016801|ESCITALOPRAM 5 MG TABLET|100|EA|.0645|08/30/2013||Yes|No||08/30/2013||Yes|No|08/30/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.0462|03/29/2022|.04509|03/29/2022|.04539|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7828|||||No|No||ACCORD HEALTHCA|No||||
escitalopram oxalate|No|No|No|No|75%|16729016817|ESCITALOPRAM 5 MG TABLET|1000|EA|.0645|09/01/2021||Yes|No||09/01/2021||Yes|No|09/01/2021||Yes|No||||No|No|||Prescription required|No||008|Yes|.0462|03/29/2022|.04509|03/29/2022|.04539|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7829|||||No|No||ACCORD HEALTHCA|No||||
escitalopram oxalate|Yes|No|No|No|75%|16729016901|ESCITALOPRAM 10 MG TABLET|100|EA|.0688|08/30/2013||Yes|No||08/30/2013||Yes|No|08/30/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7830|||||No|No||ACCORD HEALTHCA|No||||
escitalopram oxalate|No|No|No|No|75%|16729016917|ESCITALOPRAM 10 MG TABLET|1000|EA|.0688|09/01/2021||Yes|No||09/01/2021||Yes|No|09/01/2021||Yes|No||||No|No|||Prescription required|No||008|Yes|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7831|||||No|No||ACCORD HEALTHCA|No||||
escitalopram oxalate|Yes|No|No|No|75%|16729017001|ESCITALOPRAM 20 MG TABLET|100|EA|.0731|08/30/2013||Yes|No||08/30/2013||Yes|No|08/30/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.07845|03/29/2022|.07656|03/29/2022|.07707|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7832|||||No|No||ACCORD HEALTHCA|No||||
escitalopram oxalate|No|No|No|No|75%|16729017017|ESCITALOPRAM 20 MG TABLET|1000|EA|.0731|02/28/2018||Yes|No||02/28/2018||Yes|No|02/28/2018||Yes|No||||No|No|||Prescription required|No||008|No|.07845|03/29/2022|.07656|03/29/2022|.07707|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7833|||||No|No||ACCORD HEALTHCA|No||||
amitriptyline HCl|No|No|No|No|75%|16729017101|AMITRIPTYLINE HCL 10 MG TAB|100|EA|.04613|02/20/2015||Yes|No||02/20/2015||Yes|No|02/20/2015||Yes|No||02/20/2015||Yes|No|||Prescription required|No||215|No|.04811|03/29/2022|.04695|03/29/2022|.04726|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7834|||||No|No||ACCORD HEALTHCA|No||||
amitriptyline HCl|No|No|No|No|75%|16729017117|AMITRIPTYLINE HCL 10 MG TAB|1000|EA|.04376|02/20/2015||Yes|No||02/20/2015||Yes|No|02/20/2015||Yes|No||02/20/2015||Yes|No|||Prescription required|No||215|No|.04811|03/29/2022|.04695|03/29/2022|.04726|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7835|||||No|No||ACCORD HEALTHCA|No||||
amitriptyline HCl|No|No|No|No|75%|16729017201|AMITRIPTYLINE HCL 25 MG TAB|100|EA|.09232|02/12/2015||Yes|No||02/12/2015||Yes|No|02/12/2015||Yes|No||02/12/2015||Yes|No|||Prescription required|No||215|No|.07343|03/29/2022|.07166|03/29/2022|.07214|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7836|||||No|No||ACCORD HEALTHCA|No||||
amitriptyline HCl|No|No|No|No|75%|16729017217|AMITRIPTYLINE HCL 25 MG TAB|1000|EA|.08753|02/12/2015||Yes|No||02/12/2015||Yes|No|02/12/2015||Yes|No||02/12/2015||Yes|No|||Prescription required|No||215|No|.07343|03/29/2022|.07166|03/29/2022|.07214|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7837|||||No|No||ACCORD HEALTHCA|No||||
amitriptyline HCl|No|No|No|No|75%|16729017301|AMITRIPTYLINE HCL 50 MG TAB|100|EA|.18429|02/12/2015||Yes|No||02/12/2015||Yes|No|02/12/2015||Yes|No||02/12/2015||Yes|No|||Prescription required|No||215|No|.14797|03/29/2022|.14441|03/29/2022|.14538|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7838|||||No|No||ACCORD HEALTHCA|No||||
amitriptyline HCl|No|No|No|No|75%|16729017317|AMITRIPTYLINE HCL 50 MG TAB|1000|EA|.15319|02/12/2015||Yes|No||02/12/2015||Yes|No|02/12/2015||Yes|No||02/12/2015||Yes|No|||Prescription required|No||215|No|.14797|03/29/2022|.14441|03/29/2022|.14538|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7839|||||No|No||ACCORD HEALTHCA|No||||
amitriptyline HCl|No|No|No|No|75%|16729017401|AMITRIPTYLINE HCL 75 MG TAB|100|EA|.27692|02/12/2015||Yes|No||02/12/2015||Yes|No|02/12/2015||Yes|No||02/12/2015||Yes|No|||Prescription required|No||215|No|.26194|03/29/2022|.25565|03/29/2022|.25735|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7840|||||No|No||ACCORD HEALTHCA|No||||
amitriptyline HCl|No|No|No|No|75%|16729017501|AMITRIPTYLINE HCL 100 MG TAB|100|EA|.36863|02/12/2015||Yes|No||02/12/2015||Yes|No|02/12/2015||Yes|No||02/12/2015||Yes|No|||Prescription required|No||215|No|.30607|03/29/2022|.29872|03/29/2022|.30071|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7841|||||No|No||ACCORD HEALTHCA|No||||
amitriptyline HCl|No|No|No|No|75%|16729017601|AMITRIPTYLINE HCL 150 MG TAB|100|EA|.5528|02/20/2015||Yes|No||02/20/2015||Yes|No|02/20/2015||Yes|No||02/20/2015||Yes|No|||Prescription required|No||215|No|.58201|03/29/2022|.56804|03/29/2022|.57182|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|7842|||||No|No||ACCORD HEALTHCA|No||||
hydrochlorothiazide|No|No|No|No|75%|16729018201|HYDROCHLOROTHIAZIDE 12.5 MG TB|100|EA|.0602|06/10/2013||Yes|No||06/10/2013||Yes|No|06/10/2013||Yes|No||06/10/2013||Yes|No|||Prescription required|No|||Yes|.05169|03/29/2022|.05044|03/29/2022|.05078|03/29/2022||||7843|||||No|No||ACCORD HEALTHCA|No||||
hydrochlorothiazide|No|No|No|No|75%|16729018217|HYDROCHLOROTHIAZIDE 12.5 MG TB|1000|EA|.0602|06/10/2013||Yes|No||06/10/2013||Yes|No|06/10/2013||Yes|No||06/10/2013||Yes|No|||Prescription required|No|||Yes|.05169|03/29/2022|.05044|03/29/2022|.05078|03/29/2022||||7844|||||No|No||ACCORD HEALTHCA|No||||
hydrochlorothiazide|Yes|No|No|No|75%|16729018301|HYDROCHLOROTHIAZIDE 25 MG TAB|100|EA|.00924|06/10/2013||Yes|No||06/10/2013||Yes|No|06/10/2013||Yes|No||06/10/2013||Yes|No|07/01/2016||Prescription required|No|||Yes|.01337|03/29/2022|.01304|03/29/2022|.01313|03/29/2022||||7845|||||No|No||ACCORD HEALTHCA|No||||
hydrochlorothiazide|Yes|No|No|No|75%|16729018317|HYDROCHLOROTHIAZIDE 25 MG TAB|1000|EA|.00851|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||10/13/2014||Yes|No|07/01/2016||Prescription required|No|||Yes|.01337|03/29/2022|.01304|03/29/2022|.01313|03/29/2022||||7846|||||No|No||ACCORD HEALTHCA|No||||
hydrochlorothiazide|Yes|No|No|No|75%|16729018401|HYDROCHLOROTHIAZIDE 50 MG TAB|100|EA|.01784|06/10/2013||Yes|No||06/10/2013||Yes|No|06/10/2013||Yes|No||06/10/2013||Yes|No|07/01/2016||Prescription required|No|||Yes|.02959|03/29/2022|.02887|03/29/2022|.02907|03/29/2022||||7847|||||No|No||ACCORD HEALTHCA|No||||
hydrochlorothiazide|Yes|No|No|No|75%|16729018417|HYDROCHLOROTHIAZIDE 50 MG TAB|1000|EA|.01429|06/10/2013||Yes|No||06/10/2013||Yes|No|06/10/2013||Yes|No||06/10/2013||Yes|No|07/01/2016||Prescription required|No|||Yes|.02959|03/29/2022|.02887|03/29/2022|.02907|03/29/2022||||7848|||||No|No||ACCORD HEALTHCA|No||||
mycophenolate sodium|No|No|No|No|75%|16729018929|MYCOPHENOLIC ACID DR 360 MG TB|120|EA|.31834|01/10/2019||Yes|No||01/10/2019||Yes|No|01/10/2019||Yes|No||01/10/2019||Yes|No|||Prescription required|Yes|09/14/2017|229|No|.56705|03/29/2022|.55344|03/29/2022|.55712|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|7849|||||No|No||ACCORD HEALTHCA|No||||
buspirone HCl|No|No|No|No|75%|16729020001|BUSPIRONE HCL 5 MG TABLET|100|EA|.01281|04/07/2017||Yes|No||04/07/2017||Yes|No|04/07/2017||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|7850|||||No|No||ACCORD HEALTHCA|No||||
buspirone HCl|No|No|No|No|75%|16729020016|BUSPIRONE HCL 5 MG TABLET|500|EA|.01281|04/07/2017||Yes|No||04/07/2017||Yes|No|04/07/2017||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|7851|||||No|No||ACCORD HEALTHCA|No||||
buspirone HCl|No|No|No|No|75%|16729020101|BUSPIRONE HCL 7.5 MG TABLET|100|EA|.10943|04/07/2017||Yes|No||04/07/2017||Yes|No|04/07/2017||Yes|No||||No|No|||Prescription required|No||090|No|.22186|03/29/2022|.21653|03/29/2022|.21797|03/29/2022|||ANXIOLYTICS|7852|||||No|No||ACCORD HEALTHCA|No||||
buspirone HCl|No|No|No|No|75%|16729020201|BUSPIRONE HCL 10 MG TABLET|100|EA|.01892|04/07/2017||Yes|No||04/07/2017||Yes|No|04/07/2017||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|7853|||||No|No||ACCORD HEALTHCA|No||||
buspirone HCl|No|No|No|No|75%|16729020216|BUSPIRONE HCL 10 MG TABLET|500|EA|.01892|04/07/2017||Yes|No||04/07/2017||Yes|No|04/07/2017||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|7854|||||No|No||ACCORD HEALTHCA|No||||
buspirone HCl|No|No|No|No|75%|16729020301|BUSPIRONE HCL 15 MG TABLET|100|EA|.02472|04/07/2017||Yes|No||04/07/2017||Yes|No|04/07/2017||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|7855|||||No|No||ACCORD HEALTHCA|No||||
buspirone HCl|No|No|No|No|75%|16729020312|BUSPIRONE HCL 15 MG TABLET|60|EA|.02472|04/07/2017||Yes|No||04/07/2017||Yes|No|04/07/2017||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|7856|||||No|No||ACCORD HEALTHCA|No||||
doxazosin mesylate|No|No|No|No|75%|16729021101|DOXAZOSIN MESYLATE 1 MG TAB|100|EA|.10057|05/11/2015||Yes|No||05/11/2015||Yes|No|05/11/2015||Yes|No||05/11/2015||Yes|No|||Prescription required|No||003|Yes|.09392|03/29/2022|.09166|03/29/2022|.09227|03/29/2022|||BPH TREATMENTS|7857|||||No|No||ACCORD HEALTHCA|No||||
doxazosin mesylate|No|No|No|No|75%|16729021301|DOXAZOSIN MESYLATE 4 MG TAB|100|EA|.11334|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||05/12/2015||Yes|No|||Prescription required|No||003|Yes|.10379|03/29/2022|.10129|03/29/2022|.10197|03/29/2022|||BPH TREATMENTS|7858|||||No|No||ACCORD HEALTHCA|No||||
doxazosin mesylate|No|No|No|No|75%|16729021317|DOXAZOSIN MESYLATE 4 MG TAB|1000|EA|.10768|02/09/2021||Yes|No||02/09/2021||Yes|No|02/09/2021||Yes|No||||No|No|||Prescription required|No||003|Yes|.10379|03/29/2022|.10129|03/29/2022|.10197|03/29/2022|||BPH TREATMENTS|7859|||||No|No||ACCORD HEALTHCA|No||||
sertraline HCl|No|No|No|No|75%|16729021510|SERTRALINE HCL 25 MG TABLET|30|EA|.03683|05/18/2017||Yes|No||05/18/2017||Yes|No|05/18/2017||Yes|No||||No|No|||Prescription required|No||008|Yes|.05057|03/29/2022|.04935|03/29/2022|.04968|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7860|||||No|No||ACCORD HEALTHCA|No||||
sertraline HCl|No|No|No|No|75%|16729021615|SERTRALINE HCL 50 MG TABLET|90|EA|.03678|05/18/2017||Yes|No||05/18/2017||Yes|No|05/18/2017||Yes|No||||No|No|||Prescription required|No||008|Yes|.04281|03/29/2022|.04178|03/29/2022|.04206|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7861|||||No|No||ACCORD HEALTHCA|No||||
sertraline HCl|No|No|No|No|75%|16729021616|SERTRALINE HCL 50 MG TABLET|500|EA|.03676|05/18/2017||Yes|No||05/18/2017||Yes|No|05/18/2017||Yes|No||||No|No|||Prescription required|No||008|Yes|.04281|03/29/2022|.04178|03/29/2022|.04206|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7862|||||No|No||ACCORD HEALTHCA|No||||
sertraline HCl|No|No|No|No|75%|16729021715|SERTRALINE HCL 100 MG TABLET|90|EA|.03678|05/18/2017||Yes|No||05/18/2017||Yes|No|05/18/2017||Yes|No||||No|No|||Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7863|||||No|No||ACCORD HEALTHCA|No||||
sertraline HCl|No|No|No|No|75%|16729021716|SERTRALINE HCL 100 MG TABLET|500|EA|.03676|05/18/2017||Yes|No||05/18/2017||Yes|No|05/18/2017||Yes|No||||No|No|||Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|7864|||||No|No||ACCORD HEALTHCA|No||||
clopidogrel bisulfate|No|No|No|No|75%|16729021810|CLOPIDOGREL 75 MG TABLET|30|EA|.0387|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||10/01/2013||Yes|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|7865|||||No|No||ACCORD HEALTHCA|No||||
clopidogrel bisulfate|No|No|No|No|75%|16729021815|CLOPIDOGREL 75 MG TABLET|90|EA|.0387|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||10/01/2013||Yes|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|7866|||||No|No||ACCORD HEALTHCA|No||||
clopidogrel bisulfate|No|No|No|No|75%|16729021816|CLOPIDOGREL 75 MG TABLET|500|EA|.0387|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||10/01/2013||Yes|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|7867|||||No|No||ACCORD HEALTHCA|Yes|09/01/2020|||
spironolactone|No|No|No|No|75%|16729022501|SPIRONOLACTONE 25 MG TABLET|100|EA|.05387|09/11/2017||Yes|No||09/11/2017||Yes|No|09/11/2017||Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||7868|||||No|No||ACCORD HEALTHCA|No||||
spironolactone|No|No|No|No|75%|16729022516|SPIRONOLACTONE 25 MG TABLET|500|EA|.05387|09/11/2017||Yes|No||09/11/2017||Yes|No|09/11/2017||Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||7869|||||No|No||ACCORD HEALTHCA|No||||
spironolactone|No|No|No|No|75%|16729022517|SPIRONOLACTONE 25 MG TABLET|1000|EA|.05387|09/11/2017||Yes|No||09/11/2017||Yes|No|09/11/2017||Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||7870|||||No|No||ACCORD HEALTHCA|No||||
spironolactone|No|No|No|No|75%|16729022601|SPIRONOLACTONE 50 MG TABLET|100|EA|.12753|09/11/2017||Yes|No||09/11/2017||Yes|No|09/11/2017||Yes|No||||No|No|||Prescription required|No|||No|.12042|03/29/2022|.11752|03/29/2022|.11831|03/29/2022||||7871|||||No|No||ACCORD HEALTHCA|No||||
spironolactone|No|No|No|No|75%|16729022616|SPIRONOLACTONE 50 MG TABLET|500|EA|.12753|09/11/2017||Yes|No||09/11/2017||Yes|No|09/11/2017||Yes|No||||No|No|||Prescription required|No|||No|.12042|03/29/2022|.11752|03/29/2022|.11831|03/29/2022||||7872|||||No|No||ACCORD HEALTHCA|No||||
spironolactone|No|No|No|No|75%|16729022701|SPIRONOLACTONE 100 MG TABLET|100|EA|.22815|09/14/2017||Yes|No||09/14/2017||Yes|No|09/14/2017||Yes|No||||No|No|||Prescription required|No|||No|.2048|03/29/2022|.19988|03/29/2022|.20121|03/29/2022||||7873|||||No|No||ACCORD HEALTHCA|No||||
spironolactone|No|No|No|No|75%|16729022716|SPIRONOLACTONE 100 MG TABLET|500|EA|.22815|09/14/2017||Yes|No||09/14/2017||Yes|No|09/14/2017||Yes|No||||No|No|||Prescription required|No|||No|.2048|03/29/2022|.19988|03/29/2022|.20121|03/29/2022||||7874|||||No|No||ACCORD HEALTHCA|No||||
mycophenolate sodium|No|No|No|No|75%|16729026129|MYCOPHENOLIC ACID DR 180 MG TB|120|EA|.15916|01/10/2019||Yes|No||01/10/2019||Yes|No|01/10/2019||Yes|No||01/10/2019||Yes|No|||Prescription required|Yes|09/14/2017|229|No|.54568|03/29/2022|.53258|03/29/2022|.53613|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|7875|||||No|No||ACCORD HEALTHCA|No||||
aripiprazole|No|No|No|No|75%|16729027801|ARIPIPRAZOLE 2 MG TABLET|100|EA|.13502|05/19/2017||Yes|No||05/19/2017||Yes|No|05/19/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|7876|||||No|No||ACCORD HEALTHCA|No||||
aripiprazole|No|No|No|No|75%|16729027810|ARIPIPRAZOLE 2 MG TABLET|30|EA|.13502|05/19/2017||Yes|No||05/19/2017||Yes|No|05/19/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|7877|||||No|No||ACCORD HEALTHCA|No||||
aripiprazole|No|No|No|No|75%|16729027901|ARIPIPRAZOLE 5 MG TABLET|100|EA|.13502|05/19/2017||Yes|No||05/19/2017||Yes|No|05/19/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|7878|||||No|No||ACCORD HEALTHCA|No||||
aripiprazole|No|No|No|No|75%|16729027910|ARIPIPRAZOLE 5 MG TABLET|30|EA|.13502|05/19/2017||Yes|No||05/19/2017||Yes|No|05/19/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|7879|||||No|No||ACCORD HEALTHCA|No||||
aripiprazole|No|No|No|No|75%|16729028001|ARIPIPRAZOLE 10 MG TABLET|100|EA|.13502|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|7880|||||No|No||ACCORD HEALTHCA|No||||
aripiprazole|No|No|No|No|75%|16729028010|ARIPIPRAZOLE 10 MG TABLET|30|EA|.13502|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|7881|||||No|No||ACCORD HEALTHCA|No||||
aripiprazole|No|No|No|No|75%|16729028101|ARIPIPRAZOLE 15 MG TABLET|100|EA|.13502|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|7882|||||No|No||ACCORD HEALTHCA|No||||
aripiprazole|No|No|No|No|75%|16729028110|ARIPIPRAZOLE 15 MG TABLET|30|EA|.13502|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|7883|||||No|No||ACCORD HEALTHCA|No||||
aripiprazole|No|No|No|No|75%|16729028201|ARIPIPRAZOLE 20 MG TABLET|100|EA|.17793|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|7884|||||No|No||ACCORD HEALTHCA|No||||
aripiprazole|No|No|No|No|75%|16729028210|ARIPIPRAZOLE 20 MG TABLET|30|EA|.17787|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|7885|||||No|No||ACCORD HEALTHCA|No||||
aripiprazole|No|No|No|No|75%|16729028301|ARIPIPRAZOLE 30 MG TABLET|100|EA|.17793|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|7886|||||No|No||ACCORD HEALTHCA|No||||
aripiprazole|No|No|No|No|75%|16729028310|ARIPIPRAZOLE 30 MG TABLET|30|EA|.17787|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|7887|||||No|No||ACCORD HEALTHCA|No||||
rosuvastatin calcium|No|No|No|No|75%|16729028415|ROSUVASTATIN CALCIUM 5 MG TAB|90|EA|.05799|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||02/22/2017||Yes|No|||Prescription required|No||063|Yes|.06753|03/29/2022|.0659|03/29/2022|.06634|03/29/2022|||LIPOTROPICS: STATINS|7888|||||No|No||ACCORD HEALTHCA|No||||
rosuvastatin calcium|No|No|No|No|75%|16729028417|ROSUVASTATIN CALCIUM 5 MG TAB|1000|EA|.06416|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||02/22/2017||Yes|No|||Prescription required|No||063|Yes|.06753|03/29/2022|.0659|03/29/2022|.06634|03/29/2022|||LIPOTROPICS: STATINS|7889|||||No|No||ACCORD HEALTHCA|No||||
rosuvastatin calcium|No|No|No|No|75%|16729028515|ROSUVASTATIN CALCIUM 10 MG TAB|90|EA|.05799|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||02/22/2017||Yes|No|||Prescription required|No||063|Yes|.05981|03/29/2022|.05837|03/29/2022|.05876|03/29/2022|||LIPOTROPICS: STATINS|7890|||||No|No||ACCORD HEALTHCA|No||||
rosuvastatin calcium|No|No|No|No|75%|16729028517|ROSUVASTATIN CALCIUM 10 MG TAB|1000|EA|.06416|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||02/22/2017||Yes|No|||Prescription required|No||063|Yes|.05981|03/29/2022|.05837|03/29/2022|.05876|03/29/2022|||LIPOTROPICS: STATINS|7891|||||No|No||ACCORD HEALTHCA|No||||
rosuvastatin calcium|No|No|No|No|75%|16729028615|ROSUVASTATIN CALCIUM 20 MG TAB|90|EA|.05799|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||02/22/2017||Yes|No|||Prescription required|No||063|Yes|.07822|03/29/2022|.07634|03/29/2022|.07685|03/29/2022|||LIPOTROPICS: STATINS|7892|||||No|No||ACCORD HEALTHCA|No||||
rosuvastatin calcium|No|No|No|No|75%|16729028617|ROSUVASTATIN CALCIUM 20 MG TAB|1000|EA|.06416|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||02/22/2017||Yes|No|||Prescription required|No||063|Yes|.07822|03/29/2022|.07634|03/29/2022|.07685|03/29/2022|||LIPOTROPICS: STATINS|7893|||||No|No||ACCORD HEALTHCA|No||||
rosuvastatin calcium|No|No|No|No|75%|16729028710|ROSUVASTATIN CALCIUM 40 MG TAB|30|EA|.07166|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||02/22/2017||Yes|No|||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|7894|||||No|No||ACCORD HEALTHCA|No||||
rosuvastatin calcium|No|No|No|No|75%|16729028715|ROSUVASTATIN CALCIUM 40 MG TAB|90|EA|.07166|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||02/22/2017||Yes|No|||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|7895|||||No|No||ACCORD HEALTHCA|No||||
rosuvastatin calcium|No|No|No|No|75%|16729028717|ROSUVASTATIN CALCIUM 40 MG TAB|1000|EA|.06416|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||02/22/2017||Yes|No|||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|7896|||||No|No||ACCORD HEALTHCA|No||||
buspirone HCl|No|No|No|No|75%|16729028912|BUSPIRONE HCL 30 MG TABLET|60|EA|.10033|04/07/2017||Yes|No||04/07/2017||Yes|No|04/07/2017||Yes|No||||No|No|||Prescription required|No||090|No|.17728|03/29/2022|.17302|03/29/2022|.17417|03/29/2022|||ANXIOLYTICS|7897|||||No|No||ACCORD HEALTHCA|No||||
eplerenone|No|No|No|No|75%|16729029310|EPLERENONE 25 MG TABLET|30|EA|.60171|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|No|||No|.73164|03/29/2022|.71408|03/29/2022|.71883|03/29/2022||||7898|||||No|No||ACCORD HEALTHCA|No||||
eplerenone|No|No|No|No|75%|16729029315|EPLERENONE 25 MG TABLET|90|EA|.60175|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|No|||No|.73164|03/29/2022|.71408|03/29/2022|.71883|03/29/2022||||7899|||||No|No||ACCORD HEALTHCA|No||||
eplerenone|No|No|No|No|75%|16729029410|EPLERENONE 50 MG TABLET|30|EA|.60185|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|No|||No|.85922|03/29/2022|.83859|03/29/2022|.84418|03/29/2022||||7900|||||No|No||ACCORD HEALTHCA|No||||
eplerenone|No|No|No|No|75%|16729029415|EPLERENONE 50 MG TABLET|90|EA|.60175|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|No|||No|.85922|03/29/2022|.83859|03/29/2022|.84418|03/29/2022||||7901|||||No|No||ACCORD HEALTHCA|No||||
trazodone HCl|No|No|No|No|75%|16729029901|TRAZODONE 50 MG TABLET|100|EA|.02859|11/21/2019||Yes|No||11/21/2019||Yes|No|11/21/2019||Yes|No||||No|No|||Prescription required|No||031|No|.03855|03/29/2022|.03762|03/29/2022|.03787|03/29/2022|||ANTIDEPRESSANTS: OTHER|7902|||||No|No||ACCORD HEALTHCA|No||||
trazodone HCl|No|No|No|No|75%|16729029917|TRAZODONE 50 MG TABLET|1000|EA|.02859|11/21/2019||Yes|No||11/21/2019||Yes|No|11/21/2019||Yes|No||||No|No|||Prescription required|No||031|No|.03855|03/29/2022|.03762|03/29/2022|.03787|03/29/2022|||ANTIDEPRESSANTS: OTHER|7903|||||No|No||ACCORD HEALTHCA|No||||
trazodone HCl|No|No|No|No|75%|16729030001|TRAZODONE 100 MG TABLET|100|EA|.05026|11/21/2019||Yes|No||11/21/2019||Yes|No|11/21/2019||Yes|No||||No|No|||Prescription required|No||031|No|.07015|03/29/2022|.06846|03/29/2022|.06892|03/29/2022|||ANTIDEPRESSANTS: OTHER|7904|||||No|No||ACCORD HEALTHCA|No||||
trazodone HCl|No|No|No|No|75%|16729030017|TRAZODONE 100 MG TABLET|1000|EA|.05026|11/21/2019||Yes|No||11/21/2019||Yes|No|11/21/2019||Yes|No||||No|No|||Prescription required|No||031|No|.07015|03/29/2022|.06846|03/29/2022|.06892|03/29/2022|||ANTIDEPRESSANTS: OTHER|7905|||||No|No||ACCORD HEALTHCA|No||||
trazodone HCl|No|No|No|No|75%|16729030101|TRAZODONE 150 MG TABLET|100|EA|.15523|11/21/2019||Yes|No||11/21/2019||Yes|No|11/21/2019||Yes|No||||No|No|||Prescription required|No||031|No|.1311|03/29/2022|.12795|03/29/2022|.1288|03/29/2022|||ANTIDEPRESSANTS: OTHER|7906|||||No|No||ACCORD HEALTHCA|No||||
trazodone HCl|No|No|No|No|75%|16729030116|TRAZODONE 150 MG TABLET|500|EA|.15523|11/21/2019||Yes|No||11/21/2019||Yes|No|11/21/2019||Yes|No||||No|No|||Prescription required|No||031|No|.1311|03/29/2022|.12795|03/29/2022|.1288|03/29/2022|||ANTIDEPRESSANTS: OTHER|7907|||||No|No||ACCORD HEALTHCA|No||||
trazodone HCl|No|No|No|No|75%|16729030201|TRAZODONE 300 MG TABLET|100|EA|1.40055|11/21/2019||Yes|No||11/21/2019||Yes|No|11/21/2019||Yes|No||||No|No|||Prescription required|No||031|No|1.52238|03/29/2022|1.48584|03/29/2022|1.49573|03/29/2022|||ANTIDEPRESSANTS: OTHER|7908|||||No|No||ACCORD HEALTHCA|No||||
diltiazem HCl|No|No|No|No|75%|16729030301|DILTIAZEM 24H ER(XR) 120 MG CP|100|EA|.23383|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||11/24/2020||Yes|No|||Prescription required|No||045|No|.44141|03/29/2022|.43081|03/29/2022|.43368|03/29/2022|||CALCIUM CHANNEL BLOCKERS|7909|||||No|No||ACCORD HEALTHCA|No||||
diltiazem HCl|No|No|No|No|75%|16729030316|DILTIAZEM 24H ER(XR) 120 MG CP|500|EA|.22212|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||11/24/2020||Yes|No|||Prescription required|No||045|No|.44141|03/29/2022|.43081|03/29/2022|.43368|03/29/2022|||CALCIUM CHANNEL BLOCKERS|7910|||||No|No||ACCORD HEALTHCA|No||||
diltiazem HCl|No|No|No|No|75%|16729030401|DILTIAZEM 24H ER(XR) 180 MG CP|100|EA|.33595|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||11/24/2020||Yes|No|||Prescription required|No||045|No|.55317|03/29/2022|.53989|03/29/2022|.54348|03/29/2022|||CALCIUM CHANNEL BLOCKERS|7911|||||No|No||ACCORD HEALTHCA|No||||
diltiazem HCl|No|No|No|No|75%|16729030416|DILTIAZEM 24H ER(XR) 180 MG CP|500|EA|.31913|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||11/24/2020||Yes|No|||Prescription required|No||045|No|.55317|03/29/2022|.53989|03/29/2022|.54348|03/29/2022|||CALCIUM CHANNEL BLOCKERS|7912|||||No|No||ACCORD HEALTHCA|No||||
diltiazem HCl|No|No|No|No|75%|16729030501|DILTIAZEM 24H ER(XR) 240 MG CP|100|EA|.39775|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||11/24/2020||Yes|No|||Prescription required|No||045|No|.79772|03/29/2022|.77857|03/29/2022|.78375|03/29/2022|||CALCIUM CHANNEL BLOCKERS|7913|||||No|No||ACCORD HEALTHCA|No||||
diltiazem HCl|No|No|No|No|75%|16729030516|DILTIAZEM 24H ER(XR) 240 MG CP|500|EA|.37786|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||11/24/2020||Yes|No|||Prescription required|No||045|No|.79772|03/29/2022|.77857|03/29/2022|.78375|03/29/2022|||CALCIUM CHANNEL BLOCKERS|7914|||||No|No||ACCORD HEALTHCA|No||||
oxybutynin chloride|No|No|No|No|75%|16729031701|OXYBUTYNIN CL ER 5 MG TABLET|100|EA|.215|04/06/2017||Yes|No||04/06/2017||Yes|No|04/06/2017||Yes|No||||No|No|||Prescription required|No||006|Yes|.15279|03/29/2022|.14912|03/29/2022|.15011|03/29/2022|||BLADDER RELAXANT PREPARATIONS|7915|||||No|No||ACCORD HEALTHCA|No||||
oxybutynin chloride|No|No|No|No|75%|16729031801|OXYBUTYNIN CL ER 10 MG TABLET|100|EA|.215|04/06/2017||Yes|No||04/06/2017||Yes|No|04/06/2017||Yes|No||||No|No|||Prescription required|No||006|No|.15833|03/29/2022|.15453|03/29/2022|.15555|03/29/2022|||BLADDER RELAXANT PREPARATIONS|7916|||||No|No||ACCORD HEALTHCA|No||||
oxybutynin chloride|No|No|No|No|75%|16729031901|OXYBUTYNIN CL ER 15 MG TABLET|100|EA|.215|04/06/2017||Yes|No||04/06/2017||Yes|No|04/06/2017||Yes|No||||No|No|||Prescription required|No||006|No|.19948|03/29/2022|.19469|03/29/2022|.19598|03/29/2022|||BLADDER RELAXANT PREPARATIONS|7917|||||No|No||ACCORD HEALTHCA|No||||
olmesartan medoxomil|No|No|No|No|75%|16729032110|OLMESARTAN MEDOXOMIL 20 MG TAB|30|EA|.05948|09/06/2017||Yes|No||09/06/2017||Yes|No|09/06/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.1002|03/29/2022|.09779|03/29/2022|.09844|03/29/2022|||ANGIOTENSIN MODULATORS|7918|||||No|No||ACCORD HEALTHCA|No||||
olmesartan medoxomil|No|No|No|No|75%|16729032115|OLMESARTAN MEDOXOMIL 20 MG TAB|90|EA|.05943|09/06/2017||Yes|No||09/06/2017||Yes|No|09/06/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.1002|03/29/2022|.09779|03/29/2022|.09844|03/29/2022|||ANGIOTENSIN MODULATORS|7919|||||No|No||ACCORD HEALTHCA|No||||
olmesartan medoxomil|No|No|No|No|75%|16729032117|OLMESARTAN MEDOXOMIL 20 MG TAB|1000|EA|.05943|09/06/2017||Yes|No||09/06/2017||Yes|No|09/06/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.1002|03/29/2022|.09779|03/29/2022|.09844|03/29/2022|||ANGIOTENSIN MODULATORS|7920|||||No|No||ACCORD HEALTHCA|No||||
olmesartan medoxomil|No|No|No|No|75%|16729032210|OLMESARTAN MEDOXOMIL 40 MG TAB|30|EA|.08256|09/06/2017||Yes|No||09/06/2017||Yes|No|09/06/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.15714|03/29/2022|.15336|03/29/2022|.15439|03/29/2022|||ANGIOTENSIN MODULATORS|7921|||||No|No||ACCORD HEALTHCA|No||||
olmesartan medoxomil|No|No|No|No|75%|16729032215|OLMESARTAN MEDOXOMIL 40 MG TAB|90|EA|.08256|09/06/2017||Yes|No||09/06/2017||Yes|No|09/06/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.15714|03/29/2022|.15336|03/29/2022|.15439|03/29/2022|||ANGIOTENSIN MODULATORS|7922|||||No|No||ACCORD HEALTHCA|No||||
olmesartan medoxomil|No|No|No|No|75%|16729032217|OLMESARTAN MEDOXOMIL 40 MG TAB|1000|EA|.08256|09/06/2017||Yes|No||09/06/2017||Yes|No|09/06/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.15714|03/29/2022|.15336|03/29/2022|.15439|03/29/2022|||ANGIOTENSIN MODULATORS|7923|||||No|No||ACCORD HEALTHCA|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|16729036615|OLMESARTAN-HCTZ 20-12.5 MG TAB|90|EA|.53998|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.22565|03/29/2022|.22023|03/29/2022|.2217|03/29/2022|||ANGIOTENSIN MODULATORS|7924|||||No|No||ACCORD HEALTHCA|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|16729036715|OLMESARTAN-HCTZ 40-12.5 MG TAB|90|EA|.75058|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.29168|03/29/2022|.28467|03/29/2022|.28657|03/29/2022|||ANGIOTENSIN MODULATORS|7925|||||No|No||ACCORD HEALTHCA|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|16729036815|OLMESARTAN-HCTZ 40-25 MG TAB|90|EA|.75058|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.29227|03/29/2022|.28525|03/29/2022|.28715|03/29/2022|||ANGIOTENSIN MODULATORS|7926|||||No|No||ACCORD HEALTHCA|No||||
doxazosin mesylate|No|No|No|No|75%|16729041401|DOXAZOSIN MESYLATE 2 MG TAB|100|EA|.10057|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||06/04/2018||Yes|No|||Prescription required|No||003|Yes|.085|03/29/2022|.08296|03/29/2022|.08351|03/29/2022|||BPH TREATMENTS|7927|||||No|No||ACCORD HEALTHCA|No||||
doxazosin mesylate|No|No|No|No|75%|16729041417|DOXAZOSIN MESYLATE 2 MG TAB|1000|EA|.09555|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||06/04/2018||Yes|No|||Prescription required|No||003|Yes|.085|03/29/2022|.08296|03/29/2022|.08351|03/29/2022|||BPH TREATMENTS|7928|||||No|No||ACCORD HEALTHCA|No||||
doxazosin mesylate|No|No|No|No|75%|16729041501|DOXAZOSIN MESYLATE 8 MG TAB|100|EA|.11356|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||06/04/2018||Yes|No|||Prescription required|No||003|No|.12737|03/29/2022|.12431|03/29/2022|.12514|03/29/2022|||BPH TREATMENTS|7929|||||No|No||ACCORD HEALTHCA|No||||
doxazosin mesylate|No|No|No|No|75%|16729041517|DOXAZOSIN MESYLATE 8 MG TAB|1000|EA|.10786|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||06/04/2018||Yes|No|||Prescription required|No||003|No|.12737|03/29/2022|.12431|03/29/2022|.12514|03/29/2022|||BPH TREATMENTS|7930|||||No|No||ACCORD HEALTHCA|No||||
dimethyl fumarate|No|No|No|No|75%|16729041604|DIMETHYL FUMARATE DR 120 MG CP|14|EA|2.30357|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||043|No|6.92871|10/26/2021|6.76242|10/26/2021|6.80745|10/26/2021|||MULTIPLE SCLEROSIS AGENTS|7931|||||No|No||ACCORD HEALTHCA|No||||
dimethyl fumarate|No|No|No|No|75%|16729041712|DIMETHYL FUMARATE DR 240 MG CP|60|EA|1.6125|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||043|No|3.05522|11/23/2021|2.98189|11/23/2021|3.00175|11/23/2021|||MULTIPLE SCLEROSIS AGENTS|7932|||||No|No||ACCORD HEALTHCA|No||||
dimethyl fumarate|No|No|No|No|75%|16729041759|DIMETHYL FUMARATE DR 240 MG CP|180|EA|1.6125|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||043|No|3.05522|11/23/2021|2.98189|11/23/2021|3.00175|11/23/2021|||MULTIPLE SCLEROSIS AGENTS|7933|||||No|No||ACCORD HEALTHCA|No||||
tacrolimus|No|No|No|No|75%|16729042101|TACROLIMUS 0.03% OINTMENT|100|GM|1.94119|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|034|Yes|1.71892|03/01/2022|1.67766|03/01/2022|1.68883|03/01/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|7934|||||No|No||ACCORD HEALTHCA|No||||
tacrolimus|No|No|No|No|75%|16729042110|TACROLIMUS 0.03% OINTMENT|30|GM|1.94116|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|034|Yes|2.05819|03/29/2022|2.00879|03/29/2022|2.02217|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|7935|||||No|No||ACCORD HEALTHCA|No||||
tacrolimus|No|No|No|No|75%|16729042112|TACROLIMUS 0.03% OINTMENT|60|GM|1.94123|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|034|Yes|1.50147|03/01/2022|1.46543|03/01/2022|1.47519|03/01/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|7936|||||No|No||ACCORD HEALTHCA|No||||
tacrolimus|No|No|No|No|75%|16729042201|TACROLIMUS 0.1% OINTMENT|100|GM|1.94119|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|034|Yes|1.89468|03/29/2022|1.8492|03/29/2022|1.86152|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|7937|||||No|No||ACCORD HEALTHCA|No||||
tacrolimus|No|No|No|No|75%|16729042210|TACROLIMUS 0.1% OINTMENT|30|GM|1.94116|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|034|Yes|2.17788|03/29/2022|2.12561|03/29/2022|2.13976|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|7938|||||No|No||ACCORD HEALTHCA|No||||
tacrolimus|No|No|No|No|75%|16729042212|TACROLIMUS 0.1% OINTMENT|60|GM|1.94123|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|034|Yes|2.14182|03/29/2022|2.09041|03/29/2022|2.10433|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|7939|||||No|No||ACCORD HEALTHCA|No||||
ezetimibe|No|No|No|No|75%|16729043310|EZETIMIBE 10 MG TABLET|30|EA|.12183|07/09/2021||Yes|No||07/09/2021||Yes|No|07/09/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|7940|||||No|No||ACCORD HEALTHCA|No||||
ezetimibe|No|No|No|No|75%|16729043316|EZETIMIBE 10 MG TABLET|500|EA|.12599|07/07/2021||Yes|No||07/07/2021||Yes|No|07/07/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|7941|||||No|No||ACCORD HEALTHCA|No||||
cinacalcet HCl|No|No|No|No|75%|16729044010|CINACALCET HCL 30 MG TABLET|30|EA|.215|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No|||No|.75588|03/29/2022|.73773|03/29/2022|.74265|03/29/2022||||7942|||||No|No||ACCORD HEALTHCA|No||||
cinacalcet HCl|No|No|No|No|75%|16729044015|CINACALCET HCL 30 MG TABLET|90|EA|.215|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No|||No|.75588|03/29/2022|.73773|03/29/2022|.74265|03/29/2022||||7943|||||No|No||ACCORD HEALTHCA|No||||
cinacalcet HCl|No|No|No|No|75%|16729044110|CINACALCET HCL 60 MG TABLET|30|EA|.387|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No|||No|1.7407|03/29/2022|1.69892|03/29/2022|1.71023|03/29/2022||||7944|||||No|No||ACCORD HEALTHCA|No||||
cinacalcet HCl|No|No|No|No|75%|16729044115|CINACALCET HCL 60 MG TABLET|90|EA|.387|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No|||No|1.7407|03/29/2022|1.69892|03/29/2022|1.71023|03/29/2022||||7945|||||No|No||ACCORD HEALTHCA|No||||
cinacalcet HCl|No|No|No|No|75%|16729044210|CINACALCET HCL 90 MG TABLET|30|EA|.559|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No|||No|3.64673|03/29/2022|3.5592|03/29/2022|3.58291|03/29/2022||||7946|||||No|No||ACCORD HEALTHCA|No||||
cinacalcet HCl|No|No|No|No|75%|16729044215|CINACALCET HCL 90 MG TABLET|90|EA|.559|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No|||No|3.64673|03/29/2022|3.5592|03/29/2022|3.58291|03/29/2022||||7947|||||No|No||ACCORD HEALTHCA|No||||
bupropion HCl|Yes|No|No|No|75%|16729044310|BUPROPION HCL XL 150 MG TABLET|30|EA|.07883|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|06/18/2019||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|7948|||||No|No||ACCORD HEALTHCA|No||||
bupropion HCl|Yes|No|No|No|75%|16729044315|BUPROPION HCL XL 150 MG TABLET|90|EA|.07883|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|06/18/2019||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|7949|||||No|No||ACCORD HEALTHCA|No||||
bupropion HCl|Yes|No|No|No|75%|16729044316|BUPROPION HCL XL 150 MG TABLET|500|EA|.07883|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|06/18/2019||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|7950|||||No|No||ACCORD HEALTHCA|No||||
bupropion HCl|Yes|No|No|No|75%|16729044410|BUPROPION HCL XL 300 MG TABLET|30|EA|.09818|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|03/20/2020||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|7951|||||No|No||ACCORD HEALTHCA|No||||
bupropion HCl|Yes|No|No|No|75%|16729044416|BUPROPION HCL XL 300 MG TABLET|500|EA|.09818|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|03/20/2020||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|7952|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729044715|LEVOTHYROXINE 25 MCG TABLET|90|EA|.04447|03/30/2021||Yes|No||03/30/2021||Yes|No|03/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.11852|03/29/2022|.11567|03/29/2022|.11644|03/29/2022||||7953|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729044717|LEVOTHYROXINE 25 MCG TABLET|1000|EA|.04358|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.11852|03/29/2022|.11567|03/29/2022|.11644|03/29/2022||||7954|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729044815|LEVOTHYROXINE 50 MCG TABLET|90|EA|.0622|03/30/2021||Yes|No||03/30/2021||Yes|No|03/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.14288|03/29/2022|.13945|03/29/2022|.14037|03/29/2022||||7955|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729044817|LEVOTHYROXINE 50 MCG TABLET|1000|EA|.06097|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.14288|03/29/2022|.13945|03/29/2022|.14037|03/29/2022||||7956|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729044915|LEVOTHYROXINE 75 MCG TABLET|90|EA|.06358|03/30/2021||Yes|No||03/30/2021||Yes|No|03/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.15545|03/29/2022|.15171|03/29/2022|.15272|03/29/2022||||7957|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729044917|LEVOTHYROXINE 75 MCG TABLET|1000|EA|.06231|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.15545|03/29/2022|.15171|03/29/2022|.15272|03/29/2022||||7958|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729045015|LEVOTHYROXINE 88 MCG TABLET|90|EA|.06311|03/30/2021||Yes|No||03/30/2021||Yes|No|03/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.16198|03/29/2022|.15809|03/29/2022|.15914|03/29/2022||||7959|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729045017|LEVOTHYROXINE 88 MCG TABLET|1000|EA|.06005|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.16198|03/29/2022|.15809|03/29/2022|.15914|03/29/2022||||7960|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729045115|LEVOTHYROXINE 100 MCG TABLET|90|EA|.06631|03/30/2021||Yes|No||03/30/2021||Yes|No|03/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.17286|03/29/2022|.16871|03/29/2022|.16983|03/29/2022||||7961|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729045117|LEVOTHYROXINE 100 MCG TABLET|1000|EA|.06499|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.17286|03/29/2022|.16871|03/29/2022|.16983|03/29/2022||||7962|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729045215|LEVOTHYROXINE 112 MCG TABLET|90|EA|.07099|03/30/2021||Yes|No||03/30/2021||Yes|No|03/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.1546|03/29/2022|.15088|03/29/2022|.15189|03/29/2022||||7963|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729045217|LEVOTHYROXINE 112 MCG TABLET|1000|EA|.06956|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.1546|03/29/2022|.15088|03/29/2022|.15189|03/29/2022||||7964|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729045315|LEVOTHYROXINE 125 MCG TABLET|90|EA|.08179|03/30/2021||Yes|No||03/30/2021||Yes|No|03/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.18894|03/29/2022|.1844|03/29/2022|.18563|03/29/2022||||7965|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729045317|LEVOTHYROXINE 125 MCG TABLET|1000|EA|.08015|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.18894|03/29/2022|.1844|03/29/2022|.18563|03/29/2022||||7966|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729045415|LEVOTHYROXINE 137 MCG TABLET|90|EA|.0664|03/30/2021||Yes|No||03/30/2021||Yes|No|03/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.22748|03/29/2022|.22202|03/29/2022|.22349|03/29/2022||||7967|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729045417|LEVOTHYROXINE 137 MCG TABLET|1000|EA|.0651|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.22748|03/29/2022|.22202|03/29/2022|.22349|03/29/2022||||7968|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729045515|LEVOTHYROXINE 150 MCG TABLET|90|EA|.06712|03/30/2021||Yes|No||03/30/2021||Yes|No|03/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.21406|03/29/2022|.20892|03/29/2022|.21031|03/29/2022||||7969|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729045517|LEVOTHYROXINE 150 MCG TABLET|1000|EA|.06577|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.21406|03/29/2022|.20892|03/29/2022|.21031|03/29/2022||||7970|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729045615|LEVOTHYROXINE 175 MCG TABLET|90|EA|.10023|03/30/2021||Yes|No||03/30/2021||Yes|No|03/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.2247|03/29/2022|.2193|03/29/2022|.22076|03/29/2022||||7971|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729045617|LEVOTHYROXINE 175 MCG TABLET|1000|EA|.08678|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.2247|03/29/2022|.2193|03/29/2022|.22076|03/29/2022||||7972|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729045715|LEVOTHYROXINE 200 MCG TABLET|90|EA|.08714|03/30/2021||Yes|No||03/30/2021||Yes|No|03/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.2307|03/29/2022|.22516|03/29/2022|.22666|03/29/2022||||7973|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729045717|LEVOTHYROXINE 200 MCG TABLET|1000|EA|.08539|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.2307|03/29/2022|.22516|03/29/2022|.22666|03/29/2022||||7974|||||No|No||ACCORD HEALTHCA|No||||
levothyroxine sodium|No|No|No|No|75%|16729045815|LEVOTHYROXINE 300 MCG TABLET|90|EA|.11819|03/30/2021||Yes|No||03/30/2021||Yes|No|03/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.17616|03/29/2022|.17193|03/29/2022|.17307|03/29/2022||||7975|||||No|No||ACCORD HEALTHCA|No||||
methylphenidate HCl|No|No|No|No|75%|16729047801|METHYLPHENIDATE 5 MG TABLET|100|EA|.04321|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No||007|Yes|.1394|03/29/2022|.13605|03/29/2022|.13696|03/29/2022|||STIMULANTS AND RELATED AGENTS|7976|||||No|No||ACCORD HEALTHCA|No||||
methylphenidate HCl|No|No|No|No|75%|16729047901|METHYLPHENIDATE 10 MG TABLET|100|EA|.05762|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No||007|Yes|.15766|03/29/2022|.15387|03/29/2022|.1549|03/29/2022|||STIMULANTS AND RELATED AGENTS|7977|||||No|No||ACCORD HEALTHCA|No||||
methylphenidate HCl|No|No|No|No|75%|16729048001|METHYLPHENIDATE 20 MG TABLET|100|EA|.06626|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No||007|Yes|.22814|03/29/2022|.22266|03/29/2022|.22414|03/29/2022|||STIMULANTS AND RELATED AGENTS|7978|||||No|No||ACCORD HEALTHCA|No||||
hydroxychloroquine sulfate|No|No|No|No|75%|16729048501|HYDROXYCHLOROQUINE 200 MG TAB|100|EA|.22265|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No|||No|.23831|03/29/2022|.23259|03/29/2022|.23413|03/29/2022||||7979|||||No|No||ACCORD HEALTHCA|No||||
hydroxychloroquine sulfate|No|No|No|No|75%|16729048516|HYDROXYCHLOROQUINE 200 MG TAB|500|EA|.22265|06/02/2020||Yes|No||06/02/2020||Yes|No|06/02/2020||Yes|No||||No|No|||Prescription required|No|||No|.23831|03/29/2022|.23259|03/29/2022|.23413|03/29/2022||||7980|||||No|No||ACCORD HEALTHCA|No||||
dofetilide|No|No|No|No|75%|16729049012|DOFETILIDE 125 MCG CAPSULE|60|EA|.688|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|No|||No|1.27252|03/29/2022|1.24197|03/29/2022|1.25025|03/29/2022||||7981|||||No|No||ACCORD HEALTHCA|No||||
dofetilide|No|No|No|No|75%|16729049112|DOFETILIDE 250 MCG CAPSULE|60|EA|.688|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|No|||No|.89477|03/29/2022|.87329|03/29/2022|.87911|03/29/2022||||7982|||||No|No||ACCORD HEALTHCA|No||||
dofetilide|No|No|No|No|75%|16729049212|DOFETILIDE 500 MCG CAPSULE|60|EA|.688|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|No|||No|.90796|03/29/2022|.88616|03/29/2022|.89207|03/29/2022||||7983|||||No|No||ACCORD HEALTHCA|No||||
vigabatrin|No|No|No|No|75%|16729052111|VIGABATRIN 500 MG POWDER PACKT|50|EA|2.58|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||056|No|5.88|02/15/2022|5.796|02/22/2022|5.52|02/15/2022|||ANTICONVULSANTS|7984|||||No|No||ACCORD HEALTHCA|No||||
fluorouracil|No|No|No|No|75%|16729054235|FLUOROURACIL 5% CREAM|40|GM|1.10682|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|No|||No|1.42743|03/28/2022|1.39317|03/28/2022|1.40244|03/28/2022||||7985|||||No|No||ACCORD HEALTHCA|No||||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|16729054910|BUPRENORPHINE-NALOX 2-0.5MG TB|30|EA|.79636|03/15/2021||Yes|No||03/15/2021||Yes|No|03/15/2021||Yes|No||||No|No|||Prescription required|No||145|Yes|.72296|03/29/2022|.7056|03/29/2022|.7103|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|7986|||||No|No||ACCORD HEALTHCA|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|16729055010|BUPRENORPHINE-NALOX 8-2 MG TAB|30|EA|.9556|03/15/2021||Yes|No||03/15/2021||Yes|No|03/15/2021||Yes|No||||No|No|||Prescription required|No||145|Yes|1.08568|03/29/2022|1.05962|03/29/2022|1.06668|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|7987|||||No|No||ACCORD HEALTHCA|Yes|09/01/2020|||
docusate sodium|No|No|No|No|75%|17433987603|ENEMEEZ MINI ENEMA|5|ML|.25148|09/07/2015||Yes|No||||No|No|09/07/2015||Yes|No||||No|No|||Over the counter|No|||No|.36547|05/26/2020|.36025|05/26/2020|.34309|05/26/2020||||7988|||||No|No||ALLIANCE LABS,|No||||
docusate sodium/benzocaine|No|No|No|No|75%|17433987703|ENEMEEZ PLUS MINI ENEMA|5|ML|.16035|09/07/2015||Yes|No||||No|No|09/07/2015||Yes|No||||No|No|||Over the counter|No|||No|.36547|06/01/2016|.36025|06/01/2016|.34309|06/01/2016||||7989|||||No|No||ALLIANCE LABS,|No||||
docusate sodium/benzocaine|No|No|No|No|75%|17433988305|DOCUSOL PLUS MINI-ENEMA|5|EA|.88064|09/07/2015||Yes|No||||No|No|09/07/2015||Yes|No||||No|No|||Over the counter|No|||No|2.00704|06/01/2016|1.97836|06/01/2016|1.88416|06/01/2016||||7990|||||No|No||ALLIANCE LABS,|No||||
docusate sodium|No|No|No|No|75%|17433988405|DOCUSOL KIDS 100 MG MINI-ENEMA|5|EA|.88064|09/07/2015||Yes|No||||No|No|09/07/2015||Yes|No||||No|No|||Over the counter|No|||No|2.00704|06/01/2016|1.97836|06/01/2016|1.88416|06/01/2016||||7991|||||No|No||ALLIANCE LABS,|No||||
naloxone HCl|No|No|No|No|75%|17478004101|NALOXONE 0.4 MG/ML VIAL|1|ML|5.63085|10/07/2019||Yes|No||10/07/2019||Yes|No|10/07/2019||Yes|No||||No|No|||Prescription required|No||145|No|12.8331|03/29/2022|12.64977|03/29/2022|12.0474|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|7992|||||No|Yes|12.56|AKORN INC.|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|17478004210|NALOXONE 4 MG/10 ML VIAL|10|ML|4.0334|10/07/2019||Yes|No||10/07/2019||Yes|No|10/07/2019||Yes|No||||No|No|||Prescription required|No||145|No|9.1924|03/29/2022|9.06108|03/29/2022|8.6296|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|7993|||||No|No||AKORN INC.|Yes|09/01/2020|||
polyvinyl alcohol|No|No|No|No|75%|17478006012|ARTIFICIAL TEARS 1.4% DROPS|15|ML|.16999|04/14/2005||Yes|No||||No|No|04/14/2005||Yes|No||||No|No|||Over the counter|No|||No|.38742|08/24/2021|.38188|08/24/2021|.3637|08/24/2021||||7994|||||No|No||AKORN INC.|No||||
mineral oil/petrolatum,white|No|No|No|No|75%|17478006235|ARTIFICIAL TEARS EYE OINTMENT|3.5|GM|.85877|06/28/2005||Yes|No||||No|No|06/28/2005||Yes|No||||No|No|||Over the counter|No|||No|1.8847|03/29/2022|1.83946|03/29/2022|1.85171|03/29/2022||||7995|||||No|No||AKORN INC.|No||||
erythromycin base|No|No|No|No|75%|17478007031|ERYTHROMYCIN 0.5% EYE OINTMENT|1|GM|3.51464|01/27/2021||Yes|No||01/27/2021||Yes|No|01/27/2021||Yes|No||||No|No|||Prescription required|No||058|No|8.01012|01/27/2021|7.89569|01/27/2021|7.51971|01/27/2021|||OPHTHALMIC ANTIBIOTICS|7996|||||No|No||AKORN INC.|No||||
erythromycin base|No|No|No|No|75%|17478007035|ERYTHROMYCIN 0.5% EYE OINTMENT|3.5|GM|1.83302|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||058|No|2.75102|03/29/2022|2.68499|03/29/2022|2.70287|03/29/2022|||OPHTHALMIC ANTIBIOTICS|7997|||||No|No||AKORN INC.|No||||
cyclopentolate HCl|No|No|No|No|75%|17478010002|CYCLOPENTOLATE 1% EYE DROPS|2|ML|2.5413|01/29/2021||Yes|No||01/29/2021||Yes|No|01/29/2021||Yes|No||||No|No|||Prescription required|No|||No|3.01079|03/29/2022|2.93853|03/29/2022|2.9581|03/29/2022||||7998|||||No|No||AKORN INC.|No||||
cyclopentolate HCl|No|No|No|No|75%|17478010012|CYCLOPENTOLATE 1% EYE DROPS|15|ML|.80152|01/29/2021||Yes|No||01/29/2021||Yes|No|01/29/2021||Yes|No||||No|No|||Prescription required|No|||No|1.23427|03/29/2022|1.20464|03/29/2022|1.21267|03/29/2022||||7999|||||No|No||AKORN INC.|No||||
tropicamide|No|No|No|No|75%|17478010112|TROPICAMIDE 0.5% EYE DROPS|15|ML|.22933|01/27/2021||Yes|No||01/27/2021||Yes|No|01/27/2021||Yes|No||||No|No|||Prescription required|No|||No|.52266|01/27/2021|.51519|01/27/2021|.49066|01/27/2021||||8000|||||No|No||AKORN INC.|No||||
tropicamide|No|No|No|No|75%|17478010212|TROPICAMIDE 1% EYE DROPS|15|ML|.24366|01/27/2021||Yes|No||01/27/2021||Yes|No|01/27/2021||Yes|No||||No|No|||Prescription required|No|||No|.55532|01/27/2021|.54739|01/27/2021|.52132|01/27/2021||||8001|||||No|No||AKORN INC.|No||||
olopatadine HCl|No|No|No|No|75%|17478010505|OLOPATADINE HCL 0.1% EYE DROPS|5|ML|3.40044|10/07/2019|02/07/2023|Yes|No||10/07/2019|02/07/2023|Yes|No|10/07/2019|02/07/2023|Yes|No||||No|No|||Prescription required|Yes|01/26/2017|002|No|3.02733|03/29/2022|2.95467|03/29/2022|2.97435|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|8002|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AKORN INC.|No||||
levofloxacin|No|No|No|No|75%|17478010610|LEVOFLOXACIN 0.5% EYE DROPS|5|ML|9.88054|09/15/2016||Yes|No||09/15/2016||Yes|No|09/15/2016||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|058|No|22.51844|01/28/2020|22.19674|01/28/2020|21.13976|01/28/2020|||OPHTHALMIC ANTIBIOTICS|8003|||||No|No||AKORN INC.|No||||
levalbuterol HCl|No|No|No|No|75%|17478017224|XOPENEX 0.31 MG/3 ML SOLUTION|3|ML|1.49591|06/15/2016||Yes|No||06/15/2016||Yes|No|06/15/2016||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|3.4093|03/20/2018|3.36059|03/20/2018|3.20056|03/20/2018|||BRONCHODILATORS: BETA AGONIST|8004|||||No|No||AKORN INC.|No||||
levalbuterol HCl|No|No|No|No|75%|17478017324|XOPENEX 0.63 MG/3 ML SOLUTION|3|ML|1.49591|05/11/2016||Yes|No||05/11/2016||Yes|No|05/11/2016||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|3.4093|03/20/2018|3.36059|03/20/2018|3.20056|03/20/2018|||BRONCHODILATORS: BETA AGONIST|8005|||||No|No||AKORN INC.|No||||
levalbuterol HCl|No|No|No|No|75%|17478017424|XOPENEX 1.25 MG/3 ML SOLUTION|3|ML|1.49591|05/11/2016||Yes|No||05/11/2016||Yes|No|05/11/2016||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|3.4093|03/27/2018|3.36059|03/27/2018|3.20056|03/27/2018|||BRONCHODILATORS: BETA AGONIST|8006|||||No|No||AKORN INC.|No||||
ketorolac tromethamine|No|No|No|No|75%|17478020910|KETOROLAC 0.5% OPHTH SOLUTION|5|ML|2.75372|01/19/2010||Yes|No||01/19/2010||Yes|No|01/19/2010||Yes|No||||No|No|||Prescription required|No||013|No|1.50166|03/29/2022|1.46562|03/29/2022|1.47538|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|8007|||||No|No||AKORN INC.|No||||
ketorolac tromethamine|No|No|No|No|75%|17478020911|KETOROLAC 0.5% OPHTH SOLUTION|10|ML|2.75372|01/19/2010||Yes|No||01/19/2010||Yes|No|01/19/2010||Yes|No||||No|No|||Prescription required|No||013|No|1.17797|03/29/2022|1.14969|03/29/2022|1.15735|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|8008|||||No|No||AKORN INC.|No||||
ketorolac tromethamine|No|No|No|No|75%|17478020919|KETOROLAC 0.5% OPHTH SOLUTION|3|ML|2.09553|01/19/2010||Yes|No||01/19/2010||Yes|No|01/19/2010||Yes|No||||No|No|||Prescription required|No||013|No|4.77586|02/25/2020|4.70763|02/25/2020|4.48346|02/25/2020|||OPHTHALMICS: ANTI-INFLAMMATORIES|8009|||||No|No||AKORN INC.|No||||
atropine sulfate|No|No|No|No|75%|17478021502|ATROPINE 1% EYE DROPS|2|ML|8.23235|10/03/2016||Yes|No||10/03/2016||Yes|No|10/03/2016||Yes|No||||No|No|||Prescription required|No|||No|18.28667|03/29/2022|17.84778|03/29/2022|17.96665|03/29/2022||||8010|||||No|No||AKORN INC.|No||||
atropine sulfate|No|No|No|No|75%|17478021505|ATROPINE 1% EYE DROPS|5|ML|4.41352|10/03/2016||Yes|No||10/03/2016||Yes|No|10/03/2016||Yes|No||||No|No|||Prescription required|No|||No|9.54286|03/29/2022|9.31383|03/29/2022|9.37585|03/29/2022||||8011|||||No|No||AKORN INC.|No||||
atropine sulfate|No|No|No|No|75%|17478021515|ATROPINE 1% EYE DROPS|15|ML|3.78543|10/03/2016||Yes|No||10/03/2016||Yes|No|10/03/2016||Yes|No||||No|No|||Prescription required|No|||No|8.43533|03/01/2022|8.23288|03/01/2022|8.28771|03/01/2022||||8012|||||No|No||AKORN INC.|No||||
pilocarpine HCl|No|No|No|No|75%|17478022312|PILOCARPINE 1% EYE DROPS|15|ML|2.19242|10/26/2000||Yes|No||10/07/2019||Yes|No|10/26/2000||Yes|No||||No|No|||Prescription required|No||088|No|4.04603|03/29/2022|3.94892|03/29/2022|3.97522|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|8013|||||No|No||AKORN INC.|No||||
pilocarpine HCl|No|No|No|No|75%|17478022412|PILOCARPINE 2% EYE DROPS|15|ML|2.24259|10/26/2000||Yes|No||10/07/2019||Yes|No|10/26/2000||Yes|No||||No|No|||Prescription required|No||088|No|4.33357|03/29/2022|4.22956|03/29/2022|4.25773|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|8014|||||No|No||AKORN INC.|No||||
pilocarpine HCl|No|No|No|No|75%|17478022612|PILOCARPINE 4% EYE DROPS|15|ML|2.35095|10/26/2000||Yes|No||11/05/2019||Yes|No|10/26/2000||Yes|No||||No|No|||Prescription required|No||088|No|4.37517|11/23/2021|4.27016|11/23/2021|4.2986|11/23/2021|||OPHTHALMICS: GLAUCOMA AGENTS|8015|||||No|No||AKORN INC.|No||||
gentamicin sulfate|No|No|No|No|75%|17478028310|GENTAMICIN 0.3% EYE DROP|5|ML|1.3201|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||058|No|.63882|03/29/2022|.62348|03/29/2022|.62764|03/29/2022|||OPHTHALMIC ANTIBIOTICS|8016|||||No|No||AKORN INC.|No||||
gentamicin sulfate|No|No|No|No|75%|17478028435|GENTAK 0.3 % EYE OINTMENT|3.5|GM|3.82822|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||058|No|8.45714|09/28/2021|8.25416|09/28/2021|8.30914|09/28/2021|||OPHTHALMIC ANTIBIOTICS|8017|||||No|No||AKORN INC.|No||||
timolol maleate|No|No|No|No|75%|17478028810|TIMOLOL MALEATE 0.5% EYE DROPS|5|ML|.74734|08/09/2005||Yes|No||08/09/2005||Yes|No|08/09/2005||Yes|No||||No|No|||Prescription required|No||088|No|1.19485|03/29/2022|1.16617|03/29/2022|1.17394|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|8018|||||No|No||AKORN INC.|No||||
timolol maleate|No|No|No|No|75%|17478028811|TIMOLOL MALEATE 0.5% EYE DROPS|10|ML|.53449|04/14/2005||Yes|No||04/14/2005||Yes|No|04/14/2005||Yes|No||||No|No|||Prescription required|No||088|No|.95525|03/29/2022|.93232|03/29/2022|.93853|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|8019|||||No|No||AKORN INC.|No||||
timolol maleate|No|No|No|No|75%|17478028812|TIMOLOL MALEATE 0.5% EYE DROPS|15|ML|.5137|08/09/2005||Yes|No||08/09/2005||Yes|No|08/09/2005||Yes|No||||No|No|||Prescription required|No||088|No|.91053|03/29/2022|.88867|03/29/2022|.89459|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|8020|||||No|No||AKORN INC.|No||||
tobramycin|No|No|No|No|75%|17478029010|TOBRAMYCIN 0.3% EYE DROP|5|ML|1.0019|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||058|No|1.42908|03/29/2022|1.39478|03/29/2022|1.40407|03/29/2022|||OPHTHALMIC ANTIBIOTICS|8021|||||No|No||AKORN INC.|No||||
cromolyn sodium|No|No|No|No|75%|17478029111|CROMOLYN 4% EYE DROPS|10|ML|.97997|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||002|No|.58006|03/29/2022|.56613|03/29/2022|.5699|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|8022|||||No|No||AKORN INC.|No||||
olopatadine HCl|No|No|No|No|75%|17478030512|OLOPATADINE HCL 0.2% EYE DROP|2.5|ML|17.14324|10/07/2019|04/30/2024|Yes|No||10/07/2019|04/30/2024|Yes|No|10/07/2019|04/30/2024|Yes|No||||No|No|||Prescription required|Yes|12/14/2017|002|No|9.7075|01/25/2022|9.47452|01/25/2022|9.53761|01/25/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|8023|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AKORN INC.|No||||
azithromycin|No|No|No|No|75%|17478030703|AZASITE 1% EYE DROPS|2.5|ML|38.30612|05/22/2015||Yes|No||05/22/2015||Yes|No|05/22/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|058|No|85.78329|01/04/2022|83.72449|01/04/2022|84.28208|01/04/2022|||OPHTHALMIC ANTIBIOTICS|8024|||||No|No||AKORN INC.|No||||
aminocaproic acid|No|No|No|No|75%|17478044708|AMINOCAPROIC ACID 0.25 GRAM/ML|236.5|ML|7.3291|04/27/2020||Yes|No||04/27/2020||Yes|No|04/27/2020||Yes|No||||No|No|||Prescription required|No|||No|10.56252|04/27/2020|10.41163|04/27/2020|9.91584|04/27/2020||||8025|||||No|No||AKORN INC.|No||||
moxifloxacin HCl|No|No|No|No|75%|17478051919|MOXIFLOXACIN 0.5% EYE DROPS|3|ML|5.59|10/14/2019||Yes|No||10/14/2019||Yes|No|10/14/2019||Yes|No||||No|No|||Prescription required|Yes|11/23/2017|058|No|3.97371|03/29/2022|3.87834|03/29/2022|3.90417|03/29/2022|||OPHTHALMIC ANTIBIOTICS|8026|||||No|No||AKORN INC.|No||||
orphenadrine citrate|No|No|No|No|75%|17478053802|ORPHENADRINE 30 MG/ML VIAL|2|ML|3.4099|01/27/2021||Yes|No||01/27/2021||Yes|No|01/27/2021||Yes|No||||No|No|||Prescription required|No|||No|7.7714|01/27/2021|7.66038|02/02/2021|7.2956|01/27/2021||||8027|||||No|No||AKORN INC.|No||||
dorzolamide/timolol/PF|No|No|No|No|75%|17478060430|COSOPT PF EYE DROPS|60|EA|1.28161|05/22/2015||Yes|No||05/22/2015||Yes|No|05/22/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|088|No|2.85719|01/04/2022|2.78861|01/04/2022|2.80718|01/04/2022|||OPHTHALMICS: GLAUCOMA AGENTS|8028|||||No|No||AKORN INC.|No||||
dorzolamide HCl/timolol maleat|No|No|No|No|75%|17478060510|COSOPT EYE DROPS|10|ML|9.01323|05/22/2015||Yes|No||05/22/2015||Yes|No|05/22/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|088|No|20.54178|12/24/2019|20.24832|12/24/2019|19.28412|12/24/2019|||OPHTHALMICS: GLAUCOMA AGENTS|8029|||||No|No||AKORN INC.|No||||
tafluprost/PF|No|No|No|No|75%|17478060930|ZIOPTAN 0.0015% EYE DROPS|30|EA|3.29738|05/22/2015||Yes|No||05/22/2015||Yes|No|05/22/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|088|No|7.34764|01/04/2022|7.17129|01/04/2022|7.21905|01/04/2022|||OPHTHALMICS: GLAUCOMA AGENTS|8030|||||No|No||AKORN INC.|No||||
sodium chloride|No|No|No|No|75%|17478062235|SODIUM CHLORIDE 5% EYE OINT|3.5|GM|1.28631|07/20/2005||Yes|No||||No|No|07/20/2005||Yes|No||||No|No|||Over the counter|No|||No|3.10166|10/26/2021|3.02722|10/26/2021|3.04738|10/26/2021||||8031|||||No|No||AKORN INC.|No||||
sodium chloride|No|No|No|No|75%|17478062312|SODIUM CHLORIDE 5% EYE DROP|15|ML|.33798|07/20/2005||Yes|No||||No|No|07/20/2005||Yes|No||||No|No|||Over the counter|No|||No|.58738|03/29/2022|.57328|03/29/2022|.5771|03/29/2022||||8032|||||No|No||AKORN INC.|No||||
latanoprost|No|No|No|No|75%|17478062512|LATANOPROST 0.005% EYE DROPS|2.5|ML|2.6746|06/13/2013||Yes|No||06/13/2013||Yes|No|06/13/2013||Yes|No||||No|No|||Prescription required|No||088|No|1.89557|03/29/2022|1.85007|03/29/2022|1.86239|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|8033|||||No|No||AKORN INC.|No||||
polymyxin B sulf/trimethoprim|No|No|No|No|75%|17478070311|POLYMYXIN B-TMP EYE DROPS|10|ML|.4429|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||058|No|.46086|03/29/2022|.44979|03/29/2022|.45279|03/29/2022|||OPHTHALMIC ANTIBIOTICS|8034|||||No|No||AKORN INC.|No||||
lidocaine HCl|No|No|No|No|75%|17478071130|LIDOCAINE HCL 2% JELLY|30|ML|1.53309|07/20/2005||Yes|No||07/20/2005||Yes|No|07/20/2005||Yes|No||||No|No|||Prescription required|No|||No|3.36445|03/29/2022|3.2837|03/29/2022|3.30557|03/29/2022||||8035|||||No|No||AKORN INC.|No||||
lidocaine HCl|No|No|No|No|75%|17478071131|LIDOCAINE HCL 2% JELLY|5|ML|.602|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No|||No|1.372|04/07/2020|1.3524|04/07/2020|1.288|04/07/2020||||8036|||||No|No||AKORN INC.|No||||
ofloxacin|No|No|No|No|75%|17478071310|OFLOXACIN 0.3% EYE DROPS|5|ML|1.4405|11/05/2019||Yes|No||11/05/2019||Yes|No|11/05/2019||Yes|No||||No|No|||Prescription required|No||058|No|1.80843|03/29/2022|1.76502|03/29/2022|1.77678|03/29/2022|||OPHTHALMIC ANTIBIOTICS|8037|||||No|No||AKORN INC.|No||||
ofloxacin|No|No|No|No|75%|17478071311|OFLOXACIN 0.3% EYE DROPS|10|ML|1.3889|01/27/2021||Yes|No||01/27/2021||Yes|No|01/27/2021||Yes|No||||No|No|||Prescription required|No||058|No|1.8791|03/29/2022|1.834|03/29/2022|1.84621|03/29/2022|||OPHTHALMIC ANTIBIOTICS|8038|||||No|No||AKORN INC.|No||||
ciprofloxacin HCl|No|No|No|No|75%|17478071410|CIPROFLOXACIN 0.3% EYE DROP|5|ML|.76282|06/28/2013||Yes|No||06/28/2013||Yes|No|06/28/2013||Yes|No||||No|No|||Prescription required|No||058|No|2.02578|03/29/2022|1.97716|03/29/2022|1.99032|03/29/2022|||OPHTHALMIC ANTIBIOTICS|8039|||||No|No||AKORN INC.|No||||
ciprofloxacin HCl|No|No|No|No|75%|17478071425|CIPROFLOXACIN 0.3% EYE DROP|2.5|ML|1.28656|08/12/2019||Yes|No||08/12/2019||Yes|No|08/12/2019||Yes|No||||No|No|||Prescription required|No||058|No|3.16994|03/29/2022|3.09386|03/29/2022|3.11446|03/29/2022|||OPHTHALMIC ANTIBIOTICS|8040|||||No|No||AKORN INC.|No||||
brimonidine tartrate|No|No|No|No|75%|17478071510|BRIMONIDINE 0.2% EYE DROP|5|ML|1.2642|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|No||088|No|.85973|03/29/2022|.83909|03/29/2022|.84468|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|8041|||||No|No||AKORN INC.|No||||
apraclonidine HCl|No|No|No|No|75%|17478071610|APRACLONIDINE HCL 0.5% DROPS|5|ML|6.0845|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|088|No|12.2696|07/27/2021|11.97512|07/27/2021|12.05488|07/27/2021|||OPHTHALMICS: GLAUCOMA AGENTS|8042|||||No|No||AKORN INC.|No||||
apraclonidine HCl|No|No|No|No|75%|17478071611|APRACLONIDINE HCL 0.5% DROPS|10|ML|6.0415|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|088|No|13.769|02/04/2021|13.5723|02/04/2021|12.926|02/04/2021|||OPHTHALMICS: GLAUCOMA AGENTS|8043|||||No|No||AKORN INC.|No||||
dronabinol|No|No|No|No|75%|17478076106|DRONABINOL 2.5 MG CAPSULE|60|EA|.72562|01/27/2021||Yes|No||01/27/2021||Yes|No|01/27/2021||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|085|No|1.39891|03/29/2022|1.36533|03/29/2022|1.37442|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|8044|||||No|No||AKORN INC.|No||||
dronabinol|No|No|No|No|75%|17478076206|DRONABINOL 5 MG CAPSULE|60|EA|1.51223|08/09/2019||Yes|No||08/09/2019||Yes|No|08/09/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|085|No|2.55851|03/29/2022|2.4971|03/29/2022|2.51373|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|8045|||||No|No||AKORN INC.|No||||
dronabinol|No|No|No|No|75%|17478076306|DRONABINOL 10 MG CAPSULE|60|EA|2.32479|01/27/2021||Yes|No||01/27/2021||Yes|No|01/27/2021||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|085|No|3.9278|03/29/2022|3.83353|03/29/2022|3.85906|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|8046|||||No|No||AKORN INC.|No||||
progesterone, micronized|No|No|No|No|75%|17478076610|PROGESTERONE 100 MG CAPSULE|100|EA|.258|06/13/2013||Yes|No||06/13/2013||Yes|No|06/13/2013||Yes|No||||No|No|||Prescription required|No|||No|.25967|03/29/2022|.25343|03/29/2022|.25512|03/29/2022||||8047|||||No|No||AKORN INC.|No||||
progesterone, micronized|No|No|No|No|75%|17478076710|PROGESTERONE 200 MG CAPSULE|100|EA|.4859|06/13/2013||Yes|No||06/13/2013||Yes|No|06/13/2013||Yes|No||||No|No|||Prescription required|No|||No|.48257|03/29/2022|.47098|03/29/2022|.47412|03/29/2022||||8048|||||No|No||AKORN INC.|No||||
aminocaproic acid|No|No|No|No|75%|17478076830|AMINOCAPROIC ACID 500 MG TAB|30|EA|12.69468|10/14/2019||Yes|No||10/14/2019||Yes|No|10/14/2019||Yes|No||||No|No|||Prescription required|No|||No|18.29528|10/14/2019|18.03392|10/14/2019|17.17516|10/14/2019||||8049|||||No|No||AKORN INC.|No||||
aminocaproic acid|No|No|No|No|75%|17478076930|AMINOCAPROIC ACID 1,000 MG TAB|30|EA|22.85048|10/14/2019||Yes|No||10/14/2019||Yes|No|10/14/2019||Yes|No||||No|No|||Prescription required|No|||No|32.93158|10/14/2019|32.46113|10/14/2019|30.91536|10/14/2019||||8050|||||No|No||AKORN INC.|No||||
lidocaine HCl/PF|No|No|No|No|75%|17478079225|AKTEN 3.5% GEL DROPS|1|ML|10.04566|10/18/2019||Yes|No||10/18/2019||Yes|No|10/18/2019||Yes|No||||No|No|||Prescription required|No|||No|22.89476|05/25/2021|22.56769|05/25/2021|21.49304|05/25/2021||||8051|||||No|No||AKORN INC.|No||||
diclofenac sodium|No|No|No|No|75%|17478089210|DICLOFENAC 0.1% EYE DROPS|5|ML|1.22464|01/19/2010||Yes|No||01/19/2010||Yes|No|01/19/2010||Yes|No||||No|No|||Prescription required|No||013|No|2.17541|03/29/2022|2.1232|03/29/2022|2.13734|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|8052|||||No|No||AKORN INC.|No||||
diclofenac sodium|No|No|No|No|75%|17478089225|DICLOFENAC 0.1% EYE DROPS|2.5|ML|1.8662|01/19/2010||Yes|No||01/19/2010||Yes|No|01/19/2010||Yes|No||||No|No|||Prescription required|No||013|No|2.09|03/29/2022|2.03984|03/29/2022|2.05342|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|8053|||||No|No||AKORN INC.|No||||
topiramate|No|No|No|No|75%|17772010101|TROKENDI XR 25 MG CAPSULE|100|EA|4.98817|11/07/2017||Yes|No||11/07/2017||Yes|No|11/07/2017||Yes|No||||No|No|||Prescription required|No||056|No|11.10417|01/11/2022|10.83766|01/11/2022|10.90984|01/11/2022|||ANTICONVULSANTS|8054|||||No|No||SUPERNUS PHARMA|No||||
topiramate|No|No|No|No|75%|17772010130|TROKENDI XR 25 MG CAPSULE|30|EA|4.98814|11/13/2017||Yes|No||11/13/2017||Yes|No|11/13/2017||Yes|No||||No|No|||Prescription required|No||056|No|11.10417|01/11/2022|10.83766|01/11/2022|10.90984|01/11/2022|||ANTICONVULSANTS|8055|||||No|No||SUPERNUS PHARMA|No||||
topiramate|No|No|No|No|75%|17772010201|TROKENDI XR 50 MG CAPSULE|100|EA|6.4976|10/26/2017||Yes|No||10/26/2017||Yes|No|10/26/2017||Yes|No||||No|No|||Prescription required|No||056|No|14.4845|01/11/2022|14.13687|01/11/2022|14.23102|01/11/2022|||ANTICONVULSANTS|8056|||||No|No||SUPERNUS PHARMA|No||||
topiramate|No|No|No|No|75%|17772010230|TROKENDI XR 50 MG CAPSULE|30|EA|6.49744|10/26/2017||Yes|No||10/26/2017||Yes|No|10/26/2017||Yes|No||||No|No|||Prescription required|No||056|No|14.4845|01/11/2022|14.13687|01/11/2022|14.23102|01/11/2022|||ANTICONVULSANTS|8057|||||No|No||SUPERNUS PHARMA|No||||
topiramate|No|No|No|No|75%|17772010301|TROKENDI XR 100 MG CAPSULE|100|EA|12.87372|11/20/2017||Yes|No||11/20/2017||Yes|No|11/20/2017||Yes|No||||No|No|||Prescription required|No||056|No|28.77689|01/11/2022|28.08624|01/11/2022|28.27329|01/11/2022|||ANTICONVULSANTS|8058|||||No|No||SUPERNUS PHARMA|No||||
topiramate|No|No|No|No|75%|17772010330|TROKENDI XR 100 MG CAPSULE|30|EA|12.87362|11/20/2017||Yes|No||11/20/2017||Yes|No|11/20/2017||Yes|No||||No|No|||Prescription required|No||056|No|28.77689|01/11/2022|28.08624|01/11/2022|28.27329|01/11/2022|||ANTICONVULSANTS|8059|||||No|No||SUPERNUS PHARMA|No||||
topiramate|No|No|No|No|75%|17772010401|TROKENDI XR 200 MG CAPSULE|100|EA|17.6103|10/26/2017||Yes|No||10/26/2017||Yes|No|10/26/2017||Yes|No||||No|No|||Prescription required|No||056|No|39.22149|01/11/2022|38.28017|01/11/2022|38.53511|01/11/2022|||ANTICONVULSANTS|8060|||||No|No||SUPERNUS PHARMA|No||||
topiramate|No|No|No|No|75%|17772010430|TROKENDI XR 200 MG CAPSULE|30|EA|17.6105|10/26/2017||Yes|No||10/26/2017||Yes|No|10/26/2017||Yes|No||||No|No|||Prescription required|No||056|No|39.22149|01/11/2022|38.28017|01/11/2022|38.53511|01/11/2022|||ANTICONVULSANTS|8061|||||No|No||SUPERNUS PHARMA|No||||
oxcarbazepine|No|No|No|No|75%|17772012101|OXTELLAR XR 150 MG TABLET|100|EA|3.45543|02/11/2013||Yes|No||02/11/2013||Yes|No|02/11/2013||Yes|No||||No|No|||Prescription required|No||056|No|7.69843|01/11/2022|7.51366|01/11/2022|7.5637|01/11/2022|||ANTICONVULSANTS|8062|||||No|No||SUPERNUS PHARMA|No||||
oxcarbazepine|No|No|No|No|75%|17772012201|OXTELLAR XR 300 MG TABLET|100|EA|4.80052|02/11/2013||Yes|No||02/11/2013||Yes|No|02/11/2013||Yes|No||||No|No|||Prescription required|No||056|No|10.74414|01/11/2022|10.48628|01/11/2022|10.55611|01/11/2022|||ANTICONVULSANTS|8063|||||No|No||SUPERNUS PHARMA|No||||
oxcarbazepine|No|No|No|No|75%|17772012301|OXTELLAR XR 600 MG TABLET|100|EA|8.78928|02/11/2013||Yes|No||02/11/2013||Yes|No|02/11/2013||Yes|No||||No|No|||Prescription required|No||056|No|19.63215|01/11/2022|19.16097|01/11/2022|19.28858|01/11/2022|||ANTICONVULSANTS|8064|||||No|No||SUPERNUS PHARMA|No||||
viloxazine HCl|No|No|No|No|75%|17772013130|QELBREE ER 100 MG CAPSULE|30|EA|4.5428|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No||007|No|10.14389|01/11/2022|9.90043|01/11/2022|9.96637|01/11/2022|||STIMULANTS AND RELATED AGENTS|8065|||||No|No||SUPERNUS PHARMA|No||||
viloxazine HCl|No|No|No|No|75%|17772013230|QELBREE ER 150 MG CAPSULE|30|EA|4.5428|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No||007|No|10.11458|03/01/2022|9.87183|03/01/2022|9.93757|03/01/2022|||STIMULANTS AND RELATED AGENTS|8066|||||No|No||SUPERNUS PHARMA|No||||
viloxazine HCl|No|No|No|No|75%|17772013330|QELBREE ER 200 MG CAPSULE|30|EA|4.5428|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No||007|No|10.10427|01/11/2022|9.86176|01/11/2022|9.92744|01/11/2022|||STIMULANTS AND RELATED AGENTS|8067|||||No|No||SUPERNUS PHARMA|No||||
dextroamphetamine sulfate|No|No|No|No|75%|21724070105|PROCENTRA 5 MG/5 ML SOLUTION|473|ML|.72727|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.6575|03/27/2018|1.63382|03/27/2018|1.55602|03/27/2018|||STIMULANTS AND RELATED AGENTS|8068|||||No|No||INDEPENDENCE PH|No||||
fluocinonide|No|No|No|No|75%|21922000101|FLUOCINONIDE 0.05% SOLUTION|60|ML|.215|03/30/2022||Yes|No||03/30/2022||Yes|No|03/30/2022||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|120|No|.3579|03/30/2022|.34931|03/30/2022|.35163|03/30/2022|||STEROIDS: TOPICAL HIGH|8069|||||No|No||ENCUBE ETHICALS|No||||
clindamycin phosphate|No|No|No|No|75%|21922000201|CLINDAMYCIN PH 1% SOLUTION|60|ML|.172|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No||104|No|.19863|03/29/2022|.19386|03/29/2022|.19515|03/29/2022|||ACNE AGENTS: TOPICAL|8070|||||No|No||ENCUBE ETHICALS|No||||
clindamycin phosphate|No|No|No|No|75%|21922000221|CLINDAMYCIN PH 1% SOLUTION|30|ML|.172|03/03/2021||Yes|No||03/03/2021||Yes|No|03/03/2021||Yes|No||||No|No|||Prescription required|No||104|No|.23242|03/29/2022|.22684|03/29/2022|.22835|03/29/2022|||ACNE AGENTS: TOPICAL|8071|||||No|No||ENCUBE ETHICALS|No||||
fluocinolone acetonide|No|No|No|No|75%|21922000301|FLUOCINOLONE 0.01% SOLUTION|60|ML|.14333|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|.3936|03/29/2022|.38415|03/29/2022|.38671|03/29/2022|||STEROIDS: TOPICAL MEDIUM|8072|||||No|No||ENCUBE ETHICALS|No||||
desonide|No|No|No|No|75%|21922000404|DESONIDE 0.05% OINTMENT|15|GM|.54466|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|118|No|.83836|03/29/2022|.81823|03/29/2022|.82368|03/29/2022|||STEROIDS: TOPICAL LOW|8073|||||No|No||ENCUBE ETHICALS|No||||
desonide|No|No|No|No|75%|21922000407|DESONIDE 0.05% OINTMENT|60|GM|.54466|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|118|No|.63751|03/29/2022|.6222|03/29/2022|.62635|03/29/2022|||STEROIDS: TOPICAL LOW|8074|||||No|No||ENCUBE ETHICALS|No||||
diclofenac sodium|No|No|No|No|75%|21922000909|DICLOFENAC SODIUM 1% GEL|100|GM|.086|05/18/2020||Yes|No||05/18/2020||Yes|No|05/18/2020||Yes|No||||No|No|||Prescription required|No||059|Yes|.08846|03/29/2022|.08633|03/29/2022|.08691|03/29/2022|||NSAIDS|8075|||||No|No||ENCUBE ETHICALS|No||||
clobetasol propionate|No|No|No|No|75%|21922001604|CLOBETASOL 0.05% CREAM|15|GM|.43|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|No||121|No|.42879|03/29/2022|.41849|03/29/2022|.42128|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|8076|||||No|No||ENCUBE ETHICALS|No||||
clobetasol propionate|No|No|No|No|75%|21922001605|CLOBETASOL 0.05% CREAM|30|GM|.43|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|No||121|No|.34489|03/29/2022|.33661|03/29/2022|.33885|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|8077|||||No|No||ENCUBE ETHICALS|No||||
clobetasol propionate|No|No|No|No|75%|21922001606|CLOBETASOL 0.05% CREAM|45|GM|.43|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|No||121|No|.31467|03/29/2022|.30711|03/29/2022|.30916|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|8078|||||No|No||ENCUBE ETHICALS|No||||
clobetasol propionate|No|No|No|No|75%|21922001607|CLOBETASOL 0.05% CREAM|60|GM|.43|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|No||121|No|.33784|03/29/2022|.32973|03/29/2022|.33192|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|8079|||||No|No||ENCUBE ETHICALS|No||||
clobetasol propionate|No|No|No|No|75%|21922001704|CLOBETASOL 0.05% OINTMENT|15|GM|.344|04/16/2020||Yes|No||04/16/2020||Yes|No|04/16/2020||Yes|No||||No|No|||Prescription required|No||121|No|.35914|03/29/2022|.35052|03/29/2022|.35285|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|8080|||||No|No||ENCUBE ETHICALS|No||||
clobetasol propionate|No|No|No|No|75%|21922001705|CLOBETASOL 0.05% OINTMENT|30|GM|.344|04/16/2020||Yes|No||04/16/2020||Yes|No|04/16/2020||Yes|No||||No|No|||Prescription required|No||121|No|.3756|03/29/2022|.36658|03/29/2022|.36902|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|8081|||||No|No||ENCUBE ETHICALS|No||||
clobetasol propionate|No|No|No|No|75%|21922001706|CLOBETASOL 0.05% OINTMENT|45|GM|.344|04/16/2020||Yes|No||04/16/2020||Yes|No|04/16/2020||Yes|No||||No|No|||Prescription required|No||121|No|.36764|03/29/2022|.35881|03/29/2022|.3612|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|8082|||||No|No||ENCUBE ETHICALS|No||||
clobetasol propionate|No|No|No|No|75%|21922001707|CLOBETASOL 0.05% OINTMENT|60|GM|.344|04/16/2020||Yes|No||04/16/2020||Yes|No|04/16/2020||Yes|No||||No|No|||Prescription required|No||121|No|.32004|03/29/2022|.31235|03/29/2022|.31443|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|8083|||||No|No||ENCUBE ETHICALS|No||||
testosterone|No|No|No|No|90%|21922001902|TESTOSTERONE 1% (50 MG/5 G) PK|5|GM|.86|03/22/2022||Yes|No||03/22/2022||Yes|No|03/22/2022||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|084|No|1.96|03/22/2022|1.932|03/22/2022|1.84|03/22/2022|||ANDROGENIC AGENTS|8084|||||No|No||ENCUBE ETHICALS|No||||
tavaborole|No|No|No|No|75%|21922002012|TAVABOROLE 5% TOPICAL SOLUTION|10|ML|3.87|03/18/2021||Yes|No||03/18/2021||Yes|No|03/18/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|061|No|12.67867|08/24/2021|12.37438|08/24/2021|12.45679|08/24/2021|||ANTIFUNGALS: TOPICAL|8085|||||No|No||ENCUBE ETHICALS|No||||
permethrin|No|No|No|No|75%|21922002107|PERMETHRIN 5% CREAM|60|GM|.215|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No||122|No|.34397|03/29/2022|.33571|03/29/2022|.33795|03/29/2022|||ANTIPARASITICS: TOPICAL|8086|||||No|No||ENCUBE ETHICALS|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|21922002206|CLIND PH-BENZOYL PEROX 1.2-5%|45|GM|.56377|10/28/2021||Yes|No||10/28/2021||Yes|No|10/28/2021||Yes|No||||No|No|||Prescription required|No||104|No|.73339|03/29/2022|.71578|03/29/2022|.72055|03/29/2022|||ACNE AGENTS: TOPICAL|8087|||||No|No||ENCUBE ETHICALS|No||||
triamcinolone acetonide|No|No|No|No|75%|21922002411|TRIAMCINOLONE 0.05% OINTMENT|430|GM|.54999|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No||120|No|1.23712|03/01/2022|1.20742|03/01/2022|1.21547|03/01/2022|||STEROIDS: TOPICAL HIGH|8088|||||No|No||ENCUBE ETHICALS|No||||
ketoconazole|No|No|No|No|75%|21922002504|KETOCONAZOLE 2% CREAM|15|GM|.43|10/28/2021||Yes|No||10/28/2021||Yes|No|10/28/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|061|No|.53088|03/29/2022|.51813|03/29/2022|.52158|03/29/2022|||ANTIFUNGALS: TOPICAL|8089|||||No|No||ENCUBE ETHICALS|No||||
ketoconazole|No|No|No|No|75%|21922002505|KETOCONAZOLE 2% CREAM|30|GM|.35833|10/14/2021||Yes|No||10/14/2021||Yes|No|10/14/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|061|No|.43567|03/29/2022|.42521|03/29/2022|.42804|03/29/2022|||ANTIFUNGALS: TOPICAL|8090|||||No|No||ENCUBE ETHICALS|No||||
ketoconazole|No|No|No|No|75%|21922002507|KETOCONAZOLE 2% CREAM|60|GM|.26875|10/28/2021||Yes|No||10/28/2021||Yes|No|10/28/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|061|No|.36478|03/29/2022|.35602|03/29/2022|.35839|03/29/2022|||ANTIFUNGALS: TOPICAL|8091|||||No|No||ENCUBE ETHICALS|No||||
clindamycin phosphate|No|No|No|No|75%|21922002705|CLINDAMYCIN PH 1% GEL|30|GM|.71666|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||104|No|.67613|03/29/2022|.6599|03/29/2022|.66429|03/29/2022|||ACNE AGENTS: TOPICAL|8092|||||No|No||ENCUBE ETHICALS|No||||
clindamycin phosphate|No|No|No|No|75%|21922002707|CLINDAMYCIN PH 1% GEL|60|GM|.71666|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||104|No|.47333|03/29/2022|.46197|03/29/2022|.46504|03/29/2022|||ACNE AGENTS: TOPICAL|8093|||||No|No||ENCUBE ETHICALS|No||||
mupirocin calcium|No|No|No|No|75%|21922002904|MUPIROCIN 2% CREAM|15|GM|4.3|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|114|No|7.17255|03/29/2022|7.0004|03/29/2022|7.04703|03/29/2022|||ANTIBIOTICS: TOPICAL|8094|||||No|No||ENCUBE ETHICALS|No||||
mupirocin calcium|No|No|No|No|75%|21922002905|MUPIROCIN 2% CREAM|30|GM|4.3|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|114|No|4.87374|03/29/2022|4.75677|03/29/2022|4.78844|03/29/2022|||ANTIBIOTICS: TOPICAL|8095|||||No|No||ENCUBE ETHICALS|No||||
nystatin/triamcin|No|No|No|No|75%|21922003104|NYSTATIN-TRIAMCINOLONE OINTM|15|GM|.258|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|.4296|03/29/2022|.41928|03/29/2022|.42208|03/29/2022|||ANTIFUNGALS: TOPICAL|8096|||||No|No||ENCUBE ETHICALS|No||||
nystatin/triamcin|No|No|No|No|75%|21922003105|NYSTATIN-TRIAMCINOLONE OINTM|30|GM|.258|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|.33412|03/29/2022|.3261|03/29/2022|.32827|03/29/2022|||ANTIFUNGALS: TOPICAL|8097|||||No|No||ENCUBE ETHICALS|No||||
nystatin/triamcin|No|No|No|No|75%|21922003107|NYSTATIN-TRIAMCINOLONE OINTM|60|GM|.258|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|.24511|03/29/2022|.23922|03/29/2022|.24082|03/29/2022|||ANTIFUNGALS: TOPICAL|8098|||||No|No||ENCUBE ETHICALS|No||||
hydralazine HCl|No|No|No|No|75%|23155000101|HYDRALAZINE 10 MG TABLET|100|EA|.01904|06/07/2010||Yes|No||06/07/2010||Yes|No|06/07/2010||Yes|No||||No|No|||Prescription required|No|||No|.03439|03/29/2022|.03356|03/29/2022|.03378|03/29/2022||||8099|||||No|No||AVET PHARMACEUT|No||||
hydralazine HCl|No|No|No|No|75%|23155000110|HYDRALAZINE 10 MG TABLET|1000|EA|.01715|06/07/2010||Yes|No||06/07/2010||Yes|No|06/07/2010||Yes|No||||No|No|||Prescription required|No|||No|.03439|03/29/2022|.03356|03/29/2022|.03378|03/29/2022||||8100|||||No|No||AVET PHARMACEUT|No||||
hydralazine HCl|No|No|No|No|75%|23155000201|HYDRALAZINE 25 MG TABLET|100|EA|.02623|12/18/2007||Yes|No||12/18/2007||Yes|No|12/18/2007||Yes|No||||No|No|||Prescription required|No|||No|.04116|03/29/2022|.04017|03/29/2022|.04043|03/29/2022||||8101|||||No|No||AVET PHARMACEUT|No||||
hydralazine HCl|No|No|No|No|75%|23155000210|HYDRALAZINE 25 MG TABLET|1000|EA|.0236|12/18/2007||Yes|No||12/18/2007||Yes|No|12/18/2007||Yes|No||||No|No|||Prescription required|No|||No|.04116|03/29/2022|.04017|03/29/2022|.04043|03/29/2022||||8102|||||No|No||AVET PHARMACEUT|No||||
hydralazine HCl|No|No|No|No|75%|23155000301|HYDRALAZINE 50 MG TABLET|100|EA|.03276|12/18/2007||Yes|No||12/18/2007||Yes|No|12/18/2007||Yes|No||||No|No|||Prescription required|No|||No|.0521|03/29/2022|.05084|03/29/2022|.05118|03/29/2022||||8103|||||No|No||AVET PHARMACEUT|No||||
hydralazine HCl|No|No|No|No|75%|23155000310|HYDRALAZINE 50 MG TABLET|1000|EA|.02949|12/18/2007||Yes|No||12/18/2007||Yes|No|12/18/2007||Yes|No||||No|No|||Prescription required|No|||No|.0521|03/29/2022|.05084|03/29/2022|.05118|03/29/2022||||8104|||||No|No||AVET PHARMACEUT|No||||
hydralazine HCl|No|No|No|No|75%|23155000401|HYDRALAZINE 100 MG TABLET|100|EA|.0611|06/07/2010||Yes|No||06/07/2010||Yes|No|06/07/2010||Yes|No||||No|No|||Prescription required|No|||No|.0869|03/29/2022|.08481|03/29/2022|.08537|03/29/2022||||8105|||||No|No||AVET PHARMACEUT|No||||
hydrochlorothiazide|Yes|No|No|No|75%|23155000810|HYDROCHLOROTHIAZIDE 25 MG TAB|1000|EA|.00851|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|06/04/2019||Prescription required|No|||Yes|.01337|03/29/2022|.01304|03/29/2022|.01313|03/29/2022||||8106|||||No|No||AVET PHARMACEUT|No||||
hydrochlorothiazide|Yes|No|No|No|75%|23155000910|HYDROCHLOROTHIAZIDE 50 MG TAB|1000|EA|.01429|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|06/04/2019||Prescription required|No|||Yes|.02959|03/29/2022|.02887|03/29/2022|.02907|03/29/2022||||8107|||||No|No||AVET PHARMACEUT|No||||
tetracycline HCl|No|No|No|No|75%|23155001701|TETRACYCLINE 250 MG CAPSULE|100|EA|1.4319|02/20/2014||Yes|No||02/20/2014||Yes|No|02/20/2014||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|213|No|.9651|03/01/2022|.94193|03/01/2022|.94821|03/01/2022|||TETRACYCLINES|8108|||||No|No||AVET PHARMACEUT|No||||
tetracycline HCl|No|No|No|No|75%|23155001801|TETRACYCLINE 500 MG CAPSULE|100|EA|2.8251|02/20/2014||Yes|No||02/20/2014||Yes|No|02/20/2014||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|213|No|1.54692|03/29/2022|1.50979|03/29/2022|1.51984|03/29/2022|||TETRACYCLINES|8109|||||No|No||AVET PHARMACEUT|No||||
ketoprofen|No|No|No|No|75%|23155002101|KETOPROFEN 50 MG CAPSULE|100|EA|.51677|06/11/2020||Yes|No||06/11/2020||Yes|No|06/11/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|1.17776|06/11/2020|1.16093|06/11/2020|1.10565|06/11/2020|||NSAIDS|8110|||||No|No||AVET PHARMACEUT|No||||
ketoprofen|No|No|No|No|75%|23155002201|KETOPROFEN 75 MG CAPSULE|100|EA|.57417|06/11/2020||Yes|No||06/11/2020||Yes|No|06/11/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|1.30859|06/11/2020|1.28989|06/11/2020|1.22847|06/11/2020|||NSAIDS|8111|||||No|No||AVET PHARMACEUT|No||||
buspirone HCl|No|No|No|No|75%|23155002301|BUSPIRONE HCL 5 MG TABLET|100|EA|.02085|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|8112|||||No|No||AVET PHARMACEUT|No||||
buspirone HCl|No|No|No|No|75%|23155002305|BUSPIRONE HCL 5 MG TABLET|500|EA|.02086|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|8113|||||No|No||AVET PHARMACEUT|No||||
buspirone HCl|No|No|No|No|75%|23155002401|BUSPIRONE HCL 10 MG TABLET|100|EA|.03237|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|8114|||||No|No||AVET PHARMACEUT|No||||
buspirone HCl|No|No|No|No|75%|23155002405|BUSPIRONE HCL 10 MG TABLET|500|EA|.03157|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|8115|||||No|No||AVET PHARMACEUT|No||||
buspirone HCl|No|No|No|No|75%|23155002501|BUSPIRONE HCL 15 MG TABLET|100|EA|.03848|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|8116|||||No|No||AVET PHARMACEUT|No||||
buspirone HCl|No|No|No|No|75%|23155002505|BUSPIRONE HCL 15 MG TABLET|500|EA|.03751|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|8117|||||No|No||AVET PHARMACEUT|No||||
buspirone HCl|No|No|No|No|75%|23155002506|BUSPIRONE HCL 15 MG TABLET|60|EA|.0387|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|8118|||||No|No||AVET PHARMACEUT|No||||
buspirone HCl|No|No|No|No|75%|23155002508|BUSPIRONE HCL 15 MG TABLET|180|EA|.03848|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|8119|||||No|No||AVET PHARMACEUT|No||||
verapamil HCl|Yes|No|No|No|75%|23155002601|VERAPAMIL 80 MG TABLET|100|EA|.02494|04/07/2011||Yes|No||04/07/2011||Yes|No|04/07/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||045|No|.05252|03/29/2022|.05125|03/29/2022|.0516|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8120|||||No|No||AVET PHARMACEUT|No||||
fluoxetine HCl|No|No|No|No|75%|23155002801|FLUOXETINE HCL 10 MG CAPSULE|100|EA|.0215|03/15/2022||Yes|No||03/15/2022||Yes|No|03/15/2022||Yes|No||||No|No|||Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|8121|||||No|No||AVET PHARMACEUT|No||||
fluoxetine HCl|No|No|No|No|75%|23155002810|FLUOXETINE HCL 10 MG CAPSULE|1000|EA|.02042|03/15/2022||Yes|No||03/15/2022||Yes|No|03/15/2022||Yes|No||||No|No|||Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|8122|||||No|No||AVET PHARMACEUT|No||||
fluoxetine HCl|No|No|No|No|75%|23155002901|FLUOXETINE HCL 20 MG CAPSULE|100|EA|.02257|03/15/2022||Yes|No||03/15/2022||Yes|No|03/15/2022||Yes|No||||No|No|||Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|8123|||||No|No||AVET PHARMACEUT|No||||
fluoxetine HCl|No|No|No|No|75%|23155002910|FLUOXETINE HCL 20 MG CAPSULE|1000|EA|.02145|03/15/2022||Yes|No||03/15/2022||Yes|No|03/15/2022||Yes|No||||No|No|||Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|8124|||||No|No||AVET PHARMACEUT|No||||
fluoxetine HCl|No|No|No|No|75%|23155003001|FLUOXETINE HCL 40 MG CAPSULE|100|EA|.043|03/15/2022||Yes|No||03/15/2022||Yes|No|03/15/2022||Yes|No||||No|No|||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|8125|||||No|No||AVET PHARMACEUT|No||||
paromomycin sulfate|No|No|No|No|75%|23155003801|PAROMOMYCIN 250 MG CAPSULE|100|EA|1.7415|11/23/2009||Yes|No||11/23/2009||Yes|No|11/23/2009||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|115|No|3.969|06/01/2016|3.9123|06/01/2016|3.726|06/01/2016|||ANTIBIOTICS: GI|8126|||||No|No||AVET PHARMACEUT|No||||
leflunomide|No|No|No|No|75%|23155004303|LEFLUNOMIDE 10 MG TABLET|30|EA|.31533|10/01/2010||Yes|No||10/01/2010||Yes|No|10/01/2010||Yes|No||||No|No|||Prescription required|No|||No|.80538|03/29/2022|.78605|03/29/2022|.79128|03/29/2022||||8127|||||No|No||AVET PHARMACEUT|No||||
leflunomide|No|No|No|No|75%|23155004403|LEFLUNOMIDE 20 MG TABLET|30|EA|.31533|09/23/2010||Yes|No||09/23/2010||Yes|No|09/23/2010||Yes|No||||No|No|||Prescription required|No|||No|.61902|03/29/2022|.60416|03/29/2022|.60818|03/29/2022||||8128|||||No|No||AVET PHARMACEUT|No||||
nystatin|No|No|No|No|75%|23155005101|NYSTATIN 500,000 UNIT ORAL TAB|100|EA|.43129|08/29/2012||Yes|No||08/29/2012||Yes|No|08/29/2012||Yes|No||||No|No|||Prescription required|No||069|No|.33632|03/29/2022|.32824|03/29/2022|.33043|03/29/2022|||ANTIFUNGALS: ORAL|8129|||||No|No||AVET PHARMACEUT|No||||
naratriptan HCl|No|No|No|No|75%|23155005419|NARATRIPTAN HCL 1 MG TABLET|9|EA|1.9111|04/05/2011||Yes|No||04/05/2011||Yes|No|04/05/2011||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|021|No|2.52833|03/29/2022|2.46765|03/29/2022|2.48408|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|8130|||||No|No||AVET PHARMACEUT|No||||
naratriptan HCl|No|No|No|No|75%|23155005519|NARATRIPTAN HCL 2.5 MG TABLET|9|EA|1.9111|04/05/2011||Yes|No||04/05/2011||Yes|No|04/05/2011||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|021|No|1.83483|03/29/2022|1.79079|03/29/2022|1.80272|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|8131|||||No|No||AVET PHARMACEUT|No||||
glyburide|Yes|No|No|No|75%|23155005601|GLYBURIDE 1.25 MG TABLET|100|EA|.086|04/04/2011||Yes|No||04/04/2011||Yes|No|04/04/2011||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.0711|03/29/2022|.06939|03/29/2022|.06985|03/29/2022||||8132|||||No|No||AVET PHARMACEUT|No||||
glyburide|Yes|No|No|No|75%|23155005701|GLYBURIDE 2.5 MG TABLET|100|EA|.086|04/04/2011||Yes|No||04/04/2011||Yes|No|04/04/2011||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.07275|03/29/2022|.071|03/29/2022|.07147|03/29/2022||||8133|||||No|No||AVET PHARMACEUT|No||||
glyburide|Yes|No|No|No|75%|23155005801|GLYBURIDE 5 MG TABLET|100|EA|.1376|04/04/2011||Yes|No||04/04/2011||Yes|No|04/04/2011||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.09415|03/29/2022|.09189|03/29/2022|.0925|03/29/2022||||8134|||||No|No||AVET PHARMACEUT|No||||
glyburide|Yes|No|No|No|75%|23155005810|GLYBURIDE 5 MG TABLET|1000|EA|.129|04/04/2011||Yes|No||04/04/2011||Yes|No|04/04/2011||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.09415|03/29/2022|.09189|03/29/2022|.0925|03/29/2022||||8135|||||No|No||AVET PHARMACEUT|No||||
verapamil HCl|No|No|No|No|75%|23155005901|VERAPAMIL 40 MG TABLET|100|EA|.06656|12/03/2015||Yes|No||12/03/2015||Yes|No|12/03/2015||Yes|No||||No|No|||Prescription required|No||045|No|.13868|03/29/2022|.13535|03/29/2022|.13625|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8136|||||No|No||AVET PHARMACEUT|No||||
methimazole|No|No|No|No|75%|23155007001|METHIMAZOLE 5 MG TABLET|100|EA|.0645|12/01/2011||Yes|No||12/01/2011||Yes|No|12/01/2011||Yes|No||||No|No|||Prescription required|No|||No|.07388|03/29/2022|.0721|03/29/2022|.07258|03/29/2022||||8137|||||No|No||AVET PHARMACEUT|No||||
methimazole|No|No|No|No|75%|23155007101|METHIMAZOLE 10 MG TABLET|100|EA|.1118|01/01/2012||Yes|No||01/01/2012||Yes|No|01/01/2012||Yes|No||||No|No|||Prescription required|No|||No|.10482|03/29/2022|.1023|03/29/2022|.10298|03/29/2022||||8138|||||No|No||AVET PHARMACEUT|No||||
buspirone HCl|No|No|No|No|75%|23155009705|BUSPIRONE HCL 30 MG TABLET|500|EA|.4515|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||||No|No|||Prescription required|No||090|No|.17728|03/29/2022|.17302|03/29/2022|.17417|03/29/2022|||ANXIOLYTICS|8139|||||No|No||AVET PHARMACEUT|No||||
buspirone HCl|No|No|No|No|75%|23155009706|BUSPIRONE HCL 30 MG TABLET|60|EA|.4515|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||||No|No|||Prescription required|No||090|No|.17728|03/29/2022|.17302|03/29/2022|.17417|03/29/2022|||ANXIOLYTICS|8140|||||No|No||AVET PHARMACEUT|No||||
metformin HCl|Yes|No|No|No|75%|23155010201|METFORMIN HCL 500 MG TABLET|100|EA|.0172|09/01/2010||Yes|No||09/01/2010||Yes|No|09/01/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|8141|||||No|No||AVET PHARMACEUT|No||||
metformin HCl|Yes|No|No|No|75%|23155010205|METFORMIN HCL 500 MG TABLET|500|EA|.01376|09/01/2010||Yes|No||09/01/2010||Yes|No|09/01/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|8142|||||No|No||AVET PHARMACEUT|No||||
metformin HCl|Yes|No|No|No|75%|23155010209|METFORMIN HCL 500 MG TABLET|90|EA|.0172|09/05/2019||Yes|No||09/05/2019||Yes|No|09/05/2019||Yes|No||||No|No|09/05/2019||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|8143|||||No|No||AVET PHARMACEUT|No||||
metformin HCl|Yes|No|No|No|75%|23155010210|METFORMIN HCL 500 MG TABLET|1000|EA|.01204|09/01/2010||Yes|No||09/01/2010||Yes|No|09/01/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|8144|||||No|No||AVET PHARMACEUT|No||||
metformin HCl|Yes|No|No|No|75%|23155010301|METFORMIN HCL 850 MG TABLET|100|EA|.0258|09/01/2010||Yes|No||09/01/2010||Yes|No|09/01/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|8145|||||No|No||AVET PHARMACEUT|No||||
metformin HCl|Yes|No|No|No|75%|23155010305|METFORMIN HCL 850 MG TABLET|500|EA|.0215|09/01/2010||Yes|No||09/01/2010||Yes|No|09/01/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|8146|||||No|No||AVET PHARMACEUT|No||||
metformin HCl|Yes|No|No|No|75%|23155010309|METFORMIN HCL 850 MG TABLET|90|EA|.0258|09/05/2019||Yes|No||09/05/2019||Yes|No|09/05/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|8147|||||No|No||AVET PHARMACEUT|No||||
metformin HCl|Yes|No|No|No|75%|23155010310|METFORMIN HCL 850 MG TABLET|1000|EA|.01935|09/01/2010||Yes|No||09/01/2010||Yes|No|09/01/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|8148|||||No|No||AVET PHARMACEUT|No||||
metformin HCl|Yes|No|No|No|75%|23155010401|METFORMIN HCL 1,000 MG TABLET|100|EA|.0301|09/01/2010||Yes|No||09/01/2010||Yes|No|09/01/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|8149|||||No|No||AVET PHARMACEUT|No||||
metformin HCl|Yes|No|No|No|75%|23155010405|METFORMIN HCL 1,000 MG TABLET|500|EA|.02408|09/01/2010||Yes|No||09/01/2010||Yes|No|09/01/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|8150|||||No|No||AVET PHARMACEUT|No||||
metformin HCl|Yes|No|No|No|75%|23155010409|METFORMIN HCL 1,000 MG TABLET|90|EA|.0301|09/05/2019||Yes|No||09/05/2019||Yes|No|09/05/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|8151|||||No|No||AVET PHARMACEUT|No||||
metformin HCl|Yes|No|No|No|75%|23155010410|METFORMIN HCL 1,000 MG TABLET|1000|EA|.0215|09/01/2010||Yes|No||09/01/2010||Yes|No|09/01/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|8152|||||No|No||AVET PHARMACEUT|No||||
glipizide/metformin HCl|Yes|No|No|No|75%|23155011501|GLIPIZIDE-METFORMIN 2.5-250 MG|100|EA|.1462|08/01/2010||Yes|No||08/01/2010||Yes|No|08/01/2010||Yes|No||||No|No|07/01/2016||Prescription required|Yes|01/26/2017|012|No|.3332|11/26/2019|.32844|11/26/2019|.3128|11/26/2019|||HYPOGLYCEMICS: METFORMINS|8153|||||No|No||AVET PHARMACEUT|No||||
glipizide/metformin HCl|Yes|No|No|No|75%|23155011601|GLIPIZIDE-METFORMIN 2.5-500 MG|100|EA|.172|08/01/2010||Yes|No||08/01/2010||Yes|No|08/01/2010||Yes|No||||No|No|07/01/2016||Prescription required|Yes|01/26/2017|012|No|.33272|03/29/2022|.32473|03/29/2022|.32689|03/29/2022|||HYPOGLYCEMICS: METFORMINS|8154|||||No|No||AVET PHARMACEUT|No||||
glipizide/metformin HCl|Yes|No|No|No|75%|23155011701|GLIPIZIDE-METFORMIN 5-500 MG|100|EA|.172|08/01/2010||Yes|No||08/01/2010||Yes|No|08/01/2010||Yes|No||||No|No|07/01/2016||Prescription required|Yes|01/26/2017|012|No|.24767|03/29/2022|.24172|03/29/2022|.24333|03/29/2022|||HYPOGLYCEMICS: METFORMINS|8155|||||No|No||AVET PHARMACEUT|No||||
acetazolamide|No|No|No|No|75%|23155012001|ACETAZOLAMIDE ER 500 MG CAP|100|EA|.5375|09/01/2011||Yes|No||09/01/2011||Yes|No|09/01/2011||Yes|No||||No|No|||Prescription required|No|||No|.39876|03/29/2022|.38918|03/29/2022|.39178|03/29/2022||||8156|||||No|No||AVET PHARMACEUT|No||||
doxycycline monohydrate|No|No|No|No|75%|23155013301|DOXYCYCLINE MONO 50 MG TABLET|100|EA|.2236|02/01/2012||Yes|No||02/01/2012||Yes|No|02/01/2012||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|213|No|.26397|03/29/2022|.25763|03/29/2022|.25935|03/29/2022|||TETRACYCLINES|8157|||||No|No||AVET PHARMACEUT|No||||
doxycycline monohydrate|No|No|No|No|75%|23155013401|DOXYCYCLINE MONO 75 MG TABLET|100|EA|.44569|02/01/2012||Yes|No||02/01/2012||Yes|No|02/01/2012||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|213|No|1.01577|06/01/2016|1.00125|06/01/2016|.95358|06/01/2016|||TETRACYCLINES|8158|||||No|No||AVET PHARMACEUT|No||||
doxycycline monohydrate|Yes|No|No|No|75%|23155013505|DOXYCYCLINE MONO 100 MG TABLET|500|EA|.3612|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||||No|No|06/18/2019||Prescription required|Yes|03/09/2018|213|No|.32436|03/29/2022|.31657|03/29/2022|.31868|03/29/2022|||TETRACYCLINES|8159|||||No|No||AVET PHARMACEUT|No||||
doxycycline monohydrate|Yes|No|No|No|75%|23155013525|DOXYCYCLINE MONO 100 MG TABLET|50|EA|.3612|02/01/2012||Yes|No||02/01/2012||Yes|No|02/01/2012||Yes|No||||No|No|11/01/2012||Prescription required|Yes|01/15/2014|213|No|.32436|03/29/2022|.31657|03/29/2022|.31868|03/29/2022|||TETRACYCLINES|8160|||||No|No||AVET PHARMACEUT|No||||
doxycycline monohydrate|No|No|No|No|75%|23155013603|DOXYCYCLINE MONO 150 MG TABLET|30|EA|2.91124|02/01/2012||Yes|No||02/01/2012||Yes|No|02/01/2012||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|213|No|6.63492|03/27/2018|6.54013|03/27/2018|6.2287|03/27/2018|||TETRACYCLINES|8161|||||No|No||AVET PHARMACEUT|No||||
doxycycline hyclate|No|No|No|No|75%|23155014101|DOXYCYCLINE HYC DR 75 MG TAB|100|EA|1.0535|11/06/2013||Yes|No||11/06/2013||Yes|No|11/06/2013||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|213|No|2.401|06/08/2021|2.3667|06/08/2021|2.254|06/08/2021|||TETRACYCLINES|8162|||||No|No||AVET PHARMACEUT|No||||
doxycycline hyclate|Yes|No|No|No|75%|23155014201|DOXYCYCLINE HYC DR 100 MG TAB|100|EA|1.2599|11/06/2013||Yes|No||11/06/2013||Yes|No|11/06/2013||Yes|No||||No|No|11/06/2013||Prescription required|Yes|01/25/2012|213|No|2.8714|06/08/2021|2.83038|06/08/2021|2.6956|06/08/2021|||TETRACYCLINES|8163|||||No|No||AVET PHARMACEUT|No||||
doxycycline hyclate|No|No|No|No|75%|23155014301|DOXYCYCLINE HYC DR 150 MG TAB|100|EA|1.6942|11/06/2013||Yes|No||11/06/2013||Yes|No|11/06/2013||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|213|No|3.8612|06/08/2021|3.80604|06/08/2021|3.6248|06/08/2021|||TETRACYCLINES|8164|||||No|No||AVET PHARMACEUT|No||||
acarbose|No|No|No|No|75%|23155014701|ACARBOSE 25 MG TABLET|100|EA|.129|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|No|||No|.17861|03/29/2022|.17432|03/29/2022|.17548|03/29/2022||||8165|||||No|No||AVET PHARMACEUT|No||||
acarbose|No|No|No|No|75%|23155014801|ACARBOSE 50 MG TABLET|100|EA|.1419|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|No|||No|.19141|03/29/2022|.18681|03/29/2022|.18806|03/29/2022||||8166|||||No|No||AVET PHARMACEUT|No||||
acarbose|No|No|No|No|75%|23155014901|ACARBOSE 100 MG TABLET|100|EA|.1677|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|No|||No|.31919|03/29/2022|.31152|03/29/2022|.3136|03/29/2022||||8167|||||No|No||AVET PHARMACEUT|No||||
isosorbide mononitrate|No|No|No|No|75%|23155017801|ISOSORBIDE MONONIT ER 60 MG TB|100|EA|.172|06/01/2012||Yes|No||06/01/2012||Yes|No|06/01/2012||Yes|No||||No|No|||Prescription required|No|||No|.12753|03/29/2022|.12446|03/29/2022|.12529|03/29/2022||||8168|||||No|No||AVET PHARMACEUT|No||||
isosorbide mononitrate|No|No|No|No|75%|23155017805|ISOSORBIDE MONONIT ER 60 MG TB|500|EA|.172|01/24/2018||Yes|No||01/24/2018||Yes|No|01/24/2018||Yes|No||||No|No|||Prescription required|No|||No|.12753|03/29/2022|.12446|03/29/2022|.12529|03/29/2022||||8169|||||No|No||AVET PHARMACEUT|No||||
bupropion HCl|No|No|No|No|75%|23155019101|BUPROPION HCL 75 MG TABLET|100|EA|.1204|12/31/2020||Yes|No||12/31/2020||Yes|No|12/31/2020||Yes|No||||No|No|||Prescription required|No||031|No|.12417|03/29/2022|.12118|03/29/2022|.12199|03/29/2022|||ANTIDEPRESSANTS: OTHER|8170|||||No|No||AVET PHARMACEUT|No||||
bupropion HCl|No|No|No|No|75%|23155019201|BUPROPION HCL 100 MG TABLET|100|EA|.1591|12/31/2020||Yes|No||12/31/2020||Yes|No|12/31/2020||Yes|No||||No|No|||Prescription required|No||031|No|.14759|03/29/2022|.14404|03/29/2022|.145|03/29/2022|||ANTIDEPRESSANTS: OTHER|8171|||||No|No||AVET PHARMACEUT|No||||
nifedipine|No|No|No|No|75%|23155019401|NIFEDIPINE 10 MG CAPSULE|100|EA|.16533|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|045|No|.40848|03/29/2022|.39867|03/29/2022|.40133|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8172|||||No|No||AVET PHARMACEUT|No||||
nifedipine|No|No|No|No|75%|23155019501|NIFEDIPINE 20 MG CAPSULE|100|EA|.35647|03/19/2021||Yes|No||03/19/2021||Yes|No|03/19/2021||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|045|No|.81242|12/08/2020|.80081|12/08/2020|.76268|12/08/2020|||CALCIUM CHANNEL BLOCKERS|8173|||||No|No||AVET PHARMACEUT|No||||
acyclovir|Yes|No|No|No|75%|23155022701|ACYCLOVIR 400 MG TABLET|100|EA|.07589|02/20/2014||Yes|No||02/20/2014||Yes|No|02/20/2014||Yes|No||||No|No|02/20/2014||Prescription required|No||025|No|.0985|03/29/2022|.09613|03/29/2022|.09677|03/29/2022|||ANTIVIRALS: ORAL|8174|||||No|No||AVET PHARMACEUT|No||||
acyclovir|Yes|No|No|No|75%|23155022705|ACYCLOVIR 400 MG TABLET|500|EA|.074|02/20/2014||Yes|No||02/20/2014||Yes|No|02/20/2014||Yes|No||||No|No|02/20/2014||Prescription required|No||025|No|.0985|03/29/2022|.09613|03/29/2022|.09677|03/29/2022|||ANTIVIRALS: ORAL|8175|||||No|No||AVET PHARMACEUT|No||||
acyclovir|No|No|No|No|75%|23155022801|ACYCLOVIR 800 MG TABLET|100|EA|.13007|02/20/2014||Yes|No||02/20/2014||Yes|No|02/20/2014||Yes|No||||No|No|||Prescription required|No||025|No|.19021|03/29/2022|.18564|03/29/2022|.18688|03/29/2022|||ANTIVIRALS: ORAL|8176|||||No|No||AVET PHARMACEUT|No||||
acyclovir|No|No|No|No|75%|23155022805|ACYCLOVIR 800 MG TABLET|500|EA|.1268|02/20/2014||Yes|No||02/20/2014||Yes|No|02/20/2014||Yes|No||||No|No|||Prescription required|No||025|No|.19021|03/29/2022|.18564|03/29/2022|.18688|03/29/2022|||ANTIVIRALS: ORAL|8177|||||No|No||AVET PHARMACEUT|No||||
acyclovir|Yes|No|No|No|75%|23155022901|ACYCLOVIR 200 MG CAPSULE|100|EA|.0774|08/27/2018||Yes|No||08/27/2018||Yes|No|08/27/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||025|No|.11267|03/29/2022|.10996|03/29/2022|.11069|03/29/2022|||ANTIVIRALS: ORAL|8178|||||No|No||AVET PHARMACEUT|No||||
acyclovir|Yes|No|No|No|75%|23155022905|ACYCLOVIR 200 MG CAPSULE|500|EA|.0774|08/27/2018||Yes|No||08/27/2018||Yes|No|08/27/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||025|No|.11267|03/29/2022|.10996|03/29/2022|.11069|03/29/2022|||ANTIVIRALS: ORAL|8179|||||No|No||AVET PHARMACEUT|No||||
metoclopramide HCl|No|No|No|No|75%|23155024041|METOCLOPRAMIDE 10 MG/2 ML VIAL|2|ML|.473|03/30/2022||Yes|No||03/30/2022||Yes|No|03/30/2022||Yes|No||||No|No|||Prescription required|No|||No|1.078|05/07/2019|1.0626|05/07/2019|1.012|05/07/2019||||8180|||||No|No||AVET PHARMACEUT|No||||
acetazolamide|No|No|No|No|75%|23155028701|ACETAZOLAMIDE 125 MG TABLET|100|EA|.1118|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No|||No|.16397|03/29/2022|.16003|03/29/2022|.1611|03/29/2022||||8181|||||No|No||AVET PHARMACEUT|No||||
acetazolamide|No|No|No|No|75%|23155028801|ACETAZOLAMIDE 250 MG TABLET|100|EA|.1505|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No|||No|.25723|03/29/2022|.25105|03/29/2022|.25272|03/29/2022||||8182|||||No|No||AVET PHARMACEUT|No||||
amikacin sulfate|No|No|No|No|75%|23155029041|AMIKACIN SULF 500 MG/2 ML VIAL|2|ML|2.63482|06/10/2014||Yes|No||06/10/2014||Yes|No|06/10/2014||Yes|No||||No|No|||Prescription required|No|||No|6.00495|01/29/2019|5.91916|01/29/2019|5.6373|01/29/2019||||8183|||||No|No||AVET PHARMACEUT|No||||
amikacin sulfate|No|No|No|No|75%|23155029042|AMIKACIN SULF 1 GRAM/4 ML VIAL|4|ML|2.63482|06/10/2014||Yes|No||06/10/2014||Yes|No|06/10/2014||Yes|No||||No|No|||Prescription required|No|||No|6.00495|12/04/2018|5.91916|12/04/2018|5.6373|12/04/2018||||8184|||||No|No||AVET PHARMACEUT|No||||
amantadine HCl|No|No|No|No|75%|23155036201|AMANTADINE 100 MG CAPSULE|100|EA|.34649|10/28/2021||Yes|No||10/28/2021||Yes|No|10/28/2021||Yes|No||||No|No|||Prescription required|No||015|No|.2857|03/29/2022|.27884|03/29/2022|.2807|03/29/2022|||ANTIPARKINSON'S AGENTS|8185|||||No|No||AVET PHARMACEUT|No||||
amantadine HCl|No|No|No|No|75%|23155036205|AMANTADINE 100 MG CAPSULE|500|EA|.34656|10/04/2021||Yes|No||10/04/2021||Yes|No|10/04/2021||Yes|No||||No|No|||Prescription required|No||015|No|.2857|03/29/2022|.27884|03/29/2022|.2807|03/29/2022|||ANTIPARKINSON'S AGENTS|8186|||||No|No||AVET PHARMACEUT|No||||
furosemide|No|No|No|No|75%|23155047341|FUROSEMIDE 20 MG/2 ML VIAL|2|ML|.473|12/31/2020||Yes|No||12/31/2020||Yes|No|||No|No||||No|No|||Prescription required|No|||No|1.078|12/31/2020|1.0626|12/31/2020|1.012|12/31/2020||||8187|||||No|No||AVET PHARMACEUT|No||||
furosemide|No|No|No|No|75%|23155047342|FUROSEMIDE 40 MG/4 ML VIAL|4|ML|.31175|12/31/2020||Yes|No||12/31/2020||Yes|No|||No|No||||No|No|||Prescription required|No|||No|.7105|12/31/2020|.70035|01/05/2021|.667|12/31/2020||||8188|||||No|No||AVET PHARMACEUT|No||||
furosemide|No|No|No|No|75%|23155047344|FUROSEMIDE 100 MG/10 ML VIAL|10|ML|.13975|12/31/2020||Yes|No||12/31/2020||Yes|No|||No|No||||No|No|||Prescription required|No|||No|.3185|12/31/2020|.31395|12/31/2020|.299|12/31/2020||||8189|||||No|No||AVET PHARMACEUT|No||||
verapamil HCl|Yes|No|No|No|75%|23155048601|VERAPAMIL 120 MG TABLET|100|EA|.03762|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||045|No|.07071|03/29/2022|.06901|03/29/2022|.06947|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8190|||||No|No||AVET PHARMACEUT|No||||
desmopressin acetate|No|No|No|No|75%|23155048901|DESMOPRESSIN ACETATE 0.1 MG TB|100|EA|.45098|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|No|||Yes|.41734|03/29/2022|.40732|03/29/2022|.41003|03/29/2022||||8191|||||No|No||AVET PHARMACEUT|No||||
desmopressin acetate|No|No|No|No|75%|23155049001|DESMOPRESSIN ACETATE 0.2 MG TB|100|EA|.50632|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|No|||Yes|.446|03/29/2022|.43529|03/29/2022|.43819|03/29/2022||||8192|||||No|No||AVET PHARMACEUT|No||||
hydroxyzine HCl|No|No|No|No|75%|23155050001|HYDROXYZINE HCL 10 MG TABLET|100|EA|.01965|12/14/2015||Yes|No||12/14/2015||Yes|No|12/14/2015||Yes|No||||No|No|||Prescription required|No||574|Yes|.03952|03/29/2022|.03857|03/29/2022|.03882|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|8193|||||No|No||AVET PHARMACEUT|No||||
hydroxyzine HCl|No|No|No|No|75%|23155050005|HYDROXYZINE HCL 10 MG TABLET|500|EA|.01917|12/14/2015||Yes|No||12/14/2015||Yes|No|12/14/2015||Yes|No||||No|No|||Prescription required|No||574|Yes|.03952|03/29/2022|.03857|03/29/2022|.03882|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|8194|||||No|No||AVET PHARMACEUT|No||||
hydroxyzine HCl|No|No|No|No|75%|23155050010|HYDROXYZINE HCL 10 MG TABLET|1000|EA|.01866|12/14/2015||Yes|No||12/14/2015||Yes|No|12/14/2015||Yes|No||||No|No|||Prescription required|No||574|Yes|.03952|03/29/2022|.03857|03/29/2022|.03882|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|8195|||||No|No||AVET PHARMACEUT|No||||
hydroxyzine HCl|No|No|No|No|75%|23155050101|HYDROXYZINE HCL 25 MG TABLET|100|EA|.02429|12/14/2015||Yes|No||12/14/2015||Yes|No|12/14/2015||Yes|No||||No|No|||Prescription required|No||574|Yes|.06757|03/29/2022|.06594|03/29/2022|.06638|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|8196|||||No|No||AVET PHARMACEUT|No||||
hydroxyzine HCl|No|No|No|No|75%|23155050105|HYDROXYZINE HCL 25 MG TABLET|500|EA|.02365|12/14/2015||Yes|No||12/14/2015||Yes|No|12/14/2015||Yes|No||||No|No|||Prescription required|No||574|Yes|.06757|03/29/2022|.06594|03/29/2022|.06638|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|8197|||||No|No||AVET PHARMACEUT|No||||
hydroxyzine HCl|No|No|No|No|75%|23155050110|HYDROXYZINE HCL 25 MG TABLET|1000|EA|.02309|12/14/2015||Yes|No||12/14/2015||Yes|No|12/14/2015||Yes|No||||No|No|||Prescription required|No||574|Yes|.06757|03/29/2022|.06594|03/29/2022|.06638|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|8198|||||No|No||AVET PHARMACEUT|No||||
hydroxyzine HCl|No|No|No|No|75%|23155050201|HYDROXYZINE HCL 50 MG TABLET|100|EA|.03513|12/14/2015||Yes|No||12/14/2015||Yes|No|12/14/2015||Yes|No||||No|No|||Prescription required|No||574|Yes|.09594|03/29/2022|.09363|03/29/2022|.09426|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|8199|||||No|No||AVET PHARMACEUT|No||||
hydroxyzine HCl|No|No|No|No|75%|23155050205|HYDROXYZINE HCL 50 MG TABLET|500|EA|.03422|12/14/2015||Yes|No||12/14/2015||Yes|No|12/14/2015||Yes|No||||No|No|||Prescription required|No||574|Yes|.09594|03/29/2022|.09363|03/29/2022|.09426|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|8200|||||No|No||AVET PHARMACEUT|No||||
nimodipine|No|No|No|No|75%|23155051200|NIMODIPINE 30 MG CAPSULE|100|EA|.516|05/30/2018||Yes|No||05/30/2018||Yes|No|05/30/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|045|No|1.176|06/08/2021|1.1592|06/08/2021|1.104|06/08/2021|||CALCIUM CHANNEL BLOCKERS|8201|||||No|No||AVET PHARMACEUT|No||||
nimodipine|No|No|No|No|75%|23155051230|NIMODIPINE 30 MG CAPSULE|30|EA|.516|05/30/2018||Yes|No||05/30/2018||Yes|No|05/30/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|045|No|1.176|06/08/2021|1.1592|06/08/2021|1.104|06/08/2021|||CALCIUM CHANNEL BLOCKERS|8202|||||No|No||AVET PHARMACEUT|No||||
isosorbide mononitrate|No|No|No|No|75%|23155051901|ISOSORBIDE MONONIT ER 30 MG TB|100|EA|.09017|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No|||No|.09715|03/29/2022|.09481|03/29/2022|.09544|03/29/2022||||8203|||||No|No||AVET PHARMACEUT|No||||
isosorbide mononitrate|No|No|No|No|75%|23155051905|ISOSORBIDE MONONIT ER 30 MG TB|500|EA|.08568|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No|||No|.09715|03/29/2022|.09481|03/29/2022|.09544|03/29/2022||||8204|||||No|No||AVET PHARMACEUT|No||||
trospium chloride|No|No|No|No|75%|23155053005|TROSPIUM CHLORIDE 20 MG TABLET|500|EA|.18636|07/20/2017||Yes|No||07/20/2017||Yes|No|07/20/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|006|No|.42162|03/29/2022|.4115|03/29/2022|.41424|03/29/2022|||BLADDER RELAXANT PREPARATIONS|8205|||||No|No||AVET PHARMACEUT|No||||
trospium chloride|No|No|No|No|75%|23155053006|TROSPIUM CHLORIDE 20 MG TABLET|60|EA|.18633|02/23/2017||Yes|No||02/23/2017||Yes|No|02/23/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|006|No|.42162|03/29/2022|.4115|03/29/2022|.41424|03/29/2022|||BLADDER RELAXANT PREPARATIONS|8206|||||No|No||AVET PHARMACEUT|No||||
calcium acetate|No|No|No|No|75%|23155053102|CALCIUM ACETATE 667 MG CAPSULE|200|EA|.1075|02/25/2016||Yes|No||02/25/2016||Yes|No|02/25/2016||Yes|No||||No|No|||Prescription required|No||052|Yes|.28113|03/29/2022|.27438|03/29/2022|.27621|03/29/2022|||PHOSPHATE BINDERS|8207|||||No|No||AVET PHARMACEUT|No||||
ethosuximide|No|No|No|No|75%|23155053201|ETHOSUXIMIDE 250 MG CAPSULE|100|EA|.516|06/29/2016||Yes|No||06/29/2016||Yes|No|06/29/2016||Yes|No||||No|No|||Prescription required|No||056|No|.61011|03/29/2022|.59546|03/29/2022|.59943|03/29/2022|||ANTICONVULSANTS|8208|||||No|No||AVET PHARMACEUT|No||||
doxercalciferol|No|No|No|No|75%|23155053825|DOXERCALCIFEROL 0.5 MCG CAP|50|EA|2.58|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|No|||No|5.88|05/17/2021|5.796|05/25/2021|5.52|05/17/2021||||8209|||||No|No||AVET PHARMACEUT|No||||
doxercalciferol|No|No|No|No|75%|23155053925|DOXERCALCIFEROL 1 MCG CAPSULE|50|EA|5.16|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|No|||No|11.76|05/17/2021|11.592|05/25/2021|11.04|05/17/2021||||8210|||||No|No||AVET PHARMACEUT|No||||
doxercalciferol|No|No|No|No|75%|23155054025|DOXERCALCIFEROL 2.5 MCG CAP|50|EA|5.977|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|No|||No|13.622|05/18/2021|13.4274|05/18/2021|12.788|05/18/2021||||8211|||||No|No||AVET PHARMACEUT|No||||
ondansetron HCl|No|No|No|No|75%|23155054931|ONDANSETRON 40 MG/20 ML VIAL|20|ML|.1075|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|No|||No|.245|02/16/2022|.2415|02/16/2022|.23|02/16/2022||||8212|||||No|No||AVET PHARMACEUT|No||||
desipramine HCl|No|No|No|No|75%|23155057801|DESIPRAMINE 10 MG TABLET|100|EA|.37883|09/26/2017||Yes|No||09/26/2017||Yes|No|09/26/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.3086|03/29/2022|.30119|03/29/2022|.30319|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|8213|||||No|No||AVET PHARMACEUT|No||||
desipramine HCl|No|No|No|No|75%|23155057901|DESIPRAMINE 25 MG TABLET|100|EA|.45511|09/26/2017||Yes|No||09/26/2017||Yes|No|09/26/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.4119|03/01/2022|.40201|03/01/2022|.40469|03/01/2022|||ANTIDEPRESSANTS: TRICYCLIC|8214|||||No|No||AVET PHARMACEUT|No||||
desipramine HCl|No|No|No|No|75%|23155058001|DESIPRAMINE 50 MG TABLET|100|EA|.85668|09/26/2017||Yes|No||09/26/2017||Yes|No|09/26/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.3099|01/25/2022|.30246|01/25/2022|.30447|01/25/2022|||ANTIDEPRESSANTS: TRICYCLIC|8215|||||No|No||AVET PHARMACEUT|No||||
desipramine HCl|No|No|No|No|75%|23155058101|DESIPRAMINE 75 MG TABLET|100|EA|1.0298|09/26/2017||Yes|No||09/26/2017||Yes|No|09/26/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|2.347|09/26/2017|2.31347|09/26/2017|2.2033|09/26/2017|||ANTIDEPRESSANTS: TRICYCLIC|8216|||||No|No||AVET PHARMACEUT|No||||
desipramine HCl|No|No|No|No|75%|23155058201|DESIPRAMINE 100 MG TABLET|100|EA|1.43293|09/26/2017||Yes|No||09/26/2017||Yes|No|09/26/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|3.26575|10/29/2019|3.21909|10/29/2019|3.0658|10/29/2019|||ANTIDEPRESSANTS: TRICYCLIC|8217|||||No|No||AVET PHARMACEUT|No||||
desipramine HCl|No|No|No|No|75%|23155058325|DESIPRAMINE 150 MG TABLET|50|EA|2.07621|09/26/2017||Yes|No||09/26/2017||Yes|No|09/26/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|4.73183|03/24/2020|4.66423|03/24/2020|4.44212|03/24/2020|||ANTIDEPRESSANTS: TRICYCLIC|8218|||||No|No||AVET PHARMACEUT|No||||
clindamycin palmitate HCl|No|No|No|No|75%|23155060351|CLINDAMYCIN (PEDI) 75 MG/5 ML|100|ML|.17802|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|No||146|No|.19356|03/29/2022|.18891|03/29/2022|.19017|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|8219|||||No|No||AVET PHARMACEUT|No||||
modafinil|No|No|No|No|90%|23155060403|MODAFINIL 100 MG TABLET|30|EA|.559|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.4088|03/29/2022|.39898|03/29/2022|.40164|03/29/2022|||STIMULANTS AND RELATED AGENTS|8220|||||No|No||AVET PHARMACEUT|No||||
modafinil|No|No|No|No|90%|23155060409|MODAFINIL 100 MG TABLET|90|EA|.54466|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.4088|03/29/2022|.39898|03/29/2022|.40164|03/29/2022|||STIMULANTS AND RELATED AGENTS|8221|||||No|No||AVET PHARMACEUT|No||||
modafinil|No|No|No|No|90%|23155060503|MODAFINIL 200 MG TABLET|30|EA|.71666|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55328|03/29/2022|.54|03/29/2022|.54359|03/29/2022|||STIMULANTS AND RELATED AGENTS|8222|||||No|No||AVET PHARMACEUT|No||||
modafinil|No|No|No|No|90%|23155060509|MODAFINIL 200 MG TABLET|90|EA|.559|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55328|03/29/2022|.54|03/29/2022|.54359|03/29/2022|||STIMULANTS AND RELATED AGENTS|8223|||||No|No||AVET PHARMACEUT|No||||
glycopyrrolate|No|No|No|No|75%|23155060601|GLYCOPYRROLATE 1 MG TABLET|100|EA|.05129|11/10/2017||Yes|No||11/10/2017||Yes|No|11/10/2017||Yes|No||||No|No|||Prescription required|No|||No|.10136|03/29/2022|.09892|03/29/2022|.09958|03/29/2022||||8224|||||No|No||AVET PHARMACEUT|No||||
glycopyrrolate|No|No|No|No|75%|23155060701|GLYCOPYRROLATE 2 MG TABLET|100|EA|.09206|11/10/2017||Yes|No||11/10/2017||Yes|No|11/10/2017||Yes|No||||No|No|||Prescription required|No|||No|.22028|03/29/2022|.21499|03/29/2022|.21642|03/29/2022||||8225|||||No|No||AVET PHARMACEUT|No||||
calcium acetate|No|No|No|No|75%|23155062102|CALCIUM ACETATE 667 MG TABLET|200|EA|.1809|01/15/2018||Yes|No||01/15/2018||Yes|No|01/15/2018||Yes|No||||No|No|||Prescription required|No||052|Yes|.41228|02/26/2019|.40639|02/26/2019|.38704|02/26/2019|||PHOSPHATE BINDERS|8226|||||No|No||AVET PHARMACEUT|No||||
isosorbide mononitrate|No|No|No|No|75%|23155062801|ISOSORBIDE MONONIT ER 120 MG|100|EA|.26122|09/04/2019||Yes|No||09/04/2019||Yes|No|09/04/2019||Yes|No||||No|No|||Prescription required|No|||No|.25435|03/29/2022|.24824|03/29/2022|.24989|03/29/2022||||8227|||||No|No||AVET PHARMACEUT|No||||
metronidazole|No|No|No|No|75%|23155065101|METRONIDAZOLE 250 MG TABLET|100|EA|.12255|12/31/2020||Yes|No||12/31/2020||Yes|No|12/31/2020||Yes|No||||No|No|||Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|8228|||||No|No||AVET PHARMACEUT|No||||
metronidazole|No|No|No|No|75%|23155065105|METRONIDAZOLE 250 MG TABLET|500|EA|.11642|12/31/2020||Yes|No||12/31/2020||Yes|No|12/31/2020||Yes|No||||No|No|||Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|8229|||||No|No||AVET PHARMACEUT|No||||
metronidazole|No|No|No|No|75%|23155065201|METRONIDAZOLE 500 MG TABLET|100|EA|.21908|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|No||115|No|.15479|03/29/2022|.15107|03/29/2022|.15208|03/29/2022|||ANTIBIOTICS: GI|8230|||||No|No||AVET PHARMACEUT|No||||
metronidazole|No|No|No|No|75%|23155065205|METRONIDAZOLE 500 MG TABLET|500|EA|.20813|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|No||115|No|.15479|03/29/2022|.15107|03/29/2022|.15208|03/29/2022|||ANTIBIOTICS: GI|8231|||||No|No||AVET PHARMACEUT|No||||
calcitriol|No|No|No|No|75%|23155066201|CALCITRIOL 0.25 MCG CAPSULE|100|EA|.11653|10/12/2018||Yes|No||10/12/2018||Yes|No|10/12/2018||Yes|No||||No|No|||Prescription required|No|||No|.18695|03/29/2022|.18246|03/29/2022|.18367|03/29/2022||||8232|||||No|No||AVET PHARMACEUT|No||||
calcitriol|No|No|No|No|75%|23155066203|CALCITRIOL 0.25 MCG CAPSULE|30|EA|.11653|10/12/2018||Yes|No||10/12/2018||Yes|No|10/12/2018||Yes|No||||No|No|||Prescription required|No|||No|.18695|03/29/2022|.18246|03/29/2022|.18367|03/29/2022||||8233|||||No|No||AVET PHARMACEUT|No||||
calcitriol|No|No|No|No|75%|23155066301|CALCITRIOL 0.5 MCG CAPSULE|100|EA|.18249|10/12/2018||Yes|No||10/12/2018||Yes|No|10/12/2018||Yes|No||||No|No|||Prescription required|No|||No|.32158|03/29/2022|.31386|03/29/2022|.31595|03/29/2022||||8234|||||No|No||AVET PHARMACEUT|No||||
allopurinol|No|No|No|No|75%|23155069301|ALLOPURINOL 100 MG TABLET|100|EA|.0473|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|8235|||||No|No||AVET PHARMACEUT|No||||
allopurinol|No|No|No|No|75%|23155069310|ALLOPURINOL 100 MG TABLET|1000|EA|.04271|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|8236|||||No|No||AVET PHARMACEUT|No||||
allopurinol|No|No|No|No|75%|23155069401|ALLOPURINOL 300 MG TABLET|100|EA|.0903|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|8237|||||No|No||AVET PHARMACEUT|No||||
allopurinol|No|No|No|No|75%|23155069405|ALLOPURINOL 300 MG TABLET|500|EA|.08578|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|8238|||||No|No||AVET PHARMACEUT|No||||
cyproheptadine HCl|No|No|No|No|75%|23155070301|CYPROHEPTADINE 4 MG TABLET|100|EA|.1118|06/09/2021||Yes|No||06/09/2021||Yes|No|06/09/2021||Yes|No||||No|No|||Prescription required|No||574|Yes|.09783|03/29/2022|.09548|03/29/2022|.09611|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|8239|||||No|No||AVET PHARMACEUT|No||||
enalapril maleate|No|No|No|No|75%|23155070401|ENALAPRIL MALEATE 2.5 MG TAB|100|EA|.07189|03/19/2021||Yes|No||03/19/2021||Yes|No|03/19/2021||Yes|No||||No|No|||Prescription required|No||113|No|.11585|03/29/2022|.11306|03/29/2022|.11382|03/29/2022|||ANGIOTENSIN MODULATORS|8240|||||No|No||AVET PHARMACEUT|No||||
enalapril maleate|No|No|No|No|75%|23155070410|ENALAPRIL MALEATE 2.5 MG TAB|1000|EA|.0683|03/19/2021||Yes|No||03/19/2021||Yes|No|03/19/2021||Yes|No||||No|No|||Prescription required|No||113|No|.11585|03/29/2022|.11306|03/29/2022|.11382|03/29/2022|||ANGIOTENSIN MODULATORS|8241|||||No|No||AVET PHARMACEUT|No||||
enalapril maleate|No|No|No|No|75%|23155070501|ENALAPRIL MALEATE 5 MG TABLET|100|EA|.09133|03/19/2021||Yes|No||03/19/2021||Yes|No|03/19/2021||Yes|No||||No|No|||Prescription required|No||113|No|.15947|03/29/2022|.15564|03/29/2022|.15667|03/29/2022|||ANGIOTENSIN MODULATORS|8242|||||No|No||AVET PHARMACEUT|No||||
enalapril maleate|No|No|No|No|75%|23155070510|ENALAPRIL MALEATE 5 MG TABLET|1000|EA|.08676|03/19/2021||Yes|No||03/19/2021||Yes|No|03/19/2021||Yes|No||||No|No|||Prescription required|No||113|No|.15947|03/29/2022|.15564|03/29/2022|.15667|03/29/2022|||ANGIOTENSIN MODULATORS|8243|||||No|No||AVET PHARMACEUT|No||||
labetalol HCl|No|No|No|No|75%|23155072301|LABETALOL HCL 100 MG TABLET|100|EA|.12353|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||070|No|.12868|03/29/2022|.12559|03/29/2022|.12642|03/29/2022|||BETA-BLOCKERS|8244|||||No|No||AVET PHARMACEUT|No||||
labetalol HCl|No|No|No|No|75%|23155072305|LABETALOL HCL 100 MG TABLET|500|EA|.1172|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||070|No|.12868|03/29/2022|.12559|03/29/2022|.12642|03/29/2022|||BETA-BLOCKERS|8245|||||No|No||AVET PHARMACEUT|No||||
labetalol HCl|No|No|No|No|75%|23155072401|LABETALOL HCL 200 MG TABLET|100|EA|.17526|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||070|No|.17218|03/29/2022|.16804|03/29/2022|.16916|03/29/2022|||BETA-BLOCKERS|8246|||||No|No||AVET PHARMACEUT|No||||
labetalol HCl|No|No|No|No|75%|23155072405|LABETALOL HCL 200 MG TABLET|500|EA|.16653|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||070|No|.17218|03/29/2022|.16804|03/29/2022|.16916|03/29/2022|||BETA-BLOCKERS|8247|||||No|No||AVET PHARMACEUT|No||||
labetalol HCl|No|No|No|No|75%|23155072501|LABETALOL HCL 300 MG TABLET|100|EA|.23314|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||070|No|.21583|03/29/2022|.21065|03/29/2022|.21205|03/29/2022|||BETA-BLOCKERS|8248|||||No|No||AVET PHARMACEUT|No||||
nadolol|No|No|No|No|75%|23155073001|NADOLOL 20 MG TABLET|100|EA|.0688|03/19/2021||Yes|No||03/19/2021||Yes|No|03/19/2021||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|070|No|.34023|03/29/2022|.33206|03/29/2022|.33427|03/29/2022|||BETA-BLOCKERS|8249|||||No|No||AVET PHARMACEUT|No||||
nadolol|No|No|No|No|75%|23155073101|NADOLOL 40 MG TABLET|100|EA|.0946|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|070|No|.40202|03/29/2022|.39237|03/29/2022|.39498|03/29/2022|||BETA-BLOCKERS|8250|||||No|No||AVET PHARMACEUT|No||||
nadolol|No|No|No|No|75%|23155073201|NADOLOL 80 MG TABLET|100|EA|.1978|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|070|No|.57501|03/29/2022|.5612|03/29/2022|.56494|03/29/2022|||BETA-BLOCKERS|8251|||||No|No||AVET PHARMACEUT|No||||
terazosin HCl|No|No|No|No|75%|23155073501|TERAZOSIN 1 MG CAPSULE|100|EA|.0774|10/28/2021||Yes|No||10/28/2021||Yes|No|10/28/2021||Yes|No||||No|No|||Prescription required|No||003|Yes|.15217|03/29/2022|.14851|03/29/2022|.1495|03/29/2022|||BPH TREATMENTS|8252|||||No|No||AVET PHARMACEUT|No||||
terazosin HCl|No|No|No|No|75%|23155073510|TERAZOSIN 1 MG CAPSULE|1000|EA|.0774|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|No||003|Yes|.15217|03/29/2022|.14851|03/29/2022|.1495|03/29/2022|||BPH TREATMENTS|8253|||||No|No||AVET PHARMACEUT|No||||
terazosin HCl|No|No|No|No|75%|23155073601|TERAZOSIN 2 MG CAPSULE|100|EA|.0774|10/28/2021||Yes|No||10/28/2021||Yes|No|10/28/2021||Yes|No||||No|No|||Prescription required|No||003|No|.15336|03/29/2022|.14967|03/29/2022|.15067|03/29/2022|||BPH TREATMENTS|8254|||||No|No||AVET PHARMACEUT|No||||
terazosin HCl|No|No|No|No|75%|23155073610|TERAZOSIN 2 MG CAPSULE|1000|EA|.0774|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|No||003|No|.15336|03/29/2022|.14967|03/29/2022|.15067|03/29/2022|||BPH TREATMENTS|8255|||||No|No||AVET PHARMACEUT|No||||
terazosin HCl|No|No|No|No|75%|23155073701|TERAZOSIN 5 MG CAPSULE|100|EA|.0774|10/28/2021||Yes|No||10/28/2021||Yes|No|10/28/2021||Yes|No||||No|No|||Prescription required|No||003|Yes|.15866|03/29/2022|.15485|03/29/2022|.15588|03/29/2022|||BPH TREATMENTS|8256|||||No|No||AVET PHARMACEUT|No||||
terazosin HCl|No|No|No|No|75%|23155073710|TERAZOSIN 5 MG CAPSULE|1000|EA|.0774|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|No||003|Yes|.15866|03/29/2022|.15485|03/29/2022|.15588|03/29/2022|||BPH TREATMENTS|8257|||||No|No||AVET PHARMACEUT|No||||
terazosin HCl|No|No|No|No|75%|23155073801|TERAZOSIN 10 MG CAPSULE|100|EA|.0774|10/28/2021||Yes|No||10/28/2021||Yes|No|10/28/2021||Yes|No||||No|No|||Prescription required|No||003|No|.16419|03/29/2022|.16024|03/29/2022|.16131|03/29/2022|||BPH TREATMENTS|8258|||||No|No||AVET PHARMACEUT|No||||
terazosin HCl|No|No|No|No|75%|23155073810|TERAZOSIN 10 MG CAPSULE|1000|EA|.0774|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|No||003|No|.16419|03/29/2022|.16024|03/29/2022|.16131|03/29/2022|||BPH TREATMENTS|8259|||||No|No||AVET PHARMACEUT|No||||
rasagiline mesylate|No|No|No|No|75%|23155074603|RASAGILINE MESYLATE 0.5 MG TAB|30|EA|1.23266|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|4.5286|03/29/2022|4.41991|03/29/2022|4.44934|03/29/2022|||ANTIPARKINSON'S AGENTS|8260|||||No|No||AVET PHARMACEUT|No||||
rasagiline mesylate|No|No|No|No|75%|23155074703|RASAGILINE MESYLATE 1 MG TAB|30|EA|1.23266|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|1.78642|03/29/2022|1.74354|03/29/2022|1.75515|03/29/2022|||ANTIPARKINSON'S AGENTS|8261|||||No|No||AVET PHARMACEUT|No||||
tetracycline HCl|No|No|No|No|75%|23155076601|TETRACYCLINE 250 MG CAPSULE|100|EA|.817|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|213|No|.9651|03/01/2022|.94193|03/01/2022|.94821|03/01/2022|||TETRACYCLINES|8262|||||No|No||AVET PHARMACEUT|No||||
tetracycline HCl|No|No|No|No|75%|23155076701|TETRACYCLINE 500 MG CAPSULE|100|EA|1.41255|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|213|No|1.54692|03/29/2022|1.50979|03/29/2022|1.51984|03/29/2022|||TETRACYCLINES|8263|||||No|No||AVET PHARMACEUT|No||||
enalapril maleate|No|No|No|No|75%|23155077201|ENALAPRIL MALEATE 10 MG TAB|100|EA|.09593|03/19/2021||Yes|No||03/19/2021||Yes|No|03/19/2021||Yes|No||||No|No|||Prescription required|No||113|No|.11378|03/29/2022|.11104|03/29/2022|.11178|03/29/2022|||ANGIOTENSIN MODULATORS|8264|||||No|No||AVET PHARMACEUT|No||||
enalapril maleate|No|No|No|No|75%|23155077210|ENALAPRIL MALEATE 10 MG TAB|1000|EA|.09113|03/19/2021||Yes|No||03/19/2021||Yes|No|03/19/2021||Yes|No||||No|No|||Prescription required|No||113|No|.11378|03/29/2022|.11104|03/29/2022|.11178|03/29/2022|||ANGIOTENSIN MODULATORS|8265|||||No|No||AVET PHARMACEUT|No||||
enalapril maleate|No|No|No|No|75%|23155077301|ENALAPRIL MALEATE 20 MG TAB|100|EA|.13648|03/19/2021||Yes|No||03/19/2021||Yes|No|03/19/2021||Yes|No||||No|No|||Prescription required|No||113|No|.14625|03/29/2022|.14274|03/29/2022|.14369|03/29/2022|||ANGIOTENSIN MODULATORS|8266|||||No|No||AVET PHARMACEUT|No||||
enalapril maleate|No|No|No|No|75%|23155077310|ENALAPRIL MALEATE 20 MG TAB|1000|EA|.12965|03/19/2021||Yes|No||03/19/2021||Yes|No|03/19/2021||Yes|No||||No|No|||Prescription required|No||113|No|.14625|03/29/2022|.14274|03/29/2022|.14369|03/29/2022|||ANGIOTENSIN MODULATORS|8267|||||No|No||AVET PHARMACEUT|No||||
amikacin sulfate|No|No|No|No|75%|23155078541|AMIKACIN SULF 500 MG/2 ML VIAL|2|ML|1.18572|08/23/2021||Yes|No||08/23/2021||Yes|No|08/23/2021||Yes|No||||No|No|||Prescription required|No|||No|2.70235|08/31/2021|2.66374|08/23/2021|2.5369|08/23/2021||||8268|||||No|No||AVET/NOVAPLUS|No||||
amikacin sulfate|No|No|No|No|75%|23155078641|AMIKACIN SULF 1 GRAM/4 ML VIAL|4|ML|1.18572|08/23/2021||Yes|No||08/23/2021||Yes|No|08/23/2021||Yes|No||||No|No|||Prescription required|No|||No|2.70235|08/31/2021|2.66374|08/23/2021|2.5369|08/23/2021||||8269|||||No|No||AVET/NOVAPLUS|No||||
acetazolamide|No|No|No|No|75%|23155078701|ACETAZOLAMIDE ER 500 MG CAP|100|EA|.29558|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|No|||No|.39876|03/29/2022|.38918|03/29/2022|.39178|03/29/2022||||8270|||||No|No||AVET PHARMACEUT|No||||
pyrilamine/chlophedianol|No|No|No|No|75%|23359003216|NINJACOF LIQUID|473|ML|.03408|04/14/2015||Yes|No||||No|No|04/14/2015||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.07767|11/24/2020|.07656|11/24/2020|.07291|11/24/2020|||COUGH AND COLD: NON-NARCOTIC|8271|||||No|No||CENTURION LABS|No||||
codeine phosphate/guaifenesin|No|No|No|No|90%|23359004016|NINJACOF-XG LIQUID|473|ML|.02908|03/06/2015||Yes|No||||No|No|03/06/2015||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|183|Yes|.06627|06/01/2016|.06533|06/01/2016|.06221|06/01/2016|||COUGH AND COLD: NARCOTIC|8272|||||No|No||CENTURION LABS|No||||
iron fum/folic acid/mv,min 15|No|No|No|No|75%|23359010010|CENTRATEX CAPSULE|100|EA||07/01/2011||Yes|No||07/01/2011||Yes|No|07/01/2011||Yes|No||||No|No|||Over the counter|No||506|No|||||||||IRON: ORAL|8273|||||No|No||CENTURION LABS|No||||
iron fum/folic acid/mv,min 15|No|No|No|No|75%|23359010030|CENTRATEX CAPSULE|30|EA||07/01/2011||Yes|No||07/01/2011||Yes|No|07/01/2011||Yes|No||||No|No|||Over the counter|No||506|No|||||||||IRON: ORAL|8274|||||No|No||CENTURION LABS|No||||
pedi multivit 33/fluoride/iron|No|No|No|No|75%|23594010030|POLY-VI-FLOR WITH IRON 0.5 MG|30|EA|4.74648|03/07/2017||Yes|No||05/17/2017||Yes|No|03/07/2017||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|10.81756|01/04/2022|10.66302|01/04/2022|10.15526|01/04/2022|||PEDIATRIC VITAMIN PREPARATIONS|8275|||||No|No||ZYLERA|No||||
carbinoxamine maleate|No|No|No|No|75%|23594010105|KARBINAL ER 4 MG/5 ML SUSP|480|ML|.48498|06/21/2018||Yes|No||06/21/2018||Yes|No|06/21/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|574|Yes|1.08986|02/15/2022|1.0637|02/15/2022|1.07078|02/15/2022|||ANTIHISTAMINES: FIRST GENERATION|8276|||||No|No||ZYLERA/CERECOR|No||||
pedi multivit no.33/fluoride|No|No|No|No|75%|23594020030|POLY-VI-FLOR 0.25 MG TAB CHEW|30|EA|4.74648|02/28/2017||Yes|No||05/17/2017||Yes|No|02/28/2017||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|10.81756|01/04/2022|10.66302|01/04/2022|10.15526|01/04/2022|||PEDIATRIC VITAMIN PREPARATIONS|8277|||||No|No||ZYLERA|No||||
rabeprazole sodium|No|No|No|No|75%|23594020501|ACIPHEX SPRINKLE DR 5 MG CAP|30|EA|8.10535|09/06/2018|01/31/2022|Yes|No||09/06/2018|01/31/2022|Yes|No|09/06/2018|01/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|18.47266|01/01/2019|18.20877|01/01/2019|17.34168|01/01/2019|||PROTON PUMP INHIBITORS|8278|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ZYLERA/CERECOR|No||||
rabeprazole sodium|No|No|No|No|75%|23594021001|ACIPHEX SPRINKLE DR 10 MG CAP|30|EA|8.64629|09/06/2018|01/31/2022|Yes|No||09/06/2018|01/31/2022|Yes|No|09/06/2018|01/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|19.7055|01/01/2019|19.42399|01/01/2019|18.49904|01/01/2019|||PROTON PUMP INHIBITORS|8279|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ZYLERA/CERECOR|No||||
cefaclor|No|No|No|No|75%|23594025001|CEFACLOR 250 MG/5 ML SUSP|150|ML|1.654|06/21/2018||Yes|No||06/21/2018||Yes|No|06/21/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|046|No|3.76959|01/01/2019|3.71574|01/01/2019|3.5388|01/01/2019|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|8280|||||No|No||ZYLERA/CERECOR|No||||
pedi multivit no.33/fluoride|No|No|No|No|75%|23594030030|POLY-VI-FLOR 0.5 MG TAB CHEW|30|EA|4.74648|02/28/2017||Yes|No||05/17/2017||Yes|No|02/28/2017||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|10.81756|01/04/2022|10.66302|01/04/2022|10.15526|01/04/2022|||PEDIATRIC VITAMIN PREPARATIONS|8281|||||No|No||ZYLERA|No||||
pedi multivit no.33/fluoride|No|No|No|No|75%|23594040030|POLY-VI-FLOR 1 MG TAB CHEW|30|EA|4.74648|02/28/2017||Yes|No||05/17/2017||Yes|No|02/28/2017||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|10.81756|01/04/2022|10.66302|01/04/2022|10.15526|01/04/2022|||PEDIATRIC VITAMIN PREPARATIONS|8282|||||No|No||ZYLERA|No||||
pedi multivit no.37 w-fluoride|No|No|No|No|75%|23594050050|POLY-VI-FLOR 0.25 MG DROPS|50|ML|2.84789|02/28/2017||Yes|No||05/17/2017||Yes|No|02/28/2017||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|6.49054|01/04/2022|6.39781|01/04/2022|6.09316|01/04/2022|||PEDIATRIC VITAMIN PREPARATIONS|8283|||||No|No||ZYLERA|No||||
prednisolone|No|No|No|No|75%|23594050501|MILLIPRED 5 MG TABLET|100|EA|6.04399|12/07/2015||Yes|No||12/07/2015||Yes|No|12/07/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|168|Yes|13.77468|07/17/2018|13.5779|07/17/2018|12.93133|07/17/2018|||GLUCOCORTICOIDS: ORAL|8284|||||No|No||ZYLERA|No||||
pedi multivit 37/fluoride/iron|No|No|No|No|75%|23594060050|POLY-VI-FLOR WITH IRON 0.25 MG|50|ML|2.84789|02/28/2017||Yes|No||05/17/2017||Yes|No|02/28/2017||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|6.49054|01/04/2022|6.39781|01/04/2022|6.09316|01/04/2022|||PEDIATRIC VITAMIN PREPARATIONS|8285|||||No|No||ZYLERA|No||||
ped mvit A,C,D3 no.38/fluoride|No|No|No|No|75%|23594070050|TRI-VI-FLOR 0.25 MG DROPS|50|ML|2.84789|02/28/2017||Yes|No||05/17/2017||Yes|No|02/28/2017||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|6.49054|01/04/2022|6.39781|01/04/2022|6.09316|01/04/2022|||PEDIATRIC VITAMIN PREPARATIONS|8286|||||No|No||ZYLERA|No||||
ped mvit A,C,D3 no.38/fluoride|No|No|No|No|75%|23594080050|TRI-VI-FLOR 0.5 MG DROPS|50|ML|1.95968|02/28/2017||Yes|No||05/17/2017||Yes|No|02/28/2017||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|4.46625|06/16/2020|4.40244|06/16/2020|4.1928|06/16/2020|||PEDIATRIC VITAMIN PREPARATIONS|8287|||||No|No||ZYLERA|No||||
oxycodone HCl|No|No|No|No|90%|23635058110|ROXICODONE 15 MG TABLET|100|EA|2.23363|07/25/2013||Yes|No||07/25/2013||Yes|No|||No|No||||No|No|||Prescription required|Yes|01/23/2013|109|Yes|5.09061|03/07/2017|5.01788|03/07/2017|4.77894|03/07/2017|||ANALGESICS: NARCOTICS SHORT|8288|||||No|No||MALLINCKRODT BR|No||||
oxycodone HCl|No|No|No|No|90%|23635058210|ROXICODONE 30 MG TABLET|100|EA|4.38247|10/14/2013||Yes|No||10/14/2013||Yes|No|||No|No||||No|No|||Prescription required|Yes|07/26/2012|109|Yes|9.98796|03/23/2021|9.84527|03/23/2021|9.37645|03/23/2021|||ANALGESICS: NARCOTICS SHORT|8289|||||No|No||MALLINCKRODT BR|No||||
dihydroergotamine mesylate|No|No|No|No|75%|24201046308|DIHYDROERGOTAMINE 4 MG/ML SPRY|1|ML|184.1948|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|537|No|162.55946|03/29/2022|158.65803|03/29/2022|159.71466|03/29/2022|||ANTIMIGRAINE AGENTS: OTHER|8290|||||No|No||LEUCADIA PHARMA|No||||
timolol maleate|No|No|No|No|75%|24208000403|ISTALOL 0.5% EYE DROPS|5|ML|33.31898|10/11/2013||Yes|No||10/11/2013||Yes|No|10/11/2013||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|088|No|75.93628|01/25/2022|74.85147|01/25/2022|71.28712|01/25/2022|||OPHTHALMICS: GLAUCOMA AGENTS|8291|||||No|No||BAUSCH HEALTH U|No||||
sodium chloride|No|No|No|No|75%|24208027615|MURO-128 2% EYE DROPS|15|ML|.43516|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No|||No|.99176|12/29/2020|.97759|12/29/2020|.93104|12/29/2020||||8292|||||No|No||BAUSCH HEALTH U|No||||
sodium chloride|No|No|No|No|75%|24208027715|MURO-128 5% EYE DROPS|15|ML|.45809|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No|||No|1.04402|10/27/2020|1.0291|10/27/2020|.9801|10/27/2020||||8293|||||No|No||BAUSCH HEALTH U|No||||
tobramycin/dexamethasone|No|No|No|No|75%|24208029505|TOBRAMYCIN-DEXAMETH OPHTH SUSP|5|ML|8.7204|01/12/2009||Yes|No||01/12/2009||Yes|No|01/12/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|036|No|14.32103|03/29/2022|13.97732|03/29/2022|14.07041|03/29/2022|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|8294|||||No|No||BAUSCH HEALTH U|No||||
tobramycin/dexamethasone|No|No|No|No|75%|24208029510|TOBRAMYCIN-DEXAMETH OPHTH SUSP|10|ML|8.72083|01/12/2009||Yes|No||01/12/2009||Yes|No|01/12/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|036|No|12.73383|03/01/2022|12.42821|03/01/2022|12.51098|03/01/2022|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|8295|||||No|No||BAUSCH HEALTH U|No||||
tobramycin/dexamethasone|No|No|No|No|75%|24208029525|TOBRAMYCIN-DEXAMETH OPHTH SUSP|2.5|ML|8.69804|01/12/2009||Yes|No||01/12/2009||Yes|No|01/12/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|036|No|14.38|03/29/2022|14.03488|03/29/2022|14.12835|03/29/2022|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|8296|||||No|No||BAUSCH HEALTH U|No||||
loteprednol etabonate|No|No|No|No|75%|24208029905|LOTEMAX 0.5% EYE DROPS|5|ML|24.34918|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||013|No|54.25131|01/18/2022|52.94927|01/18/2022|53.30191|01/18/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|8297|||||No|No||BAUSCH HEALTH U|No||||
loteprednol etabonate|No|No|No|No|75%|24208029910|LOTEMAX 0.5% EYE DROPS|10|ML|24.3466|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||013|No|54.24864|01/18/2022|52.94667|01/18/2022|53.29928|01/18/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|8298|||||No|No||BAUSCH HEALTH U|No||||
loteprednol etabonate|No|No|No|No|75%|24208029915|LOTEMAX 0.5% EYE DROPS|15|ML|24.13131|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||013|No|54.99694|01/11/2022|54.21127|01/11/2022|51.62978|01/11/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|8299|||||No|No||BAUSCH HEALTH U|No||||
polymyxin B sulf/trimethoprim|No|No|No|No|75%|24208031510|POLYMYXIN B-TMP EYE DROPS|10|ML|.46225|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||058|No|.46086|03/29/2022|.44979|03/29/2022|.45279|03/29/2022|||OPHTHALMIC ANTIBIOTICS|8300|||||No|No||BAUSCH HEALTH U|No||||
sulfacetamide/prednisolone sp|No|No|No|No|75%|24208031705|SULF-PRED 10-0.23% EYE DROPS|5|ML|1.29|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||036|No|2.67733|03/29/2022|2.61307|03/29/2022|2.63047|03/29/2022|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|8301|||||No|No||BAUSCH HEALTH U|No||||
desmopressin acetate|No|No|No|No|75%|24208034205|DESMOPRESSIN 0.01% SOLUTION|5|ML|16.94286|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|38.61396|04/28/2020|38.06233|04/28/2020|36.24984|04/28/2020||||8302|||||No|No||BAUSCH HEALTH U|No||||
flunisolide|No|No|No|No|75%|24208034425|FLUNISOLIDE 0.025% SPRAY|25|ML|1.03114|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|019|No|1.99882|03/29/2022|1.95084|03/29/2022|1.96384|03/29/2022|||INTRANASAL RHINITIS AGENTS|8303|||||No|No||BAUSCH HEALTH U|No||||
loteprednol etabonate|No|No|No|No|75%|24208035305|ALREX 0.2% EYE DROPS|5|ML|22.88976|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|002|No|51.11063|01/18/2022|49.88397|01/18/2022|50.21619|01/18/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|8304|||||No|No||BAUSCH HEALTH U|No||||
loteprednol etabonate|No|No|No|No|75%|24208035310|ALREX 0.2% EYE DROPS|10|ML|22.8889|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|002|No|50.80758|01/18/2022|49.58819|01/18/2022|49.91844|01/18/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|8305|||||No|No||BAUSCH HEALTH U|No||||
tobramycin/lotepred etab|No|No|No|No|75%|24208035805|ZYLET EYE DROPS|5|ML|25.3399|02/21/2005||Yes|No||02/21/2005||Yes|No|02/21/2005||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|036|No|56.36985|01/18/2022|55.01697|01/18/2022|55.38337|01/18/2022|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|8306|||||No|No||BAUSCH HEALTH U|No||||
tobramycin/lotepred etab|No|No|No|No|75%|24208035810|ZYLET EYE DROPS|10|ML|25.34033|02/21/2005||Yes|No||02/21/2005||Yes|No|02/21/2005||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|036|No|57.75238|01/11/2022|56.92734|01/11/2022|54.21652|01/11/2022|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|8307|||||No|No||BAUSCH HEALTH U|No||||
ipratropium bromide|No|No|No|No|75%|24208039830|IPRATROPIUM 0.03% SPRAY|30|ML|.52316|04/03/2003||Yes|No||04/03/2003||Yes|No|04/03/2003||Yes|No||||No|No|||Prescription required|Yes|07/12/2005|019|No|.75257|03/29/2022|.7345|03/29/2022|.7394|03/29/2022|||INTRANASAL RHINITIS AGENTS|8308|||||No|No||BAUSCH HEALTH U|Yes|09/01/2020|||
ipratropium bromide|No|No|No|No|75%|24208039915|IPRATROPIUM 0.06% SPRAY|15|ML|1.04633|04/03/2003||Yes|No||04/03/2003||Yes|No|04/03/2003||Yes|No||||No|No|||Prescription required|Yes|07/12/2005|019|No|1.39746|03/29/2022|1.36392|03/29/2022|1.373|03/29/2022|||INTRANASAL RHINITIS AGENTS|8309|||||No|No||BAUSCH HEALTH U|Yes|09/01/2020|||
ofloxacin|No|No|No|No|75%|24208041005|OFLOXACIN 0.3% EAR DROPS|5|ML|11.05702|03/20/2008||Yes|No||03/20/2008||Yes|No|03/20/2008||Yes|No||||No|No|||Prescription required|No||051|No|2.13104|03/29/2022|2.07989|03/29/2022|2.09374|03/29/2022|||OTIC ANTIBIOTICS|8310|||||No|No||BAUSCH HEALTH U|No||||
ofloxacin|No|No|No|No|75%|24208041010|OFLOXACIN 0.3% EAR DROPS|10|ML|11.05659|03/20/2008||Yes|No||03/20/2008||Yes|No|03/20/2008||Yes|No||||No|No|||Prescription required|No||051|No|2.28641|03/29/2022|2.23153|03/29/2022|2.24639|03/29/2022|||OTIC ANTIBIOTICS|8311|||||No|No||BAUSCH HEALTH U|No||||
brimonidine tartrate|No|No|No|No|75%|24208041105|BRIMONIDINE 0.2% EYE DROP|5|ML|1.247|05/29/2003||Yes|No||05/29/2003||Yes|No|05/29/2003||Yes|No||||No|No|||Prescription required|No||088|No|.85973|03/29/2022|.83909|03/29/2022|.84468|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|8312|||||No|No||BAUSCH HEALTH U|No||||
brimonidine tartrate|No|No|No|No|75%|24208041110|BRIMONIDINE 0.2% EYE DROP|10|ML|1.17175|05/29/2003||Yes|No||05/29/2003||Yes|No|05/29/2003||Yes|No||||No|No|||Prescription required|No||088|No|.62326|03/29/2022|.6083|03/29/2022|.61235|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|8313|||||No|No||BAUSCH HEALTH U|No||||
brimonidine tartrate|No|No|No|No|75%|24208041115|BRIMONIDINE 0.2% EYE DROP|15|ML|1.25416|05/29/2003||Yes|No||05/29/2003||Yes|No|05/29/2003||Yes|No||||No|No|||Prescription required|No||088|No|.58721|03/29/2022|.57311|03/29/2022|.57693|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|8314|||||No|No||BAUSCH HEALTH U|No||||
ofloxacin|No|No|No|No|75%|24208043405|OFLOXACIN 0.3% EYE DROPS|5|ML|1.75784|06/08/2004||Yes|No||06/08/2004||Yes|No|06/08/2004||Yes|No||||No|No|||Prescription required|No||058|No|1.80843|03/29/2022|1.76502|03/29/2022|1.77678|03/29/2022|||OPHTHALMIC ANTIBIOTICS|8315|||||No|No||BAUSCH HEALTH U|No||||
ofloxacin|No|No|No|No|75%|24208043410|OFLOXACIN 0.3% EYE DROPS|10|ML|1.67012|06/08/2004||Yes|No||06/08/2004||Yes|No|06/08/2004||Yes|No||||No|No|||Prescription required|No||058|No|1.8791|03/29/2022|1.834|03/29/2022|1.84621|03/29/2022|||OPHTHALMIC ANTIBIOTICS|8316|||||No|No||BAUSCH HEALTH U|No||||
loteprednol etabonate|No|No|No|No|75%|24208044335|LOTEMAX 0.5% EYE OINTMENT|3.5|GM|39.27005|08/22/2011||Yes|No||08/22/2011||Yes|No|08/22/2011||Yes|No||||No|No|||Prescription required|No||013|No|87.49181|01/18/2022|85.392|01/18/2022|85.9607|01/18/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|8317|||||No|No||BAUSCH HEALTH U|No||||
besifloxacin HCl|No|No|No|No|75%|24208044605|BESIVANCE 0.6% SUSP|5|ML|17.34706|06/05/2009||Yes|No||06/05/2009||Yes|No|06/05/2009||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|058|No|38.74638|01/18/2022|37.81646|01/18/2022|38.06831|01/18/2022|||OPHTHALMIC ANTIBIOTICS|8318|||||No|No||BAUSCH HEALTH U|No||||
latanoprost|No|No|No|No|75%|24208046325|LATANOPROST 0.005% EYE DROPS|2.5|ML|3.096|03/28/2011||Yes|No||03/28/2011||Yes|No|03/28/2011||Yes|No||||No|No|||Prescription required|No||088|No|1.89557|03/29/2022|1.85007|03/29/2022|1.86239|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|8319|||||No|No||BAUSCH HEALTH U|No||||
dorzolamide HCl|No|No|No|No|75%|24208048510|DORZOLAMIDE HCL 2% EYE DROPS|10|ML|1.46157|06/02/2010||Yes|No||06/02/2010||Yes|No|06/02/2010||Yes|No||||No|No|||Prescription required|No||088|No|1.39302|03/29/2022|1.35958|03/29/2022|1.36864|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|8320|||||No|No||BAUSCH HEALTH U|No||||
dorzolamide HCl/timolol maleat|No|No|No|No|75%|24208048610|DORZOLAMIDE-TIMOLOL EYE DROPS|10|ML|2.14957|06/02/2010||Yes|No||06/02/2010||Yes|No|06/02/2010||Yes|No||||No|No|||Prescription required|No||088|No|1.24117|03/29/2022|1.21138|03/29/2022|1.21944|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|8321|||||No|No||BAUSCH HEALTH U|No||||
timolol maleate/PF|No|No|No|No|75%|24208049605|TIMOLOL MALEATE 0.5% EYE DROP|60|EA|3.45282|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|088|No|3.85464|03/01/2022|3.76212|03/01/2022|3.78718|03/01/2022|||OPHTHALMICS: GLAUCOMA AGENTS|8322|||||No|No||BAUSCH HEALTH U|No||||
loteprednol etabonate|No|No|No|No|75%|24208050307|LOTEMAX 0.5% OPHTHALMIC GEL|5|GM|19.53576|03/20/2013||Yes|No||03/20/2013||Yes|No|03/20/2013||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|013|No|43.54133|01/18/2022|42.49633|01/18/2022|42.77935|01/18/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|8323|||||No|No||BAUSCH HEALTH U|No||||
latanoprostene bunod|No|No|No|No|75%|24208050402|VYZULTA 0.024% OPHTH SOLUTION|2.5|ML|39.087|12/07/2018||Yes|No||12/07/2018||Yes|No|12/07/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|088|No|87.46325|01/18/2022|85.36413|01/18/2022|85.93264|01/18/2022|||OPHTHALMICS: GLAUCOMA AGENTS|8324|||||No|No||BAUSCH HEALTH U|No||||
latanoprostene bunod|No|No|No|No|75%|24208050405|VYZULTA 0.024% OPHTH SOLUTION|5|ML|39.08614|03/06/2019||Yes|No||03/06/2019||Yes|No|03/06/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|088|No|87.19902|01/18/2022|85.10624|01/18/2022|85.67303|01/18/2022|||OPHTHALMICS: GLAUCOMA AGENTS|8325|||||No|No||BAUSCH HEALTH U|No||||
levobunolol HCl|No|No|No|No|75%|24208050505|LEVOBUNOLOL 0.5% EYE DROPS|5|ML|1.54026|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||088|No|2.131|03/29/2022|2.07985|03/29/2022|2.0937|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|8326|||||No|No||BAUSCH HEALTH U|No||||
loteprednol etabonate|No|No|No|No|75%|24208050707|LOTEMAX SM 0.38% OPHTH GEL|5|GM|19.53576|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|013|No|43.63015|01/18/2022|42.58302|01/18/2022|42.86662|01/18/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|8327|||||No|No||BAUSCH HEALTH U|No||||
loteprednol etabonate|No|No|No|No|75%|24208050801|LOTEPREDNOL 0.5% OPHTHALMC GEL|5|GM|16.56876|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|013|No|29.0694|03/29/2022|28.37173|03/29/2022|28.56068|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|8328|||||No|No||BAUSCH HEALTH U|No||||
ganciclovir|No|No|No|No|75%|24208053535|ZIRGAN 0.15% OPHTHALMIC GEL|5|GM|35.97896|01/28/2011||Yes|No||01/28/2011||Yes|No|01/28/2011||Yes|No||||No|No|||Prescription required|No|||No|80.12279|01/18/2022|78.19984|01/18/2022|78.72064|01/18/2022||||8329|||||No|No||BAUSCH HEALTH U|No||||
bacitracin/polymyxin B sulfate|No|No|No|No|75%|24208055555|BACITRACIN-POLYMYXIN EYE OINT|3.5|GM|2.81588|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||058|No|3.21333|03/29/2022|3.13621|03/29/2022|3.15709|03/29/2022|||OPHTHALMIC ANTIBIOTICS|8330|||||No|No||BAUSCH HEALTH U|No||||
gentamicin sulfate|No|No|No|No|75%|24208058060|GENTAMICIN 0.3% EYE DROP|5|ML|3.07106|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||058|No|.63882|03/29/2022|.62348|03/29/2022|.62764|03/29/2022|||OPHTHALMIC ANTIBIOTICS|8331|||||No|No||BAUSCH HEALTH U|No||||
bepotastine besilate|No|No|No|No|75%|24208062901|BEPREVE 1.5% EYE DROPS|10|ML|21.06226|10/11/2013||Yes|No||10/11/2013||Yes|No|10/11/2013||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|002|No|47.16595|01/18/2022|46.03396|01/18/2022|46.34054|01/18/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|8332|||||No|No||BAUSCH HEALTH U|No||||
bepotastine besilate|No|No|No|No|75%|24208062902|BEPREVE 1.5% EYE DROPS|5|ML|22.02546|10/11/2013||Yes|No||10/11/2013||Yes|No|10/11/2013||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|002|No|49.03411|01/18/2022|47.85729|01/18/2022|48.17601|01/18/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|8333|||||No|No||BAUSCH HEALTH U|No||||
bepotastine besilate|No|No|No|No|75%|24208063005|BEPOTASTINE 1.5% EYE DROP|5|ML|18.68006|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|002|No|27.33943|03/29/2022|26.68328|03/29/2022|26.86098|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|8334|||||No|No||BAUSCH HEALTH U|No||||
bepotastine besilate|No|No|No|No|75%|24208063010|BEPOTASTINE 1.5% EYE DROP|10|ML|17.86349|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|002|No|32.0966|03/01/2022|31.32628|03/01/2022|31.5349|03/01/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|8335|||||No|No||BAUSCH HEALTH U|No||||
neomycin/polymyxin B/hydrocort|No|No|No|No|75%|24208063110|NEOMYCIN-POLYMYXIN-HC EAR SOLN|10|ML|3.6077|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||051|No|5.83849|03/29/2022|5.69836|03/29/2022|5.73631|03/29/2022|||OTIC ANTIBIOTICS|8336|||||No|No||BAUSCH HEALTH U|No||||
neomycin/polymyxin B/hydrocort|No|No|No|No|75%|24208063562|NEOMYCIN-POLYMYXIN-HC EAR SUSP|10|ML|3.6077|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||051|No|5.91929|03/29/2022|5.77722|03/29/2022|5.8157|03/29/2022|||OTIC ANTIBIOTICS|8337|||||No|No||BAUSCH HEALTH U|No||||
sulfacetamide sodium|No|No|No|No|75%|24208067004|SULFACETAMIDE 10% EYE DROPS|15|ML|1.3975|09/09/2002||Yes|No||09/09/2002||Yes|No|09/09/2002||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|058|No|2.29667|03/29/2022|2.24154|03/29/2022|2.25647|03/29/2022|||OPHTHALMIC ANTIBIOTICS|8338|||||No|No||BAUSCH HEALTH U|No||||
prednisolone sodium phosphate|No|No|No|No|75%|24208071510|PREDNISOLONE SOD 1% EYE DROP|10|ML|2.26653|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|013|No|4.7922|06/29/2021|4.67718|06/29/2021|4.70833|06/29/2021|||OPHTHALMICS: ANTI-INFLAMMATORIES|8339|||||No|No||BAUSCH HEALTH U|No||||
dexamethasone sodium phosphate|No|No|No|No|75%|24208072002|DEXAMETHASONE 0.1% EYE DROP|5|ML|4.6354|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|02/01/2018|013|No|8.79886|03/29/2022|8.58768|03/29/2022|8.64487|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|8340|||||No|No||BAUSCH HEALTH U|No||||
neomycin/bacitracin/polymyxinB|No|No|No|No|75%|24208078055|NEOMYC-BACIT-POLYMIX EYE OINT|3.5|GM|5.5986|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|058|No|6.36143|03/29/2022|6.20875|03/29/2022|6.2501|03/29/2022|||OPHTHALMIC ANTIBIOTICS|8341|||||No|No||BAUSCH HEALTH U|No||||
neomycin/polymyxn B/gramicidin|No|No|No|No|75%|24208079062|NEOMYC-POLYM-GRAMICID EYE DROP|10|ML|2.19515|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|058|No|5.0029|10/26/2021|4.93143|10/26/2021|4.6966|10/26/2021|||OPHTHALMIC ANTIBIOTICS|8342|||||No|No||BAUSCH HEALTH U|No||||
neomycin/polymyxin B/dexametha|No|No|No|No|75%|24208079535|NEOMYC-POLYM-DEXAMET EYE OINTM|3.5|GM|1.9522|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||036|No|3.06312|03/29/2022|2.9896|03/29/2022|3.00951|03/29/2022|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|8343|||||No|No||BAUSCH HEALTH U|No||||
timolol maleate|No|No|No|No|75%|24208081205|TIMOPTIC 0.25% EYE DROP|5|ML|16.8173|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|088|No|38.3278|01/12/2021|37.78026|01/12/2021|35.9812|01/12/2021|||OPHTHALMICS: GLAUCOMA AGENTS|8344|||||No|No||BAUSCH HEALTH U|No||||
timolol maleate|No|No|No|No|75%|24208081305|TIMOPTIC 0.5% EYE DROP|5|ML|18.19932|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|088|No|41.47752|01/12/2021|40.88498|01/12/2021|38.93808|01/12/2021|||OPHTHALMICS: GLAUCOMA AGENTS|8345|||||No|No||BAUSCH HEALTH U|No||||
timolol maleate|No|No|No|No|75%|24208081310|TIMOPTIC 0.5% EYE DROP|10|ML|11.65902|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|088|No|26.57172|01/12/2021|26.19212|01/12/2021|24.94488|01/12/2021|||OPHTHALMICS: GLAUCOMA AGENTS|8346|||||No|No||BAUSCH HEALTH U|No||||
timolol maleate|No|No|No|No|75%|24208081425|TIMOPTIC-XE 0.25% EYE GEL-SOLN|5|ML|20.85586|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|088|No|47.53196|01/11/2022|46.85293|01/11/2022|44.62184|01/11/2022|||OPHTHALMICS: GLAUCOMA AGENTS|8347|||||No|No||BAUSCH HEALTH U|No||||
timolol maleate|No|No|No|No|75%|24208081605|TIMOPTIC-XE 0.5% GEL-SOLUTION|5|ML|22.8545|01/28/2019||Yes|No||01/28/2019||Yes|No|01/28/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|088|No|52.087|01/11/2022|51.3429|01/11/2022|48.898|01/11/2022|||OPHTHALMICS: GLAUCOMA AGENTS|8348|||||No|No||BAUSCH HEALTH U|No||||
atropine sulfate|No|No|No|No|75%|24208082555|ATROPINE 1% EYE OINTMENT|3.5|GM|2.15122|09/07/2015||Yes|No||09/07/2015||Yes|No|03/24/2001||Yes|No||||No|No|||Prescription required|No|||No|4.90279|09/24/2019|4.83275|09/24/2019|4.60262|09/24/2019||||8349|||||No|No||BAUSCH HEALTH U|No||||
neomycin/polymyxin B/dexametha|No|No|No|No|75%|24208083060|NEOMYC-POLYM-DEXAMETH EYE DROP|5|ML|1.36654|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||036|No|2.47125|03/29/2022|2.41194|03/29/2022|2.428|03/29/2022|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|8350|||||No|No||BAUSCH HEALTH U|No||||
erythromycin base|No|No|No|No|75%|24208091055|ERYTHROMYCIN 0.5% EYE OINTMENT|3.5|GM|1.86742|08/03/2010||Yes|No||08/03/2010||Yes|No|08/03/2010||Yes|No||||No|No|||Prescription required|No||058|No|2.75102|03/29/2022|2.68499|03/29/2022|2.70287|03/29/2022|||OPHTHALMIC ANTIBIOTICS|8351|||||No|No||BAUSCH HEALTH U|No||||
isosorbide dinit/hydralazine|No|No|No|No|75%|24338001009|BIDIL 20 MG-37.5 MG TABLET|90|EA|1.69792|10/30/2020||Yes|No||10/30/2020||Yes|No|10/30/2020||Yes|No||||No|No|||Prescription required|No|||No|3.81154|01/04/2022|3.72006|01/04/2022|3.74483|01/04/2022||||8352|||||No|No||ARBOR PHARMACEU|No||||
isosorbide dinit/hydralazine|No|No|No|No|75%|24338001018|BIDIL 20 MG-37.5 MG TABLET|180|EA|1.64847|01/03/2013||Yes|No||01/03/2013||Yes|No|01/03/2013||Yes|No||||No|No|||Prescription required|No|||No|3.81154|01/04/2022|3.72006|01/04/2022|3.74483|01/04/2022||||8353|||||No|No||ARBOR PHARMACEU|No||||
amphetamine sulfate|No|No|No|No|90%|24338002210|EVEKEO 5 MG TABLET|100|EA|2.95655|10/26/2016||Yes|No||10/26/2016||Yes|No|10/26/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|6.73818|01/05/2021|6.64192|01/05/2021|6.32564|01/05/2021|||STIMULANTS AND RELATED AGENTS|8354|||||No|No||ARBOR PHARMACEU|No||||
amphetamine sulfate|No|No|No|No|90%|24338002610|EVEKEO 10 MG TABLET|100|EA|2.95655|10/26/2016||Yes|No||10/26/2016||Yes|No|10/26/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|6.73818|01/25/2022|6.64192|01/25/2022|6.32564|01/25/2022|||STIMULANTS AND RELATED AGENTS|8355|||||No|No||ARBOR PHARMACEU|No||||
amphetamine sulfate|No|No|No|No|90%|24338003101|EVEKEO ODT 5 MG|30|EA|2.95668|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|6.73848|02/09/2022|6.64221|02/09/2022|6.32592|02/09/2022|||STIMULANTS AND RELATED AGENTS|8356|||||No|No||ARBOR PHARMACEU|No||||
amphetamine sulfate|No|No|No|No|90%|24338003301|EVEKEO ODT 10 MG|30|EA|2.95668|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|6.73848|01/25/2022|6.64221|01/25/2022|6.32592|01/25/2022|||STIMULANTS AND RELATED AGENTS|8357|||||No|No||ARBOR PHARMACEU|No||||
amphetamine sulfate|No|No|No|No|90%|24338003501|EVEKEO ODT 15 MG|30|EA|2.95668|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|6.73848|02/09/2022|6.64221|02/09/2022|6.32592|02/09/2022|||STIMULANTS AND RELATED AGENTS|8358|||||No|No||ARBOR PHARMACEU|No||||
amphetamine sulfate|No|No|No|No|90%|24338003702|EVEKEO ODT 20 MG|30|EA|2.95668|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|6.73848|02/09/2022|6.64221|02/09/2022|6.32592|02/09/2022|||STIMULANTS AND RELATED AGENTS|8359|||||No|No||ARBOR PHARMACEU|No||||
ciprofloxacin HCl/fluocinolone|No|No|No|No|75%|24338008014|OTOVEL 0.3%-0.025% EAR DROPS|14|EA|7.64939|05/08/2017||Yes|No||05/08/2017||Yes|No|05/08/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|051|No|17.43349|03/01/2022|17.18444|03/01/2022|16.36613|03/01/2022|||OTIC ANTIBIOTICS|8360|||||No|No||ARBOR/WRASER|No||||
erythromycin ethylsuccinate|No|No|No|No|75%|24338010013|E.E.S. 400 FILMTAB|100|EA|5.2346|05/13/2011||Yes|No||05/13/2011||Yes|No|||No|No||||No|No|||Prescription required|Yes|01/15/2014|018|No|11.93003|11/14/2017|11.7596|11/14/2017|11.19962|11/14/2017|||MACROLIDES/KETOLIDES|8361|||||No|No||ARBOR PHARMACEU|No||||
erythromycin base|No|No|No|No|75%|24338010213|ERYTHROMYCIN 250 MG FILMTAB|100|EA|4.98984|09/16/2011||Yes|No||09/16/2011||Yes|No|09/16/2011||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|018|No|7.84358|03/29/2022|7.65533|03/29/2022|7.70631|03/29/2022|||MACROLIDES/KETOLIDES|8362|||||No|No||ARBOR PHARMACEU|No||||
erythromycin base|No|No|No|No|75%|24338010413|ERYTHROMYCIN 500 MG FILMTAB|100|EA|7.52199|09/15/2011||Yes|No||09/15/2011||Yes|No|09/15/2011||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|018|No|13.22133|05/25/2021|12.90401|05/25/2021|12.98995|05/25/2021|||MACROLIDES/KETOLIDES|8363|||||No|No||ARBOR PHARMACEU|No||||
erythromycin ethylsuccinate|No|No|No|No|75%|24338011003|ERYTHROMYCIN ES 400 MG TAB|30|EA|5.23467|12/13/2021||Yes|No||12/13/2021||Yes|No|12/13/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|018|No|11.93018|12/13/2021|11.75975|12/13/2021|11.19976|12/13/2021|||MACROLIDES/KETOLIDES|8364|||||No|No||ARBOR PHARMACEU|No||||
erythromycin ethylsuccinate|No|No|No|No|75%|24338011013|ERYTHROMYCIN ES 400 MG TAB|100|EA|5.2346|11/15/2011||Yes|No||11/15/2011||Yes|No|11/15/2011||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|018|No|11.93003|11/14/2017|11.7596|11/14/2017|11.19962|11/14/2017|||MACROLIDES/KETOLIDES|8365|||||No|No||ARBOR PHARMACEU|No||||
erythromycin base|No|No|No|No|75%|24338012213|ERY-TAB DR 250 MG TABLET|100|EA|3.16406|02/07/2012|03/05/2022|Yes|No||02/07/2012|03/05/2022|Yes|No|02/07/2012|03/05/2022|Yes|No||||No|No|||Prescription required|Yes|03/09/2018|018|No|4.27352|03/01/2022|4.17095|03/01/2022|4.19873|03/01/2022|||MACROLIDES/KETOLIDES|8366|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ARBOR PHARMACEU|No||||
erythromycin base|No|No|No|No|75%|24338012413|ERY-TAB DR 333 MG TABLET|100|EA|3.9839|05/13/2011|03/05/2022|Yes|No||05/13/2011|03/05/2022|Yes|No|05/13/2011|03/05/2022|Yes|No||||No|No|||Prescription required|Yes|03/09/2018|018|No|9.0796|01/29/2019|8.94989|01/29/2019|8.5237|01/29/2019|||MACROLIDES/KETOLIDES|8367|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ARBOR PHARMACEU|No||||
erythromycin base|No|No|No|No|75%|24338012613|ERY-TAB DR 500 MG TABLET|100|EA|4.90513|05/13/2011|03/05/2022|Yes|No||05/13/2011|03/05/2022|Yes|No|05/13/2011|03/05/2022|Yes|No||||No|No|||Prescription required|Yes|03/09/2018|018|No|11.17915|03/26/2019|11.01945|03/26/2019|10.49471|03/26/2019|||MACROLIDES/KETOLIDES|8368|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ARBOR PHARMACEU|No||||
erythromycin ethylsuccinate|No|No|No|No|75%|24338013013|ERYPED 400 MG/5 ML SUSPENSION|100|ML|7.40909|07/12/2012||Yes|No||07/12/2012||Yes|No|07/12/2012||Yes|No||||No|No|||Prescription required|No||018|No|6.48387|03/23/2021|6.39124|03/23/2021|6.0869|03/23/2021|||MACROLIDES/KETOLIDES|8369|||||No|No||ARBOR PHARMACEU|No||||
erythromycin ethylsuccinate|No|No|No|No|75%|24338013213|ERYPED 200 MG/5 ML SUSPENSION|100|ML|1.95932|10/14/2011||Yes|No||10/14/2011||Yes|No|10/14/2011||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|018|No|3.68705|10/27/2020|3.63438|10/27/2020|3.46131|10/27/2020|||MACROLIDES/KETOLIDES|8370|||||No|No||ARBOR PHARMACEU|No||||
erythromycin ethylsuccinate|No|No|No|No|75%|24338013402|E.E.S. 200 MG/5 ML SUSPENSION|100|ML|1.61774|05/13/2011||Yes|No||05/13/2011||Yes|No|05/13/2011||Yes|No||||No|No|||Prescription required|No||018|No|3.68695|10/27/2020|3.63428|10/27/2020|3.46122|10/27/2020|||MACROLIDES/KETOLIDES|8371|||||No|No||ARBOR PHARMACEU|No||||
erythromycin ethylsuccinate|No|No|No|No|75%|24338013610|E.E.S. 200 MG/5 ML SUSPENSION|200|ML|1.4225|07/12/2012||Yes|No||07/12/2012||Yes|No|07/12/2012||Yes|No||||No|No|||Prescription required|No||018|No|3.24198|01/24/2017|3.19567|01/24/2017|3.04349|01/24/2017|||MACROLIDES/KETOLIDES|8372|||||No|No||ARBOR PHARMACEU|No||||
ivermectin|No|No|No|No|75%|24338018304|SKLICE 0.5% LOTION|117|GM|.99965|08/12/2016|02/22/2022|Yes|No||08/12/2016|02/22/2022|Yes|No|08/12/2016|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|01/30/2020|122|No|2.27828|04/07/2020|2.24573|04/07/2020|2.13879|04/07/2020|||ANTIPARASITICS: TOPICAL|8373|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ARBOR PHARMACEU|No||||
sotalol HCl|No|No|No|No|75%|24338053025|SOTYLIZE 5 MG/ML ORAL SOLUTION|250|ML|.81368|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|070|No|1.85443|01/04/2022|1.82794|01/04/2022|1.74089|01/04/2022|||BETA-BLOCKERS|8374|||||No|No||ARBOR PHARMACEU|No||||
sotalol HCl|No|No|No|No|75%|24338053048|SOTYLIZE 5 MG/ML ORAL SOLUTION|480|ML|.81368|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|070|No|1.85444|01/04/2022|1.82795|01/04/2022|1.7409|01/04/2022|||BETA-BLOCKERS|8375|||||No|No||ARBOR PHARMACEU|No||||
dextroamphetamine sulfate|No|No|No|No|75%|24338085003|ZENZEDI 2.5 MG TABLET|30|EA|3.16121|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|7.20462|11/16/2021|7.1017|11/16/2021|6.76352|11/16/2021|||STIMULANTS AND RELATED AGENTS|8376|||||No|No||ARBOR PHARMACEU|No||||
dextroamphetamine sulfate|No|No|No|No|75%|24338085010|ZENZEDI 2.5 MG TABLET|100|EA|3.16127|06/03/2013||Yes|No||06/03/2013||Yes|No|06/03/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|7.20476|01/05/2021|7.10183|01/05/2021|6.76365|01/05/2021|||STIMULANTS AND RELATED AGENTS|8377|||||No|No||ARBOR PHARMACEU|No||||
dextroamphetamine sulfate|No|No|No|No|75%|24338085103|ZENZEDI 5 MG TABLET|30|EA|3.16121|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|7.20462|11/16/2021|7.1017|11/16/2021|6.76352|11/16/2021|||STIMULANTS AND RELATED AGENTS|8378|||||No|No||ARBOR PHARMACEU|No||||
dextroamphetamine sulfate|No|No|No|No|75%|24338085110|ZENZEDI 5 MG TABLET|100|EA|3.16127|06/03/2013||Yes|No||06/03/2013||Yes|No|06/03/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|7.20476|01/05/2021|7.10183|01/05/2021|6.76365|01/05/2021|||STIMULANTS AND RELATED AGENTS|8379|||||No|No||ARBOR PHARMACEU|No||||
dextroamphetamine sulfate|No|No|No|No|75%|24338085203|ZENZEDI 7.5 MG TABLET|30|EA|3.16121|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|7.20462|11/16/2021|7.1017|11/16/2021|6.76352|11/16/2021|||STIMULANTS AND RELATED AGENTS|8380|||||No|No||ARBOR PHARMACEU|No||||
dextroamphetamine sulfate|No|No|No|No|75%|24338085210|ZENZEDI 7.5 MG TABLET|100|EA|3.16127|06/03/2013||Yes|No||06/03/2013||Yes|No|06/03/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|7.20476|01/05/2021|7.10183|01/05/2021|6.76365|01/05/2021|||STIMULANTS AND RELATED AGENTS|8381|||||No|No||ARBOR PHARMACEU|No||||
dextroamphetamine sulfate|No|No|No|No|75%|24338085303|ZENZEDI 10 MG TABLET|30|EA|3.16121|11/10/2021||Yes|No||11/10/2021||Yes|No|11/10/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|7.20462|11/10/2021|7.1017|11/10/2021|6.76352|11/10/2021|||STIMULANTS AND RELATED AGENTS|8382|||||No|No||ARBOR PHARMACEU|No||||
dextroamphetamine sulfate|No|No|No|No|75%|24338085310|ZENZEDI 10 MG TABLET|100|EA|3.16127|06/03/2013||Yes|No||06/03/2013||Yes|No|06/03/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|7.20476|01/05/2021|7.10183|01/05/2021|6.76365|01/05/2021|||STIMULANTS AND RELATED AGENTS|8383|||||No|No||ARBOR PHARMACEU|No||||
dextroamphetamine sulfate|No|No|No|No|75%|24338085403|ZENZEDI 15 MG TABLET|30|EA|3.16121|11/10/2021||Yes|No||11/10/2021||Yes|No|11/10/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|7.20462|11/10/2021|7.1017|11/10/2021|6.76352|11/10/2021|||STIMULANTS AND RELATED AGENTS|8384|||||No|No||ARBOR PHARMACEU|No||||
dextroamphetamine sulfate|No|No|No|No|75%|24338085410|ZENZEDI 15 MG TABLET|100|EA|3.16127|05/16/2014||Yes|No||05/16/2014||Yes|No|05/16/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|7.20476|01/05/2021|7.10183|01/05/2021|6.76365|01/05/2021|||STIMULANTS AND RELATED AGENTS|8385|||||No|No||ARBOR PHARMACEU|No||||
dextroamphetamine sulfate|No|No|No|No|75%|24338085503|ZENZEDI 20 MG TABLET|30|EA|3.16121|11/10/2021||Yes|No||11/10/2021||Yes|No|11/10/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|7.04228|11/10/2021|6.87326|11/10/2021|6.91904|11/10/2021|||STIMULANTS AND RELATED AGENTS|8386|||||No|No||ARBOR PHARMACEU|No||||
dextroamphetamine sulfate|No|No|No|No|75%|24338085510|ZENZEDI 20 MG TABLET|100|EA|3.16127|05/16/2014||Yes|No||05/16/2014||Yes|No|05/16/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|7.04228|05/25/2021|6.87326|05/25/2021|6.91904|05/25/2021|||STIMULANTS AND RELATED AGENTS|8387|||||No|No||ARBOR PHARMACEU|No||||
dextroamphetamine sulfate|No|No|No|No|75%|24338085603|ZENZEDI 30 MG TABLET|30|EA|3.16121|11/10/2021||Yes|No||11/10/2021||Yes|No|11/10/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|7.05625|11/10/2021|6.8869|11/10/2021|6.93276|11/10/2021|||STIMULANTS AND RELATED AGENTS|8388|||||No|No||ARBOR PHARMACEU|No||||
dextroamphetamine sulfate|No|No|No|No|75%|24338085610|ZENZEDI 30 MG TABLET|100|EA|3.16127|05/16/2014||Yes|No||05/16/2014||Yes|No|05/16/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|7.05625|07/27/2021|6.8869|07/27/2021|6.93276|07/27/2021|||STIMULANTS AND RELATED AGENTS|8389|||||No|No||ARBOR PHARMACEU|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|24385035926|TUSSIN DM SYRUP|118|ML|.0157|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No||184|Yes|.01774|03/29/2022|.01731|03/29/2022|.01742|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|8390|||||No|No||AMERISOURCE-GNP|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|24385035934|TUSSIN DM SYRUP|237|ML|.00825|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No||184|Yes|.01304|03/29/2022|.01272|03/29/2022|.01281|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|8391|||||No|No||AMERISOURCE-GNP|No||||
diphenhydramine HCl|No|No|No|No|75%|24385037926|DIPHEDRYL 12.5 MG/5 ML ELIXIR|118|ML|.00728|||No|No||||No|No|||No|No||09/01/1999||Yes|No|||Over the counter|No|||No|.01468|03/29/2022|.01432|03/29/2022|.01442|03/29/2022||||8392|||||No|No||AMERISOURCE-GNP|No||||
loratadine|No|No|No|No|75%|24385047199|GNP LORATADINE 10 MG TABLET|30|EA|.04457|02/21/2012||Yes|No||||No|No|02/21/2012||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|8393|||||No|No||AMERISOURCE-GNP|No||||
diphenhydramine HCl|No|No|No|No|75%|24385047978|ALLERGY 25 MG TABLET|100|EA|.0138|||No|No||||No|No|||No|No||09/01/1999||Yes|No|||Over the counter|No|||No|.03535|03/29/2022|.0345|03/29/2022|.03473|03/29/2022||||8394|||||No|No||AMERISOURCE-GNP|No||||
loratadine|No|No|No|No|75%|24385053126|ALLERGY RELIEF 5 MG/5 ML SOLN|120|ML|.02264|05/10/2011||Yes|No||||No|No|05/10/2011||Yes|No||||No|No|||Over the counter|No||030|Yes|.04114|03/29/2022|.04015|03/29/2022|.04042|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|8395|||||No|No||AMERISOURCE-GNP|No||||
ibuprofen|No|No|No|No|75%|24385060471|IBUPROFEN 200 MG TABLET|50|EA|.0184|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|8396|||||No|No||AMERISOURCE-GNP|No||||
ibuprofen|No|No|No|No|75%|24385060478|IBUPROFEN 200 MG TABLET|100|EA|.01509|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|8397|||||No|No||AMERISOURCE-GNP|No||||
ibuprofen|No|No|No|No|75%|24385064771|IBUPROFEN 200 MG CAPLET|50|EA|.019|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|8398|||||No|No||AMERISOURCE-GNP|No||||
ibuprofen|No|No|No|No|75%|24385064778|IBUPROFEN 200 MG CAPLET|100|EA|.015|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|8399|||||No|No||AMERISOURCE-GNP|No||||
cetirizine HCl|No|No|No|No|75%|24385099865|ALL DAY ALLERGY 10 MG TABLET|30|EA|.06722|06/01/2011||Yes|No||||No|No|06/01/2011||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|8400|||||No|No||AMERISOURCE-GNP|No||||
cetirizine HCl|No|No|No|No|75%|24385099875|ALL DAY ALLERGY 10 MG TABLET|90|EA|.03831|06/01/2011||Yes|No||||No|No|06/01/2011||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|8401|||||No|No||AMERISOURCE-GNP|No||||
methylphenidate HCl|No|No|No|No|75%|24478007401|QUILLICHEW ER 20 MG CHEW TAB|100|EA|5.34309|11/05/2018||Yes|No||11/05/2018||Yes|No|11/05/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|11.9611|10/26/2021|11.67403|10/26/2021|11.75178|10/26/2021|||STIMULANTS AND RELATED AGENTS|8402|||||No|No||TRIS PHARMA INC|No||||
methylphenidate HCl|No|No|No|No|75%|24478007501|QUILLICHEW ER 30 MG CHEW TAB|100|EA|5.34309|11/05/2018||Yes|No||11/05/2018||Yes|No|11/05/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|11.96591|10/26/2021|11.67872|10/26/2021|11.7565|10/26/2021|||STIMULANTS AND RELATED AGENTS|8403|||||No|No||TRIS PHARMA INC|No||||
methylphenidate HCl|No|No|No|No|75%|24478007601|QUILLICHEW ER 40 MG CHEW TAB|100|EA|5.34309|11/05/2018||Yes|No||11/05/2018||Yes|No|11/05/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|11.92723|07/27/2021|11.64097|07/27/2021|11.7185|07/27/2021|||STIMULANTS AND RELATED AGENTS|8404|||||No|No||TRIS PHARMA INC|No||||
methylphenidate HCl|No|No|No|No|75%|24478032102|QUILLIVANT XR 25 MG/5 ML SUSP|60|ML|2.42899|11/05/2018||Yes|No||11/05/2018||Yes|No|11/05/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|5.41797|01/11/2022|5.28793|01/11/2022|5.32315|01/11/2022|||STIMULANTS AND RELATED AGENTS|8405|||||No|No||TRIS PHARMA INC|No||||
methylphenidate HCl|No|No|No|No|75%|24478032204|QUILLIVANT XR 25 MG/5 ML SUSP|120|ML|1.21449|11/05/2018||Yes|No||11/05/2018||Yes|No|11/05/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|2.71759|01/11/2022|2.65236|01/11/2022|2.67003|01/11/2022|||STIMULANTS AND RELATED AGENTS|8406|||||No|No||TRIS PHARMA INC|No||||
methylphenidate HCl|No|No|No|No|75%|24478032305|QUILLIVANT XR 25 MG/5 ML SUSP|150|ML|.97159|11/05/2018||Yes|No||11/05/2018||Yes|No|11/05/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|2.1692|01/11/2022|2.11713|01/11/2022|2.13123|01/11/2022|||STIMULANTS AND RELATED AGENTS|8407|||||No|No||TRIS PHARMA INC|No||||
methylphenidate HCl|No|No|No|No|75%|24478032406|QUILLIVANT XR 25 MG/5 ML SUSP|180|ML|.80966|11/05/2018||Yes|No||11/05/2018||Yes|No|11/05/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.80728|01/11/2022|1.7639|01/11/2022|1.77565|01/11/2022|||STIMULANTS AND RELATED AGENTS|8408|||||No|No||TRIS PHARMA INC|No||||
tobramycin/nebulizer|No|No|No|No|75%|24492085056|KITABIS PAK 300 MG/5 ML|5|ML|6.91071|07/22/2015||Yes|No||07/22/2015||Yes|No|07/22/2015||Yes|No|Submit HHS Form 1143|||No|No|||Prescription required|No||240|No|15.74999|01/07/2020|15.52499|01/07/2020|14.7857|01/07/2020|||ANTIBIOTICS: INHALED|8409|||||No|No||PARI RESPIRATOR|No||||
tapentadol HCl|No|No|No|No|90%|24510005010|NUCYNTA 50 MG TABLET|100|EA|3.79943|10/15/2019||Yes|No||10/15/2019||Yes|No|10/15/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|109|Yes|8.47004|01/18/2022|8.26675|01/18/2022|8.32181|01/18/2022|||ANALGESICS: NARCOTICS SHORT|8410|||||No|No||COLLEGIUM PHARM|No||||
tapentadol HCl|No|No|No|No|90%|24510005860|NUCYNTA ER 50 MG TABLET|60|EA|4.09166|10/15/2019||Yes|No||10/15/2019||Yes|No|10/15/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|9.14474|01/18/2022|8.92526|01/18/2022|8.9847|01/18/2022|||ANALGESICS: NARCOTICS LONG|8411|||||No|No||COLLEGIUM PHARM|No||||
tapentadol HCl|No|No|No|No|90%|24510007510|NUCYNTA 75 MG TABLET|100|EA|4.43927|10/15/2019||Yes|No||10/15/2019||Yes|No|10/15/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|109|Yes|9.91145|01/18/2022|9.67357|01/18/2022|9.73799|01/18/2022|||ANALGESICS: NARCOTICS SHORT|8412|||||No|No||COLLEGIUM PHARM|No||||
tapentadol HCl|No|No|No|No|90%|24510010010|NUCYNTA 100 MG TABLET|100|EA|5.91662|10/15/2019||Yes|No||10/15/2019||Yes|No|10/15/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|109|Yes|13.17324|01/18/2022|12.85708|01/18/2022|12.9427|01/18/2022|||ANALGESICS: NARCOTICS SHORT|8413|||||No|No||COLLEGIUM PHARM|No||||
oxycodone myristate|No|No|No|No|75%|24510011010|XTAMPZA ER 9 MG CAPSULE|100|EA|2.54388|12/21/2016||Yes|No||12/21/2016||Yes|No|12/21/2016||Yes|No||||No|No|||Prescription required|No||110|Yes|5.66571|01/18/2022|5.52973|01/18/2022|5.56656|01/18/2022|||ANALGESICS: NARCOTICS LONG|8414|||||No|No||COLLEGIUM PHARM|No||||
oxycodone myristate|No|No|No|No|75%|24510011510|XTAMPZA ER 13.5 MG CAPSULE|100|EA|3.74413|12/21/2016||Yes|No||12/21/2016||Yes|No|12/21/2016||Yes|No||||No|No|||Prescription required|No||110|Yes|8.34763|01/18/2022|8.14728|01/18/2022|8.20154|01/18/2022|||ANALGESICS: NARCOTICS LONG|8415|||||No|No||COLLEGIUM PHARM|No||||
tapentadol HCl|No|No|No|No|90%|24510011660|NUCYNTA ER 100 MG TABLET|60|EA|7.56728|10/15/2019||Yes|No||10/15/2019||Yes|No|10/15/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|16.89678|01/18/2022|16.49125|01/18/2022|16.60108|01/18/2022|||ANALGESICS: NARCOTICS LONG|8416|||||No|No||COLLEGIUM PHARM|No||||
oxycodone myristate|No|No|No|No|75%|24510012010|XTAMPZA ER 18 MG CAPSULE|100|EA|4.74818|12/21/2016||Yes|No||12/21/2016||Yes|No|12/21/2016||Yes|No||||No|No|||Prescription required|No||110|Yes|10.63878|01/18/2022|10.38344|01/18/2022|10.4526|01/18/2022|||ANALGESICS: NARCOTICS LONG|8417|||||No|No||COLLEGIUM PHARM|No||||
oxycodone myristate|No|No|No|No|75%|24510013010|XTAMPZA ER 27 MG CAPSULE|100|EA|6.60514|12/21/2016||Yes|No||12/21/2016||Yes|No|12/21/2016||Yes|No||||No|No|||Prescription required|No||110|Yes|14.72303|01/18/2022|14.36967|01/18/2022|14.46537|01/18/2022|||ANALGESICS: NARCOTICS LONG|8418|||||No|No||COLLEGIUM PHARM|No||||
oxycodone myristate|No|No|No|No|75%|24510014010|XTAMPZA ER 36 MG CAPSULE|100|EA|8.12992|12/21/2016||Yes|No||12/21/2016||Yes|No|12/21/2016||Yes|No||||No|No|||Prescription required|No||110|Yes|18.11845|01/18/2022|17.6836|01/18/2022|17.80137|01/18/2022|||ANALGESICS: NARCOTICS LONG|8419|||||No|No||COLLEGIUM PHARM|No||||
tapentadol HCl|No|No|No|No|90%|24510017460|NUCYNTA ER 150 MG TABLET|60|EA|9.76307|01/24/2020||Yes|No||01/24/2020||Yes|No|01/24/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|21.79854|01/18/2022|21.27537|01/18/2022|21.41706|01/18/2022|||ANALGESICS: NARCOTICS LONG|8420|||||No|No||COLLEGIUM PHARM|No||||
tapentadol HCl|No|No|No|No|90%|24510023260|NUCYNTA ER 200 MG TABLET|60|EA|12.39367|01/24/2020||Yes|No||01/24/2020||Yes|No|01/24/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|27.61989|01/18/2022|26.95701|01/18/2022|27.13654|01/18/2022|||ANALGESICS: NARCOTICS LONG|8421|||||No|No||COLLEGIUM PHARM|No||||
tapentadol HCl|No|No|No|No|90%|24510029160|NUCYNTA ER 250 MG TABLET|60|EA|15.5058|01/24/2020||Yes|No||01/24/2020||Yes|No|01/24/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|34.51964|01/18/2022|33.69116|01/18/2022|33.91554|01/18/2022|||ANALGESICS: NARCOTICS LONG|8422|||||No|No||COLLEGIUM PHARM|No||||
gemfibrozil|No|No|No|No|75%|24658026005|GEMFIBROZIL 600 MG TABLET|500|EA|.1419|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|||Prescription required|No||055|No|.10518|03/29/2022|.10265|03/29/2022|.10333|03/29/2022|||LIPOTROPICS: OTHER|8423|||||No|No||PURACAP LABORAT|No||||
gemfibrozil|No|No|No|No|75%|24658026018|GEMFIBROZIL 600 MG TABLET|180|EA|.32686|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|||Prescription required|No||055|No|.10518|03/29/2022|.10265|03/29/2022|.10333|03/29/2022|||LIPOTROPICS: OTHER|8424|||||No|No||PURACAP LABORAT|No||||
gemfibrozil|No|No|No|No|75%|24658026060|GEMFIBROZIL 600 MG TABLET|60|EA|.37545|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|||Prescription required|No||055|No|.10518|03/29/2022|.10265|03/29/2022|.10333|03/29/2022|||LIPOTROPICS: OTHER|8425|||||No|No||PURACAP LABORAT|No||||
terazosin HCl|No|No|No|No|75%|24689079201|TERAZOSIN 1 MG CAPSULE|100|EA|.0774|04/06/2021||Yes|No||04/06/2021||Yes|No|04/06/2021||Yes|No||||No|No|||Prescription required|No||003|Yes|.15217|03/29/2022|.14851|03/29/2022|.1495|03/29/2022|||BPH TREATMENTS|8426|||||No|No||APNAR PHARMA, L|No||||
terazosin HCl|No|No|No|No|75%|24689079210|TERAZOSIN 1 MG CAPSULE|1000|EA|.0774|04/06/2021||Yes|No||04/06/2021||Yes|No|04/06/2021||Yes|No||||No|No|||Prescription required|No||003|Yes|.15217|03/29/2022|.14851|03/29/2022|.1495|03/29/2022|||BPH TREATMENTS|8427|||||No|No||APNAR PHARMA, L|No||||
calcium acetate|No|No|No|No|75%|24689079302|CALCIUM ACETATE 667 MG CAPSULE|200|EA|.27163|04/06/2021||Yes|No||04/06/2021||Yes|No|04/06/2021||Yes|No||||No|No|||Prescription required|No||052|Yes|.28113|03/29/2022|.27438|03/29/2022|.27621|03/29/2022|||PHOSPHATE BINDERS|8428|||||No|No||APNAR PHARMA, L|No||||
terazosin HCl|No|No|No|No|75%|24689088201|TERAZOSIN 5 MG CAPSULE|100|EA|.0774|04/06/2021||Yes|No||04/06/2021||Yes|No|04/06/2021||Yes|No||||No|No|||Prescription required|No||003|Yes|.15866|03/29/2022|.15485|03/29/2022|.15588|03/29/2022|||BPH TREATMENTS|8429|||||No|No||APNAR PHARMA, L|No||||
terazosin HCl|No|No|No|No|75%|24689088210|TERAZOSIN 5 MG CAPSULE|1000|EA|.0774|04/06/2021||Yes|No||04/06/2021||Yes|No|04/06/2021||Yes|No||||No|No|||Prescription required|No||003|Yes|.15866|03/29/2022|.15485|03/29/2022|.15588|03/29/2022|||BPH TREATMENTS|8430|||||No|No||APNAR PHARMA, L|No||||
terazosin HCl|No|No|No|No|75%|24689096101|TERAZOSIN 10 MG CAPSULE|100|EA|.0774|04/06/2021||Yes|No||04/06/2021||Yes|No|04/06/2021||Yes|No||||No|No|||Prescription required|No||003|No|.16419|03/29/2022|.16024|03/29/2022|.16131|03/29/2022|||BPH TREATMENTS|8431|||||No|No||APNAR PHARMA, L|No||||
terazosin HCl|No|No|No|No|75%|24689096110|TERAZOSIN 10 MG CAPSULE|1000|EA|.0774|04/06/2021||Yes|No||04/06/2021||Yes|No|04/06/2021||Yes|No||||No|No|||Prescription required|No||003|No|.16419|03/29/2022|.16024|03/29/2022|.16131|03/29/2022|||BPH TREATMENTS|8432|||||No|No||APNAR PHARMA, L|No||||
donepezil HCl|No|No|No|No|75%|24979000406|DONEPEZIL HCL 23 MG TABLET|30|EA|.97466|08/08/2016||Yes|No||08/08/2016||Yes|No|08/08/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|011|No|.75152|03/29/2022|.73348|03/29/2022|.73836|03/29/2022|||ALZHEIMER'S AGENTS|8433|||||No|No||TWI PHARMACEUTI|No||||
donepezil HCl|No|No|No|No|75%|24979000407|DONEPEZIL HCL 23 MG TABLET|90|EA|.78045|08/08/2016||Yes|No||08/08/2016||Yes|No|08/08/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|011|No|.75152|03/29/2022|.73348|03/29/2022|.73836|03/29/2022|||ALZHEIMER'S AGENTS|8434|||||No|No||TWI PHARMACEUTI|No||||
nifedipine|No|No|No|No|75%|24979000901|NIFEDIPINE ER 90 MG TABLET|100|EA|.2795|08/09/2016||Yes|No||08/09/2016||Yes|No|08/09/2016||Yes|No||||No|No|||Prescription required|No||045|No|.38633|03/29/2022|.37705|03/29/2022|.37956|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8435|||||No|No||TWI PHARMACEUTI|No||||
nifedipine|No|No|No|No|75%|24979000912|NIFEDIPINE ER 90 MG TABLET|300|EA|.1505|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|||Prescription required|No||045|No|.38633|03/29/2022|.37705|03/29/2022|.37956|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8436|||||No|No||TWI PHARMACEUTI|No||||
nifedipine|No|No|No|No|75%|24979001001|NIFEDIPINE ER 60 MG TABLET|100|EA|.2365|08/09/2016||Yes|No||08/09/2016||Yes|No|08/09/2016||Yes|No||||No|No|||Prescription required|No||045|No|.23953|03/29/2022|.23378|03/29/2022|.23533|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8437|||||No|No||TWI PHARMACEUTI|No||||
nifedipine|No|No|No|No|75%|24979001012|NIFEDIPINE ER 60 MG TABLET|300|EA|.13616|08/09/2016||Yes|No||08/09/2016||Yes|No|08/09/2016||Yes|No||||No|No|||Prescription required|No||045|No|.23953|03/29/2022|.23378|03/29/2022|.23533|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8438|||||No|No||TWI PHARMACEUTI|No||||
nifedipine|No|No|No|No|75%|24979001101|NIFEDIPINE ER 30 MG TABLET|100|EA|.1935|08/09/2016||Yes|No||08/09/2016||Yes|No|08/09/2016||Yes|No||||No|No|||Prescription required|No||045|Yes|.17922|03/29/2022|.17491|03/29/2022|.17608|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8439|||||No|No||TWI PHARMACEUTI|No||||
nifedipine|No|No|No|No|75%|24979001112|NIFEDIPINE ER 30 MG TABLET|300|EA|.1075|08/09/2016||Yes|No||08/09/2016||Yes|No|08/09/2016||Yes|No||||No|No|||Prescription required|No||045|Yes|.17922|03/29/2022|.17491|03/29/2022|.17608|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8440|||||No|No||TWI PHARMACEUTI|No||||
diltiazem HCl|Yes|No|No|No|75%|24979002602|DILTIAZEM 24H ER(CD) 120 MG CP|500|EA|.1137|11/18/2019||Yes|No||11/18/2019||Yes|No|11/18/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||045|No|.17507|03/29/2022|.17086|03/29/2022|.172|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8441|||||No|No||TWI PHARMACEUTI|No||||
diltiazem HCl|Yes|No|No|No|75%|24979002606|DILTIAZEM 24H ER(CD) 120 MG CP|30|EA|.34256|11/18/2019||Yes|No||11/18/2019||Yes|No|11/18/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||045|No|.17507|03/29/2022|.17086|03/29/2022|.172|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8442|||||No|No||TWI PHARMACEUTI|No||||
diltiazem HCl|Yes|No|No|No|75%|24979002607|DILTIAZEM 24H ER(CD) 120 MG CP|90|EA|.1137|11/18/2019||Yes|No||11/18/2019||Yes|No|11/18/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||045|No|.17507|03/29/2022|.17086|03/29/2022|.172|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8443|||||No|No||TWI PHARMACEUTI|No||||
diltiazem HCl|Yes|No|No|No|75%|24979002702|DILTIAZEM 24H ER(CD) 180 MG CP|500|EA|.13808|11/18/2019||Yes|No||11/18/2019||Yes|No|11/18/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||045|No|.21189|03/29/2022|.2068|03/29/2022|.20818|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8444|||||No|No||TWI PHARMACEUTI|No||||
diltiazem HCl|Yes|No|No|No|75%|24979002706|DILTIAZEM 24H ER(CD) 180 MG CP|30|EA|.41423|11/18/2019||Yes|No||11/18/2019||Yes|No|11/18/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||045|No|.21189|03/29/2022|.2068|03/29/2022|.20818|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8445|||||No|No||TWI PHARMACEUTI|No||||
diltiazem HCl|Yes|No|No|No|75%|24979002707|DILTIAZEM 24H ER(CD) 180 MG CP|90|EA|.13807|11/18/2019||Yes|No||11/18/2019||Yes|No|11/18/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||045|No|.21189|03/29/2022|.2068|03/29/2022|.20818|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8446|||||No|No||TWI PHARMACEUTI|No||||
diltiazem HCl|Yes|No|No|No|75%|24979002802|DILTIAZEM 24H ER(CD) 240 MG CP|500|EA|.19589|11/18/2019||Yes|No||11/18/2019||Yes|No|11/18/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||045|No|.29728|03/29/2022|.29014|03/29/2022|.29207|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8447|||||No|No||TWI PHARMACEUTI|No||||
diltiazem HCl|Yes|No|No|No|75%|24979002806|DILTIAZEM 24H ER(CD) 240 MG CP|30|EA|.58766|11/18/2019||Yes|No||11/18/2019||Yes|No|11/18/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||045|No|.29728|03/29/2022|.29014|03/29/2022|.29207|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8448|||||No|No||TWI PHARMACEUTI|No||||
diltiazem HCl|Yes|No|No|No|75%|24979002807|DILTIAZEM 24H ER(CD) 240 MG CP|90|EA|.19588|11/18/2019||Yes|No||11/18/2019||Yes|No|11/18/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||045|No|.29728|03/29/2022|.29014|03/29/2022|.29207|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8449|||||No|No||TWI PHARMACEUTI|No||||
diltiazem HCl|Yes|No|No|No|75%|24979002902|DILTIAZEM 24H ER(CD) 300 MG CP|500|EA|.19589|11/18/2019||Yes|No||11/18/2019||Yes|No|11/18/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||045|No|.34265|03/29/2022|.33442|03/29/2022|.33665|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8450|||||No|No||TWI PHARMACEUTI|No||||
diltiazem HCl|Yes|No|No|No|75%|24979002906|DILTIAZEM 24H ER(CD) 300 MG CP|30|EA|.7611|11/18/2019||Yes|No||11/18/2019||Yes|No|11/18/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||045|No|.34265|03/29/2022|.33442|03/29/2022|.33665|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8451|||||No|No||TWI PHARMACEUTI|No||||
diltiazem HCl|Yes|No|No|No|75%|24979002907|DILTIAZEM 24H ER(CD) 300 MG CP|90|EA|.19588|11/18/2019||Yes|No||11/18/2019||Yes|No|11/18/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||045|No|.34265|03/29/2022|.33442|03/29/2022|.33665|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8452|||||No|No||TWI PHARMACEUTI|No||||
diltiazem HCl|Yes|No|No|No|75%|24979003007|DILTIAZEM 24H ER(CD) 360 MG CP|90|EA|2.10221|11/18/2019||Yes|No||11/18/2019||Yes|No|11/18/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||045|No|1.70196|03/29/2022|1.66111|03/29/2022|1.67217|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8453|||||No|No||TWI PHARMACEUTI|No||||
cyclobenzaprine HCl|No|No|No|No|75%|24979003504|CYCLOBENZAPRINE ER 15 MG CAP|60|EA|6.45|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|Yes|14.7|09/20/2019|14.49|09/20/2019|13.8|09/20/2019|||SKELETAL MUSCLE RELAXANTS|8454|||||No|No||TWI PHARMACEUTI|No||||
cyclobenzaprine HCl|No|No|No|No|75%|24979003604|CYCLOBENZAPRINE ER 30 MG CAP|60|EA|6.45|11/05/2019||Yes|No||11/05/2019||Yes|No|11/05/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|Yes|14.7|11/05/2019|14.49|11/05/2019|13.8|11/05/2019|||SKELETAL MUSCLE RELAXANTS|8455|||||No|No||TWI PHARMACEUTI|No||||
metoprolol succinate|No|No|No|No|75%|24979003701|METOPROLOL SUCC ER 25 MG TAB|100|EA|.0645|03/16/2020||Yes|No||03/16/2020||Yes|No|03/16/2020||Yes|No||||No|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|8456|||||No|No||TWI PHARMACEUTI|No||||
metoprolol succinate|No|No|No|No|75%|24979003702|METOPROLOL SUCC ER 25 MG TAB|500|EA|.0989|03/16/2020||Yes|No||03/16/2020||Yes|No|03/16/2020||Yes|No||||No|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|8457|||||No|No||TWI PHARMACEUTI|No||||
metoprolol succinate|No|No|No|No|75%|24979003703|METOPROLOL SUCC ER 25 MG TAB|1000|EA|.0989|03/16/2020||Yes|No||03/16/2020||Yes|No|03/16/2020||Yes|No||||No|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|8458|||||No|No||TWI PHARMACEUTI|No||||
metoprolol succinate|No|No|No|No|75%|24979003801|METOPROLOL SUCC ER 50 MG TAB|100|EA|.0645|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|8459|||||No|No||TWI PHARMACEUTI|No||||
metoprolol succinate|No|No|No|No|75%|24979003802|METOPROLOL SUCC ER 50 MG TAB|500|EA|.0989|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|8460|||||No|No||TWI PHARMACEUTI|No||||
metoprolol succinate|No|No|No|No|75%|24979003803|METOPROLOL SUCC ER 50 MG TAB|1000|EA|.0989|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|8461|||||No|No||TWI PHARMACEUTI|No||||
metoprolol succinate|No|No|No|No|75%|24979003901|METOPROLOL SUCC ER 100 MG TAB|100|EA|.0774|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|8462|||||No|No||TWI PHARMACEUTI|No||||
metoprolol succinate|No|No|No|No|75%|24979003902|METOPROLOL SUCC ER 100 MG TAB|500|EA|.1075|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|8463|||||No|No||TWI PHARMACEUTI|No||||
metoprolol succinate|No|No|No|No|75%|24979003903|METOPROLOL SUCC ER 100 MG TAB|1000|EA|.1075|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|8464|||||No|No||TWI PHARMACEUTI|No||||
metoprolol succinate|No|No|No|No|75%|24979004001|METOPROLOL SUCC ER 200 MG TAB|100|EA|.215|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|||Prescription required|No||070|No|.25385|03/29/2022|.24775|03/29/2022|.2494|03/29/2022|||BETA-BLOCKERS|8465|||||No|No||TWI PHARMACEUTI|No||||
megestrol acetate|No|No|No|No|75%|24979004113|MEGESTROL 625 MG/5 ML SUSP|150|ML|2.02741|08/09/2016||Yes|No||08/09/2016||Yes|No|08/09/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|197|No|1.44419|03/29/2022|1.40952|03/29/2022|1.41891|03/29/2022|||PROGESTINS FOR CACHEXIA|8466|||||No|No||TWI PHARMACEUTI|No||||
testosterone|No|No|No|No|90%|24979007815|TESTOSTERONE 1.62% GEL PUMP|75|GM|.5074|09/15/2020||Yes|No||09/15/2020||Yes|No|09/15/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|084|No|.65888|03/29/2022|.64306|03/29/2022|.64734|03/29/2022|||ANDROGENIC AGENTS|8467|||||No|No||TWI PHARMACEUTI|No||||
propafenone HCl|No|No|No|No|75%|24979008504|PROPAFENONE HCL ER 225 MG CAP|60|EA|.89583|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|No|||No|1.23841|03/29/2022|1.20868|03/29/2022|1.21673|03/29/2022||||8468|||||No|No||TWI PHARMACEUTI|No||||
propafenone HCl|No|No|No|No|75%|24979008604|PROPAFENONE HCL ER 325 MG CAP|60|EA|.89583|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|No|||No|2.24387|03/29/2022|2.19001|03/29/2022|2.2046|03/29/2022||||8469|||||No|No||TWI PHARMACEUTI|No||||
propafenone HCl|No|No|No|No|75%|24979008704|PROPAFENONE HCL ER 425 MG CAP|60|EA|.89583|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|No|||No|2.04166|03/23/2021|2.01249|03/23/2021|1.91666|03/23/2021||||8470|||||No|No||TWI PHARMACEUTI|No||||
bupropion HCl|Yes|No|No|No|75%|24979010102|BUPROPION HCL XL 150 MG TABLET|500|EA|.17916|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|06/18/2019||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|8471|||||No|No||TWI PHARMACEUTI|No||||
bupropion HCl|Yes|No|No|No|75%|24979010106|BUPROPION HCL XL 150 MG TABLET|30|EA|.17916|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|06/18/2019||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|8472|||||No|No||TWI PHARMACEUTI|No||||
bupropion HCl|Yes|No|No|No|75%|24979010107|BUPROPION HCL XL 150 MG TABLET|90|EA|.17916|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|06/18/2019||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|8473|||||No|No||TWI PHARMACEUTI|No||||
bupropion HCl|Yes|No|No|No|75%|24979010202|BUPROPION HCL XL 300 MG TABLET|500|EA|.1892|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|06/18/2019||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|8474|||||No|No||TWI PHARMACEUTI|No||||
bupropion HCl|Yes|No|No|No|75%|24979010206|BUPROPION HCL XL 300 MG TABLET|30|EA|.1892|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|06/18/2019||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|8475|||||No|No||TWI PHARMACEUTI|No||||
bupropion HCl|Yes|No|No|No|75%|24979010207|BUPROPION HCL XL 300 MG TABLET|90|EA|.1892|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|06/18/2019||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|8476|||||No|No||TWI PHARMACEUTI|No||||
fenofibric acid (choline)|No|No|No|No|75%|24979010907|FENOFIBRIC ACID DR 45 MG CAP|90|EA|.14333|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|055|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||LIPOTROPICS: OTHER|8477|||||No|No||TWI PHARMACEUTI|No||||
fenofibric acid (choline)|No|No|No|No|75%|24979011207|FENOFIBRIC ACID DR 135 MG CAP|90|EA|.35833|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|055|No|.69218|03/29/2022|.67556|03/29/2022|.68006|03/29/2022|||LIPOTROPICS: OTHER|8478|||||No|No||TWI PHARMACEUTI|No||||
dimethyl fumarate|No|No|No|No|75%|24979012721|DIMETHYL FUMARATE DR 120 MG CP|14|EA|2.30357|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|No||043|No|6.92871|10/26/2021|6.76242|10/26/2021|6.80745|10/26/2021|||MULTIPLE SCLEROSIS AGENTS|8479|||||No|No||TWI PHARMACEUTI|No||||
dimethyl fumarate|No|No|No|No|75%|24979012804|DIMETHYL FUMARATE DR 240 MG CP|60|EA|2.15|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|No||043|No|3.05522|11/23/2021|2.98189|11/23/2021|3.00175|11/23/2021|||MULTIPLE SCLEROSIS AGENTS|8480|||||No|No||TWI PHARMACEUTI|No||||
terbutaline sulfate|No|No|No|No|75%|24979013201|TERBUTALINE SULFATE 2.5 MG TAB|100|EA|1.075|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|037|No|2.45|12/15/2020|2.415|12/15/2020|2.3|12/15/2020|||BRONCHODILATORS: BETA AGONIST|8481|||||No|No||TWI PHARMACEUTI|No||||
terbutaline sulfate|No|No|No|No|75%|24979013301|TERBUTALINE SULFATE 5 MG TAB|100|EA|1.075|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|037|No|2.45|12/15/2020|2.415|12/15/2020|2.3|12/15/2020|||BRONCHODILATORS: BETA AGONIST|8482|||||No|No||TWI PHARMACEUTI|No||||
metformin HCl|No|No|No|No|75%|24979014604|METFORMIN ER 1,000 MG OSM-TAB|60|EA|.28666|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|012|No|1.48331|03/31/2022|1.44771|03/31/2022|1.45735|03/31/2022|||HYPOGLYCEMICS: METFORMINS|8483|||||No|No||TWI PHARMACEUTI|No||||
metformin HCl|No|No|No|No|75%|24979015304|METFORMIN ER 500 MG OSMOTIC TB|60|EA|.17916|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|012|No|.70527|03/31/2022|.68834|03/31/2022|.69292|03/31/2022|||HYPOGLYCEMICS: METFORMINS|8484|||||No|No||TWI PHARMACEUTI|No||||
cephalexin|No|No|No|No|75%|24979015414|CEPHALEXIN 125 MG/5 ML SUSP|100|ML|.0817|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||06/04/2018||Yes|No|||Prescription required|No||046|No|.0819|03/29/2022|.07993|03/29/2022|.08046|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|8485|||||No|No||TWI PHARMACEUTI|No||||
cephalexin|No|No|No|No|75%|24979015438|CEPHALEXIN 125 MG/5 ML SUSP|200|ML|.0688|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||06/04/2018||Yes|No|||Prescription required|No||046|No|.0415|10/26/2021|.0405|10/26/2021|.04077|10/26/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|8486|||||No|No||TWI PHARMACEUTI|No||||
cephalexin|No|No|No|No|75%|24979015514|CEPHALEXIN 250 MG/5 ML SUSP|100|ML|.0989|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||06/04/2018||Yes|No|||Prescription required|No||046|No|.09997|03/29/2022|.09757|03/29/2022|.09822|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|8487|||||No|No||TWI PHARMACEUTI|No||||
cephalexin|No|No|No|No|75%|24979015538|CEPHALEXIN 250 MG/5 ML SUSP|200|ML|.08815|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||06/04/2018||Yes|No|||Prescription required|No||046|No|.07683|03/29/2022|.07498|03/29/2022|.07548|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|8488|||||No|No||TWI PHARMACEUTI|No||||
sevelamer carbonate|No|No|No|No|75%|24979018646|SEVELAMER CARBONATE 800 MG TAB|270|EA|.16721|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|052|Yes|.27122|03/29/2022|.26471|03/29/2022|.26647|03/29/2022|||PHOSPHATE BINDERS|8489|||||No|No||TWI PHARMACEUTI|No||||
guanfacine HCl|No|No|No|No|75%|24979053301|GUANFACINE HCL ER 1 MG TABLET|100|EA|.18042|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|No||007|Yes|.25553|03/29/2022|.24939|03/29/2022|.25105|03/29/2022|||STIMULANTS AND RELATED AGENTS|8490|||||No|No||TWI PHARMACEUTI|No||||
guanfacine HCl|No|No|No|No|75%|24979053401|GUANFACINE HCL ER 2 MG TABLET|100|EA|.18042|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|No||007|Yes|.28237|03/29/2022|.27559|03/29/2022|.27742|03/29/2022|||STIMULANTS AND RELATED AGENTS|8491|||||No|No||TWI PHARMACEUTI|No||||
guanfacine HCl|No|No|No|No|75%|24979053601|GUANFACINE HCL ER 3 MG TABLET|100|EA|.18042|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|No||007|Yes|.28|03/29/2022|.27328|03/29/2022|.2751|03/29/2022|||STIMULANTS AND RELATED AGENTS|8492|||||No|No||TWI PHARMACEUTI|No||||
guanfacine HCl|No|No|No|No|75%|24979053801|GUANFACINE HCL ER 4 MG TABLET|100|EA|.18042|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|No||007|Yes|.25313|03/29/2022|.24705|03/29/2022|.2487|03/29/2022|||STIMULANTS AND RELATED AGENTS|8493|||||No|No||TWI PHARMACEUTI|No||||
penicillamine|No|No|No|No|75%|25010070515|CUPRIMINE 250 MG CAPSULE|100|EA|112.61115|02/04/2008||Yes|No||02/04/2008||Yes|No|02/04/2008||Yes|No||||No|No|||Prescription required|No|||No|256.64867|08/23/2016|252.98226|08/23/2016|240.93548|08/23/2016||||8494|||||No|No||BAUSCH HEALTH U|No||||
carbidopa|No|No|No|No|75%|25010071115|LODOSYN 25 MG TABLET|100|EA|12.72116|06/21/2012||Yes|No||06/21/2012||Yes|No|06/21/2012||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|015|No|28.99241|01/21/2020|28.57824|01/21/2020|27.21737|01/21/2020|||ANTIPARKINSON'S AGENTS|8495|||||No|No||BAUSCH HEALTH U|No||||
cefoxitin sodium|No|No|No|No|75%|25021010910|CEFOXITIN 1 GM VIAL|1|EA|2.58|08/02/2019||Yes|No||08/02/2019||Yes|No|08/02/2019||Yes|No||||No|No|||Prescription required|No|||No|5.88|08/02/2019|5.796|08/06/2019|5.52|08/02/2019||||8496|||||No|No||SAGENT PHARMACE|No||||
cefoxitin sodium|Yes|No|No|No|75%|25021011020|CEFOXITIN 2 GM VIAL|1|EA|4.3|08/02/2019||Yes|No||08/02/2019||Yes|No|08/02/2019||Yes|No||||No|No|09/27/2019||Prescription required|No|||No|9.8|08/02/2019|9.66|08/02/2019|9.2|08/02/2019||||8497|||||No|No||SAGENT PHARMACE|No||||
cefoxitin sodium|No|No|No|No|75%|25021011199|CEFOXITIN 10 GM VIAL|1|EA|21.5|08/02/2019||Yes|No||08/02/2019||Yes|No|08/02/2019||Yes|No||||No|No|||Prescription required|No|||No|49|08/02/2019|48.3|08/02/2019|46|08/02/2019||||8498|||||No|No||SAGENT PHARMACE|No||||
cefuroxime sodium|No|No|No|No|75%|25021011810|CEFUROXIME SOD 750 MG VIAL|1|EA|1.3158|08/02/2019||Yes|No||08/02/2019||Yes|No|08/02/2019||Yes|No||||No|No|||Prescription required|No|||No|2.9988|08/02/2019|2.95596|08/02/2019|2.8152|08/02/2019||||8499|||||No|No||SAGENT PHARMACE|No||||
cefuroxime sodium|No|No|No|No|75%|25021011920|CEFUROXIME SOD 1.5 GM VIAL|1|EA|2.33335|08/02/2019||Yes|No||08/02/2019||Yes|No|08/02/2019||Yes|No||||No|No|||Prescription required|No|||No|5.31787|08/02/2019|5.2419|08/02/2019|4.99228|08/02/2019||||8500|||||No|No||SAGENT PHARMACE|No||||
cefepime HCl|No|No|No|No|75%|25021012120|CEFEPIME HCL 1 GM VIAL|1|EA|2.58|04/01/2017||Yes|No||04/01/2017||Yes|No|04/01/2017||Yes|No||||No|No|||Prescription required|No|||No|5.88|06/01/2016|5.796|06/01/2016|5.52|06/01/2016||||8501|||||No|No||SAGENT PHARMACE|No||||
cefepime HCl|No|No|No|No|75%|25021012166|CEFEPIME HCL 1 GM VIAL|1|EA|1.35106|08/02/2019||Yes|No||08/02/2019||Yes|No|08/02/2019||Yes|No||||No|No|||Prescription required|No|||No|3.07916|10/13/2020|3.03517|10/13/2020|2.89064|10/13/2020||||8502|||||No|No||SAGENT/PREMIERP|No||||
cefepime HCl|No|No|No|No|75%|25021012250|CEFEPIME HCL 2 GRAM VIAL|1|EA|4.3|04/01/2017||Yes|No||04/01/2017||Yes|No|04/01/2017||Yes|No||||No|No|||Prescription required|No|||No|9.8|06/01/2016|9.66|06/01/2016|9.2|06/01/2016||||8503|||||No|No||SAGENT PHARMACE|No||||
cefepime HCl|No|No|No|No|75%|25021012267|CEFEPIME HCL 2 GRAM VIAL|1|EA|2.45229|08/02/2019||Yes|No||08/02/2019||Yes|No|08/02/2019||Yes|No||||No|No|||Prescription required|No|||No|5.58894|10/13/2020|5.50909|10/13/2020|5.24676|10/13/2020||||8504|||||No|No||SAGENT/PREMIERP|No||||
ceftazidime|No|No|No|No|75%|25021012720|CEFTAZIDIME 1 GM VIAL|1|EA|2.236|04/01/2017||Yes|No||04/01/2017||Yes|No|04/01/2017||Yes|No||||No|No|||Prescription required|No|||No|5.096|06/01/2016|5.0232|06/01/2016|4.784|06/01/2016||||8505|||||No|No||SAGENT PHARMACE|No||||
ceftazidime|No|No|No|No|75%|25021012766|CEFTAZIDIME 1 GM VIAL|1|EA|1.40214|08/02/2019||Yes|No||08/02/2019||Yes|No|08/02/2019||Yes|No||||No|No|||Prescription required|No|||No|3.19558|10/13/2020|3.14993|10/13/2020|2.99993|10/13/2020||||8506|||||No|No||SAGENT/PREMIERP|No||||
ceftazidime|No|No|No|No|75%|25021012850|CEFTAZIDIME 2 GM VIAL|1|EA|4.73|04/01/2017||Yes|No||04/01/2017||Yes|No|04/01/2017||Yes|No||||No|No|||Prescription required|No|||No|10.78|06/01/2016|10.626|06/01/2016|10.12|06/01/2016||||8507|||||No|No||SAGENT PHARMACE|No||||
ceftazidime|No|No|No|No|75%|25021012867|CEFTAZIDIME 2 GM VIAL|1|EA|2.58215|08/02/2019||Yes|No||08/02/2019||Yes|No|08/02/2019||Yes|No||||No|No|||Prescription required|No|||No|5.8849|10/13/2020|5.80083|10/13/2020|5.5246|10/13/2020||||8508|||||No|No||SAGENT/PREMIERP|No||||
ceftazidime|No|No|No|No|75%|25021012969|CEFTAZIDIME 6 GM VIAL|1|EA|9.32598|12/22/2020||Yes|No||08/02/2019||Yes|No|08/02/2019||Yes|No||||No|No|||Prescription required|No|||No|21.25456|10/13/2020|20.95092|10/13/2020|19.95326|10/13/2020||||8509|||||No|No||SAGENT/PREMIERP|No||||
ceftazidime|No|No|No|No|75%|25021012999|CEFTAZIDIME 6 GM VIAL|1|EA|12.54166|04/01/2017||Yes|No||04/01/2017||Yes|No|04/01/2017||Yes|No||||No|No|||Prescription required|No|||No|28.58332|06/01/2016|28.17499|06/01/2016|26.83332|06/01/2016||||8510|||||No|No||SAGENT PHARMACE|No||||
levofloxacin in dextrose 5 %|No|No|No|No|75%|25021013281|LEVOFLOXACIN 250 MG/50 ML-D5W|50|ML|.0602|04/01/2017||Yes|No||04/01/2017||Yes|No|04/01/2017||Yes|No||||No|No|||Prescription required|No|||No|.1372|06/01/2016|.13524|06/01/2016|.1288|06/01/2016||||8511|||||No|No||SAGENT PHARMACE|No||||
levofloxacin in dextrose 5 %|No|No|No|No|75%|25021013282|LEVOFLOXACIN 500 MG/100 ML-D5W|100|ML|.0473|04/01/2017||Yes|No||04/01/2017||Yes|No|04/01/2017||Yes|No||||No|No|||Prescription required|No|||No|.1078|06/01/2016|.10626|06/01/2016|.1012|06/01/2016||||8512|||||No|No||SAGENT PHARMACE|No||||
levofloxacin in dextrose 5 %|No|No|No|No|75%|25021013283|LEVOFLOXACIN 750 MG/150 ML-D5W|150|ML|.03153|04/01/2017||Yes|No||04/01/2017||Yes|No|04/01/2017||Yes|No||||No|No|||Prescription required|No|||No|.07186|06/01/2016|.07083|06/01/2016|.06746|06/01/2016||||8513|||||No|No||SAGENT PHARMACE|No||||
ampicillin sodium|No|No|No|No|75%|25021013610|AMPICILLIN 1 GM VIAL|1|EA|2.15|04/01/2017||Yes|No||04/01/2017||Yes|No|04/01/2017||Yes|No||||No|No|||Prescription required|No|||No|4.9|06/01/2016|4.83|06/01/2016|4.6|06/01/2016||||8514|||||No|No||SAGENT PHARMACE|No||||
ampicillin sodium|No|No|No|No|75%|25021013720|AMPICILLIN 2 GM VIAL|1|EA|3.225|04/01/2017||Yes|No||04/01/2017||Yes|No|04/01/2017||Yes|No||||No|No|||Prescription required|No|||No|7.35|06/01/2016|7.245|06/01/2016|6.9|06/01/2016||||8515|||||No|No||SAGENT PHARMACE|No||||
oxacillin sodium|No|No|No|No|75%|25021014610|OXACILLIN 1 GM VIAL|1|EA|4.8375|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No|||No|11.025|06/01/2016|10.8675|06/01/2016|10.35|06/01/2016||||8516|||||No|No||SAGENT PHARMACE|No||||
oxacillin sodium|No|No|No|No|75%|25021016224|OXACILLIN 2 GM VIAL|1|EA|9.675|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No|||No|22.05|06/01/2016|21.735|06/01/2016|20.7|06/01/2016||||8517|||||No|No||SAGENT PHARMACE|No||||
oxacillin sodium|No|No|No|No|75%|25021016399|OXACILLIN 10 GM VIAL|1|EA|47.3|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No|||No|107.8|06/01/2016|106.26|06/01/2016|101.2|06/01/2016||||8518|||||No|No||SAGENT PHARMACE|No||||
daptomycin|No|No|No|No|75%|25021017915|DAPTOMYCIN 350 MG VIAL|1|EA|119.11|04/25/2019||Yes|No||04/25/2019||Yes|No|04/25/2019||Yes|No||||No|No|||Prescription required|No|||No|271.46|04/25/2019|267.582|04/25/2019|254.84|04/25/2019||||8519|||||No|No||SAGENT PHARMACE|No||||
daptomycin|No|No|No|No|75%|25021017916|DAPTOMYCIN 350 MG VIAL|1|EA|119.11|04/25/2019||Yes|No||04/25/2019||Yes|No|04/25/2019||Yes|No||||No|No|||Prescription required|No|||No|271.46|04/25/2019|267.582|04/25/2019|254.84|04/25/2019||||8520|||||No|No||SAGENT PHARMACE|No||||
ganciclovir sodium|No|No|No|No|75%|25021018510|GANCICLOVIR 500 MG/10 ML VIAL|10|ML|2.58|04/25/2019||Yes|No||04/25/2019||Yes|No|04/25/2019||Yes|No||||No|No|||Prescription required|No|||No|5.88|04/25/2019|5.796|04/30/2019|5.52|04/25/2019||||8521|||||No|No||SAGENT PHARMACE|No||||
leucovorin calcium|No|No|No|No|75%|25021081310|LEUCOVORIN CALCIUM 50 MG VIAL|1|EA|4.3|04/01/2017||Yes|No||04/01/2017||Yes|No|04/01/2017||Yes|No||||No|No|||Prescription required|No|||No|9.8|06/01/2016|9.66|06/01/2016|9.2|06/01/2016||||8522|||||No|No||SAGENT PHARMACE|No||||
leucovorin calcium|No|No|No|No|75%|25021081430|LEUCOVORIN CALCIUM 100 MG VIAL|1|EA|8.6|04/01/2017||Yes|No||04/01/2017||Yes|No|04/01/2017||Yes|No||||No|No|||Prescription required|No|||No|19.6|06/01/2016|19.32|06/01/2016|18.4|06/01/2016||||8523|||||No|No||SAGENT PHARMACE|No||||
leucovorin calcium|No|No|No|No|75%|25021081530|LEUCOVORIN CALCIUM 200 MG VIAL|1|EA|17.2|04/01/2017||Yes|No||04/01/2017||Yes|No|04/01/2017||Yes|No||||No|No|||Prescription required|No|||No|39.2|06/01/2016|38.64|06/01/2016|36.8|06/01/2016||||8524|||||No|No||SAGENT PHARMACE|No||||
leucovorin calcium|No|No|No|No|75%|25021081630|LEUCOVORIN CALCIUM 350 MG VIAL|1|EA|30.1|04/01/2017||Yes|No||04/01/2017||Yes|No|04/01/2017||Yes|No||||No|No|||Prescription required|No|||No|68.6|06/01/2016|67.62|06/01/2016|64.4|06/01/2016||||8525|||||No|No||SAGENT PHARMACE|No||||
haloperidol decanoate|No|No|No|No|75%|25021083101|HALOPERIDOL DEC 50 MG/ML VIAL|1|ML|10.32|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|No||027|No|17.60088|09/28/2021|17.17845|09/28/2021|17.29286|09/28/2021|||ANTIPSYCHOTICS|8526|||||No|No||SAGENT PHARMACE|No||||
haloperidol decanoate|No|No|No|No|75%|25021083301|HALOPERIDOL DEC 100 MG/ML VIAL|1|ML|17.2|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|No||027|No|39.2|05/07/2019|38.64|05/07/2019|36.8|05/07/2019|||ANTIPSYCHOTICS|8527|||||No|No||SAGENT PHARMACE|Yes|09/01/2020|||
haloperidol decanoate|No|No|No|No|75%|25021083405|HALOPERIDOL DEC 500 MG/5 ML VL|5|ML|18.748|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|No||027|No|29.246|03/29/2022|28.54409|03/29/2022|28.73419|03/29/2022|||ANTIPSYCHOTICS|8528|||||No|No||SAGENT PHARMACE|No||||
pitavastatin magnesium|No|No|No|No|75%|25208020109|ZYPITAMAG 2 MG TABLET|90|EA|3.33207|09/24/2018||Yes|No||09/24/2018||Yes|No|09/24/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|063|Yes|7.59402|10/02/2018|7.48553|09/24/2018|7.12908|09/24/2018|||LIPOTROPICS: STATINS|8529|||||No|No||MEDICURE INTERN|No||||
pitavastatin magnesium|No|No|No|No|75%|25208020209|ZYPITAMAG 4 MG TABLET|90|EA|3.33207|09/24/2018||Yes|No||09/24/2018||Yes|No|09/24/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|063|Yes|7.59402|10/02/2018|7.48553|09/24/2018|7.12908|09/24/2018|||LIPOTROPICS: STATINS|8530|||||No|No||MEDICURE INTERN|No||||
asfotase alfa|No|No|No|No|75%|25682001012|STRENSIQ 18 MG/0.45 ML VIAL|.45|ML|1229.8|10/24/2016||Yes|No||10/24/2016||Yes|No|10/24/2016||Yes|No||||No|No|||Prescription required|No|||Yes|2802.8|02/06/2018|2762.76|02/06/2018|2631.2|02/06/2018||||8531|||||No|No||ALEXION PHARMAC|No||||
asfotase alfa|No|No|No|No|75%|25682001312|STRENSIQ 28 MG/0.7 ML VIAL|.7|ML|1229.8|10/24/2016||Yes|No||10/24/2016||Yes|No|10/24/2016||Yes|No||||No|No|||Prescription required|No|||Yes|2802.8|02/06/2018|2762.76|02/06/2018|2631.2|02/06/2018||||8532|||||No|No||ALEXION PHARMAC|No||||
asfotase alfa|No|No|No|No|75%|25682001612|STRENSIQ 40 MG/ML VIAL|1|ML|1229.8|10/24/2016||Yes|No||10/24/2016||Yes|No|10/24/2016||Yes|No||||No|No|||Prescription required|No|||Yes|2802.8|02/06/2018|2762.76|02/06/2018|2631.2|02/06/2018||||8533|||||No|No||ALEXION PHARMAC|No||||
asfotase alfa|No|No|No|No|75%|25682001912|STRENSIQ 80 MG/0.8 ML VIAL|.8|ML|3074.5|10/24/2016||Yes|No||10/24/2016||Yes|No|10/24/2016||Yes|No||||No|No|||Prescription required|No|||Yes|7007|08/13/2019|6906.9|08/13/2019|6578|08/13/2019||||8534|||||No|No||ALEXION PHARMAC|No||||
risperidone|No|No|No|No|75%|27241000106|RISPERIDONE 1 MG TABLET|60|EA|.0645|07/13/2015||Yes|No||07/13/2015||Yes|No|07/13/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.05646|03/29/2022|.0551|03/29/2022|.05547|03/29/2022|||ANTIPSYCHOTICS|8535|||||No|No||AJANTA PHARMA L|No||||
risperidone|No|No|No|No|75%|27241000150|RISPERIDONE 1 MG TABLET|500|EA|.0645|07/13/2015||Yes|No||07/13/2015||Yes|No|07/13/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.05646|03/29/2022|.0551|03/29/2022|.05547|03/29/2022|||ANTIPSYCHOTICS|8536|||||No|No||AJANTA PHARMA L|No||||
risperidone|No|No|No|No|75%|27241000206|RISPERIDONE 0.25 MG TABLET|60|EA|.05016|07/13/2015||Yes|No||07/13/2015||Yes|No|07/13/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.04339|03/29/2022|.04234|03/29/2022|.04263|03/29/2022|||ANTIPSYCHOTICS|8537|||||No|No||AJANTA PHARMA L|No||||
risperidone|No|No|No|No|75%|27241000250|RISPERIDONE 0.25 MG TABLET|500|EA|.04988|07/13/2015||Yes|No||07/13/2015||Yes|No|07/13/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.04339|03/29/2022|.04234|03/29/2022|.04263|03/29/2022|||ANTIPSYCHOTICS|8538|||||No|No||AJANTA PHARMA L|No||||
risperidone|No|No|No|No|75%|27241000306|RISPERIDONE 0.5 MG TABLET|60|EA|.05733|07/13/2015||Yes|No||07/13/2015||Yes|No|07/13/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.04564|03/29/2022|.04454|03/29/2022|.04484|03/29/2022|||ANTIPSYCHOTICS|8539|||||No|No||AJANTA PHARMA L|No||||
risperidone|No|No|No|No|75%|27241000350|RISPERIDONE 0.5 MG TABLET|500|EA|.05676|07/13/2015||Yes|No||07/13/2015||Yes|No|07/13/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.04564|03/29/2022|.04454|03/29/2022|.04484|03/29/2022|||ANTIPSYCHOTICS|8540|||||No|No||AJANTA PHARMA L|No||||
risperidone|No|No|No|No|75%|27241000406|RISPERIDONE 2 MG TABLET|60|EA|.07166|07/13/2015||Yes|No||07/13/2015||Yes|No|07/13/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.061|03/29/2022|.05953|03/29/2022|.05993|03/29/2022|||ANTIPSYCHOTICS|8541|||||No|No||AJANTA PHARMA L|No||||
risperidone|No|No|No|No|75%|27241000450|RISPERIDONE 2 MG TABLET|500|EA|.07138|07/13/2015||Yes|No||07/13/2015||Yes|No|07/13/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.061|03/29/2022|.05953|03/29/2022|.05993|03/29/2022|||ANTIPSYCHOTICS|8542|||||No|No||AJANTA PHARMA L|No||||
risperidone|No|No|No|No|75%|27241000506|RISPERIDONE 3 MG TABLET|60|EA|.07883|07/13/2015||Yes|No||07/13/2015||Yes|No|07/13/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.07183|03/29/2022|.0701|03/29/2022|.07057|03/29/2022|||ANTIPSYCHOTICS|8543|||||No|No||AJANTA PHARMA L|No||||
risperidone|No|No|No|No|75%|27241000550|RISPERIDONE 3 MG TABLET|500|EA|.07826|07/13/2015||Yes|No||07/13/2015||Yes|No|07/13/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.07183|03/29/2022|.0701|03/29/2022|.07057|03/29/2022|||ANTIPSYCHOTICS|8544|||||No|No||AJANTA PHARMA L|No||||
risperidone|No|No|No|No|75%|27241000606|RISPERIDONE 4 MG TABLET|60|EA|.086|07/13/2015||Yes|No||07/13/2015||Yes|No|07/13/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.10538|03/29/2022|.10285|03/29/2022|.10353|03/29/2022|||ANTIPSYCHOTICS|8545|||||No|No||AJANTA PHARMA L|No||||
risperidone|No|No|No|No|75%|27241000650|RISPERIDONE 4 MG TABLET|500|EA|.086|07/13/2015||Yes|No||07/13/2015||Yes|No|07/13/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.10538|03/29/2022|.10285|03/29/2022|.10353|03/29/2022|||ANTIPSYCHOTICS|8546|||||No|No||AJANTA PHARMA L|No||||
montelukast sodium|No|No|No|No|75%|27241001531|MONTELUKAST SOD 4 MG GRANULES|30|EA|1.29|12/04/2015||Yes|No||12/04/2015||Yes|No|12/04/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|042|Yes|1.25796|03/29/2022|1.22776|03/29/2022|1.23594|03/29/2022|||LEUKOTRIENE MODIFIERS|8547|||||No|No||AJANTA PHARMA L|No||||
montelukast sodium|No|No|No|No|75%|27241001603|MONTELUKAST SOD 4 MG TAB CHEW|30|EA|.344|12/04/2015||Yes|No||12/04/2015||Yes|No|12/04/2015||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|8548|||||No|No||AJANTA PHARMA L|No||||
montelukast sodium|No|No|No|No|75%|27241001609|MONTELUKAST SOD 4 MG TAB CHEW|90|EA|.344|12/04/2015||Yes|No||12/04/2015||Yes|No|12/04/2015||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|8549|||||No|No||AJANTA PHARMA L|No||||
montelukast sodium|No|No|No|No|75%|27241001703|MONTELUKAST SOD 5 MG TAB CHEW|30|EA|.387|12/04/2015||Yes|No||12/04/2015||Yes|No|12/04/2015||Yes|No||||No|No|||Prescription required|No||042|Yes|.08451|03/29/2022|.08248|03/29/2022|.08303|03/29/2022|||LEUKOTRIENE MODIFIERS|8550|||||No|No||AJANTA PHARMA L|No||||
montelukast sodium|No|No|No|No|75%|27241001709|MONTELUKAST SOD 5 MG TAB CHEW|90|EA|.387|12/04/2015||Yes|No||12/04/2015||Yes|No|12/04/2015||Yes|No||||No|No|||Prescription required|No||042|Yes|.08451|03/29/2022|.08248|03/29/2022|.08303|03/29/2022|||LEUKOTRIENE MODIFIERS|8551|||||No|No||AJANTA PHARMA L|No||||
zolmitriptan|No|No|No|No|75%|27241002168|ZOLMITRIPTAN 2.5 MG TABLET|6|EA|.71666|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|1.43567|03/29/2022|1.40121|03/29/2022|1.41054|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|8552|||||No|No||AJANTA PHARMA L|No||||
zolmitriptan|No|No|No|No|75%|27241002238|ZOLMITRIPTAN 5 MG TABLET|3|EA|.71666|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|1.62826|03/29/2022|1.58918|03/29/2022|1.59976|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|8553|||||No|No||AJANTA PHARMA L|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|27241002931|OMEPRAZOLE-BICARB 20-1,680 PKT|30|EA|37.56623|02/01/2018||Yes|No||02/01/2018||Yes|No|02/01/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|85.61606|09/28/2021|84.39297|09/28/2021|80.37426|09/28/2021|||PROTON PUMP INHIBITORS|8554|||||No|No||AJANTA PHARMA L|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|27241003031|OMEPRAZOLE-BICARB 40-1,680 PKT|30|EA|37.56623|02/01/2018||Yes|No||02/01/2018||Yes|No|02/01/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|85.61606|11/24/2020|84.39297|11/24/2020|80.37426|11/24/2020|||PROTON PUMP INHIBITORS|8555|||||No|No||AJANTA PHARMA L|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|27241003103|OMEPRAZOLE-BICARB 20-1,100 CAP|30|EA|1.87766|11/15/2016||Yes|No||11/15/2016||Yes|No|11/15/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|1.11633|03/29/2022|1.08953|03/29/2022|1.09679|03/29/2022|||PROTON PUMP INHIBITORS|8556|||||No|No||AJANTA PHARMA L|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|27241003203|OMEPRAZOLE-BICARB 40-1,100 CAP|30|EA|1.87766|11/15/2016||Yes|No||11/15/2016||Yes|No|11/15/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|1.14084|03/29/2022|1.11345|03/29/2022|1.12087|03/29/2022|||PROTON PUMP INHIBITORS|8557|||||No|No||AJANTA PHARMA L|No||||
eletriptan hydrobromide|No|No|No|No|75%|27241003911|ELETRIPTAN HBR 20 MG TABLET|6|EA|5.375|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|021|No|6.78979|03/29/2022|6.62683|03/29/2022|6.67096|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|8558|||||No|No||AJANTA PHARMA L|No||||
eletriptan hydrobromide|No|No|No|No|75%|27241004011|ELETRIPTAN HBR 40 MG TABLET|6|EA|5.375|02/15/2018||Yes|No||02/15/2018||Yes|No|02/15/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|021|No|3.20664|03/29/2022|3.12968|03/29/2022|3.15052|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|8559|||||No|No||AJANTA PHARMA L|No||||
eletriptan hydrobromide|No|No|No|No|75%|27241004021|ELETRIPTAN HBR 40 MG TABLET|12|EA|5.375|02/15/2018||Yes|No||02/15/2018||Yes|No|02/15/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|021|No|3.20664|03/29/2022|3.12968|03/29/2022|3.15052|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|8560|||||No|No||AJANTA PHARMA L|No||||
almotriptan malate|No|No|No|No|75%|27241004111|ALMOTRIPTAN MALATE 6.25 MG TAB|6|EA|14.19|11/10/2016||Yes|No||11/10/2016||Yes|No|11/10/2016||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|021|No|32.34|11/28/2017|31.878|11/28/2017|30.36|11/28/2017|||ANTIMIGRAINE AGENTS: TRIPTANS|8561|||||No|No||AJANTA PHARMA L|No||||
almotriptan malate|No|No|No|No|75%|27241004221|ALMOTRIPTAN MALATE 12.5 MG TAB|12|EA|14.19|11/10/2016||Yes|No||11/10/2016||Yes|No|11/10/2016||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|021|No|22.10833|03/29/2022|21.57773|03/29/2022|21.72143|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|8562|||||No|No||AJANTA PHARMA L|No||||
entacapone|No|No|No|No|75%|27241004910|ENTACAPONE 200 MG TABLET|100|EA|.387|05/22/2018||Yes|No||05/22/2018||Yes|No|05/22/2018||Yes|No||||No|No|||Prescription required|Yes|11/09/2017|015|No|.43301|03/29/2022|.42261|03/29/2022|.42543|03/29/2022|||ANTIPARKINSON'S AGENTS|8563|||||No|No||AJANTA PHARMA L|No||||
aripiprazole|No|No|No|No|75%|27241005103|ARIPIPRAZOLE 2 MG TABLET|30|EA|.301|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|8564|||||No|No||AJANTA PHARMA L|No||||
aripiprazole|No|No|No|No|75%|27241005108|ARIPIPRAZOLE 2 MG TABLET|500|EA|.301|02/13/2018||Yes|No||02/13/2018||Yes|No|02/13/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|8565|||||No|No||AJANTA PHARMA L|No||||
aripiprazole|No|No|No|No|75%|27241005203|ARIPIPRAZOLE 5 MG TABLET|30|EA|.301|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|8566|||||No|No||AJANTA PHARMA L|No||||
aripiprazole|No|No|No|No|75%|27241005208|ARIPIPRAZOLE 5 MG TABLET|500|EA|.301|02/13/2018||Yes|No||02/13/2018||Yes|No|02/13/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|8567|||||No|No||AJANTA PHARMA L|No||||
aripiprazole|No|No|No|No|75%|27241005303|ARIPIPRAZOLE 10 MG TABLET|30|EA|.301|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|8568|||||No|No||AJANTA PHARMA L|No||||
aripiprazole|No|No|No|No|75%|27241005308|ARIPIPRAZOLE 10 MG TABLET|500|EA|.301|02/13/2018||Yes|No||02/13/2018||Yes|No|02/13/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|8569|||||No|No||AJANTA PHARMA L|No||||
aripiprazole|No|No|No|No|75%|27241005403|ARIPIPRAZOLE 15 MG TABLET|30|EA|.301|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|8570|||||No|No||AJANTA PHARMA L|No||||
aripiprazole|No|No|No|No|75%|27241005408|ARIPIPRAZOLE 15 MG TABLET|500|EA|.301|02/13/2018||Yes|No||02/13/2018||Yes|No|02/13/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|8571|||||No|No||AJANTA PHARMA L|No||||
aripiprazole|No|No|No|No|75%|27241005503|ARIPIPRAZOLE 20 MG TABLET|30|EA|.43|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|8572|||||No|No||AJANTA PHARMA L|No||||
aripiprazole|No|No|No|No|75%|27241005508|ARIPIPRAZOLE 20 MG TABLET|500|EA|.43|02/13/2018||Yes|No||02/13/2018||Yes|No|02/13/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|8573|||||No|No||AJANTA PHARMA L|No||||
aripiprazole|No|No|No|No|75%|27241005603|ARIPIPRAZOLE 30 MG TABLET|30|EA|.43|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|8574|||||No|No||AJANTA PHARMA L|No||||
aripiprazole|No|No|No|No|75%|27241005608|ARIPIPRAZOLE 30 MG TABLET|500|EA|.43|02/13/2018||Yes|No||02/13/2018||Yes|No|02/13/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|8575|||||No|No||AJANTA PHARMA L|No||||
voriconazole|No|No|No|No|75%|27241006203|VORICONAZOLE 50 MG TABLET|30|EA|.93166|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|069|No|2.12332|07/30/2019|2.09299|07/30/2019|1.99332|07/30/2019|||ANTIFUNGALS: ORAL|8576|||||No|No||AJANTA PHARMA L|No||||
voriconazole|No|No|No|No|75%|27241006303|VORICONAZOLE 200 MG TABLET|30|EA|3.225|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|069|No|2.07998|03/29/2022|2.03006|03/29/2022|2.04358|03/29/2022|||ANTIFUNGALS: ORAL|8577|||||No|No||AJANTA PHARMA L|No||||
memantine HCl|No|No|No|No|75%|27241007006|MEMANTINE HCL 5 MG TABLET|60|EA|.13258|08/23/2016||Yes|No||08/23/2016||Yes|No|08/23/2016||Yes|No||||No|No|||Prescription required|No||011|No|.08825|03/29/2022|.08613|03/29/2022|.0867|03/29/2022|||ALZHEIMER'S AGENTS|8578|||||No|No||AJANTA PHARMA L|No||||
memantine HCl|No|No|No|No|75%|27241007105|MEMANTINE HCL 10 MG TABLET|500|EA|.13244|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|8579|||||No|No||AJANTA PHARMA L|No||||
memantine HCl|No|No|No|No|75%|27241007106|MEMANTINE HCL 10 MG TABLET|60|EA|.13258|08/23/2016||Yes|No||08/23/2016||Yes|No|08/23/2016||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|8580|||||No|No||AJANTA PHARMA L|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|27241008303|AMLODIPINE-OLMESARTAN 5-20 MG|30|EA|.67424|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.41945|03/29/2022|.40938|03/29/2022|.4121|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|8581|||||No|No||AJANTA PHARMA L|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|27241008309|AMLODIPINE-OLMESARTAN 5-20 MG|90|EA|.67428|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.41945|03/29/2022|.40938|03/29/2022|.4121|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|8582|||||No|No||AJANTA PHARMA L|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|27241008403|AMLODIPINE-OLMESARTAN 5-40 MG|30|EA|.85168|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.47518|03/29/2022|.46377|03/29/2022|.46686|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|8583|||||No|No||AJANTA PHARMA L|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|27241008409|AMLODIPINE-OLMESARTAN 5-40 MG|90|EA|.85168|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.47518|03/29/2022|.46377|03/29/2022|.46686|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|8584|||||No|No||AJANTA PHARMA L|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|27241008503|AMLODIPINE-OLMESARTAN 10-20 MG|30|EA|.67424|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.43528|03/29/2022|.42483|03/29/2022|.42766|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|8585|||||No|No||AJANTA PHARMA L|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|27241008509|AMLODIPINE-OLMESARTAN 10-20 MG|90|EA|.67428|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.43528|03/29/2022|.42483|03/29/2022|.42766|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|8586|||||No|No||AJANTA PHARMA L|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|27241008603|AMLODIPINE-OLMESARTAN 10-40 MG|30|EA|.85168|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.41757|03/29/2022|.40754|03/29/2022|.41026|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|8587|||||No|No||AJANTA PHARMA L|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|27241008609|AMLODIPINE-OLMESARTAN 10-40 MG|90|EA|.85168|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.41757|03/29/2022|.40754|03/29/2022|.41026|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|8588|||||No|No||AJANTA PHARMA L|No||||
duloxetine HCl|No|No|No|No|75%|27241009706|DULOXETINE HCL DR 20 MG CAP|60|EA|.129|11/17/2017||Yes|No||11/17/2017||Yes|No|11/17/2017||Yes|No||||No|No|||Prescription required|No||232|No|.13163|03/29/2022|.12847|03/29/2022|.12932|03/29/2022|||NEUROPATHIC PAIN|8589|||||No|No||AJANTA PHARMA L|No||||
duloxetine HCl|No|No|No|No|75%|27241009803|DULOXETINE HCL DR 30 MG CAP|30|EA|.129|11/17/2017||Yes|No||11/17/2017||Yes|No|11/17/2017||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|8590|||||No|No||AJANTA PHARMA L|No||||
duloxetine HCl|No|No|No|No|75%|27241009809|DULOXETINE HCL DR 30 MG CAP|90|EA|.129|11/17/2017||Yes|No||11/17/2017||Yes|No|11/17/2017||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|8591|||||No|No||AJANTA PHARMA L|No||||
duloxetine HCl|No|No|No|No|75%|27241009810|DULOXETINE HCL DR 30 MG CAP|1000|EA|.086|10/04/2021||Yes|No||10/04/2021||Yes|No|10/04/2021||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|8592|||||No|No||AJANTA PHARMA L|No||||
duloxetine HCl|No|No|No|No|75%|27241009903|DULOXETINE HCL DR 60 MG CAP|30|EA|.129|11/17/2017||Yes|No||11/17/2017||Yes|No|11/17/2017||Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|8593|||||No|No||AJANTA PHARMA L|No||||
duloxetine HCl|No|No|No|No|75%|27241009990|DULOXETINE HCL DR 60 MG CAP|1000|EA|.129|11/17/2017||Yes|No||11/17/2017||Yes|No|11/17/2017||Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|8594|||||No|No||AJANTA PHARMA L|No||||
clonidine HCl|No|No|No|No|75%|27241010806|CLONIDINE HCL ER 0.1 MG TABLET|60|EA|.78833|05/22/2018||Yes|No||05/22/2018||Yes|No|05/22/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.52051|03/29/2022|.50801|03/29/2022|.5114|03/29/2022|||STIMULANTS AND RELATED AGENTS|8595|||||No|No||AJANTA PHARMA L|No||||
divalproex sodium|No|No|No|No|75%|27241011501|DIVALPROEX DR 125 MG CAP SPRNK|100|EA|.215|04/23/2021||Yes|No||04/23/2021||Yes|No|04/23/2021||Yes|No||||No|No|||Prescription required|No||056|No|.31191|03/29/2022|.30442|03/29/2022|.30645|03/29/2022|||ANTICONVULSANTS|8596|||||No|No||AJANTA PHARMA L|No||||
divalproex sodium|No|No|No|No|75%|27241011510|DIVALPROEX DR 125 MG CAP SPRNK|1000|EA|.215|04/23/2021||Yes|No||04/23/2021||Yes|No|04/23/2021||Yes|No||||No|No|||Prescription required|No||056|No|.31191|03/29/2022|.30442|03/29/2022|.30645|03/29/2022|||ANTICONVULSANTS|8597|||||No|No||AJANTA PHARMA L|No||||
fenofibrate|No|No|No|No|75%|27241011603|FENOFIBRATE 54 MG TABLET|90|EA|.1911|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||055|No|.1459|03/29/2022|.14239|03/29/2022|.14334|03/29/2022|||LIPOTROPICS: OTHER|8598|||||No|No||AJANTA PHARMA L|No||||
fenofibrate|No|No|No|No|75%|27241011703|FENOFIBRATE 160 MG TABLET|90|EA|.28666|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||055|No|.1612|03/29/2022|.15733|03/29/2022|.15837|03/29/2022|||LIPOTROPICS: OTHER|8599|||||No|No||AJANTA PHARMA L|No||||
fenofibrate,micronized|No|No|No|No|75%|27241011804|FENOFIBRATE 67 MG CAPSULE|100|EA|.09567|06/10/2019||Yes|No||06/10/2019||Yes|No|06/10/2019||Yes|No||||No|No|||Prescription required|No||055|No|.15038|03/29/2022|.14677|03/29/2022|.14774|03/29/2022|||LIPOTROPICS: OTHER|8600|||||No|No||AJANTA PHARMA L|No||||
fenofibrate,micronized|No|No|No|No|75%|27241011904|FENOFIBRATE 134 MG CAPSULE|100|EA|.16013|06/10/2019||Yes|No||06/10/2019||Yes|No|06/10/2019||Yes|No||||No|No|||Prescription required|No||055|No|.17604|03/29/2022|.17181|03/29/2022|.17295|03/29/2022|||LIPOTROPICS: OTHER|8601|||||No|No||AJANTA PHARMA L|No||||
fenofibrate,micronized|No|No|No|No|75%|27241012004|FENOFIBRATE 200 MG CAPSULE|100|EA|.28453|06/10/2019||Yes|No||06/10/2019||Yes|No|06/10/2019||Yes|No||||No|No|||Prescription required|No||055|No|.22993|03/29/2022|.22441|03/29/2022|.2259|03/29/2022|||LIPOTROPICS: OTHER|8602|||||No|No||AJANTA PHARMA L|No||||
tadalafil|No|No|No|No|75%|27241012302|TADALAFIL 20 MG TABLET|60|EA|2.15|06/10/2019||Yes|No||06/10/2019||Yes|No|06/10/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/26/2018|171|Yes|.68104|03/29/2022|.66469|03/29/2022|.66912|03/29/2022|||PAH AGENTS: ORAL AND INHALED|8603|||||No|No||AJANTA PHARMA L|No||||
sildenafil citrate|No|No|No|No|75%|27241012403|SILDENAFIL 20 MG TABLET|90|EA|.09555|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|Yes|.09246|03/29/2022|.09024|03/29/2022|.09084|03/29/2022|||PAH AGENTS: ORAL AND INHALED|8604|||||No|No||AJANTA PHARMA L|No||||
ranolazine|No|No|No|No|75%|27241012502|RANOLAZINE ER 500 MG TABLET|60|EA|.43|10/23/2019||Yes|No||10/23/2019||Yes|No|10/23/2019||Yes|No||||No|No|||Prescription required|No|||Yes|.28604|03/29/2022|.27917|03/29/2022|.28103|03/29/2022||||8605|||||No|No||AJANTA PHARMA L|No||||
ranolazine|No|No|No|No|75%|27241012602|RANOLAZINE ER 1,000 MG TABLET|60|EA|.71666|10/23/2019||Yes|No||10/23/2019||Yes|No|10/23/2019||Yes|No||||No|No|||Prescription required|No|||Yes|.43283|03/29/2022|.42244|03/29/2022|.42525|03/29/2022||||8606|||||No|No||AJANTA PHARMA L|No||||
cholestyramine (with sugar)|No|No|No|No|75%|27241013436|CHOLESTYRAMINE PACKET|60|EA|.645|04/06/2021||Yes|No||04/06/2021||Yes|No|04/06/2021||Yes|No||||No|No|||Prescription required|No||055|No|1.02853|03/29/2022|1.00384|03/29/2022|1.01053|03/29/2022|||LIPOTROPICS: OTHER|8607|||||No|No||AJANTA PHARMA L|No||||
oseltamivir phosphate|No|No|No|No|75%|27241013909|OSELTAMIVIR 6 MG/ML SUSPENSION|60|ML|.43|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|No||025|No|.51688|03/29/2022|.50447|03/29/2022|.50783|03/29/2022|||ANTIVIRALS: ORAL|8608|||||No|No||AJANTA PHARMA L|No||||
silodosin|No|No|No|No|75%|27241014401|SILODOSIN 4 MG CAPSULE|30|EA|.86|06/10/2019||Yes|No||06/10/2019||Yes|No|06/10/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|003|No|.60384|03/29/2022|.58934|03/29/2022|.59327|03/29/2022|||BPH TREATMENTS|8609|||||No|No||AJANTA PHARMA L|No||||
silodosin|No|No|No|No|75%|27241014501|SILODOSIN 8 MG CAPSULE|30|EA|.86|06/10/2019||Yes|No||06/10/2019||Yes|No|06/10/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|003|No|.68368|03/29/2022|.66727|03/29/2022|.67171|03/29/2022|||BPH TREATMENTS|8610|||||No|No||AJANTA PHARMA L|No||||
silodosin|No|No|No|No|75%|27241014503|SILODOSIN 8 MG CAPSULE|90|EA|.86|06/10/2019||Yes|No||06/10/2019||Yes|No|06/10/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|003|No|.68368|03/29/2022|.66727|03/29/2022|.67171|03/29/2022|||BPH TREATMENTS|8611|||||No|No||AJANTA PHARMA L|No||||
doxycycline hyclate|No|No|No|No|75%|27241015302|DOXYCYCLINE HYCLATE 75 MG TAB|60|EA|.43|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|213|No|.98|12/14/2020|.966|12/14/2020|.92|12/14/2020|||TETRACYCLINES|8612|||||No|No||AJANTA PHARMA L|No||||
doxycycline hyclate|No|No|No|No|75%|27241015402|DOXYCYCLINE HYCLATE 150 MG TAB|60|EA|.43|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|213|No|.98|12/14/2020|.966|12/14/2020|.92|12/14/2020|||TETRACYCLINES|8613|||||No|No||AJANTA PHARMA L|No||||
oxybutynin chloride|No|No|No|No|75%|27241015504|OXYBUTYNIN CL ER 5 MG TABLET|100|EA|.215|10/23/2019||Yes|No||10/23/2019||Yes|No|10/23/2019||Yes|No||||No|No|||Prescription required|No||006|Yes|.15279|03/29/2022|.14912|03/29/2022|.15011|03/29/2022|||BLADDER RELAXANT PREPARATIONS|8614|||||No|No||AJANTA PHARMA L|No||||
oxybutynin chloride|No|No|No|No|75%|27241015508|OXYBUTYNIN CL ER 5 MG TABLET|500|EA|.215|10/23/2019||Yes|No||10/23/2019||Yes|No|10/23/2019||Yes|No||||No|No|||Prescription required|No||006|Yes|.15279|03/29/2022|.14912|03/29/2022|.15011|03/29/2022|||BLADDER RELAXANT PREPARATIONS|8615|||||No|No||AJANTA PHARMA L|No||||
oxybutynin chloride|No|No|No|No|75%|27241015604|OXYBUTYNIN CL ER 10 MG TABLET|100|EA|.215|10/23/2019||Yes|No||10/23/2019||Yes|No|10/23/2019||Yes|No||||No|No|||Prescription required|No||006|No|.15833|03/29/2022|.15453|03/29/2022|.15555|03/29/2022|||BLADDER RELAXANT PREPARATIONS|8616|||||No|No||AJANTA PHARMA L|No||||
oxybutynin chloride|No|No|No|No|75%|27241015608|OXYBUTYNIN CL ER 10 MG TABLET|500|EA|.215|10/23/2019||Yes|No||10/23/2019||Yes|No|10/23/2019||Yes|No||||No|No|||Prescription required|No||006|No|.15833|03/29/2022|.15453|03/29/2022|.15555|03/29/2022|||BLADDER RELAXANT PREPARATIONS|8617|||||No|No||AJANTA PHARMA L|No||||
oxybutynin chloride|No|No|No|No|75%|27241015704|OXYBUTYNIN CL ER 15 MG TABLET|100|EA|.215|10/23/2019||Yes|No||10/23/2019||Yes|No|10/23/2019||Yes|No||||No|No|||Prescription required|No||006|No|.19948|03/29/2022|.19469|03/29/2022|.19598|03/29/2022|||BLADDER RELAXANT PREPARATIONS|8618|||||No|No||AJANTA PHARMA L|No||||
valganciclovir HCl|No|No|No|No|75%|27241015860|VALGANCICLOVIR 450 MG TABLET|60|EA|3.58333|05/19/2020||Yes|No||05/19/2020||Yes|No|05/19/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|136|No|2.64507|03/29/2022|2.58158|03/29/2022|2.59878|03/29/2022|||ANTIVIRALS: GENERAL|8619|||||No|No||AJANTA PHARMA L|No||||
valganciclovir HCl|No|No|No|No|75%|27241015919|VALGANCICLOVIR HCL 50 MG/ML|88|ML|3.91035|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|136|No|8.91198|05/21/2020|8.78466|05/21/2020|8.36635|05/21/2020|||ANTIVIRALS: GENERAL|8620|||||No|No||AJANTA PHARMA L|No||||
captopril|No|No|No|No|75%|27241016001|CAPTOPRIL 12.5 MG TABLET|100|EA|.344|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|No|.58889|03/29/2022|.57475|03/29/2022|.57858|03/29/2022|||ANGIOTENSIN MODULATORS|8621|||||No|No||AJANTA PHARMA L|No||||
captopril|No|No|No|No|75%|27241016101|CAPTOPRIL 25 MG TABLET|100|EA|.3655|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|No|.40459|03/29/2022|.39487|03/29/2022|.3975|03/29/2022|||ANGIOTENSIN MODULATORS|8622|||||No|No||AJANTA PHARMA L|No||||
captopril|No|No|No|No|75%|27241016201|CAPTOPRIL 50 MG TABLET|100|EA|.602|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|No|1.25965|03/29/2022|1.22941|03/29/2022|1.2376|03/29/2022|||ANGIOTENSIN MODULATORS|8623|||||No|No||AJANTA PHARMA L|No||||
captopril|No|No|No|No|75%|27241016301|CAPTOPRIL 100 MG TABLET|100|EA|.774|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|No|1.37792|03/29/2022|1.34484|03/29/2022|1.3538|03/29/2022|||ANGIOTENSIN MODULATORS|8624|||||No|No||AJANTA PHARMA L|No||||
duloxetine HCl|No|No|No|No|75%|27241016430|DULOXETINE HCL DR 40 MG CAP|30|EA|1.419|09/09/2019||Yes|No||09/09/2019||Yes|No|09/09/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|232|No|1.94215|03/29/2022|1.89553|03/29/2022|1.90816|03/29/2022|||NEUROPATHIC PAIN|8625|||||No|No||AJANTA PHARMA L|No||||
doxepin HCl|No|No|No|No|75%|27241016701|DOXEPIN 10 MG CAPSULE|100|EA|.172|05/01/2020||Yes|No||05/01/2020||Yes|No|05/01/2020||Yes|No||||No|No|||Prescription required|No||215|No|.22181|03/29/2022|.21648|03/29/2022|.21792|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|8626|||||No|No||AJANTA PHARMA L|No||||
doxepin HCl|No|No|No|No|75%|27241016801|DOXEPIN 25 MG CAPSULE|100|EA|.215|05/01/2020||Yes|No||05/01/2020||Yes|No|05/01/2020||Yes|No||||No|No|||Prescription required|No||215|No|.30005|03/29/2022|.29284|03/29/2022|.29479|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|8627|||||No|No||AJANTA PHARMA L|No||||
doxepin HCl|No|No|No|No|75%|27241016901|DOXEPIN 50 MG CAPSULE|100|EA|.3225|05/01/2020||Yes|No||05/01/2020||Yes|No|05/01/2020||Yes|No||||No|No|||Prescription required|No||215|No|.41139|03/29/2022|.40151|03/29/2022|.40419|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|8628|||||No|No||AJANTA PHARMA L|No||||
doxepin HCl|No|No|No|No|75%|27241017001|DOXEPIN 75 MG CAPSULE|100|EA|.4945|05/01/2020||Yes|No||05/01/2020||Yes|No|05/01/2020||Yes|No||||No|No|||Prescription required|No||215|No|.56944|03/29/2022|.55577|03/29/2022|.55947|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|8629|||||No|No||AJANTA PHARMA L|No||||
doxepin HCl|No|No|No|No|75%|27241017101|DOXEPIN 100 MG CAPSULE|100|EA|.5375|05/01/2020||Yes|No||05/01/2020||Yes|No|05/01/2020||Yes|No||||No|No|||Prescription required|No||215|No|.67991|03/29/2022|.66359|03/29/2022|.66801|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|8630|||||No|No||AJANTA PHARMA L|No||||
sildenafil citrate|No|No|No|No|75%|27241017529|SILDENAFIL 10 MG/ML ORAL SUSP|112|ML|3.83928|02/28/2020||Yes|No||02/28/2020||Yes|No|02/28/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/25/2019|171|Yes|8.74999|09/08/2020|8.62499|09/08/2020|8.21428|09/08/2020|||PAH AGENTS: ORAL AND INHALED|8631|||||No|No||AJANTA PHARMA L|No||||
lamotrigine|No|No|No|No|75%|27241018330|LAMOTRIGINE ODT 25 MG TABLET|30|EA|2.15|01/12/2022||Yes|No||01/12/2022||Yes|No|01/12/2022||Yes|No||||No|No|||Prescription required|No||056|No|3.83184|03/01/2022|3.73987|03/01/2022|3.76478|03/01/2022|||ANTICONVULSANTS|8632|||||No|No||AJANTA PHARMA L|No||||
lamotrigine|No|No|No|No|75%|27241018430|LAMOTRIGINE ODT 50 MG TABLET|30|EA|2.279|01/12/2022||Yes|No||01/12/2022||Yes|No|01/12/2022||Yes|No||||No|No|||Prescription required|No||056|No|3.24575|03/29/2022|3.16785|03/29/2022|3.18894|03/29/2022|||ANTICONVULSANTS|8633|||||No|No||AJANTA PHARMA L|No||||
lamotrigine|No|No|No|No|75%|27241018530|LAMOTRIGINE ODT 100 MG TABLET|30|EA|2.408|01/12/2022||Yes|No||01/12/2022||Yes|No|01/12/2022||Yes|No||||No|No|||Prescription required|No||056|No|4.72113|03/29/2022|4.60782|03/29/2022|4.63851|03/29/2022|||ANTICONVULSANTS|8634|||||No|No||AJANTA PHARMA L|No||||
lamotrigine|No|No|No|No|75%|27241018630|LAMOTRIGINE ODT 200 MG TABLET|30|EA|2.795|01/12/2022||Yes|No||01/12/2022||Yes|No|01/12/2022||Yes|No||||No|No|||Prescription required|No||056|No|4.09893|03/01/2022|4.00055|03/01/2022|4.02719|03/01/2022|||ANTICONVULSANTS|8635|||||No|No||AJANTA PHARMA L|No||||
metformin HCl|No|No|No|No|75%|27241018860|METFORMIN ER 500 MG OSMOTIC TB|60|EA|.35833|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|012|No|.70527|01/25/2022|.68834|01/25/2022|.69292|01/25/2022|||HYPOGLYCEMICS: METFORMINS|8636|||||No|No||AJANTA PHARMA L|No||||
metformin HCl|No|No|No|No|75%|27241018960|METFORMIN ER 1,000 MG OSM-TAB|60|EA|.71666|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|012|No|1.48331|03/29/2022|1.44771|03/29/2022|1.45735|03/29/2022|||HYPOGLYCEMICS: METFORMINS|8637|||||No|No||AJANTA PHARMA L|No||||
methylergonovine maleate|No|No|No|No|75%|27437005056|METHERGINE 0.2 MG TABLET|28|EA|26.75214|08/15/2016||Yes|No||08/15/2016||Yes|No|08/15/2016||Yes|No||||No|No|||Prescription required|No|||No|60.96999|12/25/2018|60.09899|12/25/2018|57.23713|12/25/2018||||8638|||||No|No||LUPIN PHARMA|No||||
methylergonovine maleate|No|No|No|No|75%|27437005057|METHERGINE 0.2 MG TABLET|12|EA|26.7675|08/15/2016||Yes|No||08/15/2016||Yes|No|08/15/2016||Yes|No||||No|No|||Prescription required|No|||No|61.005|12/25/2018|60.1335|12/25/2018|57.27|12/25/2018||||8639|||||No|No||LUPIN PHARMA|No||||
secnidazole|No|No|No|No|75%|27437005101|SOLOSEC 2 GM GRANULE PACKET|1|EA|121.7975|08/12/2019||Yes|No||08/12/2019||Yes|No|08/12/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|124|No|277.585|11/23/2021|273.6195|11/23/2021|260.59|11/23/2021|||ANTIBIOTICS: VAGINAL|8640|||||No|No||LUPIN PHARMA|No||||
cefixime|No|No|No|No|75%|27437020311|SUPRAX 100 MG TABLET CHEWABLE|10|EA|8.39747|03/13/2013||Yes|No||03/13/2013||Yes|No|03/13/2013||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|046|No|19.13842|06/01/2016|18.86501|06/01/2016|17.96668|06/01/2016|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|8641|||||No|No||LUPIN PHARMA|No||||
cefixime|No|No|No|No|75%|27437020511|SUPRAX 200 MG TABLET CHEWABLE|10|EA|16.79537|03/13/2013||Yes|No||03/13/2013||Yes|No|03/13/2013||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|046|No|38.27782|04/23/2019|37.73099|04/23/2019|35.93428|04/23/2019|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|8642|||||No|No||LUPIN PHARMA|No||||
cefixime|No|No|No|No|75%|27437020602|SUPRAX 200 MG/5 ML SUSPENSION|75|ML|3.90164|06/19/2007||Yes|No||06/19/2007||Yes|No|06/19/2007||Yes|No||||No|No|||Prescription required|Yes|02/01/2018|046|No|8.89212|09/27/2016|8.76509|09/27/2016|8.34771|09/27/2016|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|8643|||||No|No||LUPIN PHARMA|No||||
cefixime|No|No|No|No|75%|27437020603|SUPRAX 200 MG/5 ML SUSPENSION|50|ML|3.90164|06/19/2007||Yes|No||06/19/2007||Yes|No|06/19/2007||Yes|No||||No|No|||Prescription required|Yes|02/01/2018|046|No|8.89212|02/26/2019|8.76509|02/26/2019|8.34771|02/26/2019|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|8644|||||No|No||LUPIN PHARMA|No||||
lofexidine HCl|No|No|No|No|75%|27505005036|LUCEMYRA 0.18 MG TABLET|36|EA|8.8967|12/17/2018||Yes|No||12/17/2018||Yes|No|12/17/2018||Yes|No||||No|No|||Prescription required|No||145|No|19.77619|06/29/2021|19.30156|06/29/2021|19.4301|06/29/2021|||OPIATE DEPENDENCE TREATMENTS|8645|||||No|No||US WORLDMEDS|Yes|09/01/2020|||
lofexidine HCl|No|No|No|No|75%|27505005096|LUCEMYRA 0.18 MG TABLET|96|EA|8.8967|12/17/2018||Yes|No||12/17/2018||Yes|No|12/17/2018||Yes|No||||No|No|||Prescription required|No||145|No|19.77619|06/29/2021|19.30156|06/29/2021|19.4301|06/29/2021|||OPIATE DEPENDENCE TREATMENTS|8646|||||No|No||US WORLDMEDS|Yes|09/01/2020|||
risperidone|No|No|No|No|75%|27808000201|RISPERIDONE 1 MG/ML SOLUTION|30|ML|.28666|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.33084|03/29/2022|.32289|03/29/2022|.32505|03/29/2022|||ANTIPSYCHOTICS|8647|||||No|No||TRIS PHARMA INC|No||||
theophylline anhydrous|No|No|No|No|75%|27808003301|THEOPHYLLINE 80 MG/15 ML SOLN|473|ML|.06772|06/15/2015||Yes|No||06/15/2015||Yes|No|06/15/2015||Yes|No||||No|No|||Prescription required|No|||Yes|.15435|07/25/2017|.15214|07/25/2017|.1449|07/25/2017||||8648|||||No|No||TRIS PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|27808003501|HYDROCODONE-ACETAMIN 5-325 MG|100|EA|.043|06/15/2015||Yes|No||06/15/2015||Yes|No|06/15/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8649|||||No|No||TRIS PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|27808003502|HYDROCODONE-ACETAMIN 5-325 MG|500|EA|.043|06/15/2015||Yes|No||06/15/2015||Yes|No|06/15/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8650|||||No|No||TRIS PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|27808003503|HYDROCODONE-ACETAMIN 5-325 MG|1000|EA|.043|06/15/2015||Yes|No||06/15/2015||Yes|No|06/15/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8651|||||No|No||TRIS PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|27808003601|HYDROCODONE-ACETAMIN 7.5-325|100|EA|.043|06/15/2015||Yes|No||06/15/2015||Yes|No|06/15/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8652|||||No|No||TRIS PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|27808003602|HYDROCODONE-ACETAMIN 7.5-325|500|EA|.043|06/15/2015||Yes|No||06/15/2015||Yes|No|06/15/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8653|||||No|No||TRIS PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|27808003603|HYDROCODONE-ACETAMIN 7.5-325|1000|EA|.043|06/15/2015||Yes|No||06/15/2015||Yes|No|06/15/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8654|||||No|No||TRIS PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|27808003701|HYDROCODONE-ACETAMIN 10-325 MG|100|EA|.043|06/15/2015||Yes|No||06/15/2015||Yes|No|06/15/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8655|||||No|No||TRIS PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|27808003702|HYDROCODONE-ACETAMIN 10-325 MG|500|EA|.043|06/15/2015||Yes|No||06/15/2015||Yes|No|06/15/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8656|||||No|No||TRIS PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|27808003703|HYDROCODONE-ACETAMIN 10-325 MG|1000|EA|.043|06/15/2015||Yes|No||06/15/2015||Yes|No|06/15/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8657|||||No|No||TRIS PHARMA INC|No||||
methylphenidate HCl|No|No|No|No|75%|27808005801|METHYLPHENIDATE 5 MG/5 ML SOLN|500|ML|.0602|12/20/2017||Yes|No||12/20/2017||Yes|No|12/20/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.15581|03/29/2022|.15207|03/29/2022|.15308|03/29/2022|||STIMULANTS AND RELATED AGENTS|8658|||||No|No||TRIS PHARMA INC|No||||
methylphenidate HCl|No|No|No|No|75%|27808005901|METHYLPHENIDATE 10 MG/5 ML SOL|500|ML|.086|12/20/2017||Yes|No||12/20/2017||Yes|No|12/20/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.17579|03/29/2022|.17157|03/29/2022|.17271|03/29/2022|||STIMULANTS AND RELATED AGENTS|8659|||||No|No||TRIS PHARMA INC|No||||
promethazine HCl/codeine|No|No|No|No|90%|27808006502|PROMETHAZINE-CODEINE SOLUTION|473|ML|.02454|10/21/2020||Yes|No||10/21/2020||Yes|No|10/21/2020||Yes|No||||No|No|||Prescription required|No||183|Yes|.04109|03/29/2022|.0401|03/29/2022|.04037|03/29/2022|||COUGH AND COLD: NARCOTIC|8660|||||No|No||TRIS PHARMA INC|No||||
morphine sulfate|No|No|No|No|90%|27808008201|MORPHINE SULF 100 MG/5 ML CONC|30|ML|.16483|11/03/2015||Yes|No||11/03/2015||Yes|No|11/03/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|109|Yes|.3028|03/29/2022|.29553|03/29/2022|.2975|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8661|||||No|No||TRIS PHARMA INC|No||||
morphine sulfate|No|No|No|No|90%|27808008202|MORPHINE SULF 100 MG/5 ML CONC|120|ML|.16483|11/03/2015||Yes|No||11/03/2015||Yes|No|11/03/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|109|Yes|.27485|03/29/2022|.26825|03/29/2022|.27004|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8662|||||No|No||TRIS PHARMA INC|No||||
dextroamphetamine sulfate|No|No|No|No|75%|27808008501|DEXTROAMPHETAMINE 5 MG/5 ML|473|ML|.65363|07/16/2013||Yes|No||07/16/2013||Yes|No|07/16/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.42657|10/26/2021|1.39233|10/26/2021|1.4016|10/26/2021|||STIMULANTS AND RELATED AGENTS|8663|||||No|No||TRIS PHARMA INC|No||||
hydrocodone/chlorphen p-stirex|No|No|No|No|90%|27808008601|HYDROCODONE-CHLORPHEN ER SUSP|115|ML|.21125|10/13/2015||Yes|No||10/13/2015||Yes|No|10/13/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|183|Yes|.45333|03/29/2022|.44245|03/29/2022|.44539|03/29/2022|||COUGH AND COLD: NARCOTIC|8664|||||No|No||TRIS PHARMA INC|No||||
hydrocodone/chlorphen p-stirex|No|No|No|No|90%|27808008602|HYDROCODONE-CHLORPHEN ER SUSP|473|ML|.20726|10/13/2015||Yes|No||10/13/2015||Yes|No|10/13/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|183|Yes|.43216|03/29/2022|.42178|03/29/2022|.42459|03/29/2022|||COUGH AND COLD: NARCOTIC|8665|||||No|No||TRIS PHARMA INC|No||||
dexmethylphenidate HCl|No|No|No|No|75%|27808009101|DEXMETHYLPHENIDATE 2.5 MG TAB|100|EA|.086|12/20/2017||Yes|No||12/20/2017||Yes|No|12/20/2017||Yes|No||||No|No|||Prescription required|No||007|Yes|.13596|03/29/2022|.13269|03/29/2022|.13358|03/29/2022|||STIMULANTS AND RELATED AGENTS|8666|||||No|No||TRIS PHARMA INC|No||||
dexmethylphenidate HCl|No|No|No|No|75%|27808009201|DEXMETHYLPHENIDATE 5 MG TAB|100|EA|.129|12/20/2017||Yes|No||12/20/2017||Yes|No|12/20/2017||Yes|No||||No|No|||Prescription required|No||007|Yes|.16938|03/29/2022|.16531|03/29/2022|.16641|03/29/2022|||STIMULANTS AND RELATED AGENTS|8667|||||No|No||TRIS PHARMA INC|No||||
dexmethylphenidate HCl|No|No|No|No|75%|27808009301|DEXMETHYLPHENIDATE 10 MG TAB|100|EA|.172|12/20/2017||Yes|No||12/20/2017||Yes|No|12/20/2017||Yes|No||||No|No|||Prescription required|No||007|Yes|.29016|03/29/2022|.28319|03/29/2022|.28508|03/29/2022|||STIMULANTS AND RELATED AGENTS|8668|||||No|No||TRIS PHARMA INC|No||||
amphetamine|No|No|No|No|75%|27808010201|DYANAVEL XR 2.5 MG/ML SUSP|464|ML|1.24365|06/22/2016||Yes|No||06/22/2016||Yes|No|06/22/2016||Yes|No||||No|No|||Prescription required|No||007|Yes|2.77678|01/11/2022|2.71013|01/11/2022|2.72818|01/11/2022|||STIMULANTS AND RELATED AGENTS|8669|||||No|No||TRIS PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|27808011401|HYDROCODONE-ACETAMIN 5-300 MG|100|EA|.172|12/20/2017||Yes|No||12/20/2017||Yes|No|12/20/2017||Yes|No||||No|No|||Prescription required|No||109|Yes|.19231|03/29/2022|.18769|03/29/2022|.18894|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8670|||||No|No||TRIS PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|27808011402|HYDROCODONE-ACETAMIN 5-300 MG|500|EA|.172|12/20/2017||Yes|No||12/20/2017||Yes|No|12/20/2017||Yes|No||||No|No|||Prescription required|No||109|Yes|.19231|03/29/2022|.18769|03/29/2022|.18894|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8671|||||No|No||TRIS PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|27808011501|HYDROCODONE-ACETAMIN 7.5-300|100|EA|.1935|12/20/2017||Yes|No||12/20/2017||Yes|No|12/20/2017||Yes|No||||No|No|||Prescription required|No||109|Yes|.2429|03/29/2022|.23707|03/29/2022|.23864|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8672|||||No|No||TRIS PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|27808011502|HYDROCODONE-ACETAMIN 7.5-300|500|EA|.1935|12/20/2017||Yes|No||12/20/2017||Yes|No|12/20/2017||Yes|No||||No|No|||Prescription required|No||109|Yes|.2429|03/29/2022|.23707|03/29/2022|.23864|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8673|||||No|No||TRIS PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|27808011601|HYDROCODONE-ACETAMIN 10-300 MG|100|EA|.2107|12/20/2017||Yes|No||12/20/2017||Yes|No|12/20/2017||Yes|No||||No|No|||Prescription required|No||109|Yes|.34815|03/29/2022|.33979|03/29/2022|.34205|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8674|||||No|No||TRIS PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|27808011602|HYDROCODONE-ACETAMIN 10-300 MG|500|EA|.2107|12/20/2017||Yes|No||12/20/2017||Yes|No|12/20/2017||Yes|No||||No|No|||Prescription required|No||109|Yes|.34815|03/29/2022|.33979|03/29/2022|.34205|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8675|||||No|No||TRIS PHARMA INC|No||||
rosuvastatin calcium|No|No|No|No|75%|27808015501|ROSUVASTATIN CALCIUM 5 MG TAB|90|EA|.04777|10/20/2020||Yes|No||10/20/2020||Yes|No|10/20/2020||Yes|No||||No|No|||Prescription required|No||063|Yes|.06753|03/29/2022|.0659|03/29/2022|.06634|03/29/2022|||LIPOTROPICS: STATINS|8676|||||No|No||TRIS PHARMA INC|No||||
rosuvastatin calcium|No|No|No|No|75%|27808015503|ROSUVASTATIN CALCIUM 5 MG TAB|500|EA|.04778|10/20/2020||Yes|No||10/20/2020||Yes|No|10/20/2020||Yes|No||||No|No|||Prescription required|No||063|Yes|.06753|03/29/2022|.0659|03/29/2022|.06634|03/29/2022|||LIPOTROPICS: STATINS|8677|||||No|No||TRIS PHARMA INC|No||||
rosuvastatin calcium|No|No|No|No|75%|27808015601|ROSUVASTATIN CALCIUM 10 MG TAB|90|EA|.04777|10/20/2020||Yes|No||10/20/2020||Yes|No|10/20/2020||Yes|No||||No|No|||Prescription required|No||063|Yes|.05981|03/29/2022|.05837|03/29/2022|.05876|03/29/2022|||LIPOTROPICS: STATINS|8678|||||No|No||TRIS PHARMA INC|No||||
rosuvastatin calcium|No|No|No|No|75%|27808015603|ROSUVASTATIN CALCIUM 10 MG TAB|500|EA|.04778|10/20/2020||Yes|No||10/20/2020||Yes|No|10/20/2020||Yes|No||||No|No|||Prescription required|No||063|Yes|.05981|03/29/2022|.05837|03/29/2022|.05876|03/29/2022|||LIPOTROPICS: STATINS|8679|||||No|No||TRIS PHARMA INC|No||||
rosuvastatin calcium|No|No|No|No|75%|27808015701|ROSUVASTATIN CALCIUM 20 MG TAB|90|EA|.04777|10/20/2020||Yes|No||10/20/2020||Yes|No|10/20/2020||Yes|No||||No|No|||Prescription required|No||063|Yes|.07822|03/29/2022|.07634|03/29/2022|.07685|03/29/2022|||LIPOTROPICS: STATINS|8680|||||No|No||TRIS PHARMA INC|No||||
rosuvastatin calcium|No|No|No|No|75%|27808015703|ROSUVASTATIN CALCIUM 20 MG TAB|500|EA|.04778|10/20/2020||Yes|No||10/20/2020||Yes|No|10/20/2020||Yes|No||||No|No|||Prescription required|No||063|Yes|.07822|03/29/2022|.07634|03/29/2022|.07685|03/29/2022|||LIPOTROPICS: STATINS|8681|||||No|No||TRIS PHARMA INC|No||||
rosuvastatin calcium|No|No|No|No|75%|27808015801|ROSUVASTATIN CALCIUM 40 MG TAB|30|EA|.07166|10/20/2020||Yes|No||10/20/2020||Yes|No|10/20/2020||Yes|No||||No|No|||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|8682|||||No|No||TRIS PHARMA INC|No||||
rosuvastatin calcium|No|No|No|No|75%|27808015803|ROSUVASTATIN CALCIUM 40 MG TAB|500|EA|.07166|10/20/2020||Yes|No||10/20/2020||Yes|No|10/20/2020||Yes|No||||No|No|||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|8683|||||No|No||TRIS PHARMA INC|No||||
colesevelam HCl|No|No|No|No|75%|27808019001|COLESEVELAM 625 MG TABLET|180|EA|.17916|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|055|No|.48654|03/29/2022|.47486|03/29/2022|.47802|03/29/2022|||LIPOTROPICS: OTHER|8684|||||No|No||TRIS PHARMA INC|No||||
febuxostat|No|No|No|No|75%|27808020601|FEBUXOSTAT 40 MG TABLET|30|EA|.50166|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|231|No|.89466|03/29/2022|.87318|03/29/2022|.879|03/29/2022|||ANTIHYPERURICEMICS|8685|||||No|No||TRIS PHARMA INC|No||||
febuxostat|No|No|No|No|75%|27808020701|FEBUXOSTAT 80 MG TABLET|30|EA|.50166|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|231|No|.93355|03/29/2022|.91114|03/29/2022|.91721|03/29/2022|||ANTIHYPERURICEMICS|8686|||||No|No||TRIS PHARMA INC|No||||
triprolidine HCl|No|No|No|No|75%|28595080130|HISTEX PD 0.938 MG/ML DROP|30|ML|.7332|03/17/2014||Yes|No||||No|No|03/17/2014||Yes|No||||No|No|||Over the counter|No||574|Yes|.49773|03/29/2022|.48578|03/29/2022|.48901|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|8687|||||No|No||ALLEGIS PHARMAC|No||||
triprolidine HCl|No|No|No|No|75%|28595080208|HISTEX 2.5 MG/5 ML SYRUP|237|ML|.15188|03/17/2014||Yes|No||||No|No|03/17/2014||Yes|No||||No|No|||Over the counter|No||574|Yes|||||||.40344|06/01/2016|ANTIHISTAMINES: FIRST GENERATION|8688|||||No|No||ALLEGIS PHARMAC|No||||
phenylephrine HCl/triprolidine|No|No|No|No|75%|28595080316|HISTEX-PE SYRUP|473|ML|.05918|08/20/2014||Yes|No||||No|No|08/20/2014||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|||||||.15722|06/01/2016|COUGH AND COLD: COLD|8689|||||No|No||ALLEGIS PHARMAC|No||||
triprolidine/phenylephrine/DM|No|No|No|No|75%|28595080416|HISTEX-DM SYRUP|473|ML|.05918|08/20/2014||Yes|No||||No|No|08/20/2014||Yes|No||||No|No|||Over the counter|No||184|Yes|||||||.15092|01/23/2018|COUGH AND COLD: NON-NARCOTIC|8690|||||No|No||ALLEGIS PHARMAC|No||||
brompheniramine/phenylephrine|No|No|No|No|75%|28595090060|RU-HIST D 10-4 MG TABLET|60|EA|.30809|01/17/2014||Yes|No||||No|No|01/17/2014||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|.70217|12/24/2019|.69213|12/24/2019|.65918|12/24/2019|||COUGH AND COLD: COLD|8691|||||No|No||ALLEGIS PHARMAC|No||||
theophylline anhydrous|No|No|No|No|75%|29033000101|THEOPHYLLINE ER 400 MG TABLET|100|EA|.52537|08/11/2020||Yes|No||08/11/2020||Yes|No|08/11/2020||Yes|No||||No|No|||Prescription required|No|||Yes|.77069|03/29/2022|.75219|03/29/2022|.7572|03/29/2022||||8692|||||No|No||NOSTRUM LABORAT|No||||
theophylline anhydrous|No|No|No|No|75%|29033000201|THEOPHYLLINE ER 600 MG TABLET|100|EA|.75916|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|No|||Yes|1.3129|11/23/2021|1.28139|11/23/2021|1.28992|11/23/2021||||8693|||||No|No||NOSTRUM LABORAT|No||||
sucralfate|No|No|No|No|75%|29033000301|SUCRALFATE 1 GM TABLET|100|EA|.1262|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|No|||No|.19448|03/29/2022|.18981|03/29/2022|.19107|03/29/2022||||8694|||||No|No||NOSTRUM LABORAT|No||||
sucralfate|No|No|No|No|75%|29033000305|SUCRALFATE 1 GM TABLET|500|EA|.1204|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|No|||No|.19448|03/29/2022|.18981|03/29/2022|.19107|03/29/2022||||8695|||||No|No||NOSTRUM LABORAT|No||||
carbamazepine|No|No|No|No|75%|29033000412|CARBAMAZEPINE ER 300 MG CAP|120|EA|.70383|09/28/2020||Yes|No||09/28/2020||Yes|No|09/28/2020||Yes|No||||No|No|||Prescription required|No||056|No|1.17876|03/29/2022|1.15046|03/29/2022|1.15813|03/29/2022|||ANTICONVULSANTS|8696|||||No|No||NOSTRUM LABORAT|No||||
piroxicam|No|No|No|No|75%|29033001201|PIROXICAM 10 MG CAPSULE|100|EA|.2635|10/01/2017||Yes|No||10/01/2017||Yes|No|10/01/2017||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.25876|03/01/2022|.25254|03/01/2022|.25423|03/01/2022|||NSAIDS|8697|||||No|No||NOSTRUM LABORAT|No||||
piroxicam|No|No|No|No|75%|29033001301|PIROXICAM 20 MG CAPSULE|100|EA|.46027|10/01/2017||Yes|No||10/01/2017||Yes|No|10/01/2017||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.40758|03/29/2022|.39779|03/29/2022|.40044|03/29/2022|||NSAIDS|8698|||||No|No||NOSTRUM LABORAT|No||||
carbamazepine|No|No|No|No|75%|29033001912|CARBAMAZEPINE ER 100 MG CAP|120|EA|.70383|09/24/2020||Yes|No||09/24/2020||Yes|No|09/24/2020||Yes|No||||No|No|||Prescription required|No||056|No|1.01422|03/29/2022|.98987|03/29/2022|.99647|03/29/2022|||ANTICONVULSANTS|8699|||||No|No||NOSTRUM LABORAT|No||||
carbamazepine|No|No|No|No|75%|29033002012|CARBAMAZEPINE ER 200 MG CAP|120|EA|.70383|09/28/2020||Yes|No||09/28/2020||Yes|No|09/28/2020||Yes|No||||No|No|||Prescription required|No||056|No|1.08329|03/29/2022|1.05729|03/29/2022|1.06433|03/29/2022|||ANTICONVULSANTS|8700|||||No|No||NOSTRUM LABORAT|No||||
calcium acetate|No|No|No|No|75%|29033002602|CALCIUM ACETATE 667 MG CAPSULE|200|EA|.30177|11/10/2016||Yes|No||11/10/2016||Yes|No|11/10/2016||Yes|No||||No|No|||Prescription required|No||052|Yes|.28113|03/29/2022|.27438|03/29/2022|.27621|03/29/2022|||PHOSPHATE BINDERS|8701|||||No|No||NOSTRUM LABORAT|No||||
acetazolamide|No|No|No|No|75%|29033003001|ACETAZOLAMIDE ER 500 MG CAP|100|EA|.5375|09/19/2016||Yes|No||09/19/2016||Yes|No|09/19/2016||Yes|No||||No|No|||Prescription required|No|||No|.39876|03/29/2022|.38918|03/29/2022|.39178|03/29/2022||||8702|||||No|No||NOSTRUM LABORAT|No||||
metformin HCl|No|No|No|No|75%|29033003106|METFORMIN ER 500 MG OSMOTIC TB|60|EA|1.43333|08/31/2018||Yes|No||08/31/2018||Yes|No|08/31/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|012|No|.70527|01/25/2022|.68834|01/25/2022|.69292|01/25/2022|||HYPOGLYCEMICS: METFORMINS|8703|||||No|No||NOSTRUM LABORAT|No||||
metformin HCl|No|No|No|No|75%|29033003206|METFORMIN ER 1,000 MG OSM-TAB|60|EA|1.79166|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|012|No|1.48331|03/29/2022|1.44771|03/29/2022|1.45735|03/29/2022|||HYPOGLYCEMICS: METFORMINS|8704|||||No|No||NOSTRUM LABORAT|No||||
dapsone|No|No|No|No|75%|29033003630|DAPSONE 25 MG TABLET|30|EA|.84781|11/15/2016||Yes|No||11/15/2016||Yes|No|11/15/2016||Yes|No||||No|No|||Prescription required|No|||No|.52333|03/29/2022|.51077|03/29/2022|.51417|03/29/2022||||8705|||||No|No||NOSTRUM LABORAT|No||||
dapsone|No|No|No|No|75%|29033003730|DAPSONE 100 MG TABLET|30|EA|1.03988|10/06/2016||Yes|No||10/06/2016||Yes|No|10/06/2016||Yes|No||||No|No|||Prescription required|No|||No|.77747|03/29/2022|.75881|03/29/2022|.76386|03/29/2022||||8706|||||No|No||NOSTRUM LABORAT|No||||
venlafaxine HCl|No|No|No|No|75%|29033004530|VENLAFAXINE HCL ER 150 MG TAB|30|EA|1.22851|08/30/2019||Yes|No||08/30/2019||Yes|No|08/30/2019||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|031|No|2.65947|03/29/2022|2.59564|03/29/2022|2.61292|03/29/2022|||ANTIDEPRESSANTS: OTHER|8707|||||No|No||NOSTRUM LABORAT|No||||
venlafaxine HCl|No|No|No|No|75%|29033004590|VENLAFAXINE HCL ER 150 MG TAB|90|EA|1.22851|08/30/2019||Yes|No||08/30/2019||Yes|No|08/30/2019||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|031|No|2.65947|03/29/2022|2.59564|03/29/2022|2.61292|03/29/2022|||ANTIDEPRESSANTS: OTHER|8708|||||No|No||NOSTRUM LABORAT|No||||
venlafaxine HCl|No|No|No|No|75%|29033004630|VENLAFAXINE HCL ER 225 MG TAB|30|EA|2.58917|06/01/2017||Yes|No||06/01/2017||Yes|No|06/01/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|031|No|3.46235|03/29/2022|3.37925|03/29/2022|3.40175|03/29/2022|||ANTIDEPRESSANTS: OTHER|8709|||||No|No||NOSTRUM LABORAT|No||||
venlafaxine HCl|No|No|No|No|75%|29033004690|VENLAFAXINE HCL ER 225 MG TAB|90|EA|2.58912|08/30/2019||Yes|No||08/30/2019||Yes|No|08/30/2019||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|031|No|3.46235|03/29/2022|3.37925|03/29/2022|3.40175|03/29/2022|||ANTIDEPRESSANTS: OTHER|8710|||||No|No||NOSTRUM LABORAT|No||||
metformin HCl|No|No|No|No|75%|29033005601|METFORMIN HCL ER 750 MG TABLET|100|EA|.55543|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|No||012|No|.09354|03/29/2022|.09129|03/29/2022|.0919|03/29/2022|||HYPOGLYCEMICS: METFORMINS|8711|||||No|No||NOSTRUM LABORAT|No||||
carisoprodol|No|No|No|No|90%|29033020701|CARISOPRODOL 250 MG TABLET|100|EA|1.13722|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|Yes|1.00427|03/29/2022|.98016|03/29/2022|.98669|03/29/2022|||SKELETAL MUSCLE RELAXANTS|8712|||||No|No||NOSTRUM LABORAT|No||||
lamotrigine|No|No|No|No|75%|29300011101|LAMOTRIGINE 25 MG TABLET|100|EA|.02592|12/01/2012||Yes|No||12/01/2012||Yes|No|12/01/2012||Yes|No||||No|No|||Prescription required|No||056|No|.03514|03/29/2022|.03429|03/29/2022|.03452|03/29/2022|||ANTICONVULSANTS|8713|||||No|No||UNICHEM PHARMAC|No||||
lamotrigine|No|No|No|No|75%|29300011105|LAMOTRIGINE 25 MG TABLET|500|EA|.02463|12/01/2012||Yes|No||12/01/2012||Yes|No|12/01/2012||Yes|No||||No|No|||Prescription required|No||056|No|.03514|03/29/2022|.03429|03/29/2022|.03452|03/29/2022|||ANTICONVULSANTS|8714|||||No|No||UNICHEM PHARMAC|No||||
lamotrigine|No|No|No|No|75%|29300011110|LAMOTRIGINE 25 MG TABLET|1000|EA|.02456|12/01/2012||Yes|No||12/01/2012||Yes|No|12/01/2012||Yes|No||||No|No|||Prescription required|No||056|No|.03514|03/29/2022|.03429|03/29/2022|.03452|03/29/2022|||ANTICONVULSANTS|8715|||||No|No||UNICHEM PHARMAC|No||||
lamotrigine|No|No|No|No|75%|29300011201|LAMOTRIGINE 100 MG TABLET|100|EA|.03096|12/01/2012||Yes|No||12/01/2012||Yes|No|12/01/2012||Yes|No||||No|No|||Prescription required|No||056|No|.06403|03/29/2022|.06249|03/29/2022|.0629|03/29/2022|||ANTICONVULSANTS|8716|||||No|No||UNICHEM PHARMAC|No||||
lamotrigine|No|No|No|No|75%|29300011205|LAMOTRIGINE 100 MG TABLET|500|EA|.0301|12/01/2012||Yes|No||12/01/2012||Yes|No|12/01/2012||Yes|No||||No|No|||Prescription required|No||056|No|.06403|03/29/2022|.06249|03/29/2022|.0629|03/29/2022|||ANTICONVULSANTS|8717|||||No|No||UNICHEM PHARMAC|No||||
lamotrigine|No|No|No|No|75%|29300011210|LAMOTRIGINE 100 MG TABLET|1000|EA|.02973|12/01/2012||Yes|No||12/01/2012||Yes|No|12/01/2012||Yes|No||||No|No|||Prescription required|No||056|No|.06403|03/29/2022|.06249|03/29/2022|.0629|03/29/2022|||ANTICONVULSANTS|8718|||||No|No||UNICHEM PHARMAC|No||||
lamotrigine|No|No|No|No|75%|29300011305|LAMOTRIGINE 150 MG TABLET|500|EA|.04453|12/01/2012||Yes|No||12/01/2012||Yes|No|12/01/2012||Yes|No||||No|No|||Prescription required|No||056|No|.0888|03/29/2022|.08666|03/29/2022|.08724|03/29/2022|||ANTICONVULSANTS|8719|||||No|No||UNICHEM PHARMAC|No||||
lamotrigine|No|No|No|No|75%|29300011316|LAMOTRIGINE 150 MG TABLET|60|EA|.04593|12/01/2012||Yes|No||12/01/2012||Yes|No|12/01/2012||Yes|No||||No|No|||Prescription required|No||056|No|.0888|03/29/2022|.08666|03/29/2022|.08724|03/29/2022|||ANTICONVULSANTS|8720|||||No|No||UNICHEM PHARMAC|No||||
lamotrigine|No|No|No|No|75%|29300011405|LAMOTRIGINE 200 MG TABLET|500|EA|.06099|12/01/2012||Yes|No||12/01/2012||Yes|No|12/01/2012||Yes|No||||No|No|||Prescription required|No||056|No|.10103|03/29/2022|.0986|03/29/2022|.09926|03/29/2022|||ANTICONVULSANTS|8721|||||No|No||UNICHEM PHARMAC|No||||
lamotrigine|No|No|No|No|75%|29300011416|LAMOTRIGINE 200 MG TABLET|60|EA|.06005|12/01/2012||Yes|No||12/01/2012||Yes|No|12/01/2012||Yes|No||||No|No|||Prescription required|No||056|No|.10103|03/29/2022|.0986|03/29/2022|.09926|03/29/2022|||ANTICONVULSANTS|8722|||||No|No||UNICHEM PHARMAC|No||||
topiramate|No|No|No|No|75%|29300011505|TOPIRAMATE 25 MG TABLET|500|EA|.02881|12/13/2016||Yes|No||12/13/2016||Yes|No|12/13/2016||Yes|No||||No|No|||Prescription required|No||056|No|.03423|03/29/2022|.0334|03/29/2022|.03363|03/29/2022|||ANTICONVULSANTS|8723|||||No|No||UNICHEM PHARMAC|No||||
topiramate|No|No|No|No|75%|29300011510|TOPIRAMATE 25 MG TABLET|1000|EA|.02644|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|No||056|No|.03423|03/29/2022|.0334|03/29/2022|.03363|03/29/2022|||ANTICONVULSANTS|8724|||||No|No||UNICHEM PHARMAC|No||||
topiramate|No|No|No|No|75%|29300011516|TOPIRAMATE 25 MG TABLET|60|EA|.03726|12/13/2016||Yes|No||12/13/2016||Yes|No|12/13/2016||Yes|No||||No|No|||Prescription required|No||056|No|.03423|03/29/2022|.0334|03/29/2022|.03363|03/29/2022|||ANTICONVULSANTS|8725|||||No|No||UNICHEM PHARMAC|No||||
topiramate|No|No|No|No|75%|29300011605|TOPIRAMATE 50 MG TABLET|500|EA|.0387|12/13/2016||Yes|No||12/13/2016||Yes|No|12/13/2016||Yes|No||||No|No|||Prescription required|No||056|No|.04588|03/29/2022|.04477|03/29/2022|.04507|03/29/2022|||ANTICONVULSANTS|8726|||||No|No||UNICHEM PHARMAC|No||||
topiramate|No|No|No|No|75%|29300011610|TOPIRAMATE 50 MG TABLET|1000|EA|.03827|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|No||056|No|.04588|03/29/2022|.04477|03/29/2022|.04507|03/29/2022|||ANTICONVULSANTS|8727|||||No|No||UNICHEM PHARMAC|No||||
topiramate|No|No|No|No|75%|29300011616|TOPIRAMATE 50 MG TABLET|60|EA|.05375|12/13/2016||Yes|No||12/13/2016||Yes|No|12/13/2016||Yes|No||||No|No|||Prescription required|No||056|No|.04588|03/29/2022|.04477|03/29/2022|.04507|03/29/2022|||ANTICONVULSANTS|8728|||||No|No||UNICHEM PHARMAC|No||||
topiramate|No|No|No|No|75%|29300011705|TOPIRAMATE 100 MG TABLET|500|EA|.06428|12/13/2016||Yes|No||12/13/2016||Yes|No|12/13/2016||Yes|No||||No|No|||Prescription required|No||056|No|.06953|03/29/2022|.06786|03/29/2022|.06831|03/29/2022|||ANTICONVULSANTS|8729|||||No|No||UNICHEM PHARMAC|No||||
topiramate|No|No|No|No|75%|29300011710|TOPIRAMATE 100 MG TABLET|1000|EA|.06396|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|No||056|No|.06953|03/29/2022|.06786|03/29/2022|.06831|03/29/2022|||ANTICONVULSANTS|8730|||||No|No||UNICHEM PHARMAC|No||||
topiramate|No|No|No|No|75%|29300011716|TOPIRAMATE 100 MG TABLET|60|EA|.08241|12/13/2016||Yes|No||12/13/2016||Yes|No|12/13/2016||Yes|No||||No|No|||Prescription required|No||056|No|.06953|03/29/2022|.06786|03/29/2022|.06831|03/29/2022|||ANTICONVULSANTS|8731|||||No|No||UNICHEM PHARMAC|No||||
topiramate|No|No|No|No|75%|29300011816|TOPIRAMATE 200 MG TABLET|60|EA|.13186|01/29/2016||Yes|No||01/29/2016||Yes|No|01/29/2016||Yes|No||||No|No|||Prescription required|No||056|No|.12326|03/29/2022|.1203|03/29/2022|.1211|03/29/2022|||ANTICONVULSANTS|8732|||||No|No||UNICHEM PHARMAC|No||||
meloxicam|No|No|No|No|75%|29300012401|MELOXICAM 7.5 MG TABLET|100|EA|.0172|08/26/2009||Yes|No||08/26/2009||Yes|No|08/26/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|No||059|Yes|.02308|03/29/2022|.02252|03/29/2022|.02267|03/29/2022|||NSAIDS|8733|||||No|No||UNICHEM PHARMAC|No||||
meloxicam|No|No|No|No|75%|29300012410|MELOXICAM 7.5 MG TABLET|1000|EA|.01616|08/26/2009||Yes|No||08/26/2009||Yes|No|08/26/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|No||059|Yes|.02308|03/29/2022|.02252|03/29/2022|.02267|03/29/2022|||NSAIDS|8734|||||No|No||UNICHEM PHARMAC|No||||
meloxicam|No|No|No|No|75%|29300012501|MELOXICAM 15 MG TABLET|100|EA|.0215|08/26/2009||Yes|No||08/26/2009||Yes|No|08/26/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|No||059|Yes|.02416|03/29/2022|.02358|03/29/2022|.02373|03/29/2022|||NSAIDS|8735|||||No|No||UNICHEM PHARMAC|No||||
meloxicam|No|No|No|No|75%|29300012510|MELOXICAM 15 MG TABLET|1000|EA|.02021|08/26/2009||Yes|No||08/26/2009||Yes|No|08/26/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|No||059|Yes|.02416|03/29/2022|.02358|03/29/2022|.02373|03/29/2022|||NSAIDS|8736|||||No|No||UNICHEM PHARMAC|No||||
bisoprolol fumarate|No|No|No|No|75%|29300012601|BISOPROLOL FUMARATE 5 MG TAB|100|EA|.30164|12/01/2009||Yes|No||12/01/2009||Yes|No|12/01/2009||Yes|No||12/01/2009||Yes|No|||Prescription required|No||070|No|.38321|03/29/2022|.37401|03/29/2022|.3765|03/29/2022|||BETA-BLOCKERS|8737|||||No|No||UNICHEM PHARMAC|No||||
bisoprolol fumarate|No|No|No|No|75%|29300012613|BISOPROLOL FUMARATE 5 MG TAB|30|EA|.31863|12/01/2009||Yes|No||12/01/2009||Yes|No|12/01/2009||Yes|No||12/01/2009||Yes|No|||Prescription required|No||070|No|.38321|03/29/2022|.37401|03/29/2022|.3765|03/29/2022|||BETA-BLOCKERS|8738|||||No|No||UNICHEM PHARMAC|No||||
bisoprolol fumarate|No|No|No|No|75%|29300012701|BISOPROLOL FUMARATE 10 MG TAB|100|EA|.30164|12/01/2009||Yes|No||12/01/2009||Yes|No|12/01/2009||Yes|No||12/01/2009||Yes|No|||Prescription required|No||070|No|.47062|03/29/2022|.45932|03/29/2022|.46238|03/29/2022|||BETA-BLOCKERS|8739|||||No|No||UNICHEM PHARMAC|No||||
bisoprolol fumarate|No|No|No|No|75%|29300012713|BISOPROLOL FUMARATE 10 MG TAB|30|EA|.31863|12/01/2009||Yes|No||12/01/2009||Yes|No|12/01/2009||Yes|No||12/01/2009||Yes|No|||Prescription required|No||070|No|.47062|03/29/2022|.45932|03/29/2022|.46238|03/29/2022|||BETA-BLOCKERS|8740|||||No|No||UNICHEM PHARMAC|No||||
hydrochlorothiazide|Yes|No|No|No|75%|29300012801|HYDROCHLOROTHIAZIDE 25 MG TAB|100|EA|.0172|08/26/2009||Yes|No||08/26/2009||Yes|No|08/26/2009||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No|||Yes|.01337|03/29/2022|.01304|03/29/2022|.01313|03/29/2022||||8741|||||No|No||UNICHEM PHARMAC|No||||
hydrochlorothiazide|Yes|No|No|No|75%|29300012810|HYDROCHLOROTHIAZIDE 25 MG TAB|1000|EA|.0086|08/26/2009||Yes|No||08/26/2009||Yes|No|08/26/2009||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No|||Yes|.01337|03/29/2022|.01304|03/29/2022|.01313|03/29/2022||||8742|||||No|No||UNICHEM PHARMAC|No||||
hydrochlorothiazide|Yes|No|No|No|75%|29300012901|HYDROCHLOROTHIAZIDE 50 MG TAB|100|EA|.02868|08/26/2009||Yes|No||08/26/2009||Yes|No|08/26/2009||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No|||Yes|.02959|03/29/2022|.02887|03/29/2022|.02907|03/29/2022||||8743|||||No|No||UNICHEM PHARMAC|No||||
hydrochlorothiazide|Yes|No|No|No|75%|29300012910|HYDROCHLOROTHIAZIDE 50 MG TAB|1000|EA|.01672|08/26/2009||Yes|No||08/26/2009||Yes|No|08/26/2009||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No|||Yes|.02959|03/29/2022|.02887|03/29/2022|.02907|03/29/2022||||8744|||||No|No||UNICHEM PHARMAC|No||||
hydrochlorothiazide|Yes|No|No|No|75%|29300013001|HYDROCHLOROTHIAZIDE 12.5 MG CP|100|EA|.043|08/15/2010||Yes|No||08/15/2010||Yes|No|08/15/2010||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No|||Yes|.03333|03/29/2022|.03253|03/29/2022|.03274|03/29/2022||||8745|||||No|No||UNICHEM PHARMAC|No||||
hydrochlorothiazide|Yes|No|No|No|75%|29300013005|HYDROCHLOROTHIAZIDE 12.5 MG CP|500|EA|.03306|08/15/2010||Yes|No||08/15/2010||Yes|No|08/15/2010||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No|||Yes|.03333|03/29/2022|.03253|03/29/2022|.03274|03/29/2022||||8746|||||No|No||UNICHEM PHARMAC|No||||
hydrochlorothiazide|Yes|No|No|No|75%|29300013010|HYDROCHLOROTHIAZIDE 12.5 MG CP|1000|EA|.03145|08/15/2010||Yes|No||08/15/2010||Yes|No|08/15/2010||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No|||Yes|.03333|03/29/2022|.03253|03/29/2022|.03274|03/29/2022||||8747|||||No|No||UNICHEM PHARMAC|No||||
zaleplon|No|No|No|No|90%|29300013101|ZALEPLON 5 MG CAPSULE|100|EA|.20425|06/18/2009||Yes|No||06/18/2009||Yes|No|06/18/2009||Yes|No||||No|No|||Prescription required|No||054|Yes|.1639|03/29/2022|.15996|03/29/2022|.16103|03/29/2022|||SEDATIVE HYPNOTICS|8748|||||No|No||UNICHEM PHARMAC|No||||
zaleplon|No|No|No|No|90%|29300013201|ZALEPLON 10 MG CAPSULE|100|EA|.20855|06/18/2009||Yes|No||06/18/2009||Yes|No|06/18/2009||Yes|No||||No|No|||Prescription required|No||054|Yes|.18241|03/29/2022|.17803|03/29/2022|.17921|03/29/2022|||SEDATIVE HYPNOTICS|8749|||||No|No||UNICHEM PHARMAC|No||||
clonidine HCl|No|No|No|No|75%|29300013501|CLONIDINE HCL 0.1 MG TABLET|100|EA|.02261|09/22/2014|08/31/2022|Yes|No||09/22/2014|08/31/2022|Yes|No|09/22/2014|08/31/2022|Yes|No||09/22/2014|08/31/2022|Yes|No|||Prescription required|No||166|No|.03029|03/29/2022|.02956|03/29/2022|.02975|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|8750|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||UNICHEM PHARMAC|No||||
clonidine HCl|No|No|No|No|75%|29300013505|CLONIDINE HCL 0.1 MG TABLET|500|EA|.01823|08/15/2018|08/31/2022|Yes|No||08/15/2018|08/31/2022|Yes|No|08/15/2018|08/31/2022|Yes|No||08/15/2018|08/31/2022|Yes|No|||Prescription required|No||166|No|.03029|03/29/2022|.02956|03/29/2022|.02975|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|8751|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||UNICHEM PHARMAC|No||||
clonidine HCl|No|No|No|No|75%|29300013510|CLONIDINE HCL 0.1 MG TABLET|1000|EA|.01483|09/28/2010|05/31/2022|Yes|No||09/28/2010|05/31/2022|Yes|No|09/28/2010|05/31/2022|Yes|No||01/01/2012|05/31/2022|Yes|No|||Prescription required|No||166|No|.03029|03/29/2022|.02956|03/29/2022|.02975|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|8752|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||UNICHEM PHARMAC|No||||
clonidine HCl|No|No|No|No|75%|29300013601|CLONIDINE HCL 0.2 MG TABLET|100|EA|.02494|09/28/2010||Yes|No||09/28/2010||Yes|No|09/28/2010||Yes|No||01/01/2012||Yes|No|||Prescription required|No||166|No|.0396|03/29/2022|.03864|03/29/2022|.0389|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|8753|||||No|No||UNICHEM PHARMAC|No||||
clonidine HCl|No|No|No|No|75%|29300013605|CLONIDINE HCL 0.2 MG TABLET|500|EA|.02494|08/15/2018||Yes|No||08/15/2018||Yes|No|08/15/2018||Yes|No||08/15/2018||Yes|No|||Prescription required|No||166|No|.0396|03/29/2022|.03864|03/29/2022|.0389|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|8754|||||No|No||UNICHEM PHARMAC|No||||
clonidine HCl|No|No|No|No|75%|29300013610|CLONIDINE HCL 0.2 MG TABLET|1000|EA|.02451|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||05/31/2018||Yes|No|||Prescription required|No||166|No|.0396|03/29/2022|.03864|03/29/2022|.0389|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|8755|||||No|No||UNICHEM PHARMAC|No||||
clonidine HCl|No|No|No|No|75%|29300013701|CLONIDINE HCL 0.3 MG TABLET|100|EA|.04798|09/28/2010||Yes|No||09/28/2010||Yes|No|09/28/2010||Yes|No||01/01/2012||Yes|No|||Prescription required|No||166|No|.03883|03/29/2022|.03789|03/29/2022|.03815|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|8756|||||No|No||UNICHEM PHARMAC|No||||
clonidine HCl|No|No|No|No|75%|29300013705|CLONIDINE HCL 0.3 MG TABLET|500|EA|.02492|08/15/2018||Yes|No||08/15/2018||Yes|No|08/15/2018||Yes|No||08/15/2018||Yes|No|||Prescription required|No||166|No|.03883|03/29/2022|.03789|03/29/2022|.03815|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|8757|||||No|No||UNICHEM PHARMAC|No||||
divalproex sodium|No|No|No|No|75%|29300013801|DIVALPROEX SOD DR 125 MG TAB|100|EA|.07697|11/16/2011||Yes|No||11/16/2011||Yes|No|11/16/2011||Yes|No||11/16/2011||Yes|No|||Prescription required|No||056|No|.06035|03/29/2022|.0589|03/29/2022|.05929|03/29/2022|||ANTICONVULSANTS|8758|||||No|No||UNICHEM PHARMAC|No||||
divalproex sodium|No|No|No|No|75%|29300013805|DIVALPROEX SOD DR 125 MG TAB|500|EA|.07692|11/16/2011||Yes|No||11/16/2011||Yes|No|11/16/2011||Yes|No||11/16/2011||Yes|No|||Prescription required|No||056|No|.06035|03/29/2022|.0589|03/29/2022|.05929|03/29/2022|||ANTICONVULSANTS|8759|||||No|No||UNICHEM PHARMAC|No||||
divalproex sodium|No|No|No|No|75%|29300013901|DIVALPROEX SOD DR 250 MG TAB|100|EA|.15136|11/16/2011||Yes|No||11/16/2011||Yes|No|11/16/2011||Yes|No||11/16/2011||Yes|No|||Prescription required|No||056|No|.07754|03/29/2022|.07567|03/29/2022|.07618|03/29/2022|||ANTICONVULSANTS|8760|||||No|No||UNICHEM PHARMAC|No||||
divalproex sodium|No|No|No|No|75%|29300013905|DIVALPROEX SOD DR 250 MG TAB|500|EA|.15154|11/16/2011||Yes|No||11/16/2011||Yes|No|11/16/2011||Yes|No||11/16/2011||Yes|No|||Prescription required|No||056|No|.07754|03/29/2022|.07567|03/29/2022|.07618|03/29/2022|||ANTICONVULSANTS|8761|||||No|No||UNICHEM PHARMAC|No||||
divalproex sodium|No|No|No|No|75%|29300014001|DIVALPROEX SOD DR 500 MG TAB|100|EA|.27928|11/16/2011||Yes|No||11/16/2011||Yes|No|11/16/2011||Yes|No||11/16/2011||Yes|No|||Prescription required|No||056|No|.13473|03/29/2022|.13149|03/29/2022|.13237|03/29/2022|||ANTICONVULSANTS|8762|||||No|No||UNICHEM PHARMAC|No||||
divalproex sodium|No|No|No|No|75%|29300014005|DIVALPROEX SOD DR 500 MG TAB|500|EA|.27924|11/16/2011||Yes|No||11/16/2011||Yes|No|11/16/2011||Yes|No||11/16/2011||Yes|No|||Prescription required|No||056|No|.13473|03/29/2022|.13149|03/29/2022|.13237|03/29/2022|||ANTICONVULSANTS|8763|||||No|No||UNICHEM PHARMAC|No||||
quetiapine fumarate|No|No|No|No|75%|29300014701|QUETIAPINE FUMARATE 25 MG TAB|100|EA|.03999|02/28/2017||Yes|No||02/28/2017||Yes|No|02/28/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.03239|03/29/2022|.03161|03/29/2022|.03182|03/29/2022|||ANTIPSYCHOTICS|8764|||||No|No||UNICHEM PHARMAC|No||||
quetiapine fumarate|No|No|No|No|75%|29300014710|QUETIAPINE FUMARATE 25 MG TAB|1000|EA|.03598|05/18/2017||Yes|No||05/18/2017||Yes|No|05/18/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.03239|03/29/2022|.03161|03/29/2022|.03182|03/29/2022|||ANTIPSYCHOTICS|8765|||||No|No||UNICHEM PHARMAC|No||||
quetiapine fumarate|No|No|No|No|75%|29300014801|QUETIAPINE FUMARATE 50 MG TAB|100|EA|.06561|02/28/2017||Yes|No||02/28/2017||Yes|No|02/28/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.04283|03/29/2022|.0418|03/29/2022|.04208|03/29/2022|||ANTIPSYCHOTICS|8766|||||No|No||UNICHEM PHARMAC|No||||
quetiapine fumarate|No|No|No|No|75%|29300014810|QUETIAPINE FUMARATE 50 MG TAB|1000|EA|.05903|05/18/2017||Yes|No||05/18/2017||Yes|No|05/18/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.04283|03/29/2022|.0418|03/29/2022|.04208|03/29/2022|||ANTIPSYCHOTICS|8767|||||No|No||UNICHEM PHARMAC|No||||
quetiapine fumarate|No|No|No|No|75%|29300014901|QUETIAPINE FUMARATE 100 MG TAB|100|EA|.06849|02/28/2017||Yes|No||02/28/2017||Yes|No|02/28/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.05826|03/29/2022|.05686|03/29/2022|.05724|03/29/2022|||ANTIPSYCHOTICS|8768|||||No|No||UNICHEM PHARMAC|No||||
quetiapine fumarate|No|No|No|No|75%|29300015001|QUETIAPINE FUMARATE 200 MG TAB|100|EA|.12925|02/28/2017||Yes|No||02/28/2017||Yes|No|02/28/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.10261|03/29/2022|.10014|03/29/2022|.10081|03/29/2022|||ANTIPSYCHOTICS|8769|||||No|No||UNICHEM PHARMAC|No||||
quetiapine fumarate|No|No|No|No|75%|29300015101|QUETIAPINE FUMARATE 300 MG TAB|100|EA|.16942|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.13964|03/29/2022|.13628|03/29/2022|.13719|03/29/2022|||ANTIPSYCHOTICS|8770|||||No|No||UNICHEM PHARMAC|No||||
quetiapine fumarate|No|No|No|No|75%|29300015116|QUETIAPINE FUMARATE 300 MG TAB|60|EA|.16942|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.13964|03/29/2022|.13628|03/29/2022|.13719|03/29/2022|||ANTIPSYCHOTICS|8771|||||No|No||UNICHEM PHARMAC|No||||
quetiapine fumarate|No|No|No|No|75%|29300015201|QUETIAPINE FUMARATE 400 MG TAB|100|EA|.19913|02/28/2017||Yes|No||02/28/2017||Yes|No|02/28/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.17858|03/29/2022|.17429|03/29/2022|.17545|03/29/2022|||ANTIPSYCHOTICS|8772|||||No|No||UNICHEM PHARMAC|No||||
alfuzosin HCl|No|No|No|No|75%|29300015501|ALFUZOSIN HCL ER 10 MG TABLET|100|EA|.1505|02/27/2017||Yes|No||02/27/2017||Yes|No|02/27/2017||Yes|No||||No|No|||Prescription required|No||003|No|.12775|03/29/2022|.12468|03/29/2022|.12551|03/29/2022|||BPH TREATMENTS|8773|||||No|No||UNICHEM PHARMAC|No||||
alfuzosin HCl|No|No|No|No|75%|29300015519|ALFUZOSIN HCL ER 10 MG TABLET|90|EA|.16721|05/18/2017||Yes|No||05/18/2017||Yes|No|05/18/2017||Yes|No||||No|No|||Prescription required|No||003|No|.12775|03/29/2022|.12468|03/29/2022|.12551|03/29/2022|||BPH TREATMENTS|8774|||||No|No||UNICHEM PHARMAC|No||||
tizanidine HCl|No|No|No|No|75%|29300016810|TIZANIDINE HCL 2 MG TABLET|1000|EA|.03587|08/08/2014||Yes|No||08/08/2014||Yes|No|08/08/2014||Yes|No||||No|No|||Prescription required|No||116|No|.06018|03/29/2022|.05873|03/29/2022|.05912|03/29/2022|||SKELETAL MUSCLE RELAXANTS|8775|||||No|No||UNICHEM PHARMAC|No||||
tizanidine HCl|No|No|No|No|75%|29300016815|TIZANIDINE HCL 2 MG TABLET|150|EA|.03583|08/08/2014||Yes|No||08/08/2014||Yes|No|08/08/2014||Yes|No||||No|No|||Prescription required|No||116|No|.06018|03/29/2022|.05873|03/29/2022|.05912|03/29/2022|||SKELETAL MUSCLE RELAXANTS|8776|||||No|No||UNICHEM PHARMAC|No||||
tizanidine HCl|No|No|No|No|75%|29300016903|TIZANIDINE HCL 4 MG TABLET|300|EA|.129|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||||No|No|||Prescription required|No||116|No|.05014|03/29/2022|.04893|03/29/2022|.04926|03/29/2022|||SKELETAL MUSCLE RELAXANTS|8777|||||No|No||UNICHEM PHARMAC|No||||
tizanidine HCl|No|No|No|No|75%|29300016910|TIZANIDINE HCL 4 MG TABLET|1000|EA|.0437|08/08/2014||Yes|No||08/08/2014||Yes|No|08/08/2014||Yes|No||||No|No|||Prescription required|No||116|No|.05014|03/29/2022|.04893|03/29/2022|.04926|03/29/2022|||SKELETAL MUSCLE RELAXANTS|8778|||||No|No||UNICHEM PHARMAC|No||||
tizanidine HCl|No|No|No|No|75%|29300016915|TIZANIDINE HCL 4 MG TABLET|150|EA|.04371|08/08/2014||Yes|No||08/08/2014||Yes|No|08/08/2014||Yes|No||||No|No|||Prescription required|No||116|No|.05014|03/29/2022|.04893|03/29/2022|.04926|03/29/2022|||SKELETAL MUSCLE RELAXANTS|8779|||||No|No||UNICHEM PHARMAC|No||||
memantine HCl|No|No|No|No|75%|29300017105|MEMANTINE HCL 5 MG TABLET|500|EA|.0903|08/12/2016||Yes|No||08/12/2016||Yes|No|08/12/2016||Yes|No||||No|No|||Prescription required|No||011|No|.08825|03/29/2022|.08613|03/29/2022|.0867|03/29/2022|||ALZHEIMER'S AGENTS|8780|||||No|No||UNICHEM PHARMAC|No||||
memantine HCl|No|No|No|No|75%|29300017116|MEMANTINE HCL 5 MG TABLET|60|EA|.1075|12/08/2015||Yes|No||12/08/2015||Yes|No|12/08/2015||Yes|No||||No|No|||Prescription required|No||011|No|.08825|03/29/2022|.08613|03/29/2022|.0867|03/29/2022|||ALZHEIMER'S AGENTS|8781|||||No|No||UNICHEM PHARMAC|No||||
memantine HCl|No|No|No|No|75%|29300017205|MEMANTINE HCL 10 MG TABLET|500|EA|.0903|05/13/2016||Yes|No||05/13/2016||Yes|No|05/13/2016||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|8782|||||No|No||UNICHEM PHARMAC|No||||
memantine HCl|No|No|No|No|75%|29300017216|MEMANTINE HCL 10 MG TABLET|60|EA|.1075|12/08/2015||Yes|No||12/08/2015||Yes|No|12/08/2015||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|8783|||||No|No||UNICHEM PHARMAC|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|29300018701|BISOPROLOL-HCTZ 2.5-6.25 MG TB|100|EA|.22837|02/01/2011||Yes|No||02/01/2011||Yes|No|02/01/2011||Yes|No||02/01/2011||Yes|No|||Prescription required|No||070|Yes|.36234|03/29/2022|.35364|03/29/2022|.35599|03/29/2022|||BETA-BLOCKERS|8784|||||No|No||UNICHEM PHARMAC|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|29300018705|BISOPROLOL-HCTZ 2.5-6.25 MG TB|500|EA|.15756|02/01/2011||Yes|No||02/01/2011||Yes|No|02/01/2011||Yes|No||02/01/2011||Yes|No|||Prescription required|No||070|Yes|.36234|03/29/2022|.35364|03/29/2022|.35599|03/29/2022|||BETA-BLOCKERS|8785|||||No|No||UNICHEM PHARMAC|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|29300018713|BISOPROLOL-HCTZ 2.5-6.25 MG TB|30|EA|.26|02/01/2011||Yes|No||02/01/2011||Yes|No|02/01/2011||Yes|No||02/01/2011||Yes|No|||Prescription required|No||070|Yes|.36234|03/29/2022|.35364|03/29/2022|.35599|03/29/2022|||BETA-BLOCKERS|8786|||||No|No||UNICHEM PHARMAC|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|29300018801|BISOPROLOL-HCTZ 5-6.25 MG TAB|100|EA|.22837|02/01/2011||Yes|No||02/01/2011||Yes|No|02/01/2011||Yes|No||02/01/2011||Yes|No|||Prescription required|No||070|Yes|.33991|03/29/2022|.33175|03/29/2022|.33396|03/29/2022|||BETA-BLOCKERS|8787|||||No|No||UNICHEM PHARMAC|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|29300018805|BISOPROLOL-HCTZ 5-6.25 MG TAB|500|EA|.15756|02/01/2011||Yes|No||02/01/2011||Yes|No|02/01/2011||Yes|No||02/01/2011||Yes|No|||Prescription required|No||070|Yes|.33991|03/29/2022|.33175|03/29/2022|.33396|03/29/2022|||BETA-BLOCKERS|8788|||||No|No||UNICHEM PHARMAC|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|29300018813|BISOPROLOL-HCTZ 5-6.25 MG TAB|30|EA|.26|02/01/2011||Yes|No||02/01/2011||Yes|No|02/01/2011||Yes|No||02/01/2011||Yes|No|||Prescription required|No||070|Yes|.33991|03/29/2022|.33175|03/29/2022|.33396|03/29/2022|||BETA-BLOCKERS|8789|||||No|No||UNICHEM PHARMAC|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|29300018901|BISOPROLOL-HCTZ 10-6.25 MG TAB|100|EA|.22837|02/01/2011||Yes|No||02/01/2011||Yes|No|02/01/2011||Yes|No||02/01/2011||Yes|No|||Prescription required|No||070|Yes|.33843|03/29/2022|.3303|03/29/2022|.3325|03/29/2022|||BETA-BLOCKERS|8790|||||No|No||UNICHEM PHARMAC|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|29300018905|BISOPROLOL-HCTZ 10-6.25 MG TAB|500|EA|.15756|02/01/2011||Yes|No||02/01/2011||Yes|No|02/01/2011||Yes|No||02/01/2011||Yes|No|||Prescription required|No||070|Yes|.33843|03/29/2022|.3303|03/29/2022|.3325|03/29/2022|||BETA-BLOCKERS|8791|||||No|No||UNICHEM PHARMAC|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|29300018913|BISOPROLOL-HCTZ 10-6.25 MG TAB|30|EA|.26|02/01/2011||Yes|No||02/01/2011||Yes|No|02/01/2011||Yes|No||02/01/2011||Yes|No|||Prescription required|No||070|Yes|.33843|03/29/2022|.3303|03/29/2022|.3325|03/29/2022|||BETA-BLOCKERS|8792|||||No|No||UNICHEM PHARMAC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|29300019010|LOSARTAN-HCTZ 50-12.5 MG TAB|1000|EA|.20425|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.18477|03/31/2022|.18033|03/31/2022|.18153|03/31/2022|||ANGIOTENSIN MODULATORS|8793|||||No|No||UNICHEM PHARMAC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|29300019019|LOSARTAN-HCTZ 50-12.5 MG TAB|90|EA|.215|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.18477|03/31/2022|.18033|03/31/2022|.18153|03/31/2022|||ANGIOTENSIN MODULATORS|8794|||||No|No||UNICHEM PHARMAC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|29300019110|LOSARTAN-HCTZ 100-12.5 MG TAB|1000|EA|.28084|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.20878|03/31/2022|.20376|03/31/2022|.20512|03/31/2022|||ANGIOTENSIN MODULATORS|8795|||||No|No||UNICHEM PHARMAC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|29300019119|LOSARTAN-HCTZ 100-12.5 MG TAB|90|EA|.29564|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.20878|03/31/2022|.20376|03/31/2022|.20512|03/31/2022|||ANGIOTENSIN MODULATORS|8796|||||No|No||UNICHEM PHARMAC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|29300019210|LOSARTAN-HCTZ 100-25 MG TAB|1000|EA|.28084|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.21077|03/31/2022|.20571|03/31/2022|.20708|03/31/2022|||ANGIOTENSIN MODULATORS|8797|||||No|No||UNICHEM PHARMAC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|29300019219|LOSARTAN-HCTZ 100-25 MG TAB|90|EA|.29564|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.21077|03/31/2022|.20571|03/31/2022|.20708|03/31/2022|||ANGIOTENSIN MODULATORS|8798|||||No|No||UNICHEM PHARMAC|No||||
montelukast sodium|No|No|No|No|75%|29300022010|MONTELUKAST SOD 10 MG TABLET|1000|EA|.09675|11/15/2016||Yes|No||11/15/2016||Yes|No|11/15/2016||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|8799|||||No|No||UNICHEM PHARMAC|Yes|09/01/2020|||
montelukast sodium|No|No|No|No|75%|29300022013|MONTELUKAST SOD 10 MG TABLET|30|EA|.10965|10/05/2016||Yes|No||10/05/2016||Yes|No|10/05/2016||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|8800|||||No|No||UNICHEM PHARMAC|Yes|09/01/2020|||
montelukast sodium|No|No|No|No|75%|29300022019|MONTELUKAST SOD 10 MG TABLET|90|EA|.10893|11/15/2016||Yes|No||11/15/2016||Yes|No|11/15/2016||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|8801|||||No|No||UNICHEM PHARMAC|Yes|09/01/2020|||
montelukast sodium|No|No|No|No|75%|29300022110|MONTELUKAST SOD 4 MG TAB CHEW|1000|EA|.08647|10/23/2019||Yes|No||10/23/2019||Yes|No|10/23/2019||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|8802|||||No|No||UNICHEM PHARMAC|No||||
montelukast sodium|No|No|No|No|75%|29300022113|MONTELUKAST SOD 4 MG TAB CHEW|30|EA|.09073|10/23/2019||Yes|No||10/23/2019||Yes|No|10/23/2019||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|8803|||||No|No||UNICHEM PHARMAC|No||||
montelukast sodium|No|No|No|No|75%|29300022119|MONTELUKAST SOD 4 MG TAB CHEW|90|EA|.08647|10/23/2019||Yes|No||10/23/2019||Yes|No|10/23/2019||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|8804|||||No|No||UNICHEM PHARMAC|No||||
montelukast sodium|No|No|No|No|75%|29300022210|MONTELUKAST SOD 5 MG TAB CHEW|1000|EA|.08962|10/23/2019||Yes|No||10/23/2019||Yes|No|10/23/2019||Yes|No||||No|No|||Prescription required|No||042|Yes|.08451|03/29/2022|.08248|03/29/2022|.08303|03/29/2022|||LEUKOTRIENE MODIFIERS|8805|||||No|No||UNICHEM PHARMAC|No||||
montelukast sodium|No|No|No|No|75%|29300022213|MONTELUKAST SOD 5 MG TAB CHEW|30|EA|.09302|10/23/2019||Yes|No||10/23/2019||Yes|No|10/23/2019||Yes|No||||No|No|||Prescription required|No||042|Yes|.08451|03/29/2022|.08248|03/29/2022|.08303|03/29/2022|||LEUKOTRIENE MODIFIERS|8806|||||No|No||UNICHEM PHARMAC|No||||
montelukast sodium|No|No|No|No|75%|29300022219|MONTELUKAST SOD 5 MG TAB CHEW|90|EA|.08962|10/23/2019||Yes|No||10/23/2019||Yes|No|10/23/2019||Yes|No||||No|No|||Prescription required|No||042|Yes|.08451|03/29/2022|.08248|03/29/2022|.08303|03/29/2022|||LEUKOTRIENE MODIFIERS|8807|||||No|No||UNICHEM PHARMAC|No||||
metronidazole|Yes|No|No|No|75%|29300022601|METRONIDAZOLE 250 MG TABLET|100|EA|.13059|09/29/2014||Yes|No||09/29/2014||Yes|No|09/29/2014||Yes|No||09/29/2014||Yes|No|09/29/2014||Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|8808|||||No|No||UNICHEM PHARMAC|No||||
metronidazole|Yes|No|No|No|75%|29300022605|METRONIDAZOLE 250 MG TABLET|500|EA|.12407|09/29/2014||Yes|No||09/29/2014||Yes|No|09/29/2014||Yes|No||09/29/2014||Yes|No|09/29/2014||Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|8809|||||No|No||UNICHEM PHARMAC|No||||
metronidazole|Yes|No|No|No|75%|29300022652|METRONIDAZOLE 250 MG TABLET|250|EA|.12667|09/29/2014||Yes|No||09/29/2014||Yes|No|09/29/2014||Yes|No||09/29/2014||Yes|No|09/29/2014||Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|8810|||||No|No||UNICHEM PHARMAC|No||||
metronidazole|Yes|No|No|No|75%|29300022701|METRONIDAZOLE 500 MG TABLET|100|EA|.21908|12/29/2014||Yes|No||12/29/2014||Yes|No|12/29/2014||Yes|No||12/29/2014||Yes|No|12/29/2014||Prescription required|No||115|No|.15479|03/29/2022|.15107|03/29/2022|.15208|03/29/2022|||ANTIBIOTICS: GI|8811|||||No|No||UNICHEM PHARMAC|No||||
metronidazole|Yes|No|No|No|75%|29300022705|METRONIDAZOLE 500 MG TABLET|500|EA|.21491|12/29/2014||Yes|No||12/29/2014||Yes|No|12/29/2014||Yes|No||12/29/2014||Yes|No|12/29/2014||Prescription required|No||115|No|.15479|03/29/2022|.15107|03/29/2022|.15208|03/29/2022|||ANTIBIOTICS: GI|8812|||||No|No||UNICHEM PHARMAC|No||||
metronidazole|Yes|No|No|No|75%|29300022746|METRONIDAZOLE 500 MG TABLET|50|EA|.2193|12/29/2014||Yes|No||12/29/2014||Yes|No|12/29/2014||Yes|No||12/29/2014||Yes|No|12/29/2014||Prescription required|No||115|No|.15479|03/29/2022|.15107|03/29/2022|.15208|03/29/2022|||ANTIBIOTICS: GI|8813|||||No|No||UNICHEM PHARMAC|No||||
tolterodine tartrate|No|No|No|No|75%|29300023916|TOLTERODINE TARTRATE 1 MG TAB|60|EA|.35833|06/24/2021||Yes|No||06/24/2021||Yes|No|06/24/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|No|.65955|03/29/2022|.64372|03/29/2022|.648|03/29/2022|||BLADDER RELAXANT PREPARATIONS|8814|||||No|No||UNICHEM PHARMAC|No||||
tolterodine tartrate|No|No|No|No|75%|29300024016|TOLTERODINE TARTRATE 2 MG TAB|60|EA|.35833|06/24/2021||Yes|No||06/24/2021||Yes|No|06/24/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|No|.55522|03/29/2022|.54189|03/29/2022|.5455|03/29/2022|||BLADDER RELAXANT PREPARATIONS|8815|||||No|No||UNICHEM PHARMAC|No||||
amlodipine besylate|Yes|No|No|No|75%|29300024110|AMLODIPINE BESYLATE 2.5 MG TAB|1000|EA|.01181|12/04/2014|04/30/2023|Yes|No||12/04/2014|04/30/2023|Yes|No|12/04/2014|04/30/2023|Yes|No||12/04/2014|04/30/2023|Yes|No|07/01/2016|04/30/2023|Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8816|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||UNICHEM PHARMAC|No||||
amlodipine besylate|Yes|No|No|No|75%|29300024119|AMLODIPINE BESYLATE 2.5 MG TAB|90|EA|.01552|12/04/2014|04/30/2023|Yes|No||12/04/2014|04/30/2023|Yes|No|12/04/2014|04/30/2023|Yes|No||12/04/2014|04/30/2023|Yes|No|07/01/2016|04/30/2023|Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8817|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||UNICHEM PHARMAC|No||||
amlodipine besylate|Yes|No|No|No|75%|29300024205|AMLODIPINE BESYLATE 5 MG TAB|500|EA|.01396|02/18/2015|03/31/2023|Yes|No||02/18/2015|03/31/2023|Yes|No|02/18/2015|03/31/2023|Yes|No||02/18/2015|03/31/2023|Yes|No|07/01/2016|03/31/2023|Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8818|Drug ReNumbered|Drug ReNumbered|Drug ReNumbered|Drug ReNumbered|No|No||UNICHEM PHARMAC|No||||
amlodipine besylate|Yes|No|No|No|75%|29300024210|AMLODIPINE BESYLATE 5 MG TAB|1000|EA|.01326|08/08/2014|03/31/2023|Yes|No||08/08/2014|03/31/2023|Yes|No|08/08/2014|03/31/2023|Yes|No||08/08/2014|03/31/2023|Yes|No|07/01/2016|03/31/2023|Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8819|Drug ReNumbered|Drug ReNumbered|Drug ReNumbered|Drug ReNumbered|No|No||UNICHEM PHARMAC|No||||
amlodipine besylate|Yes|No|No|No|75%|29300024219|AMLODIPINE BESYLATE 5 MG TAB|90|EA|.01743|02/18/2015|03/31/2023|Yes|No||02/18/2015|03/31/2023|Yes|No|02/18/2015|03/31/2023|Yes|No||02/18/2015|03/31/2023|Yes|No|07/01/2016|03/31/2023|Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8820|Drug ReNumbered|Drug ReNumbered|Drug ReNumbered|Drug ReNumbered|No|No||UNICHEM PHARMAC|No||||
amlodipine besylate|Yes|No|No|No|75%|29300024305|AMLODIPINE BESYLATE 10 MG TAB|500|EA|.01935|12/04/2014|04/30/2023|Yes|No||12/04/2014|04/30/2023|Yes|No|12/04/2014|04/30/2023|Yes|No||12/04/2014|04/30/2023|Yes|No|07/01/2016|04/30/2023|Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8821|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||UNICHEM PHARMAC|No||||
buspirone HCl|No|No|No|No|75%|29300024401|BUSPIRONE HCL 5 MG TABLET|100|EA|.02085|06/25/2020||Yes|No||06/25/2020||Yes|No|06/25/2020||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|8822|||||No|No||UNICHEM PHARMAC|No||||
buspirone HCl|No|No|No|No|75%|29300024405|BUSPIRONE HCL 5 MG TABLET|500|EA|.02086|06/25/2020||Yes|No||06/25/2020||Yes|No|06/25/2020||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|8823|||||No|No||UNICHEM PHARMAC|No||||
buspirone HCl|No|No|No|No|75%|29300024501|BUSPIRONE HCL 10 MG TABLET|100|EA|.02992|06/25/2020||Yes|No||06/25/2020||Yes|No|06/25/2020||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|8824|||||No|No||UNICHEM PHARMAC|No||||
buspirone HCl|No|No|No|No|75%|29300024505|BUSPIRONE HCL 10 MG TABLET|500|EA|.02993|06/25/2020||Yes|No||06/25/2020||Yes|No|06/25/2020||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|8825|||||No|No||UNICHEM PHARMAC|No||||
buspirone HCl|No|No|No|No|75%|29300024601|BUSPIRONE HCL 15 MG TABLET|100|EA|.03771|06/25/2020||Yes|No||06/25/2020||Yes|No|06/25/2020||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|8826|||||No|No||UNICHEM PHARMAC|No||||
buspirone HCl|No|No|No|No|75%|29300024605|BUSPIRONE HCL 15 MG TABLET|500|EA|.03751|06/25/2020||Yes|No||06/25/2020||Yes|No|06/25/2020||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|8827|||||No|No||UNICHEM PHARMAC|No||||
buspirone HCl|No|No|No|No|75%|29300024616|BUSPIRONE HCL 15 MG TABLET|60|EA|.03769|06/25/2020||Yes|No||06/25/2020||Yes|No|06/25/2020||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|8828|||||No|No||UNICHEM PHARMAC|No||||
buspirone HCl|No|No|No|No|75%|29300024618|BUSPIRONE HCL 15 MG TABLET|180|EA|.03771|06/25/2020||Yes|No||06/25/2020||Yes|No|06/25/2020||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|8829|||||No|No||UNICHEM PHARMAC|No||||
buspirone HCl|No|No|No|No|75%|29300024705|BUSPIRONE HCL 30 MG TABLET|500|EA|.2236|06/25/2020||Yes|No||06/25/2020||Yes|No|06/25/2020||Yes|No||||No|No|||Prescription required|No||090|No|.17728|03/29/2022|.17302|03/29/2022|.17417|03/29/2022|||ANXIOLYTICS|8830|||||No|No||UNICHEM PHARMAC|No||||
buspirone HCl|No|No|No|No|75%|29300024716|BUSPIRONE HCL 30 MG TABLET|60|EA|.25083|06/25/2020||Yes|No||06/25/2020||Yes|No|06/25/2020||Yes|No||||No|No|||Prescription required|No||090|No|.17728|03/29/2022|.17302|03/29/2022|.17417|03/29/2022|||ANXIOLYTICS|8831|||||No|No||UNICHEM PHARMAC|No||||
piroxicam|No|No|No|No|75%|29300025501|PIROXICAM 10 MG CAPSULE|100|EA|.2865|03/14/2018||Yes|No||03/14/2018||Yes|No|03/14/2018||Yes|No||||No|No|||Prescription required|Yes|10/19/2017|059|Yes|.25876|03/01/2022|.25254|03/01/2022|.25423|03/01/2022|||NSAIDS|8832|||||No|No||UNICHEM PHARMAC|No||||
piroxicam|No|No|No|No|75%|29300025601|PIROXICAM 20 MG CAPSULE|100|EA|.49927|03/14/2018||Yes|No||03/14/2018||Yes|No|03/14/2018||Yes|No||||No|No|||Prescription required|Yes|10/19/2017|059|Yes|.40758|03/29/2022|.39779|03/29/2022|.40044|03/29/2022|||NSAIDS|8833|||||No|No||UNICHEM PHARMAC|No||||
rizatriptan benzoate|No|No|No|No|75%|29300026881|RIZATRIPTAN 5 MG ODT|18|EA|.61346|02/03/2020|07/31/2022|Yes|No||02/03/2020|07/31/2022|Yes|No|02/03/2020|07/31/2022|Yes|No||||No|No|||Prescription required|No||021|No|.80419|03/29/2022|.78488|03/29/2022|.79011|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|8834|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||UNICHEM PHARMAC|No||||
rizatriptan benzoate|No|No|No|No|75%|29300026981|RIZATRIPTAN 10 MG ODT|18|EA|.68417|02/03/2020|07/31/2022|Yes|No||02/03/2020|07/31/2022|Yes|No|02/03/2020|07/31/2022|Yes|No||||No|No|||Prescription required|No||021|No|.80628|03/29/2022|.78692|03/29/2022|.79217|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|8835|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||UNICHEM PHARMAC|No||||
solifenacin succinate|No|No|No|No|75%|29300032813|SOLIFENACIN 5 MG TABLET|30|EA|.14333|06/26/2020||Yes|No||06/26/2020||Yes|No|06/26/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|Yes|.23024|03/29/2022|.22471|03/29/2022|.22621|03/29/2022|||BLADDER RELAXANT PREPARATIONS|8836|||||No|No||UNICHEM PHARMAC|No||||
solifenacin succinate|No|No|No|No|75%|29300032819|SOLIFENACIN 5 MG TABLET|90|EA|.14333|06/26/2020||Yes|No||06/26/2020||Yes|No|06/26/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|Yes|.23024|03/29/2022|.22471|03/29/2022|.22621|03/29/2022|||BLADDER RELAXANT PREPARATIONS|8837|||||No|No||UNICHEM PHARMAC|No||||
solifenacin succinate|No|No|No|No|75%|29300032913|SOLIFENACIN 10 MG TABLET|30|EA|.14333|09/17/2020||Yes|No||09/17/2020||Yes|No|09/17/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|No|.26101|03/29/2022|.25474|03/29/2022|.25644|03/29/2022|||BLADDER RELAXANT PREPARATIONS|8838|||||No|No||UNICHEM PHARMAC|No||||
solifenacin succinate|No|No|No|No|75%|29300032919|SOLIFENACIN 10 MG TABLET|90|EA|.14333|09/17/2020||Yes|No||09/17/2020||Yes|No|09/17/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|No|.26101|03/29/2022|.25474|03/29/2022|.25644|03/29/2022|||BLADDER RELAXANT PREPARATIONS|8839|||||No|No||UNICHEM PHARMAC|No||||
chlorthalidone|No|No|No|No|75%|29300033301|CHLORTHALIDONE 25 MG TABLET|100|EA|.1038|06/29/2021||Yes|No||06/29/2021||Yes|No|06/29/2021||Yes|No||||No|No|||Prescription required|No|||No|.16117|03/29/2022|.1573|03/29/2022|.15834|03/29/2022||||8840|||||No|No||UNICHEM PHARMAC|No||||
chlorthalidone|No|No|No|No|75%|29300033401|CHLORTHALIDONE 50 MG TABLET|100|EA|.12801|06/29/2021||Yes|No||06/29/2021||Yes|No|06/29/2021||Yes|No||||No|No|||Prescription required|No|||No|.3607|03/29/2022|.35204|03/29/2022|.35438|03/29/2022||||8841|||||No|No||UNICHEM PHARMAC|No||||
baclofen|No|No|No|No|75%|29300034301|BACLOFEN 10 MG TABLET|100|EA|.06424|02/25/2021||Yes|No||02/25/2021||Yes|No|02/25/2021||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|8842|||||No|No||UNICHEM PHARMAC|No||||
baclofen|No|No|No|No|75%|29300034310|BACLOFEN 10 MG TABLET|1000|EA|.05919|06/24/2021||Yes|No||06/24/2021||Yes|No|06/24/2021||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|8843|||||No|No||UNICHEM PHARMAC|No||||
baclofen|No|No|No|No|75%|29300034401|BACLOFEN 20 MG TABLET|100|EA|.09941|06/29/2021||Yes|No||06/29/2021||Yes|No|06/29/2021||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|8844|||||No|No||UNICHEM PHARMAC|No||||
baclofen|No|No|No|No|75%|29300034410|BACLOFEN 20 MG TABLET|1000|EA|.09161|06/24/2021||Yes|No||06/24/2021||Yes|No|06/24/2021||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|8845|||||No|No||UNICHEM PHARMAC|No||||
allopurinol|No|No|No|No|75%|29300034901|ALLOPURINOL 100 MG TABLET|100|EA|.0473|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No||01/29/2020||Yes|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|8846|||||No|No||UNICHEM PHARMAC|No||||
allopurinol|No|No|No|No|75%|29300034905|ALLOPURINOL 100 MG TABLET|500|EA|.0473|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No||01/29/2020||Yes|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|8847|||||No|No||UNICHEM PHARMAC|No||||
allopurinol|No|No|No|No|75%|29300035001|ALLOPURINOL 300 MG TABLET|100|EA|.0903|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No||01/29/2020||Yes|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|8848|||||No|No||UNICHEM PHARMAC|No||||
allopurinol|No|No|No|No|75%|29300035005|ALLOPURINOL 300 MG TABLET|500|EA|.08578|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No||01/29/2020||Yes|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|8849|||||No|No||UNICHEM PHARMAC|No||||
tramadol HCl|No|No|No|No|90%|29300035501|TRAMADOL HCL 50 MG TABLET|100|EA|.02021|10/20/2020||Yes|No||10/20/2020||Yes|No|10/20/2020||Yes|No||||No|No|||Prescription required|No||109|Yes|.02459|03/29/2022|.02399|03/29/2022|.02415|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8850|||||No|No||UNICHEM PHARMAC|No||||
tramadol HCl|No|No|No|No|90%|29300035505|TRAMADOL HCL 50 MG TABLET|500|EA|.01978|10/20/2020||Yes|No||10/20/2020||Yes|No|10/20/2020||Yes|No||||No|No|||Prescription required|No||109|Yes|.02459|03/29/2022|.02399|03/29/2022|.02415|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8851|||||No|No||UNICHEM PHARMAC|No||||
tramadol HCl|No|No|No|No|90%|29300035510|TRAMADOL HCL 50 MG TABLET|1000|EA|.01935|10/20/2020||Yes|No||10/20/2020||Yes|No|10/20/2020||Yes|No||||No|No|||Prescription required|No||109|Yes|.02459|03/29/2022|.02399|03/29/2022|.02415|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8852|||||No|No||UNICHEM PHARMAC|No||||
amiodarone HCl|No|No|No|No|75%|29300035905|AMIODARONE HCL 200 MG TABLET|500|EA|.11374|06/29/2021||Yes|No||06/29/2021||Yes|No|06/29/2021||Yes|No||||No|No|||Prescription required|No|||No|.12373|03/29/2022|.12076|03/29/2022|.12156|03/29/2022||||8853|||||No|No||UNICHEM PHARMAC|No||||
amiodarone HCl|No|No|No|No|75%|29300035916|AMIODARONE HCL 200 MG TABLET|60|EA|.1161|06/29/2021||Yes|No||06/29/2021||Yes|No|06/29/2021||Yes|No||||No|No|||Prescription required|No|||No|.12373|03/29/2022|.12076|03/29/2022|.12156|03/29/2022||||8854|||||No|No||UNICHEM PHARMAC|No||||
metformin HCl|No|No|No|No|75%|29300038901|METFORMIN HCL ER 500 MG TABLET|100|EA|.03741|03/29/2022||Yes|No||03/29/2022||Yes|No|03/29/2022||Yes|No||||No|No|||Prescription required|No||012|No|.03646|03/29/2022|.03558|03/29/2022|.03582|03/29/2022|||HYPOGLYCEMICS: METFORMINS|8855|||||No|No||UNICHEM PHARMAC|No||||
metformin HCl|No|No|No|No|75%|29300038905|METFORMIN HCL ER 500 MG TABLET|500|EA|.03607|03/29/2022||Yes|No||03/29/2022||Yes|No|03/29/2022||Yes|No||||No|No|||Prescription required|No||012|No|.03646|03/29/2022|.03558|03/29/2022|.03582|03/29/2022|||HYPOGLYCEMICS: METFORMINS|8856|||||No|No||UNICHEM PHARMAC|No||||
amlodipine besylate|No|No|No|No|75%|29300039605|AMLODIPINE BESYLATE 2.5 MG TAB|500|EA|.01243|02/12/2021||Yes|No||02/12/2021||Yes|No|02/12/2021||Yes|No||02/12/2021||Yes|No|||Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8857|||||No|No||UNICHEM PHARMAC|No||||
amlodipine besylate|No|No|No|No|75%|29300039610|AMLODIPINE BESYLATE 2.5 MG TAB|1000|EA|.01181|07/09/2021||Yes|No||07/09/2021||Yes|No|07/09/2021||Yes|No||||No|No|||Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8858|||||No|No||UNICHEM PHARMAC|No||||
amlodipine besylate|No|No|No|No|75%|29300039619|AMLODIPINE BESYLATE 2.5 MG TAB|90|EA|.01552|06/24/2021||Yes|No||06/24/2021||Yes|No|06/24/2021||Yes|No||||No|No|||Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8859|||||No|No||UNICHEM PHARMAC|No||||
amlodipine besylate|No|No|No|No|75%|29300039705|AMLODIPINE BESYLATE 5 MG TAB|500|EA|.01396|02/12/2021||Yes|No||02/12/2021||Yes|No|02/12/2021||Yes|No||02/12/2021||Yes|No|||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8860|||||No|No||UNICHEM PHARMAC|No||||
amlodipine besylate|No|No|No|No|75%|29300039710|AMLODIPINE BESYLATE 5 MG TAB|1000|EA|.01326|02/12/2021||Yes|No||02/12/2021||Yes|No|02/12/2021||Yes|No||02/12/2021||Yes|No|||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8861|||||No|No||UNICHEM PHARMAC|No||||
amlodipine besylate|No|No|No|No|75%|29300039719|AMLODIPINE BESYLATE 5 MG TAB|90|EA|.01743|02/12/2021||Yes|No||02/12/2021||Yes|No|02/12/2021||Yes|No||02/12/2021||Yes|No|||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8862|||||No|No||UNICHEM PHARMAC|No||||
amlodipine besylate|No|No|No|No|75%|29300039805|AMLODIPINE BESYLATE 10 MG TAB|500|EA|.01935|02/12/2021||Yes|No||02/12/2021||Yes|No|02/12/2021||Yes|No||02/12/2021||Yes|No|||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8863|||||No|No||UNICHEM PHARMAC|No||||
amlodipine besylate|No|No|No|No|75%|29300039810|AMLODIPINE BESYLATE 10 MG TAB|1000|EA|.01892|02/12/2021||Yes|No||02/12/2021||Yes|No|02/12/2021||Yes|No||02/12/2021||Yes|No|||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8864|||||No|No||UNICHEM PHARMAC|No||||
amlodipine besylate|No|No|No|No|75%|29300039819|AMLODIPINE BESYLATE 10 MG TAB|90|EA|.02221|02/12/2021||Yes|No||02/12/2021||Yes|No|02/12/2021||Yes|No||02/12/2021||Yes|No|||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|8865|||||No|No||UNICHEM PHARMAC|No||||
metformin HCl|No|No|No|No|75%|29300039901|METFORMIN HCL ER 750 MG TABLET|100|EA|.0817|03/29/2022||Yes|No||03/29/2022||Yes|No|03/29/2022||Yes|No||||No|No|||Prescription required|No||012|No|.09354|03/29/2022|.09129|03/29/2022|.0919|03/29/2022|||HYPOGLYCEMICS: METFORMINS|8866|||||No|No||UNICHEM PHARMAC|No||||
atenolol/chlorthalidone|No|No|No|No|75%|29300040001|ATENOLOL-CHLORTHALIDONE 50-25|100|EA|.24037|07/09/2021||Yes|No||07/09/2021||Yes|No|07/09/2021||Yes|No||||No|No|||Prescription required|No||070|Yes|.37465|03/29/2022|.36565|03/29/2022|.36809|03/29/2022|||BETA-BLOCKERS|8867|||||No|No||UNICHEM PHARMAC|No||||
atenolol/chlorthalidone|No|No|No|No|75%|29300040101|ATENOLOL-CHLORTHALIDONE 100-25|100|EA|.33759|07/09/2021||Yes|No||07/09/2021||Yes|No|07/09/2021||Yes|No||||No|No|||Prescription required|No||070|Yes|.47415|03/29/2022|.46277|03/29/2022|.46585|03/29/2022|||BETA-BLOCKERS|8868|||||No|No||UNICHEM PHARMAC|No||||
atenolol|No|No|No|No|75%|29300041001|ATENOLOL 25 MG TABLET|100|EA|.01935|06/24/2021||Yes|No||06/24/2021||Yes|No|06/24/2021||Yes|No||06/24/2021||Yes|No|||Prescription required|No||070|No|.02437|03/29/2022|.02378|03/29/2022|.02394|03/29/2022|||BETA-BLOCKERS|8869|||||No|No||UNICHEM PHARMAC|No||||
atenolol|No|No|No|No|75%|29300041005|ATENOLOL 25 MG TABLET|500|EA|.01763|06/24/2021||Yes|No||06/24/2021||Yes|No|06/24/2021||Yes|No||06/24/2021||Yes|No|||Prescription required|No||070|No|.02437|03/29/2022|.02378|03/29/2022|.02394|03/29/2022|||BETA-BLOCKERS|8870|||||No|No||UNICHEM PHARMAC|No||||
atenolol|No|No|No|No|75%|29300041101|ATENOLOL 50 MG TABLET|100|EA|.01935|06/24/2021||Yes|No||06/24/2021||Yes|No|06/24/2021||Yes|No||06/24/2021||Yes|No|||Prescription required|No||070|No|.02861|03/29/2022|.02792|03/29/2022|.0281|03/29/2022|||BETA-BLOCKERS|8871|||||No|No||UNICHEM PHARMAC|No||||
atenolol|No|No|No|No|75%|29300041105|ATENOLOL 50 MG TABLET|500|EA|.01763|06/24/2021||Yes|No||06/24/2021||Yes|No|06/24/2021||Yes|No||06/24/2021||Yes|No|||Prescription required|No||070|No|.02861|03/29/2022|.02792|03/29/2022|.0281|03/29/2022|||BETA-BLOCKERS|8872|||||No|No||UNICHEM PHARMAC|No||||
atenolol|No|No|No|No|75%|29300041201|ATENOLOL 100 MG TABLET|100|EA|.03655|06/29/2021||Yes|No||06/29/2021||Yes|No|06/29/2021||Yes|No||06/29/2021||Yes|No|||Prescription required|No||070|No|.04816|03/29/2022|.047|03/29/2022|.04731|03/29/2022|||BETA-BLOCKERS|8873|||||No|No||UNICHEM PHARMAC|No||||
atenolol|No|No|No|No|75%|29300041205|ATENOLOL 100 MG TABLET|500|EA|.03483|06/24/2021||Yes|No||06/24/2021||Yes|No|06/24/2021||Yes|No||06/24/2021||Yes|No|||Prescription required|No||070|No|.04816|03/29/2022|.047|03/29/2022|.04731|03/29/2022|||BETA-BLOCKERS|8874|||||No|No||UNICHEM PHARMAC|No||||
cyclobenzaprine HCl|No|No|No|No|75%|29300041301|CYCLOBENZAPRINE 5 MG TABLET|100|EA|.0172|06/29/2021||Yes|No||06/29/2021||Yes|No|06/29/2021||Yes|No||||No|No|||Prescription required|No||116|Yes|.02938|03/29/2022|.02867|03/29/2022|.02886|03/29/2022|||SKELETAL MUSCLE RELAXANTS|8875|||||No|No||UNICHEM PHARMAC|No||||
cyclobenzaprine HCl|No|No|No|No|75%|29300041305|CYCLOBENZAPRINE 5 MG TABLET|500|EA|.01118|06/29/2021||Yes|No||06/29/2021||Yes|No|06/29/2021||Yes|No||||No|No|||Prescription required|No||116|Yes|.02938|03/29/2022|.02867|03/29/2022|.02886|03/29/2022|||SKELETAL MUSCLE RELAXANTS|8876|||||No|No||UNICHEM PHARMAC|No||||
cyclobenzaprine HCl|No|No|No|No|75%|29300041319|CYCLOBENZAPRINE 5 MG TABLET|90|EA|.0191|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||116|Yes|.02938|03/31/2022|.02867|03/31/2022|.02886|03/31/2022|||SKELETAL MUSCLE RELAXANTS|8877|||||No|No||UNICHEM PHARMAC|No||||
cyclobenzaprine HCl|No|No|No|No|75%|29300041401|CYCLOBENZAPRINE 7.5 MG TABLET|100|EA|.774|06/29/2021||Yes|No||06/29/2021||Yes|No|06/29/2021||Yes|No||||No|No|||Prescription required|No||116|Yes|1.21617|03/29/2022|1.18698|03/29/2022|1.19488|03/29/2022|||SKELETAL MUSCLE RELAXANTS|8878|||||No|No||UNICHEM PHARMAC|No||||
cyclobenzaprine HCl|No|No|No|No|75%|29300041501|CYCLOBENZAPRINE 10 MG TABLET|100|EA|.01913|06/29/2021||Yes|No||06/29/2021||Yes|No|06/29/2021||Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|8879|||||No|No||UNICHEM PHARMAC|No||||
cyclobenzaprine HCl|No|No|No|No|75%|29300041510|CYCLOBENZAPRINE 10 MG TABLET|1000|EA|.01541|06/29/2021||Yes|No||06/29/2021||Yes|No|06/29/2021||Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|8880|||||No|No||UNICHEM PHARMAC|No||||
cyclobenzaprine HCl|No|No|No|No|75%|29300041519|CYCLOBENZAPRINE 10 MG TABLET|90|EA|.02125|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/31/2022|.02527|03/31/2022|.02544|03/31/2022|||SKELETAL MUSCLE RELAXANTS|8881|||||No|No||UNICHEM PHARMAC|No||||
amitriptyline HCl|No|No|No|No|75%|29300041901|AMITRIPTYLINE HCL 10 MG TAB|100|EA|.04153|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||01/31/2022||Yes|No|||Prescription required|No||215|No|.04811|03/29/2022|.04695|03/29/2022|.04726|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|8882|||||No|No||UNICHEM PHARMAC|No||||
amitriptyline HCl|No|No|No|No|75%|29300041910|AMITRIPTYLINE HCL 10 MG TAB|1000|EA|.03939|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||215|No|.04811|03/31/2022|.04695|03/31/2022|.04726|03/31/2022|||ANTIDEPRESSANTS: TRICYCLIC|8883|||||No|No||UNICHEM PHARMAC|No||||
amitriptyline HCl|No|No|No|No|75%|29300042001|AMITRIPTYLINE HCL 25 MG TAB|100|EA|.08307|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||01/31/2022||Yes|No|||Prescription required|No||215|No|.07343|03/29/2022|.07166|03/29/2022|.07214|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|8884|||||No|No||UNICHEM PHARMAC|No||||
amitriptyline HCl|No|No|No|No|75%|29300042010|AMITRIPTYLINE HCL 25 MG TAB|1000|EA|.07878|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||215|No|.07343|03/31/2022|.07166|03/31/2022|.07214|03/31/2022|||ANTIDEPRESSANTS: TRICYCLIC|8885|||||No|No||UNICHEM PHARMAC|No||||
amitriptyline HCl|No|No|No|No|75%|29300042101|AMITRIPTYLINE HCL 50 MG TAB|100|EA|.16585|03/29/2022||Yes|No||03/29/2022||Yes|No|03/29/2022||Yes|No||||No|No|||Prescription required|No||215|No|.14797|03/29/2022|.14441|03/29/2022|.14538|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|8886|||||No|No||UNICHEM PHARMAC|No||||
amitriptyline HCl|No|No|No|No|75%|29300042110|AMITRIPTYLINE HCL 50 MG TAB|1000|EA|.13787|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||215|No|.14797|03/31/2022|.14441|03/31/2022|.14538|03/31/2022|||ANTIDEPRESSANTS: TRICYCLIC|8887|||||No|No||UNICHEM PHARMAC|No||||
amitriptyline HCl|No|No|No|No|75%|29300042201|AMITRIPTYLINE HCL 75 MG TAB|100|EA|.24922|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||01/31/2022||Yes|No|||Prescription required|No||215|No|.26194|03/29/2022|.25565|03/29/2022|.25735|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|8888|||||No|No||UNICHEM PHARMAC|No||||
amitriptyline HCl|No|No|No|No|75%|29300042301|AMITRIPTYLINE HCL 100 MG TAB|100|EA|.33178|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||01/31/2022||Yes|No|||Prescription required|No||215|No|.30607|03/29/2022|.29872|03/29/2022|.30071|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|8889|||||No|No||UNICHEM PHARMAC|No||||
amitriptyline HCl|No|No|No|No|75%|29300042401|AMITRIPTYLINE HCL 150 MG TAB|100|EA|.49751|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||01/31/2022||Yes|No|||Prescription required|No||215|No|.58201|03/29/2022|.56804|03/29/2022|.57182|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|8890|||||No|No||UNICHEM PHARMAC|No||||
zonisamide|No|No|No|No|75%|29300042801|ZONISAMIDE 25 MG CAPSULE|100|EA|.06742|03/29/2022||Yes|No||03/29/2022||Yes|No|03/29/2022||Yes|No||||No|No|||Prescription required|No||056|No|.08772|03/29/2022|.08561|03/29/2022|.08618|03/29/2022|||ANTICONVULSANTS|8891|||||No|No||UNICHEM PHARMAC|No||||
zonisamide|No|No|No|No|75%|29300042901|ZONISAMIDE 50 MG CAPSULE|100|EA|.07899|03/29/2022||Yes|No||03/29/2022||Yes|No|03/29/2022||Yes|No||||No|No|||Prescription required|No||056|No|.11305|03/29/2022|.11033|03/29/2022|.11107|03/29/2022|||ANTICONVULSANTS|8892|||||No|No||UNICHEM PHARMAC|No||||
zonisamide|No|No|No|No|75%|29300043001|ZONISAMIDE 100 MG CAPSULE|100|EA|.15802|12/28/2021||Yes|No||12/28/2021||Yes|No|12/28/2021||Yes|No||||No|No|||Prescription required|No||056|No|.12763|03/29/2022|.12456|03/29/2022|.12539|03/29/2022|||ANTICONVULSANTS|8893|||||No|No||UNICHEM PHARMAC|No||||
guanfacine HCl|No|No|No|No|75%|29300045801|GUANFACINE 1 MG TABLET|100|EA|.2709|09/07/2021||Yes|No||09/07/2021||Yes|No|09/07/2021||Yes|No||09/07/2021||Yes|No|||Prescription required|No||166|No|.50477|03/29/2022|.49265|03/29/2022|.49593|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|8894|||||No|No||UNICHEM PHARMAC|No||||
guanfacine HCl|No|No|No|No|75%|29300045901|GUANFACINE 2 MG TABLET|100|EA|.43215|09/07/2021||Yes|No||09/07/2021||Yes|No|09/07/2021||Yes|No||09/07/2021||Yes|No|||Prescription required|No||166|No|.72297|03/29/2022|.70561|03/29/2022|.71031|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|8895|||||No|No||UNICHEM PHARMAC|No||||
clonidine HCl|No|No|No|No|75%|29300046801|CLONIDINE HCL 0.1 MG TABLET|100|EA|.02261|06/24/2021||Yes|No||06/24/2021||Yes|No|06/24/2021||Yes|No||06/24/2021||Yes|No|||Prescription required|No||166|No|.03029|03/29/2022|.02956|03/29/2022|.02975|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|8896|||||No|No||UNICHEM PHARMAC|No||||
clonidine HCl|No|No|No|No|75%|29300046805|CLONIDINE HCL 0.1 MG TABLET|500|EA|.01823|06/24/2021||Yes|No||06/24/2021||Yes|No|06/24/2021||Yes|No||06/24/2021||Yes|No|||Prescription required|No||166|No|.03029|03/29/2022|.02956|03/29/2022|.02975|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|8897|||||No|No||UNICHEM PHARMAC|No||||
clonidine HCl|No|No|No|No|75%|29300046810|CLONIDINE HCL 0.1 MG TABLET|1000|EA|.01483|06/24/2021||Yes|No||06/24/2021||Yes|No|06/24/2021||Yes|No||06/24/2021||Yes|No|||Prescription required|No||166|No|.03029|03/29/2022|.02956|03/29/2022|.02975|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|8898|||||No|No||UNICHEM PHARMAC|No||||
isocarboxazid|No|No|No|No|75%|30698003201|MARPLAN 10 MG TABLET|100|EA|2.13163|05/15/2008||Yes|No||05/15/2008||Yes|No|05/15/2008||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|031|No|4.85815|01/21/2020|4.78875|01/21/2020|4.56071|01/21/2020|||ANTIDEPRESSANTS: OTHER|8899|||||No|No||VALIDUS PHARMAC|No||||
calcitriol|No|No|No|No|75%|30698014301|ROCALTROL 0.25 MCG CAPSULE|100|EA|.36055|07/07/2010||Yes|No||07/07/2010||Yes|No|07/07/2010||Yes|No||||No|No|||Prescription required|No|||No|.82173|08/07/2018|.80999|08/07/2018|.77142|08/07/2018||||8900|||||No|No||VALIDUS PHARMAC|No||||
calcitriol|No|No|No|No|75%|30698014323|ROCALTROL 0.25 MCG CAPSULE|30|EA|.73315|07/07/2010||Yes|No||07/07/2010||Yes|No|07/07/2010||Yes|No||||No|No|||Prescription required|No|||No|1.6709|08/07/2018|1.64703|08/07/2018|1.5686|08/07/2018||||8901|||||No|No||VALIDUS PHARMAC|No||||
calcitriol|No|No|No|No|75%|30698014401|ROCALTROL 0.5 MCG CAPSULE|100|EA|1.15283|07/07/2010||Yes|No||07/07/2010||Yes|No|07/07/2010||Yes|No||||No|No|||Prescription required|No|||No|2.62738|08/07/2018|2.58984|08/07/2018|2.46652|08/07/2018||||8902|||||No|No||VALIDUS PHARMAC|No||||
carbamazepine|No|No|No|No|75%|30698041912|EQUETRO 100 MG CAPSULE|120|EA|1.66072|10/07/2008||Yes|No||10/07/2008||Yes|No|10/07/2008||Yes|No||||No|No|||Prescription required|No||056|No|3.78491|01/08/2019|3.73084|01/08/2019|3.55318|01/08/2019|||ANTICONVULSANTS|8903|||||No|No||VALIDUS PHARMAC|No||||
carbamazepine|No|No|No|No|75%|30698042112|EQUETRO 200 MG CAPSULE|120|EA|1.87239|10/07/2008||Yes|No||10/07/2008||Yes|No|10/07/2008||Yes|No||||No|No|||Prescription required|No||056|No|4.17075|03/29/2022|4.07065|03/29/2022|4.09776|03/29/2022|||ANTICONVULSANTS|8904|||||No|No||VALIDUS PHARMAC|No||||
carbamazepine|No|No|No|No|75%|30698042312|EQUETRO 300 MG CAPSULE|120|EA|2.10294|10/07/2008||Yes|No||10/07/2008||Yes|No|10/07/2008||Yes|No||||No|No|||Prescription required|No||056|No|4.79276|01/08/2019|4.7243|01/08/2019|4.49933|01/08/2019|||ANTICONVULSANTS|8905|||||No|No||VALIDUS PHARMAC|No||||
calcitriol|No|No|No|No|75%|30698091115|ROCALTROL 1 MCG/ML ORAL SOLN|15|ML|6.1533|07/07/2010||Yes|No||07/07/2010||Yes|No|07/07/2010||Yes|No||||No|No|||Prescription required|No|||No|14.0238|08/07/2018|13.82346|08/07/2018|13.1652|08/07/2018||||8906|||||No|No||VALIDUS PHARMAC|No||||
venlafaxine HCl|No|No|No|No|75%|31722000230|VENLAFAXINE HCL ER 37.5 MG CAP|30|EA|.17744|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|No||031|Yes|.11725|03/29/2022|.11443|03/29/2022|.11519|03/29/2022|||ANTIDEPRESSANTS: OTHER|8907|||||No|No||CAMBER PHARMACE|No||||
venlafaxine HCl|No|No|No|No|75%|31722000290|VENLAFAXINE HCL ER 37.5 MG CAP|90|EA|.17744|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|No||031|Yes|.11725|03/29/2022|.11443|03/29/2022|.11519|03/29/2022|||ANTIDEPRESSANTS: OTHER|8908|||||No|No||CAMBER PHARMACE|No||||
venlafaxine HCl|No|No|No|No|75%|31722000330|VENLAFAXINE HCL ER 75 MG CAP|30|EA|.20611|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|No||031|Yes|.12722|03/29/2022|.12416|03/29/2022|.12499|03/29/2022|||ANTIDEPRESSANTS: OTHER|8909|||||No|No||CAMBER PHARMACE|No||||
venlafaxine HCl|No|No|No|No|75%|31722000390|VENLAFAXINE HCL ER 75 MG CAP|90|EA|.20611|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|No||031|Yes|.12722|03/29/2022|.12416|03/29/2022|.12499|03/29/2022|||ANTIDEPRESSANTS: OTHER|8910|||||No|No||CAMBER PHARMACE|No||||
venlafaxine HCl|No|No|No|No|75%|31722000430|VENLAFAXINE HCL ER 150 MG CAP|30|EA|.25054|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|No||031|No|.16516|03/29/2022|.16119|03/29/2022|.16226|03/29/2022|||ANTIDEPRESSANTS: OTHER|8911|||||No|No||CAMBER PHARMACE|No||||
venlafaxine HCl|No|No|No|No|75%|31722000490|VENLAFAXINE HCL ER 150 MG CAP|90|EA|.25054|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|No||031|No|.16516|03/29/2022|.16119|03/29/2022|.16226|03/29/2022|||ANTIDEPRESSANTS: OTHER|8912|||||No|No||CAMBER PHARMACE|No||||
itraconazole|No|No|No|No|75%|31722000631|ITRACONAZOLE 10 MG/ML SOLUTION|150|ML|.71666|03/18/2021||Yes|No||03/18/2021||Yes|No|03/18/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|069|No|1.63332|11/23/2021|1.60999|11/23/2021|1.53332|11/23/2021|||ANTIFUNGALS: ORAL|8913|||||No|No||CAMBER PHARMACE|No||||
zafirlukast|No|No|No|No|75%|31722000760|ZAFIRLUKAST 10 MG TABLET|60|EA|.52847|03/18/2021||Yes|No||03/18/2021||Yes|No|03/18/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|042|Yes|1.0831|03/01/2022|1.0571|03/01/2022|1.06414|03/01/2022|||LEUKOTRIENE MODIFIERS|8914|||||No|No||CAMBER PHARMACE|No||||
zafirlukast|No|No|No|No|75%|31722000860|ZAFIRLUKAST 20 MG TABLET|60|EA|.52847|03/18/2021||Yes|No||03/18/2021||Yes|No|03/18/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|042|Yes|.93036|03/29/2022|.90803|03/29/2022|.91407|03/29/2022|||LEUKOTRIENE MODIFIERS|8915|||||No|No||CAMBER PHARMACE|No||||
droxidopa|No|No|No|No|75%|31722001090|DROXIDOPA 300 MG CAPSULE|90|EA|1.43333|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|No|||No|3.26666|11/02/2021|3.21999|11/02/2021|3.06666|11/02/2021||||8916|||||No|No||CAMBER PHARMACE|No||||
deferasirox|No|No|No|No|75%|31722001130|DEFERASIROX 90 MG TABLET|30|EA|.58766|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|1.33932|02/02/2022|1.32019|02/02/2022|1.25732|02/02/2022||||8917|||||No|No||CAMBER PHARMACE|No||||
deferasirox|No|No|No|No|75%|31722001230|DEFERASIROX 180 MG TABLET|30|EA|1.17533|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|2.67866|02/02/2022|2.64039|02/02/2022|2.51466|02/02/2022||||8918|||||No|No||CAMBER PHARMACE|No||||
deferasirox|No|No|No|No|75%|31722001330|DEFERASIROX 360 MG TABLET|30|EA|2.35066|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|5.35732|02/02/2022|5.28079|02/02/2022|5.02932|02/02/2022||||8919|||||No|No||CAMBER PHARMACE|No||||
daptomycin|No|No|No|No|75%|31722010210|DAPTOMYCIN 500 MG VIAL|1|EA|32.25|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No|||No|73.5|06/08/2021|72.45|06/08/2021|69|06/08/2021||||8920|||||No|No||CAMBER PHARMACE|No||||
cinacalcet HCl|No|No|No|No|75%|31722010330|CINACALCET HCL 30 MG TABLET|30|EA|.7912|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|No|||No|.75588|03/29/2022|.73773|03/29/2022|.74265|03/29/2022||||8921|||||No|No||CAMBER PHARMACE|No||||
cinacalcet HCl|No|No|No|No|75%|31722010430|CINACALCET HCL 60 MG TABLET|30|EA|1.5824|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|No|||No|1.7407|03/29/2022|1.69892|03/29/2022|1.71023|03/29/2022||||8922|||||No|No||CAMBER PHARMACE|No||||
cinacalcet HCl|No|No|No|No|75%|31722010530|CINACALCET HCL 90 MG TABLET|30|EA|2.3736|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|No|||No|3.64673|03/29/2022|3.5592|03/29/2022|3.58291|03/29/2022||||8923|||||No|No||CAMBER PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|31722010901|OXYCODONE HCL ER 10 MG TABLET|100|EA|1.4534|08/20/2021||Yes|No||08/20/2021||Yes|No|08/20/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|110|Yes|2.46132|09/28/2021|2.40224|09/28/2021|2.41824|09/28/2021|||ANALGESICS: NARCOTICS LONG|8924|||||No|No||CAMBER PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|31722011001|OXYCODONE HCL ER 20 MG TABLET|100|EA|2.709|08/20/2021||Yes|No||08/20/2021||Yes|No|08/20/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|110|Yes|4.05047|08/24/2021|3.95325|08/24/2021|3.97958|08/24/2021|||ANALGESICS: NARCOTICS LONG|8925|||||No|No||CAMBER PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|31722011101|OXYCODONE HCL ER 40 MG TABLET|100|EA|4.5064|08/20/2021||Yes|No||08/20/2021||Yes|No|08/20/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|110|Yes|5.67023|11/23/2021|5.53414|11/23/2021|5.571|11/23/2021|||ANALGESICS: NARCOTICS LONG|8926|||||No|No||CAMBER PHARMACE|No||||
hydromorphone HCl|No|No|No|No|90%|31722011901|HYDROMORPHONE HCL ER 8 MG TAB|100|EA|3.31035|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|110|Yes|7.54453|04/15/2021|7.43675|04/15/2021|7.08262|04/15/2021|||ANALGESICS: NARCOTICS LONG|8927|||||No|No||CAMBER PHARMACE|No||||
hydromorphone HCl|No|No|No|No|90%|31722012001|HYDROMORPHONE HCL ER 12 MG TAB|100|EA|4.94762|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|110|Yes|11.27597|04/15/2021|11.11489|04/15/2021|10.58561|04/15/2021|||ANALGESICS: NARCOTICS LONG|8928|||||No|No||CAMBER PHARMACE|No||||
hydromorphone HCl|No|No|No|No|90%|31722012101|HYDROMORPHONE HCL ER 16 MG TAB|100|EA|6.5968|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|110|Yes|15.03457|04/15/2021|14.81979|04/15/2021|14.11408|04/15/2021|||ANALGESICS: NARCOTICS LONG|8929|||||No|No||CAMBER PHARMACE|No||||
hydromorphone HCl|No|No|No|No|90%|31722012201|HYDROMORPHONE HCL ER 32 MG TAB|100|EA|8.7247|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|110|Yes|19.8842|04/15/2021|19.60014|04/15/2021|18.6668|04/15/2021|||ANALGESICS: NARCOTICS LONG|8930|||||No|No||CAMBER PHARMACE|No||||
venlafaxine HCl|No|No|No|No|75%|31722012330|VENLAFAXINE HCL ER 37.5 MG TAB|30|EA|1.43949|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|031|Yes|1.96254|10/26/2021|1.91543|10/26/2021|1.92819|10/26/2021|||ANTIDEPRESSANTS: OTHER|8931|||||No|No||CAMBER PHARMACE|No||||
venlafaxine HCl|No|No|No|No|75%|31722012390|VENLAFAXINE HCL ER 37.5 MG TAB|90|EA|1.43939|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|031|Yes|1.96254|10/26/2021|1.91543|10/26/2021|1.92819|10/26/2021|||ANTIDEPRESSANTS: OTHER|8932|||||No|No||CAMBER PHARMACE|No||||
venlafaxine HCl|No|No|No|No|75%|31722012430|VENLAFAXINE HCL ER 75 MG TAB|30|EA|1.61164|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|031|Yes|1.5965|03/29/2022|1.55818|03/29/2022|1.56856|03/29/2022|||ANTIDEPRESSANTS: OTHER|8933|||||No|No||CAMBER PHARMACE|No||||
venlafaxine HCl|No|No|No|No|75%|31722012490|VENLAFAXINE HCL ER 75 MG TAB|90|EA|1.61168|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|031|Yes|1.5965|03/29/2022|1.55818|03/29/2022|1.56856|03/29/2022|||ANTIDEPRESSANTS: OTHER|8934|||||No|No||CAMBER PHARMACE|No||||
venlafaxine HCl|No|No|No|No|75%|31722012530|VENLAFAXINE HCL ER 150 MG TAB|30|EA|1.75612|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|031|No|2.65947|03/29/2022|2.59564|03/29/2022|2.61292|03/29/2022|||ANTIDEPRESSANTS: OTHER|8935|||||No|No||CAMBER PHARMACE|No||||
venlafaxine HCl|No|No|No|No|75%|31722012590|VENLAFAXINE HCL ER 150 MG TAB|90|EA|1.75616|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|031|No|2.65947|03/29/2022|2.59564|03/29/2022|2.61292|03/29/2022|||ANTIDEPRESSANTS: OTHER|8936|||||No|No||CAMBER PHARMACE|No||||
venlafaxine HCl|No|No|No|No|75%|31722012630|VENLAFAXINE HCL ER 225 MG TAB|30|EA|3.70129|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|031|No|3.46235|03/29/2022|3.37925|03/29/2022|3.40175|03/29/2022|||ANTIDEPRESSANTS: OTHER|8937|||||No|No||CAMBER PHARMACE|No||||
venlafaxine HCl|No|No|No|No|75%|31722012690|VENLAFAXINE HCL ER 225 MG TAB|90|EA|3.70124|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|031|No|3.46235|03/29/2022|3.37925|03/29/2022|3.40175|03/29/2022|||ANTIDEPRESSANTS: OTHER|8938|||||No|No||CAMBER PHARMACE|No||||
gemfibrozil|No|No|No|No|75%|31722012805|GEMFIBROZIL 600 MG TABLET|500|EA|.05142|01/25/2022||Yes|No||01/25/2022||Yes|No|01/25/2022||Yes|No||01/25/2022||Yes|No|||Prescription required|No||055|No|.10518|03/29/2022|.10265|03/29/2022|.10333|03/29/2022|||LIPOTROPICS: OTHER|8939|||||No|No||CAMBER PHARMACE|No||||
gemfibrozil|No|No|No|No|75%|31722012860|GEMFIBROZIL 600 MG TABLET|60|EA|.07467|01/25/2022||Yes|No||01/25/2022||Yes|No|01/25/2022||Yes|No||01/25/2022||Yes|No|||Prescription required|No||055|No|.10518|03/29/2022|.10265|03/29/2022|.10333|03/29/2022|||LIPOTROPICS: OTHER|8940|||||No|No||CAMBER PHARMACE|No||||
potassium citrate|No|No|No|No|75%|31722012901|POTASSIUM CITRATE ER 5 MEQ TAB|100|EA|.086|08/20/2021||Yes|No||08/20/2021||Yes|No|08/20/2021||Yes|No||||No|No|||Prescription required|No|||No|.46644|03/29/2022|.45524|03/29/2022|.45827|03/29/2022||||8941|||||No|No||CAMBER PHARMACE|No||||
potassium citrate|No|No|No|No|75%|31722013001|POTASSIUM CITRATE ER 10 MEQ TB|100|EA|.1075|08/20/2021||Yes|No||08/20/2021||Yes|No|08/20/2021||Yes|No||||No|No|||Prescription required|No|||No|.30433|03/29/2022|.29702|03/29/2022|.299|03/29/2022||||8942|||||No|No||CAMBER PHARMACE|No||||
dutasteride|No|No|No|No|75%|31722013130|DUTASTERIDE 0.5 MG CAPSULE|30|EA|.15752|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|003|No|.20731|03/29/2022|.20233|03/29/2022|.20368|03/29/2022|||BPH TREATMENTS|8943|||||No|No||CAMBER PHARMACE|No||||
dutasteride|No|No|No|No|75%|31722013190|DUTASTERIDE 0.5 MG CAPSULE|90|EA|.15761|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|003|No|.20731|03/29/2022|.20233|03/29/2022|.20368|03/29/2022|||BPH TREATMENTS|8944|||||No|No||CAMBER PHARMACE|No||||
potassium citrate|No|No|No|No|75%|31722013201|POTASSIUM CITRATE ER 15 MEQ TB|100|EA|.129|08/20/2021||Yes|No||08/20/2021||Yes|No|08/20/2021||Yes|No||||No|No|||Prescription required|No|||No|.5925|03/29/2022|.57828|03/29/2022|.58213|03/29/2022||||8945|||||No|No||CAMBER PHARMACE|No||||
potassium chloride|No|No|No|No|75%|31722013301|POTASSIUM CL ER 10 MEQ TABLET|100|EA|.14568|10/14/2021||Yes|No||10/14/2021||Yes|No|10/14/2021||Yes|No||10/14/2021||Yes|No|||Prescription required|No|||No|.18432|03/29/2022|.17989|03/29/2022|.18109|03/29/2022||||8946|||||No|No||CAMBER PHARMACE|No||||
potassium chloride|No|No|No|No|75%|31722013305|POTASSIUM CL ER 10 MEQ TABLET|500|EA|.14568|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||02/09/2022||Yes|No|||Prescription required|No|||No|.18432|03/29/2022|.17989|03/29/2022|.18109|03/29/2022||||8947|||||No|No||CAMBER PHARMACE|No||||
potassium chloride|No|No|No|No|75%|31722013501|POTASSIUM CL ER 20 MEQ TABLET|100|EA|.21581|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||02/03/2022||Yes|No|||Prescription required|No|||No|.19104|03/29/2022|.18645|03/29/2022|.18769|03/29/2022||||8948|||||No|No||CAMBER PHARMACE|No||||
potassium chloride|No|No|No|No|75%|31722013505|POTASSIUM CL ER 20 MEQ TABLET|500|EA|.21581|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||02/03/2022||Yes|No|||Prescription required|No|||No|.19104|03/29/2022|.18645|03/29/2022|.18769|03/29/2022||||8949|||||No|No||CAMBER PHARMACE|No||||
sildenafil citrate|No|No|No|No|75%|31722013631|SILDENAFIL 10 MG/ML ORAL SUSP|112|ML|2.30357|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/29/2021|171|Yes|5.24999|02/03/2022|5.17499|02/03/2022|4.92856|02/03/2022|||PAH AGENTS: ORAL AND INHALED|8950|||||No|No||CAMBER PHARMACE|No||||
baclofen|No|No|No|No|75%|31722013801|BACLOFEN 5 MG TABLET|100|EA|.39843|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No||116|No|.53855|03/29/2022|.52562|03/29/2022|.52912|03/29/2022|||SKELETAL MUSCLE RELAXANTS|8951|||||No|No||CAMBER PHARMACE|No||||
captopril|No|No|No|No|75%|31722014101|CAPTOPRIL 12.5 MG TABLET|100|EA|.344|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||02/23/2022||Yes|No|||Prescription required|Yes|07/29/2021|113|No|.58889|03/29/2022|.57475|03/29/2022|.57858|03/29/2022|||ANGIOTENSIN MODULATORS|8952|||||No|No||CAMBER PHARMACE|No||||
captopril|No|No|No|No|75%|31722014201|CAPTOPRIL 25 MG TABLET|100|EA|.36464|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||02/23/2022||Yes|No|||Prescription required|Yes|07/29/2021|113|No|.40459|03/29/2022|.39487|03/29/2022|.3975|03/29/2022|||ANGIOTENSIN MODULATORS|8953|||||No|No||CAMBER PHARMACE|No||||
captopril|No|No|No|No|75%|31722014301|CAPTOPRIL 50 MG TABLET|100|EA|.63984|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||02/23/2022||Yes|No|||Prescription required|Yes|07/29/2021|113|No|1.25965|03/29/2022|1.22941|03/29/2022|1.2376|03/29/2022|||ANGIOTENSIN MODULATORS|8954|||||No|No||CAMBER PHARMACE|No||||
captopril|No|No|No|No|75%|31722014401|CAPTOPRIL 100 MG TABLET|100|EA|.8428|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||02/23/2022||Yes|No|||Prescription required|Yes|07/29/2021|113|No|1.37792|03/29/2022|1.34484|03/29/2022|1.3538|03/29/2022|||ANGIOTENSIN MODULATORS|8955|||||No|No||CAMBER PHARMACE|No||||
sertraline HCl|No|No|No|No|75%|31722014505|SERTRALINE HCL 25 MG TABLET|500|EA|.03676|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No||008|Yes|.05057|03/29/2022|.04935|03/29/2022|.04968|03/29/2022|||ANTIDEPRESSANTS: SSRIs|8956|||||No|No||CAMBER PHARMACE|No||||
sertraline HCl|No|No|No|No|75%|31722014530|SERTRALINE HCL 25 MG TABLET|30|EA|.04085|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No||008|Yes|.05057|03/29/2022|.04935|03/29/2022|.04968|03/29/2022|||ANTIDEPRESSANTS: SSRIs|8957|||||No|No||CAMBER PHARMACE|No||||
sertraline HCl|No|No|No|No|75%|31722014590|SERTRALINE HCL 25 MG TABLET|90|EA|.03678|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No||008|Yes|.05057|03/29/2022|.04935|03/29/2022|.04968|03/29/2022|||ANTIDEPRESSANTS: SSRIs|8958|||||No|No||CAMBER PHARMACE|No||||
sertraline HCl|No|No|No|No|75%|31722014605|SERTRALINE HCL 50 MG TABLET|500|EA|.03676|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No||008|Yes|.04281|03/29/2022|.04178|03/29/2022|.04206|03/29/2022|||ANTIDEPRESSANTS: SSRIs|8959|||||No|No||CAMBER PHARMACE|No||||
sertraline HCl|No|No|No|No|75%|31722014630|SERTRALINE HCL 50 MG TABLET|30|EA|.04085|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No||008|Yes|.04281|03/29/2022|.04178|03/29/2022|.04206|03/29/2022|||ANTIDEPRESSANTS: SSRIs|8960|||||No|No||CAMBER PHARMACE|No||||
sertraline HCl|No|No|No|No|75%|31722014705|SERTRALINE HCL 100 MG TABLET|500|EA|.03676|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|8961|||||No|No||CAMBER PHARMACE|No||||
sertraline HCl|No|No|No|No|75%|31722014730|SERTRALINE HCL 100 MG TABLET|30|EA|.04085|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|8962|||||No|No||CAMBER PHARMACE|No||||
sertraline HCl|No|No|No|No|75%|31722014790|SERTRALINE HCL 100 MG TABLET|90|EA|.03678|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|8963|||||No|No||CAMBER PHARMACE|No||||
valsartan|No|No|No|No|75%|31722015130|VALSARTAN 40 MG TABLET|30|EA|.11395|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||02/03/2022||Yes|No|||Prescription required|Yes|07/29/2021|113|Yes|.1945|03/29/2022|.18983|03/29/2022|.19109|03/29/2022|||ANGIOTENSIN MODULATORS|8964|||||No|No||CAMBER PHARMACE|No||||
valsartan|No|No|No|No|75%|31722015290|VALSARTAN 80 MG TABLET|90|EA|.13955|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||02/03/2022||Yes|No|||Prescription required|Yes|07/29/2021|113|Yes|.21024|03/29/2022|.20519|03/29/2022|.20656|03/29/2022|||ANGIOTENSIN MODULATORS|8965|||||No|No||CAMBER PHARMACE|No||||
valsartan|No|No|No|No|75%|31722015390|VALSARTAN 160 MG TABLET|90|EA|.17037|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||02/03/2022||Yes|No|||Prescription required|Yes|07/29/2021|113|Yes|.23007|03/29/2022|.22454|03/29/2022|.22604|03/29/2022|||ANGIOTENSIN MODULATORS|8966|||||No|No||CAMBER PHARMACE|No||||
valsartan|No|No|No|No|75%|31722015490|VALSARTAN 320 MG TABLET|90|EA|.21552|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||02/03/2022||Yes|No|||Prescription required|Yes|07/29/2021|113|Yes|.31156|03/29/2022|.30408|03/29/2022|.3061|03/29/2022|||ANGIOTENSIN MODULATORS|8967|||||No|No||CAMBER PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|31722015501|DEXTROAMP-AMPHETAMINE 5 MG TAB|100|EA|.1603|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.21985|03/29/2022|.21457|03/29/2022|.216|03/29/2022|||STIMULANTS AND RELATED AGENTS|8968|||||No|No||CAMBER PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|31722015601|DEXTROAMP-AMPHETAM 7.5 MG TAB|100|EA|.1603|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.45915|03/29/2022|.44813|03/29/2022|.45111|03/29/2022|||STIMULANTS AND RELATED AGENTS|8969|||||No|No||CAMBER PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|31722015701|DEXTROAMP-AMPHETAMIN 10 MG TAB|100|EA|.1603|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.24071|03/29/2022|.23493|03/29/2022|.23649|03/29/2022|||STIMULANTS AND RELATED AGENTS|8970|||||No|No||CAMBER PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|31722015801|DEXTROAMP-AMPHETAM 12.5 MG TAB|100|EA|.1603|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.65907|03/01/2022|.64325|03/01/2022|.64753|03/01/2022|||STIMULANTS AND RELATED AGENTS|8971|||||No|No||CAMBER PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|31722015901|DEXTROAMP-AMPHETAMIN 15 MG TAB|100|EA|.1603|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.25605|03/29/2022|.2499|03/29/2022|.25156|03/29/2022|||STIMULANTS AND RELATED AGENTS|8972|||||No|No||CAMBER PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|31722016301|DEXTROAMP-AMPHETAMIN 20 MG TAB|100|EA|.1603|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.31357|03/29/2022|.30604|03/29/2022|.30808|03/29/2022|||STIMULANTS AND RELATED AGENTS|8973|||||No|No||CAMBER PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|31722016401|DEXTROAMP-AMPHETAMIN 30 MG TAB|100|EA|.1603|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.30925|03/29/2022|.30182|03/29/2022|.30383|03/29/2022|||STIMULANTS AND RELATED AGENTS|8974|||||No|No||CAMBER PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|31722017301|METHYLPHENIDATE 5 MG TABLET|100|EA|.08471|08/12/2016||Yes|No||08/12/2016||Yes|No|08/12/2016||Yes|No||||No|No|||Prescription required|No||007|Yes|.1394|03/29/2022|.13605|03/29/2022|.13696|03/29/2022|||STIMULANTS AND RELATED AGENTS|8975|||||No|No||CAMBER PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|31722017401|METHYLPHENIDATE 10 MG TABLET|100|EA|.12074|08/15/2016||Yes|No||08/15/2016||Yes|No|08/15/2016||Yes|No||||No|No|||Prescription required|No||007|Yes|.15766|03/29/2022|.15387|03/29/2022|.1549|03/29/2022|||STIMULANTS AND RELATED AGENTS|8976|||||No|No||CAMBER PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|31722017501|METHYLPHENIDATE 20 MG TABLET|100|EA|.17341|08/15/2016||Yes|No||08/15/2016||Yes|No|08/15/2016||Yes|No||||No|No|||Prescription required|No||007|Yes|.22814|03/29/2022|.22266|03/29/2022|.22414|03/29/2022|||STIMULANTS AND RELATED AGENTS|8977|||||No|No||CAMBER PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|31722019101|OXYCODONE-ACETAMINOPHN 2.5-325|100|EA|.70081|12/06/2017||Yes|No||12/06/2017||Yes|No|12/06/2017||Yes|No||12/06/2017||Yes|No|||Prescription required|No||109|Yes|1.39948|03/29/2022|1.36589|03/29/2022|1.37498|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8978|||||No|No||CAMBER PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|31722019205|OXYCODONE-ACETAMINOPHEN 5-325|500|EA|.0433|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||09/07/2017||Yes|No|||Prescription required|No||109|Yes|.09091|03/29/2022|.08872|03/29/2022|.08931|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8979|||||No|No||CAMBER PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|31722019301|OXYCODONE-ACETAMINOPHN 7.5-325|100|EA|.06497|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||09/07/2017||Yes|No|||Prescription required|No||109|Yes|.14032|03/29/2022|.13695|03/29/2022|.13786|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8980|||||No|No||CAMBER PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|31722019305|OXYCODONE-ACETAMINOPHN 7.5-325|500|EA|.06497|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||09/07/2017||Yes|No|||Prescription required|No||109|Yes|.14032|03/29/2022|.13695|03/29/2022|.13786|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8981|||||No|No||CAMBER PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|31722019401|OXYCODONE-ACETAMINOPHEN 10-325|100|EA|.0866|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||09/07/2017||Yes|No|||Prescription required|No||109|Yes|.19233|03/29/2022|.18771|03/29/2022|.18896|03/29/2022|||ANALGESICS: NARCOTICS SHORT|8982|||||No|No||CAMBER PHARMACE|No||||
efavirenz|No|No|No|No|75%|31722050430|EFAVIRENZ 600 MG TABLET|30|EA|1.59999|12/17/2020||Yes|No||12/17/2020||Yes|No|12/17/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|5.43893|08/24/2021|5.30839|08/24/2021|5.34374|08/24/2021|||HIV / AIDS|8983|||||No|No||CAMBER PHARMACE|No||||
nevirapine|No|No|No|No|75%|31722050560|NEVIRAPINE 200 MG TABLET|60|EA|.10219|06/05/2012||Yes|No||06/05/2012||Yes|No|06/05/2012||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.16692|10/27/2020|.16453|10/27/2020|.1567|10/27/2020|||HIV / AIDS|8984|||||No|No||CAMBER PHARMACE|No||||
lamivudine/zidovudine|No|No|No|No|75%|31722050660|LAMIVUDINE-ZIDOVUDINE TABLET|60|EA|1.3353|10/13/2016||Yes|No||10/13/2016||Yes|No|10/13/2016||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.62913|12/28/2021|.61403|12/28/2021|.61812|12/28/2021|||HIV / AIDS|8985|||||No|No||CAMBER PHARMACE|No||||
zidovudine|No|No|No|No|75%|31722050960|ZIDOVUDINE 300 MG TABLET|60|EA|.45|12/19/2008||Yes|No||12/19/2008||Yes|No|12/19/2008||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.735|12/28/2021|.7245|12/28/2021|.69|12/28/2021|||HIV / AIDS|8986|||||No|No||CAMBER PHARMACE|No||||
hydralazine HCl|No|No|No|No|75%|31722051901|HYDRALAZINE 10 MG TABLET|100|EA|.07327|09/18/2008||Yes|No||09/18/2008||Yes|No|09/18/2008||Yes|No||07/01/2016||Yes|No|||Prescription required|No|||No|.03439|03/29/2022|.03356|03/29/2022|.03378|03/29/2022||||8987|||||No|No||CAMBER PHARMACE|No||||
hydralazine HCl|No|No|No|No|75%|31722052001|HYDRALAZINE 25 MG TABLET|100|EA|.06553|09/18/2008||Yes|No||09/18/2008||Yes|No|09/18/2008||Yes|No||07/01/2016||Yes|No|||Prescription required|No|||No|.04116|03/29/2022|.04017|03/29/2022|.04043|03/29/2022||||8988|||||No|No||CAMBER PHARMACE|No||||
hydralazine HCl|No|No|No|No|75%|31722052010|HYDRALAZINE 25 MG TABLET|1000|EA|.06222|09/18/2008||Yes|No||09/18/2008||Yes|No|09/18/2008||Yes|No||07/01/2016||Yes|No|||Prescription required|No|||No|.04116|03/29/2022|.04017|03/29/2022|.04043|03/29/2022||||8989|||||No|No||CAMBER PHARMACE|No||||
hydralazine HCl|No|No|No|No|75%|31722052101|HYDRALAZINE 50 MG TABLET|100|EA|.08187|09/18/2008||Yes|No||09/18/2008||Yes|No|09/18/2008||Yes|No||07/01/2016||Yes|No|||Prescription required|No|||No|.0521|03/29/2022|.05084|03/29/2022|.05118|03/29/2022||||8990|||||No|No||CAMBER PHARMACE|No||||
hydralazine HCl|No|No|No|No|75%|31722052110|HYDRALAZINE 50 MG TABLET|1000|EA|.07368|09/18/2008||Yes|No||09/18/2008||Yes|No|09/18/2008||Yes|No||07/01/2016||Yes|No|||Prescription required|No|||No|.0521|03/29/2022|.05084|03/29/2022|.05118|03/29/2022||||8991|||||No|No||CAMBER PHARMACE|No||||
hydralazine HCl|No|No|No|No|75%|31722052201|HYDRALAZINE 100 MG TABLET|100|EA|.15273|09/18/2008||Yes|No||09/18/2008||Yes|No|09/18/2008||Yes|No||07/01/2016||Yes|No|||Prescription required|No|||No|.0869|03/29/2022|.08481|03/29/2022|.08537|03/29/2022||||8992|||||No|No||CAMBER PHARMACE|No||||
finasteride|No|No|No|No|75%|31722052510|FINASTERIDE 5 MG TABLET|1000|EA|.16483|11/13/2018||Yes|No||11/13/2018||Yes|No|11/13/2018||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|8993|||||No|No||CAMBER PHARMACE|No||||
finasteride|No|No|No|No|75%|31722052530|FINASTERIDE 5 MG TABLET|30|EA|.16483|10/25/2010||Yes|No||10/25/2010||Yes|No|10/25/2010||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|8994|||||No|No||CAMBER PHARMACE|No||||
finasteride|No|No|No|No|75%|31722052590|FINASTERIDE 5 MG TABLET|90|EA|.16483|10/25/2010||Yes|No||10/25/2010||Yes|No|10/25/2010||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|8995|||||No|No||CAMBER PHARMACE|No||||
finasteride|No|No|No|No|75%|31722052630|FINASTERIDE 1 MG TABLET|30|EA|.11438|07/12/2013||Yes|No||07/12/2013||Yes|No|07/12/2013||Yes|No||||No|No|||Prescription required|No|||No|.04818|03/29/2022|.04702|03/29/2022|.04733|03/29/2022||||8996|||||No|No||CAMBER PHARMACE|No||||
finasteride|No|No|No|No|75%|31722052690|FINASTERIDE 1 MG TABLET|90|EA|.10286|07/12/2013||Yes|No||07/12/2013||Yes|No|07/12/2013||Yes|No||||No|No|||Prescription required|No|||No|.04818|03/29/2022|.04702|03/29/2022|.04733|03/29/2022||||8997|||||No|No||CAMBER PHARMACE|No||||
torsemide|No|No|No|No|75%|31722052901|TORSEMIDE 5 MG TABLET|100|EA|.05998|01/05/2010||Yes|No||01/05/2010||Yes|No|01/05/2010||Yes|No||07/01/2016||Yes|No|||Prescription required|No|||No|.0835|03/29/2022|.08149|03/29/2022|.08203|03/29/2022||||8998|||||No|No||CAMBER PHARMACE|No||||
torsemide|No|No|No|No|75%|31722053001|TORSEMIDE 10 MG TABLET|100|EA|.06772|01/05/2010||Yes|No||01/05/2010||Yes|No|01/05/2010||Yes|No||07/01/2016||Yes|No|||Prescription required|No|||No|.07835|03/29/2022|.07646|03/29/2022|.07697|03/29/2022||||8999|||||No|No||CAMBER PHARMACE|No||||
torsemide|No|No|No|No|75%|31722053101|TORSEMIDE 20 MG TABLET|100|EA|.09193|01/05/2010||Yes|No||01/05/2010||Yes|No|01/05/2010||Yes|No||07/01/2016||Yes|No|||Prescription required|No|||No|.08257|03/29/2022|.08058|03/29/2022|.08112|03/29/2022||||9000|||||No|No||CAMBER PHARMACE|No||||
torsemide|No|No|No|No|75%|31722053201|TORSEMIDE 100 MG TABLET|100|EA|.1935|01/05/2010||Yes|No||01/05/2010||Yes|No|01/05/2010||Yes|No||07/01/2016||Yes|No|||Prescription required|No|||No|.25463|03/29/2022|.24851|03/29/2022|.25017|03/29/2022||||9001|||||No|No||CAMBER PHARMACE|No||||
methocarbamol|No|No|No|No|75%|31722053301|METHOCARBAMOL 500 MG TABLET|100|EA|.05031|06/21/2010||Yes|No||06/21/2010||Yes|No|06/21/2010||Yes|No||||No|No|||Prescription required|No||116|Yes|.07091|03/29/2022|.0692|03/29/2022|.06966|03/29/2022|||SKELETAL MUSCLE RELAXANTS|9002|||||No|No||CAMBER PHARMACE|No||||
methocarbamol|No|No|No|No|75%|31722053305|METHOCARBAMOL 500 MG TABLET|500|EA|.04742|06/21/2010||Yes|No||06/21/2010||Yes|No|06/21/2010||Yes|No||||No|No|||Prescription required|No||116|Yes|.07091|03/29/2022|.0692|03/29/2022|.06966|03/29/2022|||SKELETAL MUSCLE RELAXANTS|9003|||||No|No||CAMBER PHARMACE|No||||
methocarbamol|No|No|No|No|75%|31722053401|METHOCARBAMOL 750 MG TABLET|100|EA|.06166|06/21/2010||Yes|No||06/21/2010||Yes|No|06/21/2010||Yes|No||||No|No|||Prescription required|No||116|Yes|.09307|03/29/2022|.09083|03/29/2022|.09144|03/29/2022|||SKELETAL MUSCLE RELAXANTS|9004|||||No|No||CAMBER PHARMACE|No||||
methocarbamol|No|No|No|No|75%|31722053405|METHOCARBAMOL 750 MG TABLET|500|EA|.05774|06/21/2010||Yes|No||06/21/2010||Yes|No|06/21/2010||Yes|No||||No|No|||Prescription required|No||116|Yes|.09307|03/29/2022|.09083|03/29/2022|.09144|03/29/2022|||SKELETAL MUSCLE RELAXANTS|9005|||||No|No||CAMBER PHARMACE|No||||
tenofovir disoproxil fumarate|No|No|No|No|75%|31722053530|TENOFOVIR DISOP FUM 300 MG TB|30|EA|2.29999|03/26/2018||Yes|No||03/26/2018||Yes|No|03/26/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.62458|03/29/2022|.60959|03/29/2022|.61364|03/29/2022|||HIV / AIDS|9006|||||No|No||CAMBER PHARMACE|No||||
levetiracetam|No|No|No|No|75%|31722053605|LEVETIRACETAM 250 MG TABLET|500|EA|.11544|08/01/2012||Yes|No||08/01/2012||Yes|No|08/01/2012||Yes|No||||No|No|||Prescription required|No||056|No|.08073|03/29/2022|.07879|03/29/2022|.07931|03/29/2022|||ANTICONVULSANTS|9007|||||No|No||CAMBER PHARMACE|No||||
levetiracetam|No|No|No|No|75%|31722053612|LEVETIRACETAM 250 MG TABLET|120|EA|.12269|08/01/2012||Yes|No||08/01/2012||Yes|No|08/01/2012||Yes|No||||No|No|||Prescription required|No||056|No|.08073|03/29/2022|.07879|03/29/2022|.07931|03/29/2022|||ANTICONVULSANTS|9008|||||No|No||CAMBER PHARMACE|No||||
levetiracetam|No|No|No|No|75%|31722053705|LEVETIRACETAM 500 MG TABLET|500|EA|.14119|08/01/2012||Yes|No||08/01/2012||Yes|No|08/01/2012||Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|9009|||||No|No||CAMBER PHARMACE|No||||
levetiracetam|No|No|No|No|75%|31722053712|LEVETIRACETAM 500 MG TABLET|120|EA|.14118|08/01/2012||Yes|No||08/01/2012||Yes|No|08/01/2012||Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|9010|||||No|No||CAMBER PHARMACE|No||||
levetiracetam|No|No|No|No|75%|31722053805|LEVETIRACETAM 750 MG TABLET|500|EA|.19128|08/01/2012||Yes|No||08/01/2012||Yes|No|08/01/2012||Yes|No||||No|No|||Prescription required|No||056|No|.15853|03/29/2022|.15472|03/29/2022|.15575|03/29/2022|||ANTICONVULSANTS|9011|||||No|No||CAMBER PHARMACE|No||||
levetiracetam|No|No|No|No|75%|31722053812|LEVETIRACETAM 750 MG TABLET|120|EA|.19127|08/01/2012||Yes|No||08/01/2012||Yes|No|08/01/2012||Yes|No||||No|No|||Prescription required|No||056|No|.15853|03/29/2022|.15472|03/29/2022|.15575|03/29/2022|||ANTICONVULSANTS|9012|||||No|No||CAMBER PHARMACE|No||||
levetiracetam|No|No|No|No|75%|31722053960|LEVETIRACETAM 1,000 MG TABLET|60|EA|.28236|08/01/2012||Yes|No||08/01/2012||Yes|No|08/01/2012||Yes|No||||No|No|||Prescription required|No||056|No|.22789|03/29/2022|.22242|03/29/2022|.2239|03/29/2022|||ANTICONVULSANTS|9013|||||No|No||CAMBER PHARMACE|No||||
indomethacin|No|No|No|No|75%|31722054201|INDOMETHACIN 25 MG CAPSULE|100|EA|.08213|10/04/2011||Yes|No||10/04/2011||Yes|No|10/04/2011||Yes|No||07/01/2016||Yes|No|||Prescription required|No||059|Yes|.10587|03/29/2022|.10332|03/29/2022|.10401|03/29/2022|||NSAIDS|9014|||||No|No||CAMBER PHARMACE|No||||
indomethacin|No|No|No|No|75%|31722054301|INDOMETHACIN 50 MG CAPSULE|100|EA|.09593|10/04/2011||Yes|No||10/04/2011||Yes|No|10/04/2011||Yes|No||07/01/2016||Yes|No|||Prescription required|No||059|Yes|.14384|03/29/2022|.14038|03/29/2022|.14132|03/29/2022|||NSAIDS|9015|||||No|No||CAMBER PHARMACE|No||||
lithium carbonate|No|No|No|No|75%|31722054401|LITHIUM CARBONATE 150 MG CAP|100|EA|.03887|10/05/2010||Yes|No||10/05/2010||Yes|No|10/05/2010||Yes|No||||No|No|||Prescription required|No|||No|.06953|03/29/2022|.06786|03/29/2022|.06831|03/29/2022||||9016|||||No|No||CAMBER PHARMACE|No||||
lithium carbonate|No|No|No|No|75%|31722054501|LITHIUM CARBONATE 300 MG CAP|100|EA|.02786|10/05/2010||Yes|No||10/05/2010||Yes|No|10/05/2010||Yes|No||||No|No|||Prescription required|No|||No|.04894|03/29/2022|.04776|03/29/2022|.04808|03/29/2022||||9017|||||No|No||CAMBER PHARMACE|No||||
lithium carbonate|No|No|No|No|75%|31722054510|LITHIUM CARBONATE 300 MG CAP|1000|EA|.02387|10/05/2010||Yes|No||10/05/2010||Yes|No|10/05/2010||Yes|No||||No|No|||Prescription required|No|||No|.04894|03/29/2022|.04776|03/29/2022|.04808|03/29/2022||||9018|||||No|No||CAMBER PHARMACE|No||||
lithium carbonate|No|No|No|No|75%|31722054601|LITHIUM CARBONATE 600 MG CAP|100|EA|.09245|10/05/2010||Yes|No||10/05/2010||Yes|No|10/05/2010||Yes|No||||No|No|||Prescription required|No|||No|.13745|03/29/2022|.13415|03/29/2022|.13504|03/29/2022||||9019|||||No|No||CAMBER PHARMACE|No||||
levocetirizine dihydrochloride|No|No|No|No|75%|31722055190|LEVOCETIRIZINE 5 MG TABLET|90|EA|.14333|08/06/2012||Yes|No||08/06/2012||Yes|No|08/06/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|030|Yes|.08234|03/29/2022|.08036|03/29/2022|.08089|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|9020|||||No|No||CAMBER PHARMACE|No||||
lopinavir/ritonavir|No|No|No|No|75%|31722055612|LOPINAVIR-RITONAVR 200-50MG TB|120|EA|4.4238|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|7.22554|08/26/2021|7.12231|08/26/2021|6.78316|08/26/2021|||HIV / AIDS|9021|||||No|No||CAMBER PHARMACE|No||||
abacavir sulfate|No|No|No|No|75%|31722055760|ABACAVIR 300 MG TABLET|60|EA|1.5|06/30/2016||Yes|No||06/30/2016||Yes|No|06/30/2016||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.69669|03/29/2022|.67996|03/29/2022|.68449|03/29/2022|||HIV / AIDS|9022|||||No|No||CAMBER PHARMACE|No||||
abacavir sulfate|No|No|No|No|75%|31722056224|ABACAVIR 20 MG/ML SOLUTION|240|ML|.31369|11/20/2017||Yes|No||11/20/2017||Yes|No|11/20/2017||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.51237|11/20/2017|.50505|11/20/2017|.481|11/20/2017|||HIV / AIDS|9023|||||No|No||CAMBER PHARMACE|No||||
citalopram hydrobromide|Yes|No|No|No|75%|31722056424|CITALOPRAM HBR 10 MG/5 ML SOLN|240|ML|.11643|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|05/21/2018||Prescription required|No||008|No|.26239|01/25/2022|.25609|01/25/2022|.25779|01/25/2022|||ANTIDEPRESSANTS: SSRIs|9024|||||No|No||CAMBER PHARMACE|No||||
indomethacin|No|No|No|No|75%|31722056501|INDOMETHACIN ER 75 MG CAPSULE|100|EA|.5375|02/20/2013||Yes|No||02/20/2013||Yes|No|02/20/2013||Yes|No||07/01/2016||Yes|No|||Prescription required|Yes|01/23/2013|059|Yes|.23098|03/29/2022|.22543|03/29/2022|.22693|03/29/2022|||NSAIDS|9025|||||No|No||CAMBER PHARMACE|No||||
indomethacin|No|No|No|No|75%|31722056560|INDOMETHACIN ER 75 MG CAPSULE|60|EA|.5375|02/20/2013||Yes|No||02/20/2013||Yes|No|02/20/2013||Yes|No||07/01/2016||Yes|No|||Prescription required|Yes|01/23/2013|059|Yes|.23098|03/29/2022|.22543|03/29/2022|.22693|03/29/2022|||NSAIDS|9026|||||No|No||CAMBER PHARMACE|No||||
escitalopram oxalate|No|No|No|No|75%|31722056924|ESCITALOPRAM OXALATE 5 MG/5 ML|240|ML|.27262|09/04/2012||Yes|No||09/04/2012||Yes|No|09/04/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|008|No|.36935|02/22/2022|.36048|02/22/2022|.36288|02/22/2022|||ANTIDEPRESSANTS: SSRIs|9027|||||No|No||CAMBER PHARMACE|No||||
lansoprazole|No|No|No|No|75%|31722057030|LANSOPRAZOLE DR 15 MG CAPSULE|30|EA|.14333|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|Yes|.24898|03/29/2022|.243|03/29/2022|.24462|03/29/2022|||PROTON PUMP INHIBITORS|9028|||||No|No||CAMBER PHARMACE|No||||
lansoprazole|No|No|No|No|75%|31722057090|LANSOPRAZOLE DR 15 MG CAPSULE|90|EA|.14333|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|Yes|.24898|03/29/2022|.243|03/29/2022|.24462|03/29/2022|||PROTON PUMP INHIBITORS|9029|||||No|No||CAMBER PHARMACE|No||||
lansoprazole|No|No|No|No|75%|31722057105|LANSOPRAZOLE DR 30 MG CAPSULE|500|EA|.14333|10/14/2021||Yes|No||10/14/2021||Yes|No|10/14/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.12249|03/29/2022|.11955|03/29/2022|.12034|03/29/2022|||PROTON PUMP INHIBITORS|9030|||||No|No||CAMBER PHARMACE|No||||
lansoprazole|No|No|No|No|75%|31722057130|LANSOPRAZOLE DR 30 MG CAPSULE|30|EA|.14333|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|No|.12249|03/29/2022|.11955|03/29/2022|.12034|03/29/2022|||PROTON PUMP INHIBITORS|9031|||||No|No||CAMBER PHARMACE|No||||
lansoprazole|No|No|No|No|75%|31722057190|LANSOPRAZOLE DR 30 MG CAPSULE|90|EA|.14333|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|No|.12249|03/29/2022|.11955|03/29/2022|.12034|03/29/2022|||PROTON PUMP INHIBITORS|9032|||||No|No||CAMBER PHARMACE|No||||
esomeprazole magnesium|No|No|No|No|75%|31722057210|ESOMEPRAZOLE MAG DR 20 MG CAP|1000|EA|.14333|09/30/2015||Yes|No||09/30/2015||Yes|No|09/30/2015||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|9033|||||No|No||CAMBER PHARMACE|No||||
esomeprazole magnesium|No|No|No|No|75%|31722057230|ESOMEPRAZOLE MAG DR 20 MG CAP|30|EA|.14333|09/30/2015||Yes|No||09/30/2015||Yes|No|09/30/2015||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|9034|||||No|No||CAMBER PHARMACE|No||||
esomeprazole magnesium|No|No|No|No|75%|31722057290|ESOMEPRAZOLE MAG DR 20 MG CAP|90|EA|.14333|09/30/2015||Yes|No||09/30/2015||Yes|No|09/30/2015||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|9035|||||No|No||CAMBER PHARMACE|No||||
esomeprazole magnesium|No|No|No|No|75%|31722057310|ESOMEPRAZOLE MAG DR 40 MG CAP|1000|EA|.14333|09/30/2015||Yes|No||09/30/2015||Yes|No|09/30/2015||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|9036|||||No|No||CAMBER PHARMACE|No||||
esomeprazole magnesium|No|No|No|No|75%|31722057330|ESOMEPRAZOLE MAG DR 40 MG CAP|30|EA|.14333|09/30/2015||Yes|No||09/30/2015||Yes|No|09/30/2015||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|9037|||||No|No||CAMBER PHARMACE|No||||
esomeprazole magnesium|No|No|No|No|75%|31722057390|ESOMEPRAZOLE MAG DR 40 MG CAP|90|EA|.14333|09/30/2015||Yes|No||09/30/2015||Yes|No|09/30/2015||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|9038|||||No|No||CAMBER PHARMACE|No||||
levetiracetam|No|No|No|No|75%|31722057447|LEVETIRACETAM 100 MG/ML SOLN|473|ML|.04086|07/11/2013||Yes|No||07/11/2013||Yes|No|07/11/2013||Yes|No||||No|No|||Prescription required|No||056|No|.03146|03/29/2022|.0307|03/29/2022|.0309|03/29/2022|||ANTICONVULSANTS|9039|||||No|No||CAMBER PHARMACE|No||||
duloxetine HCl|No|No|No|No|75%|31722058160|DULOXETINE HCL DR 20 MG CAP|60|EA|.21055|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|No||232|No|.13163|03/29/2022|.12847|03/29/2022|.12932|03/29/2022|||NEUROPATHIC PAIN|9040|||||No|No||CAMBER PHARMACE|No||||
duloxetine HCl|No|No|No|No|75%|31722058230|DULOXETINE HCL DR 30 MG CAP|30|EA|.21113|11/23/2016||Yes|No||11/23/2016||Yes|No|11/23/2016||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|9041|||||No|No||CAMBER PHARMACE|No||||
duloxetine HCl|No|No|No|No|75%|31722058330|DULOXETINE HCL DR 60 MG CAP|30|EA|.21113|11/23/2016||Yes|No||11/23/2016||Yes|No|11/23/2016||Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|9042|||||No|No||CAMBER PHARMACE|No||||
nebivolol HCl|No|No|No|No|75%|31722058530|NEBIVOLOL 2.5 MG TABLET|30|EA|.18246|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.41918|03/29/2022|.40911|03/29/2022|.41184|03/29/2022|||BETA-BLOCKERS|9043|||||No|No||CAMBER PHARMACE|No||||
nebivolol HCl|No|No|No|No|75%|31722058630|NEBIVOLOL 5 MG TABLET|30|EA|.18246|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.46205|03/29/2022|.45096|03/29/2022|.45396|03/29/2022|||BETA-BLOCKERS|9044|||||No|No||CAMBER PHARMACE|No||||
nebivolol HCl|No|No|No|No|75%|31722058690|NEBIVOLOL 5 MG TABLET|90|EA|.18246|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.46205|03/29/2022|.45096|03/29/2022|.45396|03/29/2022|||BETA-BLOCKERS|9045|||||No|No||CAMBER PHARMACE|No||||
nebivolol HCl|No|No|No|No|75%|31722058730|NEBIVOLOL 10 MG TABLET|30|EA|.18246|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.40408|03/29/2022|.39438|03/29/2022|.397|03/29/2022|||BETA-BLOCKERS|9046|||||No|No||CAMBER PHARMACE|No||||
nebivolol HCl|No|No|No|No|75%|31722058790|NEBIVOLOL 10 MG TABLET|90|EA|.18246|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.40408|03/29/2022|.39438|03/29/2022|.397|03/29/2022|||BETA-BLOCKERS|9047|||||No|No||CAMBER PHARMACE|No||||
nebivolol HCl|No|No|No|No|75%|31722058830|NEBIVOLOL 20 MG TABLET|30|EA|.18246|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.46821|03/29/2022|.45697|03/29/2022|.46001|03/29/2022|||BETA-BLOCKERS|9048|||||No|No||CAMBER PHARMACE|No||||
nebivolol HCl|No|No|No|No|75%|31722058890|NEBIVOLOL 20 MG TABLET|90|EA|.18246|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.46821|03/29/2022|.45697|03/29/2022|.46001|03/29/2022|||BETA-BLOCKERS|9049|||||No|No||CAMBER PHARMACE|No||||
metoprolol succinate|No|No|No|No|75%|31722058901|METOPROLOL SUCC ER 25 MG TAB|100|EA|.10848|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||02/03/2022||Yes|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|9050|||||No|No||CAMBER PHARMACE|No||||
metoprolol succinate|No|No|No|No|75%|31722059001|METOPROLOL SUCC ER 50 MG TAB|100|EA|.10848|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||02/03/2022||Yes|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|9051|||||No|No||CAMBER PHARMACE|No||||
metoprolol succinate|No|No|No|No|75%|31722059101|METOPROLOL SUCC ER 100 MG TAB|100|EA|.16301|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||02/03/2022||Yes|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|9052|||||No|No||CAMBER PHARMACE|No||||
metoprolol succinate|No|No|No|No|75%|31722059110|METOPROLOL SUCC ER 100 MG TAB|1000|EA|.16301|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||02/03/2022||Yes|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|9053|||||No|No||CAMBER PHARMACE|No||||
metoprolol succinate|No|No|No|No|75%|31722059201|METOPROLOL SUCC ER 200 MG TAB|100|EA|.25937|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||02/03/2022||Yes|No|||Prescription required|No||070|No|.25385|03/29/2022|.24775|03/29/2022|.2494|03/29/2022|||BETA-BLOCKERS|9054|||||No|No||CAMBER PHARMACE|No||||
fenofibrate nanocrystallized|No|No|No|No|75%|31722059590|FENOFIBRATE 48 MG TABLET|90|EA|.2191|06/29/2017||Yes|No||06/29/2017||Yes|No|06/29/2017||Yes|No||||No|No|||Prescription required|No||055|No|.11999|03/29/2022|.11711|03/29/2022|.11789|03/29/2022|||LIPOTROPICS: OTHER|9055|||||No|No||CAMBER PHARMACE|No||||
fenofibrate nanocrystallized|No|No|No|No|75%|31722059690|FENOFIBRATE 145 MG TABLET|90|EA|.40013|06/29/2017||Yes|No||06/29/2017||Yes|No|06/29/2017||Yes|No||||No|No|||Prescription required|No||055|No|.16424|03/29/2022|.16029|03/29/2022|.16136|03/29/2022|||LIPOTROPICS: OTHER|9056|||||No|No||CAMBER PHARMACE|No||||
ritonavir|No|No|No|No|75%|31722059730|RITONAVIR 100 MG TABLET|30|EA|1.59999|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|1.50357|03/29/2022|1.46748|03/29/2022|1.47725|03/29/2022|||HIV / AIDS|9057|||||No|No||CAMBER PHARMACE|No||||
rufinamide|No|No|No|No|75%|31722059812|RUFINAMIDE 200 MG TABLET|120|EA|1.83882|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||056|No|4.1908|08/26/2021|4.13093|08/26/2021|3.93422|08/26/2021|||ANTICONVULSANTS|9058|||||No|No||CAMBER PHARMACE|No||||
rufinamide|No|No|No|No|75%|31722059912|RUFINAMIDE 400 MG TABLET|120|EA|3.67764|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||056|No|5.73268|01/25/2022|5.59509|01/25/2022|5.63235|01/25/2022|||ANTICONVULSANTS|9059|||||No|No||CAMBER PHARMACE|No||||
lopinavir/ritonavir|No|No|No|No|75%|31722060360|LOPINAVIR-RITONAVR 100-25MG TB|60|EA|2.2119|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|3.61277|08/26/2021|3.56115|08/26/2021|3.39158|08/26/2021|||HIV / AIDS|9060|||||No|No||CAMBER PHARMACE|No||||
tolterodine tartrate|No|No|No|No|75%|31722060730|TOLTERODINE TART ER 2 MG CAP|30|EA|1.43333|05/28/2019||Yes|No||05/28/2019||Yes|No|05/28/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|Yes|1.20249|03/29/2022|1.17363|03/29/2022|1.18144|03/29/2022|||BLADDER RELAXANT PREPARATIONS|9061|||||No|No||CAMBER PHARMACE|No||||
tolterodine tartrate|No|No|No|No|75%|31722060830|TOLTERODINE TART ER 4 MG CAP|30|EA|1.43333|05/28/2019||Yes|No||05/28/2019||Yes|No|05/28/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|No|1.14537|03/29/2022|1.11788|03/29/2022|1.12532|03/29/2022|||BLADDER RELAXANT PREPARATIONS|9062|||||No|No||CAMBER PHARMACE|No||||
pregabalin|No|No|No|No|90%|31722061090|PREGABALIN 25 MG CAPSULE|90|EA|.03821|08/17/2020||Yes|No||08/17/2020||Yes|No|08/17/2020||Yes|No||||No|No|||Prescription required|No||232|No|.0795|03/29/2022|.07759|03/29/2022|.0781|03/29/2022|||NEUROPATHIC PAIN|9063|||||No|No||CAMBER PHARMACE|No||||
pregabalin|No|No|No|No|90%|31722061190|PREGABALIN 50 MG CAPSULE|90|EA|.03917|08/17/2020||Yes|No||08/17/2020||Yes|No|08/17/2020||Yes|No||||No|No|||Prescription required|No||232|No|.09128|03/29/2022|.08908|03/29/2022|.08968|03/29/2022|||NEUROPATHIC PAIN|9064|||||No|No||CAMBER PHARMACE|No||||
pregabalin|No|No|No|No|90%|31722061290|PREGABALIN 75 MG CAPSULE|90|EA|.04013|08/17/2020||Yes|No||08/17/2020||Yes|No|08/17/2020||Yes|No||||No|No|||Prescription required|No||232|No|.08098|03/29/2022|.07903|03/29/2022|.07956|03/29/2022|||NEUROPATHIC PAIN|9065|||||No|No||CAMBER PHARMACE|No||||
pregabalin|No|No|No|No|90%|31722061390|PREGABALIN 100 MG CAPSULE|90|EA|.04204|08/17/2020||Yes|No||08/17/2020||Yes|No|08/17/2020||Yes|No||||No|No|||Prescription required|No||232|No|.08763|03/29/2022|.08552|03/29/2022|.08609|03/29/2022|||NEUROPATHIC PAIN|9066|||||No|No||CAMBER PHARMACE|No||||
pregabalin|No|No|No|No|90%|31722061490|PREGABALIN 150 MG CAPSULE|90|EA|.04443|08/17/2020||Yes|No||08/17/2020||Yes|No|08/17/2020||Yes|No||||No|No|||Prescription required|No||232|No|.10646|03/29/2022|.1039|03/29/2022|.10459|03/29/2022|||NEUROPATHIC PAIN|9067|||||No|No||CAMBER PHARMACE|No||||
pregabalin|No|No|No|No|90%|31722061590|PREGABALIN 200 MG CAPSULE|90|EA|.04777|08/17/2020||Yes|No||08/17/2020||Yes|No|08/17/2020||Yes|No||||No|No|||Prescription required|No||232|No|.11395|03/29/2022|.11121|03/29/2022|.11195|03/29/2022|||NEUROPATHIC PAIN|9068|||||No|No||CAMBER PHARMACE|No||||
pregabalin|No|No|No|No|90%|31722061690|PREGABALIN 225 MG CAPSULE|90|EA|.05016|08/17/2020||Yes|No||08/17/2020||Yes|No|08/17/2020||Yes|No||||No|No|||Prescription required|No||232|No|.12393|03/29/2022|.12095|03/29/2022|.12176|03/29/2022|||NEUROPATHIC PAIN|9069|||||No|No||CAMBER PHARMACE|No||||
pregabalin|No|No|No|No|90%|31722061790|PREGABALIN 300 MG CAPSULE|90|EA|.05255|08/17/2020||Yes|No||08/17/2020||Yes|No|08/17/2020||Yes|No||||No|No|||Prescription required|No||232|No|.12181|03/29/2022|.11888|03/29/2022|.11967|03/29/2022|||NEUROPATHIC PAIN|9070|||||No|No||CAMBER PHARMACE|No||||
atovaquone|No|No|No|No|75%|31722062921|ATOVAQUONE 750 MG/5 ML SUSP|210|ML|1.14285|08/09/2019||Yes|No||08/09/2019||Yes|No|08/09/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|1.13871|03/29/2022|1.11138|03/29/2022|1.11878|03/29/2022||||9071|||||No|No||CAMBER PHARMACE|No||||
oseltamivir phosphate|No|No|No|No|75%|31722063031|OSELTAMIVIR PHOS 30 MG CAPSULE|10|EA|1.118|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|No||025|No|1.58155|03/29/2022|1.54359|03/29/2022|1.55387|03/29/2022|||ANTIVIRALS: ORAL|9072|||||No|No||CAMBER PHARMACE|No||||
oseltamivir phosphate|No|No|No|No|75%|31722063131|OSELTAMIVIR PHOS 45 MG CAPSULE|10|EA|1.118|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|No||025|No|1.5655|03/29/2022|1.52792|03/29/2022|1.5381|03/29/2022|||ANTIVIRALS: ORAL|9073|||||No|No||CAMBER PHARMACE|No||||
oseltamivir phosphate|No|No|No|No|75%|31722063231|OSELTAMIVIR PHOS 75 MG CAPSULE|10|EA|1.118|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|No||025|No|1.29695|03/29/2022|1.26582|03/29/2022|1.27425|03/29/2022|||ANTIVIRALS: ORAL|9074|||||No|No||CAMBER PHARMACE|No||||
silodosin|No|No|No|No|75%|31722063530|SILODOSIN 4 MG CAPSULE|30|EA|.43|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|003|No|.60384|03/29/2022|.58934|03/29/2022|.59327|03/29/2022|||BPH TREATMENTS|9075|||||No|No||CAMBER PHARMACE|No||||
silodosin|No|No|No|No|75%|31722063630|SILODOSIN 8 MG CAPSULE|30|EA|.43|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|003|No|.68368|03/29/2022|.66727|03/29/2022|.67171|03/29/2022|||BPH TREATMENTS|9076|||||No|No||CAMBER PHARMACE|No||||
silodosin|No|No|No|No|75%|31722063690|SILODOSIN 8 MG CAPSULE|90|EA|.43|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|003|No|.68368|03/29/2022|.66727|03/29/2022|.67171|03/29/2022|||BPH TREATMENTS|9077|||||No|No||CAMBER PHARMACE|No||||
tadalafil|No|No|No|No|75%|31722064730|TADALAFIL 20 MG TABLET|30|EA|.71666|05/28/2019||Yes|No||05/28/2019||Yes|No|05/28/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/26/2018|171|Yes|.68104|03/29/2022|.66469|03/29/2022|.66912|03/29/2022|||PAH AGENTS: ORAL AND INHALED|9078|||||No|No||CAMBER PHARMACE|No||||
dimethyl fumarate|No|No|No|No|75%|31722065731|DIMETHYL FUMARATE DR 120 MG CP|14|EA|2.30357|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||043|No|6.92871|10/26/2021|6.76242|10/26/2021|6.80745|10/26/2021|||MULTIPLE SCLEROSIS AGENTS|9079|||||No|No||CAMBER PHARMACE|No||||
dimethyl fumarate|No|No|No|No|75%|31722065832|DIMETHYL FUMARATE DR 240 MG CP|60|EA|1.6125|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||043|No|3.05522|11/23/2021|2.98189|11/23/2021|3.00175|11/23/2021|||MULTIPLE SCLEROSIS AGENTS|9080|||||No|No||CAMBER PHARMACE|No||||
levocetirizine dihydrochloride|No|No|No|No|75%|31722065931|LEVOCETIRIZINE 2.5 MG/5 ML SOL|148|ML|.13074|02/25/2020||Yes|No||02/25/2020||Yes|No|02/25/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|030|Yes|.20616|02/08/2022|.20121|02/08/2022|.20255|02/08/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|9081|||||No|No||CAMBER PHARMACE|No||||
esomeprazole magnesium|No|No|No|No|75%|31722066410|ESOMEPRAZOLE MAG DR 20 MG CAP|1000|EA|.14333|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||02/03/2022||Yes|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|9082|||||No|No||CAMBER PHARMACE|No||||
esomeprazole magnesium|No|No|No|No|75%|31722066430|ESOMEPRAZOLE MAG DR 20 MG CAP|30|EA|.14333|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||02/03/2022||Yes|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|9083|||||No|No||CAMBER PHARMACE|No||||
esomeprazole magnesium|No|No|No|No|75%|31722066490|ESOMEPRAZOLE MAG DR 20 MG CAP|90|EA|.14333|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||02/03/2022||Yes|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|9084|||||No|No||CAMBER PHARMACE|No||||
esomeprazole magnesium|No|No|No|No|75%|31722066510|ESOMEPRAZOLE MAG DR 40 MG CAP|1000|EA|.14333|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||02/03/2022||Yes|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|9085|||||No|No||CAMBER PHARMACE|No||||
esomeprazole magnesium|No|No|No|No|75%|31722066530|ESOMEPRAZOLE MAG DR 40 MG CAP|30|EA|.14333|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||02/03/2022||Yes|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|9086|||||No|No||CAMBER PHARMACE|No||||
dimethyl fumarate|No|No|No|No|75%|31722068060|DIMETHYL FUMARATE 30D START PK|60|EA|1.6125|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||043|No|3.675|11/02/2021|3.6225|11/02/2021|3.45|11/02/2021|||MULTIPLE SCLEROSIS AGENTS|9087|||||No|No||CAMBER PHARMACE|No||||
losartan potassium|Yes|No|No|No|75%|31722070005|LOSARTAN POTASSIUM 25 MG TAB|500|EA|.06039|01/22/2016||Yes|No||01/22/2016||Yes|No|01/22/2016||Yes|No||01/22/2016||Yes|No|07/01/2016||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|9088|||||No|No||CAMBER PHARMACE|No||||
losartan potassium|Yes|No|No|No|75%|31722070010|LOSARTAN POTASSIUM 25 MG TAB|1000|EA|.06039|01/22/2016||Yes|No||01/22/2016||Yes|No|01/22/2016||Yes|No||01/22/2016||Yes|No|07/01/2016||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|9089|||||No|No||CAMBER PHARMACE|No||||
losartan potassium|Yes|No|No|No|75%|31722070090|LOSARTAN POTASSIUM 25 MG TAB|90|EA|.06038|01/22/2016||Yes|No||01/22/2016||Yes|No|01/22/2016||Yes|No||01/22/2016||Yes|No|07/01/2016||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|9090|||||No|No||CAMBER PHARMACE|No||||
losartan potassium|Yes|No|No|No|75%|31722070110|LOSARTAN POTASSIUM 50 MG TAB|1000|EA|.08122|01/22/2016||Yes|No||01/22/2016||Yes|No|01/22/2016||Yes|No||01/22/2016||Yes|No|07/01/2016||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|9091|||||No|No||CAMBER PHARMACE|No||||
losartan potassium|Yes|No|No|No|75%|31722070130|LOSARTAN POTASSIUM 50 MG TAB|30|EA|.08155|01/26/2016||Yes|No||01/26/2016||Yes|No|01/26/2016||Yes|No||01/26/2016||Yes|No|07/01/2016||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|9092|||||No|No||CAMBER PHARMACE|No||||
losartan potassium|Yes|No|No|No|75%|31722070190|LOSARTAN POTASSIUM 50 MG TAB|90|EA|.08121|01/22/2016||Yes|No||01/22/2016||Yes|No|01/22/2016||Yes|No||01/22/2016||Yes|No|07/01/2016||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|9093|||||No|No||CAMBER PHARMACE|No||||
losartan potassium|Yes|No|No|No|75%|31722070210|LOSARTAN POTASSIUM 100 MG TAB|1000|EA|.1106|01/22/2016||Yes|No||01/22/2016||Yes|No|01/22/2016||Yes|No||01/22/2016||Yes|No|07/01/2016||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|9094|||||No|No||CAMBER PHARMACE|No||||
losartan potassium|Yes|No|No|No|75%|31722070230|LOSARTAN POTASSIUM 100 MG TAB|30|EA|.11094|01/26/2016||Yes|No||01/26/2016||Yes|No|01/26/2016||Yes|No||01/26/2016||Yes|No|07/01/2016||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|9095|||||No|No||CAMBER PHARMACE|No||||
losartan potassium|Yes|No|No|No|75%|31722070290|LOSARTAN POTASSIUM 100 MG TAB|90|EA|.1106|01/22/2016||Yes|No||01/22/2016||Yes|No|01/22/2016||Yes|No||01/22/2016||Yes|No|07/01/2016||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|9096|||||No|No||CAMBER PHARMACE|No||||
valacyclovir HCl|No|No|No|No|75%|31722070430|VALACYCLOVIR HCL 500 MG TABLET|30|EA|.35016|09/30/2015||Yes|No||09/30/2015||Yes|No|09/30/2015||Yes|No||07/01/2016||Yes|No|||Prescription required|No||025|No|.29328|03/29/2022|.28624|03/29/2022|.28814|03/29/2022|||ANTIVIRALS: ORAL|9097|||||No|No||CAMBER PHARMACE|No||||
valacyclovir HCl|No|No|No|No|75%|31722070490|VALACYCLOVIR HCL 500 MG TABLET|90|EA|.35016|09/30/2015||Yes|No||09/30/2015||Yes|No|09/30/2015||Yes|No||07/01/2016||Yes|No|||Prescription required|No||025|No|.29328|03/29/2022|.28624|03/29/2022|.28814|03/29/2022|||ANTIVIRALS: ORAL|9098|||||No|No||CAMBER PHARMACE|No||||
valacyclovir HCl|Yes|No|No|No|75%|31722070530|VALACYCLOVIR HCL 1 GRAM TABLET|30|EA|.55728|09/30/2015||Yes|No||09/30/2015||Yes|No|09/30/2015||Yes|No||07/01/2016||Yes|No|09/30/2015||Prescription required|No||025|No|.5737|03/29/2022|.55993|03/29/2022|.56366|03/29/2022|||ANTIVIRALS: ORAL|9099|||||No|No||CAMBER PHARMACE|No||||
valacyclovir HCl|Yes|No|No|No|75%|31722070590|VALACYCLOVIR HCL 1 GRAM TABLET|90|EA|.55728|09/30/2015||Yes|No||09/30/2015||Yes|No|09/30/2015||Yes|No||07/01/2016||Yes|No|09/30/2015||Prescription required|No||025|No|.5737|03/29/2022|.55993|03/29/2022|.56366|03/29/2022|||ANTIVIRALS: ORAL|9100|||||No|No||CAMBER PHARMACE|No||||
famciclovir|No|No|No|No|75%|31722070630|FAMCICLOVIR 125 MG TABLET|30|EA|.15695|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||025|No|.30813|10/26/2021|.30073|10/26/2021|.30273|10/26/2021|||ANTIVIRALS: ORAL|9101|||||No|No||CAMBER PHARMACE|No||||
famciclovir|Yes|No|No|No|75%|31722070730|FAMCICLOVIR 250 MG TABLET|30|EA|.22861|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|05/12/2015||Prescription required|No||025|No|.49235|03/29/2022|.48053|03/29/2022|.48373|03/29/2022|||ANTIVIRALS: ORAL|9102|||||No|No||CAMBER PHARMACE|No||||
famciclovir|No|No|No|No|75%|31722070830|FAMCICLOVIR 500 MG TABLET|30|EA|.50095|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||025|No|.88904|03/29/2022|.8677|03/29/2022|.87348|03/29/2022|||ANTIVIRALS: ORAL|9103|||||No|No||CAMBER PHARMACE|No||||
pantoprazole sodium|No|No|No|No|75%|31722071290|PANTOPRAZOLE SOD DR 20 MG TAB|90|EA|.04816|05/11/2015||Yes|No||05/11/2015||Yes|No|05/11/2015||Yes|No||07/01/2016||Yes|No|||Prescription required|No||047|Yes|.05306|03/29/2022|.05178|03/29/2022|.05213|03/29/2022|||PROTON PUMP INHIBITORS|9104|||||No|No||CAMBER PHARMACE|No||||
pantoprazole sodium|No|No|No|No|75%|31722071310|PANTOPRAZOLE SOD DR 40 MG TAB|1000|EA|.04816|09/29/2020||Yes|No||09/29/2020||Yes|No|09/29/2020||Yes|No||09/29/2020||Yes|No|||Prescription required|No||047|No|.05828|03/29/2022|.05688|03/29/2022|.05726|03/29/2022|||PROTON PUMP INHIBITORS|9105|||||No|No||CAMBER PHARMACE|No||||
pantoprazole sodium|No|No|No|No|75%|31722071390|PANTOPRAZOLE SOD DR 40 MG TAB|90|EA|.04816|05/11/2015||Yes|No||05/11/2015||Yes|No|05/11/2015||Yes|No||07/01/2016||Yes|No|||Prescription required|No||047|No|.05828|03/29/2022|.05688|03/29/2022|.05726|03/29/2022|||PROTON PUMP INHIBITORS|9106|||||No|No||CAMBER PHARMACE|No||||
atomoxetine HCl|No|No|No|No|75%|31722071430|ATOMOXETINE HCL 10 MG CAPSULE|30|EA|.78833|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||007|Yes|1.20613|03/29/2022|1.17718|03/29/2022|1.18502|03/29/2022|||STIMULANTS AND RELATED AGENTS|9107|||||No|No||CAMBER PHARMACE|No||||
atomoxetine HCl|No|No|No|No|75%|31722071530|ATOMOXETINE HCL 18 MG CAPSULE|30|EA|.78833|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||007|Yes|1.0614|03/29/2022|1.03592|03/29/2022|1.04282|03/29/2022|||STIMULANTS AND RELATED AGENTS|9108|||||No|No||CAMBER PHARMACE|No||||
atomoxetine HCl|No|No|No|No|75%|31722071630|ATOMOXETINE HCL 25 MG CAPSULE|30|EA|.78833|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||007|Yes|1.05569|03/29/2022|1.03035|03/29/2022|1.03721|03/29/2022|||STIMULANTS AND RELATED AGENTS|9109|||||No|No||CAMBER PHARMACE|No||||
atomoxetine HCl|No|No|No|No|75%|31722071730|ATOMOXETINE HCL 40 MG CAPSULE|30|EA|.903|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No||007|Yes|1.0462|03/29/2022|1.02109|03/29/2022|1.02789|03/29/2022|||STIMULANTS AND RELATED AGENTS|9110|||||No|No||CAMBER PHARMACE|No||||
atomoxetine HCl|No|No|No|No|75%|31722071830|ATOMOXETINE HCL 60 MG CAPSULE|30|EA|.903|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||007|Yes|1.16565|03/29/2022|1.13767|03/29/2022|1.14525|03/29/2022|||STIMULANTS AND RELATED AGENTS|9111|||||No|No||CAMBER PHARMACE|No||||
atomoxetine HCl|No|No|No|No|75%|31722071930|ATOMOXETINE HCL 80 MG CAPSULE|30|EA|1.01766|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||007|Yes|1.40838|03/29/2022|1.37457|03/29/2022|1.38373|03/29/2022|||STIMULANTS AND RELATED AGENTS|9112|||||No|No||CAMBER PHARMACE|No||||
atomoxetine HCl|No|No|No|No|75%|31722072030|ATOMOXETINE HCL 100 MG CAPSULE|30|EA|1.01766|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||007|Yes|1.76872|03/29/2022|1.72627|03/29/2022|1.73776|03/29/2022|||STIMULANTS AND RELATED AGENTS|9113|||||No|No||CAMBER PHARMACE|No||||
levofloxacin|No|No|No|No|75%|31722072150|LEVOFLOXACIN 250 MG TABLET|50|EA|.14465|02/23/2017||Yes|No||02/23/2017||Yes|No|02/23/2017||Yes|No||02/23/2017||Yes|No|||Prescription required|No||028|No|.15969|03/29/2022|.15585|03/29/2022|.15689|03/29/2022|||FLUOROQUINOLONES: ORAL|9114|||||No|No||CAMBER PHARMACE|No||||
levofloxacin|No|No|No|No|75%|31722072250|LEVOFLOXACIN 500 MG TABLET|50|EA|.1658|02/23/2017||Yes|No||02/23/2017||Yes|No|02/23/2017||Yes|No||02/23/2017||Yes|No|||Prescription required|No||028|No|.19821|03/29/2022|.19345|03/29/2022|.19474|03/29/2022|||FLUOROQUINOLONES: ORAL|9115|||||No|No||CAMBER PHARMACE|No||||
levofloxacin|No|No|No|No|75%|31722072320|LEVOFLOXACIN 750 MG TABLET|20|EA|.31046|02/23/2017||Yes|No||02/23/2017||Yes|No|02/23/2017||Yes|No||02/23/2017||Yes|No|||Prescription required|No||028|No|.38345|03/29/2022|.37424|03/29/2022|.37673|03/29/2022|||FLUOROQUINOLONES: ORAL|9116|||||No|No||CAMBER PHARMACE|No||||
montelukast sodium|No|No|No|No|75%|31722072610|MONTELUKAST SOD 10 MG TABLET|1000|EA|.0344|06/17/2015||Yes|No||06/17/2015||Yes|No|06/17/2015||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|9117|||||No|No||CAMBER PHARMACE|Yes|09/01/2020|||
montelukast sodium|No|No|No|No|75%|31722072630|MONTELUKAST SOD 10 MG TABLET|30|EA|.10033|06/17/2015||Yes|No||06/17/2015||Yes|No|06/17/2015||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|9118|||||No|No||CAMBER PHARMACE|Yes|09/01/2020|||
montelukast sodium|No|No|No|No|75%|31722072690|MONTELUKAST SOD 10 MG TABLET|90|EA|.086|06/17/2015||Yes|No||06/17/2015||Yes|No|06/17/2015||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|9119|||||No|No||CAMBER PHARMACE|Yes|09/01/2020|||
montelukast sodium|No|No|No|No|75%|31722072730|MONTELUKAST SOD 4 MG TAB CHEW|30|EA|.15265|10/22/2015||Yes|No||10/22/2015||Yes|No|10/22/2015||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|9120|||||No|No||CAMBER PHARMACE|No||||
montelukast sodium|No|No|No|No|75%|31722072790|MONTELUKAST SOD 4 MG TAB CHEW|90|EA|.14786|10/22/2015||Yes|No||10/22/2015||Yes|No|10/22/2015||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|9121|||||No|No||CAMBER PHARMACE|No||||
montelukast sodium|No|No|No|No|75%|31722072830|MONTELUKAST SOD 5 MG TAB CHEW|30|EA|.15265|10/22/2015||Yes|No||10/22/2015||Yes|No|10/22/2015||Yes|No||||No|No|||Prescription required|No||042|Yes|.08451|03/29/2022|.08248|03/29/2022|.08303|03/29/2022|||LEUKOTRIENE MODIFIERS|9122|||||No|No||CAMBER PHARMACE|No||||
montelukast sodium|No|No|No|No|75%|31722072890|MONTELUKAST SOD 5 MG TAB CHEW|90|EA|.14786|10/22/2015||Yes|No||10/22/2015||Yes|No|10/22/2015||Yes|No||||No|No|||Prescription required|No||042|Yes|.08451|03/29/2022|.08248|03/29/2022|.08303|03/29/2022|||LEUKOTRIENE MODIFIERS|9123|||||No|No||CAMBER PHARMACE|No||||
irbesartan|Yes|No|No|No|75%|31722072930|IRBESARTAN 75 MG TABLET|30|EA|.15107|09/28/2012||Yes|No||09/28/2012||Yes|No|09/28/2012||Yes|No||07/01/2016||Yes|No|07/01/2016||Prescription required|No||113|Yes|.21751|03/29/2022|.21228|03/29/2022|.2137|03/29/2022|||ANGIOTENSIN MODULATORS|9124|||||No|No||CAMBER PHARMACE|No||||
irbesartan|Yes|No|No|No|75%|31722072990|IRBESARTAN 75 MG TABLET|90|EA|.15107|09/28/2012||Yes|No||09/28/2012||Yes|No|09/28/2012||Yes|No||07/01/2016||Yes|No|07/01/2016||Prescription required|No||113|Yes|.21751|03/29/2022|.21228|03/29/2022|.2137|03/29/2022|||ANGIOTENSIN MODULATORS|9125|||||No|No||CAMBER PHARMACE|No||||
irbesartan|Yes|No|No|No|75%|31722073030|IRBESARTAN 150 MG TABLET|30|EA|.15895|09/28/2012||Yes|No||09/28/2012||Yes|No|09/28/2012||Yes|No||07/01/2016||Yes|No|07/01/2016||Prescription required|No||113|Yes|.20852|03/29/2022|.20351|03/29/2022|.20487|03/29/2022|||ANGIOTENSIN MODULATORS|9126|||||No|No||CAMBER PHARMACE|No||||
irbesartan|Yes|No|No|No|75%|31722073090|IRBESARTAN 150 MG TABLET|90|EA|.159|09/28/2012||Yes|No||09/28/2012||Yes|No|09/28/2012||Yes|No||07/01/2016||Yes|No|07/01/2016||Prescription required|No||113|Yes|.20852|03/29/2022|.20351|03/29/2022|.20487|03/29/2022|||ANGIOTENSIN MODULATORS|9127|||||No|No||CAMBER PHARMACE|No||||
irbesartan|Yes|No|No|No|75%|31722073130|IRBESARTAN 300 MG TABLET|30|EA|.1912|09/28/2012||Yes|No||09/28/2012||Yes|No|09/28/2012||Yes|No||07/01/2016||Yes|No|07/01/2016||Prescription required|No||113|Yes|.32541|03/29/2022|.3176|03/29/2022|.31971|03/29/2022|||ANGIOTENSIN MODULATORS|9128|||||No|No||CAMBER PHARMACE|No||||
irbesartan|Yes|No|No|No|75%|31722073190|IRBESARTAN 300 MG TABLET|90|EA|.1911|09/28/2012||Yes|No||09/28/2012||Yes|No|09/28/2012||Yes|No||07/01/2016||Yes|No|07/01/2016||Prescription required|No||113|Yes|.32541|03/29/2022|.3176|03/29/2022|.31971|03/29/2022|||ANGIOTENSIN MODULATORS|9129|||||No|No||CAMBER PHARMACE|No||||
donepezil HCl|No|No|No|No|75%|31722073705|DONEPEZIL HCL 5 MG TABLET|500|EA|.06306|04/27/2017||Yes|No||04/27/2017||Yes|No|04/27/2017||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|9130|||||No|No||CAMBER PHARMACE|No||||
donepezil HCl|No|No|No|No|75%|31722073730|DONEPEZIL HCL 5 MG TABLET|30|EA|.06306|09/30/2015||Yes|No||09/30/2015||Yes|No|09/30/2015||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|9131|||||No|No||CAMBER PHARMACE|No||||
donepezil HCl|No|No|No|No|75%|31722073790|DONEPEZIL HCL 5 MG TABLET|90|EA|.06306|09/30/2015||Yes|No||09/30/2015||Yes|No|09/30/2015||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|9132|||||No|No||CAMBER PHARMACE|No||||
donepezil HCl|No|No|No|No|75%|31722073805|DONEPEZIL HCL 10 MG TABLET|500|EA|.06306|04/27/2017||Yes|No||04/27/2017||Yes|No|04/27/2017||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|9133|||||No|No||CAMBER PHARMACE|No||||
donepezil HCl|No|No|No|No|75%|31722073830|DONEPEZIL HCL 10 MG TABLET|30|EA|.06306|09/30/2015||Yes|No||09/30/2015||Yes|No|09/30/2015||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|9134|||||No|No||CAMBER PHARMACE|No||||
donepezil HCl|No|No|No|No|75%|31722073890|DONEPEZIL HCL 10 MG TABLET|90|EA|.06306|09/30/2015||Yes|No||09/30/2015||Yes|No|09/30/2015||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|9135|||||No|No||CAMBER PHARMACE|No||||
valsartan|Yes|No|No|No|75%|31722074530|VALSARTAN 40 MG TABLET|30|EA|.11395|05/11/2015||Yes|No||05/11/2015||Yes|No|05/11/2015||Yes|No||07/01/2016||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.1945|03/29/2022|.18983|03/29/2022|.19109|03/29/2022|||ANGIOTENSIN MODULATORS|9136|||||No|No||CAMBER PHARMACE|No||||
valsartan|Yes|No|No|No|75%|31722074690|VALSARTAN 80 MG TABLET|90|EA|.13955|05/11/2015||Yes|No||05/11/2015||Yes|No|05/11/2015||Yes|No||07/01/2016||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.21024|03/29/2022|.20519|03/29/2022|.20656|03/29/2022|||ANGIOTENSIN MODULATORS|9137|||||No|No||CAMBER PHARMACE|No||||
valsartan|Yes|No|No|No|75%|31722074790|VALSARTAN 160 MG TABLET|90|EA|.17037|05/11/2015||Yes|No||05/11/2015||Yes|No|05/11/2015||Yes|No||07/01/2016||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.23007|03/29/2022|.22454|03/29/2022|.22604|03/29/2022|||ANGIOTENSIN MODULATORS|9138|||||No|No||CAMBER PHARMACE|No||||
valsartan|Yes|No|No|No|75%|31722074890|VALSARTAN 320 MG TABLET|90|EA|.21552|05/11/2015||Yes|No||05/11/2015||Yes|No|05/11/2015||Yes|No||07/01/2016||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.31156|03/29/2022|.30408|03/29/2022|.3061|03/29/2022|||ANGIOTENSIN MODULATORS|9139|||||No|No||CAMBER PHARMACE|No||||
linezolid|No|No|No|No|75%|31722074920|LINEZOLID 600 MG TABLET|20|EA|2.52625|08/15/2016||Yes|No||08/15/2016||Yes|No|08/15/2016||Yes|No||||No|No|||Prescription required|No||146|No|2.07915|03/29/2022|2.02925|03/29/2022|2.04276|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|9140|||||No|No||CAMBER PHARMACE|No||||
linezolid|No|No|No|No|75%|31722074930|LINEZOLID 600 MG TABLET|30|EA|2.52625|08/15/2016||Yes|No||08/15/2016||Yes|No|08/15/2016||Yes|No||||No|No|||Prescription required|No||146|No|2.07915|03/29/2022|2.02925|03/29/2022|2.04276|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|9141|||||No|No||CAMBER PHARMACE|No||||
lamivudine|No|No|No|No|75%|31722075260|LAMIVUDINE HBV 100 MG TABLET|60|EA|7.03029|06/17/2015||Yes|No||06/17/2015||Yes|No|06/17/2015||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|2.63504|03/29/2022|2.57179|03/29/2022|2.58892|03/29/2022||||9142|||||No|No||CAMBER PHARMACE|No||||
lamivudine|No|No|No|No|75%|31722075360|LAMIVUDINE 150 MG TABLET|60|EA|1.365|02/19/2015||Yes|No||02/19/2015||Yes|No|02/19/2015||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.96758|11/23/2021|.94435|11/23/2021|.95064|11/23/2021|||HIV / AIDS|9143|||||No|No||CAMBER PHARMACE|No||||
lamivudine|No|No|No|No|75%|31722075430|LAMIVUDINE 300 MG TABLET|30|EA|2.73|02/19/2015||Yes|No||02/19/2015||Yes|No|02/19/2015||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|1.29184|03/01/2022|1.26083|03/01/2022|1.26923|03/01/2022|||HIV / AIDS|9144|||||No|No||CAMBER PHARMACE|No||||
sildenafil citrate|No|No|No|No|75%|31722077605|SILDENAFIL 20 MG TABLET|500|EA|.086|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|Yes|.09246|03/29/2022|.09024|03/29/2022|.09084|03/29/2022|||PAH AGENTS: ORAL AND INHALED|9145|||||No|No||CAMBER PHARMACE|No||||
sildenafil citrate|No|No|No|No|75%|31722077690|SILDENAFIL 20 MG TABLET|90|EA|.086|05/11/2015||Yes|No||05/11/2015||Yes|No|05/11/2015||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|Yes|.09246|03/29/2022|.09024|03/29/2022|.09084|03/29/2022|||PAH AGENTS: ORAL AND INHALED|9146|||||No|No||CAMBER PHARMACE|No||||
acyclovir|Yes|No|No|No|75%|31722077701|ACYCLOVIR 400 MG TABLET|100|EA|.07955|02/19/2015||Yes|No||02/19/2015||Yes|No|02/19/2015||Yes|No||07/01/2016||Yes|No|02/19/2015||Prescription required|No||025|No|.0985|03/29/2022|.09613|03/29/2022|.09677|03/29/2022|||ANTIVIRALS: ORAL|9147|||||No|No||CAMBER PHARMACE|No||||
acyclovir|Yes|No|No|No|75%|31722077705|ACYCLOVIR 400 MG TABLET|500|EA|.074|02/19/2015||Yes|No||02/19/2015||Yes|No|02/19/2015||Yes|No||07/01/2016||Yes|No|02/19/2015||Prescription required|No||025|No|.0985|03/29/2022|.09613|03/29/2022|.09677|03/29/2022|||ANTIVIRALS: ORAL|9148|||||No|No||CAMBER PHARMACE|No||||
acyclovir|No|No|No|No|75%|31722077801|ACYCLOVIR 800 MG TABLET|100|EA|.13007|02/19/2015||Yes|No||02/19/2015||Yes|No|02/19/2015||Yes|No||07/01/2016||Yes|No|||Prescription required|No||025|No|.19021|03/29/2022|.18564|03/29/2022|.18688|03/29/2022|||ANTIVIRALS: ORAL|9149|||||No|No||CAMBER PHARMACE|No||||
acyclovir|No|No|No|No|75%|31722077805|ACYCLOVIR 800 MG TABLET|500|EA|.129|02/19/2015||Yes|No||02/19/2015||Yes|No|02/19/2015||Yes|No||07/01/2016||Yes|No|||Prescription required|No||025|No|.19021|03/29/2022|.18564|03/29/2022|.18688|03/29/2022|||ANTIVIRALS: ORAL|9150|||||No|No||CAMBER PHARMACE|No||||
tolterodine tartrate|No|No|No|No|75%|31722080660|TOLTERODINE TARTRATE 2 MG TAB|60|EA|.14333|03/24/2022||Yes|No||03/24/2022||Yes|No|03/24/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|006|No|.55522|03/29/2022|.54189|03/29/2022|.5455|03/29/2022|||BLADDER RELAXANT PREPARATIONS|9151|||||No|No||CAMBER PHARMACE|No||||
aripiprazole|No|No|No|No|75%|31722081930|ARIPIPRAZOLE 2 MG TABLET|30|EA|.11466|05/11/2015||Yes|No||05/11/2015||Yes|No|05/11/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|9152|||||No|No||CAMBER PHARMACE|No||||
aripiprazole|No|No|No|No|75%|31722082030|ARIPIPRAZOLE 5 MG TABLET|30|EA|.11466|05/11/2015||Yes|No||05/11/2015||Yes|No|05/11/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|9153|||||No|No||CAMBER PHARMACE|No||||
tetrabenazine|No|No|No|No|75%|31722082111|TETRABENAZINE 12.5 MG TABLET|112|EA|1.15178|06/22/2016||Yes|No||06/22/2016||Yes|No|06/22/2016||Yes|No||||No|No|||Prescription required|No||572|Yes|2.62499|07/13/2021|2.58749|07/13/2021|2.46428|07/13/2021|||MOVEMENT DISORDERS|9154|||||No|No||CAMBER PHARMACE|No||||
tetrabenazine|No|No|No|No|75%|31722082211|TETRABENAZINE 25 MG TABLET|112|EA|2.30357|06/22/2016||Yes|No||06/22/2016||Yes|No|06/22/2016||Yes|No||||No|No|||Prescription required|No||572|Yes|5.24999|07/13/2021|5.17499|07/13/2021|4.92856|07/13/2021|||MOVEMENT DISORDERS|9155|||||No|No||CAMBER PHARMACE|No||||
aripiprazole|No|No|No|No|75%|31722082730|ARIPIPRAZOLE 10 MG TABLET|30|EA|.129|05/11/2015||Yes|No||05/11/2015||Yes|No|05/11/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|9156|||||No|No||CAMBER PHARMACE|No||||
aripiprazole|No|No|No|No|75%|31722082830|ARIPIPRAZOLE 15 MG TABLET|30|EA|.129|05/11/2015||Yes|No||05/11/2015||Yes|No|05/11/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|9157|||||No|No||CAMBER PHARMACE|No||||
aripiprazole|No|No|No|No|75%|31722082930|ARIPIPRAZOLE 20 MG TABLET|30|EA|.14333|05/11/2015||Yes|No||05/11/2015||Yes|No|05/11/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|9158|||||No|No||CAMBER PHARMACE|No||||
aripiprazole|No|No|No|No|75%|31722083030|ARIPIPRAZOLE 30 MG TABLET|30|EA|.14333|05/11/2015||Yes|No||05/11/2015||Yes|No|05/11/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|9159|||||No|No||CAMBER PHARMACE|No||||
valganciclovir HCl|No|No|No|No|75%|31722083260|VALGANCICLOVIR 450 MG TABLET|60|EA|2.15|06/13/2016||Yes|No||06/13/2016||Yes|No|06/13/2016||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|136|No|2.64507|03/29/2022|2.58158|03/29/2022|2.59878|03/29/2022|||ANTIVIRALS: GENERAL|9160|||||No|No||CAMBER PHARMACE|No||||
entecavir|No|No|No|No|75%|31722083330|ENTECAVIR 0.5 MG TABLET|30|EA|.57333|10/05/2016||Yes|No||10/05/2016||Yes|No|10/05/2016||Yes|No||||No|No|||Prescription required|No|||No|.89227|03/29/2022|.87085|03/29/2022|.87665|03/29/2022||||9161|||||No|No||CAMBER PHARMACE|No||||
entecavir|No|No|No|No|75%|31722083390|ENTECAVIR 0.5 MG TABLET|90|EA|.57333|10/05/2016||Yes|No||10/05/2016||Yes|No|10/05/2016||Yes|No||||No|No|||Prescription required|No|||No|.89227|03/29/2022|.87085|03/29/2022|.87665|03/29/2022||||9162|||||No|No||CAMBER PHARMACE|No||||
entecavir|No|No|No|No|75%|31722083430|ENTECAVIR 1 MG TABLET|30|EA|.57333|10/05/2016||Yes|No||10/05/2016||Yes|No|10/05/2016||Yes|No||||No|No|||Prescription required|No|||No|1.06461|03/29/2022|1.03905|03/29/2022|1.04597|03/29/2022||||9163|||||No|No||CAMBER PHARMACE|No||||
tolvaptan|No|No|No|No|75%|31722086903|TOLVAPTAN 30 MG TABLET|10|EA|150.3495|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||No|342.657|02/23/2022|337.7619|03/01/2022|321.678|02/23/2022||||9164|||||No|No||CAMBER PHARMACE|No||||
rosuvastatin calcium|No|No|No|No|75%|31722088290|ROSUVASTATIN CALCIUM 5 MG TAB|90|EA|.08121|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||02/21/2017||Yes|No|||Prescription required|No||063|Yes|.06753|03/29/2022|.0659|03/29/2022|.06634|03/29/2022|||LIPOTROPICS: STATINS|9165|||||No|No||CAMBER PHARMACE|No||||
rosuvastatin calcium|No|No|No|No|75%|31722088390|ROSUVASTATIN CALCIUM 10 MG TAB|90|EA|.08121|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||02/21/2017||Yes|No|||Prescription required|No||063|Yes|.05981|03/29/2022|.05837|03/29/2022|.05876|03/29/2022|||LIPOTROPICS: STATINS|9166|||||No|No||CAMBER PHARMACE|No||||
rosuvastatin calcium|No|No|No|No|75%|31722088490|ROSUVASTATIN CALCIUM 20 MG TAB|90|EA|.08121|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||02/21/2017||Yes|No|||Prescription required|No||063|Yes|.07822|03/29/2022|.07634|03/29/2022|.07685|03/29/2022|||LIPOTROPICS: STATINS|9167|||||No|No||CAMBER PHARMACE|No||||
rosuvastatin calcium|No|No|No|No|75%|31722088530|ROSUVASTATIN CALCIUM 40 MG TAB|30|EA|.08127|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||02/21/2017||Yes|No|||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|9168|||||No|No||CAMBER PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|31722091701|OXYCODONE HCL (IR) 15 MG TAB|100|EA|.06622|02/21/2018||Yes|No||02/21/2018||Yes|No|02/21/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.15895|03/29/2022|.15513|03/29/2022|.15616|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9169|||||No|No||CAMBER PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|31722091705|OXYCODONE HCL (IR) 15 MG TAB|500|EA|.06622|02/21/2018||Yes|No||02/21/2018||Yes|No|02/21/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.15895|03/29/2022|.15513|03/29/2022|.15616|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9170|||||No|No||CAMBER PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|31722091801|OXYCODONE HCL (IR) 30 MG TAB|100|EA|.1204|02/21/2018||Yes|No||02/21/2018||Yes|No|02/21/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.2615|03/29/2022|.25522|03/29/2022|.25692|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9171|||||No|No||CAMBER PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|31722091805|OXYCODONE HCL (IR) 30 MG TAB|500|EA|.1204|02/21/2018||Yes|No||02/21/2018||Yes|No|02/21/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.2615|03/29/2022|.25522|03/29/2022|.25692|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9172|||||No|No||CAMBER PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|31722092601|METHYLPHENIDATE 2.5 MG CHEW TB|100|EA|1.06941|08/20/2019||Yes|No||08/20/2019||Yes|No|08/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|2.0264|05/25/2021|1.97776|05/25/2021|1.99093|05/25/2021|||STIMULANTS AND RELATED AGENTS|9173|||||No|No||CAMBER PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|31722092701|METHYLPHENIDATE 5 MG CHEW TAB|100|EA|1.52779|08/20/2019||Yes|No||08/20/2019||Yes|No|08/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|3.3966|11/23/2021|3.31508|11/23/2021|3.33715|11/23/2021|||STIMULANTS AND RELATED AGENTS|9174|||||No|No||CAMBER PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|31722092801|METHYLPHENIDATE 10 MG CHEW TAB|100|EA|2.17795|08/20/2019||Yes|No||08/20/2019||Yes|No|08/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|2.68588|11/23/2021|2.62141|11/23/2021|2.63887|11/23/2021|||STIMULANTS AND RELATED AGENTS|9175|||||No|No||CAMBER PHARMACE|No||||
oxymorphone HCl|No|No|No|No|90%|31722092901|OXYMORPHONE HCL 5 MG TABLET|100|EA|.4343|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|109|Yes|.56292|03/01/2022|.5494|03/01/2022|.55306|03/01/2022|||ANALGESICS: NARCOTICS SHORT|9176|||||No|No||CAMBER PHARMACE|No||||
oxymorphone HCl|No|No|No|No|90%|31722093001|OXYMORPHONE HCL 10 MG TABLET|100|EA|.731|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|109|Yes|.96999|03/29/2022|.94671|03/29/2022|.95301|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9177|||||No|No||CAMBER PHARMACE|No||||
ethinyl estradiol/drospirenone|No|Yes|No|No|75%|31722093432|DROSPIRENONE-EE 3-0.02 MG TAB|28|EA|.23035|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.36582|03/29/2022|.35704|03/29/2022|.35941|03/29/2022||||9178|||||No|No||CAMBER PHARMACE|No|||Only covered for non-contraceptive (medical) purposes|
albendazole|No|No|No|No|75%|31722093502|ALBENDAZOLE 200 MG TABLET|2|EA|12.9|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|No|||No|16.91042|03/29/2022|16.50456|03/29/2022|16.61448|03/29/2022||||9179|||||No|No||CAMBER PHARMACE|No||||
omega-3 acid ethyl esters|No|No|No|No|75%|31722093612|OMEGA-3 ETHYL ESTERS 1 GM CAP|120|EA|.16125|05/31/2019||Yes|No||05/31/2019||Yes|No|05/31/2019||Yes|No||||No|No|||Prescription required|No||055|Yes|.18363|03/29/2022|.17922|03/29/2022|.18041|03/29/2022|||LIPOTROPICS: OTHER|9180|||||No|No||CAMBER PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|31722094101|HYDROCODONE-ACETAMIN 5-325 MG|100|EA|.0516|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||09/11/2019||Yes|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9181|||||No|No||CAMBER PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|31722094105|HYDROCODONE-ACETAMIN 5-325 MG|500|EA|.0516|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||09/11/2019||Yes|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9182|||||No|No||CAMBER PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|31722094201|HYDROCODONE-ACETAMIN 7.5-325|100|EA|.0688|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||09/11/2019||Yes|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9183|||||No|No||CAMBER PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|31722094205|HYDROCODONE-ACETAMIN 7.5-325|500|EA|.0688|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||09/11/2019||Yes|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9184|||||No|No||CAMBER PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|31722094301|HYDROCODONE-ACETAMIN 10-325 MG|100|EA|.0774|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||09/11/2019||Yes|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9185|||||No|No||CAMBER PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|31722094305|HYDROCODONE-ACETAMIN 10-325 MG|500|EA|.0774|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||09/11/2019||Yes|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9186|||||No|No||CAMBER PHARMACE|No||||
ethinyl estradiol/drospirenone|No|Yes|No|No|75%|31722094531|DROSPIRENONE-EE 3-0.03 MG TAB|28|EA|.12797|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.2455|03/29/2022|.2396|03/29/2022|.2412|03/29/2022||||9187|||||No|No||CAMBER PHARMACE|No|||Only covered for non-contraceptive (medical) purposes|
methadone HCl|No|No|No|No|90%|31722094601|METHADONE HCL 5 MG TABLET|100|EA|.0399|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|.12051|03/29/2022|.11761|03/29/2022|.1184|03/29/2022|||ANALGESICS: NARCOTICS LONG|9188|||||No|No||CAMBER PHARMACE|No||||
methadone HCl|No|No|No|No|90%|31722094701|METHADONE HCL 10 MG TABLET|100|EA|.0688|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|.08598|03/29/2022|.08391|03/29/2022|.08447|03/29/2022|||ANALGESICS: NARCOTICS LONG|9189|||||No|No||CAMBER PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|31722094801|OXYCODONE-ACETAMINOPHN 2.5-325|100|EA|.70081|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||12/18/2019||Yes|No|||Prescription required|No||109|Yes|1.39948|03/29/2022|1.36589|03/29/2022|1.37498|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9190|||||No|No||CAMBER PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|31722094901|OXYCODONE-ACETAMINOPHEN 5-325|100|EA|.0433|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||12/18/2019||Yes|No|||Prescription required|No||109|Yes|.09091|03/29/2022|.08872|03/29/2022|.08931|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9191|||||No|No||CAMBER PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|31722095005|OXYCODONE-ACETAMINOPHN 7.5-325|500|EA|.06497|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||12/18/2019||Yes|No|||Prescription required|No||109|Yes|.14032|03/29/2022|.13695|03/29/2022|.13786|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9192|||||No|No||CAMBER PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|31722095101|OXYCODONE-ACETAMINOPHEN 10-325|100|EA|.0866|06/26/2020||Yes|No||06/26/2020||Yes|No|06/26/2020||Yes|No||06/26/2020||Yes|No|||Prescription required|No||109|Yes|.19233|03/29/2022|.18771|03/29/2022|.18896|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9193|||||No|No||CAMBER PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|31722095105|OXYCODONE-ACETAMINOPHEN 10-325|500|EA|.0866|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||12/18/2019||Yes|No|||Prescription required|No||109|Yes|.19233|03/29/2022|.18771|03/29/2022|.18896|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9194|||||No|No||CAMBER PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|31722095201|METHYLPHENIDATE ER 18 MG TAB|100|EA|.31089|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.56499|03/29/2022|.55143|03/29/2022|.5551|03/29/2022|||STIMULANTS AND RELATED AGENTS|9195|||||No|No||CAMBER PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|31722095301|METHYLPHENIDATE ER 27 MG TAB|100|EA|.32142|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.90623|03/29/2022|.88448|03/29/2022|.89037|03/29/2022|||STIMULANTS AND RELATED AGENTS|9196|||||No|No||CAMBER PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|31722095401|METHYLPHENIDATE ER 36 MG TAB|100|EA|.33488|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.76999|03/29/2022|.75151|03/29/2022|.75651|03/29/2022|||STIMULANTS AND RELATED AGENTS|9197|||||No|No||CAMBER PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|31722095501|METHYLPHENIDATE ER 54 MG TAB|100|EA|.37388|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.87218|03/29/2022|.85124|03/29/2022|.85691|03/29/2022|||STIMULANTS AND RELATED AGENTS|9198|||||No|No||CAMBER PHARMACE|No||||
benzonatate|No|No|No|No|75%|31722095801|BENZONATATE 200 MG CAPSULE|100|EA|.129|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No||184|Yes|.14345|03/29/2022|.14|03/29/2022|.14093|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|9199|||||No|No||CAMBER PHARMACE|No||||
dronabinol|No|No|No|No|75%|31722096060|DRONABINOL 2.5 MG CAPSULE|60|EA|.70412|09/29/2020||Yes|No||09/29/2020||Yes|No|09/29/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|085|No|1.39891|03/29/2022|1.36533|03/29/2022|1.37442|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|9200|||||No|No||CAMBER PHARMACE|No||||
dronabinol|No|No|No|No|75%|31722096160|DRONABINOL 5 MG CAPSULE|60|EA|1.46558|09/29/2020||Yes|No||09/29/2020||Yes|No|09/29/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|085|No|2.55851|03/29/2022|2.4971|03/29/2022|2.51373|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|9201|||||No|No||CAMBER PHARMACE|No||||
dronabinol|No|No|No|No|75%|31722096260|DRONABINOL 10 MG CAPSULE|60|EA|2.15329|09/29/2020||Yes|No||09/29/2020||Yes|No|09/29/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|085|No|3.9278|03/29/2022|3.83353|03/29/2022|3.85906|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|9202|||||No|No||CAMBER PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|31722099601|HYDROCODONE-ACETAMIN 5-325 MG|100|EA|.0516|10/14/2021||Yes|No||10/14/2021||Yes|No|10/14/2021||Yes|No||10/14/2021||Yes|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9203|||||No|No||CAMBER PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|31722099605|HYDROCODONE-ACETAMIN 5-325 MG|500|EA|.0516|10/14/2021||Yes|No||10/14/2021||Yes|No|10/14/2021||Yes|No||10/14/2021||Yes|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9204|||||No|No||CAMBER PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|31722099701|HYDROCODONE-ACETAMIN 10-325 MG|100|EA|.0774|10/14/2021||Yes|No||10/14/2021||Yes|No|10/14/2021||Yes|No||10/14/2021||Yes|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9205|||||No|No||CAMBER PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|31722099705|HYDROCODONE-ACETAMIN 10-325 MG|500|EA|.0774|10/14/2021||Yes|No||10/14/2021||Yes|No|10/14/2021||Yes|No||10/14/2021||Yes|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9206|||||No|No||CAMBER PHARMACE|No||||
baclofen|No|No|No|No|75%|31722099801|BACLOFEN 10 MG TABLET|100|EA|.0258|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|9207|||||No|No||CAMBER PHARMACE|No||||
baclofen|No|No|No|No|75%|31722099810|BACLOFEN 10 MG TABLET|1000|EA|.0258|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|9208|||||No|No||CAMBER PHARMACE|No||||
baclofen|No|No|No|No|75%|31722099901|BACLOFEN 20 MG TABLET|100|EA|.0344|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|9209|||||No|No||CAMBER PHARMACE|No||||
baclofen|No|No|No|No|75%|31722099905|BACLOFEN 20 MG TABLET|500|EA|.0344|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|9210|||||No|No||CAMBER PHARMACE|No||||
baclofen|No|No|No|No|75%|31722099910|BACLOFEN 20 MG TABLET|1000|EA|.0344|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|9211|||||No|No||CAMBER PHARMACE|No||||
amlodipine besylate|Yes|No|No|No|75%|33342001510|AMLODIPINE BESYLATE 5 MG TAB|90|EA|.02078|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|9212|||||No|No||MACLEODS PHARMA|No||||
amlodipine besylate|Yes|No|No|No|75%|33342001610|AMLODIPINE BESYLATE 10 MG TAB|90|EA|.02269|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|9213|||||No|No||MACLEODS PHARMA|No||||
levofloxacin|Yes|No|No|No|75%|33342002108|LEVOFLOXACIN 250 MG TABLET|50|EA|.1462|02/18/2014||Yes|No||02/18/2014||Yes|No|02/18/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||028|No|.15969|03/29/2022|.15585|03/29/2022|.15689|03/29/2022|||FLUOROQUINOLONES: ORAL|9214|||||No|No||MACLEODS PHARMA|No||||
levofloxacin|No|No|No|No|75%|33342002208|LEVOFLOXACIN 500 MG TABLET|50|EA|.1677|02/18/2014||Yes|No||02/18/2014||Yes|No|02/18/2014||Yes|No||||No|No|||Prescription required|No||028|No|.19821|03/29/2022|.19345|03/29/2022|.19474|03/29/2022|||FLUOROQUINOLONES: ORAL|9215|||||No|No||MACLEODS PHARMA|No||||
levofloxacin|No|No|No|No|75%|33342002332|LEVOFLOXACIN 750 MG TABLET|20|EA|.31175|02/18/2014||Yes|No||02/18/2014||Yes|No|02/18/2014||Yes|No||||No|No|||Prescription required|No||028|No|.38345|03/29/2022|.37424|03/29/2022|.37673|03/29/2022|||FLUOROQUINOLONES: ORAL|9216|||||No|No||MACLEODS PHARMA|No||||
famciclovir|No|No|No|No|75%|33342002407|FAMCICLOVIR 125 MG TABLET|30|EA|.15695|04/17/2013||Yes|No||04/17/2013||Yes|No|04/17/2013||Yes|No||||No|No|||Prescription required|No||025|No|.30813|10/26/2021|.30073|10/26/2021|.30273|10/26/2021|||ANTIVIRALS: ORAL|9217|||||No|No||MACLEODS PHARMA|No||||
famciclovir|Yes|No|No|No|75%|33342002507|FAMCICLOVIR 250 MG TABLET|30|EA|.22861|04/17/2013||Yes|No||04/17/2013||Yes|No|04/17/2013||Yes|No||||No|No|04/17/2013||Prescription required|No||025|No|.49235|03/29/2022|.48053|03/29/2022|.48373|03/29/2022|||ANTIVIRALS: ORAL|9218|||||No|No||MACLEODS PHARMA|No||||
famciclovir|No|No|No|No|75%|33342002607|FAMCICLOVIR 500 MG TABLET|30|EA|.50095|04/17/2013||Yes|No||04/17/2013||Yes|No|04/17/2013||Yes|No||||No|No|||Prescription required|No||025|No|.88904|03/29/2022|.8677|03/29/2022|.87348|03/29/2022|||ANTIVIRALS: ORAL|9219|||||No|No||MACLEODS PHARMA|No||||
donepezil HCl|No|No|No|No|75%|33342002707|DONEPEZIL HCL 5 MG TABLET|30|EA|.06306|12/20/2013||Yes|No||12/20/2013||Yes|No|12/20/2013||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|9220|||||No|No||MACLEODS PHARMA|No||||
donepezil HCl|No|No|No|No|75%|33342002710|DONEPEZIL HCL 5 MG TABLET|90|EA|.0621|12/20/2013||Yes|No||12/20/2013||Yes|No|12/20/2013||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|9221|||||No|No||MACLEODS PHARMA|No||||
donepezil HCl|No|No|No|No|75%|33342002715|DONEPEZIL HCL 5 MG TABLET|500|EA|.0559|08/07/2014||Yes|No||08/07/2014||Yes|No|08/07/2014||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|9222|||||No|No||MACLEODS PHARMA|No||||
donepezil HCl|No|No|No|No|75%|33342002807|DONEPEZIL HCL 10 MG TABLET|30|EA|.06306|12/20/2013||Yes|No||12/20/2013||Yes|No|12/20/2013||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|9223|||||No|No||MACLEODS PHARMA|No||||
donepezil HCl|No|No|No|No|75%|33342002810|DONEPEZIL HCL 10 MG TABLET|90|EA|.0621|12/20/2013||Yes|No||12/20/2013||Yes|No|12/20/2013||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|9224|||||No|No||MACLEODS PHARMA|No||||
donepezil HCl|No|No|No|No|75%|33342002815|DONEPEZIL HCL 10 MG TABLET|500|EA|.0559|08/07/2014||Yes|No||08/07/2014||Yes|No|08/07/2014||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|9225|||||No|No||MACLEODS PHARMA|No||||
donepezil HCl|No|No|No|No|75%|33342002907|DONEPEZIL HCL ODT 5 MG TABLET|30|EA|.17916|02/27/2014||Yes|No||02/27/2014||Yes|No|02/27/2014||Yes|No||||No|No|||Prescription required|No||011|Yes|.258|11/23/2021|.2518|11/23/2021|.25348|11/23/2021|||ALZHEIMER'S AGENTS|9226|||||No|No||MACLEODS PHARMA|No||||
donepezil HCl|No|No|No|No|75%|33342002960|DONEPEZIL HCL ODT 5 MG TABLET|28|EA|.67571|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||011|Yes|.258|11/23/2021|.2518|11/23/2021|.25348|11/23/2021|||ALZHEIMER'S AGENTS|9227|||||No|No||MACLEODS PHARMA|No||||
donepezil HCl|No|No|No|No|75%|33342003007|DONEPEZIL HCL ODT 10 MG TABLET|30|EA|.17916|02/27/2014||Yes|No||02/27/2014||Yes|No|02/27/2014||Yes|No||||No|No|||Prescription required|No||011|No|.24604|03/29/2022|.24013|03/29/2022|.24173|03/29/2022|||ALZHEIMER'S AGENTS|9228|||||No|No||MACLEODS PHARMA|No||||
donepezil HCl|No|No|No|No|75%|33342003060|DONEPEZIL HCL ODT 10 MG TABLET|28|EA|.61428|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||011|No|.24604|03/29/2022|.24013|03/29/2022|.24173|03/29/2022|||ALZHEIMER'S AGENTS|9229|||||No|No||MACLEODS PHARMA|No||||
pramipexole di-HCl|No|No|No|No|75%|33342003110|PRAMIPEXOLE 0.125 MG TABLET|90|EA|.07166|08/09/2013||Yes|No||08/09/2013||Yes|No|08/09/2013||Yes|No||||No|No|||Prescription required|No||015|No|.05408|03/29/2022|.05278|03/29/2022|.05313|03/29/2022|||ANTIPARKINSON'S AGENTS|9230|||||No|No||MACLEODS PHARMA|No||||
pramipexole di-HCl|No|No|No|No|75%|33342003210|PRAMIPEXOLE 0.25 MG TABLET|90|EA|.07166|08/09/2013||Yes|No||08/09/2013||Yes|No|08/09/2013||Yes|No||||No|No|||Prescription required|No||015|No|.05102|03/29/2022|.04979|03/29/2022|.05012|03/29/2022|||ANTIPARKINSON'S AGENTS|9231|||||No|No||MACLEODS PHARMA|No||||
pramipexole di-HCl|No|No|No|No|75%|33342003310|PRAMIPEXOLE 0.5 MG TABLET|90|EA|.07166|08/09/2013||Yes|No||08/09/2013||Yes|No|08/09/2013||Yes|No||||No|No|||Prescription required|No||015|No|.05616|03/29/2022|.05481|03/29/2022|.05517|03/29/2022|||ANTIPARKINSON'S AGENTS|9232|||||No|No||MACLEODS PHARMA|No||||
pramipexole di-HCl|No|No|No|No|75%|33342003410|PRAMIPEXOLE 1 MG TABLET|90|EA|.07166|08/09/2013||Yes|No||08/09/2013||Yes|No|08/09/2013||Yes|No||||No|No|||Prescription required|No||015|No|.06615|03/29/2022|.06456|03/29/2022|.06499|03/29/2022|||ANTIPARKINSON'S AGENTS|9233|||||No|No||MACLEODS PHARMA|No||||
pramipexole di-HCl|No|No|No|No|75%|33342003510|PRAMIPEXOLE 1.5 MG TABLET|90|EA|.07166|08/09/2013||Yes|No||08/09/2013||Yes|No|08/09/2013||Yes|No||||No|No|||Prescription required|No||015|No|.07545|03/29/2022|.07363|03/29/2022|.07412|03/29/2022|||ANTIPARKINSON'S AGENTS|9234|||||No|No||MACLEODS PHARMA|No||||
escitalopram oxalate|Yes|No|No|No|75%|33342003611|ESCITALOPRAM 5 MG TABLET|100|EA|.0645|02/15/2014||Yes|No||02/15/2014||Yes|No|02/15/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.0462|03/29/2022|.04509|03/29/2022|.04539|03/29/2022|||ANTIDEPRESSANTS: SSRIs|9235|||||No|No||MACLEODS PHARMA|No||||
escitalopram oxalate|Yes|No|No|No|75%|33342003711|ESCITALOPRAM 10 MG TABLET|100|EA|.0688|02/15/2014||Yes|No||02/15/2014||Yes|No|02/15/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIDEPRESSANTS: SSRIs|9236|||||No|No||MACLEODS PHARMA|No||||
escitalopram oxalate|Yes|No|No|No|75%|33342003811|ESCITALOPRAM 20 MG TABLET|100|EA|.0731|01/28/2014||Yes|No||01/28/2014||Yes|No|01/28/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.07845|03/29/2022|.07656|03/29/2022|.07707|03/29/2022|||ANTIDEPRESSANTS: SSRIs|9237|||||No|No||MACLEODS PHARMA|No||||
irbesartan|Yes|No|No|No|75%|33342004707|IRBESARTAN 75 MG TABLET|30|EA|.10033|04/17/2013||Yes|No||04/17/2013||Yes|No|04/17/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.21751|03/29/2022|.21228|03/29/2022|.2137|03/29/2022|||ANGIOTENSIN MODULATORS|9238|||||No|No||MACLEODS PHARMA|No||||
irbesartan|Yes|No|No|No|75%|33342004710|IRBESARTAN 75 MG TABLET|90|EA|.0903|12/04/2013||Yes|No||12/04/2013||Yes|No|12/04/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.21751|03/29/2022|.21228|03/29/2022|.2137|03/29/2022|||ANGIOTENSIN MODULATORS|9239|||||No|No||MACLEODS PHARMA|No||||
irbesartan|Yes|No|No|No|75%|33342004807|IRBESARTAN 150 MG TABLET|30|EA|.11466|04/17/2013||Yes|No||04/17/2013||Yes|No|04/17/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.20852|03/29/2022|.20351|03/29/2022|.20487|03/29/2022|||ANGIOTENSIN MODULATORS|9240|||||No|No||MACLEODS PHARMA|No||||
irbesartan|Yes|No|No|No|75%|33342004810|IRBESARTAN 150 MG TABLET|90|EA|.1032|12/04/2013||Yes|No||12/04/2013||Yes|No|12/04/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.20852|03/29/2022|.20351|03/29/2022|.20487|03/29/2022|||ANGIOTENSIN MODULATORS|9241|||||No|No||MACLEODS PHARMA|No||||
irbesartan|Yes|No|No|No|75%|33342004907|IRBESARTAN 300 MG TABLET|30|EA|.15766|04/17/2013||Yes|No||04/17/2013||Yes|No|04/17/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.32541|03/29/2022|.3176|03/29/2022|.31971|03/29/2022|||ANGIOTENSIN MODULATORS|9242|||||No|No||MACLEODS PHARMA|No||||
irbesartan|Yes|No|No|No|75%|33342004910|IRBESARTAN 300 MG TABLET|90|EA|.1419|10/14/2013||Yes|No||10/14/2013||Yes|No|10/14/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.32541|03/29/2022|.3176|03/29/2022|.31971|03/29/2022|||ANGIOTENSIN MODULATORS|9243|||||No|No||MACLEODS PHARMA|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|33342005007|LOSARTAN-HCTZ 50-12.5 MG TAB|30|EA|.05948|01/12/2022||Yes|No||01/12/2022||Yes|No|01/12/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|9244|||||No|No||MACLEODS PHARMA|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|33342005044|LOSARTAN-HCTZ 50-12.5 MG TAB|1000|EA|.05917|01/12/2022||Yes|No||01/12/2022||Yes|No|01/12/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|9245|||||No|No||MACLEODS PHARMA|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|33342005107|LOSARTAN-HCTZ 100-12.5 MG TAB|30|EA|.08084|01/12/2022||Yes|No||01/12/2022||Yes|No|01/12/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|9246|||||No|No||MACLEODS PHARMA|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|33342005144|LOSARTAN-HCTZ 100-12.5 MG TAB|1000|EA|.0806|01/12/2022||Yes|No||01/12/2022||Yes|No|01/12/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|9247|||||No|No||MACLEODS PHARMA|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|33342005207|LOSARTAN-HCTZ 100-25 MG TAB|30|EA|.08084|01/12/2022||Yes|No||01/12/2022||Yes|No|01/12/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.21077|03/01/2022|.20571|03/01/2022|.20708|03/01/2022|||ANGIOTENSIN MODULATORS|9248|||||No|No||MACLEODS PHARMA|No||||
pioglitazone HCl|No|No|No|No|75%|33342005407|PIOGLITAZONE HCL 15 MG TABLET|30|EA|.05733|07/15/2014||Yes|No||07/15/2014||Yes|No|07/15/2014||Yes|No||||No|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|9249|||||No|No||MACLEODS PHARMA|No||||
pioglitazone HCl|No|No|No|No|75%|33342005410|PIOGLITAZONE HCL 15 MG TABLET|90|EA|.05733|07/15/2014||Yes|No||07/15/2014||Yes|No|07/15/2014||Yes|No||||No|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|9250|||||No|No||MACLEODS PHARMA|No||||
pioglitazone HCl|No|No|No|No|75%|33342005415|PIOGLITAZONE HCL 15 MG TABLET|500|EA|.05676|07/15/2014||Yes|No||07/15/2014||Yes|No|07/15/2014||Yes|No||||No|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|9251|||||No|No||MACLEODS PHARMA|No||||
pioglitazone HCl|No|No|No|No|75%|33342005507|PIOGLITAZONE HCL 30 MG TABLET|30|EA|.07883|07/15/2014||Yes|No||07/15/2014||Yes|No|07/15/2014||Yes|No||||No|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|9252|||||No|No||MACLEODS PHARMA|No||||
pioglitazone HCl|No|No|No|No|75%|33342005510|PIOGLITAZONE HCL 30 MG TABLET|90|EA|.07883|07/15/2014||Yes|No||07/15/2014||Yes|No|07/15/2014||Yes|No||||No|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|9253|||||No|No||MACLEODS PHARMA|No||||
pioglitazone HCl|No|No|No|No|75%|33342005515|PIOGLITAZONE HCL 30 MG TABLET|500|EA|.07869|07/15/2014||Yes|No||07/15/2014||Yes|No|07/15/2014||Yes|No||||No|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|9254|||||No|No||MACLEODS PHARMA|No||||
pioglitazone HCl|No|No|No|No|75%|33342005607|PIOGLITAZONE HCL 45 MG TABLET|30|EA|.08241|07/15/2014||Yes|No||07/15/2014||Yes|No|07/15/2014||Yes|No||||No|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|9255|||||No|No||MACLEODS PHARMA|No||||
pioglitazone HCl|No|No|No|No|75%|33342005610|PIOGLITAZONE HCL 45 MG TABLET|90|EA|.08241|07/15/2014||Yes|No||07/15/2014||Yes|No|07/15/2014||Yes|No||||No|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|9256|||||No|No||MACLEODS PHARMA|No||||
pioglitazone HCl|No|No|No|No|75%|33342005615|PIOGLITAZONE HCL 45 MG TABLET|500|EA|.0817|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|9257|||||No|No||MACLEODS PHARMA|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|33342005707|IRBESARTAN-HCTZ 150-12.5 MG TB|30|EA|.25513|04/17/2013||Yes|No||04/17/2013||Yes|No|04/17/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.24959|03/29/2022|.24359|03/29/2022|.24522|03/29/2022|||ANGIOTENSIN MODULATORS|9258|||||No|No||MACLEODS PHARMA|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|33342005710|IRBESARTAN-HCTZ 150-12.5 MG TB|90|EA|.25513|04/17/2013||Yes|No||04/17/2013||Yes|No|04/17/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.24959|03/29/2022|.24359|03/29/2022|.24522|03/29/2022|||ANGIOTENSIN MODULATORS|9259|||||No|No||MACLEODS PHARMA|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|33342005807|IRBESARTAN-HCTZ 300-12.5 MG TB|30|EA|.50166|04/17/2013||Yes|No||04/17/2013||Yes|No|04/17/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.26247|03/29/2022|.25617|03/29/2022|.25787|03/29/2022|||ANGIOTENSIN MODULATORS|9260|||||No|No||MACLEODS PHARMA|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|33342005810|IRBESARTAN-HCTZ 300-12.5 MG TB|90|EA|.50166|04/17/2013||Yes|No||04/17/2013||Yes|No|04/17/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.26247|03/29/2022|.25617|03/29/2022|.25787|03/29/2022|||ANGIOTENSIN MODULATORS|9261|||||No|No||MACLEODS PHARMA|No||||
clopidogrel bisulfate|No|No|No|No|75%|33342006007|CLOPIDOGREL 75 MG TABLET|30|EA|.07166|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|9262|||||No|No||MACLEODS PHARMA|No||||
clopidogrel bisulfate|No|No|No|No|75%|33342006010|CLOPIDOGREL 75 MG TABLET|90|EA|.043|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|9263|||||No|No||MACLEODS PHARMA|No||||
clopidogrel bisulfate|No|No|No|No|75%|33342006015|CLOPIDOGREL 75 MG TABLET|500|EA|.0387|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|9264|||||No|No||MACLEODS PHARMA|Yes|09/01/2020|||
donepezil HCl|No|No|No|No|75%|33342006107|DONEPEZIL HCL 23 MG TABLET|30|EA|1.00333|02/01/2014||Yes|No||02/01/2014||Yes|No|02/01/2014||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.75152|03/29/2022|.73348|03/29/2022|.73836|03/29/2022|||ALZHEIMER'S AGENTS|9265|||||No|No||MACLEODS PHARMA|No||||
donepezil HCl|No|No|No|No|75%|33342006110|DONEPEZIL HCL 23 MG TABLET|90|EA|.86|02/01/2014||Yes|No||02/01/2014||Yes|No|02/01/2014||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.75152|03/29/2022|.73348|03/29/2022|.73836|03/29/2022|||ALZHEIMER'S AGENTS|9266|||||No|No||MACLEODS PHARMA|No||||
valsartan|No|No|No|No|75%|33342006207|VALSARTAN 40 MG TABLET|30|EA|.17443|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.1945|03/29/2022|.18983|03/29/2022|.19109|03/29/2022|||ANGIOTENSIN MODULATORS|9267|||||No|No||MACLEODS PHARMA|No||||
valsartan|No|No|No|No|75%|33342006310|VALSARTAN 80 MG TABLET|90|EA|.14691|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.21024|03/29/2022|.20519|03/29/2022|.20656|03/29/2022|||ANGIOTENSIN MODULATORS|9268|||||No|No||MACLEODS PHARMA|No||||
valsartan|No|No|No|No|75%|33342006410|VALSARTAN 160 MG TABLET|90|EA|.17935|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.23007|03/29/2022|.22454|03/29/2022|.22604|03/29/2022|||ANGIOTENSIN MODULATORS|9269|||||No|No||MACLEODS PHARMA|No||||
valsartan|No|No|No|No|75%|33342006510|VALSARTAN 320 MG TABLET|90|EA|.22684|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.31156|03/29/2022|.30408|03/29/2022|.3061|03/29/2022|||ANGIOTENSIN MODULATORS|9270|||||No|No||MACLEODS PHARMA|No||||
olanzapine|No|No|No|No|75%|33342006707|OLANZAPINE 2.5 MG TABLET|30|EA|.06091|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.08915|03/29/2022|.08701|03/29/2022|.08758|03/29/2022|||ANTIPSYCHOTICS|9271|||||No|No||MACLEODS PHARMA|No||||
olanzapine|No|No|No|No|75%|33342006744|OLANZAPINE 2.5 MG TABLET|1000|EA|.05181|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.08915|03/29/2022|.08701|03/29/2022|.08758|03/29/2022|||ANTIPSYCHOTICS|9272|||||No|No||MACLEODS PHARMA|No||||
olanzapine|No|No|No|No|75%|33342006807|OLANZAPINE 5 MG TABLET|30|EA|.07023|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.09455|03/29/2022|.09228|03/29/2022|.09289|03/29/2022|||ANTIPSYCHOTICS|9273|||||No|No||MACLEODS PHARMA|No||||
olanzapine|No|No|No|No|75%|33342006844|OLANZAPINE 5 MG TABLET|1000|EA|.05966|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.09455|03/29/2022|.09228|03/29/2022|.09289|03/29/2022|||ANTIPSYCHOTICS|9274|||||No|No||MACLEODS PHARMA|No||||
olanzapine|No|No|No|No|75%|33342006907|OLANZAPINE 7.5 MG TABLET|30|EA|.086|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.11617|03/29/2022|.11338|03/29/2022|.11413|03/29/2022|||ANTIPSYCHOTICS|9275|||||No|No||MACLEODS PHARMA|No||||
olanzapine|No|No|No|No|75%|33342006944|OLANZAPINE 7.5 MG TABLET|1000|EA|.0688|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.11617|03/29/2022|.11338|03/29/2022|.11413|03/29/2022|||ANTIPSYCHOTICS|9276|||||No|No||MACLEODS PHARMA|No||||
olanzapine|No|No|No|No|75%|33342007007|OLANZAPINE 10 MG TABLET|30|EA|.10248|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.12613|03/29/2022|.1231|03/29/2022|.12392|03/29/2022|||ANTIPSYCHOTICS|9277|||||No|No||MACLEODS PHARMA|No||||
olanzapine|No|No|No|No|75%|33342007015|OLANZAPINE 10 MG TABLET|500|EA|.08711|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.12613|03/29/2022|.1231|03/29/2022|.12392|03/29/2022|||ANTIPSYCHOTICS|9278|||||No|No||MACLEODS PHARMA|No||||
olanzapine|No|No|No|No|75%|33342007107|OLANZAPINE 15 MG TABLET|30|EA|.15838|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.15007|03/29/2022|.14646|03/29/2022|.14744|03/29/2022|||ANTIPSYCHOTICS|9279|||||No|No||MACLEODS PHARMA|No||||
olanzapine|No|No|No|No|75%|33342007115|OLANZAPINE 15 MG TABLET|500|EA|.13463|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.15007|03/29/2022|.14646|03/29/2022|.14744|03/29/2022|||ANTIPSYCHOTICS|9280|||||No|No||MACLEODS PHARMA|No||||
olanzapine|No|No|No|No|75%|33342007207|OLANZAPINE 20 MG TABLET|30|EA|.2064|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.18048|03/29/2022|.17614|03/29/2022|.17732|03/29/2022|||ANTIPSYCHOTICS|9281|||||No|No||MACLEODS PHARMA|No||||
olanzapine|No|No|No|No|75%|33342007215|OLANZAPINE 20 MG TABLET|500|EA|.17544|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.18048|03/29/2022|.17614|03/29/2022|.17732|03/29/2022|||ANTIPSYCHOTICS|9282|||||No|No||MACLEODS PHARMA|No||||
valsartan/hydrochlorothiazide|Yes|No|No|No|75%|33342007410|VALSARTAN-HCTZ 80-12.5 MG TAB|90|EA|.30773|06/11/2014||Yes|No||06/11/2014||Yes|No|06/11/2014||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.29054|03/29/2022|.28356|03/29/2022|.28545|03/29/2022|||ANGIOTENSIN MODULATORS|9283|||||No|No||MACLEODS PHARMA|No||||
valsartan/hydrochlorothiazide|Yes|No|No|No|75%|33342007444|VALSARTAN-HCTZ 80-12.5 MG TAB|1000|EA|.30773|06/11/2014||Yes|No||06/11/2014||Yes|No|06/11/2014||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.29054|03/29/2022|.28356|03/29/2022|.28545|03/29/2022|||ANGIOTENSIN MODULATORS|9284|||||No|No||MACLEODS PHARMA|No||||
valsartan/hydrochlorothiazide|Yes|No|No|No|75%|33342007510|VALSARTAN-HCTZ 160-12.5 MG TAB|90|EA|.33477|06/11/2014||Yes|No||06/11/2014||Yes|No|06/11/2014||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.28742|03/29/2022|.28052|03/29/2022|.28239|03/29/2022|||ANGIOTENSIN MODULATORS|9285|||||No|No||MACLEODS PHARMA|No||||
valsartan/hydrochlorothiazide|Yes|No|No|No|75%|33342007515|VALSARTAN-HCTZ 160-12.5 MG TAB|500|EA|.33478|06/11/2014||Yes|No||06/11/2014||Yes|No|06/11/2014||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.28742|03/29/2022|.28052|03/29/2022|.28239|03/29/2022|||ANGIOTENSIN MODULATORS|9286|||||No|No||MACLEODS PHARMA|No||||
valsartan/hydrochlorothiazide|Yes|No|No|No|75%|33342007610|VALSARTAN-HCTZ 160-25 MG TAB|90|EA|.37969|06/11/2014||Yes|No||06/11/2014||Yes|No|06/11/2014||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.29583|03/29/2022|.28873|03/29/2022|.29065|03/29/2022|||ANGIOTENSIN MODULATORS|9287|||||No|No||MACLEODS PHARMA|No||||
valsartan/hydrochlorothiazide|Yes|No|No|No|75%|33342007615|VALSARTAN-HCTZ 160-25 MG TAB|500|EA|.37969|06/11/2014||Yes|No||06/11/2014||Yes|No|06/11/2014||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.29583|03/29/2022|.28873|03/29/2022|.29065|03/29/2022|||ANGIOTENSIN MODULATORS|9288|||||No|No||MACLEODS PHARMA|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|33342007710|VALSARTAN-HCTZ 320-12.5 MG TAB|90|EA|.42416|06/11/2014||Yes|No||06/11/2014||Yes|No|06/11/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.41056|03/29/2022|.4007|03/29/2022|.40337|03/29/2022|||ANGIOTENSIN MODULATORS|9289|||||No|No||MACLEODS PHARMA|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|33342007715|VALSARTAN-HCTZ 320-12.5 MG TAB|500|EA|.42416|06/11/2014||Yes|No||06/11/2014||Yes|No|06/11/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.41056|03/29/2022|.4007|03/29/2022|.40337|03/29/2022|||ANGIOTENSIN MODULATORS|9290|||||No|No||MACLEODS PHARMA|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|33342007810|VALSARTAN-HCTZ 320-25 MG TAB|90|EA|.48126|06/11/2014||Yes|No||06/11/2014||Yes|No|06/11/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.3994|03/29/2022|.38981|03/29/2022|.39241|03/29/2022|||ANGIOTENSIN MODULATORS|9291|||||No|No||MACLEODS PHARMA|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|33342007815|VALSARTAN-HCTZ 320-25 MG TAB|500|EA|.48126|06/11/2014||Yes|No||06/11/2014||Yes|No|06/11/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.3994|03/29/2022|.38981|03/29/2022|.39241|03/29/2022|||ANGIOTENSIN MODULATORS|9292|||||No|No||MACLEODS PHARMA|No||||
olanzapine|No|No|No|No|75%|33342008307|OLANZAPINE ODT 5 MG TABLET|30|EA|.36793|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.59218|03/29/2022|.57796|03/29/2022|.58181|03/29/2022|||ANTIPSYCHOTICS|9293|||||No|No||MACLEODS PHARMA|No||||
olanzapine|No|No|No|No|75%|33342008311|OLANZAPINE ODT 5 MG TABLET|100|EA|.33114|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.59218|03/29/2022|.57796|03/29/2022|.58181|03/29/2022|||ANTIPSYCHOTICS|9294|||||No|No||MACLEODS PHARMA|No||||
olanzapine|No|No|No|No|75%|33342008407|OLANZAPINE ODT 10 MG TABLET|30|EA|.54051|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.58062|03/29/2022|.56668|03/29/2022|.57045|03/29/2022|||ANTIPSYCHOTICS|9295|||||No|No||MACLEODS PHARMA|No||||
olanzapine|No|No|No|No|75%|33342008411|OLANZAPINE ODT 10 MG TABLET|100|EA|.48645|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.58062|03/29/2022|.56668|03/29/2022|.57045|03/29/2022|||ANTIPSYCHOTICS|9296|||||No|No||MACLEODS PHARMA|No||||
olanzapine|No|No|No|No|75%|33342008507|OLANZAPINE ODT 15 MG TABLET|30|EA|.79707|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.85386|03/29/2022|.83336|03/29/2022|.83891|03/29/2022|||ANTIPSYCHOTICS|9297|||||No|No||MACLEODS PHARMA|No||||
olanzapine|No|No|No|No|75%|33342008511|OLANZAPINE ODT 15 MG TABLET|100|EA|.71736|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.85386|03/29/2022|.83336|03/29/2022|.83891|03/29/2022|||ANTIPSYCHOTICS|9298|||||No|No||MACLEODS PHARMA|No||||
olanzapine|No|No|No|No|75%|33342008607|OLANZAPINE ODT 20 MG TABLET|30|EA|1.05378|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|1.09|03/29/2022|1.06384|03/29/2022|1.07092|03/29/2022|||ANTIPSYCHOTICS|9299|||||No|No||MACLEODS PHARMA|No||||
olanzapine|No|No|No|No|75%|33342008611|OLANZAPINE ODT 20 MG TABLET|100|EA|.9484|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|1.09|03/29/2022|1.06384|03/29/2022|1.07092|03/29/2022|||ANTIPSYCHOTICS|9300|||||No|No||MACLEODS PHARMA|No||||
rizatriptan benzoate|No|No|No|No|75%|33342008741|RIZATRIPTAN 5 MG TABLET|18|EA|.5148|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||||No|No|||Prescription required|No||021|No|.64991|03/29/2022|.63431|03/29/2022|.63853|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|9301|||||No|No||MACLEODS PHARMA|No||||
rizatriptan benzoate|No|No|No|No|75%|33342008745|RIZATRIPTAN 5 MG TABLET|12|EA|.52853|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||||No|No|||Prescription required|No||021|No|.64991|03/29/2022|.63431|03/29/2022|.63853|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|9302|||||No|No||MACLEODS PHARMA|No||||
rizatriptan benzoate|No|No|No|No|75%|33342008750|RIZATRIPTAN 5 MG TABLET|12|EA|.52853|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||021|No|.64991|03/29/2022|.63431|03/29/2022|.63853|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|9303|||||No|No||MACLEODS PHARMA|No||||
rizatriptan benzoate|No|No|No|No|75%|33342008772|RIZATRIPTAN 5 MG TABLET|18|EA|.5148|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||021|No|.64991|03/29/2022|.63431|03/29/2022|.63853|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|9304|||||No|No||MACLEODS PHARMA|No||||
rizatriptan benzoate|No|No|No|No|75%|33342008841|RIZATRIPTAN 10 MG TABLET|18|EA|.27471|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||||No|No|||Prescription required|No||021|No|.50927|03/29/2022|.49704|03/29/2022|.50035|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|9305|||||No|No||MACLEODS PHARMA|No||||
rizatriptan benzoate|No|No|No|No|75%|33342008850|RIZATRIPTAN 10 MG TABLET|12|EA|.2777|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||021|No|.50927|03/29/2022|.49704|03/29/2022|.50035|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|9306|||||No|No||MACLEODS PHARMA|No||||
rizatriptan benzoate|No|No|No|No|75%|33342008872|RIZATRIPTAN 10 MG TABLET|18|EA|.27471|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||021|No|.50927|03/29/2022|.49704|03/29/2022|.50035|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|9307|||||No|No||MACLEODS PHARMA|No||||
rivastigmine tartrate|No|No|No|No|75%|33342009109|RIVASTIGMINE 4.5 MG CAPSULE|60|EA|.14333|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|011|No|.27604|03/29/2022|.26941|03/29/2022|.2712|03/29/2022|||ALZHEIMER'S AGENTS|9308|||||No|No||MACLEODS PHARMA|No||||
rivastigmine tartrate|No|No|No|No|75%|33342009115|RIVASTIGMINE 4.5 MG CAPSULE|500|EA|.11336|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|011|No|.27604|03/29/2022|.26941|03/29/2022|.2712|03/29/2022|||ALZHEIMER'S AGENTS|9309|||||No|No||MACLEODS PHARMA|No||||
rivastigmine tartrate|No|No|No|No|75%|33342009209|RIVASTIGMINE 6 MG CAPSULE|60|EA|.14333|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|011|No|.35091|03/29/2022|.34248|03/29/2022|.34476|03/29/2022|||ALZHEIMER'S AGENTS|9310|||||No|No||MACLEODS PHARMA|No||||
rivastigmine tartrate|No|No|No|No|75%|33342009215|RIVASTIGMINE 6 MG CAPSULE|500|EA|.11336|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|011|No|.35091|03/29/2022|.34248|03/29/2022|.34476|03/29/2022|||ALZHEIMER'S AGENTS|9311|||||No|No||MACLEODS PHARMA|No||||
tolterodine tartrate|No|No|No|No|75%|33342009709|TOLTERODINE TARTRATE 1 MG TAB|60|EA|.17458|03/12/2018||Yes|No||03/12/2018||Yes|No|03/12/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|006|No|.65955|03/29/2022|.64372|03/29/2022|.648|03/29/2022|||BLADDER RELAXANT PREPARATIONS|9312|||||No|No||MACLEODS PHARMA|No||||
tolterodine tartrate|No|No|No|No|75%|33342009715|TOLTERODINE TARTRATE 1 MG TAB|500|EA|.17455|03/12/2018||Yes|No||03/12/2018||Yes|No|03/12/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|006|No|.65955|03/29/2022|.64372|03/29/2022|.648|03/29/2022|||BLADDER RELAXANT PREPARATIONS|9313|||||No|No||MACLEODS PHARMA|No||||
tolterodine tartrate|No|No|No|No|75%|33342009809|TOLTERODINE TARTRATE 2 MG TAB|60|EA|.17916|03/12/2018||Yes|No||03/12/2018||Yes|No|03/12/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|006|No|.55522|03/29/2022|.54189|03/29/2022|.5455|03/29/2022|||BLADDER RELAXANT PREPARATIONS|9314|||||No|No||MACLEODS PHARMA|No||||
tolterodine tartrate|No|No|No|No|75%|33342009815|TOLTERODINE TARTRATE 2 MG TAB|500|EA|.17916|03/12/2018||Yes|No||03/12/2018||Yes|No|03/12/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|006|No|.55522|03/29/2022|.54189|03/29/2022|.5455|03/29/2022|||BLADDER RELAXANT PREPARATIONS|9315|||||No|No||MACLEODS PHARMA|No||||
quetiapine fumarate|No|No|No|No|75%|33342009911|QUETIAPINE FUMARATE 25 MG TAB|100|EA|.07998|03/12/2018||Yes|No||03/12/2018||Yes|No|03/12/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.03239|03/29/2022|.03161|03/29/2022|.03182|03/29/2022|||ANTIPSYCHOTICS|9316|||||No|No||MACLEODS PHARMA|No||||
quetiapine fumarate|No|No|No|No|75%|33342010011|QUETIAPINE FUMARATE 50 MG TAB|100|EA|.13119|03/12/2018||Yes|No||03/12/2018||Yes|No|03/12/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.04283|03/29/2022|.0418|03/29/2022|.04208|03/29/2022|||ANTIPSYCHOTICS|9317|||||No|No||MACLEODS PHARMA|No||||
quetiapine fumarate|No|No|No|No|75%|33342010111|QUETIAPINE FUMARATE 100 MG TAB|100|EA|.13695|03/12/2018||Yes|No||03/12/2018||Yes|No|03/12/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.05826|03/29/2022|.05686|03/29/2022|.05724|03/29/2022|||ANTIPSYCHOTICS|9318|||||No|No||MACLEODS PHARMA|No||||
montelukast sodium|No|No|No|No|75%|33342010207|MONTELUKAST SOD 10 MG TABLET|30|EA|.02795|09/25/2017||Yes|No||09/25/2017||Yes|No|09/25/2017||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|9319|||||No|No||MACLEODS PHARMA|Yes|09/01/2020|||
montelukast sodium|No|No|No|No|75%|33342010210|MONTELUKAST SOD 10 MG TABLET|90|EA|.02627|09/25/2017||Yes|No||09/25/2017||Yes|No|09/25/2017||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|9320|||||No|No||MACLEODS PHARMA|Yes|09/01/2020|||
montelukast sodium|No|No|No|No|75%|33342010215|MONTELUKAST SOD 10 MG TABLET|500|EA|.0258|09/25/2017||Yes|No||09/25/2017||Yes|No|09/25/2017||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|9321|||||No|No||MACLEODS PHARMA|Yes|09/01/2020|||
quetiapine fumarate|No|No|No|No|75%|33342010311|QUETIAPINE FUMARATE 200 MG TAB|100|EA|.25847|03/12/2018||Yes|No||03/12/2018||Yes|No|03/12/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.10261|03/29/2022|.10014|03/29/2022|.10081|03/29/2022|||ANTIPSYCHOTICS|9322|||||No|No||MACLEODS PHARMA|No||||
quetiapine fumarate|No|No|No|No|75%|33342010511|QUETIAPINE FUMARATE 400 MG TAB|100|EA|.39822|03/12/2018||Yes|No||03/12/2018||Yes|No|03/12/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.17858|03/29/2022|.17429|03/29/2022|.17545|03/29/2022|||ANTIPSYCHOTICS|9323|||||No|No||MACLEODS PHARMA|No||||
risedronate sodium|No|No|No|No|75%|33342010707|RISEDRONATE SODIUM 5 MG TABLET|30|EA|1.075|06/29/2017||Yes|No||06/29/2017||Yes|No|06/29/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|060|No|2.45|02/16/2021|2.415|02/16/2021|2.3|02/16/2021|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|9324|||||No|No||MACLEODS PHARMA|No||||
risedronate sodium|No|No|No|No|75%|33342010937|RISEDRONATE SODIUM 35 MG TAB|4|EA|2.6875|03/14/2018||Yes|No||03/14/2018||Yes|No|03/14/2018||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|060|No|2.85532|03/29/2022|2.78679|03/29/2022|2.80535|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|9325|||||No|No||MACLEODS PHARMA|No||||
risedronate sodium|No|No|No|No|75%|33342010950|RISEDRONATE SODIUM 35 MG TAB|12|EA|2.6875|03/14/2018||Yes|No||03/14/2018||Yes|No|03/14/2018||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|060|No|2.85532|03/29/2022|2.78679|03/29/2022|2.80535|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|9326|||||No|No||MACLEODS PHARMA|No||||
montelukast sodium|No|No|No|No|75%|33342011007|MONTELUKAST SOD 4 MG TAB CHEW|30|EA|.22431|09/25/2017||Yes|No||09/25/2017||Yes|No|09/25/2017||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|9327|||||No|No||MACLEODS PHARMA|No||||
montelukast sodium|No|No|No|No|75%|33342011010|MONTELUKAST SOD 4 MG TAB CHEW|90|EA|.21308|09/25/2017||Yes|No||09/25/2017||Yes|No|09/25/2017||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|9328|||||No|No||MACLEODS PHARMA|No||||
montelukast sodium|No|No|No|No|75%|33342011107|MONTELUKAST SOD 5 MG TAB CHEW|30|EA|.22431|09/25/2017||Yes|No||09/25/2017||Yes|No|09/25/2017||Yes|No||||No|No|||Prescription required|No||042|Yes|.08451|03/29/2022|.08248|03/29/2022|.08303|03/29/2022|||LEUKOTRIENE MODIFIERS|9329|||||No|No||MACLEODS PHARMA|No||||
montelukast sodium|No|No|No|No|75%|33342011110|MONTELUKAST SOD 5 MG TAB CHEW|90|EA|.21308|09/25/2017||Yes|No||09/25/2017||Yes|No|09/25/2017||Yes|No||||No|No|||Prescription required|No||042|Yes|.08451|03/29/2022|.08248|03/29/2022|.08303|03/29/2022|||LEUKOTRIENE MODIFIERS|9330|||||No|No||MACLEODS PHARMA|No||||
candesartan cilexetil|No|No|No|No|75%|33342011407|CANDESARTAN CILEXETIL 4 MG TAB|30|EA|.54466|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.89|03/29/2022|.86864|03/29/2022|.87442|03/29/2022|||ANGIOTENSIN MODULATORS|9331|||||No|No||MACLEODS PHARMA|No||||
candesartan cilexetil|No|No|No|No|75%|33342011507|CANDESARTAN CILEXETIL 8 MG TAB|30|EA|.57333|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.78972|03/29/2022|.77076|03/29/2022|.77589|03/29/2022|||ANGIOTENSIN MODULATORS|9332|||||No|No||MACLEODS PHARMA|No||||
candesartan cilexetil|No|No|No|No|75%|33342011607|CANDESARTAN CILEXETIL 16 MG TB|30|EA|.44433|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.72757|03/29/2022|.7101|03/29/2022|.71483|03/29/2022|||ANGIOTENSIN MODULATORS|9333|||||No|No||MACLEODS PHARMA|No||||
candesartan cilexetil|No|No|No|No|75%|33342011610|CANDESARTAN CILEXETIL 16 MG TB|90|EA|.44433|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.72757|03/29/2022|.7101|03/29/2022|.71483|03/29/2022|||ANGIOTENSIN MODULATORS|9334|||||No|No||MACLEODS PHARMA|No||||
candesartan cilexetil|No|No|No|No|75%|33342011707|CANDESARTAN CILEXETIL 32 MG TB|30|EA|.731|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|1.10475|03/29/2022|1.07823|03/29/2022|1.08541|03/29/2022|||ANGIOTENSIN MODULATORS|9335|||||No|No||MACLEODS PHARMA|No||||
candesartan cilexetil|No|No|No|No|75%|33342011710|CANDESARTAN CILEXETIL 32 MG TB|90|EA|.731|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|1.10475|03/29/2022|1.07823|03/29/2022|1.08541|03/29/2022|||ANGIOTENSIN MODULATORS|9336|||||No|No||MACLEODS PHARMA|No||||
sildenafil citrate|No|No|No|No|75%|33342012110|SILDENAFIL 20 MG TABLET|90|EA|.31294|06/11/2014||Yes|No||06/11/2014||Yes|No|06/11/2014||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|Yes|.09246|03/29/2022|.09024|03/29/2022|.09084|03/29/2022|||PAH AGENTS: ORAL AND INHALED|9337|||||No|No||MACLEODS PHARMA|No||||
aripiprazole|No|No|No|No|75%|33342012207|ARIPIPRAZOLE 2 MG TABLET|30|EA|.93166|03/12/2018||Yes|No||03/12/2018||Yes|No|03/12/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|9338|||||No|No||MACLEODS PHARMA|No||||
aripiprazole|No|No|No|No|75%|33342012307|ARIPIPRAZOLE 5 MG TABLET|30|EA|.93166|03/12/2018||Yes|No||03/12/2018||Yes|No|03/12/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|9339|||||No|No||MACLEODS PHARMA|No||||
aripiprazole|No|No|No|No|75%|33342012407|ARIPIPRAZOLE 10 MG TABLET|30|EA|.93166|03/12/2018||Yes|No||03/12/2018||Yes|No|03/12/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|9340|||||No|No||MACLEODS PHARMA|No||||
aripiprazole|No|No|No|No|75%|33342012507|ARIPIPRAZOLE 15 MG TABLET|30|EA|.93166|03/12/2018||Yes|No||03/12/2018||Yes|No|03/12/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|9341|||||No|No||MACLEODS PHARMA|No||||
aripiprazole|No|No|No|No|75%|33342012607|ARIPIPRAZOLE 20 MG TABLET|30|EA|1.14666|03/12/2018||Yes|No||03/12/2018||Yes|No|03/12/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|9342|||||No|No||MACLEODS PHARMA|No||||
aripiprazole|No|No|No|No|75%|33342012707|ARIPIPRAZOLE 30 MG TABLET|30|EA|1.14666|03/12/2018||Yes|No||03/12/2018||Yes|No|03/12/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|9343|||||No|No||MACLEODS PHARMA|No||||
candesartan/hydrochlorothiazid|No|No|No|No|75%|33342013110|CANDESARTAN-HCTZ 16-12.5 MG TB|90|EA|1.62372|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|1.48228|03/29/2022|1.4467|03/29/2022|1.45634|03/29/2022|||ANGIOTENSIN MODULATORS|9344|||||No|No||MACLEODS PHARMA|No||||
candesartan/hydrochlorothiazid|No|No|No|No|75%|33342013115|CANDESARTAN-HCTZ 16-12.5 MG TB|500|EA|1.62373|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|1.48228|03/29/2022|1.4467|03/29/2022|1.45634|03/29/2022|||ANGIOTENSIN MODULATORS|9345|||||No|No||MACLEODS PHARMA|No||||
candesartan/hydrochlorothiazid|No|No|No|No|75%|33342013210|CANDESARTAN-HCTZ 32-12.5 MG TB|90|EA|1.65602|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|1.84933|03/29/2022|1.80494|03/29/2022|1.81696|03/29/2022|||ANGIOTENSIN MODULATORS|9346|||||No|No||MACLEODS PHARMA|No||||
candesartan/hydrochlorothiazid|No|No|No|No|75%|33342013215|CANDESARTAN-HCTZ 32-12.5 MG TB|500|EA|1.65603|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|1.84933|03/29/2022|1.80494|03/29/2022|1.81696|03/29/2022|||ANGIOTENSIN MODULATORS|9347|||||No|No||MACLEODS PHARMA|No||||
candesartan/hydrochlorothiazid|No|No|No|No|75%|33342013310|CANDESARTAN-HCTZ 32-25 MG TAB|90|EA|1.79257|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|1.84688|03/29/2022|1.80255|03/29/2022|1.81455|03/29/2022|||ANGIOTENSIN MODULATORS|9348|||||No|No||MACLEODS PHARMA|No||||
candesartan/hydrochlorothiazid|No|No|No|No|75%|33342013315|CANDESARTAN-HCTZ 32-25 MG TAB|500|EA|1.79257|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|1.84688|03/29/2022|1.80255|03/29/2022|1.81455|03/29/2022|||ANGIOTENSIN MODULATORS|9349|||||No|No||MACLEODS PHARMA|No||||
ziprasidone HCl|No|No|No|No|75%|33342014409|ZIPRASIDONE HCL 20 MG CAPSULE|60|EA|.215|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.27381|03/29/2022|.26723|03/29/2022|.26901|03/29/2022|||ANTIPSYCHOTICS|9350|||||No|No||MACLEODS PHARMA|No||||
ziprasidone HCl|No|No|No|No|75%|33342014509|ZIPRASIDONE HCL 40 MG CAPSULE|60|EA|.215|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.29914|03/29/2022|.29196|03/29/2022|.2939|03/29/2022|||ANTIPSYCHOTICS|9351|||||No|No||MACLEODS PHARMA|No||||
ziprasidone HCl|No|No|No|No|75%|33342014609|ZIPRASIDONE HCL 60 MG CAPSULE|60|EA|.25083|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.38441|03/29/2022|.37518|03/29/2022|.37768|03/29/2022|||ANTIPSYCHOTICS|9352|||||No|No||MACLEODS PHARMA|No||||
ziprasidone HCl|No|No|No|No|75%|33342014709|ZIPRASIDONE HCL 80 MG CAPSULE|60|EA|.25083|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.42395|03/29/2022|.41377|03/29/2022|.41653|03/29/2022|||ANTIPSYCHOTICS|9353|||||No|No||MACLEODS PHARMA|No||||
celecoxib|No|No|No|No|75%|33342015509|CELECOXIB 50 MG CAPSULE|60|EA|.05733|03/12/2018||Yes|No||03/12/2018||Yes|No|03/12/2018||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.1386|03/29/2022|.13527|03/29/2022|.13617|03/29/2022|||NSAIDS|9354|||||No|No||MACLEODS PHARMA|No||||
celecoxib|No|No|No|No|75%|33342015711|CELECOXIB 200 MG CAPSULE|100|EA|.129|03/12/2018||Yes|No||03/12/2018||Yes|No|03/12/2018||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|9355|||||No|No||MACLEODS PHARMA|No||||
celecoxib|No|No|No|No|75%|33342015715|CELECOXIB 200 MG CAPSULE|500|EA|.1032|03/12/2018||Yes|No||03/12/2018||Yes|No|03/12/2018||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|9356|||||No|No||MACLEODS PHARMA|No||||
celecoxib|No|No|No|No|75%|33342015809|CELECOXIB 400 MG CAPSULE|60|EA|.25083|03/12/2018||Yes|No||03/12/2018||Yes|No|03/12/2018||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.73632|03/29/2022|.71864|03/29/2022|.72343|03/29/2022|||NSAIDS|9357|||||No|No||MACLEODS PHARMA|No||||
pioglitazone HCl/metformin HCl|No|No|No|No|75%|33342017609|PIOGLITAZONE-METFORMIN 15-500|60|EA|.5375|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|009|Yes|.53323|03/29/2022|.52043|03/29/2022|.52389|03/29/2022|||HYPOGLYCEMICS: TZD|9358|||||No|No||MACLEODS PHARMA|No||||
pioglitazone HCl/metformin HCl|No|No|No|No|75%|33342017657|PIOGLITAZONE-METFORMIN 15-500|180|EA|.5375|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|009|Yes|.53323|03/29/2022|.52043|03/29/2022|.52389|03/29/2022|||HYPOGLYCEMICS: TZD|9359|||||No|No||MACLEODS PHARMA|No||||
pioglitazone HCl/metformin HCl|No|No|No|No|75%|33342017709|PIOGLITAZONE-METFORMIN 15-850|60|EA|.5375|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|009|Yes|.44962|03/29/2022|.43882|03/29/2022|.44175|03/29/2022|||HYPOGLYCEMICS: TZD|9360|||||No|No||MACLEODS PHARMA|No||||
pioglitazone HCl/metformin HCl|No|No|No|No|75%|33342017757|PIOGLITAZONE-METFORMIN 15-850|180|EA|.5375|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|009|Yes|.44962|03/29/2022|.43882|03/29/2022|.44175|03/29/2022|||HYPOGLYCEMICS: TZD|9361|||||No|No||MACLEODS PHARMA|No||||
olmesartan medoxomil|No|No|No|No|75%|33342017807|OLMESARTAN MEDOXOMIL 5 MG TAB|30|EA|.08628|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.07425|03/29/2022|.07246|03/29/2022|.07295|03/29/2022|||ANGIOTENSIN MODULATORS|9362|||||No|No||MACLEODS PHARMA|No||||
olmesartan medoxomil|No|No|No|No|75%|33342017907|OLMESARTAN MEDOXOMIL 20 MG TAB|30|EA|.10549|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.1002|03/29/2022|.09779|03/29/2022|.09844|03/29/2022|||ANGIOTENSIN MODULATORS|9363|||||No|No||MACLEODS PHARMA|No||||
olmesartan medoxomil|No|No|No|No|75%|33342017910|OLMESARTAN MEDOXOMIL 20 MG TAB|90|EA|.09483|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.1002|03/29/2022|.09779|03/29/2022|.09844|03/29/2022|||ANGIOTENSIN MODULATORS|9364|||||No|No||MACLEODS PHARMA|No||||
olmesartan medoxomil|No|No|No|No|75%|33342018007|OLMESARTAN MEDOXOMIL 40 MG TAB|30|EA|.14663|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.15714|03/29/2022|.15336|03/29/2022|.15439|03/29/2022|||ANGIOTENSIN MODULATORS|9365|||||No|No||MACLEODS PHARMA|No||||
olmesartan medoxomil|No|No|No|No|75%|33342018010|OLMESARTAN MEDOXOMIL 40 MG TAB|90|EA|.13186|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.15714|03/29/2022|.15336|03/29/2022|.15439|03/29/2022|||ANGIOTENSIN MODULATORS|9366|||||No|No||MACLEODS PHARMA|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|33342019007|AMLODIPINE-OLMESARTAN 5-20 MG|30|EA|.215|08/16/2017||Yes|No||08/16/2017||Yes|No|08/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.41945|03/29/2022|.40938|03/29/2022|.4121|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|9367|||||No|No||MACLEODS PHARMA|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|33342019010|AMLODIPINE-OLMESARTAN 5-20 MG|90|EA|.215|08/16/2017||Yes|No||08/16/2017||Yes|No|08/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.41945|03/29/2022|.40938|03/29/2022|.4121|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|9368|||||No|No||MACLEODS PHARMA|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|33342019107|AMLODIPINE-OLMESARTAN 5-40 MG|30|EA|.27176|08/16/2017||Yes|No||08/16/2017||Yes|No|08/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.47518|03/29/2022|.46377|03/29/2022|.46686|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|9369|||||No|No||MACLEODS PHARMA|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|33342019110|AMLODIPINE-OLMESARTAN 5-40 MG|90|EA|.2717|08/16/2017||Yes|No||08/16/2017||Yes|No|08/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.47518|03/29/2022|.46377|03/29/2022|.46686|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|9370|||||No|No||MACLEODS PHARMA|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|33342019207|AMLODIPINE-OLMESARTAN 10-20 MG|30|EA|.215|08/16/2017||Yes|No||08/16/2017||Yes|No|08/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.43528|03/29/2022|.42483|03/29/2022|.42766|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|9371|||||No|No||MACLEODS PHARMA|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|33342019210|AMLODIPINE-OLMESARTAN 10-20 MG|90|EA|.215|08/16/2017||Yes|No||08/16/2017||Yes|No|08/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.43528|03/29/2022|.42483|03/29/2022|.42766|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|9372|||||No|No||MACLEODS PHARMA|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|33342019307|AMLODIPINE-OLMESARTAN 10-40 MG|30|EA|.27176|08/16/2017||Yes|No||08/16/2017||Yes|No|08/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.41757|03/29/2022|.40754|03/29/2022|.41026|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|9373|||||No|No||MACLEODS PHARMA|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|33342019310|AMLODIPINE-OLMESARTAN 10-40 MG|90|EA|.2717|08/16/2017||Yes|No||08/16/2017||Yes|No|08/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.41757|03/29/2022|.40754|03/29/2022|.41026|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|9374|||||No|No||MACLEODS PHARMA|No||||
levocetirizine dihydrochloride|No|No|No|No|75%|33342020010|LEVOCETIRIZINE 5 MG TABLET|90|EA|.14333|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|030|Yes|.08234|03/29/2022|.08036|03/29/2022|.08089|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|9375|||||No|No||MACLEODS PHARMA|No||||
tramadol HCl|No|No|No|No|90%|33342020144|TRAMADOL HCL 50 MG TABLET|1000|EA|.01935|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.02459|03/29/2022|.02399|03/29/2022|.02415|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9376|||||No|No||MACLEODS PHARMA|No||||
pramipexole di-HCl|No|No|No|No|75%|33342020807|PRAMIPEXOLE ER 0.375 MG TABLET|30|EA|4.22833|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|015|No|9.63666|03/24/2020|9.49899|03/24/2020|9.04666|03/24/2020|||ANTIPARKINSON'S AGENTS|9377|||||No|No||MACLEODS PHARMA|No||||
pramipexole di-HCl|No|No|No|No|75%|33342020907|PRAMIPEXOLE ER 0.75 MG TABLET|30|EA|4.22833|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|015|No|9.63666|03/27/2018|9.49899|03/27/2018|9.04666|03/27/2018|||ANTIPARKINSON'S AGENTS|9378|||||No|No||MACLEODS PHARMA|No||||
pramipexole di-HCl|No|No|No|No|75%|33342021007|PRAMIPEXOLE ER 1.5 MG TABLET|30|EA|4.22833|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|015|No|5.85567|03/01/2022|5.71513|03/01/2022|5.75319|03/01/2022|||ANTIPARKINSON'S AGENTS|9379|||||No|No||MACLEODS PHARMA|No||||
pramipexole di-HCl|No|No|No|No|75%|33342021107|PRAMIPEXOLE ER 2.25 MG TABLET|30|EA|4.22833|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|015|No|9.63666|03/08/2018|9.49899|03/08/2018|9.04666|03/08/2018|||ANTIPARKINSON'S AGENTS|9380|||||No|No||MACLEODS PHARMA|No||||
pramipexole di-HCl|No|No|No|No|75%|33342021207|PRAMIPEXOLE ER 3 MG TABLET|30|EA|4.22833|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|015|No|9.63666|04/27/2021|9.49899|04/27/2021|9.04666|04/27/2021|||ANTIPARKINSON'S AGENTS|9381|||||No|No||MACLEODS PHARMA|No||||
pramipexole di-HCl|No|No|No|No|75%|33342021407|PRAMIPEXOLE ER 4.5 MG TABLET|30|EA|4.22833|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|015|No|9.63666|03/08/2018|9.49899|03/08/2018|9.04666|03/08/2018|||ANTIPARKINSON'S AGENTS|9382|||||No|No||MACLEODS PHARMA|No||||
nevirapine|No|No|No|No|75%|33342023807|NEVIRAPINE ER 400 MG TABLET|30|EA|2.7|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|4.41|08/24/2021|4.347|08/24/2021|4.14|08/24/2021|||HIV / AIDS|9383|||||No|No||MACLEODS PHARMA|No||||
metformin HCl|No|No|No|No|75%|33342023911|METFORMIN HCL ER 500 MG TABLET|100|EA|.02795|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|No||012|No|.03646|03/29/2022|.03558|03/29/2022|.03582|03/29/2022|||HYPOGLYCEMICS: METFORMINS|9384|||||No|No||MACLEODS PHARMA|No||||
metformin HCl|No|No|No|No|75%|33342024011|METFORMIN HCL ER 750 MG TABLET|100|EA|.05805|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|No||012|No|.09354|03/29/2022|.09129|03/29/2022|.0919|03/29/2022|||HYPOGLYCEMICS: METFORMINS|9385|||||No|No||MACLEODS PHARMA|No||||
darifenacin hydrobromide|No|No|No|No|75%|33342027607|DARIFENACIN ER 7.5 MG TABLET|30|EA|.93166|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|006|Yes|1.71519|03/29/2022|1.67402|03/29/2022|1.68517|03/29/2022|||BLADDER RELAXANT PREPARATIONS|9386|||||No|No||MACLEODS PHARMA|No||||
darifenacin hydrobromide|No|No|No|No|75%|33342027707|DARIFENACIN ER 15 MG TABLET|30|EA|.93166|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|006|No|2.08753|03/29/2022|2.03742|03/29/2022|2.05099|03/29/2022|||BLADDER RELAXANT PREPARATIONS|9387|||||No|No||MACLEODS PHARMA|No||||
memantine HCl|No|No|No|No|75%|33342029709|MEMANTINE HCL 5 MG TABLET|60|EA|.15443|09/26/2017||Yes|No||09/26/2017||Yes|No|09/26/2017||Yes|No||||No|No|||Prescription required|No||011|No|.08825|03/29/2022|.08613|03/29/2022|.0867|03/29/2022|||ALZHEIMER'S AGENTS|9388|||||No|No||MACLEODS PHARMA|No||||
memantine HCl|No|No|No|No|75%|33342029809|MEMANTINE HCL 10 MG TABLET|60|EA|.15443|09/26/2017||Yes|No||09/26/2017||Yes|No|09/26/2017||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|9389|||||No|No||MACLEODS PHARMA|No||||
memantine HCl|No|No|No|No|75%|33342029815|MEMANTINE HCL 10 MG TABLET|500|EA|.1376|09/26/2017||Yes|No||09/26/2017||Yes|No|09/26/2017||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|9390|||||No|No||MACLEODS PHARMA|No||||
eszopiclone|No|No|No|No|90%|33342029907|ESZOPICLONE 1 MG TABLET|30|EA|.24911|08/17/2017||Yes|No||08/17/2017||Yes|No|08/17/2017||Yes|No||||No|No|||Prescription required|No||054|Yes|.19753|03/29/2022|.19278|03/29/2022|.19407|03/29/2022|||SEDATIVE HYPNOTICS|9391|||||No|No||MACLEODS PHARMA|No||||
eszopiclone|No|No|No|No|90%|33342030011|ESZOPICLONE 2 MG TABLET|100|EA|.10861|08/17/2017||Yes|No||08/17/2017||Yes|No|08/17/2017||Yes|No||||No|No|||Prescription required|No||054|Yes|.25375|03/29/2022|.24766|03/29/2022|.2493|03/29/2022|||SEDATIVE HYPNOTICS|9392|||||No|No||MACLEODS PHARMA|No||||
eszopiclone|No|No|No|No|90%|33342030111|ESZOPICLONE 3 MG TABLET|100|EA|.10861|08/17/2017||Yes|No||08/17/2017||Yes|No|08/17/2017||Yes|No||||No|No|||Prescription required|No||054|Yes|.14316|03/29/2022|.13972|03/29/2022|.14065|03/29/2022|||SEDATIVE HYPNOTICS|9393|||||No|No||MACLEODS PHARMA|No||||
triamcinolone acetonide|No|No|No|No|75%|33342032715|TRIAMCINOLONE 0.025% CREAM|15|GM|.06593|08/05/2020||Yes|No||08/05/2020||Yes|No|08/05/2020||Yes|No||||No|No|||Prescription required|No||120|No|.15373|03/29/2022|.15004|03/29/2022|.15103|03/29/2022|||STEROIDS: TOPICAL HIGH|9394|||||No|No||MACLEODS PHARMA|No||||
triamcinolone acetonide|No|No|No|No|75%|33342032780|TRIAMCINOLONE 0.025% CREAM|80|GM|.03063|08/05/2020||Yes|No||08/05/2020||Yes|No|08/05/2020||Yes|No||||No|No|||Prescription required|No||120|No|.05651|03/29/2022|.05515|03/29/2022|.05552|03/29/2022|||STEROIDS: TOPICAL HIGH|9395|||||No|No||MACLEODS PHARMA|No||||
triamcinolone acetonide|No|No|No|No|75%|33342032915|TRIAMCINOLONE 0.1% CREAM|15|GM|.1032|08/06/2020||Yes|No||08/06/2020||Yes|No|08/06/2020||Yes|No||||No|No|||Prescription required|No||120|No|.13878|03/29/2022|.13544|03/29/2022|.13635|03/29/2022|||STEROIDS: TOPICAL HIGH|9396|||||No|No||MACLEODS PHARMA|No||||
triamcinolone acetonide|No|No|No|No|75%|33342032954|TRIAMCINOLONE 0.1% CREAM|454|GM|.02367|08/06/2020||Yes|No||08/06/2020||Yes|No|08/06/2020||Yes|No||||No|No|||Prescription required|No||120|No|.03246|03/29/2022|.03168|03/29/2022|.03189|03/29/2022|||STEROIDS: TOPICAL HIGH|9397|||||No|No||MACLEODS PHARMA|No||||
triamcinolone acetonide|No|No|No|No|75%|33342032980|TRIAMCINOLONE 0.1% CREAM|80|GM|.0344|08/06/2020||Yes|No||08/06/2020||Yes|No|08/06/2020||Yes|No||||No|No|||Prescription required|No||120|No|.05241|03/29/2022|.05115|03/29/2022|.05149|03/29/2022|||STEROIDS: TOPICAL HIGH|9398|||||No|No||MACLEODS PHARMA|No||||
buprenorphine HCl|No|No|No|No|90%|35356055630|BUPRENORPHINE 8 MG TABLET SL|30|EA|.78116|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||Yes|||||||.82579|10/01/2020||9399|||||No|No||QUALITY CARE|Yes|09/01/2020|||
abacavir sulfate/lamivudine|No|No|No|No|75%|35573040230|ABACAVIR-LAMIVUDINE 600-300 MG|30|EA|3.738|10/15/2019||Yes|No||10/15/2019||Yes|No|10/15/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|2.09447|03/29/2022|2.0442|03/29/2022|2.05781|03/29/2022|||HIV / AIDS|9400|||||No|No||BUREL PHARMACEU|No||||
acyclovir|No|No|No|No|75%|35573040331|ACYCLOVIR 5% OINTMENT|30|GM|2.80159|10/18/2019|02/22/2022|Yes|No||10/18/2019|02/22/2022|Yes|No|10/18/2019|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|6.38502|03/29/2022|6.2938|03/29/2022|5.9941|03/29/2022|||ANTIVIRALS: TOPICAL|9401|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||BUREL PHARMACEU|No||||
triamcinolone acetonide|No|No|No|No|75%|35573040454|TRIAMCINOLONE 0.1% PASTE|5|GM|5.71212|10/18/2019||Yes|No||10/18/2019||Yes|No|10/18/2019||Yes|No||||No|No|||Prescription required|No|||No|5.24075|03/29/2022|5.11497|03/29/2022|5.14903|03/29/2022||||9402|||||No|No||BUREL PHARMACEU|No||||
methocarbamol|No|No|No|No|75%|35573041302|METHOCARBAMOL 500 MG TABLET|100|EA|.05031|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No||116|Yes|.07091|03/29/2022|.0692|03/29/2022|.06966|03/29/2022|||SKELETAL MUSCLE RELAXANTS|9403|||||No|No||BUREL PHARMACEU|No||||
methocarbamol|No|No|No|No|75%|35573041304|METHOCARBAMOL 500 MG TABLET|500|EA|.04742|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No||116|Yes|.07091|03/29/2022|.0692|03/29/2022|.06966|03/29/2022|||SKELETAL MUSCLE RELAXANTS|9404|||||No|No||BUREL PHARMACEU|No||||
methocarbamol|No|No|No|No|75%|35573041402|METHOCARBAMOL 750 MG TABLET|100|EA|.06166|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No||116|Yes|.09307|03/29/2022|.09083|03/29/2022|.09144|03/29/2022|||SKELETAL MUSCLE RELAXANTS|9405|||||No|No||BUREL PHARMACEU|No||||
methocarbamol|No|No|No|No|75%|35573041404|METHOCARBAMOL 750 MG TABLET|500|EA|.05774|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No||116|Yes|.09307|03/29/2022|.09083|03/29/2022|.09144|03/29/2022|||SKELETAL MUSCLE RELAXANTS|9406|||||No|No||BUREL PHARMACEU|No||||
atomoxetine HCl|No|No|No|No|75%|35573041530|ATOMOXETINE HCL 10 MG CAPSULE|30|EA|1.59143|02/28/2020||Yes|No||02/28/2020||Yes|No|02/28/2020||Yes|No||||No|No|||Prescription required|No||007|Yes|1.20613|03/29/2022|1.17718|03/29/2022|1.18502|03/29/2022|||STIMULANTS AND RELATED AGENTS|9407|||||No|No||BUREL PHARMACEU|No||||
atomoxetine HCl|No|No|No|No|75%|35573041630|ATOMOXETINE HCL 18 MG CAPSULE|30|EA|1.59143|02/28/2020||Yes|No||02/28/2020||Yes|No|02/28/2020||Yes|No||||No|No|||Prescription required|No||007|Yes|1.0614|03/29/2022|1.03592|03/29/2022|1.04282|03/29/2022|||STIMULANTS AND RELATED AGENTS|9408|||||No|No||BUREL PHARMACEU|No||||
atomoxetine HCl|No|No|No|No|75%|35573041730|ATOMOXETINE HCL 25 MG CAPSULE|30|EA|1.59143|02/28/2020||Yes|No||02/28/2020||Yes|No|02/28/2020||Yes|No||||No|No|||Prescription required|No||007|Yes|1.05569|03/29/2022|1.03035|03/29/2022|1.03721|03/29/2022|||STIMULANTS AND RELATED AGENTS|9409|||||No|No||BUREL PHARMACEU|No||||
atomoxetine HCl|No|No|No|No|75%|35573041830|ATOMOXETINE HCL 40 MG CAPSULE|30|EA|1.72903|02/28/2020||Yes|No||02/28/2020||Yes|No|02/28/2020||Yes|No||||No|No|||Prescription required|No||007|Yes|1.0462|03/29/2022|1.02109|03/29/2022|1.02789|03/29/2022|||STIMULANTS AND RELATED AGENTS|9410|||||No|No||BUREL PHARMACEU|No||||
atomoxetine HCl|No|No|No|No|75%|35573041930|ATOMOXETINE HCL 60 MG CAPSULE|30|EA|1.72903|02/28/2020||Yes|No||02/28/2020||Yes|No|02/28/2020||Yes|No||||No|No|||Prescription required|No||007|Yes|1.16565|03/29/2022|1.13767|03/29/2022|1.14525|03/29/2022|||STIMULANTS AND RELATED AGENTS|9411|||||No|No||BUREL PHARMACEU|No||||
atomoxetine HCl|No|No|No|No|75%|35573042030|ATOMOXETINE HCL 80 MG CAPSULE|30|EA|1.86548|02/28/2020||Yes|No||02/28/2020||Yes|No|02/28/2020||Yes|No||||No|No|||Prescription required|No||007|Yes|1.40838|03/29/2022|1.37457|03/29/2022|1.38373|03/29/2022|||STIMULANTS AND RELATED AGENTS|9412|||||No|No||BUREL PHARMACEU|No||||
atomoxetine HCl|No|No|No|No|75%|35573042130|ATOMOXETINE HCL 100 MG CAPSULE|30|EA|1.86548|12/29/2020||Yes|No||12/29/2020||Yes|No|12/29/2020||Yes|No||||No|No|||Prescription required|No||007|Yes|1.76872|03/29/2022|1.72627|03/29/2022|1.73776|03/29/2022|||STIMULANTS AND RELATED AGENTS|9413|||||No|No||BUREL PHARMACEU|No||||
abacavir sulfate/lamivudine|No|No|No|No|75%|35573043030|ABACAVIR-LAMIVUDINE 600-300 MG|30|EA|3.738|10/05/2020||Yes|No||10/05/2020||Yes|No|10/05/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|2.09447|03/29/2022|2.0442|03/29/2022|2.05781|03/29/2022|||HIV / AIDS|9414|||||No|No||BUREL PHARMACEU|No||||
ketoconazole|No|No|No|No|75%|35573043302|KETOCONAZOLE 200 MG TABLET|100|EA|.45193|09/21/2020||Yes|No||09/21/2020||Yes|No|09/21/2020||Yes|No||||No|No|||Prescription required|No||069|No|.87128|03/29/2022|.85036|03/29/2022|.85603|03/29/2022|||ANTIFUNGALS: ORAL|9415|||||No|No||BUREL PHARMACEU|No||||
ketoconazole|No|No|No|No|75%|35573043330|KETOCONAZOLE 200 MG TABLET|30|EA|.45193|09/21/2020||Yes|No||09/21/2020||Yes|No|09/21/2020||Yes|No||||No|No|||Prescription required|No||069|No|.87128|03/29/2022|.85036|03/29/2022|.85603|03/29/2022|||ANTIFUNGALS: ORAL|9416|||||No|No||BUREL PHARMACEU|No||||
loxapine succinate|No|No|No|No|75%|35573043602|LOXAPINE 5 MG CAPSULE|100|EA|.23512|08/23/2021||Yes|No||08/23/2021||Yes|No|08/23/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|027|Yes|.48716|01/25/2022|.47546|01/25/2022|.47863|01/25/2022|||ANTIPSYCHOTICS|9417|||||No|No||BUREL/PRASCO LA|No||||
loxapine succinate|No|No|No|No|75%|35573043702|LOXAPINE 10 MG CAPSULE|100|EA|.30917|08/23/2021||Yes|No||08/23/2021||Yes|No|08/23/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|027|Yes|.55828|01/25/2022|.54488|01/25/2022|.54851|01/25/2022|||ANTIPSYCHOTICS|9418|||||No|No||BUREL/PRASCO LA|No||||
loxapine succinate|No|No|No|No|75%|35573043802|LOXAPINE 25 MG CAPSULE|100|EA|.47029|08/23/2021||Yes|No||08/23/2021||Yes|No|08/23/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|027|Yes|.84036|01/25/2022|.82019|01/25/2022|.82565|01/25/2022|||ANTIPSYCHOTICS|9419|||||No|No||BUREL/PRASCO LA|No||||
loxapine succinate|No|No|No|No|75%|35573043902|LOXAPINE 50 MG CAPSULE|100|EA|.62685|08/23/2021||Yes|No||08/23/2021||Yes|No|08/23/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|027|Yes|1.01035|10/26/2021|.9861|10/26/2021|.99266|10/26/2021|||ANTIPSYCHOTICS|9420|||||No|No||BUREL/PRASCO LA|No||||
haloperidol|No|No|No|No|75%|35573044102|HALOPERIDOL 5 MG TABLET|100|EA|.24763|03/30/2022||Yes|No||03/30/2022||Yes|No|03/30/2022||Yes|No||||No|No|||Prescription required|No||027|Yes|.44921|03/30/2022|.43842|03/30/2022|.44134|03/30/2022|||ANTIPSYCHOTICS|9421|||||No|No||BUREL PHARMACEU|No||||
hyoscyamine sulfate|No|No|No|No|75%|39328004715|HYOSCYAMINE 0.125 MG/ML DROP|15|ML||09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|||||||.924|09/27/2016||9422|||||No|No||PATRIN PHARMA|No||||
hyoscyamine sulfate|No|No|No|No|75%|39328004816|HYOSCYAMINE 0.125 MG/5 ML ELIX|473|ML||09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|||||||.07605|07/28/2020||9423|||||No|No||PATRIN PHARMA|No||||
tobramycin sulfate|No|No|No|No|75%|39822041201|TOBRAMYCIN 1.2 GM VIAL|1|EA|34.4|05/04/2004||Yes|No||05/04/2004||Yes|No|05/04/2004||Yes|No||||No|No|||Prescription required|No|||No|78.4|10/12/2021|77.28|10/12/2021|73.6|10/12/2021||||9424|||||No|No||X-GEN PHARMACEU|No||||
tobramycin sulfate|No|No|No|No|75%|39822041206|TOBRAMYCIN 1.2 GM VIAL|1|EA|32.25|05/04/2004||Yes|No||05/04/2004||Yes|No|05/04/2004||Yes|No||||No|No|||Prescription required|No|||No|73.5|10/12/2021|72.45|10/12/2021|69|10/12/2021||||9425|||||No|No||X-GEN PHARMACEU|No||||
colistin (colistimethate Na)|No|No|No|No|75%|39822061501|COLISTIMETHATE 150 MG VIAL|1|EA|12.04|03/26/2002|06/30/2023|Yes|No||03/26/2002|06/30/2023|Yes|No|03/26/2002|06/30/2023|Yes|No||||No|No|||Prescription required|No|||No|27.44|06/28/2016|27.048|06/28/2016|25.76|06/28/2016||||9426|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||X-GEN PHARMACEU|No||||
amphotericin B|No|No|No|No|75%|39822105505|AMPHOTERICIN B 50 MG VIAL|1|EA|18.791|03/17/2004||Yes|No||03/17/2004||Yes|No|03/17/2004||Yes|No||||No|No|||Prescription required|No|||No|42.826|11/24/2020|42.2142|11/24/2020|40.204|11/24/2020||||9427|||||No|No||X-GEN PHARMACEU|No||||
neomycin sulf/polymyxin B sulf|No|No|No|No|75%|39822122001|NEOMY-POLYMYXIN B 40 MG/ML VL|20|ML|2.666|06/20/2019||Yes|No||06/20/2019||Yes|No|06/20/2019||Yes|No||||No|No|||Prescription required|No|||No|6.076|11/27/2018|5.9892|11/27/2018|5.704|11/27/2018||||9428|||||No|No||X-GEN PHARMACEU|No||||
ketorolac tromethamine|No|No|No|No|75%|41616021990|KETOROLAC 0.5% OPHTH SOLUTION|3|ML|2.09983|11/05/2009||Yes|No||11/05/2009||Yes|No|11/05/2009||Yes|No||||No|No|||Prescription required|No||013|No|4.78566|02/25/2020|4.71729|02/25/2020|4.49266|02/25/2020|||OPHTHALMICS: ANTI-INFLAMMATORIES|9429|||||No|No||SUN PHARMA GLOB|No||||
ketorolac tromethamine|No|No|No|No|75%|41616022090|KETOROLAC 0.5% OPHTH SOLUTION|5|ML|2.7563|08/26/2011||Yes|No||08/26/2011||Yes|No|08/26/2011||Yes|No||||No|No|||Prescription required|No||013|No|1.50166|03/29/2022|1.46562|03/29/2022|1.47538|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|9430|||||No|No||SUN PHARMA GLOB|No||||
ketorolac tromethamine|No|No|No|No|75%|41616022190|KETOROLAC 0.5% OPHTH SOLUTION|10|ML|2.7735|08/26/2011||Yes|No||08/26/2011||Yes|No|08/26/2011||Yes|No||||No|No|||Prescription required|No||013|No|1.17797|03/29/2022|1.14969|03/29/2022|1.15735|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|9431|||||No|No||SUN PHARMA GLOB|No||||
venlafaxine HCl|No|No|No|No|75%|41616075881|VENLAFAXINE HCL ER 150 MG TAB|90|EA|1.48469|09/30/2010||Yes|No||09/30/2010||Yes|No|09/30/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|031|No|2.65947|03/29/2022|2.59564|03/29/2022|2.61292|03/29/2022|||ANTIDEPRESSANTS: OTHER|9432|||||No|No||SUN PHARMA GLOB|No||||
venlafaxine HCl|No|No|No|No|75%|41616075883|VENLAFAXINE HCL ER 150 MG TAB|30|EA|1.48421|09/30/2010||Yes|No||09/30/2010||Yes|No|09/30/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|031|No|2.65947|03/29/2022|2.59564|03/29/2022|2.61292|03/29/2022|||ANTIDEPRESSANTS: OTHER|9433|||||No|No||SUN PHARMA GLOB|No||||
venlafaxine HCl|No|No|No|No|75%|41616075981|VENLAFAXINE HCL ER 75 MG TAB|90|EA|1.36214|09/30/2010||Yes|No||09/30/2010||Yes|No|09/30/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|031|Yes|1.5965|03/29/2022|1.55818|03/29/2022|1.56856|03/29/2022|||ANTIDEPRESSANTS: OTHER|9434|||||No|No||SUN PHARMA GLOB|No||||
venlafaxine HCl|No|No|No|No|75%|41616075983|VENLAFAXINE HCL ER 75 MG TAB|30|EA|1.36166|09/30/2010||Yes|No||09/30/2010||Yes|No|09/30/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|031|Yes|1.5965|03/29/2022|1.55818|03/29/2022|1.56856|03/29/2022|||ANTIDEPRESSANTS: OTHER|9435|||||No|No||SUN PHARMA GLOB|No||||
venlafaxine HCl|No|No|No|No|75%|41616076081|VENLAFAXINE HCL ER 37.5 MG TAB|90|EA|1.2169|09/30/2010||Yes|No||09/30/2010||Yes|No|09/30/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|031|Yes|1.96254|10/26/2021|1.91543|10/26/2021|1.92819|10/26/2021|||ANTIDEPRESSANTS: OTHER|9436|||||No|No||SUN PHARMA GLOB|No||||
venlafaxine HCl|No|No|No|No|75%|41616076083|VENLAFAXINE HCL ER 37.5 MG TAB|30|EA|1.2169|09/30/2010||Yes|No||09/30/2010||Yes|No|09/30/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|031|Yes|1.96254|10/26/2021|1.91543|10/26/2021|1.92819|10/26/2021|||ANTIDEPRESSANTS: OTHER|9437|||||No|No||SUN PHARMA GLOB|No||||
colistin (colistimethate Na)|No|No|No|No|75%|42023010701|COLY-MYCIN M 150 MG VIAL|1|EA|12.04|05/18/2009||Yes|No||05/18/2009||Yes|No|05/18/2009||Yes|No||||No|No|||Prescription required|No|||No|27.44|06/01/2016|27.048|06/01/2016|25.76|06/01/2016||||9438|||||No|No||PAR PHARMACEUTI|No||||
colistin (colistimethate Na)|No|No|No|No|75%|42023010706|COLY-MYCIN M 150 MG VIAL|1|EA|12.04|06/14/2011||Yes|No||06/14/2011||Yes|No|06/14/2011||Yes|No||||No|No|||Prescription required|No|||No|27.44|06/01/2016|27.048|06/01/2016|25.76|06/01/2016||||9439|||||No|No||PAR PHARMACEUTI|No||||
estradiol valerate|No|No|No|No|75%|42023011001|DELESTROGEN 50 MG/5 ML VIAL|5|ML|11.41478|05/18/2009||Yes|No||05/18/2009||Yes|No|05/18/2009||Yes|No||||No|No|||Prescription required|No|||Yes|26.01508|06/01/2016|25.64343|06/01/2016|24.42232|06/01/2016||||9440|||||No|No||PAR PHARMACEUTI|No||||
estradiol valerate|No|No|No|No|75%|42023011101|DELESTROGEN 100 MG/5 ML VIAL|5|ML|16.08802|05/18/2009||Yes|No||05/18/2009||Yes|No|05/18/2009||Yes|No||||No|No|||Prescription required|No|||Yes|35.849|05/25/2021|34.98862|05/25/2021|35.22164|05/25/2021||||9441|||||No|No||PAR PHARMACEUTI|No||||
estradiol valerate|No|No|No|No|75%|42023011201|DELESTROGEN 200 MG/5 ML VIAL|5|ML|26.68666|05/18/2009||Yes|No||05/18/2009||Yes|No|05/18/2009||Yes|No||||No|No|||Prescription required|No|||Yes|58.91433|06/29/2021|57.50038|06/29/2021|57.88332|06/29/2021||||9442|||||No|No||PAR PHARMACEUTI|No||||
trimethobenzamide HCl|No|No|No|No|75%|42023011925|TIGAN 100 MG/ML VIAL|2|ML|9.56328|11/09/2016||Yes|No||11/09/2016||Yes|No|11/09/2016||Yes|No||||No|No|||Prescription required|No|||No|21.79539|07/27/2021|21.48403|07/27/2021|20.46098|07/27/2021||||9443|||||No|No||PAR PHARMACEUTI|No||||
dantrolene sodium|No|No|No|No|75%|42023012401|DANTRIUM 25 MG CAPSULE|100|EA|.4601|04/08/2010||Yes|No||04/08/2010||Yes|No|04/08/2010||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|116|No|1.0486|06/01/2016|1.03362|06/01/2016|.9844|06/01/2016|||SKELETAL MUSCLE RELAXANTS|9444|||||No|No||PAR PHARMACEUTI|No||||
dantrolene sodium|No|No|No|No|75%|42023012501|DANTRIUM 50 MG CAPSULE|100|EA|.7181|04/08/2010||Yes|No||04/08/2010||Yes|No|04/08/2010||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|116|No|1.6366|06/01/2016|1.61322|06/01/2016|1.5364|06/01/2016|||SKELETAL MUSCLE RELAXANTS|9445|||||No|No||PAR PHARMACEUTI|No||||
fluphenazine decanoate|No|No|No|No|75%|42023012901|FLUPHENAZINE DEC 125 MG/5 ML|5|ML|6.708|08/10/2016||Yes|No||08/10/2016||Yes|No|08/10/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|027|No|15.04031|03/29/2022|14.67934|03/29/2022|14.7771|03/29/2022|||ANTIPSYCHOTICS|9446|||||No|No||PAR PHARM.|No||||
colistin (colistimethate Na)|No|No|No|No|75%|42023013101|COLISTIMETHATE 150 MG VIAL|1|EA|12.0357|08/24/2012||Yes|No||08/24/2012||Yes|No|08/24/2012||Yes|No||||No|No|||Prescription required|No|||No|27.4302|06/28/2016|27.03834|06/28/2016|25.7508|06/28/2016||||9447|||||No|No||PAR PHARM.|No||||
colistin (colistimethate Na)|No|No|No|No|75%|42023013106|COLISTIMETHATE 150 MG VIAL|1|EA|12.0357|08/24/2012||Yes|No||08/24/2012||Yes|No|08/24/2012||Yes|No||||No|No|||Prescription required|No|||No|27.4302|06/28/2016|27.03834|06/28/2016|25.7508|06/28/2016||||9448|||||No|No||PAR PHARM.|No||||
naratriptan HCl|No|No|No|No|75%|42043013109|NARATRIPTAN HCL 2.5 MG TABLET|9|EA|.47777|03/10/2014||Yes|No||03/10/2014||Yes|No|03/10/2014||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|021|No|1.83483|03/29/2022|1.79079|03/29/2022|1.80272|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|9449|||||No|No||ORCHID/BIONPHAR|No||||
cephalexin|No|No|No|No|75%|42043014001|CEPHALEXIN 250 MG CAPSULE|100|EA|.05676|05/08/2008||Yes|No||05/08/2008||Yes|No|05/08/2008||Yes|No||||No|No|||Prescription required|No||046|No|.09013|03/29/2022|.08796|03/29/2022|.08855|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|9450|||||No|No||ORCHIDPHARMA, I|No||||
cephalexin|No|No|No|No|75%|42043014005|CEPHALEXIN 250 MG CAPSULE|500|EA|.05418|04/01/2008||Yes|No||04/01/2008||Yes|No|04/01/2008||Yes|No||||No|No|||Prescription required|No||046|No|.09013|03/29/2022|.08796|03/29/2022|.08855|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|9451|||||No|No||ORCHIDPHARMA, I|No||||
cephalexin|No|No|No|No|75%|42043014101|CEPHALEXIN 500 MG CAPSULE|100|EA|.09374|04/01/2008||Yes|No||04/01/2008||Yes|No|04/01/2008||Yes|No||||No|No|||Prescription required|No||046|No|.12151|03/29/2022|.11859|03/29/2022|.11938|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|9452|||||No|No||ORCHIDPHARMA, I|No||||
cephalexin|No|No|No|No|75%|42043014105|CEPHALEXIN 500 MG CAPSULE|500|EA|.08858|04/01/2008||Yes|No||04/01/2008||Yes|No|04/01/2008||Yes|No||||No|No|||Prescription required|No||046|No|.12151|03/29/2022|.11859|03/29/2022|.11938|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|9453|||||No|No||ORCHIDPHARMA, I|No||||
cephalexin|No|No|No|No|75%|42043014238|CEPHALEXIN 125 MG/5 ML SUSP|100|ML|.0817|04/01/2008||Yes|No||04/01/2008||Yes|No|04/01/2008||Yes|No||||No|No|||Prescription required|No||046|No|.0819|03/29/2022|.07993|03/29/2022|.08046|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|9454|||||No|No||ORCHIDPHARMA, I|No||||
cephalexin|No|No|No|No|75%|42043014338|CEPHALEXIN 250 MG/5 ML SUSP|100|ML|.0989|04/01/2008||Yes|No||04/01/2008||Yes|No|04/01/2008||Yes|No||||No|No|||Prescription required|No||046|No|.09997|03/29/2022|.09757|03/29/2022|.09822|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|9455|||||No|No||ORCHIDPHARMA, I|No||||
cephalexin|No|No|No|No|75%|42043014358|CEPHALEXIN 250 MG/5 ML SUSP|200|ML|.08815|04/01/2008||Yes|No||04/01/2008||Yes|No|04/01/2008||Yes|No||||No|No|||Prescription required|No||046|No|.07683|03/29/2022|.07498|03/29/2022|.07548|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|9456|||||No|No||ORCHIDPHARMA, I|No||||
modafinil|No|No|No|No|90%|42043016001|MODAFINIL 100 MG TABLET|100|EA|.88997|09/16/2013||Yes|No||09/16/2013||Yes|No|09/16/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.4088|03/29/2022|.39898|03/29/2022|.40164|03/29/2022|||STIMULANTS AND RELATED AGENTS|9457|||||No|No||ORCHIDPHARMA, I|No||||
modafinil|No|No|No|No|90%|42043016003|MODAFINIL 100 MG TABLET|30|EA|.27233|09/16/2013||Yes|No||09/16/2013||Yes|No|09/16/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.4088|03/29/2022|.39898|03/29/2022|.40164|03/29/2022|||STIMULANTS AND RELATED AGENTS|9458|||||No|No||ORCHID/BIONPHAR|No||||
modafinil|No|No|No|No|90%|42043016101|MODAFINIL 200 MG TABLET|100|EA|1.04872|09/16/2013||Yes|No||09/16/2013||Yes|No|09/16/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55328|03/29/2022|.54|03/29/2022|.54359|03/29/2022|||STIMULANTS AND RELATED AGENTS|9459|||||No|No||ORCHIDPHARMA, I|No||||
modafinil|No|No|No|No|90%|42043016103|MODAFINIL 200 MG TABLET|30|EA|.30816|09/16/2013||Yes|No||09/16/2013||Yes|No|09/16/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55328|03/29/2022|.54|03/29/2022|.54359|03/29/2022|||STIMULANTS AND RELATED AGENTS|9460|||||No|No||ORCHID/BIONPHAR|No||||
modafinil|No|No|No|No|90%|42043016190|MODAFINIL 200 MG TABLET|90|EA|.20066|11/03/2015||Yes|No||||No|No|11/03/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55328|03/29/2022|.54|03/29/2022|.54359|03/29/2022|||STIMULANTS AND RELATED AGENTS|9461|||||No|No||ORCHID/BIONPHAR|No||||
zaleplon|No|No|No|No|90%|42043021001|ZALEPLON 5 MG CAPSULE|100|EA|.043|09/14/2020||Yes|No||09/14/2020||Yes|No|09/14/2020||Yes|No||||No|No|||Prescription required|No||054|Yes|.1639|03/29/2022|.15996|03/29/2022|.16103|03/29/2022|||SEDATIVE HYPNOTICS|9462|||||No|No||ORCHIDPHARMA, I|No||||
zaleplon|No|No|No|No|90%|42043021101|ZALEPLON 10 MG CAPSULE|100|EA|.043|09/14/2020||Yes|No||09/14/2020||Yes|No|09/14/2020||Yes|No||||No|No|||Prescription required|No||054|Yes|.18241|03/29/2022|.17803|03/29/2022|.17921|03/29/2022|||SEDATIVE HYPNOTICS|9463|||||No|No||ORCHIDPHARMA, I|No||||
sumatriptan succinate|No|No|No|No|75%|42043022009|SUMATRIPTAN SUCC 25 MG TABLET|9|EA|.14333|04/07/2021||Yes|No||04/07/2021||Yes|No|04/07/2021||Yes|No||||No|No|||Prescription required|No||021|No|.55768|03/29/2022|.54429|03/29/2022|.54792|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|9464|||||No|No||ORCHID/BIONPHAR|No||||
sumatriptan succinate|No|No|No|No|75%|42043022109|SUMATRIPTAN SUCC 50 MG TABLET|9|EA|.1911|04/07/2021||Yes|No||04/07/2021||Yes|No|04/07/2021||Yes|No||||No|No|||Prescription required|No||021|No|.52829|03/29/2022|.51561|03/29/2022|.51904|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|9465|||||No|No||ORCHID/BIONPHAR|No||||
sumatriptan succinate|No|No|No|No|75%|42043022209|SUMATRIPTAN SUCC 100 MG TABLET|9|EA|.23888|04/07/2021||Yes|No||04/07/2021||Yes|No|04/07/2021||Yes|No||||No|No|||Prescription required|No||021|No|.54919|03/29/2022|.536|03/29/2022|.53957|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|9466|||||No|No||ORCHID/BIONPHAR|No||||
eszopiclone|No|No|No|No|90%|42043032003|ESZOPICLONE 1 MG TABLET|30|EA|.086|11/03/2015||Yes|No||11/03/2015||Yes|No|11/03/2015||Yes|No||||No|No|||Prescription required|No||054|Yes|.19753|03/29/2022|.19278|03/29/2022|.19407|03/29/2022|||SEDATIVE HYPNOTICS|9467|||||No|No||ORCHID/BIONPHAR|No||||
eszopiclone|No|No|No|No|90%|42043032101|ESZOPICLONE 2 MG TABLET|100|EA|.0473|11/03/2015||Yes|No||11/03/2015||Yes|No|11/03/2015||Yes|No||||No|No|||Prescription required|No||054|Yes|.25375|03/29/2022|.24766|03/29/2022|.2493|03/29/2022|||SEDATIVE HYPNOTICS|9468|||||No|No||ORCHID/BIONPHAR|No||||
eszopiclone|No|No|No|No|90%|42043032201|ESZOPICLONE 3 MG TABLET|100|EA|.0602|11/03/2015||Yes|No||11/03/2015||Yes|No|11/03/2015||Yes|No||||No|No|||Prescription required|No||054|Yes|.14316|03/29/2022|.13972|03/29/2022|.14065|03/29/2022|||SEDATIVE HYPNOTICS|9469|||||No|No||ORCHID/BIONPHAR|No||||
granisetron HCl|No|No|No|No|75%|42043039002|GRANISETRON HCL 1 MG TABLET|2|EA|1.29|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|085|Yes|2.94|09/18/2020|2.898|09/22/2020|2.76|09/18/2020|||ANTIEMETIC/ANTIVERTIGO AGENTS|9470|||||No|No||ORCHID/BIONPHAR|No||||
granisetron HCl|No|No|No|No|75%|42043039020|GRANISETRON HCL 1 MG TABLET|20|EA|.4515|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|085|Yes|1.029|09/18/2020|1.0143|09/18/2020|.966|09/18/2020|||ANTIEMETIC/ANTIVERTIGO AGENTS|9471|||||No|No||ORCHID/BIONPHAR|No||||
granisetron HCl|No|No|No|No|75%|42043039021|GRANISETRON HCL 1 MG TABLET|20|EA|.4515|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|085|Yes|1.029|09/18/2020|1.0143|09/18/2020|.966|09/18/2020|||ANTIEMETIC/ANTIVERTIGO AGENTS|9472|||||No|No||ORCHID/BIONPHAR|No||||
aripiprazole|No|No|No|No|75%|42043040003|ARIPIPRAZOLE ODT 10 MG TABLET|30|EA|4.085|09/14/2020||Yes|No||09/14/2020||Yes|No|09/14/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|9.31|09/14/2020|9.177|09/14/2020|8.74|09/14/2020|||ANTIPSYCHOTICS|9473|||||No|No||ORCHIDPHARMA, I|No||||
aripiprazole|No|No|No|No|75%|42043040103|ARIPIPRAZOLE ODT 15 MG TABLET|30|EA|4.085|09/14/2020||Yes|No||09/14/2020||Yes|No|09/14/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|9.31|09/14/2020|9.177|09/14/2020|8.74|09/14/2020|||ANTIPSYCHOTICS|9474|||||No|No||ORCHIDPHARMA, I|No||||
terbinafine HCl|No|No|No|No|75%|42043041001|TERBINAFINE HCL 250 MG TABLET|100|EA|.043|08/12/2021||Yes|No||08/12/2021||Yes|No|08/12/2021||Yes|No||||No|No|||Prescription required|No||069|No|.15711|03/29/2022|.15333|03/29/2022|.15436|03/29/2022|||ANTIFUNGALS: ORAL|9475|||||No|No||ORCHID/BIONPHAR|No||||
terbinafine HCl|No|No|No|No|75%|42043041003|TERBINAFINE HCL 250 MG TABLET|30|EA|.0645|08/12/2021||Yes|No||08/12/2021||Yes|No|08/12/2021||Yes|No||||No|No|||Prescription required|No||069|No|.15711|03/29/2022|.15333|03/29/2022|.15436|03/29/2022|||ANTIFUNGALS: ORAL|9476|||||No|No||ORCHID/BIONPHAR|No||||
salicylic acid|No|No|No|No|75%|42192013510|SALICYLIC ACID 27.5% LIQUID|10|ML|3.08181|12/04/2018||Yes|No||12/04/2018||Yes|No|12/04/2018||Yes|No||||No|No|||Prescription required|No|||No|7.02366|12/04/2018|6.92332|12/04/2018|6.59364|12/04/2018||||9477|||||No|No||ACELLA PHARMACE|No||||
prenatal,calc.40/iron/folate 1|No|No|No|No|75%|42192032090|PNV-SELECT TABLET|90|EA|.86444|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|1.97012|02/26/2019|1.94197|02/26/2019|1.8495|02/26/2019|||PRENATAL VITAMINS|9478|||||No|No||ACELLA PHARMACE|No||||
multivit 47/iron/folate 1/dha|No|No|No|No|75%|42192032130|PNV-DHA SOFTGEL|30|EA|.74633|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|1.18814|03/29/2022|1.15962|03/29/2022|1.16734|03/29/2022|||PRENATAL VITAMINS|9479|||||No|No||ACELLA PHARMACE|No||||
PNV 66/iron/folic/docusate/dha|No|No|No|No|75%|42192032330|PNV-DHA + DOCUSATE SOFTGEL|30|EA|.66879|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|Yes|04/26/2020|243|No|1.52422|06/25/2019|1.50244|06/25/2019|1.4309|06/25/2019|||PRENATAL VITAMINS|9480|||||No|No||ACELLA PHARMACE|No||||
thyroid,pork|No|No|No|No|75%|42192032701|NP THYROID 15 MG TABLET|100|EA|.23981|11/19/2018||Yes|No||11/19/2018||Yes|No|11/19/2018||Yes|No||||No|No|||Prescription required|No|||No|.50059|03/29/2022|.48857|03/29/2022|.49182|03/29/2022||||9481|||||No|No||ACELLA PHARMACE|No||||
thyroid,pork|No|No|No|No|75%|42192032801|NP THYROID 120 MG TABLET|100|EA|.57353|11/19/2018||Yes|No||11/19/2018||Yes|No|11/19/2018||Yes|No||||No|No|||Prescription required|No|||No|1.22164|03/29/2022|1.19232|03/29/2022|1.20026|03/29/2022||||9482|||||No|No||ACELLA PHARMACE|No||||
thyroid,pork|No|No|No|No|75%|42192032901|NP THYROID 30 MG TABLET|100|EA|.28156|11/19/2018||Yes|No||11/19/2018||Yes|No|11/19/2018||Yes|No||||No|No|||Prescription required|No|||No|.59899|03/29/2022|.58461|03/29/2022|.5885|03/29/2022||||9483|||||No|No||ACELLA PHARMACE|No||||
thyroid,pork|No|No|No|No|75%|42192033001|NP THYROID 60 MG TABLET|100|EA|.31282|11/19/2018||Yes|No||11/19/2018||Yes|No|11/19/2018||Yes|No||||No|No|||Prescription required|No|||No|.65195|03/29/2022|.6363|03/29/2022|.64054|03/29/2022||||9484|||||No|No||ACELLA PHARMACE|No||||
thyroid,pork|No|No|No|No|75%|42192033101|NP THYROID 90 MG TABLET|100|EA|.49007|11/19/2018||Yes|No||11/19/2018||Yes|No|11/19/2018||Yes|No||||No|No|||Prescription required|No|||No|1.04045|03/29/2022|1.01547|03/29/2022|1.02224|03/29/2022||||9485|||||No|No||ACELLA PHARMACE|No||||
mv-mins 71/iron/folic no.1/dha|No|No|No|No|75%|42192033230|PNV-OMEGA SOFTGEL|30|EA|.67581|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|1.54022|02/26/2019|1.51822|02/26/2019|1.44592|02/26/2019|||PRENATAL VITAMINS|9486|||||No|No||ACELLA PHARMACE|No||||
hyoscyamine sulfate|No|No|No|No|75%|42192033801|HYOSCYAMINE 0.125 MG ODT|100|EA|.1935|10/30/2018||Yes|No||10/30/2018||Yes|No|10/30/2018||Yes|No||||No|No|||Prescription required|No|||No|.20067|03/29/2022|.19585|03/29/2022|.19715|03/29/2022||||9487|||||No|No||ACELLA PHARMACE|No||||
hyoscyamine sulfate|No|No|No|No|75%|42192033901|HYOSCYAMINE 0.125 MG TAB SL|100|EA|.1935|10/30/2018||Yes|No||10/30/2018||Yes|No|10/30/2018||Yes|No||||No|No|||Prescription required|No|||No|.14293|03/29/2022|.13949|03/29/2022|.14042|03/29/2022||||9488|||||No|No||ACELLA PHARMACE|No||||
hyoscyamine sulfate|No|No|No|No|75%|42192034001|HYOSCYAMINE SULF 0.125 MG TAB|100|EA|.1935|10/30/2018||Yes|No||10/30/2018||Yes|No|10/30/2018||Yes|No||||No|No|||Prescription required|No|||No|.1455|03/29/2022|.142|03/29/2022|.14295|03/29/2022||||9489|||||No|No||ACELLA PHARMACE|No||||
PNV 80/iron fum/folic/dss/dha|No|No|No|No|75%|42192034130|PRENAISSANCE CAPSULE|30|EA|1.0115|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|Yes|04/26/2020|243|No|2.30528|02/25/2019|2.27235|02/25/2019|2.16414|02/25/2019|||PRENATAL VITAMINS|9490|||||No|No||ACELLA PHARMACE|No||||
PNV 69/iron/folic/docusate/dha|No|No|No|No|75%|42192034330|PRENAISSANCE PLUS SOFTGEL|30|EA|.64743|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|Yes|04/26/2020|243|No|1.47554|02/26/2019|1.45446|02/26/2019|1.3852|02/26/2019|||PRENATAL VITAMINS|9491|||||No|No||ACELLA PHARMACE|No||||
doxycycline hyclate|No|No|No|No|75%|42192050105|DOXYCYCLINE HYCLATE 100 MG TAB|500|EA|.08599|10/04/2021||Yes|No||10/04/2021||Yes|No|10/04/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|9492|||||No|No||ACELLA PHARMACE|No||||
brompheniramine/pseudoephed/DM|No|No|No|No|75%|42192060704|BROMPHEN-PSE-DM 2-30-10 MG/5ML|118|ML|.06559|06/05/2018||Yes|No||06/05/2018||Yes|No|06/05/2018||Yes|No||||No|No|||Prescription required|No||184|Yes|.0774|03/29/2022|.07554|03/29/2022|.07604|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|9493|||||No|No||ACELLA PHARMACE|No||||
brompheniramine/pseudoephed/DM|No|No|No|No|75%|42192060716|BROMPHEN-PSE-DM 2-30-10 MG/5ML|473|ML|.06363|06/05/2018||Yes|No||06/05/2018||Yes|No|06/05/2018||Yes|No||||No|No|||Prescription required|No||184|Yes|.06501|03/29/2022|.06344|03/29/2022|.06387|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|9494|||||No|No||ACELLA PHARMACE|No||||
gabapentin|No|No|No|No|75%|42192060816|GABAPENTIN 250 MG/5 ML SOLN|470|ML|.08514|02/02/2018||Yes|No||02/02/2018||Yes|No|02/02/2018||Yes|No||||No|No|||Prescription required|No||232|Yes|.09961|03/29/2022|.09721|03/29/2022|.09786|03/29/2022|||NEUROPATHIC PAIN|9495|||||No|No||ACELLA PHARMACE|No||||
nifedipine|No|No|No|No|75%|42192061501|NIFEDIPINE 10 MG CAPSULE|100|EA||04/22/2021||Yes|No||04/22/2021||Yes|No|04/22/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|045|No|.40848|03/29/2022|.39867|03/29/2022|.40133|03/29/2022|||CALCIUM CHANNEL BLOCKERS|9496|||||No|No||ACELLA PHARMACE|No||||
benzonatate|No|No|No|No|75%|42192061701|BENZONATATE 100 MG CAPSULE|100|EA|.06445|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||184|Yes|.09389|03/29/2022|.09163|03/29/2022|.09224|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|9497|||||No|No||ACELLA PHARMACE|No||||
benzonatate|No|No|No|No|75%|42192061705|BENZONATATE 100 MG CAPSULE|500|EA|.05399|03/24/2022||Yes|No||03/24/2022||Yes|No|03/24/2022||Yes|No||||No|No|||Prescription required|No||184|Yes|.09389|03/29/2022|.09163|03/29/2022|.09224|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|9498|||||No|No||ACELLA PHARMACE|No||||
benzonatate|No|No|No|No|75%|42192061805|BENZONATATE 200 MG CAPSULE|500|EA|.07255|03/24/2022||Yes|No||03/24/2022||Yes|No|03/24/2022||Yes|No||||No|No|||Prescription required|No||184|Yes|.14345|03/29/2022|.14|03/29/2022|.14093|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|9499|||||No|No||ACELLA PHARMACE|No||||
naproxen|No|No|No|No|75%|42192061916|NAPROXEN 125 MG/5 ML SUSPEN|473|ML|.51478|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|1.17323|03/01/2022|1.15647|03/01/2022|1.1014|03/01/2022|||NSAIDS|9500|||||No|No||ACELLA PHARMACE|No||||
ciclopirox|No|No|No|No|75%|42192071506|CICLOPIROX 8% SOLUTION|6.6|ML|1.43267|04/16/2020||Yes|No||04/16/2020||Yes|No|04/16/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|1.90189|03/29/2022|1.85624|03/29/2022|1.8686|03/29/2022|||ANTIFUNGALS: TOPICAL|9501|||||No|No||ACELLA PHARMACE|No||||
fenoprofen calcium|No|No|No|No|75%|42195010090|FENOPROFEN 400 MG CAPSULE|90|EA|1.59376|08/11/2015|08/05/2030|Yes|No||08/11/2015|08/05/2030|Yes|No|08/11/2015|08/05/2030|Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|3.63231|03/10/2020|3.58042|03/10/2020|3.40992|03/10/2020|||NSAIDS|9502|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||XSPIRE PHARMA|No||||
dexamethasone|No|No|No|No|75%|42195012106|TAPERDEX 6 DAY 1.5 MG TABLET|21|EA|3.87|03/20/2018||Yes|No||03/20/2018||Yes|No|03/20/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|168|Yes|8.82|03/20/2018|8.694|03/27/2018|8.28|03/20/2018|||GLUCOCORTICOIDS: ORAL|9503|||||No|No||XSPIRE PHARMA|No||||
dexamethasone|No|No|No|No|75%|42195012707|TAPERDEX 7 DAY 1.5 MG TAB PACK|27|EA|3.1046|06/07/2019||Yes|No||06/07/2019||Yes|No|06/07/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|168|No|7.0756|06/07/2019|6.97452|06/11/2019|6.6424|06/07/2019|||GLUCOCORTICOIDS: ORAL|9504|||||No|No||XSPIRE PHARMA|No||||
dexamethasone|No|No|No|No|75%|42195015110|DEXAMETHASONE 1.5 MG TABLET|100|EA|1.35235|12/20/2019||Yes|No||12/20/2019||Yes|No|12/20/2019||Yes|No||||No|No|||Prescription required|No||168|Yes|.34387|03/29/2022|.33561|03/29/2022|.33785|03/29/2022|||GLUCOCORTICOIDS: ORAL|9505|||||No|No||XSPIRE PHARMA|No||||
guaifenesin/pseudoephedrne HCl|No|No|No|No|75%|42195028110|GUAIFENESIN-PSE 375-60 MG TAB|100|EA|.25572|05/18/2020||Yes|No||||No|No|05/18/2020||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|No|.5828|05/18/2020|.57448|05/18/2020|.54712|05/18/2020|||COUGH AND COLD: COLD|9506|||||No|No||XSPIRE PHARMA|No||||
fenoprofen calcium|No|No|No|No|75%|42195030809|NALFON 400 MG CAPSULE|90|EA|2.23508|02/11/2014|12/05/2030|Yes|No||02/11/2014|12/05/2030|Yes|No|02/11/2014|12/05/2030|Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|5.09392|03/10/2020|5.02115|03/10/2020|4.78204|03/10/2020|||NSAIDS|9507|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||XSPIRE PHARMA|No||||
fenoprofen calcium|No|No|No|No|75%|42195047101|FENOPROFEN 600 MG TABLET|100|EA|1.3302|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|3.03163|07/07/2020|2.98832|07/07/2020|2.84602|07/07/2020|||NSAIDS|9508|||||No|No||XSPIRE PHARMA|No||||
acetaminophen/caff/dihydrocod|No|No|No|No|90%|42195084010|ACETAMN-CAF-DIHYDRCODEIN 320.5|100|EA|1.3932|08/11/2015|08/15/2045|Yes|No||08/11/2015|08/15/2045|Yes|No|08/11/2015|08/15/2045|Yes|No||||No|No|||Prescription required|Yes|07/23/2015|109|Yes|3.1752|03/10/2020|3.12984|03/10/2020|2.9808|03/10/2020|||ANALGESICS: NARCOTICS SHORT|9509|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||XSPIRE PHARMA|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|42195095510|BUTALB-ACETAMIN-CAFF 50-300-40|100|EA|.387|11/27/2017||Yes|No||11/27/2017||Yes|No|11/27/2017||Yes|No||||No|No|||Prescription required|No|||No|.69452|03/29/2022|.67785|03/29/2022|.68236|03/29/2022||||9510|||||No|No||XSPIRE PHARMA|No||||
C1 esterase inhibitor|No|No|No|No|75%|42227008105|CINRYZE 500 UNIT VIAL|1|EA|1221.8665|02/23/2011||Yes|No||02/23/2011||Yes|No|02/23/2011||Yes|No||||No|No|||Prescription required|No||501|No|2784.719|01/12/2021|2744.9373|01/12/2021|2614.226|01/12/2021|||HAE TREATMENTS|9511|||||No|No||VIROPHARMA BIOL|No||||
C1 esterase inhibitor|No|No|No|No|75%|42227008301|CINRYZE 500 UNIT VIAL-DILUENT|1|EA|1258.524|05/14/2021||Yes|No||05/14/2021||Yes|No|05/14/2021||Yes|No||||No|No|||Prescription required|No||501|No|2868.264|01/11/2022|2827.2888|01/11/2022|2692.656|01/11/2022|||HAE TREATMENTS|9512|||||No|No||VIROPHARMA BIOL|No||||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|42291017430|BUPRENORPHINE-NALOX 2-0.5MG TB|30|EA|1.98817|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||Yes|4.53118|10/01/2020|4.46645|10/01/2020|4.25376|10/01/2020||||9513|||||No|No||AVKARE|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|42291017530|BUPRENORPHINE-NALOX 8-2 MG TAB|30|EA|3.58491|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||Yes|8.17026|10/01/2020|8.05354|10/01/2020|7.67004|10/01/2020||||9514|||||No|No||AVKARE|Yes|09/01/2020|||
naltrexone HCl|No|No|No|No|75%|42291063230|NALTREXONE 50 MG TABLET|30|EA|.40104|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||No|.914|10/01/2020|.90094|10/01/2020|.85804|10/01/2020||||9515|||||No|No||AVKARE|Yes|09/01/2020|||
esomeprazole magnesium|No|No|No|No|75%|42292000916|ESOMEPRAZOLE MAG DR 20 MG CAP|60|EA|2.92822|07/21/2017||Yes|No||07/21/2017||Yes|No|07/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|9516|||||No|No||MYLAN INSTITUTI|No||||
esomeprazole magnesium|No|No|No|No|75%|42292001016|ESOMEPRAZOLE MAG DR 40 MG CAP|60|EA|2.92822|07/21/2017||Yes|No||07/21/2017||Yes|No|07/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|9517|||||No|No||MYLAN INSTITUTI|No||||
paliperidone|No|No|No|No|75%|42292002620|PALIPERIDONE ER 3 MG TABLET|100|EA|10.93924|07/20/2017||Yes|No||07/20/2017||Yes|No|07/20/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|027|Yes|6.18339|03/29/2022|6.03498|03/29/2022|6.07518|03/29/2022|||ANTIPSYCHOTICS|9518|||||No|No||MYLAN INSTITUTI|No||||
paliperidone|No|No|No|No|75%|42292002720|PALIPERIDONE ER 6 MG TABLET|100|EA|10.93924|07/20/2017||Yes|No||07/20/2017||Yes|No|07/20/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|027|Yes|5.21133|03/29/2022|5.08625|03/29/2022|5.12013|03/29/2022|||ANTIPSYCHOTICS|9519|||||No|No||MYLAN INSTITUTI|No||||
levothyroxine sodium|No|No|No|No|75%|42292003820|LEVOTHYROXINE 88 MCG TABLET|100|EA|.21736|07/27/2017||Yes|No||07/27/2017||Yes|No|07/27/2017||Yes|No||||No|No|||Prescription required|No|||No|.16198|03/29/2022|.15809|03/29/2022|.15914|03/29/2022||||9520|||||No|No||MYLAN INSTITUTI|No||||
levothyroxine sodium|No|No|No|No|75%|42292003920|LEVOTHYROXINE 112 MCG TABLET|100|EA|.25327|07/27/2017||Yes|No||07/27/2017||Yes|No|07/27/2017||Yes|No||||No|No|||Prescription required|No|||No|.1546|03/29/2022|.15088|03/29/2022|.15189|03/29/2022||||9521|||||No|No||MYLAN INSTITUTI|No||||
levothyroxine sodium|No|No|No|No|75%|42292004020|LEVOTHYROXINE 175 MCG TABLET|100|EA|.3142|07/27/2017||Yes|No||07/27/2017||Yes|No|07/27/2017||Yes|No||||No|No|||Prescription required|No|||No|.2247|03/29/2022|.2193|03/29/2022|.22076|03/29/2022||||9522|||||No|No||MYLAN INSTITUTI|No||||
cabozantinib s-malate|No|No|No|No|75%|42388001114|COMETRIQ 140 MG DAILY-DOSE PK|112|EA|67.72238|03/07/2013||Yes|No||03/11/2013||Yes|No|03/11/2013||Yes|No||||No|No|||Prescription required|No||239|No|154.34404|01/11/2022|152.13912|01/11/2022|144.8944|01/11/2022|||ONCOLOGY: ORAL - OTHER|9523|||||No|No||EXELIXIS, INC.|No||||
cabozantinib s-malate|No|No|No|No|75%|42388001214|COMETRIQ 100 MG DAILY-DOSE PK|56|EA|135.44477|03/08/2013||Yes|No||03/07/2013||Yes|No|03/08/2013||Yes|No||||No|No|||Prescription required|No||239|No|308.68809|01/11/2022|304.27826|01/11/2022|289.78882|01/11/2022|||ONCOLOGY: ORAL - OTHER|9524|||||No|No||EXELIXIS, INC.|No||||
cabozantinib s-malate|No|No|No|No|75%|42388001314|COMETRIQ 60 MG DAILY-DOSE PACK|84|EA|90.29651|03/08/2013||Yes|No||03/19/2013||Yes|No|03/08/2013||Yes|No||||No|No|||Prescription required|No||239|No|205.79206|01/11/2022|202.85217|01/11/2022|193.19254|01/11/2022|||ONCOLOGY: ORAL - OTHER|9525|||||No|No||EXELIXIS, INC.|No||||
cabozantinib s-malate|No|No|No|No|75%|42388002326|CABOMETYX 60 MG TABLET|30|EA|333.78764|10/21/2016||Yes|No||10/21/2016||Yes|No|10/21/2016||Yes|No||||No|No|||Prescription required|No||548|No|760.72532|01/11/2022|749.85781|01/11/2022|714.1503|01/11/2022|||ONCOLOGY: ORAL - RENAL CELL|9526|||||No|No||EXELIXIS, INC.|No||||
cabozantinib s-malate|No|No|No|No|75%|42388002426|CABOMETYX 20 MG TABLET|30|EA|333.78764|10/21/2016||Yes|No||10/21/2016||Yes|No|10/21/2016||Yes|No||||No|No|||Prescription required|No||548|No|760.72532|01/11/2022|749.85781|01/11/2022|714.1503|01/11/2022|||ONCOLOGY: ORAL - RENAL CELL|9527|||||No|No||EXELIXIS, INC.|No||||
cabozantinib s-malate|No|No|No|No|75%|42388002526|CABOMETYX 40 MG TABLET|30|EA|333.78764|10/21/2016||Yes|No||10/21/2016||Yes|No|10/21/2016||Yes|No||||No|No|||Prescription required|No||548|No|760.72532|01/11/2022|749.85781|01/11/2022|714.1503|01/11/2022|||ONCOLOGY: ORAL - RENAL CELL|9528|||||No|No||EXELIXIS, INC.|No||||
glutamine|No|No|No|No|75%|42457042001|ENDARI 5 GRAM POWDER PACKET|1|EA|8.815|07/10/2018||Yes|No||07/10/2018||Yes|No|07/10/2018||Yes|No||||No|No|||Prescription required|No||580|No|20.09|02/01/2022|19.803|02/01/2022|18.86|02/01/2022|||SICKLE CELL ANEMIA TREATMENTS|9529|||||No|No||EMMAUS MEDICAL|No||||
glutamine|No|No|No|No|75%|42457042060|ENDARI 5 GRAM POWDER PACKET|60|EA|8.815|07/10/2018||Yes|No||07/10/2018||Yes|No|07/10/2018||Yes|No||||No|No|||Prescription required|No||580|No|20.09|02/01/2022|19.803|02/01/2022|18.86|02/01/2022|||SICKLE CELL ANEMIA TREATMENTS|9530|||||No|No||EMMAUS MEDICAL|No||||
amiodarone HCl|No|No|No|No|75%|42494030703|AMIODARONE HCL 100 MG TABLET|30|EA||11/05/2020||Yes|No||11/05/2020||Yes|No|11/05/2020||Yes|No||||No|No|||Prescription required|No|||No|1.5888|03/29/2022|1.55066|03/29/2022|1.56099|03/29/2022||||9531|||||No|No||CAMERON PHARMAC|No||||
amiodarone HCl|No|No|No|No|75%|42494030903|AMIODARONE HCL 400 MG TABLET|30|EA||08/05/2019||Yes|No||08/05/2019||Yes|No|08/05/2019||Yes|No||||No|No|||Prescription required|No|||No|3.05628|03/29/2022|2.98292|03/29/2022|3.00279|03/29/2022||||9532|||||No|No||CAMERON PHARMAC|No||||
flucytosine|No|No|No|No|75%|42494033901|FLUCYTOSINE 250 MG CAPSULE|100|EA||04/09/2021||Yes|No||04/09/2021||Yes|No|04/09/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|069|No|||||||69.75|08/25/2021|ANTIFUNGALS: ORAL|9533|||||No|No||CAMERON PHARMAC|No||||
flucytosine|No|No|No|No|75%|42494033903|FLUCYTOSINE 250 MG CAPSULE|30|EA||08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|069|No|||||||69.75|08/25/2021|ANTIFUNGALS: ORAL|9534|||||No|No||CAMERON PHARMAC|No||||
flucytosine|No|No|No|No|75%|42494034001|FLUCYTOSINE 500 MG CAPSULE|100|EA||04/09/2021||Yes|No||04/09/2021||Yes|No|04/09/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|069|No|||||||156.24|04/09/2021|ANTIFUNGALS: ORAL|9535|||||No|No||CAMERON PHARMAC|No||||
flucytosine|No|No|No|No|75%|42494034003|FLUCYTOSINE 500 MG CAPSULE|30|EA||08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|069|No|||||||134.985|08/25/2021|ANTIFUNGALS: ORAL|9536|||||No|No||CAMERON PHARMAC|No||||
chlordiazepoxide/clidinium Br|No|No|No|No|75%|42494040901|CHLORDIAZEPOXIDE-CLIDINIUM CAP|100|EA||08/30/2019||Yes|No||08/30/2019||Yes|No|08/30/2019||Yes|No||||No|No|||Prescription required|No|||Yes|.95937|03/29/2022|.93634|03/29/2022|.94258|03/29/2022||||9537|||||No|No||CAMERON PHARMAC|No||||
phenobarbital sodium|No|No|No|No|75%|42494041503|PHENOBARBITAL 65 MG/ML VIAL|1|ML|11.2574|11/05/2020||Yes|No||11/05/2020||Yes|No|11/05/2020||Yes|No||||No|No|||Prescription required|No|||No|25.6564|11/10/2020|25.28988|11/05/2020|24.0856|11/05/2020||||9538|||||No|No||CAMERON PHARMAC|No||||
phenobarbital sodium|No|No|No|No|75%|42494041525|PHENOBARBITAL 65 MG/ML VIAL|1|ML||06/18/2021||Yes|No||06/18/2021||Yes|No|06/18/2021||Yes|No||||No|No|||Prescription required|No|||No|||||||25.6564|06/21/2021||9539|||||No|No||CAMERON PHARMAC|No||||
phenobarbital sodium|No|No|No|No|75%|42494041603|PHENOBARBITAL 130 MG/ML VIAL|1|ML|29.2228|11/05/2020||Yes|No||11/05/2020||Yes|No|11/05/2020||Yes|No||||No|No|||Prescription required|No|||No|66.6008|11/10/2020|65.64936|11/10/2020|62.5232|11/10/2020||||9540|||||No|No||CAMERON PHARMAC|No||||
phenobarbital sodium|No|No|No|No|75%|42494041625|PHENOBARBITAL 130 MG/ML VIAL|1|ML||04/23/2021||Yes|No||04/23/2021||Yes|No|04/23/2021||Yes|No||||No|No|||Prescription required|No|||No|||||||60.99167|04/23/2021||9541|||||No|No||CAMERON PHARMAC|No||||
chlorzoxazone|No|No|No|No|75%|42494042510|CHLORZOXAZONE 375 MG TABLET|100|EA||02/05/2021||Yes|No||02/05/2021||Yes|No|02/05/2021||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|Yes|||||||7.29404|02/05/2021|SKELETAL MUSCLE RELAXANTS|9542|||||No|No||CAMERON PHARMAC|No||||
chlorzoxazone|No|No|No|No|75%|42494042810|CHLORZOXAZONE 750 MG TABLET|100|EA||02/05/2021||Yes|No||02/05/2021||Yes|No|02/05/2021||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|Yes|||||||8.15605|02/05/2021|SKELETAL MUSCLE RELAXANTS|9543|||||No|No||CAMERON PHARMAC|No||||
metoprolol tartrate|No|No|No|No|75%|42543000101|METOPROLOL TARTRATE 25 MG TAB|100|EA|.01431|10/01/2015|03/31/2023|Yes|No||10/01/2015|03/31/2023|Yes|No|10/01/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||070|No|.01777|03/29/2022|.01734|03/29/2022|.01745|03/29/2022|||BETA-BLOCKERS|9544|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
metoprolol tartrate|No|No|No|No|75%|42543000110|METOPROLOL TARTRATE 25 MG TAB|1000|EA|.01355|10/01/2015|03/31/2023|Yes|No||10/01/2015|03/31/2023|Yes|No|10/01/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||070|No|.01777|03/29/2022|.01734|03/29/2022|.01745|03/29/2022|||BETA-BLOCKERS|9545|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
metoprolol tartrate|No|No|No|No|75%|42543000201|METOPROLOL TARTRATE 50 MG TAB|100|EA|.01788|10/01/2015|03/31/2023|Yes|No||10/01/2015|03/31/2023|Yes|No|10/01/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||070|No|.02252|03/29/2022|.02197|03/29/2022|.02212|03/29/2022|||BETA-BLOCKERS|9546|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
metoprolol tartrate|No|No|No|No|75%|42543000210|METOPROLOL TARTRATE 50 MG TAB|1000|EA|.01718|10/01/2015|03/31/2023|Yes|No||10/01/2015|03/31/2023|Yes|No|10/01/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||070|No|.02252|03/29/2022|.02197|03/29/2022|.02212|03/29/2022|||BETA-BLOCKERS|9547|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
metoprolol tartrate|No|No|No|No|75%|42543000301|METOPROLOL TARTRATE 100 MG TAB|100|EA|.02446|10/01/2015|03/31/2023|Yes|No||10/01/2015|03/31/2023|Yes|No|10/01/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||070|No|.03443|03/29/2022|.0336|03/29/2022|.03382|03/29/2022|||BETA-BLOCKERS|9548|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
metoprolol tartrate|No|No|No|No|75%|42543000310|METOPROLOL TARTRATE 100 MG TAB|1000|EA|.02687|10/01/2015|03/31/2023|Yes|No||10/01/2015|03/31/2023|Yes|No|10/01/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||070|No|.03443|03/29/2022|.0336|03/29/2022|.03382|03/29/2022|||BETA-BLOCKERS|9549|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
sildenafil citrate|No|No|No|No|75%|42543000510|SILDENAFIL 20 MG TABLET|1000|EA|.20519|11/14/2017|03/31/2023|Yes|No||11/14/2017|03/31/2023|Yes|No|11/14/2017|03/31/2023|Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|Yes|.09246|03/29/2022|.09024|03/29/2022|.09084|03/29/2022|||PAH AGENTS: ORAL AND INHALED|9550|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
sildenafil citrate|No|No|No|No|75%|42543000590|SILDENAFIL 20 MG TABLET|90|EA|.2052|09/22/2017|03/31/2023|Yes|No||09/22/2017|03/31/2023|Yes|No|09/22/2017|03/31/2023|Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|Yes|.09246|03/29/2022|.09024|03/29/2022|.09084|03/29/2022|||PAH AGENTS: ORAL AND INHALED|9551|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
nystatin|No|No|No|No|75%|42543005261|NYSTATIN 100,000 UNIT/GM POWD|15|GM|.55613|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No||061|No|.35016|03/29/2022|.34175|03/29/2022|.34403|03/29/2022|||ANTIFUNGALS: TOPICAL|9552|||||No|No||VENSUN/STRIDES|No||||
nystatin|No|No|No|No|75%|42543005262|NYSTATIN 100,000 UNIT/GM POWD|30|GM|.55627|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No||061|No|.30897|03/29/2022|.30155|03/29/2022|.30356|03/29/2022|||ANTIFUNGALS: TOPICAL|9553|||||No|No||VENSUN/STRIDES|No||||
nystatin|No|No|No|No|75%|42543005263|NYSTATIN 100,000 UNIT/GM POWD|60|GM|.49665|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No||061|No|.2597|03/29/2022|.25346|03/29/2022|.25515|03/29/2022|||ANTIFUNGALS: TOPICAL|9554|||||No|No||VENSUN/STRIDES|No||||
piroxicam|No|No|No|No|75%|42543011401|PIROXICAM 10 MG CAPSULE|100|EA|.25034|03/06/2018|03/31/2023|Yes|No||03/06/2018|03/31/2023|Yes|No|03/06/2018|03/31/2023|Yes|No||||No|No|||Prescription required|Yes|03/09/2018|059|Yes|.25876|03/01/2022|.25254|03/01/2022|.25423|03/01/2022|||NSAIDS|9555|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
piroxicam|No|No|No|No|75%|42543011501|PIROXICAM 20 MG CAPSULE|100|EA|.43726|03/06/2018|03/31/2023|Yes|No||03/06/2018|03/31/2023|Yes|No|03/06/2018|03/31/2023|Yes|No||||No|No|||Prescription required|Yes|03/09/2018|059|Yes|.40758|03/29/2022|.39779|03/29/2022|.40044|03/29/2022|||NSAIDS|9556|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
hydrocortisone|No|No|No|No|75%|42543014050|HYDROCORTISONE 5 MG TABLET|50|EA|.07404|04/05/2019||Yes|No||11/16/2017||Yes|No|11/16/2017||Yes|No||||No|No|||Prescription required|No||168|Yes|.21144|03/29/2022|.20636|03/29/2022|.20773|03/29/2022|||GLUCOCORTICOIDS: ORAL|9557|||||No|No||VENSUN/STRIDES|No||||
hydrocortisone|No|No|No|No|75%|42543014101|HYDROCORTISONE 10 MG TABLET|100|EA|.12289|11/16/2017||Yes|No||11/16/2017||Yes|No|11/16/2017||Yes|No||||No|No|||Prescription required|No||168|Yes|.28946|03/29/2022|.28251|03/29/2022|.28439|03/29/2022|||GLUCOCORTICOIDS: ORAL|9558|||||No|No||VENSUN/STRIDES|No||||
hydrocortisone|No|No|No|No|75%|42543014201|HYDROCORTISONE 20 MG TABLET|100|EA|.22102|11/16/2017||Yes|No||11/16/2017||Yes|No|11/16/2017||Yes|No||||No|No|||Prescription required|No||168|Yes|.46844|03/29/2022|.45719|03/29/2022|.46024|03/29/2022|||GLUCOCORTICOIDS: ORAL|9559|||||No|No||VENSUN/STRIDES|No||||
nystatin|No|No|No|No|75%|42543035215|NYSTATIN 100,000 UNIT/GM POWD|15|GM|.55613|01/02/2019|03/31/2023|Yes|No||01/02/2019|03/31/2023|Yes|No|01/02/2019|03/31/2023|Yes|No||||No|No|||Prescription required|No||061|No|.35016|03/29/2022|.34175|03/29/2022|.34403|03/29/2022|||ANTIFUNGALS: TOPICAL|9560|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
nystatin|No|No|No|No|75%|42543035230|NYSTATIN 100,000 UNIT/GM POWD|30|GM|.55627|01/02/2019|03/31/2023|Yes|No||01/02/2019|03/31/2023|Yes|No|01/02/2019|03/31/2023|Yes|No||||No|No|||Prescription required|No||061|No|.30897|03/29/2022|.30155|03/29/2022|.30356|03/29/2022|||ANTIFUNGALS: TOPICAL|9561|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
nystatin|No|No|No|No|75%|42543035260|NYSTATIN 100,000 UNIT/GM POWD|60|GM|.49665|01/02/2019|03/31/2023|Yes|No||01/02/2019|03/31/2023|Yes|No|01/02/2019|03/31/2023|Yes|No||||No|No|||Prescription required|No||061|No|.2597|03/29/2022|.25346|03/29/2022|.25515|03/29/2022|||ANTIFUNGALS: TOPICAL|9562|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
potassium citrate|No|No|No|No|75%|42543040601|POTASSIUM CITRATE ER 5 MEQ TAB|100|EA|.43073|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No|||No|.46644|03/29/2022|.45524|03/29/2022|.45827|03/29/2022||||9563|||||No|No||STRIDES PHARMA|No||||
potassium citrate|No|No|No|No|75%|42543040701|POTASSIUM CITRATE ER 10 MEQ TB|100|EA|.6041|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No|||No|.30433|03/29/2022|.29702|03/29/2022|.299|03/29/2022||||9564|||||No|No||STRIDES PHARMA|No||||
potassium citrate|No|No|No|No|75%|42543040801|POTASSIUM CITRATE ER 15 MEQ TB|100|EA|.85226|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No|||No|.5925|03/29/2022|.57828|03/29/2022|.58213|03/29/2022||||9565|||||No|No||STRIDES PHARMA|No||||
carisoprodol|No|No|No|No|90%|42543043401|CARISOPRODOL 250 MG TABLET|100|EA|1.13722|03/30/2016|03/31/2023|Yes|No||03/30/2016|03/31/2023|Yes|No|03/30/2016|03/31/2023|Yes|No||||No|No|||Prescription required|Yes|01/28/2016|116|Yes|1.00427|03/29/2022|.98016|03/29/2022|.98669|03/29/2022|||SKELETAL MUSCLE RELAXANTS|9566|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
amantadine HCl|No|No|No|No|75%|42543049301|AMANTADINE 100 MG CAPSULE|100|EA|.34658|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|No||015|No|.2857|03/29/2022|.27884|03/29/2022|.2807|03/29/2022|||ANTIPARKINSON'S AGENTS|9567|||||No|No||STRIDES PHARMA|No||||
amantadine HCl|No|No|No|No|75%|42543049305|AMANTADINE 100 MG CAPSULE|500|EA|.34658|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|No||015|No|.2857|03/29/2022|.27884|03/29/2022|.2807|03/29/2022|||ANTIPARKINSON'S AGENTS|9568|||||No|No||STRIDES PHARMA|No||||
amantadine HCl|No|No|No|No|75%|42543049701|AMANTADINE 100 MG TABLET|100|EA|.68722|11/16/2017||Yes|No||11/16/2017||Yes|No|11/16/2017||Yes|No||||No|No|||Prescription required|No||015|No|.71929|03/29/2022|.70202|03/29/2022|.7067|03/29/2022|||ANTIPARKINSON'S AGENTS|9569|||||No|No||STRIDES PHARMA|No||||
amantadine HCl|No|No|No|No|75%|42543049705|AMANTADINE 100 MG TABLET|500|EA|.68724|11/16/2017||Yes|No||11/16/2017||Yes|No|11/16/2017||Yes|No||||No|No|||Prescription required|No||015|No|.71929|03/29/2022|.70202|03/29/2022|.7067|03/29/2022|||ANTIPARKINSON'S AGENTS|9570|||||No|No||STRIDES PHARMA|No||||
carisoprodol|No|No|No|No|90%|42543070001|CARISOPRODOL 350 MG TABLET|100|EA|.03435|02/04/2015|03/31/2023|Yes|No||02/04/2015|03/31/2023|Yes|No|02/04/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|9571|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
carisoprodol|No|No|No|No|90%|42543070005|CARISOPRODOL 350 MG TABLET|500|EA|.03298|02/04/2015|03/31/2023|Yes|No||02/04/2015|03/31/2023|Yes|No|02/04/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|9572|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
carisoprodol|No|No|No|No|90%|42543070010|CARISOPRODOL 350 MG TABLET|1000|EA|.03225|02/04/2015|03/31/2023|Yes|No||02/04/2015|03/31/2023|Yes|No|02/04/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|9573|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
donepezil HCl|No|No|No|No|75%|42543070210|DONEPEZIL HCL 5 MG TABLET|1000|EA|.0559|05/12/2015|03/31/2023|Yes|No||05/12/2015|03/31/2023|Yes|No|05/12/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|9574|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
donepezil HCl|No|No|No|No|75%|42543070230|DONEPEZIL HCL 5 MG TABLET|30|EA|.06306|05/12/2015|03/31/2023|Yes|No||05/12/2015|03/31/2023|Yes|No|05/12/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|9575|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
donepezil HCl|No|No|No|No|75%|42543070290|DONEPEZIL HCL 5 MG TABLET|90|EA|.06898|05/12/2015|03/31/2023|Yes|No||05/12/2015|03/31/2023|Yes|No|05/12/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|9576|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
donepezil HCl|No|No|No|No|75%|42543070310|DONEPEZIL HCL 10 MG TABLET|1000|EA|.0559|05/12/2015|03/31/2023|Yes|No||05/12/2015|03/31/2023|Yes|No|05/12/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|9577|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
donepezil HCl|No|No|No|No|75%|42543070330|DONEPEZIL HCL 10 MG TABLET|30|EA|.06306|05/12/2015|03/31/2023|Yes|No||05/12/2015|03/31/2023|Yes|No|05/12/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|9578|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
donepezil HCl|No|No|No|No|75%|42543070390|DONEPEZIL HCL 10 MG TABLET|90|EA|.06898|05/12/2015|03/31/2023|Yes|No||05/12/2015|03/31/2023|Yes|No|05/12/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|9579|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
pramipexole di-HCl|No|No|No|No|75%|42543070490|PRAMIPEXOLE 0.125 MG TABLET|90|EA|.07166|05/12/2015|03/31/2023|Yes|No||05/12/2015|03/31/2023|Yes|No|05/12/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||015|No|.05408|03/29/2022|.05278|03/29/2022|.05313|03/29/2022|||ANTIPARKINSON'S AGENTS|9580|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
pramipexole di-HCl|No|No|No|No|75%|42543070590|PRAMIPEXOLE 0.25 MG TABLET|90|EA|.07166|05/12/2015|03/31/2023|Yes|No||05/12/2015|03/31/2023|Yes|No|05/12/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||015|No|.05102|03/29/2022|.04979|03/29/2022|.05012|03/29/2022|||ANTIPARKINSON'S AGENTS|9581|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
pramipexole di-HCl|No|No|No|No|75%|42543070690|PRAMIPEXOLE 0.5 MG TABLET|90|EA|.07166|05/12/2015|03/31/2023|Yes|No||05/12/2015|03/31/2023|Yes|No|05/12/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||015|No|.05616|03/29/2022|.05481|03/29/2022|.05517|03/29/2022|||ANTIPARKINSON'S AGENTS|9582|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
pramipexole di-HCl|No|No|No|No|75%|42543070790|PRAMIPEXOLE 0.75 MG TABLET|90|EA|.07166|05/12/2015|03/31/2023|Yes|No||05/12/2015|03/31/2023|Yes|No|05/12/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||015|No|.07926|03/29/2022|.07735|03/29/2022|.07787|03/29/2022|||ANTIPARKINSON'S AGENTS|9583|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
pramipexole di-HCl|No|No|No|No|75%|42543070890|PRAMIPEXOLE 1 MG TABLET|90|EA|.07166|05/12/2015|03/31/2023|Yes|No||05/12/2015|03/31/2023|Yes|No|05/12/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||015|No|.06615|03/29/2022|.06456|03/29/2022|.06499|03/29/2022|||ANTIPARKINSON'S AGENTS|9584|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
pramipexole di-HCl|No|No|No|No|75%|42543070990|PRAMIPEXOLE 1.5 MG TABLET|90|EA|.07166|05/12/2015|03/31/2023|Yes|No||05/12/2015|03/31/2023|Yes|No|05/12/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||015|No|.07545|03/29/2022|.07363|03/29/2022|.07412|03/29/2022|||ANTIPARKINSON'S AGENTS|9585|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
levocetirizine dihydrochloride|No|No|No|No|75%|42543071290|LEVOCETIRIZINE 5 MG TABLET|90|EA|.24481|02/04/2015|03/31/2023|Yes|No||02/04/2015|03/31/2023|Yes|No|02/04/2015|03/31/2023|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|030|Yes|.08234|03/29/2022|.08036|03/29/2022|.08089|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|9586|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
clopidogrel bisulfate|No|No|No|No|75%|42543071305|CLOPIDOGREL 75 MG TABLET|500|EA|.07163|05/12/2015|03/31/2023|Yes|No||05/12/2015|03/31/2023|Yes|No|05/12/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|9587|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
clopidogrel bisulfate|No|No|No|No|75%|42543071310|CLOPIDOGREL 75 MG TABLET|1000|EA|.11763|05/12/2015|03/31/2023|Yes|No||05/12/2015|03/31/2023|Yes|No|05/12/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|9588|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
clopidogrel bisulfate|No|No|No|No|75%|42543071330|CLOPIDOGREL 75 MG TABLET|30|EA|.07166|05/12/2015|03/31/2023|Yes|No||05/12/2015|03/31/2023|Yes|No|05/12/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|9589|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
clopidogrel bisulfate|No|No|No|No|75%|42543071390|CLOPIDOGREL 75 MG TABLET|90|EA|.07166|05/12/2015|03/31/2023|Yes|No||05/12/2015|03/31/2023|Yes|No|05/12/2015|03/31/2023|Yes|No||||No|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|9590|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
emtricitabine/tenofovir (TDF)|No|No|No|No|75%|42543071904|EMTRICITABINE-TENOFV 200-300MG|30|EA|29.10799|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.70347|03/29/2022|.68658|03/29/2022|.69115|03/29/2022|||HIV / AIDS|9591|||||No|No||STRIDES PHARMA|No||||
fluoxetine HCl|Yes|No|No|No|75%|42543072501|FLUOXETINE HCL 10 MG CAPSULE|100|EA|.02356|11/05/2015|03/31/2023|Yes|No||11/05/2015|03/31/2023|Yes|No|11/05/2015|03/31/2023|Yes|No||||No|No|07/01/2016|03/31/2023|Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|9592|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
fluoxetine HCl|Yes|No|No|No|75%|42543072510|FLUOXETINE HCL 10 MG CAPSULE|1000|EA|.02238|11/05/2015|03/31/2023|Yes|No||11/05/2015|03/31/2023|Yes|No|11/05/2015|03/31/2023|Yes|No||||No|No|07/01/2016|03/31/2023|Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|9593|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
fluoxetine HCl|Yes|No|No|No|75%|42543072601|FLUOXETINE HCL 20 MG CAPSULE|100|EA|.02472|11/05/2015|03/31/2023|Yes|No||11/05/2015|03/31/2023|Yes|No|11/05/2015|03/31/2023|Yes|No||||No|No|07/01/2016|03/31/2023|Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|9594|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
fluoxetine HCl|Yes|No|No|No|75%|42543072610|FLUOXETINE HCL 20 MG CAPSULE|1000|EA|.02347|11/05/2015|03/31/2023|Yes|No||11/05/2015|03/31/2023|Yes|No|11/05/2015|03/31/2023|Yes|No||||No|No|07/01/2016|03/31/2023|Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|9595|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
fluoxetine HCl|Yes|No|No|No|75%|42543072701|FLUOXETINE HCL 40 MG CAPSULE|100|EA|.33325|11/05/2015|03/31/2023|Yes|No||11/05/2015|03/31/2023|Yes|No|11/05/2015|03/31/2023|Yes|No||||No|No|07/01/2016|03/31/2023|Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|9596|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
fluoxetine HCl|Yes|No|No|No|75%|42543072705|FLUOXETINE HCL 40 MG CAPSULE|500|EA|.33484|11/05/2015|03/31/2023|Yes|No||11/05/2015|03/31/2023|Yes|No|11/05/2015|03/31/2023|Yes|No||||No|No|07/01/2016|03/31/2023|Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|9597|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
fluoxetine HCl|Yes|No|No|No|75%|42543072730|FLUOXETINE HCL 40 MG CAPSULE|30|EA|.33325|11/05/2015|03/31/2023|Yes|No||11/05/2015|03/31/2023|Yes|No|11/05/2015|03/31/2023|Yes|No||||No|No|07/01/2016|03/31/2023|Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|9598|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||VENSUN/STRIDES|No||||
buspirone HCl|No|No|No|No|75%|42543074107|BUSPIRONE HCL 5 MG TABLET|500|EA|.02086|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|9599|||||No|No||STRIDES PHARMA|No||||
buspirone HCl|No|No|No|No|75%|42543074207|BUSPIRONE HCL 10 MG TABLET|500|EA|.03639|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|9600|||||No|No||STRIDES PHARMA|No||||
buspirone HCl|No|No|No|No|75%|42543074403|BUSPIRONE HCL 30 MG TABLET|60|EA|.46583|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||090|No|.17728|03/29/2022|.17302|03/29/2022|.17417|03/29/2022|||ANXIOLYTICS|9601|||||No|No||STRIDES PHARMA|No||||
buspirone HCl|No|No|No|No|75%|42543078706|BUSPIRONE HCL 7.5 MG TABLET|100|EA|.19543|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||090|No|.22186|03/29/2022|.21653|03/29/2022|.21797|03/29/2022|||ANXIOLYTICS|9602|||||No|No||STRIDES PHARMA|No||||
efavirenz|No|No|No|No|75%|42543088904|EFAVIRENZ 600 MG TABLET|30|EA|17.88639|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|5.43893|08/24/2021|5.30839|08/24/2021|5.34374|08/24/2021|||HIV / AIDS|9603|||||No|No||STRIDES PHARMA|No||||
cinacalcet HCl|No|No|No|No|75%|42543096104|CINACALCET HCL 30 MG TABLET|30|EA|9.82836|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No|||No|.75588|03/29/2022|.73773|03/29/2022|.74265|03/29/2022||||9604|||||No|No||STRIDES PHARMA|No||||
cinacalcet HCl|No|No|No|No|75%|42543096204|CINACALCET HCL 60 MG TABLET|30|EA|19.65659|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No|||No|1.7407|03/29/2022|1.69892|03/29/2022|1.71023|03/29/2022||||9605|||||No|No||STRIDES PHARMA|No||||
cinacalcet HCl|No|No|No|No|75%|42543096304|CINACALCET HCL 90 MG TABLET|30|EA|29.48495|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No|||No|3.64673|03/29/2022|3.5592|03/29/2022|3.58291|03/29/2022||||9606|||||No|No||STRIDES PHARMA|No||||
ibuprofen|No|No|No|No|75%|42543096407|IBUPROFEN 800 MG TABLET|500|EA|.07069|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No||059|Yes|.07481|03/29/2022|.07301|03/29/2022|.0735|03/29/2022|||NSAIDS|9607|||||No|No||STRIDES PHARMA|No||||
ibuprofen|No|No|No|No|75%|42543096507|IBUPROFEN 600 MG TABLET|500|EA|.05443|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No||059|Yes|.06063|03/29/2022|.05917|03/29/2022|.05956|03/29/2022|||NSAIDS|9608|||||No|No||STRIDES PHARMA|No||||
ibuprofen|No|No|No|No|75%|42543096607|IBUPROFEN 400 MG TABLET|500|EA|.03758|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No||059|Yes|.04934|03/29/2022|.04815|03/29/2022|.04847|03/29/2022|||NSAIDS|9609|||||No|No||STRIDES PHARMA|No||||
glimepiride|Yes|No|No|No|75%|42571010001|GLIMEPIRIDE 1 MG TABLET|100|EA|.03728|01/30/2020||Yes|No||01/30/2020||Yes|No|01/30/2020||Yes|No||||No|No|03/20/2020||Prescription required|No|||No|.03361|03/29/2022|.0328|03/29/2022|.03302|03/29/2022||||9610|||||No|No||MICRO LABS USA,|No||||
glimepiride|Yes|No|No|No|75%|42571010101|GLIMEPIRIDE 2 MG TABLET|100|EA|.05968|01/30/2020||Yes|No||01/30/2020||Yes|No|01/30/2020||Yes|No||||No|No|03/20/2020||Prescription required|No|||No|.03979|03/29/2022|.03883|03/29/2022|.03909|03/29/2022||||9611|||||No|No||MICRO LABS USA,|No||||
glimepiride|Yes|No|No|No|75%|42571010301|GLIMEPIRIDE 4 MG TABLET|100|EA|.0958|01/30/2020||Yes|No||01/30/2020||Yes|No|01/30/2020||Yes|No||||No|No|03/20/2020||Prescription required|No|||No|.04419|03/29/2022|.04312|03/29/2022|.04341|03/29/2022||||9612|||||No|No||MICRO LABS USA,|No||||
losartan potassium|No|No|No|No|75%|42571011010|LOSARTAN POTASSIUM 25 MG TAB|1000|EA|.02866|05/12/2017||Yes|No||05/12/2017||Yes|No|05/12/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|9613|||||No|No||MICRO LABS USA,|No||||
losartan potassium|No|No|No|No|75%|42571011110|LOSARTAN POTASSIUM 50 MG TAB|1000|EA|.03344|05/12/2017||Yes|No||05/12/2017||Yes|No|05/12/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|9614|||||No|No||MICRO LABS USA,|No||||
losartan potassium|No|No|No|No|75%|42571011210|LOSARTAN POTASSIUM 100 MG TAB|1000|EA|.043|05/12/2017||Yes|No||05/12/2017||Yes|No|05/12/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|9615|||||No|No||MICRO LABS USA,|No||||
tramadol HCl/acetaminophen|No|No|No|No|90%|42571011901|TRAMADOL-ACETAMINOPHN 37.5-325|100|EA|.129|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.11806|03/29/2022|.11522|03/29/2022|.11599|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9616|||||No|No||MICRO LABS USA,|No||||
tramadol HCl/acetaminophen|No|No|No|No|90%|42571011905|TRAMADOL-ACETAMINOPHN 37.5-325|500|EA|.129|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.11806|03/29/2022|.11522|03/29/2022|.11599|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9617|||||No|No||MICRO LABS USA,|No||||
levocetirizine dihydrochloride|No|No|No|No|75%|42571012290|LEVOCETIRIZINE 5 MG TABLET|90|EA|.14333|12/20/2018||Yes|No||12/20/2018||Yes|No|12/20/2018||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|030|Yes|.08234|03/29/2022|.08036|03/29/2022|.08089|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|9618|||||No|No||MICRO LABS USA,|No||||
travoprost|No|No|No|No|75%|42571013021|TRAVOPROST 0.004% EYE DROP|5|ML|23.71278|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|088|No|32.8|03/29/2022|32.0128|03/29/2022|32.226|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|9619|||||No|No||MICRO LABS USA,|No||||
travoprost|No|No|No|No|75%|42571013027|TRAVOPROST 0.004% EYE DROP|2.5|ML|23.71364|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|088|No|36.32982|03/29/2022|35.4579|03/29/2022|35.69404|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|9620|||||No|No||MICRO LABS USA,|No||||
cromolyn sodium|No|No|No|No|75%|42571013252|CROMOLYN 100 MG/5 ML ORAL CONC|5|ML|.35833|06/05/2017||Yes|No||06/05/2017||Yes|No|06/05/2017||Yes|No||||No|No|||Prescription required|No|||No|.44235|03/29/2022|.43173|03/29/2022|.4346|03/29/2022||||9621|||||No|No||MICRO LABS USA,|No||||
dorzolamide HCl|No|No|No|No|75%|42571014126|DORZOLAMIDE HCL 2% EYE DROPS|10|ML|1.46157|08/04/2020||Yes|No||08/04/2020||Yes|No|08/04/2020||Yes|No||||No|No|||Prescription required|No||088|No|1.39302|03/29/2022|1.35958|03/29/2022|1.36864|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|9622|||||No|No||MICRO LABS USA,|No||||
celecoxib|No|No|No|No|75%|42571014260|CELECOXIB 50 MG CAPSULE|60|EA|.11466|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.1386|03/29/2022|.13527|03/29/2022|.13617|03/29/2022|||NSAIDS|9623|||||No|No||MICRO LABS USA,|No||||
celecoxib|No|No|No|No|75%|42571014301|CELECOXIB 100 MG CAPSULE|100|EA|.129|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|9624|||||No|No||MICRO LABS USA,|No||||
celecoxib|No|No|No|No|75%|42571014305|CELECOXIB 100 MG CAPSULE|500|EA|.129|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|9625|||||No|No||MICRO LABS USA,|No||||
celecoxib|No|No|No|No|75%|42571014401|CELECOXIB 200 MG CAPSULE|100|EA|.215|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|9626|||||No|No||MICRO LABS USA,|No||||
celecoxib|No|No|No|No|75%|42571014405|CELECOXIB 200 MG CAPSULE|500|EA|.215|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|9627|||||No|No||MICRO LABS USA,|No||||
celecoxib|No|No|No|No|75%|42571014560|CELECOXIB 400 MG CAPSULE|60|EA|.50166|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.73632|03/29/2022|.71864|03/29/2022|.72343|03/29/2022|||NSAIDS|9628|||||No|No||MICRO LABS USA,|No||||
dorzolamide HCl/timolol maleat|No|No|No|No|75%|42571014726|DORZOLAMIDE-TIMOLOL EYE DROPS|10|ML|2.15|11/04/2020||Yes|No||11/04/2020||Yes|No|11/04/2020||Yes|No||||No|No|||Prescription required|No||088|No|1.24117|03/29/2022|1.21138|03/29/2022|1.21944|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|9629|||||No|No||MICRO LABS USA,|No||||
amoxicillin/potassium clav|No|No|No|No|75%|42571016030|AMOX-CLAV 250-125 MG TABLET|30|EA|.93166|03/21/2018||Yes|No||03/21/2018||Yes|No|03/21/2018||Yes|No||||No|No|||Prescription required|No||046|No|2.34666|03/29/2022|2.29034|03/29/2022|2.30559|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|9630|||||No|No||MICRO LABS USA,|No||||
amoxicillin/potassium clav|No|No|No|No|75%|42571016101|AMOX-CLAV 500-125 MG TABLET|100|EA|.215|03/21/2018||Yes|No||03/21/2018||Yes|No|03/21/2018||Yes|No||||No|No|||Prescription required|No||046|No|.31268|03/29/2022|.30517|03/29/2022|.3072|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|9631|||||No|No||MICRO LABS USA,|No||||
amoxicillin/potassium clav|No|No|No|No|75%|42571016142|AMOX-CLAV 500-125 MG TABLET|20|EA|.215|03/21/2018||Yes|No||03/21/2018||Yes|No|03/21/2018||Yes|No||||No|No|||Prescription required|No||046|No|.31268|03/29/2022|.30517|03/29/2022|.3072|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|9632|||||No|No||MICRO LABS USA,|No||||
amoxicillin/potassium clav|No|No|No|No|75%|42571016201|AMOX-CLAV 875-125 MG TABLET|100|EA|.258|06/29/2018||Yes|No||06/29/2018||Yes|No|06/29/2018||Yes|No||||No|No|||Prescription required|No||046|No|.32484|03/29/2022|.31704|03/29/2022|.31915|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|9633|||||No|No||MICRO LABS USA,|No||||
amoxicillin/potassium clav|No|No|No|No|75%|42571016242|AMOX-CLAV 875-125 MG TABLET|20|EA|.258|06/29/2018||Yes|No||06/29/2018||Yes|No|06/29/2018||Yes|No||||No|No|||Prescription required|No||046|No|.32484|03/29/2022|.31704|03/29/2022|.31915|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|9634|||||No|No||MICRO LABS USA,|No||||
atorvastatin calcium|No|No|No|No|75%|42571017210|ATORVASTATIN 10 MG TABLET|1000|EA|.08524|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|9635|||||No|No||MICRO LABS USA,|No||||
atorvastatin calcium|No|No|No|No|75%|42571017290|ATORVASTATIN 10 MG TABLET|90|EA|.08523|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|9636|||||No|No||MICRO LABS USA,|No||||
atorvastatin calcium|No|No|No|No|75%|42571017310|ATORVASTATIN 20 MG TABLET|1000|EA|.11692|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|9637|||||No|No||MICRO LABS USA,|No||||
atorvastatin calcium|No|No|No|No|75%|42571017390|ATORVASTATIN 20 MG TABLET|90|EA|.1169|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|9638|||||No|No||MICRO LABS USA,|No||||
atorvastatin calcium|No|No|No|No|75%|42571017410|ATORVASTATIN 40 MG TABLET|1000|EA|.12659|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|9639|||||No|No||MICRO LABS USA,|No||||
atorvastatin calcium|No|No|No|No|75%|42571017490|ATORVASTATIN 40 MG TABLET|90|EA|.1266|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|9640|||||No|No||MICRO LABS USA,|No||||
atorvastatin calcium|No|No|No|No|75%|42571017510|ATORVASTATIN 80 MG TABLET|1000|EA|.12961|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|9641|||||No|No||MICRO LABS USA,|No||||
atorvastatin calcium|No|No|No|No|75%|42571017590|ATORVASTATIN 80 MG TABLET|90|EA|.12961|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|9642|||||No|No||MICRO LABS USA,|No||||
piroxicam|No|No|No|No|75%|42571017601|PIROXICAM 10 MG CAPSULE|100|EA|.301|09/06/2018||Yes|No||09/06/2018||Yes|No|09/06/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.25876|03/01/2022|.25254|03/01/2022|.25423|03/01/2022|||NSAIDS|9643|||||No|No||MICRO LABS USA,|No||||
piroxicam|No|No|No|No|75%|42571017701|PIROXICAM 20 MG CAPSULE|100|EA|.516|09/06/2018||Yes|No||09/06/2018||Yes|No|09/06/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.40758|03/29/2022|.39779|03/29/2022|.40044|03/29/2022|||NSAIDS|9644|||||No|No||MICRO LABS USA,|No||||
rasagiline mesylate|No|No|No|No|75%|42571022030|RASAGILINE MESYLATE 0.5 MG TAB|30|EA|3.42265|01/30/2020||Yes|No||01/30/2020||Yes|No|01/30/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|015|No|4.5286|03/29/2022|4.41991|03/29/2022|4.44934|03/29/2022|||ANTIPARKINSON'S AGENTS|9645|||||No|No||MICRO LABS USA,|No||||
rasagiline mesylate|No|No|No|No|75%|42571022130|RASAGILINE MESYLATE 1 MG TAB|30|EA|3.42265|01/30/2020||Yes|No||01/30/2020||Yes|No|01/30/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|015|No|1.78642|03/29/2022|1.74354|03/29/2022|1.75515|03/29/2022|||ANTIPARKINSON'S AGENTS|9646|||||No|No||MICRO LABS USA,|No||||
telmisartan|No|No|No|No|75%|42571022630|TELMISARTAN 20 MG TABLET|30|EA|.35976|10/23/2020||Yes|No||10/23/2020||Yes|No|10/23/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.30407|03/29/2022|.29677|03/29/2022|.29874|03/29/2022|||ANGIOTENSIN MODULATORS|9647|||||No|No||MICRO LABS USA,|No||||
telmisartan|No|No|No|No|75%|42571022730|TELMISARTAN 40 MG TABLET|30|EA|.35976|10/23/2020||Yes|No||10/23/2020||Yes|No|10/23/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.35861|03/29/2022|.35|03/29/2022|.35233|03/29/2022|||ANGIOTENSIN MODULATORS|9648|||||No|No||MICRO LABS USA,|No||||
telmisartan|No|No|No|No|75%|42571022830|TELMISARTAN 80 MG TABLET|30|EA|.35976|10/23/2020||Yes|No||10/23/2020||Yes|No|10/23/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.33958|03/29/2022|.33143|03/29/2022|.33363|03/29/2022|||ANGIOTENSIN MODULATORS|9649|||||No|No||MICRO LABS USA,|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|42571023530|AMLODIPINE-OLMESARTAN 5-20 MG|30|EA|.35833|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|017|Yes|.41945|03/29/2022|.40938|03/29/2022|.4121|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|9650|||||No|No||MICRO LABS USA,|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|42571023590|AMLODIPINE-OLMESARTAN 5-20 MG|90|EA|.35833|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|017|Yes|.41945|03/29/2022|.40938|03/29/2022|.4121|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|9651|||||No|No||MICRO LABS USA,|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|42571023630|AMLODIPINE-OLMESARTAN 10-20 MG|30|EA|.35833|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|017|Yes|.43528|03/29/2022|.42483|03/29/2022|.42766|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|9652|||||No|No||MICRO LABS USA,|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|42571023690|AMLODIPINE-OLMESARTAN 10-20 MG|90|EA|.35833|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|017|Yes|.43528|03/29/2022|.42483|03/29/2022|.42766|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|9653|||||No|No||MICRO LABS USA,|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|42571023730|AMLODIPINE-OLMESARTAN 5-40 MG|30|EA|.4085|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|017|Yes|.47518|03/29/2022|.46377|03/29/2022|.46686|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|9654|||||No|No||MICRO LABS USA,|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|42571023790|AMLODIPINE-OLMESARTAN 5-40 MG|90|EA|.40371|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|017|Yes|.47518|03/29/2022|.46377|03/29/2022|.46686|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|9655|||||No|No||MICRO LABS USA,|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|42571023830|AMLODIPINE-OLMESARTAN 10-40 MG|30|EA|.4085|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|017|Yes|.41757|03/29/2022|.40754|03/29/2022|.41026|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|9656|||||No|No||MICRO LABS USA,|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|42571023890|AMLODIPINE-OLMESARTAN 10-40 MG|90|EA|.40371|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|017|Yes|.41757|03/29/2022|.40754|03/29/2022|.41026|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|9657|||||No|No||MICRO LABS USA,|No||||
acetazolamide|No|No|No|No|75%|42571024301|ACETAZOLAMIDE ER 500 MG CAP|100|EA|.3225|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.39876|03/29/2022|.38918|03/29/2022|.39178|03/29/2022||||9658|||||No|No||MICRO LABS USA,|No||||
caffeine citrate|No|No|No|No|75%|42571024469|CAFFEINE CIT 60 MG/3 ML VIAL|3|ML|2.43666|07/09/2018||Yes|No||07/09/2018||Yes|No|07/09/2018||Yes|No||||No|No|||Prescription required|No|||No|5.55332|07/09/2018|5.47399|07/09/2018|5.21332|07/09/2018||||9659|||||No|No||MICRO LABS USA,|No||||
clindamycin HCl|No|No|No|No|75%|42571025001|CLINDAMYCIN HCL 75 MG CAPSULE|100|EA|.21478|08/03/2020||Yes|No||08/03/2020||Yes|No|08/03/2020||Yes|No||08/03/2020||Yes|No|||Prescription required|No||146|No|.48951|08/03/2020|.48251|08/03/2020|.45954|08/03/2020|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|9660|||||No|No||MICRO LABS USA,|No||||
clindamycin HCl|No|No|No|No|75%|42571025101|CLINDAMYCIN HCL 150 MG CAPSULE|100|EA|.0617|08/03/2020||Yes|No||08/03/2020||Yes|No|08/03/2020||Yes|No||08/03/2020||Yes|No|||Prescription required|No||146|No|.12382|03/29/2022|.12084|03/29/2022|.12165|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|9661|||||No|No||MICRO LABS USA,|No||||
clindamycin HCl|No|No|No|No|75%|42571025201|CLINDAMYCIN HCL 300 MG CAPSULE|100|EA|.1849|08/03/2020||Yes|No||08/03/2020||Yes|No|08/03/2020||Yes|No||08/03/2020||Yes|No|||Prescription required|No||146|No|.25846|03/29/2022|.25225|03/29/2022|.25393|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|9662|||||No|No||MICRO LABS USA,|No||||
mefenamic acid|No|No|No|No|75%|42571025830|MEFENAMIC ACID 250 MG CAPSULE|30|EA|1.43333|05/12/2017||Yes|No||05/12/2017||Yes|No|05/12/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|2.22679|03/29/2022|2.17334|03/29/2022|2.18782|03/29/2022|||NSAIDS|9663|||||No|No||MICRO LABS USA,|No||||
dalfampridine|No|No|No|No|75%|42571027560|DALFAMPRIDINE ER 10 MG TABLET|60|EA|1.07678|08/03/2020||Yes|No||08/03/2020||Yes|No|08/03/2020||Yes|No||||No|No|||Prescription required|No||043|No|.82047|03/29/2022|.80077|03/29/2022|.80611|03/29/2022|||MULTIPLE SCLEROSIS AGENTS|9664|||||No|No||MICRO LABS USA,|No||||
clobazam|No|No|No|No|90%|42571031501|CLOBAZAM 10 MG TABLET|100|EA|.6235|08/03/2020||Yes|No||08/03/2020||Yes|No|08/03/2020||Yes|No||||No|No|||Prescription required|No||056|No|.37729|03/29/2022|.36823|03/29/2022|.37068|03/29/2022|||ANTICONVULSANTS|9665|||||No|No||MICRO LABS USA,|No||||
clobazam|No|No|No|No|90%|42571031601|CLOBAZAM 20 MG TABLET|100|EA|1.247|08/03/2020||Yes|No||08/03/2020||Yes|No|08/03/2020||Yes|No||||No|No|||Prescription required|No||056|No|.71967|03/29/2022|.70239|03/29/2022|.70707|03/29/2022|||ANTICONVULSANTS|9666|||||No|No||MICRO LABS USA,|No||||
methenamine hippurate|No|No|No|No|75%|42571033201|METHENAMINE HIPP 1 GM TABLET|100|EA|.74927|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No||||No|No|||Prescription required|No|||No|.83638|03/29/2022|.8163|03/29/2022|.82174|03/29/2022||||9667|||||No|No||MICRO LABS USA,|No||||
clomipramine HCl|No|No|No|No|75%|42571034201|CLOMIPRAMINE 25 MG CAPSULE|100|EA|1.9436|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|215|No|1.31238|03/29/2022|1.28088|03/29/2022|1.28941|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|9668|||||No|No||MICRO LABS USA,|No||||
clomipramine HCl|No|No|No|No|75%|42571034230|CLOMIPRAMINE 25 MG CAPSULE|30|EA|2.07833|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|215|No|1.31238|03/29/2022|1.28088|03/29/2022|1.28941|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|9669|||||No|No||MICRO LABS USA,|No||||
clomipramine HCl|No|No|No|No|75%|42571034301|CLOMIPRAMINE 50 MG CAPSULE|100|EA|1.9436|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|215|No|.80238|03/29/2022|.78312|03/29/2022|.78833|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|9670|||||No|No||MICRO LABS USA,|No||||
clomipramine HCl|No|No|No|No|75%|42571034330|CLOMIPRAMINE 50 MG CAPSULE|30|EA|2.07833|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|215|No|.80238|03/29/2022|.78312|03/29/2022|.78833|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|9671|||||No|No||MICRO LABS USA,|No||||
clomipramine HCl|No|No|No|No|75%|42571034401|CLOMIPRAMINE 75 MG CAPSULE|100|EA|1.9436|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|215|No|.95054|03/29/2022|.92772|03/29/2022|.9339|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|9672|||||No|No||MICRO LABS USA,|No||||
clomipramine HCl|No|No|No|No|75%|42571034430|CLOMIPRAMINE 75 MG CAPSULE|30|EA|2.07833|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|215|No|.95054|03/29/2022|.92772|03/29/2022|.9339|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|9673|||||No|No||MICRO LABS USA,|No||||
metformin HCl|No|No|No|No|75%|42571036007|METFORMIN HCL 500 MG/5 ML SOLN|473|ML|.4233|09/15/2020||Yes|No||09/15/2020||Yes|No|09/15/2020||Yes|No||||No|No|||Prescription required|Yes|04/26/2020|012|No|.91775|11/23/2021|.89572|11/23/2021|.90168|11/23/2021|||HYPOGLYCEMICS: METFORMINS|9674|||||No|No||MICRO LABS USA,|No||||
metformin HCl|No|No|No|No|75%|42571036010|METFORMIN HCL 500 MG/5 ML SOLN|118|ML|.42314|09/15/2020||Yes|No||09/15/2020||Yes|No|09/15/2020||Yes|No||||No|No|||Prescription required|Yes|04/26/2020|012|No|.96437|09/15/2020|.9506|09/15/2020|.90533|09/15/2020|||HYPOGLYCEMICS: METFORMINS|9675|||||No|No||MICRO LABS USA,|No||||
clobetasol propionate|No|No|No|No|75%|42571036281|CLOBETASOL 0.05% SOLUTION|25|ML|.688|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||121|No|.44026|03/29/2022|.42969|03/29/2022|.43255|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|9676|||||No|No||MICRO LABS USA,|No||||
clobetasol propionate|No|No|No|No|75%|42571036299|CLOBETASOL 0.05% SOLUTION|50|ML|.688|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||121|No|.35501|03/29/2022|.34648|03/29/2022|.34879|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|9677|||||No|No||MICRO LABS USA,|No||||
testosterone|No|No|No|No|90%|42667551101|NATESTO NASAL 5.5 MG/0.122 GM|7.32|GM|16.96678|04/16/2021||Yes|No||04/16/2021||Yes|No|04/16/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|084|No|38.66849|04/16/2021|38.11608|04/16/2021|36.30103|04/16/2021|||ANDROGENIC AGENTS|9678|||||No|No||ACERUS PHARMA|No||||
toremifene citrate|No|No|No|No|75%|42747032730|FARESTON 60 MG TABLET|30|EA|18.63261|03/30/2015||Yes|No||03/30/2015||Yes|No|||No|No||||No|No|||Prescription required|No||502|No|42.46502|02/26/2019|41.85838|02/26/2019|39.86512|02/26/2019|||ONCOLOGY: ORAL - BREAST|9679|||||No|No||KYOWA KIRIN, IN|No||||
granisetron|No|No|No|No|75%|42747072601|SANCUSO 3.1 MG/24 HR PATCH|1|EA|260.5155|04/19/2009||Yes|No||04/19/2009||Yes|No|04/19/2009||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|085|Yes|593.733|03/29/2022|585.2511|03/29/2022|557.382|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|9680|||||No|No||KYOWA/CUMBERLAN|No||||
adefovir dipivoxil|No|No|No|No|75%|42794000308|ADEFOVIR DIPIVOXIL 10 MG TAB|30|EA|12.82833|09/03/2013||Yes|No||09/03/2013||Yes|No|09/03/2013||Yes|No||||No|No|||Prescription required|No|||No|29.23666|11/26/2019|28.81899|11/26/2019|27.44666|11/26/2019||||9681|||||No|No||SIGMAPHARM LABO|No||||
protriptyline HCl|No|No|No|No|75%|42794000402|PROTRIPTYLINE HCL 5 MG TABLET|100|EA|2.15|10/12/2020||Yes|No||10/12/2020||Yes|No|10/12/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|215|No|4.9|03/01/2022|4.83|03/01/2022|4.6|03/01/2022|||ANTIDEPRESSANTS: TRICYCLIC|9682|||||No|No||SIGMAPHARM LABO|No||||
protriptyline HCl|No|No|No|No|75%|42794000702|PROTRIPTYLINE HCL 10 MG TABLET|100|EA|2.15|10/12/2020||Yes|No||10/12/2020||Yes|No|10/12/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|215|No|3.06317|01/25/2022|2.98965|01/25/2022|3.00956|01/25/2022|||ANTIDEPRESSANTS: TRICYCLIC|9683|||||No|No||SIGMAPHARM LABO|No||||
flucytosine|No|No|No|No|75%|42794000908|FLUCYTOSINE 250 MG CAPSULE|30|EA|12.9|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|069|No|29.4|08/29/2018|28.98|08/29/2018|27.6|08/29/2018|||ANTIFUNGALS: ORAL|9684|||||No|No||SIGMAPHARM LABO|No||||
flucytosine|No|No|No|No|75%|42794001008|FLUCYTOSINE 500 MG CAPSULE|30|EA|24.36666|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|069|No|55.53332|08/29/2018|54.73999|08/29/2018|52.13332|08/29/2018|||ANTIFUNGALS: ORAL|9685|||||No|No||SIGMAPHARM LABO|No||||
griseofulvin, microsize|No|No|No|No|75%|42794001208|GRISEOFULVIN MICRO 500 MG TAB|30|EA|3.58333|10/12/2020||Yes|No||10/12/2020||Yes|No|10/12/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|069|No|7.20637|12/28/2021|7.03341|12/28/2021|7.08025|12/28/2021|||ANTIFUNGALS: ORAL|9686|||||No|No||SIGMAPHARM LABO|No||||
liothyronine sodium|No|No|No|No|75%|42794001802|LIOTHYRONINE SOD 5 MCG TAB|100|EA|.27249|12/10/2012||Yes|No||12/10/2012||Yes|No|12/10/2012||Yes|No||||No|No|||Prescription required|No|||No|.37734|03/29/2022|.36828|03/29/2022|.37073|03/29/2022||||9687|||||No|No||SIGMAPHARM LABO|No||||
liothyronine sodium|No|No|No|No|75%|42794001806|LIOTHYRONINE SOD 5 MCG TAB|1000|EA|.25883|12/10/2012||Yes|No||12/10/2012||Yes|No|12/10/2012||Yes|No||||No|No|||Prescription required|No|||No|.37734|03/29/2022|.36828|03/29/2022|.37073|03/29/2022||||9688|||||No|No||SIGMAPHARM LABO|No||||
liothyronine sodium|No|No|No|No|75%|42794001812|LIOTHYRONINE SOD 5 MCG TAB|90|EA|.2924|05/14/2018||Yes|No||05/14/2018||Yes|No|05/14/2018||Yes|No||||No|No|||Prescription required|No|||No|.37734|03/29/2022|.36828|03/29/2022|.37073|03/29/2022||||9689|||||No|No||SIGMAPHARM LABO|No||||
liothyronine sodium|No|No|No|No|75%|42794001902|LIOTHYRONINE SOD 25 MCG TAB|100|EA|.35801|12/10/2012||Yes|No||12/10/2012||Yes|No|12/10/2012||Yes|No||||No|No|||Prescription required|No|||No|.55764|03/29/2022|.54425|03/29/2022|.54788|03/29/2022||||9690|||||No|No||SIGMAPHARM LABO|No||||
liothyronine sodium|No|No|No|No|75%|42794001906|LIOTHYRONINE SOD 25 MCG TAB|1000|EA|.34007|12/10/2012||Yes|No||12/10/2012||Yes|No|12/10/2012||Yes|No||||No|No|||Prescription required|No|||No|.55764|03/29/2022|.54425|03/29/2022|.54788|03/29/2022||||9691|||||No|No||SIGMAPHARM LABO|No||||
liothyronine sodium|No|No|No|No|75%|42794001912|LIOTHYRONINE SOD 25 MCG TAB|90|EA|.3784|05/14/2018||Yes|No||05/14/2018||Yes|No|05/14/2018||Yes|No||||No|No|||Prescription required|No|||No|.55764|03/29/2022|.54425|03/29/2022|.54788|03/29/2022||||9692|||||No|No||SIGMAPHARM LABO|No||||
liothyronine sodium|No|No|No|No|75%|42794002002|LIOTHYRONINE SOD 50 MCG TAB|100|EA|.54691|12/10/2012||Yes|No||12/10/2012||Yes|No|12/10/2012||Yes|No||||No|No|||Prescription required|No|||No|.67729|01/25/2022|.66103|01/25/2022|.66543|01/25/2022||||9693|||||No|No||SIGMAPHARM LABO|No||||
liothyronine sodium|No|No|No|No|75%|42794002012|LIOTHYRONINE SOD 50 MCG TAB|90|EA|.5676|05/14/2018||Yes|No||05/14/2018||Yes|No|05/14/2018||Yes|No||||No|No|||Prescription required|No|||No|.67729|01/25/2022|.66103|01/25/2022|.66543|01/25/2022||||9694|||||No|No||SIGMAPHARM LABO|No||||
dofetilide|No|No|No|No|75%|42794004410|DOFETILIDE 125 MCG CAPSULE|60|EA|1.34375|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|No|||No|1.27252|03/29/2022|1.24197|03/29/2022|1.25025|03/29/2022||||9695|||||No|No||SIGMAPHARM LABO|No||||
dofetilide|No|No|No|No|75%|42794004510|DOFETILIDE 250 MCG CAPSULE|60|EA|1.34375|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|No|||No|.89477|03/29/2022|.87329|03/29/2022|.87911|03/29/2022||||9696|||||No|No||SIGMAPHARM LABO|No||||
dofetilide|No|No|No|No|75%|42794004610|DOFETILIDE 500 MCG CAPSULE|60|EA|1.34375|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|No|||No|.90796|03/29/2022|.88616|03/29/2022|.89207|03/29/2022||||9697|||||No|No||SIGMAPHARM LABO|No||||
ambrisentan|No|No|No|No|75%|42794005108|AMBRISENTAN 5 MG TABLET|30|EA|85.71333|10/12/2020||Yes|No||10/12/2020||Yes|No|10/12/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|No|195.34666|10/12/2020|192.55599|10/12/2020|183.38666|10/12/2020|||PAH AGENTS: ORAL AND INHALED|9698|||||No|No||SIGMAPHARM LABO|No||||
ambrisentan|No|No|No|No|75%|42794005208|AMBRISENTAN 10 MG TABLET|30|EA|85.71333|10/12/2020||Yes|No||10/12/2020||Yes|No|10/12/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|No|195.34666|10/12/2020|192.55599|10/12/2020|183.38666|10/12/2020|||PAH AGENTS: ORAL AND INHALED|9699|||||No|No||SIGMAPHARM LABO|No||||
acitretin|No|No|No|No|75%|42794008008|ACITRETIN 10 MG CAPSULE|30|EA|10.73337|08/12/2015||Yes|No||08/12/2015||Yes|No|08/12/2015||Yes|No||||No|No|||Prescription required|No|||No|7.81961|03/29/2022|7.63193|03/29/2022|7.68276|03/29/2022||||9700|||||No|No||SIGMAPHARM LABO|No||||
acitretin|No|No|No|No|75%|42794008108|ACITRETIN 17.5 MG CAPSULE|30|EA|13.22995|08/12/2015||Yes|No||08/12/2015||Yes|No|08/12/2015||Yes|No||||No|No|||Prescription required|No|||No|30.15198|06/01/2016|29.72124|06/01/2016|28.30594|06/01/2016||||9701|||||No|No||SIGMAPHARM LABO|No||||
acitretin|No|No|No|No|75%|42794008308|ACITRETIN 25 MG CAPSULE|30|EA|13.22995|08/12/2015||Yes|No||08/12/2015||Yes|No|08/12/2015||Yes|No||||No|No|||Prescription required|No|||No|10.86025|03/29/2022|10.5996|03/29/2022|10.67019|03/29/2022||||9702|||||No|No||SIGMAPHARM LABO|No||||
sodium phenylbutyrate|No|No|No|No|75%|42794008614|SODIUM PHENYLBUTYRATE POWDER|250|GM|7.73934|04/04/2013||Yes|No||04/04/2013||Yes|No|04/04/2013||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|570|No|17.63851|06/01/2016|17.38653|06/01/2016|16.5586|06/01/2016|||UREA CYCLE DISORDERS: ORAL|9703|||||No|No||SIGMAPHARM LABO|No||||
methenamine mandelate|No|No|No|No|75%|42799010501|METHENAMINE MAND 500 MG TABLET|100|EA|.31759|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|.72382|08/28/2018|.71348|08/28/2018|.67951|08/28/2018||||9704|||||No|No||EDENBRIDGE PHAR|No||||
methenamine mandelate|No|No|No|No|75%|42799010601|METHENAMINE MAND 1 GM TABLET|100|EA|.59696|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|1.74064|06/29/2021|1.69886|06/29/2021|1.71017|06/29/2021||||9705|||||No|No||EDENBRIDGE PHAR|No||||
albendazole|No|No|No|No|75%|42799011002|ALBENDAZOLE 200 MG TABLET|2|EA|41.63475|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|No|||No|16.91042|03/29/2022|16.50456|03/29/2022|16.61448|03/29/2022||||9706|||||No|No||EDENBRIDGE PHAR|No||||
etodolac|No|No|No|No|75%|42799011101|ETODOLAC 400 MG TABLET|100|EA|.22768|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.33513|03/29/2022|.32708|03/29/2022|.32926|03/29/2022|||NSAIDS|9707|||||No|No||EDENBRIDGE PHAR|No||||
etodolac|No|No|No|No|75%|42799011201|ETODOLAC 500 MG TABLET|100|EA|.24187|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.34546|03/29/2022|.33716|03/29/2022|.33941|03/29/2022|||NSAIDS|9708|||||No|No||EDENBRIDGE PHAR|No||||
bumetanide|No|No|No|No|75%|42799011901|BUMETANIDE 0.5 MG TABLET|100|EA|.1462|10/23/2015||Yes|No||10/23/2015||Yes|No|10/23/2015||Yes|No||||No|No|||Prescription required|No|||No|.20616|03/29/2022|.20121|03/29/2022|.20255|03/29/2022||||9709|||||No|No||EDENBRIDGE PHAR|No||||
bumetanide|No|No|No|No|75%|42799012001|BUMETANIDE 1 MG TABLET|100|EA|.1462|10/23/2015||Yes|No||10/23/2015||Yes|No|10/23/2015||Yes|No||||No|No|||Prescription required|No|||No|.21417|03/29/2022|.20902|03/29/2022|.21042|03/29/2022||||9710|||||No|No||EDENBRIDGE PHAR|No||||
bumetanide|No|No|No|No|75%|42799012002|BUMETANIDE 1 MG TABLET|500|EA|.1462|10/23/2015||Yes|No||10/23/2015||Yes|No|10/23/2015||Yes|No||||No|No|||Prescription required|No|||No|.21417|03/29/2022|.20902|03/29/2022|.21042|03/29/2022||||9711|||||No|No||EDENBRIDGE PHAR|No||||
bumetanide|No|No|No|No|75%|42799012101|BUMETANIDE 2 MG TABLET|100|EA|.2924|10/23/2015||Yes|No||10/23/2015||Yes|No|10/23/2015||Yes|No||||No|No|||Prescription required|No|||No|.40198|03/29/2022|.39233|03/29/2022|.39494|03/29/2022||||9712|||||No|No||EDENBRIDGE PHAR|No||||
bumetanide|No|No|No|No|75%|42799012102|BUMETANIDE 2 MG TABLET|500|EA|.2924|10/23/2015||Yes|No||10/23/2015||Yes|No|10/23/2015||Yes|No||||No|No|||Prescription required|No|||No|.40198|03/29/2022|.39233|03/29/2022|.39494|03/29/2022||||9713|||||No|No||EDENBRIDGE PHAR|No||||
carbidopa|No|No|No|No|75%|42799012301|CARBIDOPA 25 MG TABLET|100|EA|.62758|06/08/2016||Yes|No||06/08/2016||Yes|No|06/08/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|015|No|1.9005|03/29/2022|1.85488|03/29/2022|1.86724|03/29/2022|||ANTIPARKINSON'S AGENTS|9714|||||No|No||EDENBRIDGE PHAR|No||||
tinidazole|Yes|No|No|No|75%|42799020701|TINIDAZOLE 250 MG TABLET|40|EA|.59125|08/19/2015||Yes|No||08/19/2015||Yes|No|08/19/2015||Yes|No||||No|No|08/19/2015||Prescription required|No||115|No|1.3475|09/29/2020|1.32825|09/29/2020|1.265|09/29/2020|||ANTIBIOTICS: GI|9715|||||No|No||EDENBRIDGE PHAR|No||||
tinidazole|Yes|No|No|No|75%|42799020801|TINIDAZOLE 500 MG TABLET|20|EA|1.1825|08/19/2015||Yes|No||08/19/2015||Yes|No|08/19/2015||Yes|No||||No|No|08/19/2015||Prescription required|No||115|No|2.72139|03/29/2022|2.65607|03/29/2022|2.67376|03/29/2022|||ANTIBIOTICS: GI|9716|||||No|No||EDENBRIDGE PHAR|No||||
opium tincture|No|No|No|No|75%|42799021701|OPIUM TINCTURE 10 MG/ML|118|ML|2.25071|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||Yes|2.67802|03/29/2022|2.61374|03/29/2022|2.63115|03/29/2022||||9717|||||No|No||EDENBRIDGE PHAR|No||||
opium tincture|No|No|No|No|75%|42799021702|OPIUM TINCTURE 10 MG/ML|473|ML|2.24598|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||Yes|5.11874|06/01/2016|5.04562|06/01/2016|4.80535|06/01/2016||||9718|||||No|No||EDENBRIDGE PHAR|No||||
ethacrynic acid|No|No|No|No|75%|42799040501|ETHACRYNIC ACID 25 MG TABLET|100|EA|1.075|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No|||No|2.34378|03/01/2022|2.28752|03/01/2022|2.30276|03/01/2022||||9719|||||No|No||EDENBRIDGE PHAR|No||||
miglustat|No|No|No|No|75%|42799070815|MIGLUSTAT 100 MG CAPSULE|15|EA|115.19786|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|No|||No|262.54396|12/22/2020|258.79333|12/14/2020|246.46984|12/14/2020||||9720|||||No|No||EDENBRIDGE PHAR|No||||
ivermectin|No|No|No|No|75%|42799080601|IVERMECTIN 3 MG TABLET|20|EA|1.78041|03/06/2015||Yes|No||03/06/2015||Yes|No|03/06/2015||Yes|No||||No|No|||Prescription required|No|||No|3.80717|03/29/2022|3.71579|03/29/2022|3.74054|03/29/2022||||9721|||||No|No||EDENBRIDGE PHAR|No||||
prednisolone sodium phosphate|No|No|No|No|75%|42799081201|PREDNISOLONE 10 MG/5 ML SOLN|237|ML|1.37596|05/19/2017||Yes|No||05/19/2017||Yes|No|05/19/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|168|Yes|3.13591|05/19/2017|3.09111|05/19/2017|2.94391|05/19/2017|||GLUCOCORTICOIDS: ORAL|9722|||||No|No||EDENBRIDGE PHAR|No||||
prednisolone sodium phosphate|No|No|No|No|75%|42799081301|PREDNISOLONE 20 MG/5 ML SOLN|237|ML|1.95526|05/19/2017||Yes|No||05/19/2017||Yes|No|05/19/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|168|Yes|4.45618|05/19/2017|4.39252|05/19/2017|4.18335|05/19/2017|||GLUCOCORTICOIDS: ORAL|9723|||||No|No||EDENBRIDGE PHAR|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|42799092001|BISOPROLOL-HCTZ 2.5-6.25 MG TB|100|EA|.1827|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||070|Yes|.36234|03/29/2022|.35364|03/29/2022|.35599|03/29/2022|||BETA-BLOCKERS|9724|||||No|No||EDENBRIDGE PHAR|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|42799092002|BISOPROLOL-HCTZ 2.5-6.25 MG TB|500|EA|.12605|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||070|Yes|.36234|03/29/2022|.35364|03/29/2022|.35599|03/29/2022|||BETA-BLOCKERS|9725|||||No|No||EDENBRIDGE PHAR|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|42799092030|BISOPROLOL-HCTZ 2.5-6.25 MG TB|30|EA|.20797|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||070|Yes|.36234|03/29/2022|.35364|03/29/2022|.35599|03/29/2022|||BETA-BLOCKERS|9726|||||No|No||EDENBRIDGE PHAR|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|42799092101|BISOPROLOL-HCTZ 5-6.25 MG TAB|100|EA|.1827|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||070|Yes|.33991|03/29/2022|.33175|03/29/2022|.33396|03/29/2022|||BETA-BLOCKERS|9727|||||No|No||EDENBRIDGE PHAR|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|42799092102|BISOPROLOL-HCTZ 5-6.25 MG TAB|500|EA|.12605|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||070|Yes|.33991|03/29/2022|.33175|03/29/2022|.33396|03/29/2022|||BETA-BLOCKERS|9728|||||No|No||EDENBRIDGE PHAR|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|42799092130|BISOPROLOL-HCTZ 5-6.25 MG TAB|30|EA|.20797|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||070|Yes|.33991|03/29/2022|.33175|03/29/2022|.33396|03/29/2022|||BETA-BLOCKERS|9729|||||No|No||EDENBRIDGE PHAR|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|42799092201|BISOPROLOL-HCTZ 10-6.25 MG TAB|100|EA|.1827|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||070|Yes|.33843|03/29/2022|.3303|03/29/2022|.3325|03/29/2022|||BETA-BLOCKERS|9730|||||No|No||EDENBRIDGE PHAR|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|42799092202|BISOPROLOL-HCTZ 10-6.25 MG TAB|500|EA|.12605|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||070|Yes|.33843|03/29/2022|.3303|03/29/2022|.3325|03/29/2022|||BETA-BLOCKERS|9731|||||No|No||EDENBRIDGE PHAR|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|42799092230|BISOPROLOL-HCTZ 10-6.25 MG TAB|30|EA|.20797|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||070|Yes|.33843|03/29/2022|.3303|03/29/2022|.3325|03/29/2022|||BETA-BLOCKERS|9732|||||No|No||EDENBRIDGE PHAR|No||||
oxycodone HCl|No|No|No|No|90%|42806000501|OXYCODONE HCL (IR) 5 MG TABLET|100|EA|.07525|10/15/2020||Yes|No||10/15/2020||Yes|No|10/15/2020||Yes|No||||No|No|||Prescription required|No||109|Yes|.0685|03/29/2022|.06685|03/29/2022|.0673|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9733|||||No|No||EPIC PHARMA LLC|No||||
oxycodone HCl|No|No|No|No|90%|42806000601|OXYCODONE HCL (IR) 10 MG TAB|100|EA|.12212|10/15/2020||Yes|No||10/15/2020||Yes|No|10/15/2020||Yes|No||||No|No|||Prescription required|No||109|Yes|.12568|03/29/2022|.12266|03/29/2022|.12348|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9734|||||No|No||EPIC PHARMA LLC|No||||
oxycodone HCl|No|No|No|No|90%|42806000701|OXYCODONE HCL (IR) 15 MG TAB|100|EA|.20339|10/15/2020||Yes|No||10/15/2020||Yes|No|10/15/2020||Yes|No||||No|No|||Prescription required|No||109|Yes|.15895|03/29/2022|.15513|03/29/2022|.15616|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9735|||||No|No||EPIC PHARMA LLC|No||||
oxycodone HCl|No|No|No|No|90%|42806000801|OXYCODONE HCL (IR) 30 MG TAB|100|EA|.2107|10/15/2020||Yes|No||10/15/2020||Yes|No|10/15/2020||Yes|No||||No|No|||Prescription required|No||109|Yes|.2615|03/29/2022|.25522|03/29/2022|.25692|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9736|||||No|No||EPIC PHARMA LLC|No||||
oxycodone HCl|No|No|No|No|90%|42806000901|OXYCODONE HCL (IR) 20 MG TAB|100|EA|.16125|10/15/2020||Yes|No||10/15/2020||Yes|No|10/15/2020||Yes|No||||No|No|||Prescription required|No||109|Yes|.23193|03/29/2022|.22636|03/29/2022|.22787|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9737|||||No|No||EPIC PHARMA LLC|No||||
sulindac|No|No|No|No|75%|42806001101|SULINDAC 200 MG TABLET|100|EA|.13115|04/15/2010||Yes|No||04/15/2010||Yes|No|04/15/2010||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.24702|03/29/2022|.24109|03/29/2022|.24269|03/29/2022|||NSAIDS|9738|||||No|No||EPIC PHARMA LLC|No||||
sulindac|No|No|No|No|75%|42806001105|SULINDAC 200 MG TABLET|500|EA|.13351|04/15/2010||Yes|No||04/15/2010||Yes|No|04/15/2010||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.24702|03/29/2022|.24109|03/29/2022|.24269|03/29/2022|||NSAIDS|9739|||||No|No||EPIC PHARMA LLC|No||||
meclizine HCl|No|No|No|No|75%|42806001201|MECLIZINE 12.5 MG TABLET|100|EA|.11137|10/12/2020||Yes|No||10/12/2020||Yes|No|10/12/2020||Yes|No||||No|No|||Prescription required|No||085|Yes|.08309|03/29/2022|.08109|03/29/2022|.08163|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|9740|||||No|No||EPIC PHARMA LLC|No||||
meclizine HCl|No|No|No|No|75%|42806001210|MECLIZINE 12.5 MG TABLET|1000|EA|.11137|10/12/2020||Yes|No||10/12/2020||Yes|No|10/12/2020||Yes|No||||No|No|||Prescription required|No||085|Yes|.08309|03/29/2022|.08109|03/29/2022|.08163|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|9741|||||No|No||EPIC PHARMA LLC|No||||
sodium polystyrene sulfonate|No|No|No|No|75%|42806001396|SODIUM POLYSTYRENE SULF POWDER|453.6|GM|.12464|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.12498|03/29/2022|.12198|03/29/2022|.12279|03/29/2022||||9742|||||No|No||EPIC PHARMA LLC|No||||
meclizine HCl|No|No|No|No|75%|42806001401|MECLIZINE 25 MG TABLET|100|EA|.13738|10/12/2020||Yes|No||10/12/2020||Yes|No|10/12/2020||Yes|No||||No|No|||Prescription required|No||085|Yes|.11433|03/29/2022|.11158|03/29/2022|.11232|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|9743|||||No|No||EPIC PHARMA LLC|No||||
meclizine HCl|No|No|No|No|75%|42806001410|MECLIZINE 25 MG TABLET|1000|EA|.13738|10/12/2020||Yes|No||10/12/2020||Yes|No|10/12/2020||Yes|No||||No|No|||Prescription required|No||085|Yes|.11433|03/29/2022|.11158|03/29/2022|.11232|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|9744|||||No|No||EPIC PHARMA LLC|No||||
sulindac|No|No|No|No|75%|42806001801|SULINDAC 150 MG TABLET|100|EA|.09318|09/02/2010||Yes|No||09/02/2010||Yes|No|09/02/2010||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.17191|03/29/2022|.16778|03/29/2022|.1689|03/29/2022|||NSAIDS|9745|||||No|No||EPIC PHARMA LLC|No||||
sulindac|No|No|No|No|75%|42806001805|SULINDAC 150 MG TABLET|500|EA|.09148|04/15/2010||Yes|No||04/15/2010||Yes|No|04/15/2010||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.17191|03/29/2022|.16778|03/29/2022|.1689|03/29/2022|||NSAIDS|9746|||||No|No||EPIC PHARMA LLC|No||||
citalopram hydrobromide|Yes|No|No|No|75%|42806001901|CITALOPRAM HBR 10 MG TABLET|100|EA|.04794|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||008|Yes|.02682|03/29/2022|.02617|03/29/2022|.02635|03/29/2022|||ANTIDEPRESSANTS: SSRIs|9747|||||No|No||EPIC PHARMA LLC|No||||
citalopram hydrobromide|Yes|No|No|No|75%|42806001910|CITALOPRAM HBR 10 MG TABLET|1000|EA|.04773|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||008|Yes|.02682|03/29/2022|.02617|03/29/2022|.02635|03/29/2022|||ANTIDEPRESSANTS: SSRIs|9748|||||No|No||EPIC PHARMA LLC|No||||
citalopram hydrobromide|Yes|No|No|No|75%|42806002001|CITALOPRAM HBR 20 MG TABLET|100|EA|.04945|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||008|Yes|.02946|03/29/2022|.02875|03/29/2022|.02894|03/29/2022|||ANTIDEPRESSANTS: SSRIs|9749|||||No|No||EPIC PHARMA LLC|No||||
citalopram hydrobromide|Yes|No|No|No|75%|42806002010|CITALOPRAM HBR 20 MG TABLET|1000|EA|.04945|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||008|Yes|.02946|03/29/2022|.02875|03/29/2022|.02894|03/29/2022|||ANTIDEPRESSANTS: SSRIs|9750|||||No|No||EPIC PHARMA LLC|No||||
citalopram hydrobromide|Yes|No|No|No|75%|42806002101|CITALOPRAM HBR 40 MG TABLET|100|EA|.05031|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||008|No|.03726|03/29/2022|.03636|03/29/2022|.0366|03/29/2022|||ANTIDEPRESSANTS: SSRIs|9751|||||No|No||EPIC PHARMA LLC|No||||
citalopram hydrobromide|Yes|No|No|No|75%|42806002110|CITALOPRAM HBR 40 MG TABLET|1000|EA|.05061|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||008|No|.03726|03/29/2022|.03636|03/29/2022|.0366|03/29/2022|||ANTIDEPRESSANTS: SSRIs|9752|||||No|No||EPIC PHARMA LLC|No||||
betaxolol HCl|No|No|No|No|75%|42806003801|BETAXOLOL 10 MG TABLET|100|EA|.2795|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|070|No|.52457|01/25/2022|.51198|01/25/2022|.51539|01/25/2022|||BETA-BLOCKERS|9753|||||No|No||EPIC PHARMA LLC|No||||
betaxolol HCl|No|No|No|No|75%|42806003901|BETAXOLOL 20 MG TABLET|100|EA|.4257|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|070|No|.9702|04/11/2019|.95634|04/11/2019|.9108|04/11/2019|||BETA-BLOCKERS|9754|||||No|No||EPIC PHARMA LLC|No||||
guanfacine HCl|No|No|No|No|75%|42806004801|GUANFACINE 1 MG TABLET|100|EA|.301|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|No||166|No|.50477|03/29/2022|.49265|03/29/2022|.49593|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|9755|||||No|No||EPIC PHARMA LLC|No||||
meperidine HCl|No|No|No|No|90%|42806005030|MEPERIDINE 50 MG TABLET|30|EA|16.03427|04/07/2021||Yes|No||04/07/2021||Yes|No|04/07/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|109|Yes|36.54322|01/04/2022|36.02117|01/04/2022|34.30588|01/04/2022|||ANALGESICS: NARCOTICS SHORT|9756|||||No|No||EPIC PHARMA LLC|No||||
amlodipine besylate|Yes|No|No|No|75%|42806005505|AMLODIPINE BESYLATE 2.5 MG TAB|500|EA|.03534|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|9757|||||No|No||EPIC PHARMA LLC|No||||
amlodipine besylate|Yes|No|No|No|75%|42806005509|AMLODIPINE BESYLATE 2.5 MG TAB|90|EA|.03726|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|9758|||||No|No||EPIC PHARMA LLC|No||||
amlodipine besylate|Yes|No|No|No|75%|42806005510|AMLODIPINE BESYLATE 2.5 MG TAB|1000|EA|.01151|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|9759|||||No|No||EPIC PHARMA LLC|No||||
amlodipine besylate|Yes|No|No|No|75%|42806005605|AMLODIPINE BESYLATE 5 MG TAB|500|EA|.03534|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|9760|||||No|No||EPIC PHARMA LLC|No||||
amlodipine besylate|Yes|No|No|No|75%|42806005609|AMLODIPINE BESYLATE 5 MG TAB|90|EA|.03726|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|9761|||||No|No||EPIC PHARMA LLC|No||||
amlodipine besylate|Yes|No|No|No|75%|42806005610|AMLODIPINE BESYLATE 5 MG TAB|1000|EA|.00913|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|9762|||||No|No||EPIC PHARMA LLC|No||||
amlodipine besylate|Yes|No|No|No|75%|42806005705|AMLODIPINE BESYLATE 10 MG TAB|500|EA|.0485|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|9763|||||No|No||EPIC PHARMA LLC|No||||
amlodipine besylate|Yes|No|No|No|75%|42806005709|AMLODIPINE BESYLATE 10 MG TAB|90|EA|.05111|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|9764|||||No|No||EPIC PHARMA LLC|No||||
amlodipine besylate|Yes|No|No|No|75%|42806005710|AMLODIPINE BESYLATE 10 MG TAB|1000|EA|.02045|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|9765|||||No|No||EPIC PHARMA LLC|No||||
flavoxate HCl|No|No|No|No|75%|42806005801|FLAVOXATE HCL 100 MG TABLET|100|EA|.688|04/02/2019||Yes|No||04/02/2019||Yes|No|04/02/2019||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|006|No|.75886|03/29/2022|.74064|03/29/2022|.74557|03/29/2022|||BLADDER RELAXANT PREPARATIONS|9766|||||No|No||EPIC PHARMA LLC|No||||
buspirone HCl|No|No|No|No|75%|42806008201|BUSPIRONE HCL 5 MG TABLET|100|EA|.02846|02/10/2021||Yes|No||02/10/2021||Yes|No|02/10/2021||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|9767|||||No|No||EPIC PHARMA LLC|No||||
buspirone HCl|No|No|No|No|75%|42806008205|BUSPIRONE HCL 5 MG TABLET|500|EA|.02788|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|9768|||||No|No||EPIC PHARMA LLC|No||||
buspirone HCl|No|No|No|No|75%|42806008301|BUSPIRONE HCL 7.5 MG TABLET|100|EA|.16279|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No||090|No|.22186|03/29/2022|.21653|03/29/2022|.21797|03/29/2022|||ANXIOLYTICS|9769|||||No|No||EPIC PHARMA LLC|No||||
buspirone HCl|No|No|No|No|75%|42806008305|BUSPIRONE HCL 7.5 MG TABLET|500|EA|.16279|05/21/2021||Yes|No||05/21/2021||Yes|No|05/21/2021||Yes|No||||No|No|||Prescription required|No||090|No|.22186|03/29/2022|.21653|03/29/2022|.21797|03/29/2022|||ANXIOLYTICS|9770|||||No|No||EPIC PHARMA LLC|No||||
buspirone HCl|No|No|No|No|75%|42806008401|BUSPIRONE HCL 10 MG TABLET|100|EA|.02889|05/21/2021||Yes|No||05/21/2021||Yes|No|05/21/2021||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|9771|||||No|No||EPIC PHARMA LLC|No||||
buspirone HCl|No|No|No|No|75%|42806008405|BUSPIRONE HCL 10 MG TABLET|500|EA|.02887|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|9772|||||No|No||EPIC PHARMA LLC|No||||
buspirone HCl|No|No|No|No|75%|42806008501|BUSPIRONE HCL 15 MG TABLET|100|EA|.03121|05/21/2021||Yes|No||05/21/2021||Yes|No|05/21/2021||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|9773|||||No|No||EPIC PHARMA LLC|No||||
buspirone HCl|No|No|No|No|75%|42806008505|BUSPIRONE HCL 15 MG TABLET|500|EA|.0312|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|9774|||||No|No||EPIC PHARMA LLC|No||||
buspirone HCl|No|No|No|No|75%|42806008660|BUSPIRONE HCL 30 MG TABLET|60|EA|.4085|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No||090|No|.17728|03/29/2022|.17302|03/29/2022|.17417|03/29/2022|||ANXIOLYTICS|9775|||||No|No||EPIC PHARMA LLC|No||||
estradiol|No|No|No|No|75%|42806008701|ESTRADIOL 0.5 MG TABLET|100|EA|.03113|08/30/2017||Yes|No||08/30/2017||Yes|No|08/30/2017||Yes|No||||No|No|||Prescription required|No|||Yes|.08676|03/29/2022|.08467|03/29/2022|.08524|03/29/2022||||9776|||||No|No||EPIC PHARMA LLC|No||||
estradiol|No|No|No|No|75%|42806008705|ESTRADIOL 0.5 MG TABLET|500|EA|.03113|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No|||Yes|.08676|03/29/2022|.08467|03/29/2022|.08524|03/29/2022||||9777|||||No|No||EPIC PHARMA LLC|No||||
estradiol|No|No|No|No|75%|42806008801|ESTRADIOL 1 MG TABLET|100|EA|.03741|08/30/2017||Yes|No||08/30/2017||Yes|No|08/30/2017||Yes|No||||No|No|||Prescription required|No|||Yes|.09546|03/29/2022|.09316|03/29/2022|.09378|03/29/2022||||9778|||||No|No||EPIC PHARMA LLC|No||||
estradiol|No|No|No|No|75%|42806008805|ESTRADIOL 1 MG TABLET|500|EA|.04221|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No|||Yes|.09546|03/29/2022|.09316|03/29/2022|.09378|03/29/2022||||9779|||||No|No||EPIC PHARMA LLC|No||||
estradiol|No|No|No|No|75%|42806008901|ESTRADIOL 2 MG TABLET|100|EA|.05934|08/30/2017||Yes|No||08/30/2017||Yes|No|08/30/2017||Yes|No||||No|No|||Prescription required|No|||Yes|.13189|03/29/2022|.12872|03/29/2022|.12958|03/29/2022||||9780|||||No|No||EPIC PHARMA LLC|No||||
estradiol|No|No|No|No|75%|42806008905|ESTRADIOL 2 MG TABLET|500|EA|.0677|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No|||Yes|.13189|03/29/2022|.12872|03/29/2022|.12958|03/29/2022||||9781|||||No|No||EPIC PHARMA LLC|No||||
potassium chloride|No|No|No|No|75%|42806009401|POTASSIUM CL 20 MEQ PACKET|100|EA|2.322|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|No|||No|2.51484|03/29/2022|2.45448|03/29/2022|2.47083|03/29/2022||||9782|||||No|No||EPIC PHARMA LLC|No||||
potassium chloride|No|No|No|No|75%|42806009430|POTASSIUM CL 20 MEQ PACKET|30|EA|2.365|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|No|||No|2.51484|03/29/2022|2.45448|03/29/2022|2.47083|03/29/2022||||9783|||||No|No||EPIC PHARMA LLC|No||||
protriptyline HCl|No|No|No|No|75%|42806009630|PROTRIPTYLINE HCL 5 MG TABLET|30|EA|2.15|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|215|No|4.9|03/01/2022|4.83|03/01/2022|4.6|03/01/2022|||ANTIDEPRESSANTS: TRICYCLIC|9784|||||No|No||EPIC PHARMA LLC|No||||
protriptyline HCl|No|No|No|No|75%|42806009730|PROTRIPTYLINE HCL 10 MG TABLET|30|EA|2.15|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|215|No|3.06317|01/25/2022|2.98965|01/25/2022|3.00956|01/25/2022|||ANTIDEPRESSANTS: TRICYCLIC|9785|||||No|No||EPIC PHARMA LLC|No||||
ethambutol HCl|No|No|No|No|75%|42806010101|ETHAMBUTOL HCL 100 MG TABLET|100|EA|.19737|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No|||No|.44982|04/14/2021|.44339|04/14/2021|.42228|04/14/2021||||9786|||||No|No||EPIC PHARMA LLC|No||||
ethambutol HCl|No|No|No|No|75%|42806010201|ETHAMBUTOL HCL 400 MG TABLET|100|EA|.54425|12/17/2020||Yes|No||12/17/2020||Yes|No|12/17/2020||Yes|No||||No|No|||Prescription required|No|||No|.57427|03/29/2022|.56048|03/29/2022|.56422|03/29/2022||||9787|||||No|No||EPIC PHARMA LLC|No||||
sotalol HCl|No|No|No|No|75%|42806012101|SOTALOL AF 80 MG TABLET|100|EA|.42118|08/07/2019||Yes|No||08/07/2019||Yes|No|08/07/2019||Yes|No||||No|No|||Prescription required|No||070|No|.07746|03/29/2022|.0756|03/29/2022|.0761|03/29/2022|||BETA-BLOCKERS|9788|||||No|No||EPIC PHARMA LLC|No||||
sotalol HCl|No|No|No|No|75%|42806012201|SOTALOL AF 120 MG TABLET|100|EA|.56179|08/07/2019||Yes|No||08/07/2019||Yes|No|08/07/2019||Yes|No||||No|No|||Prescription required|No||070|No|.10056|03/29/2022|.09814|03/29/2022|.0988|03/29/2022|||BETA-BLOCKERS|9789|||||No|No||EPIC PHARMA LLC|No||||
sotalol HCl|No|No|No|No|75%|42806012301|SOTALOL AF 160 MG TABLET|100|EA|.70253|08/07/2019||Yes|No||08/07/2019||Yes|No|08/07/2019||Yes|No||||No|No|||Prescription required|No||070|No|.16372|03/29/2022|.15979|03/29/2022|.16085|03/29/2022|||BETA-BLOCKERS|9790|||||No|No||EPIC PHARMA LLC|No||||
demeclocycline HCl|No|No|No|No|75%|42806014301|DEMECLOCYCLINE 150 MG TABLET|100|EA|5.44509|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|213|No|12.40974|11/26/2019|12.23245|11/26/2019|11.64996|11/26/2019|||TETRACYCLINES|9791|||||No|No||EPIC PHARMA LLC|No||||
demeclocycline HCl|No|No|No|No|75%|42806014448|DEMECLOCYCLINE 300 MG TABLET|48|EA|9.85775|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|213|No|22.4665|12/28/2021|22.14555|12/28/2021|21.091|12/28/2021|||TETRACYCLINES|9792|||||No|No||EPIC PHARMA LLC|No||||
azithromycin|No|No|No|No|75%|42806014731|AZITHROMYCIN 100 MG/5 ML SUSP|15|ML|.344|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|No||018|No|.56328|03/29/2022|.54976|03/29/2022|.55342|03/29/2022|||MACROLIDES/KETOLIDES|9793|||||No|No||EPIC PHARMA LLC|No||||
azithromycin|No|No|No|No|75%|42806014932|AZITHROMYCIN 200 MG/5 ML SUSP|15|ML|.37266|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|No||018|No|.46232|03/29/2022|.45122|03/29/2022|.45422|03/29/2022|||MACROLIDES/KETOLIDES|9794|||||No|No||EPIC PHARMA LLC|No||||
azithromycin|No|No|No|No|75%|42806015033|AZITHROMYCIN 200 MG/5 ML SUSP|22.5|ML|.26755|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|No||018|No|.35562|03/29/2022|.34708|03/29/2022|.34939|03/29/2022|||MACROLIDES/KETOLIDES|9795|||||No|No||EPIC PHARMA LLC|No||||
azithromycin|No|No|No|No|75%|42806015134|AZITHROMYCIN 200 MG/5 ML SUSP|30|ML|.215|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|No||018|No|.28375|03/29/2022|.27694|03/29/2022|.27878|03/29/2022|||MACROLIDES/KETOLIDES|9796|||||No|No||EPIC PHARMA LLC|No||||
hydroxyzine HCl|No|No|No|No|75%|42806015901|HYDROXYZINE HCL 10 MG TABLET|100|EA|.08582|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|||Prescription required|No||574|Yes|.03952|03/29/2022|.03857|03/29/2022|.03882|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|9797|||||No|No||EPIC PHARMA LLC|No||||
hydroxyzine HCl|No|No|No|No|75%|42806015905|HYDROXYZINE HCL 10 MG TABLET|500|EA|.08581|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|||Prescription required|No||574|Yes|.03952|03/29/2022|.03857|03/29/2022|.03882|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|9798|||||No|No||EPIC PHARMA LLC|No||||
hydroxyzine HCl|No|No|No|No|75%|42806015910|HYDROXYZINE HCL 10 MG TABLET|1000|EA|.08581|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|||Prescription required|No||574|Yes|.03952|03/29/2022|.03857|03/29/2022|.03882|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|9799|||||No|No||EPIC PHARMA LLC|No||||
hydroxyzine HCl|No|No|No|No|75%|42806016001|HYDROXYZINE HCL 25 MG TABLET|100|EA|.1357|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|||Prescription required|No||574|Yes|.06757|03/29/2022|.06594|03/29/2022|.06638|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|9800|||||No|No||EPIC PHARMA LLC|No||||
hydroxyzine HCl|No|No|No|No|75%|42806016005|HYDROXYZINE HCL 25 MG TABLET|500|EA|.13571|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|||Prescription required|No||574|Yes|.06757|03/29/2022|.06594|03/29/2022|.06638|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|9801|||||No|No||EPIC PHARMA LLC|No||||
hydroxyzine HCl|No|No|No|No|75%|42806016010|HYDROXYZINE HCL 25 MG TABLET|1000|EA|.13572|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|||Prescription required|No||574|Yes|.06757|03/29/2022|.06594|03/29/2022|.06638|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|9802|||||No|No||EPIC PHARMA LLC|No||||
hydroxyzine HCl|No|No|No|No|75%|42806016101|HYDROXYZINE HCL 50 MG TABLET|100|EA|.16112|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|||Prescription required|No||574|Yes|.09594|03/29/2022|.09363|03/29/2022|.09426|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|9803|||||No|No||EPIC PHARMA LLC|No||||
hydroxyzine HCl|No|No|No|No|75%|42806016105|HYDROXYZINE HCL 50 MG TABLET|500|EA|.16954|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|||Prescription required|No||574|Yes|.09594|03/29/2022|.09363|03/29/2022|.09426|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|9804|||||No|No||EPIC PHARMA LLC|No||||
hydroxyzine HCl|No|No|No|No|75%|42806016110|HYDROXYZINE HCL 50 MG TABLET|1000|EA|.16948|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|||Prescription required|No||574|Yes|.09594|03/29/2022|.09363|03/29/2022|.09426|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|9805|||||No|No||EPIC PHARMA LLC|No||||
gemfibrozil|No|No|No|No|75%|42806026005|GEMFIBROZIL 600 MG TABLET|500|EA|.04912|05/31/2017||Yes|No||05/31/2017||Yes|No|05/31/2017||Yes|No||||No|No|||Prescription required|No||055|No|.10518|03/29/2022|.10265|03/29/2022|.10333|03/29/2022|||LIPOTROPICS: OTHER|9806|||||No|No||EPIC PHARMA LLC|No||||
gemfibrozil|No|No|No|No|75%|42806026060|GEMFIBROZIL 600 MG TABLET|60|EA|.04908|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|||Prescription required|No||055|No|.10518|03/29/2022|.10265|03/29/2022|.10333|03/29/2022|||LIPOTROPICS: OTHER|9807|||||No|No||EPIC PHARMA LLC|No||||
isradipine|No|No|No|No|75%|42806026301|ISRADIPINE 2.5 MG CAPSULE|100|EA|4.19839|06/29/2021||Yes|No||06/29/2021||Yes|No|06/29/2021||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|045|No|9.56842|07/13/2021|9.43173|07/13/2021|8.9826|07/13/2021|||CALCIUM CHANNEL BLOCKERS|9808|||||No|No||EPIC PHARMA LLC|No||||
isradipine|No|No|No|No|75%|42806026401|ISRADIPINE 5 MG CAPSULE|100|EA|4.24637|06/29/2021||Yes|No||06/29/2021||Yes|No|06/29/2021||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|045|No|9.67779|07/13/2021|9.53953|07/13/2021|9.08527|07/13/2021|||CALCIUM CHANNEL BLOCKERS|9809|||||No|No||EPIC PHARMA LLC|No||||
guanfacine HCl|No|No|No|No|75%|42806029601|GUANFACINE 2 MG TABLET|100|EA|.4816|09/09/2019||Yes|No||09/09/2019||Yes|No|09/09/2019||Yes|No||||No|No|||Prescription required|No||166|No|.72297|03/29/2022|.70561|03/29/2022|.71031|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|9810|||||No|No||EPIC PHARMA LLC|No||||
doxycycline hyclate|Yes|No|No|No|75%|42806031205|DOXYCYCLINE HYCLATE 100 MG TAB|500|EA|.08599|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|03/20/2020||Prescription required|Yes|01/28/2016|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|9811|||||No|No||EPIC PHARMA LLC|No||||
doxycycline hyclate|Yes|No|No|No|75%|42806031250|DOXYCYCLINE HYCLATE 100 MG TAB|50|EA|.08591|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|03/20/2020||Prescription required|Yes|01/28/2016|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|9812|||||No|No||EPIC PHARMA LLC|No||||
molindone HCl|No|No|No|No|75%|42806033601|MOLINDONE HCL 5 MG TABLET|100|EA|3.80889|08/22/2019||Yes|No||08/22/2019||Yes|No|08/22/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|8.68074|01/04/2022|8.55673|01/04/2022|8.14926|01/04/2022|||ANTIPSYCHOTICS|9813|||||No|No||EPIC PHARMA LLC|No||||
molindone HCl|No|No|No|No|75%|42806033701|MOLINDONE HCL 10 MG TABLET|100|EA|4.57679|08/22/2019||Yes|No||08/22/2019||Yes|No|08/22/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|10.43082|01/04/2022|10.28181|01/04/2022|9.7922|01/04/2022|||ANTIPSYCHOTICS|9814|||||No|No||EPIC PHARMA LLC|No||||
molindone HCl|No|No|No|No|75%|42806033801|MOLINDONE HCL 25 MG TABLET|100|EA|5.09902|08/22/2019||Yes|No||08/22/2019||Yes|No|08/22/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|11.62103|01/04/2022|11.45502|01/04/2022|10.90954|01/04/2022|||ANTIPSYCHOTICS|9815|||||No|No||EPIC PHARMA LLC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|42806033901|DEXTROAMP-AMPHETAMINE 5 MG TAB|100|EA|.156|10/17/2019||Yes|No||10/17/2019||Yes|No|10/17/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|.21985|03/29/2022|.21457|03/29/2022|.216|03/29/2022|||STIMULANTS AND RELATED AGENTS|9816|||||No|No||EPIC PHARMA LLC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|42806034101|DEXTROAMP-AMPHETAMIN 10 MG TAB|100|EA|.156|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|||Prescription required|No||007|Yes|.24071|03/29/2022|.23493|03/29/2022|.23649|03/29/2022|||STIMULANTS AND RELATED AGENTS|9817|||||No|No||EPIC PHARMA LLC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|42806034301|DEXTROAMP-AMPHETAMIN 15 MG TAB|100|EA|.156|10/17/2019||Yes|No||10/17/2019||Yes|No|10/17/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|.25605|03/29/2022|.2499|03/29/2022|.25156|03/29/2022|||STIMULANTS AND RELATED AGENTS|9818|||||No|No||EPIC PHARMA LLC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|42806034401|DEXTROAMP-AMPHETAMIN 20 MG TAB|100|EA|.156|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|||Prescription required|No||007|Yes|.31357|03/29/2022|.30604|03/29/2022|.30808|03/29/2022|||STIMULANTS AND RELATED AGENTS|9819|||||No|No||EPIC PHARMA LLC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|42806034501|DEXTROAMP-AMPHETAMIN 30 MG TAB|100|EA|.156|10/17/2019||Yes|No||10/17/2019||Yes|No|10/17/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|.30925|03/29/2022|.30182|03/29/2022|.30383|03/29/2022|||STIMULANTS AND RELATED AGENTS|9820|||||No|No||EPIC PHARMA LLC|No||||
bupropion HCl|Yes|No|No|No|75%|42806034805|BUPROPION HCL XL 150 MG TABLET|500|EA|.07797|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|9821|||||No|No||EPIC PHARMA LLC|No||||
bupropion HCl|Yes|No|No|No|75%|42806034809|BUPROPION HCL XL 150 MG TABLET|90|EA|.17916|08/09/2019||Yes|No||08/09/2019||Yes|No|08/09/2019||Yes|No||||No|No|09/27/2019||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|9822|||||No|No||EPIC PHARMA LLC|No||||
bupropion HCl|Yes|No|No|No|75%|42806034830|BUPROPION HCL XL 150 MG TABLET|30|EA|.17916|08/09/2019||Yes|No||08/09/2019||Yes|No|08/09/2019||Yes|No||||No|No|09/27/2019||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|9823|||||No|No||EPIC PHARMA LLC|No||||
bupropion HCl|Yes|No|No|No|75%|42806034905|BUPROPION HCL XL 300 MG TABLET|500|EA|.1892|08/09/2019||Yes|No||08/09/2019||Yes|No|08/09/2019||Yes|No||||No|No|09/27/2019||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|9824|||||No|No||EPIC PHARMA LLC|No||||
bupropion HCl|Yes|No|No|No|75%|42806034909|BUPROPION HCL XL 300 MG TABLET|90|EA|.18871|08/09/2019||Yes|No||08/09/2019||Yes|No|08/09/2019||Yes|No||||No|No|09/27/2019||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|9825|||||No|No||EPIC PHARMA LLC|No||||
leucovorin calcium|No|No|No|No|75%|42806035801|LEUCOVORIN CALCIUM 5 MG TAB|100|EA|.51307|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No|||No|.873|03/29/2022|.85204|03/29/2022|.85772|03/29/2022||||9826|||||No|No||EPIC PHARMA LLC|No||||
leucovorin calcium|No|No|No|No|75%|42806035830|LEUCOVORIN CALCIUM 5 MG TAB|30|EA|.57949|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No|||No|.873|03/29/2022|.85204|03/29/2022|.85772|03/29/2022||||9827|||||No|No||EPIC PHARMA LLC|No||||
leucovorin calcium|No|No|No|No|75%|42806035925|LEUCOVORIN CALCIUM 25 MG TAB|25|EA|3.84471|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No|||No|5.60951|03/29/2022|5.47488|03/29/2022|5.51134|03/29/2022||||9828|||||No|No||EPIC PHARMA LLC|No||||
methylprednisolone|No|No|No|No|75%|42806040001|METHYLPREDNISOLONE 4 MG TABLET|100|EA|.0946|11/06/2019||Yes|No||11/06/2019||Yes|No|11/06/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|168|Yes|.21195|03/29/2022|.20686|03/29/2022|.20824|03/29/2022|||GLUCOCORTICOIDS: ORAL|9829|||||No|No||EPIC PHARMA LLC|No||||
metformin HCl|No|No|No|No|75%|42806040560|METFORMIN ER 500 MG OSMOTIC TB|60|EA|.559|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|012|No|.70527|01/25/2022|.68834|01/25/2022|.69292|01/25/2022|||HYPOGLYCEMICS: METFORMINS|9830|||||No|No||EPIC PHARMA LLC|No||||
metformin HCl|Yes|No|No|No|75%|42806040660|METFORMIN ER 1,000 MG OSM-TAB|60|EA|.86716|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|01/15/2020||Prescription required|Yes|07/29/2021|012|No|1.48331|03/29/2022|1.44771|03/29/2022|1.45735|03/29/2022|||HYPOGLYCEMICS: METFORMINS|9831|||||No|No||EPIC PHARMA LLC|No||||
nicardipine HCl|Yes|No|No|No|75%|42806050109|NICARDIPINE 20 MG CAPSULE|90|EA|5.33003|08/07/2019||Yes|No||08/07/2019||Yes|No|08/07/2019||Yes|No||||No|No|09/27/2019||Prescription required|Yes|01/28/2016|045|No|12.14753|06/30/2020|11.97399|06/30/2020|11.4038|06/30/2020|||CALCIUM CHANNEL BLOCKERS|9832|||||No|No||EPIC PHARMA LLC|No||||
nicardipine HCl|Yes|No|No|No|75%|42806050209|NICARDIPINE 30 MG CAPSULE|90|EA|7.63373|08/07/2019||Yes|No||08/07/2019||Yes|No|08/07/2019||Yes|No||||No|No|09/27/2019||Prescription required|Yes|01/28/2016|045|No|17.39782|06/30/2020|17.14928|06/30/2020|16.33264|06/30/2020|||CALCIUM CHANNEL BLOCKERS|9833|||||No|No||EPIC PHARMA LLC|No||||
ursodiol|No|No|No|No|75%|42806050301|URSODIOL 300 MG CAPSULE|100|EA|.5375|04/02/2019||Yes|No||04/02/2019||Yes|No|04/02/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|198|No|.60006|03/29/2022|.58565|03/29/2022|.58955|03/29/2022|||BILE SALTS|9834|||||No|No||EPIC PHARMA LLC|No||||
ergocalciferol (vitamin D2)|No|No|No|No|75%|42806054701|VITAMIN D2 1.25MG(50,000 UNIT)|100|EA|.15652|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|||Prescription required|No|||No|.14082|03/29/2022|.13744|03/29/2022|.13835|03/29/2022||||9835|||||No|No||EPIC PHARMA LLC|No||||
dutasteride|No|No|No|No|75%|42806054909|DUTASTERIDE 0.5 MG CAPSULE|90|EA|.14141|10/17/2019||Yes|No||10/17/2019||Yes|No|10/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|003|No|.20731|03/29/2022|.20233|03/29/2022|.20368|03/29/2022|||BPH TREATMENTS|9836|||||No|No||EPIC PHARMA LLC|No||||
dutasteride|No|No|No|No|75%|42806054930|DUTASTERIDE 0.5 MG CAPSULE|30|EA|.1376|10/17/2019||Yes|No||10/17/2019||Yes|No|10/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|003|No|.20731|03/29/2022|.20233|03/29/2022|.20368|03/29/2022|||BPH TREATMENTS|9837|||||No|No||EPIC PHARMA LLC|No||||
omega-3 acid ethyl esters|No|No|No|No|75%|42806055212|OMEGA-3 ETHYL ESTERS 1 GM CAP|120|EA|.07711|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No||055|Yes|.18363|03/29/2022|.17922|03/29/2022|.18041|03/29/2022|||LIPOTROPICS: OTHER|9838|||||No|No||EPIC PHARMA LLC|No||||
diphenhydramine HCl|No|No|No|No|75%|42806064810|DIPHENHYDRAMINE 25 MG CAPSULE|1000|EA|.0111|08/08/2019||Yes|No||||No|No|08/08/2019||Yes|No||||No|No|||Over the counter|No||574|Yes|.03464|03/29/2022|.0338|03/29/2022|.03403|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|9839|||||No|No||EPIC PHARMA LLC|No||||
diphenhydramine HCl|No|No|No|No|75%|42806064910|DIPHENHYDRAMINE 50 MG CAPSULE|1000|EA|.01243|08/08/2019||Yes|No||||No|No|08/08/2019||Yes|No||||No|No|||Over the counter|No||574|Yes|.02024|03/29/2022|.01975|03/29/2022|.01988|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|9840|||||No|No||EPIC PHARMA LLC|No||||
entecavir|No|No|No|No|75%|42806065830|ENTECAVIR 0.5 MG TABLET|30|EA|1.12373|03/05/2021||Yes|No||03/05/2021||Yes|No|03/05/2021||Yes|No||||No|No|||Prescription required|No|||No|.89227|03/29/2022|.87085|03/29/2022|.87665|03/29/2022||||9841|||||No|No||EPIC PHARMA LLC|No||||
entecavir|No|No|No|No|75%|42806065930|ENTECAVIR 1 MG TABLET|30|EA|1.12373|03/05/2021||Yes|No||03/05/2021||Yes|No|03/05/2021||Yes|No||||No|No|||Prescription required|No|||No|1.06461|03/29/2022|1.03905|03/29/2022|1.04597|03/29/2022||||9842|||||No|No||EPIC PHARMA LLC|No||||
buspirone HCl|No|No|No|No|75%|42806066201|BUSPIRONE HCL 5 MG TABLET|100|EA|.02846|05/21/2021||Yes|No||05/21/2021||Yes|No|05/21/2021||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|9843|||||No|No||EPIC PHARMA LLC|No||||
buspirone HCl|No|No|No|No|75%|42806066301|BUSPIRONE HCL 10 MG TABLET|100|EA|.02889|05/21/2021||Yes|No||05/21/2021||Yes|No|05/21/2021||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|9844|||||No|No||EPIC PHARMA LLC|No||||
buspirone HCl|No|No|No|No|75%|42806066305|BUSPIRONE HCL 10 MG TABLET|500|EA|.02887|05/21/2021||Yes|No||05/21/2021||Yes|No|05/21/2021||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|9845|||||No|No||EPIC PHARMA LLC|No||||
buspirone HCl|No|No|No|No|75%|42806066401|BUSPIRONE HCL 15 MG TABLET|100|EA|.03121|05/21/2021||Yes|No||05/21/2021||Yes|No|05/21/2021||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|9846|||||No|No||EPIC PHARMA LLC|No||||
buspirone HCl|No|No|No|No|75%|42806066405|BUSPIRONE HCL 15 MG TABLET|500|EA|.0312|05/21/2021||Yes|No||05/21/2021||Yes|No|05/21/2021||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|9847|||||No|No||EPIC PHARMA LLC|No||||
buspirone HCl|No|No|No|No|75%|42806066560|BUSPIRONE HCL 30 MG TABLET|60|EA|.4085|05/21/2021||Yes|No||05/21/2021||Yes|No|05/21/2021||Yes|No||||No|No|||Prescription required|No||090|No|.17728|03/29/2022|.17302|03/29/2022|.17417|03/29/2022|||ANXIOLYTICS|9848|||||No|No||EPIC PHARMA LLC|No||||
ethosuximide|No|No|No|No|75%|42806071101|ETHOSUXIMIDE 250 MG CAPSULE|100|EA|.516|03/04/2021||Yes|No||03/04/2021||Yes|No|03/04/2021||Yes|No||||No|No|||Prescription required|No||056|No|.61011|03/29/2022|.59546|03/29/2022|.59943|03/29/2022|||ANTICONVULSANTS|9849|||||No|No||EPIC PHARMA LLC|No||||
benzonatate|No|No|No|No|75%|42806071401|BENZONATATE 100 MG CAPSULE|100|EA|.0645|10/12/2020||Yes|No||10/12/2020||Yes|No|10/12/2020||Yes|No||||No|No|||Prescription required|No||184|Yes|.09389|03/29/2022|.09163|03/29/2022|.09224|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|9850|||||No|No||EPIC PHARMA LLC|No||||
benzonatate|No|No|No|No|75%|42806071405|BENZONATATE 100 MG CAPSULE|500|EA|.05805|10/12/2020||Yes|No||10/12/2020||Yes|No|10/12/2020||Yes|No||||No|No|||Prescription required|No||184|Yes|.09389|03/29/2022|.09163|03/29/2022|.09224|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|9851|||||No|No||EPIC PHARMA LLC|No||||
benzonatate|No|No|No|No|75%|42806071501|BENZONATATE 200 MG CAPSULE|100|EA|.08062|10/12/2020||Yes|No||10/12/2020||Yes|No|10/12/2020||Yes|No||||No|No|||Prescription required|No||184|Yes|.14345|03/29/2022|.14|03/29/2022|.14093|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|9852|||||No|No||EPIC PHARMA LLC|No||||
benzonatate|No|No|No|No|75%|42806071505|BENZONATATE 200 MG CAPSULE|500|EA|.07256|10/12/2020||Yes|No||10/12/2020||Yes|No|10/12/2020||Yes|No||||No|No|||Prescription required|No||184|Yes|.14345|03/29/2022|.14|03/29/2022|.14093|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|9853|||||No|No||EPIC PHARMA LLC|No||||
celecoxib|No|No|No|No|75%|42806072060|CELECOXIB 50 MG CAPSULE|60|EA|.05733|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|059|Yes|.1386|03/29/2022|.13527|03/29/2022|.13617|03/29/2022|||NSAIDS|9854|||||No|No||EPIC PHARMA LLC|No||||
celecoxib|No|No|No|No|75%|42806072101|CELECOXIB 100 MG CAPSULE|100|EA|.0645|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|9855|||||No|No||EPIC PHARMA LLC|No||||
celecoxib|No|No|No|No|75%|42806072105|CELECOXIB 100 MG CAPSULE|500|EA|.0516|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|9856|||||No|No||EPIC PHARMA LLC|No||||
celecoxib|No|No|No|No|75%|42806072201|CELECOXIB 200 MG CAPSULE|100|EA|.129|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|9857|||||No|No||EPIC PHARMA LLC|No||||
celecoxib|No|No|No|No|75%|42806072205|CELECOXIB 200 MG CAPSULE|500|EA|.1032|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|9858|||||No|No||EPIC PHARMA LLC|No||||
celecoxib|No|No|No|No|75%|42806072360|CELECOXIB 400 MG CAPSULE|60|EA|.25083|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|059|Yes|.73632|03/29/2022|.71864|03/29/2022|.72343|03/29/2022|||NSAIDS|9859|||||No|No||EPIC PHARMA LLC|No||||
doxepin HCl|No|No|No|No|75%|42847010330|SILENOR 3 MG TABLET|30|EA|7.7228|06/26/2014||Yes|No||06/26/2014||Yes|No|06/26/2014||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|054|No|17.6008|03/29/2022|17.34936|03/29/2022|16.5232|03/29/2022|||SEDATIVE HYPNOTICS|9860|||||No|No||PERNIX THERAPEU|No||||
doxepin HCl|No|No|No|No|75%|42847010630|SILENOR 6 MG TABLET|30|EA|7.7228|06/26/2014||Yes|No||06/26/2014||Yes|No|06/26/2014||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|054|No|17.32247|10/26/2021|16.90673|10/26/2021|17.01932|10/26/2021|||SEDATIVE HYPNOTICS|9861|||||No|No||PERNIX THERAPEU|No||||
oxycodone HCl|No|No|No|No|90%|42858000101|OXYCODONE HCL (IR) 5 MG TABLET|100|EA|.02919|11/06/2014||Yes|No||11/06/2014||Yes|No|11/06/2014||Yes|No||||No|No|||Prescription required|No||109|Yes|.0685|03/29/2022|.06685|03/29/2022|.0673|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9862|||||No|No||RHODES PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|42858000201|OXYCODONE HCL (IR) 10 MG TAB|100|EA|.0531|11/06/2014||Yes|No||11/06/2014||Yes|No|11/06/2014||Yes|No||||No|No|||Prescription required|No||109|Yes|.12568|03/29/2022|.12266|03/29/2022|.12348|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9863|||||No|No||RHODES PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|42858000301|OXYCODONE HCL (IR) 15 MG TAB|100|EA|.05581|11/06/2014||Yes|No||11/06/2014||Yes|No|11/06/2014||Yes|No||||No|No|||Prescription required|No||109|Yes|.15895|03/29/2022|.15513|03/29/2022|.15616|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9864|||||No|No||RHODES PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|42858000401|OXYCODONE HCL (IR) 20 MG TAB|100|EA|.09735|11/06/2014||Yes|No||11/06/2014||Yes|No|11/06/2014||Yes|No||||No|No|||Prescription required|No||109|Yes|.23193|03/29/2022|.22636|03/29/2022|.22787|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9865|||||No|No||RHODES PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|42858000501|OXYCODONE HCL (IR) 30 MG TAB|100|EA|.10565|11/06/2014||Yes|No||11/06/2014||Yes|No|11/06/2014||Yes|No||||No|No|||Prescription required|No||109|Yes|.2615|03/29/2022|.25522|03/29/2022|.25692|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9866|||||No|No||RHODES PHARMACE|No||||
dexmethylphenidate HCl|No|No|No|No|75%|42858001101|DEXMETHYLPHENIDATE 2.5 MG TAB|100|EA|.1505|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|.13596|03/29/2022|.13269|03/29/2022|.13358|03/29/2022|||STIMULANTS AND RELATED AGENTS|9867|||||No|No||RHODES PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|42858004001|HYDROCODONE-ACETAMIN 5-300 MG|100|EA|.1118|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.19231|03/29/2022|.18769|03/29/2022|.18894|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9868|||||No|No||RHODES PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|42858005501|DEXTROAMP-AMPHET ER 5 MG CAP|100|EA|.258|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.59233|03/29/2022|.57811|03/29/2022|.58196|03/29/2022|||STIMULANTS AND RELATED AGENTS|9869|||||No|No||RHODES PHARMACE|No||||
fenofibrate,micronized|No|No|No|No|75%|42858006701|FENOFIBRATE 67 MG CAPSULE|100|EA||11/10/2017||Yes|No||11/10/2017||Yes|No|11/10/2017||Yes|No||||No|No|||Prescription required|No||055|No|.15038|03/29/2022|.14677|03/29/2022|.14774|03/29/2022|||LIPOTROPICS: OTHER|9870|||||No|No||RHODES PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|42858007545|METHYLPHENIDATE ER 10 MG CAP|90|EA|3.04712|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|007|Yes|6.9446|10/07/2020|6.84539|10/07/2020|6.51942|10/07/2020|||STIMULANTS AND RELATED AGENTS|9871|||||No|No||RHODES PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|42858007645|METHYLPHENIDATE ER 15 MG CAP|90|EA|3.04712|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|007|Yes|6.9446|10/07/2020|6.84539|10/07/2020|6.51942|10/07/2020|||STIMULANTS AND RELATED AGENTS|9872|||||No|No||RHODES PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|42858007745|METHYLPHENIDATE ER 20 MG CAP|90|EA|3.04712|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|007|Yes|6.9446|10/07/2020|6.84539|10/07/2020|6.51942|10/07/2020|||STIMULANTS AND RELATED AGENTS|9873|||||No|No||RHODES PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|42858007845|METHYLPHENIDATE ER 30 MG CAP|90|EA|3.04712|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|007|Yes|6.9446|10/07/2020|6.84539|10/07/2020|6.51942|10/07/2020|||STIMULANTS AND RELATED AGENTS|9874|||||No|No||RHODES PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|42858007945|METHYLPHENIDATE ER 40 MG CAP|90|EA|3.04712|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|007|Yes|6.9446|10/07/2020|6.84539|10/07/2020|6.51942|10/07/2020|||STIMULANTS AND RELATED AGENTS|9875|||||No|No||RHODES PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|42858008045|METHYLPHENIDATE ER 50 MG CAP|90|EA|3.04712|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|007|Yes|6.9446|10/07/2020|6.84539|10/07/2020|6.51942|10/07/2020|||STIMULANTS AND RELATED AGENTS|9876|||||No|No||RHODES PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|42858008145|METHYLPHENIDATE ER 60 MG CAP|90|EA|3.04712|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|007|Yes|6.9446|10/07/2020|6.84539|10/07/2020|6.51942|10/07/2020|||STIMULANTS AND RELATED AGENTS|9877|||||No|No||RHODES PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|42858010201|OXYCODONE-ACETAMINOPHEN 5-325|100|EA|.03027|03/14/2018||Yes|No||03/14/2018||Yes|No|03/14/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.09091|03/29/2022|.08872|03/29/2022|.08931|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9878|||||No|No||RHODES PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|42858010250|OXYCODONE-ACETAMINOPHEN 5-325|500|EA|.0645|03/14/2018||Yes|No||03/14/2018||Yes|No|03/14/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.09091|03/29/2022|.08872|03/29/2022|.08931|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9879|||||No|No||RHODES PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|42858010301|OXYCODONE-ACETAMINOPHN 7.5-325|100|EA|.03706|03/14/2018||Yes|No||03/14/2018||Yes|No|03/14/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.14032|03/29/2022|.13695|03/29/2022|.13786|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9880|||||No|No||RHODES PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|42858010350|OXYCODONE-ACETAMINOPHN 7.5-325|500|EA|.0817|03/14/2018||Yes|No||03/14/2018||Yes|No|03/14/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.14032|03/29/2022|.13695|03/29/2022|.13786|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9881|||||No|No||RHODES PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|42858010401|OXYCODONE-ACETAMINOPHEN 10-325|100|EA|.04811|03/14/2018||Yes|No||03/14/2018||Yes|No|03/14/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.19233|03/29/2022|.18771|03/29/2022|.18896|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9882|||||No|No||RHODES PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|42858010450|OXYCODONE-ACETAMINOPHEN 10-325|500|EA|.0903|03/14/2018||Yes|No||03/14/2018||Yes|No|03/14/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.19233|03/29/2022|.18771|03/29/2022|.18896|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9883|||||No|No||RHODES PHARMACE|No||||
lidocaine|No|No|No|No|75%|42858011830|LIDOCAINE 5% PATCH|30|EA|.93166|09/29/2020||Yes|No||09/29/2020||Yes|No|09/29/2020||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|232|No|2.00634|03/29/2022|1.95818|03/29/2022|1.97122|03/29/2022|||NEUROPATHIC PAIN|9884|||||No|No||RHODES PHARMACE|No||||
hydromorphone HCl|No|No|No|No|90%|42858012201|DILAUDID 2 MG TABLET|100|EA|1.00065|08/29/2017||Yes|No||08/29/2017||Yes|No|08/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|109|Yes|2.28055|08/06/2019|2.24797|08/06/2019|2.14093|08/06/2019|||ANALGESICS: NARCOTICS SHORT|9885|||||No|No||RHODES PHARMACE|No||||
fenofibrate,micronized|No|No|No|No|75%|42858013401|FENOFIBRATE 134 MG CAPSULE|100|EA||11/10/2017||Yes|No||11/10/2017||Yes|No|11/10/2017||Yes|No||||No|No|||Prescription required|No||055|No|.17604|03/29/2022|.17181|03/29/2022|.17295|03/29/2022|||LIPOTROPICS: OTHER|9886|||||No|No||RHODES PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|42858013901|HYDROCODONE-ACETAMIN 7.5-300|100|EA|.1204|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.2429|03/29/2022|.23707|03/29/2022|.23864|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9887|||||No|No||RHODES PHARMACE|No||||
fenofibrate,micronized|No|No|No|No|75%|42858020001|FENOFIBRATE 200 MG CAPSULE|100|EA||11/10/2017||Yes|No||11/10/2017||Yes|No|11/10/2017||Yes|No||||No|No|||Prescription required|No||055|No|.22993|03/29/2022|.22441|03/29/2022|.2259|03/29/2022|||LIPOTROPICS: OTHER|9888|||||No|No||RHODES PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|42858020101|HYDROCODONE-ACETAMIN 5-325 MG|100|EA|.06493|08/14/2019||Yes|No||08/14/2019||Yes|No|08/14/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9889|||||No|No||RHODES PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|42858020150|HYDROCODONE-ACETAMIN 5-325 MG|500|EA|.05843|08/14/2019||Yes|No||08/14/2019||Yes|No|08/14/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9890|||||No|No||RHODES PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|42858020201|HYDROCODONE-ACETAMIN 7.5-325|100|EA|.07353|08/14/2019||Yes|No||08/14/2019||Yes|No|08/14/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9891|||||No|No||RHODES PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|42858020301|HYDROCODONE-ACETAMIN 10-325 MG|100|EA|.08643|08/14/2019||Yes|No||08/14/2019||Yes|No|08/14/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9892|||||No|No||RHODES PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|42858020350|HYDROCODONE-ACETAMIN 10-325 MG|500|EA|.07778|08/14/2019||Yes|No||08/14/2019||Yes|No|08/14/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9893|||||No|No||RHODES PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|42858021501|DEXTROAMP-AMPHET ER 15 MG CAP|100|EA|.258|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55636|03/29/2022|.543|03/29/2022|.54662|03/29/2022|||STIMULANTS AND RELATED AGENTS|9894|||||No|No||RHODES PHARMACE|No||||
dexmethylphenidate HCl|No|No|No|No|75%|42858022501|DEXMETHYLPHENIDATE 5 MG TAB|100|EA|.2365|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|.16938|03/29/2022|.16531|03/29/2022|.16641|03/29/2022|||STIMULANTS AND RELATED AGENTS|9895|||||No|No||RHODES PHARMACE|No||||
hydromorphone HCl|No|No|No|No|90%|42858023401|DILAUDID 4 MG TABLET|100|EA|1.63352|08/29/2017||Yes|No||08/29/2017||Yes|No|08/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|109|Yes|3.72292|08/06/2019|3.66973|08/06/2019|3.49498|08/06/2019|||ANALGESICS: NARCOTICS SHORT|9896|||||No|No||RHODES PHARMACE|No||||
hydromorphone HCl|No|No|No|No|90%|42858023450|DILAUDID 4 MG TABLET|500|EA|1.55618|08/29/2017||Yes|No||08/29/2017||Yes|No|08/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|109|Yes|3.54665|08/06/2019|3.49599|08/06/2019|3.32951|08/06/2019|||ANALGESICS: NARCOTICS SHORT|9897|||||No|No||RHODES PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|42858023801|HYDROCODONE-ACETAMIN 10-300 MG|100|EA|.129|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.34815|03/29/2022|.33979|03/29/2022|.34205|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9898|||||No|No||RHODES PHARMACE|No||||
hydromorphone HCl|No|No|No|No|90%|42858030101|HYDROMORPHONE 2 MG TABLET|100|EA|.0387|03/29/2010||Yes|No||03/29/2010||Yes|No|03/29/2010||Yes|No||||No|No|||Prescription required|No||109|Yes|.0744|03/29/2022|.07261|03/29/2022|.07309|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9899|||||No|No||RHODES PHARMACE|No||||
hydromorphone HCl|No|No|No|No|90%|42858030201|HYDROMORPHONE 4 MG TABLET|100|EA|.05263|03/29/2010||Yes|No||03/29/2010||Yes|No|03/29/2010||Yes|No||||No|No|||Prescription required|No||109|Yes|.09714|03/29/2022|.0948|03/29/2022|.09544|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9900|||||No|No||RHODES PHARMACE|No||||
hydromorphone HCl|No|No|No|No|90%|42858030250|HYDROMORPHONE 4 MG TABLET|500|EA|.04386|03/29/2010||Yes|No||03/29/2010||Yes|No|03/29/2010||Yes|No||||No|No|||Prescription required|No||109|Yes|.09714|03/29/2022|.0948|03/29/2022|.09544|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9901|||||No|No||RHODES PHARMACE|No||||
hydromorphone HCl|No|No|No|No|90%|42858030301|HYDROMORPHONE 8 MG TABLET|100|EA|.2193|03/29/2010||Yes|No||03/29/2010||Yes|No|03/29/2010||Yes|No||||No|No|||Prescription required|No||109|Yes|.27467|03/29/2022|.26807|03/29/2022|.26986|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9902|||||No|No||RHODES PHARMACE|No||||
hydromorphone HCl|No|No|No|No|90%|42858030416|HYDROMORPHONE 5 MG/5 ML SOLN|473|ML|.13753|06/10/2013||Yes|No||06/10/2013||Yes|No|06/10/2013||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|109|Yes|.24066|03/29/2022|.23488|03/29/2022|.23644|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9903|||||No|No||RHODES PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|42858032501|DEXTROAMP-AMPHET ER 25 MG CAP|100|EA|.258|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.54687|03/29/2022|.53374|03/29/2022|.53729|03/29/2022|||STIMULANTS AND RELATED AGENTS|9904|||||No|No||RHODES PHARMACE|No||||
hydromorphone HCl|No|No|No|No|90%|42858033801|DILAUDID 8 MG TABLET|100|EA|2.97306|08/29/2017||Yes|No||08/29/2017||Yes|No|08/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|109|Yes|6.77581|08/06/2019|6.67902|08/06/2019|6.36097|08/06/2019|||ANALGESICS: NARCOTICS SHORT|9905|||||No|No||RHODES PHARMACE|No||||
buprenorphine|No|No|No|No|90%|42858035340|BUPRENORPHINE 7.5 MCG/HR PATCH|4|EA|32.32095|03/14/2018||Yes|No||03/14/2018||Yes|No|03/14/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|110|Yes|65.15568|03/29/2022|63.59194|03/29/2022|64.01545|03/29/2022|||ANALGESICS: NARCOTICS LONG|9906|||||No|No||RHODES PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|42858040145|APTENSIO XR 10 MG CAPSULE|90|EA|3.58485|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|8.17014|08/06/2019|8.05342|08/06/2019|7.66992|08/06/2019|||STIMULANTS AND RELATED AGENTS|9907|||||No|No||RHODES PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|42858040245|APTENSIO XR 15 MG CAPSULE|90|EA|3.58485|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|8.17014|02/23/2021|8.05342|02/23/2021|7.66992|02/23/2021|||STIMULANTS AND RELATED AGENTS|9908|||||No|No||RHODES PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|42858040345|APTENSIO XR 20 MG CAPSULE|90|EA|3.58485|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|8.17014|08/06/2019|8.05342|08/06/2019|7.66992|08/06/2019|||STIMULANTS AND RELATED AGENTS|9909|||||No|No||RHODES PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|42858040445|APTENSIO XR 30 MG CAPSULE|90|EA|3.58485|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|8.17014|04/27/2021|8.05342|04/27/2021|7.66992|04/27/2021|||STIMULANTS AND RELATED AGENTS|9910|||||No|No||RHODES PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|42858040545|APTENSIO XR 40 MG CAPSULE|90|EA|3.58485|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|8.17014|01/26/2021|8.05342|01/26/2021|7.66992|01/26/2021|||STIMULANTS AND RELATED AGENTS|9911|||||No|No||RHODES PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|42858040645|APTENSIO XR 50 MG CAPSULE|90|EA|3.58485|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|8.17014|08/24/2021|8.05342|08/24/2021|7.66992|08/24/2021|||STIMULANTS AND RELATED AGENTS|9912|||||No|No||RHODES PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|42858040745|APTENSIO XR 60 MG CAPSULE|90|EA|3.58485|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|8.17014|07/27/2021|8.05342|07/27/2021|7.66992|07/27/2021|||STIMULANTS AND RELATED AGENTS|9913|||||No|No||RHODES PHARMACE|No||||
dexmethylphenidate HCl|No|No|No|No|75%|42858041001|DEXMETHYLPHENIDATE 10 MG TAB|100|EA|.301|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|.29016|03/29/2022|.28319|03/29/2022|.28508|03/29/2022|||STIMULANTS AND RELATED AGENTS|9914|||||No|No||RHODES PHARMACE|No||||
hydromorphone HCl|No|No|No|No|90%|42858041616|DILAUDID 5 MG/5 ML ORAL LIQUID|473|ML|.43316|08/29/2017||Yes|No||08/29/2017||Yes|No|08/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|109|Yes|.98722|08/06/2019|.97311|08/06/2019|.92678|08/06/2019|||ANALGESICS: NARCOTICS SHORT|9915|||||No|No||RHODES PHARMACE|No||||
fenofibrate|No|No|No|No|75%|42858045445|FENOFIBRATE 54 MG TABLET|90|EA||11/10/2017||Yes|No||11/10/2017||Yes|No|11/10/2017||Yes|No||||No|No|||Prescription required|No||055|No|.1459|03/29/2022|.14239|03/29/2022|.14334|03/29/2022|||LIPOTROPICS: OTHER|9916|||||No|No||RHODES PHARMACE|No||||
buprenorphine|No|No|No|No|90%|42858049340|BUPRENORPHINE 10 MCG/HR PATCH|4|EA|34.63005|03/14/2018||Yes|No||03/14/2018||Yes|No|03/14/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|110|Yes|66.68301|03/29/2022|65.08261|03/29/2022|65.51605|03/29/2022|||ANALGESICS: NARCOTICS LONG|9917|||||No|No||RHODES PHARMACE|No||||
buprenorphine HCl|No|No|No|No|90%|42858050103|BUPRENORPHINE 2 MG TABLET SL|30|EA|.13215|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||145|Yes|.37925|03/29/2022|.37014|03/29/2022|.37261|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|9918|||||No|No||RHODES PHARMACE|Yes|09/01/2020|||
buprenorphine HCl|No|No|No|No|90%|42858050203|BUPRENORPHINE 8 MG TABLET SL|30|EA|.258|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||145|Yes|.77298|03/29/2022|.75442|03/29/2022|.75945|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|9919|||||No|No||RHODES PHARMACE|Yes|09/01/2020|||
morphine sulfate|No|No|No|No|90%|42858051501|MS CONTIN ER 15 MG TABLET|100|EA|1.81017|01/03/2018||Yes|No||01/03/2018||Yes|No|01/03/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|110|Yes|4.1255|08/06/2019|4.06657|08/06/2019|3.87292|08/06/2019|||ANALGESICS: NARCOTICS LONG|9920|||||No|No||RHODES PHARMACE|No||||
buprenorphine|No|No|No|No|90%|42858058640|BUPRENORPHINE 15 MCG/HR PATCH|4|EA|49.95417|03/14/2018||Yes|No||03/14/2018||Yes|No|03/14/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|110|Yes|99.0625|03/29/2022|96.685|03/29/2022|97.3289|03/29/2022|||ANALGESICS: NARCOTICS LONG|9921|||||No|No||RHODES PHARMACE|No||||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|42858060103|BUPRENORPHINE-NALOX 2-0.5MG TB|30|EA|1.61751|11/22/2021||Yes|No||11/22/2021||Yes|No|11/22/2021||Yes|No||||No|No|||Prescription required|No||145|Yes|.72296|03/29/2022|.7056|03/29/2022|.7103|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|9922|||||No|No||RHODES PHARMACE|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|42858060203|BUPRENORPHINE-NALOX 8-2 MG TAB|30|EA|2.82338|03/29/2022||Yes|No||03/29/2022||Yes|No|03/29/2022||Yes|No||||No|No|||Prescription required|No||145|Yes|1.08568|03/29/2022|1.05962|03/29/2022|1.06668|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|9923|||||No|No||RHODES PHARMACE|Yes|09/01/2020|||
dextroamphetamine/amphetamine|No|No|No|No|75%|42858061001|DEXTROAMP-AMPHET ER 10 MG CAP|100|EA|.258|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.53198|03/29/2022|.51921|03/29/2022|.52267|03/29/2022|||STIMULANTS AND RELATED AGENTS|9924|||||No|No||RHODES PHARMACE|No||||
morphine sulfate|No|No|No|No|90%|42858063101|MS CONTIN ER 30 MG TABLET|100|EA|3.43974|01/03/2018||Yes|No||01/03/2018||Yes|No|01/03/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|110|Yes|7.83941|08/06/2019|7.72742|08/06/2019|7.35944|08/06/2019|||ANALGESICS: NARCOTICS LONG|9925|||||No|No||RHODES PHARMACE|No||||
fenofibrate|No|No|No|No|75%|42858066045|FENOFIBRATE 160 MG TABLET|90|EA||11/10/2017||Yes|No||11/10/2017||Yes|No|11/10/2017||Yes|No||||No|No|||Prescription required|No||055|No|.1612|03/29/2022|.15733|03/29/2022|.15837|03/29/2022|||LIPOTROPICS: OTHER|9926|||||No|No||RHODES PHARMACE|No||||
theophylline anhydrous|No|No|No|No|75%|42858070101|THEOPHYLLINE ER 400 MG TABLET|100|EA|.44655|07/25/2012||Yes|No||07/25/2012||Yes|No|07/25/2012||Yes|No||||No|No|||Prescription required|No|||Yes|.77069|03/29/2022|.75219|03/29/2022|.7572|03/29/2022||||9927|||||No|No||RHODES PHARMACE|No||||
theophylline anhydrous|No|No|No|No|75%|42858070201|THEOPHYLLINE ER 600 MG TABLET|100|EA|.6453|07/25/2012||Yes|No||07/25/2012||Yes|No|07/25/2012||Yes|No||||No|No|||Prescription required|No|||Yes|1.3129|11/23/2021|1.28139|11/23/2021|1.28992|11/23/2021||||9928|||||No|No||RHODES PHARMACE|No||||
paroxetine HCl|Yes|No|No|No|75%|42858070303|PAROXETINE ER 12.5 MG TABLET|30|EA|.57333|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No||||No|No|06/18/2019||Prescription required|Yes|07/26/2018|008|Yes|.80099|03/29/2022|.78176|03/29/2022|.78697|03/29/2022|||ANTIDEPRESSANTS: SSRIs|9929|||||No|No||RHODES PHARMACE|No||||
paroxetine HCl|Yes|No|No|No|75%|42858070503|PAROXETINE ER 25 MG TABLET|30|EA|.61633|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No||||No|No|06/18/2019||Prescription required|Yes|07/26/2018|008|No|1.16217|03/29/2022|1.13427|03/29/2022|1.14183|03/29/2022|||ANTIDEPRESSANTS: SSRIs|9930|||||No|No||RHODES PHARMACE|No||||
paroxetine HCl|Yes|No|No|No|75%|42858070703|PAROXETINE ER 37.5 MG TABLET|30|EA|.65933|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No||||No|No|06/18/2019||Prescription required|Yes|07/26/2018|008|No|1.12249|03/29/2022|1.09555|03/29/2022|1.10284|03/29/2022|||ANTIDEPRESSANTS: SSRIs|9931|||||No|No||RHODES PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|42858072001|DEXTROAMP-AMPHET ER 20 MG CAP|100|EA|.258|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.58746|03/29/2022|.57336|03/29/2022|.57717|03/29/2022|||STIMULANTS AND RELATED AGENTS|9932|||||No|No||RHODES PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|42858072101|DEXTROAMP-AMPHETAMINE 5 MG TAB|100|EA|.06213|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.21985|03/28/2022|.21457|03/28/2022|.216|03/28/2022|||STIMULANTS AND RELATED AGENTS|9933|||||No|No||RHODES PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|42858072201|DEXTROAMP-AMPHETAM 7.5 MG TAB|100|EA|.09915|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.45915|03/28/2022|.44813|03/28/2022|.45111|03/28/2022|||STIMULANTS AND RELATED AGENTS|9934|||||No|No||RHODES PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|42858072301|DEXTROAMP-AMPHETAMIN 10 MG TAB|100|EA|.06819|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.24071|03/28/2022|.23493|03/28/2022|.23649|03/28/2022|||STIMULANTS AND RELATED AGENTS|9935|||||No|No||RHODES PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|42858072401|DEXTROAMP-AMPHETAM 12.5 MG TAB|100|EA|.22286|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.65907|03/28/2022|.64325|03/28/2022|.64753|03/28/2022|||STIMULANTS AND RELATED AGENTS|9936|||||No|No||RHODES PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|42858072501|DEXTROAMP-AMPHETAMIN 15 MG TAB|100|EA|.08152|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.25605|03/28/2022|.2499|03/28/2022|.25156|03/28/2022|||STIMULANTS AND RELATED AGENTS|9937|||||No|No||RHODES PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|42858072601|DEXTROAMP-AMPHETAMIN 20 MG TAB|100|EA|.08165|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.31357|03/28/2022|.30604|03/28/2022|.30808|03/28/2022|||STIMULANTS AND RELATED AGENTS|9938|||||No|No||RHODES PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|42858072701|DEXTROAMP-AMPHETAMIN 30 MG TAB|100|EA|.11502|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.30925|03/28/2022|.30182|03/28/2022|.30383|03/28/2022|||STIMULANTS AND RELATED AGENTS|9939|||||No|No||RHODES PHARMACE|No||||
buprenorphine|No|No|No|No|90%|42858075040|BUPRENORPHINE 5 MCG/HR PATCH|4|EA|23.0867|03/14/2018||Yes|No||03/14/2018||Yes|No|03/14/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|110|Yes|35.41903|03/29/2022|34.56897|03/29/2022|34.79919|03/29/2022|||ANALGESICS: NARCOTICS LONG|9940|||||No|No||RHODES PHARMACE|No||||
morphine sulfate|No|No|No|No|90%|42858076001|MS CONTIN ER 60 MG TABLET|100|EA|6.71195|01/03/2018||Yes|No||01/03/2018||Yes|No|01/03/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|110|Yes|15.29701|04/07/2020|15.07848|04/07/2020|14.36046|04/07/2020|||ANALGESICS: NARCOTICS LONG|9941|||||No|No||RHODES PHARMACE|No||||
morphine sulfate|No|No|No|No|90%|42858079901|MS CONTIN ER 100 MG TABLET|100|EA|9.93742|01/03/2018||Yes|No||01/03/2018||Yes|No|01/03/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|110|Yes|22.64809|08/06/2019|22.32454|08/06/2019|21.26147|08/06/2019|||ANALGESICS: NARCOTICS LONG|9942|||||No|No||RHODES PHARMACE|No||||
morphine sulfate|No|No|No|No|90%|42858080101|MORPHINE SULF ER 15 MG TABLET|100|EA|.13833|01/17/2011||Yes|No||01/17/2011||Yes|No|01/17/2011||Yes|No||||No|No|||Prescription required|No||110|Yes|.19105|03/29/2022|.18646|03/29/2022|.1877|03/29/2022|||ANALGESICS: NARCOTICS LONG|9943|||||No|No||RHODES PHARMACE|No||||
morphine sulfate|No|No|No|No|90%|42858080201|MORPHINE SULF ER 30 MG TABLET|100|EA|.2629|01/17/2011||Yes|No||01/17/2011||Yes|No|01/17/2011||Yes|No||||No|No|||Prescription required|No||110|Yes|.34621|03/29/2022|.3379|03/29/2022|.34015|03/29/2022|||ANALGESICS: NARCOTICS LONG|9944|||||No|No||RHODES PHARMACE|No||||
morphine sulfate|No|No|No|No|90%|42858080301|MORPHINE SULF ER 60 MG TABLET|100|EA|.50228|01/17/2011||Yes|No||01/17/2011||Yes|No|01/17/2011||Yes|No||||No|No|||Prescription required|No||110|Yes|.55429|03/29/2022|.54098|03/29/2022|.54458|03/29/2022|||ANALGESICS: NARCOTICS LONG|9945|||||No|No||RHODES PHARMACE|No||||
morphine sulfate|No|No|No|No|90%|42858080401|MORPHINE SULF ER 100 MG TABLET|100|EA|.7595|01/17/2011||Yes|No||01/17/2011||Yes|No|01/17/2011||Yes|No||||No|No|||Prescription required|No||110|Yes|1.04927|03/29/2022|1.02408|03/29/2022|1.0309|03/29/2022|||ANALGESICS: NARCOTICS LONG|9946|||||No|No||RHODES PHARMACE|No||||
morphine sulfate|No|No|No|No|90%|42858080501|MORPHINE SULF ER 200 MG TABLET|100|EA|1.39092|01/17/2011||Yes|No||01/17/2011||Yes|No|01/17/2011||Yes|No||||No|No|||Prescription required|No||110|Yes|2.54414|07/27/2021|2.48308|07/27/2021|2.49961|07/27/2021|||ANALGESICS: NARCOTICS LONG|9947|||||No|No||RHODES PHARMACE|No||||
buprenorphine|No|No|No|No|90%|42858083940|BUPRENORPHINE 20 MCG/HR PATCH|4|EA|61.30725|03/14/2018||Yes|No||03/14/2018||Yes|No|03/14/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|110|Yes|115.06922|03/29/2022|112.30755|03/29/2022|113.0555|03/29/2022|||ANALGESICS: NARCOTICS LONG|9948|||||No|No||RHODES PHARMACE|No||||
dronabinol|No|No|No|No|75%|42858086706|DRONABINOL 2.5 MG CAPSULE|60|EA|.72562|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|085|No|1.39891|03/29/2022|1.36533|03/29/2022|1.37442|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|9949|||||No|No||RHODES PHARMACE|No||||
dronabinol|No|No|No|No|75%|42858086806|DRONABINOL 5 MG CAPSULE|60|EA|1.51223|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|085|No|2.55851|03/29/2022|2.4971|03/29/2022|2.51373|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|9950|||||No|No||RHODES PHARMACE|No||||
dronabinol|No|No|No|No|75%|42858086906|DRONABINOL 10 MG CAPSULE|60|EA|2.32479|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|085|No|3.9278|03/29/2022|3.83353|03/29/2022|3.85906|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|9951|||||No|No||RHODES PHARMACE|No||||
morphine sulfate|No|No|No|No|90%|42858090001|MS CONTIN ER 200 MG TABLET|100|EA|18.19927|01/03/2018||Yes|No||01/03/2018||Yes|No|01/03/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|110|Yes|41.47742|08/06/2019|40.88488|08/06/2019|38.93798|08/06/2019|||ANALGESICS: NARCOTICS LONG|9952|||||No|No||RHODES PHARMACE|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|42858093001|DEXTROAMP-AMPHET ER 30 MG CAP|100|EA|1.62737|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.61484|03/29/2022|.60008|03/29/2022|.60408|03/29/2022|||STIMULANTS AND RELATED AGENTS|9953|||||No|No||RHODES PHARMACE|No||||
iloperidone|No|No|No|No|75%|43068010102|FANAPT 1 MG TABLET|60|EA|11.58312|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|25.73356|08/17/2021|25.11595|08/17/2021|25.28322|08/17/2021|||ANTIPSYCHOTICS|9954|||||No|No||VANDA PHARMACEU|No||||
iloperidone|No|No|No|No|75%|43068010202|FANAPT 2 MG TABLET|60|EA|11.58312|08/01/2016||Yes|No||08/01/2016||Yes|No|08/01/2016||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|26.00299|08/17/2021|25.37891|08/17/2021|25.54793|08/17/2021|||ANTIPSYCHOTICS|9955|||||No|No||VANDA PHARMACEU|No||||
iloperidone|No|No|No|No|75%|43068010402|FANAPT 4 MG TABLET|60|EA|11.58312|12/08/2015||Yes|No||12/08/2015||Yes|No|12/08/2015||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|25.65976|08/17/2021|25.04392|08/17/2021|25.21071|08/17/2021|||ANTIPSYCHOTICS|9956|||||No|No||VANDA PHARMACEU|No||||
iloperidone|No|No|No|No|75%|43068010602|FANAPT 6 MG TABLET|60|EA|14.25235|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|31.77896|08/17/2021|31.01626|08/17/2021|31.22282|08/17/2021|||ANTIPSYCHOTICS|9957|||||No|No||VANDA PHARMACEU|No||||
iloperidone|No|No|No|No|75%|43068010802|FANAPT 8 MG TABLET|60|EA|14.25235|10/06/2015||Yes|No||10/06/2015||Yes|No|10/06/2015||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|31.75679|08/17/2021|30.99462|08/17/2021|31.20104|08/17/2021|||ANTIPSYCHOTICS|9958|||||No|No||VANDA PHARMACEU|No||||
iloperidone|No|No|No|No|75%|43068011002|FANAPT 10 MG TABLET|60|EA|22.82446|03/28/2016||Yes|No||03/28/2016||Yes|No|03/28/2016||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|50.66493|08/17/2021|49.44897|08/17/2021|49.77829|08/17/2021|||ANTIPSYCHOTICS|9959|||||No|No||VANDA PHARMACEU|No||||
iloperidone|No|No|No|No|75%|43068011202|FANAPT 12 MG TABLET|60|EA|22.82446|09/15/2016||Yes|No||09/15/2016||Yes|No|09/15/2016||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|50.82423|08/17/2021|49.60444|08/17/2021|49.9348|08/17/2021|||ANTIPSYCHOTICS|9960|||||No|No||VANDA PHARMACEU|No||||
iloperidone|No|No|No|No|75%|43068011304|FANAPT TITRATION PACK|8|EA|11.5842|03/01/2016||Yes|No||03/01/2016||Yes|No|03/01/2016||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|26.4012|08/10/2021|26.02404|08/10/2021|24.7848|08/10/2021|||ANTIPSYCHOTICS|9961|||||No|No||VANDA PHARMACEU|No||||
tasimelteon|No|No|No|No|75%|43068022001|HETLIOZ 20 MG CAPSULE|30|EA|314.52722|10/21/2014||Yes|No||10/21/2014||Yes|No|10/21/2014||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|054|Yes|716.82948|08/10/2021|706.58906|08/10/2021|672.94196|08/10/2021|||SEDATIVE HYPNOTICS|9962|||||No|No||VANDA PHARMACEU|No||||
tasimelteon|No|No|No|No|75%|43068030402|HETLIOZ LQ 4 MG/ML SUSPENSION|48|ML|62.90541|06/14/2021||Yes|No||06/14/2021||Yes|No|06/14/2021||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|054|Yes|143.36582|08/10/2021|141.31774|08/10/2021|134.58832|08/10/2021|||SEDATIVE HYPNOTICS|9963|||||No|No||VANDA PHARMACEU|No||||
tasimelteon|No|No|No|No|75%|43068030406|HETLIOZ LQ 4 MG/ML SUSPENSION|158|ML|62.90543|06/14/2021||Yes|No||06/14/2021||Yes|No|06/14/2021||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|054|Yes|143.36586|08/10/2021|141.31778|08/10/2021|134.58836|08/10/2021|||SEDATIVE HYPNOTICS|9964|||||No|No||VANDA PHARMACEU|No||||
hyoscyamine sulfate|No|No|No|No|75%|43199001101|HYOSCYAMINE 0.125 MG TAB SL|100|EA|.29197|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|.14293|03/29/2022|.13949|03/29/2022|.14042|03/29/2022||||9965|||||No|No||COUNTY/ALVOGEN|No||||
hyoscyamine sulfate|No|No|No|No|75%|43199001201|HYOSCYAMINE 0.125 MG ODT|100|EA|.29025|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|.20067|03/29/2022|.19585|03/29/2022|.19715|03/29/2022||||9966|||||No|No||COUNTY/ALVOGEN|No||||
hyoscyamine sulfate|No|No|No|No|75%|43199001301|HYOSCYAMINE SULF 0.125 MG TAB|100|EA|.28853|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|.1455|03/29/2022|.142|03/29/2022|.14295|03/29/2022||||9967|||||No|No||COUNTY/ALVOGEN|No||||
fenfluramine HCl|No|No|No|No|75%|43376032236|FINTEPLA 2.2 MG/ML SOLUTION|360|ML|20.0595|02/01/2021||Yes|No||02/01/2021||Yes|No|02/01/2021||Yes|No||||No|No|||Prescription required|No||056|No|45.717|07/06/2021|45.0639|07/06/2021|42.918|07/06/2021|||ANTICONVULSANTS|9968|||||No|No||ZOGENIX, INC.|No||||
fluocinonide|No|No|No|No|75%|43386002602|FLUOCINONIDE 0.05% SOLUTION|20|ML|.99029|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|.47513|03/29/2022|.46372|03/29/2022|.46681|03/29/2022|||STEROIDS: TOPICAL HIGH|9969|||||No|No||LUPIN PHARMACEU|No||||
fluocinonide|No|No|No|No|75%|43386002606|FLUOCINONIDE 0.05% SOLUTION|60|ML|.66441|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|.3579|03/29/2022|.34931|03/29/2022|.35163|03/29/2022|||STEROIDS: TOPICAL HIGH|9970|||||No|No||LUPIN PHARMACEU|No||||
clobetasol propionate|No|No|No|No|75%|43386002860|CLOBETASOL 0.05% SOLUTION|50|ML|1.118|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||||No|No|||Prescription required|No||121|No|.35501|03/29/2022|.34648|03/29/2022|.34879|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|9971|||||No|No||LUPIN PHARMACEU|No||||
voriconazole|No|No|No|No|75%|43386003860|VORICONAZOLE 40 MG/ML SUSP|75|ML|4.8403|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|069|No|11.03139|06/01/2018|10.8738|06/01/2018|10.356|06/01/2018|||ANTIFUNGALS: ORAL|9972|||||No|No||LUPIN PHARMACEU|No||||
sodium chloride/NaHCO3/KCl/peg|No|No|No|No|75%|43386005019|GAVILYTE-N SOLUTION|4000|ML|.00202|10/01/2009||Yes|No||10/01/2009||Yes|No|10/01/2009||Yes|No||||No|No|||Prescription required|No|||No|.00933|03/29/2022|.0091|03/29/2022|.00916|03/29/2022||||9973|||||No|No||GAVIS/LUPIN|No||||
peg3350/sod sulf,bicarb,Cl/KCl|No|No|No|No|75%|43386006019|GAVILYTE-C SOLUTION|4000|ML|.00136|10/01/2009||Yes|No||10/01/2009||Yes|No|10/01/2009||Yes|No||||No|No|||Prescription required|No|||No|.00264|03/29/2022|.00257|03/29/2022|.00259|03/29/2022||||9974|||||No|No||GAVIS/LUPIN|No||||
peg3350/sod sulf,bicarb,Cl/KCl|No|No|No|No|75%|43386009019|GAVILYTE-G SOLUTION|4000|ML|.00169|10/01/2009||Yes|No||10/01/2009||Yes|No|10/01/2009||Yes|No||||No|No|||Prescription required|No|||No|.00317|03/29/2022|.00309|03/29/2022|.00311|03/29/2022||||9975|||||No|No||GAVIS/LUPIN|No||||
clobetasol propionate|No|No|No|No|75%|43386009660|CLOBETASOL 0.05% OINTMENT|15|GM|.89124|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|||Prescription required|No||121|No|.35914|03/29/2022|.35052|03/29/2022|.35285|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|9976|||||No|No||LUPIN PHARMACEU|No||||
clobetasol propionate|No|No|No|No|75%|43386009661|CLOBETASOL 0.05% OINTMENT|30|GM|.74461|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|||Prescription required|No||121|No|.3756|03/29/2022|.36658|03/29/2022|.36902|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|9977|||||No|No||LUPIN PHARMACEU|No||||
clobetasol propionate|No|No|No|No|75%|43386009662|CLOBETASOL 0.05% OINTMENT|60|GM|.74461|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|||Prescription required|No||121|No|.32004|03/29/2022|.31235|03/29/2022|.31443|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|9978|||||No|No||LUPIN PHARMACEU|No||||
clobetasol propionate|No|No|No|No|75%|43386009663|CLOBETASOL 0.05% OINTMENT|45|GM|.79349|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|||Prescription required|No||121|No|.36764|03/29/2022|.35881|03/29/2022|.3612|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|9979|||||No|No||LUPIN PHARMACEU|No||||
hydrocodone bit/homatrop me-br|No|No|No|No|90%|43386011801|HYDROCODONE-HOMATROPINE 5-1.5|100|EA|.33303|02/04/2015|04/05/2022|Yes|No||02/04/2015|04/05/2022|Yes|No|02/04/2015|04/05/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|183|Yes|.88201|03/29/2022|.86084|03/29/2022|.86657|03/29/2022|||COUGH AND COLD: NARCOTIC|9980|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GAVIS/LUPIN|No||||
methylergonovine maleate|No|No|No|No|75%|43386014012|METHYLERGONOVINE 0.2 MG TABLET|12|EA|23.12683|08/28/2018|04/06/2022|Yes|No||08/28/2018|04/06/2022|Yes|No|08/28/2018|04/06/2022|Yes|No||||No|No|||Prescription required|No|||No|13.46155|05/25/2021|13.13847|05/25/2021|13.22597|05/25/2021||||9981|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LUPIN PHARMACEU|No||||
methylergonovine maleate|No|No|No|No|75%|43386014028|METHYLERGONOVINE 0.2 MG TABLET|28|EA|23.11357|10/22/2017|04/06/2022|Yes|No||10/22/2017|04/06/2022|Yes|No|10/22/2017|04/06/2022|Yes|No||||No|No|||Prescription required|No|||No|13.46155|05/25/2021|13.13847|05/25/2021|13.22597|05/25/2021||||9982|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LUPIN PHARMACEU|No||||
misoprostol|No|No|No|No|75%|43386016006|MISOPROSTOL 100 MCG TABLET|60|EA|.28451|10/17/2013||Yes|No||10/17/2013||Yes|No|10/17/2013||Yes|No||||No|No|||Prescription required|No|||No|.47956|03/29/2022|.46805|03/29/2022|.47116|03/29/2022||||9983|||||No|No||GAVIS/LUPIN|No||||
misoprostol|No|No|No|No|75%|43386016012|MISOPROSTOL 100 MCG TABLET|120|EA|.28487|10/17/2013||Yes|No||10/17/2013||Yes|No|10/17/2013||Yes|No||||No|No|||Prescription required|No|||No|.47956|03/29/2022|.46805|03/29/2022|.47116|03/29/2022||||9984|||||No|No||GAVIS/LUPIN|No||||
misoprostol|No|No|No|No|75%|43386016101|MISOPROSTOL 200 MCG TABLET|100|EA|.41495|10/17/2013||Yes|No||10/17/2013||Yes|No|10/17/2013||Yes|No||||No|No|||Prescription required|No|||No|.71283|03/29/2022|.69572|03/29/2022|.70035|03/29/2022||||9985|||||No|No||GAVIS/LUPIN|No||||
misoprostol|No|No|No|No|75%|43386016106|MISOPROSTOL 200 MCG TABLET|60|EA|.41495|10/17/2013||Yes|No||10/17/2013||Yes|No|10/17/2013||Yes|No||||No|No|||Prescription required|No|||No|.71283|03/29/2022|.69572|03/29/2022|.70035|03/29/2022||||9986|||||No|No||GAVIS/LUPIN|No||||
potassium chloride|No|No|No|No|75%|43386016801|POTASSIUM CL 10% (20 MEQ/15ML)|473|ML|.16818|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|No|||No|.13625|03/29/2022|.13298|03/29/2022|.13386|03/29/2022||||9987|||||No|No||LUPIN PHARMACEU|No||||
potassium chloride|No|No|No|No|75%|43386016901|POTASSIUM CL 20% (40 MEQ/15ML)|473|ML|.33636|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|No|||No|.44086|03/01/2022|.43027|03/01/2022|.43314|03/01/2022||||9988|||||No|No||LUPIN PHARMACEU|No||||
potassium chloride|No|No|No|No|75%|43386019430|POTASSIUM CL 20 MEQ PACKET|30|EA|2.365|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No||||No|No|||Prescription required|No|||No|2.51484|03/29/2022|2.45448|03/29/2022|2.47083|03/29/2022||||9989|||||No|No||LUPIN PHARMACEU|No||||
trimethoprim|Yes|No|No|No|75%|43386033001|TRIMETHOPRIM 100 MG TABLET|100|EA|.13136|03/21/2012|04/02/2022|Yes|No||03/21/2012|04/02/2022|Yes|No|03/21/2012|04/02/2022|Yes|No||||No|No|07/01/2016|04/02/2022|Prescription required|No|||No|.56318|03/29/2022|.54966|03/29/2022|.55332|03/29/2022||||9990|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GAVIS/LUPIN|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|43386035101|HYDROCODONE-ACETAMIN 5-300 MG|100|EA|.60716|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.19231|03/29/2022|.18769|03/29/2022|.18894|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9991|||||No|No||LUPIN PHARMACEU|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|43386035105|HYDROCODONE-ACETAMIN 5-300 MG|500|EA|.5768|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.19231|03/29/2022|.18769|03/29/2022|.18894|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9992|||||No|No||LUPIN PHARMACEU|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|43386035201|HYDROCODONE-ACETAMIN 7.5-300|100|EA|.66478|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.2429|03/29/2022|.23707|03/29/2022|.23864|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9993|||||No|No||LUPIN PHARMACEU|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|43386035205|HYDROCODONE-ACETAMIN 7.5-300|500|EA|.63154|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.2429|03/29/2022|.23707|03/29/2022|.23864|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9994|||||No|No||LUPIN PHARMACEU|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|43386035301|HYDROCODONE-ACETAMIN 10-300 MG|100|EA|.85763|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.34815|03/29/2022|.33979|03/29/2022|.34205|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9995|||||No|No||LUPIN PHARMACEU|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|43386035305|HYDROCODONE-ACETAMIN 10-300 MG|500|EA|.81475|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.34815|03/29/2022|.33979|03/29/2022|.34205|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9996|||||No|No||LUPIN PHARMACEU|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|43386035601|HYDROCODONE-ACETAMIN 5-325 MG|100|EA|.07138|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9997|||||No|No||LUPIN PHARMACEU|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|43386035610|HYDROCODONE-ACETAMIN 5-325 MG|1000|EA|.07136|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9998|||||No|No||LUPIN PHARMACEU|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|43386035701|HYDROCODONE-ACETAMIN 7.5-325|100|EA|.0795|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|9999|||||No|No||LUPIN PHARMACEU|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|43386035801|HYDROCODONE-ACETAMIN 10-325 MG|100|EA|.09872|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|10000|||||No|No||LUPIN PHARMACEU|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|43386035810|HYDROCODONE-ACETAMIN 10-325 MG|1000|EA|.09871|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|10001|||||No|No||LUPIN PHARMACEU|No||||
phenelzine sulfate|No|No|No|No|75%|43386036021|PHENELZINE SULFATE 15 MG TAB|60|EA|.28272|01/14/2011||Yes|No||01/14/2011||Yes|No|01/14/2011||Yes|No||||No|No|||Prescription required|No||031|No|.5454|01/25/2022|.53231|01/25/2022|.53585|01/25/2022|||ANTIDEPRESSANTS: OTHER|10002|||||No|No||GAVIS/LUPIN|No||||
nitazoxanide|No|No|No|No|75%|43386040503|NITAZOXANIDE 500 MG TABLET|30|EA|51.96994|09/20/2021||Yes|No||09/20/2021||Yes|No|09/20/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|115|Yes|118.44312|09/20/2021|116.75107|09/20/2021|111.1915|09/20/2021|||ANTIBIOTICS: GI|10003|||||No|No||LUPIN PHARMACEU|No||||
nitazoxanide|No|No|No|No|75%|43386040512|NITAZOXANIDE 500 MG TABLET|12|EA|55.93941|09/20/2021||Yes|No||09/20/2021||Yes|No|09/20/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|115|Yes|127.48982|09/20/2021|125.66854|09/20/2021|119.68432|09/20/2021|||ANTIBIOTICS: GI|10004|||||No|No||LUPIN PHARMACEU|No||||
oxycodone HCl|No|No|No|No|90%|43386043001|OXYCODONE HCL (IR) 15 MG TAB|100|EA|.0817|05/20/2020|05/07/2022|Yes|No||05/20/2020|05/07/2022|Yes|No|05/20/2020|05/07/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|.15895|03/29/2022|.15513|03/29/2022|.15616|03/29/2022|||ANALGESICS: NARCOTICS SHORT|10005|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LUPIN PHARMACEU|No||||
oxycodone HCl|No|No|No|No|90%|43386043101|OXYCODONE HCL (IR) 30 MG TAB|100|EA|.1548|05/20/2020|05/07/2022|Yes|No||05/20/2020|05/07/2022|Yes|No|05/20/2020|05/07/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|.2615|03/29/2022|.25522|03/29/2022|.25692|03/29/2022|||ANALGESICS: NARCOTICS SHORT|10006|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LUPIN PHARMACEU|No||||
oxycodone HCl|No|No|No|No|90%|43386043201|OXYCODONE HCL (IR) 5 MG TABLET|100|EA|.043|05/20/2020|05/07/2022|Yes|No||05/20/2020|05/07/2022|Yes|No|05/20/2020|05/07/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|.0685|03/29/2022|.06685|03/29/2022|.0673|03/29/2022|||ANALGESICS: NARCOTICS SHORT|10007|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LUPIN PHARMACEU|No||||
oxycodone HCl|No|No|No|No|90%|43386043301|OXYCODONE HCL (IR) 10 MG TAB|100|EA|.0774|05/20/2020|05/07/2022|Yes|No||05/20/2020|05/07/2022|Yes|No|05/20/2020|05/07/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|.12568|03/29/2022|.12266|03/29/2022|.12348|03/29/2022|||ANALGESICS: NARCOTICS SHORT|10008|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LUPIN PHARMACEU|No||||
oxycodone HCl|No|No|No|No|90%|43386043401|OXYCODONE HCL (IR) 20 MG TAB|100|EA|.129|05/20/2020|05/07/2022|Yes|No||05/20/2020|05/07/2022|Yes|No|05/20/2020|05/07/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|.23193|03/29/2022|.22636|03/29/2022|.22787|03/29/2022|||ANALGESICS: NARCOTICS SHORT|10009|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LUPIN PHARMACEU|No||||
nifedipine|No|No|No|No|75%|43386044024|NIFEDIPINE 10 MG CAPSULE|100|EA|.30852|09/03/2010|04/05/2022|Yes|No||09/03/2010|04/05/2022|Yes|No|09/03/2010|04/05/2022|Yes|No||||No|No|||Prescription required|Yes|01/15/2014|045|No|.40848|03/29/2022|.39867|03/29/2022|.40133|03/29/2022|||CALCIUM CHANNEL BLOCKERS|10010|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GAVIS/LUPIN|No||||
nitrofurantoin|No|No|No|No|75%|43386045011|NITROFURANTOIN 25 MG/5 ML SUSP|230|ML|.88757|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|No|||No|2.02284|04/30/2019|1.99394|04/30/2019|1.89899|04/30/2019||||10011|||||No|No||GAVIS/LUPIN|No||||
orphenadrine citrate|No|No|No|No|75%|43386048024|ORPHENADRINE ER 100 MG TABLET|100|EA|.29885|04/01/2013||Yes|No||04/01/2013||Yes|No|04/01/2013||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|116|Yes|.33346|03/29/2022|.32545|03/29/2022|.32762|03/29/2022|||SKELETAL MUSCLE RELAXANTS|10012|||||No|No||GAVIS/LUPIN|No||||
orphenadrine citrate|No|No|No|No|75%|43386048026|ORPHENADRINE ER 100 MG TABLET|500|EA|.28767|04/01/2013||Yes|No||04/01/2013||Yes|No|04/01/2013||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|116|Yes|.33346|03/29/2022|.32545|03/29/2022|.32762|03/29/2022|||SKELETAL MUSCLE RELAXANTS|10013|||||No|No||GAVIS/LUPIN|No||||
orphenadrine citrate|No|No|No|No|75%|43386048028|ORPHENADRINE ER 100 MG TABLET|1000|EA|.27642|11/25/2013||Yes|No||11/25/2013||Yes|No|11/25/2013||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|116|Yes|.33608|08/24/2021|.32801|08/24/2021|.33019|08/24/2021|||SKELETAL MUSCLE RELAXANTS|10014|||||No|No||GAVIS/LUPIN|No||||
nystatin|No|No|No|No|75%|43386053001|NYSTATIN 100,000 UNIT/GM POWD|15|GM|.42856|06/01/2018|02/15/2022|Yes|No||06/01/2018|02/15/2022|Yes|No|06/01/2018|02/15/2022|Yes|No||||No|No|||Prescription required|No||061|No|.35016|03/29/2022|.34175|03/29/2022|.34403|03/29/2022|||ANTIFUNGALS: TOPICAL|10015|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GAVIS/LUPIN|No||||
nystatin|No|No|No|No|75%|43386053002|NYSTATIN 100,000 UNIT/GM POWD|30|GM|.41495|06/01/2018|02/15/2022|Yes|No||06/01/2018|02/15/2022|Yes|No|06/01/2018|02/15/2022|Yes|No||||No|No|||Prescription required|No||061|No|.30897|03/29/2022|.30155|03/29/2022|.30356|03/29/2022|||ANTIFUNGALS: TOPICAL|10016|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GAVIS/LUPIN|No||||
nystatin|No|No|No|No|75%|43386053006|NYSTATIN 100,000 UNIT/GM POWD|60|GM|.33647|11/17/2014|02/15/2022|Yes|No||11/17/2014|02/15/2022|Yes|No|11/17/2014|02/15/2022|Yes|No||||No|No|||Prescription required|No||061|No|.2597|03/29/2022|.25346|03/29/2022|.25515|03/29/2022|||ANTIFUNGALS: TOPICAL|10017|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GAVIS/LUPIN|No||||
tinidazole|Yes|No|No|No|75%|43386055004|TINIDAZOLE 250 MG TABLET|40|EA|1.71731|06/01/2018|04/02/2022|Yes|No||06/01/2018|04/02/2022|Yes|No|06/01/2018|04/02/2022|Yes|No||||No|No|06/01/2018|04/02/2022|Prescription required|No||115|No|3.91387|08/13/2019|3.85796|08/13/2019|3.67425|08/13/2019|||ANTIBIOTICS: GI|10018|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GAVIS/LUPIN|No||||
tinidazole|Yes|No|No|No|75%|43386055102|TINIDAZOLE 500 MG TABLET|20|EA|3.43462|06/01/2018|04/02/2022|Yes|No||06/01/2018|04/02/2022|Yes|No|06/01/2018|04/02/2022|Yes|No||||No|No|06/01/2018|04/02/2022|Prescription required|No||115|No|2.72139|03/29/2022|2.65607|03/29/2022|2.67376|03/29/2022|||ANTIBIOTICS: GI|10019|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GAVIS/LUPIN|No||||
methylphenidate HCl|No|No|No|No|75%|43386057001|METHYLPHENIDATE 2.5 MG CHEW TB|100|EA|1.06941|03/24/2015|04/02/2022|Yes|No||03/24/2015|04/02/2022|Yes|No|03/24/2015|04/02/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|2.0264|05/25/2021|1.97776|05/25/2021|1.99093|05/25/2021|||STIMULANTS AND RELATED AGENTS|10020|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GAVIS/LUPIN|No||||
methylphenidate HCl|No|No|No|No|75%|43386057101|METHYLPHENIDATE 5 MG CHEW TAB|100|EA|1.52779|03/24/2015|04/02/2022|Yes|No||03/24/2015|04/02/2022|Yes|No|03/24/2015|04/02/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|3.3966|11/23/2021|3.31508|11/23/2021|3.33715|11/23/2021|||STIMULANTS AND RELATED AGENTS|10021|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GAVIS/LUPIN|No||||
methylphenidate HCl|No|No|No|No|75%|43386057201|METHYLPHENIDATE 10 MG CHEW TAB|100|EA|2.17795|03/24/2015|04/02/2022|Yes|No||03/24/2015|04/02/2022|Yes|No|03/24/2015|04/02/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|2.68588|11/23/2021|2.62141|11/23/2021|2.63887|11/23/2021|||STIMULANTS AND RELATED AGENTS|10022|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GAVIS/LUPIN|No||||
methylphenidate HCl|No|No|No|No|75%|43386057301|METHYLPHENIDATE 5 MG TABLET|100|EA|.23822|02/22/2017|05/07/2022|Yes|No||02/22/2017|05/07/2022|Yes|No|02/22/2017|05/07/2022|Yes|No||||No|No|||Prescription required|No||007|Yes|.1394|03/29/2022|.13605|03/29/2022|.13696|03/29/2022|||STIMULANTS AND RELATED AGENTS|10023|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GAVIS/LUPIN|No||||
methylphenidate HCl|No|No|No|No|75%|43386057401|METHYLPHENIDATE 10 MG TABLET|100|EA|.33948|02/22/2017|05/07/2022|Yes|No||02/22/2017|05/07/2022|Yes|No|02/22/2017|05/07/2022|Yes|No||||No|No|||Prescription required|No||007|Yes|.15766|03/29/2022|.15387|03/29/2022|.1549|03/29/2022|||STIMULANTS AND RELATED AGENTS|10024|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GAVIS/LUPIN|No||||
methylphenidate HCl|No|No|No|No|75%|43386057501|METHYLPHENIDATE 20 MG TABLET|100|EA|.48805|02/22/2017|05/07/2022|Yes|No||02/22/2017|05/07/2022|Yes|No|02/22/2017|05/07/2022|Yes|No||||No|No|||Prescription required|No||007|Yes|.22814|03/29/2022|.22266|03/29/2022|.22414|03/29/2022|||STIMULANTS AND RELATED AGENTS|10025|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GAVIS/LUPIN|No||||
metoclopramide HCl|No|No|No|No|75%|43386058031|METOCLOPRAMIDE HCL 10 MG ODT|10|EA|3.2164|09/11/2017||Yes|No||09/11/2017||Yes|No|09/11/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|085|No|7.3304|09/11/2017|7.22568|09/11/2017|6.8816|09/11/2017|||ANTIEMETIC/ANTIVERTIGO AGENTS|10026|||||No|No||LUPIN PHARMACEU|No||||
metoclopramide HCl|No|No|No|No|75%|43386058131|METOCLOPRAMIDE HCL 5 MG ODT|10|EA|3.2164|09/11/2017||Yes|No||09/11/2017||Yes|No|09/11/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|085|No|7.3304|09/11/2017|7.22568|09/11/2017|6.8816|09/11/2017|||ANTIEMETIC/ANTIVERTIGO AGENTS|10027|||||No|No||LUPIN PHARMACEU|No||||
pentazocine HCl/naloxone HCl|No|No|No|No|90%|43386068001|PENTAZOCINE-NALOXONE TABLET|100|EA|.87655|12/19/2011||Yes|No||12/19/2011||Yes|No|12/19/2011||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|109|Yes|1.88962|03/01/2022|1.84426|03/01/2022|1.85655|03/01/2022|||ANALGESICS: NARCOTICS SHORT|10028|||||No|No||GAVIS/LUPIN|No||||
dexmethylphenidate HCl|No|No|No|No|75%|43386086001|DEXMETHYLPHENIDATE 5 MG TAB|100|EA|.31411|12/17/2015|05/07/2022|Yes|No||12/17/2015|05/07/2022|Yes|No|12/17/2015|05/07/2022|Yes|No||||No|No|||Prescription required|No||007|Yes|.16938|03/29/2022|.16531|03/29/2022|.16641|03/29/2022|||STIMULANTS AND RELATED AGENTS|10029|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GAVIS/LUPIN|No||||
dexmethylphenidate HCl|No|No|No|No|75%|43386086101|DEXMETHYLPHENIDATE 10 MG TAB|100|EA|.45171|03/28/2016|05/07/2022|Yes|No||03/28/2016|05/07/2022|Yes|No|03/28/2016|05/07/2022|Yes|No||||No|No|||Prescription required|No||007|Yes|.29016|03/29/2022|.28319|03/29/2022|.28508|03/29/2022|||STIMULANTS AND RELATED AGENTS|10030|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GAVIS/LUPIN|No||||
dexmethylphenidate HCl|No|No|No|No|75%|43386086201|DEXMETHYLPHENIDATE 2.5 MG TAB|100|EA|.22016|03/28/2016|05/07/2022|Yes|No||03/28/2016|05/07/2022|Yes|No|03/28/2016|05/07/2022|Yes|No||||No|No|||Prescription required|No||007|Yes|.13596|03/29/2022|.13269|03/29/2022|.13358|03/29/2022|||STIMULANTS AND RELATED AGENTS|10031|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GAVIS/LUPIN|No||||
dextroamphetamine sulfate|No|No|No|No|75%|43386087001|DEXTROAMPHETAMINE 5 MG TAB|100|EA|.5934|06/01/2018|07/23/2022|Yes|No||06/01/2018|07/23/2022|Yes|No|06/01/2018|07/23/2022|Yes|No||||No|No|||Prescription required|No||007|Yes|.24678|03/29/2022|.24085|03/29/2022|.24246|03/29/2022|||STIMULANTS AND RELATED AGENTS|10032|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GAVIS/LUPIN|No||||
dextroamphetamine sulfate|No|No|No|No|75%|43386087101|DEXTROAMPHETAMINE 10 MG TAB|100|EA|.6106|06/01/2018|07/23/2022|Yes|No||06/01/2018|07/23/2022|Yes|No|06/01/2018|07/23/2022|Yes|No||||No|No|||Prescription required|No||007|Yes|.30046|03/29/2022|.29324|03/29/2022|.2952|03/29/2022|||STIMULANTS AND RELATED AGENTS|10033|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GAVIS/LUPIN|No||||
potassium chloride|No|No|No|No|75%|43386091510|POTASSIUM CL ER 10 MEQ TABLET|1000|EA|.205|10/24/2019|08/03/2022|Yes|No||10/24/2019|08/03/2022|Yes|No|10/24/2019|08/03/2022|Yes|No||||No|No|||Prescription required|No|||No|.18432|03/29/2022|.17989|03/29/2022|.18109|03/29/2022||||10034|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LUPIN PHARMACEU|No||||
oxycodone HCl|No|No|No|No|90%|43386092060|OXYCODONE HCL 100 MG/5 ML CONC|30|ML|2.38506|09/07/2015|05/07/2022|Yes|No||09/07/2015|05/07/2022|Yes|No|09/07/2015|05/07/2022|Yes|No||||No|No|||Prescription required|Yes|07/23/2015|109|Yes|3.65933|03/29/2022|3.5715|03/29/2022|3.59529|03/29/2022|||ANALGESICS: NARCOTICS SHORT|10035|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GAVIS/LUPIN|No||||
levetiracetam|No|No|No|No|75%|43485010160|SPRITAM 250 MG TABLET|60|EA|5.55447|08/11/2016||Yes|No||08/11/2016||Yes|No|08/11/2016||Yes|No||||No|No|||Prescription required|No||056|No|9.08901|05/04/2021|8.95916|05/04/2021|8.53254|05/04/2021|||ANTICONVULSANTS|10036|||||No|No||APRECIA PHARMAC|No||||
levetiracetam|No|No|No|No|75%|43485010260|SPRITAM 500 MG TABLET|60|EA|5.55447|08/11/2016||Yes|No||08/11/2016||Yes|No|08/11/2016||Yes|No||||No|No|||Prescription required|No||056|No|9.08901|05/04/2021|8.95916|05/04/2021|8.53254|05/04/2021|||ANTICONVULSANTS|10037|||||No|No||APRECIA PHARMAC|No||||
levetiracetam|No|No|No|No|75%|43485010360|SPRITAM 750 MG TABLET|60|EA|5.55447|08/11/2016||Yes|No||08/11/2016||Yes|No|08/11/2016||Yes|No||||No|No|||Prescription required|No||056|No|9.08901|05/04/2021|8.95916|05/04/2021|8.53254|05/04/2021|||ANTICONVULSANTS|10038|||||No|No||APRECIA PHARMAC|No||||
levetiracetam|No|No|No|No|75%|43485010460|SPRITAM 1,000 MG TABLET|60|EA|5.55447|08/11/2016||Yes|No||08/11/2016||Yes|No|08/11/2016||Yes|No||||No|No|||Prescription required|No||056|No|9.08901|05/04/2021|8.95916|05/04/2021|8.53254|05/04/2021|||ANTICONVULSANTS|10039|||||No|No||APRECIA PHARMAC|No||||
mupirocin|No|No|No|No|75%|43538030030|CENTANY 2% OINTMENT|30|GM|4.53334|03/05/2009||Yes|No||03/05/2009||Yes|No|03/05/2009||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|114|No|10.3318|08/25/2020|10.1842|08/25/2020|9.69924|08/25/2020|||ANTIBIOTICS: TOPICAL|10040|||||No|No||MEDIMETRIKS PHA|No||||
levetiracetam|No|No|No|No|75%|43547022115|LEVETIRACETAM 250 MG TABLET|120|EA|.08958|04/07/2011||Yes|No||04/07/2011||Yes|No|04/07/2011||Yes|No||||No|No|||Prescription required|No||056|No|.08073|03/29/2022|.07879|03/29/2022|.07931|03/29/2022|||ANTICONVULSANTS|10041|||||No|No||SOLCO HEALTHCAR|No||||
levetiracetam|No|No|No|No|75%|43547022211|LEVETIRACETAM 500 MG TABLET|1000|EA|.23291|10/17/2016||Yes|No||10/17/2016||Yes|No|10/17/2016||Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|10042|||||No|No||SOLCO HEALTHCAR|No||||
levetiracetam|No|No|No|No|75%|43547022215|LEVETIRACETAM 500 MG TABLET|120|EA|.1118|04/07/2011||Yes|No||04/07/2011||Yes|No|04/07/2011||Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|10043|||||No|No||SOLCO HEALTHCAR|No||||
levetiracetam|No|No|No|No|75%|43547022315|LEVETIRACETAM 750 MG TABLET|120|EA|.15981|04/07/2011||Yes|No||04/07/2011||Yes|No|04/07/2011||Yes|No||||No|No|||Prescription required|No||056|No|.15853|03/29/2022|.15472|03/29/2022|.15575|03/29/2022|||ANTICONVULSANTS|10044|||||No|No||SOLCO HEALTHCAR|No||||
levetiracetam|No|No|No|No|75%|43547022406|LEVETIRACETAM 1,000 MG TABLET|60|EA|.28236|04/07/2011||Yes|No||04/07/2011||Yes|No|04/07/2011||Yes|No||||No|No|||Prescription required|No||056|No|.22789|03/29/2022|.22242|03/29/2022|.2239|03/29/2022|||ANTICONVULSANTS|10045|||||No|No||SOLCO HEALTHCAR|No||||
methocarbamol|No|No|No|No|75%|43547022610|METHOCARBAMOL 750 MG TABLET|100|EA|.04433|10/05/2015||Yes|No||10/05/2015||Yes|No|10/05/2015||Yes|No||||No|No|||Prescription required|No||116|Yes|.09307|03/29/2022|.09083|03/29/2022|.09144|03/29/2022|||SKELETAL MUSCLE RELAXANTS|10046|||||No|No||SOLCO HEALTHCAR|No||||
methocarbamol|No|No|No|No|75%|43547022650|METHOCARBAMOL 750 MG TABLET|500|EA|.0421|10/05/2015||Yes|No||10/05/2015||Yes|No|10/05/2015||Yes|No||||No|No|||Prescription required|No||116|Yes|.09307|03/29/2022|.09083|03/29/2022|.09144|03/29/2022|||SKELETAL MUSCLE RELAXANTS|10047|||||No|No||SOLCO HEALTHCAR|No||||
chlordiazepoxide HCl|No|No|No|No|90%|43547025110|CHLORDIAZEPOXIDE 5 MG CAPSULE|100|EA|.0387|08/16/2010||Yes|No||08/16/2010||Yes|No|08/16/2010||Yes|No||||No|No|||Prescription required|No||090|Yes|.17737|03/29/2022|.17311|03/29/2022|.17426|03/29/2022|||ANXIOLYTICS|10048|||||No|No||SOLCO HEALTHCAR|No||||
chlordiazepoxide HCl|No|No|No|No|90%|43547025210|CHLORDIAZEPOXIDE 10 MG CAPSULE|100|EA|.0301|08/16/2010||Yes|No||08/16/2010||Yes|No|08/16/2010||Yes|No||||No|No|||Prescription required|No||090|Yes|.1176|03/29/2022|.11477|03/29/2022|.11554|03/29/2022|||ANXIOLYTICS|10049|||||No|No||SOLCO HEALTHCAR|No||||
chlordiazepoxide HCl|No|No|No|No|90%|43547025310|CHLORDIAZEPOXIDE 25 MG CAPSULE|100|EA|.0344|08/16/2010||Yes|No||08/16/2010||Yes|No|08/16/2010||Yes|No||||No|No|||Prescription required|No||090|Yes|.13592|03/29/2022|.13265|03/29/2022|.13354|03/29/2022|||ANXIOLYTICS|10050|||||No|No||SOLCO HEALTHCAR|Yes|09/01/2020|||
carvedilol|No|No|No|No|75%|43547025410|CARVEDILOL 3.125 MG TABLET|100|EA|.043|08/16/2010||Yes|No||08/16/2010||Yes|No|08/16/2010||Yes|No||||No|No|||Prescription required|No||070|No|.01877|03/29/2022|.01831|03/29/2022|.01844|03/29/2022|||BETA-BLOCKERS|10051|||||No|No||SOLCO HEALTHCAR|No||||
carvedilol|No|No|No|No|75%|43547025450|CARVEDILOL 3.125 MG TABLET|500|EA|.0387|08/16/2011||Yes|No||08/16/2011||Yes|No|08/16/2011||Yes|No||||No|No|||Prescription required|No||070|No|.01877|03/29/2022|.01831|03/29/2022|.01844|03/29/2022|||BETA-BLOCKERS|10052|||||No|No||SOLCO HEALTHCAR|No||||
carvedilol|No|No|No|No|75%|43547025510|CARVEDILOL 6.25 MG TABLET|100|EA|.043|08/16/2010||Yes|No||08/16/2010||Yes|No|08/16/2010||Yes|No||||No|No|||Prescription required|No||070|No|.02069|03/29/2022|.02019|03/29/2022|.02032|03/29/2022|||BETA-BLOCKERS|10053|||||No|No||SOLCO HEALTHCAR|No||||
carvedilol|No|No|No|No|75%|43547025550|CARVEDILOL 6.25 MG TABLET|500|EA|.0387|08/16/2011||Yes|No||08/16/2011||Yes|No|08/16/2011||Yes|No||||No|No|||Prescription required|No||070|No|.02069|03/29/2022|.02019|03/29/2022|.02032|03/29/2022|||BETA-BLOCKERS|10054|||||No|No||SOLCO HEALTHCAR|No||||
carvedilol|No|No|No|No|75%|43547025610|CARVEDILOL 12.5 MG TABLET|100|EA|.043|08/16/2010||Yes|No||08/16/2010||Yes|No|08/16/2010||Yes|No||||No|No|||Prescription required|No||070|No|.02277|03/29/2022|.02222|03/29/2022|.02237|03/29/2022|||BETA-BLOCKERS|10055|||||No|No||SOLCO HEALTHCAR|No||||
carvedilol|No|No|No|No|75%|43547025650|CARVEDILOL 12.5 MG TABLET|500|EA|.0387|08/16/2011||Yes|No||08/16/2011||Yes|No|08/16/2011||Yes|No||||No|No|||Prescription required|No||070|No|.02277|03/29/2022|.02222|03/29/2022|.02237|03/29/2022|||BETA-BLOCKERS|10056|||||No|No||SOLCO HEALTHCAR|No||||
carvedilol|No|No|No|No|75%|43547025710|CARVEDILOL 25 MG TABLET|100|EA|.043|08/16/2010||Yes|No||08/16/2010||Yes|No|08/16/2010||Yes|No||||No|No|||Prescription required|No||070|No|.03449|03/29/2022|.03366|03/29/2022|.03388|03/29/2022|||BETA-BLOCKERS|10057|||||No|No||SOLCO HEALTHCAR|No||||
carvedilol|No|No|No|No|75%|43547025750|CARVEDILOL 25 MG TABLET|500|EA|.0387|08/16/2011||Yes|No||08/16/2011||Yes|No|08/16/2011||Yes|No||||No|No|||Prescription required|No||070|No|.03449|03/29/2022|.03366|03/29/2022|.03388|03/29/2022|||BETA-BLOCKERS|10058|||||No|No||SOLCO HEALTHCAR|No||||
gabapentin|No|No|No|No|75%|43547026510|GABAPENTIN 100 MG CAPSULE|100|EA|.0215|03/25/2014||Yes|No||03/25/2014||Yes|No|03/25/2014||Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|10059|||||No|No||SOLCO HEALTHCAR|No||||
gabapentin|No|No|No|No|75%|43547026550|GABAPENTIN 100 MG CAPSULE|500|EA|.0215|03/25/2014||Yes|No||03/25/2014||Yes|No|03/25/2014||Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|10060|||||No|No||SOLCO HEALTHCAR|No||||
gabapentin|No|No|No|No|75%|43547026610|GABAPENTIN 300 MG CAPSULE|100|EA|.0301|03/25/2014||Yes|No||03/25/2014||Yes|No|03/25/2014||Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|10061|||||No|No||SOLCO HEALTHCAR|No||||
gabapentin|No|No|No|No|75%|43547026650|GABAPENTIN 300 MG CAPSULE|500|EA|.0301|03/25/2014||Yes|No||03/25/2014||Yes|No|03/25/2014||Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|10062|||||No|No||SOLCO HEALTHCAR|No||||
gabapentin|No|No|No|No|75%|43547026710|GABAPENTIN 400 MG CAPSULE|100|EA|.0344|03/25/2014||Yes|No||03/25/2014||Yes|No|03/25/2014||Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|10063|||||No|No||SOLCO HEALTHCAR|No||||
gabapentin|No|No|No|No|75%|43547026750|GABAPENTIN 400 MG CAPSULE|500|EA|.0344|03/25/2014||Yes|No||03/25/2014||Yes|No|03/25/2014||Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|10064|||||No|No||SOLCO HEALTHCAR|No||||
ropinirole HCl|No|No|No|No|75%|43547026810|ROPINIROLE HCL 0.25 MG TABLET|100|EA|.215|09/27/2012||Yes|No||09/27/2012||Yes|No|09/27/2012||Yes|No||||No|No|||Prescription required|No||015|No|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIPARKINSON'S AGENTS|10065|||||No|No||SOLCO HEALTHCAR|No||||
ropinirole HCl|No|No|No|No|75%|43547026850|ROPINIROLE HCL 0.25 MG TABLET|500|EA|.215|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|No||015|No|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIPARKINSON'S AGENTS|10066|||||No|No||SOLCO HEALTHCAR|No||||
ropinirole HCl|No|No|No|No|75%|43547026910|ROPINIROLE HCL 0.5 MG TABLET|100|EA|.215|09/27/2012||Yes|No||09/27/2012||Yes|No|09/27/2012||Yes|No||||No|No|||Prescription required|No||015|No|.04899|03/29/2022|.04781|03/29/2022|.04813|03/29/2022|||ANTIPARKINSON'S AGENTS|10067|||||No|No||SOLCO HEALTHCAR|No||||
ropinirole HCl|No|No|No|No|75%|43547026950|ROPINIROLE HCL 0.5 MG TABLET|500|EA|.215|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|No||015|No|.04899|03/29/2022|.04781|03/29/2022|.04813|03/29/2022|||ANTIPARKINSON'S AGENTS|10068|||||No|No||SOLCO HEALTHCAR|No||||
ropinirole HCl|No|No|No|No|75%|43547027010|ROPINIROLE HCL 1 MG TABLET|100|EA|.215|09/27/2012||Yes|No||09/27/2012||Yes|No|09/27/2012||Yes|No||||No|No|||Prescription required|No||015|No|.05246|03/29/2022|.0512|03/29/2022|.05154|03/29/2022|||ANTIPARKINSON'S AGENTS|10069|||||No|No||SOLCO HEALTHCAR|No||||
ropinirole HCl|No|No|No|No|75%|43547027050|ROPINIROLE HCL 1 MG TABLET|500|EA|.215|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|No||015|No|.05246|03/29/2022|.0512|03/29/2022|.05154|03/29/2022|||ANTIPARKINSON'S AGENTS|10070|||||No|No||SOLCO HEALTHCAR|No||||
ropinirole HCl|No|No|No|No|75%|43547027110|ROPINIROLE HCL 2 MG TABLET|100|EA|.215|09/27/2012||Yes|No||09/27/2012||Yes|No|09/27/2012||Yes|No||||No|No|||Prescription required|No||015|No|.06367|03/29/2022|.06214|03/29/2022|.06255|03/29/2022|||ANTIPARKINSON'S AGENTS|10071|||||No|No||SOLCO HEALTHCAR|No||||
ropinirole HCl|No|No|No|No|75%|43547027150|ROPINIROLE HCL 2 MG TABLET|500|EA|.215|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|No||015|No|.06367|03/29/2022|.06214|03/29/2022|.06255|03/29/2022|||ANTIPARKINSON'S AGENTS|10072|||||No|No||SOLCO HEALTHCAR|No||||
ropinirole HCl|No|No|No|No|75%|43547027210|ROPINIROLE HCL 3 MG TABLET|100|EA|.215|09/27/2012||Yes|No||09/27/2012||Yes|No|09/27/2012||Yes|No||||No|No|||Prescription required|No||015|No|.10196|03/29/2022|.09951|03/29/2022|.10017|03/29/2022|||ANTIPARKINSON'S AGENTS|10073|||||No|No||SOLCO HEALTHCAR|No||||
ropinirole HCl|No|No|No|No|75%|43547027310|ROPINIROLE HCL 4 MG TABLET|100|EA|.215|09/27/2012||Yes|No||09/27/2012||Yes|No|09/27/2012||Yes|No||||No|No|||Prescription required|No||015|No|.08517|03/29/2022|.08312|03/29/2022|.08367|03/29/2022|||ANTIPARKINSON'S AGENTS|10074|||||No|No||SOLCO HEALTHCAR|No||||
ropinirole HCl|No|No|No|No|75%|43547027410|ROPINIROLE HCL 5 MG TABLET|100|EA|.215|09/27/2012||Yes|No||09/27/2012||Yes|No|09/27/2012||Yes|No||||No|No|||Prescription required|No||015|No|.08598|03/29/2022|.08391|03/29/2022|.08447|03/29/2022|||ANTIPARKINSON'S AGENTS|10075|||||No|No||SOLCO HEALTHCAR|No||||
donepezil HCl|No|No|No|No|75%|43547027503|DONEPEZIL HCL 5 MG TABLET|30|EA|.07166|02/22/2012||Yes|No||02/22/2012||Yes|No|02/22/2012||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|10076|||||No|No||SOLCO HEALTHCAR|No||||
donepezil HCl|No|No|No|No|75%|43547027509|DONEPEZIL HCL 5 MG TABLET|90|EA|.07166|02/22/2012||Yes|No||02/22/2012||Yes|No|02/22/2012||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|10077|||||No|No||SOLCO HEALTHCAR|No||||
donepezil HCl|No|No|No|No|75%|43547027511|DONEPEZIL HCL 5 MG TABLET|1000|EA|.07166|02/22/2012||Yes|No||02/22/2012||Yes|No|02/22/2012||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|10078|||||No|No||SOLCO HEALTHCAR|No||||
donepezil HCl|No|No|No|No|75%|43547027603|DONEPEZIL HCL 10 MG TABLET|30|EA|.07166|02/22/2012||Yes|No||02/22/2012||Yes|No|02/22/2012||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|10079|||||No|No||SOLCO HEALTHCAR|No||||
donepezil HCl|No|No|No|No|75%|43547027609|DONEPEZIL HCL 10 MG TABLET|90|EA|.07166|02/22/2012||Yes|No||02/22/2012||Yes|No|02/22/2012||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|10080|||||No|No||SOLCO HEALTHCAR|No||||
donepezil HCl|No|No|No|No|75%|43547027611|DONEPEZIL HCL 10 MG TABLET|1000|EA|.07166|02/22/2012||Yes|No||02/22/2012||Yes|No|02/22/2012||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|10081|||||No|No||SOLCO HEALTHCAR|No||||
irbesartan|Yes|No|No|No|75%|43547027703|IRBESARTAN 75 MG TABLET|30|EA|.129|09/05/2012||Yes|No||09/05/2012||Yes|No|09/05/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.21751|03/29/2022|.21228|03/29/2022|.2137|03/29/2022|||ANGIOTENSIN MODULATORS|10082|||||No|No||SOLCO HEALTHCAR|No||||
escitalopram oxalate|No|No|No|No|75%|43547028010|ESCITALOPRAM 5 MG TABLET|100|EA|.043|07/22/2016||Yes|No||07/22/2016||Yes|No|07/22/2016||Yes|No||||No|No|||Prescription required|No||008|Yes|.0462|03/29/2022|.04509|03/29/2022|.04539|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10083|||||No|No||SOLCO HEALTHCAR|No||||
escitalopram oxalate|No|No|No|No|75%|43547028011|ESCITALOPRAM 5 MG TABLET|1000|EA|.043|07/22/2016||Yes|No||07/22/2016||Yes|No|07/22/2016||Yes|No||||No|No|||Prescription required|No||008|Yes|.0462|03/29/2022|.04509|03/29/2022|.04539|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10084|||||No|No||SOLCO HEALTHCAR|No||||
escitalopram oxalate|No|No|No|No|75%|43547028110|ESCITALOPRAM 10 MG TABLET|100|EA|.0516|07/22/2016||Yes|No||07/22/2016||Yes|No|07/22/2016||Yes|No||||No|No|||Prescription required|No||008|Yes|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10085|||||No|No||SOLCO HEALTHCAR|No||||
escitalopram oxalate|No|No|No|No|75%|43547028111|ESCITALOPRAM 10 MG TABLET|1000|EA|.0516|07/22/2016||Yes|No||07/22/2016||Yes|No|07/22/2016||Yes|No||||No|No|||Prescription required|No||008|Yes|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10086|||||No|No||SOLCO HEALTHCAR|No||||
escitalopram oxalate|No|No|No|No|75%|43547028210|ESCITALOPRAM 20 MG TABLET|100|EA|.0645|07/25/2016||Yes|No||07/25/2016||Yes|No|07/25/2016||Yes|No||||No|No|||Prescription required|No||008|No|.07845|03/29/2022|.07656|03/29/2022|.07707|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10087|||||No|No||SOLCO HEALTHCAR|No||||
escitalopram oxalate|No|No|No|No|75%|43547028211|ESCITALOPRAM 20 MG TABLET|1000|EA|.0645|07/25/2016||Yes|No||07/25/2016||Yes|No|07/25/2016||Yes|No||||No|No|||Prescription required|No||008|No|.07845|03/29/2022|.07656|03/29/2022|.07707|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10088|||||No|No||SOLCO HEALTHCAR|No||||
telmisartan|No|No|No|No|75%|43547028303|TELMISARTAN 20 MG TABLET|30|EA|.28666|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|Yes|10/05/2017|113|Yes|.30407|03/29/2022|.29677|03/29/2022|.29874|03/29/2022|||ANGIOTENSIN MODULATORS|10089|||||No|No||SOLCO HEALTHCAR|No||||
telmisartan|No|No|No|No|75%|43547028403|TELMISARTAN 40 MG TABLET|30|EA|.28666|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|Yes|10/05/2017|113|Yes|.35861|03/29/2022|.35|03/29/2022|.35233|03/29/2022|||ANGIOTENSIN MODULATORS|10090|||||No|No||SOLCO HEALTHCAR|No||||
telmisartan|No|No|No|No|75%|43547028503|TELMISARTAN 80 MG TABLET|30|EA|.28666|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|Yes|10/05/2017|113|Yes|.33958|03/29/2022|.33143|03/29/2022|.33363|03/29/2022|||ANGIOTENSIN MODULATORS|10091|||||No|No||SOLCO HEALTHCAR|No||||
bupropion HCl|Yes|No|No|No|75%|43547028809|BUPROPION HCL SR 100 MG TABLET|90|EA|.1075|09/16/2015||Yes|No||09/16/2015||Yes|No|09/16/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.11271|03/29/2022|.11|03/29/2022|.11073|03/29/2022|||ANTIDEPRESSANTS: OTHER|10092|||||No|No||SOLCO HEALTHCAR|No||||
bupropion HCl|No|No|No|No|75%|43547028810|BUPROPION HCL SR 100 MG TABLET|100|EA|.1075|08/22/2016||Yes|No||08/22/2016||Yes|No|08/22/2016||Yes|No||||No|No|||Prescription required|No||031|No|.11271|03/29/2022|.11|03/29/2022|.11073|03/29/2022|||ANTIDEPRESSANTS: OTHER|10093|||||No|No||SOLCO HEALTHCAR|No||||
bupropion HCl|Yes|No|No|No|75%|43547028909|BUPROPION HCL SR 150 MG TABLET|90|EA|.11466|09/16/2015||Yes|No||09/16/2015||Yes|No|09/16/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.10128|03/29/2022|.09884|03/29/2022|.0995|03/29/2022|||ANTIDEPRESSANTS: OTHER|10094|||||No|No||SOLCO HEALTHCAR|No||||
bupropion HCl|No|No|No|No|75%|43547028910|BUPROPION HCL SR 150 MG TABLET|100|EA|.1075|08/22/2016||Yes|No||08/22/2016||Yes|No|08/22/2016||Yes|No||||No|No|||Prescription required|No||031|No|.10128|03/29/2022|.09884|03/29/2022|.0995|03/29/2022|||ANTIDEPRESSANTS: OTHER|10095|||||No|No||SOLCO HEALTHCAR|No||||
bupropion HCl|Yes|No|No|No|75%|43547028950|BUPROPION HCL SR 150 MG TABLET|500|EA|.11466|09/16/2015||Yes|No||09/16/2015||Yes|No|09/16/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.10128|03/29/2022|.09884|03/29/2022|.0995|03/29/2022|||ANTIDEPRESSANTS: OTHER|10096|||||No|No||SOLCO HEALTHCAR|No||||
bupropion HCl|Yes|No|No|No|75%|43547029009|BUPROPION HCL SR 200 MG TABLET|90|EA|.129|09/16/2015||Yes|No||09/16/2015||Yes|No|09/16/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.16014|03/29/2022|.15629|03/29/2022|.15733|03/29/2022|||ANTIDEPRESSANTS: OTHER|10097|||||No|No||SOLCO HEALTHCAR|No||||
bupropion HCl|No|No|No|No|75%|43547029010|BUPROPION HCL SR 200 MG TABLET|100|EA|.129|08/22/2016||Yes|No||08/22/2016||Yes|No|08/22/2016||Yes|No||||No|No|||Prescription required|No||031|No|.16014|03/29/2022|.15629|03/29/2022|.15733|03/29/2022|||ANTIDEPRESSANTS: OTHER|10098|||||No|No||SOLCO HEALTHCAR|No||||
aripiprazole|No|No|No|No|75%|43547030203|ARIPIPRAZOLE 2 MG TABLET|30|EA|.62708|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|10099|||||No|No||SOLCO HEALTHCAR|No||||
aripiprazole|No|No|No|No|75%|43547030303|ARIPIPRAZOLE 5 MG TABLET|30|EA|.62708|10/12/2020||Yes|No||10/12/2020||Yes|No|10/12/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|10100|||||No|No||SOLCO HEALTHCAR|No||||
aripiprazole|No|No|No|No|75%|43547030403|ARIPIPRAZOLE 10 MG TABLET|30|EA|.62708|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|10101|||||No|No||SOLCO HEALTHCAR|No||||
aripiprazole|No|No|No|No|75%|43547030503|ARIPIPRAZOLE 15 MG TABLET|30|EA|.62708|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|10102|||||No|No||SOLCO HEALTHCAR|No||||
aripiprazole|No|No|No|No|75%|43547030603|ARIPIPRAZOLE 20 MG TABLET|30|EA|.72311|10/12/2020||Yes|No||10/12/2020||Yes|No|10/12/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|10103|||||No|No||SOLCO HEALTHCAR|No||||
aripiprazole|No|No|No|No|75%|43547030703|ARIPIPRAZOLE 30 MG TABLET|30|EA|.72311|10/12/2020||Yes|No||10/12/2020||Yes|No|10/12/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|10104|||||No|No||SOLCO HEALTHCAR|No||||
doxycycline hyclate|No|No|No|No|75%|43547032410|DOXYCYCLINE HYC DR 150 MG TAB|100|EA|6.05418|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|213|No|13.79791|04/23/2019|13.60079|04/23/2019|12.95314|04/23/2019|||TETRACYCLINES|10105|||||No|No||SOLCO HEALTHCAR|No||||
doxycycline hyclate|No|No|No|No|75%|43547032506|DOXYCYCLINE HYC DR 200 MG TAB|60|EA|14.93633|04/07/2017||Yes|No||04/07/2017||Yes|No|04/07/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|213|No|34.04094|04/07/2017|33.55464|04/07/2017|31.9568|04/07/2017|||TETRACYCLINES|10106|||||No|No||SOLCO HEALTHCAR|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|43547033003|IRBESARTAN-HCTZ 150-12.5 MG TB|30|EA|.14333|10/01/2015||Yes|No||10/01/2015||Yes|No|10/01/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.24959|03/29/2022|.24359|03/29/2022|.24522|03/29/2022|||ANGIOTENSIN MODULATORS|10107|||||No|No||SOLCO HEALTHCAR|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|43547033009|IRBESARTAN-HCTZ 150-12.5 MG TB|90|EA|.14333|10/01/2015||Yes|No||10/01/2015||Yes|No|10/01/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.24959|03/29/2022|.24359|03/29/2022|.24522|03/29/2022|||ANGIOTENSIN MODULATORS|10108|||||No|No||SOLCO HEALTHCAR|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|43547033103|IRBESARTAN-HCTZ 300-12.5 MG TB|30|EA|.15766|10/01/2015||Yes|No||10/01/2015||Yes|No|10/01/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.26247|03/29/2022|.25617|03/29/2022|.25787|03/29/2022|||ANGIOTENSIN MODULATORS|10109|||||No|No||SOLCO HEALTHCAR|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|43547033109|IRBESARTAN-HCTZ 300-12.5 MG TB|90|EA|.15766|10/01/2015||Yes|No||10/01/2015||Yes|No|10/01/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.26247|03/29/2022|.25617|03/29/2022|.25787|03/29/2022|||ANGIOTENSIN MODULATORS|10110|||||No|No||SOLCO HEALTHCAR|No||||
benazepril HCl|Yes|No|No|No|75%|43547033510|BENAZEPRIL HCL 5 MG TABLET|100|EA|.0301|03/25/2014||Yes|No||03/25/2014||Yes|No|03/25/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.06176|03/29/2022|.06027|03/29/2022|.06067|03/29/2022|||ANGIOTENSIN MODULATORS|10111|||||No|No||SOLCO HEALTHCAR|No||||
benazepril HCl|Yes|No|No|No|75%|43547033610|BENAZEPRIL HCL 10 MG TABLET|100|EA|.043|03/25/2014||Yes|No||03/25/2014||Yes|No|03/25/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.06947|03/29/2022|.0678|03/29/2022|.06825|03/29/2022|||ANGIOTENSIN MODULATORS|10112|||||No|No||SOLCO HEALTHCAR|No||||
benazepril HCl|Yes|No|No|No|75%|43547033650|BENAZEPRIL HCL 10 MG TABLET|500|EA|.043|03/25/2014||Yes|No||03/25/2014||Yes|No|03/25/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.06947|03/29/2022|.0678|03/29/2022|.06825|03/29/2022|||ANGIOTENSIN MODULATORS|10113|||||No|No||SOLCO HEALTHCAR|No||||
benazepril HCl|Yes|No|No|No|75%|43547033710|BENAZEPRIL HCL 20 MG TABLET|100|EA|.0516|03/25/2014||Yes|No||03/25/2014||Yes|No|03/25/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.08619|03/29/2022|.08412|03/29/2022|.08468|03/29/2022|||ANGIOTENSIN MODULATORS|10114|||||No|No||SOLCO HEALTHCAR|No||||
benazepril HCl|Yes|No|No|No|75%|43547033750|BENAZEPRIL HCL 20 MG TABLET|500|EA|.0516|03/25/2014||Yes|No||03/25/2014||Yes|No|03/25/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.08619|03/29/2022|.08412|03/29/2022|.08468|03/29/2022|||ANGIOTENSIN MODULATORS|10115|||||No|No||SOLCO HEALTHCAR|No||||
benazepril HCl|Yes|No|No|No|75%|43547033810|BENAZEPRIL HCL 40 MG TABLET|100|EA|.0645|03/25/2014||Yes|No||03/25/2014||Yes|No|03/25/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.11798|03/29/2022|.11514|03/29/2022|.11591|03/29/2022|||ANGIOTENSIN MODULATORS|10116|||||No|No||SOLCO HEALTHCAR|No||||
benazepril HCl|Yes|No|No|No|75%|43547033850|BENAZEPRIL HCL 40 MG TABLET|500|EA|.0645|03/25/2014||Yes|No||03/25/2014||Yes|No|03/25/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.11798|03/29/2022|.11514|03/29/2022|.11591|03/29/2022|||ANGIOTENSIN MODULATORS|10117|||||No|No||SOLCO HEALTHCAR|No||||
risperidone|No|No|No|No|75%|43547033906|RISPERIDONE 0.25 MG TABLET|60|EA|.07166|10/01/2015||Yes|No||10/01/2015||Yes|No|10/01/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.04339|03/29/2022|.04234|03/29/2022|.04263|03/29/2022|||ANTIPSYCHOTICS|10118|||||No|No||SOLCO HEALTHCAR|No||||
risperidone|No|No|No|No|75%|43547033950|RISPERIDONE 0.25 MG TABLET|500|EA|.0688|10/01/2015||Yes|No||10/01/2015||Yes|No|10/01/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.04339|03/29/2022|.04234|03/29/2022|.04263|03/29/2022|||ANTIPSYCHOTICS|10119|||||No|No||SOLCO HEALTHCAR|No||||
risperidone|No|No|No|No|75%|43547034006|RISPERIDONE 0.5 MG TABLET|60|EA|.07883|10/01/2015||Yes|No||10/01/2015||Yes|No|10/01/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.04564|03/29/2022|.04454|03/29/2022|.04484|03/29/2022|||ANTIPSYCHOTICS|10120|||||No|No||SOLCO HEALTHCAR|No||||
risperidone|No|No|No|No|75%|43547034050|RISPERIDONE 0.5 MG TABLET|500|EA|.0774|10/01/2015||Yes|No||10/01/2015||Yes|No|10/01/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.04564|03/29/2022|.04454|03/29/2022|.04484|03/29/2022|||ANTIPSYCHOTICS|10121|||||No|No||SOLCO HEALTHCAR|No||||
risperidone|No|No|No|No|75%|43547034106|RISPERIDONE 1 MG TABLET|60|EA|.086|10/01/2015||Yes|No||10/01/2015||Yes|No|10/01/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.05646|03/29/2022|.0551|03/29/2022|.05547|03/29/2022|||ANTIPSYCHOTICS|10122|||||No|No||SOLCO HEALTHCAR|No||||
risperidone|No|No|No|No|75%|43547034150|RISPERIDONE 1 MG TABLET|500|EA|.08342|10/01/2015||Yes|No||10/01/2015||Yes|No|10/01/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.05646|03/29/2022|.0551|03/29/2022|.05547|03/29/2022|||ANTIPSYCHOTICS|10123|||||No|No||SOLCO HEALTHCAR|No||||
risperidone|No|No|No|No|75%|43547034206|RISPERIDONE 2 MG TABLET|60|EA|.09316|10/01/2015||Yes|No||10/01/2015||Yes|No|10/01/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.061|03/29/2022|.05953|03/29/2022|.05993|03/29/2022|||ANTIPSYCHOTICS|10124|||||No|No||SOLCO HEALTHCAR|No||||
risperidone|No|No|No|No|75%|43547034250|RISPERIDONE 2 MG TABLET|500|EA|.0903|10/01/2015||Yes|No||10/01/2015||Yes|No|10/01/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.061|03/29/2022|.05953|03/29/2022|.05993|03/29/2022|||ANTIPSYCHOTICS|10125|||||No|No||SOLCO HEALTHCAR|No||||
risperidone|No|No|No|No|75%|43547034306|RISPERIDONE 3 MG TABLET|60|EA|.10033|10/01/2015||Yes|No||10/01/2015||Yes|No|10/01/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.07183|03/29/2022|.0701|03/29/2022|.07057|03/29/2022|||ANTIPSYCHOTICS|10126|||||No|No||SOLCO HEALTHCAR|No||||
risperidone|No|No|No|No|75%|43547034350|RISPERIDONE 3 MG TABLET|500|EA|.0989|10/01/2015||Yes|No||10/01/2015||Yes|No|10/01/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.07183|03/29/2022|.0701|03/29/2022|.07057|03/29/2022|||ANTIPSYCHOTICS|10127|||||No|No||SOLCO HEALTHCAR|No||||
risperidone|No|No|No|No|75%|43547034406|RISPERIDONE 4 MG TABLET|60|EA|.1075|10/01/2015||Yes|No||10/01/2015||Yes|No|10/01/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.10538|03/29/2022|.10285|03/29/2022|.10353|03/29/2022|||ANTIPSYCHOTICS|10128|||||No|No||SOLCO HEALTHCAR|No||||
risperidone|No|No|No|No|75%|43547034450|RISPERIDONE 4 MG TABLET|500|EA|.1032|10/01/2015||Yes|No||10/01/2015||Yes|No|10/01/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.10538|03/29/2022|.10285|03/29/2022|.10353|03/29/2022|||ANTIPSYCHOTICS|10129|||||No|No||SOLCO HEALTHCAR|No||||
levetiracetam|No|No|No|No|75%|43547034506|LEVETIRACETAM ER 500 MG TABLET|60|EA|.17916|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|||Prescription required|No||056|No|.22713|03/29/2022|.22167|03/29/2022|.22315|03/29/2022|||ANTICONVULSANTS|10130|||||No|No||SOLCO HEALTHCAR|No||||
levetiracetam|No|No|No|No|75%|43547034606|LEVETIRACETAM ER 750 MG TABLET|60|EA|.25083|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|||Prescription required|No||056|No|.36799|03/29/2022|.35915|03/29/2022|.36155|03/29/2022|||ANTICONVULSANTS|10131|||||No|No||SOLCO HEALTHCAR|No||||
paroxetine HCl|No|No|No|No|75%|43547034703|PAROXETINE HCL 10 MG TABLET|30|EA|.086|10/02/2015||Yes|No||10/02/2015||Yes|No|10/02/2015||Yes|No||||No|No|||Prescription required|No||008|Yes|.075|03/29/2022|.0732|03/29/2022|.07368|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10132|||||No|No||SOLCO HEALTHCAR|No||||
paroxetine HCl|No|No|No|No|75%|43547034709|PAROXETINE HCL 10 MG TABLET|90|EA|.086|10/02/2015||Yes|No||10/02/2015||Yes|No|10/02/2015||Yes|No||||No|No|||Prescription required|No||008|Yes|.075|03/29/2022|.0732|03/29/2022|.07368|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10133|||||No|No||SOLCO HEALTHCAR|No||||
paroxetine HCl|No|No|No|No|75%|43547034711|PAROXETINE HCL 10 MG TABLET|1000|EA|.086|10/02/2015||Yes|No||10/02/2015||Yes|No|10/02/2015||Yes|No||||No|No|||Prescription required|No||008|Yes|.075|03/29/2022|.0732|03/29/2022|.07368|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10134|||||No|No||SOLCO HEALTHCAR|No||||
paroxetine HCl|No|No|No|No|75%|43547034750|PAROXETINE HCL 10 MG TABLET|500|EA|.086|10/02/2015||Yes|No||10/02/2015||Yes|No|10/02/2015||Yes|No||||No|No|||Prescription required|No||008|Yes|.075|03/29/2022|.0732|03/29/2022|.07368|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10135|||||No|No||SOLCO HEALTHCAR|No||||
paroxetine HCl|No|No|No|No|75%|43547034803|PAROXETINE HCL 20 MG TABLET|30|EA|.10033|10/02/2015||Yes|No||10/02/2015||Yes|No|10/02/2015||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10136|||||No|No||SOLCO HEALTHCAR|No||||
paroxetine HCl|No|No|No|No|75%|43547034809|PAROXETINE HCL 20 MG TABLET|90|EA|.10033|10/02/2015||Yes|No||10/02/2015||Yes|No|10/02/2015||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10137|||||No|No||SOLCO HEALTHCAR|No||||
paroxetine HCl|No|No|No|No|75%|43547034811|PAROXETINE HCL 20 MG TABLET|1000|EA|.10033|10/02/2015||Yes|No||10/02/2015||Yes|No|10/02/2015||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10138|||||No|No||SOLCO HEALTHCAR|No||||
paroxetine HCl|No|No|No|No|75%|43547034850|PAROXETINE HCL 20 MG TABLET|500|EA|.10033|10/02/2015||Yes|No||10/02/2015||Yes|No|10/02/2015||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10139|||||No|No||SOLCO HEALTHCAR|No||||
paroxetine HCl|No|No|No|No|75%|43547034903|PAROXETINE HCL 30 MG TABLET|30|EA|.11466|10/02/2015||Yes|No||10/02/2015||Yes|No|10/02/2015||Yes|No||||No|No|||Prescription required|No||008|No|.13236|03/29/2022|.12918|03/29/2022|.13004|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10140|||||No|No||SOLCO HEALTHCAR|No||||
paroxetine HCl|No|No|No|No|75%|43547034909|PAROXETINE HCL 30 MG TABLET|90|EA|.11466|10/02/2015||Yes|No||10/02/2015||Yes|No|10/02/2015||Yes|No||||No|No|||Prescription required|No||008|No|.13236|03/29/2022|.12918|03/29/2022|.13004|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10141|||||No|No||SOLCO HEALTHCAR|No||||
paroxetine HCl|No|No|No|No|75%|43547034911|PAROXETINE HCL 30 MG TABLET|1000|EA|.11466|10/02/2015||Yes|No||10/02/2015||Yes|No|10/02/2015||Yes|No||||No|No|||Prescription required|No||008|No|.13236|03/29/2022|.12918|03/29/2022|.13004|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10142|||||No|No||SOLCO HEALTHCAR|No||||
paroxetine HCl|No|No|No|No|75%|43547034950|PAROXETINE HCL 30 MG TABLET|500|EA|.11466|10/02/2015||Yes|No||10/02/2015||Yes|No|10/02/2015||Yes|No||||No|No|||Prescription required|No||008|No|.13236|03/29/2022|.12918|03/29/2022|.13004|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10143|||||No|No||SOLCO HEALTHCAR|No||||
paroxetine HCl|No|No|No|No|75%|43547035003|PAROXETINE HCL 40 MG TABLET|30|EA|.129|10/02/2015||Yes|No||10/02/2015||Yes|No|10/02/2015||Yes|No||||No|No|||Prescription required|No||008|No|.13005|03/29/2022|.12692|03/29/2022|.12777|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10144|||||No|No||SOLCO HEALTHCAR|No||||
paroxetine HCl|No|No|No|No|75%|43547035009|PAROXETINE HCL 40 MG TABLET|90|EA|.129|10/02/2015||Yes|No||10/02/2015||Yes|No|10/02/2015||Yes|No||||No|No|||Prescription required|No||008|No|.13005|03/29/2022|.12692|03/29/2022|.12777|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10145|||||No|No||SOLCO HEALTHCAR|No||||
paroxetine HCl|No|No|No|No|75%|43547035011|PAROXETINE HCL 40 MG TABLET|1000|EA|.129|10/02/2015||Yes|No||10/02/2015||Yes|No|10/02/2015||Yes|No||||No|No|||Prescription required|No||008|No|.13005|03/29/2022|.12692|03/29/2022|.12777|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10146|||||No|No||SOLCO HEALTHCAR|No||||
paroxetine HCl|No|No|No|No|75%|43547035050|PAROXETINE HCL 40 MG TABLET|500|EA|.129|10/02/2015||Yes|No||10/02/2015||Yes|No|10/02/2015||Yes|No||||No|No|||Prescription required|No||008|No|.13005|03/29/2022|.12692|03/29/2022|.12777|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10147|||||No|No||SOLCO HEALTHCAR|No||||
lisinopril|Yes|No|No|No|75%|43547035110|LISINOPRIL 2.5 MG TABLET|100|EA|.0172|08/13/2015||Yes|No||08/13/2015||Yes|No|08/13/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.01617|03/29/2022|.01578|03/29/2022|.01588|03/29/2022|||ANGIOTENSIN MODULATORS|10148|||||No|No||SOLCO HEALTHCAR|No||||
lisinopril|Yes|No|No|No|75%|43547035150|LISINOPRIL 2.5 MG TABLET|500|EA|.0172|08/13/2015||Yes|No||08/13/2015||Yes|No|08/13/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.01617|03/29/2022|.01578|03/29/2022|.01588|03/29/2022|||ANGIOTENSIN MODULATORS|10149|||||No|No||SOLCO HEALTHCAR|No||||
lisinopril|Yes|No|No|No|75%|43547035210|LISINOPRIL 5 MG TABLET|100|EA|.0258|08/13/2015||Yes|No||08/13/2015||Yes|No|08/13/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.01549|03/29/2022|.01511|03/29/2022|.01521|03/29/2022|||ANGIOTENSIN MODULATORS|10150|||||No|No||SOLCO HEALTHCAR|No||||
lisinopril|Yes|No|No|No|75%|43547035211|LISINOPRIL 5 MG TABLET|1000|EA|.0258|08/13/2015||Yes|No||08/13/2015||Yes|No|08/13/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.01549|03/29/2022|.01511|03/29/2022|.01521|03/29/2022|||ANGIOTENSIN MODULATORS|10151|||||No|No||SOLCO HEALTHCAR|No||||
lisinopril|Yes|No|No|No|75%|43547035310|LISINOPRIL 10 MG TABLET|100|EA|.0301|08/13/2015||Yes|No||08/13/2015||Yes|No|08/13/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.01914|03/29/2022|.01868|03/29/2022|.0188|03/29/2022|||ANGIOTENSIN MODULATORS|10152|||||No|No||SOLCO HEALTHCAR|No||||
lisinopril|Yes|No|No|No|75%|43547035311|LISINOPRIL 10 MG TABLET|1000|EA|.0301|08/13/2015||Yes|No||08/13/2015||Yes|No|08/13/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.01914|03/29/2022|.01868|03/29/2022|.0188|03/29/2022|||ANGIOTENSIN MODULATORS|10153|||||No|No||SOLCO HEALTHCAR|No||||
lisinopril|Yes|No|No|No|75%|43547035410|LISINOPRIL 20 MG TABLET|100|EA|.0344|08/13/2015||Yes|No||08/13/2015||Yes|No|08/13/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANGIOTENSIN MODULATORS|10154|||||No|No||SOLCO HEALTHCAR|No||||
lisinopril|Yes|No|No|No|75%|43547035411|LISINOPRIL 20 MG TABLET|1000|EA|.0344|08/13/2015||Yes|No||08/13/2015||Yes|No|08/13/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANGIOTENSIN MODULATORS|10155|||||No|No||SOLCO HEALTHCAR|No||||
lisinopril|Yes|No|No|No|75%|43547035510|LISINOPRIL 30 MG TABLET|100|EA|.0473|08/13/2015||Yes|No||08/13/2015||Yes|No|08/13/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.05487|03/29/2022|.05355|03/29/2022|.0539|03/29/2022|||ANGIOTENSIN MODULATORS|10156|||||No|No||SOLCO HEALTHCAR|No||||
lisinopril|Yes|No|No|No|75%|43547035550|LISINOPRIL 30 MG TABLET|500|EA|.0473|08/13/2015||Yes|No||08/13/2015||Yes|No|08/13/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.05487|03/29/2022|.05355|03/29/2022|.0539|03/29/2022|||ANGIOTENSIN MODULATORS|10157|||||No|No||SOLCO HEALTHCAR|No||||
lisinopril|Yes|No|No|No|75%|43547035610|LISINOPRIL 40 MG TABLET|100|EA|.0688|08/13/2015||Yes|No||08/13/2015||Yes|No|08/13/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.04778|03/29/2022|.04663|03/29/2022|.04694|03/29/2022|||ANGIOTENSIN MODULATORS|10158|||||No|No||SOLCO HEALTHCAR|No||||
lisinopril|Yes|No|No|No|75%|43547035611|LISINOPRIL 40 MG TABLET|1000|EA|.0688|08/13/2015||Yes|No||08/13/2015||Yes|No|08/13/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.04778|03/29/2022|.04663|03/29/2022|.04694|03/29/2022|||ANGIOTENSIN MODULATORS|10159|||||No|No||SOLCO HEALTHCAR|No||||
metformin HCl|Yes|No|No|No|75%|43547035710|METFORMIN HCL 500 MG TABLET|100|EA|.0258|10/26/2015||Yes|No||10/26/2015||Yes|No|10/26/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|10160|||||No|No||SOLCO HEALTHCAR|No||||
metformin HCl|Yes|No|No|No|75%|43547035711|METFORMIN HCL 500 MG TABLET|1000|EA|.0258|10/26/2015||Yes|No||10/26/2015||Yes|No|10/26/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|10161|||||No|No||SOLCO HEALTHCAR|No||||
metformin HCl|Yes|No|No|No|75%|43547035750|METFORMIN HCL 500 MG TABLET|500|EA|.0258|10/26/2015||Yes|No||10/26/2015||Yes|No|10/26/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|10162|||||No|No||SOLCO HEALTHCAR|No||||
metformin HCl|Yes|No|No|No|75%|43547035810|METFORMIN HCL 850 MG TABLET|100|EA|.0387|10/26/2015||Yes|No||10/26/2015||Yes|No|10/26/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|10163|||||No|No||SOLCO HEALTHCAR|No||||
metformin HCl|Yes|No|No|No|75%|43547035850|METFORMIN HCL 850 MG TABLET|500|EA|.0387|10/26/2015||Yes|No||10/26/2015||Yes|No|10/26/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|10164|||||No|No||SOLCO HEALTHCAR|No||||
metformin HCl|Yes|No|No|No|75%|43547035910|METFORMIN HCL 1,000 MG TABLET|100|EA|.043|10/26/2015||Yes|No||10/26/2015||Yes|No|10/26/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|10165|||||No|No||SOLCO HEALTHCAR|No||||
metformin HCl|Yes|No|No|No|75%|43547035950|METFORMIN HCL 1,000 MG TABLET|500|EA|.043|10/26/2015||Yes|No||10/26/2015||Yes|No|10/26/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|10166|||||No|No||SOLCO HEALTHCAR|No||||
losartan potassium|Yes|No|No|No|75%|43547036009|LOSARTAN POTASSIUM 25 MG TAB|90|EA|.05733|10/05/2015||Yes|No||10/05/2015||Yes|No|10/05/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|10167|||||No|No||SOLCO HEALTHCAR|No||||
losartan potassium|Yes|No|No|No|75%|43547036050|LOSARTAN POTASSIUM 25 MG TAB|500|EA|.05733|10/05/2015||Yes|No||10/05/2015||Yes|No|10/05/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|10168|||||No|No||SOLCO HEALTHCAR|No||||
losartan potassium|Yes|No|No|No|75%|43547036103|LOSARTAN POTASSIUM 50 MG TAB|30|EA|.07166|10/05/2015||Yes|No||10/05/2015||Yes|No|10/05/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|10169|||||No|No||SOLCO HEALTHCAR|No||||
losartan potassium|Yes|No|No|No|75%|43547036109|LOSARTAN POTASSIUM 50 MG TAB|90|EA|.07166|10/05/2015||Yes|No||10/05/2015||Yes|No|10/05/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|10170|||||No|No||SOLCO HEALTHCAR|No||||
losartan potassium|Yes|No|No|No|75%|43547036111|LOSARTAN POTASSIUM 50 MG TAB|1000|EA|.07166|10/05/2015||Yes|No||10/05/2015||Yes|No|10/05/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|10171|||||No|No||SOLCO HEALTHCAR|No||||
losartan potassium|Yes|No|No|No|75%|43547036203|LOSARTAN POTASSIUM 100 MG TAB|30|EA|.10033|10/05/2015||Yes|No||10/05/2015||Yes|No|10/05/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|10172|||||No|No||SOLCO HEALTHCAR|No||||
losartan potassium|No|No|No|No|75%|43547036209|LOSARTAN POTASSIUM 100 MG TAB|90|EA|.10033|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|10173|||||No|No||SOLCO HEALTHCAR|No||||
losartan potassium|Yes|No|No|No|75%|43547036211|LOSARTAN POTASSIUM 100 MG TAB|1000|EA|.10033|10/05/2015||Yes|No||10/05/2015||Yes|No|10/05/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|10174|||||No|No||SOLCO HEALTHCAR|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|43547037310|HYDROCODONE-ACETAMIN 7.5-325|100|EA|.0516|11/10/2016||Yes|No||11/10/2016||Yes|No|11/10/2016||Yes|No||||No|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|10175|||||No|No||SOLCO HEALTHCAR|No||||
irbesartan|No|No|No|No|75%|43547037403|IRBESARTAN 75 MG TABLET|30|EA|.129|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.21751|03/29/2022|.21228|03/29/2022|.2137|03/29/2022|||ANGIOTENSIN MODULATORS|10176|||||No|No||SOLCO HEALTHCAR|No||||
irbesartan|No|No|No|No|75%|43547037409|IRBESARTAN 75 MG TABLET|90|EA|.129|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.21751|03/29/2022|.21228|03/29/2022|.2137|03/29/2022|||ANGIOTENSIN MODULATORS|10177|||||No|No||SOLCO HEALTHCAR|No||||
irbesartan|No|No|No|No|75%|43547037503|IRBESARTAN 150 MG TABLET|30|EA|.14333|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.20852|03/29/2022|.20351|03/29/2022|.20487|03/29/2022|||ANGIOTENSIN MODULATORS|10178|||||No|No||SOLCO HEALTHCAR|No||||
irbesartan|Yes|No|No|No|75%|43547037509|IRBESARTAN 150 MG TABLET|90|EA|.14333|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|02/21/2017||Prescription required|No||113|Yes|.20852|03/29/2022|.20351|03/29/2022|.20487|03/29/2022|||ANGIOTENSIN MODULATORS|10179|||||No|No||SOLCO HEALTHCAR|No||||
irbesartan|Yes|No|No|No|75%|43547037550|IRBESARTAN 150 MG TABLET|500|EA|.14333|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|02/21/2017||Prescription required|No||113|Yes|.20852|03/29/2022|.20351|03/29/2022|.20487|03/29/2022|||ANGIOTENSIN MODULATORS|10180|||||No|No||SOLCO HEALTHCAR|No||||
irbesartan|No|No|No|No|75%|43547037603|IRBESARTAN 300 MG TABLET|30|EA|.172|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.32541|03/29/2022|.3176|03/29/2022|.31971|03/29/2022|||ANGIOTENSIN MODULATORS|10181|||||No|No||SOLCO HEALTHCAR|No||||
irbesartan|No|No|No|No|75%|43547037609|IRBESARTAN 300 MG TABLET|90|EA|.172|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.32541|03/29/2022|.3176|03/29/2022|.31971|03/29/2022|||ANGIOTENSIN MODULATORS|10182|||||No|No||SOLCO HEALTHCAR|No||||
voriconazole|No|No|No|No|75%|43547037703|VORICONAZOLE 50 MG TABLET|30|EA|2.45745|03/02/2017||Yes|No||03/02/2017||Yes|No|03/02/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|069|No|5.6007|03/02/2017|5.52069|03/02/2017|5.2578|03/02/2017|||ANTIFUNGALS: ORAL|10183|||||No|No||SOLCO HEALTHCAR|No||||
voriconazole|No|No|No|No|75%|43547037803|VORICONAZOLE 200 MG TABLET|30|EA|8.84725|03/02/2017||Yes|No||03/02/2017||Yes|No|03/02/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|069|No|2.07998|03/29/2022|2.03006|03/29/2022|2.04358|03/29/2022|||ANTIFUNGALS: ORAL|10184|||||No|No||SOLCO HEALTHCAR|No||||
duloxetine HCl|No|No|No|No|75%|43547037906|DULOXETINE HCL DR 20 MG CAP|60|EA|.21055|10/21/2020||Yes|No||10/21/2020||Yes|No|10/21/2020||Yes|No||||No|No|||Prescription required|No||232|No|.13163|03/29/2022|.12847|03/29/2022|.12932|03/29/2022|||NEUROPATHIC PAIN|10185|||||No|No||SOLCO HEALTHCAR|No||||
duloxetine HCl|No|No|No|No|75%|43547038003|DULOXETINE HCL DR 30 MG CAP|30|EA|.21113|11/28/2017||Yes|No||11/28/2017||Yes|No|11/28/2017||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|10186|||||No|No||SOLCO HEALTHCAR|No||||
duloxetine HCl|No|No|No|No|75%|43547038009|DULOXETINE HCL DR 30 MG CAP|90|EA|.21113|10/21/2020||Yes|No||10/21/2020||Yes|No|10/21/2020||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|10187|||||No|No||SOLCO HEALTHCAR|No||||
duloxetine HCl|No|No|No|No|75%|43547038011|DULOXETINE HCL DR 30 MG CAP|1000|EA|.19307|10/21/2020||Yes|No||10/21/2020||Yes|No|10/21/2020||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|10188|||||No|No||SOLCO HEALTHCAR|No||||
duloxetine HCl|No|No|No|No|75%|43547038103|DULOXETINE HCL DR 60 MG CAP|30|EA|.21113|11/28/2017||Yes|No||11/28/2017||Yes|No|11/28/2017||Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|10189|||||No|No||SOLCO HEALTHCAR|No||||
duloxetine HCl|No|No|No|No|75%|43547038109|DULOXETINE HCL DR 60 MG CAP|90|EA|.21113|11/28/2017||Yes|No||11/28/2017||Yes|No|11/28/2017||Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|10190|||||No|No||SOLCO HEALTHCAR|No||||
duloxetine HCl|No|No|No|No|75%|43547038111|DULOXETINE HCL DR 60 MG CAP|1000|EA|.19307|11/28/2017||Yes|No||11/28/2017||Yes|No|11/28/2017||Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|10191|||||No|No||SOLCO HEALTHCAR|No||||
donepezil HCl|No|No|No|No|75%|43547038203|DONEPEZIL HCL 23 MG TABLET|30|EA|.78045|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|011|No|.75152|03/29/2022|.73348|03/29/2022|.73836|03/29/2022|||ALZHEIMER'S AGENTS|10192|||||No|No||SOLCO HEALTHCAR|No||||
gabapentin|No|No|No|No|75%|43547038450|GABAPENTIN 300 MG CAPSULE|500|EA|.0301|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|10193|||||No|No||SOLCO HEALTHCAR|No||||
gabapentin|No|No|No|No|75%|43547038510|GABAPENTIN 400 MG CAPSULE|100|EA|.0344|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|10194|||||No|No||SOLCO HEALTHCAR|No||||
gabapentin|No|No|No|No|75%|43547038550|GABAPENTIN 400 MG CAPSULE|500|EA|.0344|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|10195|||||No|No||SOLCO HEALTHCAR|No||||
fosinopril sodium|No|No|No|No|75%|43547038609|FOSINOPRIL SODIUM 10 MG TAB|90|EA|.08528|03/14/2018||Yes|No||03/14/2018||Yes|No|03/14/2018||Yes|No||||No|No|||Prescription required|No||113|Yes|.17684|03/29/2022|.17259|03/29/2022|.17374|03/29/2022|||ANGIOTENSIN MODULATORS|10196|||||No|No||SOLCO HEALTHCAR|No||||
fosinopril sodium|No|No|No|No|75%|43547038709|FOSINOPRIL SODIUM 20 MG TAB|90|EA|.09177|03/14/2018||Yes|No||03/14/2018||Yes|No|03/14/2018||Yes|No||||No|No|||Prescription required|No||113|Yes|.153|03/29/2022|.14932|03/29/2022|.15032|03/29/2022|||ANGIOTENSIN MODULATORS|10197|||||No|No||SOLCO HEALTHCAR|No||||
fosinopril sodium|No|No|No|No|75%|43547038809|FOSINOPRIL SODIUM 40 MG TAB|90|EA|.10701|03/14/2018||Yes|No||03/14/2018||Yes|No|03/14/2018||Yes|No||||No|No|||Prescription required|No||113|No|.20623|03/29/2022|.20128|03/29/2022|.20262|03/29/2022|||ANGIOTENSIN MODULATORS|10198|||||No|No||SOLCO HEALTHCAR|No||||
gabapentin|No|No|No|No|75%|43547038950|GABAPENTIN 600 MG TABLET|500|EA|.0645|02/28/2017||Yes|No||02/28/2017||Yes|No|02/28/2017||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|10199|||||No|No||SOLCO HEALTHCAR|No||||
gabapentin|No|No|No|No|75%|43547039050|GABAPENTIN 800 MG TABLET|500|EA|.086|02/28/2017||Yes|No||02/28/2017||Yes|No|02/28/2017||Yes|No||||No|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|10200|||||No|No||SOLCO HEALTHCAR|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|43547039103|OLMESARTAN-HCTZ 20-12.5 MG TAB|30|EA|.2064|08/28/2017||Yes|No||08/28/2017||Yes|No|08/28/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.22565|03/29/2022|.22023|03/29/2022|.2217|03/29/2022|||ANGIOTENSIN MODULATORS|10201|||||No|No||SOLCO HEALTHCAR|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|43547039109|OLMESARTAN-HCTZ 20-12.5 MG TAB|90|EA|.2064|08/28/2017||Yes|No||08/28/2017||Yes|No|08/28/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.22565|03/29/2022|.22023|03/29/2022|.2217|03/29/2022|||ANGIOTENSIN MODULATORS|10202|||||No|No||SOLCO HEALTHCAR|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|43547039203|OLMESARTAN-HCTZ 40-12.5 MG TAB|30|EA|.28652|08/28/2017||Yes|No||08/28/2017||Yes|No|08/28/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.29168|03/29/2022|.28467|03/29/2022|.28657|03/29/2022|||ANGIOTENSIN MODULATORS|10203|||||No|No||SOLCO HEALTHCAR|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|43547039209|OLMESARTAN-HCTZ 40-12.5 MG TAB|90|EA|.28618|08/29/2017||Yes|No||08/29/2017||Yes|No|08/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.29168|03/29/2022|.28467|03/29/2022|.28657|03/29/2022|||ANGIOTENSIN MODULATORS|10204|||||No|No||SOLCO HEALTHCAR|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|43547039303|OLMESARTAN-HCTZ 40-25 MG TAB|30|EA|.28652|08/29/2017||Yes|No||08/29/2017||Yes|No|08/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.29227|03/29/2022|.28525|03/29/2022|.28715|03/29/2022|||ANGIOTENSIN MODULATORS|10205|||||No|No||SOLCO HEALTHCAR|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|43547039309|OLMESARTAN-HCTZ 40-25 MG TAB|90|EA|.28618|08/29/2017||Yes|No||08/29/2017||Yes|No|08/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.29227|03/29/2022|.28525|03/29/2022|.28715|03/29/2022|||ANGIOTENSIN MODULATORS|10206|||||No|No||SOLCO HEALTHCAR|No||||
glimepiride|No|No|No|No|75%|43547039410|GLIMEPIRIDE 1 MG TABLET|100|EA|.03844|10/20/2017||Yes|No||10/20/2017||Yes|No|10/20/2017||Yes|No||||No|No|||Prescription required|No|||No|.03361|03/29/2022|.0328|03/29/2022|.03302|03/29/2022||||10207|||||No|No||SOLCO HEALTHCAR|No||||
glimepiride|No|No|No|No|75%|43547039450|GLIMEPIRIDE 1 MG TABLET|500|EA|.0373|10/20/2017||Yes|No||10/20/2017||Yes|No|10/20/2017||Yes|No||||No|No|||Prescription required|No|||No|.03361|03/29/2022|.0328|03/29/2022|.03302|03/29/2022||||10208|||||No|No||SOLCO HEALTHCAR|No||||
glimepiride|No|No|No|No|75%|43547039510|GLIMEPIRIDE 2 MG TABLET|100|EA|.0623|10/20/2017||Yes|No||10/20/2017||Yes|No|10/20/2017||Yes|No||||No|No|||Prescription required|No|||No|.03979|03/29/2022|.03883|03/29/2022|.03909|03/29/2022||||10209|||||No|No||SOLCO HEALTHCAR|No||||
glimepiride|No|No|No|No|75%|43547039550|GLIMEPIRIDE 2 MG TABLET|500|EA|.06037|10/20/2017||Yes|No||10/20/2017||Yes|No|10/20/2017||Yes|No||||No|No|||Prescription required|No|||No|.03979|03/29/2022|.03883|03/29/2022|.03909|03/29/2022||||10210|||||No|No||SOLCO HEALTHCAR|No||||
glimepiride|No|No|No|No|75%|43547039610|GLIMEPIRIDE 4 MG TABLET|100|EA|.11751|10/20/2017||Yes|No||10/20/2017||Yes|No|10/20/2017||Yes|No||||No|No|||Prescription required|No|||No|.04419|03/29/2022|.04312|03/29/2022|.04341|03/29/2022||||10211|||||No|No||SOLCO HEALTHCAR|No||||
glimepiride|No|No|No|No|75%|43547039650|GLIMEPIRIDE 4 MG TABLET|500|EA|.11751|10/20/2017||Yes|No||10/20/2017||Yes|No|10/20/2017||Yes|No||||No|No|||Prescription required|No|||No|.04419|03/29/2022|.04312|03/29/2022|.04341|03/29/2022||||10212|||||No|No||SOLCO HEALTHCAR|No||||
hydrochlorothiazide|No|No|No|No|75%|43547039710|HYDROCHLOROTHIAZIDE 25 MG TAB|100|EA|.00924|09/25/2017||Yes|No||09/25/2017||Yes|No|09/25/2017||Yes|No||||No|No|||Prescription required|No|||Yes|.01337|03/29/2022|.01304|03/29/2022|.01313|03/29/2022||||10213|||||No|No||SOLCO HEALTHCAR|No||||
hydrochlorothiazide|No|No|No|No|75%|43547039711|HYDROCHLOROTHIAZIDE 25 MG TAB|1000|EA|.00851|09/26/2017||Yes|No||09/26/2017||Yes|No|09/26/2017||Yes|No||||No|No|||Prescription required|No|||Yes|.01337|03/29/2022|.01304|03/29/2022|.01313|03/29/2022||||10214|||||No|No||SOLCO HEALTHCAR|No||||
hydrochlorothiazide|No|No|No|No|75%|43547039810|HYDROCHLOROTHIAZIDE 50 MG TAB|100|EA|.01784|09/25/2017||Yes|No||09/25/2017||Yes|No|09/25/2017||Yes|No||||No|No|||Prescription required|No|||Yes|.02959|03/29/2022|.02887|03/29/2022|.02907|03/29/2022||||10215|||||No|No||SOLCO HEALTHCAR|No||||
hydrochlorothiazide|No|No|No|No|75%|43547039811|HYDROCHLOROTHIAZIDE 50 MG TAB|1000|EA|.01429|09/25/2017||Yes|No||09/25/2017||Yes|No|09/25/2017||Yes|No||||No|No|||Prescription required|No|||Yes|.02959|03/29/2022|.02887|03/29/2022|.02907|03/29/2022||||10216|||||No|No||SOLCO HEALTHCAR|No||||
cyclobenzaprine HCl|No|No|No|No|75%|43547039910|CYCLOBENZAPRINE 5 MG TABLET|100|EA|.02653|09/26/2017||Yes|No||09/26/2017||Yes|No|09/26/2017||Yes|No||||No|No|||Prescription required|No||116|Yes|.02938|03/29/2022|.02867|03/29/2022|.02886|03/29/2022|||SKELETAL MUSCLE RELAXANTS|10217|||||No|No||SOLCO HEALTHCAR|No||||
cyclobenzaprine HCl|No|No|No|No|75%|43547039950|CYCLOBENZAPRINE 5 MG TABLET|500|EA|.02515|09/26/2017||Yes|No||09/26/2017||Yes|No|09/26/2017||Yes|No||||No|No|||Prescription required|No||116|Yes|.02938|03/29/2022|.02867|03/29/2022|.02886|03/29/2022|||SKELETAL MUSCLE RELAXANTS|10218|||||No|No||SOLCO HEALTHCAR|No||||
cyclobenzaprine HCl|No|No|No|No|75%|43547040010|CYCLOBENZAPRINE 10 MG TABLET|100|EA|.02304|09/26/2017||Yes|No||09/26/2017||Yes|No|09/26/2017||Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|10219|||||No|No||SOLCO HEALTHCAR|No||||
cyclobenzaprine HCl|No|No|No|No|75%|43547040011|CYCLOBENZAPRINE 10 MG TABLET|1000|EA|.01867|09/26/2017||Yes|No||09/26/2017||Yes|No|09/26/2017||Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|10220|||||No|No||SOLCO HEALTHCAR|No||||
cyclobenzaprine HCl|No|No|No|No|75%|43547040050|CYCLOBENZAPRINE 10 MG TABLET|500|EA|.02179|09/26/2017||Yes|No||09/26/2017||Yes|No|09/26/2017||Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|10221|||||No|No||SOLCO HEALTHCAR|No||||
furosemide|No|No|No|No|75%|43547040110|FUROSEMIDE 20 MG TABLET|100|EA|.01978|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No|||No|.03187|03/29/2022|.0311|03/29/2022|.03131|03/29/2022||||10222|||||No|No||SOLCO HEALTHCAR|No||||
furosemide|No|No|No|No|75%|43547040111|FUROSEMIDE 20 MG TABLET|1000|EA|.0178|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No|||No|.03187|03/29/2022|.0311|03/29/2022|.03131|03/29/2022||||10223|||||No|No||SOLCO HEALTHCAR|No||||
furosemide|No|No|No|No|75%|43547040210|FUROSEMIDE 40 MG TABLET|100|EA|.02042|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No|||No|.03326|03/29/2022|.03246|03/29/2022|.03267|03/29/2022||||10224|||||No|No||SOLCO HEALTHCAR|No||||
furosemide|No|No|No|No|75%|43547040211|FUROSEMIDE 40 MG TABLET|1000|EA|.01838|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No|||No|.03326|03/29/2022|.03246|03/29/2022|.03267|03/29/2022||||10225|||||No|No||SOLCO HEALTHCAR|No||||
furosemide|No|No|No|No|75%|43547040310|FUROSEMIDE 80 MG TABLET|100|EA|.02988|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No|||No|.06148|03/29/2022|.06|03/29/2022|.0604|03/29/2022||||10226|||||No|No||SOLCO HEALTHCAR|No||||
furosemide|No|No|No|No|75%|43547040350|FUROSEMIDE 80 MG TABLET|500|EA|.02842|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No|||No|.06148|03/29/2022|.06|03/29/2022|.0604|03/29/2022||||10227|||||No|No||SOLCO HEALTHCAR|No||||
methocarbamol|No|No|No|No|75%|43547040510|METHOCARBAMOL 500 MG TABLET|100|EA|.03272|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|No||116|Yes|.07091|03/29/2022|.0692|03/29/2022|.06966|03/29/2022|||SKELETAL MUSCLE RELAXANTS|10228|||||No|No||SOLCO HEALTHCAR|No||||
clonazepam|No|No|No|No|75%|43547040610|CLONAZEPAM 0.5 MG TABLET|100|EA|.0172|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No||056|Yes|.02441|03/29/2022|.02382|03/29/2022|.02398|03/29/2022|||ANTICONVULSANTS|10229|||||No|No||SOLCO HEALTHCAR|No||||
clonazepam|No|No|No|No|75%|43547040611|CLONAZEPAM 0.5 MG TABLET|1000|EA|.0172|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No||056|Yes|.02441|03/29/2022|.02382|03/29/2022|.02398|03/29/2022|||ANTICONVULSANTS|10230|||||No|No||SOLCO HEALTHCAR|No||||
clonazepam|No|No|No|No|75%|43547040710|CLONAZEPAM 1 MG TABLET|100|EA|.02236|01/21/2021||Yes|No||01/21/2021||Yes|No|01/21/2021||Yes|No||||No|No|||Prescription required|No||056|Yes|.0296|03/29/2022|.02888|03/29/2022|.02908|03/29/2022|||ANTICONVULSANTS|10231|||||No|No||SOLCO HEALTHCAR|No||||
clonazepam|No|No|No|No|75%|43547040711|CLONAZEPAM 1 MG TABLET|1000|EA|.02236|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No||056|Yes|.0296|03/29/2022|.02888|03/29/2022|.02908|03/29/2022|||ANTICONVULSANTS|10232|||||No|No||SOLCO HEALTHCAR|No||||
clonazepam|No|No|No|No|75%|43547040810|CLONAZEPAM 2 MG TABLET|100|EA|.02687|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No||056|Yes|.03734|03/29/2022|.03644|03/29/2022|.03668|03/29/2022|||ANTICONVULSANTS|10233|||||No|No||SOLCO HEALTHCAR|No||||
clonazepam|No|No|No|No|75%|43547040850|CLONAZEPAM 2 MG TABLET|500|EA|.02687|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No||056|Yes|.03734|03/29/2022|.03644|03/29/2022|.03668|03/29/2022|||ANTICONVULSANTS|10234|||||No|No||SOLCO HEALTHCAR|No||||
paroxetine mesylate|No|No|No|No|75%|43547040903|PAROXETINE MESYLATE 7.5 MG CAP|30|EA|1.97054|11/27/2017||Yes|No||11/27/2017||Yes|No|11/27/2017||Yes|No||||No|No|||Prescription required|Yes|09/28/2017|008|No|4.51495|03/29/2022|4.40659|03/29/2022|4.43593|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10235|||||No|No||SOLCO HEALTHCAR|No||||
quinapril HCl|Yes|No|No|No|75%|43547041009|QUINAPRIL 5 MG TABLET|90|EA|.07166|05/23/2018||Yes|No||05/23/2018||Yes|No|05/23/2018||Yes|No||||No|No|05/23/2018||Prescription required|No||113|No|.11066|03/29/2022|.108|03/29/2022|.10872|03/29/2022|||ANGIOTENSIN MODULATORS|10236|||||No|No||SOLCO HEALTHCAR|No||||
quinapril HCl|No|No|No|No|75%|43547041109|QUINAPRIL 10 MG TABLET|90|EA|.07166|05/23/2018||Yes|No||05/23/2018||Yes|No|05/23/2018||Yes|No||||No|No|||Prescription required|No||113|No|.08121|03/29/2022|.07926|03/29/2022|.07978|03/29/2022|||ANGIOTENSIN MODULATORS|10237|||||No|No||SOLCO HEALTHCAR|No||||
quinapril HCl|Yes|No|No|No|75%|43547041209|QUINAPRIL 20 MG TABLET|90|EA|.07166|05/23/2018||Yes|No||05/23/2018||Yes|No|05/23/2018||Yes|No||||No|No|05/23/2018||Prescription required|No||113|No|.08843|03/29/2022|.0863|03/29/2022|.08688|03/29/2022|||ANGIOTENSIN MODULATORS|10238|||||No|No||SOLCO HEALTHCAR|No||||
quinapril HCl|Yes|No|No|No|75%|43547041309|QUINAPRIL 40 MG TABLET|90|EA|.07166|05/23/2018||Yes|No||05/23/2018||Yes|No|05/23/2018||Yes|No||||No|No|05/23/2018||Prescription required|No||113|No|.10852|03/29/2022|.10591|03/29/2022|.10662|03/29/2022|||ANGIOTENSIN MODULATORS|10239|||||No|No||SOLCO HEALTHCAR|No||||
lisinopril/hydrochlorothiazide|Yes|No|No|No|75%|43547042010|LISINOPRIL-HCTZ 10-12.5 MG TAB|100|EA|.04063|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||113|Yes|.03674|03/29/2022|.03585|03/29/2022|.03609|03/29/2022|||ANGIOTENSIN MODULATORS|10240|||||No|No||SOLCO HEALTHCAR|No||||
lisinopril/hydrochlorothiazide|Yes|No|No|No|75%|43547042050|LISINOPRIL-HCTZ 10-12.5 MG TAB|500|EA|.03839|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||113|Yes|.03674|03/29/2022|.03585|03/29/2022|.03609|03/29/2022|||ANGIOTENSIN MODULATORS|10241|||||No|No||SOLCO HEALTHCAR|No||||
lisinopril/hydrochlorothiazide|Yes|No|No|No|75%|43547042110|LISINOPRIL-HCTZ 20-12.5 MG TAB|100|EA|.06067|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||113|Yes|.04909|03/29/2022|.04791|03/29/2022|.04823|03/29/2022|||ANGIOTENSIN MODULATORS|10242|||||No|No||SOLCO HEALTHCAR|No||||
lisinopril/hydrochlorothiazide|Yes|No|No|No|75%|43547042150|LISINOPRIL-HCTZ 20-12.5 MG TAB|500|EA|.0576|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||113|Yes|.04909|03/29/2022|.04791|03/29/2022|.04823|03/29/2022|||ANGIOTENSIN MODULATORS|10243|||||No|No||SOLCO HEALTHCAR|No||||
lisinopril/hydrochlorothiazide|Yes|No|No|No|75%|43547042210|LISINOPRIL-HCTZ 20-25 MG TAB|100|EA|.07026|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||113|Yes|.04948|03/29/2022|.04829|03/29/2022|.04861|03/29/2022|||ANGIOTENSIN MODULATORS|10244|||||No|No||SOLCO HEALTHCAR|No||||
lisinopril/hydrochlorothiazide|Yes|No|No|No|75%|43547042250|LISINOPRIL-HCTZ 20-25 MG TAB|500|EA|.06671|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||113|Yes|.04948|03/29/2022|.04829|03/29/2022|.04861|03/29/2022|||ANGIOTENSIN MODULATORS|10245|||||No|No||SOLCO HEALTHCAR|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|43547042303|LOSARTAN-HCTZ 50-12.5 MG TAB|30|EA|.0516|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|10246|||||No|No||SOLCO HEALTHCAR|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|43547042309|LOSARTAN-HCTZ 50-12.5 MG TAB|90|EA|.04042|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|10247|||||No|No||SOLCO HEALTHCAR|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|43547042311|LOSARTAN-HCTZ 50-12.5 MG TAB|1000|EA|.03359|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|10248|||||No|No||SOLCO HEALTHCAR|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|43547042403|LOSARTAN-HCTZ 100-25 MG TAB|30|EA|.07482|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.21077|03/01/2022|.20571|03/01/2022|.20708|03/01/2022|||ANGIOTENSIN MODULATORS|10249|||||No|No||SOLCO HEALTHCAR|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|43547042409|LOSARTAN-HCTZ 100-25 MG TAB|90|EA|.06344|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.21077|03/01/2022|.20571|03/01/2022|.20708|03/01/2022|||ANGIOTENSIN MODULATORS|10250|||||No|No||SOLCO HEALTHCAR|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|43547042411|LOSARTAN-HCTZ 100-25 MG TAB|1000|EA|.05731|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.21077|03/01/2022|.20571|03/01/2022|.20708|03/01/2022|||ANGIOTENSIN MODULATORS|10251|||||No|No||SOLCO HEALTHCAR|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|43547042503|LOSARTAN-HCTZ 100-12.5 MG TAB|30|EA|.07482|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|10252|||||No|No||SOLCO HEALTHCAR|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|43547042509|LOSARTAN-HCTZ 100-12.5 MG TAB|90|EA|.06344|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|10253|||||No|No||SOLCO HEALTHCAR|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|43547042511|LOSARTAN-HCTZ 100-12.5 MG TAB|1000|EA|.05754|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|10254|||||No|No||SOLCO HEALTHCAR|No||||
fenofibrate nanocrystallized|No|No|No|No|75%|43547043009|FENOFIBRATE 48 MG TABLET|90|EA|.15336|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|||Prescription required|No||055|No|.11999|03/29/2022|.11711|03/29/2022|.11789|03/29/2022|||LIPOTROPICS: OTHER|10255|||||No|No||SOLCO HEALTHCAR|No||||
fenofibrate nanocrystallized|No|No|No|No|75%|43547043109|FENOFIBRATE 145 MG TABLET|90|EA|.28011|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|||Prescription required|No||055|No|.16424|03/29/2022|.16029|03/29/2022|.16136|03/29/2022|||LIPOTROPICS: OTHER|10256|||||No|No||SOLCO HEALTHCAR|No||||
clonidine HCl|No|No|No|No|75%|43547043506|CLONIDINE HCL ER 0.1 MG TABLET|60|EA|1.25416|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.52051|03/29/2022|.50801|03/29/2022|.5114|03/29/2022|||STIMULANTS AND RELATED AGENTS|10257|||||No|No||SOLCO HEALTHCAR|No||||
entecavir|No|No|No|No|75%|43547043603|ENTECAVIR 0.5 MG TABLET|30|EA|1.43333|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||||No|No|||Prescription required|No|||No|.89227|03/29/2022|.87085|03/29/2022|.87665|03/29/2022||||10258|||||No|No||SOLCO HEALTHCAR|No||||
entecavir|No|No|No|No|75%|43547043703|ENTECAVIR 1 MG TABLET|30|EA|1.43333|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||||No|No|||Prescription required|No|||No|1.06461|03/29/2022|1.03905|03/29/2022|1.04597|03/29/2022||||10259|||||No|No||SOLCO HEALTHCAR|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|43547044103|TELMISARTAN-HCTZ 40-12.5 MG TB|30|EA|.57333|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|113|Yes|1.13569|03/29/2022|1.10843|03/29/2022|1.11581|03/29/2022|||ANGIOTENSIN MODULATORS|10260|||||No|No||SOLCO HEALTHCAR|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|43547044203|TELMISARTAN-HCTZ 80-12.5 MG TB|30|EA|.645|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|113|Yes|.94301|03/29/2022|.92037|03/29/2022|.9265|03/29/2022|||ANGIOTENSIN MODULATORS|10261|||||No|No||SOLCO HEALTHCAR|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|43547044303|TELMISARTAN-HCTZ 80-25 MG TAB|30|EA|.71666|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|113|Yes|1.29965|03/29/2022|1.26845|03/29/2022|1.2769|03/29/2022|||ANGIOTENSIN MODULATORS|10262|||||No|No||SOLCO HEALTHCAR|No||||
doxycycline hyclate|No|No|No|No|75%|43547046212|DOXYCYCLINE HYC DR 50 MG TAB|120|EA|4.03393|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|7.12484|05/25/2021|6.95384|05/25/2021|7.00015|05/25/2021|||TETRACYCLINES|10263|||||No|No||SOLCO HEALTHCAR|No||||
glycopyrrolate|No|No|No|No|75%|43547054325|GLYCOPYRROLATE 0.2 MG/ML VIAL|1|ML|1.1696|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No|||No|2.6656|05/21/2020|2.62752|05/21/2020|2.5024|05/21/2020||||10264|||||No|No||SOLCO HEALTHCAR|No||||
glycopyrrolate|No|No|No|No|75%|43547054425|GLYCOPYRROLATE 0.4 MG/2 ML VL|2|ML|1.1696|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No|||No|2.6656|05/21/2020|2.62752|05/21/2020|2.5024|05/21/2020||||10265|||||No|No||SOLCO HEALTHCAR|No||||
fluphenazine HCl|No|No|No|No|75%|43598003401|FLUPHENAZINE 1 MG TABLET|100|EA|.99149|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|1.56797|01/25/2022|1.53033|01/25/2022|1.54053|01/25/2022|||ANTIPSYCHOTICS|10266|||||No|No||DR.REDDY'S LAB|No||||
fluphenazine HCl|No|No|No|No|75%|43598003501|FLUPHENAZINE 2.5 MG TABLET|100|EA|1.53497|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|2.3014|01/25/2022|2.24616|01/25/2022|2.26112|01/25/2022|||ANTIPSYCHOTICS|10267|||||No|No||DR.REDDY'S LAB|No||||
fluphenazine HCl|No|No|No|No|75%|43598003601|FLUPHENAZINE 5 MG TABLET|100|EA|2.07677|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|2.98385|03/29/2022|2.91223|03/29/2022|2.93163|03/29/2022|||ANTIPSYCHOTICS|10268|||||No|No||DR.REDDY'S LAB|No||||
fluphenazine HCl|No|No|No|No|75%|43598003701|FLUPHENAZINE 10 MG TABLET|100|EA|2.61839|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|3.52974|03/29/2022|3.44502|03/29/2022|3.46796|03/29/2022|||ANTIPSYCHOTICS|10269|||||No|No||DR.REDDY'S LAB|No||||
olanzapine|No|No|No|No|75%|43598016405|OLANZAPINE 5 MG TABLET|500|EA|.09961|03/10/2014||Yes|No||03/10/2014||Yes|No|03/10/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.09455|03/29/2022|.09228|03/29/2022|.09289|03/29/2022|||ANTIPSYCHOTICS|10270|||||No|No||DR.REDDY'S LAB|No||||
olanzapine|No|No|No|No|75%|43598016430|OLANZAPINE 5 MG TABLET|30|EA|.09961|03/10/2014||Yes|No||03/10/2014||Yes|No|03/10/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.09455|03/29/2022|.09228|03/29/2022|.09289|03/29/2022|||ANTIPSYCHOTICS|10271|||||No|No||DR.REDDY'S LAB|No||||
olanzapine|No|No|No|No|75%|43598016505|OLANZAPINE 7.5 MG TABLET|500|EA|.12111|03/10/2014||Yes|No||03/10/2014||Yes|No|03/10/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.11617|03/29/2022|.11338|03/29/2022|.11413|03/29/2022|||ANTIPSYCHOTICS|10272|||||No|No||DR.REDDY'S LAB|No||||
olanzapine|No|No|No|No|75%|43598016530|OLANZAPINE 7.5 MG TABLET|30|EA|.12111|03/10/2014||Yes|No||03/10/2014||Yes|No|03/10/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.11617|03/29/2022|.11338|03/29/2022|.11413|03/29/2022|||ANTIPSYCHOTICS|10273|||||No|No||DR.REDDY'S LAB|No||||
olanzapine|No|No|No|No|75%|43598016605|OLANZAPINE 10 MG TABLET|500|EA|.14978|03/10/2014||Yes|No||03/10/2014||Yes|No|03/10/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.12613|03/29/2022|.1231|03/29/2022|.12392|03/29/2022|||ANTIPSYCHOTICS|10274|||||No|No||DR.REDDY'S LAB|No||||
olanzapine|No|No|No|No|75%|43598016630|OLANZAPINE 10 MG TABLET|30|EA|.14978|03/10/2014||Yes|No||03/10/2014||Yes|No|03/10/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.12613|03/29/2022|.1231|03/29/2022|.12392|03/29/2022|||ANTIPSYCHOTICS|10275|||||No|No||DR.REDDY'S LAB|No||||
silver sulfadiazine|No|No|No|No|75%|43598021025|SSD 1% CREAM|25|GM|.12882|11/09/2011||Yes|No||11/09/2011||Yes|No|11/09/2011||Yes|No||||No|No|||Prescription required|No|||No|.16293|03/29/2022|.15901|03/29/2022|.16007|03/29/2022||||10276|||||No|No||DR.REDDY'S LAB|No||||
silver sulfadiazine|No|No|No|No|75%|43598021040|SSD 1% CREAM|400|GM|.05696|11/09/2011||Yes|No||11/09/2011||Yes|No|11/09/2011||Yes|No||||No|No|||Prescription required|No|||No|.07377|03/29/2022|.07199|03/29/2022|.07247|03/29/2022||||10277|||||No|No||DR.REDDY'S LAB|No||||
silver sulfadiazine|No|No|No|No|75%|43598021050|SSD 1% CREAM|50|GM|.10664|11/09/2011||Yes|No||11/09/2011||Yes|No|11/09/2011||Yes|No||||No|No|||Prescription required|No|||No|.13137|03/29/2022|.12821|03/29/2022|.12907|03/29/2022||||10278|||||No|No||DR.REDDY'S LAB|No||||
silver sulfadiazine|No|No|No|No|75%|43598021055|SSD 1% CREAM|50|GM|.10664|11/09/2011||Yes|No||11/09/2011||Yes|No|11/09/2011||Yes|No||||No|No|||Prescription required|No|||No|.13137|03/29/2022|.12821|03/29/2022|.12907|03/29/2022||||10279|||||No|No||DR.REDDY'S LAB|No||||
silver sulfadiazine|No|No|No|No|75%|43598021085|SSD 1% CREAM|85|GM|.11159|11/09/2011||Yes|No||11/09/2011||Yes|No|11/09/2011||Yes|No||||No|No|||Prescription required|No|||No|.13473|03/29/2022|.13149|03/29/2022|.13237|03/29/2022||||10280|||||No|No||DR.REDDY'S LAB|No||||
colesevelam HCl|No|No|No|No|75%|43598023018|COLESEVELAM 625 MG TABLET|180|EA|.39416|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|055|No|.48654|03/29/2022|.47486|03/29/2022|.47802|03/29/2022|||LIPOTROPICS: OTHER|10281|||||No|No||DR.REDDY'S LAB|No||||
icosapent ethyl|No|No|No|No|75%|43598026704|ICOSAPENT ETHYL 1 GRAM CAPSULE|120|EA|1.08166|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|055|No|2.11805|03/29/2022|2.06721|03/29/2022|2.08098|03/29/2022|||LIPOTROPICS: OTHER|10282|||||No|No||DR.REDDY'S LAB|No||||
pregabalin|No|No|No|No|90%|43598029190|PREGABALIN 25 MG CAPSULE|90|EA|.11944|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.0795|03/29/2022|.07759|03/29/2022|.0781|03/29/2022|||NEUROPATHIC PAIN|10283|||||No|No||DR.REDDY'S LAB|No||||
pregabalin|No|No|No|No|90%|43598029266|PREGABALIN 50 MG CAPSULE|50|EA|.301|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|No||232|No|.09128|03/29/2022|.08908|03/29/2022|.08968|03/29/2022|||NEUROPATHIC PAIN|10284|||||No|No||DR.REDDY'S LAB|No||||
pregabalin|No|No|No|No|90%|43598029290|PREGABALIN 50 MG CAPSULE|90|EA|.11944|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.09128|03/29/2022|.08908|03/29/2022|.08968|03/29/2022|||NEUROPATHIC PAIN|10285|||||No|No||DR.REDDY'S LAB|No||||
pregabalin|No|No|No|No|90%|43598029366|PREGABALIN 75 MG CAPSULE|50|EA|.301|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|No||232|No|.08098|03/29/2022|.07903|03/29/2022|.07956|03/29/2022|||NEUROPATHIC PAIN|10286|||||No|No||DR.REDDY'S LAB|No||||
pregabalin|No|No|No|No|90%|43598029390|PREGABALIN 75 MG CAPSULE|90|EA|.11944|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.08098|03/29/2022|.07903|03/29/2022|.07956|03/29/2022|||NEUROPATHIC PAIN|10287|||||No|No||DR.REDDY'S LAB|No||||
pregabalin|No|No|No|No|90%|43598029466|PREGABALIN 100 MG CAPSULE|50|EA|.301|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|No||232|No|.08763|03/29/2022|.08552|03/29/2022|.08609|03/29/2022|||NEUROPATHIC PAIN|10288|||||No|No||DR.REDDY'S LAB|No||||
pregabalin|No|No|No|No|90%|43598029490|PREGABALIN 100 MG CAPSULE|90|EA|.11944|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.08763|03/29/2022|.08552|03/29/2022|.08609|03/29/2022|||NEUROPATHIC PAIN|10289|||||No|No||DR.REDDY'S LAB|No||||
pregabalin|No|No|No|No|90%|43598029566|PREGABALIN 150 MG CAPSULE|50|EA|.301|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|No||232|No|.10646|03/29/2022|.1039|03/29/2022|.10459|03/29/2022|||NEUROPATHIC PAIN|10290|||||No|No||DR.REDDY'S LAB|No||||
pregabalin|No|No|No|No|90%|43598029590|PREGABALIN 150 MG CAPSULE|90|EA|.11944|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.10646|03/29/2022|.1039|03/29/2022|.10459|03/29/2022|||NEUROPATHIC PAIN|10291|||||No|No||DR.REDDY'S LAB|No||||
pregabalin|No|No|No|No|90%|43598029690|PREGABALIN 200 MG CAPSULE|90|EA|.11944|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.11395|03/29/2022|.11121|03/29/2022|.11195|03/29/2022|||NEUROPATHIC PAIN|10292|||||No|No||DR.REDDY'S LAB|No||||
pregabalin|No|No|No|No|90%|43598029790|PREGABALIN 225 MG CAPSULE|90|EA|.11944|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.12393|03/29/2022|.12095|03/29/2022|.12176|03/29/2022|||NEUROPATHIC PAIN|10293|||||No|No||DR.REDDY'S LAB|No||||
pregabalin|No|No|No|No|90%|43598029890|PREGABALIN 300 MG CAPSULE|90|EA|.11944|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.12181|03/29/2022|.11888|03/29/2022|.11967|03/29/2022|||NEUROPATHIC PAIN|10294|||||No|No||DR.REDDY'S LAB|No||||
finasteride|No|No|No|No|75%|43598030330|FINASTERIDE 5 MG TABLET|30|EA|.16483|01/14/2013||Yes|No||01/14/2013||Yes|No|01/14/2013||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|10295|||||No|No||DR.REDDY'S LAB|No||||
finasteride|No|No|No|No|75%|43598030390|FINASTERIDE 5 MG TABLET|90|EA|.16483|01/14/2013||Yes|No||01/14/2013||Yes|No|01/14/2013||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|10296|||||No|No||DR.REDDY'S LAB|No||||
azacitidine|No|No|No|No|75%|43598030562|AZACITIDINE 100 MG VIAL|1|EA|86|12/20/2013||Yes|No||12/20/2013||Yes|No|12/20/2013||Yes|No||||No|No|||Prescription required|No|||No|196|06/08/2021|193.2|06/08/2021|184|06/08/2021||||10297|||||No|No||DR.REDDY'S LAB|No||||
amlodipine/atorvastatin|No|No|No|No|75%|43598031330|AMLODIPINE-ATORVAST 10-80 MG|30|EA|3.17497|08/13/2014||Yes|No||08/13/2014||Yes|No|08/13/2014||Yes|No||08/13/2014||Yes|No|||Prescription required|Yes|07/24/2013|063|Yes|4.0268|03/01/2022|3.93015|03/01/2022|3.95633|03/01/2022|||LIPOTROPICS: STATINS|10298|||||No|No||DR.REDDY'S LAB|No||||
amlodipine/atorvastatin|No|No|No|No|75%|43598031430|AMLODIPINE-ATORVAST 5-80 MG|30|EA|3.17497|08/13/2014||Yes|No||08/13/2014||Yes|No|08/13/2014||Yes|No||08/13/2014||Yes|No|||Prescription required|Yes|07/24/2013|063|Yes|7.23598|07/24/2018|7.13261|07/24/2018|6.79296|07/24/2018|||LIPOTROPICS: STATINS|10299|||||No|No||DR.REDDY'S LAB|No||||
amlodipine/atorvastatin|No|No|No|No|75%|43598031530|AMLODIPINE-ATORVAST 10-40 MG|30|EA|3.17497|07/24/2014||Yes|No||07/24/2014||Yes|No|07/24/2014||Yes|No||07/24/2014||Yes|No|||Prescription required|Yes|07/24/2013|063|Yes|2.04729|03/29/2022|1.99815|03/29/2022|2.01146|03/29/2022|||LIPOTROPICS: STATINS|10300|||||No|No||DR.REDDY'S LAB|No||||
amlodipine/atorvastatin|No|No|No|No|75%|43598031590|AMLODIPINE-ATORVAST 10-40 MG|90|EA|3.17497|09/29/2014||Yes|No||09/29/2014||Yes|No|09/29/2014||Yes|No||09/29/2014||Yes|No|||Prescription required|Yes|07/24/2013|063|Yes|2.04729|03/29/2022|1.99815|03/29/2022|2.01146|03/29/2022|||LIPOTROPICS: STATINS|10301|||||No|No||DR.REDDY'S LAB|No||||
amlodipine/atorvastatin|No|No|No|No|75%|43598031630|AMLODIPINE-ATORVAST 5-40 MG|30|EA|3.17497|08/08/2014||Yes|No||08/08/2014||Yes|No|08/08/2014||Yes|No||08/08/2014||Yes|No|||Prescription required|Yes|07/24/2013|063|Yes|3.582|03/01/2022|3.49603|03/01/2022|3.51931|03/01/2022|||LIPOTROPICS: STATINS|10302|||||No|No||DR.REDDY'S LAB|No||||
amlodipine/atorvastatin|No|No|No|No|75%|43598031690|AMLODIPINE-ATORVAST 5-40 MG|90|EA|3.17497|09/29/2014||Yes|No||09/29/2014||Yes|No|09/29/2014||Yes|No||09/29/2014||Yes|No|||Prescription required|Yes|07/24/2013|063|Yes|3.582|03/01/2022|3.49603|03/01/2022|3.51931|03/01/2022|||LIPOTROPICS: STATINS|10303|||||No|No||DR.REDDY'S LAB|No||||
amlodipine/atorvastatin|No|No|No|No|75%|43598031730|AMLODIPINE-ATORVAST 2.5-40 MG|30|EA|3.17497|08/13/2014||Yes|No||08/13/2014||Yes|No|08/13/2014||Yes|No||08/13/2014||Yes|No|||Prescription required|Yes|07/24/2013|063|Yes|7.23598|06/01/2016|7.13261|06/01/2016|6.79296|06/01/2016|||LIPOTROPICS: STATINS|10304|||||No|No||DR.REDDY'S LAB|No||||
amlodipine/atorvastatin|No|No|No|No|75%|43598031830|AMLODIPINE-ATORVAST 10-20 MG|30|EA|3.17497|07/24/2014||Yes|No||07/24/2014||Yes|No|07/24/2014||Yes|No||07/24/2014||Yes|No|||Prescription required|Yes|07/24/2013|063|Yes|1.70393|03/29/2022|1.66303|03/29/2022|1.67411|03/29/2022|||LIPOTROPICS: STATINS|10305|||||No|No||DR.REDDY'S LAB|No||||
amlodipine/atorvastatin|No|No|No|No|75%|43598031890|AMLODIPINE-ATORVAST 10-20 MG|90|EA|3.17497|09/18/2014||Yes|No||09/18/2014||Yes|No|09/18/2014||Yes|No||09/18/2014||Yes|No|||Prescription required|Yes|07/24/2013|063|Yes|1.70393|03/29/2022|1.66303|03/29/2022|1.67411|03/29/2022|||LIPOTROPICS: STATINS|10306|||||No|No||DR.REDDY'S LAB|No||||
amlodipine/atorvastatin|No|No|No|No|75%|43598031930|AMLODIPINE-ATORVAST 5-20 MG|30|EA|3.17497|07/24/2014||Yes|No||07/24/2014||Yes|No|07/24/2014||Yes|No||07/24/2014||Yes|No|||Prescription required|Yes|07/24/2013|063|Yes|2.6682|03/29/2022|2.60416|03/29/2022|2.6215|03/29/2022|||LIPOTROPICS: STATINS|10307|||||No|No||DR.REDDY'S LAB|No||||
amlodipine/atorvastatin|No|No|No|No|75%|43598031990|AMLODIPINE-ATORVAST 5-20 MG|90|EA|3.17497|09/29/2014||Yes|No||09/29/2014||Yes|No|09/29/2014||Yes|No||09/29/2014||Yes|No|||Prescription required|Yes|07/24/2013|063|Yes|2.6682|03/29/2022|2.60416|03/29/2022|2.6215|03/29/2022|||LIPOTROPICS: STATINS|10308|||||No|No||DR.REDDY'S LAB|No||||
amlodipine/atorvastatin|No|No|No|No|75%|43598032030|AMLODIPINE-ATORVAST 2.5-20 MG|30|EA|3.17497|09/18/2014||Yes|No||09/18/2014||Yes|No|09/18/2014||Yes|No||09/18/2014||Yes|No|||Prescription required|Yes|07/24/2013|063|Yes|7.23598|06/01/2016|7.13261|06/01/2016|6.79296|06/01/2016|||LIPOTROPICS: STATINS|10309|||||No|No||DR.REDDY'S LAB|No||||
amlodipine/atorvastatin|No|No|No|No|75%|43598032130|AMLODIPINE-ATORVAST 10-10 MG|30|EA|2.32071|07/24/2014||Yes|No||07/24/2014||Yes|No|07/24/2014||Yes|No||07/24/2014||Yes|No|||Prescription required|Yes|07/24/2013|063|Yes|2.18539|03/29/2022|2.13294|03/29/2022|2.14714|03/29/2022|||LIPOTROPICS: STATINS|10310|||||No|No||DR.REDDY'S LAB|No||||
amlodipine/atorvastatin|No|No|No|No|75%|43598032190|AMLODIPINE-ATORVAST 10-10 MG|90|EA|2.32071|09/29/2014||Yes|No||09/29/2014||Yes|No|09/29/2014||Yes|No||09/29/2014||Yes|No|||Prescription required|Yes|07/24/2013|063|Yes|2.18539|03/29/2022|2.13294|03/29/2022|2.14714|03/29/2022|||LIPOTROPICS: STATINS|10311|||||No|No||DR.REDDY'S LAB|No||||
amlodipine/atorvastatin|No|No|No|No|75%|43598032230|AMLODIPINE-ATORVAST 5-10 MG|30|EA|2.32071|07/24/2014||Yes|No||07/24/2014||Yes|No|07/24/2014||Yes|No||07/24/2014||Yes|No|||Prescription required|Yes|07/24/2013|063|Yes|2.51729|03/29/2022|2.45687|03/29/2022|2.47323|03/29/2022|||LIPOTROPICS: STATINS|10312|||||No|No||DR.REDDY'S LAB|No||||
amlodipine/atorvastatin|No|No|No|No|75%|43598032290|AMLODIPINE-ATORVAST 5-10 MG|90|EA|2.32071|09/18/2014||Yes|No||09/18/2014||Yes|No|09/18/2014||Yes|No||09/18/2014||Yes|No|||Prescription required|Yes|07/24/2013|063|Yes|2.51729|03/29/2022|2.45687|03/29/2022|2.47323|03/29/2022|||LIPOTROPICS: STATINS|10313|||||No|No||DR.REDDY'S LAB|No||||
amlodipine/atorvastatin|No|No|No|No|75%|43598032330|AMLODIPINE-ATORVAST 2.5-10 MG|30|EA|2.32071|08/13/2014||Yes|No||08/13/2014||Yes|No|08/13/2014||Yes|No||08/13/2014||Yes|No|||Prescription required|Yes|07/24/2013|063|Yes|5.28906|06/01/2016|5.2135|06/01/2016|4.96524|06/01/2016|||LIPOTROPICS: STATINS|10314|||||No|No||DR.REDDY'S LAB|No||||
ciprofloxacin HCl/dexameth|No|No|No|No|75%|43598032675|CIPROFLOX-DEXAMETH OTIC SUSP|7.5|ML|10.03333|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|051|No|19.45133|03/29/2022|18.98449|03/29/2022|19.11093|03/29/2022|||OTIC ANTIBIOTICS|10315|||||No|No||DR.REDDY'S LAB|No||||
aspirin/dipyridamole|No|No|No|No|75%|43598033960|ASPIRIN-DIPYRIDAM ER 25-200 MG|60|EA|.43|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||004|No|.78047|03/29/2022|.76173|03/29/2022|.76681|03/29/2022|||PLATELET AGGREGATION INHIBITORS|10316|||||No|No||DR.REDDY'S LAB|No||||
imatinib mesylate|No|No|No|No|75%|43598034490|IMATINIB MESYLATE 100 MG TAB|90|EA|1.62888|12/10/2018||Yes|No||12/10/2018||Yes|No|||No|No||||No|No|||Prescription required|No||173|No|3.71234|07/27/2021|3.65931|07/27/2021|3.48506|07/27/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|10317|||||No|No||DR.REDDY'S LAB|No||||
imatinib mesylate|No|No|No|No|75%|43598034530|IMATINIB MESYLATE 400 MG TAB|30|EA|5.8695|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|No||173|No|2.86988|03/01/2022|2.801|03/01/2022|2.81965|03/01/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|10318|||||No|No||DR.REDDY'S LAB|No||||
progesterone, micronized|No|No|No|No|75%|43598034901|PROGESTERONE 100 MG CAPSULE|100|EA|.46956|09/21/2017||Yes|No||09/21/2017||Yes|No|09/21/2017||Yes|No||||No|No|||Prescription required|No|||No|.25967|03/29/2022|.25343|03/29/2022|.25512|03/29/2022||||10319|||||No|No||DR.REDDY'S LAB|No||||
progesterone, micronized|No|No|No|No|75%|43598035001|PROGESTERONE 200 MG CAPSULE|100|EA|.8944|09/21/2017|08/31/2022|Yes|No||09/21/2017|08/31/2022|Yes|No|09/21/2017|08/31/2022|Yes|No||||No|No|||Prescription required|No|||No|.48257|03/29/2022|.47098|03/29/2022|.47412|03/29/2022||||10320|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||DR.REDDY'S LAB|No||||
abiraterone acetate|No|No|No|No|75%|43598035804|ABIRATERONE ACETATE 250 MG TAB|120|EA|1.52291|09/21/2020||Yes|No||09/21/2020||Yes|No|09/21/2020||Yes|No||||No|No|||Prescription required|No||550|No|3.47082|09/28/2021|3.42124|09/28/2021|3.25832|09/28/2021|||ONCOLOGY: ORAL - PROSTATE|10321|||||No|No||DR.REDDY'S LAB|No||||
cinacalcet HCl|No|No|No|No|75%|43598036730|CINACALCET HCL 30 MG TABLET|30|EA|.76755|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No|||No|.75588|03/29/2022|.73773|03/29/2022|.74265|03/29/2022||||10322|||||No|No||DR.REDDY'S LAB|No||||
cinacalcet HCl|No|No|No|No|75%|43598036830|CINACALCET HCL 60 MG TABLET|30|EA|1.51259|04/12/2021||Yes|No||04/12/2021||Yes|No|04/12/2021||Yes|No||||No|No|||Prescription required|No|||No|1.7407|03/29/2022|1.69892|03/29/2022|1.71023|03/29/2022||||10323|||||No|No||DR.REDDY'S LAB|No||||
cinacalcet HCl|No|No|No|No|75%|43598036930|CINACALCET HCL 90 MG TABLET|30|EA|1.88669|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No|||No|3.64673|03/29/2022|3.5592|03/29/2022|3.58291|03/29/2022||||10324|||||No|No||DR.REDDY'S LAB|No||||
colchicine|No|No|No|No|75%|43598037201|COLCHICINE 0.6 MG TABLET|100|EA|.46246|09/21/2020||Yes|No||09/21/2020||Yes|No|09/21/2020||Yes|No||09/21/2020||Yes|No|||Prescription required|Yes|07/30/2020|231|No|.64179|03/29/2022|.62638|03/29/2022|.63055|03/29/2022|||ANTIHYPERURICEMICS|10325|||||No|No||DR.REDDY'S LAB|No||||
colchicine|No|No|No|No|75%|43598037210|COLCHICINE 0.6 MG TABLET|1000|EA|.46246|12/09/2020||Yes|No||12/09/2020||Yes|No|12/09/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|231|No|.64179|03/29/2022|.62638|03/29/2022|.63055|03/29/2022|||ANTIHYPERURICEMICS|10326|||||No|No||DR.REDDY'S LAB|No||||
colchicine|No|No|No|No|75%|43598037230|COLCHICINE 0.6 MG TABLET|30|EA|.56287|09/21/2020||Yes|No||09/21/2020||Yes|No|09/21/2020||Yes|No||09/21/2020||Yes|No|||Prescription required|Yes|07/25/2019|231|No|.64179|03/29/2022|.62638|03/29/2022|.63055|03/29/2022|||ANTIHYPERURICEMICS|10327|||||No|No||DR.REDDY'S LAB|No||||
finasteride|No|No|No|No|75%|43598039030|FINASTERIDE 1 MG TABLET|30|EA|.11438|12/03/2014||Yes|No||12/03/2014||Yes|No|12/03/2014||Yes|No||||No|No|||Prescription required|No|||No|.04818|03/29/2022|.04702|03/29/2022|.04733|03/29/2022||||10328|||||No|No||DR.REDDY'S LAB|No||||
finasteride|No|No|No|No|75%|43598039090|FINASTERIDE 1 MG TABLET|90|EA|.11438|02/18/2015||Yes|No||02/18/2015||Yes|No|02/18/2015||Yes|No||||No|No|||Prescription required|No|||No|.04818|03/29/2022|.04702|03/29/2022|.04733|03/29/2022||||10329|||||No|No||DR.REDDY'S LAB|No||||
tetrabenazine|No|No|No|No|75%|43598039467|TETRABENAZINE 12.5 MG TABLET|112|EA|3.37469|05/23/2018||Yes|No||05/23/2018||Yes|No|05/23/2018||Yes|No||||No|No|||Prescription required|No||572|Yes|7.69115|10/06/2020|7.58128|10/06/2020|7.22027|10/06/2020|||MOVEMENT DISORDERS|10330|||||No|No||DR.REDDY'S LAB|No||||
tetrabenazine|No|No|No|No|75%|43598039567|TETRABENAZINE 25 MG TABLET|112|EA|6.74934|05/23/2018||Yes|No||05/23/2018||Yes|No|05/23/2018||Yes|No||||No|No|||Prescription required|No||572|Yes|15.38223|10/06/2020|15.16249|10/06/2020|14.44046|10/06/2020|||MOVEMENT DISORDERS|10331|||||No|No||DR.REDDY'S LAB|No||||
phytonadione (vit K1)|No|No|No|No|75%|43598040516|PHYTONADIONE 10 MG/ML AMPUL|1|ML|18.38972|12/29/2020||Yes|No||12/29/2020||Yes|No|||No|No||||No|No|||Prescription required|No|||No|41.91146|12/29/2020|41.31272|12/29/2020|39.34545|12/29/2020||||10332|||||No|No||DR.REDDY'S LAB|No||||
esomeprazole magnesium|No|No|No|No|75%|43598040727|ESOMEPRAZOLE MAG DR 20 MG CAP|14|EA|.23481|12/20/2019||Yes|No||||No|No|12/20/2019||Yes|No||09/01/2021||Yes|No|||Over the counter|Yes|07/29/2021|047|Yes|.3522|03/29/2022|.34374|03/29/2022|.34603|03/29/2022|||PROTON PUMP INHIBITORS|10333|||||No|No||DR.REDDY'S LAB|No||||
esomeprazole magnesium|No|No|No|No|75%|43598040733|ESOMEPRAZOLE MAG DR 20 MG CAP|14|EA|.21243|09/17/2019||Yes|No||||No|No|09/17/2019||Yes|No||09/01/2021||Yes|No|||Over the counter|Yes|07/29/2021|047|Yes|.3522|03/29/2022|.34374|03/29/2022|.34603|03/29/2022|||PROTON PUMP INHIBITORS|10334|||||No|No||DR.REDDY'S LAB|No||||
esomeprazole magnesium|No|No|No|No|75%|43598040752|ESOMEPRAZOLE MAG DR 20 MG CAP|14|EA|.26537|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||09/01/2021||Yes|No|||Over the counter|Yes|07/29/2021|047|Yes|.3522|03/29/2022|.34374|03/29/2022|.34603|03/29/2022|||PROTON PUMP INHIBITORS|10335|||||No|No||DR.REDDY'S LAB|No||||
dimethyl fumarate|No|No|No|No|75%|43598042952|DIMETHYL FUMARATE DR 120 MG CP|14|EA|5.93123|12/09/2020||Yes|No||12/09/2020||Yes|No|12/09/2020||Yes|No||||No|No|||Prescription required|No||043|No|6.92871|10/26/2021|6.76242|10/26/2021|6.80745|10/26/2021|||MULTIPLE SCLEROSIS AGENTS|10336|||||No|No||DR.REDDY'S LAB|No||||
dimethyl fumarate|No|No|No|No|75%|43598043060|DIMETHYL FUMARATE DR 240 MG CP|60|EA|5.93105|12/09/2020||Yes|No||12/09/2020||Yes|No|12/09/2020||Yes|No||||No|No|||Prescription required|No||043|No|3.05522|11/23/2021|2.98189|11/23/2021|3.00175|11/23/2021|||MULTIPLE SCLEROSIS AGENTS|10337|||||No|No||DR.REDDY'S LAB|No||||
nitroglycerin|No|No|No|No|75%|43598043501|NITROGLYCERIN 0.3 MG TABLET SL|100|EA|.16679|11/22/2016||Yes|No||11/22/2016||Yes|No|11/22/2016||Yes|No||11/22/2016||Yes|No|||Prescription required|No|||No|.22579|03/29/2022|.22037|03/29/2022|.22183|03/29/2022||||10338|||||No|No||DR.REDDY'S LAB|No||||
nitroglycerin|No|No|No|No|75%|43598043601|NITROGLYCERIN 0.4 MG TABLET SL|100|EA|.16679|11/22/2016||Yes|No||11/22/2016||Yes|No|11/22/2016||Yes|No||11/22/2016||Yes|No|||Prescription required|No|||No|.18753|03/29/2022|.18302|03/29/2022|.18424|03/29/2022||||10339|||||No|No||DR.REDDY'S LAB|No||||
nitroglycerin|No|No|No|No|75%|43598043611|NITROGLYCERIN 0.4 MG TABLET SL|25|EA|.3639|11/22/2016||Yes|No||11/22/2016||Yes|No|11/22/2016||Yes|No||11/22/2016||Yes|No|||Prescription required|No|||No|.26492|03/29/2022|.25856|03/29/2022|.26028|03/29/2022||||10340|||||No|No||DR.REDDY'S LAB|No||||
nitroglycerin|No|No|No|No|75%|43598043701|NITROGLYCERIN 0.6 MG TABLET SL|100|EA|.16679|11/22/2016||Yes|No||11/22/2016||Yes|No|11/22/2016||Yes|No||11/22/2016||Yes|No|||Prescription required|No|||No|.38014|03/29/2022|.37471|03/29/2022|.35686|03/29/2022||||10341|||||No|No||DR.REDDY'S LAB|No||||
methylphenidate HCl|No|No|No|No|75%|43598043801|METHYLPHENIDATE ER 18 MG TAB|100|EA|.83682|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|007|Yes|.56499|03/29/2022|.55143|03/29/2022|.5551|03/29/2022|||STIMULANTS AND RELATED AGENTS|10342|||||No|No||DR.REDDY'S LAB|No||||
methylphenidate HCl|No|No|No|No|75%|43598043901|METHYLPHENIDATE ER 27 MG TAB|100|EA|.8578|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|007|Yes|.90623|03/29/2022|.88448|03/29/2022|.89037|03/29/2022|||STIMULANTS AND RELATED AGENTS|10343|||||No|No||DR.REDDY'S LAB|No||||
methylphenidate HCl|No|No|No|No|75%|43598044001|METHYLPHENIDATE ER 36 MG TAB|100|EA|.88481|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|007|Yes|.76999|03/29/2022|.75151|03/29/2022|.75651|03/29/2022|||STIMULANTS AND RELATED AGENTS|10344|||||No|No||DR.REDDY'S LAB|No||||
methylphenidate HCl|No|No|No|No|75%|43598044101|METHYLPHENIDATE ER 54 MG TAB|100|EA|.96277|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|007|Yes|.87218|03/29/2022|.85124|03/29/2022|.85691|03/29/2022|||STIMULANTS AND RELATED AGENTS|10345|||||No|No||DR.REDDY'S LAB|No||||
nicotine|No|No|No|No|75%|43598044556|NICOTINE TRANSDERMAL SYSTEM|56|EA|.6549|07/20/2015||Yes|No||||No|No|07/20/2015||Yes|No||||No|No|||Over the counter|No||040|No|1.49961|03/01/2022|1.46361|03/01/2022|1.47336|03/01/2022|||SMOKING CESSATION|10346|||||No|No||DR.REDDY'S LAB|No||||
nicotine|No|No|No|No|75%|43598044674|NICOTINE 7 MG/24HR PATCH|14|EA|.76447|07/20/2015||Yes|No||||No|No|07/20/2015||Yes|No||||No|No|||Over the counter|No||040|No|1.78989|03/29/2022|1.74693|03/29/2022|1.75856|03/29/2022|||SMOKING CESSATION|10347|||||No|No||DR.REDDY'S LAB|No||||
nicotine|No|No|No|No|75%|43598044774|NICOTINE 14 MG/24HR PATCH|14|EA|.76447|07/20/2015||Yes|No||||No|No|07/20/2015||Yes|No||||No|No|||Over the counter|No||040|No|1.68083|03/29/2022|1.64049|03/29/2022|1.65141|03/29/2022|||SMOKING CESSATION|10348|||||No|No||DR.REDDY'S LAB|Yes|09/01/2020|||
nicotine|No|No|No|No|75%|43598044828|NICOTINE 21 MG/24HR PATCH|28|EA|.68938|06/10/2015||Yes|No||||No|No|06/10/2015||Yes|No||||No|No|||Over the counter|No||040|No|1.70855|03/29/2022|1.66754|03/29/2022|1.67865|03/29/2022|||SMOKING CESSATION|10349|||||No|No||DR.REDDY'S LAB|Yes|09/01/2020|||
nicotine|No|No|No|No|75%|43598044874|NICOTINE 21 MG/24HR PATCH|14|EA|.76447|07/20/2015||Yes|No||||No|No|07/20/2015||Yes|No||||No|No|||Over the counter|No||040|No|1.70855|03/29/2022|1.66754|03/29/2022|1.67865|03/29/2022|||SMOKING CESSATION|10350|||||No|No||DR.REDDY'S LAB|Yes|09/01/2020|||
albendazole|No|No|No|No|75%|43598045202|ALBENDAZOLE 200 MG TABLET|2|EA|17.2|08/23/2021||Yes|No||08/23/2021||Yes|No|08/23/2021||Yes|No||||No|No|||Prescription required|No|||No|16.91042|03/29/2022|16.50456|03/29/2022|16.61448|03/29/2022||||10351|||||No|No||DR.REDDY'S LAB|No||||
trientine HCl|No|No|No|No|75%|43598045901|TRIENTINE HCL 250 MG CAPSULE|100|EA|21.5|03/16/2020||Yes|No||03/16/2020||Yes|No|03/16/2020||Yes|No||||No|No|||Prescription required|No|||No|49|03/16/2020|48.3|03/16/2020|46|03/16/2020||||10352|||||No|No||DR.REDDY'S LAB|No||||
daptomycin|No|No|No|No|75%|43598047611|DAPTOMYCIN 350 MG VIAL|1|EA|17.2|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||No|39.2|02/23/2022|38.64|02/23/2022|36.8|02/23/2022||||10353|||||No|No||DR.REDDY'S LAB|No||||
sapropterin dihydrochloride|No|No|No|No|75%|43598047730|SAPROPTERIN 100 MG POWDER PKT|30|EA|12.47688|08/23/2021||Yes|No||08/23/2021||Yes|No|08/23/2021||Yes|No||||No|No|||Prescription required|No|||No|28.43568|08/31/2021|28.02945|08/23/2021|26.69472|08/23/2021||||10354|||||No|No||DR.REDDY'S LAB|No||||
sevelamer carbonate|No|No|No|No|75%|43598047890|SEVELAMER 0.8 GM POWDER PACKET|90|EA|4.06588|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/26/2018|052|Yes|9.26643|01/25/2022|9.13406|01/25/2022|8.6991|01/25/2022|||PHOSPHATE BINDERS|10355|||||No|No||DR.REDDY'S LAB|No||||
sevelamer carbonate|No|No|No|No|75%|43598047990|SEVELAMER 2.4 GM POWDER PACKET|90|EA|4.06588|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/26/2018|052|Yes|6.45324|08/24/2021|6.29836|08/24/2021|6.3403|08/24/2021|||PHOSPHATE BINDERS|10356|||||No|No||DR.REDDY'S LAB|No||||
nicotine polacrilex|No|No|No|No|75%|43598048672|NICOTINE 2 MG LOZENGE|72|EA|.16536|12/09/2020||Yes|No||||No|No|12/09/2020||Yes|No||||No|No|||Over the counter|No||040|No|.32832|03/29/2022|.32044|03/29/2022|.32257|03/29/2022|||SMOKING CESSATION|10357|||||No|No||DR.REDDY'S LAB|No||||
nicotine polacrilex|No|No|No|No|75%|43598048772|NICOTINE 4 MG LOZENGE|72|EA|.16536|12/09/2020||Yes|No||||No|No|12/09/2020||Yes|No||||No|No|||Over the counter|No||040|No|.35064|03/29/2022|.34222|03/29/2022|.3445|03/29/2022|||SMOKING CESSATION|10358|||||No|No||DR.REDDY'S LAB|No||||
naproxen sodium|No|No|No|No|75%|43598049401|NAPROXEN SODIUM 275 MG TAB|100|EA|.215|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||10/04/2016||Yes|No|||Prescription required|Yes|01/26/2017|059|Yes|.49|03/23/2021|.483|03/23/2021|.46|03/23/2021|||NSAIDS|10359|||||No|No||DR.REDDY'S LAB|No||||
naproxen sodium|No|No|No|No|75%|43598049501|NAPROXEN SODIUM 550 MG TAB|100|EA|.3225|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||10/04/2016||Yes|No|||Prescription required|Yes|01/26/2017|059|Yes|.37204|03/29/2022|.36311|03/29/2022|.36552|03/29/2022|||NSAIDS|10360|||||No|No||DR.REDDY'S LAB|No||||
naproxen sodium|No|No|No|No|75%|43598049505|NAPROXEN SODIUM 550 MG TAB|500|EA|.3225|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||10/04/2016||Yes|No|||Prescription required|Yes|01/26/2017|059|Yes|.37204|03/29/2022|.36311|03/29/2022|.36552|03/29/2022|||NSAIDS|10361|||||No|No||DR.REDDY'S LAB|No||||
raloxifene HCl|No|No|No|No|75%|43598050501|RALOXIFENE HCL 60 MG TABLET|100|EA|.9933|02/28/2017||Yes|No||02/28/2017||Yes|No|02/28/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|060|Yes|.36315|03/29/2022|.35443|03/29/2022|.35679|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|10362|||||No|No||DR.REDDY'S LAB|No||||
raloxifene HCl|No|No|No|No|75%|43598050510|RALOXIFENE HCL 60 MG TABLET|1000|EA|.9933|02/28/2017||Yes|No||02/28/2017||Yes|No|02/28/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|060|Yes|.36315|03/29/2022|.35443|03/29/2022|.35679|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|10363|||||No|No||DR.REDDY'S LAB|No||||
raloxifene HCl|No|No|No|No|75%|43598050530|RALOXIFENE HCL 60 MG TABLET|30|EA|.9933|02/28/2017||Yes|No||02/28/2017||Yes|No|02/28/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|060|Yes|.36315|03/29/2022|.35443|03/29/2022|.35679|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|10364|||||No|No||DR.REDDY'S LAB|No||||
esomeprazole magnesium|No|No|No|No|75%|43598050910|ESOMEPRAZOLE MAG DR 20 MG CAP|1000|EA|.35548|08/16/2016||Yes|No||08/16/2016||Yes|No|08/16/2016||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|10365|||||No|No||DR.REDDY'S LAB|No||||
esomeprazole magnesium|No|No|No|No|75%|43598050930|ESOMEPRAZOLE MAG DR 20 MG CAP|30|EA|.3665|04/01/2016||Yes|No||04/01/2016||Yes|No|04/01/2016||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|10366|||||No|No||DR.REDDY'S LAB|No||||
esomeprazole magnesium|No|No|No|No|75%|43598050990|ESOMEPRAZOLE MAG DR 20 MG CAP|90|EA|.3665|06/08/2016||Yes|No||06/08/2016||Yes|No|06/08/2016||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|10367|||||No|No||DR.REDDY'S LAB|No||||
esomeprazole magnesium|No|No|No|No|75%|43598051010|ESOMEPRAZOLE MAG DR 40 MG CAP|1000|EA|.35548|08/16/2016||Yes|No||08/16/2016||Yes|No|08/16/2016||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|10368|||||No|No||DR.REDDY'S LAB|No||||
esomeprazole magnesium|No|No|No|No|75%|43598051030|ESOMEPRAZOLE MAG DR 40 MG CAP|30|EA|.3665|04/01/2016||Yes|No||04/01/2016||Yes|No|04/01/2016||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|10369|||||No|No||DR.REDDY'S LAB|No||||
esomeprazole magnesium|No|No|No|No|75%|43598051090|ESOMEPRAZOLE MAG DR 40 MG CAP|90|EA|.3665|05/13/2016||Yes|No||05/13/2016||Yes|No|05/13/2016||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|10370|||||No|No||DR.REDDY'S LAB|No||||
lamotrigine|No|No|No|No|75%|43598055030|LAMOTRIGINE ODT 25 MG TABLET|30|EA|2.84946|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||056|No|3.83184|03/01/2022|3.73987|03/01/2022|3.76478|03/01/2022|||ANTICONVULSANTS|10371|||||No|No||DR.REDDY'S LAB|No||||
lamotrigine|No|No|No|No|75%|43598055130|LAMOTRIGINE ODT 50 MG TABLET|30|EA|3.05199|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||056|No|3.24575|03/29/2022|3.16785|03/29/2022|3.18894|03/29/2022|||ANTICONVULSANTS|10372|||||No|No||DR.REDDY'S LAB|No||||
lamotrigine|No|No|No|No|75%|43598055230|LAMOTRIGINE ODT 100 MG TABLET|30|EA|3.25438|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||056|No|4.72113|03/29/2022|4.60782|03/29/2022|4.63851|03/29/2022|||ANTICONVULSANTS|10373|||||No|No||DR.REDDY'S LAB|No||||
lamotrigine|No|No|No|No|75%|43598055330|LAMOTRIGINE ODT 200 MG TABLET|30|EA|3.88333|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||056|No|4.09893|03/01/2022|4.00055|03/01/2022|4.02719|03/01/2022|||ANTICONVULSANTS|10374|||||No|No||DR.REDDY'S LAB|No||||
aripiprazole|No|No|No|No|75%|43598055430|ARIPIPRAZOLE 2 MG TABLET|30|EA|.301|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|10375|||||No|No||DR.REDDY'S LAB|No||||
aripiprazole|No|No|No|No|75%|43598055530|ARIPIPRAZOLE 5 MG TABLET|30|EA|.301|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|10376|||||No|No||DR.REDDY'S LAB|No||||
aripiprazole|No|No|No|No|75%|43598055630|ARIPIPRAZOLE 10 MG TABLET|30|EA|.301|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|10377|||||No|No||DR.REDDY'S LAB|No||||
aripiprazole|No|No|No|No|75%|43598055730|ARIPIPRAZOLE 15 MG TABLET|30|EA|.301|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|10378|||||No|No||DR.REDDY'S LAB|No||||
aripiprazole|No|No|No|No|75%|43598055830|ARIPIPRAZOLE 20 MG TABLET|30|EA|.34041|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|10379|||||No|No||DR.REDDY'S LAB|No||||
aripiprazole|No|No|No|No|75%|43598055930|ARIPIPRAZOLE 30 MG TABLET|30|EA|.34041|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|10380|||||No|No||DR.REDDY'S LAB|No||||
lansoprazole|No|No|No|No|75%|43598056078|LANSOPRAZOLE ODT 15 MG TABLET|100|EA|2.67735|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|047|No|6.08156|03/29/2022|5.9356|03/29/2022|5.97513|03/29/2022|||PROTON PUMP INHIBITORS|10381|||||No|No||DR.REDDY'S LAB|No||||
lansoprazole|No|No|No|No|75%|43598056178|LANSOPRAZOLE ODT 30 MG TABLET|100|EA|2.67735|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|047|No|5.52111|03/29/2022|5.3886|03/29/2022|5.42449|03/29/2022|||PROTON PUMP INHIBITORS|10382|||||No|No||DR.REDDY'S LAB|No||||
fluoxetine HCl|Yes|No|No|No|75%|43598056601|FLUOXETINE HCL 20 MG TABLET|100|EA|.19728|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||008|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10383|||||No|No||DR.REDDY'S LAB|No||||
fluoxetine HCl|Yes|No|No|No|75%|43598056630|FLUOXETINE HCL 20 MG TABLET|30|EA|.22188|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||008|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10384|||||No|No||DR.REDDY'S LAB|No||||
tadalafil|No|No|No|No|75%|43598057860|TADALAFIL 20 MG TABLET|60|EA|.35797|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/26/2018|171|Yes|.68104|03/29/2022|.66469|03/29/2022|.66912|03/29/2022|||PAH AGENTS: ORAL AND INHALED|10385|||||No|No||DR.REDDY'S LAB|No||||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|43598057901|BUPRENORPHINE-NALOX 2-0.5MG FM|1|EA|1.76027|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|2.34845|03/29/2022|2.29208|03/29/2022|2.30735|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|10386|||||No|No||DR.REDDY'S LAB|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|43598057930|BUPRENORPHINE-NALOX 2-0.5MG FM|30|EA|1.51933|05/28/2019||Yes|No||05/28/2019||Yes|No|05/28/2019||Yes|No||||No|No|||Prescription required|No||145|Yes|2.34845|03/29/2022|2.29208|03/29/2022|2.30735|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|10387|||||No|No||DR.REDDY'S LAB|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|43598058001|BUPRENORPHINE-NALOX 4-1MG FILM|1|EA|3.15333|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|4.75054|03/29/2022|4.63652|03/29/2022|4.6674|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|10388|||||No|No||DR.REDDY'S LAB|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|43598058030|BUPRENORPHINE-NALOX 4-1MG FILM|30|EA|2.72333|05/28/2019||Yes|No||05/28/2019||Yes|No|05/28/2019||Yes|No||||No|No|||Prescription required|No||145|Yes|4.75054|03/29/2022|4.63652|03/29/2022|4.6674|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|10389|||||No|No||DR.REDDY'S LAB|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|43598058101|BUPRENORPHINE-NALOX 12-3MG FLM|1|EA|6.30652|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|6.93269|03/29/2022|6.7663|03/29/2022|6.81136|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|10390|||||No|No||DR.REDDY'S LAB|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|43598058130|BUPRENORPHINE-NALOX 12-3MG FLM|30|EA|5.44666|07/08/2019||Yes|No||07/08/2019||Yes|No|07/08/2019||Yes|No||||No|No|||Prescription required|No||145|Yes|6.93269|03/29/2022|6.7663|03/29/2022|6.81136|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|10391|||||No|No||DR.REDDY'S LAB|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|43598058201|BUPRENORPHINE-NALOX 8-2MG FILM|1|EA|3.15333|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|3.26802|03/29/2022|3.18958|03/29/2022|3.21082|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|10392|||||No|No||DR.REDDY'S LAB|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|43598058230|BUPRENORPHINE-NALOX 8-2MG FILM|30|EA|2.72333|03/21/2019||Yes|No||03/21/2019||Yes|No|03/21/2019||Yes|No||||No|No|||Prescription required|No||145|Yes|3.26802|03/29/2022|3.18958|03/29/2022|3.21082|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|10393|||||No|No||DR.REDDY'S LAB|Yes|09/01/2020|||
ezetimibe/simvastatin|No|No|No|No|75%|43598058310|EZETIMIBE-SIMVASTATIN 10-10 MG|1000|EA|1.78192|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|063|Yes|.75312|03/29/2022|.73504|03/29/2022|.73994|03/29/2022|||LIPOTROPICS: STATINS|10394|||||No|No||DR.REDDY'S LAB|No||||
ezetimibe/simvastatin|No|No|No|No|75%|43598058330|EZETIMIBE-SIMVASTATIN 10-10 MG|30|EA|1.78192|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|063|Yes|.75312|03/29/2022|.73504|03/29/2022|.73994|03/29/2022|||LIPOTROPICS: STATINS|10395|||||No|No||DR.REDDY'S LAB|No||||
ezetimibe/simvastatin|No|No|No|No|75%|43598058390|EZETIMIBE-SIMVASTATIN 10-10 MG|90|EA|1.78192|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|063|Yes|.75312|03/29/2022|.73504|03/29/2022|.73994|03/29/2022|||LIPOTROPICS: STATINS|10396|||||No|No||DR.REDDY'S LAB|No||||
ezetimibe/simvastatin|No|No|No|No|75%|43598058410|EZETIMIBE-SIMVASTATIN 10-20 MG|1000|EA|1.78192|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|063|Yes|.74268|03/29/2022|.72485|03/29/2022|.72968|03/29/2022|||LIPOTROPICS: STATINS|10397|||||No|No||DR.REDDY'S LAB|No||||
ezetimibe/simvastatin|No|No|No|No|75%|43598058430|EZETIMIBE-SIMVASTATIN 10-20 MG|30|EA|1.78192|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|063|Yes|.74268|03/29/2022|.72485|03/29/2022|.72968|03/29/2022|||LIPOTROPICS: STATINS|10398|||||No|No||DR.REDDY'S LAB|No||||
ezetimibe/simvastatin|No|No|No|No|75%|43598058490|EZETIMIBE-SIMVASTATIN 10-20 MG|90|EA|1.78192|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|063|Yes|.74268|03/29/2022|.72485|03/29/2022|.72968|03/29/2022|||LIPOTROPICS: STATINS|10399|||||No|No||DR.REDDY'S LAB|No||||
ezetimibe/simvastatin|No|No|No|No|75%|43598058510|EZETIMIBE-SIMVASTATIN 10-40 MG|1000|EA|1.78192|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|063|Yes|.99233|03/29/2022|.96851|03/29/2022|.97496|03/29/2022|||LIPOTROPICS: STATINS|10400|||||No|No||DR.REDDY'S LAB|No||||
ezetimibe/simvastatin|No|No|No|No|75%|43598058530|EZETIMIBE-SIMVASTATIN 10-40 MG|30|EA|1.78192|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|063|Yes|.99233|03/29/2022|.96851|03/29/2022|.97496|03/29/2022|||LIPOTROPICS: STATINS|10401|||||No|No||DR.REDDY'S LAB|No||||
ezetimibe/simvastatin|No|No|No|No|75%|43598058590|EZETIMIBE-SIMVASTATIN 10-40 MG|90|EA|1.78192|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|063|Yes|.99233|03/29/2022|.96851|03/29/2022|.97496|03/29/2022|||LIPOTROPICS: STATINS|10402|||||No|No||DR.REDDY'S LAB|No||||
ezetimibe/simvastatin|No|No|No|No|75%|43598058610|EZETIMIBE-SIMVASTATIN 10-80 MG|1000|EA|1.78192|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|063|Yes|.47172|03/29/2022|.46039|03/29/2022|.46346|03/29/2022|||LIPOTROPICS: STATINS|10403|||||No|No||DR.REDDY'S LAB|No||||
ezetimibe/simvastatin|No|No|No|No|75%|43598058630|EZETIMIBE-SIMVASTATIN 10-80 MG|30|EA|1.78192|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|063|Yes|.47172|03/29/2022|.46039|03/29/2022|.46346|03/29/2022|||LIPOTROPICS: STATINS|10404|||||No|No||DR.REDDY'S LAB|No||||
ezetimibe/simvastatin|No|No|No|No|75%|43598058690|EZETIMIBE-SIMVASTATIN 10-80 MG|90|EA|1.78192|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|063|Yes|.47172|03/29/2022|.46039|03/29/2022|.46346|03/29/2022|||LIPOTROPICS: STATINS|10405|||||No|No||DR.REDDY'S LAB|No||||
tobramycin in 0.225% sod chlor|No|No|No|No|75%|43598060556|TOBRAMYCIN 300 MG/5 ML AMPULE|5|ML|1.01053|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No|Submit HHS Form 1143|||No|No|||Prescription required|Yes|07/29/2021|240|No|3.76543|05/25/2021|3.67505|05/25/2021|3.69953|05/25/2021|||ANTIBIOTICS: INHALED|10406|||||No|No||DR.REDDY'S LAB|No||||
tobramycin in 0.225% sod chlor|No|No|No|No|75%|43598060558|TOBRAMYCIN 300 MG/5 ML AMPULE|5|ML|2.88721|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No|Submit HHS Form 1143|||No|No|||Prescription required|Yes|12/01/2021|240|No|3.76543|05/25/2021|3.67505|05/25/2021|3.69953|05/25/2021|||ANTIBIOTICS: INHALED|10407|||||No|No||DR.REDDY'S LAB|No||||
fluoxetine HCl|No|No|No|No|75%|43598063230|FLUOXETINE HCL 60 MG TABLET|30|EA|.65761|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|008|No|1.06507|03/29/2022|1.0395|03/29/2022|1.04643|03/29/2022|||ANTIDEPRESSANTS: SSRIs|10408|||||No|No||DR.REDDY'S LAB|No||||
penicillamine|No|No|No|No|75%|43598063401|PENICILLAMINE 250 MG CAPSULE|100|EA|37.16167|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No|||No|84.69405|12/10/2020|83.48413|12/10/2020|79.5087|12/10/2020||||10409|||||No|No||DR.REDDY'S LAB|No||||
levetiracetam in NaCl (iso-os)|No|No|No|No|75%|43598063510|LEVETIRACETAM-NACL 500 MG/100|100|ML|.07955|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No|||No|.1813|08/30/2018|.17871|09/04/2018|.1702|08/30/2018||||10410|||||No|No||DR.REDDY'S LAB|No||||
levetiracetam in NaCl (iso-os)|No|No|No|No|75%|43598063610|LEVETIRACETAM-NACL 1,000MG/100|100|ML|.129|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No|||No|.294|08/30/2018|.2898|08/30/2018|.276|08/30/2018||||10411|||||No|No||DR.REDDY'S LAB|No||||
levetiracetam in NaCl (iso-os)|No|No|No|No|75%|43598063710|LEVETIRACETAM-NACL 1,500MG/100|100|ML|.172|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No|||No|.392|08/30/2018|.3864|08/30/2018|.368|08/30/2018||||10412|||||No|No||DR.REDDY'S LAB|No||||
vigabatrin|No|No|No|No|75%|43598065101|VIGABATRIN 500 MG TABLET|100|EA|45.20112|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||056|No|103.01652|06/08/2021|101.54485|06/08/2021|96.70938|06/08/2021|||ANTICONVULSANTS|10413|||||No|No||DR.REDDY'S LAB|No||||
bupropion HCl|Yes|No|No|No|75%|43598065505|BUPROPION HCL XL 150 MG TABLET|500|EA|.17916|05/04/2018||Yes|No||05/04/2018||Yes|No|05/04/2018||Yes|No||||No|No|05/04/2018||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|10414|||||No|No||DR.REDDY'S LAB|No||||
bupropion HCl|Yes|No|No|No|75%|43598065530|BUPROPION HCL XL 150 MG TABLET|30|EA|.17916|05/04/2018||Yes|No||05/04/2018||Yes|No|05/04/2018||Yes|No||||No|No|05/04/2018||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|10415|||||No|No||DR.REDDY'S LAB|No||||
bupropion HCl|Yes|No|No|No|75%|43598065605|BUPROPION HCL XL 300 MG TABLET|500|EA|.1892|05/04/2018||Yes|No||05/04/2018||Yes|No|05/04/2018||Yes|No||||No|No|05/04/2018||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|10416|||||No|No||DR.REDDY'S LAB|No||||
bupropion HCl|Yes|No|No|No|75%|43598065630|BUPROPION HCL XL 300 MG TABLET|30|EA|.1892|05/04/2018||Yes|No||05/04/2018||Yes|No|05/04/2018||Yes|No||||No|No|05/04/2018||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|10417|||||No|No||DR.REDDY'S LAB|No||||
pyrimethamine|No|No|No|No|75%|43598067201|PYRIMETHAMINE 25 MG TABLET|100|EA|125.775|06/02/2020||Yes|No||06/02/2020||Yes|No|06/02/2020||Yes|No||||No|No|||Prescription required|No|||No|286.65|06/02/2020|282.555|06/02/2020|269.1|06/02/2020||||10418|||||No|No||DR.REDDY'S LAB|No||||
pyrimethamine|No|No|No|No|75%|43598067230|PYRIMETHAMINE 25 MG TABLET|30|EA|125.775|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No|||No|286.65|12/10/2020|282.555|12/10/2020|269.1|12/10/2020||||10419|||||No|No||DR.REDDY'S LAB|No||||
cefixime|No|No|No|No|75%|43598067350|CEFIXIME 100 MG/5 ML SUSP|50|ML|1.26807|11/20/2017||Yes|No||11/20/2017||Yes|No|11/20/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|046|No|2.89002|08/27/2019|2.84873|08/27/2019|2.71308|08/27/2019|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|10420|||||No|No||DR.REDDY'S LAB|No||||
cefixime|No|No|No|No|75%|43598067450|CEFIXIME 200 MG/5 ML SUSP|50|ML|2.53605|11/20/2017||Yes|No||11/20/2017||Yes|No|11/20/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|046|No|5.77984|10/29/2019|5.69727|10/29/2019|5.42597|10/29/2019|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|10421|||||No|No||DR.REDDY'S LAB|No||||
cefixime|No|No|No|No|75%|43598067451|CEFIXIME 200 MG/5 ML SUSP|75|ML|2.53607|11/20/2017||Yes|No||11/20/2017||Yes|No|11/20/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|046|No|5.7799|01/29/2019|5.69733|01/29/2019|5.42603|01/29/2019|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|10422|||||No|No||DR.REDDY'S LAB|No||||
vigabatrin|No|No|No|No|75%|43598069750|VIGABATRIN 500 MG POWDER PACKT|50|EA|31.41528|11/04/2020||Yes|No||11/04/2020||Yes|No|11/04/2020||Yes|No||||No|No|||Prescription required|No||056|No|71.59762|11/04/2020|70.5748|11/04/2020|67.21409|11/04/2020|||ANTICONVULSANTS|10423|||||No|No||DR.REDDY'S LAB|No||||
chlordiazepoxide/clidinium Br|No|No|No|No|75%|43598070601|CHLORDIAZEPOXIDE-CLIDINIUM CAP|100|EA|.473|12/16/2021||Yes|No||12/16/2021||Yes|No|12/16/2021||Yes|No||||No|No|||Prescription required|No|||Yes|.95937|03/29/2022|.93634|03/29/2022|.94258|03/29/2022||||10424|||||No|No||DR.REDDY'S LAB|No||||
chlorthalidone|Yes|No|No|No|75%|43598071901|CHLORTHALIDONE 25 MG TABLET|100|EA|.16606|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|06/18/2019||Prescription required|No|||No|.16117|03/29/2022|.1573|03/29/2022|.15834|03/29/2022||||10425|||||No|No||DR.REDDY'S LAB|No||||
chlorthalidone|Yes|No|No|No|75%|43598071910|CHLORTHALIDONE 25 MG TABLET|1000|EA|.16606|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|06/18/2019||Prescription required|No|||No|.16117|03/29/2022|.1573|03/29/2022|.15834|03/29/2022||||10426|||||No|No||DR.REDDY'S LAB|No||||
chlorthalidone|Yes|No|No|No|75%|43598072001|CHLORTHALIDONE 50 MG TABLET|100|EA|.25602|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|06/18/2019||Prescription required|No|||No|.3607|03/29/2022|.35204|03/29/2022|.35438|03/29/2022||||10427|||||No|No||DR.REDDY'S LAB|No||||
hydroxychloroquine sulfate|No|No|No|No|75%|43598072101|HYDROXYCHLOROQUINE 200 MG TAB|100|EA|.22265|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|No|||No|.23831|03/29/2022|.23259|03/29/2022|.23413|03/29/2022||||10428|||||No|No||DR.REDDY'S LAB|No||||
hydroxychloroquine sulfate|No|No|No|No|75%|43598072105|HYDROXYCHLOROQUINE 200 MG TAB|500|EA|.22263|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|No|||No|.23831|03/29/2022|.23259|03/29/2022|.23413|03/29/2022||||10429|||||No|No||DR.REDDY'S LAB|No||||
aripiprazole|No|No|No|No|75%|43598073330|ARIPIPRAZOLE ODT 10 MG TABLET|30|EA|10.80833|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|24.63294|08/29/2018|24.28104|08/29/2018|23.1248|08/29/2018|||ANTIPSYCHOTICS|10430|||||No|No||DR.REDDY'S LAB|No||||
aripiprazole|No|No|No|No|75%|43598073430|ARIPIPRAZOLE ODT 15 MG TABLET|30|EA|10.80833|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|24.63294|08/29/2018|24.28104|08/29/2018|23.1248|08/29/2018|||ANTIPSYCHOTICS|10431|||||No|No||DR.REDDY'S LAB|No||||
ramelteon|No|No|No|No|75%|43598074101|RAMELTEON 8 MG TABLET|100|EA|4.182|02/04/2020||Yes|No||02/04/2020||Yes|No|02/04/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|054|Yes|1.10393|03/29/2022|1.07743|03/29/2022|1.08461|03/29/2022|||SEDATIVE HYPNOTICS|10432|||||No|No||DR.REDDY'S LAB|No||||
ramelteon|No|No|No|No|75%|43598074130|RAMELTEON 8 MG TABLET|30|EA|4.18203|02/04/2020||Yes|No||02/04/2020||Yes|No|02/04/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|054|Yes|1.10393|03/29/2022|1.07743|03/29/2022|1.08461|03/29/2022|||SEDATIVE HYPNOTICS|10433|||||No|No||DR.REDDY'S LAB|No||||
ezetimibe/simvastatin|No|No|No|No|75%|43598074210|EZETIMIBE-SIMVASTATIN 10-10 MG|1000|EA|1.78192|06/06/2019||Yes|No||06/06/2019||Yes|No|06/06/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|063|Yes|.75312|03/29/2022|.73504|03/29/2022|.73994|03/29/2022|||LIPOTROPICS: STATINS|10434|||||No|No||DR.REDDY'S LAB|No||||
ezetimibe/simvastatin|No|No|No|No|75%|43598074230|EZETIMIBE-SIMVASTATIN 10-10 MG|30|EA|1.78192|06/06/2019||Yes|No||06/06/2019||Yes|No|06/06/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|063|Yes|.75312|03/29/2022|.73504|03/29/2022|.73994|03/29/2022|||LIPOTROPICS: STATINS|10435|||||No|No||DR.REDDY'S LAB|No||||
ezetimibe/simvastatin|No|No|No|No|75%|43598074290|EZETIMIBE-SIMVASTATIN 10-10 MG|90|EA|1.78192|06/06/2019||Yes|No||06/06/2019||Yes|No|06/06/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|063|Yes|.75312|03/29/2022|.73504|03/29/2022|.73994|03/29/2022|||LIPOTROPICS: STATINS|10436|||||No|No||DR.REDDY'S LAB|No||||
ezetimibe/simvastatin|No|No|No|No|75%|43598074305|EZETIMIBE-SIMVASTATIN 10-40 MG|500|EA|1.78192|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|063|Yes|.99233|03/29/2022|.96851|03/29/2022|.97496|03/29/2022|||LIPOTROPICS: STATINS|10437|||||No|No||DR.REDDY'S LAB|No||||
ezetimibe/simvastatin|No|No|No|No|75%|43598074330|EZETIMIBE-SIMVASTATIN 10-40 MG|30|EA|1.78192|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|063|Yes|.99233|03/29/2022|.96851|03/29/2022|.97496|03/29/2022|||LIPOTROPICS: STATINS|10438|||||No|No||DR.REDDY'S LAB|No||||
ezetimibe/simvastatin|No|No|No|No|75%|43598074390|EZETIMIBE-SIMVASTATIN 10-40 MG|90|EA|1.78192|06/06/2019||Yes|No||06/06/2019||Yes|No|06/06/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|063|Yes|.99233|03/29/2022|.96851|03/29/2022|.97496|03/29/2022|||LIPOTROPICS: STATINS|10439|||||No|No||DR.REDDY'S LAB|No||||
ezetimibe/simvastatin|No|No|No|No|75%|43598074410|EZETIMIBE-SIMVASTATIN 10-20 MG|1000|EA|1.78192|06/06/2019||Yes|No||06/06/2019||Yes|No|06/06/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|063|Yes|.74268|03/29/2022|.72485|03/29/2022|.72968|03/29/2022|||LIPOTROPICS: STATINS|10440|||||No|No||DR.REDDY'S LAB|No||||
ezetimibe/simvastatin|No|No|No|No|75%|43598074430|EZETIMIBE-SIMVASTATIN 10-20 MG|30|EA|1.78192|06/06/2019||Yes|No||06/06/2019||Yes|No|06/06/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|063|Yes|.74268|03/29/2022|.72485|03/29/2022|.72968|03/29/2022|||LIPOTROPICS: STATINS|10441|||||No|No||DR.REDDY'S LAB|No||||
ezetimibe/simvastatin|No|No|No|No|75%|43598074490|EZETIMIBE-SIMVASTATIN 10-20 MG|90|EA|1.78192|06/06/2019||Yes|No||06/06/2019||Yes|No|06/06/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|063|Yes|.74268|03/29/2022|.72485|03/29/2022|.72968|03/29/2022|||LIPOTROPICS: STATINS|10442|||||No|No||DR.REDDY'S LAB|No||||
ezetimibe/simvastatin|No|No|No|No|75%|43598074530|EZETIMIBE-SIMVASTATIN 10-80 MG|30|EA|1.78192|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|063|Yes|.47172|03/29/2022|.46039|03/29/2022|.46346|03/29/2022|||LIPOTROPICS: STATINS|10443|||||No|No||DR.REDDY'S LAB|No||||
ezetimibe/simvastatin|No|No|No|No|75%|43598074590|EZETIMIBE-SIMVASTATIN 10-80 MG|90|EA|1.78192|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|063|Yes|.47172|03/29/2022|.46039|03/29/2022|.46346|03/29/2022|||LIPOTROPICS: STATINS|10444|||||No|No||DR.REDDY'S LAB|No||||
sapropterin dihydrochloride|No|No|No|No|75%|43598074904|SAPROPTERIN 100 MG TABLET|120|EA|13.8632|04/23/2021||Yes|No||04/23/2021||Yes|No|04/23/2021||Yes|No||||No|No|||Prescription required|No|||No|31.5952|04/23/2021|31.14384|04/23/2021|29.6608|04/23/2021||||10445|||||No|No||DR.REDDY'S LAB|No||||
naloxone HCl|No|No|No|No|75%|43598075011|NALOXONE 2 MG/2 ML SYRINGE|2|ML|7.095|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|||||||16.16999|10/01/2020|OPIATE DEPENDENCE TREATMENTS|10446|||||No|No||DR.REDDY'S LAB|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|43598075058|NALOXONE 2 MG/2 ML SYRINGE|2|ML|6.74025|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|15.3615|10/01/2020|15.14205|10/01/2020|14.421|10/01/2020|||OPIATE DEPENDENCE TREATMENTS|10447|||||No|No||DR.REDDY'S LAB|Yes|09/01/2020|||
bupropion HCl|Yes|No|No|No|75%|43598075101|BUPROPION HCL SR 100 MG TABLET|100|EA|.09666|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||031|No|.11271|03/29/2022|.11|03/29/2022|.11073|03/29/2022|||ANTIDEPRESSANTS: OTHER|10448|||||No|No||DR.REDDY'S LAB|No||||
bupropion HCl|Yes|No|No|No|75%|43598075105|BUPROPION HCL SR 100 MG TABLET|500|EA|.09668|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||031|No|.11271|03/29/2022|.11|03/29/2022|.11073|03/29/2022|||ANTIDEPRESSANTS: OTHER|10449|||||No|No||DR.REDDY'S LAB|No||||
bupropion HCl|Yes|No|No|No|75%|43598075160|BUPROPION HCL SR 100 MG TABLET|60|EA|.10176|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||031|No|.11271|03/29/2022|.11|03/29/2022|.11073|03/29/2022|||ANTIDEPRESSANTS: OTHER|10450|||||No|No||DR.REDDY'S LAB|No||||
bupropion HCl|Yes|No|No|No|75%|43598075201|BUPROPION HCL SR 150 MG TABLET|100|EA|.11029|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||031|No|.10128|03/29/2022|.09884|03/29/2022|.0995|03/29/2022|||ANTIDEPRESSANTS: OTHER|10451|||||No|No||DR.REDDY'S LAB|No||||
bupropion HCl|Yes|No|No|No|75%|43598075205|BUPROPION HCL SR 150 MG TABLET|500|EA|.10478|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||031|No|.10128|03/29/2022|.09884|03/29/2022|.0995|03/29/2022|||ANTIDEPRESSANTS: OTHER|10452|||||No|No||DR.REDDY'S LAB|No||||
bupropion HCl|Yes|No|No|No|75%|43598075260|BUPROPION HCL SR 150 MG TABLET|60|EA|.1161|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||031|No|.10128|03/29/2022|.09884|03/29/2022|.0995|03/29/2022|||ANTIDEPRESSANTS: OTHER|10453|||||No|No||DR.REDDY'S LAB|No||||
bupropion HCl|Yes|No|No|No|75%|43598075360|BUPROPION HCL SR 200 MG TABLET|60|EA|.20353|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||031|No|.16014|03/29/2022|.15629|03/29/2022|.15733|03/29/2022|||ANTIDEPRESSANTS: OTHER|10454|||||No|No||DR.REDDY'S LAB|No||||
cetirizine HCl|No|No|No|No|75%|43598081112|CETIRIZINE HCL 10 MG TABLET|100|EA|.02558|12/12/2019||Yes|No||||No|No|12/12/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10455|||||No|No||DR.REDDY'S LAB|No||||
cetirizine HCl|No|No|No|No|75%|43598081115|CETIRIZINE HCL 10 MG TABLET|500|EA|.00946|12/12/2019||Yes|No||||No|No|12/12/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10456|||||No|No||DR.REDDY'S LAB|No||||
fexofenadine/pseudoephedrine|No|No|No|No|75%|43598082314|FEXOFENADINE-PSE ER 60-120 TAB|20|EA|.25714|06/12/2020||Yes|No||||No|No|06/12/2020||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.58518|03/01/2022|.57113|03/01/2022|.57493|03/01/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10457|||||No|No||DR.REDDY'S LAB|No||||
fexofenadine/pseudoephedrine|No|No|No|No|75%|43598082331|FEXOFENADINE-PSE ER 60-120 TAB|30|EA|.24753|06/12/2020||Yes|No||||No|No|06/12/2020||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.58518|03/01/2022|.57113|03/01/2022|.57493|03/01/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10458|||||No|No||DR.REDDY'S LAB|No||||
fexofenadine/pseudoephedrine|No|No|No|No|75%|43598082335|FEXOFENADINE-PSE ER 60-120 TAB|10|EA|.35862|09/21/2020||Yes|No||||No|No|09/21/2020||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.58518|03/01/2022|.57113|03/01/2022|.57493|03/01/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10459|||||No|No||DR.REDDY'S LAB|No||||
ziprasidone mesylate|No|No|No|No|75%|43598084858|ZIPRASIDONE 20 MG/ML VIAL|1|EA|20.21|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|027|Yes|46.06|12/30/2020|45.402|12/30/2020|43.24|12/30/2020|||ANTIPSYCHOTICS|10460|||||No|No||DR.REDDY'S LAB|No||||
deferasirox|No|No|No|No|75%|43598085130|DEFERASIROX 360 MG TABLET|30|EA|10.89448|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|No|||No|24.82928|03/10/2020|24.47457|03/06/2020|23.30912|03/06/2020||||10461|||||No|No||DR.REDDY'S LAB|No||||
deferasirox|No|No|No|No|75%|43598085230|DEFERASIROX 180 MG TABLET|30|EA|3.26857|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No|||No|7.4493|12/10/2020|7.34288|12/10/2020|6.99322|12/10/2020||||10462|||||No|No||DR.REDDY'S LAB|No||||
deferasirox|No|No|No|No|75%|43598085330|DEFERASIROX 90 MG TABLET|30|EA|2.72376|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|No|||No|6.20764|03/06/2020|6.11896|03/06/2020|5.82758|03/06/2020||||10463|||||No|No||DR.REDDY'S LAB|No||||
deferasirox|No|No|No|No|75%|43598085430|DEFERASIROX 500 MG TB FOR SUSP|30|EA|10.89448|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|No|||No|24.82928|03/10/2020|24.47457|03/06/2020|23.30912|03/06/2020||||10464|||||No|No||DR.REDDY'S LAB|No||||
deferasirox|No|No|No|No|75%|43598085530|DEFERASIROX 125 MG TB FOR SUSP|30|EA|2.72376|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|No|||No|6.20764|03/06/2020|6.11896|03/06/2020|5.82758|03/06/2020||||10465|||||No|No||DR.REDDY'S LAB|No||||
deferasirox|No|No|No|No|75%|43598085630|DEFERASIROX 250 MG TB FOR SUSP|30|EA|5.44738|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|No|||No|12.41496|03/06/2020|12.2376|03/06/2020|11.65486|03/06/2020||||10466|||||No|No||DR.REDDY'S LAB|No||||
bupropion HCl|No|No|No|No|75%|43598086360|BUPROPION HCL SR 150 MG TABLET|60|EA|.1548|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No||040|No|.31361|03/29/2022|.30608|03/29/2022|.30812|03/29/2022|||SMOKING CESSATION|10467|||||No|No||DR.REDDY'S LAB|No||||
amphetamine sulfate|No|No|No|No|90%|43598089701|AMPHETAMINE SULFATE 5 MG TAB|100|EA|1.20099|09/01/2020||Yes|No||09/01/2020||Yes|No|09/01/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|007|Yes|2.73714|09/01/2020|2.69803|09/01/2020|2.56956|09/01/2020|||STIMULANTS AND RELATED AGENTS|10468|||||No|No||DR.REDDY'S LAB|No||||
amphetamine sulfate|No|No|No|No|90%|43598089801|AMPHETAMINE SULFATE 10 MG TAB|100|EA|1.20099|09/01/2020||Yes|No||09/01/2020||Yes|No|09/01/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|007|Yes|.77215|11/23/2021|.75361|11/23/2021|.75863|11/23/2021|||STIMULANTS AND RELATED AGENTS|10469|||||No|No||DR.REDDY'S LAB|No||||
ertapenem sodium|No|No|No|No|75%|43598090158|ERTAPENEM 1 GRAM VIAL|1|EA|43|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No|||No|98|08/26/2021|96.6|08/26/2021|92|08/26/2021||||10470|||||No|No||DR.REDDY'S LAB|No||||
fenofibrate|No|No|No|No|75%|43598090990|FENOFIBRATE 54 MG TABLET|90|EA|.09149|09/21/2020||Yes|No||09/21/2020||Yes|No|09/21/2020||Yes|No||||No|No|||Prescription required|No||055|No|.1459|03/29/2022|.14239|03/29/2022|.14334|03/29/2022|||LIPOTROPICS: OTHER|10471|||||No|No||DR.REDDY'S LAB|No||||
fenofibrate|No|No|No|No|75%|43598091005|FENOFIBRATE 160 MG TABLET|500|EA|.21672|09/21/2020||Yes|No||09/21/2020||Yes|No|09/21/2020||Yes|No||||No|No|||Prescription required|No||055|No|.1612|03/29/2022|.15733|03/29/2022|.15837|03/29/2022|||LIPOTROPICS: OTHER|10472|||||No|No||DR.REDDY'S LAB|No||||
fenofibrate|No|No|No|No|75%|43598091090|FENOFIBRATE 160 MG TABLET|90|EA|.17056|09/21/2020||Yes|No||09/21/2020||Yes|No|09/21/2020||Yes|No||||No|No|||Prescription required|No||055|No|.1612|03/29/2022|.15733|03/29/2022|.15837|03/29/2022|||LIPOTROPICS: OTHER|10473|||||No|No||DR.REDDY'S LAB|No||||
desmopressin acetate|No|No|No|No|75%|43598093109|DESMOPRESSIN AC 4 MCG/ML AMPUL|1|ML|16.34|11/18/2021||Yes|No||11/18/2021||Yes|No|11/18/2021||Yes|No||||No|No|||Prescription required|No|||Yes|37.24|11/18/2021|36.708|11/18/2021|34.96|11/18/2021||||10474|||||No|No||DR.REDDY'S LAB|No||||
desmopressin acetate|No|No|No|No|75%|43598093111|DESMOPRESSIN AC 4 MCG/ML AMPUL|1|ML|16.34|11/18/2021||Yes|No||11/18/2021||Yes|No|11/18/2021||Yes|No||||No|No|||Prescription required|No|||Yes|37.24|11/18/2021|36.708|11/18/2021|34.96|11/18/2021||||10475|||||No|No||DR.REDDY'S LAB|No||||
aripiprazole|No|No|No|No|75%|43598096530|ARIPIPRAZOLE 2 MG TABLET|30|EA|.301|05/21/2021||Yes|No||05/21/2021||Yes|No|05/21/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|10476|||||No|No||DR.REDDY'S LAB|No||||
aripiprazole|No|No|No|No|75%|43598096630|ARIPIPRAZOLE 5 MG TABLET|30|EA|.301|05/21/2021||Yes|No||05/21/2021||Yes|No|05/21/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|10477|||||No|No||DR.REDDY'S LAB|No||||
aripiprazole|No|No|No|No|75%|43598096730|ARIPIPRAZOLE 10 MG TABLET|30|EA|.301|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|10478|||||No|No||DR.REDDY'S LAB|No||||
aripiprazole|No|No|No|No|75%|43598096830|ARIPIPRAZOLE 15 MG TABLET|30|EA|.301|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|10479|||||No|No||DR.REDDY'S LAB|No||||
aripiprazole|No|No|No|No|75%|43598096930|ARIPIPRAZOLE 20 MG TABLET|30|EA|.34041|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|10480|||||No|No||DR.REDDY'S LAB|No||||
aripiprazole|No|No|No|No|75%|43598097030|ARIPIPRAZOLE 30 MG TABLET|30|EA|.34041|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|10481|||||No|No||DR.REDDY'S LAB|No||||
diclofenac sodium|No|No|No|No|75%|43598097710|DICLOFENAC SODIUM 1% GEL|100|GM|.05151|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Over the counter|No||059|Yes|.09419|03/29/2022|.09192|03/29/2022|.09254|03/29/2022|||NSAIDS|10482|||||No|No||DR.REDDY'S LAB|No||||
indapamide|No|No|No|No|75%|43975021710|INDAPAMIDE 1.25 MG TABLET|100|EA|.11278|02/28/2017|02/22/2022|Yes|No||02/28/2017|02/22/2022|Yes|No|02/28/2017|02/22/2022|Yes|No||||No|No|||Prescription required|No|||No|.25705|03/29/2022|.25338|03/29/2022|.24131|03/29/2022||||10483|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMERIGEN PHARMA|No||||
carbidopa|No|No|No|No|75%|43975022010|CARBIDOPA 25 MG TABLET|100|EA|3.76228|07/01/2014||Yes|No||07/01/2014||Yes|No|07/01/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|015|No|1.9005|03/29/2022|1.85488|03/29/2022|1.86724|03/29/2022|||ANTIPARKINSON'S AGENTS|10484|||||No|No||AMERIGEN PHARMA|No||||
memantine HCl|No|No|No|No|75%|43975024203|MEMANTINE HCL ER 7 MG CAPSULE|30|EA|1.31264|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|011|No|.73424|03/29/2022|.71661|03/29/2022|.72139|03/29/2022|||ALZHEIMER'S AGENTS|10485|||||No|No||AMERIGEN/ANI PH|No||||
memantine HCl|No|No|No|No|75%|43975024303|MEMANTINE HCL ER 21 MG CAPSULE|30|EA|1.31264|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|011|No|.91098|03/29/2022|.88911|03/29/2022|.89503|03/29/2022|||ALZHEIMER'S AGENTS|10486|||||No|No||AMERIGEN/ANI PH|No||||
temozolomide|No|No|No|No|75%|43975025205|TEMOZOLOMIDE 5 MG CAPSULE|5|EA|1.9006|02/24/2017|02/22/2022|Yes|No||02/24/2017|02/22/2022|Yes|No|02/24/2017|02/22/2022|Yes|No||||No|No|||Prescription required|No||239|No|4.3316|02/24/2017|4.26972|02/28/2017|4.0664|02/24/2017|||ONCOLOGY: ORAL - OTHER|10487|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMERIGEN/ANI PH|No||||
temozolomide|No|No|No|No|75%|43975025214|TEMOZOLOMIDE 5 MG CAPSULE|14|EA|1.90121|02/24/2017|02/22/2022|Yes|No||02/24/2017|02/22/2022|Yes|No|02/24/2017|02/22/2022|Yes|No||||No|No|||Prescription required|No||239|No|4.33299|02/24/2017|4.27109|02/24/2017|4.0677|02/24/2017|||ONCOLOGY: ORAL - OTHER|10488|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMERIGEN/ANI PH|No||||
temozolomide|No|No|No|No|75%|43975025305|TEMOZOLOMIDE 20 MG CAPSULE|5|EA|6.91698|02/24/2017|02/22/2022|Yes|No||02/24/2017|02/22/2022|Yes|No|02/24/2017|02/22/2022|Yes|No||||No|No|||Prescription required|No||239|No|15.76428|02/28/2017|15.53907|02/24/2017|14.79912|02/28/2017|||ONCOLOGY: ORAL - OTHER|10489|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMERIGEN/ANI PH|No||||
temozolomide|No|No|No|No|75%|43975025314|TEMOZOLOMIDE 20 MG CAPSULE|14|EA|6.91624|02/24/2017|02/22/2022|Yes|No||02/24/2017|02/22/2022|Yes|No|02/24/2017|02/22/2022|Yes|No||||No|No|||Prescription required|No||239|No|15.76259|02/24/2017|15.53741|02/24/2017|14.79753|02/24/2017|||ONCOLOGY: ORAL - OTHER|10490|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMERIGEN/ANI PH|No||||
temozolomide|No|No|No|No|75%|43975025405|TEMOZOLOMIDE 100 MG CAPSULE|5|EA|34.57974|02/27/2017|02/22/2022|Yes|No||02/27/2017|02/22/2022|Yes|No|02/27/2017|02/22/2022|Yes|No||||No|No|||Prescription required|No||239|No|78.80964|11/28/2017|77.68378|11/28/2017|73.98456|11/28/2017|||ONCOLOGY: ORAL - OTHER|10491|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMERIGEN/ANI PH|No||||
temozolomide|No|No|No|No|75%|43975025414|TEMOZOLOMIDE 100 MG CAPSULE|14|EA|34.5806|02/27/2017|02/28/2022|Yes|No||02/27/2017|02/28/2022|Yes|No|02/27/2017|02/28/2022|Yes|No||||No|No|||Prescription required|No||239|No|78.8116|11/28/2017|77.68572|11/28/2017|73.9864|11/28/2017|||ONCOLOGY: ORAL - OTHER|10492|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMERIGEN/ANI PH|No||||
temozolomide|No|No|No|No|75%|43975025505|TEMOZOLOMIDE 140 MG CAPSULE|5|EA|48.41284|02/27/2017|02/28/2022|Yes|No||02/27/2017|02/28/2022|Yes|No|02/27/2017|02/28/2022|Yes|No||||No|No|||Prescription required|No||239|No|110.33624|03/29/2022|108.76|03/29/2022|103.58096|03/29/2022|||ONCOLOGY: ORAL - OTHER|10493|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMERIGEN/ANI PH|No||||
temozolomide|No|No|No|No|75%|43975025514|TEMOZOLOMIDE 140 MG CAPSULE|14|EA|48.41247|02/27/2017|02/28/2022|Yes|No||02/27/2017|02/28/2022|Yes|No|02/27/2017|02/28/2022|Yes|No||||No|No|||Prescription required|No||239|No|110.33539|03/29/2022|108.75917|03/29/2022|103.58016|03/29/2022|||ONCOLOGY: ORAL - OTHER|10494|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMERIGEN/ANI PH|No||||
temozolomide|No|No|No|No|75%|43975025605|TEMOZOLOMIDE 180 MG CAPSULE|5|EA|62.24422|02/27/2017|02/28/2022|Yes|No||02/27/2017|02/28/2022|Yes|No|02/27/2017|02/28/2022|Yes|No||||No|No|||Prescription required|No||239|No|141.85892|03/07/2017|139.83236|02/27/2017|133.17368|02/27/2017|||ONCOLOGY: ORAL - OTHER|10495|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMERIGEN/ANI PH|No||||
temozolomide|No|No|No|No|75%|43975025614|TEMOZOLOMIDE 180 MG CAPSULE|14|EA|62.24465|02/27/2017|02/28/2022|Yes|No||02/27/2017|02/28/2022|Yes|No|02/27/2017|02/28/2022|Yes|No||||No|No|||Prescription required|No||239|No|141.8599|03/07/2017|139.83333|02/27/2017|133.1746|02/27/2017|||ONCOLOGY: ORAL - OTHER|10496|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMERIGEN/ANI PH|No||||
temozolomide|No|No|No|No|75%|43975025705|TEMOZOLOMIDE 250 MG CAPSULE|5|EA|86.47386|02/27/2017|02/22/2022|Yes|No||02/27/2017|02/22/2022|Yes|No|02/27/2017|02/22/2022|Yes|No||||No|No|||Prescription required|No||239|No|197.07996|02/27/2017|194.26453|02/27/2017|185.01384|02/27/2017|||ONCOLOGY: ORAL - OTHER|10497|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMERIGEN/ANI PH|No||||
memantine HCl|No|No|No|No|75%|43975026403|MEMANTINE HCL ER 14 MG CAPSULE|30|EA|1.31264|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|011|No|.96952|03/29/2022|.94625|03/29/2022|.95255|03/29/2022|||ALZHEIMER'S AGENTS|10498|||||No|No||AMERIGEN/ANI PH|No||||
memantine HCl|No|No|No|No|75%|43975026409|MEMANTINE HCL ER 14 MG CAPSULE|90|EA|1.31264|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|011|No|.96952|03/29/2022|.94625|03/29/2022|.95255|03/29/2022|||ALZHEIMER'S AGENTS|10499|||||No|No||AMERIGEN/ANI PH|No||||
memantine HCl|No|No|No|No|75%|43975026603|MEMANTINE HCL ER 28 MG CAPSULE|30|EA|1.31264|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|011|No|1.08689|03/29/2022|1.0608|03/29/2022|1.06786|03/29/2022|||ALZHEIMER'S AGENTS|10500|||||No|No||AMERIGEN/ANI PH|No||||
memantine HCl|No|No|No|No|75%|43975026609|MEMANTINE HCL ER 28 MG CAPSULE|90|EA|1.31264|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|011|No|1.08689|03/29/2022|1.0608|03/29/2022|1.06786|03/29/2022|||ALZHEIMER'S AGENTS|10501|||||No|No||AMERIGEN/ANI PH|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|43975027710|DEXTROAMP-AMPHET ER 5 MG CAP|100|EA|.5977|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.59233|03/29/2022|.57811|03/29/2022|.58196|03/29/2022|||STIMULANTS AND RELATED AGENTS|10502|||||No|No||AMERIGEN/ANI PH|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|43975027810|DEXTROAMP-AMPHET ER 10 MG CAP|100|EA|.5977|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.53198|03/29/2022|.51921|03/29/2022|.52267|03/29/2022|||STIMULANTS AND RELATED AGENTS|10503|||||No|No||AMERIGEN/ANI PH|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|43975027910|DEXTROAMP-AMPHET ER 15 MG CAP|100|EA|.5977|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55636|03/29/2022|.543|03/29/2022|.54662|03/29/2022|||STIMULANTS AND RELATED AGENTS|10504|||||No|No||AMERIGEN/ANI PH|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|43975028010|DEXTROAMP-AMPHET ER 20 MG CAP|100|EA|.5977|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.58746|03/29/2022|.57336|03/29/2022|.57717|03/29/2022|||STIMULANTS AND RELATED AGENTS|10505|||||No|No||AMERIGEN/ANI PH|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|43975028110|DEXTROAMP-AMPHET ER 25 MG CAP|100|EA|.5977|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.54687|03/29/2022|.53374|03/29/2022|.53729|03/29/2022|||STIMULANTS AND RELATED AGENTS|10506|||||No|No||AMERIGEN/ANI PH|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|43975028210|DEXTROAMP-AMPHET ER 30 MG CAP|100|EA|.5977|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.61484|03/29/2022|.60008|03/29/2022|.60408|03/29/2022|||STIMULANTS AND RELATED AGENTS|10507|||||No|No||AMERIGEN/ANI PH|No||||
indapamide|No|No|No|No|75%|43975030410|INDAPAMIDE 2.5 MG TABLET|100|EA|.12293|02/28/2017|02/22/2022|Yes|No||02/28/2017|02/22/2022|Yes|No|02/28/2017|02/22/2022|Yes|No||||No|No|||Prescription required|No|||No|.28018|03/29/2022|.27617|03/29/2022|.26302|03/29/2022||||10508|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMERIGEN PHARMA|No||||
penicillamine|No|No|No|No|75%|43975030910|PENICILLAMINE 250 MG CAPSULE|100|EA|90.08891|11/07/2019|04/09/2023|Yes|No||11/07/2019|04/09/2023|Yes|No|11/07/2019|04/09/2023|Yes|No||||No|No|||Prescription required|No|||No|205.31891|11/07/2019|202.38579|11/07/2019|192.74837|11/07/2019||||10509|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMERIGEN PHARMA|No||||
miglustat|No|No|No|No|75%|43975031083|MIGLUSTAT 100 MG CAPSULE|90|EA|115.19786|01/24/2019||Yes|No||01/24/2019||Yes|No|01/24/2019||Yes|No||||No|No|||Prescription required|No|||No|262.54396|01/29/2019|258.79333|01/24/2019|246.46984|01/24/2019||||10510|||||No|No||ANI PHARMACEUTI|No||||
bexarotene|No|No|No|No|75%|43975031510|BEXAROTENE 75 MG CAPSULE|100|EA|25.3055|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|No|||No|57.673|12/16/2020|56.8491|12/16/2020|54.142|12/16/2020||||10511|||||No|No||ANI PHARMACEUTI|No||||
tolterodine tartrate|No|No|No|No|75%|43975032203|TOLTERODINE TART ER 2 MG CAP|30|EA|.28666|06/12/2020||Yes|No||06/12/2020||Yes|No|06/12/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|Yes|1.20249|03/29/2022|1.17363|03/29/2022|1.18144|03/29/2022|||BLADDER RELAXANT PREPARATIONS|10512|||||No|No||ANI PHARMACEUTI|No||||
tolterodine tartrate|No|No|No|No|75%|43975032209|TOLTERODINE TART ER 2 MG CAP|90|EA|.28666|06/12/2020||Yes|No||06/12/2020||Yes|No|06/12/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|Yes|1.20249|03/29/2022|1.17363|03/29/2022|1.18144|03/29/2022|||BLADDER RELAXANT PREPARATIONS|10513|||||No|No||ANI PHARMACEUTI|No||||
tolterodine tartrate|No|No|No|No|75%|43975032303|TOLTERODINE TART ER 4 MG CAP|30|EA|.28666|06/12/2020||Yes|No||06/12/2020||Yes|No|06/12/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|No|1.14537|03/29/2022|1.11788|03/29/2022|1.12532|03/29/2022|||BLADDER RELAXANT PREPARATIONS|10514|||||No|No||ANI PHARMACEUTI|No||||
tolterodine tartrate|No|No|No|No|75%|43975032309|TOLTERODINE TART ER 4 MG CAP|90|EA|.28666|06/12/2020||Yes|No||06/12/2020||Yes|No|06/12/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|No|1.14537|03/29/2022|1.11788|03/29/2022|1.12532|03/29/2022|||BLADDER RELAXANT PREPARATIONS|10515|||||No|No||ANI PHARMACEUTI|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|43975033110|DEXTROAMP-AMPHET ER 5 MG CAP|100|EA|.5977|03/27/2019|08/31/2022|Yes|No||03/27/2019|08/31/2022|Yes|No|03/27/2019|08/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.59233|03/29/2022|.57811|03/29/2022|.58196|03/29/2022|||STIMULANTS AND RELATED AGENTS|10516|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMERIGEN PHARMA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|43975033210|DEXTROAMP-AMPHET ER 10 MG CAP|100|EA|.5977|03/27/2019|10/31/2022|Yes|No||03/27/2019|10/31/2022|Yes|No|03/27/2019|10/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.53198|03/29/2022|.51921|03/29/2022|.52267|03/29/2022|||STIMULANTS AND RELATED AGENTS|10517|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMERIGEN PHARMA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|43975033310|DEXTROAMP-AMPHET ER 15 MG CAP|100|EA|.5977|03/27/2019|01/31/2023|Yes|No||03/27/2019|01/31/2023|Yes|No|03/27/2019|01/31/2023|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55636|03/29/2022|.543|03/29/2022|.54662|03/29/2022|||STIMULANTS AND RELATED AGENTS|10518|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMERIGEN PHARMA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|43975033410|DEXTROAMP-AMPHET ER 20 MG CAP|100|EA|.5977|03/27/2019|09/30/2022|Yes|No||03/27/2019|09/30/2022|Yes|No|03/27/2019|09/30/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.58746|03/29/2022|.57336|03/29/2022|.57717|03/29/2022|||STIMULANTS AND RELATED AGENTS|10519|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMERIGEN PHARMA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|43975033510|DEXTROAMP-AMPHET ER 25 MG CAP|100|EA|.5977|03/27/2019|08/31/2022|Yes|No||03/27/2019|08/31/2022|Yes|No|03/27/2019|08/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.54687|03/29/2022|.53374|03/29/2022|.53729|03/29/2022|||STIMULANTS AND RELATED AGENTS|10520|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMERIGEN PHARMA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|43975033610|DEXTROAMP-AMPHET ER 30 MG CAP|100|EA|.5977|03/27/2019|09/30/2022|Yes|No||03/27/2019|09/30/2022|Yes|No|03/27/2019|09/30/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.61484|03/29/2022|.60008|03/29/2022|.60408|03/29/2022|||STIMULANTS AND RELATED AGENTS|10521|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMERIGEN PHARMA|No||||
paliperidone|No|No|No|No|75%|43975034903|PALIPERIDONE ER 1.5 MG TABLET|30|EA|5.25675|05/18/2020||Yes|No||05/18/2020||Yes|No|05/18/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|4.83706|03/29/2022|4.72097|03/29/2022|4.75241|03/29/2022|||ANTIPSYCHOTICS|10522|||||No|No||ANI PHARMACEUTI|No||||
paliperidone|No|No|No|No|75%|43975035003|PALIPERIDONE ER 3 MG TABLET|30|EA|5.25675|05/18/2020||Yes|No||05/18/2020||Yes|No|05/18/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|6.18339|03/29/2022|6.03498|03/29/2022|6.07518|03/29/2022|||ANTIPSYCHOTICS|10523|||||No|No||ANI PHARMACEUTI|No||||
paliperidone|No|No|No|No|75%|43975035103|PALIPERIDONE ER 6 MG TABLET|30|EA|5.25675|05/18/2020||Yes|No||05/18/2020||Yes|No|05/18/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|5.21133|03/29/2022|5.08625|03/29/2022|5.12013|03/29/2022|||ANTIPSYCHOTICS|10524|||||No|No||ANI PHARMACEUTI|No||||
paliperidone|No|No|No|No|75%|43975035203|PALIPERIDONE ER 9 MG TABLET|30|EA|7.88505|05/18/2020||Yes|No||05/18/2020||Yes|No|05/18/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|7.23268|03/29/2022|7.05909|03/29/2022|7.1061|03/29/2022|||ANTIPSYCHOTICS|10525|||||No|No||ANI PHARMACEUTI|No||||
somatropin|No|No|No|No|75%|44087000407|SEROSTIM 4 MG VIAL|1|EA|180.772|03/01/2002||Yes|No||03/01/2002||Yes|No|||No|No||||No|No|||Prescription required|Yes|07/29/2021|014|Yes|411.992|02/01/2022|406.1064|02/01/2022|386.768|02/01/2022|||GROWTH HORMONE|10526|||||No|No||EMD SERONO, INC|No||||
somatropin|No|No|No|No|75%|44087000507|SEROSTIM 5 MG VIAL|1|EA|225.965|03/01/2002||Yes|No||03/01/2002||Yes|No|||No|No||||No|No|||Prescription required|Yes|07/29/2021|014|Yes|514.99|02/01/2022|507.633|02/01/2022|483.46|02/01/2022|||GROWTH HORMONE|10527|||||No|No||EMD SERONO, INC|No||||
somatropin|No|No|No|No|75%|44087000607|SEROSTIM 6 MG VIAL|1|EA|271.158|03/01/2002||Yes|No||03/01/2002||Yes|No|||No|No||||No|No|||Prescription required|Yes|07/29/2021|014|Yes|617.988|02/01/2022|609.1596|02/01/2022|580.152|02/01/2022|||GROWTH HORMONE|10528|||||No|No||EMD SERONO, INC|No||||
interferon beta-1a/albumin|No|No|No|No|75%|44087002203|REBIF 22 MCG/0.5 ML SYRINGE|.5|ML|661.38945|03/12/2002||Yes|No||03/12/2002||Yes|No|03/12/2002||Yes|No||||No|No|||Prescription required|No||043|No|1507.3527|02/01/2022|1485.81909|02/01/2022|1415.0658|02/01/2022|||MULTIPLE SCLEROSIS AGENTS|10529|||||No|No||EMD SERONO, INC|No||||
interferon beta-1a/albumin|No|No|No|No|75%|44087004403|REBIF 44 MCG/0.5 ML SYRINGE|.5|ML|661.38945|03/12/2002||Yes|No||03/12/2002||Yes|No|03/12/2002||Yes|No||||No|No|||Prescription required|No||043|No|1507.3527|02/01/2022|1485.81909|02/01/2022|1415.0658|02/01/2022|||MULTIPLE SCLEROSIS AGENTS|10530|||||No|No||EMD SERONO, INC|No||||
interferon beta-1a/albumin|No|No|No|No|75%|44087018801|REBIF REBIDOSE TITRATION PACK|4.2|ML|944.84207|05/21/2013||Yes|No||05/21/2013||Yes|No|05/21/2013||Yes|No||||No|No|||Prescription required|No||043|No|2153.36099|02/01/2022|2122.59869|02/01/2022|2021.52256|02/01/2022|||MULTIPLE SCLEROSIS AGENTS|10531|||||No|No||EMD SERONO, INC|No||||
somatropin|No|No|No|No|75%|44087100502|SAIZEN 5 MG VIAL|1|EA|308.9679|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|Yes|07/29/2021|014|Yes|704.1594|02/01/2022|694.09998|02/01/2022|661.0476|02/01/2022|||GROWTH HORMONE|10532|||||No|No||EMD SERONO, INC|No||||
somatropin|No|No|No|No|75%|44087108801|SAIZEN 8.8 MG VIAL|1|EA|494.3452|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|Yes|07/29/2021|014|Yes|1126.6472|02/01/2022|1110.55224|02/01/2022|1057.6688|02/01/2022|||GROWTH HORMONE|10533|||||No|No||EMD SERONO, INC|No||||
interferon beta-1a/albumin|No|No|No|No|75%|44087332201|REBIF REBIDOSE 22 MCG/0.5 ML|.5|ML|661.38945|05/21/2013||Yes|No||05/21/2013||Yes|No|05/21/2013||Yes|No||||No|No|||Prescription required|No||043|No|1507.3527|02/01/2022|1485.81909|02/01/2022|1415.0658|02/01/2022|||MULTIPLE SCLEROSIS AGENTS|10534|||||No|No||EMD SERONO, INC|No||||
interferon beta-1a/albumin|No|No|No|No|75%|44087334401|REBIF REBIDOSE 44 MCG/0.5 ML|.5|ML|661.38945|05/21/2013||Yes|No||05/21/2013||Yes|No|05/21/2013||Yes|No||||No|No|||Prescription required|No||043|No|1507.3527|02/01/2022|1485.81909|02/01/2022|1415.0658|02/01/2022|||MULTIPLE SCLEROSIS AGENTS|10535|||||No|No||EMD SERONO, INC|No||||
somatropin|No|No|No|No|75%|44087338807|ZORBTIVE 8.8 MG VIAL|1|EA|606.72262|04/12/2006|09/30/2022|Yes|No||04/12/2006|09/30/2022|Yes|No|04/12/2006|09/30/2022|Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|Yes|07/29/2021|014|Yes|1382.76319|01/26/2021|1363.00943|01/26/2021|1298.10422|01/26/2021|||GROWTH HORMONE|10536|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||EMD SERONO, INC|No||||
cladribine|No|No|No|No|75%|44087400000|MAVENCLAD 10 MG X 10 TABLET PK|10|EA|3708.5049|04/10/2020||Yes|No||04/10/2020||Yes|No|04/10/2020||Yes|No||||No|No|||Prescription required|No||043|No|8451.9414|01/26/2021|8331.19938|01/26/2021|7934.4756|01/26/2021|||MULTIPLE SCLEROSIS AGENTS|10537|||||No|No||EMD SERONO, INC|No||||
cladribine|No|No|No|No|75%|44087400004|MAVENCLAD 10 MG X 4 TABLET PK|4|EA|3708.5049|04/10/2020||Yes|No||04/10/2020||Yes|No|04/10/2020||Yes|No||||No|No|||Prescription required|No||043|No|8451.9414|01/26/2021|8331.19938|01/26/2021|7934.4756|01/26/2021|||MULTIPLE SCLEROSIS AGENTS|10538|||||No|No||EMD SERONO, INC|No||||
cladribine|No|No|No|No|75%|44087400005|MAVENCLAD 10 MG X 5 TABLET PK|5|EA|3708.5049|04/10/2020||Yes|No||04/10/2020||Yes|No|04/10/2020||Yes|No||||No|No|||Prescription required|No||043|No|8451.9414|01/26/2021|8331.19938|01/26/2021|7934.4756|01/26/2021|||MULTIPLE SCLEROSIS AGENTS|10539|||||No|No||EMD SERONO, INC|No||||
cladribine|No|No|No|No|75%|44087400006|MAVENCLAD 10 MG X 6 TABLET PK|6|EA|3708.5049|04/10/2020||Yes|No||04/10/2020||Yes|No|04/10/2020||Yes|No||||No|No|||Prescription required|No||043|No|8451.9414|01/26/2021|8331.19938|01/26/2021|7934.4756|01/26/2021|||MULTIPLE SCLEROSIS AGENTS|10540|||||No|No||EMD SERONO, INC|No||||
cladribine|No|No|No|No|75%|44087400007|MAVENCLAD 10 MG X 7 TABLET PK|7|EA|3708.5049|04/10/2020||Yes|No||04/10/2020||Yes|No|04/10/2020||Yes|No||||No|No|||Prescription required|No||043|No|8451.9414|01/26/2021|8331.19938|01/26/2021|7934.4756|01/26/2021|||MULTIPLE SCLEROSIS AGENTS|10541|||||No|No||EMD SERONO, INC|No||||
cladribine|No|No|No|No|75%|44087400008|MAVENCLAD 10 MG X 8 TABLET PK|8|EA|3708.5049|04/10/2020||Yes|No||04/10/2020||Yes|No|04/10/2020||Yes|No||||No|No|||Prescription required|No||043|No|8451.9414|01/26/2021|8331.19938|01/26/2021|7934.4756|01/26/2021|||MULTIPLE SCLEROSIS AGENTS|10542|||||No|No||EMD SERONO, INC|No||||
cladribine|No|No|No|No|75%|44087400009|MAVENCLAD 10 MG X 9 TABLET PK|9|EA|3708.5049|04/10/2020||Yes|No||04/10/2020||Yes|No|04/10/2020||Yes|No||||No|No|||Prescription required|No||043|No|8451.9414|01/26/2021|8331.19938|01/26/2021|7934.4756|01/26/2021|||MULTIPLE SCLEROSIS AGENTS|10543|||||No|No||EMD SERONO, INC|No||||
tepotinib HCl|No|No|No|No|75%|44087500003|TEPMETKO 225 MG TABLET|30|EA|157.2596|12/01/2021||Yes|No||12/01/2021||Yes|No|12/01/2021||Yes|No||||No|No|||Prescription required|No||551|No|358.4056|01/11/2022|353.28552|01/11/2022|336.4624|01/11/2022|||ONCOLOGY: ORAL - LUNG|10544|||||No|No||EMD SERONO, INC|No||||
interferon beta-1a/albumin|No|No|No|No|75%|44087882201|REBIF TITRATION PACK|4.2|ML|944.84207|05/23/2005||Yes|No||05/23/2005||Yes|No|05/23/2005||Yes|No||||No|No|||Prescription required|No||043|No|2153.36099|02/01/2022|2122.59869|02/01/2022|2021.52256|02/01/2022|||MULTIPLE SCLEROSIS AGENTS|10545|||||No|No||EMD SERONO, INC|No||||
immun glob G(IgG)/pro/IgA 0-50|No|No|No|No|75%|44206043605|PRIVIGEN 10% VIAL|50|ML|6.8542|01/25/2008||Yes|No||01/25/2008||Yes|No|01/25/2008||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|15.6212|01/04/2022|15.39804|01/04/2022|14.6648|01/04/2022|||IMMUNE GLOBULINS|10546|||||No|No||CSL BEHRING LLC|No||||
immun glob G(IgG)/pro/IgA 0-50|No|No|No|No|75%|44206043710|PRIVIGEN 10% VIAL|100|ML|6.8542|01/25/2008||Yes|No||01/25/2008||Yes|No|01/25/2008||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|15.6212|01/04/2022|15.39804|01/04/2022|14.6648|01/04/2022|||IMMUNE GLOBULINS|10547|||||No|No||CSL BEHRING LLC|No||||
immun glob G(IgG)/pro/IgA 0-50|No|No|No|No|75%|44206043820|PRIVIGEN 10% VIAL|200|ML|6.8542|01/25/2008||Yes|No||01/25/2008||Yes|No|01/25/2008||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|15.6212|01/04/2022|15.39804|01/04/2022|14.6648|01/04/2022|||IMMUNE GLOBULINS|10548|||||No|No||CSL BEHRING LLC|No||||
immun glob G(IgG)/pro/IgA 0-50|No|No|No|No|75%|44206043940|PRIVIGEN 10% VIAL|400|ML|6.8542|05/31/2013||Yes|No||05/31/2013||Yes|No|05/31/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|15.6212|01/04/2022|15.39804|01/04/2022|14.6648|01/04/2022|||IMMUNE GLOBULINS|10549|||||No|No||CSL BEHRING LLC|No||||
immun glob G(IgG)/pro/IgA 0-50|No|No|No|No|75%|44206045101|HIZENTRA 1 GRAM/5 ML VIAL|5|ML|17.2172|04/01/2010||Yes|No||04/01/2010||Yes|No|04/01/2010||Yes|No||||No|No|||Prescription required|No||023|No|39.2392|01/04/2022|38.67864|01/04/2022|36.8368|01/04/2022|||IMMUNE GLOBULINS|10550|||||No|No||CSL BEHRING LLC|No||||
immun glob G(IgG)/pro/IgA 0-50|No|No|No|No|75%|44206045202|HIZENTRA 2 GRAM/10 ML VIAL|10|ML|17.2172|04/01/2010||Yes|No||04/01/2010||Yes|No|04/01/2010||Yes|No||||No|No|||Prescription required|No||023|No|39.2392|01/04/2022|38.67864|01/04/2022|36.8368|01/04/2022|||IMMUNE GLOBULINS|10551|||||No|No||CSL BEHRING LLC|No||||
immun glob G(IgG)/pro/IgA 0-50|No|No|No|No|75%|44206045404|HIZENTRA 4 GRAM/20 ML VIAL|20|ML|17.2172|04/01/2010||Yes|No||04/01/2010||Yes|No|04/01/2010||Yes|No||||No|No|||Prescription required|No||023|No|39.2392|01/04/2022|38.67864|01/04/2022|36.8368|01/04/2022|||IMMUNE GLOBULINS|10552|||||No|No||CSL BEHRING LLC|No||||
immun glob G(IgG)/pro/IgA 0-50|No|No|No|No|75%|44206045510|HIZENTRA 10 GRAM/50 ML VIAL|50|ML|17.372|02/20/2014||Yes|No||02/20/2014||Yes|No|02/20/2014||Yes|No||||No|No|||Prescription required|No||023|No|39.592|01/04/2022|39.0264|01/04/2022|37.168|01/04/2022|||IMMUNE GLOBULINS|10553|||||No|No||CSL BEHRING LLC|No||||
cytomegalovirus immune globuln|No|No|No|No|75%|44206053211|CYTOGAM 2.5 GM/50 ML VIAL|50|ML|12.74021|05/21/2012|07/19/2022|Yes|No||05/21/2012|07/19/2022|Yes|No|05/21/2012|07/19/2022|Yes|No||||No|No|||Prescription required|No||023|No|29.03583|02/09/2021|28.62103|02/09/2021|27.25812|02/09/2021|||IMMUNE GLOBULINS|10554|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||CSL/SAOL THERA|No||||
prednisolone sodium phosphate|No|No|No|No|75%|44523018208|PREDNISOLONE SOD PH 25 MG/5 ML|237|ML|.53203|02/04/2020||Yes|No||02/04/2020||Yes|No|02/04/2020||Yes|No||||No|No|||Prescription required|No||168|No|1.21254|02/04/2020|1.19522|02/04/2020|1.1383|02/04/2020|||GLUCOCORTICOIDS: ORAL|10555|||||No|No||BIOCOMP PHARMA,|No||||
potassium citrate|No|No|No|No|75%|44523041501|POTASSIUM CITRATE ER 15 MEQ TB|100|EA|.85763|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|||Prescription required|No|||No|.5925|03/29/2022|.57828|03/29/2022|.58213|03/29/2022||||10556|||||No|No||BIOCOMP PHARMA,|No||||
ampicillin sodium|No|No|No|No|75%|44567010110|AMPICILLIN 500 MG VIAL|1|EA|1.29|10/09/2012||Yes|No||10/09/2012||Yes|No|10/09/2012||Yes|No||||No|No|||Prescription required|No|||No|2.94|06/01/2016|2.898|06/01/2016|2.76|06/01/2016||||10557|||||No|No||WG CRITICAL CAR|No||||
ampicillin sodium|No|No|No|No|75%|44567010210|AMPICILLIN 1 GM VIAL|1|EA|2.58|10/09/2012||Yes|No||10/09/2012||Yes|No|10/09/2012||Yes|No||||No|No|||Prescription required|No|||No|5.88|06/01/2016|5.796|06/01/2016|5.52|06/01/2016||||10558|||||No|No||WG CRITICAL CAR|No||||
ampicillin sodium|No|No|No|No|75%|44567010310|AMPICILLIN 2 GM VIAL|1|EA|4.73|10/09/2012||Yes|No||10/09/2012||Yes|No|10/09/2012||Yes|No||||No|No|||Prescription required|No|||No|10.78|06/01/2016|10.626|06/01/2016|10.12|06/01/2016||||10559|||||No|No||WG CRITICAL CAR|No||||
ampicillin sodium|No|No|No|No|75%|44567010410|AMPICILLIN 10 GM VIAL|1|EA|30.1|10/09/2012||Yes|No||10/09/2012||Yes|No|10/09/2012||Yes|No||||No|No|||Prescription required|No|||No|68.6|06/01/2016|67.62|06/01/2016|64.4|06/01/2016||||10560|||||No|No||WG CRITICAL CAR|No||||
ampicillin sodium/sulbactam Na|No|No|No|No|75%|44567021010|AMPICILLIN-SULBACTAM 1.5 GM VL|1|EA|3.4185|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|No|||No|7.791|06/01/2016|7.6797|06/07/2016|7.314|06/01/2016||||10561|||||No|No||WG CRITICAL CAR|No||||
ampicillin sodium/sulbactam Na|No|No|No|No|75%|44567021110|AMPICILLIN-SULBACTAM 3 GM VIAL|1|EA|6.8585|10/15/2013||Yes|No||10/15/2013||Yes|No|10/15/2013||Yes|No||||No|No|||Prescription required|No|||No|15.631|06/01/2016|15.4077|06/01/2016|14.674|06/01/2016||||10562|||||No|No||WG CRITICAL CAR|No||||
ampicillin sodium/sulbactam Na|No|No|No|No|75%|44567021201|AMPICILLIN-SULBACTAM 15 GM VL|1|EA|32.25|10/15/2013||Yes|No||10/15/2013||Yes|No|10/15/2013||Yes|No||||No|No|||Prescription required|No|||No|73.5|06/01/2016|72.45|06/01/2016|69|06/01/2016||||10563|||||No|No||WG CRITICAL CAR|No||||
nafcillin sodium|No|No|No|No|75%|44567022110|NAFCILLIN 1 GM VIAL|1|EA|4.73|04/01/2013||Yes|No||04/01/2013||Yes|No|04/01/2013||Yes|No||||No|No|||Prescription required|No|||No|10.78|06/01/2016|10.626|06/01/2016|10.12|06/01/2016||||10564|||||No|No||WG CRITICAL CAR|No||||
nafcillin sodium|No|No|No|No|75%|44567022210|NAFCILLIN 2 GM VIAL|1|EA|9.46|04/01/2013||Yes|No||04/01/2013||Yes|No|04/01/2013||Yes|No||||No|No|||Prescription required|No|||No|21.56|06/01/2016|21.252|06/01/2016|20.24|06/01/2016||||10565|||||No|No||WG CRITICAL CAR|No||||
nafcillin sodium|No|No|No|No|75%|44567022301|NAFCILLIN 10 GM BULK VIAL|1|EA|62.35|11/09/2016||Yes|No||11/09/2016||Yes|No|11/09/2016||Yes|No||||No|No|||Prescription required|No|||No|142.1|11/09/2016|140.07|11/09/2016|133.4|11/09/2016||||10566|||||No|No||WG CRITICAL CAR|No||||
ceftazidime|No|No|No|No|75%|44567023525|CEFTAZIDIME 1 GM VIAL|1|EA|1.935|03/03/2014||Yes|No||03/03/2014||Yes|No|03/03/2014||Yes|No||||No|No|||Prescription required|No|||No|4.41|06/01/2016|4.347|06/01/2016|4.14|06/01/2016||||10567|||||No|No||WG CRITICAL CAR|No||||
ceftazidime|No|No|No|No|75%|44567023610|CEFTAZIDIME 2 GM VIAL|1|EA|4.3|03/03/2014||Yes|No||03/03/2014||Yes|No|03/03/2014||Yes|No||||No|No|||Prescription required|No|||No|9.8|06/01/2016|9.66|06/01/2016|9.2|06/01/2016||||10568|||||No|No||WG CRITICAL CAR|No||||
ceftazidime|No|No|No|No|75%|44567023706|CEFTAZIDIME 6 GM VIAL|1|EA|10.32|03/03/2014||Yes|No||03/03/2014||Yes|No|03/03/2014||Yes|No||||No|No|||Prescription required|No|||No|23.52|06/01/2016|23.184|06/01/2016|22.08|06/01/2016||||10569|||||No|No||WG CRITICAL CAR|No||||
cefepime HCl|No|No|No|No|75%|44567024010|CEFEPIME HCL 1 GM VIAL|1|EA|2.451|10/16/2014||Yes|No||10/16/2014||Yes|No|10/16/2014||Yes|No||||No|No|||Prescription required|No|||No|5.586|06/01/2016|5.5062|06/01/2016|5.244|06/01/2016||||10570|||||No|No||WG CRITICAL CAR|No||||
cefepime HCl|No|No|No|No|75%|44567024110|CEFEPIME HCL 2 GRAM VIAL|1|EA|4.214|10/16/2014||Yes|No||10/16/2014||Yes|No|10/16/2014||Yes|No||||No|No|||Prescription required|No|||No|9.604|06/01/2016|9.4668|06/01/2016|9.016|06/01/2016||||10571|||||No|No||WG CRITICAL CAR|No||||
cefoxitin sodium|No|No|No|No|75%|44567024525|CEFOXITIN 1 GM VIAL|1|EA|4.2785|07/08/2015||Yes|No||07/08/2015||Yes|No|07/08/2015||Yes|No||||No|No|||Prescription required|No|||No|9.751|04/30/2019|9.6117|04/30/2019|9.154|04/30/2019||||10572|||||No|No||WG CRITICAL CAR|No||||
cefoxitin sodium|No|No|No|No|75%|44567024585|CEFOXITIN 1 GM VIAL|1|EA|1.29|02/06/2018||Yes|No||02/06/2018||Yes|No|02/06/2018||Yes|No||||No|No|||Prescription required|No|||No|2.94|02/06/2018|2.898|02/13/2018|2.76|02/06/2018||||10573|||||No|No||WG CRIT/NOVAPLU|No||||
cefoxitin sodium|Yes|No|No|No|75%|44567024625|CEFOXITIN 2 GM VIAL|1|EA|8.5785|07/08/2015||Yes|No||07/08/2015||Yes|No|07/08/2015||Yes|No||||No|No|07/08/2015||Prescription required|No|||No|19.551|03/12/2019|19.2717|03/12/2019|18.354|03/12/2019||||10574|||||No|No||WG CRITICAL CAR|No||||
cefoxitin sodium|Yes|No|No|No|75%|44567024685|CEFOXITIN 2 GM VIAL|1|EA|2.58|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|05/21/2018||Prescription required|No|||No|5.88|05/21/2018|5.796|05/29/2018|5.52|05/21/2018||||10575|||||No|No||WG CRIT/NOVAPLU|No||||
cefoxitin sodium|No|No|No|No|75%|44567024710|CEFOXITIN 10 GM VIAL|1|EA|38.6957|07/08/2015||Yes|No||07/08/2015||Yes|No|07/08/2015||Yes|No||||No|No|||Prescription required|No|||No|88.1902|03/12/2019|86.93034|03/12/2019|82.7908|03/12/2019||||10576|||||No|No||WG CRITICAL CAR|No||||
penicillin G potassium|No|No|No|No|75%|44567031110|PENICILLIN GK 5 MILLION UNIT|1|EA|1.72|07/08/2015||Yes|No||07/08/2015||Yes|No|07/08/2015||Yes|No||||No|No|||Prescription required|No|||No|3.92|08/10/2021|3.864|08/10/2021|3.68|08/10/2021||||10577|||||No|No||WG CRITICAL CAR|No||||
penicillin G potassium|No|No|No|No|75%|44567031201|PENICILLIN GK 20 MILLION UNIT|1|EA|21.4957|03/03/2014||Yes|No||03/03/2014||Yes|No|03/03/2014||Yes|No||||No|No|||Prescription required|No|||No|48.9902|08/10/2021|48.29034|08/10/2021|45.9908|08/10/2021||||10578|||||No|No||WG CRITICAL CAR|No||||
levofloxacin in dextrose 5 %|No|No|No|No|75%|44567043524|LEVOFLOXACIN 250 MG/50 ML-D5W|50|ML|.06192|12/28/2016||Yes|No||12/28/2016||Yes|No|12/28/2016||Yes|No||||No|No|||Prescription required|No|||No|.14112|12/28/2016|.1391|12/28/2016|.13248|12/28/2016||||10579|||||No|No||WG CRITICAL CAR|No||||
levofloxacin in dextrose 5 %|No|No|No|No|75%|44567043624|LEVOFLOXACIN 500 MG/100 ML-D5W|100|ML|.05396|12/28/2016||Yes|No||12/28/2016||Yes|No|12/28/2016||Yes|No||||No|No|||Prescription required|No|||No|.12299|12/28/2016|.12123|12/28/2016|.11546|12/28/2016||||10580|||||No|No||WG CRITICAL CAR|No||||
levofloxacin in dextrose 5 %|No|No|No|No|75%|44567043724|LEVOFLOXACIN 750 MG/150 ML-D5W|150|ML|.03726|12/28/2016||Yes|No||12/28/2016||Yes|No|12/28/2016||Yes|No||||No|No|||Prescription required|No|||No|.08492|12/28/2016|.08371|12/28/2016|.07972|12/28/2016||||10581|||||No|No||WG CRITICAL CAR|No||||
teniposide|No|No|No|No|75%|44567050701|TENIPOSIDE 50 MG/5 ML AMPULE|5|ML|214.6517|10/15/2013||Yes|No||10/15/2013||Yes|No|10/15/2013||Yes|No||||No|No|||Prescription required|No|||No|489.2062|11/01/2016|482.21754|11/01/2016|459.2548|11/01/2016||||10582|||||No|No||WG CRITICAL CAR|No||||
ceftriaxone sodium|No|No|No|No|75%|44567070125|CEFTRIAXONE 1 GM VIAL|1|EA|1.29|04/22/2013||Yes|No||04/22/2013||Yes|No|04/22/2013||Yes|No||||No|No|||Prescription required|No|||No|2.94|08/29/2017|2.898|08/29/2017|2.76|08/29/2017||||10583|||||No|No||WG CRITICAL CAR|No||||
ceftriaxone sodium|No|No|No|No|75%|44567070225|CEFTRIAXONE 2 GM VIAL|1|EA|2.58|04/22/2013||Yes|No||04/22/2013||Yes|No|04/22/2013||Yes|No||||No|No|||Prescription required|No|||No|5.88|06/01/2016|5.796|06/01/2016|5.52|06/01/2016||||10584|||||No|No||WG CRITICAL CAR|No||||
ceftriaxone sodium|No|No|No|No|75%|44567070301|CEFTRIAXONE 10 GM VIAL|1|EA|12.04|04/22/2013||Yes|No||04/22/2013||Yes|No|04/22/2013||Yes|No||||No|No|||Prescription required|No|||No|27.44|06/01/2016|27.048|06/01/2016|25.76|06/01/2016||||10585|||||No|No||WG CRITICAL CAR|No||||
cefazolin sodium|No|No|No|No|75%|44567070625|CEFAZOLIN 500 MG VIAL|1|EA|.688|12/03/2012||Yes|No||12/03/2012||Yes|No|12/03/2012||Yes|No||||No|No|||Prescription required|No|||No|1.568|06/01/2016|1.5456|06/01/2016|1.472|06/01/2016||||10586|||||No|No||WG CRITICAL CAR|No||||
cefazolin sodium|No|No|No|No|75%|44567070725|CEFAZOLIN 1 GM VIAL|1|EA|.7095|12/03/2012||Yes|No||12/03/2012||Yes|No|12/03/2012||Yes|No||||No|No|||Prescription required|No|||No|1.617|12/13/2016|1.5939|12/13/2016|1.518|12/13/2016||||10587|||||No|No||WG CRITICAL CAR|No||||
cefazolin sodium|No|No|No|No|75%|44567070810|CEFAZOLIN 10 GM VIAL|1|EA|4.73|12/03/2012||Yes|No||12/03/2012||Yes|No|12/03/2012||Yes|No||||No|No|||Prescription required|No|||No|10.78|06/01/2016|10.626|06/01/2016|10.12|06/01/2016||||10588|||||No|No||WG CRITICAL CAR|No||||
piperacillin sodium/tazobactam|No|No|No|No|75%|44567080110|PIPERACIL-TAZOBACT 2.25 GM VL|1|EA|1.2857|11/01/2012||Yes|No||11/01/2012||Yes|No|11/01/2012||Yes|No||||No|No|||Prescription required|No|||No|2.9302|11/23/2021|2.88834|11/23/2021|2.7508|11/23/2021||||10589|||||No|No||WG CRITICAL CAR|No||||
piperacillin sodium/tazobactam|No|No|No|No|75%|44567080210|PIPERACIL-TAZOBACT 3.375 GM VL|1|EA|2.2102|10/18/2013||Yes|No||10/18/2013||Yes|No|10/18/2013||Yes|No||||No|No|||Prescription required|No|||No|5.0372|11/23/2021|4.96524|11/23/2021|4.7288|11/23/2021||||10590|||||No|No||WG CRITICAL CAR|No||||
piperacillin sodium/tazobactam|No|No|No|No|75%|44567080310|PIPERACIL-TAZOBACT 4.5 GM VIAL|1|EA|2.924|11/01/2012||Yes|No||11/01/2012||Yes|No|11/01/2012||Yes|No||||No|No|||Prescription required|No|||No|6.664|11/23/2021|6.5688|11/23/2021|6.256|11/23/2021||||10591|||||No|No||WG CRITICAL CAR|No||||
piperacillin sodium/tazobactam|No|No|No|No|75%|44567080401|PIPERACIL-TAZOBACT 40.5 GRAM|1|EA|51.1743|11/01/2012||Yes|No||11/01/2012||Yes|No|11/01/2012||Yes|No||||No|No|||Prescription required|No|||No|116.6298|11/23/2021|114.96366|11/23/2021|109.4892|11/23/2021||||10592|||||No|No||WG CRITICAL CAR|No||||
ped mvit A,C,D3 no.21/fluoride|No|No|No|No|75%|44946103508|TRI-VIT-FLUOR 0.25 MG/ML DROP|50|ML|.0583|08/19/2013||Yes|No||||No|No|||No|No||||No|No|||Over the counter|No|||No|.13288|07/07/2020|.13098|07/07/2020|.12475|07/07/2020||||10593|||||No|No||SANCILIO & COMP|No||||
cholic acid|No|No|No|No|75%|45043000102|CHOLBAM 50 MG CAPSULE|90|EA|118.60833|06/09/2016||Yes|No||06/09/2016||Yes|No|06/09/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|198|No|270.31666|06/09/2016|266.45499|06/09/2016|253.76666|06/09/2016|||BILE SALTS|10594|||||No|No||MANCHESTER PHAR|No||||
cholic acid|No|No|No|No|75%|45043000202|CHOLBAM 250 MG CAPSULE|90|EA|356.9|06/09/2016||Yes|No||06/09/2016||Yes|No|06/09/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|198|No|813.4|06/09/2016|801.78|06/09/2016|763.6|06/09/2016|||BILE SALTS|10595|||||No|No||MANCHESTER PHAR|No||||
tivozanib HCl|No|No|No|No|75%|45629008901|FOTIVDA 0.89 MG CAPSULE|21|EA|519.23523|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No|||No|1183.37332|01/11/2022|1166.46799|01/11/2022|1110.92189|01/11/2022||||10596|||||No|No||AVEO PHARMACEUT|No||||
tivozanib HCl|No|No|No|No|75%|45629013401|FOTIVDA 1.34 MG CAPSULE|21|EA|519.23523|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No|||No|1183.37332|01/11/2022|1166.46799|01/11/2022|1110.92189|01/11/2022||||10597|||||No|No||AVEO PHARMACEUT|No||||
nicotine polacrilex|No|No|No|No|75%|45802000125|NICOTINE 4 MG CHEWING GUM|110|EA|.10917|08/02/2019||Yes|No||||No|No|08/02/2019||Yes|No||||No|No|||Over the counter|No||040|No|.27548|03/29/2022|.26886|03/29/2022|.27065|03/29/2022|||SMOKING CESSATION|10598|||||No|No||PERRIGO CO.|No||||
hydrocortisone|No|No|No|No|75%|45802000402|HYDROCORTISONE 2.5% CREAM|20|GM|.0559|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||118|No|.14813|03/29/2022|.14457|03/29/2022|.14553|03/29/2022|||STEROIDS: TOPICAL LOW|10599|||||No|No||PERRIGO/PADAGIS|No||||
hydrocortisone|No|No|No|No|75%|45802000403|HYDROCORTISONE 2.5% CREAM|28|GM|.05835|07/23/2009||Yes|No||07/23/2009||Yes|No|07/23/2009||Yes|No||||No|No|||Prescription required|No||118|No|.0878|03/29/2022|.08569|03/29/2022|.08626|03/29/2022|||STEROIDS: TOPICAL LOW|10600|||||No|No||PERRIGO/PADAGIS|No||||
fluocinolone acetonide oil|No|No|No|No|75%|45802000910|FLUOCINOLONE OIL 0.01% EAR DRP|20|ML|1.5953|01/25/2018||Yes|No||01/25/2018||Yes|No|01/25/2018||Yes|No||||No|No|||Prescription required|No|||No|2.06581|03/29/2022|2.01623|03/29/2022|2.02965|03/29/2022||||10601|||||No|No||PERRIGO/PADAGIS|No||||
hydrocortisone|No|No|No|No|75%|45802001402|HYDROCORTISONE 2.5% OINTMENT|20|GM|.0559|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||118|No|.10495|03/29/2022|.10243|03/29/2022|.10311|03/29/2022|||STEROIDS: TOPICAL LOW|10602|||||No|No||PERRIGO/PADAGIS|No||||
hydrocortisone|No|No|No|No|75%|45802001405|HYDROCORTISONE 2.5% OINTMENT|454|GM|.03314|02/12/2007||Yes|No||||No|No|02/12/2007||Yes|No||||No|No|||Prescription required|No||118|No|.06246|03/29/2022|.06096|03/29/2022|.06136|03/29/2022|||STEROIDS: TOPICAL LOW|10603|||||No|No||PERRIGO/PADAGIS|No||||
betamethasone dipropionate|No|No|No|No|75%|45802002146|BETAMETHASONE DP 0.05% LOT|60|ML|.26875|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||120|No|.41157|03/29/2022|.40169|03/29/2022|.40436|03/29/2022|||STEROIDS: TOPICAL HIGH|10604|||||No|No||PERRIGO/PADAGIS|No||||
azelastine HCl|No|No|No|No|75%|45802002683|AZELASTINE 0.15% NASAL SPRAY|30|ML|.43|05/12/2014||Yes|No||05/12/2014||Yes|No|05/12/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|019|Yes|.62364|03/29/2022|.60867|03/29/2022|.61272|03/29/2022|||INTRANASAL RHINITIS AGENTS|10605|||||No|No||PERRIGO/PADAGIS|No||||
erythromycin base in ethanol|No|No|No|No|75%|45802003846|ERYTHROMYCIN 2% SOLUTION|60|ML|.28666|06/11/2012||Yes|No||06/11/2012||Yes|No|06/11/2012||Yes|No||||No|No|||Prescription required|No||104|No|.42786|03/29/2022|.41759|03/29/2022|.42037|03/29/2022|||ACNE AGENTS: TOPICAL|10606|||||No|No||PERRIGO/PADAGIS|No||||
selenium sulfide|No|No|No|No|75%|45802004064|SELENIUM SULFIDE 2.5% LOTION|120|ML|.03547|09/30/2010||Yes|No||09/30/2010||Yes|No|09/30/2010||Yes|No||||No|No|||Prescription required|No|||No|.06964|03/29/2022|.06796|03/29/2022|.06842|03/29/2022||||10607|||||No|No||PERRIGO/PADAGIS|No||||
clindamycin phosphate|No|No|No|No|75%|45802004201|CLINDESSE 2% VAGINAL CREAM|5|GM|10.8919|08/24/2017||Yes|No||08/24/2017||Yes|No|08/24/2017||Yes|No||||No|No|||Prescription required|No||124|No|24.2724|05/25/2021|23.68986|05/25/2021|23.84763|05/25/2021|||ANTIBIOTICS: VAGINAL|10608|||||No|No||PERRIGO CO.|No||||
acyclovir|No|No|No|No|75%|45802004475|ACYCLOVIR 5% CREAM|5|GM|65.34796|05/28/2019||Yes|No||05/28/2019||Yes|No|05/28/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|123|No|36.3578|03/29/2022|35.48521|03/29/2022|35.72153|03/29/2022|||ANTIVIRALS: TOPICAL|10609|||||No|No||PERRIGO/PADAGIS|No||||
triamcinolone acetonide|No|No|No|No|75%|45802004501|TRIAMCINOLONE 0.147 MG/G SPRAY|63|GM|1.39476|04/24/2015||Yes|No||04/24/2015||Yes|No|04/24/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|120|No|3.17877|05/25/2021|3.13336|05/25/2021|2.98415|05/25/2021|||STEROIDS: TOPICAL HIGH|10610|||||No|No||PERRIGO/PADAGIS|No||||
triamcinolone acetonide|No|No|No|No|75%|45802004502|TRIAMCINOLONE 0.147 MG/G SPRAY|100|GM|1.39479|04/24/2015||Yes|No||04/24/2015||Yes|No|04/24/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|120|No|3.17882|10/29/2019|3.13341|10/29/2019|2.9842|10/29/2019|||STEROIDS: TOPICAL HIGH|10611|||||No|No||PERRIGO/PADAGIS|No||||
gentamicin sulfate|No|No|No|No|75%|45802004611|GENTAMICIN 0.1% OINTMENT|30|GM|1.13233|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|114|No|1.09757|03/29/2022|1.07122|03/29/2022|1.07836|03/29/2022|||ANTIBIOTICS: TOPICAL|10612|||||No|No||PERRIGO/PADAGIS|No||||
gentamicin sulfate|No|No|No|No|75%|45802004635|GENTAMICIN 0.1% OINTMENT|15|GM|1.13233|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|114|No|1.4736|03/29/2022|1.43823|03/29/2022|1.44781|03/29/2022|||ANTIBIOTICS: TOPICAL|10613|||||No|No||PERRIGO/PADAGIS|No||||
nystatin|No|No|No|No|75%|45802004811|NYSTATIN 100,000 UNIT/GM OINT|30|GM|.301|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||061|No|.27525|03/29/2022|.26864|03/29/2022|.27043|03/29/2022|||ANTIFUNGALS: TOPICAL|10614|||||No|No||PERRIGO CO.|No||||
nystatin|No|No|No|No|75%|45802004835|NYSTATIN 100,000 UNIT/GM OINT|15|GM|.40133|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||061|No|.33338|03/29/2022|.32537|03/29/2022|.32754|03/29/2022|||ANTIFUNGALS: TOPICAL|10615|||||No|No||PERRIGO CO.|No||||
triamcinolone acetonide|No|No|No|No|75%|45802004935|TRIAMCINOLONE 0.5% OINTMENT|15|GM|.23449|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||120|No|.35668|03/29/2022|.34811|03/29/2022|.35043|03/29/2022|||STEROIDS: TOPICAL HIGH|10616|||||No|No||PERRIGO/PADAGIS|No||||
dibucaine|No|No|No|No|75%|45802005003|DIBUCAINE 1% OINTMENT|28|GM|.07678|11/03/2016|12/31/2022|Yes|No||||No|No|11/03/2016|12/31/2022|Yes|No||||No|No|||Over the counter|No|||No|.15853|03/29/2022|.15472|03/29/2022|.15575|03/29/2022||||10617|No Longer Rebatable||No Longer Rebatable||No|No||PERRIGO CO.|No||||
betamethasone valerate|No|No|No|No|75%|45802005301|BETAMETHASONE VALER 0.12% FOAM|50|GM|2.24924|01/22/2013||Yes|No||01/22/2013||Yes|No|01/22/2013||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|119|No|2.1912|03/01/2022|2.13861|03/01/2022|2.15285|03/01/2022|||STEROIDS: TOPICAL MEDIUM|10618|||||No|No||PERRIGO/PADAGIS|No||||
betamethasone valerate|No|No|No|No|75%|45802005302|BETAMETHASONE VALER 0.12% FOAM|100|GM|2.09315|01/22/2013||Yes|No||01/22/2013||Yes|No|01/22/2013||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|119|No|.8923|06/29/2021|.87088|06/29/2021|.87668|06/29/2021|||STEROIDS: TOPICAL MEDIUM|10619|||||No|No||PERRIGO/PADAGIS|No||||
triamcinolone acetonide|No|No|No|No|75%|45802005405|TRIAMCINOLONE 0.025% OINT|454|GM|.02417|07/25/2007||Yes|No||07/25/2007||Yes|No|07/25/2007||Yes|No||||No|No|||Prescription required|No||120|No|.04712|03/29/2022|.04598|03/29/2022|.04629|03/29/2022|||STEROIDS: TOPICAL HIGH|10620|||||No|No||PERRIGO/PADAGIS|No||||
triamcinolone acetonide|No|No|No|No|75%|45802005435|TRIAMCINOLONE 0.025% OINT|15|GM|.14218|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||120|No|.2641|03/29/2022|.25776|03/29/2022|.25947|03/29/2022|||STEROIDS: TOPICAL HIGH|10621|||||No|No||PERRIGO/PADAGIS|No||||
triamcinolone acetonide|No|No|No|No|75%|45802005436|TRIAMCINOLONE 0.025% OINT|80|GM|.04401|09/29/2006||Yes|No||09/29/2006||Yes|No|09/29/2006||Yes|No||||No|No|||Prescription required|No||120|No|.07753|03/29/2022|.07566|03/29/2022|.07617|03/29/2022|||STEROIDS: TOPICAL HIGH|10622|||||No|No||PERRIGO/PADAGIS|No||||
triamcinolone acetonide|No|No|No|No|75%|45802005505|TRIAMCINOLONE 0.1% OINTMENT|454|GM|.03171|09/29/2006||Yes|No||09/29/2006||Yes|No|09/29/2006||Yes|No||||No|No|||Prescription required|No||120|No|.04617|03/29/2022|.04506|03/29/2022|.04536|03/29/2022|||STEROIDS: TOPICAL HIGH|10623|||||No|No||PERRIGO/PADAGIS|No||||
triamcinolone acetonide|No|No|No|No|75%|45802005535|TRIAMCINOLONE 0.1% OINTMENT|15|GM|.12928|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||120|No|.14436|03/29/2022|.14089|03/29/2022|.14183|03/29/2022|||STEROIDS: TOPICAL HIGH|10624|||||No|No||PERRIGO/PADAGIS|No||||
triamcinolone acetonide|No|No|No|No|75%|45802005536|TRIAMCINOLONE 0.1% OINTMENT|80|GM|.05519|10/27/2006||Yes|No||10/27/2006||Yes|No|10/27/2006||Yes|No||||No|No|||Prescription required|No||120|No|.06224|03/29/2022|.06074|03/29/2022|.06115|03/29/2022|||STEROIDS: TOPICAL HIGH|10625|||||No|No||PERRIGO/PADAGIS|No||||
gentamicin sulfate|No|No|No|No|75%|45802005611|GENTAMICIN 0.1% CREAM|30|GM|1.13233|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|114|No|1.27926|03/29/2022|1.24855|03/29/2022|1.25687|03/29/2022|||ANTIBIOTICS: TOPICAL|10626|||||No|No||PERRIGO/PADAGIS|No||||
gentamicin sulfate|No|No|No|No|75%|45802005635|GENTAMICIN 0.1% CREAM|15|GM|1.13233|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|114|No|1.45337|03/29/2022|1.41848|03/29/2022|1.42793|03/29/2022|||ANTIBIOTICS: TOPICAL|10627|||||No|No||PERRIGO/PADAGIS|No||||
ibuprofen|No|No|No|No|75%|45802005705|INFANT IBUPROFEN 50 MG/1.25 ML|15|ML|.10434|08/02/2019||Yes|No||||No|No|08/02/2019||Yes|No||||No|No|||Over the counter|No||059|Yes|.24939|03/29/2022|.2434|03/29/2022|.24502|03/29/2022|||NSAIDS|10628|||||No|No||PERRIGO CO.|No||||
nystatin|No|No|No|No|75%|45802005911|NYSTATIN 100,000 UNIT/GM CREAM|30|GM|.301|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||061|No|.16163|03/29/2022|.15775|03/29/2022|.1588|03/29/2022|||ANTIFUNGALS: TOPICAL|10629|||||No|No||PERRIGO CO.|No||||
nystatin|No|No|No|No|75%|45802005935|NYSTATIN 100,000 UNIT/GM CREAM|15|GM|.40133|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||061|No|.26748|03/29/2022|.26106|03/29/2022|.26279|03/29/2022|||ANTIFUNGALS: TOPICAL|10630|||||No|No||PERRIGO CO.|No||||
bacitracin|No|No|No|No|75%|45802006001|BACITRACIN 500 UNIT/GM OINTMNT|14|GM|.05221|08/02/2019||Yes|No||||No|No|08/02/2019||Yes|No||||No|No|||Over the counter|No||114|No|.11223|03/29/2022|.10953|03/29/2022|.11026|03/29/2022|||ANTIBIOTICS: TOPICAL|10631|||||No|No||PERRIGO CO.|No||||
bacitracin|No|No|No|No|75%|45802006003|BACITRACIN 500 UNIT/GM OINTMNT|28|GM|.03762|08/02/2019||Yes|No||||No|No|08/02/2019||Yes|No||||No|No|||Over the counter|No||114|No|.06344|03/29/2022|.06191|03/29/2022|.06232|03/29/2022|||ANTIBIOTICS: TOPICAL|10632|||||No|No||PERRIGO CO.|No||||
triamcinolone acetonide|No|No|No|No|75%|45802006305|TRIAMCINOLONE 0.025% CREAM|454|GM|.01743|02/23/2007||Yes|No||02/23/2007||Yes|No|02/23/2007||Yes|No||||No|No|||Prescription required|No||120|No|.0363|03/29/2022|.03542|03/29/2022|.03566|03/29/2022|||STEROIDS: TOPICAL HIGH|10633|||||No|No||PERRIGO/PADAGIS|No||||
triamcinolone acetonide|No|No|No|No|75%|45802006335|TRIAMCINOLONE 0.025% CREAM|15|GM|.1032|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||120|No|.15373|03/29/2022|.15004|03/29/2022|.15103|03/29/2022|||STEROIDS: TOPICAL HIGH|10634|||||No|No||PERRIGO/PADAGIS|No||||
triamcinolone acetonide|No|No|No|No|75%|45802006336|TRIAMCINOLONE 0.025% CREAM|80|GM|.04401|03/12/2007||Yes|No||03/12/2007||Yes|No|03/12/2007||Yes|No||||No|No|||Prescription required|No||120|No|.05651|03/29/2022|.05515|03/29/2022|.05552|03/29/2022|||STEROIDS: TOPICAL HIGH|10635|||||No|No||PERRIGO/PADAGIS|No||||
triamcinolone acetonide|No|No|No|No|75%|45802006405|TRIAMCINOLONE 0.1% CREAM|454|GM|.0184|09/02/2010||Yes|No||09/02/2010||Yes|No|09/02/2010||Yes|No||||No|No|||Prescription required|No||120|No|.03246|03/29/2022|.03168|03/29/2022|.03189|03/29/2022|||STEROIDS: TOPICAL HIGH|10636|||||No|No||PERRIGO/PADAGIS|No||||
triamcinolone acetonide|No|No|No|No|75%|45802006435|TRIAMCINOLONE 0.1% CREAM|15|GM|.09288|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||120|No|.13878|03/29/2022|.13544|03/29/2022|.13635|03/29/2022|||STEROIDS: TOPICAL HIGH|10637|||||No|No||PERRIGO/PADAGIS|No||||
triamcinolone acetonide|No|No|No|No|75%|45802006436|TRIAMCINOLONE 0.1% CREAM|80|GM|.04246|10/27/2006||Yes|No||10/27/2006||Yes|No|10/27/2006||Yes|No||||No|No|||Prescription required|No||120|No|.05241|03/29/2022|.05115|03/29/2022|.05149|03/29/2022|||STEROIDS: TOPICAL HIGH|10638|||||No|No||PERRIGO/PADAGIS|No||||
triamcinolone acetonide|No|No|No|No|75%|45802006535|TRIAMCINOLONE 0.5% CREAM|15|GM|.23478|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||120|No|.24378|03/29/2022|.23792|03/29/2022|.23951|03/29/2022|||STEROIDS: TOPICAL HIGH|10639|||||No|No||PERRIGO/PADAGIS|No||||
azelastine/fluticasone|No|No|No|No|75%|45802006601|AZELASTIN-FLUTIC 137-50MCG SPR|23|GM|3.19396|06/15/2021||Yes|No||06/15/2021||Yes|No|06/15/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|019|No|4.21868|03/29/2022|4.11743|03/29/2022|4.14485|03/29/2022|||INTRANASAL RHINITIS AGENTS|10640|||||No|No||PERRIGO/PADAGIS|No||||
alogliptin benzoate|No|No|No|No|75%|45802008765|ALOGLIPTIN 6.25 MG TABLET|30|EA|2.795|08/24/2016||Yes|No||08/24/2016||Yes|No|08/24/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|5.45674|12/28/2021|5.32577|12/28/2021|5.36124|12/28/2021|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|10641|||||No|No||PERRIGO/PADAGIS|No||||
albuterol sulfate|No|No|No|No|75%|45802008801|ALBUTEROL HFA 90 MCG INHALER|8.5|GM|1.82016|06/27/2020||Yes|No||06/27/2020||Yes|No|06/27/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|037|Yes|3.10102|03/29/2022|3.02659|03/29/2022|3.04675|03/29/2022|||BRONCHODILATORS: BETA AGONIST|10642|||||No|No||PERRIGO/PADAGIS|No||||
nicotine polacrilex|No|No|No|No|75%|45802008902|NICOTINE 2 MG MINI LOZENGE|81|EA|.16058|09/07/2016||Yes|No||||No|No|09/07/2016||Yes|No||||No|No|||Over the counter|No||040|No|.4117|11/23/2021|.40181|11/23/2021|.40449|11/23/2021|||SMOKING CESSATION|10643|||||No|No||PERRIGO CO.|No||||
estradiol|No|No|No|No|75%|45802009735|ESTRADIOL 0.01% CREAM|42.5|GM|1.01176|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|No|||Yes|.87976|03/29/2022|.85864|03/29/2022|.86436|03/29/2022||||10644|||||No|No||PERRIGO/PADAGIS|No||||
mesalamine|No|No|No|No|75%|45802009828|MESALAMINE 4 GM/60 ML ENEMA|60|ML|.09383|01/23/2008||Yes|No||01/23/2008||Yes|No|01/23/2008||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|010|No|.21384|11/26/2019|.21079|11/26/2019|.20075|11/26/2019|||ULCERATIVE COLITIS AGENTS|10645|||||No|No||PERRIGO CO.|No||||
mesalamine|No|No|No|No|75%|45802009851|MESALAMINE 4 GM/60 ML ENEMA|60|ML|.09582|08/09/2005||Yes|No||08/09/2005||Yes|No|08/09/2005||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|010|No|.12785|03/29/2022|.12478|03/29/2022|.12561|03/29/2022|||ULCERATIVE COLITIS AGENTS|10646|||||No|No||PERRIGO CO.|No||||
benzoyl peroxide|No|No|No|No|75%|45802010196|BENZOYL PEROXIDE 2.5% GEL|60|GM|.09638|03/16/2012||Yes|No||||No|No|03/16/2012||Yes|No||||No|No|||Over the counter|No|||No|.18986|03/01/2022|.1853|03/01/2022|.18653|03/01/2022||||10647|||||No|No||PERRIGO CO.|No||||
alogliptin benzoate|No|No|No|No|75%|45802010365|ALOGLIPTIN 12.5 MG TABLET|30|EA|2.795|08/24/2016||Yes|No||08/24/2016||Yes|No|08/24/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|5.21691|03/29/2022|5.0917|03/29/2022|5.12561|03/29/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|10648|||||No|No||PERRIGO/PADAGIS|No||||
olopatadine HCl|No|No|No|No|75%|45802010401|OLOPATADINE 665 MCG NASAL SPRY|30.5|GM|1.26884|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|019|No|1.24713|03/29/2022|1.21719|03/29/2022|1.2253|03/29/2022|||INTRANASAL RHINITIS AGENTS|10649|||||No|No||PERRIGO/PADAGIS|No||||
pseudoephedrine HCl|No|No|No|No|75%|45802010752|PSEUDOEPHEDRINE ER 120 MG TAB|10|EA|.129|08/02/2019||Yes|No||||No|No|08/02/2019||Yes|No||||No|No|||Over the counter|No|||No|.31485|03/29/2022|.30729|03/29/2022|.30934|03/29/2022||||10650|||||No|No||PERRIGO/PADAGIS|No||||
triamcinolone acetonide|No|No|No|No|75%|45802010901|TRIAMCINOLONE 55 MCG NASAL SPR|16.9|ML|.35722|02/16/2018||Yes|No||||No|No|02/16/2018||Yes|No||||No|No|||Over the counter|Yes|03/09/2018|019|No|.77636|03/29/2022|.75772|03/29/2022|.76277|03/29/2022|||INTRANASAL RHINITIS AGENTS|10651|||||No|No||PERRIGO/PADAGIS|No||||
diclofenac sodium|No|No|No|No|75%|45802011101|DICLOFENAC SODIUM 3% GEL|100|GM|.39977|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No|||Yes|.41138|03/29/2022|.4015|03/29/2022|.40418|03/29/2022||||10652|||||No|No||PERRIGO/PADAGIS|No||||
mupirocin|No|No|No|No|75%|45802011222|MUPIROCIN 2% OINTMENT|22|GM|.1759|12/19/2003||Yes|No||12/19/2003||Yes|No|12/19/2003||Yes|No||||No|No|||Prescription required|No||114|No|.18067|03/29/2022|.17633|03/29/2022|.1775|03/29/2022|||ANTIBIOTICS: TOPICAL|10653|||||No|No||PERRIGO CO.|No||||
mometasone furoate|No|No|No|No|75%|45802011846|MOMETASONE FUROATE 0.1% SOLN|60|ML|.3407|08/19/2005||Yes|No||08/19/2005||Yes|No|08/19/2005||Yes|No||||No|No|||Prescription required|No||119|No|.29151|03/29/2022|.28451|03/29/2022|.2864|03/29/2022|||STEROIDS: TOPICAL MEDIUM|10654|||||No|No||PERRIGO CO.|No||||
mometasone furoate|No|No|No|No|75%|45802011859|MOMETASONE FUROATE 0.1% SOLN|30|ML|.35647|08/19/2005||Yes|No||08/19/2005||Yes|No|08/19/2005||Yes|No||||No|No|||Prescription required|No||119|No|.36456|03/29/2022|.35581|03/29/2022|.35818|03/29/2022|||STEROIDS: TOPICAL MEDIUM|10655|||||No|No||PERRIGO CO.|No||||
mometasone furoate|No|No|No|No|75%|45802011937|MOMETASONE FUROATE 0.1% OINT|15|GM|.45408|10/21/2008||Yes|No||10/21/2008||Yes|No|10/21/2008||Yes|No||||No|No|||Prescription required|No||119|No|.28576|03/29/2022|.2789|03/29/2022|.28075|03/29/2022|||STEROIDS: TOPICAL MEDIUM|10656|||||No|No||PERRIGO CO.|No||||
mometasone furoate|No|No|No|No|75%|45802011942|MOMETASONE FUROATE 0.1% OINT|45|GM|.27806|07/24/2002||Yes|No||07/24/2002||Yes|No|07/24/2002||Yes|No||||No|No|||Prescription required|No||119|No|.17309|03/29/2022|.16893|03/29/2022|.17006|03/29/2022|||STEROIDS: TOPICAL MEDIUM|10657|||||No|No||PERRIGO CO.|No||||
loratadine/pseudoephedrine|No|No|No|No|75%|45802012246|LORATADINE-D 12 HOUR TABLET|10|EA|.43946|07/16/2018||Yes|No||||No|No|07/16/2018||Yes|No||||No|No|||Over the counter|Yes|01/31/2019|030|Yes|.85484|03/29/2022|.83432|03/29/2022|.83988|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10658|||||No|No||PERRIGO CO.|No||||
loratadine/pseudoephedrine|No|No|No|No|75%|45802012260|LORATADINE-D 12 HOUR TABLET|20|EA|.40312|07/16/2018||Yes|No||||No|No|07/16/2018||Yes|No||||No|No|||Over the counter|Yes|01/31/2019|030|Yes|.85484|03/29/2022|.83432|03/29/2022|.83988|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10659|||||No|No||PERRIGO CO.|No||||
loratadine/pseudoephedrine|No|No|No|No|75%|45802012265|LORATADINE-D 12 HOUR TABLET|30|EA|.32966|07/16/2018||Yes|No||||No|No|07/16/2018||Yes|No||||No|No|||Over the counter|Yes|01/31/2019|030|Yes|.85484|03/29/2022|.83432|03/29/2022|.83988|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10660|||||No|No||PERRIGO CO.|No||||
clindamycin phosphate|No|No|No|No|75%|45802012801|CLINDAMYCIN PHOSP 1% LOTION|60|ML|.68907|06/16/2021||Yes|No||06/16/2021||Yes|No|06/16/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|104|No|.74671|03/29/2022|.72878|03/29/2022|.73364|03/29/2022|||ACNE AGENTS: TOPICAL|10661|||||No|No||PERRIGO/PADAGIS|No||||
halobetasol propionate|No|No|No|No|75%|45802012932|HALOBETASOL PROP 0.05% CREAM|50|GM|.68232|12/27/2004||Yes|No||12/27/2004||Yes|No|12/27/2004||Yes|No||||No|No|||Prescription required|No||121|No|.62002|03/29/2022|.60513|03/29/2022|.60916|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|10662|||||No|No||PERRIGO/PADAGIS|No||||
halobetasol propionate|No|No|No|No|75%|45802012935|HALOBETASOL PROP 0.05% CREAM|15|GM|.946|12/27/2004||Yes|No||12/27/2004||Yes|No|12/27/2004||Yes|No||||No|No|||Prescription required|No||121|No|.76044|03/29/2022|.74218|03/29/2022|.74713|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|10663|||||No|No||PERRIGO/PADAGIS|No||||
halobetasol propionate|No|No|No|No|75%|45802013132|HALOBETASOL PROP 0.05% OINTMNT|50|GM|1.31648|12/27/2004||Yes|No||12/27/2004||Yes|No|12/27/2004||Yes|No||||No|No|||Prescription required|No||121|No|.74705|03/29/2022|.72912|03/29/2022|.73397|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|10664|||||No|No||PERRIGO/PADAGIS|No||||
halobetasol propionate|No|No|No|No|75%|45802013135|HALOBETASOL PROP 0.05% OINTMNT|15|GM|1.8252|12/27/2004||Yes|No||12/27/2004||Yes|No|12/27/2004||Yes|No||||No|No|||Prescription required|No||121|No|1.65592|03/29/2022|1.61617|03/29/2022|1.62694|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|10665|||||No|No||PERRIGO/PADAGIS|No||||
ibuprofen|No|No|No|No|75%|45802013326|CHILDREN IBUPROFEN 100 MG/5 ML|118|ML|.01362|08/02/2019||Yes|No||||No|No|08/02/2019||Yes|No||||No|No|||Over the counter|No||059|Yes|.02649|03/29/2022|.02585|03/29/2022|.02602|03/29/2022|||NSAIDS|10666|||||No|No||PERRIGO/PADAGIS|No||||
ciclopirox olamine|No|No|No|No|75%|45802013811|CICLOPIROX 0.77% CREAM|30|GM|.38814|04/17/2006||Yes|No||04/17/2006||Yes|No|04/17/2006||Yes|No||||No|No|||Prescription required|Yes|07/12/2005|061|No|.18222|03/29/2022|.17784|03/29/2022|.17903|03/29/2022|||ANTIFUNGALS: TOPICAL|10667|||||No|No||PERRIGO/PADAGIS|No||||
ciclopirox olamine|No|No|No|No|75%|45802013818|CICLOPIROX 0.77% CREAM|90|GM|.30983|04/17/2006||Yes|No||04/17/2006||Yes|No|04/17/2006||Yes|No||||No|No|||Prescription required|Yes|07/12/2005|061|No|.11129|03/29/2022|.10861|03/29/2022|.10934|03/29/2022|||ANTIFUNGALS: TOPICAL|10668|||||No|No||PERRIGO/PADAGIS|No||||
ciclopirox olamine|No|No|No|No|75%|45802013835|CICLOPIROX 0.77% CREAM|15|GM|.4406|04/17/2006||Yes|No||04/17/2006||Yes|No|04/17/2006||Yes|No||||No|No|||Prescription required|Yes|07/12/2005|061|No|.22046|03/29/2022|.21516|03/29/2022|.2166|03/29/2022|||ANTIFUNGALS: TOPICAL|10669|||||No|No||PERRIGO/PADAGIS|No||||
metronidazole|Yes|No|No|No|75%|45802013970|METRONIDAZOLE VAGINAL 0.75% GL|70|GM|.78235|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|03/20/2020||Prescription required|Yes|01/28/2021|124|No|.55819|03/29/2022|.54479|03/29/2022|.54842|03/29/2022|||ANTIBIOTICS: VAGINAL|10670|||||No|No||PERRIGO CO.|No||||
ibuprofen|No|No|No|No|75%|45802014026|CHILDREN IBUPROFEN 100 MG/5 ML|118|ML|.01417|08/02/2019||Yes|No||||No|No|08/02/2019||Yes|No||||No|No|||Over the counter|No||059|Yes|.02649|03/29/2022|.02585|03/29/2022|.02602|03/29/2022|||NSAIDS|10671|||||No|No||PERRIGO/PADAGIS|No||||
ciclopirox|No|No|No|No|75%|45802014167|CICLOPIROX 8% SOLUTION|6.6|ML|1.56363|09/19/2007||Yes|No||09/19/2007||Yes|No|09/19/2007||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|061|No|1.90189|03/29/2022|1.85624|03/29/2022|1.8686|03/29/2022|||ANTIFUNGALS: TOPICAL|10672|||||No|No||PERRIGO/PADAGIS|No||||
neomycin/bacitracin/polymyxinB|No|No|No|No|75%|45802014301|TRIPLE ANTIBIOTIC OINTMENT|14|GM|.06142|09/20/2019||Yes|No||||No|No|09/20/2019||Yes|No||||No|No|||Over the counter|No||114|No|.11137|03/29/2022|.10869|03/29/2022|.10942|03/29/2022|||ANTIBIOTICS: TOPICAL|10673|||||No|No||PERRIGO/PADAGIS|No||||
neomycin/bacitracin/polymyxinB|No|No|No|No|75%|45802014303|TRIPLE ANTIBIOTIC OINTMENT|28|GM|.04376|11/04/2015||Yes|No||||No|No|11/04/2015||Yes|No||||No|No|||Over the counter|No||114|No|.09281|03/29/2022|.09058|03/29/2022|.09118|03/29/2022|||ANTIBIOTICS: TOPICAL|10674|||||No|No||PERRIGO/PADAGIS|No||||
neomycin/bacitracin/polymyxinB|No|No|No|No|75%|45802014370|TRIPLE ANTIBIOTIC OINTMENT PKT|144|EA|.0633|11/04/2015||Yes|No||||No|No|11/04/2015||Yes|No||||No|No|||Over the counter|No||114|No|.14427|11/28/2017|.14221|11/28/2017|.13544|11/28/2017|||ANTIBIOTICS: TOPICAL|10675|||||No|No||PERRIGO/PADAGIS|No||||
cetirizine HCl/pseudoephedrine|No|No|No|No|75%|45802014753|CETIRIZINE-PSE ER 5-120 MG TAB|12|EA|.33288|03/11/2021||Yes|No||||No|No|03/11/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.59854|03/29/2022|.58417|03/29/2022|.58806|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10676|||||No|No||PERRIGO/PADAGIS|No||||
cetirizine HCl/pseudoephedrine|Yes|No|No|No|75%|45802014762|CETIRIZINE-PSE ER 5-120 MG TAB|24|EA|.32124|03/11/2021||Yes|No||||No|No|03/11/2021||Yes|No||||No|No|03/11/2021||Over the counter|Yes|07/29/2021|030|Yes|.59854|03/29/2022|.58417|03/29/2022|.58806|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10677|||||No|No||PERRIGO/PADAGIS|No||||
alogliptin benzoate|No|No|No|No|75%|45802015065|ALOGLIPTIN 25 MG TABLET|30|EA|2.795|08/24/2016||Yes|No||08/24/2016||Yes|No|08/24/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|5.22124|03/29/2022|5.09593|03/29/2022|5.12986|03/29/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|10678|||||No|No||PERRIGO/PADAGIS|No||||
fluocinonide|No|No|No|No|75%|45802015153|FLUOCINONIDE 0.1% CREAM|120|GM|.19403|01/20/2014||Yes|No||01/20/2014||Yes|No|01/20/2014||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.44222|04/27/2021|.4359|04/27/2021|.41515|04/27/2021|||STEROIDS: TOPICAL HIGH|10679|||||No|No||PERRIGO/PADAGIS|No||||
fluocinonide|No|No|No|No|75%|45802015194|FLUOCINONIDE 0.1% CREAM|30|GM|.23707|01/20/2014||Yes|No||01/20/2014||Yes|No|01/20/2014||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.34413|01/25/2022|.33587|01/25/2022|.3381|01/25/2022|||STEROIDS: TOPICAL HIGH|10680|||||No|No||PERRIGO/PADAGIS|No||||
fluocinonide|No|No|No|No|75%|45802015196|FLUOCINONIDE 0.1% CREAM|60|GM|.20425|01/20/2014||Yes|No||01/20/2014||Yes|No|01/20/2014||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.22927|03/29/2022|.22376|03/29/2022|.22525|03/29/2022|||STEROIDS: TOPICAL HIGH|10681|||||No|No||PERRIGO/PADAGIS|No||||
diclofenac sodium|No|No|No|No|75%|45802016000|DICLOFENAC SODIUM 1% GEL|100|GM|.18606|10/23/2019|03/01/2022|Yes|No||10/23/2019|03/01/2022|Yes|No|10/23/2019|03/01/2022|Yes|No||||No|No|||Prescription required|No||059|Yes|.08846|03/29/2022|.08633|03/29/2022|.08691|03/29/2022|||NSAIDS|10682|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||PERRIGO/PADAGIS|No||||
alogliptin benz/metformin HCl|No|No|No|No|75%|45802016972|ALOGLIPTIN-METFORMIN 12.5-500|60|EA|1.3975|08/24/2016||Yes|No||08/24/2016||Yes|No|08/24/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|2.34711|03/29/2022|2.29077|03/29/2022|2.30603|03/29/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|10683|||||No|No||PERRIGO/PADAGIS|No||||
acetaminophen|No|No|No|No|75%|45802020126|CHLD ACETAMINOPHEN 160 MG/5 ML|118|ML|.00878|01/11/2022||Yes|No||||No|No|01/11/2022||Yes|No||||No|No|||Over the counter|No|||No|.0211|03/29/2022|.02059|03/29/2022|.02073|03/29/2022||||10684|||||No|No||PERRIGO/PADAGIS|No||||
nicotine polacrilex|No|No|No|No|75%|45802020625|NICOTINE 2 MG CHEWING GUM|110|EA|.09045|07/29/2019||Yes|No||||No|No|07/29/2019||Yes|No||||No|No|||Over the counter|No||040|No|.22992|03/29/2022|.2244|03/29/2022|.22589|03/29/2022|||SMOKING CESSATION|10685|||||No|No||PERRIGO CO.|No||||
nitroglycerin|No|No|No|No|75%|45802021001|NITROGLYCERIN 400 MCG SPRAY|4.9|GM|16.41546|09/30/2013||Yes|No||09/30/2013||Yes|No|09/30/2013||Yes|No||||No|No|||Prescription required|No|||No|23.80705|03/29/2022|23.23568|03/29/2022|23.39042|03/29/2022||||10686|||||No|No||PERRIGO CO.|No||||
nitroglycerin|No|No|No|No|75%|45802021002|NITROGLYCERIN 400 MCG SPRAY|12|GM|10.00825|09/30/2013||Yes|No||09/30/2013||Yes|No|09/30/2013||Yes|No||||No|No|||Prescription required|No|||No|15.54|03/29/2022|15.16704|03/29/2022|15.26805|03/29/2022||||10687|||||No|No||PERRIGO CO.|No||||
alogliptin benz/metformin HCl|No|No|No|No|75%|45802021172|ALOGLIPTIN-METFORMIN 12.5-1000|60|EA|1.3975|08/24/2016||Yes|No||08/24/2016||Yes|No|08/24/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|2.67667|03/29/2022|2.61242|03/29/2022|2.62982|03/29/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|10688|||||No|No||PERRIGO/PADAGIS|No||||
benzoyl peroxide|No|No|No|No|75%|45802021601|BENZOYL PEROXIDE 5% GEL|90|GM|.07749|03/16/2012||Yes|No||||No|No|03/16/2012||Yes|No||||No|No|||Over the counter|No|||No|.17661|10/29/2019|.17409|10/29/2019|.1658|10/29/2019||||10689|||||No|No||PERRIGO CO.|No||||
benzoyl peroxide|No|No|No|No|75%|45802021696|BENZOYL PEROXIDE 5% GEL|60|GM|.09868|03/16/2012||Yes|No||||No|No|03/16/2012||Yes|No||||No|No|||Over the counter|No|||No|.22386|03/01/2022|.21848|03/01/2022|.21994|03/01/2022||||10690|||||No|No||PERRIGO CO.|No||||
fluticasone propionate|No|No|No|No|75%|45802022111|FLUTICASONE PROP 0.005% OINT|30|GM|.31891|05/19/2004||Yes|No||05/19/2004||Yes|No|05/19/2004||Yes|No||||No|No|||Prescription required|No||119|No|.41904|03/29/2022|.40898|03/29/2022|.4117|03/29/2022|||STEROIDS: TOPICAL MEDIUM|10691|||||No|No||PERRIGO/PADAGIS|No||||
fluticasone propionate|No|No|No|No|75%|45802022135|FLUTICASONE PROP 0.005% OINT|15|GM|.41423|05/19/2004||Yes|No||05/19/2004||Yes|No|05/19/2004||Yes|No||||No|No|||Prescription required|No||119|No|.59685|03/29/2022|.58252|03/29/2022|.5864|03/29/2022|||STEROIDS: TOPICAL MEDIUM|10692|||||No|No||PERRIGO/PADAGIS|No||||
fluticasone propionate|No|No|No|No|75%|45802022137|FLUTICASONE PROP 0.005% OINT|60|GM|.2519|05/19/2004||Yes|No||05/19/2004||Yes|No|05/19/2004||Yes|No||||No|No|||Prescription required|No||119|No|.49215|03/29/2022|.48033|03/29/2022|.48353|03/29/2022|||STEROIDS: TOPICAL MEDIUM|10693|||||No|No||PERRIGO/PADAGIS|No||||
fluticasone propionate|No|No|No|No|75%|45802022211|FLUTICASONE PROP 0.05% CREAM|30|GM|.31891|05/19/2004||Yes|No||05/19/2004||Yes|No|05/19/2004||Yes|No||||No|No|||Prescription required|No||119|No|.3165|03/29/2022|.3089|03/29/2022|.31096|03/29/2022|||STEROIDS: TOPICAL MEDIUM|10694|||||No|No||PERRIGO/PADAGIS|No||||
fluticasone propionate|No|No|No|No|75%|45802022235|FLUTICASONE PROP 0.05% CREAM|15|GM|.41423|05/19/2004||Yes|No||05/19/2004||Yes|No|05/19/2004||Yes|No||||No|No|||Prescription required|No||119|No|.30287|03/29/2022|.2956|03/29/2022|.29756|03/29/2022|||STEROIDS: TOPICAL MEDIUM|10695|||||No|No||PERRIGO/PADAGIS|No||||
fluticasone propionate|No|No|No|No|75%|45802022237|FLUTICASONE PROP 0.05% CREAM|60|GM|.2519|05/19/2004||Yes|No||05/19/2004||Yes|No|05/19/2004||Yes|No||||No|No|||Prescription required|No||119|No|.23471|03/29/2022|.22907|03/29/2022|.2306|03/29/2022|||STEROIDS: TOPICAL MEDIUM|10696|||||No|No||PERRIGO/PADAGIS|No||||
guaifenesin/pseudoephedrne HCl|No|No|No|No|75%|45802023068|GUAIFENESIN-PSE ER 600-60 MG|36|EA|.1972|02/01/2016|02/28/2022|Yes|No||||No|No|02/01/2016|02/28/2022|Yes|No||||No|No|||Over the counter|No||182|Yes|.44943|03/15/2022|.44301|03/15/2022|.42192|03/15/2022|||COUGH AND COLD: COLD|10697|No Longer Rebatable||No Longer Rebatable||No|No||PERRIGO/PADAGIS|No||||
guaifenesin/pseudoephedrne HCl|No|No|No|No|75%|45802023089|GUAIFENESIN-PSE ER 600-60 MG|18|EA|.20735|02/01/2016|02/28/2022|Yes|No||||No|No|02/01/2016|02/28/2022|Yes|No||||No|No|||Over the counter|No||182|Yes|.47257|03/15/2022|.46582|03/15/2022|.44364|03/15/2022|||COUGH AND COLD: COLD|10698|No Longer Rebatable||No Longer Rebatable||No|No||PERRIGO/PADAGIS|No||||
alogliptin benz/pioglitazone|No|No|No|No|75%|45802023865|ALOGLIPTIN-PIOGLIT 12.5-15 MG|30|EA|2.795|08/24/2016|08/01/2022|Yes|No||08/24/2016|08/01/2022|Yes|No|08/24/2016|08/01/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|6.37|08/24/2016|6.279|08/24/2016|5.98|08/24/2016|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|10699|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||PERRIGO CO.|No||||
nystatin/triamcin|No|No|No|No|75%|45802024414|NYSTATIN-TRIAMCINOLONE OINTM|15|GM|.4472|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|Yes|11/03/2017|061|No|.4296|03/29/2022|.41928|03/29/2022|.42208|03/29/2022|||ANTIFUNGALS: TOPICAL|10700|||||No|No||PERRIGO CO.|No||||
nystatin/triamcin|No|No|No|No|75%|45802024494|NYSTATIN-TRIAMCINOLONE OINTM|30|GM|.35131|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|Yes|11/03/2017|061|No|.33412|03/29/2022|.3261|03/29/2022|.32827|03/29/2022|||ANTIFUNGALS: TOPICAL|10701|||||No|No||PERRIGO CO.|No||||
nystatin/triamcin|No|No|No|No|75%|45802024496|NYSTATIN-TRIAMCINOLONE OINTM|60|GM|.28745|03/09/2018||Yes|No||03/09/2018||Yes|No|03/09/2018||Yes|No||||No|No|||Prescription required|Yes|11/03/2017|061|No|.24511|03/29/2022|.23922|03/29/2022|.24082|03/29/2022|||ANTIFUNGALS: TOPICAL|10702|||||No|No||PERRIGO CO.|No||||
lansoprazole|No|No|No|No|75%|45802024501|LANSOPRAZOLE DR 15 MG CAPSULE|14|EA|.2666|08/24/2012||Yes|No||||No|No|08/24/2012||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.43525|03/29/2022|.4248|03/29/2022|.42763|03/29/2022|||PROTON PUMP INHIBITORS|10703|||||No|No||PERRIGO CO.|No||||
lansoprazole|No|No|No|No|75%|45802024502|LANSOPRAZOLE DR 15 MG CAPSULE|28|EA|.23588|08/24/2012||Yes|No||||No|No|08/24/2012||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.43525|03/29/2022|.4248|03/29/2022|.42763|03/29/2022|||PROTON PUMP INHIBITORS|10704|||||No|No||PERRIGO CO.|No||||
lansoprazole|No|No|No|No|75%|45802024503|LANSOPRAZOLE DR 15 MG CAPSULE|42|EA|.21346|08/24/2012||Yes|No||||No|No|08/24/2012||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.43525|03/29/2022|.4248|03/29/2022|.42763|03/29/2022|||PROTON PUMP INHIBITORS|10705|||||No|No||PERRIGO CO.|No||||
mometasone furoate|No|No|No|No|75%|45802025735|MOMETASONE FUROATE 0.1% CREAM|15|GM|.50166|08/25/2019||Yes|No||08/25/2019||Yes|No|08/25/2019||Yes|No||||No|No|||Prescription required|No||119|No|.51132|03/29/2022|.49904|03/29/2022|.50237|03/29/2022|||STEROIDS: TOPICAL MEDIUM|10706|||||No|No||PERRIGO CO.|No||||
mometasone furoate|No|No|No|No|75%|45802025742|MOMETASONE FUROATE 0.1% CREAM|45|GM|.28666|08/25/2019||Yes|No||08/25/2019||Yes|No|08/25/2019||Yes|No||||No|No|||Prescription required|No||119|No|.32851|03/29/2022|.32062|03/29/2022|.32276|03/29/2022|||STEROIDS: TOPICAL MEDIUM|10707|||||No|No||PERRIGO CO.|No||||
alogliptin benz/pioglitazone|No|No|No|No|75%|45802026065|ALOGLIPTIN-PIOGLIT 12.5-30 MG|30|EA|2.795|08/24/2016||Yes|No||08/24/2016||Yes|No|08/24/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|6.37|08/24/2016|6.279|08/24/2016|5.98|08/24/2016|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|10708|||||No|No||PERRIGO/PADAGIS|No||||
clindamycin phosphate|No|No|No|No|75%|45802026337|CLINDAMYCIN PHOS 1% PLEDGET|60|EA|.18668|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||104|No|.30876|03/29/2022|.30134|03/29/2022|.30335|03/29/2022|||ACNE AGENTS: TOPICAL|10709|||||No|No||PERRIGO CO.|No||||
permethrin|No|No|No|No|75%|45802026937|PERMETHRIN 5% CREAM|60|GM|.7095|06/06/2003||Yes|No||06/06/2003||Yes|No|06/06/2003||Yes|No||||No|No|||Prescription required|No||122|No|.34397|03/29/2022|.33571|03/29/2022|.33795|03/29/2022|||ANTIPARASITICS: TOPICAL|10710|||||No|No||PERRIGO/PADAGIS|No||||
benzoyl peroxide|No|No|No|No|75%|45802028001|BENZOYL PEROXIDE 5% WASH|142|GM|.02264|09/20/2019||Yes|No||||No|No|09/20/2019||Yes|No||||No|No|||Over the counter|No||104|No|.05168|03/29/2022|.05043|03/29/2022|.05077|03/29/2022|||ACNE AGENTS: TOPICAL|10711|||||No|No||PERRIGO CO.|No||||
benzoyl peroxide|No|No|No|No|75%|45802028034|BENZOYL PEROXIDE 5% WASH|227|GM|.02128|09/20/2019||Yes|No||||No|No|09/20/2019||Yes|No||||No|No|||Over the counter|No||104|No|.04079|03/29/2022|.03981|03/29/2022|.04007|03/29/2022|||ACNE AGENTS: TOPICAL|10712|||||No|No||PERRIGO CO.|No||||
testosterone|No|No|No|No|90%|45802028139|TESTOSTERONE 1.62%(1.25 G) PKT|1.25|GM|3.85245|09/30/2019||Yes|No||09/30/2019||Yes|No|09/30/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|084|No|6.91737|03/29/2022|6.75135|03/29/2022|6.79631|03/29/2022|||ANDROGENIC AGENTS|10713|||||No|No||PERRIGO/PADAGIS|No||||
alogliptin benz/pioglitazone|No|No|No|No|75%|45802030465|ALOGLIPTIN-PIOGLIT 12.5-45 MG|30|EA|2.795|08/24/2016|08/01/2022|Yes|No||08/24/2016|08/01/2022|Yes|No|08/24/2016|08/01/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|6.37|08/24/2016|6.279|08/24/2016|5.98|08/24/2016|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|10714|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||PERRIGO CO.|No||||
benzoyl peroxide|No|No|No|No|75%|45802030801|BENZOYL PEROXIDE 10% GEL|90|GM|.08121|03/16/2012||Yes|No||||No|No|03/16/2012||Yes|No||||No|No|||Over the counter|No|||No|.15126|06/29/2021|.14762|06/29/2021|.14861|06/29/2021||||10715|||||No|No||PERRIGO CO.|No||||
benzoyl peroxide|No|No|No|No|75%|45802030896|BENZOYL PEROXIDE 10% GEL|60|GM|.10111|03/16/2012||Yes|No||||No|No|03/16/2012||Yes|No||||No|No|||Over the counter|No|||No|.2248|11/23/2021|.2194|11/23/2021|.22086|11/23/2021||||10716|||||No|No||PERRIGO CO.|No||||
benzoyl peroxide|No|No|No|No|75%|45802031801|BENZOYL PEROXIDE 10% WASH|142|GM|.02346|09/20/2019||Yes|No||||No|No|09/20/2019||Yes|No||||No|No|||Over the counter|No||104|No|.05107|03/29/2022|.04984|03/29/2022|.05017|03/29/2022|||ACNE AGENTS: TOPICAL|10717|||||No|No||PERRIGO CO.|No||||
benzoyl peroxide|No|No|No|No|75%|45802031834|BENZOYL PEROXIDE 10% WASH|227|GM|.02235|09/20/2019||Yes|No||||No|No|09/20/2019||Yes|No||||No|No|||Over the counter|No||104|No|.0472|03/29/2022|.04606|03/29/2022|.04637|03/29/2022|||ACNE AGENTS: TOPICAL|10718|||||No|No||PERRIGO CO.|No||||
nicotine polacrilex|No|No|No|No|75%|45802034405|NICOTINE 2 MG LOZENGE|72|EA|.16931|03/31/2014||Yes|No||||No|No|03/31/2014||Yes|No||||No|No|||Over the counter|No||040|No|.32832|03/29/2022|.32044|03/29/2022|.32257|03/29/2022|||SMOKING CESSATION|10719|||||No|No||PERRIGO CO.|No||||
alogliptin benz/pioglitazone|No|No|No|No|75%|45802035165|ALOGLIPTIN-PIOGLIT 25-15 MG TB|30|EA|2.795|08/24/2016||Yes|No||08/24/2016||Yes|No|08/24/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|6.37|12/26/2017|6.279|12/26/2017|5.98|12/26/2017|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|10720|||||No|No||PERRIGO/PADAGIS|No||||
testosterone|No|No|No|No|90%|45802036665|TESTOSTERONE 1.62% (2.5 G) PKT|2.5|GM|2.08079|09/30/2019||Yes|No||09/30/2019||Yes|No|09/30/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|084|No|2.67717|03/29/2022|2.61291|03/29/2022|2.63031|03/29/2022|||ANDROGENIC AGENTS|10721|||||No|No||PERRIGO/PADAGIS|No||||
imiquimod|No|No|No|No|75%|45802036853|IMIQUIMOD 5% CREAM PACKET|12|EA|6.32816|07/24/2012||Yes|No||07/24/2012||Yes|No|07/24/2012||Yes|No||||No|No|||Prescription required|No|||Yes|14.42232|11/24/2020|14.21629|11/24/2020|13.53932|11/24/2020||||10722|||||No|No||PERRIGO CO.|No||||
imiquimod|No|No|No|No|75%|45802036862|IMIQUIMOD 5% CREAM PACKET|24|EA|.89583|11/30/2010||Yes|No||11/30/2010||Yes|No|11/30/2010||Yes|No||||No|No|||Prescription required|No|||Yes|1.00328|03/29/2022|.9792|03/29/2022|.98572|03/29/2022||||10723|||||No|No||PERRIGO/PADAGIS|No||||
betamethasone/propylene glyc|No|No|No|No|75%|45802037632|BETAMETHASONE DP AUG 0.05% CRM|50|GM|.07421|01/09/2004||Yes|No||01/09/2004||Yes|No|01/09/2004||Yes|No||||No|No|||Prescription required|No||120|No|.14968|03/29/2022|.14608|03/29/2022|.14706|03/29/2022|||STEROIDS: TOPICAL HIGH|10724|||||No|No||PERRIGO/PADAGIS|No||||
betamethasone/propylene glyc|No|No|No|No|75%|45802037635|BETAMETHASONE DP AUG 0.05% CRM|15|GM|.11065|01/09/2004||Yes|No||01/09/2004||Yes|No|01/09/2004||Yes|No||||No|No|||Prescription required|No||120|No|.24003|03/29/2022|.23426|03/29/2022|.23582|03/29/2022|||STEROIDS: TOPICAL HIGH|10725|||||No|No||PERRIGO/PADAGIS|No||||
tacrolimus|No|No|No|No|75%|45802039000|TACROLIMUS 0.03% OINTMENT|30|GM|1.00333|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|034|Yes|2.05819|03/29/2022|2.00879|03/29/2022|2.02217|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|10726|||||No|No||PERRIGO/PADAGIS|No||||
tacrolimus|No|No|No|No|75%|45802039001|TACROLIMUS 0.03% OINTMENT|60|GM|1.0034|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|034|Yes|1.50147|03/01/2022|1.46543|03/01/2022|1.47519|03/01/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|10727|||||No|No||PERRIGO/PADAGIS|No||||
tacrolimus|No|No|No|No|75%|45802039002|TACROLIMUS 0.03% OINTMENT|100|GM|1.00336|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|034|Yes|1.71892|03/01/2022|1.67766|03/01/2022|1.68883|03/01/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|10728|||||No|No||PERRIGO/PADAGIS|No||||
vits A and D/white pet/lanolin|No|No|No|No|75%|45802039504|VITAMIN A AND D OINTMENT|113|GM|.01023|08/05/2019|01/31/2023|Yes|No||||No|No|08/05/2019|01/31/2023|Yes|No||||No|No|||Over the counter|No|||No|.02313|11/23/2021|.02257|11/23/2021|.02272|11/23/2021||||10729|No Longer Rebatable||No Longer Rebatable||No|No||PERRIGO CO.|No||||
butoconazole nitrate|No|No|No|No|75%|45802039601|GYNAZOLE 1 2% CREAM|5|GM|9.31122|01/11/2016||Yes|No||01/11/2016||Yes|No|01/11/2016||Yes|No||||No|No|||Prescription required|No|||No|21.0784|07/27/2021|20.57251|07/27/2021|20.70952|07/27/2021||||10730|||||No|No||PERRIGO/PADAGIS|No||||
ciclopirox olamine|No|No|No|No|75%|45802040046|CICLOPIROX 0.77% TOPICAL SUSP|60|ML|.645|12/28/2006||Yes|No||12/28/2006||Yes|No|12/28/2006||Yes|No||||No|No|||Prescription required|Yes|07/18/2006|061|No|.96027|03/29/2022|.93722|03/29/2022|.94346|03/29/2022|||ANTIFUNGALS: TOPICAL|10731|||||No|No||PERRIGO/PADAGIS|No||||
ciclopirox olamine|No|No|No|No|75%|45802040049|CICLOPIROX 0.77% TOPICAL SUSP|30|ML|.86|12/28/2006||Yes|No||12/28/2006||Yes|No|12/28/2006||Yes|No||||No|No|||Prescription required|Yes|07/18/2006|061|No|.81226|03/29/2022|.79276|03/29/2022|.79804|03/29/2022|||ANTIFUNGALS: TOPICAL|10732|||||No|No||PERRIGO/PADAGIS|No||||
ciclopirox|No|No|No|No|75%|45802040109|CICLOPIROX 1% SHAMPOO|120|ML|.2795|02/26/2010||Yes|No||02/26/2010||Yes|No|02/26/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|061|No|.28181|03/29/2022|.27504|03/29/2022|.27687|03/29/2022|||ANTIFUNGALS: TOPICAL|10733|||||No|No||PERRIGO/PADAGIS|No||||
alogliptin benz/pioglitazone|No|No|No|No|75%|45802040265|ALOGLIPTIN-PIOGLIT 25-30 MG TB|30|EA|2.795|08/24/2016||Yes|No||08/24/2016||Yes|No|08/24/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|6.37|09/25/2018|6.279|09/25/2018|5.98|09/25/2018|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|10734|||||No|No||PERRIGO/PADAGIS|No||||
oxymetazoline HCl|No|No|No|No|75%|45802041059|NASAL SPRAY 0.05%|30|ML|.0301|08/02/2019||Yes|No||||No|No|08/02/2019||Yes|No||||No|No|||Over the counter|No||182|Yes|.07205|03/29/2022|.07032|03/29/2022|.07078|03/29/2022|||COUGH AND COLD: COLD|10735|||||No|No||PERRIGO/PADAGIS|No||||
ammonium lactate|No|No|No|No|75%|45802041926|AMMONIUM LACTATE 12% LOTION|400|GM|.03466|10/15/2004||Yes|No||10/15/2004||Yes|No|10/15/2004||Yes|No||||No|No|||Prescription required|No|||No|.06856|03/29/2022|.06691|03/29/2022|.06736|03/29/2022||||10736|||||No|No||PERRIGO/PADAGIS|No||||
ammonium lactate|No|No|No|No|75%|45802041954|AMMONIUM LACTATE 12% LOTION|225|GM|.0385|10/15/2004||Yes|No||10/15/2004||Yes|No|10/15/2004||Yes|No||||No|No|||Prescription required|No|||No|.07608|03/29/2022|.07425|03/29/2022|.07474|03/29/2022||||10737|||||No|No||PERRIGO/PADAGIS|No||||
desonide|No|No|No|No|75%|45802042235|DESONIDE 0.05% CREAM|15|GM|.516|10/05/2013||Yes|No||10/05/2013||Yes|No|10/05/2013||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|118|No|.68707|03/29/2022|.67058|03/29/2022|.67504|03/29/2022|||STEROIDS: TOPICAL LOW|10738|||||No|No||PERRIGO/PADAGIS|No||||
desonide|No|No|No|No|75%|45802042237|DESONIDE 0.05% CREAM|60|GM|.516|10/05/2013|05/31/2023|Yes|No||10/05/2013|05/31/2023|Yes|No|10/05/2013|05/31/2023|Yes|No||||No|No|||Prescription required|Yes|01/15/2014|118|No|.61157|03/29/2022|.59689|03/29/2022|.60086|03/29/2022|||STEROIDS: TOPICAL LOW|10739|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||PERRIGO CO.|No||||
desonide|No|No|No|No|75%|45802042335|DESONIDE 0.05% OINTMENT|15|GM|.55441|10/05/2013||Yes|No||10/05/2013||Yes|No|10/05/2013||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|118|No|.83836|03/29/2022|.81823|03/29/2022|.82368|03/29/2022|||STEROIDS: TOPICAL LOW|10740|||||No|No||PERRIGO/PADAGIS|No||||
desonide|No|No|No|No|75%|45802042337|DESONIDE 0.05% OINTMENT|60|GM|.55455|10/05/2013||Yes|No||10/05/2013||Yes|No|10/05/2013||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|118|No|.63751|03/29/2022|.6222|03/29/2022|.62635|03/29/2022|||STEROIDS: TOPICAL LOW|10741|||||No|No||PERRIGO/PADAGIS|No||||
fexofenadine HCl|No|No|No|No|75%|45802042578|FEXOFENADINE HCL 60 MG TABLET|100|EA|.24742|08/16/2011|07/31/2022|Yes|No||||No|No|08/16/2011|07/31/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.15058|03/29/2022|.14696|03/29/2022|.14794|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10742|No Longer Rebatable||No Longer Rebatable||No|No||PERRIGO CO.|No||||
pseudoephedrine HCl|No|No|No|No|75%|45802043262|PSEUDOEPHEDRINE 30 MG TABLET|24|EA|.03511|06/05/2009||Yes|No||||No|No|06/05/2009||Yes|No||||No|No|||Over the counter|No|||No|.05204|03/29/2022|.05079|03/29/2022|.05112|03/29/2022||||10743|||||No|No||PERRIGO/PADAGIS|No||||
dextromethorphan polistirex|No|No|No|No|75%|45802043321|DEXTROMETHORPHAN ER 30 MG/5 ML|89|ML|.02956|12/21/2012||Yes|No||||No|No|12/21/2012||Yes|No||||No|No|||Over the counter|No||184|Yes|.05873|03/29/2022|.05732|03/29/2022|.0577|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|10744|||||No|No||PERRIGO/PADAGIS|No||||
clotrimazole|No|No|No|No|75%|45802043401|CLOTRIMAZOLE 1% TOPICAL CREAM|15|GM|.0903|04/21/2009||Yes|No||||No|No|04/21/2009||Yes|No||||No|No|||Over the counter|No||061|No|.16589|03/29/2022|.1619|03/29/2022|.16298|03/29/2022|||ANTIFUNGALS: TOPICAL|10745|||||No|No||PERRIGO/PADAGIS|No||||
clotrimazole|No|No|No|No|75%|45802043411|CLOTRIMAZOLE 1% TOPICAL CREAM|30|GM|.06521|10/23/2007||Yes|No||||No|No|10/23/2007||Yes|No||||No|No|||Over the counter|No||061|No|.10455|03/29/2022|.10204|03/29/2022|.10272|03/29/2022|||ANTIFUNGALS: TOPICAL|10746|||||No|No||PERRIGO CO.|No||||
clobetasol propionate|No|No|No|No|75%|45802043732|CLOBETASOL PROP 0.05% FOAM|50|GM|1.49253|04/01/2008||Yes|No||04/01/2008||Yes|No|04/01/2008||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|121|No|.53203|03/29/2022|.51926|03/29/2022|.52271|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|10747|||||No|No||PERRIGO CO.|No||||
clobetasol propionate|No|No|No|No|75%|45802043733|CLOBETASOL PROP 0.05% FOAM|100|GM|.88687|04/01/2008||Yes|No||04/01/2008||Yes|No|04/01/2008||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|121|No|.7435|03/29/2022|.72565|03/29/2022|.73048|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|10748|||||No|No||PERRIGO CO.|No||||
fluticasone propionate|No|No|No|No|75%|45802044102|FLUTICASONE PROP 0.05% LOTION|60|ML|2.3283|08/09/2013||Yes|No||08/09/2013||Yes|No|08/09/2013||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|119|No|3.1409|08/24/2021|3.06551|08/24/2021|3.08593|08/24/2021|||STEROIDS: TOPICAL MEDIUM|10749|||||No|No||PERRIGO/PADAGIS|No||||
adapalene|No|No|No|No|75%|45802045384|ADAPALENE 0.1% CREAM|45|GM|2.15936|11/02/2010||Yes|No||11/02/2010||Yes|No|11/02/2010||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|3.17233|03/29/2022|3.09619|03/29/2022|3.11681|03/29/2022|||ACNE AGENTS: TOPICAL|10750|||||No|No||PERRIGO/PADAGIS|No||||
hydrocortisone valerate|No|No|No|No|75%|45802045535|HYDROCORTISONE VAL 0.2% CREAM|15|GM|1.02684|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|119|No|.67989|03/29/2022|.66357|03/29/2022|.66799|03/29/2022|||STEROIDS: TOPICAL MEDIUM|10751|||||No|No||PERRIGO/PADAGIS|No||||
hydrocortisone valerate|No|No|No|No|75%|45802045537|HYDROCORTISONE VAL 0.2% CREAM|60|GM|.62242|06/03/2004||Yes|No||06/03/2004||Yes|No|06/03/2004||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|119|No|.61899|03/01/2022|.60413|03/01/2022|.60815|03/01/2022|||STEROIDS: TOPICAL MEDIUM|10752|||||No|No||PERRIGO/PADAGIS|No||||
hydrocortisone valerate|No|No|No|No|75%|45802045542|HYDROCORTISONE VAL 0.2% CREAM|45|GM|.6899|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|119|No|.56991|03/29/2022|.55623|03/29/2022|.55993|03/29/2022|||STEROIDS: TOPICAL MEDIUM|10753|||||No|No||PERRIGO/PADAGIS|No||||
ketoconazole|No|No|No|No|75%|45802046564|KETOCONAZOLE 2% SHAMPOO|120|ML|.07908|08/03/2006||Yes|No||08/03/2006||Yes|No|||No|No||||No|No|||Prescription required|No||061|No|.09082|03/29/2022|.08864|03/29/2022|.08923|03/29/2022|||ANTIFUNGALS: TOPICAL|10754|||||No|No||PERRIGO CO.|No||||
econazole nitrate|No|No|No|No|75%|45802046611|ECONAZOLE NITRATE 1% CREAM|30|GM|.71752|07/28/2004||Yes|No||07/28/2004||Yes|No|||No|No||||No|No|||Prescription required|Yes|01/20/2011|061|No|.37785|03/29/2022|.36878|03/29/2022|.37123|03/29/2022|||ANTIFUNGALS: TOPICAL|10755|||||No|No||PERRIGO/PADAGIS|No||||
econazole nitrate|No|No|No|No|75%|45802046635|ECONAZOLE NITRATE 1% CREAM|15|GM|.71752|07/28/2004||Yes|No||07/28/2004||Yes|No|||No|No||||No|No|||Prescription required|Yes|01/20/2011|061|No|.43362|03/29/2022|.42321|03/29/2022|.42603|03/29/2022|||ANTIFUNGALS: TOPICAL|10756|||||No|No||PERRIGO/PADAGIS|No||||
econazole nitrate|No|No|No|No|75%|45802046653|ECONAZOLE NITRATE 1% CREAM|85|GM|.50608|07/28/2004||Yes|No||07/28/2004||Yes|No|||No|No||||No|No|||Prescription required|Yes|01/20/2011|061|No|.19681|03/29/2022|.19208|03/29/2022|.19336|03/29/2022|||ANTIFUNGALS: TOPICAL|10757|||||No|No||PERRIGO/PADAGIS|No||||
fluocinolone/shower cap|No|No|No|No|75%|45802048526|FLUOCINOLONE 0.01% SCALP OIL|118.28|ML|.33591|09/26/2017||Yes|No||09/26/2017||Yes|No|09/26/2017||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|118|No|.27456|03/29/2022|.26797|03/29/2022|.26975|03/29/2022|||STEROIDS: TOPICAL LOW|10758|||||No|No||PERRIGO/PADAGIS|No||||
naproxen sodium|No|No|No|No|75%|45802049078|NAPROXEN SODIUM 220 MG TABLET|100|EA|.0239|08/02/2019||Yes|No||||No|No|08/02/2019||Yes|No||||No|No|||Over the counter|No||059|Yes|.0581|03/29/2022|.0567|03/29/2022|.05708|03/29/2022|||NSAIDS|10759|||||No|No||PERRIGO CO.|No||||
ammonium lactate|No|No|No|No|75%|45802049326|AMMONIUM LACTATE 12% CREAM|385|GM|.04118|01/23/2008||Yes|No||01/23/2008||Yes|No|01/23/2008||Yes|No||||No|No|||Prescription required|No|||No|.07039|03/29/2022|.0687|03/29/2022|.06915|03/29/2022||||10760|||||No|No||PERRIGO/PADAGIS|No||||
ammonium lactate|No|No|No|No|75%|45802049383|AMMONIUM LACTATE 12% CREAM|140|GM|.04328|07/24/2002||Yes|No||07/24/2002||Yes|No|07/24/2002||Yes|No||||No|No|||Prescription required|No|||No|.06126|03/29/2022|.05978|03/29/2022|.06018|03/29/2022||||10761|||||No|No||PERRIGO/PADAGIS|No||||
desoximetasone|No|No|No|No|75%|45802049535|DESOXIMETASONE 0.25% CREAM|15|GM|1.17705|05/29/2009||Yes|No||05/29/2009||Yes|No|05/29/2009||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|120|No|.62238|03/29/2022|.60744|03/29/2022|.61148|03/29/2022|||STEROIDS: TOPICAL HIGH|10762|||||No|No||PERRIGO/PADAGIS|No||||
desoximetasone|No|No|No|No|75%|45802049537|DESOXIMETASONE 0.25% CREAM|60|GM|.99473|05/29/2009||Yes|No||05/29/2009||Yes|No|05/29/2009||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|120|No|.41664|03/29/2022|.40664|03/29/2022|.40934|03/29/2022|||STEROIDS: TOPICAL HIGH|10763|||||No|No||PERRIGO/PADAGIS|No||||
desoximetasone|No|No|No|No|75%|45802049614|DESOXIMETASONE 0.25% OINTMENT|15|GM|.43|06/26/2020||Yes|No||06/26/2020||Yes|No|06/26/2020||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|120|No|.658|03/29/2022|.6422|03/29/2022|.64648|03/29/2022|||STEROIDS: TOPICAL HIGH|10764|||||No|No||PERRIGO/PADAGIS|No||||
desoximetasone|No|No|No|No|75%|45802049696|DESOXIMETASONE 0.25% OINTMENT|60|GM|.35696|04/29/2015||Yes|No||04/29/2015||Yes|No|04/29/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|120|No|.39246|03/29/2022|.38304|03/29/2022|.38559|03/29/2022|||STEROIDS: TOPICAL HIGH|10765|||||No|No||PERRIGO/PADAGIS|No||||
alogliptin benz/pioglitazone|No|No|No|No|75%|45802049965|ALOGLIPTIN-PIOGLIT 25-45 MG TB|30|EA|2.795|08/24/2016||Yes|No||08/24/2016||Yes|No|08/24/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|6.37|08/24/2016|6.279|08/24/2016|5.98|08/24/2016|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|10766|||||No|No||PERRIGO/PADAGIS|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|45802050702|CLINDAMYCIN-BENZOYL PEROX 1-5%|50|GM|1.29|09/25/2015||Yes|No||09/25/2015||Yes|No|09/25/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|.80914|03/29/2022|.78972|03/29/2022|.79498|03/29/2022|||ACNE AGENTS: TOPICAL|10767|||||No|No||PERRIGO CO.|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|45802050703|CLINDAMYCIN-BNZ PEROX 1-5% PMP|35|GM|1.10571|08/23/2016|04/01/2022|Yes|No||08/23/2016|04/01/2022|Yes|No|08/23/2016|04/01/2022|Yes|No||||No|No|||Prescription required|Yes|07/23/2015|104|No|1.74776|03/01/2022|1.70581|03/01/2022|1.71717|03/01/2022|||ACNE AGENTS: TOPICAL|10768|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||PERRIGO CO.|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|45802050704|CLINDAMYCIN-BNZ PEROX 1-5% PMP|50|GM|1.118|08/23/2016||Yes|No||08/23/2016||Yes|No|08/23/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|104|No|1.67707|03/29/2022|1.63682|03/29/2022|1.64772|03/29/2022|||ACNE AGENTS: TOPICAL|10769|||||No|No||PERRIGO/PADAGIS|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|45802050901|CLINDAMYCIN-BENZOYL PEROX 1-5%|25|GM|1.29|06/15/2021||Yes|No||06/15/2021||Yes|No|06/15/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|104|No|.996|03/29/2022|.97209|03/29/2022|.97857|03/29/2022|||ACNE AGENTS: TOPICAL|10770|||||No|No||PERRIGO/PADAGIS|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|45802051003|CLINDAMYCIN-BNZ PEROX 1-5% PMP|35|GM|1.10571|06/15/2021||Yes|No||06/15/2021||Yes|No|06/15/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|104|No|1.74776|03/01/2022|1.70581|03/01/2022|1.71717|03/01/2022|||ACNE AGENTS: TOPICAL|10771|||||No|No||PERRIGO/PADAGIS|No||||
ketoconazole|No|No|No|No|75%|45802053232|KETOCONAZOLE 2% FOAM|50|GM|5.07658|10/11/2016||Yes|No||10/11/2016||Yes|No|10/11/2016||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|061|No|11.56988|06/01/2016|11.40459|06/01/2016|10.86152|06/01/2016|||ANTIFUNGALS: TOPICAL|10772|||||No|No||PERRIGO CO.|No||||
ketoconazole|No|No|No|No|75%|45802053233|KETOCONAZOLE 2% FOAM|100|GM|2.97052|09/06/2011||Yes|No||09/06/2011||Yes|No|09/06/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|061|No|6.77003|06/01/2016|6.67332|06/01/2016|6.35554|06/01/2016|||ANTIFUNGALS: TOPICAL|10773|||||No|No||PERRIGO CO.|No||||
clindamycin phosphate|No|No|No|No|75%|45802056201|CLINDAMYCIN PH 1% SOLUTION|30|ML|.34572|09/23/2013||Yes|No||09/23/2013||Yes|No|09/23/2013||Yes|No||||No|No|||Prescription required|No||104|No|.23242|03/29/2022|.22684|03/29/2022|.22835|03/29/2022|||ACNE AGENTS: TOPICAL|10774|||||No|No||PERRIGO CO.|No||||
clindamycin phosphate|No|No|No|No|75%|45802056202|CLINDAMYCIN PH 1% SOLUTION|60|ML|.34572|09/23/2013||Yes|No||09/23/2013||Yes|No|09/23/2013||Yes|No||||No|No|||Prescription required|No||104|No|.19863|03/29/2022|.19386|03/29/2022|.19515|03/29/2022|||ACNE AGENTS: TOPICAL|10775|||||No|No||PERRIGO CO.|No||||
fexofenadine HCl|No|No|No|No|75%|45802057178|FEXOFENADINE HCL 180 MG TABLET|100|EA|.14387|04/25/2011|10/31/2022|Yes|No||||No|No|04/25/2011|10/31/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.28782|03/29/2022|.28091|03/29/2022|.28278|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10776|No Longer Rebatable||No Longer Rebatable||No|No||PERRIGO CO.|No||||
scopolamine|No|No|No|No|75%|45802058046|SCOPOLAMINE 1 MG/3 DAY PATCH|10|EA|8.24138|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|085|No|11.10069|03/29/2022|10.83427|03/29/2022|10.90642|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|10777|||||No|No||PERRIGO/PADAGIS|No||||
scopolamine|No|No|No|No|75%|45802058062|SCOPOLAMINE 1 MG/3 DAY PATCH|24|EA|8.24166|11/16/2020||Yes|No||11/16/2020||Yes|No|11/16/2020||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|085|No|11.10069|03/29/2022|10.83427|03/29/2022|10.90642|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|10778|||||No|No||PERRIGO/PADAGIS|No||||
scopolamine|No|No|No|No|75%|45802058084|SCOPOLAMINE 1 MG/3 DAY PATCH|4|EA|6.9015|11/16/2020||Yes|No||11/16/2020||Yes|No|11/16/2020||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|085|No|11.10069|03/29/2022|10.83427|03/29/2022|10.90642|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|10779|||||No|No||PERRIGO/PADAGIS|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|45802059701|CLIND PH-BENZOYL PERO 1.2-2.5%|50|GM|1.72|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|104|No|1.96427|03/29/2022|1.91712|03/29/2022|1.92989|03/29/2022|||ACNE AGENTS: TOPICAL|10780|||||No|No||PERRIGO CO.|No||||
sumatriptan|No|No|No|No|75%|45802059806|SUMATRIPTAN 20 MG NASAL SPRAY|6|EA|21.15671|03/02/2021||Yes|No||03/02/2021||Yes|No|03/02/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|021|No|23.30855|03/29/2022|22.74914|03/29/2022|22.90065|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|10781|||||No|No||PERRIGO/PADAGIS|No||||
calcitriol|No|No|No|No|75%|45802060801|CALCITRIOL 3 MCG/G OINTMENT|100|GM|2.41767|11/28/2012||Yes|No||11/28/2012||Yes|No|11/28/2012||Yes|No||||No|No|||Prescription required|No|||No|5.51005|08/29/2017|5.43133|08/29/2017|5.1727|08/29/2017||||10782|||||No|No||PERRIGO/PADAGIS|No||||
testosterone|No|No|No|No|90%|45802061001|TESTOSTERONE 30 MG/1.5 ML PUMP|90|ML|1.20624|09/27/2017||Yes|No||09/27/2017||Yes|No|09/27/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|084|No|.95473|03/29/2022|.93181|03/29/2022|.93802|03/29/2022|||ANDROGENIC AGENTS|10783|||||No|No||PERRIGO/PADAGIS|No||||
sumatriptan|No|No|No|No|75%|45802061906|SUMATRIPTAN 5 MG NASAL SPRAY|6|EA|21.15671|03/12/2021||Yes|No||03/12/2021||Yes|No|03/12/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|021|No|34.775|03/29/2022|33.9404|03/29/2022|34.16643|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|10784|||||No|No||PERRIGO/PADAGIS|No||||
cetirizine HCl|No|No|No|No|75%|45802062626|CETIRIZINE HCL 1 MG/ML SYRUP|120|ML|.01451|04/09/2009||Yes|No||04/09/2009||Yes|No|04/09/2009||Yes|No||||No|No|||Prescription required|No||030|Yes|.02395|03/29/2022|.02337|03/29/2022|.02353|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10785|||||No|No||PERRIGO/PADAGIS|No||||
clobetasol propionate/emoll|No|No|No|No|75%|45802063732|CLOBETASOL EMOLLNT 0.05% FOAM|50|GM|2.41324|02/11/2013||Yes|No||02/11/2013||Yes|No|02/11/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|121|No|2.7886|01/25/2022|2.72167|01/25/2022|2.73979|01/25/2022|||STEROIDS: TOPICAL VERY HIGH|10786|||||No|No||PERRIGO CO.|No||||
clobetasol propionate/emoll|No|No|No|No|75%|45802063733|CLOBETASOL EMOLLNT 0.05% FOAM|100|GM|2.20422|02/11/2013||Yes|No||02/11/2013||Yes|No|02/11/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|121|No|2.90918|03/01/2022|2.83935|03/01/2022|2.85826|03/01/2022|||STEROIDS: TOPICAL VERY HIGH|10787|||||No|No||PERRIGO CO.|No||||
loratadine|No|No|No|No|75%|45802065065|LORATADINE 10 MG TABLET|30|EA|.03583|11/03/2008||Yes|No||||No|No|11/03/2008||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10788|||||No|No||PERRIGO CO.|No||||
loratadine|No|No|No|No|75%|45802065078|LORATADINE 10 MG TABLET|100|EA|.02472|03/01/2012||Yes|No||||No|No|03/01/2012||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10789|||||No|No||PERRIGO CO.|No||||
loratadine|No|No|No|No|75%|45802065087|LORATADINE 10 MG TABLET|300|EA|.0172|11/03/2008||Yes|No||||No|No|11/03/2008||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10790|||||No|No||PERRIGO CO.|No||||
clindamycin phosphate|No|No|No|No|75%|45802066032|CLINDAMYCIN PHOSPHATE 1% FOAM|50|GM|2.38555|04/09/2010||Yes|No||04/09/2010||Yes|No|04/09/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|104|No|5.43684|01/26/2021|5.35917|01/26/2021|5.10397|01/26/2021|||ACNE AGENTS: TOPICAL|10791|||||No|No||PERRIGO CO.|No||||
clindamycin phosphate|No|No|No|No|75%|45802066033|CLINDAMYCIN PHOSPHATE 1% FOAM|100|GM|1.82556|04/09/2010||Yes|No||04/09/2010||Yes|No|04/09/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|104|No|4.16059|09/24/2019|4.10115|09/24/2019|3.90586|09/24/2019|||ACNE AGENTS: TOPICAL|10792|||||No|No||PERRIGO CO.|No||||
levocetirizine dihydrochloride|No|No|No|No|75%|45802068028|LEVOCETIRIZINE 2.5 MG/5 ML SOL|148|ML|.21453|11/21/2011||Yes|No||11/21/2011||Yes|No|11/21/2011||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|030|Yes|.20616|02/08/2022|.20121|02/08/2022|.20255|02/08/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10793|||||No|No||PERRIGO CO.|No||||
tacrolimus|No|No|No|No|75%|45802070000|TACROLIMUS 0.1% OINTMENT|30|GM|1.43333|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|034|Yes|2.17788|03/29/2022|2.12561|03/29/2022|2.13976|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|10794|||||No|No||PERRIGO/PADAGIS|No||||
tacrolimus|No|No|No|No|75%|45802070001|TACROLIMUS 0.1% OINTMENT|60|GM|1.4334|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|034|Yes|2.14182|03/29/2022|2.09041|03/29/2022|2.10433|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|10795|||||No|No||PERRIGO/PADAGIS|No||||
tacrolimus|No|No|No|No|75%|45802070002|TACROLIMUS 0.1% OINTMENT|100|GM|1.43336|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|034|Yes|1.89468|03/29/2022|1.8492|03/29/2022|1.86152|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|10796|||||No|No||PERRIGO/PADAGIS|No||||
terconazole|Yes|No|No|No|75%|45802071708|TERCONAZOLE 80 MG SUPPOSITORY|3|EA|11.70173|04/17/2006||Yes|No||04/17/2006||Yes|No|04/17/2006||Yes|No||||No|No|11/01/2012||Prescription required|No|||No|18.08733|03/29/2022|17.65323|03/29/2022|17.7708|03/29/2022||||10797|||||No|No||PERRIGO/PADAGIS|No||||
cetirizine HCl/pseudoephedrine|No|No|No|No|75%|45802072153|CETIRIZINE-PSE ER 5-120 MG TAB|12|EA|.33288|08/02/2019|05/01/2022|Yes|No||||No|No|08/02/2019|05/01/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.59854|03/29/2022|.58417|03/29/2022|.58806|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10798|No Longer Rebatable||No Longer Rebatable||No|No||PERRIGO CO.|No||||
acetaminophen|No|No|No|No|75%|45802073030|ACETAMINOPHEN 650 MG SUPPOS|12|EA|.15228|06/11/2019||Yes|No||||No|No|06/11/2019||Yes|No||||No|No|||Over the counter|No|||No|.34957|03/29/2022|.34118|03/29/2022|.34345|03/29/2022||||10799|||||No|No||PERRIGO/PADAGIS|No||||
acetaminophen|No|No|No|No|75%|45802073032|ACETAMINOPHEN 650 MG SUPPOS|50|EA|.11997|06/11/2019||Yes|No||||No|No|06/11/2019||Yes|No||||No|No|||Over the counter|No|||No|.34957|03/29/2022|.34118|03/29/2022|.34345|03/29/2022||||10800|||||No|No||PERRIGO/PADAGIS|No||||
acetaminophen|No|No|No|No|75%|45802073033|ACETAMINOPHEN 650 MG SUPPOS|100|EA|.08793|06/11/2019||Yes|No||||No|No|06/11/2019||Yes|No||||No|No|||Over the counter|No|||No|.34957|03/29/2022|.34118|03/29/2022|.34345|03/29/2022||||10801|||||No|No||PERRIGO/PADAGIS|No||||
acetaminophen|No|No|No|No|75%|45802073230|ACETAMINOPHEN 120 MG SUPPOS|12|EA|.13258|06/11/2019||Yes|No||||No|No|06/11/2019||Yes|No||||No|No|||Over the counter|No|||No|.3074|03/29/2022|.30002|03/29/2022|.30202|03/29/2022||||10802|||||No|No||PERRIGO/PADAGIS|No||||
acetaminophen|No|No|No|No|75%|45802073233|ACETAMINOPHEN 120 MG SUPPOS|100|EA|.08428|06/11/2019||Yes|No||||No|No|06/11/2019||Yes|No||||No|No|||Over the counter|No|||No|.3074|03/29/2022|.30002|03/29/2022|.30202|03/29/2022||||10803|||||No|No||PERRIGO/PADAGIS|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|45802073684|CLIND PH-BENZOYL PEROX 1.2-5%|45|GM|.56616|07/09/2012||Yes|No||07/09/2012||Yes|No|07/09/2012||Yes|No||||No|No|||Prescription required|No||104|No|.73339|03/29/2022|.71578|03/29/2022|.72055|03/29/2022|||ACNE AGENTS: TOPICAL|10804|||||No|No||PERRIGO CO.|No||||
testosterone|No|No|No|No|90%|45802075401|TESTOSTERONE 1.62% GEL PUMP|75|GM|.5074|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|084|No|.65888|03/29/2022|.64306|03/29/2022|.64734|03/29/2022|||ANDROGENIC AGENTS|10805|||||No|No||PERRIGO/PADAGIS|No||||
promethazine HCl|No|No|No|No|75%|45802075830|PROMETHAZINE 12.5 MG SUPPOS|12|EA|4.19142|08/08/2003||Yes|No||08/08/2003||Yes|No|08/08/2003||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|085|Yes|4.318|03/29/2022|4.21436|03/29/2022|4.24243|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|10806|||||No|No||PERRIGO/PADAGIS|No||||
promethazine HCl|No|No|No|No|75%|45802075930|PROMETHAZINE 25 MG SUPPOSITORY|12|EA|4.19142|08/15/2003||Yes|No||08/15/2003||Yes|No|08/15/2003||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|085|Yes|4.199|03/29/2022|4.09822|03/29/2022|4.12551|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|10807|||||No|No||PERRIGO/PADAGIS|No||||
desoximetasone|No|No|No|No|75%|45802080798|DESOXIMETASONE 0.25% SPRAY|100|ML|.61924|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|1.41129|04/27/2021|1.39113|04/27/2021|1.32489|04/27/2021|||STEROIDS: TOPICAL HIGH|10808|||||No|No||PERRIGO/PADAGIS|No||||
calcipotriene/betamethasone|No|No|No|No|75%|45802081601|CALCIPOTRIENE-BETAMETH DP OINT|100|GM|3.99753|08/13/2020||Yes|No||08/13/2020||Yes|No|08/13/2020||Yes|No||||No|No|||Prescription required|No|||No|3.63452|03/29/2022|3.54729|03/29/2022|3.57091|03/29/2022||||10809|||||No|No||PERRIGO/PADAGIS|No||||
calcipotriene/betamethasone|No|No|No|No|75%|45802081696|CALCIPOTRIENE-BETAMETH DP OINT|60|GM|4.52323|08/13/2020||Yes|No||08/13/2020||Yes|No|08/13/2020||Yes|No||||No|No|||Prescription required|No|||No|5.20664|03/29/2022|5.08168|03/29/2022|5.11552|03/29/2022||||10810|||||No|No||PERRIGO/PADAGIS|No||||
triamcinolone acetonide|No|No|No|No|75%|45802081701|TRIAMCINOLONE 0.05% OINTMENT|430|GM|.55721|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|No||120|No|1.23712|03/01/2022|1.20742|03/01/2022|1.21547|03/01/2022|||STEROIDS: TOPICAL HIGH|10811|||||No|No||PERRIGO/PADAGIS|No||||
adapalene/benzoyl peroxide|No|No|No|No|75%|45802084601|ADAPALENE-BNZYL PEROX 0.1-2.5%|45|GM|.95555|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|Yes|02/08/2018|104|No|.76371|03/29/2022|.74538|03/29/2022|.75034|03/29/2022|||ACNE AGENTS: TOPICAL|10812|||||No|No||PERRIGO/PADAGIS|No||||
polyethylene glycol 3350|No|No|No|No|75%|45802086801|POLYETHYLENE GLYCOL 3350 POWD|119|GM|.01481|03/27/2019||Yes|No||||No|No|03/27/2019||Yes|No||||No|No|||Over the counter|No|||No|.03052|03/29/2022|.02978|03/29/2022|.02998|03/29/2022||||10813|||||No|No||PERRIGO/PADAGIS|No||||
polyethylene glycol 3350|No|No|No|No|75%|45802086802|POLYETHYLENE GLYCOL 3350 POWD|238|GM|.01311|03/27/2019||Yes|No||||No|No|03/27/2019||Yes|No||||No|No|||Over the counter|No|||No|.02672|03/29/2022|.02607|03/29/2022|.02625|03/29/2022||||10814|||||No|No||PERRIGO/PADAGIS|No||||
polyethylene glycol 3350|No|No|No|No|75%|45802086803|POLYETHYLENE GLYCOL 3350 POWD|510|GM|.01194|01/14/2019||Yes|No||||No|No|01/14/2019||Yes|No||||No|No|||Over the counter|No|||No|.02124|03/29/2022|.02073|03/29/2022|.02086|03/29/2022||||10815|||||No|No||PERRIGO/PADAGIS|No||||
polyethylene glycol 3350|No|No|No|No|75%|45802086866|POLYETHYLENE GLYCOL 3350 POWD|14|EA|.88303|01/11/2019||Yes|No||||No|No|01/11/2019||Yes|No||||No|No|||Over the counter|No|||No|1.51205|03/29/2022|1.47576|03/29/2022|1.48558|03/29/2022||||10816|||||No|No||PERRIGO/PADAGIS|No||||
nicotine polacrilex|No|No|No|No|75%|45802087305|NICOTINE 4 MG LOZENGE|72|EA|.16931|03/31/2014||Yes|No||||No|No|03/31/2014||Yes|No||||No|No|||Over the counter|No||040|No|.35064|03/29/2022|.34222|03/29/2022|.3445|03/29/2022|||SMOKING CESSATION|10817|||||No|No||PERRIGO CO.|No||||
nystatin/triamcin|No|No|No|No|75%|45802088014|NYSTATIN-TRIAMCINOLONE CREAM|15|GM|.60056|02/05/2018||Yes|No||02/05/2018||Yes|No|02/05/2018||Yes|No||||No|No|||Prescription required|Yes|11/30/2017|061|No|.54331|03/29/2022|.53027|03/29/2022|.5338|03/29/2022|||ANTIFUNGALS: TOPICAL|10818|||||No|No||PERRIGO CO.|No||||
nystatin/triamcin|No|No|No|No|75%|45802088094|NYSTATIN-TRIAMCINOLONE CREAM|30|GM|.42168|02/05/2018||Yes|No||02/05/2018||Yes|No|02/05/2018||Yes|No||||No|No|||Prescription required|Yes|11/30/2017|061|No|.49088|03/29/2022|.47909|03/29/2022|.48228|03/29/2022|||ANTIFUNGALS: TOPICAL|10819|||||No|No||PERRIGO CO.|No||||
nystatin/triamcin|No|No|No|No|75%|45802088096|NYSTATIN-TRIAMCINOLONE CREAM|60|GM|.31304|02/05/2018||Yes|No||02/05/2018||Yes|No|02/05/2018||Yes|No||||No|No|||Prescription required|Yes|11/30/2017|061|No|.35965|03/29/2022|.35101|03/29/2022|.35335|03/29/2022|||ANTIFUNGALS: TOPICAL|10820|||||No|No||PERRIGO CO.|No||||
fluocinolone acetonide|No|No|No|No|75%|45802088726|FLUOCINOLONE 0.01% BODY OIL|118.28|ML|.23953|09/26/2017||Yes|No||09/26/2017||Yes|No|09/26/2017||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|118|No|.18968|03/29/2022|.18512|03/29/2022|.18636|03/29/2022|||STEROIDS: TOPICAL LOW|10821|||||No|No||PERRIGO/PADAGIS|No||||
omeprazole|No|No|No|No|75%|45802088830|OMEPRAZOLE DR 20 MG TABLET|28|EA|.23588|09/01/2009||Yes|No||||No|No|09/01/2009||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.45914|03/29/2022|.44812|03/29/2022|.4511|03/29/2022|||PROTON PUMP INHIBITORS|10822|||||No|No||PERRIGO/PADAGIS|No||||
omeprazole|No|No|No|No|75%|45802088855|OMEPRAZOLE DR 20 MG TABLET|42|EA|.21346|09/01/2009||Yes|No||||No|No|09/01/2009||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.45914|03/29/2022|.44812|03/29/2022|.4511|03/29/2022|||PROTON PUMP INHIBITORS|10823|||||No|No||PERRIGO/PADAGIS|No||||
calcipotriene/betamethasone|No|No|No|No|75%|45802088918|CALCIPOTRIENE-BETAMETH DP SUSP|120|GM|3.59031|03/12/2021||Yes|No||03/12/2021||Yes|No|03/12/2021||Yes|No||||No|No|||Prescription required|No|||No|8.18258|03/12/2021|8.06569|03/12/2021|7.68161|03/12/2021||||10824|||||No|No||PERRIGO/PADAGIS|No||||
calcipotriene/betamethasone|No|No|No|No|75%|45802088996|CALCIPOTRIENE-BETAMETH DP SUSP|60|GM|3.59035|03/12/2021||Yes|No||03/12/2021||Yes|No|03/12/2021||Yes|No||||No|No|||Prescription required|No|||No|8.18266|03/12/2021|8.06577|03/12/2021|7.68168|03/12/2021||||10825|||||No|No||PERRIGO/PADAGIS|No||||
sulfacetamide sodium|No|No|No|No|75%|45802089626|SULFACETAMIDE SOD 10% TOP SUSP|118|ML|.57211|10/23/2012||Yes|No||10/23/2012||Yes|No|10/23/2012||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|104|No|.79229|03/29/2022|.77327|03/29/2022|.77842|03/29/2022|||ACNE AGENTS: TOPICAL|10826|||||No|No||PERRIGO/PADAGIS|No||||
ibuprofen|No|No|No|No|75%|45802089726|CHILDREN IBUPROFEN 100 MG/5 ML|118|ML|.02736|11/28/2011||Yes|No||||No|No|11/28/2011||Yes|No||||No|No|||Over the counter|No||059|Yes|.02649|03/29/2022|.02585|03/29/2022|.02602|03/29/2022|||NSAIDS|10827|||||No|No||PERRIGO/PADAGIS|No||||
ibuprofen|No|No|No|No|75%|45802089734|CHILDREN IBUPROFEN 100 MG/5 ML|237|ML|.01171|08/02/2019||Yes|No||||No|No|08/02/2019||Yes|No||||No|No|||Over the counter|No||059|Yes|.0267|08/02/2019|.02632|08/02/2019|.02507|08/02/2019|||NSAIDS|10828|||||No|No||PERRIGO/PADAGIS|No||||
clindamycin phosphate|No|No|No|No|75%|45802090094|CLINDAMYCIN PH 1% GEL|30|GM|.645|06/16/2021||Yes|No||06/16/2021||Yes|No|06/16/2021||Yes|No||||No|No|||Prescription required|No||104|No|.67613|03/29/2022|.6599|03/29/2022|.66429|03/29/2022|||ACNE AGENTS: TOPICAL|10829|||||No|No||PERRIGO/PADAGIS|No||||
clindamycin phosphate|No|No|No|No|75%|45802090096|CLINDAMYCIN PH 1% GEL|60|GM|.645|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|No||104|No|.47333|03/29/2022|.46197|03/29/2022|.46504|03/29/2022|||ACNE AGENTS: TOPICAL|10830|||||No|No||PERRIGO/PADAGIS|No||||
cetirizine HCl|No|No|No|No|75%|45802091939|CETIRIZINE HCL 10 MG TABLET|30|EA|.10965|04/21/2009||Yes|No||||No|No|04/21/2009||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10831|||||No|No||PERRIGO/PADAGIS|No||||
cetirizine HCl|No|No|No|No|75%|45802091987|CETIRIZINE HCL 10 MG TABLET|300|EA|.07166|02/13/2008||Yes|No||||No|No|02/13/2008||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10832|||||No|No||PERRIGO/PADAGIS|No||||
mesalamine w/cleansing wipes|No|No|No|No|75%|45802092341|MESALAMINE 4 GM/60 ML KIT|1|EA|58.8412|06/22/2015||Yes|No||06/22/2015||Yes|No|06/22/2015||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|010|No|134.1032|12/26/2017|132.18744|12/26/2017|125.8928|12/26/2017|||ULCERATIVE COLITIS AGENTS|10833|||||No|No||PERRIGO CO.|No||||
clobetasol propionate|No|No|No|No|75%|45802092514|CLOBETASOL 0.05% GEL|15|GM|1.18393|07/18/2011||Yes|No||07/18/2011||Yes|No|07/18/2011||Yes|No||||No|No|||Prescription required|No||121|No|1.023|03/01/2022|.99844|03/01/2022|1.00509|03/01/2022|||STEROIDS: TOPICAL VERY HIGH|10834|||||No|No||PERRIGO CO.|No||||
clobetasol propionate|No|No|No|No|75%|45802092594|CLOBETASOL 0.05% GEL|30|GM|.98957|11/21/2008||Yes|No||11/21/2008||Yes|No|11/21/2008||Yes|No||||No|No|||Prescription required|No||121|No|1.27828|03/29/2022|1.2476|03/29/2022|1.25591|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|10835|||||No|No||PERRIGO CO.|No||||
clobetasol propionate|No|No|No|No|75%|45802092596|CLOBETASOL 0.05% GEL|60|GM|.98949|07/18/2011||Yes|No||07/18/2011||Yes|No|07/18/2011||Yes|No||||No|No|||Prescription required|No||121|No|.91682|03/29/2022|.89481|03/29/2022|.90077|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|10836|||||No|No||PERRIGO CO.|No||||
flurandrenolide|No|No|No|No|75%|45802092803|FLURANDRENOLIDE 0.05% LOTION|120|ML|1.075|02/16/2017||Yes|No||02/16/2017||Yes|No|02/16/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|119|No|2.45|02/26/2019|2.415|02/26/2019|2.3|02/26/2019|||STEROIDS: TOPICAL MEDIUM|10837|||||No|No||PERRIGO/PADAGIS|No||||
mesalamine w/cleansing wipes|No|No|No|No|75%|45802092949|MESALAMINE 4 GM/60 ML KIT|1|EA|57.56625|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|010|No|131.1975|11/29/2018|129.32325|11/29/2018|123.165|11/29/2018|||ULCERATIVE COLITIS AGENTS|10838|||||No|No||PERRIGO CO.|No||||
hydrocortisone|No|No|No|No|75%|45802093716|HYDROCORTISONE 2.5% LOTION|59|ML|.21842|10/02/2008||Yes|No||10/02/2008||Yes|No|10/02/2008||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|118|No|.19639|03/29/2022|.19167|03/29/2022|.19295|03/29/2022|||STEROIDS: TOPICAL LOW|10839|||||No|No||PERRIGO/PADAGIS|No||||
hydrocortisone|No|No|No|No|75%|45802093726|HYDROCORTISONE 2.5% LOTION|118|ML|.11788|08/06/2010||Yes|No||08/06/2010||Yes|No|08/06/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|118|No|.1955|03/29/2022|.1908|03/29/2022|.19207|03/29/2022|||STEROIDS: TOPICAL LOW|10840|||||No|No||PERRIGO/PADAGIS|No||||
ibuprofen|No|No|No|No|75%|45802095226|IBUPROFEN 100 MG/5 ML SUSP|120|ML|.0269|05/04/2007||Yes|No||05/04/2007||Yes|No|05/04/2007||Yes|No||||No|No|||Prescription required|No||059|Yes|.03892|03/29/2022|.03798|03/29/2022|.03823|03/29/2022|||NSAIDS|10841|||||No|No||PERRIGO CO.|No||||
ibuprofen|No|No|No|No|75%|45802095243|IBUPROFEN 100 MG/5 ML SUSP|473|ML|.02288|07/25/2007||Yes|No||07/25/2007||Yes|No|07/25/2007||Yes|No||||No|No|||Prescription required|No||059|Yes|.03005|03/29/2022|.02932|03/29/2022|.02952|03/29/2022|||NSAIDS|10842|||||No|No||PERRIGO CO.|No||||
diclofenac sodium|No|No|No|No|75%|45802095301|DICLOFENAC SODIUM 1% GEL|100|GM|.05267|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Over the counter|No||059|Yes|.09419|03/29/2022|.09192|03/29/2022|.09254|03/29/2022|||NSAIDS|10843|||||No|No||PERRIGO/PADAGIS|No||||
nicotine polacrilex|No|No|No|No|75%|45802095702|NICOTINE 4 MG MINI LOZENGE|81|EA|.16058|09/07/2016||Yes|No||||No|No|09/07/2016||Yes|No||||No|No|||Over the counter|No||040|No|.3724|03/29/2022|.36346|03/29/2022|.36588|03/29/2022|||SMOKING CESSATION|10844|||||No|No||PERRIGO CO.|No||||
clobetasol propionate|No|No|No|No|75%|45802096126|CLOBETASOL 0.05% SHAMPOO|118|ML|.47372|02/28/2018||Yes|No||02/28/2018||Yes|No|02/28/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|121|No|.54041|03/29/2022|.52744|03/29/2022|.53095|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|10845|||||No|No||PERRIGO/PADAGIS|No||||
erythromycin base in ethanol|No|No|No|No|75%|45802096272|ERY 2% PADS|60|EA|.55333|03/02/2009||Yes|No||03/02/2009||Yes|No|03/02/2009||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|104|No|1.26109|10/23/2018|1.24307|10/23/2018|1.18388|10/23/2018|||ACNE AGENTS: TOPICAL|10846|||||No|No||PERRIGO/PADAGIS|No||||
erythromycin base in ethanol|No|No|No|No|75%|45802096694|ERYTHROMYCIN 2% GEL|30|GM|.7224|09/24/2008||Yes|No||09/24/2008||Yes|No|09/24/2008||Yes|No||||No|No|||Prescription required|No||104|No|.72375|03/29/2022|.70638|03/29/2022|.71108|03/29/2022|||ACNE AGENTS: TOPICAL|10847|||||No|No||PERRIGO/PADAGIS|No||||
erythromycin base in ethanol|No|No|No|No|75%|45802096696|ERYTHROMYCIN 2% GEL|60|GM|.516|03/02/2009||Yes|No||03/02/2009||Yes|No|03/02/2009||Yes|No||||No|No|||Prescription required|No||104|No|.79832|03/29/2022|.77916|03/29/2022|.78434|03/29/2022|||ACNE AGENTS: TOPICAL|10848|||||No|No||PERRIGO/PADAGIS|No||||
cetirizine HCl|No|No|No|No|75%|45802097426|CETIRIZINE HCL 1 MG/ML SOLN|118|ML|.02951|04/28/2008||Yes|No||||No|No|04/28/2008||Yes|No||||No|No|||Over the counter|No||030|Yes|.03462|03/29/2022|.03378|03/29/2022|.03401|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10849|||||No|No||PERRIGO/PADAGIS|No||||
bupropion HCl|Yes|No|No|No|75%|45963014205|BUPROPION HCL XL 300 MG TABLET|500|EA|.64297|07/16/2015||Yes|No||07/16/2015||Yes|No|07/16/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|10850|||||No|No||ACTAVIS/TEVA|No||||
bupropion HCl|Yes|No|No|No|75%|45963014230|BUPROPION HCL XL 300 MG TABLET|30|EA|.64299|05/14/2015||Yes|No||05/14/2015||Yes|No|05/14/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|10851|||||No|No||ACTAVIS/TEVA|No||||
bupropion HCl|Yes|No|No|No|75%|45963014290|BUPROPION HCL XL 300 MG TABLET|90|EA|.64299|08/04/2015||Yes|No||08/04/2015||Yes|No|08/04/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|10852|||||No|No||ACTAVIS/TEVA|No||||
dextroamphetamine sulfate|No|No|No|No|75%|45963030309|DEXTROAMPHETAMINE ER 5 MG CAP|90|EA|1.25397|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.09277|03/29/2022|1.06654|03/29/2022|1.07364|03/29/2022|||STIMULANTS AND RELATED AGENTS|10853|||||No|No||ACTAVIS/TEVA|No||||
dextroamphetamine sulfate|No|No|No|No|75%|45963030409|DEXTROAMPHETAMINE ER 10 MG CAP|90|EA|1.56639|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.19348|03/29/2022|1.16483|03/29/2022|1.17259|03/29/2022|||STIMULANTS AND RELATED AGENTS|10854|||||No|No||ACTAVIS/TEVA|No||||
dextroamphetamine sulfate|No|No|No|No|75%|45963030509|DEXTROAMPHETAMINE ER 15 MG CAP|90|EA|1.99729|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.81061|03/29/2022|1.76715|03/29/2022|1.77892|03/29/2022|||STIMULANTS AND RELATED AGENTS|10855|||||No|No||ACTAVIS/TEVA|No||||
desipramine HCl|No|No|No|No|75%|45963034102|DESIPRAMINE 10 MG TABLET|100|EA|.40119|02/29/2012||Yes|No||02/29/2012||Yes|No|02/29/2012||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.3086|03/29/2022|.30119|03/29/2022|.30319|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|10856|||||No|No||ACTAVIS/TEVA|No||||
desipramine HCl|No|No|No|No|75%|45963034202|DESIPRAMINE 25 MG TABLET|100|EA|.48198|02/29/2012||Yes|No||02/29/2012||Yes|No|02/29/2012||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.4119|03/01/2022|.40201|03/01/2022|.40469|03/01/2022|||ANTIDEPRESSANTS: TRICYCLIC|10857|||||No|No||ACTAVIS/TEVA|No||||
desipramine HCl|No|No|No|No|75%|45963034302|DESIPRAMINE 50 MG TABLET|100|EA|.90738|02/29/2012||Yes|No||02/29/2012||Yes|No|02/29/2012||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.3099|01/25/2022|.30246|01/25/2022|.30447|01/25/2022|||ANTIDEPRESSANTS: TRICYCLIC|10858|||||No|No||ACTAVIS/TEVA|No||||
desipramine HCl|No|No|No|No|75%|45963034402|DESIPRAMINE 75 MG TABLET|100|EA|1.05083|02/29/2012||Yes|No||02/29/2012||Yes|No|02/29/2012||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|2.39492|06/01/2016|2.36071|06/01/2016|2.24829|06/01/2016|||ANTIDEPRESSANTS: TRICYCLIC|10859|||||No|No||ACTAVIS/TEVA|No||||
desipramine HCl|No|No|No|No|75%|45963034502|DESIPRAMINE 100 MG TABLET|100|EA|1.51764|02/29/2012||Yes|No||02/29/2012||Yes|No|02/29/2012||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|3.45881|10/29/2019|3.4094|10/29/2019|3.24704|10/29/2019|||ANTIDEPRESSANTS: TRICYCLIC|10860|||||No|No||ACTAVIS/TEVA|No||||
desipramine HCl|No|No|No|No|75%|45963034650|DESIPRAMINE 150 MG TABLET|50|EA|2.19893|11/09/2016||Yes|No||11/09/2016||Yes|No|11/09/2016||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|5.01152|03/24/2020|4.93993|03/24/2020|4.70469|03/24/2020|||ANTIDEPRESSANTS: TRICYCLIC|10861|||||No|No||ACTAVIS/TEVA|No||||
ranolazine|No|No|No|No|75%|45963041806|RANOLAZINE ER 500 MG TABLET|60|EA|.61167|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||||No|No|||Prescription required|No|||Yes|.28604|03/29/2022|.27917|03/29/2022|.28103|03/29/2022||||10862|||||No|No||ACTAVIS/TEVA|No||||
ranolazine|No|No|No|No|75%|45963041906|RANOLAZINE ER 1,000 MG TABLET|60|EA|1.00426|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||||No|No|||Prescription required|No|||Yes|.43283|03/29/2022|.42244|03/29/2022|.42525|03/29/2022||||10863|||||No|No||ACTAVIS/TEVA|No||||
lactulose|No|No|No|No|75%|45963043864|ENULOSE 10 GM/15 ML SOLUTION|473|ML|.00641|10/26/2012||Yes|No||10/26/2012||Yes|No|10/26/2012||Yes|No||||No|No|||Prescription required|No|||No|.01452|03/29/2022|.01417|03/29/2022|.01426|03/29/2022||||10864|||||No|No||ACTAVIS/TEVA|No||||
lactulose|No|No|No|No|75%|45963043963|CONSTULOSE 10 GM/15 ML SOLN|237|ML|.00725|10/26/2012||Yes|No||10/26/2012||Yes|No|10/26/2012||Yes|No||||No|No|||Prescription required|No|||No|.01653|06/29/2021|.01629|06/29/2021|.01552|06/29/2021||||10865|||||No|No||ACTAVIS/TEVA|No||||
lactulose|No|No|No|No|75%|45963043965|CONSTULOSE 10 GM/15 ML SOLN|946|ML|.00635|10/26/2012||Yes|No||10/26/2012||Yes|No|10/26/2012||Yes|No||||No|No|||Prescription required|No|||No|.0141|03/29/2022|.01376|03/29/2022|.01385|03/29/2022||||10866|||||No|No||ACTAVIS/TEVA|No||||
deferasirox|No|No|No|No|75%|45963045430|DEFERASIROX 125 MG TB FOR SUSP|30|EA|10.76419|06/03/2020||Yes|No||06/03/2020||Yes|No|06/03/2020||Yes|No||||No|No|||Prescription required|No|||No|24.53234|06/03/2020|24.18187|06/03/2020|23.03036|06/03/2020||||10867|||||No|No||ACTAVIS/TEVA|No||||
deferasirox|No|No|No|No|75%|45963045530|DEFERASIROX 250 MG TB FOR SUSP|30|EA|21.52795|06/03/2020||Yes|No||06/03/2020||Yes|No|06/03/2020||Yes|No||||No|No|||Prescription required|No|||No|49.0637|06/03/2020|48.36279|06/03/2020|46.0598|06/03/2020||||10868|||||No|No||ACTAVIS/TEVA|No||||
deferasirox|No|No|No|No|75%|45963045630|DEFERASIROX 500 MG TB FOR SUSP|30|EA|43.05504|06/03/2020||Yes|No||06/03/2020||Yes|No|06/03/2020||Yes|No||||No|No|||Prescription required|No|||No|98.12544|06/03/2020|96.72364|06/03/2020|92.11776|06/03/2020||||10869|||||No|No||ACTAVIS/TEVA|No||||
alosetron HCl|No|No|No|No|75%|45963047903|ALOSETRON HCL 0.5 MG TABLET|30|EA|10.12965|08/31/2015||Yes|No||08/31/2015||Yes|No|08/31/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|534|Yes|3.98973|03/01/2022|3.89397|03/01/2022|3.9199|03/01/2022|||GI MOTILITY: CHRONIC|10870|||||No|No||ACTAVIS/TEVA|No||||
alosetron HCl|No|No|No|No|75%|45963048003|ALOSETRON HCL 1 MG TABLET|30|EA|20.26174|05/27/2015||Yes|No||05/27/2015||Yes|No|05/27/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|534|Yes|8.58181|01/25/2022|8.37584|01/25/2022|8.43162|01/25/2022|||GI MOTILITY: CHRONIC|10871|||||No|No||ACTAVIS/TEVA|No||||
ondansetron HCl|No|No|No|No|75%|45963053830|ONDANSETRON HCL 4 MG TABLET|30|EA|.19063|03/22/2016||Yes|No||03/22/2016||Yes|No|03/22/2016||Yes|No||||No|No|||Prescription required|No||085|No|.06763|03/29/2022|.066|03/29/2022|.06644|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|10872|||||No|No||ACTAVIS/TEVA|No||||
ondansetron HCl|No|No|No|No|75%|45963053930|ONDANSETRON HCL 8 MG TABLET|30|EA|.22876|03/22/2016||Yes|No||03/22/2016||Yes|No|03/22/2016||Yes|No||||No|No|||Prescription required|No||085|No|.09975|03/29/2022|.09735|03/29/2022|.098|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|10873|||||No|No||ACTAVIS/TEVA|No||||
gabapentin|No|No|No|No|75%|45963055511|GABAPENTIN 100 MG CAPSULE|100|EA|.0258|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|10874|||||No|No||ACTAVIS/TEVA|No||||
gabapentin|No|No|No|No|75%|45963055550|GABAPENTIN 100 MG CAPSULE|500|EA|.0258|06/27/2014||Yes|No||06/27/2014||Yes|No|06/27/2014||Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|10875|||||No|No||ACTAVIS/TEVA|No||||
gabapentin|No|No|No|No|75%|45963055611|GABAPENTIN 300 MG CAPSULE|100|EA|.03762|06/27/2014||Yes|No||06/27/2014||Yes|No|06/27/2014||Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|10876|||||No|No||ACTAVIS/TEVA|No||||
gabapentin|No|No|No|No|75%|45963055650|GABAPENTIN 300 MG CAPSULE|500|EA|.03762|06/27/2014||Yes|No||06/27/2014||Yes|No|06/27/2014||Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|10877|||||No|No||ACTAVIS/TEVA|No||||
gabapentin|No|No|No|No|75%|45963055711|GABAPENTIN 400 MG CAPSULE|100|EA|.04837|06/27/2014||Yes|No||06/27/2014||Yes|No|06/27/2014||Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|10878|||||No|No||ACTAVIS/TEVA|No||||
gabapentin|No|No|No|No|75%|45963055750|GABAPENTIN 400 MG CAPSULE|500|EA|.04837|06/27/2014||Yes|No||06/27/2014||Yes|No|06/27/2014||Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|10879|||||No|No||ACTAVIS/TEVA|No||||
ezetimibe/simvastatin|No|No|No|No|75%|45963056508|EZETIMIBE-SIMVASTATIN 10-10 MG|90|EA|1.39525|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|063|Yes|.75312|03/29/2022|.73504|03/29/2022|.73994|03/29/2022|||LIPOTROPICS: STATINS|10880|||||No|No||ACTAVIS/TEVA|No||||
ezetimibe/simvastatin|No|No|No|No|75%|45963056530|EZETIMIBE-SIMVASTATIN 10-10 MG|30|EA|1.3952|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|063|Yes|.75312|03/29/2022|.73504|03/29/2022|.73994|03/29/2022|||LIPOTROPICS: STATINS|10881|||||No|No||ACTAVIS/TEVA|No||||
ezetimibe/simvastatin|No|No|No|No|75%|45963056608|EZETIMIBE-SIMVASTATIN 10-20 MG|90|EA|1.39525|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|063|Yes|.74268|03/29/2022|.72485|03/29/2022|.72968|03/29/2022|||LIPOTROPICS: STATINS|10882|||||No|No||ACTAVIS/TEVA|No||||
ezetimibe/simvastatin|No|No|No|No|75%|45963056630|EZETIMIBE-SIMVASTATIN 10-20 MG|30|EA|1.3952|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|063|Yes|.74268|03/29/2022|.72485|03/29/2022|.72968|03/29/2022|||LIPOTROPICS: STATINS|10883|||||No|No||ACTAVIS/TEVA|No||||
ezetimibe/simvastatin|No|No|No|No|75%|45963056708|EZETIMIBE-SIMVASTATIN 10-40 MG|90|EA|1.39525|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|063|Yes|.99233|03/29/2022|.96851|03/29/2022|.97496|03/29/2022|||LIPOTROPICS: STATINS|10884|||||No|No||ACTAVIS/TEVA|No||||
ezetimibe/simvastatin|No|No|No|No|75%|45963056730|EZETIMIBE-SIMVASTATIN 10-40 MG|30|EA|1.3952|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|063|Yes|.99233|03/29/2022|.96851|03/29/2022|.97496|03/29/2022|||LIPOTROPICS: STATINS|10885|||||No|No||ACTAVIS/TEVA|No||||
ezetimibe/simvastatin|No|No|No|No|75%|45963056808|EZETIMIBE-SIMVASTATIN 10-80 MG|90|EA|1.39525|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|063|Yes|.47172|03/29/2022|.46039|03/29/2022|.46346|03/29/2022|||LIPOTROPICS: STATINS|10886|||||No|No||ACTAVIS/TEVA|No||||
ezetimibe/simvastatin|No|No|No|No|75%|45963056830|EZETIMIBE-SIMVASTATIN 10-80 MG|30|EA|1.3952|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|063|Yes|.47172|03/29/2022|.46039|03/29/2022|.46346|03/29/2022|||LIPOTROPICS: STATINS|10887|||||No|No||ACTAVIS/TEVA|No||||
metoprolol succinate|No|No|No|No|75%|45963067611|METOPROLOL SUCC ER 50 MG TAB|100|EA|.10793|10/08/2020||Yes|No||10/08/2020||Yes|No|10/08/2020||Yes|No||||No|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|10888|||||No|No||ACTAVIS/TEVA|No||||
metoprolol succinate|No|No|No|No|75%|45963067696|METOPROLOL SUCC ER 50 MG TAB|1000|EA|.10255|10/08/2020||Yes|No||10/08/2020||Yes|No|10/08/2020||Yes|No||||No|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|10889|||||No|No||ACTAVIS/TEVA|No||||
metoprolol succinate|No|No|No|No|75%|45963067711|METOPROLOL SUCC ER 100 MG TAB|100|EA|.16223|03/10/2020||Yes|No||03/10/2020||Yes|No|03/10/2020||Yes|No||||No|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|10890|||||No|No||ACTAVIS/TEVA|No||||
metoprolol succinate|No|No|No|No|75%|45963067796|METOPROLOL SUCC ER 100 MG TAB|1000|EA|.15411|03/10/2020||Yes|No||03/10/2020||Yes|No|03/10/2020||Yes|No||||No|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|10891|||||No|No||ACTAVIS/TEVA|No||||
metoprolol succinate|No|No|No|No|75%|45963067811|METOPROLOL SUCC ER 200 MG TAB|100|EA|.25812|03/10/2020||Yes|No||03/10/2020||Yes|No|03/10/2020||Yes|No||||No|No|||Prescription required|No||070|No|.25385|03/29/2022|.24775|03/29/2022|.2494|03/29/2022|||BETA-BLOCKERS|10892|||||No|No||ACTAVIS/TEVA|No||||
metoprolol succinate|No|No|No|No|75%|45963070911|METOPROLOL SUCC ER 25 MG TAB|100|EA|.10793|03/10/2020||Yes|No||03/10/2020||Yes|No|03/10/2020||Yes|No||||No|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|10893|||||No|No||ACTAVIS/TEVA|No||||
metoprolol succinate|No|No|No|No|75%|45963070996|METOPROLOL SUCC ER 25 MG TAB|1000|EA|.10255|03/10/2020||Yes|No||03/10/2020||Yes|No|03/10/2020||Yes|No||||No|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|10894|||||No|No||ACTAVIS/TEVA|No||||
omeprazole|No|No|No|No|75%|46122002903|OMEPRAZOLE DR 20 MG TABLET|28|EA|.20148|02/03/2012||Yes|No||||No|No|02/03/2012||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.45914|03/29/2022|.44812|03/29/2022|.4511|03/29/2022|||PROTON PUMP INHIBITORS|10895|||||No|No||AMERISOURCE-GNP|No||||
omeprazole|No|No|No|No|75%|46122002904|OMEPRAZOLE DR 20 MG TABLET|42|EA|.17885|02/03/2012||Yes|No||||No|No|02/03/2012||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.45914|03/29/2022|.44812|03/29/2022|.4511|03/29/2022|||PROTON PUMP INHIBITORS|10896|||||No|No||AMERISOURCE-GNP|No||||
omeprazole|No|No|No|No|75%|46122002974|OMEPRAZOLE DR 20 MG TABLET|14|EA|.22759|02/03/2012||Yes|No||||No|No|02/03/2012||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.45914|03/29/2022|.44812|03/29/2022|.4511|03/29/2022|||PROTON PUMP INHIBITORS|10897|||||No|No||AMERISOURCE-GNP|No||||
permethrin|No|No|No|No|75%|46122010846|LICE TREATMENT 1% CREME RINSE|59|ML|.05713|11/10/2017||Yes|No||||No|No|11/10/2017||Yes|No||||No|No|||Over the counter|No||122|No|.10494|03/29/2022|.10242|03/29/2022|.1031|03/29/2022|||ANTIPARASITICS: TOPICAL|10898|||||No|No||AMERISOURCE-GNP|No||||
sodium polystyrene sulfon/sorb|No|No|No|No|75%|46287000601|SPS 15 GM/60 ML SUSPENSION|473|ML|.13818|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.29555|03/29/2022|.28845|03/29/2022|.29037|03/29/2022||||10899|||||No|No||CMP PHARMA, INC|No||||
sodium polystyrene sulfon/sorb|No|No|No|No|75%|46287000604|SPS 30 GM/120 ML ENEMA SUSP|120|ML|.32393|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.73826|03/29/2022|.72771|03/29/2022|.69306|03/29/2022||||10900|||||No|No||CMP PHARMA, INC|No||||
sodium polystyrene sulfon/sorb|No|No|No|No|75%|46287000660|SPS 15 GM/60 ML SUSPENSION|60|ML|.14405|10/12/2006||Yes|No||10/12/2006||Yes|No|10/12/2006||Yes|No||||No|No|||Prescription required|No|||No|.3283|03/29/2022|.32361|03/29/2022|.3082|03/29/2022||||10901|||||No|No||CMP PHARMA, INC|No||||
isoniazid|No|No|No|No|75%|46287000901|ISONIAZID 50 MG/5 ML SOLUTION|473|ML|.26545|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.60498|12/19/2017|.59634|12/19/2017|.56794|12/19/2017||||10902|||||No|No||CMP PHARMA, INC|No||||
spironolactone|No|No|No|No|75%|46287002001|CAROSPIR 25 MG/5 ML SUSPENSION|473|ML|1.38895|10/16/2018||Yes|No||10/16/2018||Yes|No|10/16/2018||Yes|No||||No|No|||Prescription required|No|||No|3.16551|10/05/2021|3.12029|10/05/2021|2.97171|10/05/2021||||10903|||||No|No||CMP PHARMA, INC|No||||
spironolactone|No|No|No|No|75%|46287002004|CAROSPIR 25 MG/5 ML SUSPENSION|118|ML|1.38893|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No|||No|3.05947|01/25/2022|2.98604|01/25/2022|3.00592|01/25/2022||||10904|||||No|No||CMP PHARMA, INC|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|46672005350|BUTALB-ACETAMIN-CAFF 50-325-40|500|EA||03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.18524|03/29/2022|.18079|03/29/2022|.18199|03/29/2022||||10905|||||No|No||MIKART, INC|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|47335000188|CARBIDOPA-LEVODOPA 50 MG-ENTA|100|EA|1.32913|09/27/2012||Yes|No||09/27/2012||Yes|No|09/27/2012||Yes|No||||No|No|||Prescription required|No||015|No|3.02918|10/29/2019|2.9859|10/29/2019|2.84372|10/29/2019|||ANTIPARKINSON'S AGENTS|10906|||||No|No||SUN PHARMA GLOB|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|47335000288|CARBIDOPA-LEVODOPA 75 MG-ENTA|100|EA|1.32913|09/27/2012||Yes|No||09/27/2012||Yes|No|09/27/2012||Yes|No||||No|No|||Prescription required|No||015|No|3.02918|08/24/2021|2.9859|08/24/2021|2.84372|08/24/2021|||ANTIPARKINSON'S AGENTS|10907|||||No|No||SUN PHARMA GLOB|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|47335000388|CARBIDOPA-LEVODOPA 100 MG-ENTA|100|EA|1.32913|04/06/2012||Yes|No||04/06/2012||Yes|No|04/06/2012||Yes|No||||No|No|||Prescription required|No||015|No|.96003|03/01/2022|.93698|03/01/2022|.94322|03/01/2022|||ANTIPARKINSON'S AGENTS|10908|||||No|No||SUN PHARMA GLOB|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|47335000488|CARBIDOPA-LEVODOPA 125 MG-ENTA|100|EA|1.32913|09/27/2012||Yes|No||09/27/2012||Yes|No|09/27/2012||Yes|No||||No|No|||Prescription required|No||015|No|.9119|07/27/2021|.89001|07/27/2021|.89594|07/27/2021|||ANTIPARKINSON'S AGENTS|10909|||||No|No||SUN PHARMA GLOB|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|47335000588|CARBIDOPA-LEVODOPA 150 MG-ENTA|100|EA|1.32913|04/06/2012||Yes|No||04/06/2012||Yes|No|04/06/2012||Yes|No||||No|No|||Prescription required|No||015|No|1.0904|05/25/2021|1.06423|05/25/2021|1.07131|05/25/2021|||ANTIPARKINSON'S AGENTS|10910|||||No|No||SUN PHARMA GLOB|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|47335000688|CARBIDOPA-LEVODOPA 200 MG-ENTA|100|EA|1.32913|09/27/2012||Yes|No||09/27/2012||Yes|No|09/27/2012||Yes|No||||No|No|||Prescription required|No||015|No|.96506|03/29/2022|.94189|03/29/2022|.94817|03/29/2022|||ANTIPARKINSON'S AGENTS|10911|||||No|No||SUN PHARMA GLOB|No||||
entacapone|No|No|No|No|75%|47335000788|ENTACAPONE 200 MG TABLET|100|EA|1.62647|04/01/2013||Yes|No||04/01/2013||Yes|No|04/01/2013||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|015|No|.43301|03/29/2022|.42261|03/29/2022|.42543|03/29/2022|||ANTIPARKINSON'S AGENTS|10912|||||No|No||SUN PHARMA GLOB|No||||
tadalafil|No|No|No|No|75%|47335001083|TADALAFIL 5 MG TABLET|30|EA|.35833|10/05/2021||Yes|No||10/05/2021||Yes|No|10/05/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|01/30/2020|003|Yes|.13737|03/29/2022|.13407|03/29/2022|.13496|03/29/2022|||BPH TREATMENTS|10913|||||No|No||SUN PHARMA GLOB|No||||
bosentan|No|No|No|No|75%|47335003886|BOSENTAN 62.5 MG TABLET|60|EA|8.33598|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/26/2018|171|No|18.99828|09/21/2021|18.72687|09/14/2021|17.83512|09/14/2021|||PAH AGENTS: ORAL AND INHALED|10914|||||No|No||SUN PHARMA GLOB|No||||
bosentan|No|No|No|No|75%|47335003986|BOSENTAN 125 MG TABLET|60|EA|8.33598|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/26/2018|171|No|18.99828|09/21/2021|18.72687|09/14/2021|17.83512|09/14/2021|||PAH AGENTS: ORAL AND INHALED|10915|||||No|No||SUN PHARMA GLOB|No||||
dofetilide|No|No|No|No|75%|47335006186|DOFETILIDE 125 MCG CAPSULE|60|EA|.688|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No|||No|1.27252|03/29/2022|1.24197|03/29/2022|1.25025|03/29/2022||||10916|||||No|No||SUN PHARMA GLOB|No||||
dofetilide|No|No|No|No|75%|47335006286|DOFETILIDE 250 MCG CAPSULE|60|EA|.688|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No|||No|.89477|03/29/2022|.87329|03/29/2022|.87911|03/29/2022||||10917|||||No|No||SUN PHARMA GLOB|No||||
dofetilide|No|No|No|No|75%|47335006386|DOFETILIDE 500 MCG CAPSULE|60|EA|.688|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No|||No|.90796|03/29/2022|.88616|03/29/2022|.89207|03/29/2022||||10918|||||No|No||SUN PHARMA GLOB|No||||
tobramycin in 0.225% sod chlor|No|No|No|No|75%|47335017149|TOBRAMYCIN 300 MG/5 ML AMPULE|5|ML|2.88721|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No|Submit HHS Form 1143|||No|No|||Prescription required|Yes|12/01/2021|240|No|3.76543|05/25/2021|3.67505|05/25/2021|3.69953|05/25/2021|||ANTIBIOTICS: INHALED|10919|||||No|No||SUN PHARMA GLOB|No||||
tildrakizumab-asmn|No|No|No|No|75%|47335017795|ILUMYA 100 MG/ML SYRINGE|1|ML|6659.582|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|071|Yes|15177.652|11/02/2021|14960.8284|11/02/2021|14248.408|11/02/2021|||CYTOKINE AND CAM ANTAGONISTS|10920|||||No|No||SUN PHARMA GLOB|No||||
tetrabenazine|No|No|No|No|75%|47335017923|TETRABENAZINE 25 MG TABLET|112|EA|11.24891|11/09/2016||Yes|No||11/09/2016||Yes|No|11/09/2016||Yes|No||||No|No|||Prescription required|No||572|Yes|25.63705|10/15/2019|25.27081|10/15/2019|24.06743|10/15/2019|||MOVEMENT DISORDERS|10921|||||No|No||SUN PHARMACEUTI|No||||
carbidopa/levodopa|No|No|No|No|75%|47335018688|CARBIDOPA-LEVO 10-100 MG ODT|100|EA|.33432|06/09/2015||Yes|No||06/09/2015||Yes|No|06/09/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|015|No|.76195|01/25/2022|.75106|01/25/2022|.7153|01/25/2022|||ANTIPARKINSON'S AGENTS|10922|||||No|No||SUN PHARMACEUTI|No||||
carbidopa/levodopa|No|No|No|No|75%|47335018788|CARBIDOPA-LEVO 25-100 MG ODT|100|EA|.37754|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|015|No|.65376|12/28/2021|.63806|12/28/2021|.64231|12/28/2021|||ANTIPARKINSON'S AGENTS|10923|||||No|No||SUN PHARMA GLOB|No||||
carbidopa/levodopa|No|No|No|No|75%|47335018888|CARBIDOPA-LEVO 25-250 MG ODT|100|EA|.48095|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|015|No|1.09613|02/03/2021|1.08047|02/03/2021|1.02902|02/03/2021|||ANTIPARKINSON'S AGENTS|10924|||||No|No||SUN PHARMA GLOB|No||||
methotrexate sodium|No|No|No|No|75%|47335023583|METHOTREXATE 2.5 MG TABLET|100|EA|.31175|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||||No|No|||Prescription required|No|||No|.26817|03/29/2022|.26173|03/29/2022|.26347|03/29/2022||||10925|||||No|No||SUN PHARMA GLOB|No||||
methotrexate sodium|No|No|No|No|75%|47335023596|METHOTREXATE 2.5 MG TABLET|36|EA|.31175|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||||No|No|||Prescription required|No|||No|.26817|03/29/2022|.26173|03/29/2022|.26347|03/29/2022||||10926|||||No|No||SUN PHARMA GLOB|No||||
ambrisentan|No|No|No|No|75%|47335023683|AMBRISENTAN 5 MG TABLET|30|EA|107.5|02/05/2021||Yes|No||02/05/2021||Yes|No|02/05/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|No|245|02/05/2021|241.5|02/05/2021|230|02/05/2021|||PAH AGENTS: ORAL AND INHALED|10927|||||No|No||SUN PHARMA GLOB|No||||
ambrisentan|No|No|No|No|75%|47335023783|AMBRISENTAN 10 MG TABLET|30|EA|107.5|02/05/2021||Yes|No||02/05/2021||Yes|No|02/05/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|No|245|02/05/2021|241.5|02/05/2021|230|02/05/2021|||PAH AGENTS: ORAL AND INHALED|10928|||||No|No||SUN PHARMA GLOB|No||||
sumatriptan succinate|No|No|No|No|75%|47335027641|SUMATRIPTAN 6 MG/0.5 ML INJECT|.5|ML|65.79|06/30/2011||Yes|No||06/30/2011||Yes|No|06/30/2011||Yes|No||||No|No|||Prescription required|No||021|No|76.75855|03/29/2022|74.91634|03/29/2022|75.41527|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|10929|||||No|No||SUN PHARMA GLOB|No||||
tetrabenazine|No|No|No|No|75%|47335027723|TETRABENAZINE 12.5 MG TABLET|112|EA|5.62447|11/09/2016||Yes|No||11/09/2016||Yes|No|11/09/2016||Yes|No||||No|No|||Prescription required|No||572|Yes|12.81856|10/15/2019|12.63544|10/15/2019|12.03375|10/15/2019|||MOVEMENT DISORDERS|10930|||||No|No||SUN PHARMACEUTI|No||||
caffeine citrate|No|No|No|No|75%|47335028927|CAFFEINE CIT 60 MG/3 ML VIAL|3|ML|5.01666|08/13/2014||Yes|No||08/13/2014||Yes|No|08/13/2014||Yes|No||||No|No|||Prescription required|No|||No|11.43332|06/01/2016|11.26999|06/01/2016|10.73332|06/01/2016||||10931|||||No|No||SUN PHARMA GLOB|No||||
caffeine citrate|No|No|No|No|75%|47335028940|CAFFEINE CIT 60 MG/3 ML VIAL|3|ML|5.01666|06/19/2014||Yes|No||06/19/2014||Yes|No|06/19/2014||Yes|No||||No|No|||Prescription required|No|||No|11.43332|06/01/2016|11.26999|06/01/2016|10.73332|06/01/2016||||10932|||||No|No||SUN PHARMA GLOB|No||||
zolpidem tartrate|No|No|No|No|90%|47335030888|ZOLPIDEM TART ER 12.5 MG TAB|100|EA|.3225|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|Yes|11/23/2017|054|Yes|.24181|03/29/2022|.236|03/29/2022|.23757|03/29/2022|||SEDATIVE HYPNOTICS|10933|||||No|No||SUN PHARMA GLOB|No||||
memantine HCl|No|No|No|No|75%|47335032186|MEMANTINE HCL 5 MG TABLET|60|EA|.08778|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No||011|No|.08825|03/29/2022|.08613|03/29/2022|.0867|03/29/2022|||ALZHEIMER'S AGENTS|10934|||||No|No||SUN PHARMA GLOB|No||||
memantine HCl|No|No|No|No|75%|47335032213|MEMANTINE HCL 10 MG TABLET|500|EA|.13257|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|10935|||||No|No||SUN PHARMA GLOB|No||||
memantine HCl|No|No|No|No|75%|47335032286|MEMANTINE HCL 10 MG TABLET|60|EA|.08778|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|10936|||||No|No||SUN PHARMA GLOB|No||||
naltrexone HCl|No|No|No|No|75%|47335032683|NALTREXONE 50 MG TABLET|30|EA|.86|06/05/2012||Yes|No||06/05/2012||Yes|No|06/05/2012||Yes|No||||No|No|||Prescription required|No||145|No|.75734|03/29/2022|.73916|03/29/2022|.74408|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|10937|||||No|No||SUN PHARMA GLOB|Yes|09/01/2020|||
naltrexone HCl|No|No|No|No|75%|47335032688|NALTREXONE 50 MG TABLET|100|EA|.86|06/05/2012||Yes|No||06/05/2012||Yes|No|06/05/2012||Yes|No||||No|No|||Prescription required|No||145|No|.75734|03/29/2022|.73916|03/29/2022|.74408|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|10938|||||No|No||SUN PHARMA GLOB|Yes|09/01/2020|||
cetirizine HCl|No|No|No|No|75%|47335034383|CHILD CETIRIZINE 5 MG CHEW TAB|30|EA|.71451|12/07/2012||Yes|No||||No|No|12/07/2012||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|1.81079|03/29/2022|1.76733|03/29/2022|1.7791|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10939|||||No|No||SUN PHARMA GLOB|No||||
cetirizine HCl|No|No|No|No|75%|47335034483|CHILD CETIRIZINE 10 MG CHEW TB|30|EA|.71451|12/07/2012||Yes|No||||No|No|12/07/2012||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|2.03003|01/25/2022|1.9813|01/25/2022|1.9945|01/25/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|10940|||||No|No||SUN PHARMA GLOB|No||||
cinacalcet HCl|No|No|No|No|75%|47335037983|CINACALCET HCL 30 MG TABLET|30|EA|2.43666|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No|||No|.75588|03/29/2022|.73773|03/29/2022|.74265|03/29/2022||||10941|||||No|No||SUN PHARMA GLOB|No||||
cinacalcet HCl|No|No|No|No|75%|47335038083|CINACALCET HCL 60 MG TABLET|30|EA|4.80166|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No|||No|1.7407|03/29/2022|1.69892|03/29/2022|1.71023|03/29/2022||||10942|||||No|No||SUN PHARMA GLOB|No||||
duloxetine HCl|No|No|No|No|75%|47335038186|DULOXETINE HCL DR 20 MG CAP|60|EA|.129|12/13/2013|09/02/2022|Yes|No||12/13/2013|09/02/2022|Yes|No|12/13/2013|09/02/2022|Yes|No||||No|No|||Prescription required|No||232|No|.13163|03/29/2022|.12847|03/29/2022|.12932|03/29/2022|||NEUROPATHIC PAIN|10943|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||SUN PHARMA GLOB|No||||
duloxetine HCl|No|No|No|No|75%|47335038188|DULOXETINE HCL DR 20 MG CAP|100|EA|.40996|12/13/2013||Yes|No||12/13/2013||Yes|No|12/13/2013||Yes|No||||No|No|||Prescription required|No||232|No|.13163|03/29/2022|.12847|03/29/2022|.12932|03/29/2022|||NEUROPATHIC PAIN|10944|||||No|No||SUN PHARMA GLOB|No||||
duloxetine HCl|No|No|No|No|75%|47335038281|DULOXETINE HCL DR 30 MG CAP|90|EA|.129|12/13/2013|09/02/2022|Yes|No||12/13/2013|09/02/2022|Yes|No|12/13/2013|09/02/2022|Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|10945|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||SUN PHARMA GLOB|No||||
duloxetine HCl|No|No|No|No|75%|47335038283|DULOXETINE HCL DR 30 MG CAP|30|EA|.129|12/13/2013|09/02/2022|Yes|No||12/13/2013|09/02/2022|Yes|No|12/13/2013|09/02/2022|Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|10946|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||SUN PHARMA GLOB|No||||
duloxetine HCl|No|No|No|No|75%|47335038318|DULOXETINE HCL DR 60 MG CAP|1000|EA|.129|12/13/2013|09/02/2022|Yes|No||12/13/2013|09/02/2022|Yes|No|12/13/2013|09/02/2022|Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|10947|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||SUN PHARMA GLOB|No||||
duloxetine HCl|No|No|No|No|75%|47335038383|DULOXETINE HCL DR 60 MG CAP|30|EA|.129|12/13/2013|09/02/2022|Yes|No||12/13/2013|09/02/2022|Yes|No|12/13/2013|09/02/2022|Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|10948|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||SUN PHARMA GLOB|No||||
abiraterone acet,submicronized|No|No|No|No|75%|47335040181|YONSA 125 MG TABLET|120|EA|33.98888|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No||||No|No|||Prescription required|No||550|No|77.46303|02/05/2019|76.35641|02/05/2019|72.72039|02/05/2019|||ONCOLOGY: ORAL - PROSTATE|10949|||||No|No||SUN PHARMA GLOB|No||||
imatinib mesylate|No|No|No|No|75%|47335047281|IMATINIB MESYLATE 100 MG TAB|90|EA|.70471|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|No||173|No|1.6061|07/27/2021|1.58315|07/27/2021|1.50776|07/27/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|10950|||||No|No||SUN PHARMA GLOB|No||||
imatinib mesylate|No|No|No|No|75%|47335047583|IMATINIB MESYLATE 400 MG TAB|30|EA|2.1672|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|No||173|No|2.86988|03/01/2022|2.801|03/01/2022|2.81965|03/01/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|10951|||||No|No||SUN PHARMA GLOB|No||||
bicalutamide|No|No|No|No|75%|47335048583|BICALUTAMIDE 50 MG TABLET|30|EA|.215|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|No||550|No|.3381|03/29/2022|.32998|03/29/2022|.33218|03/29/2022|||ONCOLOGY: ORAL - PROSTATE|10952|||||No|No||SUN PHARMA GLOB|No||||
bicalutamide|No|No|No|No|75%|47335048588|BICALUTAMIDE 50 MG TABLET|100|EA|.215|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|No||550|No|.3381|03/29/2022|.32998|03/29/2022|.33218|03/29/2022|||ONCOLOGY: ORAL - PROSTATE|10953|||||No|No||SUN PHARMA GLOB|No||||
tramadol HCl|No|No|No|No|90%|47335053183|TRAMADOL ER 100 MG TABLET|30|EA|.81728|12/23/2011||Yes|No||12/23/2011||Yes|No|12/23/2011||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|1.86264|03/01/2022|1.83603|03/01/2022|1.7486|03/01/2022|||ANALGESICS: NARCOTICS LONG|10954|||||No|No||SUN PHARMA GLOB|No||||
tramadol HCl|No|No|No|No|90%|47335053188|TRAMADOL ER 100 MG TABLET|100|EA|.7764|12/23/2011||Yes|No||12/23/2011||Yes|No|12/23/2011||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|1.76948|03/01/2022|1.7442|03/01/2022|1.66115|03/01/2022|||ANALGESICS: NARCOTICS LONG|10955|||||No|No||SUN PHARMA GLOB|No||||
tramadol HCl|No|No|No|No|90%|47335053383|TRAMADOL ER 200 MG TABLET|30|EA|1.3426|12/23/2011||Yes|No||12/23/2011||Yes|No|12/23/2011||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|2.388|06/29/2021|2.33068|06/29/2021|2.34621|06/29/2021|||ANALGESICS: NARCOTICS LONG|10956|||||No|No||SUN PHARMA GLOB|No||||
tramadol HCl|No|No|No|No|90%|47335053388|TRAMADOL ER 200 MG TABLET|100|EA|1.27546|12/23/2011||Yes|No||12/23/2011||Yes|No|12/23/2011||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|2.388|06/29/2021|2.33068|06/29/2021|2.34621|06/29/2021|||ANALGESICS: NARCOTICS LONG|10957|||||No|No||SUN PHARMA GLOB|No||||
tramadol HCl|No|No|No|No|90%|47335053783|TRAMADOL ER 300 MG TABLET|30|EA|1.77274|12/23/2011||Yes|No||12/23/2011||Yes|No|12/23/2011||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|4.0402|07/27/2021|3.98248|07/27/2021|3.79284|07/27/2021|||ANALGESICS: NARCOTICS LONG|10958|||||No|No||SUN PHARMA GLOB|No||||
tramadol HCl|No|No|No|No|90%|47335053788|TRAMADOL ER 300 MG TABLET|100|EA|1.68409|12/23/2011||Yes|No||12/23/2011||Yes|No|12/23/2011||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|3.83817|07/27/2021|3.78333|07/27/2021|3.60318|07/27/2021|||ANALGESICS: NARCOTICS LONG|10959|||||No|No||SUN PHARMA GLOB|No||||
niacin|No|No|No|No|75%|47335053981|NIACIN ER 500 MG TABLET|90|EA|.172|07/01/2014||Yes|No||07/01/2014||Yes|No|07/01/2014||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|Yes|.21332|03/29/2022|.2082|03/29/2022|.20958|03/29/2022|||LIPOTROPICS: OTHER|10960|||||No|No||SUN PHARMA GLOB|No||||
cinacalcet HCl|No|No|No|No|75%|47335060083|CINACALCET HCL 90 MG TABLET|30|EA|5.59|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No|||No|3.64673|03/29/2022|3.5592|03/29/2022|3.58291|03/29/2022||||10961|||||No|No||SUN PHARMA GLOB|No||||
alprazolam|No|No|No|No|90%|47335060313|ALPRAZOLAM 0.25 MG TABLET|500|EA|.0144|11/23/2010||Yes|No||11/23/2010||Yes|No|11/23/2010||Yes|No||||No|No|||Prescription required|No||090|Yes|.02093|03/29/2022|.02042|03/29/2022|.02056|03/29/2022|||ANXIOLYTICS|10962|||||No|No||SUN PHARMA GLOB|No||||
alprazolam|No|No|No|No|90%|47335060318|ALPRAZOLAM 0.25 MG TABLET|1000|EA|.0144|11/23/2010||Yes|No||11/23/2010||Yes|No|11/23/2010||Yes|No||||No|No|||Prescription required|No||090|Yes|.02093|03/29/2022|.02042|03/29/2022|.02056|03/29/2022|||ANXIOLYTICS|10963|||||No|No||SUN PHARMA GLOB|No||||
alprazolam|No|No|No|No|90%|47335060388|ALPRAZOLAM 0.25 MG TABLET|100|EA|.0144|11/23/2010||Yes|No||11/23/2010||Yes|No|11/23/2010||Yes|No||||No|No|||Prescription required|No||090|Yes|.02093|03/29/2022|.02042|03/29/2022|.02056|03/29/2022|||ANXIOLYTICS|10964|||||No|No||SUN PHARMA GLOB|No||||
alprazolam|No|No|No|No|90%|47335060413|ALPRAZOLAM 0.5 MG TABLET|500|EA|.01849|11/23/2010||Yes|No||11/23/2010||Yes|No|11/23/2010||Yes|No||||No|No|||Prescription required|No||090|Yes|.0228|03/29/2022|.02225|03/29/2022|.0224|03/29/2022|||ANXIOLYTICS|10965|||||No|No||SUN PHARMA GLOB|No||||
alprazolam|No|No|No|No|90%|47335060418|ALPRAZOLAM 0.5 MG TABLET|1000|EA|.01849|11/23/2010||Yes|No||11/23/2010||Yes|No|11/23/2010||Yes|No||||No|No|||Prescription required|No||090|Yes|.0228|03/29/2022|.02225|03/29/2022|.0224|03/29/2022|||ANXIOLYTICS|10966|||||No|No||SUN PHARMA GLOB|No||||
alprazolam|No|No|No|No|90%|47335060513|ALPRAZOLAM 1 MG TABLET|500|EA|.02042|11/23/2010||Yes|No||11/23/2010||Yes|No|11/23/2010||Yes|No||||No|No|||Prescription required|No||090|Yes|.02503|03/29/2022|.02442|03/29/2022|.02459|03/29/2022|||ANXIOLYTICS|10967|||||No|No||SUN PHARMA GLOB|No||||
alprazolam|No|No|No|No|90%|47335060588|ALPRAZOLAM 1 MG TABLET|100|EA|.02042|11/23/2010||Yes|No||11/23/2010||Yes|No|11/23/2010||Yes|No||||No|No|||Prescription required|No||090|Yes|.02503|03/29/2022|.02442|03/29/2022|.02459|03/29/2022|||ANXIOLYTICS|10968|||||No|No||SUN PHARMA GLOB|No||||
alprazolam|No|No|No|No|90%|47335060688|ALPRAZOLAM 2 MG TABLET|100|EA|.04773|05/15/2011||Yes|No||05/15/2011||Yes|No|05/15/2011||Yes|No||||No|No|||Prescription required|No||090|Yes|.0533|03/29/2022|.05202|03/29/2022|.05236|03/29/2022|||ANXIOLYTICS|10969|||||No|No||SUN PHARMA GLOB|No||||
niacin|No|No|No|No|75%|47335061381|NIACIN ER 1,000 MG TABLET|90|EA|.27471|07/01/2014||Yes|No||07/01/2014||Yes|No|07/01/2014||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.4737|03/29/2022|.46233|03/29/2022|.46541|03/29/2022|||LIPOTROPICS: OTHER|10970|||||No|No||SUN PHARMA GLOB|No||||
niacin|No|No|No|No|75%|47335061481|NIACIN ER 750 MG TABLET|90|EA|.26277|07/01/2014||Yes|No||07/01/2014||Yes|No|07/01/2014||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.52604|03/29/2022|.51341|03/29/2022|.51683|03/29/2022|||LIPOTROPICS: OTHER|10971|||||No|No||SUN PHARMA GLOB|No||||
budesonide|No|No|No|No|75%|47335063149|BUDESONIDE 0.25 MG/2 ML SUSP|2|ML|.60916|09/29/2021||Yes|No||09/29/2021||Yes|No|09/29/2021||Yes|No||||No|No|||Prescription required|No||033|Yes|.8321|03/29/2022|.81212|03/29/2022|.81753|03/29/2022|||GLUCOCORTICOIDS: INHALED|10972|||||No|No||SUN PHARMA GLOB|No||||
budesonide|No|No|No|No|75%|47335063249|BUDESONIDE 0.5 MG/2 ML SUSP|2|ML|.64141|09/29/2021||Yes|No||09/29/2021||Yes|No|09/29/2021||Yes|No||||No|No|||Prescription required|No||033|Yes|.57313|03/29/2022|.55937|03/29/2022|.5631|03/29/2022|||GLUCOCORTICOIDS: INHALED|10973|||||No|No||SUN PHARMA GLOB|No||||
budesonide|No|No|No|No|75%|47335063349|BUDESONIDE 1 MG/2 ML INH SUSP|2|ML|2.15|09/29/2021||Yes|No||09/29/2021||Yes|No|09/29/2021||Yes|No||||No|No|||Prescription required|No||033|Yes|3.95849|03/29/2022|3.86348|03/29/2022|3.88921|03/29/2022|||GLUCOCORTICOIDS: INHALED|10974|||||No|No||SUN PHARMA GLOB|No||||
risedronate sodium|No|No|No|No|75%|47335066862|RISEDRONATE SODIUM 35 MG TAB|12|EA|5.32805|03/16/2016||Yes|No||03/16/2016||Yes|No|03/16/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|060|No|2.85532|03/29/2022|2.78679|03/29/2022|2.80535|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|10975|||||No|No||SUN PHARMACEUTI|No||||
risedronate sodium|No|No|No|No|75%|47335066868|RISEDRONATE SODIUM 35 MG TAB|4|EA|5.32877|03/16/2016||Yes|No||03/16/2016||Yes|No|03/16/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|060|No|2.85532|03/29/2022|2.78679|03/29/2022|2.80535|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|10976|||||No|No||SUN PHARMACEUTI|No||||
diltiazem HCl|No|No|No|No|75%|47335066913|DILTIAZEM 24HR ER 120 MG CAP|500|EA|.28977|12/20/2010||Yes|No||12/20/2010||Yes|No|12/20/2010||Yes|No||||No|No|||Prescription required|No||045|No|.26247|03/29/2022|.25617|03/29/2022|.25787|03/29/2022|||CALCIUM CHANNEL BLOCKERS|10977|||||No|No||SUN PHARMA GLOB|No||||
diltiazem HCl|No|No|No|No|75%|47335066981|DILTIAZEM 24HR ER 120 MG CAP|90|EA|.28976|12/20/2010||Yes|No||12/20/2010||Yes|No|12/20/2010||Yes|No||||No|No|||Prescription required|No||045|No|.26247|03/29/2022|.25617|03/29/2022|.25787|03/29/2022|||CALCIUM CHANNEL BLOCKERS|10978|||||No|No||SUN PHARMA GLOB|No||||
diltiazem HCl|No|No|No|No|75%|47335067013|DILTIAZEM 24HR ER 180 MG CAP|500|EA|.34971|12/20/2010||Yes|No||12/20/2010||Yes|No|12/20/2010||Yes|No||||No|No|||Prescription required|No||045|No|.32818|03/29/2022|.3203|03/29/2022|.32243|03/29/2022|||CALCIUM CHANNEL BLOCKERS|10979|||||No|No||SUN PHARMA GLOB|No||||
diltiazem HCl|No|No|No|No|75%|47335067081|DILTIAZEM 24HR ER 180 MG CAP|90|EA|.34973|12/20/2010||Yes|No||12/20/2010||Yes|No|12/20/2010||Yes|No||||No|No|||Prescription required|No||045|No|.32818|03/29/2022|.3203|03/29/2022|.32243|03/29/2022|||CALCIUM CHANNEL BLOCKERS|10980|||||No|No||SUN PHARMA GLOB|No||||
diltiazem HCl|No|No|No|No|75%|47335067113|DILTIAZEM 24HR ER 240 MG CAP|500|EA|.47906|12/20/2010||Yes|No||12/20/2010||Yes|No|12/20/2010||Yes|No||||No|No|||Prescription required|No||045|No|.46814|03/29/2022|.4569|03/29/2022|.45994|03/29/2022|||CALCIUM CHANNEL BLOCKERS|10981|||||No|No||SUN PHARMA GLOB|No||||
diltiazem HCl|No|No|No|No|75%|47335067181|DILTIAZEM 24HR ER 240 MG CAP|90|EA|.49616|12/20/2010||Yes|No||12/20/2010||Yes|No|12/20/2010||Yes|No||||No|No|||Prescription required|No||045|No|.46814|03/29/2022|.4569|03/29/2022|.45994|03/29/2022|||CALCIUM CHANNEL BLOCKERS|10982|||||No|No||SUN PHARMA GLOB|No||||
diltiazem HCl|No|No|No|No|75%|47335067213|DILTIAZEM 24HR ER 300 MG CAP|500|EA|.64293|12/20/2010||Yes|No||12/20/2010||Yes|No|12/20/2010||Yes|No||||No|No|||Prescription required|No||045|No|.70564|03/29/2022|.6887|03/29/2022|.69329|03/29/2022|||CALCIUM CHANNEL BLOCKERS|10983|||||No|No||SUN PHARMA GLOB|No||||
diltiazem HCl|No|No|No|No|75%|47335067281|DILTIAZEM 24HR ER 300 MG CAP|90|EA|.64285|12/20/2010||Yes|No||12/20/2010||Yes|No|12/20/2010||Yes|No||||No|No|||Prescription required|No||045|No|.70564|03/29/2022|.6887|03/29/2022|.69329|03/29/2022|||CALCIUM CHANNEL BLOCKERS|10984|||||No|No||SUN PHARMA GLOB|No||||
diltiazem HCl|No|No|No|No|75%|47335067313|DILTIAZEM 24HR ER 360 MG CAP|500|EA|.65527|12/20/2010||Yes|No||12/20/2010||Yes|No|12/20/2010||Yes|No||||No|No|||Prescription required|No||045|No|.55311|03/29/2022|.53983|03/29/2022|.54343|03/29/2022|||CALCIUM CHANNEL BLOCKERS|10985|||||No|No||SUN PHARMA GLOB|No||||
diltiazem HCl|No|No|No|No|75%|47335067381|DILTIAZEM 24HR ER 360 MG CAP|90|EA|.65526|12/20/2010||Yes|No||12/20/2010||Yes|No|12/20/2010||Yes|No||||No|No|||Prescription required|No||045|No|.55311|03/29/2022|.53983|03/29/2022|.54343|03/29/2022|||CALCIUM CHANNEL BLOCKERS|10986|||||No|No||SUN PHARMA GLOB|No||||
albuterol sulfate|No|No|No|No|75%|47335070349|ALBUTEROL SUL 2.5 MG/3 ML SOLN|3|ML|.02293|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No||037|Yes|.04199|03/29/2022|.04098|03/29/2022|.04125|03/29/2022|||BRONCHODILATORS: BETA AGONIST|10987|||||No|No||SUN PHARMA GLOB|No||||
albuterol sulfate|No|No|No|No|75%|47335070352|ALBUTEROL SUL 2.5 MG/3 ML SOLN|3|ML|.02293|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No||037|Yes|.04903|03/29/2022|.04785|03/29/2022|.04817|03/29/2022|||BRONCHODILATORS: BETA AGONIST|10988|||||No|No||SUN PHARMA GLOB|No||||
albuterol sulfate|No|No|No|No|75%|47335070354|ALBUTEROL SUL 2.5 MG/3 ML SOLN|3|ML|.02293|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No||037|Yes|.04406|03/29/2022|.043|03/29/2022|.04328|03/29/2022|||BRONCHODILATORS: BETA AGONIST|10989|||||No|No||SUN PHARMA GLOB|No||||
ipratropium bromide|No|No|No|No|75%|47335070649|IPRATROPIUM BR 0.02% SOLN|2.5|ML|.0258|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||||No|No|||Prescription required|No||098|No|.05484|03/29/2022|.05352|03/29/2022|.05388|03/29/2022|||COPD AGENTS|10990|||||No|No||SUN PHARMA GLOB|No||||
ipratropium bromide|No|No|No|No|75%|47335070652|IPRATROPIUM BR 0.02% SOLN|2.5|ML|.0258|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||||No|No|||Prescription required|No||098|No|.05788|03/29/2022|.05649|03/29/2022|.05686|03/29/2022|||COPD AGENTS|10991|||||No|No||SUN PHARMA GLOB|No||||
ipratropium bromide|No|No|No|No|75%|47335070654|IPRATROPIUM BR 0.02% SOLN|2.5|ML|.0258|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||||No|No|||Prescription required|No||098|No|.0599|03/29/2022|.05846|03/29/2022|.05885|03/29/2022|||COPD AGENTS|10992|||||No|No||SUN PHARMA GLOB|No||||
topiramate|No|No|No|No|75%|47335070713|TOPIRAMATE 25 MG TABLET|500|EA|.02866|02/19/2016||Yes|No||02/19/2016||Yes|No|02/19/2016||Yes|No||||No|No|||Prescription required|No||056|No|.03423|03/29/2022|.0334|03/29/2022|.03363|03/29/2022|||ANTICONVULSANTS|10993|||||No|No||SUN PHARMA GLOB|No||||
topiramate|No|No|No|No|75%|47335070786|TOPIRAMATE 25 MG TABLET|60|EA|.02866|02/19/2016||Yes|No||02/19/2016||Yes|No|02/19/2016||Yes|No||||No|No|||Prescription required|No||056|No|.03423|03/29/2022|.0334|03/29/2022|.03363|03/29/2022|||ANTICONVULSANTS|10994|||||No|No||SUN PHARMA GLOB|No||||
topiramate|No|No|No|No|75%|47335071013|TOPIRAMATE 50 MG TABLET|500|EA|.03906|02/19/2016||Yes|No||02/19/2016||Yes|No|02/19/2016||Yes|No||||No|No|||Prescription required|No||056|No|.04588|03/29/2022|.04477|03/29/2022|.04507|03/29/2022|||ANTICONVULSANTS|10995|||||No|No||SUN PHARMA GLOB|No||||
topiramate|No|No|No|No|75%|47335071086|TOPIRAMATE 50 MG TABLET|60|EA|.03905|02/19/2016||Yes|No||02/19/2016||Yes|No|02/19/2016||Yes|No||||No|No|||Prescription required|No||056|No|.04588|03/29/2022|.04477|03/29/2022|.04507|03/29/2022|||ANTICONVULSANTS|10996|||||No|No||SUN PHARMA GLOB|No||||
topiramate|No|No|No|No|75%|47335071113|TOPIRAMATE 100 MG TABLET|500|EA|.05016|02/19/2016||Yes|No||02/19/2016||Yes|No|02/19/2016||Yes|No||||No|No|||Prescription required|No||056|No|.06953|03/29/2022|.06786|03/29/2022|.06831|03/29/2022|||ANTICONVULSANTS|10997|||||No|No||SUN PHARMA GLOB|No||||
topiramate|No|No|No|No|75%|47335071186|TOPIRAMATE 100 MG TABLET|60|EA|.05016|02/19/2016||Yes|No||02/19/2016||Yes|No|02/19/2016||Yes|No||||No|No|||Prescription required|No||056|No|.06953|03/29/2022|.06786|03/29/2022|.06831|03/29/2022|||ANTICONVULSANTS|10998|||||No|No||SUN PHARMA GLOB|No||||
topiramate|No|No|No|No|75%|47335071213|TOPIRAMATE 200 MG TABLET|500|EA|.0645|02/19/2016||Yes|No||02/19/2016||Yes|No|02/19/2016||Yes|No||||No|No|||Prescription required|No||056|No|.12326|03/29/2022|.1203|03/29/2022|.1211|03/29/2022|||ANTICONVULSANTS|10999|||||No|No||SUN PHARMA GLOB|No||||
topiramate|No|No|No|No|75%|47335071286|TOPIRAMATE 200 MG TABLET|60|EA|.0645|02/19/2016||Yes|No||02/19/2016||Yes|No|02/19/2016||Yes|No||||No|No|||Prescription required|No||056|No|.12326|03/29/2022|.1203|03/29/2022|.1211|03/29/2022|||ANTICONVULSANTS|11000|||||No|No||SUN PHARMA GLOB|No||||
finasteride|No|No|No|No|75%|47335071513|FINASTERIDE 5 MG TABLET|500|EA|.1505|09/28/2011||Yes|No||09/28/2011||Yes|No|09/28/2011||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|11001|||||No|No||SUN PHARMA GLOB|No||||
finasteride|No|No|No|No|75%|47335071581|FINASTERIDE 5 MG TABLET|90|EA|.15288|09/28/2011||Yes|No||09/28/2011||Yes|No|09/28/2011||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|11002|||||No|No||SUN PHARMA GLOB|No||||
finasteride|No|No|No|No|75%|47335071583|FINASTERIDE 5 MG TABLET|30|EA|.15766|09/28/2011||Yes|No||09/28/2011||Yes|No|09/28/2011||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|11003|||||No|No||SUN PHARMA GLOB|No||||
febuxostat|No|No|No|No|75%|47335072183|FEBUXOSTAT 40 MG TABLET|30|EA|1.08804|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|231|No|.89466|03/29/2022|.87318|03/29/2022|.879|03/29/2022|||ANTIHYPERURICEMICS|11004|||||No|No||SUN PHARMA GLOB|No||||
febuxostat|No|No|No|No|75%|47335072283|FEBUXOSTAT 80 MG TABLET|30|EA|1.08804|09/01/2021||Yes|No||09/01/2021||Yes|No|09/01/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|231|No|.93355|03/29/2022|.91114|03/29/2022|.91721|03/29/2022|||ANTIHYPERURICEMICS|11005|||||No|No||SUN PHARMA GLOB|No||||
bupropion HCl|Yes|No|No|No|75%|47335073613|BUPROPION HCL SR 100 MG TABLET|500|EA|.2002|06/21/2010||Yes|No||06/21/2010||Yes|No|06/21/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.11271|03/29/2022|.11|03/29/2022|.11073|03/29/2022|||ANTIDEPRESSANTS: OTHER|11006|||||No|No||SUN PHARMA GLOB|No||||
bupropion HCl|Yes|No|No|No|75%|47335073686|BUPROPION HCL SR 100 MG TABLET|60|EA|.10176|06/21/2010||Yes|No||06/21/2010||Yes|No|06/21/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.11271|03/29/2022|.11|03/29/2022|.11073|03/29/2022|||ANTIDEPRESSANTS: OTHER|11007|||||No|No||SUN PHARMA GLOB|No||||
bupropion HCl|Yes|No|No|No|75%|47335073688|BUPROPION HCL SR 100 MG TABLET|100|EA|.09666|06/21/2010||Yes|No||06/21/2010||Yes|No|06/21/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.11271|03/29/2022|.11|03/29/2022|.11073|03/29/2022|||ANTIDEPRESSANTS: OTHER|11008|||||No|No||SUN PHARMA GLOB|No||||
bupropion HCl|Yes|No|No|No|75%|47335073713|BUPROPION HCL SR 150 MG TABLET|500|EA|.10478|06/21/2010||Yes|No||06/21/2010||Yes|No|06/21/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.10128|03/29/2022|.09884|03/29/2022|.0995|03/29/2022|||ANTIDEPRESSANTS: OTHER|11009|||||No|No||SUN PHARMA GLOB|No||||
bupropion HCl|Yes|No|No|No|75%|47335073786|BUPROPION HCL SR 150 MG TABLET|60|EA|.1161|06/21/2010||Yes|No||06/21/2010||Yes|No|06/21/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.10128|03/29/2022|.09884|03/29/2022|.0995|03/29/2022|||ANTIDEPRESSANTS: OTHER|11010|||||No|No||SUN PHARMA GLOB|No||||
bupropion HCl|Yes|No|No|No|75%|47335073788|BUPROPION HCL SR 150 MG TABLET|100|EA|.11029|06/21/2010||Yes|No||06/21/2010||Yes|No|06/21/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.10128|03/29/2022|.09884|03/29/2022|.0995|03/29/2022|||ANTIDEPRESSANTS: OTHER|11011|||||No|No||SUN PHARMA GLOB|No||||
bupropion HCl|Yes|No|No|No|75%|47335073886|BUPROPION HCL SR 200 MG TABLET|60|EA|.20353|06/21/2010||Yes|No||06/21/2010||Yes|No|06/21/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.16014|03/29/2022|.15629|03/29/2022|.15733|03/29/2022|||ANTIDEPRESSANTS: OTHER|11012|||||No|No||SUN PHARMA GLOB|No||||
levalbuterol HCl|No|No|No|No|75%|47335074349|LEVALBUTEROL 0.31 MG/3 ML SOL|3|ML|.172|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|037|Yes|.392|03/01/2022|.3864|03/01/2022|.368|03/01/2022|||BRONCHODILATORS: BETA AGONIST|11013|||||No|No||SUN PHARMACEUTI|No||||
levalbuterol HCl|No|No|No|No|75%|47335074649|LEVALBUTEROL 0.63 MG/3 ML SOL|3|ML|.172|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|037|Yes|.33369|09/28/2021|.32568|09/28/2021|.32785|09/28/2021|||BRONCHODILATORS: BETA AGONIST|11014|||||No|No||SUN PHARMACEUTI|No||||
levalbuterol HCl|No|No|No|No|75%|47335075349|LEVALBUTEROL 1.25 MG/3 ML SOL|3|ML|.172|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|037|Yes|.40061|09/28/2021|.39099|09/28/2021|.39359|09/28/2021|||BRONCHODILATORS: BETA AGONIST|11015|||||No|No||SUN PHARMACEUTI|No||||
paliperidone|No|No|No|No|75%|47335076783|PALIPERIDONE ER 9 MG TABLET|30|EA|5.91465|04/08/2021||Yes|No||04/08/2021||Yes|No|04/08/2021||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|7.23268|03/29/2022|7.05909|03/29/2022|7.1061|03/29/2022|||ANTIPSYCHOTICS|11016|||||No|No||SUN PHARMA GLOB|No||||
desmopressin (nonrefrigerated)|No|No|No|No|75%|47335078891|DESMOPRESSIN 10 MCG/0.1 ML SPR|5|ML|16.942|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|No|||No|8.29308|03/29/2022|8.09404|03/29/2022|8.14795|03/29/2022||||11017|||||No|No||SUN PHARMA GLOB|No||||
galantamine HBr|No|No|No|No|75%|47335083583|GALANTAMINE ER 8 MG CAPSULE|30|EA|1.97054|08/26/2011||Yes|No||08/26/2011||Yes|No|08/26/2011||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|011|No|1.1683|03/29/2022|1.14026|03/29/2022|1.14785|03/29/2022|||ALZHEIMER'S AGENTS|11018|||||No|No||SUN PHARMA GLOB|No||||
galantamine HBr|No|No|No|No|75%|47335083683|GALANTAMINE ER 16 MG CAPSULE|30|EA|1.97054|08/26/2011||Yes|No||08/26/2011||Yes|No|08/26/2011||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|011|No|1.23595|03/29/2022|1.20628|03/29/2022|1.21432|03/29/2022|||ALZHEIMER'S AGENTS|11019|||||No|No||SUN PHARMA GLOB|No||||
galantamine HBr|No|No|No|No|75%|47335083783|GALANTAMINE ER 24 MG CAPSULE|30|EA|1.97054|08/26/2011||Yes|No||08/26/2011||Yes|No|08/26/2011||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|011|No|1.24993|03/29/2022|1.21993|03/29/2022|1.22805|03/29/2022|||ALZHEIMER'S AGENTS|11020|||||No|No||SUN PHARMA GLOB|No||||
tramadol HCl|No|No|No|No|90%|47335085983|TRAMADOL HCL ER 100 MG TABLET|30|EA|1.15885|02/10/2012||Yes|No||02/12/2012||Yes|No|02/10/2012||Yes|No||||No|No|||Prescription required|No||110|Yes|.97069|03/29/2022|.94739|03/29/2022|.9537|03/29/2022|||ANALGESICS: NARCOTICS LONG|11021|||||No|No||SUN PHARMA GLOB|No||||
tramadol HCl|No|No|No|No|90%|47335086083|TRAMADOL HCL ER 200 MG TABLET|30|EA|1.91636|02/10/2012||Yes|No||02/10/2012||Yes|No|02/10/2012||Yes|No||||No|No|||Prescription required|No||110|Yes|1.59713|03/29/2022|1.55879|03/29/2022|1.56918|03/29/2022|||ANALGESICS: NARCOTICS LONG|11022|||||No|No||SUN PHARMA GLOB|No||||
tramadol HCl|No|No|No|No|90%|47335086183|TRAMADOL HCL ER 300 MG TABLET|30|EA|3.23001|02/10/2012||Yes|No||02/10/2012||Yes|No|02/10/2012||Yes|No||||No|No|||Prescription required|No||110|Yes|2.08656|03/29/2022|2.03648|03/29/2022|2.05004|03/29/2022|||ANALGESICS: NARCOTICS LONG|11023|||||No|No||SUN PHARMA GLOB|No||||
temozolomide|No|No|No|No|75%|47335089021|TEMOZOLOMIDE 5 MG CAPSULE|14|EA|4.30706|08/14/2014||Yes|No||08/14/2014||Yes|No|08/14/2014||Yes|No||||No|No|||Prescription required|No||239|No|9.81609|06/01/2016|9.67586|06/01/2016|9.2151|06/01/2016|||ONCOLOGY: ORAL - OTHER|11024|||||No|No||SUN PHARMA GLOB|No||||
temozolomide|No|No|No|No|75%|47335089080|TEMOZOLOMIDE 5 MG CAPSULE|5|EA|4.30688|08/14/2014||Yes|No||08/14/2014||Yes|No|08/14/2014||Yes|No||||No|No|||Prescription required|No||239|No|9.81568|06/01/2016|9.67545|06/01/2016|9.21472|06/01/2016|||ONCOLOGY: ORAL - OTHER|11025|||||No|No||SUN PHARMA GLOB|No||||
temozolomide|No|No|No|No|75%|47335089121|TEMOZOLOMIDE 20 MG CAPSULE|14|EA|17.3591|08/14/2014||Yes|No||08/14/2014||Yes|No|08/14/2014||Yes|No||||No|No|||Prescription required|No||239|No|39.5626|06/01/2016|38.99742|06/01/2016|37.1404|06/01/2016|||ONCOLOGY: ORAL - OTHER|11026|||||No|No||SUN PHARMA GLOB|No||||
temozolomide|No|No|No|No|75%|47335089180|TEMOZOLOMIDE 20 MG CAPSULE|5|EA|17.3591|08/14/2014||Yes|No||08/14/2014||Yes|No|08/14/2014||Yes|No||||No|No|||Prescription required|No||239|No|39.5626|06/01/2016|38.99742|06/01/2016|37.1404|06/01/2016|||ONCOLOGY: ORAL - OTHER|11027|||||No|No||SUN PHARMA GLOB|No||||
temozolomide|No|No|No|No|75%|47335089221|TEMOZOLOMIDE 100 MG CAPSULE|14|EA|86.78935|08/14/2014||Yes|No||08/14/2014||Yes|No|08/14/2014||Yes|No||||No|No|||Prescription required|No||239|No|197.79899|11/28/2017|194.97329|11/28/2017|185.68885|11/28/2017|||ONCOLOGY: ORAL - OTHER|11028|||||No|No||SUN PHARMA GLOB|No||||
temozolomide|No|No|No|No|75%|47335089280|TEMOZOLOMIDE 100 MG CAPSULE|5|EA|86.7869|08/14/2014||Yes|No||08/14/2014||Yes|No|08/14/2014||Yes|No||||No|No|||Prescription required|No||239|No|197.7934|11/28/2017|194.96778|11/28/2017|185.6836|11/28/2017|||ONCOLOGY: ORAL - OTHER|11029|||||No|No||SUN PHARMA GLOB|No||||
temozolomide|No|No|No|No|75%|47335089380|TEMOZOLOMIDE 250 MG CAPSULE|5|EA|217.0296|08/14/2014||Yes|No||08/14/2014||Yes|No|08/14/2014||Yes|No||||No|No|||Prescription required|No||239|No|494.6256|06/01/2016|487.55952|06/01/2016|464.3424|06/01/2016|||ONCOLOGY: ORAL - OTHER|11030|||||No|No||SUN PHARMA GLOB|No||||
clopidogrel bisulfate|No|No|No|No|75%|47335089413|CLOPIDOGREL 75 MG TABLET|500|EA|.08956|05/21/2012|10/08/2022|Yes|No||05/21/2012|10/08/2022|Yes|No|05/21/2012|10/08/2022|Yes|No||||No|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|11031|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||SUN PHARMA GLOB|Yes|09/01/2020|||
clopidogrel bisulfate|No|No|No|No|75%|47335089481|CLOPIDOGREL 75 MG TABLET|90|EA|.08958|05/21/2012||Yes|No||05/21/2012||Yes|No|05/21/2012||Yes|No||||No|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|11032|||||No|No||SUN PHARMA GLOB|No||||
clopidogrel bisulfate|No|No|No|No|75%|47335089483|CLOPIDOGREL 75 MG TABLET|30|EA|.08958|05/21/2012||Yes|No||05/21/2012||Yes|No|05/21/2012||Yes|No||||No|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|11033|||||No|No||SUN PHARMA GLOB|No||||
quetiapine fumarate|No|No|No|No|75%|47335090218|QUETIAPINE FUMARATE 25 MG TAB|1000|EA|.07598|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.03239|03/29/2022|.03161|03/29/2022|.03182|03/29/2022|||ANTIPSYCHOTICS|11034|||||No|No||SUN PHARMA GLOB|No||||
quetiapine fumarate|No|No|No|No|75%|47335090288|QUETIAPINE FUMARATE 25 MG TAB|100|EA|.07998|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.03239|03/29/2022|.03161|03/29/2022|.03182|03/29/2022|||ANTIPSYCHOTICS|11035|||||No|No||SUN PHARMA GLOB|No||||
quetiapine fumarate|No|No|No|No|75%|47335090318|QUETIAPINE FUMARATE 50 MG TAB|1000|EA|.12463|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.04283|03/29/2022|.0418|03/29/2022|.04208|03/29/2022|||ANTIPSYCHOTICS|11036|||||No|No||SUN PHARMA GLOB|No||||
quetiapine fumarate|No|No|No|No|75%|47335090388|QUETIAPINE FUMARATE 50 MG TAB|100|EA|.13119|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.04283|03/29/2022|.0418|03/29/2022|.04208|03/29/2022|||ANTIPSYCHOTICS|11037|||||No|No||SUN PHARMA GLOB|No||||
quetiapine fumarate|No|No|No|No|75%|47335090418|QUETIAPINE FUMARATE 100 MG TAB|1000|EA|.1301|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.05826|03/29/2022|.05686|03/29/2022|.05724|03/29/2022|||ANTIPSYCHOTICS|11038|||||No|No||SUN PHARMA GLOB|No||||
quetiapine fumarate|No|No|No|No|75%|47335090488|QUETIAPINE FUMARATE 100 MG TAB|100|EA|.13695|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.05826|03/29/2022|.05686|03/29/2022|.05724|03/29/2022|||ANTIPSYCHOTICS|11039|||||No|No||SUN PHARMA GLOB|No||||
quetiapine fumarate|No|No|No|No|75%|47335090518|QUETIAPINE FUMARATE 200 MG TAB|1000|EA|.24555|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.10261|03/29/2022|.10014|03/29/2022|.10081|03/29/2022|||ANTIPSYCHOTICS|11040|||||No|No||SUN PHARMA GLOB|No||||
quetiapine fumarate|No|No|No|No|75%|47335090588|QUETIAPINE FUMARATE 200 MG TAB|100|EA|.25847|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.10261|03/29/2022|.10014|03/29/2022|.10081|03/29/2022|||ANTIPSYCHOTICS|11041|||||No|No||SUN PHARMA GLOB|No||||
quetiapine fumarate|No|No|No|No|75%|47335090618|QUETIAPINE FUMARATE 300 MG TAB|1000|EA|.32189|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.13964|03/29/2022|.13628|03/29/2022|.13719|03/29/2022|||ANTIPSYCHOTICS|11042|||||No|No||SUN PHARMA GLOB|No||||
quetiapine fumarate|No|No|No|No|75%|47335090686|QUETIAPINE FUMARATE 300 MG TAB|60|EA||03/30/2022||Yes|No||03/30/2022||Yes|No|03/30/2022||Yes|No||||No|No|||Prescription required|No||027|Yes|.13964|03/29/2022|.13628|03/29/2022|.13719|03/29/2022|||ANTIPSYCHOTICS|11043|||||No|No||SUN PHARMA GLOB|No||||
quetiapine fumarate|No|No|No|No|75%|47335090688|QUETIAPINE FUMARATE 300 MG TAB|100|EA|.33884|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.13964|03/29/2022|.13628|03/29/2022|.13719|03/29/2022|||ANTIPSYCHOTICS|11044|||||No|No||SUN PHARMA GLOB|No||||
quetiapine fumarate|No|No|No|No|75%|47335090718|QUETIAPINE FUMARATE 400 MG TAB|1000|EA|.37831|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.17858|03/29/2022|.17429|03/29/2022|.17545|03/29/2022|||ANTIPSYCHOTICS|11045|||||No|No||SUN PHARMA GLOB|No||||
quetiapine fumarate|No|No|No|No|75%|47335090788|QUETIAPINE FUMARATE 400 MG TAB|100|EA|.39822|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.17858|03/29/2022|.17429|03/29/2022|.17545|03/29/2022|||ANTIPSYCHOTICS|11046|||||No|No||SUN PHARMA GLOB|No||||
temozolomide|No|No|No|No|75%|47335092921|TEMOZOLOMIDE 140 MG CAPSULE|14|EA|121.5051|08/14/2014||Yes|No||08/14/2014||Yes|No|08/14/2014||Yes|No||||No|No|||Prescription required|No||239|No|13.83623|07/27/2021|13.50416|07/27/2021|13.59409|07/27/2021|||ONCOLOGY: ORAL - OTHER|11047|||||No|No||SUN PHARMA GLOB|No||||
temozolomide|No|No|No|No|75%|47335092980|TEMOZOLOMIDE 140 MG CAPSULE|5|EA|121.5051|08/14/2014||Yes|No||08/14/2014||Yes|No|08/14/2014||Yes|No||||No|No|||Prescription required|No||239|No|13.83623|07/27/2021|13.50416|07/27/2021|13.59409|07/27/2021|||ONCOLOGY: ORAL - OTHER|11048|||||No|No||SUN PHARMA GLOB|No||||
temozolomide|No|No|No|No|75%|47335093021|TEMOZOLOMIDE 180 MG CAPSULE|14|EA|156.219|08/14/2014||Yes|No||08/14/2014||Yes|No|08/14/2014||Yes|No||||No|No|||Prescription required|No||239|No|356.034|06/01/2016|350.9478|06/01/2016|334.236|06/01/2016|||ONCOLOGY: ORAL - OTHER|11049|||||No|No||SUN PHARMA GLOB|No||||
temozolomide|No|No|No|No|75%|47335093080|TEMOZOLOMIDE 180 MG CAPSULE|5|EA|156.219|08/14/2014||Yes|No||08/14/2014||Yes|No|08/14/2014||Yes|No||||No|No|||Prescription required|No||239|No|356.034|06/01/2016|350.9478|06/01/2016|334.236|06/01/2016|||ONCOLOGY: ORAL - OTHER|11050|||||No|No||SUN PHARMA GLOB|No||||
azelastine HCl|No|No|No|No|75%|47335093890|AZELASTINE HCL 0.05% DROPS|6|ML|2.50833|06/24/2010||Yes|No||06/24/2010||Yes|No|06/24/2010||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|002|No|1.22657|03/29/2022|1.19713|03/29/2022|1.2051|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|11051|||||No|No||SUN PHARMA GLOB|No||||
alfuzosin HCl|No|No|No|No|75%|47335095618|ALFUZOSIN HCL ER 10 MG TABLET|1000|EA|.1505|07/28/2011||Yes|No||07/28/2011||Yes|No|07/28/2011||Yes|No||||No|No|||Prescription required|No||003|No|.12775|03/29/2022|.12468|03/29/2022|.12551|03/29/2022|||BPH TREATMENTS|11052|||||No|No||SUN PHARMA GLOB|No||||
alfuzosin HCl|No|No|No|No|75%|47335095688|ALFUZOSIN HCL ER 10 MG TABLET|100|EA|.1505|07/28/2011||Yes|No||07/28/2011||Yes|No|07/28/2011||Yes|No||||No|No|||Prescription required|No||003|No|.12775|03/29/2022|.12468|03/29/2022|.12551|03/29/2022|||BPH TREATMENTS|11053|||||No|No||SUN PHARMA GLOB|No||||
zolmitriptan|No|No|No|No|75%|47335097863|ZOLMITRIPTAN 2.5 MG TABLET|6|EA|8.815|06/25/2015||Yes|No||06/25/2015||Yes|No|06/25/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|1.43567|03/29/2022|1.40121|03/29/2022|1.41054|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|11054|||||No|No||SUN PHARMA GLOB|No||||
zolmitriptan|No|No|No|No|75%|47335097967|ZOLMITRIPTAN 5 MG TABLET|3|EA|8.815|06/25/2015||Yes|No||06/25/2015||Yes|No|06/25/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|1.62826|03/29/2022|1.58918|03/29/2022|1.59976|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|11055|||||No|No||SUN PHARMA GLOB|No||||
ibandronate sodium|No|No|No|No|75%|47781010307|IBANDRONATE SODIUM 150 MG TAB|1|EA|47.7214|08/20/2014||Yes|No||08/20/2014||Yes|No|08/20/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|060|No|5.47616|03/29/2022|5.34473|03/29/2022|5.38032|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|11056|||||No|No||ALVOGEN INC|No||||
ibandronate sodium|No|No|No|No|75%|47781010333|IBANDRONATE SODIUM 150 MG TAB|3|EA|12.18333|08/20/2014||Yes|No||08/20/2014||Yes|No|08/20/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|060|No|5.47616|03/29/2022|5.34473|03/29/2022|5.38032|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|11057|||||No|No||ALVOGEN INC|No||||
estradiol|No|No|No|No|75%|47781010444|ESTRADIOL 0.01% CREAM|42.5|GM|1.69217|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|No|||Yes|.87976|03/29/2022|.85864|03/29/2022|.86436|03/29/2022||||11058|||||No|No||ALVOGEN INC|No||||
exemestane|No|No|No|No|75%|47781010830|EXEMESTANE 25 MG TABLET|30|EA|1.43333|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|||Prescription required|No||502|No|1.32315|03/29/2022|1.29139|03/29/2022|1.29999|03/29/2022|||ONCOLOGY: ORAL - BREAST|11059|||||No|No||ALVOGEN INC|No||||
naproxen sodium|No|No|No|No|75%|47781015301|NAPROXEN SOD CR 375 MG TABLET|100|EA|4.73|06/20/2016||Yes|No||06/20/2016||Yes|No|06/20/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|10.78|07/26/2016|10.626|07/26/2016|10.12|07/26/2016|||NSAIDS|11060|||||No|No||ALVOGEN INC|No||||
naproxen sodium|No|No|No|No|75%|47781015475|NAPROXEN SOD CR 500 MG TABLET|75|EA|4.87333|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|11.10666|01/26/2021|10.94799|01/26/2021|10.42666|01/26/2021|||NSAIDS|11061|||||No|No||ALVOGEN INC|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|47781019601|OXYCODONE-ACETAMINOPHEN 5-325|100|EA|.07305|06/30/2016||Yes|No||06/30/2016||Yes|No|06/30/2016||Yes|No||||No|No|||Prescription required|No||109|Yes|.09091|03/29/2022|.08872|03/29/2022|.08931|03/29/2022|||ANALGESICS: NARCOTICS SHORT|11062|||||No|No||ALVOGEN INC|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|47781019605|OXYCODONE-ACETAMINOPHEN 5-325|500|EA|.07629|06/30/2016||Yes|No||06/30/2016||Yes|No|06/30/2016||Yes|No||||No|No|||Prescription required|No||109|Yes|.09091|03/29/2022|.08872|03/29/2022|.08931|03/29/2022|||ANALGESICS: NARCOTICS SHORT|11063|||||No|No||ALVOGEN INC|No||||
melphalan|No|No|No|No|75%|47781020050|MELPHALAN 2 MG TABLET|50|EA|3.93854|09/27/2017||Yes|No||09/27/2017||Yes|No|09/27/2017||Yes|No||||No|No|||Prescription required|No||173|No|8.97621|09/27/2017|8.84798|09/27/2017|8.42664|09/27/2017|||ONCOLOGY: ORAL - HEMATOLOGIC|11064|||||No|No||ALVOGEN INC|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|47781022901|OXYCODONE-ACETAMINOPHN 7.5-325|100|EA|.12319|07/24/2012||Yes|No||07/24/2012||Yes|No|07/24/2012||Yes|No||||No|No|||Prescription required|No||109|Yes|.14032|03/29/2022|.13695|03/29/2022|.13786|03/29/2022|||ANALGESICS: NARCOTICS SHORT|11065|||||No|No||ALVOGEN INC|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|47781022905|OXYCODONE-ACETAMINOPHN 7.5-325|500|EA|.12319|07/24/2012||Yes|No||07/24/2012||Yes|No|07/24/2012||Yes|No||||No|No|||Prescription required|No||109|Yes|.14032|03/29/2022|.13695|03/29/2022|.13786|03/29/2022|||ANALGESICS: NARCOTICS SHORT|11066|||||No|No||ALVOGEN INC|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|47781023001|OXYCODONE-ACETAMINOPHEN 10-325|100|EA|.15071|07/24/2012||Yes|No||07/24/2012||Yes|No|07/24/2012||Yes|No||||No|No|||Prescription required|No||109|Yes|.19233|03/29/2022|.18771|03/29/2022|.18896|03/29/2022|||ANALGESICS: NARCOTICS SHORT|11067|||||No|No||ALVOGEN INC|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|47781023005|OXYCODONE-ACETAMINOPHEN 10-325|500|EA|.15071|07/24/2012||Yes|No||07/24/2012||Yes|No|07/24/2012||Yes|No||||No|No|||Prescription required|No||109|Yes|.19233|03/29/2022|.18771|03/29/2022|.18896|03/29/2022|||ANALGESICS: NARCOTICS SHORT|11068|||||No|No||ALVOGEN INC|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|47781023063|OXYCODONE-ACETAMINOPHEN 10-325|250|EA|.15072|08/12/2016||Yes|No||08/12/2016||Yes|No|08/12/2016||Yes|No||||No|No|||Prescription required|No||109|Yes|.19233|03/29/2022|.18771|03/29/2022|.18896|03/29/2022|||ANALGESICS: NARCOTICS SHORT|11069|||||No|No||ALVOGEN INC|No||||
oxycodone HCl|No|No|No|No|90%|47781026301|OXYCODONE HCL (IR) 5 MG TABLET|100|EA|.08901|02/13/2012||Yes|No||02/13/2012||Yes|No|02/13/2012||Yes|No||||No|No|||Prescription required|No||109|Yes|.0685|03/29/2022|.06685|03/29/2022|.0673|03/29/2022|||ANALGESICS: NARCOTICS SHORT|11070|||||No|No||ALVOGEN INC|No||||
oxycodone HCl|No|No|No|No|90%|47781026305|OXYCODONE HCL (IR) 5 MG TABLET|500|EA|.06594|05/15/2014||Yes|No||05/15/2014||Yes|No|05/15/2014||Yes|No||||No|No|||Prescription required|No||109|Yes|.0685|03/29/2022|.06685|03/29/2022|.0673|03/29/2022|||ANALGESICS: NARCOTICS SHORT|11071|||||No|No||ALVOGEN INC|No||||
oxycodone HCl|No|No|No|No|90%|47781026401|OXYCODONE HCL (IR) 15 MG TAB|100|EA|.1864|02/13/2012||Yes|No||02/13/2012||Yes|No|02/13/2012||Yes|No||||No|No|||Prescription required|No||109|Yes|.15895|03/29/2022|.15513|03/29/2022|.15616|03/29/2022|||ANALGESICS: NARCOTICS SHORT|11072|||||No|No||ALVOGEN INC|No||||
oxycodone HCl|No|No|No|No|90%|47781026405|OXYCODONE HCL (IR) 15 MG TAB|500|EA|.11362|05/15/2014||Yes|No||05/15/2014||Yes|No|05/15/2014||Yes|No||||No|No|||Prescription required|No||109|Yes|.15895|03/29/2022|.15513|03/29/2022|.15616|03/29/2022|||ANALGESICS: NARCOTICS SHORT|11073|||||No|No||ALVOGEN INC|No||||
oxycodone HCl|No|No|No|No|90%|47781026501|OXYCODONE HCL (IR) 30 MG TAB|100|EA|.30491|02/13/2012||Yes|No||02/13/2012||Yes|No|02/13/2012||Yes|No||||No|No|||Prescription required|No||109|Yes|.2615|03/29/2022|.25522|03/29/2022|.25692|03/29/2022|||ANALGESICS: NARCOTICS SHORT|11074|||||No|No||ALVOGEN INC|No||||
oxycodone HCl|No|No|No|No|90%|47781026505|OXYCODONE HCL (IR) 30 MG TAB|500|EA|.21371|05/15/2014||Yes|No||05/15/2014||Yes|No|05/15/2014||Yes|No||||No|No|||Prescription required|No||109|Yes|.2615|03/29/2022|.25522|03/29/2022|.25692|03/29/2022|||ANALGESICS: NARCOTICS SHORT|11075|||||No|No||ALVOGEN INC|No||||
nitroglycerin|No|No|No|No|75%|47781029603|NITROGLYCERIN 0.1 MG/HR PATCH|30|EA|.37911|03/10/2011|01/31/2022|Yes|No||03/10/2011|01/31/2022|Yes|No|03/10/2011|01/31/2022|Yes|No||||No|No|||Prescription required|No|||No|.50793|03/29/2022|.49573|03/29/2022|.49904|03/29/2022||||11076|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ALVOGEN INC|No||||
nitroglycerin|No|No|No|No|75%|47781029703|NITROGLYCERIN 0.2 MG/HR PATCH|30|EA|.30386|03/10/2011||Yes|No||03/10/2011||Yes|No|03/10/2011||Yes|No||||No|No|||Prescription required|No|||No|.5028|03/29/2022|.49073|03/29/2022|.494|03/29/2022||||11077|||||No|No||ALVOGEN INC|No||||
nitroglycerin|No|No|No|No|75%|47781029903|NITROGLYCERIN 0.6 MG/HR PATCH|30|EA|.40534|03/10/2011||Yes|No||03/10/2011||Yes|No|03/10/2011||Yes|No||||No|No|||Prescription required|No|||No|.68113|09/28/2021|.66478|09/28/2021|.66921|09/28/2021||||11078|||||No|No||ALVOGEN INC|No||||
nitrofurantoin monohyd/m-cryst|No|No|No|No|75%|47781030301|NITROFURANTOIN MONO-MCR 100 MG|100|EA|.67269|03/10/2011||Yes|No||03/10/2011||Yes|No|03/10/2011||Yes|No||||No|No|||Prescription required|No|||No|.48495|03/29/2022|.47331|03/29/2022|.47646|03/29/2022||||11079|||||No|No||ALVOGEN INC|No||||
rivastigmine|No|No|No|No|75%|47781030403|RIVASTIGMINE 4.6 MG/24HR PATCH|30|EA|4.87706|09/03/2015||Yes|No||09/03/2015||Yes|No|09/03/2015||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|011|No|2.88542|03/29/2022|2.81616|03/29/2022|2.83492|03/29/2022|||ALZHEIMER'S AGENTS|11080|||||No|No||ALVOGEN INC|No||||
rivastigmine|No|No|No|No|75%|47781030503|RIVASTIGMINE 9.5 MG/24HR PATCH|30|EA|4.87706|11/09/2015||Yes|No||11/09/2015||Yes|No|11/09/2015||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|011|No|2.83898|03/29/2022|2.77084|03/29/2022|2.78929|03/29/2022|||ALZHEIMER'S AGENTS|11081|||||No|No||ALVOGEN INC|No||||
nitrofurantoin macrocrystal|No|No|No|No|75%|47781030601|NITROFURANTOIN MCR 25 MG CAP|100|EA|2.5198|10/22/2015||Yes|No||10/22/2015||Yes|No|10/22/2015||Yes|No||||No|No|||Prescription required|No|||No|4.58426|08/24/2021|4.47423|08/24/2021|4.50403|08/24/2021||||11082|||||No|No||ALVOGEN INC|No||||
nitrofurantoin macrocrystal|Yes|No|No|No|75%|47781030701|NITROFURANTOIN MCR 50 MG CAP|100|EA|.59469|08/16/2011||Yes|No||08/16/2011||Yes|No|08/16/2011||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.39225|03/29/2022|.38283|03/29/2022|.38538|03/29/2022||||11083|||||No|No||ALVOGEN INC|No||||
nitrofurantoin macrocrystal|No|No|No|No|75%|47781030801|NITROFURANTOIN MCR 100 MG CAP|100|EA|1.00998|08/16/2011||Yes|No||08/16/2011||Yes|No|08/16/2011||Yes|No||||No|No|||Prescription required|No|||No|.47756|03/29/2022|.46609|03/29/2022|.4692|03/29/2022||||11084|||||No|No||ALVOGEN INC|No||||
nevirapine|No|No|No|No|75%|47781031730|NEVIRAPINE ER 400 MG TABLET|30|EA|10.85059|07/23/2015||Yes|No||07/23/2015||Yes|No|07/23/2015||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|17.72264|08/24/2021|17.46946|08/24/2021|16.63758|08/24/2021|||HIV / AIDS|11085|||||No|No||ALVOGEN INC|No||||
dapsone|No|No|No|No|75%|47781033331|DAPSONE 25 MG TABLET|30|EA|.84781|09/20/2016||Yes|No||09/20/2016||Yes|No|09/20/2016||Yes|No||||No|No|||Prescription required|No|||No|.52333|03/29/2022|.51077|03/29/2022|.51417|03/29/2022||||11086|||||No|No||ALVOGEN INC|No||||
dapsone|No|No|No|No|75%|47781033431|DAPSONE 100 MG TABLET|30|EA|1.03988|09/20/2016||Yes|No||09/20/2016||Yes|No|09/20/2016||Yes|No||||No|No|||Prescription required|No|||No|.77747|03/29/2022|.75881|03/29/2022|.76386|03/29/2022||||11087|||||No|No||ALVOGEN INC|No||||
pyridostigmine bromide|No|No|No|No|75%|47781033530|PYRIDOSTIGMINE ER 180 MG TAB|30|EA|6.93375|07/08/2015||Yes|No||07/08/2015||Yes|No|07/08/2015||Yes|No||||No|No|||Prescription required|No|||No|5.45827|03/29/2022|5.32727|03/29/2022|5.36275|03/29/2022||||11088|||||No|No||ALVOGEN INC|No||||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|47781035503|BUPRENORPHINE-NALOX 2-0.5MG FM|30|EA|1.51904|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|No||145|Yes|2.34845|03/29/2022|2.29208|03/29/2022|2.30735|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|11089|||||No|No||ALVOGEN INC|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|47781035511|BUPRENORPHINE-NALOX 2-0.5MG FM|1|EA|1.76027|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|||||||2.61599|10/01/2020|OPIATE DEPENDENCE TREATMENTS|11090|||||No|No||ALVOGEN INC|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|47781035603|BUPRENORPHINE-NALOX 4-1MG FILM|30|EA|2.72333|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|No||145|Yes|4.75054|03/29/2022|4.63652|03/29/2022|4.6674|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|11091|||||No|No||ALVOGEN INC|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|47781035611|BUPRENORPHINE-NALOX 4-1MG FILM|1|EA|3.15333|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|4.75054|03/29/2022|4.63652|03/29/2022|4.6674|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|11092|||||No|No||ALVOGEN INC|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|47781035703|BUPRENORPHINE-NALOX 8-2MG FILM|30|EA|2.72333|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|No||145|Yes|3.26802|03/29/2022|3.18958|03/29/2022|3.21082|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|11093|||||No|No||ALVOGEN INC|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|47781035711|BUPRENORPHINE-NALOX 8-2MG FILM|1|EA|3.15333|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|||||||3.98028|10/01/2020|OPIATE DEPENDENCE TREATMENTS|11094|||||No|No||ALVOGEN INC|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|47781035803|BUPRENORPHINE-NALOX 12-3MG FLM|30|EA|5.44294|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|No||145|Yes|6.93269|03/29/2022|6.7663|03/29/2022|6.81136|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|11095|||||No|No||ALVOGEN INC|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|47781035811|BUPRENORPHINE-NALOX 12-3MG FLM|1|EA|6.30652|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|6.93269|03/29/2022|6.7663|03/29/2022|6.81136|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|11096|||||No|No||ALVOGEN INC|Yes|09/01/2020|||
pregabalin|No|No|No|No|90%|47781037930|PREGABALIN ER 82.5 MG TABLET|30|EA|3.80679|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|232|No|8.67594|02/15/2022|8.55199|02/09/2022|8.14476|02/09/2022|||NEUROPATHIC PAIN|11097|||||No|No||ALVOGEN INC|No||||
pregabalin|No|No|No|No|90%|47781038030|PREGABALIN ER 165 MG TABLET|30|EA|3.80679|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|232|No|8.67594|02/15/2022|8.55199|02/09/2022|8.14476|02/09/2022|||NEUROPATHIC PAIN|11098|||||No|No||ALVOGEN INC|No||||
pregabalin|No|No|No|No|90%|47781038130|PREGABALIN ER 330 MG TABLET|30|EA|3.80679|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|232|No|8.67594|02/15/2022|8.55199|02/09/2022|8.14476|02/09/2022|||NEUROPATHIC PAIN|11099|||||No|No||ALVOGEN INC|No||||
oseltamivir phosphate|No|No|No|No|75%|47781038426|OSELTAMIVIR 6 MG/ML SUSPENSION|60|ML|.71838|12/15/2017||Yes|No||12/15/2017||Yes|No|12/15/2017||Yes|No||||No|No|||Prescription required|No||025|No|.51688|03/29/2022|.50447|03/29/2022|.50783|03/29/2022|||ANTIVIRALS: ORAL|11100|||||No|No||ALVOGEN INC|No||||
hydrocodone bitartrate|No|No|No|No|90%|47781039260|HYDROCODONE ER 20 MG TABLET|60|EA|3.45519|09/02/2021||Yes|No||09/02/2021||Yes|No|09/02/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|110|Yes|7.87462|09/02/2021|7.76212|09/02/2021|7.3925|09/02/2021|||ANALGESICS: NARCOTICS LONG|11101|||||No|No||ALVOGEN INC|No||||
hydrocodone bitartrate|No|No|No|No|90%|47781039360|HYDROCODONE ER 30 MG TABLET|60|EA|4.90214|09/02/2021||Yes|No||09/02/2021||Yes|No|09/02/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|110|Yes|11.17232|09/02/2021|11.01271|09/02/2021|10.4883|09/02/2021|||ANALGESICS: NARCOTICS LONG|11102|||||No|No||ALVOGEN INC|No||||
hydrocodone bitartrate|No|No|No|No|90%|47781039460|HYDROCODONE ER 40 MG TABLET|60|EA|6.60429|09/02/2021||Yes|No||09/02/2021||Yes|No|09/02/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|110|Yes|15.05165|09/02/2021|14.83662|09/02/2021|14.13012|09/02/2021|||ANALGESICS: NARCOTICS LONG|11103|||||No|No||ALVOGEN INC|No||||
hydrocodone bitartrate|No|No|No|No|90%|47781039560|HYDROCODONE ER 60 MG TABLET|60|EA|9.14481|09/02/2021||Yes|No||09/02/2021||Yes|No|09/02/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|110|Yes|20.84166|09/07/2021|20.54392|09/02/2021|19.56564|09/02/2021|||ANALGESICS: NARCOTICS LONG|11104|||||No|No||ALVOGEN INC|No||||
hydrocodone bitartrate|No|No|No|No|90%|47781039660|HYDROCODONE ER 80 MG TABLET|60|EA|12.32939|09/02/2021||Yes|No||09/02/2021||Yes|No|09/02/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|110|Yes|28.09954|09/07/2021|27.69811|09/02/2021|26.37916|09/02/2021|||ANALGESICS: NARCOTICS LONG|11105|||||No|No||ALVOGEN INC|No||||
hydrocodone bitartrate|No|No|No|No|90%|47781039760|HYDROCODONE ER 100 MG TABLET|60|EA|15.68775|09/02/2021||Yes|No||09/02/2021||Yes|No|09/02/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|110|Yes|35.75349|09/02/2021|35.24273|09/02/2021|33.5645|09/02/2021|||ANALGESICS: NARCOTICS LONG|11106|||||No|No||ALVOGEN INC|No||||
hydrocodone bitartrate|No|No|No|No|90%|47781039860|HYDROCODONE ER 120 MG TABLET|60|EA|17.38482|09/02/2021||Yes|No||09/02/2021||Yes|No|09/02/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|110|Yes|39.62123|09/02/2021|39.05521|09/02/2021|37.19544|09/02/2021|||ANALGESICS: NARCOTICS LONG|11107|||||No|No||ALVOGEN INC|No||||
rivastigmine|No|No|No|No|75%|47781040503|RIVASTIGMINE 13.3 MG/24HR PTCH|30|EA|4.87706|09/01/2015||Yes|No||09/01/2015||Yes|No|09/01/2015||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|011|No|3.24254|03/29/2022|3.16471|03/29/2022|3.18579|03/29/2022|||ALZHEIMER'S AGENTS|11108|||||No|No||ALVOGEN INC|No||||
methylphenidate HCl|No|No|No|No|75%|47781041501|METHYLPHENIDATE ER 18 MG TAB|100|EA|.83682|04/25/2019||Yes|No||04/25/2019||Yes|No|04/25/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.56499|03/29/2022|.55143|03/29/2022|.5551|03/29/2022|||STIMULANTS AND RELATED AGENTS|11109|||||No|No||ALVOGEN INC|No||||
methylphenidate HCl|No|No|No|No|75%|47781041601|METHYLPHENIDATE ER 27 MG TAB|100|EA|.8578|04/25/2019||Yes|No||04/25/2019||Yes|No|04/25/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.90623|03/29/2022|.88448|03/29/2022|.89037|03/29/2022|||STIMULANTS AND RELATED AGENTS|11110|||||No|No||ALVOGEN INC|No||||
methylphenidate HCl|No|No|No|No|75%|47781041701|METHYLPHENIDATE ER 36 MG TAB|100|EA|.88481|04/25/2019||Yes|No||04/25/2019||Yes|No|04/25/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.76999|03/29/2022|.75151|03/29/2022|.75651|03/29/2022|||STIMULANTS AND RELATED AGENTS|11111|||||No|No||ALVOGEN INC|No||||
methylphenidate HCl|No|No|No|No|75%|47781041801|METHYLPHENIDATE ER 54 MG TAB|100|EA|.96277|04/25/2019||Yes|No||04/25/2019||Yes|No|04/25/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.87218|03/29/2022|.85124|03/29/2022|.85691|03/29/2022|||STIMULANTS AND RELATED AGENTS|11112|||||No|No||ALVOGEN INC|No||||
fentanyl|No|No|No|No|90%|47781042347|FENTANYL 12 MCG/HR PATCH|5|EA|6.98406|04/11/2017||Yes|No||04/11/2017||Yes|No|04/11/2017||Yes|No||||No|No|||Prescription required|No||110|Yes|8.30578|03/29/2022|8.10644|03/29/2022|8.16042|03/29/2022|||ANALGESICS: NARCOTICS LONG|11113|||||No|No||ALVOGEN INC|No||||
fentanyl|No|No|No|No|90%|47781042447|FENTANYL 25 MCG/HR PATCH|5|EA|3.0659|04/11/2017||Yes|No||04/11/2017||Yes|No|04/11/2017||Yes|No||||No|No|||Prescription required|No||110|Yes|3.10308|03/29/2022|3.0286|03/29/2022|3.04877|03/29/2022|||ANALGESICS: NARCOTICS LONG|11114|||||No|No||ALVOGEN INC|No||||
fentanyl|No|No|No|No|90%|47781042647|FENTANYL 50 MCG/HR PATCH|5|EA|5.44638|04/11/2017||Yes|No||04/11/2017||Yes|No|04/11/2017||Yes|No||||No|No|||Prescription required|No||110|Yes|5.19805|03/29/2022|5.07329|03/29/2022|5.10708|03/29/2022|||ANALGESICS: NARCOTICS LONG|11115|||||No|No||ALVOGEN INC|No||||
fentanyl|No|No|No|No|90%|47781042747|FENTANYL 75 MCG/HR PATCH|5|EA|8.6086|04/11/2017||Yes|No||04/11/2017||Yes|No|04/11/2017||Yes|No||||No|No|||Prescription required|No||110|Yes|7.86615|03/29/2022|7.67736|03/29/2022|7.72849|03/29/2022|||ANALGESICS: NARCOTICS LONG|11116|||||No|No||ALVOGEN INC|No||||
fentanyl|No|No|No|No|90%|47781042847|FENTANYL 100 MCG/HR PATCH|5|EA|11.84994|04/11/2017||Yes|No||04/11/2017||Yes|No|04/11/2017||Yes|No||||No|No|||Prescription required|No||110|Yes|9.14035|03/29/2022|8.92098|03/29/2022|8.98039|03/29/2022|||ANALGESICS: NARCOTICS LONG|11117|||||No|No||ALVOGEN INC|No||||
voriconazole|No|No|No|No|75%|47781046671|VORICONAZOLE 200 MG VIAL|1|EA|52.4901|05/02/2017||Yes|No||05/02/2017||Yes|No|05/02/2017||Yes|No||||No|No|||Prescription required|No|||No|119.6286|05/09/2017|117.91962|05/02/2017|112.3044|05/02/2017||||11118|||||No|No||ALVOGEN INC|No||||
oseltamivir phosphate|No|No|No|No|75%|47781046813|OSELTAMIVIR PHOS 30 MG CAPSULE|10|EA|4.02437|03/14/2017||Yes|No||03/14/2017||Yes|No|03/14/2017||Yes|No||||No|No|||Prescription required|No||025|No|1.58155|03/29/2022|1.54359|03/29/2022|1.55387|03/29/2022|||ANTIVIRALS: ORAL|11119|||||No|No||ALVOGEN INC|No||||
oseltamivir phosphate|No|No|No|No|75%|47781046913|OSELTAMIVIR PHOS 45 MG CAPSULE|10|EA|4.02437|03/14/2017||Yes|No||03/14/2017||Yes|No|03/14/2017||Yes|No||||No|No|||Prescription required|No||025|No|1.5655|03/29/2022|1.52792|03/29/2022|1.5381|03/29/2022|||ANTIVIRALS: ORAL|11120|||||No|No||ALVOGEN INC|No||||
oseltamivir phosphate|No|No|No|No|75%|47781047013|OSELTAMIVIR PHOS 75 MG CAPSULE|10|EA|4.38643|03/14/2017||Yes|No||03/14/2017||Yes|No|03/14/2017||Yes|No||||No|No|||Prescription required|No||025|No|1.29695|03/29/2022|1.26582|03/29/2022|1.27425|03/29/2022|||ANTIVIRALS: ORAL|11121|||||No|No||ALVOGEN INC|No||||
doxycycline hyclate|Yes|No|No|No|75%|47781049005|DOXYCYCLINE HYCLATE 100 MG CAP|500|EA|.52922|09/28/2016||Yes|No||09/28/2016||Yes|No|09/28/2016||Yes|No||||No|No|09/28/2016||Prescription required|No||213|No|.14255|03/29/2022|.13912|03/29/2022|.14005|03/29/2022|||TETRACYCLINES|11122|||||No|No||ALVOGEN INC|No||||
doxycycline hyclate|Yes|No|No|No|75%|47781049050|DOXYCYCLINE HYCLATE 100 MG CAP|50|EA|.52924|09/28/2016||Yes|No||09/28/2016||Yes|No|09/28/2016||Yes|No||||No|No|09/28/2016||Prescription required|No||213|No|.14255|03/29/2022|.13912|03/29/2022|.14005|03/29/2022|||TETRACYCLINES|11123|||||No|No||ALVOGEN INC|No||||
doxycycline hyclate|Yes|No|No|No|75%|47781049105|DOXYCYCLINE HYCLATE 100 MG TAB|500|EA|.52922|09/28/2016||Yes|No||09/28/2016||Yes|No|09/28/2016||Yes|No||||No|No|09/28/2016||Prescription required|Yes|01/28/2016|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|11124|||||No|No||ALVOGEN INC|No||||
doxycycline hyclate|Yes|No|No|No|75%|47781049150|DOXYCYCLINE HYCLATE 100 MG TAB|50|EA|.52924|09/28/2016||Yes|No||09/28/2016||Yes|No|09/28/2016||Yes|No||||No|No|09/28/2016||Prescription required|Yes|01/28/2016|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|11125|||||No|No||ALVOGEN INC|No||||
tetracycline HCl|No|No|No|No|75%|47781050801|TETRACYCLINE 250 MG CAPSULE|100|EA|2.709|04/11/2017||Yes|No||04/11/2017||Yes|No|04/11/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|213|No|.9651|03/01/2022|.94193|03/01/2022|.94821|03/01/2022|||TETRACYCLINES|11126|||||No|No||ALVOGEN INC|No||||
tetracycline HCl|No|No|No|No|75%|47781050901|TETRACYCLINE 500 MG CAPSULE|100|EA|5.418|04/11/2017||Yes|No||04/11/2017||Yes|No|04/11/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|213|No|1.54692|03/29/2022|1.50979|03/29/2022|1.51984|03/29/2022|||TETRACYCLINES|11127|||||No|No||ALVOGEN INC|No||||
tranylcypromine sulfate|No|No|No|No|75%|47781051701|TRANYLCYPROMINE SULF 10 MG TAB|100|EA|1.161|02/04/2020||Yes|No||||No|No|||No|No||||No|No|||Prescription required|Yes|07/26/2018|031|No|1.32918|03/29/2022|1.29727|03/29/2022|1.30591|03/29/2022|||ANTIDEPRESSANTS: OTHER|11128|||||No|No||ALVOGEN INC|No||||
ciclopirox|No|No|No|No|75%|47781053073|CICLOPIROX 0.77% GEL|30|GM|.86802|06/02/2017||Yes|No||06/02/2017||Yes|No|06/02/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|061|No|.698|03/29/2022|.68124|03/29/2022|.68578|03/29/2022|||ANTIFUNGALS: TOPICAL|11129|||||No|No||ALVOGEN INC|No||||
ciclopirox|No|No|No|No|75%|47781053084|CICLOPIROX 0.77% GEL|45|GM|.87041|06/02/2017||Yes|No||06/02/2017||Yes|No|06/02/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|061|No|.72022|03/29/2022|.70293|03/29/2022|.70761|03/29/2022|||ANTIFUNGALS: TOPICAL|11130|||||No|No||ALVOGEN INC|No||||
ciclopirox|No|No|No|No|75%|47781053085|CICLOPIROX 0.77% GEL|100|GM|.78109|06/02/2017||Yes|No||06/02/2017||Yes|No|06/02/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|061|No|.5644|03/29/2022|.55085|03/29/2022|.55452|03/29/2022|||ANTIFUNGALS: TOPICAL|11131|||||No|No||ALVOGEN INC|No||||
fluocinonide/emollient base|No|No|No|No|75%|47781053226|FLUOCINONIDE-E 0.05% CREAM|60|GM|.78109|11/16/2017||Yes|No||11/16/2017||Yes|No|11/16/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|120|No|.77317|03/01/2022|.75461|03/01/2022|.75963|03/01/2022|||STEROIDS: TOPICAL HIGH|11132|||||No|No||ALVOGEN INC|No||||
fluocinonide/emollient base|No|No|No|No|75%|47781053272|FLUOCINONIDE-E 0.05% CREAM|15|GM|.80496|11/16/2017||Yes|No||11/16/2017||Yes|No|11/16/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|120|No|1.34778|08/24/2021|1.31543|08/24/2021|1.32419|08/24/2021|||STEROIDS: TOPICAL HIGH|11133|||||No|No||ALVOGEN INC|No||||
fluocinonide/emollient base|No|No|No|No|75%|47781053273|FLUOCINONIDE-E 0.05% CREAM|30|GM|.78905|11/16/2017||Yes|No||11/16/2017||Yes|No|11/16/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|120|No|1.7983|03/01/2022|1.77261|03/01/2022|1.6882|03/01/2022|||STEROIDS: TOPICAL HIGH|11134|||||No|No||ALVOGEN INC|No||||
fluocinonide|No|No|No|No|75%|47781053326|FLUOCINONIDE 0.05% GEL|60|GM|1.36574|06/01/2017||Yes|No||06/01/2017||Yes|No|06/01/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|120|No|.98528|03/29/2022|.96163|03/29/2022|.96803|03/29/2022|||STEROIDS: TOPICAL HIGH|11135|||||No|No||ALVOGEN INC|No||||
fluocinonide|No|No|No|No|75%|47781053372|FLUOCINONIDE 0.05% GEL|15|GM|1.36596|06/01/2017||Yes|No||06/01/2017||Yes|No|06/01/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|120|No|1.08815|03/29/2022|1.06203|03/29/2022|1.0691|03/29/2022|||STEROIDS: TOPICAL HIGH|11136|||||No|No||ALVOGEN INC|No||||
fluocinonide|No|No|No|No|75%|47781053373|FLUOCINONIDE 0.05% GEL|30|GM|1.36582|06/01/2017||Yes|No||06/01/2017||Yes|No|06/01/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|120|No|1.41527|03/01/2022|1.3813|03/01/2022|1.3905|03/01/2022|||STEROIDS: TOPICAL HIGH|11137|||||No|No||ALVOGEN INC|No||||
minocycline HCl|No|No|No|No|75%|47781054401|MINOCYCLINE 50 MG CAPSULE|100|EA|.0973|01/26/2018||Yes|No||01/26/2018||Yes|No|01/26/2018||Yes|No||||No|No|||Prescription required|No||213|No|.20366|03/29/2022|.19877|03/29/2022|.20009|03/29/2022|||TETRACYCLINES|11138|||||No|No||ALVOGEN INC|No||||
minocycline HCl|No|No|No|No|75%|47781054501|MINOCYCLINE 75 MG CAPSULE|100|EA|.17913|01/26/2018||Yes|No||01/26/2018||Yes|No|01/26/2018||Yes|No||||No|No|||Prescription required|No||213|No|.36632|10/26/2021|.35752|10/26/2021|.3599|10/26/2021|||TETRACYCLINES|11139|||||No|No||ALVOGEN INC|No||||
minocycline HCl|No|No|No|No|75%|47781054605|MINOCYCLINE 100 MG CAPSULE|500|EA|.18488|01/26/2018||Yes|No||01/26/2018||Yes|No|01/26/2018||Yes|No||||No|No|||Prescription required|No||213|No|.38664|03/29/2022|.37736|03/29/2022|.37987|03/29/2022|||TETRACYCLINES|11140|||||No|No||ALVOGEN INC|No||||
minocycline HCl|No|No|No|No|75%|47781054650|MINOCYCLINE 100 MG CAPSULE|50|EA|.19461|01/26/2018||Yes|No||01/26/2018||Yes|No|01/26/2018||Yes|No||||No|No|||Prescription required|No||213|No|.38664|03/29/2022|.37736|03/29/2022|.37987|03/29/2022|||TETRACYCLINES|11141|||||No|No||ALVOGEN INC|No||||
fluocinonide|No|No|No|No|75%|47781056926|FLUOCINONIDE 0.05% OINTMENT|60|GM|1.17633|02/15/2018||Yes|No||02/15/2018||Yes|No|02/15/2018||Yes|No||||No|No|||Prescription required|Yes|10/12/2017|120|No|.32783|03/29/2022|.31996|03/29/2022|.32209|03/29/2022|||STEROIDS: TOPICAL HIGH|11142|||||No|No||ALVOGEN INC|No||||
methenamine hippurate|No|No|No|No|75%|47781057701|METHENAMINE HIPP 1 GM TABLET|100|EA|.74927|02/15/2018||Yes|No||02/15/2018||Yes|No|02/15/2018||Yes|No||||No|No|||Prescription required|No|||No|.83638|03/29/2022|.8163|03/29/2022|.82174|03/29/2022||||11143|||||No|No||ALVOGEN INC|No||||
ketorolac tromethamine|No|No|No|No|75%|47781058568|KETOROLAC 60 MG/2 ML VIAL|2|ML|.2666|02/07/2018||Yes|No||02/07/2018||Yes|No|02/07/2018||Yes|No||||No|No|||Prescription required|No|||Yes|.93756|03/29/2022|.91505|03/29/2022|.92115|03/29/2022||||11144|||||No|No||ALVOGEN INC|No||||
vancomycin HCl|No|No|No|No|75%|47781059791|VANCOMYCIN 1 GM VIAL|1|EA|2.5757|11/27/2017|02/10/2022|Yes|No||||No|No|11/27/2017|02/10/2022|Yes|No||||No|No|||Prescription required|No|||No|5.8702|02/23/2021|5.78634|02/23/2021|5.5108|02/23/2021||||11145|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||ALVOGEN INC|No||||
vancomycin HCl|No|No|No|No|75%|47781059891|VANCOMYCIN 500 MG VIAL|1|EA|1.29|11/27/2017|01/21/2022|Yes|No||11/27/2017|01/21/2022|Yes|No|11/27/2017|01/21/2022|Yes|No||||No|No|||Prescription required|No|||No|2.94|11/27/2017|2.898|12/05/2017|2.76|11/27/2017||||11146|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ALVOGEN INC|No||||
fluoxetine HCl|No|No|No|No|75%|47781060030|FLUOXETINE HCL 60 MG TABLET|30|EA|2.91769|12/15/2017||Yes|No||12/15/2017||Yes|No|12/15/2017||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|008|No|1.06507|03/29/2022|1.0395|03/29/2022|1.04643|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11147|||||No|No||ALVOGEN INC|No||||
fluocinonide|No|No|No|No|75%|47781060249|FLUOCINONIDE 0.05% SOLUTION|20|ML|.99029|05/29/2018||Yes|No||05/29/2018||Yes|No|05/29/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|.47513|03/29/2022|.46372|03/29/2022|.46681|03/29/2022|||STEROIDS: TOPICAL HIGH|11148|||||No|No||ALVOGEN INC|No||||
disulfiram|No|No|No|No|75%|47781060730|DISULFIRAM 250 MG TABLET|30|EA|1.21618|08/14/2013||Yes|No||08/14/2013||Yes|No|08/14/2013||Yes|No||||No|No|||Prescription required|No|||No|1.95785|03/29/2022|1.91086|03/29/2022|1.92358|03/29/2022||||11149|||||No|No||ALVOGEN INC|Yes|09/01/2020|||
caspofungin acetate|No|No|No|No|75%|47781061307|CASPOFUNGIN ACETATE 50 MG VIAL|1|EA|40.42|02/15/2018||Yes|No||02/15/2018||Yes|No|02/15/2018||Yes|No||||No|No|||Prescription required|No|||No|92.12|02/15/2018|90.804|02/15/2018|86.48|02/15/2018||||11150|||||No|No||ALVOGEN INC|No||||
caspofungin acetate|No|No|No|No|75%|47781061407|CASPOFUNGIN ACETATE 70 MG VIAL|1|EA|42.57|02/15/2018||Yes|No||02/15/2018||Yes|No|02/15/2018||Yes|No||||No|No|||Prescription required|No|||No|97.02|02/15/2018|95.634|02/15/2018|91.08|02/15/2018||||11151|||||No|No||ALVOGEN INC|No||||
felbamate|No|No|No|No|75%|47781063001|FELBAMATE 600 MG TABLET|100|EA|1.85927|07/16/2020||Yes|No||07/16/2020||Yes|No|07/16/2020||Yes|No||||No|No|||Prescription required|No||056|No|1.94824|03/29/2022|1.90148|03/29/2022|1.91414|03/29/2022|||ANTICONVULSANTS|11152|||||No|No||ALVOGEN INC|No||||
bupropion HCl|No|No|No|No|75%|47781063730|BUPROPION HCL XL 450 MG TABLET|30|EA|5.44509|02/01/2019||Yes|No||02/01/2019||Yes|No|02/01/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|031|No|9.2459|03/29/2022|9.02399|03/29/2022|9.08409|03/29/2022|||ANTIDEPRESSANTS: OTHER|11153|||||No|No||ALVOGEN INC|No||||
levothyroxine sodium|No|No|No|No|75%|47781064010|LEVOTHYROXINE 25 MCG TABLET|1000|EA|.15656|07/24/2020||Yes|No||07/24/2020||Yes|No|07/24/2020||Yes|No||||No|No|||Prescription required|No|||No|.11852|03/29/2022|.11567|03/29/2022|.11644|03/29/2022||||11154|||||No|No||ALVOGEN INC|No||||
levothyroxine sodium|No|No|No|No|75%|47781064090|LEVOTHYROXINE 25 MCG TABLET|90|EA|.15656|11/26/2019||Yes|No||11/26/2019||Yes|No|11/26/2019||Yes|No||||No|No|||Prescription required|No|||No|.11852|03/29/2022|.11567|03/29/2022|.11644|03/29/2022||||11155|||||No|No||ALVOGEN INC|No||||
levothyroxine sodium|No|No|No|No|75%|47781064310|LEVOTHYROXINE 50 MCG TABLET|1000|EA|.17773|11/26/2019||Yes|No||11/26/2019||Yes|No|11/26/2019||Yes|No||||No|No|||Prescription required|No|||No|.14288|03/29/2022|.13945|03/29/2022|.14037|03/29/2022||||11156|||||No|No||ALVOGEN INC|No||||
levothyroxine sodium|No|No|No|No|75%|47781064390|LEVOTHYROXINE 50 MCG TABLET|90|EA|.17773|11/26/2019||Yes|No||11/26/2019||Yes|No|11/26/2019||Yes|No||||No|No|||Prescription required|No|||No|.14288|03/29/2022|.13945|03/29/2022|.14037|03/29/2022||||11157|||||No|No||ALVOGEN INC|No||||
levothyroxine sodium|No|No|No|No|75%|47781064610|LEVOTHYROXINE 75 MCG TABLET|1000|EA|.1964|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|No|||No|.15545|03/29/2022|.15171|03/29/2022|.15272|03/29/2022||||11158|||||No|No||ALVOGEN INC|No||||
levothyroxine sodium|No|No|No|No|75%|47781064990|LEVOTHYROXINE 88 MCG TABLET|90|EA|.19975|08/03/2020||Yes|No||08/03/2020||Yes|No|08/03/2020||Yes|No||||No|No|||Prescription required|No|||No|.16198|03/29/2022|.15809|03/29/2022|.15914|03/29/2022||||11159|||||No|No||ALVOGEN INC|No||||
levothyroxine sodium|No|No|No|No|75%|47781065110|LEVOTHYROXINE 100 MCG TABLET|1000|EA|.20133|11/26/2019||Yes|No||11/26/2019||Yes|No|11/26/2019||Yes|No||||No|No|||Prescription required|No|||No|.17286|03/29/2022|.16871|03/29/2022|.16983|03/29/2022||||11160|||||No|No||ALVOGEN INC|No||||
levothyroxine sodium|No|No|No|No|75%|47781065190|LEVOTHYROXINE 100 MCG TABLET|90|EA|.20133|11/26/2019||Yes|No||11/26/2019||Yes|No|11/26/2019||Yes|No||||No|No|||Prescription required|No|||No|.17286|03/29/2022|.16871|03/29/2022|.16983|03/29/2022||||11161|||||No|No||ALVOGEN INC|No||||
teriparatide|No|No|No|No|75%|47781065289|TERIPARATIDE 620 MCG/2.48 ML|2.48|ML|450.58971|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|060|No|1026.92539|07/13/2021|1012.25503|07/13/2021|964.05241|07/13/2021|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|11162|||||No|No||ALVOGEN INC|No||||
levothyroxine sodium|No|No|No|No|75%|47781065410|LEVOTHYROXINE 112 MCG TABLET|1000|EA|.23281|11/26/2019||Yes|No||11/26/2019||Yes|No|11/26/2019||Yes|No||||No|No|||Prescription required|No|||No|.1546|03/29/2022|.15088|03/29/2022|.15189|03/29/2022||||11163|||||No|No||ALVOGEN INC|No||||
levothyroxine sodium|No|No|No|No|75%|47781065490|LEVOTHYROXINE 112 MCG TABLET|90|EA|.23281|11/26/2019||Yes|No||11/26/2019||Yes|No|11/26/2019||Yes|No||||No|No|||Prescription required|No|||No|.1546|03/29/2022|.15088|03/29/2022|.15189|03/29/2022||||11164|||||No|No||ALVOGEN INC|No||||
levothyroxine sodium|No|No|No|No|75%|47781065710|LEVOTHYROXINE 125 MCG TABLET|1000|EA|.23603|11/26/2019||Yes|No||11/26/2019||Yes|No|11/26/2019||Yes|No||||No|No|||Prescription required|No|||No|.18894|03/29/2022|.1844|03/29/2022|.18563|03/29/2022||||11165|||||No|No||ALVOGEN INC|No||||
levothyroxine sodium|No|No|No|No|75%|47781065790|LEVOTHYROXINE 125 MCG TABLET|90|EA|.23601|11/26/2019||Yes|No||11/26/2019||Yes|No|11/26/2019||Yes|No||||No|No|||Prescription required|No|||No|.18894|03/29/2022|.1844|03/29/2022|.18563|03/29/2022||||11166|||||No|No||ALVOGEN INC|No||||
levothyroxine sodium|No|No|No|No|75%|47781065910|LEVOTHYROXINE 137 MCG TABLET|1000|EA|.23932|11/26/2019||Yes|No||11/26/2019||Yes|No|11/26/2019||Yes|No||||No|No|||Prescription required|No|||No|.22748|03/29/2022|.22202|03/29/2022|.22349|03/29/2022||||11167|||||No|No||ALVOGEN INC|No||||
levothyroxine sodium|No|No|No|No|75%|47781065990|LEVOTHYROXINE 137 MCG TABLET|90|EA|.23931|11/26/2019||Yes|No||11/26/2019||Yes|No|11/26/2019||Yes|No||||No|No|||Prescription required|No|||No|.22748|03/29/2022|.22202|03/29/2022|.22349|03/29/2022||||11168|||||No|No||ALVOGEN INC|No||||
levothyroxine sodium|No|No|No|No|75%|47781066210|LEVOTHYROXINE 150 MCG TABLET|1000|EA|.24291|11/26/2019||Yes|No||11/26/2019||Yes|No|11/26/2019||Yes|No||||No|No|||Prescription required|No|||No|.21406|03/29/2022|.20892|03/29/2022|.21031|03/29/2022||||11169|||||No|No||ALVOGEN INC|No||||
levothyroxine sodium|No|No|No|No|75%|47781066290|LEVOTHYROXINE 150 MCG TABLET|90|EA|.24295|11/26/2019||Yes|No||11/26/2019||Yes|No|11/26/2019||Yes|No||||No|No|||Prescription required|No|||No|.21406|03/29/2022|.20892|03/29/2022|.21031|03/29/2022||||11170|||||No|No||ALVOGEN INC|No||||
levothyroxine sodium|No|No|No|No|75%|47781066510|LEVOTHYROXINE 175 MCG TABLET|1000|EA|.28874|11/26/2019||Yes|No||11/26/2019||Yes|No|11/26/2019||Yes|No||||No|No|||Prescription required|No|||No|.2247|03/29/2022|.2193|03/29/2022|.22076|03/29/2022||||11171|||||No|No||ALVOGEN INC|No||||
levothyroxine sodium|No|No|No|No|75%|47781066590|LEVOTHYROXINE 175 MCG TABLET|90|EA|.28876|11/26/2019||Yes|No||11/26/2019||Yes|No|11/26/2019||Yes|No||||No|No|||Prescription required|No|||No|.2247|03/29/2022|.2193|03/29/2022|.22076|03/29/2022||||11172|||||No|No||ALVOGEN INC|No||||
levothyroxine sodium|No|No|No|No|75%|47781066810|LEVOTHYROXINE 200 MCG TABLET|1000|EA|.28932|11/26/2019||Yes|No||11/26/2019||Yes|No|11/26/2019||Yes|No||||No|No|||Prescription required|No|||No|.2307|03/29/2022|.22516|03/29/2022|.22666|03/29/2022||||11173|||||No|No||ALVOGEN INC|No||||
levothyroxine sodium|No|No|No|No|75%|47781066890|LEVOTHYROXINE 200 MCG TABLET|90|EA|.28929|07/27/2020||Yes|No||07/27/2020||Yes|No|07/27/2020||Yes|No||||No|No|||Prescription required|No|||No|.2307|03/29/2022|.22516|03/29/2022|.22666|03/29/2022||||11174|||||No|No||ALVOGEN INC|No||||
levothyroxine sodium|No|No|No|No|75%|47781067190|LEVOTHYROXINE 300 MCG TABLET|90|EA|.37347|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|No|||No|.17616|03/29/2022|.17193|03/29/2022|.17307|03/29/2022||||11175|||||No|No||ALVOGEN INC|No||||
vancomycin HCl|No|No|No|No|75%|47781072902|VANCOMYCIN HCL 125 MG CAPSULE|20|EA|2.15|06/26/2012||Yes|No||06/26/2012||Yes|No|06/26/2012||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|115|No|1.79287|03/29/2022|1.74984|03/29/2022|1.76149|03/29/2022|||ANTIBIOTICS: GI|11176|||||No|No||ALVOGEN INC|No||||
vancomycin HCl|No|No|No|No|75%|47781072950|VANCOMYCIN HCL 125 MG CAPSULE|50|EA|4.3|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|115|No|1.79287|03/29/2022|1.74984|03/29/2022|1.76149|03/29/2022|||ANTIBIOTICS: GI|11177|||||No|No||ALVOGEN INC|No||||
vancomycin HCl|No|No|No|No|75%|47781073002|VANCOMYCIN HCL 250 MG CAPSULE|20|EA|4.3|06/26/2012||Yes|No||06/26/2012||Yes|No|06/26/2012||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|115|No|3.02495|03/29/2022|2.95235|03/29/2022|2.97201|03/29/2022|||ANTIBIOTICS: GI|11178|||||No|No||ALVOGEN INC|No||||
vancomycin HCl|No|No|No|No|75%|47781073050|VANCOMYCIN HCL 250 MG CAPSULE|50|EA|6.88|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|115|No|3.02495|03/29/2022|2.95235|03/29/2022|2.97201|03/29/2022|||ANTIBIOTICS: GI|11179|||||No|No||ALVOGEN INC|No||||
dexamethasone|No|No|No|No|75%|47781091401|DEXAMETHASONE 4 MG TABLET|100|EA|.42621|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||168|Yes|.52706|03/29/2022|.51441|03/29/2022|.51783|03/29/2022|||GLUCOCORTICOIDS: ORAL|11180|||||No|No||ALVOGEN INC|No||||
dexamethasone|No|No|No|No|75%|47781091601|DEXAMETHASONE 6 MG TABLET|100|EA|.63932|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||168|Yes|1.17981|03/29/2022|1.15149|03/29/2022|1.15916|03/29/2022|||GLUCOCORTICOIDS: ORAL|11181|||||No|No||ALVOGEN INC|No||||
ecallantide|No|No|No|No|75%|47783010101|KALBITOR 10 MG/ML VIAL|3|ML|2245.60046|02/09/2014||Yes|No||02/09/2014||Yes|No|02/09/2014||Yes|No||||No|No|||Prescription required|No||501|No|5117.88012|01/11/2022|5044.76755|01/11/2022|4804.54052|01/11/2022|||HAE TREATMENTS|11182|||||No|No||DYAX CORP./SHIR|No||||
lanadelumab-flyo|No|No|No|No|75%|47783064401|TAKHZYRO 300 MG/2 ML VIAL|2|ML|5185.0432|02/08/2019||Yes|No||02/08/2019||Yes|No|02/08/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|501|No|11817.0752|01/11/2022|11648.25984|01/11/2022|11093.5808|01/11/2022|||HAE TREATMENTS|11183|||||No|No||DYAX CORP./SHIR|No||||
insulin regular, human|No|No|No|No|75%|47918087490|AFREZZA 4 UNIT CARTRIDGE|90|EA|1.89968|08/15/2017||Yes|No||08/15/2017||Yes|No|08/15/2017||Yes|No||||No|No|||Prescription required|Yes|09/18/2020|029|No|4.32952|10/05/2021|4.26767|10/05/2021|4.06444|10/05/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|11184|||||No|No||MANNKIND CORPOR|No||||
insulin regular, human|No|No|No|No|75%|47918087890|AFREZZA 8 UNIT CARTRIDGE|90|EA|3.79948|01/05/2018||Yes|No||01/05/2018||Yes|No|01/05/2018||Yes|No||||No|No|||Prescription required|Yes|09/18/2020|029|No|8.65928|10/05/2021|8.53557|10/05/2021|8.12912|10/05/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|11185|||||No|No||MANNKIND CORPOR|No||||
insulin regular, human|No|No|No|No|75%|47918088018|AFREZZA 90-4 UNIT / 90-8 UNIT|180|EA|2.84961|08/15/2017||Yes|No||08/15/2017||Yes|No|08/15/2017||Yes|No||||No|No|||Prescription required|Yes|09/18/2020|029|No|6.49446|10/05/2021|6.40168|10/05/2021|6.09684|10/05/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|11186|||||No|No||MANNKIND CORPOR|No||||
insulin regular, human|No|No|No|No|75%|47918089190|AFREZZA 12 UNIT CARTRIDGE|90|EA|5.69922|01/05/2018||Yes|No||01/05/2018||Yes|No|01/05/2018||Yes|No||||No|No|||Prescription required|Yes|09/18/2020|029|No|12.98892|10/05/2021|12.80336|10/05/2021|12.19368|10/05/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|11187|||||No|No||MANNKIND CORPOR|No||||
insulin regular, human|No|No|No|No|75%|47918090218|AFREZZA 4 UNIT/8 UNIT/12 UNIT|180|EA|3.7995|08/15/2017||Yes|No||08/15/2017||Yes|No|08/15/2017||Yes|No||||No|No|||Prescription required|Yes|09/18/2020|029|No|8.65932|10/05/2021|8.53562|10/05/2021|8.12916|10/05/2021|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|11188|||||No|No||MANNKIND CORPOR|No||||
calcium acetate|No|No|No|No|75%|49230064331|PHOSLYRA 667 MG/5 ML SOLUTION|473|ML|.15509|05/22/2012||Yes|No||05/22/2012||Yes|No|05/22/2012||Yes|No||07/01/2012||Yes|No|||Prescription required|Yes|07/27/2017|052|Yes|.35347|01/25/2022|.34842|01/25/2022|.33183|01/25/2022|||PHOSPHATE BINDERS|11189|||||No|No||FRESENIUS MEDIC|No||||
sucroferric oxyhydroxide|No|No|No|No|75%|49230064551|VELPHORO 500 MG CHEWABLE TAB|90|EA|7.17263|02/06/2014||Yes|No||02/06/2014||Yes|No|02/06/2014||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|01/22/2015|052|Yes|15.91603|01/04/2022|15.53404|01/04/2022|15.63749|01/04/2022|||PHOSPHATE BINDERS|11190|||||No|No||FRESENIUS MEDIC|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|49348001737|SM TUSSIN DM SYRUP|236|ML||09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No||184|Yes|||||||||COUGH AND COLD: NON-NARCOTIC|11191|||||No|No||SM-STRATEGIC SO|No||||
mag hydrox/aluminum hyd/simeth|No|No|No|No|75%|49348001939|SM ANTACID SUSPENSION|355|ML|.00458|09/01/1999|04/30/2022|Yes|No||||No|No|09/01/1999|04/30/2022|Yes|No||||No|No|||Over the counter|No|||No|.00773|03/29/2022|.00754|03/29/2022|.00759|03/29/2022||||11192|No Longer Rebatable||No Longer Rebatable||No|No||SM-STRATEGIC SO|No||||
multivit with iron,hematinic|No|No|No|No|75%|49348002123|CENTRAL-VITE TABLET|300|EA||||No|No||||No|No|||No|No||09/01/1999||Yes|No|||Over the counter|No|||No|||||||.0453|09/01/1999||11193|||||No|No||SM-STRATEGIC SO|No||||
oxymetazoline HCl|No|No|No|No|75%|49348002827|SM NASAL SPRAY 0.05%|30|ML||09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No||182|Yes|.07205|03/29/2022|.07032|03/29/2022|.07078|03/29/2022|||COUGH AND COLD: COLD|11194|||||No|No||SM-STRATEGIC SO|No||||
diphenhydramine HCl|No|No|No|No|75%|49348004534|SM ALLERGY RELIEF 12.5 MG/5 ML|118|ML|.00822|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No||574|Yes|.01468|03/29/2022|.01432|03/29/2022|.01442|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|11195|||||No|No||SM-STRATEGIC SO|No||||
ibuprofen|No|No|No|No|75%|49348019609|SM IBUPROFEN 200 MG CAPLET|50|EA||09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|11196|||||No|No||SM-STRATEGIC SO|No||||
loperamide HCl|No|No|No|No|75%|49348052902|SM ANTI-DIARRHEAL 2 MG CAPLET|12|EA||09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No|||No|.14456|03/29/2022|.14109|03/29/2022|.14203|03/29/2022||||11197|||||No|No||SM-STRATEGIC SO|No||||
miconazole nitrate|Yes|No|No|No|75%|49348053077|SM MICONAZOLE 7 CREAM|45|GM||09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|11/01/2012||Over the counter|No|||No|.13462|03/29/2022|.13138|03/29/2022|.13226|03/29/2022||||11198|||||No|No||SM-STRATEGIC SO|No||||
loratadine/pseudoephedrine|No|No|No|No|75%|49348054301|SM LORATA-DINE D 24HR TABLET|10|EA||07/24/2009||Yes|No||||No|No|07/24/2009||Yes|No||||No|No|||Over the counter|Yes|01/31/2019|030|Yes|.51383|03/29/2022|.50149|03/29/2022|.50483|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|11199|||||No|No||SM-STRATEGIC SO|No||||
loratadine|No|No|No|No|75%|49348063634|SM LORATADINE 5 MG/5 ML SYRUP|120|ML||11/01/2008||Yes|No||||No|No|11/01/2008||Yes|No||||No|No|||Over the counter|No||030|Yes|.04114|03/29/2022|.04015|03/29/2022|.04042|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|11200|||||No|No||SM-STRATEGIC SO|No||||
ibuprofen|No|No|No|No|75%|49348070609|SM IBUPROFEN 200 MG TABLET|50|EA||09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|11201|||||No|No||SM-STRATEGIC SO|No||||
ibuprofen|No|No|No|No|75%|49348070610|SM IBUPROFEN 200 MG TABLET|100|EA|.00778|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|11202|||||No|No||SM-STRATEGIC SO|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|49348086134|SM TUSSIN DM LIQUID|118|ML||09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No||184|Yes|.01867|03/29/2022|.01822|03/29/2022|.01834|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|11203|||||No|No||SM-STRATEGIC SO|No||||
belimumab|No|No|No|No|75%|49401008835|BENLYSTA 200 MG/ML AUTOINJECT|1|ML|451.30757|01/10/2018||Yes|No||01/10/2018||Yes|No|01/10/2018||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|511|No|1028.56145|02/01/2022|1013.86771|02/01/2022|965.5883|02/01/2022||||11204|||||No|No||GLAXOSMITHKLINE|No||||
belimumab|No|No|No|No|75%|49401008847|BENLYSTA 200 MG/ML SYRINGE|1|ML|451.30757|01/10/2018||Yes|No||01/10/2018||Yes|No|01/10/2018||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|511|No|1028.56145|02/01/2022|1013.86771|02/01/2022|965.5883|02/01/2022||||11205|||||No|No||GLAXOSMITHKLINE|No||||
aminocaproic acid|No|No|No|No|75%|49411005030|AMICAR 500 MG TABLET|30|EA|14.60616|09/07/2015||Yes|No||09/07/2015||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No|||No|21.05006|03/27/2018|20.74935|03/27/2018|19.76128|03/27/2018||||11206|||||No|No||CLOVER PHARMACE|No||||
aminocaproic acid|No|No|No|No|75%|49411005130|AMICAR 1,000 MG TABLET|30|EA|29.21234|09/07/2015||Yes|No||09/07/2015||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No|||No|42.10014|03/20/2018|41.49871|03/20/2018|39.52258|03/20/2018||||11207|||||No|No||CLOVER PHARMACE|No||||
aminocaproic acid|No|No|No|No|75%|49411005208|AMICAR 0.25 GRAM/ML ORAL SOLN|236.5|ML|8.0363|09/07/2015||Yes|No||09/07/2015||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No|||No|11.58172|03/26/2019|11.41627|03/26/2019|10.87264|03/26/2019||||11208|||||No|No||CLOVER PHARMACE|No||||
niacin|No|No|No|No|75%|49483001401|NIACIN SA 250 MG CAPSULE|100|EA|.01487|08/19/2013||Yes|No||||No|No|08/19/2013||Yes|No||||No|No|||Over the counter|No||055|No|.0339|07/07/2020|.03342|07/07/2020|.03183|07/07/2020|||LIPOTROPICS: OTHER|11209|||||No|No||TIME-CAP LABS|No||||
acetaminophen|No|No|No|No|75%|49483034010|ACETAMINOPHEN 325 MG TABLET|1000|EA|.00516|09/30/2021||Yes|No||||No|No|09/30/2021||Yes|No||||No|No|||Over the counter|No|||No|.02412|03/29/2022|.02354|03/29/2022|.02369|03/29/2022||||11210|||||No|No||TIME-CAP LABS|No||||
epinephrine|No|No|No|No|75%|49502010101|EPINEPHRINE 0.15 MG AUTO-INJCT|1|EA||03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||238|No|140.37068|03/29/2022|137.00178|03/29/2022|137.91419|03/29/2022|||EPINEPHRINE: SELF-INJECTED|11211|||||No|No||MYLAN SPECIALTY|No||||
epinephrine|No|No|No|No|75%|49502010102|EPINEPHRINE 0.15 MG AUTO-INJCT|2|EA|64.5|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||238|No|140.37068|03/29/2022|137.00178|03/29/2022|137.91419|03/29/2022|||EPINEPHRINE: SELF-INJECTED|11212|||||No|No||MYLAN SPECIALTY|No||||
epinephrine|No|No|No|No|75%|49502010201|EPINEPHRINE 0.3 MG AUTO-INJECT|1|EA||03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||238|No|142.30108|03/29/2022|138.88585|03/29/2022|139.81081|03/29/2022|||EPINEPHRINE: SELF-INJECTED|11213|||||No|No||MYLAN SPECIALTY|No||||
epinephrine|No|No|No|No|75%|49502010202|EPINEPHRINE 0.3 MG AUTO-INJECT|2|EA|64.5|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||238|No|142.30108|03/29/2022|138.88585|03/29/2022|139.81081|03/29/2022|||EPINEPHRINE: SELF-INJECTED|11214|||||No|No||MYLAN SPECIALTY|No||||
tobramycin|No|No|No|No|75%|49502034624|TOBI PODHALER 28 MG INHALE CAP|56|EA|19.45851|10/22/2020|06/30/2022|Yes|No||10/22/2020|06/30/2022|Yes|No|10/22/2020|06/30/2022|Yes|No|Submit HHS Form 1143|||No|No|||Prescription required|No||240|No|44.34731|10/22/2020|43.71377|10/22/2020|41.63217|10/22/2020|||ANTIBIOTICS: INHALED|11215|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||MYLAN SPECIALTY|No||||
tobramycin|No|No|No|No|75%|49502040124|TOBI PODHALER 28 MG INHALE CAP|56|EA|20.41198|10/18/2021||Yes|No||10/18/2021||Yes|No|10/18/2021||Yes|No|Submit HHS Form 1143|||No|No|||Prescription required|No||240|No|46.52033|03/22/2022|45.85575|03/22/2022|43.67215|03/22/2022|||ANTIBIOTICS: INHALED|11216|||||No|No||MYLAN SPECIALTY|No||||
efavirenz/lamivu/tenofov disop|No|No|No|No|75%|49502042593|SYMFI LO 400-300-300 MG TABLET|30|EA|34.2906|07/19/2018||Yes|No||07/19/2018||Yes|No|07/19/2018||Yes|No||||No|No|||Prescription required|No||237|No|56.00798|03/22/2022|55.20786|03/22/2022|52.57892|03/22/2022|||HIV / AIDS|11217|||||No|No||MYLAN SPECIALTY|No||||
lamivudine/tenofovir disop fum|No|No|No|No|75%|49502045093|CIMDUO 300-300 MG TABLET|30|EA|21.0948|09/26/2018||Yes|No||09/26/2018||Yes|No|09/26/2018||Yes|No||||No|No|||Prescription required|No||237|No|34.45484|03/22/2022|33.96262|03/22/2022|32.34536|03/22/2022|||HIV / AIDS|11218|||||No|No||MYLAN SPECIALTY|No||||
efavirenz/lamivu/tenofov disop|No|No|No|No|75%|49502047593|SYMFI 600-300-300 MG TABLET|30|EA|34.2906|07/19/2018||Yes|No||07/19/2018||Yes|No|07/19/2018||Yes|No||||No|No|||Prescription required|No||237|No|56.00798|03/22/2022|55.20786|03/22/2022|52.57892|03/22/2022|||HIV / AIDS|11219|||||No|No||MYLAN SPECIALTY|No||||
epinephrine|No|No|No|No|75%|49502050002|EPIPEN 2-PAK 0.3 MG AUTO-INJCT|2|EA|159.9245|04/23/2010||Yes|No||04/23/2010||Yes|No|04/23/2010||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|238|No|292.45389|12/21/2021|285.43499|12/21/2021|287.33594|12/21/2021|||EPINEPHRINE: SELF-INJECTED|11220|||||No|No||MYLAN SPECIALTY|No||||
epinephrine|No|No|No|No|75%|49502050102|EPIPEN JR 2-PAK 0.15 MG INJCTR|2|EA|159.9245|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|238|No|291.373|08/24/2021|284.38004|08/24/2021|286.27397|08/24/2021|||EPINEPHRINE: SELF-INJECTED|11221|||||No|No||MYLAN SPECIALTY|No||||
formoterol fumarate|No|No|No|No|75%|49502060561|PERFOROMIST 20 MCG/2 ML SOLN|2|ML|3.99616|10/15/2007||Yes|No||10/15/2007||Yes|No|10/15/2007||Yes|No||||No|No|||Prescription required|Yes|01/23/2008|037|Yes|8.92812|10/26/2021|8.71384|10/26/2021|8.77187|10/26/2021|||BRONCHODILATORS: BETA AGONIST|11222|||||No|No||MYLAN SPECIALTY|No||||
revefenacin|No|No|No|No|75%|49502080693|YUPELRI 175 MCG/3 ML SOLUTION|3|ML|5.53844|02/03/2020||Yes|No||02/03/2020||Yes|No|02/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|098|No|12.32409|07/13/2021|12.02831|07/13/2021|12.10841|07/13/2021|||COPD AGENTS|11223|||||No|No||MYLAN SPECIALTY|No||||
selegiline|No|No|No|No|75%|49502090030|EMSAM 6 MG/24 HOURS PATCH|30|EA|27.3652|10/26/2009||Yes|No||10/26/2009||Yes|No|10/26/2009||Yes|No||||No|No|||Prescription required|Yes|07/22/2009|031|No|62.3672|03/22/2022|61.47624|03/22/2022|58.5488|03/22/2022|||ANTIDEPRESSANTS: OTHER|11224|||||No|No||MYLAN SPECIALTY|No||||
selegiline|No|No|No|No|75%|49502090230|EMSAM 12 MG/24 HOURS PATCH|30|EA|27.3652|09/18/2009||Yes|No||09/18/2009||Yes|No|09/18/2009||Yes|No||||No|No|||Prescription required|Yes|07/22/2009|031|No|62.3672|03/22/2022|61.47624|03/22/2022|58.5488|03/22/2022|||ANTIDEPRESSANTS: OTHER|11225|||||No|No||MYLAN SPECIALTY|No||||
lamivudine/zidovudine|No|No|No|No|75%|49702020218|COMBIVIR TABLET|60|EA|9.01419|01/07/2011||Yes|No||01/07/2011||Yes|No|01/07/2011||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|14.72318|11/28/2017|14.51285|11/28/2017|13.82176|11/28/2017|||HIV / AIDS|11226|||||No|No||VIIV HEALTHCARE|No||||
lamivudine|No|No|No|No|75%|49702020318|EPIVIR 150 MG TABLET|60|EA|4.1574|01/26/2011||Yes|No||01/26/2011||Yes|No|01/26/2011||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|6.79042|06/28/2016|6.69341|06/28/2016|6.37468|06/28/2016|||HIV / AIDS|11227|||||No|No||VIIV HEALTHCARE|No||||
lamivudine|No|No|No|No|75%|49702020413|EPIVIR 300 MG TABLET|30|EA|8.3148|01/14/2011||Yes|No||01/14/2011||Yes|No|01/14/2011||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|13.58084|06/01/2016|13.38682|06/01/2016|12.74936|06/01/2016|||HIV / AIDS|11228|||||No|No||VIIV HEALTHCARE|No||||
lamivudine|No|No|No|No|75%|49702020548|EPIVIR 10 MG/ML ORAL SOLN|240|ML|.27717|01/14/2011||Yes|No||01/14/2011||Yes|No|01/14/2011||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.45271|04/25/2017|.44624|04/25/2017|.42499|04/25/2017|||HIV / AIDS|11229|||||No|No||VIIV HEALTHCARE|No||||
abacavir sulfate/lamivudine|No|No|No|No|75%|49702020613|EPZICOM TABLET|30|EA|25.8342|12/23/2010||Yes|No||12/23/2010||Yes|No|12/23/2010||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|42.19586|04/27/2021|41.59306|04/27/2021|39.61244|04/27/2021|||HIV / AIDS|11230|||||No|No||VIIV HEALTHCARE|No||||
fosamprenavir calcium|No|No|No|No|75%|49702020718|LEXIVA 700 MG TABLET|60|EA|11.5857|01/07/2011||Yes|No||01/07/2011||Yes|No|01/07/2011||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|18.92331|06/26/2018|18.65297|06/26/2018|17.76474|06/26/2018|||HIV / AIDS|11231|||||No|No||VIIV HEALTHCARE|No||||
fosamprenavir calcium|No|No|No|No|75%|49702020853|LEXIVA 50 MG/ML SUSPENSION|225|ML|.47335|09/15/2011||Yes|No||09/15/2011||Yes|No|09/15/2011||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.77315|02/07/2017|.7621|02/07/2017|.72581|02/07/2017|||HIV / AIDS|11232|||||No|No||VIIV HEALTHCARE|No||||
zidovudine|No|No|No|No|75%|49702021120|RETROVIR 100 MG CAPSULE|100|EA|1.61916|08/31/2011||Yes|No||08/31/2011||Yes|No|08/31/2011||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|2.64462|06/01/2016|2.60684|06/01/2016|2.48271|06/01/2016||||11233|||||No|No||VIIV HEALTHCARE|No||||
zidovudine|No|No|No|No|75%|49702021248|RETROVIR 10 MG/ML SYRUP|240|ML|.16189|02/18/2011||Yes|No||02/18/2011||Yes|No|02/18/2011||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.26443|06/01/2016|.26065|06/01/2016|.24824|06/01/2016|||HIV / AIDS|11234|||||No|No||VIIV HEALTHCARE|No||||
zidovudine|No|No|No|No|75%|49702021326|RETROVIR 200 MG/20 ML VIAL|20|ML|.8757|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|1.43031|05/17/2017|1.40987|05/17/2017|1.34274|05/17/2017||||11235|||||No|No||VIIV HEALTHCARE|No||||
abacavir/lamivudine/zidovudine|No|No|No|No|75%|49702021718|TRIZIVIR TABLET|60|EA|16.09699|02/02/2011||Yes|No||02/02/2011||Yes|No|02/02/2011||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|26.29176|11/29/2016|25.91616|11/29/2016|24.68206|11/29/2016|||HIV / AIDS|11236|||||No|No||VIIV HEALTHCARE|No||||
abacavir sulfate|No|No|No|No|75%|49702022118|ZIAGEN 300 MG TABLET|60|EA|5.58639|01/14/2011||Yes|No||01/14/2011||Yes|No|01/14/2011||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|9.12444|06/27/2017|8.99409|06/27/2017|8.5658|06/27/2017|||HIV / AIDS|11237|||||No|No||VIIV HEALTHCARE|No||||
abacavir sulfate|No|No|No|No|75%|49702022248|ZIAGEN 20 MG/ML SOLUTION|240|ML|.36714|03/29/2011||Yes|No||03/29/2011||Yes|No|03/29/2011||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.59967|06/01/2016|.5911|06/01/2016|.56295|06/01/2016|||HIV / AIDS|11238|||||No|No||VIIV HEALTHCARE|No||||
maraviroc|No|No|No|No|75%|49702022318|SELZENTRY 150 MG TABLET|60|EA|16.3308|10/14/2011||Yes|No||10/14/2011||Yes|No|10/14/2011||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|26.38559|02/08/2022|25.75233|02/08/2022|25.92384|02/08/2022|||HIV / AIDS|11239|||||No|No||VIIV HEALTHCARE|No||||
maraviroc|No|No|No|No|75%|49702022418|SELZENTRY 300 MG TABLET|60|EA|16.3308|09/15/2011||Yes|No||09/15/2011||Yes|No|09/15/2011||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|26.4559|02/08/2022|25.82095|02/08/2022|25.99292|02/08/2022|||HIV / AIDS|11240|||||No|No||VIIV HEALTHCARE|No||||
dolutegravir sodium|No|No|No|No|75%|49702022613|TIVICAY 10 MG TABLET|30|EA|8.04579|10/21/2016||Yes|No||10/21/2016||Yes|No|10/21/2016||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|13.14146|02/01/2022|12.95373|02/01/2022|12.33688|02/01/2022|||HIV / AIDS|11241|||||No|No||VIIV HEALTHCARE|No||||
dolutegravir sodium|No|No|No|No|75%|49702022713|TIVICAY 25 MG TABLET|30|EA|20.1138|10/21/2016||Yes|No||10/21/2016||Yes|No|10/21/2016||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|32.85254|02/01/2022|32.38321|02/01/2022|30.84116|02/01/2022|||HIV / AIDS|11242|||||No|No||VIIV HEALTHCARE|No||||
dolutegravir sodium|No|No|No|No|75%|49702022813|TIVICAY 50 MG TABLET|30|EA|40.2276|08/23/2013||Yes|No||08/23/2013||Yes|No|08/23/2013||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|65.17441|02/08/2022|63.61022|02/08/2022|64.03385|02/08/2022|||HIV / AIDS|11243|||||No|No||VIIV HEALTHCARE|No||||
abacavir/dolutegravir/lamivudi|No|No|No|No|75%|49702023113|TRIUMEQ 600-50-300 MG TABLET|30|EA|66.7812|09/02/2014||Yes|No||09/02/2014||Yes|No|09/02/2014||Yes|No||||No|No|||Prescription required|No||237|No|108.08505|02/08/2022|105.491|02/08/2022|106.19356|02/08/2022|||HIV / AIDS|11244|||||No|No||VIIV HEALTHCARE|No||||
maraviroc|No|No|No|No|75%|49702023308|SELZENTRY 25 MG TABLET|120|EA|2.72184|07/11/2017||Yes|No||07/11/2017||Yes|No|07/11/2017||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|4.44568|02/01/2022|4.38217|02/01/2022|4.17349|02/01/2022|||HIV / AIDS|11245|||||No|No||VIIV HEALTHCARE|No||||
maraviroc|No|No|No|No|75%|49702023508|SELZENTRY 75 MG TABLET|120|EA|8.1654|07/11/2017||Yes|No||07/11/2017||Yes|No|07/11/2017||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|13.33682|02/01/2022|13.14629|02/01/2022|12.52028|02/01/2022|||HIV / AIDS|11246|||||No|No||VIIV HEALTHCARE|No||||
maraviroc|No|No|No|No|75%|49702023755|SELZENTRY 20 MG/ML ORAL SOLN|230|ML|2.17742|07/17/2017||Yes|No||07/17/2017||Yes|No|07/17/2017||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|3.55645|02/01/2022|3.50565|02/01/2022|3.33871|02/01/2022|||HIV / AIDS|11247|||||No|No||VIIV HEALTHCARE|No||||
dolutegravir/rilpivirine|No|No|No|No|75%|49702024213|JULUCA 50-25 MG TABLET|30|EA|44.85502|02/01/2018||Yes|No||02/01/2018||Yes|No|02/01/2018||Yes|No||||No|No|||Prescription required|No||237|No|100.94192|02/08/2022|98.51931|02/08/2022|99.17543|02/08/2022|||HIV / AIDS|11248|||||No|No||VIIV HEALTHCARE|No||||
dolutegravir sodium/lamivudine|No|No|No|No|75%|49702024613|DOVATO 50-300 MG TABLET|30|EA|38.01472|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|||Prescription required|No||237|No|85.60326|02/08/2022|83.54878|02/08/2022|84.1052|02/08/2022|||HIV / AIDS|11249|||||No|No||VIIV HEALTHCARE|No||||
fostemsavir tromethamine|No|No|No|No|75%|49702025018|RUKOBIA ER 600 MG TABLET|60|EA|57.53335|02/01/2021||Yes|No||02/01/2021||Yes|No|02/01/2021||Yes|No||||No|No|||Prescription required|No||237|No|131.12253|02/01/2022|129.24935|02/01/2022|123.09462|02/01/2022|||HIV / AIDS|11250|||||No|No||VIIV HEALTHCARE|No||||
dolutegravir sodium|No|No|No|No|75%|49702025537|TIVICAY PD 5 MG TAB FOR SUSP|60|EA|4.02289|09/03/2020||Yes|No||09/03/2020||Yes|No|09/03/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|6.57073|02/01/2022|6.47686|02/01/2022|6.16844|02/01/2022|||HIV / AIDS|11251|||||No|No||VIIV HEALTHCARE|No||||
nitroglycerin|No|No|No|No|75%|49730011130|NITROGLYCERIN 0.2 MG/HR PATCH|30|EA|.30372|02/23/2015||Yes|No||02/23/2015||Yes|No|02/23/2015||Yes|No||||No|No|||Prescription required|No|||No|.5028|03/29/2022|.49073|03/29/2022|.494|03/29/2022||||11252|||||No|No||HERCON|No||||
nitroglycerin|No|No|No|No|75%|49730011230|NITROGLYCERIN 0.4 MG/HR PATCH|30|EA|.35102|02/23/2015||Yes|No||02/23/2015||Yes|No|02/23/2015||Yes|No||||No|No|||Prescription required|No|||No|.59249|03/29/2022|.57827|03/29/2022|.58212|03/29/2022||||11253|||||No|No||HERCON|No||||
nitroglycerin|No|No|No|No|75%|49730011330|NITROGLYCERIN 0.6 MG/HR PATCH|30|EA|.4052|02/23/2015||Yes|No||02/23/2015||Yes|No|02/23/2015||Yes|No||||No|No|||Prescription required|No|||No|.68113|09/28/2021|.66478|09/28/2021|.66921|09/28/2021||||11254|||||No|No||HERCON|No||||
sodium phenylbutyrate|No|No|No|No|75%|49884000604|SODIUM PHENYLBUTYRATE POWDER|250|GM|7.73934|01/29/2021||Yes|No||01/29/2021||Yes|No|01/29/2021||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|570|No|17.63851|01/29/2021|17.38653|01/29/2021|16.5586|01/29/2021|||UREA CYCLE DISORDERS: ORAL|11255|||||No|No||PAR PHARM.|No||||
aspirin/dipyridamole|No|No|No|No|75%|49884000702|ASPIRIN-DIPYRIDAM ER 25-200 MG|60|EA|2.14404|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||004|No|.78047|03/29/2022|.76173|03/29/2022|.76681|03/29/2022|||PLATELET AGGREGATION INHIBITORS|11256|||||No|No||PAR PHARM.|No||||
isosorbide dinitrate|No|No|No|No|75%|49884000901|ISOSORBIDE DINITRATE 30 MG TAB|100|EA|.45102|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.46251|03/29/2022|.4514|03/29/2022|.45441|03/29/2022||||11257|||||No|No||PAR PHARM.|No||||
isosorbide dinitrate|No|No|No|No|75%|49884000910|ISOSORBIDE DINITRATE 30 MG TAB|1000|EA|.45101|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.46251|03/29/2022|.4514|03/29/2022|.45441|03/29/2022||||11258|||||No|No||PAR PHARM.|No||||
isosorbide dinitrate|No|No|No|No|75%|49884002001|ISOSORBIDE DINITRATE 5 MG TAB|100|EA|.33884|05/17/2013||Yes|No||05/17/2013||Yes|No|05/17/2013||Yes|No||||No|No|||Prescription required|No|||No|.32336|03/29/2022|.31559|03/29/2022|.3177|03/29/2022||||11259|||||No|No||PAR PHARM.|No||||
isosorbide dinitrate|No|No|No|No|75%|49884002010|ISOSORBIDE DINITRATE 5 MG TAB|1000|EA|.33885|05/17/2013||Yes|No||05/17/2013||Yes|No|05/17/2013||Yes|No||||No|No|||Prescription required|No|||No|.32336|03/29/2022|.31559|03/29/2022|.3177|03/29/2022||||11260|||||No|No||PAR PHARM.|No||||
isosorbide dinitrate|No|No|No|No|75%|49884002101|ISOSORBIDE DINITRATE 10 MG TAB|100|EA|.37272|05/17/2013||Yes|No||05/17/2013||Yes|No|05/17/2013||Yes|No||||No|No|||Prescription required|No|||No|.34234|03/29/2022|.33412|03/29/2022|.33634|03/29/2022||||11261|||||No|No||PAR PHARM.|No||||
isosorbide dinitrate|No|No|No|No|75%|49884002110|ISOSORBIDE DINITRATE 10 MG TAB|1000|EA|.37274|05/17/2013||Yes|No||05/17/2013||Yes|No|05/17/2013||Yes|No||||No|No|||Prescription required|No|||No|.34234|03/29/2022|.33412|03/29/2022|.33634|03/29/2022||||11262|||||No|No||PAR PHARM.|No||||
isosorbide dinitrate|No|No|No|No|75%|49884002201|ISOSORBIDE DINITRATE 20 MG TAB|100|EA|.41|03/01/2014||Yes|No||03/01/2014||Yes|No|03/01/2014||Yes|No||||No|No|||Prescription required|No|||No|.30675|03/29/2022|.29938|03/29/2022|.30138|03/29/2022||||11263|||||No|No||PAR PHARM.|No||||
isosorbide dinitrate|No|No|No|No|75%|49884002210|ISOSORBIDE DINITRATE 20 MG TAB|1000|EA|.41001|03/01/2014||Yes|No||03/01/2014||Yes|No|03/01/2014||Yes|No||||No|No|||Prescription required|No|||No|.30675|03/29/2022|.29938|03/29/2022|.30138|03/29/2022||||11264|||||No|No||PAR PHARM.|No||||
tranylcypromine sulfate|No|No|No|No|75%|49884003201|TRANYLCYPROMINE SULF 10 MG TAB|100|EA|1.14956|07/13/2006||Yes|No||||No|No|||No|No||||No|No|||Prescription required|Yes|07/28/2010|031|No|1.32918|03/29/2022|1.29727|03/29/2022|1.30591|03/29/2022|||ANTIDEPRESSANTS: OTHER|11265|||||No|No||PAR PHARM.|No||||
phenoxybenzamine HCl|No|No|No|No|75%|49884003801|PHENOXYBENZAMINE HCL 10 MG CAP|100|EA|46.38453|09/07/2018||Yes|No||||No|No|||No|No||||No|No|||Prescription required|No|||No|105.71358|09/07/2018|104.20338|09/07/2018|99.24132|09/07/2018||||11266|||||No|No||PAR PHARM.|No||||
dexmethylphenidate HCl|No|No|No|No|75%|49884004801|DEXMETHYLPHENIDATE ER 5 MG CAP|100|EA|.4515|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.46405|03/29/2022|1.42891|03/29/2022|1.43842|03/29/2022|||STIMULANTS AND RELATED AGENTS|11267|||||No|No||PAR PHARM.|No||||
dexmethylphenidate HCl|No|No|No|No|75%|49884004901|DEXMETHYLPHENIDATE ER 10 MG CP|100|EA|.45472|10/25/2017||Yes|No||10/25/2017||Yes|No|10/25/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.21716|03/29/2022|1.18794|03/29/2022|1.19585|03/29/2022|||STIMULANTS AND RELATED AGENTS|11268|||||No|No||PAR PHARM.|No||||
imipramine HCl|No|No|No|No|75%|49884005401|IMIPRAMINE HCL 10 MG TABLET|100|EA|.0774|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.08862|03/29/2022|.08649|03/29/2022|.08706|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|11269|||||No|No||PAR PHARM.|No||||
imipramine HCl|No|No|No|No|75%|49884005410|IMIPRAMINE HCL 10 MG TABLET|1000|EA|.07378|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.08862|03/29/2022|.08649|03/29/2022|.08706|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|11270|||||No|No||PAR PHARM.|No||||
imipramine HCl|No|No|No|No|75%|49884005501|IMIPRAMINE HCL 25 MG TABLET|100|EA|.1032|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.0831|03/29/2022|.0811|03/29/2022|.08164|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|11271|||||No|No||PAR PHARM.|No||||
imipramine HCl|No|No|No|No|75%|49884005510|IMIPRAMINE HCL 25 MG TABLET|1000|EA|.09849|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.0831|03/29/2022|.0811|03/29/2022|.08164|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|11272|||||No|No||PAR PHARM.|No||||
imipramine HCl|No|No|No|No|75%|49884005601|IMIPRAMINE HCL 50 MG TABLET|100|EA|.1333|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.13692|03/29/2022|.13363|03/29/2022|.13452|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|11273|||||No|No||PAR PHARM.|No||||
imipramine HCl|No|No|No|No|75%|49884005610|IMIPRAMINE HCL 50 MG TABLET|1000|EA|.12853|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.13692|03/29/2022|.13363|03/29/2022|.13452|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|11274|||||No|No||PAR PHARM.|No||||
bosentan|No|No|No|No|75%|49884005802|BOSENTAN 62.5 MG TABLET|60|EA|8.33598|12/20/2019||Yes|No||12/20/2019||Yes|No|12/20/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/26/2018|171|No|18.99828|12/24/2019|18.72687|12/20/2019|17.83512|12/20/2019|||PAH AGENTS: ORAL AND INHALED|11275|||||No|No||PAR PHARM.|No||||
bosentan|No|No|No|No|75%|49884005902|BOSENTAN 125 MG TABLET|60|EA|8.33598|12/20/2019||Yes|No||12/20/2019||Yes|No|12/20/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/26/2018|171|No|18.99828|12/24/2019|18.72687|12/20/2019|17.83512|12/20/2019|||PAH AGENTS: ORAL AND INHALED|11276|||||No|No||PAR PHARM.|No||||
trientine HCl|No|No|No|No|75%|49884006001|TRIENTINE HCL 250 MG CAPSULE|100|EA|6.45|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No||||No|No|||Prescription required|No|||No|14.7|09/22/2020|14.49|09/22/2020|13.8|09/22/2020||||11277|||||No|No||PAR PHARM.|No||||
glycopyrrolate|No|No|No|No|75%|49884006501|GLYCOPYRROLATE 1 MG TABLET|100|EA|.18653|11/02/2007||Yes|No||11/02/2007||Yes|No|11/02/2007||Yes|No||||No|No|||Prescription required|No|||No|.10136|03/29/2022|.09892|03/29/2022|.09958|03/29/2022||||11278|||||No|No||PAR PHARM.|No||||
glycopyrrolate|No|No|No|No|75%|49884006601|GLYCOPYRROLATE 2 MG TABLET|100|EA|.33475|10/02/2006||Yes|No||10/02/2006||Yes|No|10/02/2006||Yes|No||||No|No|||Prescription required|No|||No|.22028|03/29/2022|.21499|03/29/2022|.21642|03/29/2022||||11279|||||No|No||PAR PHARM.|No||||
alprazolam|No|No|No|No|90%|49884011074|ALPRAZOLAM ODT 0.25 MG TAB|100|EA|.46397|08/25/2010||Yes|No||08/25/2010||Yes|No|08/25/2010||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|1.05742|11/29/2016|1.04231|11/29/2016|.99268|11/29/2016|||ANXIOLYTICS|11280|||||No|No||PAR PHARM.|No||||
alprazolam|No|No|No|No|90%|49884011174|ALPRAZOLAM ODT 0.5 MG TAB|100|EA|.57809|08/25/2010||Yes|No||08/25/2010||Yes|No|08/25/2010||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|1.31751|05/25/2021|1.29869|05/25/2021|1.23684|05/25/2021|||ANXIOLYTICS|11281|||||No|No||PAR PHARM.|No||||
propafenone HCl|No|No|No|No|75%|49884011302|PROPAFENONE HCL ER 225 MG CAP|60|EA|2.51413|12/13/2016||Yes|No||12/13/2016||Yes|No|12/13/2016||Yes|No||||No|No|||Prescription required|No|||No|1.23841|03/29/2022|1.20868|03/29/2022|1.21673|03/29/2022||||11282|||||No|No||PAR PHARM.|No||||
propafenone HCl|No|No|No|No|75%|49884011305|PROPAFENONE HCL ER 225 MG CAP|500|EA|2.51412|12/13/2016||Yes|No||12/13/2016||Yes|No|12/13/2016||Yes|No||||No|No|||Prescription required|No|||No|1.23841|03/29/2022|1.20868|03/29/2022|1.21673|03/29/2022||||11283|||||No|No||PAR PHARM.|No||||
propafenone HCl|No|No|No|No|75%|49884011309|PROPAFENONE HCL ER 225 MG CAP|90|EA|2.51411|12/13/2016||Yes|No||12/13/2016||Yes|No|12/13/2016||Yes|No||||No|No|||Prescription required|No|||No|1.23841|03/29/2022|1.20868|03/29/2022|1.21673|03/29/2022||||11284|||||No|No||PAR PHARM.|No||||
amiloride HCl|No|No|No|No|75%|49884011701|AMILORIDE HCL 5 MG TABLET|100|EA|.3882|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.19533|03/29/2022|.19064|03/29/2022|.19191|03/29/2022||||11285|||||No|No||PAR PHARM.|No||||
amiloride HCl|No|No|No|No|75%|49884011710|AMILORIDE HCL 5 MG TABLET|1000|EA|.3882|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.19533|03/29/2022|.19064|03/29/2022|.19191|03/29/2022||||11286|||||No|No||PAR PHARM.|No||||
everolimus|No|No|No|No|75%|49884011991|EVEROLIMUS 2.5 MG TABLET|28|EA|184.48505|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|||Prescription required|No||548|No|420.4543|03/17/2020|414.44781|03/17/2020|394.7122|03/17/2020|||ONCOLOGY: ORAL - RENAL CELL|11287|||||No|No||PAR PHARM.|No||||
labetalol HCl|No|No|No|No|75%|49884012201|LABETALOL HCL 100 MG TABLET|100|EA|.17647|03/18/2013||Yes|No||03/18/2013||Yes|No|03/18/2013||Yes|No||03/18/2013||Yes|No|||Prescription required|No||070|No|.12868|03/29/2022|.12559|03/29/2022|.12642|03/29/2022|||BETA-BLOCKERS|11288|||||No|No||PAR PHARM.|No||||
labetalol HCl|No|No|No|No|75%|49884012205|LABETALOL HCL 100 MG TABLET|500|EA|.17647|03/10/2014||Yes|No||03/10/2014||Yes|No|03/10/2014||Yes|No||03/10/2014||Yes|No|||Prescription required|No||070|No|.12868|03/29/2022|.12559|03/29/2022|.12642|03/29/2022|||BETA-BLOCKERS|11289|||||No|No||PAR PHARM.|No||||
labetalol HCl|No|No|No|No|75%|49884012301|LABETALOL HCL 200 MG TABLET|100|EA|.25038|03/18/2013||Yes|No||03/18/2013||Yes|No|03/18/2013||Yes|No||03/18/2013||Yes|No|||Prescription required|No||070|No|.17218|03/29/2022|.16804|03/29/2022|.16916|03/29/2022|||BETA-BLOCKERS|11290|||||No|No||PAR PHARM.|No||||
labetalol HCl|No|No|No|No|75%|49884012305|LABETALOL HCL 200 MG TABLET|500|EA|.25038|03/10/2014||Yes|No||03/10/2014||Yes|No|03/10/2014||Yes|No||03/10/2014||Yes|No|||Prescription required|No||070|No|.17218|03/29/2022|.16804|03/29/2022|.16916|03/29/2022|||BETA-BLOCKERS|11291|||||No|No||PAR PHARM.|No||||
labetalol HCl|No|No|No|No|75%|49884012401|LABETALOL HCL 300 MG TABLET|100|EA|.33307|03/18/2013||Yes|No||03/18/2013||Yes|No|03/18/2013||Yes|No||03/18/2013||Yes|No|||Prescription required|No||070|No|.21583|03/29/2022|.21065|03/29/2022|.21205|03/29/2022|||BETA-BLOCKERS|11292|||||No|No||PAR PHARM.|No||||
labetalol HCl|No|No|No|No|75%|49884012405|LABETALOL HCL 300 MG TABLET|500|EA|.33307|03/10/2014||Yes|No||03/10/2014||Yes|No|03/10/2014||Yes|No||03/10/2014||Yes|No|||Prescription required|No||070|No|.21583|03/29/2022|.21065|03/29/2022|.21205|03/29/2022|||BETA-BLOCKERS|11293|||||No|No||PAR PHARM.|No||||
everolimus|No|No|No|No|75%|49884012591|EVEROLIMUS 5 MG TABLET|28|EA|192.96818|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|||Prescription required|No||548|No|439.78794|03/17/2020|433.50526|03/17/2020|412.86215|03/17/2020|||ONCOLOGY: ORAL - RENAL CELL|11294|||||No|No||PAR PHARM.|No||||
everolimus|No|No|No|No|75%|49884012791|EVEROLIMUS 7.5 MG TABLET|28|EA|192.96818|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|||Prescription required|No||548|No|439.78794|03/17/2020|433.50526|03/17/2020|412.86215|03/17/2020|||ONCOLOGY: ORAL - RENAL CELL|11295|||||No|No||PAR PHARM.|No||||
penicillamine|No|No|No|No|75%|49884014601|PENICILLAMINE 250 MG CAPSULE|100|EA|90.08891|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No|||No|205.31891|05/21/2020|202.38579|05/21/2020|192.74837|05/21/2020||||11296|||||No|No||PAR PHARM.|No||||
varenicline tartrate|No|No|No|No|75%|49884015576|VARENICLINE 0.5 MG TABLET|56|EA|2.79899|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|040|No|6.32314|03/29/2022|6.17138|03/29/2022|6.21248|03/29/2022|||SMOKING CESSATION|11297|||||No|No||PAR PHARM.|No||||
varenicline tartrate|No|No|No|No|75%|49884015676|VARENICLINE 1 MG TABLET|56|EA|2.79899|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|040|No|6.34646|03/29/2022|6.19414|03/29/2022|6.23539|03/29/2022|||SMOKING CESSATION|11298|||||No|No||PAR PHARM.|No||||
calcitonin,salmon,synthetic|No|No|No|No|75%|49884016111|CALCITONIN-SALMON 200 UNITS SP|3.7|ML|8.7011|08/25/2010||Yes|No||08/25/2010||Yes|No|08/25/2010||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|060|No|7.79532|03/29/2022|7.60823|03/29/2022|7.6589|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|11299|||||No|No||PAR PHARM.|No||||
sodium phenylbutyrate|No|No|No|No|75%|49884017004|SODIUM PHENYLBUTYRATE 500MG TB|250|EA|8.5312|01/26/2018||Yes|No||01/26/2018||Yes|No|01/26/2018||Yes|No||||No|No|||Prescription required|Yes|09/28/2017|570|No|19.4432|01/26/2018|19.16544|01/26/2018|18.2528|01/26/2018|||UREA CYCLE DISORDERS: ORAL|11300|||||No|No||PAR PHARM.|No||||
doxylamine succinate/vit B6|No|No|No|No|75%|49884018601|DOXYLAMINE-PYRIDOXINE 10-10 MG|100|EA|2.35984|07/01/1999||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|085|Yes|2.71034|03/29/2022|2.64529|03/29/2022|2.6629|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|11301|||||No|No||PAR PHARM.|No||||
propafenone HCl|No|No|No|No|75%|49884021002|PROPAFENONE HCL ER 325 MG CAP|60|EA|3.18507|07/25/2012||Yes|No||07/25/2012||Yes|No|07/25/2012||Yes|No||||No|No|||Prescription required|No|||No|2.24387|03/29/2022|2.19001|03/29/2022|2.2046|03/29/2022||||11302|||||No|No||PAR PHARM.|No||||
propafenone HCl|No|No|No|No|75%|49884021009|PROPAFENONE HCL ER 325 MG CAP|90|EA|3.1851|07/25/2012||Yes|No||07/25/2012||Yes|No|07/25/2012||Yes|No||||No|No|||Prescription required|No|||No|2.24387|03/29/2022|2.19001|03/29/2022|2.2046|03/29/2022||||11303|||||No|No||PAR PHARM.|No||||
propafenone HCl|No|No|No|No|75%|49884021102|PROPAFENONE HCL ER 425 MG CAP|60|EA|3.18507|07/25/2012||Yes|No||07/25/2012||Yes|No|07/25/2012||Yes|No||||No|No|||Prescription required|No|||No|7.25901|03/23/2021|7.15531|03/23/2021|6.81458|03/23/2021||||11304|||||No|No||PAR PHARM.|No||||
risperidone|No|No|No|No|75%|49884021255|RISPERIDONE 0.25 MG ODT|30|EA|1.36998|08/25/2010||Yes|No||08/25/2010||Yes|No|08/25/2010||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|027|Yes|2.97987|11/23/2021|2.90835|11/23/2021|2.92772|11/23/2021|||ANTIPSYCHOTICS|11305|||||No|No||PAR PHARM.|No||||
alprazolam|No|No|No|No|90%|49884021374|ALPRAZOLAM ODT 1 MG TAB|100|EA|.77129|08/25/2010||Yes|No||08/25/2010||Yes|No|08/25/2010||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|1.75782|11/28/2017|1.73271|11/28/2017|1.6502|11/28/2017|||ANXIOLYTICS|11306|||||No|No||PAR PHARM.|No||||
alprazolam|No|No|No|No|90%|49884021474|ALPRAZOLAM ODT 2 MG TAB|100|EA|1.31141|08/25/2010||Yes|No||08/25/2010||Yes|No|08/25/2010||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|2.9888|06/01/2016|2.9461|06/01/2016|2.80581|06/01/2016|||ANXIOLYTICS|11307|||||No|No||PAR PHARM.|No||||
doxepin HCl|No|No|No|No|75%|49884021701|DOXEPIN 10 MG CAPSULE|100|EA|.20141|02/21/2018||Yes|No||02/21/2018||Yes|No|02/21/2018||Yes|No||||No|No|||Prescription required|No||215|No|.22181|03/29/2022|.21648|03/29/2022|.21792|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|11308|||||No|No||PAR PHARM.|No||||
doxepin HCl|No|No|No|No|75%|49884021801|DOXEPIN 25 MG CAPSULE|100|EA|.265|02/21/2018||Yes|No||02/21/2018||Yes|No|02/21/2018||Yes|No||||No|No|||Prescription required|No||215|No|.30005|03/29/2022|.29284|03/29/2022|.29479|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|11309|||||No|No||PAR PHARM.|No||||
doxepin HCl|No|No|No|No|75%|49884021901|DOXEPIN 50 MG CAPSULE|100|EA|.37969|02/21/2018||Yes|No||02/21/2018||Yes|No|02/21/2018||Yes|No||||No|No|||Prescription required|No||215|No|.41139|03/29/2022|.40151|03/29/2022|.40419|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|11310|||||No|No||PAR PHARM.|No||||
doxepin HCl|No|No|No|No|75%|49884022001|DOXEPIN 75 MG CAPSULE|100|EA|.58376|03/06/2018||Yes|No||03/06/2018||Yes|No|03/06/2018||Yes|No||||No|No|||Prescription required|No||215|No|.56944|03/29/2022|.55577|03/29/2022|.55947|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|11311|||||No|No||PAR PHARM.|No||||
doxepin HCl|No|No|No|No|75%|49884022101|DOXEPIN 100 MG CAPSULE|100|EA|.63597|02/21/2018||Yes|No||02/21/2018||Yes|No|02/21/2018||Yes|No||||No|No|||Prescription required|No||215|No|.67991|03/29/2022|.66359|03/29/2022|.66801|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|11312|||||No|No||PAR PHARM.|No||||
doxepin HCl|No|No|No|No|75%|49884022201|DOXEPIN 150 MG CAPSULE|100|EA|.32989|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.64995|03/29/2022|.63435|03/29/2022|.63857|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|11313|||||No|No||PAR PHARM.|No||||
doxepin HCl|No|No|No|No|75%|49884022203|DOXEPIN 150 MG CAPSULE|50|EA|.33694|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.64995|03/29/2022|.63435|03/29/2022|.63857|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|11314|||||No|No||PAR PHARM.|No||||
doxepin HCl|No|No|No|No|75%|49884022205|DOXEPIN 150 MG CAPSULE|500|EA|.31367|12/22/2008||Yes|No||12/22/2008||Yes|No|12/22/2008||Yes|No||||No|No|||Prescription required|No||215|No|.64995|03/29/2022|.63435|03/29/2022|.63857|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|11315|||||No|No||PAR PHARM.|No||||
praziquantel|No|No|No|No|75%|49884023183|PRAZIQUANTEL 600 MG TABLET|6|EA|28.5649|08/27/2018||Yes|No||08/27/2018||Yes|No|08/27/2018||Yes|No||||No|No|||Prescription required|No|||No|65.1014|08/27/2018|64.17138|08/27/2018|61.1156|08/27/2018||||11316|||||No|No||PAR PHARM.|No||||
dexmethylphenidate HCl|No|No|No|No|75%|49884024801|DEXMETHYLPHENIDATE ER 20 MG CP|100|EA|.49772|10/25/2017||Yes|No||10/25/2017||Yes|No|10/25/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.47249|03/29/2022|1.43715|03/29/2022|1.44672|03/29/2022|||STIMULANTS AND RELATED AGENTS|11317|||||No|No||PAR PHARM.|No||||
olanzapine/fluoxetine HCl|No|No|No|No|75%|49884025011|OLANZAPINE-FLUOXETINE 6-25 MG|30|EA|4.61304|03/18/2013||Yes|No||03/18/2013||Yes|No|03/18/2013||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|027|Yes|5.76547|03/29/2022|5.62709|03/29/2022|5.66457|03/29/2022|||ANTIPSYCHOTICS|11318|||||No|No||PAR PHARM.|No||||
olanzapine/fluoxetine HCl|No|No|No|No|75%|49884025111|OLANZAPINE-FLUOXETINE 6-50 MG|30|EA|4.61304|03/18/2013||Yes|No||03/18/2013||Yes|No|03/18/2013||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|027|Yes|5.947|01/25/2022|5.80427|01/25/2022|5.84292|01/25/2022|||ANTIPSYCHOTICS|11319|||||No|No||PAR PHARM.|No||||
olanzapine/fluoxetine HCl|No|No|No|No|75%|49884025211|OLANZAPINE-FLUOXETINE 12-25 MG|30|EA|6.95224|03/18/2013||Yes|No||03/18/2013||Yes|No|03/18/2013||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|027|Yes|15.84464|12/24/2019|15.61828|12/24/2019|14.87456|12/24/2019|||ANTIPSYCHOTICS|11320|||||No|No||PAR PHARM.|No||||
olanzapine/fluoxetine HCl|No|No|No|No|75%|49884025311|OLANZAPINE-FLUOXETINE 12-50 MG|30|EA|6.95224|03/18/2013||Yes|No||03/18/2013||Yes|No|03/18/2013||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|027|Yes|15.84464|06/25/2019|15.61828|06/25/2019|14.87456|06/25/2019|||ANTIPSYCHOTICS|11321|||||No|No||PAR PHARM.|No||||
minoxidil|No|No|No|No|75%|49884025601|MINOXIDIL 2.5 MG TABLET|100|EA|.0903|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.14809|03/29/2022|.14453|03/29/2022|.14549|03/29/2022||||11322|||||No|No||PAR PHARM.|No||||
minoxidil|No|No|No|No|75%|49884025701|MINOXIDIL 10 MG TABLET|100|EA|.1978|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.26052|03/29/2022|.25426|03/29/2022|.25596|03/29/2022||||11323|||||No|No||PAR PHARM.|No||||
minoxidil|No|No|No|No|75%|49884025705|MINOXIDIL 10 MG TABLET|500|EA|.19608|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.26052|03/29/2022|.25426|03/29/2022|.25596|03/29/2022||||11324|||||No|No||PAR PHARM.|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|49884026811|OMEPRAZOLE-BICARB 20-1,680 PKT|30|EA|37.56623|04/07/2017||Yes|No||04/07/2017||Yes|No|04/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|85.61606|09/28/2021|84.39297|09/28/2021|80.37426|09/28/2021|||PROTON PUMP INHIBITORS|11325|||||No|No||PAR PHARM.|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|49884026911|OMEPRAZOLE-BICARB 40-1,680 PKT|30|EA|37.56623|04/07/2017||Yes|No||04/07/2017||Yes|No|04/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|85.61606|11/24/2020|84.39297|11/24/2020|80.37426|11/24/2020|||PROTON PUMP INHIBITORS|11326|||||No|No||PAR PHARM.|No||||
cyanocobalamin (vitamin B-12)|No|No|No|No|75%|49884027082|NASCOBAL 500 MCG NASAL SPRAY|4|EA|72.68827|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No|||No|161.88417|01/18/2022|157.99894|01/18/2022|159.05119|01/18/2022||||11327|||||No|No||PAR PHARMACEUTI|No||||
ethacrynic acid|No|No|No|No|75%|49884027601|ETHACRYNIC ACID 25 MG TABLET|100|EA|4.29088|03/04/2019||Yes|No||03/04/2019||Yes|No|03/04/2019||Yes|No||||No|No|||Prescription required|No|||No|2.34378|03/01/2022|2.28752|03/01/2022|2.30276|03/01/2022||||11328|||||No|No||PAR PHARM.|No||||
olanzapine/fluoxetine HCl|No|No|No|No|75%|49884027711|OLANZAPINE-FLUOXETINE 3-25 MG|30|EA|3.37464|03/18/2013||Yes|No||03/18/2013||Yes|No|03/18/2013||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|027|Yes|5.27433|03/29/2022|5.14774|03/29/2022|5.18202|03/29/2022|||ANTIPSYCHOTICS|11329|||||No|No||PAR PHARM.|No||||
megestrol acetate|No|No|No|No|75%|49884028901|MEGESTROL 20 MG TABLET|100|EA|.0817|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||197|No|.14744|03/29/2022|.1439|03/29/2022|.14485|03/29/2022|||PROGESTINS FOR CACHEXIA|11330|||||No|No||PAR PHARM.|No||||
megestrol acetate|No|No|No|No|75%|49884029001|MEGESTROL 40 MG TABLET|100|EA|.1376|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||197|No|.19837|03/29/2022|.1936|03/29/2022|.19489|03/29/2022|||PROGESTINS FOR CACHEXIA|11331|||||No|No||PAR PHARM.|No||||
megestrol acetate|No|No|No|No|75%|49884029004|MEGESTROL 40 MG TABLET|250|EA|.12384|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||197|No|.19837|03/29/2022|.1936|03/29/2022|.19489|03/29/2022|||PROGESTINS FOR CACHEXIA|11332|||||No|No||PAR PHARM.|No||||
megestrol acetate|No|No|No|No|75%|49884029005|MEGESTROL 40 MG TABLET|500|EA|.11696|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||197|No|.19837|03/29/2022|.1936|03/29/2022|.19489|03/29/2022|||PROGESTINS FOR CACHEXIA|11333|||||No|No||PAR PHARM.|No||||
oxandrolone|No|No|No|No|90%|49884030101|OXANDROLONE 2.5 MG TABLET|100|EA|1.85987|08/25/2010||Yes|No||08/25/2010||Yes|No|08/25/2010||Yes|No||||No|No|||Prescription required|No|||No|4.23879|06/01/2016|4.17823|06/01/2016|3.97927|06/01/2016||||11334|||||No|No||PAR PHARM.|No||||
oxandrolone|No|No|No|No|90%|49884030202|OXANDROLONE 10 MG TABLET|60|EA|6.30681|08/25/2010||Yes|No||08/25/2010||Yes|No|08/25/2010||Yes|No||||No|No|||Prescription required|No|||No|14.37366|04/25/2017|14.16832|04/25/2017|13.49364|04/25/2017||||11335|||||No|No||PAR PHARM.|No||||
doxycycline monohydrate|No|No|No|No|75%|49884030502|DOXYCYCLINE MONO 150 MG CAP|60|EA|7.85194|04/27/2012||Yes|No||04/27/2012||Yes|No|04/27/2012||Yes|No||04/27/2012||Yes|No|||Prescription required|Yes|01/25/2012|213|No|17.89512|06/01/2016|17.63947|06/01/2016|16.7995|06/01/2016|||TETRACYCLINES|11336|||||No|No||PAR PHARM.|No||||
clonazepam|No|No|No|No|75%|49884030602|CLONAZEPAM 0.125 MG DIS TAB|60|EA|.39717|08/17/2005||Yes|No||08/17/2005||Yes|No|08/17/2005||Yes|No||08/17/2005||Yes|No|||Prescription required|No||056|Yes|.69971|03/29/2022|.68291|03/29/2022|.68746|03/29/2022|||ANTICONVULSANTS|11337|||||No|No||PAR PHARM.|No||||
clonazepam|No|No|No|No|75%|49884030702|CLONAZEPAM 0.25 MG ODT|60|EA|.39717|08/17/2005||Yes|No||08/17/2005||Yes|No|08/17/2005||Yes|No||08/17/2005||Yes|No|||Prescription required|No||056|Yes|.70247|03/29/2022|.68561|03/29/2022|.69017|03/29/2022|||ANTICONVULSANTS|11338|||||No|No||PAR PHARM.|No||||
clonazepam|No|No|No|No|75%|49884030802|CLONAZEPAM 0.5 MG DIS TABLET|60|EA|.39652|08/17/2005||Yes|No||08/17/2005||Yes|No|08/17/2005||Yes|No||08/17/2005||Yes|No|||Prescription required|No||056|Yes|.67976|03/29/2022|.66344|03/29/2022|.66786|03/29/2022|||ANTICONVULSANTS|11339|||||No|No||PAR PHARM.|No||||
clonazepam|No|No|No|No|75%|49884030902|CLONAZEPAM 1 MG DIS TABLET|60|EA|.45314|08/17/2005||Yes|No||08/17/2005||Yes|No|08/17/2005||Yes|No||08/17/2005||Yes|No|||Prescription required|No||056|Yes|.76385|03/29/2022|.74551|03/29/2022|.75048|03/29/2022|||ANTICONVULSANTS|11340|||||No|No||PAR PHARM.|No||||
clonazepam|No|No|No|No|75%|49884031002|CLONAZEPAM 2 MG ODT|60|EA|.62786|08/17/2005||Yes|No||08/17/2005||Yes|No|08/17/2005||Yes|No||08/17/2005||Yes|No|||Prescription required|No||056|Yes|1.00233|01/25/2022|.97827|01/25/2022|.98478|01/25/2022|||ANTICONVULSANTS|11341|||||No|No||PAR PHARM.|No||||
risperidone|No|No|No|No|75%|49884031155|RISPERIDONE 0.5 MG ODT|30|EA|1.50342|08/25/2010||Yes|No||08/25/2010||Yes|No|08/25/2010||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|027|Yes|.87328|03/29/2022|.85232|03/29/2022|.85799|03/29/2022|||ANTIPSYCHOTICS|11342|||||No|No||PAR PHARM.|No||||
risperidone|No|No|No|No|75%|49884031191|RISPERIDONE 0.5 MG ODT|28|EA|1.50331|08/25/2010||Yes|No||08/25/2010||Yes|No|08/25/2010||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|027|Yes|.87328|03/29/2022|.85232|03/29/2022|.85799|03/29/2022|||ANTIPSYCHOTICS|11343|||||No|No||PAR PHARM.|No||||
risperidone|No|No|No|No|75%|49884031555|RISPERIDONE 1 MG ODT|30|EA|1.75683|08/25/2010||Yes|No||08/25/2010||Yes|No|08/25/2010||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|027|Yes|.82075|03/29/2022|.80105|03/29/2022|.80638|03/29/2022|||ANTIPSYCHOTICS|11344|||||No|No||PAR PHARM.|No||||
risperidone|No|No|No|No|75%|49884031591|RISPERIDONE 1 MG ODT|28|EA|1.75655|08/25/2010||Yes|No||08/25/2010||Yes|No|08/25/2010||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|027|Yes|.82075|03/29/2022|.80105|03/29/2022|.80638|03/29/2022|||ANTIPSYCHOTICS|11345|||||No|No||PAR PHARM.|No||||
olanzapine|No|No|No|No|75%|49884032055|OLANZAPINE ODT 5 MG TABLET|30|EA|.36793|01/09/2012||Yes|No||01/09/2012||Yes|No|01/09/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.59218|03/29/2022|.57796|03/29/2022|.58181|03/29/2022|||ANTIPSYCHOTICS|11346|||||No|No||PAR PHARM.|No||||
olanzapine|No|No|No|No|75%|49884032155|OLANZAPINE ODT 10 MG TABLET|30|EA|.54051|01/09/2012||Yes|No||01/09/2012||Yes|No|01/09/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.58062|03/29/2022|.56668|03/29/2022|.57045|03/29/2022|||ANTIPSYCHOTICS|11347|||||No|No||PAR PHARM.|No||||
olanzapine|No|No|No|No|75%|49884032255|OLANZAPINE ODT 15 MG TABLET|30|EA|.79707|01/09/2012||Yes|No||01/09/2012||Yes|No|01/09/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.85386|03/29/2022|.83336|03/29/2022|.83891|03/29/2022|||ANTIPSYCHOTICS|11348|||||No|No||PAR PHARM.|No||||
olanzapine|No|No|No|No|75%|49884032355|OLANZAPINE ODT 20 MG TABLET|30|EA|1.05378|01/09/2012||Yes|No||01/09/2012||Yes|No|01/09/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|1.09|03/29/2022|1.06384|03/29/2022|1.07092|03/29/2022|||ANTIPSYCHOTICS|11349|||||No|No||PAR PHARM.|No||||
dexmethylphenidate HCl|No|No|No|No|75%|49884033301|DEXMETHYLPHENIDATE ER 25 MG CP|100|EA|.53642|08/29/2019||Yes|No||08/29/2019||Yes|No|08/29/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.83308|03/29/2022|1.78908|03/29/2022|1.801|03/29/2022|||STIMULANTS AND RELATED AGENTS|11350|||||No|No||PAR PHARMACEUTI|No||||
fluoxetine HCl|No|No|No|No|75%|49884033501|FLUOXETINE HCL 10 MG TABLET|100|EA|.49321|03/07/2017||Yes|No||03/07/2017||Yes|No|03/07/2017||Yes|No||||No|No|||Prescription required|No||008|No|.24078|03/29/2022|.235|03/29/2022|.23656|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11351|||||No|No||PAR PHARM.|No||||
fluoxetine HCl|No|No|No|No|75%|49884033511|FLUOXETINE HCL 10 MG TABLET|30|EA|.49321|03/07/2017||Yes|No||03/07/2017||Yes|No|03/07/2017||Yes|No||||No|No|||Prescription required|No||008|No|.24078|03/29/2022|.235|03/29/2022|.23656|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11352|||||No|No||PAR PHARM.|No||||
fluoxetine HCl|No|No|No|No|75%|49884033601|FLUOXETINE HCL 20 MG TABLET|100|EA|.72257|03/07/2017||Yes|No||03/07/2017||Yes|No|03/07/2017||Yes|No||||No|No|||Prescription required|No||008|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11353|||||No|No||PAR PHARM.|No||||
fluoxetine HCl|No|No|No|No|75%|49884033611|FLUOXETINE HCL 20 MG TABLET|30|EA|.72254|03/07/2017||Yes|No||03/07/2017||Yes|No|03/07/2017||Yes|No||||No|No|||Prescription required|No||008|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11354|||||No|No||PAR PHARM.|No||||
dexmethylphenidate HCl|No|No|No|No|75%|49884033901|DEXMETHYLPHENIDATE ER 35 MG CP|100|EA|.64822|08/29/2019||Yes|No||08/29/2019||Yes|No|08/29/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|2.40563|01/25/2022|2.34789|01/25/2022|2.36353|01/25/2022|||STIMULANTS AND RELATED AGENTS|11355|||||No|No||PAR PHARMACEUTI|No||||
pimozide|No|No|No|No|75%|49884034701|PIMOZIDE 1 MG TABLET|100|EA|.58282|01/03/2017||Yes|No||01/03/2017||Yes|No|01/03/2017||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|027|Yes|1.3391|04/27/2021|1.30696|04/27/2021|1.31566|04/27/2021|||ANTIPSYCHOTICS|11356|||||No|No||PAR PHARM.|No||||
pimozide|No|No|No|No|75%|49884034801|PIMOZIDE 2 MG TABLET|100|EA|.77705|01/03/2017||Yes|No||01/03/2017||Yes|No|01/03/2017||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|027|Yes|1.77095|11/23/2021|1.74565|11/23/2021|1.66253|11/23/2021|||ANTIPSYCHOTICS|11357|||||No|No||PAR PHARM.|No||||
ambrisentan|No|No|No|No|75%|49884035311|AMBRISENTAN 5 MG TABLET|30|EA|111.3194|02/20/2020||Yes|No||02/20/2020||Yes|No|02/20/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|No|253.70468|02/20/2020|250.08033|02/20/2020|238.17174|02/20/2020|||PAH AGENTS: ORAL AND INHALED|11358|||||No|No||PAR PHARM.|No||||
ambrisentan|No|No|No|No|75%|49884035362|AMBRISENTAN 5 MG TABLET|10|EA|111.31926|02/20/2020||Yes|No||02/20/2020||Yes|No|02/20/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|No|253.70436|02/20/2020|250.08001|02/20/2020|238.17144|02/20/2020|||PAH AGENTS: ORAL AND INHALED|11359|||||No|No||PAR PHARM.|No||||
ambrisentan|No|No|No|No|75%|49884035411|AMBRISENTAN 10 MG TABLET|30|EA|111.3194|02/20/2020||Yes|No||02/20/2020||Yes|No|02/20/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|No|253.70468|02/20/2020|250.08033|02/20/2020|238.17174|02/20/2020|||PAH AGENTS: ORAL AND INHALED|11360|||||No|No||PAR PHARM.|No||||
ambrisentan|No|No|No|No|75%|49884035462|AMBRISENTAN 10 MG TABLET|10|EA|111.31926|02/20/2020||Yes|No||02/20/2020||Yes|No|02/20/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|No|253.70436|02/20/2020|250.08001|02/20/2020|238.17144|02/20/2020|||PAH AGENTS: ORAL AND INHALED|11361|||||No|No||PAR PHARM.|No||||
dantrolene sodium|No|No|No|No|75%|49884036201|DANTROLENE SODIUM 25 MG CAP|100|EA|.27855|12/13/2016||Yes|No||12/13/2016||Yes|No|12/13/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|116|No|.43377|03/29/2022|.42335|03/29/2022|.42617|03/29/2022|||SKELETAL MUSCLE RELAXANTS|11362|||||No|No||PAR PHARM.|No||||
dantrolene sodium|No|No|No|No|75%|49884036301|DANTROLENE SODIUM 50 MG CAP|100|EA|.45016|12/13/2016||Yes|No||12/13/2016||Yes|No|12/13/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|116|No|.99541|03/01/2022|.97152|03/01/2022|.97799|03/01/2022|||SKELETAL MUSCLE RELAXANTS|11363|||||No|No||PAR PHARM.|No||||
dantrolene sodium|No|No|No|No|75%|49884036401|DANTROLENE SODIUM 100 MG CAP|100|EA|.5645|12/13/2016||Yes|No||12/13/2016||Yes|No|12/13/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|116|No|.85614|03/01/2022|.83559|03/01/2022|.84115|03/01/2022|||SKELETAL MUSCLE RELAXANTS|11364|||||No|No||PAR PHARM.|No||||
risperidone|No|No|No|No|75%|49884040191|RISPERIDONE 2 MG ODT|28|EA|2.85581|08/25/2010||Yes|No||08/25/2010||Yes|No|08/25/2010||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|027|Yes|1.19262|03/29/2022|1.16399|03/29/2022|1.17174|03/29/2022|||ANTIPSYCHOTICS|11365|||||No|No||PAR PHARM.|No||||
risperidone|No|No|No|No|75%|49884040291|RISPERIDONE 3 MG ODT|28|EA|3.60278|08/25/2010||Yes|No||08/25/2010||Yes|No|08/25/2010||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|027|Yes|1.35357|03/29/2022|1.32108|03/29/2022|1.32988|03/29/2022|||ANTIPSYCHOTICS|11366|||||No|No||PAR PHARM.|No||||
risperidone|No|No|No|No|75%|49884040391|RISPERIDONE 4 MG ODT|28|EA|4.83918|08/25/2010||Yes|No||08/25/2010||Yes|No|08/25/2010||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|027|Yes|1.81143|09/28/2021|1.76795|09/28/2021|1.77972|09/28/2021|||ANTIPSYCHOTICS|11367|||||No|No||PAR PHARM.|No||||
ursodiol|No|No|No|No|75%|49884041201|URSODIOL 250 MG TABLET|100|EA|.60939|11/25/2013||Yes|No||11/25/2013||Yes|No|11/25/2013||Yes|No||11/25/2013||Yes|No|||Prescription required|No||198|No|.5902|03/29/2022|.57603|03/29/2022|.57987|03/29/2022|||BILE SALTS|11368|||||No|No||PAR PHARM.|No||||
ursodiol|No|No|No|No|75%|49884041301|URSODIOL 500 MG TABLET|100|EA|1.27391|11/25/2013||Yes|No||11/25/2013||Yes|No|11/25/2013||Yes|No||11/25/2013||Yes|No|||Prescription required|No||198|No|.95342|03/29/2022|.93053|03/29/2022|.93673|03/29/2022|||BILE SALTS|11369|||||No|No||PAR PHARM.|No||||
aliskiren hemifumarate|No|No|No|No|75%|49884042411|ALISKIREN 150 MG TABLET|30|EA|2.38277|06/10/2019||Yes|No||06/10/2019||Yes|No|06/10/2019||Yes|No||06/10/2019||Yes|No|||Prescription required|Yes|07/26/2018|113|Yes|5.71911|03/29/2022|5.58185|03/29/2022|5.61902|03/29/2022|||ANGIOTENSIN MODULATORS|11370|||||No|No||PAR PHARM.|No||||
aliskiren hemifumarate|No|No|No|No|75%|49884042511|ALISKIREN 300 MG TABLET|30|EA|3.00613|06/10/2019||Yes|No||06/10/2019||Yes|No|06/10/2019||Yes|No||06/10/2019||Yes|No|||Prescription required|Yes|07/26/2018|113|Yes|7.08183|03/29/2022|6.91186|03/29/2022|6.95789|03/29/2022|||ANGIOTENSIN MODULATORS|11371|||||No|No||PAR PHARM.|No||||
dexmethylphenidate HCl|No|No|No|No|75%|49884042801|DEXMETHYLPHENIDATE ER 15 MG CP|100|EA|.45795|01/28/2014||Yes|No||01/28/2014||Yes|No|01/28/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.90155|03/29/2022|.87991|03/29/2022|.88577|03/29/2022|||STIMULANTS AND RELATED AGENTS|11372|||||No|No||PAR PHARM.|No||||
dexmethylphenidate HCl|No|No|No|No|75%|49884043001|DEXMETHYLPHENIDATE ER 30 MG CP|100|EA|.56115|01/28/2014||Yes|No||01/28/2014||Yes|No|01/28/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|2.05596|03/29/2022|2.00661|03/29/2022|2.01998|03/29/2022|||STIMULANTS AND RELATED AGENTS|11373|||||No|No||PAR PHARM.|No||||
cholestyramine (with sugar)|No|No|No|No|75%|49884046565|CHOLESTYRAMINE PACKET|60|EA|.88171|09/12/2005||Yes|No||09/12/2005||Yes|No|09/12/2005||Yes|No||09/12/2005||Yes|No|||Prescription required|No||055|No|1.02853|03/29/2022|1.00384|03/29/2022|1.01053|03/29/2022|||LIPOTROPICS: OTHER|11374|||||No|No||PAR PHARM.|No||||
cholestyramine (with sugar)|No|No|No|No|75%|49884046566|CHOLESTYRAMINE POWDER|378|GM|.11932|09/12/2005||Yes|No||09/12/2005||Yes|No|09/12/2005||Yes|No||09/12/2005||Yes|No|||Prescription required|No||055|No|.14958|03/29/2022|.14599|03/29/2022|.14696|03/29/2022|||LIPOTROPICS: OTHER|11375|||||No|No||PAR PHARM.|No||||
cholestyramine/aspartame|No|No|No|No|75%|49884046665|CHOLESTYRAMINE LIGHT PACKET|60|EA|.88171|09/12/2005||Yes|No||09/12/2005||Yes|No|09/12/2005||Yes|No||09/12/2005||Yes|No|||Prescription required|No||055|No|1.2151|03/29/2022|1.18593|03/29/2022|1.19383|03/29/2022|||LIPOTROPICS: OTHER|11376|||||No|No||PAR PHARM.|No||||
cholestyramine/aspartame|No|No|No|No|75%|49884046667|CHOLESTYRAMINE LIGHT POWDER|210|GM|.13053|09/12/2005||Yes|No||09/12/2005||Yes|No|09/12/2005||Yes|No||09/12/2005||Yes|No|||Prescription required|No||055|No|.29749|01/26/2021|.29324|01/26/2021|.27928|01/26/2021|||LIPOTROPICS: OTHER|11377|||||No|No||PAR PHARM.|No||||
fluoxetine HCl|No|No|No|No|75%|49884046811|FLUOXETINE HCL 60 MG TABLET|30|EA|2.91769|05/04/2018||Yes|No||05/04/2018||Yes|No|05/04/2018||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|008|No|1.06507|03/29/2022|1.0395|03/29/2022|1.04643|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11378|||||No|No||PAR PHARM.|No||||
lamotrigine|No|No|No|No|75%|49884048511|LAMOTRIGINE ODT 50 MG TABLET|30|EA|3.27043|01/31/2017||Yes|No||01/31/2017||Yes|No|01/31/2017||Yes|No||||No|No|||Prescription required|No||056|No|3.24575|03/29/2022|3.16785|03/29/2022|3.18894|03/29/2022|||ANTICONVULSANTS|11379|||||No|No||PAR PHARM.|No||||
lamotrigine|No|No|No|No|75%|49884048611|LAMOTRIGINE ODT 100 MG TABLET|30|EA|3.4873|01/31/2017||Yes|No||01/31/2017||Yes|No|01/31/2017||Yes|No||||No|No|||Prescription required|No||056|No|4.72113|03/29/2022|4.60782|03/29/2022|4.63851|03/29/2022|||ANTICONVULSANTS|11380|||||No|No||PAR PHARM.|No||||
lamotrigine|No|No|No|No|75%|49884048711|LAMOTRIGINE ODT 200 MG TABLET|30|EA|4.16139|01/31/2017||Yes|No||01/31/2017||Yes|No|01/31/2017||Yes|No||||No|No|||Prescription required|No||056|No|4.09893|03/01/2022|4.00055|03/01/2022|4.02719|03/01/2022|||ANTICONVULSANTS|11381|||||No|No||PAR PHARM.|No||||
minocycline HCl|No|No|No|No|75%|49884051101|MINOCYCLINE HCL 50 MG TABLET|100|EA|.9675|06/27/2005||Yes|No||06/27/2005||Yes|No|06/27/2005||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|213|No|1.57315|03/01/2022|1.53539|03/01/2022|1.54561|03/01/2022|||TETRACYCLINES|11382|||||No|No||PAR PHARM.|No||||
minocycline HCl|No|No|No|No|75%|49884051201|MINOCYCLINE HCL 75 MG TABLET|100|EA|1.419|06/27/2005||Yes|No||06/27/2005||Yes|No|06/27/2005||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|213|No|3.234|06/01/2016|3.1878|06/01/2016|3.036|06/01/2016|||TETRACYCLINES|11383|||||No|No||PAR PHARM.|No||||
minocycline HCl|No|No|No|No|75%|49884051303|MINOCYCLINE HCL 100 MG TABLET|50|EA|1.6856|06/27/2005||Yes|No||06/27/2005||Yes|No|06/27/2005||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|213|No|1.59602|01/25/2022|1.55771|01/25/2022|1.56808|01/25/2022|||TETRACYCLINES|11384|||||No|No||PAR PHARM.|No||||
dexmethylphenidate HCl|No|No|No|No|75%|49884054601|DEXMETHYLPHENIDATE ER 40 MG CP|100|EA|.92686|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|2.72731|03/29/2022|2.66185|03/29/2022|2.67958|03/29/2022|||STIMULANTS AND RELATED AGENTS|11385|||||No|No||PAR PHARM.|No||||
zafirlukast|No|No|No|No|75%|49884054902|ZAFIRLUKAST 10 MG TABLET|60|EA|.65237|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|042|Yes|1.0831|03/01/2022|1.0571|03/01/2022|1.06414|03/01/2022|||LEUKOTRIENE MODIFIERS|11386|||||No|No||PAR PHARM.|No||||
zafirlukast|No|No|No|No|75%|49884055402|ZAFIRLUKAST 20 MG TABLET|60|EA|.65237|08/25/2016||Yes|No||08/25/2016||Yes|No|08/25/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|042|Yes|.93036|03/29/2022|.90803|03/29/2022|.91407|03/29/2022|||LEUKOTRIENE MODIFIERS|11387|||||No|No||PAR PHARM.|No||||
lamotrigine|No|No|No|No|75%|49884056111|LAMOTRIGINE ER 25 MG TABLET|30|EA|2.08564|03/18/2013||Yes|No||03/18/2013||Yes|No|03/18/2013||Yes|No||||No|No|||Prescription required|No||056|No|1.20872|03/01/2022|1.17971|03/01/2022|1.18756|03/01/2022|||ANTICONVULSANTS|11388|||||No|No||PAR PHARM.|No||||
lamotrigine|No|No|No|No|75%|49884056211|LAMOTRIGINE ER 50 MG TABLET|30|EA|4.17085|03/18/2013||Yes|No||03/18/2013||Yes|No|03/18/2013||Yes|No||||No|No|||Prescription required|No||056|No|1.67529|03/29/2022|1.63508|03/29/2022|1.64597|03/29/2022|||ANTICONVULSANTS|11389|||||No|No||PAR PHARM.|No||||
lamotrigine|No|No|No|No|75%|49884056311|LAMOTRIGINE ER 100 MG TABLET|30|EA|4.4677|03/18/2013||Yes|No||03/18/2013||Yes|No|03/18/2013||Yes|No||||No|No|||Prescription required|No||056|No|1.51472|03/29/2022|1.47836|03/29/2022|1.48821|03/29/2022|||ANTICONVULSANTS|11390|||||No|No||PAR PHARM.|No||||
lamotrigine|No|No|No|No|75%|49884056411|LAMOTRIGINE ER 200 MG TABLET|30|EA|4.76425|03/18/2013||Yes|No||03/18/2013||Yes|No|03/18/2013||Yes|No||||No|No|||Prescription required|No||056|No|1.69753|03/29/2022|1.65678|03/29/2022|1.66782|03/29/2022|||ANTICONVULSANTS|11391|||||No|No||PAR PHARM.|No||||
lamotrigine|No|No|No|No|75%|49884060411|LAMOTRIGINE ER 250 MG TABLET|30|EA|5.23654|03/18/2013||Yes|No||03/18/2013||Yes|No|03/18/2013||Yes|No||||No|No|||Prescription required|No||056|No|5.54243|03/29/2022|5.40941|03/29/2022|5.44543|03/29/2022|||ANTICONVULSANTS|11392|||||No|No||PAR PHARM.|No||||
lamotrigine|No|No|No|No|75%|49884060511|LAMOTRIGINE ER 300 MG TABLET|30|EA|7.1466|03/18/2013||Yes|No||03/18/2013||Yes|No|03/18/2013||Yes|No||||No|No|||Prescription required|No||056|No|4.96792|03/29/2022|4.84868|03/29/2022|4.88098|03/29/2022|||ANTICONVULSANTS|11393|||||No|No||PAR PHARM.|No||||
tizanidine HCl|No|No|No|No|75%|49884061153|TIZANIDINE HCL 2 MG CAPSULE|150|EA|.69954|11/09/2018||Yes|No||11/09/2018||Yes|No|11/09/2018||Yes|No||||No|No|||Prescription required|Yes|11/23/2017|116|No|.0903|03/29/2022|.08813|03/29/2022|.08871|03/29/2022|||SKELETAL MUSCLE RELAXANTS|11394|||||No|No||PAR PHARM.|No||||
methimazole|No|No|No|No|75%|49884064001|METHIMAZOLE 5 MG TABLET|100|EA|.10315|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.07388|03/29/2022|.0721|03/29/2022|.07258|03/29/2022||||11395|||||No|No||PAR PHARM.|No||||
methimazole|No|No|No|No|75%|49884064005|METHIMAZOLE 5 MG TABLET|500|EA|.10109|08/25/2010||Yes|No||08/25/2010||Yes|No|08/25/2010||Yes|No||||No|No|||Prescription required|No|||No|.07388|03/29/2022|.0721|03/29/2022|.07258|03/29/2022||||11396|||||No|No||PAR PHARM.|No||||
methimazole|No|No|No|No|75%|49884064101|METHIMAZOLE 10 MG TABLET|100|EA|.17814|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.10482|03/29/2022|.1023|03/29/2022|.10298|03/29/2022||||11397|||||No|No||PAR PHARM.|No||||
candesartan cilexetil|No|No|No|No|75%|49884065809|CANDESARTAN CILEXETIL 4 MG TAB|90|EA|1.01068|08/23/2013||Yes|No||08/23/2013||Yes|No|08/23/2013||Yes|No||08/23/2013||Yes|No|||Prescription required|Yes|07/29/2021|113|Yes|.89|03/29/2022|.86864|03/29/2022|.87442|03/29/2022|||ANGIOTENSIN MODULATORS|11398|||||No|No||PAR PHARM.|No||||
candesartan cilexetil|No|No|No|No|75%|49884065909|CANDESARTAN CILEXETIL 8 MG TAB|90|EA|1.01068|08/23/2013||Yes|No||08/23/2013||Yes|No|08/23/2013||Yes|No||08/23/2013||Yes|No|||Prescription required|Yes|07/29/2021|113|Yes|.78972|03/29/2022|.77076|03/29/2022|.77589|03/29/2022|||ANGIOTENSIN MODULATORS|11399|||||No|No||PAR PHARM.|No||||
candesartan cilexetil|No|No|No|No|75%|49884066009|CANDESARTAN CILEXETIL 16 MG TB|90|EA|1.0115|08/23/2013||Yes|No||08/23/2013||Yes|No|08/23/2013||Yes|No||08/23/2013||Yes|No|||Prescription required|Yes|07/29/2021|113|Yes|.72757|03/29/2022|.7101|03/29/2022|.71483|03/29/2022|||ANGIOTENSIN MODULATORS|11400|||||No|No||PAR PHARM.|No||||
candesartan cilexetil|No|No|No|No|75%|49884066109|CANDESARTAN CILEXETIL 32 MG TB|90|EA|1.36826|08/23/2013||Yes|No||08/23/2013||Yes|No|08/23/2013||Yes|No||08/23/2013||Yes|No|||Prescription required|Yes|07/29/2021|113|Yes|1.10475|03/29/2022|1.07823|03/29/2022|1.08541|03/29/2022|||ANGIOTENSIN MODULATORS|11401|||||No|No||PAR PHARM.|No||||
tizanidine HCl|No|No|No|No|75%|49884071953|TIZANIDINE HCL 4 MG CAPSULE|150|EA|.88671|11/09/2018||Yes|No||11/09/2018||Yes|No|11/09/2018||Yes|No||||No|No|||Prescription required|Yes|11/23/2017|116|No|.15367|03/29/2022|.14998|03/29/2022|.15098|03/29/2022|||SKELETAL MUSCLE RELAXANTS|11402|||||No|No||PAR PHARM.|No||||
sapropterin dihydrochloride|No|No|No|No|75%|49884072008|SAPROPTERIN 100 MG TABLET|120|EA|13.8632|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No|||No|31.5952|04/14/2021|31.14384|04/14/2021|29.6608|04/14/2021||||11403|||||No|No||PAR PHARM.|No||||
zileuton|No|No|No|No|75%|49884072308|ZILEUTON ER 600 MG TABLET|120|EA|10.7759|08/18/2020||Yes|No||08/18/2020||Yes|No|08/18/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|042|Yes|24.55904|11/23/2021|24.2082|11/23/2021|23.05543|11/23/2021|||LEUKOTRIENE MODIFIERS|11404|||||No|No||PAR PHARM.|No||||
hydroxyurea|No|No|No|No|75%|49884072401|HYDROXYUREA 500 MG CAPSULE|100|EA|.2408|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||580|No|.26887|03/29/2022|.26241|03/29/2022|.26416|03/29/2022|||SICKLE CELL ANEMIA TREATMENTS|11405|||||No|No||PAR PHARM.|No||||
doxycycline monohydrate|No|No|No|No|75%|49884072601|DOXYCYCLINE MONO 50 MG CAP|100|EA|.2236|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||213|No|.2073|03/29/2022|.20232|03/29/2022|.20367|03/29/2022|||TETRACYCLINES|11406|||||No|No||PAR PHARM.|No||||
doxycycline monohydrate|Yes|No|No|No|75%|49884072703|DOXYCYCLINE MONO 100 MG CAP|50|EA|.3612|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|11/01/2012||Prescription required|No||213|No|.25496|03/29/2022|.24884|03/29/2022|.25049|03/29/2022|||TETRACYCLINES|11407|||||No|No||PAR PHARM.|No||||
doxycycline monohydrate|Yes|No|No|No|75%|49884072704|DOXYCYCLINE MONO 100 MG CAP|250|EA|.34572|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|11/01/2012||Prescription required|No||213|No|.25496|03/29/2022|.24884|03/29/2022|.25049|03/29/2022|||TETRACYCLINES|11408|||||No|No||PAR PHARM.|No||||
flutamide|No|No|No|No|75%|49884075313|FLUTAMIDE 125 MG CAPSULE|180|EA|.67473|08/25/2010||Yes|No||08/25/2010||Yes|No|08/25/2010||Yes|No||||No|No|||Prescription required|No||550|No|1.53777|09/24/2019|1.5158|09/24/2019|1.44362|09/24/2019|||ONCOLOGY: ORAL - PROSTATE|11409|||||No|No||PAR PHARM.|No||||
tizanidine HCl|No|No|No|No|75%|49884076553|TIZANIDINE HCL 6 MG CAPSULE|150|EA|1.32995|11/09/2018||Yes|No||11/09/2018||Yes|No|11/09/2018||Yes|No||||No|No|||Prescription required|Yes|11/23/2017|116|No|.27523|03/29/2022|.26862|03/29/2022|.27041|03/29/2022|||SKELETAL MUSCLE RELAXANTS|11410|||||No|No||PAR PHARM.|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|49884078609|OLMSRTN-AMLDPN-HCTZ 20-5-12.5|90|EA|2.49744|01/29/2021||Yes|No||01/29/2021||Yes|No|01/29/2021||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.26872|03/29/2022|1.23827|03/29/2022|1.24651|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|11411|||||No|No||PAR PHARM.|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|49884078611|OLMSRTN-AMLDPN-HCTZ 20-5-12.5|30|EA|2.49744|01/29/2021||Yes|No||01/29/2021||Yes|No|01/29/2021||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.26872|03/29/2022|1.23827|03/29/2022|1.24651|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|11412|||||No|No||PAR PHARM.|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|49884078709|OLMSRTN-AMLDPN-HCTZ 40-5-12.5|90|EA|3.15448|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.52605|03/29/2022|1.48942|03/29/2022|1.49934|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|11413|||||No|No||PAR PHARM.|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|49884078711|OLMSRTN-AMLDPN-HCTZ 40-5-12.5|30|EA|3.15448|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.52605|03/29/2022|1.48942|03/29/2022|1.49934|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|11414|||||No|No||PAR PHARM.|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|49884078809|OLMSRTN-AMLDPN-HCTZ 40-5-25 MG|90|EA|3.15448|05/18/2017||Yes|No||05/18/2017||Yes|No|05/18/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.32536|03/29/2022|1.29355|03/29/2022|1.30216|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|11415|||||No|No||PAR PHARM.|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|49884078811|OLMSRTN-AMLDPN-HCTZ 40-5-25 MG|30|EA|3.15448|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.32536|03/29/2022|1.29355|03/29/2022|1.30216|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|11416|||||No|No||PAR PHARM.|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|49884078911|OLMSRTN-AMLDPN-HCTZ 40-10-12.5|30|EA|3.15448|01/29/2021||Yes|No||01/29/2021||Yes|No|01/29/2021||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.55605|03/29/2022|1.5187|03/29/2022|1.52881|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|11417|||||No|No||PAR PHARM.|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|49884079009|OLMSRTN-AMLDPN-HCTZ 40-10-25MG|90|EA|1.67823|05/18/2017||Yes|No||05/18/2017||Yes|No|05/18/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.46963|03/29/2022|1.43435|03/29/2022|1.44391|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|11418|||||No|No||PAR PHARM.|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|49884079011|OLMSRTN-AMLDPN-HCTZ 40-10-25MG|30|EA|1.67843|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.46963|03/29/2022|1.43435|03/29/2022|1.44391|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|11419|||||No|No||PAR PHARM.|No||||
midodrine HCl|No|No|No|No|75%|49884081401|MIDODRINE HCL 2.5 MG TABLET|100|EA|.32026|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||02/27/2019||Yes|No|||Prescription required|No|||No|.20233|03/29/2022|.19747|03/29/2022|.19878|03/29/2022||||11420|||||No|No||PAR PHARM.|No||||
alosetron HCl|No|No|No|No|75%|49884081911|ALOSETRON HCL 0.5 MG TABLET|30|EA|6.80833|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|534|Yes|3.98973|03/01/2022|3.89397|03/01/2022|3.9199|03/01/2022|||GI MOTILITY: CHRONIC|11421|||||No|No||PAR PHARM.|No||||
alosetron HCl|No|No|No|No|75%|49884082011|ALOSETRON HCL 1 MG TABLET|30|EA|13.61666|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|534|Yes|8.58181|01/25/2022|8.37584|01/25/2022|8.43162|01/25/2022|||GI MOTILITY: CHRONIC|11422|||||No|No||PAR PHARM.|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|49884083901|DEXTROAMP-AMPHET ER 5 MG CAP|100|EA|.5977|10/23/2019||Yes|No||10/23/2019||Yes|No|10/23/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.59233|03/29/2022|.57811|03/29/2022|.58196|03/29/2022|||STIMULANTS AND RELATED AGENTS|11423|||||No|No||PAR PHARM.|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|49884084001|DEXTROAMP-AMPHET ER 10 MG CAP|100|EA|.5977|10/23/2019||Yes|No||10/23/2019||Yes|No|10/23/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.53198|03/29/2022|.51921|03/29/2022|.52267|03/29/2022|||STIMULANTS AND RELATED AGENTS|11424|||||No|No||PAR PHARM.|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|49884084101|DEXTROAMP-AMPHET ER 15 MG CAP|100|EA|.5977|10/23/2019||Yes|No||10/23/2019||Yes|No|10/23/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55636|03/29/2022|.543|03/29/2022|.54662|03/29/2022|||STIMULANTS AND RELATED AGENTS|11425|||||No|No||PAR PHARM.|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|49884084201|DEXTROAMP-AMPHET ER 20 MG CAP|100|EA|.5977|10/23/2019||Yes|No||10/23/2019||Yes|No|10/23/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.58746|03/29/2022|.57336|03/29/2022|.57717|03/29/2022|||STIMULANTS AND RELATED AGENTS|11426|||||No|No||PAR PHARM.|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|49884084301|DEXTROAMP-AMPHET ER 25 MG CAP|100|EA|.5977|10/23/2019||Yes|No||10/23/2019||Yes|No|10/23/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.54687|03/29/2022|.53374|03/29/2022|.53729|03/29/2022|||STIMULANTS AND RELATED AGENTS|11427|||||No|No||PAR PHARM.|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|49884084401|DEXTROAMP-AMPHET ER 30 MG CAP|100|EA|.5977|10/23/2019||Yes|No||10/23/2019||Yes|No|10/23/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.61484|03/29/2022|.60008|03/29/2022|.60408|03/29/2022|||STIMULANTS AND RELATED AGENTS|11428|||||No|No||PAR PHARM.|No||||
midodrine HCl|No|No|No|No|75%|49884084901|MIDODRINE HCL 5 MG TABLET|100|EA|.52696|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||02/27/2019||Yes|No|||Prescription required|No|||No|.26381|03/29/2022|.25747|03/29/2022|.25919|03/29/2022||||11429|||||No|No||PAR PHARM.|No||||
sapropterin dihydrochloride|No|No|No|No|75%|49884087372|SAPROPTERIN 500 MG POWDER PKT|30|EA|69.316|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No|||No|157.976|04/14/2021|155.7192|04/20/2021|148.304|04/14/2021||||11430|||||No|No||PAR PHARM.|No||||
midodrine HCl|No|No|No|No|75%|49884087401|MIDODRINE HCL 10 MG TABLET|100|EA|.89835|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||02/27/2019||Yes|No|||Prescription required|No|||No|.40773|03/29/2022|.39794|03/29/2022|.40059|03/29/2022||||11431|||||No|No||PAR PHARM.|No||||
lamotrigine|No|No|No|No|75%|49884088099|LAMOTRIGINE ODT KIT (BLUE)|28|EA|3.9176|05/07/2018||Yes|No||05/07/2018||Yes|No|05/07/2018||Yes|No||||No|No|||Prescription required|No||056|No|8.92849|05/07/2018|8.80094|05/07/2018|8.38185|05/07/2018|||ANTICONVULSANTS|11432|||||No|No||PAR PHARM.|No||||
lamotrigine|No|No|No|No|75%|49884088199|LAMOTRIGINE ODT KIT (GREEN)|56|EA|5.59598|01/31/2017||Yes|No||01/31/2017||Yes|No|01/31/2017||Yes|No||||No|No|||Prescription required|No||056|No|12.75364|01/31/2017|12.57144|01/31/2017|11.9728|01/31/2017|||ANTICONVULSANTS|11433|||||No|No||PAR PHARM.|No||||
lamotrigine|No|No|No|No|75%|49884088299|LAMOTRIGINE ODT KIT (ORANGE)|35|EA|4.47691|01/31/2017||Yes|No||01/31/2017||Yes|No|01/31/2017||Yes|No||||No|No|||Prescription required|No||056|No|10.20319|01/31/2017|10.05743|01/31/2017|9.5785|01/31/2017|||ANTICONVULSANTS|11434|||||No|No||PAR PHARM.|No||||
zolpidem tartrate|No|No|No|No|90%|49884089811|ZOLPIDEM TART 1.75 MG TAB SL|30|EA|3.39771|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|054|Yes|7.74362|02/28/2019|7.633|02/28/2019|7.26952|02/28/2019|||SEDATIVE HYPNOTICS|11435|||||No|No||PAR PHARM.|No||||
zolpidem tartrate|No|No|No|No|90%|49884089911|ZOLPIDEM TART 3.5 MG TABLET SL|30|EA|3.39771|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|054|Yes|6.7952|08/24/2021|6.63211|08/24/2021|6.67628|08/24/2021|||SEDATIVE HYPNOTICS|11436|||||No|No||PAR PHARM.|No||||
megestrol acetate|No|No|No|No|75%|49884090738|MEGESTROL ACET 40 MG/ML SUSP|240|ML|.0645|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||197|No|.1065|03/29/2022|.10394|03/29/2022|.10463|03/29/2022|||PROGESTINS FOR CACHEXIA|11437|||||No|No||PAR PHARM.|No||||
megestrol acetate|No|No|No|No|75%|49884090761|MEGESTROL ACET 40 MG/ML SUSP|480|ML|.0645|01/01/2005||Yes|No||01/01/2005||Yes|No|01/01/2005||Yes|No||||No|No|||Prescription required|No||197|No|.10575|03/29/2022|.10321|03/29/2022|.10389|03/29/2022|||PROGESTINS FOR CACHEXIA|11438|||||No|No||PAR PHARM.|No||||
cholestyramine (with sugar)|No|No|No|No|75%|49884093665|QUESTRAN PACKET|60|GM|2.44519|11/15/2007||Yes|No||11/15/2007||Yes|No|11/15/2007||Yes|No||11/15/2007||Yes|No|||Prescription required|Yes|07/06/2006|055|No|5.57277|06/01/2016|5.49315|06/01/2016|5.23158|06/01/2016|||LIPOTROPICS: OTHER|11439|||||No|No||PAR PHARMACEUTI|No||||
cholestyramine (with sugar)|No|No|No|No|75%|49884093666|QUESTRAN POWDER|378|GM|.16997|06/06/2006||Yes|No||06/06/2006||Yes|No|06/06/2006||Yes|No||06/06/2006||Yes|No|||Prescription required|Yes|07/12/2005|055|No|.38738|06/01/2016|.38185|06/01/2016|.36366|06/01/2016|||LIPOTROPICS: OTHER|11440|||||No|No||PAR PHARMACEUTI|No||||
cholestyramine/aspartame|No|No|No|No|75%|49884093767|QUESTRAN LIGHT POWDER|210|GM|.30771|01/30/2007||Yes|No||01/30/2007||Yes|No|01/30/2007||Yes|No||01/30/2007||Yes|No|||Prescription required|Yes|07/06/2006|055|No|.70129|06/01/2016|.69127|06/01/2016|.65836|06/01/2016|||LIPOTROPICS: OTHER|11441|||||No|No||PAR PHARMACEUTI|No||||
sapropterin dihydrochloride|No|No|No|No|75%|49884094872|SAPROPTERIN 100 MG POWDER PKT|30|EA|13.8632|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No|||No|31.5952|04/14/2021|31.14384|04/14/2021|29.6608|04/14/2021||||11442|||||No|No||PAR PHARM.|No||||
nateglinide|Yes|No|No|No|75%|49884098401|NATEGLINIDE 60 MG TABLET|100|EA|.5083|08/25/2010||Yes|No||08/25/2010||Yes|No|08/25/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||022|Yes|.3103|03/29/2022|.30285|03/29/2022|.30486|03/29/2022|||HYPOGLYCEMICS: MEGLITINIDES|11443|||||No|No||PAR PHARM.|No||||
nateglinide|Yes|No|No|No|75%|49884098501|NATEGLINIDE 120 MG TABLET|100|EA|.52812|08/25/2010||Yes|No||08/25/2010||Yes|No|08/25/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||022|Yes|.33379|03/29/2022|.32577|03/29/2022|.32794|03/29/2022|||HYPOGLYCEMICS: MEGLITINIDES|11444|||||No|No||PAR PHARM.|No||||
salicylic acid|No|No|No|No|75%|49908023710|SALICYLIC ACID 27.5% LIQUID|10|ML|3.08998|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|7.04228|12/04/2018|6.94167|12/04/2018|6.61112|12/04/2018||||11445|||||No|No||ROCHESTER PHARM|No||||
dapsone|No|No|No|No|75%|49938010130|DAPSONE 100 MG TABLET|30|EA|1.204|09/03/2008||Yes|No||09/03/2008||Yes|No|09/03/2008||Yes|No||||No|No|||Prescription required|No|||No|.77747|03/29/2022|.75881|03/29/2022|.76386|03/29/2022||||11446|||||No|No||JACOBUS PHARM.|No||||
dapsone|No|No|No|No|75%|49938010230|DAPSONE 25 MG TABLET|30|EA|.98126|09/03/2008||Yes|No||09/03/2008||Yes|No|09/03/2008||Yes|No||||No|No|||Prescription required|No|||No|.52333|03/29/2022|.51077|03/29/2022|.51417|03/29/2022||||11447|||||No|No||JACOBUS PHARM.|No||||
naltrexone HCl|No|No|No|No|75%|50090286600|NALTREXONE 50 MG TABLET|30|EA|.645|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||No|||||||.7816|10/01/2020||11448|||||No|No||A-S MEDICATION|Yes|09/01/2020|||
norethindrone|Yes|Yes|No|No|75%|50102010001|LYZA 0.35 MG TABLET|28|EA||08/07/2013||Yes|No||08/07/2013||Yes|No|08/07/2013||Yes|No|Refer to program requirements|||No|No|08/07/2013||Prescription required|No|||No|.16123|03/29/2022|.15736|03/29/2022|.1584|03/29/2022||||11449|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel|No|Yes|No|No|75%|50102011101|ECONTRA EZ 1.5 MG TABLET|1|EA||04/20/2015||Yes|No||||No|No|||No|No||||No|No|||Over the counter|No|||No|10.215|03/29/2022|9.96984|03/29/2022|10.03623|03/29/2022||||11450|||||No|No||AFAXYS, INC.|No||||
levonorgestrel|No|Yes|No|No|75%|50102011112|ECONTRA EZ 1.5 MG TABLET|1|EA||04/20/2015||Yes|No||||No|No|||No|No||||No|No|||Over the counter|No|||No|10.215|03/29/2022|9.96984|03/29/2022|10.03623|03/29/2022||||11451|||||No|No||AFAXYS, INC.|No||||
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|50102012001|AUBRA-28 TABLET|28|EA||11/25/2013||Yes|No||11/25/2013||Yes|No|11/25/2013||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.21292|03/29/2022|.2078|03/29/2022|.20919|03/29/2022||||11452|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|50102012048|AUBRA-28 TABLET|28|EA||11/25/2013||Yes|No||11/25/2013||Yes|No|11/25/2013||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.21292|03/29/2022|.2078|03/29/2022|.20919|03/29/2022||||11453|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|50102012801|TARINA FE 1-20 TABLET|28|EA||05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No|Refer to program requirements|||No|No|05/12/2015||Prescription required|No|||No|.20374|03/29/2022|.19885|03/29/2022|.20017|03/29/2022||||11454|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|50102012803|TARINA FE 1-20 TABLET|28|EA||05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No|Refer to program requirements|||No|No|05/12/2015||Prescription required|No|||No|.20374|03/29/2022|.19885|03/29/2022|.20017|03/29/2022||||11455|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel-ethin estradiol|Yes|Yes|No|No|75%|50102013001|CHATEAL-28 TABLET|28|EA||04/04/2013||Yes|No||04/04/2013||Yes|No|04/04/2013||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.22171|09/24/2019|.21638|09/24/2019|.21783|09/24/2019||||11456|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|50102013048|CHATEAL-28 TABLET|28|EA||04/04/2013||Yes|No||04/04/2013||Yes|No|04/04/2013||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.17306|03/29/2022|.1689|03/29/2022|.17003|03/29/2022||||11457|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel-ethin estradiol|Yes|Yes|No|No|75%|50102013090|CHATEAL-28 TABLET|28|EA||04/04/2013||Yes|No||04/04/2013||Yes|No|04/04/2013||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.22171|09/24/2019|.21638|09/24/2019|.21783|09/24/2019||||11458|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|No|Yes|No|No|75%|50102022021|AUBRA EQ-28 TABLET|28|EA||04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.21292|03/29/2022|.2078|03/29/2022|.20919|03/29/2022||||11459|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|No|Yes|No|No|75%|50102022023|AUBRA EQ-28 TABLET|28|EA||04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.21292|03/29/2022|.2078|03/29/2022|.20919|03/29/2022||||11460|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|No|Yes|No|No|75%|50102022421|TARINA 24 FE 1 MG-20 MCG TAB|28|EA||04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.56858|03/29/2022|.55493|03/29/2022|.55862|03/29/2022||||11461|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|No|Yes|No|No|75%|50102022423|TARINA 24 FE 1 MG-20 MCG TAB|28|EA||04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.56858|03/29/2022|.55493|03/29/2022|.55862|03/29/2022||||11462|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|No|Yes|No|No|75%|50102022821|TARINA FE 1-20 EQ TABLET|28|EA||04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.20374|03/29/2022|.19885|03/29/2022|.20017|03/29/2022||||11463|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|No|Yes|No|No|75%|50102022823|TARINA FE 1-20 EQ TABLET|28|EA||04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.20374|03/29/2022|.19885|03/29/2022|.20017|03/29/2022||||11464|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|No|Yes|No|No|75%|50102023021|CHATEAL EQ-28 TABLET|28|EA||04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.17306|03/29/2022|.1689|03/29/2022|.17003|03/29/2022||||11465|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|No|Yes|No|No|75%|50102023023|CHATEAL EQ-28 TABLET|28|EA||04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.17306|03/29/2022|.1689|03/29/2022|.17003|03/29/2022||||11466|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
norgestimate-ethinyl estradiol|No|Yes|No|No|75%|50102023111|TRI-VYLIBRA LO TABLET|28|EA||04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.16464|03/29/2022|.16068|03/29/2022|.16175|03/29/2022||||11467|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
norgestimate-ethinyl estradiol|No|Yes|No|No|75%|50102023113|TRI-VYLIBRA LO TABLET|28|EA||04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.16464|03/29/2022|.16068|03/29/2022|.16175|03/29/2022||||11468|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
norgestimate-ethinyl estradiol|No|Yes|No|No|75%|50102023311|TRI-VYLIBRA 28 TABLET|28|EA||04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.1602|03/29/2022|.15635|03/29/2022|.15739|03/29/2022||||11469|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
norgestimate-ethinyl estradiol|No|Yes|No|No|75%|50102023313|TRI-VYLIBRA 28 TABLET|28|EA||04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.1602|03/29/2022|.15635|03/29/2022|.15739|03/29/2022||||11470|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
norgestimate-ethinyl estradiol|No|Yes|No|No|75%|50102023511|VYLIBRA 28 TABLET|28|EA||04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.1742|03/29/2022|.17001|03/29/2022|.17115|03/29/2022||||11471|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
norgestimate-ethinyl estradiol|No|Yes|No|No|75%|50102023513|VYLIBRA 28 TABLET|28|EA||04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.1742|03/29/2022|.17001|03/29/2022|.17115|03/29/2022||||11472|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
ethinyl estradiol/drospirenone|No|Yes|No|No|75%|50102024021|JASMIEL 3 MG-0.02 MG TABLET|28|EA||04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.36582|03/29/2022|.35704|03/29/2022|.35941|03/29/2022||||11473|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
ethinyl estradiol/drospirenone|No|Yes|No|No|75%|50102024023|JASMIEL 3 MG-0.02 MG TABLET|28|EA||04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.36582|03/29/2022|.35704|03/29/2022|.35941|03/29/2022||||11474|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
desogestrel-ethinyl estradiol|No|Yes|No|No|75%|50102025421|CYRED EQ 28 DAY TABLET|28|EA||04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.18364|03/29/2022|.17923|03/29/2022|.18042|03/29/2022||||11475|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
desogestrel-ethinyl estradiol|No|Yes|No|No|75%|50102025423|CYRED EQ 28 DAY TABLET|28|EA||04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.18364|03/29/2022|.17923|03/29/2022|.18042|03/29/2022||||11476|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone|Yes|Yes|No|No|75%|50102030011|LYLEQ 0.35 MG TABLET|28|EA|.56698|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No|Refer to program requirements|||No|No|07/09/2021||Prescription required|No|||No|.16123|03/29/2022|.15736|03/29/2022|.1584|03/29/2022||||11477|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone|Yes|Yes|No|No|75%|50102030013|LYLEQ 0.35 MG TABLET|28|EA|.56698|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No|Refer to program requirements|||No|No|07/09/2021||Prescription required|No|||No|.16123|03/29/2022|.15736|03/29/2022|.1584|03/29/2022||||11478|||||No|No||AFAXYS, INC.|No|||Only covered for non-contraceptive (medical) purposes|
medroxyprogesterone acetate|No|Yes|No|No|75%|50102059140|MEDROXYPROGESTERONE 150 MG/ML|1|ML||04/21/2021||Yes|No||||No|No|04/21/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|35.94375|03/01/2022|35.0811|03/01/2022|35.31473|03/01/2022||||11479|||||No|No||AFAXYS, INC.|No||||
ulipristal acetate|No|Yes|No|No|75%|50102091101|ELLA 30 MG TABLET|1|EA|15.3725|05/12/2014|05/31/2022|Yes|No||||No|No|||No|No||||No|No|||Prescription required|No|||No|37.37356|07/13/2021|36.47659|07/13/2021|36.71952|07/13/2021||||11480|No Longer Rebatable||||No|No||AFAXYS, INC.|No||||
hydralazine HCl|No|No|No|No|75%|50111032701|HYDRALAZINE 25 MG TABLET|100|EA|.09632|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.04116|03/29/2022|.04017|03/29/2022|.04043|03/29/2022||||11481|||||No|No||TEVA USA|No||||
hydralazine HCl|No|No|No|No|75%|50111032703|HYDRALAZINE 25 MG TABLET|1000|EA|.0915|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.04116|03/29/2022|.04017|03/29/2022|.04043|03/29/2022||||11482|||||No|No||TEVA USA|No||||
hydralazine HCl|No|No|No|No|75%|50111032801|HYDRALAZINE 50 MG TABLET|100|EA|.12663|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.0521|03/29/2022|.05084|03/29/2022|.05118|03/29/2022||||11483|||||No|No||TEVA USA|No||||
hydralazine HCl|No|No|No|No|75%|50111032803|HYDRALAZINE 50 MG TABLET|1000|EA|.1203|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.0521|03/29/2022|.05084|03/29/2022|.05118|03/29/2022||||11484|||||No|No||TEVA USA|No||||
metronidazole|Yes|No|No|No|75%|50111033301|METRONIDAZOLE 250 MG TABLET|100|EA|.13059|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|11/01/2012||Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|11485|||||No|No||TEVA USA|No||||
metronidazole|Yes|No|No|No|75%|50111033302|METRONIDAZOLE 250 MG TABLET|500|EA|.12407|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|11/01/2012||Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|11486|||||No|No||TEVA USA|No||||
metronidazole|Yes|No|No|No|75%|50111033306|METRONIDAZOLE 250 MG TABLET|250|EA|.12667|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|11/01/2012||Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|11487|||||No|No||TEVA USA|No||||
metronidazole|Yes|No|No|No|75%|50111033401|METRONIDAZOLE 500 MG TABLET|100|EA|.21908|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|11/01/2012||Prescription required|No||115|No|.15479|03/29/2022|.15107|03/29/2022|.15208|03/29/2022|||ANTIBIOTICS: GI|11488|||||No|No||TEVA USA|No||||
metronidazole|Yes|No|No|No|75%|50111033402|METRONIDAZOLE 500 MG TABLET|500|EA|.20814|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|11/01/2012||Prescription required|No||115|No|.15479|03/29/2022|.15107|03/29/2022|.15208|03/29/2022|||ANTIBIOTICS: GI|11489|||||No|No||TEVA USA|No||||
hydralazine HCl|No|No|No|No|75%|50111039701|HYDRALAZINE 100 MG TABLET|100|EA|.22467|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.0869|03/29/2022|.08481|03/29/2022|.08537|03/29/2022||||11490|||||No|No||TEVA USA|No||||
hydralazine HCl|No|No|No|No|75%|50111039801|HYDRALAZINE 10 MG TABLET|100|EA|.07327|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.03439|03/29/2022|.03356|03/29/2022|.03378|03/29/2022||||11491|||||No|No||TEVA USA|No||||
hydralazine HCl|No|No|No|No|75%|50111039803|HYDRALAZINE 10 MG TABLET|1000|EA|.0696|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.03439|03/29/2022|.03356|03/29/2022|.03378|03/29/2022||||11492|||||No|No||TEVA USA|No||||
trazodone HCl|No|No|No|No|75%|50111043401|TRAZODONE 100 MG TABLET|100|EA|.0531|03/01/2002|07/31/2022|Yes|No||03/01/2002|07/31/2022|Yes|No|03/01/2002|07/31/2022|Yes|No||||No|No|||Prescription required|No||031|No|.07015|03/29/2022|.06846|03/29/2022|.06892|03/29/2022|||ANTIDEPRESSANTS: OTHER|11493|Drug ReNumbered|Drug ReNumbered|Drug ReNumbered||No|No||TEVA USA|No||||
trazodone HCl|No|No|No|No|75%|50111043402|TRAZODONE 100 MG TABLET|500|EA|.04983|03/01/2002|07/31/2022|Yes|No||03/01/2002|07/31/2022|Yes|No|03/01/2002|07/31/2022|Yes|No||||No|No|||Prescription required|No||031|No|.07015|03/29/2022|.06846|03/29/2022|.06892|03/29/2022|||ANTIDEPRESSANTS: OTHER|11494|Drug ReNumbered|Drug ReNumbered|Drug ReNumbered||No|No||TEVA USA|No||||
trazodone HCl|No|No|No|No|75%|50111045001|TRAZODONE 150 MG TABLET|100|EA|.15523|07/01/2020||Yes|No||07/01/2020||Yes|No|07/01/2020||Yes|No||||No|No|||Prescription required|No||031|No|.1311|03/29/2022|.12795|03/29/2022|.1288|03/29/2022|||ANTIDEPRESSANTS: OTHER|11495|||||No|No||TEVA USA|No||||
trazodone HCl|No|No|No|No|75%|50111045002|TRAZODONE 150 MG TABLET|500|EA|.14706|07/01/2020||Yes|No||07/01/2020||Yes|No|07/01/2020||Yes|No||||No|No|||Prescription required|No||031|No|.1311|03/29/2022|.12795|03/29/2022|.1288|03/29/2022|||ANTIDEPRESSANTS: OTHER|11496|||||No|No||TEVA USA|No||||
oxybutynin chloride|No|No|No|No|75%|50111045601|OXYBUTYNIN 5 MG TABLET|100|EA|.18808|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|11497|||||No|No||TEVA USA|No||||
oxybutynin chloride|No|No|No|No|75%|50111045602|OXYBUTYNIN 5 MG TABLET|500|EA|.18808|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|11498|||||No|No||TEVA USA|No||||
oxybutynin chloride|No|No|No|No|75%|50111045603|OXYBUTYNIN 5 MG TABLET|1000|EA|.18808|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|11499|||||No|No||TEVA USA|No||||
trazodone HCl|No|No|No|No|75%|50111056001|TRAZODONE 50 MG TABLET|100|EA|.02859|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|No||031|No|.03855|03/29/2022|.03762|03/29/2022|.03787|03/29/2022|||ANTIDEPRESSANTS: OTHER|11500|||||No|No||TEVA USA|No||||
trazodone HCl|No|No|No|No|75%|50111056002|TRAZODONE 50 MG TABLET|500|EA|.02614|02/23/2021||Yes|No||02/23/2021||Yes|No|02/23/2021||Yes|No||||No|No|||Prescription required|No||031|No|.03855|03/29/2022|.03762|03/29/2022|.03787|03/29/2022|||ANTIDEPRESSANTS: OTHER|11501|||||No|No||TEVA USA|No||||
trazodone HCl|No|No|No|No|75%|50111056003|TRAZODONE 50 MG TABLET|1000|EA|.02594|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|No||031|No|.03855|03/29/2022|.03762|03/29/2022|.03787|03/29/2022|||ANTIDEPRESSANTS: OTHER|11502|||||No|No||TEVA USA|No||||
trazodone HCl|No|No|No|No|75%|50111056101|TRAZODONE 100 MG TABLET|100|EA|.0531|02/23/2021||Yes|No||02/23/2021||Yes|No|02/23/2021||Yes|No||||No|No|||Prescription required|No||031|No|.07015|03/29/2022|.06846|03/29/2022|.06892|03/29/2022|||ANTIDEPRESSANTS: OTHER|11503|||||No|No||TEVA USA|No||||
trazodone HCl|No|No|No|No|75%|50111056102|TRAZODONE 100 MG TABLET|500|EA|.04983|02/23/2021||Yes|No||02/23/2021||Yes|No|02/23/2021||Yes|No||||No|No|||Prescription required|No||031|No|.07015|03/29/2022|.06846|03/29/2022|.06892|03/29/2022|||ANTIDEPRESSANTS: OTHER|11504|||||No|No||TEVA USA|No||||
trazodone HCl|No|No|No|No|75%|50111056103|TRAZODONE 100 MG TABLET|1000|EA|.04738|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|No||031|No|.07015|03/29/2022|.06846|03/29/2022|.06892|03/29/2022|||ANTIDEPRESSANTS: OTHER|11505|||||No|No||TEVA USA|No||||
fluoxetine HCl|Yes|No|No|No|75%|50111064701|FLUOXETINE HCL 10 MG CAPSULE|100|EA|.02356|12/30/2003||Yes|No||12/30/2003||Yes|No|12/30/2003||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11506|||||No|No||TEVA USA|No||||
fluoxetine HCl|Yes|No|No|No|75%|50111064702|FLUOXETINE HCL 10 MG CAPSULE|500|EA|.02297|12/30/2003||Yes|No||12/30/2003||Yes|No|12/30/2003||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11507|||||No|No||TEVA USA|No||||
fluoxetine HCl|Yes|No|No|No|75%|50111064703|FLUOXETINE HCL 10 MG CAPSULE|1000|EA|.02238|12/30/2003||Yes|No||12/30/2003||Yes|No|12/30/2003||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11508|||||No|No||TEVA USA|No||||
fluoxetine HCl|Yes|No|No|No|75%|50111064801|FLUOXETINE HCL 20 MG CAPSULE|100|EA|.02472|12/30/2003||Yes|No||12/30/2003||Yes|No|12/30/2003||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11509|||||No|No||TEVA USA|No||||
fluoxetine HCl|Yes|No|No|No|75%|50111064802|FLUOXETINE HCL 20 MG CAPSULE|500|EA|.02408|12/30/2003||Yes|No||12/30/2003||Yes|No|12/30/2003||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11510|||||No|No||TEVA USA|No||||
fluoxetine HCl|Yes|No|No|No|75%|50111064803|FLUOXETINE HCL 20 MG CAPSULE|1000|EA|.02347|12/30/2003||Yes|No||12/30/2003||Yes|No|12/30/2003||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11511|||||No|No||TEVA USA|No||||
fluoxetine HCl|Yes|No|No|No|75%|50111064844|FLUOXETINE HCL 20 MG CAPSULE|2000|EA|.02347|12/30/2003||Yes|No||12/30/2003||Yes|No|12/30/2003||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11512|||||No|No||TEVA USA|No||||
azithromycin|Yes|No|No|No|75%|50111078710|AZITHROMYCIN 250 MG TABLET|30|EA|.91375|02/15/2018||Yes|No||02/15/2018||Yes|No|02/15/2018||Yes|No||02/15/2018||Yes|No|02/15/2018||Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|11513|||||No|No||TEVA USA|No||||
azithromycin|Yes|No|No|No|75%|50111078751|AZITHROMYCIN 250 MG TABLET|6|EA|1.075|09/18/2015||Yes|No||09/18/2015||Yes|No|09/18/2015||Yes|No||09/18/2015||Yes|No|09/18/2015||Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|11514|||||No|No||TEVA USA|No||||
azithromycin|Yes|No|No|No|75%|50111078766|AZITHROMYCIN 250 MG TABLET|6|EA|.60486|02/08/2012||Yes|No||02/08/2012||Yes|No|02/08/2012||Yes|No||02/08/2012||Yes|No|11/01/2012||Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|11515|||||No|No||TEVA USA|No||||
azithromycin|Yes|No|No|No|75%|50111078810|AZITHROMYCIN 500 MG TABLET|30|EA|2.07475|05/08/2017||Yes|No||05/08/2017||Yes|No|05/08/2017||Yes|No||05/08/2017||Yes|No|05/08/2017||Prescription required|No||018|No|.82092|03/29/2022|.80121|03/29/2022|.80655|03/29/2022|||MACROLIDES/KETOLIDES|11516|||||No|No||TEVA USA|No||||
azithromycin|Yes|No|No|No|75%|50111078855|AZITHROMYCIN 500 MG TABLET|3|EA|2.15|03/10/2014||Yes|No||03/10/2014||Yes|No|03/10/2014||Yes|No||03/10/2014||Yes|No|03/10/2014||Prescription required|No||018|No|.82092|03/29/2022|.80121|03/29/2022|.80655|03/29/2022|||MACROLIDES/KETOLIDES|11517|||||No|No||TEVA USA|No||||
azithromycin|Yes|No|No|No|75%|50111078867|AZITHROMYCIN 500 MG TABLET|3|EA|1.20973|03/10/2014||Yes|No||03/10/2014||Yes|No|03/10/2014||Yes|No||03/10/2014||Yes|No|03/10/2014||Prescription required|No||018|No|.82092|03/29/2022|.80121|03/29/2022|.80655|03/29/2022|||MACROLIDES/KETOLIDES|11518|||||No|No||TEVA USA|No||||
azithromycin|No|No|No|No|75%|50111078910|AZITHROMYCIN 600 MG TABLET|30|EA|1.98029|02/15/2018||Yes|No||02/15/2018||Yes|No|02/15/2018||Yes|No||02/15/2018||Yes|No|||Prescription required|No||018|No|1.08173|08/24/2021|1.05576|08/24/2021|1.06279|08/24/2021|||MACROLIDES/KETOLIDES|11519|||||No|No||TEVA USA|No||||
azithromycin|No|No|No|No|75%|50111079478|AZITHROMYCIN I.V. 500 MG VIAL|1|EA|4.386|05/01/2008||Yes|No||05/01/2008||Yes|No|05/01/2008||Yes|No||||No|No|||Prescription required|No|||No|9.996|06/01/2016|9.8532|06/01/2016|9.384|06/01/2016||||11520|||||No|No||TEVA USA|No||||
torsemide|No|No|No|No|75%|50111091501|TORSEMIDE 5 MG TABLET|100|EA|.20425|01/01/2005||Yes|No||01/01/2005||Yes|No|01/01/2005||Yes|No||01/01/2005||Yes|No|||Prescription required|No|||No|.0835|03/29/2022|.08149|03/29/2022|.08203|03/29/2022||||11521|||||No|No||TEVA USA|No||||
torsemide|No|No|No|No|75%|50111091601|TORSEMIDE 10 MG TABLET|100|EA|.22639|01/01/2005||Yes|No||01/01/2005||Yes|No|01/01/2005||Yes|No||01/01/2005||Yes|No|||Prescription required|No|||No|.07835|03/29/2022|.07646|03/29/2022|.07697|03/29/2022||||11522|||||No|No||TEVA USA|No||||
torsemide|No|No|No|No|75%|50111091701|TORSEMIDE 20 MG TABLET|100|EA|.26445|06/28/2004||Yes|No||06/28/2004||Yes|No|06/28/2004||Yes|No||06/28/2004||Yes|No|||Prescription required|No|||No|.08257|03/29/2022|.08058|03/29/2022|.08112|03/29/2022||||11523|||||No|No||TEVA USA|No||||
torsemide|No|No|No|No|75%|50111091703|TORSEMIDE 20 MG TABLET|1000|EA|.26445|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||02/01/2005||Yes|No|||Prescription required|No|||No|.08257|03/29/2022|.08058|03/29/2022|.08112|03/29/2022||||11524|||||No|No||TEVA USA|No||||
torsemide|No|No|No|No|75%|50111091801|TORSEMIDE 100 MG TABLET|100|EA|.83639|11/28/2005||Yes|No||11/28/2005||Yes|No|11/28/2005||Yes|No||11/28/2005||Yes|No|||Prescription required|No|||No|.25463|03/29/2022|.24851|03/29/2022|.25017|03/29/2022||||11525|||||No|No||TEVA USA|No||||
tacrolimus|No|No|No|No|75%|50222020310|PROTOPIC 0.03% OINTMENT|100|GM|4.15444|04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|034|Yes|9.46827|04/21/2021|9.333|04/21/2021|8.88858|04/21/2021|||IMMUNOMODULATORS: ATOPIC DERMATITIS|11526|||||No|No||LEO PHARMA INC.|No||||
tacrolimus|No|No|No|No|75%|50222020330|PROTOPIC 0.03% OINTMENT|30|GM|4.15437|04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|034|Yes|9.4681|04/21/2021|9.33284|04/21/2021|8.88842|04/21/2021|||IMMUNOMODULATORS: ATOPIC DERMATITIS|11527|||||No|No||LEO PHARMA INC.|No||||
tacrolimus|No|No|No|No|75%|50222020360|PROTOPIC 0.03% OINTMENT|60|GM|4.15444|04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|034|Yes|9.46827|04/21/2021|9.333|04/21/2021|8.88858|04/21/2021|||IMMUNOMODULATORS: ATOPIC DERMATITIS|11528|||||No|No||LEO PHARMA INC.|No||||
tacrolimus|No|No|No|No|75%|50222021110|PROTOPIC 0.1% OINTMENT|100|GM|4.15444|04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|034|Yes|9.46827|04/21/2021|9.333|04/21/2021|8.88858|04/21/2021|||IMMUNOMODULATORS: ATOPIC DERMATITIS|11529|||||No|No||LEO PHARMA INC.|No||||
tacrolimus|No|No|No|No|75%|50222021130|PROTOPIC 0.1% OINTMENT|30|GM|4.15437|04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|034|Yes|9.4681|01/25/2022|9.33284|01/25/2022|8.88842|01/25/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|11530|||||No|No||LEO PHARMA INC.|No||||
tacrolimus|No|No|No|No|75%|50222021160|PROTOPIC 0.1% OINTMENT|60|GM|4.15444|04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|034|Yes|9.21215|11/23/2021|8.99105|11/23/2021|9.05093|11/23/2021|||IMMUNOMODULATORS: ATOPIC DERMATITIS|11531|||||No|No||LEO PHARMA INC.|No||||
calcipotriene/betamethasone|No|No|No|No|75%|50222022704|TACLONEX OINTMENT|60|GM|8.03762|09/03/2010||Yes|No||09/03/2010||Yes|No|09/03/2010||Yes|No||||No|No|||Prescription required|No|||No|18.31831|01/25/2022|18.05662|01/25/2022|17.19678|01/25/2022||||11532|||||No|No||LEO PHARMA INC.|No||||
calcipotriene/betamethasone|No|No|No|No|75%|50222022781|TACLONEX OINTMENT|100|GM|7.10342|09/03/2010|11/30/2022|Yes|No||09/03/2010|11/30/2022|Yes|No|09/03/2010|11/30/2022|Yes|No||||No|No|||Prescription required|No|||No|16.1892|01/25/2022|15.95793|01/25/2022|15.19803|01/25/2022||||11533|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LEO PHARMA INC.|No||||
calcipotriene|No|No|No|No|75%|50222026006|DOVONEX 0.005% CREAM|60|GM|5.67406|09/03/2010||Yes|No||09/03/2010||Yes|No|09/03/2010||Yes|No||||No|No|||Prescription required|No|||No|12.93159|01/25/2022|12.74685|01/25/2022|12.13986|01/25/2022||||11534|||||No|No||LEO PHARMA INC.|No||||
calcipotriene|No|No|No|No|75%|50222026012|DOVONEX 0.005% CREAM|120|GM|5.42488|09/03/2010|11/30/2022|Yes|No||09/03/2010|11/30/2022|Yes|No|09/03/2010|11/30/2022|Yes|No||||No|No|||Prescription required|No|||No|12.36368|01/25/2022|12.18705|01/25/2022|11.60672|01/25/2022||||11535|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LEO PHARMA INC.|No||||
calcipotriene/betamethasone|No|No|No|No|75%|50222030260|ENSTILAR 0.005%-0.064% FOAM|60|GM|8.71258|05/10/2021||Yes|No||05/10/2021||Yes|No|05/10/2021||Yes|No||||No|No|||Prescription required|No|||No|19.52916|01/11/2022|19.06046|01/11/2022|19.18739|01/11/2022||||11536|||||No|No||LEO PHARMA INC.|No||||
calcipotriene/betamethasone|No|No|No|No|75%|50222030266|ENSTILAR 0.005%-0.064% FOAM|60|GM|8.71251|05/10/2021||Yes|No||05/10/2021||Yes|No|05/10/2021||Yes|No||||No|No|||Prescription required|No|||No|19.85642|01/04/2022|19.57276|01/04/2022|18.64072|01/04/2022||||11537|||||No|No||LEO PHARMA INC.|No||||
azelaic acid|No|No|No|No|75%|50222030350|FINACEA 15% FOAM|50|GM|3.43303|04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|221|No|7.66143|01/11/2022|7.47755|01/11/2022|7.52735|01/11/2022|||ROSACEA AGENTS: TOPICAL|11538|||||No|No||LEO PHARMA INC.|No||||
calcipotriene/betamethasone|No|No|No|No|75%|50222050106|TACLONEX 0.005%-0.064% SUSPENS|60|GM|8.5466|04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No||||No|No|||Prescription required|No|||No|18.95833|01/11/2022|18.50333|01/11/2022|18.62655|01/11/2022||||11539|||||No|No||LEO PHARMA INC.|No||||
calcipotriene/betamethasone|No|No|No|No|75%|50222050166|TACLONEX 0.005%-0.064% SUSPENS|120|GM|8.54653|07/22/2013||Yes|No||07/22/2013||Yes|No|07/22/2013||Yes|No||||No|No|||Prescription required|No|||No|18.97494|01/11/2022|18.51954|01/11/2022|18.64287|01/11/2022||||11540|||||No|No||LEO PHARMA INC.|No||||
ingenol mebutate|No|No|No|No|75%|50222050247|PICATO 0.015% GEL|3|EA|158.86636|02/29/2012|02/22/2022|Yes|No||02/29/2012|02/22/2022|Yes|No|02/29/2012|02/22/2022|Yes|No||||No|No|||Prescription required|No|||No|362.06752|10/26/2021|356.89513|10/26/2021|339.90012|10/26/2021||||11541|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LEO PHARMA INC.|No||||
ingenol mebutate|No|No|No|No|75%|50222050347|PICATO 0.05% GEL|2|EA|238.29955|02/29/2012|02/22/2022|Yes|No||02/29/2012|02/22/2022|Yes|No|02/29/2012|02/22/2022|Yes|No||||No|No|||Prescription required|No|||No|543.1013|01/26/2021|535.34271|01/26/2021|509.8502|01/26/2021||||11542|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LEO PHARMA INC.|No||||
azelaic acid|No|No|No|No|75%|50222050550|FINACEA 15% GEL|50|GM|3.20762|04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|221|No|7.3104|01/25/2022|7.20597|01/25/2022|6.86283|01/25/2022|||ROSACEA AGENTS: TOPICAL|11543|||||No|No||LEO PHARMA INC.|No||||
metformin HCl|Yes|No|No|No|75%|50228010501|METFORMIN HCL 500 MG TABLET|100|EA|.01027|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|09/20/2019||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|11544|||||No|No||SCIEGEN PHARMAC|No||||
metformin HCl|Yes|No|No|No|75%|50228010505|METFORMIN HCL 500 MG TABLET|500|EA|.01025|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|09/20/2019||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|11545|||||No|No||SCIEGEN PHARMAC|No||||
metformin HCl|Yes|No|No|No|75%|50228010510|METFORMIN HCL 500 MG TABLET|1000|EA|.01026|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|09/20/2019||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|11546|||||No|No||SCIEGEN PHARMAC|No||||
metformin HCl|Yes|No|No|No|75%|50228010601|METFORMIN HCL 850 MG TABLET|100|EA|.01427|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|11547|||||No|No||SCIEGEN PHARMAC|No||||
metformin HCl|Yes|No|No|No|75%|50228010605|METFORMIN HCL 850 MG TABLET|500|EA|.01427|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|11548|||||No|No||SCIEGEN PHARMAC|No||||
metformin HCl|Yes|No|No|No|75%|50228010701|METFORMIN HCL 1,000 MG TABLET|100|EA|.015|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|11549|||||No|No||SCIEGEN PHARMAC|No||||
metformin HCl|Yes|No|No|No|75%|50228010705|METFORMIN HCL 1,000 MG TABLET|500|EA|.015|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|11550|||||No|No||SCIEGEN PHARMAC|No||||
metformin HCl|Yes|No|No|No|75%|50228010710|METFORMIN HCL 1,000 MG TABLET|1000|EA|.015|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|11551|||||No|No||SCIEGEN PHARMAC|No||||
carisoprodol|No|No|No|No|90%|50228010901|CARISOPRODOL 350 MG TABLET|100|EA|.05155|05/31/2019||Yes|No||05/31/2019||Yes|No|05/31/2019||Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|11552|||||No|No||SCIEGEN PHARMAC|No||||
carisoprodol|No|No|No|No|90%|50228010905|CARISOPRODOL 350 MG TABLET|500|EA|.05155|05/31/2019||Yes|No||05/31/2019||Yes|No|05/31/2019||Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|11553|||||No|No||SCIEGEN PHARMAC|No||||
carisoprodol|No|No|No|No|90%|50228010910|CARISOPRODOL 350 MG TABLET|1000|EA|.05155|05/31/2019||Yes|No||05/31/2019||Yes|No|05/31/2019||Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|11554|||||No|No||SCIEGEN PHARMAC|No||||
fluoxetine HCl|Yes|No|No|No|75%|50228011301|FLUOXETINE HCL 10 MG CAPSULE|100|EA|.02451|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11555|||||No|No||SCIEGEN PHARMAC|No||||
fluoxetine HCl|Yes|No|No|No|75%|50228011305|FLUOXETINE HCL 10 MG CAPSULE|500|EA|.02149|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11556|||||No|No||SCIEGEN PHARMAC|No||||
fluoxetine HCl|Yes|No|No|No|75%|50228011310|FLUOXETINE HCL 10 MG CAPSULE|1000|EA|.02235|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11557|||||No|No||SCIEGEN PHARMAC|No||||
fluoxetine HCl|Yes|No|No|No|75%|50228011330|FLUOXETINE HCL 10 MG CAPSULE|30|EA|.04572|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11558|||||No|No||SCIEGEN PHARMAC|No||||
fluoxetine HCl|Yes|No|No|No|75%|50228011401|FLUOXETINE HCL 20 MG CAPSULE|100|EA|.02833|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11559|||||No|No||SCIEGEN PHARMAC|No||||
fluoxetine HCl|Yes|No|No|No|75%|50228011410|FLUOXETINE HCL 20 MG CAPSULE|1000|EA|.02579|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11560|||||No|No||SCIEGEN PHARMAC|No||||
fluoxetine HCl|Yes|No|No|No|75%|50228011430|FLUOXETINE HCL 20 MG CAPSULE|30|EA|.05289|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11561|||||No|No||SCIEGEN PHARMAC|No||||
fluoxetine HCl|Yes|No|No|No|75%|50228011501|FLUOXETINE HCL 40 MG CAPSULE|100|EA|.32761|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11562|||||No|No||SCIEGEN PHARMAC|No||||
fluoxetine HCl|Yes|No|No|No|75%|50228011505|FLUOXETINE HCL 40 MG CAPSULE|500|EA|.32335|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11563|||||No|No||SCIEGEN PHARMAC|No||||
fluoxetine HCl|Yes|No|No|No|75%|50228011530|FLUOXETINE HCL 40 MG CAPSULE|30|EA|.28652|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11564|||||No|No||SCIEGEN PHARMAC|No||||
clopidogrel bisulfate|No|No|No|No|75%|50228012405|CLOPIDOGREL 75 MG TABLET|500|EA|.03483|05/18/2020||Yes|No||05/18/2020||Yes|No|05/18/2020||Yes|No||||No|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|11565|||||No|No||SCIEGEN PHARMAC|No||||
clopidogrel bisulfate|No|No|No|No|75%|50228012410|CLOPIDOGREL 75 MG TABLET|1000|EA|.03483|05/18/2020||Yes|No||05/18/2020||Yes|No|05/18/2020||Yes|No||||No|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|11566|||||No|No||SCIEGEN PHARMAC|No||||
clopidogrel bisulfate|No|No|No|No|75%|50228012430|CLOPIDOGREL 75 MG TABLET|30|EA|.03483|05/18/2020||Yes|No||05/18/2020||Yes|No|05/18/2020||Yes|No||||No|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|11567|||||No|No||SCIEGEN PHARMAC|No||||
clopidogrel bisulfate|No|No|No|No|75%|50228012490|CLOPIDOGREL 75 MG TABLET|90|EA|.03483|05/18/2020||Yes|No||05/18/2020||Yes|No|05/18/2020||Yes|No||||No|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|11568|||||No|No||SCIEGEN PHARMAC|No||||
pramipexole di-HCl|No|No|No|No|75%|50228012610|PRAMIPEXOLE 0.125 MG TABLET|1000|EA|.0633|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No||015|No|.05408|03/29/2022|.05278|03/29/2022|.05313|03/29/2022|||ANTIPARKINSON'S AGENTS|11569|||||No|No||SCIEGEN PHARMAC|No||||
pramipexole di-HCl|No|No|No|No|75%|50228012710|PRAMIPEXOLE 0.25 MG TABLET|1000|EA|.0633|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No||015|No|.05102|03/29/2022|.04979|03/29/2022|.05012|03/29/2022|||ANTIPARKINSON'S AGENTS|11570|||||No|No||SCIEGEN PHARMAC|No||||
levocetirizine dihydrochloride|No|No|No|No|75%|50228013630|LEVOCETIRIZINE 5 MG TABLET|30|EA|.14333|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|030|Yes|.08234|03/29/2022|.08036|03/29/2022|.08089|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|11571|||||No|No||SCIEGEN PHARMAC|No||||
levocetirizine dihydrochloride|No|No|No|No|75%|50228013690|LEVOCETIRIZINE 5 MG TABLET|90|EA|.14333|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|030|Yes|.08234|03/29/2022|.08036|03/29/2022|.08089|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|11572|||||No|No||SCIEGEN PHARMAC|No||||
bupropion HCl|No|No|No|No|75%|50228014405|BUPROPION HCL XL 150 MG TABLET|500|EA|.07883|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|11573|||||No|No||SCIEGEN PHARMAC|No||||
bupropion HCl|No|No|No|No|75%|50228014430|BUPROPION HCL XL 150 MG TABLET|30|EA|.17916|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|11574|||||No|No||SCIEGEN PHARMAC|No||||
bupropion HCl|No|No|No|No|75%|50228014505|BUPROPION HCL XL 300 MG TABLET|500|EA|.09818|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|11575|||||No|No||SCIEGEN PHARMAC|No||||
bupropion HCl|No|No|No|No|75%|50228014530|BUPROPION HCL XL 300 MG TABLET|30|EA|.09818|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|11576|||||No|No||SCIEGEN PHARMAC|No||||
bupropion HCl|No|No|No|No|75%|50228014590|BUPROPION HCL XL 300 MG TABLET|90|EA|.1892|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|11577|||||No|No||SCIEGEN PHARMAC|No||||
hydrochlorothiazide|Yes|No|No|No|75%|50228014601|HYDROCHLOROTHIAZIDE 12.5 MG CP|100|EA|.03435|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|01/15/2020||Prescription required|No|||Yes|.03333|03/29/2022|.03253|03/29/2022|.03274|03/29/2022||||11578|||||No|No||SCIEGEN PHARMAC|No||||
hydrochlorothiazide|Yes|No|No|No|75%|50228014605|HYDROCHLOROTHIAZIDE 12.5 MG CP|500|EA|.03439|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|01/15/2020||Prescription required|No|||Yes|.03333|03/29/2022|.03253|03/29/2022|.03274|03/29/2022||||11579|||||No|No||SCIEGEN PHARMAC|No||||
hydrochlorothiazide|Yes|No|No|No|75%|50228014610|HYDROCHLOROTHIAZIDE 12.5 MG CP|1000|EA|.03138|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|01/15/2020||Prescription required|No|||Yes|.03333|03/29/2022|.03253|03/29/2022|.03274|03/29/2022||||11580|||||No|No||SCIEGEN PHARMAC|No||||
celecoxib|No|No|No|No|75%|50228015660|CELECOXIB 50 MG CAPSULE|60|EA|.05733|02/17/2022||Yes|No||02/17/2022||Yes|No|02/17/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|059|Yes|.1386|03/29/2022|.13527|03/29/2022|.13617|03/29/2022|||NSAIDS|11581|||||No|No||SCIEGEN PHARMAC|No||||
celecoxib|No|No|No|No|75%|50228015701|CELECOXIB 100 MG CAPSULE|100|EA|.0645|12/22/2021||Yes|No||12/22/2021||Yes|No|12/22/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|11582|||||No|No||SCIEGEN PHARMAC|No||||
celecoxib|No|No|No|No|75%|50228015705|CELECOXIB 100 MG CAPSULE|500|EA|.0516|12/22/2021||Yes|No||12/22/2021||Yes|No|12/22/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|11583|||||No|No||SCIEGEN PHARMAC|No||||
celecoxib|No|No|No|No|75%|50228015801|CELECOXIB 200 MG CAPSULE|100|EA|.129|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|11584|||||No|No||SCIEGEN PHARMAC|No||||
celecoxib|No|No|No|No|75%|50228015805|CELECOXIB 200 MG CAPSULE|500|EA|.1032|12/21/2021||Yes|No||12/21/2021||Yes|No|12/21/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|11585|||||No|No||SCIEGEN PHARMAC|No||||
bupropion HCl|No|No|No|No|75%|50228017401|BUPROPION HCL SR 100 MG TABLET|100|EA|.09666|09/17/2020||Yes|No||09/17/2020||Yes|No|09/17/2020||Yes|No||||No|No|||Prescription required|No||031|No|.11271|03/29/2022|.11|03/29/2022|.11073|03/29/2022|||ANTIDEPRESSANTS: OTHER|11586|||||No|No||SCIEGEN PHARMAC|No||||
bupropion HCl|No|No|No|No|75%|50228017405|BUPROPION HCL SR 100 MG TABLET|500|EA|.09668|09/17/2020||Yes|No||09/17/2020||Yes|No|09/17/2020||Yes|No||||No|No|||Prescription required|No||031|No|.11271|03/29/2022|.11|03/29/2022|.11073|03/29/2022|||ANTIDEPRESSANTS: OTHER|11587|||||No|No||SCIEGEN PHARMAC|No||||
bupropion HCl|No|No|No|No|75%|50228017460|BUPROPION HCL SR 100 MG TABLET|60|EA|.10176|09/17/2020||Yes|No||09/17/2020||Yes|No|09/17/2020||Yes|No||||No|No|||Prescription required|No||031|No|.11271|03/29/2022|.11|03/29/2022|.11073|03/29/2022|||ANTIDEPRESSANTS: OTHER|11588|||||No|No||SCIEGEN PHARMAC|No||||
bupropion HCl|No|No|No|No|75%|50228017501|BUPROPION HCL SR 150 MG TABLET|100|EA|.11029|09/17/2020||Yes|No||09/17/2020||Yes|No|09/17/2020||Yes|No||||No|No|||Prescription required|No||031|No|.10128|03/29/2022|.09884|03/29/2022|.0995|03/29/2022|||ANTIDEPRESSANTS: OTHER|11589|||||No|No||SCIEGEN PHARMAC|No||||
bupropion HCl|No|No|No|No|75%|50228017505|BUPROPION HCL SR 150 MG TABLET|500|EA|.10478|09/17/2020||Yes|No||09/17/2020||Yes|No|09/17/2020||Yes|No||||No|No|||Prescription required|No||031|No|.10128|03/29/2022|.09884|03/29/2022|.0995|03/29/2022|||ANTIDEPRESSANTS: OTHER|11590|||||No|No||SCIEGEN PHARMAC|No||||
bupropion HCl|No|No|No|No|75%|50228017560|BUPROPION HCL SR 150 MG TABLET|60|EA|.1161|09/17/2020||Yes|No||09/17/2020||Yes|No|09/17/2020||Yes|No||||No|No|||Prescription required|No||031|No|.10128|03/29/2022|.09884|03/29/2022|.0995|03/29/2022|||ANTIDEPRESSANTS: OTHER|11591|||||No|No||SCIEGEN PHARMAC|No||||
bupropion HCl|No|No|No|No|75%|50228017601|BUPROPION HCL SR 200 MG TABLET|100|EA|.129|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|No||031|No|.16014|03/29/2022|.15629|03/29/2022|.15733|03/29/2022|||ANTIDEPRESSANTS: OTHER|11592|||||No|No||SCIEGEN PHARMAC|No||||
bupropion HCl|No|No|No|No|75%|50228017660|BUPROPION HCL SR 200 MG TABLET|60|EA|.20353|09/17/2020||Yes|No||09/17/2020||Yes|No|09/17/2020||Yes|No||||No|No|||Prescription required|No||031|No|.16014|03/29/2022|.15629|03/29/2022|.15733|03/29/2022|||ANTIDEPRESSANTS: OTHER|11593|||||No|No||SCIEGEN PHARMAC|No||||
gabapentin|No|No|No|No|75%|50228017701|GABAPENTIN 600 MG TABLET|100|EA|.06342|03/04/2019||Yes|No||03/04/2019||Yes|No|03/04/2019||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|11594|||||No|No||SCIEGEN PHARMAC|No||||
gabapentin|No|No|No|No|75%|50228017705|GABAPENTIN 600 MG TABLET|500|EA|.06342|03/04/2019||Yes|No||03/04/2019||Yes|No|03/04/2019||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|11595|||||No|No||SCIEGEN PHARMAC|No||||
gabapentin|No|No|No|No|75%|50228017801|GABAPENTIN 800 MG TABLET|100|EA|.08492|03/04/2019||Yes|No||03/04/2019||Yes|No|03/04/2019||Yes|No||||No|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|11596|||||No|No||SCIEGEN PHARMAC|No||||
gabapentin|No|No|No|No|75%|50228017805|GABAPENTIN 800 MG TABLET|500|EA|.08492|03/04/2019||Yes|No||03/04/2019||Yes|No|03/04/2019||Yes|No||||No|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|11597|||||No|No||SCIEGEN PHARMAC|No||||
gabapentin|No|No|No|No|75%|50228017901|GABAPENTIN 100 MG CAPSULE|100|EA|.02042|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|11598|||||No|No||SCIEGEN PHARMAC|No||||
gabapentin|No|No|No|No|75%|50228017905|GABAPENTIN 100 MG CAPSULE|500|EA|.02042|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|11599|||||No|No||SCIEGEN PHARMAC|No||||
gabapentin|No|No|No|No|75%|50228017910|GABAPENTIN 100 MG CAPSULE|1000|EA|.01294|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|11600|||||No|No||SCIEGEN PHARMAC|No||||
gabapentin|No|No|No|No|75%|50228018001|GABAPENTIN 300 MG CAPSULE|100|EA|.02902|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|11601|||||No|No||SCIEGEN PHARMAC|No||||
gabapentin|No|No|No|No|75%|50228018005|GABAPENTIN 300 MG CAPSULE|500|EA|.02902|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|11602|||||No|No||SCIEGEN PHARMAC|No||||
gabapentin|No|No|No|No|75%|50228018010|GABAPENTIN 300 MG CAPSULE|1000|EA|.02031|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|11603|||||No|No||SCIEGEN PHARMAC|No||||
gabapentin|No|No|No|No|75%|50228018101|GABAPENTIN 400 MG CAPSULE|100|EA|.03332|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|11604|||||No|No||SCIEGEN PHARMAC|No||||
gabapentin|No|No|No|No|75%|50228018105|GABAPENTIN 400 MG CAPSULE|500|EA|.03332|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|11605|||||No|No||SCIEGEN PHARMAC|No||||
hydralazine HCl|No|No|No|No|75%|50228018201|HYDRALAZINE 10 MG TABLET|100|EA|.04764|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No|||No|.03439|03/29/2022|.03356|03/29/2022|.03378|03/29/2022||||11606|||||No|No||SCIEGEN PHARMAC|No||||
hydralazine HCl|No|No|No|No|75%|50228018210|HYDRALAZINE 10 MG TABLET|1000|EA|.04524|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No|||No|.03439|03/29/2022|.03356|03/29/2022|.03378|03/29/2022||||11607|||||No|No||SCIEGEN PHARMAC|No||||
hydralazine HCl|No|No|No|No|75%|50228018301|HYDRALAZINE 25 MG TABLET|100|EA|.06553|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No|||No|.04116|03/29/2022|.04017|03/29/2022|.04043|03/29/2022||||11608|||||No|No||SCIEGEN PHARMAC|No||||
hydralazine HCl|No|No|No|No|75%|50228018310|HYDRALAZINE 25 MG TABLET|1000|EA|.06222|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No|||No|.04116|03/29/2022|.04017|03/29/2022|.04043|03/29/2022||||11609|||||No|No||SCIEGEN PHARMAC|No||||
hydralazine HCl|No|No|No|No|75%|50228018401|HYDRALAZINE 50 MG TABLET|100|EA|.08187|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No|||No|.0521|03/29/2022|.05084|03/29/2022|.05118|03/29/2022||||11610|||||No|No||SCIEGEN PHARMAC|No||||
hydralazine HCl|No|No|No|No|75%|50228018410|HYDRALAZINE 50 MG TABLET|1000|EA|.07368|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No|||No|.0521|03/29/2022|.05084|03/29/2022|.05118|03/29/2022||||11611|||||No|No||SCIEGEN PHARMAC|No||||
hydralazine HCl|No|No|No|No|75%|50228018501|HYDRALAZINE 100 MG TABLET|100|EA|.15273|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No|||No|.0869|03/29/2022|.08481|03/29/2022|.08537|03/29/2022||||11612|||||No|No||SCIEGEN PHARMAC|No||||
levetiracetam|No|No|No|No|75%|50228018960|LEVETIRACETAM ER 500 MG TABLET|60|EA|.17916|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No||056|No|.22713|03/29/2022|.22167|03/29/2022|.22315|03/29/2022|||ANTICONVULSANTS|11613|||||No|No||SCIEGEN PHARMAC|No||||
levetiracetam|No|No|No|No|75%|50228019060|LEVETIRACETAM ER 750 MG TABLET|60|EA|.25083|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No||056|No|.36799|03/29/2022|.35915|03/29/2022|.36155|03/29/2022|||ANTICONVULSANTS|11614|||||No|No||SCIEGEN PHARMAC|No||||
metaxalone|No|No|No|No|75%|50228032301|METAXALONE 800 MG TABLET|100|EA|.1935|12/22/2021||Yes|No||12/22/2021||Yes|No|12/22/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|116|Yes|.52754|03/29/2022|.51487|03/29/2022|.5183|03/29/2022|||SKELETAL MUSCLE RELAXANTS|11615|||||No|No||SCIEGEN PHARMAC|No||||
metaxalone|No|No|No|No|75%|50228032305|METAXALONE 800 MG TABLET|500|EA|.172|12/22/2021||Yes|No||12/22/2021||Yes|No|12/22/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|116|Yes|.52754|03/29/2022|.51487|03/29/2022|.5183|03/29/2022|||SKELETAL MUSCLE RELAXANTS|11616|||||No|No||SCIEGEN PHARMAC|No||||
ethacrynic acid|No|No|No|No|75%|50228033410|ETHACRYNIC ACID 25 MG TABLET|100|EA|4.29088|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No|||No|2.34378|03/01/2022|2.28752|03/01/2022|2.30276|03/01/2022||||11617|||||No|No||SCIEGEN PHARMAC|No||||
olmesartan medoxomil|Yes|No|No|No|75%|50228033910|OLMESARTAN MEDOXOMIL 5 MG TAB|1000|EA|.086|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|09/27/2019||Prescription required|Yes|07/26/2018|113|Yes|.07425|03/29/2022|.07246|03/29/2022|.07295|03/29/2022|||ANGIOTENSIN MODULATORS|11618|||||No|No||SCIEGEN PHARMAC|No||||
olmesartan medoxomil|Yes|No|No|No|75%|50228033930|OLMESARTAN MEDOXOMIL 5 MG TAB|30|EA|.08628|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|09/27/2019||Prescription required|Yes|07/26/2018|113|Yes|.07425|03/29/2022|.07246|03/29/2022|.07295|03/29/2022|||ANGIOTENSIN MODULATORS|11619|||||No|No||SCIEGEN PHARMAC|No||||
olmesartan medoxomil|Yes|No|No|No|75%|50228033990|OLMESARTAN MEDOXOMIL 5 MG TAB|90|EA|.08628|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|09/27/2019||Prescription required|Yes|07/26/2018|113|Yes|.07425|03/29/2022|.07246|03/29/2022|.07295|03/29/2022|||ANGIOTENSIN MODULATORS|11620|||||No|No||SCIEGEN PHARMAC|No||||
olmesartan medoxomil|Yes|No|No|No|75%|50228034010|OLMESARTAN MEDOXOMIL 20 MG TAB|1000|EA|.10549|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|09/27/2019||Prescription required|Yes|07/26/2018|113|Yes|.1002|03/29/2022|.09779|03/29/2022|.09844|03/29/2022|||ANGIOTENSIN MODULATORS|11621|||||No|No||SCIEGEN PHARMAC|No||||
olmesartan medoxomil|Yes|No|No|No|75%|50228034030|OLMESARTAN MEDOXOMIL 20 MG TAB|30|EA|.10549|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|09/27/2019||Prescription required|Yes|07/26/2018|113|Yes|.1002|03/29/2022|.09779|03/29/2022|.09844|03/29/2022|||ANGIOTENSIN MODULATORS|11622|||||No|No||SCIEGEN PHARMAC|No||||
olmesartan medoxomil|Yes|No|No|No|75%|50228034090|OLMESARTAN MEDOXOMIL 20 MG TAB|90|EA|.10549|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|09/27/2019||Prescription required|Yes|07/26/2018|113|Yes|.1002|03/29/2022|.09779|03/29/2022|.09844|03/29/2022|||ANGIOTENSIN MODULATORS|11623|||||No|No||SCIEGEN PHARMAC|No||||
olmesartan medoxomil|Yes|No|No|No|75%|50228034110|OLMESARTAN MEDOXOMIL 40 MG TAB|1000|EA|.14663|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|09/27/2019||Prescription required|Yes|07/26/2018|113|Yes|.15714|03/29/2022|.15336|03/29/2022|.15439|03/29/2022|||ANGIOTENSIN MODULATORS|11624|||||No|No||SCIEGEN PHARMAC|No||||
olmesartan medoxomil|Yes|No|No|No|75%|50228034130|OLMESARTAN MEDOXOMIL 40 MG TAB|30|EA|.14663|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|09/27/2019||Prescription required|Yes|07/26/2018|113|Yes|.15714|03/29/2022|.15336|03/29/2022|.15439|03/29/2022|||ANGIOTENSIN MODULATORS|11625|||||No|No||SCIEGEN PHARMAC|No||||
olmesartan medoxomil|No|No|No|No|75%|50228034190|OLMESARTAN MEDOXOMIL 40 MG TAB|90|EA|.14663|04/07/2021||Yes|No||04/07/2021||Yes|No|04/07/2021||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|113|Yes|.15714|03/29/2022|.15336|03/29/2022|.15439|03/29/2022|||ANGIOTENSIN MODULATORS|11626|||||No|No||SCIEGEN PHARMAC|No||||
pregabalin|No|No|No|No|90%|50228035090|PREGABALIN 25 MG CAPSULE|90|EA|.0525|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.0795|03/29/2022|.07759|03/29/2022|.0781|03/29/2022|||NEUROPATHIC PAIN|11627|||||No|No||SCIEGEN PHARMAC|No||||
pregabalin|No|No|No|No|90%|50228035190|PREGABALIN 50 MG CAPSULE|90|EA|.05489|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.09128|03/29/2022|.08908|03/29/2022|.08968|03/29/2022|||NEUROPATHIC PAIN|11628|||||No|No||SCIEGEN PHARMAC|No||||
pregabalin|No|No|No|No|90%|50228035290|PREGABALIN 75 MG CAPSULE|90|EA|.05728|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.08098|03/29/2022|.07903|03/29/2022|.07956|03/29/2022|||NEUROPATHIC PAIN|11629|||||No|No||SCIEGEN PHARMAC|No||||
pregabalin|No|No|No|No|90%|50228035390|PREGABALIN 100 MG CAPSULE|90|EA|.05967|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.08763|03/29/2022|.08552|03/29/2022|.08609|03/29/2022|||NEUROPATHIC PAIN|11630|||||No|No||SCIEGEN PHARMAC|No||||
pregabalin|No|No|No|No|90%|50228035490|PREGABALIN 150 MG CAPSULE|90|EA|.06444|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.10646|03/29/2022|.1039|03/29/2022|.10459|03/29/2022|||NEUROPATHIC PAIN|11631|||||No|No||SCIEGEN PHARMAC|No||||
pregabalin|No|No|No|No|90%|50228035590|PREGABALIN 200 MG CAPSULE|90|EA|.06923|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.11395|03/29/2022|.11121|03/29/2022|.11195|03/29/2022|||NEUROPATHIC PAIN|11632|||||No|No||SCIEGEN PHARMAC|No||||
pregabalin|No|No|No|No|90%|50228035690|PREGABALIN 225 MG CAPSULE|90|EA|.07161|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.12393|03/29/2022|.12095|03/29/2022|.12176|03/29/2022|||NEUROPATHIC PAIN|11633|||||No|No||SCIEGEN PHARMAC|No||||
pregabalin|No|No|No|No|90%|50228035790|PREGABALIN 300 MG CAPSULE|90|EA|.07878|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.12181|03/29/2022|.11888|03/29/2022|.11967|03/29/2022|||NEUROPATHIC PAIN|11634|||||No|No||SCIEGEN PHARMAC|No||||
ezetimibe|No|No|No|No|75%|50228037905|EZETIMIBE 10 MG TABLET|500|EA|.07735|09/20/2021||Yes|No||09/20/2021||Yes|No|09/20/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|11635|||||No|No||SCIEGEN PHARMAC|No||||
ezetimibe|No|No|No|No|75%|50228037930|EZETIMIBE 10 MG TABLET|30|EA|.12183|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|11636|||||No|No||SCIEGEN PHARMAC|No||||
ezetimibe|No|No|No|No|75%|50228037990|EZETIMIBE 10 MG TABLET|90|EA|.11705|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|11637|||||No|No||SCIEGEN PHARMAC|No||||
quetiapine fumarate|No|No|No|No|75%|50228038060|QUETIAPINE ER 50 MG TABLET|60|EA|.14333|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|.13845|03/29/2022|.13512|03/29/2022|.13602|03/29/2022|||ANTIPSYCHOTICS|11638|||||No|No||SCIEGEN PHARMAC|No||||
quetiapine fumarate|No|No|No|No|75%|50228038160|QUETIAPINE ER 150 MG TABLET|60|EA|.17916|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|.25256|03/29/2022|.24649|03/29/2022|.24814|03/29/2022|||ANTIPSYCHOTICS|11639|||||No|No||SCIEGEN PHARMAC|No||||
quetiapine fumarate|No|No|No|No|75%|50228038260|QUETIAPINE ER 200 MG TABLET|60|EA|.20066|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|.25825|03/29/2022|.25205|03/29/2022|.25373|03/29/2022|||ANTIPSYCHOTICS|11640|||||No|No||SCIEGEN PHARMAC|No||||
quetiapine fumarate|No|No|No|No|75%|50228038360|QUETIAPINE ER 300 MG TABLET|60|EA|.22933|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|.35477|03/29/2022|.34625|03/29/2022|.34856|03/29/2022|||ANTIPSYCHOTICS|11641|||||No|No||SCIEGEN PHARMAC|No||||
quetiapine fumarate|No|No|No|No|75%|50228038460|QUETIAPINE ER 400 MG TABLET|60|EA|.25083|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|.42833|03/29/2022|.41805|03/29/2022|.42083|03/29/2022|||ANTIPSYCHOTICS|11642|||||No|No||SCIEGEN PHARMAC|No||||
fluoxetine HCl|Yes|No|No|No|75%|50228042001|FLUOXETINE HCL 10 MG TABLET|100|EA|.4929|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||008|No|.24078|03/29/2022|.235|03/29/2022|.23656|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11643|||||No|No||SCIEGEN PHARMAC|No||||
fluoxetine HCl|Yes|No|No|No|75%|50228042030|FLUOXETINE HCL 10 MG TABLET|30|EA|.49292|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||008|No|.24078|03/29/2022|.235|03/29/2022|.23656|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11644|||||No|No||SCIEGEN PHARMAC|No||||
fluoxetine HCl|Yes|No|No|No|75%|50228042101|FLUOXETINE HCL 20 MG TABLET|100|EA|.72235|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||008|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11645|||||No|No||SCIEGEN PHARMAC|No||||
fluoxetine HCl|Yes|No|No|No|75%|50228042130|FLUOXETINE HCL 20 MG TABLET|30|EA|.72225|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||008|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11646|||||No|No||SCIEGEN PHARMAC|No||||
fluoxetine HCl|Yes|No|No|No|75%|50228042230|FLUOXETINE HCL 60 MG TABLET|30|EA|2.86652|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|01/15/2020||Prescription required|Yes|07/30/2020|008|No|1.06507|03/29/2022|1.0395|03/29/2022|1.04643|03/29/2022|||ANTIDEPRESSANTS: SSRIs|11647|||||No|No||SCIEGEN PHARMAC|No||||
ranolazine|No|No|No|No|75%|50228042360|RANOLAZINE ER 500 MG TABLET|60|EA|.28659|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|No|||Yes|.28604|03/29/2022|.27917|03/29/2022|.28103|03/29/2022||||11648|||||No|No||SCIEGEN PHARMAC|No||||
ranolazine|No|No|No|No|75%|50228042460|RANOLAZINE ER 1,000 MG TABLET|60|EA|.50159|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|No|||Yes|.43283|03/29/2022|.42244|03/29/2022|.42525|03/29/2022||||11649|||||No|No||SCIEGEN PHARMAC|No||||
solifenacin succinate|No|No|No|No|75%|50228042730|SOLIFENACIN 5 MG TABLET|30|EA|.14319|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|Yes|.23024|03/29/2022|.22471|03/29/2022|.22621|03/29/2022|||BLADDER RELAXANT PREPARATIONS|11650|||||No|No||SCIEGEN PHARMAC|No||||
solifenacin succinate|No|No|No|No|75%|50228042790|SOLIFENACIN 5 MG TABLET|90|EA|.14319|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|Yes|.23024|03/29/2022|.22471|03/29/2022|.22621|03/29/2022|||BLADDER RELAXANT PREPARATIONS|11651|||||No|No||SCIEGEN PHARMAC|No||||
solifenacin succinate|No|No|No|No|75%|50228042830|SOLIFENACIN 10 MG TABLET|30|EA|.14319|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|No|.26101|03/29/2022|.25474|03/29/2022|.25644|03/29/2022|||BLADDER RELAXANT PREPARATIONS|11652|||||No|No||SCIEGEN PHARMAC|No||||
solifenacin succinate|No|No|No|No|75%|50228042890|SOLIFENACIN 10 MG TABLET|90|EA|.14319|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|No|.26101|03/29/2022|.25474|03/29/2022|.25644|03/29/2022|||BLADDER RELAXANT PREPARATIONS|11653|||||No|No||SCIEGEN PHARMAC|No||||
droxidopa|No|No|No|No|75%|50228042990|DROXIDOPA 100 MG CAPSULE|90|EA|.5351|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No|||No|1.21955|06/08/2021|1.20212|06/08/2021|1.14488|06/08/2021||||11654|||||No|No||SCIEGEN PHARMAC|No||||
droxidopa|No|No|No|No|75%|50228043090|DROXIDOPA 200 MG CAPSULE|90|EA|1.07021|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No|||No|2.4391|06/08/2021|2.40425|06/08/2021|2.28976|06/08/2021||||11655|||||No|No||SCIEGEN PHARMAC|No||||
droxidopa|No|No|No|No|75%|50228043190|DROXIDOPA 300 MG CAPSULE|90|EA|1.60533|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No|||No|3.65866|06/08/2021|3.60639|06/08/2021|3.43466|06/08/2021||||11656|||||No|No||SCIEGEN PHARMAC|No||||
naproxen sodium|No|No|No|No|75%|50228043201|NAPROXEN SODIUM 275 MG TAB|100|EA|.09107|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|.20756|03/23/2021|.20459|03/23/2021|.19485|03/23/2021|||NSAIDS|11657|||||No|No||SCIEGEN PHARMAC|No||||
naproxen sodium|No|No|No|No|75%|50228043205|NAPROXEN SODIUM 275 MG TAB|500|EA|.09107|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|.20756|03/23/2021|.20459|03/23/2021|.19485|03/23/2021|||NSAIDS|11658|||||No|No||SCIEGEN PHARMAC|No||||
naproxen sodium|No|No|No|No|75%|50228043301|NAPROXEN SODIUM 550 MG TAB|100|EA|.3225|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|.37204|03/29/2022|.36311|03/29/2022|.36552|03/29/2022|||NSAIDS|11659|||||No|No||SCIEGEN PHARMAC|No||||
naproxen sodium|No|No|No|No|75%|50228043305|NAPROXEN SODIUM 550 MG TAB|500|EA|.3225|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|.37204|03/29/2022|.36311|03/29/2022|.36552|03/29/2022|||NSAIDS|11660|||||No|No||SCIEGEN PHARMAC|No||||
naproxen|No|No|No|No|75%|50228043401|NAPROXEN 250 MG TABLET|100|EA|.02988|09/17/2020||Yes|No||09/17/2020||Yes|No|09/17/2020||Yes|No||||No|No|||Prescription required|No||059|Yes|.06074|03/29/2022|.05928|03/29/2022|.05967|03/29/2022|||NSAIDS|11661|||||No|No||SCIEGEN PHARMAC|No||||
naproxen|No|No|No|No|75%|50228043405|NAPROXEN 250 MG TABLET|500|EA|.023|09/17/2020||Yes|No||09/17/2020||Yes|No|09/17/2020||Yes|No||||No|No|||Prescription required|No||059|Yes|.06074|03/29/2022|.05928|03/29/2022|.05967|03/29/2022|||NSAIDS|11662|||||No|No||SCIEGEN PHARMAC|No||||
naproxen|No|No|No|No|75%|50228043501|NAPROXEN 375 MG TABLET|100|EA|.03289|09/17/2020||Yes|No||09/17/2020||Yes|No|09/17/2020||Yes|No||||No|No|||Prescription required|No||059|Yes|.07806|03/29/2022|.07618|03/29/2022|.07669|03/29/2022|||NSAIDS|11663|||||No|No||SCIEGEN PHARMAC|No||||
naproxen|No|No|No|No|75%|50228043505|NAPROXEN 375 MG TABLET|500|EA|.02962|09/17/2020||Yes|No||09/17/2020||Yes|No|09/17/2020||Yes|No||||No|No|||Prescription required|No||059|Yes|.07806|03/29/2022|.07618|03/29/2022|.07669|03/29/2022|||NSAIDS|11664|||||No|No||SCIEGEN PHARMAC|No||||
naproxen|No|No|No|No|75%|50228043601|NAPROXEN 500 MG TABLET|100|EA|.04704|09/17/2020||Yes|No||09/17/2020||Yes|No|09/17/2020||Yes|No||||No|No|||Prescription required|No||059|Yes|.07731|03/29/2022|.07545|03/29/2022|.07595|03/29/2022|||NSAIDS|11665|||||No|No||SCIEGEN PHARMAC|No||||
naproxen|No|No|No|No|75%|50228043605|NAPROXEN 500 MG TABLET|500|EA|.04515|09/17/2020||Yes|No||09/17/2020||Yes|No|09/17/2020||Yes|No||||No|No|||Prescription required|No||059|Yes|.07731|03/29/2022|.07545|03/29/2022|.07595|03/29/2022|||NSAIDS|11666|||||No|No||SCIEGEN PHARMAC|No||||
metformin HCl|No|No|No|No|75%|50228044501|METFORMIN ER 500 MG GASTRC-TB|100|EA|1.075|12/21/2021||Yes|No||12/21/2021||Yes|No|12/21/2021||Yes|No||||No|No|||Prescription required|No||012|No|2.40128|03/29/2022|2.34364|03/29/2022|2.35925|03/29/2022|||HYPOGLYCEMICS: METFORMINS|11667|||||No|No||SCIEGEN PHARMAC|No||||
metformin HCl|No|No|No|No|75%|50228044690|METFORMIN ER 1,000 MG GASTR-TB|90|EA|1.935|12/21/2021||Yes|No||12/21/2021||Yes|No|12/21/2021||Yes|No||||No|No|||Prescription required|No||012|No|6.02577|03/29/2022|5.88115|03/29/2022|5.92031|03/29/2022|||HYPOGLYCEMICS: METFORMINS|11668|||||No|No||SCIEGEN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|50228045110|ATORVASTATIN 10 MG TABLET|1000|EA|.03206|06/09/2021||Yes|No||06/09/2021||Yes|No|06/09/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|11669|||||No|No||SCIEGEN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|50228045205|ATORVASTATIN 20 MG TABLET|500|EA|.06855|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|11670|||||No|No||SCIEGEN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|50228045290|ATORVASTATIN 20 MG TABLET|90|EA|.04457|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|11671|||||No|No||SCIEGEN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|50228045310|ATORVASTATIN 40 MG TABLET|1000|EA|.07591|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|11672|||||No|No||SCIEGEN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|50228045390|ATORVASTATIN 40 MG TABLET|90|EA|.06454|11/22/2021||Yes|No||11/22/2021||Yes|No|11/22/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|11673|||||No|No||SCIEGEN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|50228045405|ATORVASTATIN 80 MG TABLET|500|EA|.07811|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|11674|||||No|No||SCIEGEN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|50228045490|ATORVASTATIN 80 MG TABLET|90|EA|.0664|11/22/2021||Yes|No||11/22/2021||Yes|No|11/22/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|11675|||||No|No||SCIEGEN PHARMAC|No||||
carbidopa/levodopa|No|No|No|No|75%|50228045701|CARBIDOPA-LEVODOPA 10-100 TAB|100|EA|.03822|12/22/2021||Yes|No||12/22/2021||Yes|No|12/22/2021||Yes|No||||No|No|||Prescription required|No||015|No|.14195|03/29/2022|.13854|03/29/2022|.13946|03/29/2022|||ANTIPARKINSON'S AGENTS|11676|||||No|No||SCIEGEN PHARMAC|No||||
carbidopa/levodopa|No|No|No|No|75%|50228045705|CARBIDOPA-LEVODOPA 10-100 TAB|500|EA|.03747|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|No||015|No|.14195|03/29/2022|.13854|03/29/2022|.13946|03/29/2022|||ANTIPARKINSON'S AGENTS|11677|||||No|No||SCIEGEN PHARMAC|No||||
carbidopa/levodopa|No|No|No|No|75%|50228045801|CARBIDOPA-LEVODOPA 25-100 TAB|100|EA|.04343|12/22/2021||Yes|No||12/22/2021||Yes|No|12/22/2021||Yes|No||||No|No|||Prescription required|No||015|No|.11418|03/29/2022|.11143|03/29/2022|.11218|03/29/2022|||ANTIPARKINSON'S AGENTS|11678|||||No|No||SCIEGEN PHARMAC|No||||
carbidopa/levodopa|No|No|No|No|75%|50228045805|CARBIDOPA-LEVODOPA 25-100 TAB|500|EA|.04255|12/22/2021||Yes|No||12/22/2021||Yes|No|12/22/2021||Yes|No||||No|No|||Prescription required|No||015|No|.11418|03/29/2022|.11143|03/29/2022|.11218|03/29/2022|||ANTIPARKINSON'S AGENTS|11679|||||No|No||SCIEGEN PHARMAC|No||||
carbidopa/levodopa|No|No|No|No|75%|50228045810|CARBIDOPA-LEVODOPA 25-100 TAB|1000|EA|.04255|12/21/2021||Yes|No||12/21/2021||Yes|No|12/21/2021||Yes|No||||No|No|||Prescription required|No||015|No|.11418|03/29/2022|.11143|03/29/2022|.11218|03/29/2022|||ANTIPARKINSON'S AGENTS|11680|||||No|No||SCIEGEN PHARMAC|No||||
carbidopa/levodopa|No|No|No|No|75%|50228045901|CARBIDOPA-LEVODOPA 25-250 TAB|100|EA|.05013|12/21/2021||Yes|No||12/21/2021||Yes|No|12/21/2021||Yes|No||||No|No|||Prescription required|No||015|No|.1493|03/29/2022|.14571|03/29/2022|.14668|03/29/2022|||ANTIPARKINSON'S AGENTS|11681|||||No|No||SCIEGEN PHARMAC|No||||
carbidopa/levodopa|No|No|No|No|75%|50228045905|CARBIDOPA-LEVODOPA 25-250 TAB|500|EA|.04764|12/21/2021||Yes|No||12/21/2021||Yes|No|12/21/2021||Yes|No||||No|No|||Prescription required|No||015|No|.1493|03/29/2022|.14571|03/29/2022|.14668|03/29/2022|||ANTIPARKINSON'S AGENTS|11682|||||No|No||SCIEGEN PHARMAC|No||||
nabumetone|No|No|No|No|75%|50228046501|NABUMETONE 500 MG TABLET|100|EA|.04945|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.17691|03/29/2022|.17266|03/29/2022|.17381|03/29/2022|||NSAIDS|11683|||||No|No||SCIEGEN PHARMAC|No||||
nabumetone|No|No|No|No|75%|50228046505|NABUMETONE 500 MG TABLET|500|EA|.04945|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.17691|03/29/2022|.17266|03/29/2022|.17381|03/29/2022|||NSAIDS|11684|||||No|No||SCIEGEN PHARMAC|No||||
nabumetone|No|No|No|No|75%|50228046601|NABUMETONE 750 MG TABLET|100|EA|.05267|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.2074|03/29/2022|.20242|03/29/2022|.20377|03/29/2022|||NSAIDS|11685|||||No|No||SCIEGEN PHARMAC|No||||
nabumetone|No|No|No|No|75%|50228046605|NABUMETONE 750 MG TABLET|500|EA|.05267|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.2074|03/29/2022|.20242|03/29/2022|.20377|03/29/2022|||NSAIDS|11686|||||No|No||SCIEGEN PHARMAC|No||||
satralizumab-mwge|No|No|No|No|75%|50242000701|ENSPRYNG 120 MG/ML SYRINGE|1|ML|6473.1555|01/27/2021||Yes|No||01/27/2021||Yes|No|01/27/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|071|No|14752.773|01/11/2022|14542.0191|01/11/2022|13849.542|01/11/2022|||CYTOKINE AND CAM ANTAGONISTS|11687|||||No|No||GENENTECH, INC.|No||||
erlotinib HCl|No|No|No|No|75%|50242006201|TARCEVA 25 MG TABLET|30|EA|38.99225|12/10/2004||Yes|No||12/10/2004||Yes|No|12/10/2004||Yes|No||||No|No|||Prescription required|No||551|No|88.86606|12/26/2017|87.59655|12/26/2017|83.42528|12/26/2017|||ONCOLOGY: ORAL - LUNG|11688|||||No|No||GENENTECH, INC.|No||||
erlotinib HCl|No|No|No|No|75%|50242006301|TARCEVA 100 MG TABLET|30|EA|107.09895|12/10/2004||Yes|No||12/10/2004||Yes|No|12/10/2004||Yes|No||||No|No|||Prescription required|No||551|No|244.08598|12/26/2017|240.59904|12/26/2017|229.14194|12/26/2017|||ONCOLOGY: ORAL - LUNG|11689|||||No|No||GENENTECH, INC.|No||||
erlotinib HCl|No|No|No|No|75%|50242006401|TARCEVA 150 MG TABLET|30|EA|121.13673|12/10/2004||Yes|No||12/10/2004||Yes|No|12/10/2004||Yes|No||||No|No|||Prescription required|No||551|No|276.07906|12/26/2017|272.13507|12/26/2017|259.17626|12/26/2017|||ONCOLOGY: ORAL - LUNG|11690|||||No|No||GENENTECH, INC.|No||||
obinutuzumab|No|No|No|No|75%|50242007001|GAZYVA 1,000 MG/40 ML VIAL|40|ML|76.56902|11/12/2013||Yes|No||11/12/2013||Yes|No|11/12/2013||Yes|No||||No|No|||Prescription required|No|||No|174.50615|01/11/2022|172.0132|01/11/2022|163.8221|01/11/2022||||11691|||||No|No||GENENTECH, INC.|No||||
somatropin|No|No|No|No|75%|50242007401|NUTROPIN AQ NUSPIN 10 INJECTOR|2|ML|270.33025|12/16/2010||Yes|No||12/16/2010||Yes|No|12/16/2010||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|Yes|07/29/2021|014|Yes|616.1015|12/26/2017|607.30005|12/26/2017|578.381|12/26/2017|||GROWTH HORMONE|11692|||||No|No||GENENTECH, INC.|No||||
somatropin|No|No|No|No|75%|50242007501|NUTROPIN AQ NUSPIN 5 INJECTOR|2|ML|135.16405|12/16/2010||Yes|No||12/16/2010||Yes|No|12/16/2010||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|Yes|07/29/2021|014|Yes|308.0483|12/26/2017|303.64761|12/26/2017|289.1882|12/26/2017|||GROWTH HORMONE|11693|||||No|No||GENENTECH, INC.|No||||
somatropin|No|No|No|No|75%|50242007601|NUTROPIN AQ NUSPIN 20 INJECTOR|2|ML|540.6562|12/16/2010||Yes|No||12/16/2010||Yes|No|12/16/2010||Yes|No|Submit HHS Form 1312|||No|No|||Prescription required|Yes|07/29/2021|014|Yes|1232.1932|08/13/2019|1214.59044|08/13/2019|1156.7528|08/13/2019|||GROWTH HORMONE|11694|||||No|No||GENENTECH, INC.|No||||
vemurafenib|No|No|No|No|75%|50242009002|ZELBORAF 240 MG TABLET|112|EA|19.44102|08/21/2015||Yes|No||08/21/2015||Yes|No|08/21/2015||Yes|No||||No|No|||Prescription required|No||563|No|44.30745|06/01/2016|43.67449|06/01/2016|41.59475|06/01/2016|||ONCOLOGY: ORAL - SKIN|11695|||||No|No||GENENTECH, INC.|No||||
entrectinib|No|No|No|No|75%|50242009130|ROZLYTREK 100 MG CAPSULE|30|EA|85.1549|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||||No|No|||Prescription required|No||551|No|194.07396|01/11/2022|191.30148|01/11/2022|182.19188|01/11/2022|||ONCOLOGY: ORAL - LUNG|11696|||||No|No||GENENTECH, INC.|No||||
entrectinib|No|No|No|No|75%|50242009490|ROZLYTREK 200 MG CAPSULE|90|EA|85.1549|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||||No|No|||Prescription required|No||551|No|194.07396|01/11/2022|191.30148|01/11/2022|182.19188|01/11/2022|||ONCOLOGY: ORAL - LUNG|11697|||||No|No||GENENTECH, INC.|No||||
dornase alfa|No|No|No|No|75%|50242010040|PULMOZYME 1 MG/ML AMPUL|2.5|ML|19.76612|03/09/2010||Yes|No||03/09/2010||Yes|No|03/09/2010||Yes|No|Submit HHS Form 1143|||No|No|||Prescription required|No|||No|44.67411|03/01/2022|43.60193|03/01/2022|43.89231|03/01/2022||||11698|||||No|No||GENENTECH, INC.|No||||
pirfenidone|No|No|No|No|75%|50242012101|ESBRIET 267 MG CAPSULE|270|EA|16.64168|03/28/2016||Yes|No||03/28/2016||Yes|No|03/28/2016||Yes|No||||No|No|||Prescription required|No|||No|37.92755|01/11/2022|37.38573|01/11/2022|35.60546|01/11/2022||||11699|||||No|No||GENENTECH, INC.|No||||
pirfenidone|No|No|No|No|75%|50242012206|ESBRIET 267 MG TABLET|270|EA|16.64168|10/04/2019||Yes|No||10/04/2019||Yes|No|10/04/2019||Yes|No||||No|No|||Prescription required|No|||No|37.92755|01/11/2022|37.38573|01/11/2022|35.60546|01/11/2022||||11700|||||No|No||GENENTECH, INC.|No||||
pirfenidone|No|No|No|No|75%|50242012301|ESBRIET 801 MG TABLET|90|EA|49.92505|01/05/2018||Yes|No||01/05/2018||Yes|No|01/05/2018||Yes|No||||No|No|||Prescription required|No|||No|113.78267|01/11/2022|112.1572|01/11/2022|106.81638|01/11/2022||||11701|||||No|No||GENENTECH, INC.|No||||
alectinib HCl|No|No|No|No|75%|50242013001|ALECENSA 150 MG CAPSULE|240|EA|29.54775|04/25/2017||Yes|No||04/25/2017||Yes|No|04/25/2017||Yes|No||||No|No|||Prescription required|No||551|No|67.34138|01/11/2022|66.37936|01/11/2022|63.21844|01/11/2022|||ONCOLOGY: ORAL - LUNG|11702|||||No|No||GENENTECH, INC.|No||||
tocilizumab|No|No|No|No|75%|50242013801|ACTEMRA 162 MG/0.9 ML SYRINGE|.9|ML|514.10321|11/12/2013||Yes|No||11/12/2013||Yes|No|11/12/2013||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|071|Yes|1171.6771|01/12/2021|1154.93885|01/12/2021|1099.94176|01/12/2021|||CYTOKINE AND CAM ANTAGONISTS|11703|||||No|No||GENENTECH, INC.|No||||
vismodegib|No|No|No|No|75%|50242014001|ERIVEDGE 150 MG CAPSULE|28|EA|186.10891|02/21/2012||Yes|No||02/21/2012||Yes|No|02/21/2012||Yes|No||||No|No|||Prescription required|No||563|No|424.15519|01/11/2022|418.09583|01/11/2022|398.1865|01/11/2022|||ONCOLOGY: ORAL - SKIN|11704|||||No|No||GENENTECH, INC.|No||||
tocilizumab|No|No|No|No|75%|50242014301|ACTEMRA ACTPEN 162 MG/0.9 ML|.9|ML|514.10321|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|071|Yes|1171.6771|01/12/2021|1154.93885|01/12/2021|1099.94176|01/12/2021|||CYTOKINE AND CAM ANTAGONISTS|11705|||||No|No||GENENTECH, INC.|No||||
risdiplam|No|No|No|No|75%|50242017507|EVRYSDI 60 MG/80 ML(0.75MG/ML)|80|ML|61.24189|02/01/2021||Yes|No||02/01/2021||Yes|No|02/01/2021||Yes|No||||No|No|||Prescription required|No|||No|139.57454|01/11/2022|137.58061|01/11/2022|131.02916|01/11/2022||||11706|||||No|No||GENENTECH, INC.|No||||
pralsetinib|No|No|No|No|75%|50242021060|GAVRETO 100 MG CAPSULE|60|EA|71.02345|11/29/2021||Yes|No||11/29/2021||Yes|No|11/29/2021||Yes|No||||No|No|||Prescription required|No||551|No|161.86741|01/11/2022|159.55502|01/11/2022|151.95716|01/11/2022|||ONCOLOGY: ORAL - LUNG|11707|||||No|No||GENENTECH, INC.|No||||
pralsetinib|No|No|No|No|75%|50242021090|GAVRETO 100 MG CAPSULE|90|EA|71.02343|11/29/2021||Yes|No||11/29/2021||Yes|No|11/29/2021||Yes|No||||No|No|||Prescription required|No||551|No|161.86735|01/11/2022|159.55496|01/11/2022|151.9571|01/11/2022|||ONCOLOGY: ORAL - LUNG|11708|||||No|No||GENENTECH, INC.|No||||
cobimetinib fumarate|No|No|No|No|75%|50242071701|COTELLIC 20 MG TABLET|63|EA|47.8117|04/24/2017||Yes|No||04/24/2017||Yes|No|04/24/2017||Yes|No||||No|No|||Prescription required|No||563|No|108.9662|01/09/2018|107.40954|01/09/2018|102.2948|01/09/2018|||ONCOLOGY: ORAL - SKIN|11709|||||No|No||GENENTECH, INC.|No||||
baloxavir marboxil|No|No|No|No|75%|50242082802|XOFLUZA 20 MG TAB (40 MG DOSE)|2|EA|33.2175|02/12/2019||Yes|No||02/12/2019||Yes|No|02/12/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|025|No|75.705|01/25/2022|74.6235|01/25/2022|71.07|01/25/2022|||ANTIVIRALS: ORAL|11710|||||No|No||GENENTECH, INC.|No||||
baloxavir marboxil|No|No|No|No|75%|50242086001|XOFLUZA 40 MG TABLET|1|EA|66.435|11/30/2021||Yes|No||11/30/2021||Yes|No|11/30/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|025|No|148.6425|03/29/2022|145.07508|03/29/2022|146.04125|03/29/2022|||ANTIVIRALS: ORAL|11711|||||No|No||GENENTECH, INC.|No||||
baloxavir marboxil|No|No|No|No|75%|50242086002|XOFLUZA 40 MG TAB (80 MG DOSE)|2|EA|33.2175|02/12/2019||Yes|No||02/12/2019||Yes|No|02/12/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|025|No|74.153|09/28/2021|72.37332|09/28/2021|72.85532|09/28/2021|||ANTIVIRALS: ORAL|11712|||||No|No||GENENTECH, INC.|No||||
baloxavir marboxil|No|No|No|No|75%|50242087701|XOFLUZA 80 MG TABLET|1|EA|66.435|11/30/2021||Yes|No||11/30/2021||Yes|No|11/30/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|025|No|148.0388|03/29/2022|144.48586|03/29/2022|145.44812|03/29/2022|||ANTIVIRALS: ORAL|11713|||||No|No||GENENTECH, INC.|No||||
emicizumab-kxwh|No|No|No|No|75%|50242092001|HEMLIBRA 30 MG/ML VIAL|1|ML|2147.44|03/05/2018||Yes|No||03/05/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|3094.84|01/11/2022|3050.628|01/11/2022|2905.36|01/11/2022|||HEMOPHILIA TREATMENT|11714|||||No|No||GENENTECH, INC.|No||||
emicizumab-kxwh|No|No|No|No|75%|50242092101|HEMLIBRA 60 MG/0.4 ML VIAL|.4|ML|10737.2|03/05/2018||Yes|No||03/05/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|15474.2|01/11/2022|15253.14|01/11/2022|14526.8|01/11/2022|||HEMOPHILIA TREATMENT|11715|||||No|No||GENENTECH, INC.|No||||
emicizumab-kxwh|No|No|No|No|75%|50242092201|HEMLIBRA 105 MG/0.7 ML VIAL|.7|ML|10737.20971|03/05/2018||Yes|No||03/05/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|15474.21399|01/11/2022|15253.15379|01/11/2022|14526.81313|01/11/2022|||HEMOPHILIA TREATMENT|11716|||||No|No||GENENTECH, INC.|No||||
emicizumab-kxwh|No|No|No|No|75%|50242092301|HEMLIBRA 150 MG/ML VIAL|1|ML|10737.2068|03/05/2018||Yes|No||03/05/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|15474.2098|01/11/2022|15253.14966|01/11/2022|14526.8092|01/11/2022|||HEMOPHILIA TREATMENT|11717|||||No|No||GENENTECH, INC.|No||||
estradiol/progesterone|No|No|No|No|75%|50261021130|BIJUVA 1 MG-100 MG CAPSULE|30|EA|3.37349|03/09/2020||Yes|No||03/09/2020||Yes|No|03/09/2020||Yes|No||||No|No|||Prescription required|No|||No|7.48102|01/04/2022|7.30147|01/04/2022|7.3501|01/04/2022||||11718|||||No|No||THERAPEUTICSMD|No||||
segesterone ac/ethin estradiol|Yes|Yes|No|No|75%|50261031301|ANNOVERA VAGINAL RING|1|EA|898.7|02/24/2020||Yes|No||02/24/2020||Yes|No|||No|No||||No|No|03/20/2020||Prescription required|No|||No|2009.326|03/01/2022|1961.10217|03/01/2022|1974.16279|03/01/2022||||11719|||||No|No||THERAPEUTICSMD|No|||Only covered for non-contraceptive (medical) purposes|
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|50268014411|BUPRENORPHINE-NALOX 2-0.5MG TB|1|EA||10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|.72296|03/29/2022|.7056|03/29/2022|.7103|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|11720|||||No|No||AVPAK|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|50268014415|BUPRENORPHINE-NALOX 2-0.5MG TB|50|EA|1.67562|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|.72296|03/29/2022|.7056|03/29/2022|.7103|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|11721|||||No|No||AVPAK|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|50268014511|BUPRENORPHINE-NALOX 8-2 MG TAB|1|EA||10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|1.08568|03/29/2022|1.05962|03/29/2022|1.06668|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|11722|||||No|No||AVPAK|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|50268014515|BUPRENORPHINE-NALOX 8-2 MG TAB|50|EA|2.15774|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|1.08568|03/29/2022|1.05962|03/29/2022|1.06668|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|11723|||||No|No||AVPAK|Yes|09/01/2020|||
isradipine|No|No|No|No|75%|50268045415|ISRADIPINE 2.5 MG CAPSULE|50|EA|.83789|04/08/2019||Yes|No||04/08/2019||Yes|No|04/08/2019||Yes|No||||No|No|||Prescription required|Yes|11/02/2017|045|No|1.90962|02/25/2019|1.88234|02/25/2019|1.79271|02/25/2019|||CALCIUM CHANNEL BLOCKERS|11724|||||No|No||AVPAK|No||||
isradipine|No|No|No|No|75%|50268045515|ISRADIPINE 5 MG CAPSULE|50|EA|1.34848|04/08/2019||Yes|No||04/08/2019||Yes|No|04/08/2019||Yes|No||||No|No|||Prescription required|Yes|11/02/2017|045|No|3.07328|01/28/2020|3.02937|01/28/2020|2.88512|01/28/2020|||CALCIUM CHANNEL BLOCKERS|11725|||||No|No||AVPAK|No||||
ofloxacin|No|No|No|No|75%|50383002505|OFLOXACIN 0.3% EAR DROPS|5|ML|5.59|11/28/2016||Yes|No||11/28/2016||Yes|No|11/28/2016||Yes|No||||No|No|||Prescription required|No||051|No|2.13104|03/29/2022|2.07989|03/29/2022|2.09374|03/29/2022|||OTIC ANTIBIOTICS|11726|||||No|No||HI-TECH/AKORN C|No||||
ofloxacin|No|No|No|No|75%|50383002510|OFLOXACIN 0.3% EAR DROPS|10|ML|5.59|11/28/2016||Yes|No||11/28/2016||Yes|No|11/28/2016||Yes|No||||No|No|||Prescription required|No||051|No|2.28641|03/29/2022|2.23153|03/29/2022|2.24639|03/29/2022|||OTIC ANTIBIOTICS|11727|||||No|No||HI-TECH/AKORN C|No||||
prednisolone sodium phosphate|No|No|No|No|75%|50383004004|PREDNISOLONE 5 MG/5 ML SOLN|120|ML|.28118|03/15/2007||Yes|No||03/15/2007||Yes|No|03/15/2007||Yes|No||||No|No|||Prescription required|No||168|Yes|.59232|03/29/2022|.5781|03/29/2022|.58195|03/29/2022|||GLUCOCORTICOIDS: ORAL|11728|||||No|No||HI-TECH/AKORN C|No||||
prednisolone|No|No|No|No|75%|50383004224|PREDNISOLONE 15 MG/5 ML SOLN|240|ML|.09492|11/21/2007||Yes|No||11/21/2007||Yes|No|11/21/2007||Yes|No||||No|No|||Prescription required|No||168|Yes|.14245|03/29/2022|.13903|03/29/2022|.13995|03/29/2022|||GLUCOCORTICOIDS: ORAL|11729|||||No|No||HI-TECH/AKORN C|No||||
prednisolone|No|No|No|No|75%|50383004248|PREDNISOLONE 15 MG/5 ML SOLN|480|ML|.07783|03/15/2007||Yes|No||03/15/2007||Yes|No|03/15/2007||Yes|No||||No|No|||Prescription required|No||168|Yes|.14379|03/01/2022|.14033|03/01/2022|.14127|03/01/2022|||GLUCOCORTICOIDS: ORAL|11730|||||No|No||HI-TECH/AKORN C|No||||
hydrocodone bit/homatrop me-br|No|No|No|No|90%|50383004316|HYDROCODONE-HOMATROPINE SOLN|473|ML|.06358|01/29/2010||Yes|No||01/29/2010||Yes|No|01/29/2010||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|183|Yes|.1071|03/29/2022|.10452|03/29/2022|.10522|03/29/2022|||COUGH AND COLD: NARCOTIC|11731|||||No|No||HI-TECH/AKORN C|No||||
acetaminophen with codeine|No|No|No|No|90%|50383007916|ACETAMINOP-CODEINE 120-12 MG/5|473|ML|.00727|03/02/2004||Yes|No||03/02/2004||Yes|No|03/02/2004||Yes|No||||No|No|||Prescription required|No||109|Yes|.01517|03/29/2022|.0148|03/29/2022|.0149|03/29/2022|||ANALGESICS: NARCOTICS SHORT|11732|||||No|No||HI-TECH/AKORN C|No||||
codeine phosphate/guaifenesin|No|No|No|No|90%|50383008704|GUAIATUSSIN AC LIQUID|118|ML|.03898|01/27/2021||Yes|No||||No|No|01/27/2021||Yes|No||||No|No|||Over the counter|No||183|Yes|.05917|03/29/2022|.05774|03/29/2022|.05813|03/29/2022|||COUGH AND COLD: NARCOTIC|11733|||||No|No||HI-TECH/AKORN C|No||||
codeine phosphate/guaifenesin|No|No|No|No|90%|50383008716|GUAIATUSSIN AC LIQUID|473|ML|.03245|12/02/2016||Yes|No||||No|No|12/02/2016||Yes|No||||No|No|||Over the counter|No||183|Yes|.02734|03/29/2022|.02668|03/29/2022|.02686|03/29/2022|||COUGH AND COLD: NARCOTIC|11734|||||No|No||HI-TECH/AKORN C|No||||
levocarnitine (with sugar)|No|No|No|No|75%|50383017104|LEVOCARNITINE 1 G/10 ML SOLN|118|ML|.13501|07/08/2005||Yes|No||07/08/2005||Yes|No|07/08/2005||Yes|No||||No|No|||Prescription required|No|||No|.25813|03/29/2022|.25193|03/29/2022|.25361|03/29/2022||||11735|||||No|No||HI-TECH/AKORN C|No||||
levocarnitine|No|No|No|No|75%|50383017290|LEVOCARNITINE 330 MG TABLET|90|EA|.37744|11/28/2005||Yes|No||11/28/2005||Yes|No|11/28/2005||Yes|No||||No|No|||Prescription required|No|||No|.86021|01/29/2019|.84792|01/29/2019|.80754|01/29/2019||||11736|||||No|No||HI-TECH/AKORN C|No||||
dorzolamide HCl|No|No|No|No|75%|50383023210|DORZOLAMIDE HCL 2% EYE DROPS|10|ML|1.505|02/03/2010||Yes|No||02/03/2010||Yes|No|02/03/2010||Yes|No||||No|No|||Prescription required|No||088|No|1.39302|03/29/2022|1.35958|03/29/2022|1.36864|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|11737|||||No|No||HI-TECH/AKORN C|No||||
dorzolamide HCl/timolol maleat|No|No|No|No|75%|50383023310|DORZOLAMIDE-TIMOLOL EYE DROPS|10|ML|2.15|02/03/2010||Yes|No||02/03/2010||Yes|No|02/03/2010||Yes|No||||No|No|||Prescription required|No||088|No|1.24117|03/29/2022|1.21138|03/29/2022|1.21944|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|11738|||||No|No||HI-TECH/AKORN C|No||||
levetiracetam|No|No|No|No|75%|50383024116|LEVETIRACETAM 100 MG/ML SOLN|473|ML|.05454|05/09/2012||Yes|No||05/09/2012||Yes|No|05/09/2012||Yes|No||||No|No|||Prescription required|No||056|No|.03146|03/29/2022|.0307|03/29/2022|.0309|03/29/2022|||ANTICONVULSANTS|11739|||||No|No||HI-TECH/AKORN C|No||||
bromfenac sodium|No|No|No|No|75%|50383024971|BROMFENAC SODIUM 0.09% EYE DRP|1.7|ML|45.04123|03/06/2014||Yes|No||03/06/2014||Yes|No|03/06/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|013|No|70.97765|03/29/2022|69.27418|03/29/2022|69.73554|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|11740|||||No|No||HI-TECH/AKORN C|No||||
dorzolamide/timolol/PF|No|No|No|No|75%|50383026161|DORZOLAMIDE-TIMOLOL 2%-0.5%|60|EA|.9718|10/16/2019||Yes|No||10/16/2019||Yes|No|10/16/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|088|No|1.74262|03/29/2022|1.70079|03/29/2022|1.71212|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|11741|||||No|No||AKORN INC.|No||||
loteprednol etabonate|No|No|No|No|75%|50383026505|LOTEPREDNOL ETABONATE 0.5% DRP|5|ML|16.1508|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|013|No|31.49675|03/29/2022|30.74082|03/29/2022|30.94555|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|11742|||||No|No||AKORN INC.|No||||
loteprednol etabonate|No|No|No|No|75%|50383026510|LOTEPREDNOL ETABONATE 0.5% DRP|10|ML|16.14908|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|013|No|34.3356|03/29/2022|33.51154|03/29/2022|33.73472|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|11743|||||No|No||AKORN INC.|No||||
loteprednol etabonate|No|No|No|No|75%|50383026515|LOTEPREDNOL ETABONATE 0.5% DRP|15|ML|16.00632|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|013|No|36.47952|12/24/2019|35.95838|12/19/2019|34.24608|12/19/2019|||OPHTHALMICS: ANTI-INFLAMMATORIES|11744|||||No|No||AKORN INC.|No||||
clobetasol propionate|No|No|No|No|75%|50383026625|CLOBETASOL 0.05% SOLUTION|25|ML|.86|02/24/2011||Yes|No||02/24/2011||Yes|No|02/24/2011||Yes|No||||No|No|||Prescription required|No||121|No|.44026|03/29/2022|.42969|03/29/2022|.43255|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|11745|||||No|No||HI-TECH/AKORN C|No||||
clobetasol propionate|No|No|No|No|75%|50383026650|CLOBETASOL 0.05% SOLUTION|50|ML|.86|02/24/2011||Yes|No||02/24/2011||Yes|No|02/24/2011||Yes|No||||No|No|||Prescription required|No||121|No|.35501|03/29/2022|.34648|03/29/2022|.34879|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|11746|||||No|No||HI-TECH/AKORN C|No||||
clobetasol propionate|No|No|No|No|75%|50383026715|CLOBETASOL 0.05% CREAM|15|GM|.71924|02/24/2011||Yes|No||02/24/2011||Yes|No|02/24/2011||Yes|No||||No|No|||Prescription required|No||121|No|.42879|03/29/2022|.41849|03/29/2022|.42128|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|11747|||||No|No||HI-TECH/AKORN C|No||||
clobetasol propionate|No|No|No|No|75%|50383026730|CLOBETASOL 0.05% CREAM|30|GM|.6986|02/24/2011||Yes|No||02/24/2011||Yes|No|02/24/2011||Yes|No||||No|No|||Prescription required|No||121|No|.34489|03/29/2022|.33661|03/29/2022|.33885|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|11748|||||No|No||HI-TECH/AKORN C|No||||
clobetasol propionate|No|No|No|No|75%|50383026745|CLOBETASOL 0.05% CREAM|45|GM|.69316|02/24/2011||Yes|No||02/24/2011||Yes|No|02/24/2011||Yes|No||||No|No|||Prescription required|No||121|No|.31467|03/29/2022|.30711|03/29/2022|.30916|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|11749|||||No|No||HI-TECH/AKORN C|No||||
clobetasol propionate|No|No|No|No|75%|50383026760|CLOBETASOL 0.05% CREAM|60|GM|.54932|02/24/2011||Yes|No||02/24/2011||Yes|No|02/24/2011||Yes|No||||No|No|||Prescription required|No||121|No|.33784|03/29/2022|.32973|03/29/2022|.33192|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|11750|||||No|No||HI-TECH/AKORN C|No||||
clobetasol propionate|No|No|No|No|75%|50383026815|CLOBETASOL 0.05% OINTMENT|15|GM|.71666|02/24/2011||Yes|No||02/24/2011||Yes|No|02/24/2011||Yes|No||||No|No|||Prescription required|No||121|No|.35914|03/29/2022|.35052|03/29/2022|.35285|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|11751|||||No|No||HI-TECH/AKORN C|No||||
clobetasol propionate|No|No|No|No|75%|50383026830|CLOBETASOL 0.05% OINTMENT|30|GM|.731|02/24/2011||Yes|No||02/24/2011||Yes|No|02/24/2011||Yes|No||||No|No|||Prescription required|No||121|No|.3756|03/29/2022|.36658|03/29/2022|.36902|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|11752|||||No|No||HI-TECH/AKORN C|No||||
clobetasol propionate|No|No|No|No|75%|50383026845|CLOBETASOL 0.05% OINTMENT|45|GM|.76444|02/24/2011||Yes|No||02/24/2011||Yes|No|02/24/2011||Yes|No||||No|No|||Prescription required|No||121|No|.36764|03/29/2022|.35881|03/29/2022|.3612|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|11753|||||No|No||HI-TECH/AKORN C|No||||
clobetasol propionate|No|No|No|No|75%|50383026860|CLOBETASOL 0.05% OINTMENT|60|GM|.74891|02/24/2011||Yes|No||02/24/2011||Yes|No|02/24/2011||Yes|No||||No|No|||Prescription required|No||121|No|.32004|03/29/2022|.31235|03/29/2022|.31443|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|11754|||||No|No||HI-TECH/AKORN C|No||||
clobetasol propionate|No|No|No|No|75%|50383026915|CLOBETASOL 0.05% GEL|15|GM|.86|02/24/2011||Yes|No||02/24/2011||Yes|No|02/24/2011||Yes|No||||No|No|||Prescription required|No||121|No|1.023|03/01/2022|.99844|03/01/2022|1.00509|03/01/2022|||STEROIDS: TOPICAL VERY HIGH|11755|||||No|No||HI-TECH/AKORN C|No||||
clobetasol propionate|No|No|No|No|75%|50383026930|CLOBETASOL 0.05% GEL|30|GM|.86|02/24/2011||Yes|No||02/24/2011||Yes|No|02/24/2011||Yes|No||||No|No|||Prescription required|No||121|No|1.27828|03/29/2022|1.2476|03/29/2022|1.25591|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|11756|||||No|No||HI-TECH/AKORN C|No||||
clobetasol propionate|No|No|No|No|75%|50383026960|CLOBETASOL 0.05% GEL|60|GM|.86|02/24/2011||Yes|No||02/24/2011||Yes|No|02/24/2011||Yes|No||||No|No|||Prescription required|No||121|No|.91682|03/29/2022|.89481|03/29/2022|.90077|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|11757|||||No|No||HI-TECH/AKORN C|No||||
clobetasol propionate/emoll|No|No|No|No|75%|50383027015|CLOBETASOL EMOLLIENT 0.05% CRM|15|GM|1.56262|02/24/2011||Yes|No||02/24/2011||Yes|No|02/24/2011||Yes|No||||No|No|||Prescription required|No||121|No|1.21527|03/29/2022|1.1861|03/29/2022|1.194|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|11758|||||No|No||HI-TECH/AKORN C|No||||
clobetasol propionate/emoll|No|No|No|No|75%|50383027030|CLOBETASOL EMOLLIENT 0.05% CRM|30|GM|1.56247|02/24/2011||Yes|No||02/24/2011||Yes|No|02/24/2011||Yes|No||||No|No|||Prescription required|No||121|No|.6904|03/29/2022|.67383|03/29/2022|.67831|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|11759|||||No|No||HI-TECH/AKORN C|No||||
clobetasol propionate/emoll|No|No|No|No|75%|50383027060|CLOBETASOL EMOLLIENT 0.05% CRM|60|GM|1.56254|02/24/2011||Yes|No||02/24/2011||Yes|No|02/24/2011||Yes|No||||No|No|||Prescription required|No||121|No|.73304|03/29/2022|.71544|03/29/2022|.72021|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|11760|||||No|No||HI-TECH/AKORN C|No||||
diclofenac sodium|No|No|No|No|75%|50383027201|DICLOFENAC SODIUM 1% GEL|100|GM|.16537|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No||059|Yes|.08846|03/29/2022|.08633|03/29/2022|.08691|03/29/2022|||NSAIDS|11761|||||No|No||HI-TECH/AKORN C|No||||
levofloxacin|No|No|No|No|75%|50383028604|LEVOFLOXACIN 25 MG/ML SOLUTION|100|ML|.48013|08/05/2011||Yes|No||08/05/2011||Yes|No|08/05/2011||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|028|No|1.10746|09/28/2021|1.08088|09/28/2021|1.08807|09/28/2021|||FLUOROQUINOLONES: ORAL|11762|||||No|No||HI-TECH/AKORN C|No||||
levofloxacin|No|No|No|No|75%|50383028608|LEVOFLOXACIN 25 MG/ML SOLUTION|200|ML|.48013|08/05/2011||Yes|No||08/05/2011||Yes|No|08/05/2011||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|028|No|1.09426|01/23/2018|1.07863|01/23/2018|1.02727|01/23/2018|||FLUOROQUINOLONES: ORAL|11763|||||No|No||HI-TECH/AKORN C|No||||
levofloxacin|No|No|No|No|75%|50383028616|LEVOFLOXACIN 25 MG/ML SOLUTION|480|ML|.47532|08/05/2011||Yes|No||08/05/2011||Yes|No|08/05/2011||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|028|No|1.0833|11/28/2017|1.06782|11/28/2017|1.01697|11/28/2017|||FLUOROQUINOLONES: ORAL|11764|||||No|No||HI-TECH/AKORN C|No||||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|50383028793|BUPRENORPHINE-NALOX 8-2 MG TAB|30|EA|.57333|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|1.08568|03/29/2022|1.05962|03/29/2022|1.06668|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|11765|||||No|No||HI-TECH/AKORN C|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|50383029493|BUPRENORPHINE-NALOX 2-0.5MG TB|30|EA|.39818|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|.72296|03/29/2022|.7056|03/29/2022|.7103|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|11766|||||No|No||HI-TECH/AKORN C|Yes|09/01/2020|||
gabapentin|No|No|No|No|75%|50383031147|GABAPENTIN 250 MG/5 ML SOLN|470|ML|.10204|03/04/2011||Yes|No||03/04/2011||Yes|No|03/04/2011||Yes|No||||No|No|||Prescription required|No||232|Yes|.09961|03/29/2022|.09721|03/29/2022|.09786|03/29/2022|||NEUROPATHIC PAIN|11767|||||No|No||HI-TECH/AKORN C|No||||
ciclopirox|No|No|No|No|75%|50383041906|CICLOPIROX 8% SOLUTION|6.6|ML|2.42037|09/26/2007||Yes|No||09/26/2007||Yes|No|09/26/2007||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|061|No|1.90189|03/29/2022|1.85624|03/29/2022|1.8686|03/29/2022|||ANTIFUNGALS: TOPICAL|11768|||||No|No||HI-TECH/AKORN C|No||||
neomycin sulfate|No|No|No|No|75%|50383056510|NEOMYCIN 500 MG TABLET|100|EA|.43795|06/15/2010||Yes|No||06/15/2010||Yes|No|06/15/2010||Yes|No||||No|No|||Prescription required|No||115|No|.8474|03/29/2022|.82706|03/29/2022|.83257|03/29/2022|||ANTIBIOTICS: GI|11769|||||No|No||HI-TECH/AKORN C|No||||
nystatin|No|No|No|No|75%|50383058716|NYSTATIN 100,000 UNIT/ML SUSP|473|ML|.08073|04/02/2012||Yes|No||04/02/2012||Yes|No|04/02/2012||Yes|No||||No|No|||Prescription required|No||069|No|.04529|03/29/2022|.0442|03/29/2022|.04449|03/29/2022|||ANTIFUNGALS: ORAL|11770|||||No|No||HI-TECH/AKORN C|No||||
nystatin|No|No|No|No|75%|50383058766|NYSTATIN 100,000 UNIT/ML SUSP|60|ML|.09101|04/02/2012||Yes|No||04/02/2012||Yes|No|04/02/2012||Yes|No||||No|No|||Prescription required|No||069|No|.14005|03/29/2022|.13668|03/29/2022|.13759|03/29/2022|||ANTIFUNGALS: ORAL|11771|||||No|No||HI-TECH/AKORN C|No||||
lidocaine/prilocaine|No|No|No|No|75%|50383066730|LIDOCAINE-PRILOCAINE CREAM|30|GM|.49521|10/28/2003||Yes|No||10/28/2003||Yes|No|10/28/2003||Yes|No||||No|No|||Prescription required|No|||No|.45426|03/29/2022|.44335|03/29/2022|.44631|03/29/2022||||11772|||||No|No||HI-TECH/AKORN C|No||||
fluticasone propionate|No|No|No|No|75%|50383070016|FLUTICASONE PROP 50 MCG SPRAY|16|GM|.35045|02/05/2008||Yes|No||02/05/2008||Yes|No|02/05/2008||Yes|No||||No|No|||Prescription required|No||019|No|.27037|03/29/2022|.26388|03/29/2022|.26563|03/29/2022|||INTRANASAL RHINITIS AGENTS|11773|||||No|No||HI-TECH/AKORN C|No||||
lorazepam|No|No|No|No|90%|50383070530|LORAZEPAM 2 MG/ML ORAL CONCENT|30|ML|.51026|08/15/2012||Yes|No||08/15/2012||Yes|No|08/15/2012||Yes|No||||No|No|||Prescription required|No||090|Yes|.59241|03/29/2022|.57819|03/29/2022|.58204|03/29/2022|||ANXIOLYTICS|11774|||||No|No||HI-TECH/AKORN C|No||||
calcipotriene|No|No|No|No|75%|50383073202|CALCIPOTRIENE 0.005% SOLUTION|60|ML|1.34711|05/19/2008||Yes|No||05/19/2008||Yes|No|05/19/2008||Yes|No||||No|No|||Prescription required|No|||No|.84564|03/29/2022|.82534|03/29/2022|.83084|03/29/2022||||11775|||||No|No||HI-TECH/AKORN C|No||||
albuterol sulfate|No|No|No|No|75%|50383074016|ALBUTEROL SULF 2 MG/5 ML SYRUP|473|ML|.04408|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||037|No|.03624|03/29/2022|.03537|03/29/2022|.0356|03/29/2022|||BRONCHODILATORS: BETA AGONIST|11776|||||No|No||HI-TECH/AKORN C|Yes|09/01/2020|||
albuterol sulfate|No|No|No|No|75%|50383074120|ALBUTEROL 5 MG/ML SOLUTION|20|ML|1.03823|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||037|Yes|2.3203|03/29/2022|2.26461|03/29/2022|2.27969|03/29/2022|||BRONCHODILATORS: BETA AGONIST|11777|||||No|No||HI-TECH/AKORN C|Yes|09/01/2020|||
lidocaine HCl|No|No|No|No|75%|50383077504|LIDOCAINE 2% VISCOUS SOLN|100|ML|.0473|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.06351|03/29/2022|.06198|03/29/2022|.06239|03/29/2022||||11778|||||No|No||HI-TECH/AKORN C|No||||
lactulose|No|No|No|No|75%|50383077916|LACTULOSE 10 GM/15 ML SOLUTION|473|ML|.01022|04/01/2010||Yes|No||04/01/2010||Yes|No|04/01/2010||Yes|No||||No|No|||Prescription required|No|||No|.01519|03/29/2022|.01482|03/29/2022|.01492|03/29/2022||||11779|||||No|No||HI-TECH/AKORN C|No||||
lactulose|No|No|No|No|75%|50383077932|LACTULOSE 10 GM/15 ML SOLUTION|946|ML|.01043|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.0141|03/29/2022|.01376|03/29/2022|.01385|03/29/2022||||11780|||||No|No||HI-TECH/AKORN C|No||||
valproic acid (as sodium salt)|No|No|No|No|75%|50383079216|VALPROIC ACID 250 MG/5 ML SOLN|473|ML|.01726|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||056|No|.01872|03/29/2022|.01827|03/29/2022|.01839|03/29/2022|||ANTICONVULSANTS|11781|||||No|No||HI-TECH/AKORN C|No||||
lactulose|No|No|No|No|75%|50383079516|LACTULOSE 10 GM/15 ML SOLUTION|473|ML|.01022|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.01452|03/29/2022|.01417|03/29/2022|.01426|03/29/2022||||11782|||||No|No||HI-TECH/AKORN C|No||||
promethazine HCl|No|No|No|No|75%|50383080116|PROMETHAZINE 6.25 MG/5 ML SOLN|473|ML|.01008|03/01/2004||Yes|No||03/01/2004||Yes|No|03/01/2004||Yes|No||||No|No|||Prescription required|No||085|Yes|.0426|03/29/2022|.04157|03/29/2022|.04185|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|11783|||||No|No||HI-TECH/AKORN C|No||||
promethazine HCl/codeine|No|No|No|No|90%|50383080416|PROMETHAZINE-CODEINE SYRUP|473|ML|.01122|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||183|Yes|.04109|03/29/2022|.0401|03/29/2022|.04037|03/29/2022|||COUGH AND COLD: NARCOTIC|11784|||||No|No||HI-TECH/AKORN C|No||||
amantadine HCl|No|No|No|No|75%|50383080716|AMANTADINE 50 MG/5 ML SOLUTION|473|ML|.01636|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||015|No|.02319|03/29/2022|.02263|03/29/2022|.02278|03/29/2022|||ANTIPARKINSON'S AGENTS|11785|||||No|No||HI-TECH/AKORN C|No||||
acyclovir|No|No|No|No|75%|50383081016|ACYCLOVIR 200 MG/5 ML SUSP|473|ML|.32378|09/02/2018||Yes|No||09/02/2018||Yes|No|09/02/2018||Yes|No||||No|No|||Prescription required|No||025|No|.2948|03/29/2022|.28772|03/29/2022|.28964|03/29/2022|||ANTIVIRALS: ORAL|11786|||||No|No||HI-TECH/AKORN C|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|50383082316|SULFAMETHOXAZOLE-TMP SUSP|473|ML|.08127|01/27/2021||Yes|No||01/27/2021||Yes|No|01/27/2021||Yes|No||||No|No|||Prescription required|No|||No|.05588|03/29/2022|.05453|03/29/2022|.0549|03/29/2022||||11787|||||No|No||HI-TECH/AKORN C|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|50383082416|SULFAMETHOXAZOLE-TMP SUSP|473|ML|.08127|01/27/2021||Yes|No||01/27/2021||Yes|No|01/27/2021||Yes|No||||No|No|||Prescription required|No|||No|.05588|03/29/2022|.05453|03/29/2022|.0549|03/29/2022||||11788|||||No|No||HI-TECH/AKORN C|No||||
acetic acid|No|No|No|No|75%|50383088915|ACETIC ACID 2% EAR SOLUTION|15|ML|.80266|08/21/2010||Yes|No||08/21/2010||Yes|No|08/21/2010||Yes|No||||No|No|||Prescription required|No||150|No|1.3438|03/29/2022|1.31154|03/29/2022|1.32028|03/29/2022|||OTIC ANTI-INFECTIVES & ANESTHETICS|11789|||||No|No||HI-TECH/AKORN C|No||||
hydrocortisone/acetic acid|No|No|No|No|75%|50383090110|HYDROCORTISON-ACETIC ACID SOLN|10|ML|6.92816|08/21/2010||Yes|No||08/21/2010||Yes|No|08/21/2010||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|150|No|6.99967|03/29/2022|6.83167|03/29/2022|6.87717|03/29/2022|||OTIC ANTI-INFECTIVES & ANESTHETICS|11790|||||No|No||HI-TECH/AKORN C|No||||
buprenorphine HCl|No|No|No|No|90%|50383092493|BUPRENORPHINE 2 MG TABLET SL|30|EA|.32364|12/02/2011||Yes|No||12/02/2011||Yes|No|12/02/2011||Yes|No||||No|No|||Prescription required|No||145|Yes|.37925|03/29/2022|.37014|03/29/2022|.37261|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|11791|||||No|No||HI-TECH/AKORN C|Yes|09/01/2020|||
buprenorphine HCl|No|No|No|No|90%|50383093093|BUPRENORPHINE 8 MG TABLET SL|30|EA|.57333|12/02/2011||Yes|No||12/02/2011||Yes|No|12/02/2011||Yes|No||||No|No|||Prescription required|No||145|Yes|.77298|03/29/2022|.75442|03/29/2022|.75945|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|11792|||||No|No||HI-TECH/AKORN C|Yes|09/01/2020|||
lidocaine|No|No|No|No|75%|50383093335|LIDOCAINE 5% OINTMENT|35.44|GM|.24229|04/02/2012|05/30/2022|Yes|No||04/02/2012|05/30/2022|Yes|No|04/02/2012|05/30/2022|Yes|No||||No|No|||Prescription required|No|||No|.18796|03/29/2022|.18344|03/29/2022|.18467|03/29/2022||||11793|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||HI-TECH/AKORN C|No||||
lidocaine|No|No|No|No|75%|50383093355|LIDOCAINE 5% OINTMENT|50|GM|.24475|04/02/2012||Yes|No||04/02/2012||Yes|No|04/02/2012||Yes|No||||No|No|||Prescription required|No|||No|.22969|03/29/2022|.22417|03/29/2022|.22567|03/29/2022||||11794|||||No|No||HI-TECH/AKORN C|No||||
oxycodone HCl|No|No|No|No|90%|50383096134|OXYCODONE HCL 5 MG/5 ML SOLN|500|ML|.05332|10/16/2019||Yes|No||10/16/2019||Yes|No|10/16/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.11792|03/29/2022|.11508|03/29/2022|.11585|03/29/2022|||ANALGESICS: NARCOTICS SHORT|11795|||||No|No||HI-TECH/AKORN C|No||||
oxycodone HCl|No|No|No|No|90%|50383096430|OXYCODONE HCL 100 MG/5 ML CONC|30|ML|1.57666|10/16/2019||Yes|No||10/16/2019||Yes|No|10/16/2019||Yes|No||||No|No|||Prescription required|Yes|12/14/2017|109|Yes|3.65933|03/29/2022|3.5715|03/29/2022|3.59529|03/29/2022|||ANALGESICS: NARCOTICS SHORT|11796|||||No|No||HI-TECH/AKORN C|No||||
morphine sulfate|No|No|No|No|90%|50383096504|MORPHINE SULF 100 MG/5 ML CONC|120|ML|.14386|10/16/2019||Yes|No||10/16/2019||Yes|No|10/16/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|109|Yes|.27485|03/29/2022|.26825|03/29/2022|.27004|03/29/2022|||ANALGESICS: NARCOTICS SHORT|11797|||||No|No||AKORN INC.|No||||
morphine sulfate|No|No|No|No|90%|50383096530|MORPHINE SULF 100 MG/5 ML CONC|30|ML|.1462|10/16/2019||Yes|No||10/16/2019||Yes|No|10/16/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|109|Yes|.3028|03/29/2022|.29553|03/29/2022|.2975|03/29/2022|||ANALGESICS: NARCOTICS SHORT|11798|||||No|No||AKORN INC.|No||||
cimetidine HCl|No|No|No|No|75%|50383096608|CIMETIDINE 300 MG/5 ML SOLN|237|ML|.08881|03/04/2021||Yes|No||03/04/2021||Yes|No|03/04/2021||Yes|No||||No|No|||Prescription required|No|||No|.17407|12/28/2021|.16989|12/28/2021|.17102|12/28/2021||||11799|||||No|No||HI-TECH/AKORN C|No||||
clobetasol propionate|No|No|No|No|75%|50383097904|CLOBETASOL 0.05% SHAMPOO|118|ML|.66686|10/16/2019||Yes|No||10/16/2019||Yes|No|10/16/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|121|No|.54041|03/29/2022|.52744|03/29/2022|.53095|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|11800|||||No|No||AKORN INC.|No||||
regorafenib|No|No|No|No|75%|50419017103|STIVARGA 40 MG TABLET|28|EA|100.6716|11/06/2012||Yes|No||11/06/2012||Yes|No|11/06/2012||Yes|No||||No|No|||Prescription required|No||239|No|229.4376|01/11/2022|226.15992|01/11/2022|215.3904|01/11/2022|||ONCOLOGY: ORAL - OTHER|11801|||||No|No||BAYER,PHARM DIV|No||||
regorafenib|No|No|No|No|75%|50419017106|STIVARGA 40 MG TABLET|21|EA|100.6716|07/09/2021||Yes|No||07/09/2021||Yes|No|07/09/2021||Yes|No||||No|No|||Prescription required|No||239|No|229.4376|01/11/2022|226.15992|01/11/2022|215.3904|01/11/2022|||ONCOLOGY: ORAL - OTHER|11802|||||No|No||BAYER,PHARM DIV|No||||
riociguat|No|No|No|No|75%|50419025001|ADEMPAS 0.5 MG TABLET|90|EA|58.824|11/08/2013||Yes|No||11/08/2013||Yes|No|11/08/2013||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|171|No|134.064|01/11/2022|132.1488|01/11/2022|125.856|01/11/2022|||PAH AGENTS: ORAL AND INHALED|11803|||||No|No||BAYER,PHARM DIV|No||||
riociguat|No|No|No|No|75%|50419025101|ADEMPAS 1 MG TABLET|90|EA|58.824|11/08/2013||Yes|No||11/08/2013||Yes|No|11/08/2013||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|171|No|134.064|01/11/2022|132.1488|01/11/2022|125.856|01/11/2022|||PAH AGENTS: ORAL AND INHALED|11804|||||No|No||BAYER,PHARM DIV|No||||
riociguat|No|No|No|No|75%|50419025201|ADEMPAS 1.5 MG TABLET|90|EA|58.824|11/08/2013||Yes|No||11/08/2013||Yes|No|11/08/2013||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|171|No|134.064|01/11/2022|132.1488|01/11/2022|125.856|01/11/2022|||PAH AGENTS: ORAL AND INHALED|11805|||||No|No||BAYER,PHARM DIV|No||||
riociguat|No|No|No|No|75%|50419025301|ADEMPAS 2 MG TABLET|90|EA|58.824|11/08/2013||Yes|No||11/08/2013||Yes|No|11/08/2013||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|171|No|134.064|01/11/2022|132.1488|01/11/2022|125.856|01/11/2022|||PAH AGENTS: ORAL AND INHALED|11806|||||No|No||BAYER,PHARM DIV|No||||
riociguat|No|No|No|No|75%|50419025401|ADEMPAS 2.5 MG TABLET|90|EA|58.824|11/08/2013||Yes|No||11/08/2013||Yes|No|11/08/2013||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|171|No|134.064|01/11/2022|132.1488|01/11/2022|125.856|01/11/2022|||PAH AGENTS: ORAL AND INHALED|11807|||||No|No||BAYER,PHARM DIV|No||||
larotrectinib sulfate|No|No|No|No|75%|50419039001|VITRAKVI 25 MG CAPSULE|60|EA|80.7067|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|No||239|No|183.9362|01/11/2022|181.30854|01/11/2022|172.6748|01/11/2022|||ONCOLOGY: ORAL - OTHER|11808|||||No|No||BAYER INC.|No||||
larotrectinib sulfate|No|No|No|No|75%|50419039101|VITRAKVI 100 MG CAPSULE|60|EA|242.1201|04/17/2020||Yes|No||04/17/2020||Yes|No|04/17/2020||Yes|No||||No|No|||Prescription required|No||239|No|551.8086|01/11/2022|543.92562|01/11/2022|518.0244|01/11/2022|||ONCOLOGY: ORAL - OTHER|11809|||||No|No||BAYER INC.|No||||
larotrectinib sulfate|No|No|No|No|75%|50419039201|VITRAKVI 20 MG/ML SOLUTION|100|ML|64.5645|12/13/2019||Yes|No||12/13/2019||Yes|No|12/13/2019||Yes|No||||No|No|||Prescription required|No||239|No|147.147|01/11/2022|145.0449|01/11/2022|138.138|01/11/2022|||ONCOLOGY: ORAL - OTHER|11810|||||No|No||BAYER INC.|No||||
darolutamide|No|No|No|No|75%|50419039501|NUBEQA 300 MG TABLET|120|EA|43.9073|05/11/2020||Yes|No||05/11/2020||Yes|No|05/11/2020||Yes|No||||No|No|||Prescription required|No||550|No|100.0678|01/11/2022|98.63826|01/11/2022|93.9412|01/11/2022|||ONCOLOGY: ORAL - PROSTATE|11811|||||No|No||BAYER,PHARM DIV|No||||
ethinyl estradiol/drospirenone|Yes|Yes|No|No|75%|50419040203|YASMIN 28 TABLET|28|EA|1.9203|11/01/2009||Yes|No||11/01/2009||Yes|No|11/01/2009||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|4.28716|03/29/2022|4.18426|03/29/2022|4.21213|03/29/2022||||11812|||||No|No||BAYER,PHARM DIV|No|||Only covered for non-contraceptive (medical) purposes|
drospir/eth estra/levomefol Ca|Yes|Yes|No|No|75%|50419040303|SAFYRAL TABLET|28|EA|3.06881|01/25/2011||Yes|No||01/25/2011||Yes|No|01/25/2011||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|6.99404|01/29/2019|6.89412|01/29/2019|6.56583|01/29/2019||||11813|||||No|No||BAYER,PHARM DIV|No|||Only covered for non-contraceptive (medical) purposes|
ethinyl estradiol/drospirenone|Yes|Yes|No|No|75%|50419040503|YAZ 28 TABLET|28|EA|2.5542|09/10/2008||Yes|No||09/10/2008||Yes|No|09/10/2008||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|5.71761|01/18/2022|5.58038|01/18/2022|5.61755|01/18/2022||||11814|||||No|No||BAYER,PHARM DIV|No|||Only covered for non-contraceptive (medical) purposes|
drospir/eth estra/levomefol Ca|Yes|Yes|No|No|75%|50419040703|BEYAZ 28 TABLET|28|EA|3.7281|11/02/2010||Yes|No||11/02/2010||Yes|No|11/02/2010||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|8.32036|01/18/2022|8.12067|01/18/2022|8.17475|01/18/2022||||11815|||||No|No||BAYER,PHARM DIV|No|||Only covered for non-contraceptive (medical) purposes|
estradiol valerate/dienogest|Yes|Yes|No|No|75%|50419040903|NATAZIA 28 TABLET|28|EA|3.5862|03/02/2011||Yes|No||03/02/2011||Yes|No|03/03/2011||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|7.99124|01/18/2022|7.79945|01/18/2022|7.85139|01/18/2022||||11816|||||No|No||BAYER,PHARM DIV|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel|Yes|Yes|No|No|75%|50419042201|SKYLA 13.5 MG SYSTEM|1|EA|375.6781|08/01/2014||Yes|No||||No|No|||No|No||||No|No|08/01/2014||Prescription required|No|||No|856.1966|01/11/2022|843.96522|01/11/2022|803.7764|01/11/2022||||11817|||||Yes|No||BAYER,PHARM DIV|No||||
levonorgestrel|Yes|Yes|No|No|75%|50419042301|MIRENA 52 MG SYSTEM|1|EA|451.1732|09/17/2014||Yes|No||||No|No|||No|No||||No|No|09/17/2014||Prescription required|No|||No|1028.2552|01/11/2022|1013.56584|01/11/2022|965.3008|01/11/2022||||11818|||||Yes|No||BAYER,PHARM DIV|No||||
levonorgestrel|Yes|Yes|No|No|75%|50419042401|KYLEENA 19.5 MG SYSTEM|1|EA|451.1732|08/02/2017||Yes|No||||No|No|||No|No||||No|No|08/02/2017||Prescription required|No|||No|1028.2552|01/11/2022|1013.56584|01/11/2022|965.3008|01/11/2022||||11819|||||Yes|No||BAYER,PHARM DIV|No||||
estradiol|No|No|No|No|75%|50419045104|CLIMARA 0.05 MG/DAY PATCH|4|EA|16.4045|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|36.6209|01/18/2022|35.74199|01/18/2022|35.98003|01/18/2022||||11820|||||No|No||BAYER,PHARM DIV|No||||
estradiol|No|No|No|No|75%|50419045204|CLIMARA 0.1 MG/DAY PATCH|4|EA|16.4045|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|36.80151|01/18/2022|35.91827|01/18/2022|36.15748|01/18/2022||||11821|||||No|No||BAYER,PHARM DIV|No||||
estradiol|No|No|No|No|75%|50419045304|CLIMARA 0.075 MG/DAY PATCH|4|EA|16.4045|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|37.387|01/11/2022|36.8529|01/11/2022|35.098|01/11/2022||||11822|||||No|No||BAYER,PHARM DIV|No||||
estradiol|No|No|No|No|75%|50419045404|CLIMARA 0.025 MG/DAY PATCH|4|EA|16.4045|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|37.387|01/11/2022|36.8529|01/11/2022|35.098|01/11/2022||||11823|||||No|No||BAYER,PHARM DIV|No||||
estradiol|No|No|No|No|75%|50419045504|MENOSTAR 14 MCG/DAY PATCH|4|EA|17.44402|08/17/2004||Yes|No||08/17/2004||Yes|No|08/17/2004||Yes|No||||No|No|||Prescription required|No|||Yes|39.75615|03/23/2021|39.1882|03/23/2021|37.3221|03/23/2021||||11824|||||No|No||BAYER,PHARM DIV|No||||
estradiol|No|No|No|No|75%|50419045604|CLIMARA 0.0375 MG/DAY PATCH|4|EA|16.4045|02/18/2004||Yes|No||02/18/2004||Yes|No|02/18/2004||Yes|No||||No|No|||Prescription required|No|||Yes|36.41987|01/18/2022|35.54579|01/18/2022|35.78252|01/18/2022||||11825|||||No|No||BAYER,PHARM DIV|No||||
estradiol|No|No|No|No|75%|50419045904|CLIMARA 0.06 MG/DAY PATCH|4|EA|16.4045|02/18/2004||Yes|No||02/18/2004||Yes|No|02/18/2004||Yes|No||||No|No|||Prescription required|No|||Yes|37.387|01/11/2022|36.8529|01/11/2022|35.098|01/11/2022||||11826|||||No|No||BAYER,PHARM DIV|No||||
drospirenone/estradiol|No|No|No|No|75%|50419048303|ANGELIQ 0.5 MG-1 MG TABLET|28|EA|2.85908|03/18/2008||Yes|No||||No|No|||No|No||||No|No|||Prescription required|No|||Yes|6.51605|01/28/2020|6.42297|01/28/2020|6.11711|01/28/2020||||11827|||||No|No||BAYER,PHARM DIV|No||||
sorafenib tosylate|No|No|No|No|75%|50419048858|NEXAVAR 200 MG TABLET|120|EA|79.5242|08/29/2008||Yes|No||08/29/2008||Yes|No|08/29/2008||Yes|No||||No|No|||Prescription required|No||548|No|181.2412|01/11/2022|178.65204|01/11/2022|170.1448|01/11/2022|||ONCOLOGY: ORAL - RENAL CELL|11828|||||No|No||BAYER,PHARM DIV|No||||
estradiol/levonorgestrel|No|No|No|No|75%|50419049104|CLIMARA PRO PATCH|4|EA|25.3012|02/18/2004||Yes|No||02/18/2004||Yes|No|02/18/2004||Yes|No||||No|No|||Prescription required|No|||Yes|56.4235|01/18/2022|55.06933|01/18/2022|55.43608|01/18/2022||||11829|||||No|No||BAYER,PHARM DIV|No||||
interferon beta-1b|No|No|No|No|75%|50419052435|BETASERON 0.3 MG KIT|14|EA|263.9555|01/21/2014||Yes|No||01/21/2014||Yes|No|01/21/2014||Yes|No||||No|No|||Prescription required|No||043|No|596.99188|01/18/2022|582.66407|01/18/2022|586.54452|01/18/2022|||MULTIPLE SCLEROSIS AGENTS|11830|||||No|No||BAYER,PHARM DIV|No||||
finerenone|No|No|No|No|75%|50419054001|KERENDIA 10 MG TABLET|30|EA|8.1571|02/22/2022||Yes|No||02/22/2022||Yes|No|02/22/2022||Yes|No||||No|No|||Prescription required|No|||No|18.22352|02/22/2022|17.78615|02/22/2022|17.9046|02/22/2022||||11831|||||No|No||BAYER,PHARM DIV|No||||
finerenone|No|No|No|No|75%|50419054002|KERENDIA 10 MG TABLET|90|EA|8.1571|02/22/2022||Yes|No||02/22/2022||Yes|No|02/22/2022||Yes|No||||No|No|||Prescription required|No|||No|18.22352|02/22/2022|17.78615|02/22/2022|17.9046|02/22/2022||||11832|||||No|No||BAYER,PHARM DIV|No||||
finerenone|No|No|No|No|75%|50419054101|KERENDIA 20 MG TABLET|30|EA|8.1571|02/22/2022||Yes|No||02/22/2022||Yes|No|02/22/2022||Yes|No||||No|No|||Prescription required|No|||No|18.16993|02/22/2022|17.73385|02/22/2022|17.85195|02/22/2022||||11833|||||No|No||BAYER,PHARM DIV|No||||
finerenone|No|No|No|No|75%|50419054102|KERENDIA 20 MG TABLET|90|EA|8.1571|02/22/2022||Yes|No||02/22/2022||Yes|No|02/22/2022||Yes|No||||No|No|||Prescription required|No|||No|18.16993|02/22/2022|17.73385|02/22/2022|17.85195|02/22/2022||||11834|||||No|No||BAYER,PHARM DIV|No||||
praziquantel|No|No|No|No|75%|50419074701|BILTRICIDE 600 MG TABLET|6|EA|35.70648|09/16/2011||Yes|No||09/16/2011||Yes|No|09/16/2011||Yes|No||||No|No|||Prescription required|No|||No|81.37756|06/01/2016|80.21502|06/01/2016|76.39526|06/01/2016||||11835|||||No|No||BAYER,PHARM DIV|No||||
nifurtimox|No|No|No|No|75%|50419075001|LAMPIT 30 MG TABLET|100|EA|1.075|06/14/2021||Yes|No||06/14/2021||Yes|No|06/14/2021||Yes|No||||No|No|||Prescription required|No|||No|2.45|06/14/2021|2.415|06/14/2021|2.3|06/14/2021||||11836|||||No|No||BAYER,PHARM DIV|No||||
nifurtimox|No|No|No|No|75%|50419075101|LAMPIT 120 MG TABLET|100|EA|1.29|06/14/2021||Yes|No||06/14/2021||Yes|No|06/14/2021||Yes|No||||No|No|||Prescription required|No|||No|2.94|06/14/2021|2.898|06/22/2021|2.76|06/14/2021||||11837|||||No|No||BAYER,PHARM DIV|No||||
ciprofloxacin HCl|No|No|No|No|75%|50419075401|CIPRO 500 MG TABLET|100|EA|2.4666|09/16/2011||Yes|No||09/16/2011||Yes|No|09/16/2011||Yes|No||09/16/2011||Yes|No|||Prescription required|Yes|07/27/2011|028|No|5.62157|06/01/2016|5.54126|06/01/2016|5.27739|06/01/2016|||FLUOROQUINOLONES: ORAL|11838|||||No|No||BAYER,PHARM DIV|No||||
ciprofloxacin HCl|No|No|No|No|75%|50419075801|CIPRO 250 MG TABLET|100|EA|2.10738|09/16/2011||Yes|No||09/16/2011||Yes|No|09/16/2011||Yes|No||09/16/2011||Yes|No|||Prescription required|Yes|07/27/2011|028|No|4.80288|06/01/2016|4.73426|06/01/2016|4.50882|06/01/2016|||FLUOROQUINOLONES: ORAL|11839|||||No|No||BAYER,PHARM DIV|No||||
ciprofloxacin|No|No|No|No|75%|50419077301|CIPRO 10% SUSPENSION|100|ML|.65497|09/16/2011||Yes|No||09/16/2011||Yes|No|09/16/2011||Yes|No||09/16/2011||Yes|No|||Prescription required|No||028|No|1.45835|01/25/2022|1.42334|01/25/2022|1.43282|01/25/2022|||FLUOROQUINOLONES: ORAL|11840|||||No|No||BAYER,PHARM DIV|No||||
ciprofloxacin|No|No|No|No|75%|50419077701|CIPRO 5% SUSPENSION|100|ML|.56072|09/16/2011||Yes|No||09/16/2011||Yes|No|09/16/2011||Yes|No||||No|No|||Prescription required|No||028|No|1.25644|03/01/2022|1.22628|03/01/2022|1.23445|03/01/2022|||FLUOROQUINOLONES: ORAL|11841|||||No|No||BAYER,PHARM DIV|No||||
pentosan polysulfate sodium|No|No|No|No|75%|50458009801|ELMIRON 100 MG CAPSULE|100|EA|4.323|03/16/2010||Yes|No||03/16/2010||Yes|No|03/16/2010||Yes|No||||No|No|||Prescription required|No|||No|9.63596|02/01/2022|9.40469|02/01/2022|9.46733|02/01/2022||||11842|||||No|No||JANSSEN PHARM.|No||||
canagliflozin|No|No|No|No|75%|50458014030|INVOKANA 100 MG TABLET|30|EA|8.17086|05/03/2013||Yes|No||05/03/2013||Yes|No|05/03/2013||Yes|No||||No|No|||Prescription required|No||535|No|17.77544|03/29/2022|17.34882|03/29/2022|17.46436|03/29/2022|||HYPOGLYCEMICS: SGLT2|11843|||||No|No||JANSSEN PHARM.|No||||
canagliflozin|No|No|No|No|75%|50458014090|INVOKANA 100 MG TABLET|90|EA|8.17076|07/31/2013||Yes|No||07/31/2013||Yes|No|07/31/2013||Yes|No||||No|No|||Prescription required|No||535|No|17.77544|03/29/2022|17.34882|03/29/2022|17.46436|03/29/2022|||HYPOGLYCEMICS: SGLT2|11844|||||No|No||JANSSEN PHARM.|No||||
canagliflozin|No|No|No|No|75%|50458014130|INVOKANA 300 MG TABLET|30|EA|8.17086|07/31/2013||Yes|No||07/31/2013||Yes|No|07/31/2013||Yes|No||||No|No|||Prescription required|No||535|No|18.23435|02/01/2022|17.79672|02/01/2022|17.91524|02/01/2022|||HYPOGLYCEMICS: SGLT2|11845|||||No|No||JANSSEN PHARM.|No||||
canagliflozin|No|No|No|No|75%|50458014190|INVOKANA 300 MG TABLET|90|EA|8.17076|07/31/2013||Yes|No||07/31/2013||Yes|No|07/31/2013||Yes|No||||No|No|||Prescription required|No||535|No|18.23435|02/01/2022|17.79672|02/01/2022|17.91524|02/01/2022|||HYPOGLYCEMICS: SGLT2|11846|||||No|No||JANSSEN PHARM.|No||||
haloperidol decanoate|No|No|No|No|75%|50458025303|HALDOL DECANOATE 50 AMPUL|1|ML|37.44153|05/12/2011||Yes|No||05/12/2011||Yes|No|05/12/2011||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|027|No|85.33186|06/01/2016|84.11283|06/01/2016|80.10746|06/01/2016|||ANTIPSYCHOTICS|11847|||||No|No||JANSSEN PHARM.|No||||
haloperidol decanoate|No|No|No|No|75%|50458025414|HALDOL DECANOATE 100 AMPUL|1|ML|71.37656|12/21/2010||Yes|No||12/21/2010||Yes|No|12/21/2010||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|027|No|162.67216|06/01/2016|160.34827|06/01/2016|152.71264|06/01/2016|||ANTIPSYCHOTICS|11848|||||No|No||JANSSEN PHARM.|No||||
itraconazole|No|No|No|No|75%|50458029001|SPORANOX 100 MG CAPSULE|30|EA|12.10278|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|069|No|27.58308|01/15/2019|27.18903|01/15/2019|25.89432|01/15/2019|||ANTIFUNGALS: ORAL|11849|||||No|No||JANSSEN PHARM.|No||||
itraconazole|No|No|No|No|75%|50458029004|SPORANOX 100 MG CAPSULE|30|EA|12.10278|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|069|No|27.58308|01/15/2019|27.18903|01/15/2019|25.89432|01/15/2019|||ANTIFUNGALS: ORAL|11850|||||No|No||JANSSEN PHARM.|No||||
itraconazole|No|No|No|No|75%|50458029028|SPORANOX 100 MG CAPSULE|28|EA|12.13613|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|069|No|27.65909|01/15/2019|27.26396|01/15/2019|25.96568|01/15/2019|||ANTIFUNGALS: ORAL|11851|||||No|No||JANSSEN PHARM.|No||||
itraconazole|No|No|No|No|75%|50458029515|SPORANOX 10 MG/ML SOLUTION|150|ML|.98255|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/29/2004|069|No|2.2393|01/28/2020|2.20731|01/28/2020|2.1022|01/28/2020|||ANTIFUNGALS: ORAL|11852|||||No|No||JANSSEN PHARM.|No||||
risperidone|No|No|No|No|75%|50458030001|RISPERDAL 1 MG TABLET|100|EA|2.10682|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|027|Yes|4.8016|10/05/2021|4.73301|10/05/2021|4.50763|10/05/2021|||ANTIPSYCHOTICS|11853|||||No|No||JANSSEN PHARM.|No||||
risperidone|No|No|No|No|75%|50458030006|RISPERDAL 1 MG TABLET|60|EA|2.10721|09/29/2009||Yes|No||09/29/2009||Yes|No|09/29/2009||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|027|Yes|4.80249|10/05/2021|4.73388|10/05/2021|4.50846|10/05/2021|||ANTIPSYCHOTICS|11854|||||No|No||JANSSEN PHARM.|No||||
risperidone|No|No|No|No|75%|50458030206|RISPERDAL 0.5 MG TABLET|60|EA|1.98208|01/20/2009||Yes|No||01/20/2009||Yes|No|01/20/2009||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|027|Yes|4.51731|10/05/2021|4.45277|10/05/2021|4.24074|10/05/2021|||ANTIPSYCHOTICS|11855|||||No|No||JANSSEN PHARM.|No||||
risperidone|No|No|No|No|75%|50458030503|RISPERDAL 1 MG/ML SOLUTION|30|ML|2.35439|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|027|Yes|5.36582|10/05/2021|5.28916|10/05/2021|5.0373|10/05/2021|||ANTIPSYCHOTICS|11856|||||No|No||JANSSEN PHARM.|No||||
risperidone microspheres|No|No|No|No|75%|50458030611|RISPERDAL CONSTA 25 MG VIAL|1|EA|240.3786|04/01/2005||Yes|No||04/01/2005||Yes|No|04/01/2005||Yes|No||||No|No|||Prescription required|No||027|Yes|535.80429|02/22/2022|522.94498|02/22/2022|526.42771|02/22/2022|||ANTIPSYCHOTICS|11857|||||No|Yes|12.56|JANSSEN PHARM.|No||||
risperidone microspheres|No|No|No|No|75%|50458030711|RISPERDAL CONSTA 37.5 MG VIAL|1|EA|360.5851|04/01/2005||Yes|No||04/01/2005||Yes|No|04/01/2005||Yes|No||||No|No|||Prescription required|No||027|Yes|803.26651|02/22/2022|783.98811|02/22/2022|789.20934|02/22/2022|||ANTIPSYCHOTICS|11858|||||No|Yes|12.56|JANSSEN PHARM.|No||||
risperidone microspheres|No|No|No|No|75%|50458030811|RISPERDAL CONSTA 50 MG VIAL|1|EA|480.7916|04/01/2005||Yes|No||04/01/2005||Yes|No|04/01/2005||Yes|No||||No|No|||Prescription required|No||027|Yes|1072.26158|02/22/2022|1046.5273|02/22/2022|1053.497|02/22/2022|||ANTIPSYCHOTICS|11859|||||No|Yes|12.56|JANSSEN PHARM.|No||||
risperidone microspheres|No|No|No|No|75%|50458030911|RISPERDAL CONSTA 12.5 MG VIAL|1|EA|120.1979|08/05/2009||Yes|No||08/05/2009||Yes|No|08/05/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|268.13819|02/22/2022|261.70287|02/22/2022|263.44577|02/22/2022|||ANTIPSYCHOTICS|11860|||||No|Yes|12.56|JANSSEN PHARM.|No||||
risperidone|No|No|No|No|75%|50458032001|RISPERDAL 2 MG TABLET|100|EA|3.52131|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|027|Yes|8.02531|10/05/2021|7.91067|10/05/2021|7.53397|10/05/2021|||ANTIPSYCHOTICS|11861|||||No|No||JANSSEN PHARM.|No||||
risperidone|No|No|No|No|75%|50458032006|RISPERDAL 2 MG TABLET|60|EA|3.52155|09/29/2009||Yes|No||09/29/2009||Yes|No|09/29/2009||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|027|Yes|8.02586|10/05/2021|7.91121|10/05/2021|7.53448|10/05/2021|||ANTIPSYCHOTICS|11862|||||No|No||JANSSEN PHARM.|No||||
risperidone|No|No|No|No|75%|50458033001|RISPERDAL 3 MG TABLET|100|EA|4.13612|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|027|Yes|9.42652|10/05/2021|9.29185|10/05/2021|8.84938|10/05/2021|||ANTIPSYCHOTICS|11863|||||No|No||JANSSEN PHARM.|No||||
risperidone|No|No|No|No|75%|50458033006|RISPERDAL 3 MG TABLET|60|EA|4.13631|09/29/2009||Yes|No||09/29/2009||Yes|No|09/29/2009||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|027|Yes|9.42694|10/05/2021|9.29227|10/05/2021|8.84978|10/05/2021|||ANTIPSYCHOTICS|11864|||||No|No||JANSSEN PHARM.|No||||
risperidone|No|No|No|No|75%|50458035001|RISPERDAL 4 MG TABLET|100|EA|5.55534|09/29/2009||Yes|No||09/29/2009||Yes|No|09/29/2009||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|027|Yes|12.66101|10/05/2021|12.48014|10/05/2021|11.88584|10/05/2021|||ANTIPSYCHOTICS|11865|||||No|No||JANSSEN PHARM.|No||||
risperidone|No|No|No|No|75%|50458035006|RISPERDAL 4 MG TABLET|60|EA|5.5556|01/20/2009||Yes|No||01/20/2009||Yes|No|01/20/2009||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|027|Yes|12.6616|10/05/2021|12.48072|10/05/2021|11.8864|10/05/2021|||ANTIPSYCHOTICS|11866|||||No|No||JANSSEN PHARM.|No||||
galantamine HBr|No|No|No|No|75%|50458038730|RAZADYNE ER 8 MG CAPSULE|30|EA|4.58924|05/26/2005||Yes|No||05/26/2005||Yes|No|05/26/2005||Yes|No||||No|No|||Prescription required|Yes|07/17/2007|011|No|10.4592|06/01/2016|10.30978|06/01/2016|9.81884|06/01/2016|||ALZHEIMER'S AGENTS|11867|||||No|No||JANSSEN PHARM.|No||||
galantamine HBr|No|No|No|No|75%|50458038830|RAZADYNE ER 16 MG CAPSULE|30|EA|4.58924|01/25/2009||Yes|No||01/25/2009||Yes|No|01/25/2009||Yes|No||||No|No|||Prescription required|Yes|07/17/2007|011|No|10.4592|06/01/2016|10.30978|06/01/2016|9.81884|06/01/2016|||ALZHEIMER'S AGENTS|11868|Not Specified|Not Specified|Not Specified||No|No||JANSSEN PHARM.|No||||
galantamine HBr|No|No|No|No|75%|50458038930|RAZADYNE ER 24 MG CAPSULE|30|EA|4.58924|11/07/2008||Yes|No||11/07/2008||Yes|No|11/07/2008||Yes|No||||No|No|||Prescription required|Yes|07/17/2007|011|No|10.4592|06/01/2016|10.30978|06/01/2016|9.81884|06/01/2016|||ALZHEIMER'S AGENTS|11869|||||No|No||JANSSEN PHARM.|No||||
canagliflozin/metformin HCl|No|No|No|No|75%|50458054060|INVOKAMET 50-500 MG TABLET|60|EA|4.08543|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||||No|No|||Prescription required|Yes|02/01/2018|535|No|9.31098|01/25/2022|9.17796|01/25/2022|8.74092|01/25/2022|||HYPOGLYCEMICS: SGLT2|11870|||||No|No||JANSSEN PHARM.|No||||
canagliflozin/metformin HCl|No|No|No|No|75%|50458054160|INVOKAMET 50-1,000 MG TABLET|60|EA|4.08543|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||||No|No|||Prescription required|Yes|02/01/2018|535|No|9.11614|02/01/2022|8.89735|02/01/2022|8.9566|02/01/2022|||HYPOGLYCEMICS: SGLT2|11871|||||No|No||JANSSEN PHARM.|No||||
canagliflozin/metformin HCl|No|No|No|No|75%|50458054260|INVOKAMET 150-500 MG TABLET|60|EA|4.08543|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||||No|No|||Prescription required|Yes|02/01/2018|535|No|9.31098|01/25/2022|9.17796|01/25/2022|8.74092|01/25/2022|||HYPOGLYCEMICS: SGLT2|11872|||||No|No||JANSSEN PHARM.|No||||
canagliflozin/metformin HCl|No|No|No|No|75%|50458054360|INVOKAMET 150-1,000 MG TABLET|60|EA|4.08543|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||||No|No|||Prescription required|Yes|02/01/2018|535|No|9.08955|02/01/2022|8.8714|02/01/2022|8.93048|02/01/2022|||HYPOGLYCEMICS: SGLT2|11873|||||No|No||JANSSEN PHARM.|No||||
paliperidone|No|No|No|No|75%|50458055001|INVEGA ER 3 MG TABLET|30|EA|5.27266|01/26/2007||Yes|No||01/26/2007||Yes|No|01/26/2007||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|027|Yes|11.76123|10/12/2021|11.47896|10/12/2021|11.5554|10/12/2021|||ANTIPSYCHOTICS|11874|||||No|No||JANSSEN PHARM.|No||||
paliperidone|No|No|No|No|75%|50458055101|INVEGA ER 6 MG TABLET|30|EA|5.27266|01/26/2007||Yes|No||01/26/2007||Yes|No|01/26/2007||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|027|Yes|11.84002|10/12/2021|11.55585|10/12/2021|11.63281|10/12/2021|||ANTIPSYCHOTICS|11875|||||No|No||JANSSEN PHARM.|No||||
paliperidone|No|No|No|No|75%|50458055201|INVEGA ER 9 MG TABLET|30|EA|7.90884|01/26/2007||Yes|No||01/26/2007||Yes|No|01/26/2007||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|027|Yes|17.81964|10/12/2021|17.39196|10/12/2021|17.50779|10/12/2021|||ANTIPSYCHOTICS|11876|||||No|No||JANSSEN PHARM.|No||||
paliperidone|No|No|No|No|75%|50458055401|INVEGA ER 1.5 MG TABLET|30|EA|5.27266|06/22/2010||Yes|No||06/22/2010||Yes|No|06/22/2010||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|027|Yes|11.74938|10/12/2021|11.46739|10/12/2021|11.54376|10/12/2021|||ANTIPSYCHOTICS|11877|||||No|No||JANSSEN PHARM.|No||||
paliperidone palmitate|No|No|No|No|75%|50458056001|INVEGA SUSTENNA 39 MG/0.25 ML|.25|ML|888.2596|03/26/2010||Yes|No||03/26/2010||Yes|No|03/26/2010||Yes|No||||No|No|||Prescription required|No||027|Yes|2024.4056|01/25/2022|1995.48552|01/25/2022|1900.4624|01/25/2022|||ANTIPSYCHOTICS|11878|||||No|Yes|12.56|JANSSEN PHARM.|No||||
paliperidone palmitate|No|No|No|No|75%|50458056101|INVEGA SUSTENNA 78 MG/0.5 ML|.5|ML|888.2854|03/26/2010||Yes|No||03/26/2010||Yes|No|03/26/2010||Yes|No||||No|No|||Prescription required|No||027|Yes|1982.52341|02/01/2022|1934.94284|02/01/2022|1947.82925|02/01/2022|||ANTIPSYCHOTICS|11879|||||No|Yes|12.56|JANSSEN PHARM.|No||||
paliperidone palmitate|No|No|No|No|75%|50458056201|INVEGA SUSTENNA 117 MG/0.75 ML|.75|ML|888.29973|03/26/2010||Yes|No||03/26/2010||Yes|No|03/26/2010||Yes|No||||No|No|||Prescription required|No||027|Yes|1986.57655|02/01/2022|1938.89871|02/01/2022|1951.81146|02/01/2022|||ANTIPSYCHOTICS|11880|||||No|Yes|12.56|JANSSEN PHARM.|No||||
paliperidone palmitate|No|No|No|No|75%|50458056301|INVEGA SUSTENNA 156 MG/ML SYRG|1|ML|888.3327|03/26/2010||Yes|No||03/26/2010||Yes|No|03/26/2010||Yes|No||||No|No|||Prescription required|No||027|Yes|1984.4769|02/01/2022|1936.84945|02/01/2022|1949.74855|02/01/2022|||ANTIPSYCHOTICS|11881|||||No|Yes|12.56|JANSSEN PHARM.|No||||
paliperidone palmitate|No|No|No|No|75%|50458056401|INVEGA SUSTENNA 234 MG/1.5 ML|1.5|ML|888.31406|03/26/2010||Yes|No||03/26/2010||Yes|No|03/26/2010||Yes|No||||No|No|||Prescription required|No||027|Yes|1987.03799|02/01/2022|1939.34907|02/01/2022|1952.26482|02/01/2022|||ANTIPSYCHOTICS|11882|||||No|Yes|12.56|JANSSEN PHARM.|No||||
rivaroxaban|No|No|No|No|75%|50458057710|XARELTO 2.5 MG TABLET|100|EA|3.70251|12/28/2018||Yes|No||12/28/2018||Yes|No|12/28/2018||Yes|No||||No|No|||Prescription required|No||068|Yes|8.27944|02/01/2022|8.08073|02/01/2022|8.13454|02/01/2022|||ANTICOAGULANTS|11883|||||No|No||JANSSEN PHARM.|No||||
rivaroxaban|No|No|No|No|75%|50458057718|XARELTO 2.5 MG TABLET|180|EA|3.70248|12/28/2018||Yes|No||12/28/2018||Yes|No|12/28/2018||Yes|No||||No|No|||Prescription required|No||068|Yes|8.27944|02/01/2022|8.08073|02/01/2022|8.13454|02/01/2022|||ANTICOAGULANTS|11884|||||No|No||JANSSEN PHARM.|No||||
rivaroxaban|No|No|No|No|75%|50458057760|XARELTO 2.5 MG TABLET|60|EA|3.70251|12/28/2018||Yes|No||12/28/2018||Yes|No|12/28/2018||Yes|No||||No|No|||Prescription required|No||068|Yes|8.27944|02/01/2022|8.08073|02/01/2022|8.13454|02/01/2022|||ANTICOAGULANTS|11885|||||No|No||JANSSEN PHARM.|No||||
rivaroxaban|No|No|No|No|75%|50458057810|XARELTO 15 MG TABLET|100|EA|7.40498|11/17/2011||Yes|No||11/17/2011||Yes|No|11/17/2011||Yes|No||||No|No|||Prescription required|No||068|Yes|16.52191|02/01/2022|16.12538|02/01/2022|16.23277|02/01/2022|||ANTICOAGULANTS|11886|||||No|No||JANSSEN PHARM.|No||||
rivaroxaban|No|No|No|No|75%|50458057830|XARELTO 15 MG TABLET|30|EA|7.40503|11/17/2011||Yes|No||11/17/2011||Yes|No|11/17/2011||Yes|No||||No|No|||Prescription required|No||068|Yes|16.52191|02/01/2022|16.12538|02/01/2022|16.23277|02/01/2022|||ANTICOAGULANTS|11887|||||No|No||JANSSEN PHARM.|Yes|09/01/2020|||
rivaroxaban|No|No|No|No|75%|50458057890|XARELTO 15 MG TABLET|90|EA|7.40497|11/17/2011||Yes|No||11/17/2011||Yes|No|11/17/2011||Yes|No||||No|No|||Prescription required|No||068|Yes|16.52191|02/01/2022|16.12538|02/01/2022|16.23277|02/01/2022|||ANTICOAGULANTS|11888|||||No|No||JANSSEN PHARM.|Yes|09/01/2020|||
rivaroxaban|No|No|No|No|75%|50458057910|XARELTO 20 MG TABLET|100|EA|7.40498|11/17/2011||Yes|No||11/17/2011||Yes|No|11/17/2011||Yes|No||||No|No|||Prescription required|No||068|Yes|16.54483|02/01/2022|16.14775|02/01/2022|16.25529|02/01/2022|||ANTICOAGULANTS|11889|||||No|No||JANSSEN PHARM.|No||||
rivaroxaban|No|No|No|No|75%|50458057930|XARELTO 20 MG TABLET|30|EA|7.40503|11/17/2011||Yes|No||11/17/2011||Yes|No|11/17/2011||Yes|No||||No|No|||Prescription required|No||068|Yes|16.54483|02/01/2022|16.14775|02/01/2022|16.25529|02/01/2022|||ANTICOAGULANTS|11890|||||No|No||JANSSEN PHARM.|Yes|09/01/2020|||
rivaroxaban|No|No|No|No|75%|50458057989|XARELTO 20 MG TABLET|1000|EA|7.40499|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|No||068|Yes|16.54483|02/01/2022|16.14775|02/01/2022|16.25529|02/01/2022|||ANTICOAGULANTS|11891|||||No|No||JANSSEN PHARM.|No||||
rivaroxaban|No|No|No|No|75%|50458057990|XARELTO 20 MG TABLET|90|EA|7.40497|11/17/2011||Yes|No||11/17/2011||Yes|No|11/17/2011||Yes|No||||No|No|||Prescription required|No||068|Yes|16.54483|02/01/2022|16.14775|02/01/2022|16.25529|02/01/2022|||ANTICOAGULANTS|11892|||||No|No||JANSSEN PHARM.|Yes|09/01/2020|||
rivaroxaban|No|No|No|No|75%|50458058010|XARELTO 10 MG TABLET|100|EA|7.40498|07/14/2011||Yes|No||07/14/2011||Yes|No|07/14/2011||Yes|No||||No|No|||Prescription required|No||068|Yes|16.52691|02/01/2022|16.13026|02/01/2022|16.23768|02/01/2022|||ANTICOAGULANTS|11893|||||No|No||JANSSEN PHARM.|No||||
rivaroxaban|No|No|No|No|75%|50458058030|XARELTO 10 MG TABLET|30|EA|7.40503|07/14/2011||Yes|No||07/14/2011||Yes|No|07/14/2011||Yes|No||||No|No|||Prescription required|No||068|Yes|16.52691|02/01/2022|16.13026|02/01/2022|16.23768|02/01/2022|||ANTICOAGULANTS|11894|||||No|No||JANSSEN PHARM.|Yes|09/01/2020|||
rivaroxaban|No|No|No|No|75%|50458058451|XARELTO DVT-PE TREAT START 30D|51|EA|7.4051|12/08/2014||Yes|No||12/08/2014||Yes|No|12/08/2014||Yes|No||||No|No|||Prescription required|No||068|Yes|16.7241|02/01/2022|16.32272|02/01/2022|16.43142|02/01/2022|||ANTICOAGULANTS|11895|||||No|No||JANSSEN PHARM.|Yes|09/01/2020|||
methylphenidate HCl|No|No|No|No|75%|50458058501|CONCERTA ER 18 MG TABLET|100|EA|5.43769|12/01/2008||Yes|No||12/01/2008||Yes|No|12/01/2008||Yes|No||||No|No|||Prescription required|No||007|Yes|12.10398|02/01/2022|11.81348|02/01/2022|11.89216|02/01/2022|||STIMULANTS AND RELATED AGENTS|11896|||||No|No||JANSSEN PHARM.|No||||
methylphenidate HCl|No|No|No|No|75%|50458058601|CONCERTA ER 36 MG TABLET|100|EA|5.74974|12/03/2008||Yes|No||12/03/2008||Yes|No|12/03/2008||Yes|No||||No|No|||Prescription required|No||007|Yes|12.82358|02/01/2022|12.51581|02/01/2022|12.59916|02/01/2022|||STIMULANTS AND RELATED AGENTS|11897|||||No|No||JANSSEN PHARM.|No||||
methylphenidate HCl|No|No|No|No|75%|50458058701|CONCERTA ER 54 MG TABLET|100|EA|6.25658|12/03/2008||Yes|No||12/03/2008||Yes|No|12/03/2008||Yes|No||||No|No|||Prescription required|No||007|Yes|13.95578|02/01/2022|13.62084|02/01/2022|13.71155|02/01/2022|||STIMULANTS AND RELATED AGENTS|11898|||||No|No||JANSSEN PHARM.|No||||
methylphenidate HCl|No|No|No|No|75%|50458058801|CONCERTA ER 27 MG TABLET|100|EA|5.57396|12/01/2008||Yes|No||12/01/2008||Yes|No|12/01/2008||Yes|No||||No|No|||Prescription required|No||007|Yes|12.44918|02/01/2022|12.15039|02/01/2022|12.23131|02/01/2022|||STIMULANTS AND RELATED AGENTS|11899|||||No|No||JANSSEN PHARM.|No||||
risperidone|No|No|No|No|75%|50458059601|RISPERIDONE 1 MG/ML SOLUTION|30|ML|1.74551|07/16/2008||Yes|No||07/16/2008||Yes|No|07/16/2008||Yes|No||||No|No|||Prescription required|No||027|Yes|.33084|03/29/2022|.32289|03/29/2022|.32505|03/29/2022|||ANTIPSYCHOTICS|11900|||||No|No||PATRIOT PHARMAC|No||||
paliperidone palmitate|No|No|No|No|75%|50458060601|INVEGA TRINZA 273 MG/0.88 ML|.88|ML|1514.12283|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|3450.79158|01/25/2022|3401.49455|01/25/2022|3239.51862|01/25/2022|||ANTIPSYCHOTICS|11901|||||No|Yes|12.56|JANSSEN PHARM.|No||||
paliperidone palmitate|No|No|No|No|75%|50458060701|INVEGA TRINZA 410 MG/1.32 ML|1.32|ML|1514.14726|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|3367.18845|02/01/2022|3286.37592|02/01/2022|3308.26265|02/01/2022|||ANTIPSYCHOTICS|11902|||||No|Yes|12.56|JANSSEN PHARM.|No||||
paliperidone palmitate|No|No|No|No|75%|50458060801|INVEGA TRINZA 546 MG/1.75 ML|1.75|ML|1522.85851|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|3385.99708|02/01/2022|3304.73315|02/01/2022|3326.74213|02/01/2022|||ANTIPSYCHOTICS|11903|||||No|Yes|12.56|JANSSEN PHARM.|No||||
paliperidone palmitate|No|No|No|No|75%|50458060901|INVEGA TRINZA 819 MG/2.63 ML|2.63|ML|1519.92901|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|3392.88026|02/01/2022|3311.45113|02/01/2022|3333.50485|02/01/2022|||ANTIPSYCHOTICS|11904|||||No|Yes|12.56|JANSSEN PHARM.|No||||
topiramate|No|No|No|No|75%|50458063965|TOPAMAX 25 MG TABLET|60|EA|2.76267|03/06/2009||Yes|No||03/06/2009||Yes|No|03/06/2009||Yes|No||||No|No|||Prescription required|No||056|No|6.29633|01/25/2022|6.20638|01/25/2022|5.91084|01/25/2022|||ANTICONVULSANTS|11905|||||No|No||JANSSEN PHARM.|No||||
topiramate|No|No|No|No|75%|50458064065|TOPAMAX 50 MG TABLET|60|EA|5.51367|03/06/2009||Yes|No||03/06/2009||Yes|No|03/06/2009||Yes|No||||No|No|||Prescription required|No||056|No|12.56605|01/25/2022|12.38653|01/25/2022|11.7967|01/25/2022|||ANTICONVULSANTS|11906|||||No|No||JANSSEN PHARM.|No||||
topiramate|No|No|No|No|75%|50458064165|TOPAMAX 100 MG TABLET|60|EA|7.52951|03/06/2009||Yes|No||03/06/2009||Yes|No|03/06/2009||Yes|No||||No|No|||Prescription required|No||056|No|16.74486|02/01/2022|16.34298|02/01/2022|16.45182|02/01/2022|||ANTICONVULSANTS|11907|||||No|No||JANSSEN PHARM.|No||||
topiramate|No|No|No|No|75%|50458064265|TOPAMAX 200 MG TABLET|60|EA|8.81521|03/06/2009||Yes|No||03/06/2009||Yes|No|03/06/2009||Yes|No||||No|No|||Prescription required|No||056|No|19.7299|02/01/2022|19.25638|02/01/2022|19.38462|02/01/2022|||ANTICONVULSANTS|11908|||||No|No||JANSSEN PHARM.|No||||
topiramate|No|No|No|No|75%|50458064565|TOPAMAX 25 MG SPRINKLE CAP|60|EA|3.15878|05/14/2009||Yes|No||05/14/2009||Yes|No|05/14/2009||Yes|No||||No|No|||Prescription required|No||056|No|7.19908|01/25/2022|7.09623|01/25/2022|6.75832|01/25/2022|||ANTICONVULSANTS|11909|||||No|No||JANSSEN PHARM.|No||||
topiramate|No|No|No|No|75%|50458064765|TOPAMAX 15 MG SPRINKLE CAP|60|EA|2.61303|05/14/2009||Yes|No||05/14/2009||Yes|No|05/14/2009||Yes|No||||No|No|||Prescription required|No||056|No|5.95529|01/25/2022|5.87021|01/25/2022|5.59068|01/25/2022|||ANTICONVULSANTS|11910|||||No|No||JANSSEN PHARM.|No||||
tramadol HCl/acetaminophen|No|No|No|No|90%|50458065060|ULTRACET TABLET|100|EA|1.07874|12/30/2009||Yes|No||12/30/2009||Yes|No|12/30/2009||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|109|Yes|2.45852|10/27/2020|2.4234|10/27/2020|2.308|10/27/2020|||ANALGESICS: NARCOTICS SHORT|11911|||||No|No||JANSSEN PHARM.|No||||
tramadol HCl|No|No|No|No|90%|50458065960|ULTRAM 50 MG TABLET|100|EA|1.47047|06/25/2010||Yes|No||06/25/2010||Yes|No|06/25/2010||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|109|Yes|3.3513|08/24/2021|3.30343|08/24/2021|3.14612|08/24/2021|||ANALGESICS: NARCOTICS SHORT|11912|||||No|No||JANSSEN PHARM.|No||||
ponesimod|No|No|No|No|75%|50458070714|PONVORY 14-DAY STARTER PACK|14|EA|122.12|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||043|No|278.32|01/25/2022|274.344|01/25/2022|261.28|01/25/2022|||MULTIPLE SCLEROSIS AGENTS|11913|||||No|No||JANSSEN PHARM.|No||||
ponesimod|No|No|No|No|75%|50458072030|PONVORY 20 MG TABLET|30|EA|122.12014|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||043|No|278.32032|01/25/2022|274.34431|01/25/2022|261.2803|01/25/2022|||MULTIPLE SCLEROSIS AGENTS|11914|||||No|No||JANSSEN PHARM.|No||||
oxybutynin chloride|No|No|No|No|75%|50458080501|DITROPAN XL 5 MG TABLET|100|EA|2.73252|08/13/2010||Yes|No||08/13/2010||Yes|No|08/13/2010||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|006|Yes|6.2276|06/01/2016|6.13864|06/01/2016|5.84632|06/01/2016|||BLADDER RELAXANT PREPARATIONS|11915|||||No|No||JANSSEN PHARM.|No||||
oxybutynin chloride|No|No|No|No|75%|50458081001|DITROPAN XL 10 MG TABLET|100|EA|2.73531|08/13/2010||Yes|No||08/13/2010||Yes|No|08/13/2010||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|006|No|6.23397|01/24/2017|6.14491|01/24/2017|5.8523|01/24/2017|||BLADDER RELAXANT PREPARATIONS|11916|||||No|No||JANSSEN PHARM.|No||||
canagliflozin/metformin HCl|No|No|No|No|75%|50458094001|INVOKAMET XR 50-500 MG TABLET|60|EA|4.08543|01/12/2017||Yes|No||01/12/2017||Yes|No|01/12/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|535|No|9.31098|01/25/2022|9.17796|01/25/2022|8.74092|01/25/2022|||HYPOGLYCEMICS: SGLT2|11917|||||No|No||JANSSEN PHARM.|No||||
canagliflozin/metformin HCl|No|No|No|No|75%|50458094101|INVOKAMET XR 50-1,000 MG TAB|60|EA|4.08543|01/12/2017||Yes|No||01/12/2017||Yes|No|01/12/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|535|No|9.12193|02/01/2022|8.903|02/01/2022|8.96229|02/01/2022|||HYPOGLYCEMICS: SGLT2|11918|||||No|No||JANSSEN PHARM.|No||||
canagliflozin/metformin HCl|No|No|No|No|75%|50458094201|INVOKAMET XR 150-500 MG TABLET|60|EA|4.08543|01/12/2017||Yes|No||01/12/2017||Yes|No|01/12/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|535|No|9.31098|01/25/2022|9.17796|01/25/2022|8.74092|01/25/2022|||HYPOGLYCEMICS: SGLT2|11919|||||No|No||JANSSEN PHARM.|No||||
canagliflozin/metformin HCl|No|No|No|No|75%|50458094301|INVOKAMET XR 150-1,000 MG TAB|60|EA|4.08543|01/12/2017||Yes|No||01/12/2017||Yes|No|01/12/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|535|No|9.08523|02/01/2022|8.86718|02/01/2022|8.92623|02/01/2022|||HYPOGLYCEMICS: SGLT2|11920|||||No|No||JANSSEN PHARM.|No||||
levetiracetam|No|No|No|No|75%|50474000148|KEPPRA 100 MG/ML ORAL SOLN|473|ML|.73984|09/23/2003||Yes|No||09/23/2003||Yes|No|09/23/2003||Yes|No||||No|No|||Prescription required|No||056|No|1.65595|01/18/2022|1.6162|01/18/2022|1.62697|01/18/2022|||ANTICONVULSANTS|11921|||||No|No||UCB PHARMA|No||||
levetiracetam|No|No|No|No|75%|50474000263|KEPPRA 500 MG/5 ML VIAL|5|ML|5.17264|12/19/2012||Yes|No||12/19/2012||Yes|No|12/19/2012||Yes|No||||No|No|||Prescription required|No|||No|11.78881|01/11/2022|11.6204|01/11/2022|11.06704|01/11/2022||||11922|||||No|No||UCB PHARMA|No||||
brivaracetam|No|No|No|No|75%|50474037066|BRIVIACT 10 MG TABLET|60|EA|9.30627|09/16/2016||Yes|No||09/16/2016||Yes|No|09/16/2016||Yes|No||||No|No|||Prescription required|No||056|No|21.20965|01/11/2022|20.90665|01/11/2022|19.9111|01/11/2022|||ANTICONVULSANTS|11923|||||No|No||UCB PHARMA|No||||
brivaracetam|No|No|No|No|75%|50474047009|BRIVIACT 25 MG TABLET|100|EA|9.30627|09/16/2016||Yes|No||09/16/2016||Yes|No|09/16/2016||Yes|No||||No|No|||Prescription required|No||056|No|20.68245|01/18/2022|20.18607|01/18/2022|20.3205|01/18/2022|||ANTICONVULSANTS|11924|||||No|No||UCB PHARMA|No||||
brivaracetam|No|No|No|No|75%|50474047066|BRIVIACT 25 MG TABLET|60|EA|9.30627|09/16/2016||Yes|No||09/16/2016||Yes|No|09/16/2016||Yes|No||||No|No|||Prescription required|No||056|No|20.68245|01/18/2022|20.18607|01/18/2022|20.3205|01/18/2022|||ANTICONVULSANTS|11925|||||No|No||UCB PHARMA|No||||
midazolam|No|No|No|No|75%|50474050015|NAYZILAM 5 MG NASAL SPRAY|2|EA|126.40925|02/04/2020||Yes|No||02/04/2020||Yes|No|02/04/2020||Yes|No||||No|No|||Prescription required|No||056|No|282.80293|01/18/2022|276.01565|01/18/2022|277.85387|01/18/2022|||ANTICONVULSANTS|11926|||||No|No||UCB PHARMA|No||||
brivaracetam|No|No|No|No|75%|50474057009|BRIVIACT 50 MG TABLET|100|EA|9.30627|09/16/2016||Yes|No||09/16/2016||Yes|No|09/16/2016||Yes|No||||No|No|||Prescription required|No||056|No|20.67428|01/18/2022|20.17809|01/18/2022|20.31248|01/18/2022|||ANTICONVULSANTS|11927|||||No|No||UCB PHARMA|No||||
brivaracetam|No|No|No|No|75%|50474057066|BRIVIACT 50 MG TABLET|60|EA|9.30627|09/16/2016||Yes|No||09/16/2016||Yes|No|09/16/2016||Yes|No||||No|No|||Prescription required|No||056|No|20.67428|01/18/2022|20.17809|01/18/2022|20.31248|01/18/2022|||ANTICONVULSANTS|11928|||||No|No||UCB PHARMA|No||||
levetiracetam|No|No|No|No|75%|50474059440|KEPPRA 250 MG TABLET|120|EA|3.13881|05/12/2006||Yes|No||05/12/2006||Yes|No|05/12/2006||Yes|No||||No|No|||Prescription required|No||056|No|6.97788|01/18/2022|6.81041|01/18/2022|6.85576|01/18/2022|||ANTICONVULSANTS|11929|||||No|No||UCB PHARMA|No||||
levetiracetam|No|No|No|No|75%|50474059540|KEPPRA 500 MG TABLET|120|EA|3.83627|05/12/2006||Yes|No||05/12/2006||Yes|No|05/12/2006||Yes|No||||No|No|||Prescription required|No||056|No|8.59806|01/18/2022|8.3917|01/18/2022|8.44759|01/18/2022|||ANTICONVULSANTS|11930|||||No|No||UCB PHARMA|No||||
levetiracetam|No|No|No|No|75%|50474059640|KEPPRA 750 MG TABLET|120|EA|5.19741|05/12/2006||Yes|No||05/12/2006||Yes|No|05/12/2006||Yes|No||||No|No|||Prescription required|No||056|No|11.59185|01/18/2022|11.31364|01/18/2022|11.38899|01/18/2022|||ANTICONVULSANTS|11931|||||No|No||UCB PHARMA|No||||
levetiracetam|No|No|No|No|75%|50474059766|KEPPRA 1,000 MG TABLET|60|EA|7.67255|02/05/2007||Yes|No||02/05/2007||Yes|No|02/05/2007||Yes|No||||No|No|||Prescription required|No||056|No|17.11983|01/18/2022|16.70895|01/18/2022|16.82023|01/18/2022|||ANTICONVULSANTS|11932|||||No|No||UCB PHARMA|No||||
levetiracetam|No|No|No|No|75%|50474059866|KEPPRA XR 500 MG TABLET|60|EA|3.47769|10/01/2008||Yes|No||10/01/2008||Yes|No|10/01/2008||Yes|No||||No|No|||Prescription required|No||056|No|7.72099|01/18/2022|7.53568|01/18/2022|7.58587|01/18/2022|||ANTICONVULSANTS|11933|||||No|No||UCB PHARMA|No||||
levetiracetam|No|No|No|No|75%|50474059966|KEPPRA XR 750 MG TABLET|60|EA|5.22192|04/16/2009||Yes|No||04/16/2009||Yes|No|04/16/2009||Yes|No||||No|No|||Prescription required|No||056|No|11.61044|01/18/2022|11.33178|01/18/2022|11.40725|01/18/2022|||ANTICONVULSANTS|11934|||||No|No||UCB PHARMA|No||||
brivaracetam|No|No|No|No|75%|50474067066|BRIVIACT 75 MG TABLET|60|EA|9.30627|09/16/2016||Yes|No||09/16/2016||Yes|No|09/16/2016||Yes|No||||No|No|||Prescription required|No||056|No|20.84466|01/18/2022|20.34438|01/18/2022|20.47987|01/18/2022|||ANTICONVULSANTS|11935|||||No|No||UCB PHARMA|No||||
certolizumab pegol|No|No|No|No|75%|50474071079|CIMZIA 2X200 MG/ML SYRINGE KIT|1|EA|2192.8624|05/19/2009||Yes|No||05/19/2009||Yes|No|05/19/2009||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|071|Yes|4944.14|03/29/2022|4825.48064|03/29/2022|4857.61755|03/29/2022|||CYTOKINE AND CAM ANTAGONISTS|11936|||||No|No||UCB PHARMA|No||||
certolizumab pegol|No|No|No|No|75%|50474071081|CIMZIA 2X200 MG/ML(X3)START KT|3|EA|2192.86096|05/27/2011||Yes|No||05/27/2011||Yes|No|05/27/2011||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|071|Yes|4997.68312|01/11/2022|4926.28765|01/11/2022|4691.70252|01/11/2022|||CYTOKINE AND CAM ANTAGONISTS|11937|||||No|No||UCB PHARMA|No||||
brivaracetam|No|No|No|No|75%|50474077009|BRIVIACT 100 MG TABLET|100|EA|9.30627|09/16/2016||Yes|No||09/16/2016||Yes|No|09/16/2016||Yes|No||||No|No|||Prescription required|No||056|No|20.77231|01/18/2022|20.27377|01/18/2022|20.40879|01/18/2022|||ANTICONVULSANTS|11938|||||No|No||UCB PHARMA|No||||
brivaracetam|No|No|No|No|75%|50474077066|BRIVIACT 100 MG TABLET|60|EA|9.30627|09/16/2016||Yes|No||09/16/2016||Yes|No|09/16/2016||Yes|No||||No|No|||Prescription required|No||056|No|20.77231|01/18/2022|20.27377|01/18/2022|20.40879|01/18/2022|||ANTICONVULSANTS|11939|||||No|No||UCB PHARMA|No||||
rotigotine|No|No|No|No|75%|50474080103|NEUPRO 1 MG/24 HR PATCH|30|EA|10.91698|07/20/2012||Yes|No||07/20/2012||Yes|No|07/20/2012||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|015|No|24.38311|01/18/2022|23.79791|01/18/2022|23.9564|01/18/2022|||ANTIPARKINSON'S AGENTS|11940|||||No|No||UCB PHARMA|No||||
rotigotine|No|No|No|No|75%|50474080203|NEUPRO 2 MG/24 HR PATCH|30|EA|10.91698|07/20/2012||Yes|No||07/20/2012||Yes|No|07/20/2012||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|015|No|24.24126|01/18/2022|23.65946|01/18/2022|23.81703|01/18/2022|||ANTIPARKINSON'S AGENTS|11941|||||No|No||UCB PHARMA|No||||
rotigotine|No|No|No|No|75%|50474080303|NEUPRO 3 MG/24 HR PATCH|30|EA|10.91698|07/20/2012||Yes|No||07/20/2012||Yes|No|07/20/2012||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|015|No|24.34647|01/18/2022|23.76215|01/18/2022|23.9204|01/18/2022|||ANTIPARKINSON'S AGENTS|11942|||||No|No||UCB PHARMA|No||||
rotigotine|No|No|No|No|75%|50474080403|NEUPRO 4 MG/24 HR PATCH|30|EA|10.91698|07/20/2012||Yes|No||07/20/2012||Yes|No|07/20/2012||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|015|No|24.22939|01/18/2022|23.64788|01/18/2022|23.80537|01/18/2022|||ANTIPARKINSON'S AGENTS|11943|||||No|No||UCB PHARMA|No||||
rotigotine|No|No|No|No|75%|50474080503|NEUPRO 6 MG/24 HR PATCH|30|EA|10.91698|07/20/2012||Yes|No||07/20/2012||Yes|No|07/20/2012||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|015|No|24.36863|01/18/2022|23.78378|01/18/2022|23.94217|01/18/2022|||ANTIPARKINSON'S AGENTS|11944|||||No|No||UCB PHARMA|No||||
rotigotine|No|No|No|No|75%|50474080603|NEUPRO 8 MG/24 HR PATCH|30|EA|10.91698|07/20/2012||Yes|No||07/20/2012||Yes|No|07/20/2012||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|015|No|24.45555|01/18/2022|23.86861|01/18/2022|24.02757|01/18/2022|||ANTIPARKINSON'S AGENTS|11945|||||No|No||UCB PHARMA|No||||
brivaracetam|No|No|No|No|75%|50474087015|BRIVIACT 10 MG/ML ORAL SOLN|300|ML|1.86125|09/16/2016||Yes|No||09/16/2016||Yes|No|09/16/2016||Yes|No||||No|No|||Prescription required|No||056|No|4.17109|01/18/2022|4.07098|01/18/2022|4.09809|01/18/2022|||ANTICONVULSANTS|11946|||||No|No||UCB PHARMA|No||||
brivaracetam|No|No|No|No|75%|50474097075|BRIVIACT 50 MG/5 ML VIAL|5|ML|4.78607|09/16/2016||Yes|No||09/16/2016||Yes|No|09/16/2016||Yes|No||||No|No|||Prescription required|No|||No|10.90779|01/11/2022|10.75196|01/11/2022|10.23996|01/11/2022||||11947|||||No|No||UCB PHARMA|No||||
desipramine HCl|No|No|No|No|75%|50742011201|DESIPRAMINE 10 MG TABLET|100|EA|.0516|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.3086|03/29/2022|.30119|03/29/2022|.30319|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|11948|||||No|No||INGENUS PHARMAC|No||||
desipramine HCl|No|No|No|No|75%|50742011301|DESIPRAMINE 25 MG TABLET|100|EA|.0645|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.4119|03/01/2022|.40201|03/01/2022|.40469|03/01/2022|||ANTIDEPRESSANTS: TRICYCLIC|11949|||||No|No||INGENUS PHARMAC|No||||
desipramine HCl|No|No|No|No|75%|50742011401|DESIPRAMINE 50 MG TABLET|100|EA|.1247|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.3099|01/25/2022|.30246|01/25/2022|.30447|01/25/2022|||ANTIDEPRESSANTS: TRICYCLIC|11950|||||No|No||INGENUS PHARMAC|No||||
desipramine HCl|No|No|No|No|75%|50742011501|DESIPRAMINE 75 MG TABLET|100|EA|.215|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.49|05/12/2020|.483|05/12/2020|.46|05/12/2020|||ANTIDEPRESSANTS: TRICYCLIC|11951|||||No|No||INGENUS PHARMAC|No||||
desipramine HCl|No|No|No|No|75%|50742011601|DESIPRAMINE 100 MG TABLET|100|EA|.2365|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.539|05/12/2020|.5313|05/12/2020|.506|05/12/2020|||ANTIDEPRESSANTS: TRICYCLIC|11952|||||No|No||INGENUS PHARMAC|No||||
desipramine HCl|No|No|No|No|75%|50742011750|DESIPRAMINE 150 MG TABLET|50|EA|.645|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|1.47|05/12/2020|1.449|05/12/2020|1.38|05/12/2020|||ANTIDEPRESSANTS: TRICYCLIC|11953|||||No|No||INGENUS PHARMAC|No||||
cabergoline|No|No|No|No|75%|50742011808|CABERGOLINE 0.5 MG TABLET|8|EA|1.34375|10/29/2018||Yes|No||10/29/2018||Yes|No|10/29/2018||Yes|No||||No|No|||Prescription required|No|||No|2.46183|03/29/2022|2.40274|03/29/2022|2.41874|03/29/2022||||11954|||||No|No||INGENUS PHARMAC|No||||
methenamine hippurate|No|No|No|No|75%|50742014201|METHENAMINE HIPP 1 GM TABLET|100|EA|.3096|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No|||No|.83638|03/29/2022|.8163|03/29/2022|.82174|03/29/2022||||11955|||||No|No||INGENUS PHARMAC|No||||
pantoprazole sodium|No|No|No|No|75%|50742015110|PANTOPRAZOLE SOD DR 40 MG TAB|1000|EA|.05433|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No||047|No|.05828|03/29/2022|.05688|03/29/2022|.05726|03/29/2022|||PROTON PUMP INHIBITORS|11956|||||No|No||INGENUS PHARMAC|No||||
isosorbide mononitrate|No|No|No|No|75%|50742017501|ISOSORBIDE MONONIT ER 30 MG TB|100|EA|.0516|09/09/2019||Yes|No||09/09/2019||Yes|No|09/09/2019||Yes|No||||No|No|||Prescription required|No|||No|.09715|03/29/2022|.09481|03/29/2022|.09544|03/29/2022||||11957|||||No|No||INGENUS PHARMAC|No||||
isosorbide mononitrate|No|No|No|No|75%|50742017505|ISOSORBIDE MONONIT ER 30 MG TB|500|EA|.0516|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.09715|03/29/2022|.09481|03/29/2022|.09544|03/29/2022||||11958|||||No|No||INGENUS PHARMAC|No||||
isosorbide mononitrate|No|No|No|No|75%|50742017601|ISOSORBIDE MONONIT ER 60 MG TB|100|EA|.0559|09/09/2019||Yes|No||09/09/2019||Yes|No|09/09/2019||Yes|No||||No|No|||Prescription required|No|||No|.12753|03/29/2022|.12446|03/29/2022|.12529|03/29/2022||||11959|||||No|No||INGENUS PHARMAC|No||||
isosorbide mononitrate|No|No|No|No|75%|50742017605|ISOSORBIDE MONONIT ER 60 MG TB|500|EA|.0559|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.12753|03/29/2022|.12446|03/29/2022|.12529|03/29/2022||||11960|||||No|No||INGENUS PHARMAC|No||||
isosorbide mononitrate|No|No|No|No|75%|50742017701|ISOSORBIDE MONONIT ER 120 MG|100|EA|.1118|09/09/2019||Yes|No||09/09/2019||Yes|No|09/09/2019||Yes|No||||No|No|||Prescription required|No|||No|.25435|03/29/2022|.24824|03/29/2022|.24989|03/29/2022||||11961|||||No|No||INGENUS PHARMAC|No||||
methylprednisolone|No|No|No|No|75%|50742018921|METHYLPREDNISOLONE 4 MG DOSEPK|21|EA|.13309|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||||No|No|||Prescription required|No||168|Yes|.17447|03/29/2022|.17028|03/29/2022|.17141|03/29/2022|||GLUCOCORTICOIDS: ORAL|11962|||||No|No||INGENUS PHARMAC|No||||
cyproheptadine HCl|No|No|No|No|75%|50742019001|CYPROHEPTADINE 4 MG TABLET|100|EA|.0387|09/30/2015||Yes|No||09/30/2015||Yes|No|09/30/2015||Yes|No||||No|No|||Prescription required|No||574|Yes|.09783|03/29/2022|.09548|03/29/2022|.09611|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|11963|||||No|No||INGENUS PHARMAC|No||||
cyproheptadine HCl|No|No|No|No|75%|50742019010|CYPROHEPTADINE 4 MG TABLET|1000|EA|.0387|09/30/2015||Yes|No||09/30/2015||Yes|No|09/30/2015||Yes|No||||No|No|||Prescription required|No||574|Yes|.09783|03/29/2022|.09548|03/29/2022|.09611|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|11964|||||No|No||INGENUS PHARMAC|No||||
tolcapone|No|No|No|No|75%|50742019390|TOLCAPONE 100 MG TABLET|90|EA|9.55555|11/19/2018||Yes|No||11/19/2018||Yes|No|11/19/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|015|No|21.77777|05/12/2020|21.46666|05/12/2020|20.44444|05/12/2020|||ANTIPARKINSON'S AGENTS|11965|||||No|No||INGENUS PHARMAC|No||||
tizanidine HCl|No|No|No|No|75%|50742022415|TIZANIDINE HCL 2 MG CAPSULE|150|EA|.086|09/09/2019||Yes|No||09/09/2019||Yes|No|09/09/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|No|.0903|03/29/2022|.08813|03/29/2022|.08871|03/29/2022|||SKELETAL MUSCLE RELAXANTS|11966|||||No|No||INGENUS PHARMAC|No||||
tizanidine HCl|No|No|No|No|75%|50742022515|TIZANIDINE HCL 4 MG CAPSULE|150|EA|.11466|09/09/2019||Yes|No||09/09/2019||Yes|No|09/09/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|No|.15367|03/29/2022|.14998|03/29/2022|.15098|03/29/2022|||SKELETAL MUSCLE RELAXANTS|11967|||||No|No||INGENUS PHARMAC|No||||
tizanidine HCl|No|No|No|No|75%|50742022615|TIZANIDINE HCL 6 MG CAPSULE|150|EA|.172|09/09/2019||Yes|No||09/09/2019||Yes|No|09/09/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|No|.27523|03/29/2022|.26862|03/29/2022|.27041|03/29/2022|||SKELETAL MUSCLE RELAXANTS|11968|||||No|No||INGENUS PHARMAC|No||||
acetazolamide|No|No|No|No|75%|50742023301|ACETAZOLAMIDE ER 500 MG CAP|100|EA|.215|02/15/2018||Yes|No||02/15/2018||Yes|No|02/15/2018||Yes|No||||No|No|||Prescription required|No|||No|.39876|03/29/2022|.38918|03/29/2022|.39178|03/29/2022||||11969|||||No|No||INGENUS PHARMAC|No||||
quinine sulfate|No|No|No|No|75%|50742023830|QUININE SULFATE 324 MG CAPSULE|30|EA|.71666|02/02/2018||Yes|No||02/02/2018||Yes|No|02/02/2018||Yes|No||||No|No|||Prescription required|No|||No|1.35758|03/29/2022|1.32499|03/29/2022|1.33382|03/29/2022||||11970|||||No|No||INGENUS PHARMAC|No||||
clonidine HCl|No|No|No|No|75%|50742024760|CLONIDINE HCL ER 0.1 MG TABLET|60|EA|.14333|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.52051|03/29/2022|.50801|03/29/2022|.5114|03/29/2022|||STIMULANTS AND RELATED AGENTS|11971|||||No|No||INGENUS PHARMAC|No||||
diltiazem HCl|No|No|No|No|75%|50742024830|DILTIAZEM 24H ER(CD) 120 MG CP|30|EA|.18633|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No||045|No|.17507|03/29/2022|.17086|03/29/2022|.172|03/29/2022|||CALCIUM CHANNEL BLOCKERS|11972|||||No|No||INGENUS PHARMAC|No||||
diltiazem HCl|No|No|No|No|75%|50742024890|DILTIAZEM 24H ER(CD) 120 MG CP|90|EA|.17701|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No||045|No|.17507|03/29/2022|.17086|03/29/2022|.172|03/29/2022|||CALCIUM CHANNEL BLOCKERS|11973|||||No|No||INGENUS PHARMAC|No||||
diltiazem HCl|No|No|No|No|75%|50742024930|DILTIAZEM 24H ER(CD) 180 MG CP|30|EA|.20066|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||045|No|.21189|03/29/2022|.2068|03/29/2022|.20818|03/29/2022|||CALCIUM CHANNEL BLOCKERS|11974|||||No|No||INGENUS PHARMAC|No||||
diltiazem HCl|No|No|No|No|75%|50742025030|DILTIAZEM 24H ER(CD) 240 MG CP|30|EA|.215|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No||045|No|.29728|03/29/2022|.29014|03/29/2022|.29207|03/29/2022|||CALCIUM CHANNEL BLOCKERS|11975|||||No|No||INGENUS PHARMAC|No||||
diltiazem HCl|No|No|No|No|75%|50742025090|DILTIAZEM 24H ER(CD) 240 MG CP|90|EA|.20425|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No||045|No|.29728|03/29/2022|.29014|03/29/2022|.29207|03/29/2022|||CALCIUM CHANNEL BLOCKERS|11976|||||No|No||INGENUS PHARMAC|No||||
diltiazem HCl|No|No|No|No|75%|50742025130|DILTIAZEM 24H ER(CD) 300 MG CP|30|EA|.31533|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No||045|No|.34265|03/29/2022|.33442|03/29/2022|.33665|03/29/2022|||CALCIUM CHANNEL BLOCKERS|11977|||||No|No||INGENUS PHARMAC|No||||
diltiazem HCl|No|No|No|No|75%|50742025190|DILTIAZEM 24H ER(CD) 300 MG CP|90|EA|.29956|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No||045|No|.34265|03/29/2022|.33442|03/29/2022|.33665|03/29/2022|||CALCIUM CHANNEL BLOCKERS|11978|||||No|No||INGENUS PHARMAC|No||||
diltiazem HCl|No|No|No|No|75%|50742025290|DILTIAZEM 24H ER(CD) 360 MG CP|90|EA|.31318|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No||045|No|1.70196|03/29/2022|1.66111|03/29/2022|1.67217|03/29/2022|||CALCIUM CHANNEL BLOCKERS|11979|||||No|No||INGENUS PHARMAC|No||||
carisoprodol/aspirin/codeine|No|No|No|No|90%|50742025601|CARISOPRODOL-ASPIRIN-CODEIN TB|100|EA|1.50598|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|109|Yes|3.43225|05/23/2019|3.38322|05/23/2019|3.22211|05/23/2019|||ANALGESICS: NARCOTICS SHORT|11980|||||No|No||INGENUS PHARMAC|No||||
nifedipine|Yes|No|No|No|75%|50742026001|NIFEDIPINE ER 30 MG TABLET|100|EA|.10857|06/10/2019||Yes|No||06/10/2019||Yes|No|06/10/2019||Yes|No||||No|No|09/27/2019||Prescription required|No||045|Yes|.17922|03/29/2022|.17491|03/29/2022|.17608|03/29/2022|||CALCIUM CHANNEL BLOCKERS|11981|||||No|No||INGENUS PHARMAC|No||||
nifedipine|Yes|No|No|No|75%|50742026003|NIFEDIPINE ER 30 MG TABLET|300|EA|.07525|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||045|Yes|.17922|03/29/2022|.17491|03/29/2022|.17608|03/29/2022|||CALCIUM CHANNEL BLOCKERS|11982|||||No|No||INGENUS PHARMAC|No||||
nifedipine|Yes|No|No|No|75%|50742026101|NIFEDIPINE ER 60 MG TABLET|100|EA|.11825|06/10/2019||Yes|No||06/10/2019||Yes|No|06/10/2019||Yes|No||||No|No|09/27/2019||Prescription required|No||045|No|.23953|03/29/2022|.23378|03/29/2022|.23533|03/29/2022|||CALCIUM CHANNEL BLOCKERS|11983|||||No|No||INGENUS PHARMAC|No||||
nifedipine|Yes|No|No|No|75%|50742026103|NIFEDIPINE ER 60 MG TABLET|300|EA|.07202|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||045|No|.23953|03/29/2022|.23378|03/29/2022|.23533|03/29/2022|||CALCIUM CHANNEL BLOCKERS|11984|||||No|No||INGENUS PHARMAC|No||||
nifedipine|Yes|No|No|No|75%|50742026201|NIFEDIPINE ER 90 MG TABLET|100|EA|.19565|06/10/2019||Yes|No||06/10/2019||Yes|No|06/10/2019||Yes|No||||No|No|09/27/2019||Prescription required|No||045|No|.38633|03/29/2022|.37705|03/29/2022|.37956|03/29/2022|||CALCIUM CHANNEL BLOCKERS|11985|||||No|No||INGENUS PHARMAC|No||||
probenecid/colchicine|No|No|No|No|75%|50742026301|PROBENECID-COLCHICINE TABLET|100|EA|.69015|09/09/2019||Yes|No||09/09/2019||Yes|No|09/09/2019||Yes|No||||No|No|||Prescription required|No||231|No|1.11456|03/29/2022|1.08781|03/29/2022|1.09505|03/29/2022|||ANTIHYPERURICEMICS|11986|||||No|No||INGENUS PHARMAC|No||||
norethindrone acetate|No|No|No|No|75%|50742026750|NORETHINDRONE 5 MG TABLET|50|EA|.258|04/15/2020||Yes|No||04/15/2020||Yes|No|04/15/2020||Yes|No||||No|No|||Prescription required|No|||No|.58431|03/29/2022|.57028|03/29/2022|.57408|03/29/2022||||11987|||||No|No||INGENUS PHARMAC|No||||
clobetasol propionate|No|No|No|No|75%|50742030401|CLOBETASOL PROP 0.05% FOAM|100|GM|.43|11/15/2017|07/31/2023|Yes|No||11/15/2017|07/31/2023|Yes|No|11/15/2017|07/31/2023|Yes|No||||No|No|||Prescription required|Yes|09/14/2017|121|No|.7435|03/29/2022|.72565|03/29/2022|.73048|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|11988|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||INGENUS PHARMAC|No||||
clobetasol propionate|No|No|No|No|75%|50742030450|CLOBETASOL PROP 0.05% FOAM|50|GM|.43|11/15/2017|07/31/2023|Yes|No||11/15/2017|07/31/2023|Yes|No|11/15/2017|07/31/2023|Yes|No||||No|No|||Prescription required|Yes|09/14/2017|121|No|.53203|03/29/2022|.51926|03/29/2022|.52271|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|11989|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||INGENUS PHARMAC|No||||
mafenide acetate|No|No|No|No|75%|50742031025|MAFENIDE ACETATE 50 GM POWD PK|5|EA|47.3|06/12/2019||Yes|No||06/12/2019||Yes|No|06/12/2019||Yes|No||||No|No|||Prescription required|No|||No|107.8|06/12/2019|106.26|06/18/2019|101.2|06/12/2019||||11990|||||No|No||INGENUS PHARMAC|No||||
mafenide acetate|No|No|No|No|75%|50742031050|MAFENIDE ACETATE 50 GM POWD PK|1|EA|47.3|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|107.8|09/11/2019|106.26|09/17/2019|101.2|09/11/2019||||11991|||||No|No||INGENUS PHARMAC|No||||
clobetasol propionate/emoll|No|No|No|No|75%|50742031115|CLOBETASOL EMOLLIENT 0.05% CRM|15|GM|.57333|05/19/2020||Yes|No||05/19/2020||Yes|No|05/19/2020||Yes|No||||No|No|||Prescription required|No||121|No|1.21527|03/29/2022|1.1861|03/29/2022|1.194|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|11992|||||No|No||INGENUS PHARMAC|No||||
clobetasol propionate/emoll|No|No|No|No|75%|50742031130|CLOBETASOL EMOLLIENT 0.05% CRM|30|GM|.57333|09/28/2020||Yes|No||09/28/2020||Yes|No|09/28/2020||Yes|No||||No|No|||Prescription required|No||121|No|.6904|03/29/2022|.67383|03/29/2022|.67831|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|11993|||||No|No||INGENUS PHARMAC|No||||
clobetasol propionate/emoll|No|No|No|No|75%|50742031160|CLOBETASOL EMOLLIENT 0.05% CRM|60|GM|.57333|05/19/2020||Yes|No||05/19/2020||Yes|No|05/19/2020||Yes|No||||No|No|||Prescription required|No||121|No|.73304|03/29/2022|.71544|03/29/2022|.72021|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|11994|||||No|No||INGENUS PHARMAC|No||||
betamethasone valerate|No|No|No|No|75%|50742031501|BETAMETHASONE VALER 0.12% FOAM|100|GM|.387|09/08/2017|04/30/2023|Yes|No||09/08/2017|04/30/2023|Yes|No|09/08/2017|04/30/2023|Yes|No||||No|No|||Prescription required|Yes|01/26/2017|119|No|.8923|06/29/2021|.87088|06/29/2021|.87668|06/29/2021|||STEROIDS: TOPICAL MEDIUM|11995|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||INGENUS PHARMAC|No||||
betamethasone valerate|No|No|No|No|75%|50742031550|BETAMETHASONE VALER 0.12% FOAM|50|GM|.387|09/08/2017|04/30/2023|Yes|No||09/08/2017|04/30/2023|Yes|No|09/08/2017|04/30/2023|Yes|No||||No|No|||Prescription required|Yes|01/26/2017|119|No|2.1912|03/01/2022|2.13861|03/01/2022|2.15285|03/01/2022|||STEROIDS: TOPICAL MEDIUM|11996|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||INGENUS PHARMAC|No||||
scopolamine|No|No|No|No|75%|50742050504|SCOPOLAMINE 1 MG/3 DAY PATCH|4|EA|6.9488|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|085|No|11.10069|03/29/2022|10.83427|03/29/2022|10.90642|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|11997|||||No|No||INGENUS PHARMAC|No||||
scopolamine|No|No|No|No|75%|50742050510|SCOPOLAMINE 1 MG/3 DAY PATCH|10|EA|7.90297|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|085|No|11.10069|03/29/2022|10.83427|03/29/2022|10.90642|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|11998|||||No|No||INGENUS PHARMAC|No||||
scopolamine|No|No|No|No|75%|50742050524|SCOPOLAMINE 1 MG/3 DAY PATCH|24|EA|7.90321|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|085|No|11.10069|03/29/2022|10.83427|03/29/2022|10.90642|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|11999|||||No|No||INGENUS PHARMAC|No||||
nitroglycerin|No|No|No|No|75%|50742051330|NITRO-DUR 0.1 MG/HR PATCH|30|EA|7.46379|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|||Prescription required|No|||No|17.0105|08/13/2019|16.76749|08/13/2019|15.96904|08/13/2019||||12000|||||No|No||INGENUS PHARMAC|No||||
nitroglycerin|No|No|No|No|75%|50742051430|NITRO-DUR 0.2 MG/HR PATCH|30|EA|8.03039|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|||Prescription required|No|||No|18.30182|08/13/2019|18.04036|08/13/2019|17.1813|08/13/2019||||12001|||||No|No||INGENUS PHARMAC|No||||
nitroglycerin|No|No|No|No|75%|50742051530|NITRO-DUR 0.3 MG/HR PATCH|30|EA|16.87864|05/18/2018||Yes|No||05/18/2018||Yes|No|||No|No||||No|No|||Prescription required|No|||No|38.4676|06/22/2021|37.91806|06/22/2021|36.11244|06/22/2021||||12002|||||No|No||INGENUS PHARMAC|No||||
nitroglycerin|No|No|No|No|75%|50742051630|NITRO-DUR 0.4 MG/HR PATCH|30|EA|9.0019|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|||Prescription required|No|||No|20.51596|08/13/2019|20.22288|08/13/2019|19.25988|08/13/2019||||12003|||||No|No||INGENUS PHARMAC|No||||
nitroglycerin|No|No|No|No|75%|50742051730|NITRO-DUR 0.6 MG/HR PATCH|30|EA|9.76286|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|||Prescription required|No|||No|22.25024|08/13/2019|21.93238|08/13/2019|20.88798|08/13/2019||||12004|||||No|No||INGENUS PHARMAC|No||||
nitroglycerin|No|No|No|No|75%|50742051830|NITRO-DUR 0.8 MG/HR PATCH|30|EA|18.30553|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|||Prescription required|No|||No|41.71958|03/23/2021|41.12358|03/23/2021|39.16532|03/23/2021||||12005|||||No|No||INGENUS PHARMAC|No||||
metoprolol succinate|No|No|No|No|75%|50742061501|METOPROLOL SUCC ER 25 MG TAB|100|EA|.0473|03/21/2018||Yes|No||03/21/2018||Yes|No|03/21/2018||Yes|No||||No|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|12006|||||No|No||INGENUS PHARMAC|No||||
metoprolol succinate|No|No|No|No|75%|50742061510|METOPROLOL SUCC ER 25 MG TAB|1000|EA|.0473|03/21/2018||Yes|No||03/21/2018||Yes|No|03/21/2018||Yes|No||||No|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|12007|||||No|No||INGENUS PHARMAC|No||||
metoprolol succinate|No|No|No|No|75%|50742061601|METOPROLOL SUCC ER 50 MG TAB|100|EA|.0473|03/21/2018||Yes|No||03/21/2018||Yes|No|03/21/2018||Yes|No||||No|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|12008|||||No|No||INGENUS PHARMAC|No||||
metoprolol succinate|No|No|No|No|75%|50742061610|METOPROLOL SUCC ER 50 MG TAB|1000|EA|.043|03/21/2018||Yes|No||03/21/2018||Yes|No|03/21/2018||Yes|No||||No|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|12009|||||No|No||INGENUS PHARMAC|No||||
metoprolol succinate|No|No|No|No|75%|50742061701|METOPROLOL SUCC ER 100 MG TAB|100|EA|.06342|03/21/2018||Yes|No||03/21/2018||Yes|No|03/21/2018||Yes|No||||No|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|12010|||||No|No||INGENUS PHARMAC|No||||
metoprolol succinate|No|No|No|No|75%|50742061710|METOPROLOL SUCC ER 100 MG TAB|1000|EA|.05805|03/21/2018||Yes|No||03/21/2018||Yes|No|03/21/2018||Yes|No||||No|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|12011|||||No|No||INGENUS PHARMAC|No||||
metoprolol succinate|No|No|No|No|75%|50742061801|METOPROLOL SUCC ER 200 MG TAB|100|EA|.129|03/21/2018||Yes|No||03/21/2018||Yes|No|03/21/2018||Yes|No||||No|No|||Prescription required|No||070|No|.25385|03/29/2022|.24775|03/29/2022|.2494|03/29/2022|||BETA-BLOCKERS|12012|||||No|No||INGENUS PHARMAC|No||||
nifedipine|No|No|No|No|75%|50742062001|NIFEDIPINE ER 30 MG TABLET|100|EA|.1075|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No||045|Yes|.20358|03/29/2022|.19869|03/29/2022|.20001|03/29/2022|||CALCIUM CHANNEL BLOCKERS|12013|||||No|No||INGENUS PHARMAC|No||||
nifedipine|No|No|No|No|75%|50742062101|NIFEDIPINE ER 60 MG TABLET|100|EA|.13545|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No||045|No|.22381|03/29/2022|.21843|03/29/2022|.21989|03/29/2022|||CALCIUM CHANNEL BLOCKERS|12014|||||No|No||INGENUS PHARMAC|No||||
nifedipine|No|No|No|No|75%|50742062201|NIFEDIPINE ER 90 MG TABLET|100|EA|.2408|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No||045|No|.3781|03/29/2022|.36902|03/29/2022|.37148|03/29/2022|||CALCIUM CHANNEL BLOCKERS|12015|||||No|No||INGENUS PHARMAC|No||||
metformin HCl|No|No|No|No|75%|50742063360|METFORMIN ER 500 MG OSMOTIC TB|60|EA|1.80047|03/04/2019||Yes|No||03/04/2019||Yes|No|03/04/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|012|No|.70527|01/25/2022|.68834|01/25/2022|.69292|01/25/2022|||HYPOGLYCEMICS: METFORMINS|12016|||||No|No||INGENUS PHARMAC|No||||
metformin HCl|Yes|No|No|No|75%|50742063460|METFORMIN ER 1,000 MG OSM-TAB|60|EA|.36191|03/04/2019||Yes|No||03/04/2019||Yes|No|03/04/2019||Yes|No||||No|No|09/04/2019||Prescription required|Yes|07/29/2021|012|No|1.48331|03/29/2022|1.44771|03/29/2022|1.45735|03/29/2022|||HYPOGLYCEMICS: METFORMINS|12017|||||No|No||INGENUS PHARMAC|No||||
quetiapine fumarate|No|No|No|No|75%|50742063560|QUETIAPINE ER 50 MG TABLET|60|EA|.11108|02/05/2018||Yes|No||02/05/2018||Yes|No|02/05/2018||Yes|No||||No|No|||Prescription required|Yes|12/07/2017|027|Yes|.13845|03/29/2022|.13512|03/29/2022|.13602|03/29/2022|||ANTIPSYCHOTICS|12018|||||No|No||INGENUS PHARMAC|No||||
quetiapine fumarate|No|No|No|No|75%|50742063660|QUETIAPINE ER 150 MG TABLET|60|EA|.11825|02/05/2018||Yes|No||02/05/2018||Yes|No|02/05/2018||Yes|No||||No|No|||Prescription required|Yes|12/07/2017|027|Yes|.25256|03/29/2022|.24649|03/29/2022|.24814|03/29/2022|||ANTIPSYCHOTICS|12019|||||No|No||INGENUS PHARMAC|No||||
quetiapine fumarate|No|No|No|No|75%|50742063760|QUETIAPINE ER 200 MG TABLET|60|EA|.14333|02/05/2018||Yes|No||02/05/2018||Yes|No|02/05/2018||Yes|No||||No|No|||Prescription required|Yes|12/07/2017|027|Yes|.25825|03/29/2022|.25205|03/29/2022|.25373|03/29/2022|||ANTIPSYCHOTICS|12020|||||No|No||INGENUS PHARMAC|No||||
quetiapine fumarate|No|No|No|No|75%|50742063860|QUETIAPINE ER 300 MG TABLET|60|EA|.172|02/05/2018||Yes|No||02/05/2018||Yes|No|02/05/2018||Yes|No||||No|No|||Prescription required|Yes|12/07/2017|027|Yes|.35477|03/29/2022|.34625|03/29/2022|.34856|03/29/2022|||ANTIPSYCHOTICS|12021|||||No|No||INGENUS PHARMAC|No||||
quetiapine fumarate|No|No|No|No|75%|50742063960|QUETIAPINE ER 400 MG TABLET|60|EA|.25083|02/05/2018||Yes|No||02/05/2018||Yes|No|02/05/2018||Yes|No||||No|No|||Prescription required|Yes|12/07/2017|027|Yes|.42833|03/29/2022|.41805|03/29/2022|.42083|03/29/2022|||ANTIPSYCHOTICS|12022|||||No|No||INGENUS PHARMAC|No||||
carisoprodol|No|No|No|No|90%|50742065601|CARISOPRODOL 350 MG TABLET|100|EA|.0602|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|12023|||||No|No||INGENUS PHARMAC|No||||
estradiol/norethindrone acet|No|No|No|No|75%|50742065728|ESTRADIOL-NORETH 1-0.5 MG TAB|28|EA|1.15178|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|No|||Yes|1.11831|03/29/2022|1.09147|03/29/2022|1.09873|03/29/2022||||12024|||||No|No||INGENUS PHARMAC|No||||
estradiol/norethindrone acet|No|No|No|No|75%|50742065784|ESTRADIOL-NORETH 1-0.5 MG TAB|28|EA|1.15178|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|No|||Yes|1.11831|03/29/2022|1.09147|03/29/2022|1.09873|03/29/2022||||12025|||||No|No||INGENUS PHARMAC|No||||
estradiol/norethindrone acet|No|No|No|No|75%|50742065828|ESTRADIOL-NORETH 0.5-0.1 MG TB|28|EA|1.25928|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|No|||Yes|1.2896|03/29/2022|1.25864|03/29/2022|1.26703|03/29/2022||||12026|||||No|No||INGENUS PHARMAC|No||||
estradiol/norethindrone acet|No|No|No|No|75%|50742065884|ESTRADIOL-NORETH 0.5-0.1 MG TB|28|EA|1.25928|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|No|||Yes|1.2896|03/29/2022|1.25864|03/29/2022|1.26703|03/29/2022||||12027|||||No|No||INGENUS PHARMAC|No||||
ruxolitinib phosphate|No|No|No|No|75%|50881000560|JAKAFI 5 MG TABLET|60|EA|111.63516|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|||Prescription required|No||173|No|254.42432|01/18/2022|250.78969|01/18/2022|238.84732|01/18/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|12028|||||No|No||INCYTE CORPORAT|No||||
ruxolitinib phosphate|No|No|No|No|75%|50881001060|JAKAFI 10 MG TABLET|60|EA|111.63516|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|||Prescription required|No||173|No|254.42432|01/18/2022|250.78969|01/18/2022|238.84732|01/18/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|12029|||||No|No||INCYTE CORPORAT|No||||
ruxolitinib phosphate|No|No|No|No|75%|50881001560|JAKAFI 15 MG TABLET|60|EA|111.63516|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|||Prescription required|No||173|No|254.42432|01/18/2022|250.78969|01/18/2022|238.84732|01/18/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|12030|||||No|No||INCYTE CORPORAT|No||||
ruxolitinib phosphate|No|No|No|No|75%|50881002060|JAKAFI 20 MG TABLET|60|EA|111.63516|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|||Prescription required|No||173|No|254.42432|01/18/2022|250.78969|01/18/2022|238.84732|01/18/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|12031|||||No|No||INCYTE CORPORAT|No||||
ruxolitinib phosphate|No|No|No|No|75%|50881002560|JAKAFI 25 MG TABLET|60|EA|111.63516|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|||Prescription required|No||173|No|254.42432|01/18/2022|250.78969|01/18/2022|238.84732|01/18/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|12032|||||No|No||INCYTE CORPORAT|No||||
pemigatinib|No|No|No|No|75%|50881002601|PEMAZYRE 4.5 MG TABLET|14|EA|537.80714|12/01/2021||Yes|No||12/01/2021||Yes|No|12/01/2021||Yes|No||||No|No|||Prescription required|No||239|No|1225.69999|01/18/2022|1208.18999|01/18/2022|1150.65713|01/18/2022|||ONCOLOGY: ORAL - OTHER|12033|||||No|No||INCYTE CORPORAT|No||||
pemigatinib|No|No|No|No|75%|50881002701|PEMAZYRE 9 MG TABLET|14|EA|537.80714|12/01/2021||Yes|No||12/01/2021||Yes|No|12/01/2021||Yes|No||||No|No|||Prescription required|No||239|No|1225.69999|01/18/2022|1208.18999|01/18/2022|1150.65713|01/18/2022|||ONCOLOGY: ORAL - OTHER|12034|||||No|No||INCYTE CORPORAT|No||||
pemigatinib|No|No|No|No|75%|50881002801|PEMAZYRE 13.5 MG TABLET|14|EA|537.80714|12/01/2021||Yes|No||12/01/2021||Yes|No|12/01/2021||Yes|No||||No|No|||Prescription required|No||239|No|1225.69999|01/18/2022|1208.18999|01/18/2022|1150.65713|01/18/2022|||ONCOLOGY: ORAL - OTHER|12035|||||No|No||INCYTE CORPORAT|No||||
iron bg,ps/folic/B,C no.12/suc|No|No|No|No|75%|50967012630|IROSPAN 24/6 TABLET|30|EA|2.56079|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|506|No|5.83622|02/08/2022|5.75284|02/08/2022|5.4789|02/08/2022|||IRON: ORAL|12036|||||No|No||WOMEN'S CHOICE|No||||
prenatal vit86/iron/folic acid|No|No|No|No|75%|50967021990|NESTABS TABLET|90|EA|.93763|10/01/2011||Yes|No||10/01/2011||Yes|No|10/01/2011||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|2.13693|02/23/2021|2.10641|02/23/2021|2.0061|02/23/2021|||PRENATAL VITAMINS|12037|||||No|No||WOMEN'S CHOICE|No||||
prenatal 87/iron bis/folic/dha|No|No|No|No|75%|50967031730|NESTABS DHA COMBO PACK|60|EA|1.35585|10/01/2011||Yes|No||10/01/2011||Yes|No|10/01/2011||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|3.09009|02/08/2022|3.04595|02/08/2022|2.9009|02/08/2022|||PRENATAL VITAMINS|12038|||||No|No||WOMEN'S CHOICE|No||||
guaifenesin/pseudoephedrne HCl|No|No|No|No|75%|50991021201|POLY-VENT IR TABLET|100|EA|.26337|07/03/2013||Yes|No||||No|No|07/03/2013||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|.60025|04/24/2018|.59167|04/24/2018|.5635|04/24/2018|||COUGH AND COLD: COLD|12039|||||No|No||POLY PHARMACEUT|No||||
guaifenesin/DM/pseudoephedrine|No|No|No|No|75%|50991021401|POLY-VENT DM TABLET|100|EA|.27184|07/03/2013||Yes|No||||No|No|07/03/2013||Yes|No||||No|No|||Over the counter|No||184|Yes|.61955|02/28/2017|.6107|02/28/2017|.58162|02/28/2017|||COUGH AND COLD: NON-NARCOTIC|12040|||||No|No||POLY PHARMACEUT|No||||
thonzylamine/phenylephrine/DM|No|No|No|No|75%|50991022016|POLY-HIST DM LIQUID|473|ML|.06966|07/03/2013||Yes|No||||No|No|07/03/2013||Yes|No||||No|No|||Over the counter|No||184|Yes|.15876|04/27/2021|.15649|04/27/2021|.14904|04/27/2021|||COUGH AND COLD: NON-NARCOTIC|12041|||||No|No||POLY PHARMACEUT|No||||
thonzylamine/chlophedianol|No|No|No|No|75%|50991022245|POLY-HIST PD LIQUID|45|ML|.28446|07/03/2013|03/31/2022|Yes|No||||No|No|07/03/2013|03/31/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.64831|02/26/2019|.63905|02/26/2019|.60862|02/26/2019|||COUGH AND COLD: NON-NARCOTIC|12042|No Longer Rebatable||No Longer Rebatable||No|No||POLY PHARMACEUT|No||||
dexchlorphen/phenylephrine/DM|No|No|No|No|75%|50991049216|POLYTUSSIN DM SYRUP|480|ML|.02193|07/09/2018||Yes|No||||No|No|07/09/2018||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|No|.04893|03/29/2022|.04775|03/29/2022|.04807|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|12043|||||No|No||POLY PHARMACEUT|No||||
pseudoeph/DM/guaifen/acetamin|No|No|No|No|75%|50991053501|DURAFLU 325-20-200-60 MG TAB|100|EA|.39044|07/06/2018||Yes|No||||No|No|||No|No||||No|No|||Over the counter|Yes|07/29/2021|184|No|.88984|02/25/2020|.87712|02/25/2020|.83536|02/25/2020|||COUGH AND COLD: NON-NARCOTIC|12044|||||No|No||POLY PHARMACEUT|No||||
doxylamine/phenylephrine HCl|No|No|No|No|75%|50991062601|POLY HIST FORTE 10.5-10 MG TAB|100|EA|.27266|09/23/2019||Yes|No||||No|No|09/23/2019||Yes|No||||No|No|||Over the counter|No||182|Yes|.62141|03/01/2022|.61254|03/01/2022|.58337|03/01/2022|||COUGH AND COLD: COLD|12045|||||No|No||POLY PHARMACEUT|No||||
guaifenesin/phenylephrine HCl|No|No|No|No|75%|50991073690|DECONEX IR 385-10 MG TABLET|90|EA|.27118|12/09/2016||Yes|No||||No|No|12/09/2016||Yes|No||||No|No|||Over the counter|No||182|Yes|.61804|03/01/2022|.60921|03/01/2022|.5802|03/01/2022|||COUGH AND COLD: COLD|12046|||||No|No||POLY PHARMACEUT|No||||
guaifen/dextromethorphan/PE|No|No|No|No|75%|50991074001|DECONEX DMX 17.5-400-10 MG TAB|100|EA|.2758|09/23/2019||Yes|No||||No|No|09/23/2019||Yes|No||||No|No|||Over the counter|No||184|Yes|.62857|03/01/2022|.61959|03/01/2022|.59008|03/01/2022|||COUGH AND COLD: NON-NARCOTIC|12047|||||No|No||POLY PHARMACEUT|No||||
dexbrompheniramine maleate|No|No|No|No|75%|50991078360|ALA-HIST IR 2 MG TABLET|60|EA|.27118|09/01/2011||Yes|No||||No|No|09/01/2011||Yes|No||||No|No|||Over the counter|No||182|Yes|.61804|03/01/2022|.60921|03/01/2022|.5802|03/01/2022|||COUGH AND COLD: COLD|12048|||||No|No||POLY PHARMACEUT|No||||
d-methorphan/pe/dexbromphenir|No|No|No|No|75%|50991078490|ALAHIST CF TABLET|90|EA|.27577|12/11/2017||Yes|No||||No|No|12/11/2017||Yes|No||||No|No|||Over the counter|No||184|Yes|.6285|03/01/2022|.61952|03/01/2022|.59002|03/01/2022|||COUGH AND COLD: NON-NARCOTIC|12049|||||No|No||POLY PHARMACEUT|No||||
dexbrompheniramin/phenylephrin|No|No|No|No|75%|50991078890|ALAHIST PE 2-7.5 MG TABLET|90|EA|.27577|12/15/2020||Yes|No||||No|No|12/15/2020||Yes|No||||No|No|||Over the counter|No||182|No|.6285|03/01/2022|.61952|03/01/2022|.59002|03/01/2022|||COUGH AND COLD: COLD|12050|||||No|No||POLY PHARMACEUT|No||||
d-methorphan/pe/dexbromphenir|No|No|No|No|75%|50991082616|ALAHIST DM 2-15-7.5 MG/5 ML LQ|473|ML|.02293|12/13/2016||Yes|No||||No|No|12/13/2016||Yes|No||||No|No|||Over the counter|No||184|Yes|.05227|03/01/2022|.05152|03/01/2022|.04907|03/01/2022|||COUGH AND COLD: NON-NARCOTIC|12051|||||No|No||POLY PHARMACEUT|No||||
COVID-19 test specimen collect|Yes|No|No|No|75%|51044000842|EVERLYWELL COVID19 HOM COLLECT|1|EA|.0043|01/03/2022||Yes|No||01/03/2022||Yes|No|01/03/2022||Yes|No||01/03/2022||Yes|No|01/03/2022||Over the counter|No|||No||||||||||12052|||||No|No||EVERLYWELL INC.|No||||
metolazone|No|No|No|No|75%|51079002320|METOLAZONE 2.5 MG TABLET|100|EA|1.17721|04/15/2005||Yes|No||04/15/2005||Yes|No|04/15/2005||Yes|No||||No|No|||Prescription required|No|||No|.75368|03/29/2022|.73559|03/29/2022|.74049|03/29/2022||||12053|||||No|No||MYLAN INSTITUTI|No||||
metolazone|No|No|No|No|75%|51079002420|METOLAZONE 5 MG TABLET|100|EA|1.33764|02/01/2005||Yes|No||02/01/2005||Yes|No|02/01/2005||Yes|No||||No|No|||Prescription required|No|||No|.77158|03/29/2022|.75306|03/29/2022|.75807|03/29/2022||||12054|||||No|No||MYLAN INSTITUTI|No||||
tacrolimus|No|No|No|No|75%|51079002820|TACROLIMUS 5 MG CAPSULE (IR)|100|EA|3.3325|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No||229|No|2.05753|03/29/2022|2.00814|03/29/2022|2.02152|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|12055|||||No|No||MYLAN INSTITUTI|No||||
pantoprazole sodium|No|No|No|No|75%|51079005120|PANTOPRAZOLE SOD DR 40 MG TAB|100|EA|.12259|01/29/2016||Yes|No||01/29/2016||Yes|No|01/29/2016||Yes|No||||No|No|||Prescription required|No||047|No|.05828|03/29/2022|.05688|03/29/2022|.05726|03/29/2022|||PROTON PUMP INHIBITORS|12056|||||No|No||MYLAN INSTITUTI|No||||
chlorthalidone|No|No|No|No|75%|51079005820|CHLORTHALIDONE 25 MG TABLET|100|EA|.8225|02/12/2016||Yes|No||02/12/2016||Yes|No|02/12/2016||Yes|No||||No|No|||Prescription required|No|||No|.16117|03/29/2022|.1573|03/29/2022|.15834|03/29/2022||||12057|||||No|No||MYLAN INSTITUTI|No||||
hydralazine HCl|No|No|No|No|75%|51079007420|HYDRALAZINE 10 MG TABLET|100|EA|.09864|12/18/2007||Yes|No||12/18/2007||Yes|No|12/18/2007||Yes|No||||No|No|||Prescription required|No|||No|.03439|03/29/2022|.03356|03/29/2022|.03378|03/29/2022||||12058|||||No|No||MYLAN INSTITUTI|No||||
hydralazine HCl|No|No|No|No|75%|51079007520|HYDRALAZINE 25 MG TABLET|100|EA|.09472|12/18/2007||Yes|No||12/18/2007||Yes|No|12/18/2007||Yes|No||||No|No|||Prescription required|No|||No|.04116|03/29/2022|.04017|03/29/2022|.04043|03/29/2022||||12059|||||No|No||MYLAN INSTITUTI|No||||
hydralazine HCl|No|No|No|No|75%|51079007620|HYDRALAZINE 50 MG TABLET|100|EA|.11906|||No|No||||No|No|||No|No||03/26/2008||Yes|No|||Prescription required|No|||No|.0521|03/29/2022|.05084|03/29/2022|.05118|03/29/2022||||12060|||||No|No||MYLAN INSTITUTI|No||||
mirtazapine|No|No|No|No|75%|51079008620|MIRTAZAPINE 15 MG TABLET|100|EA|.07095|09/10/2004||Yes|No||09/10/2004||Yes|No|09/10/2004||Yes|No||||No|No|||Prescription required|No||031|Yes|.08357|03/29/2022|.08156|03/29/2022|.0821|03/29/2022|||ANTIDEPRESSANTS: OTHER|12061|||||No|No||MYLAN INSTITUTI|No||||
mirtazapine|No|No|No|No|75%|51079008720|MIRTAZAPINE 30 MG TABLET|100|EA|.10148|09/10/2004||Yes|No||09/10/2004||Yes|No|09/10/2004||Yes|No||||No|No|||Prescription required|No||031|No|.09806|03/29/2022|.0957|03/29/2022|.09634|03/29/2022|||ANTIDEPRESSANTS: OTHER|12062|||||No|No||MYLAN INSTITUTI|No||||
mirtazapine|No|No|No|No|75%|51079008820|MIRTAZAPINE 45 MG TABLET|100|EA|.12599|09/10/2004||Yes|No||09/10/2004||Yes|No|09/10/2004||Yes|No||||No|No|||Prescription required|No||031|No|.13324|03/29/2022|.13004|03/29/2022|.1309|03/29/2022|||ANTIDEPRESSANTS: OTHER|12063|||||No|No||MYLAN INSTITUTI|No||||
valacyclovir HCl|No|No|No|No|75%|51079009303|VALACYCLOVIR HCL 500 MG TABLET|30|EA|1.31279|01/29/2016||Yes|No||01/29/2016||Yes|No|01/29/2016||Yes|No||||No|No|||Prescription required|No||025|No|.29328|03/29/2022|.28624|03/29/2022|.28814|03/29/2022|||ANTIVIRALS: ORAL|12064|||||No|No||MYLAN INSTITUTI|No||||
lansoprazole|No|No|No|No|75%|51079012108|LANSOPRAZOLE DR 30 MG CAPSULE|80|EA|1.01136|11/25/2015||Yes|No||11/25/2015||Yes|No|11/25/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.12249|03/29/2022|.11955|03/29/2022|.12034|03/29/2022|||PROTON PUMP INHIBITORS|12065|||||No|No||MYLAN INSTITUTI|No||||
chlordiazepoxide HCl|No|No|No|No|90%|51079014120|CHLORDIAZEPOXIDE 25 MG CAPSULE|100|EA|.22815|10/22/2015|04/30/2022|Yes|No||10/22/2015|04/30/2022|Yes|No|10/22/2015|04/30/2022|Yes|No||||No|No|||Prescription required|No||090|Yes|.13592|03/29/2022|.13265|03/29/2022|.13354|03/29/2022|||ANXIOLYTICS|12066|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN INSTITUTI|No||||
voriconazole|No|No|No|No|75%|51079016403|VORICONAZOLE 50 MG TABLET|30|EA|3.66833|09/28/2015||Yes|No||09/28/2015||Yes|No|09/28/2015||Yes|No||||No|No|||Prescription required|Yes|10/12/2017|069|No|8.36038|01/24/2017|8.24094|01/24/2017|7.84852|01/24/2017|||ANTIFUNGALS: ORAL|12067|||||No|No||MYLAN INSTITUTI|No||||
abacavir sulfate|No|No|No|No|75%|51079020406|ABACAVIR 300 MG TABLET|50|EA|5.18172|09/28/2015||Yes|No||09/28/2015||Yes|No|09/28/2015||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.69669|03/29/2022|.67996|03/29/2022|.68449|03/29/2022|||HIV / AIDS|12068|||||No|No||MYLAN INSTITUTI|No||||
allopurinol|No|No|No|No|75%|51079020520|ALLOPURINOL 100 MG TABLET|100|EA|.13506|10/22/2015||Yes|No||10/22/2015||Yes|No|10/22/2015||Yes|No||||No|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|12069|||||No|No||MYLAN INSTITUTI|No||||
allopurinol|No|No|No|No|75%|51079020620|ALLOPURINOL 300 MG TABLET|100|EA|.2715|10/22/2015||Yes|No||10/22/2015||Yes|No|10/22/2015||Yes|No||||No|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|12070|||||No|No||MYLAN INSTITUTI|No||||
atorvastatin calcium|Yes|No|No|No|75%|51079020820|ATORVASTATIN 10 MG TABLET|100|EA|.13299|10/22/2015||Yes|No||10/22/2015||Yes|No|10/22/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|12071|||||No|No||MYLAN INSTITUTI|No||||
atorvastatin calcium|Yes|No|No|No|75%|51079020920|ATORVASTATIN 20 MG TABLET|100|EA|.15897|10/22/2015||Yes|No||10/22/2015||Yes|No|10/22/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|12072|||||No|No||MYLAN INSTITUTI|No||||
atorvastatin calcium|Yes|No|No|No|75%|51079021020|ATORVASTATIN 40 MG TABLET|100|EA|.21121|10/22/2015||Yes|No||10/22/2015||Yes|No|10/22/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|12073|||||No|No||MYLAN INSTITUTI|No||||
atorvastatin calcium|Yes|No|No|No|75%|51079021103|ATORVASTATIN 80 MG TABLET|30|EA|.23349|10/22/2015||Yes|No||10/22/2015||Yes|No|10/22/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|12074|||||No|No||MYLAN INSTITUTI|No||||
acamprosate calcium|No|No|No|No|75%|51079024106|ACAMPROSATE CALC DR 333 MG TAB|50|EA|.37117|10/11/2016||Yes|No||10/11/2016||Yes|No|10/11/2016||Yes|No||||No|No|||Prescription required|No|||No|.84593|05/11/2021|.83385|05/11/2021|.79414|05/11/2021||||12075|||||No|No||MYLAN INSTITUTI|Yes|09/01/2020|||
entacapone|No|No|No|No|75%|51079027303|ENTACAPONE 200 MG TABLET|30|EA|2.44039|02/13/2015||Yes|No||02/13/2015||Yes|No|02/13/2015||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|015|No|.43301|03/29/2022|.42261|03/29/2022|.42543|03/29/2022|||ANTIPARKINSON'S AGENTS|12076|||||No|No||MYLAN INSTITUTI|No||||
clozapine|No|No|No|No|75%|51079028804|CLOZAPINE ODT 100 MG TABLET|40|EA|2.8122|07/21/2017||Yes|No||07/21/2017||Yes|No|07/21/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|027|Yes|6.4092|03/29/2022|6.31764|03/29/2022|6.0168|03/29/2022|||ANTIPSYCHOTICS|12077|||||No|No||MYLAN INSTITUTI|No||||
chlordiazepoxide HCl|No|No|No|No|90%|51079037420|CHLORDIAZEPOXIDE 5 MG CAPSULE|100|EA|.27657|10/22/2015|02/28/2022|Yes|No||10/22/2015|02/28/2022|Yes|No|10/22/2015|02/28/2022|Yes|No||||No|No|||Prescription required|No||090|Yes|.63033|03/15/2022|.62133|03/15/2022|.59174|03/15/2022|||ANXIOLYTICS|12078|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN INSTITUTI|No||||
haloperidol|No|No|No|No|75%|51079043120|HALOPERIDOL 10 MG TABLET|100|EA|.71964|03/30/2016||Yes|No||03/30/2016||Yes|No|03/30/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.48134|03/29/2022|.46978|03/29/2022|.47291|03/29/2022|||ANTIPSYCHOTICS|12079|||||No|No||MYLAN INSTITUTI|No||||
doxepin HCl|No|No|No|No|75%|51079043620|DOXEPIN 10 MG CAPSULE|100|EA|.22901|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.22181|03/29/2022|.21648|03/29/2022|.21792|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12080|||||No|No||MYLAN INSTITUTI|No||||
doxepin HCl|No|No|No|No|75%|51079043720|DOXEPIN 25 MG CAPSULE|100|EA|.30198|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.30005|03/29/2022|.29284|03/29/2022|.29479|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12081|||||No|No||MYLAN INSTITUTI|No||||
doxepin HCl|No|No|No|No|75%|51079043820|DOXEPIN 50 MG CAPSULE|100|EA|.41851|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.41139|03/29/2022|.40151|03/29/2022|.40419|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12082|||||No|No||MYLAN INSTITUTI|No||||
levothyroxine sodium|No|No|No|No|75%|51079044020|LEVOTHYROXINE 50 MCG TABLET|100|EA|.21414|02/05/2007||Yes|No||02/05/2007||Yes|No|02/05/2007||Yes|No||||No|No|||Prescription required|No|||No|.14288|03/29/2022|.13945|03/29/2022|.14037|03/29/2022||||12083|||||No|No||MYLAN INSTITUTI|No||||
levothyroxine sodium|No|No|No|No|75%|51079044120|LEVOTHYROXINE 75 MCG TABLET|100|EA|.23667|02/05/2007||Yes|No||02/05/2007||Yes|No|02/05/2007||Yes|No||||No|No|||Prescription required|No|||No|.15545|03/29/2022|.15171|03/29/2022|.15272|03/29/2022||||12084|||||No|No||MYLAN INSTITUTI|No||||
levothyroxine sodium|No|No|No|No|75%|51079044220|LEVOTHYROXINE 100 MCG TABLET|100|EA|.24256|02/05/2007||Yes|No||02/05/2007||Yes|No|02/05/2007||Yes|No||||No|No|||Prescription required|No|||No|.17286|03/29/2022|.16871|03/29/2022|.16983|03/29/2022||||12085|||||No|No||MYLAN INSTITUTI|No||||
levothyroxine sodium|No|No|No|No|75%|51079044320|LEVOTHYROXINE 125 MCG TABLET|100|EA|.285|02/05/2007||Yes|No||02/05/2007||Yes|No|02/05/2007||Yes|No||||No|No|||Prescription required|No|||No|.18894|03/29/2022|.1844|03/29/2022|.18563|03/29/2022||||12086|||||No|No||MYLAN INSTITUTI|No||||
levothyroxine sodium|No|No|No|No|75%|51079044420|LEVOTHYROXINE 25 MCG TABLET|100|EA|.18864|02/26/2007||Yes|No||02/26/2007||Yes|No|02/26/2007||Yes|No||||No|No|||Prescription required|No|||No|.11852|03/29/2022|.11567|03/29/2022|.11644|03/29/2022||||12087|||||No|No||MYLAN INSTITUTI|No||||
levothyroxine sodium|No|No|No|No|75%|51079044520|LEVOTHYROXINE 150 MCG TABLET|100|EA|.29274|02/26/2007||Yes|No||02/26/2007||Yes|No|02/26/2007||Yes|No||||No|No|||Prescription required|No|||No|.21406|03/29/2022|.20892|03/29/2022|.21031|03/29/2022||||12088|||||No|No||MYLAN INSTITUTI|No||||
midodrine HCl|No|No|No|No|75%|51079045320|MIDODRINE HCL 5 MG TABLET|100|EA|.49011|09/05/2006||Yes|No||09/05/2006||Yes|No|09/05/2006||Yes|No||||No|No|||Prescription required|No|||No|.26381|03/29/2022|.25747|03/29/2022|.25919|03/29/2022||||12089|||||No|No||MYLAN INSTITUTI|No||||
pravastatin sodium|Yes|No|No|No|75%|51079045820|PRAVASTATIN SODIUM 20 MG TAB|100|EA|.2666|01/09/2007||Yes|No||01/09/2007||Yes|No|01/09/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.05771|03/29/2022|.05632|03/29/2022|.0567|03/29/2022|||LIPOTROPICS: STATINS|12090|||||No|No||MYLAN INSTITUTI|No||||
mycophenolate sodium|No|No|No|No|75%|51079050820|MYCOPHENOLIC ACID DR 180 MG TB|100|EA|1.74223|02/13/2015||Yes|No||02/13/2015||Yes|No|02/13/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|229|No|.54568|03/29/2022|.53258|03/29/2022|.53613|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|12091|||||No|No||MYLAN INSTITUTI|No||||
mycophenolate sodium|No|No|No|No|75%|51079050920|MYCOPHENOLIC ACID DR 360 MG TB|100|EA|3.48446|02/13/2015||Yes|No||02/13/2015||Yes|No|02/13/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|229|No|.56705|03/29/2022|.55344|03/29/2022|.55712|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|12092|||||No|No||MYLAN INSTITUTI|No||||
capecitabine|No|No|No|No|75%|51079051005|CAPECITABINE 500 MG TABLET|20|EA|15.09751|06/23/2015|05/31/2022|Yes|No||06/23/2015|05/31/2022|Yes|No|06/23/2015|05/31/2022|Yes|No||||No|No|||Prescription required|No||502|No|.61977|12/28/2021|.60489|12/28/2021|.60892|12/28/2021|||ONCOLOGY: ORAL - BREAST|12093|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN INSTITUTI|No||||
acyclovir|No|No|No|No|75%|51079055068|ACYCLOVIR 5% OINTMENT|5|GM|10.06028|02/13/2015||Yes|No||02/13/2015||Yes|No|02/13/2015||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|22.92808|01/23/2018|22.60053|01/23/2018|21.52432|01/23/2018|||ANTIVIRALS: TOPICAL|12094|||||No|No||MYLAN INSTITUTI|No||||
trifluoperazine HCl|No|No|No|No|75%|51079057220|TRIFLUOPERAZINE 1 MG TABLET|100|EA|.48099|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|1.09622|06/25/2019|1.08056|06/25/2019|1.02911|06/25/2019|||ANTIPSYCHOTICS|12095|||||No|No||MYLAN INSTITUTI|No||||
trifluoperazine HCl|No|No|No|No|75%|51079057320|TRIFLUOPERAZINE 2 MG TABLET|100|EA|.71655|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|1.63307|09/24/2019|1.60974|09/24/2019|1.53308|09/24/2019|||ANTIPSYCHOTICS|12096|||||No|No||MYLAN INSTITUTI|No||||
trifluoperazine HCl|No|No|No|No|75%|51079057420|TRIFLUOPERAZINE 5 MG TABLET|100|EA|.91263|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.87564|11/23/2021|.85462|11/23/2021|.86031|11/23/2021|||ANTIPSYCHOTICS|12097|||||No|No||MYLAN INSTITUTI|No||||
trifluoperazine HCl|No|No|No|No|75%|51079057520|TRIFLUOPERAZINE 10 MG TABLET|100|EA|1.10316|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|2.51419|08/27/2019|2.47827|08/27/2019|2.36026|08/27/2019|||ANTIPSYCHOTICS|12098|||||No|No||MYLAN INSTITUTI|No||||
cetirizine HCl|No|No|No|No|75%|51079059720|CETIRIZINE HCL 10 MG TABLET|100|EA|.06278|08/23/2009||Yes|No||||No|No|08/23/2009||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|12099|||||No|No||MYLAN INSTITUTI|No||||
fenofibrate nanocrystallized|No|No|No|No|75%|51079059920|FENOFIBRATE 48 MG TABLET|100|EA|.53547|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No||055|No|.11999|03/29/2022|.11711|03/29/2022|.11789|03/29/2022|||LIPOTROPICS: OTHER|12100|||||No|No||MYLAN INSTITUTI|No||||
fenofibrate nanocrystallized|No|No|No|No|75%|51079060820|FENOFIBRATE 145 MG TABLET|100|EA|1.41869|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No||055|No|.16424|03/29/2022|.16029|03/29/2022|.16136|03/29/2022|||LIPOTROPICS: OTHER|12101|||||No|No||MYLAN INSTITUTI|No||||
mafenide acetate|No|No|No|No|75%|51079062381|SULFAMYLON 8.5% CREAM|56.7|GM|.45896|03/13/2007|08/31/2023|Yes|No||03/13/2007|08/31/2023|Yes|No|03/13/2007|08/31/2023|Yes|No||||No|No|||Prescription required|No|||No|1.04602|06/01/2016|1.03107|06/01/2016|.98198|06/01/2016||||12102|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN/RISING PH|No||||
mafenide acetate|No|No|No|No|75%|51079062382|SULFAMYLON 8.5% CREAM|113.4|GM|.44114|05/04/2007|05/31/2023|Yes|No||05/04/2007|05/31/2023|Yes|No|05/04/2007|05/31/2023|Yes|No||||No|No|||Prescription required|No|||No|1.0054|06/01/2016|.99103|06/01/2016|.94384|06/01/2016||||12103|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN/RISING PH|No||||
mafenide acetate|No|No|No|No|75%|51079062383|SULFAMYLON 8.5% CREAM|453.6|GM|.39531|02/14/2007|11/30/2022|Yes|No||02/14/2007|11/30/2022|Yes|No|02/14/2007|11/30/2022|Yes|No||||No|No|||Prescription required|No|||No|.90094|06/01/2016|.88807|06/01/2016|.84578|06/01/2016||||12104|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN/RISING PH|No||||
mafenide acetate|No|No|No|No|75%|51079062485|SULFAMYLON POWDER PACKET|5|EA|98.13374|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No|||No|223.65364|06/01/2016|220.45858|06/01/2016|209.96056|06/01/2016||||12105|||||No|No||MYLAN INSTITUTI|No||||
prazosin HCl|No|No|No|No|75%|51079063020|PRAZOSIN 1 MG CAPSULE|100|EA|.64925|01/29/2016||Yes|No||01/29/2016||Yes|No|01/29/2016||Yes|No||||No|No|||Prescription required|No|||No|.1999|03/29/2022|.1951|03/29/2022|.1964|03/29/2022||||12106|||||No|No||MYLAN INSTITUTI|No||||
prazosin HCl|No|No|No|No|75%|51079063120|PRAZOSIN 2 MG CAPSULE|100|EA|.90429|01/29/2016||Yes|No||01/29/2016||Yes|No|01/29/2016||Yes|No||||No|No|||Prescription required|No|||No|.29873|03/29/2022|.29156|03/29/2022|.2935|03/29/2022||||12107|||||No|No||MYLAN INSTITUTI|No||||
prazosin HCl|No|No|No|No|75%|51079063220|PRAZOSIN 5 MG CAPSULE|100|EA|1.54361|01/29/2016||Yes|No||01/29/2016||Yes|No|01/29/2016||Yes|No||||No|No|||Prescription required|No|||No|.53856|03/29/2022|.52563|03/29/2022|.52913|03/29/2022||||12108|||||No|No||MYLAN INSTITUTI|No||||
doxepin HCl|No|No|No|No|75%|51079065120|DOXEPIN 100 MG CAPSULE|100|EA|.71543|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.67991|03/29/2022|.66359|03/29/2022|.66801|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12109|||||No|No||MYLAN INSTITUTI|No||||
albuterol sulfate|No|No|No|No|75%|51079065720|ALBUTEROL SULFATE 2 MG TAB|100|EA|2.52625|09/28/2015||Yes|No||09/28/2015||Yes|No|09/28/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|037|No|.67057|07/27/2021|.65447|07/27/2021|.65883|07/27/2021|||BRONCHODILATORS: BETA AGONIST|12110|||||No|No||MYLAN INSTITUTI|No||||
methotrexate sodium|No|No|No|No|75%|51079067005|METHOTREXATE 2.5 MG TABLET|20|EA|1.1911|10/06/2016||Yes|No||10/06/2016||Yes|No|10/06/2016||Yes|No||||No|No|||Prescription required|No|||No|.26817|03/29/2022|.26173|03/29/2022|.26347|03/29/2022||||12111|||||No|No||MYLAN INSTITUTI|No||||
atenolol|No|No|No|No|75%|51079068420|ATENOLOL 50 MG TABLET|100|EA|.03913|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||070|No|.02861|03/29/2022|.02792|03/29/2022|.0281|03/29/2022|||BETA-BLOCKERS|12112|||||No|No||MYLAN INSTITUTI|No||||
atenolol|No|No|No|No|75%|51079068520|ATENOLOL 100 MG TABLET|100|EA|.09292|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||070|No|.04816|03/29/2022|.047|03/29/2022|.04731|03/29/2022|||BETA-BLOCKERS|12113|||||No|No||MYLAN INSTITUTI|No||||
loperamide HCl|No|No|No|No|75%|51079069020|LOPERAMIDE 2 MG CAPSULE|100|EA|.31291|||No|No||||No|No|||No|No||09/01/1999||Yes|No|||Prescription required|No|||No|.28168|03/29/2022|.27491|03/29/2022|.27675|03/29/2022||||12114|||||No|No||MYLAN INSTITUTI|No||||
haloperidol|No|No|No|No|75%|51079073320|HALOPERIDOL 0.5 MG TABLET|100|EA|.12444|09/10/2004||Yes|No||09/10/2004||Yes|No|09/10/2004||Yes|No||||No|No|||Prescription required|No||027|Yes|.24816|03/29/2022|.2422|03/29/2022|.24381|03/29/2022|||ANTIPSYCHOTICS|12115|||||No|No||MYLAN INSTITUTI|No||||
haloperidol|No|No|No|No|75%|51079073420|HALOPERIDOL 1 MG TABLET|100|EA|.17634|09/10/2004||Yes|No||09/10/2004||Yes|No|09/10/2004||Yes|No||||No|No|||Prescription required|No||027|Yes|.34011|03/29/2022|.33194|03/29/2022|.33415|03/29/2022|||ANTIPSYCHOTICS|12116|||||No|No||MYLAN INSTITUTI|No||||
haloperidol|No|No|No|No|75%|51079073520|HALOPERIDOL 2 MG TABLET|100|EA|.24153|11/25/2015||Yes|No||11/25/2015||Yes|No|11/25/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.43109|03/29/2022|.42074|03/29/2022|.42354|03/29/2022|||ANTIPSYCHOTICS|12117|||||No|No||MYLAN INSTITUTI|No||||
haloperidol|No|No|No|No|75%|51079073620|HALOPERIDOL 5 MG TABLET|100|EA|.3913|09/10/2004||Yes|No||09/10/2004||Yes|No|09/10/2004||Yes|No||||No|No|||Prescription required|No||027|Yes|.44921|03/29/2022|.43842|03/29/2022|.44134|03/29/2022|||ANTIPSYCHOTICS|12118|||||No|No||MYLAN INSTITUTI|No||||
clozapine|No|No|No|No|75%|51079074920|CLOZAPINE 200 MG TABLET|100|EA|1.1235|10/11/2016||Yes|No||10/11/2016||Yes|No|10/11/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|1.46893|03/29/2022|1.43367|03/29/2022|1.44322|03/29/2022|||ANTIPSYCHOTICS|12119|||||No|No||MYLAN INSTITUTI|No||||
atenolol|No|No|No|No|75%|51079075920|ATENOLOL 25 MG TABLET|100|EA|.07482|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||070|No|.02437|03/29/2022|.02378|03/29/2022|.02394|03/29/2022|||BETA-BLOCKERS|12120|||||No|No||MYLAN INSTITUTI|No||||
divalproex sodium|No|No|No|No|75%|51079076608|DIVALPROEX SOD ER 250 MG TAB|80|EA|.63236|09/28/2015||Yes|No||09/28/2015||Yes|No|09/28/2015||Yes|No||||No|No|||Prescription required|No||056|Yes|.17839|03/29/2022|.1741|03/29/2022|.17526|03/29/2022|||ANTICONVULSANTS|12121|||||No|No||MYLAN INSTITUTI|No||||
divalproex sodium|No|No|No|No|75%|51079076708|DIVALPROEX SOD ER 500 MG TAB|80|EA|1.06855|09/28/2015||Yes|No||09/28/2015||Yes|No|09/28/2015||Yes|No||||No|No|||Prescription required|No||056|No|.21008|03/29/2022|.20503|03/29/2022|.2064|03/29/2022|||ANTICONVULSANTS|12122|||||No|No||MYLAN INSTITUTI|No||||
carvedilol|No|No|No|No|75%|51079077120|CARVEDILOL 3.125 MG TABLET|100|EA|.05568|09/19/2007||Yes|No||09/19/2007||Yes|No|09/19/2007||Yes|No||||No|No|||Prescription required|No||070|No|.01877|03/29/2022|.01831|03/29/2022|.01844|03/29/2022|||BETA-BLOCKERS|12123|||||No|No||MYLAN INSTITUTI|No||||
pravastatin sodium|Yes|No|No|No|75%|51079078220|PRAVASTATIN SODIUM 40 MG TAB|100|EA|.3526|10/10/2007||Yes|No||10/10/2007||Yes|No|10/10/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.08966|03/29/2022|.0875|03/29/2022|.08809|03/29/2022|||LIPOTROPICS: STATINS|12124|||||No|No||MYLAN INSTITUTI|No||||
metoprolol tartrate|No|No|No|No|75%|51079080120|METOPROLOL TARTRATE 50 MG TAB|100|EA|.03315|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||070|No|.02252|03/29/2022|.02197|03/29/2022|.02212|03/29/2022|||BETA-BLOCKERS|12125|||||No|No||MYLAN INSTITUTI|No||||
glipizide|Yes|No|No|No|75%|51079081020|GLIPIZIDE 5 MG TABLET|100|EA|.13588|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.03474|03/29/2022|.0339|03/29/2022|.03413|03/29/2022||||12126|||||No|No||MYLAN INSTITUTI|No||||
glipizide|Yes|No|No|No|75%|51079081120|GLIPIZIDE 10 MG TABLET|100|EA|.27171|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.04827|03/29/2022|.04711|03/29/2022|.04742|03/29/2022||||12127|||||No|No||MYLAN INSTITUTI|No||||
nadolol|No|No|No|No|75%|51079081220|NADOLOL 20 MG TABLET|100|EA|2.21845|11/25/2015||Yes|No||11/25/2015||Yes|No|11/25/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|070|No|.34023|03/29/2022|.33206|03/29/2022|.33427|03/29/2022|||BETA-BLOCKERS|12128|||||No|No||MYLAN INSTITUTI|No||||
nadolol|No|No|No|No|75%|51079081320|NADOLOL 40 MG TABLET|100|EA|2.58946|11/25/2015||Yes|No||11/25/2015||Yes|No|11/25/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|070|No|.40202|03/29/2022|.39237|03/29/2022|.39498|03/29/2022|||BETA-BLOCKERS|12129|||||No|No||MYLAN INSTITUTI|No||||
tacrolimus|No|No|No|No|75%|51079081720|TACROLIMUS 0.5 MG CAPSULE (IR)|100|EA|.473|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No||229|No|.26138|03/29/2022|.2551|03/29/2022|.2568|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|12130|||||No|No||MYLAN INSTITUTI|No||||
tacrolimus|No|No|No|No|75%|51079081820|TACROLIMUS 1 MG CAPSULE (IR)|100|EA|.4945|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No||229|No|.35645|03/29/2022|.34789|03/29/2022|.35021|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|12131|||||No|No||MYLAN INSTITUTI|No||||
levetiracetam|No|No|No|No|75%|51079082120|LEVETIRACETAM 500 MG TABLET|100|EA|.25043|11/25/2015||Yes|No||11/25/2015||Yes|No|11/25/2015||Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|12132|||||No|No||MYLAN INSTITUTI|No||||
phenytoin sodium extended|No|No|No|No|75%|51079090520|PHENYTOIN SOD EXT 100 MG CAP|100|EA|.24393|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||056|No|.15598|03/29/2022|.15223|03/29/2022|.15325|03/29/2022|||ANTICONVULSANTS|12133|||||No|No||MYLAN INSTITUTI|No||||
verapamil HCl|No|No|No|No|75%|51079091720|VERAPAMIL ER 120 MG CAPSULE|100|EA|1.92261|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||045|No|1.14665|03/29/2022|1.11913|03/29/2022|1.12658|03/29/2022|||CALCIUM CHANNEL BLOCKERS|12134|||||No|No||MYLAN INSTITUTI|No||||
clozapine|No|No|No|No|75%|51079092120|CLOZAPINE 25 MG TABLET|100|EA|.2795|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.26318|03/29/2022|.25686|03/29/2022|.25857|03/29/2022|||ANTIPSYCHOTICS|12135|||||No|No||MYLAN INSTITUTI|No||||
clozapine|No|No|No|No|75%|51079092220|CLOZAPINE 100 MG TABLET|100|EA|.7095|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.60868|03/29/2022|.59407|03/29/2022|.59802|03/29/2022|||ANTIPSYCHOTICS|12136|||||No|No||MYLAN INSTITUTI|No||||
carbidopa/levodopa|No|No|No|No|75%|51079092320|CARBIDOPA-LEVO ER 50-200 TAB|100|EA|.3836|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||015|No|.29671|03/29/2022|.28958|03/29/2022|.29151|03/29/2022|||ANTIPARKINSON'S AGENTS|12137|||||No|No||MYLAN INSTITUTI|No||||
diltiazem HCl|No|No|No|No|75%|51079092420|DILTIAZEM 12HR ER 60 MG CAP|100|EA|1.42364|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||045|No|2.24166|03/29/2022|2.18786|03/29/2022|2.20243|03/29/2022|||CALCIUM CHANNEL BLOCKERS|12138|||||No|No||MYLAN INSTITUTI|No||||
diltiazem HCl|No|No|No|No|75%|51079092520|DILTIAZEM 12HR ER 90 MG CAP|100|EA|1.67424|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||045|No|2.28512|11/23/2021|2.23027|11/23/2021|2.24513|11/23/2021|||CALCIUM CHANNEL BLOCKERS|12139|||||No|No||MYLAN INSTITUTI|No||||
diltiazem HCl|No|No|No|No|75%|51079092620|DILTIAZEM 12HR ER 120 MG CAP|100|EA|2.33636|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||045|No|3.09075|03/29/2022|3.01657|03/29/2022|3.03666|03/29/2022|||CALCIUM CHANNEL BLOCKERS|12140|||||No|No||MYLAN INSTITUTI|No||||
carvedilol|No|No|No|No|75%|51079093020|CARVEDILOL 6.25 MG TABLET|100|EA|.05568|09/19/2007||Yes|No||09/19/2007||Yes|No|09/19/2007||Yes|No||||No|No|||Prescription required|No||070|No|.02069|03/29/2022|.02019|03/29/2022|.02032|03/29/2022|||BETA-BLOCKERS|12141|||||No|No||MYLAN INSTITUTI|No||||
carvedilol|No|No|No|No|75%|51079093120|CARVEDILOL 12.5 MG TABLET|100|EA|.05568|09/19/2007||Yes|No||09/19/2007||Yes|No|09/19/2007||Yes|No||||No|No|||Prescription required|No||070|No|.02277|03/29/2022|.02222|03/29/2022|.02237|03/29/2022|||BETA-BLOCKERS|12142|||||No|No||MYLAN INSTITUTI|No||||
carvedilol|No|No|No|No|75%|51079093220|CARVEDILOL 25 MG TABLET|100|EA|.05568|09/19/2007||Yes|No||09/19/2007||Yes|No|09/19/2007||Yes|No||||No|No|||Prescription required|No||070|No|.03449|03/29/2022|.03366|03/29/2022|.03388|03/29/2022|||BETA-BLOCKERS|12143|||||No|No||MYLAN INSTITUTI|No||||
buspirone HCl|No|No|No|No|75%|51079096020|BUSPIRONE HCL 15 MG TABLET|100|EA|.19534|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|12144|||||No|No||MYLAN INSTITUTI|No||||
carbidopa/levodopa|No|No|No|No|75%|51079097820|CARBIDOPA-LEVO ER 25-100 TAB|100|EA|.16357|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||015|No|.21193|03/29/2022|.20684|03/29/2022|.20822|03/29/2022|||ANTIPARKINSON'S AGENTS|12145|||||No|No||MYLAN INSTITUTI|No||||
spironolactone|No|No|No|No|75%|51079097920|SPIRONOLACTONE 50 MG TABLET|100|EA|.172|03/19/2002||Yes|No||03/19/2002||Yes|No|03/19/2002||Yes|No||||No|No|||Prescription required|No|||No|.12042|03/29/2022|.11752|03/29/2022|.11831|03/29/2022||||12146|||||No|No||MYLAN INSTITUTI|No||||
buspirone HCl|No|No|No|No|75%|51079098520|BUSPIRONE HCL 5 MG TABLET|100|EA|.04343|03/25/2002||Yes|No||03/25/2002||Yes|No|03/25/2002||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|12147|||||No|No||MYLAN INSTITUTI|No||||
buspirone HCl|No|No|No|No|75%|51079098620|BUSPIRONE HCL 10 MG TABLET|100|EA|.05921|03/25/2002||Yes|No||03/25/2002||Yes|No|03/25/2002||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|12148|||||No|No||MYLAN INSTITUTI|No||||
tramadol HCl|No|No|No|No|90%|51079099120|TRAMADOL HCL 50 MG TABLET|100|EA|.03306|07/08/2004|08/31/2022|Yes|No||07/08/2004|08/31/2022|Yes|No|||No|No||||No|No|||Prescription required|No||109|Yes|.02459|03/29/2022|.02399|03/29/2022|.02415|03/29/2022|||ANALGESICS: NARCOTICS SHORT|12149|No Longer Rebatable|No Longer Rebatable|||No|No||MYLAN INSTITUTI|No||||
buspirone HCl|No|No|No|No|75%|51079099420|BUSPIRONE HCL 30 MG TABLET|100|EA|.39069|07/08/2004||Yes|No||07/08/2004||Yes|No|||No|No||||No|No|||Prescription required|No||090|No|.17728|03/29/2022|.17302|03/29/2022|.17417|03/29/2022|||ANXIOLYTICS|12150|||||No|No||MYLAN INSTITUTI|No||||
tucatinib|No|No|No|No|75%|51144000160|TUKYSA 50 MG TABLET|60|EA|38.44916|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|No||502|No|87.62832|01/11/2022|86.37649|01/11/2022|82.26332|01/11/2022|||ONCOLOGY: ORAL - BREAST|12151|||||No|No||SEAGEN INC.|No||||
tucatinib|No|No|No|No|75%|51144000212|TUKYSA 150 MG TABLET|120|EA|77.314|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|No||502|No|176.204|01/11/2022|173.6868|01/11/2022|165.416|01/11/2022|||ONCOLOGY: ORAL - BREAST|12152|||||No|No||SEAGEN INC.|No||||
tucatinib|No|No|No|No|75%|51144000260|TUKYSA 150 MG TABLET|60|EA|77.314|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|No||502|No|176.204|01/11/2022|173.6868|01/11/2022|165.416|01/11/2022|||ONCOLOGY: ORAL - BREAST|12153|||||No|No||SEAGEN INC.|No||||
elexacaftor/tezacaftor/ivacaft|No|No|No|No|75%|51167010602|TRIKAFTA 50-25-37.5 MG/75 MG|84|EA|128.31937|06/24/2021||Yes|No||06/24/2021||Yes|No|||No|No||||No|No|||Prescription required|No|||Yes|292.44879|01/11/2022|288.27095|01/11/2022|274.54376|01/11/2022||||12154|||||No|No||VERTEX PHARMACE|No||||
tezacaftor/ivacaftor|No|No|No|No|75%|51167011301|SYMDEKO 50/75 MG-75 MG TABLETS|56|EA|180.428|08/02/2019||Yes|No||08/02/2019||Yes|No|||No|No||||No|No|||Prescription required|No|||Yes|411.208|01/11/2022|405.3336|01/11/2022|386.032|01/11/2022||||12155|||||No|No||VERTEX PHARMACE|No||||
ivacaftor|No|No|No|No|75%|51167020001|KALYDECO 150 MG TABLET|56|EA|192.47905|02/12/2015||Yes|No||02/12/2015||Yes|No|02/12/2015||Yes|No||||No|No|||Prescription required|No|||Yes|418.18226|06/01/2016|412.20823|06/01/2016|392.57927|06/01/2016|426.7166|06/26/2017||12156|||||No|No||VERTEX PHARMACE|No||||
ivacaftor|No|No|No|No|75%|51167030001|KALYDECO 50 MG GRANULES PACKET|56|EA|192.47905|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No|||Yes|418.18226|06/01/2016|412.20823|06/01/2016|392.57927|06/01/2016|426.7166|06/26/2017||12157|||||No|No||VERTEX PHARMACE|No||||
elexacaftor/tezacaftor/ivacaft|No|No|No|No|75%|51167033101|TRIKAFTA 100-50-75 MG/150 MG|84|EA|128.31937|12/01/2019||Yes|No||12/01/2019||Yes|No|||No|No||||No|No|||Prescription required|No|||Yes|292.44879|01/11/2022|288.27095|01/11/2022|274.54376|01/11/2022||||12158|||||No|No||VERTEX PHARMACE|No||||
ivacaftor|No|No|No|No|75%|51167040001|KALYDECO 75 MG GRANULES PACKET|56|EA|192.47905|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No|||Yes|418.18226|06/01/2016|412.20823|06/01/2016|392.57927|06/01/2016|426.7166|06/26/2017||12159|||||No|No||VERTEX PHARMACE|No||||
lumacaftor/ivacaftor|No|No|No|No|75%|51167050002|ORKAMBI 150-188 MG GRANULE PKT|56|EA||11/28/2018||Yes|No||11/28/2018||Yes|No|||No|No||||No|No|||Prescription required|No|||Yes|384.02472|01/11/2022|378.53865|01/11/2022|360.513|01/11/2022||||12160|||||No|No||VERTEX PHARMACE|No||||
ivacaftor|No|No|No|No|75%|51167060001|KALYDECO 25 MG GRANULES PACKET|56|EA|192.47905|06/28/2019||Yes|No||06/28/2019||Yes|No|06/28/2019||Yes|No||||No|No|||Prescription required|No|||Yes|438.67319|01/11/2022|432.40643|01/11/2022|411.81565|01/11/2022||||12161|||||No|No||VERTEX PHARMACE|No||||
tezacaftor/ivacaftor|No|No|No|No|75%|51167066101|SYMDEKO 100/150 MG-150 MG TABS|56|EA|180.428|05/17/2018||Yes|No||05/17/2018||Yes|No|||No|No||||No|No|||Prescription required|No|||Yes|411.208|01/11/2022|405.3336|01/11/2022|386.032|01/11/2022||||12162|||||No|No||VERTEX PHARMACE|No||||
lumacaftor/ivacaftor|No|No|No|No|75%|51167070002|ORKAMBI 100 MG-125 MG TABLET|112|EA|84.25032|12/20/2016||Yes|No||12/20/2016||Yes|No|||No|No||||No|No|||Prescription required|No|||Yes|192.01236|01/11/2022|189.26932|01/11/2022|180.2565|01/11/2022||||12163|||||No|No||VERTEX PHARMACE|No||||
lumacaftor/ivacaftor|No|No|No|No|75%|51167080901|ORKAMBI 200 MG-125 MG TABLET|112|EA|84.25032|01/19/2016||Yes|No||01/19/2016||Yes|No|||No|No||||No|No|||Prescription required|No|||Yes|192.01236|01/11/2022|189.26932|01/11/2022|180.2565|01/11/2022||||12164|||||No|No||VERTEX PHARMACE|No||||
lumacaftor/ivacaftor|No|No|No|No|75%|51167090001|ORKAMBI 100-125 MG GRANULE PKT|56|EA||11/28/2018||Yes|No||11/28/2018||Yes|No|||No|No||||No|No|||Prescription required|No|||Yes|384.02472|01/11/2022|378.53865|01/11/2022|360.513|01/11/2022||||12165|||||No|No||VERTEX PHARMACE|No||||
benzonatate|No|No|No|No|75%|51224000150|BENZONATATE 200 MG CAPSULE|100|EA|.13841|10/27/2015||Yes|No||10/27/2015||Yes|No|10/27/2015||Yes|No||||No|No|||Prescription required|No||184|Yes|.14345|03/29/2022|.14|03/29/2022|.14093|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|12166|||||No|No||TAGI PHARMA|No||||
benzonatate|No|No|No|No|75%|51224000160|BENZONATATE 200 MG CAPSULE|500|EA|.11932|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|||Prescription required|No||184|Yes|.14345|03/29/2022|.14|03/29/2022|.14093|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|12167|||||No|No||TAGI PHARMA|No||||
metformin HCl|No|No|No|No|75%|51224000750|METFORMIN HCL ER 500 MG TABLET|100|EA|.03719|09/28/2016||Yes|No||09/28/2016||Yes|No|09/28/2016||Yes|No||||No|No|||Prescription required|No||012|No|.03646|03/29/2022|.03558|03/29/2022|.03582|03/29/2022|||HYPOGLYCEMICS: METFORMINS|12168|||||No|No||TAGI PHARMA|No||||
metformin HCl|No|No|No|No|75%|51224000760|METFORMIN HCL ER 500 MG TABLET|500|EA|.03607|09/28/2016||Yes|No||09/28/2016||Yes|No|09/28/2016||Yes|No||||No|No|||Prescription required|No||012|No|.03646|03/29/2022|.03558|03/29/2022|.03582|03/29/2022|||HYPOGLYCEMICS: METFORMINS|12169|||||No|No||TAGI PHARMA|No||||
cholestyramine/aspartame|No|No|No|No|75%|51224000920|CHOLESTYRAMINE LIGHT PACKET|60|EA|.88199|08/20/2021||Yes|No||08/20/2021||Yes|No|08/20/2021||Yes|No||||No|No|||Prescription required|No||055|No|1.2151|03/29/2022|1.18593|03/29/2022|1.19383|03/29/2022|||LIPOTROPICS: OTHER|12170|||||No|No||TAGI PHARMA|No||||
benzonatate|No|No|No|No|75%|51224001050|BENZONATATE 100 MG CAPSULE|100|EA|.12341|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No||184|Yes|.09389|03/29/2022|.09163|03/29/2022|.09224|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|12171|||||No|No||TAGI PHARMA|No||||
benzonatate|No|No|No|No|75%|51224001060|BENZONATATE 100 MG CAPSULE|500|EA|.09859|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No||184|Yes|.09389|03/29/2022|.09163|03/29/2022|.09224|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|12172|||||No|No||TAGI PHARMA|No||||
cholestyramine (with sugar)|No|No|No|No|75%|51224001120|CHOLESTYRAMINE PACKET|60|EA|.79657|02/17/2022||Yes|No||02/17/2022||Yes|No|02/17/2022||Yes|No||||No|No|||Prescription required|No||055|No|1.81545|02/17/2022|1.78951|02/17/2022|1.7043|02/17/2022|||LIPOTROPICS: OTHER|12173|||||No|No||TAGI PHARMA|No||||
levetiracetam|No|No|No|No|75%|51224001310|LEVETIRACETAM 500 MG/5 ML VIAL|5|ML|.25757|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No|||No|.58702|12/21/2021|.57863|12/21/2021|.55108|12/21/2021||||12174|||||No|No||TAGI PHARMA|No||||
levetiracetam|No|No|No|No|75%|51224001325|LEVETIRACETAM 500 MG/5 ML VIAL|5|ML|.2752|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No|||No|.6272|12/21/2021|.61824|12/21/2021|.5888|12/21/2021||||12175|||||No|No||TAGI PHARMA|No||||
gabapentin|No|No|No|No|75%|51224001950|GABAPENTIN 100 MG CAPSULE|100|EA|.02257|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|12176|||||No|No||TAGI PHARMA|No||||
gabapentin|No|No|No|No|75%|51224001960|GABAPENTIN 100 MG CAPSULE|500|EA|.0218|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|12177|||||No|No||TAGI PHARMA|No||||
metformin HCl|Yes|No|No|No|75%|51224002050|METFORMIN HCL 500 MG TABLET|100|EA|.02429|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|12/11/2019||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|12178|||||No|No||TAGI PHARMA|No||||
metformin HCl|Yes|No|No|No|75%|51224002060|METFORMIN HCL 500 MG TABLET|500|EA|.02244|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|12/11/2019||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|12179|||||No|No||TAGI PHARMA|No||||
metformin HCl|Yes|No|No|No|75%|51224002070|METFORMIN HCL 500 MG TABLET|1000|EA|.02051|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|12/11/2019||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|12180|||||No|No||TAGI PHARMA|No||||
gabapentin|No|No|No|No|75%|51224002150|GABAPENTIN 600 MG TABLET|100|EA|.06708|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|12181|||||No|No||TAGI PHARMA|No||||
gabapentin|No|No|No|No|75%|51224002160|GABAPENTIN 600 MG TABLET|500|EA|.05349|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|12182|||||No|No||TAGI PHARMA|No||||
azithromycin|Yes|No|No|No|75%|51224002206|AZITHROMYCIN 250 MG TABLET|6|EA|.95316|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|12183|||||No|No||TAGI PHARMA|No||||
azithromycin|Yes|No|No|No|75%|51224002218|AZITHROMYCIN 250 MG TABLET|6|EA|.60486|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|12184|||||No|No||TAGI PHARMA|No||||
azithromycin|Yes|No|No|No|75%|51224002230|AZITHROMYCIN 250 MG TABLET|30|EA|.90687|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|12185|||||No|No||TAGI PHARMA|No||||
azithromycin|No|No|No|No|75%|51224002250|AZITHROMYCIN 250 MG TABLET|100|EA|.90596|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|12186|||||No|No||TAGI PHARMA|No||||
metformin HCl|No|No|No|No|75%|51224010750|METFORMIN HCL ER 750 MG TABLET|100|EA|.09438|09/28/2016||Yes|No||09/28/2016||Yes|No|09/28/2016||Yes|No||||No|No|||Prescription required|No||012|No|.09354|03/29/2022|.09129|03/29/2022|.0919|03/29/2022|||HYPOGLYCEMICS: METFORMINS|12187|||||No|No||TAGI PHARMA|No||||
metformin HCl|No|No|No|No|75%|51224010760|METFORMIN HCL ER 750 MG TABLET|500|EA|.08964|09/28/2016||Yes|No||09/28/2016||Yes|No|09/28/2016||Yes|No||||No|No|||Prescription required|No||012|No|.09354|03/29/2022|.09129|03/29/2022|.0919|03/29/2022|||HYPOGLYCEMICS: METFORMINS|12188|||||No|No||TAGI PHARMA|No||||
gabapentin|No|No|No|No|75%|51224011950|GABAPENTIN 300 MG CAPSULE|100|EA|.03483|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|12189|||||No|No||TAGI PHARMA|No||||
gabapentin|No|No|No|No|75%|51224011960|GABAPENTIN 300 MG CAPSULE|500|EA|.03461|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|12190|||||No|No||TAGI PHARMA|No||||
metformin HCl|Yes|No|No|No|75%|51224012050|METFORMIN HCL 850 MG TABLET|100|EA|.03117|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|12191|||||No|No||TAGI PHARMA|No||||
metformin HCl|Yes|No|No|No|75%|51224012060|METFORMIN HCL 850 MG TABLET|500|EA|.02968|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|12192|||||No|No||TAGI PHARMA|No||||
metformin HCl|Yes|No|No|No|75%|51224012070|METFORMIN HCL 850 MG TABLET|1000|EA|.02713|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|12193|||||No|No||TAGI PHARMA|No||||
gabapentin|No|No|No|No|75%|51224012150|GABAPENTIN 800 MG TABLET|100|EA|.09352|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|12194|||||No|No||TAGI PHARMA|No||||
gabapentin|No|No|No|No|75%|51224012160|GABAPENTIN 800 MG TABLET|500|EA|.08994|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|12195|||||No|No||TAGI PHARMA|No||||
azithromycin|Yes|No|No|No|75%|51224012203|AZITHROMYCIN 500 MG TABLET|3|EA|1.90633|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||018|No|.82092|03/29/2022|.80121|03/29/2022|.80655|03/29/2022|||MACROLIDES/KETOLIDES|12196|||||No|No||TAGI PHARMA|No||||
azithromycin|Yes|No|No|No|75%|51224012209|AZITHROMYCIN 500 MG TABLET|3|EA|1.20973|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||018|No|.82092|03/29/2022|.80121|03/29/2022|.80655|03/29/2022|||MACROLIDES/KETOLIDES|12197|||||No|No||TAGI PHARMA|No||||
azithromycin|Yes|No|No|No|75%|51224012230|AZITHROMYCIN 500 MG TABLET|30|EA|2.05325|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||018|No|.82092|03/29/2022|.80121|03/29/2022|.80655|03/29/2022|||MACROLIDES/KETOLIDES|12198|||||No|No||TAGI PHARMA|No||||
azithromycin|No|No|No|No|75%|51224012250|AZITHROMYCIN 500 MG TABLET|100|EA|2.05325|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No||018|No|.82092|03/29/2022|.80121|03/29/2022|.80655|03/29/2022|||MACROLIDES/KETOLIDES|12199|||||No|No||TAGI PHARMA|No||||
ursodiol|No|No|No|No|75%|51224015150|URSODIOL 300 MG CAPSULE|100|EA|.5375|09/06/2011||Yes|No||09/06/2011||Yes|No|09/06/2011||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|198|No|.60006|03/29/2022|.58565|03/29/2022|.58955|03/29/2022|||BILE SALTS|12200|||||No|No||TAGI PHARMA|No||||
calcium acetate/aluminum sulf|No|No|No|No|75%|51224016212|ASTRINGENT SOLN POWDER PACK|12|EA|.34937|12/10/2019||Yes|No||12/10/2019||Yes|No|12/10/2019||Yes|No||||No|No|||Over the counter|No|||No|.724|09/28/2021|.70662|09/28/2021|.71133|09/28/2021||||12201|||||No|No||TAGI PHARMA|No||||
naltrexone HCl|No|No|No|No|75%|51224020630|NALTREXONE 50 MG TABLET|30|EA|.37195|11/13/2013||Yes|No||11/13/2013||Yes|No|11/13/2013||Yes|No||||No|No|||Prescription required|No||145|No|.75734|03/29/2022|.73916|03/29/2022|.74408|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|12202|||||No|No||TAGI PHARMA|Yes|09/01/2020|||
naltrexone HCl|No|No|No|No|75%|51224020650|NALTREXONE 50 MG TABLET|100|EA|.36141|10/07/2016||Yes|No||10/07/2016||Yes|No|10/07/2016||Yes|No||||No|No|||Prescription required|No||145|No|.75734|03/29/2022|.73916|03/29/2022|.74408|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|12203|||||No|No||TAGI PHARMA|Yes|09/01/2020|||
gabapentin|No|No|No|No|75%|51224021950|GABAPENTIN 400 MG CAPSULE|100|EA|.04364|01/21/2021||Yes|No||01/21/2021||Yes|No|01/21/2021||Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|12204|||||No|No||TAGI PHARMA|No||||
gabapentin|No|No|No|No|75%|51224021960|GABAPENTIN 400 MG CAPSULE|500|EA|.04445|01/21/2021||Yes|No||01/21/2021||Yes|No|01/21/2021||Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|12205|||||No|No||TAGI PHARMA|No||||
metformin HCl|Yes|No|No|No|75%|51224022050|METFORMIN HCL 1,000 MG TABLET|100|EA|.04364|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|12206|||||No|No||TAGI PHARMA|No||||
metformin HCl|Yes|No|No|No|75%|51224022060|METFORMIN HCL 1,000 MG TABLET|500|EA|.04149|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|12207|||||No|No||TAGI PHARMA|No||||
metformin HCl|Yes|No|No|No|75%|51224022070|METFORMIN HCL 1,000 MG TABLET|1000|EA|.03541|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|12208|||||No|No||TAGI PHARMA|No||||
azithromycin|No|No|No|No|75%|51224022230|AZITHROMYCIN 600 MG TABLET|30|EA|1.98015|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||018|No|1.08173|08/24/2021|1.05576|08/24/2021|1.06279|08/24/2021|||MACROLIDES/KETOLIDES|12209|||||No|No||TAGI PHARMA|No||||
alendronate sodium|No|No|No|No|75%|51224030110|ALENDRONATE SOD 70 MG/75 ML|75|ML|.27469|02/12/2014|04/01/2022|Yes|No||02/12/2014|04/01/2022|Yes|No|02/12/2014|04/01/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|060|No|.62605|09/19/2017|.6171|09/19/2017|.58772|09/19/2017|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|12210|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TAGI PHARMA|No||||
tetrabenazine|No|No|No|No|75%|51224042510|TETRABENAZINE 12.5 MG TABLET|112|EA|5.62466|05/18/2017||Yes|No||05/18/2017||Yes|No|05/18/2017||Yes|No||||No|No|||Prescription required|No||572|Yes|12.819|09/22/2020|12.63587|09/22/2020|12.03417|09/22/2020|||MOVEMENT DISORDERS|12211|||||No|No||TAGI PHARMA|No||||
tetrabenazine|No|No|No|No|75%|51224042610|TETRABENAZINE 25 MG TABLET|112|EA|11.2491|05/18/2017||Yes|No||05/18/2017||Yes|No|05/18/2017||Yes|No||||No|No|||Prescription required|No||572|Yes|25.63749|09/22/2020|25.27124|09/22/2020|24.06785|09/22/2020|||MOVEMENT DISORDERS|12212|||||No|No||TAGI PHARMA|No||||
solifenacin succinate|No|No|No|No|75%|51248015001|VESICARE 5 MG TABLET|30|EA|5.52564|03/11/2005||Yes|No||03/11/2005||Yes|No|03/11/2005||Yes|No||||No|No|||Prescription required|No||006|Yes|12.59332|08/24/2021|12.41341|08/24/2021|11.8223|08/24/2021|||BLADDER RELAXANT PREPARATIONS|12213|||||No|No||ASTELLAS PHARMA|No||||
solifenacin succinate|No|No|No|No|75%|51248015003|VESICARE 5 MG TABLET|90|EA|5.52564|03/11/2005|01/31/2022|Yes|No||03/11/2005|01/31/2022|Yes|No|03/11/2005|01/31/2022|Yes|No||||No|No|||Prescription required|No||006|Yes|12.59332|08/24/2021|12.41341|08/24/2021|11.8223|08/24/2021|||BLADDER RELAXANT PREPARATIONS|12214|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ASTELLAS PHARMA|No||||
solifenacin succinate|No|No|No|No|75%|51248015101|VESICARE 10 MG TABLET|30|EA|5.52564|03/11/2005||Yes|No||03/11/2005||Yes|No|03/11/2005||Yes|No||||No|No|||Prescription required|No||006|No|12.50335|09/28/2021|12.20326|09/28/2021|12.28454|09/28/2021|||BLADDER RELAXANT PREPARATIONS|12215|||||No|No||ASTELLAS PHARMA|No||||
solifenacin succinate|No|No|No|No|75%|51248015103|VESICARE 10 MG TABLET|90|EA|5.52564|03/11/2005||Yes|No||03/11/2005||Yes|No|03/11/2005||Yes|No||||No|No|||Prescription required|No||006|No|12.50335|09/28/2021|12.20326|09/28/2021|12.28454|09/28/2021|||BLADDER RELAXANT PREPARATIONS|12216|||||No|No||ASTELLAS PHARMA|No||||
solifenacin succinate|No|No|No|No|75%|51248025099|VESICARE LS 5 MG/5 ML SUSP|150|ML|.73673|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|006|No|1.67906|06/07/2021|1.65507|06/07/2021|1.57626|06/07/2021|||BLADDER RELAXANT PREPARATIONS|12217|||||No|No||ASTELLAS PHARMA|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|51285004001|ZIAC 10-6.25 MG TABLET|30|EA|3.54033|01/12/2004||Yes|No||01/12/2004||Yes|No|01/12/2004||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|070|Yes|8.06866|01/11/2022|7.95339|01/11/2022|7.57466|01/11/2022|||BETA-BLOCKERS|12218|||||No|No||TEVA WOMEN'S HE|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|51285004702|ZIAC 2.5-6.25 MG TABLET|100|EA|3.53976|09/12/2003||Yes|No||09/12/2003||Yes|No|09/12/2003||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|070|Yes|8.06736|01/11/2022|7.95211|01/11/2022|7.57344|01/11/2022|||BETA-BLOCKERS|12219|||||No|No||TEVA WOMEN'S HE|No||||
bisoprolol/hydrochlorothiazide|No|No|No|No|75%|51285005002|ZIAC 5-6.25 MG TABLET|100|EA|3.53976|01/12/2004||Yes|No||01/12/2004||Yes|No|01/12/2004||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|070|Yes|8.06736|01/11/2022|7.95211|01/11/2022|7.57344|01/11/2022|||BETA-BLOCKERS|12220|||||No|No||TEVA WOMEN'S HE|No||||
estradiol/norgestimate|No|No|No|No|75%|51285006390|PREFEST TABLET|30|EA|2.56733|08/01/2006||Yes|No||08/01/2006||Yes|No|||No|No||||No|No|||Prescription required|No|||Yes|5.85113|01/11/2022|5.76755|01/11/2022|5.4929|01/11/2022||||12221|||||No|No||TEVA WOMEN'S HE|No||||
L-norgest/e.estradiol-e.estrad|Yes|Yes|No|No|75%|51285008787|SEASONIQUE 0.15-0.03-0.01 TAB|91|EA|2.31349|08/01/2006||Yes|No||08/01/2006||Yes|No|08/01/2006||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|5.17263|01/18/2022|5.04848|01/18/2022|5.0821|01/18/2022||||12222|||||No|No||TEVA WOMEN'S HE|No|||Only covered for non-contraceptive (medical) purposes|
L-norgest/e.estradiol-e.estrad|Yes|Yes|No|No|75%|51285009287|LOSEASONIQUE TABLET|91|EA|2.31349|12/15/2009||Yes|No||12/15/2009||Yes|No|12/15/2009||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|5.2726|01/11/2022|5.19728|01/11/2022|4.94979|01/11/2022||||12223|||||No|No||TEVA WOMEN'S HE|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|51285012570|LOESTRIN FE 1-20 TABLET|28|EA|2.58645|05/26/2015||Yes|No||05/26/2015||Yes|No|05/26/2015||Yes|No|Refer to program requirements|||No|No|05/26/2015||Prescription required|No|||No|5.8947|01/11/2022|5.81049|01/11/2022|5.5338|01/11/2022||||12224|||||No|No||TEVA WOMEN'S HE|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone ac-eth estradiol|Yes|Yes|No|No|75%|51285012797|LOESTRIN 21 1.5-30 TABLET|21|EA|3.4486|05/26/2015||Yes|No||05/26/2015||Yes|No|05/26/2015||Yes|No|Refer to program requirements|||No|No|05/26/2015||Prescription required|No|||No|7.8596|01/11/2022|7.74732|01/11/2022|7.3784|01/11/2022||||12225|||||No|No||TEVA WOMEN'S HE|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|51285012870|LOESTRIN FE 1.5-30 TABLET|28|EA|2.58645|05/26/2015||Yes|No||05/26/2015||Yes|No|05/26/2015||Yes|No|Refer to program requirements|||No|No|05/26/2015||Prescription required|No|||No|5.8947|01/11/2022|5.81049|01/11/2022|5.5338|01/11/2022||||12226|||||No|No||TEVA WOMEN'S HE|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone ac-eth estradiol|Yes|Yes|No|No|75%|51285013197|LOESTRIN 21 1-20 TABLET|21|EA|3.4486|05/26/2015||Yes|No||05/26/2015||Yes|No|05/26/2015||Yes|No|Refer to program requirements|||No|No|05/26/2015||Prescription required|No|||No|7.8596|01/11/2022|7.74732|01/11/2022|7.3784|01/11/2022||||12227|||||No|No||TEVA WOMEN'S HE|No|||Only covered for non-contraceptive (medical) purposes|
methotrexate sodium|No|No|No|No|75%|51285036601|TREXALL 5 MG TABLET|30|EA|7.57516|07/28/2009||Yes|No||07/28/2009||Yes|No|07/28/2009||Yes|No||||No|No|||Prescription required|No|||No|17.26432|01/11/2022|17.01769|01/11/2022|16.20732|01/11/2022||||12228|||||No|No||TEVA WOMEN'S HE|No||||
methotrexate sodium|No|No|No|No|75%|51285036701|TREXALL 7.5 MG TABLET|30|EA|11.36203|02/14/2007||Yes|No||02/14/2007||Yes|No|02/14/2007||Yes|No||||No|No|||Prescription required|No|||No|25.89486|01/11/2022|25.52493|01/11/2022|24.30946|01/11/2022||||12229|||||No|No||TEVA WOMEN'S HE|No||||
methotrexate sodium|No|No|No|No|75%|51285036801|TREXALL 10 MG TABLET|30|EA|15.1489|07/28/2009||Yes|No||07/28/2009||Yes|No|07/28/2009||Yes|No||||No|No|||Prescription required|No|||No|34.5254|01/11/2022|34.03218|01/11/2022|32.4116|01/11/2022||||12230|||||No|No||TEVA WOMEN'S HE|No||||
methotrexate sodium|No|No|No|No|75%|51285036901|TREXALL 15 MG TABLET|30|EA|22.72406|02/14/2007||Yes|No||02/14/2007||Yes|No|02/14/2007||Yes|No||||No|No|||Prescription required|No|||No|51.78972|01/11/2022|51.04987|01/11/2022|48.61892|01/11/2022||||12231|||||No|No||TEVA WOMEN'S HE|No||||
norethindrone acetate|No|No|No|No|75%|51285042410|AYGESTIN 5 MG TABLET|50|EA|2.60838|03/11/2005||Yes|No||03/11/2005||Yes|No|03/11/2005||Yes|No||||No|No|||Prescription required|No|||No|5.94468|01/11/2022|5.85975|01/11/2022|5.58072|01/11/2022||||12232|||||No|No||TEVA WOMEN'S HE|No||||
L-norgest/e.estradiol-e.estrad|Yes|Yes|No|No|75%|51285043165|QUARTETTE TABLET|91|EA|1.98886|09/17/2013||Yes|No||09/17/2013||Yes|No|09/17/2013||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|4.53276|07/10/2018|4.46801|07/10/2018|4.25524|07/10/2018||||12233|||||No|No||TEVA WOMEN'S HE|No|||Only covered for non-contraceptive (medical) purposes|
L-norgest/e.estradiol-e.estrad|Yes|Yes|No|No|75%|51285043187|QUARTETTE TABLET|91|EA|2.77066|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|6.31453|01/11/2022|6.22432|01/11/2022|5.92792|01/11/2022||||12234|||||No|No||TEVA WOMEN'S HE|No|||Only covered for non-contraceptive (medical) purposes|
disulfiram|No|No|No|No|75%|51285052302|ANTABUSE 250 MG TABLET|100|EA|3.77153|02/27/2007||Yes|No||02/27/2007||Yes|No|02/27/2007||Yes|No||||No|No|||Prescription required|No|||No|8.59558|01/07/2020|8.47278|01/07/2020|8.06932|01/07/2020||||12235|||||No|No||TEVA WOMEN'S HE|Yes|09/01/2020|||
phenobarbital|No|No|No|No|75%|51293062501|PHENOBARBITAL 16.2 MG TABLET|100|EA|.18382|05/17/2018||Yes|No||05/17/2018||Yes|No|05/17/2018||Yes|No||||No|No|||Prescription required|No||056|No|.22712|03/29/2022|.22166|03/29/2022|.22314|03/29/2022|||ANTICONVULSANTS|12236|||||No|No||ECI PHARMACEUTI|No||||
phenobarbital|No|No|No|No|75%|51293062510|PHENOBARBITAL 16.2 MG TABLET|1000|EA|.17415|04/18/2018||Yes|No||04/18/2018||Yes|No|04/18/2018||Yes|No||||No|No|||Prescription required|No||056|No|.22712|03/29/2022|.22166|03/29/2022|.22314|03/29/2022|||ANTICONVULSANTS|12237|||||No|No||ECI PHARMACEUTI|No||||
phenobarbital|No|No|No|No|75%|51293062601|PHENOBARBITAL 32.4 MG TABLET|100|EA|.2322|05/17/2018||Yes|No||05/17/2018||Yes|No|05/17/2018||Yes|No||||No|No|||Prescription required|No||056|No|.30495|03/29/2022|.29763|03/29/2022|.29961|03/29/2022|||ANTICONVULSANTS|12238|||||No|No||ECI PHARMACEUTI|No||||
phenobarbital|No|No|No|No|75%|51293062610|PHENOBARBITAL 32.4 MG TABLET|1000|EA|.2193|04/18/2018||Yes|No||04/18/2018||Yes|No|04/18/2018||Yes|No||||No|No|||Prescription required|No||056|No|.30495|03/29/2022|.29763|03/29/2022|.29961|03/29/2022|||ANTICONVULSANTS|12239|||||No|No||ECI PHARMACEUTI|No||||
phenobarbital|No|No|No|No|75%|51293062701|PHENOBARBITAL 64.8 MG TABLET|100|EA|.29025|04/18/2018||Yes|No||04/18/2018||Yes|No|04/18/2018||Yes|No||||No|No|||Prescription required|No||056|No|.38211|03/29/2022|.37293|03/29/2022|.37542|03/29/2022|||ANTICONVULSANTS|12240|||||No|No||ECI PHARMACEUTI|No||||
phenobarbital|No|No|No|No|75%|51293062710|PHENOBARBITAL 64.8 MG TABLET|1000|EA|.27477|05/17/2018||Yes|No||05/17/2018||Yes|No|05/17/2018||Yes|No||||No|No|||Prescription required|No||056|No|.38211|03/29/2022|.37293|03/29/2022|.37542|03/29/2022|||ANTICONVULSANTS|12241|||||No|No||ECI PHARMACEUTI|No||||
phenobarbital|No|No|No|No|75%|51293062801|PHENOBARBITAL 97.2 MG TABLET|100|EA|.40944|04/20/2018||Yes|No||04/20/2018||Yes|No|04/20/2018||Yes|No||||No|No|||Prescription required|No||056|No|.45635|03/29/2022|.44539|03/29/2022|.44836|03/29/2022|||ANTICONVULSANTS|12242|||||No|No||ECI PHARMACEUTI|No||||
phenobarbital|No|No|No|No|75%|51293062810|PHENOBARBITAL 97.2 MG TABLET|1000|EA|.38743|04/20/2018||Yes|No||04/20/2018||Yes|No|04/20/2018||Yes|No||||No|No|||Prescription required|No||056|No|.45635|03/29/2022|.44539|03/29/2022|.44836|03/29/2022|||ANTICONVULSANTS|12243|||||No|No||ECI PHARMACEUTI|No||||
chlordiazepoxide/clidinium Br|No|No|No|No|75%|51293069601|CHLORDIAZEPOXIDE-CLIDINIUM CAP|100|EA|3.8915|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||Yes|.95937|03/29/2022|.93634|03/29/2022|.94258|03/29/2022||||12244|||||No|No||ECI PHARMACEUTI|No||||
methimazole|No|No|No|No|75%|51293082001|METHIMAZOLE 5 MG TABLET|100|EA|.10255|05/04/2018||Yes|No||05/04/2018||Yes|No|05/04/2018||Yes|No||||No|No|||Prescription required|No|||No|.07388|03/29/2022|.0721|03/29/2022|.07258|03/29/2022||||12245|||||No|No||ECI PHARMACEUTI|No||||
methimazole|No|No|No|No|75%|51293082101|METHIMAZOLE 10 MG TABLET|100|EA|.17823|05/04/2018||Yes|No||05/04/2018||Yes|No|05/04/2018||Yes|No||||No|No|||Prescription required|No|||No|.10482|03/29/2022|.1023|03/29/2022|.10298|03/29/2022||||12246|||||No|No||ECI PHARMACEUTI|No||||
sodium polystyrene sulfonate|No|No|No|No|75%|51293083197|SODIUM POLYSTYRENE SULF POWDER|453.6|GM|.09479|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|No|||No|.12498|03/29/2022|.12198|03/29/2022|.12279|03/29/2022||||12247|||||No|No||ECI PHARMACEUTI|No||||
lamivudine|No|No|No|No|75%|51293083268|LAMIVUDINE 150 MG TABLET|60|EA|1.365|08/30/2019||Yes|No||08/30/2019||Yes|No|08/30/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.96758|11/23/2021|.94435|11/23/2021|.95064|11/23/2021|||HIV / AIDS|12248|||||No|No||ECI PHARMACEUTI|No||||
carisoprodol|No|No|No|No|90%|51525590101|CARISOPRODOL 250 MG TABLET|100|EA|1.13722|05/03/2011||Yes|No||05/03/2011||Yes|No|05/03/2011||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|116|Yes|1.00427|03/29/2022|.98016|03/29/2022|.98669|03/29/2022|||SKELETAL MUSCLE RELAXANTS|12249|||||No|No||WALLACE/MYLAN|No||||
valsartan|Yes|No|No|No|75%|51660014030|VALSARTAN 40 MG TABLET|30|EA|.20769|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Prescription required|Yes|12/01/2021|113|Yes|.1945|03/29/2022|.18983|03/29/2022|.19109|03/29/2022|||ANGIOTENSIN MODULATORS|12250|||||No|No||OHM LABS.|No||||
valsartan|Yes|No|No|No|75%|51660014190|VALSARTAN 80 MG TABLET|90|EA|.14691|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Prescription required|Yes|12/01/2021|113|Yes|.21024|03/29/2022|.20519|03/29/2022|.20656|03/29/2022|||ANGIOTENSIN MODULATORS|12251|||||No|No||OHM LABS.|No||||
valsartan|Yes|No|No|No|75%|51660014290|VALSARTAN 160 MG TABLET|90|EA|.19765|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Prescription required|Yes|12/01/2021|113|Yes|.23007|03/29/2022|.22454|03/29/2022|.22604|03/29/2022|||ANGIOTENSIN MODULATORS|12252|||||No|No||OHM LABS.|No||||
valsartan|Yes|No|No|No|75%|51660014390|VALSARTAN 320 MG TABLET|90|EA|.2322|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Prescription required|Yes|12/01/2021|113|Yes|.31156|03/29/2022|.30408|03/29/2022|.3061|03/29/2022|||ANGIOTENSIN MODULATORS|12253|||||No|No||OHM LABS.|No||||
ezetimibe|No|No|No|No|75%|51660020005|EZETIMIBE 10 MG TABLET|500|EA|.1943|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|12254|||||No|No||OHM-SUN PHARMAC|No||||
ezetimibe|No|No|No|No|75%|51660020030|EZETIMIBE 10 MG TABLET|30|EA|.19436|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|12255|||||No|No||OHM-SUN PHARMAC|No||||
ezetimibe|No|No|No|No|75%|51660020090|EZETIMIBE 10 MG TABLET|90|EA|.1943|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|12256|||||No|No||OHM-SUN PHARMAC|No||||
fluocinonide/emollient base|No|No|No|No|75%|51672125401|FLUOCINONIDE-E 0.05% CREAM|15|GM|1.10452|08/11/2008||Yes|No||08/11/2008||Yes|No|08/11/2008||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|1.34778|08/24/2021|1.31543|08/24/2021|1.32419|08/24/2021|||STEROIDS: TOPICAL HIGH|12257|||||No|No||TARO PHARM USA|No||||
fluocinonide/emollient base|No|No|No|No|75%|51672125402|FLUOCINONIDE-E 0.05% CREAM|30|GM|1.10452|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|2.51728|03/01/2022|2.48132|03/01/2022|2.36316|03/01/2022|||STEROIDS: TOPICAL HIGH|12258|||||No|No||TARO PHARM USA|No||||
fluocinonide/emollient base|No|No|No|No|75%|51672125403|FLUOCINONIDE-E 0.05% CREAM|60|GM|1.10452|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.77317|03/01/2022|.75461|03/01/2022|.75963|03/01/2022|||STEROIDS: TOPICAL HIGH|12259|||||No|No||TARO PHARM USA|No||||
clobetasol propionate|No|No|No|No|75%|51672125801|CLOBETASOL 0.05% CREAM|15|GM|1.78507|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||121|No|.42879|03/29/2022|.41849|03/29/2022|.42128|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|12260|||||No|No||TARO PHARM USA|No||||
clobetasol propionate|No|No|No|No|75%|51672125802|CLOBETASOL 0.05% CREAM|30|GM|1.78507|09/23/2009||Yes|No||09/23/2009||Yes|No|09/23/2009||Yes|No||||No|No|||Prescription required|No||121|No|.34489|03/29/2022|.33661|03/29/2022|.33885|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|12261|||||No|No||TARO PHARM USA|No||||
clobetasol propionate|No|No|No|No|75%|51672125803|CLOBETASOL 0.05% CREAM|60|GM|1.59737|09/23/2009||Yes|No||09/23/2009||Yes|No|09/23/2009||Yes|No||||No|No|||Prescription required|No||121|No|.33784|03/29/2022|.32973|03/29/2022|.33192|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|12262|||||No|No||TARO PHARM USA|No||||
clobetasol propionate|No|No|No|No|75%|51672125806|CLOBETASOL 0.05% CREAM|45|GM|1.78516|09/23/2009||Yes|No||09/23/2009||Yes|No|09/23/2009||Yes|No||||No|No|||Prescription required|No||121|No|.31467|03/29/2022|.30711|03/29/2022|.30916|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|12263|||||No|No||TARO PHARM USA|No||||
clobetasol propionate|No|No|No|No|75%|51672125901|CLOBETASOL 0.05% OINTMENT|15|GM|1.10854|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||121|No|.35914|03/29/2022|.35052|03/29/2022|.35285|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|12264|||||No|No||TARO PHARM USA|No||||
clobetasol propionate|No|No|No|No|75%|51672125902|CLOBETASOL 0.05% OINTMENT|30|GM|.9417|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||121|No|.3756|03/29/2022|.36658|03/29/2022|.36902|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|12265|||||No|No||TARO PHARM USA|No||||
clobetasol propionate|No|No|No|No|75%|51672125903|CLOBETASOL 0.05% OINTMENT|60|GM|.93374|06/03/2005||Yes|No||06/03/2005||Yes|No|06/03/2005||Yes|No||||No|No|||Prescription required|No||121|No|.32004|03/29/2022|.31235|03/29/2022|.31443|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|12266|||||No|No||TARO PHARM USA|No||||
clobetasol propionate|No|No|No|No|75%|51672125906|CLOBETASOL 0.05% OINTMENT|45|GM|.99148|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||121|No|.36764|03/29/2022|.35881|03/29/2022|.3612|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|12267|||||No|No||TARO PHARM USA|No||||
clotrimazole|No|No|No|No|75%|51672126003|CLOTRIMAZOLE 1% SOLUTION|30|ML|.85684|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|Yes|01/28/2021|061|No|.9845|03/29/2022|.96087|03/29/2022|.96727|03/29/2022|||ANTIFUNGALS: TOPICAL|12268|||||No|No||TARO PHARM USA|No||||
desoximetasone|No|No|No|No|75%|51672126101|DESOXIMETASONE 0.05% GEL|15|GM|2.107|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|120|No|4.802|09/24/2019|4.7334|09/24/2019|4.508|09/24/2019|||STEROIDS: TOPICAL HIGH|12269|||||No|No||TARO PHARM USA|No||||
desoximetasone|No|No|No|No|75%|51672126103|DESOXIMETASONE 0.05% GEL|60|GM|1.978|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|120|No|4.508|06/27/2017|4.4436|06/27/2017|4.232|06/27/2017|||STEROIDS: TOPICAL HIGH|12270|||||No|No||TARO PHARM USA|No||||
desoximetasone|No|No|No|No|75%|51672126201|DESOXIMETASONE 0.25% OINTMENT|15|GM|.37381|08/28/2010||Yes|No||08/28/2010||Yes|No|08/28/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|120|No|.658|03/29/2022|.6422|03/29/2022|.64648|03/29/2022|||STEROIDS: TOPICAL HIGH|12271|||||No|No||TARO PHARM USA|No||||
desoximetasone|No|No|No|No|75%|51672126203|DESOXIMETASONE 0.25% OINTMENT|60|GM|.282|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|120|No|.39246|03/29/2022|.38304|03/29/2022|.38559|03/29/2022|||STEROIDS: TOPICAL HIGH|12272|||||No|No||TARO PHARM USA|No||||
nystatin/triamcin|No|No|No|No|75%|51672126301|NYSTATIN-TRIAMCINOLONE CREAM|15|GM|.60056|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|061|No|.54331|03/29/2022|.53027|03/29/2022|.5338|03/29/2022|||ANTIFUNGALS: TOPICAL|12273|||||No|No||TARO PHARM USA|No||||
nystatin/triamcin|No|No|No|No|75%|51672126302|NYSTATIN-TRIAMCINOLONE CREAM|30|GM|.42168|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|061|No|.49088|03/29/2022|.47909|03/29/2022|.48228|03/29/2022|||ANTIFUNGALS: TOPICAL|12274|||||No|No||TARO PHARM USA|No||||
nystatin/triamcin|No|No|No|No|75%|51672126303|NYSTATIN-TRIAMCINOLONE CREAM|60|GM|.31304|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|061|No|.35965|03/29/2022|.35101|03/29/2022|.35335|03/29/2022|||ANTIFUNGALS: TOPICAL|12275|||||No|No||TARO PHARM USA|No||||
fluocinonide|No|No|No|No|75%|51672126401|FLUOCINONIDE 0.05% OINTMENT|15|GM|.53033|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|120|No|.57506|03/29/2022|.56125|03/29/2022|.56499|03/29/2022|||STEROIDS: TOPICAL HIGH|12276|||||No|No||TARO PHARM USA|No||||
fluocinonide|No|No|No|No|75%|51672126402|FLUOCINONIDE 0.05% OINTMENT|30|GM|.37137|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|120|No|.36243|03/29/2022|.35373|03/29/2022|.35608|03/29/2022|||STEROIDS: TOPICAL HIGH|12277|||||No|No||TARO PHARM USA|No||||
fluocinonide|No|No|No|No|75%|51672126403|FLUOCINONIDE 0.05% OINTMENT|60|GM|.27849|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|120|No|.32783|03/29/2022|.31996|03/29/2022|.32209|03/29/2022|||STEROIDS: TOPICAL HIGH|12278|||||No|No||TARO PHARM USA|No||||
triamcinolone acetonide|No|No|No|No|75%|51672126705|TRIAMCINOLONE 0.1% PASTE|5|GM|5.54442|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|5.24075|03/29/2022|5.11497|03/29/2022|5.14903|03/29/2022||||12279|||||No|No||TARO PHARM USA|No||||
betamethasone valerate|No|No|No|No|75%|51672126901|BETAMETHASONE VA 0.1% CREAM|15|GM|.51313|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||120|No|.68343|03/29/2022|.66702|03/29/2022|.67146|03/29/2022|||STEROIDS: TOPICAL HIGH|12280|||||No|No||TARO PHARM USA|No||||
betamethasone valerate|No|No|No|No|75%|51672126906|BETAMETHASONE VA 0.1% CREAM|45|GM|.34916|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||120|No|.43211|03/29/2022|.42173|03/29/2022|.42454|03/29/2022|||STEROIDS: TOPICAL HIGH|12281|||||No|No||TARO PHARM USA|No||||
desoximetasone|No|No|No|No|75%|51672127001|DESOXIMETASONE 0.25% CREAM|15|GM|.89698|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|120|No|.62238|03/29/2022|.60744|03/29/2022|.61148|03/29/2022|||STEROIDS: TOPICAL HIGH|12282|||||No|No||TARO PHARM USA|No||||
desoximetasone|No|No|No|No|75%|51672127003|DESOXIMETASONE 0.25% CREAM|60|GM|.39789|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|120|No|.41664|03/29/2022|.40664|03/29/2022|.40934|03/29/2022|||STEROIDS: TOPICAL HIGH|12283|||||No|No||TARO PHARM USA|No||||
desoximetasone|No|No|No|No|75%|51672127103|DESOXIMETASONE 0.05% CREAM|60|GM|2.10663|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|120|No|2.8478|03/29/2022|2.77945|03/29/2022|2.79796|03/29/2022|||STEROIDS: TOPICAL HIGH|12284|||||No|No||TARO PHARM USA|No||||
nystatin/triamcin|No|No|No|No|75%|51672127201|NYSTATIN-TRIAMCINOLONE OINTM|15|GM|1.43046|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|061|No|.4296|03/29/2022|.41928|03/29/2022|.42208|03/29/2022|||ANTIFUNGALS: TOPICAL|12285|||||No|No||TARO PHARM USA|No||||
nystatin/triamcin|No|No|No|No|75%|51672127202|NYSTATIN-TRIAMCINOLONE OINTM|30|GM|1.02125|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|061|No|.33412|03/29/2022|.3261|03/29/2022|.32827|03/29/2022|||ANTIFUNGALS: TOPICAL|12286|||||No|No||TARO PHARM USA|No||||
nystatin/triamcin|No|No|No|No|75%|51672127203|NYSTATIN-TRIAMCINOLONE OINTM|60|GM|.7439|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|061|No|.24511|03/29/2022|.23922|03/29/2022|.24082|03/29/2022|||ANTIFUNGALS: TOPICAL|12287|||||No|No||TARO PHARM USA|No||||
fluocinonide|No|No|No|No|75%|51672127302|FLUOCINONIDE 0.05% SOLUTION|20|ML|.99029|07/12/2005||Yes|No||07/12/2005||Yes|No|07/12/2005||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|120|No|.47513|03/29/2022|.46372|03/29/2022|.46681|03/29/2022|||STEROIDS: TOPICAL HIGH|12288|||||No|No||TARO PHARM USA|No||||
fluocinonide|No|No|No|No|75%|51672127304|FLUOCINONIDE 0.05% SOLUTION|60|ML|.66441|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|120|No|.3579|03/29/2022|.34931|03/29/2022|.35163|03/29/2022|||STEROIDS: TOPICAL HIGH|12289|||||No|No||TARO PHARM USA|No||||
betamethasone dipropionate|No|No|No|No|75%|51672127401|BETAMETHASONE DP 0.05% CRM|15|GM|1.00964|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|1.02286|03/29/2022|.99831|03/29/2022|1.00495|03/29/2022|||STEROIDS: TOPICAL HIGH|12290|||||No|No||TARO PHARM USA|No||||
betamethasone dipropionate|No|No|No|No|75%|51672127406|BETAMETHASONE DP 0.05% CRM|45|GM|.67299|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|.64604|03/29/2022|.63053|03/29/2022|.63473|03/29/2022|||STEROIDS: TOPICAL HIGH|12291|||||No|No||TARO PHARM USA|No||||
clotrimazole|No|No|No|No|75%|51672127501|CLOTRIMAZOLE 1% TOPICAL CREAM|15|GM|.3354|04/21/2009||Yes|No||04/21/2009||Yes|No|04/21/2009||Yes|No||04/21/2009||Yes|No|||Prescription required|No||061|No|.22379|03/29/2022|.21841|03/29/2022|.21987|03/29/2022|||ANTIFUNGALS: TOPICAL|12292|||||No|No||TARO PHARM USA|No||||
clotrimazole|No|No|No|No|75%|51672127502|CLOTRIMAZOLE 1% TOPICAL CREAM|30|GM|.31719|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||061|No|.16554|03/29/2022|.16156|03/29/2022|.16264|03/29/2022|||ANTIFUNGALS: TOPICAL|12293|||||No|No||TARO PHARM USA|No||||
clotrimazole|No|No|No|No|75%|51672127506|CLOTRIMAZOLE 1% TOPICAL CREAM|45|GM|.29717|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||061|No|.30928|03/29/2022|.30185|03/29/2022|.30386|03/29/2022|||ANTIFUNGALS: TOPICAL|12294|||||No|No||TARO PHARM USA|No||||
clotrimazole|No|No|No|No|75%|51672127507|CLOTRIMAZOLE 1% TOPICAL CREAM|45|GM|.20124|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||061|No|.45864|11/24/2020|.45208|11/24/2020|.43056|11/24/2020|||ANTIFUNGALS: TOPICAL|12295|||||No|No||TARO PHARM USA|No||||
fluocinonide|No|No|No|No|75%|51672127901|FLUOCINONIDE 0.05% GEL|15|GM|.85971|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|120|No|1.08815|03/29/2022|1.06203|03/29/2022|1.0691|03/29/2022|||STEROIDS: TOPICAL HIGH|12296|||||No|No||TARO PHARM USA|No||||
fluocinonide|No|No|No|No|75%|51672127902|FLUOCINONIDE 0.05% GEL|30|GM|.85971|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|120|No|1.41527|03/01/2022|1.3813|03/01/2022|1.3905|03/01/2022|||STEROIDS: TOPICAL HIGH|12297|||||No|No||TARO PHARM USA|No||||
fluocinonide|No|No|No|No|75%|51672127903|FLUOCINONIDE 0.05% GEL|60|GM|.64478|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|120|No|.98528|03/29/2022|.96163|03/29/2022|.96803|03/29/2022|||STEROIDS: TOPICAL HIGH|12298|||||No|No||TARO PHARM USA|No||||
desonide|No|No|No|No|75%|51672128001|DESONIDE 0.05% CREAM|15|GM|1.84126|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|118|No|.68707|03/29/2022|.67058|03/29/2022|.67504|03/29/2022|||STEROIDS: TOPICAL LOW|12299|||||No|No||TARO PHARM USA|No||||
desonide|No|No|No|No|75%|51672128003|DESONIDE 0.05% CREAM|60|GM|1.84118|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|118|No|.61157|03/29/2022|.59689|03/29/2022|.60086|03/29/2022|||STEROIDS: TOPICAL LOW|12300|||||No|No||TARO PHARM USA|No||||
desonide|No|No|No|No|75%|51672128101|DESONIDE 0.05% OINTMENT|15|GM|1.37829|08/11/2008||Yes|No||08/11/2008||Yes|No|08/11/2008||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|118|No|.83836|03/29/2022|.81823|03/29/2022|.82368|03/29/2022|||STEROIDS: TOPICAL LOW|12301|||||No|No||TARO PHARM USA|No||||
desonide|No|No|No|No|75%|51672128103|DESONIDE 0.05% OINTMENT|60|GM|1.37829|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|118|No|.63751|03/29/2022|.6222|03/29/2022|.62635|03/29/2022|||STEROIDS: TOPICAL LOW|12302|||||No|No||TARO PHARM USA|No||||
triamcinolone acetonide|No|No|No|No|75%|51672128201|TRIAMCINOLONE 0.1% CREAM|15|GM|.11839|07/12/2005||Yes|No||07/12/2005||Yes|No|07/12/2005||Yes|No||||No|No|||Prescription required|No||120|No|.13878|03/29/2022|.13544|03/29/2022|.13635|03/29/2022|||STEROIDS: TOPICAL HIGH|12303|||||No|No||TARO PHARM USA|No||||
triamcinolone acetonide|No|No|No|No|75%|51672128202|TRIAMCINOLONE 0.1% CREAM|30|GM|.0903|07/12/2005||Yes|No||07/12/2005||Yes|No|07/12/2005||Yes|No||||No|No|||Prescription required|No||120|No|.14475|03/29/2022|.14127|03/29/2022|.14221|03/29/2022|||STEROIDS: TOPICAL HIGH|12304|||||No|No||TARO PHARM USA|No||||
triamcinolone acetonide|No|No|No|No|75%|51672128208|TRIAMCINOLONE 0.1% CREAM|80|GM|.05074|07/12/2005||Yes|No||07/12/2005||Yes|No|07/12/2005||Yes|No||||No|No|||Prescription required|No||120|No|.05241|03/29/2022|.05115|03/29/2022|.05149|03/29/2022|||STEROIDS: TOPICAL HIGH|12305|||||No|No||TARO PHARM USA|No||||
triamcinolone acetonide|No|No|No|No|75%|51672128402|TRIAMCINOLONE 0.1% OINTMENT|30|GM|.086|02/02/2017||Yes|No||02/02/2017||Yes|No|02/02/2017||Yes|No||||No|No|||Prescription required|No||120|No|.15726|03/29/2022|.15348|03/29/2022|.1545|03/29/2022|||STEROIDS: TOPICAL HIGH|12306|||||No|No||TARO PHARM USA|No||||
nystatin|No|No|No|No|75%|51672128901|NYSTATIN 100,000 UNIT/GM CREAM|15|GM|.24997|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||061|No|.26748|03/29/2022|.26106|03/29/2022|.26279|03/29/2022|||ANTIFUNGALS: TOPICAL|12307|||||No|No||TARO PHARM USA|No||||
nystatin|No|No|No|No|75%|51672128902|NYSTATIN 100,000 UNIT/GM CREAM|30|GM|.18733|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||061|No|.16163|03/29/2022|.15775|03/29/2022|.1588|03/29/2022|||ANTIFUNGALS: TOPICAL|12308|||||No|No||TARO PHARM USA|No||||
hydrocortisone valerate|No|No|No|No|75%|51672129001|HYDROCORTISONE VAL 0.2% CREAM|15|GM|2.05339|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|119|No|.67989|03/29/2022|.66357|03/29/2022|.66799|03/29/2022|||STEROIDS: TOPICAL MEDIUM|12309|||||No|No||TARO PHARM USA|No||||
hydrocortisone valerate|No|No|No|No|75%|51672129003|HYDROCORTISONE VAL 0.2% CREAM|60|GM|.42433|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|119|No|.61899|03/01/2022|.60413|03/01/2022|.60815|03/01/2022|||STEROIDS: TOPICAL MEDIUM|12310|||||No|No||TARO PHARM USA|No||||
hydrocortisone valerate|No|No|No|No|75%|51672129006|HYDROCORTISONE VAL 0.2% CREAM|45|GM|.47032|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|119|No|.56991|03/29/2022|.55623|03/29/2022|.55993|03/29/2022|||STEROIDS: TOPICAL MEDIUM|12311|||||No|No||TARO PHARM USA|No||||
hydrocortisone valerate|No|No|No|No|75%|51672129201|HYDROCORTISONE VAL 0.2% OINTMT|15|GM|2.25664|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|119|No|3.63773|08/24/2021|3.55042|08/24/2021|3.57406|08/24/2021|||STEROIDS: TOPICAL MEDIUM|12312|||||No|No||TARO PHARM USA|No||||
hydrocortisone valerate|No|No|No|No|75%|51672129203|HYDROCORTISONE VAL 0.2% OINTMT|60|GM|1.36804|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|119|No|3.11787|10/23/2018|3.07332|10/23/2018|2.92698|10/23/2018|||STEROIDS: TOPICAL MEDIUM|12313|||||No|No||TARO PHARM USA|No||||
hydrocortisone valerate|No|No|No|No|75%|51672129206|HYDROCORTISONE VAL 0.2% OINTMT|45|GM|1.51646|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|119|No|2.25168|03/01/2022|2.19763|03/01/2022|2.21227|03/01/2022|||STEROIDS: TOPICAL MEDIUM|12314|||||No|No||TARO PHARM USA|No||||
clobetasol propionate|No|No|No|No|75%|51672129302|CLOBETASOL 0.05% SOLUTION|25|ML|.86|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||121|No|.44026|03/29/2022|.42969|03/29/2022|.43255|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|12315|||||No|No||TARO PHARM USA|No||||
clobetasol propionate|No|No|No|No|75%|51672129303|CLOBETASOL 0.05% SOLUTION|50|ML|.86|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||121|No|.35501|03/29/2022|.34648|03/29/2022|.34879|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|12316|||||No|No||TARO PHARM USA|No||||
clobetasol propionate|No|No|No|No|75%|51672129401|CLOBETASOL 0.05% GEL|15|GM|1.02684|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||121|No|1.023|03/01/2022|.99844|03/01/2022|1.00509|03/01/2022|||STEROIDS: TOPICAL VERY HIGH|12317|||||No|No||TARO PHARM USA|No||||
clobetasol propionate|No|No|No|No|75%|51672129402|CLOBETASOL 0.05% GEL|30|GM|.93009|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||121|No|1.27828|03/29/2022|1.2476|03/29/2022|1.25591|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|12318|||||No|No||TARO PHARM USA|No||||
clobetasol propionate|No|No|No|No|75%|51672129403|CLOBETASOL 0.05% GEL|60|GM|.89074|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||121|No|.91682|03/29/2022|.89481|03/29/2022|.90077|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|12319|||||No|No||TARO PHARM USA|No||||
diflorasone diacetate|No|No|No|No|75%|51672129501|DIFLORASONE 0.05% OINTMENT|15|GM|4.80854|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|120|No|10.959|06/01/2016|10.80244|06/01/2016|10.28804|06/01/2016|||STEROIDS: TOPICAL HIGH|12320|||||No|No||TARO PHARM USA|No||||
diflorasone diacetate|No|No|No|No|75%|51672129502|DIFLORASONE 0.05% OINTMENT|30|GM|4.80854|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|120|No|10.959|06/01/2016|10.80244|06/01/2016|10.28804|06/01/2016|||STEROIDS: TOPICAL HIGH|12321|||||No|No||TARO PHARM USA|No||||
diflorasone diacetate|No|No|No|No|75%|51672129503|DIFLORASONE 0.05% OINTMENT|60|GM|4.80861|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|120|No|10.95917|08/29/2017|10.80261|08/29/2017|10.2882|08/29/2017|||STEROIDS: TOPICAL HIGH|12322|||||No|No||TARO PHARM USA|No||||
diflorasone diacetate|No|No|No|No|75%|51672129602|DIFLORASONE 0.05% CREAM|30|GM|4.80854|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|120|No|10.959|06/27/2017|10.80244|06/27/2017|10.28804|06/27/2017|||STEROIDS: TOPICAL HIGH|12323|||||No|No||TARO PHARM USA|No||||
diflorasone diacetate|No|No|No|No|75%|51672129603|DIFLORASONE 0.05% CREAM|60|GM|4.80861|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|120|No|10.95917|12/04/2018|10.80261|12/04/2018|10.2882|12/04/2018|||STEROIDS: TOPICAL HIGH|12324|||||No|No||TARO PHARM USA|No||||
clobetasol propionate/emoll|No|No|No|No|75%|51672129701|CLOBETASOL EMOLLIENT 0.05% CRM|15|GM|1.56262|09/23/2009||Yes|No||09/23/2009||Yes|No|09/23/2009||Yes|No||||No|No|||Prescription required|No||121|No|1.21527|03/29/2022|1.1861|03/29/2022|1.194|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|12325|||||No|No||TARO PHARM USA|No||||
clobetasol propionate/emoll|No|No|No|No|75%|51672129702|CLOBETASOL EMOLLIENT 0.05% CRM|30|GM|1.56247|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||121|No|.6904|03/29/2022|.67383|03/29/2022|.67831|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|12326|||||No|No||TARO PHARM USA|No||||
clobetasol propionate/emoll|No|No|No|No|75%|51672129703|CLOBETASOL EMOLLIENT 0.05% CRM|60|GM|1.56254|09/23/2009||Yes|No||09/23/2009||Yes|No|09/23/2009||Yes|No||||No|No|||Prescription required|No||121|No|.73304|03/29/2022|.71544|03/29/2022|.72021|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|12327|||||No|No||TARO PHARM USA|No||||
ketoconazole|No|No|No|No|75%|51672129801|KETOCONAZOLE 2% CREAM|15|GM|.65016|01/10/2003||Yes|No||01/10/2003||Yes|No|01/10/2003||Yes|No||01/10/2003||Yes|No|||Prescription required|Yes|03/09/2018|061|No|.53088|03/29/2022|.51813|03/29/2022|.52158|03/29/2022|||ANTIFUNGALS: TOPICAL|12328|||||No|No||TARO PHARM USA|No||||
ketoconazole|No|No|No|No|75%|51672129802|KETOCONAZOLE 2% CREAM|30|GM|.54524|01/10/2003||Yes|No||01/10/2003||Yes|No|01/10/2003||Yes|No||01/10/2003||Yes|No|||Prescription required|Yes|03/09/2018|061|No|.43567|03/29/2022|.42521|03/29/2022|.42804|03/29/2022|||ANTIFUNGALS: TOPICAL|12329|||||No|No||TARO PHARM USA|No||||
ketoconazole|No|No|No|No|75%|51672129803|KETOCONAZOLE 2% CREAM|60|GM|.40893|01/10/2003||Yes|No||01/10/2003||Yes|No|01/10/2003||Yes|No||01/10/2003||Yes|No|||Prescription required|Yes|03/09/2018|061|No|.36478|03/29/2022|.35602|03/29/2022|.35839|03/29/2022|||ANTIFUNGALS: TOPICAL|12330|||||No|No||TARO PHARM USA|No||||
ammonium lactate|No|No|No|No|75%|51672130005|AMMONIUM LACTATE 12% LOTION|225|GM|.06551|03/14/2006||Yes|No||03/14/2006||Yes|No|03/14/2006||Yes|No||||No|No|||Prescription required|No|||No|.07608|03/29/2022|.07425|03/29/2022|.07474|03/29/2022||||12331|||||No|No||TARO PHARM USA|No||||
ammonium lactate|No|No|No|No|75%|51672130009|AMMONIUM LACTATE 12% LOTION|400|GM|.058|03/14/2006||Yes|No||03/14/2006||Yes|No|03/14/2006||Yes|No||||No|No|||Prescription required|No|||No|.06856|03/29/2022|.06691|03/29/2022|.06736|03/29/2022||||12332|||||No|No||TARO PHARM USA|No||||
ammonium lactate|No|No|No|No|75%|51672130100|AMMONIUM LACTATE 12% CREAM|385|GM|.05249|03/14/2006||Yes|No||03/14/2006||Yes|No|03/14/2006||Yes|No||||No|No|||Prescription required|No|||No|.07039|03/29/2022|.0687|03/29/2022|.06915|03/29/2022||||12333|||||No|No||TARO PHARM USA|No||||
ammonium lactate|No|No|No|No|75%|51672130104|AMMONIUM LACTATE 12% CREAM|140|GM|.05511|04/15/2003||Yes|No||04/15/2003||Yes|No|04/15/2003||Yes|No||||No|No|||Prescription required|No|||No|.06126|03/29/2022|.05978|03/29/2022|.06018|03/29/2022||||12334|||||No|No||TARO PHARM USA|No||||
terconazole|Yes|No|No|No|75%|51672130200|TERCONAZOLE 0.8% CREAM|20|GM|.77421|07/20/2004||Yes|No||07/20/2004||Yes|No|07/20/2004||Yes|No||||No|No|11/01/2012||Prescription required|No|||No|1.2859|03/29/2022|1.25503|03/29/2022|1.26339|03/29/2022||||12335|||||No|No||TARO PHARM USA|No||||
econazole nitrate|No|No|No|No|75%|51672130301|ECONAZOLE NITRATE 1% CREAM|15|GM|1.43419|01/10/2003||Yes|No||01/10/2003||Yes|No|01/10/2003||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|061|No|.43362|03/29/2022|.42321|03/29/2022|.42603|03/29/2022|||ANTIFUNGALS: TOPICAL|12336|||||No|No||TARO PHARM USA|No||||
econazole nitrate|No|No|No|No|75%|51672130302|ECONAZOLE NITRATE 1% CREAM|30|GM|1.39563|01/10/2003||Yes|No||01/10/2003||Yes|No|01/10/2003||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|061|No|.37785|03/29/2022|.36878|03/29/2022|.37123|03/29/2022|||ANTIFUNGALS: TOPICAL|12337|||||No|No||TARO PHARM USA|No||||
econazole nitrate|No|No|No|No|75%|51672130308|ECONAZOLE NITRATE 1% CREAM|85|GM|.49262|01/10/2003||Yes|No||01/10/2003||Yes|No|01/10/2003||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|061|No|.19681|03/29/2022|.19208|03/29/2022|.19336|03/29/2022|||ANTIFUNGALS: TOPICAL|12338|||||No|No||TARO PHARM USA|No||||
terconazole|Yes|No|No|No|75%|51672130406|TERCONAZOLE 0.4% CREAM|45|GM|.34409|03/15/2005||Yes|No||03/15/2005||Yes|No|03/15/2005||Yes|No||||No|No|11/01/2012||Prescription required|No|||No|.63668|03/29/2022|.62139|03/29/2022|.62553|03/29/2022||||12339|||||No|No||TARO PHARM USA|No||||
alclometasone dipropionate|No|No|No|No|75%|51672130601|ALCLOMETASONE DIPRO 0.05% CRM|15|GM|1.10252|07/24/2008||Yes|No||07/24/2008||Yes|No|07/24/2008||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|118|No|1.384|03/29/2022|1.35078|03/29/2022|1.35978|03/29/2022|||STEROIDS: TOPICAL LOW|12340|||||No|No||TARO PHARM USA|No||||
alclometasone dipropionate|No|No|No|No|75%|51672130603|ALCLOMETASONE DIPRO 0.05% CRM|60|GM|.64829|10/14/2005||Yes|No||10/14/2005||Yes|No|10/14/2005||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|118|No|.81209|03/29/2022|.79259|03/29/2022|.79787|03/29/2022|||STEROIDS: TOPICAL LOW|12341|||||No|No||TARO PHARM USA|No||||
alclometasone dipropionate|No|No|No|No|75%|51672130606|ALCLOMETASONE DIPRO 0.05% CRM|45|GM|.74542|10/14/2005||Yes|No||10/14/2005||Yes|No|10/14/2005||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|118|No|.64662|03/29/2022|.6311|03/29/2022|.6353|03/29/2022|||STEROIDS: TOPICAL LOW|12342|||||No|No||TARO PHARM USA|No||||
clotrimazole/betamethasone dip|No|No|No|No|75%|51672130803|CLOTRIMAZOLE-BETAMETHASONE LOT|30|ML|1.68574|01/07/2005||Yes|No||01/07/2005||Yes|No|01/07/2005||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|061|No|2.80479|03/29/2022|2.73747|03/29/2022|2.7557|03/29/2022|||ANTIFUNGALS: TOPICAL|12343|||||No|No||TARO PHARM USA|No||||
betamethasone dipropionate|No|No|No|No|75%|51672130901|BETAMETHASONE DP AUG 0.05% GEL|15|GM|1.41011|07/20/2004||Yes|No||07/20/2004||Yes|No|07/20/2004||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|3.21374|06/01/2016|3.16783|06/01/2016|3.01698|06/01/2016|||STEROIDS: TOPICAL HIGH|12344|||||No|No||TARO PHARM USA|No||||
betamethasone dipropionate|No|No|No|No|75%|51672130903|BETAMETHASONE DP AUG 0.05% GEL|50|GM|.94006|07/20/2004||Yes|No||07/20/2004||Yes|No|07/20/2004||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|2.14247|02/23/2021|2.11186|02/23/2021|2.0113|02/23/2021|||STEROIDS: TOPICAL HIGH|12345|||||No|No||TARO PHARM USA|No||||
betamethasone/propylene glyc|No|No|No|No|75%|51672131001|BETAMETHASONE DP AUG 0.05% CRM|15|GM|.60888|01/05/2004||Yes|No||01/05/2004||Yes|No|01/05/2004||Yes|No||||No|No|||Prescription required|No||120|No|.24003|03/29/2022|.23426|03/29/2022|.23582|03/29/2022|||STEROIDS: TOPICAL HIGH|12346|||||No|No||TARO PHARM USA|No||||
betamethasone/propylene glyc|No|No|No|No|75%|51672131003|BETAMETHASONE DP AUG 0.05% CRM|50|GM|.4085|01/05/2004||Yes|No||01/05/2004||Yes|No|01/05/2004||Yes|No||||No|No|||Prescription required|No||120|No|.14968|03/29/2022|.14608|03/29/2022|.14706|03/29/2022|||STEROIDS: TOPICAL HIGH|12347|||||No|No||TARO PHARM USA|No||||
mupirocin|No|No|No|No|75%|51672131200|MUPIROCIN 2% OINTMENT|22|GM|.3909|03/06/2006||Yes|No||03/06/2006||Yes|No|03/06/2006||Yes|No||||No|No|||Prescription required|No||114|No|.18067|03/29/2022|.17633|03/29/2022|.1775|03/29/2022|||ANTIBIOTICS: TOPICAL|12348|||||No|No||TARO PHARM USA|No||||
mupirocin|No|No|No|No|75%|51672131201|MUPIROCIN 2% OINTMENT|15|GM|.39101|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|No||114|No|.35049|03/29/2022|.34207|03/29/2022|.34435|03/29/2022|||ANTIBIOTICS: TOPICAL|12349|||||No|No||TARO PHARM USA|No||||
alclometasone dipropionate|No|No|No|No|75%|51672131601|ALCLOMETASONE DIPR 0.05% OINT|15|GM|.47787|01/07/2005||Yes|No||01/07/2005||Yes|No|01/07/2005||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|118|No|1.05408|03/29/2022|1.02878|03/29/2022|1.03563|03/29/2022|||STEROIDS: TOPICAL LOW|12350|||||No|No||TARO PHARM USA|No||||
alclometasone dipropionate|No|No|No|No|75%|51672131603|ALCLOMETASONE DIPR 0.05% OINT|60|GM|.22553|01/07/2005||Yes|No||01/07/2005||Yes|No|01/07/2005||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|118|No|.51401|06/29/2021|.50666|06/29/2021|.48254|06/29/2021|||STEROIDS: TOPICAL LOW|12351|||||No|No||TARO PHARM USA|No||||
alclometasone dipropionate|No|No|No|No|75%|51672131606|ALCLOMETASONE DIPR 0.05% OINT|45|GM|.23745|01/07/2005||Yes|No||01/07/2005||Yes|No|||No|No||||No|No|||Prescription required|Yes|01/25/2012|118|No|.54117|03/29/2022|.53344|03/29/2022|.50804|03/29/2022|||STEROIDS: TOPICAL LOW|12352|||||No|No||TARO PHARM USA|No||||
ciclopirox olamine|No|No|No|No|75%|51672131801|CICLOPIROX 0.77% CREAM|15|GM|.53291|06/03/2005||Yes|No||06/03/2005||Yes|No|06/03/2005||Yes|No||||No|No|||Prescription required|Yes|07/12/2005|061|No|.22046|03/29/2022|.21516|03/29/2022|.2166|03/29/2022|||ANTIFUNGALS: TOPICAL|12353|||||No|No||TARO PHARM USA|No||||
ciclopirox olamine|No|No|No|No|75%|51672131802|CICLOPIROX 0.77% CREAM|30|GM|.47615|06/03/2005||Yes|No||06/03/2005||Yes|No|06/03/2005||Yes|No||||No|No|||Prescription required|Yes|07/12/2005|061|No|.18222|03/29/2022|.17784|03/29/2022|.17903|03/29/2022|||ANTIFUNGALS: TOPICAL|12354|||||No|No||TARO PHARM USA|No||||
ciclopirox olamine|No|No|No|No|75%|51672131808|CICLOPIROX 0.77% CREAM|90|GM|.38432|06/03/2005||Yes|No||06/03/2005||Yes|No|06/03/2005||Yes|No||||No|No|||Prescription required|Yes|07/12/2005|061|No|.11129|03/29/2022|.10861|03/29/2022|.10934|03/29/2022|||ANTIFUNGALS: TOPICAL|12355|||||No|No||TARO PHARM USA|No||||
betamethasone/propylene glyc|No|No|No|No|75%|51672134003|BETAMETHASONE DP AUG 0.05% LOT|30|ML|.86028|04/08/2009||Yes|No||04/08/2009||Yes|No|04/08/2009||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|.90128|03/01/2022|.87964|03/01/2022|.8855|03/01/2022|||STEROIDS: TOPICAL HIGH|12356|||||No|No||TARO PHARM USA|No||||
betamethasone/propylene glyc|No|No|No|No|75%|51672134004|BETAMETHASONE DP AUG 0.05% LOT|60|ML|.84774|08/08/2009||Yes|No||08/08/2009||Yes|No|08/08/2009||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|.75016|03/29/2022|.73215|03/29/2022|.73703|03/29/2022|||STEROIDS: TOPICAL HIGH|12357|||||No|No||TARO PHARM USA|No||||
clobetasol propionate|No|No|No|No|75%|51672134708|CLOBETASOL 0.05% SHAMPOO|118|ML|.66099|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|121|No|.54041|03/29/2022|.52744|03/29/2022|.53095|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|12358|||||No|No||TARO PHARM USA|No||||
ciclopirox|No|No|No|No|75%|51672135108|CICLOPIROX 1% SHAMPOO|120|ML||02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|061|No|.28181|03/29/2022|.27504|03/29/2022|.27687|03/29/2022|||ANTIFUNGALS: TOPICAL|12359|||||No|No||TARO PHARM USA|No||||
fluocinonide|No|No|No|No|75%|51672135302|FLUOCINONIDE 0.1% CREAM|30|GM|.23707|02/13/2015||Yes|No||02/13/2015||Yes|No|02/13/2015||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.34413|01/25/2022|.33587|01/25/2022|.3381|01/25/2022|||STEROIDS: TOPICAL HIGH|12360|||||No|No||TARO PHARM USA|No||||
fluocinonide|No|No|No|No|75%|51672135303|FLUOCINONIDE 0.1% CREAM|60|GM|.20425|02/13/2015||Yes|No||02/13/2015||Yes|No|02/13/2015||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.22927|03/29/2022|.22376|03/29/2022|.22525|03/29/2022|||STEROIDS: TOPICAL HIGH|12361|||||No|No||TARO PHARM USA|No||||
fluocinonide|No|No|No|No|75%|51672135304|FLUOCINONIDE 0.1% CREAM|120|GM|.19403|02/13/2015||Yes|No||02/13/2015||Yes|No|02/13/2015||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.44222|04/27/2021|.4359|04/27/2021|.41515|04/27/2021|||STEROIDS: TOPICAL HIGH|12362|||||No|No||TARO PHARM USA|No||||
fluocinolone acetonide|No|No|No|No|75%|51672135608|FLUOCINOLONE 0.01% BODY OIL|118.28|ML|.64201|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|118|No|.18968|03/29/2022|.18512|03/29/2022|.18636|03/29/2022|||STEROIDS: TOPICAL LOW|12363|||||No|No||TARO PHARM USA|No||||
fluocinolone/shower cap|No|No|No|No|75%|51672135708|FLUOCINOLONE 0.01% SCALP OIL|118.28|ML|.64874|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|118|No|.27456|03/29/2022|.26797|03/29/2022|.26975|03/29/2022|||STEROIDS: TOPICAL LOW|12364|||||No|No||TARO PHARM USA|No||||
oxiconazole nitrate|No|No|No|No|75%|51672135902|OXICONAZOLE NITRATE 1% CREAM|30|GM|7.04899|06/21/2016||Yes|No||06/21/2016||Yes|No|06/21/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|061|No|16.06514|05/25/2021|15.83563|05/25/2021|15.08156|05/25/2021|||ANTIFUNGALS: TOPICAL|12365|||||No|No||TARO PHARM USA|No||||
oxiconazole nitrate|No|No|No|No|75%|51672135903|OXICONAZOLE NITRATE 1% CREAM|60|GM|3.57616|06/21/2016||Yes|No||06/21/2016||Yes|No|06/21/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|061|No|8.15032|09/28/2021|8.03389|09/28/2021|7.65132|09/28/2021|||ANTIFUNGALS: TOPICAL|12366|||||No|No||TARO PHARM USA|No||||
oxiconazole nitrate|No|No|No|No|75%|51672135908|OXICONAZOLE NITRATE 1% CREAM|90|GM|3.57449|06/21/2016||Yes|No||06/21/2016||Yes|No|06/21/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|061|No|8.14651|10/29/2019|8.03013|10/29/2019|7.64774|10/29/2019|||ANTIFUNGALS: TOPICAL|12367|||||No|No||TARO PHARM USA|No||||
acyclovir|No|No|No|No|75%|51672136001|ACYCLOVIR 5% OINTMENT|15|GM|1.72|06/02/2017||Yes|No||06/02/2017||Yes|No|06/02/2017||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.36934|03/29/2022|1.33647|03/29/2022|1.34537|03/29/2022|||ANTIVIRALS: TOPICAL|12368|||||No|No||TARO PHARM USA|No||||
acyclovir|No|No|No|No|75%|51672136002|ACYCLOVIR 5% OINTMENT|30|GM|2.47278|06/02/2017||Yes|No||06/02/2017||Yes|No|06/02/2017||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.03754|03/29/2022|1.01263|03/29/2022|1.01938|03/29/2022|||ANTIVIRALS: TOPICAL|12369|||||No|No||TARO PHARM USA|No||||
naftifine HCl|No|No|No|No|75%|51672136203|NAFTIFINE HCL 1% CREAM|60|GM|2.24187|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|061|No|5.10938|02/03/2021|5.03639|02/03/2021|4.79656|02/03/2021|||ANTIFUNGALS: TOPICAL|12370|||||No|No||TARO PHARM USA|No||||
naftifine HCl|No|No|No|No|75%|51672136208|NAFTIFINE HCL 1% CREAM|90|GM|1.49458|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|061|No|3.40625|02/03/2021|3.35759|02/03/2021|3.1977|02/03/2021|||ANTIFUNGALS: TOPICAL|12371|||||No|No||TARO PHARM USA|No||||
diclofenac sodium|No|No|No|No|75%|51672136307|DICLOFENAC SODIUM 3% GEL|100|GM|2.21127|09/07/2016||Yes|No||09/07/2016||Yes|No|09/07/2016||Yes|No||||No|No|||Prescription required|No|||Yes|.41138|03/29/2022|.4015|03/29/2022|.40418|03/29/2022||||12372|||||No|No||TARO PHARM USA|No||||
adapalene/benzoyl peroxide|No|No|No|No|75%|51672136403|ADAPALENE-BNZYL PEROX 0.1-2.5%|45|GM|1.94655|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|Yes|02/08/2018|104|No|.76371|03/29/2022|.74538|03/29/2022|.75034|03/29/2022|||ACNE AGENTS: TOPICAL|12373|||||No|No||TARO PHARM USA|No||||
fluocinolone acetonide|No|No|No|No|75%|51672136504|FLUOCINOLONE 0.01% SOLUTION|60|ML|1.075|06/11/2015||Yes|No||06/11/2015||Yes|No|06/11/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|119|No|.3936|03/29/2022|.38415|03/29/2022|.38671|03/29/2022|||STEROIDS: TOPICAL MEDIUM|12374|||||No|No||TARO PHARM USA|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|51672136606|CLIND PH-BENZOYL PEROX 1.2-5%|45|GM|.89|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|No||104|No|.73339|03/29/2022|.71578|03/29/2022|.72055|03/29/2022|||ACNE AGENTS: TOPICAL|12375|||||No|No||TARO PHARM USA|No||||
naftifine HCl|No|No|No|No|75%|51672136803|NAFTIFINE HCL 2% CREAM|60|GM|3.0616|02/17/2016||Yes|No||02/17/2016||Yes|No|02/17/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|061|No|1.1856|01/25/2022|1.15714|01/25/2022|1.16485|01/25/2022|||ANTIFUNGALS: TOPICAL|12376|||||No|No||TARO PHARM USA|No||||
naftifine HCl|No|No|No|No|75%|51672136806|NAFTIFINE HCL 2% CREAM|45|GM|3.0549|02/17/2016||Yes|No||02/17/2016||Yes|No|02/17/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|061|No|3.76396|09/28/2021|3.67362|09/28/2021|3.69809|09/28/2021|||ANTIFUNGALS: TOPICAL|12377|||||No|No||TARO PHARM USA|No||||
mupirocin calcium|No|No|No|No|75%|51672137001|MUPIROCIN 2% CREAM|15|GM|5.62239|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|114|No|7.17255|03/29/2022|7.0004|03/29/2022|7.04703|03/29/2022|||ANTIBIOTICS: TOPICAL|12378|||||No|No||TARO PHARM USA|No||||
mupirocin calcium|No|No|No|No|75%|51672137002|MUPIROCIN 2% CREAM|30|GM|4.76511|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|114|No|4.87374|03/29/2022|4.75677|03/29/2022|4.78844|03/29/2022|||ANTIBIOTICS: TOPICAL|12379|||||No|No||TARO PHARM USA|No||||
tazarotene|No|No|No|No|75%|51672137302|TAZAROTENE 0.1% CREAM|30|GM|4.65632|09/19/2017||Yes|No||09/19/2017||Yes|No|09/19/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|104|No|2.38122|03/29/2022|2.32407|03/29/2022|2.33954|03/29/2022|||ACNE AGENTS: TOPICAL|12380|||||No|No||TARO PHARM USA|No||||
tazarotene|No|No|No|No|75%|51672137303|TAZAROTENE 0.1% CREAM|60|GM|4.65561|09/19/2017||Yes|No||09/19/2017||Yes|No|09/19/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|104|No|3.41533|03/01/2022|3.33336|03/01/2022|3.35556|03/01/2022|||ACNE AGENTS: TOPICAL|12381|||||No|No||TARO PHARM USA|No||||
adapalene|No|No|No|No|75%|51672137706|ADAPALENE 0.3% GEL|45|GM|2.3649|03/31/2017||Yes|No||03/31/2017||Yes|No|03/31/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|.91902|03/29/2022|.89696|03/29/2022|.90293|03/29/2022|||ACNE AGENTS: TOPICAL|12382|||||No|No||TARO PHARM USA|No||||
adapalene|No|No|No|No|75%|51672137709|ADAPALENE 0.3% GEL PUMP|45|GM|2.3649|03/31/2017||Yes|No||03/31/2017||Yes|No|03/31/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|104|No|3.35906|03/01/2022|3.27844|03/01/2022|3.30027|03/01/2022|||ACNE AGENTS: TOPICAL|12383|||||No|No||TARO PHARM USA|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|51672138102|CLINDAMYCIN-BENZOYL PEROX 1-5%|25|GM|1.29|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|.996|03/29/2022|.97209|03/29/2022|.97857|03/29/2022|||ACNE AGENTS: TOPICAL|12384|||||No|No||TARO PHARM USA|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|51672138104|CLINDAMYCIN-BENZOYL PEROX 1-5%|50|GM|1.29|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|.80914|03/29/2022|.78972|03/29/2022|.79498|03/29/2022|||ACNE AGENTS: TOPICAL|12385|||||No|No||TARO PHARM USA|No||||
ibuprofen|No|No|No|No|75%|51672138508|IBUPROFEN 100 MG/5 ML SUSP|118|ML|.02736|02/27/2018||Yes|No||02/27/2018||Yes|No|02/27/2018||Yes|No||||No|No|||Prescription required|No||059|Yes|.06236|12/29/2020|.06147|12/29/2020|.05854|12/29/2020|||NSAIDS|12386|||||No|No||TARO PHARM USA|No||||
ibuprofen|No|No|No|No|75%|51672138509|IBUPROFEN 100 MG/5 ML SUSP|473|ML|.02288|02/27/2018||Yes|No||02/27/2018||Yes|No|02/27/2018||Yes|No||||No|No|||Prescription required|No||059|Yes|.03005|03/29/2022|.02932|03/29/2022|.02952|03/29/2022|||NSAIDS|12387|||||No|No||TARO PHARM USA|No||||
fluocinonide|No|No|No|No|75%|51672138601|FLUOCINONIDE 0.05% CREAM|15|GM|1.04461|06/14/2017||Yes|No||06/14/2017||Yes|No|06/14/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|120|No|.69804|03/29/2022|.68128|03/29/2022|.68582|03/29/2022|||STEROIDS: TOPICAL HIGH|12388|||||No|No||TARO PHARM USA|No||||
fluocinonide|No|No|No|No|75%|51672138602|FLUOCINONIDE 0.05% CREAM|30|GM|1.04461|06/14/2017||Yes|No||06/14/2017||Yes|No|06/14/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|120|No|.62146|03/29/2022|.60654|03/29/2022|.61058|03/29/2022|||STEROIDS: TOPICAL HIGH|12389|||||No|No||TARO PHARM USA|No||||
fluocinonide|No|No|No|No|75%|51672138603|FLUOCINONIDE 0.05% CREAM|60|GM|1.04453|06/14/2017||Yes|No||06/14/2017||Yes|No|06/14/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|120|No|.55445|03/29/2022|.54114|03/29/2022|.54474|03/29/2022|||STEROIDS: TOPICAL HIGH|12390|||||No|No||TARO PHARM USA|No||||
fluocinonide|No|No|No|No|75%|51672138604|FLUOCINONIDE 0.05% CREAM|120|GM|1.04457|06/14/2017||Yes|No||06/14/2017||Yes|No|06/14/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|120|No|1.32987|12/28/2021|1.29795|12/28/2021|1.30659|12/28/2021|||STEROIDS: TOPICAL HIGH|12391|||||No|No||TARO PHARM USA|No||||
dapsone|No|No|No|No|75%|51672138703|DAPSONE 5% GEL|60|GM|3.45791|07/09/2018||Yes|No||07/09/2018||Yes|No|07/09/2018||Yes|No||||No|No|||Prescription required|Yes|11/03/2017|104|No|3.1867|03/29/2022|3.11021|03/29/2022|3.13093|03/29/2022|||ACNE AGENTS: TOPICAL|12392|||||No|No||TARO PHARM USA|No||||
dapsone|No|No|No|No|75%|51672138708|DAPSONE 5% GEL|90|GM|3.02376|07/09/2018||Yes|No||07/09/2018||Yes|No|07/09/2018||Yes|No||||No|No|||Prescription required|Yes|11/03/2017|104|No|2.65305|03/29/2022|2.58937|03/29/2022|2.60662|03/29/2022|||ACNE AGENTS: TOPICAL|12393|||||No|No||TARO PHARM USA|No||||
azelaic acid|No|No|No|No|75%|51672138903|AZELAIC ACID 15% GEL|50|GM|1.29|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|221|No|1.03233|03/29/2022|1.00755|03/29/2022|1.01426|03/29/2022|||ROSACEA AGENTS: TOPICAL|12394|||||No|No||TARO PHARM USA|No||||
tretinoin|No|No|No|No|75%|51672139400|TRETINOIN 0.05% CREAM|20|GM|2.01842|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||104|No|2.20699|03/29/2022|2.15402|03/29/2022|2.16836|03/29/2022|||ACNE AGENTS: TOPICAL|12395|||||No|No||TARO PHARM USA|No||||
tretinoin|No|No|No|No|75%|51672139409|TRETINOIN 0.05% CREAM|45|GM|1.68234|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||104|No|1.78965|03/29/2022|1.74669|03/29/2022|1.75833|03/29/2022|||ACNE AGENTS: TOPICAL|12396|||||No|No||TARO PHARM USA|No||||
tretinoin|No|No|No|No|75%|51672139500|TRETINOIN 0.1% CREAM|20|GM|2.35554|02/10/2020||Yes|No||02/10/2020||Yes|No|02/10/2020||Yes|No||||No|No|||Prescription required|No||104|No|2.48726|03/29/2022|2.42756|03/29/2022|2.44373|03/29/2022|||ACNE AGENTS: TOPICAL|12397|||||No|No||TARO PHARM USA|No||||
tretinoin|No|No|No|No|75%|51672139509|TRETINOIN 0.1% CREAM|45|GM|1.96051|02/10/2020||Yes|No||02/10/2020||Yes|No|02/10/2020||Yes|No||||No|No|||Prescription required|No||104|No|2.33901|03/29/2022|2.28287|03/29/2022|2.29807|03/29/2022|||ACNE AGENTS: TOPICAL|12398|||||No|No||TARO PHARM USA|No||||
clindamycin phosphate|No|No|No|No|75%|51672140004|CLINDAMYCIN PHOSP 1% LOTION|60|ML|.68907|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|.74671|03/29/2022|.72878|03/29/2022|.73364|03/29/2022|||ACNE AGENTS: TOPICAL|12399|||||No|No||TARO PHARM USA|No||||
calcipotriene/betamethasone|No|No|No|No|75%|51672140204|CALCIPOTRIENE-BETAMETH DP SUSP|60|GM|5.98388|10/28/2021||Yes|No||10/28/2021||Yes|No|10/28/2021||Yes|No||||No|No|||Prescription required|No|||No|13.63768|10/28/2021|13.44285|10/28/2021|12.80272|10/28/2021||||12400|||||No|No||TARO PHARM USA|No||||
miconazole nitrate|No|No|No|No|75%|51672200101|MICONAZOLE 2% TOPICAL CREAM|15|GM|.03898|07/12/2005||Yes|No||||No|No|07/12/2005||Yes|No||||No|No|||Over the counter|No||061|No|.08884|04/27/2021|.08757|04/27/2021|.0834|04/27/2021|||ANTIFUNGALS: TOPICAL|12401|||||No|No||TARO PHARM USA|No||||
miconazole nitrate|No|No|No|No|75%|51672200102|MICONAZOLE 2% TOPICAL CREAM|30|GM|.02264|07/12/2005||Yes|No||||No|No|07/12/2005||Yes|No||||No|No|||Over the counter|No||061|No|.09559|03/29/2022|.09329|03/29/2022|.09391|03/29/2022|||ANTIFUNGALS: TOPICAL|12402|||||No|No||TARO PHARM USA|No||||
clotrimazole|No|No|No|No|75%|51672200201|CLOTRIMAZOLE 1% TOPICAL CREAM|15|GM|.1462|04/21/2009||Yes|No||||No|No|04/21/2009||Yes|No||04/21/2009||Yes|No|||Over the counter|No||061|No|.16589|03/29/2022|.1619|03/29/2022|.16298|03/29/2022|||ANTIFUNGALS: TOPICAL|12403|||||No|No||TARO PHARM USA|No||||
clotrimazole|No|No|No|No|75%|51672200202|CLOTRIMAZOLE 1% TOPICAL CREAM|30|GM|.0946|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||09/01/1999||Yes|No|||Over the counter|No||061|No|.10455|03/29/2022|.10204|03/29/2022|.10272|03/29/2022|||ANTIFUNGALS: TOPICAL|12404|||||No|No||TARO PHARM USA|No||||
clotrimazole|Yes|No|No|No|75%|51672200306|CLOTRIMAZOLE 1% VAGINAL CREAM|45|GM|.0387|11/15/2001||Yes|No||||No|No|11/15/2001||Yes|No||||No|No|11/01/2012||Over the counter|No|||No|.08902|03/29/2022|.08688|03/29/2022|.08746|03/29/2022||||12405|||||No|No||TARO PHARM USA|No||||
tolnaftate|No|No|No|No|75%|51672202001|TOLNAFTATE 1% CREAM|15|GM|.08772|06/14/2012||Yes|No||||No|No|06/14/2012||Yes|No||09/01/1999||Yes|No|||Over the counter|No||061|No|.14467|03/29/2022|.14119|03/29/2022|.14213|03/29/2022|||ANTIFUNGALS: TOPICAL|12406|||||No|No||TARO PHARM USA|No||||
tolnaftate|No|No|No|No|75%|51672202002|TOLNAFTATE 1% CREAM|30|GM|.07482|07/12/2005||Yes|No||||No|No|07/12/2005||Yes|No||||No|No|||Over the counter|No||061|No|.11362|03/29/2022|.11089|03/29/2022|.11163|03/29/2022|||ANTIFUNGALS: TOPICAL|12407|||||No|No||TARO PHARM USA|No||||
miconazole nitrate|Yes|No|No|No|75%|51672203506|MICONAZOLE 2% VAGINAL CREAM|45|GM|.07691|11/15/2001||Yes|No||||No|No|11/15/2001||Yes|No||||No|No|11/01/2012||Over the counter|No|||No|.13462|03/29/2022|.13138|03/29/2022|.13226|03/29/2022||||12408|||||No|No||TARO PHARM USA|No||||
clotrimazole|No|No|No|No|75%|51672203701|CLOTRIMAZOLE 1% SOLUTION|10|ML|1.5523|08/18/2005||Yes|No||||No|No|08/18/2005||Yes|No||08/18/2005||Yes|No|||Over the counter|No||061|No|2.75313|03/29/2022|2.68705|03/29/2022|2.70495|03/29/2022|||ANTIFUNGALS: TOPICAL|12409|||||No|No||TARO PHARM USA|No||||
loratadine|No|No|No|No|75%|51672207308|LORATADINE 5 MG/5 ML SYRUP|120|ML|.02834|08/23/2009||Yes|No||||No|No|08/23/2009||Yes|No||||No|No|||Over the counter|No||030|Yes|.04114|03/29/2022|.04015|03/29/2022|.04042|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|12410|||||No|No||TARO PHARM USA|No||||
terbinafine HCl|No|No|No|No|75%|51672208001|TERBINAFINE 1% CREAM|15|GM|.18461|08/17/2010||Yes|No||||No|No|08/17/2010||Yes|No||||No|No|||Over the counter|No||061|No|.40267|03/29/2022|.393|03/29/2022|.39562|03/29/2022|||ANTIFUNGALS: TOPICAL|12411|||||No|No||TARO PHARM USA|No||||
terbinafine HCl|No|No|No|No|75%|51672208002|TERBINAFINE 1% CREAM|30|GM|.13803|08/17/2010||Yes|No||||No|No|08/17/2010||Yes|No||||No|No|||Over the counter|No||061|No|.2902|03/29/2022|.28323|03/29/2022|.28512|03/29/2022|||ANTIFUNGALS: TOPICAL|12412|||||No|No||TARO PHARM USA|No||||
loratadine|No|No|No|No|75%|51672209208|CHILD LORATADINE 5 MG/5 ML SYR|120|ML|.02834|11/15/2012||Yes|No||||No|No|11/15/2012||Yes|No||||No|No|||Over the counter|No||030|Yes|.04114|03/29/2022|.04015|03/29/2022|.04042|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|12413|||||No|No||TARO PHARM USA|No||||
cetirizine HCl|No|No|No|No|75%|51672210208|CETIRIZINE HCL 1 MG/ML SOLN|120|ML|.02275|12/07/2012||Yes|No||||No|No|12/07/2012||Yes|No||||No|No|||Over the counter|No||030|Yes|.0312|03/29/2022|.03045|03/29/2022|.03065|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|12414|||||No|No||TARO PHARM USA|No||||
neomycin/bacitracin/polymyxinB|No|No|No|No|75%|51672212002|TRIPLE ANTIBIOTIC OINTMENT|28.4|GM|.09902|08/17/2020||Yes|No||||No|No|08/17/2020||Yes|No||08/17/2020||Yes|No|||Over the counter|No||114|No|.09275|03/29/2022|.09052|03/29/2022|.09112|03/29/2022|||ANTIBIOTICS: TOPICAL|12415|||||No|No||TARO PHARM USA|No||||
ibuprofen|No|No|No|No|75%|51672213008|CHILDREN IBUPROFEN 100 MG/5 ML|120|ML|.01099|11/18/2019||Yes|No||||No|No|11/18/2019||Yes|No||||No|No|||Over the counter|No||059|Yes|.03078|03/29/2022|.03004|03/29/2022|.03024|03/29/2022|||NSAIDS|12416|||||No|No||TARO PHARM USA|No||||
loratadine|No|No|No|No|75%|51672213108|CHILD LORATADINE 5 MG/5 ML SOL|120|ML|.02834|04/12/2019||Yes|No||||No|No|04/12/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.04114|03/29/2022|.04015|03/29/2022|.04042|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|12417|||||No|No||TARO PHARM USA|No||||
hydrocortisone|No|No|No|No|75%|51672300302|HYDROCORTISONE 2.5% CREAM|28.35|GM|.05384|09/12/2014||Yes|No||09/12/2014||Yes|No|09/12/2014||Yes|No||||No|No|||Prescription required|No||118|No|.08707|03/29/2022|.08498|03/29/2022|.08554|03/29/2022|||STEROIDS: TOPICAL LOW|12418|||||No|No||TARO PHARM USA|No||||
lidocaine|No|No|No|No|75%|51672300803|LIDOCAINE 5% OINTMENT|50|GM|.65368|03/31/2006||Yes|No||03/31/2006||Yes|No|03/31/2006||Yes|No||||No|No|||Prescription required|No|||No|.22969|03/29/2022|.22417|03/29/2022|.22567|03/29/2022||||12419|||||No|No||TARO PHARM USA|No||||
lidocaine|No|No|No|No|75%|51672300805|LIDOCAINE 5% OINTMENT|50|GM|.65368|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|No|||No|.22969|03/29/2022|.22417|03/29/2022|.22567|03/29/2022||||12420|||||No|No||TARO PHARM USA|No||||
lidocaine|No|No|No|No|75%|51672302002|LIDOCAINE 5% OINTMENT|30|GM|1.60605|04/10/2013||Yes|No||04/10/2013||Yes|No|04/10/2013||Yes|No||||No|No|||Prescription required|No|||No|.49802|03/29/2022|.48606|03/29/2022|.4893|03/29/2022||||12421|||||No|No||TARO PHARM USA|No||||
lidocaine|No|No|No|No|75%|51672302009|LIDOCAINE 5% OINTMENT|35.44|GM|1.11503|11/09/2015||Yes|No||11/09/2015||Yes|No|11/09/2015||Yes|No||||No|No|||Prescription required|No|||No|.18796|03/29/2022|.18344|03/29/2022|.18467|03/29/2022||||12422|||||No|No||TARO PHARM USA|No||||
nortriptyline HCl|No|No|No|No|75%|51672400101|NORTRIPTYLINE HCL 10 MG CAP|100|EA|.08419|02/11/2016||Yes|No||02/11/2016||Yes|No|02/11/2016||Yes|No||||No|No|||Prescription required|No||215|No|.07187|03/29/2022|.07014|03/29/2022|.07061|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12423|||||No|No||TARO PHARM USA|No||||
nortriptyline HCl|No|No|No|No|75%|51672400102|NORTRIPTYLINE HCL 10 MG CAP|500|EA|.043|03/03/2014||Yes|No||03/03/2014||Yes|No|03/03/2014||Yes|No||||No|No|||Prescription required|No||215|No|.07187|03/29/2022|.07014|03/29/2022|.07061|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12424|||||No|No||TARO PHARM USA|No||||
nortriptyline HCl|No|No|No|No|75%|51672400105|NORTRIPTYLINE HCL 10 MG CAP|90|EA|.04409|10/14/2005||Yes|No||10/14/2005||Yes|No|10/14/2005||Yes|No||||No|No|||Prescription required|No||215|No|.07187|03/29/2022|.07014|03/29/2022|.07061|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12425|||||No|No||TARO PHARM USA|No||||
nortriptyline HCl|No|No|No|No|75%|51672400201|NORTRIPTYLINE HCL 25 MG CAP|100|EA|.11438|02/11/2016||Yes|No||02/11/2016||Yes|No|02/11/2016||Yes|No||||No|No|||Prescription required|No||215|No|.09534|03/29/2022|.09305|03/29/2022|.09367|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12426|||||No|No||TARO PHARM USA|No||||
nortriptyline HCl|No|No|No|No|75%|51672400202|NORTRIPTYLINE HCL 25 MG CAP|500|EA|.05869|03/03/2014||Yes|No||03/03/2014||Yes|No|03/03/2014||Yes|No||||No|No|||Prescription required|No||215|No|.09534|03/29/2022|.09305|03/29/2022|.09367|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12427|||||No|No||TARO PHARM USA|No||||
nortriptyline HCl|No|No|No|No|75%|51672400205|NORTRIPTYLINE HCL 25 MG CAP|90|EA|.0602|10/14/2005||Yes|No||10/14/2005||Yes|No|10/14/2005||Yes|No||||No|No|||Prescription required|No||215|No|.09534|03/29/2022|.09305|03/29/2022|.09367|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12428|||||No|No||TARO PHARM USA|No||||
nortriptyline HCl|No|No|No|No|75%|51672400301|NORTRIPTYLINE HCL 50 MG CAP|100|EA|.14013|02/11/2016||Yes|No||02/11/2016||Yes|No|02/11/2016||Yes|No||||No|No|||Prescription required|No||215|No|.12931|03/29/2022|.1262|03/29/2022|.12704|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12429|||||No|No||TARO PHARM USA|No||||
nortriptyline HCl|No|No|No|No|75%|51672400302|NORTRIPTYLINE HCL 50 MG CAP|500|EA|.07189|03/03/2014||Yes|No||03/03/2014||Yes|No|03/03/2014||Yes|No||||No|No|||Prescription required|No||215|No|.12931|03/29/2022|.1262|03/29/2022|.12704|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12430|||||No|No||TARO PHARM USA|No||||
nortriptyline HCl|No|No|No|No|75%|51672400305|NORTRIPTYLINE HCL 50 MG CAP|90|EA|.07376|12/08/2015||Yes|No||12/08/2015||Yes|No|12/08/2015||Yes|No||||No|No|||Prescription required|No||215|No|.12931|03/29/2022|.1262|03/29/2022|.12704|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12431|||||No|No||TARO PHARM USA|No||||
nortriptyline HCl|No|No|No|No|75%|51672400401|NORTRIPTYLINE HCL 75 MG CAP|100|EA|.19405|02/11/2016||Yes|No||02/11/2016||Yes|No|02/11/2016||Yes|No||||No|No|||Prescription required|No||215|No|.17543|03/29/2022|.17121|03/29/2022|.17235|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12432|||||No|No||TARO PHARM USA|No||||
nortriptyline HCl|No|No|No|No|75%|51672400402|NORTRIPTYLINE HCL 75 MG CAP|500|EA|.0996|02/02/2017||Yes|No||02/02/2017||Yes|No|02/02/2017||Yes|No||||No|No|||Prescription required|No||215|No|.17543|03/29/2022|.17121|03/29/2022|.17235|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12433|||||No|No||TARO PHARM USA|No||||
nortriptyline HCl|No|No|No|No|75%|51672400405|NORTRIPTYLINE HCL 75 MG CAP|90|EA|.10214|10/14/2005||Yes|No||10/14/2005||Yes|No|10/14/2005||Yes|No||||No|No|||Prescription required|No||215|No|.17543|03/29/2022|.17121|03/29/2022|.17235|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12434|||||No|No||TARO PHARM USA|No||||
carbamazepine|No|No|No|No|75%|51672400501|CARBAMAZEPINE 200 MG TABLET|100|EA|.38919|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||056|No|.20856|03/29/2022|.20355|03/29/2022|.20491|03/29/2022|||ANTICONVULSANTS|12435|||||No|No||TARO PHARM USA|No||||
carbamazepine|No|No|No|No|75%|51672400502|CARBAMAZEPINE 200 MG TABLET|500|EA|.38334|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||056|No|.20856|03/29/2022|.20355|03/29/2022|.20491|03/29/2022|||ANTICONVULSANTS|12436|||||No|No||TARO PHARM USA|No||||
carbamazepine|No|No|No|No|75%|51672400503|CARBAMAZEPINE 200 MG TABLET|1000|EA|.3775|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||056|No|.20856|03/29/2022|.20355|03/29/2022|.20491|03/29/2022|||ANTICONVULSANTS|12437|||||No|No||TARO PHARM USA|No||||
clomipramine HCl|No|No|No|No|75%|51672401105|CLOMIPRAMINE 25 MG CAPSULE|90|EA|2.90044|04/07/2006||Yes|No||04/07/2006||Yes|No|04/07/2006||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|1.31238|03/29/2022|1.28088|03/29/2022|1.28941|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12438|||||No|No||TARO PHARM USA|No||||
clomipramine HCl|No|No|No|No|75%|51672401106|CLOMIPRAMINE 25 MG CAPSULE|30|EA|2.90049|04/07/2006||Yes|No||04/07/2006||Yes|No|04/07/2006||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|1.31238|03/29/2022|1.28088|03/29/2022|1.28941|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12439|||||No|No||TARO PHARM USA|No||||
clomipramine HCl|No|No|No|No|75%|51672401205|CLOMIPRAMINE 50 MG CAPSULE|90|EA|2.90044|04/07/2006||Yes|No||04/07/2006||Yes|No|04/07/2006||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.80238|03/29/2022|.78312|03/29/2022|.78833|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12440|||||No|No||TARO PHARM USA|No||||
clomipramine HCl|No|No|No|No|75%|51672401206|CLOMIPRAMINE 50 MG CAPSULE|30|EA|2.90049|04/07/2006||Yes|No||04/07/2006||Yes|No|04/07/2006||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.80238|03/29/2022|.78312|03/29/2022|.78833|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12441|||||No|No||TARO PHARM USA|No||||
clomipramine HCl|No|No|No|No|75%|51672401305|CLOMIPRAMINE 75 MG CAPSULE|90|EA|2.90044|04/07/2006||Yes|No||04/07/2006||Yes|No|04/07/2006||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.95054|03/29/2022|.92772|03/29/2022|.9339|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12442|||||No|No||TARO PHARM USA|No||||
clomipramine HCl|No|No|No|No|75%|51672401306|CLOMIPRAMINE 75 MG CAPSULE|30|EA|2.90049|04/07/2006||Yes|No||04/07/2006||Yes|No|04/07/2006||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.95054|03/29/2022|.92772|03/29/2022|.9339|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12443|||||No|No||TARO PHARM USA|No||||
etodolac|No|No|No|No|75%|51672401601|ETODOLAC 200 MG CAPSULE|100|EA|.46345|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.75715|03/29/2022|.73897|03/29/2022|.74389|03/29/2022|||NSAIDS|12444|||||No|No||TARO PHARM USA|No||||
etodolac|No|No|No|No|75%|51672401701|ETODOLAC 300 MG CAPSULE|100|EA|.55616|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.56927|03/29/2022|.5556|03/29/2022|.5593|03/29/2022|||NSAIDS|12445|||||No|No||TARO PHARM USA|No||||
etodolac|No|No|No|No|75%|51672401801|ETODOLAC 400 MG TABLET|100|EA|.45537|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.33513|03/29/2022|.32708|03/29/2022|.32926|03/29/2022|||NSAIDS|12446|||||No|No||TARO PHARM USA|No||||
acetazolamide|No|No|No|No|75%|51672402201|ACETAZOLAMIDE 125 MG TABLET|100|EA|.74987|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.16397|03/29/2022|.16003|03/29/2022|.1611|03/29/2022||||12447|||||No|No||TARO PHARM USA|No||||
acetazolamide|No|No|No|No|75%|51672402301|ACETAZOLAMIDE 250 MG TABLET|100|EA|.99179|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.25723|03/29/2022|.25105|03/29/2022|.25272|03/29/2022||||12448|||||No|No||TARO PHARM USA|No||||
amiodarone HCl|No|No|No|No|75%|51672402504|AMIODARONE HCL 200 MG TABLET|60|EA|.21141|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.12373|03/29/2022|.12076|03/29/2022|.12156|03/29/2022||||12449|||||No|No||TARO PHARM USA|No||||
ketoconazole|No|No|No|No|75%|51672402601|KETOCONAZOLE 200 MG TABLET|100|EA|.95266|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||069|No|.87128|03/29/2022|.85036|03/29/2022|.85603|03/29/2022|||ANTIFUNGALS: ORAL|12450|||||No|No||TARO PHARM USA|No||||
ketoconazole|No|No|No|No|75%|51672402606|KETOCONAZOLE 200 MG TABLET|30|EA|.9288|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||069|No|.87128|03/29/2022|.85036|03/29/2022|.85603|03/29/2022|||ANTIFUNGALS: ORAL|12451|||||No|No||TARO PHARM USA|No||||
warfarin sodium|No|No|No|No|75%|51672402701|WARFARIN SODIUM 1 MG TABLET|100|EA|.1339|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||068|Yes|.08991|03/29/2022|.08775|03/29/2022|.08833|03/29/2022|||ANTICOAGULANTS|12452|||||No|No||TARO PHARM USA|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|51672402703|WARFARIN SODIUM 1 MG TABLET|1000|EA|.12991|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||068|Yes|.08991|03/29/2022|.08775|03/29/2022|.08833|03/29/2022|||ANTICOAGULANTS|12453|||||No|No||TARO PHARM USA|No||||
warfarin sodium|No|No|No|No|75%|51672402801|WARFARIN SODIUM 2 MG TABLET|100|EA|.13983|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||068|Yes|.09104|03/29/2022|.08885|03/29/2022|.08944|03/29/2022|||ANTICOAGULANTS|12454|||||No|No||TARO PHARM USA|No||||
warfarin sodium|No|No|No|No|75%|51672402803|WARFARIN SODIUM 2 MG TABLET|1000|EA|.13562|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||068|Yes|.09104|03/29/2022|.08885|03/29/2022|.08944|03/29/2022|||ANTICOAGULANTS|12455|||||No|No||TARO PHARM USA|No||||
warfarin sodium|No|No|No|No|75%|51672402901|WARFARIN SODIUM 2.5 MG TABLET|100|EA|.14422|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||068|Yes|.09348|03/29/2022|.09123|03/29/2022|.09184|03/29/2022|||ANTICOAGULANTS|12456|||||No|No||TARO PHARM USA|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|51672402903|WARFARIN SODIUM 2.5 MG TABLET|1000|EA|.13986|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||068|Yes|.09348|03/29/2022|.09123|03/29/2022|.09184|03/29/2022|||ANTICOAGULANTS|12457|||||No|No||TARO PHARM USA|No||||
warfarin sodium|No|No|No|No|75%|51672403001|WARFARIN SODIUM 3 MG TABLET|100|EA|.14482|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||068|Yes|.09211|03/29/2022|.08989|03/29/2022|.09049|03/29/2022|||ANTICOAGULANTS|12458|||||No|No||TARO PHARM USA|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|51672403003|WARFARIN SODIUM 3 MG TABLET|1000|EA|.14482|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||068|Yes|.09211|03/29/2022|.08989|03/29/2022|.09049|03/29/2022|||ANTICOAGULANTS|12459|||||No|No||TARO PHARM USA|No||||
warfarin sodium|No|No|No|No|75%|51672403101|WARFARIN SODIUM 4 MG TABLET|100|EA|.14525|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||068|Yes|.09432|03/29/2022|.09205|03/29/2022|.09266|03/29/2022|||ANTICOAGULANTS|12460|||||No|No||TARO PHARM USA|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|51672403103|WARFARIN SODIUM 4 MG TABLET|1000|EA|.14087|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||068|Yes|.09432|03/29/2022|.09205|03/29/2022|.09266|03/29/2022|||ANTICOAGULANTS|12461|||||No|No||TARO PHARM USA|No||||
warfarin sodium|No|No|No|No|75%|51672403201|WARFARIN SODIUM 5 MG TABLET|100|EA|.14615|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||068|Yes|.10902|03/29/2022|.1064|03/29/2022|.10711|03/29/2022|||ANTICOAGULANTS|12462|||||No|No||TARO PHARM USA|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|51672403203|WARFARIN SODIUM 5 MG TABLET|1000|EA|.14176|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||068|Yes|.10902|03/29/2022|.1064|03/29/2022|.10711|03/29/2022|||ANTICOAGULANTS|12463|||||No|No||TARO PHARM USA|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|51672403301|WARFARIN SODIUM 6 MG TABLET|100|EA|.20734|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||068|Yes|.13556|03/29/2022|.1323|03/29/2022|.13318|03/29/2022|||ANTICOAGULANTS|12464|||||No|No||TARO PHARM USA|No||||
warfarin sodium|No|No|No|No|75%|51672403303|WARFARIN SODIUM 6 MG TABLET|1000|EA|.20734|07/12/2005||Yes|No||07/12/2005||Yes|No|07/12/2005||Yes|No||||No|No|||Prescription required|No||068|Yes|.13556|03/29/2022|.1323|03/29/2022|.13318|03/29/2022|||ANTICOAGULANTS|12465|||||No|No||TARO PHARM USA|No||||
warfarin sodium|No|No|No|No|75%|51672403401|WARFARIN SODIUM 7.5 MG TABLET|100|EA|.215|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||068|Yes|.11896|03/29/2022|.1161|03/29/2022|.11687|03/29/2022|||ANTICOAGULANTS|12466|||||No|No||TARO PHARM USA|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|51672403403|WARFARIN SODIUM 7.5 MG TABLET|1000|EA|.215|10/14/2005||Yes|No||10/14/2005||Yes|No|10/14/2005||Yes|No||||No|No|||Prescription required|No||068|Yes|.11896|03/29/2022|.1161|03/29/2022|.11687|03/29/2022|||ANTICOAGULANTS|12467|||||No|No||TARO PHARM USA|No||||
warfarin sodium|No|No|No|No|75%|51672403501|WARFARIN SODIUM 10 MG TABLET|100|EA|.22368|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||068|Yes|.12691|03/29/2022|.12386|03/29/2022|.12468|03/29/2022|||ANTICOAGULANTS|12468|||||No|No||TARO PHARM USA|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|51672403503|WARFARIN SODIUM 10 MG TABLET|1000|EA|.22368|08/21/2008||Yes|No||08/21/2008||Yes|No|08/21/2008||Yes|No||08/21/2008||Yes|No|||Prescription required|No||068|Yes|.12691|03/29/2022|.12386|03/29/2022|.12468|03/29/2022|||ANTICOAGULANTS|12469|||||No|No||TARO PHARM USA|No||||
etodolac|No|No|No|No|75%|51672403601|ETODOLAC 500 MG TABLET|100|EA|.48375|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.34546|03/29/2022|.33716|03/29/2022|.33941|03/29/2022|||NSAIDS|12470|||||No|No||TARO PHARM USA|No||||
enalapril maleate|Yes|No|No|No|75%|51672403701|ENALAPRIL MALEATE 2.5 MG TAB|100|EA|.15978|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No||113|No|.11585|03/29/2022|.11306|03/29/2022|.11382|03/29/2022|||ANGIOTENSIN MODULATORS|12471|||||No|No||TARO PHARM USA|No||||
enalapril maleate|Yes|No|No|No|75%|51672403703|ENALAPRIL MALEATE 2.5 MG TAB|1000|EA|.1518|07/12/2005||Yes|No||07/12/2005||Yes|No|07/12/2005||Yes|No||07/12/2005||Yes|No|07/01/2016||Prescription required|No||113|No|.11585|03/29/2022|.11306|03/29/2022|.11382|03/29/2022|||ANGIOTENSIN MODULATORS|12472|||||No|No||TARO PHARM USA|No||||
enalapril maleate|Yes|No|No|No|75%|51672403801|ENALAPRIL MALEATE 5 MG TABLET|100|EA|.203|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No||113|No|.15947|03/29/2022|.15564|03/29/2022|.15667|03/29/2022|||ANGIOTENSIN MODULATORS|12473|||||No|No||TARO PHARM USA|No||||
enalapril maleate|Yes|No|No|No|75%|51672403803|ENALAPRIL MALEATE 5 MG TABLET|1000|EA|.19285|07/12/2005||Yes|No||07/12/2005||Yes|No|07/12/2005||Yes|No||07/12/2005||Yes|No|07/01/2016||Prescription required|No||113|No|.15947|03/29/2022|.15564|03/29/2022|.15667|03/29/2022|||ANGIOTENSIN MODULATORS|12474|||||No|No||TARO PHARM USA|No||||
enalapril maleate|Yes|No|No|No|75%|51672403901|ENALAPRIL MALEATE 10 MG TAB|100|EA|.21315|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No||113|No|.11378|03/29/2022|.11104|03/29/2022|.11178|03/29/2022|||ANGIOTENSIN MODULATORS|12475|||||No|No||TARO PHARM USA|No||||
enalapril maleate|Yes|No|No|No|75%|51672403903|ENALAPRIL MALEATE 10 MG TAB|1000|EA|.20249|07/12/2005||Yes|No||07/12/2005||Yes|No|07/12/2005||Yes|No||07/12/2005||Yes|No|07/01/2016||Prescription required|No||113|No|.11378|03/29/2022|.11104|03/29/2022|.11178|03/29/2022|||ANGIOTENSIN MODULATORS|12476|||||No|No||TARO PHARM USA|No||||
enalapril maleate|Yes|No|No|No|75%|51672404001|ENALAPRIL MALEATE 20 MG TAB|100|EA|.30327|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No||113|No|.14625|03/29/2022|.14274|03/29/2022|.14369|03/29/2022|||ANGIOTENSIN MODULATORS|12477|||||No|No||TARO PHARM USA|No||||
enalapril maleate|Yes|No|No|No|75%|51672404003|ENALAPRIL MALEATE 20 MG TAB|1000|EA|.28812|07/12/2005||Yes|No||07/12/2005||Yes|No|07/12/2005||Yes|No||07/12/2005||Yes|No|07/01/2016||Prescription required|No||113|No|.14625|03/29/2022|.14274|03/29/2022|.14369|03/29/2022|||ANGIOTENSIN MODULATORS|12478|||||No|No||TARO PHARM USA|No||||
carbamazepine|No|No|No|No|75%|51672404101|CARBAMAZEPINE 100 MG TAB CHEW|100|EA|.17264|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||056|No|.29391|03/29/2022|.28685|03/29/2022|.28876|03/29/2022|||ANTICONVULSANTS|12479|||||No|No||TARO PHARM USA|No||||
carbamazepine|No|No|No|No|75%|51672404102|CARBAMAZEPINE 100 MG TAB CHEW|500|EA|.17263|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||056|No|.29391|03/29/2022|.28685|03/29/2022|.28876|03/29/2022|||ANTICONVULSANTS|12480|||||No|No||TARO PHARM USA|No||||
clorazepate dipotassium|No|No|No|No|90%|51672404201|CLORAZEPATE 3.75 MG TABLET|100|EA|1.38752|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.92083|12/28/2021|.89873|12/28/2021|.90471|12/28/2021|||ANXIOLYTICS|12481|||||No|No||TARO PHARM USA|Yes|09/01/2020|||
clorazepate dipotassium|No|No|No|No|90%|51672404202|CLORAZEPATE 3.75 MG TABLET|500|EA|1.38752|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.92083|12/28/2021|.89873|12/28/2021|.90471|12/28/2021|||ANXIOLYTICS|12482|||||No|No||TARO PHARM USA|No||||
clorazepate dipotassium|No|No|No|No|90%|51672404301|CLORAZEPATE 7.5 MG TABLET|100|EA|1.72623|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|1.5386|01/25/2022|1.50167|01/25/2022|1.51167|01/25/2022|||ANXIOLYTICS|12483|||||No|No||TARO PHARM USA|No||||
clorazepate dipotassium|No|No|No|No|90%|51672404302|CLORAZEPATE 7.5 MG TABLET|500|EA|1.72622|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|1.5386|01/25/2022|1.50167|01/25/2022|1.51167|01/25/2022|||ANXIOLYTICS|12484|||||No|No||TARO PHARM USA|No||||
clorazepate dipotassium|No|No|No|No|90%|51672404401|CLORAZEPATE 15 MG TABLET|100|EA|1.87359|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|2.854|01/25/2022|2.7855|01/25/2022|2.80405|01/25/2022|||ANXIOLYTICS|12485|||||No|No||TARO PHARM USA|Yes|09/01/2020|||
enalapril/hydrochlorothiazide|Yes|No|No|No|75%|51672404501|ENALAPRIL-HCTZ 5-12.5 MG TAB|100|EA|.27498|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No||113|Yes|.18131|03/29/2022|.17695|03/29/2022|.17813|03/29/2022|||ANGIOTENSIN MODULATORS|12486|||||No|No||TARO PHARM USA|No||||
enalapril/hydrochlorothiazide|Yes|No|No|No|75%|51672404601|ENALAPRIL-HCTZ 10-25 MG TABLET|100|EA|.30598|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No||113|Yes|.26699|03/29/2022|.26058|03/29/2022|.26231|03/29/2022|||ANGIOTENSIN MODULATORS|12487|||||No|No||TARO PHARM USA|No||||
carbamazepine|No|No|No|No|75%|51672404709|CARBAMAZEPINE 100 MG/5 ML SUSP|450|ML|.06771|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||056|No|.11505|03/29/2022|.11228|03/29/2022|.11303|03/29/2022|||ANTICONVULSANTS|12488|||||No|No||TARO PHARM USA|No||||
clotrimazole/betamethasone dip|No|No|No|No|75%|51672404801|CLOTRIMAZOLE-BETAMETHASONE CRM|15|GM|.48332|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||061|No|.25272|03/29/2022|.24665|03/29/2022|.24829|03/29/2022|||ANTIFUNGALS: TOPICAL|12489|||||No|No||TARO PHARM USA|No||||
clotrimazole/betamethasone dip|No|No|No|No|75%|51672404806|CLOTRIMAZOLE-BETAMETHASONE CRM|45|GM|.34686|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||061|No|.17393|03/29/2022|.16975|03/29/2022|.17088|03/29/2022|||ANTIFUNGALS: TOPICAL|12490|||||No|No||TARO PHARM USA|No||||
etodolac|No|No|No|No|75%|51672405101|ETODOLAC ER 400 MG TABLET|100|EA|.99803|04/24/2003||Yes|No||04/24/2003||Yes|No|04/24/2003||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|1.74706|03/01/2022|1.70513|03/01/2022|1.71648|03/01/2022|||NSAIDS|12491|||||No|No||TARO PHARM USA|No||||
etodolac|No|No|No|No|75%|51672405104|ETODOLAC ER 400 MG TABLET|60|EA|1.01795|04/24/2003||Yes|No||04/24/2003||Yes|No|04/24/2003||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|1.74706|03/01/2022|1.70513|03/01/2022|1.71648|03/01/2022|||NSAIDS|12492|||||No|No||TARO PHARM USA|No||||
etodolac|No|No|No|No|75%|51672405201|ETODOLAC ER 500 MG TABLET|100|EA|1.0602|04/24/2003||Yes|No||04/24/2003||Yes|No|04/24/2003||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|1.39968|03/29/2022|1.36608|03/29/2022|1.37518|03/29/2022|||NSAIDS|12493|||||No|No||TARO PHARM USA|No||||
etodolac|No|No|No|No|75%|51672405204|ETODOLAC ER 500 MG TABLET|60|EA|1.08145|04/24/2003||Yes|No||04/24/2003||Yes|No|04/24/2003||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|1.39968|03/29/2022|1.36608|03/29/2022|1.37518|03/29/2022|||NSAIDS|12494|||||No|No||TARO PHARM USA|No||||
etodolac|No|No|No|No|75%|51672405301|ETODOLAC ER 600 MG TABLET|100|EA|1.12629|04/24/2003||Yes|No||04/24/2003||Yes|No|04/24/2003||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|2.56691|06/29/2021|2.53024|06/29/2021|2.40975|06/29/2021|||NSAIDS|12495|||||No|No||TARO PHARM USA|No||||
etodolac|No|No|No|No|75%|51672405304|ETODOLAC ER 600 MG TABLET|60|EA|1.14881|04/24/2003||Yes|No||04/24/2003||Yes|No|04/24/2003||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|2.61822|06/29/2021|2.58082|06/29/2021|2.45792|06/29/2021|||NSAIDS|12496|||||No|No||TARO PHARM USA|No||||
amiodarone HCl|No|No|No|No|75%|51672405506|AMIODARONE HCL 100 MG TABLET|30|EA|1.19841|09/26/2013||Yes|No||09/26/2013||Yes|No|09/26/2013||Yes|No||||No|No|||Prescription required|No|||No|1.5888|03/29/2022|1.55066|03/29/2022|1.56099|03/29/2022||||12497|||||No|No||TARO PHARM USA|No||||
amiodarone HCl|No|No|No|No|75%|51672405706|AMIODARONE HCL 400 MG TABLET|30|EA|1.82033|04/07/2006||Yes|No||04/07/2006||Yes|No|04/07/2006||Yes|No||||No|No|||Prescription required|No|||No|3.05628|03/29/2022|2.98292|03/29/2022|3.00279|03/29/2022||||12498|||||No|No||TARO PHARM USA|No||||
hydrocortisone butyrate|No|No|No|No|75%|51672406102|HYDROCORTISONE BUTYR 0.1% SOLN|20|ML|1.37041|07/20/2004||Yes|No||07/20/2004||Yes|No|07/20/2004||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|119|No|3.12326|06/01/2016|3.07864|06/01/2016|2.93204|06/01/2016|||STEROIDS: TOPICAL MEDIUM|12499|||||No|No||TARO PHARM USA|No||||
hydrocortisone butyrate|No|No|No|No|75%|51672406104|HYDROCORTISONE BUTYR 0.1% SOLN|60|ML|1.37047|07/20/2004||Yes|No||07/20/2004||Yes|No|07/20/2004||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|119|No|3.12341|09/29/2020|3.07879|09/29/2020|2.93218|09/29/2020|||STEROIDS: TOPICAL MEDIUM|12500|||||No|No||TARO PHARM USA|No||||
fluorouracil|No|No|No|No|75%|51672406201|FLUOROURACIL 2% TOPICAL SOLN|10|ML|2.27556|04/13/2009||Yes|No||04/13/2009||Yes|No|04/13/2009||Yes|No||||No|No|||Prescription required|No|||No|5.18616|02/23/2021|5.11207|02/23/2021|4.86864|02/23/2021||||12501|||||No|No||TARO PHARM USA|No||||
fluorouracil|No|No|No|No|75%|51672406301|FLUOROURACIL 5% TOPICAL SOLN|10|ML|3.35099|07/20/2004||Yes|No||07/20/2004||Yes|No|07/20/2004||Yes|No||||No|No|||Prescription required|No|||No|6.5356|03/29/2022|6.37874|03/29/2022|6.42122|03/29/2022||||12502|||||No|No||TARO PHARM USA|No||||
phenytoin|No|No|No|No|75%|51672406901|PHENYTOIN 125 MG/5 ML SUSP|237|ML|.04359|07/20/2004||Yes|No||07/20/2004||Yes|No|07/20/2004||Yes|No||||No|No|||Prescription required|No||056|No|.07636|03/29/2022|.07452|03/29/2022|.07502|03/29/2022|||ANTICONVULSANTS|12503|||||No|No||TARO PHARM USA|No||||
cetirizine HCl|No|No|No|No|75%|51672407008|CETIRIZINE HCL 1 MG/ML SOLN|120|ML|.01429|11/04/2014||Yes|No||11/04/2014||Yes|No|11/04/2014||Yes|No||||No|No|||Prescription required|No||030|Yes|.02395|03/29/2022|.02337|03/29/2022|.02353|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|12504|||||No|No||TARO PHARM USA|No||||
hydrocortisone butyrate|No|No|No|No|75%|51672407401|HYDROCORTISONE BUTY 0.1% CREAM|15|GM|1.43792|09/07/2005||Yes|No||09/07/2005||Yes|No|09/07/2005||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|119|No|2.3324|03/01/2022|2.27642|03/01/2022|2.29158|03/01/2022|||STEROIDS: TOPICAL MEDIUM|12505|||||No|No||TARO PHARM USA|No||||
hydrocortisone butyrate|No|No|No|No|75%|51672407406|HYDROCORTISONE BUTY 0.1% CREAM|45|GM|1.44068|09/07/2005||Yes|No||09/07/2005||Yes|No|09/07/2005||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|119|No|2.30352|12/28/2021|2.24823|12/28/2021|2.2632|12/28/2021|||STEROIDS: TOPICAL MEDIUM|12506|||||No|No||TARO PHARM USA|No||||
desonide|No|No|No|No|75%|51672407904|DESONIDE 0.05% LOTION|59|ML|1.72641|01/07/2015||Yes|No||01/07/2015||Yes|No|01/07/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|118|No|1.36873|03/01/2022|1.33588|03/01/2022|1.34477|03/01/2022|||STEROIDS: TOPICAL LOW|12507|||||No|No||TARO PHARM USA|No||||
desonide|No|No|No|No|75%|51672407908|DESONIDE 0.05% LOTION|118|ML|1.27808|01/07/2015||Yes|No||01/07/2015||Yes|No|01/07/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|118|No|1.43647|03/01/2022|1.40199|03/01/2022|1.41133|03/01/2022|||STEROIDS: TOPICAL LOW|12508|||||No|No||TARO PHARM USA|No||||
clindamycin phosphate|No|No|No|No|75%|51672408103|CLINDAMYCIN PH 1% SOLUTION|30|ML|.46798|08/19/2014||Yes|No||08/19/2014||Yes|No|08/19/2014||Yes|No||||No|No|||Prescription required|No||104|No|.23242|03/29/2022|.22684|03/29/2022|.22835|03/29/2022|||ACNE AGENTS: TOPICAL|12509|||||No|No||TARO PHARM USA|No||||
clindamycin phosphate|No|No|No|No|75%|51672408104|CLINDAMYCIN PH 1% SOLUTION|60|ML|.4679|08/19/2014||Yes|No||08/19/2014||Yes|No|08/19/2014||Yes|No||||No|No|||Prescription required|No||104|No|.19863|03/29/2022|.19386|03/29/2022|.19515|03/29/2022|||ACNE AGENTS: TOPICAL|12510|||||No|No||TARO PHARM USA|No||||
hydrocortisone butyrate|No|No|No|No|75%|51672408301|HYDROCORTISONE BUTYR 0.1% OINT|15|GM|1.37026|05/20/2009||Yes|No||05/20/2009||Yes|No|05/20/2009||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|119|No|3.12292|01/29/2019|3.07831|01/29/2019|2.93172|01/29/2019|||STEROIDS: TOPICAL MEDIUM|12511|||||No|No||TARO PHARM USA|No||||
hydrocortisone butyrate|No|No|No|No|75%|51672408306|HYDROCORTISONE BUTYR 0.1% OINT|45|GM|1.37045|05/20/2009||Yes|No||05/20/2009||Yes|No|05/20/2009||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|119|No|3.12336|10/29/2019|3.07874|10/29/2019|2.93214|10/29/2019|||STEROIDS: TOPICAL MEDIUM|12512|||||No|No||TARO PHARM USA|No||||
phenytoin sodium extended|No|No|No|No|75%|51672411101|PHENYTOIN SOD EXT 100 MG CAP|100|EA|.22024|06/07/2007||Yes|No||06/07/2007||Yes|No|06/07/2007||Yes|No||||No|No|||Prescription required|No||056|No|.15598|03/29/2022|.15223|03/29/2022|.15325|03/29/2022|||ANTICONVULSANTS|12513|||||No|No||TARO PHARM USA|No||||
phenytoin sodium extended|No|No|No|No|75%|51672411103|PHENYTOIN SOD EXT 100 MG CAP|1000|EA|.22027|06/07/2007||Yes|No||06/07/2007||Yes|No|06/07/2007||Yes|No||||No|No|||Prescription required|No||056|No|.15598|03/29/2022|.15223|03/29/2022|.15325|03/29/2022|||ANTICONVULSANTS|12514|||||No|No||TARO PHARM USA|No||||
metronidazole|No|No|No|No|75%|51672411606|METRONIDAZOLE TOPICAL 0.75% GL|45|GM|1.31608|08/01/2006||Yes|No||08/01/2006||Yes|No|08/01/2006||Yes|No||||No|No|||Prescription required|No||221|No|.54113|03/29/2022|.52814|03/29/2022|.53166|03/29/2022|||ROSACEA AGENTS: TOPICAL|12515|||||No|No||TARO PHARM USA|No||||
fluorouracil|No|No|No|No|75%|51672411806|FLUOROURACIL 5% CREAM|40|GM|2.3794|08/31/2010||Yes|No||08/31/2010||Yes|No|08/31/2010||Yes|No||||No|No|||Prescription required|No|||No|1.42743|03/29/2022|1.39317|03/29/2022|1.40244|03/29/2022||||12516|||||No|No||TARO PHARM USA|No||||
carbamazepine|No|No|No|No|75%|51672412301|CARBAMAZEPINE ER 100 MG TABLET|100|EA|.3937|06/29/2016||Yes|No||06/29/2016||Yes|No|06/29/2016||Yes|No||||No|No|||Prescription required|No||056|No|.53596|03/29/2022|.52309|03/29/2022|.52658|03/29/2022|||ANTICONVULSANTS|12517|||||No|No||TARO PHARM USA|No||||
carbamazepine|No|No|No|No|75%|51672412401|CARBAMAZEPINE ER 200 MG TABLET|100|EA|.715|05/18/2009||Yes|No||05/18/2009||Yes|No|05/18/2009||Yes|No||05/18/2009||Yes|No|||Prescription required|No||056|No|.8262|03/29/2022|.80637|03/29/2022|.81174|03/29/2022|||ANTICONVULSANTS|12518|||||No|No||TARO PHARM USA|No||||
carbamazepine|No|No|No|No|75%|51672412501|CARBAMAZEPINE ER 400 MG TABLET|100|EA|1.42897|05/18/2009||Yes|No||05/18/2009||Yes|No|05/18/2009||Yes|No||05/18/2009||Yes|No|||Prescription required|No||056|No|1.58237|03/29/2022|1.54439|03/29/2022|1.55467|03/29/2022|||ANTICONVULSANTS|12519|||||No|No||TARO PHARM USA|No||||
lamotrigine|No|No|No|No|75%|51672413001|LAMOTRIGINE 25 MG TABLET|100|EA|.0258|03/05/2009||Yes|No||03/05/2009||Yes|No|03/05/2009||Yes|No||||No|No|||Prescription required|No||056|No|.03514|03/29/2022|.03429|03/29/2022|.03452|03/29/2022|||ANTICONVULSANTS|12520|||||No|No||TARO PHARM USA|No||||
lamotrigine|No|No|No|No|75%|51672413101|LAMOTRIGINE 100 MG TABLET|100|EA|.0301|03/05/2009||Yes|No||03/05/2009||Yes|No|03/05/2009||Yes|No||||No|No|||Prescription required|No||056|No|.06403|03/29/2022|.06249|03/29/2022|.0629|03/29/2022|||ANTICONVULSANTS|12521|||||No|No||TARO PHARM USA|No||||
lamotrigine|No|No|No|No|75%|51672413204|LAMOTRIGINE 150 MG TABLET|60|EA|.03769|03/05/2009||Yes|No||03/05/2009||Yes|No|03/05/2009||Yes|No||||No|No|||Prescription required|No||056|No|.0888|03/29/2022|.08666|03/29/2022|.08724|03/29/2022|||ANTICONVULSANTS|12522|||||No|No||TARO PHARM USA|No||||
lamotrigine|No|No|No|No|75%|51672413304|LAMOTRIGINE 200 MG TABLET|60|EA|.0602|03/05/2009||Yes|No||03/05/2009||Yes|No|03/05/2009||Yes|No||||No|No|||Prescription required|No||056|No|.10103|03/29/2022|.0986|03/29/2022|.09926|03/29/2022|||ANTICONVULSANTS|12523|||||No|No||TARO PHARM USA|No||||
phenytoin|No|No|No|No|75%|51672414601|PHENYTOIN 50 MG TABLET CHEW|100|EA|.18103|10/09/2014||Yes|No||10/09/2014||Yes|No|10/09/2014||Yes|No||||No|No|||Prescription required|No||056|No|.28181|03/29/2022|.27504|03/29/2022|.27687|03/29/2022|||ANTICONVULSANTS|12524|||||No|No||TARO PHARM USA|No||||
carbamazepine|No|No|No|No|75%|51672415101|CARBAMAZEPINE ER 100 MG CAP|120|EA|.61748|09/20/2013||Yes|No||09/20/2013||Yes|No|09/20/2013||Yes|No||||No|No|||Prescription required|No||056|No|1.01422|03/29/2022|.98987|03/29/2022|.99647|03/29/2022|||ANTICONVULSANTS|12525|||||No|No||TARO PHARM USA|No||||
calcipotriene|No|No|No|No|75%|51672415403|CALCIPOTRIENE 0.005% OINTMENT|60|GM|2.07481|09/30/2010||Yes|No||09/30/2010||Yes|No|09/30/2010||Yes|No||||No|No|||Prescription required|No|||No|2.14151|03/29/2022|2.09011|03/29/2022|2.10403|03/29/2022||||12526|||||No|No||TARO PHARM USA|No||||
calcipotriene|No|No|No|No|75%|51672415404|CALCIPOTRIENE 0.005% OINTMENT|120|GM|2.07485|02/02/2017||Yes|No||02/02/2017||Yes|No|02/02/2017||Yes|No||||No|No|||Prescription required|No|||No|2.11241|03/29/2022|2.06171|03/29/2022|2.07544|03/29/2022||||12527|||||No|No||TARO PHARM USA|No||||
levocetirizine dihydrochloride|No|No|No|No|75%|51672416108|LEVOCETIRIZINE 2.5 MG/5 ML SOL|118|ML|.21452|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|030|Yes|.37692|08/24/2021|.36787|08/24/2021|.37032|08/24/2021|||ANTIHISTAMINES: MINIMALLY SEDATING|12528|||||No|No||TARO PHARM USA|No||||
metronidazole|No|No|No|No|75%|51672416403|METRONIDAZOLE TOPICAL 1% GEL|60|GM|1.58963|06/14/2017||Yes|No||06/14/2017||Yes|No|06/14/2017||Yes|No||||No|No|||Prescription required|No||221|No|1.2961|03/29/2022|1.26499|03/29/2022|1.27341|03/29/2022|||ROSACEA AGENTS: TOPICAL|12529|||||No|No||TARO PHARM USA|No||||
metronidazole|No|No|No|No|75%|51672416409|METRONIDAZOLE TOP 1% GEL PUMP|55|GM|1.73414|02/27/2018||Yes|No||02/27/2018||Yes|No|02/27/2018||Yes|No||||No|No|||Prescription required|No||221|No|1.15772|03/29/2022|1.12993|03/29/2022|1.13745|03/29/2022|||ROSACEA AGENTS: TOPICAL|12530|||||No|No||TARO PHARM USA|No||||
felbamate|No|No|No|No|75%|51672417201|FELBAMATE 600 MG/5 ML SUSP|237|ML|.93128|02/27/2018||Yes|No||02/27/2018||Yes|No|02/27/2018||Yes|No||||No|No|||Prescription required|No||056|No|2.12246|02/27/2018|2.09214|02/27/2018|1.99251|02/27/2018|||ANTICONVULSANTS|12531|||||No|No||TARO PHARM USA|No||||
felbamate|No|No|No|No|75%|51672417209|FELBAMATE 600 MG/5 ML SUSP|473|ML|.89871|02/27/2018||Yes|No||02/27/2018||Yes|No|02/27/2018||Yes|No||||No|No|||Prescription required|No||056|No|2.04823|02/27/2018|2.01897|02/27/2018|1.92283|02/27/2018|||ANTICONVULSANTS|12532|||||No|No||TARO PHARM USA|No||||
betamethasone valerate|No|No|No|No|75%|51672418803|BETAMETHASONE VALER 0.12% FOAM|50|GM|1.79937|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|119|No|2.1912|03/01/2022|2.13861|03/01/2022|2.15285|03/01/2022|||STEROIDS: TOPICAL MEDIUM|12533|||||No|No||TARO PHARM USA|No||||
betamethasone valerate|No|No|No|No|75%|51672418807|BETAMETHASONE VALER 0.12% FOAM|100|GM|1.6745|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|119|No|.8923|06/29/2021|.87088|06/29/2021|.87668|06/29/2021|||STEROIDS: TOPICAL MEDIUM|12534|||||No|No||TARO PHARM USA|No||||
deferiprone|No|No|No|No|75%|51672419601|DEFERIPRONE 500 MG TABLET|100|EA|26.43674|12/17/2020||Yes|No||12/17/2020||Yes|No|12/17/2020||Yes|No||||No|No|||Prescription required|No|||No|60.25118|12/17/2020|59.39045|12/17/2020|56.56233|12/17/2020||||12535|||||No|No||TARO PHARM USA|No||||
azithromycin|No|No|No|No|75%|51672420003|AZITHROMYCIN 200 MG/5 ML SUSP|30|ML|.215|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No||018|No|.28375|03/29/2022|.27694|03/29/2022|.27878|03/29/2022|||MACROLIDES/KETOLIDES|12536|||||No|No||TARO PHARM USA|No||||
azithromycin|No|No|No|No|75%|51672420005|AZITHROMYCIN 200 MG/5 ML SUSP|15|ML|.37266|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||01/10/2022||Yes|No|||Prescription required|No||018|No|.46232|03/29/2022|.45122|03/29/2022|.45422|03/29/2022|||MACROLIDES/KETOLIDES|12537|||||No|No||TARO PHARM USA|No||||
azithromycin|No|No|No|No|75%|51672420007|AZITHROMYCIN 200 MG/5 ML SUSP|22.5|ML|.26755|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||01/10/2022||Yes|No|||Prescription required|No||018|No|.35562|03/29/2022|.34708|03/29/2022|.34939|03/29/2022|||MACROLIDES/KETOLIDES|12538|||||No|No||TARO PHARM USA|No||||
ivermectin|No|No|No|No|75%|51672421108|IVERMECTIN 0.5% LOTION|117|GM|.8253|05/03/2021|04/01/2022|Yes|No||05/03/2021|04/01/2022|Yes|No|05/03/2021|04/01/2022|Yes|No||||No|No|||Prescription required|Yes|01/30/2020|122|No|1.88092|03/09/2021|1.85405|03/09/2021|1.76576|03/09/2021|||ANTIPARASITICS: TOPICAL|12539|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TARO PHARM USA|No||||
metronidazole|No|No|No|No|75%|51672421503|METRONIDAZOLE TOPICAL 1% GEL|60|GM|1.58963|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||221|No|1.2961|03/29/2022|1.26499|03/29/2022|1.27341|03/29/2022|||ROSACEA AGENTS: TOPICAL|12540|||||No|No||TARO PHARM USA|No||||
metronidazole|No|No|No|No|75%|51672421509|METRONIDAZOLE TOP 1% GEL PUMP|55|GM|1.73414|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||221|No|1.15772|03/29/2022|1.12993|03/29/2022|1.13745|03/29/2022|||ROSACEA AGENTS: TOPICAL|12541|||||No|No||TARO PHARM USA|No||||
clobazam|No|No|No|No|90%|51672422708|CLOBAZAM 2.5 MG/ML SUSPENSION|120|ML|.19708|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No||056|No|.50176|03/29/2022|.48971|03/29/2022|.49297|03/29/2022|||ANTICONVULSANTS|12542|||||No|No||TARO PHARM USA|No||||
desoximetasone|No|No|No|No|75%|51672520203|TOPICORT 0.05% GEL|60|GM|1.71068|06/17/2004||Yes|No||06/17/2004||Yes|No|06/17/2004||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|120|No|3.89876|06/01/2016|3.84306|06/01/2016|3.66006|06/01/2016|||STEROIDS: TOPICAL HIGH|12543|||||No|No||TARO PHARM USA|No||||
desoximetasone|No|No|No|No|75%|51672520303|TOPICORT 0.25% OINTMENT|60|GM|2.46218|06/17/2004||Yes|No||06/17/2004||Yes|No|06/17/2004||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|120|No|5.61148|06/01/2016|5.53131|06/01/2016|5.26792|06/01/2016|||STEROIDS: TOPICAL HIGH|12544|||||No|No||TARO PHARM USA|No||||
desoximetasone|No|No|No|No|75%|51672520403|TOPICORT 0.25% CREAM|60|GM|2.4639|06/17/2004||Yes|No||06/17/2004||Yes|No|06/17/2004||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|120|No|5.6154|06/01/2016|5.53518|06/01/2016|5.2716|06/01/2016|||STEROIDS: TOPICAL HIGH|12545|||||No|No||TARO PHARM USA|No||||
desoximetasone|No|No|No|No|75%|51672520503|TOPICORT 0.05% CREAM|60|GM|2.3407|06/17/2004||Yes|No||06/17/2004||Yes|No|06/17/2004||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|120|No|5.33463|06/01/2016|5.25842|06/01/2016|5.00802|06/01/2016|||STEROIDS: TOPICAL HIGH|12546|||||No|No||TARO PHARM USA|No||||
desoximetasone|No|No|No|No|75%|51672526303|TOPICORT 0.05% OINTMENT|60|GM|2.33905|06/23/2011||Yes|No||06/23/2011||Yes|No|06/23/2011||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|120|No|5.33086|06/01/2016|5.25471|06/01/2016|5.00448|06/01/2016|||STEROIDS: TOPICAL HIGH|12547|||||No|No||TARO PHARM USA|No||||
desoximetasone|No|No|No|No|75%|51672528107|TOPICORT 0.25% SPRAY|100|ML|2.25917|08/10/2016||Yes|No||08/10/2016||Yes|No|08/10/2016||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|120|No|5.14882|03/26/2019|5.07526|03/26/2019|4.83358|03/26/2019|||STEROIDS: TOPICAL HIGH|12548|||||No|No||TARO PHARM USA|No||||
malathion|No|No|No|No|75%|51672529304|OVIDE 0.5% LOTION|59|ML|1.79564|05/12/2014||Yes|No||05/12/2014||Yes|No|05/12/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|122|No|4.09241|10/25/2016|4.03394|10/25/2016|3.84185|10/25/2016|||ANTIPARASITICS: TOPICAL|12549|||||No|No||TARO PHARM USA|No||||
malathion|No|No|No|No|75%|51672529404|MALATHION 0.5% LOTION|59|ML|1.61606|09/16/2014||Yes|No||09/16/2014||Yes|No|09/16/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|122|No|3.68313|12/28/2021|3.63051|12/28/2021|3.45763|12/28/2021|||ANTIPARASITICS: TOPICAL|12550|||||No|No||TARO PHARM USA|No||||
metronidazole|No|No|No|No|75%|51672529503|METRONIDAZOLE TOPICAL 1% GEL|60|GM|1.58963|10/09/2014||Yes|No||10/09/2014||Yes|No|10/09/2014||Yes|No||||No|No|||Prescription required|No||221|No|1.2961|03/29/2022|1.26499|03/29/2022|1.27341|03/29/2022|||ROSACEA AGENTS: TOPICAL|12551|||||No|No||TARO PHARM USA|No||||
metronidazole|No|No|No|No|75%|51672529509|METRONIDAZOLE TOP 1% GEL PUMP|55|GM|1.73414|08/10/2015||Yes|No||08/10/2015||Yes|No|08/10/2015||Yes|No||||No|No|||Prescription required|No||221|No|1.15772|03/29/2022|1.12993|03/29/2022|1.13745|03/29/2022|||ROSACEA AGENTS: TOPICAL|12552|||||No|No||TARO PHARM USA|No||||
promethazine HCl|No|No|No|No|75%|51672529601|PROMETHAZINE 12.5 MG SUPPOS|12|EA|4.19142|01/12/2016||Yes|No||01/12/2016||Yes|No|01/12/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|085|Yes|4.318|03/29/2022|4.21436|03/29/2022|4.24243|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|12553|||||No|No||TARO PHARM USA|No||||
promethazine HCl|No|No|No|No|75%|51672529701|PROMETHAZINE 25 MG SUPPOSITORY|12|EA|4.19142|12/15/2015||Yes|No||12/15/2015||Yes|No|12/15/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|085|Yes|4.199|03/29/2022|4.09822|03/29/2022|4.12551|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|12554|||||No|No||TARO PHARM USA|No||||
flurandrenolide|No|No|No|No|75%|51672529808|FLURANDRENOLIDE 0.05% LOTION|120|ML|2.95732|01/03/2017||Yes|No||01/03/2017||Yes|No|01/03/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|119|No|6.73995|01/03/2017|6.64366|01/03/2017|6.3273|01/03/2017|||STEROIDS: TOPICAL MEDIUM|12555|||||No|No||TARO PHARM USA|No||||
flurandrenolide|No|No|No|No|75%|51672530104|FLURANDRENOLIDE 0.05% CREAM|120|GM|2.95732|12/21/2016||Yes|No||12/21/2016||Yes|No|12/21/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|119|No|6.73995|12/21/2016|6.64366|12/21/2016|6.3273|12/21/2016|||STEROIDS: TOPICAL MEDIUM|12556|||||No|No||TARO PHARM USA|No||||
ciclopirox|No|No|No|No|75%|51672530200|CICLOPIROX 8% SOLUTION|6.6|ML|2.08484|09/07/2016||Yes|No||09/07/2016||Yes|No|09/07/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|061|No|1.90189|03/29/2022|1.85624|03/29/2022|1.8686|03/29/2022|||ANTIFUNGALS: TOPICAL|12557|||||No|No||TARO PHARM USA|No||||
fluoxetine HCl|No|No|No|No|75%|51672530606|FLUOXETINE HCL 60 MG TABLET|30|EA|2.13452|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|008|No|1.06507|03/29/2022|1.0395|03/29/2022|1.04643|03/29/2022|||ANTIDEPRESSANTS: SSRIs|12558|||||No|No||TARO PHARM USA|No||||
dapsone|No|No|No|No|75%|51672530703|DAPSONE 7.5% GEL PUMP|60|GM|3.86748|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|104|No|7.47092|03/01/2022|7.29161|03/01/2022|7.34017|03/01/2022|||ACNE AGENTS: TOPICAL|12559|||||No|No||TARO PHARM USA|No||||
dapsone|No|No|No|No|75%|51672530708|DAPSONE 7.5% GEL PUMP|90|GM|3.38195|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|104|No|6.81|05/25/2021|6.64656|05/25/2021|6.69082|05/25/2021|||ACNE AGENTS: TOPICAL|12560|||||No|No||TARO PHARM USA|No||||
caffeine citrate|No|No|No|No|75%|51754050001|CAFFEINE CIT 60 MG/3 ML VIAL|3|ML|3.44|07/26/2016||Yes|No||07/26/2016||Yes|No|07/26/2016||Yes|No||||No|No|||Prescription required|No|||No|7.84|07/26/2016|7.728|07/26/2016|7.36|07/26/2016||||12561|||||No|No||EXELA PHARMA SC|No||||
caffeine citrate|No|No|No|No|75%|51754050103|CAFFEINE CIT 60 MG/3 ML ORAL|3|ML|3.44|07/26/2016||Yes|No||07/26/2016||Yes|No|07/26/2016||Yes|No||||No|No|||Prescription required|No|||No|7.84|07/26/2016|7.728|07/26/2016|7.36|07/26/2016||||12562|||||No|No||EXELA PHARMA SC|No||||
fremanezumab-vfrm|No|No|No|No|75%|51759020210|AJOVY 225 MG/1.5 ML AUTOINJECT|1.5|ML|190.63333|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|537|No|427.40974|01/18/2022|417.1519|01/18/2022|419.93006|01/18/2022|||ANTIMIGRAINE AGENTS: OTHER|12563|||||No|No||TEVA USA|No||||
fremanezumab-vfrm|No|No|No|No|75%|51759020410|AJOVY 225 MG/1.5 ML SYRINGE|1.5|ML|190.63333|02/12/2019||Yes|No||02/12/2019||Yes|No|02/12/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|537|No|429.2732|01/18/2022|418.97064|01/18/2022|421.76091|01/18/2022|||ANTIMIGRAINE AGENTS: OTHER|12564|||||No|No||TEVA USA|No||||
dofetilide|No|No|No|No|75%|51862000560|DOFETILIDE 500 MCG CAPSULE|60|EA|2.94249|12/16/2016||Yes|No||12/16/2016||Yes|No|12/16/2016||Yes|No||||No|No|||Prescription required|No|||No|.90796|03/29/2022|.88616|03/29/2022|.89207|03/29/2022||||12565|||||No|No||MAYNE PHARMA IN|No||||
norethindrone ac-eth estradiol|Yes|Yes|No|No|75%|51862000706|MICROGESTIN 21 1-20 TABLET|21|EA|.44006|03/01/2020||Yes|No||03/01/2020||Yes|No|03/01/2020||Yes|No|Refer to program requirements|||No|No|03/01/2020||Prescription required|No|||No|.29153|03/29/2022|.28453|03/29/2022|.28642|03/29/2022||||12566|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|51862001206|MICROGESTIN FE 1-20 TABLET|28|EA|.33004|03/01/2020||Yes|No||03/01/2020||Yes|No|03/01/2020||Yes|No|Refer to program requirements|||No|No|03/01/2020||Prescription required|No|||No|.20374|03/29/2022|.19885|03/29/2022|.20017|03/29/2022||||12567|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
dofetilide|No|No|No|No|75%|51862002560|DOFETILIDE 250 MCG CAPSULE|60|EA|2.94249|12/16/2016||Yes|No||12/16/2016||Yes|No|12/16/2016||Yes|No||||No|No|||Prescription required|No|||No|.89477|03/29/2022|.87329|03/29/2022|.87911|03/29/2022||||12568|||||No|No||MAYNE PHARMA IN|No||||
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|51862002806|LUTERA-28 TABLET|28|EA|.36393|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.21292|03/29/2022|.2078|03/29/2022|.20919|03/29/2022||||12569|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
ethinyl estradiol/drospirenone|Yes|Yes|No|No|75%|51862003603|ZARAH TABLET|28|EA|.84786|06/29/2017||Yes|No||06/29/2017||Yes|No|06/29/2017||Yes|No|Refer to program requirements|||No|No|06/29/2017||Prescription required|No|||No|.2455|03/29/2022|.2396|03/29/2022|.2412|03/29/2022||||12570|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
doxycycline monohydrate|No|No|No|No|75%|51862004101|DOXYCYCLINE MONO 75 MG CAPSULE|100|EA|5.60204|07/16/2018||Yes|No||07/16/2018||Yes|No|07/16/2018||Yes|No||||No|No|||Prescription required|Yes|05/10/2018|213|No|12.76744|07/16/2018|12.58504|07/16/2018|11.98576|07/16/2018|||TETRACYCLINES|12571|||||No|No||MAYNE PHARMA IN|No||||
L-norgest/e.estradiol-e.estrad|Yes|Yes|No|No|75%|51862004791|AMETHIA 0.15-0.03-0.01 MG TAB|91|EA|1.01517|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.54912|03/29/2022|.53594|03/29/2022|.53951|03/29/2022||||12572|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
estazolam|No|No|No|No|90%|51862006901|ESTAZOLAM 1 MG TABLET|100|EA|2.03639|07/11/2017||Yes|No||07/11/2017||Yes|No|07/11/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|054|Yes|2.24434|12/28/2021|2.19047|12/28/2021|2.20506|12/28/2021|||SEDATIVE HYPNOTICS|12573|||||No|No||MAYNE PHARMA IN|No||||
estazolam|No|No|No|No|90%|51862007001|ESTAZOLAM 2 MG TABLET|100|EA|2.03639|11/18/2016||Yes|No||11/18/2016||Yes|No|11/18/2016||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|054|Yes|3.59229|07/27/2021|3.50607|07/27/2021|3.52942|07/27/2021|||SEDATIVE HYPNOTICS|12574|||||No|No||MAYNE PHARMA IN|No||||
desog-e.estradiol/e.estradiol|Yes|Yes|No|No|75%|51862007206|AZURETTE 28 DAY TABLET|28|EA|.66299|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No|Refer to program requirements|||No|No|05/17/2017||Prescription required|No|||No|.21935|03/29/2022|.21408|03/29/2022|.21551|03/29/2022||||12575|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
estazolam|No|No|No|No|90%|51862007301|ESTAZOLAM 1 MG TABLET|100|EA|2.03639|12/15/2021||Yes|No||12/15/2021||Yes|No|12/15/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|054|Yes|2.24434|12/28/2021|2.19047|12/28/2021|2.20506|12/28/2021|||SEDATIVE HYPNOTICS|12576|||||No|No||MAYNE PHARMA IN|No||||
estazolam|No|No|No|No|90%|51862007401|ESTAZOLAM 2 MG TABLET|100|EA|2.03639|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|054|Yes|3.59229|02/02/2022|3.50607|02/02/2022|3.52942|02/02/2022|||SEDATIVE HYPNOTICS|12577|||||No|No||MAYNE PHARMA IN|No||||
carbidopa/levodopa|No|No|No|No|75%|51862007801|CARBIDOPA-LEVODOPA 10-100 TAB|100|EA|.11244|11/10/2021||Yes|No||11/10/2021||Yes|No|11/10/2021||Yes|No||||No|No|||Prescription required|No||015|No|.14195|03/29/2022|.13854|03/29/2022|.13946|03/29/2022|||ANTIPARKINSON'S AGENTS|12578|||||No|No||MAYNE PHARMA IN|No||||
carbidopa/levodopa|No|No|No|No|75%|51862007805|CARBIDOPA-LEVODOPA 10-100 TAB|500|EA|.1102|11/10/2021||Yes|No||11/10/2021||Yes|No|11/10/2021||Yes|No||||No|No|||Prescription required|No||015|No|.14195|03/29/2022|.13854|03/29/2022|.13946|03/29/2022|||ANTIPARKINSON'S AGENTS|12579|||||No|No||MAYNE PHARMA IN|No||||
carbidopa/levodopa|No|No|No|No|75%|51862007901|CARBIDOPA-LEVODOPA 25-100 TAB|100|EA|.12771|11/18/2016||Yes|No||11/18/2016||Yes|No|11/18/2016||Yes|No||||No|No|||Prescription required|No||015|No|.11418|03/29/2022|.11143|03/29/2022|.11218|03/29/2022|||ANTIPARKINSON'S AGENTS|12580|||||No|No||MAYNE PHARMA IN|No||||
carbidopa/levodopa|No|No|No|No|75%|51862007905|CARBIDOPA-LEVODOPA 25-100 TAB|500|EA|.12515|11/10/2021||Yes|No||11/10/2021||Yes|No|11/10/2021||Yes|No||||No|No|||Prescription required|No||015|No|.11418|03/29/2022|.11143|03/29/2022|.11218|03/29/2022|||ANTIPARKINSON'S AGENTS|12581|||||No|No||MAYNE PHARMA IN|No||||
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|51862009706|LEVORA-28 TABLET|28|EA|.35625|07/11/2017||Yes|No||07/11/2017||Yes|No|07/11/2017||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.17306|03/29/2022|.1689|03/29/2022|.17003|03/29/2022||||12582|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
dofetilide|No|No|No|No|75%|51862012560|DOFETILIDE 125 MCG CAPSULE|60|EA|2.94249|12/16/2016||Yes|No||12/16/2016||Yes|No|12/16/2016||Yes|No||||No|No|||Prescription required|No|||No|1.27252|03/29/2022|1.24197|03/29/2022|1.25025|03/29/2022||||12583|||||No|No||MAYNE PHARMA IN|No||||
flurandrenolide|No|No|No|No|75%|51862015860|FLURANDRENOLIDE 0.05% OINTMENT|60|GM|4.33676|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|9.88379|12/15/2020|9.74259|12/15/2020|9.27866|12/15/2020|||STEROIDS: TOPICAL MEDIUM|12584|||||No|No||MAYNE PHARMA IN|No||||
hydrocortisone butyrate|No|No|No|No|75%|51862015904|HYDROCORTISONE BUTYR 0.1% LOTN|118|ML|3.25815|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|7.42556|01/10/2022|7.31948|01/10/2022|6.97094|01/10/2022|||STEROIDS: TOPICAL MEDIUM|12585|||||No|No||MAYNE PHARMA IN|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|51862017901|BUTALB-ACETAMIN-CAFF 50-325-40|100|EA|1.65601|05/15/2017||Yes|No||05/15/2017||Yes|No|05/15/2017||Yes|No||||No|No|||Prescription required|No|||No|3.38611|03/01/2022|3.30484|03/01/2022|3.32685|03/01/2022||||12586|||||No|No||MAYNE PHARMA IN|No||||
pramoxine HCl|No|No|No|No|75%|51862018015|PRAMOXINE HCL 1% FOAM|15|GM|1.17533|02/10/2022||Yes|No||||No|No|02/10/2022||Yes|No||||No|No|||Over the counter|No|||No|2.67866|11/13/2018|2.64039|11/13/2018|2.51466|11/13/2018||||12587|||||No|No||MAYNE PHARMA IN|No||||
morphine sulfate|No|No|No|No|90%|51862018501|MORPHINE SULF ER 15 MG TABLET|100|EA|.13833|07/11/2017||Yes|No||07/11/2017||Yes|No|07/11/2017||Yes|No||||No|No|||Prescription required|No||110|Yes|.19105|03/29/2022|.18646|03/29/2022|.1877|03/29/2022|||ANALGESICS: NARCOTICS LONG|12588|||||No|No||MAYNE PHARMA IN|No||||
morphine sulfate|No|No|No|No|90%|51862018601|MORPHINE SULF ER 30 MG TABLET|100|EA|.2629|07/11/2017||Yes|No||07/11/2017||Yes|No|07/11/2017||Yes|No||||No|No|||Prescription required|No||110|Yes|.34621|03/29/2022|.3379|03/29/2022|.34015|03/29/2022|||ANALGESICS: NARCOTICS LONG|12589|||||No|No||MAYNE PHARMA IN|No||||
morphine sulfate|No|No|No|No|90%|51862018701|MORPHINE SULF ER 60 MG TABLET|100|EA|.50228|07/11/2017||Yes|No||07/11/2017||Yes|No|07/11/2017||Yes|No||||No|No|||Prescription required|No||110|Yes|.55429|03/29/2022|.54098|03/29/2022|.54458|03/29/2022|||ANALGESICS: NARCOTICS LONG|12590|||||No|No||MAYNE PHARMA IN|No||||
morphine sulfate|No|No|No|No|90%|51862018801|MORPHINE SULF ER 100 MG TABLET|100|EA|.7595|07/11/2017||Yes|No||07/11/2017||Yes|No|07/11/2017||Yes|No||||No|No|||Prescription required|No||110|Yes|1.04927|03/29/2022|1.02408|03/29/2022|1.0309|03/29/2022|||ANALGESICS: NARCOTICS LONG|12591|||||No|No||MAYNE PHARMA IN|No||||
clarithromycin|No|No|No|No|75%|51862019460|CLARITHROMYCIN ER 500 MG TAB|60|EA|3.07908|11/18/2016||Yes|No||11/18/2016||Yes|No|11/18/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|018|No|3.72397|10/26/2021|3.63459|10/26/2021|3.6588|10/26/2021|||MACROLIDES/KETOLIDES|12592|||||No|No||MAYNE PHARMA IN|No||||
desogestrel-ethinyl estradiol|Yes|Yes|No|No|75%|51862023803|CAZIANT 28 DAY TABLET|28|EA|.76417|11/18/2016||Yes|No||11/18/2016||Yes|No|11/18/2016||Yes|No|Refer to program requirements|||No|No|11/18/2016||Prescription required|No|||No|.60615|03/29/2022|.5916|03/29/2022|.59554|03/29/2022||||12593|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
amiodarone HCl|No|No|No|No|75%|51862024030|AMIODARONE HCL 100 MG TABLET|30|EA|1.19841|07/10/2018||Yes|No||07/10/2018||Yes|No|07/10/2018||Yes|No||||No|No|||Prescription required|No|||No|1.5888|03/29/2022|1.55066|03/29/2022|1.56099|03/29/2022||||12594|||||No|No||MAYNE PHARMA IN|No||||
amiodarone HCl|No|No|No|No|75%|51862024105|AMIODARONE HCL 200 MG TABLET|500|EA|.11374|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|No|||No|.12373|03/29/2022|.12076|03/29/2022|.12156|03/29/2022||||12595|||||No|No||MAYNE PHARMA IN|No||||
amiodarone HCl|No|No|No|No|75%|51862024160|AMIODARONE HCL 200 MG TABLET|60|EA|.1161|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|No|||No|.12373|03/29/2022|.12076|03/29/2022|.12156|03/29/2022||||12596|||||No|No||MAYNE PHARMA IN|No||||
amiodarone HCl|No|No|No|No|75%|51862024190|AMIODARONE HCL 200 MG TABLET|90|EA|.11604|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|No|||No|.12373|03/29/2022|.12076|03/29/2022|.12156|03/29/2022||||12597|||||No|No||MAYNE PHARMA IN|No||||
amiodarone HCl|No|No|No|No|75%|51862024230|AMIODARONE HCL 400 MG TABLET|30|EA|1.50786|07/10/2018||Yes|No||07/10/2018||Yes|No|07/10/2018||Yes|No||||No|No|||Prescription required|No|||No|3.05628|03/29/2022|2.98292|03/29/2022|3.00279|03/29/2022||||12598|||||No|No||MAYNE PHARMA IN|No||||
drospirenone/estetrol|No|Yes|No|No|75%|51862025801|NEXTSTELLIS 3-14.2 MG TABLET|28|EA|2.91785|09/27/2021||Yes|No||||No|No|09/27/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|6.64999|09/27/2021|6.55499|09/27/2021|6.24285|09/27/2021||||12599|||||No|No||MAYNE PHARMA IN|No||||
ethynodiol d-ethinyl estradiol|Yes|Yes|No|No|75%|51862026006|ZOVIA 1-35E TABLET|28|EA|.34056|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No|Refer to program requirements|||No|No|11/21/2016||Prescription required|No|||No|.41215|03/29/2022|.40225|03/29/2022|.40493|03/29/2022||||12600|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
clozapine|No|No|No|No|75%|51862027201|CLOZAPINE 50 MG TABLET|100|EA|.39732|05/21/2018|02/22/2022|Yes|No||05/21/2018|02/22/2022|Yes|No|05/21/2018|02/22/2022|Yes|No||||No|No|||Prescription required|No||027|Yes|.90552|03/29/2022|.89258|03/29/2022|.85008|03/29/2022|||ANTIPSYCHOTICS|12601|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MAYNE PHARMA IN|No||||
clozapine|No|No|No|No|75%|51862027205|CLOZAPINE 50 MG TABLET|500|EA|.39732|05/21/2018|02/22/2022|Yes|No||05/21/2018|02/22/2022|Yes|No|05/21/2018|02/22/2022|Yes|No||||No|No|||Prescription required|No||027|Yes|.90552|03/29/2022|.89258|03/29/2022|.85008|03/29/2022|||ANTIPSYCHOTICS|12602|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MAYNE PHARMA IN|No||||
clozapine|No|No|No|No|75%|51862027301|CLOZAPINE 100 MG TABLET|100|EA|.49665|04/10/2017||Yes|No||04/10/2017||Yes|No|04/10/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.60868|03/29/2022|.59407|03/29/2022|.59802|03/29/2022|||ANTIPSYCHOTICS|12603|||||No|No||MAYNE PHARMA IN|No||||
clozapine|No|No|No|No|75%|51862027305|CLOZAPINE 100 MG TABLET|500|EA|.49665|04/10/2017||Yes|No||04/10/2017||Yes|No|04/10/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.60868|03/29/2022|.59407|03/29/2022|.59802|03/29/2022|||ANTIPSYCHOTICS|12604|||||No|No||MAYNE PHARMA IN|No||||
clozapine|No|No|No|No|75%|51862027401|CLOZAPINE 200 MG TABLET|100|EA|.78647|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|1.46893|03/29/2022|1.43367|03/29/2022|1.44322|03/29/2022|||ANTIPSYCHOTICS|12605|||||No|No||MAYNE PHARMA IN|No||||
clozapine|No|No|No|No|75%|51862027405|CLOZAPINE 200 MG TABLET|500|EA|.78645|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|1.46893|03/29/2022|1.43367|03/29/2022|1.44322|03/29/2022|||ANTIPSYCHOTICS|12606|||||No|No||MAYNE PHARMA IN|No||||
norethindrone ac-eth estradiol|Yes|Yes|No|No|75%|51862027906|MICROGESTIN 21 1.5-30 TAB|21|EA|.44006|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No|Refer to program requirements|||No|No|01/10/2022||Prescription required|No|||No|.56037|03/29/2022|.54692|03/29/2022|.55056|03/29/2022||||12607|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|51862028403|TILIA FE 28 TABLET|28|EA|2.49599|07/11/2017|02/22/2022|Yes|No||07/11/2017|02/22/2022|Yes|No|07/11/2017|02/22/2022|Yes|No|Refer to program requirements|||No|No|07/11/2017|02/22/2022|Prescription required|No|||No|5.68854|03/29/2022|5.60728|03/29/2022|5.34026|03/29/2022||||12608|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
triamcinolone acetonide|No|No|No|No|75%|51862029043|TRIAMCINOLONE 0.05% OINTMENT|430|GM|.77932|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|No||120|No|1.23712|03/01/2022|1.20742|03/01/2022|1.21547|03/01/2022|||STEROIDS: TOPICAL HIGH|12609|||||No|No||MAYNE PHARMA IN|No||||
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|51862029206|MICROGESTIN FE 1.5-30 TAB|28|EA|.33004|07/01/2019||Yes|No||07/01/2019||Yes|No|07/01/2019||Yes|No|Refer to program requirements|||No|No|07/01/2019||Prescription required|No|||No|.28591|03/29/2022|.27904|03/29/2022|.2809|03/29/2022||||12610|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
tazarotene|No|No|No|No|75%|51862029510|FABIOR 0.1% FOAM|100|GM|5.31845|08/24/2017||Yes|No||08/24/2017||Yes|No|08/24/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|104|No|12.12113|02/02/2021|11.94797|02/02/2021|11.37902|02/02/2021|||ACNE AGENTS: TOPICAL|12611|||||No|No||MAYNE PHARMA IN|No||||
tazarotene|No|No|No|No|75%|51862029550|FABIOR 0.1% FOAM|50|GM|5.31841|08/24/2017||Yes|No||08/24/2017||Yes|No|08/24/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|104|No|12.12103|02/02/2021|11.94787|02/02/2021|11.37892|02/02/2021|||ACNE AGENTS: TOPICAL|12612|||||No|No||MAYNE PHARMA IN|No||||
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|51862031803|NECON 0.5-35-28 TABLET|28|EA|.37035|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No|Refer to program requirements|||No|No|11/21/2016||Prescription required|No|||No|.626|03/29/2022|.61097|03/29/2022|.61504|03/29/2022||||12613|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
liothyronine sodium|No|No|No|No|75%|51862032001|LIOTHYRONINE SOD 5 MCG TAB|100|EA|.45515|07/12/2018||Yes|No||07/12/2018||Yes|No|07/12/2018||Yes|No||||No|No|||Prescription required|No|||No|.37734|03/29/2022|.36828|03/29/2022|.37073|03/29/2022||||12614|||||No|No||MAYNE PHARMA IN|No||||
liothyronine sodium|No|No|No|No|75%|51862032101|LIOTHYRONINE SOD 25 MCG TAB|100|EA|.59782|07/12/2018||Yes|No||07/12/2018||Yes|No|07/12/2018||Yes|No||||No|No|||Prescription required|No|||No|.55764|03/29/2022|.54425|03/29/2022|.54788|03/29/2022||||12615|||||No|No||MAYNE PHARMA IN|No||||
liothyronine sodium|No|No|No|No|75%|51862032201|LIOTHYRONINE SOD 50 MCG TAB|100|EA|.91332|07/12/2018||Yes|No||07/12/2018||Yes|No|07/12/2018||Yes|No||||No|No|||Prescription required|No|||No|.67729|01/25/2022|.66103|01/25/2022|.66543|01/25/2022||||12616|||||No|No||MAYNE PHARMA IN|No||||
estradiol|No|No|No|No|75%|51862033201|ESTRADIOL 0.5 MG TABLET|100|EA|.11584|11/18/2016||Yes|No||11/18/2016||Yes|No|11/18/2016||Yes|No||||No|No|||Prescription required|No|||Yes|.08676|03/29/2022|.08467|03/29/2022|.08524|03/29/2022||||12617|||||No|No||MAYNE PHARMA IN|No||||
estradiol|No|No|No|No|75%|51862033301|ESTRADIOL 1 MG TABLET|100|EA|.13218|11/18/2016||Yes|No||11/18/2016||Yes|No|11/18/2016||Yes|No||||No|No|||Prescription required|No|||Yes|.09546|03/29/2022|.09316|03/29/2022|.09378|03/29/2022||||12618|||||No|No||MAYNE PHARMA IN|No||||
estradiol|No|No|No|No|75%|51862033305|ESTRADIOL 1 MG TABLET|500|EA|.13212|11/18/2016||Yes|No||11/18/2016||Yes|No|11/18/2016||Yes|No||||No|No|||Prescription required|No|||Yes|.09546|03/29/2022|.09316|03/29/2022|.09378|03/29/2022||||12619|||||No|No||MAYNE PHARMA IN|No||||
estradiol|No|No|No|No|75%|51862033401|ESTRADIOL 2 MG TABLET|100|EA|.17346|11/18/2016||Yes|No||11/18/2016||Yes|No|11/18/2016||Yes|No||||No|No|||Prescription required|No|||Yes|.13189|03/29/2022|.12872|03/29/2022|.12958|03/29/2022||||12620|||||No|No||MAYNE PHARMA IN|No||||
estradiol|No|No|No|No|75%|51862033405|ESTRADIOL 2 MG TABLET|500|EA|.17356|11/18/2016||Yes|No||11/18/2016||Yes|No|11/18/2016||Yes|No||||No|No|||Prescription required|No|||Yes|.13189|03/29/2022|.12872|03/29/2022|.12958|03/29/2022||||12621|||||No|No||MAYNE PHARMA IN|No||||
chlorzoxazone|No|No|No|No|75%|51862033801|CHLORZOXAZONE 375 MG TABLET|100|EA|1.60024|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|116|Yes|3.64707|11/16/2021|3.59496|11/16/2021|3.42378|11/16/2021|||SKELETAL MUSCLE RELAXANTS|12622|||||No|No||MAYNE PHARMA IN|No||||
chlorzoxazone|No|No|No|No|75%|51862034001|CHLORZOXAZONE 750 MG TABLET|100|EA|1.78935|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|116|Yes|4.07807|11/16/2021|4.01981|11/16/2021|3.82839|11/16/2021|||SKELETAL MUSCLE RELAXANTS|12623|||||No|No||MAYNE PHARMA IN|No||||
dextroamphetamine sulfate|No|No|No|No|75%|51862034490|DEXTROAMPHETAMINE ER 5 MG CAP|90|EA|1.25397|11/18/2016||Yes|No||11/18/2016||Yes|No|11/18/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.09277|03/29/2022|1.06654|03/29/2022|1.07364|03/29/2022|||STIMULANTS AND RELATED AGENTS|12624|||||No|No||MAYNE PHARMA IN|No||||
dextroamphetamine sulfate|No|No|No|No|75%|51862034590|DEXTROAMPHETAMINE ER 10 MG CAP|90|EA|1.56639|11/18/2016||Yes|No||11/18/2016||Yes|No|11/18/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.19348|03/29/2022|1.16483|03/29/2022|1.17259|03/29/2022|||STIMULANTS AND RELATED AGENTS|12625|||||No|No||MAYNE PHARMA IN|No||||
dextroamphetamine sulfate|No|No|No|No|75%|51862034690|DEXTROAMPHETAMINE ER 15 MG CAP|90|EA|1.99729|11/18/2016||Yes|No||11/18/2016||Yes|No|11/18/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.81061|03/29/2022|1.76715|03/29/2022|1.77892|03/29/2022|||STIMULANTS AND RELATED AGENTS|12626|||||No|No||MAYNE PHARMA IN|No||||
fluorouracil|No|No|No|No|75%|51862036240|FLUOROURACIL 5% CREAM|40|GM|1.10682|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|No|||No|1.42743|03/29/2022|1.39317|03/29/2022|1.40244|03/29/2022||||12627|||||No|No||MAYNE PHARMA IN|No||||
calcipotriene|No|No|No|No|75%|51862037612|SORILUX 0.005% FOAM|120|GM|6.07321|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|No|||No|13.84127|02/02/2021|13.64354|02/02/2021|12.99385|02/02/2021||||12628|||||No|No||MAYNE PHARMA IN|No||||
calcipotriene|No|No|No|No|75%|51862037660|SORILUX 0.005% FOAM|60|GM|6.35339|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|No|||No|14.47982|02/02/2021|14.27296|02/02/2021|13.5933|02/02/2021||||12629|||||No|No||MAYNE PHARMA IN|No||||
tamoxifen citrate|No|No|No|No|75%|51862044610|TAMOXIFEN 20 MG TABLET|1000|EA|.14338|07/20/2017||Yes|No||07/20/2017||Yes|No|07/20/2017||Yes|No||||No|No|||Prescription required|No||502|No|.42352|03/29/2022|.41335|03/29/2022|.4161|03/29/2022|||ONCOLOGY: ORAL - BREAST|12630|||||No|No||MAYNE PHARMA IN|No||||
tamoxifen citrate|No|No|No|No|75%|51862044630|TAMOXIFEN 20 MG TABLET|30|EA|.16383|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|No||502|No|.42352|03/29/2022|.41335|03/29/2022|.4161|03/29/2022|||ONCOLOGY: ORAL - BREAST|12631|||||No|No||MAYNE PHARMA IN|No||||
tamoxifen citrate|No|No|No|No|75%|51862044710|TAMOXIFEN 10 MG TABLET|1000|EA|.07681|07/20/2017||Yes|No||07/20/2017||Yes|No|07/20/2017||Yes|No||||No|No|||Prescription required|No||502|No|.21342|03/29/2022|.20829|03/29/2022|.20968|03/29/2022|||ONCOLOGY: ORAL - BREAST|12632|||||No|No||MAYNE PHARMA IN|No||||
tamoxifen citrate|No|No|No|No|75%|51862044760|TAMOXIFEN 10 MG TABLET|60|EA|.08191|03/01/2020|07/31/2022|Yes|No||03/01/2020|07/31/2022|Yes|No|03/01/2020|07/31/2022|Yes|No||||No|No|||Prescription required|No||502|No|.21342|03/29/2022|.20829|03/29/2022|.20968|03/29/2022|||ONCOLOGY: ORAL - BREAST|12633|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MAYNE PHARMA IN|No||||
clonidine|No|No|No|No|75%|51862045304|CLONIDINE 0.1 MG/DAY PATCH|4|EA|5.70287|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|166|No|8.1002|03/29/2022|7.90579|03/29/2022|7.95844|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|12634|||||No|No||MAYNE PHARMA IN|No||||
clonidine|No|No|No|No|75%|51862045404|CLONIDINE 0.2 MG/DAY PATCH|4|EA|9.60297|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|166|No|12.62203|03/29/2022|12.3191|03/29/2022|12.40114|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|12635|||||No|No||MAYNE PHARMA IN|No||||
clonidine|No|No|No|No|75%|51862045504|CLONIDINE 0.3 MG/DAY PATCH|4|EA|13.3214|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|166|No|15.82856|03/29/2022|15.44867|03/29/2022|15.55156|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|12636|||||No|No||MAYNE PHARMA IN|No||||
cyclosporine, modified|No|No|No|No|75%|51862045847|CYCLOSPORINE MODIFIED 25 MG|30|EA|.33095|11/18/2016||Yes|No||11/18/2016||Yes|No|11/18/2016||Yes|No||||No|No|||Prescription required|No||229|No|.55875|03/29/2022|.54534|03/29/2022|.54897|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|12637|||||No|No||MAYNE PHARMA IN|No||||
cyclosporine, modified|No|No|No|No|75%|51862046047|CYCLOSPORINE MODIFIED 100 MG|30|EA|1.32325|11/18/2016||Yes|No||11/18/2016||Yes|No|11/18/2016||Yes|No||||No|No|||Prescription required|No||229|No|1.49497|03/29/2022|1.45909|03/29/2022|1.4688|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|12638|||||No|No||MAYNE PHARMA IN|No||||
itraconazole|No|No|No|No|75%|51862046260|TOLSURA 65 MG CAPSULE|60|EA|16.93497|02/20/2019||Yes|No||02/20/2019||Yes|No|02/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|069|No|38.59598|02/02/2021|38.04461|02/02/2021|36.23296|02/02/2021|||ANTIFUNGALS: ORAL|12639|||||No|No||MAYNE PHARMA IN|No||||
itraconazole|No|No|No|No|75%|51862046288|TOLSURA 65 MG CAPSULE|8|EA|16.93501|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|069|No|38.59607|11/16/2021|38.0447|11/16/2021|36.23305|11/16/2021|||ANTIFUNGALS: ORAL|12640|||||No|No||MAYNE PHARMA IN|No||||
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|51862047106|LEENA 28 TABLET|28|EA|.89808|11/18/2016||Yes|No||11/18/2016||Yes|No|11/18/2016||Yes|No|Refer to program requirements|||No|No|11/18/2016||Prescription required|No|||No|.60269|03/01/2022|.58822|03/01/2022|.59214|03/01/2022||||12641|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
trimethoprim|No|No|No|No|75%|51862048601|TRIMETHOPRIM 100 MG TABLET|100|EA|.80109|07/07/2017||Yes|No||07/07/2017||Yes|No|07/07/2017||Yes|No||||No|No|||Prescription required|No|||No|.56318|03/29/2022|.54966|03/29/2022|.55332|03/29/2022||||12642|||||No|No||MAYNE PHARMA IN|No||||
fluocinonide|No|No|No|No|75%|51862049415|FLUOCINONIDE 0.05% CREAM|15|GM|1.04461|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.69804|03/29/2022|.68128|03/29/2022|.68582|03/29/2022|||STEROIDS: TOPICAL HIGH|12643|||||No|No||MAYNE PHARMA IN|No||||
fluocinonide|No|No|No|No|75%|51862049430|FLUOCINONIDE 0.05% CREAM|30|GM|1.04461|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.62146|03/29/2022|.60654|03/29/2022|.61058|03/29/2022|||STEROIDS: TOPICAL HIGH|12644|||||No|No||MAYNE PHARMA IN|No||||
fluocinonide|No|No|No|No|75%|51862049460|FLUOCINONIDE 0.05% CREAM|60|GM|1.04453|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.55445|03/29/2022|.54114|03/29/2022|.54474|03/29/2022|||STEROIDS: TOPICAL HIGH|12645|||||No|No||MAYNE PHARMA IN|No||||
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|51862051006|TRIVORA-28 TABLET|28|EA|.31666|07/20/2017||Yes|No||07/20/2017||Yes|No|07/20/2017||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.4402|03/29/2022|.42963|03/29/2022|.43249|03/29/2022||||12646|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
calcipotriene|No|No|No|No|75%|51862051260|CALCIPOTRIENE 0.005% FOAM|60|GM|5.48321|12/15/2021||Yes|No||12/15/2021||Yes|No|12/15/2021||Yes|No||||No|No|||Prescription required|No|||No|12.49662|12/15/2021|12.3181|12/15/2021|11.73152|12/15/2021||||12647|||||No|No||MAYNE PHARMA IN|No||||
desogestrel-ethinyl estradiol|No|Yes|No|No|75%|51862051403|DESOGESTREL-EE 0.15-0.03 MG TB|28|EA|.3139|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.18364|03/29/2022|.17923|03/29/2022|.18042|03/29/2022||||12648|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
brompheniramine/pseudoephed/DM|No|No|No|No|75%|51862053504|BROMPHEN-PSE-DM 2-30-10 MG/5ML|118|ML|.08034|02/27/2020||Yes|No||02/27/2020||Yes|No|02/27/2020||Yes|No||||No|No|||Prescription required|No||184|Yes|.0774|03/29/2022|.07554|03/29/2022|.07604|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|12649|||||No|No||MAYNE PHARMA IN|No||||
brompheniramine/pseudoephed/DM|No|No|No|No|75%|51862053516|BROMPHEN-PSE-DM 2-30-10 MG/5ML|473|ML|.08007|02/27/2020||Yes|No||02/27/2020||Yes|No|02/27/2020||Yes|No||||No|No|||Prescription required|No||184|Yes|.06501|03/29/2022|.06344|03/29/2022|.06387|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|12650|||||No|No||MAYNE PHARMA IN|No||||
butalbital/acetaminophen|No|No|No|No|75%|51862053801|BUTALBITAL-ACETAMINOPHN 50-300|100|EA|5.00511|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|No|||No|11.407|12/04/2018|11.24404|12/04/2018|10.70861|12/04/2018||||12651|||||No|No||MAYNE PHARMA IN|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|51862054001|BUTALB-ACETAMIN-CAFF 50-325-40|100|EA|.48297|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No|||No|.18524|03/29/2022|.18079|03/29/2022|.18199|03/29/2022||||12652|||||No|No||MAYNE PHARMA IN|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|51862054005|BUTALB-ACETAMIN-CAFF 50-325-40|500|EA|.45867|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No|||No|.18524|03/29/2022|.18079|03/29/2022|.18199|03/29/2022||||12653|||||No|No||MAYNE PHARMA IN|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|51862054201|BUTALB-ACETAMIN-CAFF 50-300-40|100|EA|.72111|10/15/2020||Yes|No||10/15/2020||Yes|No|10/15/2020||Yes|No||||No|No|||Prescription required|No|||No|.69452|03/29/2022|.67785|03/29/2022|.68236|03/29/2022||||12654|||||No|No||MAYNE PHARMA IN|No||||
butalbital/acetaminophen|No|No|No|No|75%|51862054401|BUTALBITAL-ACETAMINOPHN 50-300|100|EA|5.00511|05/17/2019||Yes|No||05/17/2019||Yes|No|05/17/2019||Yes|No||||No|No|||Prescription required|No|||No|11.407|05/17/2019|11.24404|05/17/2019|10.70861|05/17/2019||||12655|||||No|No||MAYNE PHARMA IN|No||||
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|51862054506|SRONYX 0.10-0.02 MG TABLET|28|EA|.18198|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.21292|03/29/2022|.2078|03/29/2022|.20919|03/29/2022||||12656|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
doxycycline hyclate|No|No|No|No|75%|51862055712|DORYX DR 50 MG TABLET|120|EA|5.09478|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|213|No|11.61136|11/16/2021|11.44548|11/16/2021|10.90046|11/16/2021|||TETRACYCLINES|12657|||||No|No||MAYNE PHARMA IN|No||||
doxycycline hyclate|No|No|No|No|75%|51862055806|DORYX DR 200 MG TABLET|60|EA|18.86424|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|213|No|42.99292|11/16/2021|42.37873|11/16/2021|40.3607|11/16/2021|||TETRACYCLINES|12658|||||No|No||MAYNE PHARMA IN|No||||
doxycycline hyclate|No|No|No|No|75%|51862055930|DORYX MPC DR 120 MG TABLET|30|EA|5.375|02/13/2019||Yes|No||02/13/2019||Yes|No|02/13/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|12.25|08/27/2019|12.075|08/27/2019|11.5|08/27/2019|||TETRACYCLINES|12659|||||No|No||MAYNE PHARMA IN|No||||
norgestrel-ethinyl estradiol|Yes|Yes|No|No|75%|51862056406|LOW-OGESTREL-28 TABLET|28|EA|.35157|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.39526|03/29/2022|.38577|03/29/2022|.38834|03/29/2022||||12660|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
doxycycline hyclate|No|No|No|No|75%|51862057130|DOXYCYCLINE HYC DR 80 MG TAB|30|EA|13.61666|12/15/2021||Yes|No||12/15/2021||Yes|No|12/15/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|213|No|31.03332|12/15/2021|30.58999|12/15/2021|29.13332|12/15/2021|||TETRACYCLINES|12661|||||No|No||MAYNE PHARMA IN|No||||
budesonide|No|No|No|No|75%|51862058001|BUDESONIDE EC 3 MG CAPSULE|100|EA|2.9436|02/19/2020||Yes|No||02/19/2020||Yes|No|02/19/2020||Yes|No||||No|No|||Prescription required|No||168|Yes|.86544|03/29/2022|.84466|03/29/2022|.85029|03/29/2022|||GLUCOCORTICOIDS: ORAL|12662|||||No|No||MAYNE PHARMA IN|No||||
halobetasol propionate|No|No|No|No|75%|51862060402|LEXETTE 0.05% FOAM|50|GM|7.28785|08/30/2019||Yes|No||08/30/2019||Yes|No|08/30/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|121|No|16.60953|02/02/2021|16.37225|02/02/2021|15.59262|02/02/2021|||STEROIDS: TOPICAL VERY HIGH|12663|||||No|No||MAYNE PHARMA IN|No||||
halobetasol propionate|No|No|No|No|75%|51862060450|LEXETTE 0.05% FOAM|50|GM|7.62407|08/30/2019||Yes|No||08/30/2019||Yes|No|08/30/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|121|No|17.37579|02/02/2021|17.12756|02/02/2021|16.31196|02/02/2021|||STEROIDS: TOPICAL VERY HIGH|12664|||||No|No||MAYNE PHARMA IN|No||||
halobetasol propionate|No|No|No|No|75%|51862060650|HALOBETASOL PROP 0.05% FOAM|50|GM|7.12527|12/29/2020||Yes|No||12/29/2020||Yes|No|12/29/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|121|No|16.23899|12/29/2020|16.007|12/29/2020|15.24476|12/29/2020|||STEROIDS: TOPICAL VERY HIGH|12665|||||No|No||MAYNE PHARMA IN|No||||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|51862060830|BUPRENORPHINE-NALOX 8-2 MG TAB|30|EA|.9556|11/22/2021||Yes|No||11/22/2021||Yes|No|11/22/2021||Yes|No||||No|No|||Prescription required|No||145|Yes|2.17788|11/22/2021|2.14677|11/22/2021|2.04454|11/22/2021|||OPIATE DEPENDENCE TREATMENTS|12666|||||No|No||MAYNE PHARMA IN|Yes|09/01/2020|||
methylphenidate HCl|No|No|No|No|75%|51862060901|METHYLPHENIDATE LA 10 MG CAP|100|EA|2.21587|07/23/2019||Yes|No||07/23/2019||Yes|No|07/23/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|5.98466|03/29/2022|5.84102|03/29/2022|5.87992|03/29/2022|||STIMULANTS AND RELATED AGENTS|12667|||||No|No||MAYNE PHARMA IN|No||||
methylphenidate HCl|No|No|No|No|75%|51862061001|METHYLPHENIDATE LA 20 MG CAP|100|EA|.66478|09/24/2019||Yes|No||09/24/2019||Yes|No|09/24/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.22563|03/29/2022|1.19621|03/29/2022|1.20418|03/29/2022|||STIMULANTS AND RELATED AGENTS|12668|||||No|No||MAYNE PHARMA IN|No||||
methylphenidate HCl|No|No|No|No|75%|51862061101|METHYLPHENIDATE LA 30 MG CAP|100|EA|.67991|11/04/2019||Yes|No||11/04/2019||Yes|No|11/04/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.80098|03/29/2022|1.75775|03/29/2022|1.76946|03/29/2022|||STIMULANTS AND RELATED AGENTS|12669|||||No|No||MAYNE PHARMA IN|No||||
methylphenidate HCl|No|No|No|No|75%|51862061201|METHYLPHENIDATE LA 40 MG CAP|100|EA|.69879|07/30/2019||Yes|No||07/30/2019||Yes|No|07/30/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.62914|03/29/2022|1.59004|03/29/2022|1.60063|03/29/2022|||STIMULANTS AND RELATED AGENTS|12670|||||No|No||MAYNE PHARMA IN|No||||
methylphenidate HCl|No|No|No|No|75%|51862061430|METHYLPHENIDATE LA 60 MG CAP|30|EA|4.25542|04/25/2019||Yes|No||04/25/2019||Yes|No|04/25/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|8.60407|09/28/2021|8.39757|09/28/2021|8.45349|09/28/2021|||STIMULANTS AND RELATED AGENTS|12671|||||No|No||MAYNE PHARMA IN|No||||
fentanyl citrate|No|No|No|No|90%|51862063428|FENTANYL CIT 100 MCG BUCCAL TB|28|EA|19.97211|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|109|Yes|45.51784|02/26/2020|44.86758|02/26/2020|42.73103|02/26/2020|||ANALGESICS: NARCOTICS SHORT|12672|||||No|No||MAYNE PHARMA IN|No||||
fentanyl citrate|No|No|No|No|90%|51862063528|FENTANYL CIT 200 MCG BUCCAL TB|28|EA|25.23393|09/19/2019||Yes|No||09/19/2019||Yes|No|09/19/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|109|Yes|57.50989|09/19/2019|56.68832|09/19/2019|53.98888|09/19/2019|||ANALGESICS: NARCOTICS SHORT|12673|||||No|No||MAYNE PHARMA IN|No||||
fentanyl citrate|No|No|No|No|90%|51862063628|FENTANYL CIT 400 MCG BUCCAL TB|28|EA|36.61235|09/19/2019||Yes|No||09/19/2019||Yes|No|09/19/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|109|Yes|83.4421|09/19/2019|82.25007|09/19/2019|78.3334|09/19/2019|||ANALGESICS: NARCOTICS SHORT|12674|||||No|No||MAYNE PHARMA IN|No||||
fentanyl citrate|No|No|No|No|90%|51862063728|FENTANYL CIT 600 MCG BUCCAL TB|28|EA|47.53358|09/19/2019||Yes|No||09/19/2019||Yes|No|09/19/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|109|Yes|108.33234|09/19/2019|106.78474|09/19/2019|101.69975|09/19/2019|||ANALGESICS: NARCOTICS SHORT|12675|||||No|No||MAYNE PHARMA IN|No||||
fentanyl citrate|No|No|No|No|90%|51862063828|FENTANYL CIT 800 MCG BUCCAL TB|28|EA|58.55939|09/19/2019||Yes|No||09/19/2019||Yes|No|09/19/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|109|Yes|133.46094|09/19/2019|131.55436|09/19/2019|125.28986|09/19/2019|||ANALGESICS: NARCOTICS SHORT|12676|||||No|No||MAYNE PHARMA IN|No||||
tamoxifen citrate|No|No|No|No|75%|51862064210|TAMOXIFEN 10 MG TABLET|1000|EA|.07681|03/08/2022||Yes|No||03/08/2022||Yes|No|03/08/2022||Yes|No||||No|No|||Prescription required|No||502|No|.21342|03/29/2022|.20829|03/29/2022|.20968|03/29/2022|||ONCOLOGY: ORAL - BREAST|12677|||||No|No||MAYNE PHARMA IN|No||||
tamoxifen citrate|No|No|No|No|75%|51862064260|TAMOXIFEN 10 MG TABLET|60|EA|.08191|03/08/2022||Yes|No||03/08/2022||Yes|No|03/08/2022||Yes|No||||No|No|||Prescription required|No||502|No|.21342|03/29/2022|.20829|03/29/2022|.20968|03/29/2022|||ONCOLOGY: ORAL - BREAST|12678|||||No|No||MAYNE PHARMA IN|No||||
tamoxifen citrate|No|No|No|No|75%|51862064310|TAMOXIFEN 20 MG TABLET|1000|EA|.14338|03/08/2022||Yes|No||03/08/2022||Yes|No|03/08/2022||Yes|No||||No|No|||Prescription required|No||502|No|.42352|03/29/2022|.41335|03/29/2022|.4161|03/29/2022|||ONCOLOGY: ORAL - BREAST|12679|||||No|No||MAYNE PHARMA IN|No||||
norgestimate-ethinyl estradiol|No|Yes|No|No|75%|51862064506|NYMYO 0.25-0.035 MG (28) TAB|28|EA|.3336|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.1742|03/29/2022|.17001|03/29/2022|.17115|03/29/2022||||12680|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
norgestimate-ethinyl estradiol|No|Yes|No|No|75%|51862064606|TRI-NYMYO 28 TABLET|28|EA|.37724|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.1602|03/29/2022|.15635|03/29/2022|.15739|03/29/2022||||12681|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|No|Yes|No|No|75%|51862064803|MICROGESTIN 24 FE 1 MG-20 MCG|28|EA|.31737|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.56858|03/29/2022|.55493|03/29/2022|.55862|03/29/2022||||12682|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
tamoxifen citrate|No|No|No|No|75%|51862068201|SOLTAMOX 20 MG/10 ML SOLN|150|ML|1.98628|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||||No|No|||Prescription required|No||502|No|4.52687|02/10/2022|4.4622|02/10/2022|4.24971|02/10/2022|||ONCOLOGY: ORAL - BREAST|12683|||||No|No||MAYNE PHARMA IN|No||||
tavaborole|No|No|No|No|75%|51862069010|TAVABOROLE 5% TOPICAL SOLUTION|10|ML|55.22146|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|061|No|12.67867|01/10/2022|12.37438|01/10/2022|12.45679|01/10/2022|||ANTIFUNGALS: TOPICAL|12684|||||No|No||MAYNE PHARMA IN|No||||
doxycycline hyclate|No|No|No|No|75%|51862069506|DOXYCYCLINE HYCLATE 75 MG TAB|60|EA|10.71574|07/06/2018||Yes|No||07/06/2018||Yes|No|07/06/2018||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|213|No|24.42192|07/06/2018|24.07303|07/06/2018|22.9267|07/06/2018|||TETRACYCLINES|12685|||||No|No||MAYNE PHARMA IN|No||||
doxycycline hyclate|No|No|No|No|75%|51862069606|DOXYCYCLINE HYCLATE 150 MG TAB|60|EA|10.71574|07/06/2018||Yes|No||07/06/2018||Yes|No|07/06/2018||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|213|No|24.42192|03/24/2020|24.07303|03/24/2020|22.9267|03/24/2020|||TETRACYCLINES|12686|||||No|No||MAYNE PHARMA IN|No||||
doxycycline hyclate|No|No|No|No|75%|51862070912|DOXYCYCLINE HYC DR 50 MG TAB|120|EA|4.03393|02/13/2019||Yes|No||02/13/2019||Yes|No|02/13/2019||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|213|No|7.12484|05/25/2021|6.95384|05/25/2021|7.00015|05/25/2021|||TETRACYCLINES|12687|||||No|No||MAYNE PHARMA IN|No||||
carbidopa/levodopa|No|No|No|No|75%|51862085501|CARBIDOPA-LEVODOPA 10-100 TAB|100|EA|.11244|07/30/2019||Yes|No||07/30/2019||Yes|No|07/30/2019||Yes|No||||No|No|||Prescription required|No||015|No|.14195|03/29/2022|.13854|03/29/2022|.13946|03/29/2022|||ANTIPARKINSON'S AGENTS|12688|||||No|No||MAYNE PHARMA IN|No||||
carbidopa/levodopa|No|No|No|No|75%|51862085505|CARBIDOPA-LEVODOPA 10-100 TAB|500|EA|.1102|01/29/2019||Yes|No||01/29/2019||Yes|No|01/29/2019||Yes|No||||No|No|||Prescription required|No||015|No|.14195|03/29/2022|.13854|03/29/2022|.13946|03/29/2022|||ANTIPARKINSON'S AGENTS|12689|||||No|No||MAYNE PHARMA IN|No||||
carbidopa/levodopa|No|No|No|No|75%|51862085601|CARBIDOPA-LEVODOPA 25-100 TAB|100|EA|.12771|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|No||015|No|.11418|03/29/2022|.11143|03/29/2022|.11218|03/29/2022|||ANTIPARKINSON'S AGENTS|12690|||||No|No||MAYNE PHARMA IN|No||||
carbidopa/levodopa|No|No|No|No|75%|51862085605|CARBIDOPA-LEVODOPA 25-100 TAB|500|EA|.12515|09/30/2019||Yes|No||09/30/2019||Yes|No|09/30/2019||Yes|No||||No|No|||Prescription required|No||015|No|.11418|03/29/2022|.11143|03/29/2022|.11218|03/29/2022|||ANTIPARKINSON'S AGENTS|12691|||||No|No||MAYNE PHARMA IN|No||||
carbidopa/levodopa|No|No|No|No|75%|51862085610|CARBIDOPA-LEVODOPA 25-100 TAB|1000|EA|.12515|01/29/2019||Yes|No||01/29/2019||Yes|No|01/29/2019||Yes|No||||No|No|||Prescription required|No||015|No|.11418|03/29/2022|.11143|03/29/2022|.11218|03/29/2022|||ANTIPARKINSON'S AGENTS|12692|||||No|No||MAYNE PHARMA IN|No||||
carbidopa/levodopa|No|No|No|No|75%|51862085801|CARBIDOPA-LEVODOPA 25-250 TAB|100|EA|.14749|01/30/2019||Yes|No||01/30/2019||Yes|No|01/30/2019||Yes|No||||No|No|||Prescription required|No||015|No|.1493|03/29/2022|.14571|03/29/2022|.14668|03/29/2022|||ANTIPARKINSON'S AGENTS|12693|||||No|No||MAYNE PHARMA IN|No||||
carbidopa/levodopa|No|No|No|No|75%|51862085805|CARBIDOPA-LEVODOPA 25-250 TAB|500|EA|.14013|09/30/2019||Yes|No||09/30/2019||Yes|No|09/30/2019||Yes|No||||No|No|||Prescription required|No||015|No|.1493|03/29/2022|.14571|03/29/2022|.14668|03/29/2022|||ANTIPARKINSON'S AGENTS|12694|||||No|No||MAYNE PHARMA IN|No||||
carbidopa/levodopa|No|No|No|No|75%|51862085810|CARBIDOPA-LEVODOPA 25-250 TAB|1000|EA|.14011|07/30/2019||Yes|No||07/30/2019||Yes|No|07/30/2019||Yes|No||||No|No|||Prescription required|No||015|No|.1493|03/29/2022|.14571|03/29/2022|.14668|03/29/2022|||ANTIPARKINSON'S AGENTS|12695|||||No|No||MAYNE PHARMA IN|No||||
norethindrone-e.estradiol-iron|No|Yes|No|No|75%|51862086606|MICROGESTIN FE 1-20 TABLET|28|EA|.33004|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.20374|03/29/2022|.19885|03/29/2022|.20017|03/29/2022||||12696|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone ac-eth estradiol|No|Yes|No|No|75%|51862086806|MICROGESTIN 21 1-20 TABLET|21|EA|.44006|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.29153|03/29/2022|.28453|03/29/2022|.28642|03/29/2022||||12697|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|No|Yes|No|No|75%|51862087006|MICROGESTIN FE 1.5-30 TAB|28|EA|.33004|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.28591|03/29/2022|.27904|03/29/2022|.2809|03/29/2022||||12698|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone ac-eth estradiol|No|Yes|No|No|75%|51862087206|MICROGESTIN 21 1.5-30 TAB|21|EA|.44006|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.56037|03/29/2022|.54692|03/29/2022|.55056|03/29/2022||||12699|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone|Yes|Yes|No|No|75%|51862088403|CAMILA 0.35 MG TABLET|28|EA|.38218|01/02/2019||Yes|No||01/02/2019||Yes|No|01/02/2019||Yes|No|Refer to program requirements|||No|No|06/18/2019||Prescription required|No|||No|.16123|03/29/2022|.15736|03/29/2022|.1584|03/29/2022||||12700|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone|Yes|Yes|No|No|75%|51862088603|ERRIN 0.35 MG TABLET|28|EA|.38218|01/02/2019||Yes|No||01/02/2019||Yes|No|01/02/2019||Yes|No|Refer to program requirements|||No|No|06/18/2019||Prescription required|No|||No|.16123|03/29/2022|.15736|03/29/2022|.1584|03/29/2022||||12701|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
desog-e.estradiol/e.estradiol|No|Yes|No|No|75%|51862089006|AZURETTE 28 DAY TABLET|28|EA|.66299|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.21935|03/29/2022|.21408|03/29/2022|.21551|03/29/2022||||12702|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-ethin. estradiol|No|Yes|No|No|75%|51862089203|NECON 0.5-35-28 TABLET|28|EA|.37035|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.626|03/29/2022|.61097|03/29/2022|.61504|03/29/2022||||12703|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
ethynodiol d-ethinyl estradiol|No|Yes|No|No|75%|51862089406|ZOVIA 1-35 TABLET|28|EA|.34056|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.41215|03/29/2022|.40225|03/29/2022|.40493|03/29/2022||||12704|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|No|Yes|No|No|75%|51862089603|TILIA FE 28 TABLET|28|EA|2.49599|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|1.27715|03/29/2022|1.24649|03/29/2022|1.25479|03/29/2022||||12705|||||No|No||MAYNE PHARMA IN|No|||Only covered for non-contraceptive (medical) purposes|
clozapine|No|No|No|No|75%|51862090001|CLOZAPINE 25 MG TABLET|100|EA|.19565|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.26318|03/29/2022|.25686|03/29/2022|.25857|03/29/2022|||ANTIPSYCHOTICS|12706|||||No|No||MAYNE PHARMA IN|No||||
clozapine|No|No|No|No|75%|51862090005|CLOZAPINE 25 MG TABLET|500|EA|.19565|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.26318|03/29/2022|.25686|03/29/2022|.25857|03/29/2022|||ANTIPSYCHOTICS|12707|||||No|No||MAYNE PHARMA IN|No||||
clozapine|No|No|No|No|75%|51862090101|CLOZAPINE 50 MG TABLET|100|EA|.39732|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.51896|03/29/2022|.5065|03/29/2022|.50987|03/29/2022|||ANTIPSYCHOTICS|12708|||||No|No||MAYNE PHARMA IN|No||||
clozapine|No|No|No|No|75%|51862090105|CLOZAPINE 50 MG TABLET|500|EA|.39732|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.51896|03/29/2022|.5065|03/29/2022|.50987|03/29/2022|||ANTIPSYCHOTICS|12709|||||No|No||MAYNE PHARMA IN|No||||
clozapine|No|No|No|No|75%|51862090201|CLOZAPINE 100 MG TABLET|100|EA|.49665|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.60868|03/29/2022|.59407|03/29/2022|.59802|03/29/2022|||ANTIPSYCHOTICS|12710|||||No|No||MAYNE PHARMA IN|No||||
clozapine|No|No|No|No|75%|51862090205|CLOZAPINE 100 MG TABLET|500|EA|.49665|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.60868|03/29/2022|.59407|03/29/2022|.59802|03/29/2022|||ANTIPSYCHOTICS|12711|||||No|No||MAYNE PHARMA IN|No||||
clozapine|No|No|No|No|75%|51862090301|CLOZAPINE 200 MG TABLET|100|EA|.78647|10/04/2021||Yes|No||10/04/2021||Yes|No|10/04/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|1.46893|03/29/2022|1.43367|03/29/2022|1.44322|03/29/2022|||ANTIPSYCHOTICS|12712|||||No|No||MAYNE PHARMA IN|No||||
clozapine|No|No|No|No|75%|51862090305|CLOZAPINE 200 MG TABLET|500|EA|.78645|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|1.46893|03/29/2022|1.43367|03/29/2022|1.44322|03/29/2022|||ANTIPSYCHOTICS|12713|||||No|No||MAYNE PHARMA IN|No||||
diazepam|No|No|No|No|75%|51862094101|DIAZEPAM 2 MG TABLET|100|EA|.06063|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|No||090|Yes|.02435|03/29/2022|.02376|03/29/2022|.02392|03/29/2022|||ANXIOLYTICS|12714|||||No|No||MAYNE PHARMA IN|No||||
diazepam|No|No|No|No|75%|51862094105|DIAZEPAM 2 MG TABLET|500|EA|.05882|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|No||090|Yes|.02435|03/29/2022|.02376|03/29/2022|.02392|03/29/2022|||ANXIOLYTICS|12715|||||No|No||MAYNE PHARMA IN|No||||
diazepam|No|No|No|No|75%|51862094201|DIAZEPAM 5 MG TABLET|100|EA|.06321|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|No||090|Yes|.02374|03/29/2022|.02317|03/29/2022|.02332|03/29/2022|||ANXIOLYTICS|12716|||||No|No||MAYNE PHARMA IN|No||||
diazepam|No|No|No|No|75%|51862094205|DIAZEPAM 5 MG TABLET|500|EA|.06131|04/23/2020||Yes|No||04/23/2020||Yes|No|04/23/2020||Yes|No||||No|No|||Prescription required|No||090|Yes|.02374|03/29/2022|.02317|03/29/2022|.02332|03/29/2022|||ANXIOLYTICS|12717|||||No|No||MAYNE PHARMA IN|No||||
diazepam|No|No|No|No|75%|51862094210|DIAZEPAM 5 MG TABLET|1000|EA|.06007|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|No||090|Yes|.02374|03/29/2022|.02317|03/29/2022|.02332|03/29/2022|||ANXIOLYTICS|12718|||||No|No||MAYNE PHARMA IN|No||||
diazepam|No|No|No|No|75%|51862094301|DIAZEPAM 10 MG TABLET|100|EA|.08213|02/19/2020||Yes|No||02/19/2020||Yes|No|02/19/2020||Yes|No||||No|No|||Prescription required|No||090|Yes|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANXIOLYTICS|12719|||||No|No||MAYNE PHARMA IN|No||||
diazepam|No|No|No|No|75%|51862094305|DIAZEPAM 10 MG TABLET|500|EA|.07968|04/23/2020||Yes|No||04/23/2020||Yes|No|04/23/2020||Yes|No||||No|No|||Prescription required|No||090|Yes|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANXIOLYTICS|12720|||||No|No||MAYNE PHARMA IN|No||||
diazepam|No|No|No|No|75%|51862094310|DIAZEPAM 10 MG TABLET|1000|EA|.07808|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|No||090|Yes|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANXIOLYTICS|12721|||||No|No||MAYNE PHARMA IN|No||||
nortriptyline HCl|No|No|No|No|75%|51862094501|NORTRIPTYLINE HCL 10 MG CAP|100|EA|.08376|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|No||215|No|.07187|03/29/2022|.07014|03/29/2022|.07061|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12722|||||No|No||MAYNE PHARMA IN|No||||
nortriptyline HCl|No|No|No|No|75%|51862094505|NORTRIPTYLINE HCL 10 MG CAP|500|EA|.0817|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|No||215|No|.07187|03/29/2022|.07014|03/29/2022|.07061|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12723|||||No|No||MAYNE PHARMA IN|No||||
nortriptyline HCl|No|No|No|No|75%|51862094601|NORTRIPTYLINE HCL 25 MG CAP|100|EA|.11438|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|No||215|No|.09534|03/29/2022|.09305|03/29/2022|.09367|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12724|||||No|No||MAYNE PHARMA IN|No||||
nortriptyline HCl|No|No|No|No|75%|51862094605|NORTRIPTYLINE HCL 25 MG CAP|500|EA|.11152|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|No||215|No|.09534|03/29/2022|.09305|03/29/2022|.09367|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12725|||||No|No||MAYNE PHARMA IN|No||||
nortriptyline HCl|No|No|No|No|75%|51862094701|NORTRIPTYLINE HCL 50 MG CAP|100|EA|.14013|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|No||215|No|.12931|03/29/2022|.1262|03/29/2022|.12704|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12726|||||No|No||MAYNE PHARMA IN|No||||
nortriptyline HCl|No|No|No|No|75%|51862094705|NORTRIPTYLINE HCL 50 MG CAP|500|EA|.1366|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|No||215|No|.12931|03/29/2022|.1262|03/29/2022|.12704|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12727|||||No|No||MAYNE PHARMA IN|No||||
nortriptyline HCl|No|No|No|No|75%|51862094801|NORTRIPTYLINE HCL 75 MG CAP|100|EA|.19405|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|No||215|No|.17543|03/29/2022|.17121|03/29/2022|.17235|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|12728|||||No|No||MAYNE PHARMA IN|No||||
exemestane|No|No|No|No|75%|51991000533|EXEMESTANE 25 MG TABLET|30|EA|1.43333|10/08/2020||Yes|No||10/08/2020||Yes|No|10/08/2020||Yes|No||||No|No|||Prescription required|No||502|No|1.32315|03/29/2022|1.29139|03/29/2022|1.29999|03/29/2022|||ONCOLOGY: ORAL - BREAST|12729|||||No|No||BRECKENRIDGE|No||||
exemestane|No|No|No|No|75%|51991000590|EXEMESTANE 25 MG TABLET|90|EA|1.43333|10/14/2021||Yes|No||10/14/2021||Yes|No|10/14/2021||Yes|No||||No|No|||Prescription required|No||502|No|1.32315|03/29/2022|1.29139|03/29/2022|1.29999|03/29/2022|||ONCOLOGY: ORAL - BREAST|12730|||||No|No||BRECKENRIDGE|No||||
desvenlafaxine succinate|No|No|No|No|75%|51991000633|DESVENLAFAXINE SUCCNT ER 25 MG|30|EA|.41939|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.63768|03/29/2022|.62237|03/29/2022|.62652|03/29/2022|||ANTIDEPRESSANTS: OTHER|12731|||||No|No||BRECKENRIDGE|No||||
butalbit/acetamin/caff/codeine|No|No|No|No|90%|51991007301|BUTALB-ACETAMIN-CAF-COD 50-325|100|EA|.4902|09/07/2004||Yes|No||09/07/2004||Yes|No|09/07/2004||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|109|Yes|.68873|03/29/2022|.6722|03/29/2022|.67667|03/29/2022|||ANALGESICS: NARCOTICS SHORT|12732|||||No|No||BRECKENRIDGE|No||||
codeine/butalbital/ASA/caffein|No|No|No|No|90%|51991007401|ASCOMP WITH CODEINE CAPSULE|100|EA|.98173|08/29/2002||Yes|No||08/29/2002||Yes|No|08/29/2002||Yes|No||08/29/2002||Yes|No|||Prescription required|Yes|07/17/2014|109|Yes|1.16307|03/29/2022|1.13515|03/29/2022|1.14271|03/29/2022|||ANALGESICS: NARCOTICS SHORT|12733|||||No|No||BRECKENRIDGE|No||||
codeine/butalbital/ASA/caffein|No|No|No|No|90%|51991007405|ASCOMP WITH CODEINE CAPSULE|500|EA|.96209|08/29/2002||Yes|No||08/29/2002||Yes|No|08/29/2002||Yes|No||08/29/2002||Yes|No|||Prescription required|Yes|07/17/2014|109|Yes|1.16307|03/29/2022|1.13515|03/29/2022|1.14271|03/29/2022|||ANALGESICS: NARCOTICS SHORT|12734|||||No|No||BRECKENRIDGE|No||||
folic acid/vit B complex and C|No|No|No|No|75%|51991008290|FOLBEE PLUS TABLET|90|EA|.18255|||No|No||||No|No|||No|No||06/15/2004||Yes|No|||Over the counter|No|||No|.41605|07/07/2020|.41011|07/07/2020|.39058|07/07/2020||||12735|||||No|No||BRECKENRIDGE|No||||
cyanocobalamin/folic ac/vit B6|No|No|No|No|75%|51991008490|FOLBEE TABLET|90|EA|.24863|||No|No||||No|No|||No|No||06/15/2004||Yes|No|||Over the counter|No|||No|||||||.36257|06/02/2016||12736|||||No|No||BRECKENRIDGE|No||||
ferrous fumarate|No|No|No|No|75%|51991018142|FERROCITE TABLET|100|EA|.07288|||No|No||||No|No|||No|No||09/30/2009||Yes|No|||Over the counter|No|||No|.16611|07/07/2020|.16373|07/07/2020|.15594|07/07/2020||||12737|||||No|No||BRECKENRIDGE|No||||
methscopolamine bromide|No|No|No|No|75%|51991019101|METHSCOPOLAMINE BROM 2.5 MG TB|100|EA|.43|10/14/2021||Yes|No||10/14/2021||Yes|No|10/14/2021||Yes|No||||No|No|||Prescription required|No|||No|1.01825|09/28/2021|.99381|09/28/2021|1.00043|09/28/2021||||12738|||||No|No||BRECKENRIDGE|No||||
methscopolamine bromide|No|No|No|No|75%|51991019206|METHSCOPOLAMINE BROM 5 MG TAB|60|EA|.71666|10/14/2021||Yes|No||10/14/2021||Yes|No|10/14/2021||Yes|No||||No|No|||Prescription required|No|||No|1.63332|01/26/2021|1.60999|01/26/2021|1.53332|01/26/2021||||12739|||||No|No||BRECKENRIDGE|No||||
iron ps complex/B12/folic acid|No|No|No|No|75%|51991019811|FERREX 150 FORTE CAPSULE|100|EA|.05439|||No|No||||No|No|||No|No||09/01/1999||Yes|No|||Over the counter|No|||No|.12397|07/07/2020|.12219|07/07/2020|.11638|07/07/2020||||12740|||||No|No||BRECKENRIDGE|No||||
iron ps complex/B12/folic acid|No|No|No|No|75%|51991019899|FERREX 150 FORTE CAPSULE|1|EA||||No|No||||No|No|||No|No||09/15/2015||Yes|No|||Over the counter|No|||No||||||||||12741|||||No|No||BRECKENRIDGE|No||||
iron polysaccharide complex|No|No|No|No|75%|51991020301|FERREX 150 CAPSULE|100|EA|.05439|||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|.12397|07/07/2020|.12219|07/07/2020|.11638|07/07/2020||||12742|||||No|No||BRECKENRIDGE|No||||
iron polysaccharide complex|No|No|No|No|75%|51991020311|FERREX 150 CAPSULE|100|EA|.05439|||No|No||||No|No|||No|No||09/01/1999||Yes|No|||Over the counter|No|||No|||||||.14168|06/20/2016||12743|||||No|No||BRECKENRIDGE|No||||
cyanocobalamin/folic ac/vit B6|No|No|No|No|75%|51991025201|FOLPLEX 2.2 TABLET|100|EA|.11588|||No|No||||No|No|||No|No||06/09/2004||Yes|No|||Over the counter|No|||No|.26411|07/07/2020|.26033|07/07/2020|.24794|07/07/2020||||12744|||||No|No||BRECKENRIDGE|No||||
oxcarbazepine|No|No|No|No|75%|51991029201|OXCARBAZEPINE 150 MG TABLET|100|EA|.23439|02/25/2008||Yes|No||02/25/2008||Yes|No|02/25/2008||Yes|No||||No|No|||Prescription required|No||056|No|.13883|03/29/2022|.13549|03/29/2022|.1364|03/29/2022|||ANTICONVULSANTS|12745|||||No|No||BRECKENRIDGE|No||||
oxcarbazepine|No|No|No|No|75%|51991029205|OXCARBAZEPINE 150 MG TABLET|500|EA|.23204|02/25/2008||Yes|No||02/25/2008||Yes|No|02/25/2008||Yes|No||||No|No|||Prescription required|No||056|No|.13883|03/29/2022|.13549|03/29/2022|.1364|03/29/2022|||ANTICONVULSANTS|12746|||||No|No||BRECKENRIDGE|No||||
oxcarbazepine|No|No|No|No|75%|51991029301|OXCARBAZEPINE 300 MG TABLET|100|EA|.33342|02/25/2008||Yes|No||02/25/2008||Yes|No|02/25/2008||Yes|No||||No|No|||Prescription required|No||056|No|.21647|03/29/2022|.21127|03/29/2022|.21268|03/29/2022|||ANTICONVULSANTS|12747|||||No|No||BRECKENRIDGE|No||||
oxcarbazepine|No|No|No|No|75%|51991029305|OXCARBAZEPINE 300 MG TABLET|500|EA|.33023|02/25/2008||Yes|No||02/25/2008||Yes|No|02/25/2008||Yes|No||||No|No|||Prescription required|No||056|No|.21647|03/29/2022|.21127|03/29/2022|.21268|03/29/2022|||ANTICONVULSANTS|12748|||||No|No||BRECKENRIDGE|No||||
oxcarbazepine|No|No|No|No|75%|51991029401|OXCARBAZEPINE 600 MG TABLET|100|EA|.61184|02/25/2008||Yes|No||02/25/2008||Yes|No|02/25/2008||Yes|No||||No|No|||Prescription required|No||056|No|.41799|03/29/2022|.40795|03/29/2022|.41067|03/29/2022|||ANTICONVULSANTS|12749|||||No|No||BRECKENRIDGE|No||||
oxcarbazepine|No|No|No|No|75%|51991029405|OXCARBAZEPINE 600 MG TABLET|500|EA|.57755|02/25/2008||Yes|No||02/25/2008||Yes|No|02/25/2008||Yes|No||||No|No|||Prescription required|No||056|No|.41799|03/29/2022|.40795|03/29/2022|.41067|03/29/2022|||ANTICONVULSANTS|12750|||||No|No||BRECKENRIDGE|No||||
desvenlafaxine succinate|No|No|No|No|75%|51991031110|DESVENLAFAXINE SUCCNT ER 50 MG|1000|EA|.3246|05/30/2017||Yes|No||05/30/2017||Yes|No|05/30/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.57735|03/29/2022|.56349|03/29/2022|.56724|03/29/2022|||ANTIDEPRESSANTS: OTHER|12751|||||No|No||BRECKENRIDGE|No||||
desvenlafaxine succinate|No|No|No|No|75%|51991031133|DESVENLAFAXINE SUCCNT ER 50 MG|30|EA|.32465|05/30/2017||Yes|No||05/30/2017||Yes|No|05/30/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.57735|03/29/2022|.56349|03/29/2022|.56724|03/29/2022|||ANTIDEPRESSANTS: OTHER|12752|||||No|No||BRECKENRIDGE|No||||
desvenlafaxine succinate|No|No|No|No|75%|51991031190|DESVENLAFAXINE SUCCNT ER 50 MG|90|EA|.32459|05/30/2017||Yes|No||05/30/2017||Yes|No|05/30/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.57735|03/29/2022|.56349|03/29/2022|.56724|03/29/2022|||ANTIDEPRESSANTS: OTHER|12753|||||No|No||BRECKENRIDGE|No||||
desvenlafaxine succinate|No|No|No|No|75%|51991031210|DESVENLAFAXINE SUCCNT ER 100MG|1000|EA|.3246|05/30/2017||Yes|No||05/30/2017||Yes|No|05/30/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.60974|03/29/2022|.5951|03/29/2022|.59906|03/29/2022|||ANTIDEPRESSANTS: OTHER|12754|||||No|No||BRECKENRIDGE|No||||
desvenlafaxine succinate|No|No|No|No|75%|51991031233|DESVENLAFAXINE SUCCNT ER 100MG|30|EA|.32465|05/30/2017||Yes|No||05/30/2017||Yes|No|05/30/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.60974|03/29/2022|.5951|03/29/2022|.59906|03/29/2022|||ANTIDEPRESSANTS: OTHER|12755|||||No|No||BRECKENRIDGE|No||||
desvenlafaxine succinate|No|No|No|No|75%|51991031290|DESVENLAFAXINE SUCCNT ER 100MG|90|EA|.32459|05/30/2017||Yes|No||05/30/2017||Yes|No|05/30/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.60974|03/29/2022|.5951|03/29/2022|.59906|03/29/2022|||ANTIDEPRESSANTS: OTHER|12756|||||No|No||BRECKENRIDGE|No||||
megestrol acetate|No|No|No|No|75%|51991031359|MEGESTROL 625 MG/5 ML SUSP|150|ML|2.02741|11/09/2018||Yes|No||11/09/2018||Yes|No|11/09/2018||Yes|No||||No|No|||Prescription required|Yes|12/14/2017|197|No|1.44419|03/29/2022|1.40952|03/29/2022|1.41891|03/29/2022|||PROGESTINS FOR CACHEXIA|12757|||||No|No||BRECKENRIDGE|No||||
carbinoxamine maleate|No|No|No|No|75%|51991033301|CARBINOXAMINE MALEATE 4 MG TAB|100|EA|.21229|11/09/2018||Yes|No||11/09/2018||Yes|No|11/09/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|574|Yes|.36388|03/01/2022|.35514|03/01/2022|.35751|03/01/2022|||ANTIHISTAMINES: FIRST GENERATION|12758|||||No|No||BRECKENRIDGE|No||||
carbinoxamine maleate|No|No|No|No|75%|51991033404|CARBINOXAMINE 4 MG/5 ML LIQUID|118|ML|.0473|06/28/2013||Yes|No||06/28/2013||Yes|No|06/28/2013||Yes|No||||No|No|||Prescription required|No||574|Yes|.1078|01/26/2021|.10626|01/26/2021|.1012|01/26/2021|||ANTIHISTAMINES: FIRST GENERATION|12759|||||No|No||BRECKENRIDGE|No||||
rizatriptan benzoate|No|No|No|No|75%|51991035478|RIZATRIPTAN 5 MG TABLET|18|EA|2.38888|01/04/2013||Yes|No||01/04/2013||Yes|No|01/04/2013||Yes|No||||No|No|||Prescription required|No||021|No|.64991|03/29/2022|.63431|03/29/2022|.63853|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|12760|||||No|No||BRECKENRIDGE|No||||
rizatriptan benzoate|No|No|No|No|75%|51991035578|RIZATRIPTAN 10 MG TABLET|18|EA|2.38888|01/04/2013||Yes|No||01/04/2013||Yes|No|01/04/2013||Yes|No||||No|No|||Prescription required|No||021|No|.50927|03/29/2022|.49704|03/29/2022|.50035|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|12761|||||No|No||BRECKENRIDGE|No||||
asenapine maleate|No|No|No|No|75%|51991035860|ASENAPINE 5 MG TABLET SL|60|EA|7.74522|08/12/2021||Yes|No||08/12/2021||Yes|No|08/12/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|027|Yes|4.41931|03/29/2022|4.31324|03/29/2022|4.34197|03/29/2022|||ANTIPSYCHOTICS|12762|||||No|No||BRECKENRIDGE|No||||
asenapine maleate|No|No|No|No|75%|51991036060|ASENAPINE 10 MG TABLET SL|60|EA|7.74522|08/12/2021||Yes|No||08/12/2021||Yes|No|08/12/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|027|Yes|4.33734|03/29/2022|4.23324|03/29/2022|4.26143|03/29/2022|||ANTIPSYCHOTICS|12763|||||No|No||BRECKENRIDGE|No||||
rizatriptan benzoate|No|No|No|No|75%|51991036278|RIZATRIPTAN 5 MG ODT|18|EA|2.38888|07/03/2013||Yes|No||07/03/2013||Yes|No|07/03/2013||Yes|No||||No|No|||Prescription required|No||021|No|.80419|03/29/2022|.78488|03/29/2022|.79011|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|12764|||||No|No||BRECKENRIDGE|No||||
rizatriptan benzoate|No|No|No|No|75%|51991036378|RIZATRIPTAN 10 MG ODT|18|EA|2.38888|07/03/2013||Yes|No||07/03/2013||Yes|No|07/03/2013||Yes|No||||No|No|||Prescription required|No||021|No|.80628|03/29/2022|.78692|03/29/2022|.79217|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|12765|||||No|No||BRECKENRIDGE|No||||
imatinib mesylate|No|No|No|No|75%|51991037690|IMATINIB MESYLATE 100 MG TAB|90|EA|.51504|09/18/2020|03/31/2023|Yes|No||09/18/2020|03/31/2023|Yes|No|09/18/2020|03/31/2023|Yes|No||||No|No|||Prescription required|No||173|No|1.17381|07/27/2021|1.15704|07/27/2021|1.10194|07/27/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|12766|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||BRECKENRIDGE|No||||
imatinib mesylate|No|No|No|No|75%|51991037733|IMATINIB MESYLATE 400 MG TAB|30|EA|1.82606|09/18/2020|06/30/2023|Yes|No||09/18/2020|06/30/2023|Yes|No|09/18/2020|06/30/2023|Yes|No||||No|No|||Prescription required|No||173|No|2.86988|03/01/2022|2.801|03/01/2022|2.81965|03/01/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|12767|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||BRECKENRIDGE|No||||
everolimus|No|No|No|No|75%|51991037960|EVEROLIMUS 0.25 MG TABLET|60|EA|3.38932|12/16/2021||Yes|No||12/16/2021||Yes|No|12/16/2021||Yes|No||12/16/2021||Yes|No|||Prescription required|Yes|01/28/2021|229|No|7.72451|12/16/2021|7.61416|12/16/2021|7.25158|12/16/2021|||IMMUNOSUPPRESSIVES: ORAL|12768|||||No|No||BRECKENRIDGE|No||||
everolimus|No|No|No|No|75%|51991038060|EVEROLIMUS 0.5 MG TABLET|60|EA|6.77866|12/16/2021||Yes|No||12/16/2021||Yes|No|12/16/2021||Yes|No||12/16/2021||Yes|No|||Prescription required|Yes|01/28/2021|229|No|15.44904|12/16/2021|15.22834|12/16/2021|14.50318|12/16/2021|||IMMUNOSUPPRESSIVES: ORAL|12769|||||No|No||BRECKENRIDGE|No||||
everolimus|No|No|No|No|75%|51991038160|EVEROLIMUS 0.75 MG TABLET|60|EA|10.16799|12/16/2021||Yes|No||12/16/2021||Yes|No|12/16/2021||Yes|No||12/16/2021||Yes|No|||Prescription required|Yes|01/28/2021|229|No|23.17357|12/21/2021|22.84251|12/16/2021|21.75478|12/16/2021|||IMMUNOSUPPRESSIVES: ORAL|12770|||||No|No||BRECKENRIDGE|No||||
cyanocobalamin/folic ac/vit B6|No|No|No|No|75%|51991038490|FOLBIC TABLET|90|EA|.33147|||No|No||||No|No|||No|No||03/31/2005||Yes|No|||Over the counter|No|||No|.75546|07/07/2020|.74467|07/07/2020|.7092|07/07/2020||||12771|||||No|No||BRECKENRIDGE|No||||
estradiol/norethindrone acet|No|No|No|No|75%|51991047428|ESTRADIOL-NORETH 1-0.5 MG TAB|28|EA|1.75117|04/28/2008||Yes|No||04/28/2008||Yes|No|04/28/2008||Yes|No||||No|No|||Prescription required|No|||Yes|1.11831|03/29/2022|1.09147|03/29/2022|1.09873|03/29/2022||||12772|||||No|No||BRECKENRIDGE|No||||
terbinafine HCl|No|No|No|No|75%|51991052601|TERBINAFINE HCL 250 MG TABLET|100|EA|.05056|01/10/2011||Yes|No||01/10/2011||Yes|No|01/10/2011||Yes|No||||No|No|||Prescription required|No||069|No|.15711|03/29/2022|.15333|03/29/2022|.15436|03/29/2022|||ANTIFUNGALS: ORAL|12773|||||No|No||BRECKENRIDGE|No||||
terbinafine HCl|No|No|No|No|75%|51991052633|TERBINAFINE HCL 250 MG TABLET|30|EA|.05905|01/10/2011||Yes|No||01/10/2011||Yes|No|01/10/2011||Yes|No||||No|No|||Prescription required|No||069|No|.15711|03/29/2022|.15333|03/29/2022|.15436|03/29/2022|||ANTIFUNGALS: ORAL|12774|||||No|No||BRECKENRIDGE|No||||
folic acid/vit Bcomp,C/Cu/zinc|No|No|No|No|75%|51991052890|FOLBEE PLUS CZ TABLET|90|EA|.24342|||No|No||||No|No|||No|No||08/01/2008||Yes|No|||Over the counter|No|||No|||||||.60151|06/15/2016||12775|||||No|No||BRECKENRIDGE|No||||
methylphenidate HCl|No|No|No|No|75%|51991061150|METHYLPHENIDATE 5 MG/5 ML SOLN|500|ML|.0817|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.15581|03/29/2022|.15207|03/29/2022|.15308|03/29/2022|||STIMULANTS AND RELATED AGENTS|12776|||||No|No||BRECKENRIDGE|No||||
methylphenidate HCl|No|No|No|No|75%|51991061250|METHYLPHENIDATE 10 MG/5 ML SOL|500|ML|.1032|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.17579|03/29/2022|.17157|03/29/2022|.17271|03/29/2022|||STIMULANTS AND RELATED AGENTS|12777|||||No|No||BRECKENRIDGE|No||||
anastrozole|No|No|No|No|75%|51991062010|ANASTROZOLE 1 MG TABLET|1000|EA|.12771|07/14/2010||Yes|No||07/14/2010||Yes|No|07/14/2010||Yes|No||||No|No|||Prescription required|No||502|No|.11251|03/29/2022|.1098|03/29/2022|.11054|03/29/2022|||ONCOLOGY: ORAL - BREAST|12778|||||No|No||BRECKENRIDGE|No||||
anastrozole|No|No|No|No|75%|51991062033|ANASTROZOLE 1 MG TABLET|30|EA|.129|07/14/2010||Yes|No||07/14/2010||Yes|No|07/14/2010||Yes|No||||No|No|||Prescription required|No||502|No|.11251|03/29/2022|.1098|03/29/2022|.11054|03/29/2022|||ONCOLOGY: ORAL - BREAST|12779|||||No|No||BRECKENRIDGE|No||||
estradiol/norethindrone acet|No|No|No|No|75%|51991062328|ESTRADIOL-NORETH 0.5-0.1 MG TB|28|EA|1.59315|08/05/2011||Yes|No||08/05/2011||Yes|No|08/05/2011||Yes|No||||No|No|||Prescription required|No|||Yes|1.2896|03/29/2022|1.25864|03/29/2022|1.26703|03/29/2022||||12780|||||No|No||BRECKENRIDGE|No||||
omeprazole|No|No|No|No|75%|51991064310|OMEPRAZOLE DR 20 MG CAPSULE|1000|EA|.0258|07/17/2018||Yes|No||07/17/2018||Yes|No|07/17/2018||Yes|No||07/17/2018||Yes|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|12781|||||No|No||BRECKENRIDGE|No||||
omeprazole|No|No|No|No|75%|51991064405|OMEPRAZOLE DR 40 MG CAPSULE|500|EA|.0688|07/17/2018||Yes|No||07/17/2018||Yes|No|07/17/2018||Yes|No||07/17/2018||Yes|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|12782|||||No|No||BRECKENRIDGE|No||||
multivit-mins no.7/folic acid|No|No|No|No|75%|51991064501|V-C FORTE CAPSULE|100|EA|.08346|||No|No||||No|No|||No|No||09/01/1999||Yes|No|||Over the counter|No|||No|.19021|07/07/2020|.1875|07/07/2020|.17857|07/07/2020||||12783|||||No|No||BRECKENRIDGE|No||||
levetiracetam|No|No|No|No|75%|51991065116|LEVETIRACETAM 100 MG/ML SOLN|473|ML|.04086|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|No||056|No|.03146|03/29/2022|.0307|03/29/2022|.0309|03/29/2022|||ANTICONVULSANTS|12784|||||No|No||BRECKENRIDGE|No||||
alprazolam|No|No|No|No|90%|51991070401|ALPRAZOLAM 0.25 MG TABLET|100|EA|.01436|10/19/2018||Yes|No||10/19/2018||Yes|No|10/19/2018||Yes|No||||No|No|||Prescription required|No||090|Yes|.02093|03/29/2022|.02042|03/29/2022|.02056|03/29/2022|||ANXIOLYTICS|12785|||||No|No||BRECKENRIDGE|No||||
alprazolam|No|No|No|No|90%|51991070405|ALPRAZOLAM 0.25 MG TABLET|500|EA|.01406|10/19/2018||Yes|No||10/19/2018||Yes|No|10/19/2018||Yes|No||||No|No|||Prescription required|No||090|Yes|.02093|03/29/2022|.02042|03/29/2022|.02056|03/29/2022|||ANXIOLYTICS|12786|||||No|No||BRECKENRIDGE|No||||
alprazolam|No|No|No|No|90%|51991070410|ALPRAZOLAM 0.25 MG TABLET|1000|EA|.01286|10/19/2018||Yes|No||10/19/2018||Yes|No|10/19/2018||Yes|No||||No|No|||Prescription required|No||090|Yes|.02093|03/29/2022|.02042|03/29/2022|.02056|03/29/2022|||ANXIOLYTICS|12787|||||No|No||BRECKENRIDGE|No||||
alprazolam|No|No|No|No|90%|51991070501|ALPRAZOLAM 0.5 MG TABLET|100|EA|.0181|10/19/2018||Yes|No||10/19/2018||Yes|No|10/19/2018||Yes|No||||No|No|||Prescription required|No||090|Yes|.0228|03/29/2022|.02225|03/29/2022|.0224|03/29/2022|||ANXIOLYTICS|12788|||||No|No||BRECKENRIDGE|No||||
alprazolam|No|No|No|No|90%|51991070505|ALPRAZOLAM 0.5 MG TABLET|500|EA|.0156|10/19/2018||Yes|No||10/19/2018||Yes|No|10/19/2018||Yes|No||||No|No|||Prescription required|No||090|Yes|.0228|03/29/2022|.02225|03/29/2022|.0224|03/29/2022|||ANXIOLYTICS|12789|||||No|No||BRECKENRIDGE|No||||
alprazolam|No|No|No|No|90%|51991070510|ALPRAZOLAM 0.5 MG TABLET|1000|EA|.01518|10/19/2018||Yes|No||10/19/2018||Yes|No|10/19/2018||Yes|No||||No|No|||Prescription required|No||090|Yes|.0228|03/29/2022|.02225|03/29/2022|.0224|03/29/2022|||ANXIOLYTICS|12790|||||No|No||BRECKENRIDGE|No||||
alprazolam|No|No|No|No|90%|51991070601|ALPRAZOLAM 1 MG TABLET|100|EA|.02033|10/19/2018||Yes|No||10/19/2018||Yes|No|10/19/2018||Yes|No||||No|No|||Prescription required|No||090|Yes|.02503|03/29/2022|.02442|03/29/2022|.02459|03/29/2022|||ANXIOLYTICS|12791|||||No|No||BRECKENRIDGE|No||||
alprazolam|No|No|No|No|90%|51991070605|ALPRAZOLAM 1 MG TABLET|500|EA|.01739|10/19/2018||Yes|No||10/19/2018||Yes|No|10/19/2018||Yes|No||||No|No|||Prescription required|No||090|Yes|.02503|03/29/2022|.02442|03/29/2022|.02459|03/29/2022|||ANXIOLYTICS|12792|||||No|No||BRECKENRIDGE|No||||
alprazolam|No|No|No|No|90%|51991070610|ALPRAZOLAM 1 MG TABLET|1000|EA|.01677|10/19/2018||Yes|No||10/19/2018||Yes|No|10/19/2018||Yes|No||||No|No|||Prescription required|No||090|Yes|.02503|03/29/2022|.02442|03/29/2022|.02459|03/29/2022|||ANXIOLYTICS|12793|||||No|No||BRECKENRIDGE|No||||
alprazolam|No|No|No|No|90%|51991070701|ALPRAZOLAM 2 MG TABLET|100|EA|.04149|10/19/2018||Yes|No||10/19/2018||Yes|No|10/19/2018||Yes|No||||No|No|||Prescription required|No||090|Yes|.0533|03/29/2022|.05202|03/29/2022|.05236|03/29/2022|||ANXIOLYTICS|12794|||||No|No||BRECKENRIDGE|No||||
alprazolam|No|No|No|No|90%|51991070705|ALPRAZOLAM 2 MG TABLET|500|EA|.03799|10/19/2018||Yes|No||10/19/2018||Yes|No|10/19/2018||Yes|No||||No|No|||Prescription required|No||090|Yes|.0533|03/29/2022|.05202|03/29/2022|.05236|03/29/2022|||ANXIOLYTICS|12795|||||No|No||BRECKENRIDGE|No||||
granisetron HCl|No|No|No|No|75%|51991073520|GRANISETRON HCL 1 MG TABLET|20|EA|1.548|10/13/2010||Yes|No||10/13/2010||Yes|No|10/13/2010||Yes|No||||No|No|||Prescription required|Yes|07/28/2010|085|Yes|3.528|03/24/2020|3.4776|03/24/2020|3.312|03/24/2020|||ANTIEMETIC/ANTIVERTIGO AGENTS|12796|||||No|No||BRECKENRIDGE|No||||
granisetron HCl|No|No|No|No|75%|51991073532|GRANISETRON HCL 1 MG TABLET|2|EA|4.3|11/19/2018||Yes|No||11/19/2018||Yes|No|11/19/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|085|Yes|9.8|03/24/2020|9.66|03/24/2020|9.2|03/24/2020|||ANTIEMETIC/ANTIVERTIGO AGENTS|12797|||||No|No||BRECKENRIDGE|No||||
duloxetine HCl|No|No|No|No|75%|51991074605|DULOXETINE HCL DR 20 MG CAP|500|EA|.129|06/16/2014||Yes|No||06/16/2014||Yes|No|06/16/2014||Yes|No||||No|No|||Prescription required|No||232|No|.13163|03/29/2022|.12847|03/29/2022|.12932|03/29/2022|||NEUROPATHIC PAIN|12798|||||No|No||BRECKENRIDGE|No||||
duloxetine HCl|No|No|No|No|75%|51991074690|DULOXETINE HCL DR 20 MG CAP|90|EA|.129|06/16/2014||Yes|No||06/16/2014||Yes|No|06/16/2014||Yes|No||||No|No|||Prescription required|No||232|No|.13163|03/29/2022|.12847|03/29/2022|.12932|03/29/2022|||NEUROPATHIC PAIN|12799|||||No|No||BRECKENRIDGE|No||||
duloxetine HCl|No|No|No|No|75%|51991074710|DULOXETINE HCL DR 30 MG CAP|1000|EA|.129|06/16/2014||Yes|No||06/16/2014||Yes|No|06/16/2014||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|12800|||||No|No||BRECKENRIDGE|No||||
duloxetine HCl|No|No|No|No|75%|51991074790|DULOXETINE HCL DR 30 MG CAP|90|EA|.129|06/16/2014||Yes|No||06/16/2014||Yes|No|06/16/2014||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|12801|||||No|No||BRECKENRIDGE|No||||
duloxetine HCl|No|No|No|No|75%|51991074810|DULOXETINE HCL DR 60 MG CAP|1000|EA|.129|06/16/2014||Yes|No||06/16/2014||Yes|No|06/16/2014||Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|12802|||||No|No||BRECKENRIDGE|No||||
duloxetine HCl|No|No|No|No|75%|51991074890|DULOXETINE HCL DR 60 MG CAP|90|EA|.129|06/16/2014||Yes|No||06/16/2014||Yes|No|06/16/2014||Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|12803|||||No|No||BRECKENRIDGE|No||||
duloxetine HCl|No|No|No|No|75%|51991075033|DULOXETINE HCL DR 40 MG CAP|30|EA|1.419|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|232|No|1.94215|03/29/2022|1.89553|03/29/2022|1.90816|03/29/2022|||NEUROPATHIC PAIN|12804|||||No|No||BRECKENRIDGE|No||||
letrozole|No|No|No|No|75%|51991075910|LETROZOLE 2.5 MG TABLET|1000|EA|.12629|06/15/2011||Yes|No||06/15/2011||Yes|No|06/15/2011||Yes|No||||No|No|||Prescription required|No||502|No|.1337|03/29/2022|.13049|03/29/2022|.13136|03/29/2022|||ONCOLOGY: ORAL - BREAST|12805|||||No|No||BRECKENRIDGE|No||||
letrozole|No|No|No|No|75%|51991075933|LETROZOLE 2.5 MG TABLET|30|EA|.129|06/15/2011||Yes|No||06/15/2011||Yes|No|06/15/2011||Yes|No||||No|No|||Prescription required|No||502|No|.1337|03/29/2022|.13049|03/29/2022|.13136|03/29/2022|||ONCOLOGY: ORAL - BREAST|12806|||||No|No||BRECKENRIDGE|No||||
rivastigmine tartrate|No|No|No|No|75%|51991079306|RIVASTIGMINE 1.5 MG CAPSULE|60|EA|.44791|08/06/2012||Yes|No||08/06/2012||Yes|No|08/06/2012||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.26635|03/29/2022|.25995|03/29/2022|.26168|03/29/2022|||ALZHEIMER'S AGENTS|12807|||||No|No||BRECKENRIDGE|No||||
rivastigmine tartrate|No|No|No|No|75%|51991079406|RIVASTIGMINE 3 MG CAPSULE|60|EA|.44791|08/06/2012||Yes|No||08/06/2012||Yes|No|08/06/2012||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.2376|03/29/2022|.23189|03/29/2022|.23344|03/29/2022|||ALZHEIMER'S AGENTS|12808|||||No|No||BRECKENRIDGE|No||||
rivastigmine tartrate|No|No|No|No|75%|51991079506|RIVASTIGMINE 4.5 MG CAPSULE|60|EA|.44791|08/06/2012||Yes|No||08/06/2012||Yes|No|08/06/2012||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.27604|03/29/2022|.26941|03/29/2022|.2712|03/29/2022|||ALZHEIMER'S AGENTS|12809|||||No|No||BRECKENRIDGE|No||||
rivastigmine tartrate|No|No|No|No|75%|51991079606|RIVASTIGMINE 6 MG CAPSULE|60|EA|.44791|08/06/2012||Yes|No||08/06/2012||Yes|No|08/06/2012||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.35091|03/29/2022|.34248|03/29/2022|.34476|03/29/2022|||ALZHEIMER'S AGENTS|12810|||||No|No||BRECKENRIDGE|No||||
azelastine HCl|No|No|No|No|75%|51991081403|AZELASTINE 0.1% (137 MCG) SPRY|30|ML|.31175|03/21/2016||Yes|No||03/21/2016||Yes|No|03/21/2016||Yes|No||||No|No|||Prescription required|No||019|Yes|.27761|03/29/2022|.27094|03/29/2022|.27275|03/29/2022|||INTRANASAL RHINITIS AGENTS|12811|||||No|No||BRECKENRIDGE|No||||
propranolol HCl|No|No|No|No|75%|51991081701|PROPRANOLOL ER 60 MG CAPSULE|100|EA|.47007|03/15/2013||Yes|No||03/15/2013||Yes|No|03/15/2013||Yes|No||03/15/2013||Yes|No|||Prescription required|Yes|07/26/2012|070|No|.32013|03/29/2022|.31244|03/29/2022|.31452|03/29/2022|||BETA-BLOCKERS|12812|||||No|No||BRECKENRIDGE|No||||
propranolol HCl|No|No|No|No|75%|51991081801|PROPRANOLOL ER 80 MG CAPSULE|100|EA|.54906|03/07/2013||Yes|No||03/07/2013||Yes|No|03/07/2013||Yes|No||03/07/2013||Yes|No|||Prescription required|Yes|07/26/2012|070|No|.35912|03/29/2022|.3505|03/29/2022|.35283|03/29/2022|||BETA-BLOCKERS|12813|||||No|No||BRECKENRIDGE|No||||
propranolol HCl|No|No|No|No|75%|51991081901|PROPRANOLOL ER 120 MG CAPSULE|100|EA|.68107|03/07/2013||Yes|No||03/07/2013||Yes|No|03/07/2013||Yes|No||03/07/2013||Yes|No|||Prescription required|Yes|07/26/2012|070|No|.4314|03/29/2022|.42104|03/29/2022|.42385|03/29/2022|||BETA-BLOCKERS|12814|||||No|No||BRECKENRIDGE|No||||
propranolol HCl|No|No|No|No|75%|51991082001|PROPRANOLOL ER 160 MG CAPSULE|100|EA|.89169|03/07/2013||Yes|No||03/07/2013||Yes|No|03/07/2013||Yes|No||03/07/2013||Yes|No|||Prescription required|Yes|07/26/2012|070|No|.61078|03/29/2022|.59612|03/29/2022|.60009|03/29/2022|||BETA-BLOCKERS|12815|||||No|No||BRECKENRIDGE|No||||
everolimus|No|No|No|No|75%|51991082128|EVEROLIMUS 2.5 MG TABLET|28|EA|49.14285|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No||548|No|111.99999|08/30/2021|110.39999|08/30/2021|105.14285|08/30/2021|||ONCOLOGY: ORAL - RENAL CELL|12816|||||No|No||BRECKENRIDGE|No||||
everolimus|No|No|No|No|75%|51991082228|EVEROLIMUS 5 MG TABLET|28|EA|49.14285|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No||548|No|111.99999|08/30/2021|110.39999|08/30/2021|105.14285|08/30/2021|||ONCOLOGY: ORAL - RENAL CELL|12817|||||No|No||BRECKENRIDGE|No||||
everolimus|No|No|No|No|75%|51991082328|EVEROLIMUS 7.5 MG TABLET|28|EA|49.14285|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No||548|No|111.99999|08/30/2021|110.39999|08/30/2021|105.14285|08/30/2021|||ONCOLOGY: ORAL - RENAL CELL|12818|||||No|No||BRECKENRIDGE|No||||
everolimus|No|No|No|No|75%|51991082428|EVEROLIMUS 10 MG TABLET|28|EA|49.14285|03/15/2022||Yes|No||03/15/2022||Yes|No|03/15/2022||Yes|No||||No|No|||Prescription required|No||548|No|111.99999|03/15/2022|110.39999|03/15/2022|105.14285|03/15/2022|||ONCOLOGY: ORAL - RENAL CELL|12819|||||No|No||BRECKENRIDGE|No||||
epinastine HCl|No|No|No|No|75%|51991083675|EPINASTINE HCL 0.05% EYE DROPS|5|ML|7.36074|11/27/2013||Yes|No||11/27/2013||Yes|No|11/27/2013||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|002|No|15.8565|03/29/2022|15.47594|03/29/2022|15.57901|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|12820|||||No|No||BRECKENRIDGE|No||||
cetirizine HCl|No|No|No|No|75%|51991083704|CETIRIZINE HCL 1 MG/ML SYRUP|120|ML|.01429|06/09/2014||Yes|No||06/09/2014||Yes|No|06/09/2014||Yes|No||||No|No|||Prescription required|No||030|Yes|.02395|03/29/2022|.02337|03/29/2022|.02353|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|12821|||||No|No||BRECKENRIDGE|No||||
cetirizine HCl|No|No|No|No|75%|51991083716|CETIRIZINE HCL 1 MG/ML SYRUP|480|ML|.01075|06/09/2014||Yes|No||06/09/2014||Yes|No|06/09/2014||Yes|No||||No|No|||Prescription required|No||030|Yes|.02192|03/29/2022|.02139|03/29/2022|.02153|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|12822|||||No|No||BRECKENRIDGE|No||||
cyproheptadine HCl|No|No|No|No|75%|51991083801|CYPROHEPTADINE 4 MG TABLET|100|EA|.28272|11/27/2013||Yes|No||11/27/2013||Yes|No|11/27/2013||Yes|No||||No|No|||Prescription required|No||574|Yes|.09783|03/29/2022|.09548|03/29/2022|.09611|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|12823|||||No|No||BRECKENRIDGE|No||||
cyproheptadine HCl|No|No|No|No|75%|51991083810|CYPROHEPTADINE 4 MG TABLET|1000|EA|.27707|11/27/2013||Yes|No||11/27/2013||Yes|No|11/27/2013||Yes|No||||No|No|||Prescription required|No||574|Yes|.09783|03/29/2022|.09548|03/29/2022|.09611|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|12824|||||No|No||BRECKENRIDGE|No||||
brompheniramine/pseudoephed/DM|No|No|No|No|75%|51991084704|BROMPHEN-PSE-DM 2-30-10 MG/5ML|118|ML|.05465|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||184|Yes|.0774|03/29/2022|.07554|03/29/2022|.07604|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|12825|||||No|No||BRECKENRIDGE|No||||
brompheniramine/pseudoephed/DM|No|No|No|No|75%|51991084716|BROMPHEN-PSE-DM 2-30-10 MG/5ML|473|ML|.03636|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||184|Yes|.06501|03/29/2022|.06344|03/29/2022|.06387|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|12826|||||No|No||BRECKENRIDGE|No||||
repaglinide|Yes|No|No|No|75%|51991085301|REPAGLINIDE 0.5 MG TABLET|100|EA|.172|12/08/2015||Yes|No||12/08/2015||Yes|No|12/08/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||022|Yes|.11854|03/29/2022|.11569|03/29/2022|.11646|03/29/2022|||HYPOGLYCEMICS: MEGLITINIDES|12827|||||No|No||BRECKENRIDGE|No||||
repaglinide|Yes|No|No|No|75%|51991085401|REPAGLINIDE 1 MG TABLET|100|EA|.172|12/08/2015||Yes|No||12/08/2015||Yes|No|12/08/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||022|Yes|.12359|03/29/2022|.12062|03/29/2022|.12142|03/29/2022|||HYPOGLYCEMICS: MEGLITINIDES|12828|||||No|No||BRECKENRIDGE|No||||
repaglinide|Yes|No|No|No|75%|51991085501|REPAGLINIDE 2 MG TABLET|100|EA|.172|12/08/2015||Yes|No||12/08/2015||Yes|No|12/08/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||022|Yes|.12502|03/29/2022|.12201|03/29/2022|.12283|03/29/2022|||HYPOGLYCEMICS: MEGLITINIDES|12829|||||No|No||BRECKENRIDGE|No||||
eplerenone|No|No|No|No|75%|51991087733|EPLERENONE 25 MG TABLET|30|EA|.60171|12/07/2018||Yes|No||12/07/2018||Yes|No|12/07/2018||Yes|No||||No|No|||Prescription required|No|||No|.73164|03/29/2022|.71408|03/29/2022|.71883|03/29/2022||||12830|||||No|No||BRECKENRIDGE|No||||
eplerenone|No|No|No|No|75%|51991087790|EPLERENONE 25 MG TABLET|90|EA|.60175|12/07/2018||Yes|No||12/07/2018||Yes|No|12/07/2018||Yes|No||||No|No|||Prescription required|No|||No|.73164|03/29/2022|.71408|03/29/2022|.71883|03/29/2022||||12831|||||No|No||BRECKENRIDGE|No||||
eplerenone|No|No|No|No|75%|51991087833|EPLERENONE 50 MG TABLET|30|EA|.60171|12/07/2018||Yes|No||12/07/2018||Yes|No|12/07/2018||Yes|No||||No|No|||Prescription required|No|||No|.85922|03/29/2022|.83859|03/29/2022|.84418|03/29/2022||||12832|||||No|No||BRECKENRIDGE|No||||
eplerenone|No|No|No|No|75%|51991087890|EPLERENONE 50 MG TABLET|90|EA|.60175|12/07/2018||Yes|No||12/07/2018||Yes|No|12/07/2018||Yes|No||||No|No|||Prescription required|No|||No|.85922|03/29/2022|.83859|03/29/2022|.84418|03/29/2022||||12833|||||No|No||BRECKENRIDGE|No||||
erlotinib HCl|No|No|No|No|75%|51991089033|ERLOTINIB HCL 25 MG TABLET|30|EA|4.3|10/08/2020||Yes|No||10/08/2020||Yes|No|10/08/2020||Yes|No||||No|No|||Prescription required|No||551|No|9.8|10/08/2020|9.66|10/08/2020|9.2|10/08/2020|||ONCOLOGY: ORAL - LUNG|12834|||||No|No||BRECKENRIDGE|No||||
erlotinib HCl|No|No|No|No|75%|51991089133|ERLOTINIB HCL 100 MG TABLET|30|EA|5.73333|10/08/2020||Yes|No||10/08/2020||Yes|No|10/08/2020||Yes|No||||No|No|||Prescription required|No||551|No|13.06666|10/08/2020|12.87999|10/08/2020|12.26666|10/08/2020|||ONCOLOGY: ORAL - LUNG|12835|||||No|No||BRECKENRIDGE|No||||
erlotinib HCl|No|No|No|No|75%|51991089233|ERLOTINIB HCL 150 MG TABLET|30|EA|6.45|10/08/2020||Yes|No||10/08/2020||Yes|No|10/08/2020||Yes|No||||No|No|||Prescription required|No||551|No|14.7|10/08/2020|14.49|10/08/2020|13.8|10/08/2020|||ONCOLOGY: ORAL - LUNG|12836|||||No|No||BRECKENRIDGE|No||||
entecavir|No|No|No|No|75%|51991089533|ENTECAVIR 0.5 MG TABLET|30|EA|2.86666|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|No|||No|.89227|03/29/2022|.87085|03/29/2022|.87665|03/29/2022||||12837|||||No|No||BRECKENRIDGE|No||||
entecavir|No|No|No|No|75%|51991089633|ENTECAVIR 1 MG TABLET|30|EA|2.86666|08/29/2018||Yes|No||08/29/2018||Yes|No|||No|No||||No|No|||Prescription required|No|||No|1.06461|03/29/2022|1.03905|03/29/2022|1.04597|03/29/2022||||12838|||||No|No||BRECKENRIDGE|No||||
rivastigmine|No|No|No|No|75%|51991089730|RIVASTIGMINE 4.6 MG/24HR PATCH|30|EA|2.43853|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|011|No|2.88542|03/29/2022|2.81616|03/29/2022|2.83492|03/29/2022|||ALZHEIMER'S AGENTS|12839|||||No|No||BRECKENRIDGE|No||||
rivastigmine|No|No|No|No|75%|51991089830|RIVASTIGMINE 9.5 MG/24HR PATCH|30|EA|2.43853|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|011|No|2.83898|03/29/2022|2.77084|03/29/2022|2.78929|03/29/2022|||ALZHEIMER'S AGENTS|12840|||||No|No||BRECKENRIDGE|No||||
rivastigmine|No|No|No|No|75%|51991089930|RIVASTIGMINE 13.3 MG/24HR PTCH|30|EA|2.43853|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|011|No|3.24254|03/29/2022|3.16471|03/29/2022|3.18579|03/29/2022|||ALZHEIMER'S AGENTS|12841|||||No|No||BRECKENRIDGE|No||||
clobazam|No|No|No|No|90%|51991090001|CLOBAZAM 10 MG TABLET|100|EA|.258|01/03/2019||Yes|No||01/03/2019||Yes|No|01/03/2019||Yes|No||||No|No|||Prescription required|No||056|No|.37729|03/29/2022|.36823|03/29/2022|.37068|03/29/2022|||ANTICONVULSANTS|12842|||||No|No||BRECKENRIDGE|No||||
clobazam|No|No|No|No|90%|51991090101|CLOBAZAM 20 MG TABLET|100|EA|.516|01/03/2019||Yes|No||01/03/2019||Yes|No|01/03/2019||Yes|No||||No|No|||Prescription required|No||056|No|.71967|03/29/2022|.70239|03/29/2022|.70707|03/29/2022|||ANTICONVULSANTS|12843|||||No|No||BRECKENRIDGE|No||||
tetracycline HCl|No|No|No|No|75%|51991090601|TETRACYCLINE 250 MG CAPSULE|100|EA|.71595|09/19/2019||Yes|No||09/19/2019||Yes|No|09/19/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|.9651|03/01/2022|.94193|03/01/2022|.94821|03/01/2022|||TETRACYCLINES|12844|||||No|No||BRECKENRIDGE|No||||
tetracycline HCl|No|No|No|No|75%|51991090701|TETRACYCLINE 500 MG CAPSULE|100|EA|1.41255|09/19/2019||Yes|No||09/19/2019||Yes|No|09/19/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|1.54692|03/29/2022|1.50979|03/29/2022|1.51984|03/29/2022|||TETRACYCLINES|12845|||||No|No||BRECKENRIDGE|No||||
asenapine maleate|No|No|No|No|75%|51991092860|ASENAPINE 2.5 MG TABLET SL|60|EA|7.74522|08/12/2021||Yes|No||08/12/2021||Yes|No|08/12/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|027|Yes|7.502|10/26/2021|7.32195|10/26/2021|7.37071|10/26/2021|||ANTIPSYCHOTICS|12846|||||No|No||BRECKENRIDGE|No||||
moxifloxacin HCl|No|No|No|No|75%|51991094333|MOXIFLOXACIN HCL 400 MG TABLET|30|EA|1.26477|11/03/2017||Yes|No||11/03/2017||Yes|No|11/03/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|028|No|1.23895|03/29/2022|1.20921|03/29/2022|1.21726|03/29/2022|||FLUOROQUINOLONES: ORAL|12847|||||No|No||BRECKENRIDGE|No||||
trimipramine maleate|No|No|No|No|75%|51991094401|TRIMIPRAMINE MALEATE 25 MG CAP|100|EA|1.16057|11/03/2017||Yes|No||11/03/2017||Yes|No|11/03/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|2.64502|11/07/2017|2.60723|11/03/2017|2.48308|11/03/2017|||ANTIDEPRESSANTS: TRICYCLIC|12848|||||No|No||BRECKENRIDGE|No||||
trimipramine maleate|No|No|No|No|75%|51991094501|TRIMIPRAMINE MALEATE 50 MG CAP|100|EA|1.93426|11/03/2017||Yes|No||11/03/2017||Yes|No|11/03/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|4.40833|11/03/2017|4.34535|11/03/2017|4.13843|11/03/2017|||ANTIDEPRESSANTS: TRICYCLIC|12849|||||No|No||BRECKENRIDGE|No||||
trimipramine maleate|No|No|No|No|75%|51991094601|TRIMIPRAMINE MALEATE 100 MG CP|100|EA|2.67821|11/03/2017||Yes|No||11/03/2017||Yes|No|11/03/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|6.10383|11/03/2017|6.01663|11/03/2017|5.73012|11/03/2017|||ANTIDEPRESSANTS: TRICYCLIC|12850|||||No|No||BRECKENRIDGE|No||||
polyethylene glycol 3350|No|No|No|No|75%|51991096158|POLYETHYLENE GLYCOL 3350 POWD|238|GM|.00713|09/20/2019||Yes|No||||No|No|09/20/2019||Yes|No||09/20/2019||Yes|No|||Over the counter|No|||No|.02672|03/29/2022|.02607|03/29/2022|.02625|03/29/2022||||12851|||||No|No||BRECKENRIDGE|No||||
polyethylene glycol 3350|No|No|No|No|75%|51991096257|POLYETHYLENE GLYCOL 3350 POWD|510|GM|.00712|09/20/2019||Yes|No||||No|No|09/20/2019||Yes|No||09/20/2019||Yes|No|||Over the counter|No|||No|.02124|03/29/2022|.02073|03/29/2022|.02086|03/29/2022||||12852|||||No|No||BRECKENRIDGE|No||||
zolpidem tartrate|No|No|No|No|90%|51991098101|ZOLPIDEM TART ER 6.25 MG TAB|100|EA|.086|12/28/2021||Yes|No||12/28/2021||Yes|No|12/28/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|054|Yes|.20271|03/29/2022|.19784|03/29/2022|.19916|03/29/2022|||SEDATIVE HYPNOTICS|12853|||||No|No||BRECKENRIDGE|No||||
zolpidem tartrate|No|No|No|No|90%|51991098201|ZOLPIDEM TART ER 12.5 MG TAB|100|EA|.086|12/28/2021||Yes|No||12/28/2021||Yes|No|12/28/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|054|Yes|.24181|03/29/2022|.236|03/29/2022|.23757|03/29/2022|||SEDATIVE HYPNOTICS|12854|||||No|No||BRECKENRIDGE|No||||
fidaxomicin|No|No|No|No|75%|52015008001|DIFICID 200 MG TABLET|20|EA|96.2168|10/01/2011||Yes|No||10/01/2011||Yes|No|10/01/2011||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|115|No|214.52629|01/18/2022|209.37765|01/18/2022|210.77207|01/18/2022|||ANTIBIOTICS: GI|12855|||||No|No||MERCK SHARP & D|No||||
fidaxomicin|No|No|No|No|75%|52015070022|DIFICID 40 MG/ML SUSPENSION|136|ML|14.14952|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|115|No|32.24776|01/11/2022|31.78708|01/11/2022|30.2734|01/11/2022|||ANTIBIOTICS: GI|12856|||||No|No||MERCK SHARP & D|No||||
theophylline anhydrous|No|No|No|No|75%|52244010010|THEO-24 ER 100 MG CAPSULE|100|EA|1.2534|12/30/2015||Yes|No||12/30/2015||Yes|No|12/30/2015||Yes|No||||No|No|||Prescription required|No|||Yes|2.81144|01/18/2022|2.74396|01/18/2022|2.76223|01/18/2022||||12857|||||No|No||AUXILIUM/ENDO P|No||||
theophylline anhydrous|No|No|No|No|75%|52244020010|THEO-24 ER 200 MG CAPSULE|100|EA|1.8628|12/30/2015||Yes|No||12/30/2015||Yes|No|12/30/2015||Yes|No||||No|No|||Prescription required|No|||Yes|4.1617|01/18/2022|4.06181|01/18/2022|4.08887|01/18/2022||||12858|||||No|No||AUXILIUM/ENDO P|No||||
theophylline anhydrous|No|No|No|No|75%|52244030010|THEO-24 ER 300 MG CAPSULE|100|EA|2.28953|12/30/2015||Yes|No||12/30/2015||Yes|No|12/30/2015||Yes|No||||No|No|||Prescription required|No|||Yes|5.1178|01/18/2022|4.99497|01/18/2022|5.02823|01/18/2022||||12859|||||No|No||AUXILIUM/ENDO P|No||||
theophylline anhydrous|No|No|No|No|75%|52244040010|THEO-24 ER 400 MG CAPSULE|100|EA|3.22168|12/30/2015||Yes|No||12/30/2015||Yes|No|12/30/2015||Yes|No||||No|No|||Prescription required|No|||Yes|7.19519|01/18/2022|7.0225|01/18/2022|7.06927|01/18/2022||||12860|||||No|No||AUXILIUM/ENDO P|No||||
spinosad|No|No|No|No|75%|52246092904|NATROBA 0.9% TOPICAL SUSP|120|ML|.99061|04/01/2011||Yes|No||04/01/2011||Yes|No|04/01/2011||Yes|No||||No|No|||Prescription required|No||122|No|2.20977|06/29/2021|2.15673|06/29/2021|2.17109|06/29/2021|||ANTIPARASITICS: TOPICAL|12861|||||No|No||PARAPRO LLC|No||||
sodium, potassium,mag sulfates|No|No|No|No|75%|52268001201|SUPREP BOWEL PREP KIT|354|ML|.13244|12/15/2011||Yes|No||12/15/2011||Yes|No|12/15/2011||Yes|No||||No|No|||Prescription required|No|||No|.29569|01/18/2022|.28859|01/18/2022|.29051|01/18/2022||||12862|||||No|No||BRAINTREE/SEBEL|No||||
peg3350/sod sulf,bicarb,Cl/KCl|No|No|No|No|75%|52268010001|GOLYTELY SOLUTION|4000|ML|.00152|05/07/2009||Yes|No||05/07/2009||Yes|No|05/07/2009||Yes|No||||No|No|||Prescription required|No|||No|.0034|03/23/2021|.00331|03/23/2021|.00334|03/23/2021||||12863|||||No|No||BRAINTREE/SEBEL|No||||
carglumic acid|No|No|No|No|75%|52276031205|CARBAGLU 200 MG TAB FOR SUSP|5|EA|94.8451|06/27/2011||Yes|No||06/27/2011||Yes|No|06/27/2011||Yes|No||||No|No|||Prescription required|No||570|No|216.1586|01/11/2022|213.07062|01/11/2022|202.9244|01/11/2022|||UREA CYCLE DISORDERS: ORAL|12864|||||No|No||ORPHAN EUROPE/R|No||||
carglumic acid|No|No|No|No|75%|52276031260|CARBAGLU 200 MG TAB FOR SUSP|60|EA|94.8451|06/27/2011||Yes|No||06/27/2011||Yes|No|06/27/2011||Yes|No||||No|No|||Prescription required|No||570|No|216.1586|01/11/2022|213.07062|01/11/2022|202.9244|01/11/2022|||UREA CYCLE DISORDERS: ORAL|12865|||||No|No||ORPHAN EUROPE/R|No||||
betaine|No|No|No|No|75%|52276040001|CYSTADANE 1 GRAM/SCOOP POWDER|180|GM|4.36313|04/18/2017||Yes|No||04/18/2017||Yes|No|04/18/2017||Yes|No||||No|No|||Prescription required|No|||No|9.94389|01/11/2022|9.80183|01/11/2022|9.33508|01/11/2022||||12866|||||No|No||ORPHAN EUROPE/R|No||||
nitrofurantoin monohyd/m-cryst|No|No|No|No|75%|52427028501|MACROBID 100 MG CAPSULE|100|EA|2.55776|02/28/2012||Yes|No||02/28/2012||Yes|No|02/28/2012||Yes|No||||No|No|||Prescription required|No|||No|5.82933|04/10/2018|5.74605|04/10/2018|5.47243|04/10/2018||||12867|||||No|No||ALMATICA PHARMA|No||||
nitrofurantoin macrocrystal|No|No|No|No|75%|52427028601|MACRODANTIN 25 MG CAPSULE|100|EA|5.0396|02/07/2012||Yes|No||02/07/2012||Yes|No|02/07/2012||Yes|No||||No|No|||Prescription required|No|||No|11.4856|06/01/2016|11.32152|06/01/2016|10.7824|06/01/2016||||12868|||||No|No||ALMATICA PHARMA|No||||
nitrofurantoin macrocrystal|No|No|No|No|75%|52427028701|MACRODANTIN 50 MG CAPSULE|100|EA|1.12875|11/07/2012||Yes|No||11/07/2012||Yes|No|11/07/2012||Yes|No||||No|No|||Prescription required|No|||No|2.5725|07/11/2017|2.53575|07/11/2017|2.415|07/11/2017||||12869|||||No|No||ALMATICA PHARMA|No||||
nitrofurantoin macrocrystal|No|No|No|No|75%|52427028801|MACRODANTIN 100 MG CAPSULE|100|EA|2.37037|02/07/2012||Yes|No||02/07/2012||Yes|No|02/07/2012||Yes|No||||No|No|||Prescription required|No|||No|5.40225|07/11/2017|5.32507|07/11/2017|5.0715|07/11/2017||||12870|||||No|No||ALMATICA PHARMA|No||||
atenolol/chlorthalidone|No|No|No|No|75%|52427038290|TENORETIC 50 TABLET|90|EA|5.16|06/11/2015||Yes|No||06/11/2015||Yes|No|06/11/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|070|Yes|11.76|06/01/2016|11.592|06/01/2016|11.04|06/01/2016|||BETA-BLOCKERS|12871|||||No|No||ALMATICA PHARMA|No||||
atenolol/chlorthalidone|No|No|No|No|75%|52427038390|TENORETIC 100 TABLET|90|EA|2.15|06/11/2015||Yes|No||06/11/2015||Yes|No|06/11/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|070|Yes|4.9|07/26/2016|4.83|07/26/2016|4.6|07/26/2016|||BETA-BLOCKERS|12872|||||No|No||ALMATICA PHARMA|No||||
atenolol|No|No|No|No|75%|52427042990|TENORMIN 25 MG TABLET|90|EA|5.74308|06/11/2015||Yes|No||06/11/2015||Yes|No|06/11/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|070|No|13.08888|05/11/2021|12.90189|05/11/2021|12.28752|05/11/2021|||BETA-BLOCKERS|12873|||||No|No||ALMATICA PHARMA|No||||
atenolol|No|No|No|No|75%|52427043090|TENORMIN 50 MG TABLET|90|EA|5.74308|06/11/2015||Yes|No||06/11/2015||Yes|No|06/11/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|070|No|13.08888|05/11/2021|12.90189|05/11/2021|12.28752|05/11/2021|||BETA-BLOCKERS|12874|||||No|No||ALMATICA PHARMA|No||||
atenolol|No|No|No|No|75%|52427043190|TENORMIN 100 MG TABLET|90|EA|5.74308|06/11/2015||Yes|No||06/11/2015||Yes|No|06/11/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|070|No|13.08888|05/11/2021|12.90189|05/11/2021|12.28752|05/11/2021|||BETA-BLOCKERS|12875|||||No|No||ALMATICA PHARMA|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|52427043690|ZESTORETIC 20-12.5 MG TABLET|90|EA|5.71574|06/11/2015||Yes|No||06/11/2015||Yes|No|06/11/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|113|Yes|13.02659|04/10/2018|12.84049|04/10/2018|12.22904|04/10/2018|||ANGIOTENSIN MODULATORS|12876|||||No|No||ALMATICA PHARMA|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|52427043790|ZESTORETIC 20-25 MG TABLET|90|EA|5.71574|06/11/2015||Yes|No||06/11/2015||Yes|No|06/11/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|113|Yes|13.02659|04/10/2018|12.84049|04/10/2018|12.22904|04/10/2018|||ANGIOTENSIN MODULATORS|12877|||||No|No||ALMATICA PHARMA|No||||
bupropion HCl|No|No|No|No|75%|52427057530|FORFIVO XL 450 MG TABLET|30|EA|6.72634|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|031|No|14.97727|10/26/2021|14.61781|10/26/2021|14.71516|10/26/2021|||ANTIDEPRESSANTS: OTHER|12878|||||No|No||ALMATICA PHARMA|No||||
fluoxetine HCl|No|No|No|No|75%|52427057630|FLUOXETINE HCL 60 MG TABLET|30|EA|4.36908|02/15/2018||Yes|No||02/15/2018||Yes|No|02/15/2018||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|008|No|1.06507|03/29/2022|1.0395|03/29/2022|1.04643|03/29/2022|||ANTIDEPRESSANTS: SSRIs|12879|||||No|No||ALMATICA PHARMA|No||||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|52427069203|BUPRENORPHINE-NALOX 2-0.5MG FM|30|EA|1.59071|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No||145|Yes|2.34845|03/29/2022|2.29208|03/29/2022|2.30735|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|12880|||||No|No||ALMATICA PHARMA|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|52427069211|BUPRENORPHINE-NALOX 2-0.5MG FM|1|EA|1.76027|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|||||||2.61599|10/01/2020|OPIATE DEPENDENCE TREATMENTS|12881|||||No|No||ALMATICA PHARMA|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|52427069403|BUPRENORPHINE-NALOX 4-1MG FILM|30|EA|2.795|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No||145|Yes|4.75054|03/29/2022|4.63652|03/29/2022|4.6674|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|12882|||||No|No||ALMATICA PHARMA|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|52427069411|BUPRENORPHINE-NALOX 4-1MG FILM|1|EA|3.15333|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|||||||4.68422|10/01/2020|OPIATE DEPENDENCE TREATMENTS|12883|||||No|No||ALMATICA PHARMA|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|52427069803|BUPRENORPHINE-NALOX 8-2MG FILM|30|EA|2.795|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No||145|Yes|3.26802|03/29/2022|3.18958|03/29/2022|3.21082|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|12884|||||No|No||ALMATICA PHARMA|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|52427069811|BUPRENORPHINE-NALOX 8-2MG FILM|1|EA|3.15333|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|||||||3.98028|10/01/2020|OPIATE DEPENDENCE TREATMENTS|12885|||||No|No||ALMATICA PHARMA|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|52427071203|BUPRENORPHINE-NALOX 12-3MG FLM|30|EA|5.5146|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No||145|Yes|6.93269|03/29/2022|6.7663|03/29/2022|6.81136|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|12886|||||No|No||ALMATICA PHARMA|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|52427071211|BUPRENORPHINE-NALOX 12-3MG FLM|1|EA|6.30652|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|||||||8.50806|10/01/2020|OPIATE DEPENDENCE TREATMENTS|12887|||||No|No||ALMATICA PHARMA|Yes|09/01/2020|||
entacapone|No|No|No|No|75%|52427080001|COMTAN 200 MG TABLET|100|EA|3.3159|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|7.55717|02/09/2022|7.44921|02/09/2022|7.09448|02/09/2022|||ANTIPARKINSON'S AGENTS|12888|||||No|No||ALMATICA PHARMA|No||||
gabapentin|No|No|No|No|75%|52427080390|GRALISE ER 300 MG TABLET|90|EA|4.13086|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|232|Yes|9.208|08/24/2021|8.987|08/24/2021|9.04686|08/24/2021|||NEUROPATHIC PAIN|12889|||||No|No||ALMATICA PHARMA|No||||
gabapentin|No|No|No|No|75%|52427080690|GRALISE ER 600 MG TABLET|90|EA|4.13086|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|232|Yes|9.19569|06/29/2021|8.97499|06/29/2021|9.03476|06/29/2021|||NEUROPATHIC PAIN|12890|||||No|No||ALMATICA PHARMA|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|52427081601|STALEVO 100 TABLET|100|EA|3.28803|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|7.49366|06/02/2021|7.38661|06/02/2021|7.03487|06/02/2021|||ANTIPARKINSON'S AGENTS|12891|||||No|No||ALMATICA PHARMA|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|52427083401|STALEVO 150 TABLET|100|EA|3.28803|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|7.49366|02/09/2022|7.38661|02/09/2022|7.03487|02/09/2022|||ANTIPARKINSON'S AGENTS|12892|||||No|No||ALMATICA PHARMA|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|52427084201|STALEVO 200 TABLET|100|EA|3.28803|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|7.49366|02/09/2022|7.38661|02/09/2022|7.03487|02/09/2022|||ANTIPARKINSON'S AGENTS|12893|||||No|No||ALMATICA PHARMA|No||||
dextroamphetamine sulfate|No|No|No|No|75%|52536050001|DEXTROAMPHETAMINE 5 MG TAB|100|EA|1.04275|03/08/2013||Yes|No||03/08/2013||Yes|No|03/08/2013||Yes|No||||No|No|||Prescription required|No||007|Yes|.24678|03/29/2022|.24085|03/29/2022|.24246|03/29/2022|||STIMULANTS AND RELATED AGENTS|12894|||||No|No||WILSHIRE PHARMA|No||||
dextroamphetamine sulfate|No|No|No|No|75%|52536051001|DEXTROAMPHETAMINE 10 MG TAB|100|EA|1.12875|03/06/2013||Yes|No||03/06/2013||Yes|No|03/06/2013||Yes|No||||No|No|||Prescription required|No||007|Yes|.30046|03/29/2022|.29324|03/29/2022|.2952|03/29/2022|||STIMULANTS AND RELATED AGENTS|12895|||||No|No||WILSHIRE PHARMA|No||||
noreth-ethinyl estradiol/iron|Yes|Yes|No|No|75%|52544006431|LAYOLIS FE CHEWABLE TABLET|28|EA|1.50044|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No|Refer to program requirements|||No|No|05/12/2015||Prescription required|No|||No|1.76123|03/29/2022|1.71896|03/29/2022|1.7304|03/29/2022||||12896|||||No|No||ACTAVIS/TEVA|No|||Only covered for non-contraceptive (medical) purposes|
butalb/acetaminophen/caffeine|No|No|No|No|75%|52544008001|FIORICET 50-300-40 MG CAPSULE|100|EA|2.8036|08/23/2013||Yes|No||08/23/2013||Yes|No|08/23/2013||Yes|No||||No|No|||Prescription required|No|||No|6.23372|01/18/2022|6.08411|01/18/2022|6.12462|01/18/2022||||12897|||||No|No||ACTAVIS/TEVA|No||||
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|52544029528|AMETHYST 90-20 MCG TABLET|28|EA|.72977|12/01/2011||Yes|No||12/01/2011||Yes|No|12/01/2011||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|1.10869|03/29/2022|1.08208|03/29/2022|1.08928|03/29/2022||||12898|||||No|No||ACTAVIS/TEVA|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone|Yes|Yes|No|No|75%|52544062928|NORA-BE TABLET|28|EA|.38216|01/01/2006||Yes|No||01/01/2006||Yes|No|01/01/2011||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.16123|03/29/2022|.15736|03/29/2022|.1584|03/29/2022||||12899|||||No|No||ACTAVIS/TEVA|No|||Only covered for non-contraceptive (medical) purposes|
diltiazem HCl|No|No|No|No|75%|52544069119|MATZIM LA 180 MG TABLET|90|EA|1.02358|05/23/2011||Yes|No||05/23/2011||Yes|No|05/23/2011||Yes|No||05/23/2011||Yes|No|||Prescription required|Yes|07/27/2011|045|No|1.92532|03/01/2022|1.87911|03/01/2022|1.89162|03/01/2022|||CALCIUM CHANNEL BLOCKERS|12900|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|52544069130|MATZIM LA 180 MG TABLET|30|EA|1.02354|05/23/2011||Yes|No||05/23/2011||Yes|No|05/23/2011||Yes|No||05/23/2011||Yes|No|||Prescription required|Yes|07/27/2011|045|No|1.92532|03/01/2022|1.87911|03/01/2022|1.89162|03/01/2022|||CALCIUM CHANNEL BLOCKERS|12901|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|52544069219|MATZIM LA 240 MG TABLET|90|EA|1.14714|05/23/2011||Yes|No||05/23/2011||Yes|No|05/23/2011||Yes|No||05/23/2011||Yes|No|||Prescription required|Yes|07/27/2011|045|No|2.52878|03/29/2022|2.46808|03/29/2022|2.48452|03/29/2022|||CALCIUM CHANNEL BLOCKERS|12902|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|52544069230|MATZIM LA 240 MG TABLET|30|EA|1.14724|05/23/2011||Yes|No||05/23/2011||Yes|No|05/23/2011||Yes|No||05/23/2011||Yes|No|||Prescription required|Yes|07/27/2011|045|No|2.52878|03/29/2022|2.46808|03/29/2022|2.48452|03/29/2022|||CALCIUM CHANNEL BLOCKERS|12903|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|52544069319|MATZIM LA 300 MG TABLET|90|EA|1.49228|05/23/2011||Yes|No||05/23/2011||Yes|No|05/23/2011||Yes|No||05/23/2011||Yes|No|||Prescription required|Yes|07/27/2011|045|No|3.40103|11/23/2021|3.35244|11/23/2021|3.1928|11/23/2021|||CALCIUM CHANNEL BLOCKERS|12904|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|52544069330|MATZIM LA 300 MG TABLET|30|EA|1.49253|05/23/2011||Yes|No||05/23/2011||Yes|No|05/23/2011||Yes|No||05/23/2011||Yes|No|||Prescription required|Yes|07/27/2011|045|No|3.40158|11/23/2021|3.35298|11/23/2021|3.19332|11/23/2021|||CALCIUM CHANNEL BLOCKERS|12905|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|52544069419|MATZIM LA 360 MG TABLET|90|EA|1.60562|05/23/2011||Yes|No||05/23/2011||Yes|No|05/23/2011||Yes|No||05/23/2011||Yes|No|||Prescription required|Yes|07/27/2011|045|No|3.31263|01/25/2022|3.23312|01/25/2022|3.25465|01/25/2022|||CALCIUM CHANNEL BLOCKERS|12906|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|52544069430|MATZIM LA 360 MG TABLET|30|EA|1.60562|05/23/2011||Yes|No||05/23/2011||Yes|No|05/23/2011||Yes|No||05/23/2011||Yes|No|||Prescription required|Yes|07/27/2011|045|No|3.31263|01/25/2022|3.23312|01/25/2022|3.25465|01/25/2022|||CALCIUM CHANNEL BLOCKERS|12907|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|52544069519|MATZIM LA 420 MG TABLET|90|EA|1.74226|05/23/2011||Yes|No||05/23/2011||Yes|No|05/23/2011||Yes|No||05/23/2011||Yes|No|||Prescription required|Yes|07/27/2011|045|No|3.97073|03/29/2022|3.914|03/29/2022|3.72762|03/29/2022|||CALCIUM CHANNEL BLOCKERS|12908|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|52544069530|MATZIM LA 420 MG TABLET|30|EA|1.7392|05/23/2011||Yes|No||05/23/2011||Yes|No|05/23/2011||Yes|No||05/23/2011||Yes|No|||Prescription required|Yes|07/27/2011|045|No|3.96376|03/29/2022|3.90714|03/29/2022|3.72108|03/29/2022|||CALCIUM CHANNEL BLOCKERS|12909|||||No|No||ACTAVIS/TEVA|No||||
diclofenac sodium|No|No|No|No|75%|52565000205|DICLOFENAC 1.5% TOPICAL SOLN|150|ML|.1075|09/09/2015||Yes|No||09/09/2015||Yes|No|09/09/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|.10888|03/29/2022|.10626|03/29/2022|.10697|03/29/2022|||NSAIDS|12910|||||No|No||IGI LABS, INC./|No||||
lidocaine/prilocaine|No|No|No|No|75%|52565000730|LIDOCAINE-PRILOCAINE CREAM|30|GM|.21614|05/05/2020|02/01/2023|Yes|No||05/05/2020|02/01/2023|Yes|No|05/05/2020|02/01/2023|Yes|No||||No|No|||Prescription required|No|||No|.45426|03/29/2022|.44335|03/29/2022|.44631|03/29/2022||||12911|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TELIGENT PHARMA|No||||
lidocaine|No|No|No|No|75%|52565000814|LIDOCAINE 5% OINTMENT|35.44|GM|.12739|06/13/2016||Yes|No||06/13/2016||Yes|No|06/13/2016||Yes|No||||No|No|||Prescription required|No|||No|.18796|03/29/2022|.18344|03/29/2022|.18467|03/29/2022||||12912|||||No|No||IGI LABS, INC./|No||||
lidocaine HCl|No|No|No|No|75%|52565000950|LIDOCAINE HCL 4% SOLUTION|50|ML|.46328|11/04/2014||Yes|No||11/04/2014||Yes|No|11/04/2014||Yes|No||||No|No|||Prescription required|No|||No|.45385|03/29/2022|.44295|03/29/2022|.4459|03/29/2022||||12913|||||No|No||IGI LABS, INC./|No||||
triamcinolone acetonide|No|No|No|No|75%|52565001059|TRIAMCINOLONE 0.025% LOTION|60|ML|.20783|05/10/2017||Yes|No||05/10/2017||Yes|No|05/10/2017||Yes|No||||No|No|||Prescription required|No||120|No|.38774|03/29/2022|.37843|03/29/2022|.38095|03/29/2022|||STEROIDS: TOPICAL HIGH|12914|||||No|No||IGI LABS, INC./|No||||
fluocinolone acetonide|No|No|No|No|75%|52565001259|FLUOCINOLONE 0.01% SOLUTION|60|ML|.57333|03/12/2013||Yes|No||03/12/2013||Yes|No|03/12/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|119|No|.3936|03/29/2022|.38415|03/29/2022|.38671|03/29/2022|||STEROIDS: TOPICAL MEDIUM|12915|||||No|No||IGI LABS, INC./|No||||
fluocinolone acetonide|No|No|No|No|75%|52565001315|FLUOCINOLONE 0.025% OINTMENT|15|GM|.8385|03/13/2013||Yes|No||03/13/2013||Yes|No|03/13/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|119|No|1.17785|03/29/2022|1.14958|03/29/2022|1.15723|03/29/2022|||STEROIDS: TOPICAL MEDIUM|12916|||||No|No||IGI LABS, INC./|No||||
fluocinolone acetonide|No|No|No|No|75%|52565001360|FLUOCINOLONE 0.025% OINTMENT|60|GM|.60737|03/13/2013||Yes|No||03/13/2013||Yes|No|03/13/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|119|No|.92023|03/29/2022|.89814|03/29/2022|.90412|03/29/2022|||STEROIDS: TOPICAL MEDIUM|12917|||||No|No||IGI LABS, INC./|No||||
triamcinolone acetonide|No|No|No|No|75%|52565001415|TRIAMCINOLONE 0.1% OINTMENT|15|GM|.12441|05/11/2017||Yes|No||05/11/2017||Yes|No|05/11/2017||Yes|No||||No|No|||Prescription required|No||120|No|.14436|03/29/2022|.14089|03/29/2022|.14183|03/29/2022|||STEROIDS: TOPICAL HIGH|12918|||||No|No||IGI LABS, INC./|No||||
triamcinolone acetonide|No|No|No|No|75%|52565001426|TRIAMCINOLONE 0.1% OINTMENT|454|GM|.02367|05/11/2017||Yes|No||05/11/2017||Yes|No|05/11/2017||Yes|No||||No|No|||Prescription required|No||120|No|.04617|03/29/2022|.04506|03/29/2022|.04536|03/29/2022|||STEROIDS: TOPICAL HIGH|12919|||||No|No||IGI LABS, INC./|No||||
triamcinolone acetonide|No|No|No|No|75%|52565001480|TRIAMCINOLONE 0.1% OINTMENT|80|GM|.05326|05/11/2017||Yes|No||05/11/2017||Yes|No|05/11/2017||Yes|No||||No|No|||Prescription required|No||120|No|.06224|03/29/2022|.06074|03/29/2022|.06115|03/29/2022|||STEROIDS: TOPICAL HIGH|12920|||||No|No||IGI LABS, INC./|No||||
fluocinolone acetonide|No|No|No|No|75%|52565002015|FLUOCINOLONE 0.025% CREAM|15|GM|.8385|03/13/2013||Yes|No||03/13/2013||Yes|No|03/13/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|119|No|1.52527|03/29/2022|1.48866|03/29/2022|1.49857|03/29/2022|||STEROIDS: TOPICAL MEDIUM|12921|||||No|No||IGI LABS, INC./|No||||
fluocinolone acetonide|No|No|No|No|75%|52565002060|FLUOCINOLONE 0.025% CREAM|60|GM|.60737|03/13/2013||Yes|No||03/13/2013||Yes|No|03/13/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|119|No|1.09723|12/28/2021|1.07089|12/28/2021|1.07802|12/28/2021|||STEROIDS: TOPICAL MEDIUM|12922|||||No|No||IGI LABS, INC./|No||||
econazole nitrate|No|No|No|No|75%|52565002215|ECONAZOLE NITRATE 1% CREAM|15|GM|.35833|08/09/2013||Yes|No||08/09/2013||Yes|No|08/09/2013||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|061|No|.43362|03/29/2022|.42321|03/29/2022|.42603|03/29/2022|||ANTIFUNGALS: TOPICAL|12923|||||No|No||IGI LABS, INC./|No||||
econazole nitrate|No|No|No|No|75%|52565002230|ECONAZOLE NITRATE 1% CREAM|30|GM|.25083|08/09/2013||Yes|No||08/09/2013||Yes|No|08/09/2013||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|061|No|.37785|03/29/2022|.36878|03/29/2022|.37123|03/29/2022|||ANTIFUNGALS: TOPICAL|12924|||||No|No||IGI LABS, INC./|No||||
econazole nitrate|No|No|No|No|75%|52565002285|ECONAZOLE NITRATE 1% CREAM|85|GM|.12646|08/09/2013||Yes|No||08/09/2013||Yes|No|08/09/2013||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|061|No|.19681|03/29/2022|.19208|03/29/2022|.19336|03/29/2022|||ANTIFUNGALS: TOPICAL|12925|||||No|No||IGI LABS, INC./|No||||
betamethasone/propylene glyc|No|No|No|No|75%|52565002329|BETAMETHASONE DP AUG 0.05% LOT|30|ML|.86014|08/29/2018|02/01/2023|Yes|No||08/29/2018|02/01/2023|Yes|No|08/29/2018|02/01/2023|Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|.90128|03/01/2022|.87964|03/01/2022|.8855|03/01/2022|||STEROIDS: TOPICAL HIGH|12926|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TELIGENT PHARMA|No||||
betamethasone/propylene glyc|No|No|No|No|75%|52565002359|BETAMETHASONE DP AUG 0.05% LOT|60|ML|.84767|08/29/2018|02/01/2023|Yes|No||08/29/2018|02/01/2023|Yes|No|08/29/2018|02/01/2023|Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|.75016|03/29/2022|.73215|03/29/2022|.73703|03/29/2022|||STEROIDS: TOPICAL HIGH|12927|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TELIGENT PHARMA|No||||
desoximetasone|No|No|No|No|75%|52565003015|DESOXIMETASONE 0.25% OINTMENT|15|GM|.35833|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.658|03/29/2022|.6422|03/29/2022|.64648|03/29/2022|||STEROIDS: TOPICAL HIGH|12928|||||No|No||IGI LABS, INC./|No||||
desoximetasone|No|No|No|No|75%|52565003060|DESOXIMETASONE 0.25% OINTMENT|60|GM|.26875|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.39246|03/29/2022|.38304|03/29/2022|.38559|03/29/2022|||STEROIDS: TOPICAL HIGH|12929|||||No|No||IGI LABS, INC./|No||||
desoximetasone|No|No|No|No|75%|52565003099|DESOXIMETASONE 0.25% OINTMENT|100|GM|.645|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|1.47|09/11/2018|1.449|09/11/2018|1.38|09/11/2018|||STEROIDS: TOPICAL HIGH|12930|||||No|No||IGI LABS, INC./|No||||
fluocinolone acetonide|No|No|No|No|75%|52565003115|FLUOCINOLONE 0.01% CREAM|15|GM|1.06353|08/15/2014||Yes|No||08/15/2014||Yes|No|08/15/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|119|No|1.83933|09/28/2021|1.79518|09/28/2021|1.80714|09/28/2021|||STEROIDS: TOPICAL MEDIUM|12931|||||No|No||IGI LABS, INC./|No||||
fluocinolone acetonide|No|No|No|No|75%|52565003160|FLUOCINOLONE 0.01% CREAM|60|GM|.79693|08/15/2014||Yes|No||08/15/2014||Yes|No|08/15/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|119|No|1.17667|03/01/2022|1.14842|03/01/2022|1.15607|03/01/2022|||STEROIDS: TOPICAL MEDIUM|12932|||||No|No||IGI LABS, INC./|No||||
nystatin/triamcin|No|No|No|No|75%|52565004215|NYSTATIN-TRIAMCINOLONE OINTM|15|GM|.172|05/19/2017|02/01/2023|Yes|No||05/19/2017|02/01/2023|Yes|No|05/19/2017|02/01/2023|Yes|No||||No|No|||Prescription required|Yes|01/26/2017|061|No|.4296|03/29/2022|.41928|03/29/2022|.42208|03/29/2022|||ANTIFUNGALS: TOPICAL|12933|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TELIGENT PHARMA|No||||
nystatin/triamcin|No|No|No|No|75%|52565004230|NYSTATIN-TRIAMCINOLONE OINTM|30|GM|.12183|05/19/2017|02/01/2023|Yes|No||05/19/2017|02/01/2023|Yes|No|05/19/2017|02/01/2023|Yes|No||||No|No|||Prescription required|Yes|01/26/2017|061|No|.33412|03/29/2022|.3261|03/29/2022|.32827|03/29/2022|||ANTIFUNGALS: TOPICAL|12934|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TELIGENT PHARMA|No||||
nystatin/triamcin|No|No|No|No|75%|52565004260|NYSTATIN-TRIAMCINOLONE OINTM|60|GM|.07166|05/19/2017|02/01/2023|Yes|No||05/19/2017|02/01/2023|Yes|No|05/19/2017|02/01/2023|Yes|No||||No|No|||Prescription required|Yes|01/26/2017|061|No|.24511|03/29/2022|.23922|03/29/2022|.24082|03/29/2022|||ANTIFUNGALS: TOPICAL|12935|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TELIGENT PHARMA|No||||
desoximetasone|No|No|No|No|75%|52565004560|DESOXIMETASONE 0.05% OINTMENT|60|GM|2.00781|11/19/2019|02/01/2023|Yes|No||11/19/2019|02/01/2023|Yes|No|11/19/2019|02/01/2023|Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|4.57594|01/26/2021|4.51057|01/26/2021|4.29578|01/26/2021|||STEROIDS: TOPICAL HIGH|12936|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TELIGENT PHARMA|No||||
desoximetasone|No|No|No|No|75%|52565004599|DESOXIMETASONE 0.05% OINTMENT|100|GM|2.10592|11/19/2019|02/01/2023|Yes|No||11/19/2019|02/01/2023|Yes|No|11/19/2019|02/01/2023|Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|4.79955|11/19/2019|4.73098|11/19/2019|4.5057|11/19/2019|||STEROIDS: TOPICAL HIGH|12937|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TELIGENT PHARMA|No||||
clobetasol propionate|No|No|No|No|75%|52565005502|CLOBETASOL 0.05% TOPICAL LOTN|59|ML|.32796|05/19/2017|02/01/2023|Yes|No||05/19/2017|02/01/2023|Yes|No|05/19/2017|02/01/2023|Yes|No||||No|No|||Prescription required|Yes|01/26/2017|121|No|.88758|03/29/2022|.86627|03/29/2022|.87204|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|12938|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TELIGENT PHARMA|No||||
clobetasol propionate|No|No|No|No|75%|52565005504|CLOBETASOL 0.05% TOPICAL LOTN|118|ML|.24597|05/19/2017|02/01/2023|Yes|No||05/19/2017|02/01/2023|Yes|No|05/19/2017|02/01/2023|Yes|No||||No|No|||Prescription required|Yes|01/26/2017|121|No|1.12678|03/29/2022|1.09973|03/29/2022|1.10706|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|12939|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TELIGENT PHARMA|No||||
fluocinonide|No|No|No|No|75%|52565007911|FLUOCINONIDE 0.1% CREAM|120|GM|.19403|05/05/2020|02/01/2023|Yes|No||05/05/2020|02/01/2023|Yes|No|05/05/2020|02/01/2023|Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|.44222|04/27/2021|.4359|04/27/2021|.41515|04/27/2021|||STEROIDS: TOPICAL HIGH|12940|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TELIGENT PHARMA|No||||
gentamicin sulfate|No|No|No|No|75%|52565008515|GENTAMICIN 0.1% CREAM|15|GM|1.13233|04/02/2020|02/01/2023|Yes|No||04/02/2020|02/01/2023|Yes|No|04/02/2020|02/01/2023|Yes|No||||No|No|||Prescription required|Yes|01/30/2020|114|No|1.45337|03/29/2022|1.41848|03/29/2022|1.42793|03/29/2022|||ANTIBIOTICS: TOPICAL|12941|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TELIGENT PHARMA|No||||
gentamicin sulfate|No|No|No|No|75%|52565008530|GENTAMICIN 0.1% CREAM|30|GM|1.13233|04/02/2020|02/01/2023|Yes|No||04/02/2020|02/01/2023|Yes|No|04/02/2020|02/01/2023|Yes|No||||No|No|||Prescription required|Yes|01/30/2020|114|No|1.27926|03/29/2022|1.24855|03/29/2022|1.25687|03/29/2022|||ANTIBIOTICS: TOPICAL|12942|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TELIGENT PHARMA|No||||
hydrocortisone butyrate|No|No|No|No|75%|52565008702|HYDROCORTISONE BUTYR 0.1% LOTN|59|ML|2.81321|03/27/2019|02/01/2023|Yes|No||03/27/2019|02/01/2023|Yes|No|03/27/2019|02/01/2023|Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|6.41152|03/27/2019|6.31992|03/27/2019|6.01898|03/27/2019|||STEROIDS: TOPICAL MEDIUM|12943|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TELIGENT PHARMA|No||||
hydrocortisone butyrate|No|No|No|No|75%|52565008704|HYDROCORTISONE BUTYR 0.1% LOTN|118|ML|2.76948|03/27/2019|02/01/2023|Yes|No||03/27/2019|02/01/2023|Yes|No|03/27/2019|02/01/2023|Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|6.31185|03/27/2019|6.22168|03/27/2019|5.92541|03/27/2019|||STEROIDS: TOPICAL MEDIUM|12944|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TELIGENT PHARMA|No||||
melphalan|No|No|No|No|75%|52609000105|ALKERAN 2 MG TABLET|50|EA|4.86777|07/18/2011||Yes|No||07/18/2011||Yes|No|07/18/2011||Yes|No||||No|No|||Prescription required|No||173|No|11.09399|02/28/2017|10.9355|02/28/2017|10.41476|02/28/2017|||ONCOLOGY: ORAL - HEMATOLOGIC|12945|||||No|No||APOPHARMA USA I|No||||
deferiprone|No|No|No|No|75%|52609000601|FERRIPROX 500 MG TABLET|100|EA|31.02763|12/08/2011|09/25/2022|Yes|No||12/08/2011|09/25/2022|Yes|No|12/08/2011|09/25/2022|Yes|No||||No|No|||Prescription required|No|||No|70.71415|01/12/2021|69.70395|01/12/2021|66.38471|01/12/2021||||12946|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||APOPHARMA/CHIES|No||||
deferiprone|No|No|No|No|75%|52609000705|FERRIPROX 1,000 MG TABLET|50|EA|62.05527|12/03/2020|09/25/2022|Yes|No||12/03/2020|09/25/2022|Yes|No|12/03/2020|09/25/2022|Yes|No||||No|No|||Prescription required|No|||No|141.4283|01/12/2021|139.4079|01/12/2021|132.76943|01/12/2021||||12947|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||APOPHARMA/CHIES|No||||
deferiprone|No|No|No|No|75%|52609450207|FERRIPROX 100 MG/ML SOLUTION|500|ML|6.20552|10/26/2017|05/14/2022|Yes|No||10/26/2017|05/14/2022|Yes|No|10/26/2017|05/14/2022|Yes|No||||No|No|||Prescription required|No|||No|14.14283|01/12/2021|13.94079|01/12/2021|13.27694|01/12/2021||||12948|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||APOPHARMA/CHIES|No||||
deferoxamine mesylate|No|No|No|No|75%|52609450406|DEFEROXAMINE 2 GRAM VIAL|1|EA|22.274|09/05/2018||Yes|No||09/05/2018||Yes|No|09/05/2018||Yes|No||||No|No|||Prescription required|No|||No|50.764|09/11/2018|50.0388|09/11/2018|47.656|09/05/2018||||12949|||||No|No||APOPHARMA USA I|No||||
deferoxamine mesylate|No|No|No|No|75%|52609450506|DEFEROXAMINE 500 MG VIAL|1|EA|5.5685|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||||No|No|||Prescription required|No|||No|12.691|09/04/2018|12.5097|09/04/2018|11.914|08/28/2018||||12950|||||No|No||APOPHARMA USA I|No||||
methotrexate|No|No|No|No|75%|52652200101|XATMEP 2.5 MG/ML ORAL SOLUTION|120|ML|7.20819|07/10/2017||Yes|No||07/10/2017||Yes|No|07/10/2017||Yes|No||||No|No|||Prescription required|No|||No|16.42798|01/04/2022|16.19329|01/04/2022|15.42219|01/04/2022||||12951|||||No|No||AZURITY PHARMAC|No||||
methotrexate|No|No|No|No|75%|52652200106|XATMEP 2.5 MG/ML ORAL SOLUTION|60|ML|7.57359|09/12/2018|07/31/2025|Yes|No||09/12/2018|07/31/2025|Yes|No|09/12/2018|07/31/2025|Yes|No||||No|No|||Prescription required|No|||No|17.26074|01/04/2022|17.01415|01/04/2022|16.20396|01/04/2022||||12952|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AZURITY PHARMAC|No||||
lisinopril|No|No|No|No|75%|52652300101|QBRELIS 1MG/ML SOLUTION|150|ML|1.548|12/28/2016||Yes|No||12/28/2016||Yes|No|12/28/2016||Yes|No||10/01/2019||Yes|No|||Prescription required|Yes|07/27/2017|113|No|3.528|01/07/2020|3.4776|01/07/2020|3.312|01/07/2020|||ANGIOTENSIN MODULATORS|12953|||||No|No||AZURITY PHARMAC|No||||
enalapril maleate|No|No|No|No|75%|52652400101|EPANED 1 MG/ML ORAL SOLUTION|150|ML|1.5394|04/01/2017|12/30/2030|Yes|No||04/01/2017|12/30/2030|Yes|No|04/01/2017|12/30/2030|Yes|No||10/01/2019|12/30/2030|Yes|No|||Prescription required|No||113|No|3.42711|07/27/2021|3.34485|07/27/2021|3.36713|07/27/2021|||ANGIOTENSIN MODULATORS|12954|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||AZURITY PHARMAC|No||||
amlodipine benzoate|No|No|No|No|75%|52652500101|KATERZIA 1 MG/ML SUSPENSION|150|ML|1.51176|10/01/2019||Yes|No||10/01/2019||Yes|No|10/01/2019||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|045|No|3.36611|09/07/2021|3.28532|09/07/2021|3.3072|09/07/2021|||CALCIUM CHANNEL BLOCKERS|12955|||||No|No||AZURITY PHARMAC|No||||
topiramate|No|No|No|No|75%|52652900101|EPRONTIA 25 MG/ML SOLUTION|473|ML|.60454|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|No||056|No|1.37779|02/16/2022|1.3581|02/16/2022|1.29343|02/16/2022|||ANTICONVULSANTS|12956|||||No|No||AZURITY PHARMAC|No||||
ferrous fumarate/folic acid|No|No|No|No|75%|52747030630|HEMOCYTE-F TABLET|30|EA|.14448|11/14/2016||Yes|No||11/14/2016||Yes|No|11/14/2016||Yes|No||11/14/2016||Yes|No|||Over the counter|No||506|No|.32928|08/13/2019|.32457|08/13/2019|.30912|08/13/2019|||IRON: ORAL|12957|||||No|No||US PHARMACEUTIC|No||||
ferrous fumarate/folic acid|No|No|No|No|75%|52747030670|HEMOCYTE-F TABLET|100|EA|.14413|11/14/2016||Yes|No||11/14/2016||Yes|No|11/14/2016||Yes|No||11/14/2016||Yes|No|||Over the counter|No||506|No|.32849|08/13/2019|.3238|08/13/2019|.30838|08/13/2019|||IRON: ORAL|12958|||||No|No||US PHARMACEUTIC|No||||
iron fum,ps no.1/vit C/L.casei|No|No|No|No|75%|52747050130|FUSION CAPSULE|30|EA|.34256|09/21/2016||Yes|No||||No|No|09/21/2016||Yes|No||||No|No|||Over the counter|No|||No|.78072|09/21/2016|.76957|09/21/2016|.73292|09/21/2016||||12959|||||No|No||US PHARMACEUTIC|No||||
iron,fm,ps/folic/B,C18/L.casei|No|No|No|No|75%|52747050230|FUSION PLUS CAPSULE|30|EA|.38413|11/14/2016||Yes|No||11/14/2016||Yes|No|11/14/2016||Yes|No||||No|No|||Over the counter|Yes|02/01/2018|506|No|.87546|01/12/2021|.86295|01/12/2021|.82186|01/12/2021|||IRON: ORAL|12960|||||No|No||US PHARMACEUTIC|No||||
iron fum,ps cmp/vit C/niacin|No|No|No|No|75%|52747071030|INTEGRA CAPSULE|30|EA|.16913|08/19/2013||Yes|No||||No|No|||No|No||07/01/2014||Yes|No|||Over the counter|No||506|No|.38546|07/07/2020|.37995|07/07/2020|.36186|07/07/2020|||IRON: ORAL|12961|||||No|No||US PHARMACEUTIC|No||||
iron fum,ps cmp/vit C/niacin|No|No|No|No|75%|52747071060|INTEGRA CAPSULE|90|EA|.1567|07/13/2009||Yes|No||||No|No|||No|No||07/01/2014||Yes|No|||Over the counter|No||506|No|.35715|07/07/2020|.35204|07/07/2020|.33528|07/07/2020|||IRON: ORAL|12962|||||No|No||US PHARMACEUTIC|No||||
iron fum,ps/folic acid/vitC/B3|No|No|No|No|75%|52747071130|INTEGRA F CAPSULE|30|EA|.23076|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||09/07/2015||Yes|No|||Over the counter|No||506|No|.52592|01/12/2021|.51841|01/12/2021|.49372|01/12/2021|||IRON: ORAL|12963|||||No|No||US PHARMACEUTIC|No||||
iron fum,ps/folic acid/vitC/B3|No|No|No|No|75%|52747071160|INTEGRA F CAPSULE|90|EA|.21466|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||09/07/2015||Yes|No|||Over the counter|No||506|No|.48923|01/12/2021|.48224|01/12/2021|.45928|01/12/2021|||IRON: ORAL|12964|||||No|No||US PHARMACEUTIC|No||||
iron fum,ps/folic/Bcomp,C no.9|No|No|No|No|75%|52747071230|INTEGRA PLUS CAPSULE|30|EA|.28494|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||09/07/2015||Yes|No|||Over the counter|No||506|No|.6494|01/12/2021|.64012|01/12/2021|.60964|01/12/2021|||IRON: ORAL|12965|||||No|No||US PHARMACEUTIC|No||||
iron fum,ps/folic/Bcomp,C no.9|No|No|No|No|75%|52747071260|INTEGRA PLUS CAPSULE|90|EA|.2685|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||09/07/2015||Yes|No|||Over the counter|No||506|No|.61195|01/12/2021|.6032|01/12/2021|.57448|01/12/2021|||IRON: ORAL|12966|||||No|No||US PHARMACEUTIC|No||||
iron fum/folic acid/mv,min 15|No|No|No|No|75%|52747080030|HEMOCYTE PLUS CAPSULE|30|EA|.24194|11/14/2016||Yes|No||11/14/2016||Yes|No|11/14/2016||Yes|No||||No|No|||Over the counter|No||506|No|.5514|01/12/2021|.54352|01/12/2021|.51764|01/12/2021|||IRON: ORAL|12967|||||No|No||US PHARMACEUTIC|No||||
iron fum/folic acid/mv,min 15|No|No|No|No|75%|52747080060|HEMOCYTE PLUS CAPSULE|100|EA|.24187|11/14/2016||Yes|No||11/14/2016||Yes|No|11/14/2016||Yes|No||||No|No|||Over the counter|No||506|No|.55125|01/12/2021|.54337|01/12/2021|.5175|01/12/2021|||IRON: ORAL|12968|||||No|No||US PHARMACEUTIC|No||||
ferrous fumarate/iron ps cplx|No|No|No|No|75%|52747090090|TANDEM DUAL ACTION CAPSULE|90|EA|.16153|09/07/2015||Yes|No||||No|No|09/07/2015||Yes|No||||No|No|||Over the counter|No||506|No|.36814|08/13/2019|.36288|08/13/2019|.3456|08/13/2019|||IRON: ORAL|12969|||||No|No||US PHARMACEUTIC|No||||
iron fm,ps no.1/folic/mv no.18|No|No|No|No|75%|52747090260|TANDEM PLUS CAPSULE|90|EA|.27667|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Over the counter|No||506|No|.63057|08/13/2019|.62156|08/13/2019|.59196|08/13/2019|||IRON: ORAL|12970|||||No|No||US PHARMACEUTIC|No||||
pedi multivit no.161/fluoride|No|No|No|No|75%|52796017050|FLORIVA PLUS 0.25 MG/ML DROP|50|ML|1.21002|07/09/2018||Yes|No||07/09/2018||Yes|No|07/09/2018||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|2.75772|01/14/2020|2.71832|01/14/2020|2.58888|01/14/2020|||PEDIATRIC VITAMIN PREPARATIONS|12971|||||No|No||BONGEO PHARMACE|No||||
sodium fluoride/vitamin D3|No|No|No|No|75%|52796017250|FLORIVA 0.25 MG/ML DROPS|50|ML|1.34547|07/25/2016||Yes|No||07/25/2016||Yes|No|07/25/2016||Yes|No||||No|No|||Over the counter|Yes|03/09/2018|179|No|3.06642|01/14/2020|3.02261|01/14/2020|2.87868|01/14/2020|||PEDIATRIC VITAMIN PREPARATIONS|12972|||||No|No||BONGEO PHARMACE|No||||
pedi multivit no.85/fluoride|No|No|No|No|75%|52796017390|FLORIVA 0.25 MG CHEW TABLET|90|EA|2.3478|07/25/2016||Yes|No||07/25/2016||Yes|No|07/25/2016||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|5.3508|01/14/2020|5.27436|01/14/2020|5.0232|01/14/2020|||PEDIATRIC VITAMIN PREPARATIONS|12973|||||No|No||BONGEO PHARMACE|No||||
pedi multivit no.85/fluoride|No|No|No|No|75%|52796017490|FLORIVA 0.5 MG CHEWABLE TABLET|90|EA|2.3478|07/25/2016||Yes|No||07/25/2016||Yes|No|07/25/2016||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|5.3508|01/14/2020|5.27436|01/14/2020|5.0232|01/14/2020|||PEDIATRIC VITAMIN PREPARATIONS|12974|||||No|No||BONGEO PHARMACE|No||||
pedi multivit no.85/fluoride|No|No|No|No|75%|52796017790|FLORIVA 1 MG CHEWABLE TABLET|90|EA|2.3478|07/25/2016||Yes|No||07/25/2016||Yes|No|07/25/2016||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|5.3508|01/14/2020|5.27436|01/14/2020|5.0232|01/14/2020|||PEDIATRIC VITAMIN PREPARATIONS|12975|||||No|No||BONGEO PHARMACE|No||||
quetiapine fumarate|No|No|No|No|75%|52817016060|QUETIAPINE ER 50 MG TABLET|60|EA|.11466|09/14/2017|03/01/2023|Yes|No||09/14/2017|03/01/2023|Yes|No|09/14/2017|03/01/2023|Yes|No||||No|No|||Prescription required|Yes|01/26/2017|027|Yes|.13845|03/29/2022|.13512|03/29/2022|.13602|03/29/2022|||ANTIPSYCHOTICS|12976|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TRUPHARMA, LLC.|No||||
quetiapine fumarate|No|No|No|No|75%|52817016160|QUETIAPINE ER 150 MG TABLET|60|EA|.19708|09/14/2017|03/01/2023|Yes|No||09/14/2017|03/01/2023|Yes|No|09/14/2017|03/01/2023|Yes|No||||No|No|||Prescription required|Yes|01/26/2017|027|Yes|.25256|03/29/2022|.24649|03/29/2022|.24814|03/29/2022|||ANTIPSYCHOTICS|12977|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TRUPHARMA, LLC.|No||||
quetiapine fumarate|No|No|No|No|75%|52817016260|QUETIAPINE ER 200 MG TABLET|60|EA|.22216|09/14/2017|03/01/2023|Yes|No||09/14/2017|03/01/2023|Yes|No|09/14/2017|03/01/2023|Yes|No||||No|No|||Prescription required|Yes|01/26/2017|027|Yes|.25825|03/29/2022|.25205|03/29/2022|.25373|03/29/2022|||ANTIPSYCHOTICS|12978|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TRUPHARMA, LLC.|No||||
quetiapine fumarate|No|No|No|No|75%|52817016360|QUETIAPINE ER 300 MG TABLET|60|EA|.25585|09/14/2017|03/01/2023|Yes|No||09/14/2017|03/01/2023|Yes|No|09/14/2017|03/01/2023|Yes|No||||No|No|||Prescription required|Yes|01/26/2017|027|Yes|.35477|03/29/2022|.34625|03/29/2022|.34856|03/29/2022|||ANTIPSYCHOTICS|12979|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TRUPHARMA, LLC.|No||||
quetiapine fumarate|No|No|No|No|75%|52817016460|QUETIAPINE ER 400 MG TABLET|60|EA|.28917|09/14/2017|03/01/2023|Yes|No||09/14/2017|03/01/2023|Yes|No|09/14/2017|03/01/2023|Yes|No||||No|No|||Prescription required|Yes|01/26/2017|027|Yes|.42833|03/29/2022|.41805|03/29/2022|.42083|03/29/2022|||ANTIPSYCHOTICS|12980|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TRUPHARMA, LLC.|No||||
clonidine HCl|No|No|No|No|75%|52817018000|CLONIDINE HCL 0.1 MG TABLET|1000|EA|.0133|11/16/2017||Yes|No||11/16/2017||Yes|No|11/16/2017||Yes|No||||No|No|||Prescription required|No||166|No|.03029|03/29/2022|.02956|03/29/2022|.02975|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|12981|||||No|No||TRUPHARMA, LLC.|No||||
clonidine HCl|No|No|No|No|75%|52817018010|CLONIDINE HCL 0.1 MG TABLET|100|EA|.01827|11/16/2017||Yes|No||11/16/2017||Yes|No|11/16/2017||Yes|No||||No|No|||Prescription required|No||166|No|.03029|03/29/2022|.02956|03/29/2022|.02975|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|12982|||||No|No||TRUPHARMA, LLC.|No||||
clonidine HCl|No|No|No|No|75%|52817018100|CLONIDINE HCL 0.2 MG TABLET|1000|EA|.01818|11/16/2017||Yes|No||11/16/2017||Yes|No|11/16/2017||Yes|No||||No|No|||Prescription required|No||166|No|.0396|03/29/2022|.03864|03/29/2022|.0389|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|12983|||||No|No||TRUPHARMA, LLC.|No||||
clonidine HCl|No|No|No|No|75%|52817018110|CLONIDINE HCL 0.2 MG TABLET|100|EA|.02494|11/16/2017||Yes|No||11/16/2017||Yes|No|11/16/2017||Yes|No||||No|No|||Prescription required|No||166|No|.0396|03/29/2022|.03864|03/29/2022|.0389|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|12984|||||No|No||TRUPHARMA, LLC.|No||||
clonidine HCl|No|No|No|No|75%|52817018200|CLONIDINE HCL 0.3 MG TABLET|1000|EA|.02795|02/01/2019||Yes|No||02/01/2019||Yes|No|02/01/2019||Yes|No||||No|No|||Prescription required|No||166|No|.03883|03/29/2022|.03789|03/29/2022|.03815|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|12985|||||No|No||TRUPHARMA, LLC.|No||||
clonidine HCl|No|No|No|No|75%|52817018210|CLONIDINE HCL 0.3 MG TABLET|100|EA|.02988|11/16/2017||Yes|No||11/16/2017||Yes|No|11/16/2017||Yes|No||||No|No|||Prescription required|No||166|No|.03883|03/29/2022|.03789|03/29/2022|.03815|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|12986|||||No|No||TRUPHARMA, LLC.|No||||
tramadol HCl|No|No|No|No|90%|52817019610|TRAMADOL HCL 100 MG TABLET|100|EA|.62122|06/15/2020||Yes|No||06/15/2020||Yes|No|06/15/2020||Yes|No||||No|No|||Prescription required|No||109|No|1.38692|03/29/2022|1.35363|03/29/2022|1.36264|03/29/2022|||ANALGESICS: NARCOTICS SHORT|12987|||||No|No||TRUPHARMA, LLC.|No||||
cyproheptadine HCl|No|No|No|No|75%|52817021010|CYPROHEPTADINE 4 MG TABLET|100|EA|.0473|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No||574|Yes|.09783|03/29/2022|.09548|03/29/2022|.09611|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|12988|||||No|No||TRUPHARMA, LLC.|No||||
cyproheptadine HCl|No|No|No|No|75%|52817021050|CYPROHEPTADINE 4 MG TABLET|500|EA|.04644|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No||574|Yes|.09783|03/29/2022|.09548|03/29/2022|.09611|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|12989|||||No|No||TRUPHARMA, LLC.|No||||
chlorzoxazone|No|No|No|No|75%|52817023010|CHLORZOXAZONE 375 MG TABLET|100|EA|1.591|06/21/2021||Yes|No||06/21/2021||Yes|No|06/21/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|116|Yes|3.626|06/21/2021|3.5742|06/21/2021|3.404|06/21/2021|||SKELETAL MUSCLE RELAXANTS|12990|||||No|No||TRUPHARMA, LLC.|No||||
chlorzoxazone|No|No|No|No|75%|52817023110|CHLORZOXAZONE 750 MG TABLET|100|EA|1.7845|06/21/2021||Yes|No||06/21/2021||Yes|No|06/21/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|116|Yes|4.067|06/21/2021|4.0089|06/21/2021|3.818|06/21/2021|||SKELETAL MUSCLE RELAXANTS|12991|||||No|No||TRUPHARMA, LLC.|No||||
ramelteon|No|No|No|No|75%|52817023510|RAMELTEON 8 MG TABLET|100|EA|.60909|07/09/2021||Yes|No||07/09/2021||Yes|No|07/09/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|054|Yes|1.10393|03/29/2022|1.07743|03/29/2022|1.08461|03/29/2022|||SEDATIVE HYPNOTICS|12992|||||No|No||TRUPHARMA, LLC.|No||||
ramelteon|No|No|No|No|75%|52817023530|RAMELTEON 8 MG TABLET|30|EA|.60916|07/09/2021||Yes|No||07/09/2021||Yes|No|07/09/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|054|Yes|1.10393|03/29/2022|1.07743|03/29/2022|1.08461|03/29/2022|||SEDATIVE HYPNOTICS|12993|||||No|No||TRUPHARMA, LLC.|No||||
lamotrigine|No|No|No|No|75%|52817024230|LAMOTRIGINE ER 100 MG TABLET|30|EA|.82975|09/14/2017|02/01/2023|Yes|No||09/14/2017|02/01/2023|Yes|No|09/14/2017|02/01/2023|Yes|No||||No|No|||Prescription required|No||056|No|1.51472|03/29/2022|1.47836|03/29/2022|1.48821|03/29/2022|||ANTICONVULSANTS|12994|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TRUPHARMA, LLC.|No||||
lamotrigine|No|No|No|No|75%|52817024330|LAMOTRIGINE ER 200 MG TABLET|30|EA|.88694|09/14/2017|02/01/2023|Yes|No||09/14/2017|02/01/2023|Yes|No|09/14/2017|02/01/2023|Yes|No||||No|No|||Prescription required|No||056|No|1.69753|03/29/2022|1.65678|03/29/2022|1.66782|03/29/2022|||ANTICONVULSANTS|12995|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||TRUPHARMA, LLC.|No||||
oxybutynin chloride|No|No|No|No|75%|52817026010|OXYBUTYNIN 5 MG TABLET|100|EA|.04945|06/21/2021||Yes|No||06/21/2021||Yes|No|06/21/2021||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|12996|||||No|No||TRUPHARMA, LLC.|No||||
oxybutynin chloride|No|No|No|No|75%|52817026050|OXYBUTYNIN 5 MG TABLET|500|EA|.0445|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|12997|||||No|No||TRUPHARMA, LLC.|No||||
bisoprolol fumarate|No|No|No|No|75%|52817027010|BISOPROLOL FUMARATE 5 MG TAB|100|EA|.18597|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||070|No|.38321|03/29/2022|.37401|03/29/2022|.3765|03/29/2022|||BETA-BLOCKERS|12998|||||No|No||TRUPHARMA, LLC.|No||||
bisoprolol fumarate|No|No|No|No|75%|52817027030|BISOPROLOL FUMARATE 5 MG TAB|30|EA|.20783|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||070|No|.38321|03/29/2022|.37401|03/29/2022|.3765|03/29/2022|||BETA-BLOCKERS|12999|||||No|No||TRUPHARMA, LLC.|No||||
bisoprolol fumarate|No|No|No|No|75%|52817027110|BISOPROLOL FUMARATE 10 MG TAB|100|EA|.18597|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||070|No|.47062|03/29/2022|.45932|03/29/2022|.46238|03/29/2022|||BETA-BLOCKERS|13000|||||No|No||TRUPHARMA, LLC.|No||||
bisoprolol fumarate|No|No|No|No|75%|52817027130|BISOPROLOL FUMARATE 10 MG TAB|30|EA|.20783|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||070|No|.47062|03/29/2022|.45932|03/29/2022|.46238|03/29/2022|||BETA-BLOCKERS|13001|||||No|No||TRUPHARMA, LLC.|No||||
oxazepam|No|No|No|No|90%|52817029010|OXAZEPAM 10 MG CAPSULE|100|EA|.32207|04/22/2021||Yes|No||04/22/2021||Yes|No|04/22/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|090|Yes|.8772|03/29/2022|.85614|03/29/2022|.86184|03/29/2022|||ANXIOLYTICS|13002|||||No|No||TRUPHARMA, LLC.|No||||
oxazepam|No|No|No|No|90%|52817029110|OXAZEPAM 15 MG CAPSULE|100|EA|.4128|04/22/2021||Yes|No||04/22/2021||Yes|No|04/22/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|090|Yes|1.06313|03/29/2022|1.03761|03/29/2022|1.04452|03/29/2022|||ANXIOLYTICS|13003|||||No|No||TRUPHARMA, LLC.|No||||
oxazepam|No|No|No|No|90%|52817029210|OXAZEPAM 30 MG CAPSULE|100|EA|.5504|04/22/2021||Yes|No||04/22/2021||Yes|No|04/22/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|090|Yes|1.2544|08/24/2021|1.23648|08/24/2021|1.1776|08/24/2021|||ANXIOLYTICS|13004|||||No|No||TRUPHARMA, LLC.|No||||
sildenafil citrate|No|No|No|No|75%|52817029590|SILDENAFIL 20 MG TABLET|90|EA|.043|05/28/2019||Yes|No||05/28/2019||Yes|No|05/28/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|Yes|.09246|03/29/2022|.09024|03/29/2022|.09084|03/29/2022|||PAH AGENTS: ORAL AND INHALED|13005|||||No|No||TRUPHARMA, LLC.|No||||
baclofen|No|No|No|No|75%|52817031910|BACLOFEN 5 MG TABLET|100|EA|.39843|06/22/2018||Yes|No||06/22/2018||Yes|No|06/22/2018||Yes|No||||No|No|||Prescription required|No||116|No|.53855|03/29/2022|.52562|03/29/2022|.52912|03/29/2022|||SKELETAL MUSCLE RELAXANTS|13006|||||No|No||TRUPHARMA, LLC.|No||||
baclofen|No|No|No|No|75%|52817032000|BACLOFEN 10 MG TABLET|1000|EA|.02537|06/22/2018||Yes|No||06/22/2018||Yes|No|06/22/2018||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|13007|||||No|No||TRUPHARMA, LLC.|No||||
baclofen|No|No|No|No|75%|52817032010|BACLOFEN 10 MG TABLET|100|EA|.0258|06/22/2018||Yes|No||06/22/2018||Yes|No|06/22/2018||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|13008|||||No|No||TRUPHARMA, LLC.|No||||
baclofen|No|No|No|No|75%|52817032100|BACLOFEN 20 MG TABLET|1000|EA|.04278|06/22/2018||Yes|No||06/22/2018||Yes|No|06/22/2018||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|13009|||||No|No||TRUPHARMA, LLC.|No||||
baclofen|No|No|No|No|75%|52817032110|BACLOFEN 20 MG TABLET|100|EA|.04515|06/22/2018||Yes|No||06/22/2018||Yes|No|06/22/2018||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|13010|||||No|No||TRUPHARMA, LLC.|No||||
midodrine HCl|No|No|No|No|75%|52817032310|MIDODRINE HCL 2.5 MG TABLET|100|EA|.1032|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|No|||No|.20233|03/29/2022|.19747|03/29/2022|.19878|03/29/2022||||13011|||||No|No||TRUPHARMA, LLC.|No||||
midodrine HCl|No|No|No|No|75%|52817032410|MIDODRINE HCL 5 MG TABLET|100|EA|.1548|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|No|||No|.26381|03/29/2022|.25747|03/29/2022|.25919|03/29/2022||||13012|||||No|No||TRUPHARMA, LLC.|No||||
midodrine HCl|No|No|No|No|75%|52817032510|MIDODRINE HCL 10 MG TABLET|100|EA|.258|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|No|||No|.40773|03/29/2022|.39794|03/29/2022|.40059|03/29/2022||||13013|||||No|No||TRUPHARMA, LLC.|No||||
cyclobenzaprine HCl|No|No|No|No|75%|52817033010|CYCLOBENZAPRINE 5 MG TABLET|100|EA|.0172|07/20/2018||Yes|No||07/20/2018||Yes|No|07/20/2018||Yes|No||||No|No|||Prescription required|No||116|Yes|.02938|03/29/2022|.02867|03/29/2022|.02886|03/29/2022|||SKELETAL MUSCLE RELAXANTS|13014|||||No|No||TRUPHARMA, LLC.|No||||
cyclobenzaprine HCl|No|No|No|No|75%|52817033050|CYCLOBENZAPRINE 5 MG TABLET|500|EA|.01118|07/20/2018||Yes|No||07/20/2018||Yes|No|07/20/2018||Yes|No||||No|No|||Prescription required|No||116|Yes|.02938|03/29/2022|.02867|03/29/2022|.02886|03/29/2022|||SKELETAL MUSCLE RELAXANTS|13015|||||No|No||TRUPHARMA, LLC.|No||||
cyclobenzaprine HCl|No|No|No|No|75%|52817033110|CYCLOBENZAPRINE 7.5 MG TABLET|100|EA|.774|07/20/2018||Yes|No||07/20/2018||Yes|No|07/20/2018||Yes|No||||No|No|||Prescription required|No||116|Yes|1.21617|03/29/2022|1.18698|03/29/2022|1.19488|03/29/2022|||SKELETAL MUSCLE RELAXANTS|13016|||||No|No||TRUPHARMA, LLC.|No||||
cyclobenzaprine HCl|No|No|No|No|75%|52817033200|CYCLOBENZAPRINE 10 MG TABLET|1000|EA|.00685|07/20/2018||Yes|No||07/20/2018||Yes|No|07/20/2018||Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|13017|||||No|No||TRUPHARMA, LLC.|No||||
cyclobenzaprine HCl|No|No|No|No|75%|52817033250|CYCLOBENZAPRINE 10 MG TABLET|500|EA|.00946|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|13018|||||No|No||TRUPHARMA, LLC.|No||||
metoprolol tartrate|No|No|No|No|75%|52817035810|METOPROLOL TARTRATE 37.5 MG TB|100|EA|.03504|02/05/2021||Yes|No||02/05/2021||Yes|No|02/05/2021||Yes|No||02/05/2021||Yes|No|||Prescription required|No||070|No|.07987|02/05/2021|.07872|02/05/2021|.07498|02/05/2021|||BETA-BLOCKERS|13019|||||No|No||TRUPHARMA, LLC.|No||||
metoprolol tartrate|No|No|No|No|75%|52817035910|METOPROLOL TARTRATE 75 MG TAB|100|EA|.07718|02/05/2021||Yes|No||02/05/2021||Yes|No|02/05/2021||Yes|No||02/05/2021||Yes|No|||Prescription required|No||070|No|.17591|09/28/2021|.17339|09/28/2021|.16514|09/28/2021|||BETA-BLOCKERS|13020|||||No|No||TRUPHARMA, LLC.|No||||
metoprolol tartrate|No|No|No|No|75%|52817036000|METOPROLOL TARTRATE 25 MG TAB|1000|EA|.00795|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|No||070|No|.01777|03/29/2022|.01734|03/29/2022|.01745|03/29/2022|||BETA-BLOCKERS|13021|||||No|No||TRUPHARMA, LLC.|No||||
metoprolol tartrate|No|No|No|No|75%|52817036010|METOPROLOL TARTRATE 25 MG TAB|100|EA|.00946|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|No||070|No|.01777|03/29/2022|.01734|03/29/2022|.01745|03/29/2022|||BETA-BLOCKERS|13022|||||No|No||TRUPHARMA, LLC.|No||||
metoprolol tartrate|No|No|No|No|75%|52817036100|METOPROLOL TARTRATE 50 MG TAB|1000|EA|.00892|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|No||070|No|.02252|03/29/2022|.02197|03/29/2022|.02212|03/29/2022|||BETA-BLOCKERS|13023|||||No|No||TRUPHARMA, LLC.|No||||
metoprolol tartrate|No|No|No|No|75%|52817036110|METOPROLOL TARTRATE 50 MG TAB|100|EA|.01204|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|No||070|No|.02252|03/29/2022|.02197|03/29/2022|.02212|03/29/2022|||BETA-BLOCKERS|13024|||||No|No||TRUPHARMA, LLC.|No||||
metoprolol tartrate|No|No|No|No|75%|52817036200|METOPROLOL TARTRATE 100 MG TAB|1000|EA|.01012|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|No||070|No|.03443|03/29/2022|.0336|03/29/2022|.03382|03/29/2022|||BETA-BLOCKERS|13025|||||No|No||TRUPHARMA, LLC.|No||||
metoprolol tartrate|No|No|No|No|75%|52817036210|METOPROLOL TARTRATE 100 MG TAB|100|EA|.01548|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|No||070|No|.03443|03/29/2022|.0336|03/29/2022|.03382|03/29/2022|||BETA-BLOCKERS|13026|||||No|No||TRUPHARMA, LLC.|No||||
triamterene|No|No|No|No|75%|52817036410|TRIAMTERENE 50 MG CAPSULE|100|EA|3.8485|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No|||No|8.72044|09/28/2021|8.51114|09/28/2021|8.56783|09/28/2021||||13027|||||No|No||TRUPHARMA, LLC.|No||||
triamterene|No|No|No|No|75%|52817036510|TRIAMTERENE 100 MG CAPSULE|100|EA|3.8485|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No|||No|8.771|03/03/2020|8.6457|03/03/2020|8.234|03/03/2020||||13028|||||No|No||TRUPHARMA, LLC.|No||||
ethacrynic acid|No|No|No|No|75%|52817036790|ETHACRYNIC ACID 25 MG TABLET|90|EA|1.075|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No|||No|2.34378|03/01/2022|2.28752|03/01/2022|2.30276|03/01/2022||||13029|||||No|No||TRUPHARMA, LLC.|No||||
clotrimazole|No|No|No|No|75%|52817080030|CLOTRIMAZOLE 1% SOLUTION|30|ML|.688|02/28/2020||Yes|No||02/28/2020||Yes|No|02/28/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|061|No|.9845|03/29/2022|.96087|03/29/2022|.96727|03/29/2022|||ANTIFUNGALS: TOPICAL|13030|||||No|No||TRUPHARMA, LLC.|No||||
aminocaproic acid|No|No|No|No|75%|52817081508|AMINOCAPROIC ACID 0.25 GRAM/ML|236.5|ML|2.04143|04/22/2021||Yes|No||04/22/2021||Yes|No|04/22/2021||Yes|No||||No|No|||Prescription required|No|||No|2.94206|04/22/2021|2.90003|04/22/2021|2.76194|04/22/2021||||13031|||||No|No||TRUPHARMA, LLC.|No||||
acetic acid|No|No|No|No|75%|52817081615|ACETIC ACID 2% EAR SOLUTION|15|ML|.80266|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No||150|No|1.3438|03/29/2022|1.31154|03/29/2022|1.32028|03/29/2022|||OTIC ANTI-INFECTIVES & ANESTHETICS|13032|||||No|No||TRUPHARMA, LLC.|No||||
deflazacort|No|No|No|No|75%|52856050101|EMFLAZA 6 MG TABLET|100|EA|30.89201|11/02/2018||Yes|No||11/02/2018||Yes|No|11/02/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|168|Yes|70.40506|01/18/2022|69.39927|01/18/2022|66.09454|01/18/2022|||GLUCOCORTICOIDS: ORAL|13033|||||No|No||PTC THERAPEUTIC|No||||
deflazacort|No|No|No|No|75%|52856050203|EMFLAZA 18 MG TABLET|30|EA|92.67847|11/02/2018||Yes|No||11/02/2018||Yes|No|11/02/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|168|Yes|211.2207|01/18/2022|208.20326|01/18/2022|198.28882|01/18/2022|||GLUCOCORTICOIDS: ORAL|13034|||||No|No||PTC THERAPEUTIC|No||||
deflazacort|No|No|No|No|75%|52856050303|EMFLAZA 30 MG TABLET|30|EA|154.47191|11/02/2018||Yes|No||11/02/2018||Yes|No|11/02/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|168|Yes|352.05226|01/18/2022|347.02294|01/18/2022|330.49804|01/18/2022|||GLUCOCORTICOIDS: ORAL|13035|||||No|No||PTC THERAPEUTIC|No||||
deflazacort|No|No|No|No|75%|52856050403|EMFLAZA 36 MG TABLET|30|EA|178.81879|11/02/2018||Yes|No||11/02/2018||Yes|No|11/02/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|168|Yes|407.5405|01/18/2022|401.71849|01/18/2022|382.58904|01/18/2022|||GLUCOCORTICOIDS: ORAL|13036|||||No|No||PTC THERAPEUTIC|No||||
deflazacort|No|No|No|No|75%|52856050521|EMFLAZA 22.75 MG/ML ORAL SUSP|13|ML|120.2323|11/02/2018|02/22/2022|Yes|No||11/02/2018|02/22/2022|Yes|No|11/02/2018|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|01/25/2018|168|Yes|274.0178|01/07/2020|270.10326|01/07/2020|257.2412|01/07/2020|||GLUCOCORTICOIDS: ORAL|13037|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||PTC THERAPEUTIC|No||||
deflazacort|No|No|No|No|75%|52856050522|EMFLAZA 22.75 MG/ML ORAL SUSP|13|ML|156.54976|12/30/2019||Yes|No||12/30/2019||Yes|No|12/30/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|168|Yes|356.78784|01/18/2022|351.69087|01/18/2022|334.94369|01/18/2022|||GLUCOCORTICOIDS: ORAL|13038|||||No|No||PTC THERAPEUTIC|No||||
icosapent ethyl|No|No|No|No|75%|52937000120|VASCEPA 1 GM CAPSULE|120|EA|1.27046|04/04/2013||Yes|No||04/04/2013||Yes|No|04/04/2013||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|055|No|2.83737|01/11/2022|2.76927|01/11/2022|2.78771|01/11/2022|||LIPOTROPICS: OTHER|13039|||||No|No||AMARIN PHARMA I|No||||
dronabinol|No|No|No|No|75%|53097056860|MARINOL 2.5 MG CAPSULE|60|EA|4.97674|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|085|No|11.34235|09/23/2020|11.18031|09/23/2020|10.64792|09/23/2020|||ANTIEMETIC/ANTIVERTIGO AGENTS|13040|||||No|No||THEPHARMANETWOR|No||||
dronabinol|No|No|No|No|75%|53097056960|MARINOL 5 MG CAPSULE|60|EA|10.35784|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|085|No|23.60624|11/24/2020|23.269|11/24/2020|22.16096|11/24/2020|||ANTIEMETIC/ANTIVERTIGO AGENTS|13041|||||No|No||THEPHARMANETWOR|No||||
dronabinol|No|No|No|No|75%|53097057060|MARINOL 10 MG CAPSULE|60|EA|19.02068|03/05/2021||Yes|No||03/05/2021||Yes|No|03/05/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|085|No|43.34947|03/05/2021|42.73019|03/05/2021|40.69542|03/05/2021|||ANTIEMETIC/ANTIVERTIGO AGENTS|13042|||||No|No||THEPHARMANETWOR|No||||
patiromer calcium sorbitex|No|No|No|No|75%|53436008404|VELTASSA 8.4 GM POWDER PACKET|4|EA|18.04925|12/22/2015||Yes|No||12/22/2015||Yes|No|12/22/2015||Yes|No||||No|No|||Prescription required|No|||No|40.32636|04/13/2021|39.35852|04/13/2021|39.62064|04/13/2021||||13043|||||No|No||RELYPSA/VIFOR P|No||||
patiromer calcium sorbitex|No|No|No|No|75%|53436008430|VELTASSA 8.4 GM POWDER PACKET|30|EA|13.50716|12/22/2015||Yes|No||12/22/2015||Yes|No|12/22/2015||Yes|No||||No|No|||Prescription required|No|||No|30.1993|01/25/2022|29.47451|01/25/2022|29.67081|01/25/2022||||13044|||||No|No||RELYPSA/VIFOR P|No||||
patiromer calcium sorbitex|No|No|No|No|75%|53436016830|VELTASSA 16.8 GM POWDER PACKET|30|EA|13.50716|12/22/2015||Yes|No||12/22/2015||Yes|No|12/22/2015||Yes|No||||No|No|||Prescription required|No|||No|30.17327|01/25/2022|29.44911|01/25/2022|29.64523|01/25/2022||||13045|||||No|No||RELYPSA/VIFOR P|No||||
patiromer calcium sorbitex|No|No|No|No|75%|53436025230|VELTASSA 25.2 GM POWDER PACKET|30|EA|13.50716|12/22/2015||Yes|No||12/22/2015||Yes|No|12/22/2015||Yes|No||||No|No|||Prescription required|No|||No|30.78376|04/06/2021|30.34399|04/06/2021|28.89904|04/06/2021||||13046|||||No|No||RELYPSA/VIFOR P|No||||
gabapentin enacarbil|No|No|No|No|75%|53451010101|HORIZANT ER 600 MG TABLET|30|EA|6.48167|10/03/2014||Yes|No||10/03/2014||Yes|No|10/03/2014||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|232|Yes|14.40925|01/04/2022|14.06342|01/04/2022|14.15708|01/04/2022|||NEUROPATHIC PAIN|13047|||||No|No||XENOPORT/ARBOR|No||||
gabapentin enacarbil|No|No|No|No|75%|53451010301|HORIZANT ER 300 MG TABLET|30|EA|6.48167|10/03/2014||Yes|No||10/03/2014||Yes|No|10/03/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|232|Yes|14.45243|01/04/2022|14.10557|01/04/2022|14.19951|01/04/2022|||NEUROPATHIC PAIN|13048|||||No|No||XENOPORT/ARBOR|No||||
doxycycline hyclate|No|No|No|No|75%|53489011802|DOXYCYCLINE HYCLATE 50 MG CAP|50|EA|.34881|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||213|No|.2526|03/29/2022|.24653|03/29/2022|.24817|03/29/2022|||TETRACYCLINES|13049|||||No|No||SUN PHARMACEUTI|No||||
doxycycline hyclate|No|No|No|No|75%|53489011805|DOXYCYCLINE HYCLATE 50 MG CAP|500|EA|.34881|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||213|No|.2526|03/29/2022|.24653|03/29/2022|.24817|03/29/2022|||TETRACYCLINES|13050|||||No|No||SUN PHARMACEUTI|No||||
doxycycline hyclate|Yes|No|No|No|75%|53489011902|DOXYCYCLINE HYCLATE 100 MG CAP|50|EA|.52924|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|11/01/2012||Prescription required|No||213|No|.14255|03/29/2022|.13912|03/29/2022|.14005|03/29/2022|||TETRACYCLINES|13051|||||No|No||SUN PHARMACEUTI|No||||
doxycycline hyclate|Yes|No|No|No|75%|53489011905|DOXYCYCLINE HYCLATE 100 MG CAP|500|EA|.52922|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|11/01/2012||Prescription required|No||213|No|.14255|03/29/2022|.13912|03/29/2022|.14005|03/29/2022|||TETRACYCLINES|13052|||||No|No||SUN PHARMACEUTI|No||||
doxycycline hyclate|Yes|No|No|No|75%|53489012002|DOXYCYCLINE HYCLATE 100 MG TAB|50|EA|.52924|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|11/01/2012||Prescription required|Yes|01/22/2015|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|13053|||||No|No||SUN PHARMACEUTI|No||||
doxycycline hyclate|Yes|No|No|No|75%|53489012005|DOXYCYCLINE HYCLATE 100 MG TAB|500|EA|.52922|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|11/01/2012||Prescription required|Yes|01/22/2015|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|13054|||||No|No||SUN PHARMACEUTI|No||||
quinidine gluconate|No|No|No|No|75%|53489014101|QUINIDINE GLUC ER 324 MG TAB|100|EA|3.1175|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|7.105|06/01/2016|7.0035|06/01/2016|6.67|06/01/2016||||13055|||||No|No||MUTUAL PHARM CO|No||||
spironolactone|No|No|No|No|75%|53489014301|SPIRONOLACTONE 25 MG TABLET|100|EA|.04355|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||13056|||||No|No||MUTUAL PHARM CO|No||||
spironolactone|No|No|No|No|75%|53489014305|SPIRONOLACTONE 25 MG TABLET|500|EA|.04053|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||13057|||||No|No||MUTUAL PHARM CO|No||||
spironolactone|No|No|No|No|75%|53489014310|SPIRONOLACTONE 25 MG TABLET|1000|EA|.04042|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||13058|||||No|No||SUN PHARMACEUTI|No||||
spironolact/hydrochlorothiazid|No|No|No|No|75%|53489014401|SPIRONOLACTONE-HCTZ 25-25 TAB|100|EA|.5246|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|.6635|03/29/2022|.64757|03/29/2022|.65188|03/29/2022||||13059|||||No|No||MUTUAL PHARM CO|No||||
spironolact/hydrochlorothiazid|No|No|No|No|75%|53489014405|SPIRONOLACTONE-HCTZ 25-25 TAB|500|EA|.5246|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|.6635|03/29/2022|.64757|03/29/2022|.65188|03/29/2022||||13060|||||No|No||MUTUAL PHARM CO|No||||
spironolact/hydrochlorothiazid|No|No|No|No|75%|53489014410|SPIRONOLACTONE-HCTZ 25-25 TAB|1000|EA|.5246|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|.6635|03/29/2022|.64757|03/29/2022|.65188|03/29/2022||||13061|||||No|No||MUTUAL PHARM CO|No||||
sulfamethoxazole/trimethoprim|Yes|No|No|No|75%|53489014501|SULFAMETHOXAZOLE-TMP SS TABLET|100|EA|.08165|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.07038|03/29/2022|.06869|03/29/2022|.06914|03/29/2022||||13062|||||No|No||MUTUAL PHARM CO|No||||
sulfamethoxazole/trimethoprim|Yes|No|No|No|75%|53489014505|SULFAMETHOXAZOLE-TMP SS TABLET|500|EA|.0775|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.07038|03/29/2022|.06869|03/29/2022|.06914|03/29/2022||||13063|||||No|No||MUTUAL PHARM CO|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|53489014601|SULFAMETHOXAZOLE-TMP DS TABLET|100|EA|.1087|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.06566|03/29/2022|.06408|03/29/2022|.06451|03/29/2022||||13064|||||No|No||MUTUAL PHARM CO|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|53489014605|SULFAMETHOXAZOLE-TMP DS TABLET|500|EA|.10332|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.06566|03/29/2022|.06408|03/29/2022|.06451|03/29/2022||||13065|||||No|No||MUTUAL PHARM CO|No||||
thioridazine HCl|No|No|No|No|75%|53489014801|THIORIDAZINE 10 MG TABLET|100|EA|.14641|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.33369|08/27/2019|.32892|08/27/2019|.31326|08/27/2019|||ANTIPSYCHOTICS|13066|||||No|No||MUTUAL PHARM CO|No||||
thioridazine HCl|No|No|No|No|75%|53489014810|THIORIDAZINE 10 MG TABLET|1000|EA|.14641|07/30/2007||Yes|No||07/30/2007||Yes|No|07/30/2007||Yes|No||||No|No|||Prescription required|No||027|Yes|.33369|08/27/2019|.32892|08/27/2019|.31326|08/27/2019|||ANTIPSYCHOTICS|13067|||||No|No||MUTUAL PHARM CO|No||||
thioridazine HCl|No|No|No|No|75%|53489014901|THIORIDAZINE 25 MG TABLET|100|EA|.20601|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.46951|11/23/2021|.46281|11/23/2021|.44077|11/23/2021|||ANTIPSYCHOTICS|13068|||||No|No||MUTUAL PHARM CO|No||||
thioridazine HCl|No|No|No|No|75%|53489014910|THIORIDAZINE 25 MG TABLET|1000|EA|.20601|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.46951|11/23/2021|.46281|11/23/2021|.44077|11/23/2021|||ANTIPSYCHOTICS|13069|||||No|No||MUTUAL PHARM CO|No||||
thioridazine HCl|No|No|No|No|75%|53489015001|THIORIDAZINE 50 MG TABLET|100|EA|.25761|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.58711|10/27/2020|.57873|10/27/2020|.55117|10/27/2020|||ANTIPSYCHOTICS|13070|||||No|No||MUTUAL PHARM CO|No||||
thioridazine HCl|No|No|No|No|75%|53489015010|THIORIDAZINE 50 MG TABLET|1000|EA|.25761|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.58711|10/27/2020|.57873|10/27/2020|.55117|10/27/2020|||ANTIPSYCHOTICS|13071|||||No|No||MUTUAL PHARM CO|No||||
allopurinol|No|No|No|No|75%|53489015601|ALLOPURINOL 100 MG TABLET|100|EA|.0488|01/04/2016||Yes|No||01/04/2016||Yes|No|01/04/2016||Yes|No||01/04/2016||Yes|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|13072|||||No|No||SUN PHARMACEUTI|No||||
allopurinol|No|No|No|No|75%|53489015605|ALLOPURINOL 100 MG TABLET|500|EA|.04879|01/04/2016||Yes|No||01/04/2016||Yes|No|01/04/2016||Yes|No||01/04/2016||Yes|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|13073|||||No|No||SUN PHARMACEUTI|No||||
allopurinol|No|No|No|No|75%|53489015610|ALLOPURINOL 100 MG TABLET|1000|EA|.04879|01/04/2016||Yes|No||01/04/2016||Yes|No|01/04/2016||Yes|No||01/04/2016||Yes|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|13074|||||No|No||SUN PHARMACEUTI|No||||
allopurinol|No|No|No|No|75%|53489015701|ALLOPURINOL 300 MG TABLET|100|EA|.09804|01/04/2016||Yes|No||01/04/2016||Yes|No|01/04/2016||Yes|No||01/04/2016||Yes|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|13075|||||No|No||SUN PHARMACEUTI|No||||
allopurinol|No|No|No|No|75%|53489015705|ALLOPURINOL 300 MG TABLET|500|EA|.09805|01/07/2016||Yes|No||01/07/2016||Yes|No|01/07/2016||Yes|No||01/07/2016||Yes|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|13076|||||No|No||SUN PHARMACEUTI|No||||
allopurinol|No|No|No|No|75%|53489015710|ALLOPURINOL 300 MG TABLET|1000|EA|.09805|01/07/2016||Yes|No||01/07/2016||Yes|No|01/07/2016||Yes|No||01/07/2016||Yes|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|13077|||||No|No||SUN PHARMACEUTI|No||||
albuterol sulfate|No|No|No|No|75%|53489017601|ALBUTEROL SULFATE 2 MG TAB|100|EA|.258|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|037|No|.67057|07/27/2021|.65447|07/27/2021|.65883|07/27/2021|||BRONCHODILATORS: BETA AGONIST|13078|||||No|No||MUTUAL PHARM CO|Yes|09/01/2020|||
albuterol sulfate|No|No|No|No|75%|53489017605|ALBUTEROL SULFATE 2 MG TAB|500|EA|.8084|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|037|No|.67057|07/27/2021|.65447|07/27/2021|.65883|07/27/2021|||BRONCHODILATORS: BETA AGONIST|13079|||||No|No||MUTUAL PHARM CO|No||||
albuterol sulfate|No|No|No|No|75%|53489017701|ALBUTEROL SULFATE 4 MG TAB|100|EA|.258|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|037|No|1.0884|03/01/2022|1.06227|03/01/2022|1.06935|03/01/2022|||BRONCHODILATORS: BETA AGONIST|13080|||||No|No||MUTUAL PHARM CO|No||||
albuterol sulfate|No|No|No|No|75%|53489017705|ALBUTEROL SULFATE 4 MG TAB|500|EA|.8084|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|037|No|1.0884|03/01/2022|1.06227|03/01/2022|1.06935|03/01/2022|||BRONCHODILATORS: BETA AGONIST|13081|||||No|No||MUTUAL PHARM CO|No||||
clonidine HCl|No|No|No|No|75%|53489021501|CLONIDINE HCL 0.1 MG TABLET|100|EA|.0301|08/09/2005||Yes|No||08/09/2005||Yes|No|08/09/2005||Yes|No||01/01/2012||Yes|No|||Prescription required|No||166|No|.03029|03/29/2022|.02956|03/29/2022|.02975|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|13082|||||No|No||MUTUAL PHARM CO|No||||
clonidine HCl|No|No|No|No|75%|53489021510|CLONIDINE HCL 0.1 MG TABLET|1000|EA|.0224|08/09/2005||Yes|No||08/09/2005||Yes|No|08/09/2005||Yes|No||01/01/2012||Yes|No|||Prescription required|No||166|No|.03029|03/29/2022|.02956|03/29/2022|.02975|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|13083|||||No|No||MUTUAL PHARM CO|No||||
clonidine HCl|No|No|No|No|75%|53489021601|CLONIDINE HCL 0.2 MG TABLET|100|EA|.04042|08/09/2005||Yes|No||08/09/2005||Yes|No|08/09/2005||Yes|No||01/01/2012||Yes|No|||Prescription required|No||166|No|.0396|03/29/2022|.03864|03/29/2022|.0389|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|13084|||||No|No||MUTUAL PHARM CO|No||||
clonidine HCl|No|No|No|No|75%|53489021610|CLONIDINE HCL 0.2 MG TABLET|1000|EA|.03319|08/09/2005||Yes|No||08/09/2005||Yes|No|08/09/2005||Yes|No||01/01/2012||Yes|No|||Prescription required|No||166|No|.0396|03/29/2022|.03864|03/29/2022|.0389|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|13085|||||No|No||MUTUAL PHARM CO|No||||
clonidine HCl|No|No|No|No|75%|53489021701|CLONIDINE HCL 0.3 MG TABLET|100|EA|.05203|08/09/2005||Yes|No||08/09/2005||Yes|No|08/09/2005||Yes|No||01/01/2012||Yes|No|||Prescription required|No||166|No|.03883|03/29/2022|.03789|03/29/2022|.03815|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|13086|||||No|No||MUTUAL PHARM CO|No||||
ergoloid mesylates|No|No|No|No|75%|53489028101|ERGOLOID MESYLATES 1 MG TAB|100|EA|2.78781|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|6.35363|06/01/2016|6.26286|06/01/2016|5.96463|06/01/2016||||13087|||||No|No||MUTUAL PHARM CO|No||||
spironolactone|No|No|No|No|75%|53489032801|SPIRONOLACTONE 50 MG TABLET|100|EA|.12255|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.12042|03/29/2022|.11752|03/29/2022|.11831|03/29/2022||||13088|||||No|No||MUTUAL PHARM CO|No||||
spironolactone|No|No|No|No|75%|53489032805|SPIRONOLACTONE 50 MG TABLET|500|EA|.11886|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.12042|03/29/2022|.11752|03/29/2022|.11831|03/29/2022||||13089|||||No|No||MUTUAL PHARM CO|No||||
spironolactone|No|No|No|No|75%|53489032901|SPIRONOLACTONE 100 MG TABLET|100|EA|.20541|11/19/2004||Yes|No||11/19/2004||Yes|No|11/19/2004||Yes|No||||No|No|||Prescription required|No|||No|.2048|03/29/2022|.19988|03/29/2022|.20121|03/29/2022||||13090|||||No|No||MUTUAL PHARM CO|No||||
spironolactone|No|No|No|No|75%|53489032905|SPIRONOLACTONE 100 MG TABLET|500|EA|.19925|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.2048|03/29/2022|.19988|03/29/2022|.20121|03/29/2022||||13091|||||No|No||MUTUAL PHARM CO|No||||
spironolactone|No|No|No|No|75%|53489032906|SPIRONOLACTONE 100 MG TABLET|60|EA|.20546|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No|||No|.2048|03/29/2022|.19988|03/29/2022|.20121|03/29/2022||||13092|||||No|No||MUTUAL PHARM CO|No||||
spironolactone|No|No|No|No|75%|53489032907|SPIRONOLACTONE 100 MG TABLET|30|EA|.20554|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No|||No|.2048|03/29/2022|.19988|03/29/2022|.20121|03/29/2022||||13093|||||No|No||MUTUAL PHARM CO|No||||
felodipine|Yes|No|No|No|75%|53489036801|FELODIPINE ER 2.5 MG TABLET|100|EA|.46655|12/07/2004||Yes|No||12/07/2004||Yes|No|12/07/2004||Yes|No||12/07/2004||Yes|No|07/01/2016||Prescription required|No||045|Yes|.25478|03/29/2022|.24866|03/29/2022|.25032|03/29/2022|||CALCIUM CHANNEL BLOCKERS|13094|||||No|No||MUTUAL PHARM CO|No||||
felodipine|Yes|No|No|No|75%|53489036901|FELODIPINE ER 5 MG TABLET|100|EA|.46655|12/07/2004||Yes|No||12/07/2004||Yes|No|12/07/2004||Yes|No||12/07/2004||Yes|No|07/01/2016||Prescription required|No||045|Yes|.17388|03/29/2022|.1697|03/29/2022|.17083|03/29/2022|||CALCIUM CHANNEL BLOCKERS|13095|||||No|No||MUTUAL PHARM CO|No||||
felodipine|Yes|No|No|No|75%|53489037001|FELODIPINE ER 10 MG TABLET|100|EA|.83841|12/07/2004||Yes|No||12/07/2004||Yes|No|12/07/2004||Yes|No||12/07/2004||Yes|No|07/01/2016||Prescription required|No||045|No|.22814|03/29/2022|.22266|03/29/2022|.22414|03/29/2022|||CALCIUM CHANNEL BLOCKERS|13096|||||No|No||MUTUAL PHARM CO|No||||
nystatin|No|No|No|No|75%|53489040001|NYSTATIN 500,000 UNIT ORAL TAB|100|EA|.4515|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||069|No|.33632|03/29/2022|.32824|03/29/2022|.33043|03/29/2022|||ANTIFUNGALS: ORAL|13097|||||No|No||MUTUAL PHARM CO|No||||
sulindac|No|No|No|No|75%|53489047801|SULINDAC 150 MG TABLET|100|EA|.09511|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.17191|03/29/2022|.16778|03/29/2022|.1689|03/29/2022|||NSAIDS|13098|||||No|No||MUTUAL PHARM CO|No||||
sulindac|No|No|No|No|75%|53489047805|SULINDAC 150 MG TABLET|500|EA|.0856|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.17191|03/29/2022|.16778|03/29/2022|.1689|03/29/2022|||NSAIDS|13099|||||No|No||MUTUAL PHARM CO|No||||
sulindac|No|No|No|No|75%|53489047901|SULINDAC 200 MG TABLET|100|EA|.12298|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.24702|03/29/2022|.24109|03/29/2022|.24269|03/29/2022|||NSAIDS|13100|||||No|No||MUTUAL PHARM CO|No||||
sulindac|No|No|No|No|75%|53489047905|SULINDAC 200 MG TABLET|500|EA|.11068|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.24702|03/29/2022|.24109|03/29/2022|.24269|03/29/2022|||NSAIDS|13101|||||No|No||MUTUAL PHARM CO|No||||
thioridazine HCl|No|No|No|No|75%|53489050001|THIORIDAZINE 100 MG TABLET|100|EA|.29338|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.66865|01/29/2019|.6591|01/29/2019|.62771|01/29/2019|||ANTIPSYCHOTICS|13102|||||No|No||MUTUAL PHARM CO|No||||
tolmetin sodium|No|No|No|No|75%|53489050601|TOLMETIN SODIUM 200 MG TAB|100|EA|.258|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/12/2005|059|Yes|.588|06/01/2016|.5796|06/01/2016|.552|06/01/2016|||NSAIDS|13103|||||No|No||MUTUAL PHARM CO|No||||
trazodone HCl|No|No|No|No|75%|53489051001|TRAZODONE 50 MG TABLET|100|EA|.02859|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||031|No|.03855|03/29/2022|.03762|03/29/2022|.03787|03/29/2022|||ANTIDEPRESSANTS: OTHER|13104|||||No|No||MUTUAL PHARM CO|No||||
trazodone HCl|No|No|No|No|75%|53489051101|TRAZODONE 100 MG TABLET|100|EA|.0531|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||031|No|.07015|03/29/2022|.06846|03/29/2022|.06892|03/29/2022|||ANTIDEPRESSANTS: OTHER|13105|||||No|No||MUTUAL PHARM CO|No||||
trazodone HCl|No|No|No|No|75%|53489051701|TRAZODONE 150 MG TABLET|100|EA|.15523|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||031|No|.1311|03/29/2022|.12795|03/29/2022|.1288|03/29/2022|||ANTIDEPRESSANTS: OTHER|13106|||||No|No||MUTUAL PHARM CO|No||||
propafenone HCl|No|No|No|No|75%|53489055101|PROPAFENONE HCL 150 MG TABLET|100|EA|.31673|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.14292|03/29/2022|.13948|03/29/2022|.14041|03/29/2022||||13107|||||No|No||MUTUAL PHARM CO|No||||
propafenone HCl|No|No|No|No|75%|53489055201|PROPAFENONE HCL 225 MG TAB|100|EA|.44788|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.20774|03/29/2022|.20275|03/29/2022|.2041|03/29/2022||||13108|||||No|No||MUTUAL PHARM CO|No||||
propafenone HCl|No|No|No|No|75%|53489055301|PROPAFENONE HCL 300 MG TAB|100|EA|.80895|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.57288|01/25/2022|.55913|01/25/2022|.56285|01/25/2022||||13109|||||No|No||MUTUAL PHARM CO|No||||
doxycycline hyclate|No|No|No|No|75%|53489064701|DOXYCYCLINE HYCLATE 20 MG TAB|100|EA|.16318|09/27/2006||Yes|No||09/27/2006||Yes|No|09/27/2006||Yes|No||09/27/2006||Yes|No|||Prescription required|Yes|01/22/2015|213|No|.15838|03/29/2022|.15457|03/29/2022|.1556|03/29/2022|||TETRACYCLINES|13110|||||No|No||MUTUAL PHARM CO|No||||
temazepam|No|No|No|No|90%|53489064801|TEMAZEPAM 7.5 MG CAPSULE|100|EA|2.99206|09/24/2009||Yes|No||09/24/2009||Yes|No|09/24/2009||Yes|No||||No|No|||Prescription required|Yes|07/28/2010|054|Yes|1.39989|03/29/2022|1.36629|03/29/2022|1.37539|03/29/2022|||SEDATIVE HYPNOTICS|13111|||||No|No||MUTUAL PHARM CO|No||||
temazepam|No|No|No|No|90%|53489065007|TEMAZEPAM 22.5 MG CAPSULE|30|EA|2.99208|09/24/2009||Yes|No||09/24/2009||Yes|No|09/24/2009||Yes|No||||No|No|||Prescription required|Yes|07/28/2010|054|Yes|2.70743|03/29/2022|2.64245|03/29/2022|2.66004|03/29/2022|||SEDATIVE HYPNOTICS|13112|||||No|No||MUTUAL PHARM CO|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|53746010901|HYDROCODONE-ACETAMIN 5-325 MG|100|EA|.0774|01/13/2009||Yes|No||01/13/2009||Yes|No|01/13/2009||Yes|No||01/01/2012||Yes|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13113|||||No|No||AMNEAL PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|53746010905|HYDROCODONE-ACETAMIN 5-325 MG|500|EA|.0774|01/13/2009||Yes|No||01/13/2009||Yes|No|01/13/2009||Yes|No||01/01/2012||Yes|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13114|||||No|No||AMNEAL PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|53746011001|HYDROCODONE-ACETAMIN 10-325 MG|100|EA|.08815|01/13/2009||Yes|No||01/13/2009||Yes|No|01/13/2009||Yes|No||01/01/2012||Yes|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13115|||||No|No||AMNEAL PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|53746011005|HYDROCODONE-ACETAMIN 10-325 MG|500|EA|.08815|01/13/2009||Yes|No||01/13/2009||Yes|No|01/13/2009||Yes|No||01/01/2012||Yes|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13116|||||No|No||AMNEAL PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|53746011010|HYDROCODONE-ACETAMIN 10-325 MG|1000|EA|.16679|07/15/2010|06/08/2022|Yes|No||07/15/2010|06/08/2022|Yes|No|07/15/2010|06/08/2022|Yes|No||01/01/2012|06/08/2022|Yes|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13117|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||AMNEAL PHARMACE|No||||
hydrocodone/ibuprofen|No|No|No|No|90%|53746011701|HYDROCODONE-IBUPROFEN 10-200|100|EA|1.618|11/06/2012||Yes|No||11/06/2012||Yes|No|11/06/2012||Yes|No||||No|No|||Prescription required|No||109|Yes|3.42647|03/01/2022|3.34423|03/01/2022|3.3665|03/01/2022|||ANALGESICS: NARCOTICS SHORT|13118|||||No|No||AMNEAL PHARMACE|No||||
hydrocodone/ibuprofen|No|No|No|No|90%|53746014501|HYDROCODONE-IBUPROFEN 7.5-200|100|EA|.21478|04/30/2007||Yes|No||04/30/2007||Yes|No|04/30/2007||Yes|No||01/01/2012||Yes|No|||Prescription required|No||109|Yes|.19819|03/29/2022|.19343|03/29/2022|.19472|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13119|||||No|No||AMNEAL PHARMACE|No||||
hydrocodone/ibuprofen|No|No|No|No|90%|53746014601|HYDROCODONE-IBUPROFEN 5-200 MG|100|EA|1.22679|11/06/2012||Yes|No||11/06/2012||Yes|No|11/06/2012||Yes|No||||No|No|||Prescription required|No||109|Yes|2.79594|08/29/2017|2.75599|08/29/2017|2.62476|08/29/2017|||ANALGESICS: NARCOTICS SHORT|13120|||||No|No||AMNEAL PHARMACE|No||||
memantine HCl|No|No|No|No|75%|53746016960|MEMANTINE HCL 10 MG TABLET|60|EA|.08578|03/18/2021||Yes|No||03/18/2021||Yes|No|03/18/2021||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|13121|||||No|No||AMNEAL PHARMACE|No||||
memantine HCl|No|No|No|No|75%|53746017360|MEMANTINE HCL 5 MG TABLET|60|EA|.08578|09/10/2015||Yes|No||09/10/2015||Yes|No|09/10/2015||Yes|No||||No|No|||Prescription required|No||011|No|.08825|03/29/2022|.08613|03/29/2022|.0867|03/29/2022|||ALZHEIMER'S AGENTS|13122|||||No|No||AMNEAL PHARMACE|No||||
naproxen|No|No|No|No|75%|53746019010|NAPROXEN 500 MG TABLET|1000|EA|.04327|06/02/2010|09/30/2022|Yes|No||06/02/2010|09/30/2022|Yes|No|06/02/2010|09/30/2022|Yes|No||07/01/2012|09/30/2022|Yes|No|||Prescription required|No||059|Yes|.07937|08/27/2019|.07746|08/27/2019|.07798|08/27/2019|||NSAIDS|13123|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||AMNEAL PHARMACE|No||||
naproxen sodium|No|No|No|No|75%|53746019301|NAPROXEN SODIUM 275 MG TAB|100|EA|.258|01/19/2009||Yes|No||01/19/2009||Yes|No|01/19/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|Yes|01/26/2017|059|Yes|.588|03/23/2021|.5796|03/23/2021|.552|03/23/2021|||NSAIDS|13124|||||No|No||AMNEAL PHARMACE|No||||
naproxen sodium|No|No|No|No|75%|53746019401|NAPROXEN SODIUM 550 MG TAB|100|EA|.5891|01/19/2009||Yes|No||01/19/2009||Yes|No|01/19/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|Yes|01/26/2017|059|Yes|.37204|03/29/2022|.36311|03/29/2022|.36552|03/29/2022|||NSAIDS|13125|||||No|No||AMNEAL PHARMACE|No||||
naproxen sodium|No|No|No|No|75%|53746019405|NAPROXEN SODIUM 550 MG TAB|500|EA|.5891|01/19/2009||Yes|No||01/19/2009||Yes|No|01/19/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|Yes|01/26/2017|059|Yes|.37204|03/29/2022|.36311|03/29/2022|.36552|03/29/2022|||NSAIDS|13126|||||No|No||AMNEAL PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|53746020301|OXYCODONE-ACETAMINOPHEN 5-325|100|EA|.0774|01/19/2009||Yes|No||01/19/2009||Yes|No|01/19/2009||Yes|No||01/19/2009||Yes|No|||Prescription required|No||109|Yes|.09091|03/29/2022|.08872|03/29/2022|.08931|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13127|||||No|No||AMNEAL PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|53746020305|OXYCODONE-ACETAMINOPHEN 5-325|500|EA|.0774|01/19/2009||Yes|No||01/19/2009||Yes|No|01/19/2009||Yes|No||01/19/2009||Yes|No|||Prescription required|No||109|Yes|.09091|03/29/2022|.08872|03/29/2022|.08931|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13128|||||No|No||AMNEAL PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|53746020401|OXYCODONE-ACETAMINOPHEN 10-325|100|EA|.21478|01/19/2009||Yes|No||01/19/2009||Yes|No|01/19/2009||Yes|No||01/19/2009||Yes|No|||Prescription required|No||109|Yes|.19233|03/29/2022|.18771|03/29/2022|.18896|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13129|||||No|No||AMNEAL PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|53746020405|OXYCODONE-ACETAMINOPHEN 10-325|500|EA|.21478|09/16/2016||Yes|No||09/16/2016||Yes|No|09/16/2016||Yes|No||09/16/2016||Yes|No|||Prescription required|No||109|Yes|.19233|03/29/2022|.18771|03/29/2022|.18896|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13130|||||No|No||AMNEAL PHARMACE|No||||
sulfamethoxazole/trimethoprim|Yes|No|No|No|75%|53746027101|SULFAMETHOXAZOLE-TMP SS TABLET|100|EA|.07998|01/12/2022||Yes|No||01/12/2022||Yes|No|01/12/2022||Yes|No||01/12/2022||Yes|No|01/12/2022||Prescription required|No|||No|.18228|08/31/2021|.17967|08/31/2021|.17112|08/31/2021||||13131|||||No|No||AMNEAL PHARMACE|No||||
sulfamethoxazole/trimethoprim|Yes|No|No|No|75%|53746027105|SULFAMETHOXAZOLE-TMP SS TABLET|500|EA|.07998|01/12/2022||Yes|No||01/12/2022||Yes|No|01/12/2022||Yes|No||01/12/2022||Yes|No|01/12/2022||Prescription required|No|||No|.07038|03/29/2022|.06869|03/29/2022|.06914|03/29/2022||||13132|||||No|No||AMNEAL PHARMACE|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|53746027201|SULFAMETHOXAZOLE-TMP DS TABLET|100|EA|.086|01/12/2022||Yes|No||01/12/2022||Yes|No|01/12/2022||Yes|No||01/12/2022||Yes|No|||Prescription required|No|||No|.06566|03/29/2022|.06408|03/29/2022|.06451|03/29/2022||||13133|||||No|No||AMNEAL PHARMACE|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|53746027205|SULFAMETHOXAZOLE-TMP DS TABLET|500|EA|.086|01/12/2022||Yes|No||01/12/2022||Yes|No|01/12/2022||Yes|No||01/12/2022||Yes|No|||Prescription required|No|||No|.06566|03/29/2022|.06408|03/29/2022|.06451|03/29/2022||||13134|||||No|No||AMNEAL PHARMACE|No||||
spironolactone|No|No|No|No|75%|53746051101|SPIRONOLACTONE 25 MG TABLET|100|EA|.05387|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||13135|||||No|No||AMNEAL PHARMACE|No||||
spironolactone|No|No|No|No|75%|53746051105|SPIRONOLACTONE 25 MG TABLET|500|EA|.05387|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||13136|||||No|No||AMNEAL PHARMACE|No||||
spironolactone|No|No|No|No|75%|53746051110|SPIRONOLACTONE 25 MG TABLET|1000|EA|.05387|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||13137|||||No|No||AMNEAL PHARMACE|No||||
spironolactone|No|No|No|No|75%|53746051401|SPIRONOLACTONE 50 MG TABLET|100|EA|.12753|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||||No|No|||Prescription required|No|||No|.12042|03/29/2022|.11752|03/29/2022|.11831|03/29/2022||||13138|||||No|No||AMNEAL PHARMACE|No||||
spironolactone|No|No|No|No|75%|53746051405|SPIRONOLACTONE 50 MG TABLET|500|EA|.12753|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||||No|No|||Prescription required|No|||No|.12042|03/29/2022|.11752|03/29/2022|.11831|03/29/2022||||13139|||||No|No||AMNEAL PHARMACE|No||||
spironolactone|No|No|No|No|75%|53746051501|SPIRONOLACTONE 100 MG TABLET|100|EA|.22815|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||||No|No|||Prescription required|No|||No|.2048|03/29/2022|.19988|03/29/2022|.20121|03/29/2022||||13140|||||No|No||AMNEAL PHARMACE|No||||
spironolactone|No|No|No|No|75%|53746051505|SPIRONOLACTONE 100 MG TABLET|500|EA|.22815|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||||No|No|||Prescription required|No|||No|.2048|03/29/2022|.19988|03/29/2022|.20121|03/29/2022||||13141|||||No|No||AMNEAL PHARMACE|No||||
potassium chloride|No|No|No|No|75%|53746054201|POTASSIUM CL ER 10 MEQ CAPSULE|100|EA|.1075|01/20/2015||Yes|No||01/20/2015||Yes|No|01/20/2015||Yes|No||01/20/2015||Yes|No|||Prescription required|No|||No|.15494|03/29/2022|.15122|03/29/2022|.15222|03/29/2022||||13142|||||No|No||AMNEAL PHARMACE|No||||
potassium chloride|No|No|No|No|75%|53746054205|POTASSIUM CL ER 10 MEQ CAPSULE|500|EA|.1075|01/20/2015||Yes|No||01/20/2015||Yes|No|01/20/2015||Yes|No||01/20/2015||Yes|No|||Prescription required|No|||No|.15494|03/29/2022|.15122|03/29/2022|.15222|03/29/2022||||13143|||||No|No||AMNEAL PHARMACE|No||||
potassium chloride|No|No|No|No|75%|53746054210|POTASSIUM CL ER 10 MEQ CAPSULE|1000|EA|.1075|01/20/2015||Yes|No||01/20/2015||Yes|No|01/20/2015||Yes|No||01/20/2015||Yes|No|||Prescription required|No|||No|.15494|03/29/2022|.15122|03/29/2022|.15222|03/29/2022||||13144|||||No|No||AMNEAL PHARMACE|No||||
primidone|No|No|No|No|75%|53746054401|PRIMIDONE 50 MG TABLET|100|EA|.11038|11/20/2017||Yes|No||11/20/2017||Yes|No|11/20/2017||Yes|No||||No|No|||Prescription required|No||056|No|.16327|03/29/2022|.15935|03/29/2022|.16041|03/29/2022|||ANTICONVULSANTS|13145|||||No|No||AMNEAL PHARMACE|No||||
primidone|No|No|No|No|75%|53746054405|PRIMIDONE 50 MG TABLET|500|EA|.09066|11/20/2017||Yes|No||11/20/2017||Yes|No|11/20/2017||Yes|No||||No|No|||Prescription required|No||056|No|.16327|03/29/2022|.15935|03/29/2022|.16041|03/29/2022|||ANTICONVULSANTS|13146|||||No|No||AMNEAL PHARMACE|No||||
primidone|No|No|No|No|75%|53746054501|PRIMIDONE 250 MG TABLET|100|EA|.15557|11/20/2017||Yes|No||11/20/2017||Yes|No|11/20/2017||Yes|No||||No|No|||Prescription required|No||056|No|.31086|03/29/2022|.30339|03/29/2022|.30541|03/29/2022|||ANTICONVULSANTS|13147|||||No|No||AMNEAL PHARMACE|No||||
tramadol HCl/acetaminophen|No|No|No|No|90%|53746061701|TRAMADOL-ACETAMINOPHN 37.5-325|100|EA|.09675|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||||No|No|||Prescription required|No||109|Yes|.11806|03/29/2022|.11522|03/29/2022|.11599|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13148|||||No|No||AMNEAL PHARMACE|No||||
tramadol HCl/acetaminophen|No|No|No|No|90%|53746061705|TRAMADOL-ACETAMINOPHN 37.5-325|500|EA|.09675|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|No||109|Yes|.11806|03/29/2022|.11522|03/29/2022|.11599|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13149|||||No|No||AMNEAL PHARMACE|No||||
tramadol HCl/acetaminophen|No|No|No|No|90%|53746061710|TRAMADOL-ACETAMINOPHN 37.5-325|1000|EA|.09675|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||||No|No|||Prescription required|No||109|Yes|.11806|03/29/2022|.11522|03/29/2022|.11599|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13150|||||No|No||AMNEAL PHARMACE|No||||
flecainide acetate|No|No|No|No|75%|53746064101|FLECAINIDE ACETATE 50 MG TAB|100|EA|.14809|03/19/2018||Yes|No||03/19/2018||Yes|No|03/19/2018||Yes|No||||No|No|||Prescription required|No|||No|.15465|03/29/2022|.15093|03/29/2022|.15194|03/29/2022||||13151|||||No|No||AMNEAL PHARMACE|No||||
flecainide acetate|No|No|No|No|75%|53746064201|FLECAINIDE ACETATE 100 MG TAB|100|EA|.24196|03/19/2018||Yes|No||03/19/2018||Yes|No|03/19/2018||Yes|No||||No|No|||Prescription required|No|||No|.24778|03/29/2022|.24183|03/29/2022|.24344|03/29/2022||||13152|||||No|No||AMNEAL PHARMACE|No||||
flecainide acetate|No|No|No|No|75%|53746064301|FLECAINIDE ACETATE 150 MG TAB|100|EA|.33247|03/19/2018||Yes|No||03/19/2018||Yes|No|03/19/2018||Yes|No||||No|No|||Prescription required|No|||No|.41264|03/29/2022|.40273|03/29/2022|.40541|03/29/2022||||13153|||||No|No||AMNEAL PHARMACE|No||||
acebutolol HCl|No|No|No|No|75%|53746066901|ACEBUTOLOL 200 MG CAPSULE|100|EA|.2795|03/06/2018||Yes|No||03/06/2018||Yes|No|03/06/2018||Yes|No||03/06/2018||Yes|No|||Prescription required|No||070|No|.55991|03/29/2022|.54647|03/29/2022|.55011|03/29/2022|||BETA-BLOCKERS|13154|||||No|No||AMNEAL PHARMACE|No||||
acebutolol HCl|No|No|No|No|75%|53746067001|ACEBUTOLOL 400 MG CAPSULE|100|EA|.3698|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||08/28/2018||Yes|No|||Prescription required|No||070|No|.76216|08/24/2021|.74386|08/24/2021|.74882|08/24/2021|||BETA-BLOCKERS|13155|||||No|No||AMNEAL PHARMACE|No||||
anagrelide HCl|No|No|No|No|75%|54092006301|AGRYLIN 0.5 MG CAPSULE|100|EA|3.55567|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|8.10362|06/01/2016|7.98785|06/01/2016|7.60748|06/01/2016||||13156|||||No|No||SHIRE US INC.|No||||
mesalamine|No|No|No|No|75%|54092010001|MESALAMINE DR 1.2 GM TABLET|120|EA|3.62256|11/22/2017||Yes|No||11/22/2017||Yes|No|11/22/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|010|No|2.75392|03/29/2022|2.68782|03/29/2022|2.70572|03/29/2022|||ULCERATIVE COLITIS AGENTS|13157|||||No|No||SHIRE US INC.|No||||
carbamazepine|No|No|No|No|75%|54092017112|CARBATROL ER 100 MG CAPSULE|120|EA|.76231|01/27/2004||Yes|No||01/27/2004||Yes|No|01/27/2004||Yes|No||||No|No|||Prescription required|No||056|No|1.73737|06/01/2016|1.71255|06/01/2016|1.631|06/01/2016|||ANTICONVULSANTS|13158|||||No|No||SHIRE US INC.|No||||
carbamazepine|No|No|No|No|75%|54092017212|CARBATROL ER 200 MG CAPSULE|120|EA|.76231|01/07/2003||Yes|No||01/07/2003||Yes|No|01/07/2003||Yes|No||01/07/2003||Yes|No|||Prescription required|No||056|No|1.6949|03/01/2022|1.65422|03/01/2022|1.66523|03/01/2022|||ANTICONVULSANTS|13159|||||No|No||SHIRE US INC.|No||||
carbamazepine|No|No|No|No|75%|54092017312|CARBATROL ER 300 MG CAPSULE|120|EA|.76231|01/07/2003||Yes|No||01/07/2003||Yes|No|01/07/2003||Yes|No||01/07/2003||Yes|No|||Prescription required|No||056|No|1.68674|03/01/2022|1.64625|03/01/2022|1.65722|03/01/2022|||ANTICONVULSANTS|13160|||||No|No||SHIRE US INC.|No||||
mesalamine|No|No|No|No|75%|54092018981|PENTASA 250 MG CAPSULE|240|EA|1.30556|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|010|No|2.90564|03/01/2022|2.8359|03/01/2022|2.85479|03/01/2022|||ULCERATIVE COLITIS AGENTS|13161|||||No|No||SHIRE US INC.|No||||
mesalamine|No|No|No|No|75%|54092019112|PENTASA 500 MG CAPSULE|120|EA|2.61113|08/09/2007||Yes|No||08/09/2007||Yes|No|08/09/2007||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|010|No|5.81397|10/26/2021|5.67443|10/26/2021|5.71222|10/26/2021|||ULCERATIVE COLITIS AGENTS|13162|||||No|No||SHIRE US INC.|No||||
lanthanum carbonate|No|No|No|No|75%|54092025290|FOSRENOL 500 MG TABLET CHEW|90|EA|5.16295|11/08/2006||Yes|No||11/08/2006||Yes|No|11/08/2006||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|052|Yes|11.76674|06/26/2018|11.59864|06/26/2018|11.04632|06/26/2018|||PHOSPHATE BINDERS|13163|||||No|No||SHIRE US INC.|No||||
lanthanum carbonate|No|No|No|No|75%|54092025390|FOSRENOL 750 MG TABLET CHEW|90|EA|5.16295|12/22/2005||Yes|No||12/22/2005||Yes|No|12/22/2005||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|052|Yes|11.76674|06/13/2017|11.59864|06/13/2017|11.04632|06/13/2017|||PHOSPHATE BINDERS|13164|||||No|No||SHIRE US INC.|No||||
lanthanum carbonate|No|No|No|No|75%|54092025490|FOSRENOL 1,000 MG TABLET CHEW|90|EA|5.16295|12/22/2005||Yes|No||12/22/2005||Yes|No|12/22/2005||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|052|Yes|11.76674|07/24/2018|11.59864|07/24/2018|11.04632|07/24/2018|||PHOSPHATE BINDERS|13165|||||No|No||SHIRE US INC.|No||||
lanthanum carbonate|No|No|No|No|75%|54092025602|FOSRENOL 750 MG POWDER PACKET|90|EA|5.16295|06/10/2015||Yes|No||06/10/2015||Yes|No|06/10/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|052|Yes|11.76674|06/13/2017|11.59864|06/13/2017|11.04632|06/13/2017|||PHOSPHATE BINDERS|13166|||||No|No||SHIRE US INC.|No||||
lanthanum carbonate|No|No|No|No|75%|54092025702|FOSRENOL 1,000 MG POWDER PACK|90|EA|5.16295|06/10/2015||Yes|No||06/10/2015||Yes|No|06/10/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|052|Yes|11.76674|06/13/2017|11.59864|06/13/2017|11.04632|06/13/2017|||PHOSPHATE BINDERS|13167|||||No|No||SHIRE US INC.|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|54092038101|ADDERALL XR 5 MG CAPSULE|100|EA|3.06284|10/05/2009||Yes|No||10/05/2009||Yes|No|10/05/2009||Yes|No||||No|No|||Prescription required|No||007|Yes|6.84106|03/01/2022|6.67687|03/01/2022|6.72134|03/01/2022|||STIMULANTS AND RELATED AGENTS|13168|||||No|No||SHIRE US INC.|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|54092038301|ADDERALL XR 10 MG CAPSULE|100|EA|3.06284|10/05/2009||Yes|No||10/05/2009||Yes|No|10/05/2009||Yes|No||||No|No|||Prescription required|No||007|Yes|6.82921|07/27/2021|6.6653|07/27/2021|6.70969|07/27/2021|||STIMULANTS AND RELATED AGENTS|13169|||||No|No||SHIRE US INC.|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|54092038501|ADDERALL XR 15 MG CAPSULE|100|EA|3.06284|10/05/2009||Yes|No||10/05/2009||Yes|No|10/05/2009||Yes|No||||No|No|||Prescription required|No||007|Yes|6.82744|10/26/2021|6.66358|10/26/2021|6.70795|10/26/2021|||STIMULANTS AND RELATED AGENTS|13170|||||No|No||SHIRE US INC.|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|54092038701|ADDERALL XR 20 MG CAPSULE|100|EA|3.06284|10/05/2009||Yes|No||10/05/2009||Yes|No|10/05/2009||Yes|No||||No|No|||Prescription required|No||007|Yes|6.83467|09/28/2021|6.67063|09/28/2021|6.71506|09/28/2021|||STIMULANTS AND RELATED AGENTS|13171|||||No|No||SHIRE US INC.|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|54092038901|ADDERALL XR 25 MG CAPSULE|100|EA|3.06284|10/05/2009||Yes|No||10/05/2009||Yes|No|10/05/2009||Yes|No||||No|No|||Prescription required|No||007|Yes|6.8158|10/26/2021|6.65222|10/26/2021|6.69652|10/26/2021|||STIMULANTS AND RELATED AGENTS|13172|||||No|No||SHIRE US INC.|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|54092039101|ADDERALL XR 30 MG CAPSULE|100|EA|3.06284|10/06/2009||Yes|No||10/06/2009||Yes|No|10/06/2009||Yes|No||||No|No|||Prescription required|No||007|Yes|6.84585|09/28/2021|6.68154|09/28/2021|6.72604|09/28/2021|||STIMULANTS AND RELATED AGENTS|13173|||||No|No||SHIRE US INC.|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|54092046801|MYDAYIS ER 12.5 MG CAPSULE|100|EA|4.6252|10/04/2017||Yes|No||10/04/2017||Yes|No|10/04/2017||Yes|No||||No|No|||Prescription required|Yes|06/23/2017|007|Yes|10.34935|01/18/2022|10.10096|01/18/2022|10.16823|01/18/2022|||STIMULANTS AND RELATED AGENTS|13174|||||No|No||SHIRE US INC.|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|54092047101|MYDAYIS ER 25 MG CAPSULE|100|EA|4.6252|10/04/2017||Yes|No||10/04/2017||Yes|No|10/04/2017||Yes|No||||No|No|||Prescription required|Yes|06/23/2017|007|Yes|10.30423|01/18/2022|10.05692|01/18/2022|10.1239|01/18/2022|||STIMULANTS AND RELATED AGENTS|13175|||||No|No||SHIRE US INC.|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|54092047401|MYDAYIS ER 37.5 MG CAPSULE|100|EA|4.6252|10/04/2017||Yes|No||10/04/2017||Yes|No|10/04/2017||Yes|No||||No|No|||Prescription required|Yes|06/23/2017|007|Yes|10.41949|01/18/2022|10.16942|01/18/2022|10.23714|01/18/2022|||STIMULANTS AND RELATED AGENTS|13176|||||No|No||SHIRE US INC.|No||||
mesalamine|No|No|No|No|75%|54092047612|LIALDA DR 1.2 GM TABLET|120|EA|4.02504|03/02/2007||Yes|No||03/02/2007||Yes|No|03/02/2007||Yes|No||||No|No|||Prescription required|No||010|No|9.0779|12/28/2021|8.86003|12/28/2021|8.91903|12/28/2021|||ULCERATIVE COLITIS AGENTS|13177|||||No|No||SHIRE US INC.|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|54092047701|MYDAYIS ER 50 MG CAPSULE|100|EA|4.6252|10/04/2017||Yes|No||10/04/2017||Yes|No|10/04/2017||Yes|No||||No|No|||Prescription required|Yes|06/23/2017|007|Yes|10.29917|01/18/2022|10.05198|01/18/2022|10.11893|01/18/2022|||STIMULANTS AND RELATED AGENTS|13178|||||No|No||SHIRE US INC.|No||||
guanfacine HCl|No|No|No|No|75%|54092051302|INTUNIV ER 1 MG TABLET|100|EA|4.17702|10/08/2009||Yes|No||10/08/2009||Yes|No|10/08/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|9.51972|04/25/2017|9.38372|04/25/2017|8.93688|04/25/2017|||STIMULANTS AND RELATED AGENTS|13179|||||No|No||SHIRE US INC.|No||||
guanfacine HCl|No|No|No|No|75%|54092051502|INTUNIV ER 2 MG TABLET|100|EA|4.17702|10/08/2009||Yes|No||10/08/2009||Yes|No|10/08/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|9.51972|04/25/2017|9.38372|04/25/2017|8.93688|04/25/2017|||STIMULANTS AND RELATED AGENTS|13180|||||No|No||SHIRE US INC.|No||||
guanfacine HCl|No|No|No|No|75%|54092051702|INTUNIV ER 3 MG TABLET|100|EA|4.17702|10/08/2009||Yes|No||10/08/2009||Yes|No|10/08/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|9.51972|04/25/2017|9.38372|04/25/2017|8.93688|04/25/2017|||STIMULANTS AND RELATED AGENTS|13181|||||No|No||SHIRE US INC.|No||||
guanfacine HCl|No|No|No|No|75%|54092051902|INTUNIV ER 4 MG TABLET|100|EA|4.17702|10/08/2009||Yes|No||10/08/2009||Yes|No|10/08/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|9.51972|06/25/2019|9.38372|06/25/2019|8.93688|06/25/2019|||STIMULANTS AND RELATED AGENTS|13182|||||No|No||SHIRE US INC.|No||||
prucalopride succinate|No|No|No|No|75%|54092054601|MOTEGRITY 1 MG TABLET|30|EA|6.96542|09/24/2019||Yes|No||09/24/2019||Yes|No|09/24/2019||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|534|No|15.63982|01/18/2022|15.26446|01/18/2022|15.36612|01/18/2022|||GI MOTILITY: CHRONIC|13183|||||No|No||SHIRE US INC.|No||||
prucalopride succinate|No|No|No|No|75%|54092054701|MOTEGRITY 2 MG TABLET|30|EA|6.96542|09/24/2019||Yes|No||09/24/2019||Yes|No|09/24/2019||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|534|No|15.58417|01/18/2022|15.21014|01/18/2022|15.31144|01/18/2022|||GI MOTILITY: CHRONIC|13184|||||No|No||SHIRE US INC.|No||||
idursulfase|No|No|No|No|75%|54092070001|ELAPRASE 6 MG/3 ML VIAL|3|ML|449.46896|03/11/2008||Yes|No||03/11/2008||Yes|No|03/11/2008||Yes|No||||No|No|||Prescription required|No|||Yes|1024.37112|02/21/2017|1009.73725|02/21/2017|961.65452|02/21/2017||||13185|||||No|No||SHIRE US INC.|No||||
velaglucerase alfa|No|No|No|No|75%|54092070104|VPRIV 400 UNITS VIAL|1|EA|609.8733|06/05/2012||Yes|No||06/05/2012||Yes|No|06/05/2012||Yes|No||||No|No|||Prescription required|No|||No|1389.9438|01/12/2021|1370.08746|01/12/2021|1304.8452|01/12/2021||||13186|||||No|No||SHIRE US INC.|No||||
icatibant acetate|No|No|No|No|75%|54092070202|FIRAZYR 30 MG/3 ML SYRINGE|3|ML|1597.8069|09/07/2011||Yes|No||09/07/2011||Yes|No|09/07/2011||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|501|No|3641.5134|04/23/2019|3589.49178|04/23/2019|3418.5636|04/23/2019|||HAE TREATMENTS|13187|||||No|No||SHIRE US INC.|No||||
icatibant acetate|No|No|No|No|75%|54092070203|FIRAZYR 30 MG/3 ML SYRINGE|3|ML|1597.80785|09/07/2011||Yes|No||09/07/2011||Yes|No|09/07/2011||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|501|No|3641.51557|04/23/2019|3589.49392|04/23/2019|3418.56564|04/23/2019|||HAE TREATMENTS|13188|||||No|No||SHIRE US INC.|No||||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|54123011430|ZUBSOLV 11.4-2.9 MG TABLET SL|30|EA|8.11553|12/28/2016||Yes|No||12/28/2016||Yes|No|12/28/2016||Yes|No||||No|No|||Prescription required|No||145|Yes|18.09243|01/11/2022|17.65821|01/11/2022|17.77581|01/11/2022|||OPIATE DEPENDENCE TREATMENTS|13189|||||No|No||OREXO US, INC.|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|54123090730|ZUBSOLV 0.7-0.18 MG TABLET SL|30|EA|2.02759|06/30/2017||Yes|No||06/30/2017||Yes|No|06/30/2017||Yes|No||||No|No|||Prescription required|No||145|Yes|4.53167|01/11/2022|4.4229|01/11/2022|4.45236|01/11/2022|||OPIATE DEPENDENCE TREATMENTS|13190|||||No|No||OREXO US, INC.|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|54123091430|ZUBSOLV 1.4-0.36 MG TABLET SL|30|EA|2.02759|10/01/2013||Yes|No||10/01/2013||Yes|No|10/01/2013||Yes|No||||No|No|||Prescription required|No||145|Yes|4.51747|01/11/2022|4.40905|01/11/2022|4.43841|01/11/2022|||OPIATE DEPENDENCE TREATMENTS|13191|||||No|No||OREXO US, INC.|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|54123092930|ZUBSOLV 2.9-0.71 MG TABLET SL|30|EA|4.05776|12/28/2016||Yes|No||12/28/2016||Yes|No|12/28/2016||Yes|No||||No|No|||Prescription required|No||145|Yes|9.0073|01/11/2022|8.79112|01/11/2022|8.84967|01/11/2022|||OPIATE DEPENDENCE TREATMENTS|13192|||||No|No||OREXO US, INC.|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|54123095730|ZUBSOLV 5.7-1.4 MG TABLET SL|30|EA|4.05776|10/01/2013||Yes|No||10/01/2013||Yes|No|10/01/2013||Yes|No||||No|No|||Prescription required|No||145|Yes|9.02354|01/11/2022|8.80697|01/11/2022|8.86562|01/11/2022|||OPIATE DEPENDENCE TREATMENTS|13193|||||No|No||OREXO US, INC.|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|54123098630|ZUBSOLV 8.6-2.1 MG TABLET SL|30|EA|6.08679|12/28/2016||Yes|No||12/28/2016||Yes|No|12/28/2016||Yes|No||||No|No|||Prescription required|No||145|Yes|13.54276|01/11/2022|13.21773|01/11/2022|13.30576|01/11/2022|||OPIATE DEPENDENCE TREATMENTS|13194|||||No|No||OREXO US, INC.|Yes|09/01/2020|||
methotrexate/PF|No|No|No|No|75%|54436001004|OTREXUP 10 MG/0.4 ML AUTO-INJ|.4|ML|184.93225|03/31/2014||Yes|No||03/31/2014||Yes|No|03/31/2014||Yes|No||||No|No|||Prescription required|No|||No|421.4735|02/08/2022|415.45245|02/08/2022|395.669|02/08/2022||||13195|||||No|No||ANTARES/OTTER|No||||
methotrexate/PF|No|No|No|No|75%|54436001504|OTREXUP 15 MG/0.4 ML AUTO-INJ|.4|ML|184.93225|03/31/2014||Yes|No||03/31/2014||Yes|No|03/31/2014||Yes|No||||No|No|||Prescription required|No|||No|421.4735|02/08/2022|415.45245|02/08/2022|395.669|02/08/2022||||13196|||||No|No||ANTARES/OTTER|No||||
methotrexate/PF|No|No|No|No|75%|54436002004|OTREXUP 20 MG/0.4 ML AUTO-INJ|.4|ML|184.93225|03/31/2014||Yes|No||03/31/2014||Yes|No|03/31/2014||Yes|No||||No|No|||Prescription required|No|||No|421.4735|02/08/2022|415.45245|02/08/2022|395.669|02/08/2022||||13197|||||No|No||ANTARES/OTTER|No||||
methotrexate/PF|No|No|No|No|75%|54436002504|OTREXUP 25 MG/0.4 ML AUTO-INJ|.4|ML|184.93225|03/31/2014||Yes|No||03/31/2014||Yes|No|03/31/2014||Yes|No||||No|No|||Prescription required|No|||No|421.4735|02/08/2022|415.45245|02/08/2022|395.669|02/08/2022||||13198|||||No|No||ANTARES/OTTER|No||||
cysteamine HCl|No|No|No|No|75%|54482002001|CYSTARAN 0.44% EYE DROPS|15|ML|50.03766|05/28/2013||Yes|No||05/28/2013||Yes|No|05/28/2013||Yes|No||||No|No|||Prescription required|No|||No|114.03932|01/04/2022|112.41019|01/04/2022|107.05732|01/04/2022||||13199|||||No|No||LEADIANT BIOSCI|No||||
procarbazine HCl|No|No|No|No|75%|54482005401|MATULANE 50 MG CAPSULE|100|EA|51.46717|11/14/2019||Yes|No||11/14/2019||Yes|No|11/14/2019||Yes|No||||No|No|||Prescription required|No||173|No|117.29727|01/04/2022|115.6216|01/04/2022|110.11581|01/04/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|13200|||||No|No||LEADIANT BIOSCI|No||||
levocarnitine|No|No|No|No|75%|54482014407|CARNITOR 330 MG TABLET|90|EA|.47137|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.895|01/11/2022|.87352|01/11/2022|.87933|01/11/2022||||13201|||||No|No||LEADIANT BIOSCI|No||||
levocarnitine (with sugar)|No|No|No|No|75%|54482014508|CARNITOR 100 MG/ML ORAL SOLN|118|ML|.13402|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.297|01/11/2022|.28987|01/11/2022|.2918|01/11/2022||||13202|||||No|No||LEADIANT BIOSCI|No||||
levocarnitine|No|No|No|No|75%|54482014701|CARNITOR 1 GM/5 ML VIAL|5|ML|2.92812|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|6.6734|01/04/2022|6.57807|01/04/2022|6.26483|01/04/2022||||13203|||||No|No||LEADIANT BIOSCI|No||||
levocarnitine|No|No|No|No|75%|54482014801|CARNITOR SF 100 MG/ML ORAL SOL|118|ML|.16161|09/11/2008||Yes|No||09/11/2008||Yes|No|09/11/2008||Yes|No||||No|No|||Prescription required|No|||No|.36832|01/04/2022|.36306|01/04/2022|.34577|01/04/2022||||13204|||||No|No||LEADIANT BIOSCI|No||||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|54569639900|SUBOXONE 8 MG-2 MG SL FILM|30|EA|3.8614|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||Yes|||||||8.8004|10/01/2020||13205|||||No|No||A-S MEDICATION|Yes|09/01/2020|||
magnesium|No|No|No|No|75%|54629085301|MAGNESIUM 30 MG TABLET|100|EA||||No|No||||No|No|||No|No||08/19/2013||Yes|No|||Over the counter|No|||No|||||||.02848|08/19/2013||13206|||||No|No||NAT'L VIT. CO.|No||||
magnesium oxide/magnesium|No|No|No|No|75%|54629085401|MAGNESIUM 300 MG CAPSULE|100|EA|.02365|||No|No||||No|No|||No|No||08/19/2015||Yes|No|||Over the counter|No|||No|.0539|07/07/2020|.05313|07/07/2020|.0506|07/07/2020||||13207|||||No|No||NAT'L VIT. CO.|No||||
auranofin|No|No|No|No|75%|54766009306|RIDAURA 3 MG CAPSULE|60|EA|10.17996|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|No|||No|23.20084|01/11/2022|22.8694|01/11/2022|21.78038|01/11/2022||||13208|||||No|No||SEBELA PHARMACE|No||||
alosetron HCl|No|No|No|No|75%|54766089403|LOTRONEX 0.5 MG TABLET|30|EA|16.52977|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|534|Yes|37.6725|01/11/2022|37.13432|01/11/2022|35.36602|01/11/2022|||GI MOTILITY: CHRONIC|13209|||||No|No||SEBELA PHARMACE|No||||
alosetron HCl|No|No|No|No|75%|54766089503|LOTRONEX 1 MG TABLET|30|EA|33.06313|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|534|Yes|75.35318|01/11/2022|74.2767|01/11/2022|70.73972|01/11/2022|||GI MOTILITY: CHRONIC|13210|||||No|No||SEBELA PHARMACE|No||||
pseudoephedrine HCl|No|No|No|No|75%|54838010440|CHILDREN'S SILFEDRINE LIQ|118|ML|.00601|02/28/2001||Yes|No||||No|No|02/28/2001||Yes|No||||No|No|||Over the counter|No|||No|.0137|01/28/2020|.0135|01/28/2020|.01286|01/28/2020||||13211|||||No|No||SILARX/LANNETT|No||||
pseudoephedrine HCl|No|No|No|No|75%|54838010470|CHILDREN'S SILFEDRINE LIQ|237|ML|.00351|02/28/2001||Yes|No||||No|No|02/28/2001||Yes|No||||No|No|||Over the counter|No|||No|.00801|01/28/2020|.0079|01/28/2020|.00752|01/28/2020||||13212|||||No|No||SILARX/LANNETT|No||||
chlorpheniramin/pseudoephed/DM|No|No|No|No|75%|54838011540|PEDIATRIC COUGH-COLD LIQUID|120|ML|.00619|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.01412|06/01/2016|.01392|06/01/2016|.01325|06/01/2016|||COUGH AND COLD: NON-NARCOTIC|13213|||||No|No||SILARX/LANNETT|No||||
guaifenesin|No|No|No|No|75%|54838011740|SILTUSSIN SA 100 MG/5 ML SYR|118|ML|.00958|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No||182|Yes|.01581|03/29/2022|.01543|03/29/2022|.01553|03/29/2022|||COUGH AND COLD: COLD|13214|||||No|No||SILARX/LANNETT|No||||
guaifenesin|No|No|No|No|75%|54838011770|SILTUSSIN SA 100 MG/5 ML SYR|237|ML|.00959|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No||182|Yes|.01221|03/29/2022|.01191|03/29/2022|.01199|03/29/2022|||COUGH AND COLD: COLD|13215|||||No|No||SILARX/LANNETT|No||||
guaifenesin|No|No|No|No|75%|54838011780|SILTUSSIN SA 100 MG/5 ML SYR|473|ML|.00958|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No||182|Yes|.00969|03/29/2022|.00945|03/29/2022|.00952|03/29/2022|||COUGH AND COLD: COLD|13216|||||No|No||SILARX/LANNETT|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|54838013340|SILTUSSIN DM DAS 100-10MG/5 ML|118|ML|.01548|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No||184|Yes|.01867|03/29/2022|.01822|03/29/2022|.01834|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|13217|||||No|No||SILARX/LANNETT|No||||
diphenhydramine HCl|No|No|No|No|75%|54838013540|SILADRYL 12.5 MG/5 ML LIQUID|118|ML|.01075|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||09/01/1999||Yes|No|||Over the counter|No||574|Yes|.01468|03/29/2022|.01432|03/29/2022|.01442|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|13218|||||No|No||SILARX/LANNETT|No||||
diphenhydramine HCl|No|No|No|No|75%|54838013570|SILADRYL 12.5 MG/5 ML LIQUID|237|ML|.01075|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||09/01/1999||Yes|No|||Over the counter|No||574|Yes|.01487|03/29/2022|.01451|03/29/2022|.0146|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|13219|||||No|No||SILARX/LANNETT|No||||
diphenhydramine HCl|No|No|No|No|75%|54838013580|SILADRYL 12.5 MG/5 ML LIQUID|473|ML|.01013|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||09/01/1999||Yes|No|||Over the counter|No||574|Yes|.02458|03/29/2022|.02399|03/29/2022|.02414|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|13220|||||No|No||SILARX/LANNETT|No||||
brompheniramine/pseudoephed/DM|No|No|No|No|75%|54838013640|BROTAPP DM 1-15-5 MG/5 ML LIQ|118|ML|.00761|03/01/2001||Yes|No||||No|No|03/01/2001||Yes|No||||No|No|||Over the counter|No||184|Yes|.01735|03/24/2020|.0171|03/24/2020|.01629|03/24/2020|||COUGH AND COLD: NON-NARCOTIC|13221|||||No|No||SILARX/LANNETT|No||||
brompheniramine/pseudoephed/DM|No|No|No|No|75%|54838013670|BROTAPP DM 1-15-5 MG/5 ML LIQ|237|ML|.00632|03/01/2001||Yes|No||||No|No|03/01/2001||Yes|No||||No|No|||Over the counter|No||184|Yes|.01442|03/24/2020|.01421|03/24/2020|.01354|03/24/2020|||COUGH AND COLD: NON-NARCOTIC|13222|||||No|No||SILARX/LANNETT|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|54838020940|SILTUSSIN DM COUGH SYRUP|118|ML|.01526|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No||184|Yes|.01774|03/29/2022|.01731|03/29/2022|.01742|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|13223|||||No|No||SILARX/LANNETT|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|54838020970|SILTUSSIN DM COUGH SYRUP|237|ML|.01527|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No||184|Yes|.01304|03/29/2022|.01272|03/29/2022|.01281|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|13224|||||No|No||SILARX/LANNETT|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|54838020980|SILTUSSIN DM COUGH SYRUP|473|ML|.01526|09/01/1999||Yes|No||||No|No|09/01/1999||Yes|No||||No|No|||Over the counter|No||184|Yes|.03292|01/25/2022|.03212|01/25/2022|.03234|01/25/2022|||COUGH AND COLD: NON-NARCOTIC|13225|||||No|No||SILARX/LANNETT|No||||
haloperidol lactate|No|No|No|No|75%|54838050140|HALOPERIDOL LAC 2 MG/ML CONC|120|ML|.10148|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|.21566|03/29/2022|.21048|03/29/2022|.21188|03/29/2022|||ANTIPSYCHOTICS|13226|||||No|No||SILARX/LANNETT|Yes|09/01/2020|||
hydroxyzine HCl|No|No|No|No|75%|54838050280|HYDROXYZINE 10 MG/5 ML SYRUP|473|ML|.05835|06/11/2014||Yes|No||06/11/2014||Yes|No|06/11/2014||Yes|No||||No|No|||Prescription required|No||574|Yes|.06612|03/29/2022|.06453|03/29/2022|.06496|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|13227|||||No|No||SILARX/LANNETT|No||||
metaproterenol sulfate|No|No|No|No|75%|54838050780|METAPROTERENOL 10 MG/5 ML SYR|473|ML|.00891|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/12/2005|037|No|.02031|06/01/2016|.02002|06/01/2016|.01907|06/01/2016|||BRONCHODILATORS: BETA AGONIST|13228|||||No|No||SILARX/LANNETT|No||||
oxybutynin chloride|No|No|No|No|75%|54838051080|OXYBUTYNIN 5 MG/5 ML SYRUP|473|ML|.01567|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||006|No|.03028|03/29/2022|.02955|03/29/2022|.02975|03/29/2022|||BLADDER RELAXANT PREPARATIONS|13229|||||No|No||SILARX/LANNETT|No||||
doxepin HCl|No|No|No|No|75%|54838051240|DOXEPIN 10 MG/ML ORAL CONC|120|ML|.20382|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.28572|11/23/2021|.27886|11/23/2021|.28071|11/23/2021|||ANTIDEPRESSANTS: TRICYCLIC|13230|||||No|No||SILARX/LANNETT|No||||
fluoxetine HCl|No|No|No|No|75%|54838052340|FLUOXETINE 20 MG/5 ML SOLUTION|120|ML|.24725|03/15/2007||Yes|No||03/15/2007||Yes|No|03/15/2007||Yes|No||||No|No|||Prescription required|No||008|No|.3776|03/29/2022|.36853|03/29/2022|.37099|03/29/2022|||ANTIDEPRESSANTS: SSRIs|13231|||||No|No||SILARX/LANNETT|No||||
citalopram hydrobromide|Yes|No|No|No|75%|54838054070|CITALOPRAM HBR 10 MG/5 ML SOLN|240|ML|.25998|07/20/2006||Yes|No||07/20/2006||Yes|No|07/20/2006||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.26239|01/25/2022|.25609|01/25/2022|.25779|01/25/2022|||ANTIDEPRESSANTS: SSRIs|13232|||||No|No||SILARX/LANNETT|No||||
levetiracetam|No|No|No|No|75%|54838054880|LEVETIRACETAM 100 MG/ML SOLN|473|ML|.05454|04/22/2009||Yes|No||04/22/2009||Yes|No|04/22/2009||Yes|No||||No|No|||Prescription required|No||056|No|.03146|03/29/2022|.0307|03/29/2022|.0309|03/29/2022|||ANTICONVULSANTS|13233|||||No|No||SILARX/LANNETT|No||||
escitalopram oxalate|No|No|No|No|75%|54838055170|ESCITALOPRAM OXALATE 5 MG/5 ML|240|ML|.28666|07/10/2014||Yes|No||07/10/2014||Yes|No|07/10/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|008|No|.36935|02/22/2022|.36048|02/22/2022|.36288|02/22/2022|||ANTIDEPRESSANTS: SSRIs|13234|||||No|No||SILARX/LANNETT|No||||
cetirizine HCl|No|No|No|No|75%|54838055240|CHILD CETIRIZINE HCL 1 MG/ML|120|ML|.01558|07/08/2011||Yes|No||||No|No|07/08/2011||Yes|No||||No|No|||Over the counter|No||030|Yes|.0312|03/29/2022|.03045|03/29/2022|.03065|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|13235|||||No|No||SILARX/LANNETT|No||||
ondansetron HCl|No|No|No|No|75%|54838055550|ONDANSETRON 4 MG/5 ML SOLUTION|50|ML|.215|03/22/2011||Yes|No||03/22/2011||Yes|No|03/22/2011||Yes|No||||No|No|||Prescription required|No||085|No|.25985|03/29/2022|.25361|03/29/2022|.2553|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|13236|||||No|No||SILARX/LANNETT|No||||
theophylline anhydrous|No|No|No|No|75%|54838055680|THEOPHYLLINE 80 MG/15 ML SOLN|473|ML|.06772|04/25/2011||Yes|No||04/25/2011||Yes|No|04/25/2011||Yes|No||||No|No|||Prescription required|No|||Yes|.15435|07/25/2017|.15214|07/25/2017|.1449|07/25/2017||||13237|||||No|No||SILARX/LANNETT|No||||
loratadine|No|No|No|No|75%|54838055840|LORATADINE ALLERGY 5 MG/5 ML|120|ML|.01988|03/22/2011||Yes|No||||No|No|03/22/2011||Yes|No||||No|No|||Over the counter|No||030|Yes|.04114|03/29/2022|.04015|03/29/2022|.04042|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|13238|||||No|No||SILARX/LANNETT|No||||
lamivudine|No|No|No|No|75%|54838056670|LAMIVUDINE 10 MG/ML ORAL SOLN|240|ML|.20787|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.33952|11/23/2021|.33467|11/23/2021|.31873|11/23/2021|||HIV / AIDS|13239|||||No|No||SILARX/LANNETT|No||||
aripiprazole|No|No|No|No|75%|54838057059|ARIPIPRAZOLE 1 MG/ML SOLUTION|150|ML|.87433|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|027|Yes|1.07614|03/29/2022|1.05031|03/29/2022|1.0573|03/29/2022|||ANTIPSYCHOTICS|13240|||||No|No||SILARX/LANNETT|No||||
cetirizine HCl|No|No|No|No|75%|54838057280|CETIRIZINE HCL 1 MG/ML SYRUP|473|ML|.00817|09/12/2014||Yes|No||09/12/2014||Yes|No|09/12/2014||Yes|No||||No|No|||Prescription required|No||030|Yes|.01722|03/29/2022|.0168|03/29/2022|.01691|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|13241|||||No|No||SILARX/LANNETT|No||||
ethambutol HCl|No|No|No|No|75%|54879000101|ETHAMBUTOL HCL 100 MG TABLET|100|EA|.16335|07/31/2013||Yes|No||07/31/2013||Yes|No|07/31/2013||Yes|No||||No|No|||Prescription required|No|||No|.3723|09/29/2020|.36698|09/29/2020|.3495|09/29/2020||||13242|||||No|No||STI PHARMA, LLC|No||||
ethambutol HCl|No|No|No|No|75%|54879000201|ETHAMBUTOL HCL 400 MG TABLET|100|EA|.258|07/31/2013||Yes|No||07/31/2013||Yes|No|07/31/2013||Yes|No||||No|No|||Prescription required|No|||No|.57427|03/29/2022|.56048|03/29/2022|.56422|03/29/2022||||13243|||||No|No||STI PHARMA, LLC|No||||
dexamethasone|No|No|No|No|75%|54879000308|DEXAMETHASONE 0.5 MG/5 ML ELX|237|ML|.07799|10/21/2014||Yes|No||10/21/2014||Yes|No|10/21/2014||Yes|No||||No|No|||Prescription required|No||168|Yes|.09997|03/29/2022|.09757|03/29/2022|.09822|03/29/2022|||GLUCOCORTICOIDS: ORAL|13244|||||No|No||STI PHARMA, LLC|No||||
betamethasone valerate|No|No|No|No|75%|54879000460|BETAMETHASONE VA 0.1% LOTION|60|ML|.43107|03/26/2015||Yes|No||03/26/2015||Yes|No|03/26/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|120|No|.62369|03/29/2022|.60872|03/29/2022|.61277|03/29/2022|||STEROIDS: TOPICAL HIGH|13245|||||No|No||STI PHARMA, LLC|No||||
cyclophosphamide|No|No|No|No|75%|54879002101|CYCLOPHOSPHAMIDE 25 MG CAPSULE|100|EA|2.15|08/27/2018||Yes|No||08/27/2018||Yes|No|08/27/2018||Yes|No||||No|No|||Prescription required|No||502|No|4.9|07/02/2019|4.83|07/02/2019|4.6|07/02/2019|||ONCOLOGY: ORAL - BREAST|13246|||||No|No||STI PHARMA, LLC|No||||
cyclophosphamide|No|No|No|No|75%|54879002201|CYCLOPHOSPHAMIDE 50 MG CAPSULE|100|EA|3.01|08/27/2018||Yes|No||08/27/2018||Yes|No|08/27/2018||Yes|No||||No|No|||Prescription required|No||502|No|6.86|05/25/2021|6.762|05/25/2021|6.44|05/25/2021|||ONCOLOGY: ORAL - BREAST|13247|||||No|No||STI PHARMA, LLC|No||||
phenobarbital|No|No|No|No|75%|54932050181|PHENOBARBITAL 20 MG/5 ML SOLN|473|ML|.0709|10/12/2020||Yes|No||10/12/2020||Yes|No|10/12/2020||Yes|No||||No|No|||Prescription required|No||056|No|.09847|03/29/2022|.0961|03/29/2022|.09674|03/29/2022|||ANTICONVULSANTS|13248|||||No|No||BIORAMO|No||||
moxifloxacin HCl|No|No|No|No|75%|55111011230|MOXIFLOXACIN HCL 400 MG TABLET|30|EA|1.26477|07/11/2014||Yes|No||07/11/2014||Yes|No|07/11/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|028|No|1.23895|03/29/2022|1.20921|03/29/2022|1.21726|03/29/2022|||FLUOROQUINOLONES: ORAL|13249|||||No|No||DR.REDDY'S LAB|No||||
isotretinoin|No|No|No|No|75%|55111011381|ZENATANE 30 MG CAPSULE|30|EA|2.97244|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No||144|No|3.30978|03/29/2022|3.23034|03/29/2022|3.25185|03/29/2022|||ACNE AGENTS: ORAL|13250|||||No|No||DR.REDDY'S LAB|No||||
famotidine|No|No|No|No|75%|55111011890|FAMOTIDINE 10 MG TABLET|90|EA|.03348|08/23/2021||Yes|No||||No|No|08/23/2021||Yes|No||||No|No|||Over the counter|No|||No|.09993|03/29/2022|.09753|03/29/2022|.09818|03/29/2022||||13251|||||No|No||DR.REDDY'S LAB|No||||
famotidine|No|No|No|No|75%|55111011901|FAMOTIDINE 20 MG TABLET|100|EA|.043|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No|||No|.03262|03/29/2022|.03183|03/29/2022|.03204|03/29/2022||||13252|||||No|No||DR.REDDY'S LAB|No||||
famotidine|No|No|No|No|75%|55111011910|FAMOTIDINE 20 MG TABLET|1000|EA|.043|12/20/2021||Yes|No||12/20/2021||Yes|No|12/20/2021||Yes|No||||No|No|||Prescription required|No|||No|.03262|03/29/2022|.03183|03/29/2022|.03204|03/29/2022||||13253|||||No|No||DR.REDDY'S LAB|No||||
atorvastatin calcium|Yes|No|No|No|75%|55111012105|ATORVASTATIN 10 MG TABLET|500|EA|.03562|07/25/2012||Yes|No||07/25/2012||Yes|No|07/25/2012||Yes|No||07/25/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|13254|||||No|No||DR.REDDY'S LAB|No||||
atorvastatin calcium|Yes|No|No|No|75%|55111012190|ATORVASTATIN 10 MG TABLET|90|EA|.03563|07/25/2012||Yes|No||07/25/2012||Yes|No|07/25/2012||Yes|No||07/25/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|13255|||||No|No||DR.REDDY'S LAB|No||||
atorvastatin calcium|Yes|No|No|No|75%|55111012205|ATORVASTATIN 20 MG TABLET|500|EA|.04458|07/25/2012||Yes|No||07/25/2012||Yes|No|07/25/2012||Yes|No||07/25/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|13256|||||No|No||DR.REDDY'S LAB|No||||
atorvastatin calcium|Yes|No|No|No|75%|55111012290|ATORVASTATIN 20 MG TABLET|90|EA|.04457|07/25/2012||Yes|No||07/25/2012||Yes|No|07/25/2012||Yes|No||07/25/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|13257|||||No|No||DR.REDDY'S LAB|No||||
atorvastatin calcium|Yes|No|No|No|75%|55111012305|ATORVASTATIN 40 MG TABLET|500|EA|.05866|07/25/2012||Yes|No||07/25/2012||Yes|No|07/25/2012||Yes|No||07/25/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|13258|||||No|No||DR.REDDY'S LAB|No||||
atorvastatin calcium|Yes|No|No|No|75%|55111012390|ATORVASTATIN 40 MG TABLET|90|EA|.05866|07/25/2012||Yes|No||07/25/2012||Yes|No|07/25/2012||Yes|No||07/25/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|13259|||||No|No||DR.REDDY'S LAB|No||||
atorvastatin calcium|Yes|No|No|No|75%|55111012405|ATORVASTATIN 80 MG TABLET|500|EA|.0664|07/25/2012||Yes|No||07/25/2012||Yes|No|07/25/2012||Yes|No||07/25/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|13260|||||No|No||DR.REDDY'S LAB|No||||
atorvastatin calcium|Yes|No|No|No|75%|55111012490|ATORVASTATIN 80 MG TABLET|90|EA|.0664|07/25/2012||Yes|No||07/25/2012||Yes|No|07/25/2012||Yes|No||07/25/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|13261|||||No|No||DR.REDDY'S LAB|No||||
ciprofloxacin HCl|No|No|No|No|75%|55111012506|CIPROFLOXACIN HCL 100 MG TAB|6|EA|5.23453|06/10/2004||Yes|No||06/10/2004||Yes|No|06/10/2004||Yes|No||01/01/2012||Yes|No|||Prescription required|No||028|No|11.92986|06/01/2016|11.75943|06/01/2016|11.19946|06/01/2016|||FLUOROQUINOLONES: ORAL|13262|||||No|No||DR.REDDY'S LAB|No||||
ciprofloxacin HCl|Yes|No|No|No|75%|55111012601|CIPROFLOXACIN HCL 250 MG TAB|100|EA|.05|06/10/2004||Yes|No||06/10/2004||Yes|No|06/10/2004||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No||028|No|.09397|03/29/2022|.09171|03/29/2022|.09232|03/29/2022|||FLUOROQUINOLONES: ORAL|13263|||||No|No||DR.REDDY'S LAB|No||||
ciprofloxacin HCl|No|No|No|No|75%|55111012701|CIPROFLOXACIN HCL 500 MG TAB|100|EA|.08187|06/10/2004||Yes|No||06/10/2004||Yes|No|06/10/2004||Yes|No||01/01/2012||Yes|No|||Prescription required|No||028|No|.13565|03/29/2022|.13239|03/29/2022|.13327|03/29/2022|||FLUOROQUINOLONES: ORAL|13264|||||No|No||DR.REDDY'S LAB|No||||
ciprofloxacin HCl|No|No|No|No|75%|55111012705|CIPROFLOXACIN HCL 500 MG TAB|500|EA|.07941|06/10/2004||Yes|No||06/10/2004||Yes|No|06/10/2004||Yes|No||01/01/2012||Yes|No|||Prescription required|No||028|No|.13565|03/29/2022|.13239|03/29/2022|.13327|03/29/2022|||FLUOROQUINOLONES: ORAL|13265|||||No|No||DR.REDDY'S LAB|No||||
ciprofloxacin HCl|No|No|No|No|75%|55111012850|CIPROFLOXACIN HCL 750 MG TAB|50|EA|.1376|06/10/2004||Yes|No||06/10/2004||Yes|No|06/10/2004||Yes|No||01/01/2012||Yes|No|||Prescription required|No||028|No|.288|03/29/2022|.28108|03/29/2022|.28296|03/29/2022|||FLUOROQUINOLONES: ORAL|13266|||||No|No||DR.REDDY'S LAB|No||||
isotretinoin|No|No|No|No|75%|55111013581|ZENATANE 10 MG CAPSULE|30|EA|2.15716|04/10/2013||Yes|No||04/10/2013||Yes|No|04/10/2013||Yes|No||||No|No|||Prescription required|No||144|No|2.44307|03/29/2022|2.38443|03/29/2022|2.40031|03/29/2022|||ACNE AGENTS: ORAL|13267|||||No|No||DR.REDDY'S LAB|No||||
isotretinoin|No|No|No|No|75%|55111013681|ZENATANE 20 MG CAPSULE|30|EA|2.5585|04/10/2013||Yes|No||04/10/2013||Yes|No|04/10/2013||Yes|No||||No|No|||Prescription required|No||144|No|2.5524|03/29/2022|2.49114|03/29/2022|2.50773|03/29/2022|||ACNE AGENTS: ORAL|13268|||||No|No||DR.REDDY'S LAB|No||||
isotretinoin|No|No|No|No|75%|55111013781|ZENATANE 40 MG CAPSULE|30|EA|2.97244|04/10/2013||Yes|No||04/10/2013||Yes|No|04/10/2013||Yes|No||||No|No|||Prescription required|No||144|No|3.38467|03/29/2022|3.30343|03/29/2022|3.32543|03/29/2022|||ACNE AGENTS: ORAL|13269|||||No|No||DR.REDDY'S LAB|No||||
fluconazole|No|No|No|No|75%|55111014301|FLUCONAZOLE 50 MG TABLET|100|EA|.48172|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||05/12/2015||Yes|No|||Prescription required|No||069|No|.43933|03/29/2022|.42878|03/29/2022|.43164|03/29/2022|||ANTIFUNGALS: ORAL|13270|||||No|No||DR.REDDY'S LAB|No||||
fluconazole|No|No|No|No|75%|55111014330|FLUCONAZOLE 50 MG TABLET|30|EA|.48174|05/20/2015||Yes|No||05/20/2015||Yes|No|05/20/2015||Yes|No||05/20/2015||Yes|No|||Prescription required|No||069|No|.43933|03/29/2022|.42878|03/29/2022|.43164|03/29/2022|||ANTIFUNGALS: ORAL|13271|||||No|No||DR.REDDY'S LAB|No||||
fluconazole|No|No|No|No|75%|55111014401|FLUCONAZOLE 100 MG TABLET|100|EA|.7571|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||05/12/2015||Yes|No|||Prescription required|No||069|No|.34281|03/29/2022|.33458|03/29/2022|.33681|03/29/2022|||ANTIFUNGALS: ORAL|13272|||||No|No||DR.REDDY'S LAB|No||||
fluconazole|No|No|No|No|75%|55111014430|FLUCONAZOLE 100 MG TABLET|30|EA|.75708|02/23/2015||Yes|No||02/23/2015||Yes|No|02/23/2015||Yes|No||02/23/2015||Yes|No|||Prescription required|No||069|No|.34281|03/29/2022|.33458|03/29/2022|.33681|03/29/2022|||ANTIFUNGALS: ORAL|13273|||||No|No||DR.REDDY'S LAB|No||||
fluconazole|Yes|No|No|No|75%|55111014512|FLUCONAZOLE 150 MG TABLET|1|EA|1.20435|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Prescription required|No||069|No|.74933|03/29/2022|.73134|03/29/2022|.73621|03/29/2022|||ANTIFUNGALS: ORAL|13274|||||No|No||DR.REDDY'S LAB|No||||
fluconazole|No|No|No|No|75%|55111014601|FLUCONAZOLE 200 MG TABLET|100|EA|1.23883|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||05/12/2015||Yes|No|||Prescription required|No||069|No|.52936|03/29/2022|.51665|03/29/2022|.52009|03/29/2022|||ANTIFUNGALS: ORAL|13275|||||No|No||DR.REDDY'S LAB|No||||
fluconazole|No|No|No|No|75%|55111014630|FLUCONAZOLE 200 MG TABLET|30|EA|1.23883|02/23/2015||Yes|No||02/23/2015||Yes|No|02/23/2015||Yes|No||02/23/2015||Yes|No|||Prescription required|No||069|No|.52936|03/29/2022|.51665|03/29/2022|.52009|03/29/2022|||ANTIFUNGALS: ORAL|13276|||||No|No||DR.REDDY'S LAB|No||||
fluoxetine HCl|No|No|No|No|75%|55111015001|FLUOXETINE HCL 10 MG TABLET|100|EA|.19728|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||008|No|.24078|03/29/2022|.235|03/29/2022|.23656|03/29/2022|||ANTIDEPRESSANTS: SSRIs|13277|||||No|No||DR.REDDY'S LAB|No||||
fluoxetine HCl|No|No|No|No|75%|55111015010|FLUOXETINE HCL 10 MG TABLET|1000|EA|.18572|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||008|No|.24078|03/29/2022|.235|03/29/2022|.23656|03/29/2022|||ANTIDEPRESSANTS: SSRIs|13278|||||No|No||DR.REDDY'S LAB|No||||
fluoxetine HCl|No|No|No|No|75%|55111015030|FLUOXETINE HCL 10 MG TABLET|30|EA|.22188|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||008|No|.24078|03/29/2022|.235|03/29/2022|.23656|03/29/2022|||ANTIDEPRESSANTS: SSRIs|13279|||||No|No||DR.REDDY'S LAB|No||||
ondansetron HCl|No|No|No|No|75%|55111015330|ONDANSETRON HCL 4 MG TABLET|30|EA|.19063|12/27/2006||Yes|No||12/27/2006||Yes|No|12/27/2006||Yes|No||||No|No|||Prescription required|No||085|No|.06763|03/29/2022|.066|03/29/2022|.06644|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|13280|||||No|No||DR.REDDY'S LAB|No||||
ondansetron HCl|No|No|No|No|75%|55111015430|ONDANSETRON HCL 8 MG TABLET|30|EA|.22876|12/27/2006||Yes|No||12/27/2006||Yes|No|12/27/2006||Yes|No||||No|No|||Prescription required|No||085|No|.09975|03/29/2022|.09735|03/29/2022|.098|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|13281|||||No|No||DR.REDDY'S LAB|No||||
omeprazole|No|No|No|No|75%|55111015701|OMEPRAZOLE DR 10 MG CAPSULE|100|EA|.0774|09/01/2009||Yes|No||09/01/2009||Yes|No|09/01/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|Yes|.09084|03/29/2022|.08865|03/29/2022|.08925|03/29/2022|||PROTON PUMP INHIBITORS|13282|||||No|No||DR.REDDY'S LAB|No||||
omeprazole|No|No|No|No|75%|55111015730|OMEPRAZOLE DR 10 MG CAPSULE|30|EA|.0774|09/01/2009||Yes|No||09/01/2009||Yes|No|09/01/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|Yes|.09084|03/29/2022|.08865|03/29/2022|.08925|03/29/2022|||PROTON PUMP INHIBITORS|13283|||||No|No||DR.REDDY'S LAB|No||||
omeprazole|No|No|No|No|75%|55111015801|OMEPRAZOLE DR 20 MG CAPSULE|100|EA|.0387|09/01/2009||Yes|No||09/01/2009||Yes|No|09/01/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|13284|||||No|No||DR.REDDY'S LAB|No||||
omeprazole|No|No|No|No|75%|55111015810|OMEPRAZOLE DR 20 MG CAPSULE|1000|EA|.0258|09/01/2009||Yes|No||09/01/2009||Yes|No|09/01/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|13285|||||No|No||DR.REDDY'S LAB|No||||
omeprazole|No|No|No|No|75%|55111015830|OMEPRAZOLE DR 20 MG CAPSULE|30|EA|.0602|09/01/2009||Yes|No||09/01/2009||Yes|No|09/01/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|13286|||||No|No||DR.REDDY'S LAB|No||||
omeprazole|No|No|No|No|75%|55111015901|OMEPRAZOLE DR 40 MG CAPSULE|100|EA|.05418|09/01/2009||Yes|No||09/01/2009||Yes|No|09/01/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|13287|||||No|No||DR.REDDY'S LAB|No||||
omeprazole|No|No|No|No|75%|55111015905|OMEPRAZOLE DR 40 MG CAPSULE|500|EA|.0688|09/01/2009||Yes|No||09/01/2009||Yes|No|09/01/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|13288|||||No|No||DR.REDDY'S LAB|No||||
omeprazole|No|No|No|No|75%|55111015930|OMEPRAZOLE DR 40 MG CAPSULE|30|EA|.0688|09/01/2009||Yes|No||09/01/2009||Yes|No|09/01/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|13289|||||No|No||DR.REDDY'S LAB|No||||
olanzapine|No|No|No|No|75%|55111016305|OLANZAPINE 2.5 MG TABLET|500|EA|.08456|04/30/2012||Yes|No||04/30/2012||Yes|No|04/30/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.08915|03/29/2022|.08701|03/29/2022|.08758|03/29/2022|||ANTIPSYCHOTICS|13290|||||No|No||DR.REDDY'S LAB|No||||
olanzapine|No|No|No|No|75%|55111016330|OLANZAPINE 2.5 MG TABLET|30|EA|.08456|04/30/2012||Yes|No||04/30/2012||Yes|No|04/30/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.08915|03/29/2022|.08701|03/29/2022|.08758|03/29/2022|||ANTIPSYCHOTICS|13291|||||No|No||DR.REDDY'S LAB|No||||
olanzapine|No|No|No|No|75%|55111016705|OLANZAPINE 15 MG TABLET|500|EA|.22503|04/30/2012||Yes|No||04/30/2012||Yes|No|04/30/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.15007|03/29/2022|.14646|03/29/2022|.14744|03/29/2022|||ANTIPSYCHOTICS|13292|||||No|No||DR.REDDY'S LAB|No||||
olanzapine|No|No|No|No|75%|55111016730|OLANZAPINE 15 MG TABLET|30|EA|.22503|04/30/2012||Yes|No||04/30/2012||Yes|No|04/30/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.15007|03/29/2022|.14646|03/29/2022|.14744|03/29/2022|||ANTIPSYCHOTICS|13293|||||No|No||DR.REDDY'S LAB|No||||
olanzapine|No|No|No|No|75%|55111016805|OLANZAPINE 20 MG TABLET|500|EA|.30028|04/30/2012||Yes|No||04/30/2012||Yes|No|04/30/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.18048|03/29/2022|.17614|03/29/2022|.17732|03/29/2022|||ANTIPSYCHOTICS|13294|||||No|No||DR.REDDY'S LAB|No||||
olanzapine|No|No|No|No|75%|55111016830|OLANZAPINE 20 MG TABLET|30|EA|.30028|04/30/2012||Yes|No||04/30/2012||Yes|No|04/30/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.18048|03/29/2022|.17614|03/29/2022|.17732|03/29/2022|||ANTIPSYCHOTICS|13295|||||No|No||DR.REDDY'S LAB|No||||
oxaprozin|No|No|No|No|75%|55111017001|OXAPROZIN 600 MG TABLET|100|EA|1.26041|12/05/2003||Yes|No||12/05/2003||Yes|No|12/05/2003||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.63712|03/29/2022|.62182|03/29/2022|.62597|03/29/2022|||NSAIDS|13296|||||No|No||DR.REDDY'S LAB|No||||
oxaprozin|No|No|No|No|75%|55111017005|OXAPROZIN 600 MG TABLET|500|EA|1.2289|12/05/2003||Yes|No||12/05/2003||Yes|No|12/05/2003||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.63712|03/29/2022|.62182|03/29/2022|.62597|03/29/2022|||NSAIDS|13297|||||No|No||DR.REDDY'S LAB|No||||
tizanidine HCl|No|No|No|No|75%|55111017910|TIZANIDINE HCL 2 MG TABLET|1000|EA|.03587|03/01/2005||Yes|No||03/01/2005||Yes|No|03/01/2005||Yes|No||||No|No|||Prescription required|No||116|No|.06018|03/29/2022|.05873|03/29/2022|.05912|03/29/2022|||SKELETAL MUSCLE RELAXANTS|13298|||||No|No||DR.REDDY'S LAB|No||||
tizanidine HCl|No|No|No|No|75%|55111017915|TIZANIDINE HCL 2 MG TABLET|150|EA|.03583|03/01/2005||Yes|No||03/01/2005||Yes|No|03/01/2005||Yes|No||||No|No|||Prescription required|No||116|No|.06018|03/29/2022|.05873|03/29/2022|.05912|03/29/2022|||SKELETAL MUSCLE RELAXANTS|13299|||||No|No||DR.REDDY'S LAB|No||||
tizanidine HCl|No|No|No|No|75%|55111018010|TIZANIDINE HCL 4 MG TABLET|1000|EA|.0437|03/01/2005||Yes|No||03/01/2005||Yes|No|03/01/2005||Yes|No||||No|No|||Prescription required|No||116|No|.05014|03/29/2022|.04893|03/29/2022|.04926|03/29/2022|||SKELETAL MUSCLE RELAXANTS|13300|||||No|No||DR.REDDY'S LAB|No||||
tizanidine HCl|No|No|No|No|75%|55111018015|TIZANIDINE HCL 4 MG TABLET|150|EA|.04371|03/01/2005||Yes|No||03/01/2005||Yes|No|03/01/2005||Yes|No||||No|No|||Prescription required|No||116|No|.05014|03/29/2022|.04893|03/29/2022|.04926|03/29/2022|||SKELETAL MUSCLE RELAXANTS|13301|||||No|No||DR.REDDY'S LAB|No||||
clopidogrel bisulfate|No|No|No|No|75%|55111019605|CLOPIDOGREL 75 MG TABLET|500|EA|.07163|07/02/2012||Yes|No||07/02/2012||Yes|No|07/02/2012||Yes|No||07/02/2012||Yes|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|13302|||||No|No||DR.REDDY'S LAB|Yes|09/01/2020|||
clopidogrel bisulfate|No|No|No|No|75%|55111019630|CLOPIDOGREL 75 MG TABLET|30|EA|.07166|07/02/2012||Yes|No||07/02/2012||Yes|No|07/02/2012||Yes|No||07/02/2012||Yes|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|13303|||||No|No||DR.REDDY'S LAB|Yes|09/01/2020|||
clopidogrel bisulfate|No|No|No|No|75%|55111019690|CLOPIDOGREL 75 MG TABLET|90|EA|.07166|07/02/2012||Yes|No||07/02/2012||Yes|No|07/02/2012||Yes|No||07/02/2012||Yes|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|13304|||||No|No||DR.REDDY'S LAB|No||||
simvastatin|Yes|No|No|No|75%|55111019705|SIMVASTATIN 5 MG TABLET|500|EA|.06836|09/22/2008||Yes|No||09/22/2008||Yes|No|09/22/2008||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.03036|03/29/2022|.02963|03/29/2022|.02982|03/29/2022|||LIPOTROPICS: STATINS|13305|||||No|No||DR.REDDY'S LAB|No||||
simvastatin|Yes|No|No|No|75%|55111019730|SIMVASTATIN 5 MG TABLET|30|EA|.06837|08/17/2007||Yes|No||08/17/2007||Yes|No|08/17/2007||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.03036|03/29/2022|.02963|03/29/2022|.02982|03/29/2022|||LIPOTROPICS: STATINS|13306|||||No|No||DR.REDDY'S LAB|No||||
simvastatin|Yes|No|No|No|75%|55111019790|SIMVASTATIN 5 MG TABLET|90|EA|.06837|08/17/2007||Yes|No||08/17/2007||Yes|No|08/17/2007||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.03036|03/29/2022|.02963|03/29/2022|.02982|03/29/2022|||LIPOTROPICS: STATINS|13307|||||No|No||DR.REDDY'S LAB|No||||
simvastatin|Yes|No|No|No|75%|55111019805|SIMVASTATIN 10 MG TABLET|500|EA|.09162|01/26/2007||Yes|No||01/26/2007||Yes|No|01/26/2007||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.02909|03/29/2022|.02839|03/29/2022|.02858|03/29/2022|||LIPOTROPICS: STATINS|13308|||||No|No||DR.REDDY'S LAB|No||||
simvastatin|Yes|No|No|No|75%|55111019830|SIMVASTATIN 10 MG TABLET|30|EA|.09159|01/26/2007||Yes|No||01/26/2007||Yes|No|01/26/2007||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.02909|03/29/2022|.02839|03/29/2022|.02858|03/29/2022|||LIPOTROPICS: STATINS|13309|||||No|No||DR.REDDY'S LAB|No||||
simvastatin|Yes|No|No|No|75%|55111019890|SIMVASTATIN 10 MG TABLET|90|EA|.09163|01/26/2007||Yes|No||01/26/2007||Yes|No|01/26/2007||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.02909|03/29/2022|.02839|03/29/2022|.02858|03/29/2022|||LIPOTROPICS: STATINS|13310|||||No|No||DR.REDDY'S LAB|No||||
simvastatin|Yes|No|No|No|75%|55111019905|SIMVASTATIN 20 MG TABLET|500|EA|.15986|01/26/2007||Yes|No||01/26/2007||Yes|No|01/26/2007||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.02604|03/29/2022|.02541|03/29/2022|.02558|03/29/2022|||LIPOTROPICS: STATINS|13311|||||No|No||DR.REDDY'S LAB|No||||
simvastatin|Yes|No|No|No|75%|55111019930|SIMVASTATIN 20 MG TABLET|30|EA|.15981|01/26/2007||Yes|No||01/26/2007||Yes|No|01/26/2007||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.02604|03/29/2022|.02541|03/29/2022|.02558|03/29/2022|||LIPOTROPICS: STATINS|13312|||||No|No||DR.REDDY'S LAB|No||||
simvastatin|Yes|No|No|No|75%|55111019990|SIMVASTATIN 20 MG TABLET|90|EA|.15986|01/26/2007||Yes|No||01/26/2007||Yes|No|01/26/2007||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.02604|03/29/2022|.02541|03/29/2022|.02558|03/29/2022|||LIPOTROPICS: STATINS|13313|||||No|No||DR.REDDY'S LAB|No||||
simvastatin|Yes|No|No|No|75%|55111020005|SIMVASTATIN 40 MG TABLET|500|EA|.15986|01/30/2007||Yes|No||01/30/2007||Yes|No|01/30/2007||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.04431|03/29/2022|.04324|03/29/2022|.04353|03/29/2022|||LIPOTROPICS: STATINS|13314|||||No|No||DR.REDDY'S LAB|No||||
simvastatin|Yes|No|No|No|75%|55111020030|SIMVASTATIN 40 MG TABLET|30|EA|.15981|01/30/2007||Yes|No||01/30/2007||Yes|No|01/30/2007||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.04431|03/29/2022|.04324|03/29/2022|.04353|03/29/2022|||LIPOTROPICS: STATINS|13315|||||No|No||DR.REDDY'S LAB|No||||
simvastatin|Yes|No|No|No|75%|55111020090|SIMVASTATIN 40 MG TABLET|90|EA|.15986|01/30/2007||Yes|No||01/30/2007||Yes|No|01/30/2007||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.04431|03/29/2022|.04324|03/29/2022|.04353|03/29/2022|||LIPOTROPICS: STATINS|13316|||||No|No||DR.REDDY'S LAB|No||||
lamotrigine|No|No|No|No|75%|55111022605|LAMOTRIGINE 25 MG DISPER TAB|500|EA|.26297|06/14/2009||Yes|No||06/14/2009||Yes|No|06/14/2009||Yes|No||||No|No|||Prescription required|No||056|No|.29045|03/29/2022|.28347|03/29/2022|.28536|03/29/2022|||ANTICONVULSANTS|13317|||||No|No||DR.REDDY'S LAB|No||||
pravastatin sodium|Yes|No|No|No|75%|55111022905|PRAVASTATIN SODIUM 10 MG TAB|500|EA|.04588|10/24/2006||Yes|No||10/24/2006||Yes|No|10/24/2006||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.07144|03/29/2022|.06972|03/29/2022|.07018|03/29/2022|||LIPOTROPICS: STATINS|13318|||||No|No||DR.REDDY'S LAB|No||||
pravastatin sodium|Yes|No|No|No|75%|55111022990|PRAVASTATIN SODIUM 10 MG TAB|90|EA|.05255|07/31/2015||Yes|No||07/31/2015||Yes|No|07/31/2015||Yes|No||07/31/2015||Yes|No|07/01/2016||Prescription required|No||063|Yes|.07144|03/29/2022|.06972|03/29/2022|.07018|03/29/2022|||LIPOTROPICS: STATINS|13319|||||No|No||DR.REDDY'S LAB|No||||
pravastatin sodium|Yes|No|No|No|75%|55111023005|PRAVASTATIN SODIUM 20 MG TAB|500|EA|.05335|07/31/2015||Yes|No||07/31/2015||Yes|No|07/31/2015||Yes|No||07/31/2015||Yes|No|07/01/2016||Prescription required|No||063|Yes|.05771|03/29/2022|.05632|03/29/2022|.0567|03/29/2022|||LIPOTROPICS: STATINS|13320|||||No|No||DR.REDDY'S LAB|No||||
pravastatin sodium|Yes|No|No|No|75%|55111023090|PRAVASTATIN SODIUM 20 MG TAB|90|EA|.0611|07/31/2015||Yes|No||07/31/2015||Yes|No|07/31/2015||Yes|No||07/31/2015||Yes|No|07/01/2016||Prescription required|No||063|Yes|.05771|03/29/2022|.05632|03/29/2022|.0567|03/29/2022|||LIPOTROPICS: STATINS|13321|||||No|No||DR.REDDY'S LAB|No||||
pravastatin sodium|Yes|No|No|No|75%|55111023105|PRAVASTATIN SODIUM 40 MG TAB|500|EA|.07611|07/31/2015||Yes|No||07/31/2015||Yes|No|07/31/2015||Yes|No||07/31/2015||Yes|No|07/01/2016||Prescription required|No||063|Yes|.08966|03/29/2022|.0875|03/29/2022|.08809|03/29/2022|||LIPOTROPICS: STATINS|13322|||||No|No||DR.REDDY'S LAB|No||||
pravastatin sodium|Yes|No|No|No|75%|55111023190|PRAVASTATIN SODIUM 40 MG TAB|90|EA|.08719|07/31/2015||Yes|No||07/31/2015||Yes|No|07/31/2015||Yes|No||07/31/2015||Yes|No|07/01/2016||Prescription required|No||063|Yes|.08966|03/29/2022|.0875|03/29/2022|.08809|03/29/2022|||LIPOTROPICS: STATINS|13323|||||No|No||DR.REDDY'S LAB|No||||
ziprasidone HCl|No|No|No|No|75%|55111025660|ZIPRASIDONE HCL 20 MG CAPSULE|60|EA|.215|03/13/2012||Yes|No||03/13/2012||Yes|No|03/13/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.27381|03/29/2022|.26723|03/29/2022|.26901|03/29/2022|||ANTIPSYCHOTICS|13324|||||No|No||DR.REDDY'S LAB|No||||
ziprasidone HCl|No|No|No|No|75%|55111025760|ZIPRASIDONE HCL 40 MG CAPSULE|60|EA|.215|03/13/2012||Yes|No||03/13/2012||Yes|No|03/13/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.29914|03/29/2022|.29196|03/29/2022|.2939|03/29/2022|||ANTIPSYCHOTICS|13325|||||No|No||DR.REDDY'S LAB|No||||
ziprasidone HCl|No|No|No|No|75%|55111025860|ZIPRASIDONE HCL 60 MG CAPSULE|60|EA|.25083|03/13/2012||Yes|No||03/13/2012||Yes|No|03/13/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.38441|03/29/2022|.37518|03/29/2022|.37768|03/29/2022|||ANTIPSYCHOTICS|13326|||||No|No||DR.REDDY'S LAB|No||||
ziprasidone HCl|No|No|No|No|75%|55111025960|ZIPRASIDONE HCL 80 MG CAPSULE|60|EA|.25083|03/13/2012||Yes|No||03/13/2012||Yes|No|03/13/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.42395|03/29/2022|.41377|03/29/2022|.41653|03/29/2022|||ANTIPSYCHOTICS|13327|||||No|No||DR.REDDY'S LAB|No||||
olanzapine|No|No|No|No|75%|55111026281|OLANZAPINE ODT 5 MG TABLET|30|EA|.74361|11/14/2011||Yes|No||11/14/2011||Yes|No|11/14/2011||Yes|No||||No|No|||Prescription required|No||027|Yes|.59218|03/29/2022|.57796|03/29/2022|.58181|03/29/2022|||ANTIPSYCHOTICS|13328|||||No|No||DR.REDDY'S LAB|No||||
olanzapine|No|No|No|No|75%|55111026381|OLANZAPINE ODT 10 MG TABLET|30|EA|1.09248|11/14/2011||Yes|No||11/14/2011||Yes|No|11/14/2011||Yes|No||||No|No|||Prescription required|No||027|Yes|.58062|03/29/2022|.56668|03/29/2022|.57045|03/29/2022|||ANTIPSYCHOTICS|13329|||||No|No||DR.REDDY'S LAB|No||||
olanzapine|No|No|No|No|75%|55111026481|OLANZAPINE ODT 15 MG TABLET|30|EA|1.61121|11/14/2011||Yes|No||11/14/2011||Yes|No|11/14/2011||Yes|No||||No|No|||Prescription required|No||027|Yes|.85386|03/29/2022|.83336|03/29/2022|.83891|03/29/2022|||ANTIPSYCHOTICS|13330|||||No|No||DR.REDDY'S LAB|No||||
olanzapine|No|No|No|No|75%|55111026581|OLANZAPINE ODT 20 MG TABLET|30|EA|2.12993|11/14/2011||Yes|No||11/14/2011||Yes|No|11/14/2011||Yes|No||||No|No|||Prescription required|No||027|Yes|1.09|03/29/2022|1.06384|03/29/2022|1.07092|03/29/2022|||ANTIPSYCHOTICS|13331|||||No|No||DR.REDDY'S LAB|No||||
simvastatin|Yes|No|No|No|75%|55111026805|SIMVASTATIN 80 MG TABLET|500|EA|.15986|01/26/2007||Yes|No||01/26/2007||Yes|No|01/26/2007||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.09322|03/29/2022|.09098|03/29/2022|.09158|03/29/2022|||LIPOTROPICS: STATINS|13332|||||No|No||DR.REDDY'S LAB|No||||
simvastatin|Yes|No|No|No|75%|55111026830|SIMVASTATIN 80 MG TABLET|30|EA|.15981|01/26/2007||Yes|No||01/26/2007||Yes|No|01/26/2007||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.09322|03/29/2022|.09098|03/29/2022|.09158|03/29/2022|||LIPOTROPICS: STATINS|13333|||||No|No||DR.REDDY'S LAB|No||||
simvastatin|Yes|No|No|No|75%|55111026890|SIMVASTATIN 80 MG TABLET|90|EA|.15986|01/26/2007||Yes|No||01/26/2007||Yes|No|01/26/2007||Yes|No||01/01/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.09322|03/29/2022|.09098|03/29/2022|.09158|03/29/2022|||LIPOTROPICS: STATINS|13334|||||No|No||DR.REDDY'S LAB|No||||
pravastatin sodium|Yes|No|No|No|75%|55111027405|PRAVASTATIN SODIUM 80 MG TAB|500|EA|.15222|07/31/2015||Yes|No||07/31/2015||Yes|No|07/31/2015||Yes|No||07/31/2015||Yes|No|07/01/2016||Prescription required|No||063|Yes|.14996|03/29/2022|.14636|03/29/2022|.14733|03/29/2022|||LIPOTROPICS: STATINS|13335|||||No|No||DR.REDDY'S LAB|No||||
pravastatin sodium|Yes|No|No|No|75%|55111027490|PRAVASTATIN SODIUM 80 MG TAB|90|EA|.17438|07/31/2015||Yes|No||07/31/2015||Yes|No|07/31/2015||Yes|No||07/31/2015||Yes|No|07/01/2016||Prescription required|No||063|Yes|.14996|03/29/2022|.14636|03/29/2022|.14733|03/29/2022|||LIPOTROPICS: STATINS|13336|||||No|No||DR.REDDY'S LAB|No||||
levofloxacin|Yes|No|No|No|75%|55111027950|LEVOFLOXACIN 250 MG TABLET|50|EA|.14473|11/10/2011||Yes|No||11/10/2011||Yes|No|11/10/2011||Yes|No||11/10/2011||Yes|No|07/01/2016||Prescription required|No||028|No|.15969|03/29/2022|.15585|03/29/2022|.15689|03/29/2022|||FLUOROQUINOLONES: ORAL|13337|||||No|No||DR.REDDY'S LAB|No||||
levofloxacin|No|No|No|No|75%|55111028050|LEVOFLOXACIN 500 MG TABLET|50|EA|.16589|11/10/2011||Yes|No||11/10/2011||Yes|No|11/10/2011||Yes|No||11/10/2011||Yes|No|||Prescription required|No||028|No|.19821|03/29/2022|.19345|03/29/2022|.19474|03/29/2022|||FLUOROQUINOLONES: ORAL|13338|||||No|No||DR.REDDY'S LAB|No||||
levofloxacin|No|No|No|No|75%|55111028130|LEVOFLOXACIN 750 MG TABLET|30|EA|.6212|11/10/2011||Yes|No||11/10/2011||Yes|No|11/10/2011||Yes|No||11/10/2011||Yes|No|||Prescription required|No||028|No|.38345|03/29/2022|.37424|03/29/2022|.37673|03/29/2022|||FLUOROQUINOLONES: ORAL|13339|||||No|No||DR.REDDY'S LAB|No||||
fluoxetine HCl|No|No|No|No|75%|55111028448|FLUOXETINE DR 90 MG CAPSULE|4|EA|14.0481|08/30/2010||Yes|No||08/30/2010||Yes|No|08/30/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|008|No|32.0166|02/23/2021|31.55922|02/23/2021|30.0564|02/23/2021|||ANTIDEPRESSANTS: SSRIs|13340|||||No|No||DR.REDDY'S LAB|No||||
naproxen/esomeprazole mag|No|No|No|No|75%|55111028960|NAPROXEN-ESOMEPRAZ DR 375-20MG|60|EA|11.56291|06/02/2020||Yes|No||06/02/2020||Yes|No|06/02/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|26.35269|06/02/2020|25.97622|06/02/2020|24.73926|06/02/2020|||NSAIDS|13341|||||No|No||DR.REDDY'S LAB|No||||
sumatriptan succinate|No|No|No|No|75%|55111029109|SUMATRIPTAN SUCC 25 MG TABLET|9|EA|.76205|02/15/2010|08/31/2023|Yes|No||02/15/2010|08/31/2023|Yes|No|02/15/2010|08/31/2023|Yes|No||||No|No|||Prescription required|No||021|No|.55768|03/29/2022|.54429|03/29/2022|.54792|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|13342|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||DR.REDDY'S LAB|No||||
sumatriptan succinate|No|No|No|No|75%|55111029136|SUMATRIPTAN SUCC 25 MG TABLET|36|EA|1.63447|02/15/2010||Yes|No||02/15/2010||Yes|No|02/15/2010||Yes|No||||No|No|||Prescription required|No||021|No|.55768|03/29/2022|.54429|03/29/2022|.54792|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|13343|||||No|No||DR.REDDY'S LAB|No||||
sumatriptan succinate|No|No|No|No|75%|55111029190|SUMATRIPTAN SUCC 25 MG TABLET|90|EA|1.63447|02/15/2010||Yes|No||02/15/2010||Yes|No|02/15/2010||Yes|No||||No|No|||Prescription required|No||021|No|.55768|03/29/2022|.54429|03/29/2022|.54792|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|13344|||||No|No||DR.REDDY'S LAB|No||||
sumatriptan succinate|No|No|No|No|75%|55111029198|SUMATRIPTAN SUCC 25 MG TABLET|27|EA|.76205|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||021|No|.55768|03/29/2022|.54429|03/29/2022|.54792|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|13345|||||No|No||DR.REDDY'S LAB|No||||
sumatriptan succinate|No|No|No|No|75%|55111029209|SUMATRIPTAN SUCC 50 MG TABLET|9|EA|.76205|02/15/2010|09/30/2023|Yes|No||02/15/2010|09/30/2023|Yes|No|02/15/2010|09/30/2023|Yes|No||||No|No|||Prescription required|No||021|No|.52829|03/29/2022|.51561|03/29/2022|.51904|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|13346|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||DR.REDDY'S LAB|No||||
sumatriptan succinate|No|No|No|No|75%|55111029236|SUMATRIPTAN SUCC 50 MG TABLET|36|EA|.76205|02/15/2010||Yes|No||02/15/2010||Yes|No|02/15/2010||Yes|No||||No|No|||Prescription required|No||021|No|.52829|03/29/2022|.51561|03/29/2022|.51904|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|13347|||||No|No||DR.REDDY'S LAB|No||||
sumatriptan succinate|No|No|No|No|75%|55111029290|SUMATRIPTAN SUCC 50 MG TABLET|90|EA|1.49066|02/15/2010||Yes|No||02/15/2010||Yes|No|02/15/2010||Yes|No||||No|No|||Prescription required|No||021|No|.52829|03/29/2022|.51561|03/29/2022|.51904|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|13348|||||No|No||DR.REDDY'S LAB|No||||
sumatriptan succinate|No|No|No|No|75%|55111029298|SUMATRIPTAN SUCC 50 MG TABLET|27|EA|.76205|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||021|No|.52829|03/29/2022|.51561|03/29/2022|.51904|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|13349|||||No|No||DR.REDDY'S LAB|No||||
sumatriptan succinate|No|No|No|No|75%|55111029309|SUMATRIPTAN SUCC 100 MG TABLET|9|EA|.76205|02/15/2010|08/31/2023|Yes|No||02/15/2010|08/31/2023|Yes|No|02/15/2010|08/31/2023|Yes|No||||No|No|||Prescription required|No||021|No|.54919|03/29/2022|.536|03/29/2022|.53957|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|13350|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||DR.REDDY'S LAB|No||||
sumatriptan succinate|No|No|No|No|75%|55111029336|SUMATRIPTAN SUCC 100 MG TABLET|36|EA|.76205|02/15/2010||Yes|No||02/15/2010||Yes|No|02/15/2010||Yes|No||||No|No|||Prescription required|No||021|No|.54919|03/29/2022|.536|03/29/2022|.53957|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|13351|||||No|No||DR.REDDY'S LAB|No||||
sumatriptan succinate|No|No|No|No|75%|55111029390|SUMATRIPTAN SUCC 100 MG TABLET|90|EA|1.49066|02/15/2010||Yes|No||02/15/2010||Yes|No|02/15/2010||Yes|No||||No|No|||Prescription required|No||021|No|.54919|03/29/2022|.536|03/29/2022|.53957|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|13352|||||No|No||DR.REDDY'S LAB|No||||
sumatriptan succinate|No|No|No|No|75%|55111029398|SUMATRIPTAN SUCC 100 MG TABLET|27|EA|.76205|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|No||021|No|.54919|03/29/2022|.536|03/29/2022|.53957|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|13353|||||No|No||DR.REDDY'S LAB|No||||
donepezil HCl|No|No|No|No|75%|55111030230|DONEPEZIL HCL 23 MG TABLET|30|EA|.78045|08/09/2013||Yes|No||08/09/2013||Yes|No|08/09/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.75152|03/29/2022|.73348|03/29/2022|.73836|03/29/2022|||ALZHEIMER'S AGENTS|13354|||||No|No||DR.REDDY'S LAB|No||||
donepezil HCl|No|No|No|No|75%|55111030290|DONEPEZIL HCL 23 MG TABLET|90|EA|.78045|08/09/2013||Yes|No||08/09/2013||Yes|No|08/09/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.75152|03/29/2022|.73348|03/29/2022|.73836|03/29/2022|||ALZHEIMER'S AGENTS|13355|||||No|No||DR.REDDY'S LAB|No||||
glimepiride|Yes|No|No|No|75%|55111032001|GLIMEPIRIDE 1 MG TABLET|100|EA|.03844|10/06/2005||Yes|No||10/06/2005||Yes|No|10/06/2005||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.03361|03/29/2022|.0328|03/29/2022|.03302|03/29/2022||||13356|||||No|No||DR.REDDY'S LAB|No||||
glimepiride|Yes|No|No|No|75%|55111032005|GLIMEPIRIDE 1 MG TABLET|500|EA|.03728|10/06/2005||Yes|No||10/06/2005||Yes|No|10/06/2005||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.03361|03/29/2022|.0328|03/29/2022|.03302|03/29/2022||||13357|||||No|No||DR.REDDY'S LAB|No||||
glimepiride|Yes|No|No|No|75%|55111032101|GLIMEPIRIDE 2 MG TABLET|100|EA|.0623|10/06/2005||Yes|No||10/06/2005||Yes|No|10/06/2005||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.03979|03/29/2022|.03883|03/29/2022|.03909|03/29/2022||||13358|||||No|No||DR.REDDY'S LAB|No||||
glimepiride|Yes|No|No|No|75%|55111032105|GLIMEPIRIDE 2 MG TABLET|500|EA|.06042|10/06/2005||Yes|No||10/06/2005||Yes|No|10/06/2005||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.03979|03/29/2022|.03883|03/29/2022|.03909|03/29/2022||||13359|||||No|No||DR.REDDY'S LAB|No||||
glimepiride|Yes|No|No|No|75%|55111032201|GLIMEPIRIDE 4 MG TABLET|100|EA|.11751|10/06/2005||Yes|No||10/06/2005||Yes|No|10/06/2005||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.04419|03/29/2022|.04312|03/29/2022|.04341|03/29/2022||||13360|||||No|No||DR.REDDY'S LAB|No||||
glimepiride|Yes|No|No|No|75%|55111032205|GLIMEPIRIDE 4 MG TABLET|500|EA|.11397|10/06/2005||Yes|No||10/06/2005||Yes|No|10/06/2005||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.04419|03/29/2022|.04312|03/29/2022|.04341|03/29/2022||||13361|||||No|No||DR.REDDY'S LAB|No||||
nateglinide|Yes|No|No|No|75%|55111032890|NATEGLINIDE 60 MG TABLET|90|EA|.19679|09/11/2009||Yes|No||09/11/2009||Yes|No|09/11/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||022|Yes|.3103|03/29/2022|.30285|03/29/2022|.30486|03/29/2022|||HYPOGLYCEMICS: MEGLITINIDES|13362|||||No|No||DR.REDDY'S LAB|No||||
nateglinide|Yes|No|No|No|75%|55111032990|NATEGLINIDE 120 MG TABLET|90|EA|.20448|09/11/2009||Yes|No||09/11/2009||Yes|No|09/11/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||022|Yes|.33379|03/29/2022|.32577|03/29/2022|.32794|03/29/2022|||HYPOGLYCEMICS: MEGLITINIDES|13363|||||No|No||DR.REDDY'S LAB|No||||
pantoprazole sodium|No|No|No|No|75%|55111033290|PANTOPRAZOLE SOD DR 20 MG TAB|90|EA|.09746|01/28/2011||Yes|No||01/28/2011||Yes|No|01/28/2011||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|Yes|.05306|03/29/2022|.05178|03/29/2022|.05213|03/29/2022|||PROTON PUMP INHIBITORS|13364|||||No|No||DR.REDDY'S LAB|No||||
pantoprazole sodium|No|No|No|No|75%|55111033390|PANTOPRAZOLE SOD DR 40 MG TAB|90|EA|.09746|01/28/2011||Yes|No||01/28/2011||Yes|No|01/28/2011||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|No|.05828|03/29/2022|.05688|03/29/2022|.05726|03/29/2022|||PROTON PUMP INHIBITORS|13365|||||No|No||DR.REDDY'S LAB|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|55111033801|AMLODIPINE-BENAZEPRIL 2.5-10|100|EA|.06295|07/27/2010||Yes|No||07/27/2010||Yes|No|07/27/2010||Yes|No||01/01/2012||Yes|No|||Prescription required|No||017|No|.11834|03/29/2022|.11549|03/29/2022|.11626|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13366|||||No|No||DR.REDDY'S LAB|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|55111033901|AMLODIPINE-BENAZEPRIL 5-10 MG|100|EA|.06419|07/27/2010||Yes|No||07/27/2010||Yes|No|07/27/2010||Yes|No||01/01/2012||Yes|No|||Prescription required|No||017|No|.11526|03/29/2022|.11249|03/29/2022|.11324|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13367|||||No|No||DR.REDDY'S LAB|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|55111034001|AMLODIPINE-BENAZEPRIL 5-20 MG|100|EA|.06781|07/27/2010||Yes|No||07/27/2010||Yes|No|07/27/2010||Yes|No||01/01/2012||Yes|No|||Prescription required|No||017|No|.13285|03/29/2022|.12966|03/29/2022|.13052|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13368|||||No|No||DR.REDDY'S LAB|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|55111034101|AMLODIPINE-BENAZEPRIL 10-20 MG|100|EA|.07877|07/27/2010||Yes|No||07/27/2010||Yes|No|07/27/2010||Yes|No||01/01/2012||Yes|No|||Prescription required|No||017|No|.14427|03/29/2022|.1408|03/29/2022|.14174|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13369|||||No|No||DR.REDDY'S LAB|No||||
citalopram hydrobromide|No|No|No|No|75%|55111034205|CITALOPRAM HBR 10 MG TABLET|500|EA|.0465|12/20/2021||Yes|No||12/20/2021||Yes|No|12/20/2021||Yes|No||||No|No|||Prescription required|No||008|Yes|.02682|03/29/2022|.02617|03/29/2022|.02635|03/29/2022|||ANTIDEPRESSANTS: SSRIs|13370|||||No|No||DR.REDDY'S LAB|No||||
citalopram hydrobromide|No|No|No|No|75%|55111034305|CITALOPRAM HBR 20 MG TABLET|500|EA|.04797|12/20/2021||Yes|No||12/20/2021||Yes|No|12/20/2021||Yes|No||||No|No|||Prescription required|No||008|Yes|.02946|03/29/2022|.02875|03/29/2022|.02894|03/29/2022|||ANTIDEPRESSANTS: SSRIs|13371|||||No|No||DR.REDDY'S LAB|No||||
citalopram hydrobromide|No|No|No|No|75%|55111034405|CITALOPRAM HBR 40 MG TABLET|500|EA|.0488|12/20/2021||Yes|No||12/20/2021||Yes|No|12/20/2021||Yes|No||||No|No|||Prescription required|No||008|No|.03726|03/29/2022|.03636|03/29/2022|.0366|03/29/2022|||ANTIDEPRESSANTS: SSRIs|13372|||||No|No||DR.REDDY'S LAB|No||||
rivastigmine tartrate|No|No|No|No|75%|55111035205|RIVASTIGMINE 1.5 MG CAPSULE|500|EA|.89581|11/10/2011||Yes|No||11/10/2011||Yes|No|11/10/2011||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.26635|03/29/2022|.25995|03/29/2022|.26168|03/29/2022|||ALZHEIMER'S AGENTS|13373|||||No|No||DR.REDDY'S LAB|No||||
rivastigmine tartrate|No|No|No|No|75%|55111035260|RIVASTIGMINE 1.5 MG CAPSULE|60|EA|.25083|11/10/2011||Yes|No||11/10/2011||Yes|No|11/10/2011||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.26635|03/29/2022|.25995|03/29/2022|.26168|03/29/2022|||ALZHEIMER'S AGENTS|13374|||||No|No||DR.REDDY'S LAB|No||||
rivastigmine tartrate|No|No|No|No|75%|55111035305|RIVASTIGMINE 3 MG CAPSULE|500|EA|.89581|11/10/2011||Yes|No||11/10/2011||Yes|No|11/10/2011||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.2376|03/29/2022|.23189|03/29/2022|.23344|03/29/2022|||ALZHEIMER'S AGENTS|13375|||||No|No||DR.REDDY'S LAB|No||||
rivastigmine tartrate|No|No|No|No|75%|55111035360|RIVASTIGMINE 3 MG CAPSULE|60|EA|.25083|11/10/2011||Yes|No||11/10/2011||Yes|No|11/10/2011||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.2376|03/29/2022|.23189|03/29/2022|.23344|03/29/2022|||ALZHEIMER'S AGENTS|13376|||||No|No||DR.REDDY'S LAB|No||||
rivastigmine tartrate|No|No|No|No|75%|55111035405|RIVASTIGMINE 4.5 MG CAPSULE|500|EA|.89581|11/10/2011||Yes|No||11/10/2011||Yes|No|11/10/2011||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.27604|03/29/2022|.26941|03/29/2022|.2712|03/29/2022|||ALZHEIMER'S AGENTS|13377|||||No|No||DR.REDDY'S LAB|No||||
rivastigmine tartrate|No|No|No|No|75%|55111035460|RIVASTIGMINE 4.5 MG CAPSULE|60|EA|.25083|11/10/2011||Yes|No||11/10/2011||Yes|No|11/10/2011||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.27604|03/29/2022|.26941|03/29/2022|.2712|03/29/2022|||ALZHEIMER'S AGENTS|13378|||||No|No||DR.REDDY'S LAB|No||||
rivastigmine tartrate|No|No|No|No|75%|55111035505|RIVASTIGMINE 6 MG CAPSULE|500|EA|.89581|11/10/2011||Yes|No||11/10/2011||Yes|No|11/10/2011||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.35091|03/29/2022|.34248|03/29/2022|.34476|03/29/2022|||ALZHEIMER'S AGENTS|13379|||||No|No||DR.REDDY'S LAB|No||||
rivastigmine tartrate|No|No|No|No|75%|55111035560|RIVASTIGMINE 6 MG CAPSULE|60|EA|.25083|11/10/2011||Yes|No||11/10/2011||Yes|No|11/10/2011||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.35091|03/29/2022|.34248|03/29/2022|.34476|03/29/2022|||ALZHEIMER'S AGENTS|13380|||||No|No||DR.REDDY'S LAB|No||||
donepezil HCl|No|No|No|No|75%|55111035605|DONEPEZIL HCL 5 MG TABLET|500|EA|.33486|11/10/2011||Yes|No||11/10/2011||Yes|No|11/10/2011||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|13381|||||No|No||DR.REDDY'S LAB|No||||
donepezil HCl|No|No|No|No|75%|55111035610|DONEPEZIL HCL 5 MG TABLET|1000|EA|.33486|11/10/2011||Yes|No||11/10/2011||Yes|No|11/10/2011||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|13382|||||No|No||DR.REDDY'S LAB|No||||
donepezil HCl|No|No|No|No|75%|55111035705|DONEPEZIL HCL 10 MG TABLET|500|EA|.33486|11/10/2011||Yes|No||11/10/2011||Yes|No|11/10/2011||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|13383|||||No|No||DR.REDDY'S LAB|No||||
donepezil HCl|No|No|No|No|75%|55111035710|DONEPEZIL HCL 10 MG TABLET|1000|EA|.33486|11/10/2011||Yes|No||11/10/2011||Yes|No|11/10/2011||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|13384|||||No|No||DR.REDDY'S LAB|No||||
desloratadine|No|No|No|No|75%|55111036031|DESLORATADINE 5 MG ODT|30|EA|2.08736|01/31/2013||Yes|No||01/31/2013||Yes|No|01/31/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|030|Yes|4.75724|06/01/2016|4.68928|06/01/2016|4.46598|06/01/2016|||ANTIHISTAMINES: MINIMALLY SEDATING|13385|||||No|No||DR.REDDY'S LAB|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|55111036330|OMEPRAZOLE-BICARB 20-1,100 CAP|30|EA|1.87766|11/16/2016||Yes|No||11/16/2016||Yes|No|11/16/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|1.11633|03/29/2022|1.08953|03/29/2022|1.09679|03/29/2022|||PROTON PUMP INHIBITORS|13386|||||No|No||DR.REDDY'S LAB|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|55111036430|OMEPRAZOLE-BICARB 40-1,100 CAP|30|EA|1.87766|11/16/2016||Yes|No||11/16/2016||Yes|No|11/16/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|1.14084|03/29/2022|1.11345|03/29/2022|1.12087|03/29/2022|||PROTON PUMP INHIBITORS|13387|||||No|No||DR.REDDY'S LAB|No||||
famotidine|No|No|No|No|75%|55111039601|FAMOTIDINE 20 MG TABLET|100|EA|.04291|05/19/2021||Yes|No||||No|No|05/19/2021||Yes|No||05/19/2021||Yes|No|||Over the counter|No|||No|.14581|03/29/2022|.14231|03/29/2022|.14325|03/29/2022||||13388|||||No|No||DR.REDDY'S LAB|No||||
omeprazole magnesium|No|No|No|No|75%|55111039727|OMEPRAZOLE MAG DR 20.6 MG CAP|28|EA|.23481|06/01/2016||Yes|No||||No|No|06/01/2016||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|No|.34674|03/29/2022|.33841|03/29/2022|.34067|03/29/2022|||PROTON PUMP INHIBITORS|13389|||||No|No||DR.REDDY'S LAB|No||||
omeprazole magnesium|No|No|No|No|75%|55111039733|OMEPRAZOLE MAG DR 20.6 MG CAP|42|EA|.21243|02/11/2016||Yes|No||||No|No|02/11/2016||Yes|No||||No|No|||Over the counter|Yes|12/01/2021|047|No|.34674|03/29/2022|.33841|03/29/2022|.34067|03/29/2022|||PROTON PUMP INHIBITORS|13390|||||No|No||DR.REDDY'S LAB|No||||
lansoprazole|No|No|No|No|75%|55111039830|LANSOPRAZOLE DR 15 MG CAPSULE|30|EA|.258|11/02/2010||Yes|No||11/02/2010||Yes|No|11/02/2010||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|Yes|.24898|03/29/2022|.243|03/29/2022|.24462|03/29/2022|||PROTON PUMP INHIBITORS|13391|||||No|No||DR.REDDY'S LAB|No||||
lansoprazole|No|No|No|No|75%|55111039890|LANSOPRAZOLE DR 15 MG CAPSULE|90|EA|.258|11/02/2010||Yes|No||11/02/2010||Yes|No|11/02/2010||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|Yes|.24898|03/29/2022|.243|03/29/2022|.24462|03/29/2022|||PROTON PUMP INHIBITORS|13392|||||No|No||DR.REDDY'S LAB|No||||
lansoprazole|No|No|No|No|75%|55111039905|LANSOPRAZOLE DR 30 MG CAPSULE|500|EA|.16125|11/02/2010||Yes|No||11/02/2010||Yes|No|11/02/2010||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.12249|03/29/2022|.11955|03/29/2022|.12034|03/29/2022|||PROTON PUMP INHIBITORS|13393|||||No|No||DR.REDDY'S LAB|No||||
lansoprazole|No|No|No|No|75%|55111039990|LANSOPRAZOLE DR 30 MG CAPSULE|90|EA|.16125|11/02/2010||Yes|No||11/02/2010||Yes|No|11/02/2010||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.12249|03/29/2022|.11955|03/29/2022|.12034|03/29/2022|||PROTON PUMP INHIBITORS|13394|||||No|No||DR.REDDY'S LAB|No||||
lamotrigine|No|No|No|No|75%|55111041930|LAMOTRIGINE ER 250 MG TABLET|30|EA|3.35987|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No||056|No|5.54243|03/29/2022|5.40941|03/29/2022|5.44543|03/29/2022|||ANTICONVULSANTS|13395|||||No|No||DR.REDDY'S LAB|No||||
lamotrigine|No|No|No|No|75%|55111042830|LAMOTRIGINE ER 300 MG TABLET|30|EA|5.57437|07/03/2013||Yes|No||07/03/2013||Yes|No|07/03/2013||Yes|No||||No|No|||Prescription required|No||056|No|4.96792|03/29/2022|4.84868|03/29/2022|4.88098|03/29/2022|||ANTICONVULSANTS|13396|||||No|No||DR.REDDY'S LAB|No||||
metoprolol succinate|No|No|No|No|75%|55111046601|METOPROLOL SUCC ER 25 MG TAB|100|EA|.10474|09/21/2012||Yes|No||09/21/2012||Yes|No|09/21/2012||Yes|No||09/21/2012||Yes|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|13397|||||No|No||DR.REDDY'S LAB|No||||
metoprolol succinate|No|No|No|No|75%|55111046605|METOPROLOL SUCC ER 25 MG TAB|500|EA|.10473|12/03/2012||Yes|No||12/03/2012||Yes|No|12/03/2012||Yes|No||12/03/2012||Yes|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|13398|||||No|No||DR.REDDY'S LAB|No||||
metoprolol succinate|No|No|No|No|75%|55111046701|METOPROLOL SUCC ER 50 MG TAB|100|EA|.10474|12/03/2012||Yes|No||12/03/2012||Yes|No|12/03/2012||Yes|No||12/03/2012||Yes|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|13399|||||No|No||DR.REDDY'S LAB|No||||
metoprolol succinate|No|No|No|No|75%|55111046705|METOPROLOL SUCC ER 50 MG TAB|500|EA|.10473|12/03/2012||Yes|No||12/03/2012||Yes|No|12/03/2012||Yes|No||12/03/2012||Yes|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|13400|||||No|No||DR.REDDY'S LAB|No||||
metoprolol succinate|No|No|No|No|75%|55111046801|METOPROLOL SUCC ER 100 MG TAB|100|EA|.15738|12/03/2012||Yes|No||12/03/2012||Yes|No|12/03/2012||Yes|No||12/03/2012||Yes|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|13401|||||No|No||DR.REDDY'S LAB|No||||
metoprolol succinate|No|No|No|No|75%|55111046805|METOPROLOL SUCC ER 100 MG TAB|500|EA|.15738|12/03/2012||Yes|No||12/03/2012||Yes|No|12/03/2012||Yes|No||12/03/2012||Yes|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|13402|||||No|No||DR.REDDY'S LAB|No||||
metoprolol succinate|No|No|No|No|75%|55111046901|METOPROLOL SUCC ER 200 MG TAB|100|EA|.25043|12/03/2012||Yes|No||12/03/2012||Yes|No|12/03/2012||Yes|No||12/03/2012||Yes|No|||Prescription required|No||070|No|.25385|03/29/2022|.24775|03/29/2022|.2494|03/29/2022|||BETA-BLOCKERS|13403|||||No|No||DR.REDDY'S LAB|No||||
metoprolol succinate|No|No|No|No|75%|55111046905|METOPROLOL SUCC ER 200 MG TAB|500|EA|.2504|12/03/2012||Yes|No||12/03/2012||Yes|No|12/03/2012||Yes|No||12/03/2012||Yes|No|||Prescription required|No||070|No|.25385|03/29/2022|.24775|03/29/2022|.2494|03/29/2022|||BETA-BLOCKERS|13404|||||No|No||DR.REDDY'S LAB|No||||
zolpidem tartrate|No|No|No|No|90%|55111047801|ZOLPIDEM TARTRATE 5 MG TABLET|100|EA|.05301|05/01/2007||Yes|No||05/01/2007||Yes|No|05/01/2007||Yes|No||||No|No|||Prescription required|No||054|Yes|.03056|03/29/2022|.02982|03/29/2022|.03002|03/29/2022|||SEDATIVE HYPNOTICS|13405|||||No|No||DR.REDDY'S LAB|No||||
zolpidem tartrate|No|No|No|No|90%|55111047901|ZOLPIDEM TARTRATE 10 MG TABLET|100|EA|.05301|05/01/2007||Yes|No||05/01/2007||Yes|No|05/01/2007||Yes|No||||No|No|||Prescription required|No||054|Yes|.0301|03/29/2022|.02937|03/29/2022|.02957|03/29/2022|||SEDATIVE HYPNOTICS|13406|||||No|No||DR.REDDY'S LAB|No||||
esomeprazole magnesium|No|No|No|No|75%|55111049230|ESOMEPRAZOLE MAG DR 20 MG CAP|30|EA|2.19887|01/29/2016||Yes|No||01/29/2016||Yes|No|01/29/2016||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|13407|||||No|No||DR.REDDY'S LAB|No||||
esomeprazole magnesium|No|No|No|No|75%|55111049330|ESOMEPRAZOLE MAG DR 40 MG CAP|30|EA|2.19887|12/11/2015||Yes|No||12/11/2015||Yes|No|12/11/2015||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|13408|||||No|No||DR.REDDY'S LAB|No||||
capecitabine|No|No|No|No|75%|55111049660|CAPECITABINE 150 MG TABLET|60|EA|.21858|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||502|No|.49816|06/08/2021|.49104|06/08/2021|.46766|06/08/2021|||ONCOLOGY: ORAL - BREAST|13409|||||No|No||DR.REDDY'S LAB|No||||
capecitabine|No|No|No|No|75%|55111049704|CAPECITABINE 500 MG TABLET|120|EA|.3225|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||502|No|.61977|12/28/2021|.60489|12/28/2021|.60892|12/28/2021|||ONCOLOGY: ORAL - BREAST|13410|||||No|No||DR.REDDY'S LAB|No||||
atomoxetine HCl|No|No|No|No|75%|55111051930|ATOMOXETINE HCL 10 MG CAPSULE|30|EA|1.21833|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|1.20613|03/29/2022|1.17718|03/29/2022|1.18502|03/29/2022|||STIMULANTS AND RELATED AGENTS|13411|||||No|No||DR.REDDY'S LAB|No||||
atomoxetine HCl|No|No|No|No|75%|55111052030|ATOMOXETINE HCL 18 MG CAPSULE|30|EA|1.21833|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|1.0614|03/29/2022|1.03592|03/29/2022|1.04282|03/29/2022|||STIMULANTS AND RELATED AGENTS|13412|||||No|No||DR.REDDY'S LAB|No||||
atomoxetine HCl|No|No|No|No|75%|55111052130|ATOMOXETINE HCL 40 MG CAPSULE|30|EA|1.333|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|1.0462|03/29/2022|1.02109|03/29/2022|1.02789|03/29/2022|||STIMULANTS AND RELATED AGENTS|13413|||||No|No||DR.REDDY'S LAB|No||||
atomoxetine HCl|No|No|No|No|75%|55111052230|ATOMOXETINE HCL 60 MG CAPSULE|30|EA|1.333|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|1.16565|03/29/2022|1.13767|03/29/2022|1.14525|03/29/2022|||STIMULANTS AND RELATED AGENTS|13414|||||No|No||DR.REDDY'S LAB|No||||
tacrolimus|No|No|No|No|75%|55111052501|TACROLIMUS 0.5 MG CAPSULE (IR)|100|EA|.15858|07/27/2010||Yes|No||07/27/2010||Yes|No|07/27/2010||Yes|No||01/01/2012||Yes|No|||Prescription required|No||229|No|.26138|03/29/2022|.2551|03/29/2022|.2568|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|13415|||||No|No||DR.REDDY'S LAB|No||||
tacrolimus|No|No|No|No|75%|55111052601|TACROLIMUS 1 MG CAPSULE (IR)|100|EA|.3108|07/27/2010||Yes|No||07/27/2010||Yes|No|07/27/2010||Yes|No||01/01/2012||Yes|No|||Prescription required|No||229|No|.35645|03/29/2022|.34789|03/29/2022|.35021|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|13416|||||No|No||DR.REDDY'S LAB|No||||
tacrolimus|No|No|No|No|75%|55111052701|TACROLIMUS 5 MG CAPSULE (IR)|100|EA|1.48414|07/27/2010||Yes|No||07/27/2010||Yes|No|07/27/2010||Yes|No||01/01/2012||Yes|No|||Prescription required|No||229|No|2.05753|03/29/2022|2.00814|03/29/2022|2.02152|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|13417|||||No|No||DR.REDDY'S LAB|No||||
atomoxetine HCl|No|No|No|No|75%|55111052830|ATOMOXETINE HCL 25 MG CAPSULE|30|EA|1.21833|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|1.05569|03/29/2022|1.03035|03/29/2022|1.03721|03/29/2022|||STIMULANTS AND RELATED AGENTS|13418|||||No|No||DR.REDDY'S LAB|No||||
divalproex sodium|No|No|No|No|75%|55111053201|DIVALPROEX DR 125 MG CAP SPRNK|100|EA|.40119|08/11/2009||Yes|No||08/11/2009||Yes|No|08/11/2009||Yes|No||01/01/2012||Yes|No|||Prescription required|No||056|No|.31191|03/29/2022|.30442|03/29/2022|.30645|03/29/2022|||ANTICONVULSANTS|13419|||||No|No||DR.REDDY'S LAB|No||||
divalproex sodium|No|No|No|No|75%|55111053205|DIVALPROEX DR 125 MG CAP SPRNK|500|EA|.40117|10/02/2009||Yes|No||10/02/2009||Yes|No|10/02/2009||Yes|No||01/01/2012||Yes|No|||Prescription required|No||056|No|.31191|03/29/2022|.30442|03/29/2022|.30645|03/29/2022|||ANTICONVULSANTS|13420|||||No|No||DR.REDDY'S LAB|No||||
divalproex sodium|No|No|No|No|75%|55111053301|DIVALPROEX SOD ER 250 MG TAB|100|EA|.1849|09/05/2013||Yes|No||09/05/2013||Yes|No|09/05/2013||Yes|No||09/05/2013||Yes|No|||Prescription required|No||056|Yes|.17839|03/29/2022|.1741|03/29/2022|.17526|03/29/2022|||ANTICONVULSANTS|13421|||||No|No||DR.REDDY'S LAB|No||||
divalproex sodium|No|No|No|No|75%|55111053305|DIVALPROEX SOD ER 250 MG TAB|500|EA|.17565|09/10/2013||Yes|No||09/10/2013||Yes|No|09/10/2013||Yes|No||09/10/2013||Yes|No|||Prescription required|No||056|Yes|.17839|03/29/2022|.1741|03/29/2022|.17526|03/29/2022|||ANTICONVULSANTS|13422|||||No|No||DR.REDDY'S LAB|No||||
divalproex sodium|No|No|No|No|75%|55111053401|DIVALPROEX SOD ER 500 MG TAB|100|EA|.30693|09/05/2013||Yes|No||09/05/2013||Yes|No|09/05/2013||Yes|No||09/05/2013||Yes|No|||Prescription required|No||056|No|.21008|03/29/2022|.20503|03/29/2022|.2064|03/29/2022|||ANTICONVULSANTS|13423|||||No|No||DR.REDDY'S LAB|No||||
divalproex sodium|No|No|No|No|75%|55111053405|DIVALPROEX SOD ER 500 MG TAB|500|EA|.29159|09/05/2013||Yes|No||09/05/2013||Yes|No|09/05/2013||Yes|No||09/05/2013||Yes|No|||Prescription required|No||056|No|.21008|03/29/2022|.20503|03/29/2022|.2064|03/29/2022|||ANTICONVULSANTS|13424|||||No|No||DR.REDDY'S LAB|No||||
desloratadine|No|No|No|No|75%|55111055131|DESLORATADINE 2.5 MG ODT|30|EA|2.08736|01/31/2013||Yes|No||01/31/2013||Yes|No|01/31/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|030|Yes|4.75724|06/01/2016|4.68928|06/01/2016|4.46598|06/01/2016|||ANTIHISTAMINES: MINIMALLY SEDATING|13425|||||No|No||DR.REDDY'S LAB|No||||
atomoxetine HCl|No|No|No|No|75%|55111056330|ATOMOXETINE HCL 80 MG CAPSULE|30|EA|1.44766|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|1.40838|03/29/2022|1.37457|03/29/2022|1.38373|03/29/2022|||STIMULANTS AND RELATED AGENTS|13426|||||No|No||DR.REDDY'S LAB|No||||
atomoxetine HCl|No|No|No|No|75%|55111056430|ATOMOXETINE HCL 100 MG CAPSULE|30|EA|1.44766|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|1.76872|03/29/2022|1.72627|03/29/2022|1.73776|03/29/2022|||STIMULANTS AND RELATED AGENTS|13427|||||No|No||DR.REDDY'S LAB|No||||
ibandronate sodium|No|No|No|No|75%|55111057503|IBANDRONATE SODIUM 150 MG TAB|3|EA|6.09166|07/10/2012|07/31/2024|Yes|No||07/10/2012|07/31/2024|Yes|No|07/10/2012|07/31/2024|Yes|No||||No|No|||Prescription required|Yes|01/25/2012|060|No|5.47616|03/29/2022|5.34473|03/29/2022|5.38032|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|13428|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||DR.REDDY'S LAB|No||||
ibandronate sodium|No|No|No|No|75%|55111057511|IBANDRONATE SODIUM 150 MG TAB|1|EA||02/12/2013||Yes|No||02/12/2013||Yes|No|02/12/2013||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|060|No|5.47616|03/29/2022|5.34473|03/29/2022|5.38032|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|13429|||||No|No||DR.REDDY'S LAB|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|55111058601|AMLODIPINE-BENAZEPRIL 10-40 MG|100|EA|.10827|11/10/2011||Yes|No||11/10/2011||Yes|No|11/10/2011||Yes|No||01/01/2012||Yes|No|||Prescription required|No||017|No|.17354|03/29/2022|.16937|03/29/2022|.1705|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13430|||||No|No||DR.REDDY'S LAB|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|55111058701|AMLODIPINE-BENAZEPRIL 5-40 MG|100|EA|.08961|11/10/2011||Yes|No||11/10/2011||Yes|No|11/10/2011||Yes|No||01/01/2012||Yes|No|||Prescription required|No||017|No|.15246|03/29/2022|.1488|03/29/2022|.14979|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13431|||||No|No||DR.REDDY'S LAB|No||||
memantine HCl|No|No|No|No|75%|55111059660|MEMANTINE HCL 5 MG TABLET|60|EA|.17916|06/09/2016||Yes|No||06/09/2016||Yes|No|06/09/2016||Yes|No||||No|No|||Prescription required|No||011|No|.08825|03/29/2022|.08613|03/29/2022|.0867|03/29/2022|||ALZHEIMER'S AGENTS|13432|||||No|No||DR.REDDY'S LAB|No||||
memantine HCl|No|No|No|No|75%|55111059705|MEMANTINE HCL 10 MG TABLET|500|EA|.17888|06/09/2016||Yes|No||06/09/2016||Yes|No|06/09/2016||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|13433|||||No|No||DR.REDDY'S LAB|No||||
memantine HCl|No|No|No|No|75%|55111059760|MEMANTINE HCL 10 MG TABLET|60|EA|.17916|06/09/2016||Yes|No||06/09/2016||Yes|No|06/09/2016||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|13434|||||No|No||DR.REDDY'S LAB|No||||
pramipexole di-HCl|No|No|No|No|75%|55111061130|PRAMIPEXOLE ER 0.375 MG TABLET|30|EA|5.1405|10/29/2015||Yes|No||10/29/2015||Yes|No|10/29/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|015|No|11.71556|03/24/2020|11.5482|03/24/2020|10.99828|03/24/2020|||ANTIPARKINSON'S AGENTS|13435|||||No|No||DR.REDDY'S LAB|No||||
pramipexole di-HCl|No|No|No|No|75%|55111061230|PRAMIPEXOLE ER 0.75 MG TABLET|30|EA|5.1405|10/29/2015||Yes|No||10/29/2015||Yes|No|10/29/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|015|No|11.71556|03/27/2018|11.5482|03/27/2018|10.99828|03/27/2018|||ANTIPARKINSON'S AGENTS|13436|||||No|No||DR.REDDY'S LAB|No||||
pramipexole di-HCl|No|No|No|No|75%|55111061330|PRAMIPEXOLE ER 1.5 MG TABLET|30|EA|5.1405|10/29/2015||Yes|No||10/29/2015||Yes|No|10/29/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|015|No|5.85567|03/01/2022|5.71513|03/01/2022|5.75319|03/01/2022|||ANTIPARKINSON'S AGENTS|13437|||||No|No||DR.REDDY'S LAB|No||||
pramipexole di-HCl|No|No|No|No|75%|55111061430|PRAMIPEXOLE ER 3 MG TABLET|30|EA|5.1405|10/29/2015||Yes|No||10/29/2015||Yes|No|10/29/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|015|No|11.71556|04/27/2021|11.5482|04/27/2021|10.99828|04/27/2021|||ANTIPARKINSON'S AGENTS|13438|||||No|No||DR.REDDY'S LAB|No||||
pramipexole di-HCl|No|No|No|No|75%|55111061530|PRAMIPEXOLE ER 4.5 MG TABLET|30|EA|5.1405|10/29/2015||Yes|No||10/29/2015||Yes|No|10/29/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|015|No|11.71556|10/24/2017|11.5482|10/24/2017|10.99828|10/24/2017|||ANTIPARKINSON'S AGENTS|13439|||||No|No||DR.REDDY'S LAB|No||||
eszopiclone|No|No|No|No|90%|55111061701|ESZOPICLONE 3 MG TABLET|100|EA|.10861|08/13/2014||Yes|No||08/13/2014||Yes|No|08/13/2014||Yes|No||||No|No|||Prescription required|No||054|Yes|.14316|03/29/2022|.13972|03/29/2022|.14065|03/29/2022|||SEDATIVE HYPNOTICS|13440|||||No|No||DR.REDDY'S LAB|No||||
eszopiclone|No|No|No|No|90%|55111061901|ESZOPICLONE 2 MG TABLET|100|EA|.10861|08/13/2014||Yes|No||08/13/2014||Yes|No|08/13/2014||Yes|No||||No|No|||Prescription required|No||054|Yes|.25375|03/29/2022|.24766|03/29/2022|.2493|03/29/2022|||SEDATIVE HYPNOTICS|13441|||||No|No||DR.REDDY'S LAB|No||||
zafirlukast|No|No|No|No|75%|55111062560|ZAFIRLUKAST 10 MG TABLET|60|EA|.77471|11/24/2010||Yes|No||11/24/2010||Yes|No|11/24/2010||Yes|No||||No|No|||Prescription required|Yes|07/28/2010|042|Yes|1.0831|03/01/2022|1.0571|03/01/2022|1.06414|03/01/2022|||LEUKOTRIENE MODIFIERS|13442|||||No|No||DR.REDDY'S LAB|No||||
zafirlukast|No|No|No|No|75%|55111062660|ZAFIRLUKAST 20 MG TABLET|60|EA|.77471|11/24/2010||Yes|No||11/24/2010||Yes|No|11/24/2010||Yes|No||||No|No|||Prescription required|Yes|07/28/2010|042|Yes|.93036|03/29/2022|.90803|03/29/2022|.91407|03/29/2022|||LEUKOTRIENE MODIFIERS|13443|||||No|No||DR.REDDY'S LAB|No||||
eszopiclone|No|No|No|No|90%|55111062930|ESZOPICLONE 1 MG TABLET|30|EA|.10864|08/13/2014||Yes|No||08/13/2014||Yes|No|08/13/2014||Yes|No||||No|No|||Prescription required|No||054|Yes|.19753|03/29/2022|.19278|03/29/2022|.19407|03/29/2022|||SEDATIVE HYPNOTICS|13444|||||No|No||DR.REDDY'S LAB|No||||
minocycline HCl|No|No|No|No|75%|55111063701|MINOCYCLINE HCL 50 MG TABLET|100|EA|.97476|12/27/2007||Yes|No||12/27/2007||Yes|No|12/27/2007||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|213|No|1.57315|03/01/2022|1.53539|03/01/2022|1.54561|03/01/2022|||TETRACYCLINES|13445|||||No|No||DR.REDDY'S LAB|No||||
minocycline HCl|No|No|No|No|75%|55111063801|MINOCYCLINE HCL 75 MG TABLET|100|EA|1.419|12/27/2007||Yes|No||12/27/2007||Yes|No|12/27/2007||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|213|No|3.234|06/01/2016|3.1878|06/01/2016|3.036|06/01/2016|||TETRACYCLINES|13446|||||No|No||DR.REDDY'S LAB|No||||
minocycline HCl|No|No|No|No|75%|55111063960|MINOCYCLINE HCL 100 MG TABLET|60|EA|1.70839|12/27/2007||Yes|No||12/27/2007||Yes|No|12/27/2007||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|213|No|1.59602|01/25/2022|1.55771|01/25/2022|1.56808|01/25/2022|||TETRACYCLINES|13447|||||No|No||DR.REDDY'S LAB|No||||
omeprazole|No|No|No|No|75%|55111064501|OMEPRAZOLE DR 40 MG CAPSULE|100|EA|.05418|06/20/2014||Yes|No||06/20/2014||Yes|No|06/20/2014||Yes|No||06/20/2014||Yes|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|13448|||||No|No||DR.REDDY'S LAB|No||||
omeprazole|No|No|No|No|75%|55111064505|OMEPRAZOLE DR 40 MG CAPSULE|500|EA|.0688|06/20/2014||Yes|No||06/20/2014||Yes|No|06/20/2014||Yes|No||06/20/2014||Yes|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|13449|||||No|No||DR.REDDY'S LAB|No||||
omeprazole|No|No|No|No|75%|55111064530|OMEPRAZOLE DR 40 MG CAPSULE|30|EA|.0688|06/20/2014||Yes|No||06/20/2014||Yes|No|06/20/2014||Yes|No||06/20/2014||Yes|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|13450|||||No|No||DR.REDDY'S LAB|No||||
metaxalone|No|No|No|No|75%|55111065001|METAXALONE 800 MG TABLET|100|EA|.645|11/28/2017||Yes|No||11/28/2017||Yes|No|11/28/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|116|Yes|.52754|03/29/2022|.51487|03/29/2022|.5183|03/29/2022|||SKELETAL MUSCLE RELAXANTS|13451|||||No|No||DR.REDDY'S LAB|No||||
sirolimus|No|No|No|No|75%|55111065301|SIROLIMUS 1 MG TABLET|100|EA|5.86434|02/25/2015||Yes|No||02/25/2015||Yes|No|02/25/2015||Yes|No||02/25/2015||Yes|No|||Prescription required|Yes|01/27/2022|229|No|5.87013|03/29/2022|5.72924|03/29/2022|5.7674|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|13452|||||No|No||DR.REDDY'S LAB|No||||
sirolimus|No|No|No|No|75%|55111065401|SIROLIMUS 2 MG TABLET|100|EA|11.72863|02/25/2015||Yes|No||02/25/2015||Yes|No|02/25/2015||Yes|No||02/25/2015||Yes|No|||Prescription required|Yes|01/27/2022|229|No|26.73038|05/25/2021|26.34851|05/25/2021|25.09382|05/25/2021|||IMMUNOSUPPRESSIVES: ORAL|13453|||||No|No||DR.REDDY'S LAB|No||||
ropinirole HCl|No|No|No|No|75%|55111065930|ROPINIROLE HCL ER 2 MG TABLET|30|EA|.92579|06/18/2012||Yes|No||06/18/2012||Yes|No|06/18/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|.59483|03/29/2022|.58055|03/29/2022|.58442|03/29/2022|||ANTIPARKINSON'S AGENTS|13454|||||No|No||DR.REDDY'S LAB|No||||
ropinirole HCl|No|No|No|No|75%|55111065990|ROPINIROLE HCL ER 2 MG TABLET|90|EA|.92573|06/18/2012||Yes|No||06/18/2012||Yes|No|06/18/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|.59483|03/29/2022|.58055|03/29/2022|.58442|03/29/2022|||ANTIPARKINSON'S AGENTS|13455|||||No|No||DR.REDDY'S LAB|No||||
ropinirole HCl|No|No|No|No|75%|55111066130|ROPINIROLE HCL ER 4 MG TABLET|30|EA|1.85143|12/03/2012||Yes|No||12/03/2012||Yes|No|12/03/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|1.04346|03/29/2022|1.01841|03/29/2022|1.02519|03/29/2022|||ANTIPARKINSON'S AGENTS|13456|||||No|No||DR.REDDY'S LAB|No||||
ropinirole HCl|No|No|No|No|75%|55111066190|ROPINIROLE HCL ER 4 MG TABLET|90|EA|1.85148|12/03/2012||Yes|No||12/03/2012||Yes|No|12/03/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|1.04346|03/29/2022|1.01841|03/29/2022|1.02519|03/29/2022|||ANTIPARKINSON'S AGENTS|13457|||||No|No||DR.REDDY'S LAB|No||||
ropinirole HCl|No|No|No|No|75%|55111066230|ROPINIROLE HCL ER 8 MG TABLET|30|EA|2.77722|06/18/2012||Yes|No||06/18/2012||Yes|No|06/18/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|1.52194|03/29/2022|1.48541|03/29/2022|1.4953|03/29/2022|||ANTIPARKINSON'S AGENTS|13458|||||No|No||DR.REDDY'S LAB|No||||
ropinirole HCl|No|No|No|No|75%|55111066290|ROPINIROLE HCL ER 8 MG TABLET|90|EA|2.77722|06/18/2012||Yes|No||06/18/2012||Yes|No|06/18/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|1.52194|03/29/2022|1.48541|03/29/2022|1.4953|03/29/2022|||ANTIPARKINSON'S AGENTS|13459|||||No|No||DR.REDDY'S LAB|No||||
clopidogrel bisulfate|No|No|No|No|75%|55111067131|CLOPIDOGREL 300 MG TABLET|30|EA|8.93138|07/02/2012||Yes|No||07/02/2012||Yes|No|07/02/2012||Yes|No||07/02/2012||Yes|No|||Prescription required|No||004|No|20.35524|06/01/2016|20.06445|06/01/2016|19.109|06/01/2016|||PLATELET AGGREGATION INHIBITORS|13460|||||No|No||DR.REDDY'S LAB|No||||
fondaparinux sodium|No|No|No|No|75%|55111067802|FONDAPARINUX 2.5 MG/0.5 ML SYR|.5|ML|19.8488|11/10/2011||Yes|No||11/10/2011||Yes|No|11/10/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|068|Yes|45.2368|04/06/2021|44.59056|04/06/2021|42.4672|04/06/2021|||ANTICOAGULANTS|13461|||||No|No||DR.REDDY'S LAB|No||||
fondaparinux sodium|No|No|No|No|75%|55111067810|FONDAPARINUX 2.5 MG/0.5 ML SYR|.5|ML|20.21|12/28/2011||Yes|No||12/28/2011||Yes|No|12/28/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|068|Yes|46.06|04/06/2021|45.402|04/06/2021|43.24|04/06/2021|||ANTICOAGULANTS|13462|||||No|No||DR.REDDY'S LAB|No||||
fondaparinux sodium|No|No|No|No|75%|55111067902|FONDAPARINUX 5 MG/0.4 ML SYR|.4|ML|58.394|11/10/2011||Yes|No||11/10/2011||Yes|No|11/10/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|068|Yes|133.084|04/06/2021|131.1828|04/06/2021|124.936|04/06/2021|||ANTICOAGULANTS|13463|||||No|No||DR.REDDY'S LAB|No||||
fondaparinux sodium|No|No|No|No|75%|55111067910|FONDAPARINUX 5 MG/0.4 ML SYR|.4|ML|59.4475|12/28/2011||Yes|No||12/28/2011||Yes|No|12/28/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|068|Yes|135.485|04/06/2021|133.5495|04/06/2021|127.19|04/06/2021|||ANTICOAGULANTS|13464|||||No|No||DR.REDDY'S LAB|No||||
fondaparinux sodium|No|No|No|No|75%|55111068002|FONDAPARINUX 7.5 MG/0.6 ML SYR|.6|ML|38.92933|11/10/2011||Yes|No||11/10/2011||Yes|No|11/10/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|068|Yes|88.72266|04/06/2021|87.45519|04/06/2021|83.29066|04/06/2021|||ANTICOAGULANTS|13465|||||No|No||DR.REDDY'S LAB|No||||
fondaparinux sodium|No|No|No|No|75%|55111068010|FONDAPARINUX 7.5 MG/0.6 ML SYR|.6|ML|39.63166|12/28/2011||Yes|No||12/28/2011||Yes|No|12/28/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|068|Yes|57.45472|12/28/2021|56.0758|12/28/2021|56.44926|12/28/2021|||ANTICOAGULANTS|13466|||||No|No||DR.REDDY'S LAB|No||||
fondaparinux sodium|No|No|No|No|75%|55111068102|FONDAPARINUX 10 MG/0.8 ML SYR|.8|ML|29.197|11/10/2011||Yes|No||11/10/2011||Yes|No|11/10/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|068|Yes|66.542|04/06/2021|65.5914|04/06/2021|62.468|04/06/2021|||ANTICOAGULANTS|13467|||||No|No||DR.REDDY'S LAB|No||||
fondaparinux sodium|No|No|No|No|75%|55111068110|FONDAPARINUX 10 MG/0.8 ML SYR|.8|ML|29.72375|12/28/2011||Yes|No||12/28/2011||Yes|No|12/28/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|068|Yes|67.7425|04/06/2021|66.77475|04/06/2021|63.595|04/06/2021|||ANTICOAGULANTS|13468|||||No|No||DR.REDDY'S LAB|No||||
ibuprofen|No|No|No|No|75%|55111068201|IBU 400 MG TABLET|100|EA|.0368|11/21/2008||Yes|No||11/21/2008||Yes|No|11/21/2008||Yes|No||01/01/2012||Yes|No|||Prescription required|No||059|Yes|.04934|03/29/2022|.04815|03/29/2022|.04847|03/29/2022|||NSAIDS|13469|||||No|No||DR.REDDY'S LAB|No||||
ibuprofen|No|No|No|No|75%|55111068205|IBU 400 MG TABLET|500|EA|.03495|11/21/2008||Yes|No||11/21/2008||Yes|No|11/21/2008||Yes|No||01/01/2012||Yes|No|||Prescription required|No||059|Yes|.04934|03/29/2022|.04815|03/29/2022|.04847|03/29/2022|||NSAIDS|13470|||||No|No||DR.REDDY'S LAB|No||||
ibuprofen|No|No|No|No|75%|55111068301|IBU 600 MG TABLET|100|EA|.0479|11/21/2008||Yes|No||11/21/2008||Yes|No|11/21/2008||Yes|No||01/01/2012||Yes|No|||Prescription required|No||059|Yes|.06063|03/29/2022|.05917|03/29/2022|.05956|03/29/2022|||NSAIDS|13471|||||No|No||DR.REDDY'S LAB|No||||
ibuprofen|No|No|No|No|75%|55111068305|IBU 600 MG TABLET|500|EA|.04552|11/21/2008||Yes|No||11/21/2008||Yes|No|11/21/2008||Yes|No||01/01/2012||Yes|No|||Prescription required|No||059|Yes|.06063|03/29/2022|.05917|03/29/2022|.05956|03/29/2022|||NSAIDS|13472|||||No|No||DR.REDDY'S LAB|No||||
ibuprofen|No|No|No|No|75%|55111068401|IBU 800 MG TABLET|100|EA|.06639|11/21/2008||Yes|No||11/21/2008||Yes|No|11/21/2008||Yes|No||01/01/2012||Yes|No|||Prescription required|No||059|Yes|.07481|03/29/2022|.07301|03/29/2022|.0735|03/29/2022|||NSAIDS|13473|||||No|No||DR.REDDY'S LAB|No||||
ibuprofen|No|No|No|No|75%|55111068405|IBU 800 MG TABLET|500|EA|.06308|11/21/2008||Yes|No||11/21/2008||Yes|No|11/21/2008||Yes|No||01/01/2012||Yes|No|||Prescription required|No||059|Yes|.07481|03/29/2022|.07301|03/29/2022|.0735|03/29/2022|||NSAIDS|13474|||||No|No||DR.REDDY'S LAB|No||||
zoledronic acid|No|No|No|No|75%|55111068507|ZOLEDRONIC ACID 4 MG/5 ML VIAL|5|ML|6.45|03/26/2013||Yes|No||03/26/2013||Yes|No|03/26/2013||Yes|No||||No|No|||Prescription required|No|||No|14.7|05/11/2021|14.49|05/11/2021|13.8|05/11/2021||||13475|||||No|No||DR.REDDY'S LAB|No||||
zoledronic acid/mannitol-water|No|No|No|No|75%|55111068852|ZOLEDRONIC ACID 5 MG/100 ML|100|ML|1.29|04/10/2013||Yes|No||04/10/2013||Yes|No|04/10/2013||Yes|No||||No|No|||Prescription required|No|||No|2.94|06/01/2016|2.898|06/01/2016|2.76|06/01/2016||||13476|||||No|No||DR.REDDY'S LAB|No||||
sumatriptan succinate|No|No|No|No|75%|55111069312|SUMATRIPTAN 6 MG/0.5 ML INJECT|.5|ML|75.7101|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||||No|No|||Prescription required|No||021|No|76.75855|03/29/2022|74.91634|03/29/2022|75.41527|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|13477|||||No|No||DR.REDDY'S LAB|No||||
cetirizine HCl|No|No|No|No|75%|55111069990|CETIRIZINE HCL 10 MG TABLET|90|EA|.02795|06/25/2012||Yes|No||||No|No|06/25/2012||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|13478|||||No|No||DR.REDDY'S LAB|No||||
naproxen/esomeprazole mag|No|No|No|No|75%|55111070160|NAPROXEN-ESOMEPRAZ DR 500-20MG|60|EA|11.56291|06/02/2020||Yes|No||06/02/2020||Yes|No|06/02/2020||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|059|Yes|17.77748|11/23/2021|17.35082|11/23/2021|17.46637|11/23/2021|||NSAIDS|13479|||||No|No||DR.REDDY'S LAB|No||||
lamotrigine|No|No|No|No|75%|55111071730|LAMOTRIGINE ER 25 MG TABLET|30|EA|.90099|07/03/2013||Yes|No||07/03/2013||Yes|No|07/03/2013||Yes|No||||No|No|||Prescription required|No||056|No|1.20872|03/01/2022|1.17971|03/01/2022|1.18756|03/01/2022|||ANTICONVULSANTS|13480|||||No|No||DR.REDDY'S LAB|No||||
lamotrigine|No|No|No|No|75%|55111071830|LAMOTRIGINE ER 50 MG TABLET|30|EA|1.8017|07/03/2013||Yes|No||07/03/2013||Yes|No|07/03/2013||Yes|No||||No|No|||Prescription required|No||056|No|1.67529|03/29/2022|1.63508|03/29/2022|1.64597|03/29/2022|||ANTICONVULSANTS|13481|||||No|No||DR.REDDY'S LAB|No||||
lamotrigine|No|No|No|No|75%|55111071930|LAMOTRIGINE ER 100 MG TABLET|30|EA|1.92998|07/03/2013||Yes|No||07/03/2013||Yes|No|07/03/2013||Yes|No||||No|No|||Prescription required|No||056|No|1.51472|03/29/2022|1.47836|03/29/2022|1.48821|03/29/2022|||ANTICONVULSANTS|13482|||||No|No||DR.REDDY'S LAB|No||||
lamotrigine|No|No|No|No|75%|55111072030|LAMOTRIGINE ER 200 MG TABLET|30|EA|2.05798|07/03/2013||Yes|No||07/03/2013||Yes|No|07/03/2013||Yes|No||||No|No|||Prescription required|No||056|No|1.69753|03/29/2022|1.65678|03/29/2022|1.66782|03/29/2022|||ANTICONVULSANTS|13483|||||No|No||DR.REDDY'S LAB|No||||
montelukast sodium|No|No|No|No|75%|55111072510|MONTELUKAST SOD 10 MG TABLET|1000|EA|.17909|07/31/2013||Yes|No||07/31/2013||Yes|No|07/31/2013||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|13484|||||No|No||DR.REDDY'S LAB|Yes|09/01/2020|||
montelukast sodium|No|No|No|No|75%|55111072530|MONTELUKAST SOD 10 MG TABLET|30|EA|.18275|08/13/2012||Yes|No||08/13/2012||Yes|No|08/13/2012||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|13485|||||No|No||DR.REDDY'S LAB|Yes|09/01/2020|||
montelukast sodium|No|No|No|No|75%|55111072590|MONTELUKAST SOD 10 MG TABLET|90|EA|.18275|08/13/2012||Yes|No||08/13/2012||Yes|No|08/13/2012||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|13486|||||No|No||DR.REDDY'S LAB|Yes|09/01/2020|||
ropinirole HCl|No|No|No|No|75%|55111072730|ROPINIROLE HCL ER 6 MG TABLET|30|EA|2.77722|06/18/2012||Yes|No||06/18/2012||Yes|No|06/18/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|2.547|03/29/2022|2.48587|03/29/2022|2.50242|03/29/2022|||ANTIPARKINSON'S AGENTS|13487|||||No|No||DR.REDDY'S LAB|No||||
ropinirole HCl|No|No|No|No|75%|55111072790|ROPINIROLE HCL ER 6 MG TABLET|90|EA|2.77717|06/18/2012||Yes|No||06/18/2012||Yes|No|06/18/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|2.547|03/29/2022|2.48587|03/29/2022|2.50242|03/29/2022|||ANTIPARKINSON'S AGENTS|13488|||||No|No||DR.REDDY'S LAB|No||||
ropinirole HCl|No|No|No|No|75%|55111072830|ROPINIROLE HCL ER 12 MG TABLET|30|EA|4.6288|06/18/2012||Yes|No||06/18/2012||Yes|No|06/18/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|2.53667|09/28/2021|2.47578|09/28/2021|2.49227|09/28/2021|||ANTIPARKINSON'S AGENTS|13489|||||No|No||DR.REDDY'S LAB|No||||
allopurinol|No|No|No|No|75%|55111072901|ALLOPURINOL 100 MG TABLET|100|EA|.0473|05/20/2015||Yes|No||05/20/2015||Yes|No|05/20/2015||Yes|No||05/20/2015||Yes|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|13490|||||No|No||DR.REDDY'S LAB|No||||
allopurinol|No|No|No|No|75%|55111072910|ALLOPURINOL 100 MG TABLET|1000|EA|.04271|05/21/2015||Yes|No||05/21/2015||Yes|No|05/21/2015||Yes|No||05/21/2015||Yes|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|13491|||||No|No||DR.REDDY'S LAB|No||||
allopurinol|No|No|No|No|75%|55111073001|ALLOPURINOL 300 MG TABLET|100|EA|.0903|05/20/2015||Yes|No||05/20/2015||Yes|No|05/20/2015||Yes|No||05/20/2015||Yes|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|13492|||||No|No||DR.REDDY'S LAB|No||||
allopurinol|No|No|No|No|75%|55111073005|ALLOPURINOL 300 MG TABLET|500|EA|.08578|05/21/2015||Yes|No||05/21/2015||Yes|No|05/21/2015||Yes|No||05/21/2015||Yes|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|13493|||||No|No||DR.REDDY'S LAB|No||||
valsartan|No|No|No|No|75%|55111073490|VALSARTAN 320 MG TABLET|90|EA|.1386|03/17/2022||Yes|No||03/17/2022||Yes|No|03/17/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.31156|03/29/2022|.30408|03/29/2022|.3061|03/29/2022|||ANGIOTENSIN MODULATORS|13494|||||No|No||DR.REDDY'S LAB|No||||
valganciclovir HCl|No|No|No|No|75%|55111076260|VALGANCICLOVIR 450 MG TABLET|60|EA|10.07332|03/11/2015||Yes|No||03/11/2015||Yes|No|03/11/2015||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|136|No|2.64507|03/29/2022|2.58158|03/29/2022|2.59878|03/29/2022|||ANTIVIRALS: GENERAL|13495|||||No|No||DR.REDDY'S LAB|No||||
montelukast sodium|No|No|No|No|75%|55111076303|MONTELUKAST SOD 4 MG GRANULES|30|EA|1.94618|10/01/2012||Yes|No||10/01/2012||Yes|No|10/01/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|042|Yes|1.25796|03/29/2022|1.22776|03/29/2022|1.23594|03/29/2022|||LEUKOTRIENE MODIFIERS|13496|||||No|No||DR.REDDY'S LAB|No||||
fexofenadine HCl|No|No|No|No|75%|55111078301|FEXOFENADINE HCL 60 MG TABLET|100|EA|.06553|12/13/2021||Yes|No||||No|No|12/13/2021||Yes|No||||No|No|||Over the counter|Yes|01/28/2021|030|Yes|.15058|03/29/2022|.14696|03/29/2022|.14794|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|13497|||||No|No||DR.REDDY'S LAB|No||||
fexofenadine HCl|No|No|No|No|75%|55111078401|FEXOFENADINE HCL 180 MG TABLET|100|EA|.08815|09/17/2019||Yes|No||||No|No|09/17/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.28782|03/29/2022|.28091|03/29/2022|.28278|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|13498|||||No|No||DR.REDDY'S LAB|No||||
sevelamer carbonate|No|No|No|No|75%|55111078911|SEVELAMER CARBONATE 800 MG TAB|100|EA|3.1949|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/26/2018|052|Yes|.27122|03/29/2022|.26471|03/29/2022|.26647|03/29/2022|||PHOSPHATE BINDERS|13499|||||No|No||DR.REDDY'S LAB|No||||
sevelamer carbonate|No|No|No|No|75%|55111078927|SEVELAMER CARBONATE 800 MG TAB|270|EA|.7939|11/29/2017||Yes|No||11/29/2017||Yes|No|11/29/2017||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|10/12/2017|052|Yes|.27122|03/29/2022|.26471|03/29/2022|.26647|03/29/2022|||PHOSPHATE BINDERS|13500|||||No|No||DR.REDDY'S LAB|No||||
febuxostat|No|No|No|No|75%|55111079630|FEBUXOSTAT 40 MG TABLET|30|EA|.473|06/03/2021|07/31/2023|Yes|No||06/03/2021|07/31/2023|Yes|No|06/03/2021|07/31/2023|Yes|No||||No|No|||Prescription required|Yes|07/30/2020|231|No|.89466|03/29/2022|.87318|03/29/2022|.879|03/29/2022|||ANTIHYPERURICEMICS|13501|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||DR.REDDY'S LAB|No||||
febuxostat|No|No|No|No|75%|55111079730|FEBUXOSTAT 80 MG TABLET|30|EA|.473|06/03/2021|07/31/2023|Yes|No||06/03/2021|07/31/2023|Yes|No|06/03/2021|07/31/2023|Yes|No||||No|No|||Prescription required|Yes|07/30/2020|231|No|.93355|03/29/2022|.91114|03/29/2022|.91721|03/29/2022|||ANTIHYPERURICEMICS|13502|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||DR.REDDY'S LAB|No||||
guaifenesin/pseudoephedrne HCl|No|No|No|No|75%|55111079818|GUAIFENESIN-PSE ER 600-60 MG|18|EA|.20329|09/21/2020||Yes|No||||No|No|09/21/2020||Yes|No||||No|No|||Over the counter|No||182|Yes|.46206|11/23/2021|.45097|11/23/2021|.45397|11/23/2021|||COUGH AND COLD: COLD|13503|||||No|No||DR.REDDY'S LAB|No||||
guaifenesin/pseudoephedrne HCl|No|No|No|No|75%|55111079835|GUAIFENESIN-PSE ER 600-60 MG|18|EA|.20329|08/26/2021||Yes|No||||No|No|08/26/2021||Yes|No||||No|No|||Over the counter|No||182|Yes|.46206|11/23/2021|.45097|11/23/2021|.45397|11/23/2021|||COUGH AND COLD: COLD|13504|||||No|No||DR.REDDY'S LAB|No||||
guaifenesin/pseudoephedrne HCl|No|No|No|No|75%|55111079836|GUAIFENESIN-PSE ER 600-60 MG|36|EA|.17581|09/21/2020||Yes|No||||No|No|09/21/2020||Yes|No||||No|No|||Over the counter|No||182|Yes|.46206|11/23/2021|.45097|11/23/2021|.45397|11/23/2021|||COUGH AND COLD: COLD|13505|||||No|No||DR.REDDY'S LAB|No||||
guaifenesin/pseudoephedrne HCl|No|No|No|No|75%|55111079841|GUAIFENESIN-PSE ER 600-60 MG|36|EA|.17581|08/26/2021||Yes|No||||No|No|08/26/2021||Yes|No||||No|No|||Over the counter|No||182|Yes|.46206|11/23/2021|.45097|11/23/2021|.45397|11/23/2021|||COUGH AND COLD: COLD|13506|||||No|No||DR.REDDY'S LAB|No||||
guaifenesin/pseudoephedrne HCl|No|No|No|No|75%|55111079924|GUAIFENESIN-PSE ER 1200-120 MG|24|EA|.28863|03/16/2020||Yes|No||||No|No|03/16/2020||Yes|No||||No|No|||Over the counter|No||182|Yes|.65782|03/16/2020|.64842|03/16/2020|.61755|03/16/2020|||COUGH AND COLD: COLD|13507|||||No|No||DR.REDDY'S LAB|No||||
hydroxyprogesterone caproat/PF|No|No|No|No|75%|55150030901|HYDROXYPROGEST 250 MG/ML VIAL|1|ML|293.4965|01/14/2021||Yes|No||01/14/2021||Yes|No|01/14/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|151|Yes|668.899|01/19/2021|659.3433|01/19/2021|627.946|01/14/2021|||PROGESTATIONAL AGENTS|13508|||||No|No||AUROMEDICS PHAR|No||||
naloxone HCl|No|No|No|No|75%|55150032701|NALOXONE 0.4 MG/ML VIAL|1|ML|6.7037|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|||||||15.2782|10/01/2020|OPIATE DEPENDENCE TREATMENTS|13509|||||No|No||AUROMEDICS PHAR|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|55150032710|NALOXONE 0.4 MG/ML VIAL|1|ML|4.945|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|11.27|03/29/2022|11.109|03/29/2022|10.58|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|13510|||||No|No||AUROMEDICS PHAR|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|55150032801|NALOXONE 4 MG/10 ML VIAL|10|ML|6.7037|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|||||||||OPIATE DEPENDENCE TREATMENTS|13511|||||No|No||AUROMEDICS PHAR|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|55150032810|NALOXONE 4 MG/10 ML VIAL|10|ML|4.945|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|11.27|06/01/2021|11.109|06/01/2021|10.58|06/01/2021|||OPIATE DEPENDENCE TREATMENTS|13512|||||No|No||AUROMEDICS PHAR|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|55150034510|NALOXONE 2 MG/2 ML SYRINGE|2|ML|6.7725|03/15/2021||Yes|No||03/15/2021||Yes|No|03/15/2021||Yes|No||||No|No|||Prescription required|No||145|No|15.435|03/15/2021|15.2145|03/15/2021|14.49|03/15/2021|||OPIATE DEPENDENCE TREATMENTS|13513|||||No|No||AUROMEDICS PHAR|Yes|09/01/2020|||
modafinil|No|No|No|No|90%|55253080130|MODAFINIL 100 MG TABLET|30|EA|1.97728|05/04/2012||Yes|No||05/04/2012||Yes|No|05/04/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.4088|03/29/2022|.39898|03/29/2022|.40164|03/29/2022|||STIMULANTS AND RELATED AGENTS|13514|||||No|No||CEPHALON,INC.-T|No||||
modafinil|No|No|No|No|90%|55253080190|MODAFINIL 100 MG TABLET|90|EA|1.97274|05/04/2012||Yes|No||05/04/2012||Yes|No|05/04/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.4088|03/29/2022|.39898|03/29/2022|.40164|03/29/2022|||STIMULANTS AND RELATED AGENTS|13515|||||No|No||CEPHALON,INC.-T|No||||
modafinil|No|No|No|No|90%|55253080230|MODAFINIL 200 MG TABLET|30|EA|2.98635|05/04/2012||Yes|No||05/04/2012||Yes|No|05/04/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55328|03/29/2022|.54|03/29/2022|.54359|03/29/2022|||STIMULANTS AND RELATED AGENTS|13516|||||No|No||CEPHALON,INC.-T|No||||
modafinil|No|No|No|No|90%|55253080290|MODAFINIL 200 MG TABLET|90|EA|2.98467|05/04/2012||Yes|No||05/04/2012||Yes|No|05/04/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55328|03/29/2022|.54|03/29/2022|.54359|03/29/2022|||STIMULANTS AND RELATED AGENTS|13517|||||No|No||CEPHALON,INC.-T|No||||
methamphetamine HCl|No|No|No|No|75%|55292010401|DESOXYN 5 MG TABLET|100|EA|8.85404|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|20.17898|01/11/2022|19.89071|01/11/2022|18.94353|01/11/2022|||STIMULANTS AND RELATED AGENTS|13518|||||No|No||RECORDATI RARE|No||||
pasireotide pamoate|No|No|No|No|75%|55292013901|SIGNIFOR LAR 10 MG KIT|1|EA|6279.1008|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|No|||No|14310.5088|02/16/2022|14106.07296|02/16/2022|13434.3552|02/16/2022||||13519|||||No|No||RECORDATI RARE|No||||
pasireotide pamoate|No|No|No|No|75%|55292014101|SIGNIFOR LAR 30 MG KIT|1|EA|6279.1008|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|No|||No|14310.5088|02/16/2022|14106.07296|02/16/2022|13434.3552|02/16/2022||||13520|||||No|No||RECORDATI RARE|No||||
pasireotide pamoate|No|No|No|No|75%|55292014201|SIGNIFOR LAR 40 MG KIT|1|EA|6279.1008|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|No|||No|14310.5088|02/16/2022|14106.07296|02/16/2022|13434.3552|02/16/2022||||13521|||||No|No||RECORDATI RARE|No||||
pasireotide pamoate|No|No|No|No|75%|55292014301|SIGNIFOR LAR 60 MG KIT|1|EA|6279.1008|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|No|||No|14310.5088|02/16/2022|14106.07296|02/16/2022|13434.3552|02/16/2022||||13522|||||No|No||RECORDATI RARE|No||||
succimer|No|No|No|No|75%|55292020111|CHEMET 100 MG CAPSULE|100|EA|9.57154|04/04/2014||Yes|No||04/04/2014||Yes|No|04/04/2014||Yes|No||||No|No|||Prescription required|No|||No|21.81421|01/11/2022|21.50258|01/11/2022|20.47864|01/11/2022||||13523|||||No|No||RECORDATI RARE|No||||
clorazepate dipotassium|No|No|No|No|90%|55292030401|TRANXENE T-TAB 7.5 MG|100|EA|6.17067|02/16/2018||Yes|No||02/16/2018||Yes|No|02/16/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|14.06339|01/11/2022|13.86248|01/11/2022|13.20236|01/11/2022|||ANXIOLYTICS|13524|||||No|No||RECORDATI RARE|No||||
cysteamine HCl|No|No|No|No|75%|55292041005|CYSTADROPS 0.37% EYE DROPS|5|ML|170.90436|11/19/2020||Yes|No||11/19/2020||Yes|No|11/19/2020||Yes|No||||No|No|||Prescription required|No|||No|389.50296|01/11/2022|383.93863|01/11/2022|365.65584|01/11/2022||||13525|||||No|No||RECORDATI RARE|No||||
dactinomycin|No|No|No|No|75%|55292081155|COSMEGEN 500 MCG VIAL|1|EA|1063.6265|04/04/2014||Yes|No||04/04/2014||Yes|No|04/04/2014||Yes|No||||No|No|||Prescription required|No|||No|2424.079|01/11/2022|2389.4493|01/11/2022|2275.666|01/11/2022||||13526|||||No|No||RECORDATI RARE|No||||
doxylamine succinate/vit B6|No|No|No|No|75%|55494010010|DICLEGIS DR 10-10 MG TABLET|100|EA|2.3392|08/07/2013||Yes|No||08/07/2013||Yes|No|08/07/2013||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|085|No|5.2322|03/29/2022|5.10662|03/29/2022|5.14063|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|13527|||||No|No||DUCHESNAY USA,|No||||
doxylamine succinate/vit B6|No|No|No|No|75%|55494012060|BONJESTA ER 20-20 MG TABLET|60|EA|4.9966|09/27/2018||Yes|No||09/27/2018||Yes|No|09/27/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|085|No|11.19506|01/18/2022|10.92637|01/18/2022|10.99914|01/18/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|13528|||||No|No||DUCHESNAY USA,|No||||
darbepoetin alfa in polysorbat|No|No|No|No|75%|55513000204|ARANESP 25 MCG/ML VIAL|1|ML|83.205|10/11/2006||Yes|No||10/11/2006||Yes|No|10/11/2006||Yes|No||||No|No|||Prescription required|No||038|Yes|189.63|01/24/2017|186.921|01/24/2017|178.02|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13529|||||No|No||AMGEN|No||||
darbepoetin alfa in polysorbat|No|No|No|No|75%|55513000304|ARANESP 40 MCG/ML VIAL|1|ML|133.128|10/11/2006||Yes|No||10/11/2006||Yes|No|10/11/2006||Yes|No||||No|No|||Prescription required|No||038|Yes|303.408|01/24/2017|299.0736|01/24/2017|284.832|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13530|||||No|No||AMGEN|No||||
darbepoetin alfa in polysorbat|No|No|No|No|75%|55513000404|ARANESP 60 MCG/ML VIAL|1|ML|199.692|10/11/2006||Yes|No||10/11/2006||Yes|No|10/11/2006||Yes|No||||No|No|||Prescription required|No||038|Yes|455.112|01/24/2017|448.6104|01/24/2017|427.248|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13531|||||No|No||AMGEN|No||||
darbepoetin alfa in polysorbat|No|No|No|No|75%|55513000504|ARANESP 100 MCG/ML VIAL|1|ML|332.82|10/11/2006||Yes|No||10/11/2006||Yes|No|10/11/2006||Yes|No||||No|No|||Prescription required|No||038|Yes|758.52|01/24/2017|747.684|01/24/2017|712.08|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13532|||||No|No||AMGEN|No||||
darbepoetin alfa in polysorbat|No|No|No|No|75%|55513000601|ARANESP 200 MCG/ML VIAL|1|ML|665.64|10/11/2006||Yes|No||10/11/2006||Yes|No|10/11/2006||Yes|No||||No|No|||Prescription required|No||038|Yes|1517.04|01/24/2017|1495.368|01/24/2017|1424.16|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13533|||||No|No||AMGEN|No||||
darbepoetin alfa in polysorbat|No|No|No|No|75%|55513002104|ARANESP 40 MCG/0.4 ML SYRINGE|.4|ML|332.82|10/11/2006||Yes|No||10/11/2006||Yes|No|10/11/2006||Yes|No||||No|No|||Prescription required|No||038|Yes|758.52|01/24/2017|747.684|01/24/2017|712.08|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13534|||||No|No||AMGEN|No||||
darbepoetin alfa in polysorbat|No|No|No|No|75%|55513002304|ARANESP 60 MCG/0.3 ML SYRINGE|.3|ML|665.64|10/11/2006||Yes|No||10/11/2006||Yes|No|10/11/2006||Yes|No||||No|No|||Prescription required|No||038|Yes|1517.04|01/24/2017|1495.368|01/24/2017|1424.16|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13535|||||No|No||AMGEN|No||||
darbepoetin alfa in polysorbat|No|No|No|No|75%|55513002504|ARANESP 100 MCG/0.5 ML SYRINGE|.5|ML|665.64|10/11/2006||Yes|No||10/11/2006||Yes|No|10/11/2006||Yes|No||||No|No|||Prescription required|No||038|Yes|1517.04|01/24/2017|1495.368|01/24/2017|1424.16|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13536|||||No|No||AMGEN|No||||
darbepoetin alfa in polysorbat|No|No|No|No|75%|55513002704|ARANESP 150 MCG/0.3 ML SYRINGE|.3|ML|1664.1|10/11/2006||Yes|No||10/11/2006||Yes|No|10/11/2006||Yes|No||||No|No|||Prescription required|No||038|Yes|3792.6|01/24/2017|3738.42|01/24/2017|3560.4|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13537|||||No|No||AMGEN|No||||
darbepoetin alfa in polysorbat|No|No|No|No|75%|55513002801|ARANESP 200 MCG/0.4 ML SYRINGE|.4|ML|1664.1|10/11/2006||Yes|No||10/11/2006||Yes|No|10/11/2006||Yes|No||||No|No|||Prescription required|No||038|Yes|3792.6|01/24/2017|3738.42|01/24/2017|3560.4|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13538|||||No|No||AMGEN|No||||
darbepoetin alfa in polysorbat|No|No|No|No|75%|55513003201|ARANESP 500 MCG/1 ML SYRINGE|1|ML|1664.1|10/11/2006||Yes|No||10/11/2006||Yes|No|10/11/2006||Yes|No||||No|No|||Prescription required|No||038|Yes|3792.6|01/24/2017|3738.42|01/24/2017|3560.4|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13539|||||No|No||AMGEN|No||||
darbepoetin alfa in polysorbat|No|No|No|No|75%|55513005704|ARANESP 25 MCG/0.42 ML SYRING|.42|ML|198.10714|10/11/2006||Yes|No||10/11/2006||Yes|No|10/11/2006||Yes|No||||No|No|||Prescription required|No||038|Yes|451.49999|01/24/2017|445.04999|01/24/2017|423.85713|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13540|||||No|No||AMGEN|No||||
cinacalcet HCl|No|No|No|No|75%|55513007330|SENSIPAR 30 MG TABLET|30|EA|11.5627|03/29/2004||Yes|No||03/29/2004||Yes|No|03/29/2004||Yes|No||||No|No|||Prescription required|No|||No|26.3522|06/29/2021|25.97574|06/29/2021|24.7388|06/29/2021||||13541|||||No|No||AMGEN|No||||
cinacalcet HCl|No|No|No|No|75%|55513007430|SENSIPAR 60 MG TABLET|30|EA|23.1254|03/29/2004||Yes|No||03/29/2004||Yes|No|03/29/2004||Yes|No||||No|No|||Prescription required|No|||No|52.7044|06/23/2020|51.95148|06/23/2020|49.4776|06/23/2020||||13542|||||No|No||AMGEN|No||||
cinacalcet HCl|No|No|No|No|75%|55513007530|SENSIPAR 90 MG TABLET|30|EA|34.6881|03/29/2004||Yes|No||03/29/2004||Yes|No|03/29/2004||Yes|No||||No|No|||Prescription required|No|||No|79.0566|09/24/2019|77.92722|09/24/2019|74.2164|09/24/2019||||13543|||||No|No||AMGEN|No||||
darbepoetin alfa in polysorbat|No|No|No|No|75%|55513011101|ARANESP 300 MCG/0.6 ML SYRINGE|.6|ML|1664.1|10/11/2006||Yes|No||10/11/2006||Yes|No|10/11/2006||Yes|No||||No|No|||Prescription required|No||038|Yes|3792.6|01/24/2017|3738.42|01/24/2017|3560.4|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13544|||||No|No||AMGEN|No||||
epoetin alfa|No|No|No|No|75%|55513012601|EPOGEN 2,000 UNITS/ML VIAL|1|ML|14.2588|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|038|Yes|32.4968|01/24/2017|32.03256|01/24/2017|30.5072|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13545|||||No|No||AMGEN|No||||
epoetin alfa|No|No|No|No|75%|55513012610|EPOGEN 2,000 UNITS/ML VIAL|1|ML|14.2588|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|038|Yes|32.4968|01/24/2017|32.03256|01/24/2017|30.5072|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13546|||||No|No||AMGEN|No||||
apremilast|No|No|No|No|75%|55513013760|OTEZLA 30 MG TABLET|60|EA|30.40358|07/29/2020||Yes|No||07/29/2020||Yes|No|07/29/2020||Yes|No||||No|No|||Prescription required|No||071|Yes|68.61084|02/08/2022|66.96417|02/08/2022|67.41015|02/08/2022|||CYTOKINE AND CAM ANTAGONISTS|13547|||||No|No||AMGEN|No||||
epoetin alfa|No|No|No|No|75%|55513014401|EPOGEN 10,000 UNITS/ML VIAL|1|ML|71.294|08/02/2006||Yes|No||08/02/2006||Yes|No|08/02/2006||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|038|Yes|162.484|01/24/2017|160.1628|01/24/2017|152.536|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13548|||||No|No||AMGEN|No||||
epoetin alfa|No|No|No|No|75%|55513014410|EPOGEN 10,000 UNITS/ML VIAL|1|ML|71.294|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|038|Yes|162.484|01/24/2017|160.1628|01/24/2017|152.536|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13549|||||No|No||AMGEN|No||||
epoetin alfa|No|No|No|No|75%|55513014801|EPOGEN 4,000 UNITS/ML VIAL|1|ML|28.5176|08/02/2006||Yes|No||08/02/2006||Yes|No|08/02/2006||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|038|Yes|64.9936|01/24/2017|64.06512|01/24/2017|61.0144|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13550|||||No|No||AMGEN|No||||
epoetin alfa|No|No|No|No|75%|55513014810|EPOGEN 4,000 UNITS/ML VIAL|1|ML|28.5176|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|038|Yes|64.9936|01/24/2017|64.06512|01/24/2017|61.0144|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13551|||||No|No||AMGEN|No||||
pegfilgrastim|No|No|No|No|75%|55513019001|NEULASTA 6 MG/0.6 ML SYRINGE|.6|ML|3960.64183|06/28/2002||Yes|No||06/28/2002||Yes|No|06/28/2002||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|148|No|10482.717|08/24/2021|10332.9639|08/24/2021|9840.918|08/24/2021|||COLONY STIMULATING FACTORS|13552|||||No|No||AMGEN|No||||
pegfilgrastim|No|No|No|No|75%|55513019201|NEULASTA ONPRO 6 MG/0.6 ML KIT|.6|ML|4599.5595|05/22/2015||Yes|No||05/22/2015||Yes|No|05/22/2015||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|148|No|10482.717|08/24/2021|10332.9639|08/24/2021|9840.918|08/24/2021|||COLONY STIMULATING FACTORS|13553|||||No|No||AMGEN|No||||
filgrastim|No|No|No|No|75%|55513020901|NEUPOGEN 480 MCG/0.8 ML SYR|.8|ML|285.64362|09/29/2006||Yes|No||09/29/2006||Yes|No|09/29/2006||Yes|No||||No|No|||Prescription required|No||148|No|651.00175|10/24/2017|641.70172|10/24/2017|611.1445|10/24/2017|||COLONY STIMULATING FACTORS|13554|||||No|No||AMGEN|No||||
filgrastim|No|No|No|No|75%|55513020910|NEUPOGEN 480 MCG/0.8 ML SYR|.8|ML|285.64201|09/29/2006||Yes|No||09/29/2006||Yes|No|09/29/2006||Yes|No||||No|No|||Prescription required|No||148|No|650.99807|10/23/2018|641.6981|10/23/2018|611.14105|10/23/2018|||COLONY STIMULATING FACTORS|13555|||||No|No||AMGEN|No||||
filgrastim|No|No|No|No|75%|55513020991|NEUPOGEN 480 MCG/0.8 ML SYR|.8|ML|285.64362|06/09/2014||Yes|No||06/09/2014||Yes|No|06/09/2014||Yes|No||||No|No|||Prescription required|No||148|No|651.00175|10/24/2017|641.70172|10/24/2017|611.1445|10/24/2017|||COLONY STIMULATING FACTORS|13556|||||No|No||AMGEN|No||||
epoetin alfa|No|No|No|No|75%|55513026701|EPOGEN 3,000 UNITS/ML VIAL|1|ML|21.3882|08/02/2006||Yes|No||08/02/2006||Yes|No|08/02/2006||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|038|Yes|48.7452|01/24/2017|48.04884|01/24/2017|45.7608|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13557|||||No|No||AMGEN|No||||
epoetin alfa|No|No|No|No|75%|55513026710|EPOGEN 3,000 UNITS/ML VIAL|1|ML|21.3882|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|038|Yes|48.7452|01/24/2017|48.04884|01/24/2017|45.7608|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13558|||||No|No||AMGEN|No||||
epoetin alfa|No|No|No|No|75%|55513028301|EPOGEN 20,000 UNITS/2 ML VIAL|2|ML|71.294|08/02/2006||Yes|No||08/02/2006||Yes|No|08/02/2006||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|038|Yes|162.484|01/24/2017|160.1628|01/24/2017|152.536|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13559|||||No|No||AMGEN|No||||
epoetin alfa|No|No|No|No|75%|55513028310|EPOGEN 20,000 UNITS/2 ML VIAL|2|ML|84.11495|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|038|Yes|162.484|01/24/2017|160.1628|01/24/2017|152.536|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13560|||||No|No||AMGEN|No||||
apremilast|No|No|No|No|75%|55513036955|OTEZLA 28 DAY STARTER PACK|55|EA|33.16753|07/29/2020||Yes|No||07/29/2020||Yes|No|07/29/2020||Yes|No||||No|No|||Prescription required|No||071|Yes|75.59113|02/01/2022|74.51126|02/01/2022|70.9631|02/01/2022|||CYTOKINE AND CAM ANTAGONISTS|13561|||||No|No||AMGEN|No||||
epoetin alfa|No|No|No|No|75%|55513047801|EPOGEN 20,000 UNITS/ML VIAL|1|ML|142.588|08/02/2006||Yes|No||08/02/2006||Yes|No|08/02/2006||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|038|Yes|324.968|01/24/2017|320.3256|01/24/2017|305.072|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13562|||||No|No||AMGEN|No||||
epoetin alfa|No|No|No|No|75%|55513047810|EPOGEN 20,000 UNITS/ML VIAL|1|ML|142.588|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|038|Yes|324.968|01/24/2017|320.3256|01/24/2017|305.072|01/24/2017|||ERYTHROPOIESIS STIMULATING PROTEINS|13563|||||No|No||AMGEN|No||||
filgrastim|No|No|No|No|75%|55513053001|NEUPOGEN 300 MCG/ML VIAL|1|ML|135.3769|09/29/2006||Yes|No||09/29/2006||Yes|No|09/29/2006||Yes|No||||No|No|||Prescription required|No||148|No|308.5334|10/24/2017|304.12578|10/24/2017|289.6436|10/24/2017|||COLONY STIMULATING FACTORS|13564|||||No|No||AMGEN|No||||
filgrastim|No|No|No|No|75%|55513053010|NEUPOGEN 300 MCG/ML VIAL|1|ML|135.37819|09/29/2006||Yes|No||09/29/2006||Yes|No|09/29/2006||Yes|No||||No|No|||Prescription required|No||148|No|308.53634|10/24/2017|304.12867|10/24/2017|289.64636|10/24/2017|||COLONY STIMULATING FACTORS|13565|||||No|No||AMGEN|No||||
filgrastim|No|No|No|No|75%|55513054601|NEUPOGEN 480 MCG/1.6 ML VIAL|1.6|ML|134.73243|09/29/2006||Yes|No||09/29/2006||Yes|No|09/29/2006||Yes|No||||No|No|||Prescription required|No||148|No|307.06462|10/24/2017|302.67798|10/24/2017|288.26475|10/24/2017|||COLONY STIMULATING FACTORS|13566|||||No|No||AMGEN|No||||
filgrastim|No|No|No|No|75%|55513054610|NEUPOGEN 480 MCG/1.6 ML VIAL|1.6|ML|134.73216|09/29/2006||Yes|No||09/29/2006||Yes|No|09/29/2006||Yes|No||||No|No|||Prescription required|No||148|No|307.064|10/24/2017|302.67737|10/24/2017|288.26417|10/24/2017|||COLONY STIMULATING FACTORS|13567|||||No|No||AMGEN|No||||
ivabradine HCl|No|No|No|No|75%|55513080060|CORLANOR 5 MG TABLET|60|EA|3.73017|06/01/2015||Yes|No||06/01/2015||Yes|No|06/01/2015||Yes|No||||No|No|||Prescription required|No|||No|8.39089|02/08/2022|8.1895|02/08/2022|8.24404|02/08/2022||||13568|||||No|No||AMGEN|No||||
ivabradine HCl|No|No|No|No|75%|55513081060|CORLANOR 7.5 MG TABLET|60|EA|3.73017|06/01/2015||Yes|No||06/01/2015||Yes|No|06/01/2015||Yes|No||||No|No|||Prescription required|No|||No|8.32722|02/08/2022|8.12736|02/08/2022|8.18149|02/08/2022||||13569|||||No|No||AMGEN|No||||
ivabradine HCl|No|No|No|No|75%|55513081328|CORLANOR 5 MG/5 ML ORAL SOLN|5|ML|.74601|04/07/2020||Yes|No||04/07/2020||Yes|No|04/07/2020||Yes|No||||No|No|||Prescription required|No|||No|1.70022|02/01/2022|1.67593|02/01/2022|1.59612|02/01/2022||||13570|||||No|No||AMGEN|No||||
erenumab-aooe|No|No|No|No|75%|55513084101|AIMOVIG 70 MG/ML AUTOINJECTOR|1|ML|290.8778|12/02/2018||Yes|No||12/02/2018||Yes|No|12/02/2018||Yes|No||||No|No|||Prescription required|No||537|No|655.28386|02/08/2022|639.55704|02/08/2022|643.81639|02/08/2022|||ANTIMIGRAINE AGENTS: OTHER|13571|||||No|No||AMGEN|No||||
erenumab-aooe|No|No|No|No|75%|55513084301|AIMOVIG 140 MG/ML AUTOINJECTOR|1|ML|290.8778|07/30/2019||Yes|No||07/30/2019||Yes|No|07/30/2019||Yes|No||||No|No|||Prescription required|No||537|No|655.40163|02/08/2022|639.67199|02/08/2022|643.9321|02/08/2022|||ANTIMIGRAINE AGENTS: OTHER|13572|||||No|No||AMGEN|No||||
filgrastim|No|No|No|No|75%|55513092401|NEUPOGEN 300 MCG/0.5 ML SYR|.5|ML|286.982|09/29/2006||Yes|No||09/29/2006||Yes|No|09/29/2006||Yes|No||||No|No|||Prescription required|No||148|No|654.052|10/24/2017|644.7084|10/24/2017|614.008|10/24/2017|||COLONY STIMULATING FACTORS|13573|||||No|No||AMGEN|No||||
filgrastim|No|No|No|No|75%|55513092410|NEUPOGEN 300 MCG/0.5 ML SYR|.5|ML|286.9863|09/29/2006||Yes|No||09/29/2006||Yes|No|09/29/2006||Yes|No||||No|No|||Prescription required|No||148|No|654.0618|10/24/2017|644.71806|10/24/2017|614.0172|10/24/2017|||COLONY STIMULATING FACTORS|13574|||||No|No||AMGEN|No||||
filgrastim|No|No|No|No|75%|55513092491|NEUPOGEN 300 MCG/0.5 ML SYR|.5|ML|286.982|06/09/2014||Yes|No||06/09/2014||Yes|No|06/09/2014||Yes|No||||No|No|||Prescription required|No||148|No|654.052|10/24/2017|644.7084|10/24/2017|614.008|10/24/2017|||COLONY STIMULATING FACTORS|13575|||||No|No||AMGEN|No||||
tranexamic acid|No|No|No|No|75%|55566211002|LYSTEDA 650 MG TABLET|30|EA|3.69284|05/05/2015|12/31/2022|Yes|No||05/05/2015|12/31/2022|Yes|No|01/01/2021|12/31/2022|Yes|No||||No|No|||Prescription required|No|||No|5.32204|07/30/2019|5.24601|07/30/2019|4.9962|07/30/2019||||13576|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||FERRING PH INC|No||||
desmopressin acetate|No|No|No|No|75%|55566220000|DDAVP 4 MCG/ML AMPUL|1|ML|34.8902|05/01/2017||Yes|No||05/01/2017||Yes|No|05/01/2017||Yes|No||||No|No|||Prescription required|No|||Yes|79.5172|07/30/2019|78.38124|07/30/2019|74.6488|07/30/2019||||13577|||||No|No||FERRING PH INC|No||||
desmopressin acetate|No|No|No|No|75%|55566230000|DDAVP 40 MCG/10 ML VIAL|10|ML|35.32493|07/16/2015||Yes|No||07/16/2015||Yes|No|07/16/2015||Yes|No||||No|No|||Prescription required|No|||Yes|80.50798|07/30/2019|79.35786|07/30/2019|75.57892|07/30/2019||||13578|||||No|No||FERRING PH INC|No||||
desmopressin acetate|No|No|No|No|75%|55566260000|DDAVP 0.1 MG TABLET|100|EA|3.35056|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||Yes|7.63616|07/30/2019|7.52707|07/30/2019|7.16864|07/30/2019||||13579|||||No|No||FERRING PH INC|No||||
desmopressin acetate|No|No|No|No|75%|55566270000|DDAVP 0.2 MG TABLET|100|EA|4.82718|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||Yes|11.00148|07/30/2019|10.84431|07/30/2019|10.32792|07/30/2019||||13580|||||No|No||FERRING PH INC|No||||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|55700014730|SUBOXONE 8 MG-2 MG SL FILM|30|EA|3.8614|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||Yes|||||||8.61537|10/01/2020||13581|||||No|No||QUALITY CARE|Yes|09/01/2020|||
buprenorphine HCl|No|No|No|No|90%|55700030230|BUPRENORPHINE 2 MG TABLET SL|30|EA|1.06812|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||Yes|||||||.47476|10/01/2020||13582|||||No|No||QUALITY CARE|Yes|09/01/2020|||
buprenorphine HCl|No|No|No|No|90%|55700030330|BUPRENORPHINE 8 MG TABLET SL|30|EA|1.99692|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||Yes|||||||.82579|10/01/2020||13583|||||No|No||QUALITY CARE|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|55700045701|NARCAN 4 MG NASAL SPRAY|2|EA|26.875|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||No|||||||60.03517|10/01/2020||13584|||||No|No||QUALITY CARE|Yes|09/01/2020|||
crisaborole|No|No|No|No|75%|55724021121|EUCRISA 2% OINTMENT|60|GM|4.95904|06/15/2017||Yes|No||06/15/2017||Yes|No|06/15/2017||Yes|No||||No|No|||Prescription required|No||034|Yes|11.07139|01/11/2022|10.80567|01/11/2022|10.87764|01/11/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|13585|||||No|No||PFIZER US PHARM|No||||
lansoprazole/amoxiciln/clarith|No|No|No|No|75%|57237000114|LANSOPRAZOL-AMOXICIL-CLARITHRO|112|EA|3.40732|02/15/2018||Yes|No||02/15/2018||Yes|No|02/15/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|001|No|5.33188|09/28/2021|5.20391|09/28/2021|5.23857|09/28/2021|||H. PYLORI TREATMENT|13586|||||No|No||RISING PHARM|No||||
hydrochlorothiazide|Yes|No|No|No|75%|57237000201|HYDROCHLOROTHIAZIDE 12.5 MG CP|100|EA|.0344|10/10/2013||Yes|No||10/10/2013||Yes|No|10/10/2013||Yes|No||||No|No|07/01/2016||Prescription required|No|||Yes|.03333|03/29/2022|.03253|03/29/2022|.03274|03/29/2022||||13587|||||No|No||RISING PHARM|No||||
hydrochlorothiazide|Yes|No|No|No|75%|57237000205|HYDROCHLOROTHIAZIDE 12.5 MG CP|500|EA|.0344|05/20/2015||Yes|No||05/20/2015||Yes|No|05/20/2015||Yes|No||||No|No|07/01/2016||Prescription required|No|||Yes|.03333|03/29/2022|.03253|03/29/2022|.03274|03/29/2022||||13588|||||No|No||RISING PHARM|No||||
hydrochlorothiazide|Yes|No|No|No|75%|57237000299|HYDROCHLOROTHIAZIDE 12.5 MG CP|1000|EA|.03139|10/10/2013||Yes|No||10/10/2013||Yes|No|10/10/2013||Yes|No||||No|No|07/01/2016||Prescription required|No|||Yes|.03333|03/29/2022|.03253|03/29/2022|.03274|03/29/2022||||13589|||||No|No||RISING PHARM|No||||
fluconazole|No|No|No|No|75%|57237000330|FLUCONAZOLE 50 MG TABLET|30|EA|.14333|10/10/2013||Yes|No||10/10/2013||Yes|No|10/10/2013||Yes|No||||No|No|||Prescription required|No||069|No|.43933|03/29/2022|.42878|03/29/2022|.43164|03/29/2022|||ANTIFUNGALS: ORAL|13590|||||No|No||RISING PHARM|No||||
fluconazole|No|No|No|No|75%|57237000430|FLUCONAZOLE 100 MG TABLET|30|EA|.215|10/10/2013||Yes|No||10/10/2013||Yes|No|10/10/2013||Yes|No||||No|No|||Prescription required|No||069|No|.34281|03/29/2022|.33458|03/29/2022|.33681|03/29/2022|||ANTIFUNGALS: ORAL|13591|||||No|No||RISING PHARM|No||||
fluconazole|Yes|No|No|No|75%|57237000511|FLUCONAZOLE 150 MG TABLET|12|EA|.60235|10/10/2013||Yes|No||10/10/2013||Yes|No|10/10/2013||Yes|No||||No|No|10/10/2013||Prescription required|No||069|No|.74933|03/29/2022|.73134|03/29/2022|.73621|03/29/2022|||ANTIFUNGALS: ORAL|13592|||||No|No||RISING PHARM|No||||
fluconazole|No|No|No|No|75%|57237000630|FLUCONAZOLE 200 MG TABLET|30|EA|.28666|10/10/2013||Yes|No||10/10/2013||Yes|No|10/10/2013||Yes|No||||No|No|||Prescription required|No||069|No|.52936|03/29/2022|.51665|03/29/2022|.52009|03/29/2022|||ANTIFUNGALS: ORAL|13593|||||No|No||RISING PHARM|No||||
mirtazapine|No|No|No|No|75%|57237000705|MIRTAZAPINE 7.5 MG TABLET|500|EA|.88429|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||031|Yes|.74916|03/29/2022|.73118|03/29/2022|.73604|03/29/2022|||ANTIDEPRESSANTS: OTHER|13594|||||No|No||RISING PHARM|No||||
mirtazapine|No|No|No|No|75%|57237000730|MIRTAZAPINE 7.5 MG TABLET|30|EA|.90658|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||031|Yes|.74916|03/29/2022|.73118|03/29/2022|.73604|03/29/2022|||ANTIDEPRESSANTS: OTHER|13595|||||No|No||RISING PHARM|No||||
mirtazapine|No|No|No|No|75%|57237000805|MIRTAZAPINE 15 MG TABLET|500|EA|.1199|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||031|Yes|.08357|03/29/2022|.08156|03/29/2022|.0821|03/29/2022|||ANTIDEPRESSANTS: OTHER|13596|||||No|No||RISING PHARM|No||||
mirtazapine|No|No|No|No|75%|57237000830|MIRTAZAPINE 15 MG TABLET|30|EA|.12756|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||031|Yes|.08357|03/29/2022|.08156|03/29/2022|.0821|03/29/2022|||ANTIDEPRESSANTS: OTHER|13597|||||No|No||RISING PHARM|No||||
mirtazapine|No|No|No|No|75%|57237000905|MIRTAZAPINE 30 MG TABLET|500|EA|.15157|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||031|No|.09806|03/29/2022|.0957|03/29/2022|.09634|03/29/2022|||ANTIDEPRESSANTS: OTHER|13598|||||No|No||RISING PHARM|No||||
mirtazapine|No|No|No|No|75%|57237000930|MIRTAZAPINE 30 MG TABLET|30|EA|.16125|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||031|No|.09806|03/29/2022|.0957|03/29/2022|.09634|03/29/2022|||ANTIDEPRESSANTS: OTHER|13599|||||No|No||RISING PHARM|No||||
mirtazapine|No|No|No|No|75%|57237001005|MIRTAZAPINE 45 MG TABLET|500|EA|.17178|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||031|No|.13324|03/29/2022|.13004|03/29/2022|.1309|03/29/2022|||ANTIDEPRESSANTS: OTHER|13600|||||No|No||RISING PHARM|No||||
mirtazapine|No|No|No|No|75%|57237001030|MIRTAZAPINE 45 MG TABLET|30|EA|.18275|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||031|No|.13324|03/29/2022|.13004|03/29/2022|.1309|03/29/2022|||ANTIDEPRESSANTS: OTHER|13601|||||No|No||RISING PHARM|No||||
mirtazapine|No|No|No|No|75%|57237001106|MIRTAZAPINE 15 MG ODT|30|EA|.26158|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||031|Yes|.48641|03/29/2022|.47473|03/29/2022|.47789|03/29/2022|||ANTIDEPRESSANTS: OTHER|13602|||||No|No||RISING PHARM|No||||
mirtazapine|No|No|No|No|75%|57237001206|MIRTAZAPINE 30 MG ODT|30|EA|.30902|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||031|No|.55786|03/29/2022|.54447|03/29/2022|.54809|03/29/2022|||ANTIDEPRESSANTS: OTHER|13603|||||No|No||RISING PHARM|No||||
mirtazapine|No|No|No|No|75%|57237001306|MIRTAZAPINE 45 MG ODT|30|EA|.34328|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||031|No|.723|03/29/2022|.70564|03/29/2022|.71034|03/29/2022|||ANTIDEPRESSANTS: OTHER|13604|||||No|No||RISING PHARM|No||||
tamsulosin HCl|No|No|No|No|75%|57237001401|TAMSULOSIN HCL 0.4 MG CAPSULE|100|EA|.1032|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No||003|No|.06447|03/29/2022|.06292|03/29/2022|.06334|03/29/2022|||BPH TREATMENTS|13605|||||No|No||RISING PHARM|No||||
tamsulosin HCl|No|No|No|No|75%|57237001405|TAMSULOSIN HCL 0.4 MG CAPSULE|500|EA|.1032|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No||003|No|.06447|03/29/2022|.06292|03/29/2022|.06334|03/29/2022|||BPH TREATMENTS|13606|||||No|No||RISING PHARM|No||||
duloxetine HCl|No|No|No|No|75%|57237001760|DULOXETINE HCL DR 20 MG CAP|60|EA|.129|12/31/2013||Yes|No||12/31/2013||Yes|No|12/31/2013||Yes|No||||No|No|||Prescription required|No||232|No|.13163|03/29/2022|.12847|03/29/2022|.12932|03/29/2022|||NEUROPATHIC PAIN|13607|||||No|No||RISING PHARM|No||||
duloxetine HCl|No|No|No|No|75%|57237001830|DULOXETINE HCL DR 30 MG CAP|30|EA|.14333|12/31/2013||Yes|No||12/31/2013||Yes|No|12/31/2013||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|13608|||||No|No||RISING PHARM|No||||
duloxetine HCl|No|No|No|No|75%|57237001890|DULOXETINE HCL DR 30 MG CAP|90|EA|.13377|12/31/2013||Yes|No||12/31/2013||Yes|No|12/31/2013||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|13609|||||No|No||RISING PHARM|No||||
duloxetine HCl|No|No|No|No|75%|57237001899|DULOXETINE HCL DR 30 MG CAP|1000|EA|.13244|12/31/2013||Yes|No||12/31/2013||Yes|No|12/31/2013||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|13610|||||No|No||RISING PHARM|No||||
duloxetine HCl|No|No|No|No|75%|57237001930|DULOXETINE HCL DR 60 MG CAP|30|EA|.14333|12/31/2013||Yes|No||12/31/2013||Yes|No|12/31/2013||Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|13611|||||No|No||RISING PHARM|No||||
duloxetine HCl|No|No|No|No|75%|57237001990|DULOXETINE HCL DR 60 MG CAP|90|EA|.13377|12/31/2013||Yes|No||12/31/2013||Yes|No|12/31/2013||Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|13612|||||No|No||RISING PHARM|No||||
duloxetine HCl|No|No|No|No|75%|57237001999|DULOXETINE HCL DR 60 MG CAP|1000|EA|.13244|12/31/2013||Yes|No||12/31/2013||Yes|No|12/31/2013||Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|13613|||||No|No||RISING PHARM|No||||
glyburide/metformin HCl|Yes|No|No|No|75%|57237002301|GLYBURID-METFORMIN 1.25-250 MG|100|EA|.10234|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.23324|02/25/2020|.2299|02/25/2020|.21896|02/25/2020|||HYPOGLYCEMICS: METFORMINS|13614|||||No|No||RISING PHARM|No||||
glyburide/metformin HCl|Yes|No|No|No|75%|57237002401|GLYBURIDE-METFORMIN 2.5-500 MG|100|EA|.10513|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.05324|03/29/2022|.05196|03/29/2022|.0523|03/29/2022|||HYPOGLYCEMICS: METFORMINS|13615|||||No|No||RISING PHARM|No||||
glyburide/metformin HCl|Yes|No|No|No|75%|57237002405|GLYBURIDE-METFORMIN 2.5-500 MG|500|EA|.10234|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.05324|03/29/2022|.05196|03/29/2022|.0523|03/29/2022|||HYPOGLYCEMICS: METFORMINS|13616|||||No|No||RISING PHARM|No||||
glyburide/metformin HCl|Yes|No|No|No|75%|57237002501|GLYBURIDE-METFORMIN 5-500 MG|100|EA|.10513|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.05734|03/29/2022|.05596|03/29/2022|.05633|03/29/2022|||HYPOGLYCEMICS: METFORMINS|13617|||||No|No||RISING PHARM|No||||
glyburide/metformin HCl|Yes|No|No|No|75%|57237002505|GLYBURIDE-METFORMIN 5-500 MG|500|EA|.10234|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.05734|03/29/2022|.05596|03/29/2022|.05633|03/29/2022|||HYPOGLYCEMICS: METFORMINS|13618|||||No|No||RISING PHARM|No||||
amoxicillin|No|No|No|No|75%|57237002801|AMOXICILLIN 500 MG TABLET|100|EA|.15028|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||209|No|.12149|03/29/2022|.11857|03/29/2022|.11936|03/29/2022|||PENICILLINS|13619|||||No|No||RISING PHARM|No||||
amoxicillin|No|No|No|No|75%|57237002901|AMOXICILLIN 875 MG TABLET|100|EA|.1505|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||209|No|.1448|03/29/2022|.14132|03/29/2022|.14226|03/29/2022|||PENICILLINS|13620|||||No|No||RISING PHARM|No||||
amoxicillin|No|No|No|No|75%|57237002920|AMOXICILLIN 875 MG TABLET|20|EA|.16555|09/25/2015||Yes|No||09/25/2015||Yes|No|09/25/2015||Yes|No||||No|No|||Prescription required|No||209|No|.1448|03/29/2022|.14132|03/29/2022|.14226|03/29/2022|||PENICILLINS|13621|||||No|No||RISING PHARM|No||||
amoxicillin|No|No|No|No|75%|57237003001|AMOXICILLIN 250 MG CAPSULE|100|EA|.02193|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||209|No|.06288|03/29/2022|.06137|03/29/2022|.06177|03/29/2022|||PENICILLINS|13622|||||No|No||RISING PHARM|No||||
amoxicillin|No|No|No|No|75%|57237003005|AMOXICILLIN 250 MG CAPSULE|500|EA|.02021|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||209|No|.06288|03/29/2022|.06137|03/29/2022|.06177|03/29/2022|||PENICILLINS|13623|||||No|No||RISING PHARM|No||||
amoxicillin|No|No|No|No|75%|57237003101|AMOXICILLIN 500 MG CAPSULE|100|EA|.03878|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||209|No|.07054|03/29/2022|.06884|03/29/2022|.0693|03/29/2022|||PENICILLINS|13624|||||No|No||RISING PHARM|No||||
amoxicillin|No|No|No|No|75%|57237003105|AMOXICILLIN 500 MG CAPSULE|500|EA|.03577|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||209|No|.07054|03/29/2022|.06884|03/29/2022|.0693|03/29/2022|||PENICILLINS|13625|||||No|No||RISING PHARM|No||||
cefprozil|No|No|No|No|75%|57237003401|CEFPROZIL 125 MG/5 ML SUSP|100|ML|.11696|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||046|No|.09872|03/01/2022|.09635|03/01/2022|.09699|03/01/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|13626|||||No|No||RISING PHARM|No||||
cefprozil|No|No|No|No|75%|57237003450|CEFPROZIL 125 MG/5 ML SUSP|50|ML|.13588|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||046|No|.23632|01/25/2022|.23064|01/25/2022|.23218|01/25/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|13627|||||No|No||RISING PHARM|No||||
cefprozil|No|No|No|No|75%|57237003475|CEFPROZIL 125 MG/5 ML SUSP|75|ML|.11724|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||046|No|.2672|02/28/2017|.26338|02/28/2017|.25084|02/28/2017|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|13628|||||No|No||RISING PHARM|No||||
cefprozil|No|No|No|No|75%|57237003501|CEFPROZIL 250 MG/5 ML SUSP|100|ML|.21194|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||046|No|.21431|03/29/2022|.20916|03/29/2022|.21055|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|13629|||||No|No||RISING PHARM|No||||
cefprozil|No|No|No|No|75%|57237003550|CEFPROZIL 250 MG/5 ML SUSP|50|ML|.25215|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||046|No|.3239|03/01/2022|.31612|03/01/2022|.31823|03/01/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|13630|||||No|No||RISING PHARM|No||||
cefprozil|No|No|No|No|75%|57237003575|CEFPROZIL 250 MG/5 ML SUSP|75|ML|.21407|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||046|No|.22915|03/29/2022|.22365|03/29/2022|.22513|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|13631|||||No|No||RISING PHARM|No||||
cefprozil|No|No|No|No|75%|57237003601|CEFPROZIL 250 MG TABLET|100|EA|.8385|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||046|No|.65626|11/23/2021|.6405|11/23/2021|.64477|11/23/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|13632|||||No|No||RISING PHARM|No||||
cefprozil|No|No|No|No|75%|57237003750|CEFPROZIL 500 MG TABLET|50|EA|1.7974|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||046|No|1.02667|03/29/2022|1.00202|03/29/2022|1.0087|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|13633|||||No|No||RISING PHARM|No||||
penicillin V potassium|No|No|No|No|75%|57237004001|PENICILLIN VK 250 MG TABLET|100|EA|.03483|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||209|No|.0637|03/29/2022|.06217|03/29/2022|.06258|03/29/2022|||PENICILLINS|13634|||||No|No||RISING PHARM|No||||
penicillin V potassium|No|No|No|No|75%|57237004099|PENICILLIN VK 250 MG TABLET|1000|EA|.03483|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||209|No|.0637|03/29/2022|.06217|03/29/2022|.06258|03/29/2022|||PENICILLINS|13635|||||No|No||RISING PHARM|No||||
penicillin V potassium|No|No|No|No|75%|57237004101|PENICILLIN VK 500 MG TABLET|100|EA|.08587|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||209|No|.10026|03/29/2022|.09785|03/29/2022|.0985|03/29/2022|||PENICILLINS|13636|||||No|No||RISING PHARM|No||||
penicillin V potassium|No|No|No|No|75%|57237004105|PENICILLIN VK 500 MG TABLET|500|EA|.0516|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||209|No|.10026|03/29/2022|.09785|03/29/2022|.0985|03/29/2022|||PENICILLINS|13637|||||No|No||RISING PHARM|No||||
penicillin V potassium|No|No|No|No|75%|57237004199|PENICILLIN VK 500 MG TABLET|1000|EA|.04761|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||209|No|.10026|03/29/2022|.09785|03/29/2022|.0985|03/29/2022|||PENICILLINS|13638|||||No|No||RISING PHARM|No||||
valacyclovir HCl|No|No|No|No|75%|57237004230|VALACYCLOVIR HCL 500 MG TABLET|30|EA|.172|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||025|No|.29328|03/29/2022|.28624|03/29/2022|.28814|03/29/2022|||ANTIVIRALS: ORAL|13639|||||No|No||RISING PHARM|No||||
valacyclovir HCl|No|No|No|No|75%|57237004290|VALACYCLOVIR HCL 500 MG TABLET|90|EA|.16721|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||025|No|.29328|03/29/2022|.28624|03/29/2022|.28814|03/29/2022|||ANTIVIRALS: ORAL|13640|||||No|No||RISING PHARM|No||||
valacyclovir HCl|Yes|No|No|No|75%|57237004330|VALACYCLOVIR HCL 1 GRAM TABLET|30|EA|.27233|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|07/21/2014||Prescription required|No||025|No|.5737|03/29/2022|.55993|03/29/2022|.56366|03/29/2022|||ANTIVIRALS: ORAL|13641|||||No|No||RISING PHARM|No||||
valacyclovir HCl|Yes|No|No|No|75%|57237004390|VALACYCLOVIR HCL 1 GRAM TABLET|90|EA|.26277|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|07/21/2014||Prescription required|No||025|No|.5737|03/29/2022|.55993|03/29/2022|.56366|03/29/2022|||ANTIVIRALS: ORAL|13642|||||No|No||RISING PHARM|No||||
clarithromycin|No|No|No|No|75%|57237004460|CLARITHROMYCIN 250 MG TABLET|60|EA|.40312|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||018|No|.54294|03/29/2022|.5299|03/29/2022|.53343|03/29/2022|||MACROLIDES/KETOLIDES|13643|||||No|No||RISING PHARM|No||||
clarithromycin|No|No|No|No|75%|57237004560|CLARITHROMYCIN 500 MG TABLET|60|EA|.40312|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||018|No|.44307|03/29/2022|.43243|03/29/2022|.43531|03/29/2022|||MACROLIDES/KETOLIDES|13644|||||No|No||RISING PHARM|No||||
divalproex sodium|No|No|No|No|75%|57237004701|DIVALPROEX SOD DR 250 MG TAB|100|EA|.05332|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||056|No|.07754|03/29/2022|.07567|03/29/2022|.07618|03/29/2022|||ANTICONVULSANTS|13645|||||No|No||RISING PHARM|No||||
divalproex sodium|No|No|No|No|75%|57237004705|DIVALPROEX SOD DR 250 MG TAB|500|EA|.05194|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||056|No|.07754|03/29/2022|.07567|03/29/2022|.07618|03/29/2022|||ANTICONVULSANTS|13646|||||No|No||RISING PHARM|No||||
divalproex sodium|No|No|No|No|75%|57237004801|DIVALPROEX SOD DR 500 MG TAB|100|EA|.1032|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||056|No|.13473|03/29/2022|.13149|03/29/2022|.13237|03/29/2022|||ANTICONVULSANTS|13647|||||No|No||RISING PHARM|No||||
divalproex sodium|No|No|No|No|75%|57237004805|DIVALPROEX SOD DR 500 MG TAB|500|EA|.0989|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||056|No|.13473|03/29/2022|.13149|03/29/2022|.13237|03/29/2022|||ANTICONVULSANTS|13648|||||No|No||RISING PHARM|No||||
galantamine HBr|No|No|No|No|75%|57237004960|GALANTAMINE HBR 4 MG TABLET|60|EA|.28128|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.42975|03/29/2022|.41943|03/29/2022|.42222|03/29/2022|||ALZHEIMER'S AGENTS|13649|||||No|No||RISING PHARM|No||||
galantamine HBr|No|No|No|No|75%|57237005060|GALANTAMINE HBR 8 MG TABLET|60|EA|.28128|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|Yes|.48142|03/29/2022|.46986|03/29/2022|.47299|03/29/2022|||ALZHEIMER'S AGENTS|13650|||||No|No||RISING PHARM|No||||
galantamine HBr|No|No|No|No|75%|57237005160|GALANTAMINE HBR 12 MG TABLET|60|EA|.28128|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.83193|01/25/2022|.81196|01/25/2022|.81737|01/25/2022|||ALZHEIMER'S AGENTS|13651|||||No|No||RISING PHARM|No||||
cefuroxime axetil|No|No|No|No|75%|57237005820|CEFUROXIME AXETIL 250 MG TAB|20|EA|.4085|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||046|No|.36264|03/29/2022|.35393|03/29/2022|.35629|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|13652|||||No|No||RISING PHARM|No||||
cefuroxime axetil|No|No|No|No|75%|57237005860|CEFUROXIME AXETIL 250 MG TAB|60|EA|.387|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||046|No|.36264|03/29/2022|.35393|03/29/2022|.35629|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|13653|||||No|No||RISING PHARM|No||||
cefuroxime axetil|No|No|No|No|75%|57237005920|CEFUROXIME AXETIL 500 MG TAB|20|EA|.86|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||046|No|.56985|03/29/2022|.55617|03/29/2022|.55987|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|13654|||||No|No||RISING PHARM|No||||
cefuroxime axetil|No|No|No|No|75%|57237005960|CEFUROXIME AXETIL 500 MG TAB|60|EA|.68083|07/21/2014||Yes|No||07/21/2014||Yes|No|07/21/2014||Yes|No||||No|No|||Prescription required|No||046|No|.56985|03/29/2022|.55617|03/29/2022|.55987|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|13655|||||No|No||RISING PHARM|No||||
finasteride|No|No|No|No|75%|57237006130|FINASTERIDE 1 MG TABLET|30|EA|.05375|07/05/2016||Yes|No||07/05/2016||Yes|No|07/05/2016||Yes|No||||No|No|||Prescription required|No|||No|.04818|03/29/2022|.04702|03/29/2022|.04733|03/29/2022||||13656|||||No|No||RISING PHARM|No||||
finasteride|No|No|No|No|75%|57237006190|FINASTERIDE 1 MG TABLET|90|EA|.05016|07/05/2016||Yes|No||07/05/2016||Yes|No|07/05/2016||Yes|No||||No|No|||Prescription required|No|||No|.04818|03/29/2022|.04702|03/29/2022|.04733|03/29/2022||||13657|||||No|No||RISING PHARM|No||||
finasteride|No|No|No|No|75%|57237006205|FINASTERIDE 5 MG TABLET|500|EA|.0688|07/05/2016||Yes|No||07/05/2016||Yes|No|07/05/2016||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|13658|||||No|No||RISING PHARM|No||||
finasteride|No|No|No|No|75%|57237006230|FINASTERIDE 5 MG TABLET|30|EA|.06593|07/05/2016||Yes|No||07/05/2016||Yes|No|07/05/2016||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|13659|||||No|No||RISING PHARM|No||||
finasteride|No|No|No|No|75%|57237006290|FINASTERIDE 5 MG TABLET|90|EA|.06593|07/05/2016||Yes|No||07/05/2016||Yes|No|07/05/2016||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|13660|||||No|No||RISING PHARM|No||||
flecainide acetate|No|No|No|No|75%|57237006301|FLECAINIDE ACETATE 50 MG TAB|100|EA|.24682|09/04/2015||Yes|No||09/04/2015||Yes|No|09/04/2015||Yes|No||||No|No|||Prescription required|No|||No|.15465|03/29/2022|.15093|03/29/2022|.15194|03/29/2022||||13661|||||No|No||RISING PHARM|No||||
flecainide acetate|No|No|No|No|75%|57237006401|FLECAINIDE ACETATE 100 MG TAB|100|EA|.40334|09/04/2015||Yes|No||09/04/2015||Yes|No|09/04/2015||Yes|No||||No|No|||Prescription required|No|||No|.24778|03/29/2022|.24183|03/29/2022|.24344|03/29/2022||||13662|||||No|No||RISING PHARM|No||||
flecainide acetate|No|No|No|No|75%|57237006501|FLECAINIDE ACETATE 150 MG TAB|100|EA|.55405|09/04/2015||Yes|No||09/04/2015||Yes|No|09/04/2015||Yes|No||||No|No|||Prescription required|No|||No|.41264|03/29/2022|.40273|03/29/2022|.40541|03/29/2022||||13663|||||No|No||RISING PHARM|No||||
ondansetron HCl|No|No|No|No|75%|57237007530|ONDANSETRON HCL 4 MG TABLET|30|EA|.06378|06/24/2016||Yes|No||06/24/2016||Yes|No|06/24/2016||Yes|No||||No|No|||Prescription required|No||085|No|.06763|03/29/2022|.066|03/29/2022|.06644|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|13664|||||No|No||RISING PHARM|No||||
ondansetron HCl|No|No|No|No|75%|57237007630|ONDANSETRON HCL 8 MG TABLET|30|EA|.07883|06/24/2016||Yes|No||06/24/2016||Yes|No|06/24/2016||Yes|No||||No|No|||Prescription required|No||085|No|.09975|03/29/2022|.09735|03/29/2022|.098|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|13665|||||No|No||RISING PHARM|No||||
ondansetron|No|No|No|No|75%|57237007710|ONDANSETRON ODT 4 MG TABLET|30|EA|.10778|01/09/2015||Yes|No||01/09/2015||Yes|No|01/09/2015||Yes|No||||No|No|||Prescription required|No||085|No|.24125|03/29/2022|.23546|03/29/2022|.23702|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|13666|||||No|No||RISING PHARM|No||||
ondansetron|No|No|No|No|75%|57237007730|ONDANSETRON ODT 4 MG TABLET|30|EA|.1052|05/13/2016||Yes|No||05/13/2016||Yes|No|05/13/2016||Yes|No||||No|No|||Prescription required|No||085|No|.24125|03/29/2022|.23546|03/29/2022|.23702|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|13667|||||No|No||RISING PHARM|No||||
ondansetron|No|No|No|No|75%|57237007810|ONDANSETRON ODT 8 MG TABLET|30|EA|.17142|01/09/2015||Yes|No||01/09/2015||Yes|No|01/09/2015||Yes|No||||No|No|||Prescription required|No||085|No|.24386|03/29/2022|.238|03/29/2022|.23959|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|13668|||||No|No||RISING PHARM|No||||
ondansetron|No|No|No|No|75%|57237007830|ONDANSETRON ODT 8 MG TABLET|30|EA|.14534|05/13/2016||Yes|No||05/13/2016||Yes|No|05/13/2016||Yes|No||||No|No|||Prescription required|No||085|No|.24386|03/29/2022|.238|03/29/2022|.23959|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|13669|||||No|No||RISING PHARM|No||||
rizatriptan benzoate|No|No|No|No|75%|57237008563|RIZATRIPTAN 5 MG ODT|18|EA|.61346|11/29/2016||Yes|No||11/29/2016||Yes|No|11/29/2016||Yes|No||||No|No|||Prescription required|No||021|No|.80419|03/29/2022|.78488|03/29/2022|.79011|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|13670|||||No|No||RISING PHARM|No||||
rizatriptan benzoate|No|No|No|No|75%|57237008663|RIZATRIPTAN 10 MG ODT|18|EA|.68417|11/29/2016||Yes|No||11/29/2016||Yes|No|11/29/2016||Yes|No||||No|No|||Prescription required|No||021|No|.80628|03/29/2022|.78692|03/29/2022|.79217|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|13671|||||No|No||RISING PHARM|No||||
rizatriptan benzoate|No|No|No|No|75%|57237008734|RIZATRIPTAN 5 MG TABLET|12|EA|.42283|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No||||No|No|||Prescription required|No||021|No|.64991|03/29/2022|.63431|03/29/2022|.63853|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|13672|||||No|No||RISING PHARM|No||||
rizatriptan benzoate|No|No|No|No|75%|57237008763|RIZATRIPTAN 5 MG TABLET|18|EA|.41184|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No||||No|No|||Prescription required|No||021|No|.64991|03/29/2022|.63431|03/29/2022|.63853|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|13673|||||No|No||RISING PHARM|No||||
rizatriptan benzoate|No|No|No|No|75%|57237008834|RIZATRIPTAN 10 MG TABLET|12|EA|.4343|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No||||No|No|||Prescription required|No||021|No|.50927|03/29/2022|.49704|03/29/2022|.50035|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|13674|||||No|No||RISING PHARM|No||||
rizatriptan benzoate|No|No|No|No|75%|57237008863|RIZATRIPTAN 10 MG TABLET|18|EA|.42521|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No||||No|No|||Prescription required|No||021|No|.50927|03/29/2022|.49704|03/29/2022|.50035|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|13675|||||No|No||RISING PHARM|No||||
trandolapril|Yes|No|No|No|75%|57237008901|TRANDOLAPRIL 1 MG TABLET|100|EA|.19113|10/02/2015||Yes|No||10/02/2015||Yes|No|10/02/2015||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/23/2015|113|Yes|.43561|03/01/2022|.42938|03/01/2022|.40894|03/01/2022|||ANGIOTENSIN MODULATORS|13676|||||No|No||RISING PHARM|No||||
trandolapril|Yes|No|No|No|75%|57237009001|TRANDOLAPRIL 2 MG TABLET|100|EA|.19113|10/02/2015||Yes|No||10/02/2015||Yes|No|10/02/2015||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/23/2015|113|Yes|.18405|03/29/2022|.17963|03/29/2022|.18082|03/29/2022|||ANGIOTENSIN MODULATORS|13677|||||No|No||RISING PHARM|No||||
trandolapril|Yes|No|No|No|75%|57237009101|TRANDOLAPRIL 4 MG TABLET|100|EA|.19113|10/02/2015||Yes|No||10/02/2015||Yes|No|10/02/2015||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/23/2015|113|No|.24385|03/29/2022|.23799|03/29/2022|.23958|03/29/2022|||ANGIOTENSIN MODULATORS|13678|||||No|No||RISING PHARM|No||||
cefadroxil|No|No|No|No|75%|57237009601|CEFADROXIL 500 MG CAPSULE|100|EA|.2279|01/09/2015||Yes|No||01/09/2015||Yes|No|01/09/2015||Yes|No||||No|No|||Prescription required|No||046|No|.20994|03/29/2022|.2049|03/29/2022|.20626|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|13679|||||No|No||RISING PHARM|No||||
cefadroxil|No|No|No|No|75%|57237009650|CEFADROXIL 500 MG CAPSULE|50|EA|.25585|01/09/2015||Yes|No||01/09/2015||Yes|No|01/09/2015||Yes|No||||No|No|||Prescription required|No||046|No|.20994|03/29/2022|.2049|03/29/2022|.20626|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|13680|||||No|No||RISING PHARM|No||||
cefadroxil|No|No|No|No|75%|57237009701|CEFADROXIL 250 MG/5 ML SUSP|100|ML|.20915|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||046|No|.1834|09/28/2021|.17899|09/28/2021|.18019|09/28/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|13681|||||No|No||RISING PHARM|No||||
cefadroxil|No|No|No|No|75%|57237009801|CEFADROXIL 500 MG/5 ML SUSP|100|ML|.28956|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||046|No|.25492|01/25/2022|.2488|01/25/2022|.25045|01/25/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|13682|||||No|No||RISING PHARM|No||||
cefadroxil|No|No|No|No|75%|57237009875|CEFADROXIL 500 MG/5 ML SUSP|75|ML|.28953|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||046|No|.65986|11/23/2021|.65043|11/23/2021|.61946|11/23/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|13683|||||No|No||RISING PHARM|No||||
cefdinir|No|No|No|No|75%|57237009960|CEFDINIR 300 MG CAPSULE|60|EA|.35833|01/09/2015||Yes|No||01/09/2015||Yes|No|01/09/2015||Yes|No||||No|No|||Prescription required|No||046|No|.46443|03/29/2022|.45328|03/29/2022|.4563|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|13684|||||No|No||RISING PHARM|No||||
metoprolol tartrate|No|No|No|No|75%|57237010001|METOPROLOL TARTRATE 25 MG TAB|100|EA|.01388|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No||070|No|.01777|03/29/2022|.01734|03/29/2022|.01745|03/29/2022|||BETA-BLOCKERS|13685|||||No|No||RISING PHARM|No||||
metoprolol tartrate|No|No|No|No|75%|57237010099|METOPROLOL TARTRATE 25 MG TAB|1000|EA|.01388|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No||070|No|.01777|03/29/2022|.01734|03/29/2022|.01745|03/29/2022|||BETA-BLOCKERS|13686|||||No|No||RISING PHARM|No||||
metoprolol tartrate|No|No|No|No|75%|57237010101|METOPROLOL TARTRATE 50 MG TAB|100|EA|.01431|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No||070|No|.02252|03/29/2022|.02197|03/29/2022|.02212|03/29/2022|||BETA-BLOCKERS|13687|||||No|No||RISING PHARM|No||||
metoprolol tartrate|No|No|No|No|75%|57237010199|METOPROLOL TARTRATE 50 MG TAB|1000|EA|.0114|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No||070|No|.02252|03/29/2022|.02197|03/29/2022|.02212|03/29/2022|||BETA-BLOCKERS|13688|||||No|No||RISING PHARM|No||||
metoprolol tartrate|No|No|No|No|75%|57237010201|METOPROLOL TARTRATE 100 MG TAB|100|EA|.01978|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No||070|No|.03443|03/29/2022|.0336|03/29/2022|.03382|03/29/2022|||BETA-BLOCKERS|13689|||||No|No||RISING PHARM|No||||
metoprolol tartrate|No|No|No|No|75%|57237010299|METOPROLOL TARTRATE 100 MG TAB|1000|EA|.01692|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No||070|No|.03443|03/29/2022|.0336|03/29/2022|.03382|03/29/2022|||BETA-BLOCKERS|13690|||||No|No||RISING PHARM|No||||
divalproex sodium|No|No|No|No|75%|57237010601|DIVALPROEX SOD DR 125 MG TAB|100|EA|.02687|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||056|No|.06035|03/29/2022|.0589|03/29/2022|.05929|03/29/2022|||ANTICONVULSANTS|13691|||||No|No||RISING PHARM|No||||
divalproex sodium|No|No|No|No|75%|57237010605|DIVALPROEX SOD DR 125 MG TAB|500|EA|.02623|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||056|No|.06035|03/29/2022|.0589|03/29/2022|.05929|03/29/2022|||ANTICONVULSANTS|13692|||||No|No||RISING PHARM|No||||
felodipine|Yes|No|No|No|75%|57237010801|FELODIPINE ER 2.5 MG TABLET|100|EA|.23327|05/12/2015|01/31/2022|Yes|No||05/12/2015|01/31/2022|Yes|No|05/12/2015|01/31/2022|Yes|No||||No|No|07/01/2016|01/31/2022|Prescription required|No||045|Yes|.53165|02/15/2022|.52405|02/15/2022|.4991|02/15/2022|||CALCIUM CHANNEL BLOCKERS|13693|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||RISING PHARM|No||||
felodipine|Yes|No|No|No|75%|57237010901|FELODIPINE ER 5 MG TABLET|100|EA|.23327|05/12/2015|01/31/2022|Yes|No||05/12/2015|01/31/2022|Yes|No|05/12/2015|01/31/2022|Yes|No||||No|No|07/01/2016|01/31/2022|Prescription required|No||045|Yes|.53165|02/15/2022|.52405|02/15/2022|.4991|02/15/2022|||CALCIUM CHANNEL BLOCKERS|13694|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||RISING PHARM|No||||
felodipine|Yes|No|No|No|75%|57237011001|FELODIPINE ER 10 MG TABLET|100|EA|.23327|05/12/2015|01/31/2022|Yes|No||05/12/2015|01/31/2022|Yes|No|05/12/2015|01/31/2022|Yes|No||||No|No|07/01/2016|01/31/2022|Prescription required|No||045|No|.53165|02/15/2022|.52405|02/15/2022|.4991|02/15/2022|||CALCIUM CHANNEL BLOCKERS|13695|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||RISING PHARM|No||||
alfuzosin HCl|No|No|No|No|75%|57237011490|ALFUZOSIN HCL ER 10 MG TABLET|90|EA|.16721|01/09/2015||Yes|No||01/09/2015||Yes|No|01/09/2015||Yes|No||||No|No|||Prescription required|No||003|No|.12775|03/29/2022|.12468|03/29/2022|.12551|03/29/2022|||BPH TREATMENTS|13696|||||No|No||RISING PHARM|No||||
warfarin sodium|No|No|No|No|75%|57237011901|WARFARIN SODIUM 1 MG TABLET|100|EA|.06948|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||068|Yes|.08991|03/29/2022|.08775|03/29/2022|.08833|03/29/2022|||ANTICOAGULANTS|13697|||||No|No||RISING PHARM|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|57237011999|WARFARIN SODIUM 1 MG TABLET|1000|EA|.0674|10/12/2016||Yes|No||10/12/2016||Yes|No|10/12/2016||Yes|No||||No|No|||Prescription required|No||068|Yes|.08991|03/29/2022|.08775|03/29/2022|.08833|03/29/2022|||ANTICOAGULANTS|13698|||||No|No||RISING PHARM|No||||
warfarin sodium|No|No|No|No|75%|57237012001|WARFARIN SODIUM 2 MG TABLET|100|EA|.06948|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||068|Yes|.09104|03/29/2022|.08885|03/29/2022|.08944|03/29/2022|||ANTICOAGULANTS|13699|||||No|No||RISING PHARM|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|57237012099|WARFARIN SODIUM 2 MG TABLET|1000|EA|.0674|10/12/2016||Yes|No||10/12/2016||Yes|No|10/12/2016||Yes|No||||No|No|||Prescription required|No||068|Yes|.09104|03/29/2022|.08885|03/29/2022|.08944|03/29/2022|||ANTICOAGULANTS|13700|||||No|No||RISING PHARM|No||||
warfarin sodium|No|No|No|No|75%|57237012101|WARFARIN SODIUM 2.5 MG TABLET|100|EA|.06948|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||068|Yes|.09348|03/29/2022|.09123|03/29/2022|.09184|03/29/2022|||ANTICOAGULANTS|13701|||||No|No||RISING PHARM|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|57237012199|WARFARIN SODIUM 2.5 MG TABLET|1000|EA|.0674|10/12/2016||Yes|No||10/12/2016||Yes|No|10/12/2016||Yes|No||||No|No|||Prescription required|No||068|Yes|.09348|03/29/2022|.09123|03/29/2022|.09184|03/29/2022|||ANTICOAGULANTS|13702|||||No|No||RISING PHARM|No||||
warfarin sodium|No|No|No|No|75%|57237012201|WARFARIN SODIUM 3 MG TABLET|100|EA|.06948|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||068|Yes|.09211|03/29/2022|.08989|03/29/2022|.09049|03/29/2022|||ANTICOAGULANTS|13703|||||No|No||RISING PHARM|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|57237012299|WARFARIN SODIUM 3 MG TABLET|1000|EA|.0674|10/12/2016||Yes|No||10/12/2016||Yes|No|10/12/2016||Yes|No||||No|No|||Prescription required|No||068|Yes|.09211|03/29/2022|.08989|03/29/2022|.09049|03/29/2022|||ANTICOAGULANTS|13704|||||No|No||RISING PHARM|No||||
warfarin sodium|No|No|No|No|75%|57237012301|WARFARIN SODIUM 4 MG TABLET|100|EA|.06948|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||068|Yes|.09432|03/29/2022|.09205|03/29/2022|.09266|03/29/2022|||ANTICOAGULANTS|13705|||||No|No||RISING PHARM|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|57237012399|WARFARIN SODIUM 4 MG TABLET|1000|EA|.0674|10/12/2016||Yes|No||10/12/2016||Yes|No|10/12/2016||Yes|No||||No|No|||Prescription required|No||068|Yes|.09432|03/29/2022|.09205|03/29/2022|.09266|03/29/2022|||ANTICOAGULANTS|13706|||||No|No||RISING PHARM|No||||
warfarin sodium|No|No|No|No|75%|57237012401|WARFARIN SODIUM 5 MG TABLET|100|EA|.06948|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||068|Yes|.10902|03/29/2022|.1064|03/29/2022|.10711|03/29/2022|||ANTICOAGULANTS|13707|||||No|No||RISING PHARM|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|57237012499|WARFARIN SODIUM 5 MG TABLET|1000|EA|.0674|10/12/2016||Yes|No||10/12/2016||Yes|No|10/12/2016||Yes|No||||No|No|||Prescription required|No||068|Yes|.10902|03/29/2022|.1064|03/29/2022|.10711|03/29/2022|||ANTICOAGULANTS|13708|||||No|No||RISING PHARM|No||||
warfarin sodium|No|No|No|No|75%|57237012501|WARFARIN SODIUM 6 MG TABLET|100|EA|.09993|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||068|Yes|.13556|03/29/2022|.1323|03/29/2022|.13318|03/29/2022|||ANTICOAGULANTS|13709|||||No|No||RISING PHARM|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|57237012601|WARFARIN SODIUM 7.5 MG TABLET|100|EA|.09993|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||068|Yes|.11896|03/29/2022|.1161|03/29/2022|.11687|03/29/2022|||ANTICOAGULANTS|13710|||||No|No||RISING PHARM|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|57237012701|WARFARIN SODIUM 10 MG TABLET|100|EA|.09993|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||068|Yes|.12691|03/29/2022|.12386|03/29/2022|.12468|03/29/2022|||ANTICOAGULANTS|13711|||||No|No||RISING PHARM|Yes|09/01/2020|||
torsemide|No|No|No|No|75%|57237013801|TORSEMIDE 5 MG TABLET|100|EA|.05998|01/15/2016|03/31/2022|Yes|No||01/15/2016|03/31/2022|Yes|No|01/15/2016|03/31/2022|Yes|No||||No|No|||Prescription required|No|||No|.0835|03/29/2022|.08149|03/29/2022|.08203|03/29/2022||||13712|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||RISING PHARM|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|57237014201|AMLODIPINE-BENAZEPRIL 2.5-10|100|EA|.0903|01/15/2016||Yes|No||01/15/2016||Yes|No|01/15/2016||Yes|No||||No|No|||Prescription required|No||017|No|.11834|03/29/2022|.11549|03/29/2022|.11626|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13713|||||No|No||RISING PHARM|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|57237014301|AMLODIPINE-BENAZEPRIL 5-10 MG|100|EA|.09567|01/15/2016||Yes|No||01/15/2016||Yes|No|01/15/2016||Yes|No||||No|No|||Prescription required|No||017|No|.11526|03/29/2022|.11249|03/29/2022|.11324|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13714|||||No|No||RISING PHARM|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|57237014401|AMLODIPINE-BENAZEPRIL 5-20 MG|100|EA|.09675|01/15/2016||Yes|No||01/15/2016||Yes|No|01/15/2016||Yes|No||||No|No|||Prescription required|No||017|No|.13285|03/29/2022|.12966|03/29/2022|.13052|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13715|||||No|No||RISING PHARM|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|57237014501|AMLODIPINE-BENAZEPRIL 5-40 MG|100|EA|.09782|01/15/2016||Yes|No||01/15/2016||Yes|No|01/15/2016||Yes|No||||No|No|||Prescription required|No||017|No|.15246|03/29/2022|.1488|03/29/2022|.14979|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13716|||||No|No||RISING PHARM|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|57237014601|AMLODIPINE-BENAZEPRIL 10-20 MG|100|EA|.0774|01/15/2016||Yes|No||01/15/2016||Yes|No|01/15/2016||Yes|No||||No|No|||Prescription required|No||017|No|.14427|03/29/2022|.1408|03/29/2022|.14174|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13717|||||No|No||RISING PHARM|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|57237014701|AMLODIPINE-BENAZEPRIL 10-40 MG|100|EA|.10827|01/15/2016||Yes|No||01/15/2016||Yes|No|01/15/2016||Yes|No||||No|No|||Prescription required|No||017|No|.17354|03/29/2022|.16937|03/29/2022|.1705|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13718|||||No|No||RISING PHARM|No||||
fluconazole|No|No|No|No|75%|57237014935|FLUCONAZOLE 10 MG/ML SUSP|35|ML|.24571|01/15/2016||Yes|No||01/15/2016||Yes|No|01/15/2016||Yes|No||||No|No|||Prescription required|No||069|No|.28361|03/29/2022|.2768|03/29/2022|.27864|03/29/2022|||ANTIFUNGALS: ORAL|13719|||||No|No||RISING PHARM|No||||
fluconazole|No|No|No|No|75%|57237015035|FLUCONAZOLE 40 MG/ML SUSP|35|ML|.49142|01/15/2016||Yes|No||01/15/2016||Yes|No|01/15/2016||Yes|No||||No|No|||Prescription required|No||069|No|.56233|03/29/2022|.54883|03/29/2022|.55248|03/29/2022|||ANTIFUNGALS: ORAL|13720|||||No|No||RISING PHARM|No||||
modafinil|No|No|No|No|90%|57237015430|MODAFINIL 100 MG TABLET|30|EA|.27233|01/15/2016||Yes|No||01/15/2016||Yes|No|01/15/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.4088|03/29/2022|.39898|03/29/2022|.40164|03/29/2022|||STIMULANTS AND RELATED AGENTS|13721|||||No|No||RISING PHARM|No||||
modafinil|No|No|No|No|90%|57237015490|MODAFINIL 100 MG TABLET|90|EA|.27233|01/15/2016||Yes|No||01/15/2016||Yes|No|01/15/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.4088|03/29/2022|.39898|03/29/2022|.40164|03/29/2022|||STIMULANTS AND RELATED AGENTS|13722|||||No|No||RISING PHARM|No||||
modafinil|No|No|No|No|90%|57237015530|MODAFINIL 200 MG TABLET|30|EA|.37983|01/15/2016||Yes|No||01/15/2016||Yes|No|01/15/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55328|03/29/2022|.54|03/29/2022|.54359|03/29/2022|||STIMULANTS AND RELATED AGENTS|13723|||||No|No||RISING PHARM|No||||
modafinil|No|No|No|No|90%|57237015590|MODAFINIL 200 MG TABLET|90|EA|.37983|01/15/2016||Yes|No||01/15/2016||Yes|No|01/15/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55328|03/29/2022|.54|03/29/2022|.54359|03/29/2022|||STIMULANTS AND RELATED AGENTS|13724|||||No|No||RISING PHARM|No||||
moxifloxacin HCl|No|No|No|No|75%|57237015630|MOXIFLOXACIN HCL 400 MG TABLET|30|EA|2.50833|01/15/2016||Yes|No||01/15/2016||Yes|No|01/15/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|028|No|1.23895|03/29/2022|1.20921|03/29/2022|1.21726|03/29/2022|||FLUOROQUINOLONES: ORAL|13725|||||No|No||RISING PHARM|No||||
repaglinide|No|No|No|No|75%|57237015701|REPAGLINIDE 0.5 MG TABLET|100|EA|.1333|07/05/2016||Yes|No||07/05/2016||Yes|No|07/05/2016||Yes|No||||No|No|||Prescription required|No||022|Yes|.11854|03/29/2022|.11569|03/29/2022|.11646|03/29/2022|||HYPOGLYCEMICS: MEGLITINIDES|13726|||||No|No||RISING PHARM|No||||
repaglinide|No|No|No|No|75%|57237015801|REPAGLINIDE 1 MG TABLET|100|EA|.1333|07/05/2016||Yes|No||07/05/2016||Yes|No|07/05/2016||Yes|No||||No|No|||Prescription required|No||022|Yes|.12359|03/29/2022|.12062|03/29/2022|.12142|03/29/2022|||HYPOGLYCEMICS: MEGLITINIDES|13727|||||No|No||RISING PHARM|No||||
repaglinide|No|No|No|No|75%|57237015901|REPAGLINIDE 2 MG TABLET|100|EA|.1333|07/05/2016||Yes|No||07/05/2016||Yes|No|07/05/2016||Yes|No||||No|No|||Prescription required|No||022|Yes|.12502|03/29/2022|.12201|03/29/2022|.12283|03/29/2022|||HYPOGLYCEMICS: MEGLITINIDES|13728|||||No|No||RISING PHARM|No||||
omeprazole|No|No|No|No|75%|57237016130|OMEPRAZOLE DR 20 MG CAPSULE|30|EA|.043|09/01/2020||Yes|No||09/01/2020||Yes|No|09/01/2020||Yes|No||||No|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|13729|||||No|No||RISING PHARM|No||||
omeprazole|No|No|No|No|75%|57237016190|OMEPRAZOLE DR 20 MG CAPSULE|90|EA|.02866|09/01/2020||Yes|No||09/01/2020||Yes|No|09/01/2020||Yes|No||||No|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|13730|||||No|No||RISING PHARM|No||||
omeprazole|No|No|No|No|75%|57237016199|OMEPRAZOLE DR 20 MG CAPSULE|1000|EA|.0215|11/14/2016||Yes|No||11/14/2016||Yes|No|11/14/2016||Yes|No||||No|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|13731|||||No|No||RISING PHARM|No||||
omeprazole|No|No|No|No|75%|57237016230|OMEPRAZOLE DR 40 MG CAPSULE|30|EA|.03769|09/01/2020||Yes|No||09/01/2020||Yes|No|09/01/2020||Yes|No||||No|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|13732|||||No|No||RISING PHARM|No||||
omeprazole|No|No|No|No|75%|57237016290|OMEPRAZOLE DR 40 MG CAPSULE|90|EA|.03764|09/01/2020||Yes|No||09/01/2020||Yes|No|09/01/2020||Yes|No||||No|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|13733|||||No|No||RISING PHARM|No||||
rosuvastatin calcium|No|No|No|No|75%|57237016805|ROSUVASTATIN CALCIUM 5 MG TAB|500|EA|.06416|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||063|Yes|.06753|03/29/2022|.0659|03/29/2022|.06634|03/29/2022|||LIPOTROPICS: STATINS|13734|||||No|No||RISING PHARM|No||||
rosuvastatin calcium|No|No|No|No|75%|57237016890|ROSUVASTATIN CALCIUM 5 MG TAB|90|EA|.08121|11/16/2016||Yes|No||11/16/2016||Yes|No|11/16/2016||Yes|No||||No|No|||Prescription required|No||063|Yes|.06753|03/29/2022|.0659|03/29/2022|.06634|03/29/2022|||LIPOTROPICS: STATINS|13735|||||No|No||RISING PHARM|No||||
rosuvastatin calcium|No|No|No|No|75%|57237016990|ROSUVASTATIN CALCIUM 10 MG TAB|90|EA|.08121|11/16/2016||Yes|No||11/16/2016||Yes|No|11/16/2016||Yes|No||||No|No|||Prescription required|No||063|Yes|.05981|03/29/2022|.05837|03/29/2022|.05876|03/29/2022|||LIPOTROPICS: STATINS|13736|||||No|No||RISING PHARM|No||||
rosuvastatin calcium|No|No|No|No|75%|57237016999|ROSUVASTATIN CALCIUM 10 MG TAB|1000|EA|.06416|11/16/2016||Yes|No||11/16/2016||Yes|No|11/16/2016||Yes|No||||No|No|||Prescription required|No||063|Yes|.05981|03/29/2022|.05837|03/29/2022|.05876|03/29/2022|||LIPOTROPICS: STATINS|13737|||||No|No||RISING PHARM|No||||
rosuvastatin calcium|No|No|No|No|75%|57237017090|ROSUVASTATIN CALCIUM 20 MG TAB|90|EA|.08121|11/16/2016||Yes|No||11/16/2016||Yes|No|11/16/2016||Yes|No||||No|No|||Prescription required|No||063|Yes|.07822|03/29/2022|.07634|03/29/2022|.07685|03/29/2022|||LIPOTROPICS: STATINS|13738|||||No|No||RISING PHARM|No||||
rosuvastatin calcium|No|No|No|No|75%|57237017099|ROSUVASTATIN CALCIUM 20 MG TAB|1000|EA|.06416|11/16/2016||Yes|No||11/16/2016||Yes|No|11/16/2016||Yes|No||||No|No|||Prescription required|No||063|Yes|.07822|03/29/2022|.07634|03/29/2022|.07685|03/29/2022|||LIPOTROPICS: STATINS|13739|||||No|No||RISING PHARM|No||||
rosuvastatin calcium|No|No|No|No|75%|57237017105|ROSUVASTATIN CALCIUM 40 MG TAB|500|EA|.06416|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|13740|||||No|No||RISING PHARM|No||||
rosuvastatin calcium|No|No|No|No|75%|57237017130|ROSUVASTATIN CALCIUM 40 MG TAB|30|EA|.08127|11/16/2016||Yes|No||11/16/2016||Yes|No|11/16/2016||Yes|No||||No|No|||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|13741|||||No|No||RISING PHARM|No||||
rosuvastatin calcium|No|No|No|No|75%|57237017190|ROSUVASTATIN CALCIUM 40 MG TAB|90|EA|.08121|11/16/2016||Yes|No||11/16/2016||Yes|No|11/16/2016||Yes|No||||No|No|||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|13742|||||No|No||RISING PHARM|No||||
venlafaxine HCl|No|No|No|No|75%|57237017201|VENLAFAXINE HCL 25 MG TABLET|100|EA|.05435|04/04/2017||Yes|No||04/04/2017||Yes|No|04/04/2017||Yes|No||||No|No|||Prescription required|No||031|No|.11374|03/29/2022|.11101|03/29/2022|.11174|03/29/2022|||ANTIDEPRESSANTS: OTHER|13743|||||No|No||RISING PHARM|No||||
venlafaxine HCl|No|No|No|No|75%|57237017301|VENLAFAXINE HCL 37.5 MG TABLET|100|EA|.05688|07/01/2016||Yes|No||07/01/2016||Yes|No|07/01/2016||Yes|No||||No|No|||Prescription required|No||031|Yes|.11453|03/29/2022|.11178|03/29/2022|.11252|03/29/2022|||ANTIDEPRESSANTS: OTHER|13744|||||No|No||RISING PHARM|No||||
venlafaxine HCl|No|No|No|No|75%|57237017401|VENLAFAXINE HCL 50 MG TABLET|100|EA|.05942|04/04/2017||Yes|No||04/04/2017||Yes|No|04/04/2017||Yes|No||||No|No|||Prescription required|No||031|No|.12769|03/29/2022|.12462|03/29/2022|.12545|03/29/2022|||ANTIDEPRESSANTS: OTHER|13745|||||No|No||RISING PHARM|No||||
venlafaxine HCl|No|No|No|No|75%|57237017501|VENLAFAXINE HCL 75 MG TABLET|100|EA|.062|07/05/2016||Yes|No||07/05/2016||Yes|No|07/05/2016||Yes|No||||No|No|||Prescription required|No||031|No|.10828|03/29/2022|.10568|03/29/2022|.10638|03/29/2022|||ANTIDEPRESSANTS: OTHER|13746|||||No|No||RISING PHARM|No||||
venlafaxine HCl|No|No|No|No|75%|57237017601|VENLAFAXINE HCL 100 MG TABLET|100|EA|.06454|07/05/2016||Yes|No||07/05/2016||Yes|No|07/05/2016||Yes|No||||No|No|||Prescription required|No||031|No|.13788|03/29/2022|.13457|03/29/2022|.13546|03/29/2022|||ANTIDEPRESSANTS: OTHER|13747|||||No|No||RISING PHARM|No||||
pramipexole di-HCl|No|No|No|No|75%|57237018090|PRAMIPEXOLE 0.125 MG TABLET|90|EA|.04777|01/15/2016||Yes|No||01/15/2016||Yes|No|01/15/2016||Yes|No||||No|No|||Prescription required|No||015|No|.05408|03/29/2022|.05278|03/29/2022|.05313|03/29/2022|||ANTIPARKINSON'S AGENTS|13748|||||No|No||RISING PHARM|No||||
pramipexole di-HCl|No|No|No|No|75%|57237018190|PRAMIPEXOLE 0.25 MG TABLET|90|EA|.04777|01/15/2016||Yes|No||01/15/2016||Yes|No|01/15/2016||Yes|No||||No|No|||Prescription required|No||015|No|.05102|03/29/2022|.04979|03/29/2022|.05012|03/29/2022|||ANTIPARKINSON'S AGENTS|13749|||||No|No||RISING PHARM|No||||
pramipexole di-HCl|No|No|No|No|75%|57237018290|PRAMIPEXOLE 0.5 MG TABLET|90|EA|.04777|01/15/2016||Yes|No||01/15/2016||Yes|No|01/15/2016||Yes|No||||No|No|||Prescription required|No||015|No|.05616|03/29/2022|.05481|03/29/2022|.05517|03/29/2022|||ANTIPARKINSON'S AGENTS|13750|||||No|No||RISING PHARM|No||||
pramipexole di-HCl|No|No|No|No|75%|57237018390|PRAMIPEXOLE 0.75 MG TABLET|90|EA|.04777|01/15/2016||Yes|No||01/15/2016||Yes|No|01/15/2016||Yes|No||||No|No|||Prescription required|No||015|No|.07926|03/29/2022|.07735|03/29/2022|.07787|03/29/2022|||ANTIPARKINSON'S AGENTS|13751|||||No|No||RISING PHARM|No||||
pramipexole di-HCl|No|No|No|No|75%|57237018490|PRAMIPEXOLE 1 MG TABLET|90|EA|.04777|01/15/2016||Yes|No||01/15/2016||Yes|No|01/15/2016||Yes|No||||No|No|||Prescription required|No||015|No|.06615|03/29/2022|.06456|03/29/2022|.06499|03/29/2022|||ANTIPARKINSON'S AGENTS|13752|||||No|No||RISING PHARM|No||||
pramipexole di-HCl|No|No|No|No|75%|57237018590|PRAMIPEXOLE 1.5 MG TABLET|90|EA|.04777|07/11/2016||Yes|No||07/11/2016||Yes|No|07/11/2016||Yes|No||||No|No|||Prescription required|No||015|No|.07545|03/29/2022|.07363|03/29/2022|.07412|03/29/2022|||ANTIPARKINSON'S AGENTS|13753|||||No|No||RISING PHARM|No||||
montelukast sodium|No|No|No|No|75%|57237021230|MONTELUKAST SOD 4 MG TAB CHEW|30|EA|.04658|01/15/2016||Yes|No||01/15/2016||Yes|No|01/15/2016||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|13754|||||No|No||RISING PHARM|No||||
montelukast sodium|No|No|No|No|75%|57237021290|MONTELUKAST SOD 4 MG TAB CHEW|90|EA|.0439|01/15/2016||Yes|No||01/15/2016||Yes|No|01/15/2016||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|13755|||||No|No||RISING PHARM|No||||
montelukast sodium|No|No|No|No|75%|57237021330|MONTELUKAST SOD 5 MG TAB CHEW|30|EA|.05016|01/15/2016||Yes|No||01/15/2016||Yes|No|01/15/2016||Yes|No||||No|No|||Prescription required|No||042|Yes|.08451|03/29/2022|.08248|03/29/2022|.08303|03/29/2022|||LEUKOTRIENE MODIFIERS|13756|||||No|No||RISING PHARM|No||||
montelukast sodium|No|No|No|No|75%|57237021390|MONTELUKAST SOD 5 MG TAB CHEW|90|EA|.0439|01/15/2016||Yes|No||01/15/2016||Yes|No|01/15/2016||Yes|No||||No|No|||Prescription required|No||042|Yes|.08451|03/29/2022|.08248|03/29/2022|.08303|03/29/2022|||LEUKOTRIENE MODIFIERS|13757|||||No|No||RISING PHARM|No||||
pioglitazone HCl/metformin HCl|No|No|No|No|75%|57237021760|PIOGLITAZONE-METFORMIN 15-500|60|EA|.57333|11/14/2016||Yes|No||11/14/2016||Yes|No|11/14/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|009|Yes|.53323|03/29/2022|.52043|03/29/2022|.52389|03/29/2022|||HYPOGLYCEMICS: TZD|13758|||||No|No||RISING PHARM|No||||
pioglitazone HCl/metformin HCl|No|No|No|No|75%|57237021860|PIOGLITAZONE-METFORMIN 15-850|60|EA|.71666|11/14/2016||Yes|No||11/14/2016||Yes|No|11/14/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|009|Yes|.44962|03/29/2022|.43882|03/29/2022|.44175|03/29/2022|||HYPOGLYCEMICS: TZD|13759|||||No|No||RISING PHARM|No||||
pioglitazone HCl|No|No|No|No|75%|57237021905|PIOGLITAZONE HCL 15 MG TABLET|500|EA|.05698|10/12/2018||Yes|No||10/12/2018||Yes|No|10/12/2018||Yes|No||||No|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|13760|||||No|No||RISING PHARM|No||||
pioglitazone HCl|No|No|No|No|75%|57237021930|PIOGLITAZONE HCL 15 MG TABLET|30|EA|.0645|10/12/2018||Yes|No||10/12/2018||Yes|No|10/12/2018||Yes|No||||No|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|13761|||||No|No||RISING PHARM|No||||
pioglitazone HCl|No|No|No|No|75%|57237021990|PIOGLITAZONE HCL 15 MG TABLET|90|EA|.0645|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|13762|||||No|No||RISING PHARM|No||||
pioglitazone HCl|No|No|No|No|75%|57237022005|PIOGLITAZONE HCL 30 MG TABLET|500|EA|.0751|10/12/2018||Yes|No||10/12/2018||Yes|No|10/12/2018||Yes|No||||No|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|13763|||||No|No||RISING PHARM|No||||
pioglitazone HCl|No|No|No|No|75%|57237022030|PIOGLITAZONE HCL 30 MG TABLET|30|EA|.08901|10/12/2018||Yes|No||10/12/2018||Yes|No|10/12/2018||Yes|No||||No|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|13764|||||No|No||RISING PHARM|No||||
pioglitazone HCl|No|No|No|No|75%|57237022090|PIOGLITAZONE HCL 30 MG TABLET|90|EA|.08901|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|13765|||||No|No||RISING PHARM|No||||
pioglitazone HCl|No|No|No|No|75%|57237022105|PIOGLITAZONE HCL 45 MG TABLET|500|EA|.07915|10/12/2018||Yes|No||10/12/2018||Yes|No|10/12/2018||Yes|No||||No|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|13766|||||No|No||RISING PHARM|No||||
pioglitazone HCl|No|No|No|No|75%|57237022130|PIOGLITAZONE HCL 45 MG TABLET|30|EA|.09804|10/12/2018||Yes|No||10/12/2018||Yes|No|10/12/2018||Yes|No||||No|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|13767|||||No|No||RISING PHARM|No||||
pioglitazone HCl|No|No|No|No|75%|57237022190|PIOGLITAZONE HCL 45 MG TABLET|90|EA|.08227|10/12/2018||Yes|No||10/12/2018||Yes|No|10/12/2018||Yes|No||||No|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|13768|||||No|No||RISING PHARM|No||||
ramipril|No|No|No|No|75%|57237022201|RAMIPRIL 1.25 MG CAPSULE|100|EA|.0688|10/19/2020||Yes|No||10/19/2020||Yes|No|10/19/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.12346|03/29/2022|.12049|03/29/2022|.12129|03/29/2022|||ANGIOTENSIN MODULATORS|13769|||||No|No||RISING PHARM|No||||
ramipril|No|No|No|No|75%|57237022230|RAMIPRIL 1.25 MG CAPSULE|30|EA|.07166|10/19/2020||Yes|No||10/19/2020||Yes|No|10/19/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.12346|03/29/2022|.12049|03/29/2022|.12129|03/29/2022|||ANGIOTENSIN MODULATORS|13770|||||No|No||RISING PHARM|No||||
ramipril|No|No|No|No|75%|57237022301|RAMIPRIL 2.5 MG CAPSULE|100|EA|.0473|10/19/2020||Yes|No||10/19/2020||Yes|No|10/19/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.06329|03/29/2022|.06177|03/29/2022|.06218|03/29/2022|||ANGIOTENSIN MODULATORS|13771|||||No|No||RISING PHARM|No||||
ramipril|No|No|No|No|75%|57237022305|RAMIPRIL 2.5 MG CAPSULE|500|EA|.0473|10/19/2020||Yes|No||10/19/2020||Yes|No|10/19/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.06329|03/29/2022|.06177|03/29/2022|.06218|03/29/2022|||ANGIOTENSIN MODULATORS|13772|||||No|No||RISING PHARM|No||||
ramipril|No|No|No|No|75%|57237022401|RAMIPRIL 5 MG CAPSULE|100|EA|.0516|10/19/2020||Yes|No||10/19/2020||Yes|No|10/19/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.06848|03/29/2022|.06683|03/29/2022|.06728|03/29/2022|||ANGIOTENSIN MODULATORS|13773|||||No|No||RISING PHARM|No||||
ramipril|No|No|No|No|75%|57237022405|RAMIPRIL 5 MG CAPSULE|500|EA|.0516|10/19/2020||Yes|No||10/19/2020||Yes|No|10/19/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.06848|03/29/2022|.06683|03/29/2022|.06728|03/29/2022|||ANGIOTENSIN MODULATORS|13774|||||No|No||RISING PHARM|No||||
ramipril|No|No|No|No|75%|57237022501|RAMIPRIL 10 MG CAPSULE|100|EA|.0559|10/19/2020||Yes|No||10/19/2020||Yes|No|10/19/2020||Yes|No||||No|No|||Prescription required|No||113|No|.07037|03/29/2022|.06868|03/29/2022|.06913|03/29/2022|||ANGIOTENSIN MODULATORS|13775|||||No|No||RISING PHARM|No||||
ramipril|No|No|No|No|75%|57237022505|RAMIPRIL 10 MG CAPSULE|500|EA|.0559|10/19/2020||Yes|No||10/19/2020||Yes|No|10/19/2020||Yes|No||||No|No|||Prescription required|No||113|No|.07037|03/29/2022|.06868|03/29/2022|.06913|03/29/2022|||ANGIOTENSIN MODULATORS|13776|||||No|No||RISING PHARM|No||||
sulfamethoxazole/trimethoprim|Yes|No|No|No|75%|57237023201|SULFAMETHOXAZOLE-TMP SS TABLET|100|EA|.0258|11/18/2019||Yes|No||11/18/2019||Yes|No|11/18/2019||Yes|No||||No|No|01/15/2020||Prescription required|No|||No|.07038|03/29/2022|.06869|03/29/2022|.06914|03/29/2022||||13777|||||No|No||RISING PHARM|No||||
sulfamethoxazole/trimethoprim|Yes|No|No|No|75%|57237023205|SULFAMETHOXAZOLE-TMP SS TABLET|500|EA|.02494|11/18/2019||Yes|No||11/18/2019||Yes|No|11/18/2019||Yes|No||||No|No|01/15/2020||Prescription required|No|||No|.07038|03/29/2022|.06869|03/29/2022|.06914|03/29/2022||||13778|||||No|No||RISING PHARM|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|57237023301|SULFAMETHOXAZOLE-TMP DS TABLET|100|EA|.02709|11/18/2019||Yes|No||11/18/2019||Yes|No|11/18/2019||Yes|No||||No|No|||Prescription required|No|||No|.06566|03/29/2022|.06408|03/29/2022|.06451|03/29/2022||||13779|||||No|No||RISING PHARM|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|57237023305|SULFAMETHOXAZOLE-TMP DS TABLET|500|EA|.0258|11/18/2019||Yes|No||11/18/2019||Yes|No|11/18/2019||Yes|No||||No|No|||Prescription required|No|||No|.06566|03/29/2022|.06408|03/29/2022|.06451|03/29/2022||||13780|||||No|No||RISING PHARM|No||||
zaleplon|No|No|No|No|90%|57237023901|ZALEPLON 5 MG CAPSULE|100|EA|.129|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|No||054|Yes|.1639|03/29/2022|.15996|03/29/2022|.16103|03/29/2022|||SEDATIVE HYPNOTICS|13781|||||No|No||RISING PHARM|No||||
zaleplon|No|No|No|No|90%|57237024001|ZALEPLON 10 MG CAPSULE|100|EA|.13545|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|No||054|Yes|.18241|03/29/2022|.17803|03/29/2022|.17921|03/29/2022|||SEDATIVE HYPNOTICS|13782|||||No|No||RISING PHARM|No||||
cyclobenzaprine HCl|No|No|No|No|75%|57237026601|CYCLOBENZAPRINE 7.5 MG TABLET|100|EA|1.4878|12/06/2017||Yes|No||12/06/2017||Yes|No|12/06/2017||Yes|No||||No|No|||Prescription required|No||116|Yes|1.21617|03/29/2022|1.18698|03/29/2022|1.19488|03/29/2022|||SKELETAL MUSCLE RELAXANTS|13783|||||No|No||RISING PHARM|No||||
lamivudine|No|No|No|No|75%|57237027424|LAMIVUDINE 10 MG/ML ORAL SOLN|240|ML|.19999|08/31/2020||Yes|No||08/31/2020||Yes|No|08/31/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.32666|11/23/2021|.32199|11/23/2021|.30666|11/23/2021|||HIV / AIDS|13784|||||No|No||RISING PHARM|No||||
isotretinoin|No|No|No|No|75%|57664002097|ISOTRETINOIN 10 MG CAPSULE|30|EA|12.19107|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|144|No|24.884|02/02/2022|24.28678|02/02/2022|24.44853|02/02/2022|||ACNE AGENTS: ORAL|13785|||||No|No||SUN PHARMACEUTI|No||||
isotretinoin|No|No|No|No|75%|57664002297|ISOTRETINOIN 25 MG CAPSULE|30|EA|13.11686|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|144|No|29.89424|02/02/2022|29.46718|02/02/2022|28.06398|02/02/2022|||ACNE AGENTS: ORAL|13786|||||No|No||SUN PHARMACEUTI|No||||
isotretinoin|No|No|No|No|75%|57664002497|ISOTRETINOIN 35 MG CAPSULE|30|EA|13.11686|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|144|No|29.89424|02/02/2022|29.46718|02/02/2022|28.06398|02/02/2022|||ACNE AGENTS: ORAL|13787|||||No|No||SUN PHARMACEUTI|No||||
isotretinoin|No|No|No|No|75%|57664002597|ISOTRETINOIN 40 MG CAPSULE|30|EA|13.11686|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|144|No|26.7665|02/02/2022|26.1241|02/02/2022|26.29808|02/02/2022|||ACNE AGENTS: ORAL|13788|||||No|No||SUN PHARMACEUTI|No||||
amlodipine besylate|Yes|No|No|No|75%|57664005513|AMLODIPINE BESYLATE 2.5 MG TAB|500|EA|.01552|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||01/31/2014||Yes|No|07/01/2016||Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|13789|||||No|No||CARACO/SUN PHAR|No||||
amlodipine besylate|Yes|No|No|No|75%|57664005518|AMLODIPINE BESYLATE 2.5 MG TAB|1000|EA|.01552|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||01/31/2014||Yes|No|07/01/2016||Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|13790|||||No|No||CARACO/SUN PHAR|No||||
amlodipine besylate|Yes|No|No|No|75%|57664005599|AMLODIPINE BESYLATE 2.5 MG TAB|90|EA|.01552|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||01/31/2014||Yes|No|07/01/2016||Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|13791|||||No|No||CARACO/SUN PHAR|No||||
amlodipine besylate|Yes|No|No|No|75%|57664005613|AMLODIPINE BESYLATE 5 MG TAB|500|EA|.01552|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||01/31/2014||Yes|No|07/01/2016||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|13792|||||No|No||CARACO/SUN PHAR|No||||
amlodipine besylate|Yes|No|No|No|75%|57664005618|AMLODIPINE BESYLATE 5 MG TAB|1000|EA|.01552|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||01/31/2014||Yes|No|07/01/2016||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|13793|||||No|No||CARACO/SUN PHAR|No||||
amlodipine besylate|Yes|No|No|No|75%|57664005699|AMLODIPINE BESYLATE 5 MG TAB|90|EA|.01552|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||01/31/2014||Yes|No|07/01/2016||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|13794|||||No|No||CARACO/SUN PHAR|No||||
amlodipine besylate|Yes|No|No|No|75%|57664005713|AMLODIPINE BESYLATE 10 MG TAB|500|EA|.02171|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||01/31/2014||Yes|No|07/01/2016||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|13795|||||No|No||CARACO/SUN PHAR|No||||
amlodipine besylate|Yes|No|No|No|75%|57664005718|AMLODIPINE BESYLATE 10 MG TAB|1000|EA|.02171|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||01/31/2014||Yes|No|07/01/2016||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|13796|||||No|No||CARACO/SUN PHAR|No||||
amlodipine besylate|Yes|No|No|No|75%|57664005799|AMLODIPINE BESYLATE 10 MG TAB|90|EA|.02173|01/31/2014||Yes|No||01/31/2014||Yes|No|01/31/2014||Yes|No||01/31/2014||Yes|No|07/01/2016||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|13797|||||No|No||CARACO/SUN PHAR|No||||
ferrous sulfate|No|No|No|No|75%|57664007001|FERROUS SULFATE 325 MG TABLET|100|EA|.00589|||No|No||||No|No|||No|No||05/05/2015||Yes|No|||Over the counter|No|||No|.01342|07/07/2020|.01323|07/07/2020|.0126|07/07/2020||||13798|||||No|No||SUN PHARMACEUTI|No||||
ferrous sulfate|No|No|No|No|75%|57664007010|FERROUS SULFATE 325 MG TABLET|1000|EA|.00549|||No|No||||No|No|||No|No||05/05/2015||Yes|No|||Over the counter|No|||No|.01252|07/07/2020|.01234|07/07/2020|.01175|07/07/2020||||13799|||||No|No||SUN PHARMACEUTI|No||||
ferrous sulfate|No|No|No|No|75%|57664007101|FERROUS SULFATE 325 MG TABLET|100|EA|.00589|||No|No||||No|No|||No|No||12/16/2014||Yes|No|||Over the counter|No|||No|.01342|07/07/2020|.01323|07/07/2020|.0126|07/07/2020||||13800|||||No|No||SUN PHARMACEUTI|No||||
ferrous sulfate|No|No|No|No|75%|57664007110|FERROUS SULFATE 325 MG TABLET|1000|EA|.00439|||No|No||||No|No|||No|No||12/16/2014||Yes|No|||Over the counter|No|||No|.01002|07/07/2020|.00988|07/07/2020|.00941|07/07/2020||||13801|||||No|No||SUN PHARMACEUTI|No||||
promethazine HCl|No|No|No|No|75%|57664010788|PROMETHAZINE 12.5 MG TABLET|100|EA|.0215|02/18/2009||Yes|No||02/18/2009||Yes|No|02/18/2009||Yes|No||02/18/2009||Yes|No|||Prescription required|No||085|Yes|.05281|03/29/2022|.05154|03/29/2022|.05188|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|13802|||||No|No||CARACO/SUN PHAR|No||||
promethazine HCl|No|No|No|No|75%|57664010818|PROMETHAZINE 25 MG TABLET|1000|EA|.0215|10/30/2012||Yes|No||10/30/2012||Yes|No|10/30/2012||Yes|No||10/30/2012||Yes|No|||Prescription required|No||085|Yes|.05271|03/29/2022|.05144|03/29/2022|.05178|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|13803|||||No|No||CARACO/SUN PHAR|No||||
promethazine HCl|No|No|No|No|75%|57664010888|PROMETHAZINE 25 MG TABLET|100|EA|.0215|02/18/2009||Yes|No||02/18/2009||Yes|No|02/18/2009||Yes|No||02/18/2009||Yes|No|||Prescription required|No||085|Yes|.05271|03/29/2022|.05144|03/29/2022|.05178|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|13804|||||No|No||CARACO/SUN PHAR|No||||
promethazine HCl|No|No|No|No|75%|57664010988|PROMETHAZINE 50 MG TABLET|100|EA|.0215|02/18/2009||Yes|No||02/18/2009||Yes|No|02/18/2009||Yes|No||02/18/2009||Yes|No|||Prescription required|No||085|Yes|.09825|03/29/2022|.09589|03/29/2022|.09653|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|13805|||||No|No||CARACO/SUN PHAR|No||||
verapamil HCl|Yes|No|No|No|75%|57664011688|VERAPAMIL ER 120 MG TABLET|100|EA|.31175|07/23/2012||Yes|No||07/23/2012||Yes|No|07/23/2012||Yes|No||07/23/2012||Yes|No|07/01/2016||Prescription required|No||045|No|.28596|03/29/2022|.27909|03/29/2022|.28095|03/29/2022|||CALCIUM CHANNEL BLOCKERS|13806|||||No|No||CARACO/SUN PHAR|No||||
verapamil HCl|Yes|No|No|No|75%|57664011713|VERAPAMIL ER 180 MG TABLET|500|EA|.15394|07/23/2012||Yes|No||07/23/2012||Yes|No|07/23/2012||Yes|No||07/23/2012||Yes|No|07/01/2016||Prescription required|No||045|No|.19574|03/29/2022|.19104|03/29/2022|.19231|03/29/2022|||CALCIUM CHANNEL BLOCKERS|13807|||||No|No||CARACO/SUN PHAR|No||||
verapamil HCl|Yes|No|No|No|75%|57664011788|VERAPAMIL ER 180 MG TABLET|100|EA|.1591|07/23/2012||Yes|No||07/23/2012||Yes|No|07/23/2012||Yes|No||07/23/2012||Yes|No|07/01/2016||Prescription required|No||045|No|.19574|03/29/2022|.19104|03/29/2022|.19231|03/29/2022|||CALCIUM CHANNEL BLOCKERS|13808|||||No|No||CARACO/SUN PHAR|No||||
verapamil HCl|Yes|No|No|No|75%|57664011813|VERAPAMIL ER 240 MG TABLET|500|EA|.15394|07/23/2012||Yes|No||07/23/2012||Yes|No|07/23/2012||Yes|No||07/23/2012||Yes|No|07/01/2016||Prescription required|No||045|No|.17058|03/29/2022|.16648|03/29/2022|.16759|03/29/2022|||CALCIUM CHANNEL BLOCKERS|13809|||||No|No||CARACO/SUN PHAR|No||||
verapamil HCl|Yes|No|No|No|75%|57664011888|VERAPAMIL ER 240 MG TABLET|100|EA|.1591|07/23/2012||Yes|No||07/23/2012||Yes|No|07/23/2012||Yes|No||07/23/2012||Yes|No|07/01/2016||Prescription required|No||045|No|.17058|03/29/2022|.16648|03/29/2022|.16759|03/29/2022|||CALCIUM CHANNEL BLOCKERS|13810|||||No|No||CARACO/SUN PHAR|No||||
valproic acid (as sodium salt)|No|No|No|No|75%|57664012434|VALPROIC ACID 250 MG/5 ML SOLN|473|ML|.00981|07/18/2012||Yes|No||07/18/2012||Yes|No|07/18/2012||Yes|No||||No|No|||Prescription required|No||056|No|.01872|03/29/2022|.01827|03/29/2022|.01839|03/29/2022|||ANTICONVULSANTS|13811|||||No|No||CARACO/SUN PHAR|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|57664012613|HYDROCODONE-ACETAMIN 5-325 MG|500|EA|.10006|05/06/2009||Yes|No||05/06/2009||Yes|No|05/06/2009||Yes|No||01/01/2012||Yes|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13812|||||No|No||CARACO/SUN PHAR|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|57664012688|HYDROCODONE-ACETAMIN 5-325 MG|100|EA|.06493|05/06/2009||Yes|No||05/06/2009||Yes|No|05/06/2009||Yes|No||01/01/2012||Yes|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13813|||||No|No||CARACO/SUN PHAR|No||||
benzonatate|No|No|No|No|75%|57664013388|BENZONATATE 100 MG CAPSULE|100|EA|.1204|07/22/2009||Yes|No||07/22/2009||Yes|No|07/22/2009||Yes|No||||No|No|||Prescription required|No||184|Yes|.09389|03/29/2022|.09163|03/29/2022|.09224|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|13814|||||No|No||CARACO/SUN PHAR|No||||
benzonatate|No|No|No|No|75%|57664013488|BENZONATATE 200 MG CAPSULE|100|EA|.1806|07/22/2009||Yes|No||07/22/2009||Yes|No|07/22/2009||Yes|No||||No|No|||Prescription required|No||184|Yes|.14345|03/29/2022|.14|03/29/2022|.14093|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|13815|||||No|No||CARACO/SUN PHAR|No||||
ergocalciferol (vitamin D2)|No|No|No|No|75%|57664013688|VITAMIN D2 1.25MG(50,000 UNIT)|100|EA|.25778|10/02/2012||Yes|No||10/02/2012||Yes|No|10/02/2012||Yes|No||10/02/2012||Yes|No|||Prescription required|No|||No|.14082|03/29/2022|.13744|03/29/2022|.13835|03/29/2022||||13816|||||No|No||CARACO/SUN PHAR|No||||
metoprolol tartrate|No|No|No|No|75%|57664016652|METOPROLOL TARTRATE 50 MG TAB|100|EA|.01431|03/14/2011|10/08/2022|Yes|No||03/14/2011|10/08/2022|Yes|No|03/14/2011|10/08/2022|Yes|No||03/14/2011|10/08/2022|Yes|No|||Prescription required|No||070|No|.02252|03/29/2022|.02197|03/29/2022|.02212|03/29/2022|||BETA-BLOCKERS|13817|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||CARACO/SUN PHAR|No||||
metoprolol tartrate|No|No|No|No|75%|57664016658|METOPROLOL TARTRATE 50 MG TAB|1000|EA|.0114|03/14/2011|10/08/2022|Yes|No||03/14/2011|10/08/2022|Yes|No|03/14/2011|10/08/2022|Yes|No||03/14/2011|10/08/2022|Yes|No|||Prescription required|No||070|No|.02252|03/29/2022|.02197|03/29/2022|.02212|03/29/2022|||BETA-BLOCKERS|13818|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||CARACO/SUN PHAR|No||||
metoprolol tartrate|No|No|No|No|75%|57664016752|METOPROLOL TARTRATE 100 MG TAB|100|EA|.01978|06/19/2009||Yes|No||06/19/2009||Yes|No|06/19/2009||Yes|No||06/19/2009||Yes|No|||Prescription required|No||070|No|.03443|03/29/2022|.0336|03/29/2022|.03382|03/29/2022|||BETA-BLOCKERS|13819|||||No|No||CARACO/SUN PHAR|No||||
metoprolol tartrate|No|No|No|No|75%|57664016758|METOPROLOL TARTRATE 100 MG TAB|1000|EA|.01692|06/19/2009||Yes|No||06/19/2009||Yes|No|06/19/2009||Yes|No||06/19/2009||Yes|No|||Prescription required|No||070|No|.03443|03/29/2022|.0336|03/29/2022|.03382|03/29/2022|||BETA-BLOCKERS|13820|||||No|No||CARACO/SUN PHAR|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|57664017013|HYDROCODONE-ACETAMIN 7.5-325|500|EA|.1136|05/06/2009||Yes|No||05/06/2009||Yes|No|05/06/2009||Yes|No||01/01/2012||Yes|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13821|||||No|No||CARACO/SUN PHAR|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|57664017088|HYDROCODONE-ACETAMIN 7.5-325|100|EA|.1262|05/06/2009||Yes|No||05/06/2009||Yes|No|05/06/2009||Yes|No||01/01/2012||Yes|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13822|||||No|No||CARACO/SUN PHAR|No||||
paromomycin sulfate|No|No|No|No|75%|57664017508|PAROMOMYCIN 250 MG CAPSULE|100|EA|1.7415|11/10/2006||Yes|No||11/10/2006||Yes|No|11/10/2006||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|115|No|3.969|06/01/2016|3.9123|06/01/2016|3.726|06/01/2016|||ANTIBIOTICS: GI|13823|||||No|No||CARACO/SUN PHAR|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|57664017613|HYDROCODONE-ACETAMIN 10-325 MG|500|EA|.07778|05/06/2009||Yes|No||05/06/2009||Yes|No|05/06/2009||Yes|No||01/01/2012||Yes|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13824|||||No|No||CARACO/SUN PHAR|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|57664017688|HYDROCODONE-ACETAMIN 10-325 MG|100|EA|.08643|05/06/2009||Yes|No||05/06/2009||Yes|No|05/06/2009||Yes|No||01/01/2012||Yes|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13825|||||No|No||CARACO/SUN PHAR|No||||
oxycodone HCl|No|No|No|No|90%|57664018788|OXYCODONE HCL (IR) 15 MG TAB|100|EA|.25731|05/06/2009||Yes|No||05/06/2009||Yes|No|05/06/2009||Yes|No||||No|No|||Prescription required|No||109|Yes|.15895|03/29/2022|.15513|03/29/2022|.15616|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13826|||||No|No||CARACO/SUN PHAR|No||||
clozapine|No|No|No|No|75%|57664021188|CLOZAPINE 200 MG TABLET|100|EA|1.1235|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|1.46893|03/29/2022|1.43367|03/29/2022|1.44322|03/29/2022|||ANTIPSYCHOTICS|13827|||||No|No||SUN PHARMACEUTI|No||||
oxycodone HCl|No|No|No|No|90%|57664022388|OXYCODONE HCL (IR) 5 MG TABLET|100|EA|.10965|05/06/2009||Yes|No||05/06/2009||Yes|No|05/06/2009||Yes|No||||No|No|||Prescription required|No||109|Yes|.0685|03/29/2022|.06685|03/29/2022|.0673|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13828|||||No|No||CARACO/SUN PHAR|No||||
oxycodone HCl|No|No|No|No|90%|57664022488|OXYCODONE HCL (IR) 30 MG TAB|100|EA|.40222|05/06/2009||Yes|No||05/06/2009||Yes|No|05/06/2009||Yes|No||||No|No|||Prescription required|No||109|Yes|.2615|03/29/2022|.25522|03/29/2022|.25692|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13829|||||No|No||CARACO/SUN PHAR|No||||
methylphenidate HCl|No|No|No|No|75%|57664022888|METHYLPHENIDATE 5 MG TABLET|100|EA|.08471|05/03/2013||Yes|No||05/03/2013||Yes|No|05/03/2013||Yes|No||||No|No|||Prescription required|No||007|Yes|.1394|03/29/2022|.13605|03/29/2022|.13696|03/29/2022|||STIMULANTS AND RELATED AGENTS|13830|||||No|No||CARACO/SUN PHAR|No||||
methylphenidate HCl|No|No|No|No|75%|57664022988|METHYLPHENIDATE 10 MG TABLET|100|EA|.12074|05/03/2013||Yes|No||05/03/2013||Yes|No|05/03/2013||Yes|No||||No|No|||Prescription required|No||007|Yes|.15766|03/29/2022|.15387|03/29/2022|.1549|03/29/2022|||STIMULANTS AND RELATED AGENTS|13831|||||No|No||CARACO/SUN PHAR|No||||
methylphenidate HCl|No|No|No|No|75%|57664023088|METHYLPHENIDATE 20 MG TABLET|100|EA|.17341|05/03/2013||Yes|No||05/03/2013||Yes|No|05/03/2013||Yes|No||||No|No|||Prescription required|No||007|Yes|.22814|03/29/2022|.22266|03/29/2022|.22414|03/29/2022|||STIMULANTS AND RELATED AGENTS|13832|||||No|No||CARACO/SUN PHAR|No||||
clozapine|No|No|No|No|75%|57664024188|CLOZAPINE 50 MG TABLET|100|EA|.5676|03/31/2014||Yes|No||03/31/2014||Yes|No|03/31/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.51896|03/29/2022|.5065|03/29/2022|.50987|03/29/2022|||ANTIPSYCHOTICS|13833|||||No|No||CARACO/SUN PHAR|No||||
carvedilol|No|No|No|No|75%|57664024213|CARVEDILOL 3.125 MG TABLET|500|EA|.0258|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.01877|03/29/2022|.01831|03/29/2022|.01844|03/29/2022|||BETA-BLOCKERS|13834|||||No|No||SUN PHARMACEUTI|No||||
carvedilol|No|No|No|No|75%|57664024218|CARVEDILOL 3.125 MG TABLET|1000|EA|.0258|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.01877|03/29/2022|.01831|03/29/2022|.01844|03/29/2022|||BETA-BLOCKERS|13835|||||No|No||SUN PHARMACEUTI|No||||
carvedilol|No|No|No|No|75%|57664024288|CARVEDILOL 3.125 MG TABLET|100|EA|.0258|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.01877|03/29/2022|.01831|03/29/2022|.01844|03/29/2022|||BETA-BLOCKERS|13836|||||No|No||SUN PHARMACEUTI|No||||
carvedilol|No|No|No|No|75%|57664024413|CARVEDILOL 6.25 MG TABLET|500|EA|.0258|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.02069|03/29/2022|.02019|03/29/2022|.02032|03/29/2022|||BETA-BLOCKERS|13837|||||No|No||SUN PHARMACEUTI|No||||
carvedilol|No|No|No|No|75%|57664024418|CARVEDILOL 6.25 MG TABLET|1000|EA|.0258|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.02069|03/29/2022|.02019|03/29/2022|.02032|03/29/2022|||BETA-BLOCKERS|13838|||||No|No||SUN PHARMACEUTI|No||||
carvedilol|No|No|No|No|75%|57664024488|CARVEDILOL 6.25 MG TABLET|100|EA|.0258|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.02069|03/29/2022|.02019|03/29/2022|.02032|03/29/2022|||BETA-BLOCKERS|13839|||||No|No||SUN PHARMACEUTI|No||||
carvedilol|No|No|No|No|75%|57664024513|CARVEDILOL 12.5 MG TABLET|500|EA|.0258|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.02277|03/29/2022|.02222|03/29/2022|.02237|03/29/2022|||BETA-BLOCKERS|13840|||||No|No||SUN PHARMACEUTI|No||||
carvedilol|No|No|No|No|75%|57664024518|CARVEDILOL 12.5 MG TABLET|1000|EA|.0258|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.02277|03/29/2022|.02222|03/29/2022|.02237|03/29/2022|||BETA-BLOCKERS|13841|||||No|No||SUN PHARMACEUTI|No||||
carvedilol|No|No|No|No|75%|57664024588|CARVEDILOL 12.5 MG TABLET|100|EA|.0258|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.02277|03/29/2022|.02222|03/29/2022|.02237|03/29/2022|||BETA-BLOCKERS|13842|||||No|No||SUN PHARMACEUTI|No||||
carvedilol|No|No|No|No|75%|57664024713|CARVEDILOL 25 MG TABLET|500|EA|.0258|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.03449|03/29/2022|.03366|03/29/2022|.03388|03/29/2022|||BETA-BLOCKERS|13843|||||No|No||SUN PHARMACEUTI|No||||
carvedilol|No|No|No|No|75%|57664024718|CARVEDILOL 25 MG TABLET|1000|EA|.0258|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.03449|03/29/2022|.03366|03/29/2022|.03388|03/29/2022|||BETA-BLOCKERS|13844|||||No|No||SUN PHARMACEUTI|No||||
carvedilol|No|No|No|No|75%|57664024788|CARVEDILOL 25 MG TABLET|100|EA|.0258|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.03449|03/29/2022|.03366|03/29/2022|.03388|03/29/2022|||BETA-BLOCKERS|13845|||||No|No||SUN PHARMACEUTI|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|57664033688|DEXTROAMP-AMPHET ER 5 MG CAP|100|EA|.473|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|007|Yes|.59233|03/29/2022|.57811|03/29/2022|.58196|03/29/2022|||STIMULANTS AND RELATED AGENTS|13846|||||No|No||SUN PHARMACEUTI|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|57664033788|DEXTROAMP-AMPHET ER 10 MG CAP|100|EA|.473|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|007|Yes|.53198|03/29/2022|.51921|03/29/2022|.52267|03/29/2022|||STIMULANTS AND RELATED AGENTS|13847|||||No|No||SUN PHARMACEUTI|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|57664033888|DEXTROAMP-AMPHET ER 15 MG CAP|100|EA|.473|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|007|Yes|.55636|03/29/2022|.543|03/29/2022|.54662|03/29/2022|||STIMULANTS AND RELATED AGENTS|13848|||||No|No||SUN PHARMACEUTI|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|57664033988|DEXTROAMP-AMPHET ER 20 MG CAP|100|EA|.473|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|007|Yes|.58746|03/29/2022|.57336|03/29/2022|.57717|03/29/2022|||STIMULANTS AND RELATED AGENTS|13849|||||No|No||SUN PHARMACEUTI|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|57664034088|DEXTROAMP-AMPHET ER 25 MG CAP|100|EA|.473|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|007|Yes|.54687|03/29/2022|.53374|03/29/2022|.53729|03/29/2022|||STIMULANTS AND RELATED AGENTS|13850|||||No|No||SUN PHARMACEUTI|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|57664034188|DEXTROAMP-AMPHET ER 30 MG CAP|100|EA|.473|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|007|Yes|.61484|03/29/2022|.60008|03/29/2022|.60408|03/29/2022|||STIMULANTS AND RELATED AGENTS|13851|||||No|No||SUN PHARMACEUTI|No||||
clozapine|No|No|No|No|75%|57664034588|CLOZAPINE 25 MG TABLET|100|EA|.36175|08/26/2003||Yes|No||08/26/2003||Yes|No|08/26/2003||Yes|No||||No|No|||Prescription required|No||027|Yes|.26318|03/29/2022|.25686|03/29/2022|.25857|03/29/2022|||ANTIPSYCHOTICS|13852|||||No|No||CARACO/SUN PHAR|No||||
clozapine|No|No|No|No|75%|57664034713|CLOZAPINE 100 MG TABLET|500|EA|.89442|08/26/2003||Yes|No||08/26/2003||Yes|No|08/26/2003||Yes|No||||No|No|||Prescription required|No||027|Yes|.60868|03/29/2022|.59407|03/29/2022|.59802|03/29/2022|||ANTIPSYCHOTICS|13853|||||No|No||CARACO/SUN PHAR|No||||
clozapine|No|No|No|No|75%|57664034788|CLOZAPINE 100 MG TABLET|100|EA|.93856|08/26/2003||Yes|No||08/26/2003||Yes|No|08/26/2003||Yes|No||||No|No|||Prescription required|No||027|Yes|.60868|03/29/2022|.59407|03/29/2022|.59802|03/29/2022|||ANTIPSYCHOTICS|13854|||||No|No||CARACO/SUN PHAR|No||||
dexmethylphenidate HCl|No|No|No|No|75%|57664037688|DEXMETHYLPHENIDATE 2.5 MG TAB|100|EA|.1075|12/29/2015||Yes|No||12/29/2015||Yes|No|12/29/2015||Yes|No||||No|No|||Prescription required|No||007|Yes|.13596|03/29/2022|.13269|03/29/2022|.13358|03/29/2022|||STIMULANTS AND RELATED AGENTS|13855|||||No|No||SUN PHARMACEUTI|No||||
tramadol HCl|No|No|No|No|90%|57664037708|TRAMADOL HCL 50 MG TABLET|100|EA|.02021|10/08/2003||Yes|No||10/08/2003||Yes|No|10/08/2003||Yes|No||||No|No|||Prescription required|No||109|Yes|.02459|03/29/2022|.02399|03/29/2022|.02415|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13856|||||No|No||CARACO/SUN PHAR|No||||
tramadol HCl|No|No|No|No|90%|57664037713|TRAMADOL HCL 50 MG TABLET|500|EA|.0197|10/08/2003||Yes|No||10/08/2003||Yes|No|10/08/2003||Yes|No||||No|No|||Prescription required|No||109|Yes|.02459|03/29/2022|.02399|03/29/2022|.02415|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13857|||||No|No||CARACO/SUN PHAR|No||||
tramadol HCl|No|No|No|No|90%|57664037718|TRAMADOL HCL 50 MG TABLET|1000|EA|.01935|10/08/2003||Yes|No||10/08/2003||Yes|No|10/08/2003||Yes|No||||No|No|||Prescription required|No||109|Yes|.02459|03/29/2022|.02399|03/29/2022|.02415|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13858|||||No|No||CARACO/SUN PHAR|No||||
dexmethylphenidate HCl|No|No|No|No|75%|57664037888|DEXMETHYLPHENIDATE 5 MG TAB|100|EA|.16125|12/29/2015||Yes|No||12/29/2015||Yes|No|12/29/2015||Yes|No||||No|No|||Prescription required|No||007|Yes|.16938|03/29/2022|.16531|03/29/2022|.16641|03/29/2022|||STIMULANTS AND RELATED AGENTS|13859|||||No|No||SUN PHARMACEUTI|No||||
dexmethylphenidate HCl|No|No|No|No|75%|57664037988|DEXMETHYLPHENIDATE 10 MG TAB|100|EA|.215|12/29/2015||Yes|No||12/29/2015||Yes|No|12/29/2015||Yes|No||||No|No|||Prescription required|No||007|Yes|.29016|03/29/2022|.28319|03/29/2022|.28508|03/29/2022|||STIMULANTS AND RELATED AGENTS|13860|||||No|No||SUN PHARMACEUTI|No||||
venlafaxine HCl|No|No|No|No|75%|57664039288|VENLAFAXINE HCL 25 MG TABLET|100|EA|.1376|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|No||031|No|.11374|03/29/2022|.11101|03/29/2022|.11174|03/29/2022|||ANTIDEPRESSANTS: OTHER|13861|||||No|No||CARACO/SUN PHAR|No||||
venlafaxine HCl|No|No|No|No|75%|57664039388|VENLAFAXINE HCL 37.5 MG TABLET|100|EA|.1419|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|No||031|Yes|.11453|03/29/2022|.11178|03/29/2022|.11252|03/29/2022|||ANTIDEPRESSANTS: OTHER|13862|||||No|No||CARACO/SUN PHAR|No||||
venlafaxine HCl|No|No|No|No|75%|57664039488|VENLAFAXINE HCL 50 MG TABLET|100|EA|.1462|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|No||031|No|.12769|03/29/2022|.12462|03/29/2022|.12545|03/29/2022|||ANTIDEPRESSANTS: OTHER|13863|||||No|No||CARACO/SUN PHAR|No||||
venlafaxine HCl|No|No|No|No|75%|57664039588|VENLAFAXINE HCL 75 MG TABLET|100|EA|.1548|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|No||031|No|.10828|03/29/2022|.10568|03/29/2022|.10638|03/29/2022|||ANTIDEPRESSANTS: OTHER|13864|||||No|No||CARACO/SUN PHAR|No||||
venlafaxine HCl|No|No|No|No|75%|57664039688|VENLAFAXINE HCL 100 MG TABLET|100|EA|.1634|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|No||031|No|.13788|03/29/2022|.13457|03/29/2022|.13546|03/29/2022|||ANTIDEPRESSANTS: OTHER|13865|||||No|No||CARACO/SUN PHAR|No||||
metformin HCl|Yes|No|No|No|75%|57664039751|METFORMIN HCL 500 MG TABLET|100|EA|.0215|02/18/2005||Yes|No||02/18/2005||Yes|No|02/18/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|13866|||||No|No||CARACO/SUN PHAR|No||||
metformin HCl|Yes|No|No|No|75%|57664039753|METFORMIN HCL 500 MG TABLET|500|EA|.02107|02/18/2005||Yes|No||02/18/2005||Yes|No|02/18/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|13867|||||No|No||CARACO/SUN PHAR|No||||
metformin HCl|Yes|No|No|No|75%|57664039758|METFORMIN HCL 500 MG TABLET|1000|EA|.02042|02/18/2005||Yes|No||02/18/2005||Yes|No|02/18/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|13868|||||No|No||CARACO/SUN PHAR|No||||
glipizide|Yes|No|No|No|75%|57664039813|GLIPIZIDE 5 MG TABLET|500|EA|.01935|07/20/2006||Yes|No||07/20/2006||Yes|No|07/20/2006||Yes|No||07/20/2006||Yes|No|07/01/2016||Prescription required|No|||No|.03474|03/29/2022|.0339|03/29/2022|.03413|03/29/2022||||13869|||||No|No||CARACO/SUN PHAR|No||||
glipizide|Yes|No|No|No|75%|57664039888|GLIPIZIDE 5 MG TABLET|100|EA|.01935|07/20/2006||Yes|No||07/20/2006||Yes|No|07/20/2006||Yes|No||07/20/2006||Yes|No|07/01/2016||Prescription required|No|||No|.03474|03/29/2022|.0339|03/29/2022|.03413|03/29/2022||||13870|||||No|No||CARACO/SUN PHAR|No||||
glipizide|Yes|No|No|No|75%|57664039913|GLIPIZIDE 10 MG TABLET|500|EA|.02795|07/20/2006||Yes|No||07/20/2006||Yes|No|07/20/2006||Yes|No||07/20/2006||Yes|No|07/01/2016||Prescription required|No|||No|.04827|03/29/2022|.04711|03/29/2022|.04742|03/29/2022||||13871|||||No|No||CARACO/SUN PHAR|No||||
glipizide|Yes|No|No|No|75%|57664039988|GLIPIZIDE 10 MG TABLET|100|EA|.02795|07/20/2006||Yes|No||07/20/2006||Yes|No|07/20/2006||Yes|No||07/20/2006||Yes|No|07/01/2016||Prescription required|No|||No|.04827|03/29/2022|.04711|03/29/2022|.04742|03/29/2022||||13872|||||No|No||CARACO/SUN PHAR|No||||
metformin HCl|Yes|No|No|No|75%|57664043551|METFORMIN HCL 850 MG TABLET|100|EA|.03182|02/18/2005||Yes|No||02/18/2005||Yes|No|02/18/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|13873|||||No|No||CARACO/SUN PHAR|No||||
metformin HCl|Yes|No|No|No|75%|57664043553|METFORMIN HCL 850 MG TABLET|500|EA|.03096|02/18/2005||Yes|No||02/18/2005||Yes|No|02/18/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|13874|||||No|No||CARACO/SUN PHAR|No||||
metformin HCl|Yes|No|No|No|75%|57664043558|METFORMIN HCL 850 MG TABLET|1000|EA|.0301|02/18/2005||Yes|No||02/18/2005||Yes|No|02/18/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|13875|||||No|No||CARACO/SUN PHAR|No||||
digoxin|No|No|No|No|75%|57664043718|DIGOXIN 0.125 MG TABLET|1000|EA|.25477|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||05/12/2015||Yes|No|||Prescription required|No|||No|.25031|03/29/2022|.2443|03/29/2022|.24592|03/29/2022||||13876|||||No|No||SUN PHARMACEUTI|No||||
digoxin|No|No|No|No|75%|57664043788|DIGOXIN 0.125 MG TABLET|100|EA|.25477|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||05/12/2015||Yes|No|||Prescription required|No|||No|.25031|03/29/2022|.2443|03/29/2022|.24592|03/29/2022||||13877|||||No|No||SUN PHARMACEUTI|No||||
digoxin|No|No|No|No|75%|57664044118|DIGOXIN 0.25 MG TABLET|1000|EA|.25477|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||05/12/2015||Yes|No|||Prescription required|No|||No|.22254|03/29/2022|.21719|03/29/2022|.21864|03/29/2022||||13878|||||No|No||SUN PHARMACEUTI|No||||
digoxin|No|No|No|No|75%|57664044188|DIGOXIN 0.25 MG TABLET|100|EA|.25477|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||05/12/2015||Yes|No|||Prescription required|No|||No|.22254|03/29/2022|.21719|03/29/2022|.21864|03/29/2022||||13879|||||No|No||SUN PHARMACEUTI|No||||
metformin HCl|Yes|No|No|No|75%|57664047451|METFORMIN HCL 1,000 MG TABLET|100|EA|.03612|02/18/2005||Yes|No||02/18/2005||Yes|No|02/18/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|13880|||||No|No||CARACO/SUN PHAR|No||||
metformin HCl|Yes|No|No|No|75%|57664047453|METFORMIN HCL 1,000 MG TABLET|500|EA|.03508|02/18/2005||Yes|No||02/18/2005||Yes|No|02/18/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|13881|||||No|No||CARACO/SUN PHAR|No||||
metformin HCl|Yes|No|No|No|75%|57664047458|METFORMIN HCL 1,000 MG TABLET|1000|EA|.03401|02/18/2005||Yes|No||02/18/2005||Yes|No|02/18/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|13882|||||No|No||CARACO/SUN PHAR|No||||
metoprolol tartrate|No|No|No|No|75%|57664047752|METOPROLOL TARTRATE 50 MG TAB|100|EA|.01431|06/19/2009||Yes|No||06/19/2009||Yes|No|06/19/2009||Yes|No||06/19/2009||Yes|No|||Prescription required|No||070|No|.02252|03/29/2022|.02197|03/29/2022|.02212|03/29/2022|||BETA-BLOCKERS|13883|||||No|No||CARACO/SUN PHAR|No||||
metoprolol tartrate|No|No|No|No|75%|57664047758|METOPROLOL TARTRATE 50 MG TAB|1000|EA|.0114|06/19/2009||Yes|No||06/19/2009||Yes|No|06/19/2009||Yes|No||06/19/2009||Yes|No|||Prescription required|No||070|No|.02252|03/29/2022|.02197|03/29/2022|.02212|03/29/2022|||BETA-BLOCKERS|13884|||||No|No||CARACO/SUN PHAR|No||||
mirtazapine|No|No|No|No|75%|57664049918|MIRTAZAPINE 15 MG TABLET|1000|EA|.12749|11/18/2020||Yes|No||11/18/2020||Yes|No|11/18/2020||Yes|No||||No|No|||Prescription required|No||031|Yes|.08357|03/29/2022|.08156|03/29/2022|.0821|03/29/2022|||ANTIDEPRESSANTS: OTHER|13885|||||No|No||SUN PHARMACEUTI|No||||
mirtazapine|No|No|No|No|75%|57664049983|MIRTAZAPINE 15 MG TABLET|30|EA|.12756|11/18/2020||Yes|No||11/18/2020||Yes|No|11/18/2020||Yes|No||||No|No|||Prescription required|No||031|Yes|.08357|03/29/2022|.08156|03/29/2022|.0821|03/29/2022|||ANTIDEPRESSANTS: OTHER|13886|||||No|No||SUN PHARMACEUTI|No||||
mirtazapine|No|No|No|No|75%|57664050083|MIRTAZAPINE 30 MG TABLET|30|EA|.16125|11/18/2020||Yes|No||11/18/2020||Yes|No|11/18/2020||Yes|No||||No|No|||Prescription required|No||031|No|.09806|03/29/2022|.0957|03/29/2022|.09634|03/29/2022|||ANTIDEPRESSANTS: OTHER|13887|||||No|No||SUN PHARMACEUTI|No||||
mirtazapine|No|No|No|No|75%|57664050183|MIRTAZAPINE 45 MG TABLET|30|EA|.18275|11/18/2020||Yes|No||11/18/2020||Yes|No|11/18/2020||Yes|No||||No|No|||Prescription required|No||031|No|.13324|03/29/2022|.13004|03/29/2022|.1309|03/29/2022|||ANTIDEPRESSANTS: OTHER|13888|||||No|No||SUN PHARMACEUTI|No||||
tizanidine HCl|No|No|No|No|75%|57664050218|TIZANIDINE HCL 2 MG TABLET|1000|EA|.04656|12/30/2003||Yes|No||12/30/2003||Yes|No|12/30/2003||Yes|No||||No|No|||Prescription required|No||116|No|.06018|03/29/2022|.05873|03/29/2022|.05912|03/29/2022|||SKELETAL MUSCLE RELAXANTS|13889|||||No|No||CARACO/SUN PHAR|No||||
tizanidine HCl|No|No|No|No|75%|57664050289|TIZANIDINE HCL 2 MG TABLET|150|EA|.04655|12/30/2003||Yes|No||12/30/2003||Yes|No|12/30/2003||Yes|No||||No|No|||Prescription required|No||116|No|.06018|03/29/2022|.05873|03/29/2022|.05912|03/29/2022|||SKELETAL MUSCLE RELAXANTS|13890|||||No|No||CARACO/SUN PHAR|No||||
tizanidine HCl|No|No|No|No|75%|57664050318|TIZANIDINE HCL 4 MG TABLET|1000|EA|.05681|12/30/2003||Yes|No||12/30/2003||Yes|No|12/30/2003||Yes|No||||No|No|||Prescription required|No||116|No|.05014|03/29/2022|.04893|03/29/2022|.04926|03/29/2022|||SKELETAL MUSCLE RELAXANTS|13891|||||No|No||CARACO/SUN PHAR|No||||
tizanidine HCl|No|No|No|No|75%|57664050389|TIZANIDINE HCL 4 MG TABLET|150|EA|.05681|12/30/2003||Yes|No||12/30/2003||Yes|No|12/30/2003||Yes|No||||No|No|||Prescription required|No||116|No|.05014|03/29/2022|.04893|03/29/2022|.04926|03/29/2022|||SKELETAL MUSCLE RELAXANTS|13892|||||No|No||CARACO/SUN PHAR|No||||
metoprolol tartrate|No|No|No|No|75%|57664050652|METOPROLOL TARTRATE 25 MG TAB|100|EA|.01431|06/19/2009||Yes|No||06/19/2009||Yes|No|06/19/2009||Yes|No||06/19/2009||Yes|No|||Prescription required|No||070|No|.01777|03/29/2022|.01734|03/29/2022|.01745|03/29/2022|||BETA-BLOCKERS|13893|||||No|No||CARACO/SUN PHAR|No||||
metoprolol tartrate|No|No|No|No|75%|57664050658|METOPROLOL TARTRATE 25 MG TAB|1000|EA|.0114|06/19/2009||Yes|No||06/19/2009||Yes|No|06/19/2009||Yes|No||06/19/2009||Yes|No|||Prescription required|No||070|No|.01777|03/29/2022|.01734|03/29/2022|.01745|03/29/2022|||BETA-BLOCKERS|13894|||||No|No||CARACO/SUN PHAR|No||||
citalopram hydrobromide|Yes|No|No|No|75%|57664050818|CITALOPRAM HBR 20 MG TABLET|1000|EA|.02343|07/02/2009||Yes|No||07/02/2009||Yes|No|07/02/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02946|03/29/2022|.02875|03/29/2022|.02894|03/29/2022|||ANTIDEPRESSANTS: SSRIs|13895|||||No|No||CARACO/SUN PHAR|No||||
citalopram hydrobromide|Yes|No|No|No|75%|57664050913|CITALOPRAM HBR 40 MG TABLET|500|EA|.0239|12/15/2004||Yes|No||12/15/2004||Yes|No|12/15/2004||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03726|03/29/2022|.03636|03/29/2022|.0366|03/29/2022|||ANTIDEPRESSANTS: SSRIs|13896|||||No|No||CARACO/SUN PHAR|No||||
citalopram hydrobromide|Yes|No|No|No|75%|57664050918|CITALOPRAM HBR 40 MG TABLET|1000|EA|.02386|07/02/2009||Yes|No||07/02/2009||Yes|No|07/02/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03726|03/29/2022|.03636|03/29/2022|.0366|03/29/2022|||ANTIDEPRESSANTS: SSRIs|13897|||||No|No||CARACO/SUN PHAR|No||||
citalopram hydrobromide|Yes|No|No|No|75%|57664050988|CITALOPRAM HBR 40 MG TABLET|100|EA|.02601|12/15/2004||Yes|No||12/15/2004||Yes|No|12/15/2004||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03726|03/29/2022|.03636|03/29/2022|.0366|03/29/2022|||ANTIDEPRESSANTS: SSRIs|13898|||||No|No||CARACO/SUN PHAR|No||||
tramadol HCl/acetaminophen|No|No|No|No|90%|57664053713|TRAMADOL-ACETAMINOPHN 37.5-325|500|EA|.1634|12/28/2005||Yes|No||12/28/2005||Yes|No|12/28/2005||Yes|No||||No|No|||Prescription required|No||109|Yes|.11806|03/29/2022|.11522|03/29/2022|.11599|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13899|||||No|No||CARACO/SUN PHAR|No||||
tramadol HCl/acetaminophen|No|No|No|No|90%|57664053718|TRAMADOL-ACETAMINOPHN 37.5-325|1000|EA|.1548|02/27/2006||Yes|No||02/27/2006||Yes|No|02/27/2006||Yes|No||||No|No|||Prescription required|No||109|Yes|.11806|03/29/2022|.11522|03/29/2022|.11599|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13900|Not Specified|Not Specified|Not Specified||No|No||CARACO/SUN PHAR|No||||
tramadol HCl/acetaminophen|No|No|No|No|90%|57664053788|TRAMADOL-ACETAMINOPHN 37.5-325|100|EA|.172|12/28/2005||Yes|No||12/28/2005||Yes|No|12/28/2005||Yes|No||||No|No|||Prescription required|No||109|Yes|.11806|03/29/2022|.11522|03/29/2022|.11599|03/29/2022|||ANALGESICS: NARCOTICS SHORT|13901|||||No|No||CARACO/SUN PHAR|No||||
methylphenidate HCl|No|No|No|No|75%|57664060688|METHYLPHENIDATE ER 18 MG TAB|100|EA|.62178|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|007|Yes|.56499|03/29/2022|.55143|03/29/2022|.5551|03/29/2022|||STIMULANTS AND RELATED AGENTS|13902|||||No|No||SUN PHARMACEUTI|No||||
methylphenidate HCl|No|No|No|No|75%|57664060788|METHYLPHENIDATE ER 27 MG TAB|100|EA|.64285|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|007|Yes|.90623|03/29/2022|.88448|03/29/2022|.89037|03/29/2022|||STIMULANTS AND RELATED AGENTS|13903|||||No|No||SUN PHARMACEUTI|No||||
methylphenidate HCl|No|No|No|No|75%|57664060888|METHYLPHENIDATE ER 36 MG TAB|100|EA|.66972|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|007|Yes|.76999|03/29/2022|.75151|03/29/2022|.75651|03/29/2022|||STIMULANTS AND RELATED AGENTS|13904|||||No|No||SUN PHARMACEUTI|No||||
methylphenidate HCl|No|No|No|No|75%|57664060988|METHYLPHENIDATE ER 54 MG TAB|100|EA|.74777|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|007|Yes|.87218|03/29/2022|.85124|03/29/2022|.85691|03/29/2022|||STIMULANTS AND RELATED AGENTS|13905|||||No|No||SUN PHARMACEUTI|No||||
chlorthalidone|No|No|No|No|75%|57664064888|CHLORTHALIDONE 25 MG TABLET|100|EA|.1038|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|No|||No|.16117|03/29/2022|.1573|03/29/2022|.15834|03/29/2022||||13906|||||No|No||SUN PHARMACEUTI|No||||
chlorthalidone|No|No|No|No|75%|57664064988|CHLORTHALIDONE 50 MG TABLET|100|EA|.12801|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|No|||No|.3607|03/29/2022|.35204|03/29/2022|.35438|03/29/2022||||13907|||||No|No||SUN PHARMACEUTI|No||||
pindolol|No|No|No|No|75%|57664065588|PINDOLOL 5 MG TABLET|100|EA|.37818|08/13/2014||Yes|No||08/13/2014||Yes|No|08/13/2014||Yes|No||08/13/2014||Yes|No|||Prescription required|Yes|07/24/2013|070|No|.74858|03/29/2022|.73061|03/29/2022|.73547|03/29/2022|||BETA-BLOCKERS|13908|||||No|No||CARACO/SUN PHAR|No||||
pindolol|No|No|No|No|75%|57664065688|PINDOLOL 10 MG TABLET|100|EA|.51535|03/31/2014||Yes|No||03/31/2014||Yes|No|03/31/2014||Yes|No||03/31/2014||Yes|No|||Prescription required|Yes|07/24/2013|070|No|1.17453|06/29/2021|1.15775|06/29/2021|1.10262|06/29/2021|||BETA-BLOCKERS|13909|||||No|No||CARACO/SUN PHAR|No||||
carvedilol phosphate|No|No|No|No|75%|57664066383|CARVEDILOL ER 10 MG CAPSULE|30|EA|3.55094|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||10/13/2020||Yes|No|||Prescription required|Yes|11/16/2017|070|Yes|6.70929|03/29/2022|6.54826|03/29/2022|6.59187|03/29/2022|||BETA-BLOCKERS|13910|||||No|No||SUN PHARMACEUTI|No||||
carvedilol phosphate|No|No|No|No|75%|57664066483|CARVEDILOL ER 20 MG CAPSULE|30|EA|3.55094|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||10/13/2020||Yes|No|||Prescription required|Yes|11/16/2017|070|Yes|6.10173|03/29/2022|5.95528|03/29/2022|5.99494|03/29/2022|||BETA-BLOCKERS|13911|||||No|No||SUN PHARMACEUTI|No||||
carvedilol phosphate|No|No|No|No|75%|57664066583|CARVEDILOL ER 40 MG CAPSULE|30|EA|3.55094|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||10/13/2020||Yes|No|||Prescription required|Yes|11/16/2017|070|Yes|5.77365|03/29/2022|5.63508|03/29/2022|5.67261|03/29/2022|||BETA-BLOCKERS|13912|||||No|No||SUN PHARMACEUTI|No||||
carvedilol phosphate|No|No|No|No|75%|57664066683|CARVEDILOL ER 80 MG CAPSULE|30|EA|3.55094|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||10/13/2020||Yes|No|||Prescription required|Yes|11/16/2017|070|No|6.50208|03/29/2022|6.34603|03/29/2022|6.38829|03/29/2022|||BETA-BLOCKERS|13913|||||No|No||SUN PHARMACEUTI|No||||
linezolid in dextrose 5%|No|No|No|No|75%|57664068357|LINEZOLID 600 MG/300 ML-D5W|300|ML|.08958|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||146|No|.20416|02/03/2021|.20124|02/03/2021|.19166|02/03/2021|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|13914|||||No|No||SUN PHARMACEUTI|No||||
miglitol|No|No|No|No|75%|57664068488|MIGLITOL 25 MG TABLET|100|EA|.74007|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|No|||No|1.68667|02/02/2021|1.66258|02/02/2021|1.58341|02/02/2021||||13915|||||No|No||SUN PHARMACEUTI|No||||
miglitol|No|No|No|No|75%|57664068588|MIGLITOL 50 MG TABLET|100|EA|.81377|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|No|||No|1.85465|02/02/2021|1.82815|02/02/2021|1.7411|02/02/2021||||13916|||||No|No||SUN PHARMACEUTI|No||||
miglitol|No|No|No|No|75%|57664068688|MIGLITOL 100 MG TABLET|100|EA|.96006|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|No|||No|2.18804|02/02/2021|2.15678|02/02/2021|2.05408|02/02/2021||||13917|||||No|No||SUN PHARMACEUTI|No||||
amitriptyline HCl|No|No|No|No|75%|57664068788|AMITRIPTYLINE HCL 10 MG TAB|100|EA|.06153|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||10/13/2020||Yes|No|||Prescription required|No||215|No|.04811|03/29/2022|.04695|03/29/2022|.04726|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|13918|||||No|No||SUN PHARMACEUTI|No||||
amitriptyline HCl|No|No|No|No|75%|57664068818|AMITRIPTYLINE HCL 25 MG TAB|1000|EA|.11671|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||10/13/2020||Yes|No|||Prescription required|No||215|No|.07343|03/29/2022|.07166|03/29/2022|.07214|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|13919|||||No|No||SUN PHARMACEUTI|No||||
amitriptyline HCl|No|No|No|No|75%|57664068988|AMITRIPTYLINE HCL 50 MG TAB|100|EA|.24574|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||10/13/2020||Yes|No|||Prescription required|No||215|No|.14797|03/29/2022|.14441|03/29/2022|.14538|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|13920|||||No|No||SUN PHARMACEUTI|No||||
amitriptyline HCl|No|No|No|No|75%|57664069088|AMITRIPTYLINE HCL 100 MG TAB|100|EA|.49149|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||10/13/2020||Yes|No|||Prescription required|No||215|No|.30607|03/29/2022|.29872|03/29/2022|.30071|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|13921|||||No|No||SUN PHARMACEUTI|No||||
amitriptyline HCl|No|No|No|No|75%|57664069188|AMITRIPTYLINE HCL 150 MG TAB|100|EA|.73723|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||10/13/2020||Yes|No|||Prescription required|No||215|No|.58201|03/29/2022|.56804|03/29/2022|.57182|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|13922|||||No|No||SUN PHARMACEUTI|No||||
amitriptyline HCl|No|No|No|No|75%|57664069288|AMITRIPTYLINE HCL 75 MG TAB|100|EA|.36919|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||10/13/2020||Yes|No|||Prescription required|No||215|No|.26194|03/29/2022|.25565|03/29/2022|.25735|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|13923|||||No|No||SUN PHARMACEUTI|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|57664077283|AMLODIPINE-OLMESARTAN 5-20 MG|30|EA|1.0406|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.41945|03/29/2022|.40938|03/29/2022|.4121|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13924|||||No|No||SUN PHARMACEUTI|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|57664077299|AMLODIPINE-OLMESARTAN 5-20 MG|90|EA|1.0406|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.41945|03/29/2022|.40938|03/29/2022|.4121|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13925|||||No|No||SUN PHARMACEUTI|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|57664077383|AMLODIPINE-OLMESARTAN 10-20 MG|30|EA|1.0406|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.43528|03/29/2022|.42483|03/29/2022|.42766|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13926|||||No|No||SUN PHARMACEUTI|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|57664077399|AMLODIPINE-OLMESARTAN 10-20 MG|90|EA|1.0406|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.43528|03/29/2022|.42483|03/29/2022|.42766|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13927|||||No|No||SUN PHARMACEUTI|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|57664077483|AMLODIPINE-OLMESARTAN 5-40 MG|30|EA|1.31436|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.47518|03/29/2022|.46377|03/29/2022|.46686|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13928|||||No|No||SUN PHARMACEUTI|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|57664077499|AMLODIPINE-OLMESARTAN 5-40 MG|90|EA|1.31436|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.47518|03/29/2022|.46377|03/29/2022|.46686|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13929|||||No|No||SUN PHARMACEUTI|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|57664077583|AMLODIPINE-OLMESARTAN 10-40 MG|30|EA|1.31436|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.41757|03/29/2022|.40754|03/29/2022|.41026|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13930|||||No|No||SUN PHARMACEUTI|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|57664077599|AMLODIPINE-OLMESARTAN 10-40 MG|90|EA|1.31436|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.41757|03/29/2022|.40754|03/29/2022|.41026|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13931|||||No|No||SUN PHARMACEUTI|No||||
clonazepam|No|No|No|No|75%|57664078386|CLONAZEPAM 0.125 MG ODT|60|EA|.40211|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||11/24/2020||Yes|No|||Prescription required|No||056|Yes|.69971|03/29/2022|.68291|03/29/2022|.68746|03/29/2022|||ANTICONVULSANTS|13932|||||No|No||SUN PHARMACEUTI|No||||
clonazepam|No|No|No|No|75%|57664078486|CLONAZEPAM 0.25 MG ODT|60|EA|.40211|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||11/24/2020||Yes|No|||Prescription required|No||056|Yes|.70247|03/29/2022|.68561|03/29/2022|.69017|03/29/2022|||ANTICONVULSANTS|13933|||||No|No||SUN PHARMACEUTI|No||||
clonazepam|No|No|No|No|75%|57664078586|CLONAZEPAM 0.5 MG ODT|60|EA|.40147|08/20/2020||Yes|No||08/20/2020||Yes|No|08/20/2020||Yes|No||08/20/2020||Yes|No|||Prescription required|No||056|Yes|.67976|03/29/2022|.66344|03/29/2022|.66786|03/29/2022|||ANTICONVULSANTS|13934|||||No|No||SUN PHARMACEUTI|No||||
clonazepam|No|No|No|No|75%|57664078686|CLONAZEPAM 1 MG ODT|60|EA|.45881|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||11/24/2020||Yes|No|||Prescription required|No||056|Yes|.76385|03/29/2022|.74551|03/29/2022|.75048|03/29/2022|||ANTICONVULSANTS|13935|||||No|No||SUN PHARMACEUTI|No||||
clonazepam|No|No|No|No|75%|57664078786|CLONAZEPAM 2 MG ODT|60|EA|.63568|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||11/24/2020||Yes|No|||Prescription required|No||056|Yes|1.00233|01/25/2022|.97827|01/25/2022|.98478|01/25/2022|||ANTICONVULSANTS|13936|||||No|No||SUN PHARMACEUTI|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|57664079683|OLMSRTN-AMLDPN-HCTZ 20-5-12.5|30|EA|1.5609|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.26872|03/29/2022|1.23827|03/29/2022|1.24651|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13937|||||No|No||SUN PHARMACEUTI|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|57664079699|OLMSRTN-AMLDPN-HCTZ 20-5-12.5|90|EA|1.5609|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.26872|03/29/2022|1.23827|03/29/2022|1.24651|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13938|||||No|No||SUN PHARMACEUTI|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|57664079783|OLMSRTN-AMLDPN-HCTZ 40-5-12.5|30|EA|1.97155|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.52605|03/29/2022|1.48942|03/29/2022|1.49934|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13939|||||No|No||SUN PHARMACEUTI|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|57664079799|OLMSRTN-AMLDPN-HCTZ 40-5-12.5|90|EA|1.97155|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.52605|03/29/2022|1.48942|03/29/2022|1.49934|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13940|||||No|No||SUN PHARMACEUTI|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|57664079883|OLMSRTN-AMLDPN-HCTZ 40-10-12.5|30|EA|1.97155|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.55605|03/29/2022|1.5187|03/29/2022|1.52881|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13941|||||No|No||SUN PHARMACEUTI|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|57664079899|OLMSRTN-AMLDPN-HCTZ 40-10-12.5|90|EA|1.97155|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.55605|03/29/2022|1.5187|03/29/2022|1.52881|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13942|||||No|No||SUN PHARMACEUTI|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|57664079983|OLMSRTN-AMLDPN-HCTZ 40-5-25 MG|30|EA|1.97155|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.32536|03/29/2022|1.29355|03/29/2022|1.30216|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13943|||||No|No||SUN PHARMACEUTI|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|57664079999|OLMSRTN-AMLDPN-HCTZ 40-5-25 MG|90|EA|1.97155|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.32536|03/29/2022|1.29355|03/29/2022|1.30216|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13944|||||No|No||SUN PHARMACEUTI|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|57664080083|OLMSRTN-AMLDPN-HCTZ 40-10-25MG|30|EA|1.97155|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.46963|03/29/2022|1.43435|03/29/2022|1.44391|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13945|||||No|No||SUN PHARMACEUTI|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|57664080099|OLMSRTN-AMLDPN-HCTZ 40-10-25MG|90|EA|1.97155|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|1.46963|03/29/2022|1.43435|03/29/2022|1.44391|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|13946|||||No|No||SUN PHARMACEUTI|No||||
phenytoin sodium extended|No|No|No|No|75%|57664080818|PHENYTOIN SOD EXT 100 MG CAP|1000|EA|.09791|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||02/03/2021||Yes|No|||Prescription required|No||056|No|.15598|03/29/2022|.15223|03/29/2022|.15325|03/29/2022|||ANTICONVULSANTS|13947|||||No|No||SUN PHARMACEUTI|No||||
minocycline HCl|No|No|No|No|75%|57664085188|MINOCYCLINE 50 MG CAPSULE|100|EA|.11395|01/14/2014||Yes|No||01/14/2014||Yes|No|01/14/2014||Yes|No||01/14/2014||Yes|No|||Prescription required|No||213|No|.20366|03/29/2022|.19877|03/29/2022|.20009|03/29/2022|||TETRACYCLINES|13948|||||No|No||CARACO/SUN PHAR|No||||
minocycline HCl|No|No|No|No|75%|57664085288|MINOCYCLINE 75 MG CAPSULE|100|EA|.27563|01/14/2014||Yes|No||01/14/2014||Yes|No|01/14/2014||Yes|No||01/14/2014||Yes|No|||Prescription required|No||213|No|.36632|10/26/2021|.35752|10/26/2021|.3599|10/26/2021|||TETRACYCLINES|13949|||||No|No||CARACO/SUN PHAR|No||||
minocycline HCl|No|No|No|No|75%|57664085385|MINOCYCLINE 100 MG CAPSULE|50|EA|.23951|01/14/2014||Yes|No||01/14/2014||Yes|No|01/14/2014||Yes|No||01/14/2014||Yes|No|||Prescription required|No||213|No|.38664|03/29/2022|.37736|03/29/2022|.37987|03/29/2022|||TETRACYCLINES|13950|||||No|No||CARACO/SUN PHAR|No||||
elapegademase-lvlr|No|No|No|No|75%|57665000201|REVCOVI 2.4 MG/1.5 ML VIAL|1.5|ML|3223.7358|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|||Prescription required|No|||Yes|7347.1188|01/11/2022|7242.15996|01/11/2022|6897.2952|01/11/2022||||13951|||||No|No||LEADIANT/CHIESI|No||||
amphotericin B lipid complex|No|No|No|No|75%|57665010141|ABELCET 100 MG/20 ML VIAL|20|ML|2.2575|12/17/2004||Yes|No||12/17/2004||Yes|No|12/17/2004||Yes|No||||No|No|||Prescription required|No|||No|5.145|01/04/2022|5.0715|01/04/2022|4.83|01/04/2022||||13952|||||No|No||LEADIANT BIOSCI|No||||
cromolyn sodium|No|No|No|No|75%|57782039726|CROMOLYN SODIUM NASAL SPRAY|26|ML|.1156|07/20/2001||Yes|No||||No|No|07/20/2001||Yes|No||||No|No|||Over the counter|No|||No|.26346|11/24/2020|.25969|11/24/2020|.24733|11/24/2020||||13953|||||No|No||BAUSCH HEALTH U|No||||
omeprazole/amoxicill/rifabutin|No|No|No|No|75%|57841115002|TALICIA DR 10-250-12.5 MG CAP|168|EA|1.81408|06/12/2020||Yes|No||06/12/2020||Yes|No|06/12/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|001|No|4.04267|01/04/2022|3.94564|01/04/2022|3.97192|01/04/2022|||H. PYLORI TREATMENT|13954|||||No|No||REDHILL BIOPHAR|No||||
naloxegol oxalate|No|No|No|No|75%|57841130001|MOVANTIK 12.5 MG TABLET|30|EA|5.5083|11/13/2020||Yes|No||11/13/2020||Yes|No|11/13/2020||Yes|No||||No|No|||Prescription required|No||534|Yes|12.25733|01/04/2022|11.96315|01/04/2022|12.04282|01/04/2022|||GI MOTILITY: CHRONIC|13955|||||No|No||REDHILL BIOPHAR|No||||
naloxegol oxalate|No|No|No|No|75%|57841130101|MOVANTIK 25 MG TABLET|30|EA|5.5083|11/13/2020||Yes|No||11/13/2020||Yes|No|11/13/2020||Yes|No||||No|No|||Prescription required|No||534|Yes|12.30336|01/04/2022|12.00807|01/04/2022|12.08805|01/04/2022|||GI MOTILITY: CHRONIC|13956|||||No|No||REDHILL BIOPHAR|No||||
naloxegol oxalate|No|No|No|No|75%|57841130103|MOVANTIK 25 MG TABLET|100|EA|5.5083|11/13/2020||Yes|No||11/13/2020||Yes|No|11/13/2020||Yes|No||||No|No|||Prescription required|No||534|Yes|12.30336|01/04/2022|12.00807|01/04/2022|12.08805|01/04/2022|||GI MOTILITY: CHRONIC|13957|||||No|No||REDHILL BIOPHAR|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|57844010501|ADDERALL 5 MG TABLET|100|EA|3.8528|02/18/2015||Yes|No||02/18/2015||Yes|No|02/18/2015||Yes|No||||No|No|||Prescription required|No||007|Yes|8.7808|01/11/2022|8.65536|01/11/2022|8.2432|01/11/2022|||STIMULANTS AND RELATED AGENTS|13958|||||No|No||TEVA USA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|57844011001|ADDERALL 10 MG TABLET|100|EA|3.8528|03/06/2014||Yes|No||03/06/2014||Yes|No|03/06/2014||Yes|No||||No|No|||Prescription required|No||007|Yes|8.50174|01/18/2022|8.29769|01/18/2022|8.35295|01/18/2022|||STIMULANTS AND RELATED AGENTS|13959|||||No|No||TEVA USA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|57844011201|ADDERALL 12.5 MG TABLET|100|EA|3.8528|10/28/2014||Yes|No||10/28/2014||Yes|No|10/28/2014||Yes|No||||No|No|||Prescription required|No||007|Yes|8.7808|01/11/2022|8.65536|01/11/2022|8.2432|01/11/2022|||STIMULANTS AND RELATED AGENTS|13960|||||No|No||TEVA USA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|57844011501|ADDERALL 15 MG TABLET|100|EA|3.8528|10/28/2014||Yes|No||10/28/2014||Yes|No|10/28/2014||Yes|No||||No|No|||Prescription required|No||007|Yes|8.7808|01/11/2022|8.65536|01/11/2022|8.2432|01/11/2022|||STIMULANTS AND RELATED AGENTS|13961|||||No|No||TEVA USA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|57844011701|ADDERALL 7.5 MG TABLET|100|EA|3.8528|05/26/2015||Yes|No||05/26/2015||Yes|No|05/26/2015||Yes|No||||No|No|||Prescription required|No||007|Yes|8.7808|01/11/2022|8.65536|01/11/2022|8.2432|01/11/2022|||STIMULANTS AND RELATED AGENTS|13962|||||No|No||TEVA USA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|57844012001|ADDERALL 20 MG TABLET|100|EA|3.8528|03/06/2014||Yes|No||03/06/2014||Yes|No|03/06/2014||Yes|No||||No|No|||Prescription required|No||007|Yes|8.61849|01/18/2022|8.41164|01/18/2022|8.46766|01/18/2022|||STIMULANTS AND RELATED AGENTS|13963|||||No|No||TEVA USA|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|57844013001|ADDERALL 30 MG TABLET|100|EA|3.8528|03/06/2014||Yes|No||03/06/2014||Yes|No|03/06/2014||Yes|No||||No|No|||Prescription required|No||007|Yes|8.56081|01/18/2022|8.35535|01/18/2022|8.41099|01/18/2022|||STIMULANTS AND RELATED AGENTS|13964|||||No|No||TEVA USA|No||||
zinc acetate|No|No|No|No|75%|57844020852|GALZIN 50 MG CAPSULE|250|EA|1.35897|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|3.09719|01/11/2022|3.05294|01/11/2022|2.90756|01/11/2022||||13965|||||No|No||TEVA SELECT BRA|No||||
zinc acetate|No|No|No|No|75%|57844021552|GALZIN 25 MG CAPSULE|250|EA|.81545|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|1.85847|01/11/2022|1.83192|01/11/2022|1.74468|01/11/2022||||13966|||||No|No||TEVA SELECT BRA|No||||
ustekinumab|No|No|No|No|75%|57894006002|STELARA 45 MG/0.5 ML VIAL|.5|ML|10963.7616|08/22/2012||Yes|No||08/22/2012||Yes|No|08/22/2012||Yes|No||||No|No|||Prescription required|Yes|07/28/2010|071|Yes|24987.1776|01/25/2022|24630.21792|01/25/2022|23457.3504|01/25/2022|||CYTOKINE AND CAM ANTAGONISTS|13967|||||No|No||JANSSEN BIOTECH|No||||
ustekinumab|No|No|No|No|75%|57894006003|STELARA 45 MG/0.5 ML SYRINGE|.5|ML|10963.7616|06/29/2010||Yes|No||06/29/2010||Yes|No|06/29/2010||Yes|No||||No|No|||Prescription required|Yes|07/28/2010|071|Yes|24987.1776|01/25/2022|24630.21792|01/25/2022|23457.3504|01/25/2022|||CYTOKINE AND CAM ANTAGONISTS|13968|||||No|No||JANSSEN BIOTECH|No||||
ustekinumab|No|No|No|No|75%|57894006103|STELARA 90 MG/ML SYRINGE|1|ML|10963.7616|06/29/2010||Yes|No||06/29/2010||Yes|No|06/29/2010||Yes|No||||No|No|||Prescription required|Yes|07/28/2010|071|Yes|24619.96404|02/01/2022|24029.0849|02/01/2022|24189.11466|02/01/2022|||CYTOKINE AND CAM ANTAGONISTS|13969|||||No|No||JANSSEN BIOTECH|No||||
golimumab|No|No|No|No|75%|57894007001|SIMPONI 50 MG/0.5 ML SYRINGE|.5|ML|4792.0232|03/26/2010||Yes|No||03/26/2010||Yes|No|03/26/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|071|Yes|10921.3552|01/25/2022|10765.33584|01/25/2022|10252.7008|01/25/2022|||CYTOKINE AND CAM ANTAGONISTS|13970|||||No|No||JANSSEN BIOTECH|No||||
golimumab|No|No|No|No|75%|57894007002|SIMPONI 50 MG/0.5 ML PEN INJEC|.5|ML|4792.0232|03/26/2010||Yes|No||03/26/2010||Yes|No|03/26/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|071|Yes|10843.33197|02/01/2022|10583.092|02/01/2022|10653.57366|02/01/2022|||CYTOKINE AND CAM ANTAGONISTS|13971|||||No|No||JANSSEN BIOTECH|No||||
golimumab|No|No|No|No|75%|57894007101|SIMPONI 100 MG/ML SYRINGE|1|ML|2755.4185|06/21/2013||Yes|No||06/21/2013||Yes|No|06/21/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|071|Yes|6279.791|01/25/2022|6190.0797|01/25/2022|5895.314|01/25/2022|||CYTOKINE AND CAM ANTAGONISTS|13972|||||No|No||JANSSEN BIOTECH|No||||
golimumab|No|No|No|No|75%|57894007102|SIMPONI 100 MG/ML PEN INJECTOR|1|ML|2755.4185|09/03/2013||Yes|No||09/03/2013||Yes|No|09/03/2013||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|071|Yes|6279.791|01/25/2022|6190.0797|01/25/2022|5895.314|01/25/2022|||CYTOKINE AND CAM ANTAGONISTS|13973|||||No|No||JANSSEN BIOTECH|No||||
abiraterone acetate|No|No|No|No|75%|57894015012|ZYTIGA 250 MG TABLET|120|EA|39.01181|05/12/2011||Yes|No||05/12/2011||Yes|No|05/12/2011||Yes|No||||No|No|||Prescription required|No||550|No|88.91065|01/28/2020|87.6405|01/28/2020|83.46714|01/28/2020|||ONCOLOGY: ORAL - PROSTATE|13974|||||No|No||JANSSEN BIOTECH|No||||
abiraterone acetate|No|No|No|No|75%|57894019506|ZYTIGA 500 MG TABLET|60|EA|78.02364|07/17/2017||Yes|No||07/17/2017||Yes|No|07/17/2017||Yes|No||||No|No|||Prescription required|No||550|No|177.82132|01/15/2019|175.28101|01/15/2019|166.9343|01/15/2019|||ONCOLOGY: ORAL - PROSTATE|13975|||||No|No||JANSSEN PHARM.|No||||
golimumab|No|No|No|No|75%|57894035001|SIMPONI ARIA 50 MG/4 ML VIAL|4|ML|214.91292|09/03/2013||Yes|No||09/03/2013||Yes|No|09/03/2013||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|071|Yes|489.80155|01/26/2021|482.80438|01/26/2021|459.8137|01/26/2021|||CYTOKINE AND CAM ANTAGONISTS|13976|||||No|No||JANSSEN BIOTECH|No||||
guselkumab|No|No|No|No|75%|57894064001|TREMFYA 100 MG/ML SYRINGE|1|ML|5410.7072|09/19/2018||Yes|No||09/19/2018||Yes|No|09/19/2018||Yes|No||||No|No|||Prescription required|Yes|07/17/2017|071|Yes|12331.3792|01/25/2022|12155.21664|01/25/2022|11576.3968|01/25/2022|||CYTOKINE AND CAM ANTAGONISTS|13977|||||No|No||JANSSEN BIOTECH|No||||
guselkumab|No|No|No|No|75%|57894064011|TREMFYA 100 MG/ML INJECTOR|1|ML|5410.7072|07/24/2019||Yes|No||07/24/2019||Yes|No|07/24/2019||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|071|Yes|12331.3792|01/25/2022|12155.21664|01/25/2022|11576.3968|01/25/2022|||CYTOKINE AND CAM ANTAGONISTS|13978|||||No|No||JANSSEN BIOTECH|No||||
ibrutinib|No|No|No|No|75%|57962001428|IMBRUVICA 140 MG TABLET|28|EA|229.68265|04/02/2018||Yes|No||04/02/2018||Yes|No|04/02/2018||Yes|No||||No|No|||Prescription required|No||173|No|523.46279|01/18/2022|515.98475|01/18/2022|491.41405|01/18/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|13979|||||No|No||PHARMACYCLICS,|No||||
ibrutinib|No|No|No|No|75%|57962007028|IMBRUVICA 70 MG CAPSULE|28|EA|229.68265|04/02/2018||Yes|No||04/02/2018||Yes|No|04/02/2018||Yes|No||||No|No|||Prescription required|No||173|No|523.46279|01/18/2022|515.98475|01/18/2022|491.41405|01/18/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|13980|||||No|No||PHARMACYCLICS,|No||||
ibrutinib|No|No|No|No|75%|57962014009|IMBRUVICA 140 MG CAPSULE|90|EA|76.56087|03/31/2014||Yes|No||03/31/2014||Yes|No|03/31/2014||Yes|No||||No|No|||Prescription required|No||173|No|174.48757|01/18/2022|171.99489|01/18/2022|163.80466|01/18/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|13981|||||No|No||PHARMACYCLICS,|No||||
ibrutinib|No|No|No|No|75%|57962014012|IMBRUVICA 140 MG CAPSULE|120|EA|76.56085|03/31/2014||Yes|No||03/31/2014||Yes|No|03/31/2014||Yes|No||||No|No|||Prescription required|No||173|No|174.48753|01/18/2022|171.99485|01/18/2022|163.80462|01/18/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|13982|||||No|No||PHARMACYCLICS,|No||||
ibrutinib|No|No|No|No|75%|57962028028|IMBRUVICA 280 MG TABLET|28|EA|229.68265|04/02/2018||Yes|No||04/02/2018||Yes|No|04/02/2018||Yes|No||||No|No|||Prescription required|No||173|No|523.46279|01/18/2022|515.98475|01/18/2022|491.41405|01/18/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|13983|||||No|No||PHARMACYCLICS,|No||||
ibrutinib|No|No|No|No|75%|57962042028|IMBRUVICA 420 MG TABLET|28|EA|229.68265|04/02/2018||Yes|No||04/02/2018||Yes|No|04/02/2018||Yes|No||||No|No|||Prescription required|No||173|No|523.46279|01/18/2022|515.98475|01/18/2022|491.41405|01/18/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|13984|||||No|No||PHARMACYCLICS,|No||||
ibrutinib|No|No|No|No|75%|57962056028|IMBRUVICA 560 MG TABLET|28|EA|229.68265|04/02/2018||Yes|No||04/02/2018||Yes|No|04/02/2018||Yes|No||||No|No|||Prescription required|No||173|No|523.46279|01/18/2022|515.98475|01/18/2022|491.41405|01/18/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|13985|||||No|No||PHARMACYCLICS,|No||||
dalbavancin HCl|No|No|No|No|75%|57970010001|DALVANCE 500 MG VIAL|1|EA|721.11|08/28/2019||Yes|No||08/28/2019||Yes|No|08/28/2019||Yes|No||||No|No|||Prescription required|No|||No|1643.46|02/01/2022|1619.982|02/01/2022|1542.84|02/01/2022||||13986|||||No|No||DURATA/ALLERGAN|No||||
antihemoph.FVIII,B-domain del|No|No|No|No|75%|58394001201|XYNTHA 250 UNIT KIT|1|EA|1.0812|07/09/2009||Yes|No||07/09/2009||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.5582|01/12/2021|1.53594|01/12/2021|1.4628|01/12/2021|||HEMOPHILIA TREATMENT|13987|||||No|No||WYETH/PFIZER|No||||
antihemoph.FVIII,B-domain del|No|No|No|No|75%|58394001301|XYNTHA 500 UNIT KIT|1|EA|1.0812|09/11/2008||Yes|No||09/11/2008||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.5582|01/12/2021|1.53594|01/12/2021|1.4628|01/12/2021|||HEMOPHILIA TREATMENT|13988|||||No|No||WYETH/PFIZER|No||||
antihemoph.FVIII,B-domain del|No|No|No|No|75%|58394001401|XYNTHA 1,000 UNIT KIT|1|EA|1.0812|09/11/2008||Yes|No||09/11/2008||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.5582|01/12/2021|1.53594|01/12/2021|1.4628|01/12/2021|||HEMOPHILIA TREATMENT|13989|||||No|No||WYETH/PFIZER|No||||
antihemoph.FVIII,B-domain del|No|No|No|No|75%|58394001501|XYNTHA 2,000 UNIT KIT|1|EA|1.0812|09/11/2008||Yes|No||09/11/2008||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.5582|01/12/2021|1.53594|01/12/2021|1.4628|01/12/2021|||HEMOPHILIA TREATMENT|13990|||||No|No||WYETH/PFIZER|No||||
antihemoph.FVIII,B-domain del|No|No|No|No|75%|58394001603|XYNTHA SOLOFUSE 3,000 UNIT KIT|1|EA|1.0812|11/17/2010||Yes|No||11/17/2010||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.5582|01/12/2021|1.53594|01/12/2021|1.4628|01/12/2021|||HEMOPHILIA TREATMENT|13991|||||No|No||WYETH/PFIZER|No||||
antihemoph.FVIII,B-domain del|No|No|No|No|75%|58394002203|XYNTHA SOLOFUSE 250 UNIT KIT|1|EA|1.0812|02/09/2012||Yes|No||02/09/2012||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.5582|01/12/2021|1.53594|01/12/2021|1.4628|01/12/2021|||HEMOPHILIA TREATMENT|13992|||||No|No||WYETH/PFIZER|No||||
antihemoph.FVIII,B-domain del|No|No|No|No|75%|58394002303|XYNTHA SOLOFUSE 500 UNIT KIT|1|EA|1.0812|02/09/2012||Yes|No||02/09/2012||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.5582|01/12/2021|1.53594|01/12/2021|1.4628|01/12/2021|||HEMOPHILIA TREATMENT|13993|||||No|No||WYETH/PFIZER|No||||
antihemoph.FVIII,B-domain del|No|No|No|No|75%|58394002403|XYNTHA SOLOFUSE 1,000 UNIT KIT|1|EA|1.0812|10/18/2011||Yes|No||10/18/2011||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.5582|01/12/2021|1.53594|01/12/2021|1.4628|01/12/2021|||HEMOPHILIA TREATMENT|13994|||||No|No||WYETH/PFIZER|No||||
antihemoph.FVIII,B-domain del|No|No|No|No|75%|58394002503|XYNTHA SOLOFUSE 2,000 UNIT KIT|1|EA|1.0812|10/18/2011||Yes|No||10/18/2011||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.5582|01/12/2021|1.53594|01/12/2021|1.4628|01/12/2021|||HEMOPHILIA TREATMENT|13995|||||No|No||WYETH/PFIZER|No||||
factor IX human recombinant|No|No|No|No|75%|58394063303|BENEFIX 250 UNIT RANGE|1|EA|1.0132|08/23/2011||Yes|No||08/23/2011||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.4602|01/04/2022|1.43934|01/04/2022|1.3708|01/04/2022|||HEMOPHILIA TREATMENT|13996|||||No|No||WYETH/PFIZER|No||||
factor IX human recombinant|No|No|No|No|75%|58394063403|BENEFIX 500 UNIT RANGE|1|EA|1.0132|08/23/2011||Yes|No||08/23/2011||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.4602|01/04/2022|1.43934|01/04/2022|1.3708|01/04/2022|||HEMOPHILIA TREATMENT|13997|||||No|No||WYETH/PFIZER|No||||
factor IX human recombinant|No|No|No|No|75%|58394063503|BENEFIX 1,000 UNIT RANGE|1|EA|1.0132|08/23/2011||Yes|No||08/23/2011||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.4602|01/04/2022|1.43934|01/04/2022|1.3708|01/04/2022|||HEMOPHILIA TREATMENT|13998|||||No|No||WYETH/PFIZER|No||||
factor IX human recombinant|No|No|No|No|75%|58394063603|BENEFIX 2,000 UNIT RANGE|1|EA|1.0132|08/23/2011||Yes|No||08/23/2011||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.4602|01/04/2022|1.43934|01/04/2022|1.3708|01/04/2022|||HEMOPHILIA TREATMENT|13999|||||No|No||WYETH/PFIZER|No||||
factor IX human recombinant|No|No|No|No|75%|58394063703|BENEFIX 3,000 UNIT RANGE|1|EA|1.0132|02/29/2012||Yes|No||02/29/2012||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.4602|01/04/2022|1.43934|01/04/2022|1.3708|01/04/2022|||HEMOPHILIA TREATMENT|14000|||||No|No||WYETH/PFIZER|No||||
etanercept|No|No|No|No|75%|58406001004|ENBREL 25 MG/0.5 ML SYRINGE|.5|ML|689.0535|09/18/2019||Yes|No||09/18/2019||Yes|No|09/18/2019||Yes|No||||No|No|||Prescription required|No||071|Yes|1559.98715|02/08/2022|1522.54745|02/08/2022|1532.68737|02/08/2022|||CYTOKINE AND CAM ANTAGONISTS|14001|||||No|No||AMGEN|No||||
etanercept|No|No|No|No|75%|58406002104|ENBREL 50 MG/ML SYRINGE|1|ML|689.0535|09/18/2019||Yes|No||09/18/2019||Yes|No|09/18/2019||Yes|No||||No|No|||Prescription required|No||071|Yes|1559.47178|02/08/2022|1522.04445|02/08/2022|1532.18102|02/08/2022|||CYTOKINE AND CAM ANTAGONISTS|14002|||||No|No||AMGEN|No||||
etanercept|No|No|No|No|75%|58406003204|ENBREL 50 MG/ML SURECLICK|1|ML|689.0535|08/23/2019||Yes|No||08/23/2019||Yes|No|08/23/2019||Yes|No||||No|No|||Prescription required|No||071|Yes|1562.13752|02/08/2022|1524.64621|02/08/2022|1534.80011|02/08/2022|||CYTOKINE AND CAM ANTAGONISTS|14003|||||No|No||AMGEN|No||||
etanercept|No|No|No|No|75%|58406004401|ENBREL 50 MG/ML MINI CARTRIDGE|1|ML|689.0535|01/06/2020||Yes|No||01/06/2020||Yes|No|01/06/2020||Yes|No||||No|No|||Prescription required|No||071|Yes|1570.401|02/01/2022|1547.9667|02/01/2022|1474.254|02/01/2022|||CYTOKINE AND CAM ANTAGONISTS|14004|||||No|No||AMGEN|No||||
etanercept|No|No|No|No|75%|58406004404|ENBREL 50 MG/ML MINI CARTRIDGE|1|ML|689.0535|01/06/2020||Yes|No||01/06/2020||Yes|No|01/06/2020||Yes|No||||No|No|||Prescription required|No||071|Yes|1559.506|02/08/2022|1522.07785|02/08/2022|1532.21464|02/08/2022|||CYTOKINE AND CAM ANTAGONISTS|14005|||||No|No||AMGEN|No||||
etanercept|No|No|No|No|75%|58406005501|ENBREL 25 MG/0.5 ML VIAL|.5|ML|689.0578|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|No||071|No|1570.4108|02/01/2022|1547.97636|02/01/2022|1474.2632|02/01/2022|||CYTOKINE AND CAM ANTAGONISTS|14006|||||No|No||AMGEN|No||||
etanercept|No|No|No|No|75%|58406005504|ENBREL 25 MG/0.5 ML VIAL|.5|ML|689.0535|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|No||071|No|1570.401|02/01/2022|1547.9667|02/01/2022|1474.254|02/01/2022|||CYTOKINE AND CAM ANTAGONISTS|14007|||||No|No||AMGEN|No||||
etanercept|No|No|No|No|75%|58406042534|ENBREL 25 MG KIT|4|EA|344.52675|10/13/2009|05/31/2023|Yes|No||10/13/2009|05/31/2023|Yes|No|10/13/2009|05/31/2023|Yes|No||||No|No|||Prescription required|No||071|Yes|785.2005|02/01/2022|773.98335|02/01/2022|737.127|02/01/2022|||CYTOKINE AND CAM ANTAGONISTS|14008|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMGEN|No||||
etanercept|No|No|No|No|75%|58406043501|ENBREL 50 MG/ML SYRINGE|.98|ML|703.11581|04/08/2010|03/01/2022|Yes|No||04/08/2010|03/01/2022|Yes|No|04/08/2010|03/01/2022|Yes|No||||No|No|||Prescription required|No||071|Yes|1602.44999|02/01/2022|1579.55785|02/01/2022|1504.34081|02/01/2022|||CYTOKINE AND CAM ANTAGONISTS|14009|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMGEN|No||||
etanercept|No|No|No|No|75%|58406043504|ENBREL 50 MG/ML SYRINGE|.98|ML|703.11581|04/08/2010|03/01/2022|Yes|No||04/08/2010|03/01/2022|Yes|No|04/08/2010|03/01/2022|Yes|No||||No|No|||Prescription required|No||071|Yes|1602.44999|02/01/2022|1579.55785|02/01/2022|1504.34081|02/01/2022|||CYTOKINE AND CAM ANTAGONISTS|14010|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMGEN|No||||
etanercept|No|No|No|No|75%|58406044504|ENBREL 50 MG/ML SURECLICK|.98|ML|703.11581|11/03/2010|04/01/2022|Yes|No||11/03/2010|04/01/2022|Yes|No|11/03/2010|04/01/2022|Yes|No||||No|No|||Prescription required|No||071|Yes|1602.44999|02/01/2022|1579.55785|02/01/2022|1504.34081|02/01/2022|||CYTOKINE AND CAM ANTAGONISTS|14011|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMGEN|No||||
chlorcyclizine/pseudoephedrine|No|No|No|No|75%|58407062530|STAHIST AD TABLET|30|EA|.24295|02/25/2013||Yes|No||||No|No|02/25/2013||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|.5537|12/21/2021|.54579|12/21/2021|.5198|12/21/2021|||COUGH AND COLD: COLD|14012|||||No|No||MAGNA PHARM|No||||
sevelamer HCl|No|No|No|No|75%|58468002101|RENAGEL 800 MG TABLET|180|EA|3.19791|02/01/2004||Yes|No||02/01/2004||Yes|No|02/01/2004||Yes|No||||No|No|||Prescription required|No||052|Yes|7.28826|03/01/2022|7.18414|03/01/2022|6.84204|03/01/2022|||PHOSPHATE BINDERS|14013|||||No|No||GENZYME|No||||
agalsidase beta|No|No|No|No|75%|58468004001|FABRAZYME 35 MG VIAL|1|EA|2963.9685|03/15/2005||Yes|No||03/15/2005||Yes|No|||No|No||||No|No|||Prescription required|No|||Yes|6755.091|01/25/2022|6658.5897|01/25/2022|6341.514|01/25/2022||||14014|||||No|No||GENZYME|No||||
agalsidase beta|No|No|No|No|75%|58468004101|FABRAZYME 5 MG VIAL|1|EA|423.3522|08/23/2007||Yes|No||08/23/2007||Yes|No|||No|No||||No|No|||Prescription required|No|||Yes|964.8492|01/25/2022|951.06564|01/25/2022|905.7768|01/25/2022||||14015|||||No|No||GENZYME|No||||
laronidase|No|No|No|No|75%|58468007001|ALDURAZYME 2.9 MG/5 ML VIAL|5|ML|85.12194|03/15/2005||Yes|No||03/15/2005||Yes|No|||No|No||||No|No|||Prescription required|No|||Yes|193.99884|01/25/2022|191.22742|01/25/2022|182.12136|01/25/2022||||14016|||||No|No||GENZYME|No||||
sevelamer carbonate|No|No|No|No|75%|58468013001|RENVELA 800 MG TABLET|270|EA|2.55819|04/14/2008||Yes|No||04/14/2008||Yes|No|04/14/2008||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|052|Yes|5.71544|08/24/2021|5.57826|08/24/2021|5.61541|08/24/2021|||PHOSPHATE BINDERS|14017|||||No|No||GENZYME|No||||
sevelamer carbonate|No|No|No|No|75%|58468013102|RENVELA 2.4 GM POWDER PACKET|90|EA|7.67458|02/01/2010||Yes|No||02/01/2010||Yes|No|02/01/2010||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|052|Yes|17.49092|01/14/2020|17.24105|01/14/2020|16.42004|01/14/2020|||PHOSPHATE BINDERS|14018|||||No|No||GENZYME|No||||
alglucosidase alfa|No|No|No|No|75%|58468016001|LUMIZYME 50 MG VIAL|1|EA|383.4525|10/08/2010||Yes|No||10/08/2010||Yes|No|10/08/2010||Yes|No||||No|No|||Prescription required|No|||Yes|873.915|01/25/2022|861.4305|01/25/2022|820.41|01/25/2022||||14019|||||No|No||GENZYME|No||||
alglucosidase alfa|No|No|No|No|75%|58468016002|LUMIZYME 50 MG VIAL|1|EA|361.4752|01/21/2015|04/06/2022|Yes|No||01/21/2015|04/06/2022|Yes|No|01/21/2015|04/06/2022|Yes|No||||No|No|||Prescription required|No|||Yes|823.8272|01/19/2021|812.05824|01/19/2021|773.3888|01/19/2021||||14020|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GENZYME|No||||
teriflunomide|No|No|No|No|75%|58468021002|AUBAGIO 14 MG TABLET|28|EA|122.09972|05/03/2013||Yes|No||05/03/2013||Yes|No|05/03/2013||Yes|No||||No|No|||Prescription required|No||043|No|278.27379|01/11/2022|274.29845|01/11/2022|261.23662|01/11/2022|||MULTIPLE SCLEROSIS AGENTS|14021|||||No|No||SANOFI-AVENTIS|No||||
teriflunomide|No|No|No|No|75%|58468021004|AUBAGIO 14 MG TABLET|30|EA|122.09993|09/03/2019||Yes|No||09/03/2019||Yes|No|09/03/2019||Yes|No||||No|No|||Prescription required|No||043|No|278.27426|01/11/2022|274.29891|01/11/2022|261.23706|01/11/2022|||MULTIPLE SCLEROSIS AGENTS|14022|||||No|No||SANOFI-AVENTIS|No||||
teriflunomide|No|No|No|No|75%|58468021101|AUBAGIO 7 MG TABLET|28|EA|122.09972|05/03/2013||Yes|No||05/03/2013||Yes|No|05/03/2013||Yes|No||||No|No|||Prescription required|No||043|No|278.27379|01/11/2022|274.29845|01/11/2022|261.23662|01/11/2022|||MULTIPLE SCLEROSIS AGENTS|14023|||||No|No||SANOFI-AVENTIS|No||||
teriflunomide|No|No|No|No|75%|58468021104|AUBAGIO 7 MG TABLET|30|EA|122.09993|09/03/2019||Yes|No||09/03/2019||Yes|No|09/03/2019||Yes|No||||No|No|||Prescription required|No||043|No|278.27426|01/11/2022|274.29891|01/11/2022|261.23706|01/11/2022|||MULTIPLE SCLEROSIS AGENTS|14024|||||No|No||SANOFI-AVENTIS|No||||
eliglustat tartrate|No|No|No|No|75%|58468022001|CERDELGA 84 MG CAPSULE|56|EA|226.19121|11/03/2014||Yes|No||11/03/2014||Yes|No|11/03/2014||Yes|No||||No|No|||Prescription required|No|||No|515.50554|01/25/2022|508.14118|01/25/2022|483.94398|01/25/2022||||14025|||||No|No||GENZYME|No||||
caplacizumab-yhdp|No|No|No|No|75%|58468022501|CABLIVI 11 MG KIT|1|EA|3264.56|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|||Prescription required|No|||No|7440.16|01/11/2022|7333.872|01/11/2022|6984.64|01/11/2022||||14026|||||No|No||GENZYME|No||||
imiglucerase|No|No|No|No|75%|58468466301|CEREZYME 400 UNIT VIAL|1|EA|738.2928|02/26/2010||Yes|No||02/26/2010||Yes|No|02/26/2010||Yes|No||||No|No|||Prescription required|No|||No|1682.6208|01/25/2022|1658.58336|01/25/2022|1579.6032|01/25/2022||||14027|||||No|No||GENZYME|No||||
vandetanib|No|No|No|No|75%|58468782003|CAPRELSA 100 MG TABLET|30|EA|115.54888|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|No||239|No|263.34396|01/25/2022|259.5819|01/25/2022|247.22086|01/25/2022|||ONCOLOGY: ORAL - OTHER|14028|||||No|No||GENZYME|No||||
vandetanib|No|No|No|No|75%|58468784003|CAPRELSA 300 MG TABLET|30|EA|231.09776|01/04/2018||Yes|No||01/04/2018||Yes|No|01/04/2018||Yes|No||||No|No|||Prescription required|No||239|No|526.68792|01/25/2022|519.16381|01/25/2022|494.44172|01/25/2022|||ONCOLOGY: ORAL - OTHER|14029|||||No|No||GENZYME|No||||
magnesium oxide|No|No|No|No|75%|58657012012|MAGNESIUM OXIDE 400 MG TABLET|120|EA|.02325|10/04/2021||Yes|No||||No|No|10/04/2021||Yes|No||||No|No|||Over the counter|No|||No|.03856|03/29/2022|.03763|03/29/2022|.03788|03/29/2022||||14030|||||No|No||METHOD PHARMACE|No||||
prenatal vit,calc76/iron/folic|No|No|No|No|75%|58657013390|THRIVITE RX TABLET|90|EA|.19106|11/07/2016||Yes|No||11/07/2016||Yes|No|11/07/2016||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|.28239|07/27/2021|.27561|07/27/2021|.27744|07/27/2021|||PRENATAL VITAMINS|14031|||||No|No||METHOD PHARMACE|No||||
mv, min 59/iron/folic/docusate|No|No|No|No|75%|58657013601|THRIVITE 19 TABLET|100|EA|.23852|11/07/2016||Yes|No||11/07/2016||Yes|No|11/07/2016||Yes|No||||No|No|||Over the counter|Yes|04/26/2020|243|No|.5436|06/19/2018|.53584|06/19/2018|.51032|06/19/2018|||PRENATAL VITAMINS|14032|||||No|No||METHOD PHARMACE|No||||
fluoride (sodium)|No|No|No|No|75%|58657016012|SODIUM FLUORIDE 0.25 (0.55) MG|120|EA|.03579|10/04/2021||Yes|No||||No|No|10/04/2021||Yes|No||||No|No|||Over the counter|No|||No|.08043|03/29/2022|.07849|03/29/2022|.07902|03/29/2022||||14033|||||No|No||METHOD PHARMACE|No||||
fluoride (sodium)|No|No|No|No|75%|58657016110|SODIUM FLUORIDE 0.5 MG(1.1 MG)|1000|EA|.03611|10/04/2021||Yes|No||||No|No|10/04/2021||Yes|No||||No|No|||Over the counter|No|||No|.07046|03/29/2022|.06876|03/29/2022|.06922|03/29/2022||||14034|||||No|No||METHOD PHARMACE|No||||
fluoride (sodium)|No|No|No|No|75%|58657016112|SODIUM FLUORIDE 0.5 MG(1.1 MG)|120|EA|.03579|10/04/2021||Yes|No||||No|No|10/04/2021||Yes|No||||No|No|||Over the counter|No|||No|.07046|03/29/2022|.06876|03/29/2022|.06922|03/29/2022||||14035|||||No|No||METHOD PHARMACE|No||||
fluoride (sodium)|No|No|No|No|75%|58657016212|SODIUM FLUORIDE 1 MG (2.2 MG)|120|EA|.03579|10/04/2021||Yes|No||||No|No|10/04/2021||Yes|No||||No|No|||Over the counter|No|||No|.07209|03/29/2022|.07035|03/29/2022|.07082|03/29/2022||||14036|||||No|No||METHOD PHARMACE|No||||
pedi multivit no.17 w-fluoride|No|No|No|No|75%|58657016301|MULTIVIT-FLUOR 0.25 MG TAB CHW|100|EA|.05585|10/04/2021||Yes|No||||No|No|10/04/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|.10332|03/29/2022|.10084|03/29/2022|.10151|03/29/2022|||PEDIATRIC VITAMIN PREPARATIONS|14037|||||No|No||METHOD PHARMACE|No||||
pedi multivit no.17 w-fluoride|No|No|No|No|75%|58657016390|MULTIVIT-FLUOR 0.25 MG TAB CHW|90|EA|.06206|10/04/2021||Yes|No||||No|No|10/04/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|.10332|03/29/2022|.10084|03/29/2022|.10151|03/29/2022|||PEDIATRIC VITAMIN PREPARATIONS|14038|||||No|No||METHOD PHARMACE|No||||
pedi multivit no.17 w-fluoride|No|No|No|No|75%|58657016401|MULTIVIT-FLUOR 0.5 MG TAB CHEW|100|EA|.05585|10/04/2021||Yes|No||||No|No|10/04/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|.10492|03/29/2022|.1024|03/29/2022|.10308|03/29/2022|||PEDIATRIC VITAMIN PREPARATIONS|14039|||||No|No||METHOD PHARMACE|No||||
pedi multivit no.17 w-fluoride|No|No|No|No|75%|58657016490|MULTIVIT-FLUOR 0.5 MG TAB CHEW|90|EA|.06206|10/04/2021||Yes|No||||No|No|10/04/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|.10492|03/29/2022|.1024|03/29/2022|.10308|03/29/2022|||PEDIATRIC VITAMIN PREPARATIONS|14040|||||No|No||METHOD PHARMACE|No||||
pedi multivit no.17 w-fluoride|No|No|No|No|75%|58657016501|MULTIVIT-FLUORIDE 1 MG TAB CHW|100|EA|.05585|10/05/2021||Yes|No||||No|No|10/05/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|.12083|03/29/2022|.11793|03/29/2022|.11871|03/29/2022|||PEDIATRIC VITAMIN PREPARATIONS|14041|||||No|No||METHOD PHARMACE|No||||
pedi multivit no.17 w-fluoride|No|No|No|No|75%|58657016590|MULTIVIT-FLUORIDE 1 MG TAB CHW|90|EA|.06206|10/04/2021||Yes|No||||No|No|10/04/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|.12083|03/29/2022|.11793|03/29/2022|.11871|03/29/2022|||PEDIATRIC VITAMIN PREPARATIONS|14042|||||No|No||METHOD PHARMACE|No||||
PNV,calcium 72/iron/folic acid|No|No|No|No|75%|58657017001|M-NATAL PLUS TABLET|100|EA|.05585|09/20/2021||Yes|No||||No|No|09/20/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|.11811|03/29/2022|.11527|03/29/2022|.11604|03/29/2022|||PRENATAL VITAMINS|14043|||||No|No||METHOD PHARMACE|No||||
fluoride (sodium)|No|No|No|No|75%|58657032250|SODIUM FLUORIDE 0.5 MG/ML DROP|50|ML|.08591|09/20/2021||Yes|No||09/20/2021||Yes|No|09/20/2021||Yes|No||||No|No|||Over the counter|No|||No|.21639|03/29/2022|.21119|03/29/2022|.2126|03/29/2022||||14044|||||No|No||METHOD PHARMACE|No||||
ped mvit A,C,D3 no.21/fluoride|No|No|No|No|75%|58657032350|TRI-VITE-FLUORIDE 0.25 MG/ML|50|ML|.11171|08/21/2018||Yes|No||||No|No|08/21/2018||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|.2719|03/29/2022|.26537|03/29/2022|.26714|03/29/2022|||PEDIATRIC VITAMIN PREPARATIONS|14045|||||No|No||METHOD PHARMACE|No||||
ped mvit A,C,D3 no.21/fluoride|No|No|No|No|75%|58657032450|TRI-VITE-FLUORIDE 0.5 MG/ML|50|ML|.11171|10/05/2021||Yes|No||||No|No|10/05/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|.2546|10/05/2021|.25096|10/05/2021|.23901|10/05/2021|||PEDIATRIC VITAMIN PREPARATIONS|14046|||||No|No||METHOD PHARMACE|No||||
pedi multivit no.2 w-fluoride|No|No|No|No|75%|58657032550|MULTIVIT-FLUOR 0.25 MG/ML DROP|50|ML|.11171|10/17/2017||Yes|No||10/17/2017||Yes|No|10/17/2017||Yes|No||||No|No|||Over the counter|No||179|No|.24457|03/29/2022|.2387|03/29/2022|.24029|03/29/2022|||PEDIATRIC VITAMIN PREPARATIONS|14047|||||No|No||METHOD PHARMACE|No||||
pedi multivit no.2 w-fluoride|No|No|No|No|75%|58657032650|MULTIVIT-FLUOR 0.5 MG/ML DROP|50|ML|.11171|10/17/2017||Yes|No||10/17/2017||Yes|No|10/17/2017||Yes|No||||No|No|||Over the counter|No||179|No|.1931|03/29/2022|.18846|03/29/2022|.18972|03/29/2022|||PEDIATRIC VITAMIN PREPARATIONS|14048|||||No|No||METHOD PHARMACE|No||||
pedi multivit 45/fluoride/iron|No|No|No|No|75%|58657032750|MULTIVIT-FLUOR-IRON 0.25 MG/ML|50|ML|.11171|10/17/2017||Yes|No||10/17/2017||Yes|No|10/17/2017||Yes|No||||No|No|||Over the counter|No||179|No|.23116|11/23/2021|.22561|11/23/2021|.22711|11/23/2021|||PEDIATRIC VITAMIN PREPARATIONS|14049|||||No|No||METHOD PHARMACE|No||||
codeine phosphate/guaifenesin|No|No|No|No|90%|58657050004|CODEINE-GUAIFEN 10-100 MG/5 ML|120|ML|.03837|06/16/2014||Yes|No||||No|No|06/16/2014||Yes|No||||No|No|||Over the counter|No||183|Yes|.03904|03/29/2022|.0381|03/29/2022|.03835|03/29/2022|||COUGH AND COLD: NARCOTIC|14050|||||No|No||METHOD PHARMACE|No||||
codeine phosphate/guaifenesin|No|No|No|No|90%|58657050016|CODEINE-GUAIFEN 10-100 MG/5 ML|473|ML|.03247|06/01/2014||Yes|No||||No|No|06/01/2014||Yes|No||||No|No|||Over the counter|No||183|Yes|.02734|03/29/2022|.02668|03/29/2022|.02686|03/29/2022|||COUGH AND COLD: NARCOTIC|14051|||||No|No||METHOD PHARMACE|No||||
acetaminophen|No|No|No|No|75%|58657052504|M-PAP 160 MG/5 ML LIQUID|120|ML|.01214|03/05/2020||Yes|No||||No|No|03/05/2020||Yes|No||||No|No|||Over the counter|No|||No|.02768|03/05/2020|.02728|03/05/2020|.02599|03/05/2020||||14052|||||No|No||METHOD PHARMACE|No||||
acetaminophen|No|No|No|No|75%|58657052516|M-PAP 160 MG/5 ML LIQUID|473|ML|.01078|03/05/2020||Yes|No||||No|No|03/05/2020||Yes|No||||No|No|||Over the counter|No|||No|.00905|03/29/2022|.00883|03/29/2022|.00889|03/29/2022||||14053|||||No|No||METHOD PHARMACE|No||||
labetalol HCl|No|No|No|No|75%|58657060201|LABETALOL HCL 100 MG TABLET|100|EA|.17647|03/25/2021||Yes|No||03/25/2021||Yes|No|03/25/2021||Yes|No||||No|No|||Prescription required|No||070|No|.12868|03/29/2022|.12559|03/29/2022|.12642|03/29/2022|||BETA-BLOCKERS|14054|||||No|No||METHOD PHARMACE|No||||
labetalol HCl|No|No|No|No|75%|58657060250|LABETALOL HCL 100 MG TABLET|500|EA|.0774|03/25/2021||Yes|No||03/25/2021||Yes|No|03/25/2021||Yes|No||||No|No|||Prescription required|No||070|No|.12868|03/29/2022|.12559|03/29/2022|.12642|03/29/2022|||BETA-BLOCKERS|14055|||||No|No||METHOD PHARMACE|No||||
labetalol HCl|No|No|No|No|75%|58657060301|LABETALOL HCL 200 MG TABLET|100|EA|.25038|03/25/2021||Yes|No||03/25/2021||Yes|No|03/25/2021||Yes|No||||No|No|||Prescription required|No||070|No|.17218|03/29/2022|.16804|03/29/2022|.16916|03/29/2022|||BETA-BLOCKERS|14056|||||No|No||METHOD PHARMACE|No||||
labetalol HCl|No|No|No|No|75%|58657060350|LABETALOL HCL 200 MG TABLET|500|EA|.0946|03/25/2021||Yes|No||03/25/2021||Yes|No|03/25/2021||Yes|No||||No|No|||Prescription required|No||070|No|.17218|03/29/2022|.16804|03/29/2022|.16916|03/29/2022|||BETA-BLOCKERS|14057|||||No|No||METHOD PHARMACE|No||||
labetalol HCl|No|No|No|No|75%|58657060401|LABETALOL HCL 300 MG TABLET|100|EA|.33307|03/25/2021||Yes|No||03/25/2021||Yes|No|03/25/2021||Yes|No||||No|No|||Prescription required|No||070|No|.21583|03/29/2022|.21065|03/29/2022|.21205|03/29/2022|||BETA-BLOCKERS|14058|||||No|No||METHOD PHARMACE|No||||
labetalol HCl|No|No|No|No|75%|58657060450|LABETALOL HCL 300 MG TABLET|500|EA|.1118|03/25/2021||Yes|No||03/25/2021||Yes|No|03/25/2021||Yes|No||||No|No|||Prescription required|No||070|No|.21583|03/29/2022|.21065|03/29/2022|.21205|03/29/2022|||BETA-BLOCKERS|14059|||||No|No||METHOD PHARMACE|No||||
carisoprodol|No|No|No|No|90%|58657064501|CARISOPRODOL 350 MG TABLET|100|EA|.05155|08/03/2020||Yes|No||08/03/2020||Yes|No|08/03/2020||Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|14060|||||No|No||METHOD PHARMACE|No||||
carisoprodol|No|No|No|No|90%|58657064510|CARISOPRODOL 350 MG TABLET|1000|EA|.04729|08/03/2020||Yes|No||08/03/2020||Yes|No|08/03/2020||Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|14061|||||No|No||METHOD PHARMACE|No||||
carisoprodol|No|No|No|No|90%|58657064550|CARISOPRODOL 350 MG TABLET|500|EA|.03009|08/03/2020||Yes|No||08/03/2020||Yes|No|08/03/2020||Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|14062|||||No|No||METHOD PHARMACE|No||||
haloperidol|No|No|No|No|75%|58657070001|HALOPERIDOL 0.5 MG TABLET|100|EA|.30745|03/26/2020||Yes|No||03/26/2020||Yes|No|03/26/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.24816|03/29/2022|.2422|03/29/2022|.24381|03/29/2022|||ANTIPSYCHOTICS|14063|||||No|No||METHOD PHARMACE|No||||
haloperidol|No|No|No|No|75%|58657070101|HALOPERIDOL 1 MG TABLET|100|EA|.36851|03/26/2020||Yes|No||03/26/2020||Yes|No|03/26/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.34011|03/29/2022|.33194|03/29/2022|.33415|03/29/2022|||ANTIPSYCHOTICS|14064|||||No|No||METHOD PHARMACE|No||||
haloperidol|No|No|No|No|75%|58657070201|HALOPERIDOL 2 MG TABLET|100|EA|.43|03/26/2020||Yes|No||03/26/2020||Yes|No|03/26/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.43109|03/29/2022|.42074|03/29/2022|.42354|03/29/2022|||ANTIPSYCHOTICS|14065|||||No|No||METHOD PHARMACE|No||||
haloperidol|No|No|No|No|75%|58657070301|HALOPERIDOL 5 MG TABLET|100|EA|.24763|03/26/2020||Yes|No||03/26/2020||Yes|No|03/26/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.44921|03/29/2022|.43842|03/29/2022|.44134|03/29/2022|||ANTIPSYCHOTICS|14066|||||No|No||METHOD PHARMACE|No||||
haloperidol|No|No|No|No|75%|58657070310|HALOPERIDOL 5 MG TABLET|1000|EA|.25799|09/15/2020||Yes|No||09/15/2020||Yes|No|09/15/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.44921|03/29/2022|.43842|03/29/2022|.44134|03/29/2022|||ANTIPSYCHOTICS|14067|||||No|No||METHOD PHARMACE|No||||
haloperidol|No|No|No|No|75%|58657070401|HALOPERIDOL 10 MG TABLET|100|EA|.27945|03/26/2020||Yes|No||03/26/2020||Yes|No|03/26/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.48134|03/29/2022|.46978|03/29/2022|.47291|03/29/2022|||ANTIPSYCHOTICS|14068|||||No|No||METHOD PHARMACE|No||||
haloperidol|No|No|No|No|75%|58657070501|HALOPERIDOL 20 MG TABLET|100|EA|.55895|03/26/2020||Yes|No||03/26/2020||Yes|No|03/26/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.97837|03/29/2022|.95488|03/29/2022|.96124|03/29/2022|||ANTIPSYCHOTICS|14069|||||No|No||METHOD PHARMACE|No||||
guaifen/dextromethorphan/PE|No|No|No|No|75%|58809019860|VANATAB DM CAPLET|60|EA|.36636|08/15/2017||Yes|No||||No|No|08/15/2017||Yes|No||||No|No|||Over the counter|No||184|Yes|.83496|08/22/2017|.82303|08/15/2017|.78384|08/15/2017|||COUGH AND COLD: NON-NARCOTIC|14070|||||No|No||G.M. PHARM|No||||
zinc oxide|No|No|No|No|75%|58809037504|Z-BUM 22% DIAPER RASH CREAM|113|GM|.1462|06/02/2016||Yes|No||||No|No|06/02/2016||Yes|No||||No|No|||Over the counter|No|||No|.3332|02/27/2018|.32844|02/27/2018|.3128|02/27/2018||||14071|||||No|No||G.M. PHARM|No||||
zinc oxide|No|No|No|No|75%|58809045004|COZIMA 24% DIAPER RASH CREAM|113|GM|.13246|09/23/2019||Yes|No||||No|No|09/23/2019||Yes|No||||No|No|||Over the counter|No|||No|.30188|09/23/2019|.29757|09/23/2019|.2834|09/23/2019||||14072|||||No|No||G.M. PHARM|No||||
guaifen/dextromethorphan/PE|No|No|No|No|75%|58809055508|VANACOF DM 18-200-10 MG/15 ML|240|ML|.0421|06/26/2013||Yes|No||||No|No|06/26/2013||Yes|No||||No|No|||Over the counter|No||184|Yes|.09595|11/24/2020|.09458|11/24/2020|.09007|11/24/2020|||COUGH AND COLD: NON-NARCOTIC|14073|||||No|No||G.M. PHARM|No||||
piperonyl butoxide/pyrethrins|No|No|No|No|75%|58809065008|VANALICE GEL|237|ML|.07248|08/10/2020||Yes|No||||No|No|08/10/2020||Yes|No||||No|No|||Over the counter|No||122|No|.16518|08/10/2020|.16282|08/10/2020|.15507|08/10/2020|||ANTIPARASITICS: TOPICAL|14074|||||No|No||G.M. PHARM|No||||
triprolidine HCl|No|No|No|No|75%|58809065150|PEDIACLEAR PD 0.625 MG/ML DROP|50|ML|.12857|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Over the counter|No||574|Yes|.29302|12/12/2019|.28883|12/12/2019|.27508|12/12/2019|||ANTIHISTAMINES: FIRST GENERATION|14075|||||No|No||G.M. PHARM|No||||
thonzylamine/phenylephrine|No|No|No|No|75%|58809072904|NASOPEN PE LIQUID|118|ML|.04008|08/08/2012||Yes|No||||No|No|08/08/2012||Yes|No||||No|No|||Over the counter|No||182|Yes|.09135|06/01/2016|.09005|06/01/2016|.08576|06/01/2016|||COUGH AND COLD: COLD|14076|||||No|No||G.M. PHARM|No||||
pyrilamine maleate|No|No|No|No|75%|58809077008|PEDIACLEAR-8 12.5 MG/15 ML LIQ|237|ML|.04263|01/10/2020||Yes|No||||No|No|01/10/2020||Yes|No||||No|No|||Over the counter|No||574|No|.09716|01/10/2020|.09577|01/10/2020|.09121|01/10/2020|||ANTIHISTAMINES: FIRST GENERATION|14077|||||No|No||G.M. PHARM|No||||
guaifen/dextromethorphan/PE|No|No|No|No|75%|58809085008|VANACOF DMX 18-396-10 MG/15 ML|237|ML|.04145|03/09/2020||Yes|No||||No|No|03/09/2020||Yes|No||||No|No|||Over the counter|No||184|Yes|.09448|03/09/2020|.09313|03/09/2020|.08869|03/09/2020|||COUGH AND COLD: NON-NARCOTIC|14078|||||No|No||G.M. PHARM|No||||
dexchlorphenir/pse/chlophedian|No|No|No|No|75%|58809099901|VANACOF LIQUID|473|ML|.04271|12/28/2009||Yes|No||||No|No|12/28/2009||Yes|No||||No|No|||Over the counter|No||184|Yes|.09735|05/25/2021|.09596|05/25/2021|.09139|05/25/2021|||COUGH AND COLD: NON-NARCOTIC|14079|||||No|No||G.M. PHARM|No||||
lipase/protease/amylase|No|No|No|No|75%|58914011210|VIOKACE 10,440-39,150 UNITS TB|100|EA|1.38374|10/25/2012|04/27/2022|Yes|No||10/25/2012|04/27/2022|Yes|No|10/25/2012|04/27/2022|Yes|No||||No|No|||Prescription required|Yes|01/23/2013|108|No|3.15364|01/05/2021|3.10858|01/05/2021|2.96056|01/05/2021|||PANCREATIC ENZYMES|14080|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ALLERGAN/NESTLE|No||||
lipase/protease/amylase|No|No|No|No|75%|58914011710|VIOKACE 20,880-78,300 UNITS TB|100|EA|2.72994|01/11/2013|03/01/2022|Yes|No||01/11/2013|03/01/2022|Yes|No|01/11/2013|03/01/2022|Yes|No||||No|No|||Prescription required|Yes|01/23/2013|108|No|6.22172|01/05/2021|6.13284|01/05/2021|5.8408|01/05/2021|||PANCREATIC ENZYMES|14081|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ALLERGAN/NESTLE|No||||
sucralfate|No|No|No|No|75%|58914017014|CARAFATE 1 GM/10 ML SUSP|420|ML|.24803|12/11/2008||Yes|No||12/11/2008||Yes|No|12/11/2008||Yes|No||||No|No|||Prescription required|No|||No|.56177|02/08/2022|.54828|02/08/2022|.55193|02/08/2022||||14082|||||No|No||APTALIS/ALLERGA|No||||
sucralfate|No|No|No|No|75%|58914017110|CARAFATE 1 GM TABLET|100|EA|1.93396|08/04/2004||Yes|No||08/04/2004||Yes|No|08/04/2004||Yes|No||||No|No|||Prescription required|No|||No|4.40764|02/01/2022|4.34468|02/01/2022|4.13779|02/01/2022||||14083|||||No|No||APTALIS/ALLERGA|No||||
nitroglycerin|No|No|No|No|75%|58914030180|RECTIV 0.4% OINTMENT|30|GM|9.18394|02/28/2013||Yes|No||02/28/2013||Yes|No|02/28/2013||Yes|No||||No|No|||Prescription required|No|||No|20.43963|03/01/2022|19.94907|03/01/2022|20.08193|03/01/2022||||14084|||||No|No||APTALIS/ALLERGA|No||||
mesalamine|No|No|No|No|75%|58914050156|CANASA 1,000 MG SUPPOSITORY|30|EA|16.65218|07/24/2008||Yes|No||07/24/2008||Yes|No|07/24/2008||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|010|No|37.95148|05/25/2021|37.40931|05/25/2021|35.62792|05/25/2021|||ULCERATIVE COLITIS AGENTS|14085|Not Specified|Not Specified|Not Specified||No|No||ALLERGAN INC.|No||||
bismuth/metronid/tetracycline|No|No|No|No|75%|58914060120|PYLERA CAPSULE|120|EA|3.30218|09/18/2013||Yes|No||09/18/2013||Yes|No|09/18/2013||Yes|No||||No|No|||Prescription required|No||001|No|7.35697|12/28/2021|7.1804|12/28/2021|7.22822|12/28/2021|||H. PYLORI TREATMENT|14086|||||No|No||APTALIS/ALLERGA|No||||
ursodiol|No|No|No|No|75%|58914078510|URSO 250 MG TABLET|100|EA|2.36818|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|198|No|5.39725|01/08/2019|5.32014|01/08/2019|5.0668|01/08/2019|||BILE SALTS|14087|||||No|No||APTALIS/ALLERGA|No||||
ursodiol|No|No|No|No|75%|58914079010|URSO FORTE 500 MG TABLET|100|EA|4.19658|08/08/2005||Yes|No||08/08/2005||Yes|No|08/08/2005||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|198|No|9.56431|01/08/2019|9.42767|01/08/2019|8.97874|01/08/2019|||BILE SALTS|14088|||||No|No||APTALIS/ALLERGA|No||||
hydrocodone bitartrate|No|No|No|No|90%|59011027160|HYSINGLA ER 20 MG TABLET|60|EA|4.70176|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|10.52322|01/11/2022|10.27066|01/11/2022|10.33906|01/11/2022|||ANALGESICS: NARCOTICS LONG|14089|||||No|No||PURDUE PHARMA L|No||||
hydrocodone bitartrate|No|No|No|No|90%|59011027260|HYSINGLA ER 30 MG TABLET|60|EA|6.86294|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|15.2565|01/11/2022|14.89034|01/11/2022|14.98951|01/11/2022|||ANALGESICS: NARCOTICS LONG|14090|||||No|No||PURDUE PHARMA L|No||||
hydrocodone bitartrate|No|No|No|No|90%|59011027360|HYSINGLA ER 40 MG TABLET|60|EA|9.246|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|20.71317|01/11/2022|20.21605|01/11/2022|20.35068|01/11/2022|||ANALGESICS: NARCOTICS LONG|14091|||||No|No||PURDUE PHARMA L|No||||
hydrocodone bitartrate|No|No|No|No|90%|59011027460|HYSINGLA ER 60 MG TABLET|60|EA|12.80274|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|28.44458|01/11/2022|27.76191|01/11/2022|27.94679|01/11/2022|||ANALGESICS: NARCOTICS LONG|14092|||||No|No||PURDUE PHARMA L|No||||
hydrocodone bitartrate|No|No|No|No|90%|59011027560|HYSINGLA ER 80 MG TABLET|60|EA|17.26112|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|38.39608|01/11/2022|37.47457|01/11/2022|37.72414|01/11/2022|||ANALGESICS: NARCOTICS LONG|14093|||||No|No||PURDUE PHARMA L|No||||
hydrocodone bitartrate|No|No|No|No|90%|59011027660|HYSINGLA ER 100 MG TABLET|60|EA|21.96282|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|50.0548|01/04/2022|49.33973|01/04/2022|46.99022|01/04/2022|||ANALGESICS: NARCOTICS LONG|14094|||||No|No||PURDUE PHARMA L|No||||
hydrocodone bitartrate|No|No|No|No|90%|59011027760|HYSINGLA ER 120 MG TABLET|60|EA|24.33878|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|110|Yes|55.46979|01/04/2022|54.67736|01/04/2022|52.07368|01/04/2022|||ANALGESICS: NARCOTICS LONG|14095|||||No|No||PURDUE PHARMA L|No||||
oxycodone HCl|No|No|No|No|90%|59011041010|OXYCONTIN ER 10 MG TABLET|100|EA|2.00337|08/16/2010||Yes|No||08/16/2010||Yes|No|08/16/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|110|Yes|4.47585|01/11/2022|4.36842|01/11/2022|4.39752|01/11/2022|||ANALGESICS: NARCOTICS LONG|14096|||||No|No||PURDUE PHARMA L|No||||
oxycodone HCl|No|No|No|No|90%|59011041510|OXYCONTIN ER 15 MG TABLET|100|EA|2.94928|08/16/2010||Yes|No||08/16/2010||Yes|No|08/16/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|110|Yes|6.56982|01/11/2022|6.41214|01/11/2022|6.45484|01/11/2022|||ANALGESICS: NARCOTICS LONG|14097|||||No|No||PURDUE PHARMA L|No||||
oxycodone HCl|No|No|No|No|90%|59011042010|OXYCONTIN ER 20 MG TABLET|100|EA|3.73622|08/16/2010||Yes|No||08/16/2010||Yes|No|08/16/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|110|Yes|8.33643|01/11/2022|8.13635|01/11/2022|8.19054|01/11/2022|||ANALGESICS: NARCOTICS LONG|14098|||||No|No||PURDUE PHARMA L|No||||
oxycodone HCl|No|No|No|No|90%|59011043010|OXYCONTIN ER 30 MG TABLET|100|EA|5.19607|08/16/2010||Yes|No||08/16/2010||Yes|No|08/16/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|110|Yes|11.60626|01/11/2022|11.3277|01/11/2022|11.40315|01/11/2022|||ANALGESICS: NARCOTICS LONG|14099|||||No|No||PURDUE PHARMA L|No||||
oxycodone HCl|No|No|No|No|90%|59011044010|OXYCONTIN ER 40 MG TABLET|100|EA|6.39861|08/16/2010||Yes|No||08/16/2010||Yes|No|08/16/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|110|Yes|14.28635|01/11/2022|13.94347|01/11/2022|14.03633|01/11/2022|||ANALGESICS: NARCOTICS LONG|14100|||||No|No||PURDUE PHARMA L|No||||
oxycodone HCl|No|No|No|No|90%|59011046010|OXYCONTIN ER 60 MG TABLET|100|EA|9.05941|08/16/2010||Yes|No||08/16/2010||Yes|No|08/16/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|110|Yes|20.26608|01/11/2022|19.77969|01/11/2022|19.91142|01/11/2022|||ANALGESICS: NARCOTICS LONG|14101|||||No|No||PURDUE PHARMA L|No||||
oxycodone HCl|No|No|No|No|90%|59011048010|OXYCONTIN ER 80 MG TABLET|100|EA|11.16533|08/16/2010||Yes|No||08/16/2010||Yes|No|08/16/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|110|Yes|24.87447|01/11/2022|24.27748|01/11/2022|24.43916|01/11/2022|||ANALGESICS: NARCOTICS LONG|14102|||||No|No||PURDUE PHARMA L|No||||
buprenorphine|No|No|No|No|90%|59011075004|BUTRANS 5 MCG/HR PATCH|4|EA|36.5801|01/10/2011||Yes|No||01/10/2011||Yes|No|01/10/2011||Yes|No||||No|No|||Prescription required|No||110|Yes|82.21212|01/11/2022|80.23902|01/11/2022|80.7734|01/11/2022|||ANALGESICS: NARCOTICS LONG|14103|||||No|No||PURDUE PHARMA L|No||||
buprenorphine|No|No|No|No|90%|59011075104|BUTRANS 10 MCG/HR PATCH|4|EA|54.8723|01/10/2011||Yes|No||01/10/2011||Yes|No|01/10/2011||Yes|No||||No|No|||Prescription required|No||110|Yes|121.44285|01/11/2022|118.52822|01/11/2022|119.3176|01/11/2022|||ANALGESICS: NARCOTICS LONG|14104|||||No|No||PURDUE PHARMA L|No||||
buprenorphine|No|No|No|No|90%|59011075204|BUTRANS 20 MCG/HR PATCH|4|EA|97.1413|01/10/2011||Yes|No||01/10/2011||Yes|No|01/10/2011||Yes|No||||No|No|||Prescription required|No||110|Yes|216.00775|01/11/2022|210.82356|01/11/2022|212.22761|01/11/2022|||ANALGESICS: NARCOTICS LONG|14105|||||No|No||PURDUE PHARMA L|No||||
buprenorphine|No|No|No|No|90%|59011075704|BUTRANS 7.5 MCG/HR PATCH|4|EA|51.213|10/30/2014||Yes|No||10/30/2014||Yes|No|10/30/2014||Yes|No||||No|No|||Prescription required|No||110|Yes|113.65653|01/11/2022|110.92877|01/11/2022|111.66754|01/11/2022|||ANALGESICS: NARCOTICS LONG|14106|||||No|No||PURDUE PHARMA L|No||||
buprenorphine|No|No|No|No|90%|59011075804|BUTRANS 15 MCG/HR PATCH|4|EA|79.15117|09/25/2013||Yes|No||09/25/2013||Yes|No|09/25/2013||Yes|No||||No|No|||Prescription required|No||110|Yes|175.94121|01/11/2022|171.71862|01/11/2022|172.86223|01/11/2022|||ANALGESICS: NARCOTICS LONG|14107|||||No|No||PURDUE PHARMA L|No||||
magnesium L-lactate|No|No|No|No|75%|59016042016|MAG-TAB SR 84 MG CAPLET|60|EA|.13437|||No|No||||No|No|||No|No||08/26/2005||Yes|No|||Over the counter|No|||No|.30625|07/07/2020|.30187|07/07/2020|.2875|07/07/2020||||14108|||||No|No||NICHE PHARM|No||||
magnesium L-lactate|No|No|No|No|75%|59016042017|MAG-TAB SR 84 MG CAPLET|100|EA|.12448|||No|No||||No|No|||No|No||08/26/2005||Yes|No|||Over the counter|No|||No|.28371|07/07/2020|.27965|07/07/2020|.26634|07/07/2020||||14109|||||No|No||NICHE PHARM|No||||
magnesium L-lactate|No|No|No|No|75%|59016042018|MAG-TAB SR 84 MG CAPLET|1000|EA|.08987|||No|No||||No|No|||No|No||08/26/2005||Yes|No|||Over the counter|No|||No|.20482|07/07/2020|.20189|07/07/2020|.19228|07/07/2020||||14110|||||No|No||NICHE PHARM|No||||
methotrexate/PF|No|No|No|No|75%|59137050504|RASUVO 7.5 MG/0.15 ML AUTOINJ|.15|ML|364.78333|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No|||No|831.36666|10/05/2021|819.48999|10/05/2021|780.46666|10/05/2021||||14111|||||No|No||MEDEXUS PHARMA,|No||||
methotrexate/PF|No|No|No|No|75%|59137051004|RASUVO 10 MG/0.2 ML AUTOINJ|.2|ML|273.5875|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No|||No|623.525|10/05/2021|614.6175|10/05/2021|585.35|10/05/2021||||14112|||||No|No||MEDEXUS PHARMA,|No||||
methotrexate/PF|No|No|No|No|75%|59137051504|RASUVO 12.5 MG/0.25 ML AUTOINJ|.25|ML|218.87|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No|||No|498.82|10/05/2021|491.694|10/05/2021|468.28|10/05/2021||||14113|||||No|No||MEDEXUS PHARMA,|No||||
methotrexate/PF|No|No|No|No|75%|59137052004|RASUVO 15 MG/0.3 ML AUTOINJ|.3|ML|182.39166|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No|||No|411.06514|12/21/2021|401.19957|12/21/2021|403.8715|12/21/2021||||14114|||||No|No||MEDEXUS PHARMA,|No||||
methotrexate/PF|No|No|No|No|75%|59137052504|RASUVO 17.5 MG/0.35 ML AUTOINJ|.35|ML|156.33571|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No|||No|356.29999|10/05/2021|351.20999|10/05/2021|334.4857|10/05/2021||||14115|||||No|No||MEDEXUS PHARMA,|No||||
methotrexate/PF|No|No|No|No|75%|59137053004|RASUVO 20 MG/0.4 ML AUTOINJ|.4|ML|136.79375|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No|||No|310.18107|12/21/2021|302.73672|12/21/2021|304.7529|12/21/2021||||14116|||||No|No||MEDEXUS PHARMA,|No||||
methotrexate/PF|No|No|No|No|75%|59137053504|RASUVO 22.5 MG/0.45 ML AUTOINJ|.45|ML|121.59444|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No|||No|277.12221|10/05/2021|273.16332|10/05/2021|260.15554|10/05/2021||||14117|||||No|No||MEDEXUS PHARMA,|No||||
methotrexate/PF|No|No|No|No|75%|59137054004|RASUVO 25 MG/0.5 ML AUTOINJ|.5|ML|109.435|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No|||No|245.5285|10/05/2021|239.63581|10/05/2021|241.23175|10/05/2021||||14118|||||No|No||MEDEXUS PHARMA,|No||||
methotrexate/PF|No|No|No|No|75%|59137055004|RASUVO 30 MG/0.6 ML AUTOINJ|.6|ML|91.19583|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No|||No|207.84166|10/05/2021|204.87249|10/05/2021|195.11666|10/05/2021||||14119|||||No|No||MEDEXUS PHARMA,|No||||
aripiprazole|No|No|No|No|75%|59148000613|ABILIFY 2 MG TABLET|30|EA|8.3678|02/09/2006||Yes|No||02/09/2006||Yes|No|02/09/2006||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|19.0708|12/21/2021|18.79836|12/21/2021|17.9032|12/21/2021|||ANTIPSYCHOTICS|14120|||||No|No||OTSUKA AMERICA|No||||
aripiprazole|No|No|No|No|75%|59148000713|ABILIFY 5 MG TABLET|30|EA|8.3678|09/08/2003||Yes|No||09/08/2003||Yes|No|09/08/2003||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|18.68144|12/28/2021|18.23308|12/28/2021|18.35451|12/28/2021|||ANTIPSYCHOTICS|14121|||||No|No||OTSUKA AMERICA|No||||
aripiprazole|No|No|No|No|75%|59148000813|ABILIFY 10 MG TABLET|30|EA|8.3678|11/22/2002||Yes|No||11/22/2002||Yes|No|11/22/2002||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|18.63019|03/29/2022|18.18306|03/29/2022|18.30416|03/29/2022|||ANTIPSYCHOTICS|14122|||||No|No||OTSUKA AMERICA|No||||
aripiprazole|No|No|No|No|75%|59148000913|ABILIFY 15 MG TABLET|30|EA|8.3678|11/22/2002||Yes|No||11/22/2002||Yes|No|11/22/2002||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|18.68894|12/28/2021|18.2404|12/28/2021|18.36188|12/28/2021|||ANTIPSYCHOTICS|14123|||||No|No||OTSUKA AMERICA|No||||
aripiprazole|No|No|No|No|75%|59148001013|ABILIFY 20 MG TABLET|30|EA|11.83288|11/22/2002||Yes|No||11/22/2002||Yes|No|11/22/2002||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|26.96796|12/21/2021|26.5827|12/21/2021|25.31686|12/21/2021|||ANTIPSYCHOTICS|14124|||||No|No||OTSUKA AMERICA|No||||
aripiprazole|No|No|No|No|75%|59148001113|ABILIFY 30 MG TABLET|30|EA|11.83288|11/22/2002||Yes|No||11/22/2002||Yes|No|11/22/2002||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|26.96796|12/21/2021|26.5827|12/21/2021|25.31686|12/21/2021|||ANTIPSYCHOTICS|14125|||||No|No||OTSUKA AMERICA|No||||
aripiprazole|No|No|No|No|75%|59148001871|ABILIFY MAINTENA ER 300 MG VL|1|EA|823.4285|04/09/2013||Yes|No||04/09/2013||Yes|No|04/09/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|1834.87198|02/01/2022|1790.83505|02/01/2022|1802.76172|02/01/2022|||ANTIPSYCHOTICS|14126|||||No|Yes|12.56|OTSUKA AMERICA|No||||
aripiprazole|No|No|No|No|75%|59148001971|ABILIFY MAINTENA ER 400 MG VL|1|EA|1097.9061|04/09/2013||Yes|No||04/09/2013||Yes|No|04/09/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|2445.83688|02/01/2022|2387.13679|02/01/2022|2403.03473|02/01/2022|||ANTIPSYCHOTICS|14127|||||No|Yes|12.56|OTSUKA AMERICA|No||||
tolvaptan|No|No|No|No|75%|59148002050|SAMSCA 15 MG TABLET|10|EA|209.81512|09/01/2009||Yes|No||09/01/2009||Yes|No|09/01/2009||Yes|No||||No|No|||Prescription required|No|||No|509.79306|01/19/2021|502.5103|01/19/2021|478.58124|01/19/2021||||14128|||||No|No||OTSUKA AMERICA|No||||
tolvaptan|No|No|No|No|75%|59148002150|SAMSCA 30 MG TABLET|10|EA|232.04649|09/01/2009||Yes|No||09/01/2009||Yes|No|09/01/2009||Yes|No||||No|No|||Prescription required|No|||No|528.85014|01/19/2021|521.29513|01/19/2021|496.47156|01/19/2021||||14129|||||No|No||OTSUKA AMERICA|No||||
brexpiprazole|No|No|No|No|75%|59148003513|REXULTI 0.25 MG TABLET|30|EA|19.09816|07/30/2015||Yes|No||07/30/2015||Yes|No|07/30/2015||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|027|Yes|42.64526|02/01/2022|41.62177|02/01/2022|41.89896|02/01/2022|||ANTIPSYCHOTICS|14130|||||No|No||OTSUKA AMERICA|No||||
brexpiprazole|No|No|No|No|75%|59148003613|REXULTI 0.5 MG TABLET|30|EA|19.09816|07/30/2015||Yes|No||07/30/2015||Yes|No|07/30/2015||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|027|Yes|42.54773|02/01/2022|41.52658|02/01/2022|41.80314|02/01/2022|||ANTIPSYCHOTICS|14131|||||No|No||OTSUKA AMERICA|No||||
brexpiprazole|No|No|No|No|75%|59148003713|REXULTI 1 MG TABLET|30|EA|19.09816|07/30/2015||Yes|No||07/30/2015||Yes|No|07/30/2015||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|027|Yes|42.58577|02/01/2022|41.56371|02/01/2022|41.84051|02/01/2022|||ANTIPSYCHOTICS|14132|||||No|No||OTSUKA AMERICA|No||||
brexpiprazole|No|No|No|No|75%|59148003813|REXULTI 2 MG TABLET|30|EA|19.09816|07/30/2015||Yes|No||07/30/2015||Yes|No|07/30/2015||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|027|Yes|42.6404|02/01/2022|41.61703|02/01/2022|41.89419|02/01/2022|||ANTIPSYCHOTICS|14133|||||No|No||OTSUKA AMERICA|No||||
brexpiprazole|No|No|No|No|75%|59148003913|REXULTI 3 MG TABLET|30|EA|19.09816|07/30/2015||Yes|No||07/30/2015||Yes|No|07/30/2015||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|027|Yes|42.61812|02/01/2022|41.59528|02/01/2022|41.8723|02/01/2022|||ANTIPSYCHOTICS|14134|||||No|No||OTSUKA AMERICA|No||||
brexpiprazole|No|No|No|No|75%|59148004013|REXULTI 4 MG TABLET|30|EA|19.09816|07/30/2015||Yes|No||07/30/2015||Yes|No|07/30/2015||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|027|Yes|42.53577|02/01/2022|41.51491|02/01/2022|41.79139|02/01/2022|||ANTIPSYCHOTICS|14135|||||No|No||OTSUKA AMERICA|No||||
aripiprazole|No|No|No|No|75%|59148004580|ABILIFY MAINTENA ER 300 MG SYR|1|EA|823.4285|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|1827.31252|02/01/2022|1783.45701|02/01/2022|1795.33455|02/01/2022|||ANTIPSYCHOTICS|14136|||||No|Yes|12.56|OTSUKA AMERICA|No||||
aripiprazole|No|No|No|No|75%|59148007280|ABILIFY MAINTENA ER 400 MG SYR|1|EA|1097.9061|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|2438.53237|02/01/2022|2380.00759|02/01/2022|2395.85805|02/01/2022|||ANTIPSYCHOTICS|14137|||||No|Yes|12.56|OTSUKA AMERICA|No||||
tolvaptan|No|No|No|No|75%|59148008728|JYNARQUE 45 MG-15 MG TABLET|14|EA|131.9627|08/24/2018||Yes|No||08/24/2018||Yes|No|08/24/2018||Yes|No||||No|No|||Prescription required|No|||No|300.7522|01/25/2022|296.45574|01/25/2022|282.3388|01/25/2022||||14138|||||No|No||OTSUKA AMERICA|No||||
tolvaptan|No|No|No|No|75%|59148008828|JYNARQUE 60 MG-30 MG TABLET|14|EA|131.9627|08/24/2018||Yes|No||08/24/2018||Yes|No|08/24/2018||Yes|No||||No|No|||Prescription required|No|||No|300.7522|01/25/2022|296.45574|01/25/2022|282.3388|01/25/2022||||14139|||||No|No||OTSUKA AMERICA|No||||
tolvaptan|No|No|No|No|75%|59148008928|JYNARQUE 90 MG-30 MG TABLET|14|EA|131.9627|08/24/2018||Yes|No||08/24/2018||Yes|No|08/24/2018||Yes|No||||No|No|||Prescription required|No|||No|300.7522|01/25/2022|296.45574|01/25/2022|282.3388|01/25/2022||||14140|||||No|No||OTSUKA AMERICA|No||||
fluticasone propion/salmeterol|No|No|No|No|75%|59310011106|AIRDUO DIGIHALER 55-14 MCG|1|EA|179.9765|04/27/2021||Yes|No||04/27/2021||Yes|No|04/27/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|033|Yes|410.179|01/11/2022|404.3193|01/11/2022|385.066|01/11/2022|||GLUCOCORTICOIDS: INHALED|14141|||||No|No||TEVA SPECIALTY|No||||
fluticasone propionate|No|No|No|No|75%|59310011406|ARMONAIR DIGIHALER 55 MCG|1|EA|107.8053|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|033|Yes|245.6958|01/11/2022|242.18586|01/11/2022|230.6532|01/11/2022|||GLUCOCORTICOIDS: INHALED|14142|||||No|No||TEVA SPECIALTY|No||||
albuterol sulfate|No|No|No|No|75%|59310011720|PROAIR DIGIHALER 90 MCG INHALR|1|EA|66.1598|10/26/2020||Yes|No||10/26/2020||Yes|No|10/26/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|037|No|148.84125|01/18/2022|145.26906|01/18/2022|146.23652|01/18/2022|||BRONCHODILATORS: BETA AGONIST|14143|||||No|No||TEVA SPECIALTY|No||||
fluticasone propion/salmeterol|No|No|No|No|75%|59310012906|AIRDUO DIGIHALER 113-14 MCG|1|EA|179.9765|04/27/2021||Yes|No||04/27/2021||Yes|No|04/27/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|033|Yes|401.92785|01/18/2022|392.28158|01/18/2022|394.89411|01/18/2022|||GLUCOCORTICOIDS: INHALED|14144|||||No|No||TEVA SPECIALTY|No||||
fluticasone propion/salmeterol|No|No|No|No|75%|59310013606|AIRDUO DIGIHALER 232-14 MCG|1|EA|202.53|04/27/2021||Yes|No||04/27/2021||Yes|No|04/27/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|033|Yes|461.58|01/11/2022|454.986|01/11/2022|433.32|01/11/2022|||GLUCOCORTICOIDS: INHALED|14145|||||No|No||TEVA SPECIALTY|No||||
fluticasone propionate|No|No|No|No|75%|59310020006|ARMONAIR DIGIHALER 113 MCG|1|EA|107.8053|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|033|Yes|245.6958|01/11/2022|242.18586|01/11/2022|230.6532|01/11/2022|||GLUCOCORTICOIDS: INHALED|14146|||||No|No||TEVA SPECIALTY|No||||
beclomethasone dipropionate|No|No|No|No|75%|59310030240|QVAR REDIHALER 40 MCG|10.6|GM|8.10184|02/12/2018||Yes|No||02/12/2018||Yes|No|02/12/2018||Yes|No||||No|No|||Prescription required|Yes|09/18/2020|033|Yes|18.0668|10/26/2021|17.63319|10/26/2021|17.75063|10/26/2021|||GLUCOCORTICOIDS: INHALED|14147|||||No|No||TEVA SPECIALTY|Yes|09/01/2020|||
beclomethasone dipropionate|No|No|No|No|75%|59310030480|QVAR REDIHALER 80 MCG|10.6|GM|10.84776|02/12/2018||Yes|No||02/12/2018||Yes|No|02/12/2018||Yes|No||||No|No|||Prescription required|Yes|09/18/2020|033|Yes|24.16963|10/26/2021|23.58955|10/26/2021|23.74666|10/26/2021|||GLUCOCORTICOIDS: INHALED|14148|||||No|No||TEVA SPECIALTY|Yes|09/01/2020|||
fluticasone propionate|No|No|No|No|75%|59310031106|ARMONAIR DIGIHALER 232 MCG|1|EA|134.8695|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|033|Yes|307.377|01/11/2022|302.9859|01/11/2022|288.558|01/11/2022|||GLUCOCORTICOIDS: INHALED|14149|||||No|No||TEVA SPECIALTY|No||||
beclomethasone dipropionate|No|No|No|No|75%|59310040606|QNASL CHILDREN'S 40 MCG SPRAY|6.8|GM|17.81527|05/03/2019||Yes|No||05/03/2019||Yes|No|05/03/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|019|No|39.8706|01/18/2022|38.9137|01/18/2022|39.17286|01/18/2022|||INTRANASAL RHINITIS AGENTS|14150|||||No|No||TEVA SPECIALTY|No||||
beclomethasone dipropionate|No|No|No|No|75%|59310041012|QNASL 80 MCG NASAL SPRAY|10.6|GM|11.42866|05/03/2019||Yes|No||05/03/2019||Yes|No|05/03/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|019|No|25.4535|01/18/2022|24.84261|01/18/2022|25.00806|01/18/2022|||INTRANASAL RHINITIS AGENTS|14151|||||No|No||TEVA SPECIALTY|No||||
albuterol sulfate|No|No|No|No|75%|59310057922|PROAIR HFA 90 MCG INHALER|8.5|GM|3.70811|07/29/2013||Yes|No||07/29/2013||Yes|No|07/29/2013||Yes|No||||No|No|||Prescription required|No||037|Yes|8.269|01/18/2022|8.07054|01/18/2022|8.12429|01/18/2022|||BRONCHODILATORS: BETA AGONIST|14152|||||No|No||TEVA SPECIALTY|No||||
albuterol sulfate|No|No|No|No|75%|59310058020|PROAIR RESPICLICK 90 MCG INHLR|1|EA|28.4703|08/07/2015||Yes|No||08/07/2015||Yes|No|08/07/2015||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|63.41467|03/29/2022|61.89271|03/29/2022|62.30491|03/29/2022|||BRONCHODILATORS: BETA AGONIST|14153|||||No|No||TEVA SPECIALTY|No||||
copper|Yes|Yes|No|No|75%|59365512801|PARAGARD T 380-A IUD|1|EA|402.91|12/12/2018||Yes|No||||No|No|||No|No||||No|No|06/18/2019||Prescription required|No|||No|918.26|07/06/2021|905.142|07/06/2021|862.04|07/06/2021||||14154|||||Yes|No||COOPERSURGICAL|No||||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|59385001201|BUNAVAIL 2.1-0.3 MG FILM|1|EA|3.1777|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|7.2422|10/01/2020|7.13874|10/01/2020|6.7988|10/01/2020|||OPIATE DEPENDENCE TREATMENTS|14155|||||No|No||BIODELIVERY SCI|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|59385001230|BUNAVAIL 2.1-0.3 MG FILM|30|EA|3.71391|06/29/2015||Yes|No||06/29/2015||Yes|No|06/29/2015||Yes|No||||No|No|||Prescription required|No||145|Yes|8.46426|01/07/2020|8.34334|01/07/2020|7.94604|01/07/2020|||OPIATE DEPENDENCE TREATMENTS|14156|||||No|No||BIODELIVERY SCI|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|59385001401|BUNAVAIL 4.2-0.7 MG FILM|1|EA|3.1777|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|7.2422|10/01/2020|7.13874|10/01/2020|6.7988|10/01/2020|||OPIATE DEPENDENCE TREATMENTS|14157|||||No|No||BIODELIVERY SCI|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|59385001430|BUNAVAIL 4.2-0.7 MG FILM|30|EA|3.71391|06/29/2015||Yes|No||06/29/2015||Yes|No|06/29/2015||Yes|No||||No|No|||Prescription required|No||145|Yes|8.46426|01/26/2021|8.34334|01/26/2021|7.94604|01/26/2021|||OPIATE DEPENDENCE TREATMENTS|14158|||||No|No||BIODELIVERY SCI|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|59385001601|BUNAVAIL 6.3-1 MG FILM|1|EA|6.3554|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|14.4844|10/01/2020|14.27748|10/01/2020|13.5976|10/01/2020|||OPIATE DEPENDENCE TREATMENTS|14159|||||No|No||BIODELIVERY SCI|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|59385001630|BUNAVAIL 6.3-1 MG FILM|30|EA|7.42782|06/29/2015||Yes|No||06/29/2015||Yes|No|06/29/2015||Yes|No||||No|No|||Prescription required|No||145|Yes|16.92852|01/26/2021|16.68668|01/26/2021|15.89208|01/26/2021|||OPIATE DEPENDENCE TREATMENTS|14160|||||No|No||BIODELIVERY SCI|Yes|09/01/2020|||
buprenorphine HCl|No|No|No|No|90%|59385002160|BELBUCA 75 MCG FILM|60|EA|2.75608|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|110|Yes|6.14389|01/04/2022|5.99643|01/04/2022|6.03637|01/04/2022|||ANALGESICS: NARCOTICS LONG|14161|||Drug ReNumbered||No|No||BIODELIVERY SCI|No||||
buprenorphine HCl|No|No|No|No|90%|59385002260|BELBUCA 150 MCG FILM|60|EA|2.75608|01/17/2018||Yes|No||01/17/2018||Yes|No|01/17/2018||Yes|No||||No|No|||Prescription required|Yes|11/02/2017|110|Yes|6.16499|01/04/2022|6.01703|01/04/2022|6.0571|01/04/2022|||ANALGESICS: NARCOTICS LONG|14162|||||No|No||BIODELIVERY SCI|No||||
buprenorphine HCl|No|No|No|No|90%|59385002360|BELBUCA 300 MCG FILM|60|EA|4.32852|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|110|Yes|9.65432|01/04/2022|9.42261|01/04/2022|9.48536|01/04/2022|||ANALGESICS: NARCOTICS LONG|14163|||||No|No||BIODELIVERY SCI|No||||
buprenorphine HCl|No|No|No|No|90%|59385002460|BELBUCA 450 MCG FILM|60|EA|5.88139|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|110|Yes|13.12732|01/04/2022|12.81226|01/04/2022|12.89759|01/04/2022|||ANALGESICS: NARCOTICS LONG|14164|||||No|No||BIODELIVERY SCI|No||||
buprenorphine HCl|No|No|No|No|90%|59385002560|BELBUCA 600 MCG FILM|60|EA|6.27585|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|110|Yes|13.95277|01/04/2022|13.6179|01/04/2022|13.70859|01/04/2022|||ANALGESICS: NARCOTICS LONG|14165|||||No|No||BIODELIVERY SCI|No||||
buprenorphine HCl|No|No|No|No|90%|59385002660|BELBUCA 750 MCG FILM|60|EA|6.59942|01/17/2018||Yes|No||01/17/2018||Yes|No|01/17/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|110|Yes|14.66629|01/04/2022|14.31429|01/04/2022|14.40962|01/04/2022|||ANALGESICS: NARCOTICS LONG|14166|||||No|No||BIODELIVERY SCI|No||||
buprenorphine HCl|No|No|No|No|90%|59385002760|BELBUCA 900 MCG FILM|60|EA|6.79349|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|110|Yes|15.15729|01/04/2022|14.79351|01/04/2022|14.89203|01/04/2022|||ANALGESICS: NARCOTICS LONG|14167|||||No|No||BIODELIVERY SCI|No||||
naldemedine tosylate|No|No|No|No|75%|59385004130|SYMPROIC 0.2 MG TABLET|30|EA|5.95937|08/05/2019||Yes|No||08/05/2019||Yes|No|08/05/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|534|No|13.3051|01/04/2022|12.98577|01/04/2022|13.07226|01/04/2022|||GI MOTILITY: CHRONIC|14168|||||No|No||BIODELIVERY SCI|No||||
lisdexamfetamine dimesylate|No|No|No|No|75%|59417010110|VYVANSE 10 MG CAPSULE|100|EA|5.04149|01/12/2015||Yes|No||01/12/2015||Yes|No|01/12/2015||Yes|No||||No|No|||Prescription required|No||007|Yes|11.22655|01/18/2022|10.95711|01/18/2022|11.03008|01/18/2022|||STIMULANTS AND RELATED AGENTS|14169|||||No|No||SHIRE US INC.|No||||
lisdexamfetamine dimesylate|No|No|No|No|75%|59417010210|VYVANSE 20 MG CAPSULE|100|EA|5.04149|03/20/2008||Yes|No||03/20/2008||Yes|No|03/20/2008||Yes|No||||No|No|||Prescription required|No||007|Yes|11.23942|01/18/2022|10.96967|01/18/2022|11.04273|01/18/2022|||STIMULANTS AND RELATED AGENTS|14170|||||No|No||SHIRE US INC.|No||||
lisdexamfetamine dimesylate|No|No|No|No|75%|59417010310|VYVANSE 30 MG CAPSULE|100|EA|5.04149|11/16/2007||Yes|No||11/16/2007||Yes|No|11/16/2007||Yes|No||||No|No|||Prescription required|No||007|Yes|11.25494|01/18/2022|10.98482|01/18/2022|11.05797|01/18/2022|||STIMULANTS AND RELATED AGENTS|14171|||||No|No||SHIRE US INC.|No||||
lisdexamfetamine dimesylate|No|No|No|No|75%|59417010410|VYVANSE 40 MG CAPSULE|100|EA|5.04149|03/20/2008||Yes|No||03/20/2008||Yes|No|03/20/2008||Yes|No||||No|No|||Prescription required|No||007|Yes|11.24447|01/18/2022|10.9746|01/18/2022|11.04769|01/18/2022|||STIMULANTS AND RELATED AGENTS|14172|||||No|No||SHIRE US INC.|No||||
lisdexamfetamine dimesylate|No|No|No|No|75%|59417010510|VYVANSE 50 MG CAPSULE|100|EA|5.04149|06/12/2008||Yes|No||06/12/2008||Yes|No|06/12/2008||Yes|No||||No|No|||Prescription required|No||007|Yes|11.25475|01/18/2022|10.98463|01/18/2022|11.05779|01/18/2022|||STIMULANTS AND RELATED AGENTS|14173|||||No|No||SHIRE US INC.|No||||
lisdexamfetamine dimesylate|No|No|No|No|75%|59417010610|VYVANSE 60 MG CAPSULE|100|EA|5.04149|03/20/2008||Yes|No||03/20/2008||Yes|No|03/20/2008||Yes|No||||No|No|||Prescription required|No||007|Yes|11.25711|01/18/2022|10.98693|01/18/2022|11.06011|01/18/2022|||STIMULANTS AND RELATED AGENTS|14174|||||No|No||SHIRE US INC.|No||||
lisdexamfetamine dimesylate|No|No|No|No|75%|59417010710|VYVANSE 70 MG CAPSULE|100|EA|5.04149|11/16/2007||Yes|No||11/16/2007||Yes|No|11/16/2007||Yes|No||||No|No|||Prescription required|No||007|Yes|11.24648|01/18/2022|10.97656|01/18/2022|11.04966|01/18/2022|||STIMULANTS AND RELATED AGENTS|14175|||||No|No||SHIRE US INC.|No||||
lisdexamfetamine dimesylate|No|No|No|No|75%|59417011501|VYVANSE 10 MG CHEWABLE TABLET|100|EA|5.04149|05/15/2017||Yes|No||05/15/2017||Yes|No|05/15/2017||Yes|No||||No|No|||Prescription required|No||007|Yes|11.28031|01/18/2022|11.00958|01/18/2022|11.0829|01/18/2022|||STIMULANTS AND RELATED AGENTS|14176|||||No|No||SHIRE US INC.|No||||
lisdexamfetamine dimesylate|No|No|No|No|75%|59417011601|VYVANSE 20 MG CHEWABLE TABLET|100|EA|5.04149|05/15/2017||Yes|No||05/15/2017||Yes|No|05/15/2017||Yes|No||||No|No|||Prescription required|No||007|Yes|11.23054|01/18/2022|10.961|01/18/2022|11.034|01/18/2022|||STIMULANTS AND RELATED AGENTS|14177|||||No|No||SHIRE US INC.|No||||
lisdexamfetamine dimesylate|No|No|No|No|75%|59417011701|VYVANSE 30 MG CHEWABLE TABLET|100|EA|5.04149|05/15/2017||Yes|No||05/15/2017||Yes|No|05/15/2017||Yes|No||||No|No|||Prescription required|No||007|Yes|11.26523|01/18/2022|10.99486|01/18/2022|11.06808|01/18/2022|||STIMULANTS AND RELATED AGENTS|14178|||||No|No||SHIRE US INC.|No||||
lisdexamfetamine dimesylate|No|No|No|No|75%|59417011801|VYVANSE 40 MG CHEWABLE TABLET|100|EA|5.04149|05/15/2017||Yes|No||05/15/2017||Yes|No|05/15/2017||Yes|No||||No|No|||Prescription required|No||007|Yes|11.23416|01/18/2022|10.96454|01/18/2022|11.03756|01/18/2022|||STIMULANTS AND RELATED AGENTS|14179|||||No|No||SHIRE US INC.|No||||
lisdexamfetamine dimesylate|No|No|No|No|75%|59417011901|VYVANSE 50 MG CHEWABLE TABLET|100|EA|5.04149|05/15/2017||Yes|No||05/15/2017||Yes|No|05/15/2017||Yes|No||||No|No|||Prescription required|No||007|Yes|11.23981|01/18/2022|10.97005|01/18/2022|11.04311|01/18/2022|||STIMULANTS AND RELATED AGENTS|14180|||||No|No||SHIRE US INC.|No||||
lisdexamfetamine dimesylate|No|No|No|No|75%|59417012001|VYVANSE 60 MG CHEWABLE TABLET|100|EA|5.04149|05/15/2017||Yes|No||05/15/2017||Yes|No|05/15/2017||Yes|No||||No|No|||Prescription required|No||007|Yes|11.48991|01/11/2022|11.32577|01/11/2022|10.78644|01/11/2022|||STIMULANTS AND RELATED AGENTS|14181|||||No|No||SHIRE US INC.|No||||
colchicine|No|No|No|No|75%|59467031801|MITIGARE 0.6 MG CAPSULE|100|EA|2.71463|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|No||231|No|6.05302|11/23/2021|5.90774|11/23/2021|5.94709|11/23/2021|||ANTIHYPERURICEMICS|14182|||||No|No||HIKMA SPECIALTY|No||||
colchicine|No|No|No|No|75%|59467031810|MITIGARE 0.6 MG CAPSULE|1000|EA|2.71463|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|No||231|No|6.05302|11/23/2021|5.90774|11/23/2021|5.94709|11/23/2021|||ANTIHYPERURICEMICS|14183|||||No|No||HIKMA SPECIALTY|No||||
colchicine|No|No|No|No|75%|59467031830|MITIGARE 0.6 MG CAPSULE|30|EA|2.71459|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|No||231|No|6.05302|11/23/2021|5.90774|11/23/2021|5.94709|11/23/2021|||ANTIHYPERURICEMICS|14184|||||No|No||HIKMA SPECIALTY|No||||
naloxone HCl|No|No|No|No|75%|59467067901|KLOXXADO 8 MG NASAL SPRAY|2|EA|26.875|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|No||145|No|61.25|11/16/2021|60.375|11/16/2021|57.5|11/16/2021|||OPIATE DEPENDENCE TREATMENTS|14185|||||No|No||HIKMA SPECIALTY|Yes|11/16/2021|||
B comp no3/folic/C/biotin/zinc|No|No|No|No|75%|59528031701|NEPHPLEX RX TABLET|100|EA|.16125|||No|No||||No|No|||No|No||12/21/2000||Yes|No|||Over the counter|No|||No|||||||.2856|06/03/2016||14186|||||No|No||NEPHRO-TECH|No||||
B cmplx 4/vit D3/C/folic/zinc|No|No|No|No|75%|59528198801|VITAL-D RX TABLET|100|EA|.16985|||No|No||||No|No|||No|No||12/12/2015||Yes|No|||Over the counter|No|||No|||||||.272|06/07/2016||14187|||||No|No||NEPHRO-TECH|No||||
vit B comp C no.24/iron/folic|No|No|No|No|75%|59528445601|NEPHRON FA TABLET|100|EA|.24295|09/07/2015||Yes|No||||No|No|09/07/2015||Yes|No||09/07/2015||Yes|No|||Over the counter|Yes|07/29/2021|506|No|.5537|08/13/2019|.54579|08/13/2019|.5198|08/13/2019|||IRON: ORAL|14188|||||No|No||NEPHRO-TECH|No||||
thalidomide|No|No|No|No|75%|59572020514|THALOMID 50 MG CAPSULE|28|EA|73.48776|12/11/2006||Yes|No||12/11/2006||Yes|No|12/11/2006||Yes|No||||No|No|||Prescription required|No||173|No|167.48374|06/01/2016|165.09111|06/01/2016|157.22963|06/01/2016|||ONCOLOGY: ORAL - HEMATOLOGIC|14189|||||No|No||CELGENE/BMS|No||||
thalidomide|No|No|No|No|75%|59572020594|THALOMID 50 MG CAPSULE|280|EA|73.48741|07/15/2003||Yes|No||07/15/2003||Yes|No|07/15/2003||Yes|No||||No|No|||Prescription required|No||173|No|167.48294|06/01/2016|165.09032|06/01/2016|157.22888|06/01/2016|||ONCOLOGY: ORAL - HEMATOLOGIC|14190|||||No|No||CELGENE/BMS|No||||
thalidomide|No|No|No|No|75%|59572021015|THALOMID 100 MG CAPSULE|28|EA|119.28537|12/11/2006||Yes|No||12/11/2006||Yes|No|12/11/2006||Yes|No||||No|No|||Prescription required|No||173|No|271.85969|06/01/2016|267.97598|06/01/2016|255.21522|06/01/2016|||ONCOLOGY: ORAL - HEMATOLOGIC|14191|||||No|No||CELGENE/BMS|No||||
thalidomide|No|No|No|No|75%|59572021095|THALOMID 100 MG CAPSULE|140|EA|119.28519|03/20/2003||Yes|No||03/20/2003||Yes|No|03/20/2003||Yes|No||||No|No|||Prescription required|No||173|No|271.85927|06/01/2016|267.97556|06/01/2016|255.21482|06/01/2016|||ONCOLOGY: ORAL - HEMATOLOGIC|14192|||||No|No||CELGENE/BMS|No||||
thalidomide|No|No|No|No|75%|59572021513|THALOMID 150 MG CAPSULE|28|EA|127.54537|07/27/2007||Yes|No||07/27/2007||Yes|No|07/27/2007||Yes|No||||No|No|||Prescription required|No||173|No|290.68479|06/01/2016|286.53215|06/01/2016|272.88776|06/01/2016|||ONCOLOGY: ORAL - HEMATOLOGIC|14193|||||No|No||CELGENE/BMS|No||||
thalidomide|No|No|No|No|75%|59572021593|THALOMID 150 MG CAPSULE|112|EA|127.54537|07/27/2007||Yes|No||07/27/2007||Yes|No|07/27/2007||Yes|No||||No|No|||Prescription required|No||173|No|290.68479|06/01/2016|286.53215|06/01/2016|272.88776|06/01/2016|||ONCOLOGY: ORAL - HEMATOLOGIC|14194|||||No|No||CELGENE/BMS|No||||
thalidomide|No|No|No|No|75%|59572022016|THALOMID 200 MG CAPSULE|28|EA|135.81089|07/22/2008||Yes|No||07/22/2008||Yes|No|07/22/2008||Yes|No||||No|No|||Prescription required|No||173|No|309.52249|06/01/2016|305.10074|06/01/2016|290.57213|06/01/2016|||ONCOLOGY: ORAL - HEMATOLOGIC|14195|||||No|No||CELGENE/BMS|No||||
thalidomide|No|No|No|No|75%|59572022096|THALOMID 200 MG CAPSULE|84|EA|135.81083|03/20/2003||Yes|No||03/20/2003||Yes|No|03/20/2003||Yes|No||||No|No|||Prescription required|No||173|No|309.52237|06/01/2016|305.10062|06/01/2016|290.57202|06/01/2016|||ONCOLOGY: ORAL - HEMATOLOGIC|14196|||||No|No||CELGENE/BMS|No||||
lenalidomide|No|No|No|No|75%|59572040200|REVLIMID 2.5 MG CAPSULE|100|EA|358.2867|12/13/2013||Yes|No||12/13/2013||Yes|No|12/13/2013||Yes|No||||No|No|||Prescription required|No||173|No|816.5604|01/11/2022|804.89525|01/11/2022|766.5669|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14197|||||No|No||CELGENE/BMS|No||||
lenalidomide|No|No|No|No|75%|59572040228|REVLIMID 2.5 MG CAPSULE|28|EA|358.28644|12/13/2013||Yes|No||12/13/2013||Yes|No|12/13/2013||Yes|No||||No|No|||Prescription required|No||173|No|816.55979|01/11/2022|804.89465|01/11/2022|766.56633|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14198|||||No|No||CELGENE/BMS|No||||
lenalidomide|No|No|No|No|75%|59572040500|REVLIMID 5 MG CAPSULE|100|EA|358.2867|02/16/2006||Yes|No||02/16/2006||Yes|No|02/16/2006||Yes|No||||No|No|||Prescription required|No||173|No|816.5604|01/11/2022|804.89525|01/11/2022|766.5669|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14199|||||No|No||CELGENE/BMS|No||||
lenalidomide|No|No|No|No|75%|59572040528|REVLIMID 5 MG CAPSULE|28|EA|358.28644|04/09/2009||Yes|No||04/09/2009||Yes|No|04/09/2009||Yes|No||||No|No|||Prescription required|No||173|No|816.55979|01/11/2022|804.89465|01/11/2022|766.56633|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14200|||||No|No||CELGENE/BMS|No||||
lenalidomide|No|No|No|No|75%|59572041000|REVLIMID 10 MG CAPSULE|100|EA|358.2867|02/16/2006||Yes|No||02/16/2006||Yes|No|02/16/2006||Yes|No||||No|No|||Prescription required|No||173|No|816.5604|01/11/2022|804.89525|01/11/2022|766.5669|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14201|||||No|No||CELGENE/BMS|No||||
lenalidomide|No|No|No|No|75%|59572041028|REVLIMID 10 MG CAPSULE|28|EA|358.28644|04/09/2009||Yes|No||04/09/2009||Yes|No|04/09/2009||Yes|No||||No|No|||Prescription required|No||173|No|816.55979|01/11/2022|804.89465|01/11/2022|766.56633|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14202|||||No|No||CELGENE/BMS|No||||
lenalidomide|No|No|No|No|75%|59572041500|REVLIMID 15 MG CAPSULE|100|EA|358.2867|07/13/2006||Yes|No||07/13/2006||Yes|No|07/13/2006||Yes|No||||No|No|||Prescription required|No||173|No|816.5604|01/11/2022|804.89525|01/11/2022|766.5669|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14203|||||No|No||CELGENE/BMS|No||||
lenalidomide|No|No|No|No|75%|59572041521|REVLIMID 15 MG CAPSULE|21|EA|358.28684|07/13/2006||Yes|No||07/13/2006||Yes|No|07/13/2006||Yes|No||||No|No|||Prescription required|No||173|No|816.56072|01/11/2022|804.89557|01/11/2022|766.56721|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14204|||||No|No||CELGENE/BMS|No||||
lenalidomide|No|No|No|No|75%|59572042000|REVLIMID 20 MG CAPSULE|100|EA|358.2867|12/13/2013||Yes|No||12/13/2013||Yes|No|12/13/2013||Yes|No||||No|No|||Prescription required|No||173|No|816.5604|01/11/2022|804.89525|01/11/2022|766.5669|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14205|||||No|No||CELGENE/BMS|No||||
lenalidomide|No|No|No|No|75%|59572042021|REVLIMID 20 MG CAPSULE|21|EA|358.28684|12/13/2013||Yes|No||12/13/2013||Yes|No|12/13/2013||Yes|No||||No|No|||Prescription required|No||173|No|816.56072|01/11/2022|804.89557|01/11/2022|766.56721|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14206|||||No|No||CELGENE/BMS|No||||
lenalidomide|No|No|No|No|75%|59572042500|REVLIMID 25 MG CAPSULE|100|EA|358.2867|07/13/2006||Yes|No||07/13/2006||Yes|No|07/13/2006||Yes|No||||No|No|||Prescription required|No||173|No|816.5604|01/11/2022|804.89525|01/11/2022|766.5669|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14207|||||No|No||CELGENE/BMS|No||||
lenalidomide|No|No|No|No|75%|59572042521|REVLIMID 25 MG CAPSULE|21|EA|358.28684|04/09/2009||Yes|No||04/09/2009||Yes|No|04/09/2009||Yes|No||||No|No|||Prescription required|No||173|No|816.56072|01/11/2022|804.89557|01/11/2022|766.56721|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14208|||||No|No||CELGENE/BMS|No||||
pomalidomide|No|No|No|No|75%|59572050100|POMALYST 1 MG CAPSULE|100|EA|407.83393|07/31/2013||Yes|No||07/31/2013||Yes|No|07/31/2013||Yes|No||||No|No|||Prescription required|No||173|No|929.48198|01/11/2022|916.20366|01/11/2022|872.57492|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14209|||||No|No||CELGENE/BMS|No||||
pomalidomide|No|No|No|No|75%|59572050121|POMALYST 1 MG CAPSULE|21|EA|407.83411|07/31/2013||Yes|No||07/31/2013||Yes|No|07/31/2013||Yes|No||||No|No|||Prescription required|No||173|No|929.48239|01/11/2022|916.20407|01/11/2022|872.5753|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14210|||||No|No||CELGENE/BMS|No||||
pomalidomide|No|No|No|No|75%|59572050200|POMALYST 2 MG CAPSULE|100|EA|407.83393|07/31/2013||Yes|No||07/31/2013||Yes|No|07/31/2013||Yes|No||||No|No|||Prescription required|No||173|No|929.48198|01/11/2022|916.20366|01/11/2022|872.57492|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14211|||||No|No||CELGENE/BMS|No||||
pomalidomide|No|No|No|No|75%|59572050221|POMALYST 2 MG CAPSULE|21|EA|407.83411|07/31/2013||Yes|No||07/31/2013||Yes|No|07/31/2013||Yes|No||||No|No|||Prescription required|No||173|No|929.48239|01/11/2022|916.20407|01/11/2022|872.5753|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14212|||||No|No||CELGENE/BMS|No||||
pomalidomide|No|No|No|No|75%|59572050300|POMALYST 3 MG CAPSULE|100|EA|407.83393|07/31/2013||Yes|No||07/31/2013||Yes|No|07/31/2013||Yes|No||||No|No|||Prescription required|No||173|No|929.48198|01/11/2022|916.20366|01/11/2022|872.57492|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14213|||||No|No||CELGENE/BMS|No||||
pomalidomide|No|No|No|No|75%|59572050321|POMALYST 3 MG CAPSULE|21|EA|407.83411|07/31/2013||Yes|No||07/31/2013||Yes|No|07/31/2013||Yes|No||||No|No|||Prescription required|No||173|No|929.48239|01/11/2022|916.20407|01/11/2022|872.5753|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14214|||||No|No||CELGENE/BMS|No||||
pomalidomide|No|No|No|No|75%|59572050400|POMALYST 4 MG CAPSULE|100|EA|407.83393|07/31/2013||Yes|No||07/31/2013||Yes|No|07/31/2013||Yes|No||||No|No|||Prescription required|No||173|No|929.48198|01/11/2022|916.20366|01/11/2022|872.57492|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14215|||||No|No||CELGENE/BMS|No||||
pomalidomide|No|No|No|No|75%|59572050421|POMALYST 4 MG CAPSULE|21|EA|407.83411|07/31/2013||Yes|No||07/31/2013||Yes|No|07/31/2013||Yes|No||||No|No|||Prescription required|No||173|No|929.48239|01/11/2022|916.20407|01/11/2022|872.5753|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14216|||||No|No||CELGENE/BMS|No||||
apremilast|No|No|No|No|75%|59572063106|OTEZLA 30 MG TABLET|60|EA|30.40358|04/09/2014|10/31/2022|Yes|No||04/09/2014|10/31/2022|Yes|No|04/09/2014|10/31/2022|Yes|No||||No|No|||Prescription required|No||071|Yes|68.61084|02/08/2022|66.96417|02/08/2022|67.41015|02/08/2022|||CYTOKINE AND CAM ANTAGONISTS|14217|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||CELGENE/AMGEN|No||||
apremilast|No|No|No|No|75%|59572063255|OTEZLA 28 DAY STARTER PACK|55|EA|33.16753|02/18/2015|08/31/2022|Yes|No||02/18/2015|08/31/2022|Yes|No|02/18/2015|08/31/2022|Yes|No||||No|No|||Prescription required|No||071|Yes|75.59113|02/01/2022|74.51126|02/01/2022|70.9631|02/01/2022|||CYTOKINE AND CAM ANTAGONISTS|14218|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||CELGENE/AMGEN|No||||
enasidenib mesylate|No|No|No|No|75%|59572070530|IDHIFA 50 MG TABLET|30|EA|423.07771|04/03/2019||Yes|No||04/03/2019||Yes|No|04/03/2019||Yes|No||||No|No|||Prescription required|No||173|No|964.22362|01/11/2022|950.449|01/11/2022|905.18952|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14219|||||No|No||CELGENE/BMS|No||||
enasidenib mesylate|No|No|No|No|75%|59572071030|IDHIFA 100 MG TABLET|30|EA|423.07771|04/03/2019||Yes|No||04/03/2019||Yes|No|04/03/2019||Yes|No||||No|No|||Prescription required|No||173|No|964.22362|01/11/2022|950.449|01/11/2022|905.18952|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14220|||||No|No||CELGENE/BMS|No||||
fedratinib dihydrochloride|No|No|No|No|75%|59572072012|INREBIC 100 MG CAPSULE|120|EA|82.17489|12/02/2019||Yes|No||12/02/2019||Yes|No|12/02/2019||Yes|No||||No|No|||Prescription required|No||173|No|187.28232|01/11/2022|184.60686|01/11/2022|175.81605|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14221|||||No|No||CELGENE/BMS|No||||
azacitidine|No|No|No|No|75%|59572073007|ONUREG 200 MG TABLET|7|EA|679.10022|07/07/2021||Yes|No||07/07/2021||Yes|No|07/07/2021||Yes|No||||No|No|||Prescription required|No||173|No|1547.71679|01/11/2022|1525.60655|01/11/2022|1452.95862|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14222|||||No|No||CELGENE/BMS|No||||
azacitidine|No|No|No|No|75%|59572073014|ONUREG 200 MG TABLET|14|EA|649.85623|02/24/2021|08/31/2022|Yes|No||02/24/2021|08/31/2022|Yes|No|02/24/2021|08/31/2022|Yes|No||||No|No|||Prescription required|No||173|No|1481.06769|02/24/2021|1459.90958|02/24/2021|1390.39008|02/24/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|14223|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||CELGENE/BMS|No||||
azacitidine|No|No|No|No|75%|59572074007|ONUREG 300 MG TABLET|7|EA|679.10022|07/07/2021||Yes|No||07/07/2021||Yes|No|07/07/2021||Yes|No||||No|No|||Prescription required|No||173|No|1547.71679|01/11/2022|1525.60655|01/11/2022|1452.95862|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14224|||||No|No||CELGENE/BMS|No||||
azacitidine|No|No|No|No|75%|59572074014|ONUREG 300 MG TABLET|14|EA|649.85623|02/24/2021|08/31/2022|Yes|No||02/24/2021|08/31/2022|Yes|No|02/24/2021|08/31/2022|Yes|No||||No|No|||Prescription required|No||173|No|1481.06769|02/24/2021|1459.90958|02/24/2021|1390.39008|02/24/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|14225|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||CELGENE/BMS|No||||
ozanimod hydrochloride|No|No|No|No|75%|59572081007|ZEPOSIA 0.23-0.46 MG START PCK|7|EA|110.639|11/16/2020||Yes|No||11/16/2020||Yes|No|11/16/2020||Yes|No||||No|No|||Prescription required|No||043|No|252.154|01/11/2022|248.5518|01/11/2022|236.716|01/11/2022|||MULTIPLE SCLEROSIS AGENTS|14226|||||No|No||CELGENE/BMS|No||||
ozanimod hydrochloride|No|No|No|No|75%|59572082030|ZEPOSIA 0.92 MG CAPSULE|30|EA|110.63857|11/16/2020||Yes|No||11/16/2020||Yes|No|11/16/2020||Yes|No||||No|No|||Prescription required|No||043|No|252.15302|01/11/2022|248.55083|01/11/2022|236.71508|01/11/2022|||MULTIPLE SCLEROSIS AGENTS|14227|||||No|No||CELGENE/BMS|No||||
ozanimod hydrochloride|No|No|No|No|75%|59572089091|ZEPOSIA 0.23-0.46-0.92 MG KIT|37|EA|110.63864|11/16/2020||Yes|No||11/16/2020||Yes|No|11/16/2020||Yes|No||||No|No|||Prescription required|No||043|No|252.15319|01/11/2022|248.551|01/11/2022|236.71524|01/11/2022|||MULTIPLE SCLEROSIS AGENTS|14228|||||No|No||CELGENE/BMS|No||||
gr pol-orc/sw ver/rye/Kent/tim|No|No|No|No|75%|59617001502|ORALAIR 300 IR SUBLINGUAL TAB|30|EA|6.27269|05/28/2015||Yes|No||05/28/2015||Yes|No|05/28/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|547|Yes|14.2959|04/24/2018|14.09167|04/24/2018|13.42064|04/24/2018|||ANTI-ALLERGENS: ORAL|14229|||||No|No||GREER LABORATOR|No||||
interferon beta-1a|No|No|No|No|75%|59627022205|AVONEX PREFILLED SYR 30 MCG KT|1|EA|3191.331|08/03/2015||Yes|No||08/03/2015||Yes|No|08/03/2015||Yes|No||||No|No|||Prescription required|No||043|No|7236.16959|01/11/2022|7062.50151|01/11/2022|7109.53662|01/11/2022|||MULTIPLE SCLEROSIS AGENTS|14230|||||No|No||BIOGEN-IDEC|No||||
interferon beta-1a|No|No|No|No|75%|59627033304|AVONEX PEN 30 MCG/0.5 ML KIT|1|EA|3191.331|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||043|No|7205.25119|01/11/2022|7032.32516|01/11/2022|7079.15929|01/11/2022|||MULTIPLE SCLEROSIS AGENTS|14231|||||No|No||BIOGEN-IDEC|No||||
lusutrombopag|No|No|No|No|75%|59630055107|MULPLETA 3 MG TABLET|7|EA|522.14285|03/11/2019||Yes|No||03/11/2019||Yes|No|03/11/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|235|No|1189.99999|03/11/2019|1172.99999|03/11/2019|1117.14285|03/11/2019|||THROMBOPOIESIS STIMULATING PROTEINS|14232|||||No|No||SHIONOGI PHARMA|No||||
methylphenidate HCl|No|No|No|No|75%|59630075050|METHYLIN 5 MG/5 ML SOLUTION|500|ML|.0602|08/26/2009||Yes|No||08/26/2009||Yes|No|08/26/2009||Yes|No||||No|No|||Prescription required|No||007|Yes|.1372|10/26/2021|.13524|10/26/2021|.1288|10/26/2021|||STIMULANTS AND RELATED AGENTS|14233|||||No|No||SHIONOGI PHARMA|No||||
methylphenidate HCl|No|No|No|No|75%|59630075550|METHYLIN 10 MG/5 ML SOLUTION|500|ML|.086|11/30/2009||Yes|No||11/30/2009||Yes|No|11/30/2009||Yes|No||||No|No|||Prescription required|No||007|Yes|.196|06/25/2019|.1932|06/25/2019|.184|06/25/2019|||STIMULANTS AND RELATED AGENTS|14234|||||No|No||SHIONOGI PHARMA|No||||
omeprazole|No|No|No|No|75%|59651000101|OMEPRAZOLE DR 10 MG CAPSULE|100|EA|.03977|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|No||047|Yes|.09084|03/29/2022|.08865|03/29/2022|.08925|03/29/2022|||PROTON PUMP INHIBITORS|14235|||||No|No||AUROBINDO PHARM|No||||
omeprazole|No|No|No|No|75%|59651000130|OMEPRAZOLE DR 10 MG CAPSULE|30|EA|.0774|09/30/2019||Yes|No||09/30/2019||Yes|No|09/30/2019||Yes|No||||No|No|||Prescription required|No||047|Yes|.09084|03/29/2022|.08865|03/29/2022|.08925|03/29/2022|||PROTON PUMP INHIBITORS|14236|||||No|No||AUROBINDO PHARM|No||||
omeprazole|No|No|No|No|75%|59651000205|OMEPRAZOLE DR 20 MG CAPSULE|500|EA|.03435|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|14237|||||No|No||AUROBINDO PHARM|No||||
omeprazole|No|No|No|No|75%|59651000290|OMEPRAZOLE DR 20 MG CAPSULE|90|EA|.0602|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|14238|||||No|No||AUROBINDO PHARM|No||||
omeprazole|No|No|No|No|75%|59651000305|OMEPRAZOLE DR 40 MG CAPSULE|500|EA|.03573|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|14239|||||No|No||AUROBINDO PHARM|No||||
omeprazole|No|No|No|No|75%|59651000330|OMEPRAZOLE DR 40 MG CAPSULE|30|EA|.0688|04/02/2019||Yes|No||04/02/2019||Yes|No|04/02/2019||Yes|No||||No|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|14240|||||No|No||AUROBINDO PHARM|No||||
azithromycin|No|No|No|No|75%|59651000715|AZITHROMYCIN 100 MG/5 ML SUSP|15|ML|.43|06/26/2020||Yes|No||06/26/2020||Yes|No|06/26/2020||Yes|No||||No|No|||Prescription required|No||018|No|.56328|03/29/2022|.54976|03/29/2022|.55342|03/29/2022|||MACROLIDES/KETOLIDES|14241|||||No|No||AUROBINDO PHARM|No||||
azithromycin|No|No|No|No|75%|59651000815|AZITHROMYCIN 200 MG/5 ML SUSP|15|ML|.37266|06/26/2020||Yes|No||06/26/2020||Yes|No|06/26/2020||Yes|No||||No|No|||Prescription required|No||018|No|.46232|03/29/2022|.45122|03/29/2022|.45422|03/29/2022|||MACROLIDES/KETOLIDES|14242|||||No|No||AUROBINDO PHARM|No||||
azithromycin|No|No|No|No|75%|59651000823|AZITHROMYCIN 200 MG/5 ML SUSP|22.5|ML|.26755|06/26/2020||Yes|No||06/26/2020||Yes|No|06/26/2020||Yes|No||||No|No|||Prescription required|No||018|No|.35562|03/29/2022|.34708|03/29/2022|.34939|03/29/2022|||MACROLIDES/KETOLIDES|14243|||||No|No||AUROBINDO PHARM|No||||
azithromycin|No|No|No|No|75%|59651000830|AZITHROMYCIN 200 MG/5 ML SUSP|30|ML|.215|06/26/2020||Yes|No||06/26/2020||Yes|No|06/26/2020||Yes|No||||No|No|||Prescription required|No||018|No|.28375|03/29/2022|.27694|03/29/2022|.27878|03/29/2022|||MACROLIDES/KETOLIDES|14244|||||No|No||AUROBINDO PHARM|No||||
niacin|No|No|No|No|75%|59651001890|NIACIN ER 500 MG TABLET|90|EA|.15288|10/19/2020||Yes|No||10/19/2020||Yes|No|10/19/2020||Yes|No||||No|No|||Prescription required|Yes|03/22/2018|055|Yes|.21332|03/29/2022|.2082|03/29/2022|.20958|03/29/2022|||LIPOTROPICS: OTHER|14245|||||No|No||AUROBINDO PHARM|No||||
niacin|No|No|No|No|75%|59651001990|NIACIN ER 750 MG TABLET|90|EA|.43|10/19/2020||Yes|No||10/19/2020||Yes|No|10/19/2020||Yes|No||||No|No|||Prescription required|Yes|03/22/2018|055|No|.52604|03/29/2022|.51341|03/29/2022|.51683|03/29/2022|||LIPOTROPICS: OTHER|14246|||||No|No||AUROBINDO PHARM|No||||
niacin|No|No|No|No|75%|59651002090|NIACIN ER 1,000 MG TABLET|90|EA|.23888|10/19/2020||Yes|No||10/19/2020||Yes|No|10/19/2020||Yes|No||||No|No|||Prescription required|Yes|03/22/2018|055|No|.4737|03/29/2022|.46233|03/29/2022|.46541|03/29/2022|||LIPOTROPICS: OTHER|14247|||||No|No||AUROBINDO PHARM|No||||
amoxicillin/potassium clav|No|No|No|No|75%|59651002601|AMOX-CLAV 250-62.5 MG/5 ML SUS|100|ML|.2973|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No||046|No|.4214|03/29/2022|.41128|03/29/2022|.41402|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|14248|||||No|No||AUROBINDO PHARM|No||||
amoxicillin/potassium clav|No|No|No|No|75%|59651002655|AMOX-CLAV 250-62.5 MG/5 ML SUS|150|ML|.29125|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No||046|No|.40714|03/29/2022|.39736|03/29/2022|.40001|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|14249|||||No|No||AUROBINDO PHARM|No||||
amoxicillin/potassium clav|No|No|No|No|75%|59651002675|AMOX-CLAV 250-62.5 MG/5 ML SUS|75|ML|.29687|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No||046|No|.39696|03/29/2022|.38743|03/29/2022|.39001|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|14250|||||No|No||AUROBINDO PHARM|No||||
ethinyl estradiol/drospirenone|Yes|Yes|No|No|75%|59651002988|LO-ZUMANDIMINE 3 MG-0.02 MG TB|28|EA|.28994|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No|Refer to program requirements|||No|No|01/15/2020||Prescription required|No|||No|.36582|03/29/2022|.35704|03/29/2022|.35941|03/29/2022||||14251|||||No|No||AUROBINDO PHARM|No|||Only covered for non-contraceptive (medical) purposes|
ethinyl estradiol/drospirenone|Yes|Yes|No|No|75%|59651003085|ZUMANDIMINE 3 MG-0.03 MG TAB|28|EA|.18981|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No|Refer to program requirements|||No|No|03/20/2020||Prescription required|No|||No|.2455|03/29/2022|.2396|03/29/2022|.2412|03/29/2022||||14252|||||No|No||AUROBINDO PHARM|No|||Only covered for non-contraceptive (medical) purposes|
ibuprofen|No|No|No|No|75%|59651003212|IBUPROFEN 100 MG/5 ML SUSP|120|ML|.0269|08/27/2018||Yes|No||08/27/2018||Yes|No|08/27/2018||Yes|No||||No|No|||Prescription required|No||059|Yes|.03892|03/29/2022|.03798|03/29/2022|.03823|03/29/2022|||NSAIDS|14253|||||No|No||AUROBINDO PHARM|No||||
ibuprofen|No|No|No|No|75%|59651003247|IBUPROFEN 100 MG/5 ML SUSP|473|ML|.02288|03/07/2019||Yes|No||03/07/2019||Yes|No|03/07/2019||Yes|No||||No|No|||Prescription required|No||059|Yes|.03005|03/29/2022|.02932|03/29/2022|.02952|03/29/2022|||NSAIDS|14254|||||No|No||AUROBINDO PHARM|No||||
armodafinil|No|No|No|No|90%|59651004730|ARMODAFINIL 200 MG TABLET|30|EA|.47013|11/16/2016||Yes|No||11/16/2016||Yes|No|11/16/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.63792|03/29/2022|.6226|03/29/2022|.62675|03/29/2022|||STIMULANTS AND RELATED AGENTS|14255|||||No|No||AUROBINDO PHARM|No||||
ezetimibe|No|No|No|No|75%|59651005205|EZETIMIBE 10 MG TABLET|500|EA|.07735|11/22/2021||Yes|No||11/22/2021||Yes|No|11/22/2021||Yes|No||||No|No|||Prescription required|Yes|10/19/2017|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|14256|||||No|No||AUROBINDO PHARM|No||||
ezetimibe|No|No|No|No|75%|59651005230|EZETIMIBE 10 MG TABLET|30|EA|.12183|01/25/2018||Yes|No||01/25/2018||Yes|No|01/25/2018||Yes|No||||No|No|||Prescription required|Yes|10/19/2017|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|14257|||||No|No||AUROBINDO PHARM|No||||
ezetimibe|No|No|No|No|75%|59651005290|EZETIMIBE 10 MG TABLET|90|EA|.11705|01/25/2018||Yes|No||01/25/2018||Yes|No|01/25/2018||Yes|No||||No|No|||Prescription required|Yes|10/19/2017|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|14258|||||No|No||AUROBINDO PHARM|No||||
olopatadine HCl|No|No|No|No|75%|59651006605|OLOPATADINE HCL 0.2% EYE DROP|2.5|ML|4.62852|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|002|No|9.7075|01/25/2022|9.47452|01/25/2022|9.53761|01/25/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|14259|||||No|No||AUROBINDO PHARM|No||||
silodosin|No|No|No|No|75%|59651009530|SILODOSIN 4 MG CAPSULE|30|EA|.43|08/17/2020||Yes|No||08/17/2020||Yes|No|08/17/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|003|No|.60384|03/29/2022|.58934|03/29/2022|.59327|03/29/2022|||BPH TREATMENTS|14260|||||No|No||AUROBINDO PHARM|No||||
silodosin|No|No|No|No|75%|59651009630|SILODOSIN 8 MG CAPSULE|30|EA|.43|08/17/2020||Yes|No||08/17/2020||Yes|No|08/17/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|003|No|.68368|03/29/2022|.66727|03/29/2022|.67171|03/29/2022|||BPH TREATMENTS|14261|||||No|No||AUROBINDO PHARM|No||||
silodosin|No|No|No|No|75%|59651009690|SILODOSIN 8 MG CAPSULE|90|EA|.43|08/17/2020||Yes|No||08/17/2020||Yes|No|08/17/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|003|No|.68368|03/29/2022|.66727|03/29/2022|.67171|03/29/2022|||BPH TREATMENTS|14262|||||No|No||AUROBINDO PHARM|No||||
eletriptan hydrobromide|No|No|No|No|75%|59651010469|ELETRIPTAN HBR 20 MG TABLET|6|EA|5.1385|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|021|No|6.78979|03/29/2022|6.62683|03/29/2022|6.67096|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|14263|||||No|No||AUROBINDO PHARM|No||||
eletriptan hydrobromide|No|No|No|No|75%|59651010569|ELETRIPTAN HBR 40 MG TABLET|6|EA|5.1385|08/30/2019||Yes|No||08/30/2019||Yes|No|08/30/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|021|No|3.20664|03/29/2022|3.12968|03/29/2022|3.15052|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|14264|||||No|No||AUROBINDO PHARM|No||||
aripiprazole|No|No|No|No|75%|59651011055|ARIPIPRAZOLE 1 MG/ML SOLUTION|150|ML|1.032|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|1.07614|03/29/2022|1.05031|03/29/2022|1.0573|03/29/2022|||ANTIPSYCHOTICS|14265|||||No|No||AUROBINDO PHARM|No||||
dofetilide|No|No|No|No|75%|59651011860|DOFETILIDE 125 MCG CAPSULE|60|EA|.688|09/04/2019||Yes|No||09/04/2019||Yes|No|09/04/2019||Yes|No||||No|No|||Prescription required|No|||No|1.27252|03/29/2022|1.24197|03/29/2022|1.25025|03/29/2022||||14266|||||No|No||AUROBINDO PHARM|No||||
dofetilide|No|No|No|No|75%|59651011960|DOFETILIDE 250 MCG CAPSULE|60|EA|.688|09/04/2019||Yes|No||09/04/2019||Yes|No|09/04/2019||Yes|No||||No|No|||Prescription required|No|||No|.89477|03/29/2022|.87329|03/29/2022|.87911|03/29/2022||||14267|||||No|No||AUROBINDO PHARM|No||||
dofetilide|No|No|No|No|75%|59651012060|DOFETILIDE 500 MCG CAPSULE|60|EA|.688|09/04/2019||Yes|No||09/04/2019||Yes|No|09/04/2019||Yes|No||||No|No|||Prescription required|No|||No|.90796|03/29/2022|.88616|03/29/2022|.89207|03/29/2022||||14268|||||No|No||AUROBINDO PHARM|No||||
nebivolol HCl|No|No|No|No|75%|59651013730|NEBIVOLOL 2.5 MG TABLET|30|EA|.09961|03/24/2022||Yes|No||03/24/2022||Yes|No|03/24/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.41918|03/29/2022|.40911|03/29/2022|.41184|03/29/2022|||BETA-BLOCKERS|14269|||||No|No||AUROBINDO PHARM|No||||
nebivolol HCl|No|No|No|No|75%|59651013830|NEBIVOLOL 5 MG TABLET|30|EA|.09961|03/24/2022||Yes|No||03/24/2022||Yes|No|03/24/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.46205|03/29/2022|.45096|03/29/2022|.45396|03/29/2022|||BETA-BLOCKERS|14270|||||No|No||AUROBINDO PHARM|No||||
nebivolol HCl|No|No|No|No|75%|59651013890|NEBIVOLOL 5 MG TABLET|90|EA|.09531|03/24/2022||Yes|No||03/24/2022||Yes|No|03/24/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.46205|03/29/2022|.45096|03/29/2022|.45396|03/29/2022|||BETA-BLOCKERS|14271|||||No|No||AUROBINDO PHARM|No||||
nebivolol HCl|No|No|No|No|75%|59651013930|NEBIVOLOL 10 MG TABLET|30|EA|.09961|03/24/2022||Yes|No||03/24/2022||Yes|No|03/24/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.40408|03/29/2022|.39438|03/29/2022|.397|03/29/2022|||BETA-BLOCKERS|14272|||||No|No||AUROBINDO PHARM|No||||
nebivolol HCl|No|No|No|No|75%|59651013990|NEBIVOLOL 10 MG TABLET|90|EA|.09531|03/24/2022||Yes|No||03/24/2022||Yes|No|03/24/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.40408|03/29/2022|.39438|03/29/2022|.397|03/29/2022|||BETA-BLOCKERS|14273|||||No|No||AUROBINDO PHARM|No||||
nebivolol HCl|No|No|No|No|75%|59651014030|NEBIVOLOL 20 MG TABLET|30|EA|.09961|03/23/2022||Yes|No||03/23/2022||Yes|No|03/23/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.46821|03/29/2022|.45697|03/29/2022|.46001|03/29/2022|||BETA-BLOCKERS|14274|||||No|No||AUROBINDO PHARM|No||||
nebivolol HCl|No|No|No|No|75%|59651014090|NEBIVOLOL 20 MG TABLET|90|EA|.09531|03/23/2022||Yes|No||03/23/2022||Yes|No|03/23/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.46821|03/29/2022|.45697|03/29/2022|.46001|03/29/2022|||BETA-BLOCKERS|14275|||||No|No||AUROBINDO PHARM|No||||
carbidopa|No|No|No|No|75%|59651014601|CARBIDOPA 25 MG TABLET|100|EA|1.18658|06/02/2020||Yes|No||06/02/2020||Yes|No|06/02/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|015|No|1.9005|03/29/2022|1.85488|03/29/2022|1.86724|03/29/2022|||ANTIPARKINSON'S AGENTS|14276|||||No|No||AUROBINDO PHARM|No||||
progesterone, micronized|No|No|No|No|75%|59651015201|PROGESTERONE 100 MG CAPSULE|100|EA|.086|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No|||No|.25967|03/29/2022|.25343|03/29/2022|.25512|03/29/2022||||14277|||||No|No||AUROBINDO PHARM|No||||
progesterone, micronized|No|No|No|No|75%|59651015301|PROGESTERONE 200 MG CAPSULE|100|EA|.1505|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No|||No|.48257|03/29/2022|.47098|03/29/2022|.47412|03/29/2022||||14278|||||No|No||AUROBINDO PHARM|No||||
doxepin HCl|No|No|No|No|75%|59651017301|DOXEPIN 10 MG CAPSULE|100|EA|.11008|05/05/2020||Yes|No||05/05/2020||Yes|No|05/05/2020||Yes|No||||No|No|||Prescription required|No||215|No|.22181|03/29/2022|.21648|03/29/2022|.21792|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|14279|||||No|No||AUROBINDO PHARM|No||||
doxepin HCl|No|No|No|No|75%|59651017401|DOXEPIN 25 MG CAPSULE|100|EA|.1376|05/05/2020||Yes|No||05/05/2020||Yes|No|05/05/2020||Yes|No||||No|No|||Prescription required|No||215|No|.30005|03/29/2022|.29284|03/29/2022|.29479|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|14280|||||No|No||AUROBINDO PHARM|No||||
doxepin HCl|No|No|No|No|75%|59651017501|DOXEPIN 50 MG CAPSULE|100|EA|.2064|05/05/2020||Yes|No||05/05/2020||Yes|No|05/05/2020||Yes|No||||No|No|||Prescription required|No||215|No|.41139|03/29/2022|.40151|03/29/2022|.40419|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|14281|||||No|No||AUROBINDO PHARM|No||||
doxepin HCl|No|No|No|No|75%|59651017601|DOXEPIN 75 MG CAPSULE|100|EA|.31648|05/05/2020||Yes|No||05/05/2020||Yes|No|05/05/2020||Yes|No||||No|No|||Prescription required|No||215|No|.56944|03/29/2022|.55577|03/29/2022|.55947|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|14282|||||No|No||AUROBINDO PHARM|No||||
doxepin HCl|No|No|No|No|75%|59651017701|DOXEPIN 100 MG CAPSULE|100|EA|.344|05/05/2020||Yes|No||05/05/2020||Yes|No|05/05/2020||Yes|No||||No|No|||Prescription required|No||215|No|.67991|03/29/2022|.66359|03/29/2022|.66801|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|14283|||||No|No||AUROBINDO PHARM|No||||
letrozole|No|No|No|No|75%|59651018030|LETROZOLE 2.5 MG TABLET|30|EA|.129|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||502|No|.1337|03/29/2022|.13049|03/29/2022|.13136|03/29/2022|||ONCOLOGY: ORAL - BREAST|14284|||||No|No||AUROBINDO PHARM|No||||
methotrexate sodium|No|No|No|No|75%|59651018201|METHOTREXATE 2.5 MG TABLET|100|EA|.2365|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No|||No|.26817|03/29/2022|.26173|03/29/2022|.26347|03/29/2022||||14285|||||No|No||AUROBINDO PHARM|No||||
capecitabine|No|No|No|No|75%|59651020460|CAPECITABINE 150 MG TABLET|60|EA|.516|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|||Prescription required|No||502|No|1.176|02/21/2020|1.1592|02/21/2020|1.104|02/21/2020|||ONCOLOGY: ORAL - BREAST|14286|||||No|No||AUROBINDO PHARM|No||||
capecitabine|No|No|No|No|75%|59651020508|CAPECITABINE 500 MG TABLET|120|EA|.93166|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|No||502|No|.61977|12/28/2021|.60489|12/28/2021|.60892|12/28/2021|||ONCOLOGY: ORAL - BREAST|14287|||||No|No||AUROBINDO PHARM|No||||
azelastine HCl|No|No|No|No|75%|59651021430|AZELASTINE 0.1% (137 MCG) SPRY|30|ML|.258|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No||019|No|.27761|03/29/2022|.27094|03/29/2022|.27275|03/29/2022|||INTRANASAL RHINITIS AGENTS|14288|||||No|No||AUROBINDO PHARM|No||||
azelastine HCl|No|No|No|No|75%|59651021530|AZELASTINE 0.15% NASAL SPRAY|30|ML|.43|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|019|No|.62364|03/29/2022|.60867|03/29/2022|.61272|03/29/2022|||INTRANASAL RHINITIS AGENTS|14289|||||No|No||AUROBINDO PHARM|No||||
fenofibric acid (choline)|No|No|No|No|75%|59651021690|FENOFIBRIC ACID DR 45 MG CAP|90|EA|.09555|05/26/2020||Yes|No||05/26/2020||Yes|No|05/26/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|055|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||LIPOTROPICS: OTHER|14290|||||No|No||AUROBINDO PHARM|No||||
fenofibric acid (choline)|No|No|No|No|75%|59651021790|FENOFIBRIC ACID DR 135 MG CAP|90|EA|.28666|05/26/2020||Yes|No||05/26/2020||Yes|No|05/26/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|055|No|.69218|03/29/2022|.67556|03/29/2022|.68006|03/29/2022|||LIPOTROPICS: OTHER|14291|||||No|No||AUROBINDO PHARM|No||||
pilocarpine HCl|No|No|No|No|75%|59651022401|PILOCARPINE HCL 5 MG TABLET|100|EA|.215|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||||No|No|||Prescription required|No|||No|.27963|03/29/2022|.27291|03/29/2022|.27473|03/29/2022||||14292|||||No|No||AUROBINDO PHARM|No||||
pilocarpine HCl|No|No|No|No|75%|59651022501|PILOCARPINE HCL 7.5 MG TABLET|100|EA|.387|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No|||No|.89289|03/29/2022|.87146|03/29/2022|.87726|03/29/2022||||14293|||||No|No||AUROBINDO PHARM|No||||
anastrozole|No|No|No|No|75%|59651023630|ANASTROZOLE 1 MG TABLET|30|EA|.215|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|No||502|No|.11251|03/29/2022|.1098|03/29/2022|.11054|03/29/2022|||ONCOLOGY: ORAL - BREAST|14294|||||No|No||AUROBINDO PHARM|No||||
anastrozole|No|No|No|No|75%|59651023690|ANASTROZOLE 1 MG TABLET|90|EA|.215|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|No||502|No|.11251|03/29/2022|.1098|03/29/2022|.11054|03/29/2022|||ONCOLOGY: ORAL - BREAST|14295|||||No|No||AUROBINDO PHARM|No||||
imatinib mesylate|No|No|No|No|75%|59651024090|IMATINIB MESYLATE 100 MG TAB|90|EA|.52555|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|No||173|No|1.19777|07/27/2021|1.18066|07/27/2021|1.12444|07/27/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|14296|||||No|No||AUROBINDO PHARM|No||||
imatinib mesylate|No|No|No|No|75%|59651024130|IMATINIB MESYLATE 400 MG TAB|30|EA|1.86333|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|No||173|No|2.86988|03/01/2022|2.801|03/01/2022|2.81965|03/01/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14297|||||No|No||AUROBINDO PHARM|No||||
midodrine HCl|No|No|No|No|75%|59651024601|MIDODRINE HCL 2.5 MG TABLET|100|EA|.1032|04/23/2021||Yes|No||04/23/2021||Yes|No|04/23/2021||Yes|No||||No|No|||Prescription required|No|||No|.20233|03/29/2022|.19747|03/29/2022|.19878|03/29/2022||||14298|||||No|No||AUROBINDO PHARM|No||||
midodrine HCl|No|No|No|No|75%|59651024701|MIDODRINE HCL 5 MG TABLET|100|EA|.1548|04/23/2021||Yes|No||04/23/2021||Yes|No|04/23/2021||Yes|No||||No|No|||Prescription required|No|||No|.26381|03/29/2022|.25747|03/29/2022|.25919|03/29/2022||||14299|||||No|No||AUROBINDO PHARM|No||||
midodrine HCl|No|No|No|No|75%|59651024801|MIDODRINE HCL 10 MG TABLET|100|EA|.258|04/23/2021||Yes|No||04/23/2021||Yes|No|04/23/2021||Yes|No||||No|No|||Prescription required|No|||No|.40773|03/29/2022|.39794|03/29/2022|.40059|03/29/2022||||14300|||||No|No||AUROBINDO PHARM|No||||
propafenone HCl|No|No|No|No|75%|59651025601|PROPAFENONE HCL 150 MG TABLET|100|EA|.10023|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|No|||No|.14292|03/29/2022|.13948|03/29/2022|.14041|03/29/2022||||14301|||||No|No||AUROBINDO PHARM|No||||
propafenone HCl|No|No|No|No|75%|59651025701|PROPAFENONE HCL 225 MG TAB|100|EA|.16524|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|No|||No|.20774|03/29/2022|.20275|03/29/2022|.2041|03/29/2022||||14302|||||No|No||AUROBINDO PHARM|No||||
propafenone HCl|No|No|No|No|75%|59651025801|PROPAFENONE HCL 300 MG TAB|100|EA|.46384|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|No|||No|.57288|01/25/2022|.55913|01/25/2022|.56285|01/25/2022||||14303|||||No|No||AUROBINDO PHARM|No||||
glipizide|Yes|No|No|No|75%|59651026830|GLIPIZIDE ER 2.5 MG TABLET|30|EA|.09173|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|01/15/2020||Prescription required|No|||Yes|.12809|03/29/2022|.12501|03/29/2022|.12584|03/29/2022||||14304|||||No|No||AUROBINDO PHARM|No||||
glipizide|Yes|No|No|No|75%|59651026901|GLIPIZIDE ER 5 MG TABLET|100|EA|.0565|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|01/15/2020||Prescription required|No|||Yes|.11105|03/29/2022|.10838|03/29/2022|.1091|03/29/2022||||14305|||||No|No||AUROBINDO PHARM|No||||
glipizide|Yes|No|No|No|75%|59651026905|GLIPIZIDE ER 5 MG TABLET|500|EA|.05353|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|01/15/2020||Prescription required|No|||Yes|.11105|03/29/2022|.10838|03/29/2022|.1091|03/29/2022||||14306|||||No|No||AUROBINDO PHARM|No||||
glipizide|Yes|No|No|No|75%|59651027001|GLIPIZIDE ER 10 MG TABLET|100|EA|.10904|06/06/2019||Yes|No||06/06/2019||Yes|No|06/06/2019||Yes|No||||No|No|09/27/2019||Prescription required|No|||No|.184|03/29/2022|.17958|03/29/2022|.18078|03/29/2022||||14307|||||No|No||AUROBINDO PHARM|No||||
glipizide|No|No|No|No|75%|59651027005|GLIPIZIDE ER 10 MG TABLET|500|EA|.08723|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|No|||No|.184|03/29/2022|.17958|03/29/2022|.18078|03/29/2022||||14308|||||No|No||AUROBINDO PHARM|No||||
nifedipine|No|No|No|No|75%|59651029501|NIFEDIPINE ER 30 MG TABLET|100|EA|.172|03/23/2022||Yes|No||03/23/2022||Yes|No|03/23/2022||Yes|No||||No|No|||Prescription required|No||045|Yes|.20358|03/29/2022|.19869|03/29/2022|.20001|03/29/2022|||CALCIUM CHANNEL BLOCKERS|14309|||||No|No||AUROBINDO PHARM|No||||
nifedipine|No|No|No|No|75%|59651029601|NIFEDIPINE ER 60 MG TABLET|100|EA|.1935|03/23/2022||Yes|No||03/23/2022||Yes|No|03/23/2022||Yes|No||||No|No|||Prescription required|No||045|No|.22381|03/29/2022|.21843|03/29/2022|.21989|03/29/2022|||CALCIUM CHANNEL BLOCKERS|14310|||||No|No||AUROBINDO PHARM|No||||
nifedipine|No|No|No|No|75%|59651029701|NIFEDIPINE ER 90 MG TABLET|100|EA|.344|03/23/2022||Yes|No||03/23/2022||Yes|No|03/23/2022||Yes|No||||No|No|||Prescription required|No||045|No|.3781|03/29/2022|.36902|03/29/2022|.37148|03/29/2022|||CALCIUM CHANNEL BLOCKERS|14311|||||No|No||AUROBINDO PHARM|No||||
tamoxifen citrate|No|No|No|No|75%|59651029960|TAMOXIFEN 10 MG TABLET|60|EA|.08191|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|No||502|No|.21342|03/29/2022|.20829|03/29/2022|.20968|03/29/2022|||ONCOLOGY: ORAL - BREAST|14312|||||No|No||AUROBINDO PHARM|No||||
tamoxifen citrate|No|No|No|No|75%|59651030030|TAMOXIFEN 20 MG TABLET|30|EA|.16383|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|No||502|No|.42352|03/29/2022|.41335|03/29/2022|.4161|03/29/2022|||ONCOLOGY: ORAL - BREAST|14313|||||No|No||AUROBINDO PHARM|No||||
chlorzoxazone|No|No|No|No|75%|59651030601|CHLORZOXAZONE 500 MG TABLET|100|EA|.1204|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|116|Yes|.26503|03/29/2022|.25866|03/29/2022|.26039|03/29/2022|||SKELETAL MUSCLE RELAXANTS|14314|||||No|No||AUROBINDO PHARM|No||||
chlorzoxazone|No|No|No|No|75%|59651030605|CHLORZOXAZONE 500 MG TABLET|500|EA|.11438|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|116|Yes|.26503|03/29/2022|.25866|03/29/2022|.26039|03/29/2022|||SKELETAL MUSCLE RELAXANTS|14315|||||No|No||AUROBINDO PHARM|No||||
fluoxetine HCl|No|No|No|No|75%|59651030801|FLUOXETINE HCL 10 MG TABLET|100|EA|.086|11/30/2020||Yes|No||11/30/2020||Yes|No|11/30/2020||Yes|No||||No|No|||Prescription required|No||008|No|.24078|03/29/2022|.235|03/29/2022|.23656|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14316|||||No|No||AUROBINDO PHARM|No||||
fluoxetine HCl|No|No|No|No|75%|59651030830|FLUOXETINE HCL 10 MG TABLET|30|EA|.12183|11/30/2020||Yes|No||11/30/2020||Yes|No|11/30/2020||Yes|No||||No|No|||Prescription required|No||008|No|.24078|03/29/2022|.235|03/29/2022|.23656|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14317|||||No|No||AUROBINDO PHARM|No||||
fluoxetine HCl|No|No|No|No|75%|59651030901|FLUOXETINE HCL 20 MG TABLET|100|EA|.09933|11/30/2020||Yes|No||11/30/2020||Yes|No|11/30/2020||Yes|No||||No|No|||Prescription required|No||008|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14318|||||No|No||AUROBINDO PHARM|No||||
fluoxetine HCl|No|No|No|No|75%|59651030930|FLUOXETINE HCL 20 MG TABLET|30|EA|.1376|11/30/2020||Yes|No||11/30/2020||Yes|No|11/30/2020||Yes|No||||No|No|||Prescription required|No||008|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14319|||||No|No||AUROBINDO PHARM|No||||
tizanidine HCl|No|No|No|No|75%|59651031477|TIZANIDINE HCL 2 MG CAPSULE|150|EA|.086|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|116|No|.0903|03/29/2022|.08813|03/29/2022|.08871|03/29/2022|||SKELETAL MUSCLE RELAXANTS|14320|||||No|No||AUROBINDO PHARM|No||||
tizanidine HCl|No|No|No|No|75%|59651031577|TIZANIDINE HCL 4 MG CAPSULE|150|EA|.11466|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|116|No|.15367|03/29/2022|.14998|03/29/2022|.15098|03/29/2022|||SKELETAL MUSCLE RELAXANTS|14321|||||No|No||AUROBINDO PHARM|No||||
tizanidine HCl|No|No|No|No|75%|59651031677|TIZANIDINE HCL 6 MG CAPSULE|150|EA|.172|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|116|No|.27523|03/29/2022|.26862|03/29/2022|.27041|03/29/2022|||SKELETAL MUSCLE RELAXANTS|14322|||||No|No||AUROBINDO PHARM|No||||
fluoxetine HCl|No|No|No|No|75%|59651032430|FLUOXETINE HCL 60 MG TABLET|30|EA|.41423|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|008|No|1.06507|03/29/2022|1.0395|03/29/2022|1.04643|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14323|||||No|No||AUROBINDO PHARM|No||||
montelukast sodium|No|No|No|No|75%|59651032930|MONTELUKAST SOD 4 MG GRANULES|30|EA|2.94478|11/30/2020||Yes|No||11/30/2020||Yes|No|11/30/2020||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|042|Yes|1.25796|03/29/2022|1.22776|03/29/2022|1.23594|03/29/2022|||LEUKOTRIENE MODIFIERS|14324|||||No|No||AUROBINDO PHARM|No||||
flucytosine|No|No|No|No|75%|59651033101|FLUCYTOSINE 250 MG CAPSULE|100|EA|28.23173|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|069|No|64.34209|02/15/2022|63.42292|02/15/2022|60.40278|02/15/2022|||ANTIFUNGALS: ORAL|14325|||||No|No||AUROBINDO PHARM|No||||
flucytosine|No|No|No|No|75%|59651033201|FLUCYTOSINE 500 MG CAPSULE|100|EA|54.6272|08/20/2021||Yes|No||08/20/2021||Yes|No|08/20/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|069|No|124.4992|08/20/2021|122.72064|08/20/2021|116.8768|08/20/2021|||ANTIFUNGALS: ORAL|14326|||||No|No||AUROBINDO PHARM|No||||
minocycline HCl|No|No|No|No|75%|59651033701|MINOCYCLINE HCL 50 MG TABLET|100|EA|.33088|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|213|No|1.57315|03/01/2022|1.53539|03/01/2022|1.54561|03/01/2022|||TETRACYCLINES|14327|||||No|No||AUROBINDO PHARM|No||||
minocycline HCl|No|No|No|No|75%|59651033801|MINOCYCLINE HCL 75 MG TABLET|100|EA|.52675|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|213|No|1.2005|02/10/2022|1.18335|02/10/2022|1.127|02/10/2022|||TETRACYCLINES|14328|||||No|No||AUROBINDO PHARM|No||||
minocycline HCl|No|No|No|No|75%|59651033950|MINOCYCLINE HCL 100 MG TABLET|50|EA|.66177|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|213|No|1.59602|02/10/2022|1.55771|02/10/2022|1.56808|02/10/2022|||TETRACYCLINES|14329|||||No|No||AUROBINDO PHARM|No||||
leflunomide|No|No|No|No|75%|59651034830|LEFLUNOMIDE 10 MG TABLET|30|EA|.31533|12/13/2021||Yes|No||12/13/2021||Yes|No|12/13/2021||Yes|No||||No|No|||Prescription required|No|||No|.80538|03/29/2022|.78605|03/29/2022|.79128|03/29/2022||||14330|||||No|No||AUROBINDO PHARM|No||||
leflunomide|No|No|No|No|75%|59651034930|LEFLUNOMIDE 20 MG TABLET|30|EA|.31533|12/28/2021||Yes|No||12/28/2021||Yes|No|12/28/2021||Yes|No||||No|No|||Prescription required|No|||No|.61902|03/29/2022|.60416|03/29/2022|.60818|03/29/2022||||14331|||||No|No||AUROBINDO PHARM|No||||
ibuprofen|No|No|No|No|75%|59651036001|IBUPROFEN 400 MG TABLET|100|EA|.02967|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||059|Yes|.04934|03/29/2022|.04815|03/29/2022|.04847|03/29/2022|||NSAIDS|14332|||||No|No||AUROBINDO PHARM|No||||
ibuprofen|No|No|No|No|75%|59651036005|IBUPROFEN 400 MG TABLET|500|EA|.02772|08/20/2021||Yes|No||08/20/2021||Yes|No|08/20/2021||Yes|No||||No|No|||Prescription required|No||059|Yes|.04934|03/29/2022|.04815|03/29/2022|.04847|03/29/2022|||NSAIDS|14333|||||No|No||AUROBINDO PHARM|No||||
ibuprofen|No|No|No|No|75%|59651036101|IBUPROFEN 600 MG TABLET|100|EA|.03848|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||||No|No|||Prescription required|No||059|Yes|.06063|03/29/2022|.05917|03/29/2022|.05956|03/29/2022|||NSAIDS|14334|||||No|No||AUROBINDO PHARM|No||||
ibuprofen|No|No|No|No|75%|59651036105|IBUPROFEN 600 MG TABLET|500|EA|.03848|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||059|Yes|.06063|03/29/2022|.05917|03/29/2022|.05956|03/29/2022|||NSAIDS|14335|||||No|No||AUROBINDO PHARM|No||||
ibuprofen|No|No|No|No|75%|59651036201|IBUPROFEN 800 MG TABLET|100|EA|.06901|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||||No|No|||Prescription required|No||059|Yes|.07481|03/29/2022|.07301|03/29/2022|.0735|03/29/2022|||NSAIDS|14336|||||No|No||AUROBINDO PHARM|No||||
ibuprofen|No|No|No|No|75%|59651036205|IBUPROFEN 800 MG TABLET|500|EA|.05891|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||059|Yes|.07481|03/29/2022|.07301|03/29/2022|.0735|03/29/2022|||NSAIDS|14337|||||No|No||AUROBINDO PHARM|No||||
droxidopa|No|No|No|No|75%|59651037590|DROXIDOPA 100 MG CAPSULE|90|EA|1.09578|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|No|||No|2.49736|02/16/2022|2.46168|02/16/2022|2.34446|02/16/2022||||14338|||||No|No||AUROBINDO PHARM|No||||
droxidopa|No|No|No|No|75%|59651037690|DROXIDOPA 200 MG CAPSULE|90|EA|2.19156|08/20/2021||Yes|No||08/20/2021||Yes|No|08/20/2021||Yes|No||||No|No|||Prescription required|No|||No|4.99472|08/20/2021|4.92337|08/20/2021|4.68892|08/20/2021||||14339|||||No|No||AUROBINDO PHARM|No||||
droxidopa|No|No|No|No|75%|59651037790|DROXIDOPA 300 MG CAPSULE|90|EA|3.28735|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|No|||No|7.4921|02/16/2022|7.38507|02/16/2022|7.0334|02/16/2022||||14340|||||No|No||AUROBINDO PHARM|No||||
zonisamide|No|No|No|No|75%|59651037801|ZONISAMIDE 25 MG CAPSULE|100|EA|.06742|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||||No|No|||Prescription required|No||056|No|.08772|03/29/2022|.08561|03/29/2022|.08618|03/29/2022|||ANTICONVULSANTS|14341|||||No|No||AUROBINDO PHARM|No||||
zonisamide|No|No|No|No|75%|59651037901|ZONISAMIDE 50 MG CAPSULE|100|EA|.07899|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||||No|No|||Prescription required|No||056|No|.11305|03/29/2022|.11033|03/29/2022|.11107|03/29/2022|||ANTICONVULSANTS|14342|||||No|No||AUROBINDO PHARM|No||||
zonisamide|No|No|No|No|75%|59651038001|ZONISAMIDE 100 MG CAPSULE|100|EA|.15802|12/13/2021||Yes|No||12/13/2021||Yes|No|12/13/2021||Yes|No||||No|No|||Prescription required|No||056|No|.12763|03/29/2022|.12456|03/29/2022|.12539|03/29/2022|||ANTICONVULSANTS|14343|||||No|No||AUROBINDO PHARM|No||||
buspirone HCl|No|No|No|No|75%|59651038901|BUSPIRONE HCL 5 MG TABLET|100|EA|.02064|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|14344|||||No|No||AUROBINDO PHARM|No||||
buspirone HCl|No|No|No|No|75%|59651038905|BUSPIRONE HCL 5 MG TABLET|500|EA|.02086|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|14345|||||No|No||AUROBINDO PHARM|No||||
buspirone HCl|No|No|No|No|75%|59651039001|BUSPIRONE HCL 7.5 MG TABLET|100|EA|.19543|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|No||090|No|.22186|03/29/2022|.21653|03/29/2022|.21797|03/29/2022|||ANXIOLYTICS|14346|||||No|No||AUROBINDO PHARM|No||||
buspirone HCl|No|No|No|No|75%|59651039101|BUSPIRONE HCL 10 MG TABLET|100|EA|.02992|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|14347|||||No|No||AUROBINDO PHARM|No||||
buspirone HCl|No|No|No|No|75%|59651039105|BUSPIRONE HCL 10 MG TABLET|500|EA|.02993|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|14348|||||No|No||AUROBINDO PHARM|No||||
buspirone HCl|No|No|No|No|75%|59651039201|BUSPIRONE HCL 15 MG TABLET|100|EA|.03771|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|14349|||||No|No||AUROBINDO PHARM|No||||
buspirone HCl|No|No|No|No|75%|59651039205|BUSPIRONE HCL 15 MG TABLET|500|EA|.03713|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|14350|||||No|No||AUROBINDO PHARM|No||||
buspirone HCl|No|No|No|No|75%|59651039360|BUSPIRONE HCL 30 MG TABLET|60|EA|.07539|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||090|No|.17728|03/29/2022|.17302|03/29/2022|.17417|03/29/2022|||ANXIOLYTICS|14351|||||No|No||AUROBINDO PHARM|No||||
baclofen|No|No|No|No|75%|59651039501|BACLOFEN 20 MG TABLET|100|EA|.0344|03/24/2022||Yes|No||03/24/2022||Yes|No|03/24/2022||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|14352|||||No|No||AUROBINDO PHARM|No||||
rilpivirine HCl|No|No|No|No|75%|59676027801|EDURANT 25 MG TABLET|30|EA|25.7184|06/07/2011||Yes|No||06/07/2011||Yes|No|06/07/2011||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|41.3563|02/01/2022|40.36374|02/01/2022|40.63256|02/01/2022|||HIV / AIDS|14353|||||No|No||JANSSEN PRODUCT|No||||
epoetin alfa|No|No|No|No|75%|59676030201|PROCRIT 2,000 UNITS/ML VIAL|1|ML|22.9878|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|038|Yes|52.3908|01/15/2019|51.64236|01/15/2019|49.1832|01/15/2019|||ERYTHROPOIESIS STIMULATING PROTEINS|14354|||||No|No||JANSSEN PRODUCT|No||||
epoetin alfa|No|No|No|No|75%|59676030301|PROCRIT 3,000 UNITS/ML VIAL|1|ML|34.4774|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|038|Yes|78.5764|01/15/2019|77.45388|01/15/2019|73.7656|01/15/2019|||ERYTHROPOIESIS STIMULATING PROTEINS|14355|||||No|No||JANSSEN PRODUCT|No||||
epoetin alfa|No|No|No|No|75%|59676030401|PROCRIT 4,000 UNITS/ML VIAL|1|ML|45.967|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|038|Yes|104.762|01/28/2020|103.2654|01/28/2020|98.348|01/28/2020|||ERYTHROPOIESIS STIMULATING PROTEINS|14356|||||No|No||JANSSEN PRODUCT|No||||
epoetin alfa|No|No|No|No|75%|59676031001|PROCRIT 10,000 UNITS/ML VIAL|1|ML|114.9175|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|038|Yes|261.905|10/26/2021|258.1635|10/26/2021|245.87|10/26/2021|||ERYTHROPOIESIS STIMULATING PROTEINS|14357|||||No|No||JANSSEN PRODUCT|No||||
epoetin alfa|No|No|No|No|75%|59676031002|PROCRIT 10,000 UNITS/ML VIAL|1|ML|114.9132|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|038|Yes|261.8952|01/15/2019|258.15384|01/15/2019|245.8608|01/15/2019|||ERYTHROPOIESIS STIMULATING PROTEINS|14358|||||No|No||JANSSEN PRODUCT|No||||
epoetin alfa|No|No|No|No|75%|59676031204|PROCRIT 10,000 UNITS/ML VIAL|2|ML|114.9175|01/25/2008||Yes|No||01/25/2008||Yes|No|01/25/2008||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|038|Yes|261.905|01/15/2019|258.1635|01/15/2019|245.87|01/15/2019|||ERYTHROPOIESIS STIMULATING PROTEINS|14359|||||No|No||JANSSEN PRODUCT|No||||
epoetin alfa|No|No|No|No|75%|59676032004|PROCRIT 20,000 UNITS/ML VIAL|1|ML|229.835|10/18/2007||Yes|No||10/18/2007||Yes|No|10/18/2007||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|038|Yes|520.6035|06/29/2021|508.10901|06/29/2021|511.49293|06/29/2021|||ERYTHROPOIESIS STIMULATING PROTEINS|14360|||||No|No||JANSSEN PRODUCT|No||||
epoetin alfa|No|No|No|No|75%|59676034001|PROCRIT 40,000 UNITS/ML VIAL|1|ML|459.67|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|038|Yes|1047.62|01/28/2020|1032.654|01/28/2020|983.48|01/28/2020|||ERYTHROPOIESIS STIMULATING PROTEINS|14361|||||No|No||JANSSEN PRODUCT|No||||
darunavir ethanolate|No|No|No|No|75%|59676056201|PREZISTA 600 MG TABLET|60|EA|19.48519|06/04/2008||Yes|No||06/04/2008||Yes|No|06/04/2008||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|31.42642|02/01/2022|30.67218|02/01/2022|30.87645|02/01/2022|||HIV / AIDS|14362|||||No|No||JANSSEN PRODUCT|No||||
darunavir ethanolate|No|No|No|No|75%|59676056301|PREZISTA 75 MG TABLET|480|EA|2.43564|02/17/2009||Yes|No||02/17/2009||Yes|No|02/17/2009||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|3.97822|01/25/2022|3.92139|01/25/2022|3.73465|01/25/2022|||HIV / AIDS|14363|||||No|No||JANSSEN PRODUCT|No||||
darunavir ethanolate|No|No|No|No|75%|59676056401|PREZISTA 150 MG TABLET|240|EA|4.87129|06/29/2010||Yes|No||06/29/2010||Yes|No|06/29/2010||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|7.95645|01/25/2022|7.84278|01/25/2022|7.46932|01/25/2022|||HIV / AIDS|14364|||||No|No||JANSSEN PRODUCT|No||||
darunavir ethanolate|No|No|No|No|75%|59676056501|PREZISTA 100 MG/ML SUSPENSION|200|ML|3.24732|04/02/2013||Yes|No||04/02/2013||Yes|No|04/02/2013||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|5.30395|01/25/2022|5.22818|01/25/2022|4.97922|01/25/2022|||HIV / AIDS|14365|||||No|No||JANSSEN PRODUCT|No||||
darunavir ethanolate|No|No|No|No|75%|59676056630|PREZISTA 800 MG TABLET|30|EA|38.97039|11/28/2012||Yes|No||11/28/2012||Yes|No|11/28/2012||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|63.19169|02/01/2022|61.67508|02/01/2022|62.08583|02/01/2022|||HIV / AIDS|14366|||||No|No||JANSSEN PRODUCT|No||||
etravirine|No|No|No|No|75%|59676057001|INTELENCE 100 MG TABLET|120|EA|7.19865|01/25/2008||Yes|No||01/25/2008||Yes|No|01/25/2008||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|11.75779|01/25/2022|11.58982|01/25/2022|11.03793|01/25/2022|||HIV / AIDS|14367|||||No|No||JANSSEN PRODUCT|No||||
etravirine|No|No|No|No|75%|59676057101|INTELENCE 200 MG TABLET|60|EA|14.3973|02/11/2011||Yes|No||02/11/2011||Yes|No|02/11/2011||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|23.25979|02/01/2022|22.70155|02/01/2022|22.85274|02/01/2022|||HIV / AIDS|14368|||||No|No||JANSSEN PRODUCT|No||||
etravirine|No|No|No|No|75%|59676057201|INTELENCE 25 MG TABLET|120|EA|1.79964|05/15/2012||Yes|No||05/15/2012||Yes|No|05/15/2012||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|2.93942|01/25/2022|2.89743|01/25/2022|2.75945|01/25/2022|||HIV / AIDS|14369|||||No|No||JANSSEN PRODUCT|No||||
darunavir/cobicistat|No|No|No|No|75%|59676057530|PREZCOBIX 800 MG-150 MG TABLET|30|EA|44.54259|02/12/2015||Yes|No||02/12/2015||Yes|No|02/12/2015||Yes|No||||No|No|||Prescription required|No||237|No|71.82752|02/01/2022|70.10365|02/01/2022|70.57053|02/01/2022|||HIV / AIDS|14370|||||No|No||JANSSEN PRODUCT|No||||
bedaquiline fumarate|No|No|No|No|75%|59676070101|SIRTURO 100 MG TABLET|188|EA|68.61701|05/13/2013||Yes|No||05/13/2013||Yes|No|05/13/2013||Yes|No||||No|No|||Prescription required|No|||No|156.38297|06/01/2016|154.14892|06/01/2016|146.8085|06/01/2016||||14371|||||No|No||JANSSEN PRODUCT|No||||
darunavir/cob/emtri/tenof alaf|No|No|No|No|75%|59676080030|SYMTUZA 800-150-200-10 MG TAB|30|EA|85.8486|10/16/2018||Yes|No||10/16/2018||Yes|No|10/16/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|138.47206|02/01/2022|135.14873|02/01/2022|136.04879|02/01/2022|||HIV / AIDS|14372|||||No|No||JANSSEN PRODUCT|No||||
methylprednisolone|No|No|No|No|75%|59746000103|METHYLPREDNISOLONE 4 MG DOSEPK|21|EA|.13309|07/01/2006||Yes|No||07/01/2006||Yes|No|07/01/2006||Yes|No||||No|No|||Prescription required|No||168|Yes|.17447|03/29/2022|.17028|03/29/2022|.17141|03/29/2022|||GLUCOCORTICOIDS: ORAL|14373|||||No|No||JUBILANT CADIST|No||||
methylprednisolone|No|No|No|No|75%|59746000106|METHYLPREDNISOLONE 4 MG TABLET|100|EA|.13794|07/01/2006||Yes|No||07/01/2006||Yes|No|07/01/2006||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|168|Yes|.21195|03/29/2022|.20686|03/29/2022|.20824|03/29/2022|||GLUCOCORTICOIDS: ORAL|14374|||||No|No||JUBILANT CADIST|No||||
methylprednisolone|No|No|No|No|75%|59746000204|METHYLPREDNISOLONE 8 MG TAB|25|EA|.69161|04/03/2008||Yes|No||04/03/2008||Yes|No|04/03/2008||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|168|Yes|1.23856|03/29/2022|1.20883|03/29/2022|1.21688|03/29/2022|||GLUCOCORTICOIDS: ORAL|14375|||||No|No||JUBILANT CADIST|No||||
methylprednisolone|No|No|No|No|75%|59746000314|METHYLPREDNISOLONE 16 MG TAB|50|EA|1.06837|04/03/2008||Yes|No||04/03/2008||Yes|No|04/03/2008||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|168|Yes|1.78008|03/29/2022|1.73735|03/29/2022|1.74892|03/29/2022|||GLUCOCORTICOIDS: ORAL|14376|||||No|No||JUBILANT CADIST|No||||
risperidone|No|No|No|No|75%|59746001032|RISPERIDONE 0.5 MG ODT|30|EA|.71437|03/15/2012||Yes|No||03/15/2012||Yes|No|03/15/2012||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|027|Yes|.87328|03/29/2022|.85232|03/29/2022|.85799|03/29/2022|||ANTIPSYCHOTICS|14377|||||No|No||JUBILANT CADIST|No||||
methylprednisolone|No|No|No|No|75%|59746001504|METHYLPREDNISOLONE 32 MG TAB|25|EA|1.591|04/03/2008||Yes|No||04/03/2008||Yes|No|04/03/2008||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|168|Yes|3.626|01/28/2020|3.5742|01/28/2020|3.404|01/28/2020|||GLUCOCORTICOIDS: ORAL|14378|||||No|No||JUBILANT CADIST|No||||
risperidone|No|No|No|No|75%|59746002022|RISPERIDONE 1 MG ODT|28|EA|.93647|03/15/2012||Yes|No||03/15/2012||Yes|No|03/15/2012||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|027|Yes|.82075|03/29/2022|.80105|03/29/2022|.80638|03/29/2022|||ANTIPSYCHOTICS|14379|||||No|No||JUBILANT CADIST|No||||
risperidone|No|No|No|No|75%|59746003022|RISPERIDONE 2 MG ODT|28|EA|1.4362|03/15/2012||Yes|No||03/15/2012||Yes|No|03/15/2012||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|027|Yes|1.19262|03/29/2022|1.16399|03/29/2022|1.17174|03/29/2022|||ANTIPSYCHOTICS|14380|||||No|No||JUBILANT CADIST|No||||
risperidone|No|No|No|No|75%|59746004022|RISPERIDONE 3 MG ODT|28|EA|2.89374|03/15/2012||Yes|No||03/15/2012||Yes|No|03/15/2012||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|027|Yes|1.35357|03/29/2022|1.32108|03/29/2022|1.32988|03/29/2022|||ANTIPSYCHOTICS|14381|||||No|No||JUBILANT CADIST|No||||
risperidone|No|No|No|No|75%|59746005022|RISPERIDONE 4 MG ODT|28|EA|3.90946|03/15/2012||Yes|No||03/15/2012||Yes|No|03/15/2012||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|027|Yes|1.81143|09/28/2021|1.76795|09/28/2021|1.77972|09/28/2021|||ANTIPSYCHOTICS|14382|||||No|No||JUBILANT CADIST|No||||
prochlorperazine maleate|No|No|No|No|75%|59746011306|PROCHLORPERAZINE 5 MG TABLET|100|EA|.1376|07/01/2006||Yes|No||07/01/2006||Yes|No|07/01/2006||Yes|No||||No|No|||Prescription required|No||085|No|.2903|03/29/2022|.28333|03/29/2022|.28521|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|14383|||||No|No||JUBILANT CADIST|No||||
prochlorperazine maleate|No|No|No|No|75%|59746011506|PROCHLORPERAZINE 10 MG TAB|100|EA|.2064|08/01/2006||Yes|No||08/01/2006||Yes|No|08/01/2006||Yes|No||||No|No|||Prescription required|No||085|No|.39111|03/29/2022|.38172|03/29/2022|.38426|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|14384|||||No|No||JUBILANT CADIST|No||||
meclizine HCl|No|No|No|No|75%|59746012106|MECLIZINE 25 MG TABLET|100|EA|.08208|06/15/2010||Yes|No||06/15/2010||Yes|No|06/15/2010||Yes|No||||No|No|||Prescription required|No||085|Yes|.11433|03/29/2022|.11158|03/29/2022|.11232|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|14385|||||No|No||JUBILANT CADIST|No||||
meclizine HCl|No|No|No|No|75%|59746012110|MECLIZINE 25 MG TABLET|1000|EA|.08208|06/15/2010||Yes|No||06/15/2010||Yes|No|06/15/2010||Yes|No||||No|No|||Prescription required|No||085|Yes|.11433|03/29/2022|.11158|03/29/2022|.11232|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|14386|||||No|No||JUBILANT CADIST|No||||
meclizine HCl|No|No|No|No|75%|59746012206|MECLIZINE 12.5 MG TABLET|100|EA|.07387|06/15/2010||Yes|No||06/15/2010||Yes|No|06/15/2010||Yes|No||||No|No|||Prescription required|No||085|Yes|.08309|03/29/2022|.08109|03/29/2022|.08163|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|14387|||||No|No||JUBILANT CADIST|No||||
meclizine HCl|No|No|No|No|75%|59746012210|MECLIZINE 12.5 MG TABLET|1000|EA|.07386|06/15/2010||Yes|No||06/15/2010||Yes|No|06/15/2010||Yes|No||||No|No|||Prescription required|No||085|Yes|.08309|03/29/2022|.08109|03/29/2022|.08163|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|14388|||||No|No||JUBILANT CADIST|No||||
prednisone|No|No|No|No|75%|59746017106|PREDNISONE 1 MG TABLET|100|EA|.08273|07/01/2006||Yes|No||07/01/2006||Yes|No|07/01/2006||Yes|No||||No|No|||Prescription required|No||168|Yes|.08042|03/29/2022|.07848|03/29/2022|.07901|03/29/2022|||GLUCOCORTICOIDS: ORAL|14389|||||No|No||JUBILANT CADIST|No||||
prednisone|No|No|No|No|75%|59746017110|PREDNISONE 1 MG TABLET|1000|EA|.07862|07/01/2006||Yes|No||07/01/2006||Yes|No|07/01/2006||Yes|No||||No|No|||Prescription required|No||168|Yes|.08042|03/29/2022|.07848|03/29/2022|.07901|03/29/2022|||GLUCOCORTICOIDS: ORAL|14390|||||No|No||JUBILANT CADIST|No||||
prednisone|No|No|No|No|75%|59746017206|PREDNISONE 5 MG TABLET|100|EA|.0666|04/03/2008||Yes|No||04/03/2008||Yes|No|04/03/2008||Yes|No||||No|No|||Prescription required|No||168|Yes|.07803|03/29/2022|.07615|03/29/2022|.07666|03/29/2022|||GLUCOCORTICOIDS: ORAL|14391|||||No|No||JUBILANT CADIST|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|59746017210|PREDNISONE 5 MG TABLET|1000|EA|.06586|04/03/2008||Yes|No||04/03/2008||Yes|No|04/03/2008||Yes|No||||No|No|||Prescription required|No||168|Yes|.07803|03/29/2022|.07615|03/29/2022|.07666|03/29/2022|||GLUCOCORTICOIDS: ORAL|14392|||||No|No||JUBILANT CADIST|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|59746017306|PREDNISONE 10 MG TABLET|100|EA|.07507|04/03/2008||Yes|No||04/03/2008||Yes|No|04/03/2008||Yes|No||||No|No|||Prescription required|No||168|Yes|.07092|03/29/2022|.06921|03/29/2022|.06967|03/29/2022|||GLUCOCORTICOIDS: ORAL|14393|||||No|No||JUBILANT CADIST|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|59746017310|PREDNISONE 10 MG TABLET|1000|EA|.07072|04/03/2008||Yes|No||04/03/2008||Yes|No|04/03/2008||Yes|No||||No|No|||Prescription required|No||168|Yes|.07092|03/29/2022|.06921|03/29/2022|.06967|03/29/2022|||GLUCOCORTICOIDS: ORAL|14394|||||No|No||JUBILANT CADIST|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|59746017506|PREDNISONE 20 MG TABLET|100|EA|.08019|07/01/2013||Yes|No||07/01/2013||Yes|No|07/01/2013||Yes|No||||No|No|||Prescription required|No||168|Yes|.11229|03/29/2022|.10959|03/29/2022|.11032|03/29/2022|||GLUCOCORTICOIDS: ORAL|14395|||||No|No||JUBILANT CADIST|Yes|09/01/2020|||
prednisone|No|No|No|No|75%|59746017509|PREDNISONE 20 MG TABLET|500|EA|.07937|07/01/2013||Yes|No||07/01/2013||Yes|No|07/01/2013||Yes|No||||No|No|||Prescription required|No||168|Yes|.11229|03/29/2022|.10959|03/29/2022|.11032|03/29/2022|||GLUCOCORTICOIDS: ORAL|14396|||||No|No||JUBILANT CADIST|Yes|09/01/2020|||
cyclobenzaprine HCl|No|No|No|No|75%|59746017706|CYCLOBENZAPRINE 10 MG TABLET|100|EA|.03053|03/28/2008||Yes|No||03/28/2008||Yes|No|03/28/2008||Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|14397|||||No|No||JUBILANT CADIST|No||||
cyclobenzaprine HCl|No|No|No|No|75%|59746017710|CYCLOBENZAPRINE 10 MG TABLET|1000|EA|.029|02/23/2007||Yes|No||02/23/2007||Yes|No|02/23/2007||Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|14398|||||No|No||JUBILANT CADIST|No||||
cyclobenzaprine HCl|No|No|No|No|75%|59746021106|CYCLOBENZAPRINE 5 MG TABLET|100|EA|.07095|03/28/2008||Yes|No||03/28/2008||Yes|No|03/28/2008||Yes|No||||No|No|||Prescription required|No||116|Yes|.02938|03/29/2022|.02867|03/29/2022|.02886|03/29/2022|||SKELETAL MUSCLE RELAXANTS|14399|||||No|No||JUBILANT CADIST|No||||
cyclobenzaprine HCl|No|No|No|No|75%|59746021110|CYCLOBENZAPRINE 5 MG TABLET|1000|EA|.07095|02/23/2007||Yes|No||02/23/2007||Yes|No|02/23/2007||Yes|No||||No|No|||Prescription required|No||116|Yes|.02938|03/29/2022|.02867|03/29/2022|.02886|03/29/2022|||SKELETAL MUSCLE RELAXANTS|14400|||||No|No||JUBILANT CADIST|No||||
spironolactone|No|No|No|No|75%|59746021601|SPIRONOLACTONE 25 MG TABLET|100|EA|.02476|12/22/2016||Yes|No||12/22/2016||Yes|No|12/22/2016||Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||14401|||||No|No||JUBILANT CADIST|No||||
spironolactone|No|No|No|No|75%|59746021605|SPIRONOLACTONE 25 MG TABLET|500|EA|.02399|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||14402|||||No|No||JUBILANT CADIST|No||||
spironolactone|No|No|No|No|75%|59746021701|SPIRONOLACTONE 50 MG TABLET|100|EA|.08754|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No|||No|.12042|03/29/2022|.11752|03/29/2022|.11831|03/29/2022||||14403|||||No|No||JUBILANT CADIST|No||||
spironolactone|No|No|No|No|75%|59746021801|SPIRONOLACTONE 100 MG TABLET|100|EA|.16709|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No|||No|.2048|03/29/2022|.19988|03/29/2022|.20121|03/29/2022||||14404|||||No|No||JUBILANT CADIST|No||||
lamotrigine|No|No|No|No|75%|59746024501|LAMOTRIGINE 25 MG TABLET|100|EA|.01922|03/24/2009||Yes|No||03/24/2009||Yes|No|03/24/2009||Yes|No||||No|No|||Prescription required|No||056|No|.03514|03/29/2022|.03429|03/29/2022|.03452|03/29/2022|||ANTICONVULSANTS|14405|||||No|No||JUBILANT CADIST|No||||
lamotrigine|No|No|No|No|75%|59746024505|LAMOTRIGINE 25 MG TABLET|500|EA|.02223|12/23/2016||Yes|No||12/23/2016||Yes|No|12/23/2016||Yes|No||||No|No|||Prescription required|No||056|No|.03514|03/29/2022|.03429|03/29/2022|.03452|03/29/2022|||ANTICONVULSANTS|14406|||||No|No||JUBILANT CADIST|No||||
lamotrigine|No|No|No|No|75%|59746024601|LAMOTRIGINE 100 MG TABLET|100|EA|.02803|03/24/2009||Yes|No||03/24/2009||Yes|No|03/24/2009||Yes|No||||No|No|||Prescription required|No||056|No|.06403|03/29/2022|.06249|03/29/2022|.0629|03/29/2022|||ANTICONVULSANTS|14407|||||No|No||JUBILANT CADIST|No||||
lamotrigine|No|No|No|No|75%|59746024610|LAMOTRIGINE 100 MG TABLET|1000|EA|.02549|01/31/2017||Yes|No||01/31/2017||Yes|No|01/31/2017||Yes|No||||No|No|||Prescription required|No||056|No|.06403|03/29/2022|.06249|03/29/2022|.0629|03/29/2022|||ANTICONVULSANTS|14408|||||No|No||JUBILANT CADIST|No||||
lamotrigine|No|No|No|No|75%|59746024705|LAMOTRIGINE 150 MG TABLET|500|EA|.03653|12/23/2016||Yes|No||12/23/2016||Yes|No|12/23/2016||Yes|No||||No|No|||Prescription required|No||056|No|.0888|03/29/2022|.08666|03/29/2022|.08724|03/29/2022|||ANTICONVULSANTS|14409|||||No|No||JUBILANT CADIST|No||||
lamotrigine|No|No|No|No|75%|59746024760|LAMOTRIGINE 150 MG TABLET|60|EA|.03769|03/24/2009||Yes|No||03/24/2009||Yes|No|03/24/2009||Yes|No||||No|No|||Prescription required|No||056|No|.0888|03/29/2022|.08666|03/29/2022|.08724|03/29/2022|||ANTICONVULSANTS|14410|||||No|No||JUBILANT CADIST|No||||
lamotrigine|No|No|No|No|75%|59746024805|LAMOTRIGINE 200 MG TABLET|500|EA|.03869|12/23/2016||Yes|No||12/23/2016||Yes|No|12/23/2016||Yes|No||||No|No|||Prescription required|No||056|No|.10103|03/29/2022|.0986|03/29/2022|.09926|03/29/2022|||ANTICONVULSANTS|14411|||||No|No||JUBILANT CADIST|No||||
lamotrigine|No|No|No|No|75%|59746024860|LAMOTRIGINE 200 MG TABLET|60|EA|.04493|03/24/2009||Yes|No||03/24/2009||Yes|No|03/24/2009||Yes|No||||No|No|||Prescription required|No||056|No|.10103|03/29/2022|.0986|03/29/2022|.09926|03/29/2022|||ANTICONVULSANTS|14412|||||No|No||JUBILANT CADIST|No||||
escitalopram oxalate|Yes|No|No|No|75%|59746027901|ESCITALOPRAM 5 MG TABLET|100|EA|.043|09/20/2013||Yes|No||09/20/2013||Yes|No|09/20/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.0462|03/29/2022|.04509|03/29/2022|.04539|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14413|||||No|No||JUBILANT CADIST|No||||
escitalopram oxalate|Yes|No|No|No|75%|59746028001|ESCITALOPRAM 10 MG TABLET|100|EA|.0516|09/20/2013||Yes|No||09/20/2013||Yes|No|09/20/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14414|||||No|No||JUBILANT CADIST|No||||
escitalopram oxalate|Yes|No|No|No|75%|59746028101|ESCITALOPRAM 20 MG TABLET|100|EA|.0645|09/20/2013||Yes|No||09/20/2013||Yes|No|09/20/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.07845|03/29/2022|.07656|03/29/2022|.07707|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14415|||||No|No||JUBILANT CADIST|No||||
cetirizine HCl|No|No|No|No|75%|59746028532|CHILD CETIRIZINE 5 MG CHEW TAB|30|EA|1.36152|07/09/2018|08/31/2022|Yes|No||||No|No|07/09/2018|08/31/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|1.81079|03/29/2022|1.76733|03/29/2022|1.7791|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|14416|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||JUBILANT CADIST|No||||
cetirizine HCl|No|No|No|No|75%|59746028632|CHILD CETIRIZINE 10 MG CHEW TB|30|EA|1.36152|07/09/2018|08/31/2022|Yes|No||||No|No|07/09/2018|08/31/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|2.03003|01/25/2022|1.9813|01/25/2022|1.9945|01/25/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|14417|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||JUBILANT CADIST|No||||
olanzapine|No|No|No|No|75%|59746030632|OLANZAPINE ODT 5 MG TABLET|30|EA|.36793|07/03/2013||Yes|No||07/03/2013||Yes|No|07/03/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|.59218|03/29/2022|.57796|03/29/2022|.58181|03/29/2022|||ANTIPSYCHOTICS|14418|||||No|No||JUBILANT CADIST|No||||
olanzapine|No|No|No|No|75%|59746030732|OLANZAPINE ODT 10 MG TABLET|30|EA|.54051|07/03/2013||Yes|No||07/03/2013||Yes|No|07/03/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|.58062|03/29/2022|.56668|03/29/2022|.57045|03/29/2022|||ANTIPSYCHOTICS|14419|||||No|No||JUBILANT CADIST|No||||
olanzapine|No|No|No|No|75%|59746030832|OLANZAPINE ODT 15 MG TABLET|30|EA|.79707|07/03/2013||Yes|No||07/03/2013||Yes|No|07/03/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|.85386|03/29/2022|.83336|03/29/2022|.83891|03/29/2022|||ANTIPSYCHOTICS|14420|||||No|No||JUBILANT CADIST|No||||
olanzapine|No|No|No|No|75%|59746030932|OLANZAPINE ODT 20 MG TABLET|30|EA|1.05378|07/03/2013||Yes|No||07/03/2013||Yes|No|07/03/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|1.09|03/29/2022|1.06384|03/29/2022|1.07092|03/29/2022|||ANTIPSYCHOTICS|14421|||||No|No||JUBILANT CADIST|No||||
valacyclovir HCl|No|No|No|No|75%|59746032430|VALACYCLOVIR HCL 500 MG TABLET|30|EA|.24682|11/01/2012||Yes|No||11/01/2012||Yes|No|11/01/2012||Yes|No||||No|No|||Prescription required|No||025|No|.29328|03/29/2022|.28624|03/29/2022|.28814|03/29/2022|||ANTIVIRALS: ORAL|14422|||||No|No||JUBILANT CADIST|No||||
valacyclovir HCl|No|No|No|No|75%|59746032437|VALACYCLOVIR HCL 500 MG TABLET|250|EA|.18663|11/01/2012||Yes|No||11/01/2012||Yes|No|11/01/2012||Yes|No||||No|No|||Prescription required|No||025|No|.29328|03/29/2022|.28624|03/29/2022|.28814|03/29/2022|||ANTIVIRALS: ORAL|14423|||||No|No||JUBILANT CADIST|No||||
valacyclovir HCl|Yes|No|No|No|75%|59746032530|VALACYCLOVIR HCL 1 GRAM TABLET|30|EA|.50066|11/01/2012||Yes|No||11/01/2012||Yes|No|11/01/2012||Yes|No||||No|No|11/01/2012||Prescription required|No||025|No|.5737|03/29/2022|.55993|03/29/2022|.56366|03/29/2022|||ANTIVIRALS: ORAL|14424|||||No|No||JUBILANT CADIST|No||||
valacyclovir HCl|Yes|No|No|No|75%|59746032537|VALACYCLOVIR HCL 1 GRAM TABLET|250|EA|.31556|11/01/2012||Yes|No||11/01/2012||Yes|No|11/01/2012||Yes|No||||No|No|11/01/2012||Prescription required|No||025|No|.5737|03/29/2022|.55993|03/29/2022|.56366|03/29/2022|||ANTIVIRALS: ORAL|14425|||||No|No||JUBILANT CADIST|No||||
donepezil HCl|No|No|No|No|75%|59746032930|DONEPEZIL HCL 5 MG TABLET|30|EA|.0311|06/30/2011||Yes|No||06/30/2011||Yes|No|06/30/2011||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|14426|||||No|No||JUBILANT CADIST|No||||
donepezil HCl|No|No|No|No|75%|59746032990|DONEPEZIL HCL 5 MG TABLET|90|EA|.02537|06/30/2011||Yes|No||06/30/2011||Yes|No|06/30/2011||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|14427|||||No|No||JUBILANT CADIST|No||||
donepezil HCl|No|No|No|No|75%|59746033030|DONEPEZIL HCL 10 MG TABLET|30|EA|.03124|06/30/2011||Yes|No||06/30/2011||Yes|No|06/30/2011||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|14428|||||No|No||JUBILANT CADIST|No||||
donepezil HCl|No|No|No|No|75%|59746033090|DONEPEZIL HCL 10 MG TABLET|90|EA|.02675|06/30/2011||Yes|No||06/30/2011||Yes|No|06/30/2011||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|14429|||||No|No||JUBILANT CADIST|No||||
losartan potassium|Yes|No|No|No|75%|59746033310|LOSARTAN POTASSIUM 25 MG TAB|1000|EA|.06047|03/03/2014||Yes|No||03/03/2014||Yes|No|03/03/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|14430|||||No|No||JUBILANT CADIST|No||||
losartan potassium|Yes|No|No|No|75%|59746033390|LOSARTAN POTASSIUM 25 MG TAB|90|EA|.06048|03/03/2014||Yes|No||03/03/2014||Yes|No|03/03/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|14431|||||No|No||JUBILANT CADIST|No||||
losartan potassium|Yes|No|No|No|75%|59746033410|LOSARTAN POTASSIUM 50 MG TAB|1000|EA|.08131|03/03/2014||Yes|No||03/03/2014||Yes|No|03/03/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|14432|||||No|No||JUBILANT CADIST|No||||
losartan potassium|Yes|No|No|No|75%|59746033430|LOSARTAN POTASSIUM 50 MG TAB|30|EA|.08155|03/03/2014||Yes|No||03/03/2014||Yes|No|03/03/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|14433|||||No|No||JUBILANT CADIST|No||||
losartan potassium|Yes|No|No|No|75%|59746033490|LOSARTAN POTASSIUM 50 MG TAB|90|EA|.0815|03/03/2014||Yes|No||03/03/2014||Yes|No|03/03/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|14434|||||No|No||JUBILANT CADIST|No||||
losartan potassium|Yes|No|No|No|75%|59746033510|LOSARTAN POTASSIUM 100 MG TAB|1000|EA|.11073|03/03/2014||Yes|No||03/03/2014||Yes|No|03/03/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|14435|||||No|No||JUBILANT CADIST|No||||
losartan potassium|Yes|No|No|No|75%|59746033530|LOSARTAN POTASSIUM 100 MG TAB|30|EA|.11094|03/03/2014||Yes|No||03/03/2014||Yes|No|03/03/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|14436|||||No|No||JUBILANT CADIST|No||||
losartan potassium|Yes|No|No|No|75%|59746033590|LOSARTAN POTASSIUM 100 MG TAB|90|EA|.11069|03/03/2014||Yes|No||03/03/2014||Yes|No|03/03/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|14437|||||No|No||JUBILANT CADIST|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|59746033730|LOSARTAN-HCTZ 50-12.5 MG TAB|30|EA|.08972|07/03/2013||Yes|No||07/03/2013||Yes|No|07/03/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|14438|||||No|No||JUBILANT CADIST|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|59746033790|LOSARTAN-HCTZ 50-12.5 MG TAB|90|EA|.08981|07/03/2013||Yes|No||07/03/2013||Yes|No|07/03/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|14439|||||No|No||JUBILANT CADIST|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|59746033830|LOSARTAN-HCTZ 100-12.5 MG TAB|30|EA|.1224|07/03/2013||Yes|No||07/03/2013||Yes|No|07/03/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|14440|||||No|No||JUBILANT CADIST|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|59746033890|LOSARTAN-HCTZ 100-12.5 MG TAB|90|EA|.1247|07/03/2013||Yes|No||07/03/2013||Yes|No|07/03/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|14441|||||No|No||JUBILANT CADIST|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|59746033930|LOSARTAN-HCTZ 100-25 MG TAB|30|EA|.1224|07/03/2013||Yes|No||07/03/2013||Yes|No|07/03/2013||Yes|No||||No|No|||Prescription required|No||113|Yes|.21077|03/01/2022|.20571|03/01/2022|.20708|03/01/2022|||ANGIOTENSIN MODULATORS|14442|||||No|No||JUBILANT CADIST|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|59746033990|LOSARTAN-HCTZ 100-25 MG TAB|90|EA|.1247|07/03/2013||Yes|No||07/03/2013||Yes|No|07/03/2013||Yes|No||||No|No|||Prescription required|No||113|Yes|.21077|03/01/2022|.20571|03/01/2022|.20708|03/01/2022|||ANGIOTENSIN MODULATORS|14443|||||No|No||JUBILANT CADIST|No||||
valsartan|Yes|No|No|No|75%|59746036030|VALSARTAN 40 MG TABLET|30|EA|.08972|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.1945|03/29/2022|.18983|03/29/2022|.19109|03/29/2022|||ANGIOTENSIN MODULATORS|14444|||||No|No||JUBILANT CADIST|No||||
valsartan|Yes|No|No|No|75%|59746036190|VALSARTAN 80 MG TABLET|90|EA|.10286|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.21024|03/29/2022|.20519|03/29/2022|.20656|03/29/2022|||ANGIOTENSIN MODULATORS|14445|||||No|No||JUBILANT CADIST|No||||
valsartan|Yes|No|No|No|75%|59746036290|VALSARTAN 160 MG TABLET|90|EA|.10983|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.23007|03/29/2022|.22454|03/29/2022|.22604|03/29/2022|||ANGIOTENSIN MODULATORS|14446|||||No|No||JUBILANT CADIST|No||||
valsartan|Yes|No|No|No|75%|59746036390|VALSARTAN 320 MG TABLET|90|EA|.1386|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.31156|03/29/2022|.30408|03/29/2022|.3061|03/29/2022|||ANGIOTENSIN MODULATORS|14447|||||No|No||JUBILANT CADIST|No||||
indomethacin|No|No|No|No|75%|59746037960|INDOMETHACIN ER 75 MG CAPSULE|60|EA|.19006|11/29/2016|01/31/2022|Yes|No||11/29/2016|01/31/2022|Yes|No|11/29/2016|01/31/2022|Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.23098|03/29/2022|.22543|03/29/2022|.22693|03/29/2022|||NSAIDS|14448|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||JUBILANT CADIST|No||||
hydrochlorothiazide|Yes|No|No|No|75%|59746038206|HYDROCHLOROTHIAZIDE 12.5 MG CP|100|EA|.0344|07/01/2008||Yes|No||07/01/2008||Yes|No|07/01/2008||Yes|No||||No|No|07/01/2016||Prescription required|No|||Yes|.03333|03/29/2022|.03253|03/29/2022|.03274|03/29/2022||||14449|||||No|No||JUBILANT CADIST|No||||
hydrochlorothiazide|Yes|No|No|No|75%|59746038210|HYDROCHLOROTHIAZIDE 12.5 MG CP|1000|EA|.03104|07/01/2008||Yes|No||07/01/2008||Yes|No|07/01/2008||Yes|No||||No|No|07/01/2016||Prescription required|No|||Yes|.03333|03/29/2022|.03253|03/29/2022|.03274|03/29/2022||||14450|||||No|No||JUBILANT CADIST|No||||
terazosin HCl|No|No|No|No|75%|59746038306|TERAZOSIN 1 MG CAPSULE|100|EA|.0774|07/01/2006||Yes|No||07/01/2006||Yes|No|07/01/2006||Yes|No||||No|No|||Prescription required|No||003|Yes|.15217|03/29/2022|.14851|03/29/2022|.1495|03/29/2022|||BPH TREATMENTS|14451|||||No|No||JUBILANT CADIST|No||||
terazosin HCl|No|No|No|No|75%|59746038310|TERAZOSIN 1 MG CAPSULE|1000|EA|.07585|07/01/2006||Yes|No||07/01/2006||Yes|No|07/01/2006||Yes|No||||No|No|||Prescription required|No||003|Yes|.15217|03/29/2022|.14851|03/29/2022|.1495|03/29/2022|||BPH TREATMENTS|14452|||||No|No||JUBILANT CADIST|No||||
terazosin HCl|No|No|No|No|75%|59746038406|TERAZOSIN 2 MG CAPSULE|100|EA|.0774|08/18/2006||Yes|No||08/18/2006||Yes|No|08/18/2006||Yes|No||||No|No|||Prescription required|No||003|No|.15336|03/29/2022|.14967|03/29/2022|.15067|03/29/2022|||BPH TREATMENTS|14453|||||No|No||JUBILANT CADIST|No||||
terazosin HCl|No|No|No|No|75%|59746038410|TERAZOSIN 2 MG CAPSULE|1000|EA|.07585|07/01/2006||Yes|No||07/01/2006||Yes|No|07/01/2006||Yes|No||||No|No|||Prescription required|No||003|No|.15336|03/29/2022|.14967|03/29/2022|.15067|03/29/2022|||BPH TREATMENTS|14454|||||No|No||JUBILANT CADIST|No||||
terazosin HCl|No|No|No|No|75%|59746038506|TERAZOSIN 5 MG CAPSULE|100|EA|.0774|07/01/2006||Yes|No||07/01/2006||Yes|No|07/01/2006||Yes|No||||No|No|||Prescription required|No||003|Yes|.15866|03/29/2022|.15485|03/29/2022|.15588|03/29/2022|||BPH TREATMENTS|14455|||||No|No||JUBILANT CADIST|No||||
terazosin HCl|No|No|No|No|75%|59746038510|TERAZOSIN 5 MG CAPSULE|1000|EA|.07585|07/01/2006||Yes|No||07/01/2006||Yes|No|07/01/2006||Yes|No||||No|No|||Prescription required|No||003|Yes|.15866|03/29/2022|.15485|03/29/2022|.15588|03/29/2022|||BPH TREATMENTS|14456|||||No|No||JUBILANT CADIST|No||||
terazosin HCl|No|No|No|No|75%|59746038606|TERAZOSIN 10 MG CAPSULE|100|EA|.0774|07/01/2006||Yes|No||07/01/2006||Yes|No|07/01/2006||Yes|No||||No|No|||Prescription required|No||003|No|.16419|03/29/2022|.16024|03/29/2022|.16131|03/29/2022|||BPH TREATMENTS|14457|||||No|No||JUBILANT CADIST|No||||
terazosin HCl|No|No|No|No|75%|59746038610|TERAZOSIN 10 MG CAPSULE|1000|EA|.07585|07/01/2006||Yes|No||07/01/2006||Yes|No|07/01/2006||Yes|No||||No|No|||Prescription required|No||003|No|.16419|03/29/2022|.16024|03/29/2022|.16131|03/29/2022|||BPH TREATMENTS|14458|||||No|No||JUBILANT CADIST|No||||
rizatriptan benzoate|No|No|No|No|75%|59746041419|RIZATRIPTAN 5 MG TABLET|18|EA|.5148|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|No||021|No|.64991|03/29/2022|.63431|03/29/2022|.63853|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|14459|||||No|No||JUBILANT CADIST|No||||
rizatriptan benzoate|No|No|No|No|75%|59746041519|RIZATRIPTAN 10 MG TABLET|18|EA|.53869|01/04/2017||Yes|No||01/04/2017||Yes|No|01/04/2017||Yes|No||||No|No|||Prescription required|No||021|No|.50927|03/29/2022|.49704|03/29/2022|.50035|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|14460|||||No|No||JUBILANT CADIST|No||||
irbesartan|Yes|No|No|No|75%|59746044730|IRBESARTAN 75 MG TABLET|30|EA|.15107|09/30/2015||Yes|No||09/30/2015||Yes|No|09/30/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.21751|03/29/2022|.21228|03/29/2022|.2137|03/29/2022|||ANGIOTENSIN MODULATORS|14461|||||No|No||JUBILANT CADIST|No||||
irbesartan|Yes|No|No|No|75%|59746044790|IRBESARTAN 75 MG TABLET|90|EA|.15107|09/30/2015||Yes|No||09/30/2015||Yes|No|09/30/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.21751|03/29/2022|.21228|03/29/2022|.2137|03/29/2022|||ANGIOTENSIN MODULATORS|14462|||||No|No||JUBILANT CADIST|No||||
irbesartan|Yes|No|No|No|75%|59746044830|IRBESARTAN 150 MG TABLET|30|EA|.15895|09/30/2015||Yes|No||09/30/2015||Yes|No|09/30/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.20852|03/29/2022|.20351|03/29/2022|.20487|03/29/2022|||ANGIOTENSIN MODULATORS|14463|||||No|No||JUBILANT CADIST|No||||
irbesartan|Yes|No|No|No|75%|59746044890|IRBESARTAN 150 MG TABLET|90|EA|.15895|09/30/2015||Yes|No||09/30/2015||Yes|No|09/30/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.20852|03/29/2022|.20351|03/29/2022|.20487|03/29/2022|||ANGIOTENSIN MODULATORS|14464|||||No|No||JUBILANT CADIST|No||||
irbesartan|Yes|No|No|No|75%|59746044930|IRBESARTAN 300 MG TABLET|30|EA|.1912|09/30/2015||Yes|No||09/30/2015||Yes|No|09/30/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.32541|03/29/2022|.3176|03/29/2022|.31971|03/29/2022|||ANGIOTENSIN MODULATORS|14465|||||No|No||JUBILANT CADIST|No||||
irbesartan|Yes|No|No|No|75%|59746044990|IRBESARTAN 300 MG TABLET|90|EA|.1912|09/30/2015||Yes|No||09/30/2015||Yes|No|09/30/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.32541|03/29/2022|.3176|03/29/2022|.31971|03/29/2022|||ANGIOTENSIN MODULATORS|14466|||||No|No||JUBILANT CADIST|No||||
clindamycin palmitate HCl|No|No|No|No|75%|59762001601|CLINDAMYCIN (PEDI) 75 MG/5 ML|100|ML|.17802|09/30/2010||Yes|No||09/30/2010||Yes|No|09/30/2010||Yes|No||||No|No|||Prescription required|No||146|No|.19356|03/29/2022|.18891|03/29/2022|.19017|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|14467|||||No|No||GREENSTONE LLC.|No||||
diclofenac sodium/misoprostol|No|No|No|No|75%|59762002801|DICLOFENAC-MISOPROST 50-0.2 MG|60|EA|1.1534|11/06/2012||Yes|No||11/06/2012||Yes|No|11/06/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|1.41801|03/29/2022|1.38397|03/29/2022|1.39319|03/29/2022|||NSAIDS|14468|||||No|No||GREENSTONE LLC.|No||||
diclofenac sodium/misoprostol|No|No|No|No|75%|59762002802|DICLOFENAC-MISOPROST 50-0.2 MG|90|EA|1.15326|11/06/2012||Yes|No||11/06/2012||Yes|No|11/06/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|1.41801|03/29/2022|1.38397|03/29/2022|1.39319|03/29/2022|||NSAIDS|14469|||||No|No||GREENSTONE LLC.|No||||
diclofenac sodium/misoprostol|No|No|No|No|75%|59762002901|DICLOFENAC-MISOPROST 75-0.2 MG|60|EA|1.1534|11/06/2012||Yes|No||11/06/2012||Yes|No|11/06/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|1.61285|03/29/2022|1.57414|03/29/2022|1.58462|03/29/2022|||NSAIDS|14470|||||No|No||GREENSTONE LLC.|No||||
sildenafil citrate|No|No|No|No|75%|59762003301|SILDENAFIL 20 MG TABLET|90|EA|.22197|11/08/2012||Yes|No||11/08/2012||Yes|No|11/08/2012||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|Yes|.09246|03/29/2022|.09024|03/29/2022|.09084|03/29/2022|||PAH AGENTS: ORAL AND INHALED|14471|||||No|No||GREENSTONE LLC.|No||||
dofetilide|No|No|No|No|75%|59762003702|DOFETILIDE 125 MCG CAPSULE|60|EA|1.79166|12/16/2016||Yes|No||12/16/2016||Yes|No|12/16/2016||Yes|No||||No|No|||Prescription required|No|||No|1.27252|03/29/2022|1.24197|03/29/2022|1.25025|03/29/2022||||14472|||||No|No||GREENSTONE LLC.|No||||
dofetilide|No|No|No|No|75%|59762003802|DOFETILIDE 250 MCG CAPSULE|60|EA|1.79166|12/16/2016||Yes|No||12/16/2016||Yes|No|12/16/2016||Yes|No||||No|No|||Prescription required|No|||No|.89477|03/29/2022|.87329|03/29/2022|.87911|03/29/2022||||14473|||||No|No||GREENSTONE LLC.|No||||
dofetilide|No|No|No|No|75%|59762003902|DOFETILIDE 500 MCG CAPSULE|60|EA|1.79166|12/16/2016||Yes|No||12/16/2016||Yes|No|12/16/2016||Yes|No||||No|No|||Prescription required|No|||No|.90796|03/29/2022|.88616|03/29/2022|.89207|03/29/2022||||14474|||||No|No||GREENSTONE LLC.|No||||
tolterodine tartrate|No|No|No|No|75%|59762004701|TOLTERODINE TART ER 2 MG CAP|30|EA|1.08732|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|006|Yes|1.20249|03/29/2022|1.17363|03/29/2022|1.18144|03/29/2022|||BLADDER RELAXANT PREPARATIONS|14475|||||No|No||GREENSTONE LLC.|No||||
tolterodine tartrate|No|No|No|No|75%|59762004702|TOLTERODINE TART ER 2 MG CAP|90|EA|1.08722|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|006|Yes|1.20249|03/29/2022|1.17363|03/29/2022|1.18144|03/29/2022|||BLADDER RELAXANT PREPARATIONS|14476|||||No|No||GREENSTONE LLC.|No||||
tolterodine tartrate|No|No|No|No|75%|59762004801|TOLTERODINE TART ER 4 MG CAP|30|EA|1.08732|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|006|No|1.14537|03/29/2022|1.11788|03/29/2022|1.12532|03/29/2022|||BLADDER RELAXANT PREPARATIONS|14477|||||No|No||GREENSTONE LLC.|No||||
tolterodine tartrate|No|No|No|No|75%|59762004802|TOLTERODINE TART ER 4 MG CAP|90|EA|1.08722|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|006|No|1.14537|03/29/2022|1.11788|03/29/2022|1.12532|03/29/2022|||BLADDER RELAXANT PREPARATIONS|14478|||||No|No||GREENSTONE LLC.|No||||
methylprednisolone|No|No|No|No|75%|59762004901|METHYLPREDNISOLONE 8 MG TAB|25|EA|.69161|04/12/2013||Yes|No||04/12/2013||Yes|No|04/12/2013||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|168|Yes|1.23856|03/29/2022|1.20883|03/29/2022|1.21688|03/29/2022|||GLUCOCORTICOIDS: ORAL|14479|||||No|No||GREENSTONE LLC.|No||||
methylprednisolone|No|No|No|No|75%|59762005001|METHYLPREDNISOLONE 16 MG TAB|50|EA|1.21793|04/12/2013||Yes|No||04/12/2013||Yes|No|04/12/2013||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|168|Yes|1.78008|03/29/2022|1.73735|03/29/2022|1.74892|03/29/2022|||GLUCOCORTICOIDS: ORAL|14480|||||No|No||GREENSTONE LLC.|No||||
methylprednisolone|No|No|No|No|75%|59762005101|METHYLPREDNISOLONE 32 MG TAB|25|EA|1.83971|04/12/2013||Yes|No||04/12/2013||Yes|No|04/12/2013||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|168|Yes|4.19283|01/28/2020|4.13293|01/28/2020|3.93612|01/28/2020|||GLUCOCORTICOIDS: ORAL|14481|||||No|No||GREENSTONE LLC.|No||||
medroxyprogesterone acetate|No|No|No|No|75%|59762005501|MEDROXYPROGESTERONE 2.5 MG TAB|100|EA|.06097|11/06/2019||Yes|No||11/06/2019||Yes|No|11/06/2019||Yes|No||||No|No|||Prescription required|No|||No|.10866|03/29/2022|.10605|03/29/2022|.10675|03/29/2022||||14482|||||No|No||GREENSTONE LLC.|No||||
medroxyprogesterone acetate|No|No|No|No|75%|59762005601|MEDROXYPROGESTERONE 10 MG TAB|100|EA|.11399|11/06/2019||Yes|No||11/06/2019||Yes|No|11/06/2019||Yes|No||||No|No|||Prescription required|No|||No|.14545|03/29/2022|.14195|03/29/2022|.1429|03/29/2022||||14483|||||No|No||GREENSTONE LLC.|No||||
alprazolam|No|No|No|No|90%|59762005701|ALPRAZOLAM XR 0.5 MG TABLET|60|EA|.23191|10/23/2006||Yes|No||10/23/2006||Yes|No|10/23/2006||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|.20761|03/29/2022|.20262|03/29/2022|.20397|03/29/2022|||ANXIOLYTICS|14484|||||No|No||GREENSTONE LLC.|No||||
medroxyprogesterone acetate|No|No|No|No|75%|59762005801|MEDROXYPROGESTERONE 5 MG TAB|100|EA|.09214|11/06/2019||Yes|No||11/06/2019||Yes|No|11/06/2019||Yes|No||||No|No|||Prescription required|No|||No|.13379|03/29/2022|.13057|03/29/2022|.13144|03/29/2022||||14485|||||No|No||GREENSTONE LLC.|No||||
alprazolam|No|No|No|No|90%|59762005901|ALPRAZOLAM XR 1 MG TABLET|60|EA|.30988|10/23/2006||Yes|No||10/23/2006||Yes|No|10/23/2006||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|.20127|03/29/2022|.19643|03/29/2022|.19774|03/29/2022|||ANXIOLYTICS|14486|||||No|No||GREENSTONE LLC.|No||||
alprazolam|No|No|No|No|90%|59762006601|ALPRAZOLAM XR 2 MG TABLET|60|EA|.37273|10/25/2006||Yes|No||10/25/2006||Yes|No|10/25/2006||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|.3342|03/29/2022|.32617|03/29/2022|.32835|03/29/2022|||ANXIOLYTICS|14487|||||No|No||GREENSTONE LLC.|No||||
sertraline HCl|Yes|No|No|No|75%|59762006701|SERTRALINE 20 MG/ML ORAL CONC|60|ML|.40068|06/27/2018||Yes|No||06/27/2018||Yes|No|06/27/2018||Yes|No||||No|No|06/27/2018||Prescription required|No||008|No|.67787|03/29/2022|.6616|03/29/2022|.666|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14488|||||No|No||GREENSTONE LLC.|No||||
alprazolam|No|No|No|No|90%|59762006801|ALPRAZOLAM XR 3 MG TABLET|60|EA|.59719|10/23/2006||Yes|No||10/23/2006||Yes|No|10/23/2006||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|.2755|03/29/2022|.26888|03/29/2022|.27067|03/29/2022|||ANXIOLYTICS|14489|||||No|No||GREENSTONE LLC.|No||||
hydrocortisone|No|No|No|No|75%|59762007301|HYDROCORTISONE 5 MG TABLET|50|EA|.07404|02/20/2013||Yes|No||02/20/2013||Yes|No|02/20/2013||Yes|No||||No|No|||Prescription required|No||168|Yes|.21144|03/29/2022|.20636|03/29/2022|.20773|03/29/2022|||GLUCOCORTICOIDS: ORAL|14490|||||No|No||GREENSTONE LLC.|No||||
hydrocortisone|No|No|No|No|75%|59762007401|HYDROCORTISONE 10 MG TABLET|100|EA|.12289|02/20/2013||Yes|No||02/20/2013||Yes|No|02/20/2013||Yes|No||||No|No|||Prescription required|No||168|Yes|.28946|03/29/2022|.28251|03/29/2022|.28439|03/29/2022|||GLUCOCORTICOIDS: ORAL|14491|||||No|No||GREENSTONE LLC.|No||||
hydrocortisone|No|No|No|No|75%|59762007501|HYDROCORTISONE 20 MG TABLET|100|EA|.22102|02/20/2013||Yes|No||02/20/2013||Yes|No|02/20/2013||Yes|No||||No|No|||Prescription required|No||168|Yes|.46844|03/29/2022|.45719|03/29/2022|.46024|03/29/2022|||GLUCOCORTICOIDS: ORAL|14492|||||No|No||GREENSTONE LLC.|No||||
sulfasalazine|No|No|No|No|75%|59762010405|SULFASALAZINE DR 500 MG TAB|100|EA|.11687|04/24/2020||Yes|No||04/24/2020||Yes|No|04/24/2020||Yes|No||||No|No|||Prescription required|No||010|No|.2364|03/29/2022|.23072|03/29/2022|.23226|03/29/2022|||ULCERATIVE COLITIS AGENTS|14493|||||No|No||GREENSTONE LLC.|No||||
sulfasalazine|No|No|No|No|75%|59762010406|SULFASALAZINE DR 500 MG TAB|300|EA|.11148|04/24/2020||Yes|No||04/24/2020||Yes|No|04/24/2020||Yes|No||||No|No|||Prescription required|No||010|No|.2364|03/29/2022|.23072|03/29/2022|.23226|03/29/2022|||ULCERATIVE COLITIS AGENTS|14494|||||No|No||GREENSTONE LLC.|No||||
phenelzine sulfate|No|No|No|No|75%|59762011901|PHENELZINE SULFATE 15 MG TAB|60|EA|.28601|11/21/2011||Yes|No||11/21/2011||Yes|No|11/21/2011||Yes|No||||No|No|||Prescription required|No||031|No|.5454|01/25/2022|.53231|01/25/2022|.53585|01/25/2022|||ANTIDEPRESSANTS: OTHER|14495|||||No|No||GREENSTONE LLC.|No||||
silver sulfadiazine|No|No|No|No|75%|59762013100|SILVER SULFADIAZINE 1% CREAM|20|GM|.3096|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|No|||No|.25072|03/29/2022|.2447|03/29/2022|.24633|03/29/2022||||14496|||||No|No||GREENSTONE LLC.|No||||
silver sulfadiazine|No|No|No|No|75%|59762013102|SILVER SULFADIAZINE 1% CREAM|25|GM|.12814|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|No|||No|.16293|03/29/2022|.15901|03/29/2022|.16007|03/29/2022||||14497|||||No|No||GREENSTONE LLC.|No||||
silver sulfadiazine|No|No|No|No|75%|59762013104|SILVER SULFADIAZINE 1% CREAM|400|GM|.0567|06/26/2018||Yes|No||06/26/2018||Yes|No|06/26/2018||Yes|No||||No|No|||Prescription required|No|||No|.07377|03/29/2022|.07199|03/29/2022|.07247|03/29/2022||||14498|||||No|No||GREENSTONE LLC.|No||||
silver sulfadiazine|No|No|No|No|75%|59762013105|SILVER SULFADIAZINE 1% CREAM|50|GM|.10535|06/26/2018||Yes|No||06/26/2018||Yes|No|06/26/2018||Yes|No||||No|No|||Prescription required|No|||No|.13137|03/29/2022|.12821|03/29/2022|.12907|03/29/2022||||14499|||||No|No||GREENSTONE LLC.|No||||
silver sulfadiazine|No|No|No|No|75%|59762013106|SILVER SULFADIAZINE 1% CREAM|50|GM|.10535|06/26/2018||Yes|No||06/26/2018||Yes|No|06/26/2018||Yes|No||||No|No|||Prescription required|No|||No|.13137|03/29/2022|.12821|03/29/2022|.12907|03/29/2022||||14500|||||No|No||GREENSTONE LLC.|No||||
silver sulfadiazine|No|No|No|No|75%|59762013108|SILVER SULFADIAZINE 1% CREAM|85|GM|.11154|06/26/2018||Yes|No||06/26/2018||Yes|No|06/26/2018||Yes|No||||No|No|||Prescription required|No|||No|.13473|03/29/2022|.13149|03/29/2022|.13237|03/29/2022||||14501|||||No|No||GREENSTONE LLC.|No||||
piroxicam|No|No|No|No|75%|59762014001|PIROXICAM 10 MG CAPSULE|100|EA|.2635|03/06/2014||Yes|No||03/06/2014||Yes|No|03/06/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.25876|03/01/2022|.25254|03/01/2022|.25423|03/01/2022|||NSAIDS|14502|||||No|No||GREENSTONE LLC.|No||||
piroxicam|No|No|No|No|75%|59762014501|PIROXICAM 20 MG CAPSULE|100|EA|.46027|03/06/2014||Yes|No||03/06/2014||Yes|No|03/06/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.40758|03/29/2022|.39779|03/29/2022|.40044|03/29/2022|||NSAIDS|14503|||||No|No||GREENSTONE LLC.|No||||
atorvastatin calcium|Yes|No|No|No|75%|59762015501|ATORVASTATIN 10 MG TABLET|90|EA|.09106|01/25/2013||Yes|No||01/25/2013||Yes|No|01/25/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|14504|||||No|No||GREENSTONE LLC.|No||||
atorvastatin calcium|Yes|No|No|No|75%|59762015502|ATORVASTATIN 10 MG TABLET|1000|EA|.09088|01/25/2013||Yes|No||01/25/2013||Yes|No|01/25/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|14505|||||No|No||GREENSTONE LLC.|No||||
atorvastatin calcium|Yes|No|No|No|75%|59762015601|ATORVASTATIN 20 MG TABLET|90|EA|.12961|01/25/2013||Yes|No||01/25/2013||Yes|No|01/25/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|14506|||||No|No||GREENSTONE LLC.|No||||
atorvastatin calcium|Yes|No|No|No|75%|59762015602|ATORVASTATIN 20 MG TABLET|1000|EA|.12936|01/25/2013||Yes|No||01/25/2013||Yes|No|01/25/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|14507|||||No|No||GREENSTONE LLC.|No||||
atorvastatin calcium|Yes|No|No|No|75%|59762015701|ATORVASTATIN 40 MG TABLET|90|EA|.12961|01/25/2013||Yes|No||01/25/2013||Yes|No|01/25/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|14508|||||No|No||GREENSTONE LLC.|No||||
atorvastatin calcium|Yes|No|No|No|75%|59762015702|ATORVASTATIN 40 MG TABLET|500|EA|.12938|01/25/2013||Yes|No||01/25/2013||Yes|No|01/25/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|14509|||||No|No||GREENSTONE LLC.|No||||
atorvastatin calcium|Yes|No|No|No|75%|59762015801|ATORVASTATIN 80 MG TABLET|90|EA|.12961|01/25/2013||Yes|No||01/25/2013||Yes|No|01/25/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|14510|||||No|No||GREENSTONE LLC.|No||||
atorvastatin calcium|Yes|No|No|No|75%|59762015802|ATORVASTATIN 80 MG TABLET|500|EA|.12938|01/25/2013||Yes|No||01/25/2013||Yes|No|01/25/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|14511|||||No|No||GREENSTONE LLC.|No||||
tolterodine tartrate|No|No|No|No|75%|59762017001|TOLTERODINE TARTRATE 1 MG TAB|500|EA|.6403|07/16/2018||Yes|No||07/16/2018||Yes|No|07/16/2018||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|006|No|.65955|03/29/2022|.64372|03/29/2022|.648|03/29/2022|||BLADDER RELAXANT PREPARATIONS|14512|||||No|No||GREENSTONE LLC.|No||||
tolterodine tartrate|No|No|No|No|75%|59762017006|TOLTERODINE TARTRATE 1 MG TAB|60|EA|.64033|07/16/2018||Yes|No||07/16/2018||Yes|No|07/16/2018||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|006|No|.65955|03/29/2022|.64372|03/29/2022|.648|03/29/2022|||BLADDER RELAXANT PREPARATIONS|14513|||||No|No||GREENSTONE LLC.|No||||
quinapril/hydrochlorothiazide|No|No|No|No|75%|59762022001|QUINAPRIL-HCTZ 20-12.5 MG TAB|90|EA|.37582|03/01/2006||Yes|No||03/01/2006||Yes|No|03/01/2006||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|113|Yes|.32878|03/29/2022|.32088|03/29/2022|.32302|03/29/2022|||ANGIOTENSIN MODULATORS|14514|||||No|No||GREENSTONE LLC.|No||||
quinapril/hydrochlorothiazide|No|No|No|No|75%|59762022201|QUINAPRIL-HCTZ 10-12.5 MG TAB|90|EA|.37582|03/01/2006||Yes|No||03/01/2006||Yes|No|03/01/2006||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|113|Yes|.31182|03/01/2022|.30433|03/01/2022|.30636|03/01/2022|||ANGIOTENSIN MODULATORS|14515|||||No|No||GREENSTONE LLC.|No||||
quinapril/hydrochlorothiazide|No|No|No|No|75%|59762022301|QUINAPRIL-HCTZ 20-25 MG TAB|90|EA|.37582|03/01/2006|10/19/2022|Yes|No||03/01/2006|10/19/2022|Yes|No|03/01/2006|10/19/2022|Yes|No||||No|No|||Prescription required|Yes|07/24/2013|113|Yes|.31311|03/29/2022|.30559|03/29/2022|.30763|03/29/2022|||ANGIOTENSIN MODULATORS|14516|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GREENSTONE LLC.|No||||
colestipol HCl|No|No|No|No|75%|59762026001|COLESTIPOL HCL GRANULES PACKET|30|EA|1.35206|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|055|No|2.28193|03/01/2022|2.22716|03/01/2022|2.24199|03/01/2022|||LIPOTROPICS: OTHER|14517|||||No|No||GREENSTONE LLC.|No||||
colestipol HCl|No|No|No|No|75%|59762026002|COLESTIPOL HCL GRANULES PACKET|90|EA|1.35177|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|055|No|2.28193|03/01/2022|2.22716|03/01/2022|2.24199|03/01/2022|||LIPOTROPICS: OTHER|14518|||||No|No||GREENSTONE LLC.|No||||
colestipol HCl|No|No|No|No|75%|59762026003|COLESTIPOL HCL GRANULES|500|GM|.16099|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|055|No|.36691|10/04/2016|.36167|10/04/2016|.34444|10/04/2016|||LIPOTROPICS: OTHER|14519|||||No|No||GREENSTONE LLC.|No||||
latanoprost|No|No|No|No|75%|59762033302|LATANOPROST 0.005% EYE DROPS|2.5|ML|1.78708|03/31/2011||Yes|No||03/31/2011||Yes|No|03/31/2011||Yes|No||||No|No|||Prescription required|No||088|No|1.89557|03/29/2022|1.85007|03/29/2022|1.86239|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|14520|||||No|No||GREENSTONE LLC.|No||||
sucralfate|No|No|No|No|75%|59762040101|SUCRALFATE 1 GM TABLET|100|EA|.06837|11/28/2017||Yes|No||11/28/2017||Yes|No|11/28/2017||Yes|No||||No|No|||Prescription required|No|||No|.19448|03/29/2022|.18981|03/29/2022|.19107|03/29/2022||||14521|||||No|No||GREENSTONE LLC.|No||||
sucralfate|No|No|No|No|75%|59762040105|SUCRALFATE 1 GM TABLET|500|EA|.06554|11/28/2017||Yes|No||11/28/2017||Yes|No|11/28/2017||Yes|No||||No|No|||Prescription required|No|||No|.19448|03/29/2022|.18981|03/29/2022|.19107|03/29/2022||||14522|||||No|No||GREENSTONE LLC.|No||||
risedronate sodium|No|No|No|No|75%|59762040601|RISEDRONATE SODIUM 150 MG TAB|1|EA|46.7453|05/04/2020||Yes|No||05/04/2020||Yes|No|05/04/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|060|No|20.52701|03/29/2022|20.03436|03/29/2022|20.16778|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|14523|||||No|No||GREENSTONE LLC.|No||||
risedronate sodium|No|No|No|No|75%|59762040603|RISEDRONATE SODIUM 150 MG TAB|3|EA|46.74243|11/06/2019||Yes|No||11/06/2019||Yes|No|11/06/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|060|No|20.52701|03/29/2022|20.03436|03/29/2022|20.16778|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|14524|||||No|No||GREENSTONE LLC.|No||||
risedronate sodium|No|No|No|No|75%|59762040704|RISEDRONATE SOD DR 35 MG TAB|4|EA|17.99335|06/27/2018||Yes|No||06/27/2018||Yes|No|06/27/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|060|No|29.533|03/29/2022|28.8242|03/29/2022|29.01617|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|14525|||||No|No||GREENSTONE LLC.|No||||
colestipol HCl|No|No|No|No|75%|59762045001|COLESTIPOL HCL 1 GM TABLET|120|EA|.45242|05/31/2007||Yes|No||05/31/2007||Yes|No|05/31/2007||Yes|No||||No|No|||Prescription required|No||055|No|.78231|03/29/2022|.76353|03/29/2022|.76861|03/29/2022|||LIPOTROPICS: OTHER|14526|||||No|No||GREENSTONE LLC.|No||||
nitroglycerin|No|No|No|No|75%|59762048901|NITROGLYCERIN 0.6 MG TABLET SL|100|EA|.16193|11/29/2016||Yes|No||11/29/2016||Yes|No|11/29/2016||Yes|No||||No|No|||Prescription required|No|||No|.36906|03/29/2022|.36379|03/29/2022|.34647|03/29/2022||||14527|||||No|No||GREENSTONE LLC.|No||||
glipizide|Yes|No|No|No|75%|59762054001|GLIPIZIDE XL 2.5 MG TABLET|30|EA|.11466|12/04/2013||Yes|No||12/04/2013||Yes|No|||No|No||||No|No|07/01/2016||Prescription required|No|||Yes|.12809|03/29/2022|.12501|03/29/2022|.12584|03/29/2022||||14528|||||No|No||GREENSTONE LLC.|No||||
glipizide|No|No|No|No|75%|59762054101|GLIPIZIDE XL 5 MG TABLET|100|EA|.0706|07/18/2013||Yes|No||07/18/2013||Yes|No|||No|No||||No|No|||Prescription required|No|||Yes|.11105|03/29/2022|.10838|03/29/2022|.1091|03/29/2022||||14529|||||No|No||GREENSTONE LLC.|No||||
glipizide|No|No|No|No|75%|59762054102|GLIPIZIDE XL 5 MG TABLET|500|EA|.06691|12/04/2013||Yes|No||12/04/2013||Yes|No|||No|No||||No|No|||Prescription required|No|||Yes|.11105|03/29/2022|.10838|03/29/2022|.1091|03/29/2022||||14530|||||No|No||GREENSTONE LLC.|No||||
glipizide|Yes|No|No|No|75%|59762054201|GLIPIZIDE XL 10 MG TABLET|100|EA|.13631|12/04/2013||Yes|No||12/04/2013||Yes|No|||No|No||||No|No|07/01/2016||Prescription required|No|||No|.184|03/29/2022|.17958|03/29/2022|.18078|03/29/2022||||14531|||||No|No||GREENSTONE LLC.|No||||
glipizide|Yes|No|No|No|75%|59762054202|GLIPIZIDE XL 10 MG TABLET|500|EA|.1334|12/04/2013||Yes|No||12/04/2013||Yes|No|||No|No||||No|No|07/01/2016||Prescription required|No|||No|.184|03/29/2022|.17958|03/29/2022|.18078|03/29/2022||||14532|||||No|No||GREENSTONE LLC.|No||||
tolterodine tartrate|No|No|No|No|75%|59762080002|TOLTERODINE TARTRATE 2 MG TAB|60|EA|.65718|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|006|No|.55522|03/29/2022|.54189|03/29/2022|.5455|03/29/2022|||BLADDER RELAXANT PREPARATIONS|14533|||||No|No||GREENSTONE LLC.|No||||
tolterodine tartrate|No|No|No|No|75%|59762080006|TOLTERODINE TARTRATE 2 MG TAB|500|EA|.65722|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|006|No|.55522|03/29/2022|.54189|03/29/2022|.5455|03/29/2022|||BLADDER RELAXANT PREPARATIONS|14534|||||No|No||GREENSTONE LLC.|No||||
nadolol|No|No|No|No|75%|59762081001|NADOLOL 20 MG TABLET|100|EA|.66349|05/05/2014||Yes|No||05/05/2014||Yes|No|05/05/2014||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|070|No|.34023|03/29/2022|.33206|03/29/2022|.33427|03/29/2022|||BETA-BLOCKERS|14535|||||No|No||GREENSTONE LLC.|No||||
nadolol|No|No|No|No|75%|59762081101|NADOLOL 40 MG TABLET|100|EA|.77627|05/05/2014||Yes|No||05/05/2014||Yes|No|05/05/2014||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|070|No|.40202|03/29/2022|.39237|03/29/2022|.39498|03/29/2022|||BETA-BLOCKERS|14536|||||No|No||GREENSTONE LLC.|No||||
nadolol|No|No|No|No|75%|59762081201|NADOLOL 80 MG TABLET|100|EA|1.06648|05/05/2014||Yes|No||05/05/2014||Yes|No|05/05/2014||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|070|No|.57501|03/29/2022|.5612|03/29/2022|.56494|03/29/2022|||BETA-BLOCKERS|14537|||||No|No||GREENSTONE LLC.|No||||
voriconazole|No|No|No|No|75%|59762093503|VORICONAZOLE 40 MG/ML SUSP|75|ML|4.8403|12/18/2013||Yes|No||12/18/2013||Yes|No|12/18/2013||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|069|No|11.03139|06/01/2016|10.8738|06/01/2016|10.356|06/01/2016|||ANTIFUNGALS: ORAL|14538|||||No|No||GREENSTONE LLC.|No||||
sirolimus|No|No|No|No|75%|59762100101|SIROLIMUS 0.5 MG TABLET|100|EA|2.98583|06/02/2014||Yes|No||06/02/2014||Yes|No|06/02/2014||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|229|No|4.84817|03/29/2022|4.73181|03/29/2022|4.76332|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|14539|||||No|No||GREENSTONE LLC.|No||||
sirolimus|No|No|No|No|75%|59762100201|SIROLIMUS 1 MG TABLET|100|EA|5.97171|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|229|No|5.87013|03/29/2022|5.72924|03/29/2022|5.7674|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|14540|||||No|No||GREENSTONE LLC.|No||||
sirolimus|No|No|No|No|75%|59762100301|SIROLIMUS 2 MG TABLET|100|EA|11.94342|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|229|No|27.21989|05/25/2021|26.83103|05/25/2021|25.55336|05/25/2021|||IMMUNOSUPPRESSIVES: ORAL|14541|||||No|No||GREENSTONE LLC.|No||||
nifedipine|No|No|No|No|75%|59762100401|NIFEDIPINE 10 MG CAPSULE|100|EA|.30852|03/26/2013||Yes|No||03/26/2013||Yes|No|03/26/2013||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|045|No|.40848|03/29/2022|.39867|03/29/2022|.40133|03/29/2022|||CALCIUM CHANNEL BLOCKERS|14542|||||No|No||GREENSTONE LLC.|No||||
cabergoline|No|No|No|No|75%|59762100501|CABERGOLINE 0.5 MG TABLET|8|EA|2.51496|04/07/2015||Yes|No||04/07/2015||Yes|No|04/07/2015||Yes|No||||No|No|||Prescription required|No|||No|2.46183|03/29/2022|2.40274|03/29/2022|2.41874|03/29/2022||||14543|||||No|No||GREENSTONE LLC.|No||||
diphenoxylate HCl/atropine|No|No|No|No|75%|59762106101|DIPHENOXYLATE-ATROP 2.5-0.025|100|EA|.17608|08/16/2011||Yes|No||08/16/2011||Yes|No|08/16/2011||Yes|No||||No|No|||Prescription required|No|||No|.22711|03/29/2022|.22165|03/29/2022|.22313|03/29/2022||||14544|||||No|No||GREENSTONE LLC.|No||||
diphenoxylate HCl/atropine|No|No|No|No|75%|59762106102|DIPHENOXYLATE-ATROP 2.5-0.025|1000|EA|.17608|11/14/2013||Yes|No||11/14/2013||Yes|No|11/14/2013||Yes|No||||No|No|||Prescription required|No|||No|.22711|03/29/2022|.22165|03/29/2022|.22313|03/29/2022||||14545|||||No|No||GREENSTONE LLC.|No||||
desvenlafaxine succinate|No|No|No|No|75%|59762121003|DESVENLAFAXINE SUCCNT ER 25 MG|30|EA|.28509|06/26/2017||Yes|No||06/26/2017||Yes|No|06/26/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.63768|03/29/2022|.62237|03/29/2022|.62652|03/29/2022|||ANTIDEPRESSANTS: OTHER|14546|||||No|No||GREENSTONE LLC.|No||||
desvenlafaxine succinate|No|No|No|No|75%|59762121103|DESVENLAFAXINE SUCCNT ER 50 MG|30|EA|.28509|06/26/2017||Yes|No||06/26/2017||Yes|No|06/26/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.57735|03/29/2022|.56349|03/29/2022|.56724|03/29/2022|||ANTIDEPRESSANTS: OTHER|14547|||||No|No||GREENSTONE LLC.|No||||
desvenlafaxine succinate|No|No|No|No|75%|59762122203|DESVENLAFAXINE SUCCNT ER 100MG|30|EA|.28509|06/26/2017||Yes|No||06/26/2017||Yes|No|06/26/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.60974|03/29/2022|.5951|03/29/2022|.59906|03/29/2022|||ANTIDEPRESSANTS: OTHER|14548|||||No|No||GREENSTONE LLC.|No||||
linezolid|No|No|No|No|75%|59762130701|LINEZOLID 600 MG TABLET|20|EA|3.10567|01/08/2016||Yes|No||01/08/2016||Yes|No|01/08/2016||Yes|No||||No|No|||Prescription required|No||146|No|2.07915|03/29/2022|2.02925|03/29/2022|2.04276|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|14549|||||No|No||GREENSTONE LLC.|No||||
linezolid|No|No|No|No|75%|59762130702|LINEZOLID 600 MG TABLET|20|EA|3.10567|01/08/2016||Yes|No||01/08/2016||Yes|No|01/08/2016||Yes|No||||No|No|||Prescription required|No||146|No|2.07915|03/29/2022|2.02925|03/29/2022|2.04276|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|14550|||||No|No||GREENSTONE LLC.|No||||
linezolid|No|No|No|No|75%|59762130801|LINEZOLID 100 MG/5 ML SUSP|150|ML|1.88053|06/20/2016||Yes|No||06/20/2016||Yes|No|06/20/2016||Yes|No||||No|No|||Prescription required|No||146|No|4.28586|06/20/2016|4.22463|06/20/2016|4.02346|06/20/2016|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|14551|||||No|No||GREENSTONE LLC.|No||||
rifabutin|No|No|No|No|75%|59762135001|RIFABUTIN 150 MG CAPSULE|100|EA|8.39724|05/28/2014||Yes|No||05/28/2014||Yes|No|05/28/2014||Yes|No||||No|No|||Prescription required|No|||No|13.71549|05/26/2020|13.51955|05/26/2020|12.87576|05/26/2020||||14552|||||No|No||GREENSTONE LLC.|No||||
celecoxib|No|No|No|No|75%|59762151501|CELECOXIB 50 MG CAPSULE|60|EA|.15415|01/09/2015||Yes|No||01/09/2015||Yes|No|01/09/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.1386|03/29/2022|.13527|03/29/2022|.13617|03/29/2022|||NSAIDS|14553|||||No|No||GREENSTONE LLC.|No||||
celecoxib|No|No|No|No|75%|59762151601|CELECOXIB 100 MG CAPSULE|100|EA|.2561|01/09/2015||Yes|No||01/09/2015||Yes|No|01/09/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|14554|||||No|No||GREENSTONE LLC.|No||||
celecoxib|No|No|No|No|75%|59762151603|CELECOXIB 100 MG CAPSULE|500|EA|.26125|01/09/2015||Yes|No||01/09/2015||Yes|No|01/09/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|14555|||||No|No||GREENSTONE LLC.|No||||
celecoxib|No|No|No|No|75%|59762151701|CELECOXIB 200 MG CAPSULE|100|EA|.44169|01/09/2015||Yes|No||01/09/2015||Yes|No|01/09/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|14556|||||No|No||GREENSTONE LLC.|No||||
celecoxib|No|No|No|No|75%|59762151703|CELECOXIB 200 MG CAPSULE|500|EA|.42218|01/09/2015||Yes|No||01/09/2015||Yes|No|01/09/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|14557|||||No|No||GREENSTONE LLC.|No||||
celecoxib|No|No|No|No|75%|59762151802|CELECOXIB 400 MG CAPSULE|60|EA|.8066|01/09/2015||Yes|No||01/09/2015||Yes|No|01/09/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.73632|03/29/2022|.71864|03/29/2022|.72343|03/29/2022|||NSAIDS|14558|||||No|No||GREENSTONE LLC.|No||||
eplerenone|No|No|No|No|75%|59762171001|EPLERENONE 25 MG TABLET|100|EA|1.33287|03/05/2009||Yes|No||03/05/2009||Yes|No|03/05/2009||Yes|No||||No|No|||Prescription required|No|||No|.73164|03/29/2022|.71408|03/29/2022|.71883|03/29/2022||||14559|||||No|No||GREENSTONE LLC.|No||||
eplerenone|No|No|No|No|75%|59762171002|EPLERENONE 25 MG TABLET|30|EA|.60171|03/05/2009||Yes|No||03/05/2009||Yes|No|03/05/2009||Yes|No||||No|No|||Prescription required|No|||No|.73164|03/29/2022|.71408|03/29/2022|.71883|03/29/2022||||14560|||||No|No||GREENSTONE LLC.|No||||
eplerenone|No|No|No|No|75%|59762171003|EPLERENONE 25 MG TABLET|90|EA|.60175|03/05/2009||Yes|No||03/05/2009||Yes|No|03/05/2009||Yes|No||||No|No|||Prescription required|No|||No|.73164|03/29/2022|.71408|03/29/2022|.71883|03/29/2022||||14561|||||No|No||GREENSTONE LLC.|No||||
eplerenone|No|No|No|No|75%|59762172001|EPLERENONE 50 MG TABLET|30|EA|.60171|03/05/2009||Yes|No||03/05/2009||Yes|No|03/05/2009||Yes|No||||No|No|||Prescription required|No|||No|.85922|03/29/2022|.83859|03/29/2022|.84418|03/29/2022||||14562|||||No|No||GREENSTONE LLC.|No||||
eplerenone|No|No|No|No|75%|59762172002|EPLERENONE 50 MG TABLET|90|EA|.60175|03/05/2009||Yes|No||03/05/2009||Yes|No|03/05/2009||Yes|No||||No|No|||Prescription required|No|||No|.85922|03/29/2022|.83859|03/29/2022|.84418|03/29/2022||||14563|||||No|No||GREENSTONE LLC.|No||||
ziprasidone HCl|No|No|No|No|75%|59762200101|ZIPRASIDONE HCL 20 MG CAPSULE|60|EA|.43|03/08/2012|11/03/2022|Yes|No||03/08/2012|11/03/2022|Yes|No|03/08/2012|11/03/2022|Yes|No||||No|No|||Prescription required|No||027|Yes|.27381|03/29/2022|.26723|03/29/2022|.26901|03/29/2022|||ANTIPSYCHOTICS|14564|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GREENSTONE LLC.|No||||
ziprasidone HCl|No|No|No|No|75%|59762200201|ZIPRASIDONE HCL 40 MG CAPSULE|60|EA|.43|03/08/2012||Yes|No||03/08/2012||Yes|No|03/08/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.29914|03/29/2022|.29196|03/29/2022|.2939|03/29/2022|||ANTIPSYCHOTICS|14565|||||No|No||GREENSTONE LLC.|No||||
ziprasidone HCl|No|No|No|No|75%|59762200301|ZIPRASIDONE HCL 60 MG CAPSULE|60|EA|.48375|03/08/2012||Yes|No||03/08/2012||Yes|No|03/08/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.38441|03/29/2022|.37518|03/29/2022|.37768|03/29/2022|||ANTIPSYCHOTICS|14566|||||No|No||GREENSTONE LLC.|No||||
ziprasidone HCl|No|No|No|No|75%|59762200401|ZIPRASIDONE HCL 80 MG CAPSULE|60|EA|.48375|03/08/2012||Yes|No||03/08/2012||Yes|No|03/08/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.42395|03/29/2022|.41377|03/29/2022|.41653|03/29/2022|||ANTIPSYCHOTICS|14567|||||No|No||GREENSTONE LLC.|No||||
sildenafil citrate|No|No|No|No|75%|59762205801|SILDENAFIL 10 MG/ML ORAL SUSP|112|ML|11.85832|11/21/2019||Yes|No||11/21/2019||Yes|No|11/21/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/25/2019|171|Yes|27.02595|07/28/2020|26.63986|07/28/2020|25.3713|07/28/2020|||PAH AGENTS: ORAL AND INHALED|14568|||||No|No||GREENSTONE LLC.|No||||
ethosuximide|No|No|No|No|75%|59762225002|ETHOSUXIMIDE 250 MG CAPSULE|100|EA|.51522|11/10/2015||Yes|No||11/10/2015||Yes|No|11/10/2015||Yes|No||||No|No|||Prescription required|No||056|No|.61011|03/29/2022|.59546|03/29/2022|.59943|03/29/2022|||ANTICONVULSANTS|14569|||||No|No||GREENSTONE LLC.|No||||
doxazosin mesylate|No|No|No|No|75%|59762231006|DOXAZOSIN MESYLATE 1 MG TAB|100|EA|.18287|10/01/2014|11/03/2022|Yes|No||10/01/2014|11/03/2022|Yes|No|10/01/2014|11/03/2022|Yes|No||||No|No|||Prescription required|No||003|Yes|.09392|03/29/2022|.09166|03/29/2022|.09227|03/29/2022|||BPH TREATMENTS|14570|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GREENSTONE LLC.|No||||
doxazosin mesylate|No|No|No|No|75%|59762232006|DOXAZOSIN MESYLATE 2 MG TAB|100|EA|.18287|10/01/2014|10/19/2022|Yes|No||10/01/2014|10/19/2022|Yes|No|10/01/2014|10/19/2022|Yes|No||||No|No|||Prescription required|No||003|Yes|.085|03/29/2022|.08296|03/29/2022|.08351|03/29/2022|||BPH TREATMENTS|14571|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GREENSTONE LLC.|No||||
eletriptan hydrobromide|No|No|No|No|75%|59762232101|ELETRIPTAN HBR 20 MG TABLET|6|EA|5.1385|11/16/2017||Yes|No||11/16/2017||Yes|No|11/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|021|No|6.78979|03/29/2022|6.62683|03/29/2022|6.67096|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|14572|||||No|No||GREENSTONE LLC.|No||||
eletriptan hydrobromide|No|No|No|No|75%|59762232201|ELETRIPTAN HBR 40 MG TABLET|6|EA|5.1385|11/16/2017||Yes|No||11/16/2017||Yes|No|11/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|021|No|3.20664|03/29/2022|3.12968|03/29/2022|3.15052|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|14573|||||No|No||GREENSTONE LLC.|No||||
doxazosin mesylate|No|No|No|No|75%|59762234006|DOXAZOSIN MESYLATE 4 MG TAB|100|EA|.20609|10/01/2014||Yes|No||10/01/2014||Yes|No|10/01/2014||Yes|No||||No|No|||Prescription required|No||003|Yes|.10379|03/29/2022|.10129|03/29/2022|.10197|03/29/2022|||BPH TREATMENTS|14574|||||No|No||GREENSTONE LLC.|No||||
ethosuximide|No|No|No|No|75%|59762235006|ETHOSUXIMIDE 250 MG/5 ML SOLN|474|ML|.05109|10/27/2020||Yes|No||10/27/2020||Yes|No|10/27/2020||Yes|No||||No|No|||Prescription required|No||056|No|.15831|03/01/2022|.15451|03/01/2022|.15553|03/01/2022|||ANTICONVULSANTS|14575|||||No|No||GREENSTONE LLC.|No||||
doxazosin mesylate|No|No|No|No|75%|59762238006|DOXAZOSIN MESYLATE 8 MG TAB|100|EA|.20644|10/01/2014|10/19/2022|Yes|No||10/01/2014|10/19/2022|Yes|No|10/01/2014|10/19/2022|Yes|No||||No|No|||Prescription required|No||003|No|.12737|03/29/2022|.12431|03/29/2022|.12514|03/29/2022|||BPH TREATMENTS|14576|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GREENSTONE LLC.|No||||
exemestane|No|No|No|No|75%|59762285801|EXEMESTANE 25 MG TABLET|30|EA|.71666|09/13/2012||Yes|No||09/13/2012||Yes|No|09/13/2012||Yes|No||||No|No|||Prescription required|No||502|No|1.32315|03/29/2022|1.29139|03/29/2022|1.29999|03/29/2022|||ONCOLOGY: ORAL - BREAST|14577|||||No|No||GREENSTONE LLC.|No||||
azithromycin|Yes|No|No|No|75%|59762305101|AZITHROMYCIN 1 GM PWD PACKET|10|EA|10.43825|08/01/2006||Yes|No||08/01/2006||Yes|No|08/01/2006||Yes|No||||No|No|11/01/2012||Prescription required|No||018|No|21.47267|03/29/2022|20.95732|03/29/2022|21.09689|03/29/2022|||MACROLIDES/KETOLIDES|14578|||||No|No||GREENSTONE LLC.|No||||
azithromycin|Yes|No|No|No|75%|59762305102|AZITHROMYCIN 1 GM PWD PACKET|3|EA|10.43753|08/14/2008||Yes|No||08/14/2008||Yes|No|08/14/2008||Yes|No||||No|No|11/01/2012||Prescription required|No||018|No|21.47267|03/29/2022|20.95732|03/29/2022|21.09689|03/29/2022|||MACROLIDES/KETOLIDES|14579|||||No|No||GREENSTONE LLC.|No||||
azithromycin|No|No|No|No|75%|59762311001|AZITHROMYCIN 100 MG/5 ML SUSP|15|ML|.74992|08/01/2006||Yes|No||08/01/2006||Yes|No|08/01/2006||Yes|No||||No|No|||Prescription required|No||018|No|.56328|03/29/2022|.54976|03/29/2022|.55342|03/29/2022|||MACROLIDES/KETOLIDES|14580|||||No|No||GREENSTONE LLC.|No||||
azithromycin|No|No|No|No|75%|59762312001|AZITHROMYCIN 200 MG/5 ML SUSP|15|ML|.74992|05/15/2008||Yes|No||05/15/2008||Yes|No|05/15/2008||Yes|No||||No|No|||Prescription required|No||018|No|.46232|03/29/2022|.45122|03/29/2022|.45422|03/29/2022|||MACROLIDES/KETOLIDES|14581|||||No|No||GREENSTONE LLC.|No||||
azithromycin|No|No|No|No|75%|59762313001|AZITHROMYCIN 200 MG/5 ML SUSP|22.5|ML|.49994|05/15/2008||Yes|No||05/15/2008||Yes|No|05/15/2008||Yes|No||||No|No|||Prescription required|No||018|No|.35562|03/29/2022|.34708|03/29/2022|.34939|03/29/2022|||MACROLIDES/KETOLIDES|14582|||||No|No||GREENSTONE LLC.|No||||
azithromycin|No|No|No|No|75%|59762314001|AZITHROMYCIN 200 MG/5 ML SUSP|30|ML|.37496|08/01/2006||Yes|No||08/01/2006||Yes|No|08/01/2006||Yes|No||||No|No|||Prescription required|No||018|No|.28375|03/29/2022|.27694|03/29/2022|.27878|03/29/2022|||MACROLIDES/KETOLIDES|14583|||||No|No||GREENSTONE LLC.|No||||
nitroglycerin|No|No|No|No|75%|59762330401|NITROGLYCERIN 0.4 MG TABLET SL|100|EA|.16193|11/29/2016||Yes|No||11/29/2016||Yes|No|11/29/2016||Yes|No||||No|No|||Prescription required|No|||No|.18753|03/29/2022|.18302|03/29/2022|.18424|03/29/2022||||14584|||||No|No||GREENSTONE LLC.|No||||
nitroglycerin|No|No|No|No|75%|59762330403|NITROGLYCERIN 0.4 MG TABLET SL|25|EA|.35324|11/29/2016||Yes|No||11/29/2016||Yes|No|11/29/2016||Yes|No||||No|No|||Prescription required|No|||No|.26492|03/29/2022|.25856|03/29/2022|.26028|03/29/2022||||14585|||||No|No||GREENSTONE LLC.|No||||
clindamycin HCl|No|No|No|No|75%|59762332801|CLINDAMYCIN HCL 150 MG CAPSULE|100|EA|.08595|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||146|No|.12382|03/29/2022|.12084|03/29/2022|.12165|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|14586|||||No|No||GREENSTONE LLC.|No||||
triazolam|No|No|No|No|90%|59762371709|TRIAZOLAM 0.125 MG TABLET|100|EA|1.2614|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No||054|Yes|1.52308|03/29/2022|1.48652|03/29/2022|1.49642|03/29/2022|||SEDATIVE HYPNOTICS|14587|||||No|No||GREENSTONE LLC.|No||||
triazolam|No|No|No|No|90%|59762371803|TRIAZOLAM 0.25 MG TABLET|500|EA|.63071|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||054|Yes|1.09553|03/29/2022|1.06923|03/29/2022|1.07635|03/29/2022|||SEDATIVE HYPNOTICS|14588|||||No|No||GREENSTONE LLC.|No||||
triazolam|No|No|No|No|90%|59762371809|TRIAZOLAM 0.25 MG TABLET|100|EA|1.2614|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No||054|Yes|1.09553|03/29/2022|1.06923|03/29/2022|1.07635|03/29/2022|||SEDATIVE HYPNOTICS|14589|||||No|No||GREENSTONE LLC.|No||||
alprazolam|No|No|No|No|90%|59762371901|ALPRAZOLAM 0.25 MG TABLET|100|EA|.01436|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02093|03/29/2022|.02042|03/29/2022|.02056|03/29/2022|||ANXIOLYTICS|14590|||||No|No||GREENSTONE LLC.|No||||
alprazolam|No|No|No|No|90%|59762371903|ALPRAZOLAM 0.25 MG TABLET|500|EA|.01406|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02093|03/29/2022|.02042|03/29/2022|.02056|03/29/2022|||ANXIOLYTICS|14591|||||No|No||GREENSTONE LLC.|No||||
alprazolam|No|No|No|No|90%|59762371904|ALPRAZOLAM 0.25 MG TABLET|1000|EA|.01286|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02093|03/29/2022|.02042|03/29/2022|.02056|03/29/2022|||ANXIOLYTICS|14592|||||No|No||GREENSTONE LLC.|No||||
alprazolam|No|No|No|No|90%|59762372001|ALPRAZOLAM 0.5 MG TABLET|100|EA|.0181|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.0228|03/29/2022|.02225|03/29/2022|.0224|03/29/2022|||ANXIOLYTICS|14593|||||No|No||GREENSTONE LLC.|No||||
alprazolam|No|No|No|No|90%|59762372003|ALPRAZOLAM 0.5 MG TABLET|500|EA|.0156|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.0228|03/29/2022|.02225|03/29/2022|.0224|03/29/2022|||ANXIOLYTICS|14594|||||No|No||GREENSTONE LLC.|No||||
alprazolam|No|No|No|No|90%|59762372004|ALPRAZOLAM 0.5 MG TABLET|1000|EA|.01518|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.0228|03/29/2022|.02225|03/29/2022|.0224|03/29/2022|||ANXIOLYTICS|14595|||||No|No||GREENSTONE LLC.|No||||
alprazolam|No|No|No|No|90%|59762372101|ALPRAZOLAM 1 MG TABLET|100|EA|.02033|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02503|03/29/2022|.02442|03/29/2022|.02459|03/29/2022|||ANXIOLYTICS|14596|||||No|No||GREENSTONE LLC.|No||||
alprazolam|No|No|No|No|90%|59762372103|ALPRAZOLAM 1 MG TABLET|500|EA|.01739|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02503|03/29/2022|.02442|03/29/2022|.02459|03/29/2022|||ANXIOLYTICS|14597|||||No|No||GREENSTONE LLC.|No||||
alprazolam|No|No|No|No|90%|59762372104|ALPRAZOLAM 1 MG TABLET|1000|EA|.01677|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.02503|03/29/2022|.02442|03/29/2022|.02459|03/29/2022|||ANXIOLYTICS|14598|||||No|No||GREENSTONE LLC.|No||||
alprazolam|No|No|No|No|90%|59762372201|ALPRAZOLAM 2 MG TABLET|100|EA|.04149|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.0533|03/29/2022|.05202|03/29/2022|.05236|03/29/2022|||ANXIOLYTICS|14599|||||No|No||GREENSTONE LLC.|No||||
alprazolam|No|No|No|No|90%|59762372203|ALPRAZOLAM 2 MG TABLET|500|EA|.03799|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||090|Yes|.0533|03/29/2022|.05202|03/29/2022|.05236|03/29/2022|||ANXIOLYTICS|14600|||||No|No||GREENSTONE LLC.|No||||
medroxyprogesterone acetate|No|No|No|No|75%|59762374202|MEDROXYPROGESTERONE 10 MG TAB|100|EA|.11399|03/01/2002|12/31/2022|Yes|No||03/01/2002|12/31/2022|Yes|No|03/01/2002|12/31/2022|Yes|No||||No|No|||Prescription required|No|||No|.14545|03/29/2022|.14195|03/29/2022|.1429|03/29/2022||||14601|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||GREENSTONE LLC.|No||||
clindamycin phosphate|No|No|No|No|75%|59762374301|CLINDAMYCIN PH 1% GEL|30|GM|.99043|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||104|No|.67613|03/29/2022|.6599|03/29/2022|.66429|03/29/2022|||ACNE AGENTS: TOPICAL|14602|||||No|No||GREENSTONE LLC.|No||||
clindamycin phosphate|No|No|No|No|75%|59762374302|CLINDAMYCIN PH 1% GEL|60|GM|.89203|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||104|No|.47333|03/29/2022|.46197|03/29/2022|.46504|03/29/2022|||ACNE AGENTS: TOPICAL|14603|||||No|No||GREENSTONE LLC.|No||||
clindamycin phosphate|No|No|No|No|75%|59762374401|CLINDAMYCIN PHOSP 1% LOTION|60|ML|.68907|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|104|No|.74671|03/29/2022|.72878|03/29/2022|.73364|03/29/2022|||ACNE AGENTS: TOPICAL|14604|||||No|No||GREENSTONE LLC.|No||||
methylprednisolone|No|No|No|No|75%|59762444002|METHYLPREDNISOLONE 4 MG DOSEPK|21|EA|.36877|10/13/2011||Yes|No||10/13/2011||Yes|No|10/13/2011||Yes|No||||No|No|||Prescription required|No||168|Yes|.17447|03/29/2022|.17028|03/29/2022|.17141|03/29/2022|||GLUCOCORTICOIDS: ORAL|14605|||||No|No||GREENSTONE LLC.|No||||
methylprednisolone|No|No|No|No|75%|59762444003|METHYLPREDNISOLONE 4 MG TABLET|100|EA|.36876|11/22/2011||Yes|No||11/22/2011||Yes|No|11/22/2011||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|168|Yes|.21195|03/29/2022|.20686|03/29/2022|.20824|03/29/2022|||GLUCOCORTICOIDS: ORAL|14606|||||No|No||GREENSTONE LLC.|No||||
medroxyprogesterone acetate|Yes|Yes|No|No|75%|59762453701|MEDROXYPROGESTERONE 150 MG/ML|1|ML|26.2988|02/14/2013||Yes|No||||No|No|01/01/2013||Yes|No|Refer to program requirements|||No|No|02/14/2013||Prescription required|No|||No|31.14606|03/29/2022|30.39855|03/29/2022|30.601|03/29/2022||||14607|||||No|No||GREENSTONE/PRAS|No||||
medroxyprogesterone acetate|Yes|Yes|No|No|75%|59762453702|MEDROXYPROGESTERONE 150 MG/ML|1|ML|26.26938|02/14/2013||Yes|No||||No|No|01/01/2013||Yes|No|Refer to program requirements|||No|No|02/14/2013||Prescription required|No|||No|30.77229|09/28/2021|30.03375|09/28/2021|30.23377|09/28/2021||||14608|||||No|No||GREENSTONE/PRAS|No||||
medroxyprogesterone acetate|Yes|Yes|No|No|75%|59762453802|MEDROXYPROGESTERONE 150 MG/ML|1|ML|30.96|02/19/2013||Yes|No||||No|No|01/01/2013||Yes|No|Refer to program requirements|||No|No|02/19/2013||Prescription required|No|||No|35.94375|03/01/2022|35.0811|03/01/2022|35.31473|03/01/2022||||14609|||||No|No||GREENSTONE/PRAS|No||||
nitroglycerin|No|No|No|No|75%|59762492101|NITROGLYCERIN 0.3 MG TABLET SL|100|EA|.16193|11/29/2016||Yes|No||11/29/2016||Yes|No|11/29/2016||Yes|No||||No|No|||Prescription required|No|||No|.22579|03/29/2022|.22037|03/29/2022|.22183|03/29/2022||||14610|||||No|No||GREENSTONE LLC.|No||||
misoprostol|No|No|No|No|75%|59762500701|MISOPROSTOL 100 MCG TABLET|60|EA|.28487|05/23/2005||Yes|No||05/23/2005||Yes|No|05/23/2005||Yes|No||||No|No|||Prescription required|No|||No|.47956|03/29/2022|.46805|03/29/2022|.47116|03/29/2022||||14611|||||No|No||GREENSTONE LLC.|No||||
misoprostol|No|No|No|No|75%|59762500702|MISOPROSTOL 100 MCG TABLET|120|EA|.28505|05/23/2005||Yes|No||05/23/2005||Yes|No|05/23/2005||Yes|No||||No|No|||Prescription required|No|||No|.47956|03/29/2022|.46805|03/29/2022|.47116|03/29/2022||||14612|||||No|No||GREENSTONE LLC.|No||||
misoprostol|No|No|No|No|75%|59762500801|MISOPROSTOL 200 MCG TABLET|60|EA|.4153|05/23/2005||Yes|No||05/23/2005||Yes|No|05/23/2005||Yes|No||||No|No|||Prescription required|No|||No|.71283|03/29/2022|.69572|03/29/2022|.70035|03/29/2022||||14613|||||No|No||GREENSTONE LLC.|No||||
misoprostol|No|No|No|No|75%|59762500802|MISOPROSTOL 200 MCG TABLET|100|EA|.41516|05/23/2005||Yes|No||05/23/2005||Yes|No|05/23/2005||Yes|No||||No|No|||Prescription required|No|||No|.71283|03/29/2022|.69572|03/29/2022|.70035|03/29/2022||||14614|||||No|No||GREENSTONE LLC.|No||||
clindamycin phosphate|Yes|No|No|No|75%|59762500901|CLINDAMYCIN 2% VAGINAL CREAM|40|GM|.93396|02/24/2006||Yes|No||02/24/2006||Yes|No|02/24/2006||Yes|No||||No|No|11/01/2012||Prescription required|Yes|01/30/2020|124|No|1.72408|03/29/2022|1.6827|03/29/2022|1.6939|03/29/2022|||ANTIBIOTICS: VAGINAL|14615|||||No|No||GREENSTONE LLC.|No||||
clindamycin HCl|No|No|No|No|75%|59762501002|CLINDAMYCIN HCL 300 MG CAPSULE|100|EA|.19702|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||146|No|.25846|03/29/2022|.25225|03/29/2022|.25393|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|14616|||||No|No||GREENSTONE LLC.|No||||
spironolact/hydrochlorothiazid|No|No|No|No|75%|59762501401|SPIRONOLACTONE-HCTZ 25-25 TAB|100|EA|.4257|04/09/2002||Yes|No||04/09/2002||Yes|No|04/09/2002||Yes|No||||No|No|||Prescription required|No|||Yes|.6635|03/29/2022|.64757|03/29/2022|.65188|03/29/2022||||14617|||||No|No||GREENSTONE/PRAS|No||||
fluconazole|No|No|No|No|75%|59762501601|FLUCONAZOLE 100 MG TABLET|30|EA|.56788|06/13/2005||Yes|No||06/13/2005||Yes|No|06/13/2005||Yes|No||||No|No|||Prescription required|No||069|No|.34281|03/29/2022|.33458|03/29/2022|.33681|03/29/2022|||ANTIFUNGALS: ORAL|14618|||||No|No||GREENSTONE LLC.|No||||
fluconazole|Yes|No|No|No|75%|59762501701|FLUCONAZOLE 150 MG TABLET|12|EA|1.01551|09/29/2004||Yes|No||09/29/2004||Yes|No|||No|No||||No|No|11/01/2012||Prescription required|No||069|No|.74933|03/29/2022|.73134|03/29/2022|.73621|03/29/2022|||ANTIFUNGALS: ORAL|14619|||||No|No||GREENSTONE LLC.|No||||
fluconazole|No|No|No|No|75%|59762501801|FLUCONAZOLE 200 MG TABLET|30|EA|.92908|09/29/2004||Yes|No||09/29/2004||Yes|No|||No|No||||No|No|||Prescription required|No||069|No|.52936|03/29/2022|.51665|03/29/2022|.52009|03/29/2022|||ANTIFUNGALS: ORAL|14620|||||No|No||GREENSTONE LLC.|No||||
fluconazole|No|No|No|No|75%|59762502901|FLUCONAZOLE 10 MG/ML SUSP|35|ML|.19902|09/29/2004||Yes|No||09/29/2004||Yes|No|||No|No||||No|No|||Prescription required|No||069|No|.28361|03/29/2022|.2768|03/29/2022|.27864|03/29/2022|||ANTIFUNGALS: ORAL|14621|||||No|No||GREENSTONE LLC.|No||||
fluconazole|No|No|No|No|75%|59762503001|FLUCONAZOLE 40 MG/ML SUSP|35|ML|.72301|08/22/2009||Yes|No||08/22/2009||Yes|No|||No|No||||No|No|||Prescription required|No||069|No|.56233|03/29/2022|.54883|03/29/2022|.55248|03/29/2022|||ANTIFUNGALS: ORAL|14622|||||No|No||GREENSTONE LLC.|No||||
gabapentin|No|No|No|No|75%|59762505001|GABAPENTIN 250 MG/5 ML SOLN|470|ML|.06385|05/19/2020||Yes|No||05/19/2020||Yes|No|05/19/2020||Yes|No||||No|No|||Prescription required|No||232|Yes|.09961|03/29/2022|.09721|03/29/2022|.09786|03/29/2022|||NEUROPATHIC PAIN|14623|||||No|No||GREENSTONE LLC.|No||||
sertraline HCl|Yes|No|No|No|75%|59762516001|SERTRALINE HCL 100 MG TABLET|30|EA|.04873|06/04/2020|02/28/2022|Yes|No||06/04/2020|02/28/2022|Yes|No|06/04/2020|02/28/2022|Yes|No||||No|No|09/21/2020|02/28/2022|Prescription required|No||008|No|.11106|03/15/2022|.10947|03/15/2022|.10426|03/15/2022|||ANTIDEPRESSANTS: SSRIs|14624|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||GREENSTONE LLC.|No||||
sertraline HCl|Yes|No|No|No|75%|59762516002|SERTRALINE HCL 100 MG TABLET|100|EA|.04871|06/04/2020|03/31/2022|Yes|No||06/04/2020|03/31/2022|Yes|No|06/04/2020|03/31/2022|Yes|No||||No|No|09/21/2020|03/31/2022|Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14625|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||GREENSTONE LLC.|No||||
sertraline HCl|Yes|No|No|No|75%|59762516003|SERTRALINE HCL 100 MG TABLET|500|EA|.04873|06/04/2020|03/31/2022|Yes|No||06/04/2020|03/31/2022|Yes|No|06/04/2020|03/31/2022|Yes|No||||No|No|09/21/2020|03/31/2022|Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14626|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||GREENSTONE LLC.|No||||
phenytoin|No|No|No|No|75%|59762521001|PHENYTOIN 50 MG INFATAB CHEW|100|EA|.172|01/02/2013||Yes|No||01/02/2013||Yes|No|01/02/2013||Yes|No||||No|No|||Prescription required|No||056|No|.28181|03/29/2022|.27504|03/29/2022|.27687|03/29/2022|||ANTICONVULSANTS|14627|||||No|No||GREENSTONE/PRAS|No||||
prazosin HCl|No|No|No|No|75%|59762531001|PRAZOSIN 1 MG CAPSULE|90|EA|.12995|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No|||No|.1999|03/29/2022|.1951|03/29/2022|.1964|03/29/2022||||14628|||||No|No||GREENSTONE/PRAS|No||||
prazosin HCl|No|No|No|No|75%|59762532001|PRAZOSIN 2 MG CAPSULE|90|EA|.19192|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No|||No|.29873|03/29/2022|.29156|03/29/2022|.2935|03/29/2022||||14629|||||No|No||GREENSTONE/PRAS|No||||
prazosin HCl|No|No|No|No|75%|59762535001|PRAZOSIN 5 MG CAPSULE|90|EA|.31676|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No|||No|.53856|03/29/2022|.52563|03/29/2022|.52913|03/29/2022||||14630|||||No|No||GREENSTONE/PRAS|No||||
oxaprozin|No|No|No|No|75%|59762600201|OXAPROZIN 600 MG CAPLET|100|EA|.70898|04/01/2013||Yes|No||04/01/2013||Yes|No|04/01/2013||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.63712|03/29/2022|.62182|03/29/2022|.62597|03/29/2022|||NSAIDS|14631|||||No|No||GREENSTONE LLC.|No||||
sertraline HCl|Yes|No|No|No|75%|59762634701|SERTRALINE HCL 25 MG TABLET|30|EA|.04113|06/04/2020|03/31/2022|Yes|No||06/04/2020|03/31/2022|Yes|No|06/04/2020|03/31/2022|Yes|No||||No|No|09/21/2020|03/31/2022|Prescription required|No||008|Yes|.05057|03/29/2022|.04935|03/29/2022|.04968|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14632|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||GREENSTONE LLC.|No||||
sertraline HCl|Yes|No|No|No|75%|59762644301|SERTRALINE HCL 50 MG TABLET|30|EA|.04113|06/04/2020|02/28/2022|Yes|No||06/04/2020|02/28/2022|Yes|No|06/04/2020|02/28/2022|Yes|No||||No|No|09/21/2020|02/28/2022|Prescription required|No||008|Yes|.09374|03/15/2022|.0924|03/15/2022|.088|03/15/2022|||ANTIDEPRESSANTS: SSRIs|14633|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||GREENSTONE LLC.|No||||
sertraline HCl|Yes|No|No|No|75%|59762644302|SERTRALINE HCL 50 MG TABLET|100|EA|.04115|06/04/2020|02/28/2022|Yes|No||06/04/2020|02/28/2022|Yes|No|06/04/2020|02/28/2022|Yes|No||||No|No|09/21/2020|02/28/2022|Prescription required|No||008|Yes|.09378|03/15/2022|.09244|03/15/2022|.08804|03/15/2022|||ANTIDEPRESSANTS: SSRIs|14634|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||GREENSTONE LLC.|No||||
sertraline HCl|Yes|No|No|No|75%|59762644303|SERTRALINE HCL 50 MG TABLET|500|EA|.04113|06/04/2020|02/28/2022|Yes|No||06/04/2020|02/28/2022|Yes|No|06/04/2020|02/28/2022|Yes|No||||No|No|09/21/2020|02/28/2022|Prescription required|No||008|Yes|.09374|03/15/2022|.0924|03/15/2022|.088|03/15/2022|||ANTIDEPRESSANTS: SSRIs|14635|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||GREENSTONE LLC.|No||||
amlodipine/atorvastatin|No|No|No|No|75%|59762671001|AMLODIPINE-ATORVAST 2.5-10 MG|30|EA|1.86734|08/15/2014||Yes|No||08/15/2014||Yes|No|08/15/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|063|Yes|4.2558|06/01/2016|4.195|06/01/2016|3.99524|06/01/2016|||LIPOTROPICS: STATINS|14636|||||No|No||GREENSTONE/PRAS|No||||
amlodipine/atorvastatin|No|No|No|No|75%|59762671101|AMLODIPINE-ATORVAST 2.5-20 MG|30|EA|2.41158|04/07/2014||Yes|No||04/07/2014||Yes|No|04/07/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|063|Yes|5.49616|06/01/2016|5.41764|06/01/2016|5.15966|06/01/2016|||LIPOTROPICS: STATINS|14637|||||No|No||GREENSTONE/PRAS|No||||
amlodipine/atorvastatin|No|No|No|No|75%|59762671201|AMLODIPINE-ATORVAST 2.5-40 MG|30|EA|2.59462|08/15/2014||Yes|No||08/15/2014||Yes|No|08/15/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|063|Yes|5.91332|06/01/2016|5.82884|06/01/2016|5.55128|06/01/2016|||LIPOTROPICS: STATINS|14638|||||No|No||GREENSTONE/PRAS|No||||
amlodipine/atorvastatin|No|No|No|No|75%|59762672001|AMLODIPINE-ATORVAST 5-10 MG|30|EA|1.86734|08/15/2014||Yes|No||08/15/2014||Yes|No|08/15/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|063|Yes|2.51729|03/29/2022|2.45687|03/29/2022|2.47323|03/29/2022|||LIPOTROPICS: STATINS|14639|||||No|No||GREENSTONE/PRAS|No||||
amlodipine/atorvastatin|No|No|No|No|75%|59762672101|AMLODIPINE-ATORVAST 5-20 MG|30|EA|2.41158|08/15/2014||Yes|No||08/15/2014||Yes|No|08/15/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|063|Yes|2.6682|03/29/2022|2.60416|03/29/2022|2.6215|03/29/2022|||LIPOTROPICS: STATINS|14640|||||No|No||GREENSTONE/PRAS|No||||
amlodipine/atorvastatin|No|No|No|No|75%|59762672201|AMLODIPINE-ATORVAST 5-40 MG|30|EA|2.59462|08/15/2014||Yes|No||08/15/2014||Yes|No|08/15/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|063|Yes|3.582|03/01/2022|3.49603|03/01/2022|3.51931|03/01/2022|||LIPOTROPICS: STATINS|14641|||||No|No||GREENSTONE/PRAS|No||||
amlodipine/atorvastatin|No|No|No|No|75%|59762672301|AMLODIPINE-ATORVAST 5-80 MG|30|EA|2.59462|08/15/2014||Yes|No||08/15/2014||Yes|No|08/15/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|063|Yes|5.91332|07/24/2018|5.82884|07/24/2018|5.55128|07/24/2018|||LIPOTROPICS: STATINS|14642|||||No|No||GREENSTONE/PRAS|No||||
amlodipine/atorvastatin|No|No|No|No|75%|59762673001|AMLODIPINE-ATORVAST 10-10 MG|30|EA|1.86734|08/15/2014||Yes|No||08/15/2014||Yes|No|08/15/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|063|Yes|2.18539|03/29/2022|2.13294|03/29/2022|2.14714|03/29/2022|||LIPOTROPICS: STATINS|14643|||||No|No||GREENSTONE/PRAS|No||||
amlodipine/atorvastatin|No|No|No|No|75%|59762673101|AMLODIPINE-ATORVAST 10-20 MG|30|EA|2.41158|08/15/2014||Yes|No||08/15/2014||Yes|No|08/15/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|063|Yes|1.70393|03/29/2022|1.66303|03/29/2022|1.67411|03/29/2022|||LIPOTROPICS: STATINS|14644|||||No|No||GREENSTONE/PRAS|No||||
amlodipine/atorvastatin|No|No|No|No|75%|59762673201|AMLODIPINE-ATORVAST 10-40 MG|30|EA|2.59462|08/15/2014||Yes|No||08/15/2014||Yes|No|08/15/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|063|Yes|2.04729|03/29/2022|1.99815|03/29/2022|2.01146|03/29/2022|||LIPOTROPICS: STATINS|14645|||||No|No||GREENSTONE/PRAS|No||||
amlodipine/atorvastatin|No|No|No|No|75%|59762673301|AMLODIPINE-ATORVAST 10-80 MG|30|EA|2.59462|08/15/2014||Yes|No||08/15/2014||Yes|No|08/15/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|063|Yes|4.0268|03/01/2022|3.93015|03/01/2022|3.95633|03/01/2022|||LIPOTROPICS: STATINS|14646|||||No|No||GREENSTONE/PRAS|No||||
lipase/protease/amylase|No|No|No|No|75%|59767000401|PERTZYE DR 4,000 UNIT CAPSULE|100|EA|.72541|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|108|No|1.65326|01/05/2021|1.62964|01/05/2021|1.55204|01/05/2021|||PANCREATIC ENZYMES|14647|||||No|No||DIGESTIVE CARE|No||||
lipase/protease/amylase|No|No|No|No|75%|59767000801|PERTZYE DR 8,000 UNIT CAPSULE|100|EA|1.08145|12/10/2012||Yes|No||12/10/2012||Yes|No|12/10/2012||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|108|No|2.4647|01/05/2021|2.42949|01/05/2021|2.3138|01/05/2021|||PANCREATIC ENZYMES|14648|||||No|No||DIGESTIVE CARE|No||||
lipase/protease/amylase|No|No|No|No|75%|59767000802|PERTZYE DR 8,000 UNIT CAPSULE|250|EA|1.08145|12/10/2012||Yes|No||12/10/2012||Yes|No|12/10/2012||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|108|No|2.4647|01/05/2021|2.42949|01/05/2021|2.3138|01/05/2021|||PANCREATIC ENZYMES|14649|||||No|No||DIGESTIVE CARE|No||||
lipase/protease/amylase|No|No|No|No|75%|59767001601|PERTZYE DR 16,000 UNIT CAPSULE|100|EA|2.1629|12/10/2012||Yes|No||12/10/2012||Yes|No|12/10/2012||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|108|No|4.9294|01/05/2021|4.85898|01/05/2021|4.6276|01/05/2021|||PANCREATIC ENZYMES|14650|||||No|No||DIGESTIVE CARE|No||||
lipase/protease/amylase|No|No|No|No|75%|59767001602|PERTZYE DR 16,000 UNIT CAPSULE|250|EA|2.1629|12/10/2012||Yes|No||12/10/2012||Yes|No|12/10/2012||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|108|No|4.9294|01/05/2021|4.85898|01/05/2021|4.6276|01/05/2021|||PANCREATIC ENZYMES|14651|||||No|No||DIGESTIVE CARE|No||||
lipase/protease/amylase|No|No|No|No|75%|59767002401|PERTZYE DR 24,000 UNIT CAPSULE|80|EA|3.2465|01/15/2018||Yes|No||01/15/2018||Yes|No|01/15/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|108|No|7.399|01/05/2021|7.2933|01/05/2021|6.946|01/05/2021|||PANCREATIC ENZYMES|14652|||||No|No||DIGESTIVE CARE|No||||
ferric citrate|No|No|No|No|75%|59922063101|AURYXIA 210 MG TABLET|200|EA|2.9326|11/14/2014||Yes|No||11/14/2014||Yes|No|11/14/2014||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|052|Yes|6.53308|02/01/2022|6.37628|02/01/2022|6.41875|02/01/2022|||PHOSPHATE BINDERS|14653|||||No|No||KERYX BIOPHARMA|No||||
temozolomide|No|No|No|No|75%|59923070705|TEMOZOLOMIDE 100 MG CAPSULE|5|EA|34.57974|11/04/2020||Yes|No||11/04/2020||Yes|No|11/04/2020||Yes|No||||No|No|||Prescription required|No||239|No|78.80964|11/04/2020|77.68378|11/04/2020|73.98456|11/04/2020|||ONCOLOGY: ORAL - OTHER|14654|||||No|No||AREVA PHARMACEU|No||||
temozolomide|No|No|No|No|75%|59923070814|TEMOZOLOMIDE 100 MG CAPSULE|14|EA|34.5806|11/04/2020||Yes|No||11/04/2020||Yes|No|11/04/2020||Yes|No||||No|No|||Prescription required|No||239|No|78.8116|11/04/2020|77.68572|11/04/2020|73.9864|11/04/2020|||ONCOLOGY: ORAL - OTHER|14655|||||No|No||AREVA PHARMACEU|No||||
temozolomide|No|No|No|No|75%|59923070905|TEMOZOLOMIDE 140 MG CAPSULE|5|EA|48.41284|11/04/2020||Yes|No||11/04/2020||Yes|No|11/04/2020||Yes|No||||No|No|||Prescription required|No||239|No|13.83623|07/27/2021|13.50416|07/27/2021|13.59409|07/27/2021|||ONCOLOGY: ORAL - OTHER|14656|||||No|No||AREVA PHARMACEU|No||||
temozolomide|No|No|No|No|75%|59923071014|TEMOZOLOMIDE 140 MG CAPSULE|14|EA|48.41247|11/04/2020||Yes|No||11/04/2020||Yes|No|11/04/2020||Yes|No||||No|No|||Prescription required|No||239|No|13.83623|07/27/2021|13.50416|07/27/2021|13.59409|07/27/2021|||ONCOLOGY: ORAL - OTHER|14657|||||No|No||AREVA PHARMACEU|No||||
temozolomide|No|No|No|No|75%|59923071105|TEMOZOLOMIDE 180 MG CAPSULE|5|EA|62.24422|11/04/2020||Yes|No||11/04/2020||Yes|No|11/04/2020||Yes|No||||No|No|||Prescription required|No||239|No|141.85892|11/10/2020|139.83236|11/04/2020|133.17368|11/04/2020|||ONCOLOGY: ORAL - OTHER|14658|||||No|No||AREVA PHARMACEU|No||||
temozolomide|No|No|No|No|75%|59923071214|TEMOZOLOMIDE 180 MG CAPSULE|14|EA|62.24465|11/04/2020||Yes|No||11/04/2020||Yes|No|11/04/2020||Yes|No||||No|No|||Prescription required|No||239|No|141.8599|11/10/2020|139.83333|11/04/2020|133.1746|11/04/2020|||ONCOLOGY: ORAL - OTHER|14659|||||No|No||AREVA PHARMACEU|No||||
temozolomide|No|No|No|No|75%|59923071305|TEMOZOLOMIDE 250 MG CAPSULE|5|EA|86.47386|11/04/2020||Yes|No||11/04/2020||Yes|No|11/04/2020||Yes|No||||No|No|||Prescription required|No||239|No|197.07996|11/04/2020|194.26453|11/04/2020|185.01384|11/04/2020|||ONCOLOGY: ORAL - OTHER|14660|||||No|No||AREVA PHARMACEU|No||||
capecitabine|No|No|No|No|75%|59923072160|CAPECITABINE 150 MG TABLET|60|EA|.4449|12/08/2020||Yes|No||12/08/2020||Yes|No|12/08/2020||Yes|No||||No|No|||Prescription required|No||502|No|1.01396|12/08/2020|.99948|12/08/2020|.95188|12/08/2020|||ONCOLOGY: ORAL - BREAST|14661|||||No|No||AREVA PHARMACEU|No||||
imatinib mesylate|No|No|No|No|75%|59923072390|IMATINIB MESYLATE 100 MG TAB|90|EA|1.40944|12/08/2020||Yes|No||12/08/2020||Yes|No|12/08/2020||Yes|No||||No|No|||Prescription required|No||173|No|3.21221|07/27/2021|3.16632|07/27/2021|3.01554|07/27/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|14662|||||No|No||AREVA PHARMACEU|No||||
imatinib mesylate|No|No|No|No|75%|59923072430|IMATINIB MESYLATE 400 MG TAB|30|EA|4.3344|12/08/2020||Yes|No||12/08/2020||Yes|No|12/08/2020||Yes|No||||No|No|||Prescription required|No||173|No|2.86988|03/01/2022|2.801|03/01/2022|2.81965|03/01/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14663|||||No|No||AREVA PHARMACEU|No||||
erlotinib HCl|No|No|No|No|75%|59923072530|ERLOTINIB HCL 25 MG TABLET|30|EA|20.06666|12/08/2020||Yes|No||12/08/2020||Yes|No|12/08/2020||Yes|No||||No|No|||Prescription required|No||551|No|45.73332|12/08/2020|45.07999|12/08/2020|42.93332|12/08/2020|||ONCOLOGY: ORAL - LUNG|14664|||||No|No||AREVA PHARMACEU|No||||
erlotinib HCl|No|No|No|No|75%|59923072630|ERLOTINIB HCL 100 MG TABLET|30|EA|47.3|12/08/2020||Yes|No||12/08/2020||Yes|No|12/08/2020||Yes|No||||No|No|||Prescription required|No||551|No|107.8|12/08/2020|106.26|12/15/2020|101.2|12/08/2020|||ONCOLOGY: ORAL - LUNG|14665|||||No|No||AREVA PHARMACEU|No||||
erlotinib HCl|No|No|No|No|75%|59923072730|ERLOTINIB HCL 150 MG TABLET|30|EA|54.46666|12/08/2020||Yes|No||12/08/2020||Yes|No|12/08/2020||Yes|No||||No|No|||Prescription required|No||551|No|124.13332|12/08/2020|122.35999|12/08/2020|116.53332|12/08/2020|||ONCOLOGY: ORAL - LUNG|14666|||||No|No||AREVA PHARMACEU|No||||
potassium chloride|No|No|No|No|75%|60219106501|POTASSIUM CL ER 10 MEQ TABLET|100|EA|.086|04/23/2021|01/05/2022|Yes|No||04/23/2021|01/05/2022|Yes|No|04/23/2021|01/05/2022|Yes|No||||No|No|||Prescription required|No|||No|.18432|03/29/2022|.17989|03/29/2022|.18109|03/29/2022||||14667|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
potassium chloride|No|No|No|No|75%|60219106901|POTASSIUM CL ER 20 MEQ TABLET|100|EA|.09288|05/21/2021|01/05/2022|Yes|No||05/21/2021|01/05/2022|Yes|No|05/21/2021|01/05/2022|Yes|No||||No|No|||Prescription required|No|||No|.19104|03/29/2022|.18645|03/29/2022|.18769|03/29/2022||||14668|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
potassium chloride|No|No|No|No|75%|60219106905|POTASSIUM CL ER 20 MEQ TABLET|500|EA|.09288|03/05/2021|01/05/2022|Yes|No||03/05/2021|01/05/2022|Yes|No|03/05/2021|01/05/2022|Yes|No||||No|No|||Prescription required|No|||No|.19104|03/29/2022|.18645|03/29/2022|.18769|03/29/2022||||14669|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
phenoxybenzamine HCl|No|No|No|No|75%|60219150201|PHENOXYBENZAMINE HCL 10 MG CAP|100|EA|11.825|03/18/2021||Yes|No||03/18/2021||Yes|No|03/18/2021||Yes|No||||No|No|||Prescription required|No|||No|26.95|03/18/2021|26.565|03/23/2021|25.3|03/18/2021||||14670|||||No|No||AMNEAL PHARMACE|No||||
metyrosine|No|No|No|No|75%|60219162101|METYROSINE 250 MG CAPSULE|100|EA|107.5|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No|||No|245|05/27/2021|241.5|05/27/2021|230|05/27/2021||||14671|||||No|No||AMNEAL PHARMACE|No||||
aminocaproic acid|No|No|No|No|75%|60219163703|AMINOCAPROIC ACID 500 MG TAB|30|EA|9.1401|03/02/2020|03/01/2022|Yes|No||03/02/2020|03/01/2022|Yes|No|03/02/2020|03/01/2022|Yes|No||||No|No|||Prescription required|No|||No|13.1725|03/02/2020|12.98432|03/02/2020|12.36602|03/02/2020||||14672|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
chlordiazepoxide/clidinium Br|No|No|No|No|75%|60219167701|CHLORDIAZEPOXIDE-CLIDINIUM CAP|100|EA|.3311|03/22/2022||Yes|No||03/22/2022||Yes|No|03/22/2022||Yes|No||||No|No|||Prescription required|No|||Yes|.95937|03/29/2022|.93634|03/29/2022|.94258|03/29/2022||||14673|||||No|No||AMNEAL PHARMACE|No||||
fluphenazine HCl|No|No|No|No|75%|60219167801|FLUPHENAZINE 1 MG TABLET|100|EA|.5934|03/18/2021|01/05/2022|Yes|No||03/18/2021|01/05/2022|Yes|No|03/18/2021|01/05/2022|Yes|No||||No|No|||Prescription required|No||027|Yes|1.56797|01/25/2022|1.53033|01/25/2022|1.54053|01/25/2022|||ANTIPSYCHOTICS|14674|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
fluphenazine HCl|No|No|No|No|75%|60219167901|FLUPHENAZINE 2.5 MG TABLET|100|EA|.92097|03/18/2021|01/05/2022|Yes|No||03/18/2021|01/05/2022|Yes|No|03/18/2021|01/05/2022|Yes|No||||No|No|||Prescription required|No||027|Yes|2.3014|01/25/2022|2.24616|01/25/2022|2.26112|01/25/2022|||ANTIPSYCHOTICS|14675|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
fluphenazine HCl|No|No|No|No|75%|60219168001|FLUPHENAZINE 5 MG TABLET|100|EA|1.24605|03/18/2021|01/05/2022|Yes|No||03/18/2021|01/05/2022|Yes|No|03/18/2021|01/05/2022|Yes|No||||No|No|||Prescription required|No||027|Yes|2.98385|03/29/2022|2.91223|03/29/2022|2.93163|03/29/2022|||ANTIPSYCHOTICS|14676|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
fluphenazine HCl|No|No|No|No|75%|60219168101|FLUPHENAZINE 10 MG TABLET|100|EA|1.57104|03/18/2021|01/05/2022|Yes|No||03/18/2021|01/05/2022|Yes|No|03/18/2021|01/05/2022|Yes|No||||No|No|||Prescription required|No||027|Yes|3.52974|03/29/2022|3.44502|03/29/2022|3.46796|03/29/2022|||ANTIPSYCHOTICS|14677|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
prednisone|No|No|No|No|75%|60219170501|PREDNISONE 1 MG TABLET|100|EA|.04291|03/17/2022||Yes|No||03/17/2022||Yes|No|03/17/2022||Yes|No||||No|No|||Prescription required|No||168|Yes|.08042|03/29/2022|.07848|03/29/2022|.07901|03/29/2022|||GLUCOCORTICOIDS: ORAL|14678|||||No|No||AMNEAL PHARMACE|No||||
prednisone|No|No|No|No|75%|60219170601|PREDNISONE 5 MG TABLET|100|EA|.06161|03/17/2022||Yes|No||03/17/2022||Yes|No|03/17/2022||Yes|No||||No|No|||Prescription required|No||168|Yes|.07803|03/29/2022|.07615|03/29/2022|.07666|03/29/2022|||GLUCOCORTICOIDS: ORAL|14679|||||No|No||AMNEAL PHARMACE|No||||
prednisone|No|No|No|No|75%|60219170607|PREDNISONE 5 MG TABLET|1000|EA|.05914|03/22/2022||Yes|No||03/22/2022||Yes|No|03/22/2022||Yes|No||||No|No|||Prescription required|No||168|Yes|.07803|03/29/2022|.07615|03/29/2022|.07666|03/29/2022|||GLUCOCORTICOIDS: ORAL|14680|||||No|No||AMNEAL PHARMACE|No||||
prednisone|No|No|No|No|75%|60219170701|PREDNISONE 10 MG TABLET|100|EA|.06944|03/17/2022||Yes|No||03/17/2022||Yes|No|03/17/2022||Yes|No||||No|No|||Prescription required|No||168|Yes|.07092|03/29/2022|.06921|03/29/2022|.06967|03/29/2022|||GLUCOCORTICOIDS: ORAL|14681|||||No|No||AMNEAL PHARMACE|No||||
prednisone|No|No|No|No|75%|60219170705|PREDNISONE 10 MG TABLET|500|EA|.06944|03/17/2022||Yes|No||03/17/2022||Yes|No|03/17/2022||Yes|No||||No|No|||Prescription required|No||168|Yes|.07092|03/29/2022|.06921|03/29/2022|.06967|03/29/2022|||GLUCOCORTICOIDS: ORAL|14682|||||No|No||AMNEAL PHARMACE|No||||
prednisone|No|No|No|No|75%|60219170801|PREDNISONE 20 MG TABLET|100|EA|.07417|03/17/2022||Yes|No||03/17/2022||Yes|No|03/17/2022||Yes|No||||No|No|||Prescription required|No||168|Yes|.11229|03/29/2022|.10959|03/29/2022|.11032|03/29/2022|||GLUCOCORTICOIDS: ORAL|14683|||||No|No||AMNEAL PHARMACE|No||||
etravirine|No|No|No|No|75%|60219172107|ETRAVIRINE 100 MG TABLET|120|EA|6.43644|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|10.51286|08/25/2021|10.36267|08/25/2021|9.86921|08/25/2021|||HIV / AIDS|14684|||||No|No||AMNEAL PHARMACE|No||||
etravirine|No|No|No|No|75%|60219172206|ETRAVIRINE 200 MG TABLET|60|EA|12.87289|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|21.02573|08/25/2021|20.72536|08/25/2021|19.73844|08/25/2021|||HIV / AIDS|14685|||||No|No||AMNEAL PHARMACE|No||||
pilocarpine HCl|No|No|No|No|75%|60219174508|PILOCARPINE 1% EYE DROPS|15|ML|1.80772|04/23/2021|03/10/2022|Yes|No||04/23/2021|03/10/2022|Yes|No|04/23/2021|03/10/2022|Yes|No||||No|No|||Prescription required|No||088|No|4.04603|03/29/2022|3.94892|03/29/2022|3.97522|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|14686|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
pilocarpine HCl|No|No|No|No|75%|60219174608|PILOCARPINE 2% EYE DROPS|15|ML|1.849|04/23/2021|03/10/2022|Yes|No||04/23/2021|03/10/2022|Yes|No|04/23/2021|03/10/2022|Yes|No||||No|No|||Prescription required|No||088|No|4.33357|03/29/2022|4.22956|03/29/2022|4.25773|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|14687|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
pilocarpine HCl|No|No|No|No|75%|60219174708|PILOCARPINE 4% EYE DROPS|15|ML|1.93844|04/23/2021|03/10/2022|Yes|No||04/23/2021|03/10/2022|Yes|No|04/23/2021|03/10/2022|Yes|No||||No|No|||Prescription required|No||088|No|4.37517|11/23/2021|4.27016|11/23/2021|4.2986|11/23/2021|||OPHTHALMICS: GLAUCOMA AGENTS|14688|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
azathioprine|No|No|No|No|75%|60219203601|AZATHIOPRINE 75 MG TABLET|100|EA|6.0565|03/08/2022||Yes|No||03/08/2022||Yes|No|03/08/2022||Yes|No||||No|No|||Prescription required|No||229|No|13.8032|03/08/2022|13.60601|03/08/2022|12.9581|03/08/2022|||IMMUNOSUPPRESSIVES: ORAL|14689|||||No|No||AMNEAL PHARMACE|No||||
azathioprine|No|No|No|No|75%|60219203701|AZATHIOPRINE 100 MG TABLET|100|EA|2.70018|03/08/2022||Yes|No||03/08/2022||Yes|No|03/08/2022||Yes|No||||No|No|||Prescription required|No||229|No|6.15391|03/08/2022|6.06599|03/08/2022|5.77714|03/08/2022|||IMMUNOSUPPRESSIVES: ORAL|14690|||||No|No||AMNEAL PHARMACE|No||||
dexamethasone|No|No|No|No|75%|60219204301|DEXAMETHASONE 4 MG TABLET|100|EA|.42621|03/14/2022||Yes|No||03/14/2022||Yes|No|03/14/2022||Yes|No||||No|No|||Prescription required|No||168|Yes|.52706|03/29/2022|.51441|03/29/2022|.51783|03/29/2022|||GLUCOCORTICOIDS: ORAL|14691|||||No|No||AMNEAL PHARMACE|No||||
dexamethasone|No|No|No|No|75%|60219204401|DEXAMETHASONE 6 MG TABLET|100|EA|.63932|03/14/2022||Yes|No||03/14/2022||Yes|No|03/14/2022||Yes|No||||No|No|||Prescription required|No||168|Yes|1.17981|03/29/2022|1.15149|03/29/2022|1.15916|03/29/2022|||GLUCOCORTICOIDS: ORAL|14692|||||No|No||AMNEAL PHARMACE|No||||
fluoride (sodium)|No|No|No|No|75%|60258015001|SF 5000 PLUS CREAM|51|GM|.06525|10/26/2007||Yes|No||10/26/2007||Yes|No|10/26/2007||Yes|No||||No|No|||Prescription required|No|||No|.09748|03/29/2022|.09514|03/29/2022|.09577|03/29/2022||||14693|||||No|No||CYPRESS PHARM.|No||||
fluoride (sodium)|No|No|No|No|75%|60258015101|SF 1.1% GEL|56|GM|.05367|10/26/2007||Yes|No||10/26/2007||Yes|No|10/26/2007||Yes|No||||No|No|||Prescription required|No|||No|.13387|03/29/2022|.13065|03/29/2022|.13152|03/29/2022||||14694|||||No|No||CYPRESS PHARM.|No||||
folic acid/vit B complex and C|No|No|No|No|75%|60258016001|RENA-VITE TABLET|100|EA|.02902|||No|No||||No|No|||No|No||04/05/2014||Yes|No|||Over the counter|No|||No|||||||.0756|06/07/2016||14695|||||No|No||CYPRESS PHARM.|No||||
vit B comp no.3/folic/C/biotin|No|No|No|No|75%|60258016101|RENA-VITE RX TABLET|100|EA|.08256|||No|No||||No|No|||No|No||04/05/2014||Yes|No|||Over the counter|No|||No|||||||.21504|06/01/2016||14696|||||No|No||CYPRESS PHARM.|No||||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|60429058611|BUPRENORPHINE-NALOX 2-0.5MG TB|1|EA|2.00251|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||Yes|||||||.80601|10/01/2020||14697|||||No|No||GSMS, INC.|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|60429058630|BUPRENORPHINE-NALOX 2-0.5MG TB|30|EA|.3698|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||Yes|.8428|06/15/2021|.83076|06/15/2021|.7912|06/15/2021||||14698|||||No|No||GSMS, INC.|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|60429058633|BUPRENORPHINE-NALOX 2-0.5MG TB|30|EA|.33181|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||Yes|.75622|10/01/2020|.74542|10/01/2020|.70992|10/01/2020||||14699|||||No|No||GSMS, INC.|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|60429058711|BUPRENORPHINE-NALOX 8-2 MG TAB|1|EA|3.58892|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||Yes|||||||1.12075|10/01/2020||14700|||||No|No||GSMS, INC.|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|60429058730|BUPRENORPHINE-NALOX 8-2 MG TAB|30|EA|.68857|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||Yes|1.5693|06/15/2021|1.54688|06/15/2021|1.47322|06/15/2021||||14701|||||No|No||GSMS, INC.|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|60429058733|BUPRENORPHINE-NALOX 8-2 MG TAB|30|EA|.58981|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||Yes|1.34422|10/01/2020|1.32502|10/01/2020|1.26192|10/01/2020||||14702|||||No|No||GSMS, INC.|Yes|09/01/2020|||
lactulose|No|No|No|No|75%|60432003708|LACTULOSE 10 GM/15 ML SOLUTION|237|ML|.0077|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.01757|06/29/2021|.01732|06/29/2021|.01649|06/29/2021||||14703|||||No|No||MORTON GROVE PH|No||||
lactulose|No|No|No|No|75%|60432003732|LACTULOSE 10 GM/15 ML SOLUTION|946|ML|.00671|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.0141|03/29/2022|.01376|03/29/2022|.01385|03/29/2022||||14704|||||No|No||MORTON GROVE PH|No||||
lactulose|No|No|No|No|75%|60432003816|GENERLAC 10 GM/15 ML SOLUTION|473|ML|.00641|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.01452|03/29/2022|.01417|03/29/2022|.01426|03/29/2022||||14705|||||No|No||MORTON GROVE PH|No||||
lactulose|No|No|No|No|75%|60432003864|GENERLAC 10 GM/15 ML SOLUTION|1892|ML|.00622|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.01419|11/26/2019|.01398|11/26/2019|.01332|11/26/2019||||14706|||||No|No||MORTON GROVE PH|No||||
amoxicillin/potassium clav|No|No|No|No|75%|60432006500|AMOX-CLAV 250-62.5 MG/5 ML SUS|100|ML|.2973|06/05/2012||Yes|No||06/05/2012||Yes|No|06/05/2012||Yes|No||||No|No|||Prescription required|No||046|No|.4214|03/29/2022|.41128|03/29/2022|.41402|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|14707|||||No|No||MORTON GROVE PH|No||||
amoxicillin/potassium clav|No|No|No|No|75%|60432006547|AMOX-CLAV 250-62.5 MG/5 ML SUS|150|ML|.29125|06/05/2012||Yes|No||06/05/2012||Yes|No|06/05/2012||Yes|No||||No|No|||Prescription required|No||046|No|.40714|03/29/2022|.39736|03/29/2022|.40001|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|14708|||||No|No||MORTON GROVE PH|No||||
amoxicillin/potassium clav|No|No|No|No|75%|60432006575|AMOX-CLAV 250-62.5 MG/5 ML SUS|75|ML|.29687|06/05/2012||Yes|No||06/05/2012||Yes|No|06/05/2012||Yes|No||||No|No|||Prescription required|No||046|No|.39696|03/29/2022|.38743|03/29/2022|.39001|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|14709|||||No|No||MORTON GROVE PH|No||||
oxybutynin chloride|No|No|No|No|75%|60432009216|OXYBUTYNIN 5 MG/5 ML SYRUP|473|ML|.01818|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||006|No|.03028|03/29/2022|.02955|03/29/2022|.02975|03/29/2022|||BLADDER RELAXANT PREPARATIONS|14710|||||No|No||MORTON GROVE PH|No||||
amantadine HCl|No|No|No|No|75%|60432009316|AMANTADINE 50 MG/5 ML SOLUTION|473|ML|.01631|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||015|No|.02319|03/29/2022|.02263|03/29/2022|.02278|03/29/2022|||ANTIPARKINSON'S AGENTS|14711|||||No|No||MORTON GROVE PH|No||||
megestrol acetate|No|No|No|No|75%|60432012608|MEGESTROL ACET 40 MG/ML SUSP|240|ML|.05375|11/23/2004||Yes|No||11/23/2004||Yes|No|11/23/2004||Yes|No||||No|No|||Prescription required|No||197|No|.1065|03/29/2022|.10394|03/29/2022|.10463|03/29/2022|||PROGESTINS FOR CACHEXIA|14712|||||No|No||MORTON GROVE PH|No||||
megestrol acetate|No|No|No|No|75%|60432012616|MEGESTROL ACET 40 MG/ML SUSP|480|ML|.05375|02/14/2007||Yes|No||02/14/2007||Yes|No|02/14/2007||Yes|No||||No|No|||Prescription required|No||197|No|.10575|03/29/2022|.10321|03/29/2022|.10389|03/29/2022|||PROGESTINS FOR CACHEXIA|14713|||||No|No||MORTON GROVE PH|No||||
carbamazepine|No|No|No|No|75%|60432012916|CARBAMAZEPINE 100 MG/5 ML SUSP|450|ML|.05715|12/15/2011||Yes|No||12/15/2011||Yes|No|12/15/2011||Yes|No||||No|No|||Prescription required|No||056|No|.11505|03/29/2022|.11228|03/29/2022|.11303|03/29/2022|||ANTICONVULSANTS|14714|||||No|No||MORTON GROVE PH|No||||
clobetasol propionate|No|No|No|No|75%|60432013325|CLOBETASOL 0.05% SOLUTION|25|ML|1.118|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||121|No|.44026|03/29/2022|.42969|03/29/2022|.43255|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|14715|||||No|No||MORTON GROVE PH|No||||
clobetasol propionate|No|No|No|No|75%|60432013350|CLOBETASOL 0.05% SOLUTION|50|ML|1.118|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||121|No|.35501|03/29/2022|.34648|03/29/2022|.34879|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|14716|||||No|No||MORTON GROVE PH|No||||
hydroxyzine HCl|No|No|No|No|75%|60432015004|HYDROXYZINE 10 MG/5 ML SOLN|118|ML|.05811|10/24/2008||Yes|No||10/24/2008||Yes|No|10/24/2008||Yes|No||||No|No|||Prescription required|No||574|Yes|.13245|03/29/2022|.13056|03/29/2022|.12434|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|14717|||||No|No||MORTON GROVE PH|No||||
hydroxyzine HCl|No|No|No|No|75%|60432015016|HYDROXYZINE 10 MG/5 ML SOLN|473|ML|.02904|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||574|Yes|.06612|03/29/2022|.06453|03/29/2022|.06496|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|14718|||||No|No||MORTON GROVE PH|No||||
prednisolone sodium phosphate|No|No|No|No|75%|60432021208|PREDNISOLONE 15 MG/5 ML SOLN|237|ML|.05442|10/28/2004||Yes|No||10/28/2004||Yes|No|10/28/2004||Yes|No||||No|No|||Prescription required|No||168|Yes|.11167|03/29/2022|.10898|03/29/2022|.10971|03/29/2022|||GLUCOCORTICOIDS: ORAL|14719|||||No|No||MORTON GROVE PH|No||||
acetaminophen with codeine|No|No|No|No|90%|60432024516|ACETAMINOP-CODEINE 120-12 MG/5|473|ML|.00909|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.01517|03/29/2022|.0148|03/29/2022|.0149|03/29/2022|||ANALGESICS: NARCOTICS SHORT|14720|||||No|No||MORTON GROVE PH|No||||
fluticasone propionate|No|No|No|No|75%|60432026415|FLUTICASONE PROP 50 MCG SPRAY|16|GM|.29562|02/09/2012||Yes|No||02/09/2012||Yes|No|02/09/2012||Yes|No||||No|No|||Prescription required|No||019|No|.27037|03/29/2022|.26388|03/29/2022|.26563|03/29/2022|||INTRANASAL RHINITIS AGENTS|14721|||||No|No||MORTON GROVE PH|No||||
brompheniramine/pseudoephed/DM|No|No|No|No|75%|60432027504|BROMPHEN-PSE-DM 2-30-10 MG/5ML|118|ML|.0771|05/16/2018||Yes|No||05/16/2018||Yes|No|05/16/2018||Yes|No||||No|No|||Prescription required|No||184|Yes|.0774|03/29/2022|.07554|03/29/2022|.07604|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|14722|||||No|No||WOCKHARDT USA L|No||||
brompheniramine/pseudoephed/DM|No|No|No|No|75%|60432027516|BROMPHEN-PSE-DM 2-30-10 MG/5ML|473|ML|.07693|11/13/2014||Yes|No||11/13/2014||Yes|No|11/13/2014||Yes|No||||No|No|||Prescription required|No||184|Yes|.06501|03/29/2022|.06344|03/29/2022|.06387|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|14723|||||No|No||MORTON GROVE PH|No||||
hydrocodone bit/homatrop me-br|No|No|No|No|90%|60432045516|HYDROCODONE-HOMATROPINE SOLN|473|ML|.06358|02/02/2017||Yes|No||02/02/2017||Yes|No|02/02/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|183|Yes|.1071|03/29/2022|.10452|03/29/2022|.10522|03/29/2022|||COUGH AND COLD: NARCOTIC|14724|||||No|No||MORTON GROVE PH|No||||
dexamethasone|No|No|No|No|75%|60432046608|DEXAMETHASONE 0.5 MG/5 ML ELX|237|ML|.09243|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||168|Yes|.09997|03/29/2022|.09757|03/29/2022|.09822|03/29/2022|||GLUCOCORTICOIDS: ORAL|14725|||||No|No||MORTON GROVE PH|No||||
selenium sulfide|No|No|No|No|75%|60432052804|SELENIUM SULFIDE 2.5% LOTION|118|ML|.03607|||No|No||||No|No|09/01/1999||Yes|No||||No|No|||Prescription required|No|||No|.08221|03/01/2022|.08103|03/01/2022|.07717|03/01/2022||||14726|||||No|No||MORTON GROVE PH|No||||
selenium sulfide|No|No|No|No|75%|60432052805|SELENIUM SULFIDE 2.5% LOTION|118|ML|.03607|08/05/2019||Yes|No||08/05/2019||Yes|No|08/05/2019||Yes|No||||No|No|||Prescription required|No|||No|.08221|03/01/2022|.08103|03/01/2022|.07717|03/01/2022||||14727|||||No|No||MORTON GROVE PH|No||||
nystatin|No|No|No|No|75%|60432053716|NYSTATIN 100,000 UNIT/ML SUSP|473|ML|.08073|12/31/2008||Yes|No||12/31/2008||Yes|No|12/31/2008||Yes|No||12/31/2008||Yes|No|||Prescription required|No||069|No|.04529|03/29/2022|.0442|03/29/2022|.04449|03/29/2022|||ANTIFUNGALS: ORAL|14728|||||No|No||MORTON GROVE PH|No||||
nystatin|No|No|No|No|75%|60432053760|NYSTATIN 100,000 UNIT/ML SUSP|60|ML|.09101|09/25/2006||Yes|No||09/25/2006||Yes|No|09/25/2006||Yes|No||09/25/2006||Yes|No|||Prescription required|No||069|No|.14005|03/29/2022|.13668|03/29/2022|.13759|03/29/2022|||ANTIFUNGALS: ORAL|14729|||||No|No||MORTON GROVE PH|No||||
triamcinolone acetonide|No|No|No|No|75%|60432056061|TRIAMCINOLONE 0.025% LOTION|60|ML|.20861|08/05/2019||Yes|No||08/05/2019||Yes|No|08/05/2019||Yes|No||||No|No|||Prescription required|No||120|No|.38774|03/29/2022|.37843|03/29/2022|.38095|03/29/2022|||STEROIDS: TOPICAL HIGH|14730|||||No|No||MORTON GROVE PH|No||||
triamcinolone acetonide|No|No|No|No|75%|60432056160|TRIAMCINOLONE 0.1% LOTION|60|ML|.23413|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||120|No|.34078|03/29/2022|.3326|03/29/2022|.33481|03/29/2022|||STEROIDS: TOPICAL HIGH|14731|||||No|No||MORTON GROVE PH|No||||
triamcinolone acetonide|No|No|No|No|75%|60432056161|TRIAMCINOLONE 0.1% LOTION|60|ML|.23413|08/05/2019||Yes|No||08/05/2019||Yes|No|08/05/2019||Yes|No||||No|No|||Prescription required|No||120|No|.34078|03/29/2022|.3326|03/29/2022|.33481|03/29/2022|||STEROIDS: TOPICAL HIGH|14732|||||No|No||MORTON GROVE PH|No||||
promethazine/dextromethorphan|No|No|No|No|75%|60432060416|PROMETHAZINE-DM 6.25-15 MG/5ML|473|ML|.03181|12/07/2017||Yes|No||12/07/2017||Yes|No|12/07/2017||Yes|No||||No|No|||Prescription required|No||184|Yes|.05643|03/29/2022|.05507|03/29/2022|.05544|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|14733|||||No|No||MORTON GROVE PH|No||||
promethazine HCl/codeine|No|No|No|No|90%|60432060616|PROMETHAZINE-CODEINE SYRUP|473|ML|.03636|02/18/2003||Yes|No||02/18/2003||Yes|No|02/18/2003||Yes|No||||No|No|||Prescription required|No||183|Yes|.04109|03/29/2022|.0401|03/29/2022|.04037|03/29/2022|||COUGH AND COLD: NARCOTIC|14734|||||No|No||MORTON GROVE PH|No||||
promethazine HCl|No|No|No|No|75%|60432060816|PROMETHAZINE 6.25 MG/5 ML SYRP|473|ML|.03636|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||085|Yes|.0426|03/29/2022|.04157|03/29/2022|.04185|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|14735|||||No|No||MORTON GROVE PH|No||||
furosemide|No|No|No|No|75%|60432061304|FUROSEMIDE 10 MG/ML SOLUTION|120|ML|.05041|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.10297|03/29/2022|.10049|03/29/2022|.10116|03/29/2022||||14736|||||No|No||MORTON GROVE PH|No||||
furosemide|No|No|No|No|75%|60432061360|FUROSEMIDE 10 MG/ML SOLUTION|60|ML|.05217|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.10297|03/29/2022|.10049|03/29/2022|.10116|03/29/2022||||14737|||||No|No||MORTON GROVE PH|No||||
valproic acid (as sodium salt)|No|No|No|No|75%|60432062116|VALPROIC ACID 250 MG/5 ML SOLN|473|ML|.01227|08/19/2010||Yes|No||08/19/2010||Yes|No|08/19/2010||Yes|No||||No|No|||Prescription required|No||056|No|.01872|03/29/2022|.01827|03/29/2022|.01839|03/29/2022|||ANTICONVULSANTS|14738|||||No|No||MORTON GROVE PH|No||||
doxepin HCl|No|No|No|No|75%|60432065104|DOXEPIN 10 MG/ML ORAL CONC|118|ML|.13118|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||215|No|.29897|03/24/2020|.2947|03/24/2020|.28067|03/24/2020|||ANTIDEPRESSANTS: TRICYCLIC|14739|||||No|No||MORTON GROVE PH|No||||
erythromycin base in ethanol|No|No|No|No|75%|60432067160|ERYTHROMYCIN 2% SOLUTION|60|ML|.28666|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||104|No|.42786|03/29/2022|.41759|03/29/2022|.42037|03/29/2022|||ACNE AGENTS: TOPICAL|14740|||||No|No||MORTON GROVE PH|No||||
oxycodone HCl|No|No|No|No|90%|60432070605|OXYCODONE HCL 5 MG/5 ML SOLN|500|ML|.09804|06/30/2016||Yes|No||06/30/2016||Yes|No|06/30/2016||Yes|No||||No|No|||Prescription required|No||109|Yes|.11792|03/29/2022|.11508|03/29/2022|.11585|03/29/2022|||ANALGESICS: NARCOTICS SHORT|14741|||||No|No||WOCKHARDT USA L|No||||
acetic acid|No|No|No|No|75%|60432074116|ACETIC ACID 2% EAR SOLUTION|15|ML|.80266|08/05/2019||Yes|No||08/05/2019||Yes|No|08/05/2019||Yes|No||||No|No|||Prescription required|No||150|No|1.3438|03/29/2022|1.31154|03/29/2022|1.32028|03/29/2022|||OTIC ANTI-INFECTIVES & ANESTHETICS|14742|||||No|No||MORTON GROVE PH|No||||
levetiracetam|No|No|No|No|75%|60432083116|LEVETIRACETAM 100 MG/ML SOLN|473|ML|.02727|03/25/2010||Yes|No||03/25/2010||Yes|No|03/25/2010||Yes|No||||No|No|||Prescription required|No||056|No|.03146|03/29/2022|.0307|03/29/2022|.0309|03/29/2022|||ANTICONVULSANTS|14743|||||No|No||MORTON GROVE PH|No||||
lindane|No|No|No|No|75%|60432083460|LINDANE 1% SHAMPOO|60|ML|.78467|06/25/2007||Yes|No||06/25/2007||Yes|No|||No|No||||No|No|||Prescription required|Yes|02/10/2009|122|No|1.78833|03/26/2019|1.76278|03/26/2019|1.67884|03/26/2019|||ANTIPARASITICS: TOPICAL|14744|||||No|No||MORTON GROVE PH|No||||
diltiazem HCl|Yes|No|No|No|75%|60505001406|DILT XR 120 MG CAPSULE|100|EA|.23383|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No||045|No|.44141|03/29/2022|.43081|03/29/2022|.43368|03/29/2022|||CALCIUM CHANNEL BLOCKERS|14745|||||No|No||APOTEX CORP|No||||
diltiazem HCl|Yes|No|No|No|75%|60505001408|DILT XR 120 MG CAPSULE|500|EA|.22212|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No||045|No|.44141|03/29/2022|.43081|03/29/2022|.43368|03/29/2022|||CALCIUM CHANNEL BLOCKERS|14746|||||No|No||APOTEX CORP|No||||
diltiazem HCl|Yes|No|No|No|75%|60505001506|DILT XR 180 MG CAPSULE|100|EA|.22437|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No||045|No|.55317|03/29/2022|.53989|03/29/2022|.54348|03/29/2022|||CALCIUM CHANNEL BLOCKERS|14747|||||No|No||APOTEX CORP|No||||
diltiazem HCl|Yes|No|No|No|75%|60505001508|DILT XR 180 MG CAPSULE|500|EA|.20946|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No||045|No|.55317|03/29/2022|.53989|03/29/2022|.54348|03/29/2022|||CALCIUM CHANNEL BLOCKERS|14748|||||No|No||APOTEX CORP|No||||
diltiazem HCl|Yes|No|No|No|75%|60505001606|DILT XR 240 MG CAPSULE|100|EA|.39775|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No||045|No|.79772|03/29/2022|.77857|03/29/2022|.78375|03/29/2022|||CALCIUM CHANNEL BLOCKERS|14749|||||No|No||APOTEX CORP|No||||
diltiazem HCl|Yes|No|No|No|75%|60505001608|DILT XR 240 MG CAPSULE|500|EA|.37786|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No||045|No|.79772|03/29/2022|.77857|03/29/2022|.78375|03/29/2022|||CALCIUM CHANNEL BLOCKERS|14750|||||No|No||APOTEX CORP|No||||
cimetidine|No|No|No|No|75%|60505001806|CIMETIDINE 200 MG TABLET|100|EA|.04704|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.10721|08/27/2019|.10568|08/27/2019|.10064|08/27/2019||||14751|||||No|No||APOTEX CORP|No||||
cimetidine|No|No|No|No|75%|60505001904|CIMETIDINE 300 MG TABLET|500|EA|.04705|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.32734|10/23/2018|.31948|10/23/2018|.32161|10/23/2018||||14752|||||No|No||APOTEX CORP|No||||
cimetidine|No|No|No|No|75%|60505001906|CIMETIDINE 300 MG TABLET|100|EA|.04953|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.32734|10/23/2018|.31948|10/23/2018|.32161|10/23/2018||||14753|||||No|No||APOTEX CORP|No||||
cimetidine|No|No|No|No|75%|60505002004|CIMETIDINE 400 MG TABLET|60|EA|.03956|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.09016|09/18/2018|.08887|09/18/2018|.08464|09/18/2018||||14754|||||No|No||APOTEX CORP|No||||
cimetidine|No|No|No|No|75%|60505002006|CIMETIDINE 400 MG TABLET|100|EA|.04437|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.10113|09/18/2018|.09969|09/18/2018|.09494|09/18/2018||||14755|||||No|No||APOTEX CORP|No||||
cimetidine|No|No|No|No|75%|60505002008|CIMETIDINE 400 MG TABLET|500|EA|.03919|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.08933|09/18/2018|.08806|09/18/2018|.08386|09/18/2018||||14756|||||No|No||APOTEX CORP|No||||
cimetidine|No|No|No|No|75%|60505002103|CIMETIDINE 800 MG TABLET|100|EA|.11094|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No|||No|.84877|10/23/2018|.82839|10/23/2018|.83391|10/23/2018||||14757|||||No|No||APOTEX CORP|No||||
cimetidine|No|No|No|No|75%|60505002107|CIMETIDINE 800 MG TABLET|250|EA|.11094|03/24/2006||Yes|No||03/24/2006||Yes|No|03/24/2006||Yes|No||03/24/2006||Yes|No|||Prescription required|No|||No|.84877|10/23/2018|.82839|10/23/2018|.83391|10/23/2018||||14758|||||No|No||APOTEX CORP|No||||
pentoxifylline|No|No|No|No|75%|60505003306|PENTOXIFYLLINE ER 400 MG TAB|100|EA|.18193|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.26964|03/29/2022|.26316|03/29/2022|.26492|03/29/2022||||14759|||||No|No||APOTEX CORP|No||||
pentoxifylline|No|No|No|No|75%|60505003307|PENTOXIFYLLINE ER 400 MG TAB|500|EA|.17647|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.26964|03/29/2022|.26316|03/29/2022|.26492|03/29/2022||||14760|||||No|No||APOTEX CORP|No||||
etodolac|No|No|No|No|75%|60505003901|ETODOLAC 200 MG CAPSULE|100|EA|.46345|04/10/2003||Yes|No||04/10/2003||Yes|No|04/10/2003||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.75715|03/29/2022|.73897|03/29/2022|.74389|03/29/2022|||NSAIDS|14761|||||No|No||APOTEX CORP|No||||
etodolac|No|No|No|No|75%|60505004001|ETODOLAC 300 MG CAPSULE|100|EA|.55616|04/10/2003||Yes|No||04/10/2003||Yes|No|04/10/2003||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.56927|03/29/2022|.5556|03/29/2022|.5593|03/29/2022|||NSAIDS|14762|||||No|No||APOTEX CORP|No||||
etodolac|No|No|No|No|75%|60505004101|ETODOLAC 400 MG TABLET|100|EA|.45537|04/10/2003||Yes|No||04/10/2003||Yes|No|04/10/2003||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.33513|03/29/2022|.32708|03/29/2022|.32926|03/29/2022|||NSAIDS|14763|||||No|No||APOTEX CORP|No||||
acyclovir|Yes|No|No|No|75%|60505004206|ACYCLOVIR 200 MG CAPSULE|100|EA|.0774|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|11/01/2012||Prescription required|No||025|No|.11267|03/29/2022|.10996|03/29/2022|.11069|03/29/2022|||ANTIVIRALS: ORAL|14764|||||No|No||APOTEX CORP|No||||
selegiline HCl|No|No|No|No|75%|60505005501|SELEGILINE HCL 5 MG CAPSULE|60|EA|.72025|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|1.0776|03/29/2022|1.05173|03/29/2022|1.05874|03/29/2022|||ANTIPARKINSON'S AGENTS|14765|||||No|No||APOTEX CORP|No||||
selegiline HCl|No|No|No|No|75%|60505005502|SELEGILINE HCL 5 MG CAPSULE|1000|EA|.70516|06/20/2002||Yes|No||06/20/2002||Yes|No|06/20/2002||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|1.0776|03/29/2022|1.05173|03/29/2022|1.05874|03/29/2022|||ANTIPARKINSON'S AGENTS|14766|||||No|No||APOTEX CORP|No||||
omeprazole|No|No|No|No|75%|60505006500|OMEPRAZOLE DR 20 MG CAPSULE|30|EA|.14992|03/29/2017||Yes|No||03/29/2017||Yes|No|03/29/2017||Yes|No||03/29/2017||Yes|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|14767|||||No|No||APOTEX CORP|No||||
omeprazole|No|No|No|No|75%|60505006501|OMEPRAZOLE DR 20 MG CAPSULE|1000|EA|.14994|09/02/2009||Yes|No||09/02/2009||Yes|No|09/02/2009||Yes|No||11/16/2007||Yes|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|14768|||||No|No||APOTEX CORP|No||||
omeprazole|No|No|No|No|75%|60505006502|OMEPRAZOLE DR 20 MG CAPSULE|100|EA|.14994|09/02/2009||Yes|No||09/02/2009||Yes|No|09/02/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|14769|||||No|No||APOTEX CORP|No||||
sotalol HCl|No|No|No|No|75%|60505008000|SOTALOL 80 MG TABLET|100|EA|.12091|05/14/2003||Yes|No||05/14/2003||Yes|No|05/14/2003||Yes|No||||No|No|||Prescription required|No||070|No|.07746|03/29/2022|.0756|03/29/2022|.0761|03/29/2022|||BETA-BLOCKERS|14770|||||No|No||APOTEX CORP|No||||
sotalol HCl|No|No|No|No|75%|60505008100|SOTALOL 160 MG TABLET|100|EA|.20425|05/14/2003||Yes|No||05/14/2003||Yes|No|05/14/2003||Yes|No||||No|No|||Prescription required|No||070|No|.16372|03/29/2022|.15979|03/29/2022|.16085|03/29/2022|||BETA-BLOCKERS|14771|||||No|No||APOTEX CORP|No||||
sotalol HCl|No|No|No|No|75%|60505008200|SOTALOL 240 MG TABLET|100|EA|.28328|05/14/2003||Yes|No||05/14/2003||Yes|No|05/14/2003||Yes|No||||No|No|||Prescription required|No||070|No|.64562|06/28/2016|.6364|06/28/2016|.60609|06/28/2016|||BETA-BLOCKERS|14772|||||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505008301|PAROXETINE HCL 20 MG TABLET|30|EA|.05962|08/06/2003||Yes|No||08/06/2003||Yes|No|08/06/2003||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14773|||||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505008302|PAROXETINE HCL 20 MG TABLET|100|EA|.05964|12/11/2003||Yes|No||12/11/2003||Yes|No|12/11/2003||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14774|||||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505008304|PAROXETINE HCL 20 MG TABLET|1000|EA|.05962|08/06/2003||Yes|No||08/06/2003||Yes|No|08/06/2003||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14775|||||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505008401|PAROXETINE HCL 30 MG TABLET|30|EA|.08284|08/06/2003||Yes|No||08/06/2003||Yes|No|08/06/2003||Yes|No||||No|No|||Prescription required|No||008|No|.13236|03/29/2022|.12918|03/29/2022|.13004|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14776|||||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505008402|PAROXETINE HCL 30 MG TABLET|100|EA|.08286|05/01/2006||Yes|No||05/01/2006||Yes|No|05/01/2006||Yes|No||||No|No|||Prescription required|No||008|No|.13236|03/29/2022|.12918|03/29/2022|.13004|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14777|||||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505008404|PAROXETINE HCL 30 MG TABLET|1000|EA|.08284|08/06/2003||Yes|No||08/06/2003||Yes|No|08/06/2003||Yes|No||||No|No|||Prescription required|No||008|No|.13236|03/29/2022|.12918|03/29/2022|.13004|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14778|||||No|No||APOTEX CORP|No||||
doxazosin mesylate|No|No|No|No|75%|60505009300|DOXAZOSIN MESYLATE 1 MG TAB|100|EA|.18287|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||003|Yes|.09392|03/29/2022|.09166|03/29/2022|.09227|03/29/2022|||BPH TREATMENTS|14779|||||No|No||APOTEX CORP|No||||
doxazosin mesylate|No|No|No|No|75%|60505009301|DOXAZOSIN MESYLATE 1 MG TAB|1000|EA|.18287|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||003|Yes|.09392|03/29/2022|.09166|03/29/2022|.09227|03/29/2022|||BPH TREATMENTS|14780|||||No|No||APOTEX CORP|No||||
doxazosin mesylate|No|No|No|No|75%|60505009400|DOXAZOSIN MESYLATE 2 MG TAB|100|EA|.18287|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||003|Yes|.085|03/29/2022|.08296|03/29/2022|.08351|03/29/2022|||BPH TREATMENTS|14781|||||No|No||APOTEX CORP|No||||
doxazosin mesylate|No|No|No|No|75%|60505009401|DOXAZOSIN MESYLATE 2 MG TAB|1000|EA|.18287|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||003|Yes|.085|03/29/2022|.08296|03/29/2022|.08351|03/29/2022|||BPH TREATMENTS|14782|||||No|No||APOTEX CORP|No||||
doxazosin mesylate|No|No|No|No|75%|60505009500|DOXAZOSIN MESYLATE 4 MG TAB|100|EA|.20609|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||003|Yes|.10379|03/29/2022|.10129|03/29/2022|.10197|03/29/2022|||BPH TREATMENTS|14783|||||No|No||APOTEX CORP|No||||
doxazosin mesylate|No|No|No|No|75%|60505009501|DOXAZOSIN MESYLATE 4 MG TAB|1000|EA|.20609|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||003|Yes|.10379|03/29/2022|.10129|03/29/2022|.10197|03/29/2022|||BPH TREATMENTS|14784|||||No|No||APOTEX CORP|No||||
doxazosin mesylate|No|No|No|No|75%|60505009600|DOXAZOSIN MESYLATE 8 MG TAB|100|EA|.20644|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||003|No|.12737|03/29/2022|.12431|03/29/2022|.12514|03/29/2022|||BPH TREATMENTS|14785|||||No|No||APOTEX CORP|No||||
doxazosin mesylate|No|No|No|No|75%|60505009601|DOXAZOSIN MESYLATE 8 MG TAB|1000|EA|.20644|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||003|No|.12737|03/29/2022|.12431|03/29/2022|.12514|03/29/2022|||BPH TREATMENTS|14786|||||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505009701|PAROXETINE HCL 10 MG TABLET|30|EA|.04902|08/06/2003||Yes|No||08/06/2003||Yes|No|08/06/2003||Yes|No||||No|No|||Prescription required|No||008|Yes|.075|03/29/2022|.0732|03/29/2022|.07368|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14787|||||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505009702|PAROXETINE HCL 10 MG TABLET|100|EA|.04902|05/01/2006||Yes|No||05/01/2006||Yes|No|05/01/2006||Yes|No||||No|No|||Prescription required|No||008|Yes|.075|03/29/2022|.0732|03/29/2022|.07368|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14788|||||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505009704|PAROXETINE HCL 10 MG TABLET|1000|EA|.04902|08/06/2003||Yes|No||08/06/2003||Yes|No|08/06/2003||Yes|No||||No|No|||Prescription required|No||008|Yes|.075|03/29/2022|.0732|03/29/2022|.07368|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14789|||||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505010101|PAROXETINE HCL 40 MG TABLET|30|EA|.08772|08/06/2003||Yes|No||08/06/2003||Yes|No|08/06/2003||Yes|No||||No|No|||Prescription required|No||008|No|.13005|03/29/2022|.12692|03/29/2022|.12777|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14790|||||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505010102|PAROXETINE HCL 40 MG TABLET|100|EA|.08772|05/01/2006||Yes|No||05/01/2006||Yes|No|05/01/2006||Yes|No||||No|No|||Prescription required|No||008|No|.13005|03/29/2022|.12692|03/29/2022|.12777|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14791|||||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505010104|PAROXETINE HCL 40 MG TABLET|1000|EA|.08772|08/06/2003||Yes|No||08/06/2003||Yes|No|08/06/2003||Yes|No||||No|No|||Prescription required|No||008|No|.13005|03/29/2022|.12692|03/29/2022|.12777|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14792|||||No|No||APOTEX CORP|No||||
etodolac|No|No|No|No|75%|60505010201|ETODOLAC 500 MG TABLET|100|EA|.48375|04/10/2003||Yes|No||04/10/2003||Yes|No|04/10/2003||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.34546|03/29/2022|.33716|03/29/2022|.33941|03/29/2022|||NSAIDS|14793|||||No|No||APOTEX CORP|No||||
gabapentin|No|No|No|No|75%|60505011201|GABAPENTIN 100 MG CAPSULE|100|EA|.03646|04/07/2005||Yes|No||04/07/2005||Yes|No|04/07/2005||Yes|No||07/01/2012||Yes|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|14794|||||No|No||APOTEX CORP|No||||
gabapentin|No|No|No|No|75%|60505011208|GABAPENTIN 100 MG CAPSULE|1000|EA|.03173|04/07/2005||Yes|No||04/07/2005||Yes|No|04/07/2005||Yes|No||07/01/2012||Yes|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|14795|||||No|No||APOTEX CORP|No||||
gabapentin|No|No|No|No|75%|60505011308|GABAPENTIN 300 MG CAPSULE|1000|EA|.06192|04/07/2005|06/29/2022|Yes|No||04/07/2005|06/29/2022|Yes|No|04/07/2005|06/29/2022|Yes|No||07/01/2012|06/29/2022|Yes|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|14796|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||APOTEX CORP|No||||
gabapentin|No|No|No|No|75%|60505011401|GABAPENTIN 400 MG CAPSULE|100|EA|.0946|04/07/2005||Yes|No||04/07/2005||Yes|No|04/07/2005||Yes|No||07/01/2012||Yes|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|14797|||||No|No||APOTEX CORP|No||||
gabapentin|No|No|No|No|75%|60505011405|GABAPENTIN 400 MG CAPSULE|500|EA|.0817|04/07/2005||Yes|No||04/07/2005||Yes|No|04/07/2005||Yes|No||07/01/2012||Yes|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|14798|||||No|No||APOTEX CORP|No||||
cyclosporine|No|No|No|No|75%|60505013300|CYCLOSPORINE 25 MG CAPSULE|30|EA|1.20414|05/17/2002||Yes|No||05/17/2002||Yes|No|05/17/2002||Yes|No||05/17/2002||Yes|No|||Prescription required|Yes|01/15/2014|229|No|2.31248|05/25/2021|2.25698|05/25/2021|2.27201|05/25/2021|||IMMUNOSUPPRESSIVES: ORAL|14799|||||No|No||APOTEX CORP|No||||
cyclosporine|No|No|No|No|75%|60505013400|CYCLOSPORINE 100 MG CAPSULE|30|EA|4.80625|05/17/2002||Yes|No||05/17/2002||Yes|No|05/17/2002||Yes|No||05/17/2002||Yes|No|||Prescription required|Yes|01/15/2014|229|No|8.41873|03/01/2022|8.21668|03/01/2022|8.2714|03/01/2022|||IMMUNOSUPPRESSIVES: ORAL|14800|||||No|No||APOTEX CORP|No||||
glipizide|Yes|No|No|No|75%|60505014100|GLIPIZIDE 5 MG TABLET|100|EA|.02111|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.03474|03/29/2022|.0339|03/29/2022|.03413|03/29/2022||||14801|||||No|No||APOTEX CORP|No||||
glipizide|Yes|No|No|No|75%|60505014101|GLIPIZIDE 5 MG TABLET|1000|EA|.02006|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No|||No|.03474|03/29/2022|.0339|03/29/2022|.03413|03/29/2022||||14802|||||No|No||APOTEX CORP|No||||
glipizide|Yes|No|No|No|75%|60505014102|GLIPIZIDE 5 MG TABLET|500|EA|.02078|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No|||No|.03474|03/29/2022|.0339|03/29/2022|.03413|03/29/2022||||14803|||||No|No||APOTEX CORP|No||||
glipizide|Yes|No|No|No|75%|60505014108|GLIPIZIDE 5 MG TABLET|18000|EA|.02723|03/11/2009||Yes|No||03/11/2009||Yes|No|03/11/2009||Yes|No||03/11/2009||Yes|No|07/01/2016||Prescription required|No|||No|.03474|03/29/2022|.0339|03/29/2022|.03413|03/29/2022||||14804|||||No|No||APOTEX CORP|No||||
glipizide|Yes|No|No|No|75%|60505014200|GLIPIZIDE 10 MG TABLET|100|EA|.03358|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|07/01/2016||Prescription required|No|||No|.04827|03/29/2022|.04711|03/29/2022|.04742|03/29/2022||||14805|||||No|No||APOTEX CORP|No||||
glipizide|Yes|No|No|No|75%|60505014201|GLIPIZIDE 10 MG TABLET|1000|EA|.03225|04/08/2003||Yes|No||04/08/2003||Yes|No|04/08/2003||Yes|No||03/11/2009||Yes|No|07/01/2016||Prescription required|No|||No|.04827|03/29/2022|.04711|03/29/2022|.04742|03/29/2022||||14806|||||No|No||APOTEX CORP|No||||
glipizide|Yes|No|No|No|75%|60505014202|GLIPIZIDE 10 MG TABLET|500|EA|.03279|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No|||No|.04827|03/29/2022|.04711|03/29/2022|.04742|03/29/2022||||14807|||||No|No||APOTEX CORP|No||||
glipizide|Yes|No|No|No|75%|60505014204|GLIPIZIDE 10 MG TABLET|10000|EA|.03225|03/11/2009||Yes|No||03/11/2009||Yes|No|03/11/2009||Yes|No||03/11/2009||Yes|No|07/01/2016||Prescription required|No|||No|.04827|03/29/2022|.04711|03/29/2022|.04742|03/29/2022||||14808|||||No|No||APOTEX CORP|No||||
omeprazole|No|No|No|No|75%|60505014500|OMEPRAZOLE DR 10 MG CAPSULE|30|EA|.28308|09/01/2009||Yes|No||09/01/2009||Yes|No|09/01/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|Yes|.09084|03/29/2022|.08865|03/29/2022|.08925|03/29/2022|||PROTON PUMP INHIBITORS|14809|||||No|No||APOTEX CORP|No||||
omeprazole|No|No|No|No|75%|60505014501|OMEPRAZOLE DR 10 MG CAPSULE|1000|EA|.28004|09/01/2009||Yes|No||09/01/2009||Yes|No|||No|No||07/01/2012||Yes|No|||Prescription required|No||047|Yes|.09084|03/29/2022|.08865|03/29/2022|.08925|03/29/2022|||PROTON PUMP INHIBITORS|14810|||||No|No||APOTEX CORP|No||||
omeprazole|No|No|No|No|75%|60505014502|OMEPRAZOLE DR 10 MG CAPSULE|100|EA|.28306|09/01/2009||Yes|No||09/01/2009||Yes|No|09/01/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|Yes|.09084|03/29/2022|.08865|03/29/2022|.08925|03/29/2022|||PROTON PUMP INHIBITORS|14811|||||No|No||APOTEX CORP|No||||
omeprazole|No|No|No|No|75%|60505014600|OMEPRAZOLE DR 40 MG CAPSULE|30|EA|.24839|09/01/2009||Yes|No||09/01/2009||Yes|No|09/01/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|14812|||||No|No||APOTEX CORP|No||||
omeprazole|No|No|No|No|75%|60505014602|OMEPRAZOLE DR 40 MG CAPSULE|100|EA|.24836|09/01/2009||Yes|No||09/01/2009||Yes|No|09/01/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|14813|||||No|No||APOTEX CORP|No||||
loratadine|No|No|No|No|75%|60505014701|LORATADINE 10 MG TABLET|100|EA|.15974|05/01/2006|03/29/2022|Yes|No||||No|No|05/01/2006|03/29/2022|Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|14814|No Longer Rebatable||No Longer Rebatable||No|No||APOTEX CORP|No||||
loratadine|No|No|No|No|75%|60505014708|LORATADINE 10 MG TABLET|1000|EA|.15974|05/01/2006||Yes|No||||No|No|05/01/2006||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|14815|||||No|No||APOTEX CORP|No||||
bupropion HCl|Yes|No|No|No|75%|60505015701|BUPROPION HCL 100 MG TABLET|100|EA|.30676|03/11/2009||Yes|No||03/11/2009||Yes|No|03/11/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.14759|03/29/2022|.14404|03/29/2022|.145|03/29/2022|||ANTIDEPRESSANTS: OTHER|14816|||||No|No||APOTEX CORP|No||||
bupropion HCl|Yes|No|No|No|75%|60505015801|BUPROPION HCL 75 MG TABLET|100|EA|.22996|03/11/2009||Yes|No||03/11/2009||Yes|No|03/11/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||031|No|.12417|03/29/2022|.12118|03/29/2022|.12199|03/29/2022|||ANTIDEPRESSANTS: OTHER|14817|||||No|No||APOTEX CORP|No||||
sotalol HCl|No|No|No|No|75%|60505015900|SOTALOL 120 MG TABLET|100|EA|.16125|05/14/2003||Yes|No||05/14/2003||Yes|No|05/14/2003||Yes|No||||No|No|||Prescription required|No||070|No|.10056|03/29/2022|.09814|03/29/2022|.0988|03/29/2022|||BETA-BLOCKERS|14818|||||No|No||APOTEX CORP|No||||
fluvoxamine maleate|No|No|No|No|75%|60505016401|FLUVOXAMINE MALEATE 25 MG TAB|100|EA|.215|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||008|No|.2817|03/29/2022|.27493|03/29/2022|.27677|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14819|||||No|No||APOTEX CORP|No||||
fluvoxamine maleate|No|No|No|No|75%|60505016501|FLUVOXAMINE MALEATE 50 MG TAB|100|EA|.2365|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||008|No|.34583|03/29/2022|.33753|03/29/2022|.33977|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14820|||||No|No||APOTEX CORP|No||||
fluvoxamine maleate|No|No|No|No|75%|60505016601|FLUVOXAMINE MALEATE 100 MG TAB|100|EA|.258|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||008|No|.33359|03/29/2022|.32558|03/29/2022|.32775|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14821|||||No|No||APOTEX CORP|No||||
pravastatin sodium|Yes|No|No|No|75%|60505016805|PRAVASTATIN SODIUM 10 MG TAB|500|EA|.1106|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No||063|Yes|.07144|03/29/2022|.06972|03/29/2022|.07018|03/29/2022|||LIPOTROPICS: STATINS|14822|||||No|No||APOTEX CORP|No||||
pravastatin sodium|Yes|No|No|No|75%|60505016809|PRAVASTATIN SODIUM 10 MG TAB|90|EA|.1106|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No||063|Yes|.07144|03/29/2022|.06972|03/29/2022|.07018|03/29/2022|||LIPOTROPICS: STATINS|14823|||||No|No||APOTEX CORP|No||||
pravastatin sodium|Yes|No|No|No|75%|60505016907|PRAVASTATIN SODIUM 20 MG TAB|1000|EA|.11237|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No||063|Yes|.05771|03/29/2022|.05632|03/29/2022|.0567|03/29/2022|||LIPOTROPICS: STATINS|14824|||||No|No||APOTEX CORP|No||||
pravastatin sodium|Yes|No|No|No|75%|60505016909|PRAVASTATIN SODIUM 20 MG TAB|90|EA|.11237|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No||063|Yes|.05771|03/29/2022|.05632|03/29/2022|.0567|03/29/2022|||LIPOTROPICS: STATINS|14825|||||No|No||APOTEX CORP|No||||
pravastatin sodium|Yes|No|No|No|75%|60505017007|PRAVASTATIN SODIUM 40 MG TAB|1000|EA|.16493|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No||063|Yes|.08966|03/29/2022|.0875|03/29/2022|.08809|03/29/2022|||LIPOTROPICS: STATINS|14826|||||No|No||APOTEX CORP|No||||
pravastatin sodium|Yes|No|No|No|75%|60505017009|PRAVASTATIN SODIUM 40 MG TAB|90|EA|.16492|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No||063|Yes|.08966|03/29/2022|.0875|03/29/2022|.08809|03/29/2022|||LIPOTROPICS: STATINS|14827|||||No|No||APOTEX CORP|No||||
carbamazepine|No|No|No|No|75%|60505018300|CARBAMAZEPINE 200 MG TABLET|100|EA|.55009|04/01/2002||Yes|No||04/01/2002||Yes|No|04/01/2002||Yes|No||04/01/2002||Yes|No|||Prescription required|No||056|No|.20856|03/29/2022|.20355|03/29/2022|.20491|03/29/2022|||ANTICONVULSANTS|14828|||||No|No||APOTEX CORP|No||||
carbamazepine|No|No|No|No|75%|60505018301|CARBAMAZEPINE 200 MG TABLET|1000|EA|.55009|04/01/2002||Yes|No||04/01/2002||Yes|No|04/01/2002||Yes|No||04/01/2002||Yes|No|||Prescription required|No||056|No|.20856|03/29/2022|.20355|03/29/2022|.20491|03/29/2022|||ANTICONVULSANTS|14829|||||No|No||APOTEX CORP|No||||
enalapril/hydrochlorothiazide|Yes|No|No|No|75%|60505020801|ENALAPRIL-HCTZ 5-12.5 MG TAB|100|EA|.0537|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No||113|Yes|.14643|09/24/2019|.14291|09/24/2019|.14386|09/24/2019|||ANGIOTENSIN MODULATORS|14830|||||No|No||APOTEX CORP|No||||
sotalol HCl|No|No|No|No|75%|60505022201|SOTALOL AF 80 MG TABLET|100|EA|.20799|09/02/2003||Yes|No||09/02/2003||Yes|No|09/02/2003||Yes|No||||No|No|||Prescription required|No||070|No|.07746|03/29/2022|.0756|03/29/2022|.0761|03/29/2022|||BETA-BLOCKERS|14831|||||No|No||APOTEX CORP|No||||
sotalol HCl|No|No|No|No|75%|60505022301|SOTALOL AF 120 MG TABLET|100|EA|.27747|04/03/2007||Yes|No||04/03/2007||Yes|No|04/03/2007||Yes|No||||No|No|||Prescription required|No||070|No|.10056|03/29/2022|.09814|03/29/2022|.0988|03/29/2022|||BETA-BLOCKERS|14832|||||No|No||APOTEX CORP|No||||
sotalol HCl|No|No|No|No|75%|60505022401|SOTALOL AF 160 MG TABLET|100|EA|.34696|04/03/2007||Yes|No||04/03/2007||Yes|No|04/03/2007||Yes|No||||No|No|||Prescription required|No||070|No|.16372|03/29/2022|.15979|03/29/2022|.16085|03/29/2022|||BETA-BLOCKERS|14833|||||No|No||APOTEX CORP|No||||
mirtazapine|No|No|No|No|75%|60505024701|MIRTAZAPINE 15 MG TABLET|30|EA|.12756|08/28/2007||Yes|No||08/28/2007||Yes|No|08/28/2007||Yes|No||||No|No|||Prescription required|No||031|Yes|.08357|03/29/2022|.08156|03/29/2022|.0821|03/29/2022|||ANTIDEPRESSANTS: OTHER|14834|||||No|No||APOTEX CORP|No||||
mirtazapine|No|No|No|No|75%|60505024708|MIRTAZAPINE 15 MG TABLET|1000|EA|.12756|08/28/2007||Yes|No||08/28/2007||Yes|No|08/28/2007||Yes|No||||No|No|||Prescription required|No||031|Yes|.08357|03/29/2022|.08156|03/29/2022|.0821|03/29/2022|||ANTIDEPRESSANTS: OTHER|14835|||||No|No||APOTEX CORP|No||||
mirtazapine|No|No|No|No|75%|60505024801|MIRTAZAPINE 30 MG TABLET|30|EA|.16125|08/28/2007||Yes|No||08/28/2007||Yes|No|08/28/2007||Yes|No||||No|No|||Prescription required|No||031|No|.09806|03/29/2022|.0957|03/29/2022|.09634|03/29/2022|||ANTIDEPRESSANTS: OTHER|14836|||||No|No||APOTEX CORP|No||||
mirtazapine|No|No|No|No|75%|60505024808|MIRTAZAPINE 30 MG TABLET|1000|EA|.16125|08/28/2007||Yes|No||08/28/2007||Yes|No|08/28/2007||Yes|No||||No|No|||Prescription required|No||031|No|.09806|03/29/2022|.0957|03/29/2022|.09634|03/29/2022|||ANTIDEPRESSANTS: OTHER|14837|||||No|No||APOTEX CORP|No||||
mirtazapine|No|No|No|No|75%|60505024901|MIRTAZAPINE 45 MG TABLET|30|EA|.18275|08/28/2007||Yes|No||08/28/2007||Yes|No|08/28/2007||Yes|No||||No|No|||Prescription required|No||031|No|.13324|03/29/2022|.13004|03/29/2022|.1309|03/29/2022|||ANTIDEPRESSANTS: OTHER|14838|||||No|No||APOTEX CORP|No||||
mirtazapine|No|No|No|No|75%|60505024908|MIRTAZAPINE 45 MG TABLET|1000|EA|.18275|08/28/2007||Yes|No||08/28/2007||Yes|No|08/28/2007||Yes|No||||No|No|||Prescription required|No||031|No|.13324|03/29/2022|.13004|03/29/2022|.1309|03/29/2022|||ANTIDEPRESSANTS: OTHER|14839|||||No|No||APOTEX CORP|No||||
tizanidine HCl|No|No|No|No|75%|60505025102|TIZANIDINE HCL 2 MG TABLET|1000|EA|.07181|06/01/2004||Yes|No||06/01/2004||Yes|No|06/01/2004||Yes|No||||No|No|||Prescription required|No||116|No|.06018|03/29/2022|.05873|03/29/2022|.05912|03/29/2022|||SKELETAL MUSCLE RELAXANTS|14840|||||No|No||APOTEX CORP|No||||
tizanidine HCl|No|No|No|No|75%|60505025103|TIZANIDINE HCL 2 MG TABLET|150|EA|.07163|06/01/2004||Yes|No||06/01/2004||Yes|No|06/01/2004||Yes|No||||No|No|||Prescription required|No||116|No|.06018|03/29/2022|.05873|03/29/2022|.05912|03/29/2022|||SKELETAL MUSCLE RELAXANTS|14841|||||No|No||APOTEX CORP|No||||
tizanidine HCl|No|No|No|No|75%|60505025202|TIZANIDINE HCL 4 MG TABLET|1000|EA|.0874|06/01/2004||Yes|No||06/01/2004||Yes|No|06/01/2004||Yes|No||||No|No|||Prescription required|No||116|No|.05014|03/29/2022|.04893|03/29/2022|.04926|03/29/2022|||SKELETAL MUSCLE RELAXANTS|14842|||||No|No||APOTEX CORP|No||||
tizanidine HCl|No|No|No|No|75%|60505025203|TIZANIDINE HCL 4 MG TABLET|150|EA|.0874|06/01/2004||Yes|No||06/01/2004||Yes|No|06/01/2004||Yes|No||||No|No|||Prescription required|No||116|No|.05014|03/29/2022|.04893|03/29/2022|.04926|03/29/2022|||SKELETAL MUSCLE RELAXANTS|14843|||||No|No||APOTEX CORP|No||||
clopidogrel bisulfate|No|No|No|No|75%|60505025302|CLOPIDOGREL 75 MG TABLET|90|EA|.07166|07/27/2012||Yes|No||07/27/2012||Yes|No|07/27/2012||Yes|No||07/27/2012||Yes|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|14844|||||No|No||APOTEX CORP|Yes|09/01/2020|||
clopidogrel bisulfate|No|No|No|No|75%|60505025303|CLOPIDOGREL 75 MG TABLET|1000|EA|.07166|07/27/2012||Yes|No||07/27/2012||Yes|No|07/27/2012||Yes|No||07/27/2012||Yes|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|14845|||||No|No||APOTEX CORP|Yes|09/01/2020|||
desmopressin acetate|No|No|No|No|75%|60505025701|DESMOPRESSIN ACETATE 0.1 MG TB|100|EA|.3157|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|No|||Yes|.41734|03/29/2022|.40732|03/29/2022|.41003|03/29/2022||||14846|||||No|No||APOTEX CORP|No||||
desmopressin acetate|No|No|No|No|75%|60505025801|DESMOPRESSIN ACETATE 0.2 MG TB|100|EA|.35444|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|No|||Yes|.446|03/29/2022|.43529|03/29/2022|.43819|03/29/2022||||14847|||||No|No||APOTEX CORP|No||||
benazepril/hydrochlorothiazide|No|No|No|No|75%|60505026101|BENAZEPRIL-HCTZ 5-6.25 MG TAB|100|EA|.38472|06/01/2015||Yes|No||06/01/2015||Yes|No|06/01/2015||Yes|No||06/01/2015||Yes|No|||Prescription required|Yes|07/27/2017|113|Yes|.8768|10/04/2016|.86428|10/04/2016|.82312|10/04/2016|||ANGIOTENSIN MODULATORS|14848|||||No|No||APOTEX CORP|No||||
benazepril/hydrochlorothiazide|No|No|No|No|75%|60505026301|BENAZEPRIL-HCTZ 20-12.5 MG TAB|100|EA|.38472|06/01/2015||Yes|No||06/01/2015||Yes|No|06/01/2015||Yes|No||06/01/2015||Yes|No|||Prescription required|Yes|07/27/2017|113|Yes|.60233|03/29/2022|.58787|03/29/2022|.59178|03/29/2022|||ANGIOTENSIN MODULATORS|14849|||||No|No||APOTEX CORP|No||||
benazepril/hydrochlorothiazide|No|No|No|No|75%|60505026401|BENAZEPRIL-HCTZ 20-25 MG TAB|100|EA|.38472|06/01/2015||Yes|No||06/01/2015||Yes|No|06/01/2015||Yes|No||06/01/2015||Yes|No|||Prescription required|Yes|07/27/2017|113|Yes|.5345|03/29/2022|.52167|03/29/2022|.52514|03/29/2022|||ANGIOTENSIN MODULATORS|14850|||||No|No||APOTEX CORP|No||||
ofloxacin|No|No|No|No|75%|60505036301|OFLOXACIN 0.3% EAR DROPS|5|ML|5.59|09/28/2007||Yes|No||09/28/2007||Yes|No|09/28/2007||Yes|No||||No|No|||Prescription required|No||051|No|2.13104|03/29/2022|2.07989|03/29/2022|2.09374|03/29/2022|||OTIC ANTIBIOTICS|14851|||||No|No||APOTEX CORP|No||||
ofloxacin|No|No|No|No|75%|60505036302|OFLOXACIN 0.3% EAR DROPS|10|ML|5.59|09/28/2007||Yes|No||09/28/2007||Yes|No|09/28/2007||Yes|No||||No|No|||Prescription required|No||051|No|2.28641|03/29/2022|2.23153|03/29/2022|2.24639|03/29/2022|||OTIC ANTIBIOTICS|14852|||||No|No||APOTEX CORP|No||||
diclofenac sodium|No|No|No|No|75%|60505039905|DICLOFENAC 1.5% TOPICAL SOLN|150|ML|.28666|10/19/2016|06/29/2022|Yes|No||10/19/2016|06/29/2022|Yes|No|10/19/2016|06/29/2022|Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.10888|03/29/2022|.10626|03/29/2022|.10697|03/29/2022|||NSAIDS|14853|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505040205|PAXIL 10 MG/5 ML SUSPENSION|250|ML|.69405|06/29/2011||Yes|No||06/29/2011||Yes|No|06/29/2011||Yes|No||||No|No|||Prescription required|Yes|07/22/2009|008|No|1.55846|10/26/2021|1.52105|10/26/2021|1.53118|10/26/2021|||ANTIDEPRESSANTS: SSRIs|14854|||||No|No||APOTEX CORP|No||||
aripiprazole|No|No|No|No|75%|60505040405|ARIPIPRAZOLE 1 MG/ML SOLUTION|150|ML|.71666|10/06/2015||Yes|No||10/06/2015||Yes|No|10/06/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|027|Yes|1.07614|03/29/2022|1.05031|03/29/2022|1.0573|03/29/2022|||ANTIPSYCHOTICS|14855|||||No|No||APOTEX CORP|No||||
ofloxacin|No|No|No|No|75%|60505056000|OFLOXACIN 0.3% EYE DROPS|5|ML|1.4405|08/03/2011||Yes|No||08/03/2011||Yes|No|08/03/2011||Yes|No||||No|No|||Prescription required|No||058|No|1.80843|03/29/2022|1.76502|03/29/2022|1.77678|03/29/2022|||OPHTHALMIC ANTIBIOTICS|14856|||||No|No||APOTEX CORP|No||||
ofloxacin|No|No|No|No|75%|60505056001|OFLOXACIN 0.3% EYE DROPS|10|ML|1.3889|02/07/2012||Yes|No||02/07/2012||Yes|No|02/07/2012||Yes|No||||No|No|||Prescription required|No||058|No|1.8791|03/29/2022|1.834|03/29/2022|1.84621|03/29/2022|||OPHTHALMIC ANTIBIOTICS|14857|||||No|No||APOTEX CORP|No||||
olopatadine HCl|No|No|No|No|75%|60505057501|OLOPATADINE HCL 0.1% EYE DROPS|5|ML|3.40044|02/26/2016||Yes|No||02/26/2016||Yes|No|02/26/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|002|No|3.02733|03/29/2022|2.95467|03/29/2022|2.97435|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|14858|||||No|No||APOTEX CORP|No||||
azelastine HCl|No|No|No|No|75%|60505057804|AZELASTINE HCL 0.05% DROPS|6|ML|3.58333|12/01/2009||Yes|No||12/01/2009||Yes|No|12/01/2009||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|002|No|1.22657|03/29/2022|1.19713|03/29/2022|1.2051|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|14859|||||No|No||APOTEX CORP|No||||
moxifloxacin HCl|No|No|No|No|75%|60505058204|MOXIFLOXACIN 0.5% EYE DROPS|3|ML|9.59473|11/10/2017||Yes|No||11/10/2017||Yes|No|11/10/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|058|No|3.97371|03/29/2022|3.87834|03/29/2022|3.90417|03/29/2022|||OPHTHALMIC ANTIBIOTICS|14860|||||No|No||APOTEX CORP|No||||
bimatoprost|No|No|No|No|75%|60505058301|BIMATOPROST 0.03% EYE DROPS|5|ML|18.51666|08/12/2019||Yes|No||08/12/2019||Yes|No|08/12/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|088|No|26.52867|03/29/2022|25.89198|03/29/2022|26.06441|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|14861|||||No|No||APOTEX CORP|No||||
bimatoprost|No|No|No|No|75%|60505058304|BIMATOPROST 0.03% EYE DROPS|2.5|ML|18.5244|08/12/2019||Yes|No||08/12/2019||Yes|No|08/12/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|088|No|28.61527|03/29/2022|27.9285|03/29/2022|28.1145|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|14862|||||No|No||APOTEX CORP|No||||
epinastine HCl|No|No|No|No|75%|60505058401|EPINASTINE HCL 0.05% EYE DROPS|5|ML|7.36074|10/27/2011||Yes|No||10/27/2011||Yes|No|10/27/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|002|No|15.8565|03/29/2022|15.47594|03/29/2022|15.57901|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|14863|||||No|No||APOTEX CORP|No||||
olopatadine HCl|No|No|No|No|75%|60505058604|OLOPATADINE HCL 0.2% EYE DROP|2.5|ML|4.62852|02/21/2018||Yes|No||02/21/2018||Yes|No|02/21/2018||Yes|No||||No|No|||Prescription required|Yes|12/14/2017|002|No|9.7075|01/25/2022|9.47452|01/25/2022|9.53761|01/25/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|14864|||||No|No||APOTEX CORP|No||||
travoprost|No|No|No|No|75%|60505059301|TRAVOPROST 0.004% EYE DROP|5|ML|21.63072|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|088|No|32.8|03/29/2022|32.0128|03/29/2022|32.226|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|14865|||||No|No||APOTEX CORP|No||||
travoprost|No|No|No|No|75%|60505059304|TRAVOPROST 0.004% EYE DROP|2.5|ML|21.63072|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|088|No|36.32982|03/29/2022|35.4579|03/29/2022|35.69404|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|14866|||||No|No||APOTEX CORP|No||||
cefazolin sodium|No|No|No|No|75%|60505074905|CEFAZOLIN 1 GM VIAL|1|EA|.61455|12/05/2005||Yes|No||12/05/2005||Yes|No|12/05/2005||Yes|No||||No|No|||Prescription required|No|||No|1.40061|06/28/2016|1.3806|06/28/2016|1.31486|06/28/2016||||14867|||||No|No||APOTEX CORP|No||||
ceftriaxone sodium|Yes|No|No|No|75%|60505075000|CEFTRIAXONE 250 MG VIAL|1|EA|.9675|08/09/2005||Yes|No||08/09/2005||Yes|No|08/09/2005||Yes|No||||No|No|11/01/2012||Prescription required|No|||No|2.205|11/23/2021|2.1735|11/23/2021|2.07|11/23/2021||||14868|||||No|No||APOTEX CORP|No||||
ceftriaxone sodium|Yes|No|No|No|75%|60505075004|CEFTRIAXONE 250 MG VIAL|1|EA|.80023|08/09/2005||Yes|No||08/09/2005||Yes|No|08/09/2005||Yes|No||||No|No|11/01/2012||Prescription required|No|||No|1.82378|01/23/2018|1.79772|01/23/2018|1.71212|01/23/2018||||14869|||||No|No||APOTEX CORP|No||||
ceftriaxone sodium|Yes|No|No|No|75%|60505075100|CEFTRIAXONE 500 MG VIAL|1|EA|1.5695|08/09/2005||Yes|No||08/09/2005||Yes|No|08/09/2005||Yes|No||||No|No|03/10/2021||Prescription required|No|||No|3.577|06/28/2016|3.5259|06/28/2016|3.358|06/28/2016||||14870|||||No|No||APOTEX CORP|No||||
ceftriaxone sodium|Yes|No|No|No|75%|60505075104|CEFTRIAXONE 500 MG VIAL|1|EA|1.29|08/09/2005||Yes|No||08/09/2005||Yes|No|08/09/2005||Yes|No||||No|No|03/10/2021||Prescription required|No|||No|1.2765|03/29/2022|1.24586|03/29/2022|1.25416|03/29/2022||||14871|||||No|No||APOTEX CORP|No||||
ceftriaxone sodium|No|No|No|No|75%|60505075204|CEFTRIAXONE 1 GM VIAL|1|EA|1.505|08/09/2005||Yes|No||08/09/2005||Yes|No|08/09/2005||Yes|No||||No|No|||Prescription required|No|||No|1.6715|03/29/2022|1.63138|03/29/2022|1.64224|03/29/2022||||14872|||||No|No||APOTEX CORP|No||||
ceftriaxone sodium|No|No|No|No|75%|60505075304|CEFTRIAXONE 2 GM VIAL|1|EA|2.58|08/09/2005||Yes|No||08/09/2005||Yes|No|08/09/2005||Yes|No||||No|No|||Prescription required|No|||No|5.88|06/01/2016|5.796|06/01/2016|5.52|06/01/2016||||14873|||||No|No||APOTEX CORP|No||||
cefoxitin sodium|No|No|No|No|75%|60505075905|CEFOXITIN 1 GM VIAL|1|EA|3.02702|01/30/2006||Yes|No||01/30/2006||Yes|No|01/30/2006||Yes|No||||No|No|||Prescription required|No|||No|6.8988|06/01/2016|6.80025|06/01/2016|6.47643|06/01/2016||||14874|||||No|No||APOTEX CORP|No||||
piperacillin sodium/tazobactam|No|No|No|No|75%|60505077300|PIPERACIL-TAZOBACT 40.5 GRAM|1|EA|50.4734|09/22/2009||Yes|No||09/22/2009||Yes|No|09/22/2009||Yes|No||||No|No|||Prescription required|No|||No|115.0324|06/01/2016|113.38908|06/01/2016|107.9896|06/01/2016||||14875|||||No|No||APOTEX CORP|No||||
enoxaparin sodium|No|No|No|No|75%|60505079100|ENOXAPARIN 30 MG/0.3 ML SYR|.3|ML|6.45|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|No||068|Yes|14.7|05/23/2019|14.49|05/23/2019|13.8|05/23/2019|||ANTICOAGULANTS|14876|||||No|No||APOTEX CORP|No||||
enoxaparin sodium|No|No|No|No|75%|60505079104|ENOXAPARIN 30 MG/0.3 ML SYR|.3|ML|6.45|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|No||068|Yes|12.85641|03/29/2022|12.54785|03/29/2022|12.63142|03/29/2022|||ANTICOAGULANTS|14877|||||No|No||APOTEX CORP|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|60505079200|ENOXAPARIN 40 MG/0.4 ML SYR|.4|ML|6.45|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|No||068|Yes|14.7|05/23/2019|14.49|05/23/2019|13.8|05/23/2019|||ANTICOAGULANTS|14878|||||No|No||APOTEX CORP|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|60505079204|ENOXAPARIN 40 MG/0.4 ML SYR|.4|ML|6.45|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|No||068|Yes|11.94818|03/29/2022|11.66142|03/29/2022|11.73908|03/29/2022|||ANTICOAGULANTS|14879|||||No|No||APOTEX CORP|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|60505079300|ENOXAPARIN 60 MG/0.6 ML SYR|.6|ML|6.45|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|No||068|Yes|14.7|05/23/2019|14.49|05/23/2019|13.8|05/23/2019|||ANTICOAGULANTS|14880|||||No|No||APOTEX CORP|No||||
enoxaparin sodium|No|No|No|No|75%|60505079304|ENOXAPARIN 60 MG/0.6 ML SYR|.6|ML|6.45|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|No||068|Yes|11.41069|03/29/2022|11.13683|03/29/2022|11.211|03/29/2022|||ANTICOAGULANTS|14881|||||No|No||APOTEX CORP|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|60505079400|ENOXAPARIN 80 MG/0.8 ML SYR|.8|ML|6.45|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|No||068|Yes|14.7|05/23/2019|14.49|05/23/2019|13.8|05/23/2019|||ANTICOAGULANTS|14882|||||No|No||APOTEX CORP|No||||
enoxaparin sodium|No|No|No|No|75%|60505079404|ENOXAPARIN 80 MG/0.8 ML SYR|.8|ML|6.45|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|No||068|Yes|12.0025|03/29/2022|11.71444|03/29/2022|11.79245|03/29/2022|||ANTICOAGULANTS|14883|||||No|No||APOTEX CORP|No||||
enoxaparin sodium|No|No|No|No|75%|60505079501|ENOXAPARIN 100 MG/ML SYRINGE|1|ML|6.45|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|No||068|Yes|14.7|05/23/2019|14.49|05/23/2019|13.8|05/23/2019|||ANTICOAGULANTS|14884|||||No|No||APOTEX CORP|No||||
enoxaparin sodium|No|No|No|No|75%|60505079504|ENOXAPARIN 100 MG/ML SYRINGE|1|ML|6.45|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|No||068|Yes|11.81296|03/29/2022|11.52944|03/29/2022|11.60623|03/29/2022|||ANTICOAGULANTS|14885|||||No|No||APOTEX CORP|Yes|09/01/2020|||
enoxaparin sodium|No|No|No|No|75%|60505079600|ENOXAPARIN 120 MG/0.8 ML SYR|.8|ML|9.675|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|No||068|Yes|22.05|05/23/2019|21.735|05/23/2019|20.7|05/23/2019|||ANTICOAGULANTS|14886|||||No|No||APOTEX CORP|No||||
enoxaparin sodium|No|No|No|No|75%|60505079604|ENOXAPARIN 120 MG/0.8 ML SYR|.8|ML|9.675|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|No||068|Yes|15.335|03/29/2022|14.96696|03/29/2022|15.06663|03/29/2022|||ANTICOAGULANTS|14887|||||No|No||APOTEX CORP|No||||
enoxaparin sodium|No|No|No|No|75%|60505079800|ENOXAPARIN 150 MG/ML SYRINGE|1|ML|9.675|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|No||068|Yes|22.05|05/23/2019|21.735|05/23/2019|20.7|05/23/2019|||ANTICOAGULANTS|14888|||||No|No||APOTEX CORP|No||||
enoxaparin sodium|No|No|No|No|75%|60505079804|ENOXAPARIN 150 MG/ML SYRINGE|1|ML|9.675|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|No||068|Yes|15.18|03/29/2022|14.81568|03/29/2022|14.91435|03/29/2022|||ANTICOAGULANTS|14889|||||No|No||APOTEX CORP|No||||
butorphanol tartrate|No|No|No|No|90%|60505081301|BUTORPHANOL 10 MG/ML SPRAY|2.5|ML|9.7008|06/04/2015||Yes|No||06/04/2015||Yes|No|06/04/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|109|Yes|13.82286|03/29/2022|13.49111|03/29/2022|13.58095|03/29/2022|||ANALGESICS: NARCOTICS SHORT|14890|||||No|No||APOTEX CORP|No||||
desmopressin (nonrefrigerated)|No|No|No|No|75%|60505081500|DESMOPRESSIN 10 MCG/0.1 ML SPR|5|ML|10.58918|03/18/2021||Yes|No||03/18/2021||Yes|No|03/18/2021||Yes|No||||No|No|||Prescription required|No|||No|8.29308|03/29/2022|8.09404|03/29/2022|8.14795|03/29/2022||||14891|||||No|No||APOTEX CORP|No||||
calcitonin,salmon,synthetic|No|No|No|No|75%|60505082306|CALCITONIN-SALMON 200 UNITS SP|3.7|ML|8.7011|03/11/2009||Yes|No||03/11/2009||Yes|No|03/11/2009||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|060|No|7.79532|03/29/2022|7.60823|03/29/2022|7.6589|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|14892|||||No|No||APOTEX CORP|No||||
ipratropium bromide|No|No|No|No|75%|60505082601|IPRATROPIUM 0.03% SPRAY|30|ML|.516|10/02/2020||Yes|No||10/02/2020||Yes|No|10/02/2020||Yes|No||||No|No|||Prescription required|Yes|07/12/2005|019|No|.75257|03/29/2022|.7345|03/29/2022|.7394|03/29/2022|||INTRANASAL RHINITIS AGENTS|14893|||||No|No||APOTEX CORP|Yes|10/02/2020|||
ipratropium bromide|No|No|No|No|75%|60505082701|IPRATROPIUM 0.06% SPRAY|15|ML|1.032|10/02/2020||Yes|No||10/02/2020||Yes|No|10/02/2020||Yes|No||||No|No|||Prescription required|Yes|07/12/2005|019|No|1.39746|03/29/2022|1.36392|03/29/2022|1.373|03/29/2022|||INTRANASAL RHINITIS AGENTS|14894|||||No|No||APOTEX CORP|Yes|10/02/2020|||
fluticasone propionate|No|No|No|No|75%|60505082901|FLUTICASONE PROP 50 MCG SPRAY|16|GM|.48375|09/19/2007||Yes|No||09/19/2007||Yes|No|09/19/2007||Yes|No||||No|No|||Prescription required|No||019|No|.27037|03/29/2022|.26388|03/29/2022|.26563|03/29/2022|||INTRANASAL RHINITIS AGENTS|14895|||||No|No||APOTEX CORP|No||||
mometasone furoate|No|No|No|No|75%|60505083001|MOMETASONE FUROATE 50 MCG SPRY|17|GM|3.03529|07/21/2016||Yes|No||07/21/2016||Yes|No|07/21/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|019|No|2.16676|03/29/2022|2.11475|03/29/2022|2.12884|03/29/2022|||INTRANASAL RHINITIS AGENTS|14896|||||No|No||APOTEX CORP|No||||
azelastine HCl|No|No|No|No|75%|60505083305|AZELASTINE 0.1% (137 MCG) SPRY|30|ML|.31175|06/24/2010||Yes|No||06/24/2010||Yes|No|06/24/2010||Yes|No||||No|No|||Prescription required|No||019|Yes|.27761|03/29/2022|.27094|03/29/2022|.27275|03/29/2022|||INTRANASAL RHINITIS AGENTS|14897|||||No|No||APOTEX CORP|No||||
olopatadine HCl|No|No|No|No|75%|60505084505|OLOPATADINE 665 MCG NASAL SPRY|30.5|GM|1.26884|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|019|No|1.24713|03/29/2022|1.21719|03/29/2022|1.2253|03/29/2022|||INTRANASAL RHINITIS AGENTS|14898|||||No|No||APOTEX CORP|No||||
azelastine HCl|No|No|No|No|75%|60505084805|AZELASTINE 0.15% NASAL SPRAY|30|ML|1.59644|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|019|Yes|.62364|03/29/2022|.60867|03/29/2022|.61272|03/29/2022|||INTRANASAL RHINITIS AGENTS|14899|||||No|No||APOTEX CORP|No||||
azelastine/fluticasone|No|No|No|No|75%|60505095303|AZELASTIN-FLUTIC 137-50MCG SPR|23|GM|3.19396|05/26/2020||Yes|No||05/26/2020||Yes|No|05/26/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|019|No|4.21868|03/29/2022|4.11743|03/29/2022|4.14485|03/29/2022|||INTRANASAL RHINITIS AGENTS|14900|||||No|No||APOTEX CORP|No||||
ketorolac tromethamine|No|No|No|No|75%|60505100301|KETOROLAC 0.5% OPHTH SOLUTION|5|ML|2.75716|11/05/2009||Yes|No||11/05/2009||Yes|No|11/05/2009||Yes|No||||No|No|||Prescription required|No||013|No|1.50166|03/29/2022|1.46562|03/29/2022|1.47538|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|14901|||||No|No||APOTEX CORP|No||||
ketorolac tromethamine|No|No|No|No|75%|60505100302|KETOROLAC 0.5% OPHTH SOLUTION|10|ML|2.75716|11/05/2009||Yes|No||11/05/2009||Yes|No|11/05/2009||Yes|No||||No|No|||Prescription required|No||013|No|1.17797|03/29/2022|1.14969|03/29/2022|1.15735|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|14902|||||No|No||APOTEX CORP|No||||
timolol maleate|No|No|No|No|75%|60505100501|TIMOLOL 0.5% EYE DROP|5|ML|22.17424|02/01/2018||Yes|No||02/01/2018||Yes|No|02/01/2018||Yes|No||||No|No|||Prescription required|Yes|12/07/2017|088|No|31.3164|01/25/2022|30.5648|01/25/2022|30.76836|01/25/2022|||OPHTHALMICS: GLAUCOMA AGENTS|14903|||||No|No||APOTEX CORP|No||||
timolol maleate|No|No|No|No|75%|60505100504|TIMOLOL 0.5% EYE DROP|2.5|ML|22.17768|02/01/2018||Yes|No||02/01/2018||Yes|No|02/01/2018||Yes|No||||No|No|||Prescription required|Yes|12/07/2017|088|No|37.3288|09/28/2021|36.4329|09/28/2021|36.67554|09/28/2021|||OPHTHALMICS: GLAUCOMA AGENTS|14904|||||No|No||APOTEX CORP|No||||
ciprofloxacin HCl|No|No|No|No|75%|60505131001|CIPROFLOXACIN HCL 750 MG TAB|100|EA|.1548|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No||028|No|.24264|09/24/2019|.23681|09/24/2019|.23839|09/24/2019|||FLUOROQUINOLONES: ORAL|14905|||||No|No||APOTEX CORP|No||||
paroxetine HCl|Yes|No|No|No|75%|60505131603|PAROXETINE CR 12.5 MG TABLET|30|EA|.86|06/15/2020||Yes|No||06/15/2020||Yes|No|06/15/2020||Yes|No||||No|No|09/21/2020||Prescription required|Yes|07/25/2019|008|Yes|.80099|03/29/2022|.78176|03/29/2022|.78697|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14906|||||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505131703|PAROXETINE CR 25 MG TABLET|30|EA|.903|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|008|No|1.16217|03/29/2022|1.13427|03/29/2022|1.14183|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14907|||||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505131803|PAROXETINE CR 37.5 MG TABLET|30|EA|.946|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|008|No|1.12249|03/29/2022|1.09555|03/29/2022|1.10284|03/29/2022|||ANTIDEPRESSANTS: SSRIs|14908|||||No|No||APOTEX CORP|No||||
midodrine HCl|No|No|No|No|75%|60505132001|MIDODRINE HCL 2.5 MG TABLET|100|EA|.22415|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No|||No|.20233|03/29/2022|.19747|03/29/2022|.19878|03/29/2022||||14909|||||No|No||APOTEX CORP|No||||
midodrine HCl|No|No|No|No|75%|60505132101|MIDODRINE HCL 5 MG TABLET|100|EA|.3154|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No|||No|.26381|03/29/2022|.25747|03/29/2022|.25919|03/29/2022||||14910|||||No|No||APOTEX CORP|No||||
pravastatin sodium|Yes|No|No|No|75%|60505132305|PRAVASTATIN SODIUM 80 MG TAB|500|EA|.16493|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No||063|Yes|.14996|03/29/2022|.14636|03/29/2022|.14733|03/29/2022|||LIPOTROPICS: STATINS|14911|||||No|No||APOTEX CORP|No||||
pravastatin sodium|Yes|No|No|No|75%|60505132309|PRAVASTATIN SODIUM 80 MG TAB|90|EA|.16492|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No||063|Yes|.14996|03/29/2022|.14636|03/29/2022|.14733|03/29/2022|||LIPOTROPICS: STATINS|14912|||||No|No||APOTEX CORP|No||||
midodrine HCl|No|No|No|No|75%|60505132501|MIDODRINE HCL 10 MG TABLET|100|EA|.53904|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No|||No|.40773|03/29/2022|.39794|03/29/2022|.40059|03/29/2022||||14913|||||No|No||APOTEX CORP|No||||
leflunomide|No|No|No|No|75%|60505250201|LEFLUNOMIDE 10 MG TABLET|30|EA|1.14666|09/14/2005||Yes|No||09/14/2005||Yes|No|09/14/2005||Yes|No||||No|No|||Prescription required|No|||No|.80538|03/29/2022|.78605|03/29/2022|.79128|03/29/2022||||14914|||||No|No||APOTEX CORP|No||||
leflunomide|No|No|No|No|75%|60505250203|LEFLUNOMIDE 10 MG TABLET|1000|EA|2.1768|03/15/2006||Yes|No||03/15/2006||Yes|No|03/15/2006||Yes|No||||No|No|||Prescription required|No|||No|.80538|03/29/2022|.78605|03/29/2022|.79128|03/29/2022||||14915|||||No|No||APOTEX CORP|No||||
leflunomide|No|No|No|No|75%|60505250301|LEFLUNOMIDE 20 MG TABLET|30|EA|1.18966|09/14/2005||Yes|No||09/14/2005||Yes|No|09/14/2005||Yes|No||||No|No|||Prescription required|No|||No|.61902|03/29/2022|.60416|03/29/2022|.60818|03/29/2022||||14916|||||No|No||APOTEX CORP|No||||
leflunomide|No|No|No|No|75%|60505250303|LEFLUNOMIDE 20 MG TABLET|1000|EA|2.26395|03/15/2006||Yes|No||03/15/2006||Yes|No|03/15/2006||Yes|No||||No|No|||Prescription required|No|||No|.61902|03/29/2022|.60416|03/29/2022|.60818|03/29/2022||||14917|||||No|No||APOTEX CORP|No||||
citalopram hydrobromide|Yes|No|No|No|75%|60505251801|CITALOPRAM HBR 10 MG TABLET|100|EA|.0476|11/24/2004||Yes|No||11/24/2004||Yes|No|11/24/2004||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02728|09/24/2019|.02662|09/24/2019|.0268|09/24/2019|||ANTIDEPRESSANTS: SSRIs|14918|||||No|No||APOTEX CORP|No||||
citalopram hydrobromide|Yes|No|No|No|75%|60505251804|CITALOPRAM HBR 10 MG TABLET|30|EA|.05504|11/24/2004||Yes|No||11/24/2004||Yes|No|11/24/2004||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02728|09/24/2019|.02662|09/24/2019|.0268|09/24/2019|||ANTIDEPRESSANTS: SSRIs|14919|||||No|No||APOTEX CORP|No||||
citalopram hydrobromide|Yes|No|No|No|75%|60505251808|CITALOPRAM HBR 10 MG TABLET|1000|EA|.0476|12/27/2006||Yes|No||12/27/2006||Yes|No|12/27/2006||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02728|09/24/2019|.02662|09/24/2019|.0268|09/24/2019|||ANTIDEPRESSANTS: SSRIs|14920|||||No|No||APOTEX CORP|No||||
citalopram hydrobromide|Yes|No|No|No|75%|60505251901|CITALOPRAM HBR 20 MG TABLET|100|EA|.09795|11/24/2004||Yes|No||11/24/2004||Yes|No|11/24/2004||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02793|09/24/2019|.02725|09/24/2019|.02744|09/24/2019|||ANTIDEPRESSANTS: SSRIs|14921|||||No|No||APOTEX CORP|No||||
citalopram hydrobromide|Yes|No|No|No|75%|60505251904|CITALOPRAM HBR 20 MG TABLET|30|EA|.1009|11/24/2004||Yes|No||11/24/2004||Yes|No|11/24/2004||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02793|09/24/2019|.02725|09/24/2019|.02744|09/24/2019|||ANTIDEPRESSANTS: SSRIs|14922|||||No|No||APOTEX CORP|No||||
citalopram hydrobromide|Yes|No|No|No|75%|60505251908|CITALOPRAM HBR 20 MG TABLET|1000|EA|.09795|12/27/2006||Yes|No||12/27/2006||Yes|No|12/27/2006||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02793|09/24/2019|.02725|09/24/2019|.02744|09/24/2019|||ANTIDEPRESSANTS: SSRIs|14923|||||No|No||APOTEX CORP|No||||
citalopram hydrobromide|Yes|No|No|No|75%|60505252001|CITALOPRAM HBR 40 MG TABLET|100|EA|.10221|11/24/2004||Yes|No||11/24/2004||Yes|No|11/24/2004||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.0366|09/24/2019|.03572|09/24/2019|.03595|09/24/2019|||ANTIDEPRESSANTS: SSRIs|14924|||||No|No||APOTEX CORP|No||||
citalopram hydrobromide|Yes|No|No|No|75%|60505252004|CITALOPRAM HBR 40 MG TABLET|30|EA|.1052|11/24/2004||Yes|No||11/24/2004||Yes|No|11/24/2004||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.0366|09/24/2019|.03572|09/24/2019|.03595|09/24/2019|||ANTIDEPRESSANTS: SSRIs|14925|||||No|No||APOTEX CORP|No||||
citalopram hydrobromide|Yes|No|No|No|75%|60505252008|CITALOPRAM HBR 40 MG TABLET|1000|EA|.10221|12/27/2006||Yes|No||12/27/2006||Yes|No|12/27/2006||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.0366|09/24/2019|.03572|09/24/2019|.03595|09/24/2019|||ANTIDEPRESSANTS: SSRIs|14926|||||No|No||APOTEX CORP|No||||
cilostazol|No|No|No|No|75%|60505252101|CILOSTAZOL 50 MG TABLET|60|EA|.15695|12/13/2004||Yes|No||12/13/2004||Yes|No|12/13/2004||Yes|No||||No|No|||Prescription required|No|||No|.11608|03/29/2022|.11329|03/29/2022|.11404|03/29/2022||||14927|||||No|No||APOTEX CORP|No||||
cilostazol|No|No|No|No|75%|60505252201|CILOSTAZOL 100 MG TABLET|60|EA|.15695|12/13/2004||Yes|No||12/13/2004||Yes|No|12/13/2004||Yes|No||||No|No|||Prescription required|No|||No|.13507|03/29/2022|.13182|03/29/2022|.1327|03/29/2022||||14928|||||No|No||APOTEX CORP|No||||
modafinil|No|No|No|No|90%|60505252603|MODAFINIL 100 MG TABLET|30|EA|.41566|06/19/2014||Yes|No||06/19/2014||Yes|No|06/19/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.4088|03/29/2022|.39898|03/29/2022|.40164|03/29/2022|||STIMULANTS AND RELATED AGENTS|14929|||||No|No||APOTEX CORP|No||||
modafinil|No|No|No|No|90%|60505252703|MODAFINIL 200 MG TABLET|30|EA|.54466|06/19/2014||Yes|No||06/19/2014||Yes|No|06/19/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55328|03/29/2022|.54|03/29/2022|.54359|03/29/2022|||STIMULANTS AND RELATED AGENTS|14930|||||No|No||APOTEX CORP|No||||
ziprasidone HCl|No|No|No|No|75%|60505252806|ZIPRASIDONE HCL 20 MG CAPSULE|60|EA|.57333|07/19/2012||Yes|No||07/19/2012||Yes|No|07/19/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.27381|03/29/2022|.26723|03/29/2022|.26901|03/29/2022|||ANTIPSYCHOTICS|14931|||||No|No||APOTEX CORP|No||||
ziprasidone HCl|No|No|No|No|75%|60505252906|ZIPRASIDONE HCL 40 MG CAPSULE|60|EA|.57333|07/19/2012||Yes|No||07/19/2012||Yes|No|07/19/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.29914|03/29/2022|.29196|03/29/2022|.2939|03/29/2022|||ANTIPSYCHOTICS|14932|||||No|No||APOTEX CORP|No||||
ziprasidone HCl|No|No|No|No|75%|60505253006|ZIPRASIDONE HCL 60 MG CAPSULE|60|EA|.645|07/19/2012||Yes|No||07/19/2012||Yes|No|07/19/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.38441|03/29/2022|.37518|03/29/2022|.37768|03/29/2022|||ANTIPSYCHOTICS|14933|||||No|No||APOTEX CORP|No||||
ziprasidone HCl|No|No|No|No|75%|60505253106|ZIPRASIDONE HCL 80 MG CAPSULE|60|EA|.645|07/19/2012||Yes|No||07/19/2012||Yes|No|07/19/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.42395|03/29/2022|.41377|03/29/2022|.41653|03/29/2022|||ANTIPSYCHOTICS|14934|||||No|No||APOTEX CORP|No||||
oxcarbazepine|No|No|No|No|75%|60505253405|OXCARBAZEPINE 150 MG TABLET|500|EA|.43314|04/14/2008||Yes|No||04/14/2008||Yes|No|04/14/2008||Yes|No||||No|No|||Prescription required|No|||No|.1197|09/24/2019|.11682|09/24/2019|.1176|09/24/2019||||14935|||||No|No||APOTEX CORP|No||||
oxcarbazepine|No|No|No|No|75%|60505253605|OXCARBAZEPINE 600 MG TABLET|500|EA|1.45393|04/14/2008||Yes|No||04/14/2008||Yes|No|04/14/2008||Yes|No||||No|No|||Prescription required|No|||No|.30901|09/24/2019|.30159|09/24/2019|.3036|09/24/2019||||14936|||||No|No||APOTEX CORP|No||||
galantamine HBr|No|No|No|No|75%|60505254206|GALANTAMINE HBR 4 MG TABLET|60|EA|.98527|11/06/2012||Yes|No||11/06/2012||Yes|No|11/06/2012||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|011|No|.42975|03/29/2022|.41943|03/29/2022|.42222|03/29/2022|||ALZHEIMER'S AGENTS|14937|||||No|No||APOTEX CORP|No||||
galantamine HBr|No|No|No|No|75%|60505254306|GALANTAMINE HBR 8 MG TABLET|60|EA|.98527|11/06/2012||Yes|No||11/06/2012||Yes|No|11/06/2012||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|011|Yes|.48142|03/29/2022|.46986|03/29/2022|.47299|03/29/2022|||ALZHEIMER'S AGENTS|14938|||||No|No||APOTEX CORP|No||||
galantamine HBr|No|No|No|No|75%|60505254406|GALANTAMINE HBR 12 MG TABLET|60|EA|.98527|11/06/2012||Yes|No||11/06/2012||Yes|No|11/06/2012||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|011|No|.83193|01/25/2022|.81196|01/25/2022|.81737|01/25/2022|||ALZHEIMER'S AGENTS|14939|||||No|No||APOTEX CORP|No||||
gabapentin|No|No|No|No|75%|60505255101|GABAPENTIN 600 MG TABLET|100|EA|.56652|09/18/2006||Yes|No||09/18/2006||Yes|No|09/18/2006||Yes|No||07/01/2012||Yes|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|14940|||||No|No||APOTEX CORP|No||||
gabapentin|No|No|No|No|75%|60505255105|GABAPENTIN 600 MG TABLET|500|EA|.56652|12/08/2011||Yes|No||12/08/2011||Yes|No|12/08/2011||Yes|No||07/01/2012||Yes|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|14941|||||No|No||APOTEX CORP|No||||
gabapentin|No|No|No|No|75%|60505255201|GABAPENTIN 800 MG TABLET|100|EA|.67849|09/18/2006||Yes|No||09/18/2006||Yes|No|09/18/2006||Yes|No||07/01/2012||Yes|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|14942|||||No|No||APOTEX CORP|No||||
gabapentin|No|No|No|No|75%|60505255205|GABAPENTIN 800 MG TABLET|500|EA|.67849|12/08/2011||Yes|No||12/08/2011||Yes|No|12/08/2011||Yes|No||07/01/2012||Yes|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|14943|||||No|No||APOTEX CORP|No||||
balsalazide disodium|No|No|No|No|75%|60505257507|BALSALAZIDE DISODIUM 750 MG CP|280|EA|.30714|12/28/2007||Yes|No||12/28/2007||Yes|No|12/28/2007||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|010|No|.43814|03/29/2022|.42762|03/29/2022|.43047|03/29/2022|||ULCERATIVE COLITIS AGENTS|14944|||||No|No||APOTEX CORP|No||||
atorvastatin calcium|Yes|No|No|No|75%|60505257808|ATORVASTATIN 10 MG TABLET|1000|EA|.09106|07/17/2012||Yes|No||07/17/2012||Yes|No|07/17/2012||Yes|No||07/17/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|14945|||||No|No||APOTEX CORP|No||||
atorvastatin calcium|Yes|No|No|No|75%|60505257809|ATORVASTATIN 10 MG TABLET|90|EA|.09106|06/04/2012||Yes|No||06/04/2012||Yes|No|06/04/2012||Yes|No||06/04/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|14946|||||No|No||APOTEX CORP|No||||
atorvastatin calcium|Yes|No|No|No|75%|60505257908|ATORVASTATIN 20 MG TABLET|1000|EA|.12961|07/17/2012||Yes|No||07/17/2012||Yes|No|07/17/2012||Yes|No||07/17/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|14947|||||No|No||APOTEX CORP|No||||
atorvastatin calcium|Yes|No|No|No|75%|60505257909|ATORVASTATIN 20 MG TABLET|90|EA|.12961|06/04/2012||Yes|No||06/04/2012||Yes|No|06/04/2012||Yes|No||06/04/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|14948|||||No|No||APOTEX CORP|No||||
atorvastatin calcium|Yes|No|No|No|75%|60505258008|ATORVASTATIN 40 MG TABLET|1000|EA|.12961|07/17/2012||Yes|No||07/17/2012||Yes|No|07/17/2012||Yes|No||07/17/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|14949|||||No|No||APOTEX CORP|No||||
atorvastatin calcium|Yes|No|No|No|75%|60505258009|ATORVASTATIN 40 MG TABLET|90|EA|.12961|06/04/2012||Yes|No||06/04/2012||Yes|No|06/04/2012||Yes|No||06/04/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|14950|||||No|No||APOTEX CORP|No||||
cetirizine HCl|No|No|No|No|75%|60505263301|CETIRIZINE HCL 10 MG TABLET|100|EA|.05719|02/13/2008||Yes|No||||No|No|02/13/2008||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|14951|||||No|No||APOTEX CORP|No||||
cetirizine HCl|No|No|No|No|75%|60505263308|CETIRIZINE HCL 10 MG TABLET|1000|EA|.05719|02/28/2012||Yes|No||||No|No|02/28/2012||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|14952|||||No|No||APOTEX CORP|No||||
bicalutamide|No|No|No|No|75%|60505264201|BICALUTAMIDE 50 MG TABLET|100|EA|.37625|10/20/2009||Yes|No||10/20/2009||Yes|No|10/20/2009||Yes|No||||No|No|||Prescription required|No||550|No|.3381|03/29/2022|.32998|03/29/2022|.33218|03/29/2022|||ONCOLOGY: ORAL - PROSTATE|14953|||||No|No||APOTEX CORP|No||||
bicalutamide|No|No|No|No|75%|60505264203|BICALUTAMIDE 50 MG TABLET|30|EA|.3225|08/04/2009||Yes|No||08/04/2009||Yes|No|08/04/2009||Yes|No||||No|No|||Prescription required|No||550|No|.3381|03/29/2022|.32998|03/29/2022|.33218|03/29/2022|||ONCOLOGY: ORAL - PROSTATE|14954|||||No|No||APOTEX CORP|No||||
tramadol HCl/acetaminophen|No|No|No|No|90%|60505264401|TRAMADOL-ACETAMINOPHN 37.5-325|100|EA|.129|06/01/2015||Yes|No||06/01/2015||Yes|No|06/01/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.11806|03/29/2022|.11522|03/29/2022|.11599|03/29/2022|||ANALGESICS: NARCOTICS SHORT|14955|||||No|No||APOTEX CORP|No||||
tramadol HCl/acetaminophen|No|No|No|No|90%|60505264405|TRAMADOL-ACETAMINOPHN 37.5-325|500|EA|.129|06/01/2015||Yes|No||06/01/2015||Yes|No|06/01/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.11806|03/29/2022|.11522|03/29/2022|.11599|03/29/2022|||ANALGESICS: NARCOTICS SHORT|14956|||||No|No||APOTEX CORP|No||||
tizanidine HCl|No|No|No|No|75%|60505264807|TIZANIDINE HCL 2 MG CAPSULE|150|EA|.17489|07/02/2012||Yes|No||07/02/2012||Yes|No|07/02/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|116|No|.0903|03/29/2022|.08813|03/29/2022|.08871|03/29/2022|||SKELETAL MUSCLE RELAXANTS|14957|||||No|No||APOTEX CORP|No||||
tizanidine HCl|No|No|No|No|75%|60505264907|TIZANIDINE HCL 4 MG CAPSULE|150|EA|.22167|07/02/2012||Yes|No||07/02/2012||Yes|No|07/02/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|116|No|.15367|03/29/2022|.14998|03/29/2022|.15098|03/29/2022|||SKELETAL MUSCLE RELAXANTS|14958|||||No|No||APOTEX CORP|No||||
tizanidine HCl|No|No|No|No|75%|60505265007|TIZANIDINE HCL 6 MG CAPSULE|150|EA|.3325|07/02/2012||Yes|No||07/02/2012||Yes|No|07/02/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|116|No|.27523|03/29/2022|.26862|03/29/2022|.27041|03/29/2022|||SKELETAL MUSCLE RELAXANTS|14959|||||No|No||APOTEX CORP|No||||
trazodone HCl|No|No|No|No|75%|60505265301|TRAZODONE 50 MG TABLET|100|EA|.02859|11/03/2006||Yes|No||11/03/2006||Yes|No|11/03/2006||Yes|No||||No|No|||Prescription required|No||031|No|.03855|03/29/2022|.03762|03/29/2022|.03787|03/29/2022|||ANTIDEPRESSANTS: OTHER|14960|||||No|No||APOTEX CORP|No||||
trazodone HCl|No|No|No|No|75%|60505265401|TRAZODONE 100 MG TABLET|100|EA|.0531|11/03/2006||Yes|No||11/03/2006||Yes|No|11/03/2006||Yes|No||||No|No|||Prescription required|No||031|No|.07015|03/29/2022|.06846|03/29/2022|.06892|03/29/2022|||ANTIDEPRESSANTS: OTHER|14961|||||No|No||APOTEX CORP|No||||
trazodone HCl|No|No|No|No|75%|60505265501|TRAZODONE 150 MG TABLET|100|EA|.15523|11/03/2006||Yes|No||11/03/2006||Yes|No|11/03/2006||Yes|No||||No|No|||Prescription required|No||031|No|.1311|03/29/2022|.12795|03/29/2022|.1288|03/29/2022|||ANTIDEPRESSANTS: OTHER|14962|||||No|No||APOTEX CORP|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|60505265601|TRIAMTERENE-HCTZ 37.5-25 MG TB|100|EA|.1182|11/06/2006||Yes|No||11/06/2006||Yes|No|11/06/2006||Yes|No||||No|No|||Prescription required|No|||Yes|.09986|03/29/2022|.09746|03/29/2022|.09811|03/29/2022||||14963|||||No|No||APOTEX CORP|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|60505265605|TRIAMTERENE-HCTZ 37.5-25 MG TB|500|EA|.11674|11/06/2006||Yes|No||11/06/2006||Yes|No|11/06/2006||Yes|No||||No|No|||Prescription required|No|||Yes|.09986|03/29/2022|.09746|03/29/2022|.09811|03/29/2022||||14964|||||No|No||APOTEX CORP|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|60505265701|TRIAMTERENE-HCTZ 75-50 MG TAB|100|EA|.12121|11/06/2006||Yes|No||11/06/2006||Yes|No|11/06/2006||Yes|No||||No|No|||Prescription required|No|||Yes|.1312|03/29/2022|.12805|03/29/2022|.1289|03/29/2022||||14965|||||No|No||APOTEX CORP|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|60505265705|TRIAMTERENE-HCTZ 75-50 MG TAB|500|EA|.11756|11/06/2006||Yes|No||11/06/2006||Yes|No|11/06/2006||Yes|No||||No|No|||Prescription required|No|||Yes|.1312|03/29/2022|.12805|03/29/2022|.1289|03/29/2022||||14966|||||No|No||APOTEX CORP|No||||
trazodone HCl|No|No|No|No|75%|60505265901|TRAZODONE 300 MG TABLET|100|EA|1.40055|11/03/2006||Yes|No||11/03/2006||Yes|No|11/03/2006||Yes|No||||No|No|||Prescription required|No||031|No|1.52238|03/29/2022|1.48584|03/29/2022|1.49573|03/29/2022|||ANTIDEPRESSANTS: OTHER|14967|||||No|No||APOTEX CORP|No||||
atorvastatin calcium|Yes|No|No|No|75%|60505267108|ATORVASTATIN 80 MG TABLET|1000|EA|.12961|07/17/2012||Yes|No||07/17/2012||Yes|No|07/17/2012||Yes|No||07/17/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|14968|||||No|No||APOTEX CORP|No||||
atorvastatin calcium|Yes|No|No|No|75%|60505267109|ATORVASTATIN 80 MG TABLET|90|EA|.12961|06/04/2012||Yes|No||06/04/2012||Yes|No|06/04/2012||Yes|No||06/04/2012||Yes|No|07/01/2016||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|14969|||||No|No||APOTEX CORP|No||||
aripiprazole|No|No|No|No|75%|60505267303|ARIPIPRAZOLE 5 MG TABLET|30|EA|.63926|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|14970|||||No|No||APOTEX CORP|No||||
aripiprazole|No|No|No|No|75%|60505267403|ARIPIPRAZOLE 10 MG TABLET|30|EA|.63926|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|14971|||||No|No||APOTEX CORP|No||||
aripiprazole|No|No|No|No|75%|60505267503|ARIPIPRAZOLE 15 MG TABLET|30|EA|.63926|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|14972|||||No|No||APOTEX CORP|No||||
aripiprazole|No|No|No|No|75%|60505267603|ARIPIPRAZOLE 20 MG TABLET|30|EA|.72311|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|14973|||||No|No||APOTEX CORP|No||||
aripiprazole|No|No|No|No|75%|60505267703|ARIPIPRAZOLE 30 MG TABLET|30|EA|.72311|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|14974|||||No|No||APOTEX CORP|No||||
escitalopram oxalate|Yes|No|No|No|75%|60505278001|ESCITALOPRAM 5 MG TABLET|100|EA|.19393|09/12/2012||Yes|No||09/12/2012||Yes|No|09/12/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.05965|09/24/2019|.05821|09/24/2019|.0586|09/24/2019|||ANTIDEPRESSANTS: SSRIs|14975|||||No|No||APOTEX CORP|No||||
escitalopram oxalate|Yes|No|No|No|75%|60505278008|ESCITALOPRAM 5 MG TABLET|1000|EA|.19393|09/12/2012||Yes|No||09/12/2012||Yes|No|09/12/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.05965|09/24/2019|.05821|09/24/2019|.0586|09/24/2019|||ANTIDEPRESSANTS: SSRIs|14976|||||No|No||APOTEX CORP|No||||
escitalopram oxalate|Yes|No|No|No|75%|60505278101|ESCITALOPRAM 10 MG TABLET|100|EA|.20278|09/12/2012||Yes|No||09/12/2012||Yes|No|09/12/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.06753|09/24/2019|.0659|09/24/2019|.06634|09/24/2019|||ANTIDEPRESSANTS: SSRIs|14977|||||No|No||APOTEX CORP|No||||
escitalopram oxalate|Yes|No|No|No|75%|60505278108|ESCITALOPRAM 10 MG TABLET|1000|EA|.20277|09/12/2012||Yes|No||09/12/2012||Yes|No|09/12/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.06753|09/24/2019|.0659|09/24/2019|.06634|09/24/2019|||ANTIDEPRESSANTS: SSRIs|14978|||||No|No||APOTEX CORP|No||||
escitalopram oxalate|Yes|No|No|No|75%|60505278201|ESCITALOPRAM 20 MG TABLET|100|EA|.2116|09/12/2012||Yes|No||09/12/2012||Yes|No|09/12/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.08878|09/24/2019|.08664|09/24/2019|.08722|09/24/2019|||ANTIDEPRESSANTS: SSRIs|14979|||||No|No||APOTEX CORP|No||||
escitalopram oxalate|Yes|No|No|No|75%|60505278208|ESCITALOPRAM 20 MG TABLET|1000|EA|.21159|09/12/2012||Yes|No||09/12/2012||Yes|No|09/12/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.08878|09/24/2019|.08664|09/24/2019|.08722|09/24/2019|||ANTIDEPRESSANTS: SSRIs|14980|||||No|No||APOTEX CORP|No||||
ibandronate sodium|No|No|No|No|75%|60505279500|IBANDRONATE SODIUM 150 MG TAB|3|EA|12.18333|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|060|No|5.47616|03/29/2022|5.34473|03/29/2022|5.38032|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|14981|||||No|No||APOTEX CORP|No||||
carbamazepine|No|No|No|No|75%|60505280507|CARBAMAZEPINE ER 100 MG CAP|120|EA|.70383|07/23/2012||Yes|No||07/23/2012||Yes|No|07/23/2012||Yes|No||07/23/2012||Yes|No|||Prescription required|No||056|No|1.01422|03/29/2022|.98987|03/29/2022|.99647|03/29/2022|||ANTICONVULSANTS|14982|||||No|No||APOTEX CORP|No||||
carbamazepine|No|No|No|No|75%|60505280607|CARBAMAZEPINE ER 200 MG CAP|120|EA|.70383|07/23/2012||Yes|No||07/23/2012||Yes|No|07/23/2012||Yes|No||07/23/2012||Yes|No|||Prescription required|No||056|No|1.08329|03/29/2022|1.05729|03/29/2022|1.06433|03/29/2022|||ANTICONVULSANTS|14983|||||No|No||APOTEX CORP|No||||
carbamazepine|No|No|No|No|75%|60505280707|CARBAMAZEPINE ER 300 MG CAP|120|EA|.70383|07/23/2012||Yes|No||07/23/2012||Yes|No|07/23/2012||Yes|No||07/23/2012||Yes|No|||Prescription required|No||056|No|1.17876|03/29/2022|1.15046|03/29/2022|1.15813|03/29/2022|||ANTICONVULSANTS|14984|||||No|No||APOTEX CORP|No||||
atomoxetine HCl|No|No|No|No|75%|60505283003|ATOMOXETINE HCL 10 MG CAPSULE|30|EA|1.59143|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.20613|03/29/2022|1.17718|03/29/2022|1.18502|03/29/2022|||STIMULANTS AND RELATED AGENTS|14985|||||No|No||APOTEX CORP|No||||
atomoxetine HCl|No|No|No|No|75%|60505283103|ATOMOXETINE HCL 18 MG CAPSULE|30|EA|1.59143|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.0614|03/29/2022|1.03592|03/29/2022|1.04282|03/29/2022|||STIMULANTS AND RELATED AGENTS|14986|||||No|No||APOTEX CORP|No||||
atomoxetine HCl|No|No|No|No|75%|60505283203|ATOMOXETINE HCL 25 MG CAPSULE|30|EA|1.59143|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.05569|03/29/2022|1.03035|03/29/2022|1.03721|03/29/2022|||STIMULANTS AND RELATED AGENTS|14987|||||No|No||APOTEX CORP|No||||
atomoxetine HCl|No|No|No|No|75%|60505283303|ATOMOXETINE HCL 40 MG CAPSULE|30|EA|1.72903|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.0462|03/29/2022|1.02109|03/29/2022|1.02789|03/29/2022|||STIMULANTS AND RELATED AGENTS|14988|||||No|No||APOTEX CORP|No||||
atomoxetine HCl|No|No|No|No|75%|60505283403|ATOMOXETINE HCL 60 MG CAPSULE|30|EA|1.72903|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.16565|03/29/2022|1.13767|03/29/2022|1.14525|03/29/2022|||STIMULANTS AND RELATED AGENTS|14989|||||No|No||APOTEX CORP|No||||
atomoxetine HCl|No|No|No|No|75%|60505283503|ATOMOXETINE HCL 80 MG CAPSULE|30|EA|1.86548|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.40838|03/29/2022|1.37457|03/29/2022|1.38373|03/29/2022|||STIMULANTS AND RELATED AGENTS|14990|||||No|No||APOTEX CORP|No||||
atomoxetine HCl|No|No|No|No|75%|60505283603|ATOMOXETINE HCL 100 MG CAPSULE|30|EA|1.86548|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.76872|03/29/2022|1.72627|03/29/2022|1.73776|03/29/2022|||STIMULANTS AND RELATED AGENTS|14991|||||No|No||APOTEX CORP|No||||
alfuzosin HCl|No|No|No|No|75%|60505285001|ALFUZOSIN HCL ER 10 MG TABLET|100|EA|.1505|07/18/2011||Yes|No||07/18/2011||Yes|No|07/18/2011||Yes|No||||No|No|||Prescription required|No||003|No|.12775|03/29/2022|.12468|03/29/2022|.12551|03/29/2022|||BPH TREATMENTS|14992|||||No|No||APOTEX CORP|No||||
imatinib mesylate|No|No|No|No|75%|60505290009|IMATINIB MESYLATE 100 MG TAB|90|EA|2.28869|12/16/2016||Yes|No||12/16/2016||Yes|No|12/16/2016||Yes|No||||No|No|||Prescription required|No||173|No|5.21609|07/27/2021|5.14158|07/27/2021|4.89674|07/27/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|14993|||||No|No||APOTEX CORP|No||||
imatinib mesylate|No|No|No|No|75%|60505290103|IMATINIB MESYLATE 400 MG TAB|30|EA|8.24711|12/16/2016||Yes|No||12/16/2016||Yes|No|12/16/2016||Yes|No||||No|No|||Prescription required|No||173|No|2.86988|03/01/2022|2.801|03/01/2022|2.81965|03/01/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|14994|||||No|No||APOTEX CORP|No||||
ezetimibe|No|No|No|No|75%|60505294503|EZETIMIBE 10 MG TABLET|30|EA|.3526|09/20/2017|03/29/2022|Yes|No||09/20/2017|03/29/2022|Yes|No|09/20/2017|03/29/2022|Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|14995|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||APOTEX CORP|No||||
ezetimibe|No|No|No|No|75%|60505294509|EZETIMIBE 10 MG TABLET|90|EA|.3526|09/20/2017||Yes|No||09/20/2017||Yes|No|09/20/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|14996|||||No|No||APOTEX CORP|No||||
mycophenolate sodium|No|No|No|No|75%|60505296507|MYCOPHENOLIC ACID DR 180 MG TB|120|EA|.94299|10/28/2014||Yes|No||10/28/2014||Yes|No|10/28/2014||Yes|No||10/28/2014||Yes|No|||Prescription required|Yes|01/15/2014|229|No|.54568|03/29/2022|.53258|03/29/2022|.53613|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|14997|||||No|No||APOTEX CORP|No||||
mycophenolate sodium|No|No|No|No|75%|60505296607|MYCOPHENOLIC ACID DR 360 MG TB|120|EA|1.88598|12/08/2014||Yes|No||12/08/2014||Yes|No|12/08/2014||Yes|No||12/08/2014||Yes|No|||Prescription required|Yes|01/15/2014|229|No|.56705|03/29/2022|.55344|03/29/2022|.55712|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|14998|||||No|No||APOTEX CORP|No||||
mycophenolate mofetil|No|No|No|No|75%|60505296707|MYCOPHENOLATE 500 MG TABLET|3500|EA|.32069|03/15/2010||Yes|No||03/15/2010||Yes|No|03/15/2010||Yes|No||03/15/2010||Yes|No|||Prescription required|No||229|No|.31607|09/24/2019|.30848|09/24/2019|.31053|09/24/2019|||IMMUNOSUPPRESSIVES: ORAL|14999|||||No|No||APOTEX CORP|No||||
duloxetine HCl|No|No|No|No|75%|60505299506|DULOXETINE HCL DR 20 MG CAP|60|EA|.21055|09/22/2014||Yes|No||09/22/2014||Yes|No|09/22/2014||Yes|No||||No|No|||Prescription required|No||232|No|.13163|03/29/2022|.12847|03/29/2022|.12932|03/29/2022|||NEUROPATHIC PAIN|15000|||||No|No||APOTEX CORP|No||||
duloxetine HCl|No|No|No|No|75%|60505299603|DULOXETINE HCL DR 30 MG CAP|30|EA|.21113|09/22/2014||Yes|No||09/22/2014||Yes|No|09/22/2014||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|15001|||||No|No||APOTEX CORP|No||||
duloxetine HCl|No|No|No|No|75%|60505299703|DULOXETINE HCL DR 60 MG CAP|30|EA|.21113|09/22/2014||Yes|No||09/22/2014||Yes|No|09/22/2014||Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|15002|||||No|No||APOTEX CORP|No||||
aripiprazole|No|No|No|No|75%|60505307503|ARIPIPRAZOLE 2 MG TABLET|30|EA|.63926|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|15003|||||No|No||APOTEX CORP|No||||
risedronate sodium|No|No|No|No|75%|60505309702|RISEDRONATE SODIUM 150 MG TAB|1|EA|34.4|06/04/2015||Yes|No||06/04/2015||Yes|No|06/04/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|060|No|20.52701|03/29/2022|20.03436|03/29/2022|20.16778|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|15004|||||No|No||APOTEX CORP|No||||
olanzapine|No|No|No|No|75%|60505311003|OLANZAPINE 2.5 MG TABLET|30|EA|.14333|04/23/2012||Yes|No||04/23/2012||Yes|No|04/23/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.08915|03/29/2022|.08701|03/29/2022|.08758|03/29/2022|||ANTIPSYCHOTICS|15005|||||No|No||APOTEX CORP|No||||
olanzapine|No|No|No|No|75%|60505311008|OLANZAPINE 2.5 MG TABLET|1000|EA|.14333|07/06/2017||Yes|No||07/06/2017||Yes|No|07/06/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.08915|03/29/2022|.08701|03/29/2022|.08758|03/29/2022|||ANTIPSYCHOTICS|15006|||||No|No||APOTEX CORP|No||||
olanzapine|No|No|No|No|75%|60505311108|OLANZAPINE 5 MG TABLET|1000|EA|.15408|07/06/2017||Yes|No||07/06/2017||Yes|No|07/06/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.09455|03/29/2022|.09228|03/29/2022|.09289|03/29/2022|||ANTIPSYCHOTICS|15007|||||No|No||APOTEX CORP|No||||
olanzapine|No|No|No|No|75%|60505311208|OLANZAPINE 7.5 MG TABLET|1000|EA|.1935|07/06/2017||Yes|No||07/06/2017||Yes|No|07/06/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.11617|03/29/2022|.11338|03/29/2022|.11413|03/29/2022|||ANTIPSYCHOTICS|15008|||||No|No||APOTEX CORP|No||||
olanzapine|No|No|No|No|75%|60505311308|OLANZAPINE 10 MG TABLET|1000|EA|.24008|07/06/2017||Yes|No||07/06/2017||Yes|No|07/06/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.12613|03/29/2022|.1231|03/29/2022|.12392|03/29/2022|||ANTIPSYCHOTICS|15009|||||No|No||APOTEX CORP|No||||
olanzapine|No|No|No|No|75%|60505311403|OLANZAPINE 15 MG TABLET|30|EA|.35833|04/23/2012||Yes|No||04/23/2012||Yes|No|04/23/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.15007|03/29/2022|.14646|03/29/2022|.14744|03/29/2022|||ANTIPSYCHOTICS|15010|||||No|No||APOTEX CORP|No||||
olanzapine|No|No|No|No|75%|60505311408|OLANZAPINE 15 MG TABLET|1000|EA|.35833|07/06/2017||Yes|No||07/06/2017||Yes|No|07/06/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.15007|03/29/2022|.14646|03/29/2022|.14744|03/29/2022|||ANTIPSYCHOTICS|15011|||||No|No||APOTEX CORP|No||||
fenofibrate,micronized|No|No|No|No|75%|60505312003|FENOFIBRATE 43 MG CAPSULE|30|EA|.80926|09/05/2013||Yes|No||09/05/2013||Yes|No|09/05/2013||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|055|No|1.00144|11/23/2021|.9774|11/23/2021|.98391|11/23/2021|||LIPOTROPICS: OTHER|15012|||||No|No||APOTEX CORP|No||||
fenofibrate,micronized|No|No|No|No|75%|60505312103|FENOFIBRATE 130 MG CAPSULE|30|EA|2.38263|09/05/2013||Yes|No||09/05/2013||Yes|No|09/05/2013||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|055|No|1.46614|03/29/2022|1.43095|03/29/2022|1.44048|03/29/2022|||LIPOTROPICS: OTHER|15013|||||No|No||APOTEX CORP|No||||
fenofibrate,micronized|No|No|No|No|75%|60505312109|FENOFIBRATE 130 MG CAPSULE|90|EA|2.38005|02/01/2021||Yes|No||02/01/2021||Yes|No|02/01/2021||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|055|No|1.46614|03/29/2022|1.43095|03/29/2022|1.44048|03/29/2022|||LIPOTROPICS: OTHER|15014|||||No|No||APOTEX CORP|No||||
quetiapine fumarate|No|No|No|No|75%|60505313001|QUETIAPINE FUMARATE 25 MG TAB|100|EA|.0774|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.03239|03/29/2022|.03161|03/29/2022|.03182|03/29/2022|||ANTIPSYCHOTICS|15015|||||No|No||APOTEX CORP|No||||
quetiapine fumarate|No|No|No|No|75%|60505313008|QUETIAPINE FUMARATE 25 MG TAB|1000|EA|.0774|04/10/2012||Yes|No||04/10/2012||Yes|No|04/10/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.03239|03/29/2022|.03161|03/29/2022|.03182|03/29/2022|||ANTIPSYCHOTICS|15016|||||No|No||APOTEX CORP|No||||
quetiapine fumarate|No|No|No|No|75%|60505313201|QUETIAPINE FUMARATE 50 MG TAB|100|EA|.13119|04/10/2012||Yes|No||04/10/2012||Yes|No|04/10/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.04283|03/29/2022|.0418|03/29/2022|.04208|03/29/2022|||ANTIPSYCHOTICS|15017|||||No|No||APOTEX CORP|No||||
quetiapine fumarate|No|No|No|No|75%|60505313208|QUETIAPINE FUMARATE 50 MG TAB|1000|EA|.13119|04/10/2012||Yes|No||04/10/2012||Yes|No|04/10/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.04283|03/29/2022|.0418|03/29/2022|.04208|03/29/2022|||ANTIPSYCHOTICS|15018|||||No|No||APOTEX CORP|No||||
quetiapine fumarate|No|No|No|No|75%|60505313301|QUETIAPINE FUMARATE 100 MG TAB|100|EA|.13695|04/10/2012||Yes|No||04/10/2012||Yes|No|04/10/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.05826|03/29/2022|.05686|03/29/2022|.05724|03/29/2022|||ANTIPSYCHOTICS|15019|||||No|No||APOTEX CORP|No||||
quetiapine fumarate|No|No|No|No|75%|60505313308|QUETIAPINE FUMARATE 100 MG TAB|1000|EA|.13695|04/10/2012||Yes|No||04/10/2012||Yes|No|04/10/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.05826|03/29/2022|.05686|03/29/2022|.05724|03/29/2022|||ANTIPSYCHOTICS|15020|||||No|No||APOTEX CORP|No||||
quetiapine fumarate|No|No|No|No|75%|60505313501|QUETIAPINE FUMARATE 200 MG TAB|100|EA|.25847|04/10/2012||Yes|No||04/10/2012||Yes|No|04/10/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.10261|03/29/2022|.10014|03/29/2022|.10081|03/29/2022|||ANTIPSYCHOTICS|15021|||||No|No||APOTEX CORP|No||||
quetiapine fumarate|No|No|No|No|75%|60505313508|QUETIAPINE FUMARATE 200 MG TAB|1000|EA|.25847|04/10/2012||Yes|No||04/10/2012||Yes|No|04/10/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.10261|03/29/2022|.10014|03/29/2022|.10081|03/29/2022|||ANTIPSYCHOTICS|15022|||||No|No||APOTEX CORP|No||||
quetiapine fumarate|No|No|No|No|75%|60505313706|QUETIAPINE FUMARATE 300 MG TAB|60|EA|.33884|04/10/2012||Yes|No||04/10/2012||Yes|No|04/10/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.13964|03/29/2022|.13628|03/29/2022|.13719|03/29/2022|||ANTIPSYCHOTICS|15023|||||No|No||APOTEX CORP|No||||
quetiapine fumarate|No|No|No|No|75%|60505313901|QUETIAPINE FUMARATE 400 MG TAB|100|EA|.39822|04/10/2012||Yes|No||04/10/2012||Yes|No|04/10/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.17858|03/29/2022|.17429|03/29/2022|.17545|03/29/2022|||ANTIPSYCHOTICS|15024|||||No|No||APOTEX CORP|No||||
olanzapine|No|No|No|No|75%|60505314003|OLANZAPINE 20 MG TABLET|30|EA|.48375|04/23/2012||Yes|No||04/23/2012||Yes|No|04/23/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.18048|03/29/2022|.17614|03/29/2022|.17732|03/29/2022|||ANTIPSYCHOTICS|15025|||||No|No||APOTEX CORP|No||||
olanzapine|No|No|No|No|75%|60505314008|OLANZAPINE 20 MG TABLET|1000|EA|.48375|07/06/2017||Yes|No||07/06/2017||Yes|No|07/06/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.18048|03/29/2022|.17614|03/29/2022|.17732|03/29/2022|||ANTIPSYCHOTICS|15026|||||No|No||APOTEX CORP|No||||
risedronate sodium|No|No|No|No|75%|60505316500|RISEDRONATE SODIUM 35 MG TAB|4|EA|4.859|12/03/2015||Yes|No||12/03/2015||Yes|No|12/03/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|060|No|2.85532|03/29/2022|2.78679|03/29/2022|2.80535|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|15027|||||No|No||APOTEX CORP|No||||
omega-3 acid ethyl esters|No|No|No|No|75%|60505317007|OMEGA-3 ETHYL ESTERS 1 GM CAP|120|EA|.34715|06/01/2015||Yes|No||06/01/2015||Yes|No|06/01/2015||Yes|No||||No|No|||Prescription required|No||055|Yes|.18363|03/29/2022|.17922|03/29/2022|.18041|03/29/2022|||LIPOTROPICS: OTHER|15028|||||No|No||APOTEX CORP|No||||
famciclovir|No|No|No|No|75%|60505324503|FAMCICLOVIR 125 MG TABLET|30|EA|.15695|12/16/2011||Yes|No||12/16/2011||Yes|No|12/16/2011||Yes|No||||No|No|||Prescription required|No||025|No|.30813|10/26/2021|.30073|10/26/2021|.30273|10/26/2021|||ANTIVIRALS: ORAL|15029|||||No|No||APOTEX CORP|No||||
famciclovir|Yes|No|No|No|75%|60505324603|FAMCICLOVIR 250 MG TABLET|30|EA|.22861|12/16/2011||Yes|No||12/16/2011||Yes|No|12/16/2011||Yes|No||||No|No|11/01/2012||Prescription required|No||025|No|.49235|03/29/2022|.48053|03/29/2022|.48373|03/29/2022|||ANTIVIRALS: ORAL|15030|||||No|No||APOTEX CORP|No||||
famciclovir|No|No|No|No|75%|60505324703|FAMCICLOVIR 500 MG TABLET|30|EA|.50095|12/16/2011||Yes|No||12/16/2011||Yes|No|12/16/2011||Yes|No||||No|No|||Prescription required|No||025|No|.88904|03/29/2022|.8677|03/29/2022|.87348|03/29/2022|||ANTIVIRALS: ORAL|15031|||||No|No||APOTEX CORP|No||||
lamivudine|No|No|No|No|75%|60505325006|LAMIVUDINE HBV 100 MG TABLET|60|EA|7.03029|05/29/2014||Yes|No||05/29/2014||Yes|No|05/29/2014||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|2.63504|03/29/2022|2.57179|03/29/2022|2.58892|03/29/2022||||15032|||||No|No||APOTEX CORP|No||||
lamivudine|No|No|No|No|75%|60505325106|LAMIVUDINE 150 MG TABLET|60|EA|2.25|07/19/2012||Yes|No||07/19/2012||Yes|No|07/19/2012||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.96758|11/23/2021|.94435|11/23/2021|.95064|11/23/2021|||HIV / AIDS|15033|||||No|No||APOTEX CORP|No||||
lamivudine|No|No|No|No|75%|60505325203|LAMIVUDINE 300 MG TABLET|30|EA|4.5|07/19/2012||Yes|No||07/19/2012||Yes|No|07/19/2012||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|1.29184|03/01/2022|1.26083|03/01/2022|1.26923|03/01/2022|||HIV / AIDS|15034|||||No|No||APOTEX CORP|No||||
letrozole|No|No|No|No|75%|60505325503|LETROZOLE 2.5 MG TABLET|30|EA|.15766|07/19/2012|02/02/2022|Yes|No||07/19/2012|02/02/2022|Yes|No|07/19/2012|02/02/2022|Yes|No||||No|No|||Prescription required|No||502|No|.35932|02/15/2022|.35419|02/15/2022|.33732|02/15/2022|||ONCOLOGY: ORAL - BREAST|15035|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||APOTEX CORP|No||||
letrozole|No|No|No|No|75%|60505325508|LETROZOLE 2.5 MG TABLET|1000|EA|.15766|01/03/2013||Yes|No||01/03/2013||Yes|No|01/03/2013||Yes|No||||No|No|||Prescription required|No||502|No|.1337|03/29/2022|.13049|03/29/2022|.13136|03/29/2022|||ONCOLOGY: ORAL - BREAST|15036|||||No|No||APOTEX CORP|No||||
olanzapine|No|No|No|No|75%|60505327500|OLANZAPINE ODT 5 MG TABLET|100|EA|.76767|04/27/2012||Yes|No||04/27/2012||Yes|No|04/27/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.59218|03/29/2022|.57796|03/29/2022|.58181|03/29/2022|||ANTIPSYCHOTICS|15037|||||No|No||APOTEX CORP|No||||
olanzapine|No|No|No|No|75%|60505327503|OLANZAPINE ODT 5 MG TABLET|30|EA|.36793|12/22/2017||Yes|No||12/22/2017||Yes|No|12/22/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.59218|03/29/2022|.57796|03/29/2022|.58181|03/29/2022|||ANTIPSYCHOTICS|15038|||||No|No||APOTEX CORP|No||||
olanzapine|No|No|No|No|75%|60505327600|OLANZAPINE ODT 10 MG TABLET|100|EA|1.12776|04/30/2012||Yes|No||04/30/2012||Yes|No|04/30/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.58062|03/29/2022|.56668|03/29/2022|.57045|03/29/2022|||ANTIPSYCHOTICS|15039|||||No|No||APOTEX CORP|No||||
olanzapine|No|No|No|No|75%|60505327603|OLANZAPINE ODT 10 MG TABLET|30|EA|.54051|08/16/2016||Yes|No||08/16/2016||Yes|No|08/16/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.58062|03/29/2022|.56668|03/29/2022|.57045|03/29/2022|||ANTIPSYCHOTICS|15040|||||No|No||APOTEX CORP|No||||
olanzapine|No|No|No|No|75%|60505327700|OLANZAPINE ODT 15 MG TABLET|100|EA|1.66293|04/30/2012||Yes|No||04/30/2012||Yes|No|04/30/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.85386|03/29/2022|.83336|03/29/2022|.83891|03/29/2022|||ANTIPSYCHOTICS|15041|||||No|No||APOTEX CORP|No||||
olanzapine|No|No|No|No|75%|60505327703|OLANZAPINE ODT 15 MG TABLET|30|EA|.79707|08/16/2016||Yes|No||08/16/2016||Yes|No|08/16/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.85386|03/29/2022|.83336|03/29/2022|.83891|03/29/2022|||ANTIPSYCHOTICS|15042|||||No|No||APOTEX CORP|No||||
olanzapine|No|No|No|No|75%|60505327800|OLANZAPINE ODT 20 MG TABLET|100|EA|2.19816|04/30/2012||Yes|No||04/30/2012||Yes|No|04/30/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|1.09|03/29/2022|1.06384|03/29/2022|1.07092|03/29/2022|||ANTIPSYCHOTICS|15043|||||No|No||APOTEX CORP|No||||
olanzapine|No|No|No|No|75%|60505327803|OLANZAPINE ODT 20 MG TABLET|30|EA|1.05378|08/16/2016||Yes|No||08/16/2016||Yes|No|08/16/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|1.09|03/29/2022|1.06384|03/29/2022|1.07092|03/29/2022|||ANTIPSYCHOTICS|15044|||||No|No||APOTEX CORP|No||||
levetiracetam|No|No|No|No|75%|60505328006|LEVETIRACETAM ER 500 MG TABLET|60|EA|.31869|05/29/2012||Yes|No||05/29/2012||Yes|No|05/29/2012||Yes|No||||No|No|||Prescription required|No||056|No|.22713|03/29/2022|.22167|03/29/2022|.22315|03/29/2022|||ANTICONVULSANTS|15045|||||No|No||APOTEX CORP|No||||
riluzole|No|No|No|No|75%|60505328506|RILUZOLE 50 MG TABLET|60|EA|1.13526|06/26/2013||Yes|No||06/26/2013||Yes|No|06/26/2013||Yes|No||||No|No|||Prescription required|No|||No|.46908|03/01/2022|.45782|03/01/2022|.46087|03/01/2022||||15046|||||No|No||APOTEX CORP|No||||
quinapril/hydrochlorothiazide|No|No|No|No|75%|60505340909|QUINAPRIL-HCTZ 10-12.5 MG TAB|90|EA|.3944|06/02/2014||Yes|No||06/02/2014||Yes|No|06/02/2014||Yes|No||06/02/2014||Yes|No|||Prescription required|Yes|07/24/2013|113|Yes|.31182|03/01/2022|.30433|03/01/2022|.30636|03/01/2022|||ANGIOTENSIN MODULATORS|15047|||||No|No||APOTEX CORP|No||||
selegiline HCl|No|No|No|No|75%|60505343803|SELEGILINE HCL 5 MG TABLET|60|EA|.63259|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|1.08881|03/29/2022|1.06267|03/29/2022|1.06975|03/29/2022|||ANTIPARKINSON'S AGENTS|15048|||||No|No||APOTEX CORP|No||||
selegiline HCl|No|No|No|No|75%|60505343808|SELEGILINE HCL 5 MG TABLET|500|EA|.56934|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|015|No|1.08881|03/29/2022|1.06267|03/29/2022|1.06975|03/29/2022|||ANTIPARKINSON'S AGENTS|15049|||||No|No||APOTEX CORP|No||||
trospium chloride|No|No|No|No|75%|60505345406|TROSPIUM CHLORIDE 20 MG TABLET|60|EA|.3412|06/03/2013||Yes|No||06/03/2013||Yes|No|06/03/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|006|No|.42162|03/29/2022|.4115|03/29/2022|.41424|03/29/2022|||BLADDER RELAXANT PREPARATIONS|15050|||||No|No||APOTEX CORP|No||||
amlodipine/atorvastatin|No|No|No|No|75%|60505347803|AMLODIPINE-ATORVAST 5-10 MG|30|EA|1.47275|04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No||04/21/2021||Yes|No|||Prescription required|Yes|07/30/2020|063|Yes|2.51729|03/29/2022|2.45687|03/29/2022|2.47323|03/29/2022|||LIPOTROPICS: STATINS|15051|||||No|No||APOTEX CORP|No||||
amlodipine/atorvastatin|No|No|No|No|75%|60505347903|AMLODIPINE-ATORVAST 10-10 MG|30|EA|1.47275|04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No||04/21/2021||Yes|No|||Prescription required|Yes|07/30/2020|063|Yes|2.18539|03/29/2022|2.13294|03/29/2022|2.14714|03/29/2022|||LIPOTROPICS: STATINS|15052|||||No|No||APOTEX CORP|No||||
amlodipine/atorvastatin|No|No|No|No|75%|60505348303|AMLODIPINE-ATORVAST 5-20 MG|30|EA|2.01483|04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No||04/21/2021||Yes|No|||Prescription required|Yes|07/30/2020|063|Yes|2.6682|03/29/2022|2.60416|03/29/2022|2.6215|03/29/2022|||LIPOTROPICS: STATINS|15053|||||No|No||APOTEX CORP|No||||
amlodipine/atorvastatin|No|No|No|No|75%|60505348403|AMLODIPINE-ATORVAST 10-20 MG|30|EA|2.01483|04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No||04/21/2021||Yes|No|||Prescription required|Yes|07/30/2020|063|Yes|1.70393|03/29/2022|1.66303|03/29/2022|1.67411|03/29/2022|||LIPOTROPICS: STATINS|15054|||||No|No||APOTEX CORP|No||||
amlodipine/atorvastatin|No|No|No|No|75%|60505348803|AMLODIPINE-ATORVAST 5-40 MG|30|EA|2.01483|04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No||04/21/2021||Yes|No|||Prescription required|Yes|07/30/2020|063|Yes|3.582|03/01/2022|3.49603|03/01/2022|3.51931|03/01/2022|||LIPOTROPICS: STATINS|15055|||||No|No||APOTEX CORP|No||||
amlodipine/atorvastatin|No|No|No|No|75%|60505348903|AMLODIPINE-ATORVAST 10-40 MG|30|EA|2.01483|04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No||04/21/2021||Yes|No|||Prescription required|Yes|07/30/2020|063|Yes|2.04729|03/29/2022|1.99815|03/29/2022|2.01146|03/29/2022|||LIPOTROPICS: STATINS|15056|||||No|No||APOTEX CORP|No||||
amlodipine/atorvastatin|No|No|No|No|75%|60505349203|AMLODIPINE-ATORVAST 5-80 MG|30|EA|2.01483|04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No||04/21/2021||Yes|No|||Prescription required|Yes|07/30/2020|063|Yes|4.59194|04/21/2021|4.52634|04/21/2021|4.3108|04/21/2021|||LIPOTROPICS: STATINS|15057|||||No|No||APOTEX CORP|No||||
amlodipine/atorvastatin|No|No|No|No|75%|60505349303|AMLODIPINE-ATORVAST 10-80 MG|30|EA|2.01483|04/21/2021||Yes|No||04/21/2021||Yes|No|04/21/2021||Yes|No||04/21/2021||Yes|No|||Prescription required|Yes|07/30/2020|063|Yes|4.0268|03/01/2022|3.93015|03/01/2022|3.95633|03/01/2022|||LIPOTROPICS: STATINS|15058|||||No|No||APOTEX CORP|No||||
levetiracetam|No|No|No|No|75%|60505351706|LEVETIRACETAM ER 750 MG TABLET|60|EA|.47851|05/29/2012||Yes|No||05/29/2012||Yes|No|05/29/2012||Yes|No||||No|No|||Prescription required|No||056|No|.36799|03/29/2022|.35915|03/29/2022|.36155|03/29/2022|||ANTICONVULSANTS|15059|||||No|No||APOTEX CORP|No||||
clopidogrel bisulfate|No|No|No|No|75%|60505353205|CLOPIDOGREL 300 MG TABLET|500|EA|3.18866|09/06/2017||Yes|No||09/06/2017||Yes|No|09/06/2017||Yes|No||09/06/2017||Yes|No|||Prescription required|No||004|No|7.26719|09/12/2017|7.16337|09/06/2017|6.82226|09/06/2017|||PLATELET AGGREGATION INHIBITORS|15060|||||No|No||APOTEX CORP|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|60505360303|IRBESARTAN-HCTZ 150-12.5 MG TB|30|EA|.1548|09/28/2012||Yes|No||09/28/2012||Yes|No|09/28/2012||Yes|No||09/28/2012||Yes|No|07/01/2016||Prescription required|No||113|Yes|.24433|09/24/2019|.23846|09/24/2019|.24005|09/24/2019|||ANGIOTENSIN MODULATORS|15061|||||No|No||APOTEX CORP|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|60505360309|IRBESARTAN-HCTZ 150-12.5 MG TB|90|EA|.15064|09/28/2012||Yes|No||09/28/2012||Yes|No|09/28/2012||Yes|No||09/28/2012||Yes|No|07/01/2016||Prescription required|No||113|Yes|.24433|09/24/2019|.23846|09/24/2019|.24005|09/24/2019|||ANGIOTENSIN MODULATORS|15062|||||No|No||APOTEX CORP|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|60505360403|IRBESARTAN-HCTZ 300-12.5 MG TB|30|EA|.19192|09/28/2012||Yes|No||09/28/2012||Yes|No|09/28/2012||Yes|No||09/28/2012||Yes|No|07/01/2016||Prescription required|No||113|Yes|.29708|09/24/2019|.28995|09/24/2019|.29188|09/24/2019|||ANGIOTENSIN MODULATORS|15063|||||No|No||APOTEX CORP|No||||
tranexamic acid|No|No|No|No|75%|60505363803|TRANEXAMIC ACID 650 MG TABLET|30|EA|2.83968|09/29/2014|03/29/2022|Yes|No||09/29/2014|03/29/2022|Yes|No|01/01/2021|03/29/2022|Yes|No||||No|No|||Prescription required|No|||No|1.67932|03/29/2022|1.63901|03/29/2022|1.64993|03/29/2022||||15064|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505366303|PAXIL 10 MG TABLET|30|EA|2.64908|05/19/2011||Yes|No||05/19/2011||Yes|No|05/19/2011||Yes|No||||No|No|||Prescription required|Yes|07/22/2009|008|Yes|6.03744|08/21/2018|5.95119|08/21/2018|5.6678|08/21/2018|||ANTIDEPRESSANTS: SSRIs|15065|||||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505366503|PAXIL 30 MG TABLET|30|EA|2.84774|05/19/2011||Yes|No||05/19/2011||Yes|No|05/19/2011||Yes|No||||No|No|||Prescription required|Yes|07/22/2009|008|No|6.4902|08/21/2018|6.39748|08/21/2018|6.09284|08/21/2018|||ANTIDEPRESSANTS: SSRIs|15066|||||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505366603|PAXIL 40 MG TABLET|30|EA|3.00813|04/01/2011||Yes|No||04/01/2011||Yes|No|04/01/2011||Yes|No||||No|No|||Prescription required|Yes|07/22/2009|008|No|6.85574|08/21/2018|6.7578|08/21/2018|6.436|08/21/2018|||ANTIDEPRESSANTS: SSRIs|15067|||||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505366803|PAXIL CR 12.5 MG TABLET|30|EA|3.1228|06/29/2011||Yes|No||06/29/2011||Yes|No|06/29/2011||Yes|No||||No|No|||Prescription required|Yes|07/22/2009|008|Yes|7.11708|06/29/2021|7.01541|06/29/2021|6.68134|06/29/2021|||ANTIDEPRESSANTS: SSRIs|15068|||||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505366903|PAXIL CR 25 MG TABLET|30|EA|3.25854|06/29/2011|12/06/2022|Yes|No||06/29/2011|12/06/2022|Yes|No|06/29/2011|12/06/2022|Yes|No||||No|No|||Prescription required|Yes|07/22/2009|008|No|8.00329|10/26/2021|7.81121|10/26/2021|7.86323|10/26/2021|||ANTIDEPRESSANTS: SSRIs|15069|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505367003|PAXIL CR 37.5 MG TABLET|30|EA|3.35672|06/29/2011|12/06/2022|Yes|No||06/29/2011|12/06/2022|Yes|No|06/29/2011|12/06/2022|Yes|No||||No|No|||Prescription required|Yes|07/22/2009|008|No|7.6502|06/23/2020|7.54091|06/23/2020|7.18182|06/23/2020|||ANTIDEPRESSANTS: SSRIs|15070|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505367303|PAROXETINE CR 12.5 MG TABLET|30|EA|.86|10/29/2010|12/06/2022|Yes|No||10/29/2010|12/06/2022|Yes|No|10/29/2010|12/06/2022|Yes|No||||No|No|||Prescription required|Yes|07/22/2009|008|Yes|.80099|03/29/2022|.78176|03/29/2022|.78697|03/29/2022|||ANTIDEPRESSANTS: SSRIs|15071|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505367403|PAROXETINE CR 25 MG TABLET|30|EA|.903|10/29/2010||Yes|No||10/29/2010||Yes|No|10/29/2010||Yes|No||||No|No|||Prescription required|Yes|07/22/2009|008|No|1.16217|03/29/2022|1.13427|03/29/2022|1.14183|03/29/2022|||ANTIDEPRESSANTS: SSRIs|15072|||||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505367503|PAROXETINE CR 37.5 MG TABLET|30|EA|.946|10/01/2010||Yes|No||10/01/2010||Yes|No|10/01/2010||Yes|No||||No|No|||Prescription required|Yes|07/22/2009|008|No|1.12249|03/29/2022|1.09555|03/29/2022|1.10284|03/29/2022|||ANTIDEPRESSANTS: SSRIs|15073|||||No|No||APOTEX CORP|No||||
carvedilol phosphate|No|No|No|No|75%|60505367803|CARVEDILOL ER 10 MG CAPSULE|30|EA|3.40875|01/26/2018||Yes|No||01/26/2018||Yes|No|01/26/2018||Yes|No||01/26/2018||Yes|No|||Prescription required|Yes|11/23/2017|070|Yes|6.70929|03/29/2022|6.54826|03/29/2022|6.59187|03/29/2022|||BETA-BLOCKERS|15074|||||No|No||APOTEX CORP|No||||
carvedilol phosphate|No|No|No|No|75%|60505367903|CARVEDILOL ER 20 MG CAPSULE|30|EA|3.40875|01/26/2018||Yes|No||01/26/2018||Yes|No|01/26/2018||Yes|No||01/26/2018||Yes|No|||Prescription required|Yes|11/23/2017|070|Yes|6.10173|03/29/2022|5.95528|03/29/2022|5.99494|03/29/2022|||BETA-BLOCKERS|15075|||||No|No||APOTEX CORP|No||||
carvedilol phosphate|No|No|No|No|75%|60505368003|CARVEDILOL ER 40 MG CAPSULE|30|EA|3.40875|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||01/30/2018||Yes|No|||Prescription required|Yes|11/23/2017|070|Yes|5.77365|03/29/2022|5.63508|03/29/2022|5.67261|03/29/2022|||BETA-BLOCKERS|15076|||||No|No||APOTEX CORP|No||||
carvedilol phosphate|No|No|No|No|75%|60505368103|CARVEDILOL ER 80 MG CAPSULE|30|EA|3.40875|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||01/30/2018||Yes|No|||Prescription required|Yes|11/23/2017|070|No|6.50208|03/29/2022|6.34603|03/29/2022|6.38829|03/29/2022|||BETA-BLOCKERS|15077|||||No|No||APOTEX CORP|No||||
levocetirizine dihydrochloride|No|No|No|No|75%|60505371309|LEVOCETIRIZINE 5 MG TABLET|90|EA|.14333|03/27/2018||Yes|No||03/27/2018||Yes|No|03/27/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|030|Yes|.08234|03/29/2022|.08036|03/29/2022|.08089|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|15078|||||No|No||APOTEX CORP|No||||
zolmitriptan|No|No|No|No|75%|60505371900|ZOLMITRIPTAN 5 MG ODT|3|EA|19.2769|05/21/2013||Yes|No||05/21/2013||Yes|No|05/21/2013||Yes|No||||No|No|||Prescription required|Yes|05/02/2020|021|No|3.9575|09/24/2019|3.86252|09/24/2019|3.88824|09/24/2019|||ANTIMIGRAINE AGENTS: TRIPTANS|15079|||||No|No||APOTEX CORP|No||||
rizatriptan benzoate|No|No|No|No|75%|60505372301|RIZATRIPTAN 5 MG ODT|18|EA|1.42975|07/02/2013||Yes|No||07/02/2013||Yes|No|07/02/2013||Yes|No||||No|No|||Prescription required|No||021|No|1.02264|09/24/2019|.99809|09/24/2019|1.00474|09/24/2019|||ANTIMIGRAINE AGENTS: TRIPTANS|15080|||||No|No||APOTEX CORP|No||||
rizatriptan benzoate|No|No|No|No|75%|60505372401|RIZATRIPTAN 10 MG ODT|18|EA|1.42975|07/02/2013||Yes|No||07/02/2013||Yes|No|07/02/2013||Yes|No||||No|No|||Prescription required|No||021|No|1.09643|09/24/2019|1.07011|09/24/2019|1.07724|09/24/2019|||ANTIMIGRAINE AGENTS: TRIPTANS|15081|||||No|No||APOTEX CORP|No||||
valsartan/hydrochlorothiazide|Yes|No|No|No|75%|60505380709|VALSARTAN-HCTZ 160-12.5 MG TAB|90|EA|1.47017|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||05/30/2014||Yes|No|07/01/2016||Prescription required|Yes|05/02/2020|113|Yes|.21107|09/24/2019|.206|09/24/2019|.20737|09/24/2019|||ANGIOTENSIN MODULATORS|15082|||||No|No||APOTEX CORP|No||||
valsartan/hydrochlorothiazide|Yes|No|No|No|75%|60505380809|VALSARTAN-HCTZ 160-25 MG TAB|90|EA|1.66725|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||05/30/2014||Yes|No|07/01/2016||Prescription required|Yes|05/02/2020|113|Yes|.20335|09/24/2019|.19846|09/24/2019|.19979|09/24/2019|||ANGIOTENSIN MODULATORS|15083|||||No|No||APOTEX CORP|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|60505380909|VALSARTAN-HCTZ 320-12.5 MG TAB|90|EA|1.86266|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||05/30/2014||Yes|No|||Prescription required|Yes|05/02/2020|113|Yes|.31913|09/24/2019|.31147|09/24/2019|.31354|09/24/2019|||ANGIOTENSIN MODULATORS|15084|||||No|No||APOTEX CORP|No||||
celecoxib|No|No|No|No|75%|60505384706|CELECOXIB 50 MG CAPSULE|60|EA|.11466|06/03/2015||Yes|No||06/03/2015||Yes|No|06/03/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|.1386|03/29/2022|.13527|03/29/2022|.13617|03/29/2022|||NSAIDS|15085|||||No|No||APOTEX CORP|No||||
celecoxib|No|No|No|No|75%|60505384801|CELECOXIB 100 MG CAPSULE|100|EA|.129|06/03/2015||Yes|No||06/03/2015||Yes|No|06/03/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|15086|||||No|No||APOTEX CORP|No||||
celecoxib|No|No|No|No|75%|60505384805|CELECOXIB 100 MG CAPSULE|500|EA|.129|06/03/2015||Yes|No||06/03/2015||Yes|No|06/03/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|15087|||||No|No||APOTEX CORP|No||||
celecoxib|No|No|No|No|75%|60505384901|CELECOXIB 200 MG CAPSULE|100|EA|.258|06/03/2015||Yes|No||06/03/2015||Yes|No|06/03/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|15088|||||No|No||APOTEX CORP|No||||
celecoxib|No|No|No|No|75%|60505384905|CELECOXIB 200 MG CAPSULE|500|EA|.258|06/03/2015||Yes|No||06/03/2015||Yes|No|06/03/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|15089|||||No|No||APOTEX CORP|No||||
dutasteride|No|No|No|No|75%|60505387703|DUTASTERIDE 0.5 MG CAPSULE|30|EA|.15766|11/30/2015||Yes|No||11/30/2015||Yes|No|11/30/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|003|No|.20731|03/29/2022|.20233|03/29/2022|.20368|03/29/2022|||BPH TREATMENTS|15090|||||No|No||APOTEX CORP|No||||
dutasteride|No|No|No|No|75%|60505387709|DUTASTERIDE 0.5 MG CAPSULE|90|EA|.15766|11/30/2015||Yes|No||11/30/2015||Yes|No|11/30/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|003|No|.20731|03/29/2022|.20233|03/29/2022|.20368|03/29/2022|||BPH TREATMENTS|15091|||||No|No||APOTEX CORP|No||||
tetrabenazine|No|No|No|No|75%|60505388207|TETRABENAZINE 12.5 MG TABLET|112|EA|5.62447|10/05/2020||Yes|No||10/05/2020||Yes|No|10/05/2020||Yes|No||||No|No|||Prescription required|No||572|Yes|12.81856|10/05/2020|12.63544|10/05/2020|12.03375|10/05/2020|||MOVEMENT DISORDERS|15092|||||No|No||APOTEX CORP|No||||
tetrabenazine|No|No|No|No|75%|60505388307|TETRABENAZINE 25 MG TABLET|112|EA|11.24891|10/05/2020||Yes|No||10/05/2020||Yes|No|10/05/2020||Yes|No||||No|No|||Prescription required|No||572|Yes|25.63705|10/05/2020|25.27081|10/05/2020|24.06743|10/05/2020|||MOVEMENT DISORDERS|15093|||||No|No||APOTEX CORP|No||||
guanfacine HCl|No|No|No|No|75%|60505392701|GUANFACINE HCL ER 1 MG TABLET|100|EA|.18042|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||02/22/2019||Yes|No|||Prescription required|No||007|Yes|.25553|03/29/2022|.24939|03/29/2022|.25105|03/29/2022|||STIMULANTS AND RELATED AGENTS|15094|||||No|No||APOTEX CORP|No||||
guanfacine HCl|No|No|No|No|75%|60505392801|GUANFACINE HCL ER 2 MG TABLET|100|EA|.18042|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||02/22/2019||Yes|No|||Prescription required|No||007|Yes|.28237|03/29/2022|.27559|03/29/2022|.27742|03/29/2022|||STIMULANTS AND RELATED AGENTS|15095|||||No|No||APOTEX CORP|No||||
guanfacine HCl|No|No|No|No|75%|60505392901|GUANFACINE HCL ER 3 MG TABLET|100|EA|.18042|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||02/22/2019||Yes|No|||Prescription required|No||007|Yes|.28|03/29/2022|.27328|03/29/2022|.2751|03/29/2022|||STIMULANTS AND RELATED AGENTS|15096|||||No|No||APOTEX CORP|No||||
guanfacine HCl|No|No|No|No|75%|60505393001|GUANFACINE HCL ER 4 MG TABLET|100|EA|.18042|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||02/22/2019||Yes|No|||Prescription required|No||007|Yes|.25313|03/29/2022|.24705|03/29/2022|.2487|03/29/2022|||STIMULANTS AND RELATED AGENTS|15097|||||No|No||APOTEX CORP|No||||
adefovir dipivoxil|No|No|No|No|75%|60505394703|ADEFOVIR DIPIVOXIL 10 MG TAB|30|EA|12.82833|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No|||No|29.23666|11/26/2019|28.81899|11/26/2019|27.44666|11/26/2019||||15098|||||No|No||APOTEX CORP|No||||
cyclobenzaprine HCl|No|No|No|No|75%|60505397206|CYCLOBENZAPRINE ER 15 MG CAP|60|EA|4.86731|05/30/2019||Yes|No||05/30/2019||Yes|No|05/30/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|Yes|11.09294|05/30/2019|10.93447|05/30/2019|10.41378|05/30/2019|||SKELETAL MUSCLE RELAXANTS|15099|||||No|No||APOTEX CORP|No||||
cyclobenzaprine HCl|No|No|No|No|75%|60505397306|CYCLOBENZAPRINE ER 30 MG CAP|60|EA|4.86731|05/30/2019||Yes|No||05/30/2019||Yes|No|05/30/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|Yes|11.09294|05/30/2019|10.93447|05/30/2019|10.41378|05/30/2019|||SKELETAL MUSCLE RELAXANTS|15100|||||No|No||APOTEX CORP|No||||
icosapent ethyl|No|No|No|No|75%|60505403301|ICOSAPENT ETHYL 1 GRAM CAPSULE|120|EA|1.08166|03/23/2022||Yes|No||03/23/2022||Yes|No|03/23/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|055|No|2.11805|03/29/2022|2.06721|03/29/2022|2.08098|03/29/2022|||LIPOTROPICS: OTHER|15101|||||No|No||APOTEX CORP|No||||
emtricitabine/tenofovir (TDF)|No|No|No|No|75%|60505420203|EMTRICITABINE-TENOFV 200-300MG|30|EA|1.45539|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.70347|03/29/2022|.68658|03/29/2022|.69115|03/29/2022|||HIV / AIDS|15102|||||No|No||APOTEX CORP|No||||
abiraterone acetate|No|No|No|No|75%|60505432701|ABIRATERONE ACETATE 250 MG TAB|120|EA|7.16666|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|No||550|No|16.33332|09/28/2021|16.09999|09/28/2021|15.33332|09/28/2021|||ONCOLOGY: ORAL - PROSTATE|15103|||||No|No||APOTEX CORP|No||||
paroxetine HCl|Yes|No|No|No|75%|60505437703|PAXIL CR 12.5 MG TABLET|30|EA|3.43168|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|06/19/2020||Prescription required|Yes|07/25/2019|008|Yes|7.82104|10/19/2021|7.70931|10/19/2021|7.3422|10/19/2021|||ANTIDEPRESSANTS: SSRIs|15104|||||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505437803|PAXIL CR 25 MG TABLET|30|EA|3.58075|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|008|No|8.00329|10/26/2021|7.81121|10/26/2021|7.86323|10/26/2021|||ANTIDEPRESSANTS: SSRIs|15105|||||No|No||APOTEX CORP|No||||
paroxetine HCl|No|No|No|No|75%|60505437903|PAXIL CR 37.5 MG TABLET|30|EA|3.68868|09/22/2020||Yes|No||09/22/2020||Yes|No|09/22/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|008|No|8.40676|10/19/2021|8.28666|10/19/2021|7.89206|10/19/2021|||ANTIDEPRESSANTS: SSRIs|15106|||||No|No||APOTEX CORP|No||||
doxycycline hyclate|No|No|No|No|75%|60505438206|DOXYCYCLINE HYCLATE 75 MG TAB|60|EA|1.67671|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||12/17/2019||Yes|No|||Prescription required|Yes|07/25/2019|213|No|3.82134|12/17/2019|3.76675|12/17/2019|3.58738|12/17/2019|||TETRACYCLINES|15107|||||No|No||APOTEX CORP|No||||
doxycycline hyclate|No|No|No|No|75%|60505438406|DOXYCYCLINE HYCLATE 150 MG TAB|60|EA|1.67671|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||12/17/2019||Yes|No|||Prescription required|Yes|07/25/2019|213|No|3.82134|03/24/2020|3.76675|03/24/2020|3.58738|03/24/2020|||TETRACYCLINES|15108|||||No|No||APOTEX CORP|No||||
rosuvastatin calcium|No|No|No|No|75%|60505450209|ROSUVASTATIN CALCIUM 5 MG TAB|90|EA|.15732|11/16/2016||Yes|No||11/16/2016||Yes|No|11/16/2016||Yes|No||11/16/2016||Yes|No|||Prescription required|No||063|Yes|.06753|03/29/2022|.0659|03/29/2022|.06634|03/29/2022|||LIPOTROPICS: STATINS|15109|||||No|No||APOTEX CORP|No||||
rosuvastatin calcium|No|No|No|No|75%|60505450309|ROSUVASTATIN CALCIUM 10 MG TAB|90|EA|.15732|11/16/2016||Yes|No||11/16/2016||Yes|No|11/16/2016||Yes|No||11/16/2016||Yes|No|||Prescription required|No||063|Yes|.05981|03/29/2022|.05837|03/29/2022|.05876|03/29/2022|||LIPOTROPICS: STATINS|15110|||||No|No||APOTEX CORP|No||||
rosuvastatin calcium|No|No|No|No|75%|60505450409|ROSUVASTATIN CALCIUM 20 MG TAB|90|EA|.15732|11/16/2016||Yes|No||11/16/2016||Yes|No|11/16/2016||Yes|No||03/21/2017||Yes|No|||Prescription required|No||063|Yes|.07822|03/29/2022|.07634|03/29/2022|.07685|03/29/2022|||LIPOTROPICS: STATINS|15111|||||No|No||APOTEX CORP|No||||
paroxetine HCl|Yes|No|No|No|75%|60505451703|PAXIL 10 MG TABLET|30|EA|3.33178|05/13/2019||Yes|No||05/13/2019||Yes|No|05/13/2019||Yes|No||||No|No|09/04/2019||Prescription required|Yes|07/26/2018|008|Yes|7.59336|10/19/2021|7.48488|10/19/2021|7.12846|10/19/2021|||ANTIDEPRESSANTS: SSRIs|15112|||||No|No||APOTEX CORP|No||||
paroxetine HCl|Yes|No|No|No|75%|60505451803|PAXIL 20 MG TABLET|30|EA|3.47612|05/13/2019||Yes|No||05/13/2019||Yes|No|05/13/2019||Yes|No||||No|No|09/04/2019||Prescription required|Yes|07/26/2018|008|Yes|7.92232|10/19/2021|7.80914|10/19/2021|7.43728|10/19/2021|||ANTIDEPRESSANTS: SSRIs|15113|||||No|No||APOTEX CORP|No||||
paroxetine HCl|Yes|No|No|No|75%|60505451903|PAXIL 30 MG TABLET|30|EA|3.58147|05/13/2019||Yes|No||05/13/2019||Yes|No|05/13/2019||Yes|No||||No|No|09/04/2019||Prescription required|Yes|07/26/2018|008|No|8.16242|10/19/2021|8.04581|10/19/2021|7.66268|10/19/2021|||ANTIDEPRESSANTS: SSRIs|15114|||||No|No||APOTEX CORP|No||||
paroxetine HCl|Yes|No|No|No|75%|60505452003|PAXIL 40 MG TABLET|30|EA|3.78328|05/13/2019||Yes|No||05/13/2019||Yes|No|05/13/2019||Yes|No||||No|No|09/04/2019||Prescription required|Yes|07/26/2018|008|No|8.62236|10/19/2021|8.49918|10/19/2021|8.09446|10/19/2021|||ANTIDEPRESSANTS: SSRIs|15115|||||No|No||APOTEX CORP|No||||
cyclosporine, modified|No|No|No|No|75%|60505463003|CYCLOSPORINE MODIFIED 25 MG|30|EA|.47285|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||03/12/2020||Yes|No|||Prescription required|No||229|No|.55875|03/29/2022|.54534|03/29/2022|.54897|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|15116|||||No|No||APOTEX CORP|No||||
cyclosporine, modified|No|No|No|No|75%|60505463103|CYCLOSPORINE MODIFIED 50 MG|30|EA|.94528|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||03/12/2020||Yes|No|||Prescription required|Yes|01/25/2018|229|No|1.26409|03/29/2022|1.23375|03/29/2022|1.24196|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|15117|||||No|No||APOTEX CORP|No||||
cyclosporine, modified|No|No|No|No|75%|60505463203|CYCLOSPORINE MODIFIED 100 MG|30|EA|1.89056|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||03/12/2020||Yes|No|||Prescription required|No||229|No|1.49497|03/29/2022|1.45909|03/29/2022|1.4688|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|15118|||||No|No||APOTEX CORP|No||||
prasugrel HCl|No|No|No|No|75%|60505464203|PRASUGREL 5 MG TABLET|30|EA|.35475|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|No||004|No|.53487|03/29/2022|.52203|03/29/2022|.5255|03/29/2022|||PLATELET AGGREGATION INHIBITORS|15119|||||No|No||APOTEX CORP|No||||
prasugrel HCl|No|No|No|No|75%|60505464303|PRASUGREL 10 MG TABLET|30|EA|.35475|10/28/2021||Yes|No||10/28/2021||Yes|No|10/28/2021||Yes|No||||No|No|||Prescription required|No||004|No|.35104|03/29/2022|.34261|03/29/2022|.34489|03/29/2022|||PLATELET AGGREGATION INHIBITORS|15120|||||No|No||APOTEX CORP|No||||
penicillamine|No|No|No|No|75%|60505469601|PENICILLAMINE 250 MG CAPSULE|100|EA|53.75|10/05/2020||Yes|No||10/05/2020||Yes|No|10/05/2020||Yes|No||||No|No|||Prescription required|No|||No|122.5|10/05/2020|120.75|10/05/2020|115|10/05/2020||||15121|||||No|No||APOTEX CORP|No||||
solifenacin succinate|No|No|No|No|75%|60505470203|SOLIFENACIN 5 MG TABLET|30|EA|.29842|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|Yes|.23024|03/29/2022|.22471|03/29/2022|.22621|03/29/2022|||BLADDER RELAXANT PREPARATIONS|15122|||||No|No||APOTEX CORP|No||||
solifenacin succinate|No|No|No|No|75%|60505470209|SOLIFENACIN 5 MG TABLET|90|EA|.29836|09/12/2019|03/29/2022|Yes|No||09/12/2019|03/29/2022|Yes|No|09/12/2019|03/29/2022|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|Yes|.23024|03/29/2022|.22471|03/29/2022|.22621|03/29/2022|||BLADDER RELAXANT PREPARATIONS|15123|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||APOTEX CORP|No||||
solifenacin succinate|No|No|No|No|75%|60505470303|SOLIFENACIN 10 MG TABLET|30|EA|.29842|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|No|.26101|03/29/2022|.25474|03/29/2022|.25644|03/29/2022|||BLADDER RELAXANT PREPARATIONS|15124|||||No|No||APOTEX CORP|No||||
solifenacin succinate|No|No|No|No|75%|60505470309|SOLIFENACIN 10 MG TABLET|90|EA|.29836|09/12/2019|12/06/2022|Yes|No||09/12/2019|12/06/2022|Yes|No|09/12/2019|12/06/2022|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|No|.26101|03/29/2022|.25474|03/29/2022|.25644|03/29/2022|||BLADDER RELAXANT PREPARATIONS|15125|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||APOTEX CORP|No||||
tolvaptan|No|No|No|No|75%|60505470400|TOLVAPTAN 15 MG TABLET|10|EA|194.28604|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|No|||No|442.79144|03/23/2021|436.46584|03/16/2021|415.68176|03/16/2021||||15126|||||No|No||APOTEX CORP|No||||
tolvaptan|No|No|No|No|75%|60505470500|TOLVAPTAN 30 MG TABLET|10|EA|201.54917|09/14/2020||Yes|No||09/14/2020||Yes|No|09/14/2020||Yes|No||||No|No|||Prescription required|No|||No|459.34462|09/22/2020|452.78255|09/14/2020|431.22148|09/14/2020||||15127|||||No|No||APOTEX CORP|No||||
carvedilol phosphate|No|No|No|No|75%|60505471303|CARVEDILOL ER 10 MG CAPSULE|30|EA|3.40875|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||10/07/2020||Yes|No|||Prescription required|Yes|07/26/2018|070|Yes|6.70929|03/29/2022|6.54826|03/29/2022|6.59187|03/29/2022|||BETA-BLOCKERS|15128|||||No|No||APOTEX CORP|No||||
carvedilol phosphate|No|No|No|No|75%|60505471403|CARVEDILOL ER 20 MG CAPSULE|30|EA|3.40875|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||10/07/2020||Yes|No|||Prescription required|Yes|07/26/2018|070|Yes|6.10173|03/29/2022|5.95528|03/29/2022|5.99494|03/29/2022|||BETA-BLOCKERS|15129|||||No|No||APOTEX CORP|No||||
carvedilol phosphate|No|No|No|No|75%|60505471503|CARVEDILOL ER 40 MG CAPSULE|30|EA|3.40875|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||10/07/2020||Yes|No|||Prescription required|Yes|07/26/2018|070|Yes|5.77365|03/29/2022|5.63508|03/29/2022|5.67261|03/29/2022|||BETA-BLOCKERS|15130|||||No|No||APOTEX CORP|No||||
carvedilol phosphate|No|No|No|No|75%|60505471603|CARVEDILOL ER 80 MG CAPSULE|30|EA|3.40875|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||04/14/2021||Yes|No|||Prescription required|Yes|07/26/2018|070|No|6.50208|03/29/2022|6.34603|03/29/2022|6.38829|03/29/2022|||BETA-BLOCKERS|15131|||||No|No||APOTEX CORP|No||||
abiraterone acetate|No|No|No|No|75%|60505476406|ABIRATERONE 500 MG TABLET|60|EA|35.57877|12/16/2021||Yes|No||12/16/2021||Yes|No|12/16/2021||Yes|No||||No|No|||Prescription required|No||550|No|81.0865|12/16/2021|79.92812|12/16/2021|76.12202|12/16/2021|||ONCOLOGY: ORAL - PROSTATE|15132|||||No|No||APOTEX CORP|No||||
acyclovir|Yes|No|No|No|75%|60505530601|ACYCLOVIR 400 MG TABLET|100|EA|.07589|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|11/01/2012||Prescription required|No||025|No|.0985|03/29/2022|.09613|03/29/2022|.09677|03/29/2022|||ANTIVIRALS: ORAL|15133|||||No|No||APOTEX CORP|No||||
acyclovir|Yes|No|No|No|75%|60505530608|ACYCLOVIR 400 MG TABLET|1000|EA|.07589|06/07/2007||Yes|No||06/07/2007||Yes|No|06/07/2007||Yes|No||06/07/2007||Yes|No|11/01/2012||Prescription required|No||025|No|.0985|03/29/2022|.09613|03/29/2022|.09677|03/29/2022|||ANTIVIRALS: ORAL|15134|||||No|No||APOTEX CORP|No||||
acyclovir|No|No|No|No|75%|60505530701|ACYCLOVIR 800 MG TABLET|100|EA|.13007|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No||025|No|.19021|03/29/2022|.18564|03/29/2022|.18688|03/29/2022|||ANTIVIRALS: ORAL|15135|||||No|No||APOTEX CORP|No||||
acyclovir|No|No|No|No|75%|60505530705|ACYCLOVIR 800 MG TABLET|500|EA|.13007|06/07/2007||Yes|No||06/07/2007||Yes|No|06/07/2007||Yes|No||06/07/2007||Yes|No|||Prescription required|No||025|No|.19021|03/29/2022|.18564|03/29/2022|.18688|03/29/2022|||ANTIVIRALS: ORAL|15136|||||No|No||APOTEX CORP|No||||
tigecycline|No|No|No|No|75%|60505609801|TIGECYCLINE 50 MG VIAL|1|EA|45.15|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|||Prescription required|No|||No|102.9|09/10/2019|101.43|09/10/2019|96.6|09/06/2019||||15137|||||No|No||APOTEX CORP|No||||
bepotastine besilate|No|No|No|No|75%|60505611101|BEPOTASTINE 1.5% EYE DROP|5|ML|17.93272|03/17/2022||Yes|No||03/17/2022||Yes|No|03/17/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|002|No|27.33943|03/29/2022|26.68328|03/29/2022|26.86098|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|15138|||||No|No||APOTEX CORP|No||||
bepotastine besilate|No|No|No|No|75%|60505611102|BEPOTASTINE 1.5% EYE DROP|10|ML|17.14883|03/17/2022||Yes|No||03/17/2022||Yes|No|03/17/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|002|No|32.0966|03/17/2022|31.32628|03/17/2022|31.5349|03/17/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|15139|||||No|No||APOTEX CORP|No||||
micafungin sodium|No|No|No|No|75%|60505611900|MICAFUNGIN 50 MG VIAL|1|EA|40.205|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No|||No|91.63|01/10/2022|90.321|01/10/2022|86.02|01/10/2022||||15140|||||No|No||APOTEX CORP|No||||
micafungin sodium|No|No|No|No|75%|60505611905|MICAFUNGIN 50 MG VIAL|1|EA|40.205|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No|||No|91.63|06/08/2021|90.321|06/08/2021|86.02|06/08/2021||||15141|||||No|No||APOTEX CORP|No||||
micafungin sodium|No|No|No|No|75%|60505612000|MICAFUNGIN 100 MG VIAL|1|EA|80.41|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No|||No|183.26|01/10/2022|180.642|01/10/2022|172.04|01/10/2022||||15142|||||No|No||APOTEX CORP|No||||
micafungin sodium|No|No|No|No|75%|60505612006|MICAFUNGIN 100 MG VIAL|1|EA|80.41|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No|||No|183.26|06/08/2021|180.642|06/08/2021|172.04|06/08/2021||||15143|||||No|No||APOTEX CORP|No||||
irinotecan HCl|No|No|No|No|75%|60505612800|IRINOTECAN HCL 40 MG/2 ML VIAL|2|ML|3.1261|06/14/2019||Yes|No||06/14/2019||Yes|No|06/14/2019||Yes|No||||No|No|||Prescription required|No|||No|7.1246|06/18/2019|7.02282|06/18/2019|6.6884|06/14/2019||||15144|||||No|No||APOTEX CORP|No||||
irinotecan HCl|No|No|No|No|75%|60505612801|IRINOTECAN HCL 100 MG/5 ML VL|5|ML|2.58516|06/14/2019||Yes|No||06/14/2019||Yes|No|06/14/2019||Yes|No||||No|No|||Prescription required|No|||No|5.89176|06/14/2019|5.80759|06/14/2019|5.53104|06/14/2019||||15145|||||No|No||APOTEX CORP|No||||
budesonide|No|No|No|No|75%|60505612902|BUDESONIDE 32 MCG NASAL SPRAY|8.43|ML|.70136|11/16/2016||Yes|No||||No|No|11/16/2016||Yes|No||||No|No|||Over the counter|Yes|07/23/2015|019|No|1.90218|03/29/2022|1.85652|03/29/2022|1.86889|03/29/2022|||INTRANASAL RHINITIS AGENTS|15146|||||No|No||APOTEX CORP|Yes|09/01/2020|||
ondansetron HCl/PF|No|No|No|No|75%|60505613005|ONDANSETRON HCL 4 MG/2 ML VIAL|2|ML|.0989|11/10/2016||Yes|No||11/10/2016||Yes|No|11/10/2016||Yes|No||||No|No|||Prescription required|No|||No|.18088|01/25/2022|.17653|01/25/2022|.17771|01/25/2022||||15147|||||No|No||APOTEX CORP|No||||
oxaliplatin|No|No|No|No|75%|60505613206|OXALIPLATIN 50 MG/10 ML VIAL|10|ML|2.15|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No|||No|4.9|05/16/2017|4.83|05/16/2017|4.6|05/16/2017||||15148|||||No|No||APOTEX CORP|No||||
oxaliplatin|No|No|No|No|75%|60505613207|OXALIPLATIN 100 MG/20 ML VIAL|20|ML|2.15|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No|||No|4.9|05/16/2017|4.83|05/16/2017|4.6|05/16/2017||||15149|||||No|No||APOTEX CORP|No||||
cefazolin sodium|No|No|No|No|75%|60505614205|CEFAZOLIN 1 GM VIAL|1|EA|.61455|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|No|||No|1.40061|11/15/2017|1.3806|11/15/2017|1.31486|11/15/2017||||15150|||||No|No||APOTEX CORP|No||||
cefazolin sodium|No|No|No|No|75%|60505614304|CEFAZOLIN 10 GM VIAL|1|EA|5.16|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|||Prescription required|No|||No|11.76|09/06/2019|11.592|09/10/2019|11.04|09/06/2019||||15151|||||No|No||APOTEX CORP|No||||
cefepime HCl|No|No|No|No|75%|60505614404|CEFEPIME HCL 1 GM VIAL|1|EA|1.204|05/25/2018||Yes|No||05/25/2018||Yes|No|05/25/2018||Yes|No||||No|No|||Prescription required|No|||No|2.744|08/25/2020|2.7048|08/25/2020|2.576|08/25/2020||||15152|||||No|No||APOTEX/NOVAPLUS|No||||
cefepime HCl|No|No|No|No|75%|60505614504|CEFEPIME HCL 2 GRAM VIAL|1|EA|2.26008|05/25/2018||Yes|No||05/25/2018||Yes|No|05/25/2018||Yes|No||||No|No|||Prescription required|No|||No|5.15088|08/25/2020|5.07729|08/25/2020|4.83552|08/25/2020||||15153|||||No|No||APOTEX/NOVAPLUS|No||||
cefepime HCl|No|No|No|No|75%|60505614600|CEFEPIME HCL 1 GM VIAL|1|EA|3.0616|10/03/2017||Yes|No||10/03/2017||Yes|No|10/03/2017||Yes|No||||No|No|||Prescription required|No|||No|6.9776|10/03/2017|6.87792|10/03/2017|6.5504|10/03/2017||||15154|||||No|No||APOTEX CORP|No||||
cefepime HCl|No|No|No|No|75%|60505614604|CEFEPIME HCL 1 GM VIAL|1|EA|3.0616|10/03/2017||Yes|No||10/03/2017||Yes|No|10/03/2017||Yes|No||||No|No|||Prescription required|No|||No|6.9776|10/03/2017|6.87792|10/03/2017|6.5504|10/03/2017||||15155|||||No|No||APOTEX CORP|No||||
cefepime HCl|No|No|No|No|75%|60505614700|CEFEPIME HCL 2 GRAM VIAL|1|EA|6.0759|10/04/2017||Yes|No||10/04/2017||Yes|No|10/04/2017||Yes|No||||No|No|||Prescription required|No|||No|13.8474|10/04/2017|13.64958|10/04/2017|12.9996|10/04/2017||||15156|||||No|No||APOTEX CORP|No||||
cefepime HCl|No|No|No|No|75%|60505614704|CEFEPIME HCL 2 GRAM VIAL|1|EA|6.0759|10/04/2017||Yes|No||10/04/2017||Yes|No|10/04/2017||Yes|No||||No|No|||Prescription required|No|||No|13.8474|10/04/2017|13.64958|10/04/2017|12.9996|10/04/2017||||15157|||||No|No||APOTEX CORP|No||||
ceftriaxone sodium|No|No|No|No|75%|60505614800|CEFTRIAXONE 1 GM VIAL|1|EA|1.505|11/22/2021||Yes|No||11/22/2021||Yes|No|11/22/2021||Yes|No||||No|No|||Prescription required|No|||No|3.43|11/30/2021|3.381|11/22/2021|3.22|11/22/2021||||15158|||||No|No||APOTEX CORP|No||||
ceftriaxone sodium|No|No|No|No|75%|60505614804|CEFTRIAXONE 1 GM VIAL|1|EA|1.12875|11/10/2017||Yes|No||11/10/2017||Yes|No|11/10/2017||Yes|No||||No|No|||Prescription required|No|||No|1.6715|03/29/2022|1.63138|03/29/2022|1.64224|03/29/2022||||15159|||||No|No||APOTEX CORP|No||||
ceftriaxone sodium|No|No|No|No|75%|60505614904|CEFTRIAXONE 2 GM VIAL|1|EA|1.935|11/10/2017||Yes|No||11/10/2017||Yes|No|11/10/2017||Yes|No||||No|No|||Prescription required|No|||No|4.41|03/23/2021|4.347|03/23/2021|4.14|03/23/2021||||15160|||||No|No||APOTEX CORP|No||||
ceftriaxone sodium|No|No|No|No|75%|60505615005|CEFTRIAXONE 10 GM VIAL|1|EA|13.0204|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No|||No|29.6744|06/02/2021|29.25048|06/02/2021|27.8576|06/02/2021||||15161|||||No|No||APOTEX CORP|No||||
ceftriaxone sodium|Yes|No|No|No|75%|60505615101|CEFTRIAXONE 250 MG VIAL|1|EA|.60028|11/10/2017||Yes|No||11/10/2017||Yes|No|11/10/2017||Yes|No||||No|No|11/10/2017||Prescription required|No|||No|1.36808|03/23/2021|1.34853|03/23/2021|1.28432|03/23/2021||||15162|||||No|No||APOTEX CORP|No||||
ceftriaxone sodium|Yes|No|No|No|75%|60505615104|CEFTRIAXONE 250 MG VIAL|1|EA|.7267|11/10/2017||Yes|No||11/10/2017||Yes|No|11/10/2017||Yes|No||||No|No|11/10/2017||Prescription required|No|||No|1.6562|11/23/2021|1.63254|11/23/2021|1.5548|11/23/2021||||15163|||||No|No||APOTEX CORP|No||||
ceftriaxone sodium|Yes|No|No|No|75%|60505615201|CEFTRIAXONE 500 MG VIAL|1|EA|.9675|11/10/2017||Yes|No||11/10/2017||Yes|No|11/10/2017||Yes|No||||No|No|03/10/2021||Prescription required|No|||No|1.2765|03/29/2022|1.24586|03/29/2022|1.25416|03/29/2022||||15164|||||No|No||APOTEX CORP|No||||
ceftriaxone sodium|Yes|No|No|No|75%|60505615204|CEFTRIAXONE 500 MG VIAL|1|EA|1.1782|11/10/2017||Yes|No||11/10/2017||Yes|No|11/10/2017||Yes|No||||No|No|03/10/2021||Prescription required|No|||No|2.6852|03/23/2021|2.64684|03/23/2021|2.5208|03/23/2021||||15165|||||No|No||APOTEX CORP|No||||
piperacillin sodium/tazobactam|No|No|No|No|75%|60505615604|PIPERACIL-TAZOBACT 2.25 GM VL|1|EA|2.10356|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|No|||No|4.79416|03/23/2021|4.72567|03/23/2021|4.50064|03/23/2021||||15166|||||No|No||APOTEX CORP|No||||
piperacillin sodium/tazobactam|No|No|No|No|75%|60505615704|PIPERACIL-TAZOBACT 3.375 GM VL|1|EA|3.15405|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|No|||No|7.1883|03/23/2021|7.08561|03/23/2021|6.7482|03/23/2021||||15167|||||No|No||APOTEX CORP|No||||
piperacillin sodium/tazobactam|No|No|No|No|75%|60505615904|PIPERACIL-TAZOBACT 4.5 GM VIAL|1|EA|3.95342|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|No|||No|9.01012|03/23/2021|8.8814|03/23/2021|8.45848|03/23/2021||||15168|||||No|No||APOTEX CORP|No||||
memantine HCl|No|No|No|No|75%|60505616205|MEMANTINE HCL 2 MG/ML SOLUTION|360|ML|.62666|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|Yes|03/29/2018|011|No|1.42821|08/30/2018|1.4078|08/30/2018|1.34077|08/30/2018|||ALZHEIMER'S AGENTS|15169|||||No|No||APOTEX CORP|No||||
glycopyrrolate|No|No|No|No|75%|60505617900|GLYCOPYRROLATE 0.2 MG/ML VIAL|1|ML|3.4314|10/05/2020||Yes|No||10/05/2020||Yes|No|10/05/2020||Yes|No||||No|No|||Prescription required|No|||No|7.8204|10/05/2020|7.70868|10/05/2020|7.3416|10/05/2020||||15170|||||No|No||APOTEX CORP|No||||
glycopyrrolate|No|No|No|No|75%|60505617905|GLYCOPYRROLATE 0.2 MG/ML VIAL|1|ML|3.4314|10/05/2020||Yes|No||10/05/2020||Yes|No|10/05/2020||Yes|No||||No|No|||Prescription required|No|||No|7.8204|10/05/2020|7.70868|10/05/2020|7.3416|10/05/2020||||15171|||||No|No||APOTEX CORP|No||||
glycopyrrolate|No|No|No|No|75%|60505618000|GLYCOPYRROLATE 0.4 MG/2 ML VL|2|ML|3.0057|10/05/2020||Yes|No||10/05/2020||Yes|No|10/05/2020||Yes|No||||No|No|||Prescription required|No|||No|6.8502|10/05/2020|6.75234|10/05/2020|6.4308|10/05/2020||||15172|||||No|No||APOTEX CORP|No||||
glycopyrrolate|No|No|No|No|75%|60505618005|GLYCOPYRROLATE 0.4 MG/2 ML VL|2|ML|3.0057|10/05/2020||Yes|No||10/05/2020||Yes|No|10/05/2020||Yes|No||||No|No|||Prescription required|No|||No|6.8502|10/05/2020|6.75234|10/05/2020|6.4308|10/05/2020||||15173|||||No|No||APOTEX CORP|No||||
glycopyrrolate|No|No|No|No|75%|60505618100|GLYCOPYRROLATE 1 MG/5 ML VIAL|5|ML|2.57828|10/05/2020||Yes|No||10/05/2020||Yes|No|10/05/2020||Yes|No||||No|No|||Prescription required|No|||No|5.87608|10/05/2020|5.79213|10/05/2020|5.51632|10/05/2020||||15174|||||No|No||APOTEX CORP|No||||
glycopyrrolate|No|No|No|No|75%|60505618105|GLYCOPYRROLATE 1 MG/5 ML VIAL|5|ML|2.57828|10/05/2020||Yes|No||10/05/2020||Yes|No|10/05/2020||Yes|No||||No|No|||Prescription required|No|||No|5.87608|10/05/2020|5.79213|10/05/2020|5.51632|10/05/2020||||15175|||||No|No||APOTEX CORP|No||||
glycopyrrolate|No|No|No|No|75%|60505618200|GLYCOPYRROLATE 4 MG/20 ML VIAL|20|ML|2.68642|10/05/2020||Yes|No||10/05/2020||Yes|No|10/05/2020||Yes|No||||No|No|||Prescription required|No|||No|6.12255|10/13/2020|6.03508|10/05/2020|5.7477|10/05/2020||||15176|||||No|No||APOTEX CORP|No||||
glycopyrrolate|No|No|No|No|75%|60505618204|GLYCOPYRROLATE 4 MG/20 ML VIAL|20|ML|2.68642|10/05/2020||Yes|No||10/05/2020||Yes|No|10/05/2020||Yes|No||||No|No|||Prescription required|No|||No|6.12255|10/13/2020|6.03508|10/05/2020|5.7477|10/05/2020||||15177|||||No|No||APOTEX CORP|No||||
potassium chloride|No|No|No|No|75%|60505618406|POTASSIUM CL 10% (20 MEQ/15ML)|473|ML|.16818|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||11/30/2018||Yes|No|||Prescription required|No|||No|.13625|03/29/2022|.13298|03/29/2022|.13386|03/29/2022||||15178|||||No|No||APOTEX CORP|No||||
potassium chloride|No|No|No|No|75%|60505618506|POTASSIUM CL 20% (40 MEQ/15ML)|473|ML|.33636|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||02/22/2019||Yes|No|||Prescription required|No|||No|.44086|03/01/2022|.43027|03/01/2022|.43314|03/01/2022||||15179|||||No|No||APOTEX CORP|No||||
ertapenem sodium|No|No|No|No|75%|60505619604|ERTAPENEM 1 GRAM VIAL|1|EA|34.4|09/18/2019||Yes|No||09/18/2019||Yes|No|09/18/2019||Yes|No||||No|No|||Prescription required|No|||No|78.4|08/10/2021|77.28|08/10/2021|73.6|08/10/2021||||15180|||||No|No||APOTEX CORP|No||||
sirolimus|No|No|No|No|75%|60505619702|SIROLIMUS 1 MG/ML SOLUTION|60|ML|7.54377|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||09/23/2020||Yes|No|||Prescription required|Yes|01/30/2020|229|No|8.60227|03/01/2022|8.39581|03/01/2022|8.45173|03/01/2022|||IMMUNOSUPPRESSIVES: ORAL|15181|||||No|No||APOTEX CORP|No||||
memantine HCl|No|No|No|No|75%|60505620803|MEMANTINE HCL ER 7 MG CAPSULE|30|EA|1.6426|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|011|No|.73424|03/29/2022|.71661|03/29/2022|.72139|03/29/2022|||ALZHEIMER'S AGENTS|15182|||||No|No||APOTEX CORP|No||||
memantine HCl|No|No|No|No|75%|60505620903|MEMANTINE HCL ER 14 MG CAPSULE|30|EA|1.6426|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|011|No|.96952|03/29/2022|.94625|03/29/2022|.95255|03/29/2022|||ALZHEIMER'S AGENTS|15183|||||No|No||APOTEX CORP|No||||
memantine HCl|No|No|No|No|75%|60505620909|MEMANTINE HCL ER 14 MG CAPSULE|90|EA|1.6426|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|011|No|.96952|03/29/2022|.94625|03/29/2022|.95255|03/29/2022|||ALZHEIMER'S AGENTS|15184|||||No|No||APOTEX CORP|No||||
memantine HCl|No|No|No|No|75%|60505621003|MEMANTINE HCL ER 21 MG CAPSULE|30|EA|1.6426|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|011|No|.91098|03/29/2022|.88911|03/29/2022|.89503|03/29/2022|||ALZHEIMER'S AGENTS|15185|||||No|No||APOTEX CORP|No||||
memantine HCl|No|No|No|No|75%|60505621103|MEMANTINE HCL ER 28 MG CAPSULE|30|EA|1.6426|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|011|No|1.08689|03/29/2022|1.0608|03/29/2022|1.06786|03/29/2022|||ALZHEIMER'S AGENTS|15186|||||No|No||APOTEX CORP|No||||
memantine HCl|No|No|No|No|75%|60505621109|MEMANTINE HCL ER 28 MG CAPSULE|90|EA|1.6426|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|011|No|1.08689|03/29/2022|1.0608|03/29/2022|1.06786|03/29/2022|||ALZHEIMER'S AGENTS|15187|||||No|No||APOTEX CORP|No||||
icatibant acetate|No|No|No|No|75%|60505621401|ICATIBANT 30 MG/3 ML SYRINGE|3|ML|400.7299|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No||501|No|913.2914|08/25/2021|900.24438|08/25/2021|857.3756|08/25/2021|||HAE TREATMENTS|15188|||||No|No||APOTEX CORP|No||||
atropine sulfate|No|No|No|No|75%|60505622600|ATROPINE 1% EYE DROPS|2|ML|7.81955|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||No|18.28667|03/29/2022|17.84778|03/29/2022|17.96665|03/29/2022||||15189|||||No|No||APOTEX CORP|No||||
atropine sulfate|No|No|No|No|75%|60505622601|ATROPINE 1% EYE DROPS|5|ML|3.81582|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||No|9.54286|03/29/2022|9.31383|03/29/2022|9.37585|03/29/2022||||15190|||||No|No||APOTEX CORP|No||||
deferoxamine mesylate|No|No|No|No|75%|60505623600|DEFEROXAMINE 500 MG VIAL|1|EA|5.5685|03/17/2022||Yes|No||03/17/2022||Yes|No|03/17/2022||Yes|No||||No|No|||Prescription required|No|||No|12.691|03/22/2022|12.5097|03/22/2022|11.914|03/17/2022||||15191|||||No|No||APOTEX CORP|No||||
deferoxamine mesylate|No|No|No|No|75%|60505623606|DEFEROXAMINE 500 MG VIAL|1|EA|5.5685|03/17/2022||Yes|No||03/17/2022||Yes|No|03/17/2022||Yes|No||||No|No|||Prescription required|No|||No|12.691|03/22/2022|12.5097|03/22/2022|11.914|03/17/2022||||15192|||||No|No||APOTEX CORP|No||||
deferoxamine mesylate|No|No|No|No|75%|60505623700|DEFEROXAMINE 2 GRAM VIAL|1|EA|17.716|03/17/2022||Yes|No||03/17/2022||Yes|No|03/17/2022||Yes|No||||No|No|||Prescription required|No|||No|40.376|03/17/2022|39.7992|03/17/2022|37.904|03/17/2022||||15193|||||No|No||APOTEX CORP|No||||
deferoxamine mesylate|No|No|No|No|75%|60505623706|DEFEROXAMINE 2 GRAM VIAL|1|EA|17.716|03/17/2022||Yes|No||03/17/2022||Yes|No|03/17/2022||Yes|No||||No|No|||Prescription required|No|||No|40.376|03/17/2022|39.7992|03/17/2022|37.904|03/17/2022||||15194|||||No|No||APOTEX CORP|No||||
fentanyl|No|No|No|No|90%|60505700600|FENTANYL 25 MCG/HR PATCH|1|EA|1.9651|08/07/2013|12/06/2022|Yes|No||08/07/2013|12/06/2022|Yes|No|08/07/2013|12/06/2022|Yes|No||||No|No|||Prescription required|No||110|Yes|3.10308|03/29/2022|3.0286|03/29/2022|3.04877|03/29/2022|||ANALGESICS: NARCOTICS LONG|15195|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||APOTEX CORP|No||||
fentanyl|No|No|No|No|90%|60505700602|FENTANYL 25 MCG/HR PATCH|5|EA|1.96424|08/07/2013|12/06/2022|Yes|No||08/07/2013|12/06/2022|Yes|No|08/07/2013|12/06/2022|Yes|No||||No|No|||Prescription required|No||110|Yes|3.10308|03/29/2022|3.0286|03/29/2022|3.04877|03/29/2022|||ANALGESICS: NARCOTICS LONG|15196|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||APOTEX CORP|No||||
fentanyl|No|No|No|No|90%|60505700700|FENTANYL 50 MCG/HR PATCH|1|EA|4.214|08/07/2013|12/06/2022|Yes|No||08/07/2013|12/06/2022|Yes|No|08/07/2013|12/06/2022|Yes|No||||No|No|||Prescription required|No||110|Yes|5.19805|03/29/2022|5.07329|03/29/2022|5.10708|03/29/2022|||ANALGESICS: NARCOTICS LONG|15197|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||APOTEX CORP|No||||
fentanyl|No|No|No|No|90%|60505700702|FENTANYL 50 MCG/HR PATCH|5|EA|4.214|08/07/2013|12/06/2022|Yes|No||08/07/2013|12/06/2022|Yes|No|08/07/2013|12/06/2022|Yes|No||||No|No|||Prescription required|No||110|Yes|5.19805|03/29/2022|5.07329|03/29/2022|5.10708|03/29/2022|||ANALGESICS: NARCOTICS LONG|15198|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||APOTEX CORP|No||||
fentanyl|No|No|No|No|90%|60505700800|FENTANYL 75 MCG/HR PATCH|1|EA|5.3191|08/07/2013||Yes|No||08/07/2013||Yes|No|08/07/2013||Yes|No||||No|No|||Prescription required|No||110|Yes|7.86615|03/29/2022|7.67736|03/29/2022|7.72849|03/29/2022|||ANALGESICS: NARCOTICS LONG|15199|||||No|No||APOTEX CORP|No||||
fentanyl|No|No|No|No|90%|60505700802|FENTANYL 75 MCG/HR PATCH|5|EA|5.31996|08/07/2013||Yes|No||08/07/2013||Yes|No|08/07/2013||Yes|No||||No|No|||Prescription required|No||110|Yes|7.86615|03/29/2022|7.67736|03/29/2022|7.72849|03/29/2022|||ANALGESICS: NARCOTICS LONG|15200|||||No|No||APOTEX CORP|No||||
fentanyl|No|No|No|No|90%|60505700900|FENTANYL 100 MCG/HR PATCH|1|EA|8.342|08/07/2013||Yes|No||08/07/2013||Yes|No|08/07/2013||Yes|No||||No|No|||Prescription required|No||110|Yes|9.14035|03/29/2022|8.92098|03/29/2022|8.98039|03/29/2022|||ANALGESICS: NARCOTICS LONG|15201|||||No|No||APOTEX CORP|No||||
fentanyl|No|No|No|No|90%|60505700902|FENTANYL 100 MCG/HR PATCH|5|EA|8.342|08/07/2013||Yes|No||08/07/2013||Yes|No|08/07/2013||Yes|No||||No|No|||Prescription required|No||110|Yes|9.14035|03/29/2022|8.92098|03/29/2022|8.98039|03/29/2022|||ANALGESICS: NARCOTICS LONG|15202|||||No|No||APOTEX CORP|No||||
fentanyl|No|No|No|No|90%|60505701002|FENTANYL 12 MCG/HR PATCH|5|EA|6.98406|02/01/2016||Yes|No||02/01/2016||Yes|No|02/01/2016||Yes|No||||No|No|||Prescription required|No||110|Yes|8.30578|03/29/2022|8.10644|03/29/2022|8.16042|03/29/2022|||ANALGESICS: NARCOTICS LONG|15203|||||No|No||APOTEX CORP|No||||
buprenorphine|No|No|No|No|90%|60505707505|BUPRENORPHINE 5 MCG/HR PATCH|4|EA|22.77065|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|110|Yes|35.41903|03/29/2022|34.56897|03/29/2022|34.79919|03/29/2022|||ANALGESICS: NARCOTICS LONG|15204|||||No|No||APOTEX CORP|No||||
buprenorphine|No|No|No|No|90%|60505707605|BUPRENORPHINE 7.5 MCG/HR PATCH|4|EA|32.32095|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|110|Yes|65.15568|03/29/2022|63.59194|03/29/2022|64.01545|03/29/2022|||ANALGESICS: NARCOTICS LONG|15205|||||No|No||APOTEX CORP|No||||
buprenorphine|No|No|No|No|90%|60505707705|BUPRENORPHINE 10 MCG/HR PATCH|4|EA|34.15597|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|110|Yes|66.68301|03/29/2022|65.08261|03/29/2022|65.51605|03/29/2022|||ANALGESICS: NARCOTICS LONG|15206|||||No|No||APOTEX CORP|No||||
buprenorphine|No|No|No|No|90%|60505707805|BUPRENORPHINE 15 MCG/HR PATCH|4|EA|49.2694|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|110|Yes|99.0625|03/29/2022|96.685|03/29/2022|97.3289|03/29/2022|||ANALGESICS: NARCOTICS LONG|15207|||||No|No||APOTEX CORP|No||||
buprenorphine|No|No|No|No|90%|60505707905|BUPRENORPHINE 20 MCG/HR PATCH|4|EA|60.46875|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|110|Yes|115.06922|03/29/2022|112.30755|03/29/2022|113.0555|03/29/2022|||ANALGESICS: NARCOTICS LONG|15208|||||No|No||APOTEX CORP|No||||
fentanyl|No|No|No|No|90%|60505708002|FENTANYL 12 MCG/HR PATCH|5|EA|6.98406|05/21/2021||Yes|No||05/21/2021||Yes|No|05/21/2021||Yes|No||||No|No|||Prescription required|No||110|Yes|8.30578|03/29/2022|8.10644|03/29/2022|8.16042|03/29/2022|||ANALGESICS: NARCOTICS LONG|15209|||||No|No||APOTEX CORP|No||||
fentanyl|No|No|No|No|90%|60505708102|FENTANYL 25 MCG/HR PATCH|5|EA|1.96424|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|No||110|Yes|3.10308|03/29/2022|3.0286|03/29/2022|3.04877|03/29/2022|||ANALGESICS: NARCOTICS LONG|15210|||||No|No||APOTEX CORP|No||||
fentanyl|No|No|No|No|90%|60505708202|FENTANYL 50 MCG/HR PATCH|5|EA|4.214|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|No||110|Yes|5.19805|03/29/2022|5.07329|03/29/2022|5.10708|03/29/2022|||ANALGESICS: NARCOTICS LONG|15211|||||No|No||APOTEX CORP|No||||
fentanyl|No|No|No|No|90%|60505708302|FENTANYL 75 MCG/HR PATCH|5|EA|5.31996|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|No||110|Yes|7.86615|03/29/2022|7.67736|03/29/2022|7.72849|03/29/2022|||ANALGESICS: NARCOTICS LONG|15212|||||No|No||APOTEX CORP|No||||
fentanyl|No|No|No|No|90%|60505708402|FENTANYL 100 MCG/HR PATCH|5|EA|8.342|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|No||110|Yes|9.14035|03/29/2022|8.92098|03/29/2022|8.98039|03/29/2022|||ANALGESICS: NARCOTICS LONG|15213|||||No|No||APOTEX CORP|No||||
fentanyl|No|No|No|No|90%|60505708502|FENTANYL 37.5 MCG/HR PATCH|5|EA|22.46836|05/21/2021||Yes|No||05/21/2021||Yes|No|05/21/2021||Yes|No||||No|No|||Prescription required|Yes|03/22/2018|110|Yes|42.59071|03/29/2022|41.56853|03/29/2022|41.84537|03/29/2022|||ANALGESICS: NARCOTICS LONG|15214|||||No|No||APOTEX CORP|No||||
fentanyl|No|No|No|No|90%|60505708602|FENTANYL 62.5 MCG/HR PATCH|5|EA|32.64732|05/21/2021||Yes|No||05/21/2021||Yes|No|05/21/2021||Yes|No||||No|No|||Prescription required|Yes|03/22/2018|110|Yes|74.40552|05/21/2021|73.34258|05/21/2021|69.85008|05/21/2021|||ANALGESICS: NARCOTICS LONG|15215|||||No|No||APOTEX CORP|No||||
fentanyl|No|No|No|No|90%|60505708702|FENTANYL 87.5 MCG/HR PATCH|5|EA|44.44996|05/21/2021||Yes|No||05/21/2021||Yes|No|05/21/2021||Yes|No||||No|No|||Prescription required|Yes|03/22/2018|110|Yes|101.30456|05/21/2021|99.85735|05/21/2021|95.10224|05/21/2021|||ANALGESICS: NARCOTICS LONG|15216|||||No|No||APOTEX CORP|No||||
palivizumab|No|No|No|No|75%|60574411301|SYNAGIS 100 MG/ML VIAL|1|ML|1322.0995|09/21/2020||Yes|No|Submit NOFR002 and Form 1321|09/21/2020||Yes|No|09/21/2020||Yes|No|Submit NOFR002 and Form 1325|||No|No|||Prescription required|No|||Yes|3013.157|04/06/2021|2970.1119|04/06/2021|2828.678|04/06/2021||||15217|||||No|No||MEDIMMUNE/SOBI-|No||||
palivizumab|No|No|No|No|75%|60574411401|SYNAGIS 50 MG/0.5 ML VIAL|.5|ML|1400.3208|09/21/2020||Yes|No|Submit NOFR002 and Form 1321|09/21/2020||Yes|No|09/21/2020||Yes|No|Submit NOFR002 and Form 1325|||No|No|||Prescription required|No|||Yes|3191.4288|04/06/2021|3145.83696|04/06/2021|2996.0352|04/06/2021||||15218|||||No|No||MEDIMMUNE/SOBI-|No||||
azilsartan medoxomil|No|No|No|No|75%|60631004030|EDARBI 40 MG TABLET|30|EA|2.98764|02/18/2015||Yes|No||02/18/2015||Yes|No|02/18/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|113|Yes|6.65573|01/04/2022|6.49599|01/04/2022|6.53925|01/04/2022|||ANGIOTENSIN MODULATORS|15219|||||No|No||ARBOR PHARMACEU|No||||
azilsartan medoxomil|No|No|No|No|75%|60631008030|EDARBI 80 MG TABLET|30|EA|3.24736|02/18/2015||Yes|No||02/18/2015||Yes|No|02/18/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|113|Yes|7.23767|01/04/2022|7.06396|01/04/2022|7.11101|01/04/2022|||ANGIOTENSIN MODULATORS|15220|||||No|No||ARBOR PHARMACEU|No||||
azilsartan med/chlorthalidone|No|No|No|No|75%|60631041230|EDARBYCLOR 40-12.5 MG TABLET|30|EA|3.06518|02/18/2015||Yes|No||02/18/2015||Yes|No|02/18/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|113|Yes|6.83627|01/04/2022|6.67219|01/04/2022|6.71663|01/04/2022|||ANGIOTENSIN MODULATORS|15221|||||No|No||ARBOR PHARMACEU|No||||
buprenorphine HCl|No|No|No|No|90%|60687048111|BUPRENORPHINE 2 MG TABLET SL|1|EA||10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|.37925|03/29/2022|.37014|03/29/2022|.37261|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|15222|||||No|No||AHP|Yes|09/01/2020|||
buprenorphine HCl|No|No|No|No|90%|60687048121|BUPRENORPHINE 2 MG TABLET SL|30|EA|.87791|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|.37925|03/29/2022|.37014|03/29/2022|.37261|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|15223|||||No|No||AHP|Yes|09/01/2020|||
buprenorphine HCl|No|No|No|No|90%|60687049211|BUPRENORPHINE 8 MG TABLET SL|1|EA||10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|.77298|03/29/2022|.75442|03/29/2022|.75945|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|15224|||||No|No||AHP|Yes|09/01/2020|||
buprenorphine HCl|No|No|No|No|90%|60687049221|BUPRENORPHINE 8 MG TABLET SL|30|EA|1.505|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|.77298|03/29/2022|.75442|03/29/2022|.75945|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|15225|||||No|No||AHP|Yes|09/01/2020|||
sulfacetamide sodium|No|No|No|No|75%|60758001805|SULFACETAMIDE 10% EYE DROPS|5|ML|2.6875|06/17/2015||Yes|No||06/17/2015||Yes|No|06/17/2015||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|058|No|3.3284|01/25/2022|3.24851|01/25/2022|3.27015|01/25/2022|||OPHTHALMIC ANTIBIOTICS|15226|||||No|No||PACIFIC/GREENST|No||||
prednisolone acetate|No|No|No|No|75%|60758011905|PREDNISOLONE AC 1% EYE DROP|5|ML|3.784|03/30/2016||Yes|No||03/30/2016||Yes|No|03/30/2016||Yes|No||||No|No|||Prescription required|No||013|No|5.90936|03/29/2022|5.76753|03/29/2022|5.80594|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|15227|||||No|No||PACIFIC/GREENST|No||||
prednisolone acetate|No|No|No|No|75%|60758011910|PREDNISOLONE AC 1% EYE DROP|10|ML|3.784|03/30/2016||Yes|No||03/30/2016||Yes|No|03/30/2016||Yes|No||||No|No|||Prescription required|No||013|No|6.10361|03/29/2022|5.95712|03/29/2022|5.99679|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|15228|||||No|No||PACIFIC/GREENST|No||||
prednisolone acetate|No|No|No|No|75%|60758011915|PREDNISOLONE AC 1% EYE DROP|15|ML|3.784|11/12/2004||Yes|No||11/12/2004||Yes|No|11/12/2004||Yes|No||||No|No|||Prescription required|No||013|No|6.06102|03/29/2022|5.91555|03/29/2022|5.95495|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|15229|||||No|No||PACIFIC/GREENST|No||||
gentamicin sulfate|No|No|No|No|75%|60758018805|GENTAMICIN 0.3% EYE DROP|5|ML|.37496|06/16/2016||Yes|No||06/16/2016||Yes|No|06/16/2016||Yes|No||||No|No|||Prescription required|No||058|No|.63882|03/29/2022|.62348|03/29/2022|.62764|03/29/2022|||OPHTHALMIC ANTIBIOTICS|15230|||||No|No||PACIFIC/GREENST|No||||
tazarotene|No|No|No|No|75%|60758056130|TAZAROTENE 0.1% CREAM|30|GM|3.10775|01/03/2018||Yes|No||01/03/2018||Yes|No|01/03/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|104|No|2.38122|03/29/2022|2.32407|03/29/2022|2.33954|03/29/2022|||ACNE AGENTS: TOPICAL|15231|||||No|No||PACIFIC/GREENST|No||||
tazarotene|No|No|No|No|75%|60758056160|TAZAROTENE 0.1% CREAM|60|GM|3.10724|01/03/2018||Yes|No||01/03/2018||Yes|No|01/03/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|104|No|3.41533|03/01/2022|3.33336|03/01/2022|3.35556|03/01/2022|||ACNE AGENTS: TOPICAL|15232|||||No|No||PACIFIC/GREENST|No||||
gatifloxacin|No|No|No|No|75%|60758061525|GATIFLOXACIN 0.5% EYE DROPS|2.5|ML|16.25916|06/17/2015||Yes|No||06/17/2015||Yes|No|06/17/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|058|No|12.97096|03/29/2022|12.65965|03/29/2022|12.74396|03/29/2022|||OPHTHALMIC ANTIBIOTICS|15233|||||No|No||GREENSTONE/PRAS|No||||
dapsone|No|No|No|No|75%|60758067060|DAPSONE 5% GEL|60|GM|2.33117|06/29/2018||Yes|No||06/29/2018||Yes|No|06/29/2018||Yes|No||||No|No|||Prescription required|Yes|11/03/2017|104|No|3.1867|03/29/2022|3.11021|03/29/2022|3.13093|03/29/2022|||ACNE AGENTS: TOPICAL|15234|||||No|No||PACIFIC/GREENST|No||||
dapsone|No|No|No|No|75%|60758067090|DAPSONE 5% GEL|90|GM|2.03848|06/29/2018||Yes|No||06/29/2018||Yes|No|06/29/2018||Yes|No||||No|No|||Prescription required|Yes|11/03/2017|104|No|2.65305|03/29/2022|2.58937|03/29/2022|2.60662|03/29/2022|||ACNE AGENTS: TOPICAL|15235|||||No|No||PACIFIC/GREENST|No||||
ketorolac tromethamine|No|No|No|No|75%|60758077305|KETOROLAC 0.4% OPHTH SOLUTION|5|ML|4.79364|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|013|No|9.86388|03/29/2022|9.62714|03/29/2022|9.69126|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|15236|||||No|No||PACIFIC/GREENST|No||||
timolol maleate|No|No|No|No|75%|60758080105|TIMOLOL MALEATE 0.5% EYE DROPS|5|ML|.47042|06/16/2016||Yes|No||06/16/2016||Yes|No|06/16/2016||Yes|No||||No|No|||Prescription required|No||088|No|1.19485|03/29/2022|1.16617|03/29/2022|1.17394|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15237|||||No|No||PACIFIC/GREENST|No||||
timolol maleate|No|No|No|No|75%|60758080110|TIMOLOL MALEATE 0.5% EYE DROPS|10|ML|.34443|06/16/2016||Yes|No||06/16/2016||Yes|No|06/16/2016||Yes|No||||No|No|||Prescription required|No||088|No|.95525|03/29/2022|.93232|03/29/2022|.93853|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15238|||||No|No||PACIFIC/GREENST|No||||
timolol maleate|No|No|No|No|75%|60758080205|TIMOLOL MALEATE 0.25% EYE DROP|5|ML|.25628|06/16/2016||Yes|No||06/16/2016||Yes|No|06/16/2016||Yes|No||||No|No|||Prescription required|No||088|No|.68312|03/29/2022|.66672|03/29/2022|.67116|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15239|||||No|No||PACIFIC/GREENST|No||||
timolol maleate|No|No|No|No|75%|60758080210|TIMOLOL MALEATE 0.25% EYE DROP|10|ML|.2666|06/16/2016||Yes|No||06/16/2016||Yes|No|06/16/2016||Yes|No||||No|No|||Prescription required|No||088|No|.70113|03/29/2022|.6843|03/29/2022|.68886|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15240|||||No|No||PACIFIC/GREENST|No||||
fluorometholone|No|No|No|No|75%|60758088005|FLUOROMETHOLONE 0.1% DROPS|5|ML|6.1103|06/16/2016||Yes|No||06/16/2016||Yes|No|06/16/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|013|No|13.59162|03/29/2022|13.26542|03/29/2022|13.35376|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|15241|||||No|No||PACIFIC/GREENST|No||||
fluorometholone|No|No|No|No|75%|60758088010|FLUOROMETHOLONE 0.1% DROPS|10|ML|6.10944|06/16/2016||Yes|No||06/16/2016||Yes|No|06/16/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|013|No|13.31975|03/29/2022|13.00007|03/29/2022|13.08665|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|15242|||||No|No||PACIFIC/GREENST|No||||
polymyxin B sulf/trimethoprim|No|No|No|No|75%|60758090810|POLYMYXIN B-TMP EYE DROPS|10|ML|.46827|06/08/2016||Yes|No||06/08/2016||Yes|No|06/08/2016||Yes|No||||No|No|||Prescription required|No||058|No|.46086|03/29/2022|.44979|03/29/2022|.45279|03/29/2022|||OPHTHALMIC ANTIBIOTICS|15243|||||No|No||PACIFIC/GREENST|No||||
liothyronine sodium|No|No|No|No|75%|60793011501|CYTOMEL 5 MCG TABLET|100|EA|.86176|08/22/2005||Yes|No||08/22/2005||Yes|No|||No|No||||No|No|||Prescription required|No|||No|1.92908|01/11/2022|1.88278|01/11/2022|1.89532|01/11/2022||||15244|||||No|No||PFIZER US PHARM|No||||
liothyronine sodium|No|No|No|No|75%|60793011601|CYTOMEL 25 MCG TABLET|100|EA|1.13188|11/14/2005||Yes|No||11/14/2005||Yes|No|||No|No||||No|No|||Prescription required|No|||No|2.57965|01/04/2022|2.5428|01/04/2022|2.42171|01/04/2022||||15245|||||No|No||PFIZER US PHARM|No||||
liothyronine sodium|No|No|No|No|75%|60793011701|CYTOMEL 50 MCG TABLET|100|EA|1.72928|03/15/2006||Yes|No||03/15/2006||Yes|No|03/15/2006||Yes|No||||No|No|||Prescription required|No|||No|3.94116|01/04/2022|3.88486|01/04/2022|3.69987|01/04/2022||||15246|||||No|No||PFIZER US PHARM|No||||
penicillin G procaine|No|No|No|No|75%|60793013010|PENICILLIN G 600,000 UNIT/1 ML|1|ML|16.32968|10/02/2007||Yes|No||10/02/2007||Yes|No|10/02/2007||Yes|No||||No|No|||Prescription required|No|||No|37.21648|01/04/2022|36.68481|01/04/2022|34.93792|01/04/2022||||15247|||||No|No||PFIZER US PHARM|No||||
penicillin G procaine|No|No|No|No|75%|60793013110|PEN G 1.2 MILLION UNIT/2 ML|2|ML|13.72581|10/02/2007||Yes|No||10/02/2007||Yes|No|10/02/2007||Yes|No||||No|No|||Prescription required|No|||No|31.28209|01/04/2022|30.8352|01/04/2022|29.36686|01/04/2022||||15248|||||No|No||PFIZER US PHARM|No||||
metaxalone|No|No|No|No|75%|60793013601|SKELAXIN 800 MG TABLET|100|EA|4.56922|02/17/2004||Yes|No||02/17/2004||Yes|No|02/17/2004||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|116|Yes|10.41357|01/04/2022|10.26481|01/04/2022|9.77601|01/04/2022|||SKELETAL MUSCLE RELAXANTS|15249|||||No|No||PFIZER US PHARM|No||||
pen G benz/pen G procaine|No|No|No|No|75%|60793060010|BICILLIN C-R 1.2 MILLION UNIT|2|ML|32.45575|01/15/2008||Yes|No||01/15/2008||Yes|No|01/15/2008||Yes|No||||No|No|||Prescription required|No|||No|73.96893|01/04/2022|72.91223|01/04/2022|69.44022|01/04/2022||||15250|||||No|No||PFIZER US PHARM|No||||
penicillin G benzathine|No|No|No|No|75%|60793070010|BICILLIN L-A 600,000 UNIT/ML|1|ML|47.01663|12/13/2006||Yes|No||12/13/2006||Yes|No|12/13/2006||Yes|No||||No|No|||Prescription required|No|||No|107.15418|01/04/2022|105.6234|01/04/2022|100.59372|01/04/2022||||15251|||||No|No||PFIZER US PHARM|No||||
penicillin G benzathine|No|No|No|No|75%|60793070110|BICILLIN L-A 1,200,000 UNITS|2|ML|40.71541|12/13/2006||Yes|No||12/13/2006||Yes|No|12/13/2006||Yes|No||||No|No|||Prescription required|No|||No|92.79326|01/04/2022|91.46764|01/04/2022|87.11204|01/04/2022||||15252|||||No|No||PFIZER US PHARM|No||||
penicillin G benzathine|No|No|No|No|75%|60793070210|BICILLIN L-A 2,400,000 UNITS|4|ML|41.71623|12/13/2006||Yes|No||12/13/2006||Yes|No|12/13/2006||Yes|No||||No|No|||Prescription required|No|||No|95.07421|01/04/2022|93.716|01/04/2022|89.25334|01/04/2022||||15253|||||No|No||PFIZER US PHARM|No||||
levothyroxine sodium|No|No|No|No|75%|60793085001|LEVOXYL 25 MCG TABLET|100|EA|.31291|10/09/2007||Yes|No||10/09/2007||Yes|No|10/09/2007||Yes|No||||No|No|||Prescription required|No|||No|.6958|01/11/2022|.6791|01/11/2022|.68362|01/11/2022||||15254|||||No|No||PFIZER US PHARM|No||||
levothyroxine sodium|No|No|No|No|75%|60793085010|LEVOXYL 25 MCG TABLET|1000|EA|.31293|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||||No|No|||Prescription required|No|||No|.6958|01/11/2022|.6791|01/11/2022|.68362|01/11/2022||||15255|||||No|No||PFIZER US PHARM|No||||
levothyroxine sodium|No|No|No|No|75%|60793085101|LEVOXYL 50 MCG TABLET|100|EA|.35522|10/09/2007||Yes|No||10/09/2007||Yes|No|10/09/2007||Yes|No||||No|No|||Prescription required|No|||No|.7929|01/11/2022|.77387|01/11/2022|.77902|01/11/2022||||15256|||||No|No||PFIZER US PHARM|No||||
levothyroxine sodium|No|No|No|No|75%|60793085110|LEVOXYL 50 MCG TABLET|1000|EA|.35523|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||||No|No|||Prescription required|No|||No|.7929|01/11/2022|.77387|01/11/2022|.77902|01/11/2022||||15257|||||No|No||PFIZER US PHARM|No||||
levothyroxine sodium|No|No|No|No|75%|60793085201|LEVOXYL 75 MCG TABLET|100|EA|.39259|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||||No|No|||Prescription required|No|||No|.87651|01/11/2022|.85547|01/11/2022|.86117|01/11/2022||||15258|||||No|No||PFIZER US PHARM|No||||
levothyroxine sodium|No|No|No|No|75%|60793085210|LEVOXYL 75 MCG TABLET|1000|EA|.39256|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||||No|No|||Prescription required|No|||No|.87651|01/11/2022|.85547|01/11/2022|.86117|01/11/2022||||15259|||||No|No||PFIZER US PHARM|No||||
levothyroxine sodium|No|No|No|No|75%|60793085301|LEVOXYL 88 MCG TABLET|100|EA|.39929|09/24/2007||Yes|No||09/24/2007||Yes|No|09/24/2007||Yes|No||||No|No|||Prescription required|No|||No|.89146|01/11/2022|.87006|01/11/2022|.87585|01/11/2022||||15260|||||No|No||PFIZER US PHARM|No||||
levothyroxine sodium|No|No|No|No|75%|60793085310|LEVOXYL 88 MCG TABLET|1000|EA|.39933|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||||No|No|||Prescription required|No|||No|.89146|01/11/2022|.87006|01/11/2022|.87585|01/11/2022||||15261|||||No|No||PFIZER US PHARM|No||||
levothyroxine sodium|No|No|No|No|75%|60793085401|LEVOXYL 100 MCG TABLET|100|EA|.40243|10/02/2007||Yes|No||10/02/2007||Yes|No|10/02/2007||Yes|No||||No|No|||Prescription required|No|||No|.90003|01/11/2022|.87842|01/11/2022|.88427|01/11/2022||||15262|||||No|No||PFIZER US PHARM|No||||
levothyroxine sodium|No|No|No|No|75%|60793085410|LEVOXYL 100 MCG TABLET|1000|EA|.40239|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||||No|No|||Prescription required|No|||No|.90003|01/11/2022|.87842|01/11/2022|.88427|01/11/2022||||15263|||||No|No||PFIZER US PHARM|No||||
levothyroxine sodium|No|No|No|No|75%|60793085501|LEVOXYL 112 MCG TABLET|100|EA|.46534|09/24/2007||Yes|No||09/24/2007||Yes|No|09/24/2007||Yes|No||||No|No|||Prescription required|No|||No|1.04604|01/11/2022|1.02093|01/11/2022|1.02773|01/11/2022||||15264|||||No|No||PFIZER US PHARM|No||||
levothyroxine sodium|No|No|No|No|75%|60793085510|LEVOXYL 112 MCG TABLET|1000|EA|.46532|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||||No|No|||Prescription required|No|||No|1.04604|01/11/2022|1.02093|01/11/2022|1.02773|01/11/2022||||15265|||||No|No||PFIZER US PHARM|No||||
levothyroxine sodium|No|No|No|No|75%|60793085601|LEVOXYL 125 MCG TABLET|100|EA|.47171|10/09/2007||Yes|No||10/09/2007||Yes|No|10/09/2007||Yes|No||||No|No|||Prescription required|No|||No|1.05365|01/11/2022|1.02836|01/11/2022|1.03521|01/11/2022||||15266|||||No|No||PFIZER US PHARM|No||||
levothyroxine sodium|No|No|No|No|75%|60793085610|LEVOXYL 125 MCG TABLET|1000|EA|.47178|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||||No|No|||Prescription required|No|||No|1.05365|01/11/2022|1.02836|01/11/2022|1.03521|01/11/2022||||15267|||||No|No||PFIZER US PHARM|No||||
levothyroxine sodium|No|No|No|No|75%|60793085701|LEVOXYL 137 MCG TABLET|100|EA|.47828|10/02/2007||Yes|No||10/02/2007||Yes|No|10/02/2007||Yes|No||||No|No|||Prescription required|No|||No|1.07093|01/11/2022|1.04522|01/11/2022|1.05218|01/11/2022||||15268|||||No|No||PFIZER US PHARM|No||||
levothyroxine sodium|No|No|No|No|75%|60793085710|LEVOXYL 137 MCG TABLET|1000|EA|.47832|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||||No|No|||Prescription required|No|||No|1.07093|01/11/2022|1.04522|01/11/2022|1.05218|01/11/2022||||15269|||||No|No||PFIZER US PHARM|No||||
levothyroxine sodium|No|No|No|No|75%|60793085801|LEVOXYL 150 MCG TABLET|100|EA|.48559|10/09/2007||Yes|No||10/09/2007||Yes|No|10/09/2007||Yes|No||||No|No|||Prescription required|No|||No|1.0819|01/11/2022|1.05593|01/11/2022|1.06296|01/11/2022||||15270|||||No|No||PFIZER US PHARM|No||||
levothyroxine sodium|No|No|No|No|75%|60793085810|LEVOXYL 150 MCG TABLET|1000|EA|.48557|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||||No|No|||Prescription required|No|||No|1.0819|01/11/2022|1.05593|01/11/2022|1.06296|01/11/2022||||15271|||||No|No||PFIZER US PHARM|No||||
levothyroxine sodium|No|No|No|No|75%|60793085901|LEVOXYL 175 MCG TABLET|100|EA|.57714|10/02/2007||Yes|No||10/02/2007||Yes|No|10/02/2007||Yes|No||||No|No|||Prescription required|No|||No|1.28504|01/11/2022|1.25419|01/11/2022|1.26255|01/11/2022||||15272|||||No|No||PFIZER US PHARM|No||||
levothyroxine sodium|No|No|No|No|75%|60793085910|LEVOXYL 175 MCG TABLET|1000|EA|.57711|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||||No|No|||Prescription required|No|||No|1.28504|01/11/2022|1.25419|01/11/2022|1.26255|01/11/2022||||15273|||||No|No||PFIZER US PHARM|No||||
levothyroxine sodium|No|No|No|No|75%|60793086001|LEVOXYL 200 MCG TABLET|100|EA|.56097|10/09/2007||Yes|No||10/09/2007||Yes|No|10/09/2007||Yes|No||||No|No|||Prescription required|No|||No|1.24996|01/11/2022|1.21996|01/11/2022|1.22808|01/11/2022||||15274|||||No|No||PFIZER US PHARM|No||||
levothyroxine sodium|No|No|No|No|75%|60793086010|LEVOXYL 200 MCG TABLET|1000|EA|.56103|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||||No|No|||Prescription required|No|||No|1.24996|01/11/2022|1.21996|01/11/2022|1.22808|01/11/2022||||15275|||||No|No||PFIZER US PHARM|No||||
naloxone HCl|No|No|No|No|75%|60842005101|EVZIO 2 MG AUTO-INJECTOR|.4|ML|2203.75|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||No|5022.5|10/01/2020|4950.75|10/01/2020|4715|10/01/2020||||15276|||||No|No||KALEO, INC.|Yes|09/01/2020|||
nizatidine|No|No|No|No|75%|60846030115|NIZATIDINE 15 MG/ML SOLUTION|480|ML|.54877|03/15/2017||Yes|No||03/15/2017||Yes|No|03/15/2017||Yes|No||||No|No|||Prescription required|No|||No|1.25069|02/08/2022|1.23282|02/08/2022|1.17412|02/08/2022||||15277|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|60846080101|UNITHROID 25 MCG TABLET|100|EA|1.58695|07/25/2014||Yes|No||07/25/2014||Yes|No|07/25/2014||Yes|No||||No|No|||Prescription required|No|||No|3.61678|02/08/2022|3.56511|02/08/2022|3.39535|02/08/2022||||15278|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|60846080201|UNITHROID 50 MCG TABLET|100|EA|1.58799|07/25/2014||Yes|No||07/25/2014||Yes|No|07/25/2014||Yes|No||||No|No|||Prescription required|No|||No|3.61914|02/08/2022|3.56743|02/08/2022|3.39756|02/08/2022||||15279|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|60846080301|UNITHROID 75 MCG TABLET|100|EA|1.58975|07/25/2014||Yes|No||07/25/2014||Yes|No|07/25/2014||Yes|No||||No|No|||Prescription required|No|||No|3.54402|02/15/2022|3.45896|02/15/2022|3.48199|02/15/2022||||15280|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|60846080401|UNITHROID 88 MCG TABLET|100|EA|1.59327|07/25/2014||Yes|No||07/25/2014||Yes|No|07/25/2014||Yes|No||||No|No|||Prescription required|No|||No|3.54785|02/15/2022|3.4627|02/15/2022|3.48576|02/15/2022||||15281|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|60846080501|UNITHROID 100 MCG TABLET|100|EA|1.59594|07/25/2014||Yes|No||07/25/2014||Yes|No|07/25/2014||Yes|No||||No|No|||Prescription required|No|||No|3.63727|02/08/2022|3.5853|02/08/2022|3.41458|02/08/2022||||15282|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|60846080601|UNITHROID 112 MCG TABLET|100|EA|1.59917|07/25/2014||Yes|No||07/25/2014||Yes|No|07/25/2014||Yes|No||||No|No|||Prescription required|No|||No|3.64462|02/08/2022|3.59255|02/08/2022|3.42148|02/08/2022||||15283|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|60846080701|UNITHROID 125 MCG TABLET|100|EA|1.60183|07/25/2014||Yes|No||07/25/2014||Yes|No|07/25/2014||Yes|No||||No|No|||Prescription required|No|||No|3.65069|02/08/2022|3.59854|02/08/2022|3.42718|02/08/2022||||15284|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|60846080801|UNITHROID 137 MCG TABLET|100|EA|1.60351|06/16/2015||Yes|No||06/16/2015||Yes|No|06/16/2015||Yes|No||||No|No|||Prescription required|No|||No|3.65451|02/08/2022|3.60231|02/08/2022|3.43077|02/08/2022||||15285|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|60846080901|UNITHROID 150 MCG TABLET|100|EA|1.6048|07/25/2014||Yes|No||07/25/2014||Yes|No|07/25/2014||Yes|No||||No|No|||Prescription required|No|||No|3.65745|02/08/2022|3.6052|02/08/2022|3.43353|02/08/2022||||15286|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|60846081001|UNITHROID 175 MCG TABLET|100|EA|1.60721|07/25/2014||Yes|No||07/25/2014||Yes|No|07/25/2014||Yes|No||||No|No|||Prescription required|No|||No|3.66294|02/08/2022|3.61061|02/08/2022|3.43868|02/08/2022||||15287|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|60846081101|UNITHROID 200 MCG TABLET|100|EA|1.60871|07/25/2014||Yes|No||07/25/2014||Yes|No|07/25/2014||Yes|No||||No|No|||Prescription required|No|||No|3.66637|02/08/2022|3.61399|02/08/2022|3.4419|02/08/2022||||15288|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|60846081201|UNITHROID 300 MCG TABLET|100|EA|1.61035|07/25/2014||Yes|No||07/25/2014||Yes|No|07/25/2014||Yes|No||||No|No|||Prescription required|No|||No|3.6701|02/08/2022|3.61767|02/08/2022|3.4454|02/08/2022||||15289|||||No|No||AMNEAL PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|60951060270|ENDOCET 5-325 MG TABLET|100|EA|.10758|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.09091|03/29/2022|.08872|03/29/2022|.08931|03/29/2022|||ANALGESICS: NARCOTICS SHORT|15290|||||No|No||QUALITEST/PAR P|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|60951060285|ENDOCET 5-325 MG TABLET|500|EA|.10209|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||109|Yes|.09091|03/29/2022|.08872|03/29/2022|.08931|03/29/2022|||ANALGESICS: NARCOTICS SHORT|15291|||||No|No||QUALITEST/PAR P|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|60951070070|ENDOCET 7.5-325 MG TABLET|100|EA|.46809|08/10/2004||Yes|No||08/10/2004||Yes|No|||No|No||||No|No|||Prescription required|No||109|Yes|.14032|03/29/2022|.13695|03/29/2022|.13786|03/29/2022|||ANALGESICS: NARCOTICS SHORT|15292|||||No|No||QUALITEST/PAR P|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|60951071270|ENDOCET 10-325 MG TABLET|100|EA|.61206|08/10/2004||Yes|No||08/10/2004||Yes|No|||No|No||||No|No|||Prescription required|No||109|Yes|.19233|03/29/2022|.18771|03/29/2022|.18896|03/29/2022|||ANALGESICS: NARCOTICS SHORT|15293|||||No|No||QUALITEST/PAR P|No||||
pedi multivit no.16 w-fluoride|No|No|No|No|75%|61269015101|MULTIVIT-FLUOR 0.25 MG TAB CHW|100|EA|.05581|05/18/2017||Yes|No||05/18/2017||Yes|No|05/18/2017||Yes|No||||No|No|||Over the counter|No||179|No|.101|03/01/2022|.09857|03/01/2022|.09923|03/01/2022|||PEDIATRIC VITAMIN PREPARATIONS|15294|||||No|No||H2 PHARMA LLC|No||||
pedi multivit no.16 w-fluoride|No|No|No|No|75%|61269015201|MULTIVIT-FLUOR 0.5 MG TAB CHEW|100|EA|.05581|05/18/2017|09/30/2022|Yes|No||05/18/2017|09/30/2022|Yes|No|05/18/2017|09/30/2022|Yes|No||||No|No|||Over the counter|No||179|No|.10805|10/26/2021|.10545|10/26/2021|.10615|10/26/2021|||PEDIATRIC VITAMIN PREPARATIONS|15295|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||H2 PHARMA LLC|No||||
pedi multivit no.16 w-fluoride|No|No|No|No|75%|61269015301|MULTIVIT-FLUORIDE 1 MG TAB CHW|100|EA|.05581|05/18/2017|11/01/2022|Yes|No||05/18/2017|11/01/2022|Yes|No|05/18/2017|11/01/2022|Yes|No||||No|No|||Over the counter|No||179|No|.1272|09/04/2018|.12538|09/04/2018|.11941|09/04/2018|||PEDIATRIC VITAMIN PREPARATIONS|15296|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||H2 PHARMA LLC|No||||
pedi multivit no.2 w-fluoride|No|No|No|No|75%|61269016150|MULTIVIT-FLUOR 0.25 MG/ML DROP|50|ML|.11248|05/18/2017||Yes|No||05/18/2017||Yes|No|05/18/2017||Yes|No||||No|No|||Over the counter|No||179|No|.24457|03/29/2022|.2387|03/29/2022|.24029|03/29/2022|||PEDIATRIC VITAMIN PREPARATIONS|15297|||||No|No||H2 PHARMA LLC|No||||
pedi multivit no.2 w-fluoride|No|No|No|No|75%|61269016250|MULTIVIT-FLUOR 0.5 MG/ML DROP|50|ML|.11248|05/18/2017||Yes|No||05/18/2017||Yes|No|05/18/2017||Yes|No||||No|No|||Over the counter|No||179|No|.1931|03/29/2022|.18846|03/29/2022|.18972|03/29/2022|||PEDIATRIC VITAMIN PREPARATIONS|15298|||||No|No||H2 PHARMA LLC|No||||
pedi multivit 45/fluoride/iron|No|No|No|No|75%|61269016350|MULTIVIT-IRON-FLUOR 0.25 MG/ML|50|ML|.11248|05/18/2017||Yes|No||05/18/2017||Yes|No|05/18/2017||Yes|No||||No|No|||Over the counter|No||179|No|.23116|11/23/2021|.22561|11/23/2021|.22711|11/23/2021|||PEDIATRIC VITAMIN PREPARATIONS|15299|||||No|No||H2 PHARMA LLC|No||||
ped mvit A,C,D3 no.21/fluoride|No|No|No|No|75%|61269016450|VIT A,C,D-FLUORIDE 0.25 MG/ML|50|ML|.12857|02/14/2017||Yes|No||||No|No|02/14/2017||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|179|No|.2719|03/29/2022|.26537|03/29/2022|.26714|03/29/2022|||PEDIATRIC VITAMIN PREPARATIONS|15300|||||No|No||H2 PHARMA LLC|No||||
fluoride (sodium)|No|No|No|No|75%|61269016550|SODIUM FLUORIDE 0.5 MG/ML DROP|50|ML|.11498|05/18/2017||Yes|No||05/18/2017||Yes|No|05/18/2017||Yes|No||||No|No|||Over the counter|No|||No|.21639|03/29/2022|.21119|03/29/2022|.2126|03/29/2022||||15301|||||No|No||H2 PHARMA LLC|No||||
orlistat|No|No|No|No|75%|61269046090|XENICAL 120 MG CAPSULE|90|EA|3.27664|07/30/2018||Yes|No|Submit HHS Form 1331 (fee-for-service)|07/30/2018||Yes|No|||No|No||||No|No|||Prescription required|No|||No|7.32445|04/27/2021|7.14866|04/27/2021|7.19627|04/27/2021||||15302|||||No|No||H2 PHARMA LLC|No||||
diclofenac sodium|No|No|No|No|75%|61314001405|DICLOFENAC 0.1% EYE DROPS|5|ML|1.204|02/19/2008||Yes|No||02/19/2008||Yes|No|02/19/2008||Yes|No||||No|No|||Prescription required|No||013|No|2.17541|03/29/2022|2.1232|03/29/2022|2.13734|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|15303|||||No|No||SANDOZ|No||||
diclofenac sodium|No|No|No|No|75%|61314001425|DICLOFENAC 0.1% EYE DROPS|2.5|ML|1.806|09/15/2008||Yes|No||09/15/2008||Yes|No|09/15/2008||Yes|No||||No|No|||Prescription required|No||013|No|2.09|03/29/2022|2.03984|03/29/2022|2.05342|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|15304|||||No|No||SANDOZ|No||||
proparacaine HCl|No|No|No|No|75%|61314001601|PROPARACAINE 0.5% EYE DROPS|15|ML|1.0062|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|2.2932|09/29/2020|2.26044|09/29/2020|2.1528|09/29/2020||||15305|||||No|No||SANDOZ|No||||
dorzolamide HCl|No|No|No|No|75%|61314001910|DORZOLAMIDE HCL 2% EYE DROPS|10|ML|1.075|06/16/2009||Yes|No||06/16/2009||Yes|No|06/16/2009||Yes|No||||No|No|||Prescription required|No||088|No|1.39302|03/29/2022|1.35958|03/29/2022|1.36864|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15306|||||No|No||SANDOZ|No||||
dorzolamide HCl/timolol maleat|No|No|No|No|75%|61314003002|DORZOLAMIDE-TIMOLOL EYE DROPS|10|ML|.86|01/21/2010||Yes|No||01/21/2010||Yes|No|01/21/2010||Yes|No||||No|No|||Prescription required|No||088|No|1.24117|03/29/2022|1.21138|03/29/2022|1.21944|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15307|||||No|No||SANDOZ|No||||
trifluridine|No|No|No|No|75%|61314004475|TRIFLURIDINE 1% EYE DROPS|7.5|ML|10.2254|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|20.39724|09/07/2021|19.9077|09/07/2021|20.04028|09/07/2021||||15308|||||No|No||SANDOZ|No||||
ketorolac tromethamine|No|No|No|No|75%|61314012605|KETOROLAC 0.5% OPHTH SOLUTION|5|ML|2.408|11/18/2009||Yes|No||11/18/2009||Yes|No|11/18/2009||Yes|No||||No|No|||Prescription required|No||013|No|1.50166|03/29/2022|1.46562|03/29/2022|1.47538|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|15309|||||No|No||SANDOZ|No||||
ketorolac tromethamine|No|No|No|No|75%|61314012610|KETOROLAC 0.5% OPHTH SOLUTION|10|ML|2.408|11/18/2009||Yes|No||11/18/2009||Yes|No|11/18/2009||Yes|No||||No|No|||Prescription required|No||013|No|1.17797|03/29/2022|1.14969|03/29/2022|1.15735|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|15310|||||No|No||SANDOZ|No||||
brimonidine tartrate|No|No|No|No|75%|61314014305|BRIMONIDINE 0.2% EYE DROP|5|ML|.86|09/23/2003||Yes|No||09/23/2003||Yes|No|09/23/2003||Yes|No||||No|No|||Prescription required|No||088|No|.85973|03/29/2022|.83909|03/29/2022|.84468|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15311|||||No|No||SANDOZ|No||||
brimonidine tartrate|No|No|No|No|75%|61314014310|BRIMONIDINE 0.2% EYE DROP|10|ML|.516|09/23/2003||Yes|No||09/23/2003||Yes|No|09/23/2003||Yes|No||||No|No|||Prescription required|No||088|No|.62326|03/29/2022|.6083|03/29/2022|.61235|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15312|||||No|No||SANDOZ|No||||
brimonidine tartrate|No|No|No|No|75%|61314014315|BRIMONIDINE 0.2% EYE DROP|15|ML|.43|09/23/2003||Yes|No||09/23/2003||Yes|No|09/23/2003||Yes|No||||No|No|||Prescription required|No||088|No|.58721|03/29/2022|.57311|03/29/2022|.57693|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15313|||||No|No||SANDOZ|No||||
brimonidine tartrate|No|No|No|No|75%|61314014405|BRIMONIDINE TARTRATE 0.15% DRP|5|ML|13.1881|10/09/2009||Yes|No||10/09/2009||Yes|No|10/09/2009||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|088|No|27.00388|03/29/2022|26.35578|03/29/2022|26.53131|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15314|||||No|No||SANDOZ|No||||
brimonidine tartrate|No|No|No|No|75%|61314014410|BRIMONIDINE TARTRATE 0.15% DRP|10|ML|13.18466|10/09/2009||Yes|No||10/09/2009||Yes|No|10/09/2009||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|088|No|26.07371|03/29/2022|25.44794|03/29/2022|25.61742|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15315|||||No|No||SANDOZ|No||||
brimonidine tartrate|No|No|No|No|75%|61314014415|BRIMONIDINE TARTRATE 0.15% DRP|15|ML|13.18523|10/09/2009||Yes|No||10/09/2009||Yes|No|10/09/2009||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|088|No|26.5963|03/29/2022|25.95798|03/29/2022|26.13086|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15316|||||No|No||SANDOZ|No||||
pilocarpine HCl|No|No|No|No|75%|61314020315|PILOCARPINE 1% EYE DROPS|15|ML|2.26036|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||088|No|4.04603|03/29/2022|3.94892|03/29/2022|3.97522|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15317|||||No|No||SANDOZ|No||||
pilocarpine HCl|No|No|No|No|75%|61314020415|PILOCARPINE 2% EYE DROPS|15|ML|2.31196|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||088|No|4.33357|03/29/2022|4.22956|03/29/2022|4.25773|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15318|||||No|No||SANDOZ|No||||
pilocarpine HCl|No|No|No|No|75%|61314020615|PILOCARPINE 4% EYE DROPS|15|ML|2.42376|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||088|No|4.37517|11/23/2021|4.27016|11/23/2021|4.2986|11/23/2021|||OPHTHALMICS: GLAUCOMA AGENTS|15319|||||No|No||SANDOZ|No||||
timolol maleate|No|No|No|No|75%|61314022405|TIMOLOL 0.25% GFS GEL-SOLUTION|5|ML|13.6396|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||088|No|31.0856|10/26/2021|30.64152|10/26/2021|29.1824|10/26/2021|||OPHTHALMICS: GLAUCOMA AGENTS|15320|||||No|No||SANDOZ|No||||
timolol maleate|No|No|No|No|75%|61314022505|TIMOLOL 0.5% GFS GEL-SOLUTION|5|ML|14.94766|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||088|No|31.65243|03/29/2022|30.89277|03/29/2022|31.09851|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15321|||||No|No||SANDOZ|No||||
timolol maleate|No|No|No|No|75%|61314022605|TIMOLOL MALEATE 0.25% EYE DROP|5|ML|.44462|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||088|No|.68312|03/29/2022|.66672|03/29/2022|.67116|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15322|||||No|No||SANDOZ|No||||
timolol maleate|No|No|No|No|75%|61314022610|TIMOLOL MALEATE 0.25% EYE DROP|10|ML|.47085|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||088|No|.70113|03/29/2022|.6843|03/29/2022|.68886|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15323|||||No|No||SANDOZ|No||||
timolol maleate|No|No|No|No|75%|61314022615|TIMOLOL MALEATE 0.25% EYE DROP|15|ML|.43917|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||088|No|.63767|03/01/2022|.62236|03/01/2022|.62651|03/01/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15324|||||No|No||SANDOZ|No||||
timolol maleate|No|No|No|No|75%|61314022705|TIMOLOL MALEATE 0.5% EYE DROPS|5|ML|.8299|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||088|No|1.19485|03/29/2022|1.16617|03/29/2022|1.17394|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15325|||||No|No||SANDOZ|No||||
timolol maleate|No|No|No|No|75%|61314022710|TIMOLOL MALEATE 0.5% EYE DROPS|10|ML|.60759|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||088|No|.95525|03/29/2022|.93232|03/29/2022|.93853|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15326|||||No|No||SANDOZ|No||||
timolol maleate|No|No|No|No|75%|61314022715|TIMOLOL MALEATE 0.5% EYE DROPS|15|ML|.58766|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||088|No|.91053|03/29/2022|.88867|03/29/2022|.89459|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15327|||||No|No||SANDOZ|No||||
cromolyn sodium|No|No|No|No|75%|61314023710|CROMOLYN 4% EYE DROPS|10|ML|.9675|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||002|No|.58006|03/29/2022|.56613|03/29/2022|.5699|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|15328|||||No|No||SANDOZ|No||||
carteolol HCl|No|No|No|No|75%|61314023805|CARTEOLOL HCL 1% EYE DROPS|5|ML|1.1137|04/12/2002||Yes|No||04/12/2002||Yes|No|04/12/2002||Yes|No||||No|No|||Prescription required|No||088|No|1.22686|10/26/2021|1.19741|10/26/2021|1.20538|10/26/2021|||OPHTHALMICS: GLAUCOMA AGENTS|15329|||||No|No||SANDOZ|No||||
carteolol HCl|No|No|No|No|75%|61314023810|CARTEOLOL HCL 1% EYE DROPS|10|ML|1.05135|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||088|No|2.3961|08/25/2020|2.36187|08/25/2020|2.2494|08/25/2020|||OPHTHALMICS: GLAUCOMA AGENTS|15330|||||No|No||SANDOZ|No||||
carteolol HCl|No|No|No|No|75%|61314023815|CARTEOLOL HCL 1% EYE DROPS|15|ML|1.04633|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||088|No|2.38466|06/01/2016|2.35059|06/01/2016|2.23866|06/01/2016|||OPHTHALMICS: GLAUCOMA AGENTS|15331|||||No|No||SANDOZ|No||||
betaxolol HCl|No|No|No|No|75%|61314024501|BETAXOLOL HCL 0.5% EYE DROP|5|ML|4.38428|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|02/01/2018|088|No|9.99208|09/28/2021|9.84933|09/28/2021|9.38032|09/28/2021|||OPHTHALMICS: GLAUCOMA AGENTS|15332|||||No|No||SANDOZ|No||||
betaxolol HCl|No|No|No|No|75%|61314024502|BETAXOLOL HCL 0.5% EYE DROP|15|ML|4.05432|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|02/01/2018|088|No|9.24008|06/01/2016|9.10808|06/01/2016|8.67436|06/01/2016|||OPHTHALMICS: GLAUCOMA AGENTS|15333|||||No|No||SANDOZ|No||||
betaxolol HCl|No|No|No|No|75%|61314024503|BETAXOLOL HCL 0.5% EYE DROP|10|ML|4.0764|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|02/01/2018|088|No|9.2904|08/29/2017|9.15768|08/29/2017|8.7216|08/29/2017|||OPHTHALMICS: GLAUCOMA AGENTS|15334|||||No|No||SANDOZ|No||||
azelastine HCl|No|No|No|No|75%|61314030802|AZELASTINE HCL 0.05% DROPS|6|ML|2.50833|11/06/2012||Yes|No||11/06/2012||Yes|No|11/06/2012||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|002|No|1.22657|03/29/2022|1.19713|03/29/2022|1.2051|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|15335|||||No|No||SANDOZ|No||||
filgrastim-sndz|No|No|No|No|75%|61314031810|ZARXIO 300 MCG/0.5 ML SYRINGE|.5|ML|235.95218|01/02/2019||Yes|No||01/02/2019||Yes|No|01/02/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|148|No|537.75148|04/02/2019|530.06931|04/02/2019|504.82792|04/02/2019|||COLONY STIMULATING FACTORS|15336|||||No|No||SANDOZ|No||||
olopatadine HCl|No|No|No|No|75%|61314032001|OLOPATADINE 665 MCG NASAL SPRY|30.5|GM|3.05497|09/01/2015||Yes|No||09/01/2015||Yes|No|09/01/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|019|No|1.24713|03/29/2022|1.21719|03/29/2022|1.2253|03/29/2022|||INTRANASAL RHINITIS AGENTS|15337|||||No|No||SANDOZ|No||||
filgrastim-sndz|No|No|No|No|75%|61314032610|ZARXIO 480 MCG/0.8 ML SYRINGE|.8|ML|235.95175|01/02/2019||Yes|No||01/02/2019||Yes|No|01/02/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|148|No|537.7505|01/02/2019|530.06835|01/02/2019|504.827|01/02/2019|||COLONY STIMULATING FACTORS|15338|||||No|No||SANDOZ|No||||
tropicamide|No|No|No|No|75%|61314035401|TROPICAMIDE 0.5% EYE DROPS|15|ML|.61346|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|1.39812|06/01/2016|1.37815|06/01/2016|1.31252|06/01/2016||||15339|||||No|No||SANDOZ|No||||
tropicamide|No|No|No|No|75%|61314035502|TROPICAMIDE 1% EYE DROPS|15|ML|.8772|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|1.9992|12/29/2020|1.97064|12/29/2020|1.8768|12/29/2020||||15340|||||No|No||SANDOZ|No||||
cyclopentolate HCl|No|No|No|No|75%|61314039603|CYCLOPENTOLATE 1% EYE DROPS|15|ML|.80266|09/01/2002||Yes|No||09/01/2002||Yes|No|09/01/2002||Yes|No||||No|No|||Prescription required|No|||No|1.23427|03/29/2022|1.20464|03/29/2022|1.21267|03/29/2022||||15341|||||No|No||SANDOZ|No||||
latanoprost|No|No|No|No|75%|61314054701|LATANOPROST 0.005% EYE DROPS|2.5|ML|1.8404|04/15/2011||Yes|No||04/15/2011||Yes|No|04/15/2011||Yes|No||||No|No|||Prescription required|No||088|No|1.89557|03/29/2022|1.85007|03/29/2022|1.86239|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15342|||||No|No||SANDOZ|No||||
latanoprost|No|No|No|No|75%|61314054703|LATANOPROST 0.005% EYE DROPS|2.5|ML|2.3048|04/15/2011||Yes|No||04/15/2011||Yes|No|04/15/2011||Yes|No||||No|No|||Prescription required|No||088|No|5.2528|11/29/2016|5.17776|11/29/2016|4.9312|11/29/2016|||OPHTHALMICS: GLAUCOMA AGENTS|15343|||||No|No||SANDOZ|No||||
polymyxin B sulf/trimethoprim|No|No|No|No|75%|61314062810|POLYMYXIN B-TMP EYE DROPS|10|ML|.44505|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||058|No|.46086|03/29/2022|.44979|03/29/2022|.45279|03/29/2022|||OPHTHALMIC ANTIBIOTICS|15344|||||No|No||SANDOZ|No||||
neomycin/polymyxin B/dexametha|No|No|No|No|75%|61314063006|NEOMYC-POLYM-DEXAMETH EYE DROP|5|ML|1.548|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||036|No|2.47125|03/29/2022|2.41194|03/29/2022|2.428|03/29/2022|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|15345|||||No|No||SANDOZ|No||||
neomycin/polymyxin B/dexametha|No|No|No|No|75%|61314063136|NEOMYC-POLYM-DEXAMET EYE OINTM|3.5|GM|2.21142|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||036|No|3.06312|03/29/2022|2.9896|03/29/2022|3.00951|03/29/2022|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|15346|||||No|No||SANDOZ|No||||
gentamicin sulfate|No|No|No|No|75%|61314063305|GENTAMICIN 0.3% EYE DROP|5|ML|.43|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||058|No|.63882|03/29/2022|.62348|03/29/2022|.62764|03/29/2022|||OPHTHALMIC ANTIBIOTICS|15347|||||No|No||SANDOZ|No||||
prednisolone acetate|No|No|No|No|75%|61314063705|PREDNISOLONE AC 1% EYE DROP|5|ML|3.8055|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||013|No|5.90936|03/29/2022|5.76753|03/29/2022|5.80594|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|15348|||||No|No||SANDOZ|No||||
prednisolone acetate|No|No|No|No|75%|61314063710|PREDNISOLONE AC 1% EYE DROP|10|ML|3.80249|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||013|No|6.10361|03/29/2022|5.95712|03/29/2022|5.99679|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|15349|||||No|No||SANDOZ|No||||
prednisolone acetate|No|No|No|No|75%|61314063715|PREDNISOLONE AC 1% EYE DROP|15|ML|3.6613|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||013|No|6.06102|03/29/2022|5.91555|03/29/2022|5.95495|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|15350|||||No|No||SANDOZ|No||||
neomycin/polymyxin B/hydrocort|No|No|No|No|75%|61314064175|NEOMYCIN-POLY-HC EYE DROPS|7.5|ML|7.8088|02/17/2003||Yes|No||02/17/2003||Yes|No|02/17/2003||Yes|No||||No|No|||Prescription required|Yes|07/12/2005|036|No|17.346|03/29/2022|16.92969|03/29/2022|17.04244|03/29/2022|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|15351|||||No|No||SANDOZ|No||||
tobramycin|No|No|No|No|75%|61314064305|TOBRAMYCIN 0.3% EYE DROP|5|ML|1.333|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||058|No|1.42908|03/29/2022|1.39478|03/29/2022|1.40407|03/29/2022|||OPHTHALMIC ANTIBIOTICS|15352|||||No|No||SANDOZ|No||||
neomycin/polymyxin B/hydrocort|No|No|No|No|75%|61314064511|NEOMYCIN-POLYMYXIN-HC EAR SUSP|10|ML|3.6077|03/06/2008||Yes|No||03/06/2008||Yes|No|03/06/2008||Yes|No||||No|No|||Prescription required|No||051|No|5.91929|03/29/2022|5.77722|03/29/2022|5.8157|03/29/2022|||OTIC ANTIBIOTICS|15353|||||No|No||SANDOZ|No||||
neomycin/polymyxin B/hydrocort|No|No|No|No|75%|61314064610|NEOMYCIN-POLYMYXIN-HC EAR SOLN|10|ML|3.6077|01/13/2003||Yes|No||01/13/2003||Yes|No|01/13/2003||Yes|No||||No|No|||Prescription required|No||051|No|5.83849|03/29/2022|5.69836|03/29/2022|5.73631|03/29/2022|||OTIC ANTIBIOTICS|15354|||||No|No||SANDOZ|No||||
tobramycin/dexamethasone|No|No|No|No|75%|61314064705|TOBRAMYCIN-DEXAMETH OPHTH SUSP|5|ML|6.5403|11/04/2008||Yes|No||11/04/2008||Yes|No|11/04/2008||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|036|No|14.32103|03/29/2022|13.97732|03/29/2022|14.07041|03/29/2022|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|15355|||||No|No||SANDOZ|No||||
tobramycin/dexamethasone|No|No|No|No|75%|61314064710|TOBRAMYCIN-DEXAMETH OPHTH SUSP|10|ML|6.54073|11/04/2008||Yes|No||11/04/2008||Yes|No|11/04/2008||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|036|No|12.73383|03/01/2022|12.42821|03/01/2022|12.51098|03/01/2022|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|15356|||||No|No||SANDOZ|No||||
tobramycin/dexamethasone|No|No|No|No|75%|61314064725|TOBRAMYCIN-DEXAMETH OPHTH SUSP|2.5|ML|6.52396|11/04/2008||Yes|No||11/04/2008||Yes|No|11/04/2008||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|036|No|14.38|03/29/2022|14.03488|03/29/2022|14.12835|03/29/2022|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|15357|||||No|No||SANDOZ|No||||
ciprofloxacin HCl|No|No|No|No|75%|61314065605|CIPROFLOXACIN 0.3% EYE DROP|5|ML|1.204|08/13/2008||Yes|No||08/13/2008||Yes|No|08/13/2008||Yes|No||||No|No|||Prescription required|No||058|No|2.02578|03/29/2022|1.97716|03/29/2022|1.99032|03/29/2022|||OPHTHALMIC ANTIBIOTICS|15358|||||No|No||SANDOZ|No||||
ciprofloxacin HCl|No|No|No|No|75%|61314065610|CIPROFLOXACIN 0.3% EYE DROP|10|ML|.946|05/28/2004||Yes|No||05/28/2004||Yes|No|05/28/2004||Yes|No||||No|No|||Prescription required|No||058|No|1.78414|03/29/2022|1.74132|03/29/2022|1.75291|03/29/2022|||OPHTHALMIC ANTIBIOTICS|15359|||||No|No||SANDOZ|No||||
ciprofloxacin HCl|No|No|No|No|75%|61314065625|CIPROFLOXACIN 0.3% EYE DROP|2.5|ML|1.806|08/13/2008||Yes|No||08/13/2008||Yes|No|08/13/2008||Yes|No||||No|No|||Prescription required|No||058|No|3.16994|03/29/2022|3.09386|03/29/2022|3.11446|03/29/2022|||OPHTHALMIC ANTIBIOTICS|15360|||||No|No||SANDOZ|No||||
apraclonidine HCl|No|No|No|No|75%|61314066505|APRACLONIDINE HCL 0.5% DROPS|5|ML|5.5255|09/02/2009||Yes|No||09/02/2009||Yes|No|09/02/2009||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|088|No|12.2696|07/27/2021|11.97512|07/27/2021|12.05488|07/27/2021|||OPHTHALMICS: GLAUCOMA AGENTS|15361|||||No|No||SANDOZ|No||||
apraclonidine HCl|No|No|No|No|75%|61314066510|APRACLONIDINE HCL 0.5% DROPS|10|ML|5.4782|09/02/2009||Yes|No||09/02/2009||Yes|No|09/02/2009||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|088|No|12.4852|06/01/2016|12.30684|06/01/2016|11.7208|06/01/2016|||OPHTHALMICS: GLAUCOMA AGENTS|15362|||||No|No||SANDOZ|No||||
gatifloxacin|No|No|No|No|75%|61314067225|GATIFLOXACIN 0.5% EYE DROPS|2.5|ML|8.13044|02/23/2017||Yes|No||02/23/2017||Yes|No|02/23/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|058|No|12.97096|03/29/2022|12.65965|03/29/2022|12.74396|03/29/2022|||OPHTHALMIC ANTIBIOTICS|15363|||||No|No||SANDOZ|No||||
sulfacetamide sodium|No|No|No|No|75%|61314070101|SULFACETAMIDE 10% EYE DROPS|15|ML|1.27624|02/17/2003|05/31/2022|Yes|No||02/17/2003|05/31/2022|Yes|No|02/17/2003|05/31/2022|Yes|No||||No|No|||Prescription required|Yes|01/26/2017|058|No|2.29667|03/29/2022|2.24154|03/29/2022|2.25647|03/29/2022|||OPHTHALMIC ANTIBIOTICS|15364|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SANDOZ|No||||
pegfilgrastim-bmez|No|No|No|No|75%|61314086601|ZIEXTENZO 6 MG/0.6 ML SYRINGE|.6|ML|2813.2965|02/25/2020||Yes|No||02/25/2020||Yes|No|02/25/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|148|No|6411.699|02/25/2020|6320.1033|02/25/2020|6019.146|02/25/2020|||COLONY STIMULATING FACTORS|15365|||||No|No||SANDOZ|No||||
diclofenac sodium|No|No|No|No|75%|61442010201|DICLOFENAC SOD DR 50 MG TAB|100|EA|.10535|02/23/2011||Yes|No||02/23/2011||Yes|No|02/23/2011||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.10202|03/29/2022|.09957|03/29/2022|.10023|03/29/2022|||NSAIDS|15366|||||No|No||CARLSBAD TECH|No||||
diclofenac sodium|No|No|No|No|75%|61442010210|DICLOFENAC SOD DR 50 MG TAB|1000|EA|.0989|10/22/2013||Yes|No||10/22/2013||Yes|No|10/22/2013||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.10202|03/29/2022|.09957|03/29/2022|.10023|03/29/2022|||NSAIDS|15367|||||No|No||CARLSBAD TECH|No||||
diclofenac sodium|No|No|No|No|75%|61442010260|DICLOFENAC SOD DR 50 MG TAB|60|EA|.11825|10/22/2013||Yes|No||10/22/2013||Yes|No|10/22/2013||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.10202|03/29/2022|.09957|03/29/2022|.10023|03/29/2022|||NSAIDS|15368|||||No|No||CARLSBAD TECH|No||||
diclofenac sodium|No|No|No|No|75%|61442010301|DICLOFENAC SOD DR 75 MG TAB|100|EA|.1161|10/22/2013||Yes|No||10/22/2013||Yes|No|10/22/2013||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.09618|03/29/2022|.09387|03/29/2022|.09449|03/29/2022|||NSAIDS|15369|||||No|No||CARLSBAD TECH|No||||
diclofenac sodium|No|No|No|No|75%|61442010305|DICLOFENAC SOD DR 75 MG TAB|500|EA|.16239|02/23/2011||Yes|No||02/23/2011||Yes|No|02/23/2011||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.09618|03/29/2022|.09387|03/29/2022|.09449|03/29/2022|||NSAIDS|15370|||||No|No||CARLSBAD TECH|No||||
diclofenac sodium|No|No|No|No|75%|61442010310|DICLOFENAC SOD DR 75 MG TAB|1000|EA|.1075|10/22/2013||Yes|No||10/22/2013||Yes|No|10/22/2013||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.09618|03/29/2022|.09387|03/29/2022|.09449|03/29/2022|||NSAIDS|15371|||||No|No||CARLSBAD TECH|No||||
diclofenac sodium|No|No|No|No|75%|61442010360|DICLOFENAC SOD DR 75 MG TAB|60|EA|.12183|10/23/2013||Yes|No||10/23/2013||Yes|No|10/23/2013||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.09618|03/29/2022|.09387|03/29/2022|.09449|03/29/2022|||NSAIDS|15372|||||No|No||CARLSBAD TECH|No||||
acyclovir|Yes|No|No|No|75%|61442011201|ACYCLOVIR 400 MG TABLET|100|EA|.07589|10/08/2009||Yes|No||10/08/2009||Yes|No|10/08/2009||Yes|No||||No|No|11/01/2012||Prescription required|No||025|No|.0985|03/29/2022|.09613|03/29/2022|.09677|03/29/2022|||ANTIVIRALS: ORAL|15373|||||No|No||CARLSBAD TECH|No||||
acyclovir|Yes|No|No|No|75%|61442011205|ACYCLOVIR 400 MG TABLET|500|EA|.074|10/03/2013||Yes|No||10/03/2013||Yes|No|10/03/2013||Yes|No||||No|No|10/03/2013||Prescription required|No||025|No|.0985|03/29/2022|.09613|03/29/2022|.09677|03/29/2022|||ANTIVIRALS: ORAL|15374|||||No|No||CARLSBAD TECH|No||||
acyclovir|No|No|No|No|75%|61442011301|ACYCLOVIR 800 MG TABLET|100|EA|.13007|10/08/2009||Yes|No||10/08/2009||Yes|No|10/08/2009||Yes|No||||No|No|||Prescription required|No||025|No|.19021|03/29/2022|.18564|03/29/2022|.18688|03/29/2022|||ANTIVIRALS: ORAL|15375|||||No|No||CARLSBAD TECH|No||||
acyclovir|No|No|No|No|75%|61442011305|ACYCLOVIR 800 MG TABLET|500|EA|.1268|10/03/2013||Yes|No||10/03/2013||Yes|No|10/03/2013||Yes|No||||No|No|||Prescription required|No||025|No|.19021|03/29/2022|.18564|03/29/2022|.18688|03/29/2022|||ANTIVIRALS: ORAL|15376|||||No|No||CARLSBAD TECH|No||||
glimepiride|Yes|No|No|No|75%|61442011501|GLIMEPIRIDE 1 MG TABLET|100|EA|.0301|02/23/2011||Yes|No||02/23/2011||Yes|No|02/23/2011||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.03361|03/29/2022|.0328|03/29/2022|.03302|03/29/2022||||15377|||||No|No||CARLSBAD TECH|No||||
glimepiride|No|No|No|No|75%|61442011505|GLIMEPIRIDE 1 MG TABLET|500|EA|.0301|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||||No|No|||Prescription required|No|||No|.03361|03/29/2022|.0328|03/29/2022|.03302|03/29/2022||||15378|||||No|No||CARLSBAD TECH|No||||
glimepiride|Yes|No|No|No|75%|61442011601|GLIMEPIRIDE 2 MG TABLET|100|EA|.0344|02/23/2011||Yes|No||02/23/2011||Yes|No|02/23/2011||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.03979|03/29/2022|.03883|03/29/2022|.03909|03/29/2022||||15379|||||No|No||CARLSBAD TECH|No||||
glimepiride|No|No|No|No|75%|61442011605|GLIMEPIRIDE 2 MG TABLET|500|EA|.0344|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||||No|No|||Prescription required|No|||No|.03979|03/29/2022|.03883|03/29/2022|.03909|03/29/2022||||15380|||||No|No||CARLSBAD TECH|No||||
glimepiride|Yes|No|No|No|75%|61442011701|GLIMEPIRIDE 4 MG TABLET|100|EA|.0559|02/23/2011||Yes|No||02/23/2011||Yes|No|02/23/2011||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.04419|03/29/2022|.04312|03/29/2022|.04341|03/29/2022||||15381|||||No|No||CARLSBAD TECH|No||||
glimepiride|No|No|No|No|75%|61442011705|GLIMEPIRIDE 4 MG TABLET|500|EA|.0559|09/06/2016||Yes|No||09/06/2016||Yes|No|09/06/2016||Yes|No||||No|No|||Prescription required|No|||No|.04419|03/29/2022|.04312|03/29/2022|.04341|03/29/2022||||15382|||||No|No||CARLSBAD TECH|No||||
famotidine|No|No|No|No|75%|61442012101|FAMOTIDINE 20 MG TABLET|100|EA|.02911|02/23/2011||Yes|No||02/23/2011||Yes|No|02/23/2011||Yes|No||||No|No|||Prescription required|No|||No|.03262|03/29/2022|.03183|03/29/2022|.03204|03/29/2022||||15383|||||No|No||CARLSBAD TECH|No||||
famotidine|No|No|No|No|75%|61442012110|FAMOTIDINE 20 MG TABLET|1000|EA|.02653|02/23/2011||Yes|No||02/23/2011||Yes|No|02/23/2011||Yes|No||||No|No|||Prescription required|No|||No|.03262|03/29/2022|.03183|03/29/2022|.03204|03/29/2022||||15384|||||No|No||CARLSBAD TECH|No||||
famotidine|No|No|No|No|75%|61442012201|FAMOTIDINE 40 MG TABLET|100|EA|.05258|02/23/2011||Yes|No||02/23/2011||Yes|No|02/23/2011||Yes|No||||No|No|||Prescription required|No|||No|.06888|03/29/2022|.06722|03/29/2022|.06767|03/29/2022||||15385|||||No|No||CARLSBAD TECH|No||||
famotidine|No|No|No|No|75%|61442012210|FAMOTIDINE 40 MG TABLET|1000|EA|.04991|02/23/2011||Yes|No||02/23/2011||Yes|No|02/23/2011||Yes|No||||No|No|||Prescription required|No|||No|.06888|03/29/2022|.06722|03/29/2022|.06767|03/29/2022||||15386|||||No|No||CARLSBAD TECH|No||||
meloxicam|No|No|No|No|75%|61442012601|MELOXICAM 7.5 MG TABLET|100|EA|.01642|02/23/2011||Yes|No||02/23/2011||Yes|No|02/23/2011||Yes|No||||No|No|||Prescription required|No||059|Yes|.02308|03/29/2022|.02252|03/29/2022|.02267|03/29/2022|||NSAIDS|15387|||||No|No||CARLSBAD TECH|No||||
meloxicam|No|No|No|No|75%|61442012610|MELOXICAM 7.5 MG TABLET|1000|EA|.01571|02/23/2011||Yes|No||02/23/2011||Yes|No|02/23/2011||Yes|No||||No|No|||Prescription required|No||059|Yes|.02308|03/29/2022|.02252|03/29/2022|.02267|03/29/2022|||NSAIDS|15388|||||No|No||CARLSBAD TECH|No||||
meloxicam|No|No|No|No|75%|61442012701|MELOXICAM 15 MG TABLET|100|EA|.01965|02/23/2011||Yes|No||02/23/2011||Yes|No|02/23/2011||Yes|No||||No|No|||Prescription required|No||059|Yes|.02416|03/29/2022|.02358|03/29/2022|.02373|03/29/2022|||NSAIDS|15389|||||No|No||CARLSBAD TECH|No||||
meloxicam|No|No|No|No|75%|61442012710|MELOXICAM 15 MG TABLET|1000|EA|.01637|02/23/2011||Yes|No||02/23/2011||Yes|No|02/23/2011||Yes|No||||No|No|||Prescription required|No||059|Yes|.02416|03/29/2022|.02358|03/29/2022|.02373|03/29/2022|||NSAIDS|15390|||||No|No||CARLSBAD TECH|No||||
lovastatin|Yes|No|No|No|75%|61442014101|LOVASTATIN 10 MG TABLET|100|EA|.10698|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.0534|03/29/2022|.05211|03/29/2022|.05246|03/29/2022|||LIPOTROPICS: STATINS|15391|||||No|No||CARLSBAD TECH|No||||
lovastatin|Yes|No|No|No|75%|61442014110|LOVASTATIN 10 MG TABLET|1000|EA|.10274|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.0534|03/29/2022|.05211|03/29/2022|.05246|03/29/2022|||LIPOTROPICS: STATINS|15392|||||No|No||CARLSBAD TECH|No||||
lovastatin|Yes|No|No|No|75%|61442014201|LOVASTATIN 20 MG TABLET|100|EA|.10995|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.04992|03/29/2022|.04872|03/29/2022|.04904|03/29/2022|||LIPOTROPICS: STATINS|15393|||||No|No||CARLSBAD TECH|No||||
lovastatin|Yes|No|No|No|75%|61442014210|LOVASTATIN 20 MG TABLET|1000|EA|.10557|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.04992|03/29/2022|.04872|03/29/2022|.04904|03/29/2022|||LIPOTROPICS: STATINS|15394|||||No|No||CARLSBAD TECH|No||||
lovastatin|Yes|No|No|No|75%|61442014301|LOVASTATIN 40 MG TABLET|100|EA|.17677|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.0616|03/29/2022|.06012|03/29/2022|.06052|03/29/2022|||LIPOTROPICS: STATINS|15395|||||No|No||CARLSBAD TECH|No||||
lovastatin|Yes|No|No|No|75%|61442014310|LOVASTATIN 40 MG TABLET|1000|EA|.16972|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.0616|03/29/2022|.06012|03/29/2022|.06052|03/29/2022|||LIPOTROPICS: STATINS|15396|||||No|No||CARLSBAD TECH|No||||
cefaclor|No|No|No|No|75%|61442017130|CEFACLOR 250 MG CAPSULE|30|EA|.7826|10/28/2008||Yes|No||10/28/2008||Yes|No|10/28/2008||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|046|No|1.7836|05/25/2021|1.75812|05/25/2021|1.6744|05/25/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|15397|||||No|No||CARLSBAD TECH|No||||
cefaclor|No|No|No|No|75%|61442017230|CEFACLOR 500 MG CAPSULE|30|EA|1.02483|10/28/2008||Yes|No||10/28/2008||Yes|No|10/28/2008||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|046|No|.89367|03/29/2022|.87222|03/29/2022|.87803|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|15398|||||No|No||CARLSBAD TECH|No||||
ciprofloxacin HCl|Yes|No|No|No|75%|61442022201|CIPROFLOXACIN HCL 250 MG TAB|100|EA|.0903|12/03/2009||Yes|No||12/03/2009||Yes|No|12/03/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||028|No|.09397|03/29/2022|.09171|03/29/2022|.09232|03/29/2022|||FLUOROQUINOLONES: ORAL|15399|||||No|No||CARLSBAD TECH|No||||
ciprofloxacin HCl|No|No|No|No|75%|61442022301|CIPROFLOXACIN HCL 500 MG TAB|100|EA|.129|12/03/2009||Yes|No||12/03/2009||Yes|No|12/03/2009||Yes|No||||No|No|||Prescription required|No||028|No|.13565|03/29/2022|.13239|03/29/2022|.13327|03/29/2022|||FLUOROQUINOLONES: ORAL|15400|||||No|No||CARLSBAD TECH|No||||
carisoprodol|No|No|No|No|90%|61442045101|CARISOPRODOL 350 MG TABLET|100|EA|.03435|08/14/2019|04/30/2023|Yes|No||08/14/2019|04/30/2023|Yes|No|08/14/2019|04/30/2023|Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|15401|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||CARLSBAD TECH|No||||
estrogens,esterified|No|No|No|No|75%|61570007201|MENEST 0.3 MG TABLET|100|EA|.78926|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|1.79879|01/04/2022|1.77309|01/04/2022|1.68866|01/04/2022||||15402|||||No|No||MONARCH PHRM|No||||
estrogens,esterified|No|No|No|No|75%|61570007301|MENEST 0.625 MG TABLET|100|EA|1.12144|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|2.55584|01/04/2022|2.51932|01/04/2022|2.39936|01/04/2022||||15403|||||No|No||MONARCH PHRM|No||||
estrogens,esterified|No|No|No|No|75%|61570007401|MENEST 1.25 MG TABLET|100|EA|1.56434|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||Yes|3.56524|01/04/2022|3.5143|01/04/2022|3.34696|01/04/2022||||15404|||||No|No||MONARCH PHRM|No||||
ramipril|No|No|No|No|75%|61570011001|ALTACE 1.25 MG CAPSULE|100|EA|2.27078|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/23/2007|113|Yes|5.17528|01/04/2022|5.10134|01/04/2022|4.85842|01/04/2022|||ANGIOTENSIN MODULATORS|15405|||||No|No||MONARCH PHRM|No||||
ramipril|No|No|No|No|75%|61570011101|ALTACE 2.5 MG CAPSULE|100|EA|2.68023|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/23/2007|113|Yes|6.10843|01/04/2022|6.02117|01/04/2022|5.73445|01/04/2022|||ANGIOTENSIN MODULATORS|15406|||||No|No||MONARCH PHRM|No||||
ramipril|No|No|No|No|75%|61570011201|ALTACE 5 MG CAPSULE|100|EA|2.81215|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/23/2007|113|Yes|6.4091|01/04/2022|6.31754|01/04/2022|6.0167|01/04/2022|||ANGIOTENSIN MODULATORS|15407|||||No|No||MONARCH PHRM|No||||
ramipril|No|No|No|No|75%|61570012001|ALTACE 10 MG CAPSULE|100|EA|3.29074|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|03/23/2007|113|No|7.49984|01/04/2022|7.3927|01/04/2022|7.04066|01/04/2022|||ANGIOTENSIN MODULATORS|15408|||||No|No||MONARCH PHRM|No||||
silver sulfadiazine|No|No|No|No|75%|61570013140|SILVADENE 1% CREAM|400|GM|.0636|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.14496|01/05/2021|.14289|01/05/2021|.13608|01/05/2021||||15409|||||No|No||PFIZER US PHARM|No||||
silver sulfadiazine|No|No|No|No|75%|61570013150|SILVADENE 1% CREAM|50|GM|.11911|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.19784|08/24/2021|.19309|08/24/2021|.19437|08/24/2021||||15410|||||No|No||PFIZER US PHARM|No||||
silver sulfadiazine|No|No|No|No|75%|61570013185|SILVADENE 1% CREAM|85|GM|.12459|04/26/2002||Yes|No||04/26/2002||Yes|No|04/26/2002||Yes|No||||No|No|||Prescription required|No|||No|.28396|01/05/2021|.2799|01/05/2021|.26657|01/05/2021||||15411|||||No|No||PFIZER US PHARM|No||||
silver sulfadiazine|No|No|No|No|75%|61570013198|SILVADENE 1% CREAM|1000|GM|.052|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.11853|01/05/2021|.11683|01/05/2021|.11127|01/05/2021||||15412|||||No|No||PFIZER US PHARM|No||||
cytarabine/PF|No|No|No|No|75%|61703030346|CYTARABINE 20 MG/ML VIAL|50|ML|.23658|10/03/2005||Yes|No||10/03/2005||Yes|No|10/03/2005||Yes|No||||No|No|||Prescription required|No|||No|.53919|01/04/2022|.53149|01/04/2022|.50618|01/04/2022||||15413|||||No|No||HOSPIRA/PFIZER|No||||
cytarabine|No|No|No|No|75%|61703030436|CYTARABINE 20 MG/ML VIAL|25|ML|.2678|10/03/2005||Yes|No||10/03/2005||Yes|No|10/03/2005||Yes|No||||No|No|||Prescription required|No|||No|.61034|01/04/2022|.60162|01/04/2022|.57297|01/04/2022||||15414|||||No|No||HOSPIRA/PFIZER|No||||
cytarabine/PF|No|No|No|No|75%|61703030538|CYTARABINE 100 MG/5 ML VIAL|5|ML|.54558|10/03/2005||Yes|No||10/03/2005||Yes|No|10/03/2005||Yes|No||||No|No|||Prescription required|No|||No|1.24342|01/04/2022|1.22566|01/04/2022|1.16729|01/04/2022||||15415|||||No|No||HOSPIRA/PFIZER|No||||
vincristine sulfate|No|No|No|No|75%|61703030906|VINCRISTINE 1 MG/ML VIAL|1|ML|2.5112|12/17/2010||Yes|No||12/17/2010||Yes|No|12/17/2010||Yes|No||||No|No|||Prescription required|No|||No|5.7232|01/04/2022|5.64144|01/04/2022|5.3728|01/04/2022||||15416|||||No|No||HOSPIRA/PFIZER|No||||
vincristine sulfate|No|No|No|No|75%|61703030916|VINCRISTINE 2 MG/2 ML VIAL|2|ML|2.3306|12/17/2010||Yes|No||12/17/2010||Yes|No|12/17/2010||Yes|No||||No|No|||Prescription required|No|||No|5.3116|01/04/2022|5.23572|01/04/2022|4.9864|01/04/2022||||15417|||||No|No||HOSPIRA/PFIZER|No||||
cytarabine/PF|No|No|No|No|75%|61703031922|CYTARABINE 2 G/20 ML VIAL|20|ML|.43688|10/03/2005||Yes|No||10/03/2005||Yes|No|10/03/2005||Yes|No||||No|No|||Prescription required|No|||No|.99568|01/04/2022|.98145|01/04/2022|.93472|01/04/2022||||15418|||||No|No||HOSPIRA/PFIZER|No||||
pamidronate disodium|No|No|No|No|75%|61703032418|PAMIDRONATE 30 MG/10 ML VIAL|10|ML|.60286|08/16/2016||Yes|No||08/16/2016||Yes|No|08/16/2016||Yes|No||||No|No|||Prescription required|No|||No|1.37396|01/04/2022|1.35433|01/04/2022|1.28984|01/04/2022||||15419|||||No|No||HOSPIRA/PFIZER|No||||
mitoxantrone HCl|No|No|No|No|75%|61703034318|MITOXANTRONE 20 MG/10 ML VIAL|10|ML|7.42008|04/25/2006||Yes|No||04/25/2006||Yes|No|04/25/2006||Yes|No||||No|No|||Prescription required|No|||No|16.91088|01/04/2022|16.66929|01/04/2022|15.87552|01/04/2022||||15420|||||No|No||HOSPIRA/PFIZER|No||||
mitoxantrone HCl|No|No|No|No|75%|61703034365|MITOXANTRONE 25 MG/12.5 ML VL|12.5|ML|7.42008|08/18/2006||Yes|No||08/18/2006||Yes|No|08/18/2006||Yes|No||||No|No|||Prescription required|No|||No|16.91088|01/04/2022|16.66929|01/04/2022|15.87552|01/04/2022||||15421|||||No|No||HOSPIRA/PFIZER|No||||
mitoxantrone HCl|No|No|No|No|75%|61703034366|MITOXANTRONE 30 MG/15 ML VIAL|15|ML|7.42008|04/25/2006||Yes|No||04/25/2006||Yes|No|04/25/2006||Yes|No||||No|No|||Prescription required|No|||No|16.91088|01/04/2022|16.66929|01/04/2022|15.87552|01/04/2022||||15422|||||No|No||HOSPIRA/PFIZER|No||||
irinotecan HCl|No|No|No|No|75%|61703034909|IRINOTECAN HCL 100 MG/5 ML VL|5|ML|1.88942|06/14/2019||Yes|No||06/14/2019||Yes|No|06/14/2019||Yes|No||||No|No|||Prescription required|No|||No|4.30612|01/04/2022|4.2446|01/04/2022|4.04248|01/04/2022||||15423|||||No|No||HOSPIRA/PFIZER|No||||
methotrexate sodium|No|No|No|No|75%|61703035038|METHOTREXATE 50 MG/2 ML VIAL|2|ML|1.56262|09/12/2005||Yes|No||09/12/2005||Yes|No|09/12/2005||Yes|No||||No|No|||Prescription required|No|||No|3.28658|03/29/2022|3.2077|03/29/2022|3.22906|03/29/2022||||15424|||||No|No||HOSPIRA/PFIZER|No||||
methotrexate sodium/PF|No|No|No|No|75%|61703040841|METHOTREXATE 1 GRAM/40 ML VIAL|40|ML|.39484|05/04/2012||Yes|No||05/04/2012||Yes|No|05/04/2012||Yes|No||||No|No|||Prescription required|No|||No|.89988|01/04/2022|.88702|01/04/2022|.84479|01/04/2022||||15425|||||No|No||HOSPIRA/PFIZER|No||||
pyrazinamide|No|No|No|No|75%|61748001201|PYRAZINAMIDE 500 MG TABLET|100|EA|2.11732|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|4.82552|06/26/2018|4.75658|06/26/2018|4.53008|06/26/2018||||15426|||||No|No||VERSAPHARM/AKOR|No||||
pyrazinamide|No|No|No|No|75%|61748001205|PYRAZINAMIDE 500 MG TABLET|500|EA|2.09244|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|4.76883|06/26/2018|4.70071|06/26/2018|4.47686|06/26/2018||||15427|||||No|No||VERSAPHARM/AKOR|No||||
pyrazinamide|No|No|No|No|75%|61748001206|PYRAZINAMIDE 500 MG TABLET|60|EA|2.17221|05/22/2008||Yes|No||05/22/2008||Yes|No|05/22/2008||Yes|No||||No|No|||Prescription required|No|||No|4.95062|06/26/2018|4.8799|06/26/2018|4.64752|06/26/2018||||15428|||||No|No||VERSAPHARM/AKOR|No||||
pyrazinamide|No|No|No|No|75%|61748001209|PYRAZINAMIDE 500 MG TABLET|90|EA|2.15903|01/27/2003||Yes|No||01/27/2003||Yes|No|01/27/2003||Yes|No||||No|No|||Prescription required|No|||No|4.92058|06/26/2018|4.85028|06/26/2018|4.61932|06/26/2018||||15429|||||No|No||VERSAPHARM/AKOR|No||||
pyrazinamide|No|No|No|No|75%|61748001211|PYRAZINAMIDE 500 MG TABLET|100|EA|2.23432|05/22/2008||Yes|No||05/22/2008||Yes|No|05/22/2008||Yes|No||||No|No|||Prescription required|No|||No|5.09217|06/26/2018|5.01943|06/26/2018|4.78041|06/26/2018||||15430|||||No|No||VERSAPHARM/AKOR|No||||
rifampin|No|No|No|No|75%|61748001530|RIFAMPIN 150 MG CAPSULE|30|EA|.42369|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.77852|03/29/2022|.75983|03/29/2022|.76489|03/29/2022||||15431|||||No|No||VERSAPHARM/AKOR|No||||
rifampin|No|No|No|No|75%|61748001801|RIFAMPIN 300 MG CAPSULE|100|EA|.54063|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.95898|03/29/2022|.93596|03/29/2022|.94219|03/29/2022||||15432|||||No|No||VERSAPHARM/AKOR|No||||
rifampin|No|No|No|No|75%|61748001830|RIFAMPIN 300 MG CAPSULE|30|EA|.54223|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.95898|03/29/2022|.93596|03/29/2022|.94219|03/29/2022||||15433|||||No|No||VERSAPHARM/AKOR|No||||
rifampin|No|No|No|No|75%|61748001860|RIFAMPIN 300 MG CAPSULE|60|EA|.54043|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.95898|03/29/2022|.93596|03/29/2022|.94219|03/29/2022||||15434|||||No|No||VERSAPHARM/AKOR|No||||
ethosuximide|No|No|No|No|75%|61748002416|ETHOSUXIMIDE 250 MG/5 ML SOLN|473|ML|.17067|05/22/2008|10/19/2022|Yes|No||05/22/2008|10/19/2022|Yes|No|05/22/2008|10/19/2022|Yes|No||||No|No|||Prescription required|No||056|No|.15831|03/01/2022|.15451|03/01/2022|.15553|03/01/2022|||ANTICONVULSANTS|15435|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||VERSAPHARM/AKOR|No||||
ethosuximide|No|No|No|No|75%|61748002501|ETHOSUXIMIDE 250 MG CAPSULE|100|EA|.76737|06/15/2011||Yes|No||06/15/2011||Yes|No|06/15/2011||Yes|No||||No|No|||Prescription required|No||056|No|.61011|03/29/2022|.59546|03/29/2022|.59943|03/29/2022|||ANTICONVULSANTS|15436|||||No|No||VERSAPHARM/AKOR|No||||
trihexyphenidyl HCl|No|No|No|No|75%|61748005416|TRIHEXYPHENIDYL 2 MG/5 ML SOLN|473|ML|.03635|05/22/2008||Yes|No||05/22/2008||Yes|No|05/22/2008||Yes|No||||No|No|||Prescription required|No||015|No|.08284|08/24/2021|.08166|08/24/2021|.07777|08/24/2021|||ANTIPARKINSON'S AGENTS|15437|||||No|No||VERSAPHARM/AKOR|No||||
triamcinolone acetonide|No|No|No|No|75%|61748021810|TRIAMCINOLONE 0.147 MG/G SPRAY|100|GM|1.32504|11/06/2019||Yes|No||11/06/2019||Yes|No|11/06/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|120|No|3.01987|11/06/2019|2.97672|11/06/2019|2.83498|11/06/2019|||STEROIDS: TOPICAL HIGH|15438|||||No|No||VERSAPHARM/AKOR|No||||
triamcinolone acetonide|No|No|No|No|75%|61748021863|TRIAMCINOLONE 0.147 MG/G SPRAY|63|GM|1.32501|11/06/2019||Yes|No||11/06/2019||Yes|No|11/06/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|120|No|3.01979|05/25/2021|2.97665|05/25/2021|2.8349|05/25/2021|||STEROIDS: TOPICAL HIGH|15439|||||No|No||VERSAPHARM/AKOR|No||||
isotretinoin|No|No|No|No|75%|61748030113|MYORISAN 10 MG CAPSULE|30|EA|3.0745|09/25/2012||Yes|No||09/25/2012||Yes|No|09/25/2012||Yes|No||||No|No|||Prescription required|No||144|No|2.44307|03/29/2022|2.38443|03/29/2022|2.40031|03/29/2022|||ACNE AGENTS: ORAL|15440|||||No|No||VERSAPHARM/AKOR|No||||
isotretinoin|No|No|No|No|75%|61748030211|MYORISAN 20 MG CAPSULE|100|EA|3.56255|09/25/2012||Yes|No||09/25/2012||Yes|No|09/25/2012||Yes|No||||No|No|||Prescription required|No||144|No|2.5524|03/29/2022|2.49114|03/29/2022|2.50773|03/29/2022|||ACNE AGENTS: ORAL|15441|||||No|No||VERSAPHARM/AKOR|No||||
isotretinoin|No|No|No|No|75%|61748030213|MYORISAN 20 MG CAPSULE|30|EA|3.64783|09/25/2012||Yes|No||09/25/2012||Yes|No|09/25/2012||Yes|No||||No|No|||Prescription required|No||144|No|2.5524|03/29/2022|2.49114|03/29/2022|2.50773|03/29/2022|||ACNE AGENTS: ORAL|15442|||||No|No||VERSAPHARM/AKOR|No||||
isotretinoin|No|No|No|No|75%|61748030313|MYORISAN 30 MG CAPSULE|30|EA|4.24266|10/03/2016||Yes|No||10/03/2016||Yes|No|10/03/2016||Yes|No||||No|No|||Prescription required|No||144|No|3.30978|03/29/2022|3.23034|03/29/2022|3.25185|03/29/2022|||ACNE AGENTS: ORAL|15443|||||No|No||VERSAPHARM/AKOR|No||||
isotretinoin|No|No|No|No|75%|61748030411|MYORISAN 40 MG CAPSULE|100|EA|4.13015|09/25/2012||Yes|No||09/25/2012||Yes|No|09/25/2012||Yes|No||||No|No|||Prescription required|No||144|No|3.38467|03/29/2022|3.30343|03/29/2022|3.32543|03/29/2022|||ACNE AGENTS: ORAL|15444|||||No|No||VERSAPHARM/AKOR|No||||
isotretinoin|No|No|No|No|75%|61748030413|MYORISAN 40 MG CAPSULE|30|EA|4.24266|09/25/2012||Yes|No||09/25/2012||Yes|No|09/25/2012||Yes|No||||No|No|||Prescription required|No||144|No|3.38467|03/29/2022|3.30343|03/29/2022|3.32543|03/29/2022|||ACNE AGENTS: ORAL|15445|||||No|No||VERSAPHARM/AKOR|No||||
desonide|No|No|No|No|75%|61748047015|DESONIDE 0.05% OINTMENT|15|GM|.82703|11/06/2019||Yes|No||11/06/2019||Yes|No|11/06/2019||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|118|No|.83836|03/29/2022|.81823|03/29/2022|.82368|03/29/2022|||STEROIDS: TOPICAL LOW|15446|||||No|No||AKORN INC.|No||||
desonide|No|No|No|No|75%|61748047060|DESONIDE 0.05% OINTMENT|60|GM|.82695|11/06/2019||Yes|No||11/06/2019||Yes|No|11/06/2019||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|118|No|.63751|03/29/2022|.6222|03/29/2022|.62635|03/29/2022|||STEROIDS: TOPICAL LOW|15447|||||No|No||AKORN INC.|No||||
betamethasone dipropionate|No|No|No|No|75%|61748047560|BETAMETHASONE DP 0.05% LOT|60|ML|.19772|11/06/2019||Yes|No||11/06/2019||Yes|No|11/06/2019||Yes|No||||No|No|||Prescription required|No||120|No|.41157|03/29/2022|.40169|03/29/2022|.40436|03/29/2022|||STEROIDS: TOPICAL HIGH|15448|||||No|No||VERSAPHARM/AKOR|No||||
alirocumab|No|No|No|No|75%|61755002002|PRALUENT 75 MG/ML PEN|1|ML|99.6525|06/10/2021||Yes|No||06/10/2021||Yes|No|06/10/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|055|Yes|224.37321|12/21/2021|218.98825|12/21/2021|220.44667|12/21/2021|||LIPOTROPICS: OTHER|15449|||||No|No||REGENERON PHARM|No||||
alirocumab|No|No|No|No|75%|61755002102|PRALUENT 150 MG/ML PEN|1|ML|99.6525|06/10/2021||Yes|No||06/10/2021||Yes|No|06/10/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|055|Yes|224.55614|01/25/2022|219.16679|01/25/2022|220.6264|01/25/2022|||LIPOTROPICS: OTHER|15450|||||No|No||REGENERON PHARM|No||||
eluxadoline|No|No|No|No|75%|61874007560|VIBERZI 75 MG TABLET|60|EA|10.40901|04/01/2016||Yes|No||04/01/2016||Yes|No|04/01/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|534|Yes|23.07861|02/08/2022|22.52472|02/08/2022|22.67473|02/08/2022|||GI MOTILITY: CHRONIC|15451|||||No|No||ALLERGAN INC.|No||||
eluxadoline|No|No|No|No|75%|61874010060|VIBERZI 100 MG TABLET|60|EA|10.40901|04/01/2016||Yes|No||04/01/2016||Yes|No|04/01/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|534|Yes|23.26408|02/08/2022|22.70574|02/08/2022|22.85695|02/08/2022|||GI MOTILITY: CHRONIC|15452|||||No|No||ALLERGAN INC.|No||||
cariprazine HCl|No|No|No|No|75%|61874011520|VRAYLAR 1.5 MG CAPSULE|20|EA|18.80626|05/15/2017||Yes|No||05/15/2017||Yes|No|05/15/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|41.97812|02/08/2022|40.97064|02/08/2022|41.2435|02/08/2022|||ANTIPSYCHOTICS|15453|||||No|No||ALLERGAN INC.|No||||
cariprazine HCl|No|No|No|No|75%|61874011530|VRAYLAR 1.5 MG CAPSULE|30|EA|18.80633|08/03/2016||Yes|No||08/03/2016||Yes|No|08/03/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|41.97812|02/08/2022|40.97064|02/08/2022|41.2435|02/08/2022|||ANTIPSYCHOTICS|15454|||||No|No||ALLERGAN INC.|No||||
cariprazine HCl|No|No|No|No|75%|61874013020|VRAYLAR 3 MG CAPSULE|20|EA|18.80626|05/15/2017||Yes|No||05/15/2017||Yes|No|05/15/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|41.94081|02/08/2022|40.93423|02/08/2022|41.20684|02/08/2022|||ANTIPSYCHOTICS|15455|||||No|No||ALLERGAN INC.|No||||
cariprazine HCl|No|No|No|No|75%|61874013030|VRAYLAR 3 MG CAPSULE|30|EA|18.80633|08/03/2016||Yes|No||08/03/2016||Yes|No|08/03/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|41.94081|02/08/2022|40.93423|02/08/2022|41.20684|02/08/2022|||ANTIPSYCHOTICS|15456|||||No|No||ALLERGAN INC.|No||||
cariprazine HCl|No|No|No|No|75%|61874014530|VRAYLAR 4.5 MG CAPSULE|30|EA|18.80633|08/03/2016||Yes|No||08/03/2016||Yes|No|08/03/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|41.93085|02/08/2022|40.9245|02/08/2022|41.19706|02/08/2022|||ANTIPSYCHOTICS|15457|||||No|No||ALLERGAN INC.|No||||
cariprazine HCl|No|No|No|No|75%|61874016030|VRAYLAR 6 MG CAPSULE|30|EA|18.80633|08/03/2016||Yes|No||08/03/2016||Yes|No|08/03/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|41.87017|02/08/2022|40.86528|02/08/2022|41.13744|02/08/2022|||ANTIPSYCHOTICS|15458|||||No|No||ALLERGAN INC.|No||||
cariprazine HCl|No|No|No|No|75%|61874017008|VRAYLAR 1.5 MG-3 MG PACK|7|EA|18.80574|08/03/2016||Yes|No||08/03/2016||Yes|No|08/03/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|42.85959|02/01/2022|42.24731|02/01/2022|40.23553|02/01/2022|||ANTIPSYCHOTICS|15459|||||No|No||ALLERGAN INC.|No||||
imm glob G (IgG)/sorb/IgA 0-50|No|No|No|No|75%|61953000401|FLEBOGAMMA DIF 5% VIAL|10|ML|2.27642|05/07/2007|02/22/2022|Yes|No||05/07/2007|02/22/2022|Yes|No|05/07/2007|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|5.18812|02/01/2022|5.114|02/01/2022|4.87048|02/01/2022|||IMMUNE GLOBULINS|15460|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||GRIFOLS|No||||
imm glob G (IgG)/sorb/IgA 0-50|No|No|No|No|75%|61953000402|FLEBOGAMMA DIF 5% VIAL|50|ML|2.27642|05/07/2007||Yes|No||05/07/2007||Yes|No|05/07/2007||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|5.18812|02/01/2022|5.114|02/01/2022|4.87048|02/01/2022|||IMMUNE GLOBULINS|15461|||||No|No||GRIFOLS|No||||
imm glob G (IgG)/sorb/IgA 0-50|No|No|No|No|75%|61953000403|FLEBOGAMMA DIF 5% VIAL|100|ML|2.27642|05/07/2007||Yes|No||05/07/2007||Yes|No|05/07/2007||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|5.18812|02/01/2022|5.114|02/01/2022|4.87048|02/01/2022|||IMMUNE GLOBULINS|15462|||||No|No||GRIFOLS|No||||
imm glob G (IgG)/sorb/IgA 0-50|No|No|No|No|75%|61953000404|FLEBOGAMMA DIF 5% VIAL|200|ML|2.27642|05/07/2007||Yes|No||05/07/2007||Yes|No|05/07/2007||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|5.18812|02/01/2022|5.114|02/01/2022|4.87048|02/01/2022|||IMMUNE GLOBULINS|15463|||||No|No||GRIFOLS|No||||
imm glob G (IgG)/sorb/IgA 0-50|No|No|No|No|75%|61953000405|FLEBOGAMMA DIF 5% VIAL|400|ML|2.27642|08/14/2007||Yes|No||08/14/2007||Yes|No|08/14/2007||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|5.18812|02/01/2022|5.114|02/01/2022|4.87048|02/01/2022|||IMMUNE GLOBULINS|15464|Not Specified|Not Specified|Not Specified||No|No||GRIFOLS|No||||
imm glob G (IgG)/sorb/IgA 0-50|No|No|No|No|75%|61953000501|FLEBOGAMMA DIF 10% VIAL|50|ML|4.55284|11/21/2014||Yes|No||11/21/2014||Yes|No|11/21/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|10.37624|02/01/2022|10.228|02/01/2022|9.74096|02/01/2022|||IMMUNE GLOBULINS|15465|||||No|No||GRIFOLS|No||||
imm glob G (IgG)/sorb/IgA 0-50|No|No|No|No|75%|61953000502|FLEBOGAMMA DIF 10% VIAL|100|ML|4.55284|11/21/2014||Yes|No||11/21/2014||Yes|No|11/21/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|10.37624|02/01/2022|10.228|02/01/2022|9.74096|02/01/2022|||IMMUNE GLOBULINS|15466|||||No|No||GRIFOLS|No||||
imm glob G (IgG)/sorb/IgA 0-50|No|No|No|No|75%|61953000503|FLEBOGAMMA DIF 10% VIAL|200|ML|4.55284|11/21/2014||Yes|No||11/21/2014||Yes|No|11/21/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|10.37624|02/01/2022|10.228|02/01/2022|9.74096|02/01/2022|||IMMUNE GLOBULINS|15467|||||No|No||GRIFOLS|No||||
tenofovir disoproxil fumarate|No|No|No|No|75%|61958040101|VIREAD 300 MG TABLET|30|EA|25.06999|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|40.55067|03/01/2022|39.57745|03/01/2022|39.84103|03/01/2022|||HIV / AIDS|15468|||||No|No||GILEAD SCIENCES|No||||
tenofovir disoproxil fumarate|No|No|No|No|75%|61958040301|VIREAD POWDER|60|GM|6.83479|02/14/2012||Yes|No||02/14/2012||Yes|No|02/14/2012||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|11.1635|01/14/2020|11.00402|01/14/2020|10.48002|01/14/2020|||HIV / AIDS|15469|||||No|No||GILEAD SCIENCES|No||||
tenofovir disoproxil fumarate|No|No|No|No|75%|61958040401|VIREAD 150 MG TABLET|30|EA|23.23419|02/12/2012||Yes|No||02/12/2012||Yes|No|02/12/2012||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|37.94918|01/14/2020|37.40705|01/14/2020|35.62576|01/14/2020|||HIV / AIDS|15470|||||No|No||GILEAD SCIENCES|No||||
tenofovir disoproxil fumarate|No|No|No|No|75%|61958040501|VIREAD 200 MG TABLET|30|EA|23.23419|02/14/2012||Yes|No||02/14/2012||Yes|No|02/14/2012||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|37.94918|01/14/2020|37.40705|01/14/2020|35.62576|01/14/2020|||HIV / AIDS|15471|||||No|No||GILEAD SCIENCES|No||||
tenofovir disoproxil fumarate|No|No|No|No|75%|61958040601|VIREAD 250 MG TABLET|30|EA|23.23419|12/16/2016||Yes|No||12/16/2016||Yes|No|12/16/2016||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|37.94918|01/14/2020|37.40705|01/14/2020|35.62576|01/14/2020|||HIV / AIDS|15472|||||No|No||GILEAD SCIENCES|No||||
adefovir dipivoxil|No|No|No|No|75%|61958050101|HEPSERA 10 MG TABLET|30|EA|23.3672|10/16/2002||Yes|No||10/16/2002||Yes|No|10/16/2002||Yes|No||||No|No|||Prescription required|No|||No|53.25548|01/12/2021|52.49469|01/12/2021|49.99494|01/12/2021||||15473|||||No|No||GILEAD SCIENCES|No||||
emtricitabine|No|No|No|No|75%|61958060101|EMTRIVA 200 MG CAPSULE|30|EA|10.7304|07/10/2003||Yes|No||07/10/2003||Yes|No|07/10/2003||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|17.52632|03/29/2022|17.27594|03/29/2022|16.45328|03/29/2022|||HIV / AIDS|15474|||||No|No||GILEAD SCIENCES|No||||
emtricitabine/tenofovir (TDF)|No|No|No|No|75%|61958070101|TRUVADA 200 MG-300 MG TABLET|30|EA|36.84559|08/13/2004||Yes|No||08/13/2004||Yes|No|08/13/2004||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|59.66936|08/24/2021|58.23729|08/24/2021|58.62514|08/24/2021|||HIV / AIDS|15475|||||No|No||GILEAD SCIENCES|No||||
emtricitabine/tenofovir (TDF)|No|No|No|No|75%|61958070301|TRUVADA 100 MG-150 MG TABLET|30|EA|36.84559|07/12/2016||Yes|No||07/12/2016||Yes|No|07/12/2016||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|60.18114|01/14/2020|59.32141|01/14/2020|56.49658|01/14/2020|||HIV / AIDS|15476|||||No|No||GILEAD SCIENCES|No||||
emtricitabine/tenofovir (TDF)|No|No|No|No|75%|61958070401|TRUVADA 133 MG-200 MG TABLET|30|EA|36.84559|07/12/2016||Yes|No||07/12/2016||Yes|No|07/12/2016||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|60.18114|01/14/2020|59.32141|01/14/2020|56.49658|01/14/2020|||HIV / AIDS|15477|||||No|No||GILEAD SCIENCES|No||||
emtricitabine/tenofovir (TDF)|No|No|No|No|75%|61958070501|TRUVADA 167 MG-250 MG TABLET|30|EA|36.84559|07/12/2016||Yes|No||07/12/2016||Yes|No|07/12/2016||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|60.18114|01/14/2020|59.32141|01/14/2020|56.49658|01/14/2020|||HIV / AIDS|15478|||||No|No||GILEAD SCIENCES|No||||
ambrisentan|No|No|No|No|75%|61958080101|LETAIRIS 5 MG TABLET|30|EA|161.38674|11/06/2013||Yes|No||11/06/2013||Yes|No|11/06/2013||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/30/2020|171|No|367.81164|01/11/2022|362.55718|01/11/2022|345.29256|01/11/2022|||PAH AGENTS: ORAL AND INHALED|15479|||||No|No||GILEAD SCIENCES|No||||
ambrisentan|No|No|No|No|75%|61958080105|LETAIRIS 5 MG TABLET|10|EA|161.38588|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/30/2020|171|No|367.80968|01/11/2022|362.55525|01/11/2022|345.29072|01/11/2022|||PAH AGENTS: ORAL AND INHALED|15480|||||No|No||GILEAD SCIENCES|No||||
ambrisentan|No|No|No|No|75%|61958080201|LETAIRIS 10 MG TABLET|30|EA|161.38674|10/30/2013||Yes|No||10/30/2013||Yes|No|10/30/2013||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/30/2020|171|No|367.81164|01/11/2022|362.55718|01/11/2022|345.29256|01/11/2022|||PAH AGENTS: ORAL AND INHALED|15481|||||No|No||GILEAD SCIENCES|No||||
ambrisentan|No|No|No|No|75%|61958080205|LETAIRIS 10 MG TABLET|10|EA|161.38588|12/16/2015||Yes|No||12/16/2015||Yes|No|12/16/2015||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/30/2020|171|No|367.80968|01/11/2022|362.55525|01/11/2022|345.29072|01/11/2022|||PAH AGENTS: ORAL AND INHALED|15482|||||No|No||GILEAD SCIENCES|No||||
aztreonam lysine|No|No|No|No|75%|61958090101|CAYSTON 75 MG INHAL SOLUTION|1|ML|53.21024|03/04/2010||Yes|No||03/04/2010||Yes|No|03/04/2010||Yes|No||||No|No|||Prescription required|No||240|No|121.26986|01/11/2022|119.53743|01/11/2022|113.84517|01/11/2022|||ANTIBIOTICS: INHALED|15483|||||No|No||GILEAD SCIENCES|No||||
ranolazine|No|No|No|No|75%|61958100301|RANEXA ER 500 MG TABLET|60|EA|2.94657|05/07/2012||Yes|No||05/07/2012||Yes|No|05/07/2012||Yes|No||||No|No|||Prescription required|No|||Yes|6.57411|10/26/2021|6.41633|10/26/2021|6.45906|10/26/2021||||15484|||||No|No||GILEAD SCIENCES|No||||
ranolazine|No|No|No|No|75%|61958100401|RANEXA ER 1,000 MG TABLET|60|EA|4.83764|05/07/2012||Yes|No||05/07/2012||Yes|No|05/07/2012||Yes|No||||No|No|||Prescription required|No|||Yes|11.02532|01/25/2022|10.86781|01/25/2022|10.3503|01/25/2022||||15485|||||No|No||GILEAD SCIENCES|No||||
emtricita/rilpivirine/tenof DF|No|No|No|No|75%|61958110101|COMPLERA TABLET|30|EA|65.23059|08/16/2011||Yes|No||08/16/2011||Yes|No|08/16/2011||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|105.48335|01/18/2022|102.95174|01/18/2022|103.63739|01/18/2022|||HIV / AIDS|15486|||||No|No||GILEAD SCIENCES|No||||
elviteg/cob/emtri/tenofo disop|No|No|No|No|75%|61958120101|STRIBILD TABLET|30|EA|75.18819|09/13/2012||Yes|No||09/13/2012||Yes|No|09/13/2012||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|121.34853|01/18/2022|118.43616|01/18/2022|119.22493|01/18/2022|||HIV / AIDS|15487|||||No|No||GILEAD SCIENCES|No||||
cobicistat|No|No|No|No|75%|61958140101|TYBOST 150 MG TABLET|30|EA|5.35039|11/03/2014||Yes|No||11/03/2014||Yes|No|11/03/2014||Yes|No||||No|No|||Prescription required|No||237|No|8.73898|01/11/2022|8.61414|01/11/2022|8.20394|01/11/2022|||HIV / AIDS|15488|||||No|No||GILEAD SCIENCES|No||||
sofosbuvir|No|No|No|No|75%|61958150101|SOVALDI 400 MG TABLET|28|EA|430|01/20/2015||Yes|No||||No|No|09/01/2021||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|064|Yes|980|12/10/2019|966|12/10/2019|920|12/10/2019|||HEPATITIS C AGENTS|15489|||||No|No||GILEAD SCIENCES|No||||
idelalisib|No|No|No|No|75%|61958170101|ZYDELIG 100 MG TABLET|60|EA|89.08044|07/25/2014||Yes|No||07/25/2014||Yes|No|07/25/2014||Yes|No||||No|No|||Prescription required|No||173|No|203.02055|01/11/2022|200.12025|01/11/2022|190.59072|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|15490|||||No|No||GILEAD SCIENCES|No||||
idelalisib|No|No|No|No|75%|61958170201|ZYDELIG 150 MG TABLET|60|EA|89.08044|07/25/2014||Yes|No||07/25/2014||Yes|No|07/25/2014||Yes|No||||No|No|||Prescription required|No||173|No|203.02055|01/11/2022|200.12025|01/11/2022|190.59072|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|15491|||||No|No||GILEAD SCIENCES|No||||
ledipasvir/sofosbuvir|No|No|No|No|75%|61958180101|HARVONI 90-400 MG TABLET|28|EA|483.75|04/06/2015||Yes|No||||No|No|09/01/2021||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|064|Yes|1102.5|12/10/2019|1086.75|12/10/2019|1035|12/10/2019|||HEPATITIS C AGENTS|15492|||||No|No||GILEAD SCIENCES|No||||
elviteg/cob/emtri/tenof alafen|No|No|No|No|75%|61958190101|GENVOYA TABLET|30|EA|71.676|12/04/2015||Yes|No||12/04/2015||Yes|No|12/04/2015||Yes|No||||No|No|||Prescription required|No||237|No|116.21886|01/18/2022|113.4296|01/18/2022|114.18502|01/18/2022|||HIV / AIDS|15493|||||No|No||GILEAD SCIENCES|No||||
emtricitabine/tenofov alafenam|No|No|No|No|75%|61958200201|DESCOVY 200-25 MG TABLET|30|EA|40.7766|08/18/2016||Yes|No||08/18/2016||Yes|No|08/18/2016||Yes|No||||No|No|||Prescription required|No||237|No|66.12604|01/18/2022|64.53901|01/18/2022|64.96883|01/18/2022|||HIV / AIDS|15494|||||No|No||GILEAD SCIENCES|No||||
emtricitab/rilpiviri/tenof ala|No|No|No|No|75%|61958210101|ODEFSEY TABLET|30|EA|65.23059|08/18/2016||Yes|No||08/18/2016||Yes|No|08/18/2016||Yes|No||||No|No|||Prescription required|No||237|No|105.78246|01/18/2022|103.24368|01/18/2022|103.93126|01/18/2022|||HIV / AIDS|15495|||||No|No||GILEAD SCIENCES|No||||
sofosbuvir/velpatasvir|No|No|No|No|75%|61958220101|EPCLUSA 400 MG-100 MG TABLET|28|EA|382.7|01/11/2017||Yes|No||||No|No|09/01/2021||Yes|No||||No|No|||Prescription required|No||064|Yes|872.2|05/25/2021|859.74|05/25/2021|818.8|05/25/2021|||HEPATITIS C AGENTS|15496|||||No|No||GILEAD SCIENCES|No||||
sofosbuvir/velpatasvir|No|No|No|No|75%|61958220301|EPCLUSA 200 MG-50 MG TABLET|28|EA|382.7|07/07/2021||Yes|No||||No|No|09/01/2021||Yes|No||||No|No|||Prescription required|No||064|Yes|872.2|07/13/2021|859.74|07/07/2021|818.8|07/07/2021|||HEPATITIS C AGENTS|15497|||||No|No||GILEAD SCIENCES|No||||
tenofovir alafenamide|No|No|No|No|75%|61958230101|VEMLIDY 25 MG TABLET|30|EA|18.60022|02/24/2017||Yes|No||02/24/2017||Yes|No|02/24/2017||Yes|No||||No|No|||Prescription required|No|||No|41.77955|01/18/2022|40.77684|01/18/2022|41.0484|01/18/2022||||15498|||||No|No||GILEAD SCIENCES|No||||
sofosbuvir/velpatas/voxilaprev|No|No|No|No|75%|61958240101|VOSEVI 400-100-100 MG TABLET|28|EA|382.7|02/01/2018||Yes|No||||No|No|09/01/2021||Yes|No||||No|No|||Prescription required|No||064|Yes|872.2|01/30/2018|859.74|01/23/2018|818.8|01/23/2018|||HEPATITIS C AGENTS|15499|||||No|No||GILEAD SCIENCES|No||||
bictegrav/emtricit/tenofov ala|No|No|No|No|75%|61958250101|BIKTARVY 50-200-25 MG TABLET|30|EA|71.676|05/16/2018||Yes|No||05/16/2018||Yes|No|05/16/2018||Yes|No||||No|No|||Prescription required|No||237|No|115.62523|01/18/2022|112.85022|01/18/2022|113.60178|01/18/2022|||HIV / AIDS|15500|||||No|No||GILEAD SCIENCES|No||||
piperacillin sodium/tazobactam|No|No|No|No|75%|61990011002|PIPERACIL-TAZOBACT 2.25 GM VL|1|EA|2.365|01/25/2021||Yes|No||01/25/2021||Yes|No|01/25/2021||Yes|No||||No|No|||Prescription required|No|||No|5.39|01/25/2021|5.313|01/25/2021|5.06|01/25/2021||||15501|||||No|No||APOLLO/PROVEPHA|No||||
piperacillin sodium/tazobactam|No|No|No|No|75%|61990012002|PIPERACIL-TAZOBACT 3.375 GM VL|1|EA|2.451|01/25/2021||Yes|No||01/25/2021||Yes|No|01/25/2021||Yes|No||||No|No|||Prescription required|No|||No|5.586|01/25/2021|5.5062|01/25/2021|5.244|01/25/2021||||15502|||||No|No||APOLLO/PROVEPHA|No||||
piperacillin sodium/tazobactam|No|No|No|No|75%|61990013002|PIPERACIL-TAZOBACT 4.5 GM VIAL|1|EA|3.268|01/25/2021||Yes|No||01/25/2021||Yes|No|01/25/2021||Yes|No||||No|No|||Prescription required|No|||No|7.448|02/02/2021|7.3416|01/25/2021|6.992|01/25/2021||||15503|||||No|No||APOLLO/PROVEPHA|No||||
piperacillin sodium/tazobactam|No|No|No|No|75%|61990015001|PIPERACIL-TAZOBACT 40.5 GRAM|1|EA|31.347|01/25/2021||Yes|No||01/25/2021||Yes|No|01/25/2021||Yes|No||||No|No|||Prescription required|No|||No|71.442|01/25/2021|70.4214|01/25/2021|67.068|01/25/2021||||15504|||||No|No||APOLLO/PROVEPHA|No||||
dihydroergotamine mesylate|No|No|No|No|75%|61990041101|DIHYDROERGOTAMINE 1 MG/ML AMP|1|ML|36.2103|01/25/2021||Yes|No||01/25/2021||Yes|No|01/25/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|537|No|82.5258|02/02/2021|81.34686|02/02/2021|77.4732|02/02/2021|||ANTIMIGRAINE AGENTS: OTHER|15505|||||No|No||APOLLO/PROVEPHA|No||||
dihydroergotamine mesylate|No|No|No|No|75%|61990041102|DIHYDROERGOTAMINE 1 MG/ML AMP|1|ML|32.58927|01/25/2021||Yes|No||01/25/2021||Yes|No|01/25/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|537|No|74.27322|01/25/2021|73.21217|01/25/2021|69.72588|01/25/2021|||ANTIMIGRAINE AGENTS: OTHER|15506|||||No|No||APOLLO/PROVEPHA|No||||
potassium chloride|No|No|No|No|75%|62037055901|POTASSIUM CL ER 8 MEQ CAPSULE|100|EA|.21014|02/18/2009||Yes|No||02/18/2009||Yes|No|02/18/2009||Yes|No||02/18/2009||Yes|No|||Prescription required|No|||No|.14299|03/29/2022|.13955|03/29/2022|.14048|03/29/2022||||15507|||||No|No||ACTAVIS/TEVA|No||||
potassium chloride|No|No|No|No|75%|62037055905|POTASSIUM CL ER 8 MEQ CAPSULE|500|EA|.19962|02/18/2009||Yes|No||02/18/2009||Yes|No|02/18/2009||Yes|No||02/18/2009||Yes|No|||Prescription required|No|||No|.14299|03/29/2022|.13955|03/29/2022|.14048|03/29/2022||||15508|||||No|No||ACTAVIS/TEVA|No||||
potassium chloride|No|No|No|No|75%|62037056001|POTASSIUM CL ER 10 MEQ CAPSULE|100|EA|.25606|02/26/2009||Yes|No||02/26/2009||Yes|No|02/26/2009||Yes|No||02/26/2009||Yes|No|||Prescription required|No|||No|.15494|03/29/2022|.15122|03/29/2022|.15222|03/29/2022||||15509|||||No|No||ACTAVIS/TEVA|No||||
potassium chloride|No|No|No|No|75%|62037056005|POTASSIUM CL ER 10 MEQ CAPSULE|500|EA|.24325|02/26/2009||Yes|No||02/26/2009||Yes|No|02/26/2009||Yes|No||02/26/2009||Yes|No|||Prescription required|No|||No|.15494|03/29/2022|.15122|03/29/2022|.15222|03/29/2022||||15510|||||No|No||ACTAVIS/TEVA|No||||
potassium chloride|No|No|No|No|75%|62037056010|POTASSIUM CL ER 10 MEQ CAPSULE|1000|EA|.24325|04/05/2011||Yes|No||04/05/2011||Yes|No|04/05/2011||Yes|No||04/05/2011||Yes|No|||Prescription required|No|||No|.15494|03/29/2022|.15122|03/29/2022|.15222|03/29/2022||||15511|||||No|No||ACTAVIS/TEVA|No||||
potassium chloride|No|No|No|No|75%|62037056090|POTASSIUM CL ER 10 MEQ CAPSULE|90|EA|.25608|04/05/2011||Yes|No||04/05/2011||Yes|No|04/05/2011||Yes|No||04/05/2011||Yes|No|||Prescription required|No|||No|.15494|03/29/2022|.15122|03/29/2022|.15222|03/29/2022||||15512|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|62037059705|CARTIA XT 120 MG CAPSULE|500|EA|.19986|06/09/2009||Yes|No||06/09/2009||Yes|No|06/09/2009||Yes|No||||No|No|||Prescription required|No||045|No|.17507|03/29/2022|.17086|03/29/2022|.172|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15513|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|62037059790|CARTIA XT 120 MG CAPSULE|90|EA|.19985|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||045|No|.17507|03/29/2022|.17086|03/29/2022|.172|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15514|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|62037059805|CARTIA XT 180 MG CAPSULE|500|EA|.24126|06/09/2009||Yes|No||06/09/2009||Yes|No|06/09/2009||Yes|No||||No|No|||Prescription required|No||045|No|.21189|03/29/2022|.2068|03/29/2022|.20818|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15515|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|62037059890|CARTIA XT 180 MG CAPSULE|90|EA|.24127|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||045|No|.21189|03/29/2022|.2068|03/29/2022|.20818|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15516|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|62037059905|CARTIA XT 240 MG CAPSULE|500|EA|.34225|06/09/2009||Yes|No||06/09/2009||Yes|No|06/09/2009||Yes|No||||No|No|||Prescription required|No||045|No|.29728|03/29/2022|.29014|03/29/2022|.29207|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15517|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|62037059990|CARTIA XT 240 MG CAPSULE|90|EA|.34222|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||045|No|.29728|03/29/2022|.29014|03/29/2022|.29207|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15518|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|62037060005|CARTIA XT 300 MG CAPSULE|500|EA|.44356|06/09/2009||Yes|No||06/09/2009||Yes|No|06/09/2009||Yes|No||||No|No|||Prescription required|No||045|No|.34265|03/29/2022|.33442|03/29/2022|.33665|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15519|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|62037060090|CARTIA XT 300 MG CAPSULE|90|EA|.44356|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||045|No|.34265|03/29/2022|.33442|03/29/2022|.33665|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15520|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|62037069630|TAZTIA XT 120 MG CAPSULE|30|EA|.35002|04/15/2003||Yes|No||04/15/2003||Yes|No|04/15/2003||Yes|No||04/15/2003||Yes|No|||Prescription required|No||045|No|.26247|03/29/2022|.25617|03/29/2022|.25787|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15521|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|62037069690|TAZTIA XT 120 MG CAPSULE|90|EA|.317|04/15/2003||Yes|No||04/15/2003||Yes|No|04/15/2003||Yes|No||04/15/2003||Yes|No|||Prescription required|No||045|No|.26247|03/29/2022|.25617|03/29/2022|.25787|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15522|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|62037069730|TAZTIA XT 180 MG CAPSULE|30|EA|.42269|04/15/2003||Yes|No||04/15/2003||Yes|No|04/15/2003||Yes|No||04/15/2003||Yes|No|||Prescription required|No||045|No|.32818|03/29/2022|.3203|03/29/2022|.32243|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15523|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|62037069790|TAZTIA XT 180 MG CAPSULE|90|EA|.3826|04/15/2003||Yes|No||04/15/2003||Yes|No|04/15/2003||Yes|No||04/15/2003||Yes|No|||Prescription required|No||045|No|.32818|03/29/2022|.3203|03/29/2022|.32243|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15524|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|62037069830|TAZTIA XT 240 MG CAPSULE|30|EA|.59942|04/15/2003||Yes|No||04/15/2003||Yes|No|04/15/2003||Yes|No||04/15/2003||Yes|No|||Prescription required|No||045|No|.46814|03/29/2022|.4569|03/29/2022|.45994|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15525|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|62037069890|TAZTIA XT 240 MG CAPSULE|90|EA|.54289|04/15/2003||Yes|No||04/15/2003||Yes|No|04/15/2003||Yes|No||04/15/2003||Yes|No|||Prescription required|No||045|No|.46814|03/29/2022|.4569|03/29/2022|.45994|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15526|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|62037069930|TAZTIA XT 300 MG CAPSULE|30|EA|.77686|04/15/2003||Yes|No||04/15/2003||Yes|No|04/15/2003||Yes|No||04/15/2003||Yes|No|||Prescription required|No||045|No|.70564|03/29/2022|.6887|03/29/2022|.69329|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15527|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|62037069990|TAZTIA XT 300 MG CAPSULE|90|EA|.70338|04/15/2003||Yes|No||04/15/2003||Yes|No|04/15/2003||Yes|No||04/15/2003||Yes|No|||Prescription required|No||045|No|.70564|03/29/2022|.6887|03/29/2022|.69329|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15528|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|62037070030|TAZTIA XT 360 MG CAPSULE|30|EA|.79177|04/15/2003||Yes|No||04/15/2003||Yes|No|04/15/2003||Yes|No||04/15/2003||Yes|No|||Prescription required|No||045|No|.55311|03/29/2022|.53983|03/29/2022|.54343|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15529|||||No|No||ACTAVIS/TEVA|No||||
diltiazem HCl|No|No|No|No|75%|62037070090|TAZTIA XT 360 MG CAPSULE|90|EA|.7169|04/15/2003||Yes|No||04/15/2003||Yes|No|04/15/2003||Yes|No||04/15/2003||Yes|No|||Prescription required|No||045|No|.55311|03/29/2022|.53983|03/29/2022|.54343|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15530|||||No|No||ACTAVIS/TEVA|No||||
potassium chloride|No|No|No|No|75%|62037071001|POTASSIUM CL ER 10 MEQ TABLET|100|EA|.20502|04/05/2011||Yes|No||04/05/2010||Yes|No|04/05/2011||Yes|No||||No|No|||Prescription required|No|||No|.18432|03/29/2022|.17989|03/29/2022|.18109|03/29/2022||||15531|||||No|No||ACTAVIS/TEVA|No||||
methylphenidate HCl|No|No|No|No|75%|62037072501|METHYLPHENIDATE ER 18 MG TAB|100|EA|3.34733|04/29/2019||Yes|No||04/29/2019||Yes|No|04/29/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.56499|03/29/2022|.55143|03/29/2022|.5551|03/29/2022|||STIMULANTS AND RELATED AGENTS|15532|||||No|No||ACTAVIS/TEVA|No||||
methylphenidate HCl|No|No|No|No|75%|62037072601|METHYLPHENIDATE ER 36 MG TAB|100|EA|3.53924|04/29/2019||Yes|No||04/29/2019||Yes|No|04/29/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.76999|03/29/2022|.75151|03/29/2022|.75651|03/29/2022|||STIMULANTS AND RELATED AGENTS|15533|||||No|No||ACTAVIS/TEVA|No||||
methylphenidate HCl|No|No|No|No|75%|62037072701|METHYLPHENIDATE ER 54 MG TAB|100|EA|3.85103|06/17/2019||Yes|No||06/17/2019||Yes|No|06/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.87218|03/29/2022|.85124|03/29/2022|.85691|03/29/2022|||STIMULANTS AND RELATED AGENTS|15534|||||No|No||ACTAVIS/TEVA|No||||
methylphenidate HCl|No|No|No|No|75%|62037073401|METHYLPHENIDATE ER 27 MG TAB|100|EA|3.43118|04/29/2019||Yes|No||04/29/2019||Yes|No|04/29/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.90623|03/29/2022|.88448|03/29/2022|.89037|03/29/2022|||STIMULANTS AND RELATED AGENTS|15535|||||No|No||ACTAVIS/TEVA|No||||
naproxen sodium|No|No|No|No|75%|62037082501|NAPROXEN SOD ER 375 MG TABLET|100|EA|6.20739|06/20/2016||Yes|No||06/20/2016||Yes|No|06/20/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|14.14708|06/20/2016|13.94498|06/20/2016|13.28093|06/20/2016|||NSAIDS|15536|||||No|No||ACTAVIS/TEVA|No||||
naproxen sodium|No|No|No|No|75%|62037082675|NAPROXEN SOD ER 500 MG TABLET|75|EA|6.1748|03/11/2015||Yes|No||03/11/2015||Yes|No|03/11/2015||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|14.0728|01/26/2021|13.87176|01/26/2021|13.2112|01/26/2021|||NSAIDS|15537|||||No|No||ACTAVIS/TEVA|No||||
metoprolol succinate|No|No|No|No|75%|62037083110|METOPROLOL SUCC ER 50 MG TAB|1000|EA|.30612|08/13/2009|01/31/2022|Yes|No||08/13/2009|01/31/2022|Yes|No|08/13/2009|01/31/2022|Yes|No||01/01/2012|01/31/2022|Yes|No|||Prescription required|No||070|No|.69769|02/15/2022|.68772|02/15/2022|.65497|02/15/2022|||BETA-BLOCKERS|15538|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||ACTAVIS/TEVA|No||||
potassium chloride|No|No|No|No|75%|62037099901|POTASSIUM CL ER 20 MEQ TABLET|100|EA|.21581|05/18/2006||Yes|No||05/18/2006||Yes|No|05/18/2006||Yes|No||05/18/2006||Yes|No|||Prescription required|No|||No|.19104|03/29/2022|.18645|03/29/2022|.18769|03/29/2022||||15539|||||No|No||ACTAVIS/TEVA|No||||
potassium chloride|No|No|No|No|75%|62037099905|POTASSIUM CL ER 20 MEQ TABLET|500|EA|.21582|05/18/2006||Yes|No||05/18/2006||Yes|No|05/18/2006||Yes|No||05/18/2006||Yes|No|||Prescription required|No|||No|.19104|03/29/2022|.18645|03/29/2022|.18769|03/29/2022||||15540|||||No|No||ACTAVIS/TEVA|No||||
potassium chloride|No|No|No|No|75%|62037099910|POTASSIUM CL ER 20 MEQ TABLET|1000|EA|.21582|05/18/2006||Yes|No||05/18/2006||Yes|No|05/18/2006||Yes|No||05/18/2006||Yes|No|||Prescription required|No|||No|.19104|03/29/2022|.18645|03/29/2022|.18769|03/29/2022||||15541|||||No|No||ACTAVIS/TEVA|No||||
potassium chloride|No|No|No|No|75%|62037099990|POTASSIUM CL ER 20 MEQ TABLET|90|EA|.2158|08/15/2016||Yes|No||08/15/2016||Yes|No|08/15/2016||Yes|No||08/15/2016||Yes|No|||Prescription required|No|||No|.19104|03/29/2022|.18645|03/29/2022|.18769|03/29/2022||||15542|||||No|No||ACTAVIS/TEVA|No||||
tesamorelin acetate|No|No|No|No|75%|62064024130|EGRIFTA SV 2 MG VIAL|30|EA|93.03766|03/15/2021||Yes|No||03/15/2021||Yes|No|03/15/2021||Yes|No||||No|No|||Prescription required|No|||No|212.03932|01/04/2022|209.01019|01/04/2022|199.05732|01/04/2022||||15543|||||No|No||THERATECHNOLOGI|No||||
lactulose|No|No|No|No|75%|62135000337|LACTULOSE 10 GM/15 ML SOLUTION|237|ML|.01814|09/13/2021||Yes|No||09/13/2021||Yes|No|09/13/2021||Yes|No||||No|No|||Prescription required|No|||No|.04134|09/13/2021|.04075|09/13/2021|.03881|09/13/2021||||15544|||||No|No||CHARTWELL RX LL|No||||
lactulose|No|No|No|No|75%|62135000347|LACTULOSE 10 GM/15 ML SOLUTION|473|ML|.01818|09/13/2021||Yes|No||09/13/2021||Yes|No|09/13/2021||Yes|No||||No|No|||Prescription required|No|||No|.01519|03/29/2022|.01482|03/29/2022|.01492|03/29/2022||||15545|||||No|No||CHARTWELL RX LL|No||||
lactulose|No|No|No|No|75%|62135000394|LACTULOSE 10 GM/15 ML SOLUTION|946|ML|.01818|09/13/2021||Yes|No||09/13/2021||Yes|No|09/13/2021||Yes|No||||No|No|||Prescription required|No|||No|.0141|03/29/2022|.01376|03/29/2022|.01385|03/29/2022||||15546|||||No|No||CHARTWELL RX LL|No||||
hydrocortisone|No|No|No|No|75%|62135002007|HYDROCORTISONE 100 MG/60 ML|60|ML|.35833|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No|||Yes|.81666|03/31/2022|.80499|03/31/2022|.76666|03/31/2022||||15547|||||No|No||CHARTWELL RX LL|No||||
hydrocortisone|No|No|No|No|75%|62135002021|HYDROCORTISONE 100 MG/60 ML|60|ML|.35833|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No|||Yes|.81666|03/31/2022|.80499|03/31/2022|.76666|03/31/2022||||15548|||||No|No||CHARTWELL RX LL|No||||
hydrocortisone|No|No|No|No|75%|62135002046|HYDROCORTISONE 100 MG/60 ML|60|ML|.35833|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No|||Yes|.81666|03/31/2022|.80499|03/31/2022|.76666|03/31/2022||||15549|||||No|No||CHARTWELL RX LL|No||||
benztropine mesylate|No|No|No|No|75%|62135014201|BENZTROPINE MES 2 MG TABLET|100|EA|.09662|09/02/2021||Yes|No||09/02/2021||Yes|No|09/02/2021||Yes|No||||No|No|||Prescription required|No||015|No|.12012|03/29/2022|.11723|03/29/2022|.11801|03/29/2022|||ANTIPARKINSON'S AGENTS|15550|||||No|No||CHARTWELL RX LL|No||||
benztropine mesylate|No|No|No|No|75%|62135014210|BENZTROPINE MES 2 MG TABLET|1000|EA|.09177|09/02/2021||Yes|No||09/02/2021||Yes|No|09/02/2021||Yes|No||||No|No|||Prescription required|No||015|No|.12012|03/29/2022|.11723|03/29/2022|.11801|03/29/2022|||ANTIPARKINSON'S AGENTS|15551|||||No|No||CHARTWELL RX LL|No||||
benztropine mesylate|No|No|No|No|75%|62135014401|BENZTROPINE MES 1 MG TABLET|100|EA|.06557|09/02/2021||Yes|No||09/02/2021||Yes|No|09/02/2021||Yes|No||||No|No|||Prescription required|No||015|No|.08541|03/29/2022|.08336|03/29/2022|.08391|03/29/2022|||ANTIPARKINSON'S AGENTS|15552|||||No|No||CHARTWELL RX LL|No||||
benztropine mesylate|No|No|No|No|75%|62135014410|BENZTROPINE MES 1 MG TABLET|1000|EA|.06228|09/02/2021||Yes|No||09/02/2021||Yes|No|09/02/2021||Yes|No||||No|No|||Prescription required|No||015|No|.08541|03/29/2022|.08336|03/29/2022|.08391|03/29/2022|||ANTIPARKINSON'S AGENTS|15553|||||No|No||CHARTWELL RX LL|No||||
calcium acetate|No|No|No|No|75%|62135019122|CALCIUM ACETATE 667 MG CAPSULE|200|EA|.30177|12/06/2019||Yes|No||12/06/2019||Yes|No|12/06/2019||Yes|No||06/01/2020||Yes|No|||Prescription required|No||052|Yes|.28113|03/29/2022|.27438|03/29/2022|.27621|03/29/2022|||PHOSPHATE BINDERS|15554|||||No|No||CHARTWELL RX LL|No||||
calcium acetate|No|No|No|No|75%|62135019222|CALCIUM ACETATE 667 MG TABLET|200|EA|.645|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||06/01/2020||Yes|No|||Prescription required|No||052|Yes|1.47|01/11/2022|1.449|01/11/2022|1.38|01/11/2022|||PHOSPHATE BINDERS|15555|||||No|No||CHARTWELL RX LL|No||||
methimazole|No|No|No|No|75%|62135020518|METHIMAZOLE 5 MG TABLET|180|EA|.44201|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No|||No|.07388|03/31/2022|.0721|03/31/2022|.07258|03/31/2022||||15556|||||No|No||CHARTWELL RX LL|No||||
methimazole|No|No|No|No|75%|62135020590|METHIMAZOLE 5 MG TABLET|90|EA|.44204|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No|||No|.07388|03/31/2022|.0721|03/31/2022|.07258|03/31/2022||||15557|||||No|No||CHARTWELL RX LL|No||||
methimazole|No|No|No|No|75%|62135020618|METHIMAZOLE 10 MG TABLET|180|EA|.76377|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No|||No|.10482|03/31/2022|.1023|03/31/2022|.10298|03/31/2022||||15558|||||No|No||CHARTWELL RX LL|No||||
methimazole|No|No|No|No|75%|62135020690|METHIMAZOLE 10 MG TABLET|90|EA|.76377|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No|||No|.10482|03/31/2022|.1023|03/31/2022|.10298|03/31/2022||||15559|||||No|No||CHARTWELL RX LL|No||||
folic acid|No|No|No|No|75%|62135021001|FOLIC ACID 1 MG TABLET|100|EA|.0301|01/02/2020||Yes|No||01/02/2020||Yes|No|01/02/2020||Yes|No||||No|No|||Prescription required|No|||No|.02568|03/29/2022|.02506|03/29/2022|.02523|03/29/2022||||15560|||||No|No||CHARTWELL RX LL|No||||
folic acid|No|No|No|No|75%|62135021010|FOLIC ACID 1 MG TABLET|1000|EA|.00898|01/02/2020||Yes|No||01/02/2020||Yes|No|01/02/2020||Yes|No||||No|No|||Prescription required|No|||No|.02568|03/29/2022|.02506|03/29/2022|.02523|03/29/2022||||15561|||||No|No||CHARTWELL RX LL|No||||
tetracycline HCl|No|No|No|No|75%|62135022501|TETRACYCLINE 250 MG CAPSULE|100|EA|.817|09/17/2020||Yes|No||09/17/2020||Yes|No|09/17/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|213|No|.9651|03/01/2022|.94193|03/01/2022|.94821|03/01/2022|||TETRACYCLINES|15562|||||No|No||CHARTWELL RX LL|No||||
tetracycline HCl|No|No|No|No|75%|62135022560|TETRACYCLINE 250 MG CAPSULE|60|EA|.817|09/09/2021||Yes|No||09/09/2021||Yes|No|09/09/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|213|No|.9651|03/01/2022|.94193|03/01/2022|.94821|03/01/2022|||TETRACYCLINES|15563|||||No|No||CHARTWELL RX LL|No||||
doxycycline monohydrate|No|No|No|No|75%|62135026001|DOXYCYCLINE MONO 50 MG CAP|100|EA|.387|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|213|No|.2073|03/29/2022|.20232|03/29/2022|.20367|03/29/2022|||TETRACYCLINES|15564|||||No|No||CHARTWELL RX LL|No||||
doxycycline monohydrate|No|No|No|No|75%|62135026101|DOXYCYCLINE MONO 75 MG CAPSULE|100|EA|5.375|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|213|No|12.25|01/31/2022|12.075|01/31/2022|11.5|01/31/2022|||TETRACYCLINES|15565|||||No|No||CHARTWELL RX LL|No||||
doxycycline monohydrate|No|No|No|No|75%|62135026225|DOXYCYCLINE MONO 100 MG CAP|250|EA|.6321|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|213|No|.25496|03/29/2022|.24884|03/29/2022|.25049|03/29/2022|||TETRACYCLINES|15566|||||No|No||CHARTWELL RX LL|No||||
doxycycline monohydrate|No|No|No|No|75%|62135026250|DOXYCYCLINE MONO 100 MG CAP|50|EA|.645|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|213|No|.25496|03/29/2022|.24884|03/29/2022|.25049|03/29/2022|||TETRACYCLINES|15567|||||No|No||CHARTWELL RX LL|No||||
doxycycline monohydrate|No|No|No|No|75%|62135026260|DOXYCYCLINE MONO 100 MG CAP|60|EA|.645|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|213|No|.25496|03/29/2022|.24884|03/29/2022|.25049|03/29/2022|||TETRACYCLINES|15568|||||No|No||CHARTWELL RX LL|No||||
tetracycline HCl|No|No|No|No|75%|62135026601|TETRACYCLINE 500 MG CAPSULE|100|EA|1.41255|09/17/2020||Yes|No||09/17/2020||Yes|No|09/17/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|213|No|1.54692|03/29/2022|1.50979|03/29/2022|1.51984|03/29/2022|||TETRACYCLINES|15569|||||No|No||CHARTWELL RX LL|No||||
tetracycline HCl|No|No|No|No|75%|62135026660|TETRACYCLINE 500 MG CAPSULE|60|EA|1.41255|09/09/2021||Yes|No||09/09/2021||Yes|No|09/09/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|213|No|1.54692|03/29/2022|1.50979|03/29/2022|1.51984|03/29/2022|||TETRACYCLINES|15570|||||No|No||CHARTWELL RX LL|No||||
ramipril|No|No|No|No|75%|62135027101|RAMIPRIL 1.25 MG CAPSULE|100|EA|.3845|12/09/2020||Yes|No||12/09/2020||Yes|No|12/09/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.12346|03/29/2022|.12049|03/29/2022|.12129|03/29/2022|||ANGIOTENSIN MODULATORS|15571|||||No|No||CHARTWELL RX LL|No||||
ramipril|No|No|No|No|75%|62135027130|RAMIPRIL 1.25 MG CAPSULE|30|EA|.36521|12/09/2020||Yes|No||12/09/2020||Yes|No|12/09/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.12346|03/29/2022|.12049|03/29/2022|.12129|03/29/2022|||ANGIOTENSIN MODULATORS|15572|||||No|No||CHARTWELL RX LL|No||||
ramipril|No|No|No|No|75%|62135027201|RAMIPRIL 2.5 MG CAPSULE|100|EA|.43111|12/09/2020||Yes|No||12/09/2020||Yes|No|12/09/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.06329|03/29/2022|.06177|03/29/2022|.06218|03/29/2022|||ANGIOTENSIN MODULATORS|15573|||||No|No||CHARTWELL RX LL|No||||
ramipril|No|No|No|No|75%|62135027205|RAMIPRIL 2.5 MG CAPSULE|500|EA|.40956|12/09/2020||Yes|No||12/09/2020||Yes|No|12/09/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.06329|03/29/2022|.06177|03/29/2022|.06218|03/29/2022|||ANGIOTENSIN MODULATORS|15574|||||No|No||CHARTWELL RX LL|No||||
ramipril|No|No|No|No|75%|62135027301|RAMIPRIL 5 MG CAPSULE|100|EA|.46005|12/09/2020||Yes|No||12/09/2020||Yes|No|12/09/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.06848|03/29/2022|.06683|03/29/2022|.06728|03/29/2022|||ANGIOTENSIN MODULATORS|15575|||||No|No||CHARTWELL RX LL|No||||
ramipril|No|No|No|No|75%|62135027305|RAMIPRIL 5 MG CAPSULE|500|EA|.43705|12/09/2020||Yes|No||12/09/2020||Yes|No|12/09/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.06848|03/29/2022|.06683|03/29/2022|.06728|03/29/2022|||ANGIOTENSIN MODULATORS|15576|||||No|No||CHARTWELL RX LL|No||||
ramipril|No|No|No|No|75%|62135027401|RAMIPRIL 10 MG CAPSULE|100|EA|.52799|12/09/2020||Yes|No||12/09/2020||Yes|No|12/09/2020||Yes|No||||No|No|||Prescription required|No||113|No|.07037|03/29/2022|.06868|03/29/2022|.06913|03/29/2022|||ANGIOTENSIN MODULATORS|15577|||||No|No||CHARTWELL RX LL|No||||
ramipril|No|No|No|No|75%|62135027405|RAMIPRIL 10 MG CAPSULE|500|EA|.50159|12/09/2020||Yes|No||12/09/2020||Yes|No|12/09/2020||Yes|No||||No|No|||Prescription required|No||113|No|.07037|03/29/2022|.06868|03/29/2022|.06913|03/29/2022|||ANGIOTENSIN MODULATORS|15578|||||No|No||CHARTWELL RX LL|No||||
ciprofloxacin HCl|No|No|No|No|75%|62135030801|CIPROFLOXACIN HCL 250 MG TAB|100|EA|1.2642|09/01/2021||Yes|No||09/01/2021||Yes|No|09/01/2021||Yes|No||||No|No|||Prescription required|No||028|No|.09397|03/29/2022|.09171|03/29/2022|.09232|03/29/2022|||FLUOROQUINOLONES: ORAL|15579|||||No|No||CHARTWELL RX LL|No||||
ciprofloxacin HCl|No|No|No|No|75%|62135030901|CIPROFLOXACIN HCL 500 MG TAB|100|EA|1.4792|09/01/2021||Yes|No||09/01/2021||Yes|No|09/01/2021||Yes|No||||No|No|||Prescription required|No||028|No|.13565|03/29/2022|.13239|03/29/2022|.13327|03/29/2022|||FLUOROQUINOLONES: ORAL|15580|||||No|No||CHARTWELL RX LL|No||||
ciprofloxacin HCl|No|No|No|No|75%|62135030905|CIPROFLOXACIN HCL 500 MG TAB|500|EA|1.44961|09/01/2021||Yes|No||09/01/2021||Yes|No|09/01/2021||Yes|No||||No|No|||Prescription required|No||028|No|.13565|03/29/2022|.13239|03/29/2022|.13327|03/29/2022|||FLUOROQUINOLONES: ORAL|15581|||||No|No||CHARTWELL RX LL|No||||
ciprofloxacin HCl|No|No|No|No|75%|62135030920|CIPROFLOXACIN HCL 500 MG TAB|20|EA|1.4792|09/01/2021||Yes|No||09/01/2021||Yes|No|09/01/2021||Yes|No||||No|No|||Prescription required|No||028|No|.13565|03/29/2022|.13239|03/29/2022|.13327|03/29/2022|||FLUOROQUINOLONES: ORAL|15582|||||No|No||CHARTWELL RX LL|No||||
ciprofloxacin HCl|No|No|No|No|75%|62135031050|CIPROFLOXACIN HCL 750 MG TAB|50|EA|2.2188|09/02/2021||Yes|No||09/02/2021||Yes|No|09/02/2021||Yes|No||||No|No|||Prescription required|No||028|No|.288|03/29/2022|.28108|03/29/2022|.28296|03/29/2022|||FLUOROQUINOLONES: ORAL|15583|||||No|No||CHARTWELL RX LL|No||||
doxycycline monohydrate|No|No|No|No|75%|62135041746|DOXYCYCLINE 25 MG/5 ML SUSP|60|ML|.13057|09/15/2020||Yes|No||09/15/2020||Yes|No|09/15/2020||Yes|No||||No|No|||Prescription required|No|||No|.27292|03/01/2022|.26636|03/01/2022|.26814|03/01/2022||||15584|||||No|No||CHARTWELL RX LL|No||||
disulfiram|No|No|No|No|75%|62135043130|DISULFIRAM 250 MG TABLET|30|EA|4.15666|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No|||No|1.95785|03/31/2022|1.91086|03/31/2022|1.92358|03/31/2022||||15585|||||No|No||CHARTWELL RX LL|No||||
disulfiram|No|No|No|No|75%|62135043190|DISULFIRAM 250 MG TABLET|90|EA|4.15666|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No|||No|1.95785|03/31/2022|1.91086|03/31/2022|1.92358|03/31/2022||||15586|||||No|No||CHARTWELL RX LL|No||||
disulfiram|No|No|No|No|75%|62135043230|DISULFIRAM 500 MG TABLET|30|EA|5.7253|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No|||No|13.04836|03/31/2022|12.86196|03/31/2022|12.24948|03/31/2022||||15587|||||No|No||CHARTWELL RX LL|No||||
disulfiram|No|No|No|No|75%|62135043290|DISULFIRAM 500 MG TABLET|90|EA|5.73247|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No|||No|13.0647|03/31/2022|12.87806|03/31/2022|12.26482|03/31/2022||||15588|||||No|No||CHARTWELL RX LL|No||||
griseofulvin ultramicrosize|No|No|No|No|75%|62135049401|GRISEOFULVIN ULTRA 125 MG TAB|100|EA|1.68095|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|069|No|3.83101|09/30/2021|3.77628|09/30/2021|3.59646|09/30/2021|||ANTIFUNGALS: ORAL|15589|||||No|No||CHARTWELL RX LL|No||||
griseofulvin ultramicrosize|No|No|No|No|75%|62135049430|GRISEOFULVIN ULTRA 125 MG TAB|30|EA|1.71527|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|069|No|3.90922|09/30/2021|3.85337|09/30/2021|3.66988|09/30/2021|||ANTIFUNGALS: ORAL|15590|||||No|No||CHARTWELL RX LL|No||||
griseofulvin ultramicrosize|No|No|No|No|75%|62135049501|GRISEOFULVIN ULTRA 250 MG TAB|100|EA|2.14871|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|069|No|4.20728|03/29/2022|4.1063|03/29/2022|4.13365|03/29/2022|||ANTIFUNGALS: ORAL|15591|||||No|No||CHARTWELL RX LL|No||||
griseofulvin ultramicrosize|No|No|No|No|75%|62135049530|GRISEOFULVIN ULTRA 250 MG TAB|30|EA|2.19257|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|069|No|4.20728|03/29/2022|4.1063|03/29/2022|4.13365|03/29/2022|||ANTIFUNGALS: ORAL|15592|||||No|No||CHARTWELL RX LL|No||||
griseofulvin, microsize|No|No|No|No|75%|62135049601|GRISEOFULVIN MICRO 500 MG TAB|100|EA|3.15233|09/13/2021||Yes|No||09/13/2021||Yes|No|09/13/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|069|No|7.20637|12/28/2021|7.03341|12/28/2021|7.08025|12/28/2021|||ANTIFUNGALS: ORAL|15593|||||No|No||CHARTWELL RX LL|No||||
griseofulvin, microsize|No|No|No|No|75%|62135049630|GRISEOFULVIN MICRO 500 MG TAB|30|EA|3.51166|09/13/2021||Yes|No||09/13/2021||Yes|No|09/13/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|069|No|7.20637|12/28/2021|7.03341|12/28/2021|7.08025|12/28/2021|||ANTIFUNGALS: ORAL|15594|||||No|No||CHARTWELL RX LL|No||||
clarithromycin|No|No|No|No|75%|62135061560|CLARITHROMYCIN 500 MG TABLET|60|EA|2.07833|09/13/2021||Yes|No||09/13/2021||Yes|No|09/13/2021||Yes|No||||No|No|||Prescription required|No||018|No|.44307|03/29/2022|.43243|03/29/2022|.43531|03/29/2022|||MACROLIDES/KETOLIDES|15595|||||No|No||CHARTWELL RX LL|No||||
clarithromycin|No|No|No|No|75%|62135061660|CLARITHROMYCIN 250 MG TABLET|60|EA|1.72|09/13/2021||Yes|No||09/13/2021||Yes|No|09/13/2021||Yes|No||||No|No|||Prescription required|No||018|No|.54294|03/29/2022|.5299|03/29/2022|.53343|03/29/2022|||MACROLIDES/KETOLIDES|15596|||||No|No||CHARTWELL RX LL|No||||
doxycycline hyclate|No|No|No|No|75%|62135062560|DOXYCYCLINE 50 MG TABLET|60|EA|4.65833|02/22/2022||Yes|No||02/22/2022||Yes|No|02/22/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|213|No|10.61666|02/22/2022|10.46499|02/22/2022|9.96666|02/22/2022|||TETRACYCLINES|15597|||||No|No||CHARTWELL RX LL|No||||
doxycycline hyclate|No|No|No|No|75%|62135062601|DOXYCYCLINE HYCLATE 100 MG TAB|100|EA||12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|15598|||||No|No||CHARTWELL RX LL|No||||
doxycycline hyclate|Yes|No|No|No|75%|62135062605|DOXYCYCLINE HYCLATE 100 MG TAB|500|EA|.37047|01/30/2020||Yes|No||01/30/2020||Yes|No|01/30/2020||Yes|No||||No|No|03/20/2020||Prescription required|Yes|07/25/2019|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|15599|||||No|No||CHARTWELL RX LL|No||||
doxycycline hyclate|No|No|No|No|75%|62135062610|DOXYCYCLINE HYCLATE 100 MG TAB|1000|EA||12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|15600|||||No|No||CHARTWELL RX LL|No||||
doxycycline hyclate|Yes|No|No|No|75%|62135062650|DOXYCYCLINE HYCLATE 100 MG TAB|50|EA|.37048|01/30/2020||Yes|No||01/30/2020||Yes|No|01/30/2020||Yes|No||||No|No|03/20/2020||Prescription required|Yes|07/25/2019|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|15601|||||No|No||CHARTWELL RX LL|No||||
doxycycline hyclate|No|No|No|No|75%|62135062696|DOXYCYCLINE HYCLATE 100 MG TAB|2000|EA|.0301|09/13/2021||Yes|No||09/13/2021||Yes|No|09/13/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|15602|||||No|No||CHARTWELL RX LL|No||||
sulfasalazine|No|No|No|No|75%|62135096001|SULFASALAZINE 500 MG TABLET|100|EA|.86|09/01/2021||Yes|No||09/01/2021||Yes|No|09/01/2021||Yes|No||||No|No|||Prescription required|No||010|No|.1775|03/29/2022|.17324|03/29/2022|.17439|03/29/2022|||ULCERATIVE COLITIS AGENTS|15603|||||No|No||CHARTWELL RX LL|No||||
sulfasalazine|No|No|No|No|75%|62135096005|SULFASALAZINE 500 MG TABLET|500|EA|.86|09/01/2021||Yes|No||09/01/2021||Yes|No|09/01/2021||Yes|No||||No|No|||Prescription required|No||010|No|.1775|03/29/2022|.17324|03/29/2022|.17439|03/29/2022|||ULCERATIVE COLITIS AGENTS|15604|||||No|No||CHARTWELL RX LL|No||||
sulfasalazine|No|No|No|No|75%|62135096010|SULFASALAZINE 500 MG TABLET|1000|EA|.86|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||||No|No|||Prescription required|No||010|No|.1775|03/29/2022|.17324|03/29/2022|.17439|03/29/2022|||ULCERATIVE COLITIS AGENTS|15605|||||No|No||CHARTWELL RX LL|No||||
sulfasalazine|No|No|No|No|75%|62135096031|SULFASALAZINE 500 MG TABLET|300|EA|.86|09/01/2021||Yes|No||09/01/2021||Yes|No|09/01/2021||Yes|No||||No|No|||Prescription required|No||010|No|.1775|03/29/2022|.17324|03/29/2022|.17439|03/29/2022|||ULCERATIVE COLITIS AGENTS|15606|||||No|No||CHARTWELL RX LL|No||||
griseofulvin, microsize|No|No|No|No|75%|62135096841|GRISEOFULVIN 125 MG/5 ML SUSP|120|ML|.89583|01/20/2022||Yes|No||01/20/2022||Yes|No|01/20/2022||Yes|No||||No|No|||Prescription required|No||069|No|.28513|03/29/2022|.27828|03/29/2022|.28014|03/29/2022|||ANTIFUNGALS: ORAL|15607|||||No|No||CHARTWELL RX LL|No||||
doxycycline hyclate|No|No|No|No|75%|62135098450|DOXYCYCLINE HYCLATE 50 MG CAP|50|EA|.34873|01/02/2020||Yes|No||01/02/2020||Yes|No|01/02/2020||Yes|No||||No|No|||Prescription required|No||213|No|.2526|03/29/2022|.24653|03/29/2022|.24817|03/29/2022|||TETRACYCLINES|15608|||||No|No||CHARTWELL RX LL|No||||
doxycycline hyclate|Yes|No|No|No|75%|62135098505|DOXYCYCLINE HYCLATE 100 MG CAP|500|EA|.37047|01/17/2020||Yes|No||01/17/2020||Yes|No|01/17/2020||Yes|No||||No|No|03/20/2020||Prescription required|No||213|No|.14255|03/29/2022|.13912|03/29/2022|.14005|03/29/2022|||TETRACYCLINES|15609|||||No|No||CHARTWELL RX LL|No||||
doxycycline hyclate|Yes|No|No|No|75%|62135098550|DOXYCYCLINE HYCLATE 100 MG CAP|50|EA|.37048|01/02/2020||Yes|No||01/02/2020||Yes|No|01/02/2020||Yes|No||||No|No|03/20/2020||Prescription required|No||213|No|.14255|03/29/2022|.13912|03/29/2022|.14005|03/29/2022|||TETRACYCLINES|15610|||||No|No||CHARTWELL RX LL|No||||
isosorbide mononitrate|No|No|No|No|75%|62175010601|ISOSORBIDE MONONIT 10 MG TAB|100|EA|.20842|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.20493|03/29/2022|.20001|03/29/2022|.20134|03/29/2022||||15611|||||No|No||KREMERS/LANNETT|No||||
isosorbide mononitrate|No|No|No|No|75%|62175010701|ISOSORBIDE MONONIT 20 MG TAB|100|EA|.21822|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.23897|03/29/2022|.23323|03/29/2022|.23478|03/29/2022||||15612|||||No|No||KREMERS/LANNETT|No||||
omeprazole|No|No|No|No|75%|62175011432|OMEPRAZOLE DR 10 MG CAPSULE|30|EA|.0774|09/01/2009||Yes|No||09/01/2009||Yes|No|09/01/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|Yes|.09084|03/29/2022|.08865|03/29/2022|.08925|03/29/2022|||PROTON PUMP INHIBITORS|15613|||||No|No||KREMERS/LANNETT|No||||
omeprazole|No|No|No|No|75%|62175011437|OMEPRAZOLE DR 10 MG CAPSULE|100|EA|.0774|06/07/2010||Yes|No||06/07/2010||Yes|No|06/07/2010||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|Yes|.09084|03/29/2022|.08865|03/29/2022|.08925|03/29/2022|||PROTON PUMP INHIBITORS|15614|||||No|No||KREMERS/LANNETT|No||||
omeprazole|No|No|No|No|75%|62175011832|OMEPRAZOLE DR 20 MG CAPSULE|30|EA|.0602|09/01/2009||Yes|No||09/01/2009||Yes|No|09/01/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|15615|||||No|No||KREMERS/LANNETT|No||||
omeprazole|No|No|No|No|75%|62175011837|OMEPRAZOLE DR 20 MG CAPSULE|100|EA|.0387|09/01/2009||Yes|No||09/01/2009||Yes|No|09/01/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|15616|||||No|No||KREMERS/LANNETT|No||||
omeprazole|No|No|No|No|75%|62175011843|OMEPRAZOLE DR 20 MG CAPSULE|1000|EA|.0258|09/01/2009||Yes|No||09/01/2009||Yes|No|09/01/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|15617|||||No|No||KREMERS/LANNETT|No||||
isosorbide mononitrate|No|No|No|No|75%|62175011937|ISOSORBIDE MONONIT ER 60 MG TB|100|EA|.09348|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.12753|03/29/2022|.12446|03/29/2022|.12529|03/29/2022||||15618|||||No|No||KREMERS/LANNETT|No||||
isosorbide mononitrate|No|No|No|No|75%|62175011941|ISOSORBIDE MONONIT ER 60 MG TB|500|EA|.09066|02/15/2011||Yes|No||02/15/2011||Yes|No|02/15/2011||Yes|No||||No|No|||Prescription required|No|||No|.12753|03/29/2022|.12446|03/29/2022|.12529|03/29/2022||||15619|||||No|No||KREMERS/LANNETT|No||||
isosorbide mononitrate|No|No|No|No|75%|62175011946|ISOSORBIDE MONONIT ER 60 MG TB|90|EA|.09345|02/15/2011|09/10/2022|Yes|No||02/15/2011|09/10/2022|Yes|No|02/15/2011|09/10/2022|Yes|No||||No|No|||Prescription required|No|||No|.12753|03/29/2022|.12446|03/29/2022|.12529|03/29/2022||||15620|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||KREMERS/LANNETT|No||||
nitroglycerin|No|No|No|No|75%|62175012301|NITROGLYCERIN 0.2 MG/HR PATCH|30|EA|.29168|05/15/2006|09/21/2022|Yes|No||05/15/2006|09/21/2022|Yes|No|05/15/2006|09/21/2022|Yes|No||||No|No|||Prescription required|No|||No|.5028|03/29/2022|.49073|03/29/2022|.494|03/29/2022||||15621|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||KREMERS/LANNETT|No||||
nitroglycerin|No|No|No|No|75%|62175012401|NITROGLYCERIN 0.4 MG/HR PATCH|30|EA|.35116|05/05/2006|09/21/2022|Yes|No||05/05/2006|09/21/2022|Yes|No|05/05/2006|09/21/2022|Yes|No||||No|No|||Prescription required|No|||No|.59249|03/29/2022|.57827|03/29/2022|.58212|03/29/2022||||15622|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||KREMERS/LANNETT|No||||
isosorbide mononitrate|No|No|No|No|75%|62175012837|ISOSORBIDE MONONIT ER 30 MG TB|100|EA|.08883|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.09715|03/29/2022|.09481|03/29/2022|.09544|03/29/2022||||15623|||||No|No||KREMERS/LANNETT|No||||
isosorbide mononitrate|No|No|No|No|75%|62175012841|ISOSORBIDE MONONIT ER 30 MG TB|500|EA|.08615|02/15/2011||Yes|No||02/15/2011||Yes|No|02/15/2011||Yes|No||||No|No|||Prescription required|No|||No|.09715|03/29/2022|.09481|03/29/2022|.09544|03/29/2022||||15624|||||No|No||KREMERS/LANNETT|No||||
isosorbide mononitrate|No|No|No|No|75%|62175012846|ISOSORBIDE MONONIT ER 30 MG TB|90|EA|.08881|02/15/2011||Yes|No||02/15/2011||Yes|No|02/15/2011||Yes|No||||No|No|||Prescription required|No|||No|.09715|03/29/2022|.09481|03/29/2022|.09544|03/29/2022||||15625|||||No|No||KREMERS/LANNETT|No||||
isosorbide mononitrate|No|No|No|No|75%|62175012937|ISOSORBIDE MONONIT ER 120 MG|100|EA|.13084|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.25435|03/29/2022|.24824|03/29/2022|.24989|03/29/2022||||15626|||||No|No||KREMERS/LANNETT|No||||
omeprazole|No|No|No|No|75%|62175013632|OMEPRAZOLE DR 40 MG CAPSULE|30|EA|.0688|08/25/2010||Yes|No||08/25/2010||Yes|No|08/25/2010||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|15627|||||No|No||KREMERS/LANNETT|No||||
omeprazole|No|No|No|No|75%|62175013637|OMEPRAZOLE DR 40 MG CAPSULE|100|EA|.06075|08/25/2010||Yes|No||08/25/2010||Yes|No|08/25/2010||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|15628|||||No|No||KREMERS/LANNETT|No||||
omeprazole|No|No|No|No|75%|62175013643|OMEPRAZOLE DR 40 MG CAPSULE|1000|EA|.0688|08/25/2010||Yes|No||08/25/2010||Yes|No|08/25/2010||Yes|No||07/01/2012||Yes|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|15629|||||No|No||KREMERS/LANNETT|No||||
montelukast sodium|No|No|No|No|75%|62175020432|MONTELUKAST SOD 4 MG TAB CHEW|30|EA|.33783|09/05/2012||Yes|No||09/05/2012||Yes|No|09/05/2012||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|15630|||||No|No||KREMERS/LANNETT|No||||
montelukast sodium|No|No|No|No|75%|62175020443|MONTELUKAST SOD 4 MG TAB CHEW|1000|EA|.3378|01/03/2013||Yes|No||01/03/2013||Yes|No|01/03/2013||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|15631|||||No|No||KREMERS/LANNETT|No||||
montelukast sodium|No|No|No|No|75%|62175020446|MONTELUKAST SOD 4 MG TAB CHEW|90|EA|.33783|09/05/2012||Yes|No||09/05/2012||Yes|No|09/05/2012||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|15632|||||No|No||KREMERS/LANNETT|No||||
montelukast sodium|No|No|No|No|75%|62175020532|MONTELUKAST SOD 5 MG TAB CHEW|30|EA|.33783|09/05/2012||Yes|No||09/05/2012||Yes|No|09/05/2012||Yes|No||||No|No|||Prescription required|No||042|Yes|.08451|03/29/2022|.08248|03/29/2022|.08303|03/29/2022|||LEUKOTRIENE MODIFIERS|15633|||||No|No||KREMERS/LANNETT|No||||
montelukast sodium|No|No|No|No|75%|62175020543|MONTELUKAST SOD 5 MG TAB CHEW|1000|EA|.3378|01/03/2013||Yes|No||01/03/2013||Yes|No|01/03/2013||Yes|No||||No|No|||Prescription required|No||042|Yes|.08451|03/29/2022|.08248|03/29/2022|.08303|03/29/2022|||LEUKOTRIENE MODIFIERS|15634|||||No|No||KREMERS/LANNETT|No||||
montelukast sodium|No|No|No|No|75%|62175020546|MONTELUKAST SOD 5 MG TAB CHEW|90|EA|.33783|09/05/2012||Yes|No||09/05/2012||Yes|No|09/05/2012||Yes|No||||No|No|||Prescription required|No||042|Yes|.08451|03/29/2022|.08248|03/29/2022|.08303|03/29/2022|||LEUKOTRIENE MODIFIERS|15635|||||No|No||KREMERS/LANNETT|No||||
montelukast sodium|No|No|No|No|75%|62175021032|MONTELUKAST SOD 10 MG TABLET|30|EA|.33783|09/05/2012||Yes|No||09/05/2012||Yes|No|09/05/2012||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|15636|||||No|No||KREMERS/LANNETT|Yes|09/01/2020|||
montelukast sodium|No|No|No|No|75%|62175021043|MONTELUKAST SOD 10 MG TABLET|1000|EA|.3378|10/11/2013||Yes|No||10/11/2013||Yes|No|10/11/2013||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|15637|||||No|No||KREMERS/LANNETT|No||||
montelukast sodium|No|No|No|No|75%|62175021046|MONTELUKAST SOD 10 MG TABLET|90|EA|.33783|09/05/2012||Yes|No||09/05/2012||Yes|No|09/05/2012||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|15638|||||No|No||KREMERS/LANNETT|No||||
nifedipine|No|No|No|No|75%|62175026037|NIFEDIPINE ER 30 MG TABLET|100|EA|.45988|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|||Prescription required|No||045|Yes|.17922|03/29/2022|.17491|03/29/2022|.17608|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15639|||||No|No||KREMERS/LANNETT|No||||
nifedipine|No|No|No|No|75%|62175026043|NIFEDIPINE ER 30 MG TABLET|1000|EA|.79614|07/01/2007|09/21/2022|Yes|No||07/01/2007|09/21/2022|Yes|No|07/01/2007|09/21/2022|Yes|No||07/01/2007|09/21/2022|Yes|No|||Prescription required|No||045|Yes|.17922|03/29/2022|.17491|03/29/2022|.17608|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15640|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||KREMERS/LANNETT|No||||
nifedipine|No|No|No|No|75%|62175026055|NIFEDIPINE ER 30 MG TABLET|300|EA|.45072|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|||Prescription required|No||045|Yes|.17922|03/29/2022|.17491|03/29/2022|.17608|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15641|||||No|No||KREMERS/LANNETT|No||||
nifedipine|No|No|No|No|75%|62175026137|NIFEDIPINE ER 60 MG TABLET|100|EA|.79614|09/16/2010||Yes|No||09/16/2010||Yes|No|09/16/2010||Yes|No||09/16/2010||Yes|No|||Prescription required|No||045|No|.23953|03/29/2022|.23378|03/29/2022|.23533|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15642|||||No|No||KREMERS/LANNETT|No||||
nifedipine|No|No|No|No|75%|62175026155|NIFEDIPINE ER 60 MG TABLET|300|EA|.77967|09/16/2010||Yes|No||09/16/2010||Yes|No|09/16/2010||Yes|No||09/16/2010||Yes|No|||Prescription required|No||045|No|.23953|03/29/2022|.23378|03/29/2022|.23533|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15643|||||No|No||KREMERS/LANNETT|No||||
nifedipine|No|No|No|No|75%|62175026232|NIFEDIPINE ER 90 MG TABLET|30|EA|.9159|08/16/2010||Yes|No||08/16/2010||Yes|No|08/16/2010||Yes|No||08/16/2010||Yes|No|||Prescription required|No||045|No|.38633|03/29/2022|.37705|03/29/2022|.37956|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15644|||||No|No||KREMERS/LANNETT|No||||
nifedipine|No|No|No|No|75%|62175026237|NIFEDIPINE ER 90 MG TABLET|100|EA|.91848|08/16/2010||Yes|No||08/16/2010||Yes|No|08/16/2010||Yes|No||08/16/2010||Yes|No|||Prescription required|No||045|No|.38633|03/29/2022|.37705|03/29/2022|.37956|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15645|||||No|No||KREMERS/LANNETT|No||||
nifedipine|No|No|No|No|75%|62175026246|NIFEDIPINE ER 90 MG TABLET|90|EA|.9159|08/16/2010||Yes|No||08/16/2010||Yes|No|08/16/2010||Yes|No||08/16/2010||Yes|No|||Prescription required|No||045|No|.38633|03/29/2022|.37705|03/29/2022|.37956|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15646|||||No|No||KREMERS/LANNETT|No||||
oxybutynin chloride|No|No|No|No|75%|62175027037|OXYBUTYNIN CL ER 5 MG TABLET|100|EA|.31815|10/16/2009||Yes|No||10/16/2009||Yes|No|10/16/2009||Yes|No||||No|No|||Prescription required|No||006|Yes|.15279|03/29/2022|.14912|03/29/2022|.15011|03/29/2022|||BLADDER RELAXANT PREPARATIONS|15647|||||No|No||KREMERS/LANNETT|No||||
oxybutynin chloride|No|No|No|No|75%|62175027041|OXYBUTYNIN CL ER 5 MG TABLET|500|EA|.31815|10/16/2009||Yes|No||10/16/2009||Yes|No|10/16/2009||Yes|No||||No|No|||Prescription required|No||006|Yes|.15279|03/29/2022|.14912|03/29/2022|.15011|03/29/2022|||BLADDER RELAXANT PREPARATIONS|15648|||||No|No||KREMERS/LANNETT|No||||
oxybutynin chloride|No|No|No|No|75%|62175027137|OXYBUTYNIN CL ER 10 MG TABLET|100|EA|.31845|10/16/2009||Yes|No||10/16/2009||Yes|No|10/16/2009||Yes|No||||No|No|||Prescription required|No||006|No|.15833|03/29/2022|.15453|03/29/2022|.15555|03/29/2022|||BLADDER RELAXANT PREPARATIONS|15649|||||No|No||KREMERS/LANNETT|No||||
oxybutynin chloride|No|No|No|No|75%|62175027141|OXYBUTYNIN CL ER 10 MG TABLET|500|EA|.31845|10/16/2009||Yes|No||10/16/2009||Yes|No|10/16/2009||Yes|No||||No|No|||Prescription required|No||006|No|.15833|03/29/2022|.15453|03/29/2022|.15555|03/29/2022|||BLADDER RELAXANT PREPARATIONS|15650|||||No|No||KREMERS/LANNETT|No||||
oxybutynin chloride|No|No|No|No|75%|62175027237|OXYBUTYNIN CL ER 15 MG TABLET|100|EA|.32645|10/16/2009||Yes|No||10/16/2009||Yes|No|10/16/2009||Yes|No||||No|No|||Prescription required|No||006|No|.19948|03/29/2022|.19469|03/29/2022|.19598|03/29/2022|||BLADDER RELAXANT PREPARATIONS|15651|||||No|No||KREMERS/LANNETT|No||||
oxybutynin chloride|No|No|No|No|75%|62175027241|OXYBUTYNIN CL ER 15 MG TABLET|500|EA|.32645|10/16/2009||Yes|No||10/16/2009||Yes|No|10/16/2009||Yes|No||||No|No|||Prescription required|No||006|No|.19948|03/29/2022|.19469|03/29/2022|.19598|03/29/2022|||BLADDER RELAXANT PREPARATIONS|15652|||||No|No||KREMERS/LANNETT|No||||
rabeprazole sodium|No|No|No|No|75%|62175030232|RABEPRAZOLE SOD DR 20 MG TAB|30|EA|.20195|01/06/2014||Yes|No||01/06/2014||Yes|No|01/06/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.24287|03/29/2022|.23704|03/29/2022|.23861|03/29/2022|||PROTON PUMP INHIBITORS|15653|||||No|No||KREMERS/LANNETT|No||||
rabeprazole sodium|No|No|No|No|75%|62175030243|RABEPRAZOLE SOD DR 20 MG TAB|1000|EA|.18802|04/07/2014||Yes|No||04/07/2014||Yes|No|04/07/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.24287|03/29/2022|.23704|03/29/2022|.23861|03/29/2022|||PROTON PUMP INHIBITORS|15654|||||No|No||KREMERS/LANNETT|No||||
rabeprazole sodium|No|No|No|No|75%|62175030246|RABEPRAZOLE SOD DR 20 MG TAB|90|EA|.19789|01/06/2014||Yes|No||01/06/2014||Yes|No|01/06/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.24287|03/29/2022|.23704|03/29/2022|.23861|03/29/2022|||PROTON PUMP INHIBITORS|15655|||||No|No||KREMERS/LANNETT|No||||
methylphenidate HCl|No|No|No|No|75%|62175031037|METHYLPHENIDATE ER 18 MG TAB|100|EA|2.2295|12/18/2013||Yes|No||12/18/2013||Yes|No|12/18/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.56499|03/29/2022|.55143|03/29/2022|.5551|03/29/2022|||STIMULANTS AND RELATED AGENTS|15656|||||No|No||KREMERS/LANNETT|No||||
methylphenidate HCl|No|No|No|No|75%|62175031137|METHYLPHENIDATE ER 27 MG TAB|100|EA|2.2854|12/18/2013||Yes|No||12/18/2013||Yes|No|12/18/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.90623|03/29/2022|.88448|03/29/2022|.89037|03/29/2022|||STIMULANTS AND RELATED AGENTS|15657|||||No|No||KREMERS/LANNETT|No||||
methylphenidate HCl|No|No|No|No|75%|62175031237|METHYLPHENIDATE ER 36 MG TAB|100|EA|2.3573|12/18/2013||Yes|No||12/18/2013||Yes|No|12/18/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.76999|03/29/2022|.75151|03/29/2022|.75651|03/29/2022|||STIMULANTS AND RELATED AGENTS|15658|||||No|No||KREMERS/LANNETT|No||||
methylphenidate HCl|No|No|No|No|75%|62175031337|METHYLPHENIDATE ER 54 MG TAB|100|EA|2.56507|12/18/2013||Yes|No||12/18/2013||Yes|No|12/18/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.87218|03/29/2022|.85124|03/29/2022|.85691|03/29/2022|||STIMULANTS AND RELATED AGENTS|15659|||||No|No||KREMERS/LANNETT|No||||
niacin|No|No|No|No|75%|62175032046|NIACIN ER 500 MG TABLET|90|EA|.29598|07/29/2019||Yes|No||07/29/2019||Yes|No|07/29/2019||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|055|Yes|.21332|03/29/2022|.2082|03/29/2022|.20958|03/29/2022|||LIPOTROPICS: OTHER|15660|||||No|No||LANNETT CO. INC|No||||
niacin|No|No|No|No|75%|62175032246|NIACIN ER 1,000 MG TABLET|90|EA|.4945|07/29/2019||Yes|No||07/29/2019||Yes|No|07/29/2019||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|055|No|.4737|03/29/2022|.46233|03/29/2022|.46541|03/29/2022|||LIPOTROPICS: OTHER|15661|||||No|No||LANNETT CO. INC|No||||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|62175045232|BUPRENORPHINE-NALOX 2-0.5MG TB|30|EA|.27878|07/29/2019||Yes|No||07/29/2019||Yes|No|07/29/2019||Yes|No||||No|No|||Prescription required|No||145|Yes|.72296|03/29/2022|.7056|03/29/2022|.7103|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|15662|||||No|No||LANNETT CO. INC|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|62175045832|BUPRENORPHINE-NALOX 8-2 MG TAB|30|EA|.40133|07/29/2019||Yes|No||07/29/2019||Yes|No|07/29/2019||Yes|No||||No|No|||Prescription required|No||145|Yes|1.08568|03/29/2022|1.05962|03/29/2022|1.06668|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|15663|||||No|No||LANNETT CO. INC|Yes|09/01/2020|||
verapamil HCl|No|No|No|No|75%|62175048537|VERAPAMIL ER PM 100 MG CAPSULE|100|EA|2.09706|12/19/2007||Yes|No||12/19/2007||Yes|No|12/19/2007||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|045|Yes|4.78372|03/29/2022|4.66891|03/29/2022|4.7|03/29/2022|||CALCIUM CHANNEL BLOCKERS|15664|||||No|No||KREMERS/LANNETT|No||||
verapamil HCl|No|No|No|No|75%|62175048637|VERAPAMIL ER PM 200 MG CAPSULE|100|EA|2.70083|12/19/2007||Yes|No||12/19/2007||Yes|No|12/19/2007||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|045|No|5.88632|12/28/2021|5.74504|12/28/2021|5.7833|12/28/2021|||CALCIUM CHANNEL BLOCKERS|15665|||||No|No||KREMERS/LANNETT|No||||
verapamil HCl|No|No|No|No|75%|62175048737|VERAPAMIL ER PM 300 MG CAPSULE|100|EA|3.92663|12/19/2007||Yes|No||12/19/2007||Yes|No|12/19/2007||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|045|No|7.84638|03/01/2022|7.65806|03/01/2022|7.70906|03/01/2022|||CALCIUM CHANNEL BLOCKERS|15666|||||No|No||KREMERS/LANNETT|No||||
verapamil HCl|No|No|No|No|75%|62175057037|VERELAN PM 100 MG CAP PELLET|100|EA|2.22675|02/18/2014||Yes|No||02/18/2014||Yes|No|02/18/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|045|Yes|5.07493|06/01/2016|5.00243|06/01/2016|4.76422|06/01/2016|||CALCIUM CHANNEL BLOCKERS|15667|||||No|No||KREMERS/LANNETT|No||||
verapamil HCl|No|No|No|No|75%|62175057137|VERELAN PM 200 MG CAP PELLET|100|EA|2.86788|02/18/2014||Yes|No||02/18/2014||Yes|No|02/18/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|045|No|6.53611|06/01/2016|6.44273|06/01/2016|6.13594|06/01/2016|||CALCIUM CHANNEL BLOCKERS|15668|||||No|No||KREMERS/LANNETT|No||||
verapamil HCl|No|No|No|No|75%|62175057237|VERELAN PM 300 MG CAP PELLET|100|EA|4.16949|02/18/2014||Yes|No||02/18/2014||Yes|No|02/18/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|045|No|9.50257|06/01/2016|9.36681|06/01/2016|8.92078|06/01/2016|||CALCIUM CHANNEL BLOCKERS|15669|||||No|No||KREMERS/LANNETT|No||||
verapamil HCl|No|No|No|No|75%|62175058037|VERELAN 120 MG CAP PELLET|100|EA|2.7529|02/18/2014||Yes|No||02/18/2014||Yes|No|02/18/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|045|No|6.27405|06/01/2016|6.18442|06/01/2016|5.88993|06/01/2016|||CALCIUM CHANNEL BLOCKERS|15670|||||No|No||KREMERS/LANNETT|No||||
verapamil HCl|No|No|No|No|75%|62175058137|VERELAN 180 MG CAP PELLET|100|EA|2.88302|02/18/2014||Yes|No||02/18/2014||Yes|No|02/18/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|045|No|6.5706|06/01/2016|6.47674|06/01/2016|6.16832|06/01/2016|||CALCIUM CHANNEL BLOCKERS|15671|||||No|No||KREMERS/LANNETT|No||||
verapamil HCl|No|No|No|No|75%|62175058237|VERELAN 240 MG CAP PELLET|100|EA|3.25355|02/18/2014||Yes|No||02/18/2014||Yes|No|02/18/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|045|No|7.41507|06/01/2016|7.30914|06/01/2016|6.96108|06/01/2016|||CALCIUM CHANNEL BLOCKERS|15672|||||No|No||KREMERS/LANNETT|No||||
verapamil HCl|No|No|No|No|75%|62175058337|VERELAN 360 MG CAP PELLET|100|EA|4.78276|02/18/2014||Yes|No||02/18/2014||Yes|No|02/18/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|045|No|10.90024|06/01/2016|10.74452|06/01/2016|10.23288|06/01/2016|||CALCIUM CHANNEL BLOCKERS|15673|||||No|No||KREMERS/LANNETT|No||||
pantoprazole sodium|No|No|No|No|75%|62175061743|PANTOPRAZOLE SOD DR 40 MG TAB|1000|EA|.05972|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||047|No|.05828|03/29/2022|.05688|03/29/2022|.05726|03/29/2022|||PROTON PUMP INHIBITORS|15674|||||No|No||KREMERS/LANNETT|No||||
pantoprazole sodium|No|No|No|No|75%|62175061746|PANTOPRAZOLE SOD DR 40 MG TAB|90|EA|.05971|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No||047|No|.05828|03/29/2022|.05688|03/29/2022|.05726|03/29/2022|||PROTON PUMP INHIBITORS|15675|||||No|No||KREMERS/LANNETT|No||||
esomeprazole magnesium|No|No|No|No|75%|62175082032|ESOMEPRAZOLE MAG DR 20 MG CAP|30|EA|.3665|05/01/2020||Yes|No||05/01/2020||Yes|No|05/01/2020||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|15676|||||No|No||LANNETT CO. INC|No||||
esomeprazole magnesium|No|No|No|No|75%|62175082043|ESOMEPRAZOLE MAG DR 20 MG CAP|1000|EA|.35548|05/01/2020||Yes|No||05/01/2020||Yes|No|05/01/2020||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|15677|||||No|No||LANNETT CO. INC|No||||
esomeprazole magnesium|No|No|No|No|75%|62175082046|ESOMEPRAZOLE MAG DR 20 MG CAP|90|EA|.3665|05/01/2020||Yes|No||05/01/2020||Yes|No|05/01/2020||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|15678|||||No|No||LANNETT CO. INC|No||||
esomeprazole magnesium|No|No|No|No|75%|62175084032|ESOMEPRAZOLE MAG DR 40 MG CAP|30|EA|.3665|05/01/2020||Yes|No||05/01/2020||Yes|No|05/01/2020||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|15679|||||No|No||LANNETT CO. INC|No||||
esomeprazole magnesium|No|No|No|No|75%|62175084043|ESOMEPRAZOLE MAG DR 40 MG CAP|1000|EA|.35548|05/01/2020||Yes|No||05/01/2020||Yes|No|05/01/2020||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|15680|||||No|No||LANNETT CO. INC|No||||
esomeprazole magnesium|No|No|No|No|75%|62175084046|ESOMEPRAZOLE MAG DR 40 MG CAP|90|EA|.3665|05/01/2020||Yes|No||05/01/2020||Yes|No|05/01/2020||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|15681|||||No|No||LANNETT CO. INC|No||||
atorvastatin calcium|Yes|No|No|No|75%|62175089043|ATORVASTATIN 10 MG TABLET|1000|EA|.03206|06/21/2013||Yes|No||06/21/2013||Yes|No|06/21/2013||Yes|No||06/21/2013||Yes|No|07/01/2016||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|15682|||||No|No||KREMERS/LANNETT|No||||
atorvastatin calcium|Yes|No|No|No|75%|62175089046|ATORVASTATIN 10 MG TABLET|90|EA|.03563|06/21/2013||Yes|No||06/21/2013||Yes|No|06/21/2013||Yes|No||06/21/2013||Yes|No|07/01/2016||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|15683|||||No|No||KREMERS/LANNETT|No||||
atorvastatin calcium|Yes|No|No|No|75%|62175089143|ATORVASTATIN 20 MG TABLET|1000|EA|.04011|06/21/2013||Yes|No||06/21/2013||Yes|No|06/21/2013||Yes|No||06/21/2013||Yes|No|07/01/2016||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|15684|||||No|No||KREMERS/LANNETT|No||||
atorvastatin calcium|Yes|No|No|No|75%|62175089146|ATORVASTATIN 20 MG TABLET|90|EA|.04457|06/21/2013||Yes|No||06/21/2013||Yes|No|06/21/2013||Yes|No||06/21/2013||Yes|No|07/01/2016||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|15685|||||No|No||KREMERS/LANNETT|No||||
atorvastatin calcium|Yes|No|No|No|75%|62175089241|ATORVASTATIN 40 MG TABLET|500|EA|.0613|06/21/2013||Yes|No||06/21/2013||Yes|No|06/21/2013||Yes|No||06/21/2013||Yes|No|07/01/2016||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|15686|||||No|No||KREMERS/LANNETT|No||||
atorvastatin calcium|Yes|No|No|No|75%|62175089246|ATORVASTATIN 40 MG TABLET|90|EA|.06454|06/21/2013||Yes|No||06/21/2013||Yes|No|06/21/2013||Yes|No||06/21/2013||Yes|No|07/01/2016||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|15687|||||No|No||KREMERS/LANNETT|No||||
atorvastatin calcium|Yes|No|No|No|75%|62175089741|ATORVASTATIN 80 MG TABLET|500|EA|.06308|06/21/2013||Yes|No||06/21/2013||Yes|No|06/21/2013||Yes|No||06/21/2013||Yes|No|07/01/2016||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|15688|||||No|No||KREMERS/LANNETT|No||||
atorvastatin calcium|Yes|No|No|No|75%|62175089746|ATORVASTATIN 80 MG TABLET|90|EA|.0664|06/21/2013||Yes|No||06/21/2013||Yes|No|06/21/2013||Yes|No||06/21/2013||Yes|No|07/01/2016||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|15689|||||No|No||KREMERS/LANNETT|No||||
famotidine|No|No|No|No|75%|62332000131|FAMOTIDINE 20 MG TABLET|100|EA|.08582|06/29/2016||Yes|No||06/29/2016||Yes|No|06/29/2016||Yes|No||||No|No|||Prescription required|No|||No|.03262|03/29/2022|.03183|03/29/2022|.03204|03/29/2022||||15690|||||No|No||ALEMBIC PHARMAC|No||||
famotidine|No|No|No|No|75%|62332000191|FAMOTIDINE 20 MG TABLET|1000|EA|.08598|06/29/2016||Yes|No||06/29/2016||Yes|No|06/29/2016||Yes|No||||No|No|||Prescription required|No|||No|.03262|03/29/2022|.03183|03/29/2022|.03204|03/29/2022||||15691|||||No|No||ALEMBIC PHARMAC|No||||
famotidine|No|No|No|No|75%|62332000231|FAMOTIDINE 40 MG TABLET|100|EA|.17182|06/29/2016||Yes|No||06/29/2016||Yes|No|06/29/2016||Yes|No||||No|No|||Prescription required|No|||No|.06888|03/29/2022|.06722|03/29/2022|.06767|03/29/2022||||15692|||||No|No||ALEMBIC PHARMAC|No||||
famotidine|No|No|No|No|75%|62332000271|FAMOTIDINE 40 MG TABLET|500|EA|.17196|06/29/2016||Yes|No||06/29/2016||Yes|No|06/29/2016||Yes|No||||No|No|||Prescription required|No|||No|.06888|03/29/2022|.06722|03/29/2022|.06767|03/29/2022||||15693|||||No|No||ALEMBIC PHARMAC|No||||
famotidine|No|No|No|No|75%|62332000291|FAMOTIDINE 40 MG TABLET|1000|EA|.17196|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|No|||No|.06888|03/29/2022|.06722|03/29/2022|.06767|03/29/2022||||15694|||||No|No||ALEMBIC PHARMAC|No||||
venlafaxine HCl|No|No|No|No|75%|62332000831|VENLAFAXINE HCL 25 MG TABLET|100|EA|.13115|02/09/2016||Yes|No||02/09/2016||Yes|No|02/09/2016||Yes|No||||No|No|||Prescription required|No||031|No|.11374|03/29/2022|.11101|03/29/2022|.11174|03/29/2022|||ANTIDEPRESSANTS: OTHER|15695|||||No|No||ALEMBIC PHARMAC|No||||
venlafaxine HCl|No|No|No|No|75%|62332000931|VENLAFAXINE HCL 37.5 MG TABLET|100|EA|.13545|02/09/2016||Yes|No||02/09/2016||Yes|No|02/09/2016||Yes|No||||No|No|||Prescription required|No||031|Yes|.11453|03/29/2022|.11178|03/29/2022|.11252|03/29/2022|||ANTIDEPRESSANTS: OTHER|15696|||||No|No||ALEMBIC PHARMAC|No||||
venlafaxine HCl|No|No|No|No|75%|62332001031|VENLAFAXINE HCL 50 MG TABLET|100|EA|.13975|02/09/2016||Yes|No||02/09/2016||Yes|No|02/09/2016||Yes|No||||No|No|||Prescription required|No||031|No|.12769|03/29/2022|.12462|03/29/2022|.12545|03/29/2022|||ANTIDEPRESSANTS: OTHER|15697|||||No|No||ALEMBIC PHARMAC|No||||
venlafaxine HCl|No|No|No|No|75%|62332001131|VENLAFAXINE HCL 75 MG TABLET|100|EA|.14835|02/09/2016||Yes|No||02/09/2016||Yes|No|02/09/2016||Yes|No||||No|No|||Prescription required|No||031|No|.10828|03/29/2022|.10568|03/29/2022|.10638|03/29/2022|||ANTIDEPRESSANTS: OTHER|15698|||||No|No||ALEMBIC PHARMAC|No||||
venlafaxine HCl|No|No|No|No|75%|62332001231|VENLAFAXINE HCL 100 MG TABLET|100|EA|.15695|10/06/2016||Yes|No||10/06/2016||Yes|No|10/06/2016||Yes|No||||No|No|||Prescription required|No||031|No|.13788|03/29/2022|.13457|03/29/2022|.13546|03/29/2022|||ANTIDEPRESSANTS: OTHER|15699|||||No|No||ALEMBIC PHARMAC|No||||
lithium carbonate|No|No|No|No|75%|62332001331|LITHIUM CARBONATE 150 MG CAP|100|EA|.03878|09/28/2018||Yes|No||09/28/2018||Yes|No|09/28/2018||Yes|No||||No|No|||Prescription required|No|||No|.06953|03/29/2022|.06786|03/29/2022|.06831|03/29/2022||||15700|||||No|No||ALEMBIC PHARMAC|No||||
lithium carbonate|No|No|No|No|75%|62332001431|LITHIUM CARBONATE 300 MG CAP|100|EA|.02777|09/28/2018||Yes|No||09/28/2018||Yes|No|09/28/2018||Yes|No||||No|No|||Prescription required|No|||No|.04894|03/29/2022|.04776|03/29/2022|.04808|03/29/2022||||15701|||||No|No||ALEMBIC PHARMAC|No||||
lithium carbonate|No|No|No|No|75%|62332001491|LITHIUM CARBONATE 300 MG CAP|1000|EA|.02386|02/07/2019||Yes|No||02/07/2019||Yes|No|02/07/2019||Yes|No||||No|No|||Prescription required|No|||No|.04894|03/29/2022|.04776|03/29/2022|.04808|03/29/2022||||15702|||||No|No||ALEMBIC PHARMAC|No||||
lithium carbonate|No|No|No|No|75%|62332001531|LITHIUM CARBONATE 600 MG CAP|100|EA|.09236|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|No|||No|.13745|03/29/2022|.13415|03/29/2022|.13504|03/29/2022||||15703|||||No|No||ALEMBIC PHARMAC|No||||
metronidazole|Yes|No|No|No|75%|62332001631|METRONIDAZOLE 250 MG TABLET|100|EA|.12246|04/04/2017||Yes|No||04/04/2017||Yes|No|04/04/2017||Yes|No||||No|No|04/04/2017||Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|15704|||||No|No||ALEMBIC PHARMAC|No||||
metronidazole|Yes|No|No|No|75%|62332001671|METRONIDAZOLE 250 MG TABLET|500|EA|.1164|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||||No|No|08/25/2017||Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|15705|||||No|No||ALEMBIC PHARMAC|No||||
metronidazole|Yes|No|No|No|75%|62332001731|METRONIDAZOLE 500 MG TABLET|100|EA|.21904|04/04/2017||Yes|No||04/04/2017||Yes|No|04/04/2017||Yes|No||||No|No|04/04/2017||Prescription required|No||115|No|.15479|03/29/2022|.15107|03/29/2022|.15208|03/29/2022|||ANTIBIOTICS: GI|15706|||||No|No||ALEMBIC PHARMAC|No||||
metronidazole|Yes|No|No|No|75%|62332001771|METRONIDAZOLE 500 MG TABLET|500|EA|.20812|04/04/2017||Yes|No||04/04/2017||Yes|No|04/04/2017||Yes|No||||No|No|04/04/2017||Prescription required|No||115|No|.15479|03/29/2022|.15107|03/29/2022|.15208|03/29/2022|||ANTIBIOTICS: GI|15707|||||No|No||ALEMBIC PHARMAC|No||||
metronidazole|No|No|No|No|75%|62332001850|METRONIDAZOLE 375 MG CAPSULE|50|EA|4.22793|06/30/2017||Yes|No||06/30/2017||Yes|No|06/30/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|115|No|9.63575|11/07/2017|9.49809|11/07/2017|9.0458|11/07/2017|||ANTIBIOTICS: GI|15708|||||No|No||ALEMBIC PHARMAC|No||||
meprobamate|No|No|No|No|90%|62332001931|MEPROBAMATE 200 MG TABLET|100|EA|2.365|12/21/2016||Yes|No||12/21/2016||Yes|No|12/21/2016||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|5.39|06/27/2017|5.313|06/27/2017|5.06|06/27/2017|||ANXIOLYTICS|15709|||||No|No||ALEMBIC PHARMAC|No||||
meprobamate|No|No|No|No|90%|62332002031|MEPROBAMATE 400 MG TABLET|100|EA|2.838|12/21/2016||Yes|No||12/21/2016||Yes|No|12/21/2016||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|6.468|02/23/2021|6.3756|02/23/2021|6.072|02/23/2021|||ANXIOLYTICS|15710|||||No|No||ALEMBIC PHARMAC|No||||
fluoxetine HCl|No|No|No|No|75%|62332002231|FLUOXETINE HCL 10 MG CAPSULE|100|EA|.09137|06/29/2016||Yes|No||06/29/2016||Yes|No|06/29/2016||Yes|No||||No|No|||Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|15711|||||No|No||ALEMBIC PHARMAC|No||||
fluoxetine HCl|No|No|No|No|75%|62332002291|FLUOXETINE HCL 10 MG CAPSULE|1000|EA|.08863|02/16/2018||Yes|No||02/16/2018||Yes|No|02/16/2018||Yes|No||||No|No|||Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|15712|||||No|No||ALEMBIC PHARMAC|No||||
fluoxetine HCl|No|No|No|No|75%|62332002331|FLUOXETINE HCL 20 MG CAPSULE|100|EA|.09675|06/29/2016||Yes|No||06/29/2016||Yes|No|06/29/2016||Yes|No||||No|No|||Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|15713|||||No|No||ALEMBIC PHARMAC|No||||
fluoxetine HCl|No|No|No|No|75%|62332002391|FLUOXETINE HCL 20 MG CAPSULE|1000|EA|.09382|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|15714|||||No|No||ALEMBIC PHARMAC|No||||
fluoxetine HCl|No|No|No|No|75%|62332002430|FLUOXETINE HCL 40 MG CAPSULE|30|EA|.41652|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|15715|||||No|No||ALEMBIC PHARMAC|No||||
fluoxetine HCl|No|No|No|No|75%|62332002431|FLUOXETINE HCL 40 MG CAPSULE|100|EA|.31235|06/29/2016||Yes|No||06/29/2016||Yes|No|06/29/2016||Yes|No||||No|No|||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|15716|||||No|No||ALEMBIC PHARMAC|No||||
fluoxetine HCl|No|No|No|No|75%|62332002491|FLUOXETINE HCL 40 MG CAPSULE|1000|EA|.31991|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No||||No|No|||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|15717|||||No|No||ALEMBIC PHARMAC|No||||
theophylline anhydrous|No|No|No|No|75%|62332002531|THEOPHYLLINE ER 300 MG TAB|100|EA|1.47773|06/29/2016||Yes|No||06/29/2016||Yes|No|06/29/2016||Yes|No||||No|No|||Prescription required|No|||No|2.64018|03/29/2022|2.57681|03/29/2022|2.59397|03/29/2022||||15718|||||No|No||ALEMBIC PHARMAC|No||||
theophylline anhydrous|No|No|No|No|75%|62332002631|THEOPHYLLINE ER 450 MG TAB|100|EA|2.07939|06/29/2016||Yes|No||06/29/2016||Yes|No|06/29/2016||Yes|No||||No|No|||Prescription required|No|||No|4.73908|11/07/2017|4.67138|11/07/2017|4.44893|11/07/2017||||15719|||||No|No||ALEMBIC PHARMAC|No||||
losartan potassium|No|No|No|No|75%|62332002730|LOSARTAN POTASSIUM 25 MG TAB|30|EA|.17873|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|15720|||||No|No||ALEMBIC PHARMAC|No||||
losartan potassium|No|No|No|No|75%|62332002790|LOSARTAN POTASSIUM 25 MG TAB|90|EA|.17873|03/01/2017||Yes|No||03/01/2017||Yes|No|03/01/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|15721|||||No|No||ALEMBIC PHARMAC|No||||
losartan potassium|No|No|No|No|75%|62332002791|LOSARTAN POTASSIUM 25 MG TAB|1000|EA|.17873|03/01/2017||Yes|No||03/01/2017||Yes|No|03/01/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|15722|||||No|No||ALEMBIC PHARMAC|No||||
losartan potassium|No|No|No|No|75%|62332002830|LOSARTAN POTASSIUM 50 MG TAB|30|EA|.18432|03/01/2017||Yes|No||03/01/2017||Yes|No|03/01/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|15723|||||No|No||ALEMBIC PHARMAC|No||||
losartan potassium|No|No|No|No|75%|62332002890|LOSARTAN POTASSIUM 50 MG TAB|90|EA|.18427|03/01/2017||Yes|No||03/01/2017||Yes|No|03/01/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|15724|||||No|No||ALEMBIC PHARMAC|No||||
losartan potassium|No|No|No|No|75%|62332002891|LOSARTAN POTASSIUM 50 MG TAB|1000|EA|.18428|03/01/2017||Yes|No||03/01/2017||Yes|No|03/01/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|15725|||||No|No||ALEMBIC PHARMAC|No||||
losartan potassium|No|No|No|No|75%|62332002930|LOSARTAN POTASSIUM 100 MG TAB|30|EA|.1859|03/01/2017||Yes|No||03/01/2017||Yes|No|03/01/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|15726|||||No|No||ALEMBIC PHARMAC|No||||
losartan potassium|No|No|No|No|75%|62332002990|LOSARTAN POTASSIUM 100 MG TAB|90|EA|.18585|03/01/2017||Yes|No||03/01/2017||Yes|No|03/01/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|15727|||||No|No||ALEMBIC PHARMAC|No||||
losartan potassium|No|No|No|No|75%|62332002991|LOSARTAN POTASSIUM 100 MG TAB|1000|EA|.18585|03/01/2017||Yes|No||03/01/2017||Yes|No|03/01/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|15728|||||No|No||ALEMBIC PHARMAC|No||||
ropinirole HCl|No|No|No|No|75%|62332003031|ROPINIROLE HCL 0.25 MG TABLET|100|EA|.129|08/25/2016||Yes|No||08/25/2016||Yes|No|08/25/2016||Yes|No||||No|No|||Prescription required|No||015|No|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIPARKINSON'S AGENTS|15729|||||No|No||ALEMBIC PHARMAC|No||||
ropinirole HCl|No|No|No|No|75%|62332003131|ROPINIROLE HCL 0.5 MG TABLET|100|EA|.129|08/25/2016||Yes|No||08/25/2016||Yes|No|08/25/2016||Yes|No||||No|No|||Prescription required|No||015|No|.04899|03/29/2022|.04781|03/29/2022|.04813|03/29/2022|||ANTIPARKINSON'S AGENTS|15730|||||No|No||ALEMBIC PHARMAC|No||||
ropinirole HCl|No|No|No|No|75%|62332003231|ROPINIROLE HCL 1 MG TABLET|100|EA|.129|08/25/2016||Yes|No||08/25/2016||Yes|No|08/25/2016||Yes|No||||No|No|||Prescription required|No||015|No|.05246|03/29/2022|.0512|03/29/2022|.05154|03/29/2022|||ANTIPARKINSON'S AGENTS|15731|||||No|No||ALEMBIC PHARMAC|No||||
ropinirole HCl|No|No|No|No|75%|62332003331|ROPINIROLE HCL 2 MG TABLET|100|EA|.129|08/25/2016||Yes|No||08/25/2016||Yes|No|08/25/2016||Yes|No||||No|No|||Prescription required|No||015|No|.06367|03/29/2022|.06214|03/29/2022|.06255|03/29/2022|||ANTIPARKINSON'S AGENTS|15732|||||No|No||ALEMBIC PHARMAC|No||||
ropinirole HCl|No|No|No|No|75%|62332003431|ROPINIROLE HCL 3 MG TABLET|100|EA|.1505|08/25/2016||Yes|No||08/25/2016||Yes|No|08/25/2016||Yes|No||||No|No|||Prescription required|No||015|No|.10196|03/29/2022|.09951|03/29/2022|.10017|03/29/2022|||ANTIPARKINSON'S AGENTS|15733|||||No|No||ALEMBIC PHARMAC|No||||
ropinirole HCl|No|No|No|No|75%|62332003531|ROPINIROLE HCL 4 MG TABLET|100|EA|.1505|08/25/2016||Yes|No||08/25/2016||Yes|No|08/25/2016||Yes|No||||No|No|||Prescription required|No||015|No|.08517|03/29/2022|.08312|03/29/2022|.08367|03/29/2022|||ANTIPARKINSON'S AGENTS|15734|||||No|No||ALEMBIC PHARMAC|No||||
ropinirole HCl|No|No|No|No|75%|62332003631|ROPINIROLE HCL 5 MG TABLET|100|EA|.1505|08/25/2016||Yes|No||08/25/2016||Yes|No|08/25/2016||Yes|No||||No|No|||Prescription required|No||015|No|.08598|03/29/2022|.08391|03/29/2022|.08447|03/29/2022|||ANTIPARKINSON'S AGENTS|15735|||||No|No||ALEMBIC PHARMAC|No||||
lamotrigine|No|No|No|No|75%|62332003731|LAMOTRIGINE 25 MG TABLET|100|EA|.01917|09/28/2018||Yes|No||09/28/2018||Yes|No|09/28/2018||Yes|No||||No|No|||Prescription required|No||056|No|.03514|03/29/2022|.03429|03/29/2022|.03452|03/29/2022|||ANTICONVULSANTS|15736|||||No|No||ALEMBIC PHARMAC|No||||
lamotrigine|No|No|No|No|75%|62332003831|LAMOTRIGINE 100 MG TABLET|100|EA|.02795|09/28/2018||Yes|No||09/28/2018||Yes|No|09/28/2018||Yes|No||||No|No|||Prescription required|No||056|No|.06403|03/29/2022|.06249|03/29/2022|.0629|03/29/2022|||ANTICONVULSANTS|15737|||||No|No||ALEMBIC PHARMAC|No||||
lamotrigine|No|No|No|No|75%|62332003960|LAMOTRIGINE 150 MG TABLET|60|EA|.03755|09/28/2018||Yes|No||09/28/2018||Yes|No|09/28/2018||Yes|No||||No|No|||Prescription required|No||056|No|.0888|03/29/2022|.08666|03/29/2022|.08724|03/29/2022|||ANTICONVULSANTS|15738|||||No|No||ALEMBIC PHARMAC|No||||
lamotrigine|No|No|No|No|75%|62332004060|LAMOTRIGINE 200 MG TABLET|60|EA|.04486|09/28/2018||Yes|No||09/28/2018||Yes|No|09/28/2018||Yes|No||||No|No|||Prescription required|No||056|No|.10103|03/29/2022|.0986|03/29/2022|.09926|03/29/2022|||ANTICONVULSANTS|15739|||||No|No||ALEMBIC PHARMAC|No||||
irbesartan|No|No|No|No|75%|62332004130|IRBESARTAN 75 MG TABLET|30|EA|.15121|02/27/2017||Yes|No||02/27/2017||Yes|No|02/27/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.21751|03/29/2022|.21228|03/29/2022|.2137|03/29/2022|||ANGIOTENSIN MODULATORS|15740|||||No|No||ALEMBIC PHARMAC|No||||
irbesartan|No|No|No|No|75%|62332004190|IRBESARTAN 75 MG TABLET|90|EA|.15121|02/27/2017||Yes|No||02/27/2017||Yes|No|02/27/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.21751|03/29/2022|.21228|03/29/2022|.2137|03/29/2022|||ANGIOTENSIN MODULATORS|15741|||||No|No||ALEMBIC PHARMAC|No||||
irbesartan|No|No|No|No|75%|62332004230|IRBESARTAN 150 MG TABLET|30|EA|.1591|02/01/2017||Yes|No||02/01/2017||Yes|No|02/01/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.20852|03/29/2022|.20351|03/29/2022|.20487|03/29/2022|||ANGIOTENSIN MODULATORS|15742|||||No|No||ALEMBIC PHARMAC|No||||
irbesartan|No|No|No|No|75%|62332004271|IRBESARTAN 150 MG TABLET|500|EA|.1591|02/01/2017||Yes|No||02/01/2017||Yes|No|02/01/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.20852|03/29/2022|.20351|03/29/2022|.20487|03/29/2022|||ANGIOTENSIN MODULATORS|15743|||||No|No||ALEMBIC PHARMAC|No||||
irbesartan|No|No|No|No|75%|62332004290|IRBESARTAN 150 MG TABLET|90|EA|.1591|02/01/2017||Yes|No||02/01/2017||Yes|No|02/01/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.20852|03/29/2022|.20351|03/29/2022|.20487|03/29/2022|||ANGIOTENSIN MODULATORS|15744|||||No|No||ALEMBIC PHARMAC|No||||
irbesartan|No|No|No|No|75%|62332004330|IRBESARTAN 300 MG TABLET|30|EA|.19135|02/01/2017||Yes|No||02/01/2017||Yes|No|02/01/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.32541|03/29/2022|.3176|03/29/2022|.31971|03/29/2022|||ANGIOTENSIN MODULATORS|15745|||||No|No||ALEMBIC PHARMAC|No||||
irbesartan|No|No|No|No|75%|62332004371|IRBESARTAN 300 MG TABLET|500|EA|.19135|02/01/2017||Yes|No||02/01/2017||Yes|No|02/01/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.32541|03/29/2022|.3176|03/29/2022|.31971|03/29/2022|||ANGIOTENSIN MODULATORS|15746|||||No|No||ALEMBIC PHARMAC|No||||
irbesartan|No|No|No|No|75%|62332004390|IRBESARTAN 300 MG TABLET|90|EA|.19135|02/01/2017||Yes|No||02/01/2017||Yes|No|02/01/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.32541|03/29/2022|.3176|03/29/2022|.31971|03/29/2022|||ANGIOTENSIN MODULATORS|15747|||||No|No||ALEMBIC PHARMAC|No||||
valsartan|Yes|No|No|No|75%|62332004430|VALSARTAN 40 MG TABLET|30|EA|.61991|03/27/2019||Yes|No||03/27/2019||Yes|No|03/27/2019||Yes|No||||No|No|09/04/2019||Prescription required|Yes|07/29/2021|113|Yes|.1945|03/29/2022|.18983|03/29/2022|.19109|03/29/2022|||ANGIOTENSIN MODULATORS|15748|||||No|No||ALEMBIC PHARMAC|No||||
valsartan|No|No|No|No|75%|62332004490|VALSARTAN 40 MG TABLET|90|EA|.61986|12/09/2016||Yes|No||12/09/2016||Yes|No|12/09/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.1945|03/29/2022|.18983|03/29/2022|.19109|03/29/2022|||ANGIOTENSIN MODULATORS|15749|||||No|No||ALEMBIC PHARMAC|No||||
valsartan|No|No|No|No|75%|62332004571|VALSARTAN 80 MG TABLET|500|EA|.71884|12/09/2016||Yes|No||12/09/2016||Yes|No|12/09/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.21024|03/29/2022|.20519|03/29/2022|.20656|03/29/2022|||ANGIOTENSIN MODULATORS|15750|||||No|No||ALEMBIC PHARMAC|No||||
valsartan|No|No|No|No|75%|62332004590|VALSARTAN 80 MG TABLET|90|EA|.74107|12/09/2016||Yes|No||12/09/2016||Yes|No|12/09/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.21024|03/29/2022|.20519|03/29/2022|.20656|03/29/2022|||ANGIOTENSIN MODULATORS|15751|||||No|No||ALEMBIC PHARMAC|No||||
valsartan|No|No|No|No|75%|62332004671|VALSARTAN 160 MG TABLET|500|EA|.77297|12/09/2016||Yes|No||12/09/2016||Yes|No|12/09/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.23007|03/29/2022|.22454|03/29/2022|.22604|03/29/2022|||ANGIOTENSIN MODULATORS|15752|||||No|No||ALEMBIC PHARMAC|No||||
valsartan|No|No|No|No|75%|62332004690|VALSARTAN 160 MG TABLET|90|EA|.79688|12/09/2016||Yes|No||12/09/2016||Yes|No|12/09/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.23007|03/29/2022|.22454|03/29/2022|.22604|03/29/2022|||ANGIOTENSIN MODULATORS|15753|||||No|No||ALEMBIC PHARMAC|No||||
valsartan|No|No|No|No|75%|62332004771|VALSARTAN 320 MG TABLET|500|EA|.97787|12/09/2016||Yes|No||12/09/2016||Yes|No|12/09/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.31156|03/29/2022|.30408|03/29/2022|.3061|03/29/2022|||ANGIOTENSIN MODULATORS|15754|||||No|No||ALEMBIC PHARMAC|No||||
valsartan|No|No|No|No|75%|62332004790|VALSARTAN 320 MG TABLET|90|EA|1.0081|12/09/2016||Yes|No||12/09/2016||Yes|No|12/09/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.31156|03/29/2022|.30408|03/29/2022|.3061|03/29/2022|||ANGIOTENSIN MODULATORS|15755|||||No|No||ALEMBIC PHARMAC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|62332004830|LOSARTAN-HCTZ 50-12.5 MG TAB|30|EA|.43|02/01/2017||Yes|No||02/01/2017||Yes|No|02/01/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|15756|||||No|No||ALEMBIC PHARMAC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|62332004890|LOSARTAN-HCTZ 50-12.5 MG TAB|90|EA|.43|02/01/2017||Yes|No||02/01/2017||Yes|No|02/01/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|15757|||||No|No||ALEMBIC PHARMAC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|62332004891|LOSARTAN-HCTZ 50-12.5 MG TAB|1000|EA|.4085|02/01/2017||Yes|No||02/01/2017||Yes|No|02/01/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|15758|||||No|No||ALEMBIC PHARMAC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|62332004930|LOSARTAN-HCTZ 100-12.5 MG TAB|30|EA|.59125|02/10/2017||Yes|No||02/10/2017||Yes|No|02/10/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|15759|||||No|No||ALEMBIC PHARMAC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|62332004990|LOSARTAN-HCTZ 100-12.5 MG TAB|90|EA|.59125|02/10/2017||Yes|No||02/10/2017||Yes|No|02/10/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|15760|||||No|No||ALEMBIC PHARMAC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|62332004991|LOSARTAN-HCTZ 100-12.5 MG TAB|1000|EA|.56168|02/10/2017||Yes|No||02/10/2017||Yes|No|02/10/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|15761|||||No|No||ALEMBIC PHARMAC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|62332005030|LOSARTAN-HCTZ 100-25 MG TAB|30|EA|.59125|02/01/2017||Yes|No||02/01/2017||Yes|No|02/01/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.21077|03/01/2022|.20571|03/01/2022|.20708|03/01/2022|||ANGIOTENSIN MODULATORS|15762|||||No|No||ALEMBIC PHARMAC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|62332005090|LOSARTAN-HCTZ 100-25 MG TAB|90|EA|.59125|02/01/2017||Yes|No||02/01/2017||Yes|No|02/01/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.21077|03/01/2022|.20571|03/01/2022|.20708|03/01/2022|||ANGIOTENSIN MODULATORS|15763|||||No|No||ALEMBIC PHARMAC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|62332005091|LOSARTAN-HCTZ 100-25 MG TAB|1000|EA|.56168|02/01/2017||Yes|No||02/01/2017||Yes|No|02/01/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.21077|03/01/2022|.20571|03/01/2022|.20708|03/01/2022|||ANGIOTENSIN MODULATORS|15764|||||No|No||ALEMBIC PHARMAC|No||||
irbesartan/hydrochlorothiazide|No|No|No|No|75%|62332005130|IRBESARTAN-HCTZ 150-12.5 MG TB|30|EA|.18633|01/04/2017||Yes|No||01/04/2017||Yes|No|01/04/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.24959|03/29/2022|.24359|03/29/2022|.24522|03/29/2022|||ANGIOTENSIN MODULATORS|15765|||||No|No||ALEMBIC PHARMAC|No||||
irbesartan/hydrochlorothiazide|No|No|No|No|75%|62332005190|IRBESARTAN-HCTZ 150-12.5 MG TB|90|EA|.18633|01/04/2017||Yes|No||01/04/2017||Yes|No|01/04/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.24959|03/29/2022|.24359|03/29/2022|.24522|03/29/2022|||ANGIOTENSIN MODULATORS|15766|||||No|No||ALEMBIC PHARMAC|No||||
irbesartan/hydrochlorothiazide|No|No|No|No|75%|62332005230|IRBESARTAN-HCTZ 300-12.5 MG TB|30|EA|.24366|01/04/2017||Yes|No||01/04/2017||Yes|No|01/04/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.26247|03/29/2022|.25617|03/29/2022|.25787|03/29/2022|||ANGIOTENSIN MODULATORS|15767|||||No|No||ALEMBIC PHARMAC|No||||
irbesartan/hydrochlorothiazide|No|No|No|No|75%|62332005290|IRBESARTAN-HCTZ 300-12.5 MG TB|90|EA|.24366|01/04/2017||Yes|No||01/04/2017||Yes|No|01/04/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.26247|03/29/2022|.25617|03/29/2022|.25787|03/29/2022|||ANGIOTENSIN MODULATORS|15768|||||No|No||ALEMBIC PHARMAC|No||||
clonidine HCl|No|No|No|No|75%|62332005431|CLONIDINE HCL 0.1 MG TABLET|100|EA|.01814|12/13/2016||Yes|No||12/13/2016||Yes|No|12/13/2016||Yes|No||||No|No|||Prescription required|No||166|No|.03029|03/29/2022|.02956|03/29/2022|.02975|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|15769|||||No|No||ALEMBIC PHARMAC|No||||
clonidine HCl|No|No|No|No|75%|62332005471|CLONIDINE HCL 0.1 MG TABLET|500|EA|.01616|12/13/2016||Yes|No||12/13/2016||Yes|No|12/13/2016||Yes|No||||No|No|||Prescription required|No||166|No|.03029|03/29/2022|.02956|03/29/2022|.02975|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|15770|||||No|No||ALEMBIC PHARMAC|No||||
clonidine HCl|No|No|No|No|75%|62332005491|CLONIDINE HCL 0.1 MG TABLET|1000|EA|.02054|12/13/2016||Yes|No||12/13/2016||Yes|No|12/13/2016||Yes|No||||No|No|||Prescription required|No||166|No|.03029|03/29/2022|.02956|03/29/2022|.02975|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|15771|||||No|No||ALEMBIC PHARMAC|No||||
clonidine HCl|No|No|No|No|75%|62332005531|CLONIDINE HCL 0.2 MG TABLET|100|EA|.02485|12/13/2016||Yes|No||12/13/2016||Yes|No|12/13/2016||Yes|No||||No|No|||Prescription required|No||166|No|.0396|03/29/2022|.03864|03/29/2022|.0389|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|15772|||||No|No||ALEMBIC PHARMAC|No||||
clonidine HCl|No|No|No|No|75%|62332005571|CLONIDINE HCL 0.2 MG TABLET|500|EA|.02232|12/13/2016||Yes|No||12/13/2016||Yes|No|12/13/2016||Yes|No||||No|No|||Prescription required|No||166|No|.0396|03/29/2022|.03864|03/29/2022|.0389|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|15773|||||No|No||ALEMBIC PHARMAC|No||||
clonidine HCl|No|No|No|No|75%|62332005591|CLONIDINE HCL 0.2 MG TABLET|1000|EA|.03095|12/13/2016||Yes|No||12/13/2016||Yes|No|12/13/2016||Yes|No||||No|No|||Prescription required|No||166|No|.0396|03/29/2022|.03864|03/29/2022|.0389|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|15774|||||No|No||ALEMBIC PHARMAC|No||||
clonidine HCl|No|No|No|No|75%|62332005631|CLONIDINE HCL 0.3 MG TABLET|100|EA|.02769|12/13/2016||Yes|No||12/13/2016||Yes|No|12/13/2016||Yes|No||||No|No|||Prescription required|No||166|No|.03883|03/29/2022|.03789|03/29/2022|.03815|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|15775|||||No|No||ALEMBIC PHARMAC|No||||
clonidine HCl|No|No|No|No|75%|62332005671|CLONIDINE HCL 0.3 MG TABLET|500|EA|.02492|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|No||166|No|.03883|03/29/2022|.03789|03/29/2022|.03815|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|15776|||||No|No||ALEMBIC PHARMAC|No||||
candesartan cilexetil|No|No|No|No|75%|62332006030|CANDESARTAN CILEXETIL 32 MG TB|30|EA|1.31694|11/28/2017||Yes|No||11/28/2017||Yes|No|11/28/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|1.10475|03/29/2022|1.07823|03/29/2022|1.08541|03/29/2022|||ANGIOTENSIN MODULATORS|15777|||||No|No||ALEMBIC PHARMAC|No||||
candesartan cilexetil|No|No|No|No|75%|62332006090|CANDESARTAN CILEXETIL 32 MG TB|90|EA|1.26601|11/20/2017||Yes|No||11/20/2017||Yes|No|11/20/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|1.10475|03/29/2022|1.07823|03/29/2022|1.08541|03/29/2022|||ANGIOTENSIN MODULATORS|15778|||||No|No||ALEMBIC PHARMAC|No||||
leflunomide|No|No|No|No|75%|62332006130|LEFLUNOMIDE 10 MG TABLET|30|EA|2.15|06/07/2017||Yes|No||06/07/2017||Yes|No|06/07/2017||Yes|No||||No|No|||Prescription required|No|||No|.80538|03/29/2022|.78605|03/29/2022|.79128|03/29/2022||||15779|||||No|No||ALEMBIC PHARMAC|No||||
leflunomide|No|No|No|No|75%|62332006230|LEFLUNOMIDE 20 MG TABLET|30|EA|2.15|06/07/2017||Yes|No||06/07/2017||Yes|No|06/07/2017||Yes|No||||No|No|||Prescription required|No|||No|.61902|03/29/2022|.60416|03/29/2022|.60818|03/29/2022||||15780|||||No|No||ALEMBIC PHARMAC|No||||
memantine HCl|No|No|No|No|75%|62332007531|MEMANTINE HCL 5 MG TABLET|100|EA|.15587|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||||No|No|||Prescription required|No||011|No|.08825|03/29/2022|.08613|03/29/2022|.0867|03/29/2022|||ALZHEIMER'S AGENTS|15781|||||No|No||ALEMBIC PHARMAC|No||||
memantine HCl|No|No|No|No|75%|62332007560|MEMANTINE HCL 5 MG TABLET|60|EA|.15587|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|No||011|No|.08825|03/29/2022|.08613|03/29/2022|.0867|03/29/2022|||ALZHEIMER'S AGENTS|15782|||||No|No||ALEMBIC PHARMAC|No||||
memantine HCl|No|No|No|No|75%|62332007591|MEMANTINE HCL 5 MG TABLET|1000|EA|.14028|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|No||011|No|.08825|03/29/2022|.08613|03/29/2022|.0867|03/29/2022|||ALZHEIMER'S AGENTS|15783|||||No|No||ALEMBIC PHARMAC|No||||
memantine HCl|No|No|No|No|75%|62332007631|MEMANTINE HCL 10 MG TABLET|100|EA|.15587|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|15784|||||No|No||ALEMBIC PHARMAC|No||||
memantine HCl|No|No|No|No|75%|62332007642|MEMANTINE HCL 10 MG TABLET|3000|EA|.14028|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|15785|||||No|No||ALEMBIC PHARMAC|No||||
memantine HCl|No|No|No|No|75%|62332007660|MEMANTINE HCL 10 MG TABLET|60|EA|.15587|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|15786|||||No|No||ALEMBIC PHARMAC|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|62332007971|VALSARTAN-HCTZ 80-12.5 MG TAB|500|EA|.51808|12/09/2016||Yes|No||12/09/2016||Yes|No|12/09/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.29054|03/29/2022|.28356|03/29/2022|.28545|03/29/2022|||ANGIOTENSIN MODULATORS|15787|||||No|No||ALEMBIC PHARMAC|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|62332007990|VALSARTAN-HCTZ 80-12.5 MG TAB|90|EA|.51805|12/09/2016||Yes|No||12/09/2016||Yes|No|12/09/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.29054|03/29/2022|.28356|03/29/2022|.28545|03/29/2022|||ANGIOTENSIN MODULATORS|15788|||||No|No||ALEMBIC PHARMAC|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|62332008071|VALSARTAN-HCTZ 160-12.5 MG TAB|500|EA|.56366|12/16/2016||Yes|No||12/16/2016||Yes|No|12/16/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.28742|03/29/2022|.28052|03/29/2022|.28239|03/29/2022|||ANGIOTENSIN MODULATORS|15789|||||No|No||ALEMBIC PHARMAC|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|62332008090|VALSARTAN-HCTZ 160-12.5 MG TAB|90|EA|.56363|12/09/2016||Yes|No||12/09/2016||Yes|No|12/09/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.28742|03/29/2022|.28052|03/29/2022|.28239|03/29/2022|||ANGIOTENSIN MODULATORS|15790|||||No|No||ALEMBIC PHARMAC|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|62332008171|VALSARTAN-HCTZ 160-25 MG TAB|500|EA|.63925|12/16/2016||Yes|No||12/16/2016||Yes|No|12/16/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.29583|03/29/2022|.28873|03/29/2022|.29065|03/29/2022|||ANGIOTENSIN MODULATORS|15791|||||No|No||ALEMBIC PHARMAC|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|62332008190|VALSARTAN-HCTZ 160-25 MG TAB|90|EA|.63921|12/16/2016||Yes|No||12/16/2016||Yes|No|12/16/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.29583|03/29/2022|.28873|03/29/2022|.29065|03/29/2022|||ANGIOTENSIN MODULATORS|15792|||||No|No||ALEMBIC PHARMAC|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|62332008271|VALSARTAN-HCTZ 320-12.5 MG TAB|500|EA|.71416|12/09/2016||Yes|No||12/09/2016||Yes|No|12/09/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.41056|03/29/2022|.4007|03/29/2022|.40337|03/29/2022|||ANGIOTENSIN MODULATORS|15793|||||No|No||ALEMBIC PHARMAC|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|62332008290|VALSARTAN-HCTZ 320-12.5 MG TAB|90|EA|.71413|12/16/2016||Yes|No||12/16/2016||Yes|No|12/16/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.41056|03/29/2022|.4007|03/29/2022|.40337|03/29/2022|||ANGIOTENSIN MODULATORS|15794|||||No|No||ALEMBIC PHARMAC|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|62332008371|VALSARTAN-HCTZ 320-25 MG TAB|500|EA|.8102|12/09/2016||Yes|No||12/09/2016||Yes|No|12/09/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.3994|03/29/2022|.38981|03/29/2022|.39241|03/29/2022|||ANGIOTENSIN MODULATORS|15795|||||No|No||ALEMBIC PHARMAC|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|62332008390|VALSARTAN-HCTZ 320-25 MG TAB|90|EA|.81021|12/16/2016||Yes|No||12/16/2016||Yes|No|12/16/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.3994|03/29/2022|.38981|03/29/2022|.39241|03/29/2022|||ANGIOTENSIN MODULATORS|15796|||||No|No||ALEMBIC PHARMAC|No||||
fenofibrate,micronized|No|No|No|No|75%|62332008431|FENOFIBRATE 67 MG CAPSULE|100|EA|.09563|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|No||055|No|.15038|03/29/2022|.14677|03/29/2022|.14774|03/29/2022|||LIPOTROPICS: OTHER|15797|||||No|No||ALEMBIC PHARMAC|No||||
fenofibrate,micronized|No|No|No|No|75%|62332008631|FENOFIBRATE 200 MG CAPSULE|100|EA|.28448|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|No||055|No|.22993|03/29/2022|.22441|03/29/2022|.2259|03/29/2022|||LIPOTROPICS: OTHER|15798|||||No|No||ALEMBIC PHARMAC|No||||
telmisartan|No|No|No|No|75%|62332008730|TELMISARTAN 20 MG TABLET|30|EA|.50166|12/09/2016||Yes|No||12/09/2016||Yes|No|12/09/2016||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.30407|03/29/2022|.29677|03/29/2022|.29874|03/29/2022|||ANGIOTENSIN MODULATORS|15799|||||No|No||ALEMBIC PHARMAC|No||||
telmisartan|No|No|No|No|75%|62332008830|TELMISARTAN 40 MG TABLET|30|EA|.50166|12/09/2016||Yes|No||12/09/2016||Yes|No|12/09/2016||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.35861|03/29/2022|.35|03/29/2022|.35233|03/29/2022|||ANGIOTENSIN MODULATORS|15800|||||No|No||ALEMBIC PHARMAC|No||||
telmisartan|No|No|No|No|75%|62332008930|TELMISARTAN 80 MG TABLET|30|EA|.50166|12/09/2016||Yes|No||12/09/2016||Yes|No|12/09/2016||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.33958|03/29/2022|.33143|03/29/2022|.33363|03/29/2022|||ANGIOTENSIN MODULATORS|15801|||||No|No||ALEMBIC PHARMAC|No||||
donepezil HCl|No|No|No|No|75%|62332009230|DONEPEZIL HCL 5 MG TABLET|30|EA|.33454|11/08/2016||Yes|No||11/08/2016||Yes|No|11/08/2016||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|15802|||||No|No||ALEMBIC PHARMAC|No||||
donepezil HCl|No|No|No|No|75%|62332009290|DONEPEZIL HCL 5 MG TABLET|90|EA|.33454|08/15/2016||Yes|No||08/15/2016||Yes|No|08/15/2016||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|15803|||||No|No||ALEMBIC PHARMAC|No||||
donepezil HCl|No|No|No|No|75%|62332009291|DONEPEZIL HCL 5 MG TABLET|1000|EA|.3245|03/02/2017||Yes|No||03/02/2017||Yes|No|03/02/2017||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|15804|||||No|No||ALEMBIC PHARMAC|No||||
donepezil HCl|No|No|No|No|75%|62332009330|DONEPEZIL HCL 10 MG TABLET|30|EA|.33454|12/09/2016||Yes|No||12/09/2016||Yes|No|12/09/2016||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|15805|||||No|No||ALEMBIC PHARMAC|No||||
donepezil HCl|No|No|No|No|75%|62332009390|DONEPEZIL HCL 10 MG TABLET|90|EA|.33454|03/02/2017||Yes|No||03/02/2017||Yes|No|03/02/2017||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|15806|||||No|No||ALEMBIC PHARMAC|No||||
donepezil HCl|No|No|No|No|75%|62332009391|DONEPEZIL HCL 10 MG TABLET|1000|EA|.3245|03/02/2017||Yes|No||03/02/2017||Yes|No|03/02/2017||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|15807|||||No|No||ALEMBIC PHARMAC|No||||
lamotrigine|No|No|No|No|75%|62332009531|LAMOTRIGINE 5 MG DISPER TABLET|100|EA|.1781|10/06/2016||Yes|No||10/06/2016||Yes|No|10/06/2016||Yes|No||||No|No|||Prescription required|No||056|No|.28106|12/28/2021|.27431|12/28/2021|.27614|12/28/2021|||ANTICONVULSANTS|15808|||||No|No||ALEMBIC PHARMAC|No||||
lamotrigine|No|No|No|No|75%|62332009631|LAMOTRIGINE 25 MG DISPER TAB|100|EA|.18945|10/06/2016||Yes|No||10/06/2016||Yes|No|10/06/2016||Yes|No||||No|No|||Prescription required|No||056|No|.29045|03/29/2022|.28347|03/29/2022|.28536|03/29/2022|||ANTICONVULSANTS|15809|||||No|No||ALEMBIC PHARMAC|No||||
aripiprazole|No|No|No|No|75%|62332009730|ARIPIPRAZOLE 2 MG TABLET|30|EA|.301|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|15810|||||No|No||ALEMBIC PHARMAC|No||||
aripiprazole|No|No|No|No|75%|62332009731|ARIPIPRAZOLE 2 MG TABLET|100|EA|.301|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|15811|||||No|No||ALEMBIC PHARMAC|No||||
aripiprazole|No|No|No|No|75%|62332009830|ARIPIPRAZOLE 5 MG TABLET|30|EA|.301|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|15812|||||No|No||ALEMBIC PHARMAC|No||||
aripiprazole|No|No|No|No|75%|62332009831|ARIPIPRAZOLE 5 MG TABLET|100|EA|.301|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|15813|||||No|No||ALEMBIC PHARMAC|No||||
aripiprazole|No|No|No|No|75%|62332009930|ARIPIPRAZOLE 10 MG TABLET|30|EA|.301|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|15814|||||No|No||ALEMBIC PHARMAC|No||||
aripiprazole|No|No|No|No|75%|62332009931|ARIPIPRAZOLE 10 MG TABLET|100|EA|.301|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|15815|||||No|No||ALEMBIC PHARMAC|No||||
aripiprazole|No|No|No|No|75%|62332010030|ARIPIPRAZOLE 15 MG TABLET|30|EA|.301|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|15816|||||No|No||ALEMBIC PHARMAC|No||||
aripiprazole|No|No|No|No|75%|62332010031|ARIPIPRAZOLE 15 MG TABLET|100|EA|.301|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|15817|||||No|No||ALEMBIC PHARMAC|No||||
aripiprazole|No|No|No|No|75%|62332010130|ARIPIPRAZOLE 20 MG TABLET|30|EA|.38642|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|15818|||||No|No||ALEMBIC PHARMAC|No||||
aripiprazole|No|No|No|No|75%|62332010131|ARIPIPRAZOLE 20 MG TABLET|100|EA|.38635|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|15819|||||No|No||ALEMBIC PHARMAC|No||||
aripiprazole|No|No|No|No|75%|62332010230|ARIPIPRAZOLE 30 MG TABLET|30|EA|.38642|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|15820|||||No|No||ALEMBIC PHARMAC|No||||
aripiprazole|No|No|No|No|75%|62332010231|ARIPIPRAZOLE 30 MG TABLET|100|EA|.38635|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|15821|||||No|No||ALEMBIC PHARMAC|No||||
aripiprazole|No|No|No|No|75%|62332010330|ARIPIPRAZOLE ODT 10 MG TABLET|30|EA|14.41102|02/01/2017||Yes|No||02/01/2017||Yes|No|02/01/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|027|Yes|32.84372|11/07/2017|32.37452|11/07/2017|30.83288|11/07/2017|||ANTIPSYCHOTICS|15822|||||No|No||ALEMBIC PHARMAC|No||||
aripiprazole|No|No|No|No|75%|62332010430|ARIPIPRAZOLE ODT 15 MG TABLET|30|EA|14.41102|02/01/2017||Yes|No||02/01/2017||Yes|No|02/01/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|027|Yes|32.84372|11/07/2017|32.37452|11/07/2017|30.83288|11/07/2017|||ANTIPSYCHOTICS|15823|||||No|No||ALEMBIC PHARMAC|No||||
ropinirole HCl|No|No|No|No|75%|62332010730|ROPINIROLE HCL ER 2 MG TABLET|30|EA|.92564|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|.59483|03/29/2022|.58055|03/29/2022|.58442|03/29/2022|||ANTIPARKINSON'S AGENTS|15824|||||No|No||ALEMBIC PHARMAC|No||||
ropinirole HCl|No|No|No|No|75%|62332010790|ROPINIROLE HCL ER 2 MG TABLET|90|EA|.92569|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|.59483|03/29/2022|.58055|03/29/2022|.58442|03/29/2022|||ANTIPARKINSON'S AGENTS|15825|||||No|No||ALEMBIC PHARMAC|No||||
ropinirole HCl|No|No|No|No|75%|62332010830|ROPINIROLE HCL ER 4 MG TABLET|30|EA|1.85129|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|1.04346|03/29/2022|1.01841|03/29/2022|1.02519|03/29/2022|||ANTIPARKINSON'S AGENTS|15826|||||No|No||ALEMBIC PHARMAC|No||||
ropinirole HCl|No|No|No|No|75%|62332010890|ROPINIROLE HCL ER 4 MG TABLET|90|EA|1.85143|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|1.04346|03/29/2022|1.01841|03/29/2022|1.02519|03/29/2022|||ANTIPARKINSON'S AGENTS|15827|||||No|No||ALEMBIC PHARMAC|No||||
ropinirole HCl|No|No|No|No|75%|62332010930|ROPINIROLE HCL ER 6 MG TABLET|30|EA|2.77708|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|2.547|03/29/2022|2.48587|03/29/2022|2.50242|03/29/2022|||ANTIPARKINSON'S AGENTS|15828|||||No|No||ALEMBIC PHARMAC|No||||
ropinirole HCl|No|No|No|No|75%|62332011030|ROPINIROLE HCL ER 8 MG TABLET|30|EA|2.77708|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|1.52194|03/29/2022|1.48541|03/29/2022|1.4953|03/29/2022|||ANTIPARKINSON'S AGENTS|15829|||||No|No||ALEMBIC PHARMAC|No||||
ropinirole HCl|No|No|No|No|75%|62332011090|ROPINIROLE HCL ER 8 MG TABLET|90|EA|2.77717|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|1.52194|03/29/2022|1.48541|03/29/2022|1.4953|03/29/2022|||ANTIPARKINSON'S AGENTS|15830|||||No|No||ALEMBIC PHARMAC|No||||
ropinirole HCl|No|No|No|No|75%|62332011130|ROPINIROLE HCL ER 12 MG TABLET|30|EA|4.62866|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|2.53667|09/28/2021|2.47578|09/28/2021|2.49227|09/28/2021|||ANTIPARKINSON'S AGENTS|15831|||||No|No||ALEMBIC PHARMAC|No||||
metoprolol tartrate|No|No|No|No|75%|62332011231|METOPROLOL TARTRATE 25 MG TAB|100|EA|.0135|02/09/2016||Yes|No||02/09/2016||Yes|No|02/09/2016||Yes|No||||No|No|||Prescription required|No||070|No|.01777|03/29/2022|.01734|03/29/2022|.01745|03/29/2022|||BETA-BLOCKERS|15832|||||No|No||ALEMBIC PHARMAC|No||||
metoprolol tartrate|No|No|No|No|75%|62332011291|METOPROLOL TARTRATE 25 MG TAB|1000|EA|.01139|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|No||070|No|.01777|03/29/2022|.01734|03/29/2022|.01745|03/29/2022|||BETA-BLOCKERS|15833|||||No|No||ALEMBIC PHARMAC|No||||
metoprolol tartrate|No|No|No|No|75%|62332011331|METOPROLOL TARTRATE 50 MG TAB|100|EA|.01427|06/30/2016||Yes|No||06/30/2016||Yes|No|06/30/2016||Yes|No||||No|No|||Prescription required|No||070|No|.02252|03/29/2022|.02197|03/29/2022|.02212|03/29/2022|||BETA-BLOCKERS|15834|||||No|No||ALEMBIC PHARMAC|No||||
metoprolol tartrate|No|No|No|No|75%|62332011391|METOPROLOL TARTRATE 50 MG TAB|1000|EA|.01139|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|No||070|No|.02252|03/29/2022|.02197|03/29/2022|.02212|03/29/2022|||BETA-BLOCKERS|15835|||||No|No||ALEMBIC PHARMAC|No||||
metoprolol tartrate|No|No|No|No|75%|62332011431|METOPROLOL TARTRATE 100 MG TAB|100|EA|.01969|06/30/2016||Yes|No||06/30/2016||Yes|No|06/30/2016||Yes|No||||No|No|||Prescription required|No||070|No|.03443|03/29/2022|.0336|03/29/2022|.03382|03/29/2022|||BETA-BLOCKERS|15836|||||No|No||ALEMBIC PHARMAC|No||||
metoprolol tartrate|No|No|No|No|75%|62332011491|METOPROLOL TARTRATE 100 MG TAB|1000|EA|.01691|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|No||070|No|.03443|03/29/2022|.0336|03/29/2022|.03382|03/29/2022|||BETA-BLOCKERS|15837|||||No|No||ALEMBIC PHARMAC|No||||
metoprolol/hydrochlorothiazide|No|No|No|No|75%|62332011531|METOPROLOL-HCTZ 50-25 MG TAB|100|EA|.52085|12/11/2015||Yes|No||12/11/2015||Yes|No|12/11/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|070|Yes|1.02132|03/01/2022|.9968|03/01/2022|1.00344|03/01/2022|||BETA-BLOCKERS|15838|||||No|No||ALEMBIC PHARMAC|No||||
metoprolol/hydrochlorothiazide|No|No|No|No|75%|62332011631|METOPROLOL-HCTZ 100-25 MG TAB|100|EA|.75361|12/11/2015||Yes|No||12/11/2015||Yes|No|12/11/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|070|Yes|1.54164|12/28/2021|1.50464|12/28/2021|1.51466|12/28/2021|||BETA-BLOCKERS|15839|||||No|No||ALEMBIC PHARMAC|No||||
pregabalin|No|No|No|No|90%|62332011990|PREGABALIN 25 MG CAPSULE|90|EA|.07166|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.0795|03/29/2022|.07759|03/29/2022|.0781|03/29/2022|||NEUROPATHIC PAIN|15840|||||No|No||ALEMBIC PHARMAC|No||||
pregabalin|No|No|No|No|90%|62332012090|PREGABALIN 50 MG CAPSULE|90|EA|.07166|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.09128|03/29/2022|.08908|03/29/2022|.08968|03/29/2022|||NEUROPATHIC PAIN|15841|||||No|No||ALEMBIC PHARMAC|No||||
pregabalin|No|No|No|No|90%|62332012190|PREGABALIN 75 MG CAPSULE|90|EA|.07166|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.08098|03/29/2022|.07903|03/29/2022|.07956|03/29/2022|||NEUROPATHIC PAIN|15842|||||No|No||ALEMBIC PHARMAC|No||||
pregabalin|No|No|No|No|90%|62332012290|PREGABALIN 100 MG CAPSULE|90|EA|.07166|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.08763|03/29/2022|.08552|03/29/2022|.08609|03/29/2022|||NEUROPATHIC PAIN|15843|||||No|No||ALEMBIC PHARMAC|No||||
pregabalin|No|No|No|No|90%|62332012390|PREGABALIN 150 MG CAPSULE|90|EA|.07166|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.10646|03/29/2022|.1039|03/29/2022|.10459|03/29/2022|||NEUROPATHIC PAIN|15844|||||No|No||ALEMBIC PHARMAC|No||||
pregabalin|No|No|No|No|90%|62332012490|PREGABALIN 200 MG CAPSULE|90|EA|.07166|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.11395|03/29/2022|.11121|03/29/2022|.11195|03/29/2022|||NEUROPATHIC PAIN|15845|||||No|No||ALEMBIC PHARMAC|No||||
pregabalin|No|No|No|No|90%|62332012590|PREGABALIN 225 MG CAPSULE|90|EA|.07166|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.12393|03/29/2022|.12095|03/29/2022|.12176|03/29/2022|||NEUROPATHIC PAIN|15846|||||No|No||ALEMBIC PHARMAC|No||||
pregabalin|No|No|No|No|90%|62332012690|PREGABALIN 300 MG CAPSULE|90|EA|.07166|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.12181|03/29/2022|.11888|03/29/2022|.11967|03/29/2022|||NEUROPATHIC PAIN|15847|||||No|No||ALEMBIC PHARMAC|No||||
olmesartan medoxomil|No|No|No|No|75%|62332013130|OLMESARTAN MEDOXOMIL 5 MG TAB|30|EA|.14333|09/19/2017||Yes|No||09/19/2017||Yes|No|09/19/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.07425|03/29/2022|.07246|03/29/2022|.07295|03/29/2022|||ANGIOTENSIN MODULATORS|15848|||||No|No||ALEMBIC PHARMAC|No||||
olmesartan medoxomil|No|No|No|No|75%|62332013230|OLMESARTAN MEDOXOMIL 20 MG TAB|30|EA|.172|09/25/2017||Yes|No||09/25/2017||Yes|No|09/25/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.1002|03/29/2022|.09779|03/29/2022|.09844|03/29/2022|||ANGIOTENSIN MODULATORS|15849|||||No|No||ALEMBIC PHARMAC|No||||
olmesartan medoxomil|No|No|No|No|75%|62332013290|OLMESARTAN MEDOXOMIL 20 MG TAB|90|EA|.172|09/25/2017||Yes|No||09/25/2017||Yes|No|09/25/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.1002|03/29/2022|.09779|03/29/2022|.09844|03/29/2022|||ANGIOTENSIN MODULATORS|15850|||||No|No||ALEMBIC PHARMAC|No||||
olmesartan medoxomil|No|No|No|No|75%|62332013330|OLMESARTAN MEDOXOMIL 40 MG TAB|30|EA|.172|09/25/2017||Yes|No||09/25/2017||Yes|No|09/25/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.15714|03/29/2022|.15336|03/29/2022|.15439|03/29/2022|||ANGIOTENSIN MODULATORS|15851|||||No|No||ALEMBIC PHARMAC|No||||
olmesartan medoxomil|No|No|No|No|75%|62332013390|OLMESARTAN MEDOXOMIL 40 MG TAB|90|EA|.172|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.15714|03/29/2022|.15336|03/29/2022|.15439|03/29/2022|||ANGIOTENSIN MODULATORS|15852|||||No|No||ALEMBIC PHARMAC|No||||
celecoxib|No|No|No|No|75%|62332014060|CELECOXIB 50 MG CAPSULE|60|EA|.11466|06/06/2016||Yes|No||06/06/2016||Yes|No|06/06/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.1386|03/29/2022|.13527|03/29/2022|.13617|03/29/2022|||NSAIDS|15853|||||No|No||ALEMBIC PHARMAC|No||||
celecoxib|No|No|No|No|75%|62332014131|CELECOXIB 100 MG CAPSULE|100|EA|.129|06/06/2016||Yes|No||06/06/2016||Yes|No|06/06/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|15854|||||No|No||ALEMBIC PHARMAC|No||||
celecoxib|No|No|No|No|75%|62332014171|CELECOXIB 100 MG CAPSULE|500|EA|.12771|10/31/2018||Yes|No||10/31/2018||Yes|No|10/31/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|15855|||||No|No||ALEMBIC PHARMAC|No||||
celecoxib|No|No|No|No|75%|62332014231|CELECOXIB 200 MG CAPSULE|100|EA|.258|02/09/2016||Yes|No||02/09/2016||Yes|No|02/09/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|15856|||||No|No||ALEMBIC PHARMAC|No||||
celecoxib|No|No|No|No|75%|62332014271|CELECOXIB 200 MG CAPSULE|500|EA|.2064|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|15857|||||No|No||ALEMBIC PHARMAC|No||||
celecoxib|No|No|No|No|75%|62332014291|CELECOXIB 200 MG CAPSULE|1000|EA|.19608|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|15858|||||No|No||ALEMBIC PHARMAC|No||||
celecoxib|No|No|No|No|75%|62332014360|CELECOXIB 400 MG CAPSULE|60|EA|.50166|06/06/2016||Yes|No||06/06/2016||Yes|No|06/06/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.73632|03/29/2022|.71864|03/29/2022|.72343|03/29/2022|||NSAIDS|15859|||||No|No||ALEMBIC PHARMAC|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|62332014930|OLMESARTAN-HCTZ 20-12.5 MG TAB|30|EA|.14333|09/20/2017||Yes|No||09/20/2017||Yes|No|09/20/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.22565|03/29/2022|.22023|03/29/2022|.2217|03/29/2022|||ANGIOTENSIN MODULATORS|15860|||||No|No||ALEMBIC PHARMAC|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|62332014990|OLMESARTAN-HCTZ 20-12.5 MG TAB|90|EA|.14333|09/20/2017||Yes|No||09/20/2017||Yes|No|09/20/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.22565|03/29/2022|.22023|03/29/2022|.2217|03/29/2022|||ANGIOTENSIN MODULATORS|15861|||||No|No||ALEMBIC PHARMAC|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|62332015030|OLMESARTAN-HCTZ 40-12.5 MG TAB|30|EA|.172|09/20/2017||Yes|No||09/20/2017||Yes|No|09/20/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.29168|03/29/2022|.28467|03/29/2022|.28657|03/29/2022|||ANGIOTENSIN MODULATORS|15862|||||No|No||ALEMBIC PHARMAC|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|62332015090|OLMESARTAN-HCTZ 40-12.5 MG TAB|90|EA|.172|09/20/2017||Yes|No||09/20/2017||Yes|No|09/20/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.29168|03/29/2022|.28467|03/29/2022|.28657|03/29/2022|||ANGIOTENSIN MODULATORS|15863|||||No|No||ALEMBIC PHARMAC|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|62332015130|OLMESARTAN-HCTZ 40-25 MG TAB|30|EA|.172|09/20/2017||Yes|No||09/20/2017||Yes|No|09/20/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.29227|03/29/2022|.28525|03/29/2022|.28715|03/29/2022|||ANGIOTENSIN MODULATORS|15864|||||No|No||ALEMBIC PHARMAC|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|62332015190|OLMESARTAN-HCTZ 40-25 MG TAB|90|EA|.172|09/20/2017||Yes|No||09/20/2017||Yes|No|09/20/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.29227|03/29/2022|.28525|03/29/2022|.28715|03/29/2022|||ANGIOTENSIN MODULATORS|15865|||||No|No||ALEMBIC PHARMAC|No||||
linezolid|No|No|No|No|75%|62332018320|LINEZOLID 600 MG TABLET|20|EA|5.27653|10/06/2016||Yes|No||10/06/2016||Yes|No|10/06/2016||Yes|No||||No|No|||Prescription required|No||146|No|2.07915|03/29/2022|2.02925|03/29/2022|2.04276|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|15866|||||No|No||ALEMBIC PHARMAC|No||||
febuxostat|No|No|No|No|75%|62332019030|FEBUXOSTAT 40 MG TABLET|30|EA|.75966|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|231|No|.89466|03/29/2022|.87318|03/29/2022|.879|03/29/2022|||ANTIHYPERURICEMICS|15867|||||No|No||ALEMBIC PHARMAC|No||||
febuxostat|No|No|No|No|75%|62332019130|FEBUXOSTAT 80 MG TABLET|30|EA|.75966|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|231|No|.93355|03/29/2022|.91114|03/29/2022|.91721|03/29/2022|||ANTIHYPERURICEMICS|15868|||||No|No||ALEMBIC PHARMAC|No||||
solifenacin succinate|No|No|No|No|75%|62332019230|SOLIFENACIN 5 MG TABLET|30|EA|.14333|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|Yes|.23024|03/29/2022|.22471|03/29/2022|.22621|03/29/2022|||BLADDER RELAXANT PREPARATIONS|15869|||||No|No||ALEMBIC PHARMAC|No||||
solifenacin succinate|No|No|No|No|75%|62332019290|SOLIFENACIN 5 MG TABLET|90|EA|.14333|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|Yes|.23024|03/29/2022|.22471|03/29/2022|.22621|03/29/2022|||BLADDER RELAXANT PREPARATIONS|15870|||||No|No||ALEMBIC PHARMAC|No||||
solifenacin succinate|No|No|No|No|75%|62332019330|SOLIFENACIN 10 MG TABLET|30|EA|.14333|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|No|.26101|03/29/2022|.25474|03/29/2022|.25644|03/29/2022|||BLADDER RELAXANT PREPARATIONS|15871|||||No|No||ALEMBIC PHARMAC|No||||
solifenacin succinate|No|No|No|No|75%|62332019390|SOLIFENACIN 10 MG TABLET|90|EA|.14333|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|No|.26101|03/29/2022|.25474|03/29/2022|.25644|03/29/2022|||BLADDER RELAXANT PREPARATIONS|15872|||||No|No||ALEMBIC PHARMAC|No||||
asenapine maleate|No|No|No|No|75%|62332019831|ASENAPINE 5 MG TABLET SL|100|EA|7.74511|04/08/2021||Yes|No||04/08/2021||Yes|No|04/08/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|027|Yes|4.41931|03/29/2022|4.31324|03/29/2022|4.34197|03/29/2022|||ANTIPSYCHOTICS|15873|||||No|No||ALEMBIC PHARMAC|No||||
asenapine maleate|No|No|No|No|75%|62332019860|ASENAPINE 5 MG TABLET SL|60|EA|7.74522|04/08/2021||Yes|No||04/08/2021||Yes|No|04/08/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|027|Yes|4.41931|03/29/2022|4.31324|03/29/2022|4.34197|03/29/2022|||ANTIPSYCHOTICS|15874|||||No|No||ALEMBIC PHARMAC|No||||
asenapine maleate|No|No|No|No|75%|62332019931|ASENAPINE 10 MG TABLET SL|100|EA|7.74511|04/08/2021||Yes|No||04/08/2021||Yes|No|04/08/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|027|Yes|4.33734|03/29/2022|4.23324|03/29/2022|4.26143|03/29/2022|||ANTIPSYCHOTICS|15875|||||No|No||ALEMBIC PHARMAC|No||||
asenapine maleate|No|No|No|No|75%|62332019960|ASENAPINE 10 MG TABLET SL|60|EA|7.74522|04/08/2021||Yes|No||04/08/2021||Yes|No|04/08/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|027|Yes|4.33734|03/29/2022|4.23324|03/29/2022|4.26143|03/29/2022|||ANTIPSYCHOTICS|15876|||||No|No||ALEMBIC PHARMAC|No||||
itraconazole|No|No|No|No|75%|62332020404|ITRACONAZOLE 100 MG CAPSULE|28|EA|3.20012|05/30/2018||Yes|No||05/30/2018||Yes|No|05/30/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|069|No|.85195|03/29/2022|.8315|03/29/2022|.83704|03/29/2022|||ANTIFUNGALS: ORAL|15877|||||No|No||ALEMBIC PHARMAC|No||||
itraconazole|No|No|No|No|75%|62332020430|ITRACONAZOLE 100 MG CAPSULE|30|EA|2.87211|06/30/2017||Yes|No||06/30/2017||Yes|No|06/30/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|069|No|.85195|03/29/2022|.8315|03/29/2022|.83704|03/29/2022|||ANTIFUNGALS: ORAL|15878|||||No|No||ALEMBIC PHARMAC|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|62332020530|AMLODIPINE-VALSARTAN 5-160 MG|30|EA|.23478|04/04/2017||Yes|No||04/04/2017||Yes|No|04/04/2017||Yes|No||||No|No|||Prescription required|No||017|Yes|.43208|03/29/2022|.42171|03/29/2022|.42451|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|15879|||||No|No||ALEMBIC PHARMAC|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|62332020590|AMLODIPINE-VALSARTAN 5-160 MG|90|EA|.23478|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||||No|No|||Prescription required|No||017|Yes|.43208|03/29/2022|.42171|03/29/2022|.42451|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|15880|||||No|No||ALEMBIC PHARMAC|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|62332020630|AMLODIPINE-VALSARTAN 10-160 MG|30|EA|.2666|04/04/2017||Yes|No||04/04/2017||Yes|No|04/04/2017||Yes|No||||No|No|||Prescription required|No||017|Yes|.53459|03/29/2022|.52175|03/29/2022|.52523|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|15881|||||No|No||ALEMBIC PHARMAC|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|62332020690|AMLODIPINE-VALSARTAN 10-160 MG|90|EA|.2666|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||||No|No|||Prescription required|No||017|Yes|.53459|03/29/2022|.52175|03/29/2022|.52523|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|15882|||||No|No||ALEMBIC PHARMAC|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|62332020730|AMLODIPINE-VALSARTAN 5-320 MG|30|EA|.29813|04/04/2017||Yes|No||04/04/2017||Yes|No|04/04/2017||Yes|No||||No|No|||Prescription required|No||017|Yes|.57359|03/29/2022|.55982|03/29/2022|.56355|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|15883|||||No|No||ALEMBIC PHARMAC|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|62332020790|AMLODIPINE-VALSARTAN 5-320 MG|90|EA|.29813|02/16/2018||Yes|No||02/16/2018||Yes|No|02/16/2018||Yes|No||||No|No|||Prescription required|No||017|Yes|.57359|03/29/2022|.55982|03/29/2022|.56355|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|15884|||||No|No||ALEMBIC PHARMAC|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|62332020830|AMLODIPINE-VALSARTAN 10-320 MG|30|EA|.33826|04/04/2017||Yes|No||04/04/2017||Yes|No|04/04/2017||Yes|No||||No|No|||Prescription required|No||017|Yes|.73857|03/29/2022|.72084|03/29/2022|.72564|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|15885|||||No|No||ALEMBIC PHARMAC|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|62332020890|AMLODIPINE-VALSARTAN 10-320 MG|90|EA|.33826|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||||No|No|||Prescription required|No||017|Yes|.73857|03/29/2022|.72084|03/29/2022|.72564|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|15886|||||No|No||ALEMBIC PHARMAC|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|62332020930|TELMISARTAN-HCTZ 40-12.5 MG TB|30|EA|1.61379|12/09/2016||Yes|No||12/09/2016||Yes|No|12/09/2016||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|1.13569|03/29/2022|1.10843|03/29/2022|1.11581|03/29/2022|||ANGIOTENSIN MODULATORS|15887|||||No|No||ALEMBIC PHARMAC|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|62332021030|TELMISARTAN-HCTZ 80-12.5 MG TB|30|EA|1.61379|12/16/2016||Yes|No||12/16/2016||Yes|No|12/16/2016||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.94301|03/29/2022|.92037|03/29/2022|.9265|03/29/2022|||ANGIOTENSIN MODULATORS|15888|||||No|No||ALEMBIC PHARMAC|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|62332021130|TELMISARTAN-HCTZ 80-25 MG TAB|30|EA|1.61379|12/16/2016||Yes|No||12/16/2016||Yes|No|12/16/2016||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|1.29965|03/29/2022|1.26845|03/29/2022|1.2769|03/29/2022|||ANGIOTENSIN MODULATORS|15889|||||No|No||ALEMBIC PHARMAC|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|62332021230|AMLODIPINE-OLMESARTAN 5-20 MG|30|EA|.67395|02/05/2018||Yes|No||02/05/2018||Yes|No|02/05/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|017|Yes|.41945|03/29/2022|.40938|03/29/2022|.4121|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|15890|||||No|No||ALEMBIC PHARMAC|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|62332021330|AMLODIPINE-OLMESARTAN 5-40 MG|30|EA|.8514|02/05/2018||Yes|No||02/05/2018||Yes|No|02/05/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|017|Yes|.47518|03/29/2022|.46377|03/29/2022|.46686|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|15891|||||No|No||ALEMBIC PHARMAC|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|62332021430|AMLODIPINE-OLMESARTAN 10-20 MG|30|EA|.67395|02/05/2018||Yes|No||02/05/2018||Yes|No|02/05/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|017|Yes|.43528|03/29/2022|.42483|03/29/2022|.42766|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|15892|||||No|No||ALEMBIC PHARMAC|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|62332021530|AMLODIPINE-OLMESARTAN 10-40 MG|30|EA|.8514|02/05/2018||Yes|No||02/05/2018||Yes|No|02/05/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|017|Yes|.41757|03/29/2022|.40754|03/29/2022|.41026|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|15893|||||No|No||ALEMBIC PHARMAC|No||||
fluoxetine HCl|No|No|No|No|75%|62332024230|FLUOXETINE HCL 10 MG TABLET|30|EA|.49306|12/12/2017||Yes|No||12/12/2017||Yes|No|12/12/2017||Yes|No||||No|No|||Prescription required|No||008|No|.24078|03/29/2022|.235|03/29/2022|.23656|03/29/2022|||ANTIDEPRESSANTS: SSRIs|15894|||||No|No||ALEMBIC PHARMAC|No||||
fluoxetine HCl|No|No|No|No|75%|62332024231|FLUOXETINE HCL 10 MG TABLET|100|EA|.49312|02/27/2018||Yes|No||02/27/2018||Yes|No|02/27/2018||Yes|No||||No|No|||Prescription required|No||008|No|.24078|03/29/2022|.235|03/29/2022|.23656|03/29/2022|||ANTIDEPRESSANTS: SSRIs|15895|||||No|No||ALEMBIC PHARMAC|No||||
fluoxetine HCl|No|No|No|No|75%|62332024330|FLUOXETINE HCL 20 MG TABLET|30|EA|.7224|12/06/2017||Yes|No||12/06/2017||Yes|No|12/06/2017||Yes|No||||No|No|||Prescription required|No||008|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||ANTIDEPRESSANTS: SSRIs|15896|||||No|No||ALEMBIC PHARMAC|No||||
fluoxetine HCl|No|No|No|No|75%|62332024331|FLUOXETINE HCL 20 MG TABLET|100|EA|.72252|09/20/2017||Yes|No||09/20/2017||Yes|No|09/20/2017||Yes|No||||No|No|||Prescription required|No||008|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||ANTIDEPRESSANTS: SSRIs|15897|||||No|No||ALEMBIC PHARMAC|No||||
fenofibric acid (choline)|No|No|No|No|75%|62332024490|FENOFIBRIC ACID DR 45 MG CAP|90|EA|.63716|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|055|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||LIPOTROPICS: OTHER|15898|||||No|No||ALEMBIC PHARMAC|No||||
fenofibric acid (choline)|No|No|No|No|75%|62332024590|FENOFIBRIC ACID DR 135 MG CAP|90|EA|1.91168|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|055|No|.69218|03/29/2022|.67556|03/29/2022|.68006|03/29/2022|||LIPOTROPICS: OTHER|15899|||||No|No||ALEMBIC PHARMAC|No||||
amantadine HCl|No|No|No|No|75%|62332024631|AMANTADINE 100 MG CAPSULE|100|EA|.34649|10/17/2017||Yes|No||10/17/2017||Yes|No|10/17/2017||Yes|No||||No|No|||Prescription required|No||015|No|.2857|03/29/2022|.27884|03/29/2022|.2807|03/29/2022|||ANTIPARKINSON'S AGENTS|15900|||||No|No||ALEMBIC PHARMAC|No||||
amantadine HCl|No|No|No|No|75%|62332024671|AMANTADINE 100 MG CAPSULE|500|EA|.34656|11/28/2017||Yes|No||11/28/2017||Yes|No|11/28/2017||Yes|No||||No|No|||Prescription required|No||015|No|.2857|03/29/2022|.27884|03/29/2022|.2807|03/29/2022|||ANTIPARKINSON'S AGENTS|15901|||||No|No||ALEMBIC PHARMAC|No||||
acyclovir|No|No|No|No|75%|62332024805|ACYCLOVIR 5% OINTMENT|5|GM|10.05942|12/02/2019||Yes|No||12/02/2019||Yes|No|12/02/2019||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|22.92612|12/10/2019|22.5986|12/02/2019|21.52248|12/10/2019|||ANTIVIRALS: TOPICAL|15902|||||No|No||ALEMBIC PHARMAC|No||||
acyclovir|No|No|No|No|75%|62332024815|ACYCLOVIR 5% OINTMENT|15|GM|2.47278|06/17/2019||Yes|No||06/17/2019||Yes|No|06/17/2019||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.36934|03/29/2022|1.33647|03/29/2022|1.34537|03/29/2022|||ANTIVIRALS: TOPICAL|15903|||||No|No||ALEMBIC PHARMAC|No||||
acyclovir|No|No|No|No|75%|62332024830|ACYCLOVIR 5% OINTMENT|30|GM|2.47264|12/07/2018||Yes|No||12/07/2018||Yes|No|12/07/2018||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.03754|03/29/2022|1.01263|03/29/2022|1.01938|03/29/2022|||ANTIVIRALS: TOPICAL|15904|||||No|No||ALEMBIC PHARMAC|No||||
doxycycline monohydrate|No|No|No|No|75%|62332024931|DOXYCYCLINE MONO 75 MG CAPSULE|100|EA|5.60195|08/27/2018||Yes|No||08/27/2018||Yes|No|08/27/2018||Yes|No||||No|No|||Prescription required|Yes|11/16/2017|213|No|12.76724|08/27/2018|12.58485|08/27/2018|11.98557|08/27/2018|||TETRACYCLINES|15905|||||No|No||ALEMBIC PHARMAC|No||||
doxycycline monohydrate|Yes|No|No|No|75%|62332025050|DOXYCYCLINE MONO 100 MG CAP|50|EA|.35896|02/21/2018||Yes|No||02/21/2018||Yes|No|02/21/2018||Yes|No||||No|No|02/21/2018||Prescription required|No||213|No|.25496|03/29/2022|.24884|03/29/2022|.25049|03/29/2022|||TETRACYCLINES|15906|||||No|No||ALEMBIC PHARMAC|No||||
azithromycin|No|No|No|No|75%|62332025118|AZITHROMYCIN 250 MG TABLET|6|EA|.60462|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|15907|||||No|No||ALEMBIC PHARMAC|No||||
azithromycin|No|No|No|No|75%|62332025130|AZITHROMYCIN 250 MG TABLET|30|EA|.91375|09/29/2020||Yes|No||09/29/2020||Yes|No|09/29/2020||Yes|No||||No|No|||Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|15908|||||No|No||ALEMBIC PHARMAC|No||||
azithromycin|No|No|No|No|75%|62332025209|AZITHROMYCIN 500 MG TABLET|3|EA|1.20925|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|No||018|No|.82092|03/29/2022|.80121|03/29/2022|.80655|03/29/2022|||MACROLIDES/KETOLIDES|15909|||||No|No||ALEMBIC PHARMAC|No||||
azithromycin|No|No|No|No|75%|62332025230|AZITHROMYCIN 500 MG TABLET|30|EA|1.57222|09/29/2020||Yes|No||09/29/2020||Yes|No|09/29/2020||Yes|No||||No|No|||Prescription required|No||018|No|.82092|03/29/2022|.80121|03/29/2022|.80655|03/29/2022|||MACROLIDES/KETOLIDES|15910|||||No|No||ALEMBIC PHARMAC|No||||
desipramine HCl|No|No|No|No|75%|62332031531|DESIPRAMINE 10 MG TABLET|100|EA|.07318|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|215|No|.3086|03/29/2022|.30119|03/29/2022|.30319|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|15911|||||No|No||ALEMBIC PHARMAC|No||||
desipramine HCl|No|No|No|No|75%|62332031631|DESIPRAMINE 25 MG TABLET|100|EA|.08913|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|215|No|.4119|03/01/2022|.40201|03/01/2022|.40469|03/01/2022|||ANTIDEPRESSANTS: TRICYCLIC|15912|||||No|No||ALEMBIC PHARMAC|No||||
desipramine HCl|No|No|No|No|75%|62332031731|DESIPRAMINE 50 MG TABLET|100|EA|.16946|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|215|No|.3099|01/25/2022|.30246|01/25/2022|.30447|01/25/2022|||ANTIDEPRESSANTS: TRICYCLIC|15913|||||No|No||ALEMBIC PHARMAC|No||||
desipramine HCl|No|No|No|No|75%|62332031831|DESIPRAMINE 75 MG TABLET|100|EA|.23624|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|215|No|.53841|01/06/2022|.53072|01/06/2022|.50544|01/06/2022|||ANTIDEPRESSANTS: TRICYCLIC|15914|||||No|No||ALEMBIC PHARMAC|No||||
desipramine HCl|No|No|No|No|75%|62332031931|DESIPRAMINE 100 MG TABLET|100|EA|.29738|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|215|No|.67776|01/06/2022|.66808|01/06/2022|.63627|01/06/2022|||ANTIDEPRESSANTS: TRICYCLIC|15915|||||No|No||ALEMBIC PHARMAC|No||||
desipramine HCl|No|No|No|No|75%|62332032050|DESIPRAMINE 150 MG TABLET|50|EA|.58204|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|215|No|1.32652|01/06/2022|1.30757|01/06/2022|1.24531|01/06/2022|||ANTIDEPRESSANTS: TRICYCLIC|15916|||||No|No||ALEMBIC PHARMAC|No||||
deferasirox|No|No|No|No|75%|62332032430|DEFERASIROX 125 MG TB FOR SUSP|30|EA|9.68775|03/11/2020||Yes|No||03/11/2020||Yes|No|03/11/2020||Yes|No||||No|No|||Prescription required|No|||No|22.07906|03/11/2020|21.76365|03/11/2020|20.72728|03/11/2020||||15917|||||No|No||ALEMBIC PHARMAC|No||||
deferasirox|No|No|No|No|75%|62332032530|DEFERASIROX 250 MG TB FOR SUSP|30|EA|19.37522|03/11/2020||Yes|No||03/11/2020||Yes|No|03/11/2020||Yes|No||||No|No|||Prescription required|No|||No|44.15748|03/11/2020|43.52666|03/11/2020|41.45396|03/11/2020||||15918|||||No|No||ALEMBIC PHARMAC|No||||
deferasirox|No|No|No|No|75%|62332032630|DEFERASIROX 500 MG TB FOR SUSP|30|EA|38.74959|03/11/2020||Yes|No||03/11/2020||Yes|No|03/11/2020||Yes|No||||No|No|||Prescription required|No|||No|88.31302|03/11/2020|87.0514|03/11/2020|82.9061|03/11/2020||||15919|||||No|No||ALEMBIC PHARMAC|No||||
midodrine HCl|No|No|No|No|75%|62332033831|MIDODRINE HCL 2.5 MG TABLET|100|EA|.12895|12/14/2021||Yes|No||12/14/2021||Yes|No|12/14/2021||Yes|No||||No|No|||Prescription required|No|||No|.20233|03/29/2022|.19747|03/29/2022|.19878|03/29/2022||||15920|||||No|No||ALEMBIC PHARMAC|No||||
midodrine HCl|No|No|No|No|75%|62332033931|MIDODRINE HCL 5 MG TABLET|100|EA|.19345|12/14/2021||Yes|No||12/14/2021||Yes|No|12/14/2021||Yes|No||||No|No|||Prescription required|No|||No|.26381|03/29/2022|.25747|03/29/2022|.25919|03/29/2022||||15921|||||No|No||ALEMBIC PHARMAC|No||||
midodrine HCl|No|No|No|No|75%|62332034031|MIDODRINE HCL 10 MG TABLET|100|EA|.32245|12/15/2021||Yes|No||12/15/2021||Yes|No|12/15/2021||Yes|No||||No|No|||Prescription required|No|||No|.40773|03/29/2022|.39794|03/29/2022|.40059|03/29/2022||||15922|||||No|No||ALEMBIC PHARMAC|No||||
candesartan cilexetil|Yes|No|No|No|75%|62332034130|CANDESARTAN CILEXETIL 4 MG TAB|30|EA|1.03042|12/06/2019||Yes|No||12/06/2019||Yes|No|12/06/2019||Yes|No||||No|No|03/20/2020||Prescription required|Yes|07/29/2021|113|Yes|.89|03/29/2022|.86864|03/29/2022|.87442|03/29/2022|||ANGIOTENSIN MODULATORS|15923|||||No|No||ALEMBIC PHARMAC|No||||
candesartan cilexetil|Yes|No|No|No|75%|62332034190|CANDESARTAN CILEXETIL 4 MG TAB|90|EA|.97939|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|09/04/2019||Prescription required|Yes|07/29/2021|113|Yes|.89|03/29/2022|.86864|03/29/2022|.87442|03/29/2022|||ANGIOTENSIN MODULATORS|15924|||||No|No||ALEMBIC PHARMAC|No||||
candesartan cilexetil|No|No|No|No|75%|62332034230|CANDESARTAN CILEXETIL 8 MG TAB|30|EA|1.03042|11/12/2020||Yes|No||11/12/2020||Yes|No|11/12/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.78972|03/29/2022|.77076|03/29/2022|.77589|03/29/2022|||ANGIOTENSIN MODULATORS|15925|||||No|No||ALEMBIC PHARMAC|No||||
candesartan cilexetil|Yes|No|No|No|75%|62332034290|CANDESARTAN CILEXETIL 8 MG TAB|90|EA|.97939|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|09/04/2019||Prescription required|Yes|07/29/2021|113|Yes|.78972|03/29/2022|.77076|03/29/2022|.77589|03/29/2022|||ANGIOTENSIN MODULATORS|15926|||||No|No||ALEMBIC PHARMAC|No||||
candesartan cilexetil|Yes|No|No|No|75%|62332034330|CANDESARTAN CILEXETIL 16 MG TB|30|EA|1.03042|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|09/04/2019||Prescription required|Yes|07/29/2021|113|Yes|.72757|03/29/2022|.7101|03/29/2022|.71483|03/29/2022|||ANGIOTENSIN MODULATORS|15927|||||No|No||ALEMBIC PHARMAC|No||||
candesartan cilexetil|Yes|No|No|No|75%|62332034390|CANDESARTAN CILEXETIL 16 MG TB|90|EA|.97939|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|09/04/2019||Prescription required|Yes|07/29/2021|113|Yes|.72757|03/29/2022|.7101|03/29/2022|.71483|03/29/2022|||ANGIOTENSIN MODULATORS|15928|||||No|No||ALEMBIC PHARMAC|No||||
acetazolamide|No|No|No|No|75%|62332034931|ACETAZOLAMIDE ER 500 MG CAP|100|EA|.5375|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No|||No|.39876|03/29/2022|.38918|03/29/2022|.39178|03/29/2022||||15929|||||No|No||ALEMBIC PHARMAC|No||||
doxycycline hyclate|No|No|No|No|75%|62332035231|DOXYCYCLINE HYCLATE 20 MG TAB|100|EA|.16314|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|213|No|.15838|03/29/2022|.15457|03/29/2022|.1556|03/29/2022|||TETRACYCLINES|15930|||||No|No||ALEMBIC PHARMAC|No||||
fenofibrate nanocrystallized|No|No|No|No|75%|62332036171|FENOFIBRATE 145 MG TABLET|500|EA|.28007|11/12/2020||Yes|No||11/12/2020||Yes|No|11/12/2020||Yes|No||||No|No|||Prescription required|No||055|No|.16424|03/29/2022|.16029|03/29/2022|.16136|03/29/2022|||LIPOTROPICS: OTHER|15931|||||No|No||ALEMBIC PHARMAC|No||||
fenofibrate nanocrystallized|No|No|No|No|75%|62332036190|FENOFIBRATE 145 MG TABLET|90|EA|.28007|05/26/2020||Yes|No||05/26/2020||Yes|No|05/26/2020||Yes|No||||No|No|||Prescription required|No||055|No|.16424|03/29/2022|.16029|03/29/2022|.16136|03/29/2022|||LIPOTROPICS: OTHER|15932|||||No|No||ALEMBIC PHARMAC|No||||
doxycycline hyclate|No|No|No|No|75%|62332036250|DOXYCYCLINE HYCLATE 50 MG CAP|50|EA|.34873|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|||Prescription required|No||213|No|.2526|03/29/2022|.24653|03/29/2022|.24817|03/29/2022|||TETRACYCLINES|15933|||||No|No||ALEMBIC PHARMAC|No||||
doxycycline hyclate|Yes|No|No|No|75%|62332036350|DOXYCYCLINE HYCLATE 100 MG CAP|50|EA|.3704|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|06/18/2019||Prescription required|No||213|No|.14255|03/29/2022|.13912|03/29/2022|.14005|03/29/2022|||TETRACYCLINES|15934|||||No|No||ALEMBIC PHARMAC|No||||
doxycycline hyclate|Yes|No|No|No|75%|62332036371|DOXYCYCLINE HYCLATE 100 MG CAP|500|EA|.37046|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|06/18/2019||Prescription required|No||213|No|.14255|03/29/2022|.13912|03/29/2022|.14005|03/29/2022|||TETRACYCLINES|15935|||||No|No||ALEMBIC PHARMAC|No||||
clonazepam|No|No|No|No|75%|62332036406|CLONAZEPAM 0.125 MG ODT|60|EA|.40205|02/28/2020||Yes|No||02/28/2020||Yes|No|02/28/2020||Yes|No||||No|No|||Prescription required|No||056|Yes|.69971|03/29/2022|.68291|03/29/2022|.68746|03/29/2022|||ANTICONVULSANTS|15936|||||No|No||ALEMBIC PHARMAC|No||||
clonazepam|No|No|No|No|75%|62332036506|CLONAZEPAM 0.25 MG ODT|60|EA|.40205|02/28/2020||Yes|No||02/28/2020||Yes|No|02/28/2020||Yes|No||||No|No|||Prescription required|No||056|Yes|.70247|03/29/2022|.68561|03/29/2022|.69017|03/29/2022|||ANTICONVULSANTS|15937|||||No|No||ALEMBIC PHARMAC|No||||
clonazepam|No|No|No|No|75%|62332036606|CLONAZEPAM 0.5 MG ODT|60|EA|.4014|02/28/2020||Yes|No||02/28/2020||Yes|No|02/28/2020||Yes|No||||No|No|||Prescription required|No||056|Yes|.67976|03/29/2022|.66344|03/29/2022|.66786|03/29/2022|||ANTICONVULSANTS|15938|||||No|No||ALEMBIC PHARMAC|No||||
clonazepam|No|No|No|No|75%|62332036706|CLONAZEPAM 1 MG ODT|60|EA|.45873|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No||056|Yes|.76385|03/29/2022|.74551|03/29/2022|.75048|03/29/2022|||ANTICONVULSANTS|15939|||||No|No||ALEMBIC PHARMAC|No||||
clonazepam|No|No|No|No|75%|62332036806|CLONAZEPAM 2 MG ODT|60|EA|.6356|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No||056|Yes|1.00233|01/25/2022|.97827|01/25/2022|.98478|01/25/2022|||ANTICONVULSANTS|15940|||||No|No||ALEMBIC PHARMAC|No||||
temazepam|No|No|No|No|90%|62332037931|TEMAZEPAM 7.5 MG CAPSULE|100|EA|1.35445|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|054|Yes|1.39989|03/29/2022|1.36629|03/29/2022|1.37539|03/29/2022|||SEDATIVE HYPNOTICS|15941|||||No|No||ALEMBIC PHARMAC|No||||
temazepam|No|No|No|No|90%|62332038031|TEMAZEPAM 15 MG CAPSULE|100|EA|.05525|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|No||054|Yes|.07712|03/29/2022|.07526|03/29/2022|.07577|03/29/2022|||SEDATIVE HYPNOTICS|15942|||||No|No||ALEMBIC PHARMAC|No||||
temazepam|No|No|No|No|90%|62332038071|TEMAZEPAM 15 MG CAPSULE|500|EA|.05528|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|No||054|Yes|.07712|03/29/2022|.07526|03/29/2022|.07577|03/29/2022|||SEDATIVE HYPNOTICS|15943|||||No|No||ALEMBIC PHARMAC|No||||
temazepam|No|No|No|No|90%|62332038130|TEMAZEPAM 22.5 MG CAPSULE|30|EA|2.36758|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|054|Yes|2.70743|03/29/2022|2.64245|03/29/2022|2.66004|03/29/2022|||SEDATIVE HYPNOTICS|15944|||||No|No||ALEMBIC PHARMAC|No||||
temazepam|No|No|No|No|90%|62332038231|TEMAZEPAM 30 MG CAPSULE|100|EA|.06609|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||054|Yes|.10046|03/29/2022|.09804|03/29/2022|.0987|03/29/2022|||SEDATIVE HYPNOTICS|15945|||||No|No||ALEMBIC PHARMAC|No||||
temazepam|No|No|No|No|90%|62332038271|TEMAZEPAM 30 MG CAPSULE|500|EA|.06612|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|No||054|Yes|.10046|03/29/2022|.09804|03/29/2022|.0987|03/29/2022|||SEDATIVE HYPNOTICS|15946|||||No|No||ALEMBIC PHARMAC|No||||
modafinil|No|No|No|No|90%|62332038530|MODAFINIL 100 MG TABLET|30|EA|1.04633|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.4088|03/29/2022|.39898|03/29/2022|.40164|03/29/2022|||STIMULANTS AND RELATED AGENTS|15947|||||No|No||ALEMBIC PHARMAC|No||||
modafinil|No|No|No|No|90%|62332038590|MODAFINIL 100 MG TABLET|90|EA|1.04652|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.4088|03/29/2022|.39898|03/29/2022|.40164|03/29/2022|||STIMULANTS AND RELATED AGENTS|15948|||||No|No||ALEMBIC PHARMAC|No||||
modafinil|No|No|No|No|90%|62332038630|MODAFINIL 200 MG TABLET|30|EA|1.36166|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55328|03/29/2022|.54|03/29/2022|.54359|03/29/2022|||STIMULANTS AND RELATED AGENTS|15949|||||No|No||ALEMBIC PHARMAC|No||||
modafinil|No|No|No|No|90%|62332038690|MODAFINIL 200 MG TABLET|90|EA|1.04862|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55328|03/29/2022|.54|03/29/2022|.54359|03/29/2022|||STIMULANTS AND RELATED AGENTS|15950|||||No|No||ALEMBIC PHARMAC|No||||
doxycycline hyclate|No|No|No|No|75%|62332038760|DOXYCYCLINE HYCLATE 75 MG TAB|60|EA|1.67663|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|213|No|3.82117|11/24/2020|3.76658|11/24/2020|3.58722|11/24/2020|||TETRACYCLINES|15951|||||No|No||ALEMBIC PHARMAC|No||||
doxycycline hyclate|No|No|No|No|75%|62332038860|DOXYCYCLINE HYCLATE 150 MG TAB|60|EA|1.67663|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|213|No|3.82117|11/24/2020|3.76658|11/24/2020|3.58722|11/24/2020|||TETRACYCLINES|15952|||||No|No||ALEMBIC PHARMAC|No||||
deferasirox|No|No|No|No|75%|62332041030|DEFERASIROX 90 MG TABLET|30|EA|16.34243|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No|||No|37.24554|03/02/2020|36.71346|03/02/2020|34.9652|03/02/2020||||15953|||||No|No||ALEMBIC PHARMAC|No||||
deferasirox|No|No|No|No|75%|62332041130|DEFERASIROX 180 MG TABLET|30|EA|31.37652|08/18/2020||Yes|No||08/18/2020||Yes|No|08/18/2020||Yes|No||||No|No|||Prescription required|No|||No|71.50928|08/18/2020|70.48772|08/18/2020|67.13116|08/18/2020||||15954|||||No|No||ALEMBIC PHARMAC|No||||
deferasirox|No|No|No|No|75%|62332041230|DEFERASIROX 360 MG TABLET|30|EA|65.36688|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No|||No|148.97568|03/10/2020|146.84745|03/02/2020|139.85472|03/02/2020||||15955|||||No|No||ALEMBIC PHARMAC|No||||
oseltamivir phosphate|No|No|No|No|75%|62332041310|OSELTAMIVIR PHOS 30 MG CAPSULE|10|EA|3.18157|02/28/2020||Yes|No||02/28/2020||Yes|No|02/28/2020||Yes|No||||No|No|||Prescription required|No||025|No|1.58155|03/29/2022|1.54359|03/29/2022|1.55387|03/29/2022|||ANTIVIRALS: ORAL|15956|||||No|No||ALEMBIC PHARMAC|No||||
oseltamivir phosphate|No|No|No|No|75%|62332041410|OSELTAMIVIR PHOS 45 MG CAPSULE|10|EA|3.18157|02/28/2020||Yes|No||02/28/2020||Yes|No|02/28/2020||Yes|No||||No|No|||Prescription required|No||025|No|1.5655|03/29/2022|1.52792|03/29/2022|1.5381|03/29/2022|||ANTIVIRALS: ORAL|15957|||||No|No||ALEMBIC PHARMAC|No||||
oseltamivir phosphate|No|No|No|No|75%|62332041510|OSELTAMIVIR PHOS 75 MG CAPSULE|10|EA|3.43957|02/28/2020||Yes|No||02/28/2020||Yes|No|02/28/2020||Yes|No||||No|No|||Prescription required|No||025|No|1.29695|03/29/2022|1.26582|03/29/2022|1.27425|03/29/2022|||ANTIVIRALS: ORAL|15958|||||No|No||ALEMBIC PHARMAC|No||||
lidocaine|No|No|No|No|75%|62332042430|LIDOCAINE 5% OINTMENT|30|GM|4.47329|09/02/2020||Yes|No||09/02/2020||Yes|No|09/02/2020||Yes|No||||No|No|||Prescription required|No|||No|.49802|03/29/2022|.48606|03/29/2022|.4893|03/29/2022||||15959|||||No|No||ALEMBIC PHARMAC|No||||
lidocaine|No|No|No|No|75%|62332042435|LIDOCAINE 5% OINTMENT|35.44|GM|.83621|09/02/2020||Yes|No||09/02/2020||Yes|No|09/02/2020||Yes|No||||No|No|||Prescription required|No|||No|.18796|03/29/2022|.18344|03/29/2022|.18467|03/29/2022||||15960|||||No|No||ALEMBIC PHARMAC|No||||
lidocaine|No|No|No|No|75%|62332042450|LIDOCAINE 5% OINTMENT|50|GM|1.20443|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No|||No|.22969|03/29/2022|.22417|03/29/2022|.22567|03/29/2022||||15961|||||No|No||ALEMBIC PHARMAC|No||||
clobetasol propionate|No|No|No|No|75%|62332042512|CLOBETASOL PROP 0.05% SPRAY|125|ML|.55607|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|121|No|.7112|03/29/2022|.69413|03/29/2022|.69875|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|15962|||||No|No||ALEMBIC PHARMAC|No||||
clobetasol propionate|No|No|No|No|75%|62332042559|CLOBETASOL PROP 0.05% SPRAY|59|ML|.64878|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|121|No|.72856|01/25/2022|.71107|01/25/2022|.71581|01/25/2022|||STEROIDS: TOPICAL VERY HIGH|15963|||||No|No||ALEMBIC PHARMAC|No||||
benzonatate|No|No|No|No|75%|62332042631|BENZONATATE 100 MG CAPSULE|100|EA|.12874|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No||184|Yes|.09389|03/29/2022|.09163|03/29/2022|.09224|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|15964|||||No|No||ALEMBIC PHARMAC|No||||
benzonatate|No|No|No|No|75%|62332042671|BENZONATATE 100 MG CAPSULE|500|EA|.08599|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No||184|Yes|.09389|03/29/2022|.09163|03/29/2022|.09224|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|15965|||||No|No||ALEMBIC PHARMAC|No||||
benzonatate|No|No|No|No|75%|62332042731|BENZONATATE 200 MG CAPSULE|100|EA|.17195|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No||184|Yes|.14345|03/29/2022|.14|03/29/2022|.14093|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|15966|||||No|No||ALEMBIC PHARMAC|No||||
benzonatate|No|No|No|No|75%|62332042771|BENZONATATE 200 MG CAPSULE|500|EA|.1633|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No||184|Yes|.14345|03/29/2022|.14|03/29/2022|.14093|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|15967|||||No|No||ALEMBIC PHARMAC|No||||
ergocalciferol (vitamin D2)|No|No|No|No|75%|62332046431|VITAMIN D2 1.25MG(50,000 UNIT)|100|EA|.15647|05/15/2019||Yes|No||05/15/2019||Yes|No|05/15/2019||Yes|No||||No|No|||Prescription required|No|||No|.14082|03/29/2022|.13744|03/29/2022|.13835|03/29/2022||||15968|||||No|No||ALEMBIC PHARMAC|No||||
clobetasol propionate|No|No|No|No|75%|62332046515|CLOBETASOL 0.05% OINTMENT|15|GM|.71638|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No||121|No|.35914|03/29/2022|.35052|03/29/2022|.35285|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|15969|||||No|No||ALEMBIC PHARMAC|No||||
clobetasol propionate|No|No|No|No|75%|62332046530|CLOBETASOL 0.05% OINTMENT|30|GM|.73085|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No||121|No|.3756|03/29/2022|.36658|03/29/2022|.36902|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|15970|||||No|No||ALEMBIC PHARMAC|No||||
clobetasol propionate|No|No|No|No|75%|62332046560|CLOBETASOL 0.05% OINTMENT|60|GM|.74884|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No||121|No|.32004|03/29/2022|.31235|03/29/2022|.31443|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|15971|||||No|No||ALEMBIC PHARMAC|No||||
tavaborole|No|No|No|No|75%|62332046704|TAVABOROLE 5% TOPICAL SOLUTION|4|ML|55.2206|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|061|No|125.8516|05/25/2021|124.05372|05/25/2021|118.1464|05/18/2021|||ANTIFUNGALS: TOPICAL|15972|||||No|No||ALEMBIC PHARMAC|No||||
tavaborole|No|No|No|No|75%|62332046710|TAVABOROLE 5% TOPICAL SOLUTION|10|ML|3.87|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|061|No|12.67867|08/24/2021|12.37438|08/24/2021|12.45679|08/24/2021|||ANTIFUNGALS: TOPICAL|15973|||||No|No||ALEMBIC PHARMAC|No||||
desonide|No|No|No|No|75%|62332048515|DESONIDE 0.05% OINTMENT|15|GM|.54438|05/26/2020||Yes|No||05/26/2020||Yes|No|05/26/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|118|No|.83836|03/29/2022|.81823|03/29/2022|.82368|03/29/2022|||STEROIDS: TOPICAL LOW|15974|||||No|No||ALEMBIC PHARMAC|No||||
desonide|No|No|No|No|75%|62332048560|DESONIDE 0.05% OINTMENT|60|GM|.40856|05/26/2020||Yes|No||05/26/2020||Yes|No|05/26/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|118|No|.63751|03/29/2022|.6222|03/29/2022|.62635|03/29/2022|||STEROIDS: TOPICAL LOW|15975|||||No|No||ALEMBIC PHARMAC|No||||
clobetasol propionate|No|No|No|No|75%|62332048625|CLOBETASOL 0.05% SOLUTION|25|ML|.85982|09/02/2020||Yes|No||09/02/2020||Yes|No|09/02/2020||Yes|No||||No|No|||Prescription required|No||121|No|.44026|03/29/2022|.42969|03/29/2022|.43255|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|15976|||||No|No||ALEMBIC PHARMAC|No||||
clobetasol propionate|No|No|No|No|75%|62332048650|CLOBETASOL 0.05% SOLUTION|50|ML|.85991|09/02/2020||Yes|No||09/02/2020||Yes|No|09/02/2020||Yes|No||||No|No|||Prescription required|No||121|No|.35501|03/29/2022|.34648|03/29/2022|.34879|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|15977|||||No|No||ALEMBIC PHARMAC|No||||
tizanidine HCl|No|No|No|No|75%|62332049141|TIZANIDINE HCL 2 MG CAPSULE|150|EA|.08596|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|116|No|.0903|03/29/2022|.08813|03/29/2022|.08871|03/29/2022|||SKELETAL MUSCLE RELAXANTS|15978|||||No|No||ALEMBIC PHARMAC|No||||
tizanidine HCl|No|No|No|No|75%|62332049241|TIZANIDINE HCL 4 MG CAPSULE|150|EA|.11463|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|116|No|.15367|03/29/2022|.14998|03/29/2022|.15098|03/29/2022|||SKELETAL MUSCLE RELAXANTS|15979|||||No|No||ALEMBIC PHARMAC|No||||
tizanidine HCl|No|No|No|No|75%|62332049341|TIZANIDINE HCL 6 MG CAPSULE|150|EA|.17196|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|116|No|.27523|03/29/2022|.26862|03/29/2022|.27041|03/29/2022|||SKELETAL MUSCLE RELAXANTS|15980|||||No|No||ALEMBIC PHARMAC|No||||
olopatadine HCl|No|No|No|No|75%|62332050105|OLOPATADINE HCL 0.1% EYE DROPS|5|ML|3.40044|09/17/2019|01/31/2022|Yes|No||09/17/2019|01/31/2022|Yes|No|09/17/2019|01/31/2022|Yes|No||||No|No|||Prescription required|Yes|01/25/2018|002|No|7.74984|02/15/2022|7.63912|02/15/2022|7.27536|02/15/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|15981|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ALEMBIC PHARMAC|No||||
moxifloxacin HCl|No|No|No|No|75%|62332050503|MOXIFLOXACIN 0.5% EYE DROPS|3|ML|5.01523|06/06/2019||Yes|No||06/06/2019||Yes|No|06/06/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|058|No|3.97371|03/29/2022|3.87834|03/29/2022|3.90417|03/29/2022|||OPHTHALMIC ANTIBIOTICS|15982|||||No|No||ALEMBIC PHARMAC|No||||
azelastine HCl|No|No|No|No|75%|62332050606|AZELASTINE HCL 0.05% DROPS|6|ML|1.79166|02/27/2020||Yes|No||02/27/2020||Yes|No|02/27/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|002|No|1.22657|03/29/2022|1.19713|03/29/2022|1.2051|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|15983|||||No|No||ALEMBIC PHARMAC|No||||
bimatoprost|No|No|No|No|75%|62332050705|BIMATOPROST 0.03% EYE DROPS|5|ML|17.96024|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|088|No|26.52867|03/29/2022|25.89198|03/29/2022|26.06441|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15984|||||No|No||ALEMBIC PHARMAC|No||||
bimatoprost|No|No|No|No|75%|62332050725|BIMATOPROST 0.03% EYE DROPS|2.5|ML|17.96712|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|088|No|28.61527|03/29/2022|27.9285|03/29/2022|28.1145|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15985|||||No|No||ALEMBIC PHARMAC|No||||
bromfenac sodium|No|No|No|No|75%|62332050817|BROMFENAC SODIUM 0.09% EYE DRP|1.7|ML|45.0387|02/27/2020||Yes|No||02/27/2020||Yes|No|02/27/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|013|No|70.97765|03/29/2022|69.27418|03/29/2022|69.73554|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|15986|||||No|No||ALEMBIC PHARMAC|No||||
tobramycin|No|No|No|No|75%|62332051805|TOBRAMYCIN 0.3% EYE DROP|5|ML|1.33214|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||058|No|1.42908|03/29/2022|1.39478|03/29/2022|1.40407|03/29/2022|||OPHTHALMIC ANTIBIOTICS|15987|||||No|No||ALEMBIC PHARMAC|No||||
metolazone|No|No|No|No|75%|62332053231|METOLAZONE 2.5 MG TABLET|100|EA|.71311|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|No|||No|.75368|03/29/2022|.73559|03/29/2022|.74049|03/29/2022||||15988|||||No|No||ALEMBIC PHARMAC|No||||
metolazone|No|No|No|No|75%|62332053331|METOLAZONE 5 MG TABLET|100|EA|.81029|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|No|||No|.77158|03/29/2022|.75306|03/29/2022|.75807|03/29/2022||||15989|||||No|No||ALEMBIC PHARMAC|No||||
metolazone|No|No|No|No|75%|62332053431|METOLAZONE 10 MG TABLET|100|EA|.97042|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|No|||No|1.18747|03/01/2022|1.15897|03/01/2022|1.16668|03/01/2022||||15990|||||No|No||ALEMBIC PHARMAC|No||||
timolol maleate|No|No|No|No|75%|62332054505|TIMOLOL 0.25% GEL-SOLUTION|5|ML|16.70636|03/12/2021||Yes|No||03/12/2021||Yes|No|03/12/2021||Yes|No||||No|No|||Prescription required|No||088|No|38.07496|10/26/2021|37.53103|10/26/2021|35.74384|10/26/2021|||OPHTHALMICS: GLAUCOMA AGENTS|15991|||||No|No||ALEMBIC PHARMAC|No||||
timolol maleate|No|No|No|No|75%|62332054605|TIMOLOL 0.5% GEL-SOLUTION|5|ML|18.30682|03/12/2021||Yes|No||03/12/2021||Yes|No|03/12/2021||Yes|No||||No|No|||Prescription required|No||088|No|31.65243|03/29/2022|30.89277|03/29/2022|31.09851|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|15992|||||No|No||ALEMBIC PHARMAC|No||||
clobetasol propionate|No|No|No|No|75%|62332054715|CLOBETASOL 0.05% CREAM|15|GM|.46296|10/06/2020||Yes|No||10/06/2020||Yes|No|10/06/2020||Yes|No||||No|No|||Prescription required|No||121|No|.42879|03/29/2022|.41849|03/29/2022|.42128|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|15993|||||No|No||ALEMBIC PHARMAC|No||||
clobetasol propionate|No|No|No|No|75%|62332054730|CLOBETASOL 0.05% CREAM|30|GM|.46296|10/06/2020||Yes|No||10/06/2020||Yes|No|10/06/2020||Yes|No||||No|No|||Prescription required|No||121|No|.34489|03/29/2022|.33661|03/29/2022|.33885|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|15994|||||No|No||ALEMBIC PHARMAC|No||||
clobetasol propionate|No|No|No|No|75%|62332054745|CLOBETASOL 0.05% CREAM|45|GM|.46305|10/06/2020||Yes|No||10/06/2020||Yes|No|10/06/2020||Yes|No||||No|No|||Prescription required|No||121|No|.31467|03/29/2022|.30711|03/29/2022|.30916|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|15995|||||No|No||ALEMBIC PHARMAC|No||||
clobetasol propionate|No|No|No|No|75%|62332054760|CLOBETASOL 0.05% CREAM|60|GM|.41437|10/06/2020||Yes|No||10/06/2020||Yes|No|10/06/2020||Yes|No||||No|No|||Prescription required|No||121|No|.33784|03/29/2022|.32973|03/29/2022|.33192|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|15996|||||No|No||ALEMBIC PHARMAC|No||||
clobetasol propionate|No|No|No|No|75%|62332054804|CLOBETASOL 0.05% SHAMPOO|118|ML|.66095|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|121|No|.54041|03/29/2022|.52744|03/29/2022|.53095|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|15997|||||No|No||ALEMBIC PHARMAC|No||||
adapalene|No|No|No|No|75%|62332054945|ADAPALENE 0.3% GEL|45|GM|2.3648|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|104|No|.91902|03/29/2022|.89696|03/29/2022|.90293|03/29/2022|||ACNE AGENTS: TOPICAL|15998|||||No|No||ALEMBIC PHARMAC|No||||
adapalene|No|No|No|No|75%|62332054946|ADAPALENE 0.3% GEL PUMP|45|GM|2.3648|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|104|No|3.35906|03/01/2022|3.27844|03/01/2022|3.30027|03/01/2022|||ACNE AGENTS: TOPICAL|15999|||||No|No||ALEMBIC PHARMAC|No||||
desonide|No|No|No|No|75%|62332055018|DESONIDE 0.05% LOTION|118|ML|1.27804|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|118|No|1.43647|03/01/2022|1.40199|03/01/2022|1.41133|03/01/2022|||STEROIDS: TOPICAL LOW|16000|||||No|No||ALEMBIC PHARMAC|No||||
desonide|No|No|No|No|75%|62332055059|DESONIDE 0.05% LOTION|59|ML|1.72633|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|118|No|1.36873|03/01/2022|1.33588|03/01/2022|1.34477|03/01/2022|||STEROIDS: TOPICAL LOW|16001|||||No|No||ALEMBIC PHARMAC|No||||
fenofibrate|No|No|No|No|75%|62332055490|FENOFIBRATE 54 MG TABLET|90|EA|.18871|04/30/2020||Yes|No||04/30/2020||Yes|No|04/30/2020||Yes|No||||No|No|||Prescription required|No||055|No|.1459|03/29/2022|.14239|03/29/2022|.14334|03/29/2022|||LIPOTROPICS: OTHER|16002|||||No|No||ALEMBIC PHARMAC|No||||
fenofibrate|No|No|No|No|75%|62332055590|FENOFIBRATE 160 MG TABLET|90|EA|.28427|12/29/2020||Yes|No||12/29/2020||Yes|No|12/29/2020||Yes|No||||No|No|||Prescription required|No||055|No|.1612|03/29/2022|.15733|03/29/2022|.15837|03/29/2022|||LIPOTROPICS: OTHER|16003|||||No|No||ALEMBIC PHARMAC|No||||
fenofibrate|No|No|No|No|75%|62332055591|FENOFIBRATE 160 MG TABLET|1000|EA|.28427|12/29/2020||Yes|No||12/29/2020||Yes|No|12/29/2020||Yes|No||||No|No|||Prescription required|No||055|No|.1612|03/29/2022|.15733|03/29/2022|.15837|03/29/2022|||LIPOTROPICS: OTHER|16004|||||No|No||ALEMBIC PHARMAC|No||||
amantadine HCl|No|No|No|No|75%|62332058631|AMANTADINE 100 MG TABLET|100|EA|.68718|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|No||015|No|.71929|03/29/2022|.70202|03/29/2022|.7067|03/29/2022|||ANTIPARKINSON'S AGENTS|16005|||||No|No||ALEMBIC PHARMAC|No||||
nystatin/triamcin|No|No|No|No|75%|62332060615|NYSTATIN-TRIAMCINOLONE CREAM|15|GM|.60028|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|061|No|.54331|03/29/2022|.53027|03/29/2022|.5338|03/29/2022|||ANTIFUNGALS: TOPICAL|16006|||||No|No||ALEMBIC PHARMAC|No||||
nystatin/triamcin|No|No|No|No|75%|62332060630|NYSTATIN-TRIAMCINOLONE CREAM|30|GM|.42154|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|061|No|.49088|03/29/2022|.47909|03/29/2022|.48228|03/29/2022|||ANTIFUNGALS: TOPICAL|16007|||||No|No||ALEMBIC PHARMAC|No||||
nystatin/triamcin|No|No|No|No|75%|62332060660|NYSTATIN-TRIAMCINOLONE CREAM|60|GM|.31296|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|061|No|.35965|03/29/2022|.35101|03/29/2022|.35335|03/29/2022|||ANTIFUNGALS: TOPICAL|16008|||||No|No||ALEMBIC PHARMAC|No||||
doxepin HCl|No|No|No|No|75%|62332063731|DOXEPIN 10 MG CAPSULE|100|EA|.13755|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|No||215|No|.22181|03/29/2022|.21648|03/29/2022|.21792|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|16009|||||No|No||ALEMBIC PHARMAC|No||||
doxepin HCl|No|No|No|No|75%|62332063831|DOXEPIN 25 MG CAPSULE|100|EA|.17195|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|No||215|No|.30005|03/29/2022|.29284|03/29/2022|.29479|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|16010|||||No|No||ALEMBIC PHARMAC|No||||
doxepin HCl|No|No|No|No|75%|62332063931|DOXEPIN 75 MG CAPSULE|100|EA|.39555|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|No||215|No|.56944|03/29/2022|.55577|03/29/2022|.55947|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|16011|||||No|No||ALEMBIC PHARMAC|No||||
doxepin HCl|No|No|No|No|75%|62332064031|DOXEPIN 100 MG CAPSULE|100|EA|.42995|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|No||215|No|.67991|03/29/2022|.66359|03/29/2022|.66801|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|16012|||||No|No||ALEMBIC PHARMAC|No||||
doxepin HCl|No|No|No|No|75%|62332064531|DOXEPIN 50 MG CAPSULE|100|EA|.25795|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|No||215|No|.41139|03/29/2022|.40151|03/29/2022|.40419|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|16013|||||No|No||ALEMBIC PHARMAC|No||||
mercaptopurine|No|No|No|No|75%|62484002002|PURIXAN 20 MG/ML ORAL SUSP|100|ML|5.86799|01/04/2018||Yes|No||01/04/2018||Yes|No|01/04/2018||Yes|No||||No|No|||Prescription required|No||173|No|13.37357|01/04/2022|13.18251|01/04/2022|12.55478|01/04/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|16014|||||No|No||NOVA LABORATORI|No||||
lipase/protease/amylase|No|No|No|No|75%|62541040110|PANCREAZE DR 2,600 UNIT CAP|100|EA|.31949|06/21/2019||Yes|No||06/21/2019||Yes|No|06/21/2019||Yes|No||06/21/2019||Yes|No|||Prescription required|Yes|07/26/2018|108|No|.72814|06/21/2019|.71773|06/21/2019|.68356|06/21/2019|||PANCREATIC ENZYMES|16015|||||No|No||VIVUS|No||||
lipase/protease/amylase|No|No|No|No|75%|62541040210|PANCREAZE DR 4,200 UNIT CAP|100|EA|.51643|06/21/2019||Yes|No||06/21/2019||Yes|No|06/21/2019||Yes|No||06/21/2019||Yes|No|||Prescription required|Yes|07/26/2018|108|No|1.17698|06/29/2021|1.16016|06/29/2021|1.10492|06/29/2021|||PANCREATIC ENZYMES|16016|||||No|No||VIVUS|No||||
lipase/protease/amylase|No|No|No|No|75%|62541040310|PANCREAZE DR 10,500 UNIT CAP|100|EA|1.29129|06/21/2019||Yes|No||06/21/2019||Yes|No|06/21/2019||Yes|No||06/21/2019||Yes|No|||Prescription required|Yes|07/26/2018|108|No|2.94294|06/21/2019|2.90089|06/21/2019|2.76276|06/21/2019|||PANCREATIC ENZYMES|16017|||||No|No||VIVUS|No||||
lipase/protease/amylase|No|No|No|No|75%|62541040410|PANCREAZE DR 16,800 UNIT CAP|100|EA|2.07346|06/21/2019||Yes|No||06/21/2019||Yes|No|06/21/2019||Yes|No||06/21/2019||Yes|No|||Prescription required|Yes|07/26/2018|108|No|4.72556|06/21/2019|4.65805|06/21/2019|4.43624|06/21/2019|||PANCREATIC ENZYMES|16018|||||No|No||VIVUS|No||||
lipase/protease/amylase|No|No|No|No|75%|62541040510|PANCREAZE DR 21,000 UNIT CAP|100|EA|2.58258|06/21/2019||Yes|No||06/21/2019||Yes|No|06/21/2019||Yes|No||06/21/2019||Yes|No|||Prescription required|Yes|07/26/2018|108|No|5.77324|01/25/2022|5.63468|01/25/2022|5.6722|01/25/2022|||PANCREATIC ENZYMES|16019|||||No|No||VIVUS|No||||
hydrocodone/chlorphen p-stirex|No|No|No|No|90%|62542030104|HYDROCODONE-CHLORPHEN ER SUSP|118|ML|.21044|04/03/2017||Yes|No||04/03/2017||Yes|No|04/03/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|183|Yes|.37665|03/01/2022|.36761|03/01/2022|.37005|03/01/2022|||COUGH AND COLD: NARCOTIC|16020|||||No|No||NEOS, LP/AYTU B|No||||
hydrocodone/chlorphen p-stirex|No|No|No|No|90%|62542030117|HYDROCODONE-CHLORPHEN ER SUSP|473|ML|.20545|04/03/2017||Yes|No||04/03/2017||Yes|No|04/03/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|183|Yes|.43216|03/29/2022|.42178|03/29/2022|.42459|03/29/2022|||COUGH AND COLD: NARCOTIC|16021|||||No|No||NEOS, LP/AYTU B|No||||
hydrocortisone|No|No|No|No|75%|62559011107|CORTENEMA 100 MG/60 ML ENEMA|60|ML|.17082|10/11/2013||Yes|No||10/11/2013||Yes|No|10/11/2013||Yes|No||||No|No|||Prescription required|No|||Yes|.38931|03/03/2020|.38375|03/03/2020|.36547|03/03/2020||||16022|||||No|No||ANI PHARMACEUTI|No||||
hydrocortisone|No|No|No|No|75%|62559011111|CORTENEMA 100 MG/60 ML ENEMA|60|ML|.17085|11/16/2012||Yes|No||11/16/2012||Yes|No|11/16/2012||Yes|No||||No|No|||Prescription required|No|||Yes|.38938|03/03/2020|.38382|03/03/2020|.36554|03/03/2020||||16023|||||No|No||ANI PHARMACEUTI|No||||
hydrocortisone|No|No|No|No|75%|62559013807|HYDROCORTISONE 100 MG/60 ML|60|ML|.15357|09/21/2012||Yes|No||09/21/2012||Yes|No|09/21/2012||Yes|No||||No|No|||Prescription required|No|||Yes|.1904|03/01/2022|.18583|03/01/2022|.18706|03/01/2022||||16024|||||No|No||ANI PHARMACEUTI|No||||
oxycodone HCl|No|No|No|No|90%|62559015116|OXYCODONE HCL 5 MG/5 ML SOLN|473|ML|.09803|12/02/2015||Yes|No||12/02/2015||Yes|No|12/02/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.14845|03/29/2022|.14488|03/29/2022|.14585|03/29/2022|||ANALGESICS: NARCOTICS SHORT|16025|||||No|No||ANI PHARMACEUTI|No||||
fluvoxamine maleate|No|No|No|No|75%|62559015801|FLUVOXAMINE MALEATE 25 MG TAB|100|EA|.2365|08/17/2011||Yes|No||08/17/2011||Yes|No|08/17/2011||Yes|No||||No|No|||Prescription required|No||008|No|.2817|03/29/2022|.27493|03/29/2022|.27677|03/29/2022|||ANTIDEPRESSANTS: SSRIs|16026|||||No|No||ANI PHARMACEUTI|No||||
fluvoxamine maleate|No|No|No|No|75%|62559015901|FLUVOXAMINE MALEATE 50 MG TAB|100|EA|.258|08/17/2011||Yes|No||08/17/2011||Yes|No|08/17/2011||Yes|No||||No|No|||Prescription required|No||008|No|.34583|03/29/2022|.33753|03/29/2022|.33977|03/29/2022|||ANTIDEPRESSANTS: SSRIs|16027|||||No|No||ANI PHARMACEUTI|No||||
fluvoxamine maleate|No|No|No|No|75%|62559016001|FLUVOXAMINE MALEATE 100 MG TAB|100|EA|.2795|08/17/2011||Yes|No||08/17/2011||Yes|No|08/17/2011||Yes|No||||No|No|||Prescription required|No||008|No|.33359|03/29/2022|.32558|03/29/2022|.32775|03/29/2022|||ANTIDEPRESSANTS: SSRIs|16028|||||No|No||ANI PHARMACEUTI|No||||
metoclopramide HCl|No|No|No|No|75%|62559016501|REGLAN 5 MG TABLET|100|EA|1.46406|08/15/2011||Yes|No||08/15/2011||Yes|No|08/15/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|085|No|3.3367|03/03/2020|3.28903|03/03/2020|3.13241|03/03/2020|||ANTIEMETIC/ANTIVERTIGO AGENTS|16029|||||No|No||ANI PHARMACEUTI|No||||
metoclopramide HCl|No|No|No|No|75%|62559016601|REGLAN 10 MG TABLET|100|EA|1.46406|08/15/2011||Yes|No||08/15/2011||Yes|No|08/15/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|085|No|3.3367|03/03/2020|3.28903|03/03/2020|3.13241|03/03/2020|||ANTIEMETIC/ANTIVERTIGO AGENTS|16030|||||No|No||ANI PHARMACEUTI|No||||
oxycodone HCl|No|No|No|No|90%|62559016701|OXYCODONE HCL (IR) 5 MG CAP|100|EA|.5031|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|109|Yes|.28013|03/29/2022|.2734|03/29/2022|.27522|03/29/2022|||ANALGESICS: NARCOTICS SHORT|16031|||||No|No||ANI PHARMACEUTI|No||||
morphine sulfate|No|No|No|No|90%|62559017001|MORPHINE SULF 10 MG/5 ML SOLN|100|ML|.0387|12/03/2018|06/30/2022|Yes|No||12/03/2018|06/30/2022|Yes|No|12/03/2018|06/30/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|.08934|10/26/2021|.08719|10/26/2021|.08777|10/26/2021|||ANALGESICS: NARCOTICS SHORT|16032|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ANI PHARMACEUTI|No||||
morphine sulfate|No|No|No|No|90%|62559017005|MORPHINE SULF 10 MG/5 ML SOLN|500|ML|.01978|12/03/2018|07/31/2022|Yes|No||12/03/2018|07/31/2022|Yes|No|12/03/2018|07/31/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|.04508|11/23/2021|.04443|11/23/2021|.04232|11/23/2021|||ANALGESICS: NARCOTICS SHORT|16033|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ANI PHARMACEUTI|No||||
morphine sulfate|No|No|No|No|90%|62559017101|MORPHINE SULF 20 MG/5 ML SOLN|100|ML|.05568|12/03/2018|02/22/2022|Yes|No||12/03/2018|02/22/2022|Yes|No|12/03/2018|02/22/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|.12691|12/03/2018|.12509|12/03/2018|.11914|12/03/2018|||ANALGESICS: NARCOTICS SHORT|16034|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ANI PHARMACEUTI|No||||
morphine sulfate|No|No|No|No|90%|62559017105|MORPHINE SULF 20 MG/5 ML SOLN|500|ML|.03035|12/03/2018|02/28/2022|Yes|No||12/03/2018|02/28/2022|Yes|No|12/03/2018|02/28/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|.06918|12/03/2018|.06819|12/03/2018|.06495|12/03/2018|||ANALGESICS: NARCOTICS SHORT|16035|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ANI PHARMACEUTI|No||||
nilutamide|No|No|No|No|75%|62559017331|NILUTAMIDE 150 MG TABLET|30|EA|66.30471|11/05/2018||Yes|No||11/05/2018||Yes|No|11/05/2018||Yes|No||||No|No|||Prescription required|No||550|No|151.11306|11/05/2018|148.9543|11/05/2018|141.86124|11/05/2018|||ONCOLOGY: ORAL - PROSTATE|16036|||||No|No||ANI PHARMACEUTI|No||||
metoclopramide HCl|No|No|No|No|75%|62559019016|METOCLOPRAMIDE 5 MG/5 ML SOLN|473|ML|.03181|06/18/2015||Yes|No||06/18/2015||Yes|No|06/18/2015||Yes|No||||No|No|||Prescription required|No||085|No|.03918|03/29/2022|.03823|03/29/2022|.03849|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|16037|||||No|No||ANI PHARMACEUTI|No||||
nicardipine HCl|No|No|No|No|75%|62559020590|NICARDIPINE 20 MG CAPSULE|90|EA|5.33003|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|045|No|12.14753|08/25/2021|11.97399|08/25/2021|11.4038|08/25/2021|||CALCIUM CHANNEL BLOCKERS|16038|||||No|No||ANI PHARMACEUTI|No||||
nicardipine HCl|No|No|No|No|75%|62559020690|NICARDIPINE 30 MG CAPSULE|90|EA|7.63373|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|045|No|17.39782|08/25/2021|17.14928|08/25/2021|16.33264|08/25/2021|||CALCIUM CHANNEL BLOCKERS|16039|||||No|No||ANI PHARMACEUTI|No||||
nimodipine|No|No|No|No|75%|62559021031|NIMODIPINE 30 MG CAPSULE|30|EA|5.83223|02/16/2016|02/22/2022|Yes|No||02/16/2016|02/22/2022|Yes|No|02/16/2016|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|01/22/2015|045|No|13.29206|04/27/2021|13.10217|04/27/2021|12.47826|04/27/2021|||CALCIUM CHANNEL BLOCKERS|16040|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ANI PHARMACEUTI|No||||
nimodipine|No|No|No|No|75%|62559021081|NIMODIPINE 30 MG CAPSULE|100|EA|5.5857|02/16/2016|09/30/2022|Yes|No||02/16/2016|09/30/2022|Yes|No|02/16/2016|09/30/2022|Yes|No||||No|No|||Prescription required|Yes|01/22/2015|045|No|12.7302|04/27/2021|12.54834|04/27/2021|11.9508|04/27/2021|||CALCIUM CHANNEL BLOCKERS|16041|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ANI PHARMACEUTI|No||||
propafenone HCl|No|No|No|No|75%|62559023001|PROPAFENONE HCL 150 MG TABLET|100|EA|.11657|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|||Prescription required|No|||No|.14292|03/29/2022|.13948|03/29/2022|.14041|03/29/2022||||16042|||||No|No||ANI PHARMACEUTI|No||||
propafenone HCl|No|No|No|No|75%|62559023101|PROPAFENONE HCL 225 MG TAB|100|EA|.17397|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|||Prescription required|No|||No|.20774|03/29/2022|.20275|03/29/2022|.2041|03/29/2022||||16043|||||No|No||ANI PHARMACEUTI|No||||
propafenone HCl|No|No|No|No|75%|62559023201|PROPAFENONE HCL 300 MG TAB|100|EA|.49613|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|||Prescription required|No|||No|.57288|01/25/2022|.55913|01/25/2022|.56285|01/25/2022||||16044|||||No|No||ANI PHARMACEUTI|No||||
dipyridamole|No|No|No|No|75%|62559023501|DIPYRIDAMOLE 25 MG TABLET|100|EA|.42763|03/14/2022||Yes|No||03/14/2022||Yes|No|03/14/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|004|No|1.06294|03/14/2022|1.03742|03/14/2022|1.04433|03/14/2022|||PLATELET AGGREGATION INHIBITORS|16045|||||No|No||ANI PHARMACEUTI|No||||
dipyridamole|No|No|No|No|75%|62559023601|DIPYRIDAMOLE 50 MG TABLET|100|EA|.68886|03/14/2022||Yes|No||03/14/2022||Yes|No|03/14/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|004|No|1.35098|03/14/2022|1.31855|03/14/2022|1.32733|03/14/2022|||PLATELET AGGREGATION INHIBITORS|16046|||||No|No||ANI PHARMACEUTI|No||||
dipyridamole|No|No|No|No|75%|62559023701|DIPYRIDAMOLE 75 MG TABLET|100|EA|.9217|03/14/2022||Yes|No||03/14/2022||Yes|No|03/14/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|004|No|2.10063|03/22/2022|2.07062|03/14/2022|1.97202|03/14/2022|||PLATELET AGGREGATION INHIBITORS|16047|||||No|No||ANI PHARMACEUTI|No||||
methazolamide|No|No|No|No|75%|62559024001|METHAZOLAMIDE 25 MG TABLET|100|EA|1.97675|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|No|||No|2.09477|03/01/2022|2.04449|03/01/2022|2.05811|03/01/2022||||16048|||||No|No||ANI PHARMACEUTI|No||||
methazolamide|No|No|No|No|75%|62559024101|METHAZOLAMIDE 50 MG TABLET|100|EA|3.95367|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|No|||No|4.4571|03/29/2022|4.35012|03/29/2022|4.3791|03/29/2022||||16049|||||No|No||ANI PHARMACEUTI|No||||
etodolac|No|No|No|No|75%|62559025001|ETODOLAC 200 MG CAPSULE|100|EA|.46345|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|.75715|03/29/2022|.73897|03/29/2022|.74389|03/29/2022|||NSAIDS|16050|||||No|No||ANI PHARMACEUTI|No||||
etodolac|No|No|No|No|75%|62559025101|ETODOLAC 300 MG CAPSULE|100|EA|.55616|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|.56927|03/29/2022|.5556|03/29/2022|.5593|03/29/2022|||NSAIDS|16051|||||No|No||ANI PHARMACEUTI|No||||
tranexamic acid|No|No|No|No|75%|62559026530|TRANEXAMIC ACID 650 MG TABLET|30|EA|1.81332|12/08/2021||Yes|No||12/08/2021||Yes|No|12/08/2021||Yes|No||||No|No|||Prescription required|No|||No|1.67932|03/29/2022|1.63901|03/29/2022|1.64993|03/29/2022||||16052|||||No|No||ANI PHARMACEUTI|No||||
nebivolol HCl|No|No|No|No|75%|62559027530|NEBIVOLOL 2.5 MG TABLET|30|EA|1.21116|12/21/2021||Yes|No||12/21/2021||Yes|No|12/21/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.41918|03/29/2022|.40911|03/29/2022|.41184|03/29/2022|||BETA-BLOCKERS|16053|||||No|No||ANI PHARMACEUTI|No||||
nebivolol HCl|No|No|No|No|75%|62559027630|NEBIVOLOL 5 MG TABLET|30|EA|1.21116|12/21/2021||Yes|No||12/21/2021||Yes|No|12/21/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.46205|03/29/2022|.45096|03/29/2022|.45396|03/29/2022|||BETA-BLOCKERS|16054|||||No|No||ANI PHARMACEUTI|No||||
nebivolol HCl|No|No|No|No|75%|62559027690|NEBIVOLOL 5 MG TABLET|90|EA|1.21116|12/21/2021||Yes|No||12/21/2021||Yes|No|12/21/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.46205|03/29/2022|.45096|03/29/2022|.45396|03/29/2022|||BETA-BLOCKERS|16055|||||No|No||ANI PHARMACEUTI|No||||
nebivolol HCl|No|No|No|No|75%|62559027730|NEBIVOLOL 10 MG TABLET|30|EA|1.21116|12/22/2021||Yes|No||12/22/2021||Yes|No|12/22/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.40408|03/29/2022|.39438|03/29/2022|.397|03/29/2022|||BETA-BLOCKERS|16056|||||No|No||ANI PHARMACEUTI|No||||
nebivolol HCl|No|No|No|No|75%|62559027790|NEBIVOLOL 10 MG TABLET|90|EA|1.21116|12/21/2021||Yes|No||12/21/2021||Yes|No|12/21/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.40408|03/29/2022|.39438|03/29/2022|.397|03/29/2022|||BETA-BLOCKERS|16057|||||No|No||ANI PHARMACEUTI|No||||
nebivolol HCl|No|No|No|No|75%|62559027830|NEBIVOLOL 20 MG TABLET|30|EA|1.21116|12/22/2021||Yes|No||12/22/2021||Yes|No|12/22/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.46821|03/29/2022|.45697|03/29/2022|.46001|03/29/2022|||BETA-BLOCKERS|16058|||||No|No||ANI PHARMACEUTI|No||||
nebivolol HCl|No|No|No|No|75%|62559027890|NEBIVOLOL 20 MG TABLET|90|EA|1.21116|12/21/2021||Yes|No||12/21/2021||Yes|No|12/21/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.46821|03/29/2022|.45697|03/29/2022|.46001|03/29/2022|||BETA-BLOCKERS|16059|||||No|No||ANI PHARMACEUTI|No||||
lithium carbonate|No|No|No|No|75%|62559028001|LITHOBID ER 300 MG TABLET|100|EA|5.48035|01/26/2015||Yes|No||01/26/2015||Yes|No|01/26/2015||Yes|No||||No|No|||Prescription required|No|||No|12.4901|03/03/2020|12.31167|03/03/2020|11.7254|03/03/2020||||16060|||||No|No||ANI PHARMACEUTI|No||||
potassium citrate|No|No|No|No|75%|62559029101|POTASSIUM CITRATE ER 10 MEQ TB|100|EA|.21113|04/08/2021||Yes|No||04/08/2021||Yes|No|04/08/2021||Yes|No||||No|No|||Prescription required|No|||No|.30433|03/29/2022|.29702|03/29/2022|.299|03/29/2022||||16061|||||No|No||ANI PHARMACEUTI|No||||
potassium citrate|No|No|No|No|75%|62559029201|POTASSIUM CITRATE ER 15 MEQ TB|100|EA|.45795|04/08/2021||Yes|No||04/08/2021||Yes|No|04/08/2021||Yes|No||||No|No|||Prescription required|No|||No|.5925|03/29/2022|.57828|03/29/2022|.58213|03/29/2022||||16062|||||No|No||ANI PHARMACEUTI|No||||
fenofibrate|No|No|No|No|75%|62559030590|LIPOFEN 50 MG CAPSULE|90|EA|1.86108|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|055|No|4.24154|03/22/2022|4.18095|03/22/2022|3.98186|03/22/2022|||LIPOTROPICS: OTHER|16063|||||No|No||ANI PHARMACEUTI|No||||
fenofibrate|No|No|No|No|75%|62559030690|LIPOFEN 150 MG CAPSULE|90|EA|4.07821|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|055|No|9.29453|03/22/2022|9.16175|03/22/2022|8.72548|03/22/2022|||LIPOTROPICS: OTHER|16064|||||No|No||ANI PHARMACEUTI|No||||
vancomycin HCl|No|No|No|No|75%|62559031020|VANCOCIN HCL 125 MG CAPSULE|20|EA|37.03246|01/23/2015||Yes|No||01/23/2015||Yes|No|01/23/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|115|No|84.39956|03/03/2020|83.19385|03/03/2020|79.23224|03/03/2020|||ANTIBIOTICS: GI|16065|||||No|No||ANI PHARMACEUTI|No||||
vancomycin HCl|No|No|No|No|75%|62559031120|VANCOCIN HCL 250 MG CAPSULE|20|EA|68.27927|01/23/2015||Yes|No||01/23/2015||Yes|No|01/23/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|115|No|155.61322|03/03/2020|153.39017|03/03/2020|146.08588|03/03/2020|||ANTIBIOTICS: GI|16066|||||No|No||ANI PHARMACEUTI|No||||
glipizide|No|No|No|No|75%|62559031610|GLIPIZIDE 10 MG TABLET|1000|EA|.03192|03/22/2022||Yes|No||03/22/2022||Yes|No|03/22/2022||Yes|No||||No|No|||Prescription required|No|||No|.04827|03/29/2022|.04711|03/29/2022|.04742|03/29/2022||||16067|||||No|No||ANI PHARMACEUTI|No||||
lithium carbonate|No|No|No|No|75%|62559034001|LITHIUM CARBONATE ER 300 MG TB|100|EA|.086|06/14/2017|04/30/2023|Yes|No||06/14/2017|04/30/2023|Yes|No|06/14/2017|04/30/2023|Yes|No||||No|No|||Prescription required|No|||No|.12646|03/29/2022|.12342|03/29/2022|.12424|03/29/2022||||16068|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ANI PHARMACEUTI|No||||
flecainide acetate|No|No|No|No|75%|62559038001|FLECAINIDE ACETATE 50 MG TAB|100|EA|.18511|02/16/2016||Yes|No||02/16/2016||Yes|No|02/16/2016||Yes|No||||No|No|||Prescription required|No|||No|.15465|03/29/2022|.15093|03/29/2022|.15194|03/29/2022||||16069|||||No|No||ANI PHARMACEUTI|No||||
flecainide acetate|No|No|No|No|75%|62559038101|FLECAINIDE ACETATE 100 MG TAB|100|EA|.30246|02/16/2016||Yes|No||02/16/2016||Yes|No|02/16/2016||Yes|No||||No|No|||Prescription required|No|||No|.24778|03/29/2022|.24183|03/29/2022|.24344|03/29/2022||||16070|||||No|No||ANI PHARMACEUTI|No||||
flecainide acetate|No|No|No|No|75%|62559038201|FLECAINIDE ACETATE 150 MG TAB|100|EA|.41559|02/16/2016||Yes|No||02/16/2016||Yes|No|02/16/2016||Yes|No||||No|No|||Prescription required|No|||No|.41264|03/29/2022|.40273|03/29/2022|.40541|03/29/2022||||16071|||||No|No||ANI PHARMACEUTI|No||||
vancomycin HCl|No|No|No|No|75%|62559039020|VANCOMYCIN HCL 125 MG CAPSULE|20|EA|2.0425|12/02/2015||Yes|No||12/02/2015||Yes|No|12/02/2015||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|115|No|1.79287|03/29/2022|1.74984|03/29/2022|1.76149|03/29/2022|||ANTIBIOTICS: GI|16072|||||No|No||ANI PHARMACEUTI|No||||
vancomycin HCl|No|No|No|No|75%|62559039050|VANCOMYCIN HCL 125 MG CAPSULE|50|EA|2.0425|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|115|No|1.79287|03/29/2022|1.74984|03/29/2022|1.76149|03/29/2022|||ANTIBIOTICS: GI|16073|||||No|No||ANI PHARMACEUTI|No||||
vancomycin HCl|No|No|No|No|75%|62559039120|VANCOMYCIN HCL 250 MG CAPSULE|20|EA|4.085|12/02/2015||Yes|No||12/02/2015||Yes|No|12/02/2015||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|115|No|3.02495|03/29/2022|2.95235|03/29/2022|2.97201|03/29/2022|||ANTIBIOTICS: GI|16074|||||No|No||ANI PHARMACEUTI|No||||
vancomycin HCl|No|No|No|No|75%|62559039150|VANCOMYCIN HCL 250 MG CAPSULE|50|EA|4.085|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|115|No|3.02495|03/29/2022|2.95235|03/29/2022|2.97201|03/29/2022|||ANTIBIOTICS: GI|16075|||||No|No||ANI PHARMACEUTI|No||||
omega-3 acid ethyl esters|No|No|No|No|75%|62559041012|OMEGA-3 ETHYL ESTERS 1 GM CAP|120|EA|.08958|12/30/2020|11/30/2022|Yes|No||12/30/2020|11/30/2022|Yes|No|12/30/2020|11/30/2022|Yes|No||||No|No|||Prescription required|No||055|Yes|.18363|03/29/2022|.17922|03/29/2022|.18041|03/29/2022|||LIPOTROPICS: OTHER|16076|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ANI PHARMACEUTI|No||||
mesalamine|No|No|No|No|75%|62559042007|MESALAMINE 4 GM/60 ML ENEMA|60|ML|.09521|03/16/2020||Yes|No||03/16/2020||Yes|No|03/16/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|010|No|.12785|03/29/2022|.12478|03/29/2022|.12561|03/29/2022|||ULCERATIVE COLITIS AGENTS|16077|||||No|No||ANI PHARMACEUTI|No||||
hydrocortisone|No|No|No|No|75%|62559043001|HYDROCORTISONE 1% CREAM|28.4|GM|.75704|03/16/2020||Yes|No||03/16/2020||Yes|No|03/16/2020||Yes|No||||No|No|||Prescription required|No|||No|.74753|03/01/2022|.72958|03/01/2022|.73444|03/01/2022||||16078|||||No|No||ANI PHARMACEUTI|No||||
hydrocortisone|No|No|No|No|75%|62559043130|HYDROCORTISONE 2.5% CREAM|30|GM|.9933|10/19/2016||Yes|No||10/19/2016||Yes|No|10/19/2016||Yes|No||||No|No|||Prescription required|No||118|No|.33274|03/29/2022|.32475|03/29/2022|.32691|03/29/2022|||STEROIDS: TOPICAL LOW|16079|||||No|No||ANI PHARMACEUTI|No||||
erythromycin ethylsuccinate|No|No|No|No|75%|62559044001|ERYTHROMYCIN 200 MG/5 ML SUSP|100|ML|1.39461|09/14/2018|11/30/2023|Yes|No||09/14/2018|11/30/2023|Yes|No|09/14/2018|11/30/2023|Yes|No||||No|No|||Prescription required|Yes|01/28/2016|018|No|1.82351|03/29/2022|1.77974|03/29/2022|1.79159|03/29/2022|||MACROLIDES/KETOLIDES|16080|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ANI PHARMACEUTI|No||||
erythromycin ethylsuccinate|No|No|No|No|75%|62559044002|ERYTHROMYCIN 200 MG/5 ML SUSP|200|ML|1.27742|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|018|No|2.91133|09/28/2021|2.86974|09/28/2021|2.73309|09/28/2021|||MACROLIDES/KETOLIDES|16081|||||No|No||ANI PHARMACEUTI|No||||
fenofibrate|No|No|No|No|75%|62559046090|FENOFIBRATE 50 MG CAPSULE|90|EA|1.15168|08/18/2016||Yes|No||08/18/2016||Yes|No|08/18/2016||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|055|No|2.62476|08/29/2017|2.58726|08/29/2017|2.46406|08/29/2017|||LIPOTROPICS: OTHER|16082|||||No|No||ANI PHARMACEUTI|No||||
fenofibrate|No|No|No|No|75%|62559046190|FENOFIBRATE 150 MG CAPSULE|90|EA|2.52318|08/18/2016||Yes|No||08/18/2016||Yes|No|08/18/2016||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|055|No|5.60694|01/25/2022|5.47237|01/25/2022|5.50881|01/25/2022|||LIPOTROPICS: OTHER|16083|||||No|No||ANI PHARMACEUTI|No||||
diphenoxylate HCl/atropine|No|No|No|No|75%|62559049001|DIPHENOXYLATE-ATROP 2.5-0.025|100|EA|.215|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|No|||No|.22711|03/29/2022|.22165|03/29/2022|.22313|03/29/2022||||16084|||||No|No||ANI PHARMACEUTI|No||||
diphenoxylate HCl/atropine|No|No|No|No|75%|62559049010|DIPHENOXYLATE-ATROP 2.5-0.025|1000|EA|.215|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|No|||No|.22711|03/29/2022|.22165|03/29/2022|.22313|03/29/2022||||16085|||||No|No||ANI PHARMACEUTI|No||||
indapamide|Yes|No|No|No|75%|62559051001|INDAPAMIDE 1.25 MG TABLET|100|EA|.0774|07/17/2018||Yes|No||07/17/2018||Yes|No|07/17/2018||Yes|No||||No|No|06/18/2019||Prescription required|No|||No|.12482|03/29/2022|.12182|03/29/2022|.12263|03/29/2022||||16086|||||No|No||ANI PHARMACEUTI|No||||
indapamide|Yes|No|No|No|75%|62559051101|INDAPAMIDE 2.5 MG TABLET|100|EA|.086|07/17/2018||Yes|No||07/17/2018||Yes|No|07/17/2018||Yes|No||||No|No|06/18/2019||Prescription required|No|||No|.15208|03/29/2022|.14843|03/29/2022|.14941|03/29/2022||||16087|||||No|No||ANI PHARMACEUTI|No||||
propranolol HCl|No|No|No|No|75%|62559052001|INDERAL LA 60 MG CAPSULE|100|EA|27.14405|11/29/2017||Yes|No||11/29/2017||Yes|No|11/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|070|No|61.86318|03/09/2021|60.97942|03/09/2021|58.07564|03/09/2021|||BETA-BLOCKERS|16088|||||No|No||ANI PHARMACEUTI|No||||
propranolol HCl|No|No|No|No|75%|62559052101|INDERAL LA 80 MG CAPSULE|100|EA|31.7048|11/29/2017||Yes|No||11/29/2017||Yes|No|11/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|070|No|72.25745|03/09/2021|71.2252|03/09/2021|67.83353|03/09/2021|||BETA-BLOCKERS|16089|||||No|No||ANI PHARMACEUTI|No||||
propranolol HCl|No|No|No|No|75%|62559052201|INDERAL LA 120 MG CAPSULE|100|EA|34.91531|11/30/2017||Yes|No||11/30/2017||Yes|No|11/30/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|070|No|79.57443|03/09/2021|78.43765|03/09/2021|74.70252|03/09/2021|||BETA-BLOCKERS|16090|||||No|No||ANI PHARMACEUTI|No||||
propranolol HCl|No|No|No|No|75%|62559052301|INDERAL LA 160 MG CAPSULE|100|EA|36.44882|11/30/2017||Yes|No||11/30/2017||Yes|No|11/30/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|070|No|83.0694|03/09/2021|81.8827|03/09/2021|77.98352|03/09/2021|||BETA-BLOCKERS|16091|||||No|No||ANI PHARMACEUTI|No||||
propranolol HCl|No|No|No|No|75%|62559053001|PROPRANOLOL ER 60 MG CAPSULE|100|EA|.1935|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|070|No|.32013|03/29/2022|.31244|03/29/2022|.31452|03/29/2022|||BETA-BLOCKERS|16092|||||No|No||ANI PHARMACEUTI|No||||
propranolol HCl|No|No|No|No|75%|62559053101|PROPRANOLOL ER 80 MG CAPSULE|100|EA|.215|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|070|No|.35912|03/29/2022|.3505|03/29/2022|.35283|03/29/2022|||BETA-BLOCKERS|16093|||||No|No||ANI PHARMACEUTI|No||||
propranolol HCl|No|No|No|No|75%|62559053201|PROPRANOLOL ER 120 MG CAPSULE|100|EA|.258|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|070|No|.4314|03/29/2022|.42104|03/29/2022|.42385|03/29/2022|||BETA-BLOCKERS|16094|||||No|No||ANI PHARMACEUTI|No||||
propranolol HCl|No|No|No|No|75%|62559053301|PROPRANOLOL ER 160 MG CAPSULE|100|EA|.344|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|070|No|.61078|03/29/2022|.59612|03/29/2022|.60009|03/29/2022|||BETA-BLOCKERS|16095|||||No|No||ANI PHARMACEUTI|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|62559055016|SULFAMETHOXAZOLE-TMP SUSP|473|ML|.06526|06/12/2020|10/31/2023|Yes|No||06/12/2020|10/31/2023|Yes|No|06/12/2020|10/31/2023|Yes|No||||No|No|||Prescription required|No|||No|.05588|03/29/2022|.05453|03/29/2022|.0549|03/29/2022||||16096|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ANI PHAR/PRASCO|No||||
pindolol|No|No|No|No|75%|62559056001|PINDOLOL 5 MG TABLET|100|EA|.301|03/16/2020||Yes|No||03/16/2020||Yes|No|03/16/2020||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|070|No|.74858|03/29/2022|.73061|03/29/2022|.73547|03/29/2022|||BETA-BLOCKERS|16097|||||No|No||ANI PHARMACEUTI|No||||
pindolol|No|No|No|No|75%|62559056101|PINDOLOL 10 MG TABLET|100|EA|.43|03/16/2020||Yes|No||03/16/2020||Yes|No|03/16/2020||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|070|No|.98|06/29/2021|.966|06/29/2021|.92|06/29/2021|||BETA-BLOCKERS|16098|||||No|No||ANI PHARMACEUTI|No||||
prazosin HCl|No|No|No|No|75%|62559058001|PRAZOSIN 1 MG CAPSULE|100|EA|.10827|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No|||No|.1999|03/29/2022|.1951|03/29/2022|.1964|03/29/2022||||16099|||||No|No||ANI PHARMACEUTI|No||||
prazosin HCl|No|No|No|No|75%|62559058101|PRAZOSIN 2 MG CAPSULE|100|EA|.15965|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No|||No|.29873|03/29/2022|.29156|03/29/2022|.2935|03/29/2022||||16100|||||No|No||ANI PHARMACEUTI|No||||
prazosin HCl|No|No|No|No|75%|62559058110|PRAZOSIN 2 MG CAPSULE|1000|EA|.15984|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No|||No|.29873|03/29/2022|.29156|03/29/2022|.2935|03/29/2022||||16101|||||No|No||ANI PHARMACEUTI|No||||
prazosin HCl|No|No|No|No|75%|62559058201|PRAZOSIN 5 MG CAPSULE|100|EA|.26174|08/20/2021||Yes|No||08/20/2021||Yes|No|08/20/2021||Yes|No||||No|No|||Prescription required|No|||No|.53856|03/29/2022|.52563|03/29/2022|.52913|03/29/2022||||16102|||||No|No||ANI PHARMACEUTI|No||||
propranolol HCl|No|No|No|No|75%|62559059030|INNOPRAN XL 80 MG CAPSULE|30|EA|31.30514|03/04/2020||Yes|No||03/04/2020||Yes|No|03/04/2020||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|070|No|71.3466|03/09/2021|70.32736|03/09/2021|66.97844|03/09/2021|||BETA-BLOCKERS|16103|||||No|No||ANI PHARMACEUTI|No||||
propranolol HCl|No|No|No|No|75%|62559059130|INNOPRAN XL 120 MG CAPSULE|30|EA|31.30514|03/04/2020||Yes|No||03/04/2020||Yes|No|03/04/2020||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|070|No|71.3466|03/09/2021|70.32736|03/09/2021|66.97844|03/09/2021|||BETA-BLOCKERS|16104|||||No|No||ANI PHARMACEUTI|No||||
propranolol HCl|No|No|No|No|75%|62559060030|INDERAL XL 80 MG CAPSULE|30|EA|31.30514|03/04/2020||Yes|No||03/04/2020||Yes|No|03/04/2020||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|070|No|71.3466|03/09/2021|70.32736|03/09/2021|66.97844|03/09/2021|||BETA-BLOCKERS|16105|||||No|No||ANI PHARMACEUTI|No||||
propranolol HCl|No|No|No|No|75%|62559060130|INDERAL XL 120 MG CAPSULE|30|EA|31.30514|03/04/2020||Yes|No||03/04/2020||Yes|No|03/04/2020||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|070|No|71.3466|03/09/2021|70.32736|03/09/2021|66.97844|03/09/2021|||BETA-BLOCKERS|16106|||||No|No||ANI PHARMACEUTI|No||||
cholestyramine (with sugar)|No|No|No|No|75%|62559062037|CHOLESTYRAMINE POWDER|378|GM|.08949|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||||No|No|||Prescription required|No||055|No|.14958|03/29/2022|.14599|03/29/2022|.14696|03/29/2022|||LIPOTROPICS: OTHER|16107|||||No|No||ANI PHARMACEUTI|No||||
erythromycin ethylsuccinate|No|No|No|No|75%|62559063001|ERYTHROMYCIN 200 MG/5 ML SUSP|100|ML|1.39461|04/16/2020||Yes|No||04/16/2020||Yes|No|04/16/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|018|No|1.82351|03/29/2022|1.77974|03/29/2022|1.79159|03/29/2022|||MACROLIDES/KETOLIDES|16108|||||No|No||ANI PHARMACEUTI|No||||
erythromycin ethylsuccinate|No|No|No|No|75%|62559063101|ERYTHROMYCIN 400 MG/5 ML SUSP|100|ML|2.4553|04/16/2020||Yes|No||04/16/2020||Yes|No|04/16/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|018|No|3.08133|03/29/2022|3.00737|03/29/2022|3.0274|03/29/2022|||MACROLIDES/KETOLIDES|16109|||||No|No||ANI PHARMACEUTI|No||||
candesartan cilexetil|Yes|No|No|No|75%|62559064030|ATACAND 4 MG TABLET|30|EA|2.62672|04/29/2019||Yes|No||04/29/2019||Yes|No|04/29/2019||Yes|No||||No|No|09/04/2019||Prescription required|Yes|07/26/2018|113|Yes|5.98648|03/03/2020|5.90096|03/03/2020|5.61996|03/03/2020|||ANGIOTENSIN MODULATORS|16110|||||No|No||ANI PHARMACEUTI|No||||
candesartan cilexetil|Yes|No|No|No|75%|62559064130|ATACAND 8 MG TABLET|30|EA|3.14|04/29/2019||Yes|No||04/29/2019||Yes|No|04/29/2019||Yes|No||||No|No|09/04/2019||Prescription required|Yes|07/26/2018|113|Yes|7.15628|03/03/2020|7.05405|03/03/2020|6.71814|03/03/2020|||ANGIOTENSIN MODULATORS|16111|||||No|No||ANI PHARMACEUTI|No||||
candesartan cilexetil|Yes|No|No|No|75%|62559064230|ATACAND 16 MG TABLET|30|EA|3.37636|04/29/2019||Yes|No||04/29/2019||Yes|No|04/29/2019||Yes|No||||No|No|09/04/2019||Prescription required|Yes|07/26/2018|113|Yes|7.69496|06/29/2021|7.58503|06/29/2021|7.22384|06/29/2021|||ANGIOTENSIN MODULATORS|16112|||||No|No||ANI PHARMACEUTI|No||||
candesartan cilexetil|Yes|No|No|No|75%|62559064290|ATACAND 16 MG TABLET|90|EA|3.3763|04/29/2019||Yes|No||04/29/2019||Yes|No|04/29/2019||Yes|No||||No|No|09/04/2019||Prescription required|Yes|07/26/2018|113|Yes|7.69484|06/29/2021|7.58491|06/29/2021|7.22372|06/29/2021|||ANGIOTENSIN MODULATORS|16113|||||No|No||ANI PHARMACEUTI|No||||
candesartan cilexetil|Yes|No|No|No|75%|62559064330|ATACAND 32 MG TABLET|30|EA|4.27133|04/29/2019||Yes|No||04/29/2019||Yes|No|04/29/2019||Yes|No||||No|No|09/04/2019||Prescription required|Yes|07/26/2018|113|Yes|9.73466|03/03/2020|9.59559|03/03/2020|9.13866|03/03/2020|||ANGIOTENSIN MODULATORS|16114|||||No|No||ANI PHARMACEUTI|No||||
candesartan cilexetil|Yes|No|No|No|75%|62559064390|ATACAND 32 MG TABLET|90|EA|4.27137|04/29/2019||Yes|No||04/29/2019||Yes|No|04/29/2019||Yes|No||||No|No|09/04/2019||Prescription required|Yes|07/26/2018|113|Yes|9.73477|03/03/2020|9.5957|03/03/2020|9.13876|03/03/2020|||ANGIOTENSIN MODULATORS|16115|||||No|No||ANI PHARMACEUTI|No||||
candesartan/hydrochlorothiazid|Yes|No|No|No|75%|62559065090|ATACAND HCT 16-12.5 MG TAB|90|EA|3.53125|04/29/2019||Yes|No||04/29/2019||Yes|No|04/29/2019||Yes|No||||No|No|09/04/2019||Prescription required|Yes|07/26/2018|113|Yes|8.04797|03/03/2020|7.933|03/03/2020|7.55524|03/03/2020|||ANGIOTENSIN MODULATORS|16116|||||No|No||ANI PHARMACEUTI|No||||
candesartan/hydrochlorothiazid|Yes|No|No|No|75%|62559065190|ATACAND HCT 32-12.5 MG TAB|90|EA|3.8418|04/29/2019||Yes|No||04/29/2019||Yes|No|04/29/2019||Yes|No||||No|No|09/04/2019||Prescription required|Yes|07/26/2018|113|Yes|8.75575|03/03/2020|8.63066|03/03/2020|8.21968|03/03/2020|||ANGIOTENSIN MODULATORS|16117|||||No|No||ANI PHARMACEUTI|No||||
candesartan/hydrochlorothiazid|Yes|No|No|No|75%|62559065290|ATACAND HCT 32-25 MG TABLET|90|EA|4.3569|04/29/2019||Yes|No||04/29/2019||Yes|No|04/29/2019||Yes|No||||No|No|09/04/2019||Prescription required|Yes|07/26/2018|113|Yes|9.92968|03/03/2020|9.78783|03/03/2020|9.32174|03/03/2020|||ANGIOTENSIN MODULATORS|16118|||||No|No||ANI PHARMACEUTI|No||||
candesartan/hydrochlorothiazid|Yes|No|No|No|75%|62559066090|CANDESARTAN-HCTZ 16-12.5 MG TB|90|EA|.73066|06/17/2019||Yes|No||06/17/2019||Yes|No|06/17/2019||Yes|No||||No|No|09/27/2019||Prescription required|Yes|07/29/2021|113|Yes|1.48228|03/29/2022|1.4467|03/29/2022|1.45634|03/29/2022|||ANGIOTENSIN MODULATORS|16119|||||No|No||ANI PHARMACEUTI|No||||
candesartan/hydrochlorothiazid|Yes|No|No|No|75%|62559066190|CANDESARTAN-HCTZ 32-12.5 MG TB|90|EA|.74519|06/17/2019||Yes|No||06/17/2019||Yes|No|06/17/2019||Yes|No||||No|No|09/27/2019||Prescription required|Yes|07/29/2021|113|Yes|1.84933|03/29/2022|1.80494|03/29/2022|1.81696|03/29/2022|||ANGIOTENSIN MODULATORS|16120|||||No|No||ANI PHARMACEUTI|No||||
candesartan/hydrochlorothiazid|Yes|No|No|No|75%|62559066290|CANDESARTAN-HCTZ 32-25 MG TAB|90|EA|.80668|06/17/2019||Yes|No||06/17/2019||Yes|No|06/17/2019||Yes|No||||No|No|09/27/2019||Prescription required|Yes|07/29/2021|113|Yes|1.84688|03/29/2022|1.80255|03/29/2022|1.81455|03/29/2022|||ANGIOTENSIN MODULATORS|16121|||||No|No||ANI PHARMACEUTI|No||||
anastrozole|No|No|No|No|75%|62559067030|ARIMIDEX 1 MG TABLET|30|EA|23.3973|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|||Prescription required|No||502|No|53.32408|03/09/2021|52.56231|03/09/2021|50.05934|03/09/2021|||ONCOLOGY: ORAL - BREAST|16122|||||No|No||ANI PHARMACEUTI|No||||
bicalutamide|No|No|No|No|75%|62559068030|CASODEX 50 MG TABLET|30|EA|47.24453|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|||Prescription required|No|||No|107.67358|03/03/2020|106.13538|03/03/2020|101.08132|03/03/2020||||16123|||||No|No||ANI PHARMACEUTI|No||||
ezetimibe/simvastatin|No|No|No|No|75%|62559070030|EZETIMIBE-SIMVASTATIN 10-10 MG|30|EA|.71666|09/26/2019|12/31/2022|Yes|No||09/26/2019|12/31/2022|Yes|No|09/26/2019|12/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|063|Yes|.75312|03/29/2022|.73504|03/29/2022|.73994|03/29/2022|||LIPOTROPICS: STATINS|16124|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ANI PHARMACEUTI|No||||
ezetimibe/simvastatin|No|No|No|No|75%|62559070090|EZETIMIBE-SIMVASTATIN 10-10 MG|90|EA|.71666|09/26/2019|12/31/2022|Yes|No||09/26/2019|12/31/2022|Yes|No|09/26/2019|12/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|063|Yes|.75312|03/29/2022|.73504|03/29/2022|.73994|03/29/2022|||LIPOTROPICS: STATINS|16125|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ANI PHARMACEUTI|No||||
ezetimibe/simvastatin|No|No|No|No|75%|62559070130|EZETIMIBE-SIMVASTATIN 10-20 MG|30|EA|.71666|09/26/2019|12/31/2022|Yes|No||09/26/2019|12/31/2022|Yes|No|09/26/2019|12/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|063|Yes|.74268|03/29/2022|.72485|03/29/2022|.72968|03/29/2022|||LIPOTROPICS: STATINS|16126|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ANI PHARMACEUTI|No||||
ezetimibe/simvastatin|No|No|No|No|75%|62559070190|EZETIMIBE-SIMVASTATIN 10-20 MG|90|EA|.71666|09/26/2019|07/31/2022|Yes|No||09/26/2019|07/31/2022|Yes|No|09/26/2019|07/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|063|Yes|.74268|03/29/2022|.72485|03/29/2022|.72968|03/29/2022|||LIPOTROPICS: STATINS|16127|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ANI PHARMACEUTI|No||||
ezetimibe/simvastatin|No|No|No|No|75%|62559070230|EZETIMIBE-SIMVASTATIN 10-40 MG|30|EA|.71666|09/26/2019|07/31/2022|Yes|No||09/26/2019|07/31/2022|Yes|No|09/26/2019|07/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|063|Yes|.99233|03/29/2022|.96851|03/29/2022|.97496|03/29/2022|||LIPOTROPICS: STATINS|16128|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ANI PHARMACEUTI|No||||
ezetimibe/simvastatin|No|No|No|No|75%|62559070290|EZETIMIBE-SIMVASTATIN 10-40 MG|90|EA|.71666|09/26/2019|03/31/2023|Yes|No||09/26/2019|03/31/2023|Yes|No|09/26/2019|03/31/2023|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|063|Yes|.99233|03/29/2022|.96851|03/29/2022|.97496|03/29/2022|||LIPOTROPICS: STATINS|16129|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ANI PHARMACEUTI|No||||
ezetimibe/simvastatin|No|No|No|No|75%|62559070330|EZETIMIBE-SIMVASTATIN 10-80 MG|30|EA|.71666|09/26/2019|09/30/2022|Yes|No||09/26/2019|09/30/2022|Yes|No|09/26/2019|09/30/2022|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|063|Yes|.47172|03/29/2022|.46039|03/29/2022|.46346|03/29/2022|||LIPOTROPICS: STATINS|16130|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ANI PHARMACEUTI|No||||
ezetimibe/simvastatin|No|No|No|No|75%|62559070390|EZETIMIBE-SIMVASTATIN 10-80 MG|90|EA|.71666|09/26/2019|09/30/2022|Yes|No||09/26/2019|09/30/2022|Yes|No|09/26/2019|09/30/2022|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|063|Yes|.47172|03/29/2022|.46039|03/29/2022|.46346|03/29/2022|||LIPOTROPICS: STATINS|16131|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ANI PHARMACEUTI|No||||
terbutaline sulfate|No|No|No|No|75%|62559072101|TERBUTALINE SULFATE 2.5 MG TAB|100|EA|1.075|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|037|No|2.45|03/17/2020|2.415|03/17/2020|2.3|03/17/2020|||BRONCHODILATORS: BETA AGONIST|16132|||||No|No||ANI PHARMACEUTI|No||||
terbutaline sulfate|No|No|No|No|75%|62559072201|TERBUTALINE SULFATE 5 MG TAB|100|EA|1.3115|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|037|No|2.989|03/17/2020|2.9463|03/17/2020|2.806|03/17/2020|||BRONCHODILATORS: BETA AGONIST|16133|||||No|No||ANI PHARMACEUTI|No||||
felbamate|No|No|No|No|75%|62559073001|FELBAMATE 400 MG TABLET|100|EA|.40557|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|||Prescription required|No||056|No|1.17562|10/26/2021|1.1474|10/26/2021|1.15504|10/26/2021|||ANTICONVULSANTS|16134|||||No|No||ANI PHARMACEUTI|No||||
felbamate|No|No|No|No|75%|62559073101|FELBAMATE 600 MG TABLET|100|EA|.46483|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|||Prescription required|No||056|No|1.94824|03/29/2022|1.90148|03/29/2022|1.91414|03/29/2022|||ANTICONVULSANTS|16135|||||No|No||ANI PHARMACEUTI|No||||
mexiletine HCl|No|No|No|No|75%|62559082001|MEXILETINE 150 MG CAPSULE|100|EA|.54515|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|No|||No|.76273|03/29/2022|.74442|03/29/2022|.74938|03/29/2022||||16136|||||No|No||ANI PHARMACEUTI|No||||
mexiletine HCl|No|No|No|No|75%|62559082101|MEXILETINE 200 MG CAPSULE|100|EA|.65076|12/17/2020||Yes|No||12/17/2020||Yes|No|12/17/2020||Yes|No||||No|No|||Prescription required|No|||No|.85196|03/29/2022|.83151|03/29/2022|.83705|03/29/2022||||16137|||||No|No||ANI PHARMACEUTI|No||||
mexiletine HCl|No|No|No|No|75%|62559082201|MEXILETINE 250 MG CAPSULE|100|EA|.75211|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|No|||No|1.71411|01/25/2022|1.68963|01/25/2022|1.60917|01/25/2022||||16138|||||No|No||ANI PHARMACEUTI|No||||
vancomycin HCl|No|No|No|No|75%|62559083003|VANCOMYCIN 250 MG/5 ML SOLN|300|ML|.7775|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|115|No|1.77199|03/17/2020|1.74668|03/17/2020|1.6635|03/17/2020|||ANTIBIOTICS: GI|16139|||||No|No||ANI PHARMACEUTI|No||||
vancomycin HCl|No|No|No|No|75%|62559083055|VANCOMYCIN 250 MG/5 ML SOLN|150|ML|.97825|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|115|No|2.2295|03/17/2020|2.19765|03/17/2020|2.093|03/17/2020|||ANTIBIOTICS: GI|16140|||||No|No||ANI PHARMACEUTI|No||||
vancomycin HCl|No|No|No|No|75%|62559083080|VANCOMYCIN 250 MG/5 ML SOLN|80|ML|1.38245|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|115|No|3.1507|03/24/2020|3.10569|03/24/2020|2.9578|03/17/2020|||ANTIBIOTICS: GI|16141|||||No|No||ANI PHARMACEUTI|No||||
aspirin/dipyridamole|No|No|No|No|75%|62559085060|ASPIRIN-DIPYRIDAM ER 25-200 MG|60|EA|.3455|03/03/2020|10/31/2022|Yes|No||03/03/2020|10/31/2022|Yes|No|03/03/2020|10/31/2022|Yes|No||||No|No|||Prescription required|No||004|No|.78047|03/29/2022|.76173|03/29/2022|.76681|03/29/2022|||PLATELET AGGREGATION INHIBITORS|16142|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ANI PHARMACEUTI|No||||
corticotropin|No|No|No|No|75%|62559086015|CORTROPHIN GEL 400 UNIT/5 ML|5|ML|2739.186|03/15/2022||Yes|No||03/15/2022||Yes|No|03/15/2022||Yes|No||||No|No|||Prescription required|No|||Yes|6242.796|03/22/2022|6153.6132|03/15/2022|5860.584|03/15/2022||||16143|||||No|No||ANI PHARMACEUTI|No||||
bicalutamide|No|No|No|No|75%|62559089030|BICALUTAMIDE 50 MG TABLET|30|EA|.43|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|No||550|No|.3381|03/29/2022|.32998|03/29/2022|.33218|03/29/2022|||ONCOLOGY: ORAL - PROSTATE|16144|||||No|No||ANI PHARMACEUTI|No||||
temozolomide|No|No|No|No|75%|62559092114|TEMOZOLOMIDE 20 MG CAPSULE|14|EA|3.18967|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||239|No|7.26949|06/02/2021|7.16564|06/02/2021|6.82442|06/02/2021|||ONCOLOGY: ORAL - OTHER|16145|||||No|No||ANI PHARMACEUTI|No||||
temozolomide|No|No|No|No|75%|62559092151|TEMOZOLOMIDE 20 MG CAPSULE|5|EA|3.18974|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||239|No|7.26964|06/02/2021|7.16578|06/02/2021|6.82456|06/02/2021|||ONCOLOGY: ORAL - OTHER|16146|||||No|No||ANI PHARMACEUTI|No||||
temozolomide|No|No|No|No|75%|62559092214|TEMOZOLOMIDE 100 MG CAPSULE|14|EA|14.18385|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||239|No|32.32599|06/02/2021|31.86419|06/02/2021|30.34685|06/02/2021|||ONCOLOGY: ORAL - OTHER|16147|||||No|No||ANI PHARMACEUTI|No||||
temozolomide|No|No|No|No|75%|62559092251|TEMOZOLOMIDE 100 MG CAPSULE|5|EA|14.18398|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||239|No|32.32628|06/02/2021|31.86447|06/02/2021|30.34712|06/02/2021|||ONCOLOGY: ORAL - OTHER|16148|||||No|No||ANI PHARMACEUTI|No||||
temozolomide|No|No|No|No|75%|62559092314|TEMOZOLOMIDE 140 MG CAPSULE|14|EA|19.98916|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||239|No|13.83623|07/27/2021|13.50416|07/27/2021|13.59409|07/27/2021|||ONCOLOGY: ORAL - OTHER|16149|||||No|No||ANI PHARMACEUTI|No||||
temozolomide|No|No|No|No|75%|62559092414|TEMOZOLOMIDE 180 MG CAPSULE|14|EA|26.51195|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||239|No|60.42259|06/02/2021|59.55941|06/02/2021|56.72325|06/02/2021|||ONCOLOGY: ORAL - OTHER|16150|||||No|No||ANI PHARMACEUTI|No||||
temozolomide|No|No|No|No|75%|62559092551|TEMOZOLOMIDE 250 MG CAPSULE|5|EA|36.8467|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||239|No|83.9762|06/08/2021|82.77654|06/02/2021|78.8348|06/02/2021|||ONCOLOGY: ORAL - OTHER|16151|||||No|No||ANI PHARMACEUTI|No||||
cyclophosphamide|No|No|No|No|75%|62559093001|CYCLOPHOSPHAMIDE 25 MG CAPSULE|100|EA|1.44802|12/15/2020|03/31/2023|Yes|No||12/15/2020|03/31/2023|Yes|No|12/15/2020|03/31/2023|Yes|No||||No|No|||Prescription required|No||502|No|3.30015|12/15/2020|3.253|12/15/2020|3.0981|12/15/2020|||ONCOLOGY: ORAL - BREAST|16152|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ANI PHARMACEUTI|No||||
cyclophosphamide|No|No|No|No|75%|62559093101|CYCLOPHOSPHAMIDE 50 MG CAPSULE|100|EA|2.51765|12/30/2020|08/31/2023|Yes|No||12/30/2020|08/31/2023|Yes|No|12/30/2020|08/31/2023|Yes|No||||No|No|||Prescription required|No||502|No|5.7379|05/25/2021|5.65593|05/25/2021|5.3866|05/25/2021|||ONCOLOGY: ORAL - BREAST|16153|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ANI PHARMACEUTI|No||||
penicillamine|No|No|No|No|75%|62559097001|PENICILLAMINE 250 MG CAPSULE|100|EA|16.89169|11/29/2021||Yes|No||11/29/2021||Yes|No|11/29/2021||Yes|No||||No|No|||Prescription required|No|||No|38.49734|11/29/2021|37.94737|11/29/2021|36.14036|11/29/2021||||16154|||||No|No||ANI PHARMACEUTI|No||||
clobetasol propionate/emoll|No|No|No|No|75%|62559098015|CLOBETASOL EMOLLIENT 0.05% CRM|15|GM|.57333|08/23/2021||Yes|No||08/23/2021||Yes|No|08/23/2021||Yes|No||||No|No|||Prescription required|No||121|No|1.21527|03/29/2022|1.1861|03/29/2022|1.194|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|16155|||||No|No||ANI PHARMACEUTI|No||||
clobetasol propionate/emoll|No|No|No|No|75%|62559098030|CLOBETASOL EMOLLIENT 0.05% CRM|30|GM|.57333|08/23/2021||Yes|No||08/23/2021||Yes|No|08/23/2021||Yes|No||||No|No|||Prescription required|No||121|No|.6904|03/29/2022|.67383|03/29/2022|.67831|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|16156|||||No|No||ANI PHARMACEUTI|No||||
clobetasol propionate/emoll|No|No|No|No|75%|62559098060|CLOBETASOL EMOLLIENT 0.05% CRM|60|GM|.57333|08/23/2021||Yes|No||08/23/2021||Yes|No|08/23/2021||Yes|No||||No|No|||Prescription required|No||121|No|.73304|03/29/2022|.71544|03/29/2022|.72021|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|16157|||||No|No||ANI PHARMACEUTI|No||||
fluconazole|No|No|No|No|75%|62559099030|FLUCONAZOLE 50 MG TABLET|30|EA|.1419|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No||069|No|.43933|03/29/2022|.42878|03/29/2022|.43164|03/29/2022|||ANTIFUNGALS: ORAL|16158|||||No|No||ANI PHARMACEUTI|No||||
fluconazole|No|No|No|No|75%|62559099130|FLUCONAZOLE 100 MG TABLET|30|EA|.21285|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No||069|No|.34281|03/29/2022|.33458|03/29/2022|.33681|03/29/2022|||ANTIFUNGALS: ORAL|16159|||||No|No||ANI PHARMACEUTI|No||||
fluconazole|No|No|No|No|75%|62559099330|FLUCONAZOLE 200 MG TABLET|30|EA|.2838|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No||069|No|.52936|03/29/2022|.51665|03/29/2022|.52009|03/29/2022|||ANTIFUNGALS: ORAL|16160|||||No|No||ANI PHARMACEUTI|No||||
epoprostenol sodium|No|No|No|No|75%|62756005940|EPOPROSTENOL SODIUM 0.5 MG VL|1|EA|9.5675|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No|||No|21.805|06/03/2021|21.4935|06/03/2021|20.47|06/03/2021||||16161|||||No|No||SUN PHARMACEUTI|No||||
epoprostenol sodium|No|No|No|No|75%|62756006040|EPOPROSTENOL SODIUM 1.5 MG VL|1|EA|19.135|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No|||No|43.61|06/03/2021|42.987|06/03/2021|40.94|06/03/2021||||16162|||||No|No||SUN PHARMACEUTI|No||||
medroxyprogesterone acetate|No|Yes|No|No|75%|62756009040|MEDROXYPROGESTERONE 150 MG/ML|1|ML|16.985|06/29/2021||Yes|No||||No|No|06/29/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|31.14606|03/29/2022|30.39855|03/29/2022|30.601|03/29/2022||||16163|||||No|No||SUN PHARMACEUTI|No||||
medroxyprogesterone acetate|No|Yes|No|No|75%|62756009045|MEDROXYPROGESTERONE 150 MG/ML|1|ML|16.96676|06/29/2021||Yes|No||||No|No|06/29/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|30.77229|09/28/2021|30.03375|09/28/2021|30.23377|09/28/2021||||16164|||||No|No||SUN PHARMACEUTI|No||||
medroxyprogesterone acetate|No|Yes|No|No|75%|62756009140|MEDROXYPROGESTERONE 150 MG/ML|1|ML|30.96|12/06/2021||Yes|No||||No|No|12/06/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|35.94375|03/01/2022|35.0811|03/01/2022|35.31473|03/01/2022||||16165|||||No|No||SUN PHARMACEUTI|No||||
ondansetron HCl|No|No|No|No|75%|62756013001|ONDANSETRON HCL 4 MG TABLET|30|EA|.1333|07/13/2007||Yes|No||07/13/2007||Yes|No|07/13/2007||Yes|No||||No|No|||Prescription required|No||085|No|.06763|03/29/2022|.066|03/29/2022|.06644|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|16166|||||No|No||SUN PHARMACEUTI|No||||
ondansetron HCl|No|No|No|No|75%|62756013101|ONDANSETRON HCL 8 MG TABLET|30|EA|.1505|07/17/2007||Yes|No||07/17/2007||Yes|No|07/17/2007||Yes|No||||No|No|||Prescription required|No||085|No|.09975|03/29/2022|.09735|03/29/2022|.098|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|16167|||||No|No||SUN PHARMACEUTI|No||||
gabapentin|No|No|No|No|75%|62756013702|GABAPENTIN 100 MG CAPSULE|100|EA|.02365|10/24/2006||Yes|No||10/24/2006||Yes|No|10/24/2006||Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|16168|||||No|No||SUN PHARMACEUTI|No||||
metformin HCl|Yes|No|No|No|75%|62756014201|METFORMIN HCL ER 500 MG TABLET|100|EA|.03741|07/01/2006||Yes|No||07/01/2006||Yes|No|07/01/2006||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.03646|03/29/2022|.03558|03/29/2022|.03582|03/29/2022|||HYPOGLYCEMICS: METFORMINS|16169|||||No|No||SUN PHARMACEUTI|No||||
metformin HCl|Yes|No|No|No|75%|62756014202|METFORMIN HCL ER 500 MG TABLET|500|EA|.03607|07/01/2006||Yes|No||07/01/2006||Yes|No|07/01/2006||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.03646|03/29/2022|.03558|03/29/2022|.03582|03/29/2022|||HYPOGLYCEMICS: METFORMINS|16170|||||No|No||SUN PHARMACEUTI|No||||
metformin HCl|Yes|No|No|No|75%|62756014301|METFORMIN HCL ER 750 MG TABLET|100|EA|.0817|07/01/2006||Yes|No||07/01/2006||Yes|No|07/01/2006||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.09354|03/29/2022|.09129|03/29/2022|.0919|03/29/2022|||HYPOGLYCEMICS: METFORMINS|16171|||||No|No||SUN PHARMACEUTI|No||||
rivastigmine tartrate|No|No|No|No|75%|62756014513|RIVASTIGMINE 1.5 MG CAPSULE|500|EA|.89581|07/01/2010||Yes|No||07/01/2010||Yes|No|07/01/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.26635|03/29/2022|.25995|03/29/2022|.26168|03/29/2022|||ALZHEIMER'S AGENTS|16172|||||No|No||SUN PHARMACEUTI|No||||
rivastigmine tartrate|No|No|No|No|75%|62756014586|RIVASTIGMINE 1.5 MG CAPSULE|60|EA|.25083|07/01/2010||Yes|No||07/01/2010||Yes|No|07/01/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.26635|03/29/2022|.25995|03/29/2022|.26168|03/29/2022|||ALZHEIMER'S AGENTS|16173|||||No|No||SUN PHARMACEUTI|No||||
rivastigmine tartrate|No|No|No|No|75%|62756014613|RIVASTIGMINE 3 MG CAPSULE|500|EA|.89581|07/01/2010||Yes|No||07/01/2010||Yes|No|07/01/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.2376|03/29/2022|.23189|03/29/2022|.23344|03/29/2022|||ALZHEIMER'S AGENTS|16174|||||No|No||SUN PHARMACEUTI|No||||
rivastigmine tartrate|No|No|No|No|75%|62756014686|RIVASTIGMINE 3 MG CAPSULE|60|EA|.25083|07/01/2010||Yes|No||07/01/2010||Yes|No|07/01/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.2376|03/29/2022|.23189|03/29/2022|.23344|03/29/2022|||ALZHEIMER'S AGENTS|16175|||||No|No||SUN PHARMACEUTI|No||||
rivastigmine tartrate|No|No|No|No|75%|62756014713|RIVASTIGMINE 4.5 MG CAPSULE|500|EA|.89581|07/01/2010||Yes|No||07/01/2010||Yes|No|07/01/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.27604|03/29/2022|.26941|03/29/2022|.2712|03/29/2022|||ALZHEIMER'S AGENTS|16176|||||No|No||SUN PHARMACEUTI|No||||
rivastigmine tartrate|No|No|No|No|75%|62756014786|RIVASTIGMINE 4.5 MG CAPSULE|60|EA|.25083|07/01/2010||Yes|No||07/01/2010||Yes|No|07/01/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.27604|03/29/2022|.26941|03/29/2022|.2712|03/29/2022|||ALZHEIMER'S AGENTS|16177|||||No|No||SUN PHARMACEUTI|No||||
rivastigmine tartrate|No|No|No|No|75%|62756014813|RIVASTIGMINE 6 MG CAPSULE|500|EA|.89581|07/01/2010||Yes|No||07/01/2010||Yes|No|07/01/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.35091|03/29/2022|.34248|03/29/2022|.34476|03/29/2022|||ALZHEIMER'S AGENTS|16178|||||No|No||SUN PHARMACEUTI|No||||
rivastigmine tartrate|No|No|No|No|75%|62756014886|RIVASTIGMINE 6 MG CAPSULE|60|EA|.25083|07/01/2010||Yes|No||07/01/2010||Yes|No|07/01/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|011|No|.35091|03/29/2022|.34248|03/29/2022|.34476|03/29/2022|||ALZHEIMER'S AGENTS|16179|||||No|No||SUN PHARMACEUTI|No||||
tamsulosin HCl|No|No|No|No|75%|62756016013|TAMSULOSIN HCL 0.4 MG CAPSULE|500|EA|.10492|10/30/2012||Yes|No||10/30/2012||Yes|No|10/30/2012||Yes|No||||No|No|||Prescription required|No||003|No|.06447|03/29/2022|.06292|03/29/2022|.06334|03/29/2022|||BPH TREATMENTS|16180|||||No|No||SUN PHARMACEUTI|No||||
tamsulosin HCl|No|No|No|No|75%|62756016081|TAMSULOSIN HCL 0.4 MG CAPSULE|90|EA|.05733|08/30/2011||Yes|No||08/30/2011||Yes|No|08/30/2011||Yes|No||||No|No|||Prescription required|No||003|No|.06447|03/29/2022|.06292|03/29/2022|.06334|03/29/2022|||BPH TREATMENTS|16181|||||No|No||SUN PHARMACEUTI|No||||
tamsulosin HCl|No|No|No|No|75%|62756016088|TAMSULOSIN HCL 0.4 MG CAPSULE|100|EA|.10492|07/20/2010||Yes|No||07/20/2010||Yes|No|07/20/2010||Yes|No||||No|No|||Prescription required|No||003|No|.06447|03/29/2022|.06292|03/29/2022|.06334|03/29/2022|||BPH TREATMENTS|16182|||||No|No||SUN PHARMACEUTI|No||||
desmopressin acetate|No|No|No|No|75%|62756016191|DESMOPRESSIN 0.01% SPRAY|5|ML|15.2478|05/29/2012||Yes|No||05/29/2012||Yes|No|05/29/2012||Yes|No||||No|No|||Prescription required|No|||No|34.7508|04/28/2020|34.25436|04/28/2020|32.6232|04/28/2020||||16183|||||No|No||SUN PHARMACEUTI|No||||
oxcarbazepine|No|No|No|No|75%|62756018313|OXCARBAZEPINE 150 MG TABLET|500|EA|.1247|03/24/2008||Yes|No||03/24/2008||Yes|No|03/24/2008||Yes|No||||No|No|||Prescription required|No||056|No|.13883|03/29/2022|.13549|03/29/2022|.1364|03/29/2022|||ANTICONVULSANTS|16184|||||No|No||SUN PHARMACEUTI|No||||
oxcarbazepine|No|No|No|No|75%|62756018318|OXCARBAZEPINE 150 MG TABLET|1000|EA|.1204|03/24/2008||Yes|No||03/24/2008||Yes|No|03/24/2008||Yes|No||||No|No|||Prescription required|No||056|No|.13883|03/29/2022|.13549|03/29/2022|.1364|03/29/2022|||ANTICONVULSANTS|16185|||||No|No||SUN PHARMACEUTI|No||||
oxcarbazepine|No|No|No|No|75%|62756018388|OXCARBAZEPINE 150 MG TABLET|100|EA|.129|10/16/2007||Yes|No||10/16/2007||Yes|No|10/16/2007||Yes|No||||No|No|||Prescription required|No||056|No|.13883|03/29/2022|.13549|03/29/2022|.1364|03/29/2022|||ANTICONVULSANTS|16186|||||No|No||SUN PHARMACEUTI|No||||
oxcarbazepine|No|No|No|No|75%|62756018413|OXCARBAZEPINE 300 MG TABLET|500|EA|.215|03/24/2008||Yes|No||03/24/2008||Yes|No|03/24/2008||Yes|No||||No|No|||Prescription required|No||056|No|.21647|03/29/2022|.21127|03/29/2022|.21268|03/29/2022|||ANTICONVULSANTS|16187|||||No|No||SUN PHARMACEUTI|No||||
oxcarbazepine|No|No|No|No|75%|62756018418|OXCARBAZEPINE 300 MG TABLET|1000|EA|.20425|03/24/2008||Yes|No||03/24/2008||Yes|No|03/24/2008||Yes|No||||No|No|||Prescription required|No||056|No|.21647|03/29/2022|.21127|03/29/2022|.21268|03/29/2022|||ANTICONVULSANTS|16188|||||No|No||SUN PHARMACEUTI|No||||
oxcarbazepine|No|No|No|No|75%|62756018488|OXCARBAZEPINE 300 MG TABLET|100|EA|.2365|10/16/2007||Yes|No||10/16/2007||Yes|No|10/16/2007||Yes|No||||No|No|||Prescription required|No||056|No|.21647|03/29/2022|.21127|03/29/2022|.21268|03/29/2022|||ANTICONVULSANTS|16189|||||No|No||SUN PHARMACEUTI|No||||
oxcarbazepine|No|No|No|No|75%|62756018513|OXCARBAZEPINE 600 MG TABLET|500|EA|.3182|03/24/2008||Yes|No||03/24/2008||Yes|No|03/24/2008||Yes|No||||No|No|||Prescription required|No||056|No|.41799|03/29/2022|.40795|03/29/2022|.41067|03/29/2022|||ANTICONVULSANTS|16190|||||No|No||SUN PHARMACEUTI|No||||
oxcarbazepine|No|No|No|No|75%|62756018518|OXCARBAZEPINE 600 MG TABLET|1000|EA|.301|03/24/2008||Yes|No||03/24/2008||Yes|No|03/24/2008||Yes|No||||No|No|||Prescription required|No||056|No|.41799|03/29/2022|.40795|03/29/2022|.41067|03/29/2022|||ANTICONVULSANTS|16191|||||No|No||SUN PHARMACEUTI|No||||
oxcarbazepine|No|No|No|No|75%|62756018588|OXCARBAZEPINE 600 MG TABLET|100|EA|.344|10/16/2007||Yes|No||10/16/2007||Yes|No|10/16/2007||Yes|No||||No|No|||Prescription required|No||056|No|.41799|03/29/2022|.40795|03/29/2022|.41067|03/29/2022|||ANTICONVULSANTS|16192|||||No|No||SUN PHARMACEUTI|No||||
gabapentin|No|No|No|No|75%|62756020201|GABAPENTIN 600 MG TABLET|100|EA|.2064|01/25/2007||Yes|No||01/25/2007||Yes|No|01/25/2007||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|16193|||||No|No||SUN PHARMACEUTI|No||||
gabapentin|No|No|No|No|75%|62756020203|GABAPENTIN 600 MG TABLET|500|EA|.2064|01/25/2007||Yes|No||01/25/2007||Yes|No|01/25/2007||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|16194|||||No|No||SUN PHARMACEUTI|No||||
gabapentin|No|No|No|No|75%|62756020401|GABAPENTIN 800 MG TABLET|100|EA|.2365|01/25/2007||Yes|No||01/25/2007||Yes|No|01/25/2007||Yes|No||||No|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|16195|||||No|No||SUN PHARMACEUTI|No||||
gabapentin|No|No|No|No|75%|62756020403|GABAPENTIN 800 MG TABLET|500|EA|.2365|01/25/2007||Yes|No||01/25/2007||Yes|No|01/25/2007||Yes|No||||No|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|16196|||||No|No||SUN PHARMACEUTI|No||||
tiagabine HCl|No|No|No|No|75%|62756022483|TIAGABINE HCL 4 MG TABLET|30|EA|2.72949|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|No||056|No|3.73471|03/29/2022|3.64507|03/29/2022|3.66935|03/29/2022|||ANTICONVULSANTS|16197|||||No|No||SUN PHARMACEUTI|No||||
loteprednol etabonate|No|No|No|No|75%|62756023255|LOTEPREDNOL ETABONATE 0.5% DRP|10|ML|16.14908|09/29/2021||Yes|No||09/29/2021||Yes|No|09/29/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|013|No|34.3356|03/29/2022|33.51154|03/29/2022|33.73472|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|16198|||||No|No||SUN PHARMACEUTI|No||||
loteprednol etabonate|No|No|No|No|75%|62756023256|LOTEPREDNOL ETABONATE 0.5% DRP|15|ML|16.00632|09/29/2021||Yes|No||09/29/2021||Yes|No|09/29/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|013|No|36.47952|10/05/2021|35.95838|09/29/2021|34.24608|09/29/2021|||OPHTHALMICS: ANTI-INFLAMMATORIES|16199|||||No|No||SUN PHARMACEUTI|No||||
loteprednol etabonate|No|No|No|No|75%|62756023290|LOTEPREDNOL ETABONATE 0.5% DRP|5|ML|16.1508|09/29/2021||Yes|No||09/29/2021||Yes|No|09/29/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|013|No|31.49675|03/29/2022|30.74082|03/29/2022|30.94555|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|16200|||||No|No||SUN PHARMACEUTI|No||||
capecitabine|No|No|No|No|75%|62756023886|CAPECITABINE 150 MG TABLET|60|EA|.516|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||||No|No|||Prescription required|No||502|No|1.176|10/13/2020|1.1592|10/13/2020|1.104|10/13/2020|||ONCOLOGY: ORAL - BREAST|16201|||||No|No||SUN PHARMACEUTI|No||||
capecitabine|No|No|No|No|75%|62756023920|CAPECITABINE 500 MG TABLET|120|EA|.93166|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||||No|No|||Prescription required|No||502|No|.61977|12/28/2021|.60489|12/28/2021|.60892|12/28/2021|||ONCOLOGY: ORAL - BREAST|16202|||||No|No||SUN PHARMACEUTI|No||||
ondansetron|No|No|No|No|75%|62756024064|ONDANSETRON ODT 4 MG TABLET|30|EA|.26301|06/18/2009||Yes|No||06/18/2009||Yes|No|06/18/2009||Yes|No||||No|No|||Prescription required|No||085|No|.24125|03/29/2022|.23546|03/29/2022|.23702|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|16203|||||No|No||SUN PHARMACEUTI|No||||
anastrozole|No|No|No|No|75%|62756025013|ANASTROZOLE 1 MG TABLET|500|EA|.11395|10/18/2012||Yes|No||10/18/2012||Yes|No|10/18/2012||Yes|No||||No|No|||Prescription required|No||502|No|.11251|03/29/2022|.1098|03/29/2022|.11054|03/29/2022|||ONCOLOGY: ORAL - BREAST|16204|||||No|No||SUN PHARMACEUTI|No||||
anastrozole|No|No|No|No|75%|62756025083|ANASTROZOLE 1 MG TABLET|30|EA|.11395|10/18/2012||Yes|No||10/18/2012||Yes|No|10/18/2012||Yes|No||||No|No|||Prescription required|No||502|No|.11251|03/29/2022|.1098|03/29/2022|.11054|03/29/2022|||ONCOLOGY: ORAL - BREAST|16205|||||No|No||SUN PHARMACEUTI|No||||
zonisamide|No|No|No|No|75%|62756025802|ZONISAMIDE 25 MG CAPSULE|100|EA|.08987|11/28/2006||Yes|No||11/28/2006||Yes|No|11/28/2006||Yes|No||||No|No|||Prescription required|No||056|No|.08772|03/29/2022|.08561|03/29/2022|.08618|03/29/2022|||ANTICONVULSANTS|16206|Not Specified|Not Specified|Not Specified||No|No||SUN PHARMACEUTI|No||||
zonisamide|No|No|No|No|75%|62756025902|ZONISAMIDE 50 MG CAPSULE|100|EA|.12642|10/02/2006||Yes|No||10/02/2006||Yes|No|10/02/2006||Yes|No||||No|No|||Prescription required|No||056|No|.11305|03/29/2022|.11033|03/29/2022|.11107|03/29/2022|||ANTICONVULSANTS|16207|||||No|No||SUN PHARMACEUTI|No||||
zonisamide|No|No|No|No|75%|62756026002|ZONISAMIDE 100 MG CAPSULE|100|EA|.2107|10/02/2006||Yes|No||10/02/2006||Yes|No|10/02/2006||Yes|No||||No|No|||Prescription required|No||056|No|.12763|03/29/2022|.12456|03/29/2022|.12539|03/29/2022|||ANTICONVULSANTS|16208|||||No|No||SUN PHARMACEUTI|No||||
cephalexin|No|No|No|No|75%|62756029313|CEPHALEXIN 250 MG CAPSULE|500|EA|.05615|10/22/2010||Yes|No||10/22/2010||Yes|No|10/22/2010||Yes|No||||No|No|||Prescription required|No||046|No|.09013|03/29/2022|.08796|03/29/2022|.08855|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|16209|||||No|No||SUN PHARMACEUTI|No||||
cephalexin|No|No|No|No|75%|62756029388|CEPHALEXIN 250 MG CAPSULE|100|EA|.05912|10/22/2010||Yes|No||10/22/2010||Yes|No|10/22/2010||Yes|No||||No|No|||Prescription required|No||046|No|.09013|03/29/2022|.08796|03/29/2022|.08855|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|16210|||||No|No||SUN PHARMACEUTI|No||||
cephalexin|No|No|No|No|75%|62756029413|CEPHALEXIN 500 MG CAPSULE|500|EA|.09292|08/30/2011||Yes|No||08/30/2011||Yes|No|08/30/2011||Yes|No||||No|No|||Prescription required|No||046|No|.12151|03/29/2022|.11859|03/29/2022|.11938|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|16211|||||No|No||SUN PHARMACEUTI|No||||
cephalexin|No|No|No|No|75%|62756029488|CEPHALEXIN 500 MG CAPSULE|100|EA|.09782|08/30/2011||Yes|No||08/30/2011||Yes|No|08/30/2011||Yes|No||||No|No|||Prescription required|No||046|No|.12151|03/29/2022|.11859|03/29/2022|.11938|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|16212|||||No|No||SUN PHARMACEUTI|No||||
phenytoin sodium extended|No|No|No|No|75%|62756029983|PHENYTOIN SOD EXT 200 MG CAP|30|EA|.51815|11/17/2009||Yes|No||11/17/2009||Yes|No|11/17/2009||Yes|No||||No|No|||Prescription required|No||056|No|1.13548|03/29/2022|1.10822|03/29/2022|1.1156|03/29/2022|||ANTICONVULSANTS|16213|||||No|No||SUN PHARMACEUTI|No||||
phenytoin sodium extended|No|No|No|No|75%|62756029988|PHENYTOIN SOD EXT 200 MG CAP|100|EA|.51789|11/17/2009||Yes|No||11/17/2009||Yes|No|11/17/2009||Yes|No||||No|No|||Prescription required|No||056|No|1.13548|03/29/2022|1.10822|03/29/2022|1.1156|03/29/2022|||ANTICONVULSANTS|16214|||||No|No||SUN PHARMACEUTI|No||||
epinastine HCl|No|No|No|No|75%|62756032990|EPINASTINE HCL 0.05% EYE DROPS|5|ML|7.3573|10/18/2012||Yes|No||10/18/2012||Yes|No|10/18/2012||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|002|No|15.8565|03/29/2022|15.47594|03/29/2022|15.57901|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|16215|||||No|No||SUN PHARMACEUTI|No||||
octreotide acetate|No|No|No|No|75%|62756034844|OCTREOTIDE ACET 50 MCG/ML AMP|1|ML|2.4295|07/01/2009||Yes|No||07/01/2009||Yes|No|07/01/2009||Yes|No||||No|No|||Prescription required|No|||No|5.537|06/01/2016|5.4579|06/01/2016|5.198|06/01/2016||||16216|||||No|No||SUN PHARMACEUTI|No||||
octreotide acetate|No|No|No|No|75%|62756034944|OCTREOTIDE ACET 100 MCG/ML AMP|1|ML|5.32125|07/01/2009||Yes|No||07/01/2009||Yes|No|07/01/2009||Yes|No||||No|No|||Prescription required|No|||No|12.1275|06/01/2016|11.95425|06/01/2016|11.385|06/01/2016||||16217|||||No|No||SUN PHARMACEUTI|No||||
octreotide acetate|No|No|No|No|75%|62756035040|OCTREOTIDE ACET 200 MCG/ML VL|5|ML|11.309|07/01/2009||Yes|No||07/01/2009||Yes|No|07/01/2009||Yes|No||||No|No|||Prescription required|No|||No|25.774|01/26/2021|25.4058|01/26/2021|24.196|01/26/2021||||16218|||||No|No||SUN PHARMACEUTI|No||||
octreotide acetate|No|No|No|No|75%|62756035144|OCTREOTIDE ACET 500 MCG/ML AMP|1|ML|24.7207|07/01/2009||Yes|No||07/01/2009||Yes|No|07/01/2009||Yes|No||||No|No|||Prescription required|No|||No|56.3402|06/01/2016|55.53534|06/01/2016|52.8908|06/01/2016||||16219|||||No|No||SUN PHARMACEUTI|No||||
octreotide acetate|No|No|No|No|75%|62756035240|OCTREOTIDE 1,000 MCG/ML VIAL|5|ML|52.4557|07/01/2009||Yes|No||07/01/2009||Yes|No|07/01/2009||Yes|No||||No|No|||Prescription required|No|||No|119.5502|11/28/2017|117.84234|11/28/2017|112.2308|11/28/2017||||16220|||||No|No||SUN PHARMACEUTI|No||||
ondansetron|No|No|No|No|75%|62756035664|ONDANSETRON ODT 8 MG TABLET|30|EA|.26301|06/18/2009||Yes|No||06/18/2009||Yes|No|06/18/2009||Yes|No||||No|No|||Prescription required|No||085|No|.24386|03/29/2022|.238|03/29/2022|.23959|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|16221|||||No|No||SUN PHARMACEUTI|No||||
ondansetron|No|No|No|No|75%|62756035666|ONDANSETRON ODT 8 MG TABLET|10|EA|.26316|06/18/2009||Yes|No||06/18/2009||Yes|No|06/18/2009||Yes|No||||No|No|||Prescription required|No||085|No|.24386|03/29/2022|.238|03/29/2022|.23959|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|16222|||||No|No||SUN PHARMACEUTI|No||||
metoprolol/hydrochlorothiazide|No|No|No|No|75%|62756036888|METOPROLOL-HCTZ 100-25 MG TAB|100|EA|.56975|05/25/2012||Yes|No||05/25/2012||Yes|No|05/25/2012||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|070|Yes|1.54164|12/28/2021|1.50464|12/28/2021|1.51466|12/28/2021|||BETA-BLOCKERS|16223|||||No|No||SUN PHARMACEUTI|No||||
metoprolol/hydrochlorothiazide|No|No|No|No|75%|62756036988|METOPROLOL-HCTZ 100-50 MG TAB|100|EA|.60415|05/25/2012||Yes|No||05/25/2012||Yes|No|05/25/2012||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|070|Yes|1.3769|06/01/2016|1.35723|06/01/2016|1.2926|06/01/2016|||BETA-BLOCKERS|16224|||||No|No||SUN PHARMACEUTI|No||||
metoprolol/hydrochlorothiazide|No|No|No|No|75%|62756037088|METOPROLOL-HCTZ 50-25 MG TAB|100|EA|.36335|05/25/2012||Yes|No||05/25/2012||Yes|No|05/25/2012||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|070|Yes|1.02132|03/01/2022|.9968|03/01/2022|1.00344|03/01/2022|||BETA-BLOCKERS|16225|||||No|No||SUN PHARMACEUTI|No||||
dalfampridine|No|No|No|No|75%|62756042986|DALFAMPRIDINE ER 10 MG TABLET|60|EA|.86|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No||043|No|.82047|03/29/2022|.80077|03/29/2022|.80611|03/29/2022|||MULTIPLE SCLEROSIS AGENTS|16226|||||No|No||SUN PHARMACEUTI|No||||
lithium carbonate|No|No|No|No|75%|62756043018|LITHIUM CARBONATE 300 MG TAB|1000|EA|.07138|08/23/2011||Yes|No||08/23/2011||Yes|No|08/23/2011||Yes|No||||No|No|||Prescription required|No|||No|.13413|03/29/2022|.13091|03/29/2022|.13178|03/29/2022||||16227|||||No|No||SUN PHARMACEUTI|No||||
lithium carbonate|No|No|No|No|75%|62756043088|LITHIUM CARBONATE 300 MG TAB|100|EA|.07138|08/23/2011||Yes|No||08/23/2011||Yes|No|08/23/2011||Yes|No||||No|No|||Prescription required|No|||No|.13413|03/29/2022|.13091|03/29/2022|.13178|03/29/2022||||16228|||||No|No||SUN PHARMACEUTI|No||||
phenytoin sodium extended|No|No|No|No|75%|62756043283|PHENYTOIN SOD EXT 300 MG CAP|30|EA|.776|11/17/2009||Yes|No||11/17/2009||Yes|No|11/17/2009||Yes|No||||No|No|||Prescription required|No||056|No|1.44933|03/01/2022|1.41454|03/01/2022|1.42396|03/01/2022|||ANTICONVULSANTS|16229|||||No|No||SUN PHARMACEUTI|No||||
phenytoin sodium extended|No|No|No|No|75%|62756043288|PHENYTOIN SOD EXT 300 MG CAP|100|EA|.77597|11/17/2009||Yes|No||11/17/2009||Yes|No|11/17/2009||Yes|No||||No|No|||Prescription required|No||056|No|1.44933|03/01/2022|1.41454|03/01/2022|1.42396|03/01/2022|||ANTICONVULSANTS|16230|||||No|No||SUN PHARMACEUTI|No||||
naratriptan HCl|No|No|No|No|75%|62756043769|NARATRIPTAN HCL 2.5 MG TABLET|9|EA|3.34444|07/29/2011||Yes|No||07/29/2011||Yes|No|07/29/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|021|No|1.83483|03/29/2022|1.79079|03/29/2022|1.80272|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|16231|||||No|No||SUN PHARMACEUTI|No||||
donepezil HCl|No|No|No|No|75%|62756044018|DONEPEZIL HCL 5 MG TABLET|1000|EA|.0559|06/01/2011||Yes|No||06/01/2011||Yes|No|06/01/2011||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|16232|||||No|No||SUN PHARMACEUTI|No||||
donepezil HCl|No|No|No|No|75%|62756044081|DONEPEZIL HCL 5 MG TABLET|90|EA|.05733|06/01/2011||Yes|No||06/01/2011||Yes|No|06/01/2011||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|16233|||||No|No||SUN PHARMACEUTI|No||||
donepezil HCl|No|No|No|No|75%|62756044083|DONEPEZIL HCL 5 MG TABLET|30|EA|.05733|06/02/2011||Yes|No||06/02/2011||Yes|No|06/02/2011||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|16234|||||No|No||SUN PHARMACEUTI|No||||
donepezil HCl|No|No|No|No|75%|62756044581|DONEPEZIL HCL 10 MG TABLET|90|EA|.05733|06/01/2011||Yes|No||06/01/2011||Yes|No|06/01/2011||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|16235|||||No|No||SUN PHARMACEUTI|No||||
donepezil HCl|No|No|No|No|75%|62756044583|DONEPEZIL HCL 10 MG TABLET|30|EA|.05733|06/01/2011||Yes|No||06/01/2011||Yes|No|06/01/2011||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|16236|||||No|No||SUN PHARMACEUTI|No||||
carisoprodol|No|No|No|No|90%|62756044602|CARISOPRODOL 350 MG TABLET|100|EA|.03074|06/18/2009||Yes|No||06/18/2009||Yes|No|06/18/2009||Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|16237|||||No|No||SUN PHARMACEUTI|No||||
carisoprodol|No|No|No|No|90%|62756044604|CARISOPRODOL 350 MG TABLET|1000|EA|.02891|06/18/2009||Yes|No||06/18/2009||Yes|No|06/18/2009||Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|16238|||||No|No||SUN PHARMACEUTI|No||||
carisoprodol|No|No|No|No|90%|62756044605|CARISOPRODOL 350 MG TABLET|500|EA|.02979|06/18/2009||Yes|No||06/18/2009||Yes|No|06/18/2009||Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|16239|||||No|No||SUN PHARMACEUTI|No||||
carbidopa/levodopa|No|No|No|No|75%|62756045788|CARBIDOPA-LEVO ER 50-200 TAB|100|EA|.30078|01/09/2008||Yes|No||01/09/2008||Yes|No|01/09/2008||Yes|No||||No|No|||Prescription required|No||015|No|.29671|03/29/2022|.28958|03/29/2022|.29151|03/29/2022|||ANTIPARKINSON'S AGENTS|16240|||||No|No||SUN PHARMACEUTI|No||||
buprenorphine HCl|No|No|No|No|90%|62756045983|BUPRENORPHINE 2 MG TABLET SL|30|EA|.22933|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|.37925|03/29/2022|.37014|03/29/2022|.37261|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|16241|||||No|No||SUN PHARMACEUTI|Yes|09/01/2020|||
buprenorphine HCl|No|No|No|No|90%|62756046083|BUPRENORPHINE 8 MG TABLET SL|30|EA|.71666|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|.77298|03/29/2022|.75442|03/29/2022|.75945|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|16242|||||No|No||SUN PHARMACEUTI|Yes|09/01/2020|||
carbidopa/levodopa|No|No|No|No|75%|62756046188|CARBIDOPA-LEVO ER 25-100 TAB|100|EA|.16125|01/09/2008||Yes|No||01/09/2008||Yes|No|01/09/2008||Yes|No||||No|No|||Prescription required|No||015|No|.21193|03/29/2022|.20684|03/29/2022|.20822|03/29/2022|||ANTIPARKINSON'S AGENTS|16243|||||No|No||SUN PHARMACEUTI|No||||
esomeprazole sodium|No|No|No|No|75%|62756050844|ESOMEPRAZOLE SODIUM 20 MG VIAL|1|EA|15.007|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||09/01/2021||Yes|No|||Prescription required|No|||No|34.202|06/01/2016|33.7134|06/01/2016|32.108|06/01/2016||||16244|||||No|No||SUN PHARMACEUTI|No||||
letrozole|No|No|No|No|75%|62756051183|LETROZOLE 2.5 MG TABLET|30|EA|.1075|06/15/2011||Yes|No||06/15/2011||Yes|No|06/15/2011||Yes|No||||No|No|||Prescription required|No||502|No|.1337|03/29/2022|.13049|03/29/2022|.13136|03/29/2022|||ONCOLOGY: ORAL - BREAST|16245|||||No|No||SUN PHARMACEUTI|No||||
levetiracetam|No|No|No|No|75%|62756051344|LEVETIRACETAM 500 MG/5 ML VIAL|5|ML|2.85692|10/18/2012||Yes|No||10/18/2012||Yes|No|10/18/2012||Yes|No||||No|No|||Prescription required|No|||No|6.51112|06/01/2016|6.4181|06/01/2016|6.11248|06/01/2016||||16246|||||No|No||SUN PHARMACEUTI|No||||
carbidopa/levodopa|No|No|No|No|75%|62756051713|CARBIDOPA-LEVODOPA 10-100 TAB|500|EA|.10682|02/16/2009||Yes|No||02/16/2009||Yes|No|02/16/2009||Yes|No||||No|No|||Prescription required|No||015|No|.14195|03/29/2022|.13854|03/29/2022|.13946|03/29/2022|||ANTIPARKINSON'S AGENTS|16247|||||No|No||SUN PHARMACEUTI|No||||
carbidopa/levodopa|No|No|No|No|75%|62756051788|CARBIDOPA-LEVODOPA 10-100 TAB|100|EA|.11244|02/16/2009||Yes|No||02/16/2009||Yes|No|02/16/2009||Yes|No||||No|No|||Prescription required|No||015|No|.14195|03/29/2022|.13854|03/29/2022|.13946|03/29/2022|||ANTIPARKINSON'S AGENTS|16248|||||No|No||SUN PHARMACEUTI|No||||
carbidopa/levodopa|No|No|No|No|75%|62756051813|CARBIDOPA-LEVODOPA 25-100 TAB|500|EA|.12132|02/16/2009||Yes|No||02/16/2009||Yes|No|02/16/2009||Yes|No||||No|No|||Prescription required|No||015|No|.11418|03/29/2022|.11143|03/29/2022|.11218|03/29/2022|||ANTIPARKINSON'S AGENTS|16249|||||No|No||SUN PHARMACEUTI|No||||
carbidopa/levodopa|No|No|No|No|75%|62756051818|CARBIDOPA-LEVODOPA 25-100 TAB|1000|EA|.11525|02/16/2009||Yes|No||02/16/2009||Yes|No|02/16/2009||Yes|No||||No|No|||Prescription required|No||015|No|.11418|03/29/2022|.11143|03/29/2022|.11218|03/29/2022|||ANTIPARKINSON'S AGENTS|16250|||||No|No||SUN PHARMACEUTI|No||||
carbidopa/levodopa|No|No|No|No|75%|62756051888|CARBIDOPA-LEVODOPA 25-100 TAB|100|EA|.12771|02/16/2009||Yes|No||02/16/2009||Yes|No|02/16/2009||Yes|No||||No|No|||Prescription required|No||015|No|.11418|03/29/2022|.11143|03/29/2022|.11218|03/29/2022|||ANTIPARKINSON'S AGENTS|16251|||||No|No||SUN PHARMACEUTI|No||||
carbidopa/levodopa|No|No|No|No|75%|62756051913|CARBIDOPA-LEVODOPA 25-250 TAB|500|EA|.14013|02/16/2009||Yes|No||02/16/2009||Yes|No|02/16/2009||Yes|No||||No|No|||Prescription required|No||015|No|.1493|03/29/2022|.14571|03/29/2022|.14668|03/29/2022|||ANTIPARKINSON'S AGENTS|16252|||||No|No||SUN PHARMACEUTI|No||||
carbidopa/levodopa|No|No|No|No|75%|62756051988|CARBIDOPA-LEVODOPA 25-250 TAB|100|EA|.14792|02/16/2009||Yes|No||02/16/2009||Yes|No|02/16/2009||Yes|No||||No|No|||Prescription required|No||015|No|.1493|03/29/2022|.14571|03/29/2022|.14668|03/29/2022|||ANTIPARKINSON'S AGENTS|16253|||||No|No||SUN PHARMACEUTI|No||||
sumatriptan succinate|No|No|No|No|75%|62756052069|SUMATRIPTAN SUCC 25 MG TABLET|9|EA|.76205|08/12/2009||Yes|No||08/12/2009||Yes|No|08/12/2009||Yes|No||||No|No|||Prescription required|No||021|No|.55768|03/29/2022|.54429|03/29/2022|.54792|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|16254|||||No|No||SUN PHARMACEUTI|No||||
sumatriptan succinate|No|No|No|No|75%|62756052088|SUMATRIPTAN SUCC 25 MG TABLET|100|EA|.7239|08/12/2009||Yes|No||08/12/2009||Yes|No|08/12/2009||Yes|No||||No|No|||Prescription required|No||021|No|.55768|03/29/2022|.54429|03/29/2022|.54792|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|16255|||||No|No||SUN PHARMACEUTI|No||||
sumatriptan succinate|No|No|No|No|75%|62756052169|SUMATRIPTAN SUCC 50 MG TABLET|9|EA|.76205|08/10/2009||Yes|No||08/10/2009||Yes|No|08/10/2009||Yes|No||||No|No|||Prescription required|No||021|No|.52829|03/29/2022|.51561|03/29/2022|.51904|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|16256|||||No|No||SUN PHARMACEUTI|No||||
sumatriptan succinate|No|No|No|No|75%|62756052188|SUMATRIPTAN SUCC 50 MG TABLET|100|EA|.7239|08/10/2009||Yes|No||08/10/2009||Yes|No|08/10/2009||Yes|No||||No|No|||Prescription required|No||021|No|.52829|03/29/2022|.51561|03/29/2022|.51904|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|16257|||||No|No||SUN PHARMACEUTI|No||||
sumatriptan succinate|No|No|No|No|75%|62756052269|SUMATRIPTAN SUCC 100 MG TABLET|9|EA|.76205|08/12/2009||Yes|No||08/12/2009||Yes|No|08/12/2009||Yes|No||||No|No|||Prescription required|No||021|No|.54919|03/29/2022|.536|03/29/2022|.53957|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|16258|||||No|No||SUN PHARMACEUTI|No||||
sumatriptan succinate|No|No|No|No|75%|62756052288|SUMATRIPTAN SUCC 100 MG TABLET|100|EA|.7239|08/12/2009||Yes|No||08/12/2009||Yes|No|08/12/2009||Yes|No||||No|No|||Prescription required|No||021|No|.54919|03/29/2022|.536|03/29/2022|.53957|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|16259|||||No|No||SUN PHARMACEUTI|No||||
riluzole|No|No|No|No|75%|62756053886|RILUZOLE 50 MG TABLET|60|EA|.56766|08/07/2014||Yes|No||08/07/2014||Yes|No|08/07/2014||Yes|No||||No|No|||Prescription required|No|||No|.46908|03/01/2022|.45782|03/01/2022|.46087|03/01/2022||||16260|||||No|No||SUN PHARMACEUTI|No||||
olanzapine|No|No|No|No|75%|62756055118|OLANZAPINE 2.5 MG TABLET|1000|EA|.14319|01/14/2014||Yes|No||01/14/2014||Yes|No|01/14/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.08915|03/29/2022|.08701|03/29/2022|.08758|03/29/2022|||ANTIPSYCHOTICS|16261|||||No|No||SUN PHARMACEUTI|No||||
olanzapine|No|No|No|No|75%|62756055183|OLANZAPINE 2.5 MG TABLET|30|EA|.14333|01/14/2014||Yes|No||01/14/2014||Yes|No|01/14/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.08915|03/29/2022|.08701|03/29/2022|.08758|03/29/2022|||ANTIPSYCHOTICS|16262|||||No|No||SUN PHARMACEUTI|No||||
olanzapine|No|No|No|No|75%|62756055188|OLANZAPINE 2.5 MG TABLET|100|EA|.14319|01/14/2014||Yes|No||01/14/2014||Yes|No|01/14/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.08915|03/29/2022|.08701|03/29/2022|.08758|03/29/2022|||ANTIPSYCHOTICS|16263|||||No|No||SUN PHARMACEUTI|No||||
olanzapine|No|No|No|No|75%|62756055218|OLANZAPINE 5 MG TABLET|1000|EA|.15394|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.09455|03/29/2022|.09228|03/29/2022|.09289|03/29/2022|||ANTIPSYCHOTICS|16264|||||No|No||SUN PHARMACEUTI|No||||
olanzapine|No|No|No|No|75%|62756055283|OLANZAPINE 5 MG TABLET|30|EA|.15408|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.09455|03/29/2022|.09228|03/29/2022|.09289|03/29/2022|||ANTIPSYCHOTICS|16265|||||No|No||SUN PHARMACEUTI|No||||
olanzapine|No|No|No|No|75%|62756055288|OLANZAPINE 5 MG TABLET|100|EA|.15394|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.09455|03/29/2022|.09228|03/29/2022|.09289|03/29/2022|||ANTIPSYCHOTICS|16266|||||No|No||SUN PHARMACEUTI|No||||
olanzapine|No|No|No|No|75%|62756055318|OLANZAPINE 7.5 MG TABLET|1000|EA|.1935|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.11617|03/29/2022|.11338|03/29/2022|.11413|03/29/2022|||ANTIPSYCHOTICS|16267|||||No|No||SUN PHARMACEUTI|No||||
olanzapine|No|No|No|No|75%|62756055383|OLANZAPINE 7.5 MG TABLET|30|EA|.1935|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.11617|03/29/2022|.11338|03/29/2022|.11413|03/29/2022|||ANTIPSYCHOTICS|16268|||||No|No||SUN PHARMACEUTI|No||||
olanzapine|No|No|No|No|75%|62756055388|OLANZAPINE 7.5 MG TABLET|100|EA|.1935|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.11617|03/29/2022|.11338|03/29/2022|.11413|03/29/2022|||ANTIPSYCHOTICS|16269|||||No|No||SUN PHARMACEUTI|No||||
olanzapine|No|No|No|No|75%|62756055418|OLANZAPINE 10 MG TABLET|1000|EA|.23994|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.12613|03/29/2022|.1231|03/29/2022|.12392|03/29/2022|||ANTIPSYCHOTICS|16270|||||No|No||SUN PHARMACEUTI|No||||
olanzapine|No|No|No|No|75%|62756055483|OLANZAPINE 10 MG TABLET|30|EA|.24008|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.12613|03/29/2022|.1231|03/29/2022|.12392|03/29/2022|||ANTIPSYCHOTICS|16271|||||No|No||SUN PHARMACEUTI|No||||
olanzapine|No|No|No|No|75%|62756055488|OLANZAPINE 10 MG TABLET|100|EA|.23994|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.12613|03/29/2022|.1231|03/29/2022|.12392|03/29/2022|||ANTIPSYCHOTICS|16272|||||No|No||SUN PHARMACEUTI|No||||
olanzapine|No|No|No|No|75%|62756055518|OLANZAPINE 15 MG TABLET|1000|EA|.35819|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.15007|03/29/2022|.14646|03/29/2022|.14744|03/29/2022|||ANTIPSYCHOTICS|16273|||||No|No||SUN PHARMACEUTI|No||||
olanzapine|No|No|No|No|75%|62756055583|OLANZAPINE 15 MG TABLET|30|EA|.35833|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.15007|03/29/2022|.14646|03/29/2022|.14744|03/29/2022|||ANTIPSYCHOTICS|16274|||||No|No||SUN PHARMACEUTI|No||||
olanzapine|No|No|No|No|75%|62756055588|OLANZAPINE 15 MG TABLET|100|EA|.35819|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.15007|03/29/2022|.14646|03/29/2022|.14744|03/29/2022|||ANTIPSYCHOTICS|16275|||||No|No||SUN PHARMACEUTI|No||||
olanzapine|No|No|No|No|75%|62756055618|OLANZAPINE 20 MG TABLET|1000|EA|.48375|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.18048|03/29/2022|.17614|03/29/2022|.17732|03/29/2022|||ANTIPSYCHOTICS|16276|||||No|No||SUN PHARMACEUTI|No||||
olanzapine|No|No|No|No|75%|62756055683|OLANZAPINE 20 MG TABLET|30|EA|.48375|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.18048|03/29/2022|.17614|03/29/2022|.17732|03/29/2022|||ANTIPSYCHOTICS|16277|||||No|No||SUN PHARMACEUTI|No||||
olanzapine|No|No|No|No|75%|62756055688|OLANZAPINE 20 MG TABLET|100|EA|.48375|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.18048|03/29/2022|.17614|03/29/2022|.17732|03/29/2022|||ANTIPSYCHOTICS|16278|||||No|No||SUN PHARMACEUTI|No||||
deferasirox|No|No|No|No|75%|62756056883|DEFERASIROX 125 MG TB FOR SUSP|30|EA|2.72376|04/08/2021||Yes|No||04/08/2021||Yes|No|04/08/2021||Yes|No||||No|No|||Prescription required|No|||No|6.20764|04/08/2021|6.11896|04/08/2021|5.82758|04/08/2021||||16279|||||No|No||SUN PHARMACEUTI|No||||
deferasirox|No|No|No|No|75%|62756056983|DEFERASIROX 250 MG TB FOR SUSP|30|EA|5.44738|03/12/2021||Yes|No||03/12/2021||Yes|No|03/12/2021||Yes|No||||No|No|||Prescription required|No|||No|12.41496|03/12/2021|12.2376|03/12/2021|11.65486|03/12/2021||||16280|||||No|No||SUN PHARMACEUTI|No||||
deferasirox|No|No|No|No|75%|62756057083|DEFERASIROX 500 MG TB FOR SUSP|30|EA|10.89448|04/30/2021||Yes|No||04/30/2021||Yes|No|04/30/2021||Yes|No||||No|No|||Prescription required|No|||No|24.82928|05/04/2021|24.47457|04/30/2021|23.30912|04/30/2021||||16281|||||No|No||SUN PHARMACEUTI|No||||
liothyronine sodium|No|No|No|No|75%|62756058988|LIOTHYRONINE SOD 5 MCG TAB|100|EA|.23615|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||||No|No|||Prescription required|No|||No|.37734|03/29/2022|.36828|03/29/2022|.37073|03/29/2022||||16282|||||No|No||SUN PHARMACEUTI|No||||
liothyronine sodium|No|No|No|No|75%|62756059088|LIOTHYRONINE SOD 25 MCG TAB|100|EA|.3102|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||||No|No|||Prescription required|No|||No|.55764|03/29/2022|.54425|03/29/2022|.54788|03/29/2022||||16283|||||No|No||SUN PHARMACEUTI|No||||
liothyronine sodium|No|No|No|No|75%|62756059188|LIOTHYRONINE SOD 50 MCG TAB|100|EA|.4739|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||||No|No|||Prescription required|No|||No|.67729|01/25/2022|.66103|01/25/2022|.66543|01/25/2022||||16284|||||No|No||SUN PHARMACEUTI|No||||
topiramate|No|No|No|No|75%|62756070786|TOPIRAMATE 25 MG TABLET|60|EA|.06593|||No|No||||No|No|06/18/2009||Yes|No||||No|No|||Prescription required|No|||No|.03423|03/29/2022|.0334|03/29/2022|.03363|03/29/2022||||16285|||Drug ReNumbered||No|No||SUN PHARMACEUTI|No||||
levonorgestrel|No|Yes|No|No|75%|62756071860|OPCICON ONE-STEP 1.5 MG TABLET|1|EA|8.6|06/01/2015||Yes|No||||No|No|||No|No||||No|No|||Over the counter|No|||No|10.215|03/29/2022|9.96984|03/29/2022|10.03623|03/29/2022||||16286|||||No|No||SUN PHARMACEUTI|No||||
olanzapine|No|No|No|No|75%|62756075164|OLANZAPINE ODT 5 MG TABLET|30|EA|.76683|03/01/2012||Yes|No||03/01/2012||Yes|No|03/01/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.59218|03/29/2022|.57796|03/29/2022|.58181|03/29/2022|||ANTIPSYCHOTICS|16287|||||No|No||SUN PHARMACEUTI|No||||
olanzapine|No|No|No|No|75%|62756075464|OLANZAPINE ODT 10 MG TABLET|30|EA|1.12803|03/01/2012||Yes|No||03/01/2012||Yes|No|03/01/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.58062|03/29/2022|.56668|03/29/2022|.57045|03/29/2022|||ANTIPSYCHOTICS|16288|||||No|No||SUN PHARMACEUTI|No||||
olanzapine|No|No|No|No|75%|62756075564|OLANZAPINE ODT 15 MG TABLET|30|EA|1.66338|03/01/2012||Yes|No||03/01/2012||Yes|No|03/01/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.85386|03/29/2022|.83336|03/29/2022|.83891|03/29/2022|||ANTIPSYCHOTICS|16289|||||No|No||SUN PHARMACEUTI|No||||
olanzapine|No|No|No|No|75%|62756075764|OLANZAPINE ODT 20 MG TABLET|30|EA|2.19873|03/01/2012||Yes|No||03/01/2012||Yes|No|03/01/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|1.09|03/29/2022|1.06384|03/29/2022|1.07092|03/29/2022|||ANTIPSYCHOTICS|16290|||||No|No||SUN PHARMACEUTI|No||||
divalproex sodium|No|No|No|No|75%|62756079613|DIVALPROEX SOD DR 125 MG TAB|500|EA|.02627|08/05/2008||Yes|No||08/05/2008||Yes|No|08/05/2008||Yes|No||||No|No|||Prescription required|No||056|No|.06035|03/29/2022|.0589|03/29/2022|.05929|03/29/2022|||ANTICONVULSANTS|16291|||||No|No||SUN PHARMACEUTI|No||||
divalproex sodium|No|No|No|No|75%|62756079688|DIVALPROEX SOD DR 125 MG TAB|100|EA|.02709|09/11/2008||Yes|No||09/11/2008||Yes|No|09/11/2008||Yes|No||||No|No|||Prescription required|No||056|No|.06035|03/29/2022|.0589|03/29/2022|.05929|03/29/2022|||ANTICONVULSANTS|16292|||||No|No||SUN PHARMACEUTI|No||||
divalproex sodium|No|No|No|No|75%|62756079713|DIVALPROEX SOD DR 250 MG TAB|500|EA|.05198|08/05/2008||Yes|No||08/05/2008||Yes|No|08/05/2008||Yes|No||||No|No|||Prescription required|No||056|No|.07754|03/29/2022|.07567|03/29/2022|.07618|03/29/2022|||ANTICONVULSANTS|16293|||||No|No||SUN PHARMACEUTI|No||||
divalproex sodium|No|No|No|No|75%|62756079788|DIVALPROEX SOD DR 250 MG TAB|100|EA|.05353|08/05/2008||Yes|No||08/05/2008||Yes|No|08/05/2008||Yes|No||||No|No|||Prescription required|No||056|No|.07754|03/29/2022|.07567|03/29/2022|.07618|03/29/2022|||ANTICONVULSANTS|16294|||||No|No||SUN PHARMACEUTI|No||||
divalproex sodium|No|No|No|No|75%|62756079813|DIVALPROEX SOD DR 500 MG TAB|500|EA|.10474|08/05/2008||Yes|No||08/05/2008||Yes|No|08/05/2008||Yes|No||||No|No|||Prescription required|No||056|No|.13473|03/29/2022|.13149|03/29/2022|.13237|03/29/2022|||ANTICONVULSANTS|16295|||||No|No||SUN PHARMACEUTI|No||||
divalproex sodium|No|No|No|No|75%|62756079888|DIVALPROEX SOD DR 500 MG TAB|100|EA|.10793|08/05/2008||Yes|No||08/05/2008||Yes|No|08/05/2008||Yes|No||||No|No|||Prescription required|No||056|No|.13473|03/29/2022|.13149|03/29/2022|.13237|03/29/2022|||ANTICONVULSANTS|16296|||||No|No||SUN PHARMACEUTI|No||||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|62756096983|BUPRENORPHINE-NALOX 2-0.5MG TB|30|EA|.39818|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|.72296|03/29/2022|.7056|03/29/2022|.7103|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|16297|||||No|No||SUN PHARMACEUTI|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|62756097083|BUPRENORPHINE-NALOX 8-2 MG TAB|30|EA|.57333|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|Yes|1.08568|03/29/2022|1.05962|03/29/2022|1.06668|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|16298|||||No|No||SUN PHARMACEUTI|Yes|09/01/2020|||
rabeprazole sodium|No|No|No|No|75%|62856024330|ACIPHEX DR 20 MG TABLET|30|EA|8.19752|08/31/2009||Yes|No||08/31/2009||Yes|No|08/31/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|18.26883|10/12/2021|17.83037|10/12/2021|17.94912|10/12/2021|||PROTON PUMP INHIBITORS|16299|||||No|No||EISAI/ WOODWARD|No||||
donepezil HCl|No|No|No|No|75%|62856024530|ARICEPT 5 MG TABLET|30|EA|7.2541|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|011|Yes|16.5326|02/28/2017|16.29642|02/28/2017|15.5204|02/28/2017|||ALZHEIMER'S AGENTS|16300|||||No|No||EISAI INC.|No||||
donepezil HCl|No|No|No|No|75%|62856024630|ARICEPT 10 MG TABLET|30|EA|7.2541|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|011|No|16.5326|12/26/2017|16.29642|12/26/2017|15.5204|12/26/2017|||ALZHEIMER'S AGENTS|16301|||||No|No||EISAI INC.|No||||
donepezil HCl|No|No|No|No|75%|62856024730|ARICEPT 23 MG TABLET|30|EA|6.4844|01/07/2011||Yes|No||01/07/2011||Yes|No|01/07/2011||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|011|No|14.7784|07/26/2016|14.56728|07/26/2016|13.8736|07/26/2016|||ALZHEIMER'S AGENTS|16302|||||No|No||EISAI INC.|No||||
perampanel|No|No|No|No|75%|62856027230|FYCOMPA 2 MG TABLET|30|EA|8.041|03/06/2014||Yes|No||03/06/2014||Yes|No|03/06/2014||Yes|No||||No|No|||Prescription required|No||056|No|17.85354|01/25/2022|17.42505|01/25/2022|17.5411|01/25/2022|||ANTICONVULSANTS|16303|||||No|No||EISAI INC.|No||||
perampanel|No|No|No|No|75%|62856027430|FYCOMPA 4 MG TABLET|30|EA|15.88133|03/06/2014||Yes|No||03/06/2014||Yes|No|03/06/2014||Yes|No||||No|No|||Prescription required|No||056|No|35.66707|01/25/2022|34.81106|01/25/2022|35.04289|01/25/2022|||ANTICONVULSANTS|16304|||||No|No||EISAI INC.|No||||
perampanel|No|No|No|No|75%|62856027630|FYCOMPA 6 MG TABLET|30|EA|15.88133|03/06/2014||Yes|No||03/06/2014||Yes|No|03/06/2014||Yes|No||||No|No|||Prescription required|No||056|No|35.32747|01/25/2022|34.47961|01/25/2022|34.70923|01/25/2022|||ANTICONVULSANTS|16305|||||No|No||EISAI INC.|No||||
perampanel|No|No|No|No|75%|62856027830|FYCOMPA 8 MG TABLET|30|EA|15.88133|03/06/2014||Yes|No||03/06/2014||Yes|No|03/06/2014||Yes|No||||No|No|||Prescription required|No||056|No|35.47173|01/25/2022|34.6204|01/25/2022|34.85097|01/25/2022|||ANTICONVULSANTS|16306|||||No|No||EISAI INC.|No||||
perampanel|No|No|No|No|75%|62856028030|FYCOMPA 10 MG TABLET|30|EA|15.88133|03/06/2014||Yes|No||03/06/2014||Yes|No|03/06/2014||Yes|No||||No|No|||Prescription required|No||056|No|35.60378|01/25/2022|34.74928|01/25/2022|34.98071|01/25/2022|||ANTICONVULSANTS|16307|||||No|No||EISAI INC.|No||||
perampanel|No|No|No|No|75%|62856028230|FYCOMPA 12 MG TABLET|30|EA|15.88133|03/06/2014||Yes|No||03/06/2014||Yes|No|03/06/2014||Yes|No||||No|No|||Prescription required|No||056|No|35.29104|01/25/2022|34.44405|01/25/2022|34.67344|01/25/2022|||ANTICONVULSANTS|16308|||||No|No||EISAI INC.|No||||
perampanel|No|No|No|No|75%|62856029038|FYCOMPA 0.5 MG/ML ORAL SUSP|340|ML|2.16473|08/03/2016||Yes|No||08/03/2016||Yes|No|08/03/2016||Yes|No||||No|No|||Prescription required|No||056|No|4.07576|01/25/2022|3.97794|01/25/2022|4.00443|01/25/2022|||ANTICONVULSANTS|16309|||||No|No||EISAI INC.|No||||
lemborexant|No|No|No|No|75%|62856040530|DAYVIGO 5 MG TABLET|30|EA|4.21758|11/09/2020||Yes|No||11/09/2020||Yes|No|11/09/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|054|Yes|9.4071|12/28/2021|9.18132|12/28/2021|9.24247|12/28/2021|||SEDATIVE HYPNOTICS|16310|||||No|No||EISAI INC.|No||||
lemborexant|No|No|No|No|75%|62856041030|DAYVIGO 10 MG TABLET|30|EA|4.21758|11/09/2020||Yes|No||11/09/2020||Yes|No|11/09/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|054|Yes|9.44181|06/29/2021|9.2152|06/29/2021|9.27657|06/29/2021|||SEDATIVE HYPNOTICS|16311|||||No|No||EISAI INC.|No||||
rufinamide|No|No|No|No|75%|62856058252|BANZEL 200 MG TABLET|120|EA|5.676|12/14/2011||Yes|No||12/14/2011||Yes|No|12/14/2011||Yes|No||||No|No|||Prescription required|No||056|No|12.69075|11/23/2021|12.38617|11/23/2021|12.46866|11/23/2021|||ANTICONVULSANTS|16312|||||No|No||EISAI INC.|No||||
rufinamide|No|No|No|No|75%|62856058352|BANZEL 400 MG TABLET|120|EA|11.352|02/02/2009||Yes|No||02/02/2009||Yes|No|02/02/2009||Yes|No||||No|No|||Prescription required|No||056|No|25.29543|03/01/2022|24.68833|03/01/2022|24.85275|03/01/2022|||ANTICONVULSANTS|16313|||||No|No||EISAI INC.|No||||
rufinamide|No|No|No|No|75%|62856058446|BANZEL 40 MG/ML SUSPENSION|460|ML|1.64428|03/23/2011||Yes|No||03/23/2011||Yes|No|03/23/2011||Yes|No||||No|No|||Prescription required|No||056|No|3.72071|03/29/2022|3.63141|03/29/2022|3.65559|03/29/2022|||ANTICONVULSANTS|16314|||||No|No||EISAI INC.|No||||
lenvatinib mesylate|No|No|No|No|75%|62856070430|LENVIMA 4 MG CAPSULE|30|EA|299.882|12/28/2018||Yes|No||12/28/2018||Yes|No|12/28/2018||Yes|No||||No|No|||Prescription required|No||548|No|683.452|01/18/2022|673.6884|01/18/2022|641.608|01/18/2022|||ONCOLOGY: ORAL - RENAL CELL|16315|||||No|No||EISAI INC.|No||||
lenvatinib mesylate|No|No|No|No|75%|62856070830|LENVIMA 8 MG DAILY DOSE|60|EA|149.941|01/10/2017||Yes|No||01/10/2017||Yes|No|01/10/2017||Yes|No||||No|No|||Prescription required|No||548|No|341.726|01/18/2022|336.8442|01/18/2022|320.804|01/18/2022|||ONCOLOGY: ORAL - RENAL CELL|16316|||||No|No||EISAI INC.|No||||
lenvatinib mesylate|No|No|No|No|75%|62856071005|LENVIMA 10 MG DAILY DOSE|5|EA|299.882|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No||548|No|683.452|01/18/2022|673.6884|01/18/2022|641.608|01/18/2022|||ONCOLOGY: ORAL - RENAL CELL|16317|||||No|No||EISAI INC.|No||||
lenvatinib mesylate|No|No|No|No|75%|62856071030|LENVIMA 10 MG DAILY DOSE|30|EA|299.882|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No||548|No|683.452|01/18/2022|673.6884|01/18/2022|641.608|01/18/2022|||ONCOLOGY: ORAL - RENAL CELL|16318|||||No|No||EISAI INC.|No||||
lenvatinib mesylate|No|No|No|No|75%|62856071230|LENVIMA 12 MG DAILY DOSE|90|EA|99.96066|12/28/2018||Yes|No||12/28/2018||Yes|No|12/28/2018||Yes|No||||No|No|||Prescription required|No||548|No|227.81732|01/18/2022|224.56279|01/18/2022|213.86932|01/18/2022|||ONCOLOGY: ORAL - RENAL CELL|16319|||||No|No||EISAI INC.|No||||
lenvatinib mesylate|No|No|No|No|75%|62856071405|LENVIMA 14 MG DAILY DOSE|10|EA|149.941|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No||548|No|341.726|01/18/2022|336.8442|01/18/2022|320.804|01/18/2022|||ONCOLOGY: ORAL - RENAL CELL|16320|||||No|No||EISAI INC.|No||||
lenvatinib mesylate|No|No|No|No|75%|62856071430|LENVIMA 14 MG DAILY DOSE|60|EA|149.941|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No||548|No|341.726|01/18/2022|336.8442|01/18/2022|320.804|01/18/2022|||ONCOLOGY: ORAL - RENAL CELL|16321|||||No|No||EISAI INC.|No||||
lenvatinib mesylate|No|No|No|No|75%|62856071830|LENVIMA 18 MG DAILY DOSE|90|EA|99.96066|01/10/2017||Yes|No||01/10/2017||Yes|No|01/10/2017||Yes|No||||No|No|||Prescription required|No||548|No|227.81732|01/18/2022|224.56279|01/18/2022|213.86932|01/18/2022|||ONCOLOGY: ORAL - RENAL CELL|16322|||||No|No||EISAI INC.|No||||
lenvatinib mesylate|No|No|No|No|75%|62856072005|LENVIMA 20 MG DAILY DOSE|10|EA|149.941|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No||548|No|341.726|01/18/2022|336.8442|01/18/2022|320.804|01/18/2022|||ONCOLOGY: ORAL - RENAL CELL|16323|||||No|No||EISAI INC.|No||||
lenvatinib mesylate|No|No|No|No|75%|62856072030|LENVIMA 20 MG DAILY DOSE|60|EA|149.941|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No||548|No|341.726|01/18/2022|336.8442|01/18/2022|320.804|01/18/2022|||ONCOLOGY: ORAL - RENAL CELL|16324|||||No|No||EISAI INC.|No||||
lenvatinib mesylate|No|No|No|No|75%|62856072405|LENVIMA 24 MG DAILY DOSE|15|EA|99.96066|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No||548|No|227.81732|01/18/2022|224.56279|01/18/2022|213.86932|01/18/2022|||ONCOLOGY: ORAL - RENAL CELL|16325|||||No|No||EISAI INC.|No||||
lenvatinib mesylate|No|No|No|No|75%|62856072430|LENVIMA 24 MG DAILY DOSE|90|EA|99.96066|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No||548|No|227.81732|01/18/2022|224.56279|01/18/2022|213.86932|01/18/2022|||ONCOLOGY: ORAL - RENAL CELL|16326|||||No|No||EISAI INC.|No||||
leuprolide acetate|No|No|No|No|75%|62935022305|ELIGARD 22.5 MG SYRINGE KIT|1|EA|582.6801|09/04/2020||Yes|No||09/04/2020||Yes|No|09/04/2020||Yes|No||||No|No|||Prescription required|No|||No|1327.9686|09/04/2020|1308.99762|09/08/2020|1246.6644|09/04/2020||||16327|||||No|No||TOLMAR PHARMACE|No||||
leuprolide acetate|No|No|No|No|75%|62935030330|ELIGARD 30 MG SYRINGE KIT|1|EA|777.7668|09/04/2020||Yes|No||09/04/2020||Yes|No|09/04/2020||Yes|No||||No|No|||Prescription required|No|||No|1772.5848|09/08/2020|1747.26216|09/04/2020|1664.0592|09/04/2020||||16328|||||No|No||TOLMAR PHARMACE|No||||
leuprolide acetate|No|No|No|No|75%|62935045345|ELIGARD 45 MG SYRINGE KIT|1|EA|1165.3559|09/04/2020||Yes|No||09/04/2020||Yes|No|09/04/2020||Yes|No||||No|No|||Prescription required|No|||No|2655.9274|09/04/2020|2617.98558|09/04/2020|2493.3196|09/04/2020||||16329|||||No|No||TOLMAR PHARMACE|No||||
leuprolide acetate|No|No|No|No|75%|62935075375|ELIGARD 7.5 MG SYRINGE KIT|1|EA|194.2267|09/04/2020||Yes|No||09/04/2020||Yes|No|09/04/2020||Yes|No||||No|No|||Prescription required|No|||No|442.6562|09/04/2020|436.33254|09/04/2020|415.5548|09/04/2020||||16330|||||No|No||TOLMAR PHARMACE|No||||
corticotropin|No|No|No|No|75%|63004871001|ACTHAR GEL 400 UNIT/5 ML VIAL|5|ML|3565.474|02/06/2013||Yes|No||02/06/2013||Yes|No|02/06/2013||Yes|No||||No|No|||Prescription required|No|||Yes|8125.964|02/08/2022|8009.8788|02/08/2022|7628.456|02/08/2022||||16331|||||No|No||MALLINCKRODT PH|No||||
nelfinavir mesylate|No|No|No|No|75%|63010001030|VIRACEPT 250 MG TABLET|300|EA|2.42799|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|3.96572|01/09/2018|3.90907|01/09/2018|3.72292|01/09/2018|||HIV / AIDS|16332|||||No|No||VIIV HEALTHCARE|No||||
nelfinavir mesylate|No|No|No|No|75%|63010002770|VIRACEPT 625 MG TABLET|120|EA|6.06999|06/16/2004||Yes|No||06/16/2004||Yes|No|06/16/2004||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|9.91432|06/25/2019|9.77269|06/25/2019|9.30732|06/25/2019|||HIV / AIDS|16333|||||No|No||VIIV HEALTHCARE|No||||
mobocertinib succinate|No|No|No|No|75%|63020004012|EXKIVITY 40 MG CAPSULE|120|EA|89.58333|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||||No|No|||Prescription required|No||551|No|204.16666|02/10/2022|201.24999|02/10/2022|191.66666|02/10/2022|||ONCOLOGY: ORAL - LUNG|16334|||||No|No||TAKEDA PHARMACE|No||||
ixazomib citrate|No|No|No|No|75%|63020008001|NINLARO 4 MG CAPSULE|1|EA|1562.19|08/19/2016|01/25/2022|Yes|No||08/19/2016|01/25/2022|Yes|No|08/19/2016|01/25/2022|Yes|No||||No|No|||Prescription required|No||173|No|3560.34|01/12/2021|3509.478|01/12/2021|3342.36|01/12/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|16335|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||MILLENNIUM PHAR|No||||
ixazomib citrate|No|No|No|No|75%|63020008002|NINLARO 4 MG CAPSULE|3|EA|1561.47333|08/25/2016|01/25/2022|Yes|No||08/25/2016|01/25/2022|Yes|No|08/25/2016|01/25/2022|Yes|No||||No|No|||Prescription required|No||173|No|3558.70666|01/12/2021|3507.86799|01/12/2021|3340.82666|01/12/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|16336|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||MILLENNIUM PHAR|No||||
brigatinib|No|No|No|No|75%|63020009007|ALUNBRIG 90 MG TABLET|7|EA|256.21857|02/16/2018||Yes|No||02/16/2018||Yes|No|02/16/2018||Yes|No||||No|No|||Prescription required|No||551|No|583.93999|01/11/2022|575.59799|01/11/2022|548.18856|01/11/2022|||ONCOLOGY: ORAL - LUNG|16337|||||No|No||MILLENNIUM PHAR|No||||
brigatinib|No|No|No|No|75%|63020009030|ALUNBRIG 90 MG TABLET|30|EA|256.13666|02/16/2018||Yes|No||02/16/2018||Yes|No|02/16/2018||Yes|No||||No|No|||Prescription required|No||551|No|583.75332|01/11/2022|575.41399|01/11/2022|548.01332|01/11/2022|||ONCOLOGY: ORAL - LUNG|16338|||||No|No||MILLENNIUM PHAR|No||||
brigatinib|No|No|No|No|75%|63020011330|ALUNBRIG 30 MG TABLET|30|EA|85.41233|02/16/2018||Yes|No||02/16/2018||Yes|No|02/16/2018||Yes|No||||No|No|||Prescription required|No||551|No|194.66066|01/11/2022|191.87979|01/11/2022|182.74266|01/11/2022|||ONCOLOGY: ORAL - LUNG|16339|||||No|No||MILLENNIUM PHAR|No||||
brigatinib|No|No|No|No|75%|63020018030|ALUNBRIG 180 MG TABLET|30|EA|256.13666|02/16/2018||Yes|No||02/16/2018||Yes|No|02/16/2018||Yes|No||||No|No|||Prescription required|No||551|No|583.75332|01/11/2022|575.41399|01/11/2022|548.01332|01/11/2022|||ONCOLOGY: ORAL - LUNG|16340|||||No|No||MILLENNIUM PHAR|No||||
brigatinib|No|No|No|No|75%|63020019830|ALUNBRIG 90 MG-180 MG TAB PACK|30|EA|256.13666|02/16/2018||Yes|No||02/16/2018||Yes|No|02/16/2018||Yes|No||||No|No|||Prescription required|No||551|No|583.75332|01/11/2022|575.41399|01/11/2022|548.01332|01/11/2022|||ONCOLOGY: ORAL - LUNG|16341|||||No|No||MILLENNIUM PHAR|No||||
ixazomib citrate|No|No|No|No|75%|63020023001|NINLARO 2.3 MG CAPSULE|1|EA|1640.45|03/15/2021||Yes|No||03/15/2021||Yes|No|03/15/2021||Yes|No||||No|No|||Prescription required|No||173|No|3738.7|01/11/2022|3685.29|01/11/2022|3509.8|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|16342|||||No|No||MILLENNIUM PHAR|No||||
ixazomib citrate|No|No|No|No|75%|63020023002|NINLARO 2.3 MG CAPSULE|3|EA|1639.59|03/15/2021||Yes|No||03/15/2021||Yes|No|03/15/2021||Yes|No||||No|No|||Prescription required|No||173|No|3736.74|01/11/2022|3683.358|01/11/2022|3507.96|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|16343|||||No|No||MILLENNIUM PHAR|No||||
ixazomib citrate|No|No|No|No|75%|63020039001|NINLARO 3 MG CAPSULE|1|EA|1640.45|03/15/2021||Yes|No||03/15/2021||Yes|No|03/15/2021||Yes|No||||No|No|||Prescription required|No||173|No|3738.7|01/11/2022|3685.29|01/11/2022|3509.8|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|16344|||||No|No||MILLENNIUM PHAR|No||||
ixazomib citrate|No|No|No|No|75%|63020039002|NINLARO 3 MG CAPSULE|3|EA|1639.59|03/15/2021||Yes|No||03/15/2021||Yes|No|03/15/2021||Yes|No||||No|No|||Prescription required|No||173|No|3736.74|01/11/2022|3683.358|01/11/2022|3507.96|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|16345|||||No|No||MILLENNIUM PHAR|No||||
ixazomib citrate|No|No|No|No|75%|63020040001|NINLARO 4 MG CAPSULE|1|EA|1640.45|03/15/2021||Yes|No||03/15/2021||Yes|No|03/15/2021||Yes|No||||No|No|||Prescription required|No||173|No|3738.7|01/11/2022|3685.29|01/11/2022|3509.8|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|16346|||||No|No||MILLENNIUM PHAR|No||||
ixazomib citrate|No|No|No|No|75%|63020040002|NINLARO 4 MG CAPSULE|3|EA|1639.59|03/15/2021||Yes|No||03/15/2021||Yes|No|03/15/2021||Yes|No||||No|No|||Prescription required|No||173|No|3736.74|01/11/2022|3683.358|01/11/2022|3507.96|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|16347|||||No|No||MILLENNIUM PHAR|No||||
ponatinib HCl|No|No|No|No|75%|63020053330|ICLUSIG 30 MG TABLET|30|EA|269.59566|06/10/2021||Yes|No||06/10/2021||Yes|No|06/10/2021||Yes|No||||No|No|||Prescription required|No||173|No|614.42732|01/11/2022|605.64979|01/11/2022|576.80932|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|16348|||||No|No||MILLENNIUM PHAR|No||||
ponatinib HCl|No|No|No|No|75%|63020053430|ICLUSIG 45 MG TABLET|30|EA|269.59566|03/25/2019||Yes|No||03/25/2019||Yes|No|03/25/2019||Yes|No||||No|No|||Prescription required|No||173|No|614.42732|01/11/2022|605.64979|01/11/2022|576.80932|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|16349|||||No|No||MILLENNIUM PHAR|No||||
ponatinib HCl|No|No|No|No|75%|63020053530|ICLUSIG 15 MG TABLET|30|EA|269.59566|08/09/2018||Yes|No||08/09/2018||Yes|No|08/09/2018||Yes|No||||No|No|||Prescription required|No||173|No|614.42732|01/11/2022|605.64979|01/11/2022|576.80932|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|16350|||||No|No||MILLENNIUM PHAR|No||||
ponatinib HCl|No|No|No|No|75%|63020053630|ICLUSIG 10 MG TABLET|30|EA|269.59566|06/10/2021||Yes|No||06/10/2021||Yes|No|06/10/2021||Yes|No||||No|No|||Prescription required|No||173|No|614.42732|01/11/2022|605.64979|01/11/2022|576.80932|01/11/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|16351|||||No|No||MILLENNIUM PHAR|No||||
iron ps complex/B12/folic acid|No|No|No|No|75%|63044019801|IFEREX 150 FORTE CAPSULE|100|EA|.06445|06/01/2021||Yes|No||||No|No|06/01/2021||Yes|No||||No|No|||Over the counter|No||506|No|.1469|07/07/2020|.1448|07/07/2020|.1379|07/07/2020|||IRON: ORAL|16352|||||No|No||NNODUM CORP|No||||
iron ps complex/B12/folic acid|No|No|No|No|75%|63044019862|IFEREX 150 FORTE CAPSULE|100|EA|.06445|06/01/2021||Yes|No||||No|No|06/01/2021||Yes|No||||No|No|||Over the counter|No||506|No|.1469|07/07/2020|.1448|07/07/2020|.1379|07/07/2020|||IRON: ORAL|16353|||||No|No||NNODUM CORP|No||||
iron polysaccharide complex|No|No|No|No|75%|63044020301|IFEREX 150 CAPSULE|100|EA|.05585|06/01/2021||Yes|No||||No|No|06/01/2021||Yes|No||||No|No|||Over the counter|No||506|No|.1273|02/01/2022|.12548|02/01/2022|.1195|02/01/2022|||IRON: ORAL|16354|||||No|No||NNODUM CORP|No||||
iron polysaccharide complex|No|No|No|No|75%|63044020361|IFEREX 150 CAPSULE|100|EA|.05585|06/01/2021||Yes|No||||No|No|06/01/2021||Yes|No||||No|No|||Over the counter|No||506|No|.1273|02/01/2022|.12548|02/01/2022|.1195|02/01/2022|||IRON: ORAL|16355|||||No|No||NNODUM CORP|No||||
pimavanserin tartrate|No|No|No|No|75%|63090010030|NUPLAZID 10 MG TABLET|30|EA|59.813|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|136.318|02/15/2022|134.3706|02/15/2022|127.972|02/15/2022|||ANTIPSYCHOTICS|16356|||||No|No||ACADIA PHARMACE|No||||
pimavanserin tartrate|No|No|No|No|75%|63090034030|NUPLAZID 34 MG CAPSULE|30|EA|59.813|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|027|No|136.318|02/15/2022|134.3706|02/15/2022|127.972|02/15/2022|||ANTIPSYCHOTICS|16357|||||No|No||ACADIA PHARMACE|No||||
pregabalin|No|No|No|No|90%|63304004730|PREGABALIN ER 82.5 MG TABLET|30|EA|3.80679|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|232|No|8.67594|09/28/2021|8.55199|09/22/2021|8.14476|09/22/2021|||NEUROPATHIC PAIN|16358|||||No|No||SUN PHARMACEUTI|No||||
pregabalin|No|No|No|No|90%|63304004830|PREGABALIN ER 165 MG TABLET|30|EA|3.80679|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|232|No|8.67594|09/28/2021|8.55199|09/22/2021|8.14476|09/22/2021|||NEUROPATHIC PAIN|16359|||||No|No||SUN PHARMACEUTI|No||||
pregabalin|No|No|No|No|90%|63304004930|PREGABALIN ER 330 MG TABLET|30|EA|3.80679|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|232|No|8.67594|09/28/2021|8.55199|09/22/2021|8.14476|09/22/2021|||NEUROPATHIC PAIN|16360|||||No|No||SUN PHARMACEUTI|No||||
potassium chloride|No|No|No|No|75%|63304007801|POTASSIUM CL ER 8 MEQ CAPSULE|100|EA|.21014|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||10/13/2020||Yes|No|||Prescription required|No|||No|.14299|03/29/2022|.13955|03/29/2022|.14048|03/29/2022||||16361|||||No|No||SUN PHARMACEUTI|No||||
chlorpromazine HCl|No|No|No|No|75%|63304008301|CHLORPROMAZINE 200 MG TABLET|100|EA|1.69953|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||09/22/2021||Yes|No|||Prescription required|No||027|Yes|4.21034|03/01/2022|4.10929|03/01/2022|4.13665|03/01/2022|||ANTIPSYCHOTICS|16362|||||No|No||SUN PHARMACEUTI|No||||
droxidopa|No|No|No|No|75%|63304008690|DROXIDOPA 100 MG CAPSULE|90|EA|.47777|09/13/2021||Yes|No||09/13/2021||Yes|No|09/13/2021||Yes|No||||No|No|||Prescription required|No|||No|1.08888|11/02/2021|1.07333|11/02/2021|1.02222|11/02/2021||||16363|||||No|No||SUN PHARMACEUTI|No||||
potassium chloride|No|No|No|No|75%|63304009001|POTASSIUM CL ER 10 MEQ CAPSULE|100|EA|.25606|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||10/13/2020||Yes|No|||Prescription required|No|||No|.15494|03/29/2022|.15122|03/29/2022|.15222|03/29/2022||||16364|||||No|No||SUN PHARMACEUTI|No||||
potassium chloride|No|No|No|No|75%|63304009005|POTASSIUM CL ER 10 MEQ CAPSULE|500|EA|.24325|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||10/13/2020||Yes|No|||Prescription required|No|||No|.15494|03/29/2022|.15122|03/29/2022|.15222|03/29/2022||||16365|||||No|No||SUN PHARMACEUTI|No||||
sunitinib malate|No|No|No|No|75%|63304009127|SUNITINIB MALATE 12.5 MG CAP|28|EA|78.2107|12/15/2021||Yes|No||12/15/2021||Yes|No|12/15/2021||Yes|No||||No|No|||Prescription required|No||548|No|178.24764|12/15/2021|175.70124|12/15/2021|167.33452|12/15/2021|||ONCOLOGY: ORAL - RENAL CELL|16366|||||No|No||SUN PHARMACEUTI|No||||
sunitinib malate|No|No|No|No|75%|63304009227|SUNITINIB MALATE 25 MG CAPSULE|28|EA|156.42156|03/30/2022||Yes|No||03/30/2022||Yes|No|03/30/2022||Yes|No||||No|No|||Prescription required|No||548|No|356.49564|03/30/2022|351.40285|03/30/2022|334.66938|03/30/2022|||ONCOLOGY: ORAL - RENAL CELL|16367|||||No|No||SUN PHARMACEUTI|No||||
sunitinib malate|No|No|No|No|75%|63304009327|SUNITINIB MALATE 37.5 MG CAP|28|EA|234.63241|03/30/2022||Yes|No||03/30/2022||Yes|No|03/30/2022||Yes|No||||No|No|||Prescription required|No||548|No|534.74364|03/30/2022|527.10444|03/30/2022|502.00423|03/30/2022|||ONCOLOGY: ORAL - RENAL CELL|16368|||||No|No||SUN PHARMACEUTI|No||||
sunitinib malate|No|No|No|No|75%|63304009427|SUNITINIB MALATE 50 MG CAPSULE|28|EA|272.30778|03/30/2022||Yes|No||03/30/2022||Yes|No|03/30/2022||Yes|No||||No|No|||Prescription required|No||548|No|620.60844|03/30/2022|611.7426|03/30/2022|582.612|03/30/2022|||ONCOLOGY: ORAL - RENAL CELL|16369|||||No|No||SUN PHARMACEUTI|No||||
erlotinib HCl|No|No|No|No|75%|63304009530|ERLOTINIB HCL 25 MG TABLET|30|EA|8.89025|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No||551|No|20.2615|09/14/2021|19.97205|09/14/2021|19.021|09/14/2021|||ONCOLOGY: ORAL - LUNG|16370|||||No|No||SUN PHARMACEUTI|No||||
erlotinib HCl|No|No|No|No|75%|63304009630|ERLOTINIB HCL 100 MG TABLET|30|EA|23.09759|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No||551|No|52.64102|09/14/2021|51.889|09/14/2021|49.4181|09/14/2021|||ONCOLOGY: ORAL - LUNG|16371|||||No|No||SUN PHARMACEUTI|No||||
sumatriptan succinate|No|No|No|No|75%|63304009719|SUMATRIPTAN SUCC 25 MG TABLET|9|EA|.81413|12/15/2009||Yes|No||12/15/2009||Yes|No|12/15/2009||Yes|No||||No|No|||Prescription required|No||021|No|.55768|03/29/2022|.54429|03/29/2022|.54792|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|16372|||||No|No||OHM-SUN PHARMAC|No||||
sumatriptan succinate|No|No|No|No|75%|63304009819|SUMATRIPTAN SUCC 50 MG TABLET|9|EA|.7568|12/15/2009||Yes|No||12/15/2009||Yes|No|12/15/2009||Yes|No||||No|No|||Prescription required|No||021|No|.52829|03/29/2022|.51561|03/29/2022|.51904|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|16373|||||No|No||OHM-SUN PHARMAC|No||||
sumatriptan succinate|No|No|No|No|75%|63304009919|SUMATRIPTAN SUCC 100 MG TABLET|9|EA|.7568|07/24/2009||Yes|No||07/24/2009||Yes|No|07/24/2009||Yes|No||||No|No|||Prescription required|No||021|No|.54919|03/29/2022|.536|03/29/2022|.53957|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|16374|||||No|No||OHM-SUN PHARMAC|No||||
droxidopa|No|No|No|No|75%|63304010490|DROXIDOPA 200 MG CAPSULE|90|EA|.95555|09/13/2021||Yes|No||09/13/2021||Yes|No|09/13/2021||Yes|No||||No|No|||Prescription required|No|||No|2.17777|11/02/2021|2.14666|11/02/2021|2.04444|11/02/2021||||16375|||||No|No||SUN PHARMACEUTI|No||||
droxidopa|No|No|No|No|75%|63304011290|DROXIDOPA 300 MG CAPSULE|90|EA|1.43333|09/13/2021||Yes|No||09/13/2021||Yes|No|09/13/2021||Yes|No||||No|No|||Prescription required|No|||No|3.26666|11/02/2021|3.21999|11/02/2021|3.06666|11/02/2021||||16376|||||No|No||SUN PHARMACEUTI|No||||
chlorpromazine HCl|No|No|No|No|75%|63304011401|CHLORPROMAZINE 100 MG TABLET|100|EA|1.14435|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||09/22/2021||Yes|No|||Prescription required|No||027|Yes|2.03394|03/29/2022|1.98512|03/29/2022|1.99834|03/29/2022|||ANTIPSYCHOTICS|16377|||||No|No||SUN PHARMACEUTI|No||||
chlorpromazine HCl|No|No|No|No|75%|63304012201|CHLORPROMAZINE 50 MG TABLET|100|EA|.80865|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||09/22/2021||Yes|No|||Prescription required|No||027|Yes|1.74791|03/29/2022|1.70596|03/29/2022|1.71732|03/29/2022|||ANTIPSYCHOTICS|16378|||||No|No||SUN PHARMACEUTI|No||||
erlotinib HCl|No|No|No|No|75%|63304013530|ERLOTINIB HCL 150 MG TABLET|30|EA|26.16564|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No||551|No|59.63332|09/14/2021|58.78141|09/14/2021|55.9823|09/14/2021|||ONCOLOGY: ORAL - LUNG|16379|||||No|No||SUN PHARMACEUTI|No||||
chlorpromazine HCl|No|No|No|No|75%|63304014301|CHLORPROMAZINE 25 MG TABLET|100|EA|.4312|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||09/22/2021||Yes|No|||Prescription required|No||027|Yes|1.39549|03/29/2022|1.36199|03/29/2022|1.37106|03/29/2022|||ANTIPSYCHOTICS|16380|||||No|No||SUN PHARMACEUTI|No||||
bromocriptine mesylate|No|No|No|No|75%|63304015801|BROMOCRIPTINE 5 MG CAPSULE|100|EA|1.51317|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|4.49386|11/23/2021|4.386|11/23/2021|4.41521|11/23/2021|||ANTIPARKINSON'S AGENTS|16381|||||No|No||RANBAXY/SUN PHA|No||||
bromocriptine mesylate|No|No|No|No|75%|63304015830|BROMOCRIPTINE 5 MG CAPSULE|30|EA|1.59673|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|4.49386|11/23/2021|4.386|11/23/2021|4.41521|11/23/2021|||ANTIPARKINSON'S AGENTS|16382|||||No|No||RANBAXY/SUN PHA|No||||
mesalamine|No|No|No|No|75%|63304017513|MESALAMINE DR 1.2 GM TABLET|120|EA|1.9117|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|010|No|2.75392|03/29/2022|2.68782|03/29/2022|2.70572|03/29/2022|||ULCERATIVE COLITIS AGENTS|16383|||||No|No||SUN PHARMACEUTI|No||||
desvenlafaxine|No|No|No|No|75%|63304019130|DESVENLAFAXINE ER 50 MG TAB|30|EA|1.99677|05/17/2013||Yes|No||05/17/2013||Yes|No|05/17/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|4.17693|06/29/2021|4.07668|06/29/2021|4.10383|06/29/2021|||ANTIDEPRESSANTS: OTHER|16384|||||No|No||RANBAXY/SUN PHA|No||||
desvenlafaxine|No|No|No|No|75%|63304019230|DESVENLAFAXINE ER 100 MG TAB|30|EA|1.99677|05/17/2013||Yes|No||05/17/2013||Yes|No|05/17/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|4.24993|08/24/2021|4.14793|08/24/2021|4.17555|08/24/2021|||ANTIDEPRESSANTS: OTHER|16385|||||No|No||RANBAXY/SUN PHA|No||||
calcitriol|No|No|No|No|75%|63304023930|CALCITRIOL 0.25 MCG CAPSULE|30|EA|.4171|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No|||No|.18695|03/29/2022|.18246|03/29/2022|.18367|03/29/2022||||16386|||||No|No||RANBAXY/SUN PHA|No||||
calcitriol|No|No|No|No|75%|63304024001|CALCITRIOL 0.5 MCG CAPSULE|100|EA|.65691|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No|||No|.32158|03/29/2022|.31386|03/29/2022|.31595|03/29/2022||||16387|||||No|No||RANBAXY/SUN PHA|No||||
calcitriol|No|No|No|No|75%|63304024159|CALCITRIOL 1 MCG/ML SOLUTION|15|ML|3.89981|08/23/2013||Yes|No||08/23/2013||Yes|No|08/23/2013||Yes|No||||No|No|||Prescription required|No|||No|4.45307|03/29/2022|4.34619|03/29/2022|4.37514|03/29/2022||||16388|||||No|No||RANBAXY/SUN PHA|No||||
hydroxychloroquine sulfate|No|No|No|No|75%|63304029601|HYDROXYCHLOROQUINE 200 MG TAB|100|EA|.23435|04/14/2008||Yes|No||04/14/2008||Yes|No|04/14/2008||Yes|No||||No|No|||Prescription required|No|||No|.23831|03/29/2022|.23259|03/29/2022|.23413|03/29/2022||||16389|||||No|No||RANBAXY/SUN PHA|No||||
hydroxychloroquine sulfate|No|No|No|No|75%|63304029605|HYDROXYCHLOROQUINE 200 MG TAB|500|EA|.22263|04/14/2008||Yes|No||04/14/2008||Yes|No|04/14/2008||Yes|No||||No|No|||Prescription required|No|||No|.23831|03/29/2022|.23259|03/29/2022|.23413|03/29/2022||||16390|||||No|No||RANBAXY/SUN PHA|No||||
fenofibrate nanocrystallized|No|No|No|No|75%|63304044890|FENOFIBRATE 48 MG TABLET|90|EA|.15336|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||||No|No|||Prescription required|No||055|No|.11999|03/29/2022|.11711|03/29/2022|.11789|03/29/2022|||LIPOTROPICS: OTHER|16391|||||No|No||SUN PHARMACEUTI|No||||
fenofibrate nanocrystallized|No|No|No|No|75%|63304044905|FENOFIBRATE 145 MG TABLET|500|EA|.28007|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||||No|No|||Prescription required|No||055|No|.16424|03/29/2022|.16029|03/29/2022|.16136|03/29/2022|||LIPOTROPICS: OTHER|16392|||||No|No||SUN PHARMACEUTI|No||||
fenofibrate nanocrystallized|No|No|No|No|75%|63304044990|FENOFIBRATE 145 MG TABLET|90|EA|.28007|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||||No|No|||Prescription required|No||055|No|.16424|03/29/2022|.16029|03/29/2022|.16136|03/29/2022|||LIPOTROPICS: OTHER|16393|||||No|No||SUN PHARMACEUTI|No||||
morphine sulfate|No|No|No|No|90%|63304045001|MORPHINE SULF ER 15 MG TABLET|100|EA|.12934|12/17/2020||Yes|No||12/17/2020||Yes|No|12/17/2020||Yes|No||||No|No|||Prescription required|No||110|Yes|.19105|03/29/2022|.18646|03/29/2022|.1877|03/29/2022|||ANALGESICS: NARCOTICS LONG|16394|||||No|No||RANBAXY/SUN PHA|No||||
morphine sulfate|No|No|No|No|90%|63304045101|MORPHINE SULF ER 30 MG TABLET|100|EA|.24578|12/17/2020||Yes|No||12/17/2020||Yes|No|12/17/2020||Yes|No||||No|No|||Prescription required|No||110|Yes|.34621|03/29/2022|.3379|03/29/2022|.34015|03/29/2022|||ANALGESICS: NARCOTICS LONG|16395|||||No|No||RANBAXY/SUN PHA|No||||
morphine sulfate|No|No|No|No|90%|63304045201|MORPHINE SULF ER 100 MG TABLET|100|EA|.70872|12/17/2020||Yes|No||12/17/2020||Yes|No|12/17/2020||Yes|No||||No|No|||Prescription required|No||110|Yes|1.04927|03/29/2022|1.02408|03/29/2022|1.0309|03/29/2022|||ANALGESICS: NARCOTICS LONG|16396|||||No|No||RANBAXY/SUN PHA|No||||
morphine sulfate|No|No|No|No|90%|63304045301|MORPHINE SULF ER 200 MG TABLET|100|EA|1.28888|12/17/2020||Yes|No||12/17/2020||Yes|No|12/17/2020||Yes|No||||No|No|||Prescription required|No||110|Yes|2.54414|07/27/2021|2.48308|07/27/2021|2.49961|07/27/2021|||ANALGESICS: NARCOTICS LONG|16397|||||No|No||RANBAXY/SUN PHA|No||||
ondansetron HCl|No|No|No|No|75%|63304045830|ONDANSETRON HCL 4 MG TABLET|30|EA|.19063|01/09/2013||Yes|No||01/09/2013||Yes|No|01/09/2013||Yes|No||||No|No|||Prescription required|No||085|No|.06763|03/29/2022|.066|03/29/2022|.06644|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|16398|||||No|No||RANBAXY/SUN PHA|No||||
ondansetron HCl|No|No|No|No|75%|63304045930|ONDANSETRON HCL 8 MG TABLET|30|EA|.22876|01/09/2013||Yes|No||01/09/2013||Yes|No|01/09/2013||Yes|No||||No|No|||Prescription required|No||085|No|.09975|03/29/2022|.09735|03/29/2022|.098|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|16399|||||No|No||RANBAXY/SUN PHA|No||||
chloroquine phosphate|No|No|No|No|75%|63304046050|CHLOROQUINE PH 250 MG TABLET|50|EA|.5504|08/05/2011||Yes|No||08/05/2011||Yes|No|08/05/2011||Yes|No||||No|No|||Prescription required|No|||No|1.2544|06/01/2016|1.23648|06/01/2016|1.1776|06/01/2016||||16400|||||No|No||RANBAXY/SUN PHA|No||||
chloroquine phosphate|No|No|No|No|75%|63304046126|CHLOROQUINE PH 500 MG TABLET|25|EA|1.4448|08/05/2011||Yes|No||08/05/2011||Yes|No|08/05/2011||Yes|No||||No|No|||Prescription required|No|||No|3.2928|06/25/2019|3.24576|06/25/2019|3.0912|06/25/2019||||16401|||||No|No||RANBAXY/SUN PHA|No||||
cevimeline HCl|No|No|No|No|75%|63304047901|CEVIMELINE HCL 30 MG CAPSULE|100|EA|1.11112|01/08/2013||Yes|No||01/08/2013||Yes|No|01/08/2013||Yes|No||||No|No|||Prescription required|No|||No|.81662|03/29/2022|.79702|03/29/2022|.80232|03/29/2022||||16402|||||No|No||RANBAXY/SUN PHA|No||||
allopurinol|No|No|No|No|75%|63304053901|ALLOPURINOL 100 MG TABLET|100|EA|.02248|12/09/2013||Yes|No||12/09/2013||Yes|No|12/09/2013||Yes|No||12/09/2013||Yes|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|16403|||||No|No||RANBAXY/SUN PHA|No||||
allopurinol|No|No|No|No|75%|63304053910|ALLOPURINOL 100 MG TABLET|1000|EA|.02024|12/09/2013||Yes|No||12/09/2013||Yes|No|12/09/2013||Yes|No||12/09/2013||Yes|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|16404|||||No|No||RANBAXY/SUN PHA|No||||
allopurinol|No|No|No|No|75%|63304054001|ALLOPURINOL 300 MG TABLET|100|EA|.04725|12/09/2013||Yes|No||12/09/2013||Yes|No|12/09/2013||Yes|No||12/09/2013||Yes|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|16405|||||No|No||RANBAXY/SUN PHA|No||||
allopurinol|No|No|No|No|75%|63304054005|ALLOPURINOL 300 MG TABLET|500|EA|.04483|12/09/2013||Yes|No||12/09/2013||Yes|No|12/09/2013||Yes|No||12/09/2013||Yes|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|16406|||||No|No||RANBAXY/SUN PHA|No||||
metoprolol tartrate|No|No|No|No|75%|63304057901|METOPROLOL TARTRATE 25 MG TAB|100|EA|.01397|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No||070|No|.01777|03/29/2022|.01734|03/29/2022|.01745|03/29/2022|||BETA-BLOCKERS|16407|||||No|No||RANBAXY/SUN PHA|No||||
metoprolol tartrate|No|No|No|No|75%|63304057910|METOPROLOL TARTRATE 25 MG TAB|1000|EA|.01355|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No||070|No|.01777|03/29/2022|.01734|03/29/2022|.01745|03/29/2022|||BETA-BLOCKERS|16408|||||No|No||RANBAXY/SUN PHA|No||||
metoprolol tartrate|No|No|No|No|75%|63304058001|METOPROLOL TARTRATE 50 MG TAB|100|EA|.01431|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No||070|No|.02252|03/29/2022|.02197|03/29/2022|.02212|03/29/2022|||BETA-BLOCKERS|16409|||||No|No||RANBAXY/SUN PHA|No||||
metoprolol tartrate|No|No|No|No|75%|63304058010|METOPROLOL TARTRATE 50 MG TAB|1000|EA|.0114|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No||070|No|.02252|03/29/2022|.02197|03/29/2022|.02212|03/29/2022|||BETA-BLOCKERS|16410|||||No|No||RANBAXY/SUN PHA|No||||
metoprolol tartrate|No|No|No|No|75%|63304058101|METOPROLOL TARTRATE 100 MG TAB|100|EA|.01978|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No||070|No|.03443|03/29/2022|.0336|03/29/2022|.03382|03/29/2022|||BETA-BLOCKERS|16411|||||No|No||RANBAXY/SUN PHA|No||||
metoprolol tartrate|No|No|No|No|75%|63304058110|METOPROLOL TARTRATE 100 MG TAB|1000|EA|.01692|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No||070|No|.03443|03/29/2022|.0336|03/29/2022|.03382|03/29/2022|||BETA-BLOCKERS|16412|||||No|No||RANBAXY/SUN PHA|No||||
fosamprenavir calcium|No|No|No|No|75%|63304058360|FOSAMPRENAVIR 700 MG TABLET|60|EA|9.99889|10/12/2020||Yes|No||10/12/2020||Yes|No|10/12/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|16.33153|10/12/2020|16.09822|10/12/2020|15.33164|10/12/2020|||HIV / AIDS|16413|||||No|No||OHM-SUN PHARMAC|No||||
doxycycline monohydrate|No|No|No|No|75%|63304061650|DOXYCYCLINE MONO 100 MG CAP|50|EA|.36077|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||02/03/2021||Yes|No|||Prescription required|No||213|No|.25496|03/29/2022|.24884|03/29/2022|.25049|03/29/2022|||TETRACYCLINES|16414|||||No|No||RANBAXY/SUN PHA|No||||
atenolol|No|No|No|No|75%|63304062101|ATENOLOL 25 MG TABLET|100|EA|.01358|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No||070|No|.02437|03/29/2022|.02378|03/29/2022|.02394|03/29/2022|||BETA-BLOCKERS|16415|||||No|No||RANBAXY/SUN PHA|No||||
atenolol|No|No|No|No|75%|63304062110|ATENOLOL 25 MG TABLET|1000|EA|.0129|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No||070|No|.02437|03/29/2022|.02378|03/29/2022|.02394|03/29/2022|||BETA-BLOCKERS|16416|||||No|No||RANBAXY/SUN PHA|No||||
atenolol|No|No|No|No|75%|63304062201|ATENOLOL 50 MG TABLET|100|EA|.01431|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No||070|No|.02861|03/29/2022|.02792|03/29/2022|.0281|03/29/2022|||BETA-BLOCKERS|16417|||||No|No||RANBAXY/SUN PHA|No||||
atenolol|No|No|No|No|75%|63304062210|ATENOLOL 50 MG TABLET|1000|EA|.0136|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No||070|No|.02861|03/29/2022|.02792|03/29/2022|.0281|03/29/2022|||BETA-BLOCKERS|16418|||||No|No||RANBAXY/SUN PHA|No||||
atenolol|No|No|No|No|75%|63304062301|ATENOLOL 100 MG TABLET|100|EA|.01978|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No||070|No|.04816|03/29/2022|.047|03/29/2022|.04731|03/29/2022|||BETA-BLOCKERS|16419|||||No|No||RANBAXY/SUN PHA|No||||
atenolol|No|No|No|No|75%|63304062310|ATENOLOL 100 MG TABLET|1000|EA|.01879|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No||070|No|.04816|03/29/2022|.047|03/29/2022|.04731|03/29/2022|||BETA-BLOCKERS|16420|||||No|No||RANBAXY/SUN PHA|No||||
furosemide|No|No|No|No|75%|63304062401|FUROSEMIDE 20 MG TABLET|100|EA|.0147|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No|||No|.03187|03/29/2022|.0311|03/29/2022|.03131|03/29/2022||||16421|||||No|No||RANBAXY/SUN PHA|No||||
furosemide|No|No|No|No|75%|63304062410|FUROSEMIDE 20 MG TABLET|1000|EA|.00614|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No|||No|.03187|03/29/2022|.0311|03/29/2022|.03131|03/29/2022||||16422|||||No|No||RANBAXY/SUN PHA|No||||
furosemide|No|No|No|No|75%|63304062501|FUROSEMIDE 40 MG TABLET|100|EA|.01569|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No|||No|.03326|03/29/2022|.03246|03/29/2022|.03267|03/29/2022||||16423|||||No|No||RANBAXY/SUN PHA|No||||
furosemide|No|No|No|No|75%|63304062510|FUROSEMIDE 40 MG TABLET|1000|EA|.007|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No|||No|.03326|03/29/2022|.03246|03/29/2022|.03267|03/29/2022||||16424|||||No|No||RANBAXY/SUN PHA|No||||
furosemide|No|No|No|No|75%|63304062601|FUROSEMIDE 80 MG TABLET|100|EA|.02283|01/01/2010||Yes|No||01/01/2010||Yes|No|01/01/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No|||No|.06148|03/29/2022|.06|03/29/2022|.0604|03/29/2022||||16425|||||No|No||RANBAXY/SUN PHA|No||||
fluoxetine HCl|Yes|No|No|No|75%|63304063201|FLUOXETINE HCL 40 MG CAPSULE|100|EA|.21659|08/12/2009||Yes|No||08/12/2009||Yes|No|08/12/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|16426|||||No|No||RANBAXY/SUN PHA|No||||
fluoxetine HCl|Yes|No|No|No|75%|63304063230|FLUOXETINE HCL 40 MG CAPSULE|30|EA|.21657|07/20/2005||Yes|No||07/20/2005||Yes|No|07/20/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|16427|||||No|No||RANBAXY/SUN PHA|No||||
oxycodone HCl|No|No|No|No|90%|63304068301|OXYCODONE HCL ER 40 MG TABLET|100|EA|3.43802|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|5.67023|11/23/2021|5.53414|11/23/2021|5.571|11/23/2021|||ANALGESICS: NARCOTICS LONG|16428|||||No|No||RANBAXY/SUN PHA|No||||
oxycodone HCl|No|No|No|No|90%|63304068401|OXYCODONE HCL ER 80 MG TABLET|100|EA|5.99923|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|110|Yes|10.68078|12/28/2021|10.42444|12/28/2021|10.49386|12/28/2021|||ANALGESICS: NARCOTICS LONG|16429|||||No|No||RANBAXY/SUN PHA|No||||
clindamycin HCl|No|No|No|No|75%|63304069201|CLINDAMYCIN HCL 150 MG CAPSULE|100|EA|.0617|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||146|No|.12382|03/29/2022|.12084|03/29/2022|.12165|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|16430|||||No|No||RANBAXY/SUN PHA|No||||
clindamycin HCl|No|No|No|No|75%|63304069301|CLINDAMYCIN HCL 300 MG CAPSULE|100|EA|.18498|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||03/01/2002||Yes|No|||Prescription required|No||146|No|.25846|03/29/2022|.25225|03/29/2022|.25393|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|16431|||||No|No||RANBAXY/SUN PHA|No||||
diltiazem HCl|No|No|No|No|75%|63304071805|DILTIAZEM 24H ER(CD) 120 MG CP|500|EA|.32644|09/13/2021||Yes|No||09/13/2021||Yes|No|09/13/2021||Yes|No||09/13/2021||Yes|No|||Prescription required|No||045|No|.17507|03/29/2022|.17086|03/29/2022|.172|03/29/2022|||CALCIUM CHANNEL BLOCKERS|16432|||||No|No||SUN PHARMACEUTI|No||||
diltiazem HCl|No|No|No|No|75%|63304071890|DILTIAZEM 24H ER(CD) 120 MG CP|90|EA|.333|09/13/2021||Yes|No||09/13/2021||Yes|No|09/13/2021||Yes|No||09/13/2021||Yes|No|||Prescription required|No||045|No|.17507|03/29/2022|.17086|03/29/2022|.172|03/29/2022|||CALCIUM CHANNEL BLOCKERS|16433|||||No|No||SUN PHARMACEUTI|No||||
diltiazem HCl|No|No|No|No|75%|63304071905|DILTIAZEM 24H ER(CD) 180 MG CP|500|EA|.33444|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||09/14/2021||Yes|No|||Prescription required|No||045|No|.21189|03/29/2022|.2068|03/29/2022|.20818|03/29/2022|||CALCIUM CHANNEL BLOCKERS|16434|||||No|No||SUN PHARMACEUTI|No||||
diltiazem HCl|No|No|No|No|75%|63304071990|DILTIAZEM 24H ER(CD) 180 MG CP|90|EA|.33444|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||09/14/2021||Yes|No|||Prescription required|No||045|No|.21189|03/29/2022|.2068|03/29/2022|.20818|03/29/2022|||CALCIUM CHANNEL BLOCKERS|16435|||||No|No||SUN PHARMACEUTI|No||||
diltiazem HCl|No|No|No|No|75%|63304072005|DILTIAZEM 24H ER(CD) 240 MG CP|500|EA|.57023|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||09/14/2021||Yes|No|||Prescription required|No||045|No|.29728|03/29/2022|.29014|03/29/2022|.29207|03/29/2022|||CALCIUM CHANNEL BLOCKERS|16436|||||No|No||SUN PHARMACEUTI|No||||
diltiazem HCl|No|No|No|No|75%|63304072090|DILTIAZEM 24H ER(CD) 240 MG CP|90|EA|.57022|09/13/2021||Yes|No||09/13/2021||Yes|No|09/13/2021||Yes|No||09/13/2021||Yes|No|||Prescription required|No||045|No|.29728|03/29/2022|.29014|03/29/2022|.29207|03/29/2022|||CALCIUM CHANNEL BLOCKERS|16437|||||No|No||SUN PHARMACEUTI|No||||
diltiazem HCl|No|No|No|No|75%|63304072105|DILTIAZEM 24H ER(CD) 300 MG CP|500|EA|.68384|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||09/14/2021||Yes|No|||Prescription required|No||045|No|.34265|03/29/2022|.33442|03/29/2022|.33665|03/29/2022|||CALCIUM CHANNEL BLOCKERS|16438|||||No|No||SUN PHARMACEUTI|No||||
diltiazem HCl|No|No|No|No|75%|63304072190|DILTIAZEM 24H ER(CD) 300 MG CP|90|EA|.68384|09/13/2021||Yes|No||09/13/2021||Yes|No|09/13/2021||Yes|No||09/13/2021||Yes|No|||Prescription required|No||045|No|.34265|03/29/2022|.33442|03/29/2022|.33665|03/29/2022|||CALCIUM CHANNEL BLOCKERS|16439|||||No|No||SUN PHARMACEUTI|No||||
bupropion HCl|No|No|No|No|75%|63304072305|BUPROPION HCL XL 150 MG TABLET|500|EA|.129|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|16440|||||No|No||SUN PHARMACEUTI|No||||
bupropion HCl|No|No|No|No|75%|63304072330|BUPROPION HCL XL 150 MG TABLET|30|EA|.14333|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|16441|||||No|No||SUN PHARMACEUTI|No||||
bupropion HCl|No|No|No|No|75%|63304072390|BUPROPION HCL XL 150 MG TABLET|90|EA|.14333|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|16442|||||No|No||SUN PHARMACEUTI|No||||
bupropion HCl|No|No|No|No|75%|63304072405|BUPROPION HCL XL 300 MG TABLET|500|EA|.1548|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|16443|||||No|No||SUN PHARMACEUTI|No||||
bupropion HCl|No|No|No|No|75%|63304072430|BUPROPION HCL XL 300 MG TABLET|30|EA|.172|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|16444|||||No|No||SUN PHARMACEUTI|No||||
bupropion HCl|No|No|No|No|75%|63304072490|BUPROPION HCL XL 300 MG TABLET|90|EA|.172|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|16445|||||No|No||SUN PHARMACEUTI|No||||
morphine sulfate|No|No|No|No|90%|63304075801|MORPHINE SULF ER 60 MG TABLET|100|EA|.47957|12/17/2020||Yes|No||12/17/2020||Yes|No|12/17/2020||Yes|No||||No|No|||Prescription required|No||110|Yes|.55429|03/29/2022|.54098|03/29/2022|.54458|03/29/2022|||ANALGESICS: NARCOTICS LONG|16446|||||No|No||RANBAXY/SUN PHA|No||||
atorvastatin calcium|No|No|No|No|75%|63304082705|ATORVASTATIN 10 MG TABLET|500|EA|.04384|04/08/2021||Yes|No||04/08/2021||Yes|No|04/08/2021||Yes|No||04/08/2021||Yes|No|||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|16447|||||No|No||OHM-SUN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|63304082790|ATORVASTATIN 10 MG TABLET|90|EA|.0525|05/03/2021||Yes|No||05/03/2021||Yes|No|05/03/2021||Yes|No||05/03/2021||Yes|No|||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|16448|||||No|No||OHM-SUN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|63304082805|ATORVASTATIN 20 MG TABLET|500|EA|.06855|04/30/2021||Yes|No||04/30/2021||Yes|No|04/30/2021||Yes|No||04/30/2021||Yes|No|||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|16449|||||No|No||OHM-SUN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|63304082890|ATORVASTATIN 20 MG TABLET|90|EA|.06855|04/30/2021||Yes|No||04/30/2021||Yes|No|04/30/2021||Yes|No||04/30/2021||Yes|No|||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|16450|||||No|No||OHM-SUN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|63304082905|ATORVASTATIN 40 MG TABLET|500|EA|.07039|04/30/2021||Yes|No||04/30/2021||Yes|No|04/30/2021||Yes|No||04/30/2021||Yes|No|||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|16451|||||No|No||OHM-SUN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|63304082990|ATORVASTATIN 40 MG TABLET|90|EA|.07591|04/30/2021||Yes|No||04/30/2021||Yes|No|04/30/2021||Yes|No||04/30/2021||Yes|No|||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|16452|||||No|No||OHM-SUN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|63304083005|ATORVASTATIN 80 MG TABLET|500|EA|.07039|04/30/2021||Yes|No||04/30/2021||Yes|No|04/30/2021||Yes|No||04/30/2021||Yes|No|||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|16453|||||No|No||OHM-SUN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|63304083090|ATORVASTATIN 80 MG TABLET|90|EA|.07639|05/03/2021||Yes|No||05/03/2021||Yes|No|05/03/2021||Yes|No||05/03/2021||Yes|No|||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|16454|||||No|No||OHM-SUN PHARMAC|No||||
fenofibrate|No|No|No|No|75%|63304090090|FENOFIBRATE 54 MG TABLET|90|EA|.09149|04/12/2010||Yes|No||04/12/2010||Yes|No|04/12/2010||Yes|No||||No|No|||Prescription required|No||055|No|.1459|03/29/2022|.14239|03/29/2022|.14334|03/29/2022|||LIPOTROPICS: OTHER|16455|||||No|No||RANBAXY/SUN PHA|No||||
fenofibrate|No|No|No|No|75%|63304090190|FENOFIBRATE 160 MG TABLET|90|EA|.17056|03/13/2007||Yes|No||03/13/2007||Yes|No|03/13/2007||Yes|No||||No|No|||Prescription required|No||055|No|.1612|03/29/2022|.15733|03/29/2022|.15837|03/29/2022|||LIPOTROPICS: OTHER|16456|||||No|No||RANBAXY/SUN PHA|No||||
valacyclovir HCl|No|No|No|No|75%|63304090430|VALACYCLOVIR HCL 500 MG TABLET|30|EA|.35016|12/15/2009||Yes|No||12/15/2009||Yes|No|12/15/2009||Yes|No||07/01/2012||Yes|No|||Prescription required|No||025|No|.29328|03/29/2022|.28624|03/29/2022|.28814|03/29/2022|||ANTIVIRALS: ORAL|16457|||||No|No||OHM-SUN PHARMAC|No||||
valacyclovir HCl|Yes|No|No|No|75%|63304090530|VALACYCLOVIR HCL 1 GRAM TABLET|30|EA|.55728|12/15/2009||Yes|No||12/15/2009||Yes|No|12/15/2009||Yes|No||07/01/2012||Yes|No|11/01/2012||Prescription required|No||025|No|.5737|03/29/2022|.55993|03/29/2022|.56366|03/29/2022|||ANTIVIRALS: ORAL|16458|||||No|No||OHM-SUN PHARMAC|No||||
bromocriptine mesylate|No|No|No|No|75%|63304096201|BROMOCRIPTINE 2.5 MG TABLET|100|EA|1.29159|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|1.4796|03/29/2022|1.44408|03/29/2022|1.4537|03/29/2022|||ANTIPARKINSON'S AGENTS|16459|||||No|No||RANBAXY/SUN PHA|No||||
bromocriptine mesylate|No|No|No|No|75%|63304096230|BROMOCRIPTINE 2.5 MG TABLET|30|EA|1.42315|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|1.4796|03/29/2022|1.44408|03/29/2022|1.4537|03/29/2022|||ANTIPARKINSON'S AGENTS|16460|||||No|No||RANBAXY/SUN PHA|No||||
gentamicin sulfate|No|No|No|No|75%|63323001002|GENTAMICIN 80 MG/2 ML VIAL|2|ML|.7611|01/08/2004||Yes|No||01/08/2004||Yes|No|01/08/2004||Yes|No||||No|No|||Prescription required|No|||No|.69103|08/24/2021|.67444|08/24/2021|.67893|08/24/2021||||16461|||||No|No||FRESENIUS KABI|No||||
gentamicin sulfate|No|No|No|No|75%|63323001020|GENTAMICIN 800 MG/20 ML VIAL|20|ML|.54631|05/12/2008||Yes|No||05/12/2008||Yes|No|05/12/2008||Yes|No||||No|No|||Prescription required|No|||No|1.24509|01/18/2022|1.2273|01/18/2022|1.16886|01/18/2022||||16462|||||No|No||FRESENIUS KABI|No||||
chloramphenicol sod succinate|No|No|No|No|75%|63323001115|CHLORAMPHEN NA SUCC 1 GM VL|1|EA|16.7356|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|38.1416|06/01/2016|37.59672|06/01/2016|35.8064|06/01/2016||||16463|||||No|No||APP/FRESENIUS K|No||||
chorionic gonadotropin, human|No|No|No|No|75%|63323003011|CHORIONIC GONAD 10,000 UNIT VL|1|EA|134.2675|01/17/2018||Yes|No||01/17/2018||Yes|No|01/17/2018||Yes|No||||No|No|||Prescription required|No|||No|306.005|01/17/2018|301.6335|01/23/2018|287.27|01/17/2018||||16464|||||No|No||FRESENIUS KABI|No||||
heparin sodium,porcine|No|No|No|No|75%|63323004710|HEPARIN 50,000 UNIT/10 ML VIAL|10|ML|.74777|07/15/2009||Yes|No||07/15/2009||Yes|No|07/15/2009||Yes|No||||No|No|||Prescription required|No|||No|1.70422|01/08/2019|1.67987|01/08/2019|1.59988|01/08/2019||||16465|||||No|No||FRESENIUS KABI|No||||
sodium chloride|No|No|No|No|75%|63323008861|SODIUM CHLORIDE 4 MEQ/ML VL|100|ML|.05056|09/15/2020||Yes|No||09/15/2020||Yes|No|09/15/2020||Yes|No||||No|No|||Prescription required|No|||No|.11524|09/15/2020|.1136|09/15/2020|.10819|09/15/2020||||16466|||||No|No||APP/FRESENIUS K|No||||
sodium chloride|No|No|No|No|75%|63323008863|SODIUM CHLORIDE 4 MEQ/ML VL|200|ML|.05953|09/15/2020||Yes|No||09/15/2020||Yes|No|09/15/2020||Yes|No||||No|No|||Prescription required|No|||No|.13568|09/15/2020|.13374|09/15/2020|.12737|09/15/2020||||16467|||||No|No||APP/FRESENIUS K|No||||
sodium chloride|No|No|No|No|75%|63323009330|SODIUM CHLORIDE 120 MEQ/30 ML|30|ML|.0837|09/20/2021||Yes|No||09/20/2021||Yes|No|09/20/2021||Yes|No||||No|No|||Prescription required|No|||No|.19076|09/20/2021|.18804|09/20/2021|.17908|09/20/2021||||16468|||||No|No||FRESENIUS KABI|No||||
fluorouracil|No|No|No|No|75%|63323011718|FLUOROURACIL 500 MG/10 ML VIAL|10|ML|.1075|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|No|||No|.245|09/14/2018|.2415|09/14/2018|.23|09/14/2018||||16469|||||No|No||APP/PREMIERPRO|No||||
cytarabine/PF|No|No|No|No|75%|63323012020|CYTARABINE 2 G/20 ML VIAL|20|ML|.44935|04/14/2015||Yes|No||04/14/2015||Yes|No|04/14/2015||Yes|No||||No|No|||Prescription required|No|||No|1.0241|06/01/2016|1.00947|06/01/2016|.9614|06/01/2016||||16470|||||No|No||APP/FRESENIUS K|No||||
methotrexate sodium|No|No|No|No|75%|63323012310|METHOTREXATE 250 MG/10 ML VIAL|10|ML|1.44437|04/20/2010||Yes|No||04/20/2010||Yes|No|04/20/2010||Yes|No||||No|No|||Prescription required|No|||No|3.28658|03/29/2022|3.2077|03/29/2022|3.22906|03/29/2022||||16471|||||No|No||APP/FRESENIUS K|No||||
doxycycline hyclate|No|No|No|No|75%|63323013011|DOXY 100 MG VIAL|1|EA|11.3219|12/01/2011||Yes|No||12/01/2011||Yes|No|12/01/2011||Yes|No||||No|No|||Prescription required|No|||No|25.8034|04/30/2019|25.43478|04/30/2019|24.2236|04/30/2019||||16472|||||No|No||FRESENIUS KABI|No||||
ketorolac tromethamine|No|No|No|No|75%|63323016202|KETOROLAC 60 MG/2 ML VIAL|2|ML|1.34375|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|No|||Yes|.93756|03/29/2022|.91505|03/29/2022|.92115|03/29/2022||||16473|||||No|No||FRESENIUS KABI|No||||
dexamethasone sodium phosphate|No|No|No|No|75%|63323016501|DEXAMETHASONE 4 MG/ML VIAL|1|ML|1.1309|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|2.5774|09/28/2021|2.54058|09/28/2021|2.4196|09/28/2021||||16474|||||No|No||FRESENIUS KABI|No||||
dexamethasone sodium phosphate|No|No|No|No|75%|63323016505|DEXAMETHASONE 20 MG/5 ML VIAL|5|ML|.54266|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|1.23676|05/25/2021|1.21909|05/25/2021|1.16104|05/25/2021||||16475|||||No|No||FRESENIUS KABI|No||||
dexamethasone sodium phosphate|No|No|No|No|75%|63323016530|DEXAMETHASONE 120 MG/30 ML VL|30|ML|.53291|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|1.21454|01/18/2022|1.19719|01/18/2022|1.14018|01/18/2022||||16476|||||No|No||APP/FRESENIUS K|No||||
pyridoxine HCl (vitamin B6)|No|No|No|No|75%|63323018001|PYRIDOXINE 100 MG/ML VIAL|1|ML|7.1251|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|No|||No|16.2386|04/20/2021|16.00662|04/20/2021|15.2444|04/20/2021||||16477|||||No|No||FRESENIUS KABI|No||||
folic acid|No|No|No|No|75%|63323018410|FOLIC ACID 5 MG/ML VIAL|10|ML|2.11474|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|4.81964|02/09/2021|4.75078|02/09/2021|4.52456|02/09/2021||||16478|||||No|No||APP/FRESENIUS K|No||||
water for injection,sterile|No|No|No|No|75%|63323018500|WATER FOR INJECTION VIAL|100|ML|.03302|11/03/2014||Yes|No||11/03/2014||Yes|No|11/03/2014||Yes|No||||No|No|||Prescription required|No|||No|.07526|06/01/2016|.07418|06/01/2016|.07065|06/01/2016||||16479|||||No|No||APP/FRESENIUS K|No||||
water for injection,sterile|No|No|No|No|75%|63323018505|WATER FOR INJECTION VIAL|5|ML|.23134|11/03/2014||Yes|No||11/03/2014||Yes|No|11/03/2014||Yes|No||||No|No|||Prescription required|No|||No|.52724|06/01/2016|.5197|06/01/2016|.49496|06/01/2016||||16480|||||No|No||APP/FRESENIUS K|No||||
water for injection,sterile|No|No|No|No|75%|63323018510|WATER FOR INJECTION VIAL|10|ML|.16426|11/03/2014||Yes|No||11/03/2014||Yes|No|11/03/2014||Yes|No||||No|No|||Prescription required|No|||No|.37436|01/04/2022|.36901|01/04/2022|.35144|01/04/2022||||16481|||||No|No||FRESENIUS KABI|No||||
water for injection,sterile|No|No|No|No|75%|63323018520|WATER FOR INJECTION VIAL|20|ML|.10707|11/03/2014||Yes|No||11/03/2014||Yes|No|11/03/2014||Yes|No||||No|No|||Prescription required|No|||No|.24402|01/04/2022|.24053|01/04/2022|.22908|01/04/2022||||16482|||||No|No||APP/FRESENIUS K|No||||
water for injection,sterile|No|No|No|No|75%|63323018550|WATER FOR INJECTION VIAL|50|ML|.05555|11/03/2014||Yes|No||11/03/2014||Yes|No|11/03/2014||Yes|No||||No|No|||Prescription required|No|||No|.12661|01/04/2022|.1248|01/04/2022|.11886|01/04/2022||||16483|||||No|No||APP/FRESENIUS K|No||||
0.9 % sodium chloride|No|No|No|No|75%|63323018620|SODIUM CHLORIDE 0.9% VIAL|20|ML|.03418|||No|No||||No|No|09/23/1999||Yes|No||||No|No|||Prescription required|No|||No|.07791|01/04/2022|.07679|01/04/2022|.07314|01/04/2022||||16484|||||No|No||FRESENIUS KABI|No||||
sodium chloride|No|No|No|No|75%|63323018730|SODIUM CHLORIDE 4 MEQ/ML VL|30|ML|.0837|01/03/2012|06/09/2022|Yes|No||01/03/2012|06/09/2022|Yes|No|01/03/2012|06/09/2022|Yes|No||||No|No|||Prescription required|No|||No|.19076|06/22/2021|.18804|06/22/2021|.17908|06/22/2021||||16485|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||APP/FRESENIUS K|No||||
lidocaine HCl|No|No|No|No|75%|63323020110|LIDOCAINE HCL 1% VIAL|10|ML|.09116|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.20776|10/04/2016|.20479|10/04/2016|.19504|10/04/2016||||16486|||||No|No||APP/FRESENIUS K|No||||
lidocaine HCl/PF|No|No|No|No|75%|63323020805|LIDOCAINE HCL 2% VIAL|5|ML|.25714|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.58604|01/18/2022|.57766|01/18/2022|.55016|01/18/2022||||16487|||||No|No||APP/FRESENIUS K|No||||
vancomycin HCl|No|No|No|No|75%|63323022138|VANCOMYCIN 500 MG VIAL|1|EA|3.01|08/31/2018||Yes|No||08/31/2018||Yes|No|08/31/2018||Yes|No||||No|No|||Prescription required|No|||No|6.86|09/04/2018|6.762|08/31/2018|6.44|08/31/2018||||16488|||||No|No||FRESENIUS KABI|No||||
vancomycin HCl|No|No|No|No|75%|63323022148|VANCOMYCIN 500 MG VIAL|1|EA|1.0621|08/31/2018|04/30/2022|Yes|No||08/31/2018|04/30/2022|Yes|No|08/31/2018|04/30/2022|Yes|No||||No|No|||Prescription required|No|||No|2.4206|09/18/2018|2.38602|09/18/2018|2.2724|09/18/2018||||16489|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||FRESENIUS KABI|No||||
protamine sulfate|No|No|No|No|75%|63323022905|PROTAMINE 10 MG/ML VIAL|5|ML|1.15756|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|2.63816|01/04/2022|2.60047|01/04/2022|2.47664|01/04/2022||||16490|||||No|No||APP/FRESENIUS K|No||||
protamine sulfate|No|No|No|No|75%|63323022930|PROTAMINE 10 MG/ML VIAL|25|ML|.69419|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|1.58211|01/04/2022|1.55951|01/04/2022|1.48524|01/04/2022||||16491|||||No|No||APP/FRESENIUS K|No||||
cefazolin sodium|No|No|No|No|75%|63323023710|CEFAZOLIN 1 GM VIAL|1|EA|.6837|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|1.5582|06/28/2016|1.53594|06/28/2016|1.4628|06/28/2016||||16492|||||No|No||APP/FRESENIUS K|No||||
cefazolin sodium|No|No|No|No|75%|63323023861|CEFAZOLIN 10 GM VIAL|1|EA|4.9235|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|11.221|06/01/2016|11.0607|06/01/2016|10.534|06/01/2016||||16493|||||No|No||APP/FRESENIUS K|No||||
methylprednisolone sod succ|No|No|No|No|75%|63323026530|METHYLPREDNISOLONE SS 1 GM VL|1|EA|14.7146|03/11/2008||Yes|No||03/11/2008||Yes|No|03/11/2008||Yes|No||||No|No|||Prescription required|No|||No|33.5356|06/01/2016|33.05652|06/01/2016|31.4824|06/01/2016||||16494|||||No|No||APP/FRESENIUS K|No||||
fluphenazine decanoate|No|No|No|No|75%|63323027205|FLUPHENAZINE DEC 125 MG/5 ML|5|ML|13.32742|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|027|No|15.04031|03/29/2022|14.67934|03/29/2022|14.7771|03/29/2022|||ANTIPSYCHOTICS|16495|||||No|No||APP/FRESENIUS K|No||||
heparin sodium,porcine/PF|No|No|No|No|75%|63323027602|HEPARIN 2,000 UNIT/2 ML VIAL|2|ML|2.83585|07/15/2009||Yes|No||07/15/2009||Yes|No|07/15/2009||Yes|No||||No|No|||Prescription required|No|||No|6.4631|06/01/2016|6.37077|06/01/2016|6.0674|06/01/2016||||16496|||||No|No||FRESENIUS KABI|No||||
vinblastine sulfate|No|No|No|No|75%|63323027810|VINBLASTINE 1 MG/ML VIAL|10|ML|2.02788|11/08/2010||Yes|No||11/08/2010||Yes|No|11/08/2010||Yes|No||||No|No|||Prescription required|No|||No|4.62168|02/09/2021|4.55565|02/09/2021|4.33872|02/09/2021||||16497|||||No|No||APP/FRESENIUS K|No||||
fluphenazine HCl|No|No|No|No|75%|63323028110|FLUPHENAZINE 2.5 MG/ML VIAL|10|ML|8.25901|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|Yes|18.82286|02/09/2021|18.55396|02/09/2021|17.67044|02/09/2021|||ANTIPSYCHOTICS|16498|||||No|No||APP/FRESENIUS K|No||||
vancomycin HCl|No|No|No|No|75%|63323028420|VANCOMYCIN 1 GM VIAL|1|EA|6.837|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|15.582|02/23/2021|15.3594|02/23/2021|14.628|02/23/2021||||16499|||||No|No||FRESENIUS KABI|No||||
vancomycin HCl|No|No|No|No|75%|63323029561|VANCOMYCIN HCL 5 GM VIAL|1|EA|34.185|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|77.91|01/02/2018|76.797|01/02/2018|73.14|01/02/2018||||16500|||||No|No||APP/FRESENIUS K|No||||
tobramycin sulfate|No|No|No|No|75%|63323030502|TOBRAMYCIN 10 MG/ML VIAL|2|ML|1.1352|01/18/2012||Yes|No||01/18/2012||Yes|No|01/18/2012||Yes|No||||No|No|||Prescription required|No|||No|2.5872|09/10/2019|2.55024|09/10/2019|2.4288|09/10/2019||||16501|||||No|No||APP/FRESENIUS K|No||||
tobramycin sulfate|No|No|No|No|75%|63323030602|TOBRAMYCIN 40 MG/ML VIAL|2|ML|.72885|01/18/2012||Yes|No||01/18/2012||Yes|No|01/18/2012||Yes|No||||No|No|||Prescription required|No|||No|.84952|08/24/2021|.82913|08/24/2021|.83465|08/24/2021||||16502|||||No|No||APP/FRESENIUS K|No||||
tobramycin sulfate|No|No|No|No|75%|63323030630|TOBRAMYCIN 40 MG/ML VIAL|30|ML|.31533|01/18/2012||Yes|No||01/18/2012||Yes|No|01/18/2012||Yes|No||||No|No|||Prescription required|No|||No|.71866|06/01/2016|.70839|06/01/2016|.67466|06/01/2016||||16503|||||No|No||APP/FRESENIUS K|No||||
tobramycin sulfate|No|No|No|No|75%|63323030751|TOBRAMYCIN 40 MG/ML VIAL|50|ML|.41151|01/18/2012||Yes|No||01/18/2012||Yes|No|01/18/2012||Yes|No||||No|No|||Prescription required|No|||No|.84952|08/24/2021|.82913|08/24/2021|.83465|08/24/2021||||16504|||||No|No||APP/FRESENIUS K|No||||
daptomycin|No|No|No|No|75%|63323037110|DAPTOMYCIN 500 MG VIAL|1|EA|191.5564|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|No|||No|436.5704|09/14/2018|430.33368|09/14/2018|409.8416|09/14/2018||||16505|||||No|No||FRESENIUS KABI|No||||
daptomycin|No|No|No|No|75%|63323037119|DAPTOMYCIN 500 MG VIAL|1|EA|10.75|09/14/2018||Yes|No||09/14/2018||Yes|No|09/14/2018||Yes|No||||No|No|||Prescription required|No|||No|24.5|08/31/2021|24.15|08/31/2021|23|08/31/2021||||16506|||||No|No||FRESENIUS KABI/|No||||
octreotide acetate|No|No|No|No|75%|63323037601|OCTREOTIDE ACET 100 MCG/ML VL|1|ML|4.2742|01/03/2012||Yes|No||01/03/2012||Yes|No|01/03/2012||Yes|No||||No|No|||Prescription required|No|||No|9.7412|06/01/2016|9.60204|06/01/2016|9.1448|06/01/2016||||16507|||||No|No||APP/FRESENIUS K|No||||
octreotide acetate|No|No|No|No|75%|63323037701|OCTREOTIDE ACET 500 MCG/ML VL|1|ML|21.3667|01/03/2012||Yes|No||01/03/2012||Yes|No|01/03/2012||Yes|No||||No|No|||Prescription required|No|||No|48.6962|06/01/2016|48.00054|06/01/2016|45.7148|06/01/2016||||16508|||||No|No||APP/FRESENIUS K|No||||
octreotide acetate|No|No|No|No|75%|63323037805|OCTREOTIDE ACET 200 MCG/ML VL|5|ML|8.54668|01/03/2012||Yes|No||01/03/2012||Yes|No|01/03/2012||Yes|No||||No|No|||Prescription required|No|||No|19.47848|01/26/2021|19.20021|01/26/2021|18.28592|01/26/2021||||16509|||||No|No||APP/FRESENIUS K|No||||
octreotide acetate|No|No|No|No|75%|63323037905|OCTREOTIDE 1,000 MCG/ML VIAL|5|ML|42.73168|01/03/2012||Yes|No||01/03/2012||Yes|No|01/03/2012||Yes|No||||No|No|||Prescription required|No|||No|97.38848|11/28/2017|95.99721|11/28/2017|91.42592|11/28/2017||||16510|||||No|No||APP/FRESENIUS K|No||||
colistin (colistimethate Na)|No|No|No|No|75%|63323039306|COLISTIMETHATE 150 MG VIAL|1|EA|12.0357|12/15/2017||Yes|No||12/15/2017||Yes|No|12/15/2017||Yes|No||||No|No|||Prescription required|No|||No|27.4302|12/15/2017|27.03834|12/19/2017|25.7508|12/19/2017||||16511|||||No|No||APP/FRESENIUS K|No||||
azithromycin|No|No|No|No|75%|63323039810|AZITHROMYCIN I.V. 500 MG VIAL|1|EA|3.1949|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No|||No|7.2814|08/30/2018|7.17738|09/04/2018|6.8356|08/30/2018||||16512|||||No|No||FRESENIUS KABI|No||||
azithromycin|No|No|No|No|75%|63323039814|AZITHROMYCIN I.V. 500 MG VIAL|1|EA|1.505|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No|||No|3.43|01/08/2019|3.381|01/08/2019|3.22|01/08/2019||||16513|||||No|No||FRESENIUS KABI|No||||
aztreonam|No|No|No|No|75%|63323040120|AZTREONAM 1 GM VIAL|1|EA|15.5144|12/12/2011||Yes|No||12/12/2011||Yes|No|12/12/2011||Yes|No||||No|No|||Prescription required|No|||No|35.3584|02/23/2021|34.85328|02/23/2021|33.1936|02/23/2021||||16514|||||No|No||FRESENIUS KABI|No||||
aztreonam|No|No|No|No|75%|63323040220|AZTREONAM 2 GM VIAL|1|EA|31.5233|12/12/2011||Yes|No||12/12/2011||Yes|No|12/12/2011||Yes|No||||No|No|||Prescription required|No|||No|71.8438|02/23/2021|70.81746|02/23/2021|67.4452|02/23/2021||||16515|||||No|No||FRESENIUS KABI|No||||
haloperidol decanoate|No|No|No|No|75%|63323046901|HALOPERIDOL DEC 50 MG/ML VIAL|1|ML|12.0744|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|No|27.5184|03/01/2022|27.12528|03/01/2022|25.8336|03/01/2022|||ANTIPSYCHOTICS|16516|||||No|No||APP/FRESENIUS K|No||||
haloperidol decanoate|No|No|No|No|75%|63323046905|HALOPERIDOL DEC 50 MG/ML VIAL|5|ML|12.0744|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|No|27.5184|06/01/2016|27.12528|06/01/2016|25.8336|06/01/2016|||ANTIPSYCHOTICS|16517|||||No|No||APP/FRESENIUS K|No||||
haloperidol decanoate|No|No|No|No|75%|63323047101|HALOPERIDOL DEC 100 MG/ML VIAL|1|ML|22.1364|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|No|18.535|03/29/2022|18.09016|03/29/2022|18.21063|03/29/2022|||ANTIPSYCHOTICS|16518|||||No|No||APP/FRESENIUS K|No||||
haloperidol decanoate|No|No|No|No|75%|63323047105|HALOPERIDOL DEC 100 MG/ML VIAL|5|ML|22.1364|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No||027|No|29.246|03/29/2022|28.54409|03/29/2022|28.73419|03/29/2022|||ANTIPSYCHOTICS|16519|||||No|No||APP/FRESENIUS K|No||||
haloperidol lactate|No|No|No|No|75%|63323047410|HALOPERIDOL LAC 5 MG/ML VIAL|10|ML|2.4725|08/18/2011||Yes|No||08/18/2011||Yes|No|08/18/2011||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|027|Yes|5.635|06/01/2016|5.5545|06/01/2016|5.29|06/01/2016|||ANTIPSYCHOTICS|16520|||||No|No||APP/FRESENIUS K|No||||
heparin sodium,porcine|No|No|No|No|75%|63323054015|HEPARIN 10,000 UNIT/10 ML VIAL|10|ML|.31261|10/28/2021||Yes|No||10/28/2021||Yes|No|10/28/2021||Yes|No||||No|No|||Prescription required|No|||No|.71246|10/28/2021|.70228|10/28/2021|.66884|10/28/2021||||16521|||||No|No||FRESENIUS KABI|No||||
heparin sodium,porcine|No|No|No|No|75%|63323054036|HEPARIN 30,000 UNIT/30 ML VIAL|30|ML|.10219|10/28/2021||Yes|No||10/28/2021||Yes|No|10/28/2021||Yes|No||||No|No|||Prescription required|No|||No|.2329|10/28/2021|.22957|10/28/2021|.21864|10/28/2021||||16522|||||No|No||FRESENIUS KABI|No||||
icatibant acetate|No|No|No|No|75%|63323057486|ICATIBANT 30 MG/3 ML SYRINGE|3|ML|728.6006|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No||501|No|1660.5316|04/14/2021|1636.80972|04/14/2021|1558.8664|04/14/2021|||HAE TREATMENTS|16523|||||No|No||FRESENIUS KABI|No||||
icatibant acetate|No|No|No|No|75%|63323057493|ICATIBANT 30 MG/3 ML SYRINGE|3|ML|728.6006|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No||501|No|1660.5316|04/14/2021|1636.80972|04/14/2021|1558.8664|04/14/2021|||HAE TREATMENTS|16524|||||No|No||FRESENIUS KABI|No||||
glucagon HCl|No|No|No|No|75%|63323058282|GLUCAGON 1 MG EMERGENCY KIT|1|EA|120.314|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|583|No|210.016|08/24/2021|204.97561|08/24/2021|206.34072|08/24/2021|||GLUCAGON AGENTS|16525|||||No|No||FRESENIUS KABI|No||||
glucagon HCl|No|No|No|No|75%|63323059403|GLUCAGON 1 MG VIAL|1|EA|69.66|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|No|||No|158.76|12/03/2020|156.492|12/03/2020|149.04|12/03/2020||||16526|||||No|No||FRESENIUS KABI/|No||||
deferoxamine mesylate|No|No|No|No|75%|63323059710|DEFEROXAMINE 500 MG VIAL|1|EA|5.5685|04/21/2010||Yes|No||04/21/2010||Yes|No|04/21/2010||Yes|No||||No|No|||Prescription required|No|||No|12.691|06/01/2016|12.5097|06/01/2016|11.914|06/01/2016||||16527|||||No|No||APP/FRESENIUS K|No||||
deferoxamine mesylate|No|No|No|No|75%|63323059930|DEFEROXAMINE 2 GRAM VIAL|1|EA|17.716|04/21/2010||Yes|No||04/21/2010||Yes|No|04/21/2010||Yes|No||||No|No|||Prescription required|No|||No|40.376|06/01/2016|39.7992|06/01/2016|37.904|06/01/2016||||16528|||||No|No||APP/FRESENIUS K|No||||
hydralazine HCl|No|No|No|No|75%|63323061401|HYDRALAZINE 20 MG/ML VIAL|1|ML|6.1576|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|14.0336|01/04/2022|13.83312|01/04/2022|13.1744|01/04/2022||||16529|||||No|No||FRESENIUS KABI|No||||
dextrose 5 % in water|No|No|No|No|75%|63323062410|DEXTROSE 5%-WATER IV SOLN|1000|ML|.00167|08/14/2018||Yes|No||08/14/2018||Yes|No|08/14/2018||Yes|No||||No|No|||Prescription required|No|||No|.00382|08/14/2018|.00376|08/14/2018|.00358|08/14/2018||||16530|||||No|No||FRESENIUS KABI|No||||
terbutaline sulfate|No|No|No|No|75%|63323066501|TERBUTALINE SULF 1 MG/ML VIAL|1|ML|7.7357|03/31/2008||Yes|No||03/31/2008||Yes|No|03/31/2008||Yes|No||||No|No|||Prescription required|No|||No|17.6302|06/01/2016|17.37834|06/01/2016|16.5508|06/01/2016||||16531|||||No|No||APP/FRESENIUS K|No||||
acetylcysteine|No|No|No|No|75%|63323069210|ACETYLCYSTEINE 20% VIAL|10|ML|.52245|03/25/2022||Yes|No||03/25/2022||Yes|No|03/25/2022||Yes|No||||No|No|||Prescription required|No|||No|1.1907|03/01/2022|1.17369|03/01/2022|1.1178|03/01/2022||||16532|||||No|No||APP/FRESENIUS K|No||||
linezolid in dextrose 5%|No|No|No|No|75%|63323071313|LINEZOLID 600 MG/300 ML-D5W|300|ML|.05733|02/27/2018||Yes|No||02/27/2018||Yes|No|02/27/2018||Yes|No||||No|No|||Prescription required|No||146|No|.13066|09/29/2020|.12879|09/29/2020|.12266|09/29/2020|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|16533|||||No|No||FRESENIUS KABI|No||||
micafungin sodium|No|No|No|No|75%|63323072801|MICAFUNGIN 50 MG VIAL|1|EA||09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|No|||No|||||||91.63|09/23/2020||16534|||||No|No||FRESENIUS KABI|No||||
micafungin sodium|No|No|No|No|75%|63323072810|MICAFUNGIN 50 MG VIAL|1|EA|40.205|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|No|||No|91.63|09/23/2020|90.321|09/23/2020|86.02|09/23/2020||||16535|||||No|No||FRESENIUS KABI|No||||
micafungin sodium|No|No|No|No|75%|63323072901|MICAFUNGIN 100 MG VIAL|1|EA||09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|No|||No|||||||183.26|09/23/2020||16536|||||No|No||FRESENIUS KABI|No||||
micafungin sodium|No|No|No|No|75%|63323072910|MICAFUNGIN 100 MG VIAL|1|EA|80.41|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|No|||No|183.26|09/23/2020|180.642|09/23/2020|172.04|09/23/2020||||16537|||||No|No||FRESENIUS KABI|No||||
azacitidine|No|No|No|No|75%|63323077139|AZACITIDINE 100 MG VIAL|1|EA|133.8504|03/02/2018||Yes|No||03/02/2018||Yes|No|03/02/2018||Yes|No||||No|No|||Prescription required|No|||No|305.0544|03/02/2018|300.69648|03/06/2018|286.3776|03/02/2018||||16538|||||No|No||FRESENIUS KABI|No||||
amikacin sulfate|No|No|No|No|75%|63323081502|AMIKACIN SULF 500 MG/2 ML VIAL|2|ML|2.50475|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|No|||No|5.7085|06/04/2018|5.62695|06/04/2018|5.359|06/04/2018||||16539|||||No|No||FRESENIUS KABI|No||||
ertapenem sodium|No|No|No|No|75%|63323082301|ERTAPENEM 1 GRAM VIAL|1|EA||05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No|||No|||||||126.08|05/21/2020||16540|||||No|No||FRESENIUS KABI|No||||
ertapenem sodium|No|No|No|No|75%|63323082320|ERTAPENEM 1 GRAM VIAL|1|EA|55.3238|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No|||No|126.0868|05/21/2020|124.28556|05/26/2020|118.3672|05/21/2020||||16541|||||No|No||FRESENIUS KABI|No||||
daptomycin|No|No|No|No|75%|63323087115|DAPTOMYCIN 500 MG VIAL|1|EA|191.5564|07/03/2017||Yes|No||07/03/2017||Yes|No|07/03/2017||Yes|No||||No|No|||Prescription required|No|||No|436.5704|04/17/2018|430.33368|04/17/2018|409.8416|04/17/2018||||16542|||||No|No||FRESENIUS KABI|No||||
pentamidine isethionate|No|No|No|No|75%|63323087715|NEBUPENT 300 MG INHAL POWDER|1|EA|71.7627|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|163.5522|06/01/2016|161.21574|06/01/2016|153.5388|06/01/2016||||16543|||||No|No||APP/FRESENIUS K|No||||
levothyroxine sodium|No|No|No|No|75%|63323088510|LEVOTHYROXINE 100 MCG/5 ML VL|5|ML|9.53396|10/26/2020||Yes|No||10/26/2020||Yes|No|10/26/2020||Yes|No||||No|No|||Prescription required|No|||No|21.72856|10/26/2020|21.41815|10/26/2020|20.39824|10/26/2020||||16544|||||No|No||FRESENIUS KABI|No||||
levothyroxine sodium|No|No|No|No|75%|63323089010|LEVOTHYROXINE 200 MCG/5 ML VL|5|ML|19.06792|10/26/2020||Yes|No||10/26/2020||Yes|No|10/26/2020||Yes|No||||No|No|||Prescription required|No|||No|43.45712|10/26/2020|42.8363|10/26/2020|40.79648|10/26/2020||||16545|||||No|No||FRESENIUS KABI|No||||
levothyroxine sodium|No|No|No|No|75%|63323089510|LEVOTHYROXINE 500 MCG/5 ML VL|5|ML|47.67066|10/26/2020||Yes|No||10/26/2020||Yes|No|10/26/2020||Yes|No||||No|No|||Prescription required|No|||No|108.64476|11/03/2020|107.09269|10/26/2020|101.99304|10/26/2020||||16546|||||No|No||FRESENIUS KABI|No||||
bacteriostatic sodium chloride|No|No|No|No|75%|63323092410|BACTERIOSTATIC SALINE VIAL|10|ML|.03053|03/01/2002||Yes|Yes||03/01/2002||Yes|Yes|03/01/2002||Yes|Yes||||No|No|||Prescription required|No|||No|.06958|06/01/2016|.06858|06/01/2016|.06532|06/01/2016||||16547|||||No|No||FRESENIUS KABI|No||||
tigecycline|No|No|No|No|75%|63323096010|TIGECYCLINE 50 MG VIAL|1|EA|67.08|06/19/2017||Yes|No||06/19/2017||Yes|No|06/19/2017||Yes|No||||No|No|||Prescription required|No|||No|152.88|06/19/2017|150.696|06/19/2017|143.52|06/19/2017||||16548|||||No|No||FRESENIUS KABI|No||||
potassium chloride|No|No|No|No|75%|63323096510|POTASSIUM CL 20 MEQ/10 ML CONC|10|ML|.07525|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.1715|01/08/2019|.16905|01/08/2019|.161|01/08/2019||||16549|||||No|No||FRESENIUS KABI|No||||
potassium chloride|No|No|No|No|75%|63323096520|POTASSIUM CL 40 MEQ/20 ML CONC|20|ML|.043|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.098|01/08/2019|.0966|01/08/2019|.092|01/08/2019||||16550|||||No|No||FRESENIUS KABI|No||||
zoledronic acid/mannitol-water|No|No|No|No|75%|63323096600|ZOLEDRONIC ACID 5 MG/100 ML|100|ML|1.29|07/18/2018||Yes|No||07/18/2018||Yes|No|07/18/2018||Yes|No||||No|No|||Prescription required|No|||No|2.94|07/18/2018|2.898|07/24/2018|2.76|07/18/2018||||16551|||||No|No||FRESENIUS KABI|No||||
potassium chloride|No|No|No|No|75%|63323096730|POTASSIUM CL 60 MEQ/30 ML CONC|30|ML|.043|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|.098|01/08/2019|.0966|01/08/2019|.092|01/08/2019||||16552|||||No|No||FRESENIUS KABI|No||||
cevimeline HCl|No|No|No|No|75%|63395020113|EVOXAC 30 MG CAPSULE|100|EA|3.5002|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|No|||No|7.9772|01/12/2021|7.86324|01/12/2021|7.4888|01/12/2021||||16553|||||No|No||DAIICHI SANKYO,|No||||
apomorphine HCl|No|No|No|No|75%|63402001030|KYNMOBI 10 MG SL FILM|30|EA|12.0744|12/04/2020||Yes|No||12/04/2020||Yes|No|12/04/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|015|No|27.5184|01/11/2022|27.12528|01/11/2022|25.8336|01/11/2022|||ANTIPARKINSON'S AGENTS|16554|||||No|No||SUNOVION PHARMA|No||||
apomorphine HCl|No|No|No|No|75%|63402001530|KYNMOBI 15 MG SL FILM|30|EA|12.0744|12/04/2020||Yes|No||12/04/2020||Yes|No|12/04/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|015|No|27.5184|01/11/2022|27.12528|01/11/2022|25.8336|01/11/2022|||ANTIPARKINSON'S AGENTS|16555|||||No|No||SUNOVION PHARMA|No||||
apomorphine HCl|No|No|No|No|75%|63402002030|KYNMOBI 20 MG SL FILM|30|EA|12.0744|12/04/2020||Yes|No||12/04/2020||Yes|No|12/04/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|015|No|27.5184|01/11/2022|27.12528|01/11/2022|25.8336|01/11/2022|||ANTIPARKINSON'S AGENTS|16556|||||No|No||SUNOVION PHARMA|No||||
apomorphine HCl|No|No|No|No|75%|63402002530|KYNMOBI 25 MG SL FILM|30|EA|12.0744|12/04/2020||Yes|No||12/04/2020||Yes|No|12/04/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|015|No|27.5184|01/11/2022|27.12528|01/11/2022|25.8336|01/11/2022|||ANTIPARKINSON'S AGENTS|16557|||||No|No||SUNOVION PHARMA|No||||
apomorphine HCl|No|No|No|No|75%|63402003030|KYNMOBI 30 MG SL FILM|30|EA|12.0744|12/04/2020||Yes|No||12/04/2020||Yes|No|12/04/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|015|No|27.5184|01/11/2022|27.12528|01/11/2022|25.8336|01/11/2022|||ANTIPARKINSON'S AGENTS|16558|||||No|No||SUNOVION PHARMA|No||||
eszopiclone|No|No|No|No|90%|63402019030|LUNESTA 1 MG TABLET|30|EA|6.7424|09/01/2009||Yes|No||09/01/2009||Yes|No|09/01/2009||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|054|Yes|15.3664|01/09/2018|15.14688|01/09/2018|14.4256|01/09/2018|||SEDATIVE HYPNOTICS|16559|||||No|No||SUNOVION PHARMA|No||||
eszopiclone|No|No|No|No|90%|63402019103|LUNESTA 2 MG TABLET|30|EA|6.7424|09/30/2019||Yes|No||09/30/2019||Yes|No|09/30/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|054|Yes|15.3664|10/03/2019|15.14688|09/30/2019|14.4256|09/30/2019|||SEDATIVE HYPNOTICS|16560|||||No|No||SUNOVION PHARMA|No||||
eszopiclone|No|No|No|No|90%|63402019303|LUNESTA 3 MG TABLET|30|EA|6.7424|09/30/2019||Yes|No||09/30/2019||Yes|No|09/30/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|054|Yes|15.04122|12/28/2021|14.68023|12/28/2021|14.77799|12/28/2021|||SEDATIVE HYPNOTICS|16561|||||No|No||SUNOVION PHARMA|No||||
glycopyrrol/nebulizer/accessor|No|No|No|No|75%|63402020100|LONHALA MAGNAIR 25 MCG STARTER|1|ML|9.03|08/08/2018||Yes|No||08/08/2018||Yes|No|08/08/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|098|No|20.58|01/11/2022|20.286|01/11/2022|19.32|01/11/2022|||COPD AGENTS|16562|||||No|No||SUNOVION PHARMA|No||||
eslicarbazepine acetate|No|No|No|No|75%|63402020230|APTIOM 200 MG TABLET|30|EA|16.0605|02/20/2014||Yes|No||02/20/2014||Yes|No|02/20/2014||Yes|No||||No|No|||Prescription required|No||056|No|35.71844|01/18/2022|34.86119|01/18/2022|35.09336|01/18/2022|||ANTICONVULSANTS|16563|||||No|No||SUNOVION PHARMA|No||||
eslicarbazepine acetate|No|No|No|No|75%|63402020430|APTIOM 400 MG TABLET|30|EA|16.0605|02/20/2014||Yes|No||02/20/2014||Yes|No|02/20/2014||Yes|No||||No|No|||Prescription required|No||056|No|35.85439|01/18/2022|34.99388|01/18/2022|35.22693|01/18/2022|||ANTICONVULSANTS|16564|||||No|No||SUNOVION PHARMA|No||||
eslicarbazepine acetate|No|No|No|No|75%|63402020660|APTIOM 600 MG TABLET|60|EA|16.0605|02/20/2014||Yes|No||02/20/2014||Yes|No|02/20/2014||Yes|No||||No|No|||Prescription required|No||056|No|35.89284|01/18/2022|35.03141|01/18/2022|35.26471|01/18/2022|||ANTICONVULSANTS|16565|||||No|No||SUNOVION PHARMA|No||||
eslicarbazepine acetate|No|No|No|No|75%|63402020830|APTIOM 800 MG TABLET|30|EA|16.0605|02/20/2014||Yes|No||02/20/2014||Yes|No|02/20/2014||Yes|No||||No|No|||Prescription required|No||056|No|35.87173|01/18/2022|35.0108|01/18/2022|35.24397|01/18/2022|||ANTICONVULSANTS|16566|||||No|No||SUNOVION PHARMA|No||||
glycopyrrolate/neb.accessories|No|No|No|No|75%|63402030101|LONHALA MAGNAIR 25 MCG REFILL|1|ML|9.03|08/08/2018||Yes|No||08/08/2018||Yes|No|08/08/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|098|No|20.16453|01/18/2022|19.68058|01/18/2022|19.81165|01/18/2022|||COPD AGENTS|16567|||||No|No||SUNOVION PHARMA|No||||
lurasidone HCl|No|No|No|No|75%|63402030230|LATUDA 20 MG TABLET|30|EA|20.3347|02/23/2012||Yes|No||02/23/2012||Yes|No|02/23/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|45.38585|01/18/2022|44.29658|01/18/2022|44.59159|01/18/2022|||ANTIPSYCHOTICS|16568|||||No|No||SUNOVION PHARMA|No||||
lurasidone HCl|No|No|No|No|75%|63402030430|LATUDA 40 MG TABLET|30|EA|20.3347|01/27/2011||Yes|No||01/27/2011||Yes|No|01/27/2011||Yes|No||||No|No|||Prescription required|No||027|Yes|45.35255|01/18/2022|44.26408|01/18/2022|44.55888|01/18/2022|||ANTIPSYCHOTICS|16569|||||No|No||SUNOVION PHARMA|No||||
lurasidone HCl|No|No|No|No|75%|63402030630|LATUDA 60 MG TABLET|30|EA|20.3347|12/06/2013||Yes|No||12/06/2013||Yes|No|12/06/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|45.36304|01/18/2022|44.27432|01/18/2022|44.56918|01/18/2022|||ANTIPSYCHOTICS|16570|||||No|No||SUNOVION PHARMA|No||||
lurasidone HCl|No|No|No|No|75%|63402030830|LATUDA 80 MG TABLET|30|EA|20.3347|01/27/2011||Yes|No||01/27/2011||Yes|No|01/27/2011||Yes|No||||No|No|||Prescription required|No||027|Yes|45.32222|01/18/2022|44.23448|01/18/2022|44.52908|01/18/2022|||ANTIPSYCHOTICS|16571|||||No|No||SUNOVION PHARMA|No||||
lurasidone HCl|No|No|No|No|75%|63402031230|LATUDA 120 MG TABLET|30|EA|30.3537|10/30/2012||Yes|No||10/30/2012||Yes|No|10/30/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|67.58175|01/18/2022|65.95978|01/18/2022|66.39906|01/18/2022|||ANTIPSYCHOTICS|16572|||||No|No||SUNOVION PHARMA|No||||
levalbuterol tartrate|No|No|No|No|75%|63402051001|XOPENEX HFA 45 MCG INHALER|15|GM|1.95621|12/13/2005||Yes|No||12/13/2005||Yes|No|12/13/2005||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|4.35856|07/27/2021|4.25395|07/27/2021|4.28228|07/27/2021|||BRONCHODILATORS: BETA AGONIST|16573|||||No|No||SUNOVION PHARMA|No||||
arformoterol tartrate|No|No|No|No|75%|63402091130|BROVANA 15 MCG/2 ML SOLUTION|2|ML|4.0334|04/06/2007||Yes|No||04/06/2007||Yes|No|04/06/2007||Yes|No||||No|No|||Prescription required|Yes|01/23/2008|037|Yes|9.01378|10/26/2021|8.79744|10/26/2021|8.85603|10/26/2021|||BRONCHODILATORS: BETA AGONIST|16574|||||No|No||SUNOVION PHARMA|No||||
arformoterol tartrate|No|No|No|No|75%|63402091164|BROVANA 15 MCG/2 ML SOLUTION|2|ML|4.0334|05/14/2008||Yes|No||05/14/2008||Yes|No|05/14/2008||Yes|No||||No|No|||Prescription required|Yes|07/17/2007|037|Yes|8.90333|12/28/2021|8.68965|12/28/2021|8.74752|12/28/2021|||BRONCHODILATORS: BETA AGONIST|16575|||||No|No||SUNOVION PHARMA|No||||
modafinil|No|No|No|No|90%|63459010130|PROVIGIL 100 MG TABLET|30|EA|20.32896|01/26/2011||Yes|No||01/26/2011||Yes|No|01/26/2011||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|46.33112|01/11/2022|45.66925|01/11/2022|43.49452|01/11/2022|||STIMULANTS AND RELATED AGENTS|16576|||||No|No||CEPHALON,INC.-T|No||||
omacetaxine mepesuccinate|No|No|No|No|75%|63459017714|SYNRIBO 3.5 MG/ML VIAL|1|EA|523.095|03/26/2015||Yes|No||03/26/2015||Yes|No|03/26/2015||Yes|No||||No|No|||Prescription required|No|||No|1192.17|01/11/2022|1175.139|01/11/2022|1119.18|01/11/2022||||16577|||||No|No||CEPHALON,INC.-T|No||||
modafinil|No|No|No|No|90%|63459020130|PROVIGIL 200 MG TABLET|30|EA|30.7149|01/26/2011||Yes|No||01/26/2011||Yes|No|01/26/2011||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|68.45186|01/18/2022|66.80901|01/18/2022|67.25395|01/18/2022|||STIMULANTS AND RELATED AGENTS|16578|||||No|No||CEPHALON,INC.-T|No||||
armodafinil|No|No|No|No|90%|63459020530|NUVIGIL 50 MG TABLET|30|EA|4.82746|01/26/2011||Yes|No||01/26/2011||Yes|No|01/26/2011||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|11.00212|01/11/2022|10.84495|01/11/2022|10.32852|01/11/2022|||STIMULANTS AND RELATED AGENTS|16579|||||No|No||CEPHALON,INC.-T|No||||
armodafinil|No|No|No|No|90%|63459021530|NUVIGIL 150 MG TABLET|30|EA|14.52683|01/26/2011||Yes|No||01/26/2011||Yes|No|01/26/2011||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|32.92867|01/18/2022|32.13838|01/18/2022|32.35241|01/18/2022|||STIMULANTS AND RELATED AGENTS|16580|||||No|No||CEPHALON,INC.-T|No||||
armodafinil|No|No|No|No|90%|63459022030|NUVIGIL 200 MG TABLET|30|EA|14.52683|03/25/2014||Yes|No||03/25/2014||Yes|No|03/25/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|33.10766|01/11/2022|32.63469|01/11/2022|31.08066|01/11/2022|||STIMULANTS AND RELATED AGENTS|16581|||||No|No||CEPHALON,INC.-T|No||||
armodafinil|No|No|No|No|90%|63459022530|NUVIGIL 250 MG TABLET|30|EA|14.52683|01/26/2011||Yes|No||01/26/2011||Yes|No|01/26/2011||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|32.42347|01/18/2022|31.6453|01/18/2022|31.85605|01/18/2022|||STIMULANTS AND RELATED AGENTS|16582|||||No|No||CEPHALON,INC.-T|No||||
tiagabine HCl|No|No|No|No|75%|63459040230|GABITRIL 2 MG TABLET|30|EA|5.1213|03/29/2010||Yes|No||03/29/2010||Yes|No|03/29/2010||Yes|No||||No|No|||Prescription required|No||056|No|11.6718|01/11/2022|11.50506|01/11/2022|10.9572|01/11/2022|||ANTICONVULSANTS|16583|||||No|No||CEPHALON,INC.-T|No||||
tiagabine HCl|No|No|No|No|75%|63459040430|GABITRIL 4 MG TABLET|30|EA|5.1213|03/29/2010||Yes|No||03/29/2010||Yes|No|03/29/2010||Yes|No||||No|No|||Prescription required|No||056|No|11.41027|01/18/2022|11.13642|01/18/2022|11.21059|01/18/2022|||ANTICONVULSANTS|16584|||||No|No||CEPHALON,INC.-T|No||||
tiagabine HCl|No|No|No|No|75%|63459041230|GABITRIL 12 MG TABLET|30|EA|6.62056|03/29/2010||Yes|No||03/29/2010||Yes|No|03/29/2010||Yes|No||||No|No|||Prescription required|No||056|No|15.08872|01/11/2022|14.87317|01/11/2022|14.16492|01/11/2022|||ANTICONVULSANTS|16585|||||No|No||CEPHALON,INC.-T|No||||
tiagabine HCl|No|No|No|No|75%|63459041630|GABITRIL 16 MG TABLET|30|EA|8.6688|03/29/2010||Yes|No||03/29/2010||Yes|No|03/29/2010||Yes|No||||No|No|||Prescription required|No||056|No|19.7568|01/11/2022|19.47456|01/11/2022|18.5472|01/11/2022|||ANTICONVULSANTS|16586|||||No|No||CEPHALON,INC.-T|No||||
fentanyl citrate|No|No|No|No|90%|63459050230|ACTIQ 200 MCG LOZENGE|30|EA|37.57626|07/17/2003||Yes|No||07/17/2003||Yes|No|07/17/2003||Yes|No||||No|No|||Prescription required|Yes|11/17/2006|109|Yes|85.63892|01/11/2022|84.41551|01/11/2022|80.39572|01/11/2022|||ANALGESICS: NARCOTICS SHORT|16587|||||No|No||TEVA USA|No||||
fentanyl citrate|No|No|No|No|90%|63459050430|ACTIQ 400 MCG LOZENGE|30|EA|47.558|06/29/2007||Yes|No||06/29/2007||Yes|No|06/29/2007||Yes|No||||No|No|||Prescription required|Yes|11/17/2006|109|Yes|108.388|01/11/2022|106.8396|01/11/2022|101.752|01/11/2022|||ANALGESICS: NARCOTICS SHORT|16588|||||No|No||TEVA USA|No||||
fentanyl citrate|No|No|No|No|90%|63459050630|ACTIQ 600 MCG LOZENGE|30|EA|58.28506|06/29/2007||Yes|No||06/29/2007||Yes|No|06/29/2007||Yes|No||||No|No|||Prescription required|Yes|11/17/2006|109|Yes|132.83572|01/11/2022|130.93807|01/11/2022|124.70292|01/11/2022|||ANALGESICS: NARCOTICS SHORT|16589|||||No|No||TEVA USA|No||||
fentanyl citrate|No|No|No|No|90%|63459050830|ACTIQ 800 MCG LOZENGE|30|EA|68.9892|06/29/2007||Yes|No||06/29/2007||Yes|No|06/29/2007||Yes|No||||No|No|||Prescription required|Yes|11/17/2006|109|Yes|157.2312|01/11/2022|154.98504|01/11/2022|147.6048|01/11/2022|||ANALGESICS: NARCOTICS SHORT|16590|||||No|No||TEVA USA|No||||
fentanyl citrate|No|No|No|No|90%|63459051230|ACTIQ 1,200 MCG LOZENGE|30|EA|89.67506|06/29/2007||Yes|No||06/29/2007||Yes|No|06/29/2007||Yes|No||||No|No|||Prescription required|Yes|11/17/2006|109|Yes|204.37572|01/11/2022|201.45607|01/11/2022|191.86292|01/11/2022|||ANALGESICS: NARCOTICS SHORT|16591|||||No|No||TEVA USA|No||||
fentanyl citrate|No|No|No|No|90%|63459051630|ACTIQ 1,600 MCG LOZENGE|30|EA|110.6261|06/29/2007||Yes|No||06/29/2007||Yes|No|06/29/2007||Yes|No||||No|No|||Prescription required|Yes|11/17/2006|109|Yes|252.1246|01/11/2022|248.52282|01/11/2022|236.6884|01/11/2022|||ANALGESICS: NARCOTICS SHORT|16592|||||No|No||TEVA USA|No||||
fentanyl citrate|No|No|No|No|90%|63459054128|FENTORA 100 MCG BUCCAL TABLET|28|EA|29.46882|10/10/2006||Yes|No||10/10/2006||Yes|No|10/10/2006||Yes|No||||No|No|||Prescription required|Yes|07/17/2007|109|Yes|67.16149|01/11/2022|66.20204|01/11/2022|63.04956|01/11/2022|||ANALGESICS: NARCOTICS SHORT|16593|||||No|No||CEPHALON,INC.-T|No||||
fentanyl citrate|No|No|No|No|90%|63459054228|FENTORA 200 MCG BUCCAL TABLET|28|EA|37.23185|10/10/2006||Yes|No||10/10/2006||Yes|No|10/10/2006||Yes|No||||No|No|||Prescription required|Yes|07/17/2007|109|Yes|84.85399|01/11/2022|83.64179|01/11/2022|79.65885|01/11/2022|||ANALGESICS: NARCOTICS SHORT|16594|||||No|No||CEPHALON,INC.-T|No||||
fentanyl citrate|No|No|No|No|90%|63459054428|FENTORA 400 MCG BUCCAL TABLET|28|EA|54.02335|10/10/2006||Yes|No||10/10/2006||Yes|No|10/10/2006||Yes|No||||No|No|||Prescription required|Yes|07/17/2007|109|Yes|123.16993|01/18/2022|120.21385|01/18/2022|121.01445|01/18/2022|||ANALGESICS: NARCOTICS SHORT|16595|||||No|No||CEPHALON,INC.-T|No||||
fentanyl citrate|No|No|No|No|90%|63459054628|FENTORA 600 MCG BUCCAL TABLET|28|EA|70.13607|10/10/2006||Yes|No||10/10/2006||Yes|No|10/10/2006||Yes|No||||No|No|||Prescription required|Yes|07/17/2007|109|Yes|159.44975|01/18/2022|155.62295|01/18/2022|156.65937|01/18/2022|||ANALGESICS: NARCOTICS SHORT|16596|||||No|No||CEPHALON,INC.-T|No||||
fentanyl citrate|No|No|No|No|90%|63459054828|FENTORA 800 MCG BUCCAL TABLET|28|EA|86.40542|10/10/2006||Yes|No||10/10/2006||Yes|No|10/10/2006||Yes|No||||No|No|||Prescription required|Yes|07/17/2007|109|Yes|195.14678|01/18/2022|190.46325|01/18/2022|191.73171|01/18/2022|||ANALGESICS: NARCOTICS SHORT|16597|||||No|No||CEPHALON,INC.-T|No||||
cyclobenzaprine HCl|No|No|No|No|75%|63459070060|AMRIX ER 15 MG CAPSULE|60|EA|21.74725|11/18/2009||Yes|No||11/18/2009||Yes|No|11/18/2009||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|116|Yes|48.22276|01/18/2022|47.06541|01/18/2022|47.37886|01/18/2022|||SKELETAL MUSCLE RELAXANTS|16598|||||No|No||TEVA USA|No||||
cyclobenzaprine HCl|No|No|No|No|75%|63459070160|AMRIX ER 30 MG CAPSULE|60|EA|21.74725|11/18/2009||Yes|No||11/18/2009||Yes|No|11/18/2009||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|116|Yes|48.46632|01/18/2022|47.30312|01/18/2022|47.61815|01/18/2022|||SKELETAL MUSCLE RELAXANTS|16599|||||No|No||TEVA USA|No||||
tbo-filgrastim|No|No|No|No|75%|63459091011|GRANIX 300 MCG/0.5 ML SAFE SYR|.5|ML|214.8796|09/24/2015||Yes|No||09/24/2015||Yes|No|09/24/2015||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|148|No|489.7256|06/01/2016|482.72952|06/01/2016|459.7424|06/01/2016|||COLONY STIMULATING FACTORS|16600|||||No|No||CEPHALON,INC.-T|No||||
tbo-filgrastim|No|No|No|No|75%|63459091015|GRANIX 300 MCG/0.5 ML SAFE SYR|.5|ML|214.88218|09/24/2015||Yes|No||09/24/2015||Yes|No|09/24/2015||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|148|No|489.73148|06/01/2016|482.73531|06/01/2016|459.74792|06/01/2016|||COLONY STIMULATING FACTORS|16601|||||No|No||CEPHALON,INC.-T|No||||
tbo-filgrastim|No|No|No|No|75%|63459091017|GRANIX 300 MCG/0.5 ML SYRINGE|.5|ML|257.656|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|148|No|587.216|01/10/2017|578.8272|01/10/2017|551.264|01/10/2017|||COLONY STIMULATING FACTORS|16602|||||No|No||CEPHALON,INC.-T|No||||
tbo-filgrastim|No|No|No|No|75%|63459091036|GRANIX 300 MCG/0.5 ML SYRINGE|.5|ML|257.656|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|148|No|587.216|01/10/2017|578.8272|01/10/2017|551.264|01/10/2017|||COLONY STIMULATING FACTORS|16603|||||No|No||CEPHALON,INC.-T|No||||
tbo-filgrastim|No|No|No|No|75%|63459091211|GRANIX 480 MCG/0.8 ML SAFE SYR|.8|ML|214.94087|01/17/2014||Yes|No||01/17/2014||Yes|No|01/17/2014||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|148|No|489.86525|06/01/2016|482.86717|06/01/2016|459.8735|06/01/2016|||COLONY STIMULATING FACTORS|16604|||||No|No||CEPHALON,INC.-T|No||||
tbo-filgrastim|No|No|No|No|75%|63459091215|GRANIX 480 MCG/0.8 ML SAFE SYR|.8|ML|214.93818|01/17/2014||Yes|No||01/17/2014||Yes|No|01/17/2014||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|148|No|489.85912|06/01/2016|482.86113|06/01/2016|459.86775|06/01/2016|||COLONY STIMULATING FACTORS|16605|||||No|No||CEPHALON,INC.-T|No||||
tbo-filgrastim|No|No|No|No|75%|63459091217|GRANIX 480 MCG/0.8 ML SYRINGE|.8|ML|256.44125|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|148|No|584.4475|01/10/2017|576.09825|01/10/2017|548.665|01/10/2017|||COLONY STIMULATING FACTORS|16606|||||No|No||CEPHALON,INC.-T|No||||
tbo-filgrastim|No|No|No|No|75%|63459091236|GRANIX 480 MCG/0.8 ML SYRINGE|.8|ML|256.44125|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|148|No|584.4475|01/10/2017|576.09825|01/10/2017|548.665|01/10/2017|||COLONY STIMULATING FACTORS|16607|||||No|No||CEPHALON,INC.-T|No||||
tbo-filgrastim|No|No|No|No|75%|63459091859|GRANIX 300 MCG/ML VIAL|1|ML|107.44109|04/15/2019||Yes|No||04/15/2019||Yes|No|04/15/2019||Yes|No||||No|No|||Prescription required|No||148|No|244.86574|04/15/2019|241.36765|04/15/2019|229.87396|04/15/2019|||COLONY STIMULATING FACTORS|16608|||||No|No||CEPHALON,INC.-T|No||||
tbo-filgrastim|No|No|No|No|75%|63459092059|GRANIX 480 MCG/1.6 ML VIAL|1.6|ML|107.46909|04/15/2019||Yes|No||04/15/2019||Yes|No|04/15/2019||Yes|No||||No|No|||Prescription required|No||148|No|244.92955|04/15/2019|241.43056|04/15/2019|229.93387|04/15/2019|||COLONY STIMULATING FACTORS|16609|||||No|No||CEPHALON,INC.-T|No||||
frovatriptan succinate|No|No|No|No|75%|63481002509|FROVA 2.5 MG TABLET|9|EA|50.75958|08/16/2007||Yes|No||08/16/2007||Yes|No|08/16/2007||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|021|No|112.62867|01/18/2022|109.92558|01/18/2022|110.65766|01/18/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|16610|||||No|No||ENDO PHARM INC.|No||||
testosterone|No|No|No|No|90%|63481018316|FORTESTA 10 MG GEL PUMP|60|GM|2.96821|02/15/2011||Yes|No||02/15/2011||Yes|No|02/15/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|084|No|6.76477|03/26/2019|6.66813|03/26/2019|6.3506|03/26/2019|||ANDROGENIC AGENTS|16611|||||No|No||ENDO PHARM INC.|No||||
neomyc/colist/hydrocort/thonzn|No|No|No|No|75%|63481052910|CORTISPORIN-TC EAR SUSPENSION|10|ML|9.96095|10/23/2019||Yes|No||10/23/2019||Yes|No|10/23/2019||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|051|No|22.30171|12/28/2021|21.76646|12/28/2021|21.91143|12/28/2021|||OTIC ANTIBIOTICS|16612|||||No|No||ENDO PHARM INC.|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|63481062370|PERCOCET 5-325 MG TABLET|100|EA|9.46275|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|11/17/2006|109|Yes|21.12425|01/18/2022|20.61726|01/18/2022|20.75457|01/18/2022|||ANALGESICS: NARCOTICS SHORT|16613|||||No|No||ENDO PHARM INC.|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|63481062385|PERCOCET 5-325 MG TABLET|500|EA|9.22468|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|11/17/2006|109|Yes|21.12425|01/18/2022|20.61726|01/18/2022|20.75457|01/18/2022|||ANALGESICS: NARCOTICS SHORT|16614|||||No|No||ENDO PHARM INC.|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|63481062770|PERCOCET 2.5-325 MG TABLET|100|EA|6.76114|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|01/23/2008|109|Yes|15.40912|01/11/2022|15.18899|01/11/2022|14.46571|01/11/2022|||ANALGESICS: NARCOTICS SHORT|16615|||||No|No||ENDO PHARM INC.|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|63481062870|PERCOCET 7.5-325 MG TABLET|100|EA|10.22325|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|11/17/2006|109|Yes|22.87253|01/18/2022|22.32358|01/18/2022|22.47226|01/18/2022|||ANALGESICS: NARCOTICS SHORT|16616|||||No|No||ENDO PHARM INC.|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|63481062970|PERCOCET 10-325 MG TABLET|100|EA|13.36779|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|11/17/2006|109|Yes|29.871|01/18/2022|29.15409|01/18/2022|29.34825|01/18/2022|||ANALGESICS: NARCOTICS SHORT|16617|||||No|No||ENDO PHARM INC.|No||||
diclofenac sodium|No|No|No|No|75%|63481068447|VOLTAREN 1% GEL|100|GM|.23228|10/13/2010|04/30/2022|Yes|No||10/13/2010|04/30/2022|Yes|No|10/13/2010|04/30/2022|Yes|No||||No|No|||Prescription required|No||059|Yes|.52939|08/25/2020|.52183|08/25/2020|.49698|08/25/2020|||NSAIDS|16618|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ENDO PHARM INC.|No||||
lidocaine|No|No|No|No|75%|63481068706|LIDODERM 5% PATCH|30|EA|10.37117|04/16/2004||Yes|No||04/16/2004||Yes|No|04/16/2004||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|232|No|23.16611|01/18/2022|22.61012|01/18/2022|22.7607|01/18/2022|||NEUROPATHIC PAIN|16619|||||No|No||ENDO PHARM INC.|No||||
naltrexone HCl|No|No|No|No|75%|63629104601|NALTREXONE 50 MG TABLET|30|EA|.3364|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||No|.76668|10/01/2020|.75573|10/01/2020|.71974|10/01/2020||||16620|||||No|No||BRYANT RANCH PR|Yes|09/01/2020|||
naltrexone HCl|No|No|No|No|75%|63629104701|NALTREXONE 50 MG TABLET|100|EA|.45171|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||No|1.02949|10/01/2020|1.01478|10/01/2020|.96646|10/01/2020||||16621|||||No|No||BRYANT RANCH PR|Yes|09/01/2020|||
ketoconazole|No|No|No|No|75%|63646001004|KETOCONAZOLE 2% SHAMPOO|120|ML|.07041|06/28/2017||Yes|No||06/28/2017||Yes|No|06/28/2017||Yes|No||||No|No|||Prescription required|No||061|No|.09082|03/29/2022|.08864|03/29/2022|.08923|03/29/2022|||ANTIFUNGALS: TOPICAL|16622|||||No|No||TOLMAR INC.|No||||
calcipotriene/betamethasone|No|No|No|No|75%|63646004012|CALCIPOTRIENE-BETAMETH DP SUSP|120|GM|5.98388|10/15/2020||Yes|No||10/15/2020||Yes|No|10/15/2020||Yes|No||||No|No|||Prescription required|No|||No|13.63768|10/15/2020|13.44285|10/15/2020|12.80272|10/15/2020||||16623|||||No|No||TOLMAR INC.|No||||
calcipotriene/betamethasone|No|No|No|No|75%|63646004060|CALCIPOTRIENE-BETAMETH DP SUSP|60|GM|5.98388|10/15/2020||Yes|No||10/15/2020||Yes|No|10/15/2020||Yes|No||||No|No|||Prescription required|No|||No|13.63768|10/15/2020|13.44285|10/15/2020|12.80272|10/15/2020||||16624|||||No|No||TOLMAR INC.|No||||
acyclovir|No|No|No|No|75%|63646030015|ACYCLOVIR 5% OINTMENT|15|GM|2.43666|11/20/2017||Yes|No||11/20/2017||Yes|No|11/20/2017||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.36934|03/29/2022|1.33647|03/29/2022|1.34537|03/29/2022|||ANTIVIRALS: TOPICAL|16625|||||No|No||TOLMAR INC.|No||||
acyclovir|No|No|No|No|75%|63646030030|ACYCLOVIR 5% OINTMENT|30|GM|2.43666|11/20/2017||Yes|No||11/20/2017||Yes|No|11/20/2017||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.03754|03/29/2022|1.01263|03/29/2022|1.01938|03/29/2022|||ANTIVIRALS: TOPICAL|16626|||||No|No||TOLMAR INC.|No||||
clobetasol propionate|No|No|No|No|75%|63646050025|CLOBETASOL 0.05% SOLUTION|25|ML|.86|05/25/2017||Yes|No||05/25/2017||Yes|No|05/25/2017||Yes|No||||No|No|||Prescription required|No||121|No|.44026|03/29/2022|.42969|03/29/2022|.43255|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|16627|||||No|No||TOLMAR INC.|No||||
clobetasol propionate|No|No|No|No|75%|63646050050|CLOBETASOL 0.05% SOLUTION|50|ML|.86|05/25/2017||Yes|No||05/25/2017||Yes|No|05/25/2017||Yes|No||||No|No|||Prescription required|No||121|No|.35501|03/29/2022|.34648|03/29/2022|.34879|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|16628|||||No|No||TOLMAR INC.|No||||
clopidogrel bisulfate|No|No|No|No|75%|63653117101|PLAVIX 75 MG TABLET|90|EA|2.77153|03/01/2002|07/31/2022|Yes|No||03/01/2002|07/31/2022|Yes|No|03/01/2002|07/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|004|No|7.17246|01/18/2022|7.00032|01/18/2022|7.04694|01/18/2022|||PLATELET AGGREGATION INHIBITORS|16629|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||BMS PRIMARYCARE|No||||
misoprostol|No|No|No|No|75%|63704000801|MISOPROSTOL 200 MCG TABLET|100|EA|.3612|11/25/2013||Yes|No||11/25/2013||Yes|No|11/25/2013||Yes|No||||No|No|||Prescription required|No|||No|.71283|03/29/2022|.69572|03/29/2022|.70035|03/29/2022||||16630|||||No|No||PHARMACIST PHAR|No||||
temazepam|No|No|No|No|90%|63739000333|TEMAZEPAM 7.5 MG CAPSULE|30|EA|2.07116|01/20/2016||Yes|No||01/20/2016||Yes|No|01/20/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|054|Yes|1.39989|03/29/2022|1.36629|03/29/2022|1.37539|03/29/2022|||SEDATIVE HYPNOTICS|16631|||||No|No||MCKESSON PACKAG|No||||
ziprasidone HCl|No|No|No|No|75%|63739000532|ZIPRASIDONE HCL 40 MG CAPSULE|40|EA|1.19593|07/01/2016||Yes|No||07/01/2016||Yes|No|07/01/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.29914|03/29/2022|.29196|03/29/2022|.2939|03/29/2022|||ANTIPSYCHOTICS|16632|||||No|No||MCKESSON PACKAG|No||||
diltiazem HCl|No|No|No|No|75%|63739001610|DILTIAZEM 24H ER(CD) 240 MG CP|100|EA|.2174|02/01/2018||Yes|No||02/01/2018||Yes|No|02/01/2018||Yes|No||||No|No|||Prescription required|No||045|No|.29728|03/29/2022|.29014|03/29/2022|.29207|03/29/2022|||CALCIUM CHANNEL BLOCKERS|16633|||||No|No||MCKESSON PACKAG|No||||
benzonatate|No|No|No|No|75%|63739002910|BENZONATATE 100 MG CAPSULE|100|EA|.19711|10/06/2017||Yes|No||10/06/2017||Yes|No|10/06/2017||Yes|No||||No|No|||Prescription required|No||184|Yes|.09389|03/29/2022|.09163|03/29/2022|.09224|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|16634|||||No|No||MCKESSON PACKAG|No||||
metoclopramide HCl|No|No|No|No|75%|63739010310|METOCLOPRAMIDE 5 MG TABLET|100|EA|.04863|07/01/2016|01/31/2022|Yes|No||07/01/2016|01/31/2022|Yes|No|07/01/2016|01/31/2022|Yes|No||||No|No|||Prescription required|No||085|No|.04524|03/29/2022|.04415|03/29/2022|.04444|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|16635|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||MCKESSON PACKAG|No||||
doxycycline hyclate|Yes|No|No|No|75%|63739016833|DOXYCYCLINE HYCLATE 100 MG TAB|30|EA|1.02125|10/20/2016||Yes|No||10/20/2016||Yes|No|10/20/2016||Yes|No||||No|No|10/20/2016||Prescription required|Yes|01/28/2016|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|16636|||||No|No||MCKESSON PACKAG|No||||
promethazine HCl|No|No|No|No|75%|63739021310|PROMETHAZINE 25 MG TABLET|100|EA|.18429|09/08/2014||Yes|No||09/08/2014||Yes|No|09/08/2014||Yes|No||||No|No|||Prescription required|No||085|Yes|.05271|03/29/2022|.05144|03/29/2022|.05178|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|16637|||||No|No||SKY PHARMACEUTI|No||||
gabapentin|No|No|No|No|75%|63739023610|GABAPENTIN 300 MG CAPSULE|100|EA|.07004|02/01/2018||Yes|No||02/01/2018||Yes|No|02/01/2018||Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|16638|||||No|No||MCKESSON PACKAG|No||||
valproic acid|No|No|No|No|75%|63739025110|VALPROIC ACID 250 MG CAPSULE|100|EA|.18429|09/03/2013||Yes|No||09/03/2013||Yes|No|09/03/2013||Yes|No||||No|No|||Prescription required|No|||No|.21937|09/24/2019|.2141|09/24/2019|.21553|09/24/2019||||16639|||||No|No||MCKESSON PACKAG|No||||
tamoxifen citrate|No|No|No|No|75%|63739026910|TAMOXIFEN 10 MG TABLET|100|EA|.20566|09/08/2014||Yes|No||09/08/2014||Yes|No|09/08/2014||Yes|No||||No|No|||Prescription required|No||502|No|.21342|03/29/2022|.20829|03/29/2022|.20968|03/29/2022|||ONCOLOGY: ORAL - BREAST|16640|||||No|No||MCKESSON PACKAG|No||||
valganciclovir HCl|No|No|No|No|75%|63739035733|VALGANCICLOVIR 450 MG TABLET|30|EA|28.4875|10/06/2017||Yes|No||10/06/2017||Yes|No|10/06/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|136|No|2.64507|03/29/2022|2.58158|03/29/2022|2.59878|03/29/2022|||ANTIVIRALS: GENERAL|16641|||||No|No||MCKESSON PACKAG|No||||
isosorbide dinitrate|No|No|No|No|75%|63739036710|ISOSORBIDE DINITRATE 20 MG TAB|100|EA|.3421|07/01/2016||Yes|No||07/01/2016||Yes|No|07/01/2016||Yes|No||||No|No|||Prescription required|No|||No|.30675|03/29/2022|.29938|03/29/2022|.30138|03/29/2022||||16642|||||No|No||MCKESSON PACKAG|No||||
naproxen|No|No|No|No|75%|63739040310|NAPROXEN 500 MG TABLET|100|EA|.09137|07/01/2016||Yes|No||07/01/2016||Yes|No|07/01/2016||Yes|No||||No|No|||Prescription required|No||059|Yes|.07731|03/29/2022|.07545|03/29/2022|.07595|03/29/2022|||NSAIDS|16643|||||No|No||MCKESSON PACKAG|No||||
allopurinol|No|No|No|No|75%|63739041010|ALLOPURINOL 100 MG TABLET|100|EA|.10711|10/06/2017||Yes|No||10/06/2017||Yes|No|10/06/2017||Yes|No||||No|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|16644|||||No|No||MCKESSON PACKAG|No||||
levetiracetam|No|No|No|No|75%|63739041110|LEVETIRACETAM 500 MG TABLET|100|EA|.08062|06/30/2017||Yes|No||06/30/2017||Yes|No|06/30/2017||Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|16645|||||No|No||MCKESSON PACKAG|No||||
rifampin|No|No|No|No|75%|63739041510|RIFAMPIN 300 MG CAPSULE|100|EA|.69887|09/08/2014||Yes|No||09/08/2014||Yes|No|09/08/2014||Yes|No||||No|No|||Prescription required|No|||No|.95898|03/29/2022|.93596|03/29/2022|.94219|03/29/2022||||16646|||||No|No||MCKESSON PACKAG|No||||
hydroxyzine HCl|No|No|No|No|75%|63739048310|HYDROXYZINE HCL 10 MG TABLET|100|EA|.09808|03/18/2015||Yes|No||03/18/2015||Yes|No|03/18/2015||Yes|No||||No|No|||Prescription required|No||574|Yes|.03952|03/29/2022|.03857|03/29/2022|.03882|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|16647|||||No|No||MCKESSON PACKAG|No||||
hydroxyzine HCl|No|No|No|No|75%|63739048610|HYDROXYZINE HCL 25 MG TABLET|100|EA|.11154|03/18/2015||Yes|No||03/18/2015||Yes|No|03/18/2015||Yes|No||||No|No|||Prescription required|No||574|Yes|.06757|03/29/2022|.06594|03/29/2022|.06638|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|16648|||||No|No||MCKESSON PACKAG|No||||
ziprasidone HCl|No|No|No|No|75%|63739050832|ZIPRASIDONE HCL 80 MG CAPSULE|40|EA|1.3975|07/01/2016||Yes|No||07/01/2016||Yes|No|07/01/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.42395|03/29/2022|.41377|03/29/2022|.41653|03/29/2022|||ANTIPSYCHOTICS|16649|||||No|No||MCKESSON PACKAG|No||||
valacyclovir HCl|No|No|No|No|75%|63739052510|VALACYCLOVIR HCL 500 MG TABLET|100|EA|1.66087|11/19/2013||Yes|No||11/19/2013||Yes|No|11/19/2013||Yes|No||||No|No|||Prescription required|No||025|No|.29328|03/29/2022|.28624|03/29/2022|.28814|03/29/2022|||ANTIVIRALS: ORAL|16650|||||No|No||MCKESSON PACKAG|No||||
zolpidem tartrate|No|No|No|No|90%|63739052610|ZOLPIDEM TARTRATE 10 MG TABLET|100|EA|.03117|09/03/2013||Yes|No||09/03/2013||Yes|No|09/03/2013||Yes|No||||No|No|||Prescription required|No||054|Yes|.0301|03/29/2022|.02937|03/29/2022|.02957|03/29/2022|||SEDATIVE HYPNOTICS|16651|||||No|No||MCKESSON PACKAG|No||||
spironolactone|No|No|No|No|75%|63739054410|SPIRONOLACTONE 25 MG TABLET|100|EA|.09868|11/19/2013||Yes|No||11/19/2013||Yes|No|11/19/2013||Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||16652|||||No|No||MCKESSON PACKAG|No||||
spironolactone|No|No|No|No|75%|63739054510|SPIRONOLACTONE 50 MG TABLET|100|EA|.22575|03/18/2015||Yes|No||03/18/2015||Yes|No|03/18/2015||Yes|No||||No|No|||Prescription required|No|||No|.12042|03/29/2022|.11752|03/29/2022|.11831|03/29/2022||||16653|||||No|No||MCKESSON PACKAG|No||||
oxybutynin chloride|No|No|No|No|75%|63739054833|OXYBUTYNIN CL ER 5 MG TABLET|30|EA|1.24599|03/18/2015||Yes|No||03/18/2015||Yes|No|03/18/2015||Yes|No||||No|No|||Prescription required|No||006|Yes|.15279|03/29/2022|.14912|03/29/2022|.15011|03/29/2022|||BLADDER RELAXANT PREPARATIONS|16654|||||No|No||MCKESSON PACKAG|No||||
lansoprazole|No|No|No|No|75%|63739055510|LANSOPRAZOLE DR 30 MG CAPSULE|100|EA|.90837|08/31/2015||Yes|No||08/31/2015||Yes|No|08/31/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.12249|03/29/2022|.11955|03/29/2022|.12034|03/29/2022|||PROTON PUMP INHIBITORS|16655|||||No|No||MCKESSON PACKAG|No||||
ciprofloxacin HCl|No|No|No|No|75%|63739055910|CIPROFLOXACIN HCL 500 MG TAB|100|EA|.07714|05/20/2015||Yes|No||05/20/2015||Yes|No|05/20/2015||Yes|No||||No|No|||Prescription required|No||028|No|.13565|03/29/2022|.13239|03/29/2022|.13327|03/29/2022|||FLUOROQUINOLONES: ORAL|16656|||||No|No||MCKESSON PACKAG|No||||
gabapentin|No|No|No|No|75%|63739056010|GABAPENTIN 600 MG TABLET|100|EA|.28427|08/31/2015||Yes|No||08/31/2015||Yes|No|08/31/2015||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|16657|||||No|No||MCKESSON PACKAG|No||||
pantoprazole sodium|No|No|No|No|75%|63739056410|PANTOPRAZOLE SOD DR 40 MG TAB|100|EA|.12336|06/30/2015||Yes|No||06/30/2015||Yes|No|06/30/2015||Yes|No||||No|No|||Prescription required|No||047|No|.05828|03/29/2022|.05688|03/29/2022|.05726|03/29/2022|||PROTON PUMP INHIBITORS|16658|||||No|No||MCKESSON PACKAG|No||||
tamsulosin HCl|No|No|No|No|75%|63739056710|TAMSULOSIN HCL 0.4 MG CAPSULE|100|EA|.1701|06/30/2015||Yes|No||06/30/2015||Yes|No|06/30/2015||Yes|No||||No|No|||Prescription required|No||003|No|.06447|03/29/2022|.06292|03/29/2022|.06334|03/29/2022|||BPH TREATMENTS|16659|||||No|No||MCKESSON PACKAG|No||||
isosorbide dinitrate|No|No|No|No|75%|63739056910|ISOSORBIDE DINITRATE 10 MG TAB|100|EA|.31579|07/01/2016||Yes|No||07/01/2016||Yes|No|07/01/2016||Yes|No||||No|No|||Prescription required|No|||No|.34234|03/29/2022|.33412|03/29/2022|.33634|03/29/2022||||16660|||||No|No||MCKESSON PACKAG|No||||
simvastatin|Yes|No|No|No|75%|63739057010|SIMVASTATIN 5 MG TABLET|100|EA|.08806|06/30/2015||Yes|No||06/30/2015||Yes|No|06/30/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.03036|03/29/2022|.02963|03/29/2022|.02982|03/29/2022|||LIPOTROPICS: STATINS|16661|||||No|No||MCKESSON PACKAG|No||||
simvastatin|Yes|No|No|No|75%|63739057110|SIMVASTATIN 10 MG TABLET|100|EA|.06471|06/30/2015||Yes|No||06/30/2015||Yes|No|06/30/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.02909|03/29/2022|.02839|03/29/2022|.02858|03/29/2022|||LIPOTROPICS: STATINS|16662|||||No|No||MCKESSON PACKAG|No||||
simvastatin|Yes|No|No|No|75%|63739057210|SIMVASTATIN 20 MG TABLET|100|EA|.07374|06/30/2015||Yes|No||06/30/2015||Yes|No|06/30/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.02604|03/29/2022|.02541|03/29/2022|.02558|03/29/2022|||LIPOTROPICS: STATINS|16663|||||No|No||MCKESSON PACKAG|No||||
simvastatin|Yes|No|No|No|75%|63739057310|SIMVASTATIN 40 MG TABLET|100|EA|.07456|06/30/2015||Yes|No||06/30/2015||Yes|No|06/30/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.04431|03/29/2022|.04324|03/29/2022|.04353|03/29/2022|||LIPOTROPICS: STATINS|16664|||||No|No||MCKESSON PACKAG|No||||
gabapentin|No|No|No|No|75%|63739059110|GABAPENTIN 100 MG CAPSULE|100|EA|.0387|10/20/2016||Yes|No||10/20/2016||Yes|No|10/20/2016||Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|16665|||||No|No||MCKESSON PACKAG|No||||
famotidine|No|No|No|No|75%|63739064510|FAMOTIDINE 20 MG TABLET|100|EA|.0368|08/31/2015||Yes|No||08/31/2015||Yes|No|08/31/2015||Yes|No||||No|No|||Prescription required|No|||No|.03262|03/29/2022|.03183|03/29/2022|.03204|03/29/2022||||16666|||||No|No||SKY PHARMACEUTI|No||||
quetiapine fumarate|No|No|No|No|75%|63739066510|QUETIAPINE FUMARATE 100 MG TAB|100|EA|.21534|06/30/2015||Yes|No||06/30/2015||Yes|No|06/30/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.05826|03/29/2022|.05686|03/29/2022|.05724|03/29/2022|||ANTIPSYCHOTICS|16667|||||No|No||MCKESSON PACKAG|No||||
ziprasidone HCl|No|No|No|No|75%|63739066632|ZIPRASIDONE HCL 60 MG CAPSULE|40|EA|1.3975|07/01/2016||Yes|No||07/01/2016||Yes|No|07/01/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.38441|03/29/2022|.37518|03/29/2022|.37768|03/29/2022|||ANTIPSYCHOTICS|16668|||||No|No||MCKESSON PACKAG|No||||
losartan potassium|No|No|No|No|75%|63739067310|LOSARTAN POTASSIUM 25 MG TAB|100|EA|.21448|06/30/2017||Yes|No||06/30/2017||Yes|No|06/30/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|16669|||||No|No||MCKESSON PACKAG|No||||
quetiapine fumarate|No|No|No|No|75%|63739067710|QUETIAPINE FUMARATE 200 MG TAB|100|EA|.43915|06/30/2015||Yes|No||06/30/2015||Yes|No|06/30/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.10261|03/29/2022|.10014|03/29/2022|.10081|03/29/2022|||ANTIPSYCHOTICS|16670|||||No|No||MCKESSON PACKAG|No||||
losartan potassium|No|No|No|No|75%|63739068610|LOSARTAN POTASSIUM 50 MG TAB|100|EA|.22575|03/16/2017||Yes|No||03/16/2017||Yes|No|03/16/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|16671|||||No|No||MCKESSON PACKAG|No||||
losartan potassium|Yes|No|No|No|75%|63739069810|LOSARTAN POTASSIUM 100 MG TAB|100|EA|.29562|08/31/2015||Yes|No||||No|No|08/31/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|16672|||||No|No||MCKESSON PACKAG|No||||
ciprofloxacin HCl|Yes|No|No|No|75%|63739070010|CIPROFLOXACIN HCL 250 MG TAB|100|EA|.08763|08/31/2015||Yes|No||08/31/2015||Yes|No|08/31/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||028|No|.09397|03/29/2022|.09171|03/29/2022|.09232|03/29/2022|||FLUOROQUINOLONES: ORAL|16673|||||No|No||MCKESSON PACKAG|No||||
voriconazole|No|No|No|No|75%|63739070733|VORICONAZOLE 200 MG TABLET|30|EA|14.4265|08/31/2015|02/22/2022|Yes|No||08/31/2015|02/22/2022|Yes|No|08/31/2015|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|01/22/2015|069|No|2.07998|03/29/2022|2.03006|03/29/2022|2.04358|03/29/2022|||ANTIFUNGALS: ORAL|16674|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||MCKESSON PACKAG|No||||
hydroxychloroquine sulfate|No|No|No|No|75%|63739077710|HYDROXYCHLOROQUINE 200 MG TAB|100|EA|1.55875|07/01/2016||Yes|No||07/01/2016||Yes|No|07/01/2016||Yes|No||||No|No|||Prescription required|No|||No|.23831|03/29/2022|.23259|03/29/2022|.23413|03/29/2022||||16675|||||No|No||MCKESSON PACKAG|No||||
levetiracetam|No|No|No|No|75%|63739078710|LEVETIRACETAM 750 MG TABLET|100|EA|.12233|06/30/2017||Yes|No||06/30/2017||Yes|No|06/30/2017||Yes|No||||No|No|||Prescription required|No||056|No|.15853|03/29/2022|.15472|03/29/2022|.15575|03/29/2022|||ANTICONVULSANTS|16676|||||No|No||MCKESSON PACKAG|No||||
levetiracetam|No|No|No|No|75%|63739079510|LEVETIRACETAM 250 MG TABLET|100|EA|.08397|06/30/2017||Yes|No||06/30/2017||Yes|No|06/30/2017||Yes|No||||No|No|||Prescription required|No||056|No|.08073|03/29/2022|.07879|03/29/2022|.07931|03/29/2022|||ANTICONVULSANTS|16677|||||No|No||SKY PHARMACEUTI|No||||
allopurinol|No|No|No|No|75%|63739079610|ALLOPURINOL 300 MG TABLET|100|EA|.21861|10/06/2017||Yes|No||10/06/2017||Yes|No|10/06/2017||Yes|No||||No|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|16678|||||No|No||MCKESSON PACKAG|No||||
nimodipine|No|No|No|No|75%|63739079733|NIMODIPINE 30 MG CAPSULE|30|EA|1.23539|06/30/2017||Yes|No||06/30/2017||Yes|No|06/30/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|045|No|2.81554|04/27/2021|2.77531|04/27/2021|2.64316|04/27/2021|||CALCIUM CHANNEL BLOCKERS|16679|||||No|No||MCKESSON PACKAG|No||||
paroxetine HCl|No|No|No|No|75%|63739088810|PAROXETINE HCL 10 MG TABLET|100|EA|.2607|01/20/2016||Yes|No||01/20/2016||Yes|No|01/20/2016||Yes|No||||No|No|||Prescription required|No||008|Yes|.075|03/29/2022|.0732|03/29/2022|.07368|03/29/2022|||ANTIDEPRESSANTS: SSRIs|16680|||||No|No||SKY PHARMACEUTI|No||||
heparin sodium,porcine|No|No|No|No|75%|63739090128|HEPARIN 50,000 UNIT/10 ML VIAL|10|ML|.5446|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|No|||No|1.24118|10/04/2016|1.22345|10/04/2016|1.16519|10/04/2016||||16681|||||No|No||MCKESSON PACKAG|No||||
heparin sodium,porcine|No|No|No|No|75%|63739092025|HEPARIN SOD 1,000 UNIT/ML VIAL|1|ML|1.0793|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|No|||No|2.4598|10/11/2016|2.42466|10/04/2016|2.3092|10/11/2016||||16682|||||No|No||MCKESSON PACKAG|No||||
heparin sodium,porcine|No|No|No|No|75%|63739093128|HEPARIN 10,000 UNIT/10 ML VIAL|10|ML|.16061|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|No|||No|.36604|10/04/2016|.36082|10/04/2016|.34363|10/04/2016||||16683|||||No|No||MCKESSON PACKAG|No||||
heparin sodium,porcine|No|No|No|No|75%|63739094229|HEPARIN 30,000 UNIT/30 ML VIAL|30|ML|.10219|10/04/2016|02/22/2022|Yes|No||10/04/2016|02/22/2022|Yes|No|10/04/2016|02/22/2022|Yes|No||||No|No|||Prescription required|No|||No|.2329|10/04/2016|.22957|10/04/2016|.21864|10/04/2016||||16684|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MCKESSON PACKAG|No||||
sucralfate|No|No|No|No|75%|63739094310|SUCRALFATE 1 GM TABLET|100|EA|.11825|10/21/2016||Yes|No||10/21/2016||Yes|No|10/21/2016||Yes|No||||No|No|||Prescription required|No|||No|.19448|03/29/2022|.18981|03/29/2022|.19107|03/29/2022||||16685|||||No|No||MCKESSON PACKAG|No||||
heparin sodium,porcine|No|No|No|No|75%|63739095325|HEPARIN SOD 5,000 UNIT/ML VIAL|1|ML|1.4491|03/24/2016||Yes|No||03/24/2016||Yes|No|03/24/2016||Yes|No||||No|No|||Prescription required|No|||No|1.38512|12/28/2021|1.35187|12/28/2021|1.36088|12/28/2021||||16686|||||No|No||MCKESSON PACKAG|No||||
paroxetine HCl|No|No|No|No|75%|63739096310|PAROXETINE HCL 20 MG TABLET|100|EA|.09515|01/20/2016||Yes|No||01/20/2016||Yes|No|01/20/2016||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|16687|||||No|No||SKY PHARMACEUTI|No||||
heparin sodium,porcine|No|No|No|No|75%|63739096425|HEPARIN SOD 10,000 UNIT/ML VL|1|ML|2.31133|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|No|||No|5.26769|01/25/2022|5.19244|01/25/2022|4.94518|01/25/2022||||16688|||||No|No||MCKESSON PACKAG|No||||
gabapentin|No|No|No|No|75%|63739098410|GABAPENTIN 400 MG CAPSULE|100|EA|.07998|10/20/2016||Yes|No||10/20/2016||Yes|No|10/20/2016||Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|16689|||||No|No||MCKESSON PACKAG|No||||
heparin sodium,porcine|No|No|No|No|75%|63739098625|HEPARIN SOD 20,000 UNIT/ML VL|1|ML|5.7534|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|No|||No|13.1124|09/24/2019|12.92508|09/24/2019|12.3096|09/24/2019||||16690|||||No|No||MCKESSON PACKAG|No||||
ziprasidone HCl|No|No|No|No|75%|63739098832|ZIPRASIDONE HCL 20 MG CAPSULE|40|EA|1.19593|10/06/2017||Yes|No||10/06/2017||Yes|No|10/06/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.27381|03/29/2022|.26723|03/29/2022|.26901|03/29/2022|||ANTIPSYCHOTICS|16691|||||No|No||MCKESSON PACKAG|No||||
salicylic acid|No|No|No|No|75%|63801010701|BENSAL HP 3% OINTMENT|30|GM|12.41266|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|061|No|28.28932|08/23/2016|27.88519|08/23/2016|26.55732|08/23/2016|||ANTIFUNGALS: TOPICAL|16692|||||No|No||SMG PHARMACEUTI|No||||
guaifenesin|No|No|No|No|75%|63824000832|MUCINEX ER 600 MG TABLET|20|EA|.20554|08/26/2009||Yes|No||||No|No|08/26/2009||Yes|No||||No|No|||Over the counter|No||182|Yes|.46389|03/29/2022|.45275|03/29/2022|.45577|03/29/2022|||COUGH AND COLD: COLD|16693|||||No|No||RECKITT BENCKIS|No||||
guaifenesin|No|No|No|No|75%|63824000834|MUCINEX ER 600 MG TABLET|40|EA|.18382|08/26/2009||Yes|No||||No|No|08/26/2009||Yes|No||||No|No|||Over the counter|No||182|Yes|.46389|03/29/2022|.45275|03/29/2022|.45577|03/29/2022|||COUGH AND COLD: COLD|16694|||||No|No||RECKITT BENCKIS|No||||
guaifenesin|No|No|No|No|75%|63824000850|MUCINEX ER 600 MG TABLET|500|EA|.15731|04/04/2007||Yes|No||||No|No|||No|No||||No|No|||Over the counter|No||182|Yes|.46389|03/29/2022|.45275|03/29/2022|.45577|03/29/2022|||COUGH AND COLD: COLD|16695|||||No|No||RECKITT BENCKIS|No||||
phenylephrine/DM/acetaminop/GG|No|No|No|No|75%|63824001566|MUCINEX COLD-FLU-SORETHROAT LQ|180|ML|.02484|05/15/2012||Yes|No||||No|No|05/15/2012||Yes|No||||No|No|||Over the counter|No||184|No|.06199|03/29/2022|.0605|03/29/2022|.0609|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|16696|||||No|No||RECKITT BENCKIS|No||||
phenylephrine/DM/acetaminop/GG|No|No|No|No|75%|63824001764|CHILD'S MUCINEX COLD-FEVER LIQ|118|ML|.02689|09/27/2011||Yes|No||||No|No|09/27/2011||Yes|No||||No|No|||Over the counter|No||184|No|.06636|03/01/2022|.06476|03/01/2022|.06519|03/01/2022|||COUGH AND COLD: NON-NARCOTIC|16697|||||No|No||RECKITT BENCKIS|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|63824001966|MUCINEX FAST-MAX DM MAX LIQUID|180|ML|.023|12/03/2014||Yes|No||||No|No|12/03/2014||Yes|No||||No|No|||Over the counter|No||184|Yes|.05474|10/26/2021|.05342|10/26/2021|.05378|10/26/2021|||COUGH AND COLD: NON-NARCOTIC|16698|||||No|No||RECKITT BENCKIS|No||||
phenylephrine/DM/acetaminop/GG|No|No|No|No|75%|63824002066|MUCINEX FAST-MAX SEV COLD LIQ|180|ML|.02484|01/05/2015||Yes|No||||No|No|01/05/2015||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|No|.06199|03/29/2022|.0605|03/29/2022|.0609|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|16699|||||No|No||RECKITT BENCKIS|No||||
guaifenesin|No|No|No|No|75%|63824002335|MUCINEX ER 1,200 MG TABLET|14|EA|.34768|01/23/2015||Yes|No||||No|No|01/23/2015||Yes|No||||No|No|||Over the counter|No||182|Yes|.76902|03/29/2022|.75056|03/29/2022|.75556|03/29/2022|||COUGH AND COLD: COLD|16700|||||No|No||RECKITT BENCKIS|No||||
guaifenesin|No|No|No|No|75%|63824002336|MUCINEX ER 1,200 MG TABLET|28|EA|.30192|01/23/2015||Yes|No||||No|No|01/23/2015||Yes|No||||No|No|||Over the counter|No||182|Yes|.76902|03/29/2022|.75056|03/29/2022|.75556|03/29/2022|||COUGH AND COLD: COLD|16701|||||No|No||RECKITT BENCKIS|No||||
guaifenesin|No|No|No|No|75%|63824002346|MUCINEX ER 1,200 MG TABLET|42|EA|.2496|01/23/2015||Yes|No||||No|No|01/23/2015||Yes|No||||No|No|||Over the counter|No||182|Yes|.76902|03/29/2022|.75056|03/29/2022|.75556|03/29/2022|||COUGH AND COLD: COLD|16702|||||No|No||RECKITT BENCKIS|No||||
guaifenesin/pseudoephedrne HCl|No|No|No|No|75%|63824004124|MUCINEX D ER 1,200-120 MG TAB|24|EA|.38485|12/04/2007||Yes|No||||No|No|12/04/2007||Yes|No||||No|No|||Over the counter|No||182|Yes|.8771|12/29/2020|.86457|12/29/2020|.8234|12/29/2020|||COUGH AND COLD: COLD|16703|||||No|No||RECKITT BENCKIS|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|63824005632|MUCINEX DM ER 600-30 MG TABLET|20|EA|.22553|08/26/2009||Yes|No||||No|No|||No|No||||No|No|||Over the counter|No||184|Yes|.50381|11/23/2021|.49171|11/23/2021|.49499|11/23/2021|||COUGH AND COLD: NON-NARCOTIC|16704|||||No|No||RECKITT BENCKIS|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|63824005634|MUCINEX DM ER 600-30 MG TABLET|40|EA|.20242|08/26/2009||Yes|No||||No|No|08/26/2009||Yes|No||||No|No|||Over the counter|No||184|Yes|.50381|11/23/2021|.49171|11/23/2021|.49499|11/23/2021|||COUGH AND COLD: NON-NARCOTIC|16705|||||No|No||RECKITT BENCKIS|No||||
guaifenesin/pseudoephedrne HCl|No|No|No|No|75%|63824005718|MUCINEX D ER 600-60 MG TABLET|18|EA|.27113|11/09/2005||Yes|No||||No|No|11/09/2005||Yes|No||||No|No|||Over the counter|No||182|Yes|.61411|03/29/2022|.59937|03/29/2022|.60336|03/29/2022|||COUGH AND COLD: COLD|16706|||||No|No||RECKITT BENCKIS|No||||
guaifenesin/pseudoephedrne HCl|No|No|No|No|75%|63824005736|MUCINEX D ER 600-60 MG TABLET|36|EA|.23446|12/07/2006||Yes|No||||No|No|12/07/2006||Yes|No||||No|No|||Over the counter|No||182|Yes|.61411|03/29/2022|.59937|03/29/2022|.60336|03/29/2022|||COUGH AND COLD: COLD|16707|||||No|No||RECKITT BENCKIS|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|63824007235|MUCINEX DM ER 1,200-60 MG TAB|14|EA|.38239|08/26/2009||Yes|No||||No|No|08/26/2009||Yes|No||||No|No|||Over the counter|No||184|Yes|.86389|03/29/2022|.84315|03/29/2022|.84877|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|16708|||||No|No||RECKITT BENCKIS|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|63824007236|MUCINEX DM ER 1,200-60 MG TAB|28|EA|.33186|09/08/2009||Yes|No||||No|No|09/08/2009||Yes|No||||No|No|||Over the counter|No||184|Yes|.86389|03/29/2022|.84315|03/29/2022|.84877|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|16709|||||No|No||RECKITT BENCKIS|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|63824007246|MUCINEX DM ER 1,200-60 MG TAB|42|EA|.27448|06/01/2015||Yes|No||||No|No|06/01/2015||Yes|No||||No|No|||Over the counter|No||184|Yes|.86389|03/29/2022|.84315|03/29/2022|.84877|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|16710|||||No|No||RECKITT BENCKIS|No||||
dextromethorphan polistirex|No|No|No|No|75%|63824017163|DELSYM 30 MG/5 ML SUSPENSION|89|ML|.04019|12/07/2009||Yes|No||||No|No|12/07/2009||Yes|No||||No|No|||Over the counter|No||184|Yes|.0929|01/25/2022|.09067|01/25/2022|.09127|01/25/2022|||COUGH AND COLD: NON-NARCOTIC|16711|||||No|No||RECKITT BENCKIS|No||||
dextromethorphan polistirex|No|No|No|No|75%|63824017165|DELSYM 30 MG/5 ML SUSPENSION|148|ML|.03215|02/22/2010||Yes|No||||No|No|02/22/2010||Yes|No||||No|No|||Over the counter|No||184|Yes|.0742|03/29/2022|.07241|03/29/2022|.0729|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|16712|||||No|No||RECKITT BENCKIS|No||||
dextromethorphan polistirex|No|No|No|No|75%|63824017365|CHILD DELSYM COUGH 30 MG/5 ML|148|ML|.03215|06/28/2017||Yes|No||||No|No|06/28/2017||Yes|No||||No|No|||Over the counter|No||184|Yes|.0742|03/29/2022|.07241|03/29/2022|.0729|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|16713|||||No|No||RECKITT BENCKIS|No||||
dextromethorphan polistirex|No|No|No|No|75%|63824017563|DELSYM 30 MG/5 ML SUSPENSION|89|ML|.04019|02/22/2010||Yes|No||||No|No|02/22/2010||Yes|No||||No|No|||Over the counter|No||184|Yes|.0929|01/25/2022|.09067|01/25/2022|.09127|01/25/2022|||COUGH AND COLD: NON-NARCOTIC|16714|||||No|No||RECKITT BENCKIS|No||||
dextromethorphan polistirex|No|No|No|No|75%|63824017565|DELSYM 30 MG/5 ML SUSPENSION|148|ML|.03215|12/07/2009||Yes|No||||No|No|12/07/2009||Yes|No||||No|No|||Over the counter|No||184|Yes|.0742|03/29/2022|.07241|03/29/2022|.0729|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|16715|||||No|No||RECKITT BENCKIS|No||||
dextromethorphan polistirex|No|No|No|No|75%|63824017765|CHILD DELSYM COUGH 30 MG/5 ML|148|ML|.03215|06/28/2017||Yes|No||||No|No|06/28/2017||Yes|No||||No|No|||Over the counter|No||184|Yes|.0742|03/29/2022|.07241|03/29/2022|.0729|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|16716|||||No|No||RECKITT BENCKIS|No||||
guaifen/phenyleph/acetaminophn|No|No|No|No|75%|63824019020|MUCINEX FAST-MAX COLD-SINUS TB|20|EA|.2279|01/23/2015||Yes|No||||No|No|01/23/2015||Yes|No||||No|No|||Over the counter|No||182|No|.52908|06/29/2021|.51638|06/29/2021|.51982|06/29/2021|||COUGH AND COLD: COLD|16717|||||No|No||RECKITT BENCKIS|No||||
guaifen/dextromethorphan/PE|No|No|No|No|75%|63824019320|MUCINEX FAST-MAX CONGEST-COUGH|20|EA|.2279|01/05/2015||Yes|No||||No|No|01/05/2015||Yes|No||||No|No|||Over the counter|No||184|No|.5194|03/24/2020|.51198|03/24/2020|.4876|03/24/2020|||COUGH AND COLD: NON-NARCOTIC|16718|||||No|No||RECKITT BENCKIS|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|63824021366|DELSYM COUGH+CHEST CNGST DM LQ|180|ML|.023|01/05/2015||Yes|No||||No|No|01/05/2015||Yes|No||||No|No|||Over the counter|No||184|Yes|.05474|10/26/2021|.05342|10/26/2021|.05378|10/26/2021|||COUGH AND COLD: NON-NARCOTIC|16719|||||No|No||RECKITT BENCKIS|No||||
guaifenesin|No|No|No|No|75%|63824025412|CHILD MUCINEX CHEST 100 MG PKT|12|EA|.26445|08/04/2009||Yes|No||||No|No|08/04/2009||Yes|No||||No|No|||Over the counter|No||182|Yes|.62604|10/26/2021|.61101|10/26/2021|.61508|10/26/2021|||COUGH AND COLD: COLD|16720|||||No|No||RECKITT BENCKIS|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|63824025612|CHILD MUCINEX COUGH 5-100MG PK|12|EA|.26445|08/04/2009||Yes|No||||No|No|08/04/2009||Yes|No||||No|No|||Over the counter|No||184|Yes|.60995|01/25/2022|.59531|01/25/2022|.59927|01/25/2022|||COUGH AND COLD: NON-NARCOTIC|16721|||||No|No||RECKITT BENCKIS|No||||
phenylephrine/DM/acetaminop/GG|No|No|No|No|75%|63824027864|CHILD'S MUCINEX COLD-CGH-SORE|118|ML|.02689|12/29/2014||Yes|No||||No|No|12/29/2014||Yes|No||||No|No|||Over the counter|No||184|No|.06636|03/01/2022|.06476|03/01/2022|.06519|03/01/2022|||COUGH AND COLD: NON-NARCOTIC|16722|||||No|No||RECKITT BENCKIS|No||||
guaifen/dextromethorphan/PE|No|No|No|No|75%|63824028267|CHILD MUCINEX MULTI-SYMPTOM LQ|201|ML|.0222|01/05/2015||Yes|No||||No|No|01/05/2015||Yes|No||||No|No|||Over the counter|No||184|Yes|.0506|03/19/2019|.04988|03/19/2019|.0475|03/19/2019|||COUGH AND COLD: NON-NARCOTIC|16723|||||No|No||RECKITT BENCKIS|No||||
diphenhydram/PE/DM/acetamin/GG|No|No|No|No|75%|63824028722|CHILD MUCINEX M-S COLD DAY-NTE|236|ML|.02652|01/05/2015||Yes|No||||No|No|01/05/2015||Yes|No||||No|No|||Over the counter|No||184|No|.06045|03/19/2019|.05959|03/19/2019|.05675|03/19/2019|||COUGH AND COLD: NON-NARCOTIC|16724|||||No|No||RECKITT BENCKIS|No||||
diphenhyd/phenyleph/acetaminop|No|No|No|No|75%|63824050066|MUCINEX FAST-MAX NITE COLD-FLU|180|ML|.02484|01/05/2015||Yes|No||||No|No|01/05/2015||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|.05661|11/24/2020|.0558|11/24/2020|.05314|11/24/2020|||COUGH AND COLD: COLD|16725|||||No|No||RECKITT BENCKIS|No||||
diphenhydram/PE/DM/acetamin/GG|No|No|No|No|75%|63824052622|MUCINEX FAST-MAX DAY-NITE COLD|360|ML|.01892|01/05/2015||Yes|No||||No|No|01/05/2015||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|No|.04313|03/19/2019|.04252|03/19/2019|.04049|03/19/2019|||COUGH AND COLD: NON-NARCOTIC|16726|||||No|No||RECKITT BENCKIS|No||||
diphenhydram/PE/DM/acetamin/GG|No|No|No|No|75%|63824055530|MUCINEX FAST-MAX DAY-NITE CONG|30|EA|.18418|01/05/2015||Yes|No||||No|No|01/05/2015||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|No|.41976|06/01/2016|.41376|06/01/2016|.39406|06/01/2016|||COUGH AND COLD: NON-NARCOTIC|16727|||||No|No||RECKITT BENCKIS|No||||
diphenhyd/phenyleph/acetaminop|No|No|No|No|75%|63824060064|CHILD MUCINEX NIGHT TIME LIQ|118|ML|.02689|01/05/2015||Yes|No||||No|No|01/05/2015||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|.06128|03/19/2019|.06041|03/19/2019|.05753|03/19/2019|||COUGH AND COLD: COLD|16728|||||No|No||RECKITT BENCKIS|No||||
hum prothrombin cplx(PCC)4fact|No|No|No|No|75%|63833038602|KCENTRA 500 UNIT VIAL|1|EA|1.8496|06/21/2013||Yes|No||06/21/2013||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No|||No|2.6656|10/05/2021|2.62752|10/05/2021|2.5024|10/05/2021||||16729|||||No|No||CSL BEHRING LLC|No||||
hum prothrombin cplx(PCC)4fact|No|No|No|No|75%|63833038702|KCENTRA 1,000 UNIT VIAL|1|EA|1.8496|12/11/2020||Yes|No||12/11/2020||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No|||No|2.6656|10/05/2021|2.62752|10/05/2021|2.5024|10/05/2021||||16730|||||No|No||CSL BEHRING LLC|No||||
factor XIII|No|No|No|No|75%|63833051802|CORIFACT KIT|1|EA|7.5752|04/07/2011||Yes|No||04/07/2011||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|10.9172|10/05/2021|10.76124|10/05/2021|10.2488|10/05/2021|||HEMOPHILIA TREATMENT|16731|||||No|No||CSL BEHRING LLC|No||||
antihemophilic factor/VWF|No|No|No|No|75%|63833061502|HUMATE-P 600 UNIT VWF:RCO|1|EA|.9724|07/30/2010||Yes|No||07/30/2010||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.4014|10/05/2021|1.38138|10/05/2021|1.3156|10/05/2021|||HEMOPHILIA TREATMENT|16732|||||No|No||CSL BEHRING LLC|No||||
antihemophilic factor/VWF|No|No|No|No|75%|63833061602|HUMATE-P 1,200 UNIT VWF:RCO|1|EA|.9724|07/30/2010||Yes|No||07/30/2010||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.4014|10/05/2021|1.38138|10/05/2021|1.3156|10/05/2021|||HEMOPHILIA TREATMENT|16733|||||No|No||CSL BEHRING LLC|No||||
antihemophilic factor/VWF|No|No|No|No|75%|63833061702|HUMATE-P 2,400 UNIT VWF:RCO|1|EA|.9724|07/30/2010||Yes|No||07/30/2010||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.4014|10/05/2021|1.38138|10/05/2021|1.3156|10/05/2021|||HEMOPHILIA TREATMENT|16734|||||No|No||CSL BEHRING LLC|No||||
C1 esterase inhibitor|No|No|No|No|75%|63833082502|BERINERT 500 UNIT KIT|1|EA|1468.7725|01/10/2014||Yes|No||01/10/2014||Yes|No|01/10/2014||Yes|No||||No|No|||Prescription required|No||501|No|3347.435|01/04/2022|3299.6145|01/04/2022|3142.49|01/04/2022|||HAE TREATMENTS|16735|||||No|No||CSL BEHRING LLC|No||||
C1 esterase inhibitor|No|No|No|No|75%|63833082802|HAEGARDA 2,000 UNIT VIAL|1|EA|883.3576|12/22/2017||Yes|No||12/22/2017||Yes|No|12/22/2017||Yes|No||||No|No|||Prescription required|No||501|No|2013.2336|01/04/2022|1984.47312|01/04/2022|1889.9744|01/04/2022|||HAE TREATMENTS|16736|||||No|No||CSL BEHRING LLC|No||||
C1 esterase inhibitor|No|No|No|No|75%|63833082902|HAEGARDA 3,000 UNIT VIAL|1|EA|1325.0364|12/22/2017||Yes|No||12/22/2017||Yes|No|12/22/2017||Yes|No||||No|No|||Prescription required|No||501|No|3019.8504|01/04/2022|2976.70968|01/04/2022|2834.9616|01/04/2022|||HAE TREATMENTS|16737|||||No|No||CSL BEHRING LLC|No||||
diphenhydramine HCl|No|No|No|No|75%|63868008701|QC COMPLETE ALLERGY 25 MG CAP|100|EA|.00915|11/03/2014||Yes|No||||No|No|11/03/2014||Yes|No||||No|No|||Over the counter|No||574|Yes|.03464|03/29/2022|.0338|03/29/2022|.03403|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|16738|||||No|No||CHAIN DRUG|No||||
tolnaftate|No|No|No|No|75%|63868010446|QC TOLNAFTATE 1% CREAM|30|GM|.01906|08/08/2005||Yes|No||||No|No|08/08/2005||Yes|No||||No|No|||Over the counter|No||061|No|.11362|03/29/2022|.11089|03/29/2022|.11163|03/29/2022|||ANTIFUNGALS: TOPICAL|16739|||||No|No||CHAIN DRUG|No||||
acetaminophen/diphenhydramine|No|No|No|No|75%|63868032550|QC NON-ASPIRIN PM CAPLET|50|EA|.01143|10/29/2014||Yes|No||||No|No|10/29/2014||Yes|No||||No|No|||Over the counter|No|||Yes|.04432|03/29/2022|.04325|03/29/2022|.04354|03/29/2022||||16740|||||No|No||CHAIN DRUG|No||||
naproxen sodium|No|No|No|No|75%|63868046501|QC NAPROXEN SOD 220 MG TABLET|100|EA|.01896|11/03/2014||Yes|No||||No|No|11/03/2014||Yes|No||||No|No|||Over the counter|No||059|Yes|.0581|03/29/2022|.0567|03/29/2022|.05708|03/29/2022|||NSAIDS|16741|||||No|No||CHAIN DRUG|No||||
naproxen sodium|No|No|No|No|75%|63868046550|QC NAPROXEN SOD 220 MG TABLET|50|EA|.02132|11/03/2014||Yes|No||||No|No|11/03/2014||Yes|No||||No|No|||Over the counter|No||059|Yes|.0581|03/29/2022|.0567|03/29/2022|.05708|03/29/2022|||NSAIDS|16742|||||No|No||CHAIN DRUG|No||||
diphenhydramine HCl|No|No|No|No|75%|63868061132|QC NIGHTTIME SLEEP 25 MG TAB|32|EA|.01881|10/29/2014||Yes|No||||No|No|10/29/2014||Yes|No||||No|No|||Over the counter|No|||Yes|.06006|03/29/2022|.05861|03/29/2022|.059|03/29/2022||||16743|||||No|No||CHAIN DRUG|No||||
ibuprofen|No|No|No|No|75%|63868075940|QC IBUPROFEN 200 MG SOFTGEL|40|EA|.03386|02/10/2007||Yes|No||||No|No|02/10/2007||Yes|No||||No|No|||Over the counter|No||059|Yes|.07198|03/29/2022|.07025|03/29/2022|.07072|03/29/2022|||NSAIDS|16744|||||No|No||CHAIN DRUG|No||||
diphenhydramine HCl|No|No|No|No|75%|63868082354|QC CHILD ALLERGY 12.5 MG/5 ML|118|ML|.00626|01/26/2005||Yes|No||||No|No|01/26/2005||Yes|No||||No|No|||Over the counter|No||574|Yes|.01468|03/29/2022|.01432|03/29/2022|.01442|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|16745|||||No|No||CHAIN DRUG|No||||
hydroxyprogesterone caproat/PF|No|No|No|No|75%|64011030103|MAKENA 275 MG/1.1 ML AUTOINJCT|1.1|ML|313.9|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||||No|No|||Prescription required|No||151|Yes|715.4|05/29/2018|705.18|05/29/2018|671.6|05/29/2018|||PROGESTATIONAL AGENTS|16746|||||No|No||AMAG/COVIS PHAR|No||||
anti-inhibitor coagulant comp.|No|No|No|No|75%|64193042402|FEIBA NF 1,000 UNIT (NOMINAL)|1|EA|1.6728|05/23/2013||Yes|No||05/23/2013||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.4108|01/11/2022|2.37636|01/11/2022|2.2632|01/11/2022|||HEMOPHILIA TREATMENT|16747|||||No|No||BAXALTA US INC.|No||||
anti-inhibitor coagulant comp.|No|No|No|No|75%|64193042502|FEIBA NF 2,500 UNIT (NOMINAL)|1|EA|1.6728|05/23/2013||Yes|No||05/23/2013||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.4108|01/11/2022|2.37636|01/11/2022|2.2632|01/11/2022|||HEMOPHILIA TREATMENT|16748|||||No|No||BAXALTA US INC.|No||||
anti-inhibitor coagulant comp.|No|No|No|No|75%|64193042602|FEIBA NF 500 UNIT (NOMINAL)|1|EA|1.6728|01/05/2018||Yes|No||01/05/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.4108|01/11/2022|2.37636|01/11/2022|2.2632|01/11/2022|||HEMOPHILIA TREATMENT|16749|||||No|No||BAXALTA US INC.|No||||
coagulation factor X|No|No|No|No|75%|64208775201|COAGADEX 250 UNIT VIAL|1|EA|6.9836|10/07/2016||Yes|No||10/07/2016||Yes|No|10/07/2016||Yes|No||||No|No|||Prescription required|No||105|No|10.0646|02/22/2022|9.92082|02/22/2022|9.4484|02/22/2022|||HEMOPHILIA TREATMENT|16750|||||No|No||BIO PRODUCTS LA|No||||
coagulation factor X|No|No|No|No|75%|64208775301|COAGADEX 500 UNIT VIAL|1|EA|6.9836|10/07/2016||Yes|No||10/07/2016||Yes|No|10/07/2016||Yes|No||||No|No|||Prescription required|No||105|No|10.0646|02/22/2022|9.92082|02/22/2022|9.4484|02/22/2022|||HEMOPHILIA TREATMENT|16751|||||No|No||BIO PRODUCTS LA|No||||
propranolol HCl|No|No|No|No|75%|64370037501|HEMANGEOL 4.28 MG/ML ORAL SOLN|120|ML|2.07496|07/14/2014||Yes|No||07/14/2014||Yes|No|07/14/2014||Yes|No||||No|No|||Prescription required|No||070|No|4.72899|08/06/2019|4.66143|08/06/2019|4.43946|08/06/2019|||BETA-BLOCKERS|16752|||||No|No||PIERRE FABRE PH|No||||
ped mvit A,C,D3 no.21/fluoride|No|No|No|No|75%|64376082350|TRIPLE-VIT W-FLUOR 0.25 MG/ML|50|ML|.08144|08/19/2013||Yes|No||||No|No|||No|No||||No|No|||Over the counter|No|||No|.18561|07/07/2020|.18296|07/07/2020|.17424|07/07/2020||||16753|||||No|No||PAR PHARM.|No||||
lamivudine/zidovudine|No|No|No|No|75%|64380070703|LAMIVUDINE-ZIDOVUDINE TABLET|60|EA|1.33599|12/22/2015||Yes|No||12/22/2015||Yes|No|12/22/2015||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.62913|12/28/2021|.61403|12/28/2021|.61812|12/28/2021|||HIV / AIDS|16754|||||No|No||STRIDES PHARMA|No||||
lamivudine|No|No|No|No|75%|64380071003|LAMIVUDINE 150 MG TABLET|60|EA|.75|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.96758|11/23/2021|.94435|11/23/2021|.95064|11/23/2021|||HIV / AIDS|16755|||||No|No||STRIDES PHARMA|No||||
lamivudine|No|No|No|No|75%|64380071104|LAMIVUDINE 300 MG TABLET|30|EA|1.5|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|1.29184|03/01/2022|1.26083|03/01/2022|1.26923|03/01/2022|||HIV / AIDS|16756|||||No|No||STRIDES PHARMA|No||||
benzonatate|No|No|No|No|75%|64380071206|BENZONATATE 100 MG CAPSULE|100|EA|.12878|12/22/2015||Yes|No||12/22/2015||Yes|No|12/22/2015||Yes|No||||No|No|||Prescription required|No||184|Yes|.09389|03/29/2022|.09163|03/29/2022|.09224|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|16757|||||No|No||STRIDES PHARMA|No||||
benzonatate|No|No|No|No|75%|64380071207|BENZONATATE 100 MG CAPSULE|500|EA|.0989|03/28/2018||Yes|No||03/28/2018||Yes|No|03/28/2018||Yes|No||||No|No|||Prescription required|No||184|Yes|.09389|03/29/2022|.09163|03/29/2022|.09224|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|16758|||||No|No||STRIDES PHARMA|No||||
benzonatate|No|No|No|No|75%|64380071306|BENZONATATE 200 MG CAPSULE|100|EA|.18275|12/22/2015||Yes|No||12/22/2015||Yes|No|12/22/2015||Yes|No||||No|No|||Prescription required|No||184|Yes|.14345|03/29/2022|.14|03/29/2022|.14093|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|16759|||||No|No||STRIDES PHARMA|No||||
benzonatate|No|No|No|No|75%|64380071307|BENZONATATE 200 MG CAPSULE|500|EA|.13629|12/13/2019||Yes|No||12/13/2019||Yes|No|12/13/2019||Yes|No||||No|No|||Prescription required|No||184|Yes|.14345|03/29/2022|.14|03/29/2022|.14093|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|16760|||||No|No||STRIDES PHARMA|No||||
tenofovir disoproxil fumarate|No|No|No|No|75%|64380071404|TENOFOVIR DISOP FUM 300 MG TB|30|EA|1.21999|03/13/2018||Yes|No||03/13/2018||Yes|No|03/13/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.62458|03/29/2022|.60959|03/29/2022|.61364|03/29/2022|||HIV / AIDS|16761|||||No|No||STRIDES PHARMA|No||||
abacavir sulfate|No|No|No|No|75%|64380071703|ABACAVIR 300 MG TABLET|60|EA|4.09749|06/29/2021||Yes|No||06/29/2021||Yes|No|06/29/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.69669|03/29/2022|.67996|03/29/2022|.68449|03/29/2022|||HIV / AIDS|16762|||||No|No||STRIDES PHARMA|No||||
emtricitabine/tenofovir (TDF)|No|No|No|No|75%|64380071904|EMTRICITABINE-TENOFV 200-300MG|30|EA|1.5|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.70347|03/29/2022|.68658|03/29/2022|.69115|03/29/2022|||HIV / AIDS|16763|||||No|No||STRIDES PHARMA|No||||
tacrolimus|No|No|No|No|75%|64380072006|TACROLIMUS 0.5 MG CAPSULE (IR)|100|EA|.2389|01/09/2015||Yes|No||01/09/2015||Yes|No|01/09/2015||Yes|No||04/01/2019||Yes|No|||Prescription required|No||229|No|.26138|03/29/2022|.2551|03/29/2022|.2568|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|16764|||||No|No||STRIDES PHARMA|No||||
tacrolimus|No|No|No|No|75%|64380072106|TACROLIMUS 1 MG CAPSULE (IR)|100|EA|.47777|01/09/2015||Yes|No||01/09/2015||Yes|No|01/09/2015||Yes|No||04/01/2019||Yes|No|||Prescription required|No||229|No|.35645|03/29/2022|.34789|03/29/2022|.35021|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|16765|||||No|No||STRIDES PHARMA|No||||
tacrolimus|No|No|No|No|75%|64380072206|TACROLIMUS 5 MG CAPSULE (IR)|100|EA|2.38886|01/09/2015||Yes|No||01/09/2015||Yes|No|01/09/2015||Yes|No||04/01/2019||Yes|No|||Prescription required|No||229|No|2.05753|03/29/2022|2.00814|03/29/2022|2.02152|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|16766|||||No|No||STRIDES PHARMA|No||||
calcitriol|No|No|No|No|75%|64380072304|CALCITRIOL 0.25 MCG CAPSULE|30|EA|.41294|05/13/2015||Yes|No||05/13/2015||Yes|No|05/13/2015||Yes|No||04/01/2019||Yes|No|||Prescription required|No|||No|.18695|03/29/2022|.18246|03/29/2022|.18367|03/29/2022||||16767|||||No|No||STRIDES PHARMA|No||||
calcitriol|No|No|No|No|75%|64380072306|CALCITRIOL 0.25 MCG CAPSULE|100|EA|.40673|05/13/2015||Yes|No||05/13/2015||Yes|No|05/13/2015||Yes|No||04/01/2019||Yes|No|||Prescription required|No|||No|.18695|03/29/2022|.18246|03/29/2022|.18367|03/29/2022||||16768|||||No|No||STRIDES PHARMA|No||||
calcitriol|No|No|No|No|75%|64380072406|CALCITRIOL 0.5 MCG CAPSULE|100|EA|.65033|05/13/2015||Yes|No||05/13/2015||Yes|No|05/13/2015||Yes|No||04/01/2019||Yes|No|||Prescription required|No|||No|.32158|03/29/2022|.31386|03/29/2022|.31595|03/29/2022||||16769|||||No|No||STRIDES PHARMA|No||||
mycophenolate mofetil|No|No|No|No|75%|64380072506|MYCOPHENOLATE 500 MG TABLET|100|EA|.31011|04/22/2014||Yes|No||04/22/2014||Yes|No|04/22/2014||Yes|No||04/01/2019||Yes|No|||Prescription required|No||229|No|.30426|03/29/2022|.29695|03/29/2022|.29893|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|16770|||||No|No||STRIDES PHARMA|No||||
mycophenolate mofetil|No|No|No|No|75%|64380072507|MYCOPHENOLATE 500 MG TABLET|500|EA|.28522|02/19/2016||Yes|No||02/19/2016||Yes|No|02/19/2016||Yes|No||04/01/2019||Yes|No|||Prescription required|No||229|No|.30426|03/29/2022|.29695|03/29/2022|.29893|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|16771|||||No|No||STRIDES PHARMA|No||||
mycophenolate mofetil|No|No|No|No|75%|64380072606|MYCOPHENOLATE 250 MG CAPSULE|100|EA|.15497|04/22/2014||Yes|No||04/22/2014||Yes|No|04/22/2014||Yes|No||04/01/2019||Yes|No|||Prescription required|No||229|No|.2129|03/29/2022|.20779|03/29/2022|.20917|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|16772|||||No|No||STRIDES PHARMA|No||||
mycophenolate mofetil|No|No|No|No|75%|64380072607|MYCOPHENOLATE 250 MG CAPSULE|500|EA|.14252|02/19/2016||Yes|No||02/19/2016||Yes|No|02/19/2016||Yes|No||04/01/2019||Yes|No|||Prescription required|No||229|No|.2129|03/29/2022|.20779|03/29/2022|.20917|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|16773|||||No|No||STRIDES PHARMA|No||||
hydralazine HCl|No|No|No|No|75%|64380073406|HYDRALAZINE 25 MG TABLET|100|EA|.06553|04/22/2014||Yes|No||04/22/2014||Yes|No|04/22/2014||Yes|No||04/01/2019||Yes|No|||Prescription required|No|||No|.04116|03/29/2022|.04017|03/29/2022|.04043|03/29/2022||||16774|||||No|No||STRIDES PHARMA|No||||
hydralazine HCl|No|No|No|No|75%|64380073408|HYDRALAZINE 25 MG TABLET|1000|EA|.06222|02/19/2016||Yes|No||02/19/2016||Yes|No|02/19/2016||Yes|No||04/01/2019||Yes|No|||Prescription required|No|||No|.04116|03/29/2022|.04017|03/29/2022|.04043|03/29/2022||||16775|||||No|No||STRIDES PHARMA|No||||
hydralazine HCl|No|No|No|No|75%|64380073506|HYDRALAZINE 50 MG TABLET|100|EA|.08187|04/22/2014||Yes|No||04/22/2014||Yes|No|04/22/2014||Yes|No||04/01/2019||Yes|No|||Prescription required|No|||No|.0521|03/29/2022|.05084|03/29/2022|.05118|03/29/2022||||16776|||||No|No||STRIDES PHARMA|No||||
hydralazine HCl|No|No|No|No|75%|64380073508|HYDRALAZINE 50 MG TABLET|1000|EA|.07368|02/19/2016||Yes|No||02/19/2016||Yes|No|02/19/2016||Yes|No||04/01/2019||Yes|No|||Prescription required|No|||No|.0521|03/29/2022|.05084|03/29/2022|.05118|03/29/2022||||16777|||||No|No||STRIDES PHARMA|No||||
hydralazine HCl|No|No|No|No|75%|64380073606|HYDRALAZINE 100 MG TABLET|100|EA|.15273|04/22/2014||Yes|No||04/22/2014||Yes|No|04/22/2014||Yes|No||04/01/2019||Yes|No|||Prescription required|No|||No|.0869|03/29/2022|.08481|03/29/2022|.08537|03/29/2022||||16778|||||No|No||STRIDES PHARMA|No||||
ergocalciferol (vitamin D2)|No|No|No|No|75%|64380073706|VITAMIN D2 1.25MG(50,000 UNIT)|100|EA|.15652|03/12/2015||Yes|No||03/12/2015||Yes|No|03/12/2015||Yes|No||04/01/2019||Yes|No|||Prescription required|No|||No|.14082|03/29/2022|.13744|03/29/2022|.13835|03/29/2022||||16779|||||No|No||STRIDES PHARMA|No||||
buspirone HCl|No|No|No|No|75%|64380074106|BUSPIRONE HCL 5 MG TABLET|100|EA|.02064|05/14/2015||Yes|No||05/14/2015||Yes|No|05/14/2015||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|16780|||||No|No||STRIDES PHARMA|No||||
buspirone HCl|No|No|No|No|75%|64380074107|BUSPIRONE HCL 5 MG TABLET|500|EA|.02086|03/09/2016||Yes|No||03/09/2016||Yes|No|03/09/2016||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|16781|||||No|No||STRIDES PHARMA|No||||
buspirone HCl|No|No|No|No|75%|64380074108|BUSPIRONE HCL 5 MG TABLET|1000|EA|.01374|03/09/2016||Yes|No||03/09/2016||Yes|No|03/09/2016||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|16782|||||No|No||STRIDES PHARMA|No||||
buspirone HCl|No|No|No|No|75%|64380074206|BUSPIRONE HCL 10 MG TABLET|100|EA|.03633|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|16783|||||No|No||STRIDES PHARMA|No||||
buspirone HCl|No|No|No|No|75%|64380074207|BUSPIRONE HCL 10 MG TABLET|500|EA|.03639|03/09/2016||Yes|No||03/09/2016||Yes|No|03/09/2016||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|16784|||||No|No||STRIDES PHARMA|No||||
buspirone HCl|No|No|No|No|75%|64380074208|BUSPIRONE HCL 10 MG TABLET|1000|EA|.02679|03/09/2016||Yes|No||03/09/2016||Yes|No|03/09/2016||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|16785|||||No|No||STRIDES PHARMA|No||||
buspirone HCl|No|No|No|No|75%|64380074303|BUSPIRONE HCL 15 MG TABLET|60|EA|.0541|06/05/2018||Yes|No||06/05/2018||Yes|No|06/05/2018||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|16786|||||No|No||STRIDES PHARMA|No||||
buspirone HCl|No|No|No|No|75%|64380074318|BUSPIRONE HCL 15 MG TABLET|180|EA|.05303|06/05/2018||Yes|No||06/05/2018||Yes|No|06/05/2018||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|16787|||||No|No||STRIDES PHARMA|No||||
buspirone HCl|No|No|No|No|75%|64380074403|BUSPIRONE HCL 30 MG TABLET|60|EA|.46583|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No||090|No|.17728|03/29/2022|.17302|03/29/2022|.17417|03/29/2022|||ANXIOLYTICS|16788|||||No|No||STRIDES PHARMA|No||||
pramipexole di-HCl|No|No|No|No|75%|64380074605|PRAMIPEXOLE 0.125 MG TABLET|90|EA|.07166|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No||015|No|.05408|03/29/2022|.05278|03/29/2022|.05313|03/29/2022|||ANTIPARKINSON'S AGENTS|16789|||||No|No||STRIDES PHARMA|No||||
pramipexole di-HCl|No|No|No|No|75%|64380074705|PRAMIPEXOLE 0.25 MG TABLET|90|EA|.07166|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No||015|No|.05102|03/29/2022|.04979|03/29/2022|.05012|03/29/2022|||ANTIPARKINSON'S AGENTS|16790|||||No|No||STRIDES PHARMA|No||||
pramipexole di-HCl|No|No|No|No|75%|64380074805|PRAMIPEXOLE 0.5 MG TABLET|90|EA|.07166|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No||015|No|.05616|03/29/2022|.05481|03/29/2022|.05517|03/29/2022|||ANTIPARKINSON'S AGENTS|16791|||||No|No||STRIDES PHARMA|No||||
pramipexole di-HCl|No|No|No|No|75%|64380075005|PRAMIPEXOLE 1 MG TABLET|90|EA|.07166|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No||015|No|.06615|03/29/2022|.06456|03/29/2022|.06499|03/29/2022|||ANTIPARKINSON'S AGENTS|16792|||||No|No||STRIDES PHARMA|No||||
pramipexole di-HCl|No|No|No|No|75%|64380075105|PRAMIPEXOLE 1.5 MG TABLET|90|EA|.07166|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No||015|No|.07545|03/29/2022|.07363|03/29/2022|.07412|03/29/2022|||ANTIPARKINSON'S AGENTS|16793|||||No|No||STRIDES PHARMA|No||||
methoxsalen|No|No|No|No|75%|64380075216|METHOXSALEN 10 MG SOFTGEL|50|EA|28.70619|07/08/2014||Yes|No||07/08/2014||Yes|No|07/08/2014||Yes|No||||No|No|||Prescription required|No|||No|65.42342|06/01/2016|64.4888|06/01/2016|61.41791|06/01/2016||||16794|||||No|No||STRIDES PHARMA|No||||
acarbose|No|No|No|No|75%|64380075806|ACARBOSE 25 MG TABLET|100|EA|.16524|04/22/2014||Yes|No||04/22/2014||Yes|No|04/22/2014||Yes|No||||No|No|||Prescription required|No|||No|.17861|03/29/2022|.17432|03/29/2022|.17548|03/29/2022||||16795|||||No|No||STRIDES PHARMA|No||||
acarbose|No|No|No|No|75%|64380075906|ACARBOSE 50 MG TABLET|100|EA|.17789|04/22/2014||Yes|No||04/22/2014||Yes|No|04/22/2014||Yes|No||||No|No|||Prescription required|No|||No|.19141|03/29/2022|.18681|03/29/2022|.18806|03/29/2022||||16796|||||No|No||STRIDES PHARMA|No||||
acarbose|No|No|No|No|75%|64380076006|ACARBOSE 100 MG TABLET|100|EA|.21285|04/22/2014||Yes|No||04/22/2014||Yes|No|04/22/2014||Yes|No||||No|No|||Prescription required|No|||No|.31919|03/29/2022|.31152|03/29/2022|.3136|03/29/2022||||16797|||||No|No||STRIDES PHARMA|No||||
omega-3 acid ethyl esters|No|No|No|No|75%|64380076111|OMEGA-3 ETHYL ESTERS 1 GM CAP|120|EA|.34715|08/02/2019||Yes|No||08/02/2019||Yes|No|08/02/2019||Yes|No||||No|No|||Prescription required|No||055|Yes|.18363|03/29/2022|.17922|03/29/2022|.18041|03/29/2022|||LIPOTROPICS: OTHER|16798|||||No|No||STRIDES PHARMA|No||||
dutasteride|No|No|No|No|75%|64380076304|DUTASTERIDE 0.5 MG CAPSULE|30|EA|.28595|06/06/2016||Yes|No||06/06/2016||Yes|No|06/06/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|003|No|.20731|03/29/2022|.20233|03/29/2022|.20368|03/29/2022|||BPH TREATMENTS|16799|||||No|No||STRIDES PHARMA|No||||
dutasteride|No|No|No|No|75%|64380076305|DUTASTERIDE 0.5 MG CAPSULE|90|EA|.28595|06/06/2016||Yes|No||06/06/2016||Yes|No|06/06/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|003|No|.20731|03/29/2022|.20233|03/29/2022|.20368|03/29/2022|||BPH TREATMENTS|16800|||||No|No||STRIDES PHARMA|No||||
peg3350/sod sulf,bicarb,Cl/KCl|No|No|No|No|75%|64380076621|PEG-3350 AND ELECTROLYTES SOLN|4000|ML|.00607|06/29/2021||Yes|No||06/29/2021||Yes|No|06/29/2021||Yes|No||||No|No|||Prescription required|No|||No|.00317|03/29/2022|.00309|03/29/2022|.00311|03/29/2022||||16801|||||No|No||STRIDES PHARMA|No||||
sodium chloride/NaHCO3/KCl/peg|No|No|No|No|75%|64380076921|PEG 3350-ELECTROLYTE SOLUTION|4000|ML|.00607|11/26/2019||Yes|No||11/26/2019||Yes|No|11/26/2019||Yes|No||||No|No|||Prescription required|No|||No|.00933|03/29/2022|.0091|03/29/2022|.00916|03/29/2022||||16802|||||No|No||STRIDES PHARMA|No||||
metronidazole|No|No|No|No|75%|64380077906|METRONIDAZOLE 250 MG TABLET|100|EA|.12255|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|16803|||||No|No||STRIDES PHARMA|No||||
metronidazole|No|No|No|No|75%|64380077907|METRONIDAZOLE 250 MG TABLET|500|EA|.12407|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|16804|||||No|No||STRIDES PHARMA|No||||
metronidazole|No|No|No|No|75%|64380077925|METRONIDAZOLE 250 MG TABLET|50|EA|.17105|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|16805|||||No|No||STRIDES PHARMA|No||||
metronidazole|No|No|No|No|75%|64380077938|METRONIDAZOLE 250 MG TABLET|250|EA|.12667|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|16806|||||No|No||STRIDES PHARMA|No||||
metronidazole|No|No|No|No|75%|64380078006|METRONIDAZOLE 500 MG TABLET|100|EA|.21908|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No||115|No|.15479|03/29/2022|.15107|03/29/2022|.15208|03/29/2022|||ANTIBIOTICS: GI|16807|||||No|No||STRIDES PHARMA|No||||
metronidazole|No|No|No|No|75%|64380078007|METRONIDAZOLE 500 MG TABLET|500|EA|.20814|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No||115|No|.15479|03/29/2022|.15107|03/29/2022|.15208|03/29/2022|||ANTIBIOTICS: GI|16808|||||No|No||STRIDES PHARMA|No||||
metronidazole|No|No|No|No|75%|64380078025|METRONIDAZOLE 500 MG TABLET|50|EA|.2193|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No||115|No|.15479|03/29/2022|.15107|03/29/2022|.15208|03/29/2022|||ANTIBIOTICS: GI|16809|||||No|No||STRIDES PHARMA|No||||
buspirone HCl|No|No|No|No|75%|64380078706|BUSPIRONE HCL 7.5 MG TABLET|100|EA|.19543|09/22/2017||Yes|No||09/22/2017||Yes|No|09/22/2017||Yes|No||||No|No|||Prescription required|No||090|No|.22186|03/29/2022|.21653|03/29/2022|.21797|03/29/2022|||ANXIOLYTICS|16810|||||No|No||STRIDES PHARMA|No||||
lidocaine|No|No|No|No|75%|64380078923|LIDOCAINE 5% OINTMENT|30|GM|.86|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No|||No|.49802|03/29/2022|.48606|03/29/2022|.4893|03/29/2022||||16811|||||No|No||STRIDES PHARMA|No||||
lidocaine|No|No|No|No|75%|64380078932|LIDOCAINE 5% OINTMENT|35.44|GM|.24229|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No|||No|.18796|03/29/2022|.18344|03/29/2022|.18467|03/29/2022||||16812|||||No|No||STRIDES PHARMA|No||||
lidocaine|No|No|No|No|75%|64380078933|LIDOCAINE 5% OINTMENT|50|GM|.215|06/29/2021||Yes|No||06/29/2021||Yes|No|06/29/2021||Yes|No||||No|No|||Prescription required|No|||No|.22969|03/29/2022|.22417|03/29/2022|.22567|03/29/2022||||16813|||||No|No||STRIDES PHARMA|No||||
cyproheptadine HCl|No|No|No|No|75%|64380079506|CYPROHEPTADINE 4 MG TABLET|100|EA|.1118|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|No||574|Yes|.09783|03/29/2022|.09548|03/29/2022|.09611|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|16814|||||No|No||STRIDES PHARMA|No||||
cyproheptadine HCl|No|No|No|No|75%|64380079508|CYPROHEPTADINE 4 MG TABLET|1000|EA|.1118|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|No||574|Yes|.09783|03/29/2022|.09548|03/29/2022|.09611|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|16815|||||No|No||STRIDES PHARMA|No||||
oseltamivir phosphate|No|No|No|No|75%|64380079701|OSELTAMIVIR PHOS 30 MG CAPSULE|10|EA|3.42065|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|No||025|No|1.58155|03/29/2022|1.54359|03/29/2022|1.55387|03/29/2022|||ANTIVIRALS: ORAL|16816|||||No|No||STRIDES PHARMA|No||||
oseltamivir phosphate|No|No|No|No|75%|64380079801|OSELTAMIVIR PHOS 45 MG CAPSULE|10|EA|3.42065|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|No||025|No|1.5655|03/29/2022|1.52792|03/29/2022|1.5381|03/29/2022|||ANTIVIRALS: ORAL|16817|||||No|No||STRIDES PHARMA|No||||
oseltamivir phosphate|No|No|No|No|75%|64380079901|OSELTAMIVIR PHOS 75 MG CAPSULE|10|EA|3.72853|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|No||025|No|1.29695|03/29/2022|1.26582|03/29/2022|1.27425|03/29/2022|||ANTIVIRALS: ORAL|16818|||||No|No||STRIDES PHARMA|No||||
ibuprofen|No|No|No|No|75%|64380080706|IBUPROFEN 800 MG TABLET|100|EA|.06901|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||04/01/2019||Yes|No|||Prescription required|No||059|Yes|.07481|03/29/2022|.07301|03/29/2022|.0735|03/29/2022|||NSAIDS|16819|||||No|No||STRIDES PHARMA|No||||
ibuprofen|No|No|No|No|75%|64380080707|IBUPROFEN 800 MG TABLET|500|EA|.05891|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||04/01/2019||Yes|No|||Prescription required|No||059|Yes|.07481|03/29/2022|.07301|03/29/2022|.0735|03/29/2022|||NSAIDS|16820|||||No|No||STRIDES PHARMA|No||||
ibuprofen|No|No|No|No|75%|64380080806|IBUPROFEN 600 MG TABLET|100|EA|.04708|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||04/01/2019||Yes|No|||Prescription required|No||059|Yes|.06063|03/29/2022|.05917|03/29/2022|.05956|03/29/2022|||NSAIDS|16821|||||No|No||STRIDES PHARMA|No||||
ibuprofen|No|No|No|No|75%|64380080807|IBUPROFEN 600 MG TABLET|500|EA|.04536|06/25/2019||Yes|No||06/25/2019||Yes|No|06/25/2019||Yes|No||||No|No|||Prescription required|No||059|Yes|.06063|03/29/2022|.05917|03/29/2022|.05956|03/29/2022|||NSAIDS|16822|||||No|No||STRIDES PHARMA|No||||
ibuprofen|No|No|No|No|75%|64380080906|IBUPROFEN 400 MG TABLET|100|EA|.03375|06/25/2019||Yes|No||06/25/2019||Yes|No|06/25/2019||Yes|No||||No|No|||Prescription required|No||059|Yes|.04934|03/29/2022|.04815|03/29/2022|.04847|03/29/2022|||NSAIDS|16823|||||No|No||STRIDES PHARMA|No||||
ibuprofen|No|No|No|No|75%|64380080907|IBUPROFEN 400 MG TABLET|500|EA|.0313|06/25/2019||Yes|No||06/25/2019||Yes|No|06/25/2019||Yes|No||||No|No|||Prescription required|No||059|Yes|.04934|03/29/2022|.04815|03/29/2022|.04847|03/29/2022|||NSAIDS|16824|||||No|No||STRIDES PHARMA|No||||
ketoconazole|No|No|No|No|75%|64380082706|KETOCONAZOLE 200 MG TABLET|100|EA|.45193|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||04/01/2019||Yes|No|||Prescription required|No||069|No|.87128|03/29/2022|.85036|03/29/2022|.85603|03/29/2022|||ANTIFUNGALS: ORAL|16825|||||No|No||STRIDES PHARMA|No||||
acetazolamide|No|No|No|No|75%|64380083306|ACETAZOLAMIDE 125 MG TABLET|100|EA|.1892|02/15/2018||Yes|No||02/15/2018||Yes|No|02/15/2018||Yes|No||||No|No|||Prescription required|No|||No|.16397|03/29/2022|.16003|03/29/2022|.1611|03/29/2022||||16826|||||No|No||STRIDES PHARMA|No||||
acetazolamide|No|No|No|No|75%|64380083406|ACETAZOLAMIDE 250 MG TABLET|100|EA|.2838|02/15/2018||Yes|No||02/15/2018||Yes|No|02/15/2018||Yes|No||||No|No|||Prescription required|No|||No|.25723|03/29/2022|.25105|03/29/2022|.25272|03/29/2022||||16827|||||No|No||STRIDES PHARMA|No||||
nystatin/triamcin|No|No|No|No|75%|64380083622|NYSTATIN-TRIAMCINOLONE OINTM|15|GM|.4472|03/16/2020||Yes|No||03/16/2020||Yes|No|03/16/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|.4296|03/29/2022|.41928|03/29/2022|.42208|03/29/2022|||ANTIFUNGALS: TOPICAL|16828|||||No|No||STRIDES PHARMA|No||||
nystatin/triamcin|No|No|No|No|75%|64380083623|NYSTATIN-TRIAMCINOLONE OINTM|30|GM|.35131|03/16/2020||Yes|No||03/16/2020||Yes|No|03/16/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|.33412|03/29/2022|.3261|03/29/2022|.32827|03/29/2022|||ANTIFUNGALS: TOPICAL|16829|||||No|No||STRIDES PHARMA|No||||
nystatin/triamcin|No|No|No|No|75%|64380083653|NYSTATIN-TRIAMCINOLONE OINTM|60|GM|.28745|03/16/2020||Yes|No||03/16/2020||Yes|No|03/16/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|.24511|03/29/2022|.23922|03/29/2022|.24082|03/29/2022|||ANTIFUNGALS: TOPICAL|16830|||||No|No||STRIDES PHARMA|No||||
piroxicam|No|No|No|No|75%|64380084206|PIROXICAM 10 MG CAPSULE|100|EA|.2635|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.25876|03/01/2022|.25254|03/01/2022|.25423|03/01/2022|||NSAIDS|16831|||||No|No||STRIDES PHARMA|No||||
piroxicam|No|No|No|No|75%|64380084306|PIROXICAM 20 MG CAPSULE|100|EA|.46027|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.40758|03/29/2022|.39779|03/29/2022|.40044|03/29/2022|||NSAIDS|16832|||||No|No||STRIDES PHARMA|No||||
piroxicam|No|No|No|No|75%|64380084307|PIROXICAM 20 MG CAPSULE|500|EA|.46027|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.40758|03/29/2022|.39779|03/29/2022|.40044|03/29/2022|||NSAIDS|16833|||||No|No||STRIDES PHARMA|No||||
potassium chloride|No|No|No|No|75%|64380086006|POTASSIUM CL ER 8 MEQ TABLET|100|EA|.18451|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No|||No|.17696|03/29/2022|.17271|03/29/2022|.17386|03/29/2022||||16834|||||No|No||STRIDES PHARMA|No||||
potassium chloride|No|No|No|No|75%|64380086007|POTASSIUM CL ER 8 MEQ TABLET|500|EA|.18451|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No|||No|.17696|03/29/2022|.17271|03/29/2022|.17386|03/29/2022||||16835|||||No|No||STRIDES PHARMA|No||||
potassium chloride|No|No|No|No|75%|64380086008|POTASSIUM CL ER 8 MEQ TABLET|1000|EA|.1845|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No|||No|.17696|03/29/2022|.17271|03/29/2022|.17386|03/29/2022||||16836|||||No|No||STRIDES PHARMA|No||||
potassium chloride|No|No|No|No|75%|64380086106|POTASSIUM CL ER 10 MEQ TABLET|100|EA|.19423|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No|||No|.13824|03/29/2022|.13492|03/29/2022|.13582|03/29/2022||||16837|||||No|No||STRIDES PHARMA|No||||
potassium chloride|No|No|No|No|75%|64380086107|POTASSIUM CL ER 10 MEQ TABLET|500|EA|.19423|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No|||No|.13824|03/29/2022|.13492|03/29/2022|.13582|03/29/2022||||16838|||||No|No||STRIDES PHARMA|No||||
potassium chloride|No|No|No|No|75%|64380086108|POTASSIUM CL ER 10 MEQ TABLET|1000|EA|.19423|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No|||No|.13824|03/29/2022|.13492|03/29/2022|.13582|03/29/2022||||16839|||||No|No||STRIDES PHARMA|No||||
gabapentin|No|No|No|No|75%|64380086706|GABAPENTIN 100 MG CAPSULE|100|EA|.0215|09/23/2020|12/31/2022|Yes|No||09/23/2020|12/31/2022|Yes|No|09/23/2020|12/31/2022|Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|16840|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||STRIDES PHARMA|No||||
gabapentin|No|No|No|No|75%|64380086707|GABAPENTIN 100 MG CAPSULE|500|EA|.0215|09/23/2020|12/31/2022|Yes|No||09/23/2020|12/31/2022|Yes|No|09/23/2020|12/31/2022|Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|16841|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||STRIDES PHARMA|No||||
gabapentin|No|No|No|No|75%|64380086806|GABAPENTIN 300 MG CAPSULE|100|EA|.0301|09/23/2020|12/31/2022|Yes|No||09/23/2020|12/31/2022|Yes|No|09/23/2020|12/31/2022|Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|16842|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||STRIDES PHARMA|No||||
gabapentin|No|No|No|No|75%|64380086807|GABAPENTIN 300 MG CAPSULE|500|EA|.0301|09/23/2020|12/31/2022|Yes|No||09/23/2020|12/31/2022|Yes|No|09/23/2020|12/31/2022|Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|16843|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||STRIDES PHARMA|No||||
gabapentin|No|No|No|No|75%|64380086906|GABAPENTIN 400 MG CAPSULE|100|EA|.0344|09/23/2020|12/31/2022|Yes|No||09/23/2020|12/31/2022|Yes|No|09/23/2020|12/31/2022|Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|16844|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||STRIDES PHARMA|No||||
gabapentin|No|No|No|No|75%|64380086907|GABAPENTIN 400 MG CAPSULE|500|EA|.0344|09/23/2020|12/31/2022|Yes|No||09/23/2020|12/31/2022|Yes|No|09/23/2020|12/31/2022|Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|16845|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||STRIDES PHARMA|No||||
ethosuximide|No|No|No|No|75%|64380087806|ETHOSUXIMIDE 250 MG CAPSULE|100|EA|.516|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No||056|No|.61011|03/29/2022|.59546|03/29/2022|.59943|03/29/2022|||ANTICONVULSANTS|16846|||||No|No||STRIDES PHARMA|No||||
cinacalcet HCl|No|No|No|No|75%|64380088304|CINACALCET HCL 30 MG TABLET|30|EA|.76755|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No|||No|.75588|03/29/2022|.73773|03/29/2022|.74265|03/29/2022||||16847|||||No|No||STRIDES PHARMA|No||||
cinacalcet HCl|No|No|No|No|75%|64380088404|CINACALCET HCL 60 MG TABLET|30|EA|1.51259|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No|||No|1.7407|03/29/2022|1.69892|03/29/2022|1.71023|03/29/2022||||16848|||||No|No||STRIDES PHARMA|No||||
cinacalcet HCl|No|No|No|No|75%|64380088504|CINACALCET HCL 90 MG TABLET|30|EA|1.88669|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No|||No|3.64673|03/29/2022|3.5592|03/29/2022|3.58291|03/29/2022||||16849|||||No|No||STRIDES PHARMA|No||||
efavirenz|No|No|No|No|75%|64380088904|EFAVIRENZ 600 MG TABLET|30|EA|17.88639|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|5.43893|08/24/2021|5.30839|08/24/2021|5.34374|08/24/2021|||HIV / AIDS|16850|||||No|No||STRIDES PHARMA|No||||
tetracycline HCl|No|No|No|No|75%|64380089006|TETRACYCLINE 250 MG CAPSULE|100|EA|.71595|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|213|No|.9651|03/01/2022|.94193|03/01/2022|.94821|03/01/2022|||TETRACYCLINES|16851|||||No|No||STRIDES PHARMA|No||||
tetracycline HCl|No|No|No|No|75%|64380089106|TETRACYCLINE 500 MG CAPSULE|100|EA|1.41255|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|213|No|1.54692|03/29/2022|1.50979|03/29/2022|1.51984|03/29/2022|||TETRACYCLINES|16852|||||No|No||STRIDES PHARMA|No||||
triamcinolone acetonide|No|No|No|No|75%|64380090190|TRIAMCINOLONE 0.05% OINTMENT|430|GM|.77929|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No||120|No|1.23712|03/01/2022|1.20742|03/01/2022|1.21547|03/01/2022|||STEROIDS: TOPICAL HIGH|16853|||||No|No||STRIDES PHARMA|No||||
clarithromycin|No|No|No|No|75%|64380090503|CLARITHROMYCIN 250 MG TABLET|60|EA|.40133|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No||018|No|.54294|03/29/2022|.5299|03/29/2022|.53343|03/29/2022|||MACROLIDES/KETOLIDES|16854|||||No|No||STRIDES PHARMA|No||||
clarithromycin|No|No|No|No|75%|64380090603|CLARITHROMYCIN 500 MG TABLET|60|EA|.40133|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No||018|No|.44307|03/29/2022|.43243|03/29/2022|.43531|03/29/2022|||MACROLIDES/KETOLIDES|16855|||||No|No||STRIDES PHARMA|No||||
donepezil HCl|No|No|No|No|75%|64380090707|DONEPEZIL HCL 5 MG TABLET|500|EA|.1118|02/10/2021||Yes|No||02/10/2021||Yes|No|02/10/2021||Yes|No||||No|No|||Prescription required|No||011|Yes|.05093|03/29/2022|.0497|03/29/2022|.05003|03/29/2022|||ALZHEIMER'S AGENTS|16856|||||No|No||STRIDES PHARMA|No||||
donepezil HCl|No|No|No|No|75%|64380090804|DONEPEZIL HCL 10 MG TABLET|30|EA|.05733|11/13/2020||Yes|No||11/13/2020||Yes|No|11/13/2020||Yes|No||||No|No|||Prescription required|No||011|No|.04599|03/29/2022|.04488|03/29/2022|.04518|03/29/2022|||ALZHEIMER'S AGENTS|16857|||||No|No||STRIDES PHARMA|No||||
ursodiol|No|No|No|No|75%|64380091806|URSODIOL 250 MG TABLET|100|EA|.60939|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No||198|No|.5902|03/29/2022|.57603|03/29/2022|.57987|03/29/2022|||BILE SALTS|16858|||||No|No||STRIDES PHARMA|No||||
ursodiol|No|No|No|No|75%|64380091906|URSODIOL 500 MG TABLET|100|EA|1.27391|06/22/2021||Yes|No||06/22/2021||Yes|No|06/22/2021||Yes|No||||No|No|||Prescription required|No||198|No|.95342|03/29/2022|.93053|03/29/2022|.93673|03/29/2022|||BILE SALTS|16859|||||No|No||STRIDES PHARMA|No||||
losartan potassium|No|No|No|No|75%|64380093304|LOSARTAN POTASSIUM 25 MG TAB|30|EA|.17873|02/11/2021||Yes|No||02/11/2021||Yes|No|02/11/2021||Yes|No||||No|No|||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|16860|||||No|No||STRIDES PHARMA|No||||
losartan potassium|No|No|No|No|75%|64380093305|LOSARTAN POTASSIUM 25 MG TAB|90|EA|.17873|02/11/2021||Yes|No||02/11/2021||Yes|No|02/11/2021||Yes|No||||No|No|||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|16861|||||No|No||STRIDES PHARMA|No||||
losartan potassium|No|No|No|No|75%|64380093308|LOSARTAN POTASSIUM 25 MG TAB|1000|EA|.17873|02/11/2021||Yes|No||02/11/2021||Yes|No|02/11/2021||Yes|No||||No|No|||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|16862|||||No|No||STRIDES PHARMA|No||||
losartan potassium|No|No|No|No|75%|64380093404|LOSARTAN POTASSIUM 50 MG TAB|30|EA|.18432|02/11/2021||Yes|No||02/11/2021||Yes|No|02/11/2021||Yes|No||||No|No|||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|16863|||||No|No||STRIDES PHARMA|No||||
losartan potassium|No|No|No|No|75%|64380093405|LOSARTAN POTASSIUM 50 MG TAB|90|EA|.18432|02/11/2021||Yes|No||02/11/2021||Yes|No|02/11/2021||Yes|No||||No|No|||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|16864|||||No|No||STRIDES PHARMA|No||||
losartan potassium|No|No|No|No|75%|64380093408|LOSARTAN POTASSIUM 50 MG TAB|1000|EA|.18432|02/11/2021||Yes|No||02/11/2021||Yes|No|02/11/2021||Yes|No||||No|No|||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|16865|||||No|No||STRIDES PHARMA|No||||
losartan potassium|Yes|No|No|No|75%|64380093504|LOSARTAN POTASSIUM 100 MG TAB|30|EA|.1859|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|16866|||||No|No||STRIDES PHARMA|No||||
losartan potassium|Yes|No|No|No|75%|64380093505|LOSARTAN POTASSIUM 100 MG TAB|90|EA|.1859|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|16867|||||No|No||STRIDES PHARMA|No||||
losartan potassium|Yes|No|No|No|75%|64380093508|LOSARTAN POTASSIUM 100 MG TAB|1000|EA|.1859|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|16868|||||No|No||STRIDES PHARMA|No||||
hydrocortisone|No|No|No|No|75%|64380097025|HYDROCORTISONE 5 MG TABLET|50|EA|.22231|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|No||168|Yes|.21144|03/29/2022|.20636|03/29/2022|.20773|03/29/2022|||GLUCOCORTICOIDS: ORAL|16869|||||No|No||STRIDES PHARMA|No||||
hydrocortisone|No|No|No|No|75%|64380097106|HYDROCORTISONE 10 MG TABLET|100|EA|.36872|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|No||168|Yes|.28946|03/29/2022|.28251|03/29/2022|.28439|03/29/2022|||GLUCOCORTICOIDS: ORAL|16870|||||No|No||STRIDES PHARMA|No||||
hydrocortisone|No|No|No|No|75%|64380097206|HYDROCORTISONE 20 MG TABLET|100|EA|.66306|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|No||168|Yes|.46844|03/29/2022|.45719|03/29/2022|.46024|03/29/2022|||GLUCOCORTICOIDS: ORAL|16871|||||No|No||STRIDES PHARMA|No||||
dimethyl fumarate|No|No|No|No|75%|64406000501|TECFIDERA DR 120 MG CAPSULE|14|EA|59.31235|07/31/2013||Yes|No||07/31/2013||Yes|No|07/31/2013||Yes|No||||No|No|||Prescription required|No||043|No|135.17699|01/14/2020|133.24589|01/14/2020|126.90085|01/14/2020|||MULTIPLE SCLEROSIS AGENTS|16872|||||No|No||BIOGEN-IDEC|No||||
dimethyl fumarate|No|No|No|No|75%|64406000602|TECFIDERA DR 240 MG CAPSULE|60|EA|59.31054|07/31/2013||Yes|No||07/31/2013||Yes|No|07/31/2013||Yes|No||||No|No|||Prescription required|No||043|No|135.17287|01/14/2020|133.24182|01/14/2020|126.89698|01/14/2020|||MULTIPLE SCLEROSIS AGENTS|16873|||||No|No||BIOGEN-IDEC|No||||
dimethyl fumarate|No|No|No|No|75%|64406000703|TECFIDERA STARTER PACK|60|EA|59.31054|07/31/2013||Yes|No||07/31/2013||Yes|No|07/31/2013||Yes|No||||No|No|||Prescription required|No||043|No|135.17287|01/14/2020|133.24182|01/14/2020|126.89698|01/14/2020|||MULTIPLE SCLEROSIS AGENTS|16874|||||No|No||BIOGEN-IDEC|No||||
peginterferon beta-1a|No|No|No|No|75%|64406001101|PLEGRIDY 125 MCG/0.5 ML PEN|.5|ML|3191.331|11/09/2014||Yes|No||11/09/2014||Yes|No|11/09/2014||Yes|No||||No|No|||Prescription required|No||043|No|7273.266|01/04/2022|7169.3622|01/04/2022|6827.964|01/04/2022|||MULTIPLE SCLEROSIS AGENTS|16875|||||No|No||BIOGEN-IDEC|No||||
peginterferon beta-1a|No|No|No|No|75%|64406001201|PLEGRIDY PEN INJ STARTER PACK|1|ML|3191.331|11/09/2014||Yes|No||11/09/2014||Yes|No|11/09/2014||Yes|No||||No|No|||Prescription required|No||043|No|7273.266|01/04/2022|7169.3622|01/04/2022|6827.964|01/04/2022|||MULTIPLE SCLEROSIS AGENTS|16876|||||No|No||BIOGEN-IDEC|No||||
peginterferon beta-1a|No|No|No|No|75%|64406001501|PLEGRIDY 125 MCG/0.5 ML SYRING|.5|ML|3191.331|11/09/2014||Yes|No||11/09/2014||Yes|No|11/09/2014||Yes|No||||No|No|||Prescription required|No||043|No|7273.266|01/04/2022|7169.3622|01/04/2022|6827.964|01/04/2022|||MULTIPLE SCLEROSIS AGENTS|16877|||||No|No||BIOGEN-IDEC|No||||
peginterferon beta-1a|No|No|No|No|75%|64406001601|PLEGRIDY SYRINGE STARTER PACK|1|ML|3191.331|11/09/2014||Yes|No||11/09/2014||Yes|No|11/09/2014||Yes|No||||No|No|||Prescription required|No||043|No|7273.266|01/04/2022|7169.3622|01/04/2022|6827.964|01/04/2022|||MULTIPLE SCLEROSIS AGENTS|16878|||||No|No||BIOGEN-IDEC|No||||
peginterferon beta-1a|No|No|No|No|75%|64406001701|PLEGRIDY 125 MCG/0.5 ML SYRING|.5|ML|3191.331|06/10/2021||Yes|No||06/10/2021||Yes|No|06/10/2021||Yes|No||||No|No|||Prescription required|No||043|No|7273.266|01/04/2022|7169.3622|01/04/2022|6827.964|01/04/2022|||MULTIPLE SCLEROSIS AGENTS|16879|||||No|No||BIOGEN-IDEC|No||||
diroximel fumarate|No|No|No|No|75%|64406002003|VUMERITY DR 231 MG CAPSULE|120|EA|27.76312|05/11/2020||Yes|No||05/11/2020||Yes|No|05/11/2020||Yes|No||||No|No|||Prescription required|No||043|No|63.2741|01/04/2022|62.37018|01/04/2022|59.40017|01/04/2022|||MULTIPLE SCLEROSIS AGENTS|16880|||||No|No||BIOGEN-IDEC|No||||
diltiazem HCl|No|No|No|No|75%|64455077155|CARDIZEM 30 MG TABLET|500|EA|1.02946|03/17/2006||Yes|No||03/17/2006||Yes|No|03/17/2006||Yes|No||03/17/2006||Yes|No|||Prescription required|Yes|02/23/2004|045|No|2.34621|06/01/2016|2.3127|06/01/2016|2.20257|06/01/2016|||CALCIUM CHANNEL BLOCKERS|16881|||||No|No||BAUSCH HEALTH U|No||||
guaifenesin/phenylephrine HCl|No|No|No|No|75%|64543004404|RESCON-GG LIQUID|120|ML|.02881|11/20/2001||Yes|No||||No|No|11/20/2001||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|.06566|02/28/2017|.06472|02/28/2017|.06164|02/28/2017|||COUGH AND COLD: COLD|16882|||||No|No||CAPELLON|No||||
guaifenesin/phenylephrine HCl|No|No|No|No|75%|64543004416|RESCON-GG LIQUID|480|ML|.02453|11/20/2001||Yes|No||||No|No|11/20/2001||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|.05591|06/01/2016|.05511|06/01/2016|.05249|06/01/2016|||COUGH AND COLD: COLD|16883|||||No|No||CAPELLON|No||||
dexchlorpheniramin/pseudoephed|No|No|No|No|75%|64543009790|RESCON TABLET|90|EA|.43|09/27/2012||Yes|No||||No|No|09/27/2012||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|.98|06/01/2016|.966|06/01/2016|.92|06/01/2016|||COUGH AND COLD: COLD|16884|||||No|No||CAPELLON|No||||
chlorpheniramin/pseudoephed/DM|No|No|No|No|75%|64543010504|RESCON-DM LIQUID|118|ML|.03079|09/21/2001||Yes|No||||No|No|09/21/2001||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.07017|06/01/2016|.06917|06/01/2016|.06588|06/01/2016|||COUGH AND COLD: NON-NARCOTIC|16885|||||No|No||CAPELLON|No||||
chlorpheniramin/pseudoephed/DM|No|No|No|No|75%|64543010516|RESCON-DM LIQUID|480|ML|.0257|09/21/2001||Yes|No||||No|No|09/21/2001||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.05857|06/01/2016|.05773|06/01/2016|.05498|06/01/2016|||COUGH AND COLD: NON-NARCOTIC|16886|||||No|No||CAPELLON|No||||
dextromethorphan Hbr/quinidine|No|No|No|No|75%|64597030160|NUEDEXTA 20-10 MG CAPSULE|60|EA|10.2125|03/28/2011||Yes|No||03/28/2011||Yes|No|03/28/2011||Yes|No||||No|No|||Prescription required|No|||Yes|22.77188|01/18/2022|22.22535|01/18/2022|22.37337|01/18/2022||||16887|||||No|No||AVANIR PHARMACE|No||||
iron/FA/dha/epa/FAD/NADH/mv47|No|No|No|No|75%|64661071130|ENLYTE SOFTGEL|30|EA|2.21521|06/02/2015||Yes|No||06/29/2015||Yes|No|06/02/2015||Yes|No||||No|No|||Over the counter|No|||No|4.9632|03/01/2022|4.84408|03/01/2022|4.87634|03/01/2022||||16888|||||No|No||JAYMAC PHARMA|No||||
piperacillin sodium/tazobactam|No|No|No|No|75%|64679001201|PIPERACIL-TAZOBACT 4.5 GM VIAL|1|EA|6.27843|12/12/2018||Yes|No||12/12/2018||Yes|No|12/12/2018||Yes|No||||No|No|||Prescription required|No|||No|14.30898|12/12/2018|14.10456|12/12/2018|13.43292|12/12/2018||||16889|||||No|No||WOCKHARDT USA L|No||||
abiraterone acetate|No|No|No|No|75%|64679002101|ABIRATERONE ACETATE 250 MG TAB|120|EA|.80625|04/20/2020||Yes|No||04/20/2020||Yes|No|04/20/2020||Yes|No||||No|No|||Prescription required|No||550|No|1.8375|09/28/2021|1.81125|09/28/2021|1.725|09/28/2021|||ONCOLOGY: ORAL - PROSTATE|16890|||||No|No||WOCKHARDT USA L|No||||
piperacillin sodium/tazobactam|No|No|No|No|75%|64679003401|PIPERACIL-TAZOBACT 2.25 GM VL|1|EA|3.30455|12/12/2018||Yes|No||12/12/2018||Yes|No|12/12/2018||Yes|No||||No|No|||Prescription required|No|||No|7.5313|12/12/2018|7.42371|12/12/2018|7.0702|12/12/2018||||16891|||||No|No||WOCKHARDT USA L|No||||
piperacillin sodium/tazobactam|No|No|No|No|75%|64679005601|PIPERACIL-TAZOBACT 3.375 GM VL|1|EA|4.9579|12/12/2018||Yes|No||12/12/2018||Yes|No|12/12/2018||Yes|No||||No|No|||Prescription required|No|||No|11.2994|12/18/2018|11.13798|12/18/2018|10.6076|12/12/2018||||16892|||||No|No||WOCKHARDT USA L|No||||
azacitidine|No|No|No|No|75%|64679009601|AZACITIDINE 100 MG VIAL|1|EA|51.6|12/20/2018||Yes|No||12/20/2018||Yes|No|12/20/2018||Yes|No||||No|No|||Prescription required|No|||No|117.6|11/12/2019|115.92|11/12/2019|110.4|11/12/2019||||16893|||||No|No||WOCKHARDT USA L|No||||
piperacillin sodium/tazobactam|No|No|No|No|75%|64679067901|PIPERACIL-TAZOBACT 40.5 GRAM|1|EA|51.6|12/12/2018||Yes|No||12/12/2018||Yes|No|12/12/2018||Yes|No||||No|No|||Prescription required|No|||No|117.6|12/12/2018|115.92|12/12/2018|110.4|12/12/2018||||16894|||||No|No||WOCKHARDT USA L|No||||
oxacillin sodium|No|No|No|No|75%|64679069801|OXACILLIN 1 GM VIAL|1|EA|3.5647|12/12/2018||Yes|No||12/12/2018||Yes|No|12/12/2018||Yes|No||||No|No|||Prescription required|No|||No|8.1242|12/18/2018|8.00814|12/12/2018|7.6268|12/18/2018||||16895|||||No|No||WOCKHARDT USA L|No||||
oxacillin sodium|No|No|No|No|75%|64679069901|OXACILLIN 2 GM VIAL|1|EA|7.1294|12/12/2018||Yes|No||12/12/2018||Yes|No|12/12/2018||Yes|No||||No|No|||Prescription required|No|||No|16.2484|12/18/2018|16.01628|12/12/2018|15.2536|12/18/2018||||16896|||||No|No||WOCKHARDT USA L|No||||
oxacillin sodium|No|No|No|No|75%|64679070003|OXACILLIN 10 GM VIAL|1|EA|35.647|12/20/2018||Yes|No||12/20/2018||Yes|No|12/20/2018||Yes|No||||No|No|||Prescription required|No|||No|81.242|12/20/2018|80.0814|12/20/2018|76.268|12/20/2018||||16897|||||No|No||WOCKHARDT USA L|No||||
sumatriptan succinate|No|No|No|No|75%|64679072801|SUMATRIPTAN 6 MG/0.5 ML VIAL|.5|ML|20.64|12/06/2014||Yes|No||12/06/2014||Yes|No|12/06/2014||Yes|No||||No|No|||Prescription required|No||021|No|17.0535|01/25/2022|16.64421|01/25/2022|16.75506|01/25/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|16898|||||No|No||WOCKHARDT USA L|No||||
fosphenytoin sodium|No|No|No|No|75%|64679072901|FOSPHENYTOIN 100 MG PE/2 ML VL|2|ML|1.075|12/13/2018||Yes|No||12/13/2018||Yes|No|12/13/2018||Yes|No||||No|No|||Prescription required|No|||No|2.45|12/13/2018|2.415|12/13/2018|2.3|12/13/2018||||16899|||||No|No||WOCKHARDT USA L|No||||
fosphenytoin sodium|No|No|No|No|75%|64679073001|FOSPHENYTOIN 500 MG PE/10 ML|10|ML|1.075|12/13/2018||Yes|No||12/13/2018||Yes|No|12/13/2018||Yes|No||||No|No|||Prescription required|No|||No|2.45|12/13/2018|2.415|12/13/2018|2.3|12/13/2018||||16900|||||No|No||WOCKHARDT USA L|No||||
entacapone|No|No|No|No|75%|64679078102|ENTACAPONE 200 MG TABLET|100|EA|.2666|11/18/2014||Yes|No||11/18/2014||Yes|No|11/18/2014||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|015|No|.43301|03/29/2022|.42261|03/29/2022|.42543|03/29/2022|||ANTIPARKINSON'S AGENTS|16901|||||No|No||WOCKHARDT USA L|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|64679078204|CARBIDOPA-LEVODOPA 50 MG-ENTA|100|EA|1.29025|03/07/2016||Yes|No||03/07/2016||Yes|No|03/07/2016||Yes|No||||No|No|||Prescription required|No||015|No|2.94058|10/29/2019|2.89857|10/29/2019|2.76055|10/29/2019|||ANTIPARKINSON'S AGENTS|16902|||||No|No||WOCKHARDT USA L|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|64679078304|CARBIDOPA-LEVODOPA 75 MG-ENTA|100|EA|1.29025|03/07/2016||Yes|No||03/07/2016||Yes|No|03/07/2016||Yes|No||||No|No|||Prescription required|No||015|No|2.94058|08/24/2021|2.89857|08/24/2021|2.76055|08/24/2021|||ANTIPARKINSON'S AGENTS|16903|||||No|No||WOCKHARDT USA L|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|64679078404|CARBIDOPA-LEVODOPA 100 MG-ENTA|100|EA|1.29025|03/07/2016||Yes|No||03/07/2016||Yes|No|03/07/2016||Yes|No||||No|No|||Prescription required|No||015|No|.96003|03/01/2022|.93698|03/01/2022|.94322|03/01/2022|||ANTIPARKINSON'S AGENTS|16904|||||No|No||WOCKHARDT USA L|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|64679078504|CARBIDOPA-LEVODOPA 125 MG-ENTA|100|EA|1.29025|03/07/2016||Yes|No||03/07/2016||Yes|No|03/07/2016||Yes|No||||No|No|||Prescription required|No||015|No|.9119|07/27/2021|.89001|07/27/2021|.89594|07/27/2021|||ANTIPARKINSON'S AGENTS|16905|||||No|No||WOCKHARDT USA L|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|64679078604|CARBIDOPA-LEVODOPA 150 MG-ENTA|100|EA|1.29025|03/07/2016||Yes|No||03/07/2016||Yes|No|03/07/2016||Yes|No||||No|No|||Prescription required|No||015|No|1.0904|05/25/2021|1.06423|05/25/2021|1.07131|05/25/2021|||ANTIPARKINSON'S AGENTS|16906|||||No|No||WOCKHARDT USA L|No||||
carbidopa/levodopa/entacapone|No|No|No|No|75%|64679078704|CARBIDOPA-LEVODOPA 200 MG-ENTA|100|EA|1.29025|03/07/2016||Yes|No||03/07/2016||Yes|No|03/07/2016||Yes|No||||No|No|||Prescription required|No||015|No|.96506|03/29/2022|.94189|03/29/2022|.94817|03/29/2022|||ANTIPARKINSON'S AGENTS|16907|||||No|No||WOCKHARDT USA L|No||||
bupropion HCl|No|No|No|No|75%|64679083001|BUPROPION HCL XL 450 MG TABLET|30|EA|3.58333|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|031|No|9.2459|03/29/2022|9.02399|03/29/2022|9.08409|03/29/2022|||ANTIDEPRESSANTS: OTHER|16908|||||No|No||WOCKHARDT USA L|No||||
enalapril maleate|Yes|No|No|No|75%|64679092302|ENALAPRIL MALEATE 2.5 MG TAB|100|EA|.15978|09/20/2004||Yes|No||09/20/2004||Yes|No|09/20/2004||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.11585|03/29/2022|.11306|03/29/2022|.11382|03/29/2022|||ANGIOTENSIN MODULATORS|16909|||||No|No||WOCKHARDT USA L|No||||
enalapril maleate|Yes|No|No|No|75%|64679092303|ENALAPRIL MALEATE 2.5 MG TAB|1000|EA|.03195|09/20/2004||Yes|No||09/20/2004||Yes|No|09/20/2004||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.11585|03/29/2022|.11306|03/29/2022|.11382|03/29/2022|||ANGIOTENSIN MODULATORS|16910|||||No|No||WOCKHARDT USA L|No||||
enalapril maleate|Yes|No|No|No|75%|64679092402|ENALAPRIL MALEATE 5 MG TABLET|100|EA|.203|06/20/2005||Yes|No||06/20/2005||Yes|No|06/20/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.15947|03/29/2022|.15564|03/29/2022|.15667|03/29/2022|||ANGIOTENSIN MODULATORS|16911|||||No|No||WOCKHARDT USA L|No||||
enalapril maleate|Yes|No|No|No|75%|64679092403|ENALAPRIL MALEATE 5 MG TABLET|1000|EA|.0406|09/20/2004||Yes|No||09/20/2004||Yes|No|09/20/2004||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.15947|03/29/2022|.15564|03/29/2022|.15667|03/29/2022|||ANGIOTENSIN MODULATORS|16912|||||No|No||WOCKHARDT USA L|No||||
enalapril maleate|Yes|No|No|No|75%|64679092502|ENALAPRIL MALEATE 10 MG TAB|100|EA|.21315|09/20/2004||Yes|No||09/20/2004||Yes|No|09/20/2004||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.11378|03/29/2022|.11104|03/29/2022|.11178|03/29/2022|||ANGIOTENSIN MODULATORS|16913|||||No|No||WOCKHARDT USA L|No||||
enalapril maleate|Yes|No|No|No|75%|64679092503|ENALAPRIL MALEATE 10 MG TAB|1000|EA|.20249|09/20/2004||Yes|No||09/20/2004||Yes|No|09/20/2004||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.11378|03/29/2022|.11104|03/29/2022|.11178|03/29/2022|||ANGIOTENSIN MODULATORS|16914|||||No|No||WOCKHARDT USA L|No||||
enalapril maleate|Yes|No|No|No|75%|64679092602|ENALAPRIL MALEATE 20 MG TAB|100|EA|.30327|09/20/2004||Yes|No||09/20/2004||Yes|No|09/20/2004||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.14625|03/29/2022|.14274|03/29/2022|.14369|03/29/2022|||ANGIOTENSIN MODULATORS|16915|||||No|No||WOCKHARDT USA L|No||||
enalapril maleate|Yes|No|No|No|75%|64679092603|ENALAPRIL MALEATE 20 MG TAB|1000|EA|.28812|09/20/2004||Yes|No||09/20/2004||Yes|No|09/20/2004||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.14625|03/29/2022|.14274|03/29/2022|.14369|03/29/2022|||ANGIOTENSIN MODULATORS|16916|||||No|No||WOCKHARDT USA L|No||||
azithromycin|No|No|No|No|75%|64679096101|AZITHROMYCIN 250 MG TABLET|30|EA|.91375|11/01/2017||Yes|No||11/01/2017||Yes|No|11/01/2017||Yes|No||||No|No|||Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|16917|||||No|No||WOCKHARDT USA L|No||||
azithromycin|Yes|No|No|No|75%|64679096105|AZITHROMYCIN 250 MG TABLET|6|EA|.23888|07/01/2018||Yes|No||07/01/2018||Yes|No|07/01/2018||Yes|No||||No|No|07/01/2018||Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|16918|||||No|No||WOCKHARDT USA L|No||||
azithromycin|No|No|No|No|75%|64679096201|AZITHROMYCIN 600 MG TABLET|30|EA|1.98029|09/01/2017||Yes|No||09/01/2017||Yes|No|09/01/2017||Yes|No||||No|No|||Prescription required|No||018|No|1.08173|08/24/2021|1.05576|08/24/2021|1.06279|08/24/2021|||MACROLIDES/KETOLIDES|16919|||||No|No||WOCKHARDT USA L|No||||
azithromycin|No|No|No|No|75%|64679096401|AZITHROMYCIN 500 MG TABLET|30|EA|1.57236|05/01/2018||Yes|No||05/01/2018||Yes|No|05/01/2018||Yes|No||||No|No|||Prescription required|No||018|No|.82092|03/29/2022|.80121|03/29/2022|.80655|03/29/2022|||MACROLIDES/KETOLIDES|16920|||||No|No||WOCKHARDT USA L|No||||
azithromycin|No|No|No|No|75%|64679096405|AZITHROMYCIN 500 MG TABLET|3|EA|1.2102|05/01/2018||Yes|No||05/01/2018||Yes|No|05/01/2018||Yes|No||||No|No|||Prescription required|No||018|No|.82092|03/29/2022|.80121|03/29/2022|.80655|03/29/2022|||MACROLIDES/KETOLIDES|16921|||||No|No||WOCKHARDT USA L|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|64720013010|DEXTROAMP-AMPHETAMINE 5 MG TAB|100|EA|.4954|06/01/2007||Yes|No||06/01/2007||Yes|No|06/01/2007||Yes|No||||No|No|||Prescription required|No||007|Yes|.37197|03/23/2021|.36304|03/23/2021|.36546|03/23/2021|||STIMULANTS AND RELATED AGENTS|16922|||||No|No||COREPHARMA LLC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|64720013210|DEXTROAMP-AMPHETAMIN 10 MG TAB|100|EA|.4954|06/01/2007||Yes|No||06/01/2007||Yes|No|06/01/2007||Yes|No||||No|No|||Prescription required|No||007|Yes|.29613|03/23/2021|.28902|03/23/2021|.29094|03/23/2021|||STIMULANTS AND RELATED AGENTS|16923|||||No|No||COREPHARMA LLC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|64720013510|DEXTROAMP-AMPHETAMIN 20 MG TAB|100|EA|.4954|06/01/2007||Yes|No||06/01/2007||Yes|No|06/01/2007||Yes|No||||No|No|||Prescription required|No||007|Yes|.38506|03/23/2021|.37581|03/23/2021|.37832|03/23/2021|||STIMULANTS AND RELATED AGENTS|16924|||||No|No||COREPHARMA LLC|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|64720013610|DEXTROAMP-AMPHETAMIN 30 MG TAB|100|EA|.4954|06/01/2007||Yes|No||06/01/2007||Yes|No|06/01/2007||Yes|No||||No|No|||Prescription required|No||007|Yes|.40933|03/23/2021|.3995|03/23/2021|.40216|03/23/2021|||STIMULANTS AND RELATED AGENTS|16925|||||No|No||COREPHARMA LLC|No||||
lansoprazole|No|No|No|No|75%|64764004613|PREVACID DR 30 MG CAPSULE|100|EA|5.94969|12/19/2009||Yes|No||12/19/2009||Yes|No|12/19/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|13.23|03/01/2022|12.91248|03/01/2022|12.99847|03/01/2022|||PROTON PUMP INHIBITORS|16926|||||No|No||TAKEDA PHARMACE|No||||
lubiprostone|No|No|No|No|75%|64764008060|AMITIZA 8 MCG CAPSULE|60|EA|2.65955|07/01/2008||Yes|No||07/01/2008||Yes|No|07/01/2008||Yes|No||||No|No|||Prescription required|No||534|Yes|5.94984|03/01/2022|5.80704|03/01/2022|5.84571|03/01/2022|||GI MOTILITY: CHRONIC|16927|||||No|No||TAKEDA PHARMACE|No||||
colchicine|No|No|No|No|75%|64764011901|COLCRYS 0.6 MG TABLET|100|EA|3.092|12/20/2012||Yes|No||12/20/2012||Yes|No|12/20/2012||Yes|No||12/20/2012||Yes|No|||Prescription required|Yes|01/25/2012|231|No|6.899|03/01/2022|6.73342|03/01/2022|6.77826|03/01/2022|||ANTIHYPERURICEMICS|16928|||||No|No||TAKEDA PHARMACE|No||||
colchicine|No|No|No|No|75%|64764011907|COLCRYS 0.6 MG TABLET|30|EA|3.09198|12/20/2012||Yes|No||12/20/2012||Yes|No|12/20/2012||Yes|No||12/20/2012||Yes|No|||Prescription required|Yes|01/25/2012|231|No|6.899|03/01/2022|6.73342|03/01/2022|6.77826|03/01/2022|||ANTIHYPERURICEMICS|16929|||||No|No||TAKEDA PHARMACE|No||||
alogliptin benz/pioglitazone|No|No|No|No|75%|64764012103|OSENI 12.5-15 MG TABLET|30|EA|5.86262|07/10/2013|08/31/2022|Yes|No||07/10/2013|08/31/2022|Yes|No|07/10/2013|08/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|13.36132|01/12/2021|13.17044|01/12/2021|12.54328|01/12/2021|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|16930|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||TAKEDA PHARMACE|No||||
alogliptin benz/pioglitazone|No|No|No|No|75%|64764012303|OSENI 12.5-30 MG TABLET|30|EA|5.86262|07/10/2013||Yes|No||07/10/2013||Yes|No|07/10/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|13.36132|01/12/2021|13.17044|01/12/2021|12.54328|01/12/2021|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|16931|||||No|No||TAKEDA PHARMACE|No||||
alogliptin benz/pioglitazone|No|No|No|No|75%|64764012403|OSENI 12.5-45 MG TABLET|30|EA|5.86262|07/10/2013|08/31/2022|Yes|No||07/10/2013|08/31/2022|Yes|No|07/10/2013|08/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|13.36132|01/12/2021|13.17044|01/12/2021|12.54328|01/12/2021|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|16932|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||TAKEDA PHARMACE|No||||
alogliptin benzoate|No|No|No|No|75%|64764012530|NESINA 12.5 MG TABLET|30|EA|5.86262|07/10/2013||Yes|No||07/10/2013||Yes|No|07/10/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|13.36132|01/12/2021|13.17044|01/12/2021|12.54328|01/12/2021|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|16933|||||No|No||TAKEDA PHARMACE|No||||
dexlansoprazole|No|No|No|No|75%|64764017130|DEXILANT DR 30 MG CAPSULE|30|EA|4.42025|04/21/2010||Yes|No||04/21/2010||Yes|No|04/21/2010||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|9.86865|10/26/2021|9.6318|10/26/2021|9.69594|10/26/2021|||PROTON PUMP INHIBITORS|16934|||||No|No||TAKEDA PHARMACE|No||||
dexlansoprazole|No|No|No|No|75%|64764017530|DEXILANT DR 60 MG CAPSULE|30|EA|4.42025|04/21/2010||Yes|No||04/21/2010||Yes|No|04/21/2010||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|9.85821|10/26/2021|9.62161|10/26/2021|9.68569|10/26/2021|||PROTON PUMP INHIBITORS|16935|||||No|No||TAKEDA PHARMACE|No||||
lubiprostone|No|No|No|No|75%|64764024060|AMITIZA 24 MCG CAPSULES|60|EA|2.65955|03/06/2008||Yes|No||03/06/2008||Yes|No|03/06/2008||Yes|No||||No|No|||Prescription required|No||534|Yes|5.92371|03/01/2022|5.78154|03/01/2022|5.82004|03/01/2022|||GI MOTILITY: CHRONIC|16936|||||No|No||TAKEDA PHARMACE|No||||
alogliptin benzoate|No|No|No|No|75%|64764025030|NESINA 25 MG TABLET|30|EA|5.86262|07/10/2013||Yes|No||07/10/2013||Yes|No|07/10/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|13.14915|03/29/2022|12.83357|03/29/2022|12.91903|03/29/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|16937|||||No|No||TAKEDA PHARMACE|No||||
alogliptin benz/pioglitazone|No|No|No|No|75%|64764025103|OSENI 25-15 MG TABLET|30|EA|5.86262|07/10/2013||Yes|No||07/10/2013||Yes|No|07/10/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|13.36132|01/12/2021|13.17044|01/12/2021|12.54328|01/12/2021|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|16938|||||No|No||TAKEDA PHARMACE|No||||
alogliptin benz/pioglitazone|No|No|No|No|75%|64764025303|OSENI 25-30 MG TABLET|30|EA|5.86262|07/10/2013||Yes|No||07/10/2013||Yes|No|07/10/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|13.36132|01/12/2021|13.17044|01/12/2021|12.54328|01/12/2021|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|16939|||||No|No||TAKEDA PHARMACE|No||||
alogliptin benz/pioglitazone|No|No|No|No|75%|64764025403|OSENI 25-45 MG TABLET|30|EA|5.86262|07/10/2013||Yes|No||07/10/2013||Yes|No|07/10/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|13.36132|01/12/2021|13.17044|01/12/2021|12.54328|01/12/2021|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|16940|||||No|No||TAKEDA PHARMACE|No||||
pioglitazone HCl/glimepiride|No|No|No|No|75%|64764030230|DUETACT 30-2 MG TABLET|30|EA|8.51113|10/16/2006||Yes|No||10/16/2006||Yes|No|10/16/2006||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|009|Yes|19.39746|01/23/2018|19.12035|01/23/2018|18.20986|01/23/2018|||HYPOGLYCEMICS: TZD|16941|||||No|No||TAKEDA PHARMACE|No||||
pioglitazone HCl/glimepiride|No|No|No|No|75%|64764030430|DUETACT 30-4 MG TABLET|30|EA|8.51113|10/16/2006||Yes|No||10/16/2006||Yes|No|10/16/2006||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|009|Yes|19.39746|01/23/2018|19.12035|01/23/2018|18.20986|01/23/2018|||HYPOGLYCEMICS: TZD|16942|||||No|No||TAKEDA PHARMACE|No||||
alogliptin benz/metformin HCl|No|No|No|No|75%|64764033560|KAZANO 12.5-500 MG TABLET|60|EA|2.93131|07/10/2013||Yes|No||07/10/2013||Yes|No|07/10/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|6.68066|01/12/2021|6.58522|01/12/2021|6.27164|01/12/2021|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|16943|||||No|No||TAKEDA PHARMACE|No||||
alogliptin benz/metformin HCl|No|No|No|No|75%|64764033760|KAZANO 12.5-1,000 MG TABLET|60|EA|2.93131|07/10/2013||Yes|No||07/10/2013||Yes|No|07/10/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|6.55933|03/29/2022|6.4019|03/29/2022|6.44454|03/29/2022|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|16944|||||No|No||TAKEDA PHARMACE|No||||
lansoprazole|No|No|No|No|75%|64764054311|PREVACID 15 MG SOLUTAB|100|EA|5.94969|01/15/2009||Yes|No||01/15/2009||Yes|No|01/15/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|13.55977|03/01/2022|13.36605|03/01/2022|12.72958|03/01/2022|||PROTON PUMP INHIBITORS|16945|||||No|No||TAKEDA PHARMACE|No||||
lansoprazole|No|No|No|No|75%|64764054411|PREVACID 30 MG SOLUTAB|100|EA|5.94969|01/15/2009||Yes|No||01/15/2009||Yes|No|01/15/2009||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|13.16874|06/29/2021|12.85269|06/29/2021|12.93828|06/29/2021|||PROTON PUMP INHIBITORS|16946|||||No|No||TAKEDA PHARMACE|No||||
alogliptin benzoate|No|No|No|No|75%|64764062530|NESINA 6.25 MG TABLET|30|EA|5.86262|07/10/2013||Yes|No||07/10/2013||Yes|No|07/10/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|111|Yes|13.36132|01/12/2021|13.17044|01/12/2021|12.54328|01/12/2021|||HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS|16947|||||No|No||TAKEDA PHARMACE|No||||
febuxostat|No|No|No|No|75%|64764067730|ULORIC 80 MG TABLET|30|EA|4.73043|06/02/2009||Yes|No||06/02/2009||Yes|No|06/02/2009||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|231|No|10.51428|12/28/2021|10.26193|12/28/2021|10.33028|12/28/2021|||ANTIHYPERURICEMICS|16948|||||No|No||TAKEDA PHARMACE|No||||
vortioxetine hydrobromide|No|No|No|No|75%|64764072030|TRINTELLIX 5 MG TABLET|30|EA|6.366|06/01/2016||Yes|No||06/01/2016||Yes|No|06/01/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|031|No|14.20358|01/18/2022|13.86269|01/18/2022|13.95501|01/18/2022|||ANTIDEPRESSANTS: OTHER|16949|||||No|No||TAKEDA PHARMACE|No||||
vortioxetine hydrobromide|No|No|No|No|75%|64764073030|TRINTELLIX 10 MG TABLET|30|EA|6.366|06/22/2016||Yes|No||06/22/2016||Yes|No|06/22/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|031|No|14.21151|01/18/2022|13.87043|01/18/2022|13.9628|01/18/2022|||ANTIDEPRESSANTS: OTHER|16950|||||No|No||TAKEDA PHARMACE|No||||
vortioxetine hydrobromide|No|No|No|No|75%|64764075030|TRINTELLIX 20 MG TABLET|30|EA|6.366|06/22/2016||Yes|No||06/22/2016||Yes|No|06/22/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|031|No|14.21203|01/18/2022|13.87094|01/18/2022|13.96331|01/18/2022|||ANTIDEPRESSANTS: OTHER|16951|||||No|No||TAKEDA PHARMACE|No||||
ramelteon|No|No|No|No|75%|64764080510|ROZEREM 8 MG TABLET|100|EA|5.57598|12/06/2006||Yes|No||12/06/2006||Yes|No|12/06/2006||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|054|Yes|12.50628|09/28/2021|12.20612|09/28/2021|12.28742|09/28/2021|||SEDATIVE HYPNOTICS|16952|||||No|No||TAKEDA PHARMACE|No||||
ramelteon|No|No|No|No|75%|64764080530|ROZEREM 8 MG TABLET|30|EA|5.57609|08/28/2006||Yes|No||08/28/2006||Yes|No|08/28/2006||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|054|Yes|12.50628|09/28/2021|12.20612|09/28/2021|12.28742|09/28/2021|||SEDATIVE HYPNOTICS|16953|||||No|No||TAKEDA PHARMACE|No||||
febuxostat|No|No|No|No|75%|64764091830|ULORIC 40 MG TABLET|30|EA|4.73043|06/02/2009||Yes|No||06/02/2009||Yes|No|06/02/2009||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|231|No|10.52439|06/29/2021|10.2718|06/29/2021|10.34021|06/29/2021|||ANTIHYPERURICEMICS|16954|||||No|No||TAKEDA PHARMACE|No||||
decitabine/cedazuridine|No|No|No|No|75%|64842072709|INQOVI 35 MG-100 MG TABLET|5|EA|657.4614|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|No||173|No|1498.4004|01/18/2022|1476.99468|01/18/2022|1406.6616|01/18/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|16955|||||No|No||TAIHO ONCOLOGY|No||||
trifluridine/tipiracil HCl|No|No|No|No|75%|64842102001|LONSURF 20 MG-8.19 MG TABLET|20|EA|107.78939|09/15/2016||Yes|No||09/15/2016||Yes|No|09/15/2016||Yes|No||||No|No|||Prescription required|No||239|No|245.65954|01/18/2022|242.15011|01/18/2022|230.61916|01/18/2022|||ONCOLOGY: ORAL - OTHER|16956|||||No|No||TAIHO ONCOLOGY|No||||
trifluridine/tipiracil HCl|No|No|No|No|75%|64842102002|LONSURF 20 MG-8.19 MG TABLET|40|EA|107.78928|09/15/2016||Yes|No||09/15/2016||Yes|No|09/15/2016||Yes|No||||No|No|||Prescription required|No||239|No|245.65929|01/18/2022|242.14987|01/18/2022|230.61893|01/18/2022|||ONCOLOGY: ORAL - OTHER|16957|||||No|No||TAIHO ONCOLOGY|No||||
trifluridine/tipiracil HCl|No|No|No|No|75%|64842102003|LONSURF 20 MG-8.19 MG TABLET|60|EA|107.78902|09/15/2016||Yes|No||09/15/2016||Yes|No|09/15/2016||Yes|No||||No|No|||Prescription required|No||239|No|245.65871|01/18/2022|242.1493|01/18/2022|230.61838|01/18/2022|||ONCOLOGY: ORAL - OTHER|16958|||||No|No||TAIHO ONCOLOGY|No||||
trifluridine/tipiracil HCl|No|No|No|No|75%|64842102501|LONSURF 15 MG-6.14 MG TABLET|20|EA|80.84193|09/15/2016||Yes|No||09/15/2016||Yes|No|09/15/2016||Yes|No||||No|No|||Prescription required|No||239|No|184.24441|01/18/2022|181.61234|01/18/2022|172.96414|01/18/2022|||ONCOLOGY: ORAL - OTHER|16959|||||No|No||TAIHO ONCOLOGY|No||||
trifluridine/tipiracil HCl|No|No|No|No|75%|64842102502|LONSURF 15 MG-6.14 MG TABLET|40|EA|80.84182|09/15/2016||Yes|No||09/15/2016||Yes|No|09/15/2016||Yes|No||||No|No|||Prescription required|No||239|No|184.24416|01/18/2022|181.6121|01/18/2022|172.96391|01/18/2022|||ONCOLOGY: ORAL - OTHER|16960|||||No|No||TAIHO ONCOLOGY|No||||
trifluridine/tipiracil HCl|No|No|No|No|75%|64842102503|LONSURF 15 MG-6.14 MG TABLET|60|EA|80.84186|09/15/2016||Yes|No||09/15/2016||Yes|No|09/15/2016||Yes|No||||No|No|||Prescription required|No||239|No|184.24424|01/18/2022|181.61218|01/18/2022|172.96398|01/18/2022|||ONCOLOGY: ORAL - OTHER|16961|||||No|No||TAIHO ONCOLOGY|No||||
carbidopa/levodopa|No|No|No|No|75%|64896066101|RYTARY ER 23.75 MG-95 MG CAP|100|EA|1.65421|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|015|No|3.6808|02/15/2022|3.59246|02/15/2022|3.61638|02/15/2022|||ANTIPARKINSON'S AGENTS|16962|||||No|No||AMNEAL PHARMACE|No||||
carbidopa/levodopa|No|No|No|No|75%|64896066201|RYTARY ER 36.25 MG-145 MG CAP|100|EA|1.65421|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|015|No|3.69893|02/15/2022|3.61015|02/15/2022|3.63419|02/15/2022|||ANTIPARKINSON'S AGENTS|16963|||||No|No||AMNEAL PHARMACE|No||||
carbidopa/levodopa|No|No|No|No|75%|64896066301|RYTARY ER 48.75 MG-195 MG CAP|100|EA|1.65421|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|015|No|3.73547|02/15/2022|3.64581|02/15/2022|3.67009|02/15/2022|||ANTIPARKINSON'S AGENTS|16964|||||No|No||AMNEAL PHARMACE|No||||
carbidopa/levodopa|No|No|No|No|75%|64896066401|RYTARY ER 61.25 MG-245 MG CAP|100|EA|2.07866|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|015|No|4.61306|02/15/2022|4.50234|02/15/2022|4.53233|02/15/2022|||ANTIPARKINSON'S AGENTS|16965|||||No|No||AMNEAL PHARMACE|No||||
mebendazole|No|No|No|No|75%|64896066930|EMVERM 100 MG TABLET CHEW|1|EA|241.6643|12/28/2017||Yes|No||12/28/2017||Yes|No|12/28/2017||Yes|No||||No|No|||Prescription required|No|||No|538.54925|02/15/2022|525.62406|02/15/2022|529.12463|02/15/2022||||16966|||||No|No||AMNEAL PHARMACE|No||||
zolmitriptan|No|No|No|No|75%|64896067151|ZOMIG 2.5 MG TABLET|6|EA|55.62623|07/01/2012||Yes|No||07/01/2012||Yes|No|07/01/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|126.77606|03/03/2020|124.96497|03/03/2020|119.01426|03/03/2020|||ANTIMIGRAINE AGENTS: TRIPTANS|16967|||||No|No||AMNEAL PHARMACE|No||||
zolmitriptan|No|No|No|No|75%|64896067250|ZOMIG 5 MG TABLET|3|EA|55.6248|07/01/2012||Yes|No||07/01/2012||Yes|No|07/01/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|126.7728|03/03/2020|124.96176|03/03/2020|119.0112|03/03/2020|||ANTIMIGRAINE AGENTS: TRIPTANS|16968|||||No|No||AMNEAL PHARMACE|No||||
zolmitriptan|No|No|No|No|75%|64896068151|ZOMIG 5 MG NASAL SPRAY|6|EA|42.03751|08/24/2012||Yes|No||08/24/2012||Yes|No|08/24/2012||Yes|No||||No|No|||Prescription required|No||021|No|94.22167|09/28/2021|91.96034|09/28/2021|92.57279|09/28/2021|||ANTIMIGRAINE AGENTS: TRIPTANS|16969|||||No|No||AMNEAL PHARMACE|No||||
zolmitriptan|No|No|No|No|75%|64896068251|ZOMIG 2.5 MG NASAL SPRAY|6|EA|42.03751|02/06/2014||Yes|No||02/06/2014||Yes|No|02/06/2014||Yes|No||||No|No|||Prescription required|No||021|No|95.80642|01/25/2022|94.43776|01/25/2022|89.94072|01/25/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|16970|||||No|No||AMNEAL PHARMACE|No||||
zolmitriptan|No|No|No|No|75%|64896069151|ZOMIG ZMT 2.5 MG TABLET|6|EA|55.62623|08/24/2012|08/31/2022|Yes|No||08/24/2012|08/31/2022|Yes|No|08/24/2012|08/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|126.77606|03/03/2020|124.96497|03/03/2020|119.01426|03/03/2020|||ANTIMIGRAINE AGENTS: TRIPTANS|16971|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
zolmitriptan|No|No|No|No|75%|64896069250|ZOMIG ZMT 5 MG TABLET|3|EA|55.6248|08/24/2012|08/31/2022|Yes|No||08/24/2012|08/31/2022|Yes|No|08/24/2012|08/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|126.7728|03/03/2020|124.96176|03/03/2020|119.0112|03/03/2020|||ANTIMIGRAINE AGENTS: TRIPTANS|16972|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
oxymorphone HCl|No|No|No|No|90%|64896069501|OXYMORPHONE HCL ER 5 MG TABLET|100|EA|1.56588|03/26/2020||Yes|No||03/26/2020||Yes|No|03/26/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|2.89875|05/25/2021|2.82918|05/25/2021|2.84802|05/25/2021|||ANALGESICS: NARCOTICS LONG|16973|||||No|No||AMNEAL PHARMACE|No||||
oxymorphone HCl|No|No|No|No|90%|64896069513|OXYMORPHONE HCL ER 5 MG TABLET|60|EA|1.56577|03/26/2020||Yes|No||03/26/2020||Yes|No|03/26/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|2.89875|05/25/2021|2.82918|05/25/2021|2.84802|05/25/2021|||ANALGESICS: NARCOTICS LONG|16974|||||No|No||AMNEAL PHARMACE|No||||
oxymorphone HCl|No|No|No|No|90%|64896069601|OXYMORPHONE HCL ER 7.5 MG TAB|100|EA|2.28622|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|5.21046|02/08/2022|5.13602|02/08/2022|4.89145|02/08/2022|||ANALGESICS: NARCOTICS LONG|16975|||||No|No||AMNEAL PHARMACE|No||||
oxymorphone HCl|No|No|No|No|90%|64896069613|OXYMORPHONE HCL ER 7.5 MG TAB|60|EA|2.28623|03/26/2020||Yes|No||03/26/2020||Yes|No|03/26/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|5.21049|02/08/2022|5.13605|02/08/2022|4.89148|02/08/2022|||ANALGESICS: NARCOTICS LONG|16976|||||No|No||AMNEAL PHARMACE|No||||
oxymorphone HCl|No|No|No|No|90%|64896069701|OXYMORPHONE HCL ER 10 MG TAB|100|EA|3.00686|03/26/2020||Yes|No||03/26/2020||Yes|No|03/26/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|5.61142|03/29/2022|5.47674|03/29/2022|5.51322|03/29/2022|||ANALGESICS: NARCOTICS LONG|16977|||||No|No||AMNEAL PHARMACE|No||||
oxymorphone HCl|No|No|No|No|90%|64896069713|OXYMORPHONE HCL ER 10 MG TAB|60|EA|3.00691|03/26/2020||Yes|No||03/26/2020||Yes|No|03/26/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|5.61142|03/29/2022|5.47674|03/29/2022|5.51322|03/29/2022|||ANALGESICS: NARCOTICS LONG|16978|||||No|No||AMNEAL PHARMACE|No||||
oxymorphone HCl|No|No|No|No|90%|64896069801|OXYMORPHONE HCL ER 15 MG TAB|100|EA|4.16966|03/26/2020||Yes|No||03/26/2020||Yes|No|03/26/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|7.74241|03/29/2022|7.55659|03/29/2022|7.60691|03/29/2022|||ANALGESICS: NARCOTICS LONG|16979|||||No|No||AMNEAL PHARMACE|No||||
oxymorphone HCl|No|No|No|No|90%|64896069813|OXYMORPHONE HCL ER 15 MG TAB|60|EA|4.16977|03/26/2020||Yes|No||03/26/2020||Yes|No|03/26/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|7.74241|03/29/2022|7.55659|03/29/2022|7.60691|03/29/2022|||ANALGESICS: NARCOTICS LONG|16980|||||No|No||AMNEAL PHARMACE|No||||
oxymorphone HCl|No|No|No|No|90%|64896069901|OXYMORPHONE HCL ER 20 MG TAB|100|EA|5.33294|03/25/2020||Yes|No||03/25/2020||Yes|No|03/25/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|9.9589|11/23/2021|9.71988|11/23/2021|9.78461|11/23/2021|||ANALGESICS: NARCOTICS LONG|16981|||||No|No||AMNEAL PHARMACE|No||||
oxymorphone HCl|No|No|No|No|90%|64896069913|OXYMORPHONE HCL ER 20 MG TAB|60|EA|5.333|03/25/2020||Yes|No||03/25/2020||Yes|No|03/25/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|9.9589|11/23/2021|9.71988|11/23/2021|9.78461|11/23/2021|||ANALGESICS: NARCOTICS LONG|16982|||||No|No||AMNEAL PHARMACE|No||||
oxymorphone HCl|No|No|No|No|90%|64896070001|OXYMORPHONE HCL ER 30 MG TAB|100|EA|7.67593|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|17.49398|02/08/2022|17.24406|02/08/2022|16.42292|02/08/2022|||ANALGESICS: NARCOTICS LONG|16983|||||No|No||AMNEAL PHARMACE|No||||
oxymorphone HCl|No|No|No|No|90%|64896070013|OXYMORPHONE HCL ER 30 MG TAB|60|EA|7.67599|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|17.49413|02/08/2022|17.24422|02/08/2022|16.42306|02/08/2022|||ANALGESICS: NARCOTICS LONG|16984|||||No|No||AMNEAL PHARMACE|No||||
oxymorphone HCl|No|No|No|No|90%|64896070101|OXYMORPHONE HCL ER 40 MG TAB|100|EA|10.01895|03/26/2020||Yes|No||03/26/2020||Yes|No|03/26/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|18.32064|06/29/2021|17.88094|06/29/2021|18.00002|06/29/2021|||ANALGESICS: NARCOTICS LONG|16985|||||No|No||AMNEAL PHARMACE|No||||
oxymorphone HCl|No|No|No|No|90%|64896070113|OXYMORPHONE HCL ER 40 MG TAB|60|EA|10.019|03/26/2020||Yes|No||03/26/2020||Yes|No|03/26/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|18.32064|06/29/2021|17.88094|06/29/2021|18.00002|06/29/2021|||ANALGESICS: NARCOTICS LONG|16986|||||No|No||AMNEAL PHARMACE|No||||
sod phos di, mono/K phos mono|No|No|No|No|75%|64980010401|PHOSPHA 250 NEUTRAL TABLET|100|EA|.14568|||No|No||09/07/2015||Yes|No|||No|No||||No|No|||Over the counter|No|||No|.22689|03/29/2022|.22144|03/29/2022|.22291|03/29/2022||||16987|||||No|No||RISING PHARM|No||||
diflorasone diacetate|No|No|No|No|75%|64980012403|DIFLORASONE 0.05% OINTMENT|30|GM|6.89734|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|120|No|15.71952|12/11/2020|15.49495|12/11/2020|14.7571|12/11/2020|||STEROIDS: TOPICAL HIGH|16988|||||No|No||RISING PHARM|No||||
diflorasone diacetate|No|No|No|No|75%|64980012415|DIFLORASONE 0.05% OINTMENT|15|GM|6.89748|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|120|No|15.71984|12/11/2020|15.49527|12/11/2020|14.7574|12/11/2020|||STEROIDS: TOPICAL HIGH|16989|||||No|No||RISING PHARM|No||||
diflorasone diacetate|No|No|No|No|75%|64980012445|DIFLORASONE 0.05% OINTMENT|45|GM|6.89738|12/15/2021||Yes|No||12/15/2021||Yes|No|12/15/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|120|No|15.71963|12/15/2021|15.49506|12/15/2021|14.7572|12/15/2021|||STEROIDS: TOPICAL HIGH|16990|||||No|No||RISING PHARM|No||||
diflorasone diacetate|No|No|No|No|75%|64980012460|DIFLORASONE 0.05% OINTMENT|60|GM|6.89734|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|120|No|15.71952|12/11/2020|15.49495|12/11/2020|14.7571|12/11/2020|||STEROIDS: TOPICAL HIGH|16991|||||No|No||RISING PHARM|No||||
dipyridamole|No|No|No|No|75%|64980013401|DIPYRIDAMOLE 50 MG TABLET|100|EA|.82001|08/24/2007||Yes|No||08/24/2007||Yes|No|08/24/2007||Yes|No||||No|No|||Prescription required|Yes|07/18/2006|004|No|1.35098|01/25/2022|1.31855|01/25/2022|1.32733|01/25/2022|||PLATELET AGGREGATION INHIBITORS|16992|||||No|No||RISING PHARM|No||||
dipyridamole|No|No|No|No|75%|64980013501|DIPYRIDAMOLE 75 MG TABLET|100|EA|1.09727|08/24/2007||Yes|No||08/24/2007||Yes|No|08/24/2007||Yes|No||||No|No|||Prescription required|Yes|07/18/2006|004|No|2.50076|12/28/2021|2.46503|12/28/2021|2.34765|12/28/2021|||PLATELET AGGREGATION INHIBITORS|16993|||||No|No||RISING PHARM|No||||
chloroquine phosphate|No|No|No|No|75%|64980017750|CHLOROQUINE PH 250 MG TABLET|50|EA|1.33196|12/13/2013||Yes|No||12/13/2013||Yes|No|12/13/2013||Yes|No||||No|No|||Prescription required|No|||No|3.03564|03/31/2020|2.99228|03/31/2020|2.84979|03/31/2020||||16994|||||No|No||RISING PHARM|No||||
chloroquine phosphate|No|No|No|No|75%|64980017802|CHLOROQUINE PH 500 MG TABLET|25|EA|3.45582|06/27/2013||Yes|No||06/27/2013||Yes|No|06/27/2013||Yes|No||||No|No|||Prescription required|No|||No|7.87606|03/31/2020|7.76354|03/31/2020|7.39385|03/31/2020||||16995|||||No|No||RISING PHARM|No||||
benazepril/hydrochlorothiazide|No|No|No|No|75%|64980019401|BENAZEPRIL-HCTZ 10-12.5 MG TAB|100|EA|.38472|09/24/2015|09/30/2023|Yes|No||09/24/2015|09/30/2023|Yes|No|09/24/2015|09/30/2023|Yes|No||||No|No|||Prescription required|Yes|07/27/2017|113|Yes|.40705|03/29/2022|.39728|03/29/2022|.39992|03/29/2022|||ANGIOTENSIN MODULATORS|16996|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||RISING PHARM|No||||
benazepril/hydrochlorothiazide|No|No|No|No|75%|64980019501|BENAZEPRIL-HCTZ 20-12.5 MG TAB|100|EA|.38472|09/24/2015|11/30/2022|Yes|No||09/24/2015|11/30/2022|Yes|No|09/24/2015|11/30/2022|Yes|No||||No|No|||Prescription required|Yes|07/27/2017|113|Yes|.60233|03/29/2022|.58787|03/29/2022|.59178|03/29/2022|||ANGIOTENSIN MODULATORS|16997|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||RISING PHARM|No||||
benazepril/hydrochlorothiazide|No|No|No|No|75%|64980019601|BENAZEPRIL-HCTZ 20-25 MG TAB|100|EA|.38472|09/24/2015|11/30/2023|Yes|No||09/24/2015|11/30/2023|Yes|No|09/24/2015|11/30/2023|Yes|No||||No|No|||Prescription required|Yes|07/27/2017|113|Yes|.5345|03/29/2022|.52167|03/29/2022|.52514|03/29/2022|||ANGIOTENSIN MODULATORS|16998|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||RISING PHARM|No||||
zolmitriptan|No|No|No|No|75%|64980020316|ZOLMITRIPTAN 2.5 MG TABLET|6|EA|8.815|06/22/2017||Yes|No||06/22/2017||Yes|No|06/22/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|1.43567|03/29/2022|1.40121|03/29/2022|1.41054|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|16999|||||No|No||RISING PHARM|No||||
zolmitriptan|No|No|No|No|75%|64980020413|ZOLMITRIPTAN 5 MG TABLET|3|EA|8.815|06/30/2016||Yes|No||06/30/2016||Yes|No|06/30/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|1.62826|03/29/2022|1.58918|03/29/2022|1.59976|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|17000|||||No|No||RISING PHARM|No||||
lithium carbonate|No|No|No|No|75%|64980020501|LITHIUM CARBONATE ER 300 MG TB|100|EA|.0645|11/08/2016||Yes|No||11/08/2016||Yes|No|11/08/2016||Yes|No||||No|No|||Prescription required|No|||No|.12646|03/29/2022|.12342|03/29/2022|.12424|03/29/2022||||17001|||||No|No||RISING PHARM|No||||
lithium carbonate|No|No|No|No|75%|64980020505|LITHIUM CARBONATE ER 300 MG TB|500|EA|.0645|11/08/2016||Yes|No||11/08/2016||Yes|No|11/08/2016||Yes|No||||No|No|||Prescription required|No|||No|.12646|03/29/2022|.12342|03/29/2022|.12424|03/29/2022||||17002|||||No|No||RISING PHARM|No||||
zileuton|No|No|No|No|75%|64980020612|ZILEUTON ER 600 MG TABLET|120|EA|11.54564|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|042|Yes|26.31332|11/23/2021|25.93741|11/23/2021|24.7023|11/23/2021|||LEUKOTRIENE MODIFIERS|17003|||||No|No||RISING PHARM|No||||
oxybutynin chloride|No|No|No|No|75%|64980020901|OXYBUTYNIN CL ER 5 MG TABLET|100|EA|.0645|10/23/2017||Yes|No||10/23/2017||Yes|No|10/23/2017||Yes|No||||No|No|||Prescription required|No||006|Yes|.15279|03/29/2022|.14912|03/29/2022|.15011|03/29/2022|||BLADDER RELAXANT PREPARATIONS|17004|||||No|No||RISING PHARM|No||||
oxybutynin chloride|No|No|No|No|75%|64980021001|OXYBUTYNIN CL ER 10 MG TABLET|100|EA|.0774|10/23/2017||Yes|No||10/23/2017||Yes|No|10/23/2017||Yes|No||||No|No|||Prescription required|No||006|No|.15833|03/29/2022|.15453|03/29/2022|.15555|03/29/2022|||BLADDER RELAXANT PREPARATIONS|17005|||||No|No||RISING PHARM|No||||
oxybutynin chloride|No|No|No|No|75%|64980021101|OXYBUTYNIN CL ER 15 MG TABLET|100|EA|.0903|10/23/2017||Yes|No||10/23/2017||Yes|No|10/23/2017||Yes|No||||No|No|||Prescription required|No||006|No|.19948|03/29/2022|.19469|03/29/2022|.19598|03/29/2022|||BLADDER RELAXANT PREPARATIONS|17006|||||No|No||RISING PHARM|No||||
pyridostigmine bromide|No|No|No|No|75%|64980022003|PYRIDOSTIGMINE ER 180 MG TAB|30|EA|2.85233|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||||No|No|||Prescription required|No|||No|5.45827|03/29/2022|5.32727|03/29/2022|5.36275|03/29/2022||||17007|||||No|No||RISING PHARM|No||||
methylphenidate HCl|No|No|No|No|75%|64980022101|METHYLPHENIDATE 2.5 MG CHEW TB|100|EA|.645|05/21/2020|01/31/2022|Yes|No||05/21/2020|01/31/2022|Yes|No|05/21/2020|01/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.47|02/15/2022|1.449|02/15/2022|1.38|02/15/2022|||STIMULANTS AND RELATED AGENTS|17008|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||RISING PHARM|No||||
methylphenidate HCl|No|No|No|No|75%|64980022201|METHYLPHENIDATE 5 MG CHEW TAB|100|EA|.9675|05/21/2020|06/30/2022|Yes|No||05/21/2020|06/30/2022|Yes|No|05/21/2020|06/30/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|3.3966|11/23/2021|3.31508|11/23/2021|3.33715|11/23/2021|||STIMULANTS AND RELATED AGENTS|17009|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||RISING PHARM|No||||
methylphenidate HCl|No|No|No|No|75%|64980022301|METHYLPHENIDATE 10 MG CHEW TAB|100|EA|1.29|05/21/2020|01/31/2022|Yes|No||05/21/2020|01/31/2022|Yes|No|05/21/2020|01/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|2.94|02/15/2022|2.898|02/15/2022|2.76|02/15/2022|||STIMULANTS AND RELATED AGENTS|17010|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||RISING PHARM|No||||
zolmitriptan|No|No|No|No|75%|64980025616|ZOLMITRIPTAN 2.5 MG ODT|6|EA|2.61225|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|5.9535|03/01/2022|5.86845|03/01/2022|5.589|03/01/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|17011|||||No|No||RISING PHARM|No||||
zolmitriptan|No|No|No|No|75%|64980025713|ZOLMITRIPTAN 5 MG ODT|3|EA|2.41373|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|4.60281|03/29/2022|4.49234|03/29/2022|4.52226|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|17012|||||No|No||RISING PHARM|No||||
lithium carbonate|No|No|No|No|75%|64980027801|LITHIUM CARBONATE ER 450 MG TB|100|EA|.09675|06/21/2018||Yes|No||06/21/2018||Yes|No|06/21/2018||Yes|No||||No|No|||Prescription required|No|||No|.16553|03/29/2022|.16155|03/29/2022|.16263|03/29/2022||||17013|||||No|No||RISING PHARM|No||||
glipizide|No|No|No|No|75%|64980027903|GLIPIZIDE ER 2.5 MG TABLET|30|EA|.09173|02/22/2018||Yes|No||02/22/2018||Yes|No|02/22/2018||Yes|No||||No|No|||Prescription required|No|||Yes|.12809|03/29/2022|.12501|03/29/2022|.12584|03/29/2022||||17014|||||No|No||RISING PHARM|No||||
glipizide|No|No|No|No|75%|64980028001|GLIPIZIDE ER 5 MG TABLET|100|EA|.0565|02/22/2018||Yes|No||02/22/2018||Yes|No|02/22/2018||Yes|No||||No|No|||Prescription required|No|||Yes|.11105|03/29/2022|.10838|03/29/2022|.1091|03/29/2022||||17015|||||No|No||RISING PHARM|No||||
glipizide|No|No|No|No|75%|64980028005|GLIPIZIDE ER 5 MG TABLET|500|EA|.05353|02/22/2018||Yes|No||02/22/2018||Yes|No|02/22/2018||Yes|No||||No|No|||Prescription required|No|||Yes|.11105|03/29/2022|.10838|03/29/2022|.1091|03/29/2022||||17016|||||No|No||RISING PHARM|No||||
glipizide|Yes|No|No|No|75%|64980028010|GLIPIZIDE ER 5 MG TABLET|1000|EA|.05353|08/31/2020||Yes|No||08/31/2020||Yes|No|08/31/2020||Yes|No||||No|No|09/21/2020||Prescription required|No|||Yes|.11105|03/29/2022|.10838|03/29/2022|.1091|03/29/2022||||17017|||||No|No||RISING PHARM|No||||
glipizide|No|No|No|No|75%|64980028101|GLIPIZIDE ER 10 MG TABLET|100|EA|.10904|02/22/2018||Yes|No||02/22/2018||Yes|No|02/22/2018||Yes|No||||No|No|||Prescription required|No|||No|.184|03/29/2022|.17958|03/29/2022|.18078|03/29/2022||||17018|||||No|No||RISING PHARM|No||||
glipizide|No|No|No|No|75%|64980028105|GLIPIZIDE ER 10 MG TABLET|500|EA|.10664|02/22/2018||Yes|No||02/22/2018||Yes|No|02/22/2018||Yes|No||||No|No|||Prescription required|No|||No|.184|03/29/2022|.17958|03/29/2022|.18078|03/29/2022||||17019|||||No|No||RISING PHARM|No||||
glipizide|Yes|No|No|No|75%|64980028110|GLIPIZIDE ER 10 MG TABLET|1000|EA|.18679|08/31/2020||Yes|No||08/31/2020||Yes|No|08/31/2020||Yes|No||||No|No|09/21/2020||Prescription required|No|||No|.184|03/29/2022|.17958|03/29/2022|.18078|03/29/2022||||17020|||||No|No||RISING PHARM|No||||
mesalamine|No|No|No|No|75%|64980028203|MESALAMINE 1,000 MG SUPP|30|EA|3.58333|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No||010|No|2.81018|03/29/2022|2.74273|03/29/2022|2.761|03/29/2022|||ULCERATIVE COLITIS AGENTS|17021|||||No|No||RISING PHARM|No||||
perphenazine|No|No|No|No|75%|64980029001|PERPHENAZINE 2 MG TABLET|100|EA|.14637|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.31906|03/29/2022|.3114|03/29/2022|.31347|03/29/2022|||ANTIPSYCHOTICS|17022|||||No|No||RISING PHARM|No||||
perphenazine|No|No|No|No|75%|64980029101|PERPHENAZINE 4 MG TABLET|100|EA|.20038|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.32485|03/29/2022|.31705|03/29/2022|.31916|03/29/2022|||ANTIPSYCHOTICS|17023|||||No|No||RISING PHARM|No||||
perphenazine|No|No|No|No|75%|64980029201|PERPHENAZINE 8 MG TABLET|100|EA|.24303|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.48127|03/29/2022|.46971|03/29/2022|.47284|03/29/2022|||ANTIPSYCHOTICS|17024|||||No|No||RISING PHARM|No||||
perphenazine|No|No|No|No|75%|64980029301|PERPHENAZINE 16 MG TABLET|100|EA|.32697|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.69746|03/29/2022|.68072|03/29/2022|.68525|03/29/2022|||ANTIPSYCHOTICS|17025|||||No|No||RISING PHARM|No||||
chlorthalidone|No|No|No|No|75%|64980030301|CHLORTHALIDONE 25 MG TABLET|100|EA|.0946|03/02/2018||Yes|No||03/02/2018||Yes|No|03/02/2018||Yes|No||||No|No|||Prescription required|No|||No|.16117|03/29/2022|.1573|03/29/2022|.15834|03/29/2022||||17026|||||No|No||RISING PHARM|No||||
chlorthalidone|No|No|No|No|75%|64980030310|CHLORTHALIDONE 25 MG TABLET|1000|EA|.0946|03/02/2018||Yes|No||03/02/2018||Yes|No|03/02/2018||Yes|No||||No|No|||Prescription required|No|||No|.16117|03/29/2022|.1573|03/29/2022|.15834|03/29/2022||||17027|||||No|No||RISING PHARM|No||||
chlorthalidone|No|No|No|No|75%|64980030401|CHLORTHALIDONE 50 MG TABLET|100|EA|.129|03/02/2018||Yes|No||03/02/2018||Yes|No|03/02/2018||Yes|No||||No|No|||Prescription required|No|||No|.3607|03/29/2022|.35204|03/29/2022|.35438|03/29/2022||||17028|||||No|No||RISING PHARM|No||||
fluoride (sodium)|No|No|No|No|75%|64980030550|DENTA 5000 PLUS CREAM|51|GM|.04257|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|.09748|03/29/2022|.09514|03/29/2022|.09577|03/29/2022||||17029|||||No|No||RISING PHARM|No||||
fluoride (sodium)|No|No|No|No|75%|64980030650|DENTA 5000 PLUS CREAM|51|GM|.03583|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|.08166|01/25/2022|.08049|01/25/2022|.07666|01/25/2022||||17030|||||No|No||RISING PHARM|No||||
triamcinolone acetonide|No|No|No|No|75%|64980032005|TRIAMCINOLONE 0.1% PASTE|5|GM|5.54442|10/06/2010||Yes|No||10/06/2010||Yes|No|10/06/2010||Yes|No||||No|No|||Prescription required|No|||No|5.24075|03/29/2022|5.11497|03/29/2022|5.14903|03/29/2022||||17031|||||No|No||RISING PHARM|No||||
hydrocortisone|No|No|No|No|75%|64980032430|PROCTOZONE-HC 2.5% CREAM|30|GM|.28494|12/02/2015||Yes|No||12/02/2015||Yes|No|12/02/2015||Yes|No||||No|No|||Prescription required|No||118|No|.33274|03/29/2022|.32475|03/29/2022|.32691|03/29/2022|||STEROIDS: TOPICAL LOW|17032|||||No|No||RISING PHARM|No||||
erythromycin/benzoyl peroxide|No|No|No|No|75%|64980032801|ERYTHROMYCIN-BENZOYL GEL|23.3|GM|1.29184|03/13/2018||Yes|No||03/13/2018||Yes|No|03/13/2018||Yes|No||||No|No|||Prescription required|No||104|No|1.71854|03/29/2022|1.67729|03/29/2022|1.68846|03/29/2022|||ACNE AGENTS: TOPICAL|17033|||||No|No||RISING PHARM|No||||
erythromycin/benzoyl peroxide|No|No|No|No|75%|64980032802|ERYTHROMYCIN-BENZOYL GEL|46.6|GM|.64592|03/13/2018||Yes|No||03/13/2018||Yes|No|03/13/2018||Yes|No||||No|No|||Prescription required|No||104|No|1.12609|03/29/2022|1.09906|03/29/2022|1.10638|03/29/2022|||ACNE AGENTS: TOPICAL|17034|||||No|No||RISING PHARM|No||||
fluocinolone acetonide oil|No|No|No|No|75%|64980032920|FLUOCINOLONE OIL 0.01% EAR DRP|20|ML|.602|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|No|||No|2.06581|03/29/2022|2.01623|03/29/2022|2.02965|03/29/2022||||17035|||||No|No||RISING PHARM|No||||
fluocinolone/shower cap|No|No|No|No|75%|64980033004|FLUOCINOLONE 0.01% SCALP OIL|118.28|ML|.64201|11/30/2021||Yes|No||11/30/2021||Yes|No|11/30/2021||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|118|No|.27456|03/29/2022|.26797|03/29/2022|.26975|03/29/2022|||STEROIDS: TOPICAL LOW|17036|||||No|No||RISING PHARM|No||||
fluocinolone acetonide|No|No|No|No|75%|64980033104|FLUOCINOLONE 0.01% BODY OIL|118.28|ML|.64201|11/30/2021||Yes|No||11/30/2021||Yes|No|11/30/2021||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|118|No|.18968|03/29/2022|.18512|03/29/2022|.18636|03/29/2022|||STEROIDS: TOPICAL LOW|17037|||||No|No||RISING PHARM|No||||
alendronate sodium|No|No|No|No|75%|64980034001|ALENDRONATE SODIUM 10 MG TAB|100|EA|.0602|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|No||060|No|.14279|03/29/2022|.13936|03/29/2022|.14029|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|17038|||||No|No||RISING PHARM|No||||
alendronate sodium|No|No|No|No|75%|64980034003|ALENDRONATE SODIUM 10 MG TAB|30|EA|.086|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|No||060|No|.14279|03/29/2022|.13936|03/29/2022|.14029|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|17039|||||No|No||RISING PHARM|No||||
alendronate sodium|No|No|No|No|75%|64980034114|ALENDRONATE SODIUM 35 MG TAB|4|EA|.37625|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||||No|No|||Prescription required|No||060|No|.34811|03/29/2022|.33975|03/29/2022|.34201|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|17040|||||No|No||RISING PHARM|No||||
alendronate sodium|No|No|No|No|75%|64980034214|ALENDRONATE SODIUM 70 MG TAB|4|EA|.37625|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|No||060|No|.29635|03/29/2022|.28923|03/29/2022|.29116|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|17041|||||No|No||RISING PHARM|No||||
atomoxetine HCl|No|No|No|No|75%|64980037303|ATOMOXETINE HCL 10 MG CAPSULE|30|EA|.69989|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.20613|03/29/2022|1.17718|03/29/2022|1.18502|03/29/2022|||STIMULANTS AND RELATED AGENTS|17042|||||No|No||RISING PHARM|No||||
atomoxetine HCl|No|No|No|No|75%|64980037403|ATOMOXETINE HCL 18 MG CAPSULE|30|EA|.69989|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.0614|03/29/2022|1.03592|03/29/2022|1.04282|03/29/2022|||STIMULANTS AND RELATED AGENTS|17043|||||No|No||RISING PHARM|No||||
atomoxetine HCl|No|No|No|No|75%|64980037503|ATOMOXETINE HCL 25 MG CAPSULE|30|EA|.69989|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.05569|03/29/2022|1.03035|03/29/2022|1.03721|03/29/2022|||STIMULANTS AND RELATED AGENTS|17044|||||No|No||RISING PHARM|No||||
atomoxetine HCl|No|No|No|No|75%|64980037603|ATOMOXETINE HCL 40 MG CAPSULE|30|EA|.7611|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.0462|03/29/2022|1.02109|03/29/2022|1.02789|03/29/2022|||STIMULANTS AND RELATED AGENTS|17045|||||No|No||RISING PHARM|No||||
atomoxetine HCl|No|No|No|No|75%|64980037703|ATOMOXETINE HCL 60 MG CAPSULE|30|EA|.7611|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.16565|03/29/2022|1.13767|03/29/2022|1.14525|03/29/2022|||STIMULANTS AND RELATED AGENTS|17046|||||No|No||RISING PHARM|No||||
atomoxetine HCl|No|No|No|No|75%|64980037803|ATOMOXETINE HCL 80 MG CAPSULE|30|EA|.82244|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.40838|03/29/2022|1.37457|03/29/2022|1.38373|03/29/2022|||STIMULANTS AND RELATED AGENTS|17047|||||No|No||RISING PHARM|No||||
atomoxetine HCl|No|No|No|No|75%|64980037903|ATOMOXETINE HCL 100 MG CAPSULE|30|EA|.82244|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.76872|03/29/2022|1.72627|03/29/2022|1.73776|03/29/2022|||STIMULANTS AND RELATED AGENTS|17048|||||No|No||RISING PHARM|No||||
cefpodoxime proxetil|No|No|No|No|75%|64980040310|CEFPODOXIME 100 MG/5 ML SUSP|100|ML|.56398|03/18/2020||Yes|No||03/18/2020||Yes|No|03/18/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|046|No|1.28536|03/18/2020|1.267|03/18/2020|1.20667|03/18/2020|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17049|||||No|No||RISING PHARM|No||||
cefpodoxime proxetil|No|No|No|No|75%|64980040350|CEFPODOXIME 100 MG/5 ML SUSP|50|ML|.59279|03/18/2020||Yes|No||03/18/2020||Yes|No|03/18/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|046|No|1.35102|03/18/2020|1.33172|03/18/2020|1.26831|03/18/2020|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17050|||||No|No||RISING PHARM|No||||
toremifene citrate|No|No|No|No|75%|64980040403|TOREMIFENE CITRATE 60 MG TAB|30|EA|16.42213|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No||502|No|37.42718|09/30/2020|36.8925|09/30/2020|35.13572|09/30/2020|||ONCOLOGY: ORAL - BREAST|17051|||||No|No||RISING PHARM|No||||
abacavir sulfate|No|No|No|No|75%|64980040524|ABACAVIR 20 MG/ML SOLUTION|240|ML|.31369|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.51237|02/13/2020|.50505|02/13/2020|.481|02/13/2020|||HIV / AIDS|17052|||||No|No||RISING PHARM|No||||
efavirenz|No|No|No|No|75%|64980040603|EFAVIRENZ 50 MG CAPSULE|30|EA|1.413|08/31/2020||Yes|No||08/31/2020||Yes|No|08/31/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|2.3079|08/31/2020|2.27493|08/31/2020|2.1666|08/31/2020|||HIV / AIDS|17053|||||No|No||RISING PHARM|No||||
efavirenz|No|No|No|No|75%|64980040709|EFAVIRENZ 200 MG CAPSULE|90|EA|5.64832|08/31/2020||Yes|No||08/31/2020||Yes|No|08/31/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|9.2256|08/31/2020|9.0938|08/31/2020|8.66076|08/31/2020|||HIV / AIDS|17054|||||No|No||RISING PHARM|No||||
sertraline HCl|Yes|No|No|No|75%|64980040906|SERTRALINE 20 MG/ML ORAL CONC|60|ML|.40068|05/29/2020||Yes|No||05/29/2020||Yes|No|05/29/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||008|No|.67787|03/29/2022|.6616|03/29/2022|.666|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17055|||||No|No||RISING PHARM|No||||
pregabalin|No|No|No|No|90%|64980041009|PREGABALIN 25 MG CAPSULE|90|EA|.10869|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.0795|03/29/2022|.07759|03/29/2022|.0781|03/29/2022|||NEUROPATHIC PAIN|17056|||||No|No||RISING PHARM|No||||
pregabalin|No|No|No|No|90%|64980041109|PREGABALIN 50 MG CAPSULE|90|EA|.10869|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.09128|03/29/2022|.08908|03/29/2022|.08968|03/29/2022|||NEUROPATHIC PAIN|17057|||||No|No||RISING PHARM|No||||
pregabalin|No|No|No|No|90%|64980041110|PREGABALIN 50 MG CAPSULE|1000|EA|.09784|12/20/2019||Yes|No||12/20/2019||Yes|No|12/20/2019||Yes|No||||No|No|||Prescription required|No||232|No|.09128|03/29/2022|.08908|03/29/2022|.08968|03/29/2022|||NEUROPATHIC PAIN|17058|||||No|No||RISING PHARM|No||||
pregabalin|No|No|No|No|90%|64980041209|PREGABALIN 75 MG CAPSULE|90|EA|.10869|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.08098|03/29/2022|.07903|03/29/2022|.07956|03/29/2022|||NEUROPATHIC PAIN|17059|||||No|No||RISING PHARM|No||||
pregabalin|No|No|No|No|90%|64980041210|PREGABALIN 75 MG CAPSULE|1000|EA|.09784|12/20/2019||Yes|No||12/20/2019||Yes|No|12/20/2019||Yes|No||||No|No|||Prescription required|No||232|No|.08098|03/29/2022|.07903|03/29/2022|.07956|03/29/2022|||NEUROPATHIC PAIN|17060|||||No|No||RISING PHARM|No||||
pregabalin|No|No|No|No|90%|64980041309|PREGABALIN 100 MG CAPSULE|90|EA|.10869|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.08763|03/29/2022|.08552|03/29/2022|.08609|03/29/2022|||NEUROPATHIC PAIN|17061|||||No|No||RISING PHARM|No||||
pregabalin|No|No|No|No|90%|64980041310|PREGABALIN 100 MG CAPSULE|1000|EA|.09784|12/20/2019||Yes|No||12/20/2019||Yes|No|12/20/2019||Yes|No||||No|No|||Prescription required|No||232|No|.08763|03/29/2022|.08552|03/29/2022|.08609|03/29/2022|||NEUROPATHIC PAIN|17062|||||No|No||RISING PHARM|No||||
pregabalin|No|No|No|No|90%|64980041409|PREGABALIN 150 MG CAPSULE|90|EA|.10869|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.10646|03/29/2022|.1039|03/29/2022|.10459|03/29/2022|||NEUROPATHIC PAIN|17063|||||No|No||RISING PHARM|No||||
pregabalin|No|No|No|No|90%|64980041410|PREGABALIN 150 MG CAPSULE|1000|EA|.09784|12/20/2019||Yes|No||12/20/2019||Yes|No|12/20/2019||Yes|No||||No|No|||Prescription required|No||232|No|.10646|03/29/2022|.1039|03/29/2022|.10459|03/29/2022|||NEUROPATHIC PAIN|17064|||||No|No||RISING PHARM|No||||
pregabalin|No|No|No|No|90%|64980041509|PREGABALIN 200 MG CAPSULE|90|EA|.10869|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.11395|03/29/2022|.11121|03/29/2022|.11195|03/29/2022|||NEUROPATHIC PAIN|17065|||||No|No||RISING PHARM|No||||
pregabalin|No|No|No|No|90%|64980041609|PREGABALIN 225 MG CAPSULE|90|EA|.10869|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.12393|03/29/2022|.12095|03/29/2022|.12176|03/29/2022|||NEUROPATHIC PAIN|17066|||||No|No||RISING PHARM|No||||
pregabalin|No|No|No|No|90%|64980041709|PREGABALIN 300 MG CAPSULE|90|EA|.10869|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.12181|03/29/2022|.11888|03/29/2022|.11967|03/29/2022|||NEUROPATHIC PAIN|17067|||||No|No||RISING PHARM|No||||
abiraterone acetate|No|No|No|No|75%|64980041812|ABIRATERONE ACETATE 250 MG TAB|120|EA|2.15|02/27/2020||Yes|No||02/27/2020||Yes|No|02/27/2020||Yes|No||||No|No|||Prescription required|No||550|No|4.9|09/28/2021|4.83|09/28/2021|4.6|09/28/2021|||ONCOLOGY: ORAL - PROSTATE|17068|||||No|No||RISING PHARM|No||||
tinidazole|No|No|No|No|75%|64980042602|TINIDAZOLE 250 MG TABLET|20|EA|.91267|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No||115|No|2.08005|09/30/2020|2.05033|09/30/2020|1.9527|09/30/2020|||ANTIBIOTICS: GI|17069|||||No|No||RISING PHARM|No||||
tinidazole|No|No|No|No|75%|64980042712|TINIDAZOLE 500 MG TABLET|12|EA|1.52112|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No||115|No|2.72139|03/29/2022|2.65607|03/29/2022|2.67376|03/29/2022|||ANTIBIOTICS: GI|17070|||||No|No||RISING PHARM|No||||
triamcinolone acetonide|No|No|No|No|75%|64980042901|TRIAMCINOLONE 0.147 MG/G SPRAY|100|GM|1.32504|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|3.01987|09/18/2020|2.97672|09/18/2020|2.83498|09/18/2020|||STEROIDS: TOPICAL HIGH|17071|||||No|No||RISING PHARM|No||||
triamcinolone acetonide|No|No|No|No|75%|64980042963|TRIAMCINOLONE 0.147 MG/G SPRAY|63|GM|1.32501|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|3.01979|05/25/2021|2.97665|05/25/2021|2.8349|05/25/2021|||STEROIDS: TOPICAL HIGH|17072|||||No|No||RISING PHARM|No||||
oxybutynin chloride|No|No|No|No|75%|64980043101|OXYBUTYNIN 5 MG TABLET|100|EA|.043|09/01/2020|07/16/2022|Yes|No||09/01/2020|07/16/2022|Yes|No|09/01/2020|07/16/2022|Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|17073|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||RISING PHARM|No||||
oxybutynin chloride|No|No|No|No|75%|64980043110|OXYBUTYNIN 5 MG TABLET|1000|EA|.043|09/01/2020|07/16/2022|Yes|No||09/01/2020|07/16/2022|Yes|No|09/01/2020|07/16/2022|Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|17074|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||RISING PHARM|No||||
oxybutynin chloride|No|No|No|No|75%|64980043150|OXYBUTYNIN 5 MG TABLET|500|EA|.043|09/01/2020|07/16/2022|Yes|No||09/01/2020|07/16/2022|Yes|No|09/01/2020|07/16/2022|Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|17075|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||RISING PHARM|No||||
midodrine HCl|No|No|No|No|75%|64980043301|MIDODRINE HCL 2.5 MG TABLET|100|EA|.129|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No|||No|.20233|03/29/2022|.19747|03/29/2022|.19878|03/29/2022||||17076|||||No|No||RISING PHARM|No||||
midodrine HCl|No|No|No|No|75%|64980043401|MIDODRINE HCL 5 MG TABLET|100|EA|.1935|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No|||No|.26381|03/29/2022|.25747|03/29/2022|.25919|03/29/2022||||17077|||||No|No||RISING PHARM|No||||
midodrine HCl|No|No|No|No|75%|64980043501|MIDODRINE HCL 10 MG TABLET|100|EA|.3225|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|No|||No|.40773|03/29/2022|.39794|03/29/2022|.40059|03/29/2022||||17078|||||No|No||RISING PHARM|No||||
atenolol|No|No|No|No|75%|64980043701|ATENOLOL 25 MG TABLET|100|EA|.01466|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|No||070|No|.02437|03/29/2022|.02378|03/29/2022|.02394|03/29/2022|||BETA-BLOCKERS|17079|||||No|No||RISING PHARM|No||||
atenolol|No|No|No|No|75%|64980043710|ATENOLOL 25 MG TABLET|1000|EA|.01464|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|No||070|No|.02437|03/29/2022|.02378|03/29/2022|.02394|03/29/2022|||BETA-BLOCKERS|17080|||||No|No||RISING PHARM|No||||
atenolol|No|No|No|No|75%|64980043801|ATENOLOL 50 MG TABLET|100|EA|.01492|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|No||070|No|.02861|03/29/2022|.02792|03/29/2022|.0281|03/29/2022|||BETA-BLOCKERS|17081|||||No|No||RISING PHARM|No||||
atenolol|No|No|No|No|75%|64980043810|ATENOLOL 50 MG TABLET|1000|EA|.0149|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|No||070|No|.02861|03/29/2022|.02792|03/29/2022|.0281|03/29/2022|||BETA-BLOCKERS|17082|||||No|No||RISING PHARM|No||||
atenolol|No|No|No|No|75%|64980043901|ATENOLOL 100 MG TABLET|100|EA|.02623|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|No||070|No|.04816|03/29/2022|.047|03/29/2022|.04731|03/29/2022|||BETA-BLOCKERS|17083|||||No|No||RISING PHARM|No||||
atenolol|No|No|No|No|75%|64980043910|ATENOLOL 100 MG TABLET|1000|EA|.02623|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|No||070|No|.04816|03/29/2022|.047|03/29/2022|.04731|03/29/2022|||BETA-BLOCKERS|17084|||||No|No||RISING PHARM|No||||
clobetasol propionate|No|No|No|No|75%|64980044103|CLOBETASOL 0.05% CREAM|30|GM|.28666|03/18/2020||Yes|No||03/18/2020||Yes|No|03/18/2020||Yes|No||||No|No|||Prescription required|No||121|No|.34489|03/29/2022|.33661|03/29/2022|.33885|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|17085|||||No|No||RISING PHARM|No||||
clobetasol propionate|No|No|No|No|75%|64980044115|CLOBETASOL 0.05% CREAM|15|GM|.28666|03/18/2020||Yes|No||03/18/2020||Yes|No|03/18/2020||Yes|No||||No|No|||Prescription required|No||121|No|.42879|03/29/2022|.41849|03/29/2022|.42128|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|17086|||||No|No||RISING PHARM|No||||
clobetasol propionate|No|No|No|No|75%|64980044145|CLOBETASOL 0.05% CREAM|45|GM|.28666|03/18/2020||Yes|No||03/18/2020||Yes|No|03/18/2020||Yes|No||||No|No|||Prescription required|No||121|No|.31467|03/29/2022|.30711|03/29/2022|.30916|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|17087|||||No|No||RISING PHARM|No||||
clobetasol propionate|No|No|No|No|75%|64980044160|CLOBETASOL 0.05% CREAM|60|GM|.28666|03/18/2020||Yes|No||03/18/2020||Yes|No|03/18/2020||Yes|No||||No|No|||Prescription required|No||121|No|.33784|03/29/2022|.32973|03/29/2022|.33192|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|17088|||||No|No||RISING PHARM|No||||
albuterol sulfate|No|No|No|No|75%|64980044201|ALBUTEROL SULFATE 2 MG TAB|100|EA|1.075|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|037|No|.67057|07/27/2021|.65447|07/27/2021|.65883|07/27/2021|||BRONCHODILATORS: BETA AGONIST|17089|||||No|No||RISING PHARM|No||||
albuterol sulfate|No|No|No|No|75%|64980044301|ALBUTEROL SULFATE 4 MG TAB|100|EA|1.075|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|037|No|1.0884|03/01/2022|1.06227|03/01/2022|1.06935|03/01/2022|||BRONCHODILATORS: BETA AGONIST|17090|||||No|No||RISING PHARM|No||||
calcitriol|No|No|No|No|75%|64980044715|CALCITRIOL 1 MCG/ML SOLUTION|15|ML|2.15|03/18/2020||Yes|No||03/18/2020||Yes|No|03/18/2020||Yes|No||||No|No|||Prescription required|No|||No|4.45307|03/29/2022|4.34619|03/29/2022|4.37514|03/29/2022||||17091|||||No|No||RISING PHARM|No||||
neomycin/polymyxin B/hydrocort|No|No|No|No|75%|64980044801|NEOMYCIN-POLYMYXIN-HC EAR SUSP|10|ML|4.23636|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||051|No|5.91929|03/29/2022|5.77722|03/29/2022|5.8157|03/29/2022|||OTIC ANTIBIOTICS|17092|||||No|No||RISING PHARM|No||||
trientine HCl|No|No|No|No|75%|64980045001|TRIENTINE HCL 250 MG CAPSULE|100|EA|4.2914|09/29/2020||Yes|No||09/29/2020||Yes|No|09/29/2020||Yes|No||||No|No|||Prescription required|No|||No|9.7804|09/29/2020|9.64068|09/29/2020|9.1816|09/29/2020||||17093|||||No|No||RISING PHARM|No||||
fluocinonide|No|No|No|No|75%|64980045206|FLUOCINONIDE 0.05% SOLUTION|60|ML|.28659|08/31/2020||Yes|No||08/31/2020||Yes|No|08/31/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|.3579|03/29/2022|.34931|03/29/2022|.35163|03/29/2022|||STEROIDS: TOPICAL HIGH|17094|||||No|No||RISING PHARM|No||||
alosetron HCl|No|No|No|No|75%|64980045303|ALOSETRON HCL 0.5 MG TABLET|30|EA|2.22166|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|534|Yes|3.98973|03/01/2022|3.89397|03/01/2022|3.9199|03/01/2022|||GI MOTILITY: CHRONIC|17095|||||No|No||RISING PHARM|No||||
alosetron HCl|No|No|No|No|75%|64980045403|ALOSETRON HCL 1 MG TABLET|30|EA|4.44333|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|534|Yes|8.58181|01/25/2022|8.37584|01/25/2022|8.43162|01/25/2022|||GI MOTILITY: CHRONIC|17096|||||No|No||RISING PHARM|No||||
metaxalone|No|No|No|No|75%|64980047201|METAXALONE 800 MG TABLET|100|EA|.645|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|116|Yes|.52754|03/29/2022|.51487|03/29/2022|.5183|03/29/2022|||SKELETAL MUSCLE RELAXANTS|17097|||||No|No||RISING PHARM|No||||
levocarnitine (with sugar)|No|No|No|No|75%|64980050312|LEVOCARNITINE 1 G/10 ML SOLN|118|ML|.13501|06/22/2018||Yes|No||06/22/2018||Yes|No|06/22/2018||Yes|No||||No|No|||Prescription required|No|||No|.25813|03/29/2022|.25193|03/29/2022|.25361|03/29/2022||||17098|||||No|No||RISING PHARM|No||||
cyproheptadine HCl|No|No|No|No|75%|64980050448|CYPROHEPTADINE 2 MG/5 ML SYRUP|473|ML|.04877|09/19/2006||Yes|No||09/19/2006||Yes|No|09/19/2006||Yes|No||||No|No|||Prescription required|No||574|Yes|.06009|03/29/2022|.05864|03/29/2022|.05903|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|17099|||||No|No||RISING PHARM|No||||
dexamethasone|No|No|No|No|75%|64980050924|DEXAMETHASONE 0.5 MG/5 ML ELX|237|ML|.07984|08/25/2020||Yes|No||08/25/2020||Yes|No|08/25/2020||Yes|No||||No|No|||Prescription required|No||168|Yes|.09997|03/29/2022|.09757|03/29/2022|.09822|03/29/2022|||GLUCOCORTICOIDS: ORAL|17100|||||No|No||RISING PHARM|No||||
clindamycin palmitate HCl|No|No|No|No|75%|64980051110|CLINDAMYCIN (PEDI) 75 MG/5 ML|100|ML|.21336|06/14/2018||Yes|No||06/14/2018||Yes|No|06/14/2018||Yes|No||||No|No|||Prescription required|No||146|No|.19356|03/29/2022|.18891|03/29/2022|.19017|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|17101|||||No|No||RISING PHARM|No||||
timolol maleate|No|No|No|No|75%|64980051301|TIMOLOL MALEATE 0.25% EYE DROP|10|ML|.60028|06/08/2020||Yes|No||06/08/2020||Yes|No|06/08/2020||Yes|No||||No|No|||Prescription required|No||088|No|.70113|03/29/2022|.6843|03/29/2022|.68886|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|17102|||||No|No||RISING PHARM|No||||
timolol maleate|No|No|No|No|75%|64980051305|TIMOLOL MALEATE 0.25% EYE DROP|5|ML|.4472|06/08/2020||Yes|No||06/08/2020||Yes|No|06/08/2020||Yes|No||||No|No|||Prescription required|No||088|No|.68312|03/29/2022|.66672|03/29/2022|.67116|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|17103|||||No|No||RISING PHARM|No||||
timolol maleate|No|No|No|No|75%|64980051315|TIMOLOL MALEATE 0.25% EYE DROP|15|ML|.44146|06/08/2020||Yes|No||06/08/2020||Yes|No|06/08/2020||Yes|No||||No|No|||Prescription required|No||088|No|.63767|03/01/2022|.62236|03/01/2022|.62651|03/01/2022|||OPHTHALMICS: GLAUCOMA AGENTS|17104|||||No|No||RISING PHARM|No||||
timolol maleate|No|No|No|No|75%|64980051401|TIMOLOL MALEATE 0.5% EYE DROPS|10|ML|.6106|06/08/2020||Yes|No||06/08/2020||Yes|No|06/08/2020||Yes|No||||No|No|||Prescription required|No||088|No|.95525|03/29/2022|.93232|03/29/2022|.93853|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|17105|||||No|No||RISING PHARM|No||||
timolol maleate|No|No|No|No|75%|64980051405|TIMOLOL MALEATE 0.5% EYE DROPS|5|ML|.8342|06/08/2020||Yes|No||06/08/2020||Yes|No|06/08/2020||Yes|No||||No|No|||Prescription required|No||088|No|1.19485|03/29/2022|1.16617|03/29/2022|1.17394|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|17106|||||No|No||RISING PHARM|No||||
timolol maleate|No|No|No|No|75%|64980051415|TIMOLOL MALEATE 0.5% EYE DROPS|15|ML|.59053|06/08/2020||Yes|No||06/08/2020||Yes|No|06/08/2020||Yes|No||||No|No|||Prescription required|No||088|No|.91053|03/29/2022|.88867|03/29/2022|.89459|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|17107|||||No|No||RISING PHARM|No||||
ofloxacin|No|No|No|No|75%|64980051501|OFLOXACIN 0.3% EYE DROPS|10|ML|1.29|11/08/2016||Yes|No||11/08/2016||Yes|No|11/08/2016||Yes|No||||No|No|||Prescription required|No||058|No|1.8791|03/29/2022|1.834|03/29/2022|1.84621|03/29/2022|||OPHTHALMIC ANTIBIOTICS|17108|||||No|No||RISING PHARM|No||||
ofloxacin|No|No|No|No|75%|64980051505|OFLOXACIN 0.3% EYE DROPS|5|ML|1.29|11/08/2016||Yes|No||11/08/2016||Yes|No|11/08/2016||Yes|No||||No|No|||Prescription required|No||058|No|1.80843|03/29/2022|1.76502|03/29/2022|1.77678|03/29/2022|||OPHTHALMIC ANTIBIOTICS|17109|||||No|No||RISING PHARM|No||||
nitazoxanide|No|No|No|No|75%|64980052603|NITAZOXANIDE 500 MG TABLET|30|EA|51.96994|03/19/2021||Yes|No||03/19/2021||Yes|No|03/19/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|115|Yes|118.44312|03/19/2021|116.75107|03/19/2021|111.1915|03/19/2021|||ANTIBIOTICS: GI|17110|||||No|No||RISING PHARM|No||||
nitazoxanide|No|No|No|No|75%|64980052621|NITAZOXANIDE 500 MG TABLET|12|EA|55.93941|03/19/2021||Yes|No||03/19/2021||Yes|No|03/19/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|115|Yes|127.48982|03/19/2021|125.66854|03/19/2021|119.68432|03/19/2021|||ANTIBIOTICS: GI|17111|||||No|No||RISING PHARM|No||||
nitazoxanide|No|No|No|No|75%|64980052681|NITAZOXANIDE 500 MG TABLET|18|EA|55.93941|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|115|Yes|127.48982|08/24/2021|125.66854|08/24/2021|119.68432|08/24/2021|||ANTIBIOTICS: GI|17112|||||No|No||RISING PHARM|No||||
serdexmethylphen/dexmethylphen|No|No|No|No|75%|65038028699|AZSTARYS 26.1 MG-5.2 MG CAP|100|EA|5.547|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|No|||Yes|12.642|09/22/2021|12.4614|09/22/2021|11.868|09/22/2021||||17113|||||No|No||CORIUM/PRASCO L|No||||
serdexmethylphen/dexmethylphen|No|No|No|No|75%|65038042999|AZSTARYS 39.2 MG-7.8 MG CAP|100|EA|5.547|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|No|||Yes|12.642|09/22/2021|12.4614|09/22/2021|11.868|09/22/2021||||17114|||||No|No||CORIUM/PRASCO L|No||||
serdexmethylphen/dexmethylphen|No|No|No|No|75%|65038056199|AZSTARYS 52.3 MG-10.4 MG CAP|100|EA|5.547|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|No|||Yes|12.642|09/22/2021|12.4614|09/22/2021|11.868|09/22/2021||||17115|||||No|No||CORIUM/PRASCO L|No||||
prasugrel HCl|No|No|No|No|75%|65162000103|PRASUGREL 5 MG TABLET|30|EA|.2795|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||||No|No|||Prescription required|No||004|No|.53487|03/29/2022|.52203|03/29/2022|.5255|03/29/2022|||PLATELET AGGREGATION INHIBITORS|17116|||||No|No||AMNEAL PHARMACE|No||||
prasugrel HCl|No|No|No|No|75%|65162000203|PRASUGREL 10 MG TABLET|30|EA|.2795|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||||No|No|||Prescription required|No||004|No|.35104|03/29/2022|.34261|03/29/2022|.34489|03/29/2022|||PLATELET AGGREGATION INHIBITORS|17117|||||No|No||AMNEAL PHARMACE|No||||
acetaminophen with codeine|No|No|No|No|90%|65162003310|ACETAMINOPHEN-COD #3 TABLET|100|EA|.06149|12/18/2012||Yes|No||12/18/2012||Yes|No|12/18/2012||Yes|No||12/18/2012||Yes|No|||Prescription required|No||109|Yes|.10921|03/29/2022|.10658|03/29/2022|.10729|03/29/2022|||ANALGESICS: NARCOTICS SHORT|17118|||||No|No||AMNEAL PHARMACE|No||||
omega-3 acid ethyl esters|No|No|No|No|75%|65162003416|OMEGA-3 ETHYL ESTERS 1 GM CAP|120|EA|.09675|07/25/2016||Yes|No||07/25/2016||Yes|No|07/25/2016||Yes|No||||No|No|||Prescription required|No||055|Yes|.18363|03/29/2022|.17922|03/29/2022|.18041|03/29/2022|||LIPOTROPICS: OTHER|17119|||||No|No||AMNEAL PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|65162004710|OXYCODONE HCL (IR) 5 MG TABLET|100|EA|.05332|12/16/2014||Yes|No||12/16/2014||Yes|No|12/16/2014||Yes|No||||No|No|||Prescription required|No||109|Yes|.0685|03/29/2022|.06685|03/29/2022|.0673|03/29/2022|||ANALGESICS: NARCOTICS SHORT|17120|||||No|No||AMNEAL PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|65162004750|OXYCODONE HCL (IR) 5 MG TABLET|500|EA|.05332|08/16/2016||Yes|No||08/16/2016||Yes|No|08/16/2016||Yes|No||||No|No|||Prescription required|No||109|Yes|.0685|03/29/2022|.06685|03/29/2022|.0673|03/29/2022|||ANALGESICS: NARCOTICS SHORT|17121|||||No|No||AMNEAL PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|65162004810|OXYCODONE HCL (IR) 10 MG TAB|100|EA|.09696|12/16/2014||Yes|No||12/16/2014||Yes|No|12/16/2014||Yes|No||||No|No|||Prescription required|No||109|Yes|.12568|03/29/2022|.12266|03/29/2022|.12348|03/29/2022|||ANALGESICS: NARCOTICS SHORT|17122|||||No|No||AMNEAL PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|65162004910|OXYCODONE HCL (IR) 15 MG TAB|100|EA|.10191|12/16/2014||Yes|No||12/16/2014||Yes|No|12/16/2014||Yes|No||||No|No|||Prescription required|No||109|Yes|.15895|03/29/2022|.15513|03/29/2022|.15616|03/29/2022|||ANALGESICS: NARCOTICS SHORT|17123|||||No|No||AMNEAL PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|65162004950|OXYCODONE HCL (IR) 15 MG TAB|500|EA|.10191|08/16/2016||Yes|No||08/16/2016||Yes|No|08/16/2016||Yes|No||||No|No|||Prescription required|No||109|Yes|.15895|03/29/2022|.15513|03/29/2022|.15616|03/29/2022|||ANALGESICS: NARCOTICS SHORT|17124|||||No|No||AMNEAL PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|65162005010|OXYCODONE HCL (IR) 20 MG TAB|100|EA|.16795|12/16/2014||Yes|No||12/16/2014||Yes|No|12/16/2014||Yes|No||||No|No|||Prescription required|No||109|Yes|.23193|03/29/2022|.22636|03/29/2022|.22787|03/29/2022|||ANALGESICS: NARCOTICS SHORT|17125|||||No|No||AMNEAL PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|65162005110|OXYCODONE HCL (IR) 30 MG TAB|100|EA|.19298|12/16/2014||Yes|No||12/16/2014||Yes|No|12/16/2014||Yes|No||||No|No|||Prescription required|No||109|Yes|.2615|03/29/2022|.25522|03/29/2022|.25692|03/29/2022|||ANALGESICS: NARCOTICS SHORT|17126|||||No|No||AMNEAL PHARMACE|No||||
oxycodone HCl|No|No|No|No|90%|65162005150|OXYCODONE HCL (IR) 30 MG TAB|500|EA|.19298|08/16/2016||Yes|No||08/16/2016||Yes|No|08/16/2016||Yes|No||||No|No|||Prescription required|No||109|Yes|.2615|03/29/2022|.25522|03/29/2022|.25692|03/29/2022|||ANALGESICS: NARCOTICS SHORT|17127|||||No|No||AMNEAL PHARMACE|No||||
raloxifene HCl|No|No|No|No|75%|65162005703|RALOXIFENE HCL 60 MG TABLET|30|EA|.49665|09/01/2016||Yes|No||09/01/2016||Yes|No|09/01/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|060|Yes|.36315|03/29/2022|.35443|03/29/2022|.35679|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|17128|||||No|No||AMNEAL PHARMACE|No||||
raloxifene HCl|No|No|No|No|75%|65162005710|RALOXIFENE HCL 60 MG TABLET|100|EA|.49665|04/27/2017||Yes|No||04/27/2017||Yes|No|04/27/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|060|Yes|.36315|03/29/2022|.35443|03/29/2022|.35679|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|17129|||||No|No||AMNEAL PHARMACE|No||||
sevelamer carbonate|No|No|No|No|75%|65162005827|SEVELAMER CARBONATE 800 MG TAB|270|EA|.16721|03/19/2018||Yes|No||03/19/2018||Yes|No|03/19/2018||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|12/14/2017|052|Yes|.27122|03/29/2022|.26471|03/29/2022|.26647|03/29/2022|||PHOSPHATE BINDERS|17130|||||No|No||AMNEAL PHARMACE|No||||
sucralfate|No|No|No|No|75%|65162006205|SUCRALFATE 1 GM/10 ML SUSP|420|ML|.19541|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No|||No|.34621|03/29/2022|.3379|03/29/2022|.34015|03/29/2022||||17131|||||No|No||AMNEAL PHARMACE|No||||
itraconazole|No|No|No|No|75%|65162008774|ITRACONAZOLE 10 MG/ML SOLUTION|150|ML|.84219|12/04/2018||Yes|No||12/04/2018||Yes|No|12/04/2018||Yes|No||12/04/2018||Yes|No|||Prescription required|Yes|03/09/2018|069|No|1.91942|11/23/2021|1.892|11/23/2021|1.80191|11/23/2021|||ANTIFUNGALS: ORAL|17132|||||No|No||AMNEAL PHARMACE|No||||
gabapentin|No|No|No|No|75%|65162010110|GABAPENTIN 100 MG CAPSULE|100|EA|.02365|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||02/17/2015||Yes|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|17133|||||No|No||AMNEAL PHARMACE|No||||
gabapentin|No|No|No|No|75%|65162010111|GABAPENTIN 100 MG CAPSULE|1000|EA|.02365|09/01/2020||Yes|No||09/01/2020||Yes|No|09/01/2020||Yes|No||09/01/2020||Yes|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|17134|||||No|No||AMNEAL PHARMACE|No||||
gabapentin|No|No|No|No|75%|65162010150|GABAPENTIN 100 MG CAPSULE|500|EA|.02365|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||02/17/2015||Yes|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|17135|||||No|No||AMNEAL PHARMACE|No||||
gabapentin|No|No|No|No|75%|65162010210|GABAPENTIN 300 MG CAPSULE|100|EA|.04085|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||02/17/2015||Yes|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|17136|||||No|No||AMNEAL PHARMACE|No||||
gabapentin|No|No|No|No|75%|65162010211|GABAPENTIN 300 MG CAPSULE|1000|EA|.04085|09/06/2020||Yes|No||09/06/2020||Yes|No|09/06/2020||Yes|No||09/06/2020||Yes|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|17137|||||No|No||AMNEAL PHARMACE|No||||
gabapentin|No|No|No|No|75%|65162010250|GABAPENTIN 300 MG CAPSULE|500|EA|.04085|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||02/17/2015||Yes|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|17138|||||No|No||AMNEAL PHARMACE|No||||
gabapentin|No|No|No|No|75%|65162010310|GABAPENTIN 400 MG CAPSULE|100|EA|.05375|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||02/17/2015||Yes|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|17139|||||No|No||AMNEAL PHARMACE|No||||
gabapentin|No|No|No|No|75%|65162010350|GABAPENTIN 400 MG CAPSULE|500|EA|.05375|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||02/17/2015||Yes|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|17140|||||No|No||AMNEAL PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|65162011510|HYDROCODONE-ACETAMIN 7.5-325|100|EA|.0516|08/22/2009||Yes|No||08/22/2009||Yes|No|08/22/2009||Yes|No||08/22/2009||Yes|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|17141|||||No|No||AMNEAL PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|65162011511|HYDROCODONE-ACETAMIN 7.5-325|1000|EA|.0516|05/24/2017||Yes|No||05/24/2017||Yes|No|05/24/2017||Yes|No||05/24/2017||Yes|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|17142|||||No|No||AMNEAL PHARMACE|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|65162011550|HYDROCODONE-ACETAMIN 7.5-325|500|EA|.0516|08/22/2009||Yes|No||08/22/2009||Yes|No|08/22/2009||Yes|No||08/22/2009||Yes|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|17143|||||No|No||AMNEAL PHARMACE|No||||
estradiol|No|No|No|No|75%|65162012608|LYLLANA 0.025 MG PATCH|8|EA|7.01222|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No|||Yes|9.33155|03/29/2022|9.10759|03/29/2022|9.16824|03/29/2022||||17144|||||No|No||AMNEAL PHARMACE|No||||
estradiol|No|No|No|No|75%|65162014808|LYLLANA 0.0375 MG PATCH|8|EA|7.01222|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No|||Yes|10.33407|03/29/2022|10.08605|03/29/2022|10.15322|03/29/2022||||17145|||||No|No||AMNEAL PHARMACE|No||||
estradiol|No|No|No|No|75%|65162014908|LYLLANA 0.05 MG PATCH|8|EA|7.01222|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No|||Yes|9.27983|03/29/2022|9.05711|03/29/2022|9.11743|03/29/2022||||17146|||||No|No||AMNEAL PHARMACE|No||||
estradiol|No|No|No|No|75%|65162015008|LYLLANA 0.075 MG PATCH|8|EA|7.01222|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No|||Yes|8.4725|03/29/2022|8.26916|03/29/2022|8.32423|03/29/2022||||17147|||||No|No||AMNEAL PHARMACE|No||||
naproxen|No|No|No|No|75%|65162018810|NAPROXEN 250 MG TABLET|100|EA|.02988|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||02/17/2015||Yes|No|||Prescription required|No||059|Yes|.06074|03/29/2022|.05928|03/29/2022|.05967|03/29/2022|||NSAIDS|17148|||||No|No||AMNEAL PHARMACE|No||||
naproxen|No|No|No|No|75%|65162018850|NAPROXEN 250 MG TABLET|500|EA|.04668|03/28/2017||Yes|No||03/28/2017||Yes|No|03/28/2017||Yes|No||03/28/2017||Yes|No|||Prescription required|No||059|Yes|.06074|03/29/2022|.05928|03/29/2022|.05967|03/29/2022|||NSAIDS|17149|||||No|No||AMNEAL PHARMACE|No||||
naproxen|No|No|No|No|75%|65162018910|NAPROXEN 375 MG TABLET|100|EA|.03964|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||02/17/2015||Yes|No|||Prescription required|No||059|Yes|.07806|03/29/2022|.07618|03/29/2022|.07669|03/29/2022|||NSAIDS|17150|||||No|No||AMNEAL PHARMACE|No||||
naproxen|No|No|No|No|75%|65162018950|NAPROXEN 375 MG TABLET|500|EA|.04918|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||02/17/2015||Yes|No|||Prescription required|No||059|Yes|.07806|03/29/2022|.07618|03/29/2022|.07669|03/29/2022|||NSAIDS|17151|||||No|No||AMNEAL PHARMACE|No||||
naproxen|No|No|No|No|75%|65162019010|NAPROXEN 500 MG TABLET|100|EA|.0519|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||02/17/2015||Yes|No|||Prescription required|No||059|Yes|.07731|03/29/2022|.07545|03/29/2022|.07595|03/29/2022|||NSAIDS|17152|||||No|No||AMNEAL PHARMACE|No||||
naproxen|No|No|No|No|75%|65162019011|NAPROXEN 500 MG TABLET|1000|EA|.04327|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||02/17/2015||Yes|No|||Prescription required|No||059|Yes|.07731|03/29/2022|.07545|03/29/2022|.07595|03/29/2022|||NSAIDS|17153|||||No|No||AMNEAL PHARMACE|No||||
naproxen|No|No|No|No|75%|65162019050|NAPROXEN 500 MG TABLET|500|EA|.04898|02/17/2015||Yes|No||02/17/2015||Yes|No|02/17/2015||Yes|No||02/17/2015||Yes|No|||Prescription required|No||059|Yes|.07731|03/29/2022|.07545|03/29/2022|.07595|03/29/2022|||NSAIDS|17154|||||No|No||AMNEAL PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|65162020710|OXYCODONE-ACETAMINOPHN 7.5-325|100|EA|.20425|07/26/2016||Yes|No||07/26/2016||Yes|No|07/26/2016||Yes|No||07/26/2016||Yes|No|||Prescription required|No||109|Yes|.14032|03/29/2022|.13695|03/29/2022|.13786|03/29/2022|||ANALGESICS: NARCOTICS SHORT|17155|||||No|No||AMNEAL PHARMACE|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|65162020750|OXYCODONE-ACETAMINOPHN 7.5-325|500|EA|.20425|07/26/2016||Yes|No||07/26/2016||Yes|No|07/26/2016||Yes|No||07/26/2016||Yes|No|||Prescription required|No||109|Yes|.14032|03/29/2022|.13695|03/29/2022|.13786|03/29/2022|||ANALGESICS: NARCOTICS SHORT|17156|||||No|No||AMNEAL PHARMACE|No||||
phenytoin sodium extended|No|No|No|No|75%|65162021210|PHENYTOIN SOD EXT 100 MG CAP|100|EA|.129|11/21/2008||Yes|No||11/21/2008||Yes|No|11/21/2008||Yes|No||11/21/2008||Yes|No|||Prescription required|No||056|No|.15598|03/29/2022|.15223|03/29/2022|.15325|03/29/2022|||ANTICONVULSANTS|17157|||||No|No||AMNEAL PHARMACE|No||||
phenytoin sodium extended|No|No|No|No|75%|65162021211|PHENYTOIN SOD EXT 100 MG CAP|1000|EA|.129|04/09/2009||Yes|No||04/09/2009||Yes|No|04/09/2009||Yes|No||04/09/2009||Yes|No|||Prescription required|No||056|No|.15598|03/29/2022|.15223|03/29/2022|.15325|03/29/2022|||ANTICONVULSANTS|17158|||||No|No||AMNEAL PHARMACE|No||||
phenytoin sodium extended|No|No|No|No|75%|65162021250|PHENYTOIN SOD EXT 100 MG CAP|500|EA|.129|11/21/2008||Yes|No||11/21/2008||Yes|No|11/21/2008||Yes|No||11/21/2008||Yes|No|||Prescription required|No||056|No|.15598|03/29/2022|.15223|03/29/2022|.15325|03/29/2022|||ANTICONVULSANTS|17159|||||No|No||AMNEAL PHARMACE|No||||
estradiol|No|No|No|No|75%|65162022621|YUVAFEM 10 MCG VAGINAL INSERT|8|EA|8.34092|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|No|||Yes|7.83958|03/29/2022|7.65143|03/29/2022|7.70238|03/29/2022||||17160|||||No|No||AMNEAL PHARMACE|No||||
estradiol|No|No|No|No|75%|65162022623|YUVAFEM 10 MCG VAGINAL INSERT|18|EA|8.34128|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|No|||Yes|7.83958|03/29/2022|7.65143|03/29/2022|7.70238|03/29/2022||||17161|||||No|No||AMNEAL PHARMACE|No||||
estradiol|No|No|No|No|75%|65162022808|LYLLANA 0.1 MG PATCH|8|EA|7.01222|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No|||Yes|8.48083|03/29/2022|8.27729|03/29/2022|8.33241|03/29/2022||||17162|||||No|No||AMNEAL PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|65162023109|METHYLPHENIDATE ER 18 MG TAB|90|EA|.30606|03/19/2018||Yes|No||03/19/2018||Yes|No|03/19/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.56499|03/29/2022|.55143|03/29/2022|.5551|03/29/2022|||STIMULANTS AND RELATED AGENTS|17163|||||No|No||AMNEAL PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|65162023309|METHYLPHENIDATE ER 27 MG TAB|90|EA|.3137|03/19/2018||Yes|No||03/19/2018||Yes|No|03/19/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.90623|03/29/2022|.88448|03/29/2022|.89037|03/29/2022|||STIMULANTS AND RELATED AGENTS|17164|||||No|No||AMNEAL PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|65162023509|METHYLPHENIDATE ER 36 MG TAB|90|EA|.34065|03/19/2018||Yes|No||03/19/2018||Yes|No|03/19/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.76999|03/29/2022|.75151|03/29/2022|.75651|03/29/2022|||STIMULANTS AND RELATED AGENTS|17165|||||No|No||AMNEAL PHARMACE|No||||
methylphenidate HCl|No|No|No|No|75%|65162023709|METHYLPHENIDATE ER 54 MG TAB|90|EA|.35211|03/19/2018||Yes|No||03/19/2018||Yes|No|03/19/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.87218|03/29/2022|.85124|03/29/2022|.85691|03/29/2022|||STIMULANTS AND RELATED AGENTS|17166|||||No|No||AMNEAL PHARMACE|No||||
chlorthalidone|Yes|No|No|No|75%|65162024709|CHLORTHALIDONE 25 MG TABLET|90|EA|.0645|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|03/20/2020||Prescription required|No|||No|.16117|03/29/2022|.1573|03/29/2022|.15834|03/29/2022||||17167|||||No|No||AMNEAL PHARMACE|No||||
alosetron HCl|No|No|No|No|75%|65162024803|ALOSETRON HCL 0.5 MG TABLET|30|EA|2.22166|05/23/2017||Yes|No||05/23/2017||Yes|No|05/23/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|534|Yes|3.98973|03/01/2022|3.89397|03/01/2022|3.9199|03/01/2022|||GI MOTILITY: CHRONIC|17168|||||No|No||AMNEAL PHARMACE|No||||
alosetron HCl|No|No|No|No|75%|65162024903|ALOSETRON HCL 1 MG TABLET|30|EA|4.44333|05/23/2017||Yes|No||05/23/2017||Yes|No|05/23/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|534|Yes|8.58181|01/25/2022|8.37584|01/25/2022|8.43162|01/25/2022|||GI MOTILITY: CHRONIC|17169|||||No|No||AMNEAL PHARMACE|No||||
chlorthalidone|Yes|No|No|No|75%|65162025009|CHLORTHALIDONE 50 MG TABLET|90|EA|.0946|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|03/20/2020||Prescription required|No|||No|.3607|03/29/2022|.35204|03/29/2022|.35438|03/29/2022||||17170|||||No|No||AMNEAL PHARMACE|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|65162027110|SULFAMETHOXAZOLE-TMP SS TABLET|100|EA|.07998|08/22/2009||Yes|No||08/22/2009||Yes|No|08/22/2009||Yes|No||08/22/2009||Yes|No|||Prescription required|No|||No|.07038|03/29/2022|.06869|03/29/2022|.06914|03/29/2022||||17171|||||No|No||AMNEAL PHARMACE|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|65162027150|SULFAMETHOXAZOLE-TMP SS TABLET|500|EA|.07998|08/22/2009||Yes|No||08/22/2009||Yes|No|08/22/2009||Yes|No||08/22/2009||Yes|No|||Prescription required|No|||No|.07038|03/29/2022|.06869|03/29/2022|.06914|03/29/2022||||17172|||||No|No||AMNEAL PHARMACE|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|65162027210|SULFAMETHOXAZOLE-TMP DS TABLET|100|EA|.086|08/22/2009||Yes|No||08/22/2009||Yes|No|08/22/2009||Yes|No||08/22/2009||Yes|No|||Prescription required|No|||No|.06566|03/29/2022|.06408|03/29/2022|.06451|03/29/2022||||17173|||||No|No||AMNEAL PHARMACE|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|65162027250|SULFAMETHOXAZOLE-TMP DS TABLET|500|EA|.086|08/22/2009||Yes|No||08/22/2009||Yes|No|08/22/2009||Yes|No||08/22/2009||Yes|No|||Prescription required|No|||No|.06566|03/29/2022|.06408|03/29/2022|.06451|03/29/2022||||17174|||||No|No||AMNEAL PHARMACE|No||||
paliperidone|No|No|No|No|75%|65162028003|PALIPERIDONE ER 1.5 MG TABLET|30|EA|3.9431|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|4.83706|03/29/2022|4.72097|03/29/2022|4.75241|03/29/2022|||ANTIPSYCHOTICS|17175|||||No|No||AMNEAL PHARMACE|No||||
paliperidone|No|No|No|No|75%|65162028103|PALIPERIDONE ER 3 MG TABLET|30|EA|3.9431|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|6.18339|03/29/2022|6.03498|03/29/2022|6.07518|03/29/2022|||ANTIPSYCHOTICS|17176|||||No|No||AMNEAL PHARMACE|No||||
paliperidone|No|No|No|No|75%|65162028203|PALIPERIDONE ER 6 MG TABLET|30|EA|3.9431|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|5.21133|03/29/2022|5.08625|03/29/2022|5.12013|03/29/2022|||ANTIPSYCHOTICS|17177|||||No|No||AMNEAL PHARMACE|No||||
paliperidone|No|No|No|No|75%|65162028303|PALIPERIDONE ER 9 MG TABLET|30|EA|5.91379|05/18/2020||Yes|No||05/18/2020||Yes|No|05/18/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|7.23268|03/29/2022|7.05909|03/29/2022|7.1061|03/29/2022|||ANTIPSYCHOTICS|17178|||||No|No||AMNEAL PHARMACE|No||||
niacin|No|No|No|No|75%|65162032109|NIACIN ER 500 MG TABLET|90|EA|.15288|07/22/2016||Yes|No||07/22/2016||Yes|No|07/22/2016||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|Yes|.21332|03/29/2022|.2082|03/29/2022|.20958|03/29/2022|||LIPOTROPICS: OTHER|17179|||||No|No||AMNEAL PHARMACE|No||||
niacin|No|No|No|No|75%|65162032309|NIACIN ER 1,000 MG TABLET|90|EA|.23888|07/22/2016||Yes|No||07/22/2016||Yes|No|07/22/2016||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.4737|03/29/2022|.46233|03/29/2022|.46541|03/29/2022|||LIPOTROPICS: OTHER|17180|||||No|No||AMNEAL PHARMACE|No||||
sildenafil citrate|No|No|No|No|75%|65162035109|SILDENAFIL 20 MG TABLET|90|EA|.086|03/15/2013||Yes|No||03/15/2013||Yes|No|03/15/2013||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|Yes|.09246|03/29/2022|.09024|03/29/2022|.09084|03/29/2022|||PAH AGENTS: ORAL AND INHALED|17181|||||No|No||AMNEAL PHARMACE|No||||
norelgestromin/ethin.estradiol|No|Yes|No|No|75%|65162035803|ZAFEMY 150-35 MCG/DAY PATCH|3|EA|17.50816|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|39.90232|05/17/2021|39.33229|05/17/2021|37.45932|05/17/2021||||17182|||||No|No||AMNEAL PHARMACE|No|||Only covered for non-contraceptive (medical) purposes|
folic acid|No|No|No|No|75%|65162036110|FOLIC ACID 1 MG TABLET|100|EA|.0215|09/16/2005||Yes|No||09/16/2005||Yes|No|09/16/2005||Yes|No||09/16/2005||Yes|No|||Prescription required|No|||No|.02568|03/29/2022|.02506|03/29/2022|.02523|03/29/2022||||17183|||||No|No||AMNEAL PHARMACE|No||||
folic acid|No|No|No|No|75%|65162036111|FOLIC ACID 1 MG TABLET|1000|EA|.0215|09/16/2005||Yes|No||09/16/2005||Yes|No|09/16/2005||Yes|No||09/16/2005||Yes|No|||Prescription required|No|||No|.02568|03/29/2022|.02506|03/29/2022|.02523|03/29/2022||||17184|||||No|No||AMNEAL PHARMACE|No||||
oxybutynin chloride|No|No|No|No|75%|65162037110|OXYBUTYNIN CL ER 5 MG TABLET|100|EA|.0688|07/26/2016||Yes|No||07/26/2016||Yes|No|07/26/2016||Yes|No||||No|No|||Prescription required|No||006|Yes|.15279|03/29/2022|.14912|03/29/2022|.15011|03/29/2022|||BLADDER RELAXANT PREPARATIONS|17185|||||No|No||AMNEAL PHARMACE|No||||
oxybutynin chloride|No|No|No|No|75%|65162037150|OXYBUTYNIN CL ER 5 MG TABLET|500|EA|.04128|07/26/2016||Yes|No||07/26/2016||Yes|No|07/26/2016||Yes|No||||No|No|||Prescription required|No||006|Yes|.15279|03/29/2022|.14912|03/29/2022|.15011|03/29/2022|||BLADDER RELAXANT PREPARATIONS|17186|||||No|No||AMNEAL PHARMACE|No||||
oxybutynin chloride|No|No|No|No|75%|65162037210|OXYBUTYNIN CL ER 10 MG TABLET|100|EA|.0774|07/26/2016||Yes|No||07/26/2016||Yes|No|07/26/2016||Yes|No||||No|No|||Prescription required|No||006|No|.15833|03/29/2022|.15453|03/29/2022|.15555|03/29/2022|||BLADDER RELAXANT PREPARATIONS|17187|||||No|No||AMNEAL PHARMACE|No||||
oxybutynin chloride|No|No|No|No|75%|65162037250|OXYBUTYNIN CL ER 10 MG TABLET|500|EA|.04644|07/26/2016||Yes|No||07/26/2016||Yes|No|07/26/2016||Yes|No||||No|No|||Prescription required|No||006|No|.15833|03/29/2022|.15453|03/29/2022|.15555|03/29/2022|||BLADDER RELAXANT PREPARATIONS|17188|||||No|No||AMNEAL PHARMACE|No||||
oxybutynin chloride|No|No|No|No|75%|65162037310|OXYBUTYNIN CL ER 15 MG TABLET|100|EA|.086|07/26/2016||Yes|No||07/26/2016||Yes|No|07/26/2016||Yes|No||||No|No|||Prescription required|No||006|No|.19948|03/29/2022|.19469|03/29/2022|.19598|03/29/2022|||BLADDER RELAXANT PREPARATIONS|17189|||||No|No||AMNEAL PHARMACE|No||||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|65162041503|BUPRENORPHINE-NALOX 8-2 MG TAB|30|EA|.85469|03/04/2013||Yes|No||03/04/2013||Yes|No|03/04/2013||Yes|No||||No|No|||Prescription required|No||145|Yes|1.08568|03/29/2022|1.05962|03/29/2022|1.06668|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|17190|||||No|No||AMNEAL PHARMACE|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|65162041603|BUPRENORPHINE-NALOX 2-0.5MG TB|30|EA|.47787|03/04/2013||Yes|No||03/04/2013||Yes|No|03/04/2013||Yes|No||||No|No|||Prescription required|No||145|Yes|.72296|03/29/2022|.7056|03/29/2022|.7103|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|17191|||||No|No||AMNEAL PHARMACE|Yes|09/01/2020|||
diclofenac sodium/misoprostol|No|No|No|No|75%|65162043606|DICLOFENAC-MISOPROST 50-0.2 MG|60|EA|1.09578|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|1.41801|03/29/2022|1.38397|03/29/2022|1.39319|03/29/2022|||NSAIDS|17192|||||No|No||AMNEAL PHARMACE|No||||
diclofenac sodium/misoprostol|No|No|No|No|75%|65162043806|DICLOFENAC-MISOPROST 75-0.2 MG|60|EA|1.09578|11/17/2017||Yes|No||11/17/2017||Yes|No|11/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|1.61285|03/29/2022|1.57414|03/29/2022|1.58462|03/29/2022|||NSAIDS|17193|||||No|No||AMNEAL PHARMACE|No||||
meclizine HCl|No|No|No|No|75%|65162044110|MECLIZINE 12.5 MG TABLET|100|EA|.07387|06/01/2011||Yes|No||06/01/2011||Yes|No|06/01/2011||Yes|No||06/01/2011||Yes|No|||Prescription required|No||085|Yes|.08309|03/29/2022|.08109|03/29/2022|.08163|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|17194|||||No|No||AMNEAL PHARMACE|No||||
meclizine HCl|No|No|No|No|75%|65162044111|MECLIZINE 12.5 MG TABLET|1000|EA|.07387|06/01/2011||Yes|No||06/01/2011||Yes|No|06/01/2011||Yes|No||06/01/2011||Yes|No|||Prescription required|No||085|Yes|.08309|03/29/2022|.08109|03/29/2022|.08163|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|17195|||||No|No||AMNEAL PHARMACE|No||||
meclizine HCl|No|No|No|No|75%|65162044210|MECLIZINE 25 MG TABLET|100|EA|.08208|06/01/2011||Yes|No||06/01/2011||Yes|No|06/01/2011||Yes|No||06/01/2011||Yes|No|||Prescription required|No||085|Yes|.11433|03/29/2022|.11158|03/29/2022|.11232|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|17196|||||No|No||AMNEAL PHARMACE|No||||
meclizine HCl|No|No|No|No|75%|65162044211|MECLIZINE 25 MG TABLET|1000|EA|.08208|06/01/2011||Yes|No||06/01/2011||Yes|No|06/01/2011||Yes|No||06/01/2011||Yes|No|||Prescription required|No||085|Yes|.11433|03/29/2022|.11158|03/29/2022|.11232|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|17197|||||No|No||AMNEAL PHARMACE|No||||
entecavir|No|No|No|No|75%|65162044603|ENTECAVIR 0.5 MG TABLET|30|EA|1.17533|07/21/2016|01/25/2022|Yes|No||07/21/2016|01/25/2022|Yes|No|07/21/2016|01/25/2022|Yes|No||||No|No|||Prescription required|No|||No|2.67866|03/29/2022|2.64039|03/29/2022|2.51466|03/29/2022||||17198|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
entecavir|No|No|No|No|75%|65162044903|ENTECAVIR 1 MG TABLET|30|EA|1.17533|07/21/2016|01/25/2022|Yes|No||07/21/2016|01/25/2022|Yes|No|07/21/2016|01/25/2022|Yes|No||||No|No|||Prescription required|No|||No|1.06461|03/29/2022|1.03905|03/29/2022|1.04597|03/29/2022||||17199|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
ibuprofen|No|No|No|No|75%|65162046410|IBUPROFEN 400 MG TABLET|100|EA|.03375|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||02/22/2019||Yes|No|||Prescription required|No||059|Yes|.04934|03/29/2022|.04815|03/29/2022|.04847|03/29/2022|||NSAIDS|17200|||||No|No||AMNEAL PHARMACE|No||||
ibuprofen|No|No|No|No|75%|65162046450|IBUPROFEN 400 MG TABLET|500|EA|.03375|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||02/22/2019||Yes|No|||Prescription required|No||059|Yes|.04934|03/29/2022|.04815|03/29/2022|.04847|03/29/2022|||NSAIDS|17201|||||No|No||AMNEAL PHARMACE|No||||
ibuprofen|No|No|No|No|75%|65162046510|IBUPROFEN 600 MG TABLET|100|EA|.04708|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||08/28/2018||Yes|No|||Prescription required|No||059|Yes|.06063|03/29/2022|.05917|03/29/2022|.05956|03/29/2022|||NSAIDS|17202|||||No|No||AMNEAL PHARMACE|No||||
ibuprofen|No|No|No|No|75%|65162046550|IBUPROFEN 600 MG TABLET|500|EA|.04708|02/21/2018||Yes|No||02/21/2018||Yes|No|02/21/2018||Yes|No||02/21/2018||Yes|No|||Prescription required|No||059|Yes|.06063|03/29/2022|.05917|03/29/2022|.05956|03/29/2022|||NSAIDS|17203|||||No|No||AMNEAL PHARMACE|No||||
ibuprofen|No|No|No|No|75%|65162046609|IBUPROFEN 800 MG TABLET|90|EA|.06903|10/18/2019||Yes|No||10/18/2019||Yes|No|10/18/2019||Yes|No||10/18/2019||Yes|No|||Prescription required|No||059|Yes|.07481|03/29/2022|.07301|03/29/2022|.0735|03/29/2022|||NSAIDS|17204|||||No|No||AMNEAL PHARMACE|No||||
ibuprofen|No|No|No|No|75%|65162046610|IBUPROFEN 800 MG TABLET|100|EA|.06901|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||11/29/2018||Yes|No|||Prescription required|No||059|Yes|.07481|03/29/2022|.07301|03/29/2022|.0735|03/29/2022|||NSAIDS|17205|||||No|No||AMNEAL PHARMACE|No||||
ibuprofen|No|No|No|No|75%|65162046650|IBUPROFEN 800 MG TABLET|500|EA|.06901|02/13/2019||Yes|No||02/13/2019||Yes|No|02/13/2019||Yes|No||02/13/2019||Yes|No|||Prescription required|No||059|Yes|.07481|03/29/2022|.07301|03/29/2022|.0735|03/29/2022|||NSAIDS|17206|||||No|No||AMNEAL PHARMACE|No||||
clindamycin palmitate HCl|No|No|No|No|75%|65162046819|CLINDAMYCIN (PEDI) 75 MG/5 ML|100|ML|.2021|11/07/2014||Yes|No||11/07/2014||Yes|No|11/07/2014||Yes|No||11/07/2014||Yes|No|||Prescription required|No||146|No|.19356|03/29/2022|.18891|03/29/2022|.19017|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|17207|||||No|No||AMNEAL PHARMACE|No||||
etonogestrel/ethinyl estradiol|Yes|Yes|No|No|75%|65162046935|ELURYNG VAGINAL RING|1|EA|63.7776|03/09/2020||Yes|No||03/09/2020||Yes|No|||No|No||||No|No|06/19/2020||Prescription required|No|||No|92.38101|03/29/2022|90.16386|03/29/2022|90.76434|03/29/2022||||17208|||||No|No||AMNEAL PHARMACE|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone acetate|No|No|No|No|75%|65162047505|NORETHINDRONE 5 MG TABLET|50|EA|.79593|11/06/2012||Yes|No||11/06/2012||Yes|No|11/06/2012||Yes|No||||No|No|||Prescription required|No|||No|.58431|03/29/2022|.57028|03/29/2022|.57408|03/29/2022||||17209|||||No|No||AMNEAL PHARMACE|No||||
norethindrone acetate|No|No|No|No|75%|65162047509|NORETHINDRONE 5 MG TABLET|90|EA|.79593|11/06/2012||Yes|No||11/06/2012||Yes|No|11/06/2012||Yes|No||||No|No|||Prescription required|No|||No|.58431|03/29/2022|.57028|03/29/2022|.57408|03/29/2022||||17210|||||No|No||AMNEAL PHARMACE|No||||
nitrofurantoin monohyd/m-cryst|No|No|No|No|75%|65162047810|NITROFURANTOIN MONO-MCR 100 MG|100|EA|.60544|11/20/2017||Yes|No||11/20/2017||Yes|No|11/20/2017||Yes|No||11/20/2017||Yes|No|||Prescription required|No|||No|.48495|03/29/2022|.47331|03/29/2022|.47646|03/29/2022||||17211|||||No|No||AMNEAL PHARMACE|No||||
indomethacin|No|No|No|No|75%|65162050603|INDOMETHACIN ER 75 MG CAPSULE|30|EA|.13975|12/22/2010||Yes|No||12/22/2010||Yes|No|12/22/2010||Yes|No||12/22/2010||Yes|No|||Prescription required|Yes|01/23/2013|059|Yes|.23098|03/29/2022|.22543|03/29/2022|.22693|03/29/2022|||NSAIDS|17212|||||No|No||AMNEAL PHARMACE|No||||
indomethacin|No|No|No|No|75%|65162050606|INDOMETHACIN ER 75 MG CAPSULE|60|EA|.13975|12/22/2010||Yes|No||12/22/2010||Yes|No|12/22/2010||Yes|No||12/22/2010||Yes|No|||Prescription required|Yes|01/23/2013|059|Yes|.23098|03/29/2022|.22543|03/29/2022|.22693|03/29/2022|||NSAIDS|17213|||||No|No||AMNEAL PHARMACE|No||||
indomethacin|No|No|No|No|75%|65162050609|INDOMETHACIN ER 75 MG CAPSULE|90|EA|.13975|12/22/2010||Yes|No||12/22/2010||Yes|No|12/22/2010||Yes|No||12/22/2010||Yes|No|||Prescription required|Yes|01/23/2013|059|Yes|.23098|03/29/2022|.22543|03/29/2022|.22693|03/29/2022|||NSAIDS|17214|||||No|No||AMNEAL PHARMACE|No||||
spironolactone|No|No|No|No|75%|65162051110|SPIRONOLACTONE 25 MG TABLET|100|EA|.07095|08/09/2010|06/08/2022|Yes|No||08/09/2010|06/08/2022|Yes|No|08/09/2010|06/08/2022|Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||17215|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
spironolactone|No|No|No|No|75%|65162051111|SPIRONOLACTONE 25 MG TABLET|1000|EA|.06677|08/09/2010|06/08/2022|Yes|No||08/09/2010|06/08/2022|Yes|No|08/09/2010|06/08/2022|Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||17216|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
spironolactone|No|No|No|No|75%|65162051150|SPIRONOLACTONE 25 MG TABLET|500|EA|.06884|08/09/2010|06/08/2022|Yes|No||08/09/2010|06/08/2022|Yes|No|08/09/2010|06/08/2022|Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||17217|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
spironolactone|No|No|No|No|75%|65162051410|SPIRONOLACTONE 50 MG TABLET|100|EA|.18898|08/09/2010|06/08/2022|Yes|No||08/09/2010|06/08/2022|Yes|No|08/09/2010|06/08/2022|Yes|No||||No|No|||Prescription required|No|||No|.12042|03/29/2022|.11752|03/29/2022|.11831|03/29/2022||||17218|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
spironolactone|No|No|No|No|75%|65162051450|SPIRONOLACTONE 50 MG TABLET|500|EA|.1833|08/09/2010|06/08/2022|Yes|No||08/09/2010|06/08/2022|Yes|No|08/09/2010|06/08/2022|Yes|No||||No|No|||Prescription required|No|||No|.12042|03/29/2022|.11752|03/29/2022|.11831|03/29/2022||||17219|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
spironolactone|No|No|No|No|75%|65162051510|SPIRONOLACTONE 100 MG TABLET|100|EA|.33002|08/09/2010|06/08/2022|Yes|No||08/09/2010|06/08/2022|Yes|No|08/09/2010|06/08/2022|Yes|No||||No|No|||Prescription required|No|||No|.2048|03/29/2022|.19988|03/29/2022|.20121|03/29/2022||||17220|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
spironolactone|No|No|No|No|75%|65162051550|SPIRONOLACTONE 100 MG TABLET|500|EA|.32013|08/09/2010|06/08/2022|Yes|No||08/09/2010|06/08/2022|Yes|No|08/09/2010|06/08/2022|Yes|No||||No|No|||Prescription required|No|||No|.2048|03/29/2022|.19988|03/29/2022|.20121|03/29/2022||||17221|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
promethazine HCl|No|No|No|No|75%|65162052110|PROMETHAZINE 25 MG TABLET|100|EA|.04192|04/20/2011||Yes|No||04/20/2011||Yes|No|04/20/2011||Yes|No||04/20/2011||Yes|No|||Prescription required|No||085|Yes|.05271|03/29/2022|.05144|03/29/2022|.05178|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|17222|||||No|No||AMNEAL PHARMACE|No||||
promethazine HCl|No|No|No|No|75%|65162052111|PROMETHAZINE 25 MG TABLET|1000|EA|.04192|04/20/2011||Yes|No||04/20/2011||Yes|No|04/20/2011||Yes|No||04/20/2011||Yes|No|||Prescription required|No||085|Yes|.05271|03/29/2022|.05144|03/29/2022|.05178|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|17223|||||No|No||AMNEAL PHARMACE|No||||
promethazine HCl|No|No|No|No|75%|65162052210|PROMETHAZINE 50 MG TABLET|100|EA|.04579|04/20/2011||Yes|No||04/20/2011||Yes|No|04/20/2011||Yes|No||04/20/2011||Yes|No|||Prescription required|No||085|Yes|.09825|03/29/2022|.09589|03/29/2022|.09653|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|17224|||||No|No||AMNEAL PHARMACE|No||||
primidone|No|No|No|No|75%|65162054410|PRIMIDONE 50 MG TABLET|100|EA|.11038|07/11/2008|06/08/2022|Yes|No||07/11/2008|06/08/2022|Yes|No|07/11/2008|06/08/2022|Yes|No||||No|No|||Prescription required|No||056|No|.16327|03/29/2022|.15935|03/29/2022|.16041|03/29/2022|||ANTICONVULSANTS|17225|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
primidone|No|No|No|No|75%|65162054450|PRIMIDONE 50 MG TABLET|500|EA|.09066|07/11/2008|06/08/2022|Yes|No||07/11/2008|06/08/2022|Yes|No|07/11/2008|06/08/2022|Yes|No||||No|No|||Prescription required|No||056|No|.16327|03/29/2022|.15935|03/29/2022|.16041|03/29/2022|||ANTICONVULSANTS|17226|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
primidone|No|No|No|No|75%|65162054510|PRIMIDONE 250 MG TABLET|100|EA|.15557|07/11/2008|06/08/2022|Yes|No||07/11/2008|06/08/2022|Yes|No|07/11/2008|06/08/2022|Yes|No||||No|No|||Prescription required|No||056|No|.31086|03/29/2022|.30339|03/29/2022|.30541|03/29/2022|||ANTICONVULSANTS|17227|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
metaxalone|No|No|No|No|75%|65162055310|METAXALONE 800 MG TABLET|100|EA|.645|06/26/2013||Yes|No||06/26/2013||Yes|No|06/26/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|116|Yes|.52754|03/29/2022|.51487|03/29/2022|.5183|03/29/2022|||SKELETAL MUSCLE RELAXANTS|17228|||||No|No||AMNEAL PHARMACE|No||||
demeclocycline HCl|No|No|No|No|75%|65162055410|DEMECLOCYCLINE 150 MG TABLET|100|EA|2.72254|03/20/2008||Yes|No||03/20/2008||Yes|No|03/20/2008||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|213|No|6.20487|09/25/2018|6.11622|09/25/2018|5.82498|09/25/2018|||TETRACYCLINES|17229|||||No|No||AMNEAL PHARMACE|No||||
demeclocycline HCl|No|No|No|No|75%|65162055548|DEMECLOCYCLINE 300 MG TABLET|48|EA|4.92887|03/20/2008||Yes|No||03/20/2008||Yes|No|03/20/2008||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|213|No|11.23325|12/28/2021|11.07277|12/28/2021|10.5455|12/28/2021|||TETRACYCLINES|17230|||||No|No||AMNEAL PHARMACE|No||||
temazepam|No|No|No|No|90%|65162055610|TEMAZEPAM 15 MG CAPSULE|100|EA|.02322|02/01/2018||Yes|No||02/01/2018||Yes|No|02/01/2018||Yes|No||||No|No|||Prescription required|No||054|Yes|.07712|03/29/2022|.07526|03/29/2022|.07577|03/29/2022|||SEDATIVE HYPNOTICS|17231|||||No|No||AMNEAL PHARMACE|No||||
temazepam|No|No|No|No|90%|65162055650|TEMAZEPAM 15 MG CAPSULE|500|EA|.02322|02/01/2018||Yes|No||02/01/2018||Yes|No|02/05/2020||Yes|No||||No|No|||Prescription required|No||054|Yes|.07712|03/29/2022|.07526|03/29/2022|.07577|03/29/2022|||SEDATIVE HYPNOTICS|17232|||||No|No||AMNEAL PHARMACE|No||||
temazepam|No|No|No|No|90%|65162055710|TEMAZEPAM 30 MG CAPSULE|100|EA|.02979|02/01/2018||Yes|No||02/01/2018||Yes|No|02/01/2018||Yes|No||||No|No|||Prescription required|No||054|Yes|.10046|03/29/2022|.09804|03/29/2022|.0987|03/29/2022|||SEDATIVE HYPNOTICS|17233|||||No|No||AMNEAL PHARMACE|No||||
temazepam|No|No|No|No|90%|65162055750|TEMAZEPAM 30 MG CAPSULE|500|EA|.02979|02/01/2018||Yes|No||02/01/2018||Yes|No|02/01/2018||Yes|No||||No|No|||Prescription required|No||054|Yes|.10046|03/29/2022|.09804|03/29/2022|.0987|03/29/2022|||SEDATIVE HYPNOTICS|17234|||||No|No||AMNEAL PHARMACE|No||||
norethindrone-e.estradiol-iron|No|Yes|No|No|75%|65162055815|TAYSOFY 1 MG-20 MCG CAPSULE|28|EA|.7224|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|2.32077|03/29/2022|2.26507|03/29/2022|2.28015|03/29/2022||||17235|||||No|No||AMNEAL PHARMACE|No|||Only covered for non-contraceptive (medical) purposes|
bethanechol chloride|No|No|No|No|75%|65162057110|BETHANECHOL 5 MG TABLET|100|EA|.1035|02/29/2008||Yes|No||02/29/2008||Yes|No|02/29/2008||Yes|No||||No|No|||Prescription required|No|||No|.20616|03/01/2022|.20121|03/01/2022|.20255|03/01/2022||||17236|||||No|No||AMNEAL PHARMACE|No||||
bethanechol chloride|No|No|No|No|75%|65162057210|BETHANECHOL 10 MG TABLET|100|EA|.13618|02/29/2008||Yes|No||02/29/2008||Yes|No|02/29/2008||Yes|No||||No|No|||Prescription required|No|||No|.22911|03/29/2022|.22361|03/29/2022|.2251|03/29/2022||||17237|||||No|No||AMNEAL PHARMACE|No||||
bethanechol chloride|No|No|No|No|75%|65162057310|BETHANECHOL 25 MG TABLET|100|EA|.19595|02/29/2008||Yes|No||02/29/2008||Yes|No|02/29/2008||Yes|No||||No|No|||Prescription required|No|||No|.29586|03/29/2022|.28875|03/29/2022|.29068|03/29/2022||||17238|||||No|No||AMNEAL PHARMACE|No||||
bethanechol chloride|No|No|No|No|75%|65162057410|BETHANECHOL 50 MG TABLET|100|EA|.32387|02/29/2008||Yes|No||02/29/2008||Yes|No|02/29/2008||Yes|No||||No|No|||Prescription required|No|||No|.48885|03/01/2022|.47711|03/01/2022|.48029|03/01/2022||||17239|||||No|No||AMNEAL PHARMACE|No||||
aspirin/dipyridamole|No|No|No|No|75%|65162059606|ASPIRIN-DIPYRIDAM ER 25-200 MG|60|EA|.43|05/23/2017||Yes|No||05/23/2017||Yes|No|05/23/2017||Yes|No||||No|No|||Prescription required|No||004|No|.78047|03/29/2022|.76173|03/29/2022|.76681|03/29/2022|||PLATELET AGGREGATION INHIBITORS|17240|||||No|No||AMNEAL PHARMACE|No||||
tramadol HCl/acetaminophen|No|No|No|No|90%|65162061710|TRAMADOL-ACETAMINOPHN 37.5-325|100|EA|.29326|12/18/2009|06/08/2022|Yes|No||12/18/2009|06/08/2022|Yes|No|12/18/2009|06/08/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|.11806|03/29/2022|.11522|03/29/2022|.11599|03/29/2022|||ANALGESICS: NARCOTICS SHORT|17241|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
tramadol HCl/acetaminophen|No|No|No|No|90%|65162061711|TRAMADOL-ACETAMINOPHN 37.5-325|1000|EA|.15695|12/18/2009|06/08/2022|Yes|No||12/18/2009|06/08/2022|Yes|No|12/18/2009|06/08/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|.11806|03/29/2022|.11522|03/29/2022|.11599|03/29/2022|||ANALGESICS: NARCOTICS SHORT|17242|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
tramadol HCl/acetaminophen|No|No|No|No|90%|65162061750|TRAMADOL-ACETAMINOPHN 37.5-325|500|EA|.1806|12/18/2009|06/08/2022|Yes|No||12/18/2009|06/08/2022|Yes|No|12/18/2009|06/08/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|.11806|03/29/2022|.11522|03/29/2022|.11599|03/29/2022|||ANALGESICS: NARCOTICS SHORT|17243|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
tramadol HCl|No|No|No|No|90%|65162062710|TRAMADOL HCL 50 MG TABLET|100|EA|.04725|07/25/2007||Yes|No||07/25/2007||Yes|No|07/25/2007||Yes|No||||No|No|||Prescription required|No||109|Yes|.02459|03/29/2022|.02399|03/29/2022|.02415|03/29/2022|||ANALGESICS: NARCOTICS SHORT|17244|||||No|No||AMNEAL PHARMACE|No||||
tramadol HCl|No|No|No|No|90%|65162062711|TRAMADOL HCL 50 MG TABLET|1000|EA|.02504|07/25/2007||Yes|No||07/25/2007||Yes|No|07/25/2007||Yes|No||||No|No|||Prescription required|No||109|Yes|.02459|03/29/2022|.02399|03/29/2022|.02415|03/29/2022|||ANALGESICS: NARCOTICS SHORT|17245|||||No|No||AMNEAL PHARMACE|No||||
tramadol HCl|No|No|No|No|90%|65162062750|TRAMADOL HCL 50 MG TABLET|500|EA|.03083|07/25/2007||Yes|No||07/25/2007||Yes|No|07/25/2007||Yes|No||||No|No|||Prescription required|No||109|Yes|.02459|03/29/2022|.02399|03/29/2022|.02415|03/29/2022|||ANALGESICS: NARCOTICS SHORT|17246|||||No|No||AMNEAL PHARMACE|No||||
itraconazole|No|No|No|No|75%|65162063003|ITRACONAZOLE 100 MG CAPSULE|30|EA|.71666|04/12/2017||Yes|No||04/12/2017||Yes|No|04/12/2017||Yes|No||04/12/2017||Yes|No|||Prescription required|Yes|01/28/2016|069|No|.85195|03/29/2022|.8315|03/29/2022|.83704|03/29/2022|||ANTIFUNGALS: ORAL|17247|||||No|No||AMNEAL PHARMACE|No||||
pantoprazole sodium|No|No|No|No|75%|65162063609|PANTOPRAZOLE SOD DR 20 MG TAB|90|EA|.04816|04/12/2017||Yes|No||04/12/2017||Yes|No|04/12/2017||Yes|No||04/12/2017||Yes|No|||Prescription required|No||047|Yes|.05306|03/29/2022|.05178|03/29/2022|.05213|03/29/2022|||PROTON PUMP INHIBITORS|17248|||||No|No||AMNEAL PHARMACE|No||||
pantoprazole sodium|No|No|No|No|75%|65162063709|PANTOPRAZOLE SOD DR 40 MG TAB|90|EA|.04816|04/12/2017||Yes|No||04/12/2017||Yes|No|04/12/2017||Yes|No||04/12/2017||Yes|No|||Prescription required|No||047|No|.05828|03/29/2022|.05688|03/29/2022|.05726|03/29/2022|||PROTON PUMP INHIBITORS|17249|||||No|No||AMNEAL PHARMACE|No||||
pantoprazole sodium|No|No|No|No|75%|65162063711|PANTOPRAZOLE SOD DR 40 MG TAB|1000|EA|.04816|04/12/2017||Yes|No||04/12/2017||Yes|No|04/12/2017||Yes|No||04/12/2017||Yes|No|||Prescription required|No||047|No|.05828|03/29/2022|.05688|03/29/2022|.05726|03/29/2022|||PROTON PUMP INHIBITORS|17250|||||No|No||AMNEAL PHARMACE|No||||
flecainide acetate|No|No|No|No|75%|65162064110|FLECAINIDE ACETATE 50 MG TAB|100|EA|.24682|04/17/2009|06/08/2022|Yes|No||04/17/2009|06/08/2022|Yes|No|04/17/2009|06/08/2022|Yes|No||||No|No|||Prescription required|No|||No|.15465|03/29/2022|.15093|03/29/2022|.15194|03/29/2022||||17251|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
flecainide acetate|No|No|No|No|75%|65162064210|FLECAINIDE ACETATE 100 MG TAB|100|EA|.40334|04/17/2009|06/08/2022|Yes|No||04/17/2009|06/08/2022|Yes|No|04/17/2009|06/08/2022|Yes|No||||No|No|||Prescription required|No|||No|.24778|03/29/2022|.24183|03/29/2022|.24344|03/29/2022||||17252|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
flecainide acetate|No|No|No|No|75%|65162064310|FLECAINIDE ACETATE 150 MG TAB|100|EA|.55405|04/17/2009|06/08/2022|Yes|No||04/17/2009|06/08/2022|Yes|No|04/17/2009|06/08/2022|Yes|No||||No|No|||Prescription required|No|||No|.41264|03/29/2022|.40273|03/29/2022|.40541|03/29/2022||||17253|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
oxcarbazepine|No|No|No|No|75%|65162064978|OXCARBAZEPINE 300 MG/5 ML SUSP|250|ML|.28455|11/06/2012||Yes|No||11/06/2012||Yes|No|11/06/2012||Yes|No||||No|No|||Prescription required|No||056|No|.34245|03/29/2022|.33423|03/29/2022|.33645|03/29/2022|||ANTICONVULSANTS|17254|||||No|No||AMNEAL PHARMACE|No||||
risperidone|No|No|No|No|75%|65162067384|RISPERIDONE 1 MG/ML SOLUTION|30|ML|.301|05/31/2011||Yes|No||05/31/2011||Yes|No|05/31/2011||Yes|No||||No|No|||Prescription required|No||027|Yes|.33084|03/29/2022|.32289|03/29/2022|.32505|03/29/2022|||ANTIPSYCHOTICS|17255|||||No|No||AMNEAL PHARMACE|No||||
azelastine HCl|No|No|No|No|75%|65162067684|AZELASTINE 0.1% (137 MCG) SPRY|30|ML|.28666|02/15/2018||Yes|No||02/15/2018||Yes|No|02/15/2018||Yes|No||||No|No|||Prescription required|No||019|Yes|.27761|03/29/2022|.27094|03/29/2022|.27275|03/29/2022|||INTRANASAL RHINITIS AGENTS|17256|||||No|No||AMNEAL PHARMACE|No||||
promethazine/dextromethorphan|No|No|No|No|75%|65162068086|PROMETHAZINE-DM 6.25-15 MG/5ML|118|ML|.03188|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|No||184|Yes|.05718|03/29/2022|.0558|03/29/2022|.05617|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|17257|||||No|No||AMNEAL PHARMACE|No||||
promethazine/dextromethorphan|No|No|No|No|75%|65162068090|PROMETHAZINE-DM 6.25-15 MG/5ML|473|ML|.03181|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No||184|Yes|.05643|03/29/2022|.05507|03/29/2022|.05544|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|17258|||||No|No||AMNEAL PHARMACE|No||||
felbamate|No|No|No|No|75%|65162068688|FELBAMATE 600 MG/5 ML SUSP|240|ML|.3741|12/10/2012||Yes|No||12/10/2012||Yes|No|12/10/2012||Yes|No||||No|No|||Prescription required|No||056|No|.8526|05/18/2021|.84042|05/18/2021|.8004|05/18/2021|||ANTICONVULSANTS|17259|||||No|No||AMNEAL PHARMACE|No||||
felbamate|No|No|No|No|75%|65162068690|FELBAMATE 600 MG/5 ML SUSP|473|ML|.3741|12/10/2012||Yes|No||12/10/2012||Yes|No|12/10/2012||Yes|No||||No|No|||Prescription required|No||056|No|.8526|05/18/2021|.84042|05/18/2021|.8004|05/18/2021|||ANTICONVULSANTS|17260|||||No|No||AMNEAL PHARMACE|No||||
lorazepam|No|No|No|No|90%|65162068784|LORAZEPAM 2 MG/ML ORAL CONCENT|30|ML|.45221|02/23/2010||Yes|No||02/23/2010||Yes|No|02/23/2010||Yes|No||||No|No|||Prescription required|No||090|Yes|.59241|03/29/2022|.57819|03/29/2022|.58204|03/29/2022|||ANXIOLYTICS|17261|||||No|No||AMNEAL PHARMACE|No||||
ondansetron HCl|No|No|No|No|75%|65162069179|ONDANSETRON 4 MG/5 ML SOLUTION|50|ML|.215|06/07/2011||Yes|No||06/07/2011||Yes|No|06/07/2011||Yes|No||||No|No|||Prescription required|No||085|No|.25985|03/29/2022|.25361|03/29/2022|.2553|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|17262|||||No|No||AMNEAL PHARMACE|No||||
atovaquone|No|No|No|No|75%|65162069388|ATOVAQUONE 750 MG/5 ML SUSP|210|ML|2.45713|03/25/2014||Yes|No||03/25/2014||Yes|No|03/25/2014||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|1.13871|03/29/2022|1.11138|03/29/2022|1.11878|03/29/2022||||17263|||||No|No||AMNEAL PHARMACE|No||||
gabapentin|No|No|No|No|75%|65162069890|GABAPENTIN 250 MG/5 ML SOLN|473|ML|.10108|04/04/2012||Yes|No||04/04/2012||Yes|No|04/04/2012||Yes|No||07/01/2012||Yes|No|||Prescription required|No||232|Yes|.23038|09/28/2021|.22709|09/28/2021|.21628|09/28/2021|||NEUROPATHIC PAIN|17264|||||No|No||AMNEAL PHARMACE|No||||
fluocinolone acetonide oil|No|No|No|No|75%|65162070294|FLUOCINOLONE OIL 0.01% EAR DRP|20|ML|1.5953|11/14/2011||Yes|No||11/14/2011||Yes|No|11/14/2011||Yes|No||||No|No|||Prescription required|No|||No|2.06581|03/29/2022|2.01623|03/29/2022|2.02965|03/29/2022||||17265|||||No|No||AMNEAL PHARMACE|No||||
fluocinolone/shower cap|No|No|No|No|75%|65162070386|FLUOCINOLONE 0.01% SCALP OIL|118.28|ML|.11353|11/14/2011||Yes|No||11/14/2011||Yes|No|11/14/2011||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|118|No|.27456|03/29/2022|.26797|03/29/2022|.26975|03/29/2022|||STEROIDS: TOPICAL LOW|17266|||||No|No||AMNEAL PHARMACE|No||||
fluocinolone acetonide|No|No|No|No|75%|65162070486|FLUOCINOLONE 0.01% BODY OIL|118.28|ML|.11236|11/14/2011||Yes|No||11/14/2011||Yes|No|11/14/2011||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|118|No|.18968|03/29/2022|.18512|03/29/2022|.18636|03/29/2022|||STEROIDS: TOPICAL LOW|17267|||||No|No||AMNEAL PHARMACE|No||||
escitalopram oxalate|No|No|No|No|75%|65162070588|ESCITALOPRAM OXALATE 5 MG/5 ML|240|ML|.18812|03/15/2012||Yes|No||03/15/2012||Yes|No|03/15/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|008|No|.36935|02/22/2022|.36048|02/22/2022|.36288|02/22/2022|||ANTIDEPRESSANTS: SSRIs|17268|||||No|No||AMNEAL PHARMACE|No||||
azelastine HCl|No|No|No|No|75%|65162070684|AZELASTINE 0.15% NASAL SPRAY|30|ML|.43|06/01/2020|01/20/2023|Yes|No||06/01/2020|01/20/2023|Yes|No|06/01/2020|01/20/2023|Yes|No||||No|No|||Prescription required|Yes|07/25/2019|019|No|.62364|03/29/2022|.60867|03/29/2022|.61272|03/29/2022|||INTRANASAL RHINITIS AGENTS|17269|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
colchicine|No|No|No|No|75%|65162071003|COLCHICINE 0.6 MG TABLET|30|EA|.35245|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||02/04/2021||Yes|No|||Prescription required|Yes|07/25/2019|231|No|.64179|03/29/2022|.62638|03/29/2022|.63055|03/29/2022|||ANTIHYPERURICEMICS|17270|||||No|No||AMNEAL PHARMACE|No||||
colchicine|No|No|No|No|75%|65162071009|COLCHICINE 0.6 MG TABLET|90|EA|.35245|12/31/2020||Yes|No||12/31/2020||Yes|No|12/31/2020||Yes|No||12/31/2020||Yes|No|||Prescription required|Yes|07/25/2019|231|No|.64179|03/29/2022|.62638|03/29/2022|.63055|03/29/2022|||ANTIHYPERURICEMICS|17271|||||No|No||AMNEAL PHARMACE|No||||
guanfacine HCl|No|No|No|No|75%|65162071110|GUANFACINE 1 MG TABLET|100|EA|.2408|10/03/2014||Yes|No||10/03/2014||Yes|No|10/03/2014||Yes|No||10/03/2014||Yes|No|||Prescription required|No||166|No|.50477|03/29/2022|.49265|03/29/2022|.49593|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|17272|||||No|No||AMNEAL PHARMACE|No||||
guanfacine HCl|No|No|No|No|75%|65162071310|GUANFACINE 2 MG TABLET|100|EA|.3741|10/03/2014||Yes|No||10/03/2014||Yes|No|10/03/2014||Yes|No||10/03/2014||Yes|No|||Prescription required|No||166|No|.72297|03/29/2022|.70561|03/29/2022|.71031|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|17273|||||No|No||AMNEAL PHARMACE|No||||
felbamate|No|No|No|No|75%|65162073403|FELBAMATE 400 MG TABLET|30|EA|1.032|09/14/2011|05/18/2022|Yes|No||09/14/2011|05/18/2022|Yes|No|09/14/2011|05/18/2022|Yes|No||||No|No|||Prescription required|No||056|No|1.17562|10/26/2021|1.1474|10/26/2021|1.15504|10/26/2021|||ANTICONVULSANTS|17274|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
felbamate|No|No|No|No|75%|65162073409|FELBAMATE 400 MG TABLET|90|EA|1.032|09/14/2011||Yes|No||09/14/2011||Yes|No|09/14/2011||Yes|No||||No|No|||Prescription required|No||056|No|1.17562|10/26/2021|1.1474|10/26/2021|1.15504|10/26/2021|||ANTICONVULSANTS|17275|||||No|No||AMNEAL PHARMACE|No||||
felbamate|No|No|No|No|75%|65162073503|FELBAMATE 600 MG TABLET|30|EA|1.204|09/14/2011|05/18/2022|Yes|No||09/14/2011|05/18/2022|Yes|No|09/14/2011|05/18/2022|Yes|No||||No|No|||Prescription required|No||056|No|1.94824|03/29/2022|1.90148|03/29/2022|1.91414|03/29/2022|||ANTICONVULSANTS|17276|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
felbamate|No|No|No|No|75%|65162073509|FELBAMATE 600 MG TABLET|90|EA|1.204|09/14/2011||Yes|No||09/14/2011||Yes|No|09/14/2011||Yes|No||||No|No|||Prescription required|No||056|No|1.94824|03/29/2022|1.90148|03/29/2022|1.91414|03/29/2022|||ANTICONVULSANTS|17277|||||No|No||AMNEAL PHARMACE|No||||
felbamate|No|No|No|No|75%|65162073518|FELBAMATE 600 MG TABLET|180|EA|1.204|09/14/2011||Yes|No||09/14/2011||Yes|No|09/14/2011||Yes|No||||No|No|||Prescription required|No||056|No|1.94824|03/29/2022|1.90148|03/29/2022|1.91414|03/29/2022|||ANTICONVULSANTS|17278|||||No|No||AMNEAL PHARMACE|No||||
promethazine HCl|No|No|No|No|75%|65162074510|PROMETHAZINE 12.5 MG TABLET|100|EA|.0344|04/20/2011||Yes|No||04/20/2011||Yes|No|04/20/2011||Yes|No||04/20/2011||Yes|No|||Prescription required|No||085|Yes|.05281|03/29/2022|.05154|03/29/2022|.05188|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|17279|||||No|No||AMNEAL PHARMACE|No||||
rivastigmine|No|No|No|No|75%|65162074934|RIVASTIGMINE 13.3 MG/24HR PTCH|30|EA|1.82893|06/05/2019||Yes|No||06/05/2019||Yes|No|06/05/2019||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|011|No|3.24254|03/29/2022|3.16471|03/29/2022|3.18579|03/29/2022|||ALZHEIMER'S AGENTS|17280|||||No|No||AMNEAL PHARMACE|No||||
dutasteride|No|No|No|No|75%|65162075003|DUTASTERIDE 0.5 MG CAPSULE|30|EA|.215|07/21/2016|07/06/2022|Yes|No||07/21/2016|07/06/2022|Yes|No|07/21/2016|07/06/2022|Yes|No||||No|No|||Prescription required|Yes|07/23/2015|003|No|.20731|03/29/2022|.20233|03/29/2022|.20368|03/29/2022|||BPH TREATMENTS|17281|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
dutasteride|No|No|No|No|75%|65162075009|DUTASTERIDE 0.5 MG CAPSULE|90|EA|.215|07/21/2016||Yes|No||07/21/2016||Yes|No|07/21/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|003|No|.20731|03/29/2022|.20233|03/29/2022|.20368|03/29/2022|||BPH TREATMENTS|17282|||||No|No||AMNEAL PHARMACE|No||||
benazepril HCl|Yes|No|No|No|75%|65162075110|BENAZEPRIL HCL 5 MG TABLET|100|EA|.0301|04/06/2009||Yes|No||04/06/2009||Yes|No|04/06/2009||Yes|No||04/06/2009||Yes|No|07/01/2016||Prescription required|No||113|No|.06176|03/29/2022|.06027|03/29/2022|.06067|03/29/2022|||ANGIOTENSIN MODULATORS|17283|||||No|No||AMNEAL PHARMACE|No||||
benazepril HCl|Yes|No|No|No|75%|65162075150|BENAZEPRIL HCL 5 MG TABLET|500|EA|.0301|04/06/2009||Yes|No||04/06/2009||Yes|No|04/06/2009||Yes|No||04/06/2009||Yes|No|07/01/2016||Prescription required|No||113|No|.06176|03/29/2022|.06027|03/29/2022|.06067|03/29/2022|||ANGIOTENSIN MODULATORS|17284|||||No|No||AMNEAL PHARMACE|No||||
benazepril HCl|Yes|No|No|No|75%|65162075210|BENAZEPRIL HCL 10 MG TABLET|100|EA|.03655|04/30/2009||Yes|No||04/30/2009||Yes|No|04/30/2009||Yes|No||04/30/2009||Yes|No|07/01/2016||Prescription required|No||113|No|.06947|03/29/2022|.0678|03/29/2022|.06825|03/29/2022|||ANGIOTENSIN MODULATORS|17285|||||No|No||AMNEAL PHARMACE|No||||
benazepril HCl|Yes|No|No|No|75%|65162075250|BENAZEPRIL HCL 10 MG TABLET|500|EA|.03655|04/30/2009||Yes|No||04/30/2009||Yes|No|04/30/2009||Yes|No||04/30/2009||Yes|No|07/01/2016||Prescription required|No||113|No|.06947|03/29/2022|.0678|03/29/2022|.06825|03/29/2022|||ANGIOTENSIN MODULATORS|17286|||||No|No||AMNEAL PHARMACE|No||||
benazepril HCl|Yes|No|No|No|75%|65162075310|BENAZEPRIL HCL 20 MG TABLET|100|EA|.05052|04/30/2009||Yes|No||04/30/2009||Yes|No|04/30/2009||Yes|No||04/30/2009||Yes|No|07/01/2016||Prescription required|No||113|No|.08619|03/29/2022|.08412|03/29/2022|.08468|03/29/2022|||ANGIOTENSIN MODULATORS|17287|||||No|No||AMNEAL PHARMACE|No||||
benazepril HCl|Yes|No|No|No|75%|65162075350|BENAZEPRIL HCL 20 MG TABLET|500|EA|.05052|04/30/2009||Yes|No||04/30/2009||Yes|No|04/30/2009||Yes|No||04/30/2009||Yes|No|07/01/2016||Prescription required|No||113|No|.08619|03/29/2022|.08412|03/29/2022|.08468|03/29/2022|||ANGIOTENSIN MODULATORS|17288|||||No|No||AMNEAL PHARMACE|No||||
benazepril HCl|Yes|No|No|No|75%|65162075410|BENAZEPRIL HCL 40 MG TABLET|100|EA|.06772|04/30/2009||Yes|No||04/30/2009||Yes|No|04/30/2009||Yes|No||04/30/2009||Yes|No|07/01/2016||Prescription required|No||113|No|.11798|03/29/2022|.11514|03/29/2022|.11591|03/29/2022|||ANGIOTENSIN MODULATORS|17289|||||No|No||AMNEAL PHARMACE|No||||
benazepril HCl|Yes|No|No|No|75%|65162075450|BENAZEPRIL HCL 40 MG TABLET|500|EA|.05366|04/30/2009||Yes|No||04/30/2009||Yes|No|04/30/2009||Yes|No||04/30/2009||Yes|No|07/01/2016||Prescription required|No||113|No|.11798|03/29/2022|.11514|03/29/2022|.11591|03/29/2022|||ANGIOTENSIN MODULATORS|17290|||||No|No||AMNEAL PHARMACE|No||||
divalproex sodium|No|No|No|No|75%|65162075510|DIVALPROEX SOD ER 250 MG TAB|100|EA|.11137|09/10/2015||Yes|No||09/10/2015||Yes|No|09/10/2015||Yes|No||09/10/2015||Yes|No|||Prescription required|No||056|Yes|.17839|03/29/2022|.1741|03/29/2022|.17526|03/29/2022|||ANTICONVULSANTS|17291|||||No|No||AMNEAL PHARMACE|No||||
divalproex sodium|No|No|No|No|75%|65162075550|DIVALPROEX SOD ER 250 MG TAB|500|EA|.11137|09/10/2015||Yes|No||09/10/2015||Yes|No|09/10/2015||Yes|No||09/10/2015||Yes|No|||Prescription required|No||056|Yes|.17839|03/29/2022|.1741|03/29/2022|.17526|03/29/2022|||ANTICONVULSANTS|17292|||||No|No||AMNEAL PHARMACE|No||||
divalproex sodium|No|No|No|No|75%|65162075710|DIVALPROEX SOD ER 500 MG TAB|100|EA|.1849|09/10/2015||Yes|No||09/10/2015||Yes|No|09/10/2015||Yes|No||09/10/2015||Yes|No|||Prescription required|No||056|No|.21008|03/29/2022|.20503|03/29/2022|.2064|03/29/2022|||ANTICONVULSANTS|17293|||||No|No||AMNEAL PHARMACE|No||||
divalproex sodium|No|No|No|No|75%|65162075750|DIVALPROEX SOD ER 500 MG TAB|500|EA|.1849|09/10/2015||Yes|No||09/10/2015||Yes|No|09/10/2015||Yes|No||09/10/2015||Yes|No|||Prescription required|No||056|No|.21008|03/29/2022|.20503|03/29/2022|.2064|03/29/2022|||ANTICONVULSANTS|17294|||||No|No||AMNEAL PHARMACE|No||||
warfarin sodium|No|No|No|No|75%|65162076110|WARFARIN SODIUM 1 MG TABLET|100|EA|.06983|04/17/2015||Yes|No||04/17/2015||Yes|No|04/17/2015||Yes|No||04/17/2015||Yes|No|||Prescription required|No||068|Yes|.08991|03/29/2022|.08775|03/29/2022|.08833|03/29/2022|||ANTICOAGULANTS|17295|||||No|No||AMNEAL PHARMACE|No||||
warfarin sodium|No|No|No|No|75%|65162076111|WARFARIN SODIUM 1 MG TABLET|1000|EA|.06983|04/17/2015||Yes|No||04/17/2015||Yes|No|04/17/2015||Yes|No||04/17/2015||Yes|No|||Prescription required|No||068|Yes|.08991|03/29/2022|.08775|03/29/2022|.08833|03/29/2022|||ANTICOAGULANTS|17296|||||No|No||AMNEAL PHARMACE|No||||
warfarin sodium|No|No|No|No|75%|65162076210|WARFARIN SODIUM 2 MG TABLET|100|EA|.07138|04/17/2015||Yes|No||04/17/2015||Yes|No|04/17/2015||Yes|No||04/17/2015||Yes|No|||Prescription required|No||068|Yes|.09104|03/29/2022|.08885|03/29/2022|.08944|03/29/2022|||ANTICOAGULANTS|17297|||||No|No||AMNEAL PHARMACE|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|65162076211|WARFARIN SODIUM 2 MG TABLET|1000|EA|.07138|04/17/2015||Yes|No||04/17/2015||Yes|No|04/17/2015||Yes|No||04/17/2015||Yes|No|||Prescription required|No||068|Yes|.09104|03/29/2022|.08885|03/29/2022|.08944|03/29/2022|||ANTICOAGULANTS|17298|||||No|No||AMNEAL PHARMACE|No||||
warfarin sodium|No|No|No|No|75%|65162076310|WARFARIN SODIUM 2.5 MG TABLET|100|EA|.07254|04/17/2015||Yes|No||04/17/2015||Yes|No|04/17/2015||Yes|No||04/17/2015||Yes|No|||Prescription required|No||068|Yes|.09348|03/29/2022|.09123|03/29/2022|.09184|03/29/2022|||ANTICOAGULANTS|17299|||||No|No||AMNEAL PHARMACE|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|65162076311|WARFARIN SODIUM 2.5 MG TABLET|1000|EA|.07254|04/17/2015||Yes|No||04/17/2015||Yes|No|04/17/2015||Yes|No||04/17/2015||Yes|No|||Prescription required|No||068|Yes|.09348|03/29/2022|.09123|03/29/2022|.09184|03/29/2022|||ANTICOAGULANTS|17300|||||No|No||AMNEAL PHARMACE|No||||
warfarin sodium|No|No|No|No|75%|65162076410|WARFARIN SODIUM 3 MG TABLET|100|EA|.07267|04/17/2015||Yes|No||04/17/2015||Yes|No|04/17/2015||Yes|No||04/17/2015||Yes|No|||Prescription required|No||068|Yes|.09211|03/29/2022|.08989|03/29/2022|.09049|03/29/2022|||ANTICOAGULANTS|17301|||||No|No||AMNEAL PHARMACE|No||||
warfarin sodium|No|No|No|No|75%|65162076411|WARFARIN SODIUM 3 MG TABLET|1000|EA|.07267|04/17/2015||Yes|No||04/17/2015||Yes|No|04/17/2015||Yes|No||04/17/2015||Yes|No|||Prescription required|No||068|Yes|.09211|03/29/2022|.08989|03/29/2022|.09049|03/29/2022|||ANTICOAGULANTS|17302|||||No|No||AMNEAL PHARMACE|No||||
warfarin sodium|No|No|No|No|75%|65162076510|WARFARIN SODIUM 4 MG TABLET|100|EA|.07279|04/17/2015||Yes|No||04/17/2015||Yes|No|04/17/2015||Yes|No||04/17/2015||Yes|No|||Prescription required|No||068|Yes|.09432|03/29/2022|.09205|03/29/2022|.09266|03/29/2022|||ANTICOAGULANTS|17303|||||No|No||AMNEAL PHARMACE|No||||
warfarin sodium|No|No|No|No|75%|65162076511|WARFARIN SODIUM 4 MG TABLET|1000|EA|.07279|04/17/2015||Yes|No||04/17/2015||Yes|No|04/17/2015||Yes|No||04/17/2015||Yes|No|||Prescription required|No||068|Yes|.09432|03/29/2022|.09205|03/29/2022|.09266|03/29/2022|||ANTICOAGULANTS|17304|||||No|No||AMNEAL PHARMACE|No||||
warfarin sodium|No|No|No|No|75%|65162076610|WARFARIN SODIUM 5 MG TABLET|100|EA|.07301|04/17/2015||Yes|No||04/17/2015||Yes|No|04/17/2015||Yes|No||04/17/2015||Yes|No|||Prescription required|No||068|Yes|.10902|03/29/2022|.1064|03/29/2022|.10711|03/29/2022|||ANTICOAGULANTS|17305|||||No|No||AMNEAL PHARMACE|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|65162076611|WARFARIN SODIUM 5 MG TABLET|1000|EA|.07301|04/17/2015||Yes|No||04/17/2015||Yes|No|04/17/2015||Yes|No||04/17/2015||Yes|No|||Prescription required|No||068|Yes|.10902|03/29/2022|.1064|03/29/2022|.10711|03/29/2022|||ANTICOAGULANTS|17306|||||No|No||AMNEAL PHARMACE|No||||
warfarin sodium|No|No|No|No|75%|65162076710|WARFARIN SODIUM 6 MG TABLET|100|EA|.10427|04/17/2015||Yes|No||04/17/2015||Yes|No|04/17/2015||Yes|No||04/17/2015||Yes|No|||Prescription required|No||068|Yes|.13556|03/29/2022|.1323|03/29/2022|.13318|03/29/2022|||ANTICOAGULANTS|17307|||||No|No||AMNEAL PHARMACE|No||||
warfarin sodium|No|No|No|No|75%|65162076711|WARFARIN SODIUM 6 MG TABLET|1000|EA|.10427|04/17/2015||Yes|No||04/17/2015||Yes|No|04/17/2015||Yes|No||04/17/2015||Yes|No|||Prescription required|No||068|Yes|.13556|03/29/2022|.1323|03/29/2022|.13318|03/29/2022|||ANTICOAGULANTS|17308|||||No|No||AMNEAL PHARMACE|No||||
warfarin sodium|No|No|No|No|75%|65162076810|WARFARIN SODIUM 7.5 MG TABLET|100|EA|.10629|04/17/2015||Yes|No||04/17/2015||Yes|No|04/17/2015||Yes|No||04/17/2015||Yes|No|||Prescription required|No||068|Yes|.11896|03/29/2022|.1161|03/29/2022|.11687|03/29/2022|||ANTICOAGULANTS|17309|||||No|No||AMNEAL PHARMACE|No||||
warfarin sodium|No|No|No|No|75%|65162076811|WARFARIN SODIUM 7.5 MG TABLET|1000|EA|.10629|04/17/2015||Yes|No||04/17/2015||Yes|No|04/17/2015||Yes|No||04/17/2015||Yes|No|||Prescription required|No||068|Yes|.11896|03/29/2022|.1161|03/29/2022|.11687|03/29/2022|||ANTICOAGULANTS|17310|||||No|No||AMNEAL PHARMACE|No||||
warfarin sodium|No|No|No|No|75%|65162076910|WARFARIN SODIUM 10 MG TABLET|100|EA|.10857|04/17/2015||Yes|No||04/17/2015||Yes|No|04/17/2015||Yes|No||04/17/2015||Yes|No|||Prescription required|No||068|Yes|.12691|03/29/2022|.12386|03/29/2022|.12468|03/29/2022|||ANTICOAGULANTS|17311|||||No|No||AMNEAL PHARMACE|Yes|09/01/2020|||
warfarin sodium|No|No|No|No|75%|65162076911|WARFARIN SODIUM 10 MG TABLET|1000|EA|.10857|04/17/2015||Yes|No||04/17/2015||Yes|No|04/17/2015||Yes|No||04/17/2015||Yes|No|||Prescription required|No||068|Yes|.12691|03/29/2022|.12386|03/29/2022|.12468|03/29/2022|||ANTICOAGULANTS|17312|||||No|No||AMNEAL PHARMACE|No||||
linezolid|No|No|No|No|75%|65162077702|LINEZOLID 600 MG TABLET|20|EA|5.27696|07/22/2016|02/22/2022|Yes|No||07/22/2016|02/22/2022|Yes|No|07/22/2016|02/22/2022|Yes|No||||No|No|||Prescription required|No||146|No|12.02656|03/29/2022|11.85475|03/29/2022|11.29024|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|17313|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMNEAL PHARMACE|No||||
budesonide|No|No|No|No|75%|65162077810|BUDESONIDE EC 3 MG CAPSULE|100|EA|.95675|02/15/2018||Yes|No||02/15/2018||Yes|No|02/15/2018||Yes|No||||No|No|||Prescription required|No||168|Yes|.86544|03/29/2022|.84466|03/29/2022|.85029|03/29/2022|||GLUCOCORTICOIDS: ORAL|17314|||||No|No||AMNEAL PHARMACE|Yes|09/01/2020|||
memantine HCl|No|No|No|No|75%|65162078203|MEMANTINE HCL ER 7 MG CAPSULE|30|EA|.57261|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|011|No|.73424|03/29/2022|.71661|03/29/2022|.72139|03/29/2022|||ALZHEIMER'S AGENTS|17315|||||No|No||AMNEAL PHARMACE|No||||
memantine HCl|No|No|No|No|75%|65162078303|MEMANTINE HCL ER 14 MG CAPSULE|30|EA|.57261|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|011|No|.96952|03/29/2022|.94625|03/29/2022|.95255|03/29/2022|||ALZHEIMER'S AGENTS|17316|||||No|No||AMNEAL PHARMACE|No||||
memantine HCl|No|No|No|No|75%|65162078309|MEMANTINE HCL ER 14 MG CAPSULE|90|EA|.57261|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|011|No|.96952|03/29/2022|.94625|03/29/2022|.95255|03/29/2022|||ALZHEIMER'S AGENTS|17317|||||No|No||AMNEAL PHARMACE|No||||
memantine HCl|No|No|No|No|75%|65162078403|MEMANTINE HCL ER 21 MG CAPSULE|30|EA|.57261|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|011|No|.91098|03/29/2022|.88911|03/29/2022|.89503|03/29/2022|||ALZHEIMER'S AGENTS|17318|||||No|No||AMNEAL PHARMACE|No||||
memantine HCl|No|No|No|No|75%|65162078503|MEMANTINE HCL ER 28 MG CAPSULE|30|EA|.57261|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|011|No|1.08689|03/29/2022|1.0608|03/29/2022|1.06786|03/29/2022|||ALZHEIMER'S AGENTS|17319|||||No|No||AMNEAL PHARMACE|No||||
memantine HCl|No|No|No|No|75%|65162078509|MEMANTINE HCL ER 28 MG CAPSULE|90|EA|.57261|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|011|No|1.08689|03/29/2022|1.0608|03/29/2022|1.06786|03/29/2022|||ALZHEIMER'S AGENTS|17320|||||No|No||AMNEAL PHARMACE|No||||
lidocaine|No|No|No|No|75%|65162079108|LIDOCAINE 5% PATCH|30|EA|1.08016|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|232|No|2.00634|03/29/2022|1.95818|03/29/2022|1.97122|03/29/2022|||NEUROPATHIC PAIN|17321|||||No|No||AMNEAL PHARMACE|No||||
temozolomide|No|No|No|No|75%|65162080114|TEMOZOLOMIDE 5 MG CAPSULE|14|EA|1.14134|09/10/2015||Yes|No||09/10/2015||Yes|No|09/10/2015||Yes|No||||No|No|||Prescription required|No||239|No|2.60119|10/06/2020|2.56403|10/06/2020|2.44193|10/06/2020|||ONCOLOGY: ORAL - OTHER|17322|||||No|No||AMNEAL PHARMACE|No||||
temozolomide|No|No|No|No|75%|65162080151|TEMOZOLOMIDE 5 MG CAPSULE|5|EA|1.14122|09/10/2015||Yes|No||09/10/2015||Yes|No|09/10/2015||Yes|No||||No|No|||Prescription required|No||239|No|2.60092|10/06/2020|2.56376|10/06/2020|2.44168|10/06/2020|||ONCOLOGY: ORAL - OTHER|17323|||||No|No||AMNEAL PHARMACE|No||||
temozolomide|No|No|No|No|75%|65162080214|TEMOZOLOMIDE 20 MG CAPSULE|14|EA|2.6359|09/10/2015||Yes|No||09/10/2015||Yes|No|09/10/2015||Yes|No||||No|No|||Prescription required|No||239|No|6.0074|10/06/2020|5.92158|10/06/2020|5.6396|10/06/2020|||ONCOLOGY: ORAL - OTHER|17324|||||No|No||AMNEAL PHARMACE|No||||
temozolomide|No|No|No|No|75%|65162080251|TEMOZOLOMIDE 20 MG CAPSULE|5|EA|2.6359|09/10/2015||Yes|No||09/10/2015||Yes|No|09/10/2015||Yes|No||||No|No|||Prescription required|No||239|No|6.0074|10/06/2020|5.92158|10/06/2020|5.6396|10/06/2020|||ONCOLOGY: ORAL - OTHER|17325|||||No|No||AMNEAL PHARMACE|No||||
temozolomide|No|No|No|No|75%|65162080314|TEMOZOLOMIDE 100 MG CAPSULE|14|EA|14.85312|09/10/2015||Yes|No||09/10/2015||Yes|No|09/10/2015||Yes|No||||No|No|||Prescription required|No||239|No|33.85129|10/06/2020|33.3677|10/06/2020|31.77876|10/06/2020|||ONCOLOGY: ORAL - OTHER|17326|||||No|No||AMNEAL PHARMACE|No||||
temozolomide|No|No|No|No|75%|65162080351|TEMOZOLOMIDE 100 MG CAPSULE|5|EA|14.85306|09/10/2015||Yes|No||09/10/2015||Yes|No|09/10/2015||Yes|No||||No|No|||Prescription required|No||239|No|33.85116|10/06/2020|33.36757|10/06/2020|31.77864|10/06/2020|||ONCOLOGY: ORAL - OTHER|17327|||||No|No||AMNEAL PHARMACE|No||||
temozolomide|No|No|No|No|75%|65162080414|TEMOZOLOMIDE 140 MG CAPSULE|14|EA|21.04112|09/10/2015||Yes|No||09/10/2015||Yes|No|09/10/2015||Yes|No||||No|No|||Prescription required|No||239|No|13.83623|07/27/2021|13.50416|07/27/2021|13.59409|07/27/2021|||ONCOLOGY: ORAL - OTHER|17328|||||No|No||AMNEAL PHARMACE|No||||
temozolomide|No|No|No|No|75%|65162080451|TEMOZOLOMIDE 140 MG CAPSULE|5|EA|21.04076|09/10/2015||Yes|No||09/10/2015||Yes|No|09/10/2015||Yes|No||||No|No|||Prescription required|No||239|No|13.83623|07/27/2021|13.50416|07/27/2021|13.59409|07/27/2021|||ONCOLOGY: ORAL - OTHER|17329|||||No|No||AMNEAL PHARMACE|No||||
temozolomide|No|No|No|No|75%|65162080514|TEMOZOLOMIDE 180 MG CAPSULE|14|EA|27.9073|09/10/2015||Yes|No||09/10/2015||Yes|No|09/10/2015||Yes|No||||No|No|||Prescription required|No||239|No|63.60269|10/06/2020|62.69408|10/06/2020|59.70865|10/06/2020|||ONCOLOGY: ORAL - OTHER|17330|||||No|No||AMNEAL PHARMACE|No||||
temozolomide|No|No|No|No|75%|65162080551|TEMOZOLOMIDE 180 MG CAPSULE|5|EA|27.907|09/10/2015||Yes|No||09/10/2015||Yes|No|09/10/2015||Yes|No||||No|No|||Prescription required|No||239|No|63.602|10/06/2020|62.6934|10/06/2020|59.708|10/06/2020|||ONCOLOGY: ORAL - OTHER|17331|||||No|No||AMNEAL PHARMACE|No||||
temozolomide|No|No|No|No|75%|65162080651|TEMOZOLOMIDE 250 MG CAPSULE|5|EA|38.786|09/10/2015||Yes|No||09/10/2015||Yes|No|09/10/2015||Yes|No||||No|No|||Prescription required|No||239|No|88.396|10/06/2020|87.1332|10/06/2020|82.984|10/06/2020|||ONCOLOGY: ORAL - OTHER|17332|||||No|No||AMNEAL PHARMACE|No||||
progesterone, micronized|No|No|No|No|75%|65162080710|PROGESTERONE 100 MG CAPSULE|100|EA|.172|02/05/2018||Yes|No||02/05/2018||Yes|No|02/05/2018||Yes|No||||No|No|||Prescription required|No|||No|.25967|03/29/2022|.25343|03/29/2022|.25512|03/29/2022||||17333|||||No|No||AMNEAL PHARMACE|No||||
progesterone, micronized|No|No|No|No|75%|65162080810|PROGESTERONE 200 MG CAPSULE|100|EA|.344|02/05/2018||Yes|No||02/05/2018||Yes|No|02/05/2018||Yes|No||||No|No|||Prescription required|No|||No|.48257|03/29/2022|.47098|03/29/2022|.47412|03/29/2022||||17334|||||No|No||AMNEAL PHARMACE|No||||
rivastigmine|No|No|No|No|75%|65162082534|RIVASTIGMINE 4.6 MG/24HR PATCH|30|EA|1.82893|06/05/2019||Yes|No||06/05/2019||Yes|No|06/05/2019||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|011|No|2.88542|03/29/2022|2.81616|03/29/2022|2.83492|03/29/2022|||ALZHEIMER'S AGENTS|17335|||||No|No||AMNEAL PHARMACE|No||||
rivastigmine|No|No|No|No|75%|65162082634|RIVASTIGMINE 9.5 MG/24HR PATCH|30|EA|1.82893|06/05/2019||Yes|No||06/05/2019||Yes|No|06/05/2019||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|011|No|2.83898|03/29/2022|2.77084|03/29/2022|2.78929|03/29/2022|||ALZHEIMER'S AGENTS|17336|||||No|No||AMNEAL PHARMACE|No||||
diclofenac sodium|No|No|No|No|75%|65162083366|DICLOFENAC SODIUM 1% GEL|100|GM|.0645|08/15/2016||Yes|No||08/15/2016||Yes|No|08/15/2016||Yes|No||||No|No|||Prescription required|No||059|Yes|.08846|03/29/2022|.08633|03/29/2022|.08691|03/29/2022|||NSAIDS|17337|||||No|No||AMNEAL PHARMACE|No||||
acyclovir|No|No|No|No|75%|65162083594|ACYCLOVIR 5% OINTMENT|15|GM|.43|11/19/2015||Yes|No||11/19/2015||Yes|No|11/19/2015||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.36934|03/29/2022|1.33647|03/29/2022|1.34537|03/29/2022|||ANTIVIRALS: TOPICAL|17338|||||No|No||AMNEAL PHARMACE|No||||
acyclovir|No|No|No|No|75%|65162083596|ACYCLOVIR 5% OINTMENT|30|GM|.43|12/16/2014||Yes|No||12/16/2014||Yes|No|12/16/2014||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.03754|03/29/2022|1.01263|03/29/2022|1.01938|03/29/2022|||ANTIVIRALS: TOPICAL|17339|||||No|No||AMNEAL PHARMACE|No||||
acyclovir|No|No|No|No|75%|65162083614|ACYCLOVIR 5% CREAM|5|GM|28.23036|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|123|No|36.3578|03/29/2022|35.48521|03/29/2022|35.72153|03/29/2022|||ANTIVIRALS: TOPICAL|17340|||||No|No||AMNEAL PHARMACE|No||||
capecitabine|No|No|No|No|75%|65162084306|CAPECITABINE 150 MG TABLET|60|EA|.50166|10/13/2017||Yes|No||10/13/2017||Yes|No|10/13/2017||Yes|No||||No|No|||Prescription required|No||502|No|1.14332|11/19/2019|1.12699|11/19/2019|1.07332|11/19/2019|||ONCOLOGY: ORAL - BREAST|17341|||||No|No||AMNEAL PHARMACE|No||||
capecitabine|No|No|No|No|75%|65162084416|CAPECITABINE 500 MG TABLET|120|EA|.5375|10/13/2017||Yes|No||10/13/2017||Yes|No|10/13/2017||Yes|No||||No|No|||Prescription required|No||502|No|.61977|12/28/2021|.60489|12/28/2021|.60892|12/28/2021|||ONCOLOGY: ORAL - BREAST|17342|||||No|No||AMNEAL PHARMACE|No||||
bosentan|No|No|No|No|75%|65162087306|BOSENTAN 62.5 MG TABLET|60|EA|8.33598|09/18/2019|01/13/2022|Yes|No||09/18/2019|01/13/2022|Yes|No|09/18/2019|01/13/2022|Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/25/2019|171|No|18.99828|12/17/2019|18.72687|12/17/2019|17.83512|12/17/2019|||PAH AGENTS: ORAL AND INHALED|17343|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
bosentan|No|No|No|No|75%|65162087406|BOSENTAN 125 MG TABLET|60|EA|8.33598|09/18/2019|01/13/2022|Yes|No||09/18/2019|01/13/2022|Yes|No|09/18/2019|01/13/2022|Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/25/2019|171|No|18.99828|12/17/2019|18.72687|12/17/2019|17.83512|12/17/2019|||PAH AGENTS: ORAL AND INHALED|17344|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
olopatadine HCl|No|No|No|No|75%|65162089023|OLOPATADINE 665 MCG NASAL SPRY|30.5|GM|.70491|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|019|No|1.24713|03/29/2022|1.21719|03/29/2022|1.2253|03/29/2022|||INTRANASAL RHINITIS AGENTS|17345|||||No|No||AMNEAL PHARMACE|No||||
mometasone furoate|No|No|No|No|75%|65162089129|MOMETASONE FUROATE 50 MCG SPRY|17|GM|3.03529|10/13/2017||Yes|No||10/13/2017||Yes|No|10/13/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|019|No|2.16676|03/29/2022|2.11475|03/29/2022|2.12884|03/29/2022|||INTRANASAL RHINITIS AGENTS|17346|||||No|No||AMNEAL PHARMACE|No||||
aripiprazole|No|No|No|No|75%|65162089374|ARIPIPRAZOLE 1 MG/ML SOLUTION|150|ML|.71666|09/09/2015||Yes|No||09/09/2015||Yes|No|09/09/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|027|Yes|1.07614|03/29/2022|1.05031|03/29/2022|1.0573|03/29/2022|||ANTIPSYCHOTICS|17347|||||No|No||AMNEAL PHARMACE|No||||
aripiprazole|No|No|No|No|75%|65162089603|ARIPIPRAZOLE 2 MG TABLET|30|EA|.13172|03/02/2017||Yes|No||03/02/2017||Yes|No|03/02/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|17348|||||No|No||AMNEAL PHARMACE|No||||
aripiprazole|No|No|No|No|75%|65162089609|ARIPIPRAZOLE 2 MG TABLET|90|EA|.13172|03/02/2017||Yes|No||03/02/2017||Yes|No|03/02/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|17349|||||No|No||AMNEAL PHARMACE|No||||
aripiprazole|No|No|No|No|75%|65162089703|ARIPIPRAZOLE 5 MG TABLET|30|EA|.13172|03/02/2017||Yes|No||03/02/2017||Yes|No|03/02/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|17350|||||No|No||AMNEAL PHARMACE|No||||
aripiprazole|No|No|No|No|75%|65162089709|ARIPIPRAZOLE 5 MG TABLET|90|EA|.13172|03/02/2017||Yes|No||03/02/2017||Yes|No|03/02/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|17351|||||No|No||AMNEAL PHARMACE|No||||
aripiprazole|No|No|No|No|75%|65162089803|ARIPIPRAZOLE 10 MG TABLET|30|EA|.13172|03/02/2017||Yes|No||03/02/2017||Yes|No|03/02/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|17352|||||No|No||AMNEAL PHARMACE|No||||
aripiprazole|No|No|No|No|75%|65162089809|ARIPIPRAZOLE 10 MG TABLET|90|EA|.13172|03/02/2017||Yes|No||03/02/2017||Yes|No|03/02/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|17353|||||No|No||AMNEAL PHARMACE|No||||
aripiprazole|No|No|No|No|75%|65162089903|ARIPIPRAZOLE 15 MG TABLET|30|EA|.13172|03/02/2017||Yes|No||03/02/2017||Yes|No|03/02/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|17354|||||No|No||AMNEAL PHARMACE|No||||
aripiprazole|No|No|No|No|75%|65162089909|ARIPIPRAZOLE 15 MG TABLET|90|EA|.13172|03/02/2017||Yes|No||03/02/2017||Yes|No|03/02/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|17355|||||No|No||AMNEAL PHARMACE|No||||
aripiprazole|No|No|No|No|75%|65162090103|ARIPIPRAZOLE 20 MG TABLET|30|EA|.17357|03/02/2017||Yes|No||03/02/2017||Yes|No|03/02/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|17356|||||No|No||AMNEAL PHARMACE|No||||
aripiprazole|No|No|No|No|75%|65162090109|ARIPIPRAZOLE 20 MG TABLET|90|EA|.17357|03/02/2017||Yes|No||03/02/2017||Yes|No|03/02/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|17357|||||No|No||AMNEAL PHARMACE|No||||
aripiprazole|No|No|No|No|75%|65162090203|ARIPIPRAZOLE 30 MG TABLET|30|EA|.17357|03/02/2017||Yes|No||03/02/2017||Yes|No|03/02/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|17358|||||No|No||AMNEAL PHARMACE|No||||
aripiprazole|No|No|No|No|75%|65162090209|ARIPIPRAZOLE 30 MG TABLET|90|EA|.17357|03/02/2017||Yes|No||03/02/2017||Yes|No|03/02/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|17359|||||No|No||AMNEAL PHARMACE|No||||
diclofenac sodium|No|No|No|No|75%|65162091174|DICLOFENAC 1.5% TOPICAL SOLN|150|ML|.1075|04/11/2017||Yes|No||04/11/2017||Yes|No|04/11/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.10888|03/29/2022|.10626|03/29/2022|.10697|03/29/2022|||NSAIDS|17360|||||No|No||AMNEAL PHARMACE|No||||
voriconazole|No|No|No|No|75%|65162091322|VORICONAZOLE 40 MG/ML SUSP|75|ML|4.5983|10/17/2016||Yes|No||10/17/2016||Yes|No|10/17/2016||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|01/28/2016|069|No|10.47985|10/17/2016|10.33014|10/17/2016|9.83823|10/17/2016|||ANTIFUNGALS: ORAL|17361|||||No|No||AMNEAL PHARMACE|No||||
tobramycin in 0.225% sod chlor|No|No|No|No|75%|65162091446|TOBRAMYCIN 300 MG/5 ML AMPULE|5|ML|1.45892|09/10/2015||Yes|No||09/10/2015||Yes|No|09/10/2015||Yes|No|Submit HHS Form 1143|||No|No|||Prescription required|Yes|07/29/2021|240|No|3.76543|05/25/2021|3.67505|05/25/2021|3.69953|05/25/2021|||ANTIBIOTICS: INHALED|17362|||||No|No||AMNEAL PHARMACE|No||||
lidocaine|No|No|No|No|75%|65162091838|LIDOCAINE 5% OINTMENT|35.44|GM|.13649|11/02/2015||Yes|No||11/02/2015||Yes|No|11/02/2015||Yes|No||||No|No|||Prescription required|No|||No|.18796|03/29/2022|.18344|03/29/2022|.18467|03/29/2022||||17363|||||No|No||AMNEAL PHARMACE|No||||
lidocaine|No|No|No|No|75%|65162091853|LIDOCAINE 5% OINTMENT|50|GM|.1763|11/02/2015||Yes|No||11/02/2015||Yes|No|11/02/2015||Yes|No||||No|No|||Prescription required|No|||No|.22969|03/29/2022|.22417|03/29/2022|.22567|03/29/2022||||17364|||||No|No||AMNEAL PHARMACE|No||||
lamotrigine|No|No|No|No|75%|65162094903|LAMOTRIGINE ER 25 MG TABLET|30|EA|.4085|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No||056|No|1.20872|03/01/2022|1.17971|03/01/2022|1.18756|03/01/2022|||ANTICONVULSANTS|17365|||||No|No||AMNEAL PHARMACE|No||||
lamotrigine|No|No|No|No|75%|65162095603|LAMOTRIGINE ER 50 MG TABLET|30|EA|.6536|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No||056|No|1.67529|03/29/2022|1.63508|03/29/2022|1.64597|03/29/2022|||ANTICONVULSANTS|17366|||||No|No||AMNEAL PHARMACE|No||||
lamotrigine|No|No|No|No|75%|65162095803|LAMOTRIGINE ER 100 MG TABLET|30|EA|.78833|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No||056|No|1.51472|03/29/2022|1.47836|03/29/2022|1.48821|03/29/2022|||ANTICONVULSANTS|17367|||||No|No||AMNEAL PHARMACE|No||||
lamotrigine|No|No|No|No|75%|65162098603|LAMOTRIGINE ER 200 MG TABLET|30|EA|.84265|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No||056|No|1.69753|03/29/2022|1.65678|03/29/2022|1.66782|03/29/2022|||ANTICONVULSANTS|17368|||||No|No||AMNEAL PHARMACE|No||||
lamotrigine|No|No|No|No|75%|65162098803|LAMOTRIGINE ER 250 MG TABLET|30|EA|2.68793|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No||056|No|5.54243|03/29/2022|5.40941|03/29/2022|5.44543|03/29/2022|||ANTICONVULSANTS|17369|||||No|No||AMNEAL PHARMACE|No||||
estradiol|No|No|No|No|75%|65162098908|DOTTI 0.025 MG PATCH|8|EA|3.89687|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|No|||Yes|9.33155|03/29/2022|9.10759|03/29/2022|9.16824|03/29/2022||||17370|||||No|No||AMNEAL PHARMACE|No||||
lamotrigine|No|No|No|No|75%|65162099003|LAMOTRIGINE ER 300 MG TABLET|30|EA|5.35995|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No||056|No|4.96792|03/29/2022|4.84868|03/29/2022|4.88098|03/29/2022|||ANTICONVULSANTS|17371|||||No|No||AMNEAL PHARMACE|No||||
estradiol|No|No|No|No|75%|65162099208|DOTTI 0.0375 MG PATCH|8|EA|3.89687|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|No|||Yes|10.33407|03/29/2022|10.08605|03/29/2022|10.15322|03/29/2022||||17372|||||No|No||AMNEAL PHARMACE|No||||
estradiol|No|No|No|No|75%|65162099308|DOTTI 0.05 MG PATCH|8|EA|3.89956|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|No|||Yes|9.27983|03/29/2022|9.05711|03/29/2022|9.11743|03/29/2022||||17373|||||No|No||AMNEAL PHARMACE|No||||
estradiol|No|No|No|No|75%|65162099508|DOTTI 0.075 MG PATCH|8|EA|3.90386|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|No|||Yes|8.4725|03/29/2022|8.26916|03/29/2022|8.32423|03/29/2022||||17374|||||No|No||AMNEAL PHARMACE|No||||
estradiol|No|No|No|No|75%|65162099708|DOTTI 0.1 MG PATCH|8|EA|3.90547|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|No|||Yes|8.48083|03/29/2022|8.27729|03/29/2022|8.33241|03/29/2022||||17375|||||No|No||AMNEAL PHARMACE|No||||
olmesartan medoxomil|No|No|No|No|75%|65597010130|BENICAR 5 MG TABLET|30|EA|2.8337|05/10/2002||Yes|No||05/10/2002||Yes|No|05/10/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|113|Yes|6.4582|01/25/2022|6.36594|01/25/2022|6.0628|01/25/2022|||ANGIOTENSIN MODULATORS|17376|||||No|No||DAIICHI SANKYO,|No||||
olmesartan medoxomil|No|No|No|No|75%|65597010330|BENICAR 20 MG TABLET|30|EA|3.4615|05/10/2002||Yes|No||05/10/2002||Yes|No|05/10/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|113|Yes|7.73533|03/01/2022|7.54968|03/01/2022|7.59996|03/01/2022|||ANGIOTENSIN MODULATORS|17377|||||No|No||DAIICHI SANKYO,|No||||
olmesartan medoxomil|No|No|No|No|75%|65597010430|BENICAR 40 MG TABLET|30|EA|4.8117|05/10/2002||Yes|No||05/10/2002||Yes|No|05/10/2002||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|113|Yes|10.66575|10/26/2021|10.40977|10/26/2021|10.47909|10/26/2021|||ANGIOTENSIN MODULATORS|17378|||||No|No||DAIICHI SANKYO,|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|65597010530|BENICAR HCT 20-12.5 MG TABLET|30|EA|3.4615|08/14/2003||Yes|No||08/14/2003||Yes|No|08/14/2003||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|113|Yes|7.889|01/25/2022|7.7763|01/25/2022|7.406|01/25/2022|||ANGIOTENSIN MODULATORS|17379|||||No|No||DAIICHI SANKYO,|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|65597010630|BENICAR HCT 40-12.5 MG TABLET|30|EA|4.8117|08/14/2003||Yes|No||08/14/2003||Yes|No|08/14/2003||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|113|Yes|10.9662|01/25/2022|10.80954|01/25/2022|10.2948|01/25/2022|||ANGIOTENSIN MODULATORS|17380|||||No|No||DAIICHI SANKYO,|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|65597010730|BENICAR HCT 40-25 MG TABLET|30|EA|4.8117|08/14/2003||Yes|No||08/14/2003||Yes|No|08/14/2003||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|113|Yes|10.63813|10/26/2021|10.38281|10/26/2021|10.45196|10/26/2021|||ANGIOTENSIN MODULATORS|17381|||||No|No||DAIICHI SANKYO,|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|65597011030|AZOR 5-20 MG TABLET|30|EA|4.3172|11/19/2007||Yes|No||11/19/2007||Yes|No|11/19/2007||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|017|Yes|9.8392|01/25/2022|9.69864|01/25/2022|9.2368|01/25/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17382|||||No|No||DAIICHI SANKYO,|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|65597011130|AZOR 10-20 MG TABLET|30|EA|4.3172|11/19/2007||Yes|No||11/19/2007||Yes|No|11/19/2007||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|017|Yes|9.8392|01/12/2021|9.69864|01/12/2021|9.2368|01/12/2021|||ANGIOTENSIN MODULATOR COMBINATIONS|17383|||||No|No||DAIICHI SANKYO,|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|65597011230|AZOR 5-40 MG TABLET|30|EA|5.4481|11/19/2007||Yes|No||11/19/2007||Yes|No|11/19/2007||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|017|Yes|12.4166|01/25/2022|12.23922|01/25/2022|11.6564|01/25/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17384|||||No|No||DAIICHI SANKYO,|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|65597011330|AZOR 10-40 MG TABLET|30|EA|5.4481|11/19/2007||Yes|No||11/19/2007||Yes|No|11/19/2007||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|017|Yes|12.4166|01/25/2022|12.23922|01/25/2022|11.6564|01/25/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17385|||||No|No||DAIICHI SANKYO,|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|65597011430|TRIBENZOR 20-5-12.5 MG TABLET|30|EA|4.3172|09/15/2010||Yes|No||09/15/2010||Yes|No|09/15/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|017|Yes|9.8392|01/12/2021|9.69864|01/12/2021|9.2368|01/12/2021|||ANGIOTENSIN MODULATOR COMBINATIONS|17386|||||No|No||DAIICHI SANKYO,|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|65597011530|TRIBENZOR 40-5-12.5 MG TABLET|30|EA|5.4481|09/15/2010||Yes|No||09/15/2010||Yes|No|09/15/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|017|Yes|12.4166|01/12/2021|12.23922|01/12/2021|11.6564|01/12/2021|||ANGIOTENSIN MODULATOR COMBINATIONS|17387|||||No|No||DAIICHI SANKYO,|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|65597011630|TRIBENZOR 40-5-25 MG TABLET|30|EA|5.4481|09/15/2010||Yes|No||09/15/2010||Yes|No|09/15/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|017|Yes|12.4166|01/12/2021|12.23922|01/12/2021|11.6564|01/12/2021|||ANGIOTENSIN MODULATOR COMBINATIONS|17388|||||No|No||DAIICHI SANKYO,|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|65597011730|TRIBENZOR 40-10-12.5 MG TABLET|30|EA|5.4481|09/15/2010||Yes|No||09/15/2010||Yes|No|09/15/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|017|Yes|12.4166|01/12/2021|12.23922|01/12/2021|11.6564|01/12/2021|||ANGIOTENSIN MODULATOR COMBINATIONS|17389|||||No|No||DAIICHI SANKYO,|No||||
olmesartan/amlodipin/hcthiazid|No|No|No|No|75%|65597011830|TRIBENZOR 40-10-25 MG TABLET|30|EA|5.4481|09/15/2010||Yes|No||09/15/2010||Yes|No|09/15/2010||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|017|Yes|12.4166|01/25/2022|12.23922|01/25/2022|11.6564|01/25/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17390|||||No|No||DAIICHI SANKYO,|No||||
edoxaban tosylate|No|No|No|No|75%|65597020130|SAVAYSA 15 MG TABLET|30|EA|5.5771|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|068|Yes|12.7106|01/14/2020|12.52902|01/14/2020|11.9324|01/14/2020|||ANTICOAGULANTS|17391|||||No|No||DAIICHI SANKYO,|No||||
edoxaban tosylate|No|No|No|No|75%|65597020230|SAVAYSA 30 MG TABLET|30|EA|5.5771|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|068|Yes|12.7106|03/01/2022|12.52902|03/01/2022|11.9324|03/01/2022|||ANTICOAGULANTS|17392|||||No|No||DAIICHI SANKYO,|No||||
edoxaban tosylate|No|No|No|No|75%|65597020290|SAVAYSA 30 MG TABLET|90|EA|5.5771|05/12/2015|05/31/2022|Yes|No||05/12/2015|05/31/2022|Yes|No|05/12/2015|05/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/23/2015|068|Yes|12.7106|03/01/2022|12.52902|03/01/2022|11.9324|03/01/2022|||ANTICOAGULANTS|17393|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||DAIICHI SANKYO,|No||||
edoxaban tosylate|No|No|No|No|75%|65597020330|SAVAYSA 60 MG TABLET|30|EA|5.5771|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|068|Yes|12.46484|07/27/2021|12.16568|07/27/2021|12.2467|07/27/2021|||ANTICOAGULANTS|17394|||||No|No||DAIICHI SANKYO,|No||||
colesevelam HCl|No|No|No|No|75%|65597070118|WELCHOL 625 MG TABLET|180|EA|1.5996|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|02/23/2004|055|No|3.58682|11/23/2021|3.50073|11/23/2021|3.52405|11/23/2021|||LIPOTROPICS: OTHER|17395|||||No|No||DAIICHI SANKYO,|No||||
colesevelam HCl|No|No|No|No|75%|65597090230|WELCHOL 3.75G PACKET|30|EA|9.5976|01/19/2010||Yes|No||01/19/2010||Yes|No|01/19/2010||Yes|No||||No|No|||Prescription required|Yes|07/22/2009|055|No|21.50307|04/27/2021|20.98699|04/27/2021|21.12676|04/27/2021|||LIPOTROPICS: OTHER|17396|||||No|No||DAIICHI SANKYO,|No||||
vancomycin HCl|No|No|No|No|75%|65628020405|FIRVANQ 25 MG/ML SOLUTION|150|ML|.3079|10/31/2018||Yes|No||10/31/2018||Yes|No|10/31/2018||Yes|No||10/01/2019||Yes|No|||Prescription required|No||115|No|.70173|07/06/2021|.69171|07/06/2021|.65877|07/06/2021|||ANTIBIOTICS: GI|17397|||||No|No||AZURITY PHARMAC|No||||
vancomycin HCl|No|No|No|No|75%|65628020510|FIRVANQ 25 MG/ML SOLUTION|300|ML|.208|10/31/2018||Yes|No||10/31/2018||Yes|No|10/31/2018||Yes|No||10/01/2019||Yes|No|||Prescription required|No||115|No|.4709|07/06/2021|.45959|07/06/2021|.46265|07/06/2021|||ANTIBIOTICS: GI|17398|||||No|No||AZURITY PHARMAC|No||||
vancomycin HCl|No|No|No|No|75%|65628020605|FIRVANQ 50 MG/ML SOLUTION|150|ML|.40778|10/31/2018||Yes|No||10/31/2018||Yes|No|10/31/2018||Yes|No||10/01/2019||Yes|No|||Prescription required|No||115|No|.89657|03/01/2022|.87505|03/01/2022|.88088|03/01/2022|||ANTIBIOTICS: GI|17399|||||No|No||AZURITY PHARMAC|No||||
vancomycin HCl|No|No|No|No|75%|65628020810|FIRVANQ 50 MG/ML SOLUTION|300|ML|.32469|10/31/2018||Yes|No||10/31/2018||Yes|No|10/31/2018||Yes|No||10/01/2019||Yes|No|||Prescription required|No||115|No|.73999|07/06/2021|.72942|07/06/2021|.69469|07/06/2021|||ANTIBIOTICS: GI|17400|||||No|No||AZURITY PHARMAC|No||||
plecanatide|No|No|No|No|75%|65649000330|TRULANCE 3 MG TABLET|30|EA|7.28391|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|534|Yes|16.27124|01/18/2022|15.88073|01/18/2022|15.98649|01/18/2022|||GI MOTILITY: CHRONIC|17401|||||No|No||SALIX PHARMACEU|No||||
balsalazide disodium|No|No|No|No|75%|65649010102|COLAZAL 750 MG CAPSULE|280|EA|2.58683|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|010|No|5.89557|01/11/2022|5.81134|01/11/2022|5.53461|01/11/2022|||ULCERATIVE COLITIS AGENTS|17402|||||No|No||SALIX PHARMACEU|No||||
mesalamine|No|No|No|No|75%|65649010302|APRISO ER 0.375 GRAM CAPSULE|120|EA|1.8286|01/11/2010||Yes|No||01/11/2010||Yes|No|01/11/2010||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|010|No|4.08282|06/29/2021|3.98483|06/29/2021|4.01137|06/29/2021|||ULCERATIVE COLITIS AGENTS|17403|||||No|No||SALIX PHARMACEU|No||||
methylnaltrexone bromide|No|No|No|No|75%|65649015090|RELISTOR 150 MG TABLET|90|EA|10.40193|06/26/2017||Yes|No||06/26/2017||Yes|No|06/26/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|534|Yes|23.16775|01/18/2022|22.61172|01/18/2022|22.76231|01/18/2022|||GI MOTILITY: CHRONIC|17404|||||No|No||SALIX PHARMACEU|No||||
peg3350/sod sul/NaCl/KCl/asb/C|No|No|No|No|75%|65649020175|MOVIPREP POWDER PACKET|1|EA|54.1284|10/11/2011||Yes|No||10/11/2011||Yes|No|10/11/2011||Yes|No||||No|No|||Prescription required|No|||No|121.11593|01/18/2022|118.20914|01/18/2022|118.9964|01/18/2022||||17405|||||No|No||SALIX PHARMACEU|No||||
rifaximin|No|No|No|No|75%|65649030103|XIFAXAN 200 MG TABLET|30|EA|4.14706|01/07/2008||Yes|No||01/07/2008||Yes|No|01/07/2008||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|115|Yes|9.20629|01/18/2022|8.98533|01/18/2022|9.04517|01/18/2022|||ANTIBIOTICS: GI|17406|||||No|No||SALIX PHARMACEU|No||||
rifaximin|No|No|No|No|75%|65649030302|XIFAXAN 550 MG TABLET|60|EA|21.32312|05/25/2010||Yes|No||05/25/2010||Yes|No|05/25/2010||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|115|Yes|47.67993|01/18/2022|46.53561|01/18/2022|46.84553|01/18/2022|||ANTIBIOTICS: GI|17407|||||No|No||SALIX PHARMACEU|No||||
chlorothiazide|No|No|No|No|75%|65649031112|DIURIL 250 MG/5 ML ORAL SUSP|237|ML|.12507|01/10/2008||Yes|No||01/10/2008||Yes|No|01/10/2008||Yes|No||||No|No|||Prescription required|No|||Yes|.28013|12/28/2021|.2734|12/28/2021|.27522|12/28/2021||||17408|||||No|No||SALIX PHARMACEU|No||||
peg3350/sod sul/NaCl/KCl/asb/C|No|No|No|No|75%|65649040001|PLENVU POWDER PACKETS|3|EA|18.7781|12/12/2018||Yes|No||12/12/2018||Yes|No|12/12/2018||Yes|No||||No|No|||Prescription required|No|||No|41.73938|01/18/2022|40.73763|01/18/2022|41.00894|01/18/2022||||17409|||||No|No||SALIX PHARMACEU|No||||
hydrocortisone|No|No|No|No|75%|65649040130|ANUSOL-HC 2.5% CREAM|30|GM|2.35812|05/31/2005||Yes|No||05/31/2005||Yes|No|||No|No||||No|No|||Prescription required|No||118|No|5.37432|01/11/2022|5.29754|01/11/2022|5.04528|01/11/2022|||STEROIDS: TOPICAL LOW|17410|||||No|No||SALIX PHARMACEU|No||||
methylnaltrexone bromide|No|No|No|No|75%|65649055103|RELISTOR 12 MG/0.6 ML SYRINGE|.6|ML|104.017|01/29/2013||Yes|No||01/29/2013||Yes|No|01/29/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|534|Yes|232.19898|01/18/2022|226.6262|01/18/2022|228.13549|01/18/2022|||GI MOTILITY: CHRONIC|17411|||||No|No||SALIX PHARMACEU|No||||
methylnaltrexone bromide|No|No|No|No|75%|65649055204|RELISTOR 8 MG/0.4 ML SYRINGE|.4|ML|156.0255|01/28/2013||Yes|No||01/28/2013||Yes|No|01/28/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|534|Yes|355.593|01/11/2022|350.5131|01/11/2022|333.822|01/11/2022|||GI MOTILITY: CHRONIC|17412|||||No|No||SALIX PHARMACEU|No||||
budesonide|No|No|No|No|75%|65649065103|UCERIS 2 MG RECTAL FOAM|33.4|GM|4.89736|04/08/2020||Yes|No||04/08/2020||Yes|No|04/08/2020||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|010|No|10.92432|01/18/2022|10.66213|01/18/2022|10.73314|01/18/2022|||ULCERATIVE COLITIS AGENTS|17413|||||No|No||SALIX PHARMACEU|No||||
sod phosphate mbas/sod phos,di|No|No|No|No|75%|65649070141|OSMOPREP TABLET|100|EA|3.58108|10/11/2011||Yes|No||10/11/2011||Yes|No|10/11/2011||Yes|No||||No|No|||Prescription required|No|||No|8.01635|01/18/2022|7.82395|01/18/2022|7.87606|01/18/2022||||17414|||||No|No||SALIX PHARMACEU|No||||
naltrexone microspheres|No|No|No|No|75%|65757030001|VIVITROL 380 MG VIAL-DILUENT|1|EA|608.5747|03/27/2015||Yes|No||03/27/2015||Yes|No|03/27/2015||Yes|No||||No|No|||Prescription required|No||145|No|1364.949|03/01/2022|1332.19022|03/01/2022|1341.06239|03/01/2022|||OPIATE DEPENDENCE TREATMENTS|17415|||||No|Yes|12.56|ALKERMES INC|Yes|09/01/2020|||
naltrexone microspheres|No|No|No|No|75%|65757030202|VIVITROL 380 MG VIAL|1|ML|596.6422|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|1364.949|03/01/2022|1332.19022|03/01/2022|1341.06239|03/01/2022|||OPIATE DEPENDENCE TREATMENTS|17416|||||No|No||ALKERMES INC|Yes|09/01/2020|||
aripiprazole lauroxil|No|No|No|No|75%|65757040103|ARISTADA ER 441 MG/1.6 ML SYRN|1.6|ML|379.89962|10/14/2015||Yes|No||10/14/2015||Yes|No|10/14/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|845.79875|12/21/2021|825.49958|12/21/2021|830.99727|12/21/2021|||ANTIPSYCHOTICS|17417|||||No|Yes|12.56|ALKERMES INC|No||||
aripiprazole lauroxil|No|No|No|No|75%|65757040203|ARISTADA ER 662 MG/2.4 ML SYRN|2.4|ML|380.18808|10/14/2015||Yes|No||10/14/2015||Yes|No|10/14/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|845.42229|12/21/2021|825.13215|12/21/2021|830.62739|12/21/2021|||ANTIPSYCHOTICS|17418|||||No|Yes|12.56|ALKERMES INC|No||||
aripiprazole lauroxil|No|No|No|No|75%|65757040303|ARISTADA ER 882 MG/3.2 ML SYRN|3.2|ML|379.89962|10/14/2015||Yes|No||10/14/2015||Yes|No|10/14/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|845.65313|03/01/2022|825.35745|03/01/2022|830.8542|03/01/2022|||ANTIPSYCHOTICS|17419|||||No|Yes|12.56|ALKERMES INC|No||||
aripiprazole lauroxil|No|No|No|No|75%|65757040403|ARISTADA ER 1064 MG/3.9 ML SYR|3.9|ML|376.035|07/17/2017||Yes|No||07/17/2017||Yes|No|07/17/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|834.97106|03/01/2022|814.93175|03/01/2022|820.35906|03/01/2022|||ANTIPSYCHOTICS|17420|||||No|Yes|12.56|ALKERMES INC|No||||
aripiprazole lauroxil,submicr.|No|No|No|No|75%|65757050003|ARISTADA INITIO ER 675 MG/2.4|2.4|ML|387.65395|09/18/2018||Yes|No||09/18/2018||Yes|No|09/18/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|883.49041|04/13/2021|870.86912|04/13/2021|829.39916|04/13/2021|||ANTIPSYCHOTICS|17421|||||No|Yes|12.56|ALKERMES INC|No||||
olanzapine/samidorphan malate|No|No|No|No|75%|65757065142|LYBALVI 5-10 MG TABLET|30|EA|19.92333|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||No|45.40666|02/23/2022|44.75799|02/23/2022|42.62666|02/23/2022||||17422|||||No|No||ALKERMES INC|No||||
olanzapine/samidorphan malate|No|No|No|No|75%|65757065144|LYBALVI 5-10 MG TABLET|90|EA|19.92333|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||No|45.40666|02/23/2022|44.75799|02/23/2022|42.62666|02/23/2022||||17423|||||No|No||ALKERMES INC|No||||
olanzapine/samidorphan malate|No|No|No|No|75%|65757065242|LYBALVI 10-10 MG TABLET|30|EA|19.92333|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||No|44.3874|03/29/2022|43.3221|03/29/2022|43.61062|03/29/2022||||17424|||||No|No||ALKERMES INC|No||||
olanzapine/samidorphan malate|No|No|No|No|75%|65757065244|LYBALVI 10-10 MG TABLET|90|EA|19.92333|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||No|44.3874|03/29/2022|43.3221|03/29/2022|43.61062|03/29/2022||||17425|||||No|No||ALKERMES INC|No||||
olanzapine/samidorphan malate|No|No|No|No|75%|65757065342|LYBALVI 15-10 MG TABLET|30|EA|19.92333|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||No|45.40666|02/23/2022|44.75799|02/23/2022|42.62666|02/23/2022||||17426|||||No|No||ALKERMES INC|No||||
olanzapine/samidorphan malate|No|No|No|No|75%|65757065344|LYBALVI 15-10 MG TABLET|90|EA|19.92333|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||No|45.40666|02/23/2022|44.75799|02/23/2022|42.62666|02/23/2022||||17427|||||No|No||ALKERMES INC|No||||
olanzapine/samidorphan malate|No|No|No|No|75%|65757065442|LYBALVI 20-10 MG TABLET|30|EA|19.92333|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||No|45.40666|02/23/2022|44.75799|02/23/2022|42.62666|02/23/2022||||17428|||||No|No||ALKERMES INC|No||||
olanzapine/samidorphan malate|No|No|No|No|75%|65757065444|LYBALVI 20-10 MG TABLET|90|EA|19.92333|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||No|45.40666|02/23/2022|44.75799|02/23/2022|42.62666|02/23/2022||||17429|||||No|No||ALKERMES INC|No||||
mirtazapine|No|No|No|No|75%|65862000330|MIRTAZAPINE 30 MG TABLET|30|EA|.16125|03/02/2005||Yes|No||03/02/2005||Yes|No|03/02/2005||Yes|No||||No|No|||Prescription required|No||031|No|.09806|03/29/2022|.0957|03/29/2022|.09634|03/29/2022|||ANTIDEPRESSANTS: OTHER|17430|||||No|No||AUROBINDO PHARM|No||||
citalopram hydrobromide|Yes|No|No|No|75%|65862000501|CITALOPRAM HBR 10 MG TABLET|100|EA|.04798|03/02/2005||Yes|No||03/02/2005||Yes|No|03/02/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02682|03/29/2022|.02617|03/29/2022|.02635|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17431|||||No|No||AUROBINDO PHARM|No||||
citalopram hydrobromide|Yes|No|No|No|75%|65862000505|CITALOPRAM HBR 10 MG TABLET|500|EA|.04558|03/02/2005||Yes|No||03/02/2005||Yes|No|03/02/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02682|03/29/2022|.02617|03/29/2022|.02635|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17432|||||No|No||AUROBINDO PHARM|No||||
citalopram hydrobromide|Yes|No|No|No|75%|65862000601|CITALOPRAM HBR 20 MG TABLET|100|EA|.04945|03/02/2005||Yes|No||03/02/2005||Yes|No|03/02/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02946|03/29/2022|.02875|03/29/2022|.02894|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17433|||||No|No||AUROBINDO PHARM|No||||
citalopram hydrobromide|Yes|No|No|No|75%|65862000605|CITALOPRAM HBR 20 MG TABLET|500|EA|.04698|03/02/2005||Yes|No||03/02/2005||Yes|No|03/02/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.02946|03/29/2022|.02875|03/29/2022|.02894|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17434|||||No|No||AUROBINDO PHARM|No||||
citalopram hydrobromide|Yes|No|No|No|75%|65862000701|CITALOPRAM HBR 40 MG TABLET|100|EA|.05035|03/02/2005||Yes|No||03/02/2005||Yes|No|03/02/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03726|03/29/2022|.03636|03/29/2022|.0366|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17435|||||No|No||AUROBINDO PHARM|No||||
citalopram hydrobromide|Yes|No|No|No|75%|65862000705|CITALOPRAM HBR 40 MG TABLET|500|EA|.04783|03/02/2005||Yes|No||03/02/2005||Yes|No|03/02/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03726|03/29/2022|.03636|03/29/2022|.0366|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17436|||||No|No||AUROBINDO PHARM|No||||
metformin HCl|Yes|No|No|No|75%|65862000801|METFORMIN HCL 500 MG TABLET|100|EA|.03225|03/15/2005||Yes|No||03/15/2005||Yes|No|03/15/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|17437|||||No|No||AUROBINDO PHARM|No||||
metformin HCl|Yes|No|No|No|75%|65862000805|METFORMIN HCL 500 MG TABLET|500|EA|.03061|03/15/2005||Yes|No||03/15/2005||Yes|No|03/15/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|17438|||||No|No||AUROBINDO PHARM|No||||
metformin HCl|Yes|No|No|No|75%|65862000899|METFORMIN HCL 500 MG TABLET|1000|EA|.02449|05/19/2011||Yes|No||05/19/2011||Yes|No|05/19/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|17439|||||No|No||AUROBINDO PHARM|No||||
metformin HCl|Yes|No|No|No|75%|65862000901|METFORMIN HCL 850 MG TABLET|100|EA|.05052|03/15/2005||Yes|No||03/15/2005||Yes|No|03/15/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|17440|||||No|No||AUROBINDO PHARM|No||||
metformin HCl|Yes|No|No|No|75%|65862000905|METFORMIN HCL 850 MG TABLET|500|EA|.04798|03/15/2005||Yes|No||03/15/2005||Yes|No|03/15/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|17441|||||No|No||AUROBINDO PHARM|No||||
metformin HCl|Yes|No|No|No|75%|65862001001|METFORMIN HCL 1,000 MG TABLET|100|EA|.05611|03/15/2005||Yes|No||03/15/2005||Yes|No|03/15/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|17442|||||No|No||AUROBINDO PHARM|No||||
metformin HCl|Yes|No|No|No|75%|65862001005|METFORMIN HCL 1,000 MG TABLET|500|EA|.05332|03/15/2005||Yes|No||03/15/2005||Yes|No|03/15/2005||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|17443|||||No|No||AUROBINDO PHARM|No||||
metformin HCl|Yes|No|No|No|75%|65862001099|METFORMIN HCL 1,000 MG TABLET|1000|EA|.04265|05/19/2011||Yes|No||05/19/2011||Yes|No|05/19/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|17444|||||No|No||AUROBINDO PHARM|No||||
sertraline HCl|No|No|No|No|75%|65862001101|SERTRALINE HCL 25 MG TABLET|100|EA|.03676|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No||008|Yes|.05057|03/29/2022|.04935|03/29/2022|.04968|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17445|||||No|No||AUROBINDO PHARM|No||||
sertraline HCl|Yes|No|No|No|75%|65862001105|SERTRALINE HCL 25 MG TABLET|500|EA|.03676|02/08/2007||Yes|No||02/08/2007||Yes|No|02/08/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.05057|03/29/2022|.04935|03/29/2022|.04968|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17446|||||No|No||AUROBINDO PHARM|No||||
sertraline HCl|Yes|No|No|No|75%|65862001130|SERTRALINE HCL 25 MG TABLET|30|EA|.04085|02/08/2007||Yes|No||02/08/2007||Yes|No|02/08/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.05057|03/29/2022|.04935|03/29/2022|.04968|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17447|||||No|No||AUROBINDO PHARM|No||||
sertraline HCl|No|No|No|No|75%|65862001201|SERTRALINE HCL 50 MG TABLET|100|EA|.03676|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No||008|Yes|.04281|03/29/2022|.04178|03/29/2022|.04206|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17448|||||No|No||AUROBINDO PHARM|No||||
sertraline HCl|Yes|No|No|No|75%|65862001205|SERTRALINE HCL 50 MG TABLET|500|EA|.03676|02/08/2007||Yes|No||02/08/2007||Yes|No|02/08/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.04281|03/29/2022|.04178|03/29/2022|.04206|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17449|||||No|No||AUROBINDO PHARM|No||||
sertraline HCl|Yes|No|No|No|75%|65862001230|SERTRALINE HCL 50 MG TABLET|30|EA|.04085|02/08/2007||Yes|No||02/08/2007||Yes|No|02/08/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.04281|03/29/2022|.04178|03/29/2022|.04206|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17450|||||No|No||AUROBINDO PHARM|No||||
sertraline HCl|No|No|No|No|75%|65862001301|SERTRALINE HCL 100 MG TABLET|100|EA|.03676|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17451|||||No|No||AUROBINDO PHARM|No||||
sertraline HCl|Yes|No|No|No|75%|65862001305|SERTRALINE HCL 100 MG TABLET|500|EA|.03676|02/08/2007||Yes|No||02/08/2007||Yes|No|02/08/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17452|||||No|No||AUROBINDO PHARM|No||||
sertraline HCl|Yes|No|No|No|75%|65862001330|SERTRALINE HCL 100 MG TABLET|30|EA|.04085|02/08/2007||Yes|No||02/08/2007||Yes|No|02/08/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17453|||||No|No||AUROBINDO PHARM|No||||
amoxicillin|No|No|No|No|75%|65862001401|AMOXICILLIN 500 MG TABLET|100|EA|.15028|12/08/2006||Yes|No||12/08/2006||Yes|No|12/08/2006||Yes|No||04/01/2015||Yes|No|||Prescription required|No||209|No|.12149|03/29/2022|.11857|03/29/2022|.11936|03/29/2022|||PENICILLINS|17454|||||No|No||AUROBINDO PHARM|No||||
amoxicillin|No|No|No|No|75%|65862001501|AMOXICILLIN 875 MG TABLET|100|EA|.1505|12/08/2006||Yes|No||12/08/2006||Yes|No|12/08/2006||Yes|No||04/01/2015||Yes|No|||Prescription required|No||209|No|.1448|03/29/2022|.14132|03/29/2022|.14226|03/29/2022|||PENICILLINS|17455|||||No|No||AUROBINDO PHARM|No||||
amoxicillin|No|No|No|No|75%|65862001601|AMOXICILLIN 250 MG CAPSULE|100|EA|.02193|09/11/2008||Yes|No||09/11/2008||Yes|No|09/11/2008||Yes|No||04/01/2015||Yes|No|||Prescription required|No||209|No|.06288|03/29/2022|.06137|03/29/2022|.06177|03/29/2022|||PENICILLINS|17456|||||No|No||AUROBINDO PHARM|No||||
amoxicillin|No|No|No|No|75%|65862001605|AMOXICILLIN 250 MG CAPSULE|500|EA|.02021|09/11/2008||Yes|No||09/11/2008||Yes|No|09/11/2008||Yes|No||04/01/2015||Yes|No|||Prescription required|No||209|No|.06288|03/29/2022|.06137|03/29/2022|.06177|03/29/2022|||PENICILLINS|17457|||||No|No||AUROBINDO PHARM|No||||
amoxicillin|No|No|No|No|75%|65862001701|AMOXICILLIN 500 MG CAPSULE|100|EA|.0387|09/11/2008||Yes|No||09/11/2008||Yes|No|09/11/2008||Yes|No||04/01/2015||Yes|No|||Prescription required|No||209|No|.07054|03/29/2022|.06884|03/29/2022|.0693|03/29/2022|||PENICILLINS|17458|||||No|No||AUROBINDO PHARM|No||||
amoxicillin|No|No|No|No|75%|65862001705|AMOXICILLIN 500 MG CAPSULE|500|EA|.03577|09/11/2008||Yes|No||09/11/2008||Yes|No|09/11/2008||Yes|No||04/01/2015||Yes|No|||Prescription required|No||209|No|.07054|03/29/2022|.06884|03/29/2022|.0693|03/29/2022|||PENICILLINS|17459|||||No|No||AUROBINDO PHARM|No||||
cephalexin|No|No|No|No|75%|65862001801|CEPHALEXIN 250 MG CAPSULE|100|EA|.0473|12/01/2006||Yes|No||12/01/2006||Yes|No|12/01/2006||Yes|No||04/01/2015||Yes|No|||Prescription required|No||046|No|.09013|03/29/2022|.08796|03/29/2022|.08855|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17460|||||No|No||AUROBINDO PHARM|No||||
cephalexin|No|No|No|No|75%|65862001805|CEPHALEXIN 250 MG CAPSULE|500|EA|.04493|12/01/2006||Yes|No||12/01/2006||Yes|No|12/01/2006||Yes|No||04/01/2015||Yes|No|||Prescription required|No||046|No|.09013|03/29/2022|.08796|03/29/2022|.08855|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17461|||||No|No||AUROBINDO PHARM|No||||
cephalexin|No|No|No|No|75%|65862001901|CEPHALEXIN 500 MG CAPSULE|100|EA|.07826|12/01/2006||Yes|No||12/01/2006||Yes|No|12/01/2006||Yes|No||04/01/2015||Yes|No|||Prescription required|No||046|No|.12151|03/29/2022|.11859|03/29/2022|.11938|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17462|||||No|No||AUROBINDO PHARM|No||||
cephalexin|No|No|No|No|75%|65862001905|CEPHALEXIN 500 MG CAPSULE|500|EA|.07434|12/01/2006||Yes|No||12/01/2006||Yes|No|12/01/2006||Yes|No||04/01/2015||Yes|No|||Prescription required|No||046|No|.12151|03/29/2022|.11859|03/29/2022|.11938|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17463|||||No|No||AUROBINDO PHARM|No||||
mirtazapine|No|No|No|No|75%|65862002106|MIRTAZAPINE 15 MG ODT|30|EA|.75952|12/01/2006||Yes|No||12/01/2006||Yes|No|12/01/2006||Yes|No||||No|No|||Prescription required|No||031|Yes|.48641|03/29/2022|.47473|03/29/2022|.47789|03/29/2022|||ANTIDEPRESSANTS: OTHER|17464|||||No|No||AUROBINDO PHARM|No||||
mirtazapine|No|No|No|No|75%|65862002206|MIRTAZAPINE 30 MG ODT|30|EA|.78245|12/01/2006||Yes|No||12/01/2006||Yes|No|12/01/2006||Yes|No||||No|No|||Prescription required|No||031|No|.55786|03/29/2022|.54447|03/29/2022|.54809|03/29/2022|||ANTIDEPRESSANTS: OTHER|17465|||||No|No||AUROBINDO PHARM|No||||
mirtazapine|No|No|No|No|75%|65862002306|MIRTAZAPINE 45 MG ODT|30|EA|.83377|12/01/2006||Yes|No||12/01/2006||Yes|No|12/01/2006||Yes|No||||No|No|||Prescription required|No||031|No|.723|03/29/2022|.70564|03/29/2022|.71034|03/29/2022|||ANTIDEPRESSANTS: OTHER|17466|||||No|No||AUROBINDO PHARM|No||||
zidovudine|No|No|No|No|75%|65862002460|ZIDOVUDINE 300 MG TABLET|60|EA|.53749|12/19/2008||Yes|No||12/19/2008||Yes|No|12/19/2008||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.87791|12/28/2021|.86537|12/28/2021|.82416|12/28/2021|||HIV / AIDS|17467|||||No|No||AUROBINDO PHARM|No||||
lamivudine|No|No|No|No|75%|65862002560|LAMIVUDINE 150 MG TABLET|60|EA|.75|05/22/2018||Yes|No||05/22/2018||Yes|No|05/22/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.96758|11/23/2021|.94435|11/23/2021|.95064|11/23/2021|||HIV / AIDS|17468|||||No|No||AUROBINDO PHARM|No||||
lamivudine|No|No|No|No|75%|65862002630|LAMIVUDINE 300 MG TABLET|30|EA|2.73|05/22/2018||Yes|No||05/22/2018||Yes|No|05/22/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|1.29184|03/01/2022|1.26083|03/01/2022|1.26923|03/01/2022|||HIV / AIDS|17469|||||No|No||AUROBINDO PHARM|No||||
nevirapine|No|No|No|No|75%|65862002760|NEVIRAPINE 200 MG TABLET|60|EA|.39999|05/23/2012||Yes|No||05/23/2012||Yes|No|05/23/2012||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.65332|10/27/2020|.64399|10/27/2020|.61332|10/27/2020|||HIV / AIDS|17470|||||No|No||AUROBINDO PHARM|No||||
glyburide|Yes|No|No|No|75%|65862002801|GLYBURIDE 1.25 MG TABLET|100|EA|.06772|10/19/2010||Yes|No||10/19/2010||Yes|No|10/19/2010||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No|||No|.0711|03/29/2022|.06939|03/29/2022|.06985|03/29/2022||||17471|||||No|No||AUROBINDO PHARM|No||||
glyburide|Yes|No|No|No|75%|65862002901|GLYBURIDE 2.5 MG TABLET|100|EA|.06858|10/19/2010||Yes|No||10/19/2010||Yes|No|10/19/2010||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No|||No|.07275|03/29/2022|.071|03/29/2022|.07147|03/29/2022||||17472|||||No|No||AUROBINDO PHARM|No||||
glyburide|Yes|No|No|No|75%|65862002905|GLYBURIDE 2.5 MG TABLET|500|EA|.0617|10/19/2010||Yes|No||10/19/2010||Yes|No|10/19/2010||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No|||No|.07275|03/29/2022|.071|03/29/2022|.07147|03/29/2022||||17473|||||No|No||AUROBINDO PHARM|No||||
glyburide|Yes|No|No|No|75%|65862003001|GLYBURIDE 5 MG TABLET|100|EA|.10599|10/19/2010||Yes|No||10/19/2010||Yes|No|10/19/2010||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No|||No|.09415|03/29/2022|.09189|03/29/2022|.0925|03/29/2022||||17474|||||No|No||AUROBINDO PHARM|No||||
glyburide|Yes|No|No|No|75%|65862003099|GLYBURIDE 5 MG TABLET|1000|EA|.0946|10/19/2010||Yes|No||10/19/2010||Yes|No|10/19/2010||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No|||No|.09415|03/29/2022|.09189|03/29/2022|.0925|03/29/2022||||17475|||||No|No||AUROBINDO PHARM|No||||
mirtazapine|No|No|No|No|75%|65862003130|MIRTAZAPINE 15 MG TABLET|30|EA|.12756|10/07/2009||Yes|No||10/07/2009||Yes|No|10/07/2009||Yes|No||||No|No|||Prescription required|No||031|Yes|.08357|03/29/2022|.08156|03/29/2022|.0821|03/29/2022|||ANTIDEPRESSANTS: OTHER|17476|||||No|No||AUROBINDO PHARM|No||||
mirtazapine|No|No|No|No|75%|65862003230|MIRTAZAPINE 45 MG TABLET|30|EA|.18275|03/02/2005||Yes|No||03/02/2005||Yes|No|03/02/2005||Yes|No||||No|No|||Prescription required|No||031|No|.13324|03/29/2022|.13004|03/29/2022|.1309|03/29/2022|||ANTIDEPRESSANTS: OTHER|17477|||||No|No||AUROBINDO PHARM|No||||
lamivudine/zidovudine|No|No|No|No|75%|65862003660|LAMIVUDINE-ZIDOVUDINE TABLET|60|EA|1.24999|12/28/2021||Yes|No||12/28/2021||Yes|No|12/28/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.62913|12/28/2021|.61403|12/28/2021|.61812|12/28/2021|||HIV / AIDS|17478|||||No|No||AUROBINDO PHARM|No||||
stavudine|No|No|No|No|75%|65862004760|STAVUDINE 40 MG CAPSULE|60|EA|1.07499|03/23/2009||Yes|No||03/23/2009||Yes|No|03/23/2009||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|1.75582|11/29/2016|1.73074|11/29/2016|1.64832|11/29/2016|||HIV / AIDS|17479|||||No|No||AUROBINDO PHARM|No||||
zidovudine|No|No|No|No|75%|65862004824|ZIDOVUDINE 50 MG/5 ML SYRUP|240|ML|.09024|12/01/2006||Yes|No||12/01/2006||Yes|No|12/01/2006||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.1474|06/01/2016|.14529|06/01/2016|.13837|06/01/2016|||HIV / AIDS|17480|||||No|No||AUROBINDO PHARM|No||||
efavirenz|No|No|No|No|75%|65862004930|EFAVIRENZ 600 MG TABLET|30|EA|1.59999|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|5.43893|08/24/2021|5.30839|08/24/2021|5.34374|08/24/2021|||HIV / AIDS|17481|||||No|No||AUROBINDO PHARM|No||||
simvastatin|Yes|No|No|No|75%|65862005090|SIMVASTATIN 5 MG TABLET|90|EA|.03936|12/23/2006||Yes|No||12/23/2006||Yes|No|12/23/2006||Yes|No||04/01/2016||Yes|No|07/01/2016||Prescription required|No||063|Yes|.03036|03/29/2022|.02963|03/29/2022|.02982|03/29/2022|||LIPOTROPICS: STATINS|17482|||||No|No||AUROBINDO PHARM|No||||
simvastatin|Yes|No|No|No|75%|65862005130|SIMVASTATIN 10 MG TABLET|30|EA|.04801|12/23/2006||Yes|No||12/23/2006||Yes|No|12/23/2006||Yes|No||04/01/2016||Yes|No|07/01/2016||Prescription required|No||063|Yes|.02909|03/29/2022|.02839|03/29/2022|.02858|03/29/2022|||LIPOTROPICS: STATINS|17483|||||No|No||AUROBINDO PHARM|No||||
simvastatin|Yes|No|No|No|75%|65862005190|SIMVASTATIN 10 MG TABLET|90|EA|.04323|12/23/2006||Yes|No||12/23/2006||Yes|No|12/23/2006||Yes|No||04/01/2016||Yes|No|07/01/2016||Prescription required|No||063|Yes|.02909|03/29/2022|.02839|03/29/2022|.02858|03/29/2022|||LIPOTROPICS: STATINS|17484|||||No|No||AUROBINDO PHARM|No||||
simvastatin|Yes|No|No|No|75%|65862005199|SIMVASTATIN 10 MG TABLET|1000|EA|.03241|12/23/2006||Yes|No||12/23/2006||Yes|No|12/23/2006||Yes|No||04/01/2016||Yes|No|07/01/2016||Prescription required|No||063|Yes|.02909|03/29/2022|.02839|03/29/2022|.02858|03/29/2022|||LIPOTROPICS: STATINS|17485|||||No|No||AUROBINDO PHARM|No||||
simvastatin|Yes|No|No|No|75%|65862005230|SIMVASTATIN 20 MG TABLET|30|EA|.05919|12/23/2006||Yes|No||12/23/2006||Yes|No|12/23/2006||Yes|No||04/01/2016||Yes|No|07/01/2016||Prescription required|No||063|Yes|.02604|03/29/2022|.02541|03/29/2022|.02558|03/29/2022|||LIPOTROPICS: STATINS|17486|||||No|No||AUROBINDO PHARM|No||||
simvastatin|Yes|No|No|No|75%|65862005290|SIMVASTATIN 20 MG TABLET|90|EA|.05326|12/23/2006||Yes|No||12/23/2006||Yes|No|12/23/2006||Yes|No||04/01/2016||Yes|No|07/01/2016||Prescription required|No||063|Yes|.02604|03/29/2022|.02541|03/29/2022|.02558|03/29/2022|||LIPOTROPICS: STATINS|17487|||||No|No||AUROBINDO PHARM|No||||
simvastatin|Yes|No|No|No|75%|65862005299|SIMVASTATIN 20 MG TABLET|1000|EA|.03995|12/23/2006||Yes|No||12/23/2006||Yes|No|12/23/2006||Yes|No||04/01/2016||Yes|No|07/01/2016||Prescription required|No||063|Yes|.02604|03/29/2022|.02541|03/29/2022|.02558|03/29/2022|||LIPOTROPICS: STATINS|17488|||||No|No||AUROBINDO PHARM|No||||
simvastatin|No|No|No|No|75%|65862005322|SIMVASTATIN 40 MG TABLET|2000|EA|.03284|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||02/09/2022||Yes|No|||Prescription required|No||063|Yes|.04431|03/29/2022|.04324|03/29/2022|.04353|03/29/2022|||LIPOTROPICS: STATINS|17489|||||No|No||AUROBINDO PHARM|No||||
simvastatin|Yes|No|No|No|75%|65862005330|SIMVASTATIN 40 MG TABLET|30|EA|.06951|12/23/2006||Yes|No||12/23/2006||Yes|No|12/23/2006||Yes|No||04/01/2016||Yes|No|07/01/2016||Prescription required|No||063|Yes|.04431|03/29/2022|.04324|03/29/2022|.04353|03/29/2022|||LIPOTROPICS: STATINS|17490|||||No|No||AUROBINDO PHARM|No||||
simvastatin|Yes|No|No|No|75%|65862005390|SIMVASTATIN 40 MG TABLET|90|EA|.06258|12/23/2006||Yes|No||12/23/2006||Yes|No|12/23/2006||Yes|No||04/01/2016||Yes|No|07/01/2016||Prescription required|No||063|Yes|.04431|03/29/2022|.04324|03/29/2022|.04353|03/29/2022|||LIPOTROPICS: STATINS|17491|||||No|No||AUROBINDO PHARM|No||||
simvastatin|Yes|No|No|No|75%|65862005399|SIMVASTATIN 40 MG TABLET|1000|EA|.04692|12/23/2006||Yes|No||12/23/2006||Yes|No|12/23/2006||Yes|No||04/01/2016||Yes|No|07/01/2016||Prescription required|No||063|Yes|.04431|03/29/2022|.04324|03/29/2022|.04353|03/29/2022|||LIPOTROPICS: STATINS|17492|||||No|No||AUROBINDO PHARM|No||||
simvastatin|Yes|No|No|No|75%|65862005430|SIMVASTATIN 80 MG TABLET|30|EA|.07668|12/23/2006||Yes|No||12/23/2006||Yes|No|12/23/2006||Yes|No||04/01/2016||Yes|No|07/01/2016||Prescription required|No||063|Yes|.09322|03/29/2022|.09098|03/29/2022|.09158|03/29/2022|||LIPOTROPICS: STATINS|17493|||||No|No||AUROBINDO PHARM|No||||
simvastatin|Yes|No|No|No|75%|65862005490|SIMVASTATIN 80 MG TABLET|90|EA|.06903|12/23/2006||Yes|No||12/23/2006||Yes|No|12/23/2006||Yes|No||04/01/2016||Yes|No|07/01/2016||Prescription required|No||063|Yes|.09322|03/29/2022|.09098|03/29/2022|.09158|03/29/2022|||LIPOTROPICS: STATINS|17494|||||No|No||AUROBINDO PHARM|No||||
simvastatin|Yes|No|No|No|75%|65862005499|SIMVASTATIN 80 MG TABLET|1000|EA|.05176|12/23/2006||Yes|No||12/23/2006||Yes|No|12/23/2006||Yes|No||04/01/2016||Yes|No|07/01/2016||Prescription required|No||063|Yes|.09322|03/29/2022|.09098|03/29/2022|.09158|03/29/2022|||LIPOTROPICS: STATINS|17495|||||No|No||AUROBINDO PHARM|No||||
lamivudine|No|No|No|No|75%|65862005524|LAMIVUDINE 10 MG/ML ORAL SOLN|240|ML|.20787|09/27/2017||Yes|No||09/27/2017||Yes|No|09/27/2017||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.33952|11/23/2021|.33467|11/23/2021|.31873|11/23/2021|||HIV / AIDS|17496|||||No|No||AUROBINDO PHARM|No||||
nevirapine|No|No|No|No|75%|65862005724|NEVIRAPINE 50 MG/5 ML SUSP|240|ML|.37854|09/29/2020||Yes|No||09/29/2020||Yes|No|09/29/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.61829|09/29/2020|.60945|09/29/2020|.58043|09/29/2020|||HIV / AIDS|17497|||||No|No||AUROBINDO PHARM|No||||
metoprolol tartrate|No|No|No|No|75%|65862006201|METOPROLOL TARTRATE 25 MG TAB|100|EA|.01388|02/08/2008||Yes|No||02/08/2008||Yes|No|02/08/2008||Yes|No||04/01/2015||Yes|No|||Prescription required|No||070|No|.01777|03/29/2022|.01734|03/29/2022|.01745|03/29/2022|||BETA-BLOCKERS|17498|||||No|No||AUROBINDO PHARM|No||||
metoprolol tartrate|No|No|No|No|75%|65862006299|METOPROLOL TARTRATE 25 MG TAB|1000|EA|.01319|08/25/2009||Yes|No||08/25/2009||Yes|No|08/25/2009||Yes|No||04/01/2015||Yes|No|||Prescription required|No||070|No|.01777|03/29/2022|.01734|03/29/2022|.01745|03/29/2022|||BETA-BLOCKERS|17499|||||No|No||AUROBINDO PHARM|No||||
metoprolol tartrate|No|No|No|No|75%|65862006301|METOPROLOL TARTRATE 50 MG TAB|100|EA|.01431|02/08/2008||Yes|No||02/08/2008||Yes|No|02/08/2008||Yes|No||04/01/2015||Yes|No|||Prescription required|No||070|No|.02252|03/29/2022|.02197|03/29/2022|.02212|03/29/2022|||BETA-BLOCKERS|17500|||||No|No||AUROBINDO PHARM|No||||
metoprolol tartrate|No|No|No|No|75%|65862006359|METOPROLOL TARTRATE 50 MG TAB|5000|EA|.0114|08/17/2015||Yes|No||08/17/2015||Yes|No|08/17/2015||Yes|No||04/01/2015||Yes|No|||Prescription required|No||070|No|.02252|03/29/2022|.02197|03/29/2022|.02212|03/29/2022|||BETA-BLOCKERS|17501|||||No|No||AUROBINDO PHARM|No||||
metoprolol tartrate|No|No|No|No|75%|65862006399|METOPROLOL TARTRATE 50 MG TAB|1000|EA|.0114|03/18/2008||Yes|No||03/18/2008||Yes|No|03/18/2008||Yes|No||04/01/2015||Yes|No|||Prescription required|No||070|No|.02252|03/29/2022|.02197|03/29/2022|.02212|03/29/2022|||BETA-BLOCKERS|17502|Not Specified|Not Specified|Not Specified||No|No||AUROBINDO PHARM|No||||
metoprolol tartrate|No|No|No|No|75%|65862006401|METOPROLOL TARTRATE 100 MG TAB|100|EA|.01978|02/08/2008||Yes|No||02/08/2008||Yes|No|02/08/2008||Yes|No||04/01/2015||Yes|No|||Prescription required|No||070|No|.03443|03/29/2022|.0336|03/29/2022|.03382|03/29/2022|||BETA-BLOCKERS|17503|||||No|No||AUROBINDO PHARM|No||||
metoprolol tartrate|No|No|No|No|75%|65862006439|METOPROLOL TARTRATE 100 MG TAB|3000|EA|.01692|08/17/2015||Yes|No||08/17/2015||Yes|No|08/17/2015||Yes|No||04/01/2015||Yes|No|||Prescription required|No||070|No|.03443|03/29/2022|.0336|03/29/2022|.03382|03/29/2022|||BETA-BLOCKERS|17504|||||No|No||AUROBINDO PHARM|No||||
metoprolol tartrate|No|No|No|No|75%|65862006499|METOPROLOL TARTRATE 100 MG TAB|1000|EA|.01692|02/08/2008||Yes|No||02/08/2008||Yes|No|02/08/2008||Yes|No||04/01/2015||Yes|No|||Prescription required|No||070|No|.03443|03/29/2022|.0336|03/29/2022|.03382|03/29/2022|||BETA-BLOCKERS|17505|||||No|No||AUROBINDO PHARM|No||||
cefprozil|No|No|No|No|75%|65862006901|CEFPROZIL 500 MG TABLET|100|EA|1.763|11/21/2007||Yes|No||11/21/2007||Yes|No|11/21/2007||Yes|No||||No|No|||Prescription required|No||046|No|1.02667|03/29/2022|1.00202|03/29/2022|1.0087|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17506|||||No|No||AUROBINDO PHARM|No||||
cefprozil|No|No|No|No|75%|65862006950|CEFPROZIL 500 MG TABLET|50|EA|1.7974|11/21/2007||Yes|No||11/21/2007||Yes|No|11/21/2007||Yes|No||||No|No|||Prescription required|No||046|No|1.02667|03/29/2022|1.00202|03/29/2022|1.0087|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17507|||||No|No||AUROBINDO PHARM|No||||
amoxicillin|No|No|No|No|75%|65862007001|AMOXICILLIN 200 MG/5 ML SUSP|100|ML|.0258|06/23/2008||Yes|No||06/23/2008||Yes|No|06/23/2008||Yes|No||06/23/2008||Yes|No|||Prescription required|No||209|No|.03312|03/29/2022|.03232|03/29/2022|.03254|03/29/2022|||PENICILLINS|17508|||||No|No||AUROBINDO PHARM|No||||
amoxicillin|No|No|No|No|75%|65862007050|AMOXICILLIN 200 MG/5 ML SUSP|50|ML|.0258|06/23/2008||Yes|No||06/23/2008||Yes|No|06/23/2008||Yes|No||06/23/2008||Yes|No|||Prescription required|No||209|No|.02949|11/23/2021|.02878|11/23/2021|.02897|11/23/2021|||PENICILLINS|17509|||||No|No||AUROBINDO PHARM|No||||
amoxicillin|No|No|No|No|75%|65862007075|AMOXICILLIN 200 MG/5 ML SUSP|75|ML|.02522|06/23/2008||Yes|No||06/23/2008||Yes|No|06/23/2008||Yes|No||06/23/2008||Yes|No|||Prescription required|No||209|No|.032|01/25/2022|.03123|01/25/2022|.03144|01/25/2022|||PENICILLINS|17510|||||No|No||AUROBINDO PHARM|No||||
amoxicillin|No|No|No|No|75%|65862007101|AMOXICILLIN 400 MG/5 ML SUSP|100|ML|.02752|06/23/2008||Yes|No||06/23/2008||Yes|No|06/23/2008||Yes|No||06/23/2008||Yes|No|||Prescription required|No||209|No|.02289|03/29/2022|.02234|03/29/2022|.02248|03/29/2022|||PENICILLINS|17511|||||No|No||AUROBINDO PHARM|No||||
amoxicillin|No|No|No|No|75%|65862007150|AMOXICILLIN 400 MG/5 ML SUSP|50|ML|.02752|06/23/2008||Yes|No||06/23/2008||Yes|No|06/23/2008||Yes|No||06/23/2008||Yes|No|||Prescription required|No||209|No|.03376|03/29/2022|.03294|03/29/2022|.03316|03/29/2022|||PENICILLINS|17512|||||No|No||AUROBINDO PHARM|No||||
amoxicillin|No|No|No|No|75%|65862007175|AMOXICILLIN 400 MG/5 ML SUSP|75|ML|.02752|06/23/2008||Yes|No||06/23/2008||Yes|No|06/23/2008||Yes|No||06/23/2008||Yes|No|||Prescription required|No||209|No|.02457|03/29/2022|.02398|03/29/2022|.02414|03/29/2022|||PENICILLINS|17513|||||No|No||AUROBINDO PHARM|No||||
abacavir sulfate|No|No|No|No|75%|65862007360|ABACAVIR 300 MG TABLET|60|EA|1.5|12/18/2012||Yes|No||12/18/2012||Yes|No|12/18/2012||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.69669|03/29/2022|.67996|03/29/2022|.68449|03/29/2022|||HIV / AIDS|17514|||||No|No||AUROBINDO PHARM|No||||
ciprofloxacin HCl|Yes|No|No|No|75%|65862007601|CIPROFLOXACIN HCL 250 MG TAB|100|EA|.09675|11/19/2009||Yes|No||11/19/2009||Yes|No|11/19/2009||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||028|No|.09397|03/29/2022|.09171|03/29/2022|.09232|03/29/2022|||FLUOROQUINOLONES: ORAL|17515|||||No|No||AUROBINDO PHARM|No||||
ciprofloxacin HCl|No|No|No|No|75%|65862007701|CIPROFLOXACIN HCL 500 MG TAB|100|EA|.13115|11/03/2009||Yes|No||11/03/2009||Yes|No|11/03/2009||Yes|No||04/01/2015||Yes|No|||Prescription required|No||028|No|.13565|03/29/2022|.13239|03/29/2022|.13327|03/29/2022|||FLUOROQUINOLONES: ORAL|17516|||||No|No||AUROBINDO PHARM|No||||
ciprofloxacin HCl|No|No|No|No|75%|65862007705|CIPROFLOXACIN HCL 500 MG TAB|500|EA|.07955|03/08/2022||Yes|No||03/08/2022||Yes|No|03/08/2022||Yes|No||03/08/2022||Yes|No|||Prescription required|No||028|No|.13565|03/29/2022|.13239|03/29/2022|.13327|03/29/2022|||FLUOROQUINOLONES: ORAL|17517|||||No|No||AUROBINDO PHARM|No||||
ciprofloxacin HCl|No|No|No|No|75%|65862007850|CIPROFLOXACIN HCL 750 MG TAB|50|EA|.23116|05/18/2010||Yes|No||05/18/2010||Yes|No|05/18/2010||Yes|No||04/01/2015||Yes|No|||Prescription required|No||028|No|.288|03/29/2022|.28108|03/29/2022|.28296|03/29/2022|||FLUOROQUINOLONES: ORAL|17518|||||No|No||AUROBINDO PHARM|No||||
terbinafine HCl|No|No|No|No|75%|65862007930|TERBINAFINE HCL 250 MG TABLET|30|EA|.1075|07/17/2007||Yes|No||07/17/2007||Yes|No|07/17/2007||Yes|No||||No|No|||Prescription required|No||069|No|.15711|03/29/2022|.15333|03/29/2022|.15436|03/29/2022|||ANTIFUNGALS: ORAL|17519|||||No|No||AUROBINDO PHARM|No||||
glyburide/metformin HCl|Yes|No|No|No|75%|65862008001|GLYBURID-METFORMIN 1.25-250 MG|100|EA|.03676|03/18/2009||Yes|No||03/18/2009||Yes|No|03/18/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.08379|02/25/2020|.08259|02/25/2020|.07866|02/25/2020|||HYPOGLYCEMICS: METFORMINS|17520|||||No|No||AUROBINDO PHARM|No||||
glyburide/metformin HCl|Yes|No|No|No|75%|65862008005|GLYBURID-METFORMIN 1.25-250 MG|500|EA|.03603|10/07/2010||Yes|No||10/07/2010||Yes|No|10/07/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.08212|02/25/2020|.08095|02/25/2020|.07709|02/25/2020|||HYPOGLYCEMICS: METFORMINS|17521|||||No|No||AUROBINDO PHARM|No||||
glyburide/metformin HCl|Yes|No|No|No|75%|65862008101|GLYBURIDE-METFORMIN 2.5-500 MG|100|EA|.03762|03/18/2009||Yes|No||03/18/2009||Yes|No|03/18/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.05324|03/29/2022|.05196|03/29/2022|.0523|03/29/2022|||HYPOGLYCEMICS: METFORMINS|17522|||||No|No||AUROBINDO PHARM|No||||
glyburide/metformin HCl|Yes|No|No|No|75%|65862008105|GLYBURIDE-METFORMIN 2.5-500 MG|500|EA|.03689|10/07/2010||Yes|No||10/07/2010||Yes|No|10/07/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.05324|03/29/2022|.05196|03/29/2022|.0523|03/29/2022|||HYPOGLYCEMICS: METFORMINS|17523|||||No|No||AUROBINDO PHARM|No||||
glyburide/metformin HCl|Yes|No|No|No|75%|65862008201|GLYBURIDE-METFORMIN 5-500 MG|100|EA|.03848|03/18/2009||Yes|No||03/18/2009||Yes|No|03/18/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.05734|03/29/2022|.05596|03/29/2022|.05633|03/29/2022|||HYPOGLYCEMICS: METFORMINS|17524|||||No|No||AUROBINDO PHARM|No||||
glyburide/metformin HCl|Yes|No|No|No|75%|65862008205|GLYBURIDE-METFORMIN 5-500 MG|500|EA|.03771|10/07/2010||Yes|No||10/07/2010||Yes|No|10/07/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.05734|03/29/2022|.05596|03/29/2022|.05633|03/29/2022|||HYPOGLYCEMICS: METFORMINS|17525|||||No|No||AUROBINDO PHARM|No||||
cefadroxil|No|No|No|No|75%|65862008301|CEFADROXIL 250 MG/5 ML SUSP|100|ML|.20915|05/23/2014||Yes|No||05/23/2014||Yes|No|05/23/2014||Yes|No||04/01/2015||Yes|No|||Prescription required|No||046|No|.1834|09/28/2021|.17899|09/28/2021|.18019|09/28/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17526|||||No|No||AUROBINDO PHARM|No||||
cefadroxil|No|No|No|No|75%|65862008401|CEFADROXIL 500 MG/5 ML SUSP|100|ML|.28956|05/23/2014||Yes|No||05/23/2014||Yes|No|05/23/2014||Yes|No||04/01/2015||Yes|No|||Prescription required|No||046|No|.25492|01/25/2022|.2488|01/25/2022|.25045|01/25/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17527|||||No|No||AUROBINDO PHARM|No||||
cefadroxil|No|No|No|No|75%|65862008475|CEFADROXIL 500 MG/5 ML SUSP|75|ML|.28953|12/09/2013||Yes|No||12/09/2013||Yes|No|12/09/2013||Yes|No||04/01/2015||Yes|No|||Prescription required|No||046|No|.65986|11/23/2021|.65043|11/23/2021|.61946|11/23/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17528|||||No|No||AUROBINDO PHARM|No||||
cefadroxil|No|No|No|No|75%|65862008501|CEFADROXIL 500 MG CAPSULE|100|EA|.2279|09/14/2007||Yes|No||09/14/2007||Yes|No|09/14/2007||Yes|No||04/01/2015||Yes|No|||Prescription required|No||046|No|.20994|03/29/2022|.2049|03/29/2022|.20626|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17529|||||No|No||AUROBINDO PHARM|No||||
cefadroxil|No|No|No|No|75%|65862008550|CEFADROXIL 500 MG CAPSULE|50|EA|.25585|11/01/2008||Yes|No||11/01/2008||Yes|No|11/01/2008||Yes|No||04/01/2015||Yes|No|||Prescription required|No||046|No|.20994|03/29/2022|.2049|03/29/2022|.20626|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17530|||||No|No||AUROBINDO PHARM|No||||
bisoprolol fumarate|No|No|No|No|75%|65862008601|BISOPROLOL FUMARATE 5 MG TAB|100|EA|.38979|04/04/2017||Yes|No||04/04/2017||Yes|No|04/04/2017||Yes|No||04/04/2017||Yes|No|||Prescription required|No||070|No|.38321|03/29/2022|.37401|03/29/2022|.3765|03/29/2022|||BETA-BLOCKERS|17531|||||No|No||AUROBINDO PHARM|No||||
bisoprolol fumarate|No|No|No|No|75%|65862008701|BISOPROLOL FUMARATE 10 MG TAB|100|EA|.38979|04/04/2017||Yes|No||04/04/2017||Yes|No|04/04/2017||Yes|No||04/04/2017||Yes|No|||Prescription required|No||070|No|.47062|03/29/2022|.45932|03/29/2022|.46238|03/29/2022|||BETA-BLOCKERS|17532|||||No|No||AUROBINDO PHARM|No||||
cefpodoxime proxetil|No|No|No|No|75%|65862009520|CEFPODOXIME 100 MG TABLET|20|EA|2.3177|02/05/2008||Yes|No||02/05/2008||Yes|No|02/05/2008||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|046|No|2.53516|03/29/2022|2.47431|03/29/2022|2.49079|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17533|||||No|No||AUROBINDO PHARM|No||||
cefpodoxime proxetil|No|No|No|No|75%|65862009620|CEFPODOXIME 200 MG TABLET|20|EA|2.90916|02/05/2008||Yes|No||02/05/2008||Yes|No|02/05/2008||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|046|No|3.01774|03/29/2022|2.94531|03/29/2022|2.96492|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17534|||||No|No||AUROBINDO PHARM|No||||
meloxicam|No|No|No|No|75%|65862009701|MELOXICAM 7.5 MG TABLET|100|EA|.0172|11/26/2008||Yes|No||11/26/2008||Yes|No|11/26/2008||Yes|No||11/26/2008||Yes|No|||Prescription required|No||059|Yes|.02308|03/29/2022|.02252|03/29/2022|.02267|03/29/2022|||NSAIDS|17535|||||No|No||AUROBINDO PHARM|No||||
meloxicam|No|No|No|No|75%|65862009705|MELOXICAM 7.5 MG TABLET|500|EA|.01204|05/11/2012||Yes|No||05/11/2012||Yes|No|05/11/2012||Yes|No||05/11/2012||Yes|No|||Prescription required|No||059|Yes|.02308|03/29/2022|.02252|03/29/2022|.02267|03/29/2022|||NSAIDS|17536|||||No|No||AUROBINDO PHARM|No||||
cefprozil|No|No|No|No|75%|65862009901|CEFPROZIL 125 MG/5 ML SUSP|100|ML|.11696|11/21/2007||Yes|No||11/21/2007||Yes|No|11/21/2007||Yes|No||||No|No|||Prescription required|No||046|No|.09872|03/01/2022|.09635|03/01/2022|.09699|03/01/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17537|||||No|No||AUROBINDO PHARM|No||||
cefprozil|No|No|No|No|75%|65862009975|CEFPROZIL 125 MG/5 ML SUSP|75|ML|.11724|11/21/2007||Yes|No||11/21/2007||Yes|No|11/21/2007||Yes|No||||No|No|||Prescription required|No||046|No|.2672|02/28/2017|.26338|02/28/2017|.25084|02/28/2017|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17538|||||No|No||AUROBINDO PHARM|No||||
cefprozil|No|No|No|No|75%|65862010001|CEFPROZIL 250 MG/5 ML SUSP|100|ML|.21194|11/21/2007||Yes|No||11/21/2007||Yes|No|11/21/2007||Yes|No||||No|No|||Prescription required|No||046|No|.21431|03/29/2022|.20916|03/29/2022|.21055|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17539|||||No|No||AUROBINDO PHARM|No||||
cefprozil|No|No|No|No|75%|65862010075|CEFPROZIL 250 MG/5 ML SUSP|75|ML|.21407|11/21/2007||Yes|No||11/21/2007||Yes|No|11/21/2007||Yes|No||||No|No|||Prescription required|No||046|No|.22915|03/29/2022|.22365|03/29/2022|.22513|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17540|||||No|No||AUROBINDO PHARM|No||||
zidovudine|No|No|No|No|75%|65862010701|ZIDOVUDINE 100 MG CAPSULE|100|EA|.9087|12/01/2006||Yes|No||12/01/2006||Yes|No|12/01/2006||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|1.48421|06/01/2016|1.463|06/01/2016|1.39334|06/01/2016|||HIV / AIDS|17541|||||No|No||AUROBINDO PHARM|No||||
benazepril HCl|Yes|No|No|No|75%|65862011601|BENAZEPRIL HCL 10 MG TABLET|100|EA|.03706|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Prescription required|No||113|No|.06947|03/29/2022|.0678|03/29/2022|.06825|03/29/2022|||ANGIOTENSIN MODULATORS|17542|||||No|No||AUROBINDO PHARM|No||||
benazepril HCl|Yes|No|No|No|75%|65862011701|BENAZEPRIL HCL 20 MG TABLET|100|EA|.03706|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Prescription required|No||113|No|.08619|03/29/2022|.08412|03/29/2022|.08468|03/29/2022|||ANGIOTENSIN MODULATORS|17543|||||No|No||AUROBINDO PHARM|No||||
benazepril HCl|Yes|No|No|No|75%|65862011801|BENAZEPRIL HCL 40 MG TABLET|100|EA|.03706|05/12/2009||Yes|No||05/12/2009||Yes|No|05/12/2009||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|No|.11798|03/29/2022|.11514|03/29/2022|.11591|03/29/2022|||ANGIOTENSIN MODULATORS|17544|||||No|No||AUROBINDO PHARM|No||||
torsemide|No|No|No|No|75%|65862012501|TORSEMIDE 5 MG TABLET|100|EA|.05998|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||10/01/2020||Yes|No|||Prescription required|No|||No|.0835|03/29/2022|.08149|03/29/2022|.08203|03/29/2022||||17545|||||No|No||AUROBINDO PHARM|No||||
torsemide|No|No|No|No|75%|65862012601|TORSEMIDE 10 MG TABLET|100|EA|.06772|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||10/01/2020||Yes|No|||Prescription required|No|||No|.07835|03/29/2022|.07646|03/29/2022|.07697|03/29/2022||||17546|||||No|No||AUROBINDO PHARM|No||||
torsemide|No|No|No|No|75%|65862012701|TORSEMIDE 20 MG TABLET|100|EA|.0918|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||10/01/2020||Yes|No|||Prescription required|No|||No|.08257|03/29/2022|.08058|03/29/2022|.08112|03/29/2022||||17547|||||No|No||AUROBINDO PHARM|No||||
torsemide|No|No|No|No|75%|65862012801|TORSEMIDE 100 MG TABLET|100|EA|.1935|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||10/01/2020||Yes|No|||Prescription required|No|||No|.25463|03/29/2022|.24851|03/29/2022|.25017|03/29/2022||||17548|||||No|No||AUROBINDO PHARM|No||||
hydrochlorothiazide|Yes|No|No|No|75%|65862013399|HYDROCHLOROTHIAZIDE 25 MG TAB|1000|EA|.00851|02/08/2008||Yes|No||02/08/2008||Yes|No|02/08/2008||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No|||Yes|.01337|03/29/2022|.01304|03/29/2022|.01313|03/29/2022||||17549|||||No|No||AUROBINDO PHARM|No||||
hydrochlorothiazide|Yes|No|No|No|75%|65862013401|HYDROCHLOROTHIAZIDE 50 MG TAB|100|EA|.02145|01/14/2009||Yes|No||01/14/2009||Yes|No|01/14/2009||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No|||Yes|.02959|03/29/2022|.02887|03/29/2022|.02907|03/29/2022||||17550|||||No|No||AUROBINDO PHARM|No||||
hydrochlorothiazide|Yes|No|No|No|75%|65862013499|HYDROCHLOROTHIAZIDE 50 MG TAB|1000|EA|.01429|02/08/2008||Yes|No||02/08/2008||Yes|No|02/08/2008||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No|||Yes|.02959|03/29/2022|.02887|03/29/2022|.02907|03/29/2022||||17551|||||No|No||AUROBINDO PHARM|No||||
carvedilol|No|No|No|No|75%|65862014201|CARVEDILOL 3.125 MG TABLET|100|EA|.0215|09/07/2007||Yes|No||09/07/2007||Yes|No|09/07/2007||Yes|No||04/01/2015||Yes|No|||Prescription required|No||070|No|.01877|03/29/2022|.01831|03/29/2022|.01844|03/29/2022|||BETA-BLOCKERS|17552|||||No|No||AUROBINDO PHARM|No||||
carvedilol|No|No|No|No|75%|65862014205|CARVEDILOL 3.125 MG TABLET|500|EA|.02096|03/04/2010||Yes|No||03/04/2010||Yes|No|03/04/2010||Yes|No||04/01/2015||Yes|No|||Prescription required|No||070|No|.01877|03/29/2022|.01831|03/29/2022|.01844|03/29/2022|||BETA-BLOCKERS|17553|||||No|No||AUROBINDO PHARM|No||||
carvedilol|No|No|No|No|75%|65862014301|CARVEDILOL 6.25 MG TABLET|100|EA|.0215|09/07/2007||Yes|No||09/07/2007||Yes|No|09/07/2007||Yes|No||04/01/2015||Yes|No|||Prescription required|No||070|No|.02069|03/29/2022|.02019|03/29/2022|.02032|03/29/2022|||BETA-BLOCKERS|17554|||||No|No||AUROBINDO PHARM|No||||
carvedilol|No|No|No|No|75%|65862014305|CARVEDILOL 6.25 MG TABLET|500|EA|.02096|01/18/2018||Yes|No||01/18/2018||Yes|No|01/18/2018||Yes|No||01/18/2018||Yes|No|||Prescription required|No||070|No|.02069|03/29/2022|.02019|03/29/2022|.02032|03/29/2022|||BETA-BLOCKERS|17555|||||No|No||AUROBINDO PHARM|No||||
carvedilol|No|No|No|No|75%|65862014401|CARVEDILOL 12.5 MG TABLET|100|EA|.0215|09/07/2007||Yes|No||09/07/2007||Yes|No|09/07/2007||Yes|No||04/01/2015||Yes|No|||Prescription required|No||070|No|.02277|03/29/2022|.02222|03/29/2022|.02237|03/29/2022|||BETA-BLOCKERS|17556|||||No|No||AUROBINDO PHARM|No||||
carvedilol|No|No|No|No|75%|65862014405|CARVEDILOL 12.5 MG TABLET|500|EA|.02096|03/04/2010||Yes|No||03/04/2010||Yes|No|03/04/2010||Yes|No||04/01/2015||Yes|No|||Prescription required|No||070|No|.02277|03/29/2022|.02222|03/29/2022|.02237|03/29/2022|||BETA-BLOCKERS|17557|||||No|No||AUROBINDO PHARM|No||||
carvedilol|No|No|No|No|75%|65862014501|CARVEDILOL 25 MG TABLET|100|EA|.0215|09/07/2007||Yes|No||09/07/2007||Yes|No|09/07/2007||Yes|No||04/01/2015||Yes|No|||Prescription required|No||070|No|.03449|03/29/2022|.03366|03/29/2022|.03388|03/29/2022|||BETA-BLOCKERS|17558|||||No|No||AUROBINDO PHARM|No||||
carvedilol|No|No|No|No|75%|65862014505|CARVEDILOL 25 MG TABLET|500|EA|.02096|03/04/2010||Yes|No||03/04/2010||Yes|No|03/04/2010||Yes|No||04/01/2015||Yes|No|||Prescription required|No||070|No|.03449|03/29/2022|.03366|03/29/2022|.03388|03/29/2022|||BETA-BLOCKERS|17559|||||No|No||AUROBINDO PHARM|No||||
sumatriptan succinate|No|No|No|No|75%|65862014636|SUMATRIPTAN SUCC 25 MG TABLET|9|EA|.76205|08/21/2009||Yes|No||08/21/2009||Yes|No|08/21/2009||Yes|No||||No|No|||Prescription required|No||021|No|.55768|03/29/2022|.54429|03/29/2022|.54792|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|17560|||||No|No||AUROBINDO PHARM|No||||
sumatriptan succinate|No|No|No|No|75%|65862014736|SUMATRIPTAN SUCC 50 MG TABLET|9|EA|.76205|08/21/2009||Yes|No||08/21/2009||Yes|No|08/21/2009||Yes|No||||No|No|||Prescription required|No||021|No|.52829|03/29/2022|.51561|03/29/2022|.51904|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|17561|||||No|No||AUROBINDO PHARM|No||||
sumatriptan succinate|No|No|No|No|75%|65862014836|SUMATRIPTAN SUCC 100 MG TABLET|9|EA|.76205|08/21/2009||Yes|No||08/21/2009||Yes|No|08/21/2009||Yes|No||||No|No|||Prescription required|No||021|No|.54919|03/29/2022|.536|03/29/2022|.53957|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|17562|||||No|No||AUROBINDO PHARM|No||||
finasteride|No|No|No|No|75%|65862014901|FINASTERIDE 5 MG TABLET|100|EA|.172|03/03/2008||Yes|No||03/03/2008||Yes|No|03/03/2008||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|17563|||||No|No||AUROBINDO PHARM|No||||
finasteride|No|No|No|No|75%|65862014905|FINASTERIDE 5 MG TABLET|500|EA|.0559|05/22/2014||Yes|No||05/22/2014||Yes|No|05/22/2014||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|17564|||||No|No||AUROBINDO PHARM|No||||
finasteride|No|No|No|No|75%|65862014930|FINASTERIDE 5 MG TABLET|30|EA|.06593|03/03/2008||Yes|No||03/03/2008||Yes|No|03/03/2008||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|17565|||||No|No||AUROBINDO PHARM|No||||
finasteride|No|No|No|No|75%|65862014990|FINASTERIDE 5 MG TABLET|90|EA|.05733|03/03/2008||Yes|No||03/03/2008||Yes|No|03/03/2008||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|17566|||||No|No||AUROBINDO PHARM|No||||
paroxetine HCl|No|No|No|No|75%|65862015505|PAROXETINE HCL 20 MG TABLET|500|EA|.09735|11/21/2007||Yes|No||11/21/2007||Yes|No|11/21/2007||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17567|||||No|No||AUROBINDO PHARM|No||||
paroxetine HCl|No|No|No|No|75%|65862015530|PAROXETINE HCL 20 MG TABLET|30|EA|.10248|11/21/2007||Yes|No||11/21/2007||Yes|No|11/21/2007||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17568|||||No|No||AUROBINDO PHARM|No||||
paroxetine HCl|No|No|No|No|75%|65862015599|PAROXETINE HCL 20 MG TABLET|1000|EA|.0559|11/21/2007||Yes|No||11/21/2007||Yes|No|11/21/2007||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17569|||||No|No||AUROBINDO PHARM|No||||
carisoprodol|No|No|No|No|90%|65862015801|CARISOPRODOL 350 MG TABLET|100|EA|.0516|09/02/2009||Yes|No||09/02/2009||Yes|No|09/02/2009||Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|17570|||||No|No||AUROBINDO PHARM|No||||
zolpidem tartrate|No|No|No|No|90%|65862015901|ZOLPIDEM TARTRATE 5 MG TABLET|100|EA|.01982|04/04/2017||Yes|No||04/04/2017||Yes|No|04/04/2017||Yes|No||||No|No|||Prescription required|No||054|Yes|.03056|03/29/2022|.02982|03/29/2022|.03002|03/29/2022|||SEDATIVE HYPNOTICS|17571|||||No|No||AUROBINDO PHARM|No||||
zolpidem tartrate|No|No|No|No|90%|65862016001|ZOLPIDEM TARTRATE 10 MG TABLET|100|EA|.01982|04/04/2017||Yes|No||04/04/2017||Yes|No|04/04/2017||Yes|No||||No|No|||Prescription required|No||054|Yes|.0301|03/29/2022|.02937|03/29/2022|.02957|03/29/2022|||SEDATIVE HYPNOTICS|17572|||||No|No||AUROBINDO PHARM|No||||
quinapril/hydrochlorothiazide|No|No|No|No|75%|65862016190|QUINAPRIL-HCTZ 10-12.5 MG TAB|90|EA|.3944|12/16/2008||Yes|No||12/16/2008||Yes|No|12/16/2008||Yes|No||04/01/2015||Yes|No|||Prescription required|Yes|07/24/2013|113|Yes|.31182|03/01/2022|.30433|03/01/2022|.30636|03/01/2022|||ANGIOTENSIN MODULATORS|17573|||||No|No||AUROBINDO PHARM|No||||
quinapril/hydrochlorothiazide|No|No|No|No|75%|65862016290|QUINAPRIL-HCTZ 20-12.5 MG TAB|90|EA|.3944|12/16/2008||Yes|No||12/16/2008||Yes|No|12/16/2008||Yes|No||04/01/2015||Yes|No|||Prescription required|Yes|07/24/2013|113|Yes|.32878|03/29/2022|.32088|03/29/2022|.32302|03/29/2022|||ANGIOTENSIN MODULATORS|17574|||||No|No||AUROBINDO PHARM|No||||
quinapril/hydrochlorothiazide|No|No|No|No|75%|65862016390|QUINAPRIL-HCTZ 20-25 MG TAB|90|EA|.3944|12/16/2008||Yes|No||12/16/2008||Yes|No|12/16/2008||Yes|No||04/01/2015||Yes|No|||Prescription required|Yes|07/24/2013|113|Yes|.31311|03/29/2022|.30559|03/29/2022|.30763|03/29/2022|||ANGIOTENSIN MODULATORS|17575|||||No|No||AUROBINDO PHARM|No||||
atenolol|No|No|No|No|75%|65862016801|ATENOLOL 25 MG TABLET|100|EA|.01466|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||12/30/2020||Yes|No|||Prescription required|No||070|No|.02437|03/29/2022|.02378|03/29/2022|.02394|03/29/2022|||BETA-BLOCKERS|17576|||||No|No||AUROBINDO PHARM|No||||
atenolol|No|No|No|No|75%|65862016899|ATENOLOL 25 MG TABLET|1000|EA|.01464|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||12/30/2020||Yes|No|||Prescription required|No||070|No|.02437|03/29/2022|.02378|03/29/2022|.02394|03/29/2022|||BETA-BLOCKERS|17577|||||No|No||AUROBINDO PHARM|No||||
atenolol|No|No|No|No|75%|65862016901|ATENOLOL 50 MG TABLET|100|EA|.01492|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||05/17/2021||Yes|No|||Prescription required|No||070|No|.02861|03/29/2022|.02792|03/29/2022|.0281|03/29/2022|||BETA-BLOCKERS|17578|||||No|No||AUROBINDO PHARM|No||||
atenolol|No|No|No|No|75%|65862016999|ATENOLOL 50 MG TABLET|1000|EA|.0149|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||03/17/2021||Yes|No|||Prescription required|No||070|No|.02861|03/29/2022|.02792|03/29/2022|.0281|03/29/2022|||BETA-BLOCKERS|17579|||||No|No||AUROBINDO PHARM|No||||
atenolol|No|No|No|No|75%|65862017001|ATENOLOL 100 MG TABLET|100|EA|.02623|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||12/30/2020||Yes|No|||Prescription required|No||070|No|.04816|03/29/2022|.047|03/29/2022|.04731|03/29/2022|||BETA-BLOCKERS|17580|||||No|No||AUROBINDO PHARM|No||||
atenolol|No|No|No|No|75%|65862017099|ATENOLOL 100 MG TABLET|1000|EA|.02623|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||12/30/2020||Yes|No|||Prescription required|No||070|No|.04816|03/29/2022|.047|03/29/2022|.04731|03/29/2022|||BETA-BLOCKERS|17581|||||No|No||AUROBINDO PHARM|No||||
topiramate|No|No|No|No|75%|65862017160|TOPIRAMATE 25 MG TABLET|60|EA|.02866|03/22/2022||Yes|No||03/22/2022||Yes|No|03/22/2022||Yes|No||||No|No|||Prescription required|No||056|No|.03423|03/29/2022|.0334|03/29/2022|.03363|03/29/2022|||ANTICONVULSANTS|17582|||||No|No||AUROBINDO PHARM|No||||
topiramate|No|No|No|No|75%|65862017260|TOPIRAMATE 50 MG TABLET|60|EA|.03905|03/22/2022||Yes|No||03/22/2022||Yes|No|03/22/2022||Yes|No||||No|No|||Prescription required|No||056|No|.04588|03/29/2022|.04477|03/29/2022|.04507|03/29/2022|||ANTICONVULSANTS|17583|||||No|No||AUROBINDO PHARM|No||||
topiramate|No|No|No|No|75%|65862017360|TOPIRAMATE 100 MG TABLET|60|EA|.05016|03/22/2022||Yes|No||03/22/2022||Yes|No|03/22/2022||Yes|No||||No|No|||Prescription required|No||056|No|.06953|03/29/2022|.06786|03/29/2022|.06831|03/29/2022|||ANTICONVULSANTS|17584|||||No|No||AUROBINDO PHARM|No||||
penicillin V potassium|No|No|No|No|75%|65862017501|PENICILLIN VK 250 MG TABLET|100|EA|.0645|09/25/2009||Yes|No||09/25/2009||Yes|No|09/25/2009||Yes|No||04/01/2015||Yes|No|||Prescription required|No||209|No|.0637|03/29/2022|.06217|03/29/2022|.06258|03/29/2022|||PENICILLINS|17585|||||No|No||AUROBINDO PHARM|No||||
penicillin V potassium|No|No|No|No|75%|65862017601|PENICILLIN VK 500 MG TABLET|100|EA|.10879|09/25/2009||Yes|No||09/25/2009||Yes|No|09/25/2009||Yes|No||04/01/2015||Yes|No|||Prescription required|No||209|No|.10026|03/29/2022|.09785|03/29/2022|.0985|03/29/2022|||PENICILLINS|17586|||||No|No||AUROBINDO PHARM|No||||
penicillin V potassium|No|No|No|No|75%|65862017605|PENICILLIN VK 500 MG TABLET|500|EA|.09791|10/08/2009||Yes|No||10/08/2009||Yes|No|10/08/2009||Yes|No||04/01/2015||Yes|No|||Prescription required|No||209|No|.10026|03/29/2022|.09785|03/29/2022|.0985|03/29/2022|||PENICILLINS|17587|||||No|No||AUROBINDO PHARM|No||||
cefdinir|No|No|No|No|75%|65862017760|CEFDINIR 300 MG CAPSULE|60|EA|.35833|04/24/2008||Yes|No||04/24/2008||Yes|No|04/24/2008||Yes|No||||No|No|||Prescription required|No||046|No|.46443|03/29/2022|.45328|03/29/2022|.4563|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17588|||||No|No||AUROBINDO PHARM|No||||
clindamycin HCl|No|No|No|No|75%|65862018501|CLINDAMYCIN HCL 150 MG CAPSULE|100|EA|.08277|09/25/2009||Yes|No||09/25/2009||Yes|No|09/25/2009||Yes|No||04/01/2015||Yes|No|||Prescription required|No||146|No|.12382|03/29/2022|.12084|03/29/2022|.12165|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|17589|||||No|No||AUROBINDO PHARM|No||||
clindamycin HCl|No|No|No|No|75%|65862018505|CLINDAMYCIN HCL 150 MG CAPSULE|500|EA|.08028|06/22/2012||Yes|No||06/22/2012||Yes|No|06/22/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||146|No|.12382|03/29/2022|.12084|03/29/2022|.12165|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|17590|||||No|No||AUROBINDO PHARM|No||||
clindamycin HCl|No|No|No|No|75%|65862018601|CLINDAMYCIN HCL 300 MG CAPSULE|100|EA|.18498|04/04/2017||Yes|No||04/04/2017||Yes|No|04/04/2017||Yes|No||04/04/2017||Yes|No|||Prescription required|No||146|No|.25846|03/29/2022|.25225|03/29/2022|.25393|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|17591|||||No|No||AUROBINDO PHARM|No||||
ondansetron HCl|No|No|No|No|75%|65862018703|ONDANSETRON HCL 4 MG TABLET|3|EA|.37983|11/21/2007||Yes|No||11/21/2007||Yes|No|11/21/2007||Yes|No||||No|No|||Prescription required|No||085|No|.06763|03/29/2022|.066|03/29/2022|.06644|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|17592|||||No|No||AUROBINDO PHARM|No||||
ondansetron HCl|No|No|No|No|75%|65862018730|ONDANSETRON HCL 4 MG TABLET|30|EA|.07883|11/21/2007||Yes|No||11/21/2007||Yes|No|11/21/2007||Yes|No||||No|No|||Prescription required|No||085|No|.06763|03/29/2022|.066|03/29/2022|.06644|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|17593|||||No|No||AUROBINDO PHARM|No||||
ondansetron HCl|No|No|No|No|75%|65862018803|ONDANSETRON HCL 8 MG TABLET|3|EA|.63783|11/21/2007||Yes|No||11/21/2007||Yes|No|11/21/2007||Yes|No||||No|No|||Prescription required|No||085|No|.09975|03/29/2022|.09735|03/29/2022|.098|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|17594|||||No|No||AUROBINDO PHARM|No||||
ondansetron HCl|No|No|No|No|75%|65862018830|ONDANSETRON HCL 8 MG TABLET|30|EA|.08241|11/21/2007||Yes|No||11/21/2007||Yes|No|11/21/2007||Yes|No||||No|No|||Prescription required|No||085|No|.09975|03/29/2022|.09735|03/29/2022|.098|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|17595|||||No|No||AUROBINDO PHARM|No||||
cyclobenzaprine HCl|No|No|No|No|75%|65862019105|CYCLOBENZAPRINE 10 MG TABLET|500|EA|.0301|04/04/2017||Yes|No||04/04/2017||Yes|No|04/04/2017||Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|17596|||||No|No||AUROBINDO PHARM|No||||
fluoxetine HCl|Yes|No|No|No|75%|65862019201|FLUOXETINE HCL 10 MG CAPSULE|100|EA|.02485|11/26/2008||Yes|No||11/26/2008||Yes|No|11/26/2008||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17597|||||No|No||AUROBINDO PHARM|No||||
fluoxetine HCl|Yes|No|No|No|75%|65862019299|FLUOXETINE HCL 10 MG CAPSULE|1000|EA|.02149|11/26/2008||Yes|No||11/26/2008||Yes|No|11/26/2008||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17598|||||No|No||AUROBINDO PHARM|No||||
fluoxetine HCl|Yes|No|No|No|75%|65862019301|FLUOXETINE HCL 20 MG CAPSULE|100|EA|.02863|11/26/2008||Yes|No||11/26/2008||Yes|No|11/26/2008||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17599|||||No|No||AUROBINDO PHARM|No||||
fluoxetine HCl|Yes|No|No|No|75%|65862019399|FLUOXETINE HCL 20 MG CAPSULE|1000|EA|.01612|11/26/2008||Yes|No||11/26/2008||Yes|No|11/26/2008||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17600|||||No|No||AUROBINDO PHARM|No||||
fluoxetine HCl|Yes|No|No|No|75%|65862019401|FLUOXETINE HCL 40 MG CAPSULE|100|EA|.05018|08/01/2017||Yes|No||08/01/2017||Yes|No|08/01/2017||Yes|No||||No|No|08/01/2017||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17601|||||No|No||AUROBINDO PHARM|No||||
fluoxetine HCl|Yes|No|No|No|75%|65862019405|FLUOXETINE HCL 40 MG CAPSULE|500|EA|.02924|05/22/2014||Yes|No||05/22/2014||Yes|No|05/22/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17602|||||No|No||AUROBINDO PHARM|No||||
fluoxetine HCl|Yes|No|No|No|75%|65862019430|FLUOXETINE HCL 40 MG CAPSULE|30|EA|.05016|11/26/2008||Yes|No||11/26/2008||Yes|No|11/26/2008||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17603|||||No|No||AUROBINDO PHARM|No||||
fluoxetine HCl|Yes|No|No|No|75%|65862019499|FLUOXETINE HCL 40 MG CAPSULE|1000|EA|.0301|05/22/2014||Yes|No||05/22/2014||Yes|No|05/22/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17604|||||No|No||AUROBINDO PHARM|No||||
gabapentin|No|No|No|No|75%|65862019801|GABAPENTIN 100 MG CAPSULE|100|EA|.0215|06/15/2010||Yes|No||06/15/2010||Yes|No|06/15/2010||Yes|No||04/01/2015||Yes|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|17605|||||No|No||AUROBINDO PHARM|No||||
gabapentin|No|No|No|No|75%|65862019805|GABAPENTIN 100 MG CAPSULE|500|EA|.0215|06/15/2010||Yes|No||06/15/2010||Yes|No|06/15/2010||Yes|No||04/01/2015||Yes|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|17606|||||No|No||AUROBINDO PHARM|No||||
gabapentin|No|No|No|No|75%|65862019899|GABAPENTIN 100 MG CAPSULE|1000|EA|.0215|06/15/2010||Yes|No||06/15/2010||Yes|No|06/15/2010||Yes|No||04/01/2015||Yes|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|17607|||||No|No||AUROBINDO PHARM|No||||
gabapentin|No|No|No|No|75%|65862019901|GABAPENTIN 300 MG CAPSULE|100|EA|.0344|06/15/2010||Yes|No||06/15/2010||Yes|No|06/15/2010||Yes|No||04/01/2015||Yes|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|17608|||||No|No||AUROBINDO PHARM|No||||
gabapentin|No|No|No|No|75%|65862019905|GABAPENTIN 300 MG CAPSULE|500|EA|.0344|09/27/2010||Yes|No||09/27/2010||Yes|No|09/27/2010||Yes|No||04/01/2015||Yes|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|17609|||||No|No||AUROBINDO PHARM|No||||
gabapentin|No|No|No|No|75%|65862019999|GABAPENTIN 300 MG CAPSULE|1000|EA|.03225|06/15/2010||Yes|No||06/15/2010||Yes|No|06/15/2010||Yes|No||04/01/2015||Yes|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|17610|||||No|No||AUROBINDO PHARM|No||||
gabapentin|No|No|No|No|75%|65862020001|GABAPENTIN 400 MG CAPSULE|100|EA|.0344|06/15/2010||Yes|No||06/15/2010||Yes|No|06/15/2010||Yes|No||04/01/2015||Yes|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|17611|||||No|No||AUROBINDO PHARM|No||||
gabapentin|No|No|No|No|75%|65862020005|GABAPENTIN 400 MG CAPSULE|500|EA|.0344|06/15/2010||Yes|No||06/15/2010||Yes|No|06/15/2010||Yes|No||04/01/2015||Yes|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|17612|||||No|No||AUROBINDO PHARM|No||||
losartan potassium|Yes|No|No|No|75%|65862020190|LOSARTAN POTASSIUM 25 MG TAB|90|EA|.03344|10/19/2010||Yes|No||10/19/2010||Yes|No|10/19/2010||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|17613|||||No|No||AUROBINDO PHARM|No||||
losartan potassium|Yes|No|No|No|75%|65862020199|LOSARTAN POTASSIUM 25 MG TAB|1000|EA|.0165|10/19/2010||Yes|No||10/19/2010||Yes|No|10/19/2010||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|17614|||||No|No||AUROBINDO PHARM|No||||
losartan potassium|Yes|No|No|No|75%|65862020230|LOSARTAN POTASSIUM 50 MG TAB|30|EA|.03812|10/19/2010||Yes|No||10/19/2010||Yes|No|10/19/2010||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|17615|||||No|No||AUROBINDO PHARM|No||||
losartan potassium|Yes|No|No|No|75%|65862020290|LOSARTAN POTASSIUM 50 MG TAB|90|EA|.04085|10/19/2010||Yes|No||10/19/2010||Yes|No|10/19/2010||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|17616|||||No|No||AUROBINDO PHARM|No||||
losartan potassium|Yes|No|No|No|75%|65862020299|LOSARTAN POTASSIUM 50 MG TAB|1000|EA|.02369|10/19/2010||Yes|No||10/19/2010||Yes|No|10/19/2010||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|17617|||||No|No||AUROBINDO PHARM|No||||
losartan potassium|Yes|No|No|No|75%|65862020330|LOSARTAN POTASSIUM 100 MG TAB|30|EA|.04629|10/19/2010||Yes|No||10/19/2010||Yes|No|10/19/2010||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|17618|||||No|No||AUROBINDO PHARM|No||||
losartan potassium|Yes|No|No|No|75%|65862020390|LOSARTAN POTASSIUM 100 MG TAB|90|EA|.0612|10/19/2010||Yes|No||10/19/2010||Yes|No|10/19/2010||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|17619|||||No|No||AUROBINDO PHARM|No||||
losartan potassium|Yes|No|No|No|75%|65862020399|LOSARTAN POTASSIUM 100 MG TAB|1000|EA|.0299|10/19/2010||Yes|No||10/19/2010||Yes|No|10/19/2010||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|17620|||||No|No||AUROBINDO PHARM|No||||
ribavirin|No|No|No|No|75%|65862020768|RIBAVIRIN 200 MG TABLET|168|EA|.26337|07/07/2020||Yes|No||07/07/2020||Yes|No|07/07/2020||Yes|No||||No|No|||Prescription required|No||064|No|.60025|07/07/2020|.59167|07/07/2020|.5635|07/07/2020|||HEPATITIS C AGENTS|17621|||||No|No||AUROBINDO PHARM|No||||
minocycline HCl|No|No|No|No|75%|65862020901|MINOCYCLINE 50 MG CAPSULE|100|EA|.11395|11/02/2009||Yes|No||11/02/2009||Yes|No|11/02/2009||Yes|No||11/02/2009||Yes|No|||Prescription required|No||213|No|.20366|03/29/2022|.19877|03/29/2022|.20009|03/29/2022|||TETRACYCLINES|17622|||||No|No||AUROBINDO PHARM|No||||
minocycline HCl|No|No|No|No|75%|65862021001|MINOCYCLINE 75 MG CAPSULE|100|EA|.27563|11/02/2009||Yes|No||11/02/2009||Yes|No|11/02/2009||Yes|No||11/02/2009||Yes|No|||Prescription required|No||213|No|.36632|10/26/2021|.35752|10/26/2021|.3599|10/26/2021|||TETRACYCLINES|17623|||||No|No||AUROBINDO PHARM|No||||
minocycline HCl|No|No|No|No|75%|65862021105|MINOCYCLINE 100 MG CAPSULE|500|EA|.22753|09/11/2015||Yes|No||09/11/2015||Yes|No|09/11/2015||Yes|No||09/11/2015||Yes|No|||Prescription required|No||213|No|.38664|03/29/2022|.37736|03/29/2022|.37987|03/29/2022|||TETRACYCLINES|17624|||||No|No||AUROBINDO PHARM|No||||
minocycline HCl|No|No|No|No|75%|65862021150|MINOCYCLINE 100 MG CAPSULE|50|EA|.23951|11/02/2009||Yes|No||11/02/2009||Yes|No|11/02/2009||Yes|No||11/02/2009||Yes|No|||Prescription required|No||213|No|.38664|03/29/2022|.37736|03/29/2022|.37987|03/29/2022|||TETRACYCLINES|17625|||||No|No||AUROBINDO PHARM|No||||
zaleplon|No|No|No|No|90%|65862021401|ZALEPLON 5 MG CAPSULE|100|EA|.0903|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||054|Yes|.1639|03/29/2022|.15996|03/29/2022|.16103|03/29/2022|||SEDATIVE HYPNOTICS|17626|||||No|No||AUROBINDO PHARM|No||||
zaleplon|No|No|No|No|90%|65862021501|ZALEPLON 10 MG CAPSULE|100|EA|.086|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||054|Yes|.18241|03/29/2022|.17803|03/29/2022|.17921|03/29/2022|||SEDATIVE HYPNOTICS|17627|||||No|No||AUROBINDO PHARM|No||||
cefdinir|No|No|No|No|75%|65862021801|CEFDINIR 125 MG/5 ML SUSP|100|ML|.1075|04/24/2008||Yes|No||04/24/2008||Yes|No|04/24/2008||Yes|No||||No|No|||Prescription required|No||046|No|.11292|03/29/2022|.1102|03/29/2022|.11094|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17628|||||No|No||AUROBINDO PHARM|No||||
cefdinir|No|No|No|No|75%|65862021860|CEFDINIR 125 MG/5 ML SUSP|60|ML|.14333|04/24/2008||Yes|No||04/24/2008||Yes|No|04/24/2008||Yes|No||||No|No|||Prescription required|No||046|No|.15822|03/29/2022|.15442|03/29/2022|.15545|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17629|||||No|No||AUROBINDO PHARM|No||||
cefdinir|No|No|No|No|75%|65862021901|CEFDINIR 250 MG/5 ML SUSP|100|ML|.1075|04/24/2008||Yes|No||04/24/2008||Yes|No|04/24/2008||Yes|No||||No|No|||Prescription required|No||046|No|.18689|03/29/2022|.1824|03/29/2022|.18361|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17630|||||No|No||AUROBINDO PHARM|No||||
cefdinir|No|No|No|No|75%|65862021960|CEFDINIR 250 MG/5 ML SUSP|60|ML|.14333|04/24/2008||Yes|No||04/24/2008||Yes|No|04/24/2008||Yes|No||||No|No|||Prescription required|No||046|No|.18029|03/29/2022|.17596|03/29/2022|.17713|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17631|||||No|No||AUROBINDO PHARM|No||||
clarithromycin|No|No|No|No|75%|65862022560|CLARITHROMYCIN 250 MG TABLET|60|EA|.40133|08/28/2012||Yes|No||08/28/2012||Yes|No|08/28/2012||Yes|No||||No|No|||Prescription required|No||018|No|.54294|03/29/2022|.5299|03/29/2022|.53343|03/29/2022|||MACROLIDES/KETOLIDES|17632|||||No|No||AUROBINDO PHARM|No||||
clarithromycin|No|No|No|No|75%|65862022660|CLARITHROMYCIN 500 MG TABLET|60|EA|.40133|08/28/2012||Yes|No||08/28/2012||Yes|No|08/28/2012||Yes|No||||No|No|||Prescription required|No||018|No|.44307|03/29/2022|.43243|03/29/2022|.43531|03/29/2022|||MACROLIDES/KETOLIDES|17633|||||No|No||AUROBINDO PHARM|No||||
lamotrigine|No|No|No|No|75%|65862022701|LAMOTRIGINE 25 MG TABLET|100|EA|.08922|03/25/2009||Yes|No||03/25/2009||Yes|No|03/25/2009||Yes|No||||No|No|||Prescription required|No||056|No|.03514|03/29/2022|.03429|03/29/2022|.03452|03/29/2022|||ANTICONVULSANTS|17634|||||No|No||AUROBINDO PHARM|No||||
lamotrigine|No|No|No|No|75%|65862022801|LAMOTRIGINE 100 MG TABLET|100|EA|.10148|03/25/2009||Yes|No||03/25/2009||Yes|No|03/25/2009||Yes|No||||No|No|||Prescription required|No||056|No|.06403|03/29/2022|.06249|03/29/2022|.0629|03/29/2022|||ANTICONVULSANTS|17635|||||No|No||AUROBINDO PHARM|No||||
lamotrigine|No|No|No|No|75%|65862022901|LAMOTRIGINE 150 MG TABLET|100|EA|.12448|03/25/2009||Yes|No||03/25/2009||Yes|No|03/25/2009||Yes|No||||No|No|||Prescription required|No||056|No|.0888|03/29/2022|.08666|03/29/2022|.08724|03/29/2022|||ANTICONVULSANTS|17636|||||No|No||AUROBINDO PHARM|No||||
lamotrigine|No|No|No|No|75%|65862022960|LAMOTRIGINE 150 MG TABLET|60|EA|.13115|03/25/2009||Yes|No||03/25/2009||Yes|No|03/25/2009||Yes|No||||No|No|||Prescription required|No||056|No|.0888|03/29/2022|.08666|03/29/2022|.08724|03/29/2022|||ANTICONVULSANTS|17637|||||No|No||AUROBINDO PHARM|No||||
lamotrigine|No|No|No|No|75%|65862023001|LAMOTRIGINE 200 MG TABLET|100|EA|.1348|03/25/2009||Yes|No||03/25/2009||Yes|No|03/25/2009||Yes|No||||No|No|||Prescription required|No||056|No|.10103|03/29/2022|.0986|03/29/2022|.09926|03/29/2022|||ANTICONVULSANTS|17638|||||No|No||AUROBINDO PHARM|No||||
lamotrigine|No|No|No|No|75%|65862023060|LAMOTRIGINE 200 MG TABLET|60|EA|.1419|03/25/2009||Yes|No||03/25/2009||Yes|No|03/25/2009||Yes|No||||No|No|||Prescription required|No||056|No|.10103|03/29/2022|.0986|03/29/2022|.09926|03/29/2022|||ANTICONVULSANTS|17639|||||No|No||AUROBINDO PHARM|No||||
ibandronate sodium|No|No|No|No|75%|65862023703|IBANDRONATE SODIUM 150 MG TAB|3|EA|4.29283|05/25/2017||Yes|No||05/25/2017||Yes|No|05/25/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|060|No|5.47616|03/29/2022|5.34473|03/29/2022|5.38032|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|17640|||||No|No||AUROBINDO PHARM|No||||
levetiracetam|No|No|No|No|75%|65862024508|LEVETIRACETAM 250 MG TABLET|120|EA|.08778|05/07/2009||Yes|No||05/07/2009||Yes|No|05/07/2009||Yes|No||||No|No|||Prescription required|No||056|No|.08073|03/29/2022|.07879|03/29/2022|.07931|03/29/2022|||ANTICONVULSANTS|17641|||||No|No||AUROBINDO PHARM|No||||
levetiracetam|No|No|No|No|75%|65862024605|LEVETIRACETAM 500 MG TABLET|500|EA|.11544|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|17642|||||No|No||AUROBINDO PHARM|No||||
levetiracetam|No|No|No|No|75%|65862024608|LEVETIRACETAM 500 MG TABLET|120|EA|.10391|05/07/2009||Yes|No||05/07/2009||Yes|No|05/07/2009||Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|17643|||||No|No||AUROBINDO PHARM|No||||
levetiracetam|No|No|No|No|75%|65862024708|LEVETIRACETAM 750 MG TABLET|120|EA|.129|05/07/2009||Yes|No||05/07/2009||Yes|No|05/07/2009||Yes|No||||No|No|||Prescription required|No||056|No|.15853|03/29/2022|.15472|03/29/2022|.15575|03/29/2022|||ANTICONVULSANTS|17644|||||No|No||AUROBINDO PHARM|No||||
levetiracetam|No|No|No|No|75%|65862025047|LEVETIRACETAM 100 MG/ML SOLN|473|ML|.02727|03/22/2022||Yes|No||03/22/2022||Yes|No|03/22/2022||Yes|No||||No|No|||Prescription required|No||056|No|.03146|03/29/2022|.0307|03/29/2022|.0309|03/29/2022|||ANTICONVULSANTS|17645|||||No|No||AUROBINDO PHARM|No||||
perindopril erbumine|Yes|No|No|No|75%|65862028601|PERINDOPRIL ERBUMINE 2 MG TAB|100|EA|.2408|11/12/2009||Yes|No||11/12/2009||Yes|No|11/12/2009||Yes|No||||No|No|07/01/2016||Prescription required|Yes|02/10/2009|113|No|.5488|06/01/2016|.54096|06/01/2016|.5152|06/01/2016|||ANGIOTENSIN MODULATORS|17646|||||No|No||AUROBINDO PHARM|No||||
perindopril erbumine|Yes|No|No|No|75%|65862028701|PERINDOPRIL ERBUMINE 4 MG TAB|100|EA|.2537|11/12/2009||Yes|No||11/12/2009||Yes|No|11/12/2009||Yes|No||||No|No|07/01/2016||Prescription required|Yes|02/10/2009|113|No|.48097|07/27/2021|.46942|07/27/2021|.47255|07/27/2021|||ANGIOTENSIN MODULATORS|17647|||||No|No||AUROBINDO PHARM|No||||
perindopril erbumine|Yes|No|No|No|75%|65862028801|PERINDOPRIL ERBUMINE 8 MG TAB|100|EA|.2795|11/12/2009||Yes|No||11/12/2009||Yes|No|11/12/2009||Yes|No||||No|No|07/01/2016||Prescription required|Yes|02/10/2009|113|No|.45998|08/24/2021|.44894|08/24/2021|.45193|08/24/2021|||ANGIOTENSIN MODULATORS|17648|||||No|No||AUROBINDO PHARM|No||||
ribavirin|No|No|No|No|75%|65862029018|RIBAVIRIN 200 MG CAPSULE|180|EA|.56867|02/01/2010||Yes|No||02/01/2010||Yes|No|02/01/2010||Yes|No||||No|No|||Prescription required|No||064|No|1.29605|06/27/2017|1.27753|06/27/2017|1.2167|06/27/2017|||HEPATITIS C AGENTS|17649|||||No|No||AUROBINDO PHARM|No||||
ribavirin|No|No|No|No|75%|65862029042|RIBAVIRIN 200 MG CAPSULE|42|EA|.58848|02/01/2010||Yes|No||02/01/2010||Yes|No|02/01/2010||Yes|No||||No|No|||Prescription required|No||064|No|1.34119|06/27/2017|1.32203|06/27/2017|1.25908|06/27/2017|||HEPATITIS C AGENTS|17650|||||No|No||AUROBINDO PHARM|No||||
ribavirin|No|No|No|No|75%|65862029056|RIBAVIRIN 200 MG CAPSULE|56|EA|.58349|02/01/2010||Yes|No||02/01/2010||Yes|No|02/01/2010||Yes|No||||No|No|||Prescription required|No||064|No|1.32982|06/27/2017|1.31082|06/27/2017|1.2484|06/27/2017|||HEPATITIS C AGENTS|17651|||||No|No||AUROBINDO PHARM|No||||
ribavirin|No|No|No|No|75%|65862029070|RIBAVIRIN 200 MG CAPSULE|70|EA|.57859|02/01/2010||Yes|No||02/01/2010||Yes|No|02/01/2010||Yes|No||||No|No|||Prescription required|No||064|No|1.31865|06/27/2017|1.29982|06/27/2017|1.23792|06/27/2017|||HEPATITIS C AGENTS|17652|||||No|No||AUROBINDO PHARM|No||||
ribavirin|No|No|No|No|75%|65862029084|RIBAVIRIN 200 MG CAPSULE|84|EA|.57363|02/01/2010||Yes|No||02/01/2010||Yes|No|02/01/2010||Yes|No||||No|No|||Prescription required|No||064|No|1.30735|06/27/2017|1.28868|06/27/2017|1.22731|06/27/2017|||HEPATITIS C AGENTS|17653|||||No|No||AUROBINDO PHARM|No||||
rosuvastatin calcium|Yes|No|No|No|75%|65862029390|ROSUVASTATIN CALCIUM 5 MG TAB|90|EA|.08121|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No||12/03/2018||Yes|No|06/18/2019||Prescription required|No||063|Yes|.06753|03/29/2022|.0659|03/29/2022|.06634|03/29/2022|||LIPOTROPICS: STATINS|17654|||||No|No||AUROBINDO PHARM|No||||
rosuvastatin calcium|Yes|No|No|No|75%|65862029490|ROSUVASTATIN CALCIUM 10 MG TAB|90|EA|.08121|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No||12/03/2018||Yes|No|06/18/2019||Prescription required|No||063|Yes|.05981|03/29/2022|.05837|03/29/2022|.05876|03/29/2022|||LIPOTROPICS: STATINS|17655|||||No|No||AUROBINDO PHARM|No||||
rosuvastatin calcium|Yes|No|No|No|75%|65862029590|ROSUVASTATIN CALCIUM 20 MG TAB|90|EA|.08121|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No||12/03/2018||Yes|No|06/18/2019||Prescription required|No||063|Yes|.07822|03/29/2022|.07634|03/29/2022|.07685|03/29/2022|||LIPOTROPICS: STATINS|17656|||||No|No||AUROBINDO PHARM|No||||
rosuvastatin calcium|Yes|No|No|No|75%|65862029630|ROSUVASTATIN CALCIUM 40 MG TAB|30|EA|.08127|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No||12/03/2018||Yes|No|06/18/2019||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|17657|||||No|No||AUROBINDO PHARM|No||||
rosuvastatin calcium|Yes|No|No|No|75%|65862029690|ROSUVASTATIN CALCIUM 40 MG TAB|90|EA|.08121|02/27/2020||Yes|No||02/27/2020||Yes|No|02/27/2020||Yes|No||02/27/2020||Yes|No|03/20/2020||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|17658|||||No|No||AUROBINDO PHARM|No||||
fluoxetine HCl|No|No|No|No|75%|65862030612|FLUOXETINE 20 MG/5 ML SOLUTION|120|ML|.24725|11/30/2020||Yes|No||11/30/2020||Yes|No|11/30/2020||Yes|No||||No|No|||Prescription required|No||008|No|.3776|03/29/2022|.36853|03/29/2022|.37099|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17659|||||No|No||AUROBINDO PHARM|No||||
fosinopril/hydrochlorothiazide|No|No|No|No|75%|65862030801|FOSINOPRIL-HCTZ 10-12.5 MG TAB|100|EA|.48805|09/04/2010||Yes|No||09/04/2010||Yes|No|09/04/2010||Yes|No||04/01/2015||Yes|No|||Prescription required|Yes|07/24/2013|113|Yes|1.1123|07/28/2020|1.09641|07/28/2020|1.0442|07/28/2020|||ANGIOTENSIN MODULATORS|17660|||||No|No||AUROBINDO PHARM|No||||
fosinopril/hydrochlorothiazide|No|No|No|No|75%|65862030901|FOSINOPRIL-HCTZ 20-12.5 MG TAB|100|EA|.48805|10/13/2009||Yes|No||10/13/2009||Yes|No|10/13/2009||Yes|No||04/01/2015||Yes|No|||Prescription required|Yes|07/24/2013|113|Yes|1.1123|06/29/2021|1.09641|06/29/2021|1.0442|06/29/2021|||ANGIOTENSIN MODULATORS|17661|||||No|No||AUROBINDO PHARM|No||||
didanosine|No|No|No|No|75%|65862031230|DIDANOSINE DR 250 MG CAPSULE|30|EA|3.39939|12/10/2008||Yes|No||12/10/2008||Yes|No|12/10/2008||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|5.55234|06/01/2016|5.47302|06/01/2016|5.2124|06/01/2016|||HIV / AIDS|17662|||||No|No||AUROBINDO PHARM|No||||
didanosine|No|No|No|No|75%|65862031330|DIDANOSINE DR 400 MG CAPSULE|30|EA|5.30959|12/10/2008||Yes|No||12/10/2008||Yes|No|12/10/2008||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|8.67234|06/01/2016|8.54845|06/01/2016|8.14138|06/01/2016|||HIV / AIDS|17663|||||No|No||AUROBINDO PHARM|No||||
levetiracetam|No|No|No|No|75%|65862031560|LEVETIRACETAM 1,000 MG TABLET|60|EA|.28666|05/07/2009||Yes|No||05/07/2009||Yes|No|05/07/2009||Yes|No||||No|No|||Prescription required|No||056|No|.22789|03/29/2022|.22242|03/29/2022|.2239|03/29/2022|||ANTICONVULSANTS|17664|||||No|No||AUROBINDO PHARM|No||||
alendronate sodium|No|No|No|No|75%|65862032804|ALENDRONATE SODIUM 35 MG TAB|4|EA|.80625|08/04/2020||Yes|No||08/04/2020||Yes|No|08/04/2020||Yes|No||||No|No|||Prescription required|No||060|No|.34811|03/29/2022|.33975|03/29/2022|.34201|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|17665|||||No|No||AUROBINDO PHARM|No||||
alendronate sodium|No|No|No|No|75%|65862032904|ALENDRONATE SODIUM 70 MG TAB|4|EA|.59125|08/12/2008||Yes|No||08/12/2008||Yes|No|08/12/2008||Yes|No||||No|No|||Prescription required|No||060|No|.29635|03/29/2022|.28923|03/29/2022|.29116|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|17666|||||No|No||AUROBINDO PHARM|No||||
abacavir sulfate/lamivudine|No|No|No|No|75%|65862033530|ABACAVIR-LAMIVUDINE 600-300 MG|30|EA|3.69499|05/19/2020||Yes|No||05/19/2020||Yes|No|05/19/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|2.09447|03/29/2022|2.0442|03/29/2022|2.05781|03/29/2022|||HIV / AIDS|17667|||||No|No||AUROBINDO PHARM|No||||
emtricitabine/tenofovir (TDF)|No|No|No|No|75%|65862035430|EMTRICITABINE-TENOFV 200-300MG|30|EA|.6|12/13/2021||Yes|No||12/13/2021||Yes|No|12/13/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.70347|03/29/2022|.68658|03/29/2022|.69115|03/29/2022|||HIV / AIDS|17668|||||No|No||AUROBINDO PHARM|No||||
clopidogrel bisulfate|No|No|No|No|75%|65862035705|CLOPIDOGREL 75 MG TABLET|500|EA|.07163|05/21/2012||Yes|No||05/21/2012||Yes|No|05/21/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|17669|||||No|No||AUROBINDO PHARM|Yes|09/01/2020|||
clopidogrel bisulfate|No|No|No|No|75%|65862035730|CLOPIDOGREL 75 MG TABLET|30|EA|.07166|05/21/2012||Yes|No||05/21/2012||Yes|No|05/21/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|17670|||||No|No||AUROBINDO PHARM|No||||
clopidogrel bisulfate|No|No|No|No|75%|65862035761|CLOPIDOGREL 75 MG TABLET|6000|EA|.07163|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||02/16/2022||Yes|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|17671|||||No|No||AUROBINDO PHARM|No||||
clopidogrel bisulfate|No|No|No|No|75%|65862035790|CLOPIDOGREL 75 MG TABLET|90|EA|.07166|05/21/2012||Yes|No||05/21/2012||Yes|No|05/21/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|17672|||||No|No||AUROBINDO PHARM|Yes|09/01/2020|||
lamotrigine|No|No|No|No|75%|65862036101|LAMOTRIGINE 5 MG DISPER TABLET|100|EA|.129|11/30/2020||Yes|No||11/30/2020||Yes|No|11/30/2020||Yes|No||||No|No|||Prescription required|No||056|No|.28106|12/28/2021|.27431|12/28/2021|.27614|12/28/2021|||ANTICONVULSANTS|17673|||||No|No||AUROBINDO PHARM|No||||
lamotrigine|No|No|No|No|75%|65862036201|LAMOTRIGINE 25 MG DISPER TAB|100|EA|.13545|11/30/2020||Yes|No||11/30/2020||Yes|No|11/30/2020||Yes|No||||No|No|||Prescription required|No||056|No|.29045|03/29/2022|.28347|03/29/2022|.28536|03/29/2022|||ANTICONVULSANTS|17674|||||No|No||AUROBINDO PHARM|No||||
escitalopram oxalate|Yes|No|No|No|75%|65862037301|ESCITALOPRAM 5 MG TABLET|100|EA|.10191|09/10/2012||Yes|No||09/10/2012||Yes|No|09/10/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.0462|03/29/2022|.04509|03/29/2022|.04539|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17675|||||No|No||AUROBINDO PHARM|No||||
escitalopram oxalate|Yes|No|No|No|75%|65862037305|ESCITALOPRAM 5 MG TABLET|500|EA|.09687|09/10/2012||Yes|No||09/10/2012||Yes|No|09/10/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.0462|03/29/2022|.04509|03/29/2022|.04539|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17676|||||No|No||AUROBINDO PHARM|No||||
escitalopram oxalate|Yes|No|No|No|75%|65862037401|ESCITALOPRAM 10 MG TABLET|100|EA|.10642|09/10/2012||Yes|No||09/10/2012||Yes|No|09/10/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17677|||||No|No||AUROBINDO PHARM|No||||
escitalopram oxalate|Yes|No|No|No|75%|65862037405|ESCITALOPRAM 10 MG TABLET|500|EA|.10113|09/10/2012||Yes|No||09/10/2012||Yes|No|09/10/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17678|||||No|No||AUROBINDO PHARM|No||||
escitalopram oxalate|Yes|No|No|No|75%|65862037501|ESCITALOPRAM 20 MG TABLET|100|EA|.11416|09/10/2012||Yes|No||09/10/2012||Yes|No|09/10/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.07845|03/29/2022|.07656|03/29/2022|.07707|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17679|||||No|No||AUROBINDO PHARM|No||||
escitalopram oxalate|Yes|No|No|No|75%|65862037505|ESCITALOPRAM 20 MG TABLET|500|EA|.10848|09/10/2012||Yes|No||09/10/2012||Yes|No|09/10/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.07845|03/29/2022|.07656|03/29/2022|.07707|03/29/2022|||ANTIDEPRESSANTS: SSRIs|17680|||||No|No||AUROBINDO PHARM|No||||
ondansetron|No|No|No|No|75%|65862039010|ONDANSETRON ODT 4 MG TABLET|30|EA|.26301|05/23/2012||Yes|No||05/23/2012||Yes|No|05/23/2012||Yes|No||||No|No|||Prescription required|No||085|No|.24125|03/29/2022|.23546|03/29/2022|.23702|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|17681|||||No|No||AUROBINDO PHARM|No||||
ondansetron|No|No|No|No|75%|65862039110|ONDANSETRON ODT 8 MG TABLET|30|EA|.36335|05/23/2012||Yes|No||05/23/2012||Yes|No|05/23/2012||Yes|No||||No|No|||Prescription required|No||085|No|.24386|03/29/2022|.238|03/29/2022|.23959|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|17682|||||No|No||AUROBINDO PHARM|No||||
sulfamethoxazole/trimethoprim|Yes|No|No|No|75%|65862041901|SULFAMETHOXAZOLE-TMP SS TABLET|100|EA|.0258|02/15/2011||Yes|No||02/15/2011||Yes|No|02/15/2011||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No|||No|.07038|03/29/2022|.06869|03/29/2022|.06914|03/29/2022||||17683|||||No|No||AUROBINDO PHARM|No||||
sulfamethoxazole/trimethoprim|Yes|No|No|No|75%|65862041905|SULFAMETHOXAZOLE-TMP SS TABLET|500|EA|.02494|02/15/2011||Yes|No||02/15/2011||Yes|No|02/15/2011||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No|||No|.07038|03/29/2022|.06869|03/29/2022|.06914|03/29/2022||||17684|||||No|No||AUROBINDO PHARM|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|65862042001|SULFAMETHOXAZOLE-TMP DS TABLET|100|EA|.02709|02/15/2011||Yes|No||02/15/2011||Yes|No|02/15/2011||Yes|No||04/01/2015||Yes|No|||Prescription required|No|||No|.06566|03/29/2022|.06408|03/29/2022|.06451|03/29/2022||||17685|||||No|No||AUROBINDO PHARM|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|65862042005|SULFAMETHOXAZOLE-TMP DS TABLET|500|EA|.0258|02/15/2011||Yes|No||02/15/2011||Yes|No|02/15/2011||Yes|No||04/01/2015||Yes|No|||Prescription required|No|||No|.06566|03/29/2022|.06408|03/29/2022|.06451|03/29/2022||||17686|||||No|No||AUROBINDO PHARM|No||||
tenofovir disoproxil fumarate|No|No|No|No|75%|65862042130|TENOFOVIR DISOP FUM 300 MG TB|30|EA|1.2|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.62458|03/29/2022|.60959|03/29/2022|.61364|03/29/2022|||HIV / AIDS|17687|||||No|No||AUROBINDO PHARM|No||||
valacyclovir HCl|No|No|No|No|75%|65862044830|VALACYCLOVIR HCL 500 MG TABLET|30|EA|.35016|06/15/2010||Yes|No||06/15/2010||Yes|No|06/15/2010||Yes|No||04/01/2015||Yes|No|||Prescription required|No||025|No|.29328|03/29/2022|.28624|03/29/2022|.28814|03/29/2022|||ANTIVIRALS: ORAL|17688|||||No|No||AUROBINDO PHARM|No||||
valacyclovir HCl|No|No|No|No|75%|65862044890|VALACYCLOVIR HCL 500 MG TABLET|90|EA|.35016|12/10/2010||Yes|No||12/10/2010||Yes|No|12/10/2010||Yes|No||04/01/2015||Yes|No|||Prescription required|No||025|No|.29328|03/29/2022|.28624|03/29/2022|.28814|03/29/2022|||ANTIVIRALS: ORAL|17689|||||No|No||AUROBINDO PHARM|No||||
valacyclovir HCl|Yes|No|No|No|75%|65862044930|VALACYCLOVIR HCL 1 GRAM TABLET|30|EA|.55728|06/15/2010||Yes|No||06/15/2010||Yes|No|06/15/2010||Yes|No||04/01/2015||Yes|No|11/01/2012||Prescription required|No||025|No|.5737|03/29/2022|.55993|03/29/2022|.56366|03/29/2022|||ANTIVIRALS: ORAL|17690|||||No|No||AUROBINDO PHARM|No||||
valacyclovir HCl|Yes|No|No|No|75%|65862044990|VALACYCLOVIR HCL 1 GRAM TABLET|90|EA|.55728|12/10/2010||Yes|No||12/10/2010||Yes|No|12/10/2010||Yes|No||04/01/2015||Yes|No|11/01/2012||Prescription required|No||025|No|.5737|03/29/2022|.55993|03/29/2022|.56366|03/29/2022|||ANTIVIRALS: ORAL|17691|||||No|No||AUROBINDO PHARM|No||||
alprazolam|No|No|No|No|90%|65862045460|ALPRAZOLAM ER 0.5 MG TABLET|60|EA|.14333|06/25/2012||Yes|No||06/25/2012||Yes|No|06/25/2012||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|.20761|03/29/2022|.20262|03/29/2022|.20397|03/29/2022|||ANXIOLYTICS|17692|||||No|No||AUROBINDO PHARM|No||||
alprazolam|No|No|No|No|90%|65862045560|ALPRAZOLAM ER 1 MG TABLET|60|EA|.14512|06/25/2012||Yes|No||06/25/2012||Yes|No|06/25/2012||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|.20127|03/29/2022|.19643|03/29/2022|.19774|03/29/2022|||ANXIOLYTICS|17693|||||No|No||AUROBINDO PHARM|No||||
alprazolam|No|No|No|No|90%|65862045660|ALPRAZOLAM ER 2 MG TABLET|60|EA|.14691|06/25/2012||Yes|No||06/25/2012||Yes|No|06/25/2012||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|.3342|03/29/2022|.32617|03/29/2022|.32835|03/29/2022|||ANXIOLYTICS|17694|||||No|No||AUROBINDO PHARM|No||||
alprazolam|No|No|No|No|90%|65862045760|ALPRAZOLAM ER 3 MG TABLET|60|EA|.15013|06/25/2012||Yes|No||06/25/2012||Yes|No|06/25/2012||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|090|Yes|.2755|03/29/2022|.26888|03/29/2022|.27067|03/29/2022|||ANXIOLYTICS|17695|||||No|No||AUROBINDO PHARM|No||||
galantamine HBr|No|No|No|No|75%|65862045860|GALANTAMINE HBR 4 MG TABLET|60|EA|.28308|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|011|No|.42975|03/29/2022|.41943|03/29/2022|.42222|03/29/2022|||ALZHEIMER'S AGENTS|17696|||||No|No||AUROBINDO PHARM|No||||
galantamine HBr|No|No|No|No|75%|65862045960|GALANTAMINE HBR 8 MG TABLET|60|EA|.49808|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|011|Yes|.48142|03/29/2022|.46986|03/29/2022|.47299|03/29/2022|||ALZHEIMER'S AGENTS|17697|||||No|No||AUROBINDO PHARM|No||||
galantamine HBr|No|No|No|No|75%|65862046060|GALANTAMINE HBR 12 MG TABLET|60|EA|.71308|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|011|No|.83193|01/25/2022|.81196|01/25/2022|.81737|01/25/2022|||ALZHEIMER'S AGENTS|17698|||||No|No||AUROBINDO PHARM|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|65862046830|LOSARTAN-HCTZ 50-12.5 MG TAB|30|EA|.08972|10/19/2010||Yes|No||10/19/2010||Yes|No|10/19/2010||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|17699|||||No|No||AUROBINDO PHARM|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|65862046890|LOSARTAN-HCTZ 50-12.5 MG TAB|90|EA|.08981|10/19/2010||Yes|No||10/19/2010||Yes|No|10/19/2010||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|17700|||||No|No||AUROBINDO PHARM|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|65862046899|LOSARTAN-HCTZ 50-12.5 MG TAB|1000|EA|.08991|10/19/2010||Yes|No||10/19/2010||Yes|No|10/19/2010||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|17701|||||No|No||AUROBINDO PHARM|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|65862046930|LOSARTAN-HCTZ 100-12.5 MG TAB|30|EA|.1224|10/19/2010||Yes|No||10/19/2010||Yes|No|10/19/2010||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|17702|||||No|No||AUROBINDO PHARM|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|65862046990|LOSARTAN-HCTZ 100-12.5 MG TAB|90|EA|.06349|10/19/2010||Yes|No||10/19/2010||Yes|No|10/19/2010||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|17703|||||No|No||AUROBINDO PHARM|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|65862046999|LOSARTAN-HCTZ 100-12.5 MG TAB|1000|EA|.12247|10/19/2010||Yes|No||10/19/2010||Yes|No|10/19/2010||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|17704|||||No|No||AUROBINDO PHARM|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|65862047030|LOSARTAN-HCTZ 100-25 MG TAB|30|EA|.1224|10/19/2010||Yes|No||10/19/2010||Yes|No|10/19/2010||Yes|No||04/01/2015||Yes|No|||Prescription required|No||113|Yes|.21077|03/01/2022|.20571|03/01/2022|.20708|03/01/2022|||ANGIOTENSIN MODULATORS|17705|||||No|No||AUROBINDO PHARM|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|65862047090|LOSARTAN-HCTZ 100-25 MG TAB|90|EA|.06349|10/19/2010||Yes|No||10/19/2010||Yes|No|10/19/2010||Yes|No||04/01/2015||Yes|No|||Prescription required|No||113|Yes|.21077|03/01/2022|.20571|03/01/2022|.20708|03/01/2022|||ANGIOTENSIN MODULATORS|17706|||||No|No||AUROBINDO PHARM|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|65862047099|LOSARTAN-HCTZ 100-25 MG TAB|1000|EA|.12226|10/19/2010||Yes|No||10/19/2010||Yes|No|10/19/2010||Yes|No||04/01/2015||Yes|No|||Prescription required|No||113|Yes|.21077|03/01/2022|.20571|03/01/2022|.20708|03/01/2022|||ANGIOTENSIN MODULATORS|17707|||||No|No||AUROBINDO PHARM|No||||
ramipril|No|No|No|No|75%|65862047401|RAMIPRIL 1.25 MG CAPSULE|100|EA|.0344|04/04/2017||Yes|No||04/04/2017||Yes|No|04/04/2017||Yes|No||04/04/2017||Yes|No|||Prescription required|No||113|Yes|.12346|03/29/2022|.12049|03/29/2022|.12129|03/29/2022|||ANGIOTENSIN MODULATORS|17708|||||No|No||AUROBINDO PHARM|No||||
ramipril|Yes|No|No|No|75%|65862047501|RAMIPRIL 2.5 MG CAPSULE|100|EA|.0817|02/22/2012||Yes|No||02/22/2012||Yes|No|02/22/2012||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|Yes|.06329|03/29/2022|.06177|03/29/2022|.06218|03/29/2022|||ANGIOTENSIN MODULATORS|17709|||||No|No||AUROBINDO PHARM|No||||
ramipril|Yes|No|No|No|75%|65862047505|RAMIPRIL 2.5 MG CAPSULE|500|EA|.06944|02/22/2012||Yes|No||02/22/2012||Yes|No|02/22/2012||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|Yes|.06329|03/29/2022|.06177|03/29/2022|.06218|03/29/2022|||ANGIOTENSIN MODULATORS|17710|||||No|No||AUROBINDO PHARM|No||||
ramipril|Yes|No|No|No|75%|65862047601|RAMIPRIL 5 MG CAPSULE|100|EA|.086|02/22/2012||Yes|No||02/22/2012||Yes|No|02/22/2012||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|Yes|.06848|03/29/2022|.06683|03/29/2022|.06728|03/29/2022|||ANGIOTENSIN MODULATORS|17711|||||No|No||AUROBINDO PHARM|No||||
ramipril|Yes|No|No|No|75%|65862047605|RAMIPRIL 5 MG CAPSULE|500|EA|.0731|02/22/2012||Yes|No||02/22/2012||Yes|No|02/22/2012||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|Yes|.06848|03/29/2022|.06683|03/29/2022|.06728|03/29/2022|||ANGIOTENSIN MODULATORS|17712|||||No|No||AUROBINDO PHARM|No||||
ramipril|Yes|No|No|No|75%|65862047701|RAMIPRIL 10 MG CAPSULE|100|EA|.0903|02/22/2012||Yes|No||02/22/2012||Yes|No|02/22/2012||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|No|.07037|03/29/2022|.06868|03/29/2022|.06913|03/29/2022|||ANGIOTENSIN MODULATORS|17713|||||No|No||AUROBINDO PHARM|No||||
ramipril|Yes|No|No|No|75%|65862047705|RAMIPRIL 10 MG CAPSULE|500|EA|.07675|02/22/2012||Yes|No||02/22/2012||Yes|No|02/22/2012||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|No|.07037|03/29/2022|.06868|03/29/2022|.06913|03/29/2022|||ANGIOTENSIN MODULATORS|17714|||||No|No||AUROBINDO PHARM|No||||
quetiapine fumarate|No|No|No|No|75%|65862048901|QUETIAPINE FUMARATE 25 MG TAB|100|EA|.02171|04/04/2017||Yes|No||04/04/2017||Yes|No|04/04/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.03239|03/29/2022|.03161|03/29/2022|.03182|03/29/2022|||ANTIPSYCHOTICS|17715|||||No|No||AUROBINDO PHARM|No||||
quetiapine fumarate|No|No|No|No|75%|65862049001|QUETIAPINE FUMARATE 50 MG TAB|100|EA|.03259|04/04/2017||Yes|No||04/04/2017||Yes|No|04/04/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.04283|03/29/2022|.0418|03/29/2022|.04208|03/29/2022|||ANTIPSYCHOTICS|17716|||||No|No||AUROBINDO PHARM|No||||
quetiapine fumarate|No|No|No|No|75%|65862049101|QUETIAPINE FUMARATE 100 MG TAB|100|EA|.0516|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.05826|03/29/2022|.05686|03/29/2022|.05724|03/29/2022|||ANTIPSYCHOTICS|17717|||||No|No||AUROBINDO PHARM|No||||
quetiapine fumarate|No|No|No|No|75%|65862049301|QUETIAPINE FUMARATE 200 MG TAB|100|EA|.07529|04/04/2017||Yes|No||04/04/2017||Yes|No|04/04/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.10261|03/29/2022|.10014|03/29/2022|.10081|03/29/2022|||ANTIPSYCHOTICS|17718|||||No|No||AUROBINDO PHARM|No||||
quetiapine fumarate|No|No|No|No|75%|65862049460|QUETIAPINE FUMARATE 300 MG TAB|60|EA|.1085|04/04/2017||Yes|No||04/04/2017||Yes|No|04/04/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.13964|03/29/2022|.13628|03/29/2022|.13719|03/29/2022|||ANTIPSYCHOTICS|17719|||||No|No||AUROBINDO PHARM|No||||
quetiapine fumarate|No|No|No|No|75%|65862049501|QUETIAPINE FUMARATE 400 MG TAB|100|EA|.13381|04/04/2017||Yes|No||04/04/2017||Yes|No|04/04/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.17858|03/29/2022|.17429|03/29/2022|.17545|03/29/2022|||ANTIPSYCHOTICS|17720|||||No|No||AUROBINDO PHARM|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|65862049647|SULFAMETHOXAZOLE-TMP SUSP|473|ML|.03915|04/25/2011||Yes|No||04/25/2011||Yes|No|04/25/2011||Yes|No||04/01/2015||Yes|No|||Prescription required|No|||No|.05588|03/29/2022|.05453|03/29/2022|.0549|03/29/2022||||17721|||||No|No||AUROBINDO PHARM|No||||
efavirenz/emtricit/tenofovr df|No|No|No|No|75%|65862049730|EFAVIR-EMTRI-TENOF 600-200-300|30|EA|4.8|12/13/2021||Yes|No||12/13/2021||Yes|No|12/13/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|4.79678|12/28/2021|4.68165|12/28/2021|4.71283|12/28/2021|||HIV / AIDS|17722|||||No|No||AUROBINDO PHARM|No||||
amoxicillin/potassium clav|No|No|No|No|75%|65862050130|AMOX-CLAV 250-125 MG TABLET|30|EA|1.8361|04/04/2017||Yes|No||04/04/2017||Yes|No|04/04/2017||Yes|No||||No|No|||Prescription required|No||046|No|2.34666|03/29/2022|2.29034|03/29/2022|2.30559|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17723|||||No|No||AUROBINDO PHARM|No||||
amoxicillin/potassium clav|No|No|No|No|75%|65862050220|AMOX-CLAV 500-125 MG TABLET|20|EA|.1892|01/24/2012||Yes|No||01/24/2012||Yes|No|01/24/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||046|No|.31268|03/29/2022|.30517|03/29/2022|.3072|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17724|||||No|No||AUROBINDO PHARM|No||||
amoxicillin/potassium clav|No|No|No|No|75%|65862050301|AMOX-CLAV 875-125 MG TABLET|100|EA|.2064|01/24/2012||Yes|No||01/24/2012||Yes|No|01/24/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||046|No|.32484|03/29/2022|.31704|03/29/2022|.31915|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17725|||||No|No||AUROBINDO PHARM|No||||
amoxicillin/potassium clav|No|No|No|No|75%|65862050320|AMOX-CLAV 875-125 MG TABLET|20|EA|.2064|01/24/2012||Yes|No||01/24/2012||Yes|No|01/24/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||046|No|.32484|03/29/2022|.31704|03/29/2022|.31915|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17726|||||No|No||AUROBINDO PHARM|No||||
pioglitazone HCl|No|No|No|No|75%|65862051205|PIOGLITAZONE HCL 15 MG TABLET|500|EA|.05733|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||02/21/2020||Yes|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|17727|||||No|No||AUROBINDO PHARM|No||||
pioglitazone HCl|No|No|No|No|75%|65862051230|PIOGLITAZONE HCL 15 MG TABLET|30|EA|.05733|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||02/10/2022||Yes|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|17728|||||No|No||AUROBINDO PHARM|No||||
pioglitazone HCl|No|No|No|No|75%|65862051290|PIOGLITAZONE HCL 15 MG TABLET|90|EA|.05733|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||09/23/2020||Yes|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|17729|||||No|No||AUROBINDO PHARM|No||||
pioglitazone HCl|No|No|No|No|75%|65862051305|PIOGLITAZONE HCL 30 MG TABLET|500|EA|.07883|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||02/21/2020||Yes|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|17730|||||No|No||AUROBINDO PHARM|No||||
pioglitazone HCl|No|No|No|No|75%|65862051330|PIOGLITAZONE HCL 30 MG TABLET|30|EA|.07883|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||12/03/2020||Yes|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|17731|||||No|No||AUROBINDO PHARM|No||||
pioglitazone HCl|No|No|No|No|75%|65862051405|PIOGLITAZONE HCL 45 MG TABLET|500|EA|.08242|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||02/21/2020||Yes|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|17732|||||No|No||AUROBINDO PHARM|No||||
pioglitazone HCl|No|No|No|No|75%|65862051430|PIOGLITAZONE HCL 45 MG TABLET|30|EA|.08241|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|17733|||||No|No||AUROBINDO PHARM|No||||
naproxen sodium|No|No|No|No|75%|65862051501|NAPROXEN SODIUM 275 MG TAB|100|EA|.215|02/23/2017||Yes|No||02/23/2017||Yes|No|02/23/2017||Yes|No||02/23/2017||Yes|No|||Prescription required|Yes|01/26/2017|059|Yes|.49|03/23/2021|.483|03/23/2021|.46|03/23/2021|||NSAIDS|17734|||||No|No||AUROBINDO PHARM|No||||
naproxen sodium|No|No|No|No|75%|65862051601|NAPROXEN SODIUM 550 MG TAB|100|EA|.3225|02/23/2017||Yes|No||02/23/2017||Yes|No|02/23/2017||Yes|No||02/23/2017||Yes|No|||Prescription required|Yes|01/26/2017|059|Yes|.37204|03/29/2022|.36311|03/29/2022|.36552|03/29/2022|||NSAIDS|17735|||||No|No||AUROBINDO PHARM|No||||
naproxen|No|No|No|No|75%|65862052201|NAPROXEN 500 MG TABLET|100|EA|.03977|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||02/10/2022||Yes|No|||Prescription required|No||059|Yes|.07731|03/29/2022|.07545|03/29/2022|.07595|03/29/2022|||NSAIDS|17736|||||No|No||AUROBINDO PHARM|No||||
naproxen|No|No|No|No|75%|65862052205|NAPROXEN 500 MG TABLET|500|EA|.0358|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||09/30/2020||Yes|No|||Prescription required|No||059|Yes|.07731|03/29/2022|.07545|03/29/2022|.07595|03/29/2022|||NSAIDS|17737|||||No|No||AUROBINDO PHARM|No||||
gabapentin|No|No|No|No|75%|65862052301|GABAPENTIN 600 MG TABLET|100|EA|.0774|11/09/2011||Yes|No||11/09/2011||Yes|No|11/09/2011||Yes|No||04/01/2015||Yes|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|17738|||||No|No||AUROBINDO PHARM|No||||
gabapentin|No|No|No|No|75%|65862052305|GABAPENTIN 600 MG TABLET|500|EA|.0774|11/09/2011||Yes|No||11/09/2011||Yes|No|11/09/2011||Yes|No||04/01/2015||Yes|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|17739|||||No|No||AUROBINDO PHARM|No||||
gabapentin|No|No|No|No|75%|65862052401|GABAPENTIN 800 MG TABLET|100|EA|.0946|11/09/2011||Yes|No||11/09/2011||Yes|No|11/09/2011||Yes|No||04/01/2015||Yes|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|17740|||||No|No||AUROBINDO PHARM|No||||
gabapentin|No|No|No|No|75%|65862052405|GABAPENTIN 800 MG TABLET|500|EA|.086|11/09/2011||Yes|No||11/09/2011||Yes|No|11/09/2011||Yes|No||04/01/2015||Yes|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|17741|||||No|No||AUROBINDO PHARM|No||||
pioglitazone HCl/metformin HCl|No|No|No|No|75%|65862052518|PIOGLITAZONE-METFORMIN 15-500|180|EA|.54227|02/14/2013||Yes|No||02/14/2013||Yes|No|02/14/2013||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|009|Yes|.53323|03/29/2022|.52043|03/29/2022|.52389|03/29/2022|||HYPOGLYCEMICS: TZD|17742|||||No|No||AUROBINDO PHARM|No||||
pioglitazone HCl/metformin HCl|No|No|No|No|75%|65862052560|PIOGLITAZONE-METFORMIN 15-500|60|EA|.5375|02/14/2013||Yes|No||02/14/2013||Yes|No|02/14/2013||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|009|Yes|.53323|03/29/2022|.52043|03/29/2022|.52389|03/29/2022|||HYPOGLYCEMICS: TZD|17743|||||No|No||AUROBINDO PHARM|No||||
pioglitazone HCl/metformin HCl|No|No|No|No|75%|65862052618|PIOGLITAZONE-METFORMIN 15-850|180|EA|.54227|02/14/2013||Yes|No||02/14/2013||Yes|No|02/14/2013||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|009|Yes|.44962|03/29/2022|.43882|03/29/2022|.44175|03/29/2022|||HYPOGLYCEMICS: TZD|17744|||||No|No||AUROBINDO PHARM|No||||
pioglitazone HCl/metformin HCl|No|No|No|No|75%|65862052660|PIOGLITAZONE-METFORMIN 15-850|60|EA|.5375|02/14/2013||Yes|No||02/14/2013||Yes|No|02/14/2013||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|009|Yes|.44962|03/29/2022|.43882|03/29/2022|.44175|03/29/2022|||HYPOGLYCEMICS: TZD|17745|||||No|No||AUROBINDO PHARM|No||||
venlafaxine HCl|No|No|No|No|75%|65862052701|VENLAFAXINE HCL ER 37.5 MG CAP|100|EA|.17556|08/08/2012||Yes|No||08/08/2012||Yes|No|08/08/2012||Yes|No||||No|No|||Prescription required|No||031|Yes|.11725|03/29/2022|.11443|03/29/2022|.11519|03/29/2022|||ANTIDEPRESSANTS: OTHER|17746|||||No|No||AUROBINDO PHARM|No||||
venlafaxine HCl|No|No|No|No|75%|65862052730|VENLAFAXINE HCL ER 37.5 MG CAP|30|EA|.11653|03/14/2012||Yes|No||03/14/2012||Yes|No|03/14/2012||Yes|No||||No|No|||Prescription required|No||031|Yes|.11725|03/29/2022|.11443|03/29/2022|.11519|03/29/2022|||ANTIDEPRESSANTS: OTHER|17747|||||No|No||AUROBINDO PHARM|No||||
venlafaxine HCl|No|No|No|No|75%|65862052790|VENLAFAXINE HCL ER 37.5 MG CAP|90|EA|.11647|03/14/2012||Yes|No||03/14/2012||Yes|No|03/14/2012||Yes|No||||No|No|||Prescription required|No||031|Yes|.11725|03/29/2022|.11443|03/29/2022|.11519|03/29/2022|||ANTIDEPRESSANTS: OTHER|17748|||||No|No||AUROBINDO PHARM|No||||
venlafaxine HCl|No|No|No|No|75%|65862052799|VENLAFAXINE HCL ER 37.5 MG CAP|1000|EA|.10271|08/08/2012||Yes|No||08/08/2012||Yes|No|08/08/2012||Yes|No||||No|No|||Prescription required|No||031|Yes|.11725|03/29/2022|.11443|03/29/2022|.11519|03/29/2022|||ANTIDEPRESSANTS: OTHER|17749|||||No|No||AUROBINDO PHARM|No||||
venlafaxine HCl|No|No|No|No|75%|65862052801|VENLAFAXINE HCL ER 75 MG CAP|100|EA|.2107|08/08/2012||Yes|No||08/08/2012||Yes|No|08/08/2012||Yes|No||||No|No|||Prescription required|No||031|Yes|.12722|03/29/2022|.12416|03/29/2022|.12499|03/29/2022|||ANTIDEPRESSANTS: OTHER|17750|||||No|No||AUROBINDO PHARM|No||||
venlafaxine HCl|No|No|No|No|75%|65862052830|VENLAFAXINE HCL ER 75 MG CAP|30|EA|.13975|03/14/2012||Yes|No||03/14/2012||Yes|No|03/14/2012||Yes|No||||No|No|||Prescription required|No||031|Yes|.12722|03/29/2022|.12416|03/29/2022|.12499|03/29/2022|||ANTIDEPRESSANTS: OTHER|17751|||||No|No||AUROBINDO PHARM|No||||
venlafaxine HCl|No|No|No|No|75%|65862052890|VENLAFAXINE HCL ER 75 MG CAP|90|EA|.13975|03/14/2012||Yes|No||03/14/2012||Yes|No|03/14/2012||Yes|No||||No|No|||Prescription required|No||031|Yes|.12722|03/29/2022|.12416|03/29/2022|.12499|03/29/2022|||ANTIDEPRESSANTS: OTHER|17752|||||No|No||AUROBINDO PHARM|No||||
venlafaxine HCl|No|No|No|No|75%|65862052899|VENLAFAXINE HCL ER 75 MG CAP|1000|EA|.12325|08/08/2012||Yes|No||08/08/2012||Yes|No|08/08/2012||Yes|No||||No|No|||Prescription required|No||031|Yes|.12722|03/29/2022|.12416|03/29/2022|.12499|03/29/2022|||ANTIDEPRESSANTS: OTHER|17753|||||No|No||AUROBINDO PHARM|No||||
amoxicillin/potassium clav|No|No|No|No|75%|65862053301|AMOX-CLAV 200-28.5 MG/5 ML SUS|100|ML|.04644|01/24/2012||Yes|No||01/24/2012||Yes|No|01/24/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||046|No|.05885|03/29/2022|.05743|03/29/2022|.05782|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17754|||||No|No||AUROBINDO PHARM|No||||
amoxicillin/potassium clav|No|No|No|No|75%|65862053350|AMOX-CLAV 200-28.5 MG/5 ML SUS|50|ML|.0743|01/24/2012||Yes|No||01/24/2012||Yes|No|01/24/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||046|No|.16934|10/27/2020|.16692|10/27/2020|.15897|10/27/2020|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17755|||||No|No||AUROBINDO PHARM|No||||
amoxicillin/potassium clav|No|No|No|No|75%|65862053375|AMOX-CLAV 200-28.5 MG/5 ML SUS|75|ML|.05274|01/24/2012||Yes|No||01/24/2012||Yes|No|01/24/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||046|No|.1202|03/23/2021|.11848|03/23/2021|.11284|03/23/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17756|||||No|No||AUROBINDO PHARM|No||||
amoxicillin/potassium clav|No|No|No|No|75%|65862053401|AMOX-CLAV 400-57 MG/5 ML SUSP|100|ML|.06278|01/24/2012||Yes|No||01/24/2012||Yes|No|01/24/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||046|No|.07681|03/29/2022|.07496|03/29/2022|.07546|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17757|||||No|No||AUROBINDO PHARM|No||||
amoxicillin/potassium clav|No|No|No|No|75%|65862053450|AMOX-CLAV 400-57 MG/5 ML SUSP|50|ML|.09288|01/24/2012||Yes|No||01/24/2012||Yes|No|01/24/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||046|No|.0974|03/29/2022|.09506|03/29/2022|.09569|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17758|||||No|No||AUROBINDO PHARM|No||||
amoxicillin/potassium clav|No|No|No|No|75%|65862053475|AMOX-CLAV 400-57 MG/5 ML SUSP|75|ML|.06593|01/24/2012||Yes|No||01/24/2012||Yes|No|01/24/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||046|No|.0795|03/29/2022|.07759|03/29/2022|.0781|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17759|||||No|No||AUROBINDO PHARM|No||||
amoxicillin/potassium clav|No|No|No|No|75%|65862053502|AMOX-CLAV 600-42.9 MG/5 ML SUS|200|ML|.086|01/24/2012||Yes|No||01/24/2012||Yes|No|01/24/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||046|No|.06244|03/29/2022|.06094|03/29/2022|.06134|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17760|||||No|No||AUROBINDO PHARM|No||||
amoxicillin/potassium clav|No|No|No|No|75%|65862053513|AMOX-CLAV 600-42.9 MG/5 ML SUS|125|ML|.0602|01/24/2012||Yes|No||01/24/2012||Yes|No|01/24/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||046|No|.06559|03/29/2022|.06401|03/29/2022|.06444|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17761|||||No|No||AUROBINDO PHARM|No||||
amoxicillin/potassium clav|No|No|No|No|75%|65862053575|AMOX-CLAV 600-42.9 MG/5 ML SUS|75|ML|.0817|01/24/2012||Yes|No||01/24/2012||Yes|No|01/24/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||046|No|.08577|03/29/2022|.08371|03/29/2022|.08426|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17762|||||No|No||AUROBINDO PHARM|No||||
levofloxacin|Yes|No|No|No|75%|65862053650|LEVOFLOXACIN 250 MG TABLET|50|EA|.1376|06/29/2011||Yes|No||06/29/2011||Yes|No|06/29/2011||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||028|No|.15969|03/29/2022|.15585|03/29/2022|.15689|03/29/2022|||FLUOROQUINOLONES: ORAL|17763|||||No|No||AUROBINDO PHARM|No||||
levofloxacin|No|No|No|No|75%|65862053750|LEVOFLOXACIN 500 MG TABLET|50|EA|.1634|06/29/2011||Yes|No||06/29/2011||Yes|No|06/29/2011||Yes|No||04/01/2015||Yes|No|||Prescription required|No||028|No|.19821|03/29/2022|.19345|03/29/2022|.19474|03/29/2022|||FLUOROQUINOLONES: ORAL|17764|||||No|No||AUROBINDO PHARM|No||||
levofloxacin|No|No|No|No|75%|65862053820|LEVOFLOXACIN 750 MG TABLET|20|EA|.31175|06/29/2011||Yes|No||06/29/2011||Yes|No|06/29/2011||Yes|No||04/01/2015||Yes|No|||Prescription required|No||028|No|.38345|03/29/2022|.37424|03/29/2022|.37673|03/29/2022|||FLUOROQUINOLONES: ORAL|17765|||||No|No||AUROBINDO PHARM|No||||
valsartan/hydrochlorothiazide|Yes|No|No|No|75%|65862054799|VALSARTAN-HCTZ 80-12.5 MG TAB|1000|EA|.4228|03/22/2013||Yes|No||03/22/2013||Yes|No|03/22/2013||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.29054|03/29/2022|.28356|03/29/2022|.28545|03/29/2022|||ANGIOTENSIN MODULATORS|17766|||||No|No||AUROBINDO PHARM|No||||
valsartan/hydrochlorothiazide|Yes|No|No|No|75%|65862054890|VALSARTAN-HCTZ 160-12.5 MG TAB|90|EA|.06497|05/28/2014||Yes|No||05/28/2014||Yes|No|05/28/2014||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.28742|03/29/2022|.28052|03/29/2022|.28239|03/29/2022|||ANGIOTENSIN MODULATORS|17767|||||No|No||AUROBINDO PHARM|No||||
valsartan/hydrochlorothiazide|Yes|No|No|No|75%|65862054899|VALSARTAN-HCTZ 160-12.5 MG TAB|1000|EA|.45956|03/22/2013||Yes|No||03/22/2013||Yes|No|03/22/2013||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.28742|03/29/2022|.28052|03/29/2022|.28239|03/29/2022|||ANGIOTENSIN MODULATORS|17768|||||No|No||AUROBINDO PHARM|No||||
valsartan/hydrochlorothiazide|Yes|No|No|No|75%|65862054990|VALSARTAN-HCTZ 160-25 MG TAB|90|EA|.06736|12/03/2014||Yes|No||12/03/2014||Yes|No|12/03/2014||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.29583|03/29/2022|.28873|03/29/2022|.29065|03/29/2022|||ANGIOTENSIN MODULATORS|17769|||||No|No||AUROBINDO PHARM|No||||
valsartan/hydrochlorothiazide|Yes|No|No|No|75%|65862054999|VALSARTAN-HCTZ 160-25 MG TAB|1000|EA|.52574|03/22/2013||Yes|No||03/22/2013||Yes|No|03/22/2013||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.29583|03/29/2022|.28873|03/29/2022|.29065|03/29/2022|||ANGIOTENSIN MODULATORS|17770|||||No|No||AUROBINDO PHARM|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|65862055005|VALSARTAN-HCTZ 320-12.5 MG TAB|500|EA|.70434|12/03/2014||Yes|No||12/03/2014||Yes|No|12/03/2014||Yes|No||04/01/2015||Yes|No|||Prescription required|Yes|07/29/2021|113|Yes|.41056|03/29/2022|.4007|03/29/2022|.40337|03/29/2022|||ANGIOTENSIN MODULATORS|17771|||||No|No||AUROBINDO PHARM|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|65862055090|VALSARTAN-HCTZ 320-12.5 MG TAB|90|EA|.11227|03/22/2013||Yes|No||03/22/2013||Yes|No|03/22/2013||Yes|No||04/01/2015||Yes|No|||Prescription required|Yes|07/29/2021|113|Yes|.41056|03/29/2022|.4007|03/29/2022|.40337|03/29/2022|||ANGIOTENSIN MODULATORS|17772|||||No|No||AUROBINDO PHARM|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|65862055105|VALSARTAN-HCTZ 320-25 MG TAB|500|EA|.784|12/03/2014||Yes|No||12/03/2014||Yes|No|12/03/2014||Yes|No||04/01/2015||Yes|No|||Prescription required|Yes|07/29/2021|113|Yes|.3994|03/29/2022|.38981|03/29/2022|.39241|03/29/2022|||ANGIOTENSIN MODULATORS|17773|||||No|No||AUROBINDO PHARM|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|65862055190|VALSARTAN-HCTZ 320-25 MG TAB|90|EA|.11323|03/22/2013||Yes|No||03/22/2013||Yes|No|03/22/2013||Yes|No||04/01/2015||Yes|No|||Prescription required|Yes|07/29/2021|113|Yes|.3994|03/29/2022|.38981|03/29/2022|.39241|03/29/2022|||ANGIOTENSIN MODULATORS|17774|||||No|No||AUROBINDO PHARM|No||||
lamivudine|No|No|No|No|75%|65862055260|LAMIVUDINE 150 MG TABLET|60|EA|1.365|12/05/2011||Yes|No||12/05/2011||Yes|No|12/05/2011||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.96758|11/23/2021|.94435|11/23/2021|.95064|11/23/2021|||HIV / AIDS|17775|||||No|No||AUROBINDO PHARM|No||||
lamivudine|No|No|No|No|75%|65862055330|LAMIVUDINE 300 MG TABLET|30|EA|2.73|12/05/2011||Yes|No||12/05/2011||Yes|No|12/05/2011||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|1.29184|03/01/2022|1.26083|03/01/2022|1.26923|03/01/2022|||HIV / AIDS|17776|||||No|No||AUROBINDO PHARM|No||||
minocycline HCl|No|No|No|No|75%|65862055530|MINOCYCLINE ER 65 MG TABLET|30|EA|2.59791|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||02/26/2020||Yes|No|||Prescription required|Yes|07/25/2019|213|No|5.92082|02/26/2020|5.83624|02/26/2020|5.55832|02/26/2020|||TETRACYCLINES|17777|||||No|No||AUROBINDO PHARM|No||||
minocycline HCl|No|No|No|No|75%|65862055730|MINOCYCLINE ER 115 MG TABLET|30|EA|2.59791|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||12/17/2019||Yes|No|||Prescription required|Yes|07/25/2019|213|No|5.92082|12/17/2019|5.83624|12/17/2019|5.55832|12/17/2019|||TETRACYCLINES|17778|||||No|No||AUROBINDO PHARM|No||||
pantoprazole sodium|No|No|No|No|75%|65862055990|PANTOPRAZOLE SOD DR 20 MG TAB|90|EA|.04466|11/27/2013||Yes|No||11/27/2013||Yes|No|11/27/2013||Yes|No||04/01/2015||Yes|No|||Prescription required|No||047|Yes|.05306|03/29/2022|.05178|03/29/2022|.05213|03/29/2022|||PROTON PUMP INHIBITORS|17779|||||No|No||AUROBINDO PHARM|No||||
pantoprazole sodium|No|No|No|No|75%|65862056090|PANTOPRAZOLE SOD DR 40 MG TAB|90|EA|.05971|11/27/2013||Yes|No||11/27/2013||Yes|No|11/27/2013||Yes|No||11/27/2013||Yes|No|||Prescription required|No||047|No|.05828|03/29/2022|.05688|03/29/2022|.05726|03/29/2022|||PROTON PUMP INHIBITORS|17780|||||No|No||AUROBINDO PHARM|No||||
pantoprazole sodium|No|No|No|No|75%|65862056099|PANTOPRAZOLE SOD DR 40 MG TAB|1000|EA|.05972|04/18/2017||Yes|No||04/18/2017||Yes|No|04/18/2017||Yes|No||04/18/2017||Yes|No|||Prescription required|No||047|No|.05828|03/29/2022|.05688|03/29/2022|.05726|03/29/2022|||PROTON PUMP INHIBITORS|17781|||||No|No||AUROBINDO PHARM|No||||
olanzapine|No|No|No|No|75%|65862056130|OLANZAPINE 2.5 MG TABLET|30|EA|.14333|04/24/2012||Yes|No||04/24/2012||Yes|No|04/24/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.08915|03/29/2022|.08701|03/29/2022|.08758|03/29/2022|||ANTIPSYCHOTICS|17782|||||No|No||AUROBINDO PHARM|No||||
olanzapine|No|No|No|No|75%|65862056199|OLANZAPINE 2.5 MG TABLET|1000|EA|.13437|04/24/2012||Yes|No||04/24/2012||Yes|No|04/24/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.08915|03/29/2022|.08701|03/29/2022|.08758|03/29/2022|||ANTIPSYCHOTICS|17783|||||No|No||AUROBINDO PHARM|No||||
olanzapine|No|No|No|No|75%|65862056230|OLANZAPINE 5 MG TABLET|30|EA|.15408|04/24/2012||Yes|No||04/24/2012||Yes|No|04/24/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.09455|03/29/2022|.09228|03/29/2022|.09289|03/29/2022|||ANTIPSYCHOTICS|17784|||||No|No||AUROBINDO PHARM|No||||
olanzapine|No|No|No|No|75%|65862056299|OLANZAPINE 5 MG TABLET|1000|EA|.13975|04/24/2012||Yes|No||04/24/2012||Yes|No|04/24/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.09455|03/29/2022|.09228|03/29/2022|.09289|03/29/2022|||ANTIPSYCHOTICS|17785|||||No|No||AUROBINDO PHARM|No||||
olanzapine|No|No|No|No|75%|65862056330|OLANZAPINE 7.5 MG TABLET|30|EA|.1935|04/24/2012||Yes|No||04/24/2012||Yes|No|04/24/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.11617|03/29/2022|.11338|03/29/2022|.11413|03/29/2022|||ANTIPSYCHOTICS|17786|||||No|No||AUROBINDO PHARM|No||||
olanzapine|No|No|No|No|75%|65862056399|OLANZAPINE 7.5 MG TABLET|1000|EA|.17737|04/24/2012||Yes|No||04/24/2012||Yes|No|04/24/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.11617|03/29/2022|.11338|03/29/2022|.11413|03/29/2022|||ANTIPSYCHOTICS|17787|||||No|No||AUROBINDO PHARM|No||||
olanzapine|No|No|No|No|75%|65862056430|OLANZAPINE 10 MG TABLET|30|EA|.24008|04/24/2012||Yes|No||04/24/2012||Yes|No|04/24/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.12613|03/29/2022|.1231|03/29/2022|.12392|03/29/2022|||ANTIPSYCHOTICS|17788|||||No|No||AUROBINDO PHARM|No||||
olanzapine|No|No|No|No|75%|65862056499|OLANZAPINE 10 MG TABLET|1000|EA|.22575|04/24/2012||Yes|No||04/24/2012||Yes|No|04/24/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.12613|03/29/2022|.1231|03/29/2022|.12392|03/29/2022|||ANTIPSYCHOTICS|17789|||||No|No||AUROBINDO PHARM|No||||
olanzapine|No|No|No|No|75%|65862056530|OLANZAPINE 15 MG TABLET|30|EA|.35833|04/24/2012||Yes|No||04/24/2012||Yes|No|04/24/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.15007|03/29/2022|.14646|03/29/2022|.14744|03/29/2022|||ANTIPSYCHOTICS|17790|||||No|No||AUROBINDO PHARM|No||||
olanzapine|No|No|No|No|75%|65862056599|OLANZAPINE 15 MG TABLET|1000|EA|.344|04/24/2012||Yes|No||04/24/2012||Yes|No|04/24/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.15007|03/29/2022|.14646|03/29/2022|.14744|03/29/2022|||ANTIPSYCHOTICS|17791|||||No|No||AUROBINDO PHARM|No||||
olanzapine|No|No|No|No|75%|65862056630|OLANZAPINE 20 MG TABLET|30|EA|.48375|04/24/2012||Yes|No||04/24/2012||Yes|No|04/24/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.18048|03/29/2022|.17614|03/29/2022|.17732|03/29/2022|||ANTIPSYCHOTICS|17792|||||No|No||AUROBINDO PHARM|No||||
olanzapine|No|No|No|No|75%|65862056699|OLANZAPINE 20 MG TABLET|1000|EA|.4515|04/24/2012||Yes|No||04/24/2012||Yes|No|04/24/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.18048|03/29/2022|.17614|03/29/2022|.17732|03/29/2022|||ANTIPSYCHOTICS|17793|||||No|No||AUROBINDO PHARM|No||||
montelukast sodium|No|No|No|No|75%|65862056790|MONTELUKAST SOD 4 MG TAB CHEW|90|EA|.09555|08/11/2012||Yes|No||08/11/2012||Yes|No|08/11/2012||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|17794|||||No|No||AUROBINDO PHARM|No||||
montelukast sodium|No|No|No|No|75%|65862056890|MONTELUKAST SOD 5 MG TAB CHEW|90|EA|.09555|08/11/2012||Yes|No||08/11/2012||Yes|No|08/11/2012||Yes|No||||No|No|||Prescription required|No||042|Yes|.08451|03/29/2022|.08248|03/29/2022|.08303|03/29/2022|||LEUKOTRIENE MODIFIERS|17795|||||No|No||AUROBINDO PHARM|No||||
valsartan|Yes|No|No|No|75%|65862057030|VALSARTAN 40 MG TABLET|30|EA|.17443|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.1945|03/29/2022|.18983|03/29/2022|.19109|03/29/2022|||ANGIOTENSIN MODULATORS|17796|||||No|No||AUROBINDO PHARM|No||||
valsartan|Yes|No|No|No|75%|65862057190|VALSARTAN 80 MG TABLET|90|EA|.14691|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.21024|03/29/2022|.20519|03/29/2022|.20656|03/29/2022|||ANGIOTENSIN MODULATORS|17797|||||No|No||AUROBINDO PHARM|No||||
valsartan|Yes|No|No|No|75%|65862057290|VALSARTAN 160 MG TABLET|90|EA|.17935|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.23007|03/29/2022|.22454|03/29/2022|.22604|03/29/2022|||ANGIOTENSIN MODULATORS|17798|||||No|No||AUROBINDO PHARM|No||||
valsartan|Yes|No|No|No|75%|65862057390|VALSARTAN 320 MG TABLET|90|EA|.22684|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.31156|03/29/2022|.30408|03/29/2022|.3061|03/29/2022|||ANGIOTENSIN MODULATORS|17799|||||No|No||AUROBINDO PHARM|No||||
montelukast sodium|No|No|No|No|75%|65862057490|MONTELUKAST SOD 10 MG TABLET|90|EA|.05494|08/11/2012||Yes|No||08/11/2012||Yes|No|08/11/2012||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|17800|||||No|No||AUROBINDO PHARM|Yes|09/01/2020|||
amlodipine besylate/benazepril|No|No|No|No|75%|65862058201|AMLODIPINE-BENAZEPRIL 2.5-10|100|EA|.0903|10/23/2012||Yes|No||10/23/2012||Yes|No|10/23/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||017|No|.11834|03/29/2022|.11549|03/29/2022|.11626|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17801|||||No|No||AUROBINDO PHARM|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|65862058301|AMLODIPINE-BENAZEPRIL 5-10 MG|100|EA|.09567|10/23/2012||Yes|No||10/23/2012||Yes|No|10/23/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||017|No|.11526|03/29/2022|.11249|03/29/2022|.11324|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17802|||||No|No||AUROBINDO PHARM|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|65862058305|AMLODIPINE-BENAZEPRIL 5-10 MG|500|EA|.09073|12/04/2012||Yes|No||12/04/2012||Yes|No|12/04/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||017|No|.11526|03/29/2022|.11249|03/29/2022|.11324|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17803|||||No|No||AUROBINDO PHARM|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|65862058401|AMLODIPINE-BENAZEPRIL 5-20 MG|100|EA|.09675|10/23/2012||Yes|No||10/23/2012||Yes|No|10/23/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||017|No|.13285|03/29/2022|.12966|03/29/2022|.13052|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17804|||||No|No||AUROBINDO PHARM|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|65862058405|AMLODIPINE-BENAZEPRIL 5-20 MG|500|EA|.09159|12/04/2012||Yes|No||12/04/2012||Yes|No|12/04/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||017|No|.13285|03/29/2022|.12966|03/29/2022|.13052|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17805|||||No|No||AUROBINDO PHARM|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|65862058501|AMLODIPINE-BENAZEPRIL 5-40 MG|100|EA|.09782|10/23/2012||Yes|No||10/23/2012||Yes|No|10/23/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||017|No|.15246|03/29/2022|.1488|03/29/2022|.14979|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17806|||||No|No||AUROBINDO PHARM|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|65862058505|AMLODIPINE-BENAZEPRIL 5-40 MG|500|EA|.09288|12/04/2012||Yes|No||12/04/2012||Yes|No|12/04/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||017|No|.15246|03/29/2022|.1488|03/29/2022|.14979|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17807|||||No|No||AUROBINDO PHARM|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|65862058601|AMLODIPINE-BENAZEPRIL 10-20 MG|100|EA|.10105|10/23/2012||Yes|No||10/23/2012||Yes|No|10/23/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||017|No|.14427|03/29/2022|.1408|03/29/2022|.14174|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17808|||||No|No||AUROBINDO PHARM|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|65862058605|AMLODIPINE-BENAZEPRIL 10-20 MG|500|EA|.09589|12/04/2012||Yes|No||12/04/2012||Yes|No|12/04/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||017|No|.14427|03/29/2022|.1408|03/29/2022|.14174|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17809|||||No|No||AUROBINDO PHARM|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|65862058701|AMLODIPINE-BENAZEPRIL 10-40 MG|100|EA|.10827|10/23/2012||Yes|No||10/23/2012||Yes|No|10/23/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||017|No|.17354|03/29/2022|.16937|03/29/2022|.1705|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17810|||||No|No||AUROBINDO PHARM|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|65862058705|AMLODIPINE-BENAZEPRIL 10-40 MG|500|EA|.10286|12/04/2012||Yes|No||12/04/2012||Yes|No|12/04/2012||Yes|No||04/01/2015||Yes|No|||Prescription required|No||017|No|.17354|03/29/2022|.16937|03/29/2022|.1705|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17811|||||No|No||AUROBINDO PHARM|No||||
divalproex sodium|No|No|No|No|75%|65862059401|DIVALPROEX SOD ER 250 MG TAB|100|EA|.05332|06/06/2014||Yes|No||06/06/2014||Yes|No|06/06/2014||Yes|No||04/01/2015||Yes|No|||Prescription required|No||056|Yes|.17839|03/29/2022|.1741|03/29/2022|.17526|03/29/2022|||ANTICONVULSANTS|17812|||||No|No||AUROBINDO PHARM|No||||
divalproex sodium|No|No|No|No|75%|65862059499|DIVALPROEX SOD ER 250 MG TAB|1000|EA|.84445|06/06/2014||Yes|No||06/06/2014||Yes|No|06/06/2014||Yes|No||04/01/2015||Yes|No|||Prescription required|No||056|Yes|.17839|03/29/2022|.1741|03/29/2022|.17526|03/29/2022|||ANTICONVULSANTS|17813|||||No|No||AUROBINDO PHARM|No||||
divalproex sodium|No|No|No|No|75%|65862059501|DIVALPROEX SOD ER 500 MG TAB|100|EA|.1032|06/06/2014||Yes|No||06/06/2014||Yes|No|06/06/2014||Yes|No||04/01/2015||Yes|No|||Prescription required|No||056|No|.21008|03/29/2022|.20503|03/29/2022|.2064|03/29/2022|||ANTICONVULSANTS|17814|||||No|No||AUROBINDO PHARM|No||||
divalproex sodium|No|No|No|No|75%|65862059505|DIVALPROEX SOD ER 500 MG TAB|500|EA|.0989|06/06/2014||Yes|No||06/06/2014||Yes|No|06/06/2014||Yes|No||04/01/2015||Yes|No|||Prescription required|No||056|No|.21008|03/29/2022|.20503|03/29/2022|.2064|03/29/2022|||ANTICONVULSANTS|17815|||||No|No||AUROBINDO PHARM|No||||
clindamycin palmitate HCl|No|No|No|No|75%|65862059601|CLINDAMYCIN (PEDI) 75 MG/5 ML|100|ML|.20227|01/06/2014||Yes|No||01/06/2014||Yes|No|01/06/2014||Yes|No||04/01/2015||Yes|No|||Prescription required|No||146|No|.19356|03/29/2022|.18891|03/29/2022|.19017|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|17816|||||No|No||AUROBINDO PHARM|No||||
lamivudine/zidovudine|No|No|No|No|75%|65862059760|LAMIVUDINE-ZIDOVUDINE TABLET|60|EA|1.24999|05/17/2012|08/27/2022|Yes|No||05/17/2012|08/27/2022|Yes|No|05/17/2012|08/27/2022|Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.62913|12/28/2021|.61403|12/28/2021|.61812|12/28/2021|||HIV / AIDS|17817|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AUROBINDO PHARM|No||||
tamsulosin HCl|No|No|No|No|75%|65862059801|TAMSULOSIN HCL 0.4 MG CAPSULE|100|EA|.05568|06/27/2017||Yes|No||06/27/2017||Yes|No|06/27/2017||Yes|No||||No|No|||Prescription required|No||003|No|.06447|03/29/2022|.06292|03/29/2022|.06334|03/29/2022|||BPH TREATMENTS|17818|||||No|No||AUROBINDO PHARM|No||||
tamsulosin HCl|No|No|No|No|75%|65862059805|TAMSULOSIN HCL 0.4 MG CAPSULE|500|EA|.04295|02/16/2014||Yes|No||02/16/2014||Yes|No|02/16/2014||Yes|No||||No|No|||Prescription required|No||003|No|.06447|03/29/2022|.06292|03/29/2022|.06334|03/29/2022|||BPH TREATMENTS|17819|||||No|No||AUROBINDO PHARM|No||||
rizatriptan benzoate|No|No|No|No|75%|65862059912|RIZATRIPTAN 5 MG TABLET|12|EA|.6432|01/03/2013||Yes|No||01/03/2013||Yes|No|01/03/2013||Yes|No||||No|No|||Prescription required|No||021|No|.64991|03/29/2022|.63431|03/29/2022|.63853|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|17820|||||No|No||AUROBINDO PHARM|No||||
rizatriptan benzoate|No|No|No|No|75%|65862060012|RIZATRIPTAN 10 MG TABLET|12|EA|.6432|01/03/2013||Yes|No||01/03/2013||Yes|No|01/03/2013||Yes|No||||No|No|||Prescription required|No||021|No|.50927|03/29/2022|.49704|03/29/2022|.50035|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|17821|||||No|No||AUROBINDO PHARM|No||||
modafinil|No|No|No|No|90%|65862060101|MODAFINIL 100 MG TABLET|100|EA|.172|09/28/2012||Yes|No||09/28/2012||Yes|No|09/28/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.4088|03/29/2022|.39898|03/29/2022|.40164|03/29/2022|||STIMULANTS AND RELATED AGENTS|17822|||||No|No||AUROBINDO PHARM|No||||
modafinil|No|No|No|No|90%|65862060130|MODAFINIL 100 MG TABLET|30|EA|.172|04/01/2014||Yes|No||04/01/2014||Yes|No|04/01/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.4088|03/29/2022|.39898|03/29/2022|.40164|03/29/2022|||STIMULANTS AND RELATED AGENTS|17823|||||No|No||AUROBINDO PHARM|No||||
modafinil|No|No|No|No|90%|65862060201|MODAFINIL 200 MG TABLET|100|EA|.344|09/28/2012||Yes|No||09/28/2012||Yes|No|09/28/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55328|03/29/2022|.54|03/29/2022|.54359|03/29/2022|||STIMULANTS AND RELATED AGENTS|17824|||||No|No||AUROBINDO PHARM|No||||
modafinil|No|No|No|No|90%|65862060230|MODAFINIL 200 MG TABLET|30|EA|.344|04/01/2014||Yes|No||04/01/2014||Yes|No|04/01/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55328|03/29/2022|.54|03/29/2022|.54359|03/29/2022|||STIMULANTS AND RELATED AGENTS|17825|||||No|No||AUROBINDO PHARM|No||||
moxifloxacin HCl|No|No|No|No|75%|65862060330|MOXIFLOXACIN HCL 400 MG TABLET|30|EA|1.26477|03/07/2014||Yes|No||03/07/2014||Yes|No|03/07/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|028|No|1.23895|03/29/2022|1.20921|03/29/2022|1.21726|03/29/2022|||FLUOROQUINOLONES: ORAL|17826|||||No|No||AUROBINDO PHARM|No||||
pramipexole di-HCl|No|No|No|No|75%|65862060490|PRAMIPEXOLE 0.125 MG TABLET|90|EA|.0633|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||015|No|.05408|03/29/2022|.05278|03/29/2022|.05313|03/29/2022|||ANTIPARKINSON'S AGENTS|17827|||||No|No||AUROBINDO PHARM|No||||
pramipexole di-HCl|No|No|No|No|75%|65862060590|PRAMIPEXOLE 0.25 MG TABLET|90|EA|.0633|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||015|No|.05102|03/29/2022|.04979|03/29/2022|.05012|03/29/2022|||ANTIPARKINSON'S AGENTS|17828|||||No|No||AUROBINDO PHARM|No||||
pramipexole di-HCl|No|No|No|No|75%|65862060690|PRAMIPEXOLE 0.5 MG TABLET|90|EA|.0633|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||015|No|.05616|03/29/2022|.05481|03/29/2022|.05517|03/29/2022|||ANTIPARKINSON'S AGENTS|17829|||||No|No||AUROBINDO PHARM|No||||
pramipexole di-HCl|No|No|No|No|75%|65862060890|PRAMIPEXOLE 1 MG TABLET|90|EA|.0633|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||015|No|.06615|03/29/2022|.06456|03/29/2022|.06499|03/29/2022|||ANTIPARKINSON'S AGENTS|17830|||||No|No||AUROBINDO PHARM|No||||
pramipexole di-HCl|No|No|No|No|75%|65862060990|PRAMIPEXOLE 1.5 MG TABLET|90|EA|.0633|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||015|No|.07545|03/29/2022|.07363|03/29/2022|.07412|03/29/2022|||ANTIPARKINSON'S AGENTS|17831|||||No|No||AUROBINDO PHARM|No||||
quinapril HCl|Yes|No|No|No|75%|65862061790|QUINAPRIL 5 MG TABLET|90|EA|.07166|12/18/2013||Yes|No||12/18/2013||Yes|No|12/18/2013||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|No|.11066|03/29/2022|.108|03/29/2022|.10872|03/29/2022|||ANGIOTENSIN MODULATORS|17832|||||No|No||AUROBINDO PHARM|No||||
quinapril HCl|No|No|No|No|75%|65862061890|QUINAPRIL 10 MG TABLET|90|EA|.07166|12/18/2013||Yes|No||12/18/2013||Yes|No|12/18/2013||Yes|No||04/01/2015||Yes|No|||Prescription required|No||113|No|.08121|03/29/2022|.07926|03/29/2022|.07978|03/29/2022|||ANGIOTENSIN MODULATORS|17833|||||No|No||AUROBINDO PHARM|No||||
quinapril HCl|Yes|No|No|No|75%|65862061990|QUINAPRIL 20 MG TABLET|90|EA|.07166|12/18/2013||Yes|No||12/18/2013||Yes|No|12/18/2013||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|No|.08843|03/29/2022|.0863|03/29/2022|.08688|03/29/2022|||ANGIOTENSIN MODULATORS|17834|||||No|No||AUROBINDO PHARM|No||||
quinapril HCl|Yes|No|No|No|75%|65862062090|QUINAPRIL 40 MG TABLET|90|EA|.07166|12/18/2013||Yes|No||12/18/2013||Yes|No|12/18/2013||Yes|No||04/01/2015||Yes|No|07/01/2016||Prescription required|No||113|No|.10852|03/29/2022|.10591|03/29/2022|.10662|03/29/2022|||ANGIOTENSIN MODULATORS|17835|||||No|No||AUROBINDO PHARM|No||||
flecainide acetate|No|No|No|No|75%|65862062101|FLECAINIDE ACETATE 50 MG TAB|100|EA|.18511|10/05/2016||Yes|No||10/05/2016||Yes|No|10/05/2016||Yes|No||||No|No|||Prescription required|No|||No|.15465|03/29/2022|.15093|03/29/2022|.15194|03/29/2022||||17836|||||No|No||AUROBINDO PHARM|No||||
flecainide acetate|No|No|No|No|75%|65862062201|FLECAINIDE ACETATE 100 MG TAB|100|EA|.30246|10/05/2016||Yes|No||10/05/2016||Yes|No|10/05/2016||Yes|No||||No|No|||Prescription required|No|||No|.24778|03/29/2022|.24183|03/29/2022|.24344|03/29/2022||||17837|||||No|No||AUROBINDO PHARM|No||||
flecainide acetate|No|No|No|No|75%|65862062301|FLECAINIDE ACETATE 150 MG TAB|100|EA|.41559|10/05/2016||Yes|No||10/05/2016||Yes|No|10/05/2016||Yes|No||||No|No|||Prescription required|No|||No|.41264|03/29/2022|.40273|03/29/2022|.40541|03/29/2022||||17838|||||No|No||AUROBINDO PHARM|No||||
gemfibrozil|No|No|No|No|75%|65862062405|GEMFIBROZIL 600 MG TABLET|500|EA|.05142|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No||12/03/2018||Yes|No|||Prescription required|No||055|No|.10518|03/29/2022|.10265|03/29/2022|.10333|03/29/2022|||LIPOTROPICS: OTHER|17839|||||No|No||AUROBINDO PHARM|No||||
gemfibrozil|No|No|No|No|75%|65862062460|GEMFIBROZIL 600 MG TABLET|60|EA|.07467|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||10/01/2020||Yes|No|||Prescription required|No||055|No|.10518|03/29/2022|.10265|03/29/2022|.10333|03/29/2022|||LIPOTROPICS: OTHER|17840|||||No|No||AUROBINDO PHARM|No||||
rizatriptan benzoate|No|No|No|No|75%|65862062512|RIZATRIPTAN 5 MG ODT|12|EA|.87791|07/03/2013||Yes|No||07/03/2013||Yes|No|07/03/2013||Yes|No||||No|No|||Prescription required|No||021|No|.80419|03/29/2022|.78488|03/29/2022|.79011|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|17841|||||No|No||AUROBINDO PHARM|No||||
rizatriptan benzoate|No|No|No|No|75%|65862062590|RIZATRIPTAN 5 MG ODT|9|EA|.87815|12/21/2016||Yes|No||12/21/2016||Yes|No|12/21/2016||Yes|No||||No|No|||Prescription required|No||021|No|.80419|03/29/2022|.78488|03/29/2022|.79011|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|17842|||||No|No||AUROBINDO PHARM|No||||
rizatriptan benzoate|No|No|No|No|75%|65862062612|RIZATRIPTAN 10 MG ODT|12|EA|.87791|07/03/2013||Yes|No||07/03/2013||Yes|No|07/03/2013||Yes|No||||No|No|||Prescription required|No||021|No|.80628|03/29/2022|.78692|03/29/2022|.79217|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|17843|||||No|No||AUROBINDO PHARM|No||||
rizatriptan benzoate|No|No|No|No|75%|65862062690|RIZATRIPTAN 10 MG ODT|9|EA|.87815|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No||021|No|.80628|03/29/2022|.78692|03/29/2022|.79217|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|17844|||||No|No||AUROBINDO PHARM|No||||
azithromycin|Yes|No|No|No|75%|65862064130|AZITHROMYCIN 250 MG TABLET|30|EA|.37926|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||11/29/2018||Yes|No|06/18/2019||Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|17845|||||No|No||AUROBINDO PHARM|No||||
azithromycin|Yes|No|No|No|75%|65862064163|AZITHROMYCIN 250 MG TABLET|6|EA|.31605|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||11/29/2018||Yes|No|06/18/2019||Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|17846|||||No|No||AUROBINDO PHARM|No||||
azithromycin|Yes|No|No|No|75%|65862064169|AZITHROMYCIN 250 MG TABLET|6|EA|.31605|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||02/25/2019||Yes|No|06/18/2019||Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|17847|||||No|No||AUROBINDO PHARM|No||||
azithromycin|Yes|No|No|No|75%|65862064230|AZITHROMYCIN 500 MG TABLET|30|EA|.54782|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||11/29/2018||Yes|No|06/18/2019||Prescription required|No||018|No|.82092|03/29/2022|.80121|03/29/2022|.80655|03/29/2022|||MACROLIDES/KETOLIDES|17848|||||No|No||AUROBINDO PHARM|No||||
azithromycin|Yes|No|No|No|75%|65862064264|AZITHROMYCIN 500 MG TABLET|3|EA|.6321|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||11/29/2018||Yes|No|06/18/2019||Prescription required|No||018|No|.82092|03/29/2022|.80121|03/29/2022|.80655|03/29/2022|||MACROLIDES/KETOLIDES|17849|||||No|No||AUROBINDO PHARM|No||||
azithromycin|Yes|No|No|No|75%|65862064290|AZITHROMYCIN 500 MG TABLET|3|EA|.6321|09/30/2019||Yes|No||09/30/2019||Yes|No|09/30/2019||Yes|No||09/30/2019||Yes|No|01/15/2020||Prescription required|No||018|No|.82092|03/29/2022|.80121|03/29/2022|.80655|03/29/2022|||MACROLIDES/KETOLIDES|17850|||||No|No||AUROBINDO PHARM|No||||
rivastigmine tartrate|No|No|No|No|75%|65862064860|RIVASTIGMINE 1.5 MG CAPSULE|60|EA|.25083|10/04/2017||Yes|No||10/04/2017||Yes|No|10/04/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|011|No|.26635|03/29/2022|.25995|03/29/2022|.26168|03/29/2022|||ALZHEIMER'S AGENTS|17851|||||No|No||AUROBINDO PHARM|No||||
rivastigmine tartrate|No|No|No|No|75%|65862064960|RIVASTIGMINE 3 MG CAPSULE|60|EA|.25083|07/23/2020||Yes|No||07/23/2020||Yes|No|07/23/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|011|No|.2376|03/29/2022|.23189|03/29/2022|.23344|03/29/2022|||ALZHEIMER'S AGENTS|17852|||||No|No||AUROBINDO PHARM|No||||
rivastigmine tartrate|No|No|No|No|75%|65862065060|RIVASTIGMINE 4.5 MG CAPSULE|60|EA|.25083|07/23/2020||Yes|No||07/23/2020||Yes|No|07/23/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|011|No|.27604|03/29/2022|.26941|03/29/2022|.2712|03/29/2022|||ALZHEIMER'S AGENTS|17853|||||No|No||AUROBINDO PHARM|No||||
rivastigmine tartrate|No|No|No|No|75%|65862065160|RIVASTIGMINE 6 MG CAPSULE|60|EA|.25083|07/23/2020||Yes|No||07/23/2020||Yes|No|07/23/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|011|No|.35091|03/29/2022|.34248|03/29/2022|.34476|03/29/2022|||ALZHEIMER'S AGENTS|17854|||||No|No||AUROBINDO PHARM|No||||
memantine HCl|No|No|No|No|75%|65862065260|MEMANTINE HCL 5 MG TABLET|60|EA|.1573|10/14/2015||Yes|No||10/14/2015||Yes|No|10/14/2015||Yes|No||||No|No|||Prescription required|No||011|No|.08825|03/29/2022|.08613|03/29/2022|.0867|03/29/2022|||ALZHEIMER'S AGENTS|17855|||||No|No||AUROBINDO PHARM|No||||
memantine HCl|No|No|No|No|75%|65862065360|MEMANTINE HCL 10 MG TABLET|60|EA|.1573|10/14/2015||Yes|No||10/14/2015||Yes|No|10/14/2015||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|17856|||||No|No||AUROBINDO PHARM|No||||
memantine HCl|No|No|No|No|75%|65862065399|MEMANTINE HCL 10 MG TABLET|1000|EA|.1573|08/18/2016||Yes|No||08/18/2016||Yes|No|08/18/2016||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|17857|||||No|No||AUROBINDO PHARM|No||||
entacapone|No|No|No|No|75%|65862065401|ENTACAPONE 200 MG TABLET|100|EA|.2666|08/28/2015||Yes|No||08/28/2015||Yes|No|08/28/2015||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|015|No|.43301|03/29/2022|.42261|03/29/2022|.42543|03/29/2022|||ANTIPARKINSON'S AGENTS|17858|||||No|No||AUROBINDO PHARM|No||||
olanzapine|No|No|No|No|75%|65862065603|OLANZAPINE ODT 5 MG TABLET|30|EA|.35575|05/26/2014||Yes|No||05/26/2014||Yes|No|05/26/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.59218|03/29/2022|.57796|03/29/2022|.58181|03/29/2022|||ANTIPSYCHOTICS|17859|||||No|No||AUROBINDO PHARM|No||||
olanzapine|No|No|No|No|75%|65862065703|OLANZAPINE ODT 10 MG TABLET|30|EA|.52832|05/26/2014||Yes|No||05/26/2014||Yes|No|05/26/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.58062|03/29/2022|.56668|03/29/2022|.57045|03/29/2022|||ANTIPSYCHOTICS|17860|||||No|No||AUROBINDO PHARM|No||||
olanzapine|No|No|No|No|75%|65862065803|OLANZAPINE ODT 15 MG TABLET|30|EA|.78489|05/26/2015||Yes|No||05/26/2015||Yes|No|05/26/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.85386|03/29/2022|.83336|03/29/2022|.83891|03/29/2022|||ANTIPSYCHOTICS|17861|||||No|No||AUROBINDO PHARM|No||||
olanzapine|No|No|No|No|75%|65862065903|OLANZAPINE ODT 20 MG TABLET|30|EA|1.0416|05/26/2015||Yes|No||05/26/2015||Yes|No|05/26/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|1.09|03/29/2022|1.06384|03/29/2022|1.07092|03/29/2022|||ANTIPSYCHOTICS|17862|||||No|No||AUROBINDO PHARM|No||||
aripiprazole|No|No|No|No|75%|65862066105|ARIPIPRAZOLE 2 MG TABLET|500|EA|.32185|08/12/2016||Yes|No||08/12/2016||Yes|No|08/12/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|17863|||||No|No||AUROBINDO PHARM|No||||
aripiprazole|No|No|No|No|75%|65862066130|ARIPIPRAZOLE 2 MG TABLET|30|EA|.35761|10/09/2015||Yes|No||10/09/2015||Yes|No|10/09/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|17864|||||No|No||AUROBINDO PHARM|No||||
aripiprazole|No|No|No|No|75%|65862066205|ARIPIPRAZOLE 5 MG TABLET|500|EA|.32185|08/12/2016||Yes|No||08/12/2016||Yes|No|08/12/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|17865|||||No|No||AUROBINDO PHARM|No||||
aripiprazole|No|No|No|No|75%|65862066230|ARIPIPRAZOLE 5 MG TABLET|30|EA|.35761|10/09/2015||Yes|No||10/09/2015||Yes|No|10/09/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|17866|||||No|No||AUROBINDO PHARM|No||||
aripiprazole|No|No|No|No|75%|65862066305|ARIPIPRAZOLE 10 MG TABLET|500|EA|.32185|08/12/2016||Yes|No||08/12/2016||Yes|No|08/12/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|17867|||||No|No||AUROBINDO PHARM|No||||
aripiprazole|No|No|No|No|75%|65862066330|ARIPIPRAZOLE 10 MG TABLET|30|EA|.35761|10/09/2015||Yes|No||10/09/2015||Yes|No|10/09/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|17868|||||No|No||AUROBINDO PHARM|No||||
aripiprazole|No|No|No|No|75%|65862066405|ARIPIPRAZOLE 15 MG TABLET|500|EA|.32185|08/12/2016||Yes|No||08/12/2016||Yes|No|08/12/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|17869|||||No|No||AUROBINDO PHARM|No||||
aripiprazole|No|No|No|No|75%|65862066430|ARIPIPRAZOLE 15 MG TABLET|30|EA|.35761|10/09/2015||Yes|No||10/09/2015||Yes|No|10/09/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|17870|||||No|No||AUROBINDO PHARM|No||||
aripiprazole|No|No|No|No|75%|65862066505|ARIPIPRAZOLE 20 MG TABLET|500|EA|.38635|08/12/2016||Yes|No||08/12/2016||Yes|No|08/12/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|17871|||||No|No||AUROBINDO PHARM|No||||
aripiprazole|No|No|No|No|75%|65862066530|ARIPIPRAZOLE 20 MG TABLET|30|EA|.42928|10/09/2015||Yes|No||10/09/2015||Yes|No|10/09/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|17872|||||No|No||AUROBINDO PHARM|No||||
aripiprazole|No|No|No|No|75%|65862066605|ARIPIPRAZOLE 30 MG TABLET|500|EA|.38635|08/12/2016||Yes|No||08/12/2016||Yes|No|08/12/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|17873|||||No|No||AUROBINDO PHARM|No||||
aripiprazole|No|No|No|No|75%|65862066630|ARIPIPRAZOLE 30 MG TABLET|30|EA|.42928|10/09/2015||Yes|No||10/09/2015||Yes|No|10/09/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|17874|||||No|No||AUROBINDO PHARM|No||||
repaglinide|Yes|No|No|No|75%|65862067001|REPAGLINIDE 0.5 MG TABLET|100|EA|.1333|01/23/2014||Yes|No||01/23/2014||Yes|No|01/23/2014||Yes|No||01/23/2014||Yes|No|07/01/2016||Prescription required|No||022|Yes|.11854|03/29/2022|.11569|03/29/2022|.11646|03/29/2022|||HYPOGLYCEMICS: MEGLITINIDES|17875|||||No|No||AUROBINDO PHARM|No||||
repaglinide|Yes|No|No|No|75%|65862067101|REPAGLINIDE 1 MG TABLET|100|EA|.1333|01/23/2014||Yes|No||01/23/2014||Yes|No|01/23/2014||Yes|No||01/23/2014||Yes|No|07/01/2016||Prescription required|No||022|Yes|.12359|03/29/2022|.12062|03/29/2022|.12142|03/29/2022|||HYPOGLYCEMICS: MEGLITINIDES|17876|||||No|No||AUROBINDO PHARM|No||||
repaglinide|Yes|No|No|No|75%|65862067201|REPAGLINIDE 2 MG TABLET|100|EA|.1333|01/23/2014||Yes|No||01/23/2014||Yes|No|01/23/2014||Yes|No||01/23/2014||Yes|No|07/01/2016||Prescription required|No||022|Yes|.12502|03/29/2022|.12201|03/29/2022|.12283|03/29/2022|||HYPOGLYCEMICS: MEGLITINIDES|17877|||||No|No||AUROBINDO PHARM|No||||
alprazolam|No|No|No|No|90%|65862067601|ALPRAZOLAM 0.25 MG TABLET|100|EA|.0172|05/26/2020||Yes|No||05/26/2020||Yes|No|05/26/2020||Yes|No||||No|No|||Prescription required|No||090|Yes|.02093|03/29/2022|.02042|03/29/2022|.02056|03/29/2022|||ANXIOLYTICS|17878|||||No|No||AUROBINDO PHARM|No||||
alprazolam|No|No|No|No|90%|65862067605|ALPRAZOLAM 0.25 MG TABLET|500|EA|.01668|08/07/2020||Yes|No||08/07/2020||Yes|No|08/07/2020||Yes|No||||No|No|||Prescription required|No||090|Yes|.02093|03/29/2022|.02042|03/29/2022|.02056|03/29/2022|||ANXIOLYTICS|17879|||||No|No||AUROBINDO PHARM|No||||
alprazolam|No|No|No|No|90%|65862067699|ALPRAZOLAM 0.25 MG TABLET|1000|EA|.01634|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No||090|Yes|.02093|03/29/2022|.02042|03/29/2022|.02056|03/29/2022|||ANXIOLYTICS|17880|||||No|No||AUROBINDO PHARM|No||||
alprazolam|No|No|No|No|90%|65862067701|ALPRAZOLAM 0.5 MG TABLET|100|EA|.01827|05/26/2020||Yes|No||05/26/2020||Yes|No|05/26/2020||Yes|No||||No|No|||Prescription required|No||090|Yes|.0228|03/29/2022|.02225|03/29/2022|.0224|03/29/2022|||ANXIOLYTICS|17881|||||No|No||AUROBINDO PHARM|No||||
alprazolam|No|No|No|No|90%|65862067705|ALPRAZOLAM 0.5 MG TABLET|500|EA|.01376|08/07/2020||Yes|No||08/07/2020||Yes|No|08/07/2020||Yes|No||||No|No|||Prescription required|No||090|Yes|.0228|03/29/2022|.02225|03/29/2022|.0224|03/29/2022|||ANXIOLYTICS|17882|||||No|No||AUROBINDO PHARM|No||||
alprazolam|No|No|No|No|90%|65862067799|ALPRAZOLAM 0.5 MG TABLET|1000|EA|.01735|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No||090|Yes|.0228|03/29/2022|.02225|03/29/2022|.0224|03/29/2022|||ANXIOLYTICS|17883|||||No|No||AUROBINDO PHARM|No||||
alprazolam|No|No|No|No|90%|65862067801|ALPRAZOLAM 1 MG TABLET|100|EA|.01935|08/07/2020||Yes|No||08/07/2020||Yes|No|08/07/2020||Yes|No||||No|No|||Prescription required|No||090|Yes|.02503|03/29/2022|.02442|03/29/2022|.02459|03/29/2022|||ANXIOLYTICS|17884|||||No|No||AUROBINDO PHARM|No||||
alprazolam|No|No|No|No|90%|65862067805|ALPRAZOLAM 1 MG TABLET|500|EA|.01879|08/07/2020||Yes|No||08/07/2020||Yes|No|08/07/2020||Yes|No||||No|No|||Prescription required|No||090|Yes|.02503|03/29/2022|.02442|03/29/2022|.02459|03/29/2022|||ANXIOLYTICS|17885|||||No|No||AUROBINDO PHARM|No||||
alprazolam|No|No|No|No|90%|65862067899|ALPRAZOLAM 1 MG TABLET|1000|EA|.01838|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|||Prescription required|No||090|Yes|.02503|03/29/2022|.02442|03/29/2022|.02459|03/29/2022|||ANXIOLYTICS|17886|||||No|No||AUROBINDO PHARM|No||||
alprazolam|No|No|No|No|90%|65862067901|ALPRAZOLAM 2 MG TABLET|100|EA|.0258|08/07/2020||Yes|No||08/07/2020||Yes|No|08/07/2020||Yes|No||||No|No|||Prescription required|No||090|Yes|.0533|03/29/2022|.05202|03/29/2022|.05236|03/29/2022|||ANXIOLYTICS|17887|||||No|No||AUROBINDO PHARM|No||||
alprazolam|No|No|No|No|90%|65862067905|ALPRAZOLAM 2 MG TABLET|500|EA|.02502|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||090|Yes|.0533|03/29/2022|.05202|03/29/2022|.05236|03/29/2022|||ANXIOLYTICS|17888|||||No|No||AUROBINDO PHARM|No||||
ritonavir|No|No|No|No|75%|65862068730|RITONAVIR 100 MG TABLET|30|EA|1.59999|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|1.50357|03/29/2022|1.46748|03/29/2022|1.47725|03/29/2022|||HIV / AIDS|17889|||||No|No||AUROBINDO PHARM|No||||
sildenafil citrate|No|No|No|No|75%|65862068890|SILDENAFIL 20 MG TABLET|90|EA|.09555|01/20/2016||Yes|No||01/20/2016||Yes|No|01/20/2016||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|Yes|.09246|03/29/2022|.09024|03/29/2022|.09084|03/29/2022|||PAH AGENTS: ORAL AND INHALED|17890|||||No|No||AUROBINDO PHARM|No||||
phenytoin sodium extended|No|No|No|No|75%|65862069201|PHENYTOIN SOD EXT 100 MG CAP|100|EA|.14538|11/15/2016||Yes|No||11/15/2016||Yes|No|11/15/2016||Yes|No||11/15/2016||Yes|No|||Prescription required|No||056|No|.15598|03/29/2022|.15223|03/29/2022|.15325|03/29/2022|||ANTICONVULSANTS|17891|||||No|No||AUROBINDO PHARM|No||||
phenytoin sodium extended|No|No|No|No|75%|65862069299|PHENYTOIN SOD EXT 100 MG CAP|1000|EA|.14538|11/15/2016||Yes|No||11/15/2016||Yes|No|11/15/2016||Yes|No||11/15/2016||Yes|No|||Prescription required|No||056|No|.15598|03/29/2022|.15223|03/29/2022|.15325|03/29/2022|||ANTICONVULSANTS|17892|||||No|No||AUROBINDO PHARM|No||||
venlafaxine HCl|No|No|No|No|75%|65862069701|VENLAFAXINE HCL ER 150 MG CAP|100|EA|.2709|08/08/2012||Yes|No||08/08/2012||Yes|No|08/08/2012||Yes|No||08/08/2012||Yes|No|||Prescription required|No||031|No|.16516|03/29/2022|.16119|03/29/2022|.16226|03/29/2022|||ANTIDEPRESSANTS: OTHER|17893|||||No|No||AUROBINDO PHARM|No||||
venlafaxine HCl|No|No|No|No|75%|65862069705|VENLAFAXINE HCL ER 150 MG CAP|500|EA|.18963|08/08/2012||Yes|No||08/08/2012||Yes|No|08/08/2012||Yes|No||||No|No|||Prescription required|No||031|No|.16516|03/29/2022|.16119|03/29/2022|.16226|03/29/2022|||ANTIDEPRESSANTS: OTHER|17894|||||No|No||AUROBINDO PHARM|No||||
venlafaxine HCl|No|No|No|No|75%|65862069730|VENLAFAXINE HCL ER 150 MG CAP|30|EA|.18633|08/08/2012||Yes|No||08/08/2012||Yes|No|08/08/2012||Yes|No||||No|No|||Prescription required|No||031|No|.16516|03/29/2022|.16119|03/29/2022|.16226|03/29/2022|||ANTIDEPRESSANTS: OTHER|17895|||||No|No||AUROBINDO PHARM|No||||
venlafaxine HCl|No|No|No|No|75%|65862069790|VENLAFAXINE HCL ER 150 MG CAP|90|EA|.18633|08/08/2012||Yes|No||08/08/2012||Yes|No|08/08/2012||Yes|No||||No|No|||Prescription required|No||031|No|.16516|03/29/2022|.16119|03/29/2022|.16226|03/29/2022|||ANTIDEPRESSANTS: OTHER|17896|||||No|No||AUROBINDO PHARM|No||||
cefuroxime axetil|No|No|No|No|75%|65862069920|CEFUROXIME AXETIL 250 MG TAB|20|EA|.18275|08/05/2014||Yes|No||08/05/2014||Yes|No|08/05/2014||Yes|No||08/05/2014||Yes|No|||Prescription required|No||046|No|.36264|03/29/2022|.35393|03/29/2022|.35629|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17897|||||No|No||AUROBINDO PHARM|No||||
cefuroxime axetil|No|No|No|No|75%|65862069960|CEFUROXIME AXETIL 250 MG TAB|60|EA|.22575|08/05/2014||Yes|No||08/05/2014||Yes|No|08/05/2014||Yes|No||08/05/2014||Yes|No|||Prescription required|No||046|No|.36264|03/29/2022|.35393|03/29/2022|.35629|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17898|||||No|No||AUROBINDO PHARM|No||||
cefuroxime axetil|No|No|No|No|75%|65862070020|CEFUROXIME AXETIL 500 MG TAB|20|EA|.71487|08/05/2014||Yes|No||08/05/2014||Yes|No|08/05/2014||Yes|No||08/05/2014||Yes|No|||Prescription required|No||046|No|.56985|03/29/2022|.55617|03/29/2022|.55987|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17899|||||No|No||AUROBINDO PHARM|No||||
cefuroxime axetil|No|No|No|No|75%|65862070060|CEFUROXIME AXETIL 500 MG TAB|60|EA|.58945|08/05/2014||Yes|No||08/05/2014||Yes|No|08/05/2014||Yes|No||08/05/2014||Yes|No|||Prescription required|No||046|No|.56985|03/29/2022|.55617|03/29/2022|.55987|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17900|||||No|No||AUROBINDO PHARM|No||||
ziprasidone HCl|No|No|No|No|75%|65862070260|ZIPRASIDONE HCL 20 MG CAPSULE|60|EA|.17916|09/27/2017||Yes|No||09/27/2017||Yes|No|09/27/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.27381|03/29/2022|.26723|03/29/2022|.26901|03/29/2022|||ANTIPSYCHOTICS|17901|||||No|No||AUROBINDO PHARM|No||||
ziprasidone HCl|No|No|No|No|75%|65862070360|ZIPRASIDONE HCL 40 MG CAPSULE|60|EA|.17916|09/27/2017||Yes|No||09/27/2017||Yes|No|09/27/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.29914|03/29/2022|.29196|03/29/2022|.2939|03/29/2022|||ANTIPSYCHOTICS|17902|||||No|No||AUROBINDO PHARM|No||||
ziprasidone HCl|No|No|No|No|75%|65862070460|ZIPRASIDONE HCL 60 MG CAPSULE|60|EA|.28666|09/27/2017||Yes|No||09/27/2017||Yes|No|09/27/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.38441|03/29/2022|.37518|03/29/2022|.37768|03/29/2022|||ANTIPSYCHOTICS|17903|||||No|No||AUROBINDO PHARM|No||||
ziprasidone HCl|No|No|No|No|75%|65862070560|ZIPRASIDONE HCL 80 MG CAPSULE|60|EA|.28666|09/27/2017||Yes|No||09/27/2017||Yes|No|09/27/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.42395|03/29/2022|.41377|03/29/2022|.41653|03/29/2022|||ANTIPSYCHOTICS|17904|||||No|No||AUROBINDO PHARM|No||||
amoxicillin|No|No|No|No|75%|65862070601|AMOXICILLIN 125 MG/5 ML SUSP|100|ML|.01225|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||09/07/2015||Yes|No|||Prescription required|No||209|No|.02009|03/29/2022|.0196|03/29/2022|.01973|03/29/2022|||PENICILLINS|17905|||||No|No||AUROBINDO PHARM|No||||
amoxicillin|No|No|No|No|75%|65862070655|AMOXICILLIN 125 MG/5 ML SUSP|150|ML|.01075|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||09/07/2015||Yes|No|||Prescription required|No||209|No|.01643|03/29/2022|.01603|03/29/2022|.01614|03/29/2022|||PENICILLINS|17906|||||No|No||AUROBINDO PHARM|No||||
amoxicillin|No|No|No|No|75%|65862070680|AMOXICILLIN 125 MG/5 ML SUSP|80|ML|.0129|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||09/07/2015||Yes|No|||Prescription required|No||209|No|.01904|03/29/2022|.01858|03/29/2022|.0187|03/29/2022|||PENICILLINS|17907|||||No|No||AUROBINDO PHARM|No||||
amoxicillin|No|No|No|No|75%|65862070701|AMOXICILLIN 250 MG/5 ML SUSP|100|ML|.01526|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||09/07/2015||Yes|No|||Prescription required|No||209|No|.01967|03/29/2022|.01919|03/29/2022|.01932|03/29/2022|||PENICILLINS|17908|||||No|No||AUROBINDO PHARM|No||||
amoxicillin|No|No|No|No|75%|65862070755|AMOXICILLIN 250 MG/5 ML SUSP|150|ML|.01433|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||09/07/2015||Yes|No|||Prescription required|No||209|No|.01799|03/29/2022|.01755|03/29/2022|.01767|03/29/2022|||PENICILLINS|17909|||||No|No||AUROBINDO PHARM|No||||
amoxicillin|No|No|No|No|75%|65862070780|AMOXICILLIN 250 MG/5 ML SUSP|80|ML|.01666|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||09/07/2015||Yes|No|||Prescription required|No||209|No|.02476|03/29/2022|.02416|03/29/2022|.02432|03/29/2022|||PENICILLINS|17910|||||No|No||AUROBINDO PHARM|No||||
raloxifene HCl|No|No|No|No|75%|65862070901|RALOXIFENE HCL 60 MG TABLET|100|EA|.49665|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|060|Yes|.36315|03/29/2022|.35443|03/29/2022|.35679|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|17911|||||No|No||AUROBINDO PHARM|No||||
raloxifene HCl|No|No|No|No|75%|65862070930|RALOXIFENE HCL 60 MG TABLET|30|EA|.49665|03/23/2022||Yes|No||03/23/2022||Yes|No|03/23/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|060|Yes|.36315|03/29/2022|.35443|03/29/2022|.35679|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|17912|||||No|No||AUROBINDO PHARM|No||||
atazanavir sulfate|No|No|No|No|75%|65862071160|ATAZANAVIR SULFATE 150 MG CAP|60|EA|1.782|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|2.9106|12/01/2020|2.86902|12/01/2020|2.7324|12/01/2020|||HIV / AIDS|17913|||||No|No||AUROBINDO PHARM|No||||
atazanavir sulfate|No|No|No|No|75%|65862071260|ATAZANAVIR SULFATE 200 MG CAP|60|EA|1.782|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|2.9106|02/23/2021|2.86902|02/23/2021|2.7324|02/23/2021|||HIV / AIDS|17914|||||No|No||AUROBINDO PHARM|No||||
atazanavir sulfate|No|No|No|No|75%|65862071330|ATAZANAVIR SULFATE 300 MG CAP|30|EA|3.564|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|5.91006|05/25/2021|5.76821|05/25/2021|5.80663|05/25/2021|||HIV / AIDS|17915|||||No|No||AUROBINDO PHARM|No||||
rabeprazole sodium|No|No|No|No|75%|65862072130|RABEPRAZOLE SOD DR 20 MG TAB|30|EA|.14333|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.24287|03/29/2022|.23704|03/29/2022|.23861|03/29/2022|||PROTON PUMP INHIBITORS|17916|||||No|No||AUROBINDO PHARM|No||||
rabeprazole sodium|No|No|No|No|75%|65862072190|RABEPRAZOLE SOD DR 20 MG TAB|90|EA|.14333|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.24287|03/29/2022|.23704|03/29/2022|.23861|03/29/2022|||PROTON PUMP INHIBITORS|17917|||||No|No||AUROBINDO PHARM|No||||
amiodarone HCl|No|No|No|No|75%|65862073205|AMIODARONE HCL 200 MG TABLET|500|EA|.11374|11/15/2016||Yes|No||11/15/2016||Yes|No|11/15/2016||Yes|No||||No|No|||Prescription required|No|||No|.12373|03/29/2022|.12076|03/29/2022|.12156|03/29/2022||||17918|||||No|No||AUROBINDO PHARM|No||||
amiodarone HCl|No|No|No|No|75%|65862073260|AMIODARONE HCL 200 MG TABLET|60|EA|.1161|11/15/2016||Yes|No||11/15/2016||Yes|No|11/15/2016||Yes|No||||No|No|||Prescription required|No|||No|.12373|03/29/2022|.12076|03/29/2022|.12156|03/29/2022||||17919|||||No|No||AUROBINDO PHARM|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|65862073730|AMLODIPINE-VALSARTAN 5-160 MG|30|EA|.23506|11/15/2016||Yes|No||11/15/2016||Yes|No|11/15/2016||Yes|No||11/15/2016||Yes|No|||Prescription required|No||017|Yes|.43208|03/29/2022|.42171|03/29/2022|.42451|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17920|||||No|No||AUROBINDO PHARM|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|65862073830|AMLODIPINE-VALSARTAN 5-320 MG|30|EA|.29827|11/15/2016||Yes|No||11/15/2016||Yes|No|11/15/2016||Yes|No||11/15/2016||Yes|No|||Prescription required|No||017|Yes|.57359|03/29/2022|.55982|03/29/2022|.56355|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17921|||||No|No||AUROBINDO PHARM|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|65862073930|AMLODIPINE-VALSARTAN 10-160 MG|30|EA|.26674|11/15/2016||Yes|No||11/15/2016||Yes|No|11/15/2016||Yes|No||11/15/2016||Yes|No|||Prescription required|No||017|Yes|.53459|03/29/2022|.52175|03/29/2022|.52523|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17922|||||No|No||AUROBINDO PHARM|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|65862074030|AMLODIPINE-VALSARTAN 10-320 MG|30|EA|.33855|11/15/2016||Yes|No||11/15/2016||Yes|No|11/15/2016||Yes|No||11/15/2016||Yes|No|||Prescription required|No||017|Yes|.73857|03/29/2022|.72084|03/29/2022|.72564|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17923|||||No|No||AUROBINDO PHARM|No||||
olmesartan medoxomil|No|No|No|No|75%|65862074130|OLMESARTAN MEDOXOMIL 5 MG TAB|30|EA|.04859|08/29/2017||Yes|No||08/29/2017||Yes|No|08/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.07425|03/29/2022|.07246|03/29/2022|.07295|03/29/2022|||ANGIOTENSIN MODULATORS|17924|||||No|No||AUROBINDO PHARM|No||||
olmesartan medoxomil|No|No|No|No|75%|65862074230|OLMESARTAN MEDOXOMIL 20 MG TAB|30|EA|.05948|08/29/2017||Yes|No||08/29/2017||Yes|No|08/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.1002|03/29/2022|.09779|03/29/2022|.09844|03/29/2022|||ANGIOTENSIN MODULATORS|17925|||||No|No||AUROBINDO PHARM|No||||
olmesartan medoxomil|No|No|No|No|75%|65862074290|OLMESARTAN MEDOXOMIL 20 MG TAB|90|EA|.05943|08/29/2017||Yes|No||08/29/2017||Yes|No|08/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.1002|03/29/2022|.09779|03/29/2022|.09844|03/29/2022|||ANGIOTENSIN MODULATORS|17926|||||No|No||AUROBINDO PHARM|No||||
olmesartan medoxomil|No|No|No|No|75%|65862074330|OLMESARTAN MEDOXOMIL 40 MG TAB|30|EA|.08256|08/29/2017||Yes|No||08/29/2017||Yes|No|08/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.15714|03/29/2022|.15336|03/29/2022|.15439|03/29/2022|||ANGIOTENSIN MODULATORS|17927|||||No|No||AUROBINDO PHARM|No||||
olmesartan medoxomil|No|No|No|No|75%|65862074390|OLMESARTAN MEDOXOMIL 40 MG TAB|90|EA|.08256|08/29/2017||Yes|No||08/29/2017||Yes|No|08/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.15714|03/29/2022|.15336|03/29/2022|.15439|03/29/2022|||ANGIOTENSIN MODULATORS|17928|||||No|No||AUROBINDO PHARM|No||||
galantamine HBr|No|No|No|No|75%|65862074430|GALANTAMINE ER 8 MG CAPSULE|30|EA|.645|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|011|No|1.1683|03/29/2022|1.14026|03/29/2022|1.14785|03/29/2022|||ALZHEIMER'S AGENTS|17929|||||No|No||AUROBINDO PHARM|No||||
galantamine HBr|No|No|No|No|75%|65862074530|GALANTAMINE ER 16 MG CAPSULE|30|EA|.645|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|011|No|1.23595|03/29/2022|1.20628|03/29/2022|1.21432|03/29/2022|||ALZHEIMER'S AGENTS|17930|||||No|No||AUROBINDO PHARM|No||||
galantamine HBr|No|No|No|No|75%|65862074630|GALANTAMINE ER 24 MG CAPSULE|30|EA|.645|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|011|No|1.24993|03/29/2022|1.21993|03/29/2022|1.22805|03/29/2022|||ALZHEIMER'S AGENTS|17931|||||No|No||AUROBINDO PHARM|No||||
cefixime|No|No|No|No|75%|65862075150|CEFIXIME 100 MG/5 ML SUSP|50|ML|1.43654|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|046|No|3.27398|08/27/2019|3.22721|08/27/2019|3.07353|08/27/2019|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17932|||||No|No||AUROBINDO PHARM|No||||
cefixime|No|No|No|No|75%|65862075250|CEFIXIME 200 MG/5 ML SUSP|50|ML|2.87308|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|046|No|6.54796|10/29/2019|6.45442|10/29/2019|6.14707|10/29/2019|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17933|||||No|No||AUROBINDO PHARM|No||||
cefixime|No|No|No|No|75%|65862075275|CEFIXIME 200 MG/5 ML SUSP|75|ML|2.87302|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|046|No|6.54783|01/29/2019|6.45429|01/29/2019|6.14694|01/29/2019|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|17934|||||No|No||AUROBINDO PHARM|No||||
valganciclovir HCl|No|No|No|No|75%|65862075360|VALGANCICLOVIR 450 MG TABLET|60|EA|1.70673|06/29/2016||Yes|No||06/29/2016||Yes|No|06/29/2016||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|136|No|2.64507|03/29/2022|2.58158|03/29/2022|2.59878|03/29/2022|||ANTIVIRALS: GENERAL|17935|||||No|No||AUROBINDO PHARM|No||||
olopatadine HCl|No|No|No|No|75%|65862075705|OLOPATADINE HCL 0.1% EYE DROPS|5|ML|3.655|12/21/2015||Yes|No||12/21/2015||Yes|No|12/21/2015||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|002|No|3.02733|03/29/2022|2.95467|03/29/2022|2.97435|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|17936|||||No|No||AUROBINDO PHARM|No||||
fenofibrate nanocrystallized|No|No|No|No|75%|65862076890|FENOFIBRATE 48 MG TABLET|90|EA|.09966|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|No||055|No|.11999|03/29/2022|.11711|03/29/2022|.11789|03/29/2022|||LIPOTROPICS: OTHER|17937|||||No|No||AUROBINDO PHARM|No||||
fenofibrate nanocrystallized|No|No|No|No|75%|65862076990|FENOFIBRATE 145 MG TABLET|90|EA|.18203|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|No||055|No|.16424|03/29/2022|.16029|03/29/2022|.16136|03/29/2022|||LIPOTROPICS: OTHER|17938|||||No|No||AUROBINDO PHARM|No||||
norgestimate-ethinyl estradiol|Yes|Yes|No|No|75%|65862077685|MILI 0.25-0.035 MG TABLET|28|EA|.16416|08/27/2018||Yes|No||08/27/2018||Yes|No|08/27/2018||Yes|No|Refer to program requirements|||No|No|06/18/2019||Prescription required|No|||No|.1742|03/29/2022|.17001|03/29/2022|.17115|03/29/2022||||17939|||||No|No||AUROBINDO PHARM|No|||Only covered for non-contraceptive (medical) purposes|
norgestimate-ethinyl estradiol|No|Yes|No|No|75%|65862077785|TRI-MILI 28 TABLET|28|EA|.16416|09/01/2020||Yes|No||09/01/2020||Yes|No|09/01/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.1602|03/29/2022|.15635|03/29/2022|.15739|03/29/2022||||17940|||||No|No||AUROBINDO PHARM|No|||Only covered for non-contraceptive (medical) purposes|
norgestimate-ethinyl estradiol|Yes|Yes|No|No|75%|65862077885|TRI-LO-MILI TABLET|28|EA|.18013|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No|Refer to program requirements|||No|No|01/15/2020||Prescription required|No|||No|.16464|03/29/2022|.16068|03/29/2022|.16175|03/29/2022||||17941|||||No|No||AUROBINDO PHARM|No|||Only covered for non-contraceptive (medical) purposes|
olmesartan/hydrochlorothiazide|No|No|No|No|75%|65862077930|OLMESARTAN-HCTZ 20-12.5 MG TAB|30|EA|.53993|08/29/2017||Yes|No||08/29/2017||Yes|No|08/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.22565|03/29/2022|.22023|03/29/2022|.2217|03/29/2022|||ANGIOTENSIN MODULATORS|17942|||||No|No||AUROBINDO PHARM|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|65862077990|OLMESARTAN-HCTZ 20-12.5 MG TAB|90|EA|.53998|08/29/2017||Yes|No||08/29/2017||Yes|No|08/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.22565|03/29/2022|.22023|03/29/2022|.2217|03/29/2022|||ANGIOTENSIN MODULATORS|17943|||||No|No||AUROBINDO PHARM|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|65862078030|OLMESARTAN-HCTZ 40-12.5 MG TAB|30|EA|.75063|08/29/2017||Yes|No||08/29/2017||Yes|No|08/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.29168|03/29/2022|.28467|03/29/2022|.28657|03/29/2022|||ANGIOTENSIN MODULATORS|17944|||||No|No||AUROBINDO PHARM|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|65862078090|OLMESARTAN-HCTZ 40-12.5 MG TAB|90|EA|.75058|08/29/2017||Yes|No||08/29/2017||Yes|No|08/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.29168|03/29/2022|.28467|03/29/2022|.28657|03/29/2022|||ANGIOTENSIN MODULATORS|17945|||||No|No||AUROBINDO PHARM|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|65862078130|OLMESARTAN-HCTZ 40-25 MG TAB|30|EA|.75063|08/29/2017||Yes|No||08/29/2017||Yes|No|08/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.29227|03/29/2022|.28525|03/29/2022|.28715|03/29/2022|||ANGIOTENSIN MODULATORS|17946|||||No|No||AUROBINDO PHARM|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|65862078190|OLMESARTAN-HCTZ 40-25 MG TAB|90|EA|.75058|08/29/2017||Yes|No||08/29/2017||Yes|No|08/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.29227|03/29/2022|.28525|03/29/2022|.28715|03/29/2022|||ANGIOTENSIN MODULATORS|17947|||||No|No||AUROBINDO PHARM|No||||
methenamine hippurate|No|No|No|No|75%|65862078201|METHENAMINE HIPP 1 GM TABLET|100|EA|.344|02/16/2017||Yes|No||02/16/2017||Yes|No|02/16/2017||Yes|No||||No|No|||Prescription required|No|||No|.83638|03/29/2022|.8163|03/29/2022|.82174|03/29/2022||||17948|||||No|No||AUROBINDO PHARM|No||||
esomeprazole magnesium|No|No|No|No|75%|65862078330|ESOMEPRAZOLE MAG DR 20 MG CAP|30|EA|.14333|02/27/2017||Yes|No||02/27/2017||Yes|No|02/27/2017||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|17949|||||No|No||AUROBINDO PHARM|No||||
esomeprazole magnesium|No|No|No|No|75%|65862078390|ESOMEPRAZOLE MAG DR 20 MG CAP|90|EA|.36277|02/27/2017||Yes|No||02/27/2017||Yes|No|02/27/2017||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|17950|||||No|No||AUROBINDO PHARM|No||||
esomeprazole magnesium|No|No|No|No|75%|65862078430|ESOMEPRAZOLE MAG DR 40 MG CAP|30|EA|.14333|02/27/2017||Yes|No||02/27/2017||Yes|No|02/27/2017||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|17951|||||No|No||AUROBINDO PHARM|No||||
esomeprazole magnesium|No|No|No|No|75%|65862078490|ESOMEPRAZOLE MAG DR 40 MG CAP|90|EA|.14333|02/27/2017||Yes|No||02/27/2017||Yes|No|02/27/2017||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|17952|||||No|No||AUROBINDO PHARM|No||||
armodafinil|No|No|No|No|90%|65862080530|ARMODAFINIL 50 MG TABLET|30|EA|.15623|08/07/2020||Yes|No||08/07/2020||Yes|No|08/07/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.28825|03/29/2022|.28133|03/29/2022|.2832|03/29/2022|||STIMULANTS AND RELATED AGENTS|17953|||||No|No||AUROBINDO PHARM|No||||
armodafinil|No|No|No|No|90%|65862080630|ARMODAFINIL 150 MG TABLET|30|EA|.47013|08/24/2020||Yes|No||08/24/2020||Yes|No|08/24/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.83403|03/29/2022|.81401|03/29/2022|.81943|03/29/2022|||STIMULANTS AND RELATED AGENTS|17954|||||No|No||AUROBINDO PHARM|No||||
armodafinil|No|No|No|No|90%|65862080730|ARMODAFINIL 250 MG TABLET|30|EA|.47013|08/07/2020||Yes|No||08/07/2020||Yes|No|08/07/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.10963|03/29/2022|1.08299|03/29/2022|1.09021|03/29/2022|||STIMULANTS AND RELATED AGENTS|17955|||||No|No||AUROBINDO PHARM|No||||
prasugrel HCl|No|No|No|No|75%|65862082930|PRASUGREL 5 MG TABLET|30|EA|.35475|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|No||004|No|.53487|03/29/2022|.52203|03/29/2022|.5255|03/29/2022|||PLATELET AGGREGATION INHIBITORS|17956|||||No|No||AUROBINDO PHARM|No||||
prasugrel HCl|No|No|No|No|75%|65862083030|PRASUGREL 10 MG TABLET|30|EA|.35475|01/26/2018||Yes|No||01/26/2018||Yes|No|01/26/2018||Yes|No||||No|No|||Prescription required|No||004|No|.35104|03/29/2022|.34261|03/29/2022|.34489|03/29/2022|||PLATELET AGGREGATION INHIBITORS|17957|||||No|No||AUROBINDO PHARM|No||||
cinacalcet HCl|No|No|No|No|75%|65862083105|CINACALCET HCL 30 MG TABLET|500|EA|.1075|12/28/2021||Yes|No||12/28/2021||Yes|No|12/28/2021||Yes|No||||No|No|||Prescription required|No|||No|.75588|03/29/2022|.73773|03/29/2022|.74265|03/29/2022||||17958|||||No|No||AUROBINDO PHARM|No||||
cinacalcet HCl|No|No|No|No|75%|65862083130|CINACALCET HCL 30 MG TABLET|30|EA|.215|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.75588|03/29/2022|.73773|03/29/2022|.74265|03/29/2022||||17959|||||No|No||AUROBINDO PHARM|No||||
cinacalcet HCl|No|No|No|No|75%|65862083205|CINACALCET HCL 60 MG TABLET|500|EA|.215|12/28/2021||Yes|No||12/28/2021||Yes|No|12/28/2021||Yes|No||||No|No|||Prescription required|No|||No|1.7407|03/29/2022|1.69892|03/29/2022|1.71023|03/29/2022||||17960|||||No|No||AUROBINDO PHARM|No||||
cinacalcet HCl|No|No|No|No|75%|65862083230|CINACALCET HCL 60 MG TABLET|30|EA|.387|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No|||No|1.7407|03/29/2022|1.69892|03/29/2022|1.71023|03/29/2022||||17961|||||No|No||AUROBINDO PHARM|No||||
cinacalcet HCl|No|No|No|No|75%|65862083305|CINACALCET HCL 90 MG TABLET|500|EA|.3225|12/28/2021||Yes|No||12/28/2021||Yes|No|12/28/2021||Yes|No||||No|No|||Prescription required|No|||No|3.64673|03/29/2022|3.5592|03/29/2022|3.58291|03/29/2022||||17962|||||No|No||AUROBINDO PHARM|No||||
cinacalcet HCl|No|No|No|No|75%|65862083330|CINACALCET HCL 90 MG TABLET|30|EA|.559|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|No|||No|3.64673|03/29/2022|3.5592|03/29/2022|3.58291|03/29/2022||||17963|||||No|No||AUROBINDO PHARM|No||||
amlodipine/valsartan/hcthiazid|No|No|No|No|75%|65862083430|AMLOD-VALSA-HCTZ 5-160-12.5 MG|30|EA|.4644|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||05/20/2019||Yes|No|||Prescription required|Yes|07/26/2018|017|Yes|1.0584|12/28/2021|1.04328|12/28/2021|.9936|12/28/2021|||ANGIOTENSIN MODULATOR COMBINATIONS|17964|||||No|No||AUROBINDO PHARM|No||||
amlodipine/valsartan/hcthiazid|No|No|No|No|75%|65862083530|AMLOD-VALSA-HCTZ 5-160-25 MG|30|EA|.4644|09/19/2019||Yes|No||09/19/2019||Yes|No|09/19/2019||Yes|No||09/19/2019||Yes|No|||Prescription required|Yes|07/26/2018|017|Yes|1.0584|01/25/2022|1.04328|01/25/2022|.9936|01/25/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17965|||||No|No||AUROBINDO PHARM|No||||
amlodipine/valsartan/hcthiazid|No|No|No|No|75%|65862083630|AMLOD-VALSA-HCTZ 10-160-12.5MG|30|EA|.5418|09/19/2019||Yes|No||09/19/2019||Yes|No|09/19/2019||Yes|No||09/19/2019||Yes|No|||Prescription required|Yes|07/26/2018|017|Yes|1.2348|12/28/2021|1.21716|12/28/2021|1.1592|12/28/2021|||ANGIOTENSIN MODULATOR COMBINATIONS|17966|||||No|No||AUROBINDO PHARM|No||||
amlodipine/valsartan/hcthiazid|No|No|No|No|75%|65862083730|AMLOD-VALSA-HCTZ 10-160-25 MG|30|EA|.5418|09/19/2019||Yes|No||09/19/2019||Yes|No|09/19/2019||Yes|No||09/19/2019||Yes|No|||Prescription required|Yes|07/26/2018|017|Yes|1.2348|12/28/2021|1.21716|12/28/2021|1.1592|12/28/2021|||ANGIOTENSIN MODULATOR COMBINATIONS|17967|||||No|No||AUROBINDO PHARM|No||||
amlodipine/valsartan/hcthiazid|No|No|No|No|75%|65862083830|AMLOD-VALSA-HCTZ 10-320-25 MG|30|EA|.7224|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||05/20/2019||Yes|No|||Prescription required|Yes|07/26/2018|017|Yes|1.6464|01/25/2022|1.62288|01/25/2022|1.5456|01/25/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17968|||||No|No||AUROBINDO PHARM|No||||
moxifloxacin HCl|No|No|No|No|75%|65862084003|MOXIFLOXACIN 0.5% EYE DROPS|3|ML|4.79736|08/27/2018||Yes|No||08/27/2018||Yes|No|08/27/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|058|No|3.97371|03/29/2022|3.87834|03/29/2022|3.90417|03/29/2022|||OPHTHALMIC ANTIBIOTICS|17969|||||No|No||AUROBINDO PHARM|No||||
entecavir|No|No|No|No|75%|65862084130|ENTECAVIR 0.5 MG TABLET|30|EA|.91733|10/05/2016||Yes|No||10/05/2016||Yes|No|10/05/2016||Yes|No||||No|No|||Prescription required|No|||No|.89227|03/29/2022|.87085|03/29/2022|.87665|03/29/2022||||17970|||||No|No||AUROBINDO PHARM|No||||
entecavir|No|No|No|No|75%|65862084230|ENTECAVIR 1 MG TABLET|30|EA|.91733|10/05/2016||Yes|No||10/05/2016||Yes|No|10/05/2016||Yes|No||||No|No|||Prescription required|No|||No|1.06461|03/29/2022|1.03905|03/29/2022|1.04597|03/29/2022||||17971|||||No|No||AUROBINDO PHARM|No||||
clozapine|No|No|No|No|75%|65862084401|CLOZAPINE 25 MG TABLET|100|EA|.2795|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.26318|03/29/2022|.25686|03/29/2022|.25857|03/29/2022|||ANTIPSYCHOTICS|17972|||||No|No||AUROBINDO PHARM|No||||
clozapine|No|No|No|No|75%|65862084501|CLOZAPINE 50 MG TABLET|100|EA|.5676|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.51896|03/29/2022|.5065|03/29/2022|.50987|03/29/2022|||ANTIPSYCHOTICS|17973|||||No|No||AUROBINDO PHARM|No||||
clozapine|No|No|No|No|75%|65862084601|CLOZAPINE 100 MG TABLET|100|EA|.46827|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.60868|03/29/2022|.59407|03/29/2022|.59802|03/29/2022|||ANTIPSYCHOTICS|17974|||||No|No||AUROBINDO PHARM|No||||
clozapine|No|No|No|No|75%|65862084605|CLOZAPINE 100 MG TABLET|500|EA|.59047|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|.60868|03/29/2022|.59407|03/29/2022|.59802|03/29/2022|||ANTIPSYCHOTICS|17975|||||No|No||AUROBINDO PHARM|No||||
clozapine|No|No|No|No|75%|65862084701|CLOZAPINE 200 MG TABLET|100|EA|1.1235|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No||||No|No|||Prescription required|No||027|Yes|1.46893|03/29/2022|1.43367|03/29/2022|1.44322|03/29/2022|||ANTIPSYCHOTICS|17976|||||No|No||AUROBINDO PHARM|No||||
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|65862084888|AYUNA-28 TABLET|28|EA|.0774|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No|Refer to program requirements|||No|No|01/15/2020||Prescription required|No|||No|.17306|03/29/2022|.1689|03/29/2022|.17003|03/29/2022||||17977|||||No|No||AUROBINDO PHARM|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|65862084988|AFIRMELLE-28 TABLET|28|EA|.13115|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No|Refer to program requirements|||No|No|01/15/2020||Prescription required|No|||No|.21292|03/29/2022|.2078|03/29/2022|.20919|03/29/2022||||17978|||||No|No||AUROBINDO PHARM|No|||Only covered for non-contraceptive (medical) purposes|
amlodipine bes/olmesartan med|No|No|No|No|75%|65862085430|AMLODIPINE-OLMESARTAN 5-20 MG|30|EA|.3225|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.41945|03/29/2022|.40938|03/29/2022|.4121|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17979|||||No|No||AUROBINDO PHARM|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|65862085530|AMLODIPINE-OLMESARTAN 5-40 MG|30|EA|.4085|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.47518|03/29/2022|.46377|03/29/2022|.46686|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17980|||||No|No||AUROBINDO PHARM|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|65862085630|AMLODIPINE-OLMESARTAN 10-20 MG|30|EA|.3225|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.43528|03/29/2022|.42483|03/29/2022|.42766|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17981|||||No|No||AUROBINDO PHARM|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|65862085730|AMLODIPINE-OLMESARTAN 10-40 MG|30|EA|.4085|09/07/2017||Yes|No||09/07/2017||Yes|No|09/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|017|Yes|.41757|03/29/2022|.40754|03/29/2022|.41026|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|17982|||||No|No||AUROBINDO PHARM|No||||
famotidine|No|No|No|No|75%|65862085901|FAMOTIDINE 20 MG TABLET|100|EA|.043|07/05/2016||Yes|No||07/05/2016||Yes|No|07/05/2016||Yes|No||||No|No|||Prescription required|No|||No|.03262|03/29/2022|.03183|03/29/2022|.03204|03/29/2022||||17983|||||No|No||AUROBINDO PHARM|No||||
famotidine|No|No|No|No|75%|65862085999|FAMOTIDINE 20 MG TABLET|1000|EA|.043|10/03/2017||Yes|No||10/03/2017||Yes|No|10/03/2017||Yes|No||||No|No|||Prescription required|No|||No|.03262|03/29/2022|.03183|03/29/2022|.03204|03/29/2022||||17984|||||No|No||AUROBINDO PHARM|No||||
famotidine|No|No|No|No|75%|65862086001|FAMOTIDINE 40 MG TABLET|100|EA|.0645|07/05/2016||Yes|No||07/05/2016||Yes|No|07/05/2016||Yes|No||||No|No|||Prescription required|No|||No|.06888|03/29/2022|.06722|03/29/2022|.06767|03/29/2022||||17985|||||No|No||AUROBINDO PHARM|No||||
famotidine|No|No|No|No|75%|65862086099|FAMOTIDINE 40 MG TABLET|1000|EA|.0602|10/03/2017||Yes|No||10/03/2017||Yes|No|10/03/2017||Yes|No||||No|No|||Prescription required|No|||No|.06888|03/29/2022|.06722|03/29/2022|.06767|03/29/2022||||17986|||||No|No||AUROBINDO PHARM|No||||
darifenacin hydrobromide|No|No|No|No|75%|65862086130|DARIFENACIN ER 7.5 MG TABLET|30|EA|3.52227|02/16/2017||Yes|No||02/16/2017||Yes|No|02/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|006|Yes|1.71519|03/29/2022|1.67402|03/29/2022|1.68517|03/29/2022|||BLADDER RELAXANT PREPARATIONS|17987|||||No|No||AUROBINDO PHARM|No||||
darifenacin hydrobromide|No|No|No|No|75%|65862086230|DARIFENACIN ER 15 MG TABLET|30|EA|3.52227|02/16/2017||Yes|No||02/16/2017||Yes|No|02/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|006|No|2.08753|03/29/2022|2.03742|03/29/2022|2.05099|03/29/2022|||BLADDER RELAXANT PREPARATIONS|17988|||||No|No||AUROBINDO PHARM|No||||
dalfampridine|No|No|No|No|75%|65862086360|DALFAMPRIDINE ER 10 MG TABLET|60|EA|1.39785|12/04/2018||Yes|No||12/04/2018||Yes|No|12/04/2018||Yes|No||||No|No|||Prescription required|No||043|No|.82047|03/29/2022|.80077|03/29/2022|.80611|03/29/2022|||MULTIPLE SCLEROSIS AGENTS|17989|||||No|No||AUROBINDO PHARM|No||||
L-norgest/e.estradiol-e.estrad|Yes|Yes|No|No|75%|65862086495|SIMPESSE 0.15-0.03-0.01 MG TAB|91|EA|.40637|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No|Refer to program requirements|||No|No|01/15/2020||Prescription required|No|||No|.54912|03/29/2022|.53594|03/29/2022|.53951|03/29/2022||||17990|||||No|No||AUROBINDO PHARM|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|No|Yes|No|No|75%|65862086583|ICLEVIA 0.15 MG-0.03 MG TABLET|91|EA|.25965|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.17533|03/29/2022|.17112|03/29/2022|.17226|03/29/2022||||17991|||||No|No||AUROBINDO PHARM|No|||Only covered for non-contraceptive (medical) purposes|
telmisartan|No|No|No|No|75%|65862086703|TELMISARTAN 20 MG TABLET|30|EA|1.13262|08/22/2016||Yes|No||08/22/2016||Yes|No|08/22/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|113|Yes|.30407|03/29/2022|.29677|03/29/2022|.29874|03/29/2022|||ANGIOTENSIN MODULATORS|17992|||||No|No||AUROBINDO PHARM|No||||
telmisartan|No|No|No|No|75%|65862086730|TELMISARTAN 20 MG TABLET|30|EA|.20425|03/17/2022||Yes|No||03/17/2022||Yes|No|03/17/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.30407|03/29/2022|.29677|03/29/2022|.29874|03/29/2022|||ANGIOTENSIN MODULATORS|17993|||||No|No||AUROBINDO PHARM|No||||
telmisartan|No|No|No|No|75%|65862086803|TELMISARTAN 40 MG TABLET|30|EA|1.13262|08/23/2016||Yes|No||08/23/2016||Yes|No|08/23/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|113|Yes|.35861|03/29/2022|.35|03/29/2022|.35233|03/29/2022|||ANGIOTENSIN MODULATORS|17994|||||No|No||AUROBINDO PHARM|No||||
telmisartan|No|No|No|No|75%|65862086830|TELMISARTAN 40 MG TABLET|30|EA|.20425|03/17/2022||Yes|No||03/17/2022||Yes|No|03/17/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.35861|03/29/2022|.35|03/29/2022|.35233|03/29/2022|||ANGIOTENSIN MODULATORS|17995|||||No|No||AUROBINDO PHARM|No||||
telmisartan|No|No|No|No|75%|65862086903|TELMISARTAN 80 MG TABLET|30|EA|1.13262|08/23/2016||Yes|No||08/23/2016||Yes|No|08/23/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|113|Yes|.33958|03/29/2022|.33143|03/29/2022|.33363|03/29/2022|||ANGIOTENSIN MODULATORS|17996|||||No|No||AUROBINDO PHARM|No||||
telmisartan|No|No|No|No|75%|65862086930|TELMISARTAN 80 MG TABLET|30|EA|.20425|03/17/2022||Yes|No||03/17/2022||Yes|No|03/17/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.33958|03/29/2022|.33143|03/29/2022|.33363|03/29/2022|||ANGIOTENSIN MODULATORS|17997|||||No|No||AUROBINDO PHARM|No||||
risedronate sodium|No|No|No|No|75%|65862087003|RISEDRONATE SODIUM 150 MG TAB|3|EA|7.4175|05/15/2017||Yes|No||05/15/2017||Yes|No|05/15/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|060|No|20.52701|03/29/2022|20.03436|03/29/2022|20.16778|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|17998|||||No|No||AUROBINDO PHARM|No||||
risedronate sodium|No|No|No|No|75%|65862087011|RISEDRONATE SODIUM 150 MG TAB|1|EA|13.4375|05/15/2017||Yes|No||05/15/2017||Yes|No|05/15/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|060|No|20.52701|03/29/2022|20.03436|03/29/2022|20.16778|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|17999|||||No|No||AUROBINDO PHARM|No||||
quetiapine fumarate|No|No|No|No|75%|65862087360|QUETIAPINE ER 50 MG TABLET|60|EA|.30501|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||||No|No|||Prescription required|Yes|12/07/2017|027|Yes|.13845|03/29/2022|.13512|03/29/2022|.13602|03/29/2022|||ANTIPSYCHOTICS|18000|||||No|No||AUROBINDO PHARM|No||||
quetiapine fumarate|No|No|No|No|75%|65862087460|QUETIAPINE ER 150 MG TABLET|60|EA|.33683|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||||No|No|||Prescription required|Yes|12/07/2017|027|Yes|.25256|03/29/2022|.24649|03/29/2022|.24814|03/29/2022|||ANTIPSYCHOTICS|18001|||||No|No||AUROBINDO PHARM|No||||
quetiapine fumarate|No|No|No|No|75%|65862087560|QUETIAPINE ER 200 MG TABLET|60|EA|.37983|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||||No|No|||Prescription required|Yes|12/07/2017|027|Yes|.25825|03/29/2022|.25205|03/29/2022|.25373|03/29/2022|||ANTIPSYCHOTICS|18002|||||No|No||AUROBINDO PHARM|No||||
quetiapine fumarate|No|No|No|No|75%|65862087660|QUETIAPINE ER 300 MG TABLET|60|EA|.43716|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||||No|No|||Prescription required|Yes|12/07/2017|027|Yes|.35477|03/29/2022|.34625|03/29/2022|.34856|03/29/2022|||ANTIPSYCHOTICS|18003|||||No|No||AUROBINDO PHARM|No||||
quetiapine fumarate|No|No|No|No|75%|65862087760|QUETIAPINE ER 400 MG TABLET|60|EA|.4945|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||||No|No|||Prescription required|Yes|12/07/2017|027|Yes|.42833|03/29/2022|.41805|03/29/2022|.42083|03/29/2022|||ANTIPSYCHOTICS|18004|||||No|No||AUROBINDO PHARM|No||||
tadalafil|No|No|No|No|75%|65862088060|TADALAFIL 20 MG TABLET|60|EA|.35797|05/28/2019||Yes|No||05/28/2019||Yes|No|05/28/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/26/2018|171|Yes|.68104|03/29/2022|.66469|03/29/2022|.66912|03/29/2022|||PAH AGENTS: ORAL AND INHALED|18005|||||No|No||AUROBINDO PHARM|No||||
minocycline HCl|No|No|No|No|75%|65862088330|MINOCYCLINE ER 55 MG TABLET|30|EA|9.42531|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No||03/03/2020||Yes|No|||Prescription required|Yes|07/25/2019|213|No|21.48094|03/03/2020|21.17407|03/03/2020|20.16578|03/03/2020|||TETRACYCLINES|18006|||||No|No||AUROBINDO PHARM|No||||
minocycline HCl|No|No|No|No|75%|65862088430|MINOCYCLINE ER 80 MG TABLET|30|EA|9.42531|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||02/26/2020||Yes|No|||Prescription required|Yes|07/25/2019|213|No|21.48094|04/27/2021|21.17407|04/27/2021|20.16578|04/27/2021|||TETRACYCLINES|18007|||||No|No||AUROBINDO PHARM|No||||
minocycline HCl|No|No|No|No|75%|65862088530|MINOCYCLINE ER 105 MG TABLET|30|EA|9.42531|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||02/26/2020||Yes|No|||Prescription required|Yes|07/25/2019|213|No|21.48094|02/26/2020|21.17407|02/26/2020|20.16578|02/26/2020|||TETRACYCLINES|18008|||||No|No||AUROBINDO PHARM|No||||
desog-e.estradiol/e.estradiol|Yes|Yes|No|No|75%|65862088688|SIMLIYA 28 DAY TABLET|28|EA|.25354|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No|Refer to program requirements|||No|No|06/19/2020||Prescription required|No|||No|.21935|03/29/2022|.21408|03/29/2022|.21551|03/29/2022||||18009|||||No|No||AUROBINDO PHARM|No|||Only covered for non-contraceptive (medical) purposes|
glipizide|Yes|No|No|No|75%|65862088830|GLIPIZIDE ER 2.5 MG TABLET|30|EA|.09173|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||08/28/2018||Yes|No|06/18/2019||Prescription required|No|||Yes|.12809|03/29/2022|.12501|03/29/2022|.12584|03/29/2022||||18010|||||No|No||AUROBINDO PHARM|No||||
glipizide|Yes|No|No|No|75%|65862088901|GLIPIZIDE ER 5 MG TABLET|100|EA|.0565|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||11/27/2018||Yes|No|06/18/2019||Prescription required|No|||Yes|.11105|03/29/2022|.10838|03/29/2022|.1091|03/29/2022||||18011|||||No|No||AUROBINDO PHARM|No||||
glipizide|Yes|No|No|No|75%|65862088905|GLIPIZIDE ER 5 MG TABLET|500|EA|.05353|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||11/27/2018||Yes|No|06/18/2019||Prescription required|No|||Yes|.11105|03/29/2022|.10838|03/29/2022|.1091|03/29/2022||||18012|||||No|No||AUROBINDO PHARM|No||||
glipizide|Yes|No|No|No|75%|65862089001|GLIPIZIDE ER 10 MG TABLET|100|EA|.10904|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||08/28/2018||Yes|No|06/18/2019||Prescription required|No|||No|.184|03/29/2022|.17958|03/29/2022|.18078|03/29/2022||||18013|||||No|No||AUROBINDO PHARM|No||||
voriconazole|No|No|No|No|75%|65862089130|VORICONAZOLE 50 MG TABLET|30|EA|.93166|11/15/2016||Yes|No||11/15/2016||Yes|No|11/15/2016||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|01/28/2016|069|No|2.12332|06/25/2019|2.09299|06/25/2019|1.99332|06/25/2019|||ANTIFUNGALS: ORAL|18014|||||No|No||AUROBINDO PHARM|No||||
voriconazole|No|No|No|No|75%|65862089230|VORICONAZOLE 200 MG TABLET|30|EA|3.225|11/15/2016||Yes|No||11/15/2016||Yes|No|11/15/2016||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|01/28/2016|069|No|2.07998|03/29/2022|2.03006|03/29/2022|2.04358|03/29/2022|||ANTIFUNGALS: ORAL|18015|||||No|No||AUROBINDO PHARM|No||||
norethindrone-ethin. estradiol|No|Yes|No|No|75%|65862089788|NYLIA 7-7-7-28 TABLET|28|EA|.11108|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.43221|03/29/2022|.42183|03/29/2022|.42464|03/29/2022||||18016|||||No|No||AUROBINDO PHARM|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-ethin. estradiol|No|Yes|No|No|75%|65862089888|NYLIA 1-35 28 TABLET|28|EA|.10109|03/23/2022||Yes|No||03/23/2022||Yes|No|03/23/2022||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.34259|03/29/2022|.33436|03/29/2022|.33659|03/29/2022||||18017|||||No|No||AUROBINDO PHARM|No|||Only covered for non-contraceptive (medical) purposes|
abacavir sulfate/lamivudine|No|No|No|No|75%|65862090030|ABACAVIR-LAMIVUDINE 600-300 MG|30|EA|3.69499|06/02/2017||Yes|No||06/02/2017||Yes|No|06/02/2017||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|2.09447|03/29/2022|2.0442|03/29/2022|2.05781|03/29/2022|||HIV / AIDS|18018|||||No|No||AUROBINDO PHARM|No||||
ipratropium bromide|No|No|No|No|75%|65862090525|IPRATROPIUM BR 0.02% SOLN|2.5|ML|.0258|05/26/2017||Yes|No||05/26/2017||Yes|No|05/26/2017||Yes|No||||No|No|||Prescription required|No||098|No|.05484|03/29/2022|.05352|03/29/2022|.05388|03/29/2022|||COPD AGENTS|18019|||||No|No||AUROBINDO PHARM|No||||
ipratropium bromide|No|No|No|No|75%|65862090530|IPRATROPIUM BR 0.02% SOLN|2.5|ML|.0258|05/26/2017||Yes|No||05/26/2017||Yes|No|05/26/2017||Yes|No||||No|No|||Prescription required|No||098|No|.0588|05/26/2017|.05796|05/26/2017|.0552|05/26/2017|||COPD AGENTS|18020|||||No|No||AUROBINDO PHARM|No||||
ipratropium bromide|No|No|No|No|75%|65862090560|IPRATROPIUM BR 0.02% SOLN|2.5|ML|.0258|05/26/2017||Yes|No||05/26/2017||Yes|No|05/26/2017||Yes|No||||No|No|||Prescription required|No||098|No|.0599|03/29/2022|.05846|03/29/2022|.05885|03/29/2022|||COPD AGENTS|18021|||||No|No||AUROBINDO PHARM|No||||
celecoxib|No|No|No|No|75%|65862090760|CELECOXIB 50 MG CAPSULE|60|EA|.05733|11/15/2016||Yes|No||11/15/2016||Yes|No|11/15/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.1386|03/29/2022|.13527|03/29/2022|.13617|03/29/2022|||NSAIDS|18022|||||No|No||AUROBINDO PHARM|No||||
celecoxib|No|No|No|No|75%|65862090801|CELECOXIB 100 MG CAPSULE|100|EA|.0645|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|18023|||||No|No||AUROBINDO PHARM|No||||
celecoxib|No|No|No|No|75%|65862090805|CELECOXIB 100 MG CAPSULE|500|EA|.0516|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|18024|||||No|No||AUROBINDO PHARM|No||||
celecoxib|No|No|No|No|75%|65862090901|CELECOXIB 200 MG CAPSULE|100|EA|.129|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|18025|||||No|No||AUROBINDO PHARM|No||||
celecoxib|No|No|No|No|75%|65862090905|CELECOXIB 200 MG CAPSULE|500|EA|.1032|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|18026|||||No|No||AUROBINDO PHARM|No||||
celecoxib|No|No|No|No|75%|65862091060|CELECOXIB 400 MG CAPSULE|60|EA|.25083|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.73632|03/29/2022|.71864|03/29/2022|.72343|03/29/2022|||NSAIDS|18027|||||No|No||AUROBINDO PHARM|No||||
zolmitriptan|No|No|No|No|75%|65862091469|ZOLMITRIPTAN 2.5 MG TABLET|6|EA|.28308|10/04/2017||Yes|No||10/04/2017||Yes|No|10/04/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|1.43567|03/29/2022|1.40121|03/29/2022|1.41054|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|18028|||||No|No||AUROBINDO PHARM|No||||
zolmitriptan|No|No|No|No|75%|65862091564|ZOLMITRIPTAN 5 MG TABLET|3|EA|.2795|10/04/2017||Yes|No||10/04/2017||Yes|No|10/04/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|1.62826|03/29/2022|1.58918|03/29/2022|1.59976|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|18029|||||No|No||AUROBINDO PHARM|No||||
sevelamer carbonate|No|No|No|No|75%|65862092127|SEVELAMER CARBONATE 800 MG TAB|270|EA|.16721|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/27/2017|052|Yes|.27122|03/29/2022|.26471|03/29/2022|.26647|03/29/2022|||PHOSPHATE BINDERS|18030|||||No|No||AUROBINDO PHARM|No||||
tramadol HCl/acetaminophen|No|No|No|No|90%|65862092201|TRAMADOL-ACETAMINOPHN 37.5-325|100|EA|.09675|06/26/2020||Yes|No||06/26/2020||Yes|No|06/26/2020||Yes|No||||No|No|||Prescription required|No||109|Yes|.11806|03/29/2022|.11522|03/29/2022|.11599|03/29/2022|||ANALGESICS: NARCOTICS SHORT|18031|||||No|No||AUROBINDO PHARM|No||||
tramadol HCl/acetaminophen|No|No|No|No|90%|65862092205|TRAMADOL-ACETAMINOPHN 37.5-325|500|EA|.09675|06/26/2020||Yes|No||06/26/2020||Yes|No|06/26/2020||Yes|No||||No|No|||Prescription required|No||109|Yes|.11806|03/29/2022|.11522|03/29/2022|.11599|03/29/2022|||ANALGESICS: NARCOTICS SHORT|18032|||||No|No||AUROBINDO PHARM|No||||
norethindrone|No|Yes|No|No|75%|65862092585|INCASSIA 0.35 MG TABLET|28|EA|.06142|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.16123|03/29/2022|.15736|03/29/2022|.1584|03/29/2022||||18033|||||No|No||AUROBINDO PHARM|No|||Only covered for non-contraceptive (medical) purposes|
finasteride|No|No|No|No|75%|65862092730|FINASTERIDE 1 MG TABLET|30|EA|.03583|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No|||No|.04818|03/29/2022|.04702|03/29/2022|.04733|03/29/2022||||18034|||||No|No||AUROBINDO PHARM|No||||
finasteride|No|No|No|No|75%|65862092790|FINASTERIDE 1 MG TABLET|90|EA|.02365|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No|||No|.04818|03/29/2022|.04702|03/29/2022|.04733|03/29/2022||||18035|||||No|No||AUROBINDO PHARM|No||||
sumatriptan succ/naproxen sod|No|No|No|No|75%|65862092836|SUMATRIPTAN-NAPROXEN 85-500 MG|9|EA|10.84555|03/26/2018||Yes|No||03/26/2018||Yes|No|03/26/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|021|Yes|22.04755|03/29/2022|21.5184|03/29/2022|21.66171|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|18036|||||No|No||AUROBINDO PHARM|No||||
sevelamer carbonate|No|No|No|No|75%|65862093090|SEVELAMER 0.8 GM POWDER PACKET|90|EA|.81221|01/15/2018||Yes|No||01/15/2018||Yes|No|01/15/2018||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/21/2016|052|Yes|1.8511|01/25/2022|1.82465|01/25/2022|1.73776|01/25/2022|||PHOSPHATE BINDERS|18037|||||No|No||AUROBINDO PHARM|No||||
sevelamer carbonate|No|No|No|No|75%|65862093190|SEVELAMER 2.4 GM POWDER PACKET|90|EA|.81221|01/15/2018||Yes|No||01/15/2018||Yes|No|01/15/2018||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/21/2016|052|Yes|6.45324|08/24/2021|6.29836|08/24/2021|6.3403|08/24/2021|||PHOSPHATE BINDERS|18038|||||No|No||AUROBINDO PHARM|No||||
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|65862093488|AUROVELA 24 FE 1 MG-20 MCG TAB|28|EA|.31743|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No|Refer to program requirements|||No|No|01/15/2020||Prescription required|No|||No|.56858|03/29/2022|.55493|03/29/2022|.55862|03/29/2022||||18039|||||No|No||AUROBINDO PHARM|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone ac-eth estradiol|No|Yes|No|No|75%|65862093574|AUROVELA 21 1.5-30 TABLET|21|EA|.44003|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.56037|03/29/2022|.54692|03/29/2022|.55056|03/29/2022||||18040|||||No|No||AUROBINDO PHARM|No|||Only covered for non-contraceptive (medical) purposes|
paricalcitol|No|No|No|No|75%|65862093630|PARICALCITOL 1 MCG CAPSULE|30|EA|.63783|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No|||No|1.13472|03/29/2022|1.10748|03/29/2022|1.11486|03/29/2022||||18041|||||No|No||AUROBINDO PHARM|No||||
paricalcitol|No|No|No|No|75%|65862093730|PARICALCITOL 2 MCG CAPSULE|30|EA|1.2685|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No|||No|2.891|08/28/2018|2.8497|08/28/2018|2.714|08/28/2018||||18042|||||No|No||AUROBINDO PHARM|No||||
norethindrone ac-eth estradiol|Yes|Yes|No|No|75%|65862093988|AUROVELA 1 MG-20 MCG TABLET|21|EA|.14251|09/09/2019||Yes|No||09/09/2019||Yes|No|09/09/2019||Yes|No|Refer to program requirements|||No|No|01/15/2020||Prescription required|No|||No|.29153|03/29/2022|.28453|03/29/2022|.28642|03/29/2022||||18043|||||No|No||AUROBINDO PHARM|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|65862094088|AUROVELA FE 1-20 TABLET|28|EA|.11778|09/09/2019||Yes|No||09/09/2019||Yes|No|09/09/2019||Yes|No|Refer to program requirements|||No|No|01/15/2020||Prescription required|No|||No|.20374|03/29/2022|.19885|03/29/2022|.20017|03/29/2022||||18044|||||No|No||AUROBINDO PHARM|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|65862094188|AUROVELA FE 1.5 MG-30 MCG TAB|28|EA|.11778|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No|Refer to program requirements|||No|No|01/15/2020||Prescription required|No|||No|.28591|03/29/2022|.27904|03/29/2022|.2809|03/29/2022||||18045|||||No|No||AUROBINDO PHARM|No|||Only covered for non-contraceptive (medical) purposes|
levalbuterol HCl|No|No|No|No|75%|65862094324|LEVALBUTEROL 0.31 MG/3 ML SOL|3|ML|.172|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|.392|03/01/2022|.3864|03/01/2022|.368|03/01/2022|||BRONCHODILATORS: BETA AGONIST|18046|||||No|No||AUROBINDO PHARM|No||||
levalbuterol HCl|No|No|No|No|75%|65862094424|LEVALBUTEROL 0.63 MG/3 ML SOL|3|ML|.172|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|.33369|09/28/2021|.32568|09/28/2021|.32785|09/28/2021|||BRONCHODILATORS: BETA AGONIST|18047|||||No|No||AUROBINDO PHARM|Yes|09/01/2020|||
levalbuterol HCl|No|No|No|No|75%|65862094524|LEVALBUTEROL 1.25 MG/3 ML SOL|3|ML|.172|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|.40061|09/28/2021|.39099|09/28/2021|.39359|09/28/2021|||BRONCHODILATORS: BETA AGONIST|18048|||||No|No||AUROBINDO PHARM|No||||
dorzolamide/timolol/PF|No|No|No|No|75%|65862094760|DORZOLAMIDE-TIMOLOL 2%-0.5%|60|EA|.9718|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|088|No|1.74262|03/29/2022|1.70079|03/29/2022|1.71212|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|18049|||||No|No||AUROBINDO PHARM|No||||
eszopiclone|No|No|No|No|90%|65862096701|ESZOPICLONE 1 MG TABLET|100|EA|.0688|05/25/2017||Yes|No||05/25/2017||Yes|No|05/25/2017||Yes|No||||No|No|||Prescription required|No||054|Yes|.19753|03/29/2022|.19278|03/29/2022|.19407|03/29/2022|||SEDATIVE HYPNOTICS|18050|||||No|No||AUROBINDO PHARM|No||||
eszopiclone|No|No|No|No|90%|65862096730|ESZOPICLONE 1 MG TABLET|30|EA|.0688|06/25/2020||Yes|No||06/25/2020||Yes|No|06/25/2020||Yes|No||||No|No|||Prescription required|No||054|Yes|.19753|03/29/2022|.19278|03/29/2022|.19407|03/29/2022|||SEDATIVE HYPNOTICS|18051|||||No|No||AUROBINDO PHARM|No||||
eszopiclone|No|No|No|No|90%|65862096801|ESZOPICLONE 2 MG TABLET|100|EA|.0688|05/25/2017||Yes|No||05/25/2017||Yes|No|05/25/2017||Yes|No||||No|No|||Prescription required|No||054|Yes|.25375|03/29/2022|.24766|03/29/2022|.2493|03/29/2022|||SEDATIVE HYPNOTICS|18052|||||No|No||AUROBINDO PHARM|No||||
eszopiclone|No|No|No|No|90%|65862096901|ESZOPICLONE 3 MG TABLET|100|EA|.07525|05/25/2017||Yes|No||05/25/2017||Yes|No|05/25/2017||Yes|No||||No|No|||Prescription required|No||054|Yes|.14316|03/29/2022|.13972|03/29/2022|.14065|03/29/2022|||SEDATIVE HYPNOTICS|18053|||||No|No||AUROBINDO PHARM|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|65862097603|TELMISARTAN-HCTZ 40-12.5 MG TB|30|EA|.57333|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|Yes|11/09/2017|113|Yes|1.13569|03/29/2022|1.10843|03/29/2022|1.11581|03/29/2022|||ANGIOTENSIN MODULATORS|18054|||||No|No||AUROBINDO PHARM|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|65862097703|TELMISARTAN-HCTZ 80-12.5 MG TB|30|EA|.645|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|Yes|11/09/2017|113|Yes|.94301|03/29/2022|.92037|03/29/2022|.9265|03/29/2022|||ANGIOTENSIN MODULATORS|18055|||||No|No||AUROBINDO PHARM|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|65862097803|TELMISARTAN-HCTZ 80-25 MG TAB|30|EA|.78833|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|Yes|11/09/2017|113|Yes|1.29965|03/29/2022|1.26845|03/29/2022|1.2769|03/29/2022|||ANGIOTENSIN MODULATORS|18056|||||No|No||AUROBINDO PHARM|No||||
potassium chloride|No|No|No|No|75%|65862098601|POTASSIUM CL ER 8 MEQ TABLET|100|EA|.18451|06/03/2020||Yes|No||06/03/2020||Yes|No|06/03/2020||Yes|No||06/03/2020||Yes|No|||Prescription required|No|||No|.17696|03/29/2022|.17271|03/29/2022|.17386|03/29/2022||||18057|||||No|No||AUROBINDO PHARM|No||||
potassium chloride|No|No|No|No|75%|65862098605|POTASSIUM CL ER 8 MEQ TABLET|500|EA|.18451|06/03/2020||Yes|No||06/03/2020||Yes|No|06/03/2020||Yes|No||06/03/2020||Yes|No|||Prescription required|No|||No|.17696|03/29/2022|.17271|03/29/2022|.17386|03/29/2022||||18058|||||No|No||AUROBINDO PHARM|No||||
potassium chloride|No|No|No|No|75%|65862098701|POTASSIUM CL ER 10 MEQ TABLET|100|EA|.19423|06/03/2020||Yes|No||06/03/2020||Yes|No|06/03/2020||Yes|No||06/03/2020||Yes|No|||Prescription required|No|||No|.13824|03/29/2022|.13492|03/29/2022|.13582|03/29/2022||||18059|||||No|No||AUROBINDO PHARM|No||||
potassium chloride|No|No|No|No|75%|65862098799|POTASSIUM CL ER 10 MEQ TABLET|1000|EA|.19421|06/03/2020||Yes|No||06/03/2020||Yes|No|06/03/2020||Yes|No||06/03/2020||Yes|No|||Prescription required|No|||No|.13824|03/29/2022|.13492|03/29/2022|.13582|03/29/2022||||18060|||||No|No||AUROBINDO PHARM|No||||
armodafinil|No|No|No|No|90%|65862099830|ARMODAFINIL 200 MG TABLET|30|EA|.47013|02/25/2020||Yes|No||02/25/2020||Yes|No|02/25/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.63792|03/29/2022|.6226|03/29/2022|.62675|03/29/2022|||STIMULANTS AND RELATED AGENTS|18061|||||No|No||AUROBINDO PHARM|No||||
bosentan|No|No|No|No|75%|66215010106|TRACLEER 62.5 MG TABLET|60|EA|83.3598|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|No|189.9828|01/29/2019|187.26876|01/29/2019|178.3512|01/29/2019|||PAH AGENTS: ORAL AND INHALED|18062|||||No|No||ACTELION PHARMA|No||||
bosentan|No|No|No|No|75%|66215010206|TRACLEER 125 MG TABLET|60|EA|83.3598|03/01/2002||Yes|No||03/01/2002||Yes|No|03/01/2002||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|No|189.9828|02/05/2019|187.26876|02/05/2019|178.3512|02/05/2019|||PAH AGENTS: ORAL AND INHALED|18063|||||No|No||ACTELION PHARMA|No||||
bosentan|No|No|No|No|75%|66215010314|TRACLEER 32 MG TABLET FOR SUSP|14|EA|83.3598|09/12/2018||Yes|No||09/12/2018||Yes|No|09/12/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/26/2018|171|No|189.9828|01/22/2019|187.26876|01/22/2019|178.3512|01/22/2019|||PAH AGENTS: ORAL AND INHALED|18064|||||No|No||ACTELION PHARMA|No||||
bosentan|No|No|No|No|75%|66215010356|TRACLEER 32 MG TABLET FOR SUSP|56|EA|83.3598|01/03/2018||Yes|No||01/03/2018||Yes|No|01/03/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/26/2018|171|No|189.9828|01/29/2019|187.26876|01/29/2019|178.3512|01/29/2019|||PAH AGENTS: ORAL AND INHALED|18065|||||No|No||ACTELION PHARMA|No||||
miglustat|No|No|No|No|75%|66215020190|ZAVESCA 100 MG CAPSULE|90|EA|128.14|04/09/2004||Yes|No||04/09/2004||Yes|No|04/09/2004||Yes|No||||No|No|||Prescription required|No|||No|292.04|06/01/2016|287.868|06/01/2016|274.16|06/01/2016||||18066|||||No|No||ACTELION PHARMA|No||||
iloprost tromethamine|No|No|No|No|75%|66215030200|VENTAVIS 10 MCG/1 ML SOLUTION|1|ML|57.921|01/05/2010||Yes|No||01/05/2010||Yes|No|||No|No||||No|No|||Prescription required|Yes|07/26/2012|171|No|132.006|11/28/2017|130.1202|11/28/2017|123.924|11/28/2017|||PAH AGENTS: ORAL AND INHALED|18067|||||No|No||ACTELION PHARMA|No||||
iloprost tromethamine|No|No|No|No|75%|66215030230|VENTAVIS 10 MCG/1 ML SOLUTION|1|ML|57.921|01/05/2010||Yes|No||01/05/2010||Yes|No|||No|No||||No|No|||Prescription required|Yes|07/26/2012|171|No|132.006|11/28/2017|130.1202|11/28/2017|123.924|11/28/2017|||PAH AGENTS: ORAL AND INHALED|18068|||||No|No||ACTELION PHARMA|No||||
iloprost tromethamine|No|No|No|No|75%|66215030300|VENTAVIS 20 MCG/1 ML SOLUTION|1|ML|57.921|12/18/2009||Yes|No||12/18/2009||Yes|No|||No|No||||No|No|||Prescription required|Yes|07/26/2012|171|No|132.006|11/28/2017|130.1202|11/28/2017|123.924|11/28/2017|||PAH AGENTS: ORAL AND INHALED|18069|||||No|No||ACTELION PHARMA|No||||
iloprost tromethamine|No|No|No|No|75%|66215030330|VENTAVIS 20 MCG/1 ML SOLUTION|1|ML|57.921|12/18/2009||Yes|No||12/18/2009||Yes|No|||No|No||||No|No|||Prescription required|Yes|07/26/2012|171|No|132.006|11/28/2017|130.1202|11/28/2017|123.924|11/28/2017|||PAH AGENTS: ORAL AND INHALED|18070|||||No|No||ACTELION PHARMA|No||||
epoprostenol sodium|No|No|No|No|75%|66215040201|VELETRI 1.5 MG VIAL|1|EA|20.1412|10/23/2012||Yes|No||10/23/2012||Yes|No|10/23/2012||Yes|No||||No|No|||Prescription required|No|||No|45.9032|11/28/2017|45.24744|11/28/2017|43.0928|11/28/2017||||18071|||||No|No||ACTELION PHARMA|No||||
epoprostenol sodium|No|No|No|No|75%|66215040301|VELETRI 0.5 MG VIAL|1|EA|10.0706|10/23/2012||Yes|No||10/23/2012||Yes|No|10/23/2012||Yes|No||||No|No|||Prescription required|No|||No|22.9516|11/28/2017|22.62372|11/28/2017|21.5464|11/28/2017||||18072|||||No|No||ACTELION PHARMA|No||||
macitentan|No|No|No|No|75%|66215050130|OPSUMIT 10 MG TABLET|30|EA|160.31632|04/02/2014||Yes|No||04/02/2014||Yes|No|04/02/2014||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|171|No|365.37208|01/25/2022|360.15248|01/25/2022|343.00236|01/25/2022|||PAH AGENTS: ORAL AND INHALED|18073|||||No|No||ACTELION PHARMA|No||||
selexipag|No|No|No|No|75%|66215060206|UPTRAVI 200 MCG TABLET|60|EA|93.43648|06/08/2016||Yes|No||06/08/2016||Yes|No|06/08/2016||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/21/2016|171|No|212.94827|01/25/2022|209.90615|01/25/2022|199.91062|01/25/2022|||PAH AGENTS: ORAL AND INHALED|18074|||||No|No||ACTELION PHARMA|No||||
selexipag|No|No|No|No|75%|66215060214|UPTRAVI 200 MCG TABLET|140|EA|93.43651|06/08/2016||Yes|No||06/08/2016||Yes|No|06/08/2016||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/21/2016|171|No|212.94832|01/25/2022|209.9062|01/25/2022|199.91067|01/25/2022|||PAH AGENTS: ORAL AND INHALED|18075|||||No|No||ACTELION PHARMA|No||||
selexipag|No|No|No|No|75%|66215060406|UPTRAVI 400 MCG TABLET|60|EA|145.3091|06/08/2016||Yes|No||06/08/2016||Yes|No|06/08/2016||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/21/2016|171|No|331.16959|01/25/2022|326.4386|01/25/2022|310.8939|01/25/2022|||PAH AGENTS: ORAL AND INHALED|18076|||||No|No||ACTELION PHARMA|No||||
selexipag|No|No|No|No|75%|66215060606|UPTRAVI 600 MCG TABLET|60|EA|145.3091|06/08/2016||Yes|No||06/08/2016||Yes|No|06/08/2016||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/21/2016|171|No|331.16959|01/25/2022|326.4386|01/25/2022|310.8939|01/25/2022|||PAH AGENTS: ORAL AND INHALED|18077|||||No|No||ACTELION PHARMA|No||||
selexipag|No|No|No|No|75%|66215060806|UPTRAVI 800 MCG TABLET|60|EA|145.3091|06/08/2016||Yes|No||06/08/2016||Yes|No|06/08/2016||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/21/2016|171|No|331.16959|01/25/2022|326.4386|01/25/2022|310.8939|01/25/2022|||PAH AGENTS: ORAL AND INHALED|18078|||||No|No||ACTELION PHARMA|No||||
selexipag|No|No|No|No|75%|66215061006|UPTRAVI 1,000 MCG TABLET|60|EA|145.3091|06/08/2016||Yes|No||06/08/2016||Yes|No|06/08/2016||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/21/2016|171|No|331.16959|01/25/2022|326.4386|01/25/2022|310.8939|01/25/2022|||PAH AGENTS: ORAL AND INHALED|18079|||||No|No||ACTELION PHARMA|No||||
selexipag|No|No|No|No|75%|66215061206|UPTRAVI 1,200 MCG TABLET|60|EA|145.3091|06/08/2016||Yes|No||06/08/2016||Yes|No|06/08/2016||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/21/2016|171|No|331.16959|01/25/2022|326.4386|01/25/2022|310.8939|01/25/2022|||PAH AGENTS: ORAL AND INHALED|18080|||||No|No||ACTELION PHARMA|No||||
selexipag|No|No|No|No|75%|66215061406|UPTRAVI 1,400 MCG TABLET|60|EA|145.3091|06/08/2016||Yes|No||06/08/2016||Yes|No|06/08/2016||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/21/2016|171|No|331.16959|01/25/2022|326.4386|01/25/2022|310.8939|01/25/2022|||PAH AGENTS: ORAL AND INHALED|18081|||||No|No||ACTELION PHARMA|No||||
selexipag|No|No|No|No|75%|66215061606|UPTRAVI 1,600 MCG TABLET|60|EA|145.3091|06/08/2016||Yes|No||06/08/2016||Yes|No|06/08/2016||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/21/2016|171|No|331.16959|01/25/2022|326.4386|01/25/2022|310.8939|01/25/2022|||PAH AGENTS: ORAL AND INHALED|18082|||||No|No||ACTELION PHARMA|No||||
selexipag|No|No|No|No|75%|66215062820|UPTRAVI 200-800 TITRATION PACK|200|EA|65.40504|06/08/2016||Yes|No||06/08/2016||Yes|No|06/08/2016||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/21/2016|171|No|149.06265|01/25/2022|146.93318|01/25/2022|139.93637|01/25/2022|||PAH AGENTS: ORAL AND INHALED|18083|||||No|No||ACTELION PHARMA|No||||
omeprazole/clarith/amoxicillin|No|No|No|No|75%|66220042202|OMECLAMOX-PAK COMBO PACK|80|EA|3.77566|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|001|No|8.605|01/14/2020|8.48207|01/14/2020|8.07817|01/14/2020|||H. PYLORI TREATMENT|18084|||||No|No||CUMBERLAND PHAR|No||||
lactulose|No|No|No|No|75%|66220071930|KRISTALOSE 10 GM PACKET|30|EA|3.60139|11/15/2006||Yes|No||11/15/2006||Yes|No|11/15/2006||Yes|No||||No|No|||Prescription required|No|||No|8.05334|11/23/2021|7.86005|11/23/2021|7.9124|11/23/2021||||18085|||||No|No||CUMBERLAND PHAR|No||||
lactulose|No|No|No|No|75%|66220072930|KRISTALOSE 20 GM PACKET|30|EA|3.73197|11/15/2006||Yes|No||11/15/2006||Yes|No|11/15/2006||Yes|No||||No|No|||Prescription required|No|||No|8.33434|11/23/2021|8.13431|11/23/2021|8.18848|11/23/2021||||18086|||||No|No||CUMBERLAND PHAR|No||||
treprostinil sodium|No|No|No|No|75%|66302010101|REMODULIN 1 MG/ML VIAL|20|ML|27.37638|11/27/2002||Yes|No||11/27/2002||Yes|No|11/27/2002||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|62.39268|04/10/2018|61.50135|04/10/2018|58.57272|04/10/2018||||18087|||||No|No||UNITED THERAP|No||||
treprostinil sodium|No|No|No|No|75%|66302010201|REMODULIN 2.5 MG/ML VIAL|20|ML|68.44095|11/27/2002||Yes|No||11/27/2002||Yes|No|11/27/2002||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|155.9817|04/10/2018|153.75339|04/10/2018|146.4318|04/10/2018||||18088|||||No|No||UNITED THERAP|No||||
treprostinil sodium|No|No|No|No|75%|66302010501|REMODULIN 5 MG/ML VIAL|20|ML|136.8819|11/27/2002||Yes|No||11/27/2002||Yes|No|11/27/2002||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|311.9634|04/10/2018|307.50678|04/10/2018|292.8636|04/10/2018||||18089|||||No|No||UNITED THERAP|No||||
treprostinil sodium|No|No|No|No|75%|66302011001|REMODULIN 10 MG/ML VIAL|20|ML|273.7638|10/01/2002||Yes|No||10/01/2002||Yes|No|10/01/2002||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|623.9268|04/10/2018|615.01356|04/10/2018|585.7272|04/10/2018||||18090|||||No|No||UNITED THERAP|No||||
treprostinil/nebulizer/accesor|No|No|No|No|75%|66302020601|TYVASO INHALATION STARTER KIT|81.2|ML|112.23465|04/07/2010||Yes|No||04/07/2010||Yes|No|04/07/2010||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/26/2012|171|No|255.79061|10/05/2021|252.13646|10/05/2021|240.12996|10/05/2021|||PAH AGENTS: ORAL AND INHALED|18091|||||No|No||UNITED THERAP|No||||
treprostinil/neb accessories|No|No|No|No|75%|66302020602|TYVASO INHALATION REFILL KIT|81.2|ML|100.60871|08/28/2009||Yes|No||08/28/2009||Yes|No|08/28/2009||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/26/2012|171|No|229.29428|10/05/2021|226.01865|10/05/2021|215.25585|10/05/2021|||PAH AGENTS: ORAL AND INHALED|18092|||||No|No||UNITED THERAP|No||||
treprostinil|No|No|No|No|75%|66302020603|TYVASO 1.74 MG/2.9 ML SOLUTION|11.6|ML|100.6085|08/28/2009||Yes|No||08/28/2009||Yes|No|08/28/2009||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/26/2012|171|No|229.2938|10/05/2021|226.01817|10/05/2021|215.2554|10/05/2021|||PAH AGENTS: ORAL AND INHALED|18093|||||No|No||UNITED THERAP|No||||
treprostinil diolamine|No|No|No|No|75%|66302030001|ORENITRAM ER 0.125 MG TABLET|100|EA|2.66275|04/15/2014||Yes|No||04/15/2014||Yes|No|04/15/2014||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|01/22/2015|171|No|6.0686|01/04/2022|5.9819|01/04/2022|5.69705|01/04/2022|||PAH AGENTS: ORAL AND INHALED|18094|||||No|No||UNITED THERAP|No||||
treprostinil diolamine|No|No|No|No|75%|66302030201|ORENITRAM ER 0.25 MG TABLET|100|EA|5.32524|04/15/2014||Yes|No||04/15/2014||Yes|No|04/15/2014||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|01/22/2015|171|No|12.13659|01/04/2022|11.96321|01/04/2022|11.39353|01/04/2022|||PAH AGENTS: ORAL AND INHALED|18095|||||No|No||UNITED THERAP|No||||
treprostinil diolamine|No|No|No|No|75%|66302031001|ORENITRAM ER 1 MG TABLET|100|EA|21.3015|04/15/2014||Yes|No||04/15/2014||Yes|No|04/15/2014||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|01/22/2015|171|No|48.54762|01/04/2022|47.85408|01/04/2022|45.57531|01/04/2022|||PAH AGENTS: ORAL AND INHALED|18096|||||No|No||UNITED THERAP|No||||
treprostinil diolamine|No|No|No|No|75%|66302032501|ORENITRAM ER 2.5 MG TABLET|100|EA|53.25381|04/15/2014||Yes|No||04/15/2014||Yes|No|04/15/2014||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|01/22/2015|171|No|121.36916|01/04/2022|119.63532|01/04/2022|113.9384|01/04/2022|||PAH AGENTS: ORAL AND INHALED|18097|||||No|No||UNITED THERAP|No||||
tadalafil|No|No|No|No|75%|66302046760|ADCIRCA 20 MG TABLET|60|EA|29.885|12/01/2009||Yes|No||12/01/2009||Yes|No|12/01/2009||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|Yes|68.11|02/25/2020|67.137|02/25/2020|63.94|02/25/2020|||PAH AGENTS: ORAL AND INHALED|18098|||||No|No||ELI LILLY & CO.|No||||
trientine HCl|No|No|No|No|75%|66435070012|CLOVIQUE 250 MG CAPSULE|12|EA|67.1574|05/11/2020|10/01/2022|Yes|No||05/11/2020|10/01/2022|Yes|No|05/11/2020|10/01/2022|Yes|No||||No|No|||Prescription required|No|||No|153.0564|05/11/2020|150.86988|05/11/2020|143.6856|05/11/2020||||18099|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||KADMON PHARMACE|No||||
trientine HCl|No|No|No|No|75%|66435070020|CLOVIQUE 250 MG CAPSULE|120|EA|67.1574|05/11/2020|10/01/2022|Yes|No||05/11/2020|10/01/2022|Yes|No|05/11/2020|10/01/2022|Yes|No||||No|No|||Prescription required|No|||No|153.0564|05/11/2020|150.86988|05/11/2020|143.6856|05/11/2020||||18100|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||KADMON PHARMACE|No||||
dihydroergotamine mesylate|No|No|No|No|75%|66490004101|D.H.E.45 1 MG/ML AMPUL|1|ML|506.00422|02/12/2003||Yes|No||02/12/2003||Yes|No|02/12/2003||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|537|No|1153.21892|06/01/2016|1136.74436|06/01/2016|1082.61368|06/01/2016|||ANTIMIGRAINE AGENTS: OTHER|18101|||||No|No||BAUSCH HEALTH U|No||||
diazepam|No|No|No|No|75%|66490065020|DIASTAT 2.5 MG PEDI SYSTEM|1|EA|127.1424|12/18/2002||Yes|No||12/18/2002||Yes|No|12/18/2002||Yes|No||||No|No|||Prescription required|No||056|Yes|289.7664|01/21/2020|285.62688|01/21/2020|272.0256|01/21/2020|||ANTICONVULSANTS|18102|||||No|No||BAUSCH HEALTH U|No||||
primidone|No|No|No|No|75%|66490069010|MYSOLINE 50 MG TABLET|100|EA|7.43457|07/02/2003||Yes|No||07/02/2003||Yes|No|07/02/2003||Yes|No||||No|No|||Prescription required|No||056|No|16.9439|01/11/2022|16.70185|01/11/2022|15.90652|01/11/2022|||ANTICONVULSANTS|18103|||||No|No||BAUSCH HEALTH U|No||||
primidone|No|No|No|No|75%|66490069110|MYSOLINE 250 MG TABLET|100|EA|25.58435|01/08/2003||Yes|No||01/08/2003||Yes|No|01/08/2003||Yes|No||||No|No|||Prescription required|No||056|No|58.30853|01/11/2022|57.47555|01/11/2022|54.73862|01/11/2022|||ANTICONVULSANTS|18104|||||No|No||BAUSCH HEALTH U|No||||
fluorouracil|No|No|No|No|75%|66530024940|FLUOROURACIL 5% CREAM|40|GM|2.21353|04/13/2009|08/31/2022|Yes|No||04/13/2009|08/31/2022|Yes|No|04/13/2009|08/31/2022|Yes|No||||No|No|||Prescription required|No|||No|1.42743|03/29/2022|1.39317|03/29/2022|1.40244|03/29/2022||||18105|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SPEAR PHARM/MAY|No||||
ezetimibe/simvastatin|No|No|No|No|75%|66582031131|VYTORIN 10-10 MG TABLET|30|EA|4.8977|07/27/2004||Yes|No||07/27/2004||Yes|No|07/27/2004||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|063|Yes|11.1622|01/29/2019|11.00274|01/29/2019|10.4788|01/29/2019|||LIPOTROPICS: STATINS|18106|||||No|No||MERCK SHARP & D|No||||
ezetimibe/simvastatin|No|No|No|No|75%|66582031154|VYTORIN 10-10 MG TABLET|90|EA|4.8977|07/27/2004||Yes|No||07/27/2004||Yes|No|07/27/2004||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|063|Yes|11.1622|01/29/2019|11.00274|01/29/2019|10.4788|01/29/2019|||LIPOTROPICS: STATINS|18107|||||No|No||MERCK SHARP & D|No||||
ezetimibe/simvastatin|No|No|No|No|75%|66582031231|VYTORIN 10-20 MG TABLET|30|EA|4.8977|07/27/2004||Yes|No||07/27/2004||Yes|No|07/27/2004||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|063|Yes|11.1622|11/24/2020|11.00274|11/24/2020|10.4788|11/24/2020|||LIPOTROPICS: STATINS|18108|||||No|No||MERCK SHARP & D|No||||
ezetimibe/simvastatin|No|No|No|No|75%|66582031254|VYTORIN 10-20 MG TABLET|90|EA|4.8977|07/27/2004||Yes|No||07/27/2004||Yes|No|07/27/2004||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|063|Yes|11.1622|11/24/2020|11.00274|11/24/2020|10.4788|11/24/2020|||LIPOTROPICS: STATINS|18109|||||No|No||MERCK SHARP & D|No||||
ezetimibe/simvastatin|No|No|No|No|75%|66582031331|VYTORIN 10-40 MG TABLET|30|EA|4.8977|07/27/2004||Yes|No||07/27/2004||Yes|No|07/27/2004||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|063|Yes|11.1622|10/27/2020|11.00274|10/27/2020|10.4788|10/27/2020|||LIPOTROPICS: STATINS|18110|||||No|No||MERCK SHARP & D|No||||
ezetimibe/simvastatin|No|No|No|No|75%|66582031354|VYTORIN 10-40 MG TABLET|90|EA|4.8977|07/27/2004||Yes|No||07/27/2004||Yes|No|07/27/2004||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|063|Yes|11.1622|10/27/2020|11.00274|10/27/2020|10.4788|10/27/2020|||LIPOTROPICS: STATINS|18111|||||No|No||MERCK SHARP & D|No||||
ezetimibe/simvastatin|No|No|No|No|75%|66582031531|VYTORIN 10-80 MG TABLET|30|EA|4.8977|07/27/2004||Yes|No||07/27/2004||Yes|No|07/27/2004||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|063|Yes|11.1622|01/29/2019|11.00274|01/29/2019|10.4788|01/29/2019|||LIPOTROPICS: STATINS|18112|||||No|No||MERCK SHARP & D|No||||
ezetimibe/simvastatin|No|No|No|No|75%|66582031554|VYTORIN 10-80 MG TABLET|90|EA|4.8977|07/27/2004||Yes|No||07/27/2004||Yes|No|07/27/2004||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|063|Yes|11.1622|01/29/2019|11.00274|01/29/2019|10.4788|01/29/2019|||LIPOTROPICS: STATINS|18113|||||No|No||MERCK SHARP & D|No||||
ezetimibe|No|No|No|No|75%|66582041431|ZETIA 10 MG TABLET|30|EA|4.945|11/13/2002||Yes|No||11/13/2002||Yes|No|11/13/2002||Yes|No||||No|No|||Prescription required|No||055|No|11.65334|01/25/2022|11.37365|01/25/2022|11.4494|01/25/2022|||LIPOTROPICS: OTHER|18114|||||No|No||MERCK SHARP & D|No||||
nitisinone|No|No|No|No|75%|66658010260|ORFADIN 2 MG CAPSULE|60|EA|39.05395|05/06/2014||Yes|No||05/06/2014||Yes|No|05/06/2014||Yes|No||||No|No|||Prescription required|No|||Yes|89.00669|01/17/2017|87.73517|01/17/2017|83.5573|01/17/2017||||18115|||||No|No||SOBI-SWEDISH OR|No||||
nitisinone|No|No|No|No|75%|66658010560|ORFADIN 5 MG CAPSULE|60|EA|97.63429|05/06/2014||Yes|No||05/06/2014||Yes|No|05/06/2014||Yes|No||||No|No|||Prescription required|No|||Yes|222.51537|01/17/2017|219.33657|01/17/2017|208.89198|01/17/2017||||18116|||||No|No||SOBI-SWEDISH OR|No||||
nitisinone|No|No|No|No|75%|66658011060|ORFADIN 10 MG CAPSULE|60|EA|195.2688|05/06/2014||Yes|No||05/06/2014||Yes|No|05/06/2014||Yes|No||||No|No|||Prescription required|No|||Yes|445.03123|01/17/2017|438.67364|01/17/2017|417.78442|01/17/2017||||18117|||||No|No||SOBI-SWEDISH OR|No||||
nitisinone|No|No|No|No|75%|66658012060|ORFADIN 20 MG CAPSULE|60|EA|390.53753|09/15/2016||Yes|No||09/15/2016||Yes|No|09/15/2016||Yes|No||||No|No|||Prescription required|No|||Yes|890.06229|01/17/2017|877.34711|01/17/2017|835.56868|01/17/2017||||18118|||||No|No||SOBI-SWEDISH OR|No||||
nitisinone|No|No|No|No|75%|66658020490|ORFADIN 4 MG/ML SUSPENSION|90|ML|85.13464|08/10/2016||Yes|No||08/10/2016||Yes|No|08/10/2016||Yes|No||||No|No|||Prescription required|No|||Yes|194.02779|01/17/2017|191.25597|01/17/2017|182.14854|01/17/2017||||18119|||||No|No||SOBI-SWEDISH OR|No||||
palivizumab|No|No|No|No|75%|66658023001|SYNAGIS 50 MG/0.5 ML VIAL|.5|ML|1400.3208|12/03/2021||Yes|No|Submit NOFR002 and Form 1321|12/03/2021||Yes|No|12/03/2021||Yes|No|Submit NOFR002 and Form 1325|||No|No|||Prescription required|No|||Yes|3191.4288|12/07/2021|3145.83696|12/07/2021|2996.0352|12/03/2021||||18120|||||No|No||SOBI-SWEDISH OR|No||||
palivizumab|No|No|No|No|75%|66658023101|SYNAGIS 100 MG/ML VIAL|1|ML|1322.0995|12/03/2021||Yes|No|Submit NOFR002 and Form 1321|12/03/2021||Yes|No|12/03/2021||Yes|No|Submit NOFR002 and Form 1325|||No|No|||Prescription required|No|||Yes|3013.157|12/03/2021|2970.1119|12/03/2021|2828.678|12/03/2021||||18121|||||No|No||SOBI-SWEDISH OR|No||||
anakinra|No|No|No|No|75%|66658023407|KINERET 100 MG/0.67 ML SYRINGE|.67|ML|109.35385|07/07/2016||Yes|No||07/07/2016||Yes|No|07/07/2016||Yes|No||||No|No|||Prescription required|Yes|01/20/2011|071|Yes|249.22507|01/04/2022|245.66471|01/04/2022|233.96639|01/04/2022|||CYTOKINE AND CAM ANTAGONISTS|18122|||||No|No||SOBI-SWEDISH OR|No||||
amoxicillin/potassium clav|No|No|No|No|75%|66685100100|AMOX-CLAV 875-125 MG TABLET|20|EA|.72584|01/27/2006|05/31/2022|Yes|No||01/27/2006|05/31/2022|Yes|No|01/27/2006|05/31/2022|Yes|No||||No|No|||Prescription required|No||046|No|.32484|03/29/2022|.31704|03/29/2022|.31915|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18123|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SANDOZ|No||||
amoxicillin/potassium clav|No|No|No|No|75%|66685100101|AMOX-CLAV 875-125 MG TABLET|100|EA|.48779|12/09/2004||Yes|No||12/09/2004||Yes|No|12/09/2004||Yes|No||||No|No|||Prescription required|No||046|No|.32484|03/29/2022|.31704|03/29/2022|.31915|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18124|||||No|No||SANDOZ|No||||
amoxicillin/potassium clav|No|No|No|No|75%|66685100202|AMOX-CLAV 500-125 MG TABLET|100|EA|.40759|12/28/2011||Yes|No||12/28/2011||Yes|No|12/28/2011||Yes|No||||No|No|||Prescription required|No||046|No|.31268|03/29/2022|.30517|03/29/2022|.3072|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18125|||||No|No||SANDOZ|No||||
amoxicillin/potassium clav|No|No|No|No|75%|66685101100|AMOX-CLAV 200-28.5 MG/5 ML SUS|50|ML|.0743|02/02/2005||Yes|No||02/02/2005||Yes|No|02/02/2005||Yes|No||||No|No|||Prescription required|No||046|No|.16934|10/27/2020|.16692|10/27/2020|.15897|10/27/2020|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18126|||||No|No||SANDOZ|No||||
amoxicillin/potassium clav|No|No|No|No|75%|66685101101|AMOX-CLAV 200-28.5 MG/5 ML SUS|75|ML|.05274|02/02/2005||Yes|No||02/02/2005||Yes|No|02/02/2005||Yes|No||||No|No|||Prescription required|No||046|No|.1202|03/23/2021|.11848|03/23/2021|.11284|03/23/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18127|||||No|No||SANDOZ|No||||
amoxicillin/potassium clav|No|No|No|No|75%|66685101200|AMOX-CLAV 400-57 MG/5 ML SUSP|50|ML|.09288|02/02/2005||Yes|No||02/02/2005||Yes|No|02/02/2005||Yes|No||||No|No|||Prescription required|No||046|No|.0974|03/29/2022|.09506|03/29/2022|.09569|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18128|||||No|No||SANDOZ|No||||
amoxicillin/potassium clav|No|No|No|No|75%|66685101201|AMOX-CLAV 400-57 MG/5 ML SUSP|75|ML|.06593|02/02/2005||Yes|No||02/02/2005||Yes|No|02/02/2005||Yes|No||||No|No|||Prescription required|No||046|No|.0795|03/29/2022|.07759|03/29/2022|.0781|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18129|||||No|No||SANDOZ|No||||
nystatin|No|No|No|No|75%|66689000802|NYSTATIN 100,000 UNIT/ML SUSP|60|ML|.086|06/22/2013||Yes|No||06/22/2013||Yes|No|06/22/2013||Yes|No||||No|No|||Prescription required|No||069|No|.14005|03/29/2022|.13668|03/29/2022|.13759|03/29/2022|||ANTIFUNGALS: ORAL|18130|||||No|No||VISTAPHARM|No||||
nystatin|No|No|No|No|75%|66689000816|NYSTATIN 100,000 UNIT/ML SUSP|480|ML|.03045|01/25/2013||Yes|No||01/25/2013||Yes|No|01/25/2013||Yes|No||||No|No|||Prescription required|No||069|No|.05586|03/29/2022|.05451|03/29/2022|.05488|03/29/2022|||ANTIFUNGALS: ORAL|18131|||||No|No||VISTAPHARM|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|66689002304|HYDROCODONE-ACETAMN 7.5-325/15|120|ML|.05733|04/14/2014||Yes|No||04/14/2014||Yes|No|04/14/2014||Yes|No||||No|No|||Prescription required|No||109|Yes|.13066|06/01/2016|.12879|06/01/2016|.12266|06/01/2016|||ANALGESICS: NARCOTICS SHORT|18132|||||No|No||VISTAPHARM|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|66689002316|HYDROCODONE-ACETAMN 7.5-325/15|473|ML|.04363|01/25/2013||Yes|No||01/25/2013||Yes|No|01/25/2013||Yes|No||||No|No|||Prescription required|No||109|Yes|.08003|03/29/2022|.0781|03/29/2022|.07862|03/29/2022|||ANALGESICS: NARCOTICS SHORT|18133|||||No|No||VISTAPHARM|No||||
oxycodone HCl|No|No|No|No|90%|66689002530|OXYCODONE HCL 100 MG/5 ML CONC|30|ML|1.43333|01/25/2013||Yes|No||01/25/2013||Yes|No|01/25/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|109|Yes|3.65933|03/29/2022|3.5715|03/29/2022|3.59529|03/29/2022|||ANALGESICS: NARCOTICS SHORT|18134|||||No|No||VISTAPHARM|No||||
clobazam|No|No|No|No|90%|66689005804|CLOBAZAM 2.5 MG/ML SUSPENSION|120|ML|.28666|01/02/2020||Yes|No||01/02/2020||Yes|No|01/02/2020||Yes|No||||No|No|||Prescription required|No||056|No|.50176|03/29/2022|.48971|03/29/2022|.49297|03/29/2022|||ANTICONVULSANTS|18135|||||No|No||VISTAPHARM|No||||
levothyroxine sodium|No|No|No|No|75%|66689010502|THYQUIDITY 100 MCG/5 ML SOLN|100|ML|.47085|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No|||No|1.0731|05/27/2021|1.05777|06/01/2021|1.0074|05/27/2021||||18136|||||No|No||VISTAPHARM|No||||
mycophenolate mofetil|No|No|No|No|75%|66689030708|MYCOPHENOLATE 200 MG/ML SUSP|160|ML|3.11763|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|229|No|4.66856|01/25/2022|4.55651|01/25/2022|4.58686|01/25/2022|||IMMUNOSUPPRESSIVES: ORAL|18137|||||No|No||VISTAPHARM|No||||
digoxin|No|No|No|No|75%|66689032702|DIGOXIN 0.05 MG/ML SOLUTION|60|ML|.85283|03/16/2020||Yes|No||03/16/2020||Yes|No|03/16/2020||Yes|No||||No|No|||Prescription required|No|||No|1.9807|03/29/2022|1.93316|03/29/2022|1.94603|03/29/2022||||18138|||||No|No||VISTAPHARM|No||||
aminocaproic acid|No|No|No|No|75%|66689033008|AMINOCAPROIC ACID 0.25 GRAM/ML|236.5|ML|7.3291|06/25/2020||Yes|No||06/25/2020||Yes|No|06/25/2020||Yes|No||||No|No|||Prescription required|No|||No|10.56252|06/25/2020|10.41163|06/25/2020|9.91584|06/25/2020||||18139|||||No|No||VISTAPHARM|No||||
cyproheptadine HCl|No|No|No|No|75%|66689033316|CYPROHEPTADINE 2 MG/5 ML SOLN|473|ML|.04877|02/21/2020|09/23/2022|Yes|No||02/21/2020|09/23/2022|Yes|No|02/21/2020|09/23/2022|Yes|No||||No|No|||Prescription required|No||574|Yes|.06009|03/29/2022|.05864|03/29/2022|.05903|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|18140|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||VISTAPHARM|No||||
acyclovir|No|No|No|No|75%|66689034216|ACYCLOVIR 200 MG/5 ML SUSP|473|ML|.15865|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No||025|No|.2948|03/29/2022|.28772|03/29/2022|.28964|03/29/2022|||ANTIVIRALS: ORAL|18141|||||No|No||VISTAPHARM|No||||
chlorthalidone|Yes|No|No|No|75%|66689034599|CHLORTHALIDONE 25 MG TABLET|100|EA|.2076|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|03/20/2020||Prescription required|No|||No|.16117|03/29/2022|.1573|03/29/2022|.15834|03/29/2022||||18142|||||No|No||VISTAPHARM|No||||
chlorthalidone|Yes|No|No|No|75%|66689034699|CHLORTHALIDONE 50 MG TABLET|100|EA|.25602|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|03/20/2020||Prescription required|No|||No|.3607|03/29/2022|.35204|03/29/2022|.35438|03/29/2022||||18143|||||No|No||VISTAPHARM|No||||
sirolimus|No|No|No|No|75%|66689034702|SIROLIMUS 1 MG/ML SOLUTION|60|ML|12.54166|06/06/2019||Yes|No||06/06/2019||Yes|No|06/06/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|229|No|8.60227|03/01/2022|8.39581|03/01/2022|8.45173|03/01/2022|||IMMUNOSUPPRESSIVES: ORAL|18144|||||No|No||VISTAPHARM|No||||
oxycodone HCl|No|No|No|No|90%|66689040316|OXYCODONE HCL 5 MG/5 ML SOLN|500|ML|.09804|04/18/2013||Yes|No||04/18/2013||Yes|No|04/18/2013||Yes|No||||No|No|||Prescription required|No||109|Yes|.11792|03/29/2022|.11508|03/29/2022|.11585|03/29/2022|||ANALGESICS: NARCOTICS SHORT|18145|||||No|No||VISTAPHARM|No||||
aripiprazole|No|No|No|No|75%|66689073505|ARIPIPRAZOLE 1 MG/ML SOLUTION|150|ML|.71666|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|027|Yes|1.07614|03/29/2022|1.05031|03/29/2022|1.0573|03/29/2022|||ANTIPSYCHOTICS|18146|||||No|No||VISTAPHARM|No||||
felbamate|No|No|No|No|75%|66689082508|FELBAMATE 600 MG/5 ML SUSP|237|ML|.17961|01/02/2020||Yes|No||01/02/2020||Yes|No|01/02/2020||Yes|No||||No|No|||Prescription required|No||056|No|.40936|01/02/2020|.40351|01/02/2020|.3843|01/02/2020|||ANTICONVULSANTS|18147|||||No|No||VISTAPHARM|No||||
felbamate|No|No|No|No|75%|66689082516|FELBAMATE 600 MG/5 ML SUSP|473|ML|.17999|05/21/2020|08/31/2022|Yes|No||05/21/2020|08/31/2022|Yes|No|05/21/2020|08/31/2022|Yes|No||||No|No|||Prescription required|No||056|No|.41022|05/21/2020|.40436|05/21/2020|.38511|05/21/2020|||ANTICONVULSANTS|18148|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||VISTAPHARM|No||||
insulin lispro|Yes|No|No|No|75%|66733077301|INSULIN LISPRO 100 UNIT/ML VL|10|ML|3.54363|08/30/2019|12/31/2022|Yes|No||08/30/2019|12/31/2022|Yes|No|08/30/2019|12/31/2022|Yes|No||||No|No|09/27/2019|12/31/2022|Prescription required|No||029|No|7.91897|03/29/2022|7.72891|03/29/2022|7.78038|03/29/2022|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|18149|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ELI LILLY & CO.|No||||
insulin lispro|Yes|No|No|No|75%|66733082259|INSULIN LISPRO 100 UNIT/ML PEN|3|ML|4.56144|08/30/2019|07/31/2022|Yes|No||08/30/2019|07/31/2022|Yes|No|08/30/2019|07/31/2022|Yes|No||||No|No|09/27/2019|07/31/2022|Prescription required|No||029|No|10.18483|03/29/2022|9.94039|03/29/2022|10.00659|03/29/2022|||HYPOGLYCEMICS: INSULIN AND RELATED AGENTS|18150|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ELI LILLY & CO.|No||||
potassium bicarbonate/cit ac|No|No|No|No|75%|66758014034|KLOR-CON-EF 25 MEQ TAB EFF|30|EA|.54051|12/16/2015|01/31/2022|Yes|No||12/16/2015|01/31/2022|Yes|No|12/16/2015|01/31/2022|Yes|No||||No|No|||Prescription required|No|||No|1.23186|10/27/2020|1.21426|10/27/2020|1.15644|10/27/2020||||18151|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SANDOZ|No||||
potassium chloride|No|No|No|No|75%|66758016005|KLOR-CON 10 MEQ TABLET|500|EA|.19423|04/30/2015|01/31/2022|Yes|No||04/30/2015|01/31/2022|Yes|No|04/30/2015|01/31/2022|Yes|No||||No|No|||Prescription required|No|||No|.44266|08/25/2020|.43634|08/25/2020|.41556|08/25/2020||||18152|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SANDOZ|No||||
potassium chloride|No|No|No|No|75%|66758016013|KLOR-CON 10 MEQ TABLET|100|EA|.21689|10/12/2016|01/31/2022|Yes|No||10/12/2016|01/31/2022|Yes|No|10/12/2016|01/31/2022|Yes|No||||No|No|||Prescription required|No|||No|.49431|08/25/2020|.48725|08/25/2020|.46404|08/25/2020||||18153|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SANDOZ|No||||
albuterol sulfate|No|No|No|No|75%|66758095985|PROVENTIL HFA 90 MCG INHALER|6.7|GM|5.117|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|No||037|Yes|11.40955|09/22/2021|11.13572|09/22/2021|11.20988|09/22/2021|||BRONCHODILATORS: BETA AGONIST|18154|||||No|No||SANDOZ INC.|No||||
pitavastatin calcium|No|No|No|No|75%|66869010490|LIVALO 1 MG TABLET|90|EA|4.58279|09/17/2013||Yes|No||09/17/2013||Yes|No|09/17/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|063|Yes|10.20221|10/26/2021|9.95735|10/26/2021|10.02367|10/26/2021|||LIPOTROPICS: STATINS|18155|||||No|No||KOWA PHARMACEUT|No||||
fenofibrate|No|No|No|No|75%|66869013730|LIPOFEN 50 MG CAPSULE|90|EA|1.55994|08/30/2010|05/31/2023|Yes|No||08/30/2010|05/31/2023|Yes|No|08/30/2010|05/31/2023|Yes|No||||No|No|||Prescription required|Yes|07/22/2008|055|No|3.55521|01/01/2019|3.50442|01/01/2019|3.33754|01/01/2019|||LIPOTROPICS: OTHER|18156|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||KOWA PHARMACEUT|No||||
fenofibrate|No|No|No|No|75%|66869014730|LIPOFEN 150 MG CAPSULE|90|EA|3.41825|07/31/2009|06/30/2022|Yes|No||07/31/2009|06/30/2022|Yes|No|07/31/2009|06/30/2022|Yes|No||||No|No|||Prescription required|Yes|07/17/2007|055|No|7.79045|01/01/2019|7.67915|01/01/2019|7.31348|01/01/2019|||LIPOTROPICS: OTHER|18157|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||KOWA PHARMACEUT|No||||
pitavastatin calcium|No|No|No|No|75%|66869020490|LIVALO 2 MG TABLET|90|EA|4.58279|09/17/2013||Yes|No||09/17/2013||Yes|No|09/17/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|063|Yes|10.22548|10/26/2021|9.98006|10/26/2021|10.04653|10/26/2021|||LIPOTROPICS: STATINS|18158|||||No|No||KOWA PHARMACEUT|No||||
pitavastatin calcium|No|No|No|No|75%|66869040490|LIVALO 4 MG TABLET|90|EA|4.58279|09/17/2013||Yes|No||09/17/2013||Yes|No|09/17/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|063|Yes|10.20677|10/26/2021|9.9618|10/26/2021|10.02815|10/26/2021|||LIPOTROPICS: STATINS|18159|||||No|No||KOWA PHARMACEUT|No||||
testosterone|No|No|No|No|90%|66887000105|TESTIM 1% (50MG) GEL|5|GM|1.69723|07/01/2003||Yes|No||07/01/2003||Yes|No|07/01/2003||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|084|No|3.81354|07/27/2021|3.72201|07/27/2021|3.7468|07/27/2021|||ANDROGENIC AGENTS|18160|||||No|No||AUXILIUM/ENDO P|No||||
estradiol|No|No|No|No|75%|66993000210|ESTRADIOL 0.01% CREAM|42.5|GM|1.01176|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||Yes|.87976|03/29/2022|.85864|03/29/2022|.86436|03/29/2022||||18161|||||No|No||PRASCO LABS|No||||
albuterol sulfate|No|No|No|No|75%|66993001968|ALBUTEROL HFA 90 MCG INHALER|18|GM|.85951|06/17/2019||Yes|No||06/17/2019||Yes|No|06/17/2019||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|1.85568|03/29/2022|1.81114|03/29/2022|1.8232|03/29/2022|||BRONCHODILATORS: BETA AGONIST|18162|||||No|No||PRASCO LABS|Yes|09/01/2020|||
levalbuterol HCl|No|No|No|No|75%|66993002127|LEVALBUTEROL 0.31 MG/3 ML SOL|3|ML|.40013|08/20/2012||Yes|No||08/20/2012||Yes|No|08/20/2012||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|.91193|03/01/2022|.89891|03/01/2022|.8561|03/01/2022|||BRONCHODILATORS: BETA AGONIST|18163|||||No|No||PRASCO LABS|Yes|09/01/2020|||
levalbuterol HCl|No|No|No|No|75%|66993002227|LEVALBUTEROL 0.63 MG/3 ML SOL|3|ML|.40013|08/20/2012||Yes|No||08/20/2012||Yes|No|08/20/2012||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|.33369|09/28/2021|.32568|09/28/2021|.32785|09/28/2021|||BRONCHODILATORS: BETA AGONIST|18164|||||No|No||PRASCO LABS|Yes|09/01/2020|||
levalbuterol HCl|No|No|No|No|75%|66993002327|LEVALBUTEROL 1.25 MG/3 ML SOL|3|ML|.40013|08/20/2012||Yes|No||08/20/2012||Yes|No|08/20/2012||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|.40061|09/28/2021|.39099|09/28/2021|.39359|09/28/2021|||BRONCHODILATORS: BETA AGONIST|18165|||||No|No||PRASCO LABS|Yes|09/01/2020|||
hydroxyprogesterone caproat/PF|No|No|No|No|75%|66993003883|HYDROXYPROGEST 250 MG/ML VIAL|1|ML|310.417|08/15/2018||Yes|No||08/15/2018||Yes|No|08/15/2018||Yes|No||||No|No|||Prescription required|Yes|09/28/2017|151|Yes|707.462|08/15/2018|697.3554|08/21/2018|664.148|08/15/2018|||PROGESTATIONAL AGENTS|18166|||||No|No||PRASCO LABS|No||||
atomoxetine HCl|No|No|No|No|75%|66993004030|ATOMOXETINE HCL 10 MG CAPSULE|30|EA|2.54746|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.20613|03/29/2022|1.17718|03/29/2022|1.18502|03/29/2022|||STIMULANTS AND RELATED AGENTS|18167|||||No|No||PRASCO LABS|No||||
atomoxetine HCl|No|No|No|No|75%|66993004130|ATOMOXETINE HCL 18 MG CAPSULE|30|EA|2.54746|03/05/2018|02/22/2022|Yes|No||03/05/2018|02/22/2022|Yes|No|03/05/2018|02/22/2022|Yes|No||||No|No|||Prescription required|No||007|Yes|5.80584|03/29/2022|5.7229|03/29/2022|5.45038|03/29/2022|||STIMULANTS AND RELATED AGENTS|18168|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||PRASCO LABS|No||||
atomoxetine HCl|No|No|No|No|75%|66993004230|ATOMOXETINE HCL 25 MG CAPSULE|30|EA|2.54746|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.05569|03/29/2022|1.03035|03/29/2022|1.03721|03/29/2022|||STIMULANTS AND RELATED AGENTS|18169|||||No|No||PRASCO LABS|No||||
atomoxetine HCl|No|No|No|No|75%|66993004330|ATOMOXETINE HCL 40 MG CAPSULE|30|EA|2.76791|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.0462|03/29/2022|1.02109|03/29/2022|1.02789|03/29/2022|||STIMULANTS AND RELATED AGENTS|18170|||||No|No||PRASCO LABS|No||||
atomoxetine HCl|No|No|No|No|75%|66993004430|ATOMOXETINE HCL 60 MG CAPSULE|30|EA|2.76791|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.16565|03/29/2022|1.13767|03/29/2022|1.14525|03/29/2022|||STIMULANTS AND RELATED AGENTS|18171|||||No|No||PRASCO LABS|No||||
atomoxetine HCl|No|No|No|No|75%|66993004530|ATOMOXETINE HCL 80 MG CAPSULE|30|EA|2.98635|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.40838|03/29/2022|1.37457|03/29/2022|1.38373|03/29/2022|||STIMULANTS AND RELATED AGENTS|18172|||||No|No||PRASCO LABS|No||||
atomoxetine HCl|No|No|No|No|75%|66993004630|ATOMOXETINE HCL 100 MG CAPSULE|30|EA|2.98635|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.76872|03/29/2022|1.72627|03/29/2022|1.73776|03/29/2022|||STIMULANTS AND RELATED AGENTS|18173|||||No|No||PRASCO LABS|No||||
hydroxychloroquine sulfate|No|No|No|No|75%|66993005702|HYDROXYCHLOROQUINE 200 MG TAB|100|EA|.51651|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No|||No|.23831|03/29/2022|.23259|03/29/2022|.23413|03/29/2022||||18174|||||No|No||PRASCO LABS|No||||
hydroxychloroquine sulfate|No|No|No|No|75%|66993005704|HYDROXYCHLOROQUINE 200 MG TAB|500|EA|.49069|07/16/2015||Yes|No||07/16/2015||Yes|No|07/16/2015||Yes|No||||No|No|||Prescription required|No|||No|.23831|03/29/2022|.23259|03/29/2022|.23413|03/29/2022||||18175|||||No|No||PRASCO LABS|No||||
atovaquone/proguanil HCl|No|No|No|No|75%|66993006002|ATOVAQUONE-PROGUANIL 250-100|100|EA|2.60154|08/13/2012||Yes|No||08/13/2012||Yes|No|08/13/2012||Yes|No||||No|No|||Prescription required|No|||No|2.47536|03/29/2022|2.41595|03/29/2022|2.43204|03/29/2022||||18176|||||No|No||PRASCO LABS|No||||
atovaquone/proguanil HCl|No|No|No|No|75%|66993006027|ATOVAQUONE-PROGUANIL 250-100|24|EA|2.65453|08/13/2012||Yes|No||08/13/2012||Yes|No|08/13/2012||Yes|No||||No|No|||Prescription required|No|||No|2.47536|03/29/2022|2.41595|03/29/2022|2.43204|03/29/2022||||18177|||||No|No||PRASCO LABS|No||||
phenoxybenzamine HCl|No|No|No|No|75%|66993006602|PHENOXYBENZAMINE HCL 10 MG CAP|100|EA|46.38453|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No|||No|105.71358|06/26/2017|104.20338|06/26/2017|99.24132|06/26/2017||||18178|||||No|No||PRASCO LABS|No||||
pantoprazole sodium|No|No|No|No|75%|66993006785|PANTOPRAZOLE SOD DR 20 MG TAB|90|EA|.15551|04/30/2015||Yes|No||04/30/2015||Yes|No|04/30/2015||Yes|No||||No|No|||Prescription required|No||047|Yes|.05306|03/29/2022|.05178|03/29/2022|.05213|03/29/2022|||PROTON PUMP INHIBITORS|18179|||||No|No||PRASCO LABS|No||||
pantoprazole sodium|No|No|No|No|75%|66993006885|PANTOPRAZOLE SOD DR 40 MG TAB|90|EA|.15551|04/30/2015||Yes|No||04/30/2015||Yes|No|04/30/2015||Yes|No||||No|No|||Prescription required|No||047|No|.05828|03/29/2022|.05688|03/29/2022|.05726|03/29/2022|||PROTON PUMP INHIBITORS|18180|||||No|No||PRASCO LABS|No||||
sumatriptan|No|No|No|No|75%|66993008169|SUMATRIPTAN 5 MG NASAL SPRAY|6|EA|21.15671|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|021|No|34.775|03/29/2022|33.9404|03/29/2022|34.16643|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|18181|||||No|No||PRASCO LABS|No||||
sumatriptan|No|No|No|No|75%|66993008269|SUMATRIPTAN 20 MG NASAL SPRAY|6|EA|21.15671|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|021|No|23.30855|03/29/2022|22.74914|03/29/2022|22.90065|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|18182|||||No|No||PRASCO LABS|No||||
sumatriptan succinate|No|No|No|No|75%|66993008379|SUMATRIPTAN 4 MG/0.5 ML CART|1|ML|73.0183|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No||021|No|166.4138|12/10/2020|164.03646|12/10/2020|156.2252|12/10/2020|||ANTIMIGRAINE AGENTS: TRIPTANS|18183|||||No|No||PRASCO LABS|No||||
sumatriptan succinate|No|No|No|No|75%|66993008398|SUMATRIPTAN 4 MG/0.5 ML INJECT|1|ML|77.0904|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No||021|No|129.29|03/01/2022|126.18704|03/01/2022|127.02742|03/01/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|18184|||||No|No||PRASCO LABS|No||||
sumatriptan succinate|No|No|No|No|75%|66993008479|SUMATRIPTAN 6 MG/0.5 ML CART|1|ML|65.833|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No||021|No|126.73571|03/29/2022|123.69405|03/29/2022|124.51783|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|18185|||||No|No||PRASCO LABS|No||||
sumatriptan succinate|No|No|No|No|75%|66993008498|SUMATRIPTAN 6 MG/0.5 ML INJECT|1|ML|77.0904|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No||021|No|76.75855|03/29/2022|74.91634|03/29/2022|75.41527|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|18186|||||No|No||PRASCO LABS|No||||
propafenone HCl|No|No|No|No|75%|66993011460|PROPAFENONE HCL ER 225 MG CAP|60|EA|2.51413|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No|||No|1.23841|03/29/2022|1.20868|03/29/2022|1.21673|03/29/2022||||18187|||||No|No||PRASCO LABS|No||||
propafenone HCl|No|No|No|No|75%|66993011560|PROPAFENONE HCL ER 325 MG CAP|60|EA|3.18507|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No|||No|2.24387|03/29/2022|2.19001|03/29/2022|2.2046|03/29/2022||||18188|||||No|No||PRASCO LABS|No||||
propafenone HCl|No|No|No|No|75%|66993011660|PROPAFENONE HCL ER 425 MG CAP|60|EA|3.18507|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No|||No|7.25901|03/23/2021|7.15531|03/23/2021|6.81458|03/23/2021||||18189|||||No|No||PRASCO LABS|No||||
aliskiren hemifumarate|No|No|No|No|75%|66993014130|ALISKIREN 150 MG TABLET|30|EA|2.67761|06/05/2019||Yes|No||06/05/2019||Yes|No|06/05/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|113|Yes|5.71911|03/29/2022|5.58185|03/29/2022|5.61902|03/29/2022|||ANGIOTENSIN MODULATORS|18190|||||No|No||PRASCO LABS|No||||
aliskiren hemifumarate|No|No|No|No|75%|66993014230|ALISKIREN 300 MG TABLET|30|EA|3.37808|06/05/2019||Yes|No||06/05/2019||Yes|No|06/05/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|113|Yes|7.08183|03/29/2022|6.91186|03/29/2022|6.95789|03/29/2022|||ANGIOTENSIN MODULATORS|18191|||||No|No||PRASCO LABS|No||||
ketorolac tromethamine|No|No|No|No|75%|66993019395|KETOROLAC 15.75 MG NASAL SPRAY|5|EA|151.8072|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|345.9792|12/11/2020|341.03664|12/11/2020|324.7968|12/11/2020|||NSAIDS|18192|||||No|No||PRASCO LABS|No||||
tobramycin|No|No|No|No|75%|66993019594|TOBRAMYCIN 300 MG/4 ML AMPULE|4|ML|9.49954|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No|Submit HHS Form 1143|||No|No|||Prescription required|Yes|07/25/2019|240|No|21.65012|12/11/2020|21.34083|12/11/2020|20.3246|12/11/2020|||ANTIBIOTICS: INHALED|18193|||||No|No||PRASCO LABS|No||||
nilutamide|No|No|No|No|75%|66993021238|NILUTAMIDE 150 MG TABLET|30|EA|62.58865|12/02/2020||Yes|No||12/02/2020||Yes|No|12/02/2020||Yes|No||||No|No|||Prescription required|No||550|No|142.6439|12/02/2020|140.60613|12/02/2020|133.9106|12/02/2020|||ONCOLOGY: ORAL - PROSTATE|18194|||||No|No||PRASCO LABS|No||||
eplerenone|No|No|No|No|75%|66993034330|EPLERENONE 25 MG TABLET|30|EA|.60171|12/16/2021||Yes|No||12/16/2021||Yes|No|12/16/2021||Yes|No||||No|No|||Prescription required|No|||No|.73164|03/29/2022|.71408|03/29/2022|.71883|03/29/2022||||18195|||||No|No||PRASCO LABS|No||||
eplerenone|No|No|No|No|75%|66993034385|EPLERENONE 25 MG TABLET|90|EA|.60175|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||No|.73164|03/29/2022|.71408|03/29/2022|.71883|03/29/2022||||18196|||||No|No||PRASCO LABS|No||||
eplerenone|No|No|No|No|75%|66993034430|EPLERENONE 50 MG TABLET|30|EA|.60185|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||No|.85922|03/29/2022|.83859|03/29/2022|.84418|03/29/2022||||18197|||||No|No||PRASCO LABS|No||||
eplerenone|No|No|No|No|75%|66993034485|EPLERENONE 50 MG TABLET|90|EA|.60175|12/16/2021||Yes|No||12/16/2021||Yes|No|12/16/2021||Yes|No||||No|No|||Prescription required|No|||No|.85922|03/29/2022|.83859|03/29/2022|.84418|03/29/2022||||18198|||||No|No||PRASCO LABS|No||||
dextroamphetamine sulfate|No|No|No|No|75%|66993035957|DEXTROAMPHETAMINE 5 MG/5 ML|473|ML|.65363|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.42657|10/26/2021|1.39233|10/26/2021|1.4016|10/26/2021|||STIMULANTS AND RELATED AGENTS|18199|||||No|No||PRASCO LABS|No||||
amphetamine|No|No|No|No|75%|66993036087|AMPHETAMINE ER 1.25 MG/ML SUSP|450|ML|.55141|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|No|1.25672|03/02/2020|1.23876|03/02/2020|1.17978|03/02/2020|||STIMULANTS AND RELATED AGENTS|18200|||||No|No||PRASCO LABS|No||||
medroxyprogesterone acetate|No|Yes|No|No|75%|66993037179|MEDROXYPROGESTERONE 150 MG/ML|1|ML|30.96|12/28/2021||Yes|No||||No|No|12/28/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|35.94375|03/29/2022|35.0811|03/29/2022|35.31473|03/29/2022||||18201|||||No|No||PRASCO LABS|No||||
carbamazepine|No|No|No|No|75%|66993040732|CARBAMAZEPINE ER 100 MG CAP|120|EA|.70383|12/15/2011||Yes|No||12/15/2011||Yes|No|12/15/2011||Yes|No||||No|No|||Prescription required|No||056|No|1.01422|03/29/2022|.98987|03/29/2022|.99647|03/29/2022|||ANTICONVULSANTS|18202|||||No|No||PRASCO LABS|No||||
carbamazepine|No|No|No|No|75%|66993040832|CARBAMAZEPINE ER 200 MG CAP|120|EA|.70383|12/15/2011||Yes|No||12/15/2011||Yes|No|12/15/2011||Yes|No||||No|No|||Prescription required|No||056|No|1.08329|03/29/2022|1.05729|03/29/2022|1.06433|03/29/2022|||ANTICONVULSANTS|18203|||||No|No||PRASCO LABS|No||||
carbamazepine|No|No|No|No|75%|66993040932|CARBAMAZEPINE ER 300 MG CAP|120|EA|.70383|12/15/2011||Yes|No||12/15/2011||Yes|No|12/15/2011||Yes|No||||No|No|||Prescription required|No||056|No|1.17876|03/29/2022|1.15046|03/29/2022|1.15813|03/29/2022|||ANTICONVULSANTS|18204|||||No|No||PRASCO LABS|No||||
lanthanum carbonate|No|No|No|No|75%|66993042285|LANTHANUM CARB 500 MG TAB CHEW|90|EA|4.64151|11/20/2017||Yes|No||11/20/2017||Yes|No|11/20/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|052|Yes|10.57833|02/23/2021|10.42721|02/23/2021|9.93068|02/23/2021|||PHOSPHATE BINDERS|18205|||||No|No||PRASCO LABS|No||||
lanthanum carbonate|No|No|No|No|75%|66993042385|LANTHANUM CARB 750 MG TAB CHEW|90|EA|4.64151|11/20/2017||Yes|No||11/20/2017||Yes|No|11/20/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|052|Yes|10.57833|11/20/2017|10.42721|11/20/2017|9.93068|11/20/2017|||PHOSPHATE BINDERS|18206|||||No|No||PRASCO LABS|No||||
lanthanum carbonate|No|No|No|No|75%|66993042485|LANTHANUM CARB 1,000 MG TB CHW|90|EA|4.64151|11/20/2017||Yes|No||11/20/2017||Yes|No|11/20/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|052|Yes|7.25704|03/29/2022|7.08287|03/29/2022|7.13004|03/29/2022|||PHOSPHATE BINDERS|18207|||||No|No||PRASCO LABS|No||||
nisoldipine|No|No|No|No|75%|66993047202|NISOLDIPINE ER 8.5 MG TABLET|100|EA|2.20082|03/21/2012||Yes|No||03/21/2012||Yes|No|03/21/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|045|No|3.32904|04/27/2021|3.24914|04/27/2021|3.27078|04/27/2021|||CALCIUM CHANNEL BLOCKERS|18208|||||No|No||PRASCO LABS|No||||
nisoldipine|No|No|No|No|75%|66993047302|NISOLDIPINE ER 17 MG TABLET|100|EA|2.75832|03/21/2012||Yes|No||03/21/2012||Yes|No|03/21/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|045|No|6.2864|10/26/2021|6.1966|10/26/2021|5.90152|10/26/2021|||CALCIUM CHANNEL BLOCKERS|18209|||||No|No||PRASCO LABS|No||||
nisoldipine|No|No|No|No|75%|66993047502|NISOLDIPINE ER 34 MG TABLET|100|EA|3.00815|03/21/2012||Yes|No||03/21/2012||Yes|No|03/21/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|045|No|5.37038|08/24/2021|5.24149|08/24/2021|5.27639|08/24/2021|||CALCIUM CHANNEL BLOCKERS|18210|||||No|No||PRASCO LABS|No||||
lamivudine|No|No|No|No|75%|66993047860|LAMIVUDINE HBV 100 MG TABLET|60|EA|7.03029|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|2.63504|03/29/2022|2.57179|03/29/2022|2.58892|03/29/2022||||18211|||||No|No||PRASCO LABS|No||||
zileuton|No|No|No|No|75%|66993048532|ZILEUTON ER 600 MG TABLET|120|EA|11.53281|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|042|Yes|26.28409|11/23/2021|25.9086|11/23/2021|24.67486|11/23/2021|||LEUKOTRIENE MODIFIERS|18212|||||No|No||PRASCO LABS|No||||
dactinomycin|No|No|No|No|75%|66993048983|DACTINOMYCIN 500 MCG VIAL|1|EA|652.8346|02/07/2018||Yes|No||02/07/2018||Yes|No|02/07/2018||Yes|No||||No|No|||Prescription required|No|||No|1487.8556|02/07/2018|1466.60052|02/07/2018|1396.7624|02/07/2018||||18213|||||No|No||PRASCO LABS|No||||
fluticasone propion/salmeterol|No|No|No|No|75%|66993058497|FLUTICASONE-SALMETEROL 100-50|60|EA|2.04271|05/28/2019||Yes|No||05/28/2019||Yes|No|05/28/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|033|Yes|1.62434|03/29/2022|1.58535|03/29/2022|1.59591|03/29/2022|||GLUCOCORTICOIDS: INHALED|18214|||||No|No||PRASCO LABS|No||||
fluticasone propion/salmeterol|No|No|No|No|75%|66993058597|FLUTICASONE-SALMETEROL 250-50|60|EA|2.53807|05/28/2019||Yes|No||05/28/2019||Yes|No|05/28/2019||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|033|Yes|1.91406|03/29/2022|1.86812|03/29/2022|1.88056|03/29/2022|||GLUCOCORTICOIDS: INHALED|18215|||||No|No||PRASCO LABS|No||||
fluticasone propion/salmeterol|No|No|No|No|75%|66993058697|FLUTICASONE-SALMETEROL 500-50|60|EA|3.33809|05/28/2019||Yes|No||05/28/2019||Yes|No|05/28/2019||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|033|Yes|3.44519|03/29/2022|3.3625|03/29/2022|3.38489|03/29/2022|||GLUCOCORTICOIDS: INHALED|18216|||||No|No||PRASCO LABS|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|66993059402|DEXTROAMP-AMPHET ER 5 MG CAP|100|EA|.473|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.59233|03/29/2022|.57811|03/29/2022|.58196|03/29/2022|||STIMULANTS AND RELATED AGENTS|18217|||||No|No||PRASCO LABS|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|66993059502|DEXTROAMP-AMPHET ER 10 MG CAP|100|EA|.473|03/08/2017||Yes|No||03/08/2017||Yes|No|03/08/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.53198|03/29/2022|.51921|03/29/2022|.52267|03/29/2022|||STIMULANTS AND RELATED AGENTS|18218|||||No|No||PRASCO LABS|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|66993059602|DEXTROAMP-AMPHET ER 15 MG CAP|100|EA|.473|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.55636|03/29/2022|.543|03/29/2022|.54662|03/29/2022|||STIMULANTS AND RELATED AGENTS|18219|||||No|No||PRASCO LABS|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|66993059702|DEXTROAMP-AMPHET ER 20 MG CAP|100|EA|.473|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.58746|03/29/2022|.57336|03/29/2022|.57717|03/29/2022|||STIMULANTS AND RELATED AGENTS|18220|||||No|No||PRASCO LABS|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|66993059802|DEXTROAMP-AMPHET ER 25 MG CAP|100|EA|.473|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.54687|03/29/2022|.53374|03/29/2022|.53729|03/29/2022|||STIMULANTS AND RELATED AGENTS|18221|||||No|No||PRASCO LABS|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|66993059902|DEXTROAMP-AMPHET ER 30 MG CAP|100|EA|.473|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.61484|03/29/2022|.60008|03/29/2022|.60408|03/29/2022|||STIMULANTS AND RELATED AGENTS|18222|||||No|No||PRASCO LABS|No||||
etonogestrel/ethinyl estradiol|Yes|Yes|No|No|75%|66993060536|ETONOGESTREL-EE VAGINAL RING|1|EA|59.44176|03/09/2020||Yes|No||03/09/2020||Yes|No|06/23/2021||Yes|No|Refer to program requirements|||No|No|06/19/2020||Prescription required|No|||No|92.38101|03/29/2022|90.16386|03/29/2022|90.76434|03/29/2022||||18223|||||No|No||PRASCO LABS|No|||Only covered for non-contraceptive (medical) purposes|
raloxifene HCl|No|No|No|No|75%|66993066130|RALOXIFENE HCL 60 MG TABLET|30|EA|1.29|11/04/2015||Yes|No||11/04/2015||Yes|No|11/04/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|060|Yes|.36315|03/29/2022|.35443|03/29/2022|.35679|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|18224|||||No|No||PRASCO LABS|No||||
raloxifene HCl|No|No|No|No|75%|66993066188|RALOXIFENE HCL 60 MG TABLET|2000|EA|1.29|10/21/2015||Yes|No||10/21/2015||Yes|No|10/21/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|060|Yes|.36315|03/29/2022|.35443|03/29/2022|.35679|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|18225|||||No|No||PRASCO LABS|No||||
olanzapine|No|No|No|No|75%|66993068030|OLANZAPINE 2.5 MG TABLET|30|EA|.14333|07/21/2015||Yes|No||07/21/2015||Yes|No|07/21/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.08915|03/29/2022|.08701|03/29/2022|.08758|03/29/2022|||ANTIPSYCHOTICS|18226|||||No|No||PRASCO LABS|No||||
olanzapine|No|No|No|No|75%|66993068130|OLANZAPINE 5 MG TABLET|30|EA|.15408|07/21/2015||Yes|No||07/21/2015||Yes|No|07/21/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.09455|03/29/2022|.09228|03/29/2022|.09289|03/29/2022|||ANTIPSYCHOTICS|18227|||||No|No||PRASCO LABS|No||||
olanzapine|No|No|No|No|75%|66993068230|OLANZAPINE 7.5 MG TABLET|30|EA|.1935|07/21/2015||Yes|No||07/21/2015||Yes|No|07/21/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.11617|03/29/2022|.11338|03/29/2022|.11413|03/29/2022|||ANTIPSYCHOTICS|18228|||||No|No||PRASCO LABS|No||||
olanzapine|No|No|No|No|75%|66993068330|OLANZAPINE 10 MG TABLET|30|EA|.24008|07/21/2015||Yes|No||07/21/2015||Yes|No|07/21/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.12613|03/29/2022|.1231|03/29/2022|.12392|03/29/2022|||ANTIPSYCHOTICS|18229|||||No|No||PRASCO LABS|No||||
olanzapine|No|No|No|No|75%|66993068430|OLANZAPINE 15 MG TABLET|30|EA|.35833|07/21/2015||Yes|No||07/21/2015||Yes|No|07/21/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.15007|03/29/2022|.14646|03/29/2022|.14744|03/29/2022|||ANTIPSYCHOTICS|18230|||||No|No||PRASCO LABS|No||||
olanzapine|No|No|No|No|75%|66993068530|OLANZAPINE 20 MG TABLET|30|EA|.48375|07/21/2015||Yes|No||07/21/2015||Yes|No|07/21/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.18048|03/29/2022|.17614|03/29/2022|.17732|03/29/2022|||ANTIPSYCHOTICS|18231|||||No|No||PRASCO LABS|No||||
doxycycline monohydrate|No|No|No|No|75%|66993081530|DOXYCYCLINE IR-DR 40 MG CAP|30|EA|8.93726|05/18/2015||Yes|No||05/18/2015||Yes|No|05/18/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|213|No|16.45919|03/01/2022|16.06416|03/01/2022|16.17115|03/01/2022|||TETRACYCLINES|18232|||||No|No||PRASCO LABS|No||||
pioglitazone HCl/glimepiride|No|No|No|No|75%|66993082130|PIOGLITAZONE-GLIMEPIRIDE 30-2|30|EA|5.59645|08/20/2015||Yes|No||08/20/2015||Yes|No|08/20/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|009|Yes|12.7547|01/23/2018|12.57249|01/23/2018|11.9738|01/23/2018|||HYPOGLYCEMICS: TZD|18233|||||No|No||PRASCO LABS|No||||
pioglitazone HCl/glimepiride|No|No|No|No|75%|66993082230|PIOGLITAZONE-GLIMEPIRIDE 30-4|30|EA|5.59645|08/20/2015||Yes|No||08/20/2015||Yes|No|08/20/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|009|Yes|12.7547|06/25/2019|12.57249|06/25/2019|11.9738|06/25/2019|||HYPOGLYCEMICS: TZD|18234|||||No|No||PRASCO LABS|No||||
triamterene|No|No|No|No|75%|66993083102|TRIAMTERENE 50 MG CAPSULE|100|EA|4.10254|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No|||No|8.72044|09/28/2021|8.51114|09/28/2021|8.56783|09/28/2021||||18235|||||No|No||PRASCO LABS|No||||
triamterene|No|No|No|No|75%|66993083202|TRIAMTERENE 100 MG CAPSULE|100|EA|4.10254|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No|||No|9.34998|12/16/2019|9.21641|12/16/2019|8.77753|12/16/2019||||18236|||||No|No||PRASCO LABS|No||||
prednisolone sodium phosphate|No|No|No|No|75%|66993084435|PREDNISOLONE ODT 10 MG TABLET|12|EA|4.94822|03/19/2021||Yes|No||03/19/2021||Yes|No|03/19/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|168|Yes|11.27735|03/19/2021|11.11624|03/19/2021|10.5869|03/19/2021|||GLUCOCORTICOIDS: ORAL|18237|||||No|No||PRASCO LABS|No||||
prednisolone sodium phosphate|No|No|No|No|75%|66993084535|PREDNISOLONE ODT 15 MG TABLET|12|EA|8.24703|03/19/2021||Yes|No||03/19/2021||Yes|No|03/19/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|168|Yes|18.79557|03/19/2021|18.52706|03/19/2021|17.64482|03/19/2021|||GLUCOCORTICOIDS: ORAL|18238|||||No|No||PRASCO LABS|No||||
prednisolone sodium phosphate|No|No|No|No|75%|66993084635|PREDNISOLONE ODT 30 MG TABLET|12|EA|10.60308|03/19/2021||Yes|No||03/19/2021||Yes|No|03/19/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|168|Yes|24.16516|03/19/2021|23.81994|03/19/2021|22.68566|03/19/2021|||GLUCOCORTICOIDS: ORAL|18239|||||No|No||PRASCO LABS|No||||
prednisolone sodium phosphate|No|No|No|No|75%|66993084662|PREDNISOLONE ODT 30 MG TABLET|48|EA|10.60308|10/29/2015||Yes|No||10/29/2015||Yes|No|10/29/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|168|Yes|24.16516|06/01/2016|23.81994|06/01/2016|22.68566|06/01/2016|||GLUCOCORTICOIDS: ORAL|18240|||||No|No||PRASCO LABS|No||||
adapalene/benzoyl peroxide|No|No|No|No|75%|66993086948|ADAPALENE-BNZYL PEROX 0.1-2.5%|45|GM|3.53927|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|104|No|.76371|03/29/2022|.74538|03/29/2022|.75034|03/29/2022|||ACNE AGENTS: TOPICAL|18241|||||No|No||PRASCO LABS|No||||
calcipotriene|No|No|No|No|75%|66993087761|CALCIPOTRIENE 0.005% CREAM|60|GM|2.01383|08/06/2012||Yes|No||08/06/2012||Yes|No|08/06/2012||Yes|No||||No|No|||Prescription required|No|||No|1.06701|03/29/2022|1.0414|03/29/2022|1.04833|03/29/2022||||18242|||||No|No||PRASCO LABS|No||||
calcipotriene|No|No|No|No|75%|66993087778|CALCIPOTRIENE 0.005% CREAM|120|GM|1.9255|08/06/2012||Yes|No||08/06/2012||Yes|No|08/06/2012||Yes|No||||No|No|||Prescription required|No|||No|1.10109|03/29/2022|1.07466|03/29/2022|1.08182|03/29/2022||||18243|||||No|No||PRASCO LABS|No||||
calcipotriene|No|No|No|No|75%|66993087861|CALCIPOTRIENE 0.005% OINTMENT|60|GM|2.16132|08/23/2013||Yes|No||08/23/2013||Yes|No|08/23/2013||Yes|No||||No|No|||Prescription required|No|||No|2.14151|03/29/2022|2.09011|03/29/2022|2.10403|03/29/2022||||18244|||||No|No||PRASCO LABS|No||||
calcipotriene|No|No|No|No|75%|66993087878|CALCIPOTRIENE 0.005% OINTMENT|120|GM|2.16128|08/23/2013||Yes|No||08/23/2013||Yes|No|08/23/2013||Yes|No||||No|No|||Prescription required|No|||No|2.11241|03/29/2022|2.06171|03/29/2022|2.07544|03/29/2022||||18245|||||No|No||PRASCO LABS|No||||
adapalene|No|No|No|No|75%|66993088445|ADAPALENE 0.3% GEL|45|GM|2.3649|08/08/2014||Yes|No||08/08/2014||Yes|No|08/08/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|.91902|03/29/2022|.89696|03/29/2022|.90293|03/29/2022|||ACNE AGENTS: TOPICAL|18246|||||No|No||PRASCO LABS|No||||
adapalene|No|No|No|No|75%|66993088448|ADAPALENE 0.3% GEL PUMP|45|GM|2.3649|08/08/2014||Yes|No||08/08/2014||Yes|No|08/08/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|104|No|3.35906|03/01/2022|3.27844|03/01/2022|3.30027|03/01/2022|||ACNE AGENTS: TOPICAL|18247|||||No|No||PRASCO LABS|No||||
acitretin|No|No|No|No|75%|66993089630|ACITRETIN 25 MG CAPSULE|30|EA|13.76602|07/22/2013||Yes|No||07/22/2013||Yes|No|07/22/2013||Yes|No||||No|No|||Prescription required|No|||No|10.86025|03/29/2022|10.5996|03/29/2022|10.67019|03/29/2022||||18248|||||No|No||PRASCO LABS|No||||
betamethasone/propylene glyc|No|No|No|No|75%|66993089715|BETAMETHASONE DP AUG 0.05% OIN|15|GM|1.51732|08/06/2012||Yes|No||08/06/2012||Yes|No|08/06/2012||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|120|No|1.24083|03/29/2022|1.21105|03/29/2022|1.21911|03/29/2022|||STEROIDS: TOPICAL HIGH|18249|||||No|No||PRASCO LABS|No||||
betamethasone/propylene glyc|No|No|No|No|75%|66993089749|BETAMETHASONE DP AUG 0.05% OIN|50|GM|1.01806|08/06/2012||Yes|No||08/06/2012||Yes|No|08/06/2012||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|120|No|1.07205|03/29/2022|1.04632|03/29/2022|1.05328|03/29/2022|||STEROIDS: TOPICAL HIGH|18250|||||No|No||PRASCO LABS|No||||
metronidazole|No|No|No|No|75%|66993093658|METRONIDAZOLE TOP 1% GEL PUMP|55|GM|1.73414|05/19/2017||Yes|No||05/19/2017||Yes|No|05/19/2017||Yes|No||||No|No|||Prescription required|No||221|No|1.15772|03/29/2022|1.12993|03/29/2022|1.13745|03/29/2022|||ROSACEA AGENTS: TOPICAL|18251|||||No|No||PRASCO LABS|No||||
metronidazole|No|No|No|No|75%|66993093661|METRONIDAZOLE TOPICAL 1% GEL|60|GM|1.58963|05/19/2017||Yes|No||05/19/2017||Yes|No|05/19/2017||Yes|No||||No|No|||Prescription required|No||221|No|1.2961|03/29/2022|1.26499|03/29/2022|1.27341|03/29/2022|||ROSACEA AGENTS: TOPICAL|18252|||||No|No||PRASCO LABS|No||||
calcipotriene/betamethasone|No|No|No|No|75%|66993093761|CALCIPOTRIENE-BETAMETH DP SUSP|60|GM|6.78174|05/19/2020||Yes|No||05/19/2020||Yes|No|05/19/2020||Yes|No||||No|No|||Prescription required|No|||No|15.45607|05/26/2020|15.23526|05/19/2020|14.50978|05/19/2020||||18253|||||No|No||PRASCO LABS|No||||
calcipotriene/betamethasone|No|No|No|No|75%|66993093778|CALCIPOTRIENE-BETAMETH DP SUSP|120|GM|6.78174|05/19/2020||Yes|No||05/19/2020||Yes|No|05/19/2020||Yes|No||||No|No|||Prescription required|No|||No|15.45607|05/26/2020|15.23526|05/19/2020|14.50978|05/19/2020||||18254|||||No|No||PRASCO LABS|No||||
calcipotriene/betamethasone|No|No|No|No|75%|66993093861|CALCIPOTRIENE-BETAMETH DP OINT|60|GM|4.52323|05/19/2020||Yes|No||05/19/2020||Yes|No|05/19/2020||Yes|No||||No|No|||Prescription required|No|||No|5.20664|03/29/2022|5.08168|03/29/2022|5.11552|03/29/2022||||18255|||||No|No||PRASCO LABS|No||||
calcipotriene/betamethasone|No|No|No|No|75%|66993093865|CALCIPOTRIENE-BETAMETH DP OINT|100|GM|3.99753|05/19/2020||Yes|No||05/19/2020||Yes|No|05/19/2020||Yes|No||||No|No|||Prescription required|No|||No|3.63452|03/29/2022|3.54729|03/29/2022|3.57091|03/29/2022||||18256|||||No|No||PRASCO LABS|No||||
clobetasol propionate|No|No|No|No|75%|66993093955|CLOBETASOL 0.05% SHAMPOO|118|ML|.66099|10/16/2020||Yes|No||10/16/2020||Yes|No|10/16/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|121|No|.54041|03/29/2022|.52744|03/29/2022|.53095|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|18257|||||No|No||PRASCO LABS|No||||
clocortolone pivalate|No|No|No|No|75%|66993094748|CLOCORTOLONE PIVALATE 0.1% CRM|45|GM|2.56776|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|5.85211|12/16/2019|5.76851|12/16/2019|5.49382|12/16/2019|||STEROIDS: TOPICAL MEDIUM|18258|||||No|No||PRASCO LABS|No||||
clocortolone pivalate|No|No|No|No|75%|66993094779|CLOCORTOLONE 0.1% CREAM PUMP|75|GM|2.56784|02/27/2020||Yes|No||02/27/2020||Yes|No|02/27/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|5.85229|02/27/2020|5.76869|02/27/2020|5.49399|02/27/2020|||STEROIDS: TOPICAL MEDIUM|18259|||||No|No||PRASCO LABS|No||||
clocortolone pivalate|No|No|No|No|75%|66993094793|CLOCORTOLONE PIVALATE 0.1% CRM|90|GM|2.56781|05/19/2020||Yes|No||05/19/2020||Yes|No|05/19/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|119|No|5.85222|05/19/2020|5.76862|05/19/2020|5.49392|05/19/2020|||STEROIDS: TOPICAL MEDIUM|18260|||||No|No||PRASCO LABS|No||||
clindamycin/tretinoin|No|No|No|No|75%|66993095931|CLINDA-TRETINOIN 1.2%-0.025%|30|GM|5.16501|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|104|No|11.77142|10/29/2019|11.60326|10/29/2019|11.05072|10/29/2019|||ACNE AGENTS: TOPICAL|18261|||||No|No||PRASCO LABS|No||||
clindamycin/tretinoin|No|No|No|No|75%|66993095961|CLINDA-TRETINOIN 1.2%-0.025%|60|GM|4.8643|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|104|No|11.08608|06/25/2019|10.92771|06/25/2019|10.40734|06/25/2019|||ACNE AGENTS: TOPICAL|18262|||||No|No||PRASCO LABS|No||||
metronidazole|No|No|No|No|75%|66993096045|METRONIDAZOLE 0.75% CREAM|45|GM|1.45836|01/06/2014||Yes|No||01/06/2014||Yes|No|01/06/2014||Yes|No||||No|No|||Prescription required|No||221|No|.99332|03/29/2022|.96948|03/29/2022|.97593|03/29/2022|||ROSACEA AGENTS: TOPICAL|18263|||||No|No||PRASCO LABS|No||||
metronidazole|No|No|No|No|75%|66993096159|METRONIDAZOLE 0.75% LOTION|59|ML|1.5098|01/06/2014||Yes|No||01/06/2014||Yes|No|01/06/2014||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|221|No|2.21171|03/29/2022|2.15862|03/29/2022|2.173|03/29/2022|||ROSACEA AGENTS: TOPICAL|18264|||||No|No||PRASCO LABS|No||||
metronidazole|No|No|No|No|75%|66993096245|METRONIDAZOLE TOPICAL 0.75% GL|45|GM|1.31761|10/01/2014||Yes|No||10/01/2014||Yes|No|10/01/2014||Yes|No||||No|No|||Prescription required|No||221|No|.54113|03/29/2022|.52814|03/29/2022|.53166|03/29/2022|||ROSACEA AGENTS: TOPICAL|18265|||||No|No||PRASCO LABS|No||||
mesna|No|No|No|No|75%|67108356509|MESNEX 400 MG TABLET|10|EA|33.79413|09/02/2010||Yes|No||09/02/2010||Yes|No|09/02/2010||Yes|No||||No|No|||Prescription required|No|||No|77.01918|06/01/2016|75.9189|06/01/2016|72.30372|06/01/2016||||18266|||||No|No||BAXTER HEALTHCA|No||||
prenatal vit103/iron fum/folic|No|No|No|No|75%|67112010100|TRICARE PRENATAL TABLET|100|EA|.42604|02/09/2010||Yes|No||02/09/2010||Yes|No|02/09/2010||Yes|No||||No|No|||Over the counter|No||243|No|.97098|09/28/2021|.95711|09/28/2021|.91153|09/28/2021|||PRENATAL VITAMINS|18267|||||No|No||MEDECOR PHARMA|No||||
propylthiouracil|No|No|No|No|75%|67253065110|PROPYLTHIOURACIL 50 MG TABLET|100|EA|.3225|08/08/2014||Yes|No||08/08/2014||Yes|No|08/08/2014||Yes|No||||No|No|||Prescription required|No|||Yes|.52222|03/29/2022|.50968|03/29/2022|.51308|03/29/2022||||18268|||||No|No||QUALITEST/PAR P|No||||
vigabatrin|No|No|No|No|75%|67386011101|SABRIL 500 MG TABLET|100|EA|79.85534|08/28/2009||Yes|No||08/28/2009||Yes|No|08/28/2009||Yes|No||||No|No|||Prescription required|No||056|No|181.99589|01/04/2022|179.39595|01/04/2022|170.85329|01/04/2022|||ANTICONVULSANTS|18269|||||No|No||LUNDBECK INC.|No||||
vigabatrin|No|No|No|No|75%|67386021165|SABRIL 500 MG POWDER PACKET|50|EA|79.85547|08/28/2009||Yes|No||08/28/2009||Yes|No|08/28/2009||Yes|No||||No|No|||Prescription required|No||056|No|181.99619|01/04/2022|179.39624|01/04/2022|170.85356|01/04/2022|||ANTICONVULSANTS|18270|||||No|No||LUNDBECK INC.|No||||
clobazam|No|No|No|No|90%|67386031321|ONFI 2.5 MG/ML SUSPENSION|120|ML|3.02178|10/15/2013||Yes|No||10/15/2013||Yes|No|10/15/2013||Yes|No||||No|No|||Prescription required|No||056|No|10.66183|01/11/2022|10.40594|01/11/2022|10.47524|01/11/2022|||ANTICONVULSANTS|18271|||||No|No||LUNDBECK INC.|No||||
clobazam|No|No|No|No|90%|67386031401|ONFI 10 MG TABLET|100|EA|6.12213|12/23/2013||Yes|No||12/23/2013||Yes|No|12/23/2013||Yes|No||||No|No|||Prescription required|No||056|No|24.37037|01/11/2022|23.78548|01/11/2022|23.94388|01/11/2022|||ANTICONVULSANTS|18272|||||No|No||LUNDBECK INC.|No||||
clobazam|No|No|No|No|90%|67386031501|ONFI 20 MG TABLET|100|EA|21.7813|12/23/2013||Yes|No||12/23/2013||Yes|No|12/23/2013||Yes|No||||No|No|||Prescription required|No||056|No|48.6179|01/11/2022|47.45107|01/11/2022|47.76708|01/11/2022|||ANTICONVULSANTS|18273|||||No|No||LUNDBECK INC.|No||||
tetrabenazine|No|No|No|No|75%|67386042101|XENAZINE 12.5 MG TABLET|112|EA|68.14989|12/08/2008||Yes|No||12/08/2008||Yes|No|12/08/2008||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|572|Yes|155.31835|01/04/2022|153.09952|01/04/2022|145.80907|01/04/2022|||MOVEMENT DISORDERS|18274|||||No|No||LUNDBECK INC.|No||||
tetrabenazine|No|No|No|No|75%|67386042201|XENAZINE 25 MG TABLET|112|EA|136.29982|12/08/2008||Yes|No||12/08/2008||Yes|No|12/08/2008||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|572|Yes|310.6368|01/04/2022|306.19913|01/04/2022|291.61822|01/04/2022|||MOVEMENT DISORDERS|18275|||||No|No||LUNDBECK INC.|No||||
droxidopa|No|No|No|No|75%|67386082019|NORTHERA 100 MG CAPSULE|90|EA|15.37674|09/02/2014||Yes|No||09/02/2014||Yes|No|09/02/2014||Yes|No||||No|No|||Prescription required|No|||No|35.04468|01/04/2022|34.54404|01/04/2022|32.89908|01/04/2022||||18276|||||No|No||LUNDBECK INC.|No||||
droxidopa|No|No|No|No|75%|67386082119|NORTHERA 200 MG CAPSULE|90|EA|30.7534|09/02/2014||Yes|No||09/02/2014||Yes|No|09/02/2014||Yes|No||||No|No|||Prescription required|No|||No|70.08915|01/04/2022|69.08788|01/04/2022|65.79798|01/04/2022||||18277|||||No|No||LUNDBECK INC.|No||||
droxidopa|No|No|No|No|75%|67386082219|NORTHERA 300 MG CAPSULE|90|EA|46.1302|09/02/2014||Yes|No||09/02/2014||Yes|No|09/02/2014||Yes|No||||No|No|||Prescription required|No|||No|105.13395|01/04/2022|103.63204|01/04/2022|98.69718|01/04/2022||||18278|||||No|No||LUNDBECK INC.|No||||
terbinafine HCl|No|No|No|No|75%|67405050003|TERBINAFINE HCL 250 MG TABLET|30|EA|.07166|10/15/2014||Yes|No||10/15/2014||Yes|No|10/15/2014||Yes|No||||No|No|||Prescription required|No||069|No|.15711|03/29/2022|.15333|03/29/2022|.15436|03/29/2022|||ANTIFUNGALS: ORAL|18279|||||No|No||HARRIS PHARM|No||||
terbinafine HCl|No|No|No|No|75%|67405050010|TERBINAFINE HCL 250 MG TABLET|100|EA|.0731|10/15/2014||Yes|No||10/15/2014||Yes|No|10/15/2014||Yes|No||||No|No|||Prescription required|No||069|No|.15711|03/29/2022|.15333|03/29/2022|.15436|03/29/2022|||ANTIFUNGALS: ORAL|18280|||||No|No||HARRIS PHARM|No||||
doxycycline hyclate|Yes|No|No|No|75%|67405055005|DOXYCYCLINE HYCLATE 100 MG TAB|500|EA|.52922|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|11/17/2014||Prescription required|Yes|01/22/2015|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|18281|||||No|No||HARRIS PHARM|No||||
doxycycline hyclate|Yes|No|No|No|75%|67405055055|DOXYCYCLINE HYCLATE 100 MG TAB|50|EA|.52924|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|11/17/2014||Prescription required|Yes|01/22/2015|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|18282|||||No|No||HARRIS PHARM|No||||
fluconazole|No|No|No|No|75%|67405060103|FLUCONAZOLE 50 MG TABLET|30|EA|.28666|08/07/2015|07/31/2023|Yes|No||08/07/2015|07/31/2023|Yes|No|08/07/2015|07/31/2023|Yes|No||||No|No|||Prescription required|No||069|No|.43933|03/29/2022|.42878|03/29/2022|.43164|03/29/2022|||ANTIFUNGALS: ORAL|18283|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||HARRIS PHARM|No||||
fluconazole|No|No|No|No|75%|67405060203|FLUCONAZOLE 100 MG TABLET|30|EA|.43|08/07/2015|07/31/2023|Yes|No||08/07/2015|07/31/2023|Yes|No|08/07/2015|07/31/2023|Yes|No||||No|No|||Prescription required|No||069|No|.34281|03/29/2022|.33458|03/29/2022|.33681|03/29/2022|||ANTIFUNGALS: ORAL|18284|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||HARRIS PHARM|No||||
fluconazole|Yes|No|No|No|75%|67405060301|FLUCONAZOLE 150 MG TABLET|12|EA|.8539|05/17/2017|05/31/2022|Yes|No||05/17/2017|05/31/2022|Yes|No|05/17/2017|05/31/2022|Yes|No||||No|No|05/17/2017|05/31/2022|Prescription required|No||069|No|.74933|03/29/2022|.73134|03/29/2022|.73621|03/29/2022|||ANTIFUNGALS: ORAL|18285|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||HARRIS PHARM|No||||
fluconazole|No|No|No|No|75%|67405060403|FLUCONAZOLE 200 MG TABLET|30|EA|.57333|08/07/2015|07/31/2023|Yes|No||08/07/2015|07/31/2023|Yes|No|08/07/2015|07/31/2023|Yes|No||||No|No|||Prescription required|No||069|No|.52936|03/29/2022|.51665|03/29/2022|.52009|03/29/2022|||ANTIFUNGALS: ORAL|18286|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||HARRIS PHARM|No||||
doxycycline hyclate|No|No|No|No|75%|67405065055|DOXYCYCLINE HYCLATE 50 MG CAP|50|EA|.34881|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|||Prescription required|No||213|No|.2526|03/29/2022|.24653|03/29/2022|.24817|03/29/2022|||TETRACYCLINES|18287|||||No|No||HARRIS PHARM|No||||
doxycycline hyclate|Yes|No|No|No|75%|67405065105|DOXYCYCLINE HYCLATE 100 MG CAP|500|EA|.37047|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|11/17/2014||Prescription required|No||213|No|.14255|03/29/2022|.13912|03/29/2022|.14005|03/29/2022|||TETRACYCLINES|18288|||||No|No||HARRIS PHARM|No||||
doxycycline hyclate|Yes|No|No|No|75%|67405065155|DOXYCYCLINE HYCLATE 100 MG CAP|50|EA|.37048|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|11/17/2014||Prescription required|No||213|No|.14255|03/29/2022|.13912|03/29/2022|.14005|03/29/2022|||TETRACYCLINES|18289|||||No|No||HARRIS PHARM|No||||
tetracycline HCl|No|No|No|No|75%|67405066010|TETRACYCLINE 250 MG CAPSULE|100|EA|2.709|07/07/2016||Yes|No||07/07/2016||Yes|No|07/07/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|213|No|.9651|03/01/2022|.94193|03/01/2022|.94821|03/01/2022|||TETRACYCLINES|18290|||||No|No||HARRIS PHARM|No||||
tetracycline HCl|No|No|No|No|75%|67405066110|TETRACYCLINE 500 MG CAPSULE|100|EA|5.418|07/07/2016||Yes|No||07/07/2016||Yes|No|07/07/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|213|No|1.54692|03/29/2022|1.50979|03/29/2022|1.51984|03/29/2022|||TETRACYCLINES|18291|||||No|No||HARRIS PHARM|No||||
benzoyl peroxide|No|No|No|No|75%|67405082505|BENZOYL PEROXIDE 5% WASH|148|GM|.02173|05/16/2017||Yes|No||||No|No|05/16/2017||Yes|No||||No|No|||Over the counter|No||104|No|.04831|03/29/2022|.04715|03/29/2022|.04746|03/29/2022|||ACNE AGENTS: TOPICAL|18292|||||No|No||HARRIS PHARM|No||||
benzoyl peroxide|No|No|No|No|75%|67405082508|BENZOYL PEROXIDE 5% WASH|237|GM|.02039|05/16/2017||Yes|No||||No|No|05/16/2017||Yes|No||||No|No|||Over the counter|No||104|No|.0445|03/29/2022|.04343|03/29/2022|.04372|03/29/2022|||ACNE AGENTS: TOPICAL|18293|||||No|No||HARRIS PHARM|No||||
benzoyl peroxide|No|No|No|No|75%|67405083005|BENZOYL PEROXIDE 10% WASH|148|GM|.02251|05/16/2017||Yes|No||||No|No|05/16/2017||Yes|No||||No|No|||Over the counter|No||104|No|.05196|03/29/2022|.05071|03/29/2022|.05105|03/29/2022|||ACNE AGENTS: TOPICAL|18294|||||No|No||HARRIS PHARM|No||||
benzoyl peroxide|No|No|No|No|75%|67405083008|BENZOYL PEROXIDE 10% WASH|237|GM|.0214|05/16/2017||Yes|No||||No|No|05/16/2017||Yes|No||||No|No|||Over the counter|No||104|No|.04904|03/29/2022|.04786|03/29/2022|.04818|03/29/2022|||ACNE AGENTS: TOPICAL|18295|||||No|No||HARRIS PHARM|No||||
diphenhydramine HCl|No|No|No|No|75%|67457012410|DIPHENHYDRAMINE 50 MG/ML VIAL|10|ML|.4945|11/30/2015||Yes|No||11/30/2015||Yes|No|11/30/2015||Yes|No||||No|No|||Prescription required|No|||Yes|1.127|09/08/2020|1.1109|09/08/2020|1.058|09/08/2020||||18296|||||No|No||MYLAN INSTITUTI|No||||
cidofovir|No|No|No|No|75%|67457021005|CIDOFOVIR 375 MG/5 ML VIAL|5|ML|85.02992|11/07/2014||Yes|No||11/07/2014||Yes|No|11/07/2014||Yes|No||||No|No|||Prescription required|No|||No|193.78912|06/01/2016|191.0207|06/01/2016|181.92448|06/01/2016||||18297|||||No|No||MYLAN INSTITUTI|No||||
octreotide acetate|No|No|No|No|75%|67457023901|OCTREOTIDE ACET 50 MCG/ML SYR|1|ML|1.67958|06/02/2016||Yes|No||06/02/2016||Yes|No|06/02/2016||Yes|No||||No|No|||Prescription required|No|||No|3.82788|06/02/2016|3.77319|06/02/2016|3.59352|06/02/2016||||18298|||||No|No||MYLAN INSTITUTI|No||||
octreotide acetate|No|No|No|No|75%|67457024501|OCTREOTIDE ACET 100 MCG/ML SYR|1|ML|2.88358|06/02/2016||Yes|No||06/02/2016||Yes|No|06/02/2016||Yes|No||||No|No|||Prescription required|No|||No|6.57188|06/02/2016|6.47799|06/02/2016|6.16952|06/02/2016||||18299|||||No|No||MYLAN INSTITUTI|No||||
octreotide acetate|No|No|No|No|75%|67457024601|OCTREOTIDE ACET 500 MCG/ML SYR|1|ML|14.41747|06/02/2016||Yes|No||06/02/2016||Yes|No|06/02/2016||Yes|No||||No|No|||Prescription required|No|||No|32.85842|06/02/2016|32.38901|06/02/2016|30.84668|06/02/2016||||18300|||||No|No||MYLAN INSTITUTI|No||||
azacitidine|No|No|No|No|75%|67457025430|AZACITIDINE 100 MG VIAL|1|EA|133.8504|02/10/2017||Yes|No||02/10/2017||Yes|No|02/10/2017||Yes|No||||No|No|||Prescription required|No|||No|305.0544|02/10/2017|300.69648|02/14/2017|286.3776|02/10/2017||||18301|||||No|No||MYLAN INSTITUTI|No||||
levetiracetam in NaCl (iso-os)|No|No|No|No|75%|67457025510|LEVETIRACETAM-NACL 500 MG/100|100|ML|.0602|02/27/2015||Yes|No||02/27/2015||Yes|No|02/27/2015||Yes|No||||No|No|||Prescription required|No|||No|.1372|01/19/2021|.13524|01/19/2021|.1288|01/19/2021||||18302|||||No|No||MYLAN INSTITUTI|No||||
levetiracetam in NaCl (iso-os)|No|No|No|No|75%|67457026510|LEVETIRACETAM-NACL 1,000MG/100|100|ML|.09245|02/27/2015||Yes|No||02/27/2015||Yes|No|02/27/2015||Yes|No||||No|No|||Prescription required|No|||No|.2107|01/19/2021|.20769|01/19/2021|.1978|01/19/2021||||18303|||||No|No||MYLAN INSTITUTI|No||||
levetiracetam in NaCl (iso-os)|No|No|No|No|75%|67457026610|LEVETIRACETAM-NACL 1,500MG/100|100|ML|.12255|02/27/2015||Yes|No||02/27/2015||Yes|No|02/27/2015||Yes|No||||No|No|||Prescription required|No|||No|.2793|01/19/2021|.27531|01/19/2021|.2622|01/19/2021||||18304|||||No|No||MYLAN INSTITUTI|No||||
naloxone HCl|No|No|No|No|75%|67457029200|NALOXONE 0.4 MG/ML VIAL|1|ML|6.7037|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|||||||15.2782|10/01/2020|OPIATE DEPENDENCE TREATMENTS|18305|||||No|No||MYLAN INSTITUTI|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|67457029202|NALOXONE 0.4 MG/ML VIAL|1|ML|4.3|08/11/2014||Yes|No||08/11/2014||Yes|No|08/11/2014||Yes|No||||No|No|||Prescription required|No||145|No|9.8|03/29/2022|9.66|03/29/2022|9.2|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|18306|||||No|Yes|12.56|MYLAN INSTITUTI|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|67457029900|NALOXONE 4 MG/10 ML VIAL|10|ML|6.7037|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|||||||||OPIATE DEPENDENCE TREATMENTS|18307|||||No|No||MYLAN INSTITUTI|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|67457029910|NALOXONE 4 MG/10 ML VIAL|10|ML|3.999|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|9.114|10/01/2020|8.9838|10/01/2020|8.556|10/01/2020|||OPIATE DEPENDENCE TREATMENTS|18308|||||No|No||MYLAN INSTITUTI|Yes|09/01/2020|||
vancomycin HCl|No|No|No|No|75%|67457033950|VANCOMYCIN 500 MG VIAL|1|EA|3.4572|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No|||No|7.8792|08/29/2017|7.76664|08/29/2017|7.3968|08/29/2017||||18309|||||No|No||MYLAN INSTITUTI|No||||
vancomycin HCl|No|No|No|No|75%|67457034001|VANCOMYCIN 1 GM VIAL|1|EA|6.8972|08/11/2014||Yes|No||08/11/2014||Yes|No|08/11/2014||Yes|No||||No|No|||Prescription required|No|||No|15.7192|02/23/2021|15.49464|02/23/2021|14.7568|02/23/2021||||18310|||||No|No||MYLAN INSTITUTI|No||||
vancomycin HCl|No|No|No|No|75%|67457034105|VANCOMYCIN HCL 5 GM VIAL|1|EA|38.2399|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No|||No|87.1514|12/12/2017|85.90638|12/12/2017|81.8156|12/12/2017||||18311|||||No|No||MYLAN INSTITUTI|No||||
fluphenazine decanoate|No|No|No|No|75%|67457035959|FLUPHENAZINE DEC 125 MG/5 ML|5|ML|10.406|04/23/2021||Yes|No||04/23/2021||Yes|No|04/23/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|027|No|15.04031|03/29/2022|14.67934|03/29/2022|14.7771|03/29/2022|||ANTIPSYCHOTICS|18312|||||No|No||MYLAN INSTITUTI|No||||
heparin sodium,porcine|No|No|No|No|75%|67457037299|HEPARIN SOD 1,000 UNIT/ML VIAL|1|ML|1.1868|01/09/2019||Yes|No||01/09/2019||Yes|No|01/09/2019||Yes|No||||No|No|||Prescription required|No|||No|2.7048|03/17/2020|2.66616|03/17/2020|2.5392|03/17/2020||||18313|||||No|No||MYLAN INSTITUTI|No||||
heparin sodium,porcine|No|No|No|No|75%|67457037399|HEPARIN SOD 20,000 UNIT/ML VL|1|ML|4.945|01/09/2019||Yes|No||01/09/2019||Yes|No|01/09/2019||Yes|No||||No|No|||Prescription required|No|||No|11.27|03/17/2020|11.109|03/17/2020|10.58|03/17/2020||||18314|||||No|No||MYLAN INSTITUTI|No||||
heparin sodium,porcine|No|No|No|No|75%|67457037499|HEPARIN SOD 5,000 UNIT/ML VIAL|1|ML|1.2857|01/09/2019||Yes|No||01/09/2019||Yes|No|01/09/2019||Yes|No||||No|No|||Prescription required|No|||No|1.38512|12/28/2021|1.35187|12/28/2021|1.36088|12/28/2021||||18315|||||No|No||MYLAN INSTITUTI|No||||
haloperidol decanoate|No|No|No|No|75%|67457038158|HALOPERIDOL DEC 100 MG/ML VIAL|5|ML|17.2|01/04/2017||Yes|No||01/04/2017||Yes|No|01/04/2017||Yes|No||||No|No|||Prescription required|No||027|No|39.2|03/05/2019|38.64|03/05/2019|36.8|03/05/2019|||ANTIPSYCHOTICS|18316|||||No|No||MYLAN INSTITUTI|No||||
heparin sodium,porcine|No|No|No|No|75%|67457038399|HEPARIN 50,000 UNIT/10 ML VIAL|10|ML|.41538|01/09/2019||Yes|No||01/09/2019||Yes|No|01/09/2019||Yes|No||||No|No|||Prescription required|No|||No|.94668|03/17/2020|.93315|03/17/2020|.88872|03/17/2020||||18317|||||No|No||MYLAN INSTITUTI|No||||
heparin sodium,porcine|No|No|No|No|75%|67457038499|HEPARIN 30,000 UNIT/30 ML VIAL|30|ML|.11208|01/09/2019||Yes|No||01/09/2019||Yes|No|01/09/2019||Yes|No||||No|No|||Prescription required|No|||No|.25544|03/17/2020|.25179|03/17/2020|.2398|03/17/2020||||18318|||||No|No||MYLAN INSTITUTI|No||||
heparin sodium,porcine|No|No|No|No|75%|67457038599|HEPARIN 10,000 UNIT/10 ML VIAL|10|ML|.17802|01/09/2019||Yes|No||01/09/2019||Yes|No|01/09/2019||Yes|No||||No|No|||Prescription required|No|||No|.40572|03/17/2020|.39992|03/17/2020|.38088|03/17/2020||||18319|||||No|No||MYLAN INSTITUTI|No||||
zoledronic acid|No|No|No|No|75%|67457039054|ZOLEDRONIC ACID 4 MG/5 ML VIAL|5|ML|3.784|11/30/2015||Yes|No||11/30/2015||Yes|No|11/30/2015||Yes|No||||No|No|||Prescription required|No|||No|8.624|03/17/2020|8.5008|03/17/2020|8.096|03/17/2020||||18320|||||No|No||MYLAN INSTITUTI|No||||
haloperidol decanoate|No|No|No|No|75%|67457040913|HALOPERIDOL DEC 100 MG/ML VIAL|1|ML|18.92|01/04/2017||Yes|No||01/04/2017||Yes|No|01/04/2017||Yes|No||||No|No|||Prescription required|No||027|No|29.246|03/29/2022|28.54409|03/29/2022|28.73419|03/29/2022|||ANTIPSYCHOTICS|18321|||||No|No||MYLAN INSTITUTI|No||||
haloperidol decanoate|No|No|No|No|75%|67457041013|HALOPERIDOL DEC 50 MG/ML VIAL|1|ML|9.46|01/04/2017||Yes|No||01/04/2017||Yes|No|01/04/2017||Yes|No||||No|No|||Prescription required|No||027|No|17.60088|09/28/2021|17.17845|09/28/2021|17.29286|09/28/2021|||ANTIPSYCHOTICS|18322|||||No|No||MYLAN INSTITUTI|No||||
dexamethasone sodium phosphate|No|No|No|No|75%|67457042312|DEXAMETHASONE 4 MG/ML VIAL|1|ML|.33385|10/11/2016||Yes|No||10/11/2016||Yes|No|10/11/2016||Yes|No||||No|No|||Prescription required|No|||No|.76087|09/28/2021|.75|09/28/2021|.71428|09/28/2021||||18323|||||No|No||MYLAN INSTITUTI|No||||
haloperidol lactate|No|No|No|No|75%|67457042612|HALOPERIDOL LAC 5 MG/ML VIAL|1|ML|.3784|06/02/2016||Yes|No||06/02/2016||Yes|No|06/02/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|027|Yes|.8624|08/24/2021|.85008|08/24/2021|.8096|08/24/2021|||ANTIPSYCHOTICS|18324|||||No|No||MYLAN INSTITUTI|No||||
tobramycin sulfate|No|No|No|No|75%|67457042830|TOBRAMYCIN 1.2 GRAM/30 ML VIAL|30|ML|.31218|11/30/2015||Yes|No||11/30/2015||Yes|No|11/30/2015||Yes|No||||No|No|||Prescription required|No|||No|.71148|06/01/2016|.70131|06/01/2016|.66792|06/01/2016||||18325|||||No|No||MYLAN INSTITUTI|No||||
ondansetron HCl/PF|No|No|No|No|75%|67457044022|ONDANSETRON HCL 4 MG/2 ML VIAL|2|ML|.129|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No|||No|.18088|01/25/2022|.17653|01/25/2022|.17771|01/25/2022||||18326|||||No|No||MYLAN INSTITUTI|No||||
ondansetron HCl|No|No|No|No|75%|67457044120|ONDANSETRON 40 MG/20 ML VIAL|20|ML|.0645|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No|||No|.147|09/28/2021|.1449|09/28/2021|.138|09/28/2021||||18327|||||No|No||MYLAN INSTITUTI|No||||
oxaliplatin|No|No|No|No|75%|67457044220|OXALIPLATIN 100 MG/20 ML VIAL|20|ML|2.15|06/25/2015||Yes|No||06/25/2015||Yes|No|06/25/2015||Yes|No||||No|No|||Prescription required|No|||No|4.9|01/14/2020|4.83|01/14/2020|4.6|01/14/2020||||18328|||||No|No||MYLAN INSTITUTI|No||||
rifampin|No|No|No|No|75%|67457044560|RIFAMPIN IV 600 MG VIAL|1|EA|66.263|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No||||No|No|||Prescription required|No|||No|151.018|06/01/2016|148.8606|06/01/2016|141.772|06/01/2016||||18329|||||No|No||MYLAN INSTITUTI|No||||
cytarabine/PF|No|No|No|No|75%|67457045220|CYTARABINE 2 G/20 ML VIAL|20|ML|.43|11/06/2014|12/31/2022|Yes|No||11/06/2014|12/31/2022|Yes|No|11/06/2014|12/31/2022|Yes|No||||No|No|||Prescription required|No|||No|.98|06/01/2016|.966|06/01/2016|.92|06/01/2016||||18330|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MYLAN INSTITUTI|No||||
oxaliplatin|No|No|No|No|75%|67457046910|OXALIPLATIN 50 MG/10 ML VIAL|10|ML|2.15|06/25/2015||Yes|No||06/25/2015||Yes|No|06/25/2015||Yes|No||||No|No|||Prescription required|No|||No|4.9|01/14/2020|4.83|01/14/2020|4.6|01/14/2020||||18331|||||No|No||MYLAN INSTITUTI|No||||
fondaparinux sodium|No|No|No|No|75%|67457058210|FONDAPARINUX 2.5 MG/0.5 ML SYR|.5|ML|21.37788|05/21/2015||Yes|No||05/21/2015||Yes|No|05/21/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|068|Yes|48.72168|03/23/2021|48.02565|03/23/2021|45.73872|03/23/2021|||ANTICOAGULANTS|18332|||||No|No||MYLAN INSTITUTI|No||||
fondaparinux sodium|No|No|No|No|75%|67457058304|FONDAPARINUX 5 MG/0.4 ML SYR|.4|ML|62.88535|05/21/2015||Yes|No||05/21/2015||Yes|No|05/21/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|068|Yes|143.3201|06/01/2016|141.27267|06/01/2016|134.5454|06/01/2016|||ANTICOAGULANTS|18333|||||No|No||MYLAN INSTITUTI|No||||
fondaparinux sodium|No|No|No|No|75%|67457058406|FONDAPARINUX 7.5 MG/0.6 ML SYR|.6|ML|41.92356|05/21/2015||Yes|No||05/21/2015||Yes|No|05/21/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|068|Yes|57.45472|12/28/2021|56.0758|12/28/2021|56.44926|12/28/2021|||ANTICOAGULANTS|18334|||||No|No||MYLAN INSTITUTI|No||||
fondaparinux sodium|No|No|No|No|75%|67457058508|FONDAPARINUX 10 MG/0.8 ML SYR|.8|ML|31.44267|05/21/2015||Yes|No||05/21/2015||Yes|No|05/21/2015||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|068|Yes|71.66005|06/01/2016|70.63633|06/01/2016|67.2727|06/01/2016|||ANTICOAGULANTS|18335|||||No|No||MYLAN INSTITUTI|No||||
fondaparinux sodium|No|No|No|No|75%|67457059406|ARIXTRA 7.5 MG/0.6 ML SYRINGE|.6|ML|93.79303|03/30/2016||Yes|No||03/30/2016||Yes|No|03/30/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|068|Yes|213.76086|06/01/2016|210.70713|06/01/2016|200.67346|06/01/2016|||ANTICOAGULANTS|18336|||||No|No||MYLAN INSTITUTI|No||||
naloxone HCl|No|No|No|No|75%|67457059900|NALOXONE 0.4 MG/ML VIAL|1|ML|6.8069|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|||||||15.5134|10/01/2020|OPIATE DEPENDENCE TREATMENTS|18337|||||No|No||MYLAN INSTITUTI|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|67457059902|NALOXONE 0.4 MG/ML VIAL|1|ML|4.3|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|9.8|03/29/2022|9.66|03/29/2022|9.2|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|18338|||||No|No||MYLAN INSTITUTI|Yes|09/01/2020|||
heparin sodium,porcine|No|No|No|No|75%|67457060299|HEPARIN SOD 10,000 UNIT/ML VL|1|ML|1.978|01/09/2019||Yes|No||01/09/2019||Yes|No|01/09/2019||Yes|No||||No|No|||Prescription required|No|||No|4.508|01/25/2022|4.4436|01/25/2022|4.232|01/25/2022||||18339|||||No|No||MYLAN INSTITUTI|No||||
heparin sodium,porcine|No|No|No|No|75%|67457060399|HEPARIN 40,000 UNIT/4 ML VIAL|4|ML|.93955|01/09/2019||Yes|No||01/09/2019||Yes|No|01/09/2019||Yes|No||||No|No|||Prescription required|No|||No|2.1413|03/17/2020|2.11071|03/17/2020|2.0102|03/17/2020||||18340|||||No|No||MYLAN INSTITUTI|No||||
naloxone HCl|No|No|No|No|75%|67457064500|NALOXONE 0.4 MG/ML VIAL|1|ML|6.7037|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|||||||15.2782|10/01/2020|OPIATE DEPENDENCE TREATMENTS|18341|||||No|No||MYLAN INST-NOVA|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|67457064502|NALOXONE 0.4 MG/ML VIAL|1|ML|4.3|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|9.8|03/29/2022|9.66|03/29/2022|9.2|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|18342|||||No|No||MYLAN INST-NOVA|Yes|09/01/2020|||
daptomycin|No|No|No|No|75%|67457081350|DAPTOMYCIN 500 MG VIAL|1|EA|53.7543|02/15/2019||Yes|No||02/15/2019||Yes|No|02/15/2019||Yes|No||||No|No|||Prescription required|No|||No|122.5098|01/19/2021|120.75966|01/19/2021|115.0092|01/19/2021||||18343|||||No|No||MYLAN INSTITUTI|No||||
pegfilgrastim-jmdb|No|No|No|No|75%|67457083306|FULPHILA 6 MG/0.6 ML SYRINGE|.6|ML|2992.08333|03/14/2019||Yes|No||03/14/2019||Yes|No|03/14/2019||Yes|No||||No|No|||Prescription required|No||148|No|6819.16666|03/14/2019|6721.74999|03/14/2019|6401.66666|03/14/2019|||COLONY STIMULATING FACTORS|18344|||||No|No||MYLAN INSTITUTI|No||||
medroxyprogesterone acetate|Yes|Yes|No|No|75%|67457088701|MEDROXYPROGESTERONE 150 MG/ML|1|ML|14.78976|03/05/2019||Yes|No||||No|No|03/05/2019||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|30.77229|09/28/2021|30.03375|09/28/2021|30.23377|09/28/2021||||18345|||||No|No||MYLAN INSTITUTI|No||||
medroxyprogesterone acetate|Yes|Yes|No|No|75%|67457088799|MEDROXYPROGESTERONE 150 MG/ML|1|ML|14.7877|03/05/2019||Yes|No||||No|No|03/05/2019||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|31.14606|03/29/2022|30.39855|03/29/2022|30.601|03/29/2022||||18346|||||No|No||MYLAN INSTITUTI|No||||
hydroxyprogesterone caproat/PF|No|No|No|No|75%|67457096701|HYDROXYPROGEST 250 MG/ML VIAL|1|ML|122.55|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|151|Yes|279.3|01/19/2021|275.31|01/19/2021|262.2|01/19/2021|||PROGESTATIONAL AGENTS|18347|||||No|No||MYLAN INSTITUTI|No||||
naloxone HCl|No|No|No|No|75%|67457098700|NALOXONE 4 MG/10 ML VIAL|10|ML|6.8069|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|||||||||OPIATE DEPENDENCE TREATMENTS|18348|||||No|No||MYLAN INST-NOVA|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|67457098710|NALOXONE 4 MG/10 ML VIAL|10|ML|3.999|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|9.114|06/01/2021|8.9838|06/01/2021|8.556|06/01/2021|||OPIATE DEPENDENCE TREATMENTS|18349|||||No|No||MYLAN INST-NOVA|Yes|09/01/2020|||
triamcinolone acetonide|No|No|No|No|75%|67857080619|TRIANEX 0.05% OINTMENT|430|GM|.903|02/23/2015|08/31/2022|Yes|No||02/23/2015|08/31/2022|Yes|No|02/23/2015|08/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|120|No|2.058|01/02/2018|2.0286|01/02/2018|1.932|01/02/2018|||STEROIDS: TOPICAL HIGH|18350|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||PROMIUS/ENCORE|No||||
sumatriptan|No|No|No|No|75%|67857081261|TOSYMRA 10 MG NASAL SPRAY|6|EA|41.925|03/15/2021|06/30/2022|Yes|No||03/15/2021|06/30/2022|Yes|No|03/15/2021|06/30/2022|Yes|No||||No|No|||Prescription required|Yes|07/30/2020|021|No|95.55|03/15/2021|94.185|03/15/2021|89.7|03/15/2021|||ANTIMIGRAINE AGENTS: TRIPTANS|18351|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||PROMIUS/UPSHER-|No||||
methadone HCl|No|No|No|No|90%|67877011601|METHADONE HCL 10 MG TABLET|100|EA|.04407|01/24/2012||Yes|No||01/24/2012||Yes|No|01/24/2012||Yes|No||||No|No|||Prescription required|Yes|07/28/2017|110|Yes|.08598|03/29/2022|.08391|03/29/2022|.08447|03/29/2022|||ANALGESICS: NARCOTICS LONG|18352|||||No|No||ASCEND LABORATO|Yes|09/01/2020|||
silver sulfadiazine|No|No|No|No|75%|67877012405|SILVER SULFADIAZINE 1% CREAM|50|GM|.10535|08/01/2009||Yes|No||08/01/2009||Yes|No|08/01/2009||Yes|No||||No|No|||Prescription required|No|||No|.13137|03/29/2022|.12821|03/29/2022|.12907|03/29/2022||||18353|||||No|No||ASCEND LABORATO|No||||
silver sulfadiazine|No|No|No|No|75%|67877012420|SILVER SULFADIAZINE 1% CREAM|20|GM|.12577|07/12/2010||Yes|No||07/12/2010||Yes|No|07/12/2010||Yes|No||||No|No|||Prescription required|No|||No|.25072|03/29/2022|.2447|03/29/2022|.24633|03/29/2022||||18354|||||No|No||ASCEND LABORATO|No||||
silver sulfadiazine|No|No|No|No|75%|67877012425|SILVER SULFADIAZINE 1% CREAM|25|GM|.12814|10/17/2013||Yes|No||10/17/2013||Yes|No|10/17/2013||Yes|No||||No|No|||Prescription required|No|||No|.16293|03/29/2022|.15901|03/29/2022|.16007|03/29/2022||||18355|||||No|No||ASCEND LABORATO|No||||
silver sulfadiazine|No|No|No|No|75%|67877012440|SILVER SULFADIAZINE 1% CREAM|400|GM|.0567|08/01/2009||Yes|No||08/01/2009||Yes|No|08/01/2009||Yes|No||||No|No|||Prescription required|No|||No|.07377|03/29/2022|.07199|03/29/2022|.07247|03/29/2022||||18356|||||No|No||ASCEND LABORATO|No||||
silver sulfadiazine|No|No|No|No|75%|67877012450|SILVER SULFADIAZINE 1% CREAM|50|GM|.10535|07/12/2010||Yes|No||07/12/2010||Yes|No|07/12/2010||Yes|No||||No|No|||Prescription required|No|||No|.13137|03/29/2022|.12821|03/29/2022|.12907|03/29/2022||||18357|||||No|No||ASCEND LABORATO|No||||
silver sulfadiazine|No|No|No|No|75%|67877012485|SILVER SULFADIAZINE 1% CREAM|85|GM|.11154|08/01/2009||Yes|No||08/01/2009||Yes|No|08/01/2009||Yes|No||||No|No|||Prescription required|No|||No|.13473|03/29/2022|.13149|03/29/2022|.13237|03/29/2022||||18358|||||No|No||ASCEND LABORATO|No||||
temazepam|No|No|No|No|90%|67877014601|TEMAZEPAM 15 MG CAPSULE|100|EA|.03977|02/12/2010||Yes|No||02/12/2010||Yes|No|02/12/2010||Yes|No||||No|No|||Prescription required|No||054|Yes|.07712|03/29/2022|.07526|03/29/2022|.07577|03/29/2022|||SEDATIVE HYPNOTICS|18359|||||No|No||ASCEND LABORATO|No||||
temazepam|No|No|No|No|90%|67877014605|TEMAZEPAM 15 MG CAPSULE|500|EA|.03762|02/12/2010||Yes|No||02/12/2010||Yes|No|02/12/2010||Yes|No||||No|No|||Prescription required|No||054|Yes|.07712|03/29/2022|.07526|03/29/2022|.07577|03/29/2022|||SEDATIVE HYPNOTICS|18360|||||No|No||ASCEND LABORATO|No||||
temazepam|No|No|No|No|90%|67877014701|TEMAZEPAM 30 MG CAPSULE|100|EA|.05052|02/12/2010||Yes|No||02/12/2010||Yes|No|02/12/2010||Yes|No||||No|No|||Prescription required|No||054|Yes|.10046|03/29/2022|.09804|03/29/2022|.0987|03/29/2022|||SEDATIVE HYPNOTICS|18361|||||No|No||ASCEND LABORATO|No||||
temazepam|No|No|No|No|90%|67877014705|TEMAZEPAM 30 MG CAPSULE|500|EA|.04837|02/12/2010||Yes|No||02/12/2010||Yes|No|02/12/2010||Yes|No||||No|No|||Prescription required|No||054|Yes|.10046|03/29/2022|.09804|03/29/2022|.0987|03/29/2022|||SEDATIVE HYPNOTICS|18362|||||No|No||ASCEND LABORATO|No||||
temazepam|No|No|No|No|90%|67877014801|TEMAZEPAM 7.5 MG CAPSULE|100|EA|2.00306|07/03/2012||Yes|No||07/03/2012||Yes|No|07/03/2012||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|054|Yes|1.39989|03/29/2022|1.36629|03/29/2022|1.37539|03/29/2022|||SEDATIVE HYPNOTICS|18363|||||No|No||ASCEND LABORATO|No||||
temazepam|No|No|No|No|90%|67877014930|TEMAZEPAM 22.5 MG CAPSULE|30|EA|2.36772|07/03/2012||Yes|No||07/03/2012||Yes|No|07/03/2012||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|054|Yes|2.70743|03/29/2022|2.64245|03/29/2022|2.66004|03/29/2022|||SEDATIVE HYPNOTICS|18364|||||No|No||ASCEND LABORATO|No||||
metformin HCl|Yes|No|No|No|75%|67877015901|METFORMIN HCL ER 500 MG TABLET|100|EA|.02128|10/17/2013||Yes|No||10/17/2013||Yes|No|10/17/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.03646|03/29/2022|.03558|03/29/2022|.03582|03/29/2022|||HYPOGLYCEMICS: METFORMINS|18365|||||No|No||ASCEND LABORATO|No||||
metformin HCl|Yes|No|No|No|75%|67877015905|METFORMIN HCL ER 500 MG TABLET|500|EA|.01569|10/17/2013||Yes|No||10/17/2013||Yes|No|10/17/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.03646|03/29/2022|.03558|03/29/2022|.03582|03/29/2022|||HYPOGLYCEMICS: METFORMINS|18366|||||No|No||ASCEND LABORATO|No||||
amlodipine besylate|Yes|No|No|No|75%|67877019705|AMLODIPINE BESYLATE 2.5 MG TAB|500|EA|.00524|04/07/2011||Yes|No||04/07/2011||Yes|No|04/07/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|18367|||||No|No||ASCEND LABORATO|No||||
amlodipine besylate|Yes|No|No|No|75%|67877019710|AMLODIPINE BESYLATE 2.5 MG TAB|1000|EA|.00311|04/07/2011||Yes|No||04/07/2011||Yes|No|04/07/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|18368|||||No|No||ASCEND LABORATO|No||||
amlodipine besylate|Yes|No|No|No|75%|67877019790|AMLODIPINE BESYLATE 2.5 MG TAB|90|EA|.00835|04/07/2011||Yes|No||04/07/2011||Yes|No|04/07/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|18369|||||No|No||ASCEND LABORATO|No||||
amlodipine besylate|Yes|No|No|No|75%|67877019805|AMLODIPINE BESYLATE 5 MG TAB|500|EA|.00653|04/07/2011||Yes|No||04/07/2011||Yes|No|04/07/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|18370|||||No|No||ASCEND LABORATO|No||||
amlodipine besylate|Yes|No|No|No|75%|67877019810|AMLODIPINE BESYLATE 5 MG TAB|1000|EA|.00634|04/07/2011||Yes|No||04/07/2011||Yes|No|04/07/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|18371|||||No|No||ASCEND LABORATO|No||||
amlodipine besylate|Yes|No|No|No|75%|67877019890|AMLODIPINE BESYLATE 5 MG TAB|90|EA|.00854|04/07/2011||Yes|No||04/07/2011||Yes|No|04/07/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|18372|||||No|No||ASCEND LABORATO|No||||
amlodipine besylate|Yes|No|No|No|75%|67877019905|AMLODIPINE BESYLATE 10 MG TAB|500|EA|.00786|04/25/2011||Yes|No||04/25/2011||Yes|No|04/25/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|18373|||||No|No||ASCEND LABORATO|No||||
amlodipine besylate|Yes|No|No|No|75%|67877019910|AMLODIPINE BESYLATE 10 MG TAB|1000|EA|.00784|04/25/2011||Yes|No||04/25/2011||Yes|No|04/25/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|18374|||||No|No||ASCEND LABORATO|No||||
amlodipine besylate|Yes|No|No|No|75%|67877019990|AMLODIPINE BESYLATE 10 MG TAB|90|EA|.01552|04/25/2011||Yes|No||04/25/2011||Yes|No|04/25/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|18375|||||No|No||ASCEND LABORATO|No||||
cefuroxime axetil|No|No|No|No|75%|67877021520|CEFUROXIME AXETIL 250 MG TAB|20|EA|.18275|04/07/2011||Yes|No||04/07/2011||Yes|No|04/07/2011||Yes|No||04/07/2011||Yes|No|||Prescription required|No||046|No|.36264|03/29/2022|.35393|03/29/2022|.35629|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18376|||||No|No||ASCEND LABORATO|No||||
cefuroxime axetil|No|No|No|No|75%|67877021560|CEFUROXIME AXETIL 250 MG TAB|60|EA|.22575|04/07/2011||Yes|No||04/07/2011||Yes|No|04/07/2011||Yes|No||04/07/2011||Yes|No|||Prescription required|No||046|No|.36264|03/29/2022|.35393|03/29/2022|.35629|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18377|||||No|No||ASCEND LABORATO|No||||
cefuroxime axetil|No|No|No|No|75%|67877021620|CEFUROXIME AXETIL 500 MG TAB|20|EA|.71487|04/07/2011||Yes|No||04/07/2011||Yes|No|04/07/2011||Yes|No||04/07/2011||Yes|No|||Prescription required|No||046|No|.56985|03/29/2022|.55617|03/29/2022|.55987|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18378|||||No|No||ASCEND LABORATO|No||||
cefuroxime axetil|No|No|No|No|75%|67877021660|CEFUROXIME AXETIL 500 MG TAB|60|EA|.58945|04/07/2011||Yes|No||04/07/2011||Yes|No|04/07/2011||Yes|No||04/07/2011||Yes|No|||Prescription required|No||046|No|.56985|03/29/2022|.55617|03/29/2022|.55987|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18379|||||No|No||ASCEND LABORATO|No||||
cephalexin|No|No|No|No|75%|67877021901|CEPHALEXIN 500 MG CAPSULE|100|EA|.12147|07/05/2011||Yes|No||07/05/2011||Yes|No|07/05/2011||Yes|No||||No|No|||Prescription required|No||046|No|.12151|03/29/2022|.11859|03/29/2022|.11938|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18380|||||No|No||ASCEND LABORATO|No||||
cephalexin|No|No|No|No|75%|67877021905|CEPHALEXIN 500 MG CAPSULE|500|EA|.12169|02/22/2012||Yes|No||02/22/2012||Yes|No|02/22/2012||Yes|No||||No|No|||Prescription required|No||046|No|.12151|03/29/2022|.11859|03/29/2022|.11938|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18381|||||No|No||ASCEND LABORATO|No||||
cephalexin|No|No|No|No|75%|67877022001|CEPHALEXIN 250 MG CAPSULE|100|EA|.07288|02/22/2012||Yes|No||02/22/2012||Yes|No|02/22/2012||Yes|No||||No|No|||Prescription required|No||046|No|.09013|03/29/2022|.08796|03/29/2022|.08855|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18382|||||No|No||ASCEND LABORATO|No||||
cephalexin|No|No|No|No|75%|67877022005|CEPHALEXIN 250 MG CAPSULE|500|EA|.07439|02/22/2012||Yes|No||02/22/2012||Yes|No|02/22/2012||Yes|No||||No|No|||Prescription required|No||046|No|.09013|03/29/2022|.08796|03/29/2022|.08855|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18383|||||No|No||ASCEND LABORATO|No||||
gabapentin|No|No|No|No|75%|67877022201|GABAPENTIN 100 MG CAPSULE|100|EA|.01698|05/09/2011||Yes|No||05/09/2011||Yes|No|05/09/2011||Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|18384|||||No|No||ASCEND LABORATO|No||||
gabapentin|No|No|No|No|75%|67877022205|GABAPENTIN 100 MG CAPSULE|500|EA|.01483|05/09/2011||Yes|No||05/09/2011||Yes|No|05/09/2011||Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|18385|||||No|No||ASCEND LABORATO|No||||
gabapentin|No|No|No|No|75%|67877022210|GABAPENTIN 100 MG CAPSULE|1000|EA|.01294|12/07/2016||Yes|No||12/07/2016||Yes|No|12/07/2016||Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|18386|||||No|No||ASCEND LABORATO|No||||
gabapentin|No|No|No|No|75%|67877022301|GABAPENTIN 300 MG CAPSULE|100|EA|.02838|05/09/2011||Yes|No||05/09/2011||Yes|No|05/09/2011||Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|18387|||||No|No||ASCEND LABORATO|No||||
gabapentin|No|No|No|No|75%|67877022305|GABAPENTIN 300 MG CAPSULE|500|EA|.0233|05/09/2011||Yes|No||05/09/2011||Yes|No|05/09/2011||Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|18388|||||No|No||ASCEND LABORATO|No||||
gabapentin|No|No|No|No|75%|67877022310|GABAPENTIN 300 MG CAPSULE|1000|EA|.02031|12/07/2016||Yes|No||12/07/2016||Yes|No|12/07/2016||Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|18389|||||No|No||ASCEND LABORATO|No||||
gabapentin|No|No|No|No|75%|67877022401|GABAPENTIN 400 MG CAPSULE|100|EA|.03053|12/05/2011||Yes|No||12/05/2011||Yes|No|12/05/2011||Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|18390|||||No|No||ASCEND LABORATO|No||||
gabapentin|No|No|No|No|75%|67877022405|GABAPENTIN 400 MG CAPSULE|500|EA|.02687|12/05/2011||Yes|No||12/05/2011||Yes|No|12/05/2011||Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|18391|||||No|No||ASCEND LABORATO|No||||
gabapentin|No|No|No|No|75%|67877022410|GABAPENTIN 400 MG CAPSULE|1000|EA|.02235|12/07/2016||Yes|No||12/07/2016||Yes|No|12/07/2016||Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|18392|||||No|No||ASCEND LABORATO|No||||
mycophenolate mofetil|No|No|No|No|75%|67877022501|MYCOPHENOLATE 500 MG TABLET|100|EA|.21048|10/17/2013||Yes|No||10/17/2013||Yes|No|10/17/2013||Yes|No||||No|No|||Prescription required|No||229|No|.30426|03/29/2022|.29695|03/29/2022|.29893|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|18393|||||No|No||ASCEND LABORATO|No||||
mycophenolate mofetil|No|No|No|No|75%|67877022505|MYCOPHENOLATE 500 MG TABLET|500|EA|.21048|10/17/2013||Yes|No||10/17/2013||Yes|No|10/17/2013||Yes|No||||No|No|||Prescription required|No||229|No|.30426|03/29/2022|.29695|03/29/2022|.29893|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|18394|||||No|No||ASCEND LABORATO|No||||
mycophenolate mofetil|No|No|No|No|75%|67877023022|MYCOPHENOLATE 200 MG/ML SUSP|160|ML|3.11763|01/08/2015||Yes|No||01/08/2015||Yes|No|01/08/2015||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|229|No|4.66856|01/25/2022|4.55651|01/25/2022|4.58686|01/25/2022|||IMMUNOSUPPRESSIVES: ORAL|18395|||||No|No||ASCEND LABORATO|No||||
quetiapine fumarate|No|No|No|No|75%|67877024201|QUETIAPINE FUMARATE 25 MG TAB|100|EA|.01505|10/17/2013||Yes|No||10/17/2013||Yes|No|10/17/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|.03239|03/29/2022|.03161|03/29/2022|.03182|03/29/2022|||ANTIPSYCHOTICS|18396|||||No|No||ASCEND LABORATO|No||||
quetiapine fumarate|No|No|No|No|75%|67877024210|QUETIAPINE FUMARATE 25 MG TAB|1000|EA|.01317|10/17/2013||Yes|No||10/17/2013||Yes|No|10/17/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|.03239|03/29/2022|.03161|03/29/2022|.03182|03/29/2022|||ANTIPSYCHOTICS|18397|||||No|No||ASCEND LABORATO|No||||
quetiapine fumarate|No|No|No|No|75%|67877024601|QUETIAPINE FUMARATE 200 MG TAB|100|EA|.05203|10/17/2013||Yes|No||10/17/2013||Yes|No|10/17/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|.10261|03/29/2022|.10014|03/29/2022|.10081|03/29/2022|||ANTIPSYCHOTICS|18398|||||No|No||ASCEND LABORATO|No||||
quetiapine fumarate|No|No|No|No|75%|67877024610|QUETIAPINE FUMARATE 200 MG TAB|1000|EA|.05181|11/06/2015||Yes|No||11/06/2015||Yes|No|11/06/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.10261|03/29/2022|.10014|03/29/2022|.10081|03/29/2022|||ANTIPSYCHOTICS|18399|||||No|No||ASCEND LABORATO|No||||
quetiapine fumarate|No|No|No|No|75%|67877024710|QUETIAPINE FUMARATE 300 MG TAB|1000|EA|.0546|11/06/2015||Yes|No||11/06/2015||Yes|No|11/06/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.13964|03/29/2022|.13628|03/29/2022|.13719|03/29/2022|||ANTIPSYCHOTICS|18400|||||No|No||ASCEND LABORATO|No||||
quetiapine fumarate|No|No|No|No|75%|67877024760|QUETIAPINE FUMARATE 300 MG TAB|60|EA|.07703|10/17/2013||Yes|No||10/17/2013||Yes|No|10/17/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|.13964|03/29/2022|.13628|03/29/2022|.13719|03/29/2022|||ANTIPSYCHOTICS|18401|||||No|No||ASCEND LABORATO|No||||
quetiapine fumarate|No|No|No|No|75%|67877024801|QUETIAPINE FUMARATE 400 MG TAB|100|EA|.07955|10/17/2013||Yes|No||10/17/2013||Yes|No|10/17/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|.17858|03/29/2022|.17429|03/29/2022|.17545|03/29/2022|||ANTIPSYCHOTICS|18402|||||No|No||ASCEND LABORATO|No||||
quetiapine fumarate|No|No|No|No|75%|67877024810|QUETIAPINE FUMARATE 400 MG TAB|1000|EA|.06938|11/06/2015||Yes|No||11/06/2015||Yes|No|11/06/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.17858|03/29/2022|.17429|03/29/2022|.17545|03/29/2022|||ANTIPSYCHOTICS|18403|||||No|No||ASCEND LABORATO|No||||
quetiapine fumarate|No|No|No|No|75%|67877024901|QUETIAPINE FUMARATE 50 MG TAB|100|EA|.02623|10/17/2013||Yes|No||10/17/2013||Yes|No|10/17/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|.04283|03/29/2022|.0418|03/29/2022|.04208|03/29/2022|||ANTIPSYCHOTICS|18404|||||No|No||ASCEND LABORATO|No||||
quetiapine fumarate|No|No|No|No|75%|67877024910|QUETIAPINE FUMARATE 50 MG TAB|1000|EA|.02601|02/19/2016||Yes|No||02/19/2016||Yes|No|02/19/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.04283|03/29/2022|.0418|03/29/2022|.04208|03/29/2022|||ANTIPSYCHOTICS|18405|||||No|No||ASCEND LABORATO|No||||
quetiapine fumarate|No|No|No|No|75%|67877025001|QUETIAPINE FUMARATE 100 MG TAB|100|EA|.03053|10/17/2013||Yes|No||10/17/2013||Yes|No|10/17/2013||Yes|No||||No|No|||Prescription required|No||027|Yes|.05826|03/29/2022|.05686|03/29/2022|.05724|03/29/2022|||ANTIPSYCHOTICS|18406|||||No|No||ASCEND LABORATO|No||||
quetiapine fumarate|No|No|No|No|75%|67877025010|QUETIAPINE FUMARATE 100 MG TAB|1000|EA|.03031|02/19/2016||Yes|No||02/19/2016||Yes|No|02/19/2016||Yes|No||||No|No|||Prescription required|No||027|Yes|.05826|03/29/2022|.05686|03/29/2022|.05724|03/29/2022|||ANTIPSYCHOTICS|18407|||||No|No||ASCEND LABORATO|No||||
triamcinolone acetonide|No|No|No|No|75%|67877025115|TRIAMCINOLONE 0.1% CREAM|15|GM|.12183|07/10/2012||Yes|No||07/10/2012||Yes|No|07/10/2012||Yes|No||||No|No|||Prescription required|No||120|No|.13878|03/29/2022|.13544|03/29/2022|.13635|03/29/2022|||STEROIDS: TOPICAL HIGH|18408|||||No|No||ASCEND LABORATO|No||||
triamcinolone acetonide|No|No|No|No|75%|67877025130|TRIAMCINOLONE 0.1% CREAM|30|GM|.08743|08/07/2012||Yes|No||08/07/2012||Yes|No|08/07/2012||Yes|No||||No|No|||Prescription required|No||120|No|.14475|03/29/2022|.14127|03/29/2022|.14221|03/29/2022|||STEROIDS: TOPICAL HIGH|18409|||||No|No||ASCEND LABORATO|No||||
triamcinolone acetonide|No|No|No|No|75%|67877025145|TRIAMCINOLONE 0.1% CREAM|454|GM|.02116|07/10/2012||Yes|No||07/10/2012||Yes|No|07/10/2012||Yes|No||||No|No|||Prescription required|No||120|No|.03246|03/29/2022|.03168|03/29/2022|.03189|03/29/2022|||STEROIDS: TOPICAL HIGH|18410|||||No|No||ASCEND LABORATO|No||||
triamcinolone acetonide|No|No|No|No|75%|67877025180|TRIAMCINOLONE 0.1% CREAM|80|GM|.0473|07/10/2012||Yes|No||07/10/2012||Yes|No|07/10/2012||Yes|No||||No|No|||Prescription required|No||120|No|.05241|03/29/2022|.05115|03/29/2022|.05149|03/29/2022|||STEROIDS: TOPICAL HIGH|18411|||||No|No||ASCEND LABORATO|No||||
cephalexin|No|No|No|No|75%|67877025520|CEPHALEXIN 750 MG CAPSULE|20|EA|2.6445|10/17/2013||Yes|No||10/17/2013||Yes|No|10/17/2013||Yes|No||||No|No|||Prescription required|No||046|No|5.53852|12/28/2021|5.40559|12/28/2021|5.44159|12/28/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18412|||||No|No||ASCEND LABORATO|No||||
cephalexin|No|No|No|No|75%|67877025523|CEPHALEXIN 750 MG CAPSULE|50|EA|2.6445|12/07/2016||Yes|No||12/07/2016||Yes|No|12/07/2016||Yes|No||||No|No|||Prescription required|No||046|No|5.53852|12/28/2021|5.40559|12/28/2021|5.44159|12/28/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18413|||||No|No||ASCEND LABORATO|No||||
rasagiline mesylate|No|No|No|No|75%|67877025930|RASAGILINE MESYLATE 0.5 MG TAB|30|EA|3.42781|02/01/2018||Yes|No||02/01/2018||Yes|No|02/01/2018||Yes|No||||No|No|||Prescription required|Yes|11/09/2017|015|No|4.5286|03/29/2022|4.41991|03/29/2022|4.44934|03/29/2022|||ANTIPARKINSON'S AGENTS|18414|||||No|No||ASCEND LABORATO|No||||
rasagiline mesylate|No|No|No|No|75%|67877026030|RASAGILINE MESYLATE 1 MG TAB|30|EA|3.42781|02/01/2018||Yes|No||02/01/2018||Yes|No|02/01/2018||Yes|No||||No|No|||Prescription required|Yes|11/09/2017|015|No|1.78642|03/29/2022|1.74354|03/29/2022|1.75515|03/29/2022|||ANTIPARKINSON'S AGENTS|18415|||||No|No||ASCEND LABORATO|No||||
rizatriptan benzoate|No|No|No|No|75%|67877026118|RIZATRIPTAN 5 MG TABLET|18|EA|.35475|02/02/2017||Yes|No||02/02/2017||Yes|No|02/02/2017||Yes|No||||No|No|||Prescription required|No||021|No|.64991|03/29/2022|.63431|03/29/2022|.63853|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|18416|||||No|No||ASCEND LABORATO|No||||
rizatriptan benzoate|No|No|No|No|75%|67877026218|RIZATRIPTAN 10 MG TABLET|18|EA|.35475|02/02/2017||Yes|No||02/02/2017||Yes|No|02/02/2017||Yes|No||||No|No|||Prescription required|No||021|No|.50927|03/29/2022|.49704|03/29/2022|.50035|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|18417|||||No|No||ASCEND LABORATO|No||||
duloxetine HCl|No|No|No|No|75%|67877026360|DULOXETINE HCL DR 20 MG CAP|60|EA|.02902|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|||Prescription required|No||232|No|.13163|03/29/2022|.12847|03/29/2022|.12932|03/29/2022|||NEUROPATHIC PAIN|18418|||||No|No||ASCEND LABORATO|No||||
duloxetine HCl|No|No|No|No|75%|67877026430|DULOXETINE HCL DR 30 MG CAP|30|EA|.07095|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|18419|||||No|No||ASCEND LABORATO|No||||
duloxetine HCl|No|No|No|No|75%|67877026490|DULOXETINE HCL DR 30 MG CAP|90|EA|.05088|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|18420|||||No|No||ASCEND LABORATO|No||||
duloxetine HCl|No|No|No|No|75%|67877026590|DULOXETINE HCL DR 60 MG CAP|90|EA|.05088|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|18421|||||No|No||ASCEND LABORATO|No||||
mycophenolate mofetil|No|No|No|No|75%|67877026601|MYCOPHENOLATE 250 MG CAPSULE|100|EA|.15462|01/08/2015||Yes|No||01/08/2015||Yes|No|01/08/2015||Yes|No||||No|No|||Prescription required|No||229|No|.2129|03/29/2022|.20779|03/29/2022|.20917|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|18422|||||No|No||ASCEND LABORATO|No||||
mycophenolate mofetil|No|No|No|No|75%|67877026605|MYCOPHENOLATE 250 MG CAPSULE|500|EA|.15462|01/08/2015||Yes|No||01/08/2015||Yes|No|01/08/2015||Yes|No||||No|No|||Prescription required|No||229|No|.2129|03/29/2022|.20779|03/29/2022|.20917|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|18423|||||No|No||ASCEND LABORATO|No||||
tacrolimus|No|No|No|No|75%|67877027801|TACROLIMUS 0.5 MG CAPSULE (IR)|100|EA|.14405|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No||229|No|.26138|03/29/2022|.2551|03/29/2022|.2568|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|18424|||||No|No||ASCEND LABORATO|No||||
tacrolimus|No|No|No|No|75%|67877027901|TACROLIMUS 1 MG CAPSULE (IR)|100|EA|.2509|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|No||229|No|.35645|03/29/2022|.34789|03/29/2022|.35021|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|18425|||||No|No||ASCEND LABORATO|No||||
tacrolimus|No|No|No|No|75%|67877028001|TACROLIMUS 5 MG CAPSULE (IR)|100|EA|1.25409|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||229|No|2.05753|03/29/2022|2.00814|03/29/2022|2.02152|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|18426|||||No|No||ASCEND LABORATO|No||||
riluzole|No|No|No|No|75%|67877028660|RILUZOLE 50 MG TABLET|60|EA|.28595|11/15/2016||Yes|No||11/15/2016||Yes|No|11/15/2016||Yes|No||||No|No|||Prescription required|No|||No|.46908|03/01/2022|.45782|03/01/2022|.46087|03/01/2022||||18427|||||No|No||ASCEND LABORATO|No||||
finasteride|No|No|No|No|75%|67877028810|FINASTERIDE 5 MG TABLET|1000|EA|.03369|02/16/2018||Yes|No||02/16/2018||Yes|No|02/16/2018||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|18428|||||No|No||ASCEND LABORATO|No||||
finasteride|No|No|No|No|75%|67877028890|FINASTERIDE 5 MG TABLET|90|EA|.03702|02/16/2018||Yes|No||02/16/2018||Yes|No|02/16/2018||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|18429|||||No|No||ASCEND LABORATO|No||||
cholestyramine (with sugar)|No|No|No|No|75%|67877029837|CHOLESTYRAMINE POWDER|368.76|GM|.05027|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|No||055|No|.10947|03/28/2022|.10684|03/28/2022|.10755|03/28/2022|||LIPOTROPICS: OTHER|18430|||||No|No||ASCEND LABORATO|No||||
cholestyramine (with sugar)|No|No|No|No|75%|67877029860|CHOLESTYRAMINE PACKET|60|EA|.4153|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|No||055|No|1.02853|03/28/2022|1.00384|03/28/2022|1.01053|03/28/2022|||LIPOTROPICS: OTHER|18431|||||No|No||ASCEND LABORATO|No||||
triamcinolone acetonide|No|No|No|No|75%|67877031715|TRIAMCINOLONE 0.025% CREAM|15|GM|.0989|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No||120|No|.15373|03/29/2022|.15004|03/29/2022|.15103|03/29/2022|||STEROIDS: TOPICAL HIGH|18432|||||No|No||ASCEND LABORATO|No||||
triamcinolone acetonide|No|No|No|No|75%|67877031745|TRIAMCINOLONE 0.025% CREAM|454|GM|.01728|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No||120|No|.0363|03/29/2022|.03542|03/29/2022|.03566|03/29/2022|||STEROIDS: TOPICAL HIGH|18433|||||No|No||ASCEND LABORATO|No||||
triamcinolone acetonide|No|No|No|No|75%|67877031780|TRIAMCINOLONE 0.025% CREAM|80|GM|.04917|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No||120|No|.05651|03/29/2022|.05515|03/29/2022|.05552|03/29/2022|||STEROIDS: TOPICAL HIGH|18434|||||No|No||ASCEND LABORATO|No||||
triamcinolone acetonide|No|No|No|No|75%|67877031815|TRIAMCINOLONE 0.5% CREAM|15|GM|.24796|05/03/2018||Yes|No||05/03/2018||Yes|No|05/03/2018||Yes|No||||No|No|||Prescription required|No||120|No|.24378|03/29/2022|.23792|03/29/2022|.23951|03/29/2022|||STEROIDS: TOPICAL HIGH|18435|||||No|No||ASCEND LABORATO|No||||
ibuprofen|No|No|No|No|75%|67877031901|IBUPROFEN 400 MG TABLET|100|EA|.02967|02/01/2018||Yes|No||02/01/2018||Yes|No|02/01/2018||Yes|No||||No|No|||Prescription required|No||059|Yes|.04934|03/29/2022|.04815|03/29/2022|.04847|03/29/2022|||NSAIDS|18436|||||No|No||ASCEND LABORATO|No||||
ibuprofen|No|No|No|No|75%|67877031905|IBUPROFEN 400 MG TABLET|500|EA|.02772|02/01/2018||Yes|No||02/01/2018||Yes|No|02/01/2018||Yes|No||||No|No|||Prescription required|No||059|Yes|.04934|03/29/2022|.04815|03/29/2022|.04847|03/29/2022|||NSAIDS|18437|||||No|No||ASCEND LABORATO|No||||
ibuprofen|No|No|No|No|75%|67877032001|IBUPROFEN 600 MG TABLET|100|EA|.03848|12/21/2017||Yes|No||12/21/2017||Yes|No|12/21/2017||Yes|No||||No|No|||Prescription required|No||059|Yes|.06063|03/29/2022|.05917|03/29/2022|.05956|03/29/2022|||NSAIDS|18438|||||No|No||ASCEND LABORATO|No||||
ibuprofen|No|No|No|No|75%|67877032005|IBUPROFEN 600 MG TABLET|500|EA|.03848|12/21/2017||Yes|No||12/21/2017||Yes|No|12/21/2017||Yes|No||||No|No|||Prescription required|No||059|Yes|.06063|03/29/2022|.05917|03/29/2022|.05956|03/29/2022|||NSAIDS|18439|||||No|No||ASCEND LABORATO|No||||
ibuprofen|No|No|No|No|75%|67877032030|IBUPROFEN 600 MG TABLET|30|EA|.06163|12/21/2017||Yes|No||12/21/2017||Yes|No|12/21/2017||Yes|No||||No|No|||Prescription required|No||059|Yes|.06063|03/29/2022|.05917|03/29/2022|.05956|03/29/2022|||NSAIDS|18440|||||No|No||ASCEND LABORATO|No||||
ibuprofen|No|No|No|No|75%|67877032050|IBUPROFEN 600 MG TABLET|50|EA|.04902|08/01/2017||Yes|No||08/01/2017||Yes|No|08/01/2017||Yes|No||||No|No|||Prescription required|No||059|Yes|.06063|03/29/2022|.05917|03/29/2022|.05956|03/29/2022|||NSAIDS|18441|||||No|No||ASCEND LABORATO|No||||
ibuprofen|No|No|No|No|75%|67877032101|IBUPROFEN 800 MG TABLET|100|EA|.07004|11/15/2016||Yes|No||11/15/2016||Yes|No|11/15/2016||Yes|No||||No|No|||Prescription required|No||059|Yes|.07481|03/29/2022|.07301|03/29/2022|.0735|03/29/2022|||NSAIDS|18442|||||No|No||ASCEND LABORATO|No||||
ibuprofen|No|No|No|No|75%|67877032105|IBUPROFEN 800 MG TABLET|500|EA|.07004|12/21/2017||Yes|No||12/21/2017||Yes|No|12/21/2017||Yes|No||||No|No|||Prescription required|No||059|Yes|.07481|03/29/2022|.07301|03/29/2022|.0735|03/29/2022|||NSAIDS|18443|||||No|No||ASCEND LABORATO|No||||
ibuprofen|No|No|No|No|75%|67877032130|IBUPROFEN 800 MG TABLET|30|EA|.07023|12/21/2017||Yes|No||12/21/2017||Yes|No|12/21/2017||Yes|No||||No|No|||Prescription required|No||059|Yes|.07481|03/29/2022|.07301|03/29/2022|.0735|03/29/2022|||NSAIDS|18444|||||No|No||ASCEND LABORATO|No||||
ibuprofen|No|No|No|No|75%|67877032150|IBUPROFEN 800 MG TABLET|50|EA|.07009|12/21/2017||Yes|No||12/21/2017||Yes|No|12/21/2017||Yes|No||||No|No|||Prescription required|No||059|Yes|.07481|03/29/2022|.07301|03/29/2022|.0735|03/29/2022|||NSAIDS|18445|||||No|No||ASCEND LABORATO|No||||
nebivolol HCl|No|No|No|No|75%|67877039030|NEBIVOLOL 20 MG TABLET|30|EA|.24008|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.46821|03/29/2022|.45697|03/29/2022|.46001|03/29/2022|||BETA-BLOCKERS|18446|||||No|No||ASCEND LABORATO|No||||
nebivolol HCl|No|No|No|No|75%|67877039090|NEBIVOLOL 20 MG TABLET|90|EA|.2396|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.46821|03/29/2022|.45697|03/29/2022|.46001|03/29/2022|||BETA-BLOCKERS|18447|||||No|No||ASCEND LABORATO|No||||
nebivolol HCl|No|No|No|No|75%|67877039130|NEBIVOLOL 10 MG TABLET|30|EA|.19995|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.40408|03/29/2022|.39438|03/29/2022|.397|03/29/2022|||BETA-BLOCKERS|18448|||||No|No||ASCEND LABORATO|No||||
nebivolol HCl|No|No|No|No|75%|67877039190|NEBIVOLOL 10 MG TABLET|90|EA|.19995|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.40408|03/29/2022|.39438|03/29/2022|.397|03/29/2022|||BETA-BLOCKERS|18449|||||No|No||ASCEND LABORATO|No||||
nebivolol HCl|No|No|No|No|75%|67877039230|NEBIVOLOL 5 MG TABLET|30|EA|.19923|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.46205|03/29/2022|.45096|03/29/2022|.45396|03/29/2022|||BETA-BLOCKERS|18450|||||No|No||ASCEND LABORATO|No||||
nebivolol HCl|No|No|No|No|75%|67877039290|NEBIVOLOL 5 MG TABLET|90|EA|.19851|02/08/2022||Yes|No||02/08/2022||Yes|No|02/08/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.46205|03/29/2022|.45096|03/29/2022|.45396|03/29/2022|||BETA-BLOCKERS|18451|||||No|No||ASCEND LABORATO|No||||
nebivolol HCl|No|No|No|No|75%|67877039330|NEBIVOLOL 2.5 MG TABLET|30|EA|.19851|02/08/2022||Yes|No||02/08/2022||Yes|No|02/08/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.41918|03/29/2022|.40911|03/29/2022|.41184|03/29/2022|||BETA-BLOCKERS|18452|||||No|No||ASCEND LABORATO|No||||
metformin HCl|Yes|No|No|No|75%|67877041301|METFORMIN HCL ER 500 MG TABLET|100|EA|.02128|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||012|No|.03646|03/29/2022|.03558|03/29/2022|.03582|03/29/2022|||HYPOGLYCEMICS: METFORMINS|18453|||||No|No||ASCEND LABORATO|No||||
metformin HCl|Yes|No|No|No|75%|67877041305|METFORMIN HCL ER 500 MG TABLET|500|EA|.01569|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No||||No|No|03/20/2020||Prescription required|No||012|No|.03646|03/29/2022|.03558|03/29/2022|.03582|03/29/2022|||HYPOGLYCEMICS: METFORMINS|18454|||||No|No||ASCEND LABORATO|No||||
metformin HCl|No|No|No|No|75%|67877041390|METFORMIN HCL ER 500 MG TABLET|90|EA|.0213|06/09/2021||Yes|No||06/09/2021||Yes|No|06/09/2021||Yes|No||||No|No|||Prescription required|No||012|No|.03646|03/29/2022|.03558|03/29/2022|.03582|03/29/2022|||HYPOGLYCEMICS: METFORMINS|18455|||||No|No||ASCEND LABORATO|No||||
metformin HCl|Yes|No|No|No|75%|67877041401|METFORMIN HCL ER 750 MG TABLET|100|EA|.03053|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||012|No|.09354|03/29/2022|.09129|03/29/2022|.0919|03/29/2022|||HYPOGLYCEMICS: METFORMINS|18456|||||No|No||ASCEND LABORATO|No||||
valsartan|Yes|No|No|No|75%|67877041530|VALSARTAN 40 MG TABLET|30|EA|.17415|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|01/15/2020||Prescription required|Yes|07/29/2021|113|Yes|.1945|03/29/2022|.18983|03/29/2022|.19109|03/29/2022|||ANGIOTENSIN MODULATORS|18457|||||No|No||ASCEND LABORATO|No||||
valsartan|Yes|No|No|No|75%|67877041690|VALSARTAN 80 MG TABLET|90|EA|.14022|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|01/15/2020||Prescription required|Yes|07/29/2021|113|Yes|.21024|03/29/2022|.20519|03/29/2022|.20656|03/29/2022|||ANGIOTENSIN MODULATORS|18458|||||No|No||ASCEND LABORATO|No||||
valsartan|Yes|No|No|No|75%|67877041790|VALSARTAN 160 MG TABLET|90|EA|.17032|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|01/15/2020||Prescription required|Yes|07/29/2021|113|Yes|.23007|03/29/2022|.22454|03/29/2022|.22604|03/29/2022|||ANGIOTENSIN MODULATORS|18459|||||No|No||ASCEND LABORATO|No||||
valsartan|Yes|No|No|No|75%|67877041890|VALSARTAN 320 MG TABLET|90|EA|.22565|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|01/15/2020||Prescription required|Yes|07/29/2021|113|Yes|.31156|03/29/2022|.30408|03/29/2022|.3061|03/29/2022|||ANGIOTENSIN MODULATORS|18460|||||No|No||ASCEND LABORATO|No||||
linezolid|No|No|No|No|75%|67877041920|LINEZOLID 600 MG TABLET|20|EA|1.1825|03/04/2016||Yes|No||03/04/2016||Yes|No|03/04/2016||Yes|No||||No|No|||Prescription required|No||146|No|2.07915|03/29/2022|2.02925|03/29/2022|2.04276|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|18461|||||No|No||ASCEND LABORATO|No||||
linezolid|No|No|No|No|75%|67877041933|LINEZOLID 600 MG TABLET|10|EA||12/07/2016||Yes|No||12/07/2016||Yes|No|12/07/2016||Yes|No||||No|No|||Prescription required|No||146|No|2.07915|03/29/2022|2.02925|03/29/2022|2.04276|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|18462|||||No|No||ASCEND LABORATO|No||||
linezolid|No|No|No|No|75%|67877041984|LINEZOLID 600 MG TABLET|30|EA|1.505|03/04/2016||Yes|No||03/04/2016||Yes|No|03/04/2016||Yes|No||||No|No|||Prescription required|No||146|No|2.07915|03/29/2022|2.02925|03/29/2022|2.04276|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|18463|||||No|No||ASCEND LABORATO|No||||
mycophenolate sodium|No|No|No|No|75%|67877042612|MYCOPHENOLIC ACID DR 180 MG TB|120|EA|.07972|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|229|No|.54568|03/28/2022|.53258|03/28/2022|.53613|03/28/2022|||IMMUNOSUPPRESSIVES: ORAL|18464|||||No|No||ASCEND LABORATO|No||||
mycophenolate sodium|No|No|No|No|75%|67877042712|MYCOPHENOLIC ACID DR 360 MG TB|120|EA|.15945|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|229|No|.56705|03/28/2022|.55344|03/28/2022|.55712|03/28/2022|||IMMUNOSUPPRESSIVES: ORAL|18465|||||No|No||ASCEND LABORATO|No||||
gabapentin|No|No|No|No|75%|67877042801|GABAPENTIN 600 MG TABLET|100|EA|.06385|04/05/2017||Yes|No||04/05/2017||Yes|No|04/05/2017||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|18466|||||No|No||ASCEND LABORATO|No||||
gabapentin|No|No|No|No|75%|67877042805|GABAPENTIN 600 MG TABLET|500|EA|.06385|04/05/2017||Yes|No||04/05/2017||Yes|No|04/05/2017||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|18467|||||No|No||ASCEND LABORATO|No||||
gabapentin|No|No|No|No|75%|67877042901|GABAPENTIN 800 MG TABLET|100|EA|.07202|04/05/2017||Yes|No||04/05/2017||Yes|No|04/05/2017||Yes|No||||No|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|18468|||||No|No||ASCEND LABORATO|No||||
gabapentin|No|No|No|No|75%|67877042905|GABAPENTIN 800 MG TABLET|500|EA|.07202|04/06/2017||Yes|No||04/06/2017||Yes|No|04/06/2017||Yes|No||||No|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|18469|||||No|No||ASCEND LABORATO|No||||
aripiprazole|No|No|No|No|75%|67877043003|ARIPIPRAZOLE 2 MG TABLET|30|EA|.09961|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|18470|||||No|No||ASCEND LABORATO|No||||
aripiprazole|No|No|No|No|75%|67877043005|ARIPIPRAZOLE 2 MG TABLET|500|EA|.09933|08/31/2020||Yes|No||08/31/2020||Yes|No|08/31/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.14075|03/29/2022|.13737|03/29/2022|.13828|03/29/2022|||ANTIPSYCHOTICS|18471|||||No|No||ASCEND LABORATO|No||||
aripiprazole|No|No|No|No|75%|67877043103|ARIPIPRAZOLE 5 MG TABLET|30|EA|.10033|02/27/2020||Yes|No||02/27/2020||Yes|No|02/27/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|18472|||||No|No||ASCEND LABORATO|No||||
aripiprazole|No|No|No|No|75%|67877043105|ARIPIPRAZOLE 5 MG TABLET|500|EA|.10019|08/31/2020||Yes|No||08/31/2020||Yes|No|08/31/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.14982|03/29/2022|.14622|03/29/2022|.14719|03/29/2022|||ANTIPSYCHOTICS|18473|||||No|No||ASCEND LABORATO|No||||
aripiprazole|No|No|No|No|75%|67877043203|ARIPIPRAZOLE 10 MG TABLET|30|EA|.10176|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|18474|||||No|No||ASCEND LABORATO|No||||
aripiprazole|No|No|No|No|75%|67877043205|ARIPIPRAZOLE 10 MG TABLET|500|EA|.10169|08/31/2020||Yes|No||08/31/2020||Yes|No|08/31/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.15149|03/29/2022|.14785|03/29/2022|.14883|03/29/2022|||ANTIPSYCHOTICS|18475|||||No|No||ASCEND LABORATO|No||||
aripiprazole|No|No|No|No|75%|67877043303|ARIPIPRAZOLE 15 MG TABLET|30|EA|.10391|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|18476|||||No|No||ASCEND LABORATO|No||||
aripiprazole|No|No|No|No|75%|67877043305|ARIPIPRAZOLE 15 MG TABLET|500|EA|.10384|08/31/2020||Yes|No||08/31/2020||Yes|No|08/31/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.16995|03/29/2022|.16587|03/29/2022|.16697|03/29/2022|||ANTIPSYCHOTICS|18477|||||No|No||ASCEND LABORATO|No||||
aripiprazole|No|No|No|No|75%|67877043403|ARIPIPRAZOLE 20 MG TABLET|30|EA|.11825|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|18478|||||No|No||ASCEND LABORATO|No||||
aripiprazole|No|No|No|No|75%|67877043405|ARIPIPRAZOLE 20 MG TABLET|500|EA|.11825|08/31/2020||Yes|No||08/31/2020||Yes|No|08/31/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.2218|03/29/2022|.21647|03/29/2022|.21791|03/29/2022|||ANTIPSYCHOTICS|18479|||||No|No||ASCEND LABORATO|No||||
aripiprazole|No|No|No|No|75%|67877043503|ARIPIPRAZOLE 30 MG TABLET|30|EA|.12183|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|18480|||||No|No||ASCEND LABORATO|No||||
aripiprazole|No|No|No|No|75%|67877043505|ARIPIPRAZOLE 30 MG TABLET|500|EA|.12169|08/31/2020||Yes|No||08/31/2020||Yes|No|08/31/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|.25959|03/29/2022|.25335|03/29/2022|.25504|03/29/2022|||ANTIPSYCHOTICS|18481|||||No|No||ASCEND LABORATO|No||||
minocycline HCl|No|No|No|No|75%|67877043630|MINOCYCLINE ER 55 MG TABLET|30|EA|2.59791|10/05/2020||Yes|No||10/05/2020||Yes|No|10/05/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|213|No|5.92082|10/05/2020|5.83624|10/05/2020|5.55832|10/05/2020|||TETRACYCLINES|18482|||||No|No||ASCEND LABORATO|No||||
minocycline HCl|No|No|No|No|75%|67877043730|MINOCYCLINE ER 80 MG TABLET|30|EA|2.59791|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|5.92082|04/27/2021|5.83624|04/27/2021|5.55832|04/27/2021|||TETRACYCLINES|18483|||||No|No||ASCEND LABORATO|No||||
minocycline HCl|No|No|No|No|75%|67877043830|MINOCYCLINE ER 105 MG TABLET|30|EA|2.59791|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|5.92082|05/29/2019|5.83624|05/29/2019|5.55832|05/29/2019|||TETRACYCLINES|18484|||||No|No||ASCEND LABORATO|No||||
rosuvastatin calcium|No|No|No|No|75%|67877043990|ROSUVASTATIN CALCIUM 5 MG TAB|90|EA|.04777|02/01/2018||Yes|No||02/01/2018||Yes|No|02/01/2018||Yes|No||||No|No|||Prescription required|No||063|Yes|.06753|03/29/2022|.0659|03/29/2022|.06634|03/29/2022|||LIPOTROPICS: STATINS|18485|||||No|No||ASCEND LABORATO|No||||
rosuvastatin calcium|No|No|No|No|75%|67877044005|ROSUVASTATIN CALCIUM 10 MG TAB|500|EA|.04777|10/05/2020||Yes|No||10/05/2020||Yes|No|10/05/2020||Yes|No||||No|No|||Prescription required|No||063|Yes|.05981|03/29/2022|.05837|03/29/2022|.05876|03/29/2022|||LIPOTROPICS: STATINS|18486|||||No|No||ASCEND LABORATO|No||||
rosuvastatin calcium|No|No|No|No|75%|67877044090|ROSUVASTATIN CALCIUM 10 MG TAB|90|EA|.04777|02/15/2018||Yes|No||02/15/2018||Yes|No|02/15/2018||Yes|No||||No|No|||Prescription required|No||063|Yes|.05981|03/29/2022|.05837|03/29/2022|.05876|03/29/2022|||LIPOTROPICS: STATINS|18487|||||No|No||ASCEND LABORATO|No||||
rosuvastatin calcium|No|No|No|No|75%|67877044190|ROSUVASTATIN CALCIUM 20 MG TAB|90|EA|.04777|02/15/2018||Yes|No||02/15/2018||Yes|No|02/15/2018||Yes|No||||No|No|||Prescription required|No||063|Yes|.07822|03/29/2022|.07634|03/29/2022|.07685|03/29/2022|||LIPOTROPICS: STATINS|18488|||||No|No||ASCEND LABORATO|No||||
rosuvastatin calcium|No|No|No|No|75%|67877044230|ROSUVASTATIN CALCIUM 40 MG TAB|30|EA|.07166|05/16/2018||Yes|No||05/16/2018||Yes|No|05/16/2018||Yes|No||||No|No|||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|18489|||||No|No||ASCEND LABORATO|No||||
rosuvastatin calcium|No|No|No|No|75%|67877044290|ROSUVASTATIN CALCIUM 40 MG TAB|90|EA|.07166|10/05/2020||Yes|No||10/05/2020||Yes|No|10/05/2020||Yes|No||||No|No|||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|18490|||||No|No||ASCEND LABORATO|No||||
rabeprazole sodium|No|No|No|No|75%|67877044390|RABEPRAZOLE SOD DR 20 MG TAB|90|EA|.1161|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.24287|03/29/2022|.23704|03/29/2022|.23861|03/29/2022|||PROTON PUMP INHIBITORS|18491|||||No|No||ASCEND LABORATO|No||||
dalfampridine|No|No|No|No|75%|67877044460|DALFAMPRIDINE ER 10 MG TABLET|60|EA|.86|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No||||No|No|||Prescription required|No||043|No|.82047|03/29/2022|.80077|03/29/2022|.80611|03/29/2022|||MULTIPLE SCLEROSIS AGENTS|18492|||||No|No||ASCEND LABORATO|No||||
olmesartan medoxomil|No|No|No|No|75%|67877044530|OLMESARTAN MEDOXOMIL 5 MG TAB|30|EA|.09101|02/20/2018||Yes|No||02/20/2018||Yes|No|02/20/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.07425|03/29/2022|.07246|03/29/2022|.07295|03/29/2022|||ANGIOTENSIN MODULATORS|18493|||||No|No||ASCEND LABORATO|No||||
olmesartan medoxomil|No|No|No|No|75%|67877044630|OLMESARTAN MEDOXOMIL 20 MG TAB|30|EA|.10965|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.1002|03/29/2022|.09779|03/29/2022|.09844|03/29/2022|||ANGIOTENSIN MODULATORS|18494|||||No|No||ASCEND LABORATO|No||||
olmesartan medoxomil|No|No|No|No|75%|67877044690|OLMESARTAN MEDOXOMIL 20 MG TAB|90|EA|.1106|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.1002|03/29/2022|.09779|03/29/2022|.09844|03/29/2022|||ANGIOTENSIN MODULATORS|18495|||||No|No||ASCEND LABORATO|No||||
olmesartan medoxomil|No|No|No|No|75%|67877044730|OLMESARTAN MEDOXOMIL 40 MG TAB|30|EA|.15265|02/06/2018||Yes|No||02/06/2018||Yes|No|02/06/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.15714|03/29/2022|.15336|03/29/2022|.15439|03/29/2022|||ANGIOTENSIN MODULATORS|18496|||||No|No||ASCEND LABORATO|No||||
olmesartan medoxomil|No|No|No|No|75%|67877044790|OLMESARTAN MEDOXOMIL 40 MG TAB|90|EA|.15288|02/06/2018||Yes|No||02/06/2018||Yes|No|02/06/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.15714|03/29/2022|.15336|03/29/2022|.15439|03/29/2022|||ANGIOTENSIN MODULATORS|18497|||||No|No||ASCEND LABORATO|No||||
tamsulosin HCl|No|No|No|No|75%|67877045001|TAMSULOSIN HCL 0.4 MG CAPSULE|100|EA|.11803|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No||003|No|.06447|03/29/2022|.06292|03/29/2022|.06334|03/29/2022|||BPH TREATMENTS|18498|||||No|No||ASCEND LABORATO|No||||
tamsulosin HCl|No|No|No|No|75%|67877045005|TAMSULOSIN HCL 0.4 MG CAPSULE|500|EA|.11803|02/16/2018||Yes|No||02/16/2018||Yes|No|02/16/2018||Yes|No||||No|No|||Prescription required|No||003|No|.06447|03/29/2022|.06292|03/29/2022|.06334|03/29/2022|||BPH TREATMENTS|18499|||||No|No||ASCEND LABORATO|No||||
tamsulosin HCl|No|No|No|No|75%|67877045010|TAMSULOSIN HCL 0.4 MG CAPSULE|1000|EA|.11803|02/16/2018||Yes|No||02/16/2018||Yes|No|02/16/2018||Yes|No||||No|No|||Prescription required|No||003|No|.06447|03/29/2022|.06292|03/29/2022|.06334|03/29/2022|||BPH TREATMENTS|18500|||||No|No||ASCEND LABORATO|No||||
itraconazole|No|No|No|No|75%|67877045430|ITRACONAZOLE 100 MG CAPSULE|30|EA|.71666|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|069|No|.85195|03/29/2022|.8315|03/29/2022|.83704|03/29/2022|||ANTIFUNGALS: ORAL|18501|||||No|No||ASCEND LABORATO|No||||
pregabalin|No|No|No|No|90%|67877045747|PREGABALIN 20 MG/ML SOLUTION|473|ML|.05909|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|232|No|.13467|12/16/2019|.13274|12/16/2019|.12642|12/16/2019|||NEUROPATHIC PAIN|18502|||||No|No||ASCEND LABORATO|No||||
capecitabine|No|No|No|No|75%|67877045860|CAPECITABINE 150 MG TABLET|60|EA|.21944|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|||Prescription required|No||502|No|.50012|05/25/2021|.49297|05/25/2021|.4695|05/25/2021|||ONCOLOGY: ORAL - BREAST|18503|||||No|No||ASCEND LABORATO|No||||
capecitabine|No|No|No|No|75%|67877045912|CAPECITABINE 500 MG TABLET|120|EA|.34256|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|||Prescription required|No||502|No|.61977|12/28/2021|.60489|12/28/2021|.60892|12/28/2021|||ONCOLOGY: ORAL - BREAST|18504|||||No|No||ASCEND LABORATO|No||||
pregabalin|No|No|No|No|90%|67877046205|PREGABALIN 25 MG CAPSULE|500|EA|.03105|12/28/2021||Yes|No||12/28/2021||Yes|No|12/28/2021||Yes|No||||No|No|||Prescription required|No||232|No|.0795|03/29/2022|.07759|03/29/2022|.0781|03/29/2022|||NEUROPATHIC PAIN|18505|||||No|No||ASCEND LABORATO|No||||
pregabalin|No|No|No|No|90%|67877046290|PREGABALIN 25 MG CAPSULE|90|EA|.03105|02/28/2020||Yes|No||02/28/2020||Yes|No|02/28/2020||Yes|No||||No|No|||Prescription required|No||232|No|.0795|03/29/2022|.07759|03/29/2022|.0781|03/29/2022|||NEUROPATHIC PAIN|18506|||||No|No||ASCEND LABORATO|No||||
pregabalin|No|No|No|No|90%|67877046305|PREGABALIN 50 MG CAPSULE|500|EA|.03225|01/07/2022||Yes|No||01/07/2022||Yes|No|01/07/2022||Yes|No||||No|No|||Prescription required|No||232|No|.09128|03/29/2022|.08908|03/29/2022|.08968|03/29/2022|||NEUROPATHIC PAIN|18507|||||No|No||ASCEND LABORATO|No||||
pregabalin|No|No|No|No|90%|67877046390|PREGABALIN 50 MG CAPSULE|90|EA|.03225|02/28/2020||Yes|No||02/28/2020||Yes|No|02/28/2020||Yes|No||||No|No|||Prescription required|No||232|No|.09128|03/29/2022|.08908|03/29/2022|.08968|03/29/2022|||NEUROPATHIC PAIN|18508|||||No|No||ASCEND LABORATO|No||||
pregabalin|No|No|No|No|90%|67877046405|PREGABALIN 75 MG CAPSULE|500|EA|.03941|01/07/2022||Yes|No||01/07/2022||Yes|No|01/07/2022||Yes|No||||No|No|||Prescription required|No||232|No|.08098|03/29/2022|.07903|03/29/2022|.07956|03/29/2022|||NEUROPATHIC PAIN|18509|||||No|No||ASCEND LABORATO|No||||
pregabalin|No|No|No|No|90%|67877046490|PREGABALIN 75 MG CAPSULE|90|EA|.03941|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.08098|03/29/2022|.07903|03/29/2022|.07956|03/29/2022|||NEUROPATHIC PAIN|18510|||||No|No||ASCEND LABORATO|No||||
pregabalin|No|No|No|No|90%|67877046505|PREGABALIN 100 MG CAPSULE|500|EA|.04442|12/16/2021||Yes|No||12/16/2021||Yes|No|12/16/2021||Yes|No||||No|No|||Prescription required|No||232|No|.08763|03/29/2022|.08552|03/29/2022|.08609|03/29/2022|||NEUROPATHIC PAIN|18511|||||No|No||ASCEND LABORATO|No||||
pregabalin|No|No|No|No|90%|67877046590|PREGABALIN 100 MG CAPSULE|90|EA|.04443|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.08763|03/29/2022|.08552|03/29/2022|.08609|03/29/2022|||NEUROPATHIC PAIN|18512|||||No|No||ASCEND LABORATO|No||||
pregabalin|No|No|No|No|90%|67877046690|PREGABALIN 150 MG CAPSULE|90|EA|.04538|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.10646|03/29/2022|.1039|03/29/2022|.10459|03/29/2022|||NEUROPATHIC PAIN|18513|||||No|No||ASCEND LABORATO|No||||
pregabalin|No|No|No|No|90%|67877046705|PREGABALIN 200 MG CAPSULE|500|EA|.05183|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|No||232|No|.11395|03/29/2022|.11121|03/29/2022|.11195|03/29/2022|||NEUROPATHIC PAIN|18514|||||No|No||ASCEND LABORATO|No||||
pregabalin|No|No|No|No|90%|67877046790|PREGABALIN 200 MG CAPSULE|90|EA|.05183|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.11395|03/29/2022|.11121|03/29/2022|.11195|03/29/2022|||NEUROPATHIC PAIN|18515|||||No|No||ASCEND LABORATO|No||||
pregabalin|No|No|No|No|90%|67877046805|PREGABALIN 225 MG CAPSULE|500|EA|.06043|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|No||232|No|.12393|03/29/2022|.12095|03/29/2022|.12176|03/29/2022|||NEUROPATHIC PAIN|18516|||||No|No||ASCEND LABORATO|No||||
pregabalin|No|No|No|No|90%|67877046890|PREGABALIN 225 MG CAPSULE|90|EA|.06043|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.12393|03/29/2022|.12095|03/29/2022|.12176|03/29/2022|||NEUROPATHIC PAIN|18517|||||No|No||ASCEND LABORATO|No||||
pregabalin|No|No|No|No|90%|67877046905|PREGABALIN 300 MG CAPSULE|500|EA|.07357|03/30/2022||Yes|No||03/30/2022||Yes|No|03/30/2022||Yes|No||||No|No|||Prescription required|No||232|No|.12181|03/30/2022|.11888|03/30/2022|.11967|03/30/2022|||NEUROPATHIC PAIN|18518|||||No|No||ASCEND LABORATO|No||||
pregabalin|No|No|No|No|90%|67877046990|PREGABALIN 300 MG CAPSULE|90|EA|.07357|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.12181|03/29/2022|.11888|03/29/2022|.11967|03/29/2022|||NEUROPATHIC PAIN|18519|||||No|No||ASCEND LABORATO|No||||
lidocaine|No|No|No|No|75%|67877047379|LIDOCAINE 5% OINTMENT|35.44|GM|.14559|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No|||No|.18796|03/29/2022|.18344|03/29/2022|.18467|03/29/2022||||18520|||||No|No||ASCEND LABORATO|No||||
lidocaine|No|No|No|No|75%|67877047380|LIDOCAINE 5% OINTMENT|50|GM|.1376|03/10/2021||Yes|No||03/10/2021||Yes|No|03/10/2021||Yes|No||||No|No|||Prescription required|No|||No|.22969|03/29/2022|.22417|03/29/2022|.22567|03/29/2022||||18521|||||No|No||ASCEND LABORATO|No||||
azelastine HCl|No|No|No|No|75%|67877047750|AZELASTINE 0.1% (137 MCG) SPRY|30|ML|.258|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No||019|Yes|.27761|03/29/2022|.27094|03/29/2022|.27275|03/29/2022|||INTRANASAL RHINITIS AGENTS|18522|||||No|No||ASCEND LABORATO|No||||
esomeprazole magnesium|No|No|No|No|75%|67877047810|ESOMEPRAZOLE MAG DR 20 MG CAP|1000|EA|.08533|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|18523|||||No|No||ASCEND LABORATO|No||||
esomeprazole magnesium|No|No|No|No|75%|67877047830|ESOMEPRAZOLE MAG DR 20 MG CAP|30|EA|.18561|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|18524|||||No|No||ASCEND LABORATO|No||||
esomeprazole magnesium|No|No|No|No|75%|67877047890|ESOMEPRAZOLE MAG DR 20 MG CAP|90|EA|.09507|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|18525|||||No|No||ASCEND LABORATO|No||||
esomeprazole magnesium|No|No|No|No|75%|67877047910|ESOMEPRAZOLE MAG DR 40 MG CAP|1000|EA|.08533|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|18526|||||No|No||ASCEND LABORATO|No||||
esomeprazole magnesium|No|No|No|No|75%|67877047930|ESOMEPRAZOLE MAG DR 40 MG CAP|30|EA|.18561|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|18527|||||No|No||ASCEND LABORATO|No||||
esomeprazole magnesium|No|No|No|No|75%|67877047990|ESOMEPRAZOLE MAG DR 40 MG CAP|90|EA|.09507|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|18528|||||No|No||ASCEND LABORATO|No||||
telmisartan|Yes|No|No|No|75%|67877048230|TELMISARTAN 20 MG TABLET|30|EA|.11968|12/02/2019||Yes|No||12/06/2019||Yes|No|12/02/2019||Yes|No||||No|No|03/20/2020||Prescription required|Yes|07/25/2019|113|Yes|.30407|03/29/2022|.29677|03/29/2022|.29874|03/29/2022|||ANGIOTENSIN MODULATORS|18529|||||No|No||ASCEND LABORATO|No||||
telmisartan|No|No|No|No|75%|67877048284|TELMISARTAN 20 MG TABLET|30|EA|.35976|08/29/2016||Yes|No||08/29/2016||Yes|No|08/29/2016||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.30407|03/29/2022|.29677|03/29/2022|.29874|03/29/2022|||ANGIOTENSIN MODULATORS|18530|||||No|No||ASCEND LABORATO|No||||
telmisartan|Yes|No|No|No|75%|67877048330|TELMISARTAN 40 MG TABLET|30|EA|.19063|12/02/2019||Yes|No||12/02/2019||Yes|No|12/02/2019||Yes|No||||No|No|03/20/2020||Prescription required|Yes|07/25/2019|113|Yes|.35861|03/29/2022|.35|03/29/2022|.35233|03/29/2022|||ANGIOTENSIN MODULATORS|18531|||||No|No||ASCEND LABORATO|No||||
telmisartan|No|No|No|No|75%|67877048384|TELMISARTAN 40 MG TABLET|30|EA|.35976|08/29/2016||Yes|No||08/29/2016||Yes|No|08/29/2016||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.35861|03/29/2022|.35|03/29/2022|.35233|03/29/2022|||ANGIOTENSIN MODULATORS|18532|||||No|No||ASCEND LABORATO|No||||
telmisartan|Yes|No|No|No|75%|67877048430|TELMISARTAN 80 MG TABLET|30|EA|.2365|12/02/2019||Yes|No||12/02/2019||Yes|No|12/02/2019||Yes|No||||No|No|03/20/2020||Prescription required|Yes|07/25/2019|113|Yes|.33958|03/29/2022|.33143|03/29/2022|.33363|03/29/2022|||ANGIOTENSIN MODULATORS|18533|||||No|No||ASCEND LABORATO|No||||
telmisartan|No|No|No|No|75%|67877048484|TELMISARTAN 80 MG TABLET|30|EA|.35976|08/29/2016||Yes|No||08/29/2016||Yes|No|08/29/2016||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.33958|03/29/2022|.33143|03/29/2022|.33363|03/29/2022|||ANGIOTENSIN MODULATORS|18534|||||No|No||ASCEND LABORATO|No||||
ezetimibe|No|No|No|No|75%|67877049005|EZETIMIBE 10 MG TABLET|500|EA|.12599|03/08/2018||Yes|No||03/08/2018||Yes|No|03/08/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|18535|||||No|No||ASCEND LABORATO|No||||
ezetimibe|No|No|No|No|75%|67877049030|EZETIMIBE 10 MG TABLET|30|EA|.13258|05/30/2018||Yes|No||05/30/2018||Yes|No|05/30/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|18536|||||No|No||ASCEND LABORATO|No||||
ezetimibe|No|No|No|No|75%|67877049090|EZETIMIBE 10 MG TABLET|90|EA|.12613|05/30/2018||Yes|No||05/30/2018||Yes|No|05/30/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|18537|||||No|No||ASCEND LABORATO|No||||
azathioprine|No|No|No|No|75%|67877049301|AZATHIOPRINE 50 MG TABLET|100|EA|.1075|10/05/2020||Yes|No||10/05/2020||Yes|No|10/05/2020||Yes|No||||No|No|||Prescription required|No||229|No|.24374|03/29/2022|.23789|03/29/2022|.23947|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|18538|||||No|No||ASCEND LABORATO|No||||
azathioprine|No|No|No|No|75%|67877049305|AZATHIOPRINE 50 MG TABLET|500|EA|.0817|12/07/2020||Yes|No||12/07/2020||Yes|No|12/07/2020||Yes|No||||No|No|||Prescription required|No||229|No|.24374|03/29/2022|.23789|03/29/2022|.23947|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|18539|||||No|No||ASCEND LABORATO|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|67877050130|AMLODIPINE-OLMESARTAN 5-40 MG|30|EA|.40921|01/02/2019||Yes|No||01/02/2019||Yes|No|01/02/2019||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|017|Yes|.47518|03/29/2022|.46377|03/29/2022|.46686|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|18540|||||No|No||ASCEND LABORATO|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|67877050230|AMLODIPINE-OLMESARTAN 10-40 MG|30|EA|.40921|01/02/2019||Yes|No||01/02/2019||Yes|No|01/02/2019||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|017|Yes|.41757|03/29/2022|.40754|03/29/2022|.41026|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|18541|||||No|No||ASCEND LABORATO|No||||
cinacalcet HCl|No|No|No|No|75%|67877050330|CINACALCET HCL 30 MG TABLET|30|EA|.21299|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No|||No|.75588|03/29/2022|.73773|03/29/2022|.74265|03/29/2022||||18542|||||No|No||ASCEND LABORATO|No||||
cinacalcet HCl|No|No|No|No|75%|67877050430|CINACALCET HCL 60 MG TABLET|30|EA|.38599|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No|||No|1.7407|03/29/2022|1.69892|03/29/2022|1.71023|03/29/2022||||18543|||||No|No||ASCEND LABORATO|No||||
cinacalcet HCl|No|No|No|No|75%|67877050530|CINACALCET HCL 90 MG TABLET|30|EA|.55857|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No|||No|3.64673|03/29/2022|3.5592|03/29/2022|3.58291|03/29/2022||||18544|||||No|No||ASCEND LABORATO|No||||
colesevelam HCl|No|No|No|No|75%|67877050651|COLESEVELAM 625 MG TABLET|180|EA|.38489|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|055|No|.48654|03/29/2022|.47486|03/29/2022|.47802|03/29/2022|||LIPOTROPICS: OTHER|18545|||||No|No||ASCEND LABORATO|No||||
ezetimibe/simvastatin|No|No|No|No|75%|67877050730|EZETIMIBE-SIMVASTATIN 10-10 MG|30|EA|.45866|03/19/2018||Yes|No||03/19/2018||Yes|No|03/19/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|063|Yes|.75312|03/29/2022|.73504|03/29/2022|.73994|03/29/2022|||LIPOTROPICS: STATINS|18546|||||No|No||ASCEND LABORATO|No||||
ezetimibe/simvastatin|No|No|No|No|75%|67877050790|EZETIMIBE-SIMVASTATIN 10-10 MG|90|EA|.45866|05/30/2018||Yes|No||05/30/2018||Yes|No|05/30/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|063|Yes|.75312|03/29/2022|.73504|03/29/2022|.73994|03/29/2022|||LIPOTROPICS: STATINS|18547|||||No|No||ASCEND LABORATO|No||||
ezetimibe/simvastatin|No|No|No|No|75%|67877050830|EZETIMIBE-SIMVASTATIN 10-20 MG|30|EA|.45866|03/19/2018||Yes|No||03/19/2018||Yes|No|03/19/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|063|Yes|.74268|03/29/2022|.72485|03/29/2022|.72968|03/29/2022|||LIPOTROPICS: STATINS|18548|||||No|No||ASCEND LABORATO|No||||
ezetimibe/simvastatin|No|No|No|No|75%|67877050890|EZETIMIBE-SIMVASTATIN 10-20 MG|90|EA|.45866|05/30/2018||Yes|No||05/30/2018||Yes|No|05/30/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|063|Yes|.74268|03/29/2022|.72485|03/29/2022|.72968|03/29/2022|||LIPOTROPICS: STATINS|18549|||||No|No||ASCEND LABORATO|No||||
ezetimibe/simvastatin|No|No|No|No|75%|67877050930|EZETIMIBE-SIMVASTATIN 10-40 MG|30|EA|.45866|03/19/2018||Yes|No||03/19/2018||Yes|No|03/19/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|063|Yes|.99233|03/29/2022|.96851|03/29/2022|.97496|03/29/2022|||LIPOTROPICS: STATINS|18550|||||No|No||ASCEND LABORATO|No||||
ezetimibe/simvastatin|No|No|No|No|75%|67877050990|EZETIMIBE-SIMVASTATIN 10-40 MG|90|EA|.45866|05/30/2018||Yes|No||05/30/2018||Yes|No|05/30/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|063|Yes|.99233|03/29/2022|.96851|03/29/2022|.97496|03/29/2022|||LIPOTROPICS: STATINS|18551|||||No|No||ASCEND LABORATO|No||||
ezetimibe/simvastatin|No|No|No|No|75%|67877051030|EZETIMIBE-SIMVASTATIN 10-80 MG|30|EA|.45866|03/19/2018||Yes|No||03/19/2018||Yes|No|03/19/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|063|Yes|.47172|03/29/2022|.46039|03/29/2022|.46346|03/29/2022|||LIPOTROPICS: STATINS|18552|||||No|No||ASCEND LABORATO|No||||
ezetimibe/simvastatin|No|No|No|No|75%|67877051090|EZETIMIBE-SIMVASTATIN 10-80 MG|90|EA|.45866|05/30/2018||Yes|No||05/30/2018||Yes|No|05/30/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|063|Yes|.47172|03/29/2022|.46039|03/29/2022|.46346|03/29/2022|||LIPOTROPICS: STATINS|18553|||||No|No||ASCEND LABORATO|No||||
atorvastatin calcium|Yes|No|No|No|75%|67877051105|ATORVASTATIN 10 MG TABLET|500|EA|.05494|12/02/2019||Yes|No||12/02/2019||Yes|No|12/02/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|18554|||||No|No||ASCEND LABORATO|No||||
atorvastatin calcium|Yes|No|No|No|75%|67877051190|ATORVASTATIN 10 MG TABLET|90|EA|.05494|12/02/2019||Yes|No||12/02/2019||Yes|No|12/02/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|18555|||||No|No||ASCEND LABORATO|No||||
atorvastatin calcium|Yes|No|No|No|75%|67877051210|ATORVASTATIN 20 MG TABLET|1000|EA|.06855|05/30/2019||Yes|No||05/30/2019||Yes|No|05/30/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|18556|||||No|No||ASCEND LABORATO|No||||
atorvastatin calcium|Yes|No|No|No|75%|67877051290|ATORVASTATIN 20 MG TABLET|90|EA|.06855|05/30/2019||Yes|No||05/30/2019||Yes|No|05/30/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|18557|||||No|No||ASCEND LABORATO|No||||
atorvastatin calcium|No|No|No|No|75%|67877051310|ATORVASTATIN 40 MG TABLET|1000|EA|.07591|03/04/2022||Yes|No||03/04/2022||Yes|No|03/04/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|18558|||||No|No||ASCEND LABORATO|No||||
atorvastatin calcium|Yes|No|No|No|75%|67877051390|ATORVASTATIN 40 MG TABLET|90|EA|.07591|05/31/2019||Yes|No||05/31/2019||Yes|No|05/31/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|18559|||||No|No||ASCEND LABORATO|No||||
atorvastatin calcium|Yes|No|No|No|75%|67877051405|ATORVASTATIN 80 MG TABLET|500|EA|.07811|09/30/2019||Yes|No||09/30/2019||Yes|No|09/30/2019||Yes|No||||No|No|01/15/2020||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|18560|||||No|No||ASCEND LABORATO|No||||
atorvastatin calcium|Yes|No|No|No|75%|67877051490|ATORVASTATIN 80 MG TABLET|90|EA|.07811|05/31/2019||Yes|No||05/31/2019||Yes|No|05/31/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|18561|||||No|No||ASCEND LABORATO|No||||
colesevelam HCl|No|No|No|No|75%|67877052330|COLESEVELAM HCL 3.75 G PACKET|30|EA|3.79833|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|055|No|9.26917|03/29/2022|9.0467|03/29/2022|9.10695|03/29/2022|||LIPOTROPICS: OTHER|18562|||||No|No||ASCEND LABORATO|No||||
ranolazine|No|No|No|No|75%|67877052560|RANOLAZINE ER 500 MG TABLET|60|EA|.12541|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No|||Yes|.28604|03/29/2022|.27917|03/29/2022|.28103|03/29/2022||||18563|||||No|No||ASCEND LABORATO|No||||
ranolazine|No|No|No|No|75%|67877052660|RANOLAZINE ER 1,000 MG TABLET|60|EA|.20102|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No|||Yes|.43283|03/29/2022|.42244|03/29/2022|.42525|03/29/2022||||18564|||||No|No||ASCEND LABORATO|No||||
solifenacin succinate|No|No|No|No|75%|67877052730|SOLIFENACIN 5 MG TABLET|30|EA|.172|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|Yes|.23024|03/29/2022|.22471|03/29/2022|.22621|03/29/2022|||BLADDER RELAXANT PREPARATIONS|18565|||||No|No||ASCEND LABORATO|No||||
solifenacin succinate|No|No|No|No|75%|67877052790|SOLIFENACIN 5 MG TABLET|90|EA|.172|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|Yes|.23024|03/29/2022|.22471|03/29/2022|.22621|03/29/2022|||BLADDER RELAXANT PREPARATIONS|18566|||||No|No||ASCEND LABORATO|No||||
solifenacin succinate|No|No|No|No|75%|67877052830|SOLIFENACIN 10 MG TABLET|30|EA|.215|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|No|.26101|03/29/2022|.25474|03/29/2022|.25644|03/29/2022|||BLADDER RELAXANT PREPARATIONS|18567|||||No|No||ASCEND LABORATO|No||||
solifenacin succinate|No|No|No|No|75%|67877052890|SOLIFENACIN 10 MG TABLET|90|EA|.215|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|No|.26101|03/29/2022|.25474|03/29/2022|.25644|03/29/2022|||BLADDER RELAXANT PREPARATIONS|18568|||||No|No||ASCEND LABORATO|No||||
cefdinir|No|No|No|No|75%|67877054360|CEFDINIR 300 MG CAPSULE|60|EA|.35833|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|No||046|No|.46443|03/29/2022|.45328|03/29/2022|.4563|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18569|||||No|No||ASCEND LABORATO|No||||
cephalexin|No|No|No|No|75%|67877054468|CEPHALEXIN 125 MG/5 ML SUSP|200|ML|.03655|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||||No|No|||Prescription required|No||046|No|.0415|10/26/2021|.0405|10/26/2021|.04077|10/26/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18570|||||No|No||ASCEND LABORATO|No||||
cephalexin|No|No|No|No|75%|67877054488|CEPHALEXIN 125 MG/5 ML SUSP|100|ML|.03848|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||||No|No|||Prescription required|No||046|No|.0819|03/29/2022|.07993|03/29/2022|.08046|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18571|||||No|No||ASCEND LABORATO|No||||
cephalexin|No|No|No|No|75%|67877054568|CEPHALEXIN 250 MG/5 ML SUSP|200|ML|.056|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||||No|No|||Prescription required|No||046|No|.07683|03/29/2022|.07498|03/29/2022|.07548|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18572|||||No|No||ASCEND LABORATO|No||||
cephalexin|No|No|No|No|75%|67877054588|CEPHALEXIN 250 MG/5 ML SUSP|100|ML|.05568|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||||No|No|||Prescription required|No||046|No|.09997|03/29/2022|.09757|03/29/2022|.09822|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18573|||||No|No||ASCEND LABORATO|No||||
cefdinir|No|No|No|No|75%|67877054788|CEFDINIR 125 MG/5 ML SUSP|100|ML|.0645|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No||046|No|.11292|03/29/2022|.1102|03/29/2022|.11094|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18574|||||No|No||ASCEND LABORATO|No||||
cefdinir|No|No|No|No|75%|67877054888|CEFDINIR 250 MG/5 ML SUSP|100|ML|.0645|08/04/2021||Yes|No||08/04/2021||Yes|No|08/04/2021||Yes|No||||No|No|||Prescription required|No||046|No|.18689|03/29/2022|.1824|03/29/2022|.18361|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18575|||||No|No||ASCEND LABORATO|No||||
cefdinir|No|No|No|No|75%|67877054898|CEFDINIR 250 MG/5 ML SUSP|60|ML|.07166|08/04/2021||Yes|No||08/04/2021||Yes|No|08/04/2021||Yes|No||||No|No|||Prescription required|No||046|No|.18029|03/29/2022|.17596|03/29/2022|.17713|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18576|||||No|No||ASCEND LABORATO|No||||
deferasirox|No|No|No|No|75%|67877054930|DEFERASIROX 125 MG TB FOR SUSP|30|EA|.71595|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|No|||No|1.6317|03/06/2020|1.60839|03/06/2020|1.5318|03/06/2020||||18577|||||No|No||ASCEND LABORATO|No||||
deferasirox|No|No|No|No|75%|67877055030|DEFERASIROX 250 MG TB FOR SUSP|30|EA|1.4319|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|No|||No|3.2634|03/06/2020|3.21678|03/06/2020|3.0636|03/06/2020||||18578|||||No|No||ASCEND LABORATO|No||||
deferasirox|No|No|No|No|75%|67877055130|DEFERASIROX 500 MG TB FOR SUSP|30|EA|2.8638|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|No|||No|6.5268|03/06/2020|6.43356|03/06/2020|6.1272|03/06/2020||||18579|||||No|No||ASCEND LABORATO|No||||
deferasirox|No|No|No|No|75%|67877055230|DEFERASIROX 90 MG TABLET|30|EA|.33468|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|No|||No|.76276|03/28/2022|.75186|03/28/2022|.71606|03/28/2022||||18580|||||No|No||ASCEND LABORATO|No||||
deferasirox|No|No|No|No|75%|67877055430|DEFERASIROX 360 MG TABLET|30|EA|1.21833|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|No|||No|2.77666|03/28/2022|2.73699|03/28/2022|2.60666|03/28/2022||||18581|||||No|No||ASCEND LABORATO|No||||
dimethyl fumarate|No|No|No|No|75%|67877055514|DIMETHYL FUMARATE DR 120 MG CP|14|EA|3.37857|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|No||043|No|6.92871|10/26/2021|6.76242|10/26/2021|6.80745|10/26/2021|||MULTIPLE SCLEROSIS AGENTS|18582|||||No|No||ASCEND LABORATO|No||||
dimethyl fumarate|No|No|No|No|75%|67877055660|DIMETHYL FUMARATE DR 240 MG CP|60|EA|1.6125|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No||043|No|3.05522|11/23/2021|2.98189|11/23/2021|3.00175|11/23/2021|||MULTIPLE SCLEROSIS AGENTS|18583|||||No|No||ASCEND LABORATO|No||||
metformin HCl|Yes|No|No|No|75%|67877056101|METFORMIN HCL 500 MG TABLET|100|EA|.01315|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|01/30/2018||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|18584|||||No|No||ASCEND LABORATO|No||||
metformin HCl|Yes|No|No|No|75%|67877056105|METFORMIN HCL 500 MG TABLET|500|EA|.01066|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|01/30/2018||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|18585|||||No|No||ASCEND LABORATO|No||||
metformin HCl|Yes|No|No|No|75%|67877056110|METFORMIN HCL 500 MG TABLET|1000|EA|.01018|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|01/30/2018||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|18586|||||No|No||ASCEND LABORATO|No||||
metformin HCl|No|No|No|No|75%|67877056201|METFORMIN HCL 850 MG TABLET|100|EA|.02343|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|18587|||||No|No||ASCEND LABORATO|No||||
metformin HCl|No|No|No|No|75%|67877056205|METFORMIN HCL 850 MG TABLET|500|EA|.0199|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|18588|||||No|No||ASCEND LABORATO|No||||
metformin HCl|No|No|No|No|75%|67877056210|METFORMIN HCL 850 MG TABLET|1000|EA|.01932|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|18589|||||No|No||ASCEND LABORATO|No||||
metformin HCl|No|No|No|No|75%|67877056301|METFORMIN HCL 1,000 MG TABLET|100|EA|.02558|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|18590|||||No|No||ASCEND LABORATO|No||||
metformin HCl|No|No|No|No|75%|67877056305|METFORMIN HCL 1,000 MG TABLET|500|EA|.02129|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|18591|||||No|No||ASCEND LABORATO|No||||
metformin HCl|No|No|No|No|75%|67877056310|METFORMIN HCL 1,000 MG TABLET|1000|EA|.01925|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|18592|||||No|No||ASCEND LABORATO|No||||
dronabinol|No|No|No|No|75%|67877056860|DRONABINOL 2.5 MG CAPSULE|60|EA|.7249|02/02/2018|06/21/2022|Yes|No||02/02/2018|06/21/2022|Yes|No|02/02/2018|06/21/2022|Yes|No||||No|No|||Prescription required|Yes|03/09/2018|085|No|1.39891|03/29/2022|1.36533|03/29/2022|1.37442|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|18593|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ASCEND LABORATO|No||||
dronabinol|No|No|No|No|75%|67877056960|DRONABINOL 5 MG CAPSULE|60|EA|1.33658|02/02/2018|02/08/2022|Yes|No||02/02/2018|02/08/2022|Yes|No|02/02/2018|02/08/2022|Yes|No||||No|No|||Prescription required|Yes|03/09/2018|085|No|2.55851|03/29/2022|2.4971|03/29/2022|2.51373|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|18594|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ASCEND LABORATO|No||||
dronabinol|No|No|No|No|75%|67877057060|DRONABINOL 10 MG CAPSULE|60|EA|2.21306|02/01/2018|04/01/2022|Yes|No||02/01/2018|04/01/2022|Yes|No|02/01/2018|04/01/2022|Yes|No||||No|No|||Prescription required|Yes|03/09/2018|085|No|3.9278|03/29/2022|3.83353|03/29/2022|3.85906|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|18595|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||ASCEND LABORATO|No||||
esomeprazole magnesium|No|No|No|No|75%|67877057130|ESOMEPRAZOLE MAG DR 20 MG CAP|30|EA|.18561|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|18596|||||No|No||ASCEND LABORATO|No||||
esomeprazole magnesium|No|No|No|No|75%|67877057190|ESOMEPRAZOLE MAG DR 20 MG CAP|90|EA|.09507|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|18597|||||No|No||ASCEND LABORATO|No||||
esomeprazole magnesium|No|No|No|No|75%|67877057210|ESOMEPRAZOLE MAG DR 40 MG CAP|1000|EA|.08533|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|18598|||||No|No||ASCEND LABORATO|No||||
esomeprazole magnesium|No|No|No|No|75%|67877057230|ESOMEPRAZOLE MAG DR 40 MG CAP|30|EA|.18561|08/23/2021||Yes|No||08/23/2021||Yes|No|08/23/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|18599|||||No|No||ASCEND LABORATO|No||||
esomeprazole magnesium|No|No|No|No|75%|67877057290|ESOMEPRAZOLE MAG DR 40 MG CAP|90|EA|.09507|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|18600|||||No|No||ASCEND LABORATO|No||||
benzonatate|No|No|No|No|75%|67877057301|BENZONATATE 100 MG CAPSULE|100|EA|.07353|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No||184|Yes|.09389|03/29/2022|.09163|03/29/2022|.09224|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|18601|||||No|No||ASCEND LABORATO|No||||
benzonatate|No|No|No|No|75%|67877057305|BENZONATATE 100 MG CAPSULE|500|EA|.06204|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|No||184|Yes|.09389|03/29/2022|.09163|03/29/2022|.09224|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|18602|||||No|No||ASCEND LABORATO|No||||
benzonatate|No|No|No|No|75%|67877057401|BENZONATATE 150 MG CAPSULE|100|EA|.94772|03/13/2018||Yes|No||03/13/2018||Yes|No|03/13/2018||Yes|No||||No|No|||Prescription required|No||184|Yes|2.15992|03/13/2018|2.12906|03/13/2018|2.02768|03/13/2018|||COUGH AND COLD: NON-NARCOTIC|18603|||||No|No||ASCEND LABORATO|No||||
benzonatate|No|No|No|No|75%|67877057501|BENZONATATE 200 MG CAPSULE|100|EA|.11545|03/13/2018||Yes|No||03/13/2018||Yes|No|03/13/2018||Yes|No||||No|No|||Prescription required|No||184|Yes|.14345|03/29/2022|.14|03/29/2022|.14093|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|18604|||||No|No||ASCEND LABORATO|No||||
benzonatate|No|No|No|No|75%|67877057505|BENZONATATE 200 MG CAPSULE|500|EA|.08385|03/13/2018||Yes|No||03/13/2018||Yes|No|03/13/2018||Yes|No||||No|No|||Prescription required|No||184|Yes|.14345|03/29/2022|.14|03/29/2022|.14093|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|18605|||||No|No||ASCEND LABORATO|No||||
minocycline HCl|No|No|No|No|75%|67877057630|MINOCYCLINE ER 90 MG TABLET|30|EA|1.52291|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|3.47082|11/30/2018|3.42124|11/30/2018|3.25832|11/30/2018|||TETRACYCLINES|18606|||||No|No||ASCEND LABORATO|No||||
minocycline HCl|No|No|No|No|75%|67877057730|MINOCYCLINE ER 135 MG TABLET|30|EA|1.52291|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|3.47082|11/30/2018|3.42124|11/30/2018|3.25832|11/30/2018|||TETRACYCLINES|18607|||||No|No||ASCEND LABORATO|No||||
minocycline HCl|No|No|No|No|75%|67877057830|MINOCYCLINE ER 45 MG TABLET|30|EA|1.52291|05/29/2019||Yes|No||05/29/2019||Yes|No|05/29/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|3.47082|05/29/2019|3.42124|05/29/2019|3.25832|05/29/2019|||TETRACYCLINES|18608|||||No|No||ASCEND LABORATO|No||||
cefixime|No|No|No|No|75%|67877058450|CEFIXIME 400 MG CAPSULE|50|EA|5.16|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|046|No|11.76|11/23/2021|11.592|11/23/2021|11.04|11/23/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18609|||||No|No||ASCEND LABORATO|No||||
colchicine|No|No|No|No|75%|67877058901|COLCHICINE 0.6 MG TABLET|100|EA|.473|06/12/2020||Yes|No||06/12/2020||Yes|No|06/12/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|231|No|.64179|03/29/2022|.62638|03/29/2022|.63055|03/29/2022|||ANTIHYPERURICEMICS|18610|||||No|No||ASCEND LABORATO|No||||
metoprolol succinate|No|No|No|No|75%|67877059001|METOPROLOL SUCC ER 25 MG TAB|100|EA|.02687|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|18611|||||No|No||ASCEND LABORATO|No||||
metoprolol succinate|No|No|No|No|75%|67877059005|METOPROLOL SUCC ER 25 MG TAB|500|EA|.01935|01/07/2022||Yes|No||01/07/2022||Yes|No|01/07/2022||Yes|No||||No|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|18612|||||No|No||ASCEND LABORATO|No||||
metoprolol succinate|No|No|No|No|75%|67877059101|METOPROLOL SUCC ER 50 MG TAB|100|EA|.02687|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|18613|||||No|No||ASCEND LABORATO|No||||
metoprolol succinate|No|No|No|No|75%|67877059105|METOPROLOL SUCC ER 50 MG TAB|500|EA|.01935|01/07/2022||Yes|No||01/07/2022||Yes|No|01/07/2022||Yes|No||||No|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|18614|||||No|No||ASCEND LABORATO|No||||
metoprolol succinate|No|No|No|No|75%|67877059201|METOPROLOL SUCC ER 100 MG TAB|100|EA|.03977|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|18615|||||No|No||ASCEND LABORATO|No||||
metoprolol succinate|No|No|No|No|75%|67877059205|METOPROLOL SUCC ER 100 MG TAB|500|EA|.03784|12/28/2021||Yes|No||12/28/2021||Yes|No|12/28/2021||Yes|No||||No|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|18616|||||No|No||ASCEND LABORATO|No||||
metoprolol succinate|No|No|No|No|75%|67877059301|METOPROLOL SUCC ER 200 MG TAB|100|EA|.0645|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|No||070|No|.25385|03/29/2022|.24775|03/29/2022|.2494|03/29/2022|||BETA-BLOCKERS|18617|||||No|No||ASCEND LABORATO|No||||
tizanidine HCl|No|No|No|No|75%|67877061015|TIZANIDINE HCL 2 MG CAPSULE|150|EA|.10033|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|No|.0903|03/29/2022|.08813|03/29/2022|.08871|03/29/2022|||SKELETAL MUSCLE RELAXANTS|18618|||||No|No||ASCEND LABORATO|No||||
tizanidine HCl|No|No|No|No|75%|67877061115|TIZANIDINE HCL 4 MG CAPSULE|150|EA|.14046|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|No|.15367|03/29/2022|.14998|03/29/2022|.15098|03/29/2022|||SKELETAL MUSCLE RELAXANTS|18619|||||No|No||ASCEND LABORATO|No||||
tizanidine HCl|No|No|No|No|75%|67877061215|TIZANIDINE HCL 6 MG CAPSULE|150|EA|.18862|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|No|.27523|03/29/2022|.26862|03/29/2022|.27041|03/29/2022|||SKELETAL MUSCLE RELAXANTS|18620|||||No|No||ASCEND LABORATO|No||||
tizanidine HCl|No|No|No|No|75%|67877061315|TIZANIDINE HCL 2 MG TABLET|150|EA|.02279|02/27/2020||Yes|No||02/27/2020||Yes|No|02/27/2020||Yes|No||||No|No|||Prescription required|No||116|No|.06018|03/29/2022|.05873|03/29/2022|.05912|03/29/2022|||SKELETAL MUSCLE RELAXANTS|18621|||||No|No||ASCEND LABORATO|No||||
tizanidine HCl|No|No|No|No|75%|67877061415|TIZANIDINE HCL 4 MG TABLET|150|EA|.02788|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No||||No|No|||Prescription required|No||116|No|.05014|03/29/2022|.04893|03/29/2022|.04926|03/29/2022|||SKELETAL MUSCLE RELAXANTS|18622|||||No|No||ASCEND LABORATO|No||||
methylphenidate HCl|No|No|No|No|75%|67877061601|METHYLPHENIDATE 5 MG TABLET|100|EA|.04149|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.1394|03/29/2022|.13605|03/29/2022|.13696|03/29/2022|||STIMULANTS AND RELATED AGENTS|18623|||||No|No||ASCEND LABORATO|No||||
methylphenidate HCl|No|No|No|No|75%|67877061701|METHYLPHENIDATE 10 MG TABLET|100|EA|.05375|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.15766|03/29/2022|.15387|03/29/2022|.1549|03/29/2022|||STIMULANTS AND RELATED AGENTS|18624|||||No|No||ASCEND LABORATO|No||||
methylphenidate HCl|No|No|No|No|75%|67877061801|METHYLPHENIDATE 20 MG TABLET|100|EA|.06493|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.22814|03/29/2022|.22266|03/29/2022|.22414|03/29/2022|||STIMULANTS AND RELATED AGENTS|18625|||||No|No||ASCEND LABORATO|No||||
ibuprofen/famotidine|No|No|No|No|75%|67877062690|IBUPROFEN-FAMOTIDIN 800-26.6MG|90|EA|1.93021|12/13/2021||Yes|No||12/13/2021||Yes|No|12/13/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|059|Yes|3.80728|03/01/2022|3.7159|03/01/2022|3.74065|03/01/2022|||NSAIDS|18626|||||No|No||ASCEND LABORATO|No||||
tolvaptan|No|No|No|No|75%|67877063602|TOLVAPTAN 30 MG TABLET|10|EA|206.62575|10/05/2020||Yes|No||10/05/2020||Yes|No|10/05/2020||Yes|No||||No|No|||Prescription required|No|||No|470.9145|10/05/2020|464.18715|10/05/2020|442.083|10/13/2020||||18627|||||No|No||ASCEND LABORATO|No||||
tolvaptan|No|No|No|No|75%|67877063633|TOLVAPTAN 30 MG TABLET|10|EA|206.62575|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No|||No|470.9145|08/26/2021|464.18715|08/26/2021|442.083|08/31/2021||||18628|||||No|No||ASCEND LABORATO|No||||
minocycline HCl|No|No|No|No|75%|67877064330|MINOCYCLINE ER 65 MG TABLET|30|EA|2.59791|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|5.92082|11/30/2018|5.83624|11/30/2018|5.55832|11/30/2018|||TETRACYCLINES|18629|||||No|No||ASCEND LABORATO|No||||
minocycline HCl|No|No|No|No|75%|67877064430|MINOCYCLINE ER 115 MG TABLET|30|EA|2.59791|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|5.92082|11/30/2018|5.83624|11/30/2018|5.55832|11/30/2018|||TETRACYCLINES|18630|||||No|No||ASCEND LABORATO|No||||
clobazam|No|No|No|No|90%|67877065861|CLOBAZAM 2.5 MG/ML SUSPENSION|120|ML|.19708|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||056|No|.50176|03/29/2022|.48971|03/29/2022|.49297|03/29/2022|||ANTICONVULSANTS|18631|||||No|No||ASCEND LABORATO|No||||
clobazam|No|No|No|No|90%|67877066501|CLOBAZAM 10 MG TABLET|100|EA|.13244|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|No||056|No|.37729|03/29/2022|.36823|03/29/2022|.37068|03/29/2022|||ANTICONVULSANTS|18632|||||No|No||ASCEND LABORATO|No||||
clobazam|No|No|No|No|90%|67877066601|CLOBAZAM 20 MG TABLET|100|EA|.2107|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|No||056|No|.71967|03/29/2022|.70239|03/29/2022|.70707|03/29/2022|||ANTICONVULSANTS|18633|||||No|No||ASCEND LABORATO|No||||
morphine sulfate|No|No|No|No|90%|67877067001|MORPHINE SULFATE IR 15 MG TAB|100|EA|.16469|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||109|Yes|.29802|03/29/2022|.29086|03/29/2022|.2928|03/29/2022|||ANALGESICS: NARCOTICS SHORT|18634|||||No|No||ASCEND LABORATO|No||||
morphine sulfate|No|No|No|No|90%|67877067101|MORPHINE SULFATE IR 30 MG TAB|100|EA|.27692|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||109|Yes|.43937|03/29/2022|.42882|03/29/2022|.43168|03/29/2022|||ANALGESICS: NARCOTICS SHORT|18635|||||No|No||ASCEND LABORATO|No||||
rufinamide|No|No|No|No|75%|67877067362|RUFINAMIDE 40 MG/ML SUSPENSION|460|ML|1.12395|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||056|No|1.88512|03/01/2022|1.83987|03/01/2022|1.85213|03/01/2022|||ANTICONVULSANTS|18636|||||No|No||ASCEND LABORATO|No||||
vigabatrin|No|No|No|No|75%|67877067463|VIGABATRIN 500 MG POWDER PACKT|50|EA|4.34644|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||056|No|9.90584|06/08/2021|9.76432|06/08/2021|9.29936|06/08/2021|||ANTICONVULSANTS|18637|||||No|No||ASCEND LABORATO|No||||
deferasirox|No|No|No|No|75%|67877067584|DEFERASIROX 90 MG GRANULE PKT|30|EA|15.43442|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|No|||No|35.17612|11/24/2020|34.6736|11/24/2020|33.02248|11/24/2020||||18638|||||No|No||ASCEND LABORATO|No||||
deferasirox|No|No|No|No|75%|67877067684|DEFERASIROX 180 MG GRANULE PKT|30|EA|30.86826|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|No|||No|70.35092|11/24/2020|69.34591|11/24/2020|66.04372|11/24/2020||||18639|||||No|No||ASCEND LABORATO|No||||
deferasirox|No|No|No|No|75%|67877067784|DEFERASIROX 360 MG GRANULE PKT|30|EA|61.73538|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|No|||No|140.69924|11/24/2020|138.68925|11/24/2020|132.085|11/24/2020||||18640|||||No|No||ASCEND LABORATO|No||||
chlorthalidone|No|No|No|No|75%|67877069601|CHLORTHALIDONE 25 MG TABLET|100|EA|.07955|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|No|||No|.16117|03/29/2022|.1573|03/29/2022|.15834|03/29/2022||||18641|||||No|No||ASCEND LABORATO|No||||
chlorthalidone|No|No|No|No|75%|67877069701|CHLORTHALIDONE 50 MG TABLET|100|EA|.0946|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|No|||No|.3607|03/29/2022|.35204|03/29/2022|.35438|03/29/2022||||18642|||||No|No||ASCEND LABORATO|No||||
droxidopa|No|No|No|No|75%|67877070490|DROXIDOPA 100 MG CAPSULE|90|EA|.66888|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No|||No|1.52443|06/08/2021|1.50266|06/08/2021|1.4311|06/08/2021||||18643|||||No|No||ASCEND LABORATO|No||||
droxidopa|No|No|No|No|75%|67877070590|DROXIDOPA 200 MG CAPSULE|90|EA|1.39363|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No|||No|3.17618|06/08/2021|3.1308|06/08/2021|2.98172|06/08/2021||||18644|||||No|No||ASCEND LABORATO|No||||
droxidopa|No|No|No|No|75%|67877070690|DROXIDOPA 300 MG CAPSULE|90|EA|1.99104|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No|||No|4.53772|06/08/2021|4.47289|06/08/2021|4.2599|06/08/2021||||18645|||||No|No||ASCEND LABORATO|No||||
mesalamine|No|No|No|No|75%|67877071712|MESALAMINE ER 0.375 GRAM CAP|120|EA|.94062|12/28/2021||Yes|No||12/28/2021||Yes|No|12/28/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|010|No|1.86918|03/29/2022|1.82431|03/29/2022|1.83646|03/29/2022|||ULCERATIVE COLITIS AGENTS|18646|||||No|No||ASCEND LABORATO|No||||
everolimus|No|No|No|No|75%|67877071831|EVEROLIMUS 0.25 MG TABLET|60|EA|1.79166|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|229|No|4.08332|03/28/2022|4.02499|03/28/2022|3.83332|03/28/2022|||IMMUNOSUPPRESSIVES: ORAL|18647|||||No|No||ASCEND LABORATO|No||||
everolimus|No|No|No|No|75%|67877071931|EVEROLIMUS 0.5 MG TABLET|60|EA|3.5242|03/30/2022||Yes|No||03/30/2022||Yes|No|03/30/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|229|No|8.03191|03/30/2022|7.91717|03/30/2022|7.54016|03/30/2022|||IMMUNOSUPPRESSIVES: ORAL|18648|||||No|No||ASCEND LABORATO|No||||
everolimus|No|No|No|No|75%|67877072031|EVEROLIMUS 0.75 MG TABLET|60|EA|5.375|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|229|No|12.25|03/28/2022|12.075|03/28/2022|11.5|03/28/2022|||IMMUNOSUPPRESSIVES: ORAL|18649|||||No|No||ASCEND LABORATO|No||||
everolimus|No|No|No|No|75%|67877072131|EVEROLIMUS 1 MG TABLET|60|EA|14.67375|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|229|No|33.4425|03/28/2022|32.96475|03/28/2022|31.395|03/28/2022|||IMMUNOSUPPRESSIVES: ORAL|18650|||||No|No||ASCEND LABORATO|No||||
venlafaxine HCl|No|No|No|No|75%|67877072630|VENLAFAXINE HCL ER 37.5 MG TAB|30|EA|.36693|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|Yes|1.96254|03/02/2022|1.91543|03/02/2022|1.92819|03/02/2022|||ANTIDEPRESSANTS: OTHER|18651|||||No|No||ASCEND LABORATO|No||||
venlafaxine HCl|No|No|No|No|75%|67877072730|VENLAFAXINE HCL ER 75 MG TAB|30|EA|.44505|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|Yes|1.5965|03/29/2022|1.55818|03/29/2022|1.56856|03/29/2022|||ANTIDEPRESSANTS: OTHER|18652|||||No|No||ASCEND LABORATO|No||||
venlafaxine HCl|No|No|No|No|75%|67877072790|VENLAFAXINE HCL ER 75 MG TAB|90|EA|.44505|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|Yes|1.5965|03/28/2022|1.55818|03/28/2022|1.56856|03/28/2022|||ANTIDEPRESSANTS: OTHER|18653|||||No|No||ASCEND LABORATO|No||||
venlafaxine HCl|No|No|No|No|75%|67877072830|VENLAFAXINE HCL ER 150 MG TAB|30|EA|.15093|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|2.65947|03/29/2022|2.59564|03/29/2022|2.61292|03/29/2022|||ANTIDEPRESSANTS: OTHER|18654|||||No|No||ASCEND LABORATO|No||||
venlafaxine HCl|No|No|No|No|75%|67877072890|VENLAFAXINE HCL ER 150 MG TAB|90|EA|.15093|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|2.65947|03/28/2022|2.59564|03/28/2022|2.61292|03/28/2022|||ANTIDEPRESSANTS: OTHER|18655|||||No|No||ASCEND LABORATO|No||||
venlafaxine HCl|No|No|No|No|75%|67877072930|VENLAFAXINE HCL ER 225 MG TAB|30|EA|.45737|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|3.46235|03/29/2022|3.37925|03/29/2022|3.40175|03/29/2022|||ANTIDEPRESSANTS: OTHER|18656|||||No|No||ASCEND LABORATO|No||||
venlafaxine HCl|No|No|No|No|75%|67877072990|VENLAFAXINE HCL ER 225 MG TAB|90|EA|.45737|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|3.46235|03/28/2022|3.37925|03/28/2022|3.40175|03/28/2022|||ANTIDEPRESSANTS: OTHER|18657|||||No|No||ASCEND LABORATO|No||||
chlordiazepoxide/clidinium Br|No|No|No|No|75%|67877073101|CHLORDIAZEPOXIDE-CLIDINIUM CAP|100|EA|.18275|08/23/2021||Yes|No||08/23/2021||Yes|No|08/23/2021||Yes|No||||No|No|||Prescription required|No|||Yes|.95937|03/29/2022|.93634|03/29/2022|.94258|03/29/2022||||18658|||||No|No||ASCEND LABORATO|No||||
sirolimus|No|No|No|No|75%|67877074601|SIROLIMUS 0.5 MG TABLET|100|EA|2.37523|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|229|No|4.84817|03/29/2022|4.73181|03/29/2022|4.76332|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|18659|||||No|No||ASCEND LABORATO|No||||
sirolimus|No|No|No|No|75%|67877074701|SIROLIMUS 1 MG TABLET|100|EA|2.46914|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|229|No|5.87013|03/29/2022|5.72924|03/29/2022|5.7674|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|18660|||||No|No||ASCEND LABORATO|No||||
sirolimus|No|No|No|No|75%|67877074801|SIROLIMUS 2 MG TABLET|100|EA|4.29062|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|229|No|9.77863|08/24/2021|9.63894|08/24/2021|9.17994|08/24/2021|||IMMUNOSUPPRESSIVES: ORAL|18661|||||No|No||ASCEND LABORATO|No||||
fosfomycin tromethamine|No|No|No|No|75%|67877074957|FOSFOMYCIN 3 GM SACHET|1|EA|30.014|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|No|||No|68.855|03/28/2022|67.20248|03/28/2022|67.65003|03/28/2022||||18662|||||No|No||ASCEND LABORATO|No||||
dronabinol|No|No|No|No|75%|67877075360|DRONABINOL 2.5 MG CAPSULE|60|EA|.7249|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|085|No|1.39891|03/29/2022|1.36533|03/29/2022|1.37442|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|18663|||||No|No||ASCEND LABORATO|No||||
dronabinol|No|No|No|No|75%|67877075460|DRONABINOL 5 MG CAPSULE|60|EA|1.33658|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|085|No|2.55851|03/29/2022|2.4971|03/29/2022|2.51373|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|18664|||||No|No||ASCEND LABORATO|No||||
dronabinol|No|No|No|No|75%|67877075560|DRONABINOL 10 MG CAPSULE|60|EA|2.21306|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|085|No|3.9278|03/29/2022|3.83353|03/29/2022|3.85906|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|18665|||||No|No||ASCEND LABORATO|No||||
daptomycin|No|No|No|No|75%|67919001101|CUBICIN 500 MG VIAL|1|EA|191.5607|08/08/2007||Yes|No||08/08/2007||Yes|No|08/08/2007||Yes|No||||No|No|||Prescription required|No|||No|436.5802|06/01/2016|430.34334|06/01/2016|409.8508|06/01/2016||||18666|||||No|No||MERCK SHARP & D|No||||
daptomycin|No|No|No|No|75%|67919001201|CUBICIN RF 500 MG VIAL|1|EA|191.5607|11/03/2016||Yes|No||11/03/2016||Yes|No|11/03/2016||Yes|No||||No|No|||Prescription required|No|||No|436.5802|11/03/2016|430.34334|11/03/2016|409.8508|11/03/2016||||18667|||||No|No||MERCK SHARP & D|No||||
daptomycin|No|No|No|No|75%|67919001202|CUBICIN RF 500 MG VIAL|1|EA|191.5607|11/03/2016||Yes|No||11/03/2016||Yes|No|11/03/2016||Yes|No||||No|No|||Prescription required|No|||No|436.5802|11/03/2016|430.34334|11/03/2016|409.8508|11/03/2016||||18668|||||No|No||MERCK SHARP & D|No||||
tedizolid phosphate|No|No|No|No|75%|67919004001|SIVEXTRO 200 MG VIAL|1|EA|132.3282|11/09/2016||Yes|No||11/09/2016||Yes|No|11/09/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|146|No|301.5852|01/14/2020|297.27684|01/14/2020|283.1208|01/14/2020|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|18669|||||No|No||MERCK SHARP & D|No||||
tedizolid phosphate|No|No|No|No|75%|67919004101|SIVEXTRO 200 MG TABLET|30|EA|166.1219|08/24/2015||Yes|No||08/24/2015||Yes|No|08/24/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|146|No|378.6034|01/14/2020|373.19478|01/14/2020|355.4236|01/14/2020|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|18670|||||No|No||MERCK SHARP & D|No||||
tedizolid phosphate|No|No|No|No|75%|67919004102|SIVEXTRO 200 MG TABLET|6|EA|166.1219|08/24/2015||Yes|No||08/24/2015||Yes|No|08/24/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|146|No|378.6034|01/14/2020|373.19478|01/14/2020|355.4236|01/14/2020|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|18671|||||No|No||MERCK SHARP & D|No||||
metaxalone|No|No|No|No|75%|68001000400|METAXALONE 800 MG TABLET|100|EA|.87556|02/11/2014||Yes|No||02/11/2014||Yes|No|02/11/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|116|Yes|.52754|03/29/2022|.51487|03/29/2022|.5183|03/29/2022|||SKELETAL MUSCLE RELAXANTS|18672|||||No|No||BLUEPOINT LABOR|No||||
methylprednisolone|No|No|No|No|75%|68001000501|METHYLPREDNISOLONE 4 MG DOSEPK|21|EA|.2453|02/11/2014||Yes|No||02/11/2014||Yes|No|02/11/2014||Yes|No||||No|No|||Prescription required|No||168|Yes|.17447|03/29/2022|.17028|03/29/2022|.17141|03/29/2022|||GLUCOCORTICOIDS: ORAL|18673|||||No|No||BLUEPOINT LABOR|No||||
divalproex sodium|No|No|No|No|75%|68001010500|DIVALPROEX SOD ER 250 MG TAB|100|EA|.33243|02/11/2014||Yes|No||02/11/2014||Yes|No|02/11/2014||Yes|No||||No|No|||Prescription required|No||056|Yes|.17839|03/29/2022|.1741|03/29/2022|.17526|03/29/2022|||ANTICONVULSANTS|18674|||||No|No||BLUEPOINT LABOR|No||||
divalproex sodium|No|No|No|No|75%|68001010503|DIVALPROEX SOD ER 250 MG TAB|500|EA|.32899|02/11/2014||Yes|No||02/11/2014||Yes|No|02/11/2014||Yes|No||||No|No|||Prescription required|No||056|Yes|.17839|03/29/2022|.1741|03/29/2022|.17526|03/29/2022|||ANTICONVULSANTS|18675|||||No|No||BLUEPOINT LABOR|No||||
divalproex sodium|No|No|No|No|75%|68001010600|DIVALPROEX SOD ER 500 MG TAB|100|EA|.37547|02/11/2014||Yes|No||02/11/2014||Yes|No|02/11/2014||Yes|No||||No|No|||Prescription required|No||056|No|.21008|03/29/2022|.20503|03/29/2022|.2064|03/29/2022|||ANTICONVULSANTS|18676|||||No|No||BLUEPOINT LABOR|No||||
divalproex sodium|No|No|No|No|75%|68001010603|DIVALPROEX SOD ER 500 MG TAB|500|EA|.36802|02/11/2014||Yes|No||02/11/2014||Yes|No|02/11/2014||Yes|No||||No|No|||Prescription required|No||056|No|.21008|03/29/2022|.20503|03/29/2022|.2064|03/29/2022|||ANTICONVULSANTS|18677|||||No|No||BLUEPOINT LABOR|No||||
lansoprazole|No|No|No|No|75%|68001011104|LANSOPRAZOLE DR 15 MG CAPSULE|30|EA|.36535|03/18/2014||Yes|No||03/18/2014||Yes|No|03/18/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|Yes|.24898|03/29/2022|.243|03/29/2022|.24462|03/29/2022|||PROTON PUMP INHIBITORS|18678|||||No|No||BLUEPOINT LABOR|No||||
lansoprazole|No|No|No|No|75%|68001011105|LANSOPRAZOLE DR 15 MG CAPSULE|90|EA|.36406|04/29/2014||Yes|No||04/29/2014||Yes|No|04/29/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|Yes|.24898|03/29/2022|.243|03/29/2022|.24462|03/29/2022|||PROTON PUMP INHIBITORS|18679|||||No|No||BLUEPOINT LABOR|No||||
lansoprazole|No|No|No|No|75%|68001011203|LANSOPRAZOLE DR 30 MG CAPSULE|500|EA|.129|04/29/2014||Yes|No||04/29/2014||Yes|No|04/29/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.12249|03/29/2022|.11955|03/29/2022|.12034|03/29/2022|||PROTON PUMP INHIBITORS|18680|||||No|No||BLUEPOINT LABOR|No||||
lansoprazole|No|No|No|No|75%|68001011205|LANSOPRAZOLE DR 30 MG CAPSULE|90|EA|.16125|04/29/2014||Yes|No||04/29/2014||Yes|No|04/29/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.12249|03/29/2022|.11955|03/29/2022|.12034|03/29/2022|||PROTON PUMP INHIBITORS|18681|||||No|No||BLUEPOINT LABOR|No||||
levetiracetam|No|No|No|No|75%|68001011306|LEVETIRACETAM ER 500 MG TABLET|60|EA|.2228|04/30/2014||Yes|No||04/30/2014||Yes|No|04/30/2014||Yes|No||||No|No|||Prescription required|No||056|No|.22713|03/29/2022|.22167|03/29/2022|.22315|03/29/2022|||ANTICONVULSANTS|18682|||||No|No||BLUEPOINT LABOR|No||||
levetiracetam|No|No|No|No|75%|68001011406|LEVETIRACETAM ER 750 MG TABLET|60|EA|.32938|04/30/2014||Yes|No||04/30/2014||Yes|No|04/30/2014||Yes|No||||No|No|||Prescription required|No||056|No|.36799|03/29/2022|.35915|03/29/2022|.36155|03/29/2022|||ANTICONVULSANTS|18683|||||No|No||BLUEPOINT LABOR|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|68001013000|AMLODIPINE-BENAZEPRIL 10-20 MG|100|EA|.15217|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|No||017|No|.14427|03/29/2022|.1408|03/29/2022|.14174|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|18684|||||No|No||BLUEPOINT LABOR|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|68001013100|AMLODIPINE-BENAZEPRIL 10-40 MG|100|EA|.15325|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|No||017|No|.17354|03/29/2022|.16937|03/29/2022|.1705|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|18685|||||No|No||BLUEPOINT LABOR|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|68001013200|AMLODIPINE-BENAZEPRIL 2.5-10|100|EA|.19638|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|No||017|No|.11834|03/29/2022|.11549|03/29/2022|.11626|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|18686|||||No|No||BLUEPOINT LABOR|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|68001013300|AMLODIPINE-BENAZEPRIL 5-10 MG|100|EA|.15578|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|No||017|No|.11526|03/29/2022|.11249|03/29/2022|.11324|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|18687|||||No|No||BLUEPOINT LABOR|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|68001013400|AMLODIPINE-BENAZEPRIL 5-20 MG|100|EA|.1336|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|No||017|No|.13285|03/29/2022|.12966|03/29/2022|.13052|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|18688|||||No|No||BLUEPOINT LABOR|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|68001013500|AMLODIPINE-BENAZEPRIL 5-40 MG|100|EA|.19745|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|No||017|No|.15246|03/29/2022|.1488|03/29/2022|.14979|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|18689|||||No|No||BLUEPOINT LABOR|No||||
carvedilol|No|No|No|No|75%|68001015100|CARVEDILOL 12.5 MG TABLET|100|EA|.0215|03/18/2014||Yes|No||03/18/2014||Yes|No|03/18/2014||Yes|No||||No|No|||Prescription required|No||070|No|.02277|03/29/2022|.02222|03/29/2022|.02237|03/29/2022|||BETA-BLOCKERS|18690|||||No|No||BLUEPOINT LABOR|No||||
carvedilol|No|No|No|No|75%|68001015103|CARVEDILOL 12.5 MG TABLET|500|EA|.02096|03/18/2014||Yes|No||03/18/2014||Yes|No|03/18/2014||Yes|No||||No|No|||Prescription required|No||070|No|.02277|03/29/2022|.02222|03/29/2022|.02237|03/29/2022|||BETA-BLOCKERS|18691|||||No|No||BLUEPOINT LABOR|No||||
carvedilol|No|No|No|No|75%|68001015200|CARVEDILOL 25 MG TABLET|100|EA|.0215|03/18/2014||Yes|No||03/18/2014||Yes|No|03/18/2014||Yes|No||||No|No|||Prescription required|No||070|No|.03449|03/29/2022|.03366|03/29/2022|.03388|03/29/2022|||BETA-BLOCKERS|18692|||||No|No||BLUEPOINT LABOR|No||||
carvedilol|No|No|No|No|75%|68001015203|CARVEDILOL 25 MG TABLET|500|EA|.02096|03/18/2014||Yes|No||03/18/2014||Yes|No|03/18/2014||Yes|No||||No|No|||Prescription required|No||070|No|.03449|03/29/2022|.03366|03/29/2022|.03388|03/29/2022|||BETA-BLOCKERS|18693|||||No|No||BLUEPOINT LABOR|No||||
carvedilol|No|No|No|No|75%|68001015300|CARVEDILOL 3.125 MG TABLET|100|EA|.0215|03/18/2014||Yes|No||03/18/2014||Yes|No|03/18/2014||Yes|No||||No|No|||Prescription required|No||070|No|.01877|03/29/2022|.01831|03/29/2022|.01844|03/29/2022|||BETA-BLOCKERS|18694|||||No|No||BLUEPOINT LABOR|No||||
carvedilol|No|No|No|No|75%|68001015303|CARVEDILOL 3.125 MG TABLET|500|EA|.02096|03/18/2014||Yes|No||03/18/2014||Yes|No|03/18/2014||Yes|No||||No|No|||Prescription required|No||070|No|.01877|03/29/2022|.01831|03/29/2022|.01844|03/29/2022|||BETA-BLOCKERS|18695|||||No|No||BLUEPOINT LABOR|No||||
carvedilol|No|No|No|No|75%|68001015400|CARVEDILOL 6.25 MG TABLET|100|EA|.0215|03/18/2014||Yes|No||03/18/2014||Yes|No|03/18/2014||Yes|No||||No|No|||Prescription required|No||070|No|.02069|03/29/2022|.02019|03/29/2022|.02032|03/29/2022|||BETA-BLOCKERS|18696|||||No|No||BLUEPOINT LABOR|No||||
carvedilol|No|No|No|No|75%|68001015403|CARVEDILOL 6.25 MG TABLET|500|EA|.02096|03/18/2014||Yes|No||03/18/2014||Yes|No|03/18/2014||Yes|No||||No|No|||Prescription required|No||070|No|.02069|03/29/2022|.02019|03/29/2022|.02032|03/29/2022|||BETA-BLOCKERS|18697|||||No|No||BLUEPOINT LABOR|No||||
anastrozole|No|No|No|No|75%|68001015504|ANASTROZOLE 1 MG TABLET|30|EA|.215|02/12/2014||Yes|No||02/12/2014||Yes|No|02/12/2014||Yes|No||||No|No|||Prescription required|No||502|No|.11251|03/29/2022|.1098|03/29/2022|.11054|03/29/2022|||ONCOLOGY: ORAL - BREAST|18698|||||No|No||BLUEPOINT LABOR|No||||
anastrozole|No|No|No|No|75%|68001015508|ANASTROZOLE 1 MG TABLET|1000|EA|.12771|02/12/2014||Yes|No||02/12/2014||Yes|No|02/12/2014||Yes|No||||No|No|||Prescription required|No||502|No|.11251|03/29/2022|.1098|03/29/2022|.11054|03/29/2022|||ONCOLOGY: ORAL - BREAST|18699|||||No|No||BLUEPOINT LABOR|No||||
venlafaxine HCl|No|No|No|No|75%|68001015600|VENLAFAXINE HCL 100 MG TABLET|100|EA|.1634|02/12/2014||Yes|No||02/12/2014||Yes|No|02/12/2014||Yes|No||||No|No|||Prescription required|No||031|No|.13788|03/29/2022|.13457|03/29/2022|.13546|03/29/2022|||ANTIDEPRESSANTS: OTHER|18700|||||No|No||BLUEPOINT LABOR|No||||
venlafaxine HCl|No|No|No|No|75%|68001015700|VENLAFAXINE HCL 25 MG TABLET|100|EA|.1376|02/12/2014||Yes|No||02/12/2014||Yes|No|02/12/2014||Yes|No||||No|No|||Prescription required|No||031|No|.11374|03/29/2022|.11101|03/29/2022|.11174|03/29/2022|||ANTIDEPRESSANTS: OTHER|18701|||||No|No||BLUEPOINT LABOR|No||||
venlafaxine HCl|No|No|No|No|75%|68001015800|VENLAFAXINE HCL 37.5 MG TABLET|100|EA|.1419|02/12/2014||Yes|No||02/12/2014||Yes|No|02/12/2014||Yes|No||||No|No|||Prescription required|No||031|Yes|.11453|03/29/2022|.11178|03/29/2022|.11252|03/29/2022|||ANTIDEPRESSANTS: OTHER|18702|||||No|No||BLUEPOINT LABOR|No||||
venlafaxine HCl|No|No|No|No|75%|68001015900|VENLAFAXINE HCL 50 MG TABLET|100|EA|.1462|02/12/2014||Yes|No||02/12/2014||Yes|No|02/12/2014||Yes|No||||No|No|||Prescription required|No||031|No|.12769|03/29/2022|.12462|03/29/2022|.12545|03/29/2022|||ANTIDEPRESSANTS: OTHER|18703|||||No|No||BLUEPOINT LABOR|No||||
venlafaxine HCl|No|No|No|No|75%|68001016000|VENLAFAXINE HCL 75 MG TABLET|100|EA|.10457|02/12/2014||Yes|No||02/12/2014||Yes|No|02/12/2014||Yes|No||||No|No|||Prescription required|No||031|No|.10828|03/29/2022|.10568|03/29/2022|.10638|03/29/2022|||ANTIDEPRESSANTS: OTHER|18704|||||No|No||BLUEPOINT LABOR|No||||
promethazine HCl|No|No|No|No|75%|68001016100|PROMETHAZINE 12.5 MG TABLET|100|EA|.04945|03/18/2014||Yes|No||03/18/2014||Yes|No|03/18/2014||Yes|No||||No|No|||Prescription required|No||085|Yes|.05281|03/29/2022|.05154|03/29/2022|.05188|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|18705|||||No|No||BLUEPOINT LABOR|No||||
promethazine HCl|No|No|No|No|75%|68001016200|PROMETHAZINE 25 MG TABLET|100|EA|.04988|03/18/2014||Yes|No||03/18/2014||Yes|No|03/18/2014||Yes|No||||No|No|||Prescription required|No||085|Yes|.05271|03/29/2022|.05144|03/29/2022|.05178|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|18706|||||No|No||BLUEPOINT LABOR|No||||
promethazine HCl|No|No|No|No|75%|68001016208|PROMETHAZINE 25 MG TABLET|1000|EA|.03981|03/18/2014||Yes|No||03/18/2014||Yes|No|03/18/2014||Yes|No||||No|No|||Prescription required|No||085|Yes|.05271|03/29/2022|.05144|03/29/2022|.05178|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|18707|||||No|No||BLUEPOINT LABOR|No||||
promethazine HCl|No|No|No|No|75%|68001016300|PROMETHAZINE 50 MG TABLET|100|EA|.08987|03/18/2014||Yes|No||03/18/2014||Yes|No|03/18/2014||Yes|No||||No|No|||Prescription required|No||085|Yes|.09825|03/29/2022|.09589|03/29/2022|.09653|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|18708|||||No|No||BLUEPOINT LABOR|No||||
carbidopa/levodopa|No|No|No|No|75%|68001017100|CARBIDOPA-LEVO ER 25-100 TAB|100|EA|.29708|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|No||015|No|.21193|03/29/2022|.20684|03/29/2022|.20822|03/29/2022|||ANTIPARKINSON'S AGENTS|18709|||||No|No||BLUEPOINT LABOR|No||||
carbidopa/levodopa|No|No|No|No|75%|68001017200|CARBIDOPA-LEVO ER 50-200 TAB|100|EA|.30078|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|No||015|No|.29671|03/29/2022|.28958|03/29/2022|.29151|03/29/2022|||ANTIPARKINSON'S AGENTS|18710|||||No|No||BLUEPOINT LABOR|No||||
glimepiride|Yes|No|No|No|75%|68001017700|GLIMEPIRIDE 1 MG TABLET|100|EA|.04841|04/30/2014||Yes|No||04/30/2014||Yes|No|04/30/2014||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.03361|03/29/2022|.0328|03/29/2022|.03302|03/29/2022||||18711|||||No|No||BLUEPOINT LABOR|No||||
glimepiride|Yes|No|No|No|75%|68001017703|GLIMEPIRIDE 1 MG TABLET|500|EA|.05155|12/04/2014||Yes|No||12/04/2014||Yes|No|12/04/2014||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.03361|03/29/2022|.0328|03/29/2022|.03302|03/29/2022||||18712|||||No|No||BLUEPOINT LABOR|No||||
glimepiride|Yes|No|No|No|75%|68001017800|GLIMEPIRIDE 2 MG TABLET|100|EA|.08066|04/30/2014||Yes|No||04/30/2014||Yes|No|04/30/2014||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.03979|03/29/2022|.03883|03/29/2022|.03909|03/29/2022||||18713|||||No|No||BLUEPOINT LABOR|No||||
glimepiride|Yes|No|No|No|75%|68001017803|GLIMEPIRIDE 2 MG TABLET|500|EA|.07106|12/04/2014||Yes|No||12/04/2014||Yes|No|12/04/2014||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.03979|03/29/2022|.03883|03/29/2022|.03909|03/29/2022||||18714|||||No|No||BLUEPOINT LABOR|No||||
glimepiride|Yes|No|No|No|75%|68001017900|GLIMEPIRIDE 4 MG TABLET|100|EA|.15785|04/30/2014||Yes|No||04/30/2014||Yes|No|04/30/2014||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.04419|03/29/2022|.04312|03/29/2022|.04341|03/29/2022||||18715|||||No|No||BLUEPOINT LABOR|No||||
glimepiride|Yes|No|No|No|75%|68001017903|GLIMEPIRIDE 4 MG TABLET|500|EA|.13758|12/04/2014||Yes|No||12/04/2014||Yes|No|12/04/2014||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.04419|03/29/2022|.04312|03/29/2022|.04341|03/29/2022||||18716|||||No|No||BLUEPOINT LABOR|No||||
quetiapine fumarate|No|No|No|No|75%|68001018000|QUETIAPINE FUMARATE 50 MG TAB|100|EA|.07641|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.04283|03/29/2022|.0418|03/29/2022|.04208|03/29/2022|||ANTIPSYCHOTICS|18717|||||No|No||BLUEPOINT LABOR|No||||
quetiapine fumarate|No|No|No|No|75%|68001018008|QUETIAPINE FUMARATE 50 MG TAB|1000|EA|.07275|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.04283|03/29/2022|.0418|03/29/2022|.04208|03/29/2022|||ANTIPSYCHOTICS|18718|||||No|No||BLUEPOINT LABOR|No||||
quetiapine fumarate|No|No|No|No|75%|68001018100|QUETIAPINE FUMARATE 400 MG TAB|100|EA|.24243|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.17858|03/29/2022|.17429|03/29/2022|.17545|03/29/2022|||ANTIPSYCHOTICS|18719|||||No|No||BLUEPOINT LABOR|No||||
quetiapine fumarate|No|No|No|No|75%|68001018103|QUETIAPINE FUMARATE 400 MG TAB|500|EA|.23742|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.17858|03/29/2022|.17429|03/29/2022|.17545|03/29/2022|||ANTIPSYCHOTICS|18720|||||No|No||BLUEPOINT LABOR|No||||
quetiapine fumarate|No|No|No|No|75%|68001018200|QUETIAPINE FUMARATE 200 MG TAB|100|EA|.15531|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.10261|03/29/2022|.10014|03/29/2022|.10081|03/29/2022|||ANTIPSYCHOTICS|18721|||||No|No||BLUEPOINT LABOR|No||||
quetiapine fumarate|No|No|No|No|75%|68001018203|QUETIAPINE FUMARATE 200 MG TAB|500|EA|.15141|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.10261|03/29/2022|.10014|03/29/2022|.10081|03/29/2022|||ANTIPSYCHOTICS|18722|||||No|No||BLUEPOINT LABOR|No||||
quetiapine fumarate|No|No|No|No|75%|68001018300|QUETIAPINE FUMARATE 300 MG TAB|100|EA|.21912|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.13964|03/29/2022|.13628|03/29/2022|.13719|03/29/2022|||ANTIPSYCHOTICS|18723|||||No|No||BLUEPOINT LABOR|No||||
quetiapine fumarate|No|No|No|No|75%|68001018303|QUETIAPINE FUMARATE 300 MG TAB|500|EA|.21366|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.13964|03/29/2022|.13628|03/29/2022|.13719|03/29/2022|||ANTIPSYCHOTICS|18724|||||No|No||BLUEPOINT LABOR|No||||
quetiapine fumarate|No|No|No|No|75%|68001018306|QUETIAPINE FUMARATE 300 MG TAB|60|EA|.21915|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.13964|03/29/2022|.13628|03/29/2022|.13719|03/29/2022|||ANTIPSYCHOTICS|18725|||||No|No||BLUEPOINT LABOR|No||||
quetiapine fumarate|No|No|No|No|75%|68001018400|QUETIAPINE FUMARATE 100 MG TAB|100|EA|.08535|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.05826|03/29/2022|.05686|03/29/2022|.05724|03/29/2022|||ANTIPSYCHOTICS|18726|||||No|No||BLUEPOINT LABOR|No||||
quetiapine fumarate|No|No|No|No|75%|68001018408|QUETIAPINE FUMARATE 100 MG TAB|1000|EA|.08238|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.05826|03/29/2022|.05686|03/29/2022|.05724|03/29/2022|||ANTIPSYCHOTICS|18727|||||No|No||BLUEPOINT LABOR|No||||
quetiapine fumarate|No|No|No|No|75%|68001018500|QUETIAPINE FUMARATE 25 MG TAB|100|EA|.05263|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.03239|03/29/2022|.03161|03/29/2022|.03182|03/29/2022|||ANTIPSYCHOTICS|18728|||||No|No||BLUEPOINT LABOR|No||||
quetiapine fumarate|No|No|No|No|75%|68001018508|QUETIAPINE FUMARATE 25 MG TAB|1000|EA|.04984|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||027|Yes|.03239|03/29/2022|.03161|03/29/2022|.03182|03/29/2022|||ANTIPSYCHOTICS|18729|||||No|No||BLUEPOINT LABOR|No||||
quinapril HCl|Yes|No|No|No|75%|68001018705|QUINAPRIL 20 MG TABLET|90|EA|.07166|04/30/2014||Yes|No||04/30/2014||Yes|No|04/30/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.08843|03/29/2022|.0863|03/29/2022|.08688|03/29/2022|||ANGIOTENSIN MODULATORS|18730|||||No|No||BLUEPOINT LABOR|No||||
quinapril HCl|No|No|No|No|75%|68001018805|QUINAPRIL 10 MG TABLET|90|EA|.07166|04/30/2014||Yes|No||04/30/2014||Yes|No|04/30/2014||Yes|No||||No|No|||Prescription required|No||113|No|.08121|03/29/2022|.07926|03/29/2022|.07978|03/29/2022|||ANGIOTENSIN MODULATORS|18731|||||No|No||BLUEPOINT LABOR|No||||
quinapril HCl|Yes|No|No|No|75%|68001018905|QUINAPRIL 5 MG TABLET|90|EA|.07166|04/30/2014||Yes|No||04/30/2014||Yes|No|04/30/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.11066|03/29/2022|.108|03/29/2022|.10872|03/29/2022|||ANGIOTENSIN MODULATORS|18732|||||No|No||BLUEPOINT LABOR|No||||
escitalopram oxalate|Yes|No|No|No|75%|68001019500|ESCITALOPRAM 5 MG TABLET|100|EA|.0645|05/30/2014|02/23/2022|Yes|No||05/30/2014|02/23/2022|Yes|No|05/30/2014|02/23/2022|Yes|No||||No|No|07/01/2016|02/23/2022|Prescription required|No||008|Yes|.0462|03/29/2022|.04509|03/29/2022|.04539|03/29/2022|||ANTIDEPRESSANTS: SSRIs|18733|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPOINT LABOR|No||||
escitalopram oxalate|Yes|No|No|No|75%|68001019600|ESCITALOPRAM 10 MG TABLET|100|EA|.0688|05/30/2014|06/07/2022|Yes|No||05/30/2014|06/07/2022|Yes|No|05/30/2014|06/07/2022|Yes|No||||No|No|07/01/2016|06/07/2022|Prescription required|No||008|Yes|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIDEPRESSANTS: SSRIs|18734|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPOINT LABOR|No||||
escitalopram oxalate|Yes|No|No|No|75%|68001019603|ESCITALOPRAM 10 MG TABLET|500|EA|.0688|05/30/2014|06/07/2022|Yes|No||05/30/2014|06/07/2022|Yes|No|05/30/2014|06/07/2022|Yes|No||||No|No|07/01/2016|06/07/2022|Prescription required|No||008|Yes|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIDEPRESSANTS: SSRIs|18735|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPOINT LABOR|No||||
escitalopram oxalate|Yes|No|No|No|75%|68001019700|ESCITALOPRAM 20 MG TABLET|100|EA|.0731|05/30/2014|02/23/2022|Yes|No||05/30/2014|02/23/2022|Yes|No|05/30/2014|02/23/2022|Yes|No||||No|No|07/01/2016|02/23/2022|Prescription required|No||008|No|.07845|03/29/2022|.07656|03/29/2022|.07707|03/29/2022|||ANTIDEPRESSANTS: SSRIs|18736|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPOINT LABOR|No||||
escitalopram oxalate|Yes|No|No|No|75%|68001019703|ESCITALOPRAM 20 MG TABLET|500|EA|.0731|05/30/2014|02/23/2022|Yes|No||05/30/2014|02/23/2022|Yes|No|05/30/2014|02/23/2022|Yes|No||||No|No|07/01/2016|02/23/2022|Prescription required|No||008|No|.07845|03/29/2022|.07656|03/29/2022|.07707|03/29/2022|||ANTIDEPRESSANTS: SSRIs|18737|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPOINT LABOR|No||||
nadolol|No|No|No|No|75%|68001022008|NADOLOL 40 MG TABLET|1000|EA|1.38004|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|070|No|.40202|03/29/2022|.39237|03/29/2022|.39498|03/29/2022|||BETA-BLOCKERS|18738|||||No|No||BLUEPOINT LABOR|No||||
isosorbide dinitrate|No|No|No|No|75%|68001022308|ISOSORBIDE DINITRATE 5 MG TAB|1000|EA|.33885|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|No|||No|.32336|03/29/2022|.31559|03/29/2022|.3177|03/29/2022||||18739|||||No|No||BLUEPOINT LABOR|No||||
metronidazole|Yes|No|No|No|75%|68001022903|METRONIDAZOLE 250 MG TABLET|500|EA|.12407|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|04/16/2014||Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|18740|||||No|No||BLUEPOINT LABOR|No||||
diclofenac sodium/misoprostol|No|No|No|No|75%|68001023106|DICLOFENAC-MISOPROST 50-0.2 MG|60|EA|1.1534|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|1.41801|03/29/2022|1.38397|03/29/2022|1.39319|03/29/2022|||NSAIDS|18741|||||No|No||BLUEPOINT LABOR|No||||
diclofenac sodium/misoprostol|No|No|No|No|75%|68001023206|DICLOFENAC-MISOPROST 75-0.2 MG|60|EA|1.09578|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|1.61285|03/29/2022|1.57414|03/29/2022|1.58462|03/29/2022|||NSAIDS|18742|||||No|No||BLUEPOINT LABOR|No||||
potassium chloride|No|No|No|No|75%|68001023500|POTASSIUM CL ER 20 MEQ TABLET|100|EA|.21581|04/16/2014|03/10/2022|Yes|No||04/16/2014|03/10/2022|Yes|No|04/16/2014|03/10/2022|Yes|No||||No|No|||Prescription required|No|||No|.19104|03/29/2022|.18645|03/29/2022|.18769|03/29/2022||||18743|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPOINT LABOR|No||||
potassium chloride|No|No|No|No|75%|68001023503|POTASSIUM CL ER 20 MEQ TABLET|500|EA|.21579|04/16/2014|04/30/2022|Yes|No||04/16/2014|04/30/2022|Yes|No|04/16/2014|04/30/2022|Yes|No||||No|No|||Prescription required|No|||No|.19104|03/29/2022|.18645|03/29/2022|.18769|03/29/2022||||18744|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPOINT LABOR|No||||
potassium chloride|No|No|No|No|75%|68001023508|POTASSIUM CL ER 20 MEQ TABLET|1000|EA|.21579|07/03/2014|02/28/2022|Yes|No||07/03/2014|02/28/2022|Yes|No|07/03/2014|02/28/2022|Yes|No||||No|No|||Prescription required|No|||No|.49181|03/15/2022|.48478|03/15/2022|.4617|03/15/2022||||18745|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||BLUEPOINT LABOR|No||||
clonidine HCl|No|No|No|No|75%|68001023700|CLONIDINE HCL 0.1 MG TABLET|100|EA|.01814|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|No||166|No|.03029|03/29/2022|.02956|03/29/2022|.02975|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|18746|||||No|No||BLUEPOINT LABOR|No||||
clonidine HCl|No|No|No|No|75%|68001023703|CLONIDINE HCL 0.1 MG TABLET|500|EA|.01823|04/29/2014||Yes|No||04/29/2014||Yes|No|04/29/2014||Yes|No||||No|No|||Prescription required|No||166|No|.03029|03/29/2022|.02956|03/29/2022|.02975|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|18747|||||No|No||BLUEPOINT LABOR|No||||
clonidine HCl|No|No|No|No|75%|68001023800|CLONIDINE HCL 0.2 MG TABLET|100|EA|.02494|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|No||166|No|.0396|03/29/2022|.03864|03/29/2022|.0389|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|18748|||||No|No||BLUEPOINT LABOR|No||||
clonidine HCl|No|No|No|No|75%|68001023803|CLONIDINE HCL 0.2 MG TABLET|500|EA|.02232|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|No||166|No|.0396|03/29/2022|.03864|03/29/2022|.0389|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|18749|||||No|No||BLUEPOINT LABOR|No||||
clonidine HCl|No|No|No|No|75%|68001023900|CLONIDINE HCL 0.3 MG TABLET|100|EA|.02769|04/16/2014||Yes|No||04/16/2014||Yes|No|04/16/2014||Yes|No||||No|No|||Prescription required|No||166|No|.03883|03/29/2022|.03789|03/29/2022|.03815|03/29/2022|||ANTIHYPERTENSIVES: SYMPATHOLYTICS|18750|||||No|No||BLUEPOINT LABOR|No||||
zonisamide|No|No|No|No|75%|68001024200|ZONISAMIDE 25 MG CAPSULE|100|EA|.08987|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||056|No|.08772|03/29/2022|.08561|03/29/2022|.08618|03/29/2022|||ANTICONVULSANTS|18751|||||No|No||BLUEPOINT LABOR|No||||
zonisamide|No|No|No|No|75%|68001024300|ZONISAMIDE 50 MG CAPSULE|100|EA|.1053|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||056|No|.11305|03/29/2022|.11033|03/29/2022|.11107|03/29/2022|||ANTICONVULSANTS|18752|||||No|No||BLUEPOINT LABOR|No||||
zonisamide|No|No|No|No|75%|68001024400|ZONISAMIDE 100 MG CAPSULE|100|EA|.2107|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||056|No|.12763|03/29/2022|.12456|03/29/2022|.12539|03/29/2022|||ANTICONVULSANTS|18753|||||No|No||BLUEPOINT LABOR|No||||
zonisamide|No|No|No|No|75%|68001024403|ZONISAMIDE 100 MG CAPSULE|500|EA|.20016|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||056|No|.12763|03/29/2022|.12456|03/29/2022|.12539|03/29/2022|||ANTICONVULSANTS|18754|||||No|No||BLUEPOINT LABOR|No||||
atovaquone/proguanil HCl|No|No|No|No|75%|68001024500|ATOVAQUONE-PROGUANIL 250-100|100|EA|2.45972|04/30/2014||Yes|No||04/30/2014||Yes|No|04/30/2014||Yes|No||||No|No|||Prescription required|No|||No|2.47536|03/29/2022|2.41595|03/29/2022|2.43204|03/29/2022||||18755|||||No|No||BLUEPOINT LABOR|No||||
atovaquone/proguanil HCl|No|No|No|No|75%|68001024515|ATOVAQUONE-PROGUANIL 250-100|24|EA|2.50976|04/30/2014||Yes|No||04/30/2014||Yes|No|04/30/2014||Yes|No||||No|No|||Prescription required|No|||No|2.47536|03/29/2022|2.41595|03/29/2022|2.43204|03/29/2022||||18756|||||No|No||BLUEPOINT LABOR|No||||
ondansetron|No|No|No|No|75%|68001024604|ONDANSETRON ODT 4 MG TABLET|30|EA|.26301|06/11/2018||Yes|No||06/11/2018||Yes|No|06/11/2018||Yes|No||||No|No|||Prescription required|No||085|No|.24125|03/29/2022|.23546|03/29/2022|.23702|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|18757|||||No|No||BLUEPOINT LABOR|No||||
ondansetron|No|No|No|No|75%|68001024617|ONDANSETRON ODT 4 MG TABLET|30|EA|.29612|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||085|No|.24125|03/29/2022|.23546|03/29/2022|.23702|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|18758|||||No|No||BLUEPOINT LABOR|No||||
ondansetron|No|No|No|No|75%|68001024704|ONDANSETRON ODT 8 MG TABLET|30|EA|.36335|06/11/2018||Yes|No||06/11/2018||Yes|No|06/11/2018||Yes|No||||No|No|||Prescription required|No||085|No|.24386|03/29/2022|.238|03/29/2022|.23959|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|18759|||||No|No||BLUEPOINT LABOR|No||||
ondansetron|No|No|No|No|75%|68001024717|ONDANSETRON ODT 8 MG TABLET|30|EA|.48432|05/30/2014||Yes|No||05/30/2014||Yes|No|05/30/2014||Yes|No||||No|No|||Prescription required|No||085|No|.24386|03/29/2022|.238|03/29/2022|.23959|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|18760|||||No|No||BLUEPOINT LABOR|No||||
zolmitriptan|No|No|No|No|75%|68001024901|ZOLMITRIPTAN 2.5 MG TABLET|6|EA|3.0057|10/07/2014||Yes|No||10/07/2014||Yes|No|10/07/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|1.43567|03/29/2022|1.40121|03/29/2022|1.41054|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|18761|||||No|No||BLUEPOINT LABOR|No||||
zolmitriptan|No|No|No|No|75%|68001025001|ZOLMITRIPTAN 5 MG TABLET|3|EA|4.67983|10/07/2014||Yes|No||10/07/2014||Yes|No|10/07/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|1.62826|03/29/2022|1.58918|03/29/2022|1.59976|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|18762|||||No|No||BLUEPOINT LABOR|No||||
fluconazole|No|No|No|No|75%|68001025104|FLUCONAZOLE 50 MG TABLET|30|EA|.48174|04/30/2014||Yes|No||04/30/2014||Yes|No|04/30/2014||Yes|No||||No|No|||Prescription required|No||069|No|.43933|03/29/2022|.42878|03/29/2022|.43164|03/29/2022|||ANTIFUNGALS: ORAL|18763|||||No|No||BLUEPOINT LABOR|No||||
fluconazole|No|No|No|No|75%|68001025204|FLUCONAZOLE 100 MG TABLET|30|EA|.64299|04/30/2014||Yes|No||04/30/2014||Yes|No|04/30/2014||Yes|No||||No|No|||Prescription required|No||069|No|.34281|03/29/2022|.33458|03/29/2022|.33681|03/29/2022|||ANTIFUNGALS: ORAL|18764|||||No|No||BLUEPOINT LABOR|No||||
fluconazole|Yes|No|No|No|75%|68001025320|FLUCONAZOLE 150 MG TABLET|12|EA|.8668|04/30/2014|12/22/2022|Yes|No||04/30/2014|12/22/2022|Yes|No|04/30/2014|12/22/2022|Yes|No||||No|No|04/30/2014|12/22/2022|Prescription required|No||069|No|.74933|03/29/2022|.73134|03/29/2022|.73621|03/29/2022|||ANTIFUNGALS: ORAL|18765|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPOINT LABOR|No||||
fluconazole|No|No|No|No|75%|68001025404|FLUCONAZOLE 200 MG TABLET|30|EA|.82244|04/30/2014||Yes|No||04/30/2014||Yes|No|04/30/2014||Yes|No||||No|No|||Prescription required|No||069|No|.52936|03/29/2022|.51665|03/29/2022|.52009|03/29/2022|||ANTIFUNGALS: ORAL|18766|||||No|No||BLUEPOINT LABOR|No||||
quinapril HCl|Yes|No|No|No|75%|68001026005|QUINAPRIL 40 MG TABLET|90|EA|.07166|08/04/2015||Yes|No||08/04/2015||Yes|No|08/04/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.10852|03/29/2022|.10591|03/29/2022|.10662|03/29/2022|||ANGIOTENSIN MODULATORS|18767|||||No|No||BLUEPOINT LABOR|No||||
etoposide|No|No|No|No|75%|68001026525|ETOPOSIDE 100 MG/5 ML VIAL|5|ML|.80582|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No|||No|1.83652|06/01/2016|1.81028|06/01/2016|1.72408|06/01/2016||||18768|||||No|No||BLUEPOINT LABOR|No||||
etoposide|No|No|No|No|75%|68001026526|ETOPOSIDE 500 MG/25 ML VIAL|25|ML|.80582|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No|||No|1.83652|01/04/2022|1.81028|01/04/2022|1.72408|01/04/2022||||18769|||||No|No||BLUEPOINT LABOR|No||||
etoposide|No|No|No|No|75%|68001026527|ETOPOSIDE 1,000 MG/50 ML VIAL|50|ML|.80582|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No|||No|1.83652|01/04/2022|1.81028|01/04/2022|1.72408|01/04/2022||||18770|||||No|No||BLUEPOINT LABOR|No||||
fluorouracil|No|No|No|No|75%|68001026627|FLUOROURACIL 2.5 GRAM/50 ML VL|50|ML|.22102|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No|||No|.50372|03/13/2018|.49652|03/13/2018|.47288|03/13/2018||||18771|||||No|No||BLUEPOINT LABOR|No||||
fluorouracil|No|No|No|No|75%|68001026630|FLUOROURACIL 500 MG/10 ML VIAL|10|ML|.258|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No|||No|.588|12/14/2021|.5796|12/14/2021|.552|12/14/2021||||18772|||||No|No||BLUEPOINT LABOR|No||||
fluorouracil|No|No|No|No|75%|68001026631|FLUOROURACIL 1 GRAM/20 ML VIAL|20|ML|.258|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No|||No|.588|12/14/2021|.5796|12/14/2021|.552|12/14/2021||||18773|||||No|No||BLUEPOINT LABOR|No||||
fluorouracil|No|No|No|No|75%|68001026632|FLUOROURACIL 5 GRAM/100 ML VL|100|ML|.22102|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|No|||No|.50372|12/14/2021|.49652|12/14/2021|.47288|12/14/2021||||18774|||||No|No||BLUEPOINT LABOR|No||||
diclofenac sodium|No|No|No|No|75%|68001027900|DICLOFENAC SOD DR 25 MG TAB|100|EA|.45855|08/12/2016||Yes|No||08/12/2016||Yes|No|08/12/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.86294|03/29/2022|.84222|03/29/2022|.84783|03/29/2022|||NSAIDS|18775|||||No|No||BLUEPOINT LABOR|No||||
diclofenac sodium|No|No|No|No|75%|68001028000|DICLOFENAC SOD DR 50 MG TAB|100|EA|.10535|05/13/2016||Yes|No||05/13/2016||Yes|No|05/13/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.10202|03/29/2022|.09957|03/29/2022|.10023|03/29/2022|||NSAIDS|18776|||||No|No||BLUEPOINT LABOR|No||||
diclofenac sodium|No|No|No|No|75%|68001028006|DICLOFENAC SOD DR 50 MG TAB|60|EA|.11825|05/13/2016||Yes|No||05/13/2016||Yes|No|05/13/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.10202|03/29/2022|.09957|03/29/2022|.10023|03/29/2022|||NSAIDS|18777|||||No|No||BLUEPOINT LABOR|No||||
diclofenac sodium|No|No|No|No|75%|68001028008|DICLOFENAC SOD DR 50 MG TAB|1000|EA|.0989|05/13/2016||Yes|No||05/13/2016||Yes|No|05/13/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.10202|03/29/2022|.09957|03/29/2022|.10023|03/29/2022|||NSAIDS|18778|||||No|No||BLUEPOINT LABOR|No||||
diclofenac sodium|No|No|No|No|75%|68001028100|DICLOFENAC SOD DR 75 MG TAB|100|EA|.1161|05/13/2016||Yes|No||05/13/2016||Yes|No|05/13/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.09618|03/29/2022|.09387|03/29/2022|.09449|03/29/2022|||NSAIDS|18779|||||No|No||BLUEPOINT LABOR|No||||
diclofenac sodium|No|No|No|No|75%|68001028103|DICLOFENAC SOD DR 75 MG TAB|500|EA|.16239|05/13/2016||Yes|No||05/13/2016||Yes|No|05/13/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.09618|03/29/2022|.09387|03/29/2022|.09449|03/29/2022|||NSAIDS|18780|||||No|No||BLUEPOINT LABOR|No||||
diclofenac sodium|No|No|No|No|75%|68001028106|DICLOFENAC SOD DR 75 MG TAB|60|EA|.12183|05/13/2016||Yes|No||05/13/2016||Yes|No|05/13/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.09618|03/29/2022|.09387|03/29/2022|.09449|03/29/2022|||NSAIDS|18781|||||No|No||BLUEPOINT LABOR|No||||
diclofenac sodium|No|No|No|No|75%|68001028108|DICLOFENAC SOD DR 75 MG TAB|1000|EA|.1075|05/13/2016||Yes|No||05/13/2016||Yes|No|05/13/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.09618|03/29/2022|.09387|03/29/2022|.09449|03/29/2022|||NSAIDS|18782|||||No|No||BLUEPOINT LABOR|No||||
leucovorin calcium|No|No|No|No|75%|68001028536|LEUCOVORIN CALCIUM 100 MG VIAL|1|EA|8.6|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||||No|No|||Prescription required|No|||No|19.6|08/25/2017|19.32|08/25/2017|18.4|08/25/2017||||18783|||||No|No||BLUEPOINT LABOR|No||||
leucovorin calcium|No|No|No|No|75%|68001028537|LEUCOVORIN CALCIUM 200 MG VIAL|1|EA|17.2|08/25/2017||Yes|No||08/25/2017||Yes|No|08/25/2017||Yes|No||||No|No|||Prescription required|No|||No|39.2|08/25/2017|38.64|08/25/2017|36.8|08/25/2017||||18784|||||No|No||BLUEPOINT LABOR|No||||
leucovorin calcium|No|No|No|No|75%|68001028540|LEUCOVORIN CALCIUM 50 MG VIAL|1|EA|4.3|03/14/2017||Yes|No||03/14/2017||Yes|No|03/14/2017||Yes|No||||No|No|||Prescription required|No|||No|9.8|03/14/2017|9.66|03/14/2017|9.2|03/14/2017||||18785|||||No|No||BLUEPOINT LABOR|No||||
leucovorin calcium|No|No|No|No|75%|68001028638|LEUCOVORIN CALCIUM 350 MG VIAL|1|EA|30.1|03/15/2017||Yes|No||03/15/2017||Yes|No|03/15/2017||Yes|No||||No|No|||Prescription required|No|||No|68.6|03/15/2017|67.62|03/15/2017|64.4|03/15/2017||||18786|||||No|No||BLUEPOINT LABOR|No||||
bupropion HCl|No|No|No|No|75%|68001030800|BUPROPION HCL 75 MG TABLET|100|EA|.21504|05/31/2017||Yes|No||05/31/2017||Yes|No|05/31/2017||Yes|No||||No|No|||Prescription required|No||031|No|.12417|03/29/2022|.12118|03/29/2022|.12199|03/29/2022|||ANTIDEPRESSANTS: OTHER|18787|||||No|No||BLUEPOINT LABOR|No||||
bupropion HCl|No|No|No|No|75%|68001030900|BUPROPION HCL 100 MG TABLET|100|EA|.28681|05/31/2017||Yes|No||05/31/2017||Yes|No|05/31/2017||Yes|No||||No|No|||Prescription required|No||031|No|.14759|03/29/2022|.14404|03/29/2022|.145|03/29/2022|||ANTIDEPRESSANTS: OTHER|18788|||||No|No||BLUEPOINT LABOR|No||||
azacitidine|No|No|No|No|75%|68001031356|AZACITIDINE 100 MG VIAL|1|EA|133.8504|02/22/2018||Yes|No||02/22/2018||Yes|No|02/22/2018||Yes|No||||No|No|||Prescription required|No|||No|305.0544|01/04/2022|300.69648|01/04/2022|286.3776|01/04/2022||||18789|||||No|No||BLUEPOINT LABOR|No||||
lovastatin|No|No|No|No|75%|68001031400|LOVASTATIN 10 MG TABLET|100|EA|.05628|01/26/2018||Yes|No||01/26/2018||Yes|No|01/26/2018||Yes|No||||No|No|||Prescription required|No||063|Yes|.0534|03/29/2022|.05211|03/29/2022|.05246|03/29/2022|||LIPOTROPICS: STATINS|18790|||||No|No||BLUEPOINT LABOR|No||||
lovastatin|No|No|No|No|75%|68001031500|LOVASTATIN 20 MG TABLET|100|EA|.06557|11/20/2017||Yes|No||11/20/2017||Yes|No|11/20/2017||Yes|No||||No|No|||Prescription required|No||063|Yes|.04992|03/29/2022|.04872|03/29/2022|.04904|03/29/2022|||LIPOTROPICS: STATINS|18791|||||No|No||BLUEPOINT LABOR|No||||
lovastatin|No|No|No|No|75%|68001031508|LOVASTATIN 20 MG TABLET|1000|EA|.06229|11/20/2017||Yes|No||11/20/2017||Yes|No|11/20/2017||Yes|No||||No|No|||Prescription required|No||063|Yes|.04992|03/29/2022|.04872|03/29/2022|.04904|03/29/2022|||LIPOTROPICS: STATINS|18792|||||No|No||BLUEPOINT LABOR|No||||
lovastatin|No|No|No|No|75%|68001031600|LOVASTATIN 40 MG TABLET|100|EA|.0746|06/07/2017||Yes|No||06/07/2017||Yes|No|06/07/2017||Yes|No||||No|No|||Prescription required|No||063|Yes|.0616|03/29/2022|.06012|03/29/2022|.06052|03/29/2022|||LIPOTROPICS: STATINS|18793|||||No|No||BLUEPOINT LABOR|No||||
lovastatin|No|No|No|No|75%|68001031608|LOVASTATIN 40 MG TABLET|1000|EA|.07087|06/07/2017||Yes|No||06/07/2017||Yes|No|06/07/2017||Yes|No||||No|No|||Prescription required|No||063|Yes|.0616|03/29/2022|.06012|03/29/2022|.06052|03/29/2022|||LIPOTROPICS: STATINS|18794|||||No|No||BLUEPOINT LABOR|No||||
nadolol|No|No|No|No|75%|68001031700|NADOLOL 20 MG TABLET|100|EA|.79322|06/07/2017||Yes|No||06/07/2017||Yes|No|06/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|070|No|.34023|03/29/2022|.33206|03/29/2022|.33427|03/29/2022|||BETA-BLOCKERS|18795|||||No|No||BLUEPOINT LABOR|No||||
nadolol|No|No|No|No|75%|68001031800|NADOLOL 40 MG TABLET|100|EA|1.38004|06/07/2017||Yes|No||06/07/2017||Yes|No|06/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|070|No|.40202|03/29/2022|.39237|03/29/2022|.39498|03/29/2022|||BETA-BLOCKERS|18796|||||No|No||BLUEPOINT LABOR|No||||
nadolol|No|No|No|No|75%|68001031900|NADOLOL 80 MG TABLET|100|EA|1.35097|06/07/2017||Yes|No||06/07/2017||Yes|No|06/07/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|070|No|.57501|03/29/2022|.5612|03/29/2022|.56494|03/29/2022|||BETA-BLOCKERS|18797|||||No|No||BLUEPOINT LABOR|No||||
bupropion HCl|No|No|No|No|75%|68001032103|BUPROPION HCL XL 300 MG TABLET|500|EA|.24549|08/30/2017||Yes|No||08/30/2017||Yes|No|08/30/2017||Yes|No||||No|No|||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|18798|||||No|No||BLUEPOINT LABOR|No||||
bupropion HCl|No|No|No|No|75%|68001032104|BUPROPION HCL XL 300 MG TABLET|30|EA|.33783|08/30/2017||Yes|No||08/30/2017||Yes|No|08/30/2017||Yes|No||||No|No|||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|18799|||||No|No||BLUEPOINT LABOR|No||||
bupropion HCl|No|No|No|No|75%|68001032105|BUPROPION HCL XL 300 MG TABLET|90|EA|.25694|08/30/2017||Yes|No||08/30/2017||Yes|No|08/30/2017||Yes|No||||No|No|||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|18800|||||No|No||BLUEPOINT LABOR|No||||
bupropion HCl|No|No|No|No|75%|68001032203|BUPROPION HCL XL 150 MG TABLET|500|EA|.27075|08/30/2017|10/29/2022|Yes|No||08/30/2017|10/29/2022|Yes|No|08/30/2017|10/29/2022|Yes|No||||No|No|||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|18801|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPOINT LABOR|No||||
bupropion HCl|No|No|No|No|75%|68001032204|BUPROPION HCL XL 150 MG TABLET|30|EA|.29225|08/30/2017|11/30/2022|Yes|No||08/30/2017|11/30/2022|Yes|No|08/30/2017|11/30/2022|Yes|No||||No|No|||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|18802|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPOINT LABOR|No||||
bupropion HCl|No|No|No|No|75%|68001032205|BUPROPION HCL XL 150 MG TABLET|90|EA|.2578|08/30/2017|10/29/2022|Yes|No||08/30/2017|10/29/2022|Yes|No|08/30/2017|10/29/2022|Yes|No||||No|No|||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|18803|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPOINT LABOR|No||||
desmopressin acetate|No|No|No|No|75%|68001032500|DESMOPRESSIN ACETATE 0.1 MG TB|100|EA|.56287|02/08/2018||Yes|No||02/08/2018||Yes|No|02/08/2018||Yes|No||||No|No|||Prescription required|No|||Yes|.41734|03/29/2022|.40732|03/29/2022|.41003|03/29/2022||||18804|||||No|No||BLUEPOINT LABOR|No||||
desmopressin acetate|No|No|No|No|75%|68001032600|DESMOPRESSIN ACETATE 0.2 MG TB|100|EA|.50632|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|No|||Yes|.446|03/29/2022|.43529|03/29/2022|.43819|03/29/2022||||18805|||||No|No||BLUEPOINT LABOR|No||||
lisinopril|No|No|No|No|75%|68001033200|LISINOPRIL 2.5 MG TABLET|100|EA|.01053|02/23/2018||Yes|No||02/23/2018||Yes|No|02/23/2018||Yes|No||||No|No|||Prescription required|No||113|No|.01617|03/29/2022|.01578|03/29/2022|.01588|03/29/2022|||ANGIOTENSIN MODULATORS|18806|||||No|No||BLUEPOINT LABOR|No||||
lisinopril|No|No|No|No|75%|68001033203|LISINOPRIL 2.5 MG TABLET|500|EA|.00987|02/23/2018||Yes|No||02/23/2018||Yes|No|02/23/2018||Yes|No||||No|No|||Prescription required|No||113|No|.01617|03/29/2022|.01578|03/29/2022|.01588|03/29/2022|||ANGIOTENSIN MODULATORS|18807|||||No|No||BLUEPOINT LABOR|No||||
lisinopril|No|No|No|No|75%|68001033300|LISINOPRIL 5 MG TABLET|100|EA|.01384|02/23/2018||Yes|No||02/23/2018||Yes|No|02/23/2018||Yes|No||||No|No|||Prescription required|No||113|No|.01549|03/29/2022|.01511|03/29/2022|.01521|03/29/2022|||ANGIOTENSIN MODULATORS|18808|||||No|No||BLUEPOINT LABOR|No||||
lisinopril|No|No|No|No|75%|68001033308|LISINOPRIL 5 MG TABLET|1000|EA|.01316|02/23/2018||Yes|No||02/23/2018||Yes|No|02/23/2018||Yes|No||||No|No|||Prescription required|No||113|No|.01549|03/29/2022|.01511|03/29/2022|.01521|03/29/2022|||ANGIOTENSIN MODULATORS|18809|||||No|No||BLUEPOINT LABOR|No||||
lisinopril|No|No|No|No|75%|68001033400|LISINOPRIL 10 MG TABLET|100|EA|.01947|02/23/2018||Yes|No||02/23/2018||Yes|No|02/23/2018||Yes|No||||No|No|||Prescription required|No||113|No|.01914|03/29/2022|.01868|03/29/2022|.0188|03/29/2022|||ANGIOTENSIN MODULATORS|18810|||||No|No||BLUEPOINT LABOR|No||||
lisinopril|No|No|No|No|75%|68001033408|LISINOPRIL 10 MG TABLET|1000|EA|.0185|02/23/2018||Yes|No||02/23/2018||Yes|No|02/23/2018||Yes|No||||No|No|||Prescription required|No||113|No|.01914|03/29/2022|.01868|03/29/2022|.0188|03/29/2022|||ANGIOTENSIN MODULATORS|18811|||||No|No||BLUEPOINT LABOR|No||||
lisinopril|No|No|No|No|75%|68001033500|LISINOPRIL 20 MG TABLET|100|EA|.02919|02/23/2018||Yes|No||02/23/2018||Yes|No|02/23/2018||Yes|No||||No|No|||Prescription required|No||113|No|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANGIOTENSIN MODULATORS|18812|||||No|No||BLUEPOINT LABOR|No||||
lisinopril|No|No|No|No|75%|68001033508|LISINOPRIL 20 MG TABLET|1000|EA|.02772|02/23/2018||Yes|No||02/23/2018||Yes|No|02/23/2018||Yes|No||||No|No|||Prescription required|No||113|No|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANGIOTENSIN MODULATORS|18813|||||No|No||BLUEPOINT LABOR|No||||
lisinopril|No|No|No|No|75%|68001033600|LISINOPRIL 30 MG TABLET|100|EA|.04674|02/23/2018||Yes|No||02/23/2018||Yes|No|02/23/2018||Yes|No||||No|No|||Prescription required|No||113|No|.05487|03/29/2022|.05355|03/29/2022|.0539|03/29/2022|||ANGIOTENSIN MODULATORS|18814|||||No|No||BLUEPOINT LABOR|No||||
lisinopril|No|No|No|No|75%|68001033700|LISINOPRIL 40 MG TABLET|100|EA|.05263|02/23/2018|10/11/2022|Yes|No||02/23/2018|10/11/2022|Yes|No|02/23/2018|10/11/2022|Yes|No||||No|No|||Prescription required|No||113|No|.04778|03/29/2022|.04663|03/29/2022|.04694|03/29/2022|||ANGIOTENSIN MODULATORS|18815|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPOINT LABOR|No||||
lisinopril|No|No|No|No|75%|68001033708|LISINOPRIL 40 MG TABLET|1000|EA|.05003|02/23/2018|10/11/2022|Yes|No||02/23/2018|10/11/2022|Yes|No|02/23/2018|10/11/2022|Yes|No||||No|No|||Prescription required|No||113|No|.04778|03/29/2022|.04663|03/29/2022|.04694|03/29/2022|||ANGIOTENSIN MODULATORS|18816|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPOINT LABOR|No||||
metoprolol succinate|No|No|No|No|75%|68001035600|METOPROLOL SUCC ER 25 MG TAB|100|EA|.1075|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|18817|||||No|No||BLUEPOINT LABOR|No||||
metoprolol succinate|No|No|No|No|75%|68001035603|METOPROLOL SUCC ER 25 MG TAB|500|EA|.1075|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|18818|||||No|No||BLUEPOINT LABOR|No||||
metoprolol succinate|No|No|No|No|75%|68001035700|METOPROLOL SUCC ER 50 MG TAB|100|EA|.16494|02/25/2019|04/30/2022|Yes|No||02/25/2019|04/30/2022|Yes|No|02/25/2019|04/30/2022|Yes|No||||No|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|18819|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPOINT LABOR|No||||
metoprolol succinate|No|No|No|No|75%|68001035703|METOPROLOL SUCC ER 50 MG TAB|500|EA|.20946|02/25/2019|04/30/2022|Yes|No||02/25/2019|04/30/2022|Yes|No|02/25/2019|04/30/2022|Yes|No||||No|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|18820|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPOINT LABOR|No||||
metoprolol succinate|No|No|No|No|75%|68001035800|METOPROLOL SUCC ER 100 MG TAB|100|EA|.31742|02/25/2019|07/26/2022|Yes|No||02/25/2019|07/26/2022|Yes|No|02/25/2019|07/26/2022|Yes|No||||No|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|18821|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPOINT LABOR|No||||
metoprolol succinate|No|No|No|No|75%|68001035803|METOPROLOL SUCC ER 100 MG TAB|500|EA|.31477|02/25/2019|04/30/2022|Yes|No||02/25/2019|04/30/2022|Yes|No|02/25/2019|04/30/2022|Yes|No||||No|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|18822|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPOINT LABOR|No||||
metoprolol succinate|No|No|No|No|75%|68001036000|METOPROLOL SUCC ER 200 MG TAB|100|EA|.57301|02/25/2019|07/26/2022|Yes|No||02/25/2019|07/26/2022|Yes|No|02/25/2019|07/26/2022|Yes|No||||No|No|||Prescription required|No||070|No|.25385|03/29/2022|.24775|03/29/2022|.2494|03/29/2022|||BETA-BLOCKERS|18823|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPOINT LABOR|No||||
montelukast sodium|No|No|No|No|75%|68001036103|MONTELUKAST SOD 10 MG TABLET|500|EA|.05466|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|18824|||||No|No||BLUEPOINT LABOR|Yes|09/01/2020|||
montelukast sodium|No|No|No|No|75%|68001036105|MONTELUKAST SOD 10 MG TABLET|90|EA|.06688|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|18825|||||No|No||BLUEPOINT LABOR|Yes|09/01/2020|||
cefdinir|No|No|No|No|75%|68001036206|CEFDINIR 300 MG CAPSULE|60|EA|.51972|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No||046|No|.46443|03/29/2022|.45328|03/29/2022|.4563|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|18826|||||No|No||BLUEPOINT LABOR|No||||
sildenafil citrate|No|No|No|No|75%|68001036305|SILDENAFIL 20 MG TABLET|90|EA|.16086|04/16/2020||Yes|No||04/16/2020||Yes|No|04/16/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|Yes|.09246|03/29/2022|.09024|03/29/2022|.09084|03/29/2022|||PAH AGENTS: ORAL AND INHALED|18827|||||No|No||BLUEPOINT LABOR|No||||
metronidazole|Yes|No|No|No|75%|68001036400|METRONIDAZOLE 250 MG TABLET|100|EA|.13059|12/13/2018||Yes|No||12/13/2018||Yes|No|12/13/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|18828|||||No|No||BLUEPOINT LABOR|No||||
metronidazole|Yes|No|No|No|75%|68001036500|METRONIDAZOLE 500 MG TABLET|100|EA|.21908|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|06/18/2019||Prescription required|No||115|No|.15479|03/29/2022|.15107|03/29/2022|.15208|03/29/2022|||ANTIBIOTICS: GI|18829|||||No|No||BLUEPOINT LABOR|No||||
metronidazole|Yes|No|No|No|75%|68001036503|METRONIDAZOLE 500 MG TABLET|500|EA|.20814|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|06/18/2019||Prescription required|No||115|No|.15479|03/29/2022|.15107|03/29/2022|.15208|03/29/2022|||ANTIBIOTICS: GI|18830|||||No|No||BLUEPOINT LABOR|No||||
potassium chloride|No|No|No|No|75%|68001036700|POTASSIUM CL ER 10 MEQ TABLET|100|EA|.20502|10/16/2019||Yes|No||10/16/2019||Yes|No|10/16/2019||Yes|No||||No|No|||Prescription required|No|||No|.18432|03/29/2022|.17989|03/29/2022|.18109|03/29/2022||||18831|||||No|No||BLUEPOINT LABOR|No||||
potassium chloride|No|No|No|No|75%|68001036703|POTASSIUM CL ER 10 MEQ TABLET|500|EA|.205|10/16/2019||Yes|No||10/16/2019||Yes|No|10/16/2019||Yes|No||||No|No|||Prescription required|No|||No|.18432|03/29/2022|.17989|03/29/2022|.18109|03/29/2022||||18832|||||No|No||BLUEPOINT LABOR|No||||
duloxetine HCl|No|No|No|No|75%|68001036804|DULOXETINE HCL DR 40 MG CAP|30|EA|1.419|05/28/2019||Yes|No||05/28/2019||Yes|No|05/28/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|232|No|1.94215|03/29/2022|1.89553|03/29/2022|1.90816|03/29/2022|||NEUROPATHIC PAIN|18833|||||No|No||BLUEPOINT LABOR|No||||
isosorbide dinitrate|No|No|No|No|75%|68001037300|ISOSORBIDE DINITRATE 5 MG TAB|100|EA|.22587|08/05/2019||Yes|No||08/05/2019||Yes|No|08/05/2019||Yes|No||||No|No|||Prescription required|No|||No|.32336|03/29/2022|.31559|03/29/2022|.3177|03/29/2022||||18834|||||No|No||BLUEPOINT LABOR|No||||
isosorbide dinitrate|No|No|No|No|75%|68001037400|ISOSORBIDE DINITRATE 10 MG TAB|100|EA|.37272|08/05/2019||Yes|No||08/05/2019||Yes|No|08/05/2019||Yes|No||||No|No|||Prescription required|No|||No|.34234|03/29/2022|.33412|03/29/2022|.33634|03/29/2022||||18835|||||No|No||BLUEPOINT LABOR|No||||
isosorbide dinitrate|No|No|No|No|75%|68001037500|ISOSORBIDE DINITRATE 20 MG TAB|100|EA|.41|08/05/2019||Yes|No||08/05/2019||Yes|No|08/05/2019||Yes|No||||No|No|||Prescription required|No|||No|.30675|03/29/2022|.29938|03/29/2022|.30138|03/29/2022||||18836|||||No|No||BLUEPOINT LABOR|No||||
ursodiol|No|No|No|No|75%|68001037700|URSODIOL 250 MG TABLET|100|EA|.92273|04/16/2020||Yes|No||04/16/2020||Yes|No|04/16/2020||Yes|No||||No|No|||Prescription required|No||198|No|.5902|03/29/2022|.57603|03/29/2022|.57987|03/29/2022|||BILE SALTS|18837|||||No|No||BLUEPOINT LABOR|No||||
ursodiol|No|No|No|No|75%|68001037800|URSODIOL 500 MG TABLET|100|EA|1.63516|04/16/2020||Yes|No||04/16/2020||Yes|No|04/16/2020||Yes|No||||No|No|||Prescription required|No||198|No|.95342|03/29/2022|.93053|03/29/2022|.93673|03/29/2022|||BILE SALTS|18838|||||No|No||BLUEPOINT LABOR|No||||
labetalol HCl|No|No|No|No|75%|68001038100|LABETALOL HCL 100 MG TABLET|100|EA|.17647|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|||Prescription required|No||070|No|.12868|03/29/2022|.12559|03/29/2022|.12642|03/29/2022|||BETA-BLOCKERS|18839|||||No|No||BLUEPOINT LABOR|No||||
labetalol HCl|No|No|No|No|75%|68001038103|LABETALOL HCL 100 MG TABLET|500|EA|.16743|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|||Prescription required|No||070|No|.12868|03/29/2022|.12559|03/29/2022|.12642|03/29/2022|||BETA-BLOCKERS|18840|||||No|No||BLUEPOINT LABOR|No||||
labetalol HCl|No|No|No|No|75%|68001038200|LABETALOL HCL 200 MG TABLET|100|EA|.24406|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|||Prescription required|No||070|No|.17218|03/29/2022|.16804|03/29/2022|.16916|03/29/2022|||BETA-BLOCKERS|18841|||||No|No||BLUEPOINT LABOR|No||||
labetalol HCl|No|No|No|No|75%|68001038203|LABETALOL HCL 200 MG TABLET|500|EA|.2379|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|||Prescription required|No||070|No|.17218|03/29/2022|.16804|03/29/2022|.16916|03/29/2022|||BETA-BLOCKERS|18842|||||No|No||BLUEPOINT LABOR|No||||
labetalol HCl|No|No|No|No|75%|68001038300|LABETALOL HCL 300 MG TABLET|100|EA|.32142|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|||Prescription required|No||070|No|.21583|03/29/2022|.21065|03/29/2022|.21205|03/29/2022|||BETA-BLOCKERS|18843|||||No|No||BLUEPOINT LABOR|No||||
labetalol HCl|No|No|No|No|75%|68001038303|LABETALOL HCL 300 MG TABLET|500|EA|.33307|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|||Prescription required|No||070|No|.21583|03/29/2022|.21065|03/29/2022|.21205|03/29/2022|||BETA-BLOCKERS|18844|||||No|No||BLUEPOINT LABOR|No||||
nitrofurantoin macrocrystal|No|No|No|No|75%|68001038400|NITROFURANTOIN MCR 25 MG CAP|100|EA|2.5198|04/16/2020||Yes|No||04/16/2020||Yes|No|04/16/2020||Yes|No||||No|No|||Prescription required|No|||No|4.58426|08/24/2021|4.47423|08/24/2021|4.50403|08/24/2021||||18845|||||No|No||BLUEPOINT LABOR|No||||
nitrofurantoin macrocrystal|Yes|No|No|No|75%|68001038500|NITROFURANTOIN MCR 50 MG CAP|100|EA|.43215|04/16/2020||Yes|No||04/16/2020||Yes|No|04/16/2020||Yes|No||||No|No|06/19/2020||Prescription required|No|||No|.39225|03/29/2022|.38283|03/29/2022|.38538|03/29/2022||||18846|||||No|No||BLUEPOINT LABOR|No||||
nitrofurantoin macrocrystal|No|No|No|No|75%|68001038600|NITROFURANTOIN MCR 100 MG CAP|100|EA|.71427|04/16/2020||Yes|No||04/16/2020||Yes|No|04/16/2020||Yes|No||||No|No|||Prescription required|No|||No|.47756|03/29/2022|.46609|03/29/2022|.4692|03/29/2022||||18847|||||No|No||BLUEPOINT LABOR|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|68001038700|TRIAMTERENE-HCTZ 37.5-25 MG TB|100|EA|.1182|03/02/2020|08/26/2022|Yes|No||03/02/2020|08/26/2022|Yes|No|03/02/2020|08/26/2022|Yes|No||||No|No|||Prescription required|No|||Yes|.09986|03/29/2022|.09746|03/29/2022|.09811|03/29/2022||||18848|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPOINT LABOR|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|68001038703|TRIAMTERENE-HCTZ 37.5-25 MG TB|500|EA|.11674|05/18/2020|08/26/2022|Yes|No||05/18/2020|08/26/2022|Yes|No|05/18/2020|08/26/2022|Yes|No||||No|No|||Prescription required|No|||Yes|.09986|03/29/2022|.09746|03/29/2022|.09811|03/29/2022||||18849|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPOINT LABOR|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|68001038800|TRIAMTERENE-HCTZ 75-50 MG TAB|100|EA|.12121|03/02/2020|06/07/2022|Yes|No||03/02/2020|06/07/2022|Yes|No|03/02/2020|06/07/2022|Yes|No||||No|No|||Prescription required|No|||Yes|.1312|03/29/2022|.12805|03/29/2022|.1289|03/29/2022||||18850|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPOINT LABOR|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|68001038803|TRIAMTERENE-HCTZ 75-50 MG TAB|500|EA|.11756|03/02/2020|06/07/2022|Yes|No||03/02/2020|06/07/2022|Yes|No|03/02/2020|06/07/2022|Yes|No||||No|No|||Prescription required|No|||Yes|.1312|03/29/2022|.12805|03/29/2022|.1289|03/29/2022||||18851|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPOINT LABOR|No||||
potassium chloride|No|No|No|No|75%|68001039600|POTASSIUM CL ER 10 MEQ CAPSULE|100|EA|.22764|02/24/2020||Yes|No||02/24/2020||Yes|No|02/24/2020||Yes|No||||No|No|||Prescription required|No|||No|.15494|03/29/2022|.15122|03/29/2022|.15222|03/29/2022||||18852|||||No|No||BLUEPOINT LABOR|No||||
potassium chloride|No|No|No|No|75%|68001039603|POTASSIUM CL ER 10 MEQ CAPSULE|500|EA|.21394|02/24/2020||Yes|No||02/24/2020||Yes|No|02/24/2020||Yes|No||||No|No|||Prescription required|No|||No|.15494|03/29/2022|.15122|03/29/2022|.15222|03/29/2022||||18853|||||No|No||BLUEPOINT LABOR|No||||
famotidine|No|No|No|No|75%|68001039700|FAMOTIDINE 20 MG TABLET|100|EA|.0602|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No|||No|.03262|03/29/2022|.03183|03/29/2022|.03204|03/29/2022||||18854|||||No|No||BLUEPOINT LABOR|No||||
famotidine|No|No|No|No|75%|68001039708|FAMOTIDINE 20 MG TABLET|1000|EA|.0602|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No|||No|.03262|03/29/2022|.03183|03/29/2022|.03204|03/29/2022||||18855|||||No|No||BLUEPOINT LABOR|No||||
famotidine|No|No|No|No|75%|68001039800|FAMOTIDINE 40 MG TABLET|100|EA|.1204|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No|||No|.06888|03/29/2022|.06722|03/29/2022|.06767|03/29/2022||||18856|||||No|No||BLUEPOINT LABOR|No||||
famotidine|No|No|No|No|75%|68001039803|FAMOTIDINE 40 MG TABLET|500|EA|.1204|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No|||No|.06888|03/29/2022|.06722|03/29/2022|.06767|03/29/2022||||18857|||||No|No||BLUEPOINT LABOR|No||||
fluoxetine HCl|Yes|No|No|No|75%|68001039900|FLUOXETINE HCL 10 MG CAPSULE|100|EA|.02485|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|18858|||||No|No||BLUEPOINT LABOR|No||||
fluoxetine HCl|Yes|No|No|No|75%|68001039908|FLUOXETINE HCL 10 MG CAPSULE|1000|EA|.02149|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|18859|||||No|No||BLUEPOINT LABOR|No||||
fluoxetine HCl|Yes|No|No|No|75%|68001040000|FLUOXETINE HCL 20 MG CAPSULE|100|EA|.02863|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|18860|||||No|No||BLUEPOINT LABOR|No||||
fluoxetine HCl|Yes|No|No|No|75%|68001040008|FLUOXETINE HCL 20 MG CAPSULE|1000|EA|.01612|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|18861|||||No|No||BLUEPOINT LABOR|No||||
fluoxetine HCl|Yes|No|No|No|75%|68001040100|FLUOXETINE HCL 40 MG CAPSULE|100|EA|.31235|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|18862|||||No|No||BLUEPOINT LABOR|No||||
fluoxetine HCl|Yes|No|No|No|75%|68001040103|FLUOXETINE HCL 40 MG CAPSULE|500|EA|.08354|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|18863|||||No|No||BLUEPOINT LABOR|No||||
fluoxetine HCl|Yes|No|No|No|75%|68001040104|FLUOXETINE HCL 40 MG CAPSULE|30|EA|.09187|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|18864|||||No|No||BLUEPOINT LABOR|No||||
levetiracetam|No|No|No|No|75%|68001040203|LEVETIRACETAM 250 MG TABLET|500|EA|.11544|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No||056|No|.08073|03/29/2022|.07879|03/29/2022|.07931|03/29/2022|||ANTICONVULSANTS|18865|||||No|No||BLUEPOINT LABOR|No||||
levetiracetam|No|No|No|No|75%|68001040207|LEVETIRACETAM 250 MG TABLET|120|EA|.11552|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No||056|No|.08073|03/29/2022|.07879|03/29/2022|.07931|03/29/2022|||ANTICONVULSANTS|18866|||||No|No||BLUEPOINT LABOR|No||||
levetiracetam|No|No|No|No|75%|68001040303|LEVETIRACETAM 500 MG TABLET|500|EA|.14119|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|18867|||||No|No||BLUEPOINT LABOR|No||||
levetiracetam|No|No|No|No|75%|68001040307|LEVETIRACETAM 500 MG TABLET|120|EA|.14118|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|18868|||||No|No||BLUEPOINT LABOR|No||||
levetiracetam|No|No|No|No|75%|68001040403|LEVETIRACETAM 750 MG TABLET|500|EA|.19128|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No||056|No|.15853|03/29/2022|.15472|03/29/2022|.15575|03/29/2022|||ANTICONVULSANTS|18869|||||No|No||BLUEPOINT LABOR|No||||
levetiracetam|No|No|No|No|75%|68001040407|LEVETIRACETAM 750 MG TABLET|120|EA|.19127|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No||056|No|.15853|03/29/2022|.15472|03/29/2022|.15575|03/29/2022|||ANTICONVULSANTS|18870|||||No|No||BLUEPOINT LABOR|No||||
levetiracetam|No|No|No|No|75%|68001040506|LEVETIRACETAM 1,000 MG TABLET|60|EA|.28236|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No||056|No|.22789|03/29/2022|.22242|03/29/2022|.2239|03/29/2022|||ANTICONVULSANTS|18871|||||No|No||BLUEPOINT LABOR|No||||
gabapentin|No|No|No|No|75%|68001041100|GABAPENTIN 600 MG TABLET|100|EA|.08496|03/09/2020||Yes|No||03/09/2020||Yes|No|03/09/2020||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|18872|||||No|No||BLUEPOINT LABOR|No||||
gabapentin|No|No|No|No|75%|68001041103|GABAPENTIN 600 MG TABLET|500|EA|.0645|03/09/2020||Yes|No||03/09/2020||Yes|No|03/09/2020||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|18873|||||No|No||BLUEPOINT LABOR|No||||
gabapentin|No|No|No|No|75%|68001041200|GABAPENTIN 800 MG TABLET|100|EA|.10354|03/09/2020||Yes|No||03/09/2020||Yes|No|03/09/2020||Yes|No||||No|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|18874|||||No|No||BLUEPOINT LABOR|No||||
gabapentin|No|No|No|No|75%|68001041203|GABAPENTIN 800 MG TABLET|500|EA|.086|03/09/2020||Yes|No||03/09/2020||Yes|No|03/09/2020||Yes|No||||No|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|18875|||||No|No||BLUEPOINT LABOR|No||||
duloxetine HCl|No|No|No|No|75%|68001041306|DULOXETINE HCL DR 20 MG CAP|60|EA|.2021|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|No||232|No|.13163|03/29/2022|.12847|03/29/2022|.12932|03/29/2022|||NEUROPATHIC PAIN|18876|||||No|No||BLUEPOINT LABOR|No||||
duloxetine HCl|No|No|No|No|75%|68001041404|DULOXETINE HCL DR 30 MG CAP|30|EA|.20324|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|18877|||||No|No||BLUEPOINT LABOR|No||||
duloxetine HCl|No|No|No|No|75%|68001041405|DULOXETINE HCL DR 30 MG CAP|90|EA|.20099|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|18878|||||No|No||BLUEPOINT LABOR|No||||
duloxetine HCl|No|No|No|No|75%|68001041408|DULOXETINE HCL DR 30 MG CAP|1000|EA|.19096|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|18879|||||No|No||BLUEPOINT LABOR|No||||
duloxetine HCl|No|No|No|No|75%|68001041504|DULOXETINE HCL DR 60 MG CAP|30|EA|.129|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|18880|||||No|No||BLUEPOINT LABOR|No||||
duloxetine HCl|No|No|No|No|75%|68001041508|DULOXETINE HCL DR 60 MG CAP|1000|EA|.14159|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|18881|||||No|No||BLUEPOINT LABOR|No||||
trospium chloride|No|No|No|No|75%|68001042704|TROSPIUM CHLORIDE ER 60 MG CAP|30|EA|2.31741|04/22/2021||Yes|No||04/22/2021||Yes|No|04/22/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|No|3.47514|03/29/2022|3.39173|03/29/2022|3.41432|03/29/2022|||BLADDER RELAXANT PREPARATIONS|18882|||||No|No||BLUEPOINT LABOR|No||||
ramipril|No|No|No|No|75%|68001042800|RAMIPRIL 1.25 MG CAPSULE|100|EA|.1333|10/19/2020||Yes|No||10/19/2020||Yes|No|10/19/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.12346|03/29/2022|.12049|03/29/2022|.12129|03/29/2022|||ANGIOTENSIN MODULATORS|18883|||||No|No||BLUEPOINT LABOR|No||||
ramipril|No|No|No|No|75%|68001042900|RAMIPRIL 2.5 MG CAPSULE|100|EA|.0817|10/19/2020||Yes|No||10/19/2020||Yes|No|10/19/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.06329|03/29/2022|.06177|03/29/2022|.06218|03/29/2022|||ANGIOTENSIN MODULATORS|18884|||||No|No||BLUEPOINT LABOR|No||||
ramipril|No|No|No|No|75%|68001043000|RAMIPRIL 5 MG CAPSULE|100|EA|.086|10/19/2020||Yes|No||10/19/2020||Yes|No|10/19/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.06848|03/29/2022|.06683|03/29/2022|.06728|03/29/2022|||ANGIOTENSIN MODULATORS|18885|||||No|No||BLUEPOINT LABOR|No||||
ramipril|No|No|No|No|75%|68001043003|RAMIPRIL 5 MG CAPSULE|500|EA|.0731|10/19/2020||Yes|No||10/19/2020||Yes|No|10/19/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.06848|03/29/2022|.06683|03/29/2022|.06728|03/29/2022|||ANGIOTENSIN MODULATORS|18886|||||No|No||BLUEPOINT LABOR|No||||
ramipril|No|No|No|No|75%|68001043100|RAMIPRIL 10 MG CAPSULE|100|EA|.0903|10/19/2020||Yes|No||10/19/2020||Yes|No|10/19/2020||Yes|No||||No|No|||Prescription required|No||113|No|.07037|03/29/2022|.06868|03/29/2022|.06913|03/29/2022|||ANGIOTENSIN MODULATORS|18887|||||No|No||BLUEPOINT LABOR|No||||
ramipril|No|No|No|No|75%|68001043103|RAMIPRIL 10 MG CAPSULE|500|EA|.07675|10/19/2020||Yes|No||10/19/2020||Yes|No|10/19/2020||Yes|No||||No|No|||Prescription required|No||113|No|.07037|03/29/2022|.06868|03/29/2022|.06913|03/29/2022|||ANGIOTENSIN MODULATORS|18888|||||No|No||BLUEPOINT LABOR|No||||
nicotine|No|No|No|No|75%|68001043488|NICOTINE 21 MG/24HR PATCH|7|EA|.85692|06/08/2021||Yes|No||||No|No|06/08/2021||Yes|No||||No|No|||Over the counter|No||040|No|1.70855|03/29/2022|1.66754|03/29/2022|1.67865|03/29/2022|||SMOKING CESSATION|18889|||||No|No||BLUEPOINT LABOR|No||||
nicotine|No|No|No|No|75%|68001043490|NICOTINE 21 MG/24HR PATCH|14|EA|.73683|06/08/2021||Yes|No||||No|No|06/08/2021||Yes|No||||No|No|||Over the counter|No||040|No|1.70855|03/29/2022|1.66754|03/29/2022|1.67865|03/29/2022|||SMOKING CESSATION|18890|||||No|No||BLUEPOINT LABOR|No||||
nicotine|No|No|No|No|75%|68001043491|NICOTINE 21 MG/24HR PATCH|28|EA|.76708|06/08/2021||Yes|No||||No|No|06/08/2021||Yes|No||||No|No|||Over the counter|No||040|No|1.70855|03/29/2022|1.66754|03/29/2022|1.67865|03/29/2022|||SMOKING CESSATION|18891|||||No|No||BLUEPOINT LABOR|No||||
ibuprofen|No|No|No|No|75%|68001043592|CHILDREN IBUPROFEN 100 MG/5 ML|120|ML|.0269|05/27/2021||Yes|No||||No|No|05/27/2021||Yes|No||||No|No|||Over the counter|No||059|Yes|.03078|03/29/2022|.03004|03/29/2022|.03024|03/29/2022|||NSAIDS|18892|||||No|No||BLUEPOINT LABOR|No||||
ibuprofen|No|No|No|No|75%|68001043594|CHILDREN IBUPROFEN 100 MG/5 ML|240|ML|.01049|05/27/2021||Yes|No||||No|No|05/27/2021||Yes|No||||No|No|||Over the counter|No||059|Yes|.02479|03/29/2022|.02419|03/29/2022|.02435|03/29/2022|||NSAIDS|18893|||||No|No||BLUEPOINT LABOR|No||||
cetirizine HCl|No|No|No|No|75%|68001043604|CETIRIZINE HCL 10 MG TABLET|30|EA|.10965|06/16/2021||Yes|No||||No|No|06/16/2021||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|18894|||||No|No||BLUEPOINT LABOR|No||||
cetirizine HCl|No|No|No|No|75%|68001043697|CETIRIZINE HCL 10 MG TABLET|300|EA|.07166|06/16/2021||Yes|No||||No|No|06/16/2021||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|18895|||||No|No||BLUEPOINT LABOR|No||||
loratadine|No|No|No|No|75%|68001043800|LORATADINE 10 MG TABLET|100|EA|.02472|06/08/2021||Yes|No||||No|No|06/08/2021||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|18896|||||No|No||BLUEPOINT LABOR|No||||
loratadine|No|No|No|No|75%|68001043804|LORATADINE 10 MG TABLET|30|EA|.03583|06/08/2021||Yes|No||||No|No|06/08/2021||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|18897|||||No|No||BLUEPOINT LABOR|No||||
loratadine|No|No|No|No|75%|68001043896|LORATADINE 10 MG TABLET|100|EA|.12474|06/08/2021||Yes|No||||No|No|06/08/2021||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|18898|||||No|No||BLUEPOINT LABOR|No||||
loratadine|No|No|No|No|75%|68001043897|LORATADINE 10 MG TABLET|300|EA|.01576|06/08/2021||Yes|No||||No|No|06/08/2021||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|18899|||||No|No||BLUEPOINT LABOR|No||||
fexofenadine HCl|No|No|No|No|75%|68001043900|FEXOFENADINE HCL 60 MG TABLET|100|EA|.05766|04/22/2021||Yes|No||||No|No|04/22/2021||Yes|No||||No|No|||Over the counter|Yes|12/01/2021|030|Yes|.15058|03/29/2022|.14696|03/29/2022|.14794|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|18900|||||No|No||BLUEPOINT LABOR|No||||
fexofenadine HCl|No|No|No|No|75%|68001044000|FEXOFENADINE HCL 180 MG TABLET|100|EA|.11395|04/22/2021||Yes|No||||No|No|04/22/2021||Yes|No||||No|No|||Over the counter|Yes|12/01/2021|030|Yes|.28782|03/29/2022|.28091|03/29/2022|.28278|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|18901|||||No|No||BLUEPOINT LABOR|No||||
fexofenadine HCl|No|No|No|No|75%|68001044004|FEXOFENADINE HCL 180 MG TABLET|30|EA|.20281|04/22/2021||Yes|No||||No|No|04/22/2021||Yes|No||||No|No|||Over the counter|Yes|12/01/2021|030|Yes|.28782|03/29/2022|.28091|03/29/2022|.28278|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|18902|||||No|No||BLUEPOINT LABOR|No||||
omeprazole|No|No|No|No|75%|68001044139|OMEPRAZOLE DR 20 MG TABLET|28|EA|.23588|06/08/2021||Yes|No||||No|No|06/08/2021||Yes|No||||No|No|||Over the counter|Yes|12/01/2021|047|Yes|.45914|03/29/2022|.44812|03/29/2022|.4511|03/29/2022|||PROTON PUMP INHIBITORS|18903|||||No|No||BLUEPOINT LABOR|No||||
omeprazole|No|No|No|No|75%|68001044140|OMEPRAZOLE DR 20 MG TABLET|42|EA|.22933|06/08/2021||Yes|No||||No|No|06/08/2021||Yes|No||||No|No|||Over the counter|Yes|12/01/2021|047|Yes|.45914|03/29/2022|.44812|03/29/2022|.4511|03/29/2022|||PROTON PUMP INHIBITORS|18904|||||No|No||BLUEPOINT LABOR|No||||
omeprazole|No|No|No|No|75%|68001044198|OMEPRAZOLE DR 20 MG TABLET|14|EA|.29025|06/08/2021||Yes|No||||No|No|06/08/2021||Yes|No||||No|No|||Over the counter|Yes|12/01/2021|047|Yes|.45914|03/29/2022|.44812|03/29/2022|.4511|03/29/2022|||PROTON PUMP INHIBITORS|18905|||||No|No||BLUEPOINT LABOR|No||||
loratadine|No|No|No|No|75%|68001044998|LORATADINE 5 MG/5 ML SOLUTION|120|ML|.01898|08/23/2021||Yes|No||||No|No|08/23/2021||Yes|No||||No|No|||Over the counter|No||030|Yes|.04114|03/29/2022|.04015|03/29/2022|.04042|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|18906|||||No|No||BLUEPOINT LABOR|No||||
ziprasidone HCl|No|No|No|No|75%|68001045006|ZIPRASIDONE HCL 20 MG CAPSULE|60|EA|.39122|05/21/2021||Yes|No||05/21/2021||Yes|No|05/21/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.27381|03/29/2022|.26723|03/29/2022|.26901|03/29/2022|||ANTIPSYCHOTICS|18907|||||No|No||BLUEPOINT LABOR|No||||
ziprasidone HCl|No|No|No|No|75%|68001045106|ZIPRASIDONE HCL 40 MG CAPSULE|60|EA|.39122|05/21/2021||Yes|No||05/21/2021||Yes|No|05/21/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.29914|03/29/2022|.29196|03/29/2022|.2939|03/29/2022|||ANTIPSYCHOTICS|18908|||||No|No||BLUEPOINT LABOR|No||||
ziprasidone HCl|No|No|No|No|75%|68001045206|ZIPRASIDONE HCL 60 MG CAPSULE|60|EA|.40326|05/21/2021||Yes|No||05/21/2021||Yes|No|05/21/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.38441|03/29/2022|.37518|03/29/2022|.37768|03/29/2022|||ANTIPSYCHOTICS|18909|||||No|No||BLUEPOINT LABOR|No||||
ziprasidone HCl|No|No|No|No|75%|68001045306|ZIPRASIDONE HCL 80 MG CAPSULE|60|EA|.40326|05/21/2021||Yes|No||05/21/2021||Yes|No|05/21/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.42395|03/29/2022|.41377|03/29/2022|.41653|03/29/2022|||ANTIPSYCHOTICS|18910|||||No|No||BLUEPOINT LABOR|No||||
escitalopram oxalate|No|No|No|No|75%|68001045400|ESCITALOPRAM 5 MG TABLET|100|EA|.0645|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||008|Yes|.0462|03/29/2022|.04509|03/29/2022|.04539|03/29/2022|||ANTIDEPRESSANTS: SSRIs|18911|||||No|No||BLUEPOINT LABOR|No||||
escitalopram oxalate|No|No|No|No|75%|68001045500|ESCITALOPRAM 10 MG TABLET|100|EA|.0688|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||008|Yes|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIDEPRESSANTS: SSRIs|18912|||||No|No||BLUEPOINT LABOR|No||||
escitalopram oxalate|No|No|No|No|75%|68001045508|ESCITALOPRAM 10 MG TABLET|1000|EA|.0688|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||008|Yes|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIDEPRESSANTS: SSRIs|18913|||||No|No||BLUEPOINT LABOR|No||||
escitalopram oxalate|No|No|No|No|75%|68001045600|ESCITALOPRAM 20 MG TABLET|100|EA|.0731|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||008|No|.07845|03/29/2022|.07656|03/29/2022|.07707|03/29/2022|||ANTIDEPRESSANTS: SSRIs|18914|||||No|No||BLUEPOINT LABOR|No||||
escitalopram oxalate|No|No|No|No|75%|68001045608|ESCITALOPRAM 20 MG TABLET|1000|EA|.0731|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||008|No|.07845|03/29/2022|.07656|03/29/2022|.07707|03/29/2022|||ANTIDEPRESSANTS: SSRIs|18915|||||No|No||BLUEPOINT LABOR|No||||
enoxaparin sodium|No|No|No|No|75%|68001045742|ENOXAPARIN 30 MG/0.3 ML SYR|.3|ML|6.45|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||068|Yes|12.85641|03/29/2022|12.54785|03/29/2022|12.63142|03/29/2022|||ANTICOAGULANTS|18916|||||No|No||BLUEPOINT LABOR|No||||
enoxaparin sodium|No|No|No|No|75%|68001045842|ENOXAPARIN 40 MG/0.4 ML SYR|.4|ML|6.45|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||068|Yes|11.94818|03/29/2022|11.66142|03/29/2022|11.73908|03/29/2022|||ANTICOAGULANTS|18917|||||No|No||BLUEPOINT LABOR|No||||
enoxaparin sodium|No|No|No|No|75%|68001045942|ENOXAPARIN 60 MG/0.6 ML SYR|.6|ML|6.45|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||068|Yes|11.41069|03/29/2022|11.13683|03/29/2022|11.211|03/29/2022|||ANTICOAGULANTS|18918|||||No|No||BLUEPOINT LABOR|No||||
enoxaparin sodium|No|No|No|No|75%|68001046042|ENOXAPARIN 80 MG/0.8 ML SYR|.8|ML|6.45|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||068|Yes|12.0025|03/29/2022|11.71444|03/29/2022|11.79245|03/29/2022|||ANTICOAGULANTS|18919|||||No|No||BLUEPOINT LABOR|No||||
enoxaparin sodium|No|No|No|No|75%|68001046142|ENOXAPARIN 100 MG/ML SYRINGE|1|ML|6.45|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||068|Yes|11.81296|03/29/2022|11.52944|03/29/2022|11.60623|03/29/2022|||ANTICOAGULANTS|18920|||||No|No||BLUEPOINT LABOR|No||||
enoxaparin sodium|No|No|No|No|75%|68001046242|ENOXAPARIN 120 MG/0.8 ML SYR|.8|ML|9.675|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||068|Yes|15.335|03/29/2022|14.96696|03/29/2022|15.06663|03/29/2022|||ANTICOAGULANTS|18921|||||No|No||BLUEPOINT LABOR|No||||
enoxaparin sodium|No|No|No|No|75%|68001046342|ENOXAPARIN 150 MG/ML SYRINGE|1|ML|9.675|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||068|Yes|15.18|03/29/2022|14.81568|03/29/2022|14.91435|03/29/2022|||ANTICOAGULANTS|18922|||||No|No||BLUEPOINT LABOR|No||||
enoxaparin sodium|No|No|No|No|75%|68001046441|ENOXAPARIN 300 MG/3 ML VIAL|3|ML|4.58666|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||068|Yes|10.45332|01/25/2022|10.30399|01/25/2022|9.81332|01/25/2022|||ANTICOAGULANTS|18923|||||No|No||BLUEPOINT LABOR|No||||
abiraterone acetate|No|No|No|No|75%|68001048907|ABIRATERONE ACETATE 250 MG TAB|120|EA|.80625|08/23/2021||Yes|No||08/23/2021||Yes|No|08/23/2021||Yes|No||||No|No|||Prescription required|No||550|No|1.8375|09/28/2021|1.81125|09/28/2021|1.725|09/28/2021|||ONCOLOGY: ORAL - PROSTATE|18924|||||No|No||BLUEPOINT/ONCOP|No||||
metformin HCl|No|No|No|No|75%|68012000316|GLUMETZA ER 1,000 MG TABLET|90|EA|47.8719|11/07/2014||Yes|No||11/07/2014||Yes|No|11/07/2014||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|012|No|109.1034|08/29/2017|107.54478|08/29/2017|102.4236|08/29/2017|||HYPOGLYCEMICS: METFORMINS|18925|||||No|No||SANTARUS INC/SA|No||||
metformin HCl|No|No|No|No|75%|68012000450|GLUMETZA ER 500 MG TABLET|100|EA|22.1364|10/12/2018||Yes|No||10/12/2018||Yes|No|10/12/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|012|No|50.4504|06/29/2021|49.72968|06/29/2021|47.3616|06/29/2021|||HYPOGLYCEMICS: METFORMINS|18926|||||No|No||SANTARUS INC/SA|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|68012005230|ZEGERID 20 MG PACKET|30|EA|47.39775|10/01/2014||Yes|No||10/01/2014||Yes|No|10/01/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|108.02278|01/16/2018|106.4796|01/16/2018|101.40914|01/16/2018|||PROTON PUMP INHIBITORS|18927|Temporarily Deleted||||No|No||SANTARUS INC/SA|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|68012005430|ZEGERID 40 MG PACKET|30|EA|47.39775|10/01/2014||Yes|No||10/01/2014||Yes|No|10/01/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|108.02278|01/16/2018|106.4796|01/16/2018|101.40914|01/16/2018|||PROTON PUMP INHIBITORS|18928|||||No|No||SANTARUS INC/SA|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|68012010230|ZEGERID 20 MG CAPSULE|30|EA|47.39775|10/01/2014||Yes|No||10/01/2014||Yes|No|10/01/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|108.02278|01/16/2018|106.4796|01/16/2018|101.40914|01/16/2018|||PROTON PUMP INHIBITORS|18929|||||No|No||SANTARUS INC/SA|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|68012010430|ZEGERID 40 MG CAPSULE|30|EA|47.39775|10/01/2014||Yes|No||10/01/2014||Yes|No|10/01/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|108.02278|01/16/2018|106.4796|01/16/2018|101.40914|01/16/2018|||PROTON PUMP INHIBITORS|18930|||||No|No||SANTARUS INC/SA|No||||
bromocriptine mesylate|No|No|No|No|75%|68012025820|CYCLOSET 0.8 MG TABLET|200|EA|2.22544|10/01/2014||Yes|No||10/01/2014||Yes|No|10/01/2014||Yes|No||||No|No|||Prescription required|No|||No|4.99645|01/18/2022|4.87653|01/18/2022|4.90901|01/18/2022||||18931|||||No|No||SANTARUS INC/SA|No||||
budesonide|No|No|No|No|75%|68012030930|UCERIS 9 MG ER TABLET|30|EA|25.69737|10/01/2014||Yes|No||10/01/2014||Yes|No|10/01/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|010|No|57.16067|10/26/2021|55.78881|10/26/2021|56.16035|10/26/2021|||ULCERATIVE COLITIS AGENTS|18932|||||No|No||SANTARUS INC/SA|No||||
C1 esterase inhibitor, recomb|No|No|No|No|75%|68012035002|RUCONEST 2,100 UNIT VIAL|1|EA|2680.62|09/10/2014|01/18/2022|Yes|No||09/10/2014|01/18/2022|Yes|No|09/10/2014|01/18/2022|Yes|No||||No|No|||Prescription required|Yes|07/17/2014|501|No|6722.8|03/01/2022|6626.76|03/01/2022|6311.2|03/01/2022|||HAE TREATMENTS|18933|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SANTARUS/PHARMI|No||||
fenofibrate|No|No|No|No|75%|68012049090|FENOGLIDE 40 MG TABLET|90|EA|5.31852|10/01/2014||Yes|No||10/01/2014||Yes|No|10/01/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|055|No|12.12128|01/16/2018|11.94812|01/16/2018|11.37916|01/16/2018|||LIPOTROPICS: OTHER|18934|||||No|No||SANTARUS INC/SA|No||||
fenofibrate|No|No|No|No|75%|68012049590|FENOGLIDE 120 MG TABLET|90|EA|15.95562|10/01/2014||Yes|No||10/01/2014||Yes|No|10/01/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|055|No|36.36398|01/16/2018|35.8445|01/16/2018|34.13762|01/16/2018|||LIPOTROPICS: OTHER|18935|||||No|No||SANTARUS INC/SA|No||||
multivit-min69/iron/folic acid|No|No|No|No|75%|68025001010|OB COMPLETE CAPLET|100|EA|1.11559|06/18/2007||Yes|No||06/18/2007||Yes|No|06/18/2007||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|2.54251|11/16/2021|2.50619|11/16/2021|2.38684|11/16/2021|||PRENATAL VITAMINS|18936|||||No|No||VERTICAL/AVION|No||||
PNV83/iron,carb,asp/folic acid|No|No|No|No|75%|68025004330|OB COMPLETE PREMIER TABLET|30|EA|2.08564|01/10/2011||Yes|No||01/10/2011||Yes|No|01/10/2011||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|4.75332|11/16/2021|4.68541|11/16/2021|4.4623|11/16/2021|||PRENATAL VITAMINS|18937|||||No|No||VERTICAL/AVION|No||||
PNV 85/iron/folic/dha/fish oil|No|No|No|No|75%|68025004430|OB COMPLETE ONE SOFTGEL|30|EA|2.97588|01/10/2011||Yes|No||01/10/2011||Yes|No|01/10/2011||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|6.64776|11/23/2021|6.48821|11/23/2021|6.53142|11/23/2021|||PRENATAL VITAMINS|18938|||||No|No||VERTICAL/AVION|No||||
chlorzoxazone|No|No|No|No|75%|68025004610|LORZONE 375 MG TABLET|100|EA|4.22075|11/16/2011||Yes|No||11/16/2011||Yes|No|11/16/2011||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|116|Yes|9.61938|01/05/2021|9.48196|01/05/2021|9.03044|01/05/2021|||SKELETAL MUSCLE RELAXANTS|18939|||||No|No||VERTICAL PHARM|No||||
chlorzoxazone|No|No|No|No|75%|68025004710|LORZONE 750 MG TABLET|100|EA|4.7195|07/03/2012||Yes|No||07/03/2012||Yes|No|07/03/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|116|Yes|10.75608|01/25/2022|10.60242|01/25/2022|10.09755|01/25/2022|||SKELETAL MUSCLE RELAXANTS|18940|||||No|No||VERTICAL PHARM|No||||
iron,carb/folate6/mv,min no.41|No|No|No|No|75%|68025005230|CORVITE 150 TABLET|30|EA|2.14211|02/01/2016||Yes|No||02/01/2016||Yes|No|02/01/2016||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|506|No|4.88202|11/16/2021|4.81228|11/16/2021|4.58312|11/16/2021|||IRON: ORAL|18941|||||No|No||VERTICAL/AVION|No||||
prenatal56/iron/folic acid/dha|No|No|No|No|75%|68025005930|OB COMPLETE PETITE SOFTGEL|30|EA|3.01401|11/14/2012||Yes|No||11/14/2012||Yes|No|11/14/2012||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|6.74311|11/23/2021|6.58127|11/23/2021|6.6251|11/23/2021|||PRENATAL VITAMINS|18942|||||No|No||VERTICAL/AVION|No||||
iron/folate no.6/mv,mins no.40|No|No|No|No|75%|68025006030|CORVITE FE TABLET|30|EA|2.81764|02/01/2016||Yes|No||02/01/2016||Yes|No|02/01/2016||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|506|No|6.4216|11/16/2021|6.32986|11/16/2021|6.02844|11/16/2021|||IRON: ORAL|18943|||||No|No||VERTICAL/AVION|No||||
estradiol|No|No|No|No|75%|68025006530|DIVIGEL 0.25 MG GEL PACKET|1|EA|2.32243|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No|||Yes|5.1729|11/23/2021|5.04875|11/23/2021|5.08237|11/23/2021||||18944|||||No|No||VERTICAL/AVION|No||||
estradiol|No|No|No|No|75%|68025006630|DIVIGEL 0.5 MG GEL PACKET|1|EA|2.32243|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No|||Yes|5.17586|11/23/2021|5.05163|11/23/2021|5.08528|11/23/2021||||18945|||||No|No||VERTICAL/AVION|No||||
estradiol|No|No|No|No|75%|68025006730|DIVIGEL 1 MG GEL PACKET|1|GM|2.32243|01/07/2015||Yes|No||01/07/2015||Yes|No|01/07/2015||Yes|No||||No|No|||Prescription required|No|||Yes|5.18657|11/23/2021|5.06209|11/23/2021|5.0958|11/23/2021||||18946|||||No|No||VERTICAL/AVION|No||||
amantadine HCl|No|No|No|No|75%|68025007530|OSMOLEX ER 129 MG TABLET|30|EA|7.08855|02/20/2019|06/30/2023|Yes|No||02/20/2019|06/30/2023|Yes|No|02/20/2019|06/30/2023|Yes|No||||No|No|||Prescription required|Yes|01/31/2019|015|No|16.1553|01/04/2022|15.92451|01/04/2022|15.1662|01/04/2022|||ANTIPARKINSON'S AGENTS|18947|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SUPERNUS/ ADAMA|No||||
amantadine HCl|No|No|No|No|75%|68025007590|OSMOLEX ER 129 MG TABLET|90|EA|7.08855|02/20/2019|06/30/2023|Yes|No||02/20/2019|06/30/2023|Yes|No|02/20/2019|06/30/2023|Yes|No||||No|No|||Prescription required|Yes|01/31/2019|015|No|16.1553|01/04/2022|15.92451|01/04/2022|15.1662|01/04/2022|||ANTIPARKINSON'S AGENTS|18948|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SUPERNUS/ ADAMA|No||||
amantadine HCl|No|No|No|No|75%|68025007630|OSMOLEX ER 193 MG TABLET|30|EA|6.45|02/20/2019|08/02/2022|Yes|No||02/20/2019|08/02/2022|Yes|No|02/20/2019|08/02/2022|Yes|No||||No|No|||Prescription required|Yes|01/31/2019|015|No|14.7|02/20/2019|14.49|02/20/2019|13.8|02/20/2019|||ANTIPARKINSON'S AGENTS|18949|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||VERTICAL/ADAMAS|No||||
amantadine HCl|No|No|No|No|75%|68025007690|OSMOLEX ER 193 MG TABLET|90|EA|7.08855|02/20/2019|03/31/2023|Yes|No||02/20/2019|03/31/2023|Yes|No|02/20/2019|03/31/2023|Yes|No||||No|No|||Prescription required|Yes|01/31/2019|015|No|16.1553|01/04/2022|15.92451|01/04/2022|15.1662|01/04/2022|||ANTIPARKINSON'S AGENTS|18950|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||SUPERNUS/ ADAMA|No||||
venlafaxine HCl|No|No|No|No|75%|68025008230|VENLAFAXINE HCL ER 225 MG TAB|30|EA|7.4648|01/12/2017||Yes|No||01/12/2017||Yes|No|01/12/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|031|No|3.46235|03/29/2022|3.37925|03/29/2022|3.40175|03/29/2022|||ANTIDEPRESSANTS: OTHER|18951|||||No|No||VERTICAL PHARM|No||||
benzocaine|No|No|No|No|75%|68047005715|PINNACAINE 20% OTIC DROPS|15|ML|4.84036|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|150|No|11.03152|06/01/2016|10.87393|06/01/2016|10.35612|06/01/2016|||OTIC ANTI-INFECTIVES & ANESTHETICS|18952|||||No|No||SIRCLE LABORATO|No||||
chlorpheniramine/pseudoephed|No|No|No|No|75%|68047012016|LOHIST-D LIQUID|473|ML|.02324|09/24/2004||Yes|No||||No|No|09/24/2004||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|.05296|05/12/2020|.05221|05/12/2020|.04972|05/12/2020|||COUGH AND COLD: COLD|18953|||||No|No||LARKEN LABS|No||||
brompheniram/phenylephrine/DM|No|No|No|No|75%|68047012916|LOHIST-DM SYRUP|473|ML|.03074|07/15/2009||Yes|No||||No|No|07/15/2009||Yes|No||||No|No|||Over the counter|No||184|Yes|.07007|05/12/2020|.06906|05/12/2020|.06578|05/12/2020|||COUGH AND COLD: NON-NARCOTIC|18954|||||No|No||LARKEN LABS|No||||
brompheniram/phenylephrine/DM|No|No|No|No|75%|68047014316|ENDACOF-DM LIQUID|473|ML|.02343|04/17/2012||Yes|No||||No|No|04/17/2012||Yes|No||||No|No|||Over the counter|No||184|Yes|.03893|03/29/2022|.03799|03/29/2022|.03824|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|18955|||||No|No||LARKEN LABS|No||||
chlorpheniramine/phenylephrine|No|No|No|No|75%|68047018516|NOHIST-LQ LIQUID|473|ML|.0235|03/01/2011||Yes|No||||No|No|03/01/2011||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|.04063|11/23/2021|.03965|11/23/2021|.03991|11/23/2021|||COUGH AND COLD: COLD|18956|||||No|No||LARKEN LABS|No||||
chlorpheniramine/phenyleph/DM|No|No|No|No|75%|68047018616|NOHIST-DM LIQUID|473|ML|.03013|03/01/2011||Yes|No||||No|No|03/01/2011||Yes|No||||No|No|||Over the counter|No||184|Yes|.06812|03/29/2022|.06648|03/29/2022|.06692|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|18957|||||No|No||LARKEN LABS|No||||
hyoscyamine sulfate|No|No|No|No|75%|68047025201|OSCIMIN 0.125 MG TABLET|100|EA|.10801|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|.1455|03/29/2022|.142|03/29/2022|.14295|03/29/2022||||18958|||||No|No||LARKEN LABS|No||||
hyoscyamine sulfate|No|No|No|No|75%|68047025301|OSCIMIN SL 0.125 MG TABLET|100|EA|.09872|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|.14293|03/29/2022|.13949|03/29/2022|.14042|03/29/2022||||18959|||||No|No||LARKEN LABS|No||||
dexamethasone|No|No|No|No|75%|68047070221|DEXAMETHASONE 6 DAY 1.5 MG TAB|21|EA|2.95737|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|168|Yes|6.74005|11/28/2018|6.64377|11/28/2018|6.3274|11/28/2018|||GLUCOCORTICOIDS: ORAL|18960|||||No|No||LARKEN LABS|No||||
dexamethasone|No|No|No|No|75%|68047070235|DEXAMETHASONE 10 DAY 1.5 MG TB|35|EA|2.95778|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|168|Yes|6.74099|11/28/2018|6.64469|11/28/2018|6.32828|11/28/2018|||GLUCOCORTICOIDS: ORAL|18961|||||No|No||LARKEN LABS|No||||
dexamethasone|No|No|No|No|75%|68047070251|DEXAMETHASONE 13 DAY 1.5 MG TB|51|EA|2.95747|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|168|Yes|6.74028|11/28/2018|6.64399|11/28/2018|6.32761|11/28/2018|||GLUCOCORTICOIDS: ORAL|18962|||||No|No||LARKEN LABS|No||||
ofloxacin|No|No|No|No|75%|68047071320|OFLOXACIN 400 MG TABLET|20|EA|6.96105|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|028|No|15.86473|08/26/2021|15.63809|08/26/2021|14.89342|08/26/2021|||FLUOROQUINOLONES: ORAL|18963|||||No|No||LARKEN LABS|No||||
doxycycline hyclate|No|No|No|No|75%|68047071401|DOXYCYCLINE HYCLATE 20 MG TAB|100|EA|.16318|02/18/2011||Yes|No||02/18/2011||Yes|No|02/18/2011||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|213|No|.15838|03/29/2022|.15457|03/29/2022|.1556|03/29/2022|||TETRACYCLINES|18964|||||No|No||LARKEN LABS|No||||
doxycycline hyclate|No|No|No|No|75%|68047071460|DOXYCYCLINE HYCLATE 20 MG TAB|60|EA|.19163|02/18/2011||Yes|No||02/18/2011||Yes|No|02/18/2011||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|213|No|.15838|03/29/2022|.15457|03/29/2022|.1556|03/29/2022|||TETRACYCLINES|18965|||||No|No||LARKEN LABS|No||||
butalbital/acetaminophen|No|No|No|No|75%|68047072101|BUTALBITAL-ACETAMINOPHN 50-325|100|EA|.53216|02/17/2016||Yes|No||02/17/2016||Yes|No|02/17/2016||Yes|No||||No|No|||Prescription required|No|||No|.8699|03/29/2022|.84902|03/29/2022|.85467|03/29/2022||||18966|||||No|No||LARKEN LABS|No||||
butalbital/acetaminophen|No|No|No|No|75%|68047072130|BUTALBITAL-ACETAMINOPHN 50-325|30|EA|.79306|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|No|||No|.8699|03/29/2022|.84902|03/29/2022|.85467|03/29/2022||||18967|||||No|No||LARKEN LABS|No||||
butalbital/acetaminophen|No|No|No|No|75%|68047075201|ALLZITAL 25-325 MG TABLET|100|EA|1.6773|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|No|||No|3.82268|04/06/2021|3.76807|04/06/2021|3.58864|04/06/2021||||18968|||||No|No||LARKEN LABS|No||||
naltrexone HCl|No|No|No|No|75%|68084029111|NALTREXONE 50 MG TABLET|1|EA||10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|.75734|03/29/2022|.73916|03/29/2022|.74408|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|18969|||||No|No||AHP|Yes|09/01/2020|||
naltrexone HCl|No|No|No|No|75%|68084029121|NALTREXONE 50 MG TABLET|30|EA|.92751|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|.75734|03/29/2022|.73916|03/29/2022|.74408|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|18970|||||No|No||AHP|Yes|09/01/2020|||
naltrexone HCl|No|No|No|No|75%|68094085362|NALTREXONE 50 MG TABLET|30|EA|.9804|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|.75734|03/29/2022|.73916|03/29/2022|.74408|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|18971|||||No|No||PRECISION DOSE|Yes|09/01/2020|||
naproxen|No|No|No|No|75%|68134020116|NAPROXEN 125 MG/5 ML SUSPEN|500|ML|.40362|05/13/2016|07/31/2022|Yes|No||05/13/2016|07/31/2022|Yes|No|05/13/2016|07/31/2022|Yes|No||||No|No|||Prescription required|Yes|08/24/2016|059|Yes|.91988|02/05/2019|.90674|02/05/2019|.86356|02/05/2019|||NSAIDS|18972|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||PALMETTO PHARMA|No||||
galsulfase|No|No|No|No|75%|68135002001|NAGLAZYME 5 MG/5 ML VIAL|5|ML|179.912|07/18/2007||Yes|No||07/18/2007||Yes|No|07/18/2007||Yes|No||||No|No|||Prescription required|No|||Yes|410.032|01/11/2022|404.1744|01/11/2022|384.928|01/11/2022||||18973|||||No|No||BIOMARIN PHARMA|No||||
pegvaliase-pqpz|No|No|No|No|75%|68135005890|PALYNZIQ 2.5 MG/0.5 ML SYRINGE|.5|ML|482.46|11/07/2018||Yes|No||11/07/2018||Yes|No|11/07/2018||Yes|No||||No|No|||Prescription required|No|||No|1099.56|01/11/2022|1083.852|01/11/2022|1032.24|01/11/2022||||18974|||||No|No||BIOMARIN PHARMA|No||||
vosoritide|No|No|No|No|75%|68135008236|VOXZOGO 0.4 MG VIAL|1|EA|386.57|02/17/2022||Yes|No||02/17/2022||Yes|No|02/17/2022||Yes|No||||No|No|||Prescription required|No|||No|881.02|02/17/2022|868.434|02/17/2022|827.08|02/17/2022||||18975|||||No|No||BIOMARIN PHARMA|No||||
elosulfase alfa|No|No|No|No|75%|68135010001|VIMIZIM 5 MG/5 ML VIAL|5|ML|109.134|04/07/2014||Yes|No||04/07/2014||Yes|No|04/07/2014||Yes|No||||No|No|||Prescription required|No|||Yes|248.724|01/11/2022|245.1708|01/11/2022|233.496|01/11/2022||||18976|||||No|No||BIOMARIN PHARMA|No||||
vosoritide|No|No|No|No|75%|68135011966|VOXZOGO 0.56 MG VIAL|1|EA|386.57|02/17/2022||Yes|No||02/17/2022||Yes|No|02/17/2022||Yes|No||||No|No|||Prescription required|No|||No|881.02|02/17/2022|868.434|02/17/2022|827.08|02/17/2022||||18977|||||No|No||BIOMARIN PHARMA|No||||
vosoritide|No|No|No|No|75%|68135018193|VOXZOGO 1.2 MG VIAL|1|EA|386.57|02/17/2022||Yes|No||02/17/2022||Yes|No|02/17/2022||Yes|No||||No|No|||Prescription required|No|||No|881.02|02/17/2022|868.434|02/17/2022|827.08|02/17/2022||||18978|||||No|No||BIOMARIN PHARMA|No||||
sapropterin dihydrochloride|No|No|No|No|75%|68135030002|KUVAN 100 MG TABLET|120|EA|18.06|04/27/2009||Yes|No||04/27/2009||Yes|No|04/27/2009||Yes|No||||No|No|||Prescription required|No|||No|41.16|01/12/2021|40.572|01/12/2021|38.64|01/12/2021||||18979|||||No|No||BIOMARIN PHARMA|No||||
sapropterin dihydrochloride|No|No|No|No|75%|68135030111|KUVAN 100 MG POWDER PACKET|1|EA||04/07/2014||Yes|No||04/07/2014||Yes|No|04/07/2014||Yes|No||||No|No|||Prescription required|No|||No|||||||32.11132|06/01/2016||18980|||||No|No||BIOMARIN PHARMA|No||||
sapropterin dihydrochloride|No|No|No|No|75%|68135030122|KUVAN 100 MG POWDER PACKET|30|EA|18.06|04/07/2014||Yes|No||04/07/2014||Yes|No|04/07/2014||Yes|No||||No|No|||Prescription required|No|||No|41.16|01/12/2021|40.572|01/12/2021|38.64|01/12/2021||||18981|||||No|No||BIOMARIN PHARMA|No||||
sapropterin dihydrochloride|No|No|No|No|75%|68135048211|KUVAN 500 MG POWDER PACKET|30|EA|90.3|03/02/2016||Yes|No||03/02/2016||Yes|No|03/02/2016||Yes|No||||No|No|||Prescription required|No|||No|205.8|01/12/2021|202.86|01/12/2021|193.2|01/12/2021||||18982|||||No|No||BIOMARIN PHARMA|No||||
pegvaliase-pqpz|No|No|No|No|75%|68135067340|PALYNZIQ 20 MG/ML SYRINGE|1|ML|241.23|11/07/2018||Yes|No||11/07/2018||Yes|No|11/07/2018||Yes|No||||No|No|||Prescription required|No|||No|549.78|01/11/2022|541.926|01/11/2022|516.12|01/11/2022||||18983|||||No|No||BIOMARIN PHARMA|No||||
pegvaliase-pqpz|No|No|No|No|75%|68135075620|PALYNZIQ 10 MG/0.5 ML SYRINGE|.5|ML|482.46|11/07/2018||Yes|No||11/07/2018||Yes|No|11/07/2018||Yes|No||||No|No|||Prescription required|No|||No|1099.56|01/11/2022|1083.852|01/11/2022|1032.24|01/11/2022||||18984|||||No|No||BIOMARIN PHARMA|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|68180010102|VALSARTAN-HCTZ 320-12.5 MG TAB|500|EA|.71417|03/22/2013||Yes|No||03/22/2013||Yes|No|03/22/2013||Yes|No||03/22/2013||Yes|No|||Prescription required|Yes|07/29/2021|113|Yes|.41056|03/29/2022|.4007|03/29/2022|.40337|03/29/2022|||ANGIOTENSIN MODULATORS|18985|||||No|No||LUPIN PHARMACEU|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|68180010109|VALSARTAN-HCTZ 320-12.5 MG TAB|90|EA|.71417|03/22/2013||Yes|No||03/22/2013||Yes|No|03/22/2013||Yes|No||03/22/2013||Yes|No|||Prescription required|Yes|07/29/2021|113|Yes|.41056|03/29/2022|.4007|03/29/2022|.40337|03/29/2022|||ANGIOTENSIN MODULATORS|18986|||||No|No||LUPIN PHARMACEU|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|68180010202|VALSARTAN-HCTZ 320-25 MG TAB|500|EA|.81026|03/22/2013||Yes|No||03/22/2013||Yes|No|03/22/2013||Yes|No||03/22/2013||Yes|No|||Prescription required|Yes|07/29/2021|113|Yes|.3994|03/29/2022|.38981|03/29/2022|.39241|03/29/2022|||ANGIOTENSIN MODULATORS|18987|||||No|No||LUPIN PHARMACEU|No||||
valsartan/hydrochlorothiazide|No|No|No|No|75%|68180010209|VALSARTAN-HCTZ 320-25 MG TAB|90|EA|.81026|03/22/2013||Yes|No||03/22/2013||Yes|No|03/22/2013||Yes|No||03/22/2013||Yes|No|||Prescription required|Yes|07/29/2021|113|Yes|.3994|03/29/2022|.38981|03/29/2022|.39241|03/29/2022|||ANGIOTENSIN MODULATORS|18988|||||No|No||LUPIN PHARMACEU|No||||
valsartan/hydrochlorothiazide|Yes|No|No|No|75%|68180010302|VALSARTAN-HCTZ 80-12.5 MG TAB|500|EA|.51809|03/22/2013||Yes|No||03/22/2013||Yes|No|03/22/2013||Yes|No||03/22/2013||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.29054|03/29/2022|.28356|03/29/2022|.28545|03/29/2022|||ANGIOTENSIN MODULATORS|18989|||||No|No||LUPIN PHARMACEU|No||||
valsartan/hydrochlorothiazide|Yes|No|No|No|75%|68180010309|VALSARTAN-HCTZ 80-12.5 MG TAB|90|EA|.51809|03/22/2013||Yes|No||03/22/2013||Yes|No|03/22/2013||Yes|No||03/22/2013||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.29054|03/29/2022|.28356|03/29/2022|.28545|03/29/2022|||ANGIOTENSIN MODULATORS|18990|||||No|No||LUPIN PHARMACEU|No||||
valsartan/hydrochlorothiazide|Yes|No|No|No|75%|68180010402|VALSARTAN-HCTZ 160-12.5 MG TAB|500|EA|.56367|03/22/2013||Yes|No||03/22/2013||Yes|No|03/22/2013||Yes|No||03/22/2013||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.28742|03/29/2022|.28052|03/29/2022|.28239|03/29/2022|||ANGIOTENSIN MODULATORS|18991|||||No|No||LUPIN PHARMACEU|No||||
valsartan/hydrochlorothiazide|Yes|No|No|No|75%|68180010409|VALSARTAN-HCTZ 160-12.5 MG TAB|90|EA|.56367|03/22/2013||Yes|No||03/22/2013||Yes|No|03/22/2013||Yes|No||03/22/2013||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.28742|03/29/2022|.28052|03/29/2022|.28239|03/29/2022|||ANGIOTENSIN MODULATORS|18992|||||No|No||LUPIN PHARMACEU|No||||
valsartan/hydrochlorothiazide|Yes|No|No|No|75%|68180010502|VALSARTAN-HCTZ 160-25 MG TAB|500|EA|.63926|03/22/2013||Yes|No||03/22/2013||Yes|No|03/22/2013||Yes|No||03/22/2013||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.29583|03/29/2022|.28873|03/29/2022|.29065|03/29/2022|||ANGIOTENSIN MODULATORS|18993|||||No|No||LUPIN PHARMACEU|No||||
valsartan/hydrochlorothiazide|Yes|No|No|No|75%|68180010509|VALSARTAN-HCTZ 160-25 MG TAB|90|EA|.63926|03/22/2013||Yes|No||03/22/2013||Yes|No|03/22/2013||Yes|No||03/22/2013||Yes|No|07/01/2016||Prescription required|Yes|07/29/2021|113|Yes|.29583|03/29/2022|.28873|03/29/2022|.29065|03/29/2022|||ANGIOTENSIN MODULATORS|18994|||||No|No||LUPIN PHARMACEU|No||||
levetiracetam|No|No|No|No|75%|68180011202|LEVETIRACETAM 250 MG TABLET|500|EA|.11553|05/14/2009||Yes|No||05/14/2009||Yes|No|05/14/2009||Yes|No||||No|No|||Prescription required|No||056|No|.08073|03/29/2022|.07879|03/29/2022|.07931|03/29/2022|||ANTICONVULSANTS|18995|||||No|No||LUPIN PHARMACEU|No||||
levetiracetam|No|No|No|No|75%|68180011209|LEVETIRACETAM 250 MG TABLET|90|EA|.11552|01/15/2010||Yes|No||01/15/2010||Yes|No|01/15/2010||Yes|No||||No|No|||Prescription required|No||056|No|.08073|03/29/2022|.07879|03/29/2022|.07931|03/29/2022|||ANTICONVULSANTS|18996|||||No|No||LUPIN PHARMACEU|No||||
levetiracetam|No|No|No|No|75%|68180011216|LEVETIRACETAM 250 MG TABLET|120|EA|.11552|01/30/2009||Yes|No||01/30/2009||Yes|No|01/30/2009||Yes|No||||No|No|||Prescription required|No||056|No|.08073|03/29/2022|.07879|03/29/2022|.07931|03/29/2022|||ANTICONVULSANTS|18997|||||No|No||LUPIN PHARMACEU|No||||
levetiracetam|No|No|No|No|75%|68180011302|LEVETIRACETAM 500 MG TABLET|500|EA|.14119|05/14/2009||Yes|No||05/14/2009||Yes|No|05/14/2009||Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|18998|||||No|No||LUPIN PHARMACEU|No||||
levetiracetam|No|No|No|No|75%|68180011309|LEVETIRACETAM 500 MG TABLET|90|EA|.14118|03/08/2010||Yes|No||03/08/2010||Yes|No|03/08/2010||Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|18999|||||No|No||LUPIN PHARMACEU|No||||
levetiracetam|No|No|No|No|75%|68180011316|LEVETIRACETAM 500 MG TABLET|120|EA|.14118|01/30/2009||Yes|No||01/30/2009||Yes|No|01/30/2009||Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|19000|||||No|No||LUPIN PHARMACEU|No||||
levetiracetam|No|No|No|No|75%|68180011402|LEVETIRACETAM 750 MG TABLET|500|EA|.19128|05/14/2009||Yes|No||05/14/2009||Yes|No|05/14/2009||Yes|No||||No|No|||Prescription required|No||056|No|.15853|03/29/2022|.15472|03/29/2022|.15575|03/29/2022|||ANTICONVULSANTS|19001|||||No|No||LUPIN PHARMACEU|No||||
levetiracetam|No|No|No|No|75%|68180011409|LEVETIRACETAM 750 MG TABLET|90|EA|.19129|01/15/2010||Yes|No||01/15/2010||Yes|No|01/15/2010||Yes|No||||No|No|||Prescription required|No||056|No|.15853|03/29/2022|.15472|03/29/2022|.15575|03/29/2022|||ANTICONVULSANTS|19002|||||No|No||LUPIN PHARMACEU|No||||
levetiracetam|No|No|No|No|75%|68180011416|LEVETIRACETAM 750 MG TABLET|120|EA|.19127|01/30/2009||Yes|No||01/30/2009||Yes|No|01/30/2009||Yes|No||||No|No|||Prescription required|No||056|No|.15853|03/29/2022|.15472|03/29/2022|.15575|03/29/2022|||ANTICONVULSANTS|19003|||||No|No||LUPIN PHARMACEU|No||||
levetiracetam|No|No|No|No|75%|68180011507|LEVETIRACETAM 1,000 MG TABLET|60|EA|.28236|01/30/2009||Yes|No||01/30/2009||Yes|No|01/30/2009||Yes|No||||No|No|||Prescription required|No||056|No|.22789|03/29/2022|.22242|03/29/2022|.2239|03/29/2022|||ANTICONVULSANTS|19004|||||No|No||LUPIN PHARMACEU|No||||
levetiracetam|No|No|No|No|75%|68180011707|LEVETIRACETAM ER 500 MG TABLET|60|EA|.31869|09/13/2011||Yes|No||09/13/2011||Yes|No|09/13/2011||Yes|No||||No|No|||Prescription required|No||056|No|.22713|03/29/2022|.22167|03/29/2022|.22315|03/29/2022|||ANTICONVULSANTS|19005|||||No|No||LUPIN PHARMACEU|No||||
levetiracetam|No|No|No|No|75%|68180011807|LEVETIRACETAM ER 750 MG TABLET|60|EA|.47851|09/13/2011||Yes|No||09/13/2011||Yes|No|09/13/2011||Yes|No||||No|No|||Prescription required|No||056|No|.36799|03/29/2022|.35915|03/29/2022|.36155|03/29/2022|||ANTICONVULSANTS|19006|||||No|No||LUPIN PHARMACEU|No||||
cephalexin|No|No|No|No|75%|68180012101|CEPHALEXIN 250 MG CAPSULE|100|EA|.07202|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|||Prescription required|No||046|No|.09013|03/29/2022|.08796|03/29/2022|.08855|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19007|||||No|No||LUPIN PHARMACEU|No||||
cephalexin|No|No|No|No|75%|68180012102|CEPHALEXIN 250 MG CAPSULE|500|EA|.06987|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|||Prescription required|No||046|No|.09013|03/29/2022|.08796|03/29/2022|.08855|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19008|||||No|No||LUPIN PHARMACEU|No||||
cephalexin|No|No|No|No|75%|68180012201|CEPHALEXIN 500 MG CAPSULE|100|EA|.12745|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|||Prescription required|No||046|No|.12151|03/29/2022|.11859|03/29/2022|.11938|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19009|||||No|No||LUPIN PHARMACEU|No||||
cephalexin|No|No|No|No|75%|68180012202|CEPHALEXIN 500 MG CAPSULE|500|EA|.12362|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|||Prescription required|No||046|No|.12151|03/29/2022|.11859|03/29/2022|.11938|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19010|||||No|No||LUPIN PHARMACEU|No||||
fenofibric acid (choline)|No|No|No|No|75%|68180012809|FENOFIBRIC ACID DR 45 MG CAP|90|EA|.16334|12/27/2013||Yes|No||12/27/2013||Yes|No|12/27/2013||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|055|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||LIPOTROPICS: OTHER|19011|||||No|No||LUPIN PHARMACEU|No||||
fenofibric acid (choline)|No|No|No|No|75%|68180012909|FENOFIBRIC ACID DR 135 MG CAP|90|EA|.57046|12/27/2013||Yes|No||12/27/2013||Yes|No|12/27/2013||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|055|No|.69218|03/29/2022|.67556|03/29/2022|.68006|03/29/2022|||LIPOTROPICS: OTHER|19012|||||No|No||LUPIN PHARMACEU|No||||
fenofibrate,micronized|No|No|No|No|75%|68180013006|FENOFIBRATE 43 MG CAPSULE|30|EA|.80926|02/25/2013||Yes|No||02/25/2013||Yes|No|02/25/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|055|No|1.00144|11/23/2021|.9774|11/23/2021|.98391|11/23/2021|||LIPOTROPICS: OTHER|19013|||||No|No||LUPIN PHARMACEU|No||||
fenofibrate,micronized|No|No|No|No|75%|68180013106|FENOFIBRATE 130 MG CAPSULE|30|EA|2.38263|02/25/2013||Yes|No||02/25/2013||Yes|No|02/25/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|055|No|1.46614|03/29/2022|1.43095|03/29/2022|1.44048|03/29/2022|||LIPOTROPICS: OTHER|19014|||||No|No||LUPIN PHARMACEU|No||||
escitalopram oxalate|Yes|No|No|No|75%|68180013501|ESCITALOPRAM 10 MG TABLET|100|EA|.07955|09/17/2012||Yes|No||09/17/2012||Yes|No|09/17/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19015|||||No|No||LUPIN PHARMACEU|No||||
escitalopram oxalate|Yes|No|No|No|75%|68180013601|ESCITALOPRAM 20 MG TABLET|100|EA|.08385|09/17/2012||Yes|No||09/17/2012||Yes|No|09/17/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.07845|03/29/2022|.07656|03/29/2022|.07707|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19016|||||No|No||LUPIN PHARMACEU|No||||
escitalopram oxalate|Yes|No|No|No|75%|68180013701|ESCITALOPRAM 5 MG TABLET|100|EA|.07525|09/17/2012||Yes|No||09/17/2012||Yes|No|09/17/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.0462|03/29/2022|.04509|03/29/2022|.04539|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19017|||||No|No||LUPIN PHARMACEU|No||||
famotidine|No|No|No|No|75%|68180015001|FAMOTIDINE 40 MG/5 ML SUSP|50|ML|.8514|06/29/2010||Yes|No||06/29/2010||Yes|No|06/29/2010||Yes|No||||No|No|||Prescription required|No|||No|.81888|03/29/2022|.79922|03/29/2022|.80454|03/29/2022||||19018|||||No|No||LUPIN PHARMACEU|No||||
desloratadine|No|No|No|No|75%|68180015301|DESLORATADINE 5 MG TABLET|100|EA|.43|02/19/2013||Yes|No||02/19/2013||Yes|No|02/19/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|030|Yes|.33933|03/29/2022|.33118|03/29/2022|.33339|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|19019|||||No|No||LUPIN PHARMACEU|No||||
desloratadine|No|No|No|No|75%|68180015302|DESLORATADINE 5 MG TABLET|500|EA|.43|01/24/2016||Yes|No||01/24/2016||Yes|No|01/24/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|030|Yes|.33933|03/29/2022|.33118|03/29/2022|.33339|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|19020|||||No|No||LUPIN PHARMACEU|No||||
clobazam|No|No|No|No|90%|68180015601|CLOBAZAM 2.5 MG/ML SUSPENSION|120|ML|.5375|09/04/2019||Yes|No||09/04/2019||Yes|No|09/04/2019||Yes|No||||No|No|||Prescription required|No||056|No|.50176|03/29/2022|.48971|03/29/2022|.49297|03/29/2022|||ANTICONVULSANTS|19021|||||No|No||LUPIN PHARMACEU|No||||
clobazam|No|No|No|No|90%|68180015701|CLOBAZAM 10 MG TABLET|100|EA|.258|06/11/2019||Yes|No||06/11/2019||Yes|No|06/11/2019||Yes|No||||No|No|||Prescription required|No||056|No|.37729|03/29/2022|.36823|03/29/2022|.37068|03/29/2022|||ANTICONVULSANTS|19022|||||No|No||LUPIN PHARMACEU|No||||
clobazam|No|No|No|No|90%|68180015801|CLOBAZAM 20 MG TABLET|100|EA|.516|06/11/2019||Yes|No||06/11/2019||Yes|No|06/11/2019||Yes|No||||No|No|||Prescription required|No||056|No|.71967|03/29/2022|.70239|03/29/2022|.70707|03/29/2022|||ANTICONVULSANTS|19023|||||No|No||LUPIN PHARMACEU|No||||
ethacrynic acid|No|No|No|No|75%|68180015901|ETHACRYNIC ACID 25 MG TABLET|100|EA|4.29088|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No|||No|2.34378|03/01/2022|2.28752|03/01/2022|2.30276|03/01/2022||||19024|||||No|No||LUPIN PHARMACEU|No||||
azithromycin|Yes|No|No|No|75%|68180016006|AZITHROMYCIN 250 MG TABLET|30|EA|.91375|08/18/2015||Yes|No||08/18/2015||Yes|No|08/18/2015||Yes|No||08/18/2015||Yes|No|08/18/2015||Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|19025|||||No|No||LUPIN PHARMACEU|No||||
azithromycin|Yes|No|No|No|75%|68180016013|AZITHROMYCIN 250 MG TABLET|6|EA|.60486|08/18/2015|09/01/2022|Yes|No||08/18/2015|09/01/2022|Yes|No|08/18/2015|09/01/2022|Yes|No||08/18/2015|09/01/2022|Yes|No|08/18/2015|09/01/2022|Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|19026|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||LUPIN PHARMACEU|No||||
azithromycin|Yes|No|No|No|75%|68180016106|AZITHROMYCIN 500 MG TABLET|30|EA|2.07475|08/18/2015||Yes|No||08/18/2015||Yes|No|08/18/2015||Yes|No||08/18/2015||Yes|No|08/18/2015||Prescription required|No||018|No|.82092|03/29/2022|.80121|03/29/2022|.80655|03/29/2022|||MACROLIDES/KETOLIDES|19027|||||No|No||LUPIN PHARMACEU|No||||
azithromycin|No|No|No|No|75%|68180016111|AZITHROMYCIN 500 MG TABLET|3|EA|1.20973|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||02/16/2022||Yes|No|||Prescription required|No||018|No|.82092|03/29/2022|.80121|03/29/2022|.80655|03/29/2022|||MACROLIDES/KETOLIDES|19028|||||No|No||LUPIN PHARMACEU|No||||
azithromycin|Yes|No|No|No|75%|68180016113|AZITHROMYCIN 500 MG TABLET|3|EA|1.20973|08/18/2015|10/04/2022|Yes|No||08/18/2015|10/04/2022|Yes|No|08/18/2015|10/04/2022|Yes|No||08/18/2015|10/04/2022|Yes|No|08/18/2015|10/04/2022|Prescription required|No||018|No|.82092|03/29/2022|.80121|03/29/2022|.80655|03/29/2022|||MACROLIDES/KETOLIDES|19029|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||LUPIN PHARMACEU|No||||
azithromycin|No|No|No|No|75%|68180016206|AZITHROMYCIN 600 MG TABLET|30|EA|1.98029|08/18/2015||Yes|No||08/18/2015||Yes|No|08/18/2015||Yes|No||08/18/2015||Yes|No|||Prescription required|No||018|No|1.08173|08/24/2021|1.05576|08/24/2021|1.06279|08/24/2021|||MACROLIDES/KETOLIDES|19030|||||No|No||LUPIN PHARMACEU|No||||
vancomycin HCl|No|No|No|No|75%|68180016613|VANCOMYCIN HCL 125 MG CAPSULE|20|EA|2.15|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||05/12/2015||Yes|No|||Prescription required|Yes|01/31/2019|115|No|1.79287|03/29/2022|1.74984|03/29/2022|1.76149|03/29/2022|||ANTIBIOTICS: GI|19031|||||No|No||LUPIN PHARMACEU|No||||
vancomycin HCl|No|No|No|No|75%|68180016713|VANCOMYCIN HCL 250 MG CAPSULE|20|EA|4.3|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||05/12/2015||Yes|No|||Prescription required|Yes|01/31/2019|115|No|3.02495|03/29/2022|2.95235|03/29/2022|2.97201|03/29/2022|||ANTIBIOTICS: GI|19032|||||No|No||LUPIN PHARMACEU|No||||
zileuton|No|No|No|No|75%|68180016916|ZILEUTON ER 600 MG TABLET|120|EA|5.375|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|042|Yes|12.25|11/23/2021|12.075|11/23/2021|11.5|11/23/2021|||LEUKOTRIENE MODIFIERS|19033|||||No|No||LUPIN PHARMACEU|No||||
cefadroxil|No|No|No|No|75%|68180018001|CEFADROXIL 500 MG CAPSULE|100|EA|.2279|09/22/2008||Yes|No||09/22/2008||Yes|No|09/22/2008||Yes|No||09/22/2008||Yes|No|||Prescription required|No||046|No|.20994|03/29/2022|.2049|03/29/2022|.20626|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19034|||||No|No||LUPIN PHARMACEU|No||||
cefadroxil|No|No|No|No|75%|68180018008|CEFADROXIL 500 MG CAPSULE|50|EA|.25585|09/22/2008||Yes|No||09/22/2008||Yes|No|09/22/2008||Yes|No||09/22/2008||Yes|No|||Prescription required|No||046|No|.20994|03/29/2022|.2049|03/29/2022|.20626|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19035|||||No|No||LUPIN PHARMACEU|No||||
cefadroxil|No|No|No|No|75%|68180018102|CEFADROXIL 250 MG/5 ML SUSP|100|ML|.20915|10/28/2008||Yes|No||10/28/2008||Yes|No|10/28/2008||Yes|No||10/28/2008||Yes|No|||Prescription required|No||046|No|.1834|09/28/2021|.17899|09/28/2021|.18019|09/28/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19036|||||No|No||LUPIN PHARMACEU|No||||
cefadroxil|No|No|No|No|75%|68180018202|CEFADROXIL 500 MG/5 ML SUSP|75|ML|.28953|10/28/2008||Yes|No||10/28/2008||Yes|No|10/28/2008||Yes|No||10/28/2008||Yes|No|||Prescription required|No||046|No|.65986|11/23/2021|.65043|11/23/2021|.61946|11/23/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19037|||||No|No||LUPIN PHARMACEU|No||||
cefadroxil|No|No|No|No|75%|68180018203|CEFADROXIL 500 MG/5 ML SUSP|100|ML|.28956|10/28/2008||Yes|No||10/28/2008||Yes|No|10/28/2008||Yes|No||10/28/2008||Yes|No|||Prescription required|No||046|No|.25492|01/25/2022|.2488|01/25/2022|.25045|01/25/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19038|||||No|No||LUPIN PHARMACEU|No||||
mefenamic acid|No|No|No|No|75%|68180018506|MEFENAMIC ACID 250 MG CAPSULE|30|EA|5.9899|09/07/2011||Yes|No||09/07/2011||Yes|No|09/07/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2011|059|Yes|2.22679|03/29/2022|2.17334|03/29/2022|2.18782|03/29/2022|||NSAIDS|19039|||||No|No||LUPIN PHARMACEU|No||||
meloxicam, submicronized|No|No|No|No|75%|68180018806|MELOXICAM 5 MG CAPSULE|30|EA|10.68191|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||04/15/2021||Yes|No|||Prescription required|Yes|01/30/2020|059|No|24.34482|04/15/2021|23.99704|04/15/2021|22.85432|04/15/2021|||NSAIDS|19040|||||No|No||LUPIN PHARMACEU|No||||
meloxicam, submicronized|No|No|No|No|75%|68180018906|MELOXICAM 10 MG CAPSULE|30|EA|10.68191|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||04/15/2021||Yes|No|||Prescription required|Yes|01/30/2020|059|No|24.34482|04/15/2021|23.99704|04/15/2021|22.85432|04/15/2021|||NSAIDS|19041|||||No|No||LUPIN PHARMACEU|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|68180019306|TELMISARTAN-HCTZ 40-12.5 MG TB|30|EA|1.65894|06/11/2015||Yes|No||06/11/2015||Yes|No|06/11/2015||Yes|No||06/11/2015||Yes|No|||Prescription required|Yes|07/17/2014|113|Yes|1.13569|03/29/2022|1.10843|03/29/2022|1.11581|03/29/2022|||ANGIOTENSIN MODULATORS|19042|||||No|No||LUPIN PHARMACEU|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|68180019406|TELMISARTAN-HCTZ 80-12.5 MG TB|30|EA|1.65894|06/11/2015||Yes|No||06/11/2015||Yes|No|06/11/2015||Yes|No||06/11/2015||Yes|No|||Prescription required|Yes|07/17/2014|113|Yes|.94301|03/29/2022|.92037|03/29/2022|.9265|03/29/2022|||ANGIOTENSIN MODULATORS|19043|||||No|No||LUPIN PHARMACEU|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|68180019506|TELMISARTAN-HCTZ 80-25 MG TAB|30|EA|1.65894|06/11/2015||Yes|No||06/11/2015||Yes|No|06/11/2015||Yes|No||06/11/2015||Yes|No|||Prescription required|Yes|07/17/2014|113|Yes|1.29965|03/29/2022|1.26845|03/29/2022|1.2769|03/29/2022|||ANGIOTENSIN MODULATORS|19044|||||No|No||LUPIN PHARMACEU|No||||
telmisartan/amlodipine|No|No|No|No|75%|68180019606|TELMISARTAN-AMLODIPINE 40-5 MG|30|EA|1.78507|01/09/2014||Yes|No||01/09/2014||Yes|No|01/09/2014||Yes|No||01/09/2014||Yes|No|||Prescription required|Yes|07/24/2013|017|Yes|4.0683|06/01/2016|4.01018|06/01/2016|3.81922|06/01/2016|||ANGIOTENSIN MODULATOR COMBINATIONS|19045|||||No|No||LUPIN PHARMACEU|No||||
telmisartan/amlodipine|No|No|No|No|75%|68180019706|TELMISARTAN-AMLODIPINE 40-10|30|EA|1.78507|01/09/2014||Yes|No||01/09/2014||Yes|No|01/09/2014||Yes|No||01/09/2014||Yes|No|||Prescription required|Yes|07/24/2013|017|Yes|4.0683|06/01/2016|4.01018|06/01/2016|3.81922|06/01/2016|||ANGIOTENSIN MODULATOR COMBINATIONS|19046|||||No|No||LUPIN PHARMACEU|No||||
telmisartan/amlodipine|No|No|No|No|75%|68180019806|TELMISARTAN-AMLODIPINE 80-5 MG|30|EA|1.78507|01/09/2014||Yes|No||01/09/2014||Yes|No|01/09/2014||Yes|No||01/09/2014||Yes|No|||Prescription required|Yes|07/24/2013|017|Yes|4.0683|08/25/2020|4.01018|08/25/2020|3.81922|08/25/2020|||ANGIOTENSIN MODULATOR COMBINATIONS|19047|||||No|No||LUPIN PHARMACEU|No||||
telmisartan/amlodipine|No|No|No|No|75%|68180019906|TELMISARTAN-AMLODIPINE 80-10|30|EA|1.78507|01/09/2014||Yes|No||01/09/2014||Yes|No|01/09/2014||Yes|No||01/09/2014||Yes|No|||Prescription required|Yes|07/24/2013|017|Yes|4.0683|06/01/2016|4.01018|06/01/2016|3.81922|06/01/2016|||ANGIOTENSIN MODULATOR COMBINATIONS|19048|||||No|No||LUPIN PHARMACEU|No||||
cefixime|No|No|No|No|75%|68180020203|SUPRAX 100 MG/5 ML SUSPENSION|50|ML|3.06565|05/06/2004||Yes|No||05/06/2004||Yes|No|05/06/2004||Yes|No||||No|No|||Prescription required|Yes|02/01/2018|046|No|4.44606|02/26/2019|4.38254|02/26/2019|4.17385|02/26/2019|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19049|||||No|No||LUPIN PHARMA|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|68180021506|LOSARTAN-HCTZ 50-12.5 MG TAB|30|EA|.09875|01/24/2011||Yes|No||01/24/2011||Yes|No|01/24/2011||Yes|No||01/24/2011||Yes|No|07/01/2016||Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|19050|||||No|No||LUPIN PHARMACEU|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|68180021509|LOSARTAN-HCTZ 50-12.5 MG TAB|90|EA|.0987|10/06/2010||Yes|No||10/06/2010||Yes|No|10/06/2010||Yes|No||10/06/2010||Yes|No|07/01/2016||Prescription required|No||113|Yes|.18477|03/29/2022|.18033|03/29/2022|.18153|03/29/2022|||ANGIOTENSIN MODULATORS|19051|||||No|No||LUPIN PHARMACEU|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|68180021606|LOSARTAN-HCTZ 100-12.5 MG TAB|30|EA|.13444|05/24/2010||Yes|No||05/24/2010||Yes|No|05/24/2010||Yes|No||05/24/2010||Yes|No|07/01/2016||Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|19052|||||No|No||LUPIN PHARMACEU|No||||
losartan/hydrochlorothiazide|Yes|No|No|No|75%|68180021609|LOSARTAN-HCTZ 100-12.5 MG TAB|90|EA|.10501|05/24/2010||Yes|No||05/24/2010||Yes|No|05/24/2010||Yes|No||05/24/2010||Yes|No|07/01/2016||Prescription required|No||113|Yes|.20878|03/29/2022|.20376|03/29/2022|.20512|03/29/2022|||ANGIOTENSIN MODULATORS|19053|||||No|No||LUPIN PHARMACEU|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|68180021706|LOSARTAN-HCTZ 100-25 MG TAB|30|EA|.13444|01/24/2011||Yes|No||01/24/2011||Yes|No|01/24/2011||Yes|No||01/24/2011||Yes|No|||Prescription required|No||113|Yes|.21077|03/01/2022|.20571|03/01/2022|.20708|03/01/2022|||ANGIOTENSIN MODULATORS|19054|||||No|No||LUPIN PHARMACEU|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|68180021709|LOSARTAN-HCTZ 100-25 MG TAB|90|EA|.10501|10/06/2010||Yes|No||10/06/2010||Yes|No|10/06/2010||Yes|No||10/06/2010||Yes|No|||Prescription required|No||113|Yes|.21077|03/01/2022|.20571|03/01/2022|.20708|03/01/2022|||ANGIOTENSIN MODULATORS|19055|||||No|No||LUPIN PHARMACEU|No||||
rabeprazole sodium|No|No|No|No|75%|68180022006|RABEPRAZOLE SOD DR 20 MG TAB|30|EA|.98541|11/08/2013||Yes|No||11/08/2013||Yes|No|11/08/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.24287|03/29/2022|.23704|03/29/2022|.23861|03/29/2022|||PROTON PUMP INHIBITORS|19056|||||No|No||LUPIN PHARMACEU|No||||
rabeprazole sodium|No|No|No|No|75%|68180022009|RABEPRAZOLE SOD DR 20 MG TAB|90|EA|.98541|11/08/2013||Yes|No||11/08/2013||Yes|No|11/08/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.24287|03/29/2022|.23704|03/29/2022|.23861|03/29/2022|||PROTON PUMP INHIBITORS|19057|||||No|No||LUPIN PHARMACEU|No||||
niacin|No|No|No|No|75%|68180022101|NIACIN ER 500 MG TABLET|100|EA|1.45744|03/25/2014||Yes|No||03/25/2014||Yes|No|03/25/2014||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|Yes|.21332|03/29/2022|.2082|03/29/2022|.20958|03/29/2022|||LIPOTROPICS: OTHER|19058|||||No|No||LUPIN PHARMACEU|No||||
niacin|No|No|No|No|75%|68180022103|NIACIN ER 500 MG TABLET|1000|EA|1.45745|08/28/2014||Yes|No||08/28/2014||Yes|No|08/28/2014||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|Yes|.21332|03/29/2022|.2082|03/29/2022|.20958|03/29/2022|||LIPOTROPICS: OTHER|19059|||||No|No||LUPIN PHARMACEU|No||||
niacin|No|No|No|No|75%|68180022201|NIACIN ER 750 MG TABLET|100|EA|2.07887|03/25/2014||Yes|No||03/25/2014||Yes|No|03/25/2014||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.52604|03/29/2022|.51341|03/29/2022|.51683|03/29/2022|||LIPOTROPICS: OTHER|19060|||||No|No||LUPIN PHARMACEU|No||||
niacin|No|No|No|No|75%|68180022301|NIACIN ER 1,000 MG TABLET|100|EA|2.57772|03/25/2014||Yes|No||03/25/2014||Yes|No|03/25/2014||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.4737|03/29/2022|.46233|03/29/2022|.46541|03/29/2022|||LIPOTROPICS: OTHER|19061|||||No|No||LUPIN PHARMACEU|No||||
niacin|No|No|No|No|75%|68180022303|NIACIN ER 1,000 MG TABLET|1000|EA|2.5777|08/28/2014||Yes|No||08/28/2014||Yes|No|08/28/2014||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.4737|03/29/2022|.46233|03/29/2022|.46541|03/29/2022|||LIPOTROPICS: OTHER|19062|||||No|No||LUPIN PHARMACEU|No||||
memantine HCl|No|No|No|No|75%|68180022907|MEMANTINE HCL 5 MG TABLET|60|EA|.1573|10/03/2016||Yes|No||10/03/2016||Yes|No|10/03/2016||Yes|No||||No|No|||Prescription required|No||011|No|.08825|03/29/2022|.08613|03/29/2022|.0867|03/29/2022|||ALZHEIMER'S AGENTS|19063|||||No|No||LUPIN PHARMACEU|No||||
memantine HCl|No|No|No|No|75%|68180023007|MEMANTINE HCL 10 MG TABLET|60|EA|.1573|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|19064|||||No|No||LUPIN PHARMACEU|No||||
divalproex sodium|No|No|No|No|75%|68180026001|DIVALPROEX SOD ER 250 MG TAB|100|EA|.1849|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||12/10/2020||Yes|No|||Prescription required|No||056|Yes|.17839|03/29/2022|.1741|03/29/2022|.17526|03/29/2022|||ANTICONVULSANTS|19065|||||No|No||LUPIN PHARMACEU|No||||
divalproex sodium|No|No|No|No|75%|68180026002|DIVALPROEX SOD ER 250 MG TAB|500|EA|.17565|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||12/10/2020||Yes|No|||Prescription required|No||056|Yes|.17839|03/29/2022|.1741|03/29/2022|.17526|03/29/2022|||ANTICONVULSANTS|19066|||||No|No||LUPIN PHARMACEU|No||||
divalproex sodium|No|No|No|No|75%|68180026101|DIVALPROEX SOD ER 500 MG TAB|100|EA|.30693|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||12/10/2020||Yes|No|||Prescription required|No||056|No|.21008|03/29/2022|.20503|03/29/2022|.2064|03/29/2022|||ANTICONVULSANTS|19067|||||No|No||LUPIN PHARMACEU|No||||
divalproex sodium|No|No|No|No|75%|68180026102|DIVALPROEX SOD ER 500 MG TAB|500|EA|.29159|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||12/10/2020||Yes|No|||Prescription required|No||056|No|.21008|03/29/2022|.20503|03/29/2022|.2064|03/29/2022|||ANTICONVULSANTS|19068|||||No|No||LUPIN PHARMACEU|No||||
ethambutol HCl|No|No|No|No|75%|68180028001|ETHAMBUTOL HCL 100 MG TABLET|100|EA|.19737|11/05/2009||Yes|No||11/05/2009||Yes|No|11/05/2009||Yes|No||||No|No|||Prescription required|No|||No|.44982|09/29/2020|.44339|09/29/2020|.42228|09/29/2020||||19069|||||No|No||LUPIN PHARMACEU|No||||
ethambutol HCl|No|No|No|No|75%|68180028101|ETHAMBUTOL HCL 400 MG TABLET|100|EA|.54653|11/05/2009||Yes|No||11/05/2009||Yes|No|11/05/2009||Yes|No||||No|No|||Prescription required|No|||No|.57427|03/29/2022|.56048|03/29/2022|.56422|03/29/2022||||19070|||||No|No||LUPIN PHARMACEU|No||||
atovaquone|No|No|No|No|75%|68180028201|ATOVAQUONE 750 MG/5 ML SUSP|210|ML|2.28571|05/20/2019|06/07/2022|Yes|No||05/20/2019|06/07/2022|Yes|No|05/20/2019|06/07/2022|Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|1.13871|03/29/2022|1.11138|03/29/2022|1.11878|03/29/2022||||19071|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LUPIN PHARMACEU|No||||
lamivudine/zidovudine|No|No|No|No|75%|68180028407|LAMIVUDINE-ZIDOVUDINE TABLET|60|EA|2.74999|05/15/2012||Yes|No||05/15/2012||Yes|No|05/15/2012||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.62913|12/28/2021|.61403|12/28/2021|.61812|12/28/2021|||HIV / AIDS|19072|||||No|No||LUPIN PHARMACEU|No||||
abacavir/lamivudine/zidovudine|No|No|No|No|75%|68180028607|ABACAVIR-LAMIVUDINE-ZIDOV TAB|60|EA|13.9077|12/18/2013||Yes|No||12/18/2013||Yes|No|12/18/2013||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|22.71591|06/26/2018|22.39139|06/26/2018|21.32514|06/26/2018|||HIV / AIDS|19073|||||No|No||LUPIN PHARMACEU|No||||
abacavir sulfate/lamivudine|No|No|No|No|75%|68180028806|ABACAVIR-LAMIVUDINE 600-300 MG|30|EA|1.98|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|2.09447|03/29/2022|2.0442|03/29/2022|2.05781|03/29/2022|||HIV / AIDS|19074|||||No|No||LUPIN PHARMACEU|No||||
duloxetine HCl|No|No|No|No|75%|68180029403|DULOXETINE HCL DR 20 MG CAP|1000|EA|.215|07/16/2014||Yes|No||07/16/2014||Yes|No|07/16/2014||Yes|No||||No|No|||Prescription required|No||232|No|.13163|03/29/2022|.12847|03/29/2022|.12932|03/29/2022|||NEUROPATHIC PAIN|19075|||||No|No||LUPIN PHARMACEU|No||||
duloxetine HCl|No|No|No|No|75%|68180029407|DULOXETINE HCL DR 20 MG CAP|60|EA|.215|12/13/2013||Yes|No||12/13/2013||Yes|No|12/13/2013||Yes|No||||No|No|||Prescription required|No||232|No|.13163|03/29/2022|.12847|03/29/2022|.12932|03/29/2022|||NEUROPATHIC PAIN|19076|||||No|No||LUPIN PHARMACEU|No||||
duloxetine HCl|No|No|No|No|75%|68180029503|DULOXETINE HCL DR 30 MG CAP|1000|EA|.258|03/25/2014||Yes|No||03/25/2014||Yes|No|03/25/2014||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|19077|||||No|No||LUPIN PHARMACEU|No||||
duloxetine HCl|No|No|No|No|75%|68180029506|DULOXETINE HCL DR 30 MG CAP|30|EA|.258|12/13/2013||Yes|No||12/13/2013||Yes|No|12/13/2013||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|19078|||||No|No||LUPIN PHARMACEU|No||||
duloxetine HCl|No|No|No|No|75%|68180029509|DULOXETINE HCL DR 30 MG CAP|90|EA|.258|12/13/2013||Yes|No||12/13/2013||Yes|No|12/13/2013||Yes|No||||No|No|||Prescription required|No||232|No|.10619|03/29/2022|.10364|03/29/2022|.10433|03/29/2022|||NEUROPATHIC PAIN|19079|||||No|No||LUPIN PHARMACEU|No||||
duloxetine HCl|No|No|No|No|75%|68180029603|DULOXETINE HCL DR 60 MG CAP|1000|EA|.258|12/13/2013||Yes|No||12/13/2013||Yes|No|12/13/2013||Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|19080|||||No|No||LUPIN PHARMACEU|No||||
duloxetine HCl|No|No|No|No|75%|68180029606|DULOXETINE HCL DR 60 MG CAP|30|EA|.258|12/13/2013||Yes|No||12/13/2013||Yes|No|12/13/2013||Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|19081|||||No|No||LUPIN PHARMACEU|No||||
duloxetine HCl|No|No|No|No|75%|68180029609|DULOXETINE HCL DR 60 MG CAP|90|EA|.258|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|No||232|No|.12412|03/29/2022|.12114|03/29/2022|.12194|03/29/2022|||NEUROPATHIC PAIN|19082|||||No|No||LUPIN PHARMACEU|No||||
duloxetine HCl|No|No|No|No|75%|68180029706|DULOXETINE HCL DR 40 MG CAP|30|EA|1.419|06/25/2018||Yes|No||06/25/2018||Yes|No|06/25/2018||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|232|No|1.94215|03/29/2022|1.89553|03/29/2022|1.90816|03/29/2022|||NEUROPATHIC PAIN|19083|||||No|No||LUPIN PHARMACEU|No||||
cefuroxime axetil|No|No|No|No|75%|68180030220|CEFUROXIME AXETIL 250 MG TAB|20|EA|.79012|05/16/2006||Yes|No||05/16/2006||Yes|No|05/16/2006||Yes|No||07/01/2012||Yes|No|||Prescription required|No||046|No|.36264|03/29/2022|.35393|03/29/2022|.35629|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19084|||||No|No||LUPIN PHARMACEU|No||||
cefuroxime axetil|No|No|No|No|75%|68180030260|CEFUROXIME AXETIL 250 MG TAB|60|EA|.72562|12/02/2008||Yes|No||12/02/2008||Yes|No|12/02/2008||Yes|No||07/01/2012||Yes|No|||Prescription required|No||046|No|.36264|03/29/2022|.35393|03/29/2022|.35629|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19085|||||No|No||LUPIN PHARMACEU|No||||
cefuroxime axetil|No|No|No|No|75%|68180030320|CEFUROXIME AXETIL 500 MG TAB|20|EA|1.52865|05/16/2006||Yes|No||05/16/2006||Yes|No|05/16/2006||Yes|No||07/01/2012||Yes|No|||Prescription required|No||046|No|.56985|03/29/2022|.55617|03/29/2022|.55987|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19086|||||No|No||LUPIN PHARMACEU|No||||
cefuroxime axetil|No|No|No|No|75%|68180030360|CEFUROXIME AXETIL 500 MG TAB|60|EA|1.40072|12/02/2008||Yes|No||12/02/2008||Yes|No|12/02/2008||Yes|No||07/01/2012||Yes|No|||Prescription required|No||046|No|.56985|03/29/2022|.55617|03/29/2022|.55987|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19087|||||No|No||LUPIN PHARMACEU|No||||
imipramine pamoate|No|No|No|No|75%|68180031406|IMIPRAMINE PAMOATE 75 MG CAP|30|EA|5.07414|04/19/2010||Yes|No||04/19/2010||Yes|No|04/19/2010||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|5.75067|05/25/2021|5.61265|05/25/2021|5.65003|05/25/2021|||ANTIDEPRESSANTS: TRICYCLIC|19088|||||No|No||LUPIN PHARMACEU|No||||
imipramine pamoate|No|No|No|No|75%|68180031506|IMIPRAMINE PAMOATE 100 MG CAP|30|EA|5.07414|01/03/2011||Yes|No||01/03/2011||Yes|No|01/03/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|4.74483|04/27/2021|4.63095|04/27/2021|4.66179|04/27/2021|||ANTIDEPRESSANTS: TRICYCLIC|19089|||||No|No||LUPIN PHARMACEU|No||||
imipramine pamoate|No|No|No|No|75%|68180031606|IMIPRAMINE PAMOATE 125 MG CAP|30|EA|5.07414|01/03/2011||Yes|No||01/03/2011||Yes|No|01/03/2011||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|11.56432|06/01/2016|11.39911|06/01/2016|10.8563|06/01/2016|||ANTIDEPRESSANTS: TRICYCLIC|19090|||||No|No||LUPIN PHARMACEU|No||||
imipramine pamoate|No|No|No|No|75%|68180031706|IMIPRAMINE PAMOATE 150 MG CAP|30|EA|5.07414|04/19/2010||Yes|No||04/19/2010||Yes|No|04/19/2010||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|11.56432|02/27/2018|11.39911|02/27/2018|10.8563|02/27/2018|||ANTIDEPRESSANTS: TRICYCLIC|19091|||||No|No||LUPIN PHARMACEU|No||||
bupropion HCl|Yes|No|No|No|75%|68180031902|BUPROPION HCL XL 150 MG TABLET|500|EA|.07883|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||||No|No|05/31/2018||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|19092|||||No|No||LUPIN PHARMACEU|No||||
bupropion HCl|Yes|No|No|No|75%|68180031906|BUPROPION HCL XL 150 MG TABLET|30|EA|.07883|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||||No|No|05/31/2018||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|19093|||||No|No||LUPIN PHARMACEU|No||||
bupropion HCl|Yes|No|No|No|75%|68180031909|BUPROPION HCL XL 150 MG TABLET|90|EA|.07883|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||||No|No|05/31/2018||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|19094|||||No|No||LUPIN PHARMACEU|No||||
bupropion HCl|Yes|No|No|No|75%|68180032002|BUPROPION HCL XL 300 MG TABLET|500|EA|.09819|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||||No|No|05/31/2018||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|19095|||||No|No||LUPIN PHARMACEU|No||||
bupropion HCl|Yes|No|No|No|75%|68180032006|BUPROPION HCL XL 300 MG TABLET|30|EA|.09818|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||||No|No|05/31/2018||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|19096|||||No|No||LUPIN PHARMACEU|No||||
eszopiclone|No|No|No|No|90%|68180032201|ESZOPICLONE 1 MG TABLET|100|EA|.301|07/23/2014||Yes|No||07/23/2014||Yes|No|07/23/2014||Yes|No||||No|No|||Prescription required|No||054|Yes|.19753|03/29/2022|.19278|03/29/2022|.19407|03/29/2022|||SEDATIVE HYPNOTICS|19097|||||No|No||LUPIN PHARMACEU|No||||
eszopiclone|No|No|No|No|90%|68180032301|ESZOPICLONE 2 MG TABLET|100|EA|.301|07/23/2014||Yes|No||07/23/2014||Yes|No|07/23/2014||Yes|No||||No|No|||Prescription required|No||054|Yes|.25375|03/29/2022|.24766|03/29/2022|.2493|03/29/2022|||SEDATIVE HYPNOTICS|19098|||||No|No||LUPIN PHARMACEU|No||||
eszopiclone|No|No|No|No|90%|68180032401|ESZOPICLONE 3 MG TABLET|100|EA|.301|07/23/2014||Yes|No||07/23/2014||Yes|No|07/23/2014||Yes|No||||No|No|||Prescription required|No||054|Yes|.14316|03/29/2022|.13972|03/29/2022|.14065|03/29/2022|||SEDATIVE HYPNOTICS|19099|||||No|No||LUPIN PHARMACEU|No||||
ziprasidone HCl|No|No|No|No|75%|68180033107|ZIPRASIDONE HCL 20 MG CAPSULE|60|EA|.57333|03/05/2012||Yes|No||03/05/2012||Yes|No|03/05/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.27381|03/29/2022|.26723|03/29/2022|.26901|03/29/2022|||ANTIPSYCHOTICS|19100|||||No|No||LUPIN PHARMACEU|No||||
ziprasidone HCl|No|No|No|No|75%|68180033207|ZIPRASIDONE HCL 40 MG CAPSULE|60|EA|.57333|03/05/2012||Yes|No||03/05/2012||Yes|No|03/05/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.29914|03/29/2022|.29196|03/29/2022|.2939|03/29/2022|||ANTIPSYCHOTICS|19101|||||No|No||LUPIN PHARMACEU|No||||
ziprasidone HCl|No|No|No|No|75%|68180033307|ZIPRASIDONE HCL 60 MG CAPSULE|60|EA|.645|03/05/2012||Yes|No||03/05/2012||Yes|No|03/05/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.38441|03/29/2022|.37518|03/29/2022|.37768|03/29/2022|||ANTIPSYCHOTICS|19102|||||No|No||LUPIN PHARMACEU|No||||
ziprasidone HCl|No|No|No|No|75%|68180033407|ZIPRASIDONE HCL 80 MG CAPSULE|60|EA|.645|03/05/2012||Yes|No||03/05/2012||Yes|No|03/05/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.42395|03/29/2022|.41377|03/29/2022|.41653|03/29/2022|||ANTIPSYCHOTICS|19103|||||No|No||LUPIN PHARMACEU|No||||
sertraline HCl|Yes|No|No|No|75%|68180035103|SERTRALINE HCL 25 MG TABLET|1000|EA|.0784|06/25/2018||Yes|No||06/25/2018||Yes|No|06/25/2018||Yes|No||||No|No|06/25/2018||Prescription required|No||008|Yes|.05057|03/29/2022|.04935|03/29/2022|.04968|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19104|||||No|No||LUPIN PHARMACEU|No||||
sertraline HCl|Yes|No|No|No|75%|68180035106|SERTRALINE HCL 25 MG TABLET|30|EA|.07883|02/23/2007||Yes|No||02/23/2007||Yes|No|02/23/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.05057|03/29/2022|.04935|03/29/2022|.04968|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19105|||||No|No||LUPIN PHARMACEU|No||||
sertraline HCl|Yes|No|No|No|75%|68180035109|SERTRALINE HCL 25 MG TABLET|90|EA|.0784|02/23/2007||Yes|No||02/23/2007||Yes|No|02/23/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.05057|03/29/2022|.04935|03/29/2022|.04968|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19106|||||No|No||LUPIN PHARMACEU|No||||
sertraline HCl|Yes|No|No|No|75%|68180035202|SERTRALINE HCL 50 MG TABLET|500|EA|.07838|02/23/2007||Yes|No||02/23/2007||Yes|No|02/23/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.04281|03/29/2022|.04178|03/29/2022|.04206|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19107|||||No|No||LUPIN PHARMACEU|No||||
sertraline HCl|Yes|No|No|No|75%|68180035205|SERTRALINE HCL 50 MG TABLET|5000|EA|.07838|02/23/2007||Yes|No||02/23/2007||Yes|No|02/23/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.04281|03/29/2022|.04178|03/29/2022|.04206|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19108|||||No|No||LUPIN PHARMACEU|No||||
sertraline HCl|Yes|No|No|No|75%|68180035206|SERTRALINE HCL 50 MG TABLET|30|EA|.086|02/23/2007||Yes|No||02/23/2007||Yes|No|02/23/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.04281|03/29/2022|.04178|03/29/2022|.04206|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19109|||||No|No||LUPIN PHARMACEU|No||||
sertraline HCl|Yes|No|No|No|75%|68180035209|SERTRALINE HCL 50 MG TABLET|90|EA|.0784|06/23/2009||Yes|No||06/23/2009||Yes|No|06/23/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.04281|03/29/2022|.04178|03/29/2022|.04206|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19110|||||No|No||LUPIN PHARMACEU|No||||
sertraline HCl|Yes|No|No|No|75%|68180035302|SERTRALINE HCL 100 MG TABLET|500|EA|.07838|02/23/2007||Yes|No||02/23/2007||Yes|No|02/23/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19111|||||No|No||LUPIN PHARMACEU|No||||
sertraline HCl|Yes|No|No|No|75%|68180035305|SERTRALINE HCL 100 MG TABLET|5000|EA|.07838|02/23/2007||Yes|No||02/23/2007||Yes|No|02/23/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19112|||||No|No||LUPIN PHARMACEU|No||||
sertraline HCl|Yes|No|No|No|75%|68180035306|SERTRALINE HCL 100 MG TABLET|30|EA|.10033|02/23/2007||Yes|No||02/23/2007||Yes|No|02/23/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19113|||||No|No||LUPIN PHARMACEU|No||||
sertraline HCl|Yes|No|No|No|75%|68180035309|SERTRALINE HCL 100 MG TABLET|90|EA|.0784|11/30/2009||Yes|No||11/30/2009||Yes|No|11/30/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19114|||||No|No||LUPIN PHARMACEU|No||||
losartan potassium|Yes|No|No|No|75%|68180037603|LOSARTAN POTASSIUM 25 MG TAB|1000|EA|.0172|06/10/2020||Yes|No||06/10/2020||Yes|No|06/10/2020||Yes|No||06/10/2020||Yes|No|09/21/2020||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|19115|||||No|No||LUPIN PHARMACEU|No||||
losartan potassium|Yes|No|No|No|75%|68180037703|LOSARTAN POTASSIUM 50 MG TAB|1000|EA|.01935|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|19116|||||No|No||LUPIN PHARMACEU|No||||
losartan potassium|Yes|No|No|No|75%|68180037803|LOSARTAN POTASSIUM 100 MG TAB|1000|EA|.03225|04/09/2020||Yes|No||04/09/2020||Yes|No|04/09/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|19117|||||No|No||LUPIN PHARMACEU|No||||
imatinib mesylate|No|No|No|No|75%|68180039009|IMATINIB MESYLATE 100 MG TAB|90|EA|2.17426|12/12/2019|01/19/2022|Yes|No||12/12/2019|01/19/2022|Yes|No|12/12/2019|01/19/2022|Yes|No||||No|No|||Prescription required|No||173|No|4.95531|07/27/2021|4.88452|07/27/2021|4.65192|07/27/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|19118|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LUPIN PHARMACEU|No||||
imatinib mesylate|No|No|No|No|75%|68180039106|IMATINIB MESYLATE 400 MG TAB|30|EA|7.83474|12/12/2019|01/19/2022|Yes|No||12/12/2019|01/19/2022|Yes|No|12/12/2019|01/19/2022|Yes|No||||No|No|||Prescription required|No||173|No|2.86988|03/01/2022|2.801|03/01/2022|2.81965|03/01/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|19119|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LUPIN PHARMACEU|No||||
ciprofloxacin|No|No|No|No|75%|68180039201|CIPROFLOXACIN 250 MG/5 ML SUSP|100|ML|.41933|06/10/2014||Yes|No||06/10/2014||Yes|No|06/10/2014||Yes|No||06/10/2014||Yes|No|||Prescription required|No||028|No|.95569|06/01/2016|.94204|06/01/2016|.89718|06/01/2016|||FLUOROQUINOLONES: ORAL|19120|||||No|No||LUPIN PHARMACEU|No||||
ciprofloxacin|No|No|No|No|75%|68180039301|CIPROFLOXACIN 500 MG/5 ML SUSP|100|ML|.49088|06/10/2014||Yes|No||06/10/2014||Yes|No|06/10/2014||Yes|No||06/10/2014||Yes|No|||Prescription required|No||028|No|1.11876|06/01/2016|1.10278|06/01/2016|1.05027|06/01/2016|||FLUOROQUINOLONES: ORAL|19121|||||No|No||LUPIN PHARMACEU|No||||
celecoxib|No|No|No|No|75%|68180039507|CELECOXIB 50 MG CAPSULE|60|EA|.25083|10/14/2015||Yes|No||10/14/2015||Yes|No|10/14/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|.1386|03/29/2022|.13527|03/29/2022|.13617|03/29/2022|||NSAIDS|19122|||||No|No||LUPIN PHARMACEU|No||||
celecoxib|No|No|No|No|75%|68180039601|CELECOXIB 100 MG CAPSULE|100|EA|.51737|08/15/2016||Yes|No||08/15/2016||Yes|No|08/15/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|19123|||||No|No||LUPIN PHARMACEU|No||||
celecoxib|No|No|No|No|75%|68180039602|CELECOXIB 100 MG CAPSULE|500|EA|.51737|03/09/2016||Yes|No||03/09/2016||Yes|No|03/09/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|19124|||||No|No||LUPIN PHARMACEU|No||||
celecoxib|No|No|No|No|75%|68180039807|CELECOXIB 400 MG CAPSULE|60|EA|1.32031|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|.73632|03/29/2022|.71864|03/29/2022|.72343|03/29/2022|||NSAIDS|19125|||||No|No||LUPIN PHARMACEU|No||||
celecoxib|No|No|No|No|75%|68180039901|CELECOXIB 200 MG CAPSULE|100|EA|.85686|09/10/2020||Yes|No||09/10/2020||Yes|No|09/10/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|19126|||||No|No||LUPIN PHARMACEU|No||||
cefprozil|No|No|No|No|75%|68180040101|CEFPROZIL 125 MG/5 ML SUSP|50|ML|.13588|02/27/2007||Yes|No||02/27/2007||Yes|No|02/27/2007||Yes|No||||No|No|||Prescription required|No||046|No|.23632|01/25/2022|.23064|01/25/2022|.23218|01/25/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19127|||||No|No||LUPIN PHARMACEU|No||||
cefprozil|No|No|No|No|75%|68180040102|CEFPROZIL 125 MG/5 ML SUSP|75|ML|.1353|01/10/2006||Yes|No||01/10/2006||Yes|No|01/10/2006||Yes|No||||No|No|||Prescription required|No||046|No|.30836|02/28/2017|.30396|02/28/2017|.28948|02/28/2017|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19128|||||No|No||LUPIN PHARMACEU|No||||
cefprozil|No|No|No|No|75%|68180040103|CEFPROZIL 125 MG/5 ML SUSP|100|ML|.13497|12/28/2005||Yes|No||12/28/2005||Yes|No|12/28/2005||Yes|No||||No|No|||Prescription required|No||046|No|.09872|03/01/2022|.09635|03/01/2022|.09699|03/01/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19129|||||No|No||LUPIN PHARMACEU|No||||
cefprozil|No|No|No|No|75%|68180040201|CEFPROZIL 250 MG/5 ML SUSP|50|ML|.25215|01/11/2006||Yes|No||01/11/2006||Yes|No|01/11/2006||Yes|No||||No|No|||Prescription required|No||046|No|.3239|03/01/2022|.31612|03/01/2022|.31823|03/01/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19130|||||No|No||LUPIN PHARMACEU|No||||
cefprozil|No|No|No|No|75%|68180040202|CEFPROZIL 250 MG/5 ML SUSP|75|ML|.24704|12/28/2005||Yes|No||12/28/2005||Yes|No|12/28/2005||Yes|No||||No|No|||Prescription required|No||046|No|.22915|03/29/2022|.22365|03/29/2022|.22513|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19131|||||No|No||LUPIN PHARMACEU|No||||
cefprozil|No|No|No|No|75%|68180040203|CEFPROZIL 250 MG/5 ML SUSP|100|ML|.24454|01/11/2006||Yes|No||01/11/2006||Yes|No|01/11/2006||Yes|No||||No|No|||Prescription required|No||046|No|.21431|03/29/2022|.20916|03/29/2022|.21055|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19132|||||No|No||LUPIN PHARMACEU|No||||
cefprozil|No|No|No|No|75%|68180040301|CEFPROZIL 250 MG TABLET|100|EA|.68623|12/28/2005||Yes|No||12/28/2005||Yes|No|12/28/2005||Yes|No||||No|No|||Prescription required|No||046|No|.65626|11/23/2021|.6405|11/23/2021|.64477|11/23/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19133|||||No|No||LUPIN PHARMACEU|No||||
cefprozil|No|No|No|No|75%|68180040401|CEFPROZIL 500 MG TABLET|50|EA|1.41366|12/28/2005||Yes|No||12/28/2005||Yes|No|12/28/2005||Yes|No||||No|No|||Prescription required|No||046|No|1.02667|03/29/2022|1.00202|03/29/2022|1.0087|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19134|||||No|No||LUPIN PHARMACEU|No||||
cefixime|No|No|No|No|75%|68180040501|CEFIXIME 100 MG/5 ML SUSP|50|ML|.387|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|046|No|.882|09/28/2021|.8694|09/28/2021|.828|09/28/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19135|||||No|No||LUPIN PHARMACEU|No||||
cefixime|No|No|No|No|75%|68180040703|CEFIXIME 200 MG/5 ML SUSP|50|ML|.774|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|046|No|1.764|09/28/2021|1.7388|09/28/2021|1.656|09/28/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19136|||||No|No||LUPIN PHARMACEU|No||||
cefixime|No|No|No|No|75%|68180040704|CEFIXIME 200 MG/5 ML SUSP|75|ML|.688|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|046|No|1.568|09/28/2021|1.5456|09/28/2021|1.472|09/28/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19137|||||No|No||LUPIN PHARMACEU|No||||
irbesartan|Yes|No|No|No|75%|68180041006|IRBESARTAN 75 MG TABLET|30|EA|.15107|11/01/2012|01/07/2022|Yes|No||11/01/2012|01/07/2022|Yes|No|11/01/2012|01/07/2022|Yes|No||11/01/2012|01/07/2022|Yes|No|07/01/2016|01/07/2022|Prescription required|No||113|Yes|.21751|03/29/2022|.21228|03/29/2022|.2137|03/29/2022|||ANGIOTENSIN MODULATORS|19138|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||LUPIN PHARMACEU|No||||
irbesartan|Yes|No|No|No|75%|68180041009|IRBESARTAN 75 MG TABLET|90|EA|.15107|11/01/2012|01/07/2022|Yes|No||11/01/2012|01/07/2022|Yes|No|11/01/2012|01/07/2022|Yes|No||11/01/2012|01/07/2022|Yes|No|07/01/2016|01/07/2022|Prescription required|No||113|Yes|.21751|03/29/2022|.21228|03/29/2022|.2137|03/29/2022|||ANGIOTENSIN MODULATORS|19139|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||LUPIN PHARMACEU|No||||
irbesartan|Yes|No|No|No|75%|68180041106|IRBESARTAN 150 MG TABLET|30|EA|.15895|11/01/2012|01/07/2022|Yes|No||11/01/2012|01/07/2022|Yes|No|11/01/2012|01/07/2022|Yes|No||11/01/2012|01/07/2022|Yes|No|07/01/2016|01/07/2022|Prescription required|No||113|Yes|.20852|03/29/2022|.20351|03/29/2022|.20487|03/29/2022|||ANGIOTENSIN MODULATORS|19140|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||LUPIN PHARMACEU|No||||
irbesartan|Yes|No|No|No|75%|68180041109|IRBESARTAN 150 MG TABLET|90|EA|.15895|11/01/2012|01/07/2022|Yes|No||11/01/2012|01/07/2022|Yes|No|11/01/2012|01/07/2022|Yes|No||11/01/2012|01/07/2022|Yes|No|07/01/2016|01/07/2022|Prescription required|No||113|Yes|.20852|03/29/2022|.20351|03/29/2022|.20487|03/29/2022|||ANGIOTENSIN MODULATORS|19141|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||LUPIN PHARMACEU|No||||
irbesartan|Yes|No|No|No|75%|68180041206|IRBESARTAN 300 MG TABLET|30|EA|.1912|11/01/2012|01/07/2022|Yes|No||11/01/2012|01/07/2022|Yes|No|11/01/2012|01/07/2022|Yes|No||11/01/2012|01/07/2022|Yes|No|07/01/2016|01/07/2022|Prescription required|No||113|Yes|.32541|03/29/2022|.3176|03/29/2022|.31971|03/29/2022|||ANGIOTENSIN MODULATORS|19142|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||LUPIN PHARMACEU|No||||
irbesartan|Yes|No|No|No|75%|68180041209|IRBESARTAN 300 MG TABLET|90|EA|.1912|11/01/2012|01/07/2022|Yes|No||11/01/2012|01/07/2022|Yes|No|11/01/2012|01/07/2022|Yes|No||11/01/2012|01/07/2022|Yes|No|07/01/2016|01/07/2022|Prescription required|No||113|Yes|.32541|03/29/2022|.3176|03/29/2022|.31971|03/29/2022|||ANGIOTENSIN MODULATORS|19143|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||LUPIN PHARMACEU|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|68180041306|IRBESARTAN-HCTZ 150-12.5 MG TB|30|EA|.1548|04/05/2013|01/07/2022|Yes|No||04/05/2013|01/07/2022|Yes|No|04/05/2013|01/07/2022|Yes|No||04/05/2013|01/07/2022|Yes|No|07/01/2016|01/07/2022|Prescription required|No||113|Yes|.24959|03/29/2022|.24359|03/29/2022|.24522|03/29/2022|||ANGIOTENSIN MODULATORS|19144|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||LUPIN PHARMACEU|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|68180041309|IRBESARTAN-HCTZ 150-12.5 MG TB|90|EA|.15064|04/05/2013|01/07/2022|Yes|No||04/05/2013|01/07/2022|Yes|No|04/05/2013|01/07/2022|Yes|No||04/05/2013|01/07/2022|Yes|No|07/01/2016|01/07/2022|Prescription required|No||113|Yes|.24959|03/29/2022|.24359|03/29/2022|.24522|03/29/2022|||ANGIOTENSIN MODULATORS|19145|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||LUPIN PHARMACEU|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|68180041406|IRBESARTAN-HCTZ 300-12.5 MG TB|30|EA|.19192|04/05/2013|01/07/2022|Yes|No||04/05/2013|01/07/2022|Yes|No|04/05/2013|01/07/2022|Yes|No||04/05/2013|01/07/2022|Yes|No|07/01/2016|01/07/2022|Prescription required|No||113|Yes|.26247|03/29/2022|.25617|03/29/2022|.25787|03/29/2022|||ANGIOTENSIN MODULATORS|19146|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||LUPIN PHARMACEU|No||||
irbesartan/hydrochlorothiazide|Yes|No|No|No|75%|68180041409|IRBESARTAN-HCTZ 300-12.5 MG TB|90|EA|.18561|04/05/2013|01/07/2022|Yes|No||04/05/2013|01/07/2022|Yes|No|04/05/2013|01/07/2022|Yes|No||04/05/2013|01/07/2022|Yes|No|07/01/2016|01/07/2022|Prescription required|No||113|Yes|.26247|03/29/2022|.25617|03/29/2022|.25787|03/29/2022|||ANGIOTENSIN MODULATORS|19147|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||LUPIN PHARMACEU|No||||
moxifloxacin HCl|No|No|No|No|75%|68180042101|MOXIFLOXACIN 0.5% EYE DROPS|3|ML|21.01553|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|058|No|47.89586|09/18/2020|47.21163|09/18/2020|44.96346|09/18/2020|||OPHTHALMIC ANTIBIOTICS|19148|||||No|No||LUPIN PHARMACEU|No||||
moxifloxacin HCl|No|No|No|No|75%|68180042201|MOXIFLOXACIN 0.5% EYE DROPS|3|ML|5.01666|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|058|No|3.97371|03/29/2022|3.87834|03/29/2022|3.90417|03/29/2022|||OPHTHALMIC ANTIBIOTICS|19149|||||No|No||LUPIN PHARMACEU|No||||
bimatoprost|No|No|No|No|75%|68180042901|BIMATOPROST 0.03% EYE DROPS|2.5|ML|18.5244|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|088|No|28.61527|03/29/2022|27.9285|03/29/2022|28.1145|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|19150|||||No|No||LUPIN PHARMACEU|No||||
bimatoprost|No|No|No|No|75%|68180042902|BIMATOPROST 0.03% EYE DROPS|5|ML|18.51666|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|088|No|26.52867|03/29/2022|25.89198|03/29/2022|26.06441|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|19151|||||No|No||LUPIN PHARMACEU|No||||
bimatoprost|No|No|No|No|75%|68180042903|BIMATOPROST 0.03% EYE DROPS|7.5|ML|18.51637|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|088|No|42.2001|06/01/2016|41.59724|06/01/2016|39.61642|06/01/2016|||OPHTHALMICS: GLAUCOMA AGENTS|19152|||||No|No||LUPIN PHARMACEU|No||||
gatifloxacin|No|No|No|No|75%|68180043501|GATIFLOXACIN 0.5% EYE DROPS|2.5|ML|16.25916|10/03/2013||Yes|No||10/03/2013||Yes|No|10/03/2013||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|058|No|12.97096|03/29/2022|12.65965|03/29/2022|12.74396|03/29/2022|||OPHTHALMIC ANTIBIOTICS|19153|||||No|No||LUPIN PHARMACEU|No||||
cephalexin|No|No|No|No|75%|68180044001|CEPHALEXIN 125 MG/5 ML SUSP|100|ML|.0817|03/29/2019||Yes|No||03/29/2019||Yes|No|03/29/2019||Yes|No||03/29/2019||Yes|No|||Prescription required|No||046|No|.0819|03/29/2022|.07993|03/29/2022|.08046|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19154|||||No|No||LUPIN PHARMACEU|No||||
cephalexin|No|No|No|No|75%|68180044002|CEPHALEXIN 125 MG/5 ML SUSP|200|ML|.0688|03/29/2019||Yes|No||03/29/2019||Yes|No|03/29/2019||Yes|No||03/29/2019||Yes|No|||Prescription required|No||046|No|.0415|10/26/2021|.0405|10/26/2021|.04077|10/26/2021|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19155|||||No|No||LUPIN PHARMACEU|No||||
cephalexin|No|No|No|No|75%|68180044101|CEPHALEXIN 250 MG/5 ML SUSP|100|ML|.0989|06/10/2019||Yes|No||06/10/2019||Yes|No|06/10/2019||Yes|No||06/10/2019||Yes|No|||Prescription required|No||046|No|.09997|03/29/2022|.09757|03/29/2022|.09822|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19156|||||No|No||LUPIN PHARMACEU|No||||
cephalexin|No|No|No|No|75%|68180044102|CEPHALEXIN 250 MG/5 ML SUSP|200|ML|.08815|03/29/2019||Yes|No||03/29/2019||Yes|No|03/29/2019||Yes|No||03/29/2019||Yes|No|||Prescription required|No||046|No|.07683|03/29/2022|.07498|03/29/2022|.07548|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19157|||||No|No||LUPIN PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|68180044501|QUETIAPINE FUMARATE 25 MG TAB|100|EA|.02171|03/29/2012||Yes|No||03/29/2012||Yes|No|03/29/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.03239|03/29/2022|.03161|03/29/2022|.03182|03/29/2022|||ANTIPSYCHOTICS|19158|||||No|No||LUPIN PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|68180044503|QUETIAPINE FUMARATE 25 MG TAB|1000|EA|.02169|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.03239|03/29/2022|.03161|03/29/2022|.03182|03/29/2022|||ANTIPSYCHOTICS|19159|||||No|No||LUPIN PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|68180044601|QUETIAPINE FUMARATE 50 MG TAB|100|EA|.03259|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.04283|03/29/2022|.0418|03/29/2022|.04208|03/29/2022|||ANTIPSYCHOTICS|19160|||||No|No||LUPIN PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|68180044603|QUETIAPINE FUMARATE 50 MG TAB|1000|EA|.03257|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.04283|03/29/2022|.0418|03/29/2022|.04208|03/29/2022|||ANTIPSYCHOTICS|19161|||||No|No||LUPIN PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|68180044701|QUETIAPINE FUMARATE 100 MG TAB|100|EA|.0516|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.05826|03/29/2022|.05686|03/29/2022|.05724|03/29/2022|||ANTIPSYCHOTICS|19162|||||No|No||LUPIN PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|68180044703|QUETIAPINE FUMARATE 100 MG TAB|1000|EA|.0516|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.05826|03/29/2022|.05686|03/29/2022|.05724|03/29/2022|||ANTIPSYCHOTICS|19163|||||No|No||LUPIN PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|68180044801|QUETIAPINE FUMARATE 200 MG TAB|100|EA|.07529|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.10261|03/29/2022|.10014|03/29/2022|.10081|03/29/2022|||ANTIPSYCHOTICS|19164|||||No|No||LUPIN PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|68180044802|QUETIAPINE FUMARATE 200 MG TAB|500|EA|.07531|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.10261|03/29/2022|.10014|03/29/2022|.10081|03/29/2022|||ANTIPSYCHOTICS|19165|||||No|No||LUPIN PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|68180044901|QUETIAPINE FUMARATE 300 MG TAB|100|EA|.10848|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.13964|03/29/2022|.13628|03/29/2022|.13719|03/29/2022|||ANTIPSYCHOTICS|19166|||||No|No||LUPIN PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|68180044902|QUETIAPINE FUMARATE 300 MG TAB|500|EA|.10847|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.13964|03/29/2022|.13628|03/29/2022|.13719|03/29/2022|||ANTIPSYCHOTICS|19167|||||No|No||LUPIN PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|68180044907|QUETIAPINE FUMARATE 300 MG TAB|60|EA|.1085|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.13964|03/29/2022|.13628|03/29/2022|.13719|03/29/2022|||ANTIPSYCHOTICS|19168|||||No|No||LUPIN PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|68180045001|QUETIAPINE FUMARATE 400 MG TAB|100|EA|.13381|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.17858|03/29/2022|.17429|03/29/2022|.17545|03/29/2022|||ANTIPSYCHOTICS|19169|||||No|No||LUPIN PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|68180045002|QUETIAPINE FUMARATE 400 MG TAB|500|EA|.13381|03/28/2012||Yes|No||03/28/2012||Yes|No|03/28/2012||Yes|No||||No|No|||Prescription required|No||027|Yes|.17858|03/29/2022|.17429|03/29/2022|.17545|03/29/2022|||ANTIPSYCHOTICS|19170|||||No|No||LUPIN PHARMACEU|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|68180045901|AMLODIPINE-BENAZEPRIL 5-20 MG|100|EA|.23736|02/21/2019||Yes|No||02/21/2019||Yes|No|02/21/2019||Yes|No||02/21/2019||Yes|No|||Prescription required|No||017|No|.13285|03/29/2022|.12966|03/29/2022|.13052|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|19171|||||No|No||LUPIN PHARMACEU|No||||
minocycline HCl|No|No|No|No|75%|68180046006|MINOCYCLINE ER 55 MG TABLET|30|EA|15.7089|09/04/2019||Yes|No||09/04/2019||Yes|No|09/04/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|35.80168|09/04/2019|35.29023|09/04/2019|33.60974|09/04/2019|||TETRACYCLINES|19172|||||No|No||LUPIN PHARMACEU|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|68180046301|AMLODIPINE-BENAZEPRIL 5-40 MG|100|EA|.31368|10/15/2018||Yes|No||10/15/2018||Yes|No|10/15/2018||Yes|No||10/15/2018||Yes|No|||Prescription required|No||017|No|.15246|03/29/2022|.1488|03/29/2022|.14979|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|19173|||||No|No||LUPIN PHARMACEU|No||||
simvastatin|Yes|No|No|No|75%|68180046403|SIMVASTATIN 40 MG TABLET|1000|EA|.04601|05/11/2016||Yes|No||05/11/2016||Yes|No|05/11/2016||Yes|No||05/11/2016||Yes|No|07/01/2016||Prescription required|No||063|Yes|.04431|03/29/2022|.04324|03/29/2022|.04353|03/29/2022|||LIPOTROPICS: STATINS|19174|||||No|No||LUPIN PHARMACEU|No||||
simvastatin|No|No|No|No|75%|68180046406|SIMVASTATIN 40 MG TABLET|30|EA|.04601|08/15/2016||Yes|No||08/15/2016||Yes|No|08/15/2016||Yes|No||08/15/2016||Yes|No|||Prescription required|No||063|Yes|.04431|03/29/2022|.04324|03/29/2022|.04353|03/29/2022|||LIPOTROPICS: STATINS|19175|||||No|No||LUPIN PHARMACEU|No||||
simvastatin|No|No|No|No|75%|68180046409|SIMVASTATIN 40 MG TABLET|90|EA|.04601|08/15/2016||Yes|No||08/15/2016||Yes|No|08/15/2016||Yes|No||08/15/2016||Yes|No|||Prescription required|No||063|Yes|.04431|03/29/2022|.04324|03/29/2022|.04353|03/29/2022|||LIPOTROPICS: STATINS|19176|||||No|No||LUPIN PHARMACEU|No||||
simvastatin|Yes|No|No|No|75%|68180046503|SIMVASTATIN 80 MG TABLET|1000|EA|.05203|05/11/2016||Yes|No||05/11/2016||Yes|No|05/11/2016||Yes|No||05/11/2016||Yes|No|07/01/2016||Prescription required|No||063|Yes|.09322|03/29/2022|.09098|03/29/2022|.09158|03/29/2022|||LIPOTROPICS: STATINS|19177|||||No|No||LUPIN PHARMACEU|No||||
simvastatin|Yes|No|No|No|75%|68180046506|SIMVASTATIN 80 MG TABLET|30|EA|.05203|05/11/2016||Yes|No||05/11/2016||Yes|No|05/11/2016||Yes|No||05/11/2016||Yes|No|07/01/2016||Prescription required|No||063|Yes|.09322|03/29/2022|.09098|03/29/2022|.09158|03/29/2022|||LIPOTROPICS: STATINS|19178|||||No|No||LUPIN PHARMACEU|No||||
simvastatin|Yes|No|No|No|75%|68180046509|SIMVASTATIN 80 MG TABLET|90|EA|.05203|05/11/2016||Yes|No||05/11/2016||Yes|No|05/11/2016||Yes|No||05/11/2016||Yes|No|07/01/2016||Prescription required|No||063|Yes|.09322|03/29/2022|.09098|03/29/2022|.09158|03/29/2022|||LIPOTROPICS: STATINS|19179|||||No|No||LUPIN PHARMACEU|No||||
lovastatin|Yes|No|No|No|75%|68180046701|LOVASTATIN 10 MG TABLET|100|EA|.09417|03/18/2008||Yes|No||03/18/2008||Yes|No|03/18/2008||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.0534|03/29/2022|.05211|03/29/2022|.05246|03/29/2022|||LIPOTROPICS: STATINS|19180|||||No|No||LUPIN PHARMACEU|No||||
lovastatin|Yes|No|No|No|75%|68180046703|LOVASTATIN 10 MG TABLET|1000|EA|.08562|03/18/2008||Yes|No||03/18/2008||Yes|No|03/18/2008||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.0534|03/29/2022|.05211|03/29/2022|.05246|03/29/2022|||LIPOTROPICS: STATINS|19181|||||No|No||LUPIN PHARMACEU|No||||
lovastatin|Yes|No|No|No|75%|68180046707|LOVASTATIN 10 MG TABLET|60|EA|.09001|03/18/2008||Yes|No||03/18/2008||Yes|No|03/18/2008||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.0534|03/29/2022|.05211|03/29/2022|.05246|03/29/2022|||LIPOTROPICS: STATINS|19182|||||No|No||LUPIN PHARMACEU|No||||
lovastatin|Yes|No|No|No|75%|68180046801|LOVASTATIN 20 MG TABLET|100|EA|.09163|11/01/2007||Yes|No||11/01/2007||Yes|No|11/01/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.04992|03/29/2022|.04872|03/29/2022|.04904|03/29/2022|||LIPOTROPICS: STATINS|19183|||||No|No||LUPIN PHARMACEU|No||||
lovastatin|Yes|No|No|No|75%|68180046803|LOVASTATIN 20 MG TABLET|1000|EA|.08797|11/01/2007||Yes|No||11/01/2007||Yes|No|11/01/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.04992|03/29/2022|.04872|03/29/2022|.04904|03/29/2022|||LIPOTROPICS: STATINS|19184|||||No|No||LUPIN PHARMACEU|No||||
lovastatin|Yes|No|No|No|75%|68180046805|LOVASTATIN 20 MG TABLET|5000|EA|.08797|03/04/2010||Yes|No||03/04/2010||Yes|No|03/04/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.04992|03/29/2022|.04872|03/29/2022|.04904|03/29/2022|||LIPOTROPICS: STATINS|19185|||||No|No||LUPIN PHARMACEU|No||||
lovastatin|Yes|No|No|No|75%|68180046807|LOVASTATIN 20 MG TABLET|60|EA|.09259|11/01/2007||Yes|No||11/01/2007||Yes|No|11/01/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.04992|03/29/2022|.04872|03/29/2022|.04904|03/29/2022|||LIPOTROPICS: STATINS|19186|||||No|No||LUPIN PHARMACEU|No||||
lovastatin|Yes|No|No|No|75%|68180046901|LOVASTATIN 40 MG TABLET|100|EA|.14731|11/01/2007||Yes|No||11/01/2007||Yes|No|11/01/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.0616|03/29/2022|.06012|03/29/2022|.06052|03/29/2022|||LIPOTROPICS: STATINS|19187|||||No|No||LUPIN PHARMACEU|No||||
lovastatin|Yes|No|No|No|75%|68180046903|LOVASTATIN 40 MG TABLET|1000|EA|.14143|11/01/2007||Yes|No||11/01/2007||Yes|No|11/01/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.0616|03/29/2022|.06012|03/29/2022|.06052|03/29/2022|||LIPOTROPICS: STATINS|19188|||||No|No||LUPIN PHARMACEU|No||||
lovastatin|Yes|No|No|No|75%|68180046905|LOVASTATIN 40 MG TABLET|5000|EA|.14143|03/04/2010||Yes|No||03/04/2010||Yes|No|03/04/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.0616|03/29/2022|.06012|03/29/2022|.06052|03/29/2022|||LIPOTROPICS: STATINS|19189|||||No|No||LUPIN PHARMACEU|No||||
lovastatin|Yes|No|No|No|75%|68180046907|LOVASTATIN 40 MG TABLET|60|EA|.14878|11/01/2007||Yes|No||11/01/2007||Yes|No|11/01/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.0616|03/29/2022|.06012|03/29/2022|.06052|03/29/2022|||LIPOTROPICS: STATINS|19190|||||No|No||LUPIN PHARMACEU|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|68180047201|AMLODIPINE-BENAZEPRIL 10-20 MG|100|EA|.27571|09/30/2019||Yes|No||09/30/2019||Yes|No|09/30/2019||Yes|No||09/30/2019||Yes|No|||Prescription required|No||017|No|.14427|03/29/2022|.1408|03/29/2022|.14174|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|19191|||||No|No||LUPIN PHARMACEU|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|68180047301|AMLODIPINE-BENAZEPRIL 10-40 MG|100|EA|.37891|01/24/2019||Yes|No||01/24/2019||Yes|No|01/24/2019||Yes|No||01/24/2019||Yes|No|||Prescription required|No||017|No|.17354|03/29/2022|.16937|03/29/2022|.1705|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|19192|||||No|No||LUPIN PHARMACEU|No||||
simvastatin|Yes|No|No|No|75%|68180047801|SIMVASTATIN 10 MG TABLET|30|EA|.03225|05/11/2007||Yes|No||05/11/2007||Yes|No|05/11/2007||Yes|No||05/11/2007||Yes|No|07/01/2016||Prescription required|No||063|Yes|.02909|03/29/2022|.02839|03/29/2022|.02858|03/29/2022|||LIPOTROPICS: STATINS|19193|||||No|No||LUPIN PHARMACEU|No||||
simvastatin|Yes|No|No|No|75%|68180047802|SIMVASTATIN 10 MG TABLET|90|EA|.03225|05/11/2007||Yes|No||05/11/2007||Yes|No|05/11/2007||Yes|No||05/11/2007||Yes|No|07/01/2016||Prescription required|No||063|Yes|.02909|03/29/2022|.02839|03/29/2022|.02858|03/29/2022|||LIPOTROPICS: STATINS|19194|||||No|No||LUPIN PHARMACEU|No||||
simvastatin|Yes|No|No|No|75%|68180047803|SIMVASTATIN 10 MG TABLET|1000|EA|.03225|07/30/2008||Yes|No||07/30/2008||Yes|No|07/30/2008||Yes|No||07/30/2008||Yes|No|07/01/2016||Prescription required|No||063|Yes|.02909|03/29/2022|.02839|03/29/2022|.02858|03/29/2022|||LIPOTROPICS: STATINS|19195|||||No|No||LUPIN PHARMACEU|No||||
simvastatin|Yes|No|No|No|75%|68180047901|SIMVASTATIN 20 MG TABLET|30|EA|.03526|05/11/2007||Yes|No||05/11/2007||Yes|No|05/11/2007||Yes|No||05/11/2007||Yes|No|07/01/2016||Prescription required|No||063|Yes|.02604|03/29/2022|.02541|03/29/2022|.02558|03/29/2022|||LIPOTROPICS: STATINS|19196|||||No|No||LUPIN PHARMACEU|No||||
simvastatin|Yes|No|No|No|75%|68180047902|SIMVASTATIN 20 MG TABLET|90|EA|.03526|05/11/2007||Yes|No||05/11/2007||Yes|No|05/11/2007||Yes|No||05/11/2007||Yes|No|07/01/2016||Prescription required|No||063|Yes|.02604|03/29/2022|.02541|03/29/2022|.02558|03/29/2022|||LIPOTROPICS: STATINS|19197|||||No|No||LUPIN PHARMACEU|No||||
simvastatin|Yes|No|No|No|75%|68180047903|SIMVASTATIN 20 MG TABLET|1000|EA|.03526|07/30/2008||Yes|No||07/30/2008||Yes|No|07/30/2008||Yes|No||07/30/2008||Yes|No|07/01/2016||Prescription required|No||063|Yes|.02604|03/29/2022|.02541|03/29/2022|.02558|03/29/2022|||LIPOTROPICS: STATINS|19198|||||No|No||LUPIN PHARMACEU|No||||
repaglinide/metformin HCl|No|No|No|No|75%|68180049001|REPAGLINIDE-METFORMIN 1-500 MG|100|EA|2.11375|11/19/2015||Yes|No||11/19/2015||Yes|No|11/19/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|022|Yes|4.81738|06/01/2016|4.74856|06/01/2016|4.52244|06/01/2016|||HYPOGLYCEMICS: MEGLITINIDES|19199|||||No|No||LUPIN PHARMACEU|No||||
repaglinide/metformin HCl|No|No|No|No|75%|68180049101|REPAGLINIDE-METFORMIN 2-500 MG|100|EA|2.11375|11/19/2015||Yes|No||11/19/2015||Yes|No|11/19/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|022|Yes|4.81738|06/01/2016|4.74856|06/01/2016|4.52244|06/01/2016|||HYPOGLYCEMICS: MEGLITINIDES|19200|||||No|No||LUPIN PHARMACEU|No||||
clomipramine HCl|No|No|No|No|75%|68180049201|CLOMIPRAMINE 25 MG CAPSULE|100|EA|1.94493|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|1.31238|03/29/2022|1.28088|03/29/2022|1.28941|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|19201|||||No|No||LUPIN PHARMACEU|No||||
clomipramine HCl|No|No|No|No|75%|68180049206|CLOMIPRAMINE 25 MG CAPSULE|30|EA|2.08894|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|1.31238|03/29/2022|1.28088|03/29/2022|1.28941|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|19202|||||No|No||LUPIN PHARMACEU|No||||
clomipramine HCl|No|No|No|No|75%|68180049301|CLOMIPRAMINE 50 MG CAPSULE|100|EA|1.94493|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.80238|03/29/2022|.78312|03/29/2022|.78833|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|19203|||||No|No||LUPIN PHARMACEU|No||||
clomipramine HCl|No|No|No|No|75%|68180049306|CLOMIPRAMINE 50 MG CAPSULE|30|EA|2.08894|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.80238|03/29/2022|.78312|03/29/2022|.78833|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|19204|||||No|No||LUPIN PHARMACEU|No||||
clomipramine HCl|No|No|No|No|75%|68180049401|CLOMIPRAMINE 75 MG CAPSULE|100|EA|1.94493|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.95054|03/29/2022|.92772|03/29/2022|.9339|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|19205|||||No|No||LUPIN PHARMACEU|No||||
clomipramine HCl|No|No|No|No|75%|68180049406|CLOMIPRAMINE 75 MG CAPSULE|30|EA|2.08894|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.95054|03/29/2022|.92772|03/29/2022|.9339|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|19206|||||No|No||LUPIN PHARMACEU|No||||
meloxicam|No|No|No|No|75%|68180050101|MELOXICAM 7.5 MG TABLET|100|EA|.0172|07/19/2006||Yes|No||07/19/2006||Yes|No|07/19/2006||Yes|No||07/01/2012||Yes|No|||Prescription required|No||059|Yes|.02172|08/24/2021|.02119|08/24/2021|.02133|08/24/2021|||NSAIDS|19207|||||No|No||LUPIN PHARMACEU|No||||
meloxicam|No|No|No|No|75%|68180050103|MELOXICAM 7.5 MG TABLET|1000|EA|.0172|10/17/2007||Yes|No||10/17/2007||Yes|No|10/17/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||059|Yes|.02172|08/24/2021|.02119|08/24/2021|.02133|08/24/2021|||NSAIDS|19208|||||No|No||LUPIN PHARMACEU|No||||
meloxicam|No|No|No|No|75%|68180050201|MELOXICAM 15 MG TABLET|100|EA|.0215|07/19/2006||Yes|No||07/19/2006||Yes|No|07/19/2006||Yes|No||07/01/2012||Yes|No|||Prescription required|No||059|Yes|.02201|08/24/2021|.02148|08/24/2021|.02162|08/24/2021|||NSAIDS|19209|||||No|No||LUPIN PHARMACEU|No||||
meloxicam|No|No|No|No|75%|68180050203|MELOXICAM 15 MG TABLET|1000|EA|.0215|10/17/2007||Yes|No||10/17/2007||Yes|No|10/17/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||059|Yes|.02201|08/24/2021|.02148|08/24/2021|.02162|08/24/2021|||NSAIDS|19210|||||No|No||LUPIN PHARMACEU|No||||
lisinopril|Yes|No|No|No|75%|68180051201|LISINOPRIL 2.5 MG TABLET|100|EA|.01053|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2016||Prescription required|No||113|No|.01617|03/29/2022|.01578|03/29/2022|.01588|03/29/2022|||ANGIOTENSIN MODULATORS|19211|||||No|No||LUPIN PHARMACEU|No||||
lisinopril|Yes|No|No|No|75%|68180051202|LISINOPRIL 2.5 MG TABLET|500|EA|.00987|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2016||Prescription required|No||113|No|.01617|03/29/2022|.01578|03/29/2022|.01588|03/29/2022|||ANGIOTENSIN MODULATORS|19212|||||No|No||LUPIN PHARMACEU|No||||
lisinopril|Yes|No|No|No|75%|68180051209|LISINOPRIL 2.5 MG TABLET|90|EA|.01055|07/05/2011||Yes|No||07/05/2011||Yes|No|07/05/2011||Yes|No||07/05/2011||Yes|No|07/01/2016||Prescription required|No||113|No|.01617|03/29/2022|.01578|03/29/2022|.01588|03/29/2022|||ANGIOTENSIN MODULATORS|19213|||||No|No||LUPIN PHARMACEU|No||||
lisinopril|Yes|No|No|No|75%|68180051301|LISINOPRIL 5 MG TABLET|100|EA|.01384|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2016||Prescription required|No||113|No|.01549|03/29/2022|.01511|03/29/2022|.01521|03/29/2022|||ANGIOTENSIN MODULATORS|19214|||||No|No||LUPIN PHARMACEU|No||||
lisinopril|Yes|No|No|No|75%|68180051303|LISINOPRIL 5 MG TABLET|1000|EA|.01316|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2016||Prescription required|No||113|No|.01549|03/29/2022|.01511|03/29/2022|.01521|03/29/2022|||ANGIOTENSIN MODULATORS|19215|||||No|No||LUPIN PHARMACEU|No||||
lisinopril|Yes|No|No|No|75%|68180051309|LISINOPRIL 5 MG TABLET|90|EA|.01385|07/05/2011||Yes|No||07/05/2011||Yes|No|07/05/2011||Yes|No||07/05/2011||Yes|No|07/01/2016||Prescription required|No||113|No|.01549|03/29/2022|.01511|03/29/2022|.01521|03/29/2022|||ANGIOTENSIN MODULATORS|19216|||||No|No||LUPIN PHARMACEU|No||||
lisinopril|Yes|No|No|No|75%|68180051409|LISINOPRIL 10 MG TABLET|90|EA|.01935|07/05/2011||Yes|No||07/05/2011||Yes|No|07/05/2011||Yes|No||07/05/2011||Yes|No|07/01/2016||Prescription required|No||113|No|.01914|03/29/2022|.01868|03/29/2022|.0188|03/29/2022|||ANGIOTENSIN MODULATORS|19217|||||No|No||LUPIN PHARMACEU|No||||
lisinopril|Yes|No|No|No|75%|68180051509|LISINOPRIL 20 MG TABLET|90|EA|.02918|07/05/2011||Yes|No||07/05/2011||Yes|No|07/05/2011||Yes|No||07/05/2011||Yes|No|07/01/2016||Prescription required|No||113|No|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANGIOTENSIN MODULATORS|19218|||||No|No||LUPIN PHARMACEU|No||||
lisinopril|Yes|No|No|No|75%|68180051609|LISINOPRIL 30 MG TABLET|90|EA|.04672|07/05/2011||Yes|No||07/05/2011||Yes|No|07/05/2011||Yes|No||07/05/2011||Yes|No|07/01/2016||Prescription required|No||113|No|.05487|03/29/2022|.05355|03/29/2022|.0539|03/29/2022|||ANGIOTENSIN MODULATORS|19219|||||No|No||LUPIN PHARMACEU|No||||
lisinopril|Yes|No|No|No|75%|68180051701|LISINOPRIL 40 MG TABLET|100|EA|.05263|07/01/2007|07/29/2022|Yes|No||07/01/2007|07/29/2022|Yes|No|07/01/2007|07/29/2022|Yes|No||07/01/2007|07/29/2022|Yes|No|07/01/2016|07/29/2022|Prescription required|No||113|No|.04778|03/29/2022|.04663|03/29/2022|.04694|03/29/2022|||ANGIOTENSIN MODULATORS|19220|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||LUPIN PHARMACEU|No||||
lisinopril|Yes|No|No|No|75%|68180051703|LISINOPRIL 40 MG TABLET|1000|EA|.05003|07/01/2007|06/24/2022|Yes|No||07/01/2007|06/24/2022|Yes|No|07/01/2007|06/24/2022|Yes|No||07/01/2007|06/24/2022|Yes|No|07/01/2016|06/24/2022|Prescription required|No||113|No|.04778|03/29/2022|.04663|03/29/2022|.04694|03/29/2022|||ANGIOTENSIN MODULATORS|19221|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer|No|No||LUPIN PHARMACEU|No||||
lisinopril|Yes|No|No|No|75%|68180051709|LISINOPRIL 40 MG TABLET|90|EA|.05264|07/05/2011||Yes|No||07/05/2011||Yes|No|07/05/2011||Yes|No||07/05/2011||Yes|No|07/01/2016||Prescription required|No||113|No|.04778|03/29/2022|.04663|03/29/2022|.04694|03/29/2022|||ANGIOTENSIN MODULATORS|19222|||||No|No||LUPIN PHARMACEU|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|68180051801|LISINOPRIL-HCTZ 10-12.5 MG TAB|100|EA|.04063|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|||Prescription required|No||113|Yes|.03674|03/29/2022|.03585|03/29/2022|.03609|03/29/2022|||ANGIOTENSIN MODULATORS|19223|||||No|No||LUPIN PHARMACEU|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|68180051802|LISINOPRIL-HCTZ 10-12.5 MG TAB|500|EA|.03839|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|||Prescription required|No||113|Yes|.03674|03/29/2022|.03585|03/29/2022|.03609|03/29/2022|||ANGIOTENSIN MODULATORS|19224|||||No|No||LUPIN PHARMACEU|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|68180051830|LISINOPRIL-HCTZ 10-12.5 MG TAB|5000|EA|.03839|07/01/2015||Yes|No||07/01/2015||Yes|No|07/01/2015||Yes|No||07/01/2015||Yes|No|||Prescription required|No||113|Yes|.03674|03/29/2022|.03585|03/29/2022|.03609|03/29/2022|||ANGIOTENSIN MODULATORS|19225|||||No|No||LUPIN PHARMACEU|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|68180051901|LISINOPRIL-HCTZ 20-12.5 MG TAB|100|EA|.06067|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|||Prescription required|No||113|Yes|.04909|03/29/2022|.04791|03/29/2022|.04823|03/29/2022|||ANGIOTENSIN MODULATORS|19226|||||No|No||LUPIN PHARMACEU|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|68180051902|LISINOPRIL-HCTZ 20-12.5 MG TAB|500|EA|.0576|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|||Prescription required|No||113|Yes|.04909|03/29/2022|.04791|03/29/2022|.04823|03/29/2022|||ANGIOTENSIN MODULATORS|19227|||||No|No||LUPIN PHARMACEU|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|68180051930|LISINOPRIL-HCTZ 20-12.5 MG TAB|5000|EA|.0576|07/01/2015||Yes|No||07/01/2015||Yes|No|07/01/2015||Yes|No||07/01/2015||Yes|No|||Prescription required|No||113|Yes|.04909|03/29/2022|.04791|03/29/2022|.04823|03/29/2022|||ANGIOTENSIN MODULATORS|19228|||||No|No||LUPIN PHARMACEU|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|68180052001|LISINOPRIL-HCTZ 20-25 MG TAB|100|EA|.07026|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|||Prescription required|No||113|Yes|.04948|03/29/2022|.04829|03/29/2022|.04861|03/29/2022|||ANGIOTENSIN MODULATORS|19229|||||No|No||LUPIN PHARMACEU|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|68180052002|LISINOPRIL-HCTZ 20-25 MG TAB|500|EA|.06671|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|||Prescription required|No||113|Yes|.04948|03/29/2022|.04829|03/29/2022|.04861|03/29/2022|||ANGIOTENSIN MODULATORS|19230|||||No|No||LUPIN PHARMACEU|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|68180052030|LISINOPRIL-HCTZ 20-25 MG TAB|5000|EA|.06671|07/01/2015||Yes|No||07/01/2015||Yes|No|07/01/2015||Yes|No||07/01/2015||Yes|No|||Prescription required|No||113|Yes|.04948|03/29/2022|.04829|03/29/2022|.04861|03/29/2022|||ANGIOTENSIN MODULATORS|19231|||||No|No||LUPIN PHARMACEU|No||||
donepezil HCl|No|No|No|No|75%|68180052706|DONEPEZIL HCL 23 MG TABLET|30|EA|.97667|03/28/2016||Yes|No||03/28/2016||Yes|No|03/28/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|011|No|.75152|03/29/2022|.73348|03/29/2022|.73836|03/29/2022|||ALZHEIMER'S AGENTS|19232|||||No|No||LUPIN PHARMACEU|No||||
donepezil HCl|No|No|No|No|75%|68180052709|DONEPEZIL HCL 23 MG TABLET|90|EA|.97667|03/28/2016||Yes|No||03/28/2016||Yes|No|03/28/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|011|No|.75152|03/29/2022|.73348|03/29/2022|.73836|03/29/2022|||ALZHEIMER'S AGENTS|19233|||||No|No||LUPIN PHARMACEU|No||||
diclofenac sodium|No|No|No|No|75%|68180053801|DICLOFENAC 1.5% TOPICAL SOLN|150|ML|.59787|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.10888|03/29/2022|.10626|03/29/2022|.10697|03/29/2022|||NSAIDS|19234|||||No|No||LUPIN PHARMACEU|No||||
nystatin/triamcin|No|No|No|No|75%|68180054502|NYSTATIN-TRIAMCINOLONE CREAM|30|GM|1.02125|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|.49088|03/29/2022|.47909|03/29/2022|.48228|03/29/2022|||ANTIFUNGALS: TOPICAL|19235|||||No|No||LUPIN PHARMACEU|No||||
nystatin/triamcin|No|No|No|No|75%|68180054503|NYSTATIN-TRIAMCINOLONE CREAM|60|GM|.7439|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|.35965|03/29/2022|.35101|03/29/2022|.35335|03/29/2022|||ANTIFUNGALS: TOPICAL|19236|||||No|No||LUPIN PHARMACEU|No||||
quinapril HCl|Yes|No|No|No|75%|68180055409|QUINAPRIL 40 MG TABLET|90|EA|.07166|02/18/2015||Yes|No||02/18/2015||Yes|No|02/18/2015||Yes|No||02/18/2015||Yes|No|07/01/2016||Prescription required|No||113|No|.10852|03/29/2022|.10591|03/29/2022|.10662|03/29/2022|||ANGIOTENSIN MODULATORS|19237|||||No|No||LUPIN PHARMACEU|No||||
quinapril HCl|Yes|No|No|No|75%|68180055609|QUINAPRIL 5 MG TABLET|90|EA|.07166|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2016||Prescription required|No||113|No|.11066|03/29/2022|.108|03/29/2022|.10872|03/29/2022|||ANGIOTENSIN MODULATORS|19238|||||No|No||LUPIN PHARMACEU|No||||
quinapril HCl|No|No|No|No|75%|68180055709|QUINAPRIL 10 MG TABLET|90|EA|.07166|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|||Prescription required|No||113|No|.08121|03/29/2022|.07926|03/29/2022|.07978|03/29/2022|||ANGIOTENSIN MODULATORS|19239|||||No|No||LUPIN PHARMACEU|No||||
quinapril HCl|Yes|No|No|No|75%|68180055809|QUINAPRIL 20 MG TABLET|90|EA|.07166|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2007||Yes|No||07/01/2007||Yes|No|07/01/2016||Prescription required|No||113|No|.08843|03/29/2022|.0863|03/29/2022|.08688|03/29/2022|||ANGIOTENSIN MODULATORS|19240|||||No|No||LUPIN PHARMACEU|No||||
quinine sulfate|No|No|No|No|75%|68180056006|QUININE SULFATE 324 MG CAPSULE|30|EA|2.43294|07/30/2015||Yes|No||07/30/2015||Yes|No|07/30/2015||Yes|No||||No|No|||Prescription required|No|||No|1.35758|03/29/2022|1.32499|03/29/2022|1.33382|03/29/2022||||19241|||||No|No||LUPIN PHARMACEU|No||||
trandolapril|Yes|No|No|No|75%|68180056601|TRANDOLAPRIL 1 MG TABLET|100|EA|.23736|06/12/2007||Yes|No||06/12/2007||Yes|No|06/12/2007||Yes|No||||No|No|07/01/2016||Prescription required|Yes|03/23/2007|113|Yes|.54096|03/01/2022|.53323|03/01/2022|.50784|03/01/2022|||ANGIOTENSIN MODULATORS|19242|||||No|No||LUPIN PHARMACEU|No||||
trandolapril|Yes|No|No|No|75%|68180056701|TRANDOLAPRIL 2 MG TABLET|100|EA|.23736|06/12/2007||Yes|No||06/12/2007||Yes|No|06/12/2007||Yes|No||||No|No|07/01/2016||Prescription required|Yes|03/23/2007|113|Yes|.18405|03/29/2022|.17963|03/29/2022|.18082|03/29/2022|||ANGIOTENSIN MODULATORS|19243|||||No|No||LUPIN PHARMACEU|No||||
trandolapril|Yes|No|No|No|75%|68180056801|TRANDOLAPRIL 4 MG TABLET|100|EA|.23736|06/12/2007||Yes|No||06/12/2007||Yes|No|06/12/2007||Yes|No||||No|No|07/01/2016||Prescription required|Yes|03/23/2007|113|No|.24385|03/29/2022|.23799|03/29/2022|.23958|03/29/2022|||ANGIOTENSIN MODULATORS|19244|||||No|No||LUPIN PHARMACEU|No||||
ramipril|Yes|No|No|No|75%|68180058901|RAMIPRIL 2.5 MG CAPSULE|100|EA|.14061|06/10/2008||Yes|No||06/10/2008||Yes|No|06/10/2008||Yes|No||06/10/2008||Yes|No|07/01/2016||Prescription required|No||113|Yes|.06329|03/29/2022|.06177|03/29/2022|.06218|03/29/2022|||ANGIOTENSIN MODULATORS|19245|||||No|No||LUPIN PHARMACEU|No||||
ramipril|Yes|No|No|No|75%|68180058902|RAMIPRIL 2.5 MG CAPSULE|500|EA|.1333|06/10/2008||Yes|No||06/10/2008||Yes|No|06/10/2008||Yes|No||06/10/2008||Yes|No|07/01/2016||Prescription required|No||113|Yes|.06329|03/29/2022|.06177|03/29/2022|.06218|03/29/2022|||ANGIOTENSIN MODULATORS|19246|||||No|No||LUPIN PHARMACEU|No||||
ramipril|Yes|No|No|No|75%|68180058909|RAMIPRIL 2.5 MG CAPSULE|90|EA|.14061|07/05/2011||Yes|No||07/05/2011||Yes|No|07/05/2011||Yes|No||07/05/2011||Yes|No|07/01/2016||Prescription required|No||113|Yes|.06329|03/29/2022|.06177|03/29/2022|.06218|03/29/2022|||ANGIOTENSIN MODULATORS|19247|||||No|No||LUPIN PHARMACEU|No||||
ramipril|Yes|No|No|No|75%|68180059001|RAMIPRIL 5 MG CAPSULE|100|EA|.14792|06/10/2008||Yes|No||06/10/2008||Yes|No|06/10/2008||Yes|No||06/10/2008||Yes|No|07/01/2016||Prescription required|No||113|Yes|.06848|03/29/2022|.06683|03/29/2022|.06728|03/29/2022|||ANGIOTENSIN MODULATORS|19248|||||No|No||LUPIN PHARMACEU|No||||
ramipril|Yes|No|No|No|75%|68180059002|RAMIPRIL 5 MG CAPSULE|500|EA|.14026|06/10/2008||Yes|No||06/10/2008||Yes|No|06/10/2008||Yes|No||06/10/2008||Yes|No|07/01/2016||Prescription required|No||113|Yes|.06848|03/29/2022|.06683|03/29/2022|.06728|03/29/2022|||ANGIOTENSIN MODULATORS|19249|||||No|No||LUPIN PHARMACEU|No||||
ramipril|Yes|No|No|No|75%|68180059009|RAMIPRIL 5 MG CAPSULE|90|EA|.14792|07/05/2011||Yes|No||07/05/2011||Yes|No|07/05/2011||Yes|No||07/05/2011||Yes|No|07/01/2016||Prescription required|No||113|Yes|.06848|03/29/2022|.06683|03/29/2022|.06728|03/29/2022|||ANGIOTENSIN MODULATORS|19250|||||No|No||LUPIN PHARMACEU|No||||
ramipril|Yes|No|No|No|75%|68180059101|RAMIPRIL 10 MG CAPSULE|100|EA|.16297|06/10/2008||Yes|No||06/10/2008||Yes|No|06/10/2008||Yes|No||06/10/2008||Yes|No|07/01/2016||Prescription required|No||113|No|.07037|03/29/2022|.06868|03/29/2022|.06913|03/29/2022|||ANGIOTENSIN MODULATORS|19251|||||No|No||LUPIN PHARMACEU|No||||
ramipril|Yes|No|No|No|75%|68180059102|RAMIPRIL 10 MG CAPSULE|500|EA|.15462|06/10/2008||Yes|No||06/10/2008||Yes|No|06/10/2008||Yes|No||06/10/2008||Yes|No|07/01/2016||Prescription required|No||113|No|.07037|03/29/2022|.06868|03/29/2022|.06913|03/29/2022|||ANGIOTENSIN MODULATORS|19252|||||No|No||LUPIN PHARMACEU|No||||
ramipril|Yes|No|No|No|75%|68180059109|RAMIPRIL 10 MG CAPSULE|90|EA|.16297|07/05/2011||Yes|No||07/05/2011||Yes|No|07/05/2011||Yes|No||07/05/2011||Yes|No|07/01/2016||Prescription required|No||113|No|.07037|03/29/2022|.06868|03/29/2022|.06913|03/29/2022|||ANGIOTENSIN MODULATORS|19253|||||No|No||LUPIN PHARMACEU|No||||
desvenlafaxine succinate|No|No|No|No|75%|68180059206|DESVENLAFAXINE SUCCNT ER 50 MG|30|EA|1.48006|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.57735|03/29/2022|.56349|03/29/2022|.56724|03/29/2022|||ANTIDEPRESSANTS: OTHER|19254|||||No|No||LUPIN PHARMACEU|No||||
desvenlafaxine succinate|No|No|No|No|75%|68180059306|DESVENLAFAXINE SUCCNT ER 100MG|30|EA|1.48006|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.60974|03/29/2022|.5951|03/29/2022|.59906|03/29/2022|||ANTIDEPRESSANTS: OTHER|19255|||||No|No||LUPIN PHARMACEU|No||||
lamivudine|No|No|No|No|75%|68180060207|LAMIVUDINE 150 MG TABLET|60|EA|3.43729|03/25/2015||Yes|No||03/25/2015||Yes|No|03/25/2015||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.96758|11/23/2021|.94435|11/23/2021|.95064|11/23/2021|||HIV / AIDS|19256|||||No|No||LUPIN PHARMACEU|No||||
lamivudine|No|No|No|No|75%|68180060306|LAMIVUDINE 300 MG TABLET|30|EA|6.87459|03/25/2015||Yes|No||03/25/2015||Yes|No|03/25/2015||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|1.29184|03/01/2022|1.26083|03/01/2022|1.26923|03/01/2022|||HIV / AIDS|19257|||||No|No||LUPIN PHARMACEU|No||||
clonidine HCl|No|No|No|No|75%|68180060607|CLONIDINE HCL ER 0.1 MG TABLET|60|EA|1.43333|03/18/2019||Yes|No||03/18/2019||Yes|No|03/18/2019||Yes|No||03/18/2019||Yes|No|||Prescription required|Yes|07/29/2021|007|Yes|.52051|03/29/2022|.50801|03/29/2022|.5114|03/29/2022|||STIMULANTS AND RELATED AGENTS|19258|||||No|No||LUPIN PHARMACEU|No||||
ceftriaxone sodium|Yes|No|No|No|75%|68180061101|CEFTRIAXONE 250 MG VIAL|1|EA|.9675|07/20/2005||Yes|No||07/20/2005||Yes|No|07/20/2005||Yes|No||||No|No|11/01/2012||Prescription required|No|||No|2.205|11/23/2021|2.1735|11/23/2021|2.07|11/23/2021||||19259|||||No|No||LUPIN PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|68180061207|QUETIAPINE ER 50 MG TABLET|60|EA|.57204|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|027|Yes|.13845|03/29/2022|.13512|03/29/2022|.13602|03/29/2022|||ANTIPSYCHOTICS|19260|||||No|No||LUPIN PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|68180061307|QUETIAPINE ER 150 MG TABLET|60|EA|1.02719|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|027|Yes|.25256|03/29/2022|.24649|03/29/2022|.24814|03/29/2022|||ANTIPSYCHOTICS|19261|||||No|No||LUPIN PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|68180061407|QUETIAPINE ER 200 MG TABLET|60|EA|1.13053|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|027|Yes|.25825|03/29/2022|.25205|03/29/2022|.25373|03/29/2022|||ANTIPSYCHOTICS|19262|||||No|No||LUPIN PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|68180061507|QUETIAPINE ER 300 MG TABLET|60|EA|1.48235|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|027|Yes|.35477|03/29/2022|.34625|03/29/2022|.34856|03/29/2022|||ANTIPSYCHOTICS|19263|||||No|No||LUPIN PHARMACEU|No||||
quetiapine fumarate|No|No|No|No|75%|68180061607|QUETIAPINE ER 400 MG TABLET|60|EA|1.74214|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|027|Yes|.42833|03/29/2022|.41805|03/29/2022|.42083|03/29/2022|||ANTIPSYCHOTICS|19264|||||No|No||LUPIN PHARMACEU|No||||
ceftriaxone sodium|Yes|No|No|No|75%|68180062201|CEFTRIAXONE 500 MG VIAL|1|EA|1.5695|07/20/2005||Yes|No||07/20/2005||Yes|No|07/20/2005||Yes|No||||No|No|03/10/2021||Prescription required|No|||No|3.577|06/28/2016|3.5259|06/28/2016|3.358|06/28/2016||||19265|||||No|No||LUPIN PHARMACEU|No||||
ceftriaxone sodium|No|No|No|No|75%|68180063301|CEFTRIAXONE 1 GM VIAL|1|EA|2.3736|07/20/2005||Yes|No||07/20/2005||Yes|No|07/20/2005||Yes|No||||No|No|||Prescription required|No|||No|5.4096|06/01/2016|5.33232|06/01/2016|5.0784|06/01/2016||||19266|||||No|No||LUPIN PHARMACEU|No||||
atorvastatin calcium|No|No|No|No|75%|68180063502|ATORVASTATIN 10 MG TABLET|500|EA|.09106|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||12/10/2020||Yes|No|||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|19267|||||No|No||LUPIN PHARMACEU|No||||
atorvastatin calcium|No|No|No|No|75%|68180063509|ATORVASTATIN 10 MG TABLET|90|EA|.09106|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||12/10/2020||Yes|No|||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|19268|||||No|No||LUPIN PHARMACEU|No||||
atorvastatin calcium|No|No|No|No|75%|68180063602|ATORVASTATIN 20 MG TABLET|500|EA|.12961|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||12/10/2020||Yes|No|||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|19269|||||No|No||LUPIN PHARMACEU|No||||
atorvastatin calcium|No|No|No|No|75%|68180063609|ATORVASTATIN 20 MG TABLET|90|EA|.12961|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||12/10/2020||Yes|No|||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|19270|||||No|No||LUPIN PHARMACEU|No||||
atorvastatin calcium|No|No|No|No|75%|68180063702|ATORVASTATIN 40 MG TABLET|500|EA|.12961|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||12/10/2020||Yes|No|||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|19271|||||No|No||LUPIN PHARMACEU|No||||
atorvastatin calcium|No|No|No|No|75%|68180063709|ATORVASTATIN 40 MG TABLET|90|EA|.12961|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||12/10/2020||Yes|No|||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|19272|||||No|No||LUPIN PHARMACEU|No||||
atorvastatin calcium|No|No|No|No|75%|68180063802|ATORVASTATIN 80 MG TABLET|500|EA|.12961|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||12/10/2020||Yes|No|||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|19273|||||No|No||LUPIN PHARMACEU|No||||
atorvastatin calcium|No|No|No|No|75%|68180063809|ATORVASTATIN 80 MG TABLET|90|EA|.12961|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||12/10/2020||Yes|No|||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|19274|||||No|No||LUPIN PHARMACEU|No||||
paroxetine HCl|No|No|No|No|75%|68180064506|PAROXETINE ER 37.5 MG TABLET|30|EA|2.0617|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|008|No|1.12249|03/29/2022|1.09555|03/29/2022|1.10284|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19275|||||No|No||LUPIN PHARMACEU|No||||
paroxetine HCl|No|No|No|No|75%|68180064606|PAROXETINE ER 25 MG TABLET|30|EA|2.00165|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|008|No|1.16217|03/29/2022|1.13427|03/29/2022|1.14183|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19276|||||No|No||LUPIN PHARMACEU|No||||
paroxetine HCl|No|No|No|No|75%|68180064706|PAROXETINE ER 12.5 MG TABLET|30|EA|1.91794|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|008|Yes|.80099|03/29/2022|.78176|03/29/2022|.78697|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19277|||||No|No||LUPIN PHARMACEU|No||||
doxycycline monohydrate|No|No|No|No|75%|68180065001|DOXYCYCLINE MONO 50 MG CAP|100|EA|.2236|03/06/2015||Yes|No||03/06/2015||Yes|No|03/06/2015||Yes|No||03/06/2015||Yes|No|||Prescription required|No||213|No|.2073|03/29/2022|.20232|03/29/2022|.20367|03/29/2022|||TETRACYCLINES|19278|||||No|No||LUPIN PHARMACEU|No||||
doxycycline monohydrate|Yes|No|No|No|75%|68180065208|DOXYCYCLINE MONO 100 MG CAP|50|EA|.3612|03/06/2015||Yes|No||03/06/2015||Yes|No|03/06/2015||Yes|No||03/06/2015||Yes|No|03/06/2015||Prescription required|No||213|No|.25496|03/29/2022|.24884|03/29/2022|.25049|03/29/2022|||TETRACYCLINES|19279|||||No|No||LUPIN PHARMACEU|No||||
doxycycline hyclate|No|No|No|No|75%|68180065307|DOXYCYCLINE HYCLATE 75 MG TAB|60|EA|10.73071|07/06/2018||Yes|No||07/06/2018||Yes|No|07/06/2018||Yes|No||07/06/2018||Yes|No|||Prescription required|Yes|11/09/2017|213|No|24.45605|07/06/2018|24.10668|07/06/2018|22.95874|07/06/2018|||TETRACYCLINES|19280|||||No|No||LUPIN PHARMACEU|No||||
doxycycline hyclate|No|No|No|No|75%|68180065407|DOXYCYCLINE HYCLATE 150 MG TAB|60|EA|10.73071|07/06/2018||Yes|No||07/06/2018||Yes|No|07/06/2018||Yes|No||07/06/2018||Yes|No|||Prescription required|Yes|11/09/2017|213|No|24.45605|03/24/2020|24.10668|03/24/2020|22.95874|03/24/2020|||TETRACYCLINES|19281|||||No|No||LUPIN PHARMACEU|No||||
doxycycline monohydrate|No|No|No|No|75%|68180065701|DOXYCYCLINE 25 MG/5 ML SUSP|60|ML|.13057|06/11/2013||Yes|No||06/11/2013||Yes|No|06/11/2013||Yes|No||06/11/2013||Yes|No|||Prescription required|No|||No|.27292|03/01/2022|.26636|03/01/2022|.26814|03/01/2022||||19282|||||No|No||LUPIN PHARMACEU|No||||
rifampin|No|No|No|No|75%|68180065801|RIFAMPIN 150 MG CAPSULE|100|EA|1.1152|05/01/2014||Yes|No||05/01/2014||Yes|No|05/01/2014||Yes|No||||No|No|||Prescription required|No|||No|.77852|03/29/2022|.75983|03/29/2022|.76489|03/29/2022||||19283|||||No|No||LUPIN PHARMACEU|No||||
rifampin|No|No|No|No|75%|68180065806|RIFAMPIN 150 MG CAPSULE|30|EA|1.11527|05/01/2014||Yes|No||05/01/2014||Yes|No|05/01/2014||Yes|No||||No|No|||Prescription required|No|||No|.77852|03/29/2022|.75983|03/29/2022|.76489|03/29/2022||||19284|||||No|No||LUPIN PHARMACEU|No||||
rifampin|No|No|No|No|75%|68180065901|RIFAMPIN 300 MG CAPSULE|100|EA|1.57956|05/01/2014||Yes|No||05/01/2014||Yes|No|05/01/2014||Yes|No||||No|No|||Prescription required|No|||No|.95898|03/29/2022|.93596|03/29/2022|.94219|03/29/2022||||19285|||||No|No||LUPIN PHARMACEU|No||||
rifampin|No|No|No|No|75%|68180065906|RIFAMPIN 300 MG CAPSULE|30|EA|1.57953|05/01/2014||Yes|No||05/01/2014||Yes|No|05/01/2014||Yes|No||||No|No|||Prescription required|No|||No|.95898|03/29/2022|.93596|03/29/2022|.94219|03/29/2022||||19286|||||No|No||LUPIN PHARMACEU|No||||
rifampin|No|No|No|No|75%|68180065907|RIFAMPIN 300 MG CAPSULE|60|EA|1.57953|05/01/2014||Yes|No||05/01/2014||Yes|No|05/01/2014||Yes|No||||No|No|||Prescription required|No|||No|.95898|03/29/2022|.93596|03/29/2022|.94219|03/29/2022||||19287|||||No|No||LUPIN PHARMACEU|No||||
oseltamivir phosphate|No|No|No|No|75%|68180067511|OSELTAMIVIR PHOS 30 MG CAPSULE|10|EA|1.72|05/25/2018||Yes|No||05/25/2018||Yes|No|05/25/2018||Yes|No||||No|No|||Prescription required|No||025|No|1.58155|03/29/2022|1.54359|03/29/2022|1.55387|03/29/2022|||ANTIVIRALS: ORAL|19288|||||No|No||LUPIN PHARMACEU|No||||
oseltamivir phosphate|No|No|No|No|75%|68180067611|OSELTAMIVIR PHOS 45 MG CAPSULE|10|EA|1.72|05/25/2018||Yes|No||05/25/2018||Yes|No|05/25/2018||Yes|No||||No|No|||Prescription required|No||025|No|1.5655|03/29/2022|1.52792|03/29/2022|1.5381|03/29/2022|||ANTIVIRALS: ORAL|19289|||||No|No||LUPIN PHARMACEU|No||||
oseltamivir phosphate|No|No|No|No|75%|68180067711|OSELTAMIVIR PHOS 75 MG CAPSULE|10|EA|1.935|05/25/2018||Yes|No||05/25/2018||Yes|No|05/25/2018||Yes|No||||No|No|||Prescription required|No||025|No|1.29695|03/29/2022|1.26582|03/29/2022|1.27425|03/29/2022|||ANTIVIRALS: ORAL|19290|||||No|No||LUPIN PHARMACEU|No||||
oseltamivir phosphate|No|No|No|No|75%|68180067801|OSELTAMIVIR 6 MG/ML SUSPENSION|60|ML|.50166|10/19/2018||Yes|No||10/19/2018||Yes|No|10/19/2018||Yes|No||||No|No|||Prescription required|No||025|No|.51688|03/29/2022|.50447|03/29/2022|.50783|03/29/2022|||ANTIVIRALS: ORAL|19291|||||No|No||LUPIN PHARMACEU|No||||
tramadol HCl|No|No|No|No|90%|68180069706|TRAMADOL HCL ER 100 MG TABLET|30|EA|1.15899|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||||No|No|||Prescription required|No||110|Yes|.97069|03/29/2022|.94739|03/29/2022|.9537|03/29/2022|||ANALGESICS: NARCOTICS LONG|19292|||||No|No||LUPIN PHARMACEU|No||||
tramadol HCl|No|No|No|No|90%|68180069806|TRAMADOL HCL ER 200 MG TABLET|30|EA|1.91694|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||||No|No|||Prescription required|No||110|Yes|1.59713|03/29/2022|1.55879|03/29/2022|1.56918|03/29/2022|||ANALGESICS: NARCOTICS LONG|19293|||||No|No||LUPIN PHARMACEU|No||||
tramadol HCl|No|No|No|No|90%|68180069906|TRAMADOL HCL ER 300 MG TABLET|30|EA|3.23044|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||||No|No|||Prescription required|No||110|Yes|2.08656|03/29/2022|2.03648|03/29/2022|2.05004|03/29/2022|||ANALGESICS: NARCOTICS LONG|19294|||||No|No||LUPIN PHARMACEU|No||||
cefdinir|No|No|No|No|75%|68180071160|CEFDINIR 300 MG CAPSULE|60|EA|.60916|04/30/2007||Yes|No||04/30/2007||Yes|No|04/30/2007||Yes|No||||No|No|||Prescription required|No||046|No|.46443|03/29/2022|.45328|03/29/2022|.4563|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19295|||||No|No||LUPIN PHARMACEU|No||||
amlodipine besylate|Yes|No|No|No|75%|68180071909|AMLODIPINE BESYLATE 2.5 MG TAB|90|EA|.02866|11/14/2018||Yes|No||11/14/2018||Yes|No|11/14/2018||Yes|No||11/14/2018||Yes|No|06/18/2019||Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19296|||||No|No||LUPIN PHARMACEU|No||||
amlodipine besylate|Yes|No|No|No|75%|68180072003|AMLODIPINE BESYLATE 5 MG TAB|1000|EA|.02977|11/14/2018||Yes|No||11/14/2018||Yes|No|11/14/2018||Yes|No||11/14/2018||Yes|No|06/18/2019||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19297|||||No|No||LUPIN PHARMACEU|No||||
amlodipine besylate|Yes|No|No|No|75%|68180072009|AMLODIPINE BESYLATE 5 MG TAB|90|EA|.02866|01/24/2020||Yes|No||01/24/2020||Yes|No|01/24/2020||Yes|No||01/24/2020||Yes|No|03/20/2020||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19298|||||No|No||LUPIN PHARMACEU|No||||
amlodipine besylate|Yes|No|No|No|75%|68180072103|AMLODIPINE BESYLATE 10 MG TAB|1000|EA|.04085|01/24/2019||Yes|No||01/24/2019||Yes|No|01/24/2019||Yes|No||01/24/2019||Yes|No|06/18/2019||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19299|||||No|No||LUPIN PHARMACEU|No||||
amlodipine besylate|Yes|No|No|No|75%|68180072109|AMLODIPINE BESYLATE 10 MG TAB|90|EA|.04085|01/24/2019||Yes|No||01/24/2019||Yes|No|01/24/2019||Yes|No||01/24/2019||Yes|No|06/18/2019||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19300|||||No|No||LUPIN PHARMACEU|No||||
cefdinir|No|No|No|No|75%|68180072204|CEFDINIR 125 MG/5 ML SUSP|60|ML|.17816|09/10/2020||Yes|No||09/10/2020||Yes|No|09/10/2020||Yes|No||||No|No|||Prescription required|No||046|No|.15822|03/29/2022|.15442|03/29/2022|.15545|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19301|||||No|No||LUPIN PHARMACEU|No||||
cefdinir|No|No|No|No|75%|68180072205|CEFDINIR 125 MG/5 ML SUSP|100|ML|.16933|09/10/2020||Yes|No||09/10/2020||Yes|No|09/10/2020||Yes|No||||No|No|||Prescription required|No||046|No|.11292|03/29/2022|.1102|03/29/2022|.11094|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19302|||||No|No||LUPIN PHARMACEU|No||||
cefdinir|No|No|No|No|75%|68180072304|CEFDINIR 250 MG/5 ML SUSP|60|ML|.34758|09/10/2020||Yes|No||09/10/2020||Yes|No|09/10/2020||Yes|No||||No|No|||Prescription required|No||046|No|.18029|03/29/2022|.17596|03/29/2022|.17713|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19303|||||No|No||LUPIN PHARMACEU|No||||
cefdinir|No|No|No|No|75%|68180072305|CEFDINIR 250 MG/5 ML SUSP|100|ML|.33024|09/10/2020||Yes|No||09/10/2020||Yes|No|09/10/2020||Yes|No||||No|No|||Prescription required|No||046|No|.18689|03/29/2022|.1824|03/29/2022|.18361|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|19304|||||No|No||LUPIN PHARMACEU|No||||
silodosin|No|No|No|No|75%|68180074006|SILODOSIN 4 MG CAPSULE|30|EA|.43|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|003|No|.60384|03/29/2022|.58934|03/29/2022|.59327|03/29/2022|||BPH TREATMENTS|19305|||||No|No||LUPIN PHARMACEU|No||||
silodosin|No|No|No|No|75%|68180074106|SILODOSIN 8 MG CAPSULE|30|EA|.43|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|003|No|.68368|03/29/2022|.66727|03/29/2022|.67171|03/29/2022|||BPH TREATMENTS|19306|||||No|No||LUPIN PHARMACEU|No||||
silodosin|No|No|No|No|75%|68180074109|SILODOSIN 8 MG CAPSULE|90|EA|.43|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|003|No|.68368|03/29/2022|.66727|03/29/2022|.67171|03/29/2022|||BPH TREATMENTS|19307|||||No|No||LUPIN PHARMACEU|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|68180075501|AMLODIPINE-BENAZEPRIL 2.5-10|100|EA|.22037|02/05/2010||Yes|No||02/05/2010||Yes|No|02/05/2010||Yes|No||01/01/2012||Yes|No|||Prescription required|No||017|No|.11834|03/29/2022|.11549|03/29/2022|.11626|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|19308|||||No|No||LUPIN PHARMACEU|No||||
amlodipine besylate/benazepril|No|No|No|No|75%|68180075601|AMLODIPINE-BENAZEPRIL 5-10 MG|100|EA|.22471|08/06/2010||Yes|No||08/06/2010||Yes|No|08/06/2010||Yes|No||01/01/2012||Yes|No|||Prescription required|No||017|No|.11526|03/29/2022|.11249|03/29/2022|.11324|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|19309|||||No|No||LUPIN PHARMACEU|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|68180076406|AMLODIPINE-VALSARTAN 5-160 MG|30|EA|1.7415|03/30/2015||Yes|No||03/30/2015||Yes|No|03/30/2015||Yes|No||03/30/2015||Yes|No|||Prescription required|No||017|Yes|.43208|03/29/2022|.42171|03/29/2022|.42451|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|19310|||||No|No||LUPIN PHARMACEU|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|68180076506|AMLODIPINE-VALSARTAN 10-160 MG|30|EA|1.97556|03/30/2015||Yes|No||03/30/2015||Yes|No|03/30/2015||Yes|No||03/30/2015||Yes|No|||Prescription required|No||017|Yes|.53459|03/29/2022|.52175|03/29/2022|.52523|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|19311|||||No|No||LUPIN PHARMACEU|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|68180076606|AMLODIPINE-VALSARTAN 5-320 MG|30|EA|2.20891|03/30/2015||Yes|No||03/30/2015||Yes|No|03/30/2015||Yes|No||03/30/2015||Yes|No|||Prescription required|No||017|Yes|.57359|03/29/2022|.55982|03/29/2022|.56355|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|19312|||||No|No||LUPIN PHARMACEU|No||||
amlodipine besylate/valsartan|No|No|No|No|75%|68180076706|AMLODIPINE-VALSARTAN 10-320 MG|30|EA|2.5079|03/30/2015||Yes|No||03/30/2015||Yes|No|03/30/2015||Yes|No||03/30/2015||Yes|No|||Prescription required|No||017|Yes|.73857|03/29/2022|.72084|03/29/2022|.72564|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|19313|||||No|No||LUPIN PHARMACEU|No||||
amlodipine/valsartan/hcthiazid|No|No|No|No|75%|68180077106|AMLOD-VALSA-HCTZ 5-160-12.5 MG|30|EA|1.95908|06/04/2015||Yes|No||06/04/2015||Yes|No|06/04/2015||Yes|No||06/04/2015||Yes|No|||Prescription required|Yes|07/26/2018|017|Yes|4.46488|12/28/2021|4.40109|12/28/2021|4.19152|12/28/2021|||ANGIOTENSIN MODULATOR COMBINATIONS|19314|||||No|No||LUPIN PHARMACEU|No||||
amlodipine/valsartan/hcthiazid|No|No|No|No|75%|68180077109|AMLOD-VALSA-HCTZ 5-160-12.5 MG|90|EA|1.95908|06/04/2015||Yes|No||06/04/2015||Yes|No|06/04/2015||Yes|No||06/04/2015||Yes|No|||Prescription required|Yes|07/26/2018|017|Yes|4.46488|12/28/2021|4.40109|12/28/2021|4.19152|12/28/2021|||ANGIOTENSIN MODULATOR COMBINATIONS|19315|||||No|No||LUPIN PHARMACEU|No||||
amlodipine/valsartan/hcthiazid|No|No|No|No|75%|68180077206|AMLOD-VALSA-HCTZ 10-160-12.5MG|30|EA|2.22252|06/04/2015||Yes|No||06/04/2015||Yes|No|06/04/2015||Yes|No||06/04/2015||Yes|No|||Prescription required|Yes|07/26/2018|017|Yes|5.06528|12/28/2021|4.99292|12/28/2021|4.75516|12/28/2021|||ANGIOTENSIN MODULATOR COMBINATIONS|19316|||||No|No||LUPIN PHARMACEU|No||||
amlodipine/valsartan/hcthiazid|No|No|No|No|75%|68180077209|AMLOD-VALSA-HCTZ 10-160-12.5MG|90|EA|2.22257|06/04/2015||Yes|No||06/04/2015||Yes|No|06/04/2015||Yes|No||06/04/2015||Yes|No|||Prescription required|Yes|07/26/2018|017|Yes|5.06539|12/28/2021|4.99303|12/28/2021|4.75526|12/28/2021|||ANGIOTENSIN MODULATOR COMBINATIONS|19317|||||No|No||LUPIN PHARMACEU|No||||
amlodipine/valsartan/hcthiazid|No|No|No|No|75%|68180077306|AMLOD-VALSA-HCTZ 5-160-25 MG|30|EA|1.95908|06/04/2015||Yes|No||06/04/2015||Yes|No|06/04/2015||Yes|No||06/04/2015||Yes|No|||Prescription required|Yes|07/26/2018|017|Yes|4.46488|01/25/2022|4.40109|01/25/2022|4.19152|01/25/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|19318|||||No|No||LUPIN PHARMACEU|No||||
amlodipine/valsartan/hcthiazid|No|No|No|No|75%|68180077309|AMLOD-VALSA-HCTZ 5-160-25 MG|90|EA|1.95908|06/04/2015||Yes|No||06/04/2015||Yes|No|06/04/2015||Yes|No||06/04/2015||Yes|No|||Prescription required|Yes|07/26/2018|017|Yes|4.46488|01/25/2022|4.40109|01/25/2022|4.19152|01/25/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|19319|||||No|No||LUPIN PHARMACEU|No||||
amlodipine/valsartan/hcthiazid|No|No|No|No|75%|68180077406|AMLOD-VALSA-HCTZ 10-160-25 MG|30|EA|2.22252|06/04/2015||Yes|No||06/04/2015||Yes|No|06/04/2015||Yes|No||06/04/2015||Yes|No|||Prescription required|Yes|07/26/2018|017|Yes|5.06528|12/28/2021|4.99292|12/28/2021|4.75516|12/28/2021|||ANGIOTENSIN MODULATOR COMBINATIONS|19320|||||No|No||LUPIN PHARMACEU|No||||
amlodipine/valsartan/hcthiazid|No|No|No|No|75%|68180077409|AMLOD-VALSA-HCTZ 10-160-25 MG|90|EA|2.22257|06/04/2015||Yes|No||06/04/2015||Yes|No|06/04/2015||Yes|No||06/04/2015||Yes|No|||Prescription required|Yes|07/26/2018|017|Yes|5.06539|12/28/2021|4.99303|12/28/2021|4.75526|12/28/2021|||ANGIOTENSIN MODULATOR COMBINATIONS|19321|||||No|No||LUPIN PHARMACEU|No||||
amlodipine/valsartan/hcthiazid|No|No|No|No|75%|68180077506|AMLOD-VALSA-HCTZ 10-320-25 MG|30|EA|2.82137|06/04/2015||Yes|No||06/04/2015||Yes|No|06/04/2015||Yes|No||06/04/2015||Yes|No|||Prescription required|Yes|07/26/2018|017|Yes|6.4301|01/25/2022|6.33824|01/25/2022|6.03642|01/25/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|19322|||||No|No||LUPIN PHARMACEU|No||||
amlodipine/valsartan/hcthiazid|No|No|No|No|75%|68180077509|AMLOD-VALSA-HCTZ 10-320-25 MG|90|EA|2.82137|06/04/2015||Yes|No||06/04/2015||Yes|No|06/04/2015||Yes|No||06/04/2015||Yes|No|||Prescription required|Yes|07/26/2018|017|Yes|6.4301|01/25/2022|6.33824|01/25/2022|6.03642|01/25/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|19323|||||No|No||LUPIN PHARMACEU|No||||
zolpidem tartrate|No|No|No|No|90%|68180077901|ZOLPIDEM TART ER 6.25 MG TAB|100|EA|.1075|04/18/2014||Yes|No||04/18/2014||Yes|No|04/18/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|054|Yes|.20271|03/29/2022|.19784|03/29/2022|.19916|03/29/2022|||SEDATIVE HYPNOTICS|19324|||||No|No||LUPIN PHARMACEU|No||||
zolpidem tartrate|No|No|No|No|90%|68180078001|ZOLPIDEM TART ER 12.5 MG TAB|100|EA|.1075|04/18/2014||Yes|No||04/18/2014||Yes|No|04/18/2014||Yes|No||||No|No|||Prescription required|Yes|07/24/2013|054|Yes|.24181|03/29/2022|.236|03/29/2022|.23757|03/29/2022|||SEDATIVE HYPNOTICS|19325|||||No|No||LUPIN PHARMACEU|No||||
potassium chloride|No|No|No|No|75%|68180079801|POTASSIUM CL ER 8 MEQ CAPSULE|100|EA|.32327|02/16/2016||Yes|No||02/16/2016||Yes|No|02/16/2016||Yes|No||02/16/2016||Yes|No|||Prescription required|No|||No|.14299|03/29/2022|.13955|03/29/2022|.14048|03/29/2022||||19326|||||No|No||LUPIN PHARMACEU|No||||
potassium chloride|No|No|No|No|75%|68180079802|POTASSIUM CL ER 8 MEQ CAPSULE|500|EA|.3071|02/16/2016||Yes|No||02/16/2016||Yes|No|02/16/2016||Yes|No||02/16/2016||Yes|No|||Prescription required|No|||No|.14299|03/29/2022|.13955|03/29/2022|.14048|03/29/2022||||19327|||||No|No||LUPIN PHARMACEU|No||||
potassium chloride|No|No|No|No|75%|68180079901|POTASSIUM CL ER 10 MEQ CAPSULE|100|EA|.34142|02/16/2016||Yes|No||02/16/2016||Yes|No|02/16/2016||Yes|No||02/16/2016||Yes|No|||Prescription required|No|||No|.15494|03/29/2022|.15122|03/29/2022|.15222|03/29/2022||||19328|||||No|No||LUPIN PHARMACEU|No||||
potassium chloride|No|No|No|No|75%|68180079902|POTASSIUM CL ER 10 MEQ CAPSULE|500|EA|.32434|02/16/2016||Yes|No||02/16/2016||Yes|No|02/16/2016||Yes|No||02/16/2016||Yes|No|||Prescription required|No|||No|.15494|03/29/2022|.15122|03/29/2022|.15222|03/29/2022||||19329|||||No|No||LUPIN PHARMACEU|No||||
lapatinib ditosylate|No|No|No|No|75%|68180080136|LAPATINIB 250 MG TABLET|150|EA|20.68924|12/29/2020||Yes|No||12/29/2020||Yes|No|12/29/2020||Yes|No||||No|No|||Prescription required|No||502|No|47.15223|12/29/2020|46.47863|12/29/2020|44.26536|12/29/2020|||ONCOLOGY: ORAL - BREAST|19330|||||No|No||LUPIN PHARMACEU|No||||
lanthanum carbonate|No|No|No|No|75%|68180081942|LANTHANUM CARB 500 MG TAB CHEW|90|EA|4.46072|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|052|Yes|10.16629|02/23/2021|10.02106|02/23/2021|9.54386|02/23/2021|||PHOSPHATE BINDERS|19331|||||No|No||LUPIN PHARMACEU|No||||
lanthanum carbonate|No|No|No|No|75%|68180082046|LANTHANUM CARB 750 MG TAB CHEW|90|EA|4.46072|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|052|Yes|10.16629|06/01/2018|10.02106|06/01/2018|9.54386|06/01/2018|||PHOSPHATE BINDERS|19332|||||No|No||LUPIN PHARMACEU|No||||
lanthanum carbonate|No|No|No|No|75%|68180082147|LANTHANUM CARB 1,000 MG TB CHW|90|EA|4.46072|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|052|Yes|7.25704|03/29/2022|7.08287|03/29/2022|7.13004|03/29/2022|||PHOSPHATE BINDERS|19333|||||No|No||LUPIN PHARMACEU|No||||
norethindrone ac-eth estradiol|No|No|No|No|75%|68180082709|FYAVOLV 0.5 MG-2.5 MCG TABLET|90|EA|1.25263|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|No|||Yes|1.79681|03/29/2022|1.75368|03/29/2022|1.76536|03/29/2022||||19334|||||No|No||LUPIN PHARMACEU|No||||
norethindrone ac-eth estradiol|No|No|No|No|75%|68180082809|FYAVOLV 1 MG-5 MCG TABLET|90|EA|.94041|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No||||No|No|||Prescription required|No|||Yes|1.33067|03/29/2022|1.29873|03/29/2022|1.30738|03/29/2022||||19335|||||No|No||LUPIN PHARMACEU|No||||
norgestimate-ethinyl estradiol|Yes|Yes|No|No|75%|68180083773|TRI-LO-MARZIA TABLET|28|EA|.18018|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No|Refer to program requirements|||No|No|03/20/2020||Prescription required|No|||No|.16464|03/29/2022|.16068|03/29/2022|.16175|03/29/2022||||19336|||||No|No||LUPIN PHARMACEU|No|||Only covered for non-contraceptive (medical) purposes|
norgestimate-ethinyl estradiol|No|Yes|No|No|75%|68180084073|NORG-ETHIN ESTRA 0.25-0.035 MG|28|EA|.3336|10/29/2020||Yes|No||10/29/2020||Yes|No|10/29/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.1742|03/29/2022|.17001|03/29/2022|.17115|03/29/2022||||19337|||||No|No||LUPIN PHARMACEU|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|68180084313|LEVONOR-ETH ESTRAD 0.15-0.03|91|EA|.54661|06/01/2018||Yes|No||06/01/2018||Yes|No|06/01/2018||Yes|No|Refer to program requirements|||No|No|06/01/2018||Prescription required|No|||No|.17533|03/29/2022|.17112|03/29/2022|.17226|03/29/2022||||19338|||||No|No||LUPIN PHARMACEU|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|68180084473|KURVELO-28 TABLET|28|EA|.35628|07/31/2020||Yes|No||07/31/2020||Yes|No|07/31/2020||Yes|No|Refer to program requirements|||No|No|09/21/2020||Prescription required|No|||No|.17306|03/29/2022|.1689|03/29/2022|.17003|03/29/2022||||19339|||||No|No||LUPIN PHARMACEU|No|||Only covered for non-contraceptive (medical) purposes|
L-norgest/e.estradiol-e.estrad|Yes|Yes|No|No|75%|68180084613|DAYSEE 0.15-0.03-0.01 MG TAB|91|EA|1.01517|04/15/2013||Yes|No||04/15/2013||Yes|No|04/15/2013||Yes|No|Refer to program requirements|||No|No|04/15/2013||Prescription required|No|||No|.54912|03/29/2022|.53594|03/29/2022|.53951|03/29/2022||||19340|||||No|No||LUPIN PHARMACEU|No|||Only covered for non-contraceptive (medical) purposes|
L-norgest/e.estradiol-e.estrad|Yes|Yes|No|No|75%|68180084813|LEVONOR-E ESTRAD 0.1-0.02-0.01|91|EA|1.01517|12/12/2011||Yes|No||12/12/2011||Yes|No|12/12/2011||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.32321|03/01/2022|.31545|03/01/2022|.31755|03/01/2022||||19341|||||No|No||LUPIN PHARMACEU|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel|No|Yes|No|No|75%|68180085211|MY WAY 1.5 MG TABLET|1|EA|12.5775|09/07/2017||Yes|No||||No|No|||No|No||||No|No|||Over the counter|No|||No|10.215|03/29/2022|9.96984|03/29/2022|10.03623|03/29/2022||||19342|||||No|No||LUPIN PHARMACEU|No||||
levonorgestrel|No|Yes|No|No|75%|68180085212|MY WAY 1.5 MG TABLET|2|EA|12.5775|09/11/2017||Yes|No||||No|No|||No|No||||No|No|||Over the counter|No|||No|10.215|03/29/2022|9.96984|03/29/2022|10.03623|03/29/2022||||19343|||||No|No||LUPIN PHARMACEU|No||||
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|68180085473|LEVONOR-ETH ESTRAD 0.1-0.02 MG|28|EA|.36396|01/24/2020||Yes|No||01/24/2020||Yes|No|01/24/2020||Yes|No|Refer to program requirements|||No|No|03/20/2020||Prescription required|No|||No|.21292|03/29/2022|.2078|03/29/2022|.20919|03/29/2022||||19344|||||No|No||LUPIN PHARMACEU|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|No|Yes|No|No|75%|68180086473|BLISOVI 24 FE TABLET|28|EA|.31737|02/14/2020||Yes|No||02/14/2020||Yes|No|02/14/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.56858|03/29/2022|.55493|03/29/2022|.55862|03/29/2022||||19345|||||No|No||LUPIN PHARMACEU|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|68180086573|BLISOVI FE 1-20 TABLET|28|EA|.11773|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No|Refer to program requirements|||No|No|03/20/2020||Prescription required|No|||No|.20374|03/29/2022|.19885|03/29/2022|.20017|03/29/2022||||19346|||||No|No||LUPIN PHARMACEU|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|68180086673|BLISOVI FE 1.5-30 TABLET|28|EA|.11773|01/23/2020||Yes|No||01/23/2020||Yes|No|01/23/2020||Yes|No|Refer to program requirements|||No|No|03/20/2020||Prescription required|No|||No|.28591|03/29/2022|.27904|03/29/2022|.2809|03/29/2022||||19347|||||No|No||LUPIN PHARMACEU|No|||Only covered for non-contraceptive (medical) purposes|
noreth-ethinyl estradiol/iron|Yes|Yes|No|No|75%|68180087313|WYMZYA FE 0.4-0.035 MG CHEW TB|28|EA|.89905|06/01/2018|01/26/2022|Yes|No||06/01/2018|01/26/2022|Yes|No|06/01/2018|01/26/2022|Yes|No|Refer to program requirements|||No|No|06/01/2018|01/26/2022|Prescription required|No|||No|2.04901|10/23/2018|2.01974|10/23/2018|1.92356|10/23/2018||||19348|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LUPIN PHARMACEU|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|68180087513|VYFEMLA 0.4 MG-0.035 MG TABLET|28|EA|.49577|02/06/2014|01/26/2022|Yes|No||02/06/2014|01/26/2022|Yes|No|02/06/2014|01/26/2022|Yes|No|Refer to program requirements|||No|No|02/06/2014|01/26/2022|Prescription required|No|||No|.44932|03/29/2022|.43853|03/29/2022|.44145|03/29/2022||||19349|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LUPIN PHARMACEU|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone|Yes|Yes|No|No|75%|68180087613|NORETHINDRONE 0.35 MG TABLET|28|EA|.45354|11/17/2011|04/01/2022|Yes|No||11/17/2011|04/01/2022|Yes|No|11/17/2011|04/01/2022|Yes|No|Refer to program requirements|||No|No|11/01/2012|04/01/2022|Prescription required|No|||No|.16123|03/29/2022|.15736|03/29/2022|.1584|03/29/2022||||19350|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LUPIN PHARMACEU|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone|No|Yes|No|No|75%|68180087773|JENCYCLA 0.35 MG TABLET|28|EA|.38218|09/11/2020||Yes|No||09/11/2020||Yes|No|09/11/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.16123|03/29/2022|.15736|03/29/2022|.1584|03/29/2022||||19351|||||No|No||LUPIN PHARMACEU|No|||Only covered for non-contraceptive (medical) purposes|
desog-e.estradiol/e.estradiol|Yes|Yes|No|No|75%|68180087913|BEKYREE 28 DAY TABLET|28|EA|.25349|06/27/2018|01/21/2022|Yes|No||06/27/2018|01/21/2022|Yes|No|06/27/2018|01/21/2022|Yes|No|Refer to program requirements|||No|No|09/04/2019|01/21/2022|Prescription required|No|||No|.21935|03/29/2022|.21408|03/29/2022|.21551|03/29/2022||||19352|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LUPIN PHARMACEU|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-ethin. estradiol|No|Yes|No|No|75%|68180089273|PIRMELLA 7-7-7-28 TABLET|28|EA|.3336|10/29/2020||Yes|No||10/29/2020||Yes|No|10/29/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.43221|03/29/2022|.42183|03/29/2022|.42464|03/29/2022||||19353|||||No|No||LUPIN PHARMACEU|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-ethin. estradiol|No|Yes|No|No|75%|68180089373|PIRMELLA 1-35 28 TABLET|28|EA|.33944|10/29/2020||Yes|No||10/29/2020||Yes|No|10/29/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.34259|03/29/2022|.33436|03/29/2022|.33659|03/29/2022||||19354|||||No|No||LUPIN PHARMACEU|No|||Only covered for non-contraceptive (medical) purposes|
ethinyl estradiol/drospirenone|Yes|Yes|No|No|75%|68180090213|DROSPIRENONE-EE 3-0.03 MG TAB|28|EA|.18975|01/03/2013|04/05/2022|Yes|No||01/03/2013|04/05/2022|Yes|No|01/03/2013|04/05/2022|Yes|No|Refer to program requirements|||No|No|01/03/2013|04/05/2022|Prescription required|No|||No|.2455|03/29/2022|.2396|03/29/2022|.2412|03/29/2022||||19355|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LUPIN PHARMACEU|No|||Only covered for non-contraceptive (medical) purposes|
noreth-ethinyl estradiol/iron|Yes|Yes|No|No|75%|68180090313|KAITLIB FE 0.8-0.025MG CHEW TB|28|EA|1.50044|03/28/2016|03/12/2022|Yes|No||03/28/2016|03/12/2022|Yes|No|03/28/2016|03/12/2022|Yes|No|Refer to program requirements|||No|No|03/28/2016|03/12/2022|Prescription required|No|||No|1.76123|03/29/2022|1.71896|03/29/2022|1.7304|03/29/2022||||19356|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LUPIN PHARMACEU|No|||Only covered for non-contraceptive (medical) purposes|
drospir/eth estra/levomefol Ca|Yes|Yes|No|No|75%|68180090411|TYDEMY 3-0.03-0.451 MG TABLET|28|EA||06/04/2018|02/11/2022|Yes|No||06/04/2018|02/11/2022|Yes|No|06/04/2018|02/11/2022|Yes|No|Refer to program requirements|||No|No|06/04/2018|02/11/2022|Prescription required|No|||No||||||||||19357|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LUPIN PHARMACEU|No|||Only covered for non-contraceptive (medical) purposes|
drospir/eth estra/levomefol Ca|Yes|Yes|No|No|75%|68180090413|TYDEMY 3-0.03-0.451 MG TABLET|28|EA|2.65146|06/01/2018|02/11/2022|Yes|No||06/01/2018|02/11/2022|Yes|No|06/01/2018|02/11/2022|Yes|No|Refer to program requirements|||No|No|06/01/2018|02/11/2022|Prescription required|No|||No|6.04286|09/28/2021|5.95653|09/28/2021|5.67289|09/28/2021||||19358|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LUPIN PHARMACEU|No|||Only covered for non-contraceptive (medical) purposes|
testosterone|No|No|No|No|90%|68180094111|TESTOSTERONE 1.62% GEL PUMP|75|GM|1.05636|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|084|No|.65888|03/29/2022|.64306|03/29/2022|.64734|03/29/2022|||ANDROGENIC AGENTS|19359|||||No|No||LUPIN PHARMACEU|No||||
desoximetasone|No|No|No|No|75%|68180094433|DESOXIMETASONE 0.25% SPRAY|100|ML|2.03325|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|4.63393|04/27/2021|4.56773|04/27/2021|4.35022|04/27/2021|||STEROIDS: TOPICAL HIGH|19360|||||No|No||LUPIN PHARMACEU|No||||
desoximetasone|No|No|No|No|75%|68180094601|DESOXIMETASONE 0.25% OINTMENT|15|GM|2.11875|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|120|No|.658|03/29/2022|.6422|03/29/2022|.64648|03/29/2022|||STEROIDS: TOPICAL HIGH|19361|||||No|No||LUPIN PHARMACEU|No||||
desoximetasone|No|No|No|No|75%|68180094604|DESOXIMETASONE 0.25% OINTMENT|60|GM|1.75905|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|120|No|.39246|03/29/2022|.38304|03/29/2022|.38559|03/29/2022|||STEROIDS: TOPICAL HIGH|19362|||||No|No||LUPIN PHARMACEU|No||||
betamethasone/propylene glyc|No|No|No|No|75%|68180094701|BETAMETHASONE DP AUG 0.05% OIN|15|GM|1.51732|09/15/2020||Yes|No||09/15/2020||Yes|No|09/15/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|120|No|1.24083|03/29/2022|1.21105|03/29/2022|1.21911|03/29/2022|||STEROIDS: TOPICAL HIGH|19363|||||No|No||LUPIN PHARMACEU|No||||
betamethasone/propylene glyc|No|No|No|No|75%|68180094702|BETAMETHASONE DP AUG 0.05% OIN|50|GM|1.01806|09/15/2020||Yes|No||09/15/2020||Yes|No|09/15/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|120|No|1.07205|03/29/2022|1.04632|03/29/2022|1.05328|03/29/2022|||STEROIDS: TOPICAL HIGH|19364|||||No|No||LUPIN PHARMACEU|No||||
desoximetasone|No|No|No|No|75%|68180094804|DESOXIMETASONE 0.05% OINTMENT|60|GM|2.1052|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|120|No|4.79791|01/26/2021|4.72937|01/26/2021|4.50416|01/26/2021|||STEROIDS: TOPICAL HIGH|19365|||||No|No||LUPIN PHARMACEU|No||||
desoximetasone|No|No|No|No|75%|68180094902|DESOXIMETASONE 0.05% CREAM|60|GM|2.10663|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|120|No|2.8478|03/29/2022|2.77945|03/29/2022|2.79796|03/29/2022|||STEROIDS: TOPICAL HIGH|19366|||||No|No||LUPIN PHARMACEU|No||||
desoximetasone|No|No|No|No|75%|68180094904|DESOXIMETASONE 0.05% CREAM|100|GM|2.10515|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|120|No|4.79778|05/31/2018|4.72924|05/31/2018|4.50404|05/31/2018|||STEROIDS: TOPICAL HIGH|19367|||||No|No||LUPIN PHARMACEU|No||||
desoximetasone|No|No|No|No|75%|68180095001|DESOXIMETASONE 0.25% CREAM|15|GM|1.17705|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|120|No|.62238|03/29/2022|.60744|03/29/2022|.61148|03/29/2022|||STEROIDS: TOPICAL HIGH|19368|||||No|No||LUPIN PHARMACEU|No||||
desoximetasone|No|No|No|No|75%|68180095002|DESOXIMETASONE 0.25% CREAM|60|GM|.99473|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|120|No|.41664|03/29/2022|.40664|03/29/2022|.40934|03/29/2022|||STEROIDS: TOPICAL HIGH|19369|||||No|No||LUPIN PHARMACEU|No||||
desoximetasone|No|No|No|No|75%|68180095004|DESOXIMETASONE 0.25% CREAM|100|GM|.99471|05/31/2018||Yes|No||05/31/2018||Yes|No|05/31/2018||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|120|No|.73438|06/29/2021|.71675|06/29/2021|.72152|06/29/2021|||STEROIDS: TOPICAL HIGH|19370|||||No|No||LUPIN PHARMACEU|No||||
hydrocortisone butyrate|No|No|No|No|75%|68180095101|HYDROCORTISONE BUTYR 0.1% LOTN|59|ML|2.81321|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|6.41152|12/10/2018|6.31992|12/10/2018|6.01898|12/10/2018|||STEROIDS: TOPICAL MEDIUM|19371|||||No|No||LUPIN PHARMACEU|No||||
hydrocortisone butyrate|No|No|No|No|75%|68180095102|HYDROCORTISONE BUTYR 0.1% LOTN|118|ML|2.76948|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|6.31185|12/10/2018|6.22168|12/10/2018|5.92541|12/10/2018|||STEROIDS: TOPICAL MEDIUM|19372|||||No|No||LUPIN PHARMACEU|No||||
hydrocortisone valerate|No|No|No|No|75%|68180095401|HYDROCORTISONE VAL 0.2% CREAM|15|GM|.28666|02/28/2020||Yes|No||02/28/2020||Yes|No|02/28/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|.67989|03/29/2022|.66357|03/29/2022|.66799|03/29/2022|||STEROIDS: TOPICAL MEDIUM|19373|||||No|No||LUPIN PHARMACEU|No||||
clobetasol propionate|No|No|No|No|75%|68180095601|CLOBETASOL 0.05% CREAM|15|GM|1.78507|01/28/2019||Yes|No||01/28/2019||Yes|No|01/28/2019||Yes|No||||No|No|||Prescription required|No||121|No|.42879|03/29/2022|.41849|03/29/2022|.42128|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|19374|||||No|No||LUPIN PHARMACEU|No||||
clobetasol propionate|No|No|No|No|75%|68180095602|CLOBETASOL 0.05% CREAM|30|GM|1.78507|01/28/2019||Yes|No||01/28/2019||Yes|No|01/28/2019||Yes|No||||No|No|||Prescription required|No||121|No|.34489|03/29/2022|.33661|03/29/2022|.33885|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|19375|||||No|No||LUPIN PHARMACEU|No||||
clobetasol propionate|No|No|No|No|75%|68180095603|CLOBETASOL 0.05% CREAM|45|GM|1.78516|01/28/2019||Yes|No||01/28/2019||Yes|No|01/28/2019||Yes|No||||No|No|||Prescription required|No||121|No|.31467|03/29/2022|.30711|03/29/2022|.30916|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|19376|||||No|No||LUPIN PHARMACEU|No||||
clobetasol propionate|No|No|No|No|75%|68180095604|CLOBETASOL 0.05% CREAM|60|GM|1.59737|01/28/2019||Yes|No||01/28/2019||Yes|No|01/28/2019||Yes|No||||No|No|||Prescription required|No||121|No|.33784|03/29/2022|.32973|03/29/2022|.33192|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|19377|||||No|No||LUPIN PHARMACEU|No||||
tobramycin in 0.225% sod chlor|No|No|No|No|75%|68180096256|TOBRAMYCIN 300 MG/5 ML AMPULE|5|ML|1.15178|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No|Submit HHS Form 1143|||No|No|||Prescription required|Yes|07/29/2021|240|No|2.62499|07/27/2021|2.58749|07/27/2021|2.46428|07/27/2021|||ANTIBIOTICS: INHALED|19378|||||No|No||LUPIN PHARMACEU|No||||
albuterol sulfate|No|No|No|No|75%|68180096301|ALBUTEROL HFA 90 MCG INHALER|8.5|GM|1.82016|10/26/2020||Yes|No||10/26/2020||Yes|No|10/26/2020||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|037|Yes|3.10102|03/29/2022|3.02659|03/29/2022|3.04675|03/29/2022|||BRONCHODILATORS: BETA AGONIST|19379|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180096501|LEVOTHYROXINE 25 MCG TABLET|100|EA|.04446|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.11852|03/29/2022|.11567|03/29/2022|.11644|03/29/2022||||19380|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180096503|LEVOTHYROXINE 25 MCG TABLET|1000|EA|.04447|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.11852|03/29/2022|.11567|03/29/2022|.11644|03/29/2022||||19381|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180096601|LEVOTHYROXINE 50 MCG TABLET|100|EA|.06222|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.14288|03/29/2022|.13945|03/29/2022|.14037|03/29/2022||||19382|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180096603|LEVOTHYROXINE 50 MCG TABLET|1000|EA|.0622|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.14288|03/29/2022|.13945|03/29/2022|.14037|03/29/2022||||19383|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180096701|LEVOTHYROXINE 75 MCG TABLET|100|EA|.06359|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.15545|03/29/2022|.15171|03/29/2022|.15272|03/29/2022||||19384|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180096703|LEVOTHYROXINE 75 MCG TABLET|1000|EA|.06359|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.15545|03/29/2022|.15171|03/29/2022|.15272|03/29/2022||||19385|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180096801|LEVOTHYROXINE 88 MCG TABLET|100|EA|.06312|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.16198|03/29/2022|.15809|03/29/2022|.15914|03/29/2022||||19386|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180096803|LEVOTHYROXINE 88 MCG TABLET|1000|EA|.06311|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.16198|03/29/2022|.15809|03/29/2022|.15914|03/29/2022||||19387|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180096901|LEVOTHYROXINE 100 MCG TABLET|100|EA|.0663|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.17286|03/29/2022|.16871|03/29/2022|.16983|03/29/2022||||19388|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180096903|LEVOTHYROXINE 100 MCG TABLET|1000|EA|.06631|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.17286|03/29/2022|.16871|03/29/2022|.16983|03/29/2022||||19389|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180097001|LEVOTHYROXINE 112 MCG TABLET|100|EA|.07099|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.1546|03/29/2022|.15088|03/29/2022|.15189|03/29/2022||||19390|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180097003|LEVOTHYROXINE 112 MCG TABLET|1000|EA|.07099|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.1546|03/29/2022|.15088|03/29/2022|.15189|03/29/2022||||19391|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180097101|LEVOTHYROXINE 125 MCG TABLET|100|EA|.08178|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.18894|03/29/2022|.1844|03/29/2022|.18563|03/29/2022||||19392|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180097103|LEVOTHYROXINE 125 MCG TABLET|1000|EA|.08179|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.18894|03/29/2022|.1844|03/29/2022|.18563|03/29/2022||||19393|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180097201|LEVOTHYROXINE 137 MCG TABLET|100|EA|.06639|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.22748|03/29/2022|.22202|03/29/2022|.22349|03/29/2022||||19394|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180097203|LEVOTHYROXINE 137 MCG TABLET|1000|EA|.0664|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.22748|03/29/2022|.22202|03/29/2022|.22349|03/29/2022||||19395|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180097301|LEVOTHYROXINE 150 MCG TABLET|100|EA|.06712|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.21406|03/29/2022|.20892|03/29/2022|.21031|03/29/2022||||19396|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180097303|LEVOTHYROXINE 150 MCG TABLET|1000|EA|.06712|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.21406|03/29/2022|.20892|03/29/2022|.21031|03/29/2022||||19397|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180097401|LEVOTHYROXINE 175 MCG TABLET|100|EA|.10023|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.2247|03/29/2022|.2193|03/29/2022|.22076|03/29/2022||||19398|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180097403|LEVOTHYROXINE 175 MCG TABLET|1000|EA|.10023|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.2247|03/29/2022|.2193|03/29/2022|.22076|03/29/2022||||19399|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180097501|LEVOTHYROXINE 200 MCG TABLET|100|EA|.08716|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.2307|03/29/2022|.22516|03/29/2022|.22666|03/29/2022||||19400|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180097503|LEVOTHYROXINE 200 MCG TABLET|1000|EA|.08714|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.2307|03/29/2022|.22516|03/29/2022|.22666|03/29/2022||||19401|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180097601|LEVOTHYROXINE 300 MCG TABLET|100|EA|.1182|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.17616|03/29/2022|.17193|03/29/2022|.17307|03/29/2022||||19402|||||No|No||LUPIN PHARMACEU|No||||
levothyroxine sodium|No|No|No|No|75%|68180097603|LEVOTHYROXINE 300 MCG TABLET|1000|EA|.1182|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.17616|03/29/2022|.17193|03/29/2022|.17307|03/29/2022||||19403|||||No|No||LUPIN PHARMACEU|No||||
lisinopril|No|No|No|No|75%|68180098001|LISINOPRIL 10 MG TABLET|100|EA|.01935|08/23/2017||Yes|No||08/23/2017||Yes|No|08/23/2017||Yes|No||08/23/2017||Yes|No|||Prescription required|No||113|No|.01914|03/29/2022|.01868|03/29/2022|.0188|03/29/2022|||ANGIOTENSIN MODULATORS|19404|||||No|No||LUPIN PHARMACEU|No||||
lisinopril|No|No|No|No|75%|68180098003|LISINOPRIL 10 MG TABLET|1000|EA|.0185|05/30/2017||Yes|No||05/30/2017||Yes|No|05/30/2017||Yes|No||05/30/2017||Yes|No|||Prescription required|No||113|No|.01914|03/29/2022|.01868|03/29/2022|.0188|03/29/2022|||ANGIOTENSIN MODULATORS|19405|||||No|No||LUPIN PHARMACEU|No||||
lisinopril|No|No|No|No|75%|68180098101|LISINOPRIL 20 MG TABLET|100|EA|.02919|08/23/2017||Yes|No||08/23/2017||Yes|No|08/23/2017||Yes|No||08/23/2017||Yes|No|||Prescription required|No||113|No|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANGIOTENSIN MODULATORS|19406|||||No|No||LUPIN PHARMACEU|No||||
lisinopril|No|No|No|No|75%|68180098103|LISINOPRIL 20 MG TABLET|1000|EA|.02772|05/30/2017||Yes|No||05/30/2017||Yes|No|05/30/2017||Yes|No||05/30/2017||Yes|No|||Prescription required|No||113|No|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANGIOTENSIN MODULATORS|19407|||||No|No||LUPIN PHARMACEU|No||||
lisinopril|No|No|No|No|75%|68180098201|LISINOPRIL 30 MG TABLET|100|EA|.04674|08/23/2017||Yes|No||08/23/2017||Yes|No|08/23/2017||Yes|No||08/23/2017||Yes|No|||Prescription required|No||113|No|.05487|03/29/2022|.05355|03/29/2022|.0539|03/29/2022|||ANGIOTENSIN MODULATORS|19408|||||No|No||LUPIN PHARMACEU|No||||
lisinopril|No|No|No|No|75%|68180098202|LISINOPRIL 30 MG TABLET|500|EA|.04627|08/23/2017||Yes|No||08/23/2017||Yes|No|08/23/2017||Yes|No||08/23/2017||Yes|No|||Prescription required|No||113|No|.05487|03/29/2022|.05355|03/29/2022|.0539|03/29/2022|||ANGIOTENSIN MODULATORS|19409|||||No|No||LUPIN PHARMACEU|No||||
budesonide|No|No|No|No|75%|68180098430|BUDESONIDE 0.5 MG/2 ML SUSP|2|ML|.215|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||033|Yes|.57313|03/29/2022|.55937|03/29/2022|.5631|03/29/2022|||GLUCOCORTICOIDS: INHALED|19410|||||No|No||LUPIN PHARMACEU|No||||
fluoxetine HCl|Yes|No|No|No|75%|68180099706|FLUOXETINE HCL 60 MG TABLET|30|EA|.89583|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|01/16/2020||Prescription required|Yes|07/30/2020|008|No|1.06507|03/29/2022|1.0395|03/29/2022|1.04643|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19411|||||No|No||LUPIN PHARMACEU|No||||
fluoxetine HCl|Yes|No|No|No|75%|68180099801|FLUOXETINE HCL 10 MG TABLET|100|EA|.49321|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||008|No|.24078|03/29/2022|.235|03/29/2022|.23656|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19412|||||No|No||LUPIN PHARMACEU|No||||
fluoxetine HCl|Yes|No|No|No|75%|68180099806|FLUOXETINE HCL 10 MG TABLET|30|EA|.49321|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||008|No|.24078|03/29/2022|.235|03/29/2022|.23656|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19413|||||No|No||LUPIN PHARMACEU|No||||
fluoxetine HCl|Yes|No|No|No|75%|68180099901|FLUOXETINE HCL 20 MG TABLET|100|EA|.72257|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||008|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19414|||||No|No||LUPIN PHARMACEU|No||||
fluoxetine HCl|Yes|No|No|No|75%|68180099906|FLUOXETINE HCL 20 MG TABLET|30|EA|.72254|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|03/20/2020||Prescription required|No||008|No|.26902|03/29/2022|.26256|03/29/2022|.26431|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19415|||||No|No||LUPIN PHARMACEU|No||||
hyoscyamine sulfate|No|No|No|No|75%|68220011310|LEVSIN-SL 0.125 MG TABLET SL|100|EA|1.07874|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|2.45852|03/22/2022|2.4234|03/22/2022|2.308|03/22/2022||||19416|||||No|No||MEDA/MYLAN SPEC|No||||
oxycodone HCl|No|No|No|No|90%|68308002003|OXYCODONE HCL 100 MG/5 ML CONC|30|ML|2.50833|05/09/2017||Yes|No||05/09/2017||Yes|No|05/09/2017||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|109|Yes|3.65933|03/29/2022|3.5715|03/29/2022|3.59529|03/29/2022|||ANALGESICS: NARCOTICS SHORT|19417|||||No|No||MAYNE PHARMA IN|No||||
methamphetamine HCl|No|No|No|No|75%|68308011501|METHAMPHETAMINE 5 MG TABLET|100|EA|6.94673|11/07/2016||Yes|No||11/07/2016||Yes|No|11/07/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|6.82872|07/27/2021|6.66483|07/27/2021|6.70921|07/27/2021|||STIMULANTS AND RELATED AGENTS|19418|||||No|No||MAYNE PHARMA IN|No||||
oxycodone HCl|No|No|No|No|90%|68308014501|OXYCODONE HCL (IR) 5 MG CAP|100|EA|.6321|08/29/2012||Yes|No||08/29/2012||Yes|No|08/29/2012||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|109|Yes|.28013|03/29/2022|.2734|03/29/2022|.27522|03/29/2022|||ANALGESICS: NARCOTICS SHORT|19419|||||No|No||MAYNE PHARMA IN|No||||
nystatin|No|No|No|No|75%|68308015215|NYSTATIN 100,000 UNIT/GM POWD|15|GM|.20066|10/07/2009||Yes|No||10/07/2009||Yes|No|10/07/2009||Yes|No||||No|No|||Prescription required|No||061|No|.35016|03/29/2022|.34175|03/29/2022|.34403|03/29/2022|||ANTIFUNGALS: TOPICAL|19420|||||No|No||MAYNE PHARMA IN|No||||
nystatin|No|No|No|No|75%|68308015230|NYSTATIN 100,000 UNIT/GM POWD|30|GM|.20066|10/07/2009||Yes|No||10/07/2009||Yes|No|10/07/2009||Yes|No||||No|No|||Prescription required|No||061|No|.30897|03/29/2022|.30155|03/29/2022|.30356|03/29/2022|||ANTIFUNGALS: TOPICAL|19421|||||No|No||MAYNE PHARMA IN|No||||
nystatin|No|No|No|No|75%|68308015260|NYSTATIN 100,000 UNIT/GM POWD|60|GM|.15766|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|No||061|No|.2597|03/29/2022|.25346|03/29/2022|.25515|03/29/2022|||ANTIFUNGALS: TOPICAL|19422|||||No|No||MAYNE PHARMA IN|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|68308021901|ESGIC CAPSULE|100|EA|2.26928|05/16/2014||Yes|No||05/16/2014||Yes|No|05/16/2014||Yes|No||||No|No|||Prescription required|No|||No|5.17185|10/09/2018|5.09796|10/09/2018|4.8552|10/09/2018||||19423|||||No|No||MAYNE PHARMA IN|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|68308022001|ESGIC 50-325-40 MG TABLET|100|EA|2.26928|05/16/2014||Yes|No||05/16/2014||Yes|No|05/16/2014||Yes|No||||No|No|||Prescription required|No|||No|5.17185|10/09/2018|5.09796|10/09/2018|4.8552|10/09/2018||||19424|||||No|No||MAYNE PHARMA IN|No||||
erythromycin base|No|No|No|No|75%|68308025010|ERYTHROMYCIN DR 250 MG CAP|100|EA|3.16415|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|No||018|No|7.21133|10/05/2021|7.10831|10/05/2021|6.76982|10/05/2021|||MACROLIDES/KETOLIDES|19425|||||No|No||MAYNE PHARMA IN|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|68308047547|OXYCODONE-ACETAMINOPHN 7.5-325|100|EA|.65484|04/09/2014||Yes|No||04/09/2014||Yes|No|04/09/2014||Yes|No||||No|No|||Prescription required|No||109|Yes|.14032|03/29/2022|.13695|03/29/2022|.13786|03/29/2022|||ANALGESICS: NARCOTICS SHORT|19426|||||No|No||MAYNE PHARMA IN|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|68308048047|OXYCODONE-ACETAMINOPHEN 10-325|100|EA|.77378|04/09/2014||Yes|No||04/09/2014||Yes|No|04/09/2014||Yes|No||||No|No|||Prescription required|No||109|Yes|.19233|03/29/2022|.18771|03/29/2022|.18896|03/29/2022|||ANALGESICS: NARCOTICS SHORT|19427|||||No|No||MAYNE PHARMA IN|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|68308055410|ZEBUTAL 50-325-40 MG CAPSULE|100|EA|2.29843|03/07/2014||Yes|No||03/07/2014||Yes|No|03/07/2014||Yes|No||||No|No|||Prescription required|No|||No|3.38611|03/01/2022|3.30484|03/01/2022|3.32685|03/01/2022||||19428|||||No|No||MAYNE PHARMA IN|No||||
isotretinoin|No|No|No|No|75%|68308057030|ISOTRETINOIN 10 MG CAPSULE|30|EA|13.8093|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No||144|No|24.884|01/10/2022|24.28678|01/10/2022|24.44853|01/10/2022|||ACNE AGENTS: ORAL|19429|||||No|No||MAYNE PHARMA IN|No||||
isotretinoin|No|No|No|No|75%|68308057130|ISOTRETINOIN 20 MG CAPSULE|30|EA|13.8093|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No||144|No|24.80699|01/10/2022|24.21162|01/10/2022|24.37286|01/10/2022|||ACNE AGENTS: ORAL|19430|||||No|No||MAYNE PHARMA IN|No||||
isotretinoin|No|No|No|No|75%|68308057330|ISOTRETINOIN 30 MG CAPSULE|30|EA|14.85793|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No||144|No|26.6923|01/10/2022|26.05168|01/10/2022|26.22518|01/10/2022|||ACNE AGENTS: ORAL|19431|||||No|No||MAYNE PHARMA IN|No||||
isotretinoin|No|No|No|No|75%|68308057530|ISOTRETINOIN 40 MG CAPSULE|30|EA|14.85793|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No||144|No|26.7665|01/10/2022|26.1241|01/10/2022|26.29808|01/10/2022|||ACNE AGENTS: ORAL|19432|||||No|No||MAYNE PHARMA IN|No||||
tazarotene|No|No|No|No|75%|68308068550|TAZAROTENE 0.1% FOAM|50|GM|4.58999|12/15/2021||Yes|No||12/15/2021||Yes|No|12/15/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|104|No|10.46091|12/15/2021|10.31147|12/15/2021|9.82044|12/15/2021|||ACNE AGENTS: TOPICAL|19433|||||No|No||MAYNE PHARMA IN|No||||
doxycycline hyclate|Yes|No|No|No|75%|68308071010|DOXYCYCLINE HYC DR 100 MG TAB|100|EA|4.52295|07/11/2017||Yes|No||07/11/2017||Yes|No|07/11/2017||Yes|No||||No|No|07/11/2017||Prescription required|Yes|01/25/2012|213|No|10.30813|09/24/2019|10.16087|09/24/2019|9.67702|09/24/2019|||TETRACYCLINES|19434|||||No|No||MAYNE PHARMA IN|No||||
doxycycline hyclate|No|No|No|No|75%|68308071510|DOXYCYCLINE HYC DR 150 MG TAB|100|EA|6.05418|08/12/2014||Yes|No||08/12/2014||Yes|No|08/12/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|213|No|13.79791|04/23/2019|13.60079|04/23/2019|12.95314|04/23/2019|||TETRACYCLINES|19435|||||No|No||MAYNE PHARMA IN|No||||
doxycycline hyclate|No|No|No|No|75%|68308071530|DOXYCYCLINE HYC DR 150 MG TAB|30|EA|6.05425|07/20/2018||Yes|No||07/20/2018||Yes|No|07/20/2018||Yes|No||||No|No|||Prescription required|Yes|11/30/2017|213|No|13.79806|04/23/2019|13.60095|04/23/2019|12.95328|04/23/2019|||TETRACYCLINES|19436|||||No|No||MAYNE PHARMA IN|No||||
doxycycline hyclate|No|No|No|No|75%|68308071630|DOXYCYCLINE HYC DR 200 MG TAB|30|EA|14.93633|11/16/2021||Yes|No||11/16/2021||Yes|No|11/16/2021||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|34.04094|11/16/2021|33.55464|11/16/2021|31.9568|11/16/2021|||TETRACYCLINES|19437|||||No|No||MAYNE PHARMA IN|No||||
doxycycline hyclate|No|No|No|No|75%|68308077560|DOXYCYCLINE HYC DR 75 MG TAB|60|EA|3.51703|07/07/2017||Yes|No||07/07/2017||Yes|No|07/07/2017||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|213|No|8.01557|07/07/2017|7.90106|07/07/2017|7.52482|07/07/2017|||TETRACYCLINES|19438|||||No|No||MAYNE PHARMA IN|No||||
paroxetine HCl|No|No|No|No|75%|68382000105|PAROXETINE HCL 40 MG TABLET|500|EA|.08624|08/07/2007||Yes|No||08/07/2007||Yes|No|08/07/2007||Yes|No||||No|No|||Prescription required|No||008|No|.13005|03/29/2022|.12692|03/29/2022|.12777|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19439|||||No|No||ZYDUS PHARMACEU|No||||
paroxetine HCl|No|No|No|No|75%|68382000106|PAROXETINE HCL 40 MG TABLET|30|EA|.08772|10/31/2007||Yes|No||10/31/2007||Yes|No|10/31/2007||Yes|No||||No|No|||Prescription required|No||008|No|.13005|03/29/2022|.12692|03/29/2022|.12777|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19440|||||No|No||ZYDUS PHARMACEU|No||||
paroxetine HCl|No|No|No|No|75%|68382000116|PAROXETINE HCL 40 MG TABLET|90|EA|.08637|08/07/2007||Yes|No||08/07/2007||Yes|No|08/07/2007||Yes|No||||No|No|||Prescription required|No||008|No|.13005|03/29/2022|.12692|03/29/2022|.12777|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19441|||||No|No||ZYDUS PHARMACEU|No||||
azathioprine|No|No|No|No|75%|68382000301|AZATHIOPRINE 50 MG TABLET|100|EA|.14512|05/01/2007||Yes|No||05/01/2007||Yes|No|05/01/2007||Yes|No||01/01/2010||Yes|No|||Prescription required|No||229|No|.24374|03/29/2022|.23789|03/29/2022|.23947|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|19442|||||No|No||ZYDUS PHARMACEU|No||||
azathioprine|No|No|No|No|75%|68382000305|AZATHIOPRINE 50 MG TABLET|500|EA|.14512|05/01/2007||Yes|No||05/01/2007||Yes|No|05/01/2007||Yes|No||01/01/2010||Yes|No|||Prescription required|No||229|No|.24374|03/29/2022|.23789|03/29/2022|.23947|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|19443|||||No|No||ZYDUS PHARMACEU|No||||
topiramate|No|No|No|No|75%|68382000414|TOPIRAMATE 15 MG SPRINKLE CAP|60|EA|.46583|10/15/2009||Yes|No||10/15/2009||Yes|No|10/15/2009||Yes|No||||No|No|||Prescription required|No||056|No|.62827|03/29/2022|.61319|03/29/2022|.61727|03/29/2022|||ANTICONVULSANTS|19444|||||No|No||ZYDUS PHARMACEU|No||||
topiramate|No|No|No|No|75%|68382000514|TOPIRAMATE 25 MG SPRINKLE CAP|60|EA|.56975|10/15/2009||Yes|No||10/15/2009||Yes|No|10/15/2009||Yes|No||||No|No|||Prescription required|No||056|No|.73898|03/29/2022|.72124|03/29/2022|.72604|03/29/2022|||ANTICONVULSANTS|19445|||||No|No||ZYDUS PHARMACEU|No||||
lamotrigine|No|No|No|No|75%|68382000601|LAMOTRIGINE 25 MG TABLET|100|EA|.08698|07/24/2017||Yes|No||07/24/2017||Yes|No|07/24/2017||Yes|No||||No|No|||Prescription required|No||056|No|.03514|03/29/2022|.03429|03/29/2022|.03452|03/29/2022|||ANTICONVULSANTS|19446|||||No|No||ZYDUS PHARMACEU|No||||
lamotrigine|No|No|No|No|75%|68382000610|LAMOTRIGINE 25 MG TABLET|1000|EA|.08699|07/24/2017||Yes|No||07/24/2017||Yes|No|07/24/2017||Yes|No||||No|No|||Prescription required|No||056|No|.03514|03/29/2022|.03429|03/29/2022|.03452|03/29/2022|||ANTICONVULSANTS|19447|||||No|No||ZYDUS PHARMACEU|No||||
lamotrigine|No|No|No|No|75%|68382000801|LAMOTRIGINE 100 MG TABLET|100|EA|.09937|02/15/2013||Yes|No||02/15/2013||Yes|No|02/15/2013||Yes|No||||No|No|||Prescription required|No||056|No|.06403|03/29/2022|.06249|03/29/2022|.0629|03/29/2022|||ANTICONVULSANTS|19448|||||No|No||ZYDUS PHARMACEU|No||||
lamotrigine|No|No|No|No|75%|68382000810|LAMOTRIGINE 100 MG TABLET|1000|EA|.09937|12/13/2016||Yes|No||12/13/2016||Yes|No|12/13/2016||Yes|No||||No|No|||Prescription required|No||056|No|.06403|03/29/2022|.06249|03/29/2022|.0629|03/29/2022|||ANTICONVULSANTS|19449|||||No|No||ZYDUS PHARMACEU|No||||
lamotrigine|No|No|No|No|75%|68382000905|LAMOTRIGINE 150 MG TABLET|500|EA|.10675|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|No||056|No|.0888|03/29/2022|.08666|03/29/2022|.08724|03/29/2022|||ANTICONVULSANTS|19450|||||No|No||ZYDUS PHARMACEU|No||||
lamotrigine|No|No|No|No|75%|68382000914|LAMOTRIGINE 150 MG TABLET|60|EA|.10893|01/29/2009||Yes|No||01/29/2009||Yes|No|01/29/2009||Yes|No||||No|No|||Prescription required|No||056|No|.0888|03/29/2022|.08666|03/29/2022|.08724|03/29/2022|||ANTICONVULSANTS|19451|||||No|No||ZYDUS PHARMACEU|No||||
lamotrigine|No|No|No|No|75%|68382001014|LAMOTRIGINE 200 MG TABLET|60|EA|.11853|01/29/2009||Yes|No||01/29/2009||Yes|No|01/29/2009||Yes|No||||No|No|||Prescription required|No||056|No|.10103|03/29/2022|.0986|03/29/2022|.09926|03/29/2022|||ANTICONVULSANTS|19452|||||No|No||ZYDUS PHARMACEU|No||||
venlafaxine HCl|No|No|No|No|75%|68382001801|VENLAFAXINE HCL 25 MG TABLET|100|EA|.1376|06/23/2008||Yes|No||06/23/2008||Yes|No|06/23/2008||Yes|No||||No|No|||Prescription required|No||031|No|.11374|03/29/2022|.11101|03/29/2022|.11174|03/29/2022|||ANTIDEPRESSANTS: OTHER|19453|||||No|No||ZYDUS PHARMACEU|No||||
venlafaxine HCl|No|No|No|No|75%|68382001901|VENLAFAXINE HCL 37.5 MG TABLET|100|EA|.1419|06/23/2008||Yes|No||06/23/2008||Yes|No|06/23/2008||Yes|No||||No|No|||Prescription required|No||031|Yes|.11453|03/29/2022|.11178|03/29/2022|.11252|03/29/2022|||ANTIDEPRESSANTS: OTHER|19454|||||No|No||ZYDUS PHARMACEU|No||||
venlafaxine HCl|No|No|No|No|75%|68382002001|VENLAFAXINE HCL 50 MG TABLET|100|EA|.1462|06/23/2008||Yes|No||06/23/2008||Yes|No|06/23/2008||Yes|No||||No|No|||Prescription required|No||031|No|.12769|03/29/2022|.12462|03/29/2022|.12545|03/29/2022|||ANTIDEPRESSANTS: OTHER|19455|||||No|No||ZYDUS PHARMACEU|No||||
venlafaxine HCl|No|No|No|No|75%|68382002101|VENLAFAXINE HCL 75 MG TABLET|100|EA|.1548|06/23/2008||Yes|No||06/23/2008||Yes|No|06/23/2008||Yes|No||||No|No|||Prescription required|No||031|No|.10828|03/29/2022|.10568|03/29/2022|.10638|03/29/2022|||ANTIDEPRESSANTS: OTHER|19456|||||No|No||ZYDUS PHARMACEU|No||||
atenolol|No|No|No|No|75%|68382002201|ATENOLOL 25 MG TABLET|100|EA|.03134|10/01/2005||Yes|No||10/01/2005||Yes|No|10/01/2005||Yes|No||01/01/2010||Yes|No|||Prescription required|No||070|No|.02437|03/29/2022|.02378|03/29/2022|.02394|03/29/2022|||BETA-BLOCKERS|19457|||||No|No||ZYDUS PHARMACEU|No||||
atenolol|No|No|No|No|75%|68382002210|ATENOLOL 25 MG TABLET|1000|EA|.02819|10/01/2005||Yes|No||10/01/2005||Yes|No|10/01/2005||Yes|No||01/01/2010||Yes|No|||Prescription required|No||070|No|.02437|03/29/2022|.02378|03/29/2022|.02394|03/29/2022|||BETA-BLOCKERS|19458|||||No|No||ZYDUS PHARMACEU|No||||
atenolol|No|No|No|No|75%|68382002301|ATENOLOL 50 MG TABLET|100|EA|.0402|10/01/2005||Yes|No||10/01/2005||Yes|No|10/01/2005||Yes|No||01/01/2010||Yes|No|||Prescription required|No||070|No|.02861|03/29/2022|.02792|03/29/2022|.0281|03/29/2022|||BETA-BLOCKERS|19459|||||No|No||ZYDUS PHARMACEU|No||||
atenolol|No|No|No|No|75%|68382002310|ATENOLOL 50 MG TABLET|1000|EA|.03619|10/01/2005||Yes|No||10/01/2005||Yes|No|10/01/2005||Yes|No||01/01/2010||Yes|No|||Prescription required|No||070|No|.02861|03/29/2022|.02792|03/29/2022|.0281|03/29/2022|||BETA-BLOCKERS|19460|||||No|No||ZYDUS PHARMACEU|No||||
atenolol|No|No|No|No|75%|68382002401|ATENOLOL 100 MG TABLET|100|EA|.05508|10/01/2005||Yes|No||10/01/2005||Yes|No|10/01/2005||Yes|No||01/01/2010||Yes|No|||Prescription required|No||070|No|.04816|03/29/2022|.047|03/29/2022|.04731|03/29/2022|||BETA-BLOCKERS|19461|||||No|No||ZYDUS PHARMACEU|No||||
atenolol|No|No|No|No|75%|68382002410|ATENOLOL 100 MG TABLET|1000|EA|.04957|10/01/2005||Yes|No||10/01/2005||Yes|No|10/01/2005||Yes|No||01/01/2010||Yes|No|||Prescription required|No||070|No|.04816|03/29/2022|.047|03/29/2022|.04731|03/29/2022|||BETA-BLOCKERS|19462|||||No|No||ZYDUS PHARMACEU|No||||
venlafaxine HCl|No|No|No|No|75%|68382003410|VENLAFAXINE HCL ER 37.5 MG CAP|1000|EA|.13924|06/01/2011||Yes|No||06/01/2011||Yes|No|06/01/2011||Yes|No||||No|No|||Prescription required|No||031|Yes|.11725|03/29/2022|.11443|03/29/2022|.11519|03/29/2022|||ANTIDEPRESSANTS: OTHER|19463|||||No|No||ZYDUS PHARMACEU|No||||
venlafaxine HCl|No|No|No|No|75%|68382003416|VENLAFAXINE HCL ER 37.5 MG CAP|90|EA|.17558|06/01/2011||Yes|No||06/01/2011||Yes|No|06/01/2011||Yes|No||||No|No|||Prescription required|No||031|Yes|.11725|03/29/2022|.11443|03/29/2022|.11519|03/29/2022|||ANTIDEPRESSANTS: OTHER|19464|||||No|No||ZYDUS PHARMACEU|No||||
venlafaxine HCl|No|No|No|No|75%|68382003510|VENLAFAXINE HCL ER 75 MG CAP|1000|EA|.1559|06/01/2011||Yes|No||06/01/2011||Yes|No|06/01/2011||Yes|No||||No|No|||Prescription required|No||031|Yes|.12722|03/29/2022|.12416|03/29/2022|.12499|03/29/2022|||ANTIDEPRESSANTS: OTHER|19465|||||No|No||ZYDUS PHARMACEU|No||||
venlafaxine HCl|No|No|No|No|75%|68382003516|VENLAFAXINE HCL ER 75 MG CAP|90|EA|.19669|06/01/2011||Yes|No||06/01/2011||Yes|No|06/01/2011||Yes|No||||No|No|||Prescription required|No||031|Yes|.12722|03/29/2022|.12416|03/29/2022|.12499|03/29/2022|||ANTIDEPRESSANTS: OTHER|19466|||||No|No||ZYDUS PHARMACEU|No||||
venlafaxine HCl|No|No|No|No|75%|68382003610|VENLAFAXINE HCL ER 150 MG CAP|1000|EA|.16997|06/01/2011||Yes|No||06/01/2011||Yes|No|06/01/2011||Yes|No||||No|No|||Prescription required|No||031|No|.16516|03/29/2022|.16119|03/29/2022|.16226|03/29/2022|||ANTIDEPRESSANTS: OTHER|19467|||||No|No||ZYDUS PHARMACEU|No||||
venlafaxine HCl|No|No|No|No|75%|68382003616|VENLAFAXINE HCL ER 150 MG CAP|90|EA|.21428|06/01/2011||Yes|No||06/01/2011||Yes|No|06/01/2011||Yes|No||||No|No|||Prescription required|No||031|No|.16516|03/29/2022|.16119|03/29/2022|.16226|03/29/2022|||ANTIDEPRESSANTS: OTHER|19468|||||No|No||ZYDUS PHARMACEU|No||||
promethazine HCl|No|No|No|No|75%|68382004001|PROMETHAZINE 12.5 MG TABLET|100|EA|.04644|12/12/2005||Yes|No||12/12/2005||Yes|No|12/12/2005||Yes|No||01/01/2010||Yes|No|||Prescription required|No||085|Yes|.05281|03/29/2022|.05154|03/29/2022|.05188|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|19469|||||No|No||ZYDUS PHARMACEU|No||||
promethazine HCl|No|No|No|No|75%|68382004101|PROMETHAZINE 25 MG TABLET|100|EA|.05676|12/12/2005||Yes|No||12/12/2005||Yes|No|12/12/2005||Yes|No||01/01/2010||Yes|No|||Prescription required|No||085|Yes|.05271|03/29/2022|.05144|03/29/2022|.05178|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|19470|||||No|No||ZYDUS PHARMACEU|No||||
promethazine HCl|No|No|No|No|75%|68382004110|PROMETHAZINE 25 MG TABLET|1000|EA|.05676|05/01/2007||Yes|No||05/01/2007||Yes|No|05/01/2007||Yes|No||01/01/2010||Yes|No|||Prescription required|No||085|Yes|.05271|03/29/2022|.05144|03/29/2022|.05178|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|19471|||||No|No||ZYDUS PHARMACEU|No||||
promethazine HCl|No|No|No|No|75%|68382004201|PROMETHAZINE 50 MG TABLET|100|EA|.06192|12/12/2005||Yes|No||12/12/2005||Yes|No|12/12/2005||Yes|No||01/01/2010||Yes|No|||Prescription required|No||085|Yes|.09825|03/29/2022|.09589|03/29/2022|.09653|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|19472|||||No|No||ZYDUS PHARMACEU|No||||
meloxicam|No|No|No|No|75%|68382005001|MELOXICAM 7.5 MG TABLET|100|EA|.0172|07/19/2006||Yes|No||07/19/2006||Yes|No|07/19/2006||Yes|No||07/01/2012||Yes|No|||Prescription required|No||059|Yes|.02308|03/29/2022|.02252|03/29/2022|.02267|03/29/2022|||NSAIDS|19473|||||No|No||ZYDUS PHARMACEU|No||||
meloxicam|No|No|No|No|75%|68382005005|MELOXICAM 7.5 MG TABLET|500|EA|.0172|07/19/2006||Yes|No||07/19/2006||Yes|No|07/19/2006||Yes|No||07/01/2012||Yes|No|||Prescription required|No||059|Yes|.02308|03/29/2022|.02252|03/29/2022|.02267|03/29/2022|||NSAIDS|19474|||||No|No||ZYDUS PHARMACEU|No||||
meloxicam|No|No|No|No|75%|68382005101|MELOXICAM 15 MG TABLET|100|EA|.0215|07/19/2006||Yes|No||07/19/2006||Yes|No|07/19/2006||Yes|No||07/01/2012||Yes|No|||Prescription required|No||059|Yes|.02416|03/29/2022|.02358|03/29/2022|.02373|03/29/2022|||NSAIDS|19475|||||No|No||ZYDUS PHARMACEU|No||||
meloxicam|No|No|No|No|75%|68382005105|MELOXICAM 15 MG TABLET|500|EA|.0215|10/26/2006||Yes|No||10/26/2006||Yes|No|10/26/2006||Yes|No||07/01/2012||Yes|No|||Prescription required|No||059|Yes|.02416|03/29/2022|.02358|03/29/2022|.02373|03/29/2022|||NSAIDS|19476|||||No|No||ZYDUS PHARMACEU|No||||
pravastatin sodium|Yes|No|No|No|75%|68382007005|PRAVASTATIN SODIUM 10 MG TAB|500|EA|.20737|11/30/2010|04/30/2022|Yes|No||11/30/2010|04/30/2022|Yes|No|11/30/2010|04/30/2022|Yes|No||11/30/2010|04/30/2022|Yes|No|07/01/2016|04/30/2022|Prescription required|No||063|Yes|.07144|03/29/2022|.06972|03/29/2022|.07018|03/29/2022|||LIPOTROPICS: STATINS|19477|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||ZYDUS PHARMACEU|No||||
pravastatin sodium|Yes|No|No|No|75%|68382007016|PRAVASTATIN SODIUM 10 MG TAB|90|EA|.20735|09/09/2010|04/30/2022|Yes|No||09/09/2010|04/30/2022|Yes|No|09/09/2010|04/30/2022|Yes|No||01/01/2010|04/30/2022|Yes|No|07/01/2016|04/30/2022|Prescription required|No||063|Yes|.07144|03/29/2022|.06972|03/29/2022|.07018|03/29/2022|||LIPOTROPICS: STATINS|19478|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||ZYDUS PHARMACEU|No||||
pravastatin sodium|Yes|No|No|No|75%|68382007105|PRAVASTATIN SODIUM 20 MG TAB|500|EA|.21072|11/30/2010|05/31/2022|Yes|No||11/30/2010|05/31/2022|Yes|No|11/30/2010|05/31/2022|Yes|No||11/30/2010|05/31/2022|Yes|No|07/01/2016|05/31/2022|Prescription required|No||063|Yes|.05771|03/29/2022|.05632|03/29/2022|.0567|03/29/2022|||LIPOTROPICS: STATINS|19479|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||ZYDUS PHARMACEU|No||||
pravastatin sodium|Yes|No|No|No|75%|68382007116|PRAVASTATIN SODIUM 20 MG TAB|90|EA|.21074|09/09/2010|05/31/2022|Yes|No||09/09/2010|05/31/2022|Yes|No|09/09/2010|05/31/2022|Yes|No||01/01/2010|05/31/2022|Yes|No|07/01/2016|05/31/2022|Prescription required|No||063|Yes|.05771|03/29/2022|.05632|03/29/2022|.0567|03/29/2022|||LIPOTROPICS: STATINS|19480|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||ZYDUS PHARMACEU|No||||
pravastatin sodium|Yes|No|No|No|75%|68382007205|PRAVASTATIN SODIUM 40 MG TAB|500|EA|.30923|11/30/2010|05/31/2022|Yes|No||11/30/2010|05/31/2022|Yes|No|11/30/2010|05/31/2022|Yes|No||11/30/2010|05/31/2022|Yes|No|07/01/2016|05/31/2022|Prescription required|No||063|Yes|.08966|03/29/2022|.0875|03/29/2022|.08809|03/29/2022|||LIPOTROPICS: STATINS|19481|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||ZYDUS PHARMACEU|No||||
pravastatin sodium|Yes|No|No|No|75%|68382007216|PRAVASTATIN SODIUM 40 MG TAB|90|EA|.30926|09/09/2010|05/31/2022|Yes|No||09/09/2010|05/31/2022|Yes|No|09/09/2010|05/31/2022|Yes|No||01/01/2010|05/31/2022|Yes|No|07/01/2016|05/31/2022|Prescription required|No||063|Yes|.08966|03/29/2022|.0875|03/29/2022|.08809|03/29/2022|||LIPOTROPICS: STATINS|19482|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||ZYDUS PHARMACEU|No||||
haloperidol|No|No|No|No|75%|68382007901|HALOPERIDOL 5 MG TABLET|100|EA|.26857|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.44921|03/29/2022|.43842|03/29/2022|.44134|03/29/2022|||ANTIPSYCHOTICS|19483|||||No|No||ZYDUS PHARMACEU|Yes|09/01/2020|||
haloperidol|No|No|No|No|75%|68382007910|HALOPERIDOL 5 MG TABLET|1000|EA|.26738|02/04/2015||Yes|No||02/04/2015||Yes|No|02/04/2015||Yes|No||||No|No|||Prescription required|No||027|Yes|.44921|03/29/2022|.43842|03/29/2022|.44134|03/29/2022|||ANTIPSYCHOTICS|19484|||||No|No||ZYDUS PHARMACEU|Yes|09/01/2020|||
haloperidol|No|No|No|No|75%|68382008001|HALOPERIDOL 10 MG TABLET|100|EA|.34357|11/29/2007||Yes|No||11/29/2007||Yes|No|11/29/2007||Yes|No||||No|No|||Prescription required|No||027|Yes|.48134|03/29/2022|.46978|03/29/2022|.47291|03/29/2022|||ANTIPSYCHOTICS|19485|||||No|No||ZYDUS PHARMACEU|Yes|09/01/2020|||
haloperidol|No|No|No|No|75%|68382008101|HALOPERIDOL 20 MG TABLET|100|EA|.74983|11/29/2007||Yes|No||11/29/2007||Yes|No|11/29/2007||Yes|No||||No|No|||Prescription required|No||027|Yes|.97837|03/29/2022|.95488|03/29/2022|.96124|03/29/2022|||ANTIPSYCHOTICS|19486|||||No|No||ZYDUS PHARMACEU|No||||
benzonatate|No|No|No|No|75%|68382009101|BENZONATATE 200 MG CAPSULE|100|EA|.18275|02/17/2022||Yes|No||02/17/2022||Yes|No|02/17/2022||Yes|No||||No|No|||Prescription required|No||184|Yes|.14345|03/29/2022|.14|03/29/2022|.14093|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|19487|||||No|No||ZYDUS PHARMACEU|No||||
carvedilol|No|No|No|No|75%|68382009201|CARVEDILOL 3.125 MG TABLET|100|EA|.0215|04/02/2008||Yes|No||04/02/2008||Yes|No|04/02/2008||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.01877|03/29/2022|.01831|03/29/2022|.01844|03/29/2022|||BETA-BLOCKERS|19488|||||No|No||ZYDUS PHARMACEU|No||||
carvedilol|No|No|No|No|75%|68382009205|CARVEDILOL 3.125 MG TABLET|500|EA|.02096|04/02/2008||Yes|No||04/02/2008||Yes|No|04/02/2008||Yes|No||04/02/2008||Yes|No|||Prescription required|No||070|No|.01877|03/29/2022|.01831|03/29/2022|.01844|03/29/2022|||BETA-BLOCKERS|19489|||||No|No||ZYDUS PHARMACEU|No||||
carvedilol|No|No|No|No|75%|68382009301|CARVEDILOL 6.25 MG TABLET|100|EA|.0215|09/06/2007||Yes|No||09/06/2007||Yes|No|09/06/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.02069|03/29/2022|.02019|03/29/2022|.02032|03/29/2022|||BETA-BLOCKERS|19490|||||No|No||ZYDUS PHARMACEU|No||||
carvedilol|No|No|No|No|75%|68382009305|CARVEDILOL 6.25 MG TABLET|500|EA|.02096|09/06/2007||Yes|No||09/06/2007||Yes|No|09/06/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.02069|03/29/2022|.02019|03/29/2022|.02032|03/29/2022|||BETA-BLOCKERS|19491|||||No|No||ZYDUS PHARMACEU|No||||
carvedilol|No|No|No|No|75%|68382009401|CARVEDILOL 12.5 MG TABLET|100|EA|.0215|09/06/2007||Yes|No||09/06/2007||Yes|No|09/06/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.02277|03/29/2022|.02222|03/29/2022|.02237|03/29/2022|||BETA-BLOCKERS|19492|||||No|No||ZYDUS PHARMACEU|No||||
carvedilol|No|No|No|No|75%|68382009405|CARVEDILOL 12.5 MG TABLET|500|EA|.02096|09/06/2007||Yes|No||09/06/2007||Yes|No|09/06/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.02277|03/29/2022|.02222|03/29/2022|.02237|03/29/2022|||BETA-BLOCKERS|19493|||||No|No||ZYDUS PHARMACEU|No||||
carvedilol|No|No|No|No|75%|68382009501|CARVEDILOL 25 MG TABLET|100|EA|.0215|09/06/2007||Yes|No||09/06/2007||Yes|No|09/06/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.03449|03/29/2022|.03366|03/29/2022|.03388|03/29/2022|||BETA-BLOCKERS|19494|||||No|No||ZYDUS PHARMACEU|No||||
carvedilol|No|No|No|No|75%|68382009505|CARVEDILOL 25 MG TABLET|500|EA|.02096|09/06/2007||Yes|No||09/06/2007||Yes|No|09/06/2007||Yes|No||07/01/2012||Yes|No|||Prescription required|No||070|No|.03449|03/29/2022|.03366|03/29/2022|.03388|03/29/2022|||BETA-BLOCKERS|19495|||||No|No||ZYDUS PHARMACEU|No||||
hydroxychloroquine sulfate|No|No|No|No|75%|68382009601|HYDROXYCHLOROQUINE 200 MG TAB|100|EA|.49213|12/14/2007||Yes|No||12/14/2007||Yes|No|12/14/2007||Yes|No||||No|No|||Prescription required|No|||No|.23831|03/29/2022|.23259|03/29/2022|.23413|03/29/2022||||19496|||||No|No||ZYDUS PHARMACEU|No||||
hydroxychloroquine sulfate|No|No|No|No|75%|68382009605|HYDROXYCHLOROQUINE 200 MG TAB|500|EA|.46753|12/14/2007||Yes|No||12/14/2007||Yes|No|12/14/2007||Yes|No||||No|No|||Prescription required|No|||No|.23831|03/29/2022|.23259|03/29/2022|.23413|03/29/2022||||19497|||||No|No||ZYDUS PHARMACEU|No||||
paroxetine HCl|No|No|No|No|75%|68382009705|PAROXETINE HCL 10 MG TABLET|500|EA|.04301|04/01/2007||Yes|No||04/01/2007||Yes|No|04/01/2007||Yes|No||||No|No|||Prescription required|No||008|Yes|.075|03/29/2022|.0732|03/29/2022|.07368|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19498|||||No|No||ZYDUS PHARMACEU|No||||
paroxetine HCl|No|No|No|No|75%|68382009706|PAROXETINE HCL 10 MG TABLET|30|EA|.04902|04/01/2007||Yes|No||04/01/2007||Yes|No|04/01/2007||Yes|No||||No|No|||Prescription required|No||008|Yes|.075|03/29/2022|.0732|03/29/2022|.07368|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19499|||||No|No||ZYDUS PHARMACEU|No||||
paroxetine HCl|No|No|No|No|75%|68382009710|PAROXETINE HCL 10 MG TABLET|1000|EA|.04274|09/16/2008||Yes|No||09/16/2008||Yes|No|09/16/2008||Yes|No||||No|No|||Prescription required|No||008|Yes|.075|03/29/2022|.0732|03/29/2022|.07368|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19500|||||No|No||ZYDUS PHARMACEU|No||||
paroxetine HCl|No|No|No|No|75%|68382009716|PAROXETINE HCL 10 MG TABLET|90|EA|.04806|04/01/2007||Yes|No||04/01/2007||Yes|No|04/01/2007||Yes|No||||No|No|||Prescription required|No||008|Yes|.075|03/29/2022|.0732|03/29/2022|.07368|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19501|||||No|No||ZYDUS PHARMACEU|No||||
paroxetine HCl|No|No|No|No|75%|68382009801|PAROXETINE HCL 20 MG TABLET|100|EA|.05925|04/01/2007||Yes|No||04/01/2007||Yes|No|04/01/2007||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19502|||||No|No||ZYDUS PHARMACEU|No||||
paroxetine HCl|No|No|No|No|75%|68382009805|PAROXETINE HCL 20 MG TABLET|500|EA|.05762|04/01/2007||Yes|No||04/01/2007||Yes|No|04/01/2007||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19503|||||No|No||ZYDUS PHARMACEU|No||||
paroxetine HCl|No|No|No|No|75%|68382009806|PAROXETINE HCL 20 MG TABLET|30|EA|.05962|04/01/2007||Yes|No||04/01/2007||Yes|No|04/01/2007||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19504|||||No|No||ZYDUS PHARMACEU|No||||
paroxetine HCl|No|No|No|No|75%|68382009810|PAROXETINE HCL 20 MG TABLET|1000|EA|.05464|09/16/2008||Yes|No||09/16/2008||Yes|No|09/16/2008||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19505|||||No|No||ZYDUS PHARMACEU|No||||
paroxetine HCl|No|No|No|No|75%|68382009816|PAROXETINE HCL 20 MG TABLET|90|EA|.05924|04/01/2007||Yes|No||04/01/2007||Yes|No|04/01/2007||Yes|No||||No|No|||Prescription required|No||008|Yes|.08736|03/29/2022|.08526|03/29/2022|.08583|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19506|||||No|No||ZYDUS PHARMACEU|No||||
paroxetine HCl|No|No|No|No|75%|68382009905|PAROXETINE HCL 30 MG TABLET|500|EA|.07527|04/01/2007||Yes|No||04/01/2007||Yes|No|04/01/2007||Yes|No||||No|No|||Prescription required|No||008|No|.13236|03/29/2022|.12918|03/29/2022|.13004|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19507|||||No|No||ZYDUS PHARMACEU|No||||
paroxetine HCl|No|No|No|No|75%|68382009906|PAROXETINE HCL 30 MG TABLET|30|EA|.08284|04/01/2007||Yes|No||04/01/2007||Yes|No|04/01/2007||Yes|No||||No|No|||Prescription required|No||008|No|.13236|03/29/2022|.12918|03/29/2022|.13004|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19508|||||No|No||ZYDUS PHARMACEU|No||||
paroxetine HCl|No|No|No|No|75%|68382009910|PAROXETINE HCL 30 MG TABLET|1000|EA|.0744|09/16/2008||Yes|No||09/16/2008||Yes|No|09/16/2008||Yes|No||||No|No|||Prescription required|No||008|No|.13236|03/29/2022|.12918|03/29/2022|.13004|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19509|||||No|No||ZYDUS PHARMACEU|No||||
paroxetine HCl|No|No|No|No|75%|68382009916|PAROXETINE HCL 30 MG TABLET|90|EA|.07706|04/01/2007||Yes|No||04/01/2007||Yes|No|04/01/2007||Yes|No||||No|No|||Prescription required|No||008|No|.13236|03/29/2022|.12918|03/29/2022|.13004|03/29/2022|||ANTIDEPRESSANTS: SSRIs|19510|||||No|No||ZYDUS PHARMACEU|No||||
venlafaxine HCl|No|No|No|No|75%|68382010101|VENLAFAXINE HCL 100 MG TABLET|100|EA|.1634|06/23/2008||Yes|No||06/23/2008||Yes|No|06/23/2008||Yes|No||||No|No|||Prescription required|No||031|No|.13788|03/29/2022|.13457|03/29/2022|.13546|03/29/2022|||ANTIDEPRESSANTS: OTHER|19511|||||No|No||ZYDUS PHARMACEU|No||||
divalproex sodium|No|No|No|No|75%|68382010601|DIVALPROEX DR 125 MG CP(SPRNK)|100|EA|.24252|08/11/2009||Yes|No||08/11/2009||Yes|No|08/11/2009||Yes|No||01/01/2010||Yes|No|||Prescription required|No||056|No|.31191|03/29/2022|.30442|03/29/2022|.30645|03/29/2022|||ANTICONVULSANTS|19512|||||No|No||ZYDUS PHARMACEU|No||||
divalproex sodium|No|No|No|No|75%|68382010610|DIVALPROEX DR 125 MG CP(SPRNK)|1000|EA|.24245|08/11/2009||Yes|No||08/11/2009||Yes|No|08/11/2009||Yes|No||01/01/2010||Yes|No|||Prescription required|No||056|No|.31191|03/29/2022|.30442|03/29/2022|.30645|03/29/2022|||ANTICONVULSANTS|19513|||||No|No||ZYDUS PHARMACEU|No||||
bromocriptine mesylate|No|No|No|No|75%|68382011006|BROMOCRIPTINE 5 MG CAPSULE|30|EA|3.20278|11/24/2008||Yes|No||11/24/2008||Yes|No|11/24/2008||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|4.49386|11/23/2021|4.386|11/23/2021|4.41521|11/23/2021|||ANTIPARKINSON'S AGENTS|19514|||||No|No||ZYDUS PHARMACEU|No||||
risperidone|No|No|No|No|75%|68382011205|RISPERIDONE 0.25 MG TABLET|500|EA|.04409|01/11/2010||Yes|No||01/11/2010||Yes|No|01/11/2010||Yes|No||||No|No|||Prescription required|No||027|Yes|.04339|03/29/2022|.04234|03/29/2022|.04263|03/29/2022|||ANTIPSYCHOTICS|19515|||||No|No||ZYDUS PHARMACEU|No||||
risperidone|No|No|No|No|75%|68382011214|RISPERIDONE 0.25 MG TABLET|60|EA|.045|01/20/2009||Yes|No||01/20/2009||Yes|No|01/20/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.04339|03/29/2022|.04234|03/29/2022|.04263|03/29/2022|||ANTIPSYCHOTICS|19516|||||No|No||ZYDUS PHARMACEU|No||||
risperidone|No|No|No|No|75%|68382011305|RISPERIDONE 0.5 MG TABLET|500|EA|.05198|09/29/2009||Yes|No||09/29/2009||Yes|No|09/29/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.04564|03/29/2022|.04454|03/29/2022|.04484|03/29/2022|||ANTIPSYCHOTICS|19517|||||No|No||ZYDUS PHARMACEU|No||||
risperidone|No|No|No|No|75%|68382011314|RISPERIDONE 0.5 MG TABLET|60|EA|.05303|01/20/2009||Yes|No||01/20/2009||Yes|No|01/20/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.04564|03/29/2022|.04454|03/29/2022|.04484|03/29/2022|||ANTIPSYCHOTICS|19518|||||No|No||ZYDUS PHARMACEU|No||||
risperidone|No|No|No|No|75%|68382011405|RISPERIDONE 1 MG TABLET|500|EA|.05688|10/30/2008||Yes|No||10/30/2008||Yes|No|10/30/2008||Yes|No||||No|No|||Prescription required|No||027|Yes|.05646|03/29/2022|.0551|03/29/2022|.05547|03/29/2022|||ANTIPSYCHOTICS|19519|||||No|No||ZYDUS PHARMACEU|No||||
risperidone|No|No|No|No|75%|68382011414|RISPERIDONE 1 MG TABLET|60|EA|.05805|09/29/2009||Yes|No||09/29/2009||Yes|No|09/29/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.05646|03/29/2022|.0551|03/29/2022|.05547|03/29/2022|||ANTIPSYCHOTICS|19520|||||No|No||ZYDUS PHARMACEU|No||||
risperidone|No|No|No|No|75%|68382011505|RISPERIDONE 2 MG TABLET|500|EA|.06548|10/30/2008||Yes|No||10/30/2008||Yes|No|10/30/2008||Yes|No||||No|No|||Prescription required|No||027|Yes|.061|03/29/2022|.05953|03/29/2022|.05993|03/29/2022|||ANTIPSYCHOTICS|19521|||||No|No||ZYDUS PHARMACEU|No||||
risperidone|No|No|No|No|75%|68382011514|RISPERIDONE 2 MG TABLET|60|EA|.06686|09/29/2009||Yes|No||09/29/2009||Yes|No|09/29/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.061|03/29/2022|.05953|03/29/2022|.05993|03/29/2022|||ANTIPSYCHOTICS|19522|||||No|No||ZYDUS PHARMACEU|No||||
risperidone|No|No|No|No|75%|68382011605|RISPERIDONE 3 MG TABLET|500|EA|.07054|10/30/2008||Yes|No||10/30/2008||Yes|No|10/30/2008||Yes|No||||No|No|||Prescription required|No||027|Yes|.07183|03/29/2022|.0701|03/29/2022|.07057|03/29/2022|||ANTIPSYCHOTICS|19523|||||No|No||ZYDUS PHARMACEU|No||||
risperidone|No|No|No|No|75%|68382011614|RISPERIDONE 3 MG TABLET|60|EA|.07202|09/29/2009||Yes|No||09/29/2009||Yes|No|09/29/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.07183|03/29/2022|.0701|03/29/2022|.07057|03/29/2022|||ANTIPSYCHOTICS|19524|||||No|No||ZYDUS PHARMACEU|No||||
risperidone|No|No|No|No|75%|68382011705|RISPERIDONE 4 MG TABLET|500|EA|.07561|09/29/2009||Yes|No||09/29/2009||Yes|No|09/29/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.10538|03/29/2022|.10285|03/29/2022|.10353|03/29/2022|||ANTIPSYCHOTICS|19525|||||No|No||ZYDUS PHARMACEU|No||||
risperidone|No|No|No|No|75%|68382011714|RISPERIDONE 4 MG TABLET|60|EA|.07718|01/20/2009||Yes|No||01/20/2009||Yes|No|01/20/2009||Yes|No||||No|No|||Prescription required|No||027|Yes|.10538|03/29/2022|.10285|03/29/2022|.10353|03/29/2022|||ANTIPSYCHOTICS|19526|||||No|No||ZYDUS PHARMACEU|No||||
azathioprine|No|No|No|No|75%|68382011901|AZATHIOPRINE 75 MG TABLET|100|EA|7.12531|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||02/23/2022||Yes|No|||Prescription required|No||229|No|16.23909|03/01/2022|16.0071|02/23/2022|15.24486|02/23/2022|||IMMUNOSUPPRESSIVES: ORAL|19527|||||No|No||ZYDUS PHARMACEU|No||||
azathioprine|No|No|No|No|75%|68382012001|AZATHIOPRINE 100 MG TABLET|100|EA|3.17666|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||02/23/2022||Yes|No|||Prescription required|No||229|No|7.23984|02/23/2022|7.13642|02/23/2022|6.79659|02/23/2022|||IMMUNOSUPPRESSIVES: ORAL|19528|||||No|No||ZYDUS PHARMACEU|No||||
amlodipine besylate|Yes|No|No|No|75%|68382012105|AMLODIPINE BESYLATE 2.5 MG TAB|500|EA|.0106|12/10/2007||Yes|No||12/10/2007||Yes|No|12/10/2007||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19529|||||No|No||ZYDUS PHARMACEU|No||||
amlodipine besylate|Yes|No|No|No|75%|68382012116|AMLODIPINE BESYLATE 2.5 MG TAB|90|EA|.01118|12/10/2007||Yes|No||12/10/2007||Yes|No|12/10/2007||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19530|||||No|No||ZYDUS PHARMACEU|No||||
amlodipine besylate|Yes|No|No|No|75%|68382012205|AMLODIPINE BESYLATE 5 MG TAB|500|EA|.0099|12/10/2007||Yes|No||12/10/2007||Yes|No|12/10/2007||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19531|||||No|No||ZYDUS PHARMACEU|No||||
amlodipine besylate|Yes|No|No|No|75%|68382012216|AMLODIPINE BESYLATE 5 MG TAB|90|EA|.01161|12/10/2007||Yes|No||12/10/2007||Yes|No|12/10/2007||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19532|||||No|No||ZYDUS PHARMACEU|No||||
amlodipine besylate|Yes|No|No|No|75%|68382012305|AMLODIPINE BESYLATE 10 MG TAB|500|EA|.01726|12/10/2007||Yes|No||12/10/2007||Yes|No|12/10/2007||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19533|||||No|No||ZYDUS PHARMACEU|No||||
amlodipine besylate|Yes|No|No|No|75%|68382012316|AMLODIPINE BESYLATE 10 MG TAB|90|EA|.01892|12/10/2007||Yes|No||12/10/2007||Yes|No|12/10/2007||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19534|||||No|No||ZYDUS PHARMACEU|No||||
tamsulosin HCl|No|No|No|No|75%|68382013201|TAMSULOSIN HCL 0.4 MG CAPSULE|100|EA|.11825|05/03/2010||Yes|No||05/03/2010||Yes|No|05/03/2010||Yes|No||||No|No|||Prescription required|No||003|No|.06447|03/29/2022|.06292|03/29/2022|.06334|03/29/2022|||BPH TREATMENTS|19535|||||No|No||ZYDUS PHARMACEU|No||||
tamsulosin HCl|No|No|No|No|75%|68382013210|TAMSULOSIN HCL 0.4 MG CAPSULE|1000|EA|.11825|08/25/2016||Yes|No||08/25/2016||Yes|No|08/25/2016||Yes|No||||No|No|||Prescription required|No||003|No|.06447|03/29/2022|.06292|03/29/2022|.06334|03/29/2022|||BPH TREATMENTS|19536|||||No|No||ZYDUS PHARMACEU|No||||
losartan potassium|Yes|No|No|No|75%|68382013506|LOSARTAN POTASSIUM 25 MG TAB|30|EA|.06048|10/13/2010||Yes|No||10/13/2010||Yes|No|10/13/2010||Yes|No||10/13/2010||Yes|No|07/01/2016||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|19537|||||No|No||ZYDUS PHARMACEU|No||||
losartan potassium|Yes|No|No|No|75%|68382013510|LOSARTAN POTASSIUM 25 MG TAB|1000|EA|.06047|10/13/2010||Yes|No||10/13/2010||Yes|No|10/13/2010||Yes|No||10/13/2010||Yes|No|07/01/2016||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|19538|||||No|No||ZYDUS PHARMACEU|No||||
losartan potassium|Yes|No|No|No|75%|68382013516|LOSARTAN POTASSIUM 25 MG TAB|90|EA|.06048|10/13/2010||Yes|No||10/13/2010||Yes|No|10/13/2010||Yes|No||10/13/2010||Yes|No|07/01/2016||Prescription required|No||113|Yes|.0613|03/29/2022|.05982|03/29/2022|.06022|03/29/2022|||ANGIOTENSIN MODULATORS|19539|||||No|No||ZYDUS PHARMACEU|No||||
losartan potassium|Yes|No|No|No|75%|68382013606|LOSARTAN POTASSIUM 50 MG TAB|30|EA|.08155|10/13/2010||Yes|No||10/13/2010||Yes|No|10/13/2010||Yes|No||10/13/2010||Yes|No|07/01/2016||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|19540|||||No|No||ZYDUS PHARMACEU|No||||
losartan potassium|Yes|No|No|No|75%|68382013610|LOSARTAN POTASSIUM 50 MG TAB|1000|EA|.08131|10/13/2010||Yes|No||10/13/2010||Yes|No|10/13/2010||Yes|No||10/13/2010||Yes|No|07/01/2016||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|19541|||||No|No||ZYDUS PHARMACEU|No||||
losartan potassium|Yes|No|No|No|75%|68382013616|LOSARTAN POTASSIUM 50 MG TAB|90|EA|.0815|10/13/2010||Yes|No||10/13/2010||Yes|No|10/13/2010||Yes|No||10/13/2010||Yes|No|07/01/2016||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|19542|||||No|No||ZYDUS PHARMACEU|No||||
losartan potassium|Yes|No|No|No|75%|68382013706|LOSARTAN POTASSIUM 100 MG TAB|30|EA|.11094|10/13/2010||Yes|No||10/13/2010||Yes|No|10/13/2010||Yes|No||10/13/2010||Yes|No|07/01/2016||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|19543|||||No|No||ZYDUS PHARMACEU|No||||
losartan potassium|Yes|No|No|No|75%|68382013710|LOSARTAN POTASSIUM 100 MG TAB|1000|EA|.11073|10/13/2010||Yes|No||10/13/2010||Yes|No|10/13/2010||Yes|No||10/13/2010||Yes|No|07/01/2016||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|19544|||||No|No||ZYDUS PHARMACEU|No||||
losartan potassium|Yes|No|No|No|75%|68382013716|LOSARTAN POTASSIUM 100 MG TAB|90|EA|.11069|10/13/2010||Yes|No||10/13/2010||Yes|No|10/13/2010||Yes|No||10/13/2010||Yes|No|07/01/2016||Prescription required|No||113|Yes|.10526|03/29/2022|.10273|03/29/2022|.10341|03/29/2022|||ANGIOTENSIN MODULATORS|19545|||||No|No||ZYDUS PHARMACEU|No||||
topiramate|No|No|No|No|75%|68382013805|TOPIRAMATE 25 MG TABLET|500|EA|.02866|03/30/2009||Yes|No||03/30/2009||Yes|No|03/30/2009||Yes|No||||No|No|||Prescription required|No||056|No|.03423|03/29/2022|.0334|03/29/2022|.03363|03/29/2022|||ANTICONVULSANTS|19546|||||No|No||ZYDUS PHARMACEU|No||||
topiramate|No|No|No|No|75%|68382013814|TOPIRAMATE 25 MG TABLET|60|EA|.02866|03/30/2009||Yes|No||03/30/2009||Yes|No|03/30/2009||Yes|No||||No|No|||Prescription required|No||056|No|.03423|03/29/2022|.0334|03/29/2022|.03363|03/29/2022|||ANTICONVULSANTS|19547|||||No|No||ZYDUS PHARMACEU|No||||
topiramate|No|No|No|No|75%|68382013905|TOPIRAMATE 50 MG TABLET|500|EA|.03906|03/30/2009||Yes|No||03/30/2009||Yes|No|03/30/2009||Yes|No||||No|No|||Prescription required|No||056|No|.04588|03/29/2022|.04477|03/29/2022|.04507|03/29/2022|||ANTICONVULSANTS|19548|||||No|No||ZYDUS PHARMACEU|No||||
topiramate|No|No|No|No|75%|68382013914|TOPIRAMATE 50 MG TABLET|60|EA|.03905|03/30/2009||Yes|No||03/30/2009||Yes|No|03/30/2009||Yes|No||||No|No|||Prescription required|No||056|No|.04588|03/29/2022|.04477|03/29/2022|.04507|03/29/2022|||ANTICONVULSANTS|19549|||||No|No||ZYDUS PHARMACEU|No||||
topiramate|No|No|No|No|75%|68382014005|TOPIRAMATE 100 MG TABLET|500|EA|.05016|03/30/2009||Yes|No||03/30/2009||Yes|No|03/30/2009||Yes|No||||No|No|||Prescription required|No||056|No|.06953|03/29/2022|.06786|03/29/2022|.06831|03/29/2022|||ANTICONVULSANTS|19550|||||No|No||ZYDUS PHARMACEU|No||||
topiramate|No|No|No|No|75%|68382014014|TOPIRAMATE 100 MG TABLET|60|EA|.05016|03/30/2009||Yes|No||03/30/2009||Yes|No|03/30/2009||Yes|No||||No|No|||Prescription required|No||056|No|.06953|03/29/2022|.06786|03/29/2022|.06831|03/29/2022|||ANTICONVULSANTS|19551|||||No|No||ZYDUS PHARMACEU|No||||
topiramate|No|No|No|No|75%|68382014105|TOPIRAMATE 200 MG TABLET|500|EA|.0645|03/30/2009||Yes|No||03/30/2009||Yes|No|03/30/2009||Yes|No||||No|No|||Prescription required|No||056|No|.12326|03/29/2022|.1203|03/29/2022|.1211|03/29/2022|||ANTICONVULSANTS|19552|||||No|No||ZYDUS PHARMACEU|No||||
topiramate|No|No|No|No|75%|68382014114|TOPIRAMATE 200 MG TABLET|60|EA|.0645|03/30/2009||Yes|No||03/30/2009||Yes|No|03/30/2009||Yes|No||||No|No|||Prescription required|No||056|No|.12326|03/29/2022|.1203|03/29/2022|.1211|03/29/2022|||ANTICONVULSANTS|19553|||||No|No||ZYDUS PHARMACEU|No||||
ramipril|No|No|No|No|75%|68382014406|RAMIPRIL 1.25 MG CAPSULE|30|EA|.1333|12/22/2010||Yes|No||12/22/2010||Yes|No|12/22/2010||Yes|No||01/01/2010||Yes|No|||Prescription required|No||113|Yes|.12346|03/29/2022|.12049|03/29/2022|.12129|03/29/2022|||ANGIOTENSIN MODULATORS|19554|||||No|No||ZYDUS PHARMACEU|No||||
ramipril|Yes|No|No|No|75%|68382014501|RAMIPRIL 2.5 MG CAPSULE|100|EA|.08359|12/22/2010||Yes|No||12/22/2010||Yes|No|12/22/2010||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No||113|Yes|.06329|03/29/2022|.06177|03/29/2022|.06218|03/29/2022|||ANGIOTENSIN MODULATORS|19555|||||No|No||ZYDUS PHARMACEU|No||||
ramipril|Yes|No|No|No|75%|68382014601|RAMIPRIL 5 MG CAPSULE|100|EA|.08999|12/22/2010||Yes|No||12/22/2010||Yes|No|12/22/2010||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No||113|Yes|.06848|03/29/2022|.06683|03/29/2022|.06728|03/29/2022|||ANGIOTENSIN MODULATORS|19556|||||No|No||ZYDUS PHARMACEU|No||||
ramipril|Yes|No|No|No|75%|68382014701|RAMIPRIL 10 MG CAPSULE|100|EA|.09644|12/22/2010||Yes|No||12/22/2010||Yes|No|12/22/2010||Yes|No||01/01/2010||Yes|No|07/01/2016||Prescription required|No||113|No|.07037|03/29/2022|.06868|03/29/2022|.06913|03/29/2022|||ANGIOTENSIN MODULATORS|19557|||||No|No||ZYDUS PHARMACEU|No||||
buspirone HCl|No|No|No|No|75%|68382018001|BUSPIRONE HCL 5 MG TABLET|100|EA|.02085|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|19558|||||No|No||ZYDUS PHARMACEU|No||||
buspirone HCl|No|No|No|No|75%|68382018005|BUSPIRONE HCL 5 MG TABLET|500|EA|.02086|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|19559|||||No|No||ZYDUS PHARMACEU|No||||
buspirone HCl|No|No|No|No|75%|68382018101|BUSPIRONE HCL 10 MG TABLET|100|EA|.03237|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|19560|||||No|No||ZYDUS PHARMACEU|No||||
buspirone HCl|No|No|No|No|75%|68382018105|BUSPIRONE HCL 10 MG TABLET|500|EA|.03157|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|19561|||||No|No||ZYDUS PHARMACEU|No||||
buspirone HCl|No|No|No|No|75%|68382018201|BUSPIRONE HCL 15 MG TABLET|100|EA|.03848|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|19562|||||No|No||ZYDUS PHARMACEU|No||||
buspirone HCl|No|No|No|No|75%|68382018205|BUSPIRONE HCL 15 MG TABLET|500|EA|.03751|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|19563|||||No|No||ZYDUS PHARMACEU|No||||
buspirone HCl|No|No|No|No|75%|68382018305|BUSPIRONE HCL 30 MG TABLET|500|EA|.4515|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|||Prescription required|No||090|No|.17728|03/29/2022|.17302|03/29/2022|.17417|03/29/2022|||ANXIOLYTICS|19564|||||No|No||ZYDUS PHARMACEU|No||||
buspirone HCl|No|No|No|No|75%|68382018314|BUSPIRONE HCL 30 MG TABLET|60|EA|.4515|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|||Prescription required|No||090|No|.17728|03/29/2022|.17302|03/29/2022|.17417|03/29/2022|||ANXIOLYTICS|19565|||||No|No||ZYDUS PHARMACEU|No||||
glipizide/metformin HCl|No|No|No|No|75%|68382018401|GLIPIZIDE-METFORMIN 2.5-250 MG|100|EA|.18713|11/23/2016||Yes|No||11/23/2016||Yes|No|11/23/2016||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|012|No|.42649|04/07/2020|.4204|04/07/2020|.40038|04/07/2020|||HYPOGLYCEMICS: METFORMINS|19566|||||No|No||ZYDUS PHARMACEU|No||||
glipizide/metformin HCl|No|No|No|No|75%|68382018501|GLIPIZIDE-METFORMIN 2.5-500 MG|100|EA|.22325|11/23/2016||Yes|No||11/23/2016||Yes|No|11/23/2016||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|012|No|.33272|03/29/2022|.32473|03/29/2022|.32689|03/29/2022|||HYPOGLYCEMICS: METFORMINS|19567|||||No|No||ZYDUS PHARMACEU|No||||
glipizide/metformin HCl|No|No|No|No|75%|68382018601|GLIPIZIDE-METFORMIN 5-500 MG|100|EA|.22325|11/23/2016||Yes|No||11/23/2016||Yes|No|11/23/2016||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|012|No|.24767|03/29/2022|.24172|03/29/2022|.24333|03/29/2022|||HYPOGLYCEMICS: METFORMINS|19568|||||No|No||ZYDUS PHARMACEU|No||||
gabapentin|No|No|No|No|75%|68382020401|GABAPENTIN 600 MG TABLET|100|EA|.06338|11/28/2012||Yes|No||11/28/2012||Yes|No|11/28/2012||Yes|No||11/28/2012||Yes|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|19569|||||No|No||ZYDUS PHARMACEU|No||||
gabapentin|No|No|No|No|75%|68382020405|GABAPENTIN 600 MG TABLET|500|EA|.06021|11/28/2012||Yes|No||11/28/2012||Yes|No|11/28/2012||Yes|No||11/28/2012||Yes|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|19570|||||No|No||ZYDUS PHARMACEU|No||||
gabapentin|No|No|No|No|75%|68382020501|GABAPENTIN 800 MG TABLET|100|EA|.0998|11/28/2012||Yes|No||11/28/2012||Yes|No|11/28/2012||Yes|No||11/28/2012||Yes|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|19571|||||No|No||ZYDUS PHARMACEU|No||||
gabapentin|No|No|No|No|75%|68382020505|GABAPENTIN 800 MG TABLET|500|EA|.09481|11/28/2012||Yes|No||11/28/2012||Yes|No|11/28/2012||Yes|No||11/28/2012||Yes|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|19572|||||No|No||ZYDUS PHARMACEU|No||||
anastrozole|No|No|No|No|75%|68382020906|ANASTROZOLE 1 MG TABLET|30|EA|.21715|06/28/2010||Yes|No||06/28/2010||Yes|No|06/28/2010||Yes|No||||No|No|||Prescription required|No||502|No|.11251|03/29/2022|.1098|03/29/2022|.11054|03/29/2022|||ONCOLOGY: ORAL - BREAST|19573|||||No|No||ZYDUS PHARMACEU|No||||
amiodarone HCl|No|No|No|No|75%|68382022705|AMIODARONE HCL 200 MG TABLET|500|EA|.11374|06/18/2009||Yes|No||06/18/2009||Yes|No|06/18/2009||Yes|No||||No|No|||Prescription required|No|||No|.12373|03/29/2022|.12076|03/29/2022|.12156|03/29/2022||||19574|||||No|No||ZYDUS PHARMACEU|No||||
amiodarone HCl|No|No|No|No|75%|68382022714|AMIODARONE HCL 200 MG TABLET|60|EA|.1161|06/18/2009||Yes|No||06/18/2009||Yes|No|06/18/2009||Yes|No||||No|No|||Prescription required|No|||No|.12373|03/29/2022|.12076|03/29/2022|.12156|03/29/2022||||19575|||||No|No||ZYDUS PHARMACEU|No||||
benzonatate|No|No|No|No|75%|68382024701|BENZONATATE 100 MG CAPSULE|100|EA|.14542|10/31/2007||Yes|No||10/31/2007||Yes|No|10/31/2007||Yes|No||||No|No|||Prescription required|No||184|Yes|.09389|03/29/2022|.09163|03/29/2022|.09224|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|19576|||||No|No||ZYDUS PHARMACEU|No||||
benzonatate|No|No|No|No|75%|68382024705|BENZONATATE 100 MG CAPSULE|500|EA|.13816|10/31/2007||Yes|No||10/31/2007||Yes|No|10/31/2007||Yes|No||||No|No|||Prescription required|No||184|Yes|.09389|03/29/2022|.09163|03/29/2022|.09224|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|19577|||||No|No||ZYDUS PHARMACEU|No||||
oxybutynin chloride|No|No|No|No|75%|68382025501|OXYBUTYNIN CL ER 5 MG TABLET|100|EA|.22979|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|No||006|Yes|.15279|03/29/2022|.14912|03/29/2022|.15011|03/29/2022|||BLADDER RELAXANT PREPARATIONS|19578|||||No|No||ZYDUS PHARMACEU|No||||
oxybutynin chloride|No|No|No|No|75%|68382025505|OXYBUTYNIN CL ER 5 MG TABLET|500|EA|.22947|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|No||006|Yes|.15279|03/29/2022|.14912|03/29/2022|.15011|03/29/2022|||BLADDER RELAXANT PREPARATIONS|19579|||||No|No||ZYDUS PHARMACEU|No||||
oxybutynin chloride|No|No|No|No|75%|68382025601|OXYBUTYNIN CL ER 10 MG TABLET|100|EA|.23|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|No||006|No|.15833|03/29/2022|.15453|03/29/2022|.15555|03/29/2022|||BLADDER RELAXANT PREPARATIONS|19580|||||No|No||ZYDUS PHARMACEU|No||||
oxybutynin chloride|No|No|No|No|75%|68382025605|OXYBUTYNIN CL ER 10 MG TABLET|500|EA|.22971|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|No||006|No|.15833|03/29/2022|.15453|03/29/2022|.15555|03/29/2022|||BLADDER RELAXANT PREPARATIONS|19581|||||No|No||ZYDUS PHARMACEU|No||||
oxybutynin chloride|No|No|No|No|75%|68382025701|OXYBUTYNIN CL ER 15 MG TABLET|100|EA|.23576|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|No||006|No|.19948|03/29/2022|.19469|03/29/2022|.19598|03/29/2022|||BLADDER RELAXANT PREPARATIONS|19582|||||No|No||ZYDUS PHARMACEU|No||||
etodolac|No|No|No|No|75%|68382027101|ETODOLAC ER 400 MG TABLET|100|EA|.99803|09/08/2014||Yes|No||09/08/2014||Yes|No|09/08/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|1.74706|03/01/2022|1.70513|03/01/2022|1.71648|03/01/2022|||NSAIDS|19583|||||No|No||ZYDUS PHARMACEU|No||||
etodolac|No|No|No|No|75%|68382027114|ETODOLAC ER 400 MG TABLET|60|EA|1.01795|09/08/2014||Yes|No||09/08/2014||Yes|No|09/08/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|1.74706|03/01/2022|1.70513|03/01/2022|1.71648|03/01/2022|||NSAIDS|19584|||||No|No||ZYDUS PHARMACEU|No||||
etodolac|No|No|No|No|75%|68382027201|ETODOLAC ER 500 MG TABLET|100|EA|1.0602|06/06/2014||Yes|No||06/06/2014||Yes|No|06/06/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|1.39968|03/29/2022|1.36608|03/29/2022|1.37518|03/29/2022|||NSAIDS|19585|||||No|No||ZYDUS PHARMACEU|No||||
etodolac|No|No|No|No|75%|68382027301|ETODOLAC ER 600 MG TABLET|100|EA|1.12629|06/06/2014||Yes|No||06/06/2014||Yes|No|06/06/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|2.56691|06/29/2021|2.53024|06/29/2021|2.40975|06/29/2021|||NSAIDS|19586|||||No|No||ZYDUS PHARMACEU|No||||
etodolac|No|No|No|No|75%|68382027314|ETODOLAC ER 600 MG TABLET|60|EA|1.14881|01/03/2017||Yes|No||01/03/2017||Yes|No|01/03/2017||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|2.61822|06/29/2021|2.58082|06/29/2021|2.45792|06/29/2021|||NSAIDS|19587|||||No|No||ZYDUS PHARMACEU|No||||
nitroglycerin|No|No|No|No|75%|68382030930|NITROGLYCERIN 0.2 MG/HR PATCH|30|EA|.30372|06/01/2017||Yes|No||06/01/2017||Yes|No|06/01/2017||Yes|No||||No|No|||Prescription required|No|||No|.5028|03/29/2022|.49073|03/29/2022|.494|03/29/2022||||19588|||||No|No||ZYDUS PHARMACEU|No||||
nitroglycerin|No|No|No|No|75%|68382031030|NITROGLYCERIN 0.4 MG/HR PATCH|30|EA|.35102|06/01/2017||Yes|No||06/01/2017||Yes|No|06/01/2017||Yes|No||||No|No|||Prescription required|No|||No|.59249|03/29/2022|.57827|03/29/2022|.58212|03/29/2022||||19589|||||No|No||ZYDUS PHARMACEU|No||||
nitroglycerin|No|No|No|No|75%|68382031130|NITROGLYCERIN 0.6 MG/HR PATCH|30|EA|.4052|09/22/2017||Yes|No||09/22/2017||Yes|No|09/22/2017||Yes|No||||No|No|||Prescription required|No|||No|.68113|09/28/2021|.66478|09/28/2021|.66921|09/28/2021||||19590|||||No|No||ZYDUS PHARMACEU|No||||
minocycline HCl|No|No|No|No|75%|68382031601|MINOCYCLINE 50 MG CAPSULE|100|EA|.0973|09/08/2017||Yes|No||09/08/2017||Yes|No|09/08/2017||Yes|No||||No|No|||Prescription required|No||213|No|.20366|03/29/2022|.19877|03/29/2022|.20009|03/29/2022|||TETRACYCLINES|19591|||||No|No||ZYDUS PHARMACEU|No||||
minocycline HCl|No|No|No|No|75%|68382031701|MINOCYCLINE 75 MG CAPSULE|100|EA|.17913|09/08/2017||Yes|No||09/08/2017||Yes|No|09/08/2017||Yes|No||||No|No|||Prescription required|No||213|No|.36632|10/26/2021|.35752|10/26/2021|.3599|10/26/2021|||TETRACYCLINES|19592|||||No|No||ZYDUS PHARMACEU|No||||
minocycline HCl|No|No|No|No|75%|68382031818|MINOCYCLINE 100 MG CAPSULE|50|EA|.19461|08/18/2017||Yes|No||08/18/2017||Yes|No|08/18/2017||Yes|No||||No|No|||Prescription required|No||213|No|.38664|03/29/2022|.37736|03/29/2022|.37987|03/29/2022|||TETRACYCLINES|19593|||||No|No||ZYDUS PHARMACEU|No||||
paricalcitol|No|No|No|No|75%|68382033006|PARICALCITOL 1 MCG CAPSULE|30|EA|3.81524|12/06/2019||Yes|No||12/06/2019||Yes|No|12/06/2019||Yes|No||||No|No|||Prescription required|No|||No|1.13472|03/29/2022|1.10748|03/29/2022|1.11486|03/29/2022||||19594|||||No|No||ZYDUS PHARMACEU|No||||
paricalcitol|No|No|No|No|75%|68382033106|PARICALCITOL 2 MCG CAPSULE|30|EA|7.63006|12/06/2019||Yes|No||12/06/2019||Yes|No|12/06/2019||Yes|No||||No|No|||Prescription required|No|||No|17.38944|12/06/2019|17.14102|12/06/2019|16.32478|12/06/2019||||19595|||||No|No||ZYDUS PHARMACEU|No||||
tramadol HCl/acetaminophen|No|No|No|No|90%|68382033401|TRAMADOL-ACETAMINOPHN 37.5-325|100|EA|.13222|11/28/2012|08/31/2022|Yes|No||11/28/2012|08/31/2022|Yes|No|11/28/2012|08/31/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|.11806|03/29/2022|.11522|03/29/2022|.11599|03/29/2022|||ANALGESICS: NARCOTICS SHORT|19596|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ZYDUS PHARMACEU|No||||
tramadol HCl/acetaminophen|No|No|No|No|90%|68382033405|TRAMADOL-ACETAMINOPHN 37.5-325|500|EA|.13213|11/28/2012|08/31/2022|Yes|No||11/28/2012|08/31/2022|Yes|No|11/28/2012|08/31/2022|Yes|No||||No|No|||Prescription required|No||109|Yes|.11806|03/29/2022|.11522|03/29/2022|.11599|03/29/2022|||ANALGESICS: NARCOTICS SHORT|19597|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ZYDUS PHARMACEU|No||||
glipizide|Yes|No|No|No|75%|68382033506|GLIPIZIDE ER 2.5 MG TABLET|30|EA|.07267|12/07/2018||Yes|No||12/07/2018||Yes|No|12/07/2018||Yes|No||12/07/2018||Yes|No|06/18/2019||Prescription required|No|||Yes|.12809|03/29/2022|.12501|03/29/2022|.12584|03/29/2022||||19598|||||No|No||ZYDUS PHARMACEU|No||||
glipizide|Yes|No|No|No|75%|68382033601|GLIPIZIDE ER 5 MG TABLET|100|EA|.06462|12/07/2018||Yes|No||12/07/2018||Yes|No|12/07/2018||Yes|No||12/07/2018||Yes|No|06/18/2019||Prescription required|No|||Yes|.11105|03/29/2022|.10838|03/29/2022|.1091|03/29/2022||||19599|||||No|No||ZYDUS PHARMACEU|No||||
bupropion HCl|Yes|No|No|No|75%|68382035305|BUPROPION HCL XL 150 MG TABLET|500|EA|.11959|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|09/27/2019||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|19600|||||No|No||ZYDUS PHARMACEU|No||||
bupropion HCl|Yes|No|No|No|75%|68382035306|BUPROPION HCL XL 150 MG TABLET|30|EA|.1462|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|09/27/2019||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|19601|||||No|No||ZYDUS PHARMACEU|No||||
bupropion HCl|Yes|No|No|No|75%|68382035316|BUPROPION HCL XL 150 MG TABLET|90|EA|.1462|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|09/27/2019||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|19602|||||No|No||ZYDUS PHARMACEU|No||||
nystatin|No|No|No|No|75%|68382037001|NYSTATIN 100,000 UNIT/GM POWD|15|GM|.20066|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No||061|No|.35016|03/29/2022|.34175|03/29/2022|.34403|03/29/2022|||ANTIFUNGALS: TOPICAL|19603|||||No|No||ZYDUS PHARMACEU|No||||
nystatin|No|No|No|No|75%|68382037002|NYSTATIN 100,000 UNIT/GM POWD|30|GM|.20066|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No||061|No|.30897|03/29/2022|.30155|03/29/2022|.30356|03/29/2022|||ANTIFUNGALS: TOPICAL|19604|||||No|No||ZYDUS PHARMACEU|No||||
nystatin|No|No|No|No|75%|68382037003|NYSTATIN 100,000 UNIT/GM POWD|60|GM|.15766|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No||061|No|.2597|03/29/2022|.25346|03/29/2022|.25515|03/29/2022|||ANTIFUNGALS: TOPICAL|19605|||||No|No||ZYDUS PHARMACEU|No||||
exemestane|No|No|No|No|75%|68382038306|EXEMESTANE 25 MG TABLET|30|EA|1.28598|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||502|No|1.32315|03/29/2022|1.29139|03/29/2022|1.29999|03/29/2022|||ONCOLOGY: ORAL - BREAST|19606|||||No|No||ZYDUS PHARMACEU|No||||
desmopressin (nonrefrigerated)|No|No|No|No|75%|68382038401|DESMOPRESSIN 10 MCG/0.1 ML SPR|5|ML|15.43958|06/05/2019||Yes|No||06/05/2019||Yes|No|06/05/2019||Yes|No||||No|No|||Prescription required|No|||No|8.29308|03/29/2022|8.09404|03/29/2022|8.14795|03/29/2022||||19607|||||No|No||ZYDUS PHARMACEU|No||||
potassium chloride|No|No|No|No|75%|68382039801|POTASSIUM CL ER 20 MEQ TABLET|100|EA|.21581|11/03/2016||Yes|No||11/03/2016||Yes|No|11/03/2016||Yes|No||11/03/2016||Yes|No|||Prescription required|No|||No|.25896|03/29/2022|.25274|03/29/2022|.25442|03/29/2022||||19608|||||No|No||ZYDUS PHARMACEU|No||||
omeprazole|No|No|No|No|75%|68382041101|OMEPRAZOLE DR 10 MG CAPSULE|100|EA|.0774|12/21/2012||Yes|No||12/21/2012||Yes|No|12/21/2012||Yes|No||12/21/2012||Yes|No|||Prescription required|No||047|Yes|.09084|03/29/2022|.08865|03/29/2022|.08925|03/29/2022|||PROTON PUMP INHIBITORS|19609|||||No|No||ZYDUS PHARMACEU|No||||
omeprazole|No|No|No|No|75%|68382041205|OMEPRAZOLE DR 20 MG CAPSULE|500|EA|.03676|06/11/2015||Yes|No||06/11/2015||Yes|No|06/11/2015||Yes|No||06/11/2015||Yes|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|19610|||||No|No||ZYDUS PHARMACEU|No||||
mesalamine|No|No|No|No|75%|68382043528|MESALAMINE 800 MG DR TABLET|180|EA|3.19023|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|010|No|6.32467|03/29/2022|6.17287|03/29/2022|6.21398|03/29/2022|||ULCERATIVE COLITIS AGENTS|19611|||||No|No||ZYDUS PHARMACEU|No||||
famotidine|No|No|No|No|75%|68382044405|FAMOTIDINE 40 MG/5 ML SUSP|50|ML|.84925|06/14/2021||Yes|No||06/14/2021||Yes|No|06/14/2021||Yes|No||||No|No|||Prescription required|No|||No|.81888|03/29/2022|.79922|03/29/2022|.80454|03/29/2022||||19612|||||No|No||ZYDUS PHARMACEU|No||||
bosentan|No|No|No|No|75%|68382044614|BOSENTAN 62.5 MG TABLET|60|EA|21.58284|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/26/2018|171|No|49.1888|06/22/2021|48.4861|06/22/2021|46.17724|06/22/2021|||PAH AGENTS: ORAL AND INHALED|19613|||||No|No||ZYDUS PHARMACEU|No||||
bosentan|No|No|No|No|75%|68382044714|BOSENTAN 125 MG TABLET|60|EA|21.58284|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/26/2018|171|No|49.1888|06/22/2021|48.4861|06/22/2021|46.17724|06/22/2021|||PAH AGENTS: ORAL AND INHALED|19614|||||No|No||ZYDUS PHARMACEU|No||||
mesalamine|No|No|No|No|75%|68382045219|MESALAMINE ER 0.375 GRAM CAP|120|EA|.94062|12/15/2021||Yes|No||12/15/2021||Yes|No|12/15/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|010|No|1.86918|03/29/2022|1.82431|03/29/2022|1.83646|03/29/2022|||ULCERATIVE COLITIS AGENTS|19615|||||No|No||ZYDUS PHARMACEU|No||||
telmisartan|Yes|No|No|No|75%|68382047178|TELMISARTAN 20 MG TABLET|30|EA|.645|12/08/2014||Yes|No||12/08/2014||Yes|No|12/08/2014||Yes|No||12/08/2014||Yes|No|07/01/2016||Prescription required|Yes|07/17/2014|113|Yes|.30407|03/29/2022|.29677|03/29/2022|.29874|03/29/2022|||ANGIOTENSIN MODULATORS|19616|||||No|No||ZYDUS PHARMACEU|No||||
telmisartan|Yes|No|No|No|75%|68382047278|TELMISARTAN 40 MG TABLET|30|EA|.645|12/08/2014||Yes|No||12/08/2014||Yes|No|12/08/2014||Yes|No||12/08/2014||Yes|No|07/01/2016||Prescription required|Yes|07/17/2014|113|Yes|.35861|03/29/2022|.35|03/29/2022|.35233|03/29/2022|||ANGIOTENSIN MODULATORS|19617|||||No|No||ZYDUS PHARMACEU|No||||
telmisartan|Yes|No|No|No|75%|68382047378|TELMISARTAN 80 MG TABLET|30|EA|.645|12/08/2014||Yes|No||12/08/2014||Yes|No|12/08/2014||Yes|No||12/08/2014||Yes|No|07/01/2016||Prescription required|Yes|07/17/2014|113|Yes|.33958|03/29/2022|.33143|03/29/2022|.33363|03/29/2022|||ANGIOTENSIN MODULATORS|19618|||||No|No||ZYDUS PHARMACEU|No||||
omeprazole|No|No|No|No|75%|68382050001|OMEPRAZOLE DR 40 MG CAPSULE|100|EA|.06325|12/21/2012||Yes|No||12/21/2012||Yes|No|12/21/2012||Yes|No||12/21/2012||Yes|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|19619|||||No|No||ZYDUS PHARMACEU|No||||
omeprazole|No|No|No|No|75%|68382050010|OMEPRAZOLE DR 40 MG CAPSULE|1000|EA|.05694|12/21/2012||Yes|No||12/21/2012||Yes|No|12/21/2012||Yes|No||12/21/2012||Yes|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|19620|||||No|No||ZYDUS PHARMACEU|No||||
amantadine HCl|No|No|No|No|75%|68382051201|AMANTADINE 100 MG CAPSULE|100|EA|.34658|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|No||015|No|.2857|03/29/2022|.27884|03/29/2022|.2807|03/29/2022|||ANTIPARKINSON'S AGENTS|19621|||||No|No||ZYDUS PHARMACEU|No||||
amantadine HCl|No|No|No|No|75%|68382051205|AMANTADINE 100 MG CAPSULE|500|EA|.34658|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|No||015|No|.2857|03/29/2022|.27884|03/29/2022|.2807|03/29/2022|||ANTIPARKINSON'S AGENTS|19622|||||No|No||ZYDUS PHARMACEU|No||||
sirolimus|No|No|No|No|75%|68382052001|SIROLIMUS 0.5 MG TABLET|100|EA|2.34754|01/21/2014||Yes|No||01/21/2014||Yes|No|01/21/2014||Yes|No||01/21/2014||Yes|No|||Prescription required|Yes|01/27/2022|229|No|4.84817|03/29/2022|4.73181|03/29/2022|4.76332|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|19623|||||No|No||ZYDUS PHARMACEU|No||||
bumetanide|No|No|No|No|75%|68382052605|BUMETANIDE 1 MG TABLET|500|EA|.20111|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||10/07/2020||Yes|No|||Prescription required|No|||No|.21417|03/29/2022|.20902|03/29/2022|.21042|03/29/2022||||19624|||||No|No||ZYDUS PHARMACEU|No||||
bumetanide|No|No|No|No|75%|68382052705|BUMETANIDE 2 MG TABLET|500|EA|.37306|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||10/07/2020||Yes|No|||Prescription required|No|||No|.40198|03/29/2022|.39233|03/29/2022|.39494|03/29/2022||||19625|||||No|No||ZYDUS PHARMACEU|No||||
cholestyramine (with sugar)|No|No|No|No|75%|68382052842|CHOLESTYRAMINE POWDER|378|GM|.0965|12/07/2018||Yes|No||12/07/2018||Yes|No|12/07/2018||Yes|No||12/07/2018||Yes|No|||Prescription required|No||055|No|.14958|03/29/2022|.14599|03/29/2022|.14696|03/29/2022|||LIPOTROPICS: OTHER|19626|||||No|No||ZYDUS PHARMACEU|No||||
cholestyramine (with sugar)|No|No|No|No|75%|68382052860|CHOLESTYRAMINE PACKET|60|EA|.87669|12/07/2018||Yes|No||12/07/2018||Yes|No|12/07/2018||Yes|No||12/07/2018||Yes|No|||Prescription required|No||055|No|1.02853|03/29/2022|1.00384|03/29/2022|1.01053|03/29/2022|||LIPOTROPICS: OTHER|19627|||||No|No||ZYDUS PHARMACEU|No||||
cholestyramine/aspartame|No|No|No|No|75%|68382052942|CHOLESTYRAMINE LIGHT POWDER|231|GM|.11866|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||05/21/2018||Yes|No|||Prescription required|No||055|No|.21025|03/29/2022|.2052|03/29/2022|.20657|03/29/2022|||LIPOTROPICS: OTHER|19628|||||No|No||ZYDUS PHARMACEU|No||||
cholestyramine/aspartame|No|No|No|No|75%|68382052960|CHOLESTYRAMINE LIGHT PACKET|60|EA|.88171|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||05/21/2018||Yes|No|||Prescription required|No||055|No|1.2151|03/29/2022|1.18593|03/29/2022|1.19383|03/29/2022|||LIPOTROPICS: OTHER|19629|||||No|No||ZYDUS PHARMACEU|No||||
potassium citrate|No|No|No|No|75%|68382053601|POTASSIUM CITRATE ER 5 MEQ TAB|100|EA|.4318|11/07/2014||Yes|No||11/07/2014||Yes|No|11/07/2014||Yes|No||11/07/2014||Yes|No|||Prescription required|No|||No|.46644|03/29/2022|.45524|03/29/2022|.45827|03/29/2022||||19630|||||No|No||ZYDUS PHARMACEU|No||||
potassium citrate|No|No|No|No|75%|68382053701|POTASSIUM CITRATE ER 10 MEQ TB|100|EA|.60518|11/04/2014||Yes|No||11/04/2014||Yes|No|11/04/2014||Yes|No||11/04/2014||Yes|No|||Prescription required|No|||No|.30433|03/29/2022|.29702|03/29/2022|.299|03/29/2022||||19631|||||No|No||ZYDUS PHARMACEU|No||||
potassium citrate|No|No|No|No|75%|68382053801|POTASSIUM CITRATE ER 15 MEQ TB|100|EA|.85333|11/04/2014||Yes|No||11/04/2014||Yes|No|11/04/2014||Yes|No||11/04/2014||Yes|No|||Prescription required|No|||No|.5925|03/29/2022|.57828|03/29/2022|.58213|03/29/2022||||19632|||||No|No||ZYDUS PHARMACEU|No||||
memantine HCl|No|No|No|No|75%|68382054606|MEMANTINE HCL ER 7 MG CAPSULE|30|EA|1.31408|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|011|No|.73424|03/29/2022|.71661|03/29/2022|.72139|03/29/2022|||ALZHEIMER'S AGENTS|19633|||||No|No||ZYDUS PHARMACEU|No||||
memantine HCl|No|No|No|No|75%|68382054706|MEMANTINE HCL ER 14 MG CAPSULE|30|EA|1.31408|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|011|No|.96952|03/29/2022|.94625|03/29/2022|.95255|03/29/2022|||ALZHEIMER'S AGENTS|19634|||||No|No||ZYDUS PHARMACEU|No||||
memantine HCl|No|No|No|No|75%|68382054716|MEMANTINE HCL ER 14 MG CAPSULE|90|EA|1.31408|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|011|No|.96952|03/29/2022|.94625|03/29/2022|.95255|03/29/2022|||ALZHEIMER'S AGENTS|19635|||||No|No||ZYDUS PHARMACEU|No||||
memantine HCl|No|No|No|No|75%|68382054806|MEMANTINE HCL ER 21 MG CAPSULE|30|EA|1.31408|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|011|No|.91098|03/29/2022|.88911|03/29/2022|.89503|03/29/2022|||ALZHEIMER'S AGENTS|19636|||||No|No||ZYDUS PHARMACEU|No||||
memantine HCl|No|No|No|No|75%|68382054906|MEMANTINE HCL ER 28 MG CAPSULE|30|EA|1.31408|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|011|No|1.08689|03/29/2022|1.0608|03/29/2022|1.06786|03/29/2022|||ALZHEIMER'S AGENTS|19637|||||No|No||ZYDUS PHARMACEU|No||||
memantine HCl|No|No|No|No|75%|68382054916|MEMANTINE HCL ER 28 MG CAPSULE|90|EA|1.31408|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|011|No|1.08689|03/29/2022|1.0608|03/29/2022|1.06786|03/29/2022|||ALZHEIMER'S AGENTS|19638|||||No|No||ZYDUS PHARMACEU|No||||
carbamazepine|No|No|No|No|75%|68382055501|CARBAMAZEPINE ER 100 MG TABLET|100|EA|.3937|08/20/2021||Yes|No||08/20/2021||Yes|No|08/20/2021||Yes|No||08/20/2021||Yes|No|||Prescription required|No||056|No|.53596|03/29/2022|.52309|03/29/2022|.52658|03/29/2022|||ANTICONVULSANTS|19639|||||No|No||ZYDUS PHARMACEU|No||||
carbamazepine|No|No|No|No|75%|68382055601|CARBAMAZEPINE ER 200 MG TABLET|100|EA|.715|08/20/2021||Yes|No||08/20/2021||Yes|No|08/20/2021||Yes|No||08/20/2021||Yes|No|||Prescription required|No||056|No|.8262|03/29/2022|.80637|03/29/2022|.81174|03/29/2022|||ANTICONVULSANTS|19640|||||No|No||ZYDUS PHARMACEU|No||||
carbamazepine|No|No|No|No|75%|68382055701|CARBAMAZEPINE ER 400 MG TABLET|100|EA|1.42897|08/20/2021||Yes|No||08/20/2021||Yes|No|08/20/2021||Yes|No||08/20/2021||Yes|No|||Prescription required|No||056|No|1.58237|03/29/2022|1.54439|03/29/2022|1.55467|03/29/2022|||ANTICONVULSANTS|19641|||||No|No||ZYDUS PHARMACEU|No||||
nitrofurantoin macrocrystal|Yes|No|No|No|75%|68382055901|NITROFURANTOIN MCR 50 MG CAP|100|EA|.43215|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||02/22/2019||Yes|No|06/18/2019||Prescription required|No|||No|.39225|03/29/2022|.38283|03/29/2022|.38538|03/29/2022||||19642|||||No|No||ZYDUS PHARMACEU|No||||
nitrofurantoin macrocrystal|No|No|No|No|75%|68382056001|NITROFURANTOIN MCR 100 MG CAP|100|EA|.71427|02/22/2019|04/30/2022|Yes|No||02/22/2019|04/30/2022|Yes|No|02/22/2019|04/30/2022|Yes|No||02/22/2019|04/30/2022|Yes|No|||Prescription required|No|||No|.47756|03/29/2022|.46609|03/29/2022|.4692|03/29/2022||||19643|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable|No|No||ZYDUS PHARMACEU|No||||
metoprolol succinate|No|No|No|No|75%|68382056401|METOPROLOL SUCC ER 25 MG TAB|100|EA|.10848|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||12/06/2018||Yes|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|19644|||||No|No||ZYDUS PHARMACEU|No||||
metoprolol succinate|No|No|No|No|75%|68382056501|METOPROLOL SUCC ER 50 MG TAB|100|EA|.10848|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||12/06/2018||Yes|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|19645|||||No|No||ZYDUS PHARMACEU|No||||
metoprolol succinate|No|No|No|No|75%|68382056510|METOPROLOL SUCC ER 50 MG TAB|1000|EA|.10521|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||12/06/2018||Yes|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|19646|||||No|No||ZYDUS PHARMACEU|No||||
metoprolol succinate|No|No|No|No|75%|68382056601|METOPROLOL SUCC ER 100 MG TAB|100|EA|.16301|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||12/06/2018||Yes|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|19647|||||No|No||ZYDUS PHARMACEU|No||||
metoprolol succinate|No|No|No|No|75%|68382056610|METOPROLOL SUCC ER 100 MG TAB|1000|EA|.15812|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||12/06/2018||Yes|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|19648|||||No|No||ZYDUS PHARMACEU|No||||
metoprolol succinate|No|No|No|No|75%|68382056701|METOPROLOL SUCC ER 200 MG TAB|100|EA|.25937|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||12/06/2018||Yes|No|||Prescription required|No||070|No|.25385|03/29/2022|.24775|03/29/2022|.2494|03/29/2022|||BETA-BLOCKERS|19649|||||No|No||ZYDUS PHARMACEU|No||||
metoprolol succinate|No|No|No|No|75%|68382056705|METOPROLOL SUCC ER 200 MG TAB|500|EA|.25157|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||12/06/2018||Yes|No|||Prescription required|No||070|No|.25385|03/29/2022|.24775|03/29/2022|.2494|03/29/2022|||BETA-BLOCKERS|19650|||||No|No||ZYDUS PHARMACEU|No||||
acamprosate calcium|No|No|No|No|75%|68382056928|ACAMPROSATE CALC DR 333 MG TAB|180|EA|.60441|10/31/2017||Yes|No||10/31/2017||Yes|No|10/31/2017||Yes|No||||No|No|||Prescription required|No|||No|.6071|03/29/2022|.59252|03/29/2022|.59647|03/29/2022||||19651|||||No|No||ZYDUS PHARMACEU|Yes|09/01/2020|||
liothyronine sodium|No|No|No|No|75%|68382058201|LIOTHYRONINE SOD 5 MCG TAB|100|EA|.27249|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No|||No|.37734|03/29/2022|.36828|03/29/2022|.37073|03/29/2022||||19652|||||No|No||ZYDUS PHARMACEU|No||||
liothyronine sodium|No|No|No|No|75%|68382058301|LIOTHYRONINE SOD 25 MCG TAB|100|EA|.35801|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No|||No|.55764|03/29/2022|.54425|03/29/2022|.54788|03/29/2022||||19653|||||No|No||ZYDUS PHARMACEU|No||||
liothyronine sodium|No|No|No|No|75%|68382058401|LIOTHYRONINE SOD 50 MCG TAB|100|EA|.54691|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No|||No|.67729|01/25/2022|.66103|01/25/2022|.66543|01/25/2022||||19654|||||No|No||ZYDUS PHARMACEU|No||||
perphenazine|No|No|No|No|75%|68382059101|PERPHENAZINE 2 MG TABLET|100|EA|.14637|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.31906|03/29/2022|.3114|03/29/2022|.31347|03/29/2022|||ANTIPSYCHOTICS|19655|||||No|No||ZYDUS PHARMACEU|No||||
perphenazine|No|No|No|No|75%|68382059201|PERPHENAZINE 4 MG TABLET|100|EA|.20038|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.32485|03/29/2022|.31705|03/29/2022|.31916|03/29/2022|||ANTIPSYCHOTICS|19656|||||No|No||ZYDUS PHARMACEU|No||||
perphenazine|No|No|No|No|75%|68382059301|PERPHENAZINE 8 MG TABLET|100|EA|.24303|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.48127|03/29/2022|.46971|03/29/2022|.47284|03/29/2022|||ANTIPSYCHOTICS|19657|||||No|No||ZYDUS PHARMACEU|No||||
perphenazine|No|No|No|No|75%|68382059401|PERPHENAZINE 16 MG TABLET|100|EA|.32697|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|.69746|03/29/2022|.68072|03/29/2022|.68525|03/29/2022|||ANTIPSYCHOTICS|19658|||||No|No||ZYDUS PHARMACEU|No||||
diltiazem HCl|Yes|No|No|No|75%|68382059505|DILTIAZEM 24H ER(CD) 120 MG CP|500|EA|.20672|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||02/26/2019||Yes|No|06/18/2019||Prescription required|No||045|No|.17507|03/29/2022|.17086|03/29/2022|.172|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19659|||||No|No||ZYDUS PHARMACEU|No||||
diltiazem HCl|Yes|No|No|No|75%|68382059516|DILTIAZEM 24H ER(CD) 120 MG CP|90|EA|.21103|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||02/27/2019||Yes|No|06/18/2019||Prescription required|No||045|No|.17507|03/29/2022|.17086|03/29/2022|.172|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19660|||||No|No||ZYDUS PHARMACEU|No||||
diltiazem HCl|Yes|No|No|No|75%|68382059605|DILTIAZEM 24H ER(CD) 180 MG CP|500|EA|.23183|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||02/26/2019||Yes|No|06/18/2019||Prescription required|No||045|No|.21189|03/29/2022|.2068|03/29/2022|.20818|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19661|||||No|No||ZYDUS PHARMACEU|No||||
diltiazem HCl|Yes|No|No|No|75%|68382059616|DILTIAZEM 24H ER(CD) 180 MG CP|90|EA|.23659|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||02/27/2019||Yes|No|06/18/2019||Prescription required|No||045|No|.21189|03/29/2022|.2068|03/29/2022|.20818|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19662|||||No|No||ZYDUS PHARMACEU|No||||
diltiazem HCl|Yes|No|No|No|75%|68382059705|DILTIAZEM 24H ER(CD) 240 MG CP|500|EA|.31653|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||02/26/2019||Yes|No|06/18/2019||Prescription required|No||045|No|.29728|03/29/2022|.29014|03/29/2022|.29207|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19663|||||No|No||ZYDUS PHARMACEU|No||||
diltiazem HCl|Yes|No|No|No|75%|68382059716|DILTIAZEM 24H ER(CD) 240 MG CP|90|EA|.32603|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||02/27/2019||Yes|No|06/18/2019||Prescription required|No||045|No|.29728|03/29/2022|.29014|03/29/2022|.29207|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19664|||||No|No||ZYDUS PHARMACEU|No||||
diltiazem HCl|Yes|No|No|No|75%|68382059805|DILTIAZEM 24H ER(CD) 300 MG CP|500|EA|.43258|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||02/26/2019||Yes|No|06/18/2019||Prescription required|No||045|No|.34265|03/29/2022|.33442|03/29/2022|.33665|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19665|||||No|No||ZYDUS PHARMACEU|No||||
diltiazem HCl|Yes|No|No|No|75%|68382059816|DILTIAZEM 24H ER(CD) 300 MG CP|90|EA|.44136|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||02/27/2019||Yes|No|06/18/2019||Prescription required|No||045|No|.34265|03/29/2022|.33442|03/29/2022|.33665|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19666|||||No|No||ZYDUS PHARMACEU|No||||
diltiazem HCl|Yes|No|No|No|75%|68382059916|DILTIAZEM 24H ER(CD) 360 MG CP|90|EA|2.13509|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||02/27/2019||Yes|No|06/18/2019||Prescription required|No||045|No|1.70196|03/29/2022|1.66111|03/29/2022|1.67217|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19667|||||No|No||ZYDUS PHARMACEU|No||||
dutasteride/tamsulosin HCl|No|No|No|No|75%|68382064006|DUTASTERIDE-TAMSULOSIN 0.5-0.4|30|EA|1.70939|08/20/2019||Yes|No||08/20/2019||Yes|No|08/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|003|No|2.12378|03/29/2022|2.0728|03/29/2022|2.08661|03/29/2022|||BPH TREATMENTS|19668|||||No|No||ZYDUS PHARMACEU|No||||
dutasteride/tamsulosin HCl|No|No|No|No|75%|68382064016|DUTASTERIDE-TAMSULOSIN 0.5-0.4|90|EA|1.8146|08/20/2019||Yes|No||08/20/2019||Yes|No|08/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|003|No|2.12378|03/29/2022|2.0728|03/29/2022|2.08661|03/29/2022|||BPH TREATMENTS|19669|||||No|No||ZYDUS PHARMACEU|No||||
isosorbide mononitrate|No|No|No|No|75%|68382065001|ISOSORBIDE MONONIT ER 30 MG TB|100|EA|.17759|10/27/2014||Yes|No||10/27/2014||Yes|No|10/27/2014||Yes|No||||No|No|||Prescription required|No|||No|.09715|03/29/2022|.09481|03/29/2022|.09544|03/29/2022||||19670|||||No|No||ZYDUS PHARMACEU|No||||
isosorbide mononitrate|No|No|No|No|75%|68382065005|ISOSORBIDE MONONIT ER 30 MG TB|500|EA|.17226|02/18/2016||Yes|No||02/18/2016||Yes|No|02/18/2016||Yes|No||||No|No|||Prescription required|No|||No|.09715|03/29/2022|.09481|03/29/2022|.09544|03/29/2022||||19671|||||No|No||ZYDUS PHARMACEU|No||||
isosorbide mononitrate|No|No|No|No|75%|68382065101|ISOSORBIDE MONONIT ER 60 MG TB|100|EA|.18705|10/27/2014||Yes|No||10/27/2014||Yes|No|10/27/2014||Yes|No||||No|No|||Prescription required|No|||No|.12753|03/29/2022|.12446|03/29/2022|.12529|03/29/2022||||19672|||||No|No||ZYDUS PHARMACEU|No||||
isosorbide mononitrate|No|No|No|No|75%|68382065105|ISOSORBIDE MONONIT ER 60 MG TB|500|EA|.18144|02/18/2016||Yes|No||02/18/2016||Yes|No|02/18/2016||Yes|No||||No|No|||Prescription required|No|||No|.12753|03/29/2022|.12446|03/29/2022|.12529|03/29/2022||||19673|||||No|No||ZYDUS PHARMACEU|No||||
isosorbide mononitrate|No|No|No|No|75%|68382065201|ISOSORBIDE MONONIT ER 120 MG|100|EA|.26122|10/27/2014||Yes|No||10/27/2014||Yes|No|10/27/2014||Yes|No||||No|No|||Prescription required|No|||No|.25435|03/29/2022|.24824|03/29/2022|.24989|03/29/2022||||19674|||||No|No||ZYDUS PHARMACEU|No||||
pyridostigmine bromide|No|No|No|No|75%|68382065906|PYRIDOSTIGMINE BR 60 MG TABLET|30|EA|.4386|09/22/2017||Yes|No||09/22/2017||Yes|No|09/22/2017||Yes|No||||No|No|||Prescription required|No|||No|.31425|03/29/2022|.3067|03/29/2022|.30875|03/29/2022||||19675|||||No|No||ZYDUS PHARMACEU|No||||
spironolactone|No|No|No|No|75%|68382066001|SPIRONOLACTONE 25 MG TABLET|100|EA|.05319|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||19676|||||No|No||ZYDUS PHARMACEU|No||||
spironolactone|No|No|No|No|75%|68382066005|SPIRONOLACTONE 25 MG TABLET|500|EA|.05006|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||19677|||||No|No||ZYDUS PHARMACEU|No||||
spironolactone|No|No|No|No|75%|68382066010|SPIRONOLACTONE 25 MG TABLET|1000|EA|.04728|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|No|||No|.05188|03/29/2022|.05063|03/29/2022|.05097|03/29/2022||||19678|||||No|No||ZYDUS PHARMACEU|No||||
spironolactone|No|No|No|No|75%|68382066101|SPIRONOLACTONE 50 MG TABLET|100|EA|.12861|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|No|||No|.12042|03/29/2022|.11752|03/29/2022|.11831|03/29/2022||||19679|||||No|No||ZYDUS PHARMACEU|No||||
spironolactone|No|No|No|No|75%|68382066105|SPIRONOLACTONE 50 MG TABLET|500|EA|.12499|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|No|||No|.12042|03/29/2022|.11752|03/29/2022|.11831|03/29/2022||||19680|||||No|No||ZYDUS PHARMACEU|No||||
spironolactone|No|No|No|No|75%|68382066201|SPIRONOLACTONE 100 MG TABLET|100|EA|.19582|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|No|||No|.2048|03/29/2022|.19988|03/29/2022|.20121|03/29/2022||||19681|||||No|No||ZYDUS PHARMACEU|No||||
spironolactone|No|No|No|No|75%|68382066205|SPIRONOLACTONE 100 MG TABLET|500|EA|.18889|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|No|||No|.2048|03/29/2022|.19988|03/29/2022|.20121|03/29/2022||||19682|||||No|No||ZYDUS PHARMACEU|No||||
doxycycline monohydrate|Yes|No|No|No|75%|68382070718|DOXYCYCLINE MONO 100 MG CAP|50|EA|.3612|10/06/2016||Yes|No||10/06/2016||Yes|No|10/06/2016||Yes|No||10/06/2016||Yes|No|10/06/2016||Prescription required|No||213|No|.25496|03/29/2022|.24884|03/29/2022|.25049|03/29/2022|||TETRACYCLINES|19683|||||No|No||ZYDUS PHARMACEU|No||||
mesalamine|No|No|No|No|75%|68382071119|MESALAMINE DR 1.2 GM TABLET|120|EA|1.9117|11/29/2017||Yes|No||11/29/2017||Yes|No|11/29/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|010|No|2.75392|03/29/2022|2.68782|03/29/2022|2.70572|03/29/2022|||ULCERATIVE COLITIS AGENTS|19684|||||No|No||ZYDUS PHARMACEU|No||||
zolmitriptan|No|No|No|No|75%|68382071586|ZOLMITRIPTAN 2.5 MG ODT|6|EA|3.00785|07/10/2013||Yes|No||07/10/2013||Yes|No|07/10/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|6.8551|03/01/2022|6.75717|03/01/2022|6.4354|03/01/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|19685|||||No|No||ZYDUS PHARMACEU|No||||
zolmitriptan|No|No|No|No|75%|68382071782|ZOLMITRIPTAN 5 MG ODT|3|EA|3.57616|07/10/2013||Yes|No||07/10/2013||Yes|No|07/10/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|4.60281|03/29/2022|4.49234|03/29/2022|4.52226|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|19686|||||No|No||ZYDUS PHARMACEU|No||||
nateglinide|No|No|No|No|75%|68382072116|NATEGLINIDE 60 MG TABLET|90|EA|.21442|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No||||No|No|||Prescription required|No||022|Yes|.3103|03/29/2022|.30285|03/29/2022|.30486|03/29/2022|||HYPOGLYCEMICS: MEGLITINIDES|19687|||||No|No||ZYDUS PHARMACEU|No||||
nateglinide|No|No|No|No|75%|68382072216|NATEGLINIDE 120 MG TABLET|90|EA|.22278|03/15/2017||Yes|No||03/15/2017||Yes|No|03/15/2017||Yes|No||||No|No|||Prescription required|No||022|Yes|.33379|03/29/2022|.32577|03/29/2022|.32794|03/29/2022|||HYPOGLYCEMICS: MEGLITINIDES|19688|||||No|No||ZYDUS PHARMACEU|No||||
nadolol|No|No|No|No|75%|68382073201|NADOLOL 20 MG TABLET|100|EA|.24084|12/20/2017||Yes|No||12/20/2017||Yes|No|12/20/2017||Yes|No||12/20/2017||Yes|No|||Prescription required|Yes|11/09/2017|070|No|.34023|03/29/2022|.33206|03/29/2022|.33427|03/29/2022|||BETA-BLOCKERS|19689|||||No|No||ZYDUS PHARMACEU|No||||
nadolol|No|No|No|No|75%|68382073301|NADOLOL 40 MG TABLET|100|EA|.2816|01/25/2018||Yes|No||01/25/2018||Yes|No|01/25/2018||Yes|No||01/25/2018||Yes|No|||Prescription required|Yes|11/09/2017|070|No|.40202|03/29/2022|.39237|03/29/2022|.39498|03/29/2022|||BETA-BLOCKERS|19690|||||No|No||ZYDUS PHARMACEU|No||||
nadolol|No|No|No|No|75%|68382073401|NADOLOL 80 MG TABLET|100|EA|.38162|01/25/2018||Yes|No||01/25/2018||Yes|No|01/25/2018||Yes|No||01/25/2018||Yes|No|||Prescription required|Yes|11/09/2017|070|No|.57501|03/29/2022|.5612|03/29/2022|.56494|03/29/2022|||BETA-BLOCKERS|19691|||||No|No||ZYDUS PHARMACEU|No||||
midodrine HCl|No|No|No|No|75%|68382073701|MIDODRINE HCL 2.5 MG TABLET|100|EA|.129|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||06/03/2021||Yes|No|||Prescription required|No|||No|.20233|03/29/2022|.19747|03/29/2022|.19878|03/29/2022||||19692|||||No|No||ZYDUS PHARMACEU|No||||
midodrine HCl|No|No|No|No|75%|68382073801|MIDODRINE HCL 5 MG TABLET|100|EA|.1935|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||06/03/2021||Yes|No|||Prescription required|No|||No|.26381|03/29/2022|.25747|03/29/2022|.25919|03/29/2022||||19693|||||No|No||ZYDUS PHARMACEU|No||||
midodrine HCl|No|No|No|No|75%|68382073901|MIDODRINE HCL 10 MG TABLET|100|EA|.3225|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||06/03/2021||Yes|No|||Prescription required|No|||No|.40773|03/29/2022|.39794|03/29/2022|.40059|03/29/2022||||19694|||||No|No||ZYDUS PHARMACEU|No||||
diltiazem HCl|Yes|No|No|No|75%|68382074516|TIADYLT ER 120 MG CAPSULE|90|EA|.2675|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||05/21/2020||Yes|No|06/19/2020||Prescription required|No||045|No|.26247|03/29/2022|.25617|03/29/2022|.25787|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19695|||||No|No||ZYDUS PHARMACEU|No||||
diltiazem HCl|Yes|No|No|No|75%|68382074616|TIADYLT ER 180 MG CAPSULE|90|EA|.32283|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||05/21/2020||Yes|No|06/19/2020||Prescription required|No||045|No|.32818|03/29/2022|.3203|03/29/2022|.32243|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19696|||||No|No||ZYDUS PHARMACEU|No||||
diltiazem HCl|Yes|No|No|No|75%|68382074716|TIADYLT ER 240 MG CAPSULE|90|EA|.45809|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||05/21/2020||Yes|No|06/19/2020||Prescription required|No||045|No|.46814|03/29/2022|.4569|03/29/2022|.45994|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19697|||||No|No||ZYDUS PHARMACEU|No||||
diltiazem HCl|Yes|No|No|No|75%|68382074816|TIADYLT ER 300 MG CAPSULE|90|EA|.59349|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||05/21/2020||Yes|No|06/19/2020||Prescription required|No||045|No|.70564|03/29/2022|.6887|03/29/2022|.69329|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19698|||||No|No||ZYDUS PHARMACEU|No||||
diltiazem HCl|Yes|No|No|No|75%|68382074916|TIADYLT ER 360 MG CAPSULE|90|EA|.60491|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||03/17/2020||Yes|No|06/19/2020||Prescription required|No||045|No|.55311|03/29/2022|.53983|03/29/2022|.54343|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19699|||||No|No||ZYDUS PHARMACEU|No||||
diltiazem HCl|Yes|No|No|No|75%|68382075016|TIADYLT ER 420 MG CAPSULE|90|EA|.63396|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||05/21/2020||Yes|No|06/19/2020||Prescription required|No||045|No|1.19987|03/29/2022|1.17107|03/29/2022|1.17887|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19700|||||No|No||ZYDUS PHARMACEU|No||||
metformin HCl|Yes|No|No|No|75%|68382075801|METFORMIN HCL 500 MG TABLET|100|EA|.02485|02/01/2016||Yes|No||02/01/2016||Yes|No|02/01/2016||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|19701|||||No|No||ZYDUS PHARMACEU|No||||
metformin HCl|Yes|No|No|No|75%|68382075805|METFORMIN HCL 500 MG TABLET|500|EA|.02371|11/08/2016||Yes|No||11/08/2016||Yes|No|11/08/2016||Yes|No||||No|No|11/08/2016||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|19702|||||No|No||ZYDUS PHARMACEU|No||||
metformin HCl|Yes|No|No|No|75%|68382075810|METFORMIN HCL 500 MG TABLET|1000|EA|.01714|07/16/2015||Yes|No||07/16/2015||Yes|No|07/16/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|19703|||||No|No||ZYDUS PHARMACEU|No||||
metformin HCl|Yes|No|No|No|75%|68382075901|METFORMIN HCL 850 MG TABLET|100|EA|.03538|02/18/2016||Yes|No||02/18/2016||Yes|No|02/18/2016||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|19704|||||No|No||ZYDUS PHARMACEU|No||||
metformin HCl|Yes|No|No|No|75%|68382075905|METFORMIN HCL 850 MG TABLET|500|EA|.03359|02/23/2015||Yes|No||02/23/2015||Yes|No|02/23/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|19705|||||No|No||ZYDUS PHARMACEU|No||||
metformin HCl|Yes|No|No|No|75%|68382075910|METFORMIN HCL 850 MG TABLET|1000|EA|.02761|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|19706|||||No|No||ZYDUS PHARMACEU|No||||
metformin HCl|Yes|No|No|No|75%|68382076001|METFORMIN HCL 1,000 MG TABLET|100|EA|.0393|07/16/2015||Yes|No||07/16/2015||Yes|No|07/16/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|19707|||||No|No||ZYDUS PHARMACEU|No||||
metformin HCl|Yes|No|No|No|75%|68382076005|METFORMIN HCL 1,000 MG TABLET|500|EA|.03732|05/13/2015||Yes|No||05/13/2015||Yes|No|05/13/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|19708|||||No|No||ZYDUS PHARMACEU|No||||
metformin HCl|Yes|No|No|No|75%|68382076010|METFORMIN HCL 1,000 MG TABLET|1000|EA|.02985|03/23/2015||Yes|No||03/23/2015||Yes|No|03/23/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|19709|||||No|No||ZYDUS PHARMACEU|No||||
lansoprazole|No|No|No|No|75%|68382077177|LANSOPRAZOLE ODT 15 MG TABLET|100|EA|2.71579|08/20/2019||Yes|No||08/20/2019||Yes|No|08/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|047|No|6.08156|03/29/2022|5.9356|03/29/2022|5.97513|03/29/2022|||PROTON PUMP INHIBITORS|19710|||||No|No||ZYDUS PHARMACEU|No||||
lansoprazole|No|No|No|No|75%|68382077277|LANSOPRAZOLE ODT 30 MG TABLET|100|EA|2.71579|08/20/2019||Yes|No||08/20/2019||Yes|No|08/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|047|No|5.52111|03/29/2022|5.3886|03/29/2022|5.42449|03/29/2022|||PROTON PUMP INHIBITORS|19711|||||No|No||ZYDUS PHARMACEU|No||||
ezetimibe|No|No|No|No|75%|68382077305|EZETIMIBE 10 MG TABLET|500|EA|.13601|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|Yes|03/22/2018|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|19712|||||No|No||ZYDUS PHARMACEU|No||||
ezetimibe|No|No|No|No|75%|68382077306|EZETIMIBE 10 MG TABLET|30|EA|.13602|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|Yes|03/22/2018|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|19713|||||No|No||ZYDUS PHARMACEU|No||||
methotrexate sodium|No|No|No|No|75%|68382077501|METHOTREXATE 2.5 MG TABLET|100|EA|.23916|05/26/2017||Yes|No||05/26/2017||Yes|No|05/26/2017||Yes|No||||No|No|||Prescription required|No|||No|.26817|03/29/2022|.26173|03/29/2022|.26347|03/29/2022||||19714|||||No|No||ZYDUS PHARMACEU|No||||
potassium chloride|No|No|No|No|75%|68382077601|POTASSIUM CL ER 8 MEQ TABLET|100|EA|.18451|05/12/2015||Yes|No||05/12/2015||Yes|No|05/12/2015||Yes|No||05/12/2015||Yes|No|||Prescription required|No|||No|.17696|03/29/2022|.17271|03/29/2022|.17386|03/29/2022||||19715|||||No|No||ZYDUS PHARMACEU|No||||
doxycycline monohydrate|No|No|No|No|75%|68382078201|DOXYCYCLINE MONO 50 MG CAP|100|EA|.2236|10/06/2016||Yes|No||10/06/2016||Yes|No|10/06/2016||Yes|No||10/06/2016||Yes|No|||Prescription required|No||213|No|.2073|03/29/2022|.20232|03/29/2022|.20367|03/29/2022|||TETRACYCLINES|19716|||||No|No||ZYDUS PHARMACEU|No||||
doxazosin mesylate|No|No|No|No|75%|68382078301|DOXAZOSIN MESYLATE 1 MG TAB|100|EA|.10057|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||05/24/2018||Yes|No|||Prescription required|No||003|Yes|.09392|03/29/2022|.09166|03/29/2022|.09227|03/29/2022|||BPH TREATMENTS|19717|||||No|No||ZYDUS PHARMACEU|No||||
doxazosin mesylate|No|No|No|No|75%|68382078401|DOXAZOSIN MESYLATE 2 MG TAB|100|EA|.10057|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||05/24/2018||Yes|No|||Prescription required|No||003|Yes|.085|03/29/2022|.08296|03/29/2022|.08351|03/29/2022|||BPH TREATMENTS|19718|||||No|No||ZYDUS PHARMACEU|No||||
doxazosin mesylate|No|No|No|No|75%|68382078501|DOXAZOSIN MESYLATE 4 MG TAB|100|EA|.11334|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||05/24/2018||Yes|No|||Prescription required|No||003|Yes|.10379|03/29/2022|.10129|03/29/2022|.10197|03/29/2022|||BPH TREATMENTS|19719|||||No|No||ZYDUS PHARMACEU|No||||
doxazosin mesylate|No|No|No|No|75%|68382078601|DOXAZOSIN MESYLATE 8 MG TAB|100|EA|.11356|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||05/24/2018||Yes|No|||Prescription required|No||003|No|.12737|03/29/2022|.12431|03/29/2022|.12514|03/29/2022|||BPH TREATMENTS|19720|||||No|No||ZYDUS PHARMACEU|No||||
acyclovir|Yes|No|No|No|75%|68382079101|ACYCLOVIR 400 MG TABLET|100|EA|.07525|01/02/2017||Yes|No||01/02/2017||Yes|No|01/02/2017||Yes|No||01/02/2017||Yes|No|01/02/2017||Prescription required|No||025|No|.0985|03/29/2022|.09613|03/29/2022|.09677|03/29/2022|||ANTIVIRALS: ORAL|19721|||||No|No||ZYDUS PHARMACEU|No||||
acyclovir|Yes|No|No|No|75%|68382079105|ACYCLOVIR 400 MG TABLET|500|EA|.0731|01/02/2017||Yes|No||01/02/2017||Yes|No|01/02/2017||Yes|No||01/02/2017||Yes|No|01/02/2017||Prescription required|No||025|No|.0985|03/29/2022|.09613|03/29/2022|.09677|03/29/2022|||ANTIVIRALS: ORAL|19722|||||No|No||ZYDUS PHARMACEU|No||||
acyclovir|No|No|No|No|75%|68382079201|ACYCLOVIR 800 MG TABLET|100|EA|.129|01/02/2017||Yes|No||01/02/2017||Yes|No|01/02/2017||Yes|No||01/02/2017||Yes|No|||Prescription required|No||025|No|.19021|03/29/2022|.18564|03/29/2022|.18688|03/29/2022|||ANTIVIRALS: ORAL|19723|||||No|No||ZYDUS PHARMACEU|No||||
acyclovir|No|No|No|No|75%|68382079205|ACYCLOVIR 800 MG TABLET|500|EA|.1247|01/02/2017||Yes|No||01/02/2017||Yes|No|01/02/2017||Yes|No||01/02/2017||Yes|No|||Prescription required|No||025|No|.19021|03/29/2022|.18564|03/29/2022|.18688|03/29/2022|||ANTIVIRALS: ORAL|19724|||||No|No||ZYDUS PHARMACEU|No||||
labetalol HCl|No|No|No|No|75%|68382079801|LABETALOL HCL 100 MG TABLET|100|EA|.12353|06/12/2019||Yes|No||06/12/2019||Yes|No|06/12/2019||Yes|No||06/12/2019||Yes|No|||Prescription required|No||070|No|.12868|03/29/2022|.12559|03/29/2022|.12642|03/29/2022|||BETA-BLOCKERS|19725|||||No|No||ZYDUS PHARMACEU|No||||
labetalol HCl|No|No|No|No|75%|68382079805|LABETALOL HCL 100 MG TABLET|500|EA|.1172|06/12/2019||Yes|No||06/12/2019||Yes|No|06/12/2019||Yes|No||06/12/2019||Yes|No|||Prescription required|No||070|No|.12868|03/29/2022|.12559|03/29/2022|.12642|03/29/2022|||BETA-BLOCKERS|19726|||||No|No||ZYDUS PHARMACEU|No||||
labetalol HCl|No|No|No|No|75%|68382079901|LABETALOL HCL 200 MG TABLET|100|EA|.17526|06/12/2019||Yes|No||06/12/2019||Yes|No|06/12/2019||Yes|No||06/12/2019||Yes|No|||Prescription required|No||070|No|.17218|03/29/2022|.16804|03/29/2022|.16916|03/29/2022|||BETA-BLOCKERS|19727|||||No|No||ZYDUS PHARMACEU|No||||
labetalol HCl|No|No|No|No|75%|68382079905|LABETALOL HCL 200 MG TABLET|500|EA|.16653|06/12/2019||Yes|No||06/12/2019||Yes|No|06/12/2019||Yes|No||06/12/2019||Yes|No|||Prescription required|No||070|No|.17218|03/29/2022|.16804|03/29/2022|.16916|03/29/2022|||BETA-BLOCKERS|19728|||||No|No||ZYDUS PHARMACEU|No||||
labetalol HCl|No|No|No|No|75%|68382080001|LABETALOL HCL 300 MG TABLET|100|EA|.23314|06/12/2019||Yes|No||06/12/2019||Yes|No|06/12/2019||Yes|No||06/12/2019||Yes|No|||Prescription required|No||070|No|.21583|03/29/2022|.21065|03/29/2022|.21205|03/29/2022|||BETA-BLOCKERS|19729|||||No|No||ZYDUS PHARMACEU|No||||
labetalol HCl|No|No|No|No|75%|68382080005|LABETALOL HCL 300 MG TABLET|500|EA|.23315|06/12/2019||Yes|No||06/12/2019||Yes|No|06/12/2019||Yes|No||06/12/2019||Yes|No|||Prescription required|No||070|No|.21583|03/29/2022|.21065|03/29/2022|.21205|03/29/2022|||BETA-BLOCKERS|19730|||||No|No||ZYDUS PHARMACEU|No||||
trazodone HCl|No|No|No|No|75%|68382080501|TRAZODONE 50 MG TABLET|100|EA|.02859|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|No||031|No|.03855|03/29/2022|.03762|03/29/2022|.03787|03/29/2022|||ANTIDEPRESSANTS: OTHER|19731|||||No|No||ZYDUS PHARMACEU|No||||
trazodone HCl|No|No|No|No|75%|68382080505|TRAZODONE 50 MG TABLET|500|EA|.02614|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|No||031|No|.03855|03/29/2022|.03762|03/29/2022|.03787|03/29/2022|||ANTIDEPRESSANTS: OTHER|19732|||||No|No||ZYDUS PHARMACEU|No||||
trazodone HCl|No|No|No|No|75%|68382080510|TRAZODONE 50 MG TABLET|1000|EA|.02594|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|No||031|No|.03855|03/29/2022|.03762|03/29/2022|.03787|03/29/2022|||ANTIDEPRESSANTS: OTHER|19733|||||No|No||ZYDUS PHARMACEU|No||||
trazodone HCl|No|No|No|No|75%|68382080601|TRAZODONE 100 MG TABLET|100|EA|.0531|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|No||031|No|.07015|03/29/2022|.06846|03/29/2022|.06892|03/29/2022|||ANTIDEPRESSANTS: OTHER|19734|||||No|No||ZYDUS PHARMACEU|No||||
trazodone HCl|No|No|No|No|75%|68382080605|TRAZODONE 100 MG TABLET|500|EA|.04983|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|No||031|No|.07015|03/29/2022|.06846|03/29/2022|.06892|03/29/2022|||ANTIDEPRESSANTS: OTHER|19735|||||No|No||ZYDUS PHARMACEU|No||||
trazodone HCl|No|No|No|No|75%|68382080610|TRAZODONE 100 MG TABLET|1000|EA|.04738|05/30/2018||Yes|No||05/30/2018||Yes|No|05/30/2018||Yes|No||||No|No|||Prescription required|No||031|No|.07015|03/29/2022|.06846|03/29/2022|.06892|03/29/2022|||ANTIDEPRESSANTS: OTHER|19736|||||No|No||ZYDUS PHARMACEU|No||||
trazodone HCl|No|No|No|No|75%|68382080701|TRAZODONE 150 MG TABLET|100|EA|.15523|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|No||031|No|.1311|03/29/2022|.12795|03/29/2022|.1288|03/29/2022|||ANTIDEPRESSANTS: OTHER|19737|||||No|No||ZYDUS PHARMACEU|No||||
trazodone HCl|No|No|No|No|75%|68382080705|TRAZODONE 150 MG TABLET|500|EA|.14706|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|No||031|No|.1311|03/29/2022|.12795|03/29/2022|.1288|03/29/2022|||ANTIDEPRESSANTS: OTHER|19738|||||No|No||ZYDUS PHARMACEU|No||||
trazodone HCl|No|No|No|No|75%|68382080801|TRAZODONE 300 MG TABLET|100|EA|1.40055|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|No||031|No|1.52238|03/29/2022|1.48584|03/29/2022|1.49573|03/29/2022|||ANTIDEPRESSANTS: OTHER|19739|||||No|No||ZYDUS PHARMACEU|No||||
sevelamer carbonate|No|No|No|No|75%|68382082427|SEVELAMER CARBONATE 800 MG TAB|270|EA|.16721|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|07/25/2019|052|Yes|.27122|03/29/2022|.26471|03/29/2022|.26647|03/29/2022|||PHOSPHATE BINDERS|19740|||||No|No||ZYDUS PHARMACEU|No||||
tamoxifen citrate|No|No|No|No|75%|68382082614|TAMOXIFEN 10 MG TABLET|60|EA|.16375|08/20/2019|02/28/2022|Yes|No||08/20/2019|02/28/2022|Yes|No|08/20/2019|02/28/2022|Yes|No||||No|No|||Prescription required|No||502|No|.37321|03/15/2022|.36788|03/15/2022|.35036|03/15/2022|||ONCOLOGY: ORAL - BREAST|19741|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ZYDUS PHARMACEU|No||||
tamoxifen citrate|No|No|No|No|75%|68382082701|TAMOXIFEN 20 MG TABLET|100|EA|.32744|08/20/2019|01/31/2022|Yes|No||08/20/2019|01/31/2022|Yes|No|08/20/2019|01/31/2022|Yes|No||||No|No|||Prescription required|No||502|No|.74627|02/15/2022|.7356|02/15/2022|.70058|02/15/2022|||ONCOLOGY: ORAL - BREAST|19742|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ZYDUS PHARMACEU|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|68382085601|TRIAMTERENE-HCTZ 37.5-25 MG TB|100|EA|.08866|08/20/2019||Yes|No||08/20/2019||Yes|No|08/20/2019||Yes|No||||No|No|||Prescription required|No|||Yes|.09986|03/29/2022|.09746|03/29/2022|.09811|03/29/2022||||19743|||||No|No||ZYDUS PHARMACEU|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|68382085605|TRIAMTERENE-HCTZ 37.5-25 MG TB|500|EA|.08755|08/20/2019||Yes|No||08/20/2019||Yes|No|08/20/2019||Yes|No||||No|No|||Prescription required|No|||Yes|.09986|03/29/2022|.09746|03/29/2022|.09811|03/29/2022||||19744|||||No|No||ZYDUS PHARMACEU|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|68382085701|TRIAMTERENE-HCTZ 75-50 MG TAB|100|EA|.0909|08/20/2019||Yes|No||08/20/2019||Yes|No|08/20/2019||Yes|No||||No|No|||Prescription required|No|||Yes|.1312|03/29/2022|.12805|03/29/2022|.1289|03/29/2022||||19745|||||No|No||ZYDUS PHARMACEU|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|68382085705|TRIAMTERENE-HCTZ 75-50 MG TAB|500|EA|.08817|08/20/2019||Yes|No||08/20/2019||Yes|No|08/20/2019||Yes|No||||No|No|||Prescription required|No|||Yes|.1312|03/29/2022|.12805|03/29/2022|.1289|03/29/2022||||19746|||||No|No||ZYDUS PHARMACEU|No||||
desoximetasone|No|No|No|No|75%|68382088902|DESOXIMETASONE 0.25% OINTMENT|60|GM|.26875|09/17/2019|05/31/2022|Yes|No||09/17/2019|05/31/2022|Yes|No|09/17/2019|05/31/2022|Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|.39246|03/29/2022|.38304|03/29/2022|.38559|03/29/2022|||STEROIDS: TOPICAL HIGH|19747|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ZYDUS PHARMACEU|No||||
desoximetasone|No|No|No|No|75%|68382088903|DESOXIMETASONE 0.25% OINTMENT|100|GM|.645|09/17/2019|05/31/2022|Yes|No||09/17/2019|05/31/2022|Yes|No|09/17/2019|05/31/2022|Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|1.47|09/17/2019|1.449|09/24/2019|1.38|09/17/2019|||STEROIDS: TOPICAL HIGH|19748|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ZYDUS PHARMACEU|No||||
erlotinib HCl|No|No|No|No|75%|68382091306|ERLOTINIB HCL 25 MG TABLET|30|EA|3.01|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|No||551|No|6.86|01/04/2022|6.762|01/04/2022|6.44|01/04/2022|||ONCOLOGY: ORAL - LUNG|19749|||||No|No||ZYDUS PHARMACEU|No||||
erlotinib HCl|No|No|No|No|75%|68382091406|ERLOTINIB HCL 100 MG TABLET|30|EA|4.01333|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|No||551|No|9.14666|01/04/2022|9.01599|01/04/2022|8.58666|01/04/2022|||ONCOLOGY: ORAL - LUNG|19750|||||No|No||ZYDUS PHARMACEU|No||||
erlotinib HCl|No|No|No|No|75%|68382091506|ERLOTINIB HCL 150 MG TABLET|30|EA|4.515|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|No||551|No|10.29|01/04/2022|10.143|01/04/2022|9.66|01/04/2022|||ONCOLOGY: ORAL - LUNG|19751|||||No|No||ZYDUS PHARMACEU|No||||
methylprednisolone|No|No|No|No|75%|68382091601|METHYLPREDNISOLONE 4 MG TABLET|100|EA|.17711|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||12/06/2018||Yes|No|||Prescription required|Yes|01/25/2018|168|Yes|.21195|03/29/2022|.20686|03/29/2022|.20824|03/29/2022|||GLUCOCORTICOIDS: ORAL|19752|||||No|No||ZYDUS PHARMACEU|No||||
methylprednisolone|No|No|No|No|75%|68382091634|METHYLPREDNISOLONE 4 MG DOSEPK|21|EA|.17814|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||12/06/2018||Yes|No|||Prescription required|No||168|Yes|.17447|03/29/2022|.17028|03/29/2022|.17141|03/29/2022|||GLUCOCORTICOIDS: ORAL|19753|||||No|No||ZYDUS PHARMACEU|No||||
methylprednisolone|No|No|No|No|75%|68382091711|METHYLPREDNISOLONE 8 MG TAB|25|EA|.61971|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||12/06/2018||Yes|No|||Prescription required|Yes|01/25/2018|168|Yes|1.23856|03/29/2022|1.20883|03/29/2022|1.21688|03/29/2022|||GLUCOCORTICOIDS: ORAL|19754|||||No|No||ZYDUS PHARMACEU|No||||
methylprednisolone|No|No|No|No|75%|68382091818|METHYLPREDNISOLONE 16 MG TAB|50|EA|1.01239|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||12/06/2018||Yes|No|||Prescription required|Yes|01/25/2018|168|Yes|1.78008|03/29/2022|1.73735|03/29/2022|1.74892|03/29/2022|||GLUCOCORTICOIDS: ORAL|19755|||||No|No||ZYDUS PHARMACEU|No||||
methylprednisolone|No|No|No|No|75%|68382091911|METHYLPREDNISOLONE 32 MG TAB|25|EA|1.77848|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||12/06/2018||Yes|No|||Prescription required|Yes|01/25/2018|168|Yes|4.05328|01/28/2020|3.99537|01/28/2020|3.80512|01/28/2020|||GLUCOCORTICOIDS: ORAL|19756|||||No|No||ZYDUS PHARMACEU|No||||
entecavir|No|No|No|No|75%|68382092006|ENTECAVIR 0.5 MG TABLET|30|EA|1.12373|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|No|||No|.89227|03/29/2022|.87085|03/29/2022|.87665|03/29/2022||||19757|||||No|No||ZYDUS PHARMACEU|No||||
entecavir|No|No|No|No|75%|68382092106|ENTECAVIR 1 MG TABLET|30|EA|1.12373|05/24/2018||Yes|No||05/24/2018||Yes|No|05/24/2018||Yes|No||||No|No|||Prescription required|No|||No|1.06461|03/29/2022|1.03905|03/29/2022|1.04597|03/29/2022||||19758|||||No|No||ZYDUS PHARMACEU|No||||
eletriptan hydrobromide|No|No|No|No|75%|68382092286|ELETRIPTAN HBR 20 MG TABLET|6|EA|5.1385|11/29/2017||Yes|No||11/29/2017||Yes|No|11/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|021|No|6.78979|03/29/2022|6.62683|03/29/2022|6.67096|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|19759|||||No|No||ZYDUS PHARMACEU|No||||
eletriptan hydrobromide|No|No|No|No|75%|68382092386|ELETRIPTAN HBR 40 MG TABLET|6|EA|5.1385|11/29/2017||Yes|No||11/29/2017||Yes|No|11/29/2017||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|021|No|3.20664|03/29/2022|3.12968|03/29/2022|3.15052|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|19760|||||No|No||ZYDUS PHARMACEU|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|68382095001|DEXTROAMP-AMPHETAMINE 5 MG TAB|100|EA|.1603|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|.21985|03/29/2022|.21457|03/29/2022|.216|03/29/2022|||STIMULANTS AND RELATED AGENTS|19761|||||No|No||ZYDUS PHARMACEU|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|68382095101|DEXTROAMP-AMPHETAM 7.5 MG TAB|100|EA|.1603|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|.45915|03/29/2022|.44813|03/29/2022|.45111|03/29/2022|||STIMULANTS AND RELATED AGENTS|19762|||||No|No||ZYDUS PHARMACEU|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|68382095201|DEXTROAMP-AMPHETAMIN 10 MG TAB|100|EA|.1603|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|.24071|03/29/2022|.23493|03/29/2022|.23649|03/29/2022|||STIMULANTS AND RELATED AGENTS|19763|||||No|No||ZYDUS PHARMACEU|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|68382095301|DEXTROAMP-AMPHETAM 12.5 MG TAB|100|EA|.1603|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|.65907|03/01/2022|.64325|03/01/2022|.64753|03/01/2022|||STIMULANTS AND RELATED AGENTS|19764|||||No|No||ZYDUS PHARMACEU|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|68382095401|DEXTROAMP-AMPHETAMIN 15 MG TAB|100|EA|.1603|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|.25605|03/29/2022|.2499|03/29/2022|.25156|03/29/2022|||STIMULANTS AND RELATED AGENTS|19765|||||No|No||ZYDUS PHARMACEU|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|68382095501|DEXTROAMP-AMPHETAMIN 20 MG TAB|100|EA|.1603|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|.31357|03/29/2022|.30604|03/29/2022|.30808|03/29/2022|||STIMULANTS AND RELATED AGENTS|19766|||||No|No||ZYDUS PHARMACEU|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|68382095601|DEXTROAMP-AMPHETAMIN 30 MG TAB|100|EA|.1603|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|.30925|03/29/2022|.30182|03/29/2022|.30383|03/29/2022|||STIMULANTS AND RELATED AGENTS|19767|||||No|No||ZYDUS PHARMACEU|No||||
chlorthalidone|Yes|No|No|No|75%|68382097001|CHLORTHALIDONE 25 MG TABLET|100|EA|.1121|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|03/20/2020||Prescription required|No|||No|.16117|03/29/2022|.1573|03/29/2022|.15834|03/29/2022||||19768|||||No|No||ZYDUS PHARMACEU|No||||
chlorthalidone|Yes|No|No|No|75%|68382097010|CHLORTHALIDONE 25 MG TABLET|1000|EA|.1121|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|03/20/2020||Prescription required|No|||No|.16117|03/29/2022|.1573|03/29/2022|.15834|03/29/2022||||19769|||||No|No||ZYDUS PHARMACEU|No||||
chlorthalidone|Yes|No|No|No|75%|68382097101|CHLORTHALIDONE 50 MG TABLET|100|EA|.15359|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|03/20/2020||Prescription required|No|||No|.3607|03/29/2022|.35204|03/29/2022|.35438|03/29/2022||||19770|||||No|No||ZYDUS PHARMACEU|No||||
lamotrigine|No|No|No|No|75%|68382097906|LAMOTRIGINE ER 25 MG TABLET|30|EA|.61934|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|No||056|No|1.20872|03/01/2022|1.17971|03/01/2022|1.18756|03/01/2022|||ANTICONVULSANTS|19771|||||No|No||ZYDUS PHARMACEU|No||||
lamotrigine|No|No|No|No|75%|68382098006|LAMOTRIGINE ER 50 MG TABLET|30|EA|.95718|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|No||056|No|1.67529|03/29/2022|1.63508|03/29/2022|1.64597|03/29/2022|||ANTICONVULSANTS|19772|||||No|No||ZYDUS PHARMACEU|No||||
lamotrigine|No|No|No|No|75%|68382098106|LAMOTRIGINE ER 100 MG TABLET|30|EA|1.14595|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|No||056|No|1.51472|03/29/2022|1.47836|03/29/2022|1.48821|03/29/2022|||ANTICONVULSANTS|19773|||||No|No||ZYDUS PHARMACEU|No||||
lamotrigine|No|No|No|No|75%|68382098206|LAMOTRIGINE ER 200 MG TABLET|30|EA|1.22191|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|No||056|No|1.69753|03/29/2022|1.65678|03/29/2022|1.66782|03/29/2022|||ANTICONVULSANTS|19774|||||No|No||ZYDUS PHARMACEU|No||||
lamotrigine|No|No|No|No|75%|68382098306|LAMOTRIGINE ER 250 MG TABLET|30|EA|3.06962|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||056|No|5.54243|03/29/2022|5.40941|03/29/2022|5.44543|03/29/2022|||ANTICONVULSANTS|19775|||||No|No||ZYDUS PHARMACEU|No||||
acyclovir|No|No|No|No|75%|68382099201|ACYCLOVIR 5% OINTMENT|15|GM|1.57666|12/12/2019|04/30/2022|Yes|No||12/12/2019|04/30/2022|Yes|No|12/12/2019|04/30/2022|Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.36934|03/29/2022|1.33647|03/29/2022|1.34537|03/29/2022|||ANTIVIRALS: TOPICAL|19776|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ZYDUS PHARMACEU|No||||
clobetasol propionate|No|No|No|No|75%|68382099801|CLOBETASOL PROP 0.05% SPRAY|59|ML|.64886|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|121|No|.72856|01/25/2022|.71107|01/25/2022|.71581|01/25/2022|||STEROIDS: TOPICAL VERY HIGH|19777|||||No|No||ZYDUS PHARMACEU|No||||
clobetasol propionate|No|No|No|No|75%|68382099802|CLOBETASOL PROP 0.05% SPRAY|125|ML|.55611|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|121|No|.7112|03/29/2022|.69413|03/29/2022|.69875|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|19778|||||No|No||ZYDUS PHARMACEU|No||||
stiripentol|No|No|No|No|75%|68418793906|DIACOMIT 250 MG CAPSULE|60|EA|10.75|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||056|No|24.5|12/17/2019|24.15|12/17/2019|23|12/17/2019|||ANTICONVULSANTS|19779|||||No|No||BIOCODEX, INC|No||||
stiripentol|No|No|No|No|75%|68418794006|DIACOMIT 500 MG CAPSULE|60|EA|21.5|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||056|No|49|12/17/2019|48.3|12/17/2019|46|12/17/2019|||ANTICONVULSANTS|19780|||||No|No||BIOCODEX, INC|No||||
stiripentol|No|No|No|No|75%|68418794106|DIACOMIT 250 MG POWDER PACKET|60|EA|10.75|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||056|No|24.5|12/17/2019|24.15|12/17/2019|23|12/17/2019|||ANTICONVULSANTS|19781|||||No|No||BIOCODEX, INC|No||||
stiripentol|No|No|No|No|75%|68418794206|DIACOMIT 500 MG POWDER PACKET|60|EA|21.5|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||056|No|49|12/17/2019|48.3|12/17/2019|46|12/17/2019|||ANTICONVULSANTS|19782|||||No|No||BIOCODEX, INC|No||||
fluconazole|No|No|No|No|75%|68462010130|FLUCONAZOLE 50 MG TABLET|30|EA|.28666|06/14/2006||Yes|No||06/14/2006||Yes|No|06/14/2006||Yes|No||||No|No|||Prescription required|No||069|No|.43933|03/29/2022|.42878|03/29/2022|.43164|03/29/2022|||ANTIFUNGALS: ORAL|19783|||||No|No||GLENMARK PHARMA|No||||
fluconazole|No|No|No|No|75%|68462010230|FLUCONAZOLE 100 MG TABLET|30|EA|.43|06/14/2006||Yes|No||06/14/2006||Yes|No|06/14/2006||Yes|No||||No|No|||Prescription required|No||069|No|.34281|03/29/2022|.33458|03/29/2022|.33681|03/29/2022|||ANTIFUNGALS: ORAL|19784|||||No|No||GLENMARK PHARMA|No||||
fluconazole|Yes|No|No|No|75%|68462010340|FLUCONAZOLE 150 MG TABLET|1|EA|.90371|06/14/2006|02/08/2022|Yes|No||06/14/2006|02/08/2022|Yes|No|06/14/2006|02/08/2022|Yes|No||||No|No|11/01/2012|02/08/2022|Prescription required|No||069|No|.74933|03/29/2022|.73134|03/29/2022|.73621|03/29/2022|||ANTIFUNGALS: ORAL|19785|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GLENMARK PHARMA|No||||
fluconazole|No|No|No|No|75%|68462010430|FLUCONAZOLE 200 MG TABLET|30|EA|.57333|06/14/2006||Yes|No||06/14/2006||Yes|No|06/14/2006||Yes|No||||No|No|||Prescription required|No||069|No|.52936|03/29/2022|.51665|03/29/2022|.52009|03/29/2022|||ANTIFUNGALS: ORAL|19786|||||No|No||GLENMARK PHARMA|No||||
ondansetron HCl|No|No|No|No|75%|68462010530|ONDANSETRON HCL 4 MG TABLET|30|EA|.1333|10/26/2009||Yes|No||10/26/2009||Yes|No|10/26/2009||Yes|No||||No|No|||Prescription required|No||085|No|.06763|03/29/2022|.066|03/29/2022|.06644|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|19787|||||No|No||GLENMARK PHARMA|No||||
ondansetron HCl|No|No|No|No|75%|68462010630|ONDANSETRON HCL 8 MG TABLET|30|EA|.16053|05/13/2008||Yes|No||05/13/2008||Yes|No|05/13/2008||Yes|No||||No|No|||Prescription required|No||085|No|.09975|03/29/2022|.09735|03/29/2022|.098|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|19788|||||No|No||GLENMARK PHARMA|No||||
topiramate|No|No|No|No|75%|68462010805|TOPIRAMATE 25 MG TABLET|500|EA|.02867|04/01/2021||Yes|No||04/01/2021||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||056|No|.03423|03/29/2022|.0334|03/29/2022|.03363|03/29/2022|||ANTICONVULSANTS|19789|||||No|No||GLENMARK PHARMA|No||||
topiramate|No|No|No|No|75%|68462010810|TOPIRAMATE 25 MG TABLET|1000|EA|.02866|03/30/2009||Yes|No||03/30/2009||Yes|No|03/30/2009||Yes|No||||No|No|||Prescription required|No||056|No|.03423|03/29/2022|.0334|03/29/2022|.03363|03/29/2022|||ANTICONVULSANTS|19790|||||No|No||GLENMARK PHARMA|No||||
topiramate|No|No|No|No|75%|68462010860|TOPIRAMATE 25 MG TABLET|60|EA|.02866|03/30/2009||Yes|No||03/30/2009||Yes|No|03/30/2009||Yes|No||||No|No|||Prescription required|No||056|No|.03423|03/29/2022|.0334|03/29/2022|.03363|03/29/2022|||ANTICONVULSANTS|19791|||||No|No||GLENMARK PHARMA|No||||
topiramate|No|No|No|No|75%|68462010905|TOPIRAMATE 100 MG TABLET|500|EA|.05017|03/12/2021||Yes|No||03/12/2021||Yes|No|03/12/2021||Yes|No||||No|No|||Prescription required|No||056|No|.06953|03/29/2022|.06786|03/29/2022|.06831|03/29/2022|||ANTICONVULSANTS|19792|||||No|No||GLENMARK PHARMA|No||||
topiramate|No|No|No|No|75%|68462010910|TOPIRAMATE 100 MG TABLET|1000|EA|.05016|03/30/2009||Yes|No||03/30/2009||Yes|No|03/30/2009||Yes|No||||No|No|||Prescription required|No||056|No|.06953|03/29/2022|.06786|03/29/2022|.06831|03/29/2022|||ANTICONVULSANTS|19793|||||No|No||GLENMARK PHARMA|No||||
topiramate|No|No|No|No|75%|68462010960|TOPIRAMATE 100 MG TABLET|60|EA|.05016|03/30/2009||Yes|No||03/30/2009||Yes|No|03/30/2009||Yes|No||||No|No|||Prescription required|No||056|No|.06953|03/29/2022|.06786|03/29/2022|.06831|03/29/2022|||ANTICONVULSANTS|19794|||||No|No||GLENMARK PHARMA|No||||
topiramate|No|No|No|No|75%|68462011010|TOPIRAMATE 200 MG TABLET|1000|EA|.0645|03/30/2009||Yes|No||03/30/2009||Yes|No|03/30/2009||Yes|No||||No|No|||Prescription required|No||056|No|.12326|03/29/2022|.1203|03/29/2022|.1211|03/29/2022|||ANTICONVULSANTS|19795|||||No|No||GLENMARK PHARMA|No||||
topiramate|No|No|No|No|75%|68462011060|TOPIRAMATE 200 MG TABLET|60|EA|.0645|03/30/2009||Yes|No||03/30/2009||Yes|No|03/30/2009||Yes|No||||No|No|||Prescription required|No||056|No|.12326|03/29/2022|.1203|03/29/2022|.1211|03/29/2022|||ANTICONVULSANTS|19796|||||No|No||GLENMARK PHARMA|No||||
aprepitant|No|No|No|No|75%|68462011233|APREPITANT 125-80-80 MG PACK|3|EA|82.7019|02/07/2018||Yes|No||02/07/2018||Yes|No|02/07/2018||Yes|No||||No|No|||Prescription required|Yes|11/03/2017|085|Yes|144.5|10/26/2021|141.032|10/26/2021|141.97125|10/26/2021|||ANTIEMETIC/ANTIVERTIGO AGENTS|19797|||||No|No||GLENMARK PHARMA|No||||
fluconazole|Yes|No|No|No|75%|68462011940|FLUCONAZOLE 150 MG TABLET|1|EA||05/20/2021||Yes|No||05/20/2021||Yes|No|05/20/2021||Yes|No||||No|No|11/02/2021||Prescription required|No||069|No|.74933|03/29/2022|.73134|03/29/2022|.73621|03/29/2022|||ANTIFUNGALS: ORAL|19798|||||No|No||GLENMARK PHARMA|No||||
fluconazole|Yes|No|No|No|75%|68462011944|FLUCONAZOLE 150 MG TABLET|12|EA|.90371|05/20/2021||Yes|No||05/20/2021||Yes|No|05/20/2021||Yes|No||||No|No|11/02/2021||Prescription required|No||069|No|.74933|03/29/2022|.73134|03/29/2022|.73621|03/29/2022|||ANTIFUNGALS: ORAL|19799|||||No|No||GLENMARK PHARMA|No||||
gabapentin|No|No|No|No|75%|68462012601|GABAPENTIN 600 MG TABLET|100|EA|.08514|08/30/2006||Yes|No||08/30/2006||Yes|No|08/30/2006||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|19800|||||No|No||GLENMARK PHARMA|No||||
gabapentin|No|No|No|No|75%|68462012605|GABAPENTIN 600 MG TABLET|500|EA|.08514|12/13/2006||Yes|No||12/13/2006||Yes|No|12/13/2006||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|19801|||||No|No||GLENMARK PHARMA|No||||
gabapentin|No|No|No|No|75%|68462012701|GABAPENTIN 800 MG TABLET|100|EA|.10105|08/30/2006||Yes|No||08/30/2006||Yes|No|08/30/2006||Yes|No||||No|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|19802|||||No|No||GLENMARK PHARMA|No||||
gabapentin|No|No|No|No|75%|68462012705|GABAPENTIN 800 MG TABLET|500|EA|.10105|08/30/2006||Yes|No||08/30/2006||Yes|No|08/30/2006||Yes|No||||No|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|19803|||||No|No||GLENMARK PHARMA|No||||
zonisamide|No|No|No|No|75%|68462012801|ZONISAMIDE 25 MG CAPSULE|100|EA|.06742|06/14/2006||Yes|No||06/14/2006||Yes|No|06/14/2006||Yes|No||||No|No|||Prescription required|No||056|No|.08772|03/29/2022|.08561|03/29/2022|.08618|03/29/2022|||ANTICONVULSANTS|19804|||||No|No||GLENMARK PHARMA|No||||
zonisamide|No|No|No|No|75%|68462012901|ZONISAMIDE 50 MG CAPSULE|100|EA|.07899|06/14/2006||Yes|No||06/14/2006||Yes|No|06/14/2006||Yes|No||||No|No|||Prescription required|No||056|No|.11305|03/29/2022|.11033|03/29/2022|.11107|03/29/2022|||ANTICONVULSANTS|19805|||||No|No||GLENMARK PHARMA|No||||
zonisamide|No|No|No|No|75%|68462013001|ZONISAMIDE 100 MG CAPSULE|100|EA|.15802|06/14/2006||Yes|No||06/14/2006||Yes|No|06/14/2006||Yes|No||||No|No|||Prescription required|No||056|No|.12763|03/29/2022|.12456|03/29/2022|.12539|03/29/2022|||ANTICONVULSANTS|19806|||||No|No||GLENMARK PHARMA|No||||
zonisamide|No|No|No|No|75%|68462013005|ZONISAMIDE 100 MG CAPSULE|500|EA|.15802|06/14/2006||Yes|No||06/14/2006||Yes|No|06/14/2006||Yes|No||||No|No|||Prescription required|No||056|No|.12763|03/29/2022|.12456|03/29/2022|.12539|03/29/2022|||ANTICONVULSANTS|19807|||||No|No||GLENMARK PHARMA|No||||
norethindrone ac-eth estradiol|Yes|Yes|No|No|75%|68462013281|NORETHIND-ETH ESTRAD 1-0.02 MG|21|EA|.14244|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No|Refer to program requirements|||No|No|10/04/2016||Prescription required|No|||No|.29153|03/29/2022|.28453|03/29/2022|.28642|03/29/2022||||19808|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
oxcarbazepine|No|No|No|No|75%|68462013701|OXCARBAZEPINE 150 MG TABLET|100|EA|.129|10/12/2007||Yes|No||10/12/2007||Yes|No|10/12/2007||Yes|No||||No|No|||Prescription required|No||056|No|.13883|03/29/2022|.13549|03/29/2022|.1364|03/29/2022|||ANTICONVULSANTS|19809|||||No|No||GLENMARK PHARMA|No||||
oxcarbazepine|No|No|No|No|75%|68462013801|OXCARBAZEPINE 300 MG TABLET|100|EA|.2365|10/12/2007||Yes|No||10/12/2007||Yes|No|10/12/2007||Yes|No||||No|No|||Prescription required|No||056|No|.21647|03/29/2022|.21127|03/29/2022|.21268|03/29/2022|||ANTICONVULSANTS|19810|||||No|No||GLENMARK PHARMA|No||||
oxcarbazepine|No|No|No|No|75%|68462013901|OXCARBAZEPINE 600 MG TABLET|100|EA|.344|10/12/2007||Yes|No||10/12/2007||Yes|No|10/12/2007||Yes|No||||No|No|||Prescription required|No||056|No|.41799|03/29/2022|.40795|03/29/2022|.41067|03/29/2022|||ANTICONVULSANTS|19811|||||No|No||GLENMARK PHARMA|No||||
topiramate|No|No|No|No|75%|68462015305|TOPIRAMATE 50 MG TABLET|500|EA|.03906|04/08/2021||Yes|No||04/08/2021||Yes|No|04/08/2021||Yes|No||||No|No|||Prescription required|No||056|No|.04588|03/29/2022|.04477|03/29/2022|.04507|03/29/2022|||ANTICONVULSANTS|19812|||||No|No||GLENMARK PHARMA|No||||
topiramate|No|No|No|No|75%|68462015310|TOPIRAMATE 50 MG TABLET|1000|EA|.03905|03/30/2009||Yes|No||03/30/2009||Yes|No|03/30/2009||Yes|No||||No|No|||Prescription required|No||056|No|.04588|03/29/2022|.04477|03/29/2022|.04507|03/29/2022|||ANTICONVULSANTS|19813|||||No|No||GLENMARK PHARMA|No||||
topiramate|No|No|No|No|75%|68462015360|TOPIRAMATE 50 MG TABLET|60|EA|.03905|03/30/2009||Yes|No||03/30/2009||Yes|No|03/30/2009||Yes|No||||No|No|||Prescription required|No||056|No|.04588|03/29/2022|.04477|03/29/2022|.04507|03/29/2022|||ANTICONVULSANTS|19814|||||No|No||GLENMARK PHARMA|No||||
ondansetron|No|No|No|No|75%|68462015713|ONDANSETRON ODT 4 MG TABLET|30|EA|.19722|10/10/2007||Yes|No||10/10/2007||Yes|No|10/10/2007||Yes|No||||No|No|||Prescription required|No||085|No|.24125|03/29/2022|.23546|03/29/2022|.23702|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|19815|||||No|No||GLENMARK PHARMA|No||||
ondansetron|No|No|No|No|75%|68462015811|ONDANSETRON ODT 8 MG TABLET|10|EA|.27262|10/10/2007||Yes|No||10/10/2007||Yes|No|10/10/2007||Yes|No||||No|No|||Prescription required|No||085|No|.24386|03/29/2022|.238|03/29/2022|.23959|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|19816|||||No|No||GLENMARK PHARMA|No||||
ondansetron|No|No|No|No|75%|68462015813|ONDANSETRON ODT 8 MG TABLET|30|EA|.27247|10/10/2007||Yes|No||10/10/2007||Yes|No|10/10/2007||Yes|No||||No|No|||Prescription required|No||085|No|.24386|03/29/2022|.238|03/29/2022|.23959|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|19817|||||No|No||GLENMARK PHARMA|No||||
carvedilol|No|No|No|No|75%|68462016201|CARVEDILOL 3.125 MG TABLET|100|EA|.0258|10/17/2007||Yes|No||10/17/2007||Yes|No|10/17/2007||Yes|No||||No|No|||Prescription required|No||070|No|.01877|03/29/2022|.01831|03/29/2022|.01844|03/29/2022|||BETA-BLOCKERS|19818|||||No|No||GLENMARK PHARMA|No||||
carvedilol|No|No|No|No|75%|68462016205|CARVEDILOL 3.125 MG TABLET|500|EA|.02451|10/17/2007||Yes|No||10/17/2007||Yes|No|10/17/2007||Yes|No||||No|No|||Prescription required|No||070|No|.01877|03/29/2022|.01831|03/29/2022|.01844|03/29/2022|||BETA-BLOCKERS|19819|||||No|No||GLENMARK PHARMA|No||||
carvedilol|No|No|No|No|75%|68462016301|CARVEDILOL 6.25 MG TABLET|100|EA|.0258|10/17/2007||Yes|No||10/17/2007||Yes|No|10/17/2007||Yes|No||||No|No|||Prescription required|No||070|No|.02069|03/29/2022|.02019|03/29/2022|.02032|03/29/2022|||BETA-BLOCKERS|19820|||||No|No||GLENMARK PHARMA|No||||
carvedilol|No|No|No|No|75%|68462016305|CARVEDILOL 6.25 MG TABLET|500|EA|.02451|10/17/2007||Yes|No||10/17/2007||Yes|No|10/17/2007||Yes|No||||No|No|||Prescription required|No||070|No|.02069|03/29/2022|.02019|03/29/2022|.02032|03/29/2022|||BETA-BLOCKERS|19821|||||No|No||GLENMARK PHARMA|No||||
carvedilol|No|No|No|No|75%|68462016401|CARVEDILOL 12.5 MG TABLET|100|EA|.0258|10/17/2007||Yes|No||10/17/2007||Yes|No|10/17/2007||Yes|No||||No|No|||Prescription required|No||070|No|.02277|03/29/2022|.02222|03/29/2022|.02237|03/29/2022|||BETA-BLOCKERS|19822|||||No|No||GLENMARK PHARMA|No||||
carvedilol|No|No|No|No|75%|68462016405|CARVEDILOL 12.5 MG TABLET|500|EA|.02451|10/17/2007||Yes|No||10/17/2007||Yes|No|10/17/2007||Yes|No||||No|No|||Prescription required|No||070|No|.02277|03/29/2022|.02222|03/29/2022|.02237|03/29/2022|||BETA-BLOCKERS|19823|||||No|No||GLENMARK PHARMA|No||||
carvedilol|No|No|No|No|75%|68462016501|CARVEDILOL 25 MG TABLET|100|EA|.0258|10/17/2007||Yes|No||10/17/2007||Yes|No|10/17/2007||Yes|No||||No|No|||Prescription required|No||070|No|.03449|03/29/2022|.03366|03/29/2022|.03388|03/29/2022|||BETA-BLOCKERS|19824|||||No|No||GLENMARK PHARMA|No||||
carvedilol|No|No|No|No|75%|68462016505|CARVEDILOL 25 MG TABLET|500|EA|.02451|10/17/2007||Yes|No||10/17/2007||Yes|No|10/17/2007||Yes|No||||No|No|||Prescription required|No||070|No|.03449|03/29/2022|.03366|03/29/2022|.03388|03/29/2022|||BETA-BLOCKERS|19825|||||No|No||GLENMARK PHARMA|No||||
naproxen sodium|No|No|No|No|75%|68462017801|NAPROXEN SODIUM 275 MG TAB|100|EA|.19848|06/25/2007||Yes|No||06/25/2007||Yes|No|06/25/2007||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|059|Yes|.45236|06/08/2021|.4459|06/08/2021|.42467|06/08/2021|||NSAIDS|19826|||||No|No||GLENMARK PHARMA|No||||
naproxen sodium|No|No|No|No|75%|68462017901|NAPROXEN SODIUM 550 MG TAB|100|EA|.30908|06/25/2007||Yes|No||06/25/2007||Yes|No|06/25/2007||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|059|Yes|.37204|03/29/2022|.36311|03/29/2022|.36552|03/29/2022|||NSAIDS|19827|||||No|No||GLENMARK PHARMA|No||||
naproxen sodium|No|No|No|No|75%|68462017905|NAPROXEN SODIUM 550 MG TAB|500|EA|.30907|06/25/2007||Yes|No||06/25/2007||Yes|No|06/25/2007||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|059|Yes|.37204|03/29/2022|.36311|03/29/2022|.36552|03/29/2022|||NSAIDS|19828|||||No|No||GLENMARK PHARMA|No||||
mupirocin|No|No|No|No|75%|68462018022|MUPIROCIN 2% OINTMENT|22|GM|.1759|11/10/2010||Yes|No||11/10/2010||Yes|No|11/10/2010||Yes|No||||No|No|||Prescription required|No||114|No|.18067|03/29/2022|.17633|03/29/2022|.1775|03/29/2022|||ANTIBIOTICS: TOPICAL|19829|||||No|No||GLENMARK PHARMA|No||||
clotrimazole|No|No|No|No|75%|68462018117|CLOTRIMAZOLE 1% TOPICAL CREAM|15|GM|.27262|07/30/2015||Yes|No||07/30/2015||Yes|No|07/30/2015||Yes|No||||No|No|||Prescription required|No||061|No|.22379|03/29/2022|.21841|03/29/2022|.21987|03/29/2022|||ANTIFUNGALS: TOPICAL|19830|||||No|No||GLENMARK PHARMA|No||||
clotrimazole|No|No|No|No|75%|68462018135|CLOTRIMAZOLE 1% TOPICAL CREAM|30|GM|.23836|07/30/2015||Yes|No||07/30/2015||Yes|No|07/30/2015||Yes|No||||No|No|||Prescription required|No||061|No|.16554|03/29/2022|.16156|03/29/2022|.16264|03/29/2022|||ANTIFUNGALS: TOPICAL|19831|||||No|No||GLENMARK PHARMA|No||||
clotrimazole|No|No|No|No|75%|68462018147|CLOTRIMAZOLE 1% TOPICAL CREAM|45|GM|.22321|07/30/2015||Yes|No||07/30/2015||Yes|No|07/30/2015||Yes|No||||No|No|||Prescription required|No||061|No|.30928|03/29/2022|.30185|03/29/2022|.30386|03/29/2022|||ANTIFUNGALS: TOPICAL|19832|||||No|No||GLENMARK PHARMA|No||||
fluocinolone acetonide oil|No|No|No|No|75%|68462018556|FLUOCINOLONE OIL 0.01% EAR DRP|20|ML|2.25492|06/06/2019||Yes|No||06/06/2019||Yes|No|06/06/2019||Yes|No||||No|No|||Prescription required|No|||No|2.06581|03/29/2022|2.01623|03/29/2022|2.02965|03/29/2022||||19833|||||No|No||GLENMARK PHARMA|No||||
naproxen|No|No|No|No|75%|68462018801|NAPROXEN 250 MG TABLET|100|EA|.03655|04/01/2005||Yes|No||04/01/2005||Yes|No|04/01/2005||Yes|No||||No|No|||Prescription required|No||059|Yes|.06074|03/29/2022|.05928|03/29/2022|.05967|03/29/2022|||NSAIDS|19834|||||No|No||GLENMARK PHARMA|No||||
naproxen|No|No|No|No|75%|68462018805|NAPROXEN 250 MG TABLET|500|EA|.03633|04/01/2005||Yes|No||04/01/2005||Yes|No|04/01/2005||Yes|No||||No|No|||Prescription required|No||059|Yes|.06074|03/29/2022|.05928|03/29/2022|.05967|03/29/2022|||NSAIDS|19835|||||No|No||GLENMARK PHARMA|No||||
naproxen|No|No|No|No|75%|68462018901|NAPROXEN 375 MG TABLET|100|EA|.04407|04/01/2005||Yes|No||04/01/2005||Yes|No|04/01/2005||Yes|No||||No|No|||Prescription required|No||059|Yes|.07806|03/29/2022|.07618|03/29/2022|.07669|03/29/2022|||NSAIDS|19836|||||No|No||GLENMARK PHARMA|No||||
naproxen|No|No|No|No|75%|68462018905|NAPROXEN 375 MG TABLET|500|EA|.04515|04/01/2005||Yes|No||04/01/2005||Yes|No|04/01/2005||Yes|No||||No|No|||Prescription required|No||059|Yes|.07806|03/29/2022|.07618|03/29/2022|.07669|03/29/2022|||NSAIDS|19837|||||No|No||GLENMARK PHARMA|No||||
naproxen|No|No|No|No|75%|68462019001|NAPROXEN 500 MG TABLET|100|EA|.0516|04/01/2005||Yes|No||04/01/2005||Yes|No|04/01/2005||Yes|No||||No|No|||Prescription required|No||059|Yes|.07731|03/29/2022|.07545|03/29/2022|.07595|03/29/2022|||NSAIDS|19838|||||No|No||GLENMARK PHARMA|No||||
naproxen|No|No|No|No|75%|68462019005|NAPROXEN 500 MG TABLET|500|EA|.05181|04/01/2005||Yes|No||04/01/2005||Yes|No|04/01/2005||Yes|No||||No|No|||Prescription required|No||059|Yes|.07731|03/29/2022|.07545|03/29/2022|.07595|03/29/2022|||NSAIDS|19839|||||No|No||GLENMARK PHARMA|No||||
naproxen|No|No|No|No|75%|68462019030|NAPROXEN 500 MG TABLET|30|EA|.0516|11/19/2015||Yes|No||11/19/2015||Yes|No|11/19/2015||Yes|No||||No|No|||Prescription required|No||059|Yes|.07731|03/29/2022|.07545|03/29/2022|.07595|03/29/2022|||NSAIDS|19840|||||No|No||GLENMARK PHARMA|No||||
mometasone furoate|No|No|No|No|75%|68462019217|MOMETASONE FUROATE 0.1% CREAM|15|GM|.50166|11/10/2008||Yes|No||11/10/2008||Yes|No|11/10/2008||Yes|No||||No|No|||Prescription required|No||119|No|.51132|03/29/2022|.49904|03/29/2022|.50237|03/29/2022|||STEROIDS: TOPICAL MEDIUM|19841|||||No|No||GLENMARK PHARMA|No||||
mometasone furoate|No|No|No|No|75%|68462019255|MOMETASONE FUROATE 0.1% CREAM|45|GM|.28666|11/06/2008||Yes|No||11/06/2008||Yes|No|11/06/2008||Yes|No||||No|No|||Prescription required|No||119|No|.32851|03/29/2022|.32062|03/29/2022|.32276|03/29/2022|||STEROIDS: TOPICAL MEDIUM|19842|||||No|No||GLENMARK PHARMA|No||||
pravastatin sodium|Yes|No|No|No|75%|68462019505|PRAVASTATIN SODIUM 10 MG TAB|500|EA|.15551|07/12/2007||Yes|No||07/12/2007||Yes|No|07/12/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.07144|03/29/2022|.06972|03/29/2022|.07018|03/29/2022|||LIPOTROPICS: STATINS|19843|||||No|No||GLENMARK PHARMA|No||||
pravastatin sodium|Yes|No|No|No|75%|68462019590|PRAVASTATIN SODIUM 10 MG TAB|90|EA|.15551|06/25/2007||Yes|No||06/25/2007||Yes|No|06/25/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.07144|03/29/2022|.06972|03/29/2022|.07018|03/29/2022|||LIPOTROPICS: STATINS|19844|||||No|No||GLENMARK PHARMA|No||||
pravastatin sodium|Yes|No|No|No|75%|68462019605|PRAVASTATIN SODIUM 20 MG TAB|500|EA|.15805|06/25/2007||Yes|No||06/25/2007||Yes|No|06/25/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.05771|03/29/2022|.05632|03/29/2022|.0567|03/29/2022|||LIPOTROPICS: STATINS|19845|||||No|No||GLENMARK PHARMA|No||||
pravastatin sodium|Yes|No|No|No|75%|68462019690|PRAVASTATIN SODIUM 20 MG TAB|90|EA|.15804|06/25/2007||Yes|No||06/25/2007||Yes|No|06/25/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.05771|03/29/2022|.05632|03/29/2022|.0567|03/29/2022|||LIPOTROPICS: STATINS|19846|||||No|No||GLENMARK PHARMA|No||||
pravastatin sodium|Yes|No|No|No|75%|68462019705|PRAVASTATIN SODIUM 40 MG TAB|500|EA|.23195|06/25/2007||Yes|No||06/25/2007||Yes|No|06/25/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.08966|03/29/2022|.0875|03/29/2022|.08809|03/29/2022|||LIPOTROPICS: STATINS|19847|||||No|No||GLENMARK PHARMA|No||||
pravastatin sodium|Yes|No|No|No|75%|68462019790|PRAVASTATIN SODIUM 40 MG TAB|90|EA|.23195|06/25/2007||Yes|No||06/25/2007||Yes|No|06/25/2007||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.08966|03/29/2022|.0875|03/29/2022|.08809|03/29/2022|||LIPOTROPICS: STATINS|19848|||||No|No||GLENMARK PHARMA|No||||
pravastatin sodium|Yes|No|No|No|75%|68462019805|PRAVASTATIN SODIUM 80 MG TAB|500|EA|.23195|01/07/2008||Yes|No||01/07/2008||Yes|No|01/07/2008||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.14996|03/29/2022|.14636|03/29/2022|.14733|03/29/2022|||LIPOTROPICS: STATINS|19849|||||No|No||GLENMARK PHARMA|No||||
pravastatin sodium|Yes|No|No|No|75%|68462019890|PRAVASTATIN SODIUM 80 MG TAB|90|EA|.23195|01/07/2008||Yes|No||01/07/2008||Yes|No|01/07/2008||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.14996|03/29/2022|.14636|03/29/2022|.14733|03/29/2022|||LIPOTROPICS: STATINS|19850|||||No|No||GLENMARK PHARMA|No||||
telmisartan|Yes|No|No|No|75%|68462019913|TELMISARTAN 20 MG TABLET|30|EA|.34041|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/17/2014|113|Yes|.30407|03/29/2022|.29677|03/29/2022|.29874|03/29/2022|||ANGIOTENSIN MODULATORS|19851|||||No|No||GLENMARK PHARMA|No||||
telmisartan|No|No|No|No|75%|68462019930|TELMISARTAN 20 MG TABLET|30|EA|.20425|05/20/2021||Yes|No||05/20/2021||Yes|No|05/20/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.30407|03/29/2022|.29677|03/29/2022|.29874|03/29/2022|||ANGIOTENSIN MODULATORS|19852|||||No|No||GLENMARK PHARMA|No||||
telmisartan|Yes|No|No|No|75%|68462020013|TELMISARTAN 40 MG TABLET|30|EA|.34041|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/17/2014|113|Yes|.35861|03/29/2022|.35|03/29/2022|.35233|03/29/2022|||ANGIOTENSIN MODULATORS|19853|||||No|No||GLENMARK PHARMA|No||||
telmisartan|No|No|No|No|75%|68462020030|TELMISARTAN 40 MG TABLET|30|EA|.20425|05/20/2021||Yes|No||05/20/2021||Yes|No|05/20/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.35861|03/29/2022|.35|03/29/2022|.35233|03/29/2022|||ANGIOTENSIN MODULATORS|19854|||||No|No||GLENMARK PHARMA|No||||
telmisartan|Yes|No|No|No|75%|68462020113|TELMISARTAN 80 MG TABLET|30|EA|.34041|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|07/01/2016||Prescription required|Yes|07/17/2014|113|Yes|.33958|03/29/2022|.33143|03/29/2022|.33363|03/29/2022|||ANGIOTENSIN MODULATORS|19855|||||No|No||GLENMARK PHARMA|No||||
telmisartan|No|No|No|No|75%|68462020130|TELMISARTAN 80 MG TABLET|30|EA|.20425|05/20/2021||Yes|No||05/20/2021||Yes|No|05/20/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.33958|03/29/2022|.33143|03/29/2022|.33363|03/29/2022|||ANGIOTENSIN MODULATORS|19856|||||No|No||GLENMARK PHARMA|No||||
moexipril HCl|No|No|No|No|75%|68462020801|MOEXIPRIL HCL 15 MG TABLET|100|EA|.40678|10/05/2016||Yes|No||10/05/2016||Yes|No|10/05/2016||Yes|No||||No|No|||Prescription required|Yes|07/28/2010|113|No|.79767|03/29/2022|.77852|03/29/2022|.78371|03/29/2022|||ANGIOTENSIN MODULATORS|19857|||||No|No||GLENMARK PHARMA|No||||
moexipril HCl|No|No|No|No|75%|68462020901|MOEXIPRIL HCL 7.5 MG TABLET|100|EA|.38829|10/05/2016||Yes|No||10/05/2016||Yes|No|10/05/2016||Yes|No||||No|No|||Prescription required|Yes|07/28/2010|113|No|.75532|07/27/2021|.73719|07/27/2021|.7421|07/27/2021|||ANGIOTENSIN MODULATORS|19858|||||No|No||GLENMARK PHARMA|No||||
lithium carbonate|No|No|No|No|75%|68462022001|LITHIUM CARBONATE 150 MG CAP|100|EA|.04803|02/09/2009||Yes|No||02/09/2009||Yes|No|02/09/2009||Yes|No||||No|No|||Prescription required|No|||No|.06953|03/29/2022|.06786|03/29/2022|.06831|03/29/2022||||19859|||||No|No||GLENMARK PHARMA|No||||
lithium carbonate|No|No|No|No|75%|68462022101|LITHIUM CARBONATE 300 MG CAP|100|EA|.0344|02/09/2009||Yes|No||02/09/2009||Yes|No|02/09/2009||Yes|No||||No|No|||Prescription required|No|||No|.04894|03/29/2022|.04776|03/29/2022|.04808|03/29/2022||||19860|||||No|No||GLENMARK PHARMA|No||||
lithium carbonate|No|No|No|No|75%|68462022110|LITHIUM CARBONATE 300 MG CAP|1000|EA|.03014|07/07/2010||Yes|No||07/07/2010||Yes|No|07/07/2010||Yes|No||||No|No|||Prescription required|No|||No|.04894|03/29/2022|.04776|03/29/2022|.04808|03/29/2022||||19861|||||No|No||GLENMARK PHARMA|No||||
lithium carbonate|No|No|No|No|75%|68462022201|LITHIUM CARBONATE 600 MG CAP|100|EA|.13863|02/09/2009||Yes|No||02/09/2009||Yes|No|02/09/2009||Yes|No||||No|No|||Prescription required|No|||No|.13745|03/29/2022|.13415|03/29/2022|.13504|03/29/2022||||19862|||||No|No||GLENMARK PHARMA|No||||
lithium carbonate|No|No|No|No|75%|68462022301|LITHIUM CARBONATE ER 300 MG TB|100|EA|.08802|01/10/2011||Yes|No||01/10/2011||Yes|No|01/10/2011||Yes|No||||No|No|||Prescription required|No|||No|.12646|03/29/2022|.12342|03/29/2022|.12424|03/29/2022||||19863|||||No|No||GLENMARK PHARMA|No||||
lithium carbonate|No|No|No|No|75%|68462022401|LITHIUM CARBONATE ER 450 MG TB|100|EA|.11631|08/14/2015||Yes|No||08/14/2015||Yes|No|08/14/2015||Yes|No||||No|No|||Prescription required|No|||No|.16553|03/29/2022|.16155|03/29/2022|.16263|03/29/2022||||19864|||||No|No||GLENMARK PHARMA|No||||
mometasone furoate|No|No|No|No|75%|68462022517|MOMETASONE FUROATE 0.1% OINT|15|GM|.344|10/21/2008||Yes|No||10/21/2008||Yes|No|10/21/2008||Yes|No||||No|No|||Prescription required|No||119|No|.28576|03/29/2022|.2789|03/29/2022|.28075|03/29/2022|||STEROIDS: TOPICAL MEDIUM|19865|||||No|No||GLENMARK PHARMA|No||||
mometasone furoate|No|No|No|No|75%|68462022555|MOMETASONE FUROATE 0.1% OINT|45|GM|.20066|07/16/2008||Yes|No||07/16/2008||Yes|No|07/16/2008||Yes|No||||No|No|||Prescription required|No||119|No|.17309|03/29/2022|.16893|03/29/2022|.17006|03/29/2022|||STEROIDS: TOPICAL MEDIUM|19866|||||No|No||GLENMARK PHARMA|No||||
lamotrigine|No|No|No|No|75%|68462022801|LAMOTRIGINE 5 MG DISPER TABLET|100|EA|.1781|08/28/2009||Yes|No||08/28/2009||Yes|No|08/28/2009||Yes|No||||No|No|||Prescription required|No||056|No|.28106|12/28/2021|.27431|12/28/2021|.27614|12/28/2021|||ANTICONVULSANTS|19867|||||No|No||GLENMARK PHARMA|No||||
lamotrigine|No|No|No|No|75%|68462022901|LAMOTRIGINE 25 MG DISPER TAB|100|EA|.18945|08/28/2009||Yes|No||08/28/2009||Yes|No|08/28/2009||Yes|No||||No|No|||Prescription required|No||056|No|.29045|03/29/2022|.28347|03/29/2022|.28536|03/29/2022|||ANTICONVULSANTS|19868|||||No|No||GLENMARK PHARMA|No||||
felodipine|Yes|No|No|No|75%|68462023301|FELODIPINE ER 2.5 MG TABLET|100|EA|.16331|12/22/2010||Yes|No||12/22/2010||Yes|No|12/22/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.25478|03/29/2022|.24866|03/29/2022|.25032|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19869|||||No|No||GLENMARK PHARMA|No||||
felodipine|Yes|No|No|No|75%|68462023401|FELODIPINE ER 5 MG TABLET|100|EA|.16331|12/22/2010||Yes|No||12/22/2010||Yes|No|12/22/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.17388|03/29/2022|.1697|03/29/2022|.17083|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19870|||||No|No||GLENMARK PHARMA|No||||
felodipine|Yes|No|No|No|75%|68462023501|FELODIPINE ER 10 MG TABLET|100|EA|.29343|12/22/2010||Yes|No||12/22/2010||Yes|No|12/22/2010||Yes|No||||No|No|07/01/2016||Prescription required|No||045|No|.22814|03/29/2022|.22266|03/29/2022|.22414|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19871|||||No|No||GLENMARK PHARMA|No||||
desonide|No|No|No|No|75%|68462025217|DESONIDE 0.05% CREAM|15|GM|.66277|02/07/2018||Yes|No||02/07/2018||Yes|No|02/07/2018||Yes|No||||No|No|||Prescription required|Yes|10/12/2017|118|No|.68707|03/29/2022|.67058|03/29/2022|.67504|03/29/2022|||STEROIDS: TOPICAL LOW|19872|||||No|No||GLENMARK PHARMA|No||||
desonide|No|No|No|No|75%|68462025265|DESONIDE 0.05% CREAM|60|GM|.66284|02/07/2018||Yes|No||02/07/2018||Yes|No|02/07/2018||Yes|No||||No|No|||Prescription required|Yes|10/12/2017|118|No|.61157|03/29/2022|.59689|03/29/2022|.60086|03/29/2022|||STEROIDS: TOPICAL LOW|19873|||||No|No||GLENMARK PHARMA|No||||
ropinirole HCl|No|No|No|No|75%|68462025301|ROPINIROLE HCL 0.25 MG TABLET|100|EA|.0516|09/16/2010||Yes|No||09/16/2010||Yes|No|09/16/2010||Yes|No||||No|No|||Prescription required|No||015|No|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIPARKINSON'S AGENTS|19874|||||No|No||GLENMARK PHARMA|No||||
ropinirole HCl|No|No|No|No|75%|68462025401|ROPINIROLE HCL 0.5 MG TABLET|100|EA|.0516|09/16/2010||Yes|No||09/16/2010||Yes|No|09/16/2010||Yes|No||||No|No|||Prescription required|No||015|No|.04899|03/29/2022|.04781|03/29/2022|.04813|03/29/2022|||ANTIPARKINSON'S AGENTS|19875|||||No|No||GLENMARK PHARMA|No||||
ropinirole HCl|No|No|No|No|75%|68462025501|ROPINIROLE HCL 1 MG TABLET|100|EA|.0516|09/16/2010||Yes|No||09/16/2010||Yes|No|09/16/2010||Yes|No||||No|No|||Prescription required|No||015|No|.05246|03/29/2022|.0512|03/29/2022|.05154|03/29/2022|||ANTIPARKINSON'S AGENTS|19876|||||No|No||GLENMARK PHARMA|No||||
ropinirole HCl|No|No|No|No|75%|68462025601|ROPINIROLE HCL 2 MG TABLET|100|EA|.0516|09/16/2010||Yes|No||09/16/2010||Yes|No|09/16/2010||Yes|No||||No|No|||Prescription required|No||015|No|.06367|03/29/2022|.06214|03/29/2022|.06255|03/29/2022|||ANTIPARKINSON'S AGENTS|19877|||||No|No||GLENMARK PHARMA|No||||
ropinirole HCl|No|No|No|No|75%|68462025701|ROPINIROLE HCL 3 MG TABLET|100|EA|.0602|09/16/2010||Yes|No||09/16/2010||Yes|No|09/16/2010||Yes|No||||No|No|||Prescription required|No||015|No|.10196|03/29/2022|.09951|03/29/2022|.10017|03/29/2022|||ANTIPARKINSON'S AGENTS|19878|||||No|No||GLENMARK PHARMA|No||||
ropinirole HCl|No|No|No|No|75%|68462025801|ROPINIROLE HCL 4 MG TABLET|100|EA|.0602|09/16/2010||Yes|No||09/16/2010||Yes|No|09/16/2010||Yes|No||||No|No|||Prescription required|No||015|No|.08517|03/29/2022|.08312|03/29/2022|.08367|03/29/2022|||ANTIPARKINSON'S AGENTS|19879|||||No|No||GLENMARK PHARMA|No||||
ropinirole HCl|No|No|No|No|75%|68462025901|ROPINIROLE HCL 5 MG TABLET|100|EA|.0602|09/16/2010||Yes|No||09/16/2010||Yes|No|09/16/2010||Yes|No||||No|No|||Prescription required|No||015|No|.08598|03/29/2022|.08391|03/29/2022|.08447|03/29/2022|||ANTIPARKINSON'S AGENTS|19880|||||No|No||GLENMARK PHARMA|No||||
verapamil HCl|Yes|No|No|No|75%|68462026001|VERAPAMIL ER 240 MG TABLET|100|EA|.13308|09/29/2009||Yes|No||09/29/2009||Yes|No|09/29/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||045|No|.17058|03/29/2022|.16648|03/29/2022|.16759|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19881|||||No|No||GLENMARK PHARMA|No||||
verapamil HCl|Yes|No|No|No|75%|68462026005|VERAPAMIL ER 240 MG TABLET|500|EA|.12753|09/29/2009||Yes|No||09/29/2009||Yes|No|09/29/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||045|No|.17058|03/29/2022|.16648|03/29/2022|.16759|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19882|||||No|No||GLENMARK PHARMA|No||||
rosuvastatin calcium|No|No|No|No|75%|68462026110|ROSUVASTATIN CALCIUM 5 MG TAB|1000|EA|.08122|05/25/2021||Yes|No||05/25/2021||Yes|No|05/25/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.06753|03/29/2022|.0659|03/29/2022|.06634|03/29/2022|||LIPOTROPICS: STATINS|19883|||||No|No||GLENMARK PHARMA|No||||
rosuvastatin calcium|No|No|No|No|75%|68462026190|ROSUVASTATIN CALCIUM 5 MG TAB|90|EA|.08121|09/19/2016||Yes|No||09/19/2016||Yes|No|09/19/2016||Yes|No||||No|No|||Prescription required|No||063|Yes|.06753|03/29/2022|.0659|03/29/2022|.06634|03/29/2022|||LIPOTROPICS: STATINS|19884|||||No|No||GLENMARK PHARMA|No||||
rosuvastatin calcium|No|No|No|No|75%|68462026210|ROSUVASTATIN CALCIUM 10 MG TAB|1000|EA|.08122|05/24/2021||Yes|No||05/24/2021||Yes|No|05/24/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.05981|03/29/2022|.05837|03/29/2022|.05876|03/29/2022|||LIPOTROPICS: STATINS|19885|||||No|No||GLENMARK PHARMA|No||||
rosuvastatin calcium|No|No|No|No|75%|68462026290|ROSUVASTATIN CALCIUM 10 MG TAB|90|EA|.08121|09/19/2016||Yes|No||09/19/2016||Yes|No|09/19/2016||Yes|No||||No|No|||Prescription required|No||063|Yes|.05981|03/29/2022|.05837|03/29/2022|.05876|03/29/2022|||LIPOTROPICS: STATINS|19886|||||No|No||GLENMARK PHARMA|No||||
rosuvastatin calcium|No|No|No|No|75%|68462026310|ROSUVASTATIN CALCIUM 20 MG TAB|1000|EA|.08122|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.07822|03/29/2022|.07634|03/29/2022|.07685|03/29/2022|||LIPOTROPICS: STATINS|19887|||||No|No||GLENMARK PHARMA|No||||
rosuvastatin calcium|No|No|No|No|75%|68462026390|ROSUVASTATIN CALCIUM 20 MG TAB|90|EA|.08121|09/19/2016||Yes|No||09/19/2016||Yes|No|09/19/2016||Yes|No||||No|No|||Prescription required|No||063|Yes|.07822|03/29/2022|.07634|03/29/2022|.07685|03/29/2022|||LIPOTROPICS: STATINS|19888|||||No|No||GLENMARK PHARMA|No||||
rosuvastatin calcium|No|No|No|No|75%|68462026405|ROSUVASTATIN CALCIUM 40 MG TAB|500|EA|.08127|10/21/2021||Yes|No||10/21/2021||Yes|No|10/21/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|19889|||||No|No||GLENMARK PHARMA|No||||
rosuvastatin calcium|No|No|No|No|75%|68462026430|ROSUVASTATIN CALCIUM 40 MG TAB|30|EA|.08127|09/19/2016||Yes|No||09/19/2016||Yes|No|09/19/2016||Yes|No||||No|No|||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|19890|||||No|No||GLENMARK PHARMA|No||||
atomoxetine HCl|No|No|No|No|75%|68462026530|ATOMOXETINE HCL 10 MG CAPSULE|30|EA|.97466|02/27/2018||Yes|No||02/27/2018||Yes|No|02/27/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.20613|03/29/2022|1.17718|03/29/2022|1.18502|03/29/2022|||STIMULANTS AND RELATED AGENTS|19891|||||No|No||GLENMARK PHARMA|No||||
atomoxetine HCl|No|No|No|No|75%|68462026630|ATOMOXETINE HCL 18 MG CAPSULE|30|EA|.97466|02/28/2018||Yes|No||02/27/2018||Yes|No|02/27/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.0614|03/29/2022|1.03592|03/29/2022|1.04282|03/29/2022|||STIMULANTS AND RELATED AGENTS|19892|||||No|No||GLENMARK PHARMA|No||||
atomoxetine HCl|No|No|No|No|75%|68462026730|ATOMOXETINE HCL 25 MG CAPSULE|30|EA|.97466|02/27/2018||Yes|No||02/27/2018||Yes|No|02/27/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.05569|03/29/2022|1.03035|03/29/2022|1.03721|03/29/2022|||STIMULANTS AND RELATED AGENTS|19893|||||No|No||GLENMARK PHARMA|No||||
atomoxetine HCl|No|No|No|No|75%|68462026830|ATOMOXETINE HCL 40 MG CAPSULE|30|EA|1.0664|02/27/2018||Yes|No||02/27/2018||Yes|No|02/27/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.0462|03/29/2022|1.02109|03/29/2022|1.02789|03/29/2022|||STIMULANTS AND RELATED AGENTS|19894|||||No|No||GLENMARK PHARMA|No||||
atomoxetine HCl|No|No|No|No|75%|68462026930|ATOMOXETINE HCL 60 MG CAPSULE|30|EA|1.0664|02/27/2018||Yes|No||02/27/2018||Yes|No|02/27/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.16565|03/29/2022|1.13767|03/29/2022|1.14525|03/29/2022|||STIMULANTS AND RELATED AGENTS|19895|||||No|No||GLENMARK PHARMA|No||||
atomoxetine HCl|No|No|No|No|75%|68462027030|ATOMOXETINE HCL 80 MG CAPSULE|30|EA|1.15813|02/27/2018||Yes|No||02/27/2018||Yes|No|02/27/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.40838|03/29/2022|1.37457|03/29/2022|1.38373|03/29/2022|||STIMULANTS AND RELATED AGENTS|19896|||||No|No||GLENMARK PHARMA|No||||
atomoxetine HCl|No|No|No|No|75%|68462027130|ATOMOXETINE HCL 100 MG CAPSULE|30|EA|1.15813|02/27/2018||Yes|No||02/27/2018||Yes|No|02/27/2018||Yes|No||||No|No|||Prescription required|No||007|Yes|1.76872|03/29/2022|1.72627|03/29/2022|1.73776|03/29/2022|||STIMULANTS AND RELATED AGENTS|19897|||||No|No||GLENMARK PHARMA|No||||
desmopressin acetate|No|No|No|No|75%|68462027501|DESMOPRESSIN ACETATE 0.1 MG TB|100|EA|.3157|01/06/2016||Yes|No||01/06/2016||Yes|No|01/06/2016||Yes|No||||No|No|||Prescription required|No|||Yes|.41734|03/29/2022|.40732|03/29/2022|.41003|03/29/2022||||19898|||||No|No||GLENMARK PHARMA|No||||
desmopressin acetate|No|No|No|No|75%|68462027601|DESMOPRESSIN ACETATE 0.2 MG TB|100|EA|.35444|01/06/2016||Yes|No||01/06/2016||Yes|No|01/06/2016||Yes|No||||No|No|||Prescription required|No|||Yes|.446|03/29/2022|.43529|03/29/2022|.43819|03/29/2022||||19899|||||No|No||GLENMARK PHARMA|No||||
betamethasone/propylene glyc|No|No|No|No|75%|68462029052|BETAMETHASONE DP AUG 0.05% CRM|50|GM|.13484|07/30/2015||Yes|No||07/30/2015||Yes|No|07/30/2015||Yes|No||||No|No|||Prescription required|No||120|No|.14968|03/29/2022|.14608|03/29/2022|.14706|03/29/2022|||STEROIDS: TOPICAL HIGH|19900|||||No|No||GLENMARK PHARMA|No||||
verapamil HCl|Yes|No|No|No|75%|68462029201|VERAPAMIL ER 120 MG TABLET|100|EA|.2589|08/16/2011||Yes|No||08/16/2011||Yes|No|08/16/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||045|No|.28596|03/29/2022|.27909|03/29/2022|.28095|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19901|||||No|No||GLENMARK PHARMA|No||||
verapamil HCl|Yes|No|No|No|75%|68462029301|VERAPAMIL ER 180 MG TABLET|100|EA|.13867|08/16/2011||Yes|No||08/16/2011||Yes|No|08/16/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||045|No|.19574|03/29/2022|.19104|03/29/2022|.19231|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19902|||||No|No||GLENMARK PHARMA|No||||
verapamil HCl|Yes|No|No|No|75%|68462029305|VERAPAMIL ER 180 MG TABLET|500|EA|.13166|08/16/2011||Yes|No||08/16/2011||Yes|No|08/16/2011||Yes|No||||No|No|07/01/2016||Prescription required|No||045|No|.19574|03/29/2022|.19104|03/29/2022|.19231|03/29/2022|||CALCIUM CHANNEL BLOCKERS|19903|||||No|No||GLENMARK PHARMA|No||||
trandolapril/verapamil HCl|No|No|No|No|75%|68462029401|TRANDOLAPR-VERAPAM ER 1-240 MG|100|EA|1.81984|07/21/2015||Yes|No||07/21/2015||Yes|No|07/21/2015||Yes|No||||No|No|||Prescription required|Yes|07/28/2010|017|No|4.14755|06/01/2016|4.0883|06/01/2016|3.89362|06/01/2016|||ANGIOTENSIN MODULATOR COMBINATIONS|19904|||||No|No||GLENMARK PHARMA|No||||
trandolapril/verapamil HCl|No|No|No|No|75%|68462029501|TRANDOLAPR-VERAPAM ER 2-180 MG|100|EA|1.81984|07/21/2015||Yes|No||07/21/2015||Yes|No|07/21/2015||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|017|No|4.14755|06/01/2016|4.0883|06/01/2016|3.89362|06/01/2016|||ANGIOTENSIN MODULATOR COMBINATIONS|19905|||||No|No||GLENMARK PHARMA|No||||
trandolapril/verapamil HCl|No|No|No|No|75%|68462029601|TRANDOLAPR-VERAPAM ER 2-240 MG|100|EA|1.81984|07/21/2015||Yes|No||07/21/2015||Yes|No|07/21/2015||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|017|No|4.14755|06/01/2016|4.0883|06/01/2016|3.89362|06/01/2016|||ANGIOTENSIN MODULATOR COMBINATIONS|19906|||||No|No||GLENMARK PHARMA|No||||
ciclopirox olamine|No|No|No|No|75%|68462029717|CICLOPIROX 0.77% CREAM|15|GM|.4406|08/06/2010||Yes|No||08/06/2010||Yes|No|08/06/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|061|No|.22046|03/29/2022|.21516|03/29/2022|.2166|03/29/2022|||ANTIFUNGALS: TOPICAL|19907|||||No|No||GLENMARK PHARMA|No||||
ciclopirox olamine|No|No|No|No|75%|68462029735|CICLOPIROX 0.77% CREAM|30|GM|.38814|08/06/2010||Yes|No||08/06/2010||Yes|No|08/06/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|061|No|.18222|03/29/2022|.17784|03/29/2022|.17903|03/29/2022|||ANTIFUNGALS: TOPICAL|19908|||||No|No||GLENMARK PHARMA|No||||
ciclopirox olamine|No|No|No|No|75%|68462029792|CICLOPIROX 0.77% CREAM|90|GM|.30983|08/06/2010||Yes|No||08/06/2010||Yes|No|08/06/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|061|No|.11129|03/29/2022|.10861|03/29/2022|.10934|03/29/2022|||ANTIFUNGALS: TOPICAL|19909|||||No|No||GLENMARK PHARMA|No||||
clotrimazole/betamethasone dip|No|No|No|No|75%|68462029817|CLOTRIMAZOLE-BETAMETHASONE CRM|15|GM|.2901|01/22/2016||Yes|No||01/22/2016||Yes|No|01/22/2016||Yes|No||||No|No|||Prescription required|No||061|No|.25272|03/29/2022|.24665|03/29/2022|.24829|03/29/2022|||ANTIFUNGALS: TOPICAL|19910|||||No|No||GLENMARK PHARMA|No||||
clotrimazole/betamethasone dip|No|No|No|No|75%|68462029855|CLOTRIMAZOLE-BETAMETHASONE CRM|45|GM|.20812|01/22/2016||Yes|No||01/22/2016||Yes|No|01/22/2016||Yes|No||||No|No|||Prescription required|No||061|No|.17393|03/29/2022|.16975|03/29/2022|.17088|03/29/2022|||ANTIFUNGALS: TOPICAL|19911|||||No|No||GLENMARK PHARMA|No||||
alclometasone dipropionate|No|No|No|No|75%|68462029917|ALCLOMETASONE DIPR 0.05% OINT|15|GM|1.16042|05/20/2021||Yes|No||05/20/2021||Yes|No|05/20/2021||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|118|No|1.05408|03/29/2022|1.02878|03/29/2022|1.03563|03/29/2022|||STEROIDS: TOPICAL LOW|19912|||||No|No||GLENMARK PHARMA|No||||
alclometasone dipropionate|No|No|No|No|75%|68462029947|ALCLOMETASONE DIPR 0.05% OINT|45|GM|.78469|05/20/2021||Yes|No||05/20/2021||Yes|No|05/20/2021||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|118|No|1.78838|03/29/2022|1.76283|03/29/2022|1.67888|03/29/2022|||STEROIDS: TOPICAL LOW|19913|||||No|No||GLENMARK PHARMA|No||||
alclometasone dipropionate|No|No|No|No|75%|68462029965|ALCLOMETASONE DIPR 0.05% OINT|60|GM|.68241|07/30/2015||Yes|No||07/30/2015||Yes|No|07/30/2015||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|118|No|1.55526|06/29/2021|1.53304|06/29/2021|1.46004|06/29/2021|||STEROIDS: TOPICAL LOW|19914|||||No|No||GLENMARK PHARMA|No||||
alclometasone dipropionate|No|No|No|No|75%|68462030017|ALCLOMETASONE DIPRO 0.05% CRM|15|GM|1.10252|08/28/2009||Yes|No||08/28/2009||Yes|No|08/28/2009||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|118|No|1.384|03/29/2022|1.35078|03/29/2022|1.35978|03/29/2022|||STEROIDS: TOPICAL LOW|19915|||||No|No||GLENMARK PHARMA|No||||
alclometasone dipropionate|No|No|No|No|75%|68462030047|ALCLOMETASONE DIPRO 0.05% CRM|45|GM|.74542|08/28/2009||Yes|No||08/28/2009||Yes|No|08/28/2009||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|118|No|.64662|03/29/2022|.6311|03/29/2022|.6353|03/29/2022|||STEROIDS: TOPICAL LOW|19916|||||No|No||GLENMARK PHARMA|No||||
alclometasone dipropionate|No|No|No|No|75%|68462030065|ALCLOMETASONE DIPRO 0.05% CRM|60|GM|.64829|08/28/2009||Yes|No||08/28/2009||Yes|No|08/28/2009||Yes|No||||No|No|||Prescription required|Yes|01/25/2012|118|No|.81209|03/29/2022|.79259|03/29/2022|.79787|03/29/2022|||STEROIDS: TOPICAL LOW|19917|||||No|No||GLENMARK PHARMA|No||||
adapalene/benzoyl peroxide|No|No|No|No|75%|68462030147|ADAPALENE-BNZYL PEROX 0.1-2.5%|45|GM|.6813|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|104|No|.76371|03/29/2022|.74538|03/29/2022|.75034|03/29/2022|||ACNE AGENTS: TOPICAL|19918|||||No|No||GLENMARK PHARMA|No||||
indomethacin|No|No|No|No|75%|68462030201|INDOMETHACIN 50 MG CAPSULE|100|EA|.10659|12/23/2010||Yes|No||12/23/2010||Yes|No|12/23/2010||Yes|No||||No|No|||Prescription required|No||059|Yes|.14384|03/29/2022|.14038|03/29/2022|.14132|03/29/2022|||NSAIDS|19919|||||No|No||GLENMARK PHARMA|No||||
indomethacin|No|No|No|No|75%|68462030205|INDOMETHACIN 50 MG CAPSULE|500|EA|.09354|12/23/2010||Yes|No||12/23/2010||Yes|No|12/23/2010||Yes|No||||No|No|||Prescription required|No||059|Yes|.14384|03/29/2022|.14038|03/29/2022|.14132|03/29/2022|||NSAIDS|19920|||||No|No||GLENMARK PHARMA|No||||
norethindrone|Yes|Yes|No|No|75%|68462030329|HEATHER 0.35 MG TABLET|28|EA|.2322|08/02/2010||Yes|No||08/02/2010||Yes|No|08/02/2010||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.16123|03/29/2022|.15736|03/29/2022|.1584|03/29/2022||||19921|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone acetate|No|No|No|No|75%|68462030450|NORETHINDRONE 5 MG TABLET|50|EA|.4146|08/04/2010||Yes|No||08/04/2010||Yes|No|08/04/2010||Yes|No||||No|No|||Prescription required|No|||No|.58431|03/29/2022|.57028|03/29/2022|.57408|03/29/2022||||19922|||||No|No||GLENMARK PHARMA|No||||
norethindrone|Yes|Yes|No|No|75%|68462030529|NORETHINDRONE 0.35 MG TABLET|28|EA|.25543|10/13/2010||Yes|No||10/13/2010||Yes|No|10/13/2010||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.16123|03/29/2022|.15736|03/29/2022|.1584|03/29/2022||||19923|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
norgestimate-ethinyl estradiol|Yes|Yes|No|No|75%|68462030929|NORG-ETHIN ESTRA 0.25-0.035 MG|28|EA|.24187|04/18/2012||Yes|No||04/18/2012||Yes|No|04/18/2012||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.1742|03/29/2022|.17001|03/29/2022|.17115|03/29/2022||||19924|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
calcipotriene|No|No|No|No|75%|68462031065|CALCIPOTRIENE 0.005% OINTMENT|60|GM|2.16132|06/06/2019||Yes|No||06/06/2019||Yes|No|06/06/2019||Yes|No||||No|No|||Prescription required|No|||No|2.14151|03/29/2022|2.09011|03/29/2022|2.10403|03/29/2022||||19925|||||No|No||GLENMARK PHARMA|No||||
calcipotriene|No|No|No|No|75%|68462031066|CALCIPOTRIENE 0.005% OINTMENT|120|GM|2.16128|06/06/2019||Yes|No||06/06/2019||Yes|No|06/06/2019||Yes|No||||No|No|||Prescription required|No|||No|2.11241|03/29/2022|2.06171|03/29/2022|2.07544|03/29/2022||||19926|||||No|No||GLENMARK PHARMA|No||||
nystatin/triamcin|No|No|No|No|75%|68462031417|NYSTATIN-TRIAMCINOLONE CREAM|15|GM|.60056|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|061|No|.54331|03/29/2022|.53027|03/29/2022|.5338|03/29/2022|||ANTIFUNGALS: TOPICAL|19927|||||No|No||GLENMARK PHARMA|No||||
nystatin/triamcin|No|No|No|No|75%|68462031435|NYSTATIN-TRIAMCINOLONE CREAM|30|GM|.42168|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|061|No|.49088|03/29/2022|.47909|03/29/2022|.48228|03/29/2022|||ANTIFUNGALS: TOPICAL|19928|||||No|No||GLENMARK PHARMA|No||||
nystatin/triamcin|No|No|No|No|75%|68462031465|NYSTATIN-TRIAMCINOLONE CREAM|60|GM|.31304|02/22/2017||Yes|No||02/22/2017||Yes|No|02/22/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|061|No|.35965|03/29/2022|.35101|03/29/2022|.35335|03/29/2022|||ANTIFUNGALS: TOPICAL|19929|||||No|No||GLENMARK PHARMA|No||||
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|68462031629|BRIELLYN TABLET|28|EA|.49577|04/25/2011||Yes|No||04/25/2011||Yes|No|04/25/2011||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.44932|03/29/2022|.43853|03/29/2022|.44145|03/29/2022||||19930|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
desog-e.estradiol/e.estradiol|Yes|Yes|No|No|75%|68462031829|VIORELE 28 DAY TABLET|28|EA|.26491|04/18/2012||Yes|No||04/18/2012||Yes|No|04/18/2012||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.21935|03/29/2022|.21408|03/29/2022|.21551|03/29/2022||||19931|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
ranolazine|No|No|No|No|75%|68462031960|RANOLAZINE ER 500 MG TABLET|60|EA|.28666|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No|||Yes|.28604|03/29/2022|.27917|03/29/2022|.28103|03/29/2022||||19932|||||No|No||GLENMARK PHARMA|No||||
ranolazine|No|No|No|No|75%|68462032060|RANOLAZINE ER 1,000 MG TABLET|60|EA|.50166|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No|||Yes|.43283|03/29/2022|.42244|03/29/2022|.42525|03/29/2022||||19933|||||No|No||GLENMARK PHARMA|No||||
ezetimibe/simvastatin|No|No|No|No|75%|68462032130|EZETIMIBE-SIMVASTATIN 10-10 MG|30|EA|.35833|06/15/2020||Yes|No||06/15/2020||Yes|No|06/15/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|063|Yes|.75312|03/29/2022|.73504|03/29/2022|.73994|03/29/2022|||LIPOTROPICS: STATINS|19934|||||No|No||GLENMARK PHARMA|No||||
ezetimibe/simvastatin|No|No|No|No|75%|68462032230|EZETIMIBE-SIMVASTATIN 10-20 MG|30|EA|.35833|06/15/2020||Yes|No||06/15/2020||Yes|No|06/15/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|063|Yes|.74268|03/29/2022|.72485|03/29/2022|.72968|03/29/2022|||LIPOTROPICS: STATINS|19935|||||No|No||GLENMARK PHARMA|No||||
ezetimibe/simvastatin|No|No|No|No|75%|68462032290|EZETIMIBE-SIMVASTATIN 10-20 MG|90|EA|.35833|06/15/2020||Yes|No||06/15/2020||Yes|No|06/15/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|063|Yes|.74268|03/29/2022|.72485|03/29/2022|.72968|03/29/2022|||LIPOTROPICS: STATINS|19936|||||No|No||GLENMARK PHARMA|No||||
ezetimibe/simvastatin|No|No|No|No|75%|68462032330|EZETIMIBE-SIMVASTATIN 10-40 MG|30|EA|.35833|06/15/2020||Yes|No||06/15/2020||Yes|No|06/15/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|063|Yes|.99233|03/29/2022|.96851|03/29/2022|.97496|03/29/2022|||LIPOTROPICS: STATINS|19937|||||No|No||GLENMARK PHARMA|No||||
ezetimibe/simvastatin|No|No|No|No|75%|68462032430|EZETIMIBE-SIMVASTATIN 10-80 MG|30|EA|.35833|06/15/2020||Yes|No||06/15/2020||Yes|No|06/15/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|063|Yes|.47172|03/29/2022|.46039|03/29/2022|.46346|03/29/2022|||LIPOTROPICS: STATINS|19938|||||No|No||GLENMARK PHARMA|No||||
indomethacin|No|No|No|No|75%|68462032501|INDOMETHACIN ER 75 MG CAPSULE|100|EA|.1505|02/16/2018||Yes|No||02/16/2018||Yes|No|02/16/2018||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|059|Yes|.23098|03/29/2022|.22543|03/29/2022|.22693|03/29/2022|||NSAIDS|19939|||||No|No||GLENMARK PHARMA|No||||
indomethacin|No|No|No|No|75%|68462032560|INDOMETHACIN ER 75 MG CAPSULE|60|EA|.1505|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|059|Yes|.23098|03/29/2022|.22543|03/29/2022|.22693|03/29/2022|||NSAIDS|19940|||||No|No||GLENMARK PHARMA|No||||
indomethacin|No|No|No|No|75%|68462032590|INDOMETHACIN ER 75 MG CAPSULE|90|EA|.1505|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|059|Yes|.23098|03/29/2022|.22543|03/29/2022|.22693|03/29/2022|||NSAIDS|19941|||||No|No||GLENMARK PHARMA|No||||
trandolapril/verapamil HCl|No|No|No|No|75%|68462032901|TRANDOLAPR-VERAPAM ER 4-240 MG|100|EA|1.81984|07/21/2015||Yes|No||07/21/2015||Yes|No|07/21/2015||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|017|No|4.14755|08/27/2019|4.0883|08/27/2019|3.89362|08/27/2019|||ANGIOTENSIN MODULATOR COMBINATIONS|19942|||||No|No||GLENMARK PHARMA|No||||
pramipexole di-HCl|No|No|No|No|75%|68462033090|PRAMIPEXOLE 0.125 MG TABLET|90|EA|.04777|10/11/2010||Yes|No||10/11/2010||Yes|No|10/11/2010||Yes|No||||No|No|||Prescription required|No||015|No|.05408|03/29/2022|.05278|03/29/2022|.05313|03/29/2022|||ANTIPARKINSON'S AGENTS|19943|||||No|No||GLENMARK PHARMA|No||||
pramipexole di-HCl|No|No|No|No|75%|68462033190|PRAMIPEXOLE 0.25 MG TABLET|90|EA|.04777|10/11/2010||Yes|No||10/11/2010||Yes|No|10/11/2010||Yes|No||||No|No|||Prescription required|No||015|No|.05102|03/29/2022|.04979|03/29/2022|.05012|03/29/2022|||ANTIPARKINSON'S AGENTS|19944|||||No|No||GLENMARK PHARMA|No||||
pramipexole di-HCl|No|No|No|No|75%|68462033290|PRAMIPEXOLE 0.5 MG TABLET|90|EA|.04777|10/11/2010||Yes|No||10/11/2010||Yes|No|10/11/2010||Yes|No||||No|No|||Prescription required|No||015|No|.05616|03/29/2022|.05481|03/29/2022|.05517|03/29/2022|||ANTIPARKINSON'S AGENTS|19945|||||No|No||GLENMARK PHARMA|No||||
pramipexole di-HCl|No|No|No|No|75%|68462033390|PRAMIPEXOLE 1 MG TABLET|90|EA|.04777|10/11/2010||Yes|No||10/11/2010||Yes|No|10/11/2010||Yes|No||||No|No|||Prescription required|No||015|No|.06615|03/29/2022|.06456|03/29/2022|.06499|03/29/2022|||ANTIPARKINSON'S AGENTS|19946|||||No|No||GLENMARK PHARMA|No||||
pramipexole di-HCl|No|No|No|No|75%|68462033490|PRAMIPEXOLE 1.5 MG TABLET|90|EA|.04777|10/11/2010||Yes|No||10/11/2010||Yes|No|10/11/2010||Yes|No||||No|No|||Prescription required|No||015|No|.07545|03/29/2022|.07363|03/29/2022|.07412|03/29/2022|||ANTIPARKINSON'S AGENTS|19947|||||No|No||GLENMARK PHARMA|No||||
levocetirizine dihydrochloride|No|No|No|No|75%|68462034690|LEVOCETIRIZINE 5 MG TABLET|90|EA|.0731|04/26/2011||Yes|No||04/26/2011||Yes|No|04/26/2011||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|030|Yes|.08234|03/29/2022|.08036|03/29/2022|.08089|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|19948|||||No|No||GLENMARK PHARMA|No||||
diclofenac sodium|No|No|No|No|75%|68462035594|DICLOFENAC SODIUM 3% GEL|100|GM|.39977|11/29/2016||Yes|No||11/29/2016||Yes|No|11/29/2016||Yes|No||||No|No|||Prescription required|No|||Yes|.41138|03/29/2022|.4015|03/29/2022|.40418|03/29/2022||||19949|||||No|No||GLENMARK PHARMA|No||||
theophylline anhydrous|No|No|No|No|75%|68462035601|THEOPHYLLINE ER 600 MG TABLET|100|EA|.75916|08/01/2018||Yes|No||08/01/2018||Yes|No|08/01/2018||Yes|No||||No|No|||Prescription required|No|||Yes|1.3129|11/23/2021|1.28139|11/23/2021|1.28992|11/23/2021||||19950|||||No|No||GLENMARK PHARMA|No||||
potassium chloride|No|No|No|No|75%|68462035701|POTASSIUM CL ER 10 MEQ CAPSULE|100|EA|.0774|07/18/2016||Yes|No||07/18/2016||Yes|No|07/18/2016||Yes|No||||No|No|||Prescription required|No|||No|.15494|03/29/2022|.15122|03/29/2022|.15222|03/29/2022||||19951|||||No|No||GLENMARK PHARMA|No||||
potassium chloride|No|No|No|No|75%|68462035705|POTASSIUM CL ER 10 MEQ CAPSULE|500|EA|.0774|07/18/2016||Yes|No||07/18/2016||Yes|No|07/18/2016||Yes|No||||No|No|||Prescription required|No|||No|.15494|03/29/2022|.15122|03/29/2022|.15222|03/29/2022||||19952|||||No|No||GLENMARK PHARMA|No||||
topiramate|No|No|No|No|75%|68462037030|TOPIRAMATE ER 150 MG CAPSULE|30|EA|9.41298|05/25/2021||Yes|No||05/25/2021||Yes|No|05/25/2021||Yes|No||||No|No|||Prescription required|No||056|No|21.45284|05/25/2021|21.14637|05/25/2021|20.1394|05/25/2021|||ANTICONVULSANTS|19953|||||No|No||GLENMARK PHARMA|No||||
topiramate|No|No|No|No|75%|68462037130|TOPIRAMATE ER 200 MG CAPSULE|30|EA|10.46878|05/24/2021||Yes|No||05/24/2021||Yes|No|05/24/2021||Yes|No||||No|No|||Prescription required|No||056|No|24.30273|10/26/2021|23.71946|10/26/2021|23.87743|10/26/2021|||ANTICONVULSANTS|19954|||||No|No||GLENMARK PHARMA|No||||
topiramate|No|No|No|No|75%|68462037230|TOPIRAMATE ER 25 MG CAPSULE|30|EA|2.96542|05/24/2021||Yes|No||05/24/2021||Yes|No|05/24/2021||Yes|No||||No|No|||Prescription required|No||056|No|6.7584|05/24/2021|6.66185|05/24/2021|6.34462|05/24/2021|||ANTICONVULSANTS|19955|||||No|No||GLENMARK PHARMA|No||||
topiramate|No|No|No|No|75%|68462037330|TOPIRAMATE ER 50 MG CAPSULE|30|EA|3.86254|05/24/2021||Yes|No||05/24/2021||Yes|No|05/24/2021||Yes|No||||No|No|||Prescription required|No||056|No|8.67793|01/25/2022|8.46965|01/25/2022|8.52606|01/25/2022|||ANTICONVULSANTS|19956|||||No|No||GLENMARK PHARMA|No||||
topiramate|No|No|No|No|75%|68462037430|TOPIRAMATE ER 100 MG CAPSULE|30|EA|7.65271|05/24/2021||Yes|No||05/24/2021||Yes|No|05/24/2021||Yes|No||||No|No|||Prescription required|No||056|No|17.264|03/29/2022|16.84966|03/29/2022|16.96188|03/29/2022|||ANTICONVULSANTS|19957|||||No|No||GLENMARK PHARMA|No||||
theophylline anhydrous|No|No|No|No|75%|68462038001|THEOPHYLLINE ER 400 MG TABLET|100|EA|.52537|07/01/2018||Yes|No||07/01/2018||Yes|No|07/01/2018||Yes|No||||No|No|||Prescription required|No|||Yes|.77069|03/29/2022|.75219|03/29/2022|.7572|03/29/2022||||19958|||||No|No||GLENMARK PHARMA|No||||
riluzole|No|No|No|No|75%|68462038160|RILUZOLE 50 MG TABLET|60|EA|.56766|10/11/2016||Yes|No||10/11/2016||Yes|No|10/11/2016||Yes|No||||No|No|||Prescription required|No|||No|.46908|03/01/2022|.45782|03/01/2022|.46087|03/01/2022||||19959|||||No|No||GLENMARK PHARMA|No||||
eszopiclone|No|No|No|No|90%|68462038201|ESZOPICLONE 1 MG TABLET|100|EA|.215|08/25/2014||Yes|No||08/25/2014||Yes|No|08/25/2014||Yes|No||||No|No|||Prescription required|No||054|Yes|.19753|03/29/2022|.19278|03/29/2022|.19407|03/29/2022|||SEDATIVE HYPNOTICS|19960|||||No|No||GLENMARK PHARMA|No||||
eszopiclone|No|No|No|No|90%|68462038301|ESZOPICLONE 2 MG TABLET|100|EA|.215|08/25/2014||Yes|No||08/25/2014||Yes|No|08/25/2014||Yes|No||||No|No|||Prescription required|No||054|Yes|.25375|03/29/2022|.24766|03/29/2022|.2493|03/29/2022|||SEDATIVE HYPNOTICS|19961|||||No|No||GLENMARK PHARMA|No||||
eszopiclone|No|No|No|No|90%|68462038401|ESZOPICLONE 3 MG TABLET|100|EA|.215|08/25/2014||Yes|No||08/25/2014||Yes|No|08/25/2014||Yes|No||||No|No|||Prescription required|No||054|Yes|.14316|03/29/2022|.13972|03/29/2022|.14065|03/29/2022|||SEDATIVE HYPNOTICS|19962|||||No|No||GLENMARK PHARMA|No||||
mometasone furoate|No|No|No|No|75%|68462038502|MOMETASONE FUROATE 0.1% SOLN|60|ML|.25828|05/20/2021||Yes|No||05/20/2021||Yes|No|05/20/2021||Yes|No||||No|No|||Prescription required|No||119|No|.29151|03/29/2022|.28451|03/29/2022|.2864|03/29/2022|||STEROIDS: TOPICAL MEDIUM|19963|||||No|No||GLENMARK PHARMA|No||||
mometasone furoate|No|No|No|No|75%|68462038537|MOMETASONE FUROATE 0.1% SOLN|30|ML|.26975|05/20/2021||Yes|No||05/20/2021||Yes|No|05/20/2021||Yes|No||||No|No|||Prescription required|No||119|No|.36456|03/29/2022|.35581|03/29/2022|.35818|03/29/2022|||STEROIDS: TOPICAL MEDIUM|19964|||||No|No||GLENMARK PHARMA|No||||
solifenacin succinate|No|No|No|No|75%|68462038630|SOLIFENACIN 5 MG TABLET|30|EA|.14333|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|Yes|.23024|03/29/2022|.22471|03/29/2022|.22621|03/29/2022|||BLADDER RELAXANT PREPARATIONS|19965|||||No|No||GLENMARK PHARMA|No||||
solifenacin succinate|No|No|No|No|75%|68462038690|SOLIFENACIN 5 MG TABLET|90|EA|.14333|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|Yes|.23024|03/29/2022|.22471|03/29/2022|.22621|03/29/2022|||BLADDER RELAXANT PREPARATIONS|19966|||||No|No||GLENMARK PHARMA|No||||
solifenacin succinate|No|No|No|No|75%|68462038730|SOLIFENACIN 10 MG TABLET|30|EA|.14333|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|No|.26101|03/29/2022|.25474|03/29/2022|.25644|03/29/2022|||BLADDER RELAXANT PREPARATIONS|19967|||||No|No||GLENMARK PHARMA|No||||
solifenacin succinate|No|No|No|No|75%|68462038790|SOLIFENACIN 10 MG TABLET|90|EA|.14333|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|No|.26101|03/29/2022|.25474|03/29/2022|.25644|03/29/2022|||BLADDER RELAXANT PREPARATIONS|19968|||||No|No||GLENMARK PHARMA|No||||
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|68462038829|MARLISSA-28 TABLET|28|EA|.17921|04/18/2012||Yes|No||04/18/2012||Yes|No|04/18/2012||Yes|No|Refer to program requirements|||No|No|09/04/2019||Prescription required|No|||No|.17306|03/29/2022|.1689|03/29/2022|.17003|03/29/2022||||19969|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|68462039429|ALYACEN 1-35 28 TABLET|28|EA|.3033|07/25/2012||Yes|No||07/25/2012||Yes|No|07/25/2012||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.34259|03/29/2022|.33436|03/29/2022|.33659|03/29/2022||||19970|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
omeprazole|No|No|No|No|75%|68462039501|OMEPRAZOLE DR 10 MG CAPSULE|100|EA|.06192|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||047|Yes|.09084|03/29/2022|.08865|03/29/2022|.08925|03/29/2022|||PROTON PUMP INHIBITORS|19971|||||No|No||GLENMARK PHARMA|No||||
omeprazole|No|No|No|No|75%|68462039530|OMEPRAZOLE DR 10 MG CAPSULE|30|EA|.06192|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||047|Yes|.09084|03/29/2022|.08865|03/29/2022|.08925|03/29/2022|||PROTON PUMP INHIBITORS|19972|||||No|No||GLENMARK PHARMA|No||||
omeprazole|No|No|No|No|75%|68462039590|OMEPRAZOLE DR 10 MG CAPSULE|90|EA|.06192|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||047|Yes|.09084|03/29/2022|.08865|03/29/2022|.08925|03/29/2022|||PROTON PUMP INHIBITORS|19973|||||No|No||GLENMARK PHARMA|No||||
omeprazole|No|No|No|No|75%|68462039601|OMEPRAZOLE DR 20 MG CAPSULE|100|EA|.04816|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|19974|||||No|No||GLENMARK PHARMA|No||||
omeprazole|No|No|No|No|75%|68462039610|OMEPRAZOLE DR 20 MG CAPSULE|1000|EA|.04816|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|19975|||||No|No||GLENMARK PHARMA|No||||
omeprazole|No|No|No|No|75%|68462039630|OMEPRAZOLE DR 20 MG CAPSULE|30|EA|.04816|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|19976|||||No|No||GLENMARK PHARMA|No||||
omeprazole|No|No|No|No|75%|68462039690|OMEPRAZOLE DR 20 MG CAPSULE|90|EA|.04816|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|19977|||||No|No||GLENMARK PHARMA|No||||
omeprazole|No|No|No|No|75%|68462039701|OMEPRAZOLE DR 40 MG CAPSULE|100|EA|.05504|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|19978|||||No|No||GLENMARK PHARMA|No||||
omeprazole|No|No|No|No|75%|68462039710|OMEPRAZOLE DR 40 MG CAPSULE|1000|EA|.05504|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|19979|||||No|No||GLENMARK PHARMA|No||||
omeprazole|No|No|No|No|75%|68462039730|OMEPRAZOLE DR 40 MG CAPSULE|30|EA|.05504|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|19980|||||No|No||GLENMARK PHARMA|No||||
omeprazole|No|No|No|No|75%|68462039790|OMEPRAZOLE DR 40 MG CAPSULE|90|EA|.05504|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No||047|No|.05959|03/29/2022|.05815|03/29/2022|.05854|03/29/2022|||PROTON PUMP INHIBITORS|19981|||||No|No||GLENMARK PHARMA|No||||
atovaquone/proguanil HCl|No|No|No|No|75%|68462040201|ATOVAQUONE-PROGUANIL 62.5-25|100|EA|.92376|10/15/2015||Yes|No||10/15/2015||Yes|No|10/15/2015||Yes|No||||No|No|||Prescription required|No|||No|2.10533|01/26/2021|2.07525|01/26/2021|1.97643|01/26/2021||||19982|||||No|No||GLENMARK PHARMA|No||||
adapalene|No|No|No|No|75%|68462040355|ADAPALENE 0.1% GEL|45|GM|1.5026|08/16/2010|05/31/2023|Yes|No||08/16/2010|05/31/2023|Yes|No|08/16/2010|05/31/2023|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|2.50035|03/01/2022|2.44034|03/01/2022|2.45659|03/01/2022|||ACNE AGENTS: TOPICAL|19983|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||GLENMARK PHARMA|No||||
atovaquone/proguanil HCl|No|No|No|No|75%|68462040401|ATOVAQUONE-PROGUANIL 250-100|100|EA|2.45972|09/20/2011||Yes|No||09/20/2011||Yes|No|09/20/2011||Yes|No||||No|No|||Prescription required|No|||No|2.47536|03/29/2022|2.41595|03/29/2022|2.43204|03/29/2022||||19984|||||No|No||GLENMARK PHARMA|No||||
atovaquone/proguanil HCl|No|No|No|No|75%|68462040467|ATOVAQUONE-PROGUANIL 250-100|24|EA|2.50976|09/20/2011||Yes|No||09/20/2011||Yes|No|09/20/2011||Yes|No||||No|No|||Prescription required|No|||No|2.47536|03/29/2022|2.41595|03/29/2022|2.43204|03/29/2022||||19985|||||No|No||GLENMARK PHARMA|No||||
aspirin/dipyridamole|No|No|No|No|75%|68462040560|ASPIRIN-DIPYRIDAM ER 25-200 MG|60|EA|.3455|05/27/2020||Yes|No||05/27/2020||Yes|No|05/27/2020||Yes|No||||No|No|||Prescription required|No||004|No|.78047|03/29/2022|.76173|03/29/2022|.76681|03/29/2022|||PLATELET AGGREGATION INHIBITORS|19986|||||No|No||GLENMARK PHARMA|No||||
indomethacin|No|No|No|No|75%|68462040601|INDOMETHACIN 25 MG CAPSULE|100|EA|.08643|12/23/2010||Yes|No||12/23/2010||Yes|No|12/23/2010||Yes|No||||No|No|||Prescription required|No||059|Yes|.10587|03/29/2022|.10332|03/29/2022|.10401|03/29/2022|||NSAIDS|19987|||||No|No||GLENMARK PHARMA|No||||
indomethacin|No|No|No|No|75%|68462040610|INDOMETHACIN 25 MG CAPSULE|1000|EA|.07802|12/23/2010||Yes|No||12/23/2010||Yes|No|12/23/2010||Yes|No||||No|No|||Prescription required|No||059|Yes|.10587|03/29/2022|.10332|03/29/2022|.10401|03/29/2022|||NSAIDS|19988|||||No|No||GLENMARK PHARMA|No||||
propafenone HCl|No|No|No|No|75%|68462040860|PROPAFENONE HCL ER 225 MG CAP|60|EA|.94284|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No|||No|1.23841|03/29/2022|1.20868|03/29/2022|1.21673|03/29/2022||||19989|||||No|No||GLENMARK PHARMA|No||||
propafenone HCl|No|No|No|No|75%|68462040960|PROPAFENONE HCL ER 325 MG CAP|60|EA|1.19439|07/10/2018||Yes|No||07/10/2018||Yes|No|07/10/2018||Yes|No||||No|No|||Prescription required|No|||No|2.24387|03/29/2022|2.19001|03/29/2022|2.2046|03/29/2022||||19990|||||No|No||GLENMARK PHARMA|No||||
propafenone HCl|No|No|No|No|75%|68462041060|PROPAFENONE HCL ER 425 MG CAP|60|EA|1.19439|07/10/2018||Yes|No||07/10/2018||Yes|No|07/10/2018||Yes|No||||No|No|||Prescription required|No|||No|2.7221|03/23/2021|2.68321|03/23/2021|2.55544|03/23/2021||||19991|||||No|No||GLENMARK PHARMA|No||||
lidocaine|No|No|No|No|75%|68462041820|LIDOCAINE 5% OINTMENT|35.44|GM|.3345|11/28/2016||Yes|No||11/28/2016||Yes|No|11/28/2016||Yes|No||||No|No|||Prescription required|No|||No|.18796|03/29/2022|.18344|03/29/2022|.18467|03/29/2022||||19992|||||No|No||GLENMARK PHARMA|No||||
lidocaine|No|No|No|No|75%|68462041827|LIDOCAINE 5% OINTMENT|50|GM|.48177|11/28/2016||Yes|No||11/28/2016||Yes|No|11/28/2016||Yes|No||||No|No|||Prescription required|No|||No|.22969|03/29/2022|.22417|03/29/2022|.22567|03/29/2022||||19993|||||No|No||GLENMARK PHARMA|No||||
norethindrone-e.estradiol-iron|No|Yes|No|No|75%|68462041929|HAILEY FE 1-20 TABLET|28|EA|.11778|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.20374|03/29/2022|.19885|03/29/2022|.20017|03/29/2022||||19994|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
atovaquone|No|No|No|No|75%|68462042121|ATOVAQUONE 750 MG/5 ML SUSP|210|ML|1.14285|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|1.13871|03/29/2022|1.11138|03/29/2022|1.11878|03/29/2022||||19995|||||No|No||GLENMARK PHARMA|No||||
atovaquone|No|No|No|No|75%|68462042169|ATOVAQUONE 750 MG/5 ML SUSP|5|ML|3.54|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|1.13871|03/29/2022|1.11138|03/29/2022|1.11878|03/29/2022||||19996|||||No|No||GLENMARK PHARMA|No||||
fluticasone propionate|No|No|No|No|75%|68462042702|FLUTICASONE PROP 0.05% LOTION|60|ML|2.3283|03/27/2012||Yes|No||03/27/2012||Yes|No|03/27/2012||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|119|No|3.1409|08/24/2021|3.06551|08/24/2021|3.08593|08/24/2021|||STEROIDS: TOPICAL MEDIUM|19997|||||No|No||GLENMARK PHARMA|No||||
colesevelam HCl|No|No|No|No|75%|68462043318|COLESEVELAM 625 MG TABLET|180|EA|.47629|08/27/2018||Yes|No||08/27/2018||Yes|No|08/27/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|055|No|.48654|03/29/2022|.47486|03/29/2022|.47802|03/29/2022|||LIPOTROPICS: OTHER|19998|||||No|No||GLENMARK PHARMA|No||||
acamprosate calcium|No|No|No|No|75%|68462043518|ACAMPROSATE CALC DR 333 MG TAB|180|EA|.47228|07/22/2015||Yes|No||07/22/2015||Yes|No|07/22/2015||Yes|No||||No|No|||Prescription required|No|||No|.6071|03/29/2022|.59252|03/29/2022|.59647|03/29/2022||||19999|||||No|No||GLENMARK PHARMA|Yes|09/01/2020|||
olmesartan medoxomil|No|No|No|No|75%|68462043630|OLMESARTAN MEDOXOMIL 5 MG TAB|30|EA|.04859|09/21/2017||Yes|No||09/21/2017||Yes|No|09/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.07425|03/29/2022|.07246|03/29/2022|.07295|03/29/2022|||ANGIOTENSIN MODULATORS|20000|||||No|No||GLENMARK PHARMA|No||||
olmesartan medoxomil|No|No|No|No|75%|68462043730|OLMESARTAN MEDOXOMIL 20 MG TAB|30|EA|.05948|09/21/2017||Yes|No||09/21/2017||Yes|No|09/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.1002|03/29/2022|.09779|03/29/2022|.09844|03/29/2022|||ANGIOTENSIN MODULATORS|20001|||||No|No||GLENMARK PHARMA|No||||
olmesartan medoxomil|No|No|No|No|75%|68462043790|OLMESARTAN MEDOXOMIL 20 MG TAB|90|EA|.05943|09/21/2017||Yes|No||09/21/2017||Yes|No|09/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.1002|03/29/2022|.09779|03/29/2022|.09844|03/29/2022|||ANGIOTENSIN MODULATORS|20002|||||No|No||GLENMARK PHARMA|No||||
olmesartan medoxomil|No|No|No|No|75%|68462043830|OLMESARTAN MEDOXOMIL 40 MG TAB|30|EA|.08256|09/21/2017||Yes|No||09/21/2017||Yes|No|09/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.15714|03/29/2022|.15336|03/29/2022|.15439|03/29/2022|||ANGIOTENSIN MODULATORS|20003|||||No|No||GLENMARK PHARMA|No||||
olmesartan medoxomil|No|No|No|No|75%|68462043890|OLMESARTAN MEDOXOMIL 40 MG TAB|90|EA|.08256|09/21/2017||Yes|No||09/21/2017||Yes|No|09/21/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|.15714|03/29/2022|.15336|03/29/2022|.15439|03/29/2022|||ANGIOTENSIN MODULATORS|20004|||||No|No||GLENMARK PHARMA|No||||
sevelamer HCl|No|No|No|No|75%|68462044626|SEVELAMER HCL 400 MG TABLET|360|EA|1.38354|06/07/2019||Yes|No||06/07/2019||Yes|No|06/07/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|052|Yes|3.15319|06/07/2019|3.10815|06/07/2019|2.96014|06/07/2019|||PHOSPHATE BINDERS|20005|||||No|No||GLENMARK PHARMA|No||||
sevelamer HCl|No|No|No|No|75%|68462044718|SEVELAMER HCL 800 MG TABLET|180|EA|2.76709|06/06/2019||Yes|No||06/06/2019||Yes|No|06/06/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|052|Yes|4.51707|12/28/2021|4.40866|12/28/2021|4.43802|12/28/2021|||PHOSPHATE BINDERS|20006|||||No|No||GLENMARK PHARMA|No||||
ciclopirox|No|No|No|No|75%|68462045535|CICLOPIROX 0.77% GEL|30|GM|.92966|08/06/2010||Yes|No||08/06/2010||Yes|No|08/06/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|061|No|.698|03/29/2022|.68124|03/29/2022|.68578|03/29/2022|||ANTIFUNGALS: TOPICAL|20007|||||No|No||GLENMARK PHARMA|No||||
ciclopirox|No|No|No|No|75%|68462045547|CICLOPIROX 0.77% GEL|45|GM|.92984|08/06/2010||Yes|No||08/06/2010||Yes|No|08/06/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|061|No|.72022|03/29/2022|.70293|03/29/2022|.70761|03/29/2022|||ANTIFUNGALS: TOPICAL|20008|||||No|No||GLENMARK PHARMA|No||||
ciclopirox|No|No|No|No|75%|68462045594|CICLOPIROX 0.77% GEL|100|GM|.8354|08/06/2010||Yes|No||08/06/2010||Yes|No|08/06/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|061|No|.5644|03/29/2022|.55085|03/29/2022|.55452|03/29/2022|||ANTIFUNGALS: TOPICAL|20009|||||No|No||GLENMARK PHARMA|No||||
trospium chloride|No|No|No|No|75%|68462046160|TROSPIUM CHLORIDE 20 MG TABLET|60|EA|.3412|09/01/2010||Yes|No||09/01/2010||Yes|No|09/01/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|006|No|.42162|03/29/2022|.4115|03/29/2022|.41424|03/29/2022|||BLADDER RELAXANT PREPARATIONS|20010|||||No|No||GLENMARK PHARMA|No||||
hydrocortisone butyrate/emoll|No|No|No|No|75%|68462046447|HYDROCORT BUTY 0.1% LIPO CREAM|45|GM|3.09399|06/20/2016||Yes|No||06/20/2016||Yes|No|06/20/2016||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|119|No|7.05142|06/01/2016|6.95068|06/01/2016|6.6197|06/01/2016|||STEROIDS: TOPICAL MEDIUM|20011|||||No|No||GLENMARK PHARMA|No||||
hydrocortisone butyrate/emoll|No|No|No|No|75%|68462046465|HYDROCORT BUTY 0.1% LIPO CREAM|60|GM|3.09391|06/20/2016||Yes|No||06/20/2016||Yes|No|06/20/2016||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|119|No|7.05125|06/20/2016|6.95052|06/20/2016|6.61954|06/20/2016|||STEROIDS: TOPICAL MEDIUM|20012|||||No|No||GLENMARK PHARMA|No||||
rizatriptan benzoate|No|No|No|No|75%|68462046599|RIZATRIPTAN 5 MG TABLET|18|EA|.5148|01/03/2013||Yes|No||01/03/2013||Yes|No|01/03/2013||Yes|No||||No|No|||Prescription required|No||021|No|.64991|03/29/2022|.63431|03/29/2022|.63853|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|20013|||||No|No||GLENMARK PHARMA|No||||
rizatriptan benzoate|No|No|No|No|75%|68462046699|RIZATRIPTAN 10 MG TABLET|18|EA|.53869|01/03/2013||Yes|No||01/03/2013||Yes|No|01/03/2013||Yes|No||||No|No|||Prescription required|No||021|No|.50927|03/29/2022|.49704|03/29/2022|.50035|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|20014|||||No|No||GLENMARK PHARMA|No||||
rizatriptan benzoate|No|No|No|No|75%|68462046706|RIZATRIPTAN 5 MG ODT|18|EA|.62755|10/11/2016||Yes|No||10/11/2016||Yes|No|10/11/2016||Yes|No||||No|No|||Prescription required|No||021|No|.80419|03/29/2022|.78488|03/29/2022|.79011|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|20015|||||No|No||GLENMARK PHARMA|No||||
rizatriptan benzoate|No|No|No|No|75%|68462046740|RIZATRIPTAN 5 MG ODT|1|EA||10/11/2016||Yes|No||10/11/2016||Yes|No|10/11/2016||Yes|No||||No|No|||Prescription required|No||021|No|.80419|03/29/2022|.78488|03/29/2022|.79011|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|20016|||||No|No||GLENMARK PHARMA|No||||
rizatriptan benzoate|No|No|No|No|75%|68462046746|RIZATRIPTAN 5 MG ODT|3|EA||10/11/2016||Yes|No||10/11/2016||Yes|No|10/11/2016||Yes|No||||No|No|||Prescription required|No||021|No|.80419|03/29/2022|.78488|03/29/2022|.79011|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|20017|||||No|No||GLENMARK PHARMA|No||||
rizatriptan benzoate|No|No|No|No|75%|68462046806|RIZATRIPTAN 10 MG ODT|18|EA|.6985|10/11/2016||Yes|No||10/11/2016||Yes|No|10/11/2016||Yes|No||||No|No|||Prescription required|No||021|No|.80628|03/29/2022|.78692|03/29/2022|.79217|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|20018|||||No|No||GLENMARK PHARMA|No||||
rizatriptan benzoate|No|No|No|No|75%|68462046840|RIZATRIPTAN 10 MG ODT|1|EA||10/11/2016||Yes|No||10/11/2016||Yes|No|10/11/2016||Yes|No||||No|No|||Prescription required|No||021|No|.80628|03/29/2022|.78692|03/29/2022|.79217|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|20019|||||No|No||GLENMARK PHARMA|No||||
potassium chloride|No|No|No|No|75%|68462047101|POTASSIUM CL ER 10 MEQ TABLET|100|EA|.20502|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No|||No|.18432|03/29/2022|.17989|03/29/2022|.18109|03/29/2022||||20020|||||No|No||GLENMARK PHARMA|No||||
potassium chloride|No|No|No|No|75%|68462047201|POTASSIUM CL ER 20 MEQ TABLET|100|EA|.21581|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No|||No|.19104|03/29/2022|.18645|03/29/2022|.18769|03/29/2022||||20021|||||No|No||GLENMARK PHARMA|No||||
potassium chloride|No|No|No|No|75%|68462047205|POTASSIUM CL ER 20 MEQ TABLET|500|EA|.21582|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No|||No|.19104|03/29/2022|.18645|03/29/2022|.18769|03/29/2022||||20022|||||No|No||GLENMARK PHARMA|No||||
ursodiol|No|No|No|No|75%|68462047301|URSODIOL 250 MG TABLET|100|EA|.60939|07/14/2011||Yes|No||07/14/2011||Yes|No|07/14/2011||Yes|No||||No|No|||Prescription required|No||198|No|.5902|03/29/2022|.57603|03/29/2022|.57987|03/29/2022|||BILE SALTS|20023|||||No|No||GLENMARK PHARMA|No||||
ursodiol|No|No|No|No|75%|68462047401|URSODIOL 500 MG TABLET|100|EA|1.27391|07/14/2011||Yes|No||07/14/2011||Yes|No|07/14/2011||Yes|No||||No|No|||Prescription required|No||198|No|.95342|03/29/2022|.93053|03/29/2022|.93673|03/29/2022|||BILE SALTS|20024|||||No|No||GLENMARK PHARMA|No||||
clobetasol propionate|No|No|No|No|75%|68462048039|CLOBETASOL PROP 0.05% SPRAY|59|ML|.51905|08/27/2018||Yes|No||08/27/2018||Yes|No|08/27/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|121|No|.72856|01/25/2022|.71107|01/25/2022|.71581|01/25/2022|||STEROIDS: TOPICAL VERY HIGH|20025|||||No|No||GLENMARK PHARMA|No||||
clobetasol propionate|No|No|No|No|75%|68462048056|CLOBETASOL PROP 0.05% SPRAY|125|ML|.44489|08/27/2018||Yes|No||08/27/2018||Yes|No|08/27/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|121|No|.7112|03/29/2022|.69413|03/29/2022|.69875|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|20026|||||No|No||GLENMARK PHARMA|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|68462048619|CLINDAMYCIN-BENZOYL PEROX 1-5%|25|GM|1.29|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|.996|03/29/2022|.97209|03/29/2022|.97857|03/29/2022|||ACNE AGENTS: TOPICAL|20027|||||No|No||GLENMARK PHARMA|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|68462048627|CLINDAMYCIN-BENZOYL PEROX 1-5%|50|GM|1.29|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|.80914|03/29/2022|.78972|03/29/2022|.79498|03/29/2022|||ACNE AGENTS: TOPICAL|20028|||||No|No||GLENMARK PHARMA|No||||
deferasirox|No|No|No|No|75%|68462049430|DEFERASIROX 125 MG TB FOR SUSP|30|EA|.71595|05/29/2020||Yes|No||05/29/2020||Yes|No|05/29/2020||Yes|No||||No|No|||Prescription required|No|||No|1.6317|08/24/2021|1.60839|08/24/2021|1.5318|08/24/2021||||20029|||||No|No||GLENMARK PHARMA|No||||
deferasirox|No|No|No|No|75%|68462049530|DEFERASIROX 250 MG TB FOR SUSP|30|EA|1.4319|05/29/2020||Yes|No||05/29/2020||Yes|No|05/29/2020||Yes|No||||No|No|||Prescription required|No|||No|3.2634|08/24/2021|3.21678|08/24/2021|3.0636|08/24/2021||||20030|||||No|No||GLENMARK PHARMA|No||||
deferasirox|No|No|No|No|75%|68462049630|DEFERASIROX 500 MG TB FOR SUSP|30|EA|2.8638|05/29/2020||Yes|No||05/29/2020||Yes|No|05/29/2020||Yes|No||||No|No|||Prescription required|No|||No|6.5268|08/24/2021|6.43356|08/24/2021|6.1272|08/24/2021||||20031|||||No|No||GLENMARK PHARMA|No||||
zolmitriptan|No|No|No|No|75%|68462049776|ZOLMITRIPTAN 2.5 MG TABLET|6|EA|1.80456|10/14/2015||Yes|No||10/14/2015||Yes|No|10/14/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|1.43567|03/29/2022|1.40121|03/29/2022|1.41054|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|20032|||||No|No||GLENMARK PHARMA|No||||
zolmitriptan|No|No|No|No|75%|68462049833|ZOLMITRIPTAN 5 MG TABLET|3|EA|2.1457|10/14/2015||Yes|No||10/14/2015||Yes|No|10/14/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|1.62826|03/29/2022|1.58918|03/29/2022|1.59976|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|20033|||||No|No||GLENMARK PHARMA|No||||
zolmitriptan|No|No|No|No|75%|68462049976|ZOLMITRIPTAN 2.5 MG ODT|6|EA|2.25606|10/14/2015||Yes|No||10/14/2015||Yes|No|10/14/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|5.14172|03/01/2022|5.06827|03/01/2022|4.82692|03/01/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|20034|||||No|No||GLENMARK PHARMA|No||||
zolmitriptan|No|No|No|No|75%|68462050033|ZOLMITRIPTAN 5 MG ODT|3|EA|2.68176|10/14/2015||Yes|No||10/14/2015||Yes|No|10/14/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|4.60281|03/29/2022|4.49234|03/29/2022|4.52226|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|20035|||||No|No||GLENMARK PHARMA|No||||
calcipotriene|No|No|No|No|75%|68462050165|CALCIPOTRIENE 0.005% CREAM|60|GM|1.50557|08/26/2015||Yes|No||08/26/2015||Yes|No|08/26/2015||Yes|No||||No|No|||Prescription required|No|||No|1.06701|03/29/2022|1.0414|03/29/2022|1.04833|03/29/2022||||20036|||||No|No||GLENMARK PHARMA|No||||
calcipotriene|No|No|No|No|75%|68462050166|CALCIPOTRIENE 0.005% CREAM|120|GM|1.43953|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Prescription required|No|||No|1.10109|03/29/2022|1.07466|03/29/2022|1.08182|03/29/2022||||20037|||||No|No||GLENMARK PHARMA|No||||
azathioprine|No|No|No|No|75%|68462050201|AZATHIOPRINE 50 MG TABLET|100|EA|.1695|11/11/2015|02/08/2022|Yes|No||11/11/2015|02/08/2022|Yes|No|11/11/2015|02/08/2022|Yes|No||||No|No|||Prescription required|No||229|No|.24374|03/29/2022|.23789|03/29/2022|.23947|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|20038|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GLENMARK PHARMA|No||||
norethindrone-e.estradiol-iron|No|Yes|No|No|75%|68462050329|HAILEY FE 1.5-30 TABLET|28|EA|.11778|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.28591|03/29/2022|.27904|03/29/2022|.2809|03/29/2022||||20039|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|No|Yes|No|No|75%|68462050384|HAILEY FE 1.5-30 TABLET|28|EA||12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.28591|03/29/2022|.27904|03/29/2022|.2809|03/29/2022||||20040|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone ac-eth estradiol|Yes|Yes|No|No|75%|68462050479|HAILEY 21 1.5 MG-30 MCG TAB|21|EA||12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No|Refer to program requirements|||No|No|03/20/2020||Prescription required|No|||No|.56037|03/29/2022|.54692|03/29/2022|.55056|03/29/2022||||20041|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone ac-eth estradiol|Yes|Yes|No|No|75%|68462050481|HAILEY 21 1.5 MG-30 MCG TAB|21|EA|.4401|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No|Refer to program requirements|||No|No|03/20/2020||Prescription required|No|||No|.56037|03/29/2022|.54692|03/29/2022|.55056|03/29/2022||||20042|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
fluocinonide|No|No|No|No|75%|68462050535|FLUOCINONIDE 0.1% CREAM|30|GM|1.53137|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.34413|01/25/2022|.33587|01/25/2022|.3381|01/25/2022|||STEROIDS: TOPICAL HIGH|20043|||||No|No||GLENMARK PHARMA|No||||
fluocinonide|No|No|No|No|75%|68462050565|FLUOCINONIDE 0.1% CREAM|60|GM|1.31952|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|.22927|03/29/2022|.22376|03/29/2022|.22525|03/29/2022|||STEROIDS: TOPICAL HIGH|20044|||||No|No||GLENMARK PHARMA|No||||
fluocinonide|No|No|No|No|75%|68462050566|FLUOCINONIDE 0.1% CREAM|120|GM|1.25337|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|120|No|2.85653|04/27/2021|2.81572|04/27/2021|2.68164|04/27/2021|||STEROIDS: TOPICAL HIGH|20045|||||No|No||GLENMARK PHARMA|No||||
desonide|No|No|No|No|75%|68462051339|DESONIDE 0.05% LOTION|59|ML|1.72641|02/15/2018||Yes|No||02/15/2018||Yes|No|02/15/2018||Yes|No||||No|No|||Prescription required|Yes|12/14/2017|118|No|1.36873|03/01/2022|1.33588|03/01/2022|1.34477|03/01/2022|||STEROIDS: TOPICAL LOW|20046|||||No|No||GLENMARK PHARMA|No||||
desonide|No|No|No|No|75%|68462051389|DESONIDE 0.05% LOTION|118|ML|1.27808|02/15/2018||Yes|No||02/15/2018||Yes|No|02/15/2018||Yes|No||||No|No|||Prescription required|Yes|12/14/2017|118|No|1.43647|03/01/2022|1.40199|03/01/2022|1.41133|03/01/2022|||STEROIDS: TOPICAL LOW|20047|||||No|No||GLENMARK PHARMA|No||||
metformin HCl|No|No|No|No|75%|68462052001|METFORMIN ER 500 MG GASTRC-TB|100|EA|3.01|03/10/2020||Yes|No||03/10/2020||Yes|No|03/10/2020||Yes|No||||No|No|||Prescription required|No||012|No|2.40128|03/29/2022|2.34364|03/29/2022|2.35925|03/29/2022|||HYPOGLYCEMICS: METFORMINS|20048|||||No|No||GLENMARK PHARMA|No||||
metformin HCl|Yes|No|No|No|75%|68462052190|METFORMIN ER 1,000 MG GASTR-TB|90|EA|5.97221|03/10/2020||Yes|No||03/10/2020||Yes|No|03/10/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||012|No|6.02577|03/29/2022|5.88115|03/29/2022|5.92031|03/29/2022|||HYPOGLYCEMICS: METFORMINS|20049|||||No|No||GLENMARK PHARMA|No||||
desonide|No|No|No|No|75%|68462052817|DESONIDE 0.05% OINTMENT|15|GM|.55441|02/07/2018||Yes|No||02/07/2018||Yes|No|02/07/2018||Yes|No||||No|No|||Prescription required|Yes|10/19/2017|118|No|.83836|03/29/2022|.81823|03/29/2022|.82368|03/29/2022|||STEROIDS: TOPICAL LOW|20050|||||No|No||GLENMARK PHARMA|No||||
desonide|No|No|No|No|75%|68462052865|DESONIDE 0.05% OINTMENT|60|GM|.55441|02/07/2018||Yes|No||02/07/2018||Yes|No|02/07/2018||Yes|No||||No|No|||Prescription required|Yes|10/19/2017|118|No|.63751|03/29/2022|.6222|03/29/2022|.62635|03/29/2022|||STEROIDS: TOPICAL LOW|20051|||||No|No||GLENMARK PHARMA|No||||
clobetasol propionate|No|No|No|No|75%|68462052917|CLOBETASOL 0.05% CREAM|15|GM|.35718|12/07/2018||Yes|No||12/07/2018||Yes|No|12/07/2018||Yes|No||||No|No|||Prescription required|No||121|No|.42879|03/29/2022|.41849|03/29/2022|.42128|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|20052|||||No|No||GLENMARK PHARMA|No||||
clobetasol propionate|No|No|No|No|75%|68462052935|CLOBETASOL 0.05% CREAM|30|GM|.35704|12/07/2018||Yes|No||12/07/2018||Yes|No|12/07/2018||Yes|No||||No|No|||Prescription required|No||121|No|.34489|03/29/2022|.33661|03/29/2022|.33885|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|20053|||||No|No||GLENMARK PHARMA|No||||
clobetasol propionate|No|No|No|No|75%|68462052947|CLOBETASOL 0.05% CREAM|45|GM|.35708|12/07/2018||Yes|No||12/07/2018||Yes|No|12/07/2018||Yes|No||||No|No|||Prescription required|No||121|No|.31467|03/29/2022|.30711|03/29/2022|.30916|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|20054|||||No|No||GLENMARK PHARMA|No||||
clobetasol propionate|No|No|No|No|75%|68462052965|CLOBETASOL 0.05% CREAM|60|GM|.31949|12/07/2018||Yes|No||12/07/2018||Yes|No|12/07/2018||Yes|No||||No|No|||Prescription required|No||121|No|.33784|03/29/2022|.32973|03/29/2022|.33192|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|20055|||||No|No||GLENMARK PHARMA|No||||
clobetasol propionate|No|No|No|No|75%|68462053017|CLOBETASOL 0.05% OINTMENT|15|GM|1.06955|06/06/2017||Yes|No||06/06/2017||Yes|No|06/06/2017||Yes|No||||No|No|||Prescription required|No||121|No|.35914|03/29/2022|.35052|03/29/2022|.35285|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|20056|||||No|No||GLENMARK PHARMA|No||||
clobetasol propionate|No|No|No|No|75%|68462053035|CLOBETASOL 0.05% OINTMENT|30|GM|.89354|06/06/2017||Yes|No||06/06/2017||Yes|No|06/06/2017||Yes|No||||No|No|||Prescription required|No||121|No|.3756|03/29/2022|.36658|03/29/2022|.36902|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|20057|||||No|No||GLENMARK PHARMA|No||||
clobetasol propionate|No|No|No|No|75%|68462053047|CLOBETASOL 0.05% OINTMENT|45|GM|.9522|07/20/2018||Yes|No||07/20/2018||Yes|No|07/20/2018||Yes|No||||No|No|||Prescription required|No||121|No|.36764|03/29/2022|.35881|03/29/2022|.3612|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|20058|||||No|No||GLENMARK PHARMA|No||||
clobetasol propionate|No|No|No|No|75%|68462053065|CLOBETASOL 0.05% OINTMENT|60|GM|.89354|07/20/2018||Yes|No||07/20/2018||Yes|No|07/20/2018||Yes|No||||No|No|||Prescription required|No||121|No|.32004|03/29/2022|.31235|03/29/2022|.31443|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|20059|||||No|No||GLENMARK PHARMA|No||||
desoximetasone|No|No|No|No|75%|68462053165|DESOXIMETASONE 0.25% OINTMENT|60|GM|.75858|07/30/2015||Yes|No||07/30/2015||Yes|No|07/30/2015||Yes|No||||No|No|||Prescription required|Yes|07/26/2012|120|No|.39246|03/29/2022|.38304|03/29/2022|.38559|03/29/2022|||STEROIDS: TOPICAL HIGH|20060|||||No|No||GLENMARK PHARMA|No||||
clobetasol propionate|No|No|No|No|75%|68462053228|CLOBETASOL 0.05% SOLUTION|25|ML|.516|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No||121|No|.44026|03/29/2022|.42969|03/29/2022|.43255|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|20061|||||No|No||GLENMARK PHARMA|No||||
clobetasol propionate|No|No|No|No|75%|68462053253|CLOBETASOL 0.05% SOLUTION|50|ML|.516|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No||121|No|.35501|03/29/2022|.34648|03/29/2022|.34879|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|20062|||||No|No||GLENMARK PHARMA|No||||
tacrolimus|No|No|No|No|75%|68462053435|TACROLIMUS 0.1% OINTMENT|30|GM|1.94116|08/27/2018||Yes|No||08/27/2018||Yes|No|08/27/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|034|Yes|2.17788|03/29/2022|2.12561|03/29/2022|2.13976|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|20063|||||No|No||GLENMARK PHARMA|No||||
tacrolimus|No|No|No|No|75%|68462053465|TACROLIMUS 0.1% OINTMENT|60|GM|1.94123|08/27/2018||Yes|No||08/27/2018||Yes|No|08/27/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|034|Yes|2.14182|03/29/2022|2.09041|03/29/2022|2.10433|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|20064|||||No|No||GLENMARK PHARMA|No||||
tacrolimus|No|No|No|No|75%|68462053494|TACROLIMUS 0.1% OINTMENT|100|GM|1.94119|08/27/2018||Yes|No||08/27/2018||Yes|No|08/27/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|034|Yes|1.89468|03/29/2022|1.8492|03/29/2022|1.86152|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|20065|||||No|No||GLENMARK PHARMA|No||||
imiquimod|No|No|No|No|75%|68462053670|IMIQUIMOD 5% CREAM PACKET|24|EA|2.6875|06/05/2012||Yes|No||06/05/2012||Yes|No|06/05/2012||Yes|No||||No|No|||Prescription required|No|||Yes|1.00328|03/29/2022|.9792|03/29/2022|.98572|03/29/2022||||20066|||||No|No||GLENMARK PHARMA|No||||
fosinopril/hydrochlorothiazide|No|No|No|No|75%|68462055501|FOSINOPRIL-HCTZ 20-12.5 MG TAB|100|EA|.4816|08/28/2009|01/31/2022|Yes|No||08/28/2009|01/31/2022|Yes|No|08/28/2009|01/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/24/2013|113|Yes|1.0976|06/29/2021|1.08192|06/29/2021|1.0304|06/29/2021|||ANGIOTENSIN MODULATORS|20067|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||GLENMARK PHARMA|No||||
norethindrone-ethin. estradiol|Yes|Yes|No|No|75%|68462055629|ALYACEN 7-7-7-28 TABLET|28|EA|.26875|07/25/2012||Yes|No||07/25/2012||Yes|No|07/25/2012||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.43221|03/29/2022|.42183|03/29/2022|.42464|03/29/2022||||20068|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
diltiazem HCl|No|No|No|No|75%|68462056201|DILTIAZEM 12HR ER 120 MG CAP|100|EA|1.6254|05/20/2021||Yes|No||05/20/2021||Yes|No|05/20/2021||Yes|No||||No|No|||Prescription required|No||045|No|3.09075|03/29/2022|3.01657|03/29/2022|3.03666|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20069|||||No|No||GLENMARK PHARMA|No||||
mupirocin calcium|No|No|No|No|75%|68462056417|MUPIROCIN 2% CREAM|15|GM|5.62239|01/28/2013||Yes|No||01/28/2013||Yes|No|01/28/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|114|No|7.17255|03/29/2022|7.0004|03/29/2022|7.04703|03/29/2022|||ANTIBIOTICS: TOPICAL|20070|||||No|No||GLENMARK PHARMA|No||||
mupirocin calcium|No|No|No|No|75%|68462056435|MUPIROCIN 2% CREAM|30|GM|4.76511|01/28/2013||Yes|No||01/28/2013||Yes|No|01/28/2013||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|114|No|4.87374|03/29/2022|4.75677|03/29/2022|4.78844|03/29/2022|||ANTIBIOTICS: TOPICAL|20071|||||No|No||GLENMARK PHARMA|No||||
norgestimate-ethinyl estradiol|Yes|Yes|No|No|75%|68462056529|NORG-EE 0.18-0.215-0.25/0.035|28|EA|.16416|07/14/2011||Yes|No||07/14/2011||Yes|No|07/14/2011||Yes|No|Refer to program requirements|||No|No|11/01/2012||Prescription required|No|||No|.1602|03/29/2022|.15635|03/29/2022|.15739|03/29/2022||||20072|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
amlodipine bes/olmesartan med|No|No|No|No|75%|68462056630|AMLODIPINE-OLMESARTAN 5-20 MG|30|EA|.3225|06/15/2020||Yes|No||06/15/2020||Yes|No|06/15/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|017|Yes|.41945|03/29/2022|.40938|03/29/2022|.4121|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|20073|||||No|No||GLENMARK PHARMA|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|68462056690|AMLODIPINE-OLMESARTAN 5-20 MG|90|EA|.3225|06/15/2020||Yes|No||06/15/2020||Yes|No|06/15/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|017|Yes|.41945|03/29/2022|.40938|03/29/2022|.4121|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|20074|||||No|No||GLENMARK PHARMA|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|68462056730|AMLODIPINE-OLMESARTAN 10-20 MG|30|EA|.3225|06/15/2020||Yes|No||06/15/2020||Yes|No|06/15/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|017|Yes|.43528|03/29/2022|.42483|03/29/2022|.42766|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|20075|||||No|No||GLENMARK PHARMA|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|68462056790|AMLODIPINE-OLMESARTAN 10-20 MG|90|EA|.3225|06/15/2020||Yes|No||06/15/2020||Yes|No|06/15/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|017|Yes|.43528|03/29/2022|.42483|03/29/2022|.42766|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|20076|||||No|No||GLENMARK PHARMA|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|68462056830|AMLODIPINE-OLMESARTAN 5-40 MG|30|EA|.4085|06/15/2020||Yes|No||06/15/2020||Yes|No|06/15/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|017|Yes|.47518|03/29/2022|.46377|03/29/2022|.46686|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|20077|||||No|No||GLENMARK PHARMA|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|68462056890|AMLODIPINE-OLMESARTAN 5-40 MG|90|EA|.4085|06/15/2020||Yes|No||06/15/2020||Yes|No|06/15/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|017|Yes|.47518|03/29/2022|.46377|03/29/2022|.46686|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|20078|||||No|No||GLENMARK PHARMA|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|68462056930|AMLODIPINE-OLMESARTAN 10-40 MG|30|EA|.4085|06/15/2020||Yes|No||06/15/2020||Yes|No|06/15/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|017|Yes|.41757|03/29/2022|.40754|03/29/2022|.41026|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|20079|||||No|No||GLENMARK PHARMA|No||||
amlodipine bes/olmesartan med|No|No|No|No|75%|68462056990|AMLODIPINE-OLMESARTAN 10-40 MG|90|EA|.4085|06/15/2020||Yes|No||06/15/2020||Yes|No|06/15/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|017|Yes|.41757|03/29/2022|.40754|03/29/2022|.41026|03/29/2022|||ANGIOTENSIN MODULATOR COMBINATIONS|20080|||||No|No||GLENMARK PHARMA|No||||
voriconazole|No|No|No|No|75%|68462057230|VORICONAZOLE 50 MG TABLET|30|EA|.93166|12/21/2015||Yes|No||12/21/2015||Yes|No|12/21/2015||Yes|No||09/01/2021||Yes|No|||Prescription required|Yes|01/22/2015|069|No|2.12332|12/07/2021|2.09299|12/07/2021|1.99332|12/07/2021|||ANTIFUNGALS: ORAL|20081|||||No|No||GLENMARK PHARMA|No||||
voriconazole|No|No|No|No|75%|68462057330|VORICONAZOLE 200 MG TABLET|30|EA|3.225|12/21/2015||Yes|No||12/21/2015||Yes|No|12/21/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|069|No|2.07998|03/29/2022|2.03006|03/29/2022|2.04358|03/29/2022|||ANTIFUNGALS: ORAL|20082|||||No|No||GLENMARK PHARMA|No||||
hydrocortisone valerate|No|No|No|No|75%|68462057517|HYDROCORTISONE VAL 0.2% CREAM|15|GM|1.02684|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|.67989|03/29/2022|.66357|03/29/2022|.66799|03/29/2022|||STEROIDS: TOPICAL MEDIUM|20083|||||No|No||GLENMARK PHARMA|No||||
hydrocortisone valerate|No|No|No|No|75%|68462057547|HYDROCORTISONE VAL 0.2% CREAM|45|GM|.6899|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|.56991|03/29/2022|.55623|03/29/2022|.55993|03/29/2022|||STEROIDS: TOPICAL MEDIUM|20084|||||No|No||GLENMARK PHARMA|No||||
hydrocortisone valerate|No|No|No|No|75%|68462057565|HYDROCORTISONE VAL 0.2% CREAM|60|GM|.62242|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|.61899|03/01/2022|.60413|03/01/2022|.60815|03/01/2022|||STEROIDS: TOPICAL MEDIUM|20085|||||No|No||GLENMARK PHARMA|No||||
fenofibrate,micronized|No|No|No|No|75%|68462058001|FENOFIBRATE 67 MG CAPSULE|100|EA|.06923|09/06/2017||Yes|No||09/06/2017||Yes|No|09/06/2017||Yes|No||||No|No|||Prescription required|No||055|No|.15038|03/29/2022|.14677|03/29/2022|.14774|03/29/2022|||LIPOTROPICS: OTHER|20086|||||No|No||GLENMARK PHARMA|No||||
fenofibrate,micronized|No|No|No|No|75%|68462058101|FENOFIBRATE 134 MG CAPSULE|100|EA|.09137|09/06/2017||Yes|No||09/06/2017||Yes|No|09/06/2017||Yes|No||||No|No|||Prescription required|No||055|No|.17604|03/29/2022|.17181|03/29/2022|.17295|03/29/2022|||LIPOTROPICS: OTHER|20087|||||No|No||GLENMARK PHARMA|No||||
fenofibrate,micronized|No|No|No|No|75%|68462058201|FENOFIBRATE 200 MG CAPSULE|100|EA|.15652|09/06/2017||Yes|No||09/06/2017||Yes|No|09/06/2017||Yes|No||||No|No|||Prescription required|No||055|No|.22993|03/29/2022|.22441|03/29/2022|.2259|03/29/2022|||LIPOTROPICS: OTHER|20088|||||No|No||GLENMARK PHARMA|No||||
aprepitant|No|No|No|No|75%|68462058340|APREPITANT 40 MG CAPSULE|1|EA|37.8185|02/27/2018||Yes|No||02/27/2018||Yes|No|02/27/2018||Yes|No||||No|No|||Prescription required|Yes|11/03/2017|085|Yes|60.95057|01/25/2022|59.48775|01/25/2022|59.88393|01/25/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|20089|||||No|No||GLENMARK PHARMA|No||||
aprepitant|No|No|No|No|75%|68462058385|APREPITANT 40 MG CAPSULE|5|EA|37.81764|02/07/2018||Yes|No||02/07/2018||Yes|No|02/07/2018||Yes|No||||No|No|||Prescription required|Yes|11/03/2017|085|Yes|60.95057|01/25/2022|59.48775|01/25/2022|59.88393|01/25/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|20090|||||No|No||GLENMARK PHARMA|No||||
aprepitant|No|No|No|No|75%|68462058458|APREPITANT 80 MG CAPSULE|2|EA|70.10075|02/07/2018||Yes|No||02/07/2018||Yes|No|02/07/2018||Yes|No||||No|No|||Prescription required|Yes|11/03/2017|085|Yes|130.01571|12/21/2021|126.89533|12/21/2021|127.74043|12/21/2021|||ANTIEMETIC/ANTIVERTIGO AGENTS|20091|||||No|No||GLENMARK PHARMA|No||||
aprepitant|No|No|No|No|75%|68462058476|APREPITANT 80 MG CAPSULE|6|EA|70.09358|02/07/2018||Yes|No||02/07/2018||Yes|No|02/07/2018||Yes|No||||No|No|||Prescription required|Yes|11/03/2017|085|Yes|130.01571|12/21/2021|126.89533|12/21/2021|127.74043|12/21/2021|||ANTIEMETIC/ANTIVERTIGO AGENTS|20092|||||No|No||GLENMARK PHARMA|No||||
aprepitant|No|No|No|No|75%|68462058576|APREPITANT 125 MG CAPSULE|6|EA|109.52458|02/07/2018||Yes|No||02/07/2018||Yes|No|02/07/2018||Yes|No||||No|No|||Prescription required|Yes|11/03/2017|085|Yes|249.61416|02/07/2018|246.04824|02/07/2018|234.33166|02/07/2018|||ANTIEMETIC/ANTIVERTIGO AGENTS|20093|||||No|No||GLENMARK PHARMA|No||||
fluocinolone/shower cap|No|No|No|No|75%|68462059089|FLUOCINOLONE 0.01% SCALP OIL|118.28|ML|.11353|06/05/2019||Yes|No||06/05/2019||Yes|No|06/05/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|118|No|.27456|03/29/2022|.26797|03/29/2022|.26975|03/29/2022|||STEROIDS: TOPICAL LOW|20094|||||No|No||GLENMARK PHARMA|No||||
fluocinolone acetonide|No|No|No|No|75%|68462059189|FLUOCINOLONE 0.01% BODY OIL|118.28|ML|.11236|06/06/2019||Yes|No||06/06/2019||Yes|No|06/06/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|118|No|.18968|03/29/2022|.18512|03/29/2022|.18636|03/29/2022|||STEROIDS: TOPICAL LOW|20095|||||No|No||GLENMARK PHARMA|No||||
clobetasol propionate|No|No|No|No|75%|68462060827|CLOBETASOL PROP 0.05% FOAM|50|GM|.43|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|01/27/2018|121|No|.53203|03/29/2022|.51926|03/29/2022|.52271|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|20096|||||No|No||GLENMARK PHARMA|No||||
clobetasol propionate|No|No|No|No|75%|68462060894|CLOBETASOL PROP 0.05% FOAM|100|GM|.43|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|01/27/2018|121|No|.7435|03/29/2022|.72565|03/29/2022|.73048|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|20097|||||No|No||GLENMARK PHARMA|No||||
pimecrolimus|No|No|No|No|75%|68462060935|PIMECROLIMUS 1% CREAM|30|GM|3.63536|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|034|Yes|5.06554|03/29/2022|4.94396|03/29/2022|4.97689|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|20098|||||No|No||GLENMARK PHARMA|No||||
pimecrolimus|No|No|No|No|75%|68462060965|PIMECROLIMUS 1% CREAM|60|GM|3.63536|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|034|Yes|4.49404|03/29/2022|4.38618|03/29/2022|4.41539|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|20099|||||No|No||GLENMARK PHARMA|No||||
pimecrolimus|No|No|No|No|75%|68462060994|PIMECROLIMUS 1% CREAM|100|GM|3.63534|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|034|Yes|4.27357|03/29/2022|4.171|03/29/2022|4.19878|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|20100|||||No|No||GLENMARK PHARMA|No||||
colesevelam HCl|No|No|No|No|75%|68462062030|COLESEVELAM HCL 3.75 G PACKET|30|EA|5.80141|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|055|No|9.26917|03/29/2022|9.0467|03/29/2022|9.10695|03/29/2022|||LIPOTROPICS: OTHER|20101|||||No|No||GLENMARK PHARMA|No||||
clobetasol propionate/emoll|No|No|No|No|75%|68462062527|CLOBETASOL EMULSION 0.05% FOAM|50|GM|2.41324|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|121|No|2.7886|01/25/2022|2.72167|01/25/2022|2.73979|01/25/2022|||STEROIDS: TOPICAL VERY HIGH|20102|||||No|No||GLENMARK PHARMA|No||||
clobetasol propionate/emoll|No|No|No|No|75%|68462062594|CLOBETASOL EMULSION 0.05% FOAM|100|GM|2.20422|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|121|No|2.90918|03/01/2022|2.83935|03/01/2022|2.85826|03/01/2022|||STEROIDS: TOPICAL VERY HIGH|20103|||||No|No||GLENMARK PHARMA|No||||
azelaic acid|No|No|No|No|75%|68462062652|AZELAIC ACID 15% GEL|50|GM|1.29|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|221|No|1.03233|03/29/2022|1.00755|03/29/2022|1.01426|03/29/2022|||ROSACEA AGENTS: TOPICAL|20104|||||No|No||GLENMARK PHARMA|No||||
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|68462063729|LEVONOR-ETH ESTRA 0.09-0.02 MG|28|EA|.72977|07/21/2015||Yes|No||07/21/2015||Yes|No|07/21/2015||Yes|No|Refer to program requirements|||No|No|07/21/2015||Prescription required|No|||No|1.10869|03/29/2022|1.08208|03/29/2022|1.08928|03/29/2022||||20105|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
nitroglycerin|No|No|No|No|75%|68462063801|NITROGLYCERIN 0.3 MG TABLET SL|100|EA|.16193|02/06/2018||Yes|No||02/06/2018||Yes|No|02/06/2018||Yes|No||||No|No|||Prescription required|No|||No|.22579|03/29/2022|.22037|03/29/2022|.22183|03/29/2022||||20106|||||No|No||GLENMARK PHARMA|No||||
nitroglycerin|No|No|No|No|75%|68462063901|NITROGLYCERIN 0.4 MG TABLET SL|100|EA|.16193|02/06/2018||Yes|No||02/06/2018||Yes|No|02/06/2018||Yes|No||||No|No|||Prescription required|No|||No|.18753|03/29/2022|.18302|03/29/2022|.18424|03/29/2022||||20107|||||No|No||GLENMARK PHARMA|No||||
nitroglycerin|No|No|No|No|75%|68462063945|NITROGLYCERIN 0.4 MG TABLET SL|25|EA|.35324|02/06/2018||Yes|No||02/06/2018||Yes|No|02/06/2018||Yes|No||||No|No|||Prescription required|No|||No|.26492|03/29/2022|.25856|03/29/2022|.26028|03/29/2022||||20108|||||No|No||GLENMARK PHARMA|No||||
nitroglycerin|No|No|No|No|75%|68462064001|NITROGLYCERIN 0.6 MG TABLET SL|100|EA|.16193|02/06/2018||Yes|No||02/06/2018||Yes|No|02/06/2018||Yes|No||||No|No|||Prescription required|No|||No|.36906|03/29/2022|.36379|03/29/2022|.34647|03/29/2022||||20109|||||No|No||GLENMARK PHARMA|No||||
L-norgest/e.estradiol-e.estrad|Yes|Yes|No|No|75%|68462064693|ASHLYNA 0.15-0.03-0.01 MG TAB|91|EA|.40637|06/23/2015||Yes|No||06/23/2015||Yes|No|06/23/2015||Yes|No|Refer to program requirements|||No|No|06/23/2015||Prescription required|No|||No|.54912|03/29/2022|.53594|03/29/2022|.53951|03/29/2022||||20110|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone ac-eth estradiol|No|No|No|No|75%|68462065629|NORETHIND-ETH ESTRAD 0.5-2.5|28|EA|1.34211|10/03/2016||Yes|No||10/03/2016||Yes|No|10/03/2016||Yes|No||||No|No|||Prescription required|No|||Yes|1.79681|03/29/2022|1.75368|03/29/2022|1.76536|03/29/2022||||20111|||||No|No||GLENMARK PHARMA|No||||
norethindrone ac-eth estradiol|No|No|No|No|75%|68462065684|NORETHIND-ETH ESTRAD 0.5-2.5|28|EA||10/03/2016||Yes|No||10/03/2016||Yes|No|10/03/2016||Yes|No||||No|No|||Prescription required|No|||Yes|1.79681|03/29/2022|1.75368|03/29/2022|1.76536|03/29/2022||||20112|||||No|No||GLENMARK PHARMA|No||||
norethindrone ac-eth estradiol|No|No|No|No|75%|68462065729|NORETHIN-ETH ESTRAD 1 MG-5 MCG|28|EA|.85646|07/22/2015||Yes|No||07/22/2015||Yes|No|07/22/2015||Yes|No||||No|No|||Prescription required|No|||Yes|1.33067|03/29/2022|1.29873|03/29/2022|1.30738|03/29/2022||||20113|||||No|No||GLENMARK PHARMA|No||||
norethindrone ac-eth estradiol|No|No|No|No|75%|68462065784|NORETHIN-ETH ESTRAD 1 MG-5 MCG|28|EA||10/03/2016||Yes|No||10/03/2016||Yes|No|10/03/2016||Yes|No||||No|No|||Prescription required|No|||Yes|1.33067|03/29/2022|1.29873|03/29/2022|1.30738|03/29/2022||||20114|||||No|No||GLENMARK PHARMA|No||||
norethindrone ac-eth estradiol|No|No|No|No|75%|68462065790|NORETHIN-ETH ESTRAD 1 MG-5 MCG|90|EA|.85627|07/29/2015||Yes|No||07/29/2015||Yes|No|07/29/2015||Yes|No||||No|No|||Prescription required|No|||Yes|1.33067|03/29/2022|1.29873|03/29/2022|1.30738|03/29/2022||||20115|||||No|No||GLENMARK PHARMA|No||||
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|68462067295|LEVONOR-ETH ESTRAD 0.15-0.03|91|EA|.19472|09/14/2015||Yes|No||09/14/2015||Yes|No|09/14/2015||Yes|No|Refer to program requirements|||No|No|09/14/2015||Prescription required|No|||No|.17533|03/29/2022|.17112|03/29/2022|.17226|03/29/2022||||20116|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
sirolimus|No|No|No|No|75%|68462068201|SIROLIMUS 0.5 MG TABLET|100|EA|2.34754|04/01/2021||Yes|No||04/01/2021||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|229|No|4.84817|03/29/2022|4.73181|03/29/2022|4.76332|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|20117|||||No|No||GLENMARK PHARMA|No||||
sirolimus|No|No|No|No|75%|68462068301|SIROLIMUS 1 MG TABLET|100|EA|4.69375|03/12/2021||Yes|No||03/12/2021||Yes|No|03/12/2021||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|229|No|5.87013|03/29/2022|5.72924|03/29/2022|5.7674|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|20118|||||No|No||GLENMARK PHARMA|No||||
sirolimus|No|No|No|No|75%|68462068401|SIROLIMUS 2 MG TABLET|100|EA|9.38754|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|229|No|21.39487|12/07/2021|21.08922|12/07/2021|20.08498|12/07/2021|||IMMUNOSUPPRESSIVES: ORAL|20119|||||No|No||GLENMARK PHARMA|No||||
tacrolimus|No|No|No|No|75%|68462068501|TACROLIMUS 0.5 MG CAPSULE (IR)|100|EA|.14405|04/01/2021||Yes|No||04/01/2021||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||229|No|.26138|03/29/2022|.2551|03/29/2022|.2568|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|20120|||||No|No||GLENMARK PHARMA|No||||
tacrolimus|No|No|No|No|75%|68462068601|TACROLIMUS 1 MG CAPSULE (IR)|100|EA|.2509|04/01/2021||Yes|No||04/01/2021||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||229|No|.35645|03/29/2022|.34789|03/29/2022|.35021|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|20121|||||No|No||GLENMARK PHARMA|No||||
tacrolimus|No|No|No|No|75%|68462068701|TACROLIMUS 5 MG CAPSULE (IR)|100|EA|1.25409|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No||229|No|2.05753|03/29/2022|2.00814|03/29/2022|2.02152|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|20122|||||No|No||GLENMARK PHARMA|No||||
frovatriptan succinate|No|No|No|No|75%|68462069497|FROVATRIPTAN SUCC 2.5 MG TAB|9|EA|12.23731|10/17/2016||Yes|No||10/17/2016||Yes|No|10/17/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|021|No|12.36667|03/29/2022|12.06986|03/29/2022|12.15025|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|20123|||||No|No||GLENMARK PHARMA|No||||
estradiol|No|No|No|No|75%|68462071171|ESTRADIOL 10 MCG VAGINAL INSRT|8|EA|8.34092|12/07/2018||Yes|No||12/07/2018||Yes|No|12/07/2018||Yes|No||||No|No|||Prescription required|No|||Yes|7.83958|03/29/2022|7.65143|03/29/2022|7.70238|03/29/2022||||20124|||||No|No||GLENMARK PHARMA|No||||
estradiol|No|No|No|No|75%|68462071188|ESTRADIOL 10 MCG VAGINAL INSRT|18|EA|8.34128|12/07/2018||Yes|No||12/07/2018||Yes|No|12/07/2018||Yes|No||||No|No|||Prescription required|No|||Yes|7.83958|03/29/2022|7.65143|03/29/2022|7.70238|03/29/2022||||20125|||||No|No||GLENMARK PHARMA|No||||
rufinamide|No|No|No|No|75%|68462071308|RUFINAMIDE 200 MG TABLET|120|EA|3.22908|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No||056|No|7.35931|08/30/2021|7.25417|08/30/2021|6.90874|08/30/2021|||ANTICONVULSANTS|20126|||||No|No||GLENMARK PHARMA|No||||
rufinamide|No|No|No|No|75%|68462071408|RUFINAMIDE 400 MG TABLET|120|EA|6.45813|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No||056|No|5.73268|01/25/2022|5.59509|01/25/2022|5.63235|01/25/2022|||ANTICONVULSANTS|20127|||||No|No||GLENMARK PHARMA|No||||
norgestimate-ethinyl estradiol|Yes|Yes|No|No|75%|68462071929|NORG-EE 0.18-0.215-0.25/0.025|28|EA|.18018|07/18/2016||Yes|No||07/18/2016||Yes|No|07/18/2016||Yes|No|Refer to program requirements|||No|No|07/18/2016||Prescription required|No|||No|.16464|03/29/2022|.16068|03/29/2022|.16175|03/29/2022||||20128|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
ethinyl estradiol/drospirenone|Yes|Yes|No|No|75%|68462072029|DROSPIRENONE-EE 3-0.02 MG TAB|28|EA|.28999|11/20/2015||Yes|No||11/20/2015||Yes|No|11/20/2015||Yes|No|Refer to program requirements|||No|No|11/20/2015||Prescription required|No|||No|.36582|03/29/2022|.35704|03/29/2022|.35941|03/29/2022||||20129|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
theophylline anhydrous|No|No|No|No|75%|68462072101|THEOPHYLLINE ER 300 MG TAB|100|EA|1.47773|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No|||No|2.64018|03/29/2022|2.57681|03/29/2022|2.59397|03/29/2022||||20130|||||No|No||GLENMARK PHARMA|No||||
theophylline anhydrous|No|No|No|No|75%|68462072201|THEOPHYLLINE ER 450 MG TAB|100|EA|2.07939|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|No|||No|4.73908|08/30/2021|4.67138|08/30/2021|4.44893|08/30/2021||||20131|||||No|No||GLENMARK PHARMA|No||||
chlorzoxazone|No|No|No|No|75%|68462072401|CHLORZOXAZONE 375 MG TABLET|100|EA|1.591|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|116|Yes|3.626|08/24/2021|3.5742|08/24/2021|3.404|08/24/2021|||SKELETAL MUSCLE RELAXANTS|20132|||||No|No||GLENMARK PHARMA|No||||
chlorzoxazone|No|No|No|No|75%|68462072501|CHLORZOXAZONE 750 MG TABLET|100|EA|1.7845|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|116|Yes|4.067|08/24/2021|4.0089|08/24/2021|3.818|08/24/2021|||SKELETAL MUSCLE RELAXANTS|20133|||||No|No||GLENMARK PHARMA|No||||
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|68462073129|HAILEY 24 FE 1 MG-20 MCG TAB|28|EA|.31737|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No|Refer to program requirements|||No|No|06/18/2019||Prescription required|No|||No|.56858|03/29/2022|.55493|03/29/2022|.55862|03/29/2022||||20134|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
ethinyl estradiol/drospirenone|Yes|Yes|No|No|75%|68462073329|DROSPIRENONE-EE 3-0.03 MG TAB|28|EA|.18975|08/18/2016||Yes|No||08/18/2016||Yes|No|08/18/2016||Yes|No|Refer to program requirements|||No|No|08/18/2016||Prescription required|No|||No|.2455|03/29/2022|.2396|03/29/2022|.2412|03/29/2022||||20135|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
acyclovir|No|No|No|No|75%|68462074617|ACYCLOVIR 5% OINTMENT|15|GM|.86|12/07/2017||Yes|No||12/07/2017||Yes|No|12/07/2017||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.36934|03/29/2022|1.33647|03/29/2022|1.34537|03/29/2022|||ANTIVIRALS: TOPICAL|20136|||||No|No||GLENMARK PHARMA|No||||
acyclovir|No|No|No|No|75%|68462074635|ACYCLOVIR 5% OINTMENT|30|GM|.86|12/07/2017||Yes|No||12/07/2017||Yes|No|12/07/2017||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.03754|03/29/2022|1.01263|03/29/2022|1.01938|03/29/2022|||ANTIVIRALS: TOPICAL|20137|||||No|No||GLENMARK PHARMA|No||||
tretinoin|No|No|No|No|75%|68462079201|TRETINOIN 10 MG CAPSULE|100|EA|11.5642|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No||173|No|26.35563|05/23/2017|25.97912|05/16/2017|24.74202|05/16/2017|||ONCOLOGY: ORAL - HEMATOLOGIC|20138|||||No|No||GLENMARK PHARMA|No||||
triamcinolone acetonide|No|No|No|No|75%|68462079817|TRIAMCINOLONE 0.5% OINTMENT|15|GM|.23449|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No||||No|No|||Prescription required|No||120|No|.35668|03/29/2022|.34811|03/29/2022|.35043|03/29/2022|||STEROIDS: TOPICAL HIGH|20139|||||No|No||GLENMARK PHARMA|No||||
nystatin/triamcin|No|No|No|No|75%|68462079917|NYSTATIN-TRIAMCINOLONE OINTM|15|GM|.36034|12/28/2016||Yes|No||12/28/2016||Yes|No|12/28/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|061|No|.4296|03/29/2022|.41928|03/29/2022|.42208|03/29/2022|||ANTIFUNGALS: TOPICAL|20140|||||No|No||GLENMARK PHARMA|No||||
nystatin/triamcin|No|No|No|No|75%|68462079935|NYSTATIN-TRIAMCINOLONE OINTM|30|GM|.25298|12/28/2016||Yes|No||12/28/2016||Yes|No|12/28/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|061|No|.33412|03/29/2022|.3261|03/29/2022|.32827|03/29/2022|||ANTIFUNGALS: TOPICAL|20141|||||No|No||GLENMARK PHARMA|No||||
nystatin/triamcin|No|No|No|No|75%|68462079965|NYSTATIN-TRIAMCINOLONE OINTM|60|GM|.18783|12/28/2016||Yes|No||12/28/2016||Yes|No|12/28/2016||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|061|No|.24511|03/29/2022|.23922|03/29/2022|.24082|03/29/2022|||ANTIFUNGALS: TOPICAL|20142|||||No|No||GLENMARK PHARMA|No||||
trimipramine maleate|No|No|No|No|75%|68462080430|TRIMIPRAMINE MALEATE 25 MG CAP|30|EA|1.16057|09/19/2019|08/31/2022|Yes|No||09/19/2019|08/31/2022|Yes|No|09/19/2019|08/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/25/2019|215|No|2.64502|09/24/2019|2.60723|09/19/2019|2.48308|09/19/2019|||ANTIDEPRESSANTS: TRICYCLIC|20143|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||GLENMARK PHARMA|No||||
trimipramine maleate|No|No|No|No|75%|68462080530|TRIMIPRAMINE MALEATE 50 MG CAP|30|EA|1.93428|09/19/2019|08/31/2022|Yes|No||09/19/2019|08/31/2022|Yes|No|09/19/2019|08/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/25/2019|215|No|4.40836|09/19/2019|4.34538|09/19/2019|4.13846|09/19/2019|||ANTIDEPRESSANTS: TRICYCLIC|20144|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||GLENMARK PHARMA|No||||
trimipramine maleate|No|No|No|No|75%|68462080630|TRIMIPRAMINE MALEATE 100 MG CP|30|EA|2.67818|09/19/2019|08/31/2022|Yes|No||09/19/2019|08/31/2022|Yes|No|09/19/2019|08/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/25/2019|215|No|6.10376|09/19/2019|6.01656|09/19/2019|5.73006|09/19/2019|||ANTIDEPRESSANTS: TRICYCLIC|20145|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||GLENMARK PHARMA|No||||
isradipine|Yes|No|No|No|75%|68462080701|ISRADIPINE 2.5 MG CAPSULE|100|EA|.41667|09/20/2019|09/22/2022|Yes|No||09/20/2019|09/22/2022|Yes|No|09/20/2019|09/22/2022|Yes|No||||No|No|01/16/2020|09/22/2022|Prescription required|Yes|01/25/2018|045|No|.94962|09/24/2019|.93605|09/20/2019|.89148|09/20/2019|||CALCIUM CHANNEL BLOCKERS|20146|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GLENMARK PHARMA|No||||
isradipine|Yes|No|No|No|75%|68462080801|ISRADIPINE 5 MG CAPSULE|100|EA|.60935|09/20/2019|09/22/2022|Yes|No||09/20/2019|09/22/2022|Yes|No|09/20/2019|09/22/2022|Yes|No||||No|No|01/16/2020|09/22/2022|Prescription required|Yes|01/25/2018|045|No|1.38875|01/28/2020|1.36891|01/28/2020|1.30373|01/28/2020|||CALCIUM CHANNEL BLOCKERS|20147|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||GLENMARK PHARMA|No||||
arformoterol tartrate|No|No|No|No|75%|68462083335|ARFORMOTEROL 15 MCG/2 ML SOLN|2|ML|3.67843|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|037|Yes|3.35685|03/29/2022|3.27628|03/29/2022|3.2981|03/29/2022|||BRONCHODILATORS: BETA AGONIST|20148|||||No|No||GLENMARK PHARMA|No||||
arformoterol tartrate|No|No|No|No|75%|68462083365|ARFORMOTEROL 15 MCG/2 ML SOLN|2|ML|3.67843|08/30/2021||Yes|No||08/30/2021||Yes|No|08/30/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|037|Yes|3.32444|03/29/2022|3.24465|03/29/2022|3.26626|03/29/2022|||BRONCHODILATORS: BETA AGONIST|20149|||||No|No||GLENMARK PHARMA|No||||
hydrocortisone valerate|No|No|No|No|75%|68462083617|HYDROCORTISONE VAL 0.2% OINTMT|15|GM|2.25664|11/07/2019||Yes|No||11/07/2019||Yes|No|11/07/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|3.63773|08/24/2021|3.55042|08/24/2021|3.57406|08/24/2021|||STEROIDS: TOPICAL MEDIUM|20150|||||No|No||GLENMARK PHARMA|No||||
hydrocortisone valerate|No|No|No|No|75%|68462083647|HYDROCORTISONE VAL 0.2% OINTMT|45|GM|1.51646|11/07/2019||Yes|No||11/07/2019||Yes|No|11/07/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|2.25168|03/01/2022|2.19763|03/01/2022|2.21227|03/01/2022|||STEROIDS: TOPICAL MEDIUM|20151|||||No|No||GLENMARK PHARMA|No||||
hydrocortisone valerate|No|No|No|No|75%|68462083665|HYDROCORTISONE VAL 0.2% OINTMT|60|GM|1.36804|11/07/2019||Yes|No||11/07/2019||Yes|No|11/07/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|3.11787|11/07/2019|3.07332|11/07/2019|2.92698|11/07/2019|||STEROIDS: TOPICAL MEDIUM|20152|||||No|No||GLENMARK PHARMA|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|68462084011|TELMISARTAN-HCTZ 40-12.5 MG TB|1|EA||01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|1.13569|03/29/2022|1.10843|03/29/2022|1.11581|03/29/2022|||ANGIOTENSIN MODULATORS|20153|||||No|No||GLENMARK PHARMA|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|68462084013|TELMISARTAN-HCTZ 40-12.5 MG TB|30|EA|.645|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|1.13569|03/29/2022|1.10843|03/29/2022|1.11581|03/29/2022|||ANGIOTENSIN MODULATORS|20154|||||No|No||GLENMARK PHARMA|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|68462084111|TELMISARTAN-HCTZ 80-12.5 MG TB|1|EA||01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.94301|03/29/2022|.92037|03/29/2022|.9265|03/29/2022|||ANGIOTENSIN MODULATORS|20155|||||No|No||GLENMARK PHARMA|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|68462084113|TELMISARTAN-HCTZ 80-12.5 MG TB|30|EA|.645|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|.94301|03/29/2022|.92037|03/29/2022|.9265|03/29/2022|||ANGIOTENSIN MODULATORS|20156|||||No|No||GLENMARK PHARMA|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|68462084211|TELMISARTAN-HCTZ 80-25 MG TAB|1|EA||01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|1.29965|03/29/2022|1.26845|03/29/2022|1.2769|03/29/2022|||ANGIOTENSIN MODULATORS|20157|||||No|No||GLENMARK PHARMA|No||||
telmisartan/hydrochlorothiazid|No|No|No|No|75%|68462084213|TELMISARTAN-HCTZ 80-25 MG TAB|30|EA|.645|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|1.29965|03/29/2022|1.26845|03/29/2022|1.2769|03/29/2022|||ANGIOTENSIN MODULATORS|20158|||||No|No||GLENMARK PHARMA|No||||
diltiazem HCl|No|No|No|No|75%|68462085001|DILTIAZEM 12HR ER 60 MG CAP|100|EA|1.09125|05/20/2021||Yes|No||05/20/2021||Yes|No|05/20/2021||Yes|No||||No|No|||Prescription required|No||045|No|2.24166|03/29/2022|2.18786|03/29/2022|2.20243|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20159|||||No|No||GLENMARK PHARMA|No||||
diltiazem HCl|No|No|No|No|75%|68462085101|DILTIAZEM 12HR ER 90 MG CAP|100|EA|1.24682|05/20/2021||Yes|No||05/20/2021||Yes|No|05/20/2021||Yes|No||||No|No|||Prescription required|No||045|No|2.28512|11/23/2021|2.23027|11/23/2021|2.24513|11/23/2021|||CALCIUM CHANNEL BLOCKERS|20160|||||No|No||GLENMARK PHARMA|No||||
norethindrone-e.estradiol-iron|No|Yes|No|No|75%|68462085229|CHARLOTTE 24 FE CHEWABLE TAB|28|EA|.92337|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.64997|03/29/2022|.63437|03/29/2022|.63859|03/29/2022||||20161|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
norethindrone-e.estradiol-iron|No|Yes|No|No|75%|68462085284|CHARLOTTE 24 FE CHEWABLE TAB|28|EA||12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.64997|03/29/2022|.63437|03/29/2022|.63859|03/29/2022||||20162|||||No|No||GLENMARK PHARMA|No|||Only covered for non-contraceptive (medical) purposes|
chlorpromazine HCl|No|No|No|No|75%|68462086101|CHLORPROMAZINE 10 MG TABLET|100|EA|.25696|05/24/2021||Yes|No||05/24/2021||Yes|No|05/24/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|1.29919|10/26/2021|1.268|10/26/2021|1.27645|10/26/2021|||ANTIPSYCHOTICS|20163|||||No|No||GLENMARK PHARMA|No||||
chlorpromazine HCl|No|No|No|No|75%|68462086201|CHLORPROMAZINE 25 MG TABLET|100|EA|.36653|05/24/2021||Yes|No||05/24/2021||Yes|No|05/24/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|1.39549|03/29/2022|1.36199|03/29/2022|1.37106|03/29/2022|||ANTIPSYCHOTICS|20164|||||No|No||GLENMARK PHARMA|No||||
chlorpromazine HCl|No|No|No|No|75%|68462086301|CHLORPROMAZINE 50 MG TABLET|100|EA|.68735|05/24/2021||Yes|No||05/24/2021||Yes|No|05/24/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|1.74791|03/29/2022|1.70596|03/29/2022|1.71732|03/29/2022|||ANTIPSYCHOTICS|20165|||||No|No||GLENMARK PHARMA|No||||
chlorpromazine HCl|No|No|No|No|75%|68462086401|CHLORPROMAZINE 100 MG TABLET|100|EA|.9727|05/24/2021||Yes|No||05/24/2021||Yes|No|05/24/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|2.03394|03/29/2022|1.98512|03/29/2022|1.99834|03/29/2022|||ANTIPSYCHOTICS|20166|||||No|No||GLENMARK PHARMA|No||||
chlorpromazine HCl|No|No|No|No|75%|68462086501|CHLORPROMAZINE 200 MG TABLET|100|EA|1.44458|05/25/2021||Yes|No||05/25/2021||Yes|No|05/25/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|4.21034|03/01/2022|4.10929|03/01/2022|4.13665|03/01/2022|||ANTIPSYCHOTICS|20167|||||No|No||GLENMARK PHARMA|No||||
clindamycin phosphate|No|No|No|No|75%|68462086635|CLINDAMYCIN PH 1% GEL|30|GM|.99043|05/20/2021||Yes|No||05/20/2021||Yes|No|05/20/2021||Yes|No||||No|No|||Prescription required|No||104|No|.67613|03/29/2022|.6599|03/29/2022|.66429|03/29/2022|||ACNE AGENTS: TOPICAL|20168|||||No|No||GLENMARK PHARMA|No||||
clindamycin phosphate|No|No|No|No|75%|68462086665|CLINDAMYCIN PH 1% GEL|60|GM|.89203|05/20/2021||Yes|No||05/20/2021||Yes|No|05/20/2021||Yes|No||||No|No|||Prescription required|No||104|No|.47333|03/29/2022|.46197|03/29/2022|.46504|03/29/2022|||ACNE AGENTS: TOPICAL|20169|||||No|No||GLENMARK PHARMA|No||||
factor IX cplx(pcc)no4,3factor|No|No|No|No|75%|68516320701|PROFILNINE 500 UNIT VIAL|1|EA|.9384|07/17/2018||Yes|No||07/17/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.3524|04/06/2021|1.33308|04/06/2021|1.2696|04/06/2021|||HEMOPHILIA TREATMENT|20170|||||No|No||GRIFOLS|No||||
factor IX cplx(pcc)no4,3factor|No|No|No|No|75%|68516320802|PROFILNINE 1,000 UNIT VIAL|1|EA|.9384|07/17/2018||Yes|No||07/17/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.3524|04/06/2021|1.33308|04/06/2021|1.2696|04/06/2021|||HEMOPHILIA TREATMENT|20171|||||No|No||GRIFOLS|No||||
factor IX|No|No|No|No|75%|68516360702|ALPHANINE SD 500 UNIT VIAL|1|EA|1.0064|07/17/2018||Yes|No||07/17/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.4504|04/06/2021|1.42968|04/06/2021|1.3616|04/06/2021|||HEMOPHILIA TREATMENT|20172|||||No|No||GRIFOLS|No||||
factor IX|No|No|No|No|75%|68516360802|ALPHANINE SD 1,000 UNIT VIAL|1|EA|1.0064|07/17/2018||Yes|No||07/17/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.4504|04/06/2021|1.42968|04/06/2021|1.3616|04/06/2021|||HEMOPHILIA TREATMENT|20173|||||No|No||GRIFOLS|No||||
factor IX|No|No|No|No|75%|68516360902|ALPHANINE SD 1,500 UNIT VIAL|1|EA|1.0064|07/17/2018||Yes|No||07/17/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.4504|04/06/2021|1.42968|04/06/2021|1.3616|04/06/2021|||HEMOPHILIA TREATMENT|20174|||||No|No||GRIFOLS|No||||
antihemophilic factor/VWF|No|No|No|No|75%|68516461101|ALPHANATE 250-100 UNIT VIAL|1|EA|.884|07/17/2018||Yes|No||07/17/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.274|04/06/2021|1.2558|04/06/2021|1.196|04/06/2021|||HEMOPHILIA TREATMENT|20175|||||No|No||GRIFOLS|No||||
antihemophilic factor/VWF|No|No|No|No|75%|68516461201|ALPHANATE 500-200 UNIT VIAL|1|EA|.884|07/17/2018||Yes|No||07/17/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.274|04/06/2021|1.2558|04/06/2021|1.196|04/06/2021|||HEMOPHILIA TREATMENT|20176|||||No|No||GRIFOLS|No||||
antihemophilic factor/VWF|No|No|No|No|75%|68516461302|ALPHANATE 1,000-400 UNIT VIAL|1|EA|.884|07/17/2018||Yes|No||07/17/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.274|04/06/2021|1.2558|04/06/2021|1.196|04/06/2021|||HEMOPHILIA TREATMENT|20177|||||No|No||GRIFOLS|No||||
antihemophilic factor/VWF|No|No|No|No|75%|68516461402|ALPHANATE 1,500-600 UNIT VIAL|1|EA|.884|07/17/2018||Yes|No||07/17/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.274|04/06/2021|1.2558|04/06/2021|1.196|04/06/2021|||HEMOPHILIA TREATMENT|20178|||||No|No||GRIFOLS|No||||
antihemophilic factor/VWF|No|No|No|No|75%|68516461502|ALPHANATE 2,000-800 UNIT VIAL|1|EA|.884|07/17/2018||Yes|No||07/17/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.274|04/06/2021|1.2558|04/06/2021|1.196|04/06/2021|||HEMOPHILIA TREATMENT|20179|||||No|No||GRIFOLS|No||||
rasagiline mesylate|No|No|No|No|75%|68546014256|AZILECT 0.5 MG TABLET|30|EA|14.28316|02/05/2007||Yes|No||02/05/2007||Yes|No|02/05/2007||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|015|No|32.0685|01/18/2022|31.29885|01/18/2022|31.5073|01/18/2022|||ANTIPARKINSON'S AGENTS|20180|||||No|No||TEVA NEUROSCIEN|No||||
deutetrabenazine|No|No|No|No|75%|68546017060|AUSTEDO 6 MG TABLET|60|EA|31.67595|08/31/2017||Yes|No||08/31/2017||Yes|No|08/31/2017||Yes|No||||No|No|||Prescription required|No||572|Yes|70.44946|01/18/2022|68.75867|01/18/2022|69.21659|01/18/2022|||MOVEMENT DISORDERS|20181|||||No|No||TEVA USA|No||||
deutetrabenazine|No|No|No|No|75%|68546017160|AUSTEDO 9 MG TABLET|60|EA|35.63553|08/31/2017||Yes|No||08/31/2017||Yes|No|08/31/2017||Yes|No||||No|No|||Prescription required|No||572|Yes|79.73808|01/18/2022|77.82436|01/18/2022|78.34266|01/18/2022|||MOVEMENT DISORDERS|20182|||||No|No||TEVA USA|No||||
deutetrabenazine|No|No|No|No|75%|68546017260|AUSTEDO 12 MG TABLET|60|EA|47.51428|08/31/2017||Yes|No||08/31/2017||Yes|No|08/31/2017||Yes|No||||No|No|||Prescription required|No||572|Yes|106.03217|01/18/2022|103.48739|01/18/2022|104.1766|01/18/2022|||MOVEMENT DISORDERS|20183|||||No|No||TEVA USA|No||||
rasagiline mesylate|No|No|No|No|75%|68546022956|AZILECT 1 MG TABLET|30|EA|14.28316|02/05/2007||Yes|No||02/05/2007||Yes|No|02/05/2007||Yes|No||||No|No|||Prescription required|Yes|02/10/2009|015|No|32.04771|01/18/2022|31.27856|01/18/2022|31.48687|01/18/2022|||ANTIPARKINSON'S AGENTS|20184|||||No|No||TEVA NEUROSCIEN|No||||
glatiramer acetate|No|No|No|No|75%|68546031730|COPAXONE 20 MG/ML SYRINGE|1|ML|101.96733|05/27/2008||Yes|No||05/27/2008||Yes|No|05/27/2008||Yes|No||||No|No|||Prescription required|No||043|No|230.69117|12/21/2021|225.15458|12/21/2021|226.65407|12/21/2021|||MULTIPLE SCLEROSIS AGENTS|20185|||||No|No||TEVA NEUROSCIEN|No||||
glatiramer acetate|No|No|No|No|75%|68546032512|COPAXONE 40 MG/ML SYRINGE|1|ML|208.98|03/06/2014||Yes|No||03/06/2014||Yes|No|03/06/2014||Yes|No||||No|No|||Prescription required|No||043|No|472.31097|12/21/2021|460.9755|12/21/2021|464.04552|12/21/2021|||MULTIPLE SCLEROSIS AGENTS|20186|||||No|No||TEVA NEUROSCIEN|No||||
fluoxetine HCl|Yes|No|No|No|75%|68645013054|FLUOXETINE HCL 20 MG CAPSULE|30|EA|.02472|08/26/2009||Yes|No||08/26/2009||Yes|No|08/26/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20187|||||No|No||LEGACY PHARMACE|No||||
fluoxetine HCl|Yes|No|No|No|75%|68645013154|FLUOXETINE HCL 10 MG CAPSULE|30|EA|.02356|06/24/2009||Yes|No||06/24/2009||Yes|No|06/24/2009||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20188|||||No|No||LEGACY PHARMACE|No||||
famotidine|No|No|No|No|75%|68645014059|FAMOTIDINE 20 MG TABLET|60|EA|.043|02/18/2009||Yes|No||02/18/2009||Yes|No|02/18/2009||Yes|No||||No|No|||Prescription required|No|||No|.03262|03/29/2022|.03183|03/29/2022|.03204|03/29/2022||||20189|||||No|No||LEGACY PHARMACE|No||||
metoprolol tartrate|No|No|No|No|75%|68645019059|METOPROLOL TARTRATE 50 MG TAB|60|EA|.01431|02/18/2009||Yes|No||02/18/2009||Yes|No|02/18/2009||Yes|No||||No|No|||Prescription required|No||070|No|.02252|03/29/2022|.02197|03/29/2022|.02212|03/29/2022|||BETA-BLOCKERS|20190|||||No|No||LEGACY PHARMACE|No||||
metoprolol tartrate|No|No|No|No|75%|68645019159|METOPROLOL TARTRATE 100 MG TAB|60|EA|.01978|02/18/2009||Yes|No||02/18/2009||Yes|No|02/18/2009||Yes|No||||No|No|||Prescription required|No||070|No|.03443|03/29/2022|.0336|03/29/2022|.03382|03/29/2022|||BETA-BLOCKERS|20191|||||No|No||LEGACY PHARMACE|No||||
metformin HCl|Yes|No|No|No|75%|68645030059|METFORMIN HCL 1,000 MG TABLET|60|EA|.05611|06/06/2012||Yes|No||06/06/2012||Yes|No|06/06/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|20192|||||No|No||LEGACY PHARMACE|No||||
carvedilol|No|No|No|No|75%|68645035059|CARVEDILOL 6.25 MG TABLET|60|EA|.043|06/06/2012||Yes|No||06/06/2012||Yes|No|06/06/2012||Yes|No||||No|No|||Prescription required|No||070|No|.02069|03/29/2022|.02019|03/29/2022|.02032|03/29/2022|||BETA-BLOCKERS|20193|||||No|No||LEGACY PHARMACE|No||||
carvedilol|No|No|No|No|75%|68645035159|CARVEDILOL 12.5 MG TABLET|60|EA|.043|06/06/2012||Yes|No||06/06/2012||Yes|No|06/06/2012||Yes|No||||No|No|||Prescription required|No||070|No|.02277|03/29/2022|.02222|03/29/2022|.02237|03/29/2022|||BETA-BLOCKERS|20194|||||No|No||LEGACY PHARMACE|No||||
enalapril maleate|Yes|No|No|No|75%|68645045590|ENALAPRIL MALEATE 5 MG TABLET|90|EA|.23882|05/24/2013||Yes|No||05/24/2013||Yes|No|05/24/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.15947|03/29/2022|.15564|03/29/2022|.15667|03/29/2022|||ANGIOTENSIN MODULATORS|20195|||||No|No||LEGACY PHARMACE|No||||
enalapril maleate|Yes|No|No|No|75%|68645045690|ENALAPRIL MALEATE 10 MG TAB|90|EA|.25072|05/24/2013||Yes|No||05/24/2013||Yes|No|05/24/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.11378|03/29/2022|.11104|03/29/2022|.11178|03/29/2022|||ANGIOTENSIN MODULATORS|20196|||||No|No||LEGACY PHARMACE|No||||
enalapril maleate|Yes|No|No|No|75%|68645045790|ENALAPRIL MALEATE 20 MG TAB|90|EA|.3568|05/24/2013||Yes|No||05/24/2013||Yes|No|05/24/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.14625|03/29/2022|.14274|03/29/2022|.14369|03/29/2022|||ANGIOTENSIN MODULATORS|20197|||||No|No||LEGACY PHARMACE|No||||
simvastatin|Yes|No|No|No|75%|68645047054|SIMVASTATIN 20 MG TABLET|30|EA|.03526|11/06/2013||Yes|No||11/06/2013||Yes|No|11/06/2013||Yes|No||||No|No|07/01/2016||Prescription required|No||063|Yes|.02604|03/29/2022|.02541|03/29/2022|.02558|03/29/2022|||LIPOTROPICS: STATINS|20198|||||No|No||LEGACY PHARMACE|No||||
metoprolol succinate|No|No|No|No|75%|68645047754|METOPROLOL SUCC ER 25 MG TAB|30|EA|.32223|03/18/2014||Yes|No||03/18/2014||Yes|No|03/18/2014||Yes|No||||No|No|||Prescription required|No||070|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||BETA-BLOCKERS|20199|||||No|No||LEGACY PHARMACE|No||||
metoprolol succinate|No|No|No|No|75%|68645047854|METOPROLOL SUCC ER 50 MG TAB|30|EA|.32223|03/18/2014||Yes|No||03/18/2014||Yes|No|03/18/2014||Yes|No||||No|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|20200|||||No|No||LEGACY PHARMACE|No||||
metoprolol succinate|No|No|No|No|75%|68645047954|METOPROLOL SUCC ER 100 MG TAB|30|EA|.48426|03/18/2014||Yes|No||03/18/2014||Yes|No|03/18/2014||Yes|No||||No|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|20201|||||No|No||LEGACY PHARMACE|No||||
atorvastatin calcium|No|No|No|No|75%|68645048054|ATORVASTATIN 10 MG TABLET|30|EA|.09106|08/24/2017|06/30/2022|Yes|No||08/24/2017|06/30/2022|Yes|No|08/24/2017|06/30/2022|Yes|No||||No|No|||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|20202|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||LEGACY PHARMACE|No||||
atorvastatin calcium|No|No|No|No|75%|68645048154|ATORVASTATIN 20 MG TABLET|30|EA|.12961|08/24/2017|06/30/2022|Yes|No||08/24/2017|06/30/2022|Yes|No|08/24/2017|06/30/2022|Yes|No||||No|No|||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|20203|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||LEGACY PHARMACE|No||||
pantoprazole sodium|No|No|No|No|75%|68645049154|PANTOPRAZOLE SOD DR 40 MG TAB|30|EA|.09746|07/16/2015||Yes|No||07/16/2015||Yes|No|07/16/2015||Yes|No||||No|No|||Prescription required|No||047|No|.05828|03/29/2022|.05688|03/29/2022|.05726|03/29/2022|||PROTON PUMP INHIBITORS|20204|||||No|No||LEGACY PHARMACE|No||||
pantoprazole sodium|No|No|No|No|75%|68645049254|PANTOPRAZOLE SOD DR 40 MG TAB|30|EA|.09746|08/24/2017|01/31/2022|Yes|No||08/24/2017|01/31/2022|Yes|No|08/24/2017|01/31/2022|Yes|No||||No|No|||Prescription required|No||047|No|.22212|02/15/2022|.21895|02/15/2022|.20852|02/15/2022|||PROTON PUMP INHIBITORS|20205|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||LEGACY PHARMACE|No||||
losartan potassium|Yes|No|No|No|75%|68645049454|LOSARTAN POTASSIUM 50 MG TAB|30|EA|.08934|02/18/2015||Yes|No||02/18/2015||Yes|No|02/18/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|20206|||||No|No||LEGACY PHARMACE|No||||
atorvastatin calcium|Yes|No|No|No|75%|68645049554|ATORVASTATIN 80 MG TABLET|30|EA|.12961|07/16/2015|06/30/2022|Yes|No||07/16/2015|06/30/2022|Yes|No|07/16/2015|06/30/2022|Yes|No||||No|No|07/01/2016|06/30/2022|Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|20207|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||LEGACY PHARMACE|No||||
carvedilol|No|No|No|No|75%|68645049659|CARVEDILOL 25 MG TABLET|60|EA|.043|07/16/2015||Yes|No||07/16/2015||Yes|No|07/16/2015||Yes|No||||No|No|||Prescription required|No||070|No|.03449|03/29/2022|.03366|03/29/2022|.03388|03/29/2022|||BETA-BLOCKERS|20208|||||No|No||LEGACY PHARMACE|No||||
hydrochlorothiazide|No|No|No|No|75%|68645051054|HYDROCHLOROTHIAZIDE 25 MG TAB|30|EA|.00851|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|||Prescription required|No|||Yes|.01337|03/29/2022|.01304|03/29/2022|.01313|03/29/2022||||20209|||||No|No||LEGACY PHARMACE|No||||
nifedipine|No|No|No|No|75%|68645051254|NIFEDIPINE ER 30 MG TABLET|30|EA|.45988|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No||||No|No|||Prescription required|No||045|Yes|.17922|03/29/2022|.17491|03/29/2022|.17608|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20210|||||No|No||LEGACY PHARMACE|No||||
nifedipine|No|No|No|No|75%|68645051354|NIFEDIPINE ER 60 MG TABLET|30|EA|.79614|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No||||No|No|||Prescription required|No||045|No|.23953|03/29/2022|.23378|03/29/2022|.23533|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20211|||||No|No||LEGACY PHARMACE|No||||
amlodipine besylate|Yes|No|No|No|75%|68645051554|AMLODIPINE BESYLATE 5 MG TAB|30|EA|.03721|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|02/21/2017||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20212|||||No|No||LEGACY PHARMACE|No||||
amlodipine besylate|Yes|No|No|No|75%|68645051654|AMLODIPINE BESYLATE 10 MG TAB|30|EA|.05107|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|02/21/2017||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20213|||||No|No||LEGACY PHARMACE|No||||
escitalopram oxalate|Yes|No|No|No|75%|68645051954|ESCITALOPRAM 10 MG TABLET|30|EA|.07955|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|02/21/2017||Prescription required|No||008|Yes|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20214|||||No|No||LEGACY PHARMACE|No||||
escitalopram oxalate|Yes|No|No|No|75%|68645052054|ESCITALOPRAM 20 MG TABLET|30|EA|.08385|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|02/21/2017||Prescription required|No||008|No|.07845|03/29/2022|.07656|03/29/2022|.07707|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20215|||||No|No||LEGACY PHARMACE|No||||
sertraline HCl|Yes|No|No|No|75%|68645052154|SERTRALINE HCL 25 MG TABLET|30|EA|.11022|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|02/21/2017||Prescription required|No||008|Yes|.05057|03/29/2022|.04935|03/29/2022|.04968|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20216|||||No|No||LEGACY PHARMACE|No||||
sertraline HCl|Yes|No|No|No|75%|68645052254|SERTRALINE HCL 50 MG TABLET|30|EA|.11022|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|02/21/2017||Prescription required|No||008|Yes|.04281|03/29/2022|.04178|03/29/2022|.04206|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20217|||||No|No||LEGACY PHARMACE|No||||
sertraline HCl|Yes|No|No|No|75%|68645052354|SERTRALINE HCL 100 MG TABLET|30|EA|.11022|02/21/2017||Yes|No||02/21/2017||Yes|No|02/21/2017||Yes|No||||No|No|02/21/2017||Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20218|||||No|No||LEGACY PHARMACE|No||||
simvastatin|No|No|No|No|75%|68645052754|SIMVASTATIN 40 MG TABLET|30|EA|.04601|08/12/2016||Yes|No||08/12/2016||Yes|No|08/12/2016||Yes|No||||No|No|||Prescription required|No||063|Yes|.04431|03/29/2022|.04324|03/29/2022|.04353|03/29/2022|||LIPOTROPICS: STATINS|20219|||||No|No||LEGACY PHARMACE|No||||
lisinopril|No|No|No|No|75%|68645053254|LISINOPRIL 20 MG TABLET|30|EA|.02918|08/23/2017||Yes|No||08/23/2017||Yes|No|08/23/2017||Yes|No||||No|No|||Prescription required|No||113|No|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANGIOTENSIN MODULATORS|20220|||||No|No||LEGACY PHARMACE|No||||
metformin HCl|Yes|No|No|No|75%|68645054459|METFORMIN HCL 500 MG TABLET|60|EA|.02691|08/24/2017||Yes|No||08/24/2017||Yes|No|08/24/2017||Yes|No||||No|No|08/24/2017||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|20221|||||No|No||LEGACY PHARMACE|No||||
metformin HCl|No|No|No|No|75%|68645054559|METFORMIN HCL 1,000 MG TABLET|60|EA|.05611|08/24/2017||Yes|No||08/24/2017||Yes|No|08/24/2017||Yes|No||||No|No|||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|20222|||||No|No||LEGACY PHARMACE|No||||
metformin HCl|No|No|No|No|75%|68645054659|METFORMIN HCL 1,000 MG TABLET|60|EA|.05611|08/24/2017||Yes|No||08/24/2017||Yes|No|08/24/2017||Yes|No||||No|No|||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|20223|||||No|No||LEGACY PHARMACE|No||||
metformin HCl|No|No|No|No|75%|68645054759|METFORMIN HCL 850 MG TABLET|60|EA|.03379|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|20224|||||No|No||LEGACY PHARMACE|No||||
metformin HCl|No|No|No|No|75%|68645054859|METFORMIN HCL 850 MG TABLET|60|EA|.03379|05/16/2017|01/31/2022|Yes|No||05/16/2017|01/31/2022|Yes|No|05/16/2017|01/31/2022|Yes|No||||No|No|||Prescription required|No||012|No|.07701|02/15/2022|.07591|02/15/2022|.0723|02/15/2022|||HYPOGLYCEMICS: METFORMINS|20225|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||LEGACY PHARMACE|No||||
lisinopril|No|No|No|No|75%|68645055054|LISINOPRIL 2.5 MG TABLET|30|EA|.01053|08/24/2017||Yes|No||08/24/2017||Yes|No|08/24/2017||Yes|No||||No|No|||Prescription required|No||113|No|.01617|03/29/2022|.01578|03/29/2022|.01588|03/29/2022|||ANGIOTENSIN MODULATORS|20226|||||No|No||LEGACY PHARMACE|No||||
lisinopril|No|No|No|No|75%|68645055154|LISINOPRIL 5 MG TABLET|30|EA|.01053|08/24/2017||Yes|No||08/24/2017||Yes|No|08/24/2017||Yes|No||||No|No|||Prescription required|No||113|No|.01549|03/29/2022|.01511|03/29/2022|.01521|03/29/2022|||ANGIOTENSIN MODULATORS|20227|||||No|No||LEGACY PHARMACE|No||||
lisinopril|No|No|No|No|75%|68645055254|LISINOPRIL 10 MG TABLET|30|EA|.01947|12/21/2017||Yes|No||12/21/2017||Yes|No|12/21/2017||Yes|No||||No|No|||Prescription required|No||113|No|.01914|03/29/2022|.01868|03/29/2022|.0188|03/29/2022|||ANGIOTENSIN MODULATORS|20228|||||No|No||LEGACY PHARMACE|No||||
lisinopril|No|No|No|No|75%|68645055354|LISINOPRIL 20 MG TABLET|30|EA|.02918|08/23/2017||Yes|No||08/23/2017||Yes|No|08/23/2017||Yes|No||||No|No|||Prescription required|No||113|No|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANGIOTENSIN MODULATORS|20229|||||No|No||LEGACY PHARMACE|No||||
lisinopril|No|No|No|No|75%|68645055454|LISINOPRIL 30 MG TABLET|30|EA|.04673|12/21/2017||Yes|No||12/21/2017||Yes|No|12/21/2017||Yes|No||||No|No|||Prescription required|No||113|No|.05487|03/29/2022|.05355|03/29/2022|.0539|03/29/2022|||ANGIOTENSIN MODULATORS|20230|||||No|No||LEGACY PHARMACE|No||||
lisinopril|No|No|No|No|75%|68645055554|LISINOPRIL 40 MG TABLET|30|EA|.05262|08/24/2017||Yes|No||08/24/2017||Yes|No|08/24/2017||Yes|No||||No|No|||Prescription required|No||113|No|.04778|03/29/2022|.04663|03/29/2022|.04694|03/29/2022|||ANGIOTENSIN MODULATORS|20231|||||No|No||LEGACY PHARMACE|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|68645055654|LISINOPRIL-HCTZ 10-12.5 MG TAB|30|EA|.04063|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.03674|03/29/2022|.03585|03/29/2022|.03609|03/29/2022|||ANGIOTENSIN MODULATORS|20232|||||No|No||LEGACY PHARMACE|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|68645055754|LISINOPRIL-HCTZ 20-12.5 MG TAB|30|EA|.06067|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.04909|03/29/2022|.04791|03/29/2022|.04823|03/29/2022|||ANGIOTENSIN MODULATORS|20233|||||No|No||LEGACY PHARMACE|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|68645055854|LISINOPRIL-HCTZ 20-25 MG TAB|30|EA|.07025|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No||113|Yes|.04948|03/29/2022|.04829|03/29/2022|.04861|03/29/2022|||ANGIOTENSIN MODULATORS|20234|||||No|No||LEGACY PHARMACE|No||||
citalopram hydrobromide|No|No|No|No|75%|68645055954|CITALOPRAM HBR 40 MG TABLET|30|EA|.05035|04/08/2021||Yes|No||04/08/2021||Yes|No|04/08/2021||Yes|No||||No|No|||Prescription required|No||008|No|.03726|03/29/2022|.03636|03/29/2022|.0366|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20235|||||No|No||LEGACY PHARMACE|No||||
montelukast sodium|No|No|No|No|75%|68645056054|MONTELUKAST SOD 10 MG TABLET|30|EA|.18275|04/08/2021||Yes|No||04/08/2021||Yes|No|04/08/2021||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|20236|||||No|No||LEGACY PHARMACE|No||||
ibuprofen|No|No|No|No|75%|68645056259|IBUPROFEN 600 MG TABLET|60|EA|.0479|04/08/2021||Yes|No||04/08/2021||Yes|No|04/08/2021||Yes|No||||No|No|||Prescription required|No||059|Yes|.06063|03/29/2022|.05917|03/29/2022|.05956|03/29/2022|||NSAIDS|20237|||||No|No||LEGACY PHARMACE|No||||
ibuprofen|No|No|No|No|75%|68645056354|IBUPROFEN 800 MG TABLET|30|EA|.06638|03/21/2018||Yes|No||03/21/2018||Yes|No|03/21/2018||Yes|No||||No|No|||Prescription required|No||059|Yes|.07481|03/29/2022|.07301|03/29/2022|.0735|03/29/2022|||NSAIDS|20238|||||No|No||LEGACY PHARMACE|No||||
lovastatin|Yes|No|No|No|75%|68645056690|LOVASTATIN 20 MG TABLET|90|EA|.09259|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||063|Yes|.04992|03/29/2022|.04872|03/29/2022|.04904|03/29/2022|||LIPOTROPICS: STATINS|20239|||||No|No||LEGACY PHARMACE|No||||
lovastatin|Yes|No|No|No|75%|68645056790|LOVASTATIN 40 MG TABLET|90|EA|.14878|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||063|Yes|.0616|03/29/2022|.06012|03/29/2022|.06052|03/29/2022|||LIPOTROPICS: STATINS|20240|||||No|No||LEGACY PHARMACE|No||||
atorvastatin calcium|Yes|No|No|No|75%|68645056854|ATORVASTATIN 40 MG TABLET|30|EA|.12961|04/11/2019|05/31/2022|Yes|No||04/11/2019|05/31/2022|Yes|No|04/11/2019|05/31/2022|Yes|No||||No|No|09/04/2019|05/31/2022|Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|20241|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||LEGACY PHARMACE|No||||
citalopram hydrobromide|Yes|No|No|No|75%|68645056954|CITALOPRAM HBR 10 MG TABLET|30|EA|.04794|04/11/2019|08/31/2022|Yes|No||04/11/2019|08/31/2022|Yes|No|04/11/2019|08/31/2022|Yes|No||||No|No|09/04/2019|08/31/2022|Prescription required|No||008|Yes|.02682|03/29/2022|.02617|03/29/2022|.02635|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20242|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||LEGACY PHARMACE|No||||
citalopram hydrobromide|Yes|No|No|No|75%|68645057054|CITALOPRAM HBR 20 MG TABLET|30|EA|.04945|04/11/2019|09/30/2022|Yes|No||04/11/2019|09/30/2022|Yes|No|04/11/2019|09/30/2022|Yes|No||||No|No|09/04/2019|09/30/2022|Prescription required|No||008|Yes|.02946|03/29/2022|.02875|03/29/2022|.02894|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20243|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||LEGACY PHARMACE|No||||
citalopram hydrobromide|Yes|No|No|No|75%|68645057154|CITALOPRAM HBR 40 MG TABLET|30|EA|.05035|04/11/2019|11/30/2022|Yes|No||04/11/2019|11/30/2022|Yes|No|04/11/2019|11/30/2022|Yes|No||||No|No|09/04/2019|11/30/2022|Prescription required|No||008|No|.03726|03/29/2022|.03636|03/29/2022|.0366|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20244|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||LEGACY PHARMACE|No||||
glimepiride|Yes|No|No|No|75%|68645057290|GLIMEPIRIDE 2 MG TABLET|90|EA|.0623|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|09/04/2019||Prescription required|No|||No|.03979|03/29/2022|.03883|03/29/2022|.03909|03/29/2022||||20245|||||No|No||LEGACY PHARMACE|No||||
glimepiride|Yes|No|No|No|75%|68645057390|GLIMEPIRIDE 4 MG TABLET|90|EA|.11751|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|09/04/2019||Prescription required|No|||No|.04419|03/29/2022|.04312|03/29/2022|.04341|03/29/2022||||20246|||||No|No||LEGACY PHARMACE|No||||
glipizide|Yes|No|No|No|75%|68645057454|GLIPIZIDE 5 MG TABLET|30|EA|.019|11/19/2018||Yes|No||11/19/2018||Yes|No|11/19/2018||Yes|No||||No|No|06/18/2019||Prescription required|No|||No|.03474|03/29/2022|.0339|03/29/2022|.03413|03/29/2022||||20247|||||No|No||LEGACY PHARMACE|No||||
glipizide|Yes|No|No|No|75%|68645057559|GLIPIZIDE 10 MG TABLET|60|EA|.02687|11/19/2018||Yes|No||11/19/2018||Yes|No|11/19/2018||Yes|No||||No|No|06/18/2019||Prescription required|No|||No|.04827|03/29/2022|.04711|03/29/2022|.04742|03/29/2022||||20248|||||No|No||LEGACY PHARMACE|No||||
metformin HCl|Yes|No|No|No|75%|68645058259|METFORMIN HCL 500 MG TABLET|60|EA|.02691|05/05/2020||Yes|No||05/05/2020||Yes|No|05/05/2020||Yes|No||||No|No|05/05/2020||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|20249|||||No|No||LEGACY PHARMACE|No||||
metformin HCl|No|No|No|No|75%|68645058359|METFORMIN HCL 850 MG TABLET|60|EA|.03379|09/21/2020||Yes|No||09/21/2020||Yes|No|09/21/2020||Yes|No||||No|No|||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|20250|||||No|No||LEGACY PHARMACE|No||||
metformin HCl|Yes|No|No|No|75%|68645058459|METFORMIN HCL 1,000 MG TABLET|60|EA|.05611|05/05/2020||Yes|No||05/05/2020||Yes|No|05/05/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|20251|||||No|No||LEGACY PHARMACE|No||||
losartan potassium|No|No|No|No|75%|68645058654|LOSARTAN POTASSIUM 50 MG TAB|30|EA|.08935|09/28/2020||Yes|No||09/28/2020||Yes|No|09/28/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.07314|03/29/2022|.07138|03/29/2022|.07186|03/29/2022|||ANGIOTENSIN MODULATORS|20252|||||No|No||LEGACY PHARMACE|No||||
lisinopril|Yes|No|No|No|75%|68645058754|LISINOPRIL 10 MG TABLET|30|EA||02/03/2020||Yes|No||02/03/2020||Yes|No|02/03/2020||Yes|No||||No|No|03/20/2020||Prescription required|No||113|No|.01914|03/29/2022|.01868|03/29/2022|.0188|03/29/2022|||ANGIOTENSIN MODULATORS|20253|||||No|No||LEGACY PHARMACE|No||||
lisinopril/hydrochlorothiazide|Yes|No|No|No|75%|68645058854|LISINOPRIL-HCTZ 20-12.5 MG TAB|30|EA|.06067|02/03/2020||Yes|No||02/03/2020||Yes|No|02/03/2020||Yes|No||||No|No|03/20/2020||Prescription required|No||113|Yes|.04909|03/29/2022|.04791|03/29/2022|.04823|03/29/2022|||ANGIOTENSIN MODULATORS|20254|||||No|No||LEGACY PHARMACE|No||||
clopidogrel bisulfate|No|No|No|No|75%|68645059090|CLOPIDOGREL 75 MG TABLET|90|EA|.07168|03/16/2020||Yes|No||03/16/2020||Yes|No|03/16/2020||Yes|No||||No|No|||Prescription required|No||004|No|.067|03/29/2022|.06539|03/29/2022|.06582|03/29/2022|||PLATELET AGGREGATION INHIBITORS|20255|||||No|No||LEGACY PHARMACE|No||||
lisinopril|No|No|No|No|75%|68645059354|LISINOPRIL 40 MG TABLET|30|EA|.05262|01/20/2022||Yes|No||01/20/2022||Yes|No|01/20/2022||Yes|No||||No|No|||Prescription required|No||113|No|.04778|03/29/2022|.04663|03/29/2022|.04694|03/29/2022|||ANGIOTENSIN MODULATORS|20256|||||No|No||LEGACY PHARMACE|No||||
famotidine|No|No|No|No|75%|68645059459|FAMOTIDINE 20 MG TABLET|60|EA|.043|03/29/2022||Yes|No||03/29/2022||Yes|No|03/29/2022||Yes|No||||No|No|||Prescription required|No|||No|.03262|03/29/2022|.03183|03/29/2022|.03204|03/29/2022||||20257|||||No|No||LEGACY PHARMACE|No||||
bexarotene|No|No|No|No|75%|68682000310|BEXAROTENE 75 MG CAPSULE|100|EA|96.15771|01/15/2018||Yes|No||01/15/2018||Yes|No|01/15/2018||Yes|No||||No|No|||Prescription required|No|||No|219.15014|01/15/2018|216.01943|01/15/2018|205.73279|01/15/2018||||20258|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682000610|DILTIAZEM 30 MG TABLET|100|EA|.35806|02/20/2018||Yes|No||02/20/2018||Yes|No|02/20/2018||Yes|No||||No|No|||Prescription required|No||045|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20259|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682000650|DILTIAZEM 30 MG TABLET|500|EA|.35175|02/20/2018||Yes|No||02/20/2018||Yes|No|02/20/2018||Yes|No||||No|No|||Prescription required|No||045|No|.08799|03/29/2022|.08587|03/29/2022|.08645|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20260|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682000710|DILTIAZEM 60 MG TABLET|100|EA|.56145|03/27/2018||Yes|No||03/27/2018||Yes|No|03/27/2018||Yes|No||||No|No|||Prescription required|No||045|No|.18408|03/29/2022|.17966|03/29/2022|.18085|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20261|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682000750|DILTIAZEM 60 MG TABLET|500|EA|.55157|03/27/2018||Yes|No||03/27/2018||Yes|No|03/27/2018||Yes|No||||No|No|||Prescription required|No||045|No|.18408|03/29/2022|.17966|03/29/2022|.18085|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20262|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682000810|DILTIAZEM 90 MG TABLET|100|EA|.76763|03/27/2018||Yes|No||03/27/2018||Yes|No|03/27/2018||Yes|No||||No|No|||Prescription required|No||045|No|.24252|03/29/2022|.23669|03/29/2022|.23827|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20263|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682000850|DILTIAZEM 90 MG TABLET|500|EA|.76765|05/16/2018||Yes|No||05/16/2018||Yes|No|05/16/2018||Yes|No||||No|No|||Prescription required|No||045|No|.24252|03/29/2022|.23669|03/29/2022|.23827|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20264|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682000910|DILTIAZEM 120 MG TABLET|100|EA|1.03359|03/27/2018||Yes|No||03/27/2018||Yes|No|03/27/2018||Yes|No||||No|No|||Prescription required|No||045|No|.30465|03/29/2022|.29733|03/29/2022|.29931|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20265|||||No|No||OCEANSIDE PHARM|No||||
sulfacetamide sodium|No|No|No|No|75%|68682001004|SODIUM SULFACETAMIDE 10% LOTN|118|ML|.57211|12/15/2017||Yes|No||12/15/2017||Yes|No|12/15/2017||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|104|No|.79229|03/29/2022|.77327|03/29/2022|.77842|03/29/2022|||ACNE AGENTS: TOPICAL|20266|||||No|No||OCEANSIDE PHARM|No||||
ethacrynic acid|No|No|No|No|75%|68682001110|ETHACRYNIC ACID 25 MG TABLET|100|EA|8.58168|04/12/2017||Yes|No||04/12/2017||Yes|No|04/12/2017||Yes|No||||No|No|||Prescription required|No|||No|2.34378|03/01/2022|2.28752|03/01/2022|2.30276|03/01/2022||||20267|||||No|No||OCEANSIDE PHARM|No||||
metformin HCl|No|No|No|No|75%|68682001890|METFORMIN ER 1,000 MG GASTR-TB|90|EA|5.97221|05/23/2018||Yes|No||05/23/2018||Yes|No|05/23/2018||Yes|No||||No|No|||Prescription required|No||012|No|6.02577|03/29/2022|5.88115|03/29/2022|5.92031|03/29/2022|||HYPOGLYCEMICS: METFORMINS|20268|||||No|No||OCEANSIDE PHARM|No||||
penicillamine|No|No|No|No|75%|68682002010|PENICILLAMINE 250 MG CAPSULE|100|EA|101.23743|09/18/2019||Yes|No||09/18/2019||Yes|No|09/18/2019||Yes|No||||No|No|||Prescription required|No|||No|230.72718|09/18/2019|227.43107|09/18/2019|216.60102|09/18/2019||||20269|||||No|No||OCEANSIDE PHARM|No||||
metformin HCl|No|No|No|No|75%|68682002150|METFORMIN ER 500 MG GASTRC-TB|100|EA|3.01|05/30/2018||Yes|No||05/30/2018||Yes|No|05/30/2018||Yes|No||||No|No|||Prescription required|No||012|No|2.40128|03/29/2022|2.34364|03/29/2022|2.35925|03/29/2022|||HYPOGLYCEMICS: METFORMINS|20270|||||No|No||OCEANSIDE PHARM|No||||
methazolamide|No|No|No|No|75%|68682002210|METHAZOLAMIDE 25 MG TABLET|100|EA|1.31782|04/08/2021||Yes|No||04/08/2021||Yes|No|04/08/2021||Yes|No||||No|No|||Prescription required|No|||No|2.09477|03/01/2022|2.04449|03/01/2022|2.05811|03/01/2022||||20271|||||No|No||OCEANSIDE PHARM|No||||
methazolamide|No|No|No|No|75%|68682002310|METHAZOLAMIDE 50 MG TABLET|100|EA|2.63577|04/30/2021||Yes|No||04/30/2021||Yes|No|04/30/2021||Yes|No||||No|No|||Prescription required|No|||No|4.4571|03/29/2022|4.35012|03/29/2022|4.3791|03/29/2022||||20272|||||No|No||OCEANSIDE PHARM|No||||
timolol maleate|No|No|No|No|75%|68682004525|TIMOLOL 0.5% EYE DROP|2.5|ML|25.15156|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|088|No|37.3288|09/28/2021|36.4329|09/28/2021|36.67554|09/28/2021|||OPHTHALMICS: GLAUCOMA AGENTS|20273|||||No|No||OCEANSIDE PHARM|No||||
timolol maleate|No|No|No|No|75%|68682004550|TIMOLOL 0.5% EYE DROP|5|ML|25.14984|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|088|No|31.3164|01/25/2022|30.5648|01/25/2022|30.76836|01/25/2022|||OPHTHALMICS: GLAUCOMA AGENTS|20274|||||No|No||OCEANSIDE PHARM|No||||
pentoxifylline|No|No|No|No|75%|68682010110|PENTOXIFYLLINE ER 400 MG TAB|100|EA|.15488|12/09/2016|01/07/2023|Yes|No||12/09/2016|01/07/2023|Yes|No|12/09/2016|01/07/2023|Yes|No||||No|No|||Prescription required|No|||No|.26964|03/29/2022|.26316|03/29/2022|.26492|03/29/2022||||20275|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||OCEANSIDE PHARM|No||||
pentoxifylline|No|No|No|No|75%|68682010150|PENTOXIFYLLINE ER 400 MG TAB|500|EA|.15102|12/09/2016|01/07/2023|Yes|No||12/09/2016|01/07/2023|Yes|No|12/09/2016|01/07/2023|Yes|No||||No|No|||Prescription required|No|||No|.26964|03/29/2022|.26316|03/29/2022|.26492|03/29/2022||||20276|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||OCEANSIDE PHARM|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|68682010230|OMEPRAZOLE-BICARB 20-1,100 CAP|30|EA|4.77916|08/15/2018|02/22/2022|Yes|No||08/15/2018|02/22/2022|Yes|No|08/15/2018|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|10.89204|09/28/2021|10.73644|09/28/2021|10.22518|09/28/2021|||PROTON PUMP INHIBITORS|20277|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||OCEANSIDE PHARM|No||||
diclofenac sodium|No|No|No|No|75%|68682010301|DICLOFENAC SOD ER 100 MG TAB|100|EA|.96728|06/04/2018||Yes|No||06/04/2018||Yes|No|06/04/2018||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|1.0568|03/29/2022|1.03143|03/29/2022|1.0383|03/29/2022|||NSAIDS|20278|||||No|No||OCEANSIDE PHARM|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|68682010430|OMEPRAZOLE-BICARB 40-1,100 CAP|30|EA|4.77916|08/01/2018||Yes|No||08/01/2018||Yes|No|08/01/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|1.14084|03/29/2022|1.11345|03/29/2022|1.12087|03/29/2022|||PROTON PUMP INHIBITORS|20279|||||No|No||OCEANSIDE PHARM|No||||
nifedipine|Yes|No|No|No|75%|68682010510|NIFEDIPINE ER 30 MG TABLET|100|EA|.49953|11/19/2018||Yes|No||11/19/2018||Yes|No|11/19/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||045|Yes|.20358|03/29/2022|.19869|03/29/2022|.20001|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20280|||||No|No||OCEANSIDE PHARM|No||||
nifedipine|Yes|No|No|No|75%|68682010610|NIFEDIPINE ER 60 MG TABLET|100|EA|.88979|11/19/2018||Yes|No||11/19/2018||Yes|No|11/19/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||045|No|.22381|03/29/2022|.21843|03/29/2022|.21989|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20281|||||No|No||OCEANSIDE PHARM|No||||
nifedipine|No|No|No|No|75%|68682010710|NIFEDIPINE ER 90 MG TABLET|100|EA|1.04279|12/05/2016||Yes|No||12/05/2016||Yes|No|12/05/2016||Yes|No||||No|No|||Prescription required|No||045|No|.3781|03/29/2022|.36902|03/29/2022|.37148|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20282|||||No|No||OCEANSIDE PHARM|No||||
nifedipine|No|No|No|No|75%|68682010830|NIFEDIPINE ER 30 MG TABLET|300|EA|.4507|10/30/2017||Yes|No||10/30/2017||Yes|No|10/30/2017||Yes|No||||No|No|||Prescription required|No||045|Yes|.17922|03/29/2022|.17491|03/29/2022|.17608|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20283|||||No|No||OCEANSIDE PHARM|No||||
nifedipine|No|No|No|No|75%|68682010910|NIFEDIPINE ER 60 MG TABLET|100|EA|.79614|10/30/2017||Yes|No||10/30/2017||Yes|No|10/30/2017||Yes|No||||No|No|||Prescription required|No||045|No|.23953|03/29/2022|.23378|03/29/2022|.23533|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20284|||||No|No||OCEANSIDE PHARM|No||||
pimecrolimus|No|No|No|No|75%|68682011001|PIMECROLIMUS 1% CREAM|30|GM|3.63536|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|034|Yes|5.06554|03/29/2022|4.94396|03/29/2022|4.97689|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|20285|||||No|No||OCEANSIDE PHARM|No||||
pimecrolimus|No|No|No|No|75%|68682011102|PIMECROLIMUS 1% CREAM|60|GM|3.63536|02/28/2019||Yes|No||02/28/2019||Yes|No|02/28/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|034|Yes|4.49404|03/29/2022|4.38618|03/29/2022|4.41539|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|20286|||||No|No||OCEANSIDE PHARM|No||||
pimecrolimus|No|No|No|No|75%|68682011203|PIMECROLIMUS 1% CREAM|100|GM|3.63534|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|034|Yes|4.27357|03/29/2022|4.171|03/29/2022|4.19878|03/29/2022|||IMMUNOMODULATORS: ATOPIC DERMATITIS|20287|||||No|No||OCEANSIDE PHARM|No||||
mesalamine|No|No|No|No|75%|68682011320|MESALAMINE ER 0.375 GRAM CAP|120|EA|1.64392|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|010|No|1.86918|03/29/2022|1.82431|03/29/2022|1.83646|03/29/2022|||ULCERATIVE COLITIS AGENTS|20288|||||No|No||OCEANSIDE PHARM|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|68682013250|CLIND PH-BENZOYL PERO 1.2-2.5%|50|GM|4.07837|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|104|No|1.96427|03/29/2022|1.91712|03/29/2022|1.92989|03/29/2022|||ACNE AGENTS: TOPICAL|20289|||||No|No||OCEANSIDE PHARM|No||||
phytonadione (vit K1)|No|No|No|No|75%|68682017030|PHYTONADIONE 5 MG TABLET|30|EA|23.04327|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No|||No|52.51722|07/27/2021|51.76697|07/27/2021|49.30188|07/27/2021||||20290|||||No|No||OCEANSIDE PHARM|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|68682019025|CLINDAMYCIN-BENZOYL PEROX 1-5%|25|GM|2.92658|03/07/2018|03/31/2022|Yes|No||03/07/2018|03/31/2022|Yes|No|03/07/2018|03/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|.996|03/29/2022|.97209|03/29/2022|.97857|03/29/2022|||ACNE AGENTS: TOPICAL|20291|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||OCEANSIDE PHARM|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|68682019035|CLINDAMYCIN-BNZ PEROX 1-5% PMP|35|GM|3.96914|03/07/2018|02/28/2022|Yes|No||03/07/2018|02/28/2022|Yes|No|03/07/2018|02/28/2022|Yes|No||||No|No|||Prescription required|Yes|07/21/2016|104|No|9.04595|03/29/2022|8.91673|03/29/2022|8.49212|03/29/2022|||ACNE AGENTS: TOPICAL|20292|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||OCEANSIDE PHARM|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|68682019050|CLINDAMYCIN-BNZ PEROX 1-5% PMP|50|GM|3.3896|03/07/2018|06/30/2022|Yes|No||03/07/2018|06/30/2022|Yes|No|03/07/2018|06/30/2022|Yes|No||||No|No|||Prescription required|Yes|07/21/2016|104|No|1.67707|03/29/2022|1.63682|03/29/2022|1.64772|03/29/2022|||ACNE AGENTS: TOPICAL|20293|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||OCEANSIDE PHARM|No||||
isosorbide dinitrate|No|No|No|No|75%|68682019201|ISOSORBIDE DINITRATE 40 MG TAB|100|EA|7.80333|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|No|||No|17.78435|12/03/2020|17.53029|12/03/2020|16.69551|12/03/2020||||20294|||||No|No||OCEANSIDE PHARM|No||||
isosorbide dinitrate|No|No|No|No|75%|68682019301|ISOSORBIDE DINITRATE 5 MG TAB|100|EA|.33884|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|No|||No|.32336|03/29/2022|.31559|03/29/2022|.3177|03/29/2022||||20295|||||No|No||OCEANSIDE PHARM|No||||
peg3350/sod sul/NaCl/KCl/asb/C|No|No|No|No|75%|68682020175|PEG3350 100-7.5-2.691-1.01-5.9|1|EA|43.3096|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|No|||No|83.08|03/29/2022|81.08608|03/29/2022|81.6261|03/29/2022||||20296|||||No|No||OCEANSIDE PHARM|No||||
trientine HCl|No|No|No|No|75%|68682021210|TRIENTINE HCL 250 MG CAPSULE|100|EA|82.21105|05/25/2018||Yes|No||05/25/2018||Yes|No|05/25/2018||Yes|No||||No|No|||Prescription required|No|||No|187.36473|05/25/2018|184.68809|05/25/2018|175.89342|05/25/2018||||20297|||||No|No||OCEANSIDE PHARM|No||||
hydrocortisone butyrate|No|No|No|No|75%|68682027115|HYDROCORTISONE BUTYR 0.1% OINT|15|GM|1.36883|12/31/2020||Yes|No||12/31/2020||Yes|No|12/31/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|119|No|3.11966|12/31/2020|3.07509|12/31/2020|2.92866|12/31/2020|||STEROIDS: TOPICAL MEDIUM|20298|||||No|No||OCEANSIDE PHARM|No||||
hydrocortisone butyrate|No|No|No|No|75%|68682027145|HYDROCORTISONE BUTYR 0.1% OINT|45|GM|1.36998|12/31/2020||Yes|No||12/31/2020||Yes|No|12/31/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|119|No|3.12228|12/31/2020|3.07767|12/31/2020|2.93112|12/31/2020|||STEROIDS: TOPICAL MEDIUM|20299|||||No|No||OCEANSIDE PHARM|No||||
imiquimod|No|No|No|No|75%|68682027275|IMIQUIMOD 3.75% CREAM PUMP|7.5|GM|63.5087|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|No|||Yes|144.74076|12/10/2018|142.67304|12/10/2018|135.87908|12/10/2018||||20300|||||No|No||OCEANSIDE PHARM|No||||
loteprednol etabonate|No|No|No|No|75%|68682029905|LOTEPREDNOL ETABONATE 0.5% DRP|5|ML|18.37906|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|013|No|31.49675|03/29/2022|30.74082|03/29/2022|30.94555|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|20301|||||No|No||OCEANSIDE PHARM|No||||
loteprednol etabonate|No|No|No|No|75%|68682029910|LOTEPREDNOL ETABONATE 0.5% DRP|10|ML|18.37734|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|013|No|34.3356|03/29/2022|33.51154|03/29/2022|33.73472|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|20302|||||No|No||OCEANSIDE PHARM|No||||
loteprednol etabonate|No|No|No|No|75%|68682029915|LOTEPREDNOL ETABONATE 0.5% DRP|15|ML|18.2148|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|013|No|41.5128|12/17/2019|40.91976|12/17/2019|38.9712|12/17/2019|||OPHTHALMICS: ANTI-INFLAMMATORIES|20303|||||No|No||OCEANSIDE PHARM|No||||
clindamycin/tretinoin|No|No|No|No|75%|68682030030|CLINDA-TRETINOIN 1.2%-0.025%|30|GM|4.72899|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|104|No|10.7777|02/03/2021|10.62373|02/03/2021|10.11784|02/03/2021|||ACNE AGENTS: TOPICAL|20304|||||No|No||OCEANSIDE PHARM|No||||
pyridostigmine bromide|No|No|No|No|75%|68682030130|PYRIDOSTIGMINE ER 180 MG TAB|30|EA|8.89813|01/04/2017||Yes|No||01/04/2017||Yes|No|01/04/2017||Yes|No||||No|No|||Prescription required|No|||No|5.45827|03/29/2022|5.32727|03/29/2022|5.36275|03/29/2022||||20305|||||No|No||OCEANSIDE PHARM|No||||
pyridostigmine bromide|No|No|No|No|75%|68682030210|PYRIDOSTIGMINE BR 60 MG TABLET|100|EA|.4386|09/13/2010||Yes|No||09/13/2010||Yes|No|09/13/2010||Yes|No||||No|No|||Prescription required|No|||No|.31425|03/29/2022|.3067|03/29/2022|.30875|03/29/2022||||20306|||||No|No||OCEANSIDE PHARM|No||||
butalbital/acetaminophen|No|No|No|No|75%|68682030601|BUTALBITAL-ACETAMINOPHN 50-300|100|EA|5.21366|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|No|||No|11.8823|12/04/2018|11.71255|12/04/2018|11.15481|12/04/2018||||20307|||||No|No||OCEANSIDE PHARM|No||||
pyridostigmine bromide|No|No|No|No|75%|68682030705|PYRIDOSTIGMINE 60 MG/5 ML SOLN|473|ML|1.01359|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No|||No|2.31005|12/19/2019|2.27705|12/19/2019|2.16862|12/19/2019||||20308|||||No|No||OCEANSIDE PHARM|No||||
budesonide|No|No|No|No|75%|68682030930|BUDESONIDE ER 9 MG TABLET|30|EA|23.10189|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|010|No|33.23257|03/29/2022|32.43498|03/29/2022|32.651|03/29/2022|||ULCERATIVE COLITIS AGENTS|20309|||||No|No||OCEANSIDE PHARM|Yes|09/01/2020|||
metyrosine|No|No|No|No|75%|68682031001|METYROSINE 250 MG CAPSULE|100|EA|142.44244|04/07/2021||Yes|No||04/07/2021||Yes|No|04/07/2021||Yes|No||||No|No|||Prescription required|No|||No|324.63627|04/07/2021|319.9986|04/07/2021|304.76058|04/07/2021||||20310|||||No|No||OCEANSIDE PHARM|No||||
dihydroergotamine mesylate|No|No|No|No|75%|68682035710|DIHYDROERGOTAMINE 4 MG/ML SPRY|1|ML|184.19265|12/31/2020||Yes|No||12/31/2020||Yes|No|12/31/2020||Yes|No||||No|No|||Prescription required|Yes|07/17/2014|537|No|162.55946|03/29/2022|158.65803|03/29/2022|159.71466|03/29/2022|||ANTIMIGRAINE AGENTS: OTHER|20311|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682036790|DILTIAZEM 24HR ER 120 MG CAP|90|EA|.26746|12/05/2016||Yes|No||12/05/2016||Yes|No|12/05/2016||Yes|No||||No|No|||Prescription required|No||045|No|.26247|03/29/2022|.25617|03/29/2022|.25787|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20312|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682036890|DILTIAZEM 24HR ER 180 MG CAP|90|EA|.32273|12/05/2016||Yes|No||12/05/2016||Yes|No|12/05/2016||Yes|No||||No|No|||Prescription required|No||045|No|.32818|03/29/2022|.3203|03/29/2022|.32243|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20313|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682036990|DILTIAZEM 24HR ER 240 MG CAP|90|EA|.45804|12/05/2016||Yes|No||12/05/2016||Yes|No|12/05/2016||Yes|No||||No|No|||Prescription required|No||045|No|.46814|03/29/2022|.4569|03/29/2022|.45994|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20314|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682037090|DILTIAZEM 24HR ER 300 MG CAP|90|EA|.5934|12/05/2016||Yes|No||12/05/2016||Yes|No|12/05/2016||Yes|No||||No|No|||Prescription required|No||045|No|.70564|03/29/2022|.6887|03/29/2022|.69329|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20315|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682037190|DILTIAZEM 24HR ER 360 MG CAP|90|EA|.60486|12/05/2016||Yes|No||12/05/2016||Yes|No|12/05/2016||Yes|No||||No|No|||Prescription required|No||045|No|.55311|03/29/2022|.53983|03/29/2022|.54343|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20316|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682037290|DILTIAZEM 24HR ER 420 MG CAP|90|EA|.63391|12/05/2016||Yes|No||12/05/2016||Yes|No|12/05/2016||Yes|No||||No|No|||Prescription required|No||045|No|1.19987|03/29/2022|1.17107|03/29/2022|1.17887|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20317|||||No|No||OCEANSIDE PHARM|No||||
hydrocortisone butyrate|No|No|No|No|75%|68682039202|HYDROCORTISONE BUTYR 0.1% LOTN|59|ML|3.45158|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|7.8664|11/30/2018|7.75402|11/30/2018|7.38478|11/30/2018|||STEROIDS: TOPICAL MEDIUM|20318|||||No|No||OCEANSIDE PHARM|No||||
hydrocortisone butyrate|No|No|No|No|75%|68682039204|HYDROCORTISONE BUTYR 0.1% LOTN|118|ML|3.39389|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|7.73493|11/30/2018|7.62443|11/30/2018|7.26136|11/30/2018|||STEROIDS: TOPICAL MEDIUM|20319|||||No|No||OCEANSIDE PHARM|No||||
tetrabenazine|No|No|No|No|75%|68682042112|TETRABENAZINE 12.5 MG TABLET|112|EA|5.62466|03/02/2017||Yes|No||03/02/2017||Yes|No|03/02/2017||Yes|No||||No|No|||Prescription required|No||572|Yes|12.819|01/29/2019|12.63587|01/29/2019|12.03417|01/29/2019|||MOVEMENT DISORDERS|20320|||||No|No||OCEANSIDE PHARM|No||||
tetrabenazine|No|No|No|No|75%|68682042225|TETRABENAZINE 25 MG TABLET|112|EA|11.2491|03/29/2017||Yes|No||03/29/2017||Yes|No|03/29/2017||Yes|No||||No|No|||Prescription required|No||572|Yes|25.63749|01/29/2019|25.27124|01/29/2019|24.06785|01/29/2019|||MOVEMENT DISORDERS|20321|||||No|No||OCEANSIDE PHARM|No||||
metronidazole|Yes|No|No|No|75%|68682045570|METRONIDAZOLE VAGINAL 0.75% GL|70|GM|.81859|11/23/2016||Yes|No||11/23/2016||Yes|No|11/23/2016||Yes|No||||No|No|11/23/2016||Prescription required|Yes|01/28/2021|124|No|.55819|03/29/2022|.54479|03/29/2022|.54842|03/29/2022|||ANTIBIOTICS: VAGINAL|20322|||||No|No||OCEANSIDE PHARM|No||||
clindamycin phosphate|No|No|No|No|75%|68682046275|CLINDAMYCIN PHOSPHATE 1% GEL|75|ML|5.09481|11/30/2018||Yes|No||11/30/2018||Yes|No|11/30/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|11.61143|11/30/2018|11.44555|11/30/2018|10.90052|11/30/2018|||ACNE AGENTS: TOPICAL|20323|||||No|No||OCEANSIDE PHARM|No||||
minocycline HCl|No|No|No|No|75%|68682046630|MINOCYCLINE ER 80 MG TABLET|30|EA|.89583|06/05/2019|02/22/2022|Yes|No||06/05/2019|02/22/2022|Yes|No|06/05/2019|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|2.04166|04/27/2021|2.01249|04/27/2021|1.91666|04/27/2021|||TETRACYCLINES|20324|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||OCEANSIDE PHARM|No||||
minocycline HCl|No|No|No|No|75%|68682046730|MINOCYCLINE ER 55 MG TABLET|30|EA|.89583|02/26/2019|02/22/2022|Yes|No||02/26/2019|02/22/2022|Yes|No|02/26/2019|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|2.04166|02/16/2021|2.01249|02/16/2021|1.91666|02/16/2021|||TETRACYCLINES|20325|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||OCEANSIDE PHARM|No||||
minocycline HCl|No|No|No|No|75%|68682046830|MINOCYCLINE ER 105 MG TABLET|30|EA|.89583|06/05/2019|02/22/2022|Yes|No||06/05/2019|02/22/2022|Yes|No|06/05/2019|02/22/2022|Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|2.04166|02/16/2021|2.01249|02/16/2021|1.91666|02/16/2021|||TETRACYCLINES|20326|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||OCEANSIDE PHARM|No||||
fenofibrate|No|No|No|No|75%|68682049090|FENOFIBRATE 40 MG TABLET|90|EA|4.78135|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|055|No|10.89705|02/09/2022|10.74137|02/09/2022|10.22988|02/09/2022|||LIPOTROPICS: OTHER|20327|||||No|No||OCEANSIDE PHARM|No||||
fenofibrate|No|No|No|No|75%|68682049590|FENOFIBRATE 120 MG TABLET|90|EA|14.34412|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|055|No|10.5118|03/29/2022|10.25951|03/29/2022|10.32784|03/29/2022|||LIPOTROPICS: OTHER|20328|||||No|No||OCEANSIDE PHARM|No||||
tretinoin microspheres|No|No|No|No|75%|68682051382|TRETINOIN GEL MICRO 0.1% TUBE|20|GM|5.37564|03/02/2018||Yes|No||03/02/2018||Yes|No|03/02/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|12.25147|01/29/2019|12.07644|01/29/2019|11.50138|01/29/2019|||ACNE AGENTS: TOPICAL|20329|||||No|No||OCEANSIDE PHARM|No||||
tretinoin microspheres|No|No|No|No|75%|68682051384|TRETINOIN GEL MICRO 0.1% TUBE|45|GM|4.31662|03/02/2018||Yes|No||03/02/2018||Yes|No|03/02/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|7.63538|03/29/2022|7.45213|03/29/2022|7.50176|03/29/2022|||ACNE AGENTS: TOPICAL|20330|||||No|No||OCEANSIDE PHARM|No||||
tretinoin microspheres|No|No|No|No|75%|68682051385|TRETINOIN GEL MICRO 0.1% PUMP|50|GM|4.51465|03/02/2018||Yes|No||03/02/2018||Yes|No|03/02/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|10.28921|03/02/2018|10.14222|03/02/2018|9.65926|03/02/2018|||ACNE AGENTS: TOPICAL|20331|||||No|No||OCEANSIDE PHARM|No||||
tretinoin microspheres|No|No|No|No|75%|68682051492|TRETINOIN GEL MICRO 0.04% TUBE|20|GM|5.37564|02/28/2018||Yes|No||02/28/2018||Yes|No|02/28/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|12.25147|06/26/2018|12.07644|06/26/2018|11.50138|06/26/2018|||ACNE AGENTS: TOPICAL|20332|||||No|No||OCEANSIDE PHARM|No||||
tretinoin microspheres|No|No|No|No|75%|68682051494|TRETINOIN GEL MICRO 0.04% TUBE|45|GM|4.31662|02/28/2018||Yes|No||02/28/2018||Yes|No|02/28/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|9.83788|09/28/2021|9.69734|09/28/2021|9.23556|09/28/2021|||ACNE AGENTS: TOPICAL|20333|||||No|No||OCEANSIDE PHARM|No||||
tretinoin microspheres|No|No|No|No|75%|68682051495|TRETINOIN GEL MICRO 0.04% PUMP|50|GM|4.51465|02/28/2018||Yes|No||02/28/2018||Yes|No|02/28/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|10.28921|02/28/2018|10.14222|02/28/2018|9.65926|02/28/2018|||ACNE AGENTS: TOPICAL|20334|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682052101|DILTIAZEM 24H ER(CD) 360 MG CP|90|EA|3.52064|03/07/2018||Yes|No||03/07/2018||Yes|No|||No|No||||No|No|||Prescription required|No||045|No|1.70196|03/29/2022|1.66111|03/29/2022|1.67217|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20335|||||No|No||OCEANSIDE PHARM|No||||
diazepam|No|No|No|No|75%|68682065020|DIAZEPAM 2.5 MG RECTAL GEL SYS|1|EA|109.9725|11/22/2017||Yes|No||||No|No|11/22/2017||Yes|No||||No|No|||Prescription required|No||056|Yes|218.185|12/28/2021|212.94856|12/28/2021|214.36676|12/28/2021|||ANTICONVULSANTS|20336|||||No|No||OCEANSIDE PHARM|No||||
diazepam|No|No|No|No|75%|68682065220|DIAZEPAM 10 MG RECTAL GEL SYST|1|EA|130.4534|11/22/2017||Yes|No||11/22/2017||Yes|No|11/22/2017||Yes|No||||No|No|||Prescription required|No||056|Yes|243.97591|03/29/2022|238.12048|03/29/2022|239.70633|03/29/2022|||ANTICONVULSANTS|20337|||||No|No||OCEANSIDE PHARM|No||||
diazepam|No|No|No|No|75%|68682065520|DIAZEPAM 20 MG RECTAL GEL SYST|1|EA|130.4534|11/22/2017||Yes|No||11/22/2017||Yes|No|11/22/2017||Yes|No||||No|No|||Prescription required|No||056|Yes|279.97857|03/29/2022|273.25908|03/29/2022|275.07894|03/29/2022|||ANTICONVULSANTS|20338|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682070530|DILTIAZEM 24H ER(LA) 180 MG TB|30|EA|1.0234|12/31/2020||Yes|No||12/31/2020||Yes|No|12/31/2020||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|045|No|1.92532|03/01/2022|1.87911|03/01/2022|1.89162|03/01/2022|||CALCIUM CHANNEL BLOCKERS|20339|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682070590|DILTIAZEM 24H ER(LA) 180 MG TB|90|EA|1.02354|12/31/2020||Yes|No||12/31/2020||Yes|No|12/31/2020||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|045|No|1.92532|03/01/2022|1.87911|03/01/2022|1.89162|03/01/2022|||CALCIUM CHANNEL BLOCKERS|20340|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682070630|DILTIAZEM 24H ER(LA) 240 MG TB|30|EA|1.14709|12/31/2020||Yes|No||12/31/2020||Yes|No|12/31/2020||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|045|No|2.52878|03/29/2022|2.46808|03/29/2022|2.48452|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20341|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682070690|DILTIAZEM 24H ER(LA) 240 MG TB|90|EA|1.14709|12/31/2020||Yes|No||12/31/2020||Yes|No|12/31/2020||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|045|No|2.52878|03/29/2022|2.46808|03/29/2022|2.48452|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20342|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682070730|DILTIAZEM 24H ER(LA) 300 MG TB|30|EA|1.49238|12/31/2020||Yes|No||12/31/2020||Yes|No|12/31/2020||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|045|No|3.40124|11/23/2021|3.35265|11/23/2021|3.193|11/23/2021|||CALCIUM CHANNEL BLOCKERS|20343|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682070790|DILTIAZEM 24H ER(LA) 300 MG TB|90|EA|1.49224|12/31/2020||Yes|No||12/31/2020||Yes|No|12/31/2020||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|045|No|3.40092|11/23/2021|3.35233|11/23/2021|3.1927|11/23/2021|||CALCIUM CHANNEL BLOCKERS|20344|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682070830|DILTIAZEM 24H ER(LA) 360 MG TB|30|EA|1.60547|12/31/2020||Yes|No||12/31/2020||Yes|No|12/31/2020||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|045|No|3.31263|01/25/2022|3.23312|01/25/2022|3.25465|01/25/2022|||CALCIUM CHANNEL BLOCKERS|20345|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682070890|DILTIAZEM 24H ER(LA) 360 MG TB|90|EA|1.60556|12/31/2020||Yes|No||12/31/2020||Yes|No|12/31/2020||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|045|No|3.31263|01/25/2022|3.23312|01/25/2022|3.25465|01/25/2022|||CALCIUM CHANNEL BLOCKERS|20346|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682070930|DILTIAZEM 24H ER(LA) 420 MG TB|30|EA|1.73906|12/31/2020||Yes|No||12/31/2020||Yes|No|12/31/2020||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|045|No|3.96344|03/29/2022|3.90682|03/29/2022|3.72078|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20347|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682070990|DILTIAZEM 24H ER(LA) 420 MG TB|90|EA|1.74221|12/31/2020||Yes|No||12/31/2020||Yes|No|12/31/2020||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|045|No|3.97062|03/29/2022|3.9139|03/29/2022|3.72752|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20348|||||No|No||OCEANSIDE PHARM|No||||
enalapril maleate|No|No|No|No|75%|68682071001|ENALAPRIL MALEATE 2.5 MG TAB|100|EA|.18795|08/15/2016||Yes|No||08/15/2016||Yes|No|08/15/2016||Yes|No||||No|No|||Prescription required|No||113|No|.11585|03/29/2022|.11306|03/29/2022|.11382|03/29/2022|||ANGIOTENSIN MODULATORS|20349|||||No|No||OCEANSIDE PHARM|No||||
enalapril maleate|No|No|No|No|75%|68682071010|ENALAPRIL MALEATE 2.5 MG TAB|1000|EA|.17855|08/15/2016||Yes|No||08/15/2016||Yes|No|08/15/2016||Yes|No||||No|No|||Prescription required|No||113|No|.11585|03/29/2022|.11306|03/29/2022|.11382|03/29/2022|||ANGIOTENSIN MODULATORS|20350|||||No|No||OCEANSIDE PHARM|No||||
enalapril maleate|No|No|No|No|75%|68682071101|ENALAPRIL MALEATE 5 MG TABLET|100|EA|.23877|08/12/2016||Yes|No||08/12/2016||Yes|No|08/12/2016||Yes|No||||No|No|||Prescription required|No||113|No|.15947|03/29/2022|.15564|03/29/2022|.15667|03/29/2022|||ANGIOTENSIN MODULATORS|20351|||||No|No||OCEANSIDE PHARM|No||||
enalapril maleate|No|No|No|No|75%|68682071110|ENALAPRIL MALEATE 5 MG TABLET|1000|EA|.22684|08/12/2016||Yes|No||08/12/2016||Yes|No|08/12/2016||Yes|No||||No|No|||Prescription required|No||113|No|.15947|03/29/2022|.15564|03/29/2022|.15667|03/29/2022|||ANGIOTENSIN MODULATORS|20352|||||No|No||OCEANSIDE PHARM|No||||
enalapril maleate|No|No|No|No|75%|68682071201|ENALAPRIL MALEATE 10 MG TAB|100|EA|.25073|08/12/2016||Yes|No||08/12/2016||Yes|No|08/12/2016||Yes|No||||No|No|||Prescription required|No||113|No|.11378|03/29/2022|.11104|03/29/2022|.11178|03/29/2022|||ANGIOTENSIN MODULATORS|20353|||||No|No||OCEANSIDE PHARM|No||||
enalapril maleate|No|No|No|No|75%|68682071210|ENALAPRIL MALEATE 10 MG TAB|1000|EA|.23819|08/12/2016||Yes|No||08/12/2016||Yes|No|08/12/2016||Yes|No||||No|No|||Prescription required|No||113|No|.11378|03/29/2022|.11104|03/29/2022|.11178|03/29/2022|||ANGIOTENSIN MODULATORS|20354|||||No|No||OCEANSIDE PHARM|No||||
enalapril maleate|No|No|No|No|75%|68682071301|ENALAPRIL MALEATE 20 MG TAB|100|EA|.35677|08/12/2016||Yes|No||08/12/2016||Yes|No|08/12/2016||Yes|No||||No|No|||Prescription required|No||113|No|.14625|03/29/2022|.14274|03/29/2022|.14369|03/29/2022|||ANGIOTENSIN MODULATORS|20355|||||No|No||OCEANSIDE PHARM|No||||
enalapril maleate|No|No|No|No|75%|68682071310|ENALAPRIL MALEATE 20 MG TAB|1000|EA|.33893|08/12/2016||Yes|No||08/12/2016||Yes|No|08/12/2016||Yes|No||||No|No|||Prescription required|No||113|No|.14625|03/29/2022|.14274|03/29/2022|.14369|03/29/2022|||ANGIOTENSIN MODULATORS|20356|||||No|No||OCEANSIDE PHARM|No||||
benoxinate HCl/fluorescein sod|No|No|No|No|75%|68682073205|FLUORESCEIN-BENOXIN 0.3%-0.4%|5|ML|2.752|09/21/2021||Yes|No||09/21/2021||Yes|No|09/21/2021||Yes|No||||No|No|||Prescription required|No|||No|6.272|09/21/2021|6.1824|09/21/2021|5.888|09/21/2021||||20357|||||No|No||OCEANSIDE PHARM|No||||
tretinoin|No|No|No|No|75%|68682080045|TRETINOIN 0.05% GEL|45|GM|2.68692|02/16/2017||Yes|No||02/16/2017||Yes|No|02/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|104|No|4.28857|03/01/2022|4.18564|03/01/2022|4.21352|03/01/2022|||ACNE AGENTS: TOPICAL|20358|||||No|No||OCEANSIDE PHARM|No||||
timolol maleate|No|No|No|No|75%|68682081305|TIMOLOL MALEATE 0.5% EYE DROPS|5|ML|.946|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|No||088|No|1.19485|03/29/2022|1.16617|03/29/2022|1.17394|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|20359|||||No|No||OCEANSIDE PHARM|No||||
luliconazole|No|No|No|No|75%|68682085060|LULICONAZOLE 1% CREAM|60|GM|1.43333|12/17/2018||Yes|No||12/17/2018||Yes|No|12/17/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|3.26666|12/17/2018|3.21999|12/17/2018|3.06666|12/17/2018|||ANTIFUNGALS: TOPICAL|20360|||||No|No||OCEANSIDE PHARM|No||||
erythromycin/benzoyl peroxide|No|No|No|No|75%|68682090023|ERYTHROMYCIN-BENZOYL GEL|23.3|GM|3.06167|03/02/2018||Yes|No||03/02/2018||Yes|No|03/02/2018||Yes|No||||No|No|||Prescription required|No||104|No|1.71854|03/29/2022|1.67729|03/29/2022|1.68846|03/29/2022|||ACNE AGENTS: TOPICAL|20361|||||No|No||OCEANSIDE PHARM|No||||
erythromycin/benzoyl peroxide|No|No|No|No|75%|68682090146|ERYTHROMYCIN-BENZOYL GEL|46.6|GM|.57671|12/06/2016||Yes|No||12/06/2016||Yes|No|12/06/2016||Yes|No||||No|No|||Prescription required|No||104|No|1.12609|03/29/2022|1.09906|03/29/2022|1.10638|03/29/2022|||ACNE AGENTS: TOPICAL|20362|||||No|No||OCEANSIDE PHARM|No||||
tetracaine HCl|No|No|No|No|75%|68682092005|TETRACAINE 0.5% EYE DROP|5|ML|2.58|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|No|||No|5.88|09/18/2020|5.796|09/22/2020|5.52|09/18/2020||||20363|||||No|No||OCEANSIDE PHARM|No||||
tetracaine HCl|No|No|No|No|75%|68682092064|TETRACAINE 0.5% EYE DROP|15|ML|2.58|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No|||No|5.88|07/27/2021|5.796|07/27/2021|5.52|07/27/2021||||20364|||||No|No||OCEANSIDE PHARM|No||||
tolcapone|No|No|No|No|75%|68682093890|TOLCAPONE 100 MG TABLET|90|EA|42.08428|12/31/2020||Yes|No||12/31/2020||Yes|No|12/31/2020||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|015|No|95.91303|12/31/2020|94.54284|12/31/2020|90.0408|12/31/2020|||ANTIPARKINSON'S AGENTS|20365|||||No|No||OCEANSIDE PHARM|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|68682099030|OMEPRAZOLE-BICARB 20-1,680 PKT|30|EA|37.56623|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|85.61606|09/28/2021|84.39297|09/28/2021|80.37426|09/28/2021|||PROTON PUMP INHIBITORS|20366|||||No|No||OCEANSIDE PHARM|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|68682099130|OMEPRAZOLE-BICARB 40-1,680 PKT|30|EA|37.56623|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|85.61606|11/24/2020|84.39297|11/24/2020|80.37426|11/24/2020|||PROTON PUMP INHIBITORS|20367|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682099398|DILTIAZEM 24H ER(CD) 120 MG CP|90|EA|.333|08/02/2016||Yes|No||08/02/2016||Yes|No|08/02/2016||Yes|No||||No|No|||Prescription required|No||045|No|.17507|03/29/2022|.17086|03/29/2022|.172|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20368|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682099498|DILTIAZEM 24H ER(CD) 180 MG CP|90|EA|.40205|08/02/2016||Yes|No||08/02/2016||Yes|No|08/02/2016||Yes|No||||No|No|||Prescription required|No||045|No|.21189|03/29/2022|.2068|03/29/2022|.20818|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20369|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682099798|DILTIAZEM 24H ER(CD) 240 MG CP|90|EA|.57022|08/02/2016||Yes|No||08/02/2016||Yes|No|08/02/2016||Yes|No||||No|No|||Prescription required|No||045|No|.29728|03/29/2022|.29014|03/29/2022|.29207|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20370|||||No|No||OCEANSIDE PHARM|No||||
diltiazem HCl|No|No|No|No|75%|68682099898|DILTIAZEM 24H ER(CD) 300 MG CP|90|EA|.73911|08/02/2016||Yes|No||08/02/2016||Yes|No|08/02/2016||Yes|No||||No|No|||Prescription required|No||045|No|.34265|03/29/2022|.33442|03/29/2022|.33665|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20371|||||No|No||OCEANSIDE PHARM|No||||
sodium oxybate|No|No|No|No|75%|68727010001|XYREM 500 MG/ML ORAL SOLUTION|180|ML|14.35721|03/01/2011||Yes|No||||No|No|||No|No||||No|No|||Prescription required|No|||Yes|32.7211|01/18/2022|32.25365|01/18/2022|30.71776|01/18/2022||||20372|||||No|No||JAZZ PHARMACEUT|No||||
sodium,calcium,mag,pot oxybate|No|No|No|No|75%|68727015001|XYWAV 0.5 GM/ML ORAL SOLUTION|180|ML|13.23444|03/02/2021||Yes|No||03/02/2021||Yes|No|03/02/2021||Yes|No||||No|No|||Prescription required|No|||No|30.16221|01/18/2022|29.73132|01/18/2022|28.31554|01/18/2022||||20373|||||No|No||JAZZ PHARMACEUT|No||||
solriamfetol HCl|No|No|No|No|75%|68727035001|SUNOSI 75 MG TABLET|30|EA|10.82166|01/31/2020||Yes|No||01/31/2020||Yes|No|01/31/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|24.06846|01/25/2022|23.49081|01/25/2022|23.64726|01/25/2022|||STIMULANTS AND RELATED AGENTS|20374|||||No|No||JAZZ PHARMACEUT|No||||
solriamfetol HCl|No|No|No|No|75%|68727035101|SUNOSI 150 MG TABLET|30|EA|10.82166|01/31/2020||Yes|No||01/31/2020||Yes|No|01/31/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|24.13666|01/25/2022|23.55738|01/25/2022|23.71426|01/25/2022|||STIMULANTS AND RELATED AGENTS|20375|||||No|No||JAZZ PHARMACEUT|No||||
fluocinolone acetonide|No|No|No|No|75%|68791010104|DERMA-SMOOTHE-FS BODY OIL|118.28|ML|.13283|05/16/2014||Yes|No||05/16/2014||Yes|No|05/16/2014||Yes|No||||No|No|||Prescription required|No||118|No|.29548|11/23/2021|.28838|11/23/2021|.2903|11/23/2021|||STEROIDS: TOPICAL LOW|20376|||||No|No||ROYAL PHARMACEU|No||||
fluocinolone/shower cap|No|No|No|No|75%|68791010204|DERMA-SMOOTHE-FS SCALP OIL|118.28|ML|.12636|05/16/2014||Yes|No||05/16/2014||Yes|No|05/16/2014||Yes|No||||No|No|||Prescription required|No||118|No|.28337|03/01/2022|.27656|03/01/2022|.27841|03/01/2022|||STEROIDS: TOPICAL LOW|20377|||||No|No||ROYAL PHARMACEU|No||||
fluocinolone acetonide oil|No|No|No|No|75%|68791010320|DERMOTIC OIL 0.01% EAR DROPS|20|ML|.60372|05/16/2014||Yes|No||05/16/2014||Yes|No|05/16/2014||Yes|No||||No|No|||Prescription required|No|||No|1.347|03/01/2022|1.31467|03/01/2022|1.32342|03/01/2022||||20378|||||No|No||ROYAL PHARMACEU|No||||
teduglutide|No|No|No|No|75%|68875010201|GATTEX 5 MG 30-VIAL KIT|1|EA|18452.7835|06/10/2013||Yes|No||06/10/2013||Yes|No|||No|No||||No|No|||Prescription required|No|||No|42055.181|01/11/2022|41454.3927|01/11/2022|39480.374|01/11/2022||||20379|||||No|No||NPS PHARMACEUTI|No||||
parathyroid hormone|No|No|No|No|75%|68875020202|NATPARA 25 MCG DOSE CARTRIDGE|2|EA|2132.18725|08/03/2016||Yes|No||08/03/2016||Yes|No|08/03/2016||Yes|No||||No|No|||Prescription required|No|||No|4859.4035|04/23/2019|4789.98345|04/23/2019|4561.889|04/23/2019||||20380|||||No|No||SHIRE US INC.|No||||
parathyroid hormone|No|No|No|No|75%|68875020302|NATPARA 50 MCG DOSE CARTRIDGE|2|EA|2132.18725|08/03/2016||Yes|No||08/03/2016||Yes|No|08/03/2016||Yes|No||||No|No|||Prescription required|No|||No|4859.4035|04/23/2019|4789.98345|04/23/2019|4561.889|04/23/2019||||20381|||||No|No||SHIRE US INC.|No||||
parathyroid hormone|No|No|No|No|75%|68875020402|NATPARA 75 MCG DOSE CARTRIDGE|2|EA|2132.18725|08/03/2016||Yes|No||08/03/2016||Yes|No|08/03/2016||Yes|No||||No|No|||Prescription required|No|||No|4859.4035|04/23/2019|4789.98345|04/23/2019|4561.889|04/23/2019||||20382|||||No|No||SHIRE US INC.|No||||
parathyroid hormone|No|No|No|No|75%|68875020502|NATPARA 100 MCG DOSE CARTRIDGE|2|EA|2132.18725|08/03/2016||Yes|No||08/03/2016||Yes|No|08/03/2016||Yes|No||||No|No|||Prescription required|No|||No|4859.4035|04/23/2019|4789.98345|04/23/2019|4561.889|04/23/2019||||20383|||||No|No||SHIRE US INC.|No||||
asenapine|No|No|No|No|75%|68968017203|SECUADO 3.8 MG/24 HR PATCH|30|EA|18.232|03/09/2020||Yes|No||03/09/2020||Yes|No|03/09/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|027|Yes|41.552|01/04/2022|40.9584|01/04/2022|39.008|01/04/2022|||ANTIPSYCHOTICS|20384|||||No|No||NOVEN THERAPEUT|No||||
asenapine|No|No|No|No|75%|68968017303|SECUADO 5.7 MG/24 HR PATCH|30|EA|18.232|03/09/2020||Yes|No||||No|No|||No|No||||No|No|||Prescription required|Yes|07/30/2020|027|Yes|41.552|01/04/2022|40.9584|01/04/2022|39.008|01/04/2022|||ANTIPSYCHOTICS|20385|||||No|No||NOVEN THERAPEUT|No||||
asenapine|No|No|No|No|75%|68968017403|SECUADO 7.6 MG/24 HR PATCH|30|EA|18.232|03/09/2020||Yes|No||03/09/2020||Yes|No|03/09/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|027|Yes|41.552|01/04/2022|40.9584|01/04/2022|39.008|01/04/2022|||ANTIPSYCHOTICS|20386|||||No|No||NOVEN THERAPEUT|No||||
estradiol/norethindrone acet|No|No|No|No|75%|68968051408|COMBIPATCH 0.05-0.14 MG PTCH|8|EA|12.44258|03/10/2016||Yes|No||03/10/2016||Yes|No|03/10/2016||Yes|No||||No|No|||Prescription required|No|||Yes|27.70162|01/04/2022|27.03678|01/04/2022|27.21684|01/04/2022||||20387|||||No|No||NOVEN THERAPEUT|No||||
estradiol/norethindrone acet|No|No|No|No|75%|68968052508|COMBIPATCH 0.05-0.25 MG PTCH|8|EA|12.44258|03/10/2016||Yes|No||03/10/2016||Yes|No|03/10/2016||Yes|No||||No|No|||Prescription required|No|||Yes|27.66407|01/04/2022|27.00013|01/04/2022|27.17994|01/04/2022||||20388|||||No|No||NOVEN THERAPEUT|No||||
estradiol|No|No|No|No|75%|68968341008|ESTRADIOL 0.1 MG PATCH (2/WK)|8|EA|8.76501|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No|||Yes|8.48083|03/29/2022|8.27729|03/29/2022|8.33241|03/29/2022||||20389|||||No|No||NOVEN THERAPEUT|No||||
estradiol|No|No|No|No|75%|68968342508|ESTRADIOL 0.025 MG PATCH(2/WK)|8|EA|8.76501|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No|||Yes|9.33155|03/29/2022|9.10759|03/29/2022|9.16824|03/29/2022||||20390|||||No|No||NOVEN THERAPEUT|No||||
estradiol|No|No|No|No|75%|68968343708|ESTRADIOL 0.0375MG PATCH(2/WK)|8|EA|8.76501|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No|||Yes|10.33407|03/29/2022|10.08605|03/29/2022|10.15322|03/29/2022||||20391|||||No|No||NOVEN THERAPEUT|No||||
estradiol|No|No|No|No|75%|68968345008|ESTRADIOL 0.05 MG PATCH (2/WK)|8|EA|8.76501|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No|||Yes|9.27983|03/29/2022|9.05711|03/29/2022|9.11743|03/29/2022||||20392|||||No|No||NOVEN THERAPEUT|No||||
estradiol|No|No|No|No|75%|68968347508|ESTRADIOL 0.075 MG PATCH(2/WK)|8|EA|8.76501|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|No|||Yes|8.4725|03/29/2022|8.26916|03/29/2022|8.32423|03/29/2022||||20393|||||No|No||NOVEN THERAPEUT|No||||
methylphenidate|No|No|No|No|75%|68968555203|DAYTRANA 10 MG/9 HR PATCH|30|EA|6.32057|03/30/2011||Yes|No||03/30/2011||Yes|No|03/30/2011||Yes|No||||No|No|||Prescription required|No||007|Yes|14.2055|01/04/2022|13.86456|01/04/2022|13.9569|01/04/2022|||STIMULANTS AND RELATED AGENTS|20394|||||No|No||NOVEN THERAPEUT|No||||
methylphenidate|No|No|No|No|75%|68968555303|DAYTRANA 15 MG/9 HR PATCH|30|EA|6.32057|03/30/2011||Yes|No||03/30/2011||Yes|No|03/30/2011||Yes|No||||No|No|||Prescription required|No||007|Yes|14.09785|01/04/2022|13.7595|01/04/2022|13.85113|01/04/2022|||STIMULANTS AND RELATED AGENTS|20395|||||No|No||NOVEN THERAPEUT|No||||
methylphenidate|No|No|No|No|75%|68968555403|DAYTRANA 20 MG/9 HOUR PATCH|30|EA|6.32057|03/30/2011||Yes|No||03/30/2011||Yes|No|03/30/2011||Yes|No||||No|No|||Prescription required|No||007|Yes|14.06308|01/04/2022|13.72556|01/04/2022|13.81697|01/04/2022|||STIMULANTS AND RELATED AGENTS|20396|||||No|No||NOVEN THERAPEUT|No||||
methylphenidate|No|No|No|No|75%|68968555503|DAYTRANA 30 MG/9 HOUR PATCH|30|EA|6.32057|03/30/2011||Yes|No||03/30/2011||Yes|No|03/30/2011||Yes|No||||No|No|||Prescription required|No||007|Yes|14.10774|01/04/2022|13.76915|01/04/2022|13.86085|01/04/2022|||STIMULANTS AND RELATED AGENTS|20397|||||No|No||NOVEN THERAPEUT|No||||
chenodiol|No|No|No|No|75%|68974087640|CHENODAL 250 MG TABLET|100|EA|203.39|04/24/2017||Yes|No||04/24/2017||Yes|No|04/24/2017||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|198|No|463.54|05/02/2017|456.918|04/24/2017|435.16|04/24/2017|||BILE SALTS|20398|||||No|No||RETROPHIN, INC.|No||||
antihemoph.FVIII,HEK B-delete|No|No|No|No|75%|68982013901|NUWIQ 250 UNIT VIAL PACK|1|EA|1.292|07/28/2016||Yes|No||07/28/2016||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.862|02/08/2022|1.8354|02/08/2022|1.748|02/08/2022|||HEMOPHILIA TREATMENT|20399|||||No|No||OCTAPHARMA USA|No||||
antihemoph.FVIII,HEK B-delete|No|No|No|No|75%|68982014101|NUWIQ 500 UNIT VIAL PACK|1|EA|1.292|07/28/2016||Yes|No||07/28/2016||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.862|02/08/2022|1.8354|02/08/2022|1.748|02/08/2022|||HEMOPHILIA TREATMENT|20400|||||No|No||OCTAPHARMA USA|No||||
antihemoph.FVIII,HEK B-delete|No|No|No|No|75%|68982014301|NUWIQ 1,000 UNIT VIAL PACK|1|EA|1.292|07/28/2016||Yes|No||07/28/2016||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.862|02/08/2022|1.8354|02/08/2022|1.748|02/08/2022|||HEMOPHILIA TREATMENT|20401|||||No|No||OCTAPHARMA USA|No||||
antihemoph.FVIII,HEK B-delete|No|No|No|No|75%|68982014501|NUWIQ 2,000 UNIT VIAL PACK|1|EA|1.292|07/28/2016||Yes|No||07/28/2016||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.862|02/08/2022|1.8354|02/08/2022|1.748|02/08/2022|||HEMOPHILIA TREATMENT|20402|||||No|No||OCTAPHARMA USA|No||||
antihemoph.FVIII,HEK B-delete|No|No|No|No|75%|68982014701|NUWIQ 2,500 UNIT VIAL PACK|1|EA|1.292|12/22/2017||Yes|No||12/22/2017||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.862|02/08/2022|1.8354|02/08/2022|1.748|02/08/2022|||HEMOPHILIA TREATMENT|20403|||||No|No||OCTAPHARMA USA|No||||
antihemoph.FVIII,HEK B-delete|No|No|No|No|75%|68982014901|NUWIQ 3,000 UNIT VIAL PACK|1|EA|1.292|12/22/2017||Yes|No||12/22/2017||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.862|02/08/2022|1.8354|02/08/2022|1.748|02/08/2022|||HEMOPHILIA TREATMENT|20404|||||No|No||OCTAPHARMA USA|No||||
antihemoph.FVIII,HEK B-delete|No|No|No|No|75%|68982015101|NUWIQ 4,000 UNIT VIAL PACK|1|EA|1.292|12/22/2017||Yes|No||12/22/2017||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.862|02/08/2022|1.8354|02/08/2022|1.748|02/08/2022|||HEMOPHILIA TREATMENT|20405|||||No|No||OCTAPHARMA USA|No||||
antihemophilic factor/VWF|No|No|No|No|75%|68982018201|WILATE 500-500 UNIT VIAL|1|EA|1.0812|08/01/2016||Yes|No||08/01/2016||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.5582|02/08/2022|1.53594|02/08/2022|1.4628|02/08/2022|||HEMOPHILIA TREATMENT|20406|||||No|No||OCTAPHARMA USA|No||||
antihemophilic factor/VWF|No|No|No|No|75%|68982018202|WILATE 1,000-1,000 UNIT VIAL|1|EA|1.0812|08/01/2016||Yes|No||08/01/2016||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.5582|02/08/2022|1.53594|02/08/2022|1.4628|02/08/2022|||HEMOPHILIA TREATMENT|20407|||||No|No||OCTAPHARMA USA|No||||
immun globG(IgG)/malt/IgA ov50|No|No|No|No|75%|68982084001|OCTAGAM 5% VIAL|20|ML|3.8614|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|8.8004|10/05/2021|8.67468|10/05/2021|8.2616|10/05/2021|||IMMUNE GLOBULINS|20408|||||No|No||OCTAPHARMA USA|No||||
immun globG(IgG)/malt/IgA ov50|No|No|No|No|75%|68982084002|OCTAGAM 5% VIAL|50|ML|3.8614|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|8.8004|10/05/2021|8.67468|10/05/2021|8.2616|10/05/2021|||IMMUNE GLOBULINS|20409|||||No|No||OCTAPHARMA USA|No||||
immun globG(IgG)/malt/IgA ov50|No|No|No|No|75%|68982084003|OCTAGAM 5% VIAL|100|ML|3.8614|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|8.8004|10/05/2021|8.67468|10/05/2021|8.2616|10/05/2021|||IMMUNE GLOBULINS|20410|||||No|No||OCTAPHARMA USA|No||||
immun globG(IgG)/malt/IgA ov50|No|No|No|No|75%|68982084004|OCTAGAM 5% VIAL|200|ML|3.8614|10/04/2016||Yes|No||10/04/2016||Yes|No|10/04/2016||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|8.8004|10/05/2021|8.67468|10/05/2021|8.2616|10/05/2021|||IMMUNE GLOBULINS|20411|||||No|No||OCTAPHARMA USA|No||||
immun globG(IgG)/malt/IgA ov50|No|No|No|No|75%|68982085001|OCTAGAM 10% VIAL|20|ML|7.7228|07/17/2017||Yes|No||07/17/2017||Yes|No|07/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|17.6008|10/05/2021|17.34936|10/05/2021|16.5232|10/05/2021|||IMMUNE GLOBULINS|20412|||||No|No||OCTAPHARMA USA|No||||
immun globG(IgG)/malt/IgA ov50|No|No|No|No|75%|68982085002|OCTAGAM 10% VIAL|50|ML|7.7228|07/17/2017||Yes|No||07/17/2017||Yes|No|07/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|17.6008|10/05/2021|17.34936|10/05/2021|16.5232|10/05/2021|||IMMUNE GLOBULINS|20413|||||No|No||OCTAPHARMA USA|No||||
immun globG(IgG)/malt/IgA ov50|No|No|No|No|75%|68982085003|OCTAGAM 10% VIAL|100|ML|7.7228|07/17/2017||Yes|No||07/17/2017||Yes|No|07/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|17.6008|10/05/2021|17.34936|10/05/2021|16.5232|10/05/2021|||IMMUNE GLOBULINS|20414|||||No|No||OCTAPHARMA USA|No||||
immun globG(IgG)/malt/IgA ov50|No|No|No|No|75%|68982085004|OCTAGAM 10% VIAL|200|ML|7.7228|07/17/2017||Yes|No||07/17/2017||Yes|No|07/17/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|023|No|17.6008|10/05/2021|17.34936|10/05/2021|16.5232|10/05/2021|||IMMUNE GLOBULINS|20415|||||No|No||OCTAPHARMA USA|No||||
tacrolimus|No|No|No|No|75%|68992301001|ENVARSUS XR 1 MG TABLET|100|EA|2.54697|12/23/2015||Yes|No||12/23/2015||Yes|No|12/23/2015||Yes|No||04/01/2016||Yes|No|||Prescription required|Yes|01/28/2016|229|No|5.77873|01/04/2022|5.64004|01/04/2022|5.6776|01/04/2022|||IMMUNOSUPPRESSIVES: ORAL|20416|||||No|No||VELOXIS PHARMAC|No||||
tacrolimus|No|No|No|No|75%|68992301003|ENVARSUS XR 1 MG TABLET|30|EA|2.54703|12/23/2015||Yes|No||12/23/2015||Yes|No|12/23/2015||Yes|No||04/01/2016||Yes|No|||Prescription required|Yes|01/28/2016|229|No|5.77873|01/04/2022|5.64004|01/04/2022|5.6776|01/04/2022|||IMMUNOSUPPRESSIVES: ORAL|20417|||||No|No||VELOXIS PHARMAC|No||||
tacrolimus|No|No|No|No|75%|68992304001|ENVARSUS XR 4 MG TABLET|100|EA|10.18773|12/23/2015||Yes|No||12/23/2015||Yes|No|12/23/2015||Yes|No||04/01/2016||Yes|No|||Prescription required|Yes|01/28/2016|229|No|23.21855|12/28/2021|22.88685|12/28/2021|21.797|12/28/2021|||IMMUNOSUPPRESSIVES: ORAL|20418|||||No|No||VELOXIS PHARMAC|No||||
tacrolimus|No|No|No|No|75%|68992304003|ENVARSUS XR 4 MG TABLET|30|EA|10.18756|12/23/2015||Yes|No||12/23/2015||Yes|No|12/23/2015||Yes|No||04/01/2016||Yes|No|||Prescription required|Yes|01/28/2016|229|No|23.21816|12/28/2021|22.88647|12/28/2021|21.79664|12/28/2021|||IMMUNOSUPPRESSIVES: ORAL|20419|||||No|No||VELOXIS PHARMAC|No||||
tacrolimus|No|No|No|No|75%|68992307501|ENVARSUS XR 0.75 MG TABLET|100|EA|1.91018|12/23/2015||Yes|No||12/23/2015||Yes|No|12/23/2015||Yes|No||04/01/2016||Yes|No|||Prescription required|Yes|01/28/2016|229|No|4.35345|12/28/2021|4.29126|12/28/2021|4.08691|12/28/2021|||IMMUNOSUPPRESSIVES: ORAL|20420|||||No|No||VELOXIS PHARMAC|No||||
tacrolimus|No|No|No|No|75%|68992307503|ENVARSUS XR 0.75 MG TABLET|30|EA|1.91034|12/23/2015||Yes|No||12/23/2015||Yes|No|12/23/2015||Yes|No||04/01/2016||Yes|No|||Prescription required|Yes|01/28/2016|229|No|4.3538|12/28/2021|4.2916|12/28/2021|4.08724|12/28/2021|||IMMUNOSUPPRESSIVES: ORAL|20421|||||No|No||VELOXIS PHARMAC|No||||
acyclovir|Yes|No|No|No|75%|69076014601|ACYCLOVIR 200 MG CAPSULE|100|EA|.0731|11/09/2016||Yes|No||11/09/2016||Yes|No|11/09/2016||Yes|No||||No|No|11/09/2016||Prescription required|No||025|No|.11267|03/29/2022|.10996|03/29/2022|.11069|03/29/2022|||ANTIVIRALS: ORAL|20422|||||No|No||QUINN PHARMACEU|No||||
glycopyrrolate|No|No|No|No|75%|69076047501|GLYCOPYRROLATE 1 MG TABLET|100|EA|.18653|11/09/2016||Yes|No||11/09/2016||Yes|No|11/09/2016||Yes|No||||No|No|||Prescription required|No|||No|.10136|03/29/2022|.09892|03/29/2022|.09958|03/29/2022||||20423|||||No|No||QUINN PHARMACEU|No||||
glycopyrrolate|No|No|No|No|75%|69076047601|GLYCOPYRROLATE 2 MG TABLET|100|EA|.33475|11/09/2016||Yes|No||11/09/2016||Yes|No|11/09/2016||Yes|No||||No|No|||Prescription required|No|||No|.22028|03/29/2022|.21499|03/29/2022|.21642|03/29/2022||||20424|||||No|No||QUINN PHARMACEU|No||||
levetiracetam|No|No|No|No|75%|69076050060|LEVETIRACETAM ER 500 MG TABLET|60|EA|.31869|10/14/2016||Yes|No||10/14/2016||Yes|No|10/14/2016||Yes|No||||No|No|||Prescription required|No||056|No|.22713|03/29/2022|.22167|03/29/2022|.22315|03/29/2022|||ANTICONVULSANTS|20425|||||No|No||QUINN PHARMACEU|No||||
levetiracetam|No|No|No|No|75%|69076075060|LEVETIRACETAM ER 750 MG TABLET|60|EA|.47851|11/14/2016||Yes|No||11/14/2016||Yes|No|11/14/2016||Yes|No||||No|No|||Prescription required|No||056|No|.36799|03/29/2022|.35915|03/29/2022|.36155|03/29/2022|||ANTICONVULSANTS|20426|||||No|No||QUINN PHARMACEU|No||||
mercaptopurine|No|No|No|No|75%|69076091302|MERCAPTOPURINE 50 MG TABLET|25|EA|1.3631|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|No||173|No|.93312|03/29/2022|.91072|03/29/2022|.91679|03/29/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|20427|||||No|No||QUINN PHARMACEU|No||||
mercaptopurine|No|No|No|No|75%|69076091325|MERCAPTOPURINE 50 MG TABLET|250|EA|1.22679|05/17/2017||Yes|No||05/17/2017||Yes|No|05/17/2017||Yes|No||||No|No|||Prescription required|No||173|No|.93312|03/29/2022|.91072|03/29/2022|.91679|03/29/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|20428|||||No|No||QUINN PHARMACEU|No||||
testosterone undecanoate|No|No|No|No|75%|69087015812|JATENZO 158 MG CAPSULE|120|EA|3.44946|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|No|||No|7.86156|01/11/2022|7.74925|01/11/2022|7.38024|01/11/2022||||20429|||||No|No||CLARUS THERAPEU|No||||
testosterone undecanoate|No|No|No|No|75%|69087019812|JATENZO 198 MG CAPSULE|120|EA|3.44946|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|No|||No|7.86156|01/11/2022|7.74925|01/11/2022|7.38024|01/11/2022||||20430|||||No|No||CLARUS THERAPEU|No||||
testosterone undecanoate|No|No|No|No|75%|69087023712|JATENZO 237 MG CAPSULE|120|EA|6.89884|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|No|||No|15.33794|01/18/2022|14.96982|01/18/2022|15.06952|01/18/2022||||20431|||||No|No||CLARUS THERAPEU|No||||
topiramate|No|No|No|No|75%|69097012203|TOPIRAMATE 25 MG TABLET|60|EA|.02866|03/05/2015||Yes|No||03/05/2015||Yes|No|03/05/2015||Yes|No||||No|No|||Prescription required|No||056|No|.03423|03/29/2022|.0334|03/29/2022|.03363|03/29/2022|||ANTICONVULSANTS|20432|||||No|No||CIPLA USA, INC.|No||||
topiramate|No|No|No|No|75%|69097012212|TOPIRAMATE 25 MG TABLET|500|EA|.02721|03/05/2015||Yes|No||03/05/2015||Yes|No|03/05/2015||Yes|No||||No|No|||Prescription required|No||056|No|.03423|03/29/2022|.0334|03/29/2022|.03363|03/29/2022|||ANTICONVULSANTS|20433|||||No|No||CIPLA USA, INC.|No||||
topiramate|No|No|No|No|75%|69097012215|TOPIRAMATE 25 MG TABLET|1000|EA|.0264|03/05/2015||Yes|No||03/05/2015||Yes|No|03/05/2015||Yes|No||||No|No|||Prescription required|No||056|No|.03423|03/29/2022|.0334|03/29/2022|.03363|03/29/2022|||ANTICONVULSANTS|20434|||||No|No||CIPLA USA, INC.|No||||
topiramate|No|No|No|No|75%|69097012303|TOPIRAMATE 50 MG TABLET|60|EA|.03905|03/05/2015||Yes|No||03/05/2015||Yes|No|03/05/2015||Yes|No||||No|No|||Prescription required|No||056|No|.04588|03/29/2022|.04477|03/29/2022|.04507|03/29/2022|||ANTICONVULSANTS|20435|||||No|No||CIPLA USA, INC.|No||||
topiramate|No|No|No|No|75%|69097012312|TOPIRAMATE 50 MG TABLET|500|EA|.03706|03/05/2015||Yes|No||03/05/2015||Yes|No|03/05/2015||Yes|No||||No|No|||Prescription required|No||056|No|.04588|03/29/2022|.04477|03/29/2022|.04507|03/29/2022|||ANTICONVULSANTS|20436|||||No|No||CIPLA USA, INC.|No||||
topiramate|No|No|No|No|75%|69097012315|TOPIRAMATE 50 MG TABLET|1000|EA|.03594|03/05/2015||Yes|No||03/05/2015||Yes|No|03/05/2015||Yes|No||||No|No|||Prescription required|No||056|No|.04588|03/29/2022|.04477|03/29/2022|.04507|03/29/2022|||ANTICONVULSANTS|20437|||||No|No||CIPLA USA, INC.|No||||
topiramate|No|No|No|No|75%|69097012403|TOPIRAMATE 100 MG TABLET|60|EA|.05016|03/05/2015||Yes|No||03/05/2015||Yes|No|03/05/2015||Yes|No||||No|No|||Prescription required|No||056|No|.06953|03/29/2022|.06786|03/29/2022|.06831|03/29/2022|||ANTICONVULSANTS|20438|||||No|No||CIPLA USA, INC.|No||||
topiramate|No|No|No|No|75%|69097012412|TOPIRAMATE 100 MG TABLET|500|EA|.04764|03/05/2015||Yes|No||03/05/2015||Yes|No|03/05/2015||Yes|No||||No|No|||Prescription required|No||056|No|.06953|03/29/2022|.06786|03/29/2022|.06831|03/29/2022|||ANTICONVULSANTS|20439|||||No|No||CIPLA USA, INC.|No||||
topiramate|No|No|No|No|75%|69097012415|TOPIRAMATE 100 MG TABLET|1000|EA|.04622|03/05/2015||Yes|No||03/05/2015||Yes|No|03/05/2015||Yes|No||||No|No|||Prescription required|No||056|No|.06953|03/29/2022|.06786|03/29/2022|.06831|03/29/2022|||ANTICONVULSANTS|20440|||||No|No||CIPLA USA, INC.|No||||
topiramate|No|No|No|No|75%|69097012503|TOPIRAMATE 200 MG TABLET|60|EA|.0645|03/05/2015||Yes|No||03/05/2015||Yes|No|03/05/2015||Yes|No||||No|No|||Prescription required|No||056|No|.12326|03/29/2022|.1203|03/29/2022|.1211|03/29/2022|||ANTICONVULSANTS|20441|||||No|No||CIPLA USA, INC.|No||||
topiramate|No|No|No|No|75%|69097012512|TOPIRAMATE 200 MG TABLET|500|EA|.06127|03/05/2015||Yes|No||03/05/2015||Yes|No|03/05/2015||Yes|No||||No|No|||Prescription required|No||056|No|.12326|03/29/2022|.1203|03/29/2022|.1211|03/29/2022|||ANTICONVULSANTS|20442|||||No|No||CIPLA USA, INC.|No||||
topiramate|No|No|No|No|75%|69097012515|TOPIRAMATE 200 MG TABLET|1000|EA|.05942|03/05/2015||Yes|No||03/05/2015||Yes|No|03/05/2015||Yes|No||||No|No|||Prescription required|No||056|No|.12326|03/29/2022|.1203|03/29/2022|.1211|03/29/2022|||ANTICONVULSANTS|20443|||||No|No||CIPLA USA, INC.|No||||
amlodipine besylate|Yes|No|No|No|75%|69097012605|AMLODIPINE BESYLATE 2.5 MG TAB|90|EA|.01253|10/04/2015||Yes|No||10/04/2015||Yes|No|10/04/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20444|||||No|No||CIPLA USA, INC.|No||||
amlodipine besylate|Yes|No|No|No|75%|69097012615|AMLODIPINE BESYLATE 2.5 MG TAB|1000|EA|.00826|10/04/2015||Yes|No||10/04/2015||Yes|No|10/04/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20445|||||No|No||CIPLA USA, INC.|No||||
amlodipine besylate|Yes|No|No|No|75%|69097012705|AMLODIPINE BESYLATE 5 MG TAB|90|EA|.01655|10/04/2015||Yes|No||10/04/2015||Yes|No|10/04/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20446|||||No|No||CIPLA USA, INC.|No||||
amlodipine besylate|Yes|No|No|No|75%|69097012715|AMLODIPINE BESYLATE 5 MG TAB|1000|EA|.00928|10/04/2015||Yes|No||10/04/2015||Yes|No|10/04/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20447|||||No|No||CIPLA USA, INC.|No||||
amlodipine besylate|Yes|No|No|No|75%|69097012805|AMLODIPINE BESYLATE 10 MG TAB|90|EA|.01655|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20448|||||No|No||CIPLA USA, INC.|No||||
amlodipine besylate|Yes|No|No|No|75%|69097012815|AMLODIPINE BESYLATE 10 MG TAB|1000|EA|.00928|10/12/2015||Yes|No||10/12/2015||Yes|No|10/12/2015||Yes|No||||No|No|07/01/2016||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20449|||||No|No||CIPLA USA, INC.|No||||
albuterol sulfate|No|No|No|No|75%|69097014260|ALBUTEROL HFA 90 MCG INHALER|6.7|GM|2.30916|09/24/2020||Yes|No||09/24/2020||Yes|No|09/24/2020||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|3.77137|03/29/2022|3.68085|03/29/2022|3.70537|03/29/2022|||BRONCHODILATORS: BETA AGONIST|20450|||||No|No||CIPLA USA, INC.|No||||
valacyclovir HCl|No|No|No|No|75%|69097015302|VALACYCLOVIR HCL 500 MG TABLET|30|EA|.35045|03/05/2015||Yes|No||03/05/2015||Yes|No|03/05/2015||Yes|No||||No|No|||Prescription required|No||025|No|.29328|03/29/2022|.28624|03/29/2022|.28814|03/29/2022|||ANTIVIRALS: ORAL|20451|||||No|No||CIPLA USA, INC.|No||||
valacyclovir HCl|No|No|No|No|75%|69097015305|VALACYCLOVIR HCL 500 MG TABLET|90|EA|.34973|03/05/2015||Yes|No||03/05/2015||Yes|No|03/05/2015||Yes|No||||No|No|||Prescription required|No||025|No|.29328|03/29/2022|.28624|03/29/2022|.28814|03/29/2022|||ANTIVIRALS: ORAL|20452|||||No|No||CIPLA USA, INC.|No||||
valacyclovir HCl|No|No|No|No|75%|69097015312|VALACYCLOVIR HCL 500 MG TABLET|500|EA|.33221|03/05/2015||Yes|No||03/05/2015||Yes|No|03/05/2015||Yes|No||||No|No|||Prescription required|No||025|No|.29328|03/29/2022|.28624|03/29/2022|.28814|03/29/2022|||ANTIVIRALS: ORAL|20453|||||No|No||CIPLA USA, INC.|No||||
valacyclovir HCl|Yes|No|No|No|75%|69097015402|VALACYCLOVIR HCL 1 GRAM TABLET|30|EA|.55756|03/05/2015||Yes|No||03/05/2015||Yes|No|03/05/2015||Yes|No||||No|No|03/05/2015||Prescription required|No||025|No|.5737|03/29/2022|.55993|03/29/2022|.56366|03/29/2022|||ANTIVIRALS: ORAL|20454|||||No|No||CIPLA USA, INC.|No||||
valacyclovir HCl|Yes|No|No|No|75%|69097015405|VALACYCLOVIR HCL 1 GRAM TABLET|90|EA|.55756|03/05/2015||Yes|No||03/05/2015||Yes|No|03/05/2015||Yes|No||||No|No|03/05/2015||Prescription required|No||025|No|.5737|03/29/2022|.55993|03/29/2022|.56366|03/29/2022|||ANTIVIRALS: ORAL|20455|||||No|No||CIPLA USA, INC.|No||||
valacyclovir HCl|Yes|No|No|No|75%|69097015412|VALACYCLOVIR HCL 1 GRAM TABLET|500|EA|.52967|03/05/2015||Yes|No||03/05/2015||Yes|No|03/05/2015||Yes|No||||No|No|03/05/2015||Prescription required|No||025|No|.5737|03/29/2022|.55993|03/29/2022|.56366|03/29/2022|||ANTIVIRALS: ORAL|20456|||||No|No||CIPLA USA, INC.|No||||
meloxicam|No|No|No|No|75%|69097015807|MELOXICAM 7.5 MG TABLET|100|EA|.0172|03/02/2015||Yes|No||03/02/2015||Yes|No|03/02/2015||Yes|No||||No|No|||Prescription required|No||059|Yes|.02308|03/29/2022|.02252|03/29/2022|.02267|03/29/2022|||NSAIDS|20457|||||No|No||CIPLA USA, INC.|No||||
meloxicam|No|No|No|No|75%|69097015812|MELOXICAM 7.5 MG TABLET|500|EA|.01668|03/02/2015||Yes|No||03/02/2015||Yes|No|03/02/2015||Yes|No||||No|No|||Prescription required|No||059|Yes|.02308|03/29/2022|.02252|03/29/2022|.02267|03/29/2022|||NSAIDS|20458|||||No|No||CIPLA USA, INC.|No||||
meloxicam|No|No|No|No|75%|69097015815|MELOXICAM 7.5 MG TABLET|1000|EA|.01616|03/02/2015||Yes|No||03/02/2015||Yes|No|03/02/2015||Yes|No||||No|No|||Prescription required|No||059|Yes|.02308|03/29/2022|.02252|03/29/2022|.02267|03/29/2022|||NSAIDS|20459|||||No|No||CIPLA USA, INC.|No||||
meloxicam|No|No|No|No|75%|69097015907|MELOXICAM 15 MG TABLET|100|EA|.0215|03/02/2015||Yes|No||03/02/2015||Yes|No|03/02/2015||Yes|No||||No|No|||Prescription required|No||059|Yes|.02416|03/29/2022|.02358|03/29/2022|.02373|03/29/2022|||NSAIDS|20460|||||No|No||CIPLA USA, INC.|No||||
meloxicam|No|No|No|No|75%|69097015912|MELOXICAM 15 MG TABLET|500|EA|.02085|03/02/2015||Yes|No||03/02/2015||Yes|No|03/02/2015||Yes|No||||No|No|||Prescription required|No||059|Yes|.02416|03/29/2022|.02358|03/29/2022|.02373|03/29/2022|||NSAIDS|20461|||||No|No||CIPLA USA, INC.|No||||
meloxicam|No|No|No|No|75%|69097015915|MELOXICAM 15 MG TABLET|1000|EA|.02021|03/02/2015||Yes|No||03/02/2015||Yes|No|03/02/2015||Yes|No||||No|No|||Prescription required|No||059|Yes|.02416|03/29/2022|.02358|03/29/2022|.02373|03/29/2022|||NSAIDS|20462|||||No|No||CIPLA USA, INC.|No||||
arformoterol tartrate|No|No|No|No|75%|69097016864|ARFORMOTEROL 15 MCG/2 ML SOLN|2|ML|1.97083|09/07/2021||Yes|No||09/07/2021||Yes|No|09/07/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|037|Yes|3.32444|03/29/2022|3.24465|03/29/2022|3.26626|03/29/2022|||BRONCHODILATORS: BETA AGONIST|20463|||||No|No||CIPLA USA, INC.|No||||
arformoterol tartrate|No|No|No|No|75%|69097016887|ARFORMOTEROL 15 MCG/2 ML SOLN|2|ML|1.97083|09/07/2021||Yes|No||09/07/2021||Yes|No|09/07/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|037|Yes|3.35685|03/29/2022|3.27628|03/29/2022|3.2981|03/29/2022|||BRONCHODILATORS: BETA AGONIST|20464|||||No|No||CIPLA USA, INC.|No||||
ipratropium/albuterol sulfate|No|No|No|No|75%|69097017353|IPRAT-ALBUT 0.5-3(2.5) MG/3 ML|3|ML|.043|12/06/2016||Yes|No||12/06/2016||Yes|No|12/06/2016||Yes|No||||No|No|||Prescription required|No||098|Yes|.07201|03/29/2022|.07028|03/29/2022|.07074|03/29/2022|||COPD AGENTS|20465|||||No|No||CIPLA USA, INC.|Yes|09/01/2020|||
ipratropium/albuterol sulfate|No|No|No|No|75%|69097017364|IPRAT-ALBUT 0.5-3(2.5) MG/3 ML|3|ML|.043|12/06/2016||Yes|No||12/06/2016||Yes|No|12/06/2016||Yes|No||||No|No|||Prescription required|No||098|Yes|.06072|03/29/2022|.05926|03/29/2022|.05965|03/29/2022|||COPD AGENTS|20466|||||No|No||CIPLA USA, INC.|Yes|09/01/2020|||
emtricitabine/tenofovir (TDF)|No|No|No|No|75%|69097020902|EMTRICITABINE-TENOFV 200-300MG|30|EA|1.5|09/01/2021||Yes|No||09/01/2021||Yes|No|09/01/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.70347|03/29/2022|.68658|03/29/2022|.69115|03/29/2022|||HIV / AIDS|20467|||||No|No||CIPLA USA, INC.|No||||
efavirenz/emtricit/tenofovr df|No|No|No|No|75%|69097021002|EFAVIR-EMTRI-TENOF 600-200-300|30|EA|4.99999|06/16/2021||Yes|No||06/16/2021||Yes|No|06/16/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|4.79678|12/28/2021|4.68165|12/28/2021|4.71283|12/28/2021|||HIV / AIDS|20468|||||No|No||CIPLA USA, INC.|No||||
alendronate sodium|No|No|No|No|75%|69097022316|ALENDRONATE SODIUM 35 MG TAB|4|EA|.37625|03/01/2017||Yes|No||03/01/2017||Yes|No|03/01/2017||Yes|No||||No|No|||Prescription required|No||060|No|.34811|03/29/2022|.33975|03/29/2022|.34201|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|20469|||||No|No||CIPLA USA, INC.|No||||
alendronate sodium|No|No|No|No|75%|69097022376|ALENDRONATE SODIUM 35 MG TAB|12|EA|.37625|03/01/2017||Yes|No||03/01/2017||Yes|No|03/01/2017||Yes|No||||No|No|||Prescription required|No||060|No|.34811|03/29/2022|.33975|03/29/2022|.34201|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|20470|||||No|No||CIPLA USA, INC.|No||||
alendronate sodium|No|No|No|No|75%|69097022416|ALENDRONATE SODIUM 70 MG TAB|4|EA|.37625|03/01/2017||Yes|No||03/01/2017||Yes|No|03/01/2017||Yes|No||||No|No|||Prescription required|No||060|No|.29635|03/29/2022|.28923|03/29/2022|.29116|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|20471|||||No|No||CIPLA USA, INC.|No||||
alendronate sodium|No|No|No|No|75%|69097022476|ALENDRONATE SODIUM 70 MG TAB|12|EA|.37625|03/01/2017||Yes|No||03/01/2017||Yes|No|03/01/2017||Yes|No||||No|No|||Prescription required|No||060|No|.29635|03/29/2022|.28923|03/29/2022|.29116|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|20472|||||No|No||CIPLA USA, INC.|No||||
doxycycline monohydrate|No|No|No|No|75%|69097022843|DOXYCYCLINE 25 MG/5 ML SUSP|60|ML|.15408|10/05/2016|02/22/2022|Yes|No||10/05/2016|02/22/2022|Yes|No|10/05/2016|02/22/2022|Yes|No||||No|No|||Prescription required|No|||No|.35116|03/29/2022|.34614|03/29/2022|.32966|03/29/2022||||20473|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||CIPLA USA, INC.|No||||
albendazole|No|No|No|No|75%|69097023772|ALBENDAZOLE 200 MG TABLET|2|EA|13.975|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|No|||No|16.91042|03/29/2022|16.50456|03/29/2022|16.61448|03/29/2022||||20474|||||No|No||CIPLA USA, INC.|No||||
valganciclovir HCl|No|No|No|No|75%|69097027703|VALGANCICLOVIR 450 MG TABLET|60|EA|1.70673|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|136|No|2.64507|03/29/2022|2.58158|03/29/2022|2.59878|03/29/2022|||ANTIVIRALS: GENERAL|20475|||||No|No||CIPLA USA, INC.|No||||
efavirenz|No|No|No|No|75%|69097030102|EFAVIRENZ 600 MG TABLET|30|EA|3.92259|05/25/2021||Yes|No||05/25/2021||Yes|No|05/25/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|5.43893|08/24/2021|5.30839|08/24/2021|5.34374|08/24/2021|||HIV / AIDS|20476|||||No|No||CIPLA USA, INC.|No||||
exemestane|No|No|No|No|75%|69097031602|EXEMESTANE 25 MG TABLET|30|EA|.71666|01/29/2021||Yes|No||01/29/2021||Yes|No|01/29/2021||Yes|No||||No|No|||Prescription required|No||502|No|1.32315|03/29/2022|1.29139|03/29/2022|1.29999|03/29/2022|||ONCOLOGY: ORAL - BREAST|20477|||||No|No||CIPLA USA, INC.|No||||
budesonide|No|No|No|No|75%|69097031853|BUDESONIDE 0.25 MG/2 ML SUSP|2|ML|1.69979|05/28/2021||Yes|No||05/28/2021||Yes|No|05/28/2021||Yes|No||||No|No|||Prescription required|No||033|Yes|.8321|03/29/2022|.81212|03/29/2022|.81753|03/29/2022|||GLUCOCORTICOIDS: INHALED|20478|||||No|No||CIPLA USA, INC.|No||||
budesonide|No|No|No|No|75%|69097031887|BUDESONIDE 0.25 MG/2 ML SUSP|2|ML|.60916|05/08/2018||Yes|No||05/08/2018||Yes|No|05/08/2018||Yes|No||||No|No|||Prescription required|No||033|Yes|.8321|03/29/2022|.81212|03/29/2022|.81753|03/29/2022|||GLUCOCORTICOIDS: INHALED|20479|||||No|No||CIPLA USA, INC.|No||||
budesonide|No|No|No|No|75%|69097031953|BUDESONIDE 0.5 MG/2 ML SUSP|2|ML|2.0005|10/08/2020||Yes|No||10/08/2020||Yes|No|10/08/2020||Yes|No||||No|No|||Prescription required|No||033|Yes|.57313|03/29/2022|.55937|03/29/2022|.5631|03/29/2022|||GLUCOCORTICOIDS: INHALED|20480|||||No|No||CIPLA USA, INC.|No||||
budesonide|No|No|No|No|75%|69097031987|BUDESONIDE 0.5 MG/2 ML SUSP|2|ML|.64141|05/08/2018||Yes|No||05/08/2018||Yes|No|05/08/2018||Yes|No||||No|No|||Prescription required|No||033|Yes|.57313|03/29/2022|.55937|03/29/2022|.5631|03/29/2022|||GLUCOCORTICOIDS: INHALED|20481|||||No|No||CIPLA USA, INC.|Yes|09/01/2020|||
budesonide|No|No|No|No|75%|69097032153|BUDESONIDE 1 MG/2 ML INH SUSP|2|ML|2.15|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||||No|No|||Prescription required|No||033|Yes|3.95849|03/29/2022|3.86348|03/29/2022|3.88921|03/29/2022|||GLUCOCORTICOIDS: INHALED|20482|||||No|No||CIPLA USA, INC.|No||||
budesonide|No|No|No|No|75%|69097032187|BUDESONIDE 1 MG/2 ML INH SUSP|2|ML|2.23944|05/08/2018||Yes|No||05/08/2018||Yes|No|05/08/2018||Yes|No||||No|No|||Prescription required|No||033|Yes|3.95849|03/29/2022|3.86348|03/29/2022|3.88921|03/29/2022|||GLUCOCORTICOIDS: INHALED|20483|||||No|No||CIPLA USA, INC.|Yes|09/01/2020|||
dimethyl fumarate|No|No|No|No|75%|69097032289|DIMETHYL FUMARATE DR 120 MG CP|14|EA|2.30357|02/09/2021||Yes|No||02/09/2021||Yes|No|02/09/2021||Yes|No||||No|No|||Prescription required|No||043|No|6.92871|10/26/2021|6.76242|10/26/2021|6.80745|10/26/2021|||MULTIPLE SCLEROSIS AGENTS|20484|||||No|No||CIPLA USA, INC.|No||||
dimethyl fumarate|No|No|No|No|75%|69097032303|DIMETHYL FUMARATE DR 240 MG CP|60|EA|1.6125|02/12/2021||Yes|No||02/12/2021||Yes|No|02/12/2021||Yes|No||||No|No|||Prescription required|No||043|No|3.05522|11/23/2021|2.98189|11/23/2021|3.00175|11/23/2021|||MULTIPLE SCLEROSIS AGENTS|20485|||||No|No||CIPLA USA, INC.|No||||
griseofulvin, microsize|No|No|No|No|75%|69097036108|GRISEOFULVIN 125 MG/5 ML SUSP|120|ML|.1735|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|No||069|No|.28513|03/29/2022|.27828|03/29/2022|.28014|03/29/2022|||ANTIFUNGALS: ORAL|20486|||||No|No||CIPLA USA, INC.|No||||
abacavir sulfate/lamivudine|No|No|No|No|75%|69097036202|ABACAVIR-LAMIVUDINE 600-300 MG|30|EA|3.69499|10/12/2018||Yes|No||10/12/2018||Yes|No|10/12/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|2.09447|03/29/2022|2.0442|03/29/2022|2.05781|03/29/2022|||HIV / AIDS|20487|||||No|No||CIPLA USA, INC.|No||||
testosterone|No|No|No|No|90%|69097036344|TESTOSTERONE 30 MG/1.5 ML PUMP|90|ML|1.20624|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|084|No|.95473|03/29/2022|.93181|03/29/2022|.93802|03/29/2022|||ANDROGENIC AGENTS|20488|||||No|No||CIPLA USA, INC.|No||||
ambrisentan|No|No|No|No|75%|69097038602|AMBRISENTAN 5 MG TABLET|30|EA|16.51257|10/30/2019||Yes|No||10/30/2019||Yes|No|10/30/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|No|37.6333|07/28/2020|37.09568|07/28/2020|35.32922|07/28/2020|||PAH AGENTS: ORAL AND INHALED|20489|||||No|No||CIPLA USA, INC.|No||||
ambrisentan|No|No|No|No|75%|69097038702|AMBRISENTAN 10 MG TABLET|30|EA|16.51257|10/30/2019||Yes|No||10/30/2019||Yes|No|10/30/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|No|37.6333|07/28/2020|37.09568|07/28/2020|35.32922|07/28/2020|||PAH AGENTS: ORAL AND INHALED|20490|||||No|No||CIPLA USA, INC.|No||||
metoprolol succinate|No|No|No|No|75%|69097040707|METOPROLOL SUCC ER 50 MG TAB|100|EA|.1075|10/30/2019||Yes|No||10/30/2019||Yes|No|10/30/2019||Yes|No||||No|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|20491|||||No|No||CIPLA USA, INC.|No||||
metoprolol succinate|No|No|No|No|75%|69097040715|METOPROLOL SUCC ER 50 MG TAB|1000|EA|.043|06/16/2021||Yes|No||06/16/2021||Yes|No|06/16/2021||Yes|No||||No|No|||Prescription required|No||070|No|.10316|03/29/2022|.10068|03/29/2022|.10135|03/29/2022|||BETA-BLOCKERS|20492|||||No|No||CIPLA USA, INC.|No||||
metoprolol succinate|No|No|No|No|75%|69097040807|METOPROLOL SUCC ER 100 MG TAB|100|EA|.1075|10/30/2019||Yes|No||10/30/2019||Yes|No|10/30/2019||Yes|No||||No|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|20493|||||No|No||CIPLA USA, INC.|No||||
metoprolol succinate|No|No|No|No|75%|69097040815|METOPROLOL SUCC ER 100 MG TAB|1000|EA|.043|06/16/2021||Yes|No||06/16/2021||Yes|No|06/16/2021||Yes|No||||No|No|||Prescription required|No||070|No|.16108|03/29/2022|.15721|03/29/2022|.15826|03/29/2022|||BETA-BLOCKERS|20494|||||No|No||CIPLA USA, INC.|No||||
metoprolol succinate|No|No|No|No|75%|69097040907|METOPROLOL SUCC ER 200 MG TAB|100|EA|.215|10/30/2019||Yes|No||10/30/2019||Yes|No|10/30/2019||Yes|No||||No|No|||Prescription required|No||070|No|.25385|03/29/2022|.24775|03/29/2022|.2494|03/29/2022|||BETA-BLOCKERS|20495|||||No|No||CIPLA USA, INC.|No||||
cinacalcet HCl|No|No|No|No|75%|69097041002|CINACALCET HCL 30 MG TABLET|30|EA|.215|12/06/2019||Yes|No||12/06/2019||Yes|No|12/06/2019||Yes|No||||No|No|||Prescription required|No|||No|.75588|03/29/2022|.73773|03/29/2022|.74265|03/29/2022||||20496|||||No|No||CIPLA USA, INC.|No||||
cinacalcet HCl|No|No|No|No|75%|69097041102|CINACALCET HCL 60 MG TABLET|30|EA|.387|12/06/2019||Yes|No||12/06/2019||Yes|No|12/06/2019||Yes|No||||No|No|||Prescription required|No|||No|1.7407|03/29/2022|1.69892|03/29/2022|1.71023|03/29/2022||||20497|||||No|No||CIPLA USA, INC.|No||||
cinacalcet HCl|No|No|No|No|75%|69097041202|CINACALCET HCL 90 MG TABLET|30|EA|.559|12/06/2019||Yes|No||12/06/2019||Yes|No|12/06/2019||Yes|No||||No|No|||Prescription required|No|||No|3.64673|03/29/2022|3.5592|03/29/2022|3.58291|03/29/2022||||20498|||||No|No||CIPLA USA, INC.|No||||
celecoxib|No|No|No|No|75%|69097042003|CELECOXIB 400 MG CAPSULE|60|EA|.25083|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.73632|03/29/2022|.71864|03/29/2022|.72343|03/29/2022|||NSAIDS|20499|||||No|No||CIPLA USA, INC.|No||||
celecoxib|No|No|No|No|75%|69097042107|CELECOXIB 200 MG CAPSULE|100|EA|.129|02/02/2017||Yes|No||02/02/2017||Yes|No|02/02/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|20500|||||No|No||CIPLA USA, INC.|No||||
celecoxib|No|No|No|No|75%|69097042112|CELECOXIB 200 MG CAPSULE|500|EA|.1032|02/02/2017||Yes|No||02/02/2017||Yes|No|02/02/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|20501|||||No|No||CIPLA USA, INC.|No||||
celecoxib|No|No|No|No|75%|69097042207|CELECOXIB 100 MG CAPSULE|100|EA|.0645|02/02/2017||Yes|No||02/02/2017||Yes|No|02/02/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|20502|||||No|No||CIPLA USA, INC.|No||||
celecoxib|No|No|No|No|75%|69097042212|CELECOXIB 100 MG CAPSULE|500|EA|.0516|02/02/2017||Yes|No||02/02/2017||Yes|No|02/02/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|20503|||||No|No||CIPLA USA, INC.|No||||
celecoxib|No|No|No|No|75%|69097042303|CELECOXIB 50 MG CAPSULE|60|EA|.05733|02/02/2017||Yes|No||02/02/2017||Yes|No|02/02/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|059|Yes|.1386|03/29/2022|.13527|03/29/2022|.13617|03/29/2022|||NSAIDS|20504|||||No|No||CIPLA USA, INC.|No||||
entecavir|No|No|No|No|75%|69097042502|ENTECAVIR 1 MG TABLET|30|EA|.91733|05/25/2021||Yes|No||05/25/2021||Yes|No|05/25/2021||Yes|No||||No|No|||Prescription required|No|||No|1.06461|03/29/2022|1.03905|03/29/2022|1.04597|03/29/2022||||20505|||||No|No||CIPLA USA, INC.|No||||
entecavir|No|No|No|No|75%|69097042602|ENTECAVIR 0.5 MG TABLET|30|EA|.91733|05/25/2021||Yes|No||05/25/2021||Yes|No|05/25/2021||Yes|No||||No|No|||Prescription required|No|||No|.89227|03/29/2022|.87085|03/29/2022|.87665|03/29/2022||||20506|||||No|No||CIPLA USA, INC.|No||||
darifenacin hydrobromide|No|No|No|No|75%|69097043102|DARIFENACIN ER 7.5 MG TABLET|30|EA|1.40896|04/11/2017||Yes|No||04/11/2017||Yes|No|04/11/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|006|Yes|1.71519|03/29/2022|1.67402|03/29/2022|1.68517|03/29/2022|||BLADDER RELAXANT PREPARATIONS|20507|||||No|No||CIPLA USA, INC.|No||||
darifenacin hydrobromide|No|No|No|No|75%|69097043105|DARIFENACIN ER 7.5 MG TABLET|90|EA|1.40896|04/11/2017||Yes|No||04/11/2017||Yes|No|04/11/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|006|Yes|1.71519|03/29/2022|1.67402|03/29/2022|1.68517|03/29/2022|||BLADDER RELAXANT PREPARATIONS|20508|||||No|No||CIPLA USA, INC.|No||||
darifenacin hydrobromide|No|No|No|No|75%|69097043202|DARIFENACIN ER 15 MG TABLET|30|EA|1.40896|04/11/2017||Yes|No||04/11/2017||Yes|No|04/11/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|006|No|2.08753|03/29/2022|2.03742|03/29/2022|2.05099|03/29/2022|||BLADDER RELAXANT PREPARATIONS|20509|||||No|No||CIPLA USA, INC.|No||||
darifenacin hydrobromide|No|No|No|No|75%|69097043205|DARIFENACIN ER 15 MG TABLET|90|EA|1.40896|04/11/2017||Yes|No||04/11/2017||Yes|No|04/11/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|006|No|2.08753|03/29/2022|2.03742|03/29/2022|2.05099|03/29/2022|||BLADDER RELAXANT PREPARATIONS|20510|||||No|No||CIPLA USA, INC.|No||||
atazanavir sulfate|No|No|No|No|75%|69097044403|ATAZANAVIR SULFATE 150 MG CAP|60|EA|1.782|02/11/2021||Yes|No||02/11/2021||Yes|No|02/11/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|2.9106|03/02/2021|2.86902|03/02/2021|2.7324|03/02/2021|||HIV / AIDS|20511|||||No|No||CIPLA USA, INC.|No||||
atazanavir sulfate|No|No|No|No|75%|69097044503|ATAZANAVIR SULFATE 200 MG CAP|60|EA|1.782|06/29/2021||Yes|No||06/29/2021||Yes|No|06/29/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|2.9106|06/29/2021|2.86902|06/29/2021|2.7324|06/29/2021|||HIV / AIDS|20512|||||No|No||CIPLA USA, INC.|No||||
atazanavir sulfate|No|No|No|No|75%|69097044602|ATAZANAVIR SULFATE 300 MG CAP|30|EA|3.564|02/11/2021||Yes|No||02/11/2021||Yes|No|02/11/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|5.91006|05/25/2021|5.76821|05/25/2021|5.80663|05/25/2021|||HIV / AIDS|20513|||||No|No||CIPLA USA, INC.|No||||
fenofibrate nanocrystallized|No|No|No|No|75%|69097045805|FENOFIBRATE 145 MG TABLET|90|EA|.18203|09/14/2017||Yes|No||09/14/2017||Yes|No|09/14/2017||Yes|No||||No|No|||Prescription required|No||055|No|.16424|03/29/2022|.16029|03/29/2022|.16136|03/29/2022|||LIPOTROPICS: OTHER|20514|||||No|No||CIPLA USA, INC.|No||||
fenofibrate nanocrystallized|No|No|No|No|75%|69097045905|FENOFIBRATE 48 MG TABLET|90|EA|.09966|09/14/2017||Yes|No||09/14/2017||Yes|No|09/14/2017||Yes|No||||No|No|||Prescription required|No||055|No|.11999|03/29/2022|.11711|03/29/2022|.11789|03/29/2022|||LIPOTROPICS: OTHER|20515|||||No|No||CIPLA USA, INC.|No||||
dihydroergotamine mesylate|No|No|No|No|75%|69097050327|DIHYDROERGOTAMINE 4 MG/ML SPRY|1|ML|129|09/15/2020||Yes|No||09/15/2020||Yes|No|09/15/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|537|No|162.55946|03/29/2022|158.65803|03/29/2022|159.71466|03/29/2022|||ANTIMIGRAINE AGENTS: OTHER|20516|||||No|No||CIPLA USA, INC.|No||||
dihydroergotamine mesylate|No|No|No|No|75%|69097050331|DIHYDROERGOTAMINE 4 MG/ML SPRY|1|ML||05/25/2021||Yes|No||05/25/2021||Yes|No|05/25/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|537|No|||||||119.26679|05/25/2021|ANTIMIGRAINE AGENTS: OTHER|20517|||||No|No||CIPLA USA, INC.|No||||
abacavir sulfate|No|No|No|No|75%|69097051403|ABACAVIR 300 MG TABLET|60|EA|.99999|06/05/2018||Yes|No||06/05/2018||Yes|No|06/05/2018||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.69669|03/29/2022|.67996|03/29/2022|.68449|03/29/2022|||HIV / AIDS|20518|||||No|No||CIPLA USA, INC.|No||||
cyclophosphamide|No|No|No|No|75%|69097051607|CYCLOPHOSPHAMIDE 25 MG CAPSULE|100|EA|1.29|05/25/2021||Yes|No||05/25/2021||Yes|No|05/25/2021||Yes|No||||No|No|||Prescription required|No||502|No|2.94|08/31/2021|2.898|08/31/2021|2.76|08/31/2021|||ONCOLOGY: ORAL - BREAST|20519|||||No|No||CIPLA USA, INC.|No||||
cyclophosphamide|No|No|No|No|75%|69097051707|CYCLOPHOSPHAMIDE 50 MG CAPSULE|100|EA|2.365|01/29/2021||Yes|No||01/29/2021||Yes|No|01/29/2021||Yes|No||||No|No|||Prescription required|No||502|No|5.39|08/31/2021|5.313|08/31/2021|5.06|08/31/2021|||ONCOLOGY: ORAL - BREAST|20520|||||No|No||CIPLA USA, INC.|No||||
diclofenac sodium|No|No|No|No|75%|69097052444|DICLOFENAC SODIUM 1% GEL|100|GM|.0645|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|No||059|Yes|.08846|03/29/2022|.08633|03/29/2022|.08691|03/29/2022|||NSAIDS|20521|||||No|No||CIPLA USA, INC.|No||||
tadalafil|No|No|No|No|75%|69097052603|TADALAFIL 20 MG TABLET|60|EA|.35797|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/26/2018|171|Yes|.68104|03/29/2022|.66469|03/29/2022|.66912|03/29/2022|||PAH AGENTS: ORAL AND INHALED|20522|||||No|No||CIPLA USA, INC.|No||||
esomeprazole magnesium|No|No|No|No|75%|69097052734|ESOMEPRAZOLE DR 10 MG PACKET|30|EA|3.356|06/25/2020||Yes|No||06/25/2020||Yes|No|06/25/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|6.8942|03/01/2022|6.72873|03/01/2022|6.77355|03/01/2022|||PROTON PUMP INHIBITORS|20523|||||No|No||CIPLA USA, INC.|No||||
esomeprazole magnesium|No|No|No|No|75%|69097052834|ESOMEPRAZOLE DR 20 MG PACKET|30|EA|3.356|06/25/2020||Yes|No||06/25/2020||Yes|No|06/25/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|6.26773|03/01/2022|6.1173|03/01/2022|6.15804|03/01/2022|||PROTON PUMP INHIBITORS|20524|||||No|No||CIPLA USA, INC.|No||||
esomeprazole magnesium|No|No|No|No|75%|69097052934|ESOMEPRAZOLE DR 40 MG PACKET|30|EA|3.356|06/25/2020||Yes|No||06/25/2020||Yes|No|06/25/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|7.06722|11/23/2021|6.8976|11/23/2021|6.94354|11/23/2021|||PROTON PUMP INHIBITORS|20525|||||No|No||CIPLA USA, INC.|No||||
tenofovir disoproxil fumarate|No|No|No|No|75%|69097053302|TENOFOVIR DISOP FUM 300 MG TB|30|EA|.576|02/12/2021||Yes|No||02/12/2021||Yes|No|02/12/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.62458|03/29/2022|.60959|03/29/2022|.61364|03/29/2022|||HIV / AIDS|20526|||||No|No||CIPLA USA, INC.|No||||
dimethyl fumarate|No|No|No|No|75%|69097055203|DIMETHYL FUMARATE 30D START PK|60|EA|1.6125|05/03/2021||Yes|No||05/03/2021||Yes|No|05/03/2021||Yes|No||||No|No|||Prescription required|No||043|No|3.675|12/28/2021|3.6225|12/28/2021|3.45|12/28/2021|||MULTIPLE SCLEROSIS AGENTS|20527|||||No|No||CIPLA USA, INC.|No||||
emtricitabine|No|No|No|No|75%|69097064202|EMTRICITABINE 200 MG CAPSULE|30|EA|9.27|01/29/2021||Yes|No||01/29/2021||Yes|No|01/29/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|15.141|02/02/2021|14.9247|01/29/2021|14.214|01/29/2021|||HIV / AIDS|20528|||||No|No||CIPLA USA, INC.|No||||
sumatriptan|No|No|No|No|75%|69097064448|SUMATRIPTAN 20 MG NASAL SPRAY|6|EA|12.54166|09/07/2021||Yes|No||09/07/2021||Yes|No|09/07/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|021|No|23.30855|03/29/2022|22.74914|03/29/2022|22.90065|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|20529|||||No|No||CIPLA USA, INC.|No||||
pregabalin|No|No|No|No|90%|69097067705|PREGABALIN 25 MG CAPSULE|90|EA|.07166|05/25/2021||Yes|No||05/25/2021||Yes|No|05/25/2021||Yes|No||||No|No|||Prescription required|No||232|No|.0795|03/29/2022|.07759|03/29/2022|.0781|03/29/2022|||NEUROPATHIC PAIN|20530|||||No|No||CIPLA USA, INC.|No||||
pregabalin|No|No|No|No|90%|69097067805|PREGABALIN 50 MG CAPSULE|90|EA|.07166|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||232|No|.09128|03/29/2022|.08908|03/29/2022|.08968|03/29/2022|||NEUROPATHIC PAIN|20531|||||No|No||CIPLA USA, INC.|No||||
pregabalin|No|No|No|No|90%|69097067905|PREGABALIN 75 MG CAPSULE|90|EA|.07166|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||232|No|.08098|03/29/2022|.07903|03/29/2022|.07956|03/29/2022|||NEUROPATHIC PAIN|20532|||||No|No||CIPLA USA, INC.|No||||
pregabalin|No|No|No|No|90%|69097068105|PREGABALIN 100 MG CAPSULE|90|EA|.07166|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||232|No|.08763|03/29/2022|.08552|03/29/2022|.08609|03/29/2022|||NEUROPATHIC PAIN|20533|||||No|No||CIPLA USA, INC.|No||||
pregabalin|No|No|No|No|90%|69097068205|PREGABALIN 150 MG CAPSULE|90|EA|.07166|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||232|No|.10646|03/29/2022|.1039|03/29/2022|.10459|03/29/2022|||NEUROPATHIC PAIN|20534|||||No|No||CIPLA USA, INC.|No||||
pregabalin|No|No|No|No|90%|69097068305|PREGABALIN 200 MG CAPSULE|90|EA|.07166|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||232|No|.11395|03/29/2022|.11121|03/29/2022|.11195|03/29/2022|||NEUROPATHIC PAIN|20535|||||No|No||CIPLA USA, INC.|No||||
pregabalin|No|No|No|No|90%|69097068405|PREGABALIN 225 MG CAPSULE|90|EA|.07166|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||232|No|.12393|03/29/2022|.12095|03/29/2022|.12176|03/29/2022|||NEUROPATHIC PAIN|20536|||||No|No||CIPLA USA, INC.|No||||
pregabalin|No|No|No|No|90%|69097068505|PREGABALIN 300 MG CAPSULE|90|EA|.07166|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||232|No|.12181|03/29/2022|.11888|03/29/2022|.11967|03/29/2022|||NEUROPATHIC PAIN|20537|||||No|No||CIPLA USA, INC.|No||||
tavaborole|No|No|No|No|75%|69097068637|TAVABOROLE 5% TOPICAL SOLUTION|10|ML|3.87|06/16/2021||Yes|No||06/16/2021||Yes|No|06/16/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|061|No|12.67867|08/24/2021|12.37438|08/24/2021|12.45679|08/24/2021|||ANTIFUNGALS: TOPICAL|20538|||||No|No||CIPLA USA, INC.|No||||
terbinafine HCl|No|No|No|No|75%|69097073102|TERBINAFINE HCL 250 MG TABLET|30|EA|.1247|06/06/2021||Yes|No||06/06/2021||Yes|No|06/06/2021||Yes|No||||No|No|||Prescription required|No||069|No|.15711|03/29/2022|.15333|03/29/2022|.15436|03/29/2022|||ANTIFUNGALS: ORAL|20539|||||No|No||CIPLA USA, INC.|No||||
terbinafine HCl|No|No|No|No|75%|69097073107|TERBINAFINE HCL 250 MG TABLET|100|EA|.1247|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|No||069|No|.15711|03/29/2022|.15333|03/29/2022|.15436|03/29/2022|||ANTIFUNGALS: ORAL|20540|||||No|No||CIPLA USA, INC.|No||||
dihydroergotamine mesylate|No|No|No|No|75%|69097074031|DIHYDROERGOTAMINE 4 MG/ML SPRY|1|ML|129|06/21/2021||Yes|No||06/21/2021||Yes|No|06/21/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|537|No|294|12/28/2021|289.8|12/28/2021|276|12/28/2021|||ANTIMIGRAINE AGENTS: OTHER|20541|||||No|No||CIPLA USA, INC.|No||||
emtricitabine/tenofovir (TDF)|No|No|No|No|75%|69097074102|EMTRICITABINE-TENOFV 200-300MG|30|EA|1.5|03/30/2022||Yes|No||03/30/2022||Yes|No|03/30/2022||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.70347|03/30/2022|.68658|03/30/2022|.69115|03/30/2022|||HIV / AIDS|20542|||||No|No||CIPLA USA, INC.|No||||
testosterone cypionate|No|No|No|No|90%|69097080232|TESTOSTERONE CYP 200 MG/ML|1|ML|8.2775|08/02/2019||Yes|No||08/02/2019||Yes|No|08/02/2019||Yes|No||||No|No|||Prescription required|No|||No|15.53502|03/29/2022|15.16217|03/29/2022|15.26315|03/29/2022||||20543|||||No|No||CIPLA USA, INC.|No||||
testosterone cypionate|No|No|No|No|90%|69097080237|TESTOSTERON CYP 2,000 MG/10 ML|10|ML|2.15|08/02/2019||Yes|No||08/02/2019||Yes|No|08/02/2019||Yes|No||||No|No|||Prescription required|No|||No|3.11913|03/29/2022|3.04427|03/29/2022|3.06454|03/29/2022||||20544|||||No|No||CIPLA USA, INC.|No||||
azacitidine|No|No|No|No|75%|69097080540|AZACITIDINE 100 MG VIAL|1|EA|90.3|11/05/2019||Yes|No||11/05/2019||Yes|No|11/05/2019||Yes|No||||No|No|||Prescription required|No|||No|205.8|11/12/2019|202.86|11/12/2019|193.2|11/05/2019||||20545|||||No|No||CIPLA USA, INC.|No||||
daptomycin|No|No|No|No|75%|69097080737|DAPTOMYCIN 500 MG VIAL|1|EA|25.8|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|No|||No|58.8|02/09/2021|57.96|02/09/2021|55.2|02/09/2021||||20546|||||No|No||CIPLA USA, INC.|No||||
gabapentin|No|No|No|No|75%|69097081307|GABAPENTIN 100 MG CAPSULE|100|EA|.0215|09/02/2016||Yes|No||09/02/2016||Yes|No|09/02/2016||Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|20547|||||No|No||CIPLA USA, INC.|No||||
gabapentin|No|No|No|No|75%|69097081312|GABAPENTIN 100 MG CAPSULE|500|EA|.0215|09/02/2016||Yes|No||09/02/2016||Yes|No|09/02/2016||Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|20548|||||No|No||CIPLA USA, INC.|No||||
gabapentin|No|No|No|No|75%|69097081507|GABAPENTIN 400 MG CAPSULE|100|EA|.0946|09/02/2016||Yes|No||09/02/2016||Yes|No|09/02/2016||Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|20549|||||No|No||CIPLA USA, INC.|No||||
gabapentin|No|No|No|No|75%|69097081512|GABAPENTIN 400 MG CAPSULE|500|EA|.0817|09/02/2016||Yes|No||09/02/2016||Yes|No|09/02/2016||Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|20550|||||No|No||CIPLA USA, INC.|No||||
gemfibrozil|No|No|No|No|75%|69097082103|GEMFIBROZIL 600 MG TABLET|60|EA|.07467|09/02/2016||Yes|No||09/02/2016||Yes|No|09/02/2016||Yes|No||||No|No|||Prescription required|No||055|No|.10518|03/29/2022|.10265|03/29/2022|.10333|03/29/2022|||LIPOTROPICS: OTHER|20551|||||No|No||CIPLA USA, INC.|No||||
gemfibrozil|No|No|No|No|75%|69097082112|GEMFIBROZIL 600 MG TABLET|500|EA|.05142|09/02/2016||Yes|No||09/02/2016||Yes|No|09/02/2016||Yes|No||||No|No|||Prescription required|No||055|No|.10518|03/29/2022|.10265|03/29/2022|.10333|03/29/2022|||LIPOTROPICS: OTHER|20552|||||No|No||CIPLA USA, INC.|No||||
citalopram hydrobromide|No|No|No|No|75%|69097082207|CITALOPRAM HBR 10 MG TABLET|100|EA|.02438|09/02/2016||Yes|No||09/02/2016||Yes|No|09/02/2016||Yes|No||||No|No|||Prescription required|No||008|Yes|.02682|03/29/2022|.02617|03/29/2022|.02635|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20553|||||No|No||CIPLA USA, INC.|No||||
citalopram hydrobromide|No|No|No|No|75%|69097082212|CITALOPRAM HBR 10 MG TABLET|500|EA|.023|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|||Prescription required|No||008|Yes|.02682|03/29/2022|.02617|03/29/2022|.02635|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20554|||||No|No||CIPLA USA, INC.|No||||
citalopram hydrobromide|Yes|No|No|No|75%|69097082307|CITALOPRAM HBR 20 MG TABLET|100|EA|.02438|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|11/17/2016||Prescription required|No||008|Yes|.02946|03/29/2022|.02875|03/29/2022|.02894|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20555|||||No|No||CIPLA USA, INC.|No||||
citalopram hydrobromide|Yes|No|No|No|75%|69097082312|CITALOPRAM HBR 20 MG TABLET|500|EA|.023|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|11/17/2016||Prescription required|No||008|Yes|.02946|03/29/2022|.02875|03/29/2022|.02894|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20556|||||No|No||CIPLA USA, INC.|No||||
citalopram hydrobromide|No|No|No|No|75%|69097082407|CITALOPRAM HBR 40 MG TABLET|100|EA|.02438|09/02/2016||Yes|No||09/02/2016||Yes|No|09/02/2016||Yes|No||||No|No|||Prescription required|No||008|No|.03726|03/29/2022|.03636|03/29/2022|.0366|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20557|||||No|No||CIPLA USA, INC.|No||||
citalopram hydrobromide|Yes|No|No|No|75%|69097082412|CITALOPRAM HBR 40 MG TABLET|500|EA|.023|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|11/17/2016||Prescription required|No||008|No|.03726|03/29/2022|.03636|03/29/2022|.0366|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20558|||||No|No||CIPLA USA, INC.|No||||
raloxifene HCl|No|No|No|No|75%|69097082502|RALOXIFENE HCL 60 MG TABLET|30|EA|.49665|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|060|Yes|.36315|03/29/2022|.35443|03/29/2022|.35679|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|20559|||||No|No||CIPLA USA, INC.|No||||
raloxifene HCl|No|No|No|No|75%|69097082507|RALOXIFENE HCL 60 MG TABLET|100|EA|.49665|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|060|Yes|.36315|03/29/2022|.35443|03/29/2022|.35679|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|20560|||||No|No||CIPLA USA, INC.|No||||
raloxifene HCl|No|No|No|No|75%|69097082515|RALOXIFENE HCL 60 MG TABLET|1000|EA|.49665|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|060|Yes|.36315|03/29/2022|.35443|03/29/2022|.35679|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|20561|||||No|No||CIPLA USA, INC.|No||||
benztropine mesylate|No|No|No|No|75%|69097082607|BENZTROPINE MES 0.5 MG TAB|100|EA|.0559|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||015|No|.08426|03/29/2022|.08223|03/29/2022|.08278|03/29/2022|||ANTIPARKINSON'S AGENTS|20562|||||No|No||CIPLA USA, INC.|No||||
benztropine mesylate|No|No|No|No|75%|69097082707|BENZTROPINE MES 1 MG TABLET|100|EA|.06514|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||015|No|.08541|03/29/2022|.08336|03/29/2022|.08391|03/29/2022|||ANTIPARKINSON'S AGENTS|20563|||||No|No||CIPLA USA, INC.|No||||
benztropine mesylate|No|No|No|No|75%|69097083207|BENZTROPINE MES 2 MG TABLET|100|EA|.08311|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||015|No|.12012|03/29/2022|.11723|03/29/2022|.11801|03/29/2022|||ANTIPARKINSON'S AGENTS|20564|||||No|No||CIPLA USA, INC.|No||||
sertraline HCl|Yes|No|No|No|75%|69097083302|SERTRALINE HCL 25 MG TABLET|30|EA|.04515|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|11/17/2016||Prescription required|No||008|Yes|.05057|03/29/2022|.04935|03/29/2022|.04968|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20565|||||No|No||CIPLA USA, INC.|No||||
sertraline HCl|Yes|No|No|No|75%|69097083305|SERTRALINE HCL 25 MG TABLET|90|EA|.0344|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|11/17/2016||Prescription required|No||008|Yes|.05057|03/29/2022|.04935|03/29/2022|.04968|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20566|||||No|No||CIPLA USA, INC.|No||||
sertraline HCl|Yes|No|No|No|75%|69097083312|SERTRALINE HCL 25 MG TABLET|500|EA|.03173|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|11/17/2016||Prescription required|No||008|Yes|.05057|03/29/2022|.04935|03/29/2022|.04968|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20567|||||No|No||CIPLA USA, INC.|No||||
sertraline HCl|No|No|No|No|75%|69097083402|SERTRALINE HCL 50 MG TABLET|30|EA|.05805|09/02/2016||Yes|No||09/02/2016||Yes|No|09/02/2016||Yes|No||||No|No|||Prescription required|No||008|Yes|.04281|03/29/2022|.04178|03/29/2022|.04206|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20568|||||No|No||CIPLA USA, INC.|No||||
sertraline HCl|Yes|No|No|No|75%|69097083412|SERTRALINE HCL 50 MG TABLET|500|EA|.04349|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|11/17/2016||Prescription required|No||008|Yes|.04281|03/29/2022|.04178|03/29/2022|.04206|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20569|||||No|No||CIPLA USA, INC.|No||||
sertraline HCl|Yes|No|No|No|75%|69097083502|SERTRALINE HCL 100 MG TABLET|30|EA|.08385|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|11/17/2016||Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20570|||||No|No||CIPLA USA, INC.|No||||
sertraline HCl|Yes|No|No|No|75%|69097083512|SERTRALINE HCL 100 MG TABLET|500|EA|.06888|09/02/2016||Yes|No||09/02/2016||Yes|No|09/02/2016||Yes|No||||No|No|09/02/2016||Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20571|||||No|No||CIPLA USA, INC.|No||||
amlodipine besylate|No|No|No|No|75%|69097083605|AMLODIPINE BESYLATE 2.5 MG TAB|90|EA|.01791|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|||Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20572|||||No|No||CIPLA USA, INC.|No||||
amlodipine besylate|Yes|No|No|No|75%|69097083615|AMLODIPINE BESYLATE 2.5 MG TAB|1000|EA|.01698|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|11/17/2016||Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20573|||||No|No||CIPLA USA, INC.|No||||
amlodipine besylate|Yes|No|No|No|75%|69097083705|AMLODIPINE BESYLATE 5 MG TAB|90|EA|.02365|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|11/17/2016||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20574|||||No|No||CIPLA USA, INC.|No||||
amlodipine besylate|No|No|No|No|75%|69097083715|AMLODIPINE BESYLATE 5 MG TAB|1000|EA|.02246|09/02/2016||Yes|No||09/02/2016||Yes|No|09/02/2016||Yes|No||||No|No|||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20575|||||No|No||CIPLA USA, INC.|No||||
amlodipine besylate|Yes|No|No|No|75%|69097083805|AMLODIPINE BESYLATE 10 MG TAB|90|EA|.02365|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|11/17/2016||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20576|||||No|No||CIPLA USA, INC.|No||||
amlodipine besylate|Yes|No|No|No|75%|69097083815|AMLODIPINE BESYLATE 10 MG TAB|1000|EA|.02246|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|11/17/2016||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20577|||||No|No||CIPLA USA, INC.|No||||
ipratropium/albuterol sulfate|No|No|No|No|75%|69097084053|IPRAT-ALBUT 0.5-3(2.5) MG/3 ML|3|ML|.09316|02/25/2021||Yes|No||02/25/2021||Yes|No|02/25/2021||Yes|No||||No|No|||Prescription required|No||098|Yes|.07201|03/29/2022|.07028|03/29/2022|.07074|03/29/2022|||COPD AGENTS|20578|||||No|No||CIPLA USA, INC.|No||||
ipratropium/albuterol sulfate|No|No|No|No|75%|69097084064|IPRAT-ALBUT 0.5-3(2.5) MG/3 ML|3|ML|.043|05/28/2021||Yes|No||05/28/2021||Yes|No|05/28/2021||Yes|No||||No|No|||Prescription required|No||098|Yes|.06072|03/29/2022|.05926|03/29/2022|.05965|03/29/2022|||COPD AGENTS|20579|||||No|No||CIPLA USA, INC.|No||||
ipratropium/albuterol sulfate|No|No|No|No|75%|69097084087|IPRAT-ALBUT 0.5-3(2.5) MG/3 ML|3|ML|.043|05/28/2021||Yes|No||05/28/2021||Yes|No|05/28/2021||Yes|No||||No|No|||Prescription required|No||098|Yes|.07201|03/29/2022|.07028|03/29/2022|.07074|03/29/2022|||COPD AGENTS|20580|||||No|No||CIPLA USA, INC.|No||||
alfuzosin HCl|No|No|No|No|75%|69097084407|ALFUZOSIN HCL ER 10 MG TABLET|100|EA|.1505|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|||Prescription required|No||003|No|.12775|03/29/2022|.12468|03/29/2022|.12551|03/29/2022|||BPH TREATMENTS|20581|||||No|No||CIPLA USA, INC.|No||||
alfuzosin HCl|No|No|No|No|75%|69097084412|ALFUZOSIN HCL ER 10 MG TABLET|500|EA|.1505|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|||Prescription required|No||003|No|.12775|03/29/2022|.12468|03/29/2022|.12551|03/29/2022|||BPH TREATMENTS|20582|||||No|No||CIPLA USA, INC.|No||||
cyclobenzaprine HCl|No|No|No|No|75%|69097084507|CYCLOBENZAPRINE 5 MG TABLET|100|EA|.02021|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|||Prescription required|No||116|Yes|.02938|03/29/2022|.02867|03/29/2022|.02886|03/29/2022|||SKELETAL MUSCLE RELAXANTS|20583|||||No|No||CIPLA USA, INC.|No||||
cyclobenzaprine HCl|No|No|No|No|75%|69097084607|CYCLOBENZAPRINE 10 MG TABLET|100|EA|.01913|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|20584|||||No|No||CIPLA USA, INC.|No||||
cyclobenzaprine HCl|No|No|No|No|75%|69097084615|CYCLOBENZAPRINE 10 MG TABLET|1000|EA|.01541|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|||Prescription required|No||116|Yes|.0259|03/29/2022|.02527|03/29/2022|.02544|03/29/2022|||SKELETAL MUSCLE RELAXANTS|20585|||||No|No||CIPLA USA, INC.|No||||
escitalopram oxalate|No|No|No|No|75%|69097084705|ESCITALOPRAM 5 MG TABLET|90|EA|.04777|09/02/2016||Yes|No||09/02/2016||Yes|No|09/02/2016||Yes|No||||No|No|||Prescription required|No||008|Yes|.0462|03/29/2022|.04509|03/29/2022|.04539|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20586|||||No|No||CIPLA USA, INC.|No||||
escitalopram oxalate|No|No|No|No|75%|69097084805|ESCITALOPRAM 10 MG TABLET|90|EA|.05733|09/02/2016||Yes|No||09/02/2016||Yes|No|09/02/2016||Yes|No||||No|No|||Prescription required|No||008|Yes|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20587|||||No|No||CIPLA USA, INC.|No||||
escitalopram oxalate|No|No|No|No|75%|69097084905|ESCITALOPRAM 20 MG TABLET|90|EA|.07166|09/02/2016||Yes|No||09/02/2016||Yes|No|09/02/2016||Yes|No||||No|No|||Prescription required|No||008|No|.07845|03/29/2022|.07656|03/29/2022|.07707|03/29/2022|||ANTIDEPRESSANTS: SSRIs|20588|||||No|No||CIPLA USA, INC.|No||||
fosinopril sodium|No|No|No|No|75%|69097085605|FOSINOPRIL SODIUM 10 MG TAB|90|EA|.14643|09/02/2016||Yes|No||09/02/2016||Yes|No|09/02/2016||Yes|No||||No|No|||Prescription required|No||113|Yes|.17684|03/29/2022|.17259|03/29/2022|.17374|03/29/2022|||ANGIOTENSIN MODULATORS|20589|||||No|No||CIPLA USA, INC.|No||||
fosinopril sodium|No|No|No|No|75%|69097085705|FOSINOPRIL SODIUM 20 MG TAB|90|EA|.14643|09/02/2016||Yes|No||09/02/2016||Yes|No|09/02/2016||Yes|No||||No|No|||Prescription required|No||113|Yes|.153|03/29/2022|.14932|03/29/2022|.15032|03/29/2022|||ANGIOTENSIN MODULATORS|20590|||||No|No||CIPLA USA, INC.|No||||
fosinopril sodium|No|No|No|No|75%|69097085805|FOSINOPRIL SODIUM 40 MG TAB|90|EA|.14643|09/02/2016||Yes|No||09/02/2016||Yes|No|09/02/2016||Yes|No||||No|No|||Prescription required|No||113|No|.20623|03/29/2022|.20128|03/29/2022|.20262|03/29/2022|||ANGIOTENSIN MODULATORS|20591|||||No|No||CIPLA USA, INC.|No||||
terbinafine HCl|No|No|No|No|75%|69097085902|TERBINAFINE HCL 250 MG TABLET|30|EA|.1247|09/02/2016||Yes|No||09/02/2016||Yes|No|09/02/2016||Yes|No||||No|No|||Prescription required|No||069|No|.15711|03/29/2022|.15333|03/29/2022|.15436|03/29/2022|||ANTIFUNGALS: ORAL|20592|||||No|No||CIPLA USA, INC.|No||||
terbinafine HCl|No|No|No|No|75%|69097085907|TERBINAFINE HCL 250 MG TABLET|100|EA|.1247|09/02/2016||Yes|No||09/02/2016||Yes|No|09/02/2016||Yes|No||||No|No|||Prescription required|No||069|No|.15711|03/29/2022|.15333|03/29/2022|.15436|03/29/2022|||ANTIFUNGALS: ORAL|20593|||||No|No||CIPLA USA, INC.|No||||
zonisamide|No|No|No|No|75%|69097086107|ZONISAMIDE 100 MG CAPSULE|100|EA|.15802|09/02/2016||Yes|No||09/02/2016||Yes|No|09/02/2016||Yes|No||||No|No|||Prescription required|No||056|No|.12763|03/29/2022|.12456|03/29/2022|.12539|03/29/2022|||ANTICONVULSANTS|20594|||||No|No||CIPLA USA, INC.|No||||
calcium acetate|No|No|No|No|75%|69097086283|CALCIUM ACETATE 667 MG CAPSULE|200|EA|.129|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|||Prescription required|No||052|Yes|.28113|03/29/2022|.27438|03/29/2022|.27621|03/29/2022|||PHOSPHATE BINDERS|20595|||||No|No||CIPLA USA, INC.|No||||
rizatriptan benzoate|No|No|No|No|75%|69097086585|RIZATRIPTAN 5 MG TABLET|18|EA|.42521|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|||Prescription required|No||021|No|.64991|03/29/2022|.63431|03/29/2022|.63853|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|20596|||||No|No||CIPLA USA, INC.|No||||
rizatriptan benzoate|No|No|No|No|75%|69097086685|RIZATRIPTAN 10 MG TABLET|18|EA|.42521|11/17/2016||Yes|No||11/17/2016||Yes|No|11/17/2016||Yes|No||||No|No|||Prescription required|No||021|No|.50927|03/29/2022|.49704|03/29/2022|.50035|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|20597|||||No|No||CIPLA USA, INC.|No||||
nadolol|No|No|No|No|75%|69097086707|NADOLOL 20 MG TABLET|100|EA|.0688|07/18/2016||Yes|No||07/18/2016||Yes|No|07/18/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|070|No|.34023|03/29/2022|.33206|03/29/2022|.33427|03/29/2022|||BETA-BLOCKERS|20598|||||No|No||CIPLA USA, INC.|No||||
nadolol|No|No|No|No|75%|69097086807|NADOLOL 40 MG TABLET|100|EA|.0946|07/18/2016||Yes|No||07/18/2016||Yes|No|07/18/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|070|No|.40202|03/29/2022|.39237|03/29/2022|.39498|03/29/2022|||BETA-BLOCKERS|20599|||||No|No||CIPLA USA, INC.|No||||
nadolol|No|No|No|No|75%|69097086907|NADOLOL 80 MG TABLET|100|EA|.1978|07/18/2016||Yes|No||07/18/2016||Yes|No|07/18/2016||Yes|No||||No|No|||Prescription required|Yes|07/23/2015|070|No|.57501|03/29/2022|.5612|03/29/2022|.56494|03/29/2022|||BETA-BLOCKERS|20600|||||No|No||CIPLA USA, INC.|No||||
bupropion HCl|No|No|No|No|75%|69097087502|BUPROPION HCL XL 150 MG TABLET|30|EA|.14333|05/02/2017||Yes|No||05/02/2017||Yes|No|05/02/2017||Yes|No||||No|No|||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|20601|||||No|No||CIPLA USA, INC.|No||||
bupropion HCl|No|No|No|No|75%|69097087505|BUPROPION HCL XL 150 MG TABLET|90|EA|.14333|05/02/2017||Yes|No||05/02/2017||Yes|No|05/02/2017||Yes|No||||No|No|||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|20602|||||No|No||CIPLA USA, INC.|No||||
bupropion HCl|No|No|No|No|75%|69097087512|BUPROPION HCL XL 150 MG TABLET|500|EA|.129|05/02/2017||Yes|No||05/02/2017||Yes|No|05/02/2017||Yes|No||||No|No|||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|20603|||||No|No||CIPLA USA, INC.|No||||
bupropion HCl|No|No|No|No|75%|69097087602|BUPROPION HCL XL 300 MG TABLET|30|EA|.172|05/02/2017||Yes|No||05/02/2017||Yes|No|05/02/2017||Yes|No||||No|No|||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|20604|||||No|No||CIPLA USA, INC.|No||||
bupropion HCl|No|No|No|No|75%|69097087612|BUPROPION HCL XL 300 MG TABLET|500|EA|.1548|05/02/2017||Yes|No||05/02/2017||Yes|No|05/02/2017||Yes|No||||No|No|||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|20605|||||No|No||CIPLA USA, INC.|No||||
fenofibrate,micronized|No|No|No|No|75%|69097089407|FENOFIBRATE 67 MG CAPSULE|100|EA|.09567|05/25/2021||Yes|No||05/25/2021||Yes|No|05/25/2021||Yes|No||||No|No|||Prescription required|No||055|No|.15038|03/29/2022|.14677|03/29/2022|.14774|03/29/2022|||LIPOTROPICS: OTHER|20606|||||No|No||CIPLA USA, INC.|No||||
fenofibrate,micronized|No|No|No|No|75%|69097089507|FENOFIBRATE 134 MG CAPSULE|100|EA|.16013|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||055|No|.17604|03/29/2022|.17181|03/29/2022|.17295|03/29/2022|||LIPOTROPICS: OTHER|20607|||||No|No||CIPLA USA, INC.|No||||
fenofibrate,micronized|No|No|No|No|75%|69097089607|FENOFIBRATE 200 MG CAPSULE|100|EA|.28453|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||055|No|.22993|03/29/2022|.22441|03/29/2022|.2259|03/29/2022|||LIPOTROPICS: OTHER|20608|||||No|No||CIPLA USA, INC.|No||||
trospium chloride|No|No|No|No|75%|69097091203|TROSPIUM CHLORIDE 20 MG TABLET|60|EA|.3412|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|006|No|.42162|03/29/2022|.4115|03/29/2022|.41424|03/29/2022|||BLADDER RELAXANT PREPARATIONS|20609|||||No|No||CIPLA USA, INC.|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|69097091302|OMEPRAZOLE-BICARB 20-1,100 CAP|30|EA|.71666|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|1.11633|03/29/2022|1.08953|03/29/2022|1.09679|03/29/2022|||PROTON PUMP INHIBITORS|20610|||||No|No||CIPLA USA, INC.|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|69097091402|OMEPRAZOLE-BICARB 40-1,100 CAP|30|EA|.71666|05/25/2021||Yes|No||05/25/2021||Yes|No|05/25/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|1.14084|03/29/2022|1.11345|03/29/2022|1.12087|03/29/2022|||PROTON PUMP INHIBITORS|20611|||||No|No||CIPLA USA, INC.|No||||
gabapentin|No|No|No|No|75%|69097094307|GABAPENTIN 300 MG CAPSULE|100|EA|.0344|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|20612|||||No|No||CIPLA USA, INC.|No||||
gabapentin|No|No|No|No|75%|69097094312|GABAPENTIN 300 MG CAPSULE|500|EA|.0344|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|20613|||||No|No||CIPLA USA, INC.|No||||
atorvastatin calcium|No|No|No|No|75%|69097094405|ATORVASTATIN 10 MG TABLET|90|EA|.05479|06/26/2018||Yes|No||06/26/2018||Yes|No|06/26/2018||Yes|No||||No|No|||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|20614|||||No|No||CIPLA USA, INC.|No||||
atorvastatin calcium|No|No|No|No|75%|69097094415|ATORVASTATIN 10 MG TABLET|1000|EA|.04384|06/26/2018||Yes|No||06/26/2018||Yes|No|06/26/2018||Yes|No||||No|No|||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|20615|||||No|No||CIPLA USA, INC.|No||||
atorvastatin calcium|No|No|No|No|75%|69097094505|ATORVASTATIN 20 MG TABLET|90|EA|.0782|06/26/2018||Yes|No||06/26/2018||Yes|No|06/26/2018||Yes|No||||No|No|||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|20616|||||No|No||CIPLA USA, INC.|No||||
atorvastatin calcium|No|No|No|No|75%|69097094512|ATORVASTATIN 20 MG TABLET|500|EA|.07039|06/26/2018||Yes|No||06/26/2018||Yes|No|06/26/2018||Yes|No||||No|No|||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|20617|||||No|No||CIPLA USA, INC.|No||||
atorvastatin calcium|No|No|No|No|75%|69097094605|ATORVASTATIN 40 MG TABLET|90|EA|.0782|06/26/2018||Yes|No||06/26/2018||Yes|No|06/26/2018||Yes|No||||No|No|||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|20618|||||No|No||CIPLA USA, INC.|No||||
atorvastatin calcium|No|No|No|No|75%|69097094615|ATORVASTATIN 40 MG TABLET|1000|EA|.06256|06/26/2018||Yes|No||06/26/2018||Yes|No|06/26/2018||Yes|No||||No|No|||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|20619|||||No|No||CIPLA USA, INC.|No||||
atorvastatin calcium|No|No|No|No|75%|69097094705|ATORVASTATIN 80 MG TABLET|90|EA|.0782|06/26/2018||Yes|No||06/26/2018||Yes|No|06/26/2018||Yes|No||||No|No|||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|20620|||||No|No||CIPLA USA, INC.|No||||
atorvastatin calcium|No|No|No|No|75%|69097094712|ATORVASTATIN 80 MG TABLET|500|EA|.07039|06/26/2018||Yes|No||06/26/2018||Yes|No|06/26/2018||Yes|No||||No|No|||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|20621|||||No|No||CIPLA USA, INC.|No||||
capecitabine|No|No|No|No|75%|69097094808|CAPECITABINE 500 MG TABLET|120|EA|.43817|01/29/2021||Yes|No||01/29/2021||Yes|No|01/29/2021||Yes|No||||No|No|||Prescription required|No||502|No|.61977|12/28/2021|.60489|12/28/2021|.60892|12/28/2021|||ONCOLOGY: ORAL - BREAST|20622|||||No|No||CIPLA USA, INC.|No||||
capecitabine|No|No|No|No|75%|69097094903|CAPECITABINE 150 MG TABLET|60|EA|.22245|01/29/2021||Yes|No||01/29/2021||Yes|No|01/29/2021||Yes|No||||No|No|||Prescription required|No||502|No|.50698|01/29/2021|.49974|01/29/2021|.47594|01/29/2021|||ONCOLOGY: ORAL - BREAST|20623|||||No|No||CIPLA USA, INC.|No||||
pregabalin|No|No|No|No|90%|69097095405|PREGABALIN 25 MG CAPSULE|90|EA|.07166|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|No||232|No|.0795|03/29/2022|.07759|03/29/2022|.0781|03/29/2022|||NEUROPATHIC PAIN|20624|||||No|No||CIPLA USA, INC.|No||||
pregabalin|No|No|No|No|90%|69097095505|PREGABALIN 50 MG CAPSULE|90|EA|.07166|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|No||232|No|.09128|03/29/2022|.08908|03/29/2022|.08968|03/29/2022|||NEUROPATHIC PAIN|20625|||||No|No||CIPLA USA, INC.|No||||
pregabalin|No|No|No|No|90%|69097095605|PREGABALIN 75 MG CAPSULE|90|EA|.07166|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|No||232|No|.08098|03/29/2022|.07903|03/29/2022|.07956|03/29/2022|||NEUROPATHIC PAIN|20626|||||No|No||CIPLA USA, INC.|No||||
pregabalin|No|No|No|No|90%|69097095705|PREGABALIN 100 MG CAPSULE|90|EA|.07166|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|No||232|No|.08763|03/29/2022|.08552|03/29/2022|.08609|03/29/2022|||NEUROPATHIC PAIN|20627|||||No|No||CIPLA USA, INC.|No||||
pregabalin|No|No|No|No|90%|69097095805|PREGABALIN 150 MG CAPSULE|90|EA|.07166|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|No||232|No|.10646|03/29/2022|.1039|03/29/2022|.10459|03/29/2022|||NEUROPATHIC PAIN|20628|||||No|No||CIPLA USA, INC.|No||||
pregabalin|No|No|No|No|90%|69097095905|PREGABALIN 200 MG CAPSULE|90|EA|.07166|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|No||232|No|.11395|03/29/2022|.11121|03/29/2022|.11195|03/29/2022|||NEUROPATHIC PAIN|20629|||||No|No||CIPLA USA, INC.|No||||
pregabalin|No|No|No|No|90%|69097096105|PREGABALIN 225 MG CAPSULE|90|EA|.07166|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|No||232|No|.12393|03/29/2022|.12095|03/29/2022|.12176|03/29/2022|||NEUROPATHIC PAIN|20630|||||No|No||CIPLA USA, INC.|No||||
pregabalin|No|No|No|No|90%|69097096205|PREGABALIN 300 MG CAPSULE|90|EA|.07166|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|||Prescription required|No||232|No|.12181|03/29/2022|.11888|03/29/2022|.11967|03/29/2022|||NEUROPATHIC PAIN|20631|||||No|No||CIPLA USA, INC.|No||||
vigabatrin|No|No|No|No|75%|69097096453|VIGABATRIN 500 MG POWDER PACKT|50|EA|2.58|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|No||056|No|5.88|03/02/2021|5.796|03/02/2021|5.52|03/02/2021|||ANTICONVULSANTS|20632|||||No|No||CIPLA USA, INC.|No||||
nabumetone|No|No|No|No|75%|69097096507|NABUMETONE 500 MG TABLET|100|EA|.10874|08/02/2019||Yes|No||08/02/2019||Yes|No|08/02/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.17691|03/29/2022|.17266|03/29/2022|.17381|03/29/2022|||NSAIDS|20633|||||No|No||CIPLA USA, INC.|No||||
nabumetone|No|No|No|No|75%|69097096512|NABUMETONE 500 MG TABLET|500|EA|.10381|08/02/2019||Yes|No||08/02/2019||Yes|No|08/02/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.17691|03/29/2022|.17266|03/29/2022|.17381|03/29/2022|||NSAIDS|20634|||||No|No||CIPLA USA, INC.|No||||
nabumetone|No|No|No|No|75%|69097096607|NABUMETONE 750 MG TABLET|100|EA|.11373|08/02/2019||Yes|No||08/02/2019||Yes|No|08/02/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.2074|03/29/2022|.20242|03/29/2022|.20377|03/29/2022|||NSAIDS|20635|||||No|No||CIPLA USA, INC.|No||||
nabumetone|No|No|No|No|75%|69097096612|NABUMETONE 750 MG TABLET|500|EA|.10879|08/02/2019||Yes|No||08/02/2019||Yes|No|08/02/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.2074|03/29/2022|.20242|03/29/2022|.20377|03/29/2022|||NSAIDS|20636|||||No|No||CIPLA USA, INC.|No||||
sevelamer carbonate|No|No|No|No|75%|69097096793|SEVELAMER CARBONATE 800 MG TAB|270|EA|.1274|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|052|Yes|.27122|03/29/2022|.26471|03/29/2022|.26647|03/29/2022|||PHOSPHATE BINDERS|20637|||||No|No||CIPLA USA, INC.|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|69097096807|LISINOPRIL-HCTZ 10-12.5 MG TAB|100|EA|.04153|09/14/2020||Yes|No||09/14/2020||Yes|No|09/14/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.03674|03/29/2022|.03585|03/29/2022|.03609|03/29/2022|||ANGIOTENSIN MODULATORS|20638|||||No|No||CIPLA USA, INC.|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|69097096812|LISINOPRIL-HCTZ 10-12.5 MG TAB|500|EA|.03965|09/14/2020||Yes|No||09/14/2020||Yes|No|09/14/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.03674|03/29/2022|.03585|03/29/2022|.03609|03/29/2022|||ANGIOTENSIN MODULATORS|20639|||||No|No||CIPLA USA, INC.|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|69097096907|LISINOPRIL-HCTZ 20-12.5 MG TAB|100|EA|.06097|09/14/2020||Yes|No||09/14/2020||Yes|No|09/14/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.04909|03/29/2022|.04791|03/29/2022|.04823|03/29/2022|||ANGIOTENSIN MODULATORS|20640|||||No|No||CIPLA USA, INC.|No||||
lisinopril/hydrochlorothiazide|No|No|No|No|75%|69097096912|LISINOPRIL-HCTZ 20-12.5 MG TAB|500|EA|.05843|09/14/2020||Yes|No||09/14/2020||Yes|No|09/14/2020||Yes|No||||No|No|||Prescription required|No||113|Yes|.04909|03/29/2022|.04791|03/29/2022|.04823|03/29/2022|||ANGIOTENSIN MODULATORS|20641|||||No|No||CIPLA USA, INC.|No||||
lisinopril/hydrochlorothiazide|Yes|No|No|No|75%|69097097107|LISINOPRIL-HCTZ 20-25 MG TAB|100|EA|.07026|06/25/2020||Yes|No||06/25/2020||Yes|No|06/25/2020||Yes|No||||No|No|09/21/2020||Prescription required|No||113|Yes|.04948|03/29/2022|.04829|03/29/2022|.04861|03/29/2022|||ANGIOTENSIN MODULATORS|20642|||||No|No||CIPLA USA, INC.|No||||
lisinopril/hydrochlorothiazide|Yes|No|No|No|75%|69097097112|LISINOPRIL-HCTZ 20-25 MG TAB|500|EA|.06731|06/25/2020||Yes|No||06/25/2020||Yes|No|06/25/2020||Yes|No||||No|No|09/21/2020||Prescription required|No||113|Yes|.04948|03/29/2022|.04829|03/29/2022|.04861|03/29/2022|||ANGIOTENSIN MODULATORS|20643|||||No|No||CIPLA USA, INC.|No||||
fosinopril/hydrochlorothiazide|No|No|No|No|75%|69097097207|FOSINOPRIL-HCTZ 10-12.5 MG TAB|100|EA|.4816|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|1.0976|12/28/2020|1.08192|12/28/2020|1.0304|12/28/2020|||ANGIOTENSIN MODULATORS|20644|||||No|No||CIPLA USA, INC.|No||||
fosinopril/hydrochlorothiazide|No|No|No|No|75%|69097097307|FOSINOPRIL-HCTZ 20-12.5 MG TAB|100|EA|.4816|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|1.0976|06/29/2021|1.08192|06/29/2021|1.0304|06/29/2021|||ANGIOTENSIN MODULATORS|20645|||||No|No||CIPLA USA, INC.|No||||
meprobamate|No|No|No|No|90%|69097097407|MEPROBAMATE 200 MG TABLET|100|EA|2.365|09/07/2021||Yes|No||09/07/2021||Yes|No|09/07/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|090|Yes|5.39|09/07/2021|5.313|09/07/2021|5.06|09/07/2021|||ANXIOLYTICS|20646|||||No|No||CIPLA USA, INC.|No||||
meprobamate|No|No|No|No|90%|69097097507|MEPROBAMATE 400 MG TABLET|100|EA|2.838|09/07/2021||Yes|No||09/07/2021||Yes|No|09/07/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|090|Yes|6.468|09/07/2021|6.3756|09/14/2021|6.072|09/07/2021|||ANXIOLYTICS|20647|||||No|No||CIPLA USA, INC.|No||||
lamotrigine|No|No|No|No|75%|69102013710|LAMOTRIGINE TAB START KT-ORANG|49|EA|5.96734|03/15/2022||Yes|No||03/15/2022||Yes|No|03/15/2022||Yes|No||||No|No|||Prescription required|No||056|No|13.59999|03/15/2022|13.40571|03/15/2022|12.76734|03/15/2022|||ANTICONVULSANTS|20648|||||No|No||OWP PHARMACEUTI|No||||
lamotrigine|No|No|No|No|75%|69102015006|SUBVENITE 150 MG TABLET|100|EA|.043|01/28/2019||Yes|No||01/28/2019||Yes|No|01/28/2019||Yes|No||||No|No|||Prescription required|No||056|No|.0888|03/29/2022|.08666|03/29/2022|.08724|03/29/2022|||ANTICONVULSANTS|20649|||||No|No||OWP PHARMACEUTI|No||||
lamotrigine|No|No|No|No|75%|69102030001|SUBVENITE TAB START KT(ORANGE)|49|EA|5.96734|01/28/2019||Yes|No||01/28/2019||Yes|No|01/28/2019||Yes|No||||No|No|||Prescription required|No||056|No|13.59999|02/01/2022|13.40571|02/01/2022|12.76734|02/01/2022|||ANTICONVULSANTS|20650|||||No|No||OWP PHARMACEUTI|No||||
lamotrigine|No|No|No|No|75%|69102030101|SUBVENITE 25 MG TABLET|100|EA|.0344|01/28/2019||Yes|No||01/28/2019||Yes|No|01/28/2019||Yes|No||||No|No|||Prescription required|No||056|No|.03514|03/29/2022|.03429|03/29/2022|.03452|03/29/2022|||ANTICONVULSANTS|20651|||||No|No||OWP PHARMACEUTI|No||||
lamotrigine|No|No|No|No|75%|69102030601|SUBVENITE TAB START KIT (BLUE)|35|EA|5.74971|01/28/2019||Yes|No||01/28/2019||Yes|No|01/28/2019||Yes|No||||No|No|||Prescription required|No||056|No|13.10399|02/01/2022|12.91679|02/01/2022|12.3017|02/01/2022|||ANTICONVULSANTS|20652|||||No|No||OWP PHARMACEUTI|No||||
lamotrigine|No|No|No|No|75%|69102031201|SUBVENITE TAB START KIT(GREEN)|98|EA|5.74357|01/28/2019||Yes|No||01/28/2019||Yes|No|01/28/2019||Yes|No||||No|No|||Prescription required|No||056|No|13.08999|02/01/2022|12.90299|02/01/2022|12.28856|02/01/2022|||ANTICONVULSANTS|20653|||||No|No||OWP PHARMACEUTI|No||||
lamotrigine|No|No|No|No|75%|69102031901|SUBVENITE 100 MG TABLET|100|EA|.0387|01/28/2019||Yes|No||01/28/2019||Yes|No|01/28/2019||Yes|No||||No|No|||Prescription required|No||056|No|.06403|03/29/2022|.06249|03/29/2022|.0629|03/29/2022|||ANTICONVULSANTS|20654|||||No|No||OWP PHARMACEUTI|No||||
lamotrigine|No|No|No|No|75%|69102032001|SUBVENITE 200 MG TABLET|100|EA|.0473|01/28/2019||Yes|No||01/28/2019||Yes|No|01/28/2019||Yes|No||||No|No|||Prescription required|No||056|No|.10103|03/29/2022|.0986|03/29/2022|.09926|03/29/2022|||ANTICONVULSANTS|20655|||||No|No||OWP PHARMACEUTI|No||||
lamotrigine|No|No|No|No|75%|69102035911|LAMOTRIGINE TAB START KT-GREEN|98|EA|5.74357|03/15/2022||Yes|No||03/15/2022||Yes|No|03/15/2022||Yes|No||||No|No|||Prescription required|No||056|No|13.08999|03/15/2022|12.90299|03/15/2022|12.28856|03/15/2022|||ANTICONVULSANTS|20656|||||No|No||OWP PHARMACEUTI|No||||
lamotrigine|No|No|No|No|75%|69102063909|LAMOTRIGINE TAB START KIT-BLUE|35|EA|5.74971|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|No||056|No|13.10399|03/02/2022|12.91679|03/02/2022|12.3017|03/02/2022|||ANTICONVULSANTS|20657|||||No|No||OWP PHARMACEUTI|No||||
anastrozole|No|No|No|No|75%|69117000301|ANASTROZOLE 1 MG TABLET|30|EA|.19995|02/25/2021||Yes|No||02/25/2021||Yes|No|02/25/2021||Yes|No||||No|No|||Prescription required|No||502|No|.11251|03/29/2022|.1098|03/29/2022|.11054|03/29/2022|||ONCOLOGY: ORAL - BREAST|20658|||||No|No||YILING PHARMACE|No||||
acyclovir|Yes|No|No|No|75%|69117001801|ACYCLOVIR 400 MG TABLET|100|EA|.05435|03/12/2020|01/01/2040|Yes|No||03/12/2020|01/01/2040|Yes|No|03/12/2020|01/01/2040|Yes|No||||No|No|06/19/2020|01/01/2040|Prescription required|No||025|No|.0985|03/29/2022|.09613|03/29/2022|.09677|03/29/2022|||ANTIVIRALS: ORAL|20659|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||YILING PHARMACE|No||||
acyclovir|Yes|No|No|No|75%|69117001802|ACYCLOVIR 400 MG TABLET|500|EA|.05438|03/12/2020|01/01/2040|Yes|No||03/12/2020|01/01/2040|Yes|No|03/12/2020|01/01/2040|Yes|No||||No|No|06/19/2020|01/01/2040|Prescription required|No||025|No|.0985|03/29/2022|.09613|03/29/2022|.09677|03/29/2022|||ANTIVIRALS: ORAL|20660|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||YILING PHARMACE|No||||
acyclovir|No|No|No|No|75%|69117001901|ACYCLOVIR 800 MG TABLET|100|EA|.11713|03/12/2020|01/01/2040|Yes|No||03/12/2020|01/01/2040|Yes|No|03/12/2020|01/01/2040|Yes|No||||No|No|||Prescription required|No||025|No|.19021|03/29/2022|.18564|03/29/2022|.18688|03/29/2022|||ANTIVIRALS: ORAL|20661|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||YILING PHARMACE|No||||
acyclovir|No|No|No|No|75%|69117001902|ACYCLOVIR 800 MG TABLET|500|EA|.117|03/12/2020|01/01/2040|Yes|No||03/12/2020|01/01/2040|Yes|No|03/12/2020|01/01/2040|Yes|No||||No|No|||Prescription required|No||025|No|.19021|03/29/2022|.18564|03/29/2022|.18688|03/29/2022|||ANTIVIRALS: ORAL|20662|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||YILING PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69117004001|BUSPIRONE HCL 5 MG TABLET|100|EA|.02107|02/05/2021|04/30/2022|Yes|No||02/05/2021|04/30/2022|Yes|No|02/05/2021|04/30/2022|Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|20663|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||YILING PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69117004102|BUSPIRONE HCL 10 MG TABLET|500|EA|.02993|02/09/2021|04/30/2022|Yes|No||02/09/2021|04/30/2022|Yes|No|02/09/2021|04/30/2022|Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|20664|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||YILING PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69117004201|BUSPIRONE HCL 15 MG TABLET|60|EA|.03769|02/12/2021|04/30/2022|Yes|No||02/12/2021|04/30/2022|Yes|No|02/12/2021|04/30/2022|Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|20665|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||YILING PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69117004202|BUSPIRONE HCL 15 MG TABLET|100|EA|.03848|02/12/2021|04/30/2022|Yes|No||02/12/2021|04/30/2022|Yes|No|02/12/2021|04/30/2022|Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|20666|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||YILING PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69117004203|BUSPIRONE HCL 15 MG TABLET|180|EA|.05412|02/12/2021|04/30/2022|Yes|No||02/12/2021|04/30/2022|Yes|No|02/12/2021|04/30/2022|Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|20667|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||YILING PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69117004204|BUSPIRONE HCL 15 MG TABLET|500|EA|.03751|02/12/2021|04/30/2022|Yes|No||02/12/2021|04/30/2022|Yes|No|02/12/2021|04/30/2022|Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|20668|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||YILING PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69117004301|BUSPIRONE HCL 30 MG TABLET|60|EA|.4515|02/12/2021|04/30/2022|Yes|No||02/12/2021|04/30/2022|Yes|No|02/12/2021|04/30/2022|Yes|No||||No|No|||Prescription required|No||090|No|.17728|03/29/2022|.17302|03/29/2022|.17417|03/29/2022|||ANXIOLYTICS|20669|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||YILING PHARMACE|No||||
fexofenadine HCl|No|No|No|No|75%|69230020105|FEXOFENADINE HCL 60 MG TABLET|500|EA|.0559|03/17/2022||Yes|No||||No|No|03/17/2022||Yes|No||||No|No|||Over the counter|Yes|01/28/2021|030|Yes|.15058|03/29/2022|.14696|03/29/2022|.14794|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|20670|||||No|No||CAMBER CONSUMER|No||||
fexofenadine HCl|No|No|No|No|75%|69230030001|ALLERGY RELIEF 180 MG TABLET|100|EA|.11395|10/14/2021||Yes|No||||No|No|10/14/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.28782|03/29/2022|.28091|03/29/2022|.28278|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|20671|||||No|No||CAMBER CONSUMER|No||||
fexofenadine HCl|No|No|No|No|75%|69230030005|ALLERGY RELIEF 180 MG TABLET|500|EA|.1032|10/14/2021||Yes|No||||No|No|10/14/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.28782|03/29/2022|.28091|03/29/2022|.28278|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|20672|||||No|No||CAMBER CONSUMER|No||||
fexofenadine HCl|No|No|No|No|75%|69230030030|ALLERGY RELIEF 180 MG TABLET|30|EA|.20281|10/14/2021||Yes|No||||No|No|10/14/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.28782|03/29/2022|.28091|03/29/2022|.28278|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|20673|||||No|No||CAMBER CONSUMER|No||||
cetirizine HCl|No|No|No|No|75%|69230030401|ALLERGY RLF (CETRZN) 10 MG TAB|100|EA|.04945|10/14/2021||Yes|No||||No|No|10/14/2021||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|20674|||||No|No||CAMBER CONSUMER|No||||
cetirizine HCl|No|No|No|No|75%|69230030405|ALLERGY RLF (CETRZN) 10 MG TAB|500|EA|.0258|10/14/2021||Yes|No||||No|No|10/14/2021||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|20675|||||No|No||CAMBER CONSUMER|No||||
ibuprofen|No|No|No|No|75%|69230030811|CHILDREN IBUPROFEN 100 MG/5 ML|118|ML|.02736|10/14/2021||Yes|No||||No|No|10/14/2021||Yes|No||||No|No|||Over the counter|No||059|Yes|.02649|03/29/2022|.02585|03/29/2022|.02602|03/29/2022|||NSAIDS|20676|||||No|No||CAMBER CONSUMER|No||||
ibuprofen|No|No|No|No|75%|69230030812|CHILDREN IBUPROFEN 100 MG/5 ML|237|ML|.0267|10/21/2021||Yes|No||||No|No|10/21/2021||Yes|No||||No|No|||Over the counter|No||059|Yes|.06085|10/21/2021|.05998|10/21/2021|.05713|10/21/2021|||NSAIDS|20677|||||No|No||CAMBER CONSUMER|No||||
ibuprofen|No|No|No|No|75%|69230030911|CHILDREN IBUPROFEN 100 MG/5 ML|118|ML|.02736|10/14/2021||Yes|No||||No|No|10/14/2021||Yes|No||||No|No|||Over the counter|No||059|Yes|.02649|03/29/2022|.02585|03/29/2022|.02602|03/29/2022|||NSAIDS|20678|||||No|No||CAMBER CONSUMER|No||||
ibuprofen|No|No|No|No|75%|69230030912|CHILDREN IBUPROFEN 100 MG/5 ML|237|ML|.0267|10/14/2021||Yes|No||||No|No|10/14/2021||Yes|No||||No|No|||Over the counter|No||059|Yes|.06085|10/14/2021|.05998|10/14/2021|.05713|10/14/2021|||NSAIDS|20679|||||No|No||CAMBER CONSUMER|No||||
ibuprofen|No|No|No|No|75%|69230031011|CHILDREN IBUPROFEN 100 MG/5 ML|118|ML|.02736|10/14/2021||Yes|No||||No|No|10/14/2021||Yes|No||||No|No|||Over the counter|No||059|Yes|.02649|03/29/2022|.02585|03/29/2022|.02602|03/29/2022|||NSAIDS|20680|||||No|No||CAMBER CONSUMER|No||||
ibuprofen|No|No|No|No|75%|69230031012|CHILDREN IBUPROFEN 100 MG/5 ML|237|ML|.0267|10/14/2021||Yes|No||||No|No|10/14/2021||Yes|No||||No|No|||Over the counter|No||059|Yes|.06085|10/14/2021|.05998|10/14/2021|.05713|10/14/2021|||NSAIDS|20681|||||No|No||CAMBER CONSUMER|No||||
ibuprofen|No|No|No|No|75%|69230031111|CHILDREN IBUPROFEN 100 MG/5 ML|118|ML|.02736|10/21/2021||Yes|No||||No|No|10/21/2021||Yes|No||||No|No|||Over the counter|No||059|Yes|.02649|03/29/2022|.02585|03/29/2022|.02602|03/29/2022|||NSAIDS|20682|||||No|No||CAMBER CONSUMER|No||||
ibuprofen|No|No|No|No|75%|69230031112|CHILDREN IBUPROFEN 100 MG/5 ML|237|ML|.0267|10/14/2021||Yes|No||||No|No|10/14/2021||Yes|No||||No|No|||Over the counter|No||059|Yes|.06085|10/14/2021|.05998|10/14/2021|.05713|10/14/2021|||NSAIDS|20683|||||No|No||CAMBER CONSUMER|No||||
cetirizine HCl|No|No|No|No|75%|69230031611|CHILD ALLERGY RELIEF 1 MG/ML|118|ML|.01475|10/14/2021||Yes|No||||No|No|10/14/2021||Yes|No||||No|No|||Over the counter|No||030|Yes|.03462|03/29/2022|.03378|03/29/2022|.03401|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|20684|||||No|No||CAMBER CONSUMER|No||||
loratadine|No|No|No|No|75%|69230031701|ALLERGY (LORATADINE) 10 MG TAB|100|EA|.02472|10/13/2021||Yes|No||||No|No|10/13/2021||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|20685|||||No|No||CAMBER CONSUMER|No||||
loratadine|No|No|No|No|75%|69230031703|ALLERGY (LORATADINE) 10 MG TAB|300|EA|.0172|10/13/2021||Yes|No||||No|No|10/13/2021||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|20686|||||No|No||CAMBER CONSUMER|No||||
omeprazole magnesium|No|No|No|No|75%|69230031835|OMEPRAZOLE MAG DR 20 MG TABLET|14|EA|.27642|02/08/2022||Yes|No||||No|No|02/08/2022||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.50629|03/29/2022|.49413|03/29/2022|.49742|03/29/2022|||PROTON PUMP INHIBITORS|20687|||||No|No||CAMBER CONSUMER|No||||
omeprazole magnesium|No|No|No|No|75%|69230031836|OMEPRAZOLE MAG DR 20 MG TABLET|28|EA|.215|10/21/2021||Yes|No||||No|No|10/21/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.50629|03/29/2022|.49413|03/29/2022|.49742|03/29/2022|||PROTON PUMP INHIBITORS|20688|||||No|No||CAMBER CONSUMER|No||||
omeprazole magnesium|No|No|No|No|75%|69230031837|OMEPRAZOLE MAG DR 20 MG TABLET|42|EA|.20476|10/04/2021||Yes|No||||No|No|10/04/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.50629|03/29/2022|.49413|03/29/2022|.49742|03/29/2022|||PROTON PUMP INHIBITORS|20689|||||No|No||CAMBER CONSUMER|No||||
esomeprazole magnesium|No|No|No|No|75%|69230032031|ESOMEPRAZOLE MAG DR 20 MG CAP|14|EA|.24571|10/28/2021||Yes|No||||No|No|10/28/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.3522|03/29/2022|.34374|03/29/2022|.34603|03/29/2022|||PROTON PUMP INHIBITORS|20690|||||No|No||CAMBER CONSUMER|No||||
esomeprazole magnesium|No|No|No|No|75%|69230032032|ESOMEPRAZOLE MAG DR 20 MG CAP|14|EA|.24571|10/28/2021||Yes|No||||No|No|10/28/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.3522|03/29/2022|.34374|03/29/2022|.34603|03/29/2022|||PROTON PUMP INHIBITORS|20691|||||No|No||CAMBER CONSUMER|No||||
esomeprazole magnesium|No|No|No|No|75%|69230032033|ESOMEPRAZOLE MAG DR 20 MG CAP|14|EA|.24571|10/28/2021||Yes|No||||No|No|10/28/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.3522|03/29/2022|.34374|03/29/2022|.34603|03/29/2022|||PROTON PUMP INHIBITORS|20692|||||No|No||CAMBER CONSUMER|No||||
levocetirizine dihydrochloride|No|No|No|No|75%|69230032110|LEVOCETIRIZINE 5 MG TABLET|1000|EA|.086|10/14/2021||Yes|No||||No|No|10/14/2021||Yes|No||||No|No|||Over the counter|Yes|01/28/2021|030|Yes|.15309|03/29/2022|.14941|03/29/2022|.15041|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|20693|||||No|No||CAMBER CONSUMER|No||||
levocetirizine dihydrochloride|No|No|No|No|75%|69230032131|LEVOCETIRIZINE 5 MG TABLET|35|EA|.086|10/14/2021||Yes|No||||No|No|10/14/2021||Yes|No||||No|No|||Over the counter|Yes|01/28/2021|030|Yes|.15309|03/29/2022|.14941|03/29/2022|.15041|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|20694|||||No|No||CAMBER CONSUMER|No||||
levocetirizine dihydrochloride|No|No|No|No|75%|69230032133|LEVOCETIRIZINE 5 MG TABLET|80|EA|.086|10/14/2021||Yes|No||||No|No|10/14/2021||Yes|No||||No|No|||Over the counter|Yes|01/28/2021|030|Yes|.15309|03/29/2022|.14941|03/29/2022|.15041|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|20695|||||No|No||CAMBER CONSUMER|No||||
loratadine|No|No|No|No|75%|69230032212|CHILD LORATADINE 5 MG/5 ML SOL|120|ML|.02809|03/17/2022||Yes|No||||No|No|03/17/2022||Yes|No||||No|No|||Over the counter|No||030|Yes|.04114|03/29/2022|.04015|03/29/2022|.04042|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|20696|||||No|No||CAMBER CONSUMER|No||||
polyethylene glycol 3350|No|No|No|No|75%|69230032434|POLYETHYLENE GLYCOL 3350 POWD|119|GM|.01481|12/27/2021||Yes|No||||No|No|12/27/2021||Yes|No||||No|No|||Over the counter|No|||No|.03052|03/29/2022|.02978|03/29/2022|.02998|03/29/2022||||20697|||||No|No||CAMBER CONSUMER|No||||
loperamide HCl/simethicone|No|No|No|No|75%|69230032512|LOPERAMIDE-SIMETH 2-125 MG TAB|12|EA|.1057|02/17/2022||Yes|No||||No|No|02/17/2022||Yes|No||||No|No|||Over the counter|No|||No|.27521|03/01/2022|.2686|03/01/2022|.27039|03/01/2022||||20698|||||No|No||CAMBER CONSUMER|No||||
loperamide HCl/simethicone|No|No|No|No|75%|69230032524|LOPERAMIDE-SIMETH 2-125 MG TAB|24|EA|.1057|02/17/2022||Yes|No||||No|No|02/17/2022||Yes|No||||No|No|||Over the counter|No|||No|.27521|03/01/2022|.2686|03/01/2022|.27039|03/01/2022||||20699|||||No|No||CAMBER CONSUMER|No||||
testosterone|No|No|No|No|90%|69238101302|TESTOSTERONE 1.62% GEL PUMP|75|GM|.38126|10/16/2019||Yes|No||10/16/2019||Yes|No|10/16/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|084|No|.65888|03/29/2022|.64306|03/29/2022|.64734|03/29/2022|||ANDROGENIC AGENTS|20700|||||No|No||AMNEAL PHARMACE|No||||
isotretinoin|No|No|No|No|75%|69238101703|ISOTRETINOIN 30 MG CAPSULE|30|EA|2.97244|05/22/2018||Yes|No||05/22/2018||Yes|No|05/22/2018||Yes|No||||No|No|||Prescription required|No||144|No|3.30978|03/29/2022|3.23034|03/29/2022|3.25185|03/29/2022|||ACNE AGENTS: ORAL|20701|||||No|No||AMNEAL PHARMACE|No||||
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|69238103107|MELODETTA 24 FE CHEWABLE TAB|28|EA|.3078|11/09/2018|02/22/2022|Yes|No||11/09/2018|02/22/2022|Yes|No|11/09/2018|02/22/2022|Yes|No|Refer to program requirements|||No|No|06/18/2019|02/22/2022|Prescription required|No|||No|.70151|03/29/2022|.69149|03/29/2022|.65856|03/29/2022||||20702|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMNEAL PHARMACE|No|||Only covered for non-contraceptive (medical) purposes|
phytonadione (vit K1)|No|No|No|No|75%|69238105103|PHYTONADIONE 5 MG TABLET|30|EA|17.2|04/02/2019||Yes|No||04/02/2019||Yes|No|04/02/2019||Yes|No||||No|No|||Prescription required|No|||No|39.2|07/27/2021|38.64|07/27/2021|36.8|07/27/2021||||20703|||||No|No||AMNEAL PHARMACE|No||||
desipramine HCl|No|No|No|No|75%|69238105301|DESIPRAMINE 10 MG TABLET|100|EA|.09472|08/22/2016||Yes|No||08/22/2016||Yes|No|08/22/2016||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.3086|03/29/2022|.30119|03/29/2022|.30319|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|20704|||||No|No||AMNEAL PHARMACE|No||||
chlorpromazine HCl|No|No|No|No|75%|69238105401|CHLORPROMAZINE 10 MG TABLET|100|EA|.72816|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|1.29919|10/26/2021|1.268|10/26/2021|1.27645|10/26/2021|||ANTIPSYCHOTICS|20705|||||No|No||AMNEAL PHARMACE|No||||
desipramine HCl|No|No|No|No|75%|69238105501|DESIPRAMINE 25 MG TABLET|100|EA|.11377|08/22/2016||Yes|No||08/22/2016||Yes|No|08/22/2016||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.4119|03/01/2022|.40201|03/01/2022|.40469|03/01/2022|||ANTIDEPRESSANTS: TRICYCLIC|20706|||||No|No||AMNEAL PHARMACE|No||||
chlorpromazine HCl|No|No|No|No|75%|69238105601|CHLORPROMAZINE 25 MG TABLET|100|EA|1.04025|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|1.39549|03/29/2022|1.36199|03/29/2022|1.37106|03/29/2022|||ANTIPSYCHOTICS|20707|||||No|No||AMNEAL PHARMACE|No||||
desipramine HCl|No|No|No|No|75%|69238105701|DESIPRAMINE 50 MG TABLET|100|EA|.21418|08/22/2016||Yes|No||08/22/2016||Yes|No|08/22/2016||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.3099|01/25/2022|.30246|01/25/2022|.30447|01/25/2022|||ANTIDEPRESSANTS: TRICYCLIC|20708|||||No|No||AMNEAL PHARMACE|No||||
chlorpromazine HCl|No|No|No|No|75%|69238105801|CHLORPROMAZINE 50 MG TABLET|100|EA|1.48238|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|1.74791|03/29/2022|1.70596|03/29/2022|1.71732|03/29/2022|||ANTIPSYCHOTICS|20709|||||No|No||AMNEAL PHARMACE|No||||
desipramine HCl|No|No|No|No|75%|69238105901|DESIPRAMINE 75 MG TABLET|100|EA|.25744|08/22/2016||Yes|No||08/22/2016||Yes|No|08/22/2016||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.58672|10/06/2020|.57834|10/06/2020|.5508|10/06/2020|||ANTIDEPRESSANTS: TRICYCLIC|20710|||||No|No||AMNEAL PHARMACE|No||||
chlorpromazine HCl|No|No|No|No|75%|69238106001|CHLORPROMAZINE 100 MG TABLET|100|EA|2.1177|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|2.03394|03/29/2022|1.98512|03/29/2022|1.99834|03/29/2022|||ANTIPSYCHOTICS|20711|||||No|No||AMNEAL PHARMACE|No||||
desipramine HCl|No|No|No|No|75%|69238106101|DESIPRAMINE 100 MG TABLET|100|EA|.35823|08/22/2016||Yes|No||08/22/2016||Yes|No|08/22/2016||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|.81643|10/06/2020|.80477|10/06/2020|.76645|10/06/2020|||ANTIDEPRESSANTS: TRICYCLIC|20712|||||No|No||AMNEAL PHARMACE|No||||
chlorpromazine HCl|No|No|No|No|75%|69238106201|CHLORPROMAZINE 200 MG TABLET|100|EA|3.02522|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|4.21034|03/01/2022|4.10929|03/01/2022|4.13665|03/01/2022|||ANTIPSYCHOTICS|20713|||||No|No||AMNEAL PHARMACE|No||||
desipramine HCl|No|No|No|No|75%|69238106302|DESIPRAMINE 150 MG TABLET|50|EA|.51909|08/22/2016||Yes|No||08/22/2016||Yes|No|08/22/2016||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|215|No|1.18305|10/06/2020|1.16615|10/06/2020|1.11062|10/06/2020|||ANTIDEPRESSANTS: TRICYCLIC|20714|||||No|No||AMNEAL PHARMACE|No||||
potassium chloride|No|No|No|No|75%|69238106501|POTASSIUM CL ER 10 MEQ TABLET|100|EA|.086|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|No|||No|.18432|03/29/2022|.17989|03/29/2022|.18109|03/29/2022||||20715|||||No|No||AMNEAL PHARMACE|No||||
potassium chloride|No|No|No|No|75%|69238106507|POTASSIUM CL ER 10 MEQ TABLET|1000|EA|.086|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|No|||No|.18432|03/29/2022|.17989|03/29/2022|.18109|03/29/2022||||20716|||||No|No||AMNEAL PHARMACE|No||||
potassium chloride|No|No|No|No|75%|69238106901|POTASSIUM CL ER 20 MEQ TABLET|100|EA|.09288|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|No|||No|.19104|03/29/2022|.18645|03/29/2022|.18769|03/29/2022||||20717|||||No|No||AMNEAL PHARMACE|No||||
potassium chloride|No|No|No|No|75%|69238106905|POTASSIUM CL ER 20 MEQ TABLET|500|EA|.09288|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|No|||No|.19104|03/29/2022|.18645|03/29/2022|.18769|03/29/2022||||20718|||||No|No||AMNEAL PHARMACE|No||||
doxycycline hyclate|Yes|No|No|No|75%|69238110002|DOXYCYCLINE HYCLATE 100 MG CAP|50|EA|.1204|04/11/2017||Yes|No||04/11/2017||Yes|No|04/11/2017||Yes|No||||No|No|04/11/2017||Prescription required|No||213|No|.14255|03/29/2022|.13912|03/29/2022|.14005|03/29/2022|||TETRACYCLINES|20719|||||No|No||AMNEAL PHARMACE|No||||
doxycycline hyclate|Yes|No|No|No|75%|69238110005|DOXYCYCLINE HYCLATE 100 MG CAP|500|EA|.1204|04/11/2017||Yes|No||04/11/2017||Yes|No|04/11/2017||Yes|No||||No|No|04/11/2017||Prescription required|No||213|No|.14255|03/29/2022|.13912|03/29/2022|.14005|03/29/2022|||TETRACYCLINES|20720|||||No|No||AMNEAL PHARMACE|No||||
tiagabine HCl|No|No|No|No|75%|69238110403|TIAGABINE HCL 2 MG TABLET|30|EA|1.82893|05/23/2018|01/18/2022|Yes|No||05/23/2018|01/18/2022|Yes|No|05/23/2018|01/18/2022|Yes|No||||No|No|||Prescription required|No||056|No|4.16826|06/29/2021|4.10871|06/29/2021|3.91306|06/29/2021|||ANTICONVULSANTS|20721|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
tiagabine HCl|No|No|No|No|75%|69238110503|TIAGABINE HCL 4 MG TABLET|30|EA|1.82893|05/23/2018|01/18/2022|Yes|No||05/23/2018|01/18/2022|Yes|No|05/23/2018|01/18/2022|Yes|No||||No|No|||Prescription required|No||056|No|4.16826|03/29/2022|4.10871|03/29/2022|3.91306|03/29/2022|||ANTICONVULSANTS|20722|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
tiagabine HCl|No|No|No|No|75%|69238110603|TIAGABINE HCL 12 MG TABLET|30|EA|3.96087|05/23/2018|01/18/2022|Yes|No||05/23/2018|01/18/2022|Yes|No|05/23/2018|01/18/2022|Yes|No||||No|No|||Prescription required|No||056|No|9.0271|05/23/2018|8.89814|05/23/2018|8.47442|05/23/2018|||ANTICONVULSANTS|20723|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
tiagabine HCl|No|No|No|No|75%|69238110703|TIAGABINE HCL 16 MG TABLET|30|EA|5.18694|05/23/2018|01/18/2022|Yes|No||05/23/2018|01/18/2022|Yes|No|05/23/2018|01/18/2022|Yes|No||||No|No|||Prescription required|No||056|No|11.8214|05/23/2018|11.65252|05/23/2018|11.09764|05/23/2018|||ANTICONVULSANTS|20724|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
clomipramine HCl|No|No|No|No|75%|69238110803|CLOMIPRAMINE 25 MG CAPSULE|30|EA|.14333|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|1.31238|03/29/2022|1.28088|03/29/2022|1.28941|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|20725|||||No|No||AMNEAL PHARMACE|No||||
clomipramine HCl|No|No|No|No|75%|69238110809|CLOMIPRAMINE 25 MG CAPSULE|90|EA|.14333|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|1.31238|03/29/2022|1.28088|03/29/2022|1.28941|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|20726|||||No|No||AMNEAL PHARMACE|No||||
clomipramine HCl|No|No|No|No|75%|69238110903|CLOMIPRAMINE 50 MG CAPSULE|30|EA|.172|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.80238|03/29/2022|.78312|03/29/2022|.78833|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|20727|||||No|No||AMNEAL PHARMACE|No||||
clomipramine HCl|No|No|No|No|75%|69238110909|CLOMIPRAMINE 50 MG CAPSULE|90|EA|.172|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.80238|03/29/2022|.78312|03/29/2022|.78833|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|20728|||||No|No||AMNEAL PHARMACE|No||||
clomipramine HCl|No|No|No|No|75%|69238111003|CLOMIPRAMINE 75 MG CAPSULE|30|EA|.215|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.95054|03/29/2022|.92772|03/29/2022|.9339|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|20729|||||No|No||AMNEAL PHARMACE|No||||
clomipramine HCl|No|No|No|No|75%|69238111009|CLOMIPRAMINE 75 MG CAPSULE|90|EA|.215|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.95054|03/29/2022|.92772|03/29/2022|.9339|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|20730|||||No|No||AMNEAL PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69238111501|BUSPIRONE HCL 5 MG TABLET|100|EA|.02107|10/17/2019||Yes|No||10/17/2019||Yes|No|10/17/2019||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|20731|||||No|No||AMNEAL PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69238111505|BUSPIRONE HCL 5 MG TABLET|500|EA|.02107|10/17/2019|02/28/2022|Yes|No||10/17/2019|02/28/2022|Yes|No|10/17/2019|02/28/2022|Yes|No||||No|No|||Prescription required|No||090|No|.04803|03/29/2022|.04735|03/29/2022|.04509|03/29/2022|||ANXIOLYTICS|20732|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMNEAL PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69238111601|BUSPIRONE HCL 7.5 MG TABLET|100|EA|.16279|10/17/2019||Yes|No||10/17/2019||Yes|No|10/17/2019||Yes|No||||No|No|||Prescription required|No||090|No|.22186|03/29/2022|.21653|03/29/2022|.21797|03/29/2022|||ANXIOLYTICS|20733|||||No|No||AMNEAL PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69238111701|BUSPIRONE HCL 10 MG TABLET|100|EA|.02992|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|20734|||||No|No||AMNEAL PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69238111705|BUSPIRONE HCL 10 MG TABLET|500|EA|.02992|01/03/2020|04/02/2022|Yes|No||01/03/2020|04/02/2022|Yes|No|01/03/2020|04/02/2022|Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|20735|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69238111801|BUSPIRONE HCL 15 MG TABLET|100|EA|.03771|10/17/2019||Yes|No||10/17/2019||Yes|No|10/17/2019||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|20736|||||No|No||AMNEAL PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69238111805|BUSPIRONE HCL 15 MG TABLET|500|EA|.03771|10/17/2019|04/02/2022|Yes|No||10/17/2019|04/02/2022|Yes|No|10/17/2019|04/02/2022|Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|20737|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69238111806|BUSPIRONE HCL 15 MG TABLET|60|EA|.03769|10/17/2019||Yes|No||10/17/2019||Yes|No|10/17/2019||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|20738|||||No|No||AMNEAL PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69238111906|BUSPIRONE HCL 30 MG TABLET|60|EA|.25083|10/17/2019||Yes|No||10/17/2019||Yes|No|10/17/2019||Yes|No||||No|No|||Prescription required|No||090|No|.17728|03/29/2022|.17302|03/29/2022|.17417|03/29/2022|||ANXIOLYTICS|20739|||||No|No||AMNEAL PHARMACE|No||||
oxaprozin|No|No|No|No|75%|69238112001|OXAPROZIN 600 MG TABLET|100|EA|.6302|02/02/2018||Yes|No||02/02/2018||Yes|No|02/02/2018||Yes|No||||No|No|||Prescription required|Yes|11/02/2017|059|Yes|.63712|03/29/2022|.62182|03/29/2022|.62597|03/29/2022|||NSAIDS|20740|||||No|No||AMNEAL PHARMACE|No||||
nadolol|No|No|No|No|75%|69238112309|NADOLOL 20 MG TABLET|90|EA|.24968|02/02/2018||Yes|No||02/02/2018||Yes|No|02/02/2018||Yes|No||||No|No|||Prescription required|Yes|10/12/2017|070|No|.34023|03/29/2022|.33206|03/29/2022|.33427|03/29/2022|||BETA-BLOCKERS|20741|||||No|No||AMNEAL PHARMACE|No||||
nadolol|No|No|No|No|75%|69238112409|NADOLOL 40 MG TABLET|90|EA|.29512|02/02/2018||Yes|No||02/02/2018||Yes|No|02/02/2018||Yes|No||||No|No|||Prescription required|Yes|10/12/2017|070|No|.40202|03/29/2022|.39237|03/29/2022|.39498|03/29/2022|||BETA-BLOCKERS|20742|||||No|No||AMNEAL PHARMACE|No||||
nadolol|No|No|No|No|75%|69238112509|NADOLOL 80 MG TABLET|90|EA|.39578|02/02/2018||Yes|No||02/02/2018||Yes|No|02/02/2018||Yes|No||||No|No|||Prescription required|Yes|10/12/2017|070|No|.57501|03/29/2022|.5612|03/29/2022|.56494|03/29/2022|||BETA-BLOCKERS|20743|||||No|No||AMNEAL PHARMACE|No||||
ethacrynic acid|No|No|No|No|75%|69238112601|ETHACRYNIC ACID 25 MG TABLET|100|EA|.9675|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No|||No|2.34378|03/01/2022|2.28752|03/01/2022|2.30276|03/01/2022||||20744|||||No|No||AMNEAL PHARMACE|No||||
atazanavir sulfate|No|No|No|No|75%|69238113606|ATAZANAVIR SULFATE 150 MG CAP|60|EA|1.782|12/08/2020||Yes|No||12/08/2020||Yes|No|12/08/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|2.9106|12/08/2020|2.86902|12/08/2020|2.7324|12/08/2020|||HIV / AIDS|20745|||||No|No||AMNEAL PHARMACE|No||||
atazanavir sulfate|No|No|No|No|75%|69238113706|ATAZANAVIR SULFATE 200 MG CAP|60|EA|1.782|12/08/2020||Yes|No||12/08/2020||Yes|No|12/08/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|2.9106|02/23/2021|2.86902|02/23/2021|2.7324|02/23/2021|||HIV / AIDS|20746|||||No|No||AMNEAL PHARMACE|No||||
atazanavir sulfate|No|No|No|No|75%|69238113803|ATAZANAVIR SULFATE 300 MG CAP|30|EA|3.564|12/08/2020||Yes|No||12/08/2020||Yes|No|12/08/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|5.91006|05/25/2021|5.76821|05/25/2021|5.80663|05/25/2021|||HIV / AIDS|20747|||||No|No||AMNEAL PHARMACE|No||||
ezetimibe|No|No|No|No|75%|69238115403|EZETIMIBE 10 MG TABLET|30|EA|.129|10/11/2017||Yes|No||10/11/2017||Yes|No|10/11/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|20748|||||No|No||AMNEAL PHARMACE|No||||
ezetimibe|No|No|No|No|75%|69238115409|EZETIMIBE 10 MG TABLET|90|EA|.129|10/11/2017||Yes|No||10/11/2017||Yes|No|10/11/2017||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|055|No|.10777|03/29/2022|.10518|03/29/2022|.10588|03/29/2022|||LIPOTROPICS: OTHER|20749|||||No|No||AMNEAL PHARMACE|No||||
ezetimibe/simvastatin|No|No|No|No|75%|69238115503|EZETIMIBE-SIMVASTATIN 10-10 MG|30|EA|.35833|02/21/2018||Yes|No||02/21/2018||Yes|No|02/21/2018||Yes|No||||No|No|||Prescription required|Yes|12/14/2017|063|Yes|.75312|03/29/2022|.73504|03/29/2022|.73994|03/29/2022|||LIPOTROPICS: STATINS|20750|||||No|No||AMNEAL PHARMACE|No||||
ezetimibe/simvastatin|No|No|No|No|75%|69238115603|EZETIMIBE-SIMVASTATIN 10-20 MG|30|EA|.35833|02/21/2018||Yes|No||02/21/2018||Yes|No|02/21/2018||Yes|No||||No|No|||Prescription required|Yes|12/14/2017|063|Yes|.74268|03/29/2022|.72485|03/29/2022|.72968|03/29/2022|||LIPOTROPICS: STATINS|20751|||||No|No||AMNEAL PHARMACE|No||||
ezetimibe/simvastatin|No|No|No|No|75%|69238115703|EZETIMIBE-SIMVASTATIN 10-40 MG|30|EA|.35833|02/21/2018||Yes|No||02/21/2018||Yes|No|02/21/2018||Yes|No||||No|No|||Prescription required|Yes|12/14/2017|063|Yes|.99233|03/29/2022|.96851|03/29/2022|.97496|03/29/2022|||LIPOTROPICS: STATINS|20752|||||No|No||AMNEAL PHARMACE|No||||
ezetimibe/simvastatin|No|No|No|No|75%|69238115803|EZETIMIBE-SIMVASTATIN 10-80 MG|30|EA|.35833|02/21/2018||Yes|No||02/21/2018||Yes|No|02/21/2018||Yes|No||||No|No|||Prescription required|Yes|12/14/2017|063|Yes|.47172|03/29/2022|.46039|03/29/2022|.46346|03/29/2022|||LIPOTROPICS: STATINS|20753|||||No|No||AMNEAL PHARMACE|No||||
abiraterone acetate|No|No|No|No|75%|69238116507|ABIRATERONE ACETATE 250 MG TAB|120|EA|1.70208|05/23/2019||Yes|No||05/23/2019||Yes|No|05/23/2019||Yes|No||||No|No|||Prescription required|No||550|No|3.87916|09/28/2021|3.82374|09/28/2021|3.64166|09/28/2021|||ONCOLOGY: ORAL - PROSTATE|20754|||||No|No||AMNEAL PHARMACE|No||||
doxepin HCl|No|No|No|No|75%|69238116609|DOXEPIN 10 MG CAPSULE|90|EA|.11466|11/27/2017||Yes|No||11/27/2017||Yes|No|11/27/2017||Yes|No||||No|No|||Prescription required|No||215|No|.22181|03/29/2022|.21648|03/29/2022|.21792|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|20755|||||No|No||AMNEAL PHARMACE|No||||
doxepin HCl|No|No|No|No|75%|69238117009|DOXEPIN 25 MG CAPSULE|90|EA|.14333|11/27/2017||Yes|No||11/27/2017||Yes|No|11/27/2017||Yes|No||||No|No|||Prescription required|No||215|No|.30005|03/29/2022|.29284|03/29/2022|.29479|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|20756|||||No|No||AMNEAL PHARMACE|No||||
doxepin HCl|No|No|No|No|75%|69238117109|DOXEPIN 50 MG CAPSULE|90|EA|.215|11/27/2017||Yes|No||11/27/2017||Yes|No|11/27/2017||Yes|No||||No|No|||Prescription required|No||215|No|.41139|03/29/2022|.40151|03/29/2022|.40419|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|20757|||||No|No||AMNEAL PHARMACE|No||||
doxepin HCl|No|No|No|No|75%|69238117209|DOXEPIN 75 MG CAPSULE|90|EA|.32966|11/27/2017||Yes|No||11/27/2017||Yes|No|11/27/2017||Yes|No||||No|No|||Prescription required|No||215|No|.56944|03/29/2022|.55577|03/29/2022|.55947|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|20758|||||No|No||AMNEAL PHARMACE|No||||
doxepin HCl|No|No|No|No|75%|69238117309|DOXEPIN 100 MG CAPSULE|90|EA|.35833|11/27/2017||Yes|No||11/27/2017||Yes|No|11/27/2017||Yes|No||||No|No|||Prescription required|No||215|No|.67991|03/29/2022|.66359|03/29/2022|.66801|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|20759|||||No|No||AMNEAL PHARMACE|No||||
isotretinoin|No|No|No|No|75%|69238117403|ISOTRETINOIN 10 MG CAPSULE|30|EA|2.15716|05/22/2018||Yes|No||05/22/2018||Yes|No|05/22/2018||Yes|No||||No|No|||Prescription required|No||144|No|2.44307|03/29/2022|2.38443|03/29/2022|2.40031|03/29/2022|||ACNE AGENTS: ORAL|20760|||||No|No||AMNEAL PHARMACE|No||||
isotretinoin|No|No|No|No|75%|69238117503|ISOTRETINOIN 20 MG CAPSULE|30|EA|2.5585|05/22/2018||Yes|No||05/22/2018||Yes|No|05/22/2018||Yes|No||||No|No|||Prescription required|No||144|No|2.5524|03/29/2022|2.49114|03/29/2022|2.50773|03/29/2022|||ACNE AGENTS: ORAL|20761|||||No|No||AMNEAL PHARMACE|No||||
isotretinoin|No|No|No|No|75%|69238117603|ISOTRETINOIN 40 MG CAPSULE|30|EA|2.97244|05/22/2018||Yes|No||05/22/2018||Yes|No|05/22/2018||Yes|No||||No|No|||Prescription required|No||144|No|3.38467|03/29/2022|3.30343|03/29/2022|3.32543|03/29/2022|||ACNE AGENTS: ORAL|20762|||||No|No||AMNEAL PHARMACE|No||||
buprenorphine|No|No|No|No|90%|69238120202|BUPRENORPHINE 5 MCG/HR PATCH|4|EA|22.77065|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|35.41903|03/29/2022|34.56897|03/29/2022|34.79919|03/29/2022|||ANALGESICS: NARCOTICS LONG|20763|||||No|No||AMNEAL PHARMACE|No||||
buprenorphine|No|No|No|No|90%|69238120302|BUPRENORPHINE 10 MCG/HR PATCH|4|EA|34.15597|09/29/2020||Yes|No||09/29/2020||Yes|No|09/29/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|66.68301|03/29/2022|65.08261|03/29/2022|65.51605|03/29/2022|||ANALGESICS: NARCOTICS LONG|20764|||||No|No||AMNEAL PHARMACE|No||||
buprenorphine|No|No|No|No|90%|69238120402|BUPRENORPHINE 15 MCG/HR PATCH|4|EA|49.2694|09/29/2020||Yes|No||09/29/2020||Yes|No|09/29/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|99.0625|03/29/2022|96.685|03/29/2022|97.3289|03/29/2022|||ANALGESICS: NARCOTICS LONG|20765|||||No|No||AMNEAL PHARMACE|No||||
buprenorphine|No|No|No|No|90%|69238120502|BUPRENORPHINE 20 MCG/HR PATCH|4|EA|60.46875|09/29/2020||Yes|No||09/29/2020||Yes|No|09/29/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|115.06922|03/29/2022|112.30755|03/29/2022|113.0555|03/29/2022|||ANALGESICS: NARCOTICS LONG|20766|||||No|No||AMNEAL PHARMACE|No||||
bexarotene|No|No|No|No|75%|69238125001|BEXAROTENE 75 MG CAPSULE|100|EA|12.19351|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No|||No|27.78986|03/15/2022|27.39286|03/15/2022|26.08844|03/15/2022||||20767|||||No|No||AMNEAL PHARMACE|No||||
oseltamivir phosphate|No|No|No|No|75%|69238126401|OSELTAMIVIR PHOS 30 MG CAPSULE|10|EA|3.42065|11/16/2017||Yes|No||11/16/2017||Yes|No|11/16/2017||Yes|No||||No|No|||Prescription required|No||025|No|1.58155|03/29/2022|1.54359|03/29/2022|1.55387|03/29/2022|||ANTIVIRALS: ORAL|20768|||||No|No||AMNEAL PHARMACE|No||||
oseltamivir phosphate|No|No|No|No|75%|69238126501|OSELTAMIVIR PHOS 45 MG CAPSULE|10|EA|3.42065|11/16/2017||Yes|No||11/16/2017||Yes|No|11/16/2017||Yes|No||||No|No|||Prescription required|No||025|No|1.5655|03/29/2022|1.52792|03/29/2022|1.5381|03/29/2022|||ANTIVIRALS: ORAL|20769|||||No|No||AMNEAL PHARMACE|No||||
oseltamivir phosphate|No|No|No|No|75%|69238126601|OSELTAMIVIR PHOS 75 MG CAPSULE|10|EA|3.72853|11/16/2017||Yes|No||11/16/2017||Yes|No|11/16/2017||Yes|No||||No|No|||Prescription required|No||025|No|1.29695|03/29/2022|1.26582|03/29/2022|1.27425|03/29/2022|||ANTIVIRALS: ORAL|20770|||||No|No||AMNEAL PHARMACE|No||||
fluocinonide|No|No|No|No|75%|69238127102|FLUOCINONIDE 0.1% CREAM|120|GM|.25083|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|.57166|04/27/2021|.56349|04/27/2021|.53666|04/27/2021|||STEROIDS: TOPICAL HIGH|20771|||||No|No||AMNEAL PHARMACE|No||||
fluocinonide|No|No|No|No|75%|69238127103|FLUOCINONIDE 0.1% CREAM|30|GM|.25083|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|.34413|01/25/2022|.33587|01/25/2022|.3381|01/25/2022|||STEROIDS: TOPICAL HIGH|20772|||||No|No||AMNEAL PHARMACE|No||||
fluocinonide|No|No|No|No|75%|69238127106|FLUOCINONIDE 0.1% CREAM|60|GM|.25083|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|.22927|03/29/2022|.22376|03/29/2022|.22525|03/29/2022|||STEROIDS: TOPICAL HIGH|20773|||||No|No||AMNEAL PHARMACE|No||||
oseltamivir phosphate|No|No|No|No|75%|69238127306|OSELTAMIVIR 6 MG/ML SUSPENSION|60|ML|.71838|05/22/2018||Yes|No||05/22/2018||Yes|No|05/22/2018||Yes|No||||No|No|||Prescription required|No||025|No|.51688|03/29/2022|.50447|03/29/2022|.50783|03/29/2022|||ANTIVIRALS: ORAL|20774|||||No|No||AMNEAL PHARMACE|No||||
mesalamine|No|No|No|No|75%|69238127403|MESALAMINE 1,000 MG SUPP|30|EA|3.87|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|No||010|No|2.81018|03/29/2022|2.74273|03/29/2022|2.761|03/29/2022|||ULCERATIVE COLITIS AGENTS|20775|||||No|No||AMNEAL PHARMACE|No||||
clobazam|No|No|No|No|90%|69238130501|CLOBAZAM 10 MG TABLET|100|EA|.13244|01/03/2019||Yes|No||01/03/2019||Yes|No|01/03/2019||Yes|No||||No|No|||Prescription required|No||056|No|.37729|03/29/2022|.36823|03/29/2022|.37068|03/29/2022|||ANTICONVULSANTS|20776|||||No|No||AMNEAL PHARMACE|No||||
clobazam|No|No|No|No|90%|69238130601|CLOBAZAM 20 MG TABLET|100|EA|.2107|01/03/2019||Yes|No||01/03/2019||Yes|No|01/03/2019||Yes|No||||No|No|||Prescription required|No||056|No|.71967|03/29/2022|.70239|03/29/2022|.70707|03/29/2022|||ANTICONVULSANTS|20777|||||No|No||AMNEAL PHARMACE|No||||
pregabalin|No|No|No|No|90%|69238131009|PREGABALIN 25 MG CAPSULE|90|EA|.03821|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No||232|No|.0795|03/29/2022|.07759|03/29/2022|.0781|03/29/2022|||NEUROPATHIC PAIN|20778|||||No|No||AMNEAL PHARMACE|No||||
pregabalin|No|No|No|No|90%|69238131109|PREGABALIN 50 MG CAPSULE|90|EA|.03917|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No||232|No|.09128|03/29/2022|.08908|03/29/2022|.08968|03/29/2022|||NEUROPATHIC PAIN|20779|||||No|No||AMNEAL PHARMACE|No||||
pregabalin|No|No|No|No|90%|69238131209|PREGABALIN 75 MG CAPSULE|90|EA|.04013|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No||232|No|.08098|03/29/2022|.07903|03/29/2022|.07956|03/29/2022|||NEUROPATHIC PAIN|20780|||||No|No||AMNEAL PHARMACE|No||||
pregabalin|No|No|No|No|90%|69238131309|PREGABALIN 100 MG CAPSULE|90|EA|.04204|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No||232|No|.08763|03/29/2022|.08552|03/29/2022|.08609|03/29/2022|||NEUROPATHIC PAIN|20781|||||No|No||AMNEAL PHARMACE|No||||
pregabalin|No|No|No|No|90%|69238131409|PREGABALIN 150 MG CAPSULE|90|EA|.04443|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No||232|No|.10646|03/29/2022|.1039|03/29/2022|.10459|03/29/2022|||NEUROPATHIC PAIN|20782|||||No|No||AMNEAL PHARMACE|No||||
pregabalin|No|No|No|No|90%|69238131509|PREGABALIN 200 MG CAPSULE|90|EA|.04777|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No||232|No|.11395|03/29/2022|.11121|03/29/2022|.11195|03/29/2022|||NEUROPATHIC PAIN|20783|||||No|No||AMNEAL PHARMACE|No||||
pregabalin|No|No|No|No|90%|69238131609|PREGABALIN 225 MG CAPSULE|90|EA|.05016|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No||232|No|.12393|03/29/2022|.12095|03/29/2022|.12176|03/29/2022|||NEUROPATHIC PAIN|20784|||||No|No||AMNEAL PHARMACE|No||||
pregabalin|No|No|No|No|90%|69238131709|PREGABALIN 300 MG CAPSULE|90|EA|.05255|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No||232|No|.12181|03/29/2022|.11888|03/29/2022|.11967|03/29/2022|||NEUROPATHIC PAIN|20785|||||No|No||AMNEAL PHARMACE|No||||
dimethyl fumarate|No|No|No|No|75%|69238131804|DIMETHYL FUMARATE DR 120 MG CP|14|EA|2.30357|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|No||043|No|6.92871|10/26/2021|6.76242|10/26/2021|6.80745|10/26/2021|||MULTIPLE SCLEROSIS AGENTS|20786|||||No|No||AMNEAL PHARMACE|No||||
dimethyl fumarate|No|No|No|No|75%|69238131906|DIMETHYL FUMARATE DR 240 MG CP|60|EA|1.6125|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|No||043|No|3.05522|11/23/2021|2.98189|11/23/2021|3.00175|11/23/2021|||MULTIPLE SCLEROSIS AGENTS|20787|||||No|No||AMNEAL PHARMACE|No||||
etodolac|No|No|No|No|75%|69238134201|ETODOLAC 400 MG TABLET|100|EA|.22768|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.33513|03/29/2022|.32708|03/29/2022|.32926|03/29/2022|||NSAIDS|20788|||||No|No||AMNEAL PHARMACE|No||||
etodolac|No|No|No|No|75%|69238134301|ETODOLAC 500 MG TABLET|100|EA|.24187|12/03/2018||Yes|No||12/03/2018||Yes|No|12/03/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.34546|03/29/2022|.33716|03/29/2022|.33941|03/29/2022|||NSAIDS|20789|||||No|No||AMNEAL PHARMACE|No||||
albuterol sulfate|No|No|No|No|75%|69238134401|ALBUTEROL SULFATE 2 MG TAB|100|EA|.258|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|037|No|.67057|07/27/2021|.65447|07/27/2021|.65883|07/27/2021|||BRONCHODILATORS: BETA AGONIST|20790|||||No|No||AMNEAL PHARMACE|No||||
albuterol sulfate|No|No|No|No|75%|69238134501|ALBUTEROL SULFATE 4 MG TAB|100|EA|.258|11/29/2018||Yes|No||11/29/2018||Yes|No|11/29/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|037|No|1.0884|03/01/2022|1.06227|03/01/2022|1.06935|03/01/2022|||BRONCHODILATORS: BETA AGONIST|20791|||||No|No||AMNEAL PHARMACE|No||||
tobramycin/dexamethasone|No|No|No|No|75%|69238137302|TOBRAMYCIN-DEXAMETH OPHTH SUSP|2.5|ML|6.52396|12/15/2021||Yes|No||12/15/2021||Yes|No|12/15/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|036|No|14.38|03/29/2022|14.03488|03/29/2022|14.12835|03/29/2022|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|20792|||||No|No||AMNEAL PHARMACE|No||||
tobramycin/dexamethasone|No|No|No|No|75%|69238137403|TOBRAMYCIN-DEXAMETH OPHTH SUSP|5|ML|6.5403|12/15/2021||Yes|No||12/15/2021||Yes|No|12/15/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|036|No|14.32103|03/29/2022|13.97732|03/29/2022|14.07041|03/29/2022|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|20793|||||No|No||AMNEAL PHARMACE|No||||
tobramycin/dexamethasone|No|No|No|No|75%|69238137506|TOBRAMYCIN-DEXAMETH OPHTH SUSP|10|ML|6.54073|12/15/2021||Yes|No||12/15/2021||Yes|No|12/15/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|036|No|12.73383|03/01/2022|12.42821|03/01/2022|12.51098|03/01/2022|||OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS|20794|||||No|No||AMNEAL PHARMACE|No||||
difluprednate|No|No|No|No|75%|69238138003|DIFLUPREDNATE 0.05% EYE DROP|5|ML|15.03968|03/23/2022||Yes|No||03/23/2022||Yes|No|03/23/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|013|No|31.84694|03/29/2022|31.08261|03/29/2022|31.28961|03/29/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|20795|||||No|No||AMNEAL PHARMACE|No||||
silodosin|No|No|No|No|75%|69238142003|SILODOSIN 8 MG CAPSULE|30|EA|.14333|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|003|No|.68368|03/29/2022|.66727|03/29/2022|.67171|03/29/2022|||BPH TREATMENTS|20796|||||No|No||AMNEAL PHARMACE|No||||
silodosin|No|No|No|No|75%|69238142009|SILODOSIN 8 MG CAPSULE|90|EA|.14333|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|003|No|.68368|03/29/2022|.66727|03/29/2022|.67171|03/29/2022|||BPH TREATMENTS|20797|||||No|No||AMNEAL PHARMACE|No||||
silodosin|No|No|No|No|75%|69238142103|SILODOSIN 4 MG CAPSULE|30|EA|.14333|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|003|No|.60384|03/29/2022|.58934|03/29/2022|.59327|03/29/2022|||BPH TREATMENTS|20798|||||No|No||AMNEAL PHARMACE|No||||
methotrexate sodium|No|No|No|No|75%|69238142301|METHOTREXATE 2.5 MG TABLET|100|EA|.1333|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|No|||No|.26817|03/29/2022|.26173|03/29/2022|.26347|03/29/2022||||20799|||||No|No||AMNEAL PHARMACE|No||||
clonidine HCl|No|No|No|No|75%|69238142606|CLONIDINE HCL ER 0.1 MG TABLET|60|EA|.14333|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.52051|03/29/2022|.50801|03/29/2022|.5114|03/29/2022|||STIMULANTS AND RELATED AGENTS|20800|||||No|No||AMNEAL PHARMACE|No||||
potassium chloride|No|No|No|No|75%|69238145802|POTASSIUM CL 20% (40 MEQ/15ML)|473|ML|.11537|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|No|||No|.44086|03/01/2022|.43027|03/01/2022|.43314|03/01/2022||||20801|||||No|No||AMNEAL PHARMACE|No||||
potassium chloride|No|No|No|No|75%|69238145902|POTASSIUM CL 10% (20 MEQ/15ML)|473|ML|.05244|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|No|||No|.13625|03/29/2022|.13298|03/29/2022|.13386|03/29/2022||||20802|||||No|No||AMNEAL PHARMACE|No||||
erythromycin base|No|No|No|No|75%|69238147101|ERYTHROMYCIN DR 250 MG TABLET|100|EA|2.88564|12/18/2019|11/03/2022|Yes|No||12/18/2019|11/03/2022|Yes|No|12/18/2019|11/03/2022|Yes|No||||No|No|||Prescription required|Yes|03/09/2018|018|No|4.27352|03/01/2022|4.17095|03/01/2022|4.19873|03/01/2022|||MACROLIDES/KETOLIDES|20803|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
erythromycin base|No|No|No|No|75%|69238147103|ERYTHROMYCIN DR 250 MG TABLET|30|EA|2.88558|03/22/2022||Yes|No||03/22/2022||Yes|No|03/22/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|018|No|4.27352|03/29/2022|4.17095|03/29/2022|4.19873|03/29/2022|||MACROLIDES/KETOLIDES|20804|||||No|No||AMNEAL PHARMACE|No||||
erythromycin base|No|No|No|No|75%|69238147201|ERYTHROMYCIN DR 333 MG TABLET|100|EA|3.63332|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|018|No|8.2806|12/18/2019|8.16231|12/18/2019|7.77363|12/18/2019|||MACROLIDES/KETOLIDES|20805|||||No|No||AMNEAL PHARMACE|No||||
erythromycin base|No|No|No|No|75%|69238147301|ERYTHROMYCIN DR 500 MG TABLET|100|EA|4.4735|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|018|No|10.19543|12/18/2019|10.04978|12/18/2019|9.57122|12/18/2019|||MACROLIDES/KETOLIDES|20806|||||No|No||AMNEAL PHARMACE|No||||
erythromycin base|No|No|No|No|75%|69238148401|ERYTHROMYCIN 250 MG FILMTAB|100|EA|4.55077|05/23/2018|01/31/2022|Yes|No||05/23/2018|01/31/2022|Yes|No|05/23/2018|01/31/2022|Yes|No||||No|No|||Prescription required|Yes|03/22/2018|018|No|10.37153|02/15/2022|10.22337|02/15/2022|9.73654|02/15/2022|||MACROLIDES/KETOLIDES|20807|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMNEAL PHARMACE|No||||
erythromycin base|No|No|No|No|75%|69238148403|ERYTHROMYCIN 250 MG FILMTAB|30|EA|4.55083|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|018|No|7.84358|03/29/2022|7.65533|03/29/2022|7.70631|03/29/2022|||MACROLIDES/KETOLIDES|20808|||||No|No||AMNEAL PHARMACE|No||||
erythromycin base|No|No|No|No|75%|69238148501|ERYTHROMYCIN 500 MG FILMTAB|100|EA|6.86004|05/23/2018|07/31/2022|Yes|No||05/23/2018|07/31/2022|Yes|No|05/23/2018|07/31/2022|Yes|No||||No|No|||Prescription required|Yes|03/22/2018|018|No|13.22133|05/25/2021|12.90401|05/25/2021|12.98995|05/25/2021|||MACROLIDES/KETOLIDES|20809|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||AMNEAL PHARMACE|No||||
erythromycin base|No|No|No|No|75%|69238148503|ERYTHROMYCIN 500 MG FILMTAB|30|EA|6.86007|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|018|No|13.22133|05/25/2021|12.90401|05/25/2021|12.98995|05/25/2021|||MACROLIDES/KETOLIDES|20810|||||No|No||AMNEAL PHARMACE|No||||
deferasirox|No|No|No|No|75%|69238148603|DEFERASIROX 90 MG TABLET|30|EA|.301|09/18/2020|01/15/2022|Yes|No||09/18/2020|01/15/2022|Yes|No|09/18/2020|01/15/2022|Yes|No||||No|No|||Prescription required|No|||No|.686|09/22/2020|.6762|09/22/2020|.644|09/18/2020||||20811|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
deferasirox|No|No|No|No|75%|69238148803|DEFERASIROX 360 MG TABLET|30|EA|1.204|05/21/2020|01/15/2022|Yes|No||05/21/2020|01/15/2022|Yes|No|05/21/2020|01/15/2022|Yes|No||||No|No|||Prescription required|No|||No|2.744|08/25/2020|2.7048|08/25/2020|2.576|08/25/2020||||20812|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AMNEAL PHARMACE|No||||
bumetanide|No|No|No|No|75%|69238148901|BUMETANIDE 0.5 MG TABLET|100|EA|.1462|02/22/2018||Yes|No||02/22/2018||Yes|No|02/22/2018||Yes|No||||No|No|||Prescription required|No|||No|.20616|03/29/2022|.20121|03/29/2022|.20255|03/29/2022||||20813|||||No|No||AMNEAL PHARMACE|No||||
bumetanide|No|No|No|No|75%|69238149001|BUMETANIDE 1 MG TABLET|100|EA|.1462|02/22/2018||Yes|No||02/22/2018||Yes|No|02/22/2018||Yes|No||||No|No|||Prescription required|No|||No|.21417|03/29/2022|.20902|03/29/2022|.21042|03/29/2022||||20814|||||No|No||AMNEAL PHARMACE|No||||
bumetanide|No|No|No|No|75%|69238149005|BUMETANIDE 1 MG TABLET|500|EA|.1462|02/22/2018||Yes|No||02/22/2018||Yes|No|02/22/2018||Yes|No||||No|No|||Prescription required|No|||No|.21417|03/29/2022|.20902|03/29/2022|.21042|03/29/2022||||20815|||||No|No||AMNEAL PHARMACE|No||||
bumetanide|No|No|No|No|75%|69238149101|BUMETANIDE 2 MG TABLET|100|EA|.2924|02/22/2018||Yes|No||02/22/2018||Yes|No|02/22/2018||Yes|No||||No|No|||Prescription required|No|||No|.40198|03/29/2022|.39233|03/29/2022|.39494|03/29/2022||||20816|||||No|No||AMNEAL PHARMACE|No||||
bumetanide|No|No|No|No|75%|69238149105|BUMETANIDE 2 MG TABLET|500|EA|.2924|02/22/2018||Yes|No||02/22/2018||Yes|No|02/22/2018||Yes|No||||No|No|||Prescription required|No|||No|.40198|03/29/2022|.39233|03/29/2022|.39494|03/29/2022||||20817|||||No|No||AMNEAL PHARMACE|No||||
erythromycin ethylsuccinate|No|No|No|No|75%|69238150301|ERYTHROMYCIN 200 MG/5 ML SUSP|100|ML|.90652|03/05/2020||Yes|No||03/05/2020||Yes|No|03/05/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|018|No|1.82351|03/29/2022|1.77974|03/29/2022|1.79159|03/29/2022|||MACROLIDES/KETOLIDES|20818|||||No|No||AMNEAL PHARMACE|No||||
erythromycin ethylsuccinate|No|No|No|No|75%|69238150402|ERYTHROMYCIN 400 MG/5 ML SUSP|100|ML|1.59594|03/05/2020||Yes|No||03/05/2020||Yes|No|03/05/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|018|No|3.08133|03/29/2022|3.00737|03/29/2022|3.0274|03/29/2022|||MACROLIDES/KETOLIDES|20819|||||No|No||AMNEAL PHARMACE|No||||
buprenorphine|No|No|No|No|90%|69238150502|BUPRENORPHINE 7.5 MCG/HR PATCH|4|EA|32.32095|09/29/2020||Yes|No||09/29/2020||Yes|No|09/29/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|110|Yes|65.15568|03/29/2022|63.59194|03/29/2022|64.01545|03/29/2022|||ANALGESICS: NARCOTICS LONG|20820|||||No|No||AMNEAL PHARMACE|No||||
tetracycline HCl|No|No|No|No|75%|69238152201|TETRACYCLINE 250 MG CAPSULE|100|EA|.52997|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|.9651|03/01/2022|.94193|03/01/2022|.94821|03/01/2022|||TETRACYCLINES|20821|||||No|No||AMNEAL PHARMACE|No||||
tetracycline HCl|No|No|No|No|75%|69238152301|TETRACYCLINE 500 MG CAPSULE|100|EA|1.05995|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|1.54692|03/29/2022|1.50979|03/29/2022|1.51984|03/29/2022|||TETRACYCLINES|20822|||||No|No||AMNEAL PHARMACE|No||||
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|69238153106|LARISSIA-28 TABLET|28|EA|.086|05/01/2017||Yes|No||05/01/2017||Yes|No|05/01/2017||Yes|No|Refer to program requirements|||No|No|05/01/2017||Prescription required|No|||No|.21292|03/29/2022|.2078|03/29/2022|.20919|03/29/2022||||20823|||||No|No||AMNEAL PHARMACE|No|||Only covered for non-contraceptive (medical) purposes|
clobetasol propionate|No|No|No|No|75%|69238153203|CLOBETASOL 0.05% CREAM|30|GM|.129|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|No||121|No|.34489|03/29/2022|.33661|03/29/2022|.33885|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|20824|||||No|No||AMNEAL PHARMACE|No||||
clobetasol propionate|No|No|No|No|75%|69238153204|CLOBETASOL 0.05% CREAM|45|GM|.129|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|No||121|No|.31467|03/29/2022|.30711|03/29/2022|.30916|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|20825|||||No|No||AMNEAL PHARMACE|No||||
clobetasol propionate|No|No|No|No|75%|69238153205|CLOBETASOL 0.05% CREAM|15|GM|.129|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|No||121|No|.42879|03/29/2022|.41849|03/29/2022|.42128|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|20826|||||No|No||AMNEAL PHARMACE|No||||
clobetasol propionate|No|No|No|No|75%|69238153206|CLOBETASOL 0.05% CREAM|60|GM|.129|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|No||121|No|.33784|03/29/2022|.32973|03/29/2022|.33192|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|20827|||||No|No||AMNEAL PHARMACE|No||||
fluocinonide|No|No|No|No|75%|69238153402|FLUOCINONIDE 0.05% CREAM|120|GM|.5223|12/14/2021||Yes|No||12/14/2021||Yes|No|12/14/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|120|No|1.32987|12/28/2021|1.29795|12/28/2021|1.30659|12/28/2021|||STEROIDS: TOPICAL HIGH|20828|||||No|No||AMNEAL PHARMACE|No||||
fluocinonide|No|No|No|No|75%|69238153403|FLUOCINONIDE 0.05% CREAM|30|GM|.41781|12/14/2021||Yes|No||12/14/2021||Yes|No|12/14/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|120|No|.62146|03/29/2022|.60654|03/29/2022|.61058|03/29/2022|||STEROIDS: TOPICAL HIGH|20829|||||No|No||AMNEAL PHARMACE|No||||
fluocinonide|No|No|No|No|75%|69238153405|FLUOCINONIDE 0.05% CREAM|15|GM|.41796|12/14/2021||Yes|No||12/14/2021||Yes|No|12/14/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|120|No|.69804|03/29/2022|.68128|03/29/2022|.68582|03/29/2022|||STEROIDS: TOPICAL HIGH|20830|||||No|No||AMNEAL PHARMACE|No||||
fluocinonide|No|No|No|No|75%|69238153406|FLUOCINONIDE 0.05% CREAM|60|GM|.39695|12/14/2021||Yes|No||12/14/2021||Yes|No|12/14/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|120|No|.55445|03/29/2022|.54114|03/29/2022|.54474|03/29/2022|||STEROIDS: TOPICAL HIGH|20831|||||No|No||AMNEAL PHARMACE|No||||
clobazam|No|No|No|No|90%|69238153502|CLOBAZAM 2.5 MG/ML SUSPENSION|120|ML|.20066|01/03/2019||Yes|No||01/03/2019||Yes|No|01/03/2019||Yes|No||||No|No|||Prescription required|No||056|No|.50176|03/29/2022|.48971|03/29/2022|.49297|03/29/2022|||ANTICONVULSANTS|20832|||||No|No||AMNEAL PHARMACE|No||||
frovatriptan succinate|No|No|No|No|75%|69238153909|FROVATRIPTAN SUCC 2.5 MG TAB|9|EA|5.73333|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|021|No|12.36667|03/29/2022|12.06986|03/29/2022|12.15025|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|20833|||||No|No||AMNEAL PHARMACE|No||||
ursodiol|No|No|No|No|75%|69238154001|URSODIOL 300 MG CAPSULE|100|EA|.4515|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|198|No|.60006|03/29/2022|.58565|03/29/2022|.58955|03/29/2022|||BILE SALTS|20834|||||No|No||AMNEAL PHARMACE|No||||
hydroxychloroquine sulfate|No|No|No|No|75%|69238154401|HYDROXYCHLOROQUINE 200 MG TAB|100|EA|.1419|10/02/2018||Yes|No||10/02/2018||Yes|No|10/02/2018||Yes|No||||No|No|||Prescription required|No|||No|.23831|03/29/2022|.23259|03/29/2022|.23413|03/29/2022||||20835|||||No|No||AMNEAL PHARMACE|No||||
norgestimate-ethinyl estradiol|Yes|Yes|No|No|75%|69238155106|FEMYNOR 28 TABLET|28|EA|.11133|05/22/2017||Yes|No||05/22/2017||Yes|No|05/22/2017||Yes|No|Refer to program requirements|||No|No|05/22/2017||Prescription required|No|||No|.1742|03/29/2022|.17001|03/29/2022|.17115|03/29/2022||||20836|||||No|No||AMNEAL PHARMACE|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|69238155406|LILLOW-28 TABLET|28|EA|.0774|11/20/2017||Yes|No||11/20/2017||Yes|No|11/20/2017||Yes|No|Refer to program requirements|||No|No|11/20/2017||Prescription required|No|||No|.17306|03/29/2022|.1689|03/29/2022|.17003|03/29/2022||||20837|||||No|No||AMNEAL PHARMACE|No|||Only covered for non-contraceptive (medical) purposes|
amphetamine sulfate|No|No|No|No|90%|69238156301|AMPHETAMINE SULFATE 5 MG TAB|100|EA|.29166|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|.66473|05/18/2021|.65523|05/18/2021|.62403|05/18/2021|||STIMULANTS AND RELATED AGENTS|20838|||||No|No||AMNEAL PHARMACE|No||||
amphetamine sulfate|No|No|No|No|90%|69238156401|AMPHETAMINE SULFATE 10 MG TAB|100|EA|.29166|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|.77215|11/23/2021|.75361|11/23/2021|.75863|11/23/2021|||STIMULANTS AND RELATED AGENTS|20839|||||No|No||AMNEAL PHARMACE|No||||
sildenafil citrate|No|No|No|No|75%|69238157401|SILDENAFIL 10 MG/ML ORAL SUSP|112|ML|2.30357|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/25/2019|171|Yes|5.24999|09/28/2021|5.17499|09/28/2021|4.92856|09/28/2021|||PAH AGENTS: ORAL AND INHALED|20840|||||No|No||AMNEAL PHARMACE|No||||
norethindrone|Yes|Yes|No|No|75%|69238158306|NORLYDA 0.35 MG TABLET|28|EA|.07678|10/13/2017||Yes|No||10/13/2017||Yes|No|10/13/2017||Yes|No|Refer to program requirements|||No|No|10/13/2017||Prescription required|No|||No|.16123|03/29/2022|.15736|03/29/2022|.1584|03/29/2022||||20841|||||No|No||AMNEAL PHARMACE|No|||Only covered for non-contraceptive (medical) purposes|
sirolimus|No|No|No|No|75%|69238159403|SIROLIMUS 1 MG/ML SOLUTION|60|ML|7.54377|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|229|No|8.60227|03/01/2022|8.39581|03/01/2022|8.45173|03/01/2022|||IMMUNOSUPPRESSIVES: ORAL|20842|||||No|No||AMNEAL PHARMACE|No||||
aminocaproic acid|No|No|No|No|75%|69238159608|AMINOCAPROIC ACID 0.25 GRAM/ML|236.5|ML|3.34249|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|No|||No|4.81712|05/18/2021|4.7483|05/18/2021|4.52219|05/18/2021||||20843|||||No|No||AMNEAL PHARMACE|No||||
methylergonovine maleate|No|No|No|No|75%|69238160502|METHYLERGONOVINE 0.2 MG TABLET|12|EA|8.6|01/09/2019||Yes|No||01/09/2019||Yes|No|01/09/2019||Yes|No||||No|No|||Prescription required|No|||No|13.46155|05/25/2021|13.13847|05/25/2021|13.22597|05/25/2021||||20844|||||No|No||AMNEAL PHARMACE|No||||
methylergonovine maleate|No|No|No|No|75%|69238160508|METHYLERGONOVINE 0.2 MG TABLET|28|EA|8.6|01/09/2019||Yes|No||01/09/2019||Yes|No|01/09/2019||Yes|No||||No|No|||Prescription required|No|||No|13.46155|05/25/2021|13.13847|05/25/2021|13.22597|05/25/2021||||20845|||||No|No||AMNEAL PHARMACE|No||||
norgestimate-ethinyl estradiol|Yes|Yes|No|No|75%|69238160706|TRI FEMYNOR 28 TABLET|28|EA|.11133|10/13/2017||Yes|No||10/13/2017||Yes|No|10/13/2017||Yes|No|Refer to program requirements|||No|No|10/13/2017||Prescription required|No|||No|.1602|03/29/2022|.15635|03/29/2022|.15739|03/29/2022||||20846|||||No|No||AMNEAL PHARMACE|No|||Only covered for non-contraceptive (medical) purposes|
ofloxacin|No|No|No|No|75%|69238161503|OFLOXACIN 0.3% EAR DROPS|5|ML|1.29|09/29/2020||Yes|No||09/29/2020||Yes|No|09/29/2020||Yes|No||||No|No|||Prescription required|No||051|No|2.13104|03/29/2022|2.07989|03/29/2022|2.09374|03/29/2022|||OTIC ANTIBIOTICS|20847|||||No|No||AMNEAL PHARMACE|No||||
ofloxacin|No|No|No|No|75%|69238161606|OFLOXACIN 0.3% EAR DROPS|10|ML|1.29|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No||||No|No|||Prescription required|No||051|No|2.28641|03/29/2022|2.23153|03/29/2022|2.24639|03/29/2022|||OTIC ANTIBIOTICS|20848|||||No|No||AMNEAL PHARMACE|No||||
potassium chloride|No|No|No|No|75%|69238161703|POTASSIUM CL 20 MEQ PACKET|30|EA|1.2083|10/16/2019||Yes|No||10/16/2019||Yes|No|10/16/2019||Yes|No||||No|No|||Prescription required|No|||No|2.51484|03/29/2022|2.45448|03/29/2022|2.47083|03/29/2022||||20849|||||No|No||AMNEAL PHARMACE|No||||
potassium chloride|No|No|No|No|75%|69238161708|POTASSIUM CL 20 MEQ PACKET|100|EA|1.2083|10/16/2019||Yes|No||10/16/2019||Yes|No|10/16/2019||Yes|No||||No|No|||Prescription required|No|||No|2.51484|03/29/2022|2.45448|03/29/2022|2.47083|03/29/2022||||20850|||||No|No||AMNEAL PHARMACE|No||||
metyrosine|No|No|No|No|75%|69238162103|METYROSINE 250 MG CAPSULE|30|EA|107.5|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No|||No|245|06/03/2021|241.5|06/03/2021|230|06/03/2021||||20851|||||No|No||AMNEAL PHARMACE|No||||
dimethyl fumarate|No|No|No|No|75%|69238162603|DIMETHYL FUMARATE 30D START PK|60|EA|1.6125|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|No||043|No|3.675|09/28/2021|3.6225|09/28/2021|3.45|09/28/2021|||MULTIPLE SCLEROSIS AGENTS|20852|||||No|No||AMNEAL PHARMACE|No||||
aminocaproic acid|No|No|No|No|75%|69238163703|AMINOCAPROIC ACID 500 MG TAB|30|EA|7.36666|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|No|||No|10.61666|03/15/2022|10.46499|03/15/2022|9.96666|03/15/2022||||20853|||||No|No||AMNEAL PHARMACE|No||||
tavaborole|No|No|No|No|75%|69238165704|TAVABOROLE 5% TOPICAL SOLUTION|4|ML|33.88937|03/08/2022||Yes|No||03/08/2022||Yes|No|03/08/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|061|No|77.23625|03/08/2022|76.13287|03/08/2022|72.5075|03/08/2022|||ANTIFUNGALS: TOPICAL|20854|||||No|No||AMNEAL PHARMACE|No||||
tavaborole|No|No|No|No|75%|69238165706|TAVABOROLE 5% TOPICAL SOLUTION|10|ML|17.2|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|061|No|12.67867|08/24/2021|12.37438|08/24/2021|12.45679|08/24/2021|||ANTIFUNGALS: TOPICAL|20855|||||No|No||AMNEAL PHARMACE|No||||
fluphenazine HCl|No|No|No|No|75%|69238167801|FLUPHENAZINE 1 MG TABLET|100|EA|.5934|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|1.56797|01/25/2022|1.53033|01/25/2022|1.54053|01/25/2022|||ANTIPSYCHOTICS|20856|||||No|No||AMNEAL PHARMACE|No||||
fluphenazine HCl|No|No|No|No|75%|69238167901|FLUPHENAZINE 2.5 MG TABLET|100|EA|.92097|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|2.3014|01/25/2022|2.24616|01/25/2022|2.26112|01/25/2022|||ANTIPSYCHOTICS|20857|||||No|No||AMNEAL PHARMACE|No||||
fluphenazine HCl|No|No|No|No|75%|69238168001|FLUPHENAZINE 5 MG TABLET|100|EA|1.24605|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|2.98385|03/29/2022|2.91223|03/29/2022|2.93163|03/29/2022|||ANTIPSYCHOTICS|20858|||||No|No||AMNEAL PHARMACE|No||||
fluphenazine HCl|No|No|No|No|75%|69238168101|FLUPHENAZINE 10 MG TABLET|100|EA|1.57104|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|3.52974|03/29/2022|3.44502|03/29/2022|3.46796|03/29/2022|||ANTIPSYCHOTICS|20859|||||No|No||AMNEAL PHARMACE|No||||
deferasirox|No|No|No|No|75%|69238170303|DEFERASIROX 180 MG GRANULE PKT|30|EA|29.38304|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|No|||No|66.966|05/17/2021|66.00934|05/17/2021|62.86604|05/17/2021||||20860|||||No|No||AMNEAL PHARMACE|No||||
deferasirox|No|No|No|No|75%|69238170403|DEFERASIROX 360 MG GRANULE PKT|30|EA|58.7648|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|No|||No|133.92908|05/17/2021|132.01581|05/17/2021|125.72934|05/17/2021||||20861|||||No|No||AMNEAL PHARMACE|No||||
naproxen|No|No|No|No|75%|69238173002|NAPROXEN 125 MG/5 ML SUSPEN|473|ML|.31817|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|.72515|03/15/2022|.71479|03/15/2022|.68075|03/15/2022|||NSAIDS|20862|||||No|No||AMNEAL PHARMACE|No||||
pyridostigmine bromide|No|No|No|No|75%|69238173102|PYRIDOSTIGMINE 60 MG/5 ML SOLN|473|ML|.77272|06/02/2020||Yes|No||06/02/2020||Yes|No|06/02/2020||Yes|No||||No|No|||Prescription required|No|||No|1.76109|06/02/2020|1.73594|06/02/2020|1.65327|06/02/2020||||20863|||||No|No||AMNEAL PHARMACE|No||||
clobetasol propionate|No|No|No|No|75%|69238173208|CLOBETASOL 0.05% SHAMPOO|118|ML|.2733|12/15/2021||Yes|No||12/15/2021||Yes|No|12/15/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|121|No|.54041|03/29/2022|.52744|03/29/2022|.53095|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|20864|||||No|No||AMNEAL PHARMACE|No||||
pilocarpine HCl|No|No|No|No|75%|69238174508|PILOCARPINE 1% EYE DROPS|15|ML|1.80772|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|No||088|No|4.04603|03/29/2022|3.94892|03/29/2022|3.97522|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|20865|||||No|No||AMNEAL PHARMACE|No||||
pilocarpine HCl|No|No|No|No|75%|69238174608|PILOCARPINE 2% EYE DROPS|15|ML|1.849|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|No||088|No|4.33357|03/29/2022|4.22956|03/29/2022|4.25773|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|20866|||||No|No||AMNEAL PHARMACE|No||||
pilocarpine HCl|No|No|No|No|75%|69238174708|PILOCARPINE 4% EYE DROPS|15|ML|1.93844|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|No||088|No|4.37517|11/23/2021|4.27016|11/23/2021|4.2986|11/23/2021|||OPHTHALMICS: GLAUCOMA AGENTS|20867|||||No|No||AMNEAL PHARMACE|No||||
abiraterone acetate|No|No|No|No|75%|69238175406|ABIRATERONE 500 MG TABLET|60|EA|35.57877|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No||550|No|81.0865|09/28/2021|79.92812|09/28/2021|76.12202|09/28/2021|||ONCOLOGY: ORAL - PROSTATE|20868|||||No|No||AMNEAL PHARMACE|No||||
hydroxyprogesterone caproat/PF|No|No|No|No|75%|69238179701|HYDROXYPROGEST 250 MG/ML VIAL|1|ML|122.55|05/02/2019||Yes|No||05/02/2019||Yes|No|05/02/2019||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|151|Yes|279.3|03/16/2021|275.31|03/16/2021|262.2|03/16/2021|||PROGESTATIONAL AGENTS|20869|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238183001|LEVOTHYROXINE 25 MCG TABLET|100|EA|.09601|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.11852|03/29/2022|.11567|03/29/2022|.11644|03/29/2022||||20870|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238183007|LEVOTHYROXINE 25 MCG TABLET|1000|EA|.09601|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.11852|03/29/2022|.11567|03/29/2022|.11644|03/29/2022||||20871|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238183101|LEVOTHYROXINE 50 MCG TABLET|100|EA|.109|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.14288|03/29/2022|.13945|03/29/2022|.14037|03/29/2022||||20872|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238183107|LEVOTHYROXINE 50 MCG TABLET|1000|EA|.109|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.14288|03/29/2022|.13945|03/29/2022|.14037|03/29/2022||||20873|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238183201|LEVOTHYROXINE 75 MCG TABLET|100|EA|.12048|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.15545|03/29/2022|.15171|03/29/2022|.15272|03/29/2022||||20874|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238183207|LEVOTHYROXINE 75 MCG TABLET|1000|EA|.12048|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.15545|03/29/2022|.15171|03/29/2022|.15272|03/29/2022||||20875|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238183301|LEVOTHYROXINE 88 MCG TABLET|100|EA|.1225|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.16198|03/29/2022|.15809|03/29/2022|.15914|03/29/2022||||20876|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238183307|LEVOTHYROXINE 88 MCG TABLET|1000|EA|.1225|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.16198|03/29/2022|.15809|03/29/2022|.15914|03/29/2022||||20877|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238183401|LEVOTHYROXINE 100 MCG TABLET|100|EA|.12345|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.17286|03/29/2022|.16871|03/29/2022|.16983|03/29/2022||||20878|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238183407|LEVOTHYROXINE 100 MCG TABLET|1000|EA|.12345|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.17286|03/29/2022|.16871|03/29/2022|.16983|03/29/2022||||20879|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238183501|LEVOTHYROXINE 112 MCG TABLET|100|EA|.1428|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.1546|03/29/2022|.15088|03/29/2022|.15189|03/29/2022||||20880|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238183507|LEVOTHYROXINE 112 MCG TABLET|1000|EA|.1428|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.1546|03/29/2022|.15088|03/29/2022|.15189|03/29/2022||||20881|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238183601|LEVOTHYROXINE 125 MCG TABLET|100|EA|.14478|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.18894|03/29/2022|.1844|03/29/2022|.18563|03/29/2022||||20882|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238183607|LEVOTHYROXINE 125 MCG TABLET|1000|EA|.14478|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.18894|03/29/2022|.1844|03/29/2022|.18563|03/29/2022||||20883|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238183701|LEVOTHYROXINE 137 MCG TABLET|100|EA|.14675|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.22748|03/29/2022|.22202|03/29/2022|.22349|03/29/2022||||20884|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238183707|LEVOTHYROXINE 137 MCG TABLET|1000|EA|.14675|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.22748|03/29/2022|.22202|03/29/2022|.22349|03/29/2022||||20885|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238183801|LEVOTHYROXINE 150 MCG TABLET|100|EA|.14899|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.21406|03/29/2022|.20892|03/29/2022|.21031|03/29/2022||||20886|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238183807|LEVOTHYROXINE 150 MCG TABLET|1000|EA|.14899|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.21406|03/29/2022|.20892|03/29/2022|.21031|03/29/2022||||20887|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238183901|LEVOTHYROXINE 175 MCG TABLET|100|EA|.17707|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.2247|03/29/2022|.2193|03/29/2022|.22076|03/29/2022||||20888|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238183907|LEVOTHYROXINE 175 MCG TABLET|1000|EA|.17707|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.2247|03/29/2022|.2193|03/29/2022|.22076|03/29/2022||||20889|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238184001|LEVOTHYROXINE 200 MCG TABLET|100|EA|.17746|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.2307|03/29/2022|.22516|03/29/2022|.22666|03/29/2022||||20890|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238184007|LEVOTHYROXINE 200 MCG TABLET|1000|EA|.17746|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.2307|03/29/2022|.22516|03/29/2022|.22666|03/29/2022||||20891|||||No|No||AMNEAL PHARMACE|No||||
levothyroxine sodium|No|No|No|No|75%|69238184101|LEVOTHYROXINE 300 MCG TABLET|100|EA|.2386|04/12/2019||Yes|No||04/12/2019||Yes|No|04/12/2019||Yes|No||||No|No|||Prescription required|No|||No|.17616|03/29/2022|.17193|03/29/2022|.17307|03/29/2022||||20892|||||No|No||AMNEAL PHARMACE|No||||
digoxin|No|No|No|No|75%|69238199101|DIGOXIN 125 MCG TABLET|100|EA|.25477|10/18/2019||Yes|No||10/18/2019||Yes|No|10/18/2019||Yes|No||||No|No|||Prescription required|No|||No|.25031|03/29/2022|.2443|03/29/2022|.24592|03/29/2022||||20893|||||No|No||AMNEAL PHARMACE|No||||
digoxin|No|No|No|No|75%|69238199107|DIGOXIN 125 MCG TABLET|1000|EA|.25477|10/18/2019||Yes|No||10/18/2019||Yes|No|10/18/2019||Yes|No||||No|No|||Prescription required|No|||No|.25031|03/29/2022|.2443|03/29/2022|.24592|03/29/2022||||20894|||||No|No||AMNEAL PHARMACE|No||||
digoxin|No|No|No|No|75%|69238199201|DIGOXIN 250 MCG TABLET|100|EA|.25477|10/18/2019||Yes|No||10/18/2019||Yes|No|10/18/2019||Yes|No||||No|No|||Prescription required|No|||No|.22254|03/29/2022|.21719|03/29/2022|.21864|03/29/2022||||20895|||||No|No||AMNEAL PHARMACE|No||||
digoxin|No|No|No|No|75%|69238199207|DIGOXIN 250 MCG TABLET|1000|EA|.25477|10/18/2019||Yes|No||10/18/2019||Yes|No|10/18/2019||Yes|No||||No|No|||Prescription required|No|||No|.22254|03/29/2022|.21719|03/29/2022|.21864|03/29/2022||||20896|||||No|No||AMNEAL PHARMACE|No||||
codeine/butalbital/ASA/caffein|No|No|No|No|90%|69238199301|ASA-BUTALB-CAFF-COD #3 CAPSULE|100|EA|.94251|02/27/2020||Yes|No||02/27/2020||Yes|No|02/27/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|109|Yes|1.16307|03/29/2022|1.13515|03/29/2022|1.14271|03/29/2022|||ANALGESICS: NARCOTICS SHORT|20897|||||No|No||AMNEAL PHARMACE|No||||
zolmitriptan|No|No|No|No|75%|69238200606|ZOLMITRIPTAN 2.5 MG NASAL SPRY|6|EA|37.13981|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|021|No|84.64422|06/03/2021|83.43502|06/03/2021|79.46192|06/03/2021|||ANTIMIGRAINE AGENTS: TRIPTANS|20898|||||No|No||AMNEAL PHARMACE|No||||
zolmitriptan|No|No|No|No|75%|69238200706|ZOLMITRIPTAN 5 MG NASAL SPRAY|6|EA|37.13981|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|021|No|72.3425|03/29/2022|70.60628|03/29/2022|71.0765|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|20899|||||No|No||AMNEAL PHARMACE|No||||
diclofenac sodium|No|No|No|No|75%|69238205301|DICLOFENAC SODIUM 1% GEL|100|GM|.086|12/16/2021||Yes|No||||No|No|12/16/2021||Yes|No||||No|No|||Over the counter|No||059|Yes|.09419|03/29/2022|.09192|03/29/2022|.09254|03/29/2022|||NSAIDS|20900|||||No|No||AMNEAL PHARMACE|No||||
propranolol HCl|No|No|No|No|75%|69238207707|PROPRANOLOL 10 MG TABLET|1000|EA|.06888|12/28/2021||Yes|No||12/28/2021||Yes|No|12/28/2021||Yes|No||||No|No|||Prescription required|No||070|No|.06946|03/29/2022|.06779|03/29/2022|.06824|03/29/2022|||BETA-BLOCKERS|20901|||||No|No||AMNEAL PHARMACE|No||||
propranolol HCl|No|No|No|No|75%|69238207807|PROPRANOLOL 20 MG TABLET|1000|EA|.08591|03/08/2022||Yes|No||03/08/2022||Yes|No|03/08/2022||Yes|No||||No|No|||Prescription required|No||070|No|.08469|03/29/2022|.08265|03/29/2022|.0832|03/29/2022|||BETA-BLOCKERS|20902|||||No|No||AMNEAL PHARMACE|No||||
propranolol HCl|No|No|No|No|75%|69238207901|PROPRANOLOL 40 MG TABLET|100|EA|.10913|12/15/2021||Yes|No||12/15/2021||Yes|No|12/15/2021||Yes|No||||No|No|||Prescription required|No||070|No|.11538|03/29/2022|.11261|03/29/2022|.11336|03/29/2022|||BETA-BLOCKERS|20903|||||No|No||AMNEAL PHARMACE|No||||
propranolol HCl|No|No|No|No|75%|69238207907|PROPRANOLOL 40 MG TABLET|1000|EA|.10913|12/15/2021||Yes|No||12/15/2021||Yes|No|12/15/2021||Yes|No||||No|No|||Prescription required|No||070|No|.11538|03/29/2022|.11261|03/29/2022|.11336|03/29/2022|||BETA-BLOCKERS|20904|||||No|No||AMNEAL PHARMACE|No||||
emtricitabine/tenofovir (TDF)|No|No|No|No|75%|69238209203|EMTRICITABINE-TENOFV 100-150MG|30|EA|8.40079|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|13.7213|09/28/2021|13.52528|09/28/2021|12.88122|09/28/2021|||HIV / AIDS|20905|||||No|No||AMNEAL PHARMACE|No||||
emtricitabine/tenofovir (TDF)|No|No|No|No|75%|69238209303|EMTRICITABINE-TENOFV 133-200MG|30|EA|8.40079|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|13.7213|09/28/2021|13.52528|09/28/2021|12.88122|09/28/2021|||HIV / AIDS|20906|||||No|No||AMNEAL PHARMACE|No||||
emtricitabine/tenofovir (TDF)|No|No|No|No|75%|69238209403|EMTRICITABINE-TENOFV 167-250MG|30|EA|8.40079|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|13.7213|09/28/2021|13.52528|09/28/2021|12.88122|09/28/2021|||HIV / AIDS|20907|||||No|No||AMNEAL PHARMACE|No||||
emtricitabine/tenofovir (TDF)|No|No|No|No|75%|69238209503|EMTRICITABINE-TENOFV 200-300MG|30|EA|.79999|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.70347|03/29/2022|.68658|03/29/2022|.69115|03/29/2022|||HIV / AIDS|20908|||||No|No||AMNEAL PHARMACE|No||||
metronidazole|Yes|No|No|No|75%|69292020750|METRONIDAZOLE 250 MG TABLET|500|EA|.11632|08/28/2020||Yes|No||08/28/2020||Yes|No|08/28/2020||Yes|No||||No|No|09/21/2020||Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|20909|||||No|No||AMICI PHARMACEU|No||||
metronidazole|Yes|No|No|No|75%|69292020850|METRONIDAZOLE 500 MG TABLET|500|EA|.1204|08/28/2020||Yes|No||08/28/2020||Yes|No|08/28/2020||Yes|No||||No|No|09/21/2020||Prescription required|No||115|No|.15479|03/29/2022|.15107|03/29/2022|.15208|03/29/2022|||ANTIBIOTICS: GI|20910|||||No|No||AMICI PHARMACEU|No||||
captopril|Yes|No|No|No|75%|69292052201|CAPTOPRIL 12.5 MG TABLET|100|EA|.43|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|06/19/2020||Prescription required|Yes|07/25/2019|113|No|.58889|03/29/2022|.57475|03/29/2022|.57858|03/29/2022|||ANGIOTENSIN MODULATORS|20911|||||No|No||AMICI PHARMACEU|No||||
captopril|Yes|No|No|No|75%|69292052210|CAPTOPRIL 12.5 MG TABLET|1000|EA|.43|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|06/19/2020||Prescription required|Yes|07/25/2019|113|No|.58889|03/29/2022|.57475|03/29/2022|.57858|03/29/2022|||ANGIOTENSIN MODULATORS|20912|||||No|No||AMICI PHARMACEU|No||||
captopril|Yes|No|No|No|75%|69292052401|CAPTOPRIL 25 MG TABLET|100|EA|.4558|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|06/19/2020||Prescription required|Yes|07/25/2019|113|No|.40459|03/29/2022|.39487|03/29/2022|.3975|03/29/2022|||ANGIOTENSIN MODULATORS|20913|||||No|No||AMICI PHARMACEU|No||||
captopril|Yes|No|No|No|75%|69292052410|CAPTOPRIL 25 MG TABLET|1000|EA|.4558|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|06/19/2020||Prescription required|Yes|07/25/2019|113|No|.40459|03/29/2022|.39487|03/29/2022|.3975|03/29/2022|||ANGIOTENSIN MODULATORS|20914|||||No|No||AMICI PHARMACEU|No||||
captopril|Yes|No|No|No|75%|69292052601|CAPTOPRIL 50 MG TABLET|100|EA|.7998|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|06/19/2020||Prescription required|Yes|07/25/2019|113|No|1.25965|03/29/2022|1.22941|03/29/2022|1.2376|03/29/2022|||ANGIOTENSIN MODULATORS|20915|||||No|No||AMICI PHARMACEU|No||||
captopril|Yes|No|No|No|75%|69292052610|CAPTOPRIL 50 MG TABLET|1000|EA|.50998|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|06/19/2020||Prescription required|Yes|07/25/2019|113|No|1.25965|03/29/2022|1.22941|03/29/2022|1.2376|03/29/2022|||ANGIOTENSIN MODULATORS|20916|||||No|No||AMICI PHARMACEU|No||||
captopril|Yes|No|No|No|75%|69292052801|CAPTOPRIL 100 MG TABLET|100|EA|1.0535|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|06/19/2020||Prescription required|Yes|07/25/2019|113|No|1.37792|03/29/2022|1.34484|03/29/2022|1.3538|03/29/2022|||ANGIOTENSIN MODULATORS|20917|||||No|No||AMICI PHARMACEU|No||||
captopril|Yes|No|No|No|75%|69292052850|CAPTOPRIL 100 MG TABLET|500|EA|1.0535|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|06/19/2020||Prescription required|Yes|07/25/2019|113|No|1.37792|03/29/2022|1.34484|03/29/2022|1.3538|03/29/2022|||ANGIOTENSIN MODULATORS|20918|||||No|No||AMICI PHARMACEU|No||||
propranolol HCl|No|No|No|No|75%|69292053001|PROPRANOLOL 10 MG TABLET|100|EA|.06966|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|No||070|No|.06946|03/29/2022|.06779|03/29/2022|.06824|03/29/2022|||BETA-BLOCKERS|20919|||||No|No||AMICI PHARMACEU|No||||
propranolol HCl|No|No|No|No|75%|69292053010|PROPRANOLOL 10 MG TABLET|1000|EA|.06963|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|No||070|No|.06946|03/29/2022|.06779|03/29/2022|.06824|03/29/2022|||BETA-BLOCKERS|20920|||||No|No||AMICI PHARMACEU|No||||
propranolol HCl|No|No|No|No|75%|69292053201|PROPRANOLOL 20 MG TABLET|100|EA|.08707|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|No||070|No|.08469|03/29/2022|.08265|03/29/2022|.0832|03/29/2022|||BETA-BLOCKERS|20921|||||No|No||AMICI PHARMACEU|No||||
propranolol HCl|No|No|No|No|75%|69292053210|PROPRANOLOL 20 MG TABLET|1000|EA|.08707|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|No||070|No|.08469|03/29/2022|.08265|03/29/2022|.0832|03/29/2022|||BETA-BLOCKERS|20922|||||No|No||AMICI PHARMACEU|No||||
propranolol HCl|No|No|No|No|75%|69292053401|PROPRANOLOL 40 MG TABLET|100|EA|.11072|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|No||070|No|.11538|03/29/2022|.11261|03/29/2022|.11336|03/29/2022|||BETA-BLOCKERS|20923|||||No|No||AMICI PHARMACEU|No||||
propranolol HCl|No|No|No|No|75%|69292053410|PROPRANOLOL 40 MG TABLET|1000|EA|.11048|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|No||070|No|.11538|03/29/2022|.11261|03/29/2022|.11336|03/29/2022|||BETA-BLOCKERS|20924|||||No|No||AMICI PHARMACEU|No||||
propranolol HCl|No|No|No|No|75%|69292053601|PROPRANOLOL 60 MG TABLET|100|EA|.30723|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|No||070|No|.35485|03/29/2022|.34633|03/29/2022|.34864|03/29/2022|||BETA-BLOCKERS|20925|||||No|No||AMICI PHARMACEU|No||||
propranolol HCl|No|No|No|No|75%|69292053801|PROPRANOLOL 80 MG TABLET|100|EA|.16555|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|No||070|No|.21823|03/29/2022|.21299|03/29/2022|.21441|03/29/2022|||BETA-BLOCKERS|20926|||||No|No||AMICI PHARMACEU|No||||
propranolol HCl|No|No|No|No|75%|69292053850|PROPRANOLOL 80 MG TABLET|500|EA|.16421|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|No||070|No|.21823|03/29/2022|.21299|03/29/2022|.21441|03/29/2022|||BETA-BLOCKERS|20927|||||No|No||AMICI PHARMACEU|No||||
diclofenac potassium|No|No|No|No|75%|69292055001|DICLOFENAC POT 50 MG TABLET|100|EA|.44969|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|No||059|Yes|.33951|03/29/2022|.33136|03/29/2022|.33356|03/29/2022|||NSAIDS|20928|||||No|No||AMICI PHARMACEU|No||||
metolazone|No|No|No|No|75%|69292056201|METOLAZONE 2.5 MG TABLET|100|EA|.559|09/02/2021||Yes|No||09/02/2021||Yes|No|09/02/2021||Yes|No||||No|No|||Prescription required|No|||No|.75368|03/29/2022|.73559|03/29/2022|.74049|03/29/2022||||20929|||||No|No||AMICI PHARMACEU|No||||
metolazone|No|No|No|No|75%|69292056401|METOLAZONE 5 MG TABLET|100|EA|.645|09/02/2021||Yes|No||09/02/2021||Yes|No|09/02/2021||Yes|No||||No|No|||Prescription required|No|||No|.77158|03/29/2022|.75306|03/29/2022|.75807|03/29/2022||||20930|||||No|No||AMICI PHARMACEU|No||||
metolazone|No|No|No|No|75%|69292056601|METOLAZONE 10 MG TABLET|100|EA|.774|09/02/2021||Yes|No||09/02/2021||Yes|No|09/02/2021||Yes|No||||No|No|||Prescription required|No|||No|1.18747|03/01/2022|1.15897|03/01/2022|1.16668|03/01/2022||||20931|||||No|No||AMICI PHARMACEU|No||||
flurbiprofen sodium|No|No|No|No|75%|69292072225|FLURBIPROFEN 0.03% EYE DROP|2.5|ML|6.192|08/02/2019||Yes|No||08/02/2019||Yes|No|08/02/2019||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|013|No|12.076|11/23/2021|11.78617|11/23/2021|11.86467|11/23/2021|||OPHTHALMICS: ANTI-INFLAMMATORIES|20932|||||No|No||AMICI PHARMACEU|No||||
furosemide|No|No|No|No|75%|69315011601|FUROSEMIDE 20 MG TABLET|100|EA|.01634|08/17/2016||Yes|No||08/17/2016||Yes|No|08/17/2016||Yes|No||||No|No|||Prescription required|No|||No|.03187|03/29/2022|.0311|03/29/2022|.03131|03/29/2022||||20933|||||No|No||LEADING PHARMA|No||||
furosemide|No|No|No|No|75%|69315011610|FUROSEMIDE 20 MG TABLET|1000|EA|.01552|08/17/2016||Yes|No||08/17/2016||Yes|No|08/17/2016||Yes|No||||No|No|||Prescription required|No|||No|.03187|03/29/2022|.0311|03/29/2022|.03131|03/29/2022||||20934|||||No|No||LEADING PHARMA|No||||
furosemide|No|No|No|No|75%|69315011701|FUROSEMIDE 40 MG TABLET|100|EA|.01741|08/17/2016||Yes|No||08/17/2016||Yes|No|08/17/2016||Yes|No||||No|No|||Prescription required|No|||No|.03326|03/29/2022|.03246|03/29/2022|.03267|03/29/2022||||20935|||||No|No||LEADING PHARMA|No||||
furosemide|No|No|No|No|75%|69315011710|FUROSEMIDE 40 MG TABLET|1000|EA|.01654|08/17/2016||Yes|No||08/17/2016||Yes|No|08/17/2016||Yes|No||||No|No|||Prescription required|No|||No|.03326|03/29/2022|.03246|03/29/2022|.03267|03/29/2022||||20936|||||No|No||LEADING PHARMA|No||||
furosemide|No|No|No|No|75%|69315011801|FUROSEMIDE 80 MG TABLET|100|EA|.02988|08/17/2016||Yes|No||08/17/2016||Yes|No|08/17/2016||Yes|No||||No|No|||Prescription required|No|||No|.06148|03/29/2022|.06|03/29/2022|.0604|03/29/2022||||20937|||||No|No||LEADING PHARMA|No||||
furosemide|No|No|No|No|75%|69315011805|FUROSEMIDE 80 MG TABLET|500|EA|.02842|10/15/2020||Yes|No||10/15/2020||Yes|No|10/15/2020||Yes|No||||No|No|||Prescription required|No|||No|.06148|03/29/2022|.06|03/29/2022|.0604|03/29/2022||||20938|||||No|No||LEADING PHARMA|No||||
folic acid|No|No|No|No|75%|69315012701|FOLIC ACID 1 MG TABLET|100|EA|.0817|08/17/2016||Yes|No||08/17/2016||Yes|No|08/17/2016||Yes|No||||No|No|||Prescription required|No|||No|.02568|03/29/2022|.02506|03/29/2022|.02523|03/29/2022||||20939|||||No|No||LEADING PHARMA|No||||
folic acid|No|No|No|No|75%|69315012710|FOLIC ACID 1 MG TABLET|1000|EA|.02752|08/17/2016||Yes|No||08/17/2016||Yes|No|08/17/2016||Yes|No||||No|No|||Prescription required|No|||No|.02568|03/29/2022|.02506|03/29/2022|.02523|03/29/2022||||20940|||||No|No||LEADING PHARMA|No||||
hydrochlorothiazide|No|No|No|No|75%|69315013001|HYDROCHLOROTHIAZIDE 50 MG TAB|100|EA|.03504|09/14/2016||Yes|No||09/14/2016||Yes|No|09/14/2016||Yes|No||||No|No|||Prescription required|No|||Yes|.02959|03/29/2022|.02887|03/29/2022|.02907|03/29/2022||||20941|||||No|No||LEADING PHARMA|No||||
hydrochlorothiazide|No|No|No|No|75%|69315013010|HYDROCHLOROTHIAZIDE 50 MG TAB|1000|EA|.03373|09/14/2016||Yes|No||09/14/2016||Yes|No|09/14/2016||Yes|No||||No|No|||Prescription required|No|||Yes|.02959|03/29/2022|.02887|03/29/2022|.02907|03/29/2022||||20942|||||No|No||LEADING PHARMA|No||||
hydrochlorothiazide|No|No|No|No|75%|69315013101|HYDROCHLOROTHIAZIDE 25 MG TAB|100|EA|.01935|09/12/2016||Yes|No||09/12/2016||Yes|No|09/12/2016||Yes|No||||No|No|||Prescription required|No|||Yes|.01337|03/29/2022|.01304|03/29/2022|.01313|03/29/2022||||20943|||||No|No||LEADING PHARMA|No||||
hydrochlorothiazide|No|No|No|No|75%|69315013110|HYDROCHLOROTHIAZIDE 25 MG TAB|1000|EA|.01768|09/12/2016||Yes|No||09/12/2016||Yes|No|09/12/2016||Yes|No||||No|No|||Prescription required|No|||Yes|.01337|03/29/2022|.01304|03/29/2022|.01313|03/29/2022||||20944|||||No|No||LEADING PHARMA|No||||
imipramine HCl|No|No|No|No|75%|69315013301|IMIPRAMINE HCL 10 MG TABLET|100|EA|.0774|09/08/2016||Yes|No||09/08/2016||Yes|No|09/08/2016||Yes|No||||No|No|||Prescription required|No||215|No|.08862|03/29/2022|.08649|03/29/2022|.08706|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|20945|||||No|No||LEADING PHARMA|No||||
imipramine HCl|No|No|No|No|75%|69315013310|IMIPRAMINE HCL 10 MG TABLET|1000|EA|.07353|09/08/2016||Yes|No||09/08/2016||Yes|No|09/08/2016||Yes|No||||No|No|||Prescription required|No||215|No|.08862|03/29/2022|.08649|03/29/2022|.08706|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|20946|||||No|No||LEADING PHARMA|No||||
imipramine HCl|No|No|No|No|75%|69315013401|IMIPRAMINE HCL 25 MG TABLET|100|EA|.1032|09/08/2016||Yes|No||09/08/2016||Yes|No|09/08/2016||Yes|No||||No|No|||Prescription required|No||215|No|.0831|03/29/2022|.0811|03/29/2022|.08164|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|20947|||||No|No||LEADING PHARMA|No||||
imipramine HCl|No|No|No|No|75%|69315013410|IMIPRAMINE HCL 25 MG TABLET|1000|EA|.09847|09/08/2016||Yes|No||09/08/2016||Yes|No|09/08/2016||Yes|No||||No|No|||Prescription required|No||215|No|.0831|03/29/2022|.0811|03/29/2022|.08164|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|20948|||||No|No||LEADING PHARMA|No||||
imipramine HCl|No|No|No|No|75%|69315013501|IMIPRAMINE HCL 50 MG TABLET|100|EA|.1333|09/08/2016||Yes|No||09/08/2016||Yes|No|09/08/2016||Yes|No||||No|No|||Prescription required|No||215|No|.13692|03/29/2022|.13363|03/29/2022|.13452|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|20949|||||No|No||LEADING PHARMA|No||||
imipramine HCl|No|No|No|No|75%|69315013510|IMIPRAMINE HCL 50 MG TABLET|1000|EA|.12814|09/08/2016||Yes|No||09/08/2016||Yes|No|09/08/2016||Yes|No||||No|No|||Prescription required|No||215|No|.13692|03/29/2022|.13363|03/29/2022|.13452|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|20950|||||No|No||LEADING PHARMA|No||||
benztropine mesylate|No|No|No|No|75%|69315013601|BENZTROPINE MES 0.5 MG TAB|100|EA|.05977|09/09/2016||Yes|No||09/09/2016||Yes|No|09/09/2016||Yes|No||||No|No|||Prescription required|No||015|No|.08426|03/29/2022|.08223|03/29/2022|.08278|03/29/2022|||ANTIPARKINSON'S AGENTS|20951|||||No|No||LEADING PHARMA|No||||
benztropine mesylate|No|No|No|No|75%|69315013610|BENZTROPINE MES 0.5 MG TAB|1000|EA|.05364|09/09/2016||Yes|No||09/09/2016||Yes|No|09/09/2016||Yes|No||||No|No|||Prescription required|No||015|No|.08426|03/29/2022|.08223|03/29/2022|.08278|03/29/2022|||ANTIPARKINSON'S AGENTS|20952|||||No|No||LEADING PHARMA|No||||
benztropine mesylate|No|No|No|No|75%|69315013701|BENZTROPINE MES 1 MG TABLET|100|EA|.06923|09/12/2016||Yes|No||09/12/2016||Yes|No|09/12/2016||Yes|No||||No|No|||Prescription required|No||015|No|.08541|03/29/2022|.08336|03/29/2022|.08391|03/29/2022|||ANTIPARKINSON'S AGENTS|20953|||||No|No||LEADING PHARMA|No||||
benztropine mesylate|No|No|No|No|75%|69315013710|BENZTROPINE MES 1 MG TABLET|1000|EA|.062|09/12/2016||Yes|No||09/12/2016||Yes|No|09/12/2016||Yes|No||||No|No|||Prescription required|No||015|No|.08541|03/29/2022|.08336|03/29/2022|.08391|03/29/2022|||ANTIPARKINSON'S AGENTS|20954|||||No|No||LEADING PHARMA|No||||
benztropine mesylate|No|No|No|No|75%|69315013801|BENZTROPINE MES 2 MG TABLET|100|EA|.08815|09/12/2016||Yes|No||09/12/2016||Yes|No|09/12/2016||Yes|No||||No|No|||Prescription required|No||015|No|.12012|03/29/2022|.11723|03/29/2022|.11801|03/29/2022|||ANTIPARKINSON'S AGENTS|20955|||||No|No||LEADING PHARMA|No||||
benztropine mesylate|No|No|No|No|75%|69315013810|BENZTROPINE MES 2 MG TABLET|1000|EA|.07907|09/12/2016||Yes|No||09/12/2016||Yes|No|09/12/2016||Yes|No||||No|No|||Prescription required|No||015|No|.12012|03/29/2022|.11723|03/29/2022|.11801|03/29/2022|||ANTIPARKINSON'S AGENTS|20956|||||No|No||LEADING PHARMA|No||||
glycopyrrolate|No|No|No|No|75%|69315013901|GLYCOPYRROLATE 1 MG TABLET|100|EA|.3784|09/07/2016||Yes|No||09/07/2016||Yes|No|09/07/2016||Yes|No||||No|No|||Prescription required|No|||No|.10136|03/29/2022|.09892|03/29/2022|.09958|03/29/2022||||20957|||||No|No||LEADING PHARMA|No||||
glycopyrrolate|No|No|No|No|75%|69315014001|GLYCOPYRROLATE 2 MG TABLET|100|EA|.6321|10/06/2016||Yes|No||10/06/2016||Yes|No|10/06/2016||Yes|No||||No|No|||Prescription required|No|||No|.22028|03/29/2022|.21499|03/29/2022|.21642|03/29/2022||||20958|||||No|No||LEADING PHARMA|No||||
hydrochlorothiazide|Yes|No|No|No|75%|69315015501|HYDROCHLOROTHIAZIDE 12.5 MG TB|100|EA|.0602|05/06/2020||Yes|No||05/06/2020||Yes|No|05/06/2020||Yes|No||||No|No|06/19/2020||Prescription required|No|||Yes|.05169|03/29/2022|.05044|03/29/2022|.05078|03/29/2022||||20959|||||No|No||LEADING PHARMA|No||||
hydrochlorothiazide|Yes|No|No|No|75%|69315015510|HYDROCHLOROTHIAZIDE 12.5 MG TB|1000|EA|.0602|05/06/2020||Yes|No||05/06/2020||Yes|No|05/06/2020||Yes|No||||No|No|06/19/2020||Prescription required|No|||Yes|.05169|03/29/2022|.05044|03/29/2022|.05078|03/29/2022||||20960|||||No|No||LEADING PHARMA|No||||
clomipramine HCl|No|No|No|No|75%|69315016501|CLOMIPRAMINE 75 MG CAPSULE|100|EA|1.36146|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|215|No|.95054|03/29/2022|.92772|03/29/2022|.9339|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|20961|||||No|No||LEADING PHARMA|No||||
clomipramine HCl|No|No|No|No|75%|69315016601|CLOMIPRAMINE 50 MG CAPSULE|100|EA|1.36146|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|215|No|.80238|03/29/2022|.78312|03/29/2022|.78833|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|20962|||||No|No||LEADING PHARMA|No||||
clomipramine HCl|No|No|No|No|75%|69315016701|CLOMIPRAMINE 25 MG CAPSULE|100|EA|1.36146|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|215|No|1.31238|03/29/2022|1.28088|03/29/2022|1.28941|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|20963|||||No|No||LEADING PHARMA|No||||
oxybutynin chloride|No|No|No|No|75%|69315018201|OXYBUTYNIN 5 MG TABLET|100|EA|.043|12/20/2021||Yes|No||12/20/2021||Yes|No|12/20/2021||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|20964|||||No|No||LEADING PHARMA|No||||
oxybutynin chloride|No|No|No|No|75%|69315018205|OXYBUTYNIN 5 MG TABLET|500|EA|.043|12/20/2021||Yes|No||12/20/2021||Yes|No|12/20/2021||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|20965|||||No|No||LEADING PHARMA|No||||
oxybutynin chloride|No|No|No|No|75%|69315018210|OXYBUTYNIN 5 MG TABLET|1000|EA|.043|12/20/2021||Yes|No||12/20/2021||Yes|No|12/20/2021||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|20966|||||No|No||LEADING PHARMA|No||||
leucovorin calcium|No|No|No|No|75%|69315018401|LEUCOVORIN CALCIUM 5 MG TAB|100|EA|.46814|12/08/2021||Yes|No||12/08/2021||Yes|No|12/08/2021||Yes|No||||No|No|||Prescription required|No|||No|.873|03/29/2022|.85204|03/29/2022|.85772|03/29/2022||||20967|||||No|No||LEADING PHARMA|No||||
leucovorin calcium|No|No|No|No|75%|69315018403|LEUCOVORIN CALCIUM 5 MG TAB|30|EA|.48045|12/08/2021||Yes|No||12/08/2021||Yes|No|12/08/2021||Yes|No||||No|No|||Prescription required|No|||No|.873|03/29/2022|.85204|03/29/2022|.85772|03/29/2022||||20968|||||No|No||LEADING PHARMA|No||||
leucovorin calcium|No|No|No|No|75%|69315018512|LEUCOVORIN CALCIUM 10 MG TAB|12|EA|2.67925|12/08/2021||Yes|No||12/08/2021||Yes|No|12/08/2021||Yes|No||||No|No|||Prescription required|No|||No|5.44565|12/08/2021|5.31495|12/08/2021|5.35035|12/08/2021||||20969|||||No|No||LEADING PHARMA|No||||
leucovorin calcium|No|No|No|No|75%|69315018524|LEUCOVORIN CALCIUM 10 MG TAB|24|EA|2.38183|12/08/2021||Yes|No||12/08/2021||Yes|No|12/08/2021||Yes|No||||No|No|||Prescription required|No|||No|5.44565|12/08/2021|5.31495|12/08/2021|5.35035|12/08/2021||||20970|||||No|No||LEADING PHARMA|No||||
leucovorin calcium|No|No|No|No|75%|69315018624|LEUCOVORIN CALCIUM 15 MG TAB|24|EA|2.27685|12/08/2021||Yes|No||12/08/2021||Yes|No|12/08/2021||Yes|No||||No|No|||Prescription required|No|||No|5.1891|12/08/2021|5.11497|12/08/2021|4.8714|12/08/2021||||20971|||||No|No||LEADING PHARMA|No||||
leucovorin calcium|No|No|No|No|75%|69315018725|LEUCOVORIN CALCIUM 25 MG TAB|25|EA|3.84471|12/08/2021||Yes|No||12/08/2021||Yes|No|12/08/2021||Yes|No||||No|No|||Prescription required|No|||No|5.60951|03/29/2022|5.47488|03/29/2022|5.51134|03/29/2022||||20972|||||No|No||LEADING PHARMA|No||||
nifedipine|No|No|No|No|75%|69315021101|NIFEDIPINE 10 MG CAPSULE|100|EA|.36747|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|045|No|.40848|03/29/2022|.39867|03/29/2022|.40133|03/29/2022|||CALCIUM CHANNEL BLOCKERS|20973|||||No|No||LEADING PHARMA|No||||
nifedipine|No|No|No|No|75%|69315021201|NIFEDIPINE 20 MG CAPSULE|100|EA|.79214|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|045|No|1.80535|11/24/2020|1.77956|11/24/2020|1.69482|11/24/2020|||CALCIUM CHANNEL BLOCKERS|20974|||||No|No||LEADING PHARMA|No||||
codeine phosphate/guaifenesin|No|No|No|No|90%|69315024812|CODEINE-GUAIFEN 10-100 MG/5 ML|120|ML|.03833|03/03/2020||Yes|No||||No|No|03/03/2020||Yes|No||||No|No|||Over the counter|No||183|Yes|.03904|03/29/2022|.0381|03/29/2022|.03835|03/29/2022|||COUGH AND COLD: NARCOTIC|20975|||||No|No||LEADING PHARMA|No||||
codeine phosphate/guaifenesin|No|No|No|No|90%|69315024848|CODEINE-GUAIFEN 10-100 MG/5 ML|473|ML|.03245|03/03/2020||Yes|No||||No|No|03/03/2020||Yes|No||||No|No|||Over the counter|No||183|Yes|.02734|03/29/2022|.02668|03/29/2022|.02686|03/29/2022|||COUGH AND COLD: NARCOTIC|20976|||||No|No||LEADING PHARMA|No||||
dorzolamide HCl|No|No|No|No|75%|69315030410|DORZOLAMIDE HCL 2% EYE DROPS|10|ML|1.46157|06/15/2020||Yes|No||06/15/2020||Yes|No|06/15/2020||Yes|No||||No|No|||Prescription required|No||088|No|1.39302|03/29/2022|1.35958|03/29/2022|1.36864|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|20977|||||No|No||LEADING PHARMA|No||||
nystatin|No|No|No|No|75%|69315030615|NYSTATIN 100,000 UNIT/GM POWD|15|GM|.55613|08/21/2018||Yes|No||08/21/2018||Yes|No|08/21/2018||Yes|No||||No|No|||Prescription required|No||061|No|.35016|03/29/2022|.34175|03/29/2022|.34403|03/29/2022|||ANTIFUNGALS: TOPICAL|20978|||||No|No||LEADING PHARMA|No||||
nystatin|No|No|No|No|75%|69315030630|NYSTATIN 100,000 UNIT/GM POWD|30|GM|.55627|08/21/2018||Yes|No||08/21/2018||Yes|No|08/21/2018||Yes|No||||No|No|||Prescription required|No||061|No|.30897|03/29/2022|.30155|03/29/2022|.30356|03/29/2022|||ANTIFUNGALS: TOPICAL|20979|||||No|No||LEADING PHARMA|No||||
nystatin|No|No|No|No|75%|69315030660|NYSTATIN 100,000 UNIT/GM POWD|60|GM|.49665|08/21/2018||Yes|No||08/21/2018||Yes|No|08/21/2018||Yes|No||||No|No|||Prescription required|No||061|No|.2597|03/29/2022|.25346|03/29/2022|.25515|03/29/2022|||ANTIFUNGALS: TOPICAL|20980|||||No|No||LEADING PHARMA|No||||
nystatin|No|No|No|No|75%|69315030715|NYSTATIN 100,000 UNIT/GM OINT|15|GM|.40133|10/13/2020|05/31/2022|Yes|No||10/13/2020|05/31/2022|Yes|No|10/13/2020|05/31/2022|Yes|No||||No|No|||Prescription required|No||061|No|.33338|03/29/2022|.32537|03/29/2022|.32754|03/29/2022|||ANTIFUNGALS: TOPICAL|20981|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||LEADING PHARMA|No||||
nystatin|No|No|No|No|75%|69315030730|NYSTATIN 100,000 UNIT/GM OINT|30|GM|.301|10/13/2020|10/31/2022|Yes|No||10/13/2020|10/31/2022|Yes|No|10/13/2020|10/31/2022|Yes|No||||No|No|||Prescription required|No||061|No|.27525|03/29/2022|.26864|03/29/2022|.27043|03/29/2022|||ANTIFUNGALS: TOPICAL|20982|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||LEADING PHARMA|No||||
ciprofloxacin HCl|No|No|No|No|75%|69315030802|CIPROFLOXACIN 0.3% EYE DROP|2.5|ML|1.806|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||058|No|3.16994|03/29/2022|3.09386|03/29/2022|3.11446|03/29/2022|||OPHTHALMIC ANTIBIOTICS|20983|||||No|No||LEADING PHARMA|No||||
ciprofloxacin HCl|No|No|No|No|75%|69315030805|CIPROFLOXACIN 0.3% EYE DROP|5|ML|1.204|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||058|No|2.02578|03/29/2022|1.97716|03/29/2022|1.99032|03/29/2022|||OPHTHALMIC ANTIBIOTICS|20984|||||No|No||LEADING PHARMA|No||||
ciprofloxacin HCl|No|No|No|No|75%|69315030810|CIPROFLOXACIN 0.3% EYE DROP|10|ML|.946|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||058|No|1.78414|03/29/2022|1.74132|03/29/2022|1.75291|03/29/2022|||OPHTHALMIC ANTIBIOTICS|20985|||||No|No||LEADING PHARMA|No||||
ciclopirox olamine|No|No|No|No|75%|69315030930|CICLOPIROX 0.77% TOPICAL SUSP|30|ML|.86|06/10/2019||Yes|No||06/10/2019||Yes|No|06/10/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|.81226|03/29/2022|.79276|03/29/2022|.79804|03/29/2022|||ANTIFUNGALS: TOPICAL|20986|||||No|No||LEADING PHARMA|No||||
ciclopirox olamine|No|No|No|No|75%|69315030960|CICLOPIROX 0.77% TOPICAL SUSP|60|ML|.645|06/10/2019||Yes|No||06/10/2019||Yes|No|06/10/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|061|No|.96027|03/29/2022|.93722|03/29/2022|.94346|03/29/2022|||ANTIFUNGALS: TOPICAL|20987|||||No|No||LEADING PHARMA|No||||
hydrocortisone|No|No|No|No|75%|69315031228|PROCTO-MED HC 2.5% CREAM|28|GM|1.075|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||||No|No|||Prescription required|No||118|No|.33274|03/29/2022|.32475|03/29/2022|.32691|03/29/2022|||STEROIDS: TOPICAL LOW|20988|||||No|No||LEADING PHARMA|No||||
lorazepam|No|No|No|No|90%|69315090401|LORAZEPAM 0.5 MG TABLET|100|EA|.03225|08/17/2016||Yes|No||08/17/2016||Yes|No|08/17/2016||Yes|No||||No|No|||Prescription required|No||090|Yes|.03794|03/29/2022|.03702|03/29/2022|.03727|03/29/2022|||ANXIOLYTICS|20989|||||No|No||LEADING PHARMA|No||||
lorazepam|No|No|No|No|90%|69315090405|LORAZEPAM 0.5 MG TABLET|500|EA|.03225|08/17/2016||Yes|No||08/17/2016||Yes|No|08/17/2016||Yes|No||||No|No|||Prescription required|No||090|Yes|.03794|03/29/2022|.03702|03/29/2022|.03727|03/29/2022|||ANXIOLYTICS|20990|||||No|No||LEADING PHARMA|No||||
lorazepam|No|No|No|No|90%|69315090410|LORAZEPAM 0.5 MG TABLET|1000|EA|.0315|08/17/2016||Yes|No||08/17/2016||Yes|No|08/17/2016||Yes|No||||No|No|||Prescription required|No||090|Yes|.03794|03/29/2022|.03702|03/29/2022|.03727|03/29/2022|||ANXIOLYTICS|20991|||||No|No||LEADING PHARMA|No||||
lorazepam|No|No|No|No|90%|69315090501|LORAZEPAM 1 MG TABLET|100|EA|.03547|08/17/2016||Yes|No||08/17/2016||Yes|No|08/17/2016||Yes|No||||No|No|||Prescription required|No||090|Yes|.04593|03/29/2022|.04482|03/29/2022|.04512|03/29/2022|||ANXIOLYTICS|20992|||||No|No||LEADING PHARMA|No||||
lorazepam|No|No|No|No|90%|69315090505|LORAZEPAM 1 MG TABLET|500|EA|.03547|08/17/2016||Yes|No||08/17/2016||Yes|No|08/17/2016||Yes|No||||No|No|||Prescription required|No||090|Yes|.04593|03/29/2022|.04482|03/29/2022|.04512|03/29/2022|||ANXIOLYTICS|20993|||||No|No||LEADING PHARMA|No||||
lorazepam|No|No|No|No|90%|69315090510|LORAZEPAM 1 MG TABLET|1000|EA|.0346|08/17/2016||Yes|No||08/17/2016||Yes|No|08/17/2016||Yes|No||||No|No|||Prescription required|No||090|Yes|.04593|03/29/2022|.04482|03/29/2022|.04512|03/29/2022|||ANXIOLYTICS|20994|||||No|No||LEADING PHARMA|No||||
lorazepam|No|No|No|No|90%|69315090601|LORAZEPAM 2 MG TABLET|100|EA|.05052|08/17/2016||Yes|No||08/17/2016||Yes|No|08/17/2016||Yes|No||||No|No|||Prescription required|No||090|Yes|.06696|03/29/2022|.06535|03/29/2022|.06578|03/29/2022|||ANXIOLYTICS|20995|||||No|No||LEADING PHARMA|No||||
lorazepam|No|No|No|No|90%|69315090605|LORAZEPAM 2 MG TABLET|500|EA|.05052|08/17/2016||Yes|No||08/17/2016||Yes|No|08/17/2016||Yes|No||||No|No|||Prescription required|No||090|Yes|.06696|03/29/2022|.06535|03/29/2022|.06578|03/29/2022|||ANXIOLYTICS|20996|||||No|No||LEADING PHARMA|No||||
lorazepam|No|No|No|No|90%|69315090610|LORAZEPAM 2 MG TABLET|1000|EA|.04963|08/17/2016||Yes|No||08/17/2016||Yes|No|08/17/2016||Yes|No||||No|No|||Prescription required|No||090|Yes|.06696|03/29/2022|.06535|03/29/2022|.06578|03/29/2022|||ANXIOLYTICS|20997|||||No|No||LEADING PHARMA|No||||
diphenoxylate HCl/atropine|No|No|No|No|75%|69315091001|DIPHENOXYLATE-ATROP 2.5-0.025|100|EA|.19995|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||||No|No|||Prescription required|No|||No|.22711|03/29/2022|.22165|03/29/2022|.22313|03/29/2022||||20998|||||No|No||LEADING PHARMA|No||||
diphenoxylate HCl/atropine|No|No|No|No|75%|69315091010|DIPHENOXYLATE-ATROP 2.5-0.025|1000|EA|.18135|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||||No|No|||Prescription required|No|||No|.22711|03/29/2022|.22165|03/29/2022|.22313|03/29/2022||||20999|||||No|No||LEADING PHARMA|No||||
zileuton|No|No|No|No|75%|69339013012|ZILEUTON ER 600 MG TABLET|120|EA|5.375|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|042|Yes|12.25|02/15/2022|12.075|02/15/2022|11.5|02/15/2022|||LEUKOTRIENE MODIFIERS|21000|||||No|No||DASH PHARMACEUT|No||||
chlorhexidine gluconate|No|No|No|No|75%|69339013817|CHLORHEXIDINE 0.12% RINSE|15|ML|.05446|08/21/2018||Yes|No||08/21/2018||Yes|No|08/21/2018||Yes|No||||No|No|||Prescription required|No|||No|.12412|08/21/2018|.12235|08/21/2018|.11652|08/21/2018||||21001|||||No|No||DASH PHARMACEUT|No||||
chlorhexidine gluconate|No|No|No|No|75%|69339013819|CHLORHEXIDINE 0.12% RINSE|15|ML|.05102|08/21/2018||Yes|No||08/21/2018||Yes|No|08/21/2018||Yes|No||||No|No|||Prescription required|No|||No|.11628|08/21/2018|.11462|08/21/2018|.10916|08/21/2018||||21002|||||No|No||DASH PHARMACEUT|No||||
testosterone|No|No|No|No|90%|69339015810|TESTOSTERONE 30 MG/1.5 ML PUMP|90|ML|1.20624|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|084|No|.95473|03/29/2022|.93181|03/29/2022|.93802|03/29/2022|||ANDROGENIC AGENTS|21003|||||No|No||DASH PHARMACEUT|No||||
indomethacin|No|No|No|No|75%|69344010101|INDOCIN 25 MG/5 ML SUSPENSION|237|ML|3.90931|06/24/2020||Yes|No||06/24/2020||Yes|No|06/24/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|8.9096|02/08/2022|8.78232|02/08/2022|8.36411|02/08/2022|||NSAIDS|21004|||||No|No||EGALET/ZYLA LIF|No||||
gabapentin|No|No|No|No|75%|69367013104|GABAPENTIN 100 MG CAPSULE|100|EA|.0193|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|21005|||||No|No||WESTMINSTER PHA|No||||
gabapentin|No|No|No|No|75%|69367013106|GABAPENTIN 100 MG CAPSULE|500|EA|.0195|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|21006|||||No|No||WESTMINSTER PHA|No||||
gabapentin|No|No|No|No|75%|69367013204|GABAPENTIN 300 MG CAPSULE|100|EA|.0279|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|21007|||||No|No||WESTMINSTER PHA|No||||
gabapentin|No|No|No|No|75%|69367013206|GABAPENTIN 300 MG CAPSULE|500|EA|.03433|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|21008|||||No|No||WESTMINSTER PHA|No||||
gabapentin|No|No|No|No|75%|69367013304|GABAPENTIN 400 MG CAPSULE|100|EA|.0322|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|21009|||||No|No||WESTMINSTER PHA|No||||
gabapentin|No|No|No|No|75%|69367013306|GABAPENTIN 400 MG CAPSULE|500|EA|.04529|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|21010|||||No|No||WESTMINSTER PHA|No||||
gabapentin|No|No|No|No|75%|69367013404|GABAPENTIN 600 MG TABLET|100|EA|.058|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|21011|||||No|No||WESTMINSTER PHA|No||||
gabapentin|No|No|No|No|75%|69367013406|GABAPENTIN 600 MG TABLET|500|EA|.09025|09/27/2016||Yes|No||09/27/2016||Yes|No|09/27/2016||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|21012|||||No|No||WESTMINSTER PHA|No||||
gabapentin|No|No|No|No|75%|69367013504|GABAPENTIN 800 MG TABLET|100|EA|.0731|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|21013|||||No|No||WESTMINSTER PHA|No||||
gabapentin|No|No|No|No|75%|69367013506|GABAPENTIN 800 MG TABLET|500|EA|.10314|09/27/2016||Yes|No||09/27/2016||Yes|No|09/27/2016||Yes|No||||No|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|21014|||||No|No||WESTMINSTER PHA|No||||
phenobarbital|No|No|No|No|75%|69367017216|PHENOBARBITAL 20 MG/5 ML ELIX|473|ML|.06444|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|No||056|No|.09847|03/29/2022|.0961|03/29/2022|.09674|03/29/2022|||ANTICONVULSANTS|21015|||||No|No||WESTMINSTER PHA|No||||
metformin HCl|Yes|No|No|No|75%|69367018001|METFORMIN HCL 500 MG TABLET|100|EA|.02691|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|03/07/2018||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21016|||||No|No||WESTMINSTER PHA|No||||
metformin HCl|Yes|No|No|No|75%|69367018005|METFORMIN HCL 500 MG TABLET|500|EA|.0227|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|03/07/2018||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21017|||||No|No||WESTMINSTER PHA|No||||
metformin HCl|Yes|No|No|No|75%|69367018010|METFORMIN HCL 500 MG TABLET|1000|EA|.01714|06/18/2020||Yes|No||06/18/2020||Yes|No|06/18/2020||Yes|No||||No|No|06/18/2020||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21018|||||No|No||WESTMINSTER PHA|No||||
metformin HCl|No|No|No|No|75%|69367018101|METFORMIN HCL 850 MG TABLET|100|EA|.04196|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21019|||||No|No||WESTMINSTER PHA|No||||
metformin HCl|No|No|No|No|75%|69367018105|METFORMIN HCL 850 MG TABLET|500|EA|.03808|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21020|||||No|No||WESTMINSTER PHA|No||||
metformin HCl|No|No|No|No|75%|69367018201|METFORMIN HCL 1,000 MG TABLET|100|EA|.04751|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21021|||||No|No||WESTMINSTER PHA|No||||
metformin HCl|No|No|No|No|75%|69367018205|METFORMIN HCL 1,000 MG TABLET|500|EA|.04265|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21022|||||No|No||WESTMINSTER PHA|No||||
metformin HCl|Yes|No|No|No|75%|69367018210|METFORMIN HCL 1,000 MG TABLET|1000|EA|.0257|06/18/2020||Yes|No||06/18/2020||Yes|No|06/18/2020||Yes|No||||No|No|09/21/2020||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21023|||||No|No||WESTMINSTER PHA|No||||
dexchlorphenir/pse/chlophedian|No|No|No|No|75%|69367018316|CHLOPHEDIANOL-DEXCHLORP-PSE LQ|473|ML|.03774|10/28/2021||Yes|No||||No|No|10/28/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.08602|10/28/2021|.08479|10/28/2021|.08075|10/28/2021|||COUGH AND COLD: NON-NARCOTIC|21024|||||No|No||WESTMINSTER PHA|No||||
guaifen/dextromethorphan/PE|No|No|No|No|75%|69367018408|DM-GUAIF-PE 18-200-10 MG/15 ML|240|ML|.03581|05/21/2018||Yes|No||||No|No|05/21/2018||Yes|No||||No|No|||Over the counter|No||184|Yes|.08162|11/24/2020|.08045|11/24/2020|.07662|11/24/2020|||COUGH AND COLD: NON-NARCOTIC|21025|||||No|No||WESTMINSTER PHA|No||||
triprolidine HCl|No|No|No|No|75%|69367018530|TRIPROLIDINE 0.625 MG/ML DROP|30|ML|.54466|05/21/2018|10/15/2022|Yes|No||||No|No|05/21/2018|10/15/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|574|Yes|1.24132|06/25/2019|1.22359|06/25/2019|1.16532|06/25/2019|||ANTIHISTAMINES: FIRST GENERATION|21026|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||WESTMINSTER PHA|No||||
triprolidine HCl|No|No|No|No|75%|69367018650|TRIPROLIDINE 0.313 MG/ML DROP|50|ML|.60888|05/21/2018|10/15/2022|Yes|No||||No|No|05/21/2018|10/15/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|574|Yes|1.38768|02/26/2019|1.36785|02/26/2019|1.30272|02/26/2019|||ANTIHISTAMINES: FIRST GENERATION|21027|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||WESTMINSTER PHA|No||||
diphenhydramine HCl|No|No|No|No|75%|69367018730|DIPHENHYDRAMINE 6.25 MG/ML DRP|30|ML|.77299|05/21/2018||Yes|No||||No|No|05/21/2018||Yes|No||||No|No|||Over the counter|No||574|Yes|1.7617|05/21/2018|1.73653|05/21/2018|1.65384|05/21/2018|||ANTIHISTAMINES: FIRST GENERATION|21028|||||No|No||WESTMINSTER PHA|No||||
zinc oxide|No|No|No|No|75%|69367018804|ZINC OXIDE 22% CREAM|113|GM|.13158|02/02/2022||Yes|No||||No|No|02/02/2022||Yes|No||||No|No|||Over the counter|No|||No|.29988|02/02/2022|.2956|02/02/2022|.28152|02/02/2022||||21029|||||No|No||WESTMINSTER PHA|No||||
clopidogrel bisulfate|No|No|No|No|75%|69367019405|CLOPIDOGREL 300 MG TABLET|500|EA|3.18845|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|No||004|No|7.2667|12/10/2018|7.16289|12/10/2018|6.8218|12/10/2018|||PLATELET AGGREGATION INHIBITORS|21030|||||No|No||WESTMINSTER PHA|No||||
clopidogrel bisulfate|No|No|No|No|75%|69367019430|CLOPIDOGREL 300 MG TABLET|30|EA|5.7061|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|No||004|No|13.0046|12/10/2018|12.81882|12/18/2018|12.2084|12/10/2018|||PLATELET AGGREGATION INHIBITORS|21031|||||No|No||WESTMINSTER PHA|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|69367019530|OMEPRAZOLE-BICARB 20-1,100 CAP|30|EA|1.87766|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|1.11633|03/29/2022|1.08953|03/29/2022|1.09679|03/29/2022|||PROTON PUMP INHIBITORS|21032|||||No|No||WESTMINSTER PHA|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|69367019630|OMEPRAZOLE-BICARB 40-1,100 CAP|30|EA|1.87766|12/10/2018||Yes|No||12/10/2018||Yes|No|12/10/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|1.14084|03/29/2022|1.11345|03/29/2022|1.12087|03/29/2022|||PROTON PUMP INHIBITORS|21033|||||No|No||WESTMINSTER PHA|No||||
dexbrompheniramin/phenylephrin|No|No|No|No|75%|69367019760|DEXBROMPHENIR-PHENYLEPH 2-10MG|60|EA|.22753|05/15/2019||Yes|No||||No|No|05/15/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|.51857|03/01/2022|.51116|03/01/2022|.48682|03/01/2022|||COUGH AND COLD: COLD|21034|||||No|No||WESTMINSTER PHA|No||||
guaifen/dextromethorphan/PE|No|No|No|No|75%|69367019890|DM-GUAIF-PE 17.5-385-10 MG TAB|90|EA|.22756|05/15/2019||Yes|No||||No|No|05/15/2019||Yes|No||||No|No|||Over the counter|No||184|Yes|.51863|08/25/2020|.51122|08/25/2020|.48688|08/25/2020|||COUGH AND COLD: NON-NARCOTIC|21035|||||No|No||WESTMINSTER PHA|No||||
doxylamine/phenylephrine HCl|No|No|No|No|75%|69367019901|DOXYLAMINE-PHENYLEPH 7.5-10 MG|100|EA|.22501|05/15/2019||Yes|No||||No|No|05/15/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|.51283|05/25/2021|.5055|05/25/2021|.48143|05/25/2021|||COUGH AND COLD: COLD|21036|||||No|No||WESTMINSTER PHA|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|69367020301|BUTALB-ACETAMIN-CAFF 50-325-40|100|EA|.28702|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.18524|03/29/2022|.18079|03/29/2022|.18199|03/29/2022||||21037|||||No|No||WESTMINSTER PHA|No||||
butalb/acetaminophen/caffeine|No|No|No|No|75%|69367020305|BUTALB-ACETAMIN-CAFF 50-325-40|500|EA|.26879|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No|||No|.18524|03/29/2022|.18079|03/29/2022|.18199|03/29/2022||||21038|||||No|No||WESTMINSTER PHA|No||||
phenobarbital|No|No|No|No|75%|69367021101|PHENOBARBITAL 16.2 MG TABLET|100|EA|.1827|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|No||056|No|.22712|03/29/2022|.22166|03/29/2022|.22314|03/29/2022|||ANTICONVULSANTS|21039|||||No|No||WESTMINSTER PHA|No||||
phenobarbital|No|No|No|No|75%|69367021110|PHENOBARBITAL 16.2 MG TABLET|1000|EA|.17541|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|No||056|No|.22712|03/29/2022|.22166|03/29/2022|.22314|03/29/2022|||ANTICONVULSANTS|21040|||||No|No||WESTMINSTER PHA|No||||
phenobarbital|No|No|No|No|75%|69367021201|PHENOBARBITAL 32.4 MG TABLET|100|EA|.23211|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|No||056|No|.30495|03/29/2022|.29763|03/29/2022|.29961|03/29/2022|||ANTICONVULSANTS|21041|||||No|No||WESTMINSTER PHA|No||||
phenobarbital|No|No|No|No|75%|69367021210|PHENOBARBITAL 32.4 MG TABLET|1000|EA|.22058|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|No||056|No|.30495|03/29/2022|.29763|03/29/2022|.29961|03/29/2022|||ANTICONVULSANTS|21042|||||No|No||WESTMINSTER PHA|No||||
phenobarbital|No|No|No|No|75%|69367021301|PHENOBARBITAL 64.8 MG TABLET|100|EA|.29016|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|No||056|No|.38211|03/29/2022|.37293|03/29/2022|.37542|03/29/2022|||ANTICONVULSANTS|21043|||||No|No||WESTMINSTER PHA|No||||
phenobarbital|No|No|No|No|75%|69367021310|PHENOBARBITAL 64.8 MG TABLET|1000|EA|.27588|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|No||056|No|.38211|03/29/2022|.37293|03/29/2022|.37542|03/29/2022|||ANTICONVULSANTS|21044|||||No|No||WESTMINSTER PHA|No||||
phenobarbital|No|No|No|No|75%|69367021401|PHENOBARBITAL 97.2 MG TABLET|100|EA|.40931|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|No||056|No|.45635|03/29/2022|.44539|03/29/2022|.44836|03/29/2022|||ANTICONVULSANTS|21045|||||No|No||WESTMINSTER PHA|No||||
phenobarbital|No|No|No|No|75%|69367021410|PHENOBARBITAL 97.2 MG TABLET|1000|EA|.38876|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|No||056|No|.45635|03/29/2022|.44539|03/29/2022|.44836|03/29/2022|||ANTICONVULSANTS|21046|||||No|No||WESTMINSTER PHA|No||||
hydrochlorothiazide|Yes|No|No|No|75%|69367021901|HYDROCHLOROTHIAZIDE 12.5 MG CP|100|EA|.03431|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|01/16/2020||Prescription required|No|||Yes|.03333|03/29/2022|.03253|03/29/2022|.03274|03/29/2022||||21047|||||No|No||WESTMINSTER PHA|No||||
hydrochlorothiazide|Yes|No|No|No|75%|69367021905|HYDROCHLOROTHIAZIDE 12.5 MG CP|500|EA|.03439|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|01/16/2020||Prescription required|No|||Yes|.03333|03/29/2022|.03253|03/29/2022|.03274|03/29/2022||||21048|||||No|No||WESTMINSTER PHA|No||||
hydrochlorothiazide|Yes|No|No|No|75%|69367021910|HYDROCHLOROTHIAZIDE 12.5 MG CP|1000|EA|.03138|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|01/16/2020||Prescription required|No|||Yes|.03333|03/29/2022|.03253|03/29/2022|.03274|03/29/2022||||21049|||||No|No||WESTMINSTER PHA|No||||
olopatadine HCl|No|No|No|No|75%|69367023305|OLOPATADINE HCL 0.1% EYE DROPS|5|ML|3.40044|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|002|No|3.02733|03/29/2022|2.95467|03/29/2022|2.97435|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|21050|||||No|No||WESTMINSTER PHA|No||||
prenatal 93/iron/folate 9/dha|No|No|No|No|75%|69367023430|WESTGEL DHA SOFTGEL|30|EA|2.43509|04/01/2021||Yes|No||||No|No|04/01/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|5.54974|04/01/2021|5.47045|04/01/2021|5.20996|04/01/2021|||PRENATAL VITAMINS|21051|||||No|No||WESTMINSTER PHA|No||||
fluoxetine HCl|Yes|No|No|No|75%|69367023501|FLUOXETINE HCL 10 MG CAPSULE|100|EA|.02356|02/10/2020||Yes|No||02/10/2020||Yes|No|02/10/2020||Yes|No||||No|No|03/20/2020||Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|21052|||||No|No||WESTMINSTER PHA|No||||
fluoxetine HCl|Yes|No|No|No|75%|69367023510|FLUOXETINE HCL 10 MG CAPSULE|1000|EA|.02261|02/10/2020||Yes|No||02/10/2020||Yes|No|02/10/2020||Yes|No||||No|No|03/20/2020||Prescription required|No||008|No|.03365|03/29/2022|.03284|03/29/2022|.03306|03/29/2022|||ANTIDEPRESSANTS: SSRIs|21053|||||No|No||WESTMINSTER PHA|No||||
fluoxetine HCl|Yes|No|No|No|75%|69367023601|FLUOXETINE HCL 20 MG CAPSULE|100|EA|.02472|02/10/2020||Yes|No||02/10/2020||Yes|No|02/10/2020||Yes|No||||No|No|03/20/2020||Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|21054|||||No|No||WESTMINSTER PHA|No||||
fluoxetine HCl|Yes|No|No|No|75%|69367023610|FLUOXETINE HCL 20 MG CAPSULE|1000|EA|.02317|02/10/2020||Yes|No||02/10/2020||Yes|No|02/10/2020||Yes|No||||No|No|03/20/2020||Prescription required|No||008|No|.03177|03/29/2022|.031|03/29/2022|.03121|03/29/2022|||ANTIDEPRESSANTS: SSRIs|21055|||||No|No||WESTMINSTER PHA|No||||
fluoxetine HCl|Yes|No|No|No|75%|69367023701|FLUOXETINE HCL 40 MG CAPSULE|100|EA|.05018|02/10/2020||Yes|No||02/10/2020||Yes|No|02/10/2020||Yes|No||||No|No|03/20/2020||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|21056|||||No|No||WESTMINSTER PHA|No||||
fluoxetine HCl|Yes|No|No|No|75%|69367023705|FLUOXETINE HCL 40 MG CAPSULE|500|EA|.04766|02/10/2020||Yes|No||02/10/2020||Yes|No|02/10/2020||Yes|No||||No|No|03/20/2020||Prescription required|No||008|No|.08204|03/29/2022|.08007|03/29/2022|.0806|03/29/2022|||ANTIDEPRESSANTS: SSRIs|21057|||||No|No||WESTMINSTER PHA|No||||
levocetirizine dihydrochloride|No|No|No|No|75%|69367023809|LEVOCETIRIZINE 5 MG TABLET|90|EA|.08547|01/02/2020||Yes|No||01/02/2020||Yes|No|01/02/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|030|Yes|.08234|03/29/2022|.08036|03/29/2022|.08089|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21058|||||No|No||WESTMINSTER PHA|No||||
solifenacin succinate|No|No|No|No|75%|69367023903|SOLIFENACIN 5 MG TABLET|30|EA|.15465|01/02/2020||Yes|No||01/02/2020||Yes|No|01/02/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|Yes|.23024|03/29/2022|.22471|03/29/2022|.22621|03/29/2022|||BLADDER RELAXANT PREPARATIONS|21059|||||No|No||WESTMINSTER PHA|No||||
solifenacin succinate|No|No|No|No|75%|69367023909|SOLIFENACIN 5 MG TABLET|90|EA|.15642|01/02/2020||Yes|No||01/02/2020||Yes|No|01/02/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|Yes|.23024|03/29/2022|.22471|03/29/2022|.22621|03/29/2022|||BLADDER RELAXANT PREPARATIONS|21060|||||No|No||WESTMINSTER PHA|No||||
solifenacin succinate|No|No|No|No|75%|69367024003|SOLIFENACIN 10 MG TABLET|30|EA|.16755|01/02/2020||Yes|No||01/02/2020||Yes|No|01/02/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|No|.26101|03/29/2022|.25474|03/29/2022|.25644|03/29/2022|||BLADDER RELAXANT PREPARATIONS|21061|||||No|No||WESTMINSTER PHA|No||||
solifenacin succinate|No|No|No|No|75%|69367024009|SOLIFENACIN 10 MG TABLET|90|EA|.16616|01/02/2020||Yes|No||01/02/2020||Yes|No|01/02/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|No|.26101|03/29/2022|.25474|03/29/2022|.25644|03/29/2022|||BLADDER RELAXANT PREPARATIONS|21062|||||No|No||WESTMINSTER PHA|No||||
nabumetone|No|No|No|No|75%|69367024101|NABUMETONE 500 MG TABLET|100|EA|.10874|02/10/2020||Yes|No||02/10/2020||Yes|No|02/10/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|.17691|03/29/2022|.17266|03/29/2022|.17381|03/29/2022|||NSAIDS|21063|||||No|No||WESTMINSTER PHA|No||||
nabumetone|No|No|No|No|75%|69367024105|NABUMETONE 500 MG TABLET|500|EA|.10381|02/10/2020||Yes|No||02/10/2020||Yes|No|02/10/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|.17691|03/29/2022|.17266|03/29/2022|.17381|03/29/2022|||NSAIDS|21064|||||No|No||WESTMINSTER PHA|No||||
nabumetone|No|No|No|No|75%|69367024201|NABUMETONE 750 MG TABLET|100|EA|.11373|02/10/2020||Yes|No||02/10/2020||Yes|No|02/10/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|.2074|03/29/2022|.20242|03/29/2022|.20377|03/29/2022|||NSAIDS|21065|||||No|No||WESTMINSTER PHA|No||||
nabumetone|No|No|No|No|75%|69367024205|NABUMETONE 750 MG TABLET|500|EA|.10879|02/10/2020||Yes|No||02/10/2020||Yes|No|02/10/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|.2074|03/29/2022|.20242|03/29/2022|.20377|03/29/2022|||NSAIDS|21066|||||No|No||WESTMINSTER PHA|No||||
cyproheptadine HCl|No|No|No|No|75%|69367024601|CYPROHEPTADINE 4 MG TABLET|100|EA|.11175|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|||Prescription required|No||574|Yes|.09783|03/29/2022|.09548|03/29/2022|.09611|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|21067|||||No|No||WESTMINSTER PHA|No||||
cyproheptadine HCl|No|No|No|No|75%|69367024610|CYPROHEPTADINE 4 MG TABLET|1000|EA|.13974|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|||Prescription required|No||574|Yes|.09783|03/29/2022|.09548|03/29/2022|.09611|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|21068|||||No|No||WESTMINSTER PHA|No||||
triprolidine HCl|No|No|No|No|75%|69367025330|TRIPROLIDINE 0.938 MG/ML DROPS|30|ML|.17916|05/26/2020||Yes|No||||No|No|05/26/2020||Yes|No||||No|No|||Over the counter|Yes|01/30/2020|574|Yes|.49773|03/29/2022|.48578|03/29/2022|.48901|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|21069|||||No|No||WESTMINSTER PHA|No||||
fenofibrate|No|No|No|No|75%|69367025405|FENOFIBRATE 160 MG TABLET|500|EA|.2167|06/18/2020||Yes|No||06/18/2020||Yes|No|06/18/2020||Yes|No||||No|No|||Prescription required|No||055|No|.1612|03/29/2022|.15733|03/29/2022|.15837|03/29/2022|||LIPOTROPICS: OTHER|21070|||||No|No||WESTMINSTER PHA|No||||
fenofibrate|No|No|No|No|75%|69367025409|FENOFIBRATE 160 MG TABLET|90|EA|.17051|06/18/2020||Yes|No||06/18/2020||Yes|No|06/18/2020||Yes|No||||No|No|||Prescription required|No||055|No|.1612|03/29/2022|.15733|03/29/2022|.15837|03/29/2022|||LIPOTROPICS: OTHER|21071|||||No|No||WESTMINSTER PHA|No||||
methocarbamol|No|No|No|No|75%|69367025501|METHOCARBAMOL 500 MG TABLET|100|EA|.03263|04/01/2021||Yes|No||04/01/2021||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||116|Yes|.07091|03/29/2022|.0692|03/29/2022|.06966|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21072|||||No|No||WESTMINSTER PHA|No||||
methocarbamol|No|No|No|No|75%|69367025505|METHOCARBAMOL 500 MG TABLET|500|EA|.03113|04/01/2021||Yes|No||04/01/2021||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||116|Yes|.07091|03/29/2022|.0692|03/29/2022|.06966|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21073|||||No|No||WESTMINSTER PHA|No||||
methocarbamol|No|No|No|No|75%|69367025601|METHOCARBAMOL 750 MG TABLET|100|EA|.04424|04/01/2021||Yes|No||04/01/2021||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||116|Yes|.09307|03/29/2022|.09083|03/29/2022|.09144|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21074|||||No|No||WESTMINSTER PHA|No||||
methocarbamol|No|No|No|No|75%|69367025605|METHOCARBAMOL 750 MG TABLET|500|EA|.04209|04/01/2021||Yes|No||04/01/2021||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||116|Yes|.09307|03/29/2022|.09083|03/29/2022|.09144|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21075|||||No|No||WESTMINSTER PHA|No||||
fenofibrate|No|No|No|No|75%|69367025709|FENOFIBRATE 54 MG TABLET|90|EA|.09149|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|No||055|No|.1459|03/29/2022|.14239|03/29/2022|.14334|03/29/2022|||LIPOTROPICS: OTHER|21076|||||No|No||WESTMINSTER PHA|No||||
PNV,calcium 72/iron/folic acid|No|No|No|No|75%|69367026701|WESTAB PLUS TABLET|100|EA|.03225|04/01/2021||Yes|No||||No|No|04/01/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|.11811|03/29/2022|.11527|03/29/2022|.11604|03/29/2022|||PRENATAL VITAMINS|21077|||||No|No||WESTMINSTER PHA|No||||
fenofibrate,micronized|No|No|No|No|75%|69367026801|FENOFIBRATE 134 MG CAPSULE|100|EA|.16013|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|No||055|No|.17604|03/29/2022|.17181|03/29/2022|.17295|03/29/2022|||LIPOTROPICS: OTHER|21078|||||No|No||WESTMINSTER PHA|No||||
fenofibrate,micronized|No|No|No|No|75%|69367026901|FENOFIBRATE 200 MG CAPSULE|100|EA|.28453|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|No||055|No|.22993|03/29/2022|.22441|03/29/2022|.2259|03/29/2022|||LIPOTROPICS: OTHER|21079|||||No|No||WESTMINSTER PHA|No||||
fenofibrate,micronized|No|No|No|No|75%|69367027001|FENOFIBRATE 67 MG CAPSULE|100|EA|.09567|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|No||055|No|.15038|03/29/2022|.14677|03/29/2022|.14774|03/29/2022|||LIPOTROPICS: OTHER|21080|||||No|No||WESTMINSTER PHA|No||||
codeine phosphate/guaifenesin|No|No|No|No|90%|69367027204|CODEINE-GUAIFEN 10-100 MG/5 ML|118|ML|.03898|04/01/2021||Yes|No||||No|No|04/01/2021||Yes|No||||No|No|||Over the counter|No||183|Yes|.05917|03/29/2022|.05774|03/29/2022|.05813|03/29/2022|||COUGH AND COLD: NARCOTIC|21081|||||No|No||WESTMINSTER PHA|No||||
codeine phosphate/guaifenesin|No|No|No|No|90%|69367027216|CODEINE-GUAIFEN 10-100 MG/5 ML|473|ML|.02179|04/01/2021||Yes|No||||No|No|04/01/2021||Yes|No||||No|No|||Over the counter|No||183|Yes|.02734|03/29/2022|.02668|03/29/2022|.02686|03/29/2022|||COUGH AND COLD: NARCOTIC|21082|||||No|No||WESTMINSTER PHA|No||||
montelukast sodium|No|No|No|No|75%|69367028705|MONTELUKAST SOD 10 MG TABLET|500|EA|.0546|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|21083|||||No|No||WESTMINSTER PHA|No||||
montelukast sodium|No|No|No|No|75%|69367028709|MONTELUKAST SOD 10 MG TABLET|90|EA|.06683|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|21084|||||No|No||WESTMINSTER PHA|No||||
bupropion HCl|No|No|No|No|75%|69367028805|BUPROPION HCL XL 150 MG TABLET|500|EA|.08512|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|21085|||||No|No||WESTMINSTER PHA|No||||
bupropion HCl|No|No|No|No|75%|69367028809|BUPROPION HCL XL 150 MG TABLET|90|EA|.14333|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|21086|||||No|No||WESTMINSTER PHA|No||||
bupropion HCl|No|No|No|No|75%|69367028905|BUPROPION HCL XL 300 MG TABLET|500|EA|.09818|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|21087|||||No|No||WESTMINSTER PHA|No||||
bupropion HCl|No|No|No|No|75%|69367028909|BUPROPION HCL XL 300 MG TABLET|90|EA|.17486|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|21088|||||No|No||WESTMINSTER PHA|No||||
ranolazine|No|No|No|No|75%|69367029360|RANOLAZINE ER 500 MG TABLET|60|EA|.61131|02/08/2022||Yes|No||02/08/2022||Yes|No|02/08/2022||Yes|No||||No|No|||Prescription required|No|||Yes|.28604|03/29/2022|.27917|03/29/2022|.28103|03/29/2022||||21089|||||No|No||WESTMINSTER PHA|No||||
ranolazine|No|No|No|No|75%|69367029460|RANOLAZINE ER 1,000 MG TABLET|60|EA|1.00426|02/08/2022||Yes|No||02/08/2022||Yes|No|02/08/2022||Yes|No||||No|No|||Prescription required|No|||Yes|.43283|03/29/2022|.42244|03/29/2022|.42525|03/29/2022||||21090|||||No|No||WESTMINSTER PHA|No||||
solifenacin succinate|No|No|No|No|75%|69367029509|SOLIFENACIN 5 MG TABLET|90|EA|.15642|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|Yes|.23024|03/29/2022|.22471|03/29/2022|.22621|03/29/2022|||BLADDER RELAXANT PREPARATIONS|21091|||||No|No||WESTMINSTER PHA|No||||
solifenacin succinate|No|No|No|No|75%|69367029530|SOLIFENACIN 5 MG TABLET|30|EA|.15465|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|Yes|.23024|03/29/2022|.22471|03/29/2022|.22621|03/29/2022|||BLADDER RELAXANT PREPARATIONS|21092|||||No|No||WESTMINSTER PHA|No||||
solifenacin succinate|No|No|No|No|75%|69367029609|SOLIFENACIN 10 MG TABLET|90|EA|.16616|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|No|.26101|03/29/2022|.25474|03/29/2022|.25644|03/29/2022|||BLADDER RELAXANT PREPARATIONS|21093|||||No|No||WESTMINSTER PHA|No||||
solifenacin succinate|No|No|No|No|75%|69367029630|SOLIFENACIN 10 MG TABLET|30|EA|.16755|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|No|.26101|03/29/2022|.25474|03/29/2022|.25644|03/29/2022|||BLADDER RELAXANT PREPARATIONS|21094|||||No|No||WESTMINSTER PHA|No||||
magnesium oxide|No|No|No|No|75%|69367029820|MAGNESIUM OXIDE 400 MG TABLET|120|EA|.01752|04/01/2021||Yes|No||||No|No|04/01/2021||Yes|No||||No|No|||Over the counter|No|||No|.03856|03/29/2022|.03763|03/29/2022|.03788|03/29/2022||||21095|||||No|No||WESTMINSTER PHA|No||||
celecoxib|No|No|No|No|75%|69367030101|CELECOXIB 100 MG CAPSULE|100|EA|.06445|06/24/2021||Yes|No||06/24/2021||Yes|No|06/24/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|21096|||||No|No||WESTMINSTER PHA|No||||
celecoxib|No|No|No|No|75%|69367030105|CELECOXIB 100 MG CAPSULE|500|EA|.05158|06/24/2021||Yes|No||06/24/2021||Yes|No|06/24/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|21097|||||No|No||WESTMINSTER PHA|No||||
celecoxib|No|No|No|No|75%|69367030201|CELECOXIB 200 MG CAPSULE|100|EA|.12891|06/24/2021||Yes|No||06/24/2021||Yes|No|06/24/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|21098|||||No|No||WESTMINSTER PHA|No||||
celecoxib|No|No|No|No|75%|69367030205|CELECOXIB 200 MG CAPSULE|500|EA|.10319|06/24/2021||Yes|No||06/24/2021||Yes|No|06/24/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|21099|||||No|No||WESTMINSTER PHA|No||||
miglitol|No|No|No|No|75%|69367030301|MIGLITOL 25 MG TABLET|100|EA|1.02026|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|No|||No|2.32524|04/20/2021|2.29202|04/20/2021|2.18288|04/20/2021||||21100|||||No|No||WESTMINSTER PHA|No||||
miglitol|No|No|No|No|75%|69367030401|MIGLITOL 50 MG TABLET|100|EA|1.12182|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|No|||No|2.55672|04/20/2021|2.52019|04/20/2021|2.40018|04/20/2021||||21101|||||No|No||WESTMINSTER PHA|No||||
miglitol|No|No|No|No|75%|69367030501|MIGLITOL 100 MG TABLET|100|EA|1.32354|04/20/2021||Yes|No||04/20/2021||Yes|No|04/20/2021||Yes|No||||No|No|||Prescription required|No|||No|3.01644|04/20/2021|2.97334|04/20/2021|2.83176|04/20/2021||||21102|||||No|No||WESTMINSTER PHA|No||||
fluoride (sodium)|No|No|No|No|75%|69367030951|SODIUM FLUORIDE 5000 PLUS CRM|51|GM|.03954|06/24/2021||Yes|No||06/24/2021||Yes|No|06/24/2021||Yes|No||||No|No|||Prescription required|No|||No|.09748|03/29/2022|.09514|03/29/2022|.09577|03/29/2022||||21103|||||No|No||WESTMINSTER PHA|No||||
fluoride (sodium)|No|No|No|No|75%|69367031056|SODIUM FLUORIDE 1.1% GEL|56|GM|.04215|06/24/2021||Yes|No||06/24/2021||Yes|No|06/24/2021||Yes|No||||No|No|||Prescription required|No|||No|.13387|03/29/2022|.13065|03/29/2022|.13152|03/29/2022||||21104|||||No|No||WESTMINSTER PHA|No||||
fluoride (sodium)|No|No|No|No|75%|69367031101|SODIUM FLUORIDE 5000 PPM PASTE|100|ML|.05581|09/20/2021||Yes|No||09/20/2021||Yes|No|09/20/2021||Yes|No||||No|No|||Prescription required|No|||No|.12026|03/29/2022|.11737|03/29/2022|.11815|03/29/2022||||21105|||||No|No||WESTMINSTER PHA|No||||
fluoride (sodium)|No|No|No|No|75%|69367031201|SODIUM FLUORIDE 5000 PPM PASTE|100|ML|.05581|09/14/2021||Yes|No||09/14/2021||Yes|No|09/14/2021||Yes|No||||No|No|||Prescription required|No|||No|.12026|03/29/2022|.11737|03/29/2022|.11815|03/29/2022||||21106|||||No|No||WESTMINSTER PHA|No||||
pregabalin|No|No|No|No|90%|69367032409|PREGABALIN 25 MG CAPSULE|90|EA|.0525|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|No||232|No|.0795|03/29/2022|.07759|03/29/2022|.0781|03/29/2022|||NEUROPATHIC PAIN|21107|||||No|No||WESTMINSTER PHA|No||||
pregabalin|No|No|No|No|90%|69367032509|PREGABALIN 50 MG CAPSULE|90|EA|.05489|02/08/2022||Yes|No||02/08/2022||Yes|No|02/08/2022||Yes|No||||No|No|||Prescription required|No||232|No|.09128|03/29/2022|.08908|03/29/2022|.08968|03/29/2022|||NEUROPATHIC PAIN|21108|||||No|No||WESTMINSTER PHA|No||||
pregabalin|No|No|No|No|90%|69367032609|PREGABALIN 75 MG CAPSULE|90|EA|.05728|02/08/2022||Yes|No||02/08/2022||Yes|No|02/08/2022||Yes|No||||No|No|||Prescription required|No||232|No|.08098|03/29/2022|.07903|03/29/2022|.07956|03/29/2022|||NEUROPATHIC PAIN|21109|||||No|No||WESTMINSTER PHA|No||||
pregabalin|No|No|No|No|90%|69367032709|PREGABALIN 100 MG CAPSULE|90|EA|.05967|02/08/2022||Yes|No||02/08/2022||Yes|No|02/08/2022||Yes|No||||No|No|||Prescription required|No||232|No|.08763|03/29/2022|.08552|03/29/2022|.08609|03/29/2022|||NEUROPATHIC PAIN|21110|||||No|No||WESTMINSTER PHA|No||||
pregabalin|No|No|No|No|90%|69367032809|PREGABALIN 150 MG CAPSULE|90|EA|.06444|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|No||232|No|.10646|03/29/2022|.1039|03/29/2022|.10459|03/29/2022|||NEUROPATHIC PAIN|21111|||||No|No||WESTMINSTER PHA|No||||
pregabalin|No|No|No|No|90%|69367032909|PREGABALIN 200 MG CAPSULE|90|EA|.07161|02/08/2022||Yes|No||02/08/2022||Yes|No|02/08/2022||Yes|No||||No|No|||Prescription required|No||232|No|.11395|03/29/2022|.11121|03/29/2022|.11195|03/29/2022|||NEUROPATHIC PAIN|21112|||||No|No||WESTMINSTER PHA|No||||
pregabalin|No|No|No|No|90%|69367033009|PREGABALIN 225 MG CAPSULE|90|EA|.07161|02/08/2022||Yes|No||02/08/2022||Yes|No|02/08/2022||Yes|No||||No|No|||Prescription required|No||232|No|.12393|03/29/2022|.12095|03/29/2022|.12176|03/29/2022|||NEUROPATHIC PAIN|21113|||||No|No||WESTMINSTER PHA|No||||
pregabalin|No|No|No|No|90%|69367033109|PREGABALIN 300 MG CAPSULE|90|EA|.07878|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|No||232|No|.12181|03/29/2022|.11888|03/29/2022|.11967|03/29/2022|||NEUROPATHIC PAIN|21114|||||No|No||WESTMINSTER PHA|No||||
levetiracetam|No|No|No|No|75%|69367033260|LEVETIRACETAM ER 500 MG TABLET|60|EA|.17909|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No||056|No|.22713|03/29/2022|.22167|03/29/2022|.22315|03/29/2022|||ANTICONVULSANTS|21115|||||No|No||WESTMINSTER PHA|No||||
levetiracetam|No|No|No|No|75%|69367033360|LEVETIRACETAM ER 750 MG TABLET|60|EA|.25075|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No||056|No|.36799|03/29/2022|.35915|03/29/2022|.36155|03/29/2022|||ANTICONVULSANTS|21116|||||No|No||WESTMINSTER PHA|No||||
dexchlorphen/phenylephrine/DM|No|No|No|No|75%|69367033416|WESTUSSIN DM 1-5-10 MG/5ML SYR|480|ML|.01789|12/20/2021||Yes|No||||No|No|12/20/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|No|.04893|03/29/2022|.04775|03/29/2022|.04807|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21117|||||No|No||WESTMINSTER PHA|No||||
paroxetine HCl|No|No|No|No|75%|69367033530|PAROXETINE ER 12.5 MG TABLET|30|EA|.47959|01/28/2022||Yes|No||01/28/2022||Yes|No|01/28/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|008|Yes|.80099|03/29/2022|.78176|03/29/2022|.78697|03/29/2022|||ANTIDEPRESSANTS: SSRIs|21118|||||No|No||WESTMINSTER PHA|No||||
paroxetine HCl|No|No|No|No|75%|69367033630|PAROXETINE ER 25 MG TABLET|30|EA|.50095|01/28/2022||Yes|No||01/28/2022||Yes|No|01/28/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|008|No|1.16217|03/29/2022|1.13427|03/29/2022|1.14183|03/29/2022|||ANTIDEPRESSANTS: SSRIs|21119|||||No|No||WESTMINSTER PHA|No||||
paroxetine HCl|No|No|No|No|75%|69367033730|PAROXETINE ER 37.5 MG TABLET|30|EA|.51542|01/28/2022||Yes|No||01/28/2022||Yes|No|01/28/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|008|No|1.12249|03/29/2022|1.09555|03/29/2022|1.10284|03/29/2022|||ANTIDEPRESSANTS: SSRIs|21120|||||No|No||WESTMINSTER PHA|No||||
carbidopa/levodopa|No|No|No|No|75%|69367033801|CARBIDOPA-LEVODOPA 10-100 TAB|100|EA|.03822|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No||015|No|.14195|03/29/2022|.13854|03/29/2022|.13946|03/29/2022|||ANTIPARKINSON'S AGENTS|21121|||||No|No||WESTMINSTER PHA|No||||
carbidopa/levodopa|No|No|No|No|75%|69367033805|CARBIDOPA-LEVODOPA 10-100 TAB|500|EA|.03747|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No||015|No|.14195|03/29/2022|.13854|03/29/2022|.13946|03/29/2022|||ANTIPARKINSON'S AGENTS|21122|||||No|No||WESTMINSTER PHA|No||||
carbidopa/levodopa|No|No|No|No|75%|69367033901|CARBIDOPA-LEVODOPA 25-100 TAB|100|EA|.04338|02/08/2022||Yes|No||02/08/2022||Yes|No|02/08/2022||Yes|No||||No|No|||Prescription required|No||015|No|.11418|03/29/2022|.11143|03/29/2022|.11218|03/29/2022|||ANTIPARKINSON'S AGENTS|21123|||||No|No||WESTMINSTER PHA|No||||
carbidopa/levodopa|No|No|No|No|75%|69367033905|CARBIDOPA-LEVODOPA 25-100 TAB|500|EA|.04255|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No||015|No|.11418|03/29/2022|.11143|03/29/2022|.11218|03/29/2022|||ANTIPARKINSON'S AGENTS|21124|||||No|No||WESTMINSTER PHA|No||||
carbidopa/levodopa|No|No|No|No|75%|69367033910|CARBIDOPA-LEVODOPA 25-100 TAB|1000|EA|.04255|02/08/2022||Yes|No||02/08/2022||Yes|No|02/08/2022||Yes|No||||No|No|||Prescription required|No||015|No|.11418|03/29/2022|.11143|03/29/2022|.11218|03/29/2022|||ANTIPARKINSON'S AGENTS|21125|||||No|No||WESTMINSTER PHA|No||||
carbidopa/levodopa|No|No|No|No|75%|69367034001|CARBIDOPA-LEVODOPA 25-250 TAB|100|EA|.05013|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No||015|No|.1493|03/29/2022|.14571|03/29/2022|.14668|03/29/2022|||ANTIPARKINSON'S AGENTS|21126|||||No|No||WESTMINSTER PHA|No||||
carbidopa/levodopa|No|No|No|No|75%|69367034005|CARBIDOPA-LEVODOPA 25-250 TAB|500|EA|.04763|02/03/2022||Yes|No||02/03/2022||Yes|No|02/03/2022||Yes|No||||No|No|||Prescription required|No||015|No|.1493|03/29/2022|.14571|03/29/2022|.14668|03/29/2022|||ANTIPARKINSON'S AGENTS|21127|||||No|No||WESTMINSTER PHA|No||||
monomethyl fumarate|No|No|No|No|75%|69387000101|BAFIERTAM DR 95 MG CAPSULE|120|EA|21.57883|05/24/2021||Yes|No||05/24/2021||Yes|No|05/24/2021||Yes|No||||No|No|||Prescription required|No||043|No|49.17966|01/04/2022|48.47709|01/04/2022|46.16866|01/04/2022|||MULTIPLE SCLEROSIS AGENTS|21128|||||No|No||BANNER LIFE SCI|No||||
pyrimethamine|No|No|No|No|75%|69413033010|DARAPRIM 25 MG TABLET|100|EA|322.5|11/10/2016||Yes|No||11/10/2016||Yes|No|11/10/2016||Yes|No||||No|No|||Prescription required|No|||No|735|11/10/2016|724.5|11/10/2016|690|11/10/2016||||21129|||||No|No||VYERA PHARMACEU|No||||
pyrimethamine|No|No|No|No|75%|69413033030|DARAPRIM 25 MG TABLET|30|EA|322.5|05/03/2016||Yes|No||05/03/2016||Yes|No|05/03/2016||Yes|No||||No|No|||Prescription required|No|||No|735|06/01/2016|724.5|06/01/2016|690|06/01/2016||||21130|||||No|No||VYERA PHARMACEU|No||||
montelukast sodium|No|No|No|No|75%|69452010513|MONTELUKAST SOD 10 MG TABLET|30|EA|.07166|06/24/2016||Yes|No||06/24/2016||Yes|No|06/24/2016||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|21131|||||No|No||BIONPHARMA INC.|Yes|09/01/2020|||
montelukast sodium|No|No|No|No|75%|69452010519|MONTELUKAST SOD 10 MG TABLET|90|EA|.04777|06/24/2016||Yes|No||06/24/2016||Yes|No|06/24/2016||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|21132|||||No|No||BIONPHARMA INC.|Yes|09/01/2020|||
montelukast sodium|No|No|No|No|75%|69452010532|MONTELUKAST SOD 10 MG TABLET|1000|EA|.0344|06/24/2016||Yes|No||06/24/2016||Yes|No|06/24/2016||Yes|No||||No|No|||Prescription required|No||042|Yes|.06589|03/29/2022|.0643|03/29/2022|.06473|03/29/2022|||LEUKOTRIENE MODIFIERS|21133|||||No|No||BIONPHARMA INC.|Yes|09/01/2020|||
montelukast sodium|No|No|No|No|75%|69452010613|MONTELUKAST SOD 4 MG TAB CHEW|30|EA|.09073|06/24/2016||Yes|No||06/24/2016||Yes|No|06/24/2016||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|21134|||||No|No||BIONPHARMA INC.|No||||
montelukast sodium|No|No|No|No|75%|69452010619|MONTELUKAST SOD 4 MG TAB CHEW|90|EA|.08647|06/24/2016||Yes|No||06/24/2016||Yes|No|06/24/2016||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|21135|||||No|No||BIONPHARMA INC.|No||||
montelukast sodium|No|No|No|No|75%|69452010713|MONTELUKAST SOD 5 MG TAB CHEW|30|EA|.09073|06/24/2016||Yes|No||06/24/2016||Yes|No|06/24/2016||Yes|No||||No|No|||Prescription required|No||042|Yes|.08451|03/29/2022|.08248|03/29/2022|.08303|03/29/2022|||LEUKOTRIENE MODIFIERS|21136|||||No|No||BIONPHARMA INC.|No||||
montelukast sodium|No|No|No|No|75%|69452010719|MONTELUKAST SOD 5 MG TAB CHEW|90|EA|.08647|06/24/2016||Yes|No||06/24/2016||Yes|No|06/24/2016||Yes|No||||No|No|||Prescription required|No||042|Yes|.08451|03/29/2022|.08248|03/29/2022|.08303|03/29/2022|||LEUKOTRIENE MODIFIERS|21137|||||No|No||BIONPHARMA INC.|No||||
clobazam|No|No|No|No|90%|69452011420|CLOBAZAM 10 MG TABLET|100|EA|.3225|01/03/2019||Yes|No||01/03/2019||Yes|No|01/03/2019||Yes|No||||No|No|||Prescription required|No||056|No|.37729|03/29/2022|.36823|03/29/2022|.37068|03/29/2022|||ANTICONVULSANTS|21138|||||No|No||BIONPHARMA INC.|No||||
clobazam|No|No|No|No|90%|69452011520|CLOBAZAM 20 MG TABLET|100|EA|.7095|01/03/2019||Yes|No||01/03/2019||Yes|No|01/03/2019||Yes|No||||No|No|||Prescription required|No||056|No|.71967|03/29/2022|.70239|03/29/2022|.70707|03/29/2022|||ANTICONVULSANTS|21139|||||No|No||BIONPHARMA INC.|No||||
clobazam|No|No|No|No|90%|69452011645|CLOBAZAM 2.5 MG/ML SUSPENSION|120|ML|.48375|01/03/2019||Yes|No||01/03/2019||Yes|No|01/03/2019||Yes|No||||No|No|||Prescription required|No||056|No|.50176|03/29/2022|.48971|03/29/2022|.49297|03/29/2022|||ANTICONVULSANTS|21140|||||No|No||BIONPHARMA INC.|No||||
oxybutynin chloride|No|No|No|No|75%|69452011920|OXYBUTYNIN CL ER 5 MG TABLET|100|EA|.172|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|No||006|Yes|.15279|03/29/2022|.14912|03/29/2022|.15011|03/29/2022|||BLADDER RELAXANT PREPARATIONS|21141|||||No|No||BIONPHARMA INC.|No||||
oxybutynin chloride|No|No|No|No|75%|69452012020|OXYBUTYNIN CL ER 10 MG TABLET|100|EA|.172|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|No||006|No|.15833|03/29/2022|.15453|03/29/2022|.15555|03/29/2022|||BLADDER RELAXANT PREPARATIONS|21142|||||No|No||BIONPHARMA INC.|No||||
oxybutynin chloride|No|No|No|No|75%|69452012120|OXYBUTYNIN CL ER 15 MG TABLET|100|EA|.172|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|No||006|No|.19948|03/29/2022|.19469|03/29/2022|.19598|03/29/2022|||BLADDER RELAXANT PREPARATIONS|21143|||||No|No||BIONPHARMA INC.|No||||
glimepiride|No|No|No|No|75%|69452012820|GLIMEPIRIDE 1 MG TABLET|100|EA|.03852|06/22/2016||Yes|No||06/22/2016||Yes|No|06/22/2016||Yes|No||||No|No|||Prescription required|No|||No|.03361|03/29/2022|.0328|03/29/2022|.03302|03/29/2022||||21144|||||No|No||BIONPHARMA INC.|No||||
glimepiride|No|No|No|No|75%|69452012830|GLIMEPIRIDE 1 MG TABLET|500|EA|.0373|06/22/2016||Yes|No||06/22/2016||Yes|No|06/22/2016||Yes|No||||No|No|||Prescription required|No|||No|.03361|03/29/2022|.0328|03/29/2022|.03302|03/29/2022||||21145|||||No|No||BIONPHARMA INC.|No||||
glimepiride|No|No|No|No|75%|69452012920|GLIMEPIRIDE 2 MG TABLET|100|EA|.0623|06/23/2016||Yes|No||06/23/2016||Yes|No|06/23/2016||Yes|No||||No|No|||Prescription required|No|||No|.03979|03/29/2022|.03883|03/29/2022|.03909|03/29/2022||||21146|||||No|No||BIONPHARMA INC.|No||||
glimepiride|No|No|No|No|75%|69452012930|GLIMEPIRIDE 2 MG TABLET|500|EA|.06037|06/23/2016||Yes|No||06/23/2016||Yes|No|06/23/2016||Yes|No||||No|No|||Prescription required|No|||No|.03979|03/29/2022|.03883|03/29/2022|.03909|03/29/2022||||21147|||||No|No||BIONPHARMA INC.|No||||
glimepiride|No|No|No|No|75%|69452013020|GLIMEPIRIDE 4 MG TABLET|100|EA|.11764|06/23/2016||Yes|No||06/23/2016||Yes|No|06/23/2016||Yes|No||||No|No|||Prescription required|No|||No|.04419|03/29/2022|.04312|03/29/2022|.04341|03/29/2022||||21148|||||No|No||BIONPHARMA INC.|No||||
glimepiride|No|No|No|No|75%|69452013030|GLIMEPIRIDE 4 MG TABLET|500|EA|.11393|06/23/2016||Yes|No||06/23/2016||Yes|No|06/23/2016||Yes|No||||No|No|||Prescription required|No|||No|.04419|03/29/2022|.04312|03/29/2022|.04341|03/29/2022||||21149|||||No|No||BIONPHARMA INC.|No||||
dofetilide|No|No|No|No|75%|69452013117|DOFETILIDE 125 MCG CAPSULE|60|EA|.688|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||||No|No|||Prescription required|No|||No|1.27252|03/29/2022|1.24197|03/29/2022|1.25025|03/29/2022||||21150|||||No|No||BIONPHARMA INC.|No||||
dofetilide|No|No|No|No|75%|69452013217|DOFETILIDE 250 MCG CAPSULE|60|EA|.688|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||||No|No|||Prescription required|No|||No|.89477|03/29/2022|.87329|03/29/2022|.87911|03/29/2022||||21151|||||No|No||BIONPHARMA INC.|No||||
dofetilide|No|No|No|No|75%|69452013317|DOFETILIDE 500 MCG CAPSULE|60|EA|.688|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No||||No|No|||Prescription required|No|||No|.90796|03/29/2022|.88616|03/29/2022|.89207|03/29/2022||||21152|||||No|No||BIONPHARMA INC.|No||||
amantadine HCl|No|No|No|No|75%|69452014220|AMANTADINE 100 MG CAPSULE|100|EA|.34658|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No||||No|No|||Prescription required|No||015|No|.2857|03/29/2022|.27884|03/29/2022|.2807|03/29/2022|||ANTIPARKINSON'S AGENTS|21153|||||No|No||BIONPHARMA INC.|No||||
amantadine HCl|No|No|No|No|75%|69452014230|AMANTADINE 100 MG CAPSULE|500|EA|.34658|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No||||No|No|||Prescription required|No||015|No|.2857|03/29/2022|.27884|03/29/2022|.2807|03/29/2022|||ANTIPARKINSON'S AGENTS|21154|||||No|No||BIONPHARMA INC.|No||||
benzonatate|No|No|No|No|75%|69452014320|BENZONATATE 100 MG CAPSULE|100|EA|.12878|11/27/2017||Yes|No||11/27/2017||Yes|No|11/27/2017||Yes|No||||No|No|||Prescription required|No||184|Yes|.09389|03/29/2022|.09163|03/29/2022|.09224|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21155|||||No|No||BIONPHARMA INC.|No||||
benzonatate|No|No|No|No|75%|69452014330|BENZONATATE 100 MG CAPSULE|500|EA|.06751|11/27/2017||Yes|No||11/27/2017||Yes|No|11/27/2017||Yes|No||||No|No|||Prescription required|No||184|Yes|.09389|03/29/2022|.09163|03/29/2022|.09224|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21156|||||No|No||BIONPHARMA INC.|No||||
benzonatate|No|No|No|No|75%|69452014420|BENZONATATE 200 MG CAPSULE|100|EA|.18275|02/28/2017||Yes|No||02/28/2017||Yes|No|02/28/2017||Yes|No||||No|No|||Prescription required|No||184|Yes|.14345|03/29/2022|.14|03/29/2022|.14093|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21157|||||No|No||BIONPHARMA INC.|No||||
benzonatate|No|No|No|No|75%|69452014430|BENZONATATE 200 MG CAPSULE|500|EA|.09576|02/28/2017||Yes|No||02/28/2017||Yes|No|02/28/2017||Yes|No||||No|No|||Prescription required|No||184|Yes|.14345|03/29/2022|.14|03/29/2022|.14093|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21158|||||No|No||BIONPHARMA INC.|No||||
paricalcitol|No|No|No|No|75%|69452014513|PARICALCITOL 1 MCG CAPSULE|30|EA|1.79166|10/24/2017||Yes|No||10/24/2017||Yes|No|10/24/2017||Yes|No||||No|No|||Prescription required|No|||No|1.13472|03/29/2022|1.10748|03/29/2022|1.11486|03/29/2022||||21159|||||No|No||BIONPHARMA INC.|No||||
paricalcitol|No|No|No|No|75%|69452014613|PARICALCITOL 2 MCG CAPSULE|30|EA|3.58333|11/15/2017||Yes|No||11/15/2017||Yes|No|11/15/2017||Yes|No||||No|No|||Prescription required|No|||No|8.16666|08/28/2018|8.04999|08/28/2018|7.66666|08/28/2018||||21160|||||No|No||BIONPHARMA INC.|No||||
valproic acid|No|No|No|No|75%|69452015020|VALPROIC ACID 250 MG CAPSULE|100|EA|.1505|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|No||056|No|.23326|03/29/2022|.22766|03/29/2022|.22917|03/29/2022|||ANTICONVULSANTS|21161|||||No|No||BIONPHARMA INC.|No||||
ergocalciferol (vitamin D2)|No|No|No|No|75%|69452015120|VITAMIN D2 1.25MG(50,000 UNIT)|100|EA|.15652|11/29/2016||Yes|No||11/29/2016||Yes|No|11/29/2016||Yes|No||||No|No|||Prescription required|No|||No|.14082|03/29/2022|.13744|03/29/2022|.13835|03/29/2022||||21162|||||No|No||BIONPHARMA INC.|No||||
ethosuximide|No|No|No|No|75%|69452015220|ETHOSUXIMIDE 250 MG CAPSULE|100|EA|.516|03/30/2017||Yes|No||03/30/2017||Yes|No|03/30/2017||Yes|No||||No|No|||Prescription required|No||056|No|.61011|03/29/2022|.59546|03/29/2022|.59943|03/29/2022|||ANTICONVULSANTS|21163|||||No|No||BIONPHARMA INC.|No||||
tacrolimus|No|No|No|No|75%|69452015320|TACROLIMUS 0.5 MG CAPSULE (IR)|100|EA|.18309|11/14/2016|05/14/2022|Yes|No||11/14/2016|05/14/2022|Yes|No|11/14/2016|05/14/2022|Yes|No||||No|No|||Prescription required|No||229|No|.26138|03/29/2022|.2551|03/29/2022|.2568|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|21164|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BIONPHARMA INC.|No||||
tacrolimus|No|No|No|No|75%|69452015420|TACROLIMUS 1 MG CAPSULE (IR)|100|EA|.36618|11/14/2016||Yes|No||11/14/2016||Yes|No|11/14/2016||Yes|No||||No|No|||Prescription required|No||229|No|.35645|03/29/2022|.34789|03/29/2022|.35021|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|21165|||||No|No||BIONPHARMA INC.|No||||
rizatriptan benzoate|No|No|No|No|75%|69452015673|RIZATRIPTAN 5 MG ODT|18|EA|.41184|12/14/2017||Yes|No||12/14/2017||Yes|No|12/14/2017||Yes|No||||No|No|||Prescription required|No||021|No|.80419|03/29/2022|.78488|03/29/2022|.79011|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|21166|||||No|No||BIONPHARMA INC.|No||||
rizatriptan benzoate|No|No|No|No|75%|69452015773|RIZATRIPTAN 10 MG ODT|18|EA|.42521|12/14/2017||Yes|No||12/14/2017||Yes|No|12/14/2017||Yes|No||||No|No|||Prescription required|No||021|No|.80628|03/29/2022|.78692|03/29/2022|.79217|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|21167|||||No|No||BIONPHARMA INC.|No||||
colesevelam HCl|No|No|No|No|75%|69452015825|COLESEVELAM 625 MG TABLET|180|EA|.24144|12/03/2020||Yes|No||12/03/2020||Yes|No|12/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|055|No|.48654|03/29/2022|.47486|03/29/2022|.47802|03/29/2022|||LIPOTROPICS: OTHER|21168|||||No|No||BIONPHARMA INC.|No||||
deferasirox|No|No|No|No|75%|69452015913|DEFERASIROX 125 MG TB FOR SUSP|30|EA|2.72376|05/19/2020||Yes|No||05/19/2020||Yes|No|05/19/2020||Yes|No||||No|No|||Prescription required|No|||No|6.20764|05/19/2020|6.11896|05/19/2020|5.82758|05/19/2020||||21169|||||No|No||BIONPHARMA INC.|No||||
deferasirox|No|No|No|No|75%|69452016013|DEFERASIROX 250 MG TB FOR SUSP|30|EA|5.44738|05/19/2020||Yes|No||05/19/2020||Yes|No|05/19/2020||Yes|No||||No|No|||Prescription required|No|||No|12.41496|05/19/2020|12.2376|05/19/2020|11.65486|05/19/2020||||21170|||||No|No||BIONPHARMA INC.|No||||
deferasirox|No|No|No|No|75%|69452016113|DEFERASIROX 500 MG TB FOR SUSP|30|EA|10.89448|05/19/2020||Yes|No||05/19/2020||Yes|No|05/19/2020||Yes|No||||No|No|||Prescription required|No|||No|24.82928|05/26/2020|24.47457|05/19/2020|23.30912|05/19/2020||||21171|||||No|No||BIONPHARMA INC.|No||||
azithromycin|Yes|No|No|No|75%|69452017104|AZITHROMYCIN 250 MG TABLET|6|EA|.31605|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|03/20/2020||Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|21172|||||No|No||BIONPHARMA INC.|No||||
azithromycin|Yes|No|No|No|75%|69452017113|AZITHROMYCIN 250 MG TABLET|30|EA|.37926|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|01/16/2020||Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|21173|||||No|No||BIONPHARMA INC.|No||||
azithromycin|Yes|No|No|No|75%|69452017173|AZITHROMYCIN 250 MG TABLET|6|EA|.31605|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|03/20/2020||Prescription required|No||018|No|.48506|03/29/2022|.47341|03/29/2022|.47657|03/29/2022|||MACROLIDES/KETOLIDES|21174|||||No|No||BIONPHARMA INC.|No||||
azithromycin|Yes|No|No|No|75%|69452017213|AZITHROMYCIN 500 MG TABLET|30|EA|.54782|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|01/16/2020||Prescription required|No||018|No|.82092|03/29/2022|.80121|03/29/2022|.80655|03/29/2022|||MACROLIDES/KETOLIDES|21175|||||No|No||BIONPHARMA INC.|No||||
azithromycin|Yes|No|No|No|75%|69452017272|AZITHROMYCIN 500 MG TABLET|3|EA|.6321|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|03/20/2020||Prescription required|No||018|No|.82092|03/29/2022|.80121|03/29/2022|.80655|03/29/2022|||MACROLIDES/KETOLIDES|21176|||||No|No||BIONPHARMA INC.|No||||
azithromycin|Yes|No|No|No|75%|69452017274|AZITHROMYCIN 500 MG TABLET|3|EA|.6321|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|03/20/2020||Prescription required|No||018|No|.82092|03/29/2022|.80121|03/29/2022|.80655|03/29/2022|||MACROLIDES/KETOLIDES|21177|||||No|No||BIONPHARMA INC.|No||||
azithromycin|No|No|No|No|75%|69452017313|AZITHROMYCIN 600 MG TABLET|30|EA|.77228|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|No||018|No|1.08173|08/24/2021|1.05576|08/24/2021|1.06279|08/24/2021|||MACROLIDES/KETOLIDES|21178|||||No|No||BIONPHARMA INC.|No||||
omega-3 acid ethyl esters|No|No|No|No|75%|69452017522|OMEGA-3 ETHYL ESTERS 1 GM CAP|120|EA|.17357|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No||||No|No|||Prescription required|No||055|Yes|.18363|03/29/2022|.17922|03/29/2022|.18041|03/29/2022|||LIPOTROPICS: OTHER|21179|||||No|No||BIONPHARMA INC.|No||||
potassium citrate|No|No|No|No|75%|69452019320|POTASSIUM CITRATE ER 10 MEQ TB|100|EA|.16017|10/21/2021||Yes|No||10/21/2021||Yes|No|10/21/2021||Yes|No||||No|No|||Prescription required|No|||No|.30433|03/29/2022|.29702|03/29/2022|.299|03/29/2022||||21180|||||No|No||BIONPHARMA INC.|No||||
potassium citrate|No|No|No|No|75%|69452019420|POTASSIUM CITRATE ER 15 MEQ TB|100|EA|.27606|10/21/2021||Yes|No||10/21/2021||Yes|No|10/21/2021||Yes|No||||No|No|||Prescription required|No|||No|.5925|03/29/2022|.57828|03/29/2022|.58213|03/29/2022||||21181|||||No|No||BIONPHARMA INC.|No||||
calcitriol|No|No|No|No|75%|69452020713|CALCITRIOL 0.25 MCG CAPSULE|30|EA|.11653|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No|||No|.18695|03/29/2022|.18246|03/29/2022|.18367|03/29/2022||||21182|||||No|No||BIONPHARMA INC.|No||||
calcitriol|No|No|No|No|75%|69452020720|CALCITRIOL 0.25 MCG CAPSULE|100|EA|.11653|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No|||No|.18695|03/29/2022|.18246|03/29/2022|.18367|03/29/2022||||21183|||||No|No||BIONPHARMA INC.|No||||
calcitriol|No|No|No|No|75%|69452020820|CALCITRIOL 0.5 MCG CAPSULE|100|EA|.18249|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No|||No|.32158|03/29/2022|.31386|03/29/2022|.31595|03/29/2022||||21184|||||No|No||BIONPHARMA INC.|No||||
nimodipine|No|No|No|No|75%|69452020913|NIMODIPINE 30 MG CAPSULE|30|EA|1.23539|02/08/2018||Yes|No||02/08/2018||Yes|No|02/08/2018||Yes|No||||No|No|||Prescription required|Yes|12/14/2017|045|No|2.81554|04/27/2021|2.77531|04/27/2021|2.64316|04/27/2021|||CALCIUM CHANNEL BLOCKERS|21185|||||No|No||BIONPHARMA INC.|No||||
nimodipine|No|No|No|No|75%|69452020920|NIMODIPINE 30 MG CAPSULE|100|EA|1.23539|02/15/2018||Yes|No||02/15/2018||Yes|No|02/15/2018||Yes|No||||No|No|||Prescription required|Yes|12/14/2017|045|No|2.81554|04/27/2021|2.77531|04/27/2021|2.64316|04/27/2021|||CALCIUM CHANNEL BLOCKERS|21186|||||No|No||BIONPHARMA INC.|No||||
rufinamide|No|No|No|No|75%|69452022384|RUFINAMIDE 40 MG/ML SUSPENSION|460|ML|1.27744|04/07/2021||Yes|No||04/07/2021||Yes|No|04/07/2021||Yes|No||||No|No|||Prescription required|No||056|No|1.88512|03/01/2022|1.83987|03/01/2022|1.85213|03/01/2022|||ANTICONVULSANTS|21187|||||No|No||BIONPHARMA INC.|No||||
amphetamine sulfate|No|No|No|No|90%|69452022720|AMPHETAMINE SULFATE 5 MG TAB|100|EA|.54042|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|007|Yes|1.23166|09/23/2020|1.21406|09/23/2020|1.15625|09/23/2020|||STIMULANTS AND RELATED AGENTS|21188|||||No|No||BIONPHARMA INC.|No||||
amphetamine sulfate|No|No|No|No|90%|69452022820|AMPHETAMINE SULFATE 10 MG TAB|100|EA|.54042|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|007|Yes|.77215|11/23/2021|.75361|11/23/2021|.75863|11/23/2021|||STIMULANTS AND RELATED AGENTS|21189|||||No|No||BIONPHARMA INC.|No||||
progesterone, micronized|No|No|No|No|75%|69452023320|PROGESTERONE 100 MG CAPSULE|100|EA|.258|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|No|||No|.25967|03/29/2022|.25343|03/29/2022|.25512|03/29/2022||||21190|||||No|No||BIONPHARMA INC.|No||||
progesterone, micronized|No|No|No|No|75%|69452023420|PROGESTERONE 200 MG CAPSULE|100|EA|.4859|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|No|||No|.48257|03/29/2022|.47098|03/29/2022|.47412|03/29/2022||||21191|||||No|No||BIONPHARMA INC.|No||||
enalapril maleate|No|No|No|No|75%|69452023746|ENALAPRIL 1 MG/ML ORAL SOLN|150|ML|1.40391|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|No|2.83331|03/29/2022|2.76531|03/29/2022|2.78372|03/29/2022|||ANGIOTENSIN MODULATORS|21192|||||No|No||BIONPHARMA INC.|No||||
trihexyphenidyl HCl|No|No|No|No|75%|69452024120|TRIHEXYPHENIDYL 2 MG TABLET|100|EA|.06467|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|No||015|No|.06083|03/29/2022|.05937|03/29/2022|.05976|03/29/2022|||ANTIPARKINSON'S AGENTS|21193|||||No|No||BIONPHARMA INC.|No||||
trihexyphenidyl HCl|No|No|No|No|75%|69452024132|TRIHEXYPHENIDYL 2 MG TABLET|1000|EA|.03309|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|No||015|No|.06083|03/29/2022|.05937|03/29/2022|.05976|03/29/2022|||ANTIPARKINSON'S AGENTS|21194|||||No|No||BIONPHARMA INC.|No||||
trihexyphenidyl HCl|No|No|No|No|75%|69452024220|TRIHEXYPHENIDYL 5 MG TABLET|100|EA|.09554|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|No||015|No|.10848|03/29/2022|.10587|03/29/2022|.10658|03/29/2022|||ANTIPARKINSON'S AGENTS|21195|||||No|No||BIONPHARMA INC.|No||||
trihexyphenidyl HCl|No|No|No|No|75%|69452024232|TRIHEXYPHENIDYL 5 MG TABLET|1000|EA|.06726|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|No||015|No|.10848|03/29/2022|.10587|03/29/2022|.10658|03/29/2022|||ANTIPARKINSON'S AGENTS|21196|||||No|No||BIONPHARMA INC.|No||||
acyclovir|No|No|No|No|75%|69452029020|ACYCLOVIR 400 MG TABLET|100|EA|.05435|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No||025|No|.0985|03/29/2022|.09613|03/29/2022|.09677|03/29/2022|||ANTIVIRALS: ORAL|21197|||||No|No||BIONPHARMA INC.|No||||
acyclovir|No|No|No|No|75%|69452029030|ACYCLOVIR 400 MG TABLET|500|EA|.05435|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No||025|No|.0985|03/29/2022|.09613|03/29/2022|.09677|03/29/2022|||ANTIVIRALS: ORAL|21198|||||No|No||BIONPHARMA INC.|No||||
acyclovir|No|No|No|No|75%|69452029120|ACYCLOVIR 800 MG TABLET|100|EA|.117|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No||025|No|.19021|03/29/2022|.18564|03/29/2022|.18688|03/29/2022|||ANTIVIRALS: ORAL|21199|||||No|No||BIONPHARMA INC.|No||||
acyclovir|No|No|No|No|75%|69452029130|ACYCLOVIR 800 MG TABLET|500|EA|.117|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No||025|No|.19021|03/29/2022|.18564|03/29/2022|.18688|03/29/2022|||ANTIVIRALS: ORAL|21200|||||No|No||BIONPHARMA INC.|No||||
obeticholic acid|No|No|No|No|75%|69516000530|OCALIVA 5 MG TABLET|30|EA|115.30464|10/07/2016||Yes|No||10/07/2016||Yes|No|10/07/2016||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|198|No|262.78732|01/25/2022|259.03321|01/25/2022|246.6983|01/25/2022|||BILE SALTS|21201|||||No|No||INTERCEPT PHARM|No||||
obeticholic acid|No|No|No|No|75%|69516001030|OCALIVA 10 MG TABLET|30|EA|115.30464|10/07/2016||Yes|No||10/07/2016||Yes|No|10/07/2016||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|198|No|262.78732|01/25/2022|259.03321|01/25/2022|246.6983|01/25/2022|||BILE SALTS|21202|||||No|No||INTERCEPT PHARM|No||||
cephalexin|No|No|No|No|75%|69543010210|CEPHALEXIN 500 MG CAPSULE|100|EA|.07434|10/21/2015||Yes|No||10/21/2015||Yes|No|10/21/2015||Yes|No||||No|No|||Prescription required|No||046|No|.12151|03/29/2022|.11859|03/29/2022|.11938|03/29/2022|||CEPHALOSPORINS AND RELATED ANTIBIOTICS|21203|||||No|No||VIRTUS PHARMACE|No||||
desloratadine|No|No|No|No|75%|69543010710|DESLORATADINE 5 MG TABLET|100|EA|.215|10/07/2020||Yes|No||10/07/2020||Yes|No|10/07/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|030|Yes|.33933|03/29/2022|.33118|03/29/2022|.33339|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21204|||||No|No||VIRTUS PHARMACE|No||||
desloratadine|No|No|No|No|75%|69543010750|DESLORATADINE 5 MG TABLET|500|EA|.19694|10/21/2015||Yes|No||10/21/2015||Yes|No|10/21/2015||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|030|Yes|.33933|03/29/2022|.33118|03/29/2022|.33339|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21205|||||No|No||VIRTUS PHARMACE|No||||
acarbose|No|No|No|No|75%|69543012010|ACARBOSE 25 MG TABLET|100|EA|.19573|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|||Prescription required|No|||No|.17861|03/29/2022|.17432|03/29/2022|.17548|03/29/2022||||21206|||||No|No||VIRTUS PHARMACE|No||||
acarbose|No|No|No|No|75%|69543012011|ACARBOSE 25 MG TABLET|1000|EA|.17996|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|||Prescription required|No|||No|.17861|03/29/2022|.17432|03/29/2022|.17548|03/29/2022||||21207|||||No|No||VIRTUS PHARMACE|No||||
acarbose|No|No|No|No|75%|69543012110|ACARBOSE 50 MG TABLET|100|EA|.20076|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|||Prescription required|No|||No|.19141|03/29/2022|.18681|03/29/2022|.18806|03/29/2022||||21208|||||No|No||VIRTUS PHARMACE|No||||
acarbose|No|No|No|No|75%|69543012111|ACARBOSE 50 MG TABLET|1000|EA|.19737|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|||Prescription required|No|||No|.19141|03/29/2022|.18681|03/29/2022|.18806|03/29/2022||||21209|||||No|No||VIRTUS PHARMACE|No||||
acarbose|No|No|No|No|75%|69543012210|ACARBOSE 100 MG TABLET|100|EA|.2601|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|||Prescription required|No|||No|.31919|03/29/2022|.31152|03/29/2022|.3136|03/29/2022||||21210|||||No|No||VIRTUS PHARMACE|No||||
acarbose|No|No|No|No|75%|69543012211|ACARBOSE 100 MG TABLET|1000|EA|.23413|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|||Prescription required|No|||No|.31919|03/29/2022|.31152|03/29/2022|.3136|03/29/2022||||21211|||||No|No||VIRTUS PHARMACE|No||||
glimepiride|Yes|No|No|No|75%|69543012310|GLIMEPIRIDE 1 MG TABLET|100|EA|.03392|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.03361|03/29/2022|.0328|03/29/2022|.03302|03/29/2022||||21212|||||No|No||VIRTUS PHARMACE|No||||
glimepiride|No|No|No|No|75%|69543012350|GLIMEPIRIDE 1 MG TABLET|500|EA|.00774|12/22/2016||Yes|No||12/22/2016||Yes|No|12/22/2016||Yes|No||||No|No|||Prescription required|No|||No|.03361|03/29/2022|.0328|03/29/2022|.03302|03/29/2022||||21213|||||No|No||VIRTUS PHARMACE|No||||
glimepiride|No|No|No|No|75%|69543012410|GLIMEPIRIDE 2 MG TABLET|100|EA|.06015|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|||Prescription required|No|||No|.03979|03/29/2022|.03883|03/29/2022|.03909|03/29/2022||||21214|||||No|No||VIRTUS PHARMACE|No||||
glimepiride|No|No|No|No|75%|69543012450|GLIMEPIRIDE 2 MG TABLET|500|EA|.01634|12/22/2016||Yes|No||12/22/2016||Yes|No|12/22/2016||Yes|No||||No|No|||Prescription required|No|||No|.03979|03/29/2022|.03883|03/29/2022|.03909|03/29/2022||||21215|||||No|No||VIRTUS PHARMACE|No||||
glimepiride|Yes|No|No|No|75%|69543012510|GLIMEPIRIDE 4 MG TABLET|100|EA|.10083|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|07/01/2016||Prescription required|No|||No|.04419|03/29/2022|.04312|03/29/2022|.04341|03/29/2022||||21216|||||No|No||VIRTUS PHARMACE|No||||
glimepiride|No|No|No|No|75%|69543012550|GLIMEPIRIDE 4 MG TABLET|500|EA|.0215|12/22/2016||Yes|No||12/22/2016||Yes|No|12/22/2016||Yes|No||||No|No|||Prescription required|No|||No|.04419|03/29/2022|.04312|03/29/2022|.04341|03/29/2022||||21217|||||No|No||VIRTUS PHARMACE|No||||
alendronate sodium|No|No|No|No|75%|69543013004|ALENDRONATE SODIUM 35 MG TAB|4|EA|.20102|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|||Prescription required|No||060|No|.34811|03/29/2022|.33975|03/29/2022|.34201|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|21218|||||No|No||VIRTUS PHARMACE|No||||
alendronate sodium|No|No|No|No|75%|69543013012|ALENDRONATE SODIUM 35 MG TAB|12|EA|.20102|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|||Prescription required|No||060|No|.34811|03/29/2022|.33975|03/29/2022|.34201|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|21219|||||No|No||VIRTUS PHARMACE|No||||
alendronate sodium|No|No|No|No|75%|69543013104|ALENDRONATE SODIUM 70 MG TAB|4|EA|.20102|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|||Prescription required|No||060|No|.29635|03/29/2022|.28923|03/29/2022|.29116|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|21220|||||No|No||VIRTUS PHARMACE|No||||
alendronate sodium|No|No|No|No|75%|69543013112|ALENDRONATE SODIUM 70 MG TAB|12|EA|.20102|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|||Prescription required|No||060|No|.29635|03/29/2022|.28923|03/29/2022|.29116|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|21221|||||No|No||VIRTUS PHARMACE|No||||
alendronate sodium|No|No|No|No|75%|69543013120|ALENDRONATE SODIUM 70 MG TAB|20|EA|1.1997|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|||Prescription required|No||060|No|.29635|03/29/2022|.28923|03/29/2022|.29116|03/29/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|21222|||||No|No||VIRTUS PHARMACE|No||||
tramadol HCl|No|No|No|No|90%|69543013610|TRAMADOL HCL 50 MG TABLET|100|EA|.02021|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.02459|03/29/2022|.02399|03/29/2022|.02415|03/29/2022|||ANALGESICS: NARCOTICS SHORT|21223|||||No|No||VIRTUS PHARMACE|No||||
tramadol HCl|No|No|No|No|90%|69543013611|TRAMADOL HCL 50 MG TABLET|1000|EA|.01935|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.02459|03/29/2022|.02399|03/29/2022|.02415|03/29/2022|||ANALGESICS: NARCOTICS SHORT|21224|||||No|No||VIRTUS PHARMACE|No||||
tramadol HCl|No|No|No|No|90%|69543013650|TRAMADOL HCL 50 MG TABLET|500|EA|.01978|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|||Prescription required|No||109|Yes|.02459|03/29/2022|.02399|03/29/2022|.02415|03/29/2022|||ANALGESICS: NARCOTICS SHORT|21225|||||No|No||VIRTUS PHARMACE|No||||
dapsone|No|No|No|No|75%|69543015030|DAPSONE 25 MG TABLET|30|EA|.42254|05/02/2017||Yes|No||05/02/2017||Yes|No|05/02/2017||Yes|No||||No|No|||Prescription required|No|||No|.52333|03/29/2022|.51077|03/29/2022|.51417|03/29/2022||||21226|||||No|No||VIRTUS PHARMACE|No||||
dapsone|No|No|No|No|75%|69543015130|DAPSONE 100 MG TABLET|30|EA|.53764|05/02/2017|01/06/2022|Yes|No||05/02/2017|01/06/2022|Yes|No|05/02/2017|01/06/2022|Yes|No||||No|No|||Prescription required|No|||No|.77747|03/29/2022|.75881|03/29/2022|.76386|03/29/2022||||21227|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||VIRTUS PHARMACE|No||||
magnesium oxide|No|No|No|No|75%|69543021712|MAGNESIUM OXIDE 400 MG TABLET|120|EA|.01967|12/10/2015||Yes|No||||No|No|12/10/2015||Yes|No||||No|No|||Over the counter|No|||No|.03856|03/29/2022|.03763|03/29/2022|.03788|03/29/2022||||21228|||||No|No||VIRTUS PHARMACE|No||||
prenatal no.52/iron/FA/dha|No|No|No|No|75%|69543022330|VP-PNV-DHA SOFTGEL|30|EA|.47285|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|1.07766|02/28/2017|1.06227|02/28/2017|1.01168|02/28/2017|||PRENATAL VITAMINS|21229|||||No|No||VIRTUS PHARMACE|No||||
prenatal 34/iron/folic/dss/dha|No|No|No|No|75%|69543022430|VP-CH-PNV PRENATAL SOFTGEL|30|EA|.72698|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|||Prescription required|Yes|04/26/2020|243|No|1.65684|06/01/2016|1.63317|06/01/2016|1.5554|06/01/2016|||PRENATAL VITAMINS|21230|||||No|No||VIRTUS PHARMACE|No||||
codeine phosphate/guaifenesin|No|No|No|No|90%|69543025116|VIRTUSSIN AC W-ALC 10-100 MG/5|473|ML|.01995|02/26/2020||Yes|No||||No|No|02/26/2020||Yes|No||||No|No|||Over the counter|No||183|Yes|.02734|03/29/2022|.02668|03/29/2022|.02686|03/29/2022|||COUGH AND COLD: NARCOTIC|21231|||||No|No||VIRTUS PHARMACE|No||||
codeine phosphate/guaifenesin|No|No|No|No|90%|69543025204|VIRTUSSIN AC 10-100 MG/5 ML LQ|118|ML|.03895|12/22/2016||Yes|No||||No|No|12/22/2016||Yes|No||||No|No|||Over the counter|No||183|Yes|.05917|03/29/2022|.05774|03/29/2022|.05813|03/29/2022|||COUGH AND COLD: NARCOTIC|21232|||||No|No||VIRTUS PHARMACE|No||||
codeine phosphate/guaifenesin|No|No|No|No|90%|69543025216|VIRTUSSIN AC 10-100 MG/5 ML LQ|473|ML|.0218|11/08/2016||Yes|No||||No|No|11/08/2016||Yes|No||||No|No|||Over the counter|No||183|Yes|.02734|03/29/2022|.02668|03/29/2022|.02686|03/29/2022|||COUGH AND COLD: NARCOTIC|21233|||||No|No||VIRTUS PHARMACE|No||||
pseudoephed/codeine/guaifen|No|No|No|No|90%|69543025304|VIRTUSSIN DAC LIQUID|118|ML|.36349|09/04/2019||Yes|No||||No|No|09/04/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|183|Yes|.82842|09/04/2019|.81658|09/04/2019|.7777|09/04/2019|||COUGH AND COLD: NARCOTIC|21234|||||No|No||VIRTUS PHARMACE|No||||
pseudoephed/codeine/guaifen|No|No|No|No|90%|69543025316|VIRTUSSIN DAC LIQUID|473|ML|.09543|12/22/2016||Yes|No||||No|No|12/22/2016||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|183|Yes|.2175|08/29/2017|.21439|08/29/2017|.20418|08/29/2017|||COUGH AND COLD: NARCOTIC|21235|||||No|No||VIRTUS PHARMACE|No||||
codeine phosphate/guaifenesin|No|No|No|No|90%|69543027616|CODEINE-GUAIFEN 10-100 MG/5 ML|473|ML|.01995|06/10/2019||Yes|No||||No|No|06/10/2019||Yes|No||||No|No|||Over the counter|No||183|Yes|.02734|03/29/2022|.02668|03/29/2022|.02686|03/29/2022|||COUGH AND COLD: NARCOTIC|21236|||||No|No||VIRTUS PHARMACE|No||||
albuterol sulfate|No|No|No|No|75%|69543029010|ALBUTEROL SULFATE 2 MG TAB|100|EA|.4257|06/10/2019||Yes|No||06/10/2019||Yes|No|06/10/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|037|No|.67057|07/27/2021|.65447|07/27/2021|.65883|07/27/2021|||BRONCHODILATORS: BETA AGONIST|21237|||||No|No||VIRTUS PHARMACE|No||||
albuterol sulfate|No|No|No|No|75%|69543029110|ALBUTEROL SULFATE 4 MG TAB|100|EA|.4257|06/10/2019||Yes|No||06/10/2019||Yes|No|06/10/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|037|No|1.0884|03/01/2022|1.06227|03/01/2022|1.06935|03/01/2022|||BRONCHODILATORS: BETA AGONIST|21238|||||No|No||VIRTUS PHARMACE|No||||
progesterone, micronized|No|No|No|No|75%|69543037210|PROMETRIUM 100 MG CAPSULE|100|EA|4.53865|10/07/2016||Yes|No||10/07/2016||Yes|No|10/07/2016||Yes|No||||No|No|||Prescription required|No|||No|10.3439|11/06/2018|10.19613|11/06/2018|9.7106|11/06/2018||||21239|||||No|No||VIRTUS PHARMACE|No||||
progesterone, micronized|No|No|No|No|75%|69543037310|PROMETRIUM 200 MG CAPSULE|100|EA|8.62171|10/07/2016||Yes|No||10/07/2016||Yes|No|10/07/2016||Yes|No||||No|No|||Prescription required|No|||No|19.64949|11/06/2018|19.36878|11/06/2018|18.44646|11/06/2018||||21240|||||No|No||VIRTUS PHARMACE|No||||
progesterone, micronized|No|No|No|No|75%|69543037410|PROGESTERONE 100 MG CAPSULE|100|EA|.258|10/07/2016||Yes|No||10/07/2016||Yes|No|10/07/2016||Yes|No||||No|No|||Prescription required|No|||No|.25967|03/29/2022|.25343|03/29/2022|.25512|03/29/2022||||21241|||||No|No||VIRTUS PHARMACE|No||||
progesterone, micronized|No|No|No|No|75%|69543037510|PROGESTERONE 200 MG CAPSULE|100|EA|.344|10/07/2016||Yes|No||10/07/2016||Yes|No|10/07/2016||Yes|No||||No|No|||Prescription required|No|||No|.48257|03/29/2022|.47098|03/29/2022|.47412|03/29/2022||||21242|||||No|No||VIRTUS PHARMACE|No||||
potassium chloride|No|No|No|No|75%|69543037910|POTASSIUM CL 20 MEQ PACKET|100|EA|1.978|03/19/2018|03/03/2022|Yes|No||03/19/2018|03/03/2022|Yes|No|03/19/2018|03/03/2022|Yes|No||||No|No|||Prescription required|No|||No|2.51484|03/29/2022|2.45448|03/29/2022|2.47083|03/29/2022||||21243|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||VIRTUS PHARMACE|No||||
potassium chloride|No|No|No|No|75%|69543037930|POTASSIUM CL 20 MEQ PACKET|30|EA|2.00666|03/19/2018|03/03/2022|Yes|No||03/19/2018|03/03/2022|Yes|No|03/19/2018|03/03/2022|Yes|No||||No|No|||Prescription required|No|||No|2.51484|03/29/2022|2.45448|03/29/2022|2.47083|03/29/2022||||21244|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||VIRTUS PHARMACE|No||||
olanzapine|No|No|No|No|75%|69543038030|OLANZAPINE 2.5 MG TABLET|30|EA|.06091|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.08915|03/29/2022|.08701|03/29/2022|.08758|03/29/2022|||ANTIPSYCHOTICS|21245|||||No|No||VIRTUS PHARMACE|No||||
olanzapine|No|No|No|No|75%|69543038090|OLANZAPINE 2.5 MG TABLET|90|EA|.05909|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.08915|03/29/2022|.08701|03/29/2022|.08758|03/29/2022|||ANTIPSYCHOTICS|21246|||||No|No||VIRTUS PHARMACE|No||||
olanzapine|No|No|No|No|75%|69543038130|OLANZAPINE 5 MG TABLET|30|EA|.07023|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.09455|03/29/2022|.09228|03/29/2022|.09289|03/29/2022|||ANTIPSYCHOTICS|21247|||||No|No||VIRTUS PHARMACE|No||||
olanzapine|No|No|No|No|75%|69543038190|OLANZAPINE 5 MG TABLET|90|EA|.06812|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.09455|03/29/2022|.09228|03/29/2022|.09289|03/29/2022|||ANTIPSYCHOTICS|21248|||||No|No||VIRTUS PHARMACE|No||||
olanzapine|No|No|No|No|75%|69543038230|OLANZAPINE 7.5 MG TABLET|30|EA|.086|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.11617|03/29/2022|.11338|03/29/2022|.11413|03/29/2022|||ANTIPSYCHOTICS|21249|||||No|No||VIRTUS PHARMACE|No||||
olanzapine|No|No|No|No|75%|69543038290|OLANZAPINE 7.5 MG TABLET|90|EA|.08342|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.11617|03/29/2022|.11338|03/29/2022|.11413|03/29/2022|||ANTIPSYCHOTICS|21250|||||No|No||VIRTUS PHARMACE|No||||
olanzapine|No|No|No|No|75%|69543038330|OLANZAPINE 10 MG TABLET|30|EA|.10248|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.12613|03/29/2022|.1231|03/29/2022|.12392|03/29/2022|||ANTIPSYCHOTICS|21251|||||No|No||VIRTUS PHARMACE|No||||
olanzapine|No|No|No|No|75%|69543038390|OLANZAPINE 10 MG TABLET|90|EA|.09942|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.12613|03/29/2022|.1231|03/29/2022|.12392|03/29/2022|||ANTIPSYCHOTICS|21252|||||No|No||VIRTUS PHARMACE|No||||
olanzapine|No|No|No|No|75%|69543038430|OLANZAPINE 15 MG TABLET|30|EA|.15838|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.15007|03/29/2022|.14646|03/29/2022|.14744|03/29/2022|||ANTIPSYCHOTICS|21253|||||No|No||VIRTUS PHARMACE|No||||
olanzapine|No|No|No|No|75%|69543038490|OLANZAPINE 15 MG TABLET|90|EA|.15365|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.15007|03/29/2022|.14646|03/29/2022|.14744|03/29/2022|||ANTIPSYCHOTICS|21254|||||No|No||VIRTUS PHARMACE|No||||
olanzapine|No|No|No|No|75%|69543038530|OLANZAPINE 20 MG TABLET|30|EA|.2064|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.18048|03/29/2022|.17614|03/29/2022|.17732|03/29/2022|||ANTIPSYCHOTICS|21255|||||No|No||VIRTUS PHARMACE|No||||
olanzapine|No|No|No|No|75%|69543038590|OLANZAPINE 20 MG TABLET|90|EA|.20018|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No||027|Yes|.18048|03/29/2022|.17614|03/29/2022|.17732|03/29/2022|||ANTIPSYCHOTICS|21256|||||No|No||VIRTUS PHARMACE|No||||
ketorolac tromethamine|No|No|No|No|75%|69543038810|KETOROLAC 10 MG TABLET|100|EA|.46371|09/11/2019||Yes|No||09/11/2019||Yes|No|09/11/2019||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|059|Yes|.74409|03/29/2022|.72623|03/29/2022|.73106|03/29/2022|||NSAIDS|21257|||||No|No||VIRTUS PHARMACE|No||||
levorphanol tartrate|No|No|No|No|90%|69543041210|LEVORPHANOL 2 MG TABLET|100|EA|19.135|06/03/2019||Yes|No||06/03/2019||Yes|No|06/03/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|109|Yes|43.61|06/03/2019|42.987|06/03/2019|40.94|06/03/2019|||ANALGESICS: NARCOTICS SHORT|21258|||||No|No||VIRTUS PHARMACE|No||||
levorphanol tartrate|No|No|No|No|90%|69543041710|LEVORPHANOL 2 MG TABLET|100|EA|19.135|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|109|Yes|43.61|05/19/2021|42.987|05/19/2021|40.94|05/19/2021|||ANALGESICS: NARCOTICS SHORT|21259|||||No|No||VIRTUS PHARMACE|No||||
naproxen|No|No|No|No|75%|69543042510|NAPROXEN DR 375 MG TABLET|100|EA|1.48023|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No||059|Yes|.40508|01/25/2022|.39535|01/25/2022|.39799|01/25/2022|||NSAIDS|21260|||||No|No||VIRTUS PHARMACE|No||||
naproxen|No|No|No|No|75%|69543042610|NAPROXEN DR 500 MG TABLET|100|EA|1.80806|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No||059|Yes|3.24464|03/29/2022|3.16676|03/29/2022|3.18785|03/29/2022|||NSAIDS|21261|||||No|No||VIRTUS PHARMACE|No||||
potassium chloride|No|No|No|No|75%|69543045110|POTASSIUM CL 20 MEQ PACKET|100|EA|1.71957|06/30/2021||Yes|No||06/30/2021||Yes|No|06/30/2021||Yes|No||||No|No|||Prescription required|No|||No|2.51484|03/29/2022|2.45448|03/29/2022|2.47083|03/29/2022||||21262|||||No|No||VIRTUS PHARMACE|No||||
potassium chloride|No|No|No|No|75%|69543045130|POTASSIUM CL 20 MEQ PACKET|30|EA|1.72616|06/30/2021||Yes|No||06/30/2021||Yes|No|06/30/2021||Yes|No||||No|No|||Prescription required|No|||No|2.51484|03/29/2022|2.45448|03/29/2022|2.47083|03/29/2022||||21263|||||No|No||VIRTUS PHARMACE|No||||
naloxone HCl|No|No|No|No|75%|69547035302|NARCAN 4 MG NASAL SPRAY|2|EA|26.875|02/25/2016||Yes|No||02/25/2016||Yes|No|02/25/2016||Yes|No||||No|No|||Prescription required|No||145|No|59.97817|12/28/2021|58.53869|12/28/2021|58.92855|12/28/2021|||OPIATE DEPENDENCE TREATMENTS|21264|||||No|Yes|12.56|ADAPT PHARMA IN|Yes|09/01/2020|||
lidocaine|No|No|No|No|75%|69557011130|ZTLIDO 1.8% TOPICAL SYSTEM|30|EA|4.4032|03/26/2019||Yes|No||03/26/2019||Yes|No|03/26/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|232|No|9.79741|01/18/2022|9.56227|01/18/2022|9.62595|01/18/2022|||NEUROPATHIC PAIN|21265|||||No|No||SCILEX PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69584009110|BUSPIRONE HCL 5 MG TABLET|100|EA|.01281|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|21266|||||No|No||OXFORD PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69584009150|BUSPIRONE HCL 5 MG TABLET|500|EA|.01238|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|21267|||||No|No||OXFORD PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69584009210|BUSPIRONE HCL 10 MG TABLET|100|EA|.01892|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|21268|||||No|No||OXFORD PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69584009250|BUSPIRONE HCL 10 MG TABLET|500|EA|.01797|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|21269|||||No|No||OXFORD PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69584009310|BUSPIRONE HCL 15 MG TABLET|100|EA|.02472|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|21270|||||No|No||OXFORD PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69584009350|BUSPIRONE HCL 15 MG TABLET|500|EA|.02132|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|21271|||||No|No||OXFORD PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69584009406|BUSPIRONE HCL 30 MG TABLET|60|EA|.10033|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No||090|No|.17728|03/29/2022|.17302|03/29/2022|.17417|03/29/2022|||ANXIOLYTICS|21272|||||No|No||OXFORD PHARMACE|No||||
buspirone HCl|No|No|No|No|75%|69584009450|BUSPIRONE HCL 30 MG TABLET|500|EA|.09331|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|No||090|No|.17728|03/29/2022|.17302|03/29/2022|.17417|03/29/2022|||ANXIOLYTICS|21273|||||No|No||OXFORD PHARMACE|No||||
carisoprodol|No|No|No|No|90%|69584011110|CARISOPRODOL 350 MG TABLET|100|EA|.02958|09/22/2020||Yes|No||09/22/2020||Yes|No|09/22/2020||Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21274|||||No|No||OXFORD PHARMACE|No||||
carisoprodol|No|No|No|No|90%|69584011190|CARISOPRODOL 350 MG TABLET|1000|EA|.02386|09/22/2020||Yes|No||09/22/2020||Yes|No|09/22/2020||Yes|No||||No|No|||Prescription required|No||116|Yes|.05909|03/29/2022|.05767|03/29/2022|.05805|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21275|||||No|No||OXFORD PHARMACE|No||||
dipyridamole|No|No|No|No|75%|69584018110|DIPYRIDAMOLE 25 MG TABLET|100|EA|.08041|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|004|No|1.06294|03/02/2022|1.03742|03/02/2022|1.04433|03/02/2022|||PLATELET AGGREGATION INHIBITORS|21276|||||No|No||OXFORD PHARMACE|No||||
dipyridamole|No|No|No|No|75%|69584018210|DIPYRIDAMOLE 50 MG TABLET|100|EA|.14577|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|004|No|1.35098|03/02/2022|1.31855|03/02/2022|1.32733|03/02/2022|||PLATELET AGGREGATION INHIBITORS|21277|||||No|No||OXFORD PHARMACE|No||||
dipyridamole|No|No|No|No|75%|69584018310|DIPYRIDAMOLE 75 MG TABLET|100|EA|.19135|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|004|No|.4361|03/02/2022|.42987|03/02/2022|.4094|03/02/2022|||PLATELET AGGREGATION INHIBITORS|21278|||||No|No||OXFORD PHARMACE|No||||
hydrochlorothiazide|No|No|No|No|75%|69584036110|HYDROCHLOROTHIAZIDE 25 MG TAB|100|EA|.00967|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No|||Yes|.01337|03/29/2022|.01304|03/29/2022|.01313|03/29/2022||||21279|||||No|No||OXFORD PHARMACE|No||||
hydrochlorothiazide|No|No|No|No|75%|69584036190|HYDROCHLOROTHIAZIDE 25 MG TAB|1000|EA|.00705|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No|||Yes|.01337|03/29/2022|.01304|03/29/2022|.01313|03/29/2022||||21280|||||No|No||OXFORD PHARMACE|No||||
hydrochlorothiazide|No|No|No|No|75%|69584036195|HYDROCHLOROTHIAZIDE 25 MG TAB|5000|EA|.00634|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No|||Yes|.01337|03/29/2022|.01304|03/29/2022|.01313|03/29/2022||||21281|||||No|No||OXFORD PHARMACE|No||||
hydrochlorothiazide|No|No|No|No|75%|69584036210|HYDROCHLOROTHIAZIDE 50 MG TAB|100|EA|.01242|01/10/2022||Yes|No||01/10/2022||Yes|No|01/10/2022||Yes|No||||No|No|||Prescription required|No|||Yes|.02959|03/29/2022|.02887|03/29/2022|.02907|03/29/2022||||21282|||||No|No||OXFORD PHARMACE|No||||
imipramine HCl|No|No|No|No|75%|69584042510|IMIPRAMINE HCL 10 MG TABLET|100|EA|.02494|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No||215|No|.08862|03/29/2022|.08649|03/29/2022|.08706|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|21283|||||No|No||OXFORD PHARMACE|No||||
imipramine HCl|No|No|No|No|75%|69584042610|IMIPRAMINE HCL 25 MG TABLET|100|EA|.02962|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No||215|No|.0831|03/29/2022|.0811|03/29/2022|.08164|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|21284|||||No|No||OXFORD PHARMACE|No||||
methocarbamol|No|No|No|No|75%|69584061110|METHOCARBAMOL 500 MG TABLET|100|EA|.03698|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|No||116|Yes|.07091|03/29/2022|.0692|03/29/2022|.06966|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21285|||||No|No||OXFORD PHARMACE|No||||
methocarbamol|No|No|No|No|75%|69584061150|METHOCARBAMOL 500 MG TABLET|500|EA|.03431|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|No||116|Yes|.07091|03/29/2022|.0692|03/29/2022|.06966|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21286|||||No|No||OXFORD PHARMACE|No||||
methocarbamol|No|No|No|No|75%|69584061210|METHOCARBAMOL 750 MG TABLET|100|EA|.05353|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|No||116|Yes|.09307|03/29/2022|.09083|03/29/2022|.09144|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21287|||||No|No||OXFORD PHARMACE|No||||
methocarbamol|No|No|No|No|75%|69584061250|METHOCARBAMOL 750 MG TABLET|500|EA|.05147|02/13/2020||Yes|No||02/13/2020||Yes|No|02/13/2020||Yes|No||||No|No|||Prescription required|No||116|Yes|.09307|03/29/2022|.09083|03/29/2022|.09144|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21288|||||No|No||OXFORD PHARMACE|No||||
primidone|No|No|No|No|75%|69584068410|PRIMIDONE 50 MG TABLET|100|EA|.10449|06/29/2021||Yes|No||06/29/2021||Yes|No|06/29/2021||Yes|No||||No|No|||Prescription required|No||056|No|.16327|03/29/2022|.15935|03/29/2022|.16041|03/29/2022|||ANTICONVULSANTS|21289|||||No|No||OXFORD PHARMACE|No||||
primidone|No|No|No|No|75%|69584068450|PRIMIDONE 50 MG TABLET|500|EA|.09967|06/16/2021||Yes|No||06/16/2021||Yes|No|06/16/2021||Yes|No||||No|No|||Prescription required|No||056|No|.16327|03/29/2022|.15935|03/29/2022|.16041|03/29/2022|||ANTICONVULSANTS|21290|||||No|No||OXFORD PHARMACE|No||||
primidone|No|No|No|No|75%|69584068510|PRIMIDONE 250 MG TABLET|100|EA|.15523|06/16/2021||Yes|No||06/16/2021||Yes|No|06/16/2021||Yes|No||||No|No|||Prescription required|No||056|No|.31086|03/29/2022|.30339|03/29/2022|.30541|03/29/2022|||ANTICONVULSANTS|21291|||||No|No||OXFORD PHARMACE|No||||
primidone|No|No|No|No|75%|69584068550|PRIMIDONE 250 MG TABLET|500|EA|.14748|06/16/2021||Yes|No||06/16/2021||Yes|No|06/16/2021||Yes|No||||No|No|||Prescription required|No||056|No|.31086|03/29/2022|.30339|03/29/2022|.30541|03/29/2022|||ANTICONVULSANTS|21292|||||No|No||OXFORD PHARMACE|No||||
sotalol HCl|No|No|No|No|75%|69584084110|SOTALOL 80 MG TABLET|100|EA|.02408|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|No||070|No|.07746|03/29/2022|.0756|03/29/2022|.0761|03/29/2022|||BETA-BLOCKERS|21293|||||No|No||OXFORD PHARMACE|No||||
sotalol HCl|No|No|No|No|75%|69584084210|SOTALOL 120 MG TABLET|100|EA|.02967|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|No||070|No|.10056|03/29/2022|.09814|03/29/2022|.0988|03/29/2022|||BETA-BLOCKERS|21294|||||No|No||OXFORD PHARMACE|No||||
sotalol HCl|No|No|No|No|75%|69584084310|SOTALOL 160 MG TABLET|100|EA|.04923|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|No||070|No|.16372|03/29/2022|.15979|03/29/2022|.16085|03/29/2022|||BETA-BLOCKERS|21295|||||No|No||OXFORD PHARMACE|No||||
sotalol HCl|No|No|No|No|75%|69584084410|SOTALOL 240 MG TABLET|100|EA|.05138|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|No||070|No|.11711|12/22/2020|.11543|12/18/2020|.10994|12/18/2020|||BETA-BLOCKERS|21296|||||No|No||OXFORD PHARMACE|No||||
amifampridine phosphate|No|No|No|No|75%|69616021103|FIRDAPSE 10 MG TABLET|240|EA|84.8304|05/13/2019||Yes|No||05/13/2019||Yes|No|05/13/2019||Yes|No||||No|No|||Prescription required|No|||No|193.3344|07/06/2021|190.57248|07/06/2021|181.4976|07/06/2021||||21297|||||No|No||CATALYST PHARMA|No||||
amifampridine phosphate|No|No|No|No|75%|69616021106|FIRDAPSE 10 MG TABLET|120|EA|84.8304|05/07/2019||Yes|No||05/07/2019||Yes|No|05/07/2019||Yes|No||||No|No|||Prescription required|No|||No|193.3344|07/06/2021|190.57248|07/06/2021|181.4976|07/06/2021||||21298|||||No|No||CATALYST PHARMA|No||||
netupitant/palonosetron HCl|No|No|No|No|75%|69639010101|AKYNZEO 300-0.5 MG CAPSULE|1|EA|296.743|07/03/2017||Yes|No||07/03/2017||Yes|No|07/03/2017||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|085|Yes|676.298|11/16/2021|666.6366|11/16/2021|634.892|11/16/2021|||ANTIEMETIC/ANTIVERTIGO AGENTS|21299|||||No|No||HELSINN THERAPE|No||||
niraparib tosylate|No|No|No|No|75%|69656010330|ZEJULA 100 MG CAPSULE|30|EA|116.89306|09/10/2018||Yes|No||09/10/2018||Yes|No|09/10/2018||Yes|No||||No|No|||Prescription required|No||239|No|266.40744|02/01/2022|262.60162|02/01/2022|250.09678|02/01/2022|||ONCOLOGY: ORAL - OTHER|21300|||||No|No||GLAXOSMITHKLINE|No||||
rucaparib camsylate|No|No|No|No|75%|69660020191|RUBRACA 200 MG TABLET|60|EA|62.2425|04/07/2017||Yes|No||04/07/2017||Yes|No|04/07/2017||Yes|No||||No|No|||Prescription required|No||239|No|141.855|04/06/2021|139.8285|04/06/2021|133.17|04/06/2021|||ONCOLOGY: ORAL - OTHER|21301|||||No|No||CLOVIS ONCOLOGY|No||||
rucaparib camsylate|No|No|No|No|75%|69660020291|RUBRACA 250 MG TABLET|60|EA|62.2425|07/10/2017||Yes|No||07/10/2017||Yes|No|07/10/2017||Yes|No||||No|No|||Prescription required|No||239|No|141.855|04/06/2021|139.8285|04/06/2021|133.17|04/06/2021|||ONCOLOGY: ORAL - OTHER|21302|||||No|No||CLOVIS ONCOLOGY|No||||
rucaparib camsylate|No|No|No|No|75%|69660020391|RUBRACA 300 MG TABLET|60|EA|62.2425|04/24/2017||Yes|No||04/24/2017||Yes|No|04/24/2017||Yes|No||||No|No|||Prescription required|No||239|No|141.855|04/06/2021|139.8285|04/06/2021|133.17|04/06/2021|||ONCOLOGY: ORAL - OTHER|21303|||||No|No||CLOVIS ONCOLOGY|No||||
cyanocobalamin (vitamin B-12)|No|No|No|No|75%|69680011225|CYANOCOBALAMIN 1,000 MCG/ML VL|1|ML|1.3846|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|No|||No|2.89168|03/29/2022|2.82227|03/29/2022|2.84107|03/29/2022||||21304|||||No|No||VITRUVIAS THERA|No||||
cyanocobalamin (vitamin B-12)|No|No|No|No|75%|69680011399|CYANOCOBALAMIN 10,000 MCG/10ML|10|ML|.67295|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|No|||No|1.44368|03/01/2022|1.40903|03/01/2022|1.41841|03/01/2022||||21305|||||No|No||VITRUVIAS THERA|No||||
aminocaproic acid|No|No|No|No|75%|69680011530|AMINOCAPROIC ACID 500 MG TAB|30|EA|12.69468|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No|||No|18.29528|02/26/2019|18.03392|02/26/2019|17.17516|02/26/2019||||21306|||||No|No||VITRUVIAS THERA|No||||
aminocaproic acid|No|No|No|No|75%|69680011630|AMINOCAPROIC ACID 1,000 MG TAB|30|EA|22.85048|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No|||No|32.93158|02/26/2019|32.46113|02/26/2019|30.91536|02/26/2019||||21307|||||No|No||VITRUVIAS THERA|No||||
lidocaine|No|No|No|No|75%|69680012035|LIDOCAINE 5% OINTMENT|35.44|GM|.26328|03/19/2018||Yes|No||03/19/2018||Yes|No|03/19/2018||Yes|No||||No|No|||Prescription required|No|||No|.18796|03/29/2022|.18344|03/29/2022|.18467|03/29/2022||||21308|||||No|No||VITRUVIAS THERA|No||||
cyanocobalamin (vitamin B-12)|No|No|No|No|75%|69680012130|CYANOCOBALAMIN 30,000 MCG/30ML|30|ML|.84566|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|1.92732|02/02/2022|1.89979|02/02/2022|1.80932|02/02/2022||||21309|||||No|No||VITRUVIAS THERA|No||||
propafenone HCl|No|No|No|No|75%|69680013060|PROPAFENONE HCL ER 225 MG CAP|60|EA|.53742|05/31/2019||Yes|No||05/31/2019||Yes|No|05/31/2019||Yes|No||||No|No|||Prescription required|No|||No|1.23841|03/29/2022|1.20868|03/29/2022|1.21673|03/29/2022||||21310|||||No|No||VITRUVIAS THERA|No||||
propafenone HCl|No|No|No|No|75%|69680013160|PROPAFENONE HCL ER 325 MG CAP|60|EA|.60909|05/31/2019||Yes|No||05/31/2019||Yes|No|05/31/2019||Yes|No||||No|No|||Prescription required|No|||No|2.24387|03/29/2022|2.19001|03/29/2022|2.2046|03/29/2022||||21311|||||No|No||VITRUVIAS THERA|No||||
propafenone HCl|No|No|No|No|75%|69680013260|PROPAFENONE HCL ER 425 MG CAP|60|EA|.60909|05/31/2019||Yes|No||05/31/2019||Yes|No|05/31/2019||Yes|No||||No|No|||Prescription required|No|||No|1.38817|03/23/2021|1.36833|03/23/2021|1.30318|03/23/2021||||21312|||||No|No||VITRUVIAS THERA|No||||
potassium chloride|No|No|No|No|75%|69680013300|POTASSIUM CL ER 10 MEQ TABLET|100|EA|.13738|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|No|||No|.13824|03/29/2022|.13492|03/29/2022|.13582|03/29/2022||||21313|||||No|No||VITRUVIAS THERA|No||||
potassium chloride|No|No|No|No|75%|69680013392|POTASSIUM CL ER 10 MEQ TABLET|500|EA|.09619|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|No|||No|.13824|03/29/2022|.13492|03/29/2022|.13582|03/29/2022||||21314|||||No|No||VITRUVIAS THERA|No||||
potassium chloride|No|No|No|No|75%|69680013393|POTASSIUM CL ER 10 MEQ TABLET|1000|EA|.08544|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|No|||No|.13824|03/29/2022|.13492|03/29/2022|.13582|03/29/2022||||21315|||||No|No||VITRUVIAS THERA|No||||
potassium chloride|No|No|No|No|75%|69680013400|POTASSIUM CL ER 20 MEQ TABLET|100|EA|.16851|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|No|||No|.25896|03/29/2022|.25274|03/29/2022|.25442|03/29/2022||||21316|||||No|No||VITRUVIAS THERA|No||||
celecoxib|No|No|No|No|75%|69680013500|CELECOXIB 200 MG CAPSULE|100|EA|.11825|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|21317|||||No|No||VITRUVIAS THERA|No||||
sevelamer carbonate|No|No|No|No|75%|69680014395|SEVELAMER CARBONATE 800 MG TAB|270|EA|.07325|09/20/2021||Yes|No||09/20/2021||Yes|No|09/20/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|052|Yes|.27122|03/29/2022|.26471|03/29/2022|.26647|03/29/2022|||PHOSPHATE BINDERS|21318|||||No|No||VITRUVIAS THERA|No||||
lactic acid/citric/potassium|Yes|Yes|No|No|75%|69751010012|PHEXXI 1.8-1-0.4% VAGINAL GEL|5|GM|2.107|02/02/2021||Yes|No||||No|No|||No|No||||No|No|02/02/2021||Prescription required|No|||No|4.70897|10/12/2021|4.59595|10/12/2021|4.62656|10/12/2021||||21319|||||No|No||EVOFEM BIOSCIEN|No||||
polyethylene glycol 3350|No|No|No|No|75%|69784018010|POLYETHYLENE GLYCOL 3350 POWD|100|EA|.66972|10/19/2018||Yes|No||10/19/2018||Yes|No|10/19/2018||Yes|No||||No|No|||Over the counter|No|||No|1.51205|03/29/2022|1.47576|03/29/2022|1.48558|03/29/2022||||21320|||||No|No||WOODWARD PHARMA|No||||
polyethylene glycol 3350|No|No|No|No|75%|69784018014|POLYETHYLENE GLYCOL 3350 POWD|14|EA|.72455|10/19/2018||Yes|No||10/19/2018||Yes|No|10/19/2018||Yes|No||||No|No|||Over the counter|No|||No|1.51205|03/29/2022|1.47576|03/29/2022|1.48558|03/29/2022||||21321|||||No|No||WOODWARD PHARMA|No||||
polyethylene glycol 3350|No|No|No|No|75%|69784018030|POLYETHYLENE GLYCOL 3350 POWD|30|EA|.64772|04/23/2019||Yes|No||||No|No|04/23/2019||Yes|No||||No|No|||Over the counter|No|||No|1.51205|03/29/2022|1.47576|03/29/2022|1.48558|03/29/2022||||21322|||||No|No||WOODWARD PHARMA|No||||
cromolyn sodium|No|No|No|No|75%|69784020096|CROMOLYN 100 MG/5 ML ORAL CONC|5|ML|.17916|05/25/2018||Yes|No||05/25/2018||Yes|No|05/25/2018||Yes|No||||No|No|||Prescription required|No|||No|.44235|03/29/2022|.43173|03/29/2022|.4346|03/29/2022||||21323|||||No|No||WOODWARD PHARMA|No||||
cromolyn sodium|No|No|No|No|75%|69784020560|CROMOLYN 20 MG/2 ML NEB SOLN|2|ML|3.88612|01/03/2018||Yes|No||01/03/2018||Yes|No|01/03/2018||Yes|No||||No|No|||Prescription required|No|||No|8.85675|04/24/2018|8.73022|04/24/2018|8.3145|04/24/2018||||21324|||||No|No||WOODWARD PHARMA|No||||
omega-3 acid ethyl esters|No|No|No|No|75%|69784042012|LOVAZA 1 GM CAPSULE|120|EA|1.4186|09/02/2021||Yes|No||09/02/2021||Yes|No|09/02/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|055|Yes|3.19816|10/12/2021|3.1214|10/12/2021|3.14219|10/12/2021|||LIPOTROPICS: OTHER|21325|||||No|No||WOODWARD PHARMA|No||||
naproxen|No|No|No|No|75%|69784050001|EC-NAPROXEN DR 500 MG TABLET|100|EA|1.80806|06/05/2019||Yes|No||06/05/2019||Yes|No|06/05/2019||Yes|No||||No|No|||Prescription required|Yes|01/27/2018|059|Yes|3.24464|03/29/2022|3.16676|03/29/2022|3.18785|03/29/2022|||NSAIDS|21326|||||No|No||WOODWARD PHARMA|No||||
naproxen|No|No|No|No|75%|69784050101|EC-NAPROXEN DR 375 MG TABLET|100|EA|1.48023|06/05/2019||Yes|No||06/05/2019||Yes|No|06/05/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.40508|01/25/2022|.39535|01/25/2022|.39799|01/25/2022|||NSAIDS|21327|||||No|No||WOODWARD PHARMA|No||||
naproxen sodium|No|No|No|No|75%|69784055001|NAPROXEN SODIUM 550 MG TAB|100|EA|.25692|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|059|Yes|.37204|03/29/2022|.36311|03/29/2022|.36552|03/29/2022|||NSAIDS|21328|||||No|No||WOODWARD PHARMA|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|69784070030|OMEPRAZOLE-BICARB 40-1,100 CAP|30|EA|.71666|09/02/2021||Yes|No||09/02/2021||Yes|No|09/02/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|No|1.14084|03/29/2022|1.11345|03/29/2022|1.12087|03/29/2022|||PROTON PUMP INHIBITORS|21329|||||No|No||WOODWARD PHARMA|No||||
omeprazole/sodium bicarbonate|No|No|No|No|75%|69784070130|OMEPRAZOLE-BICARB 20-1,100 CAP|30|EA|.71666|09/02/2021||Yes|No||09/02/2021||Yes|No|09/02/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|No|1.11633|03/29/2022|1.08953|03/29/2022|1.09679|03/29/2022|||PROTON PUMP INHIBITORS|21330|||||No|No||WOODWARD PHARMA|No||||
triheptanoin|No|No|No|No|75%|69794005050|DOJOLVI LIQUID|500|ML|4.44362|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No|||No|10.12732|01/11/2022|9.98264|01/11/2022|9.50728|01/11/2022||||21331|||||No|No||ULTRAGENYX PHAR|No||||
clozapine|No|No|No|No|75%|69809012605|CLOZARIL 25 MG TABLET|100|EA|2.43096|11/07/2017||Yes|No||11/07/2017||Yes|No|11/07/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|027|Yes|5.54033|04/03/2018|5.46118|04/03/2018|5.20112|04/03/2018|||ANTIPSYCHOTICS|21332|||||No|No||HLS THERAPEUTIC|No||||
clozapine|No|No|No|No|75%|69809012705|CLOZARIL 100 MG TABLET|100|EA|6.29825|11/07/2017||Yes|No||11/07/2017||Yes|No|11/07/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|027|Yes|14.35415|06/23/2020|14.14909|06/23/2020|13.47533|06/23/2020|||ANTIPSYCHOTICS|21333|||||No|No||HLS THERAPEUTIC|No||||
octreotide acetate|No|No|No|No|75%|69880012028|MYCAPSSA DR 20 MG CAPSULE|28|EA|43.20056|03/09/2022||Yes|No||03/09/2022||Yes|No|03/09/2022||Yes|No||||No|No|||Prescription required|No|||No|98.45709|12/07/2021|97.05056|12/07/2021|92.4291|12/07/2021||||21334|||||No|No||CHIASMA INC.|No||||
antihem.FVIII,sin-chn,B-dm tru|No|No|No|No|75%|69911047402|AFSTYLA 250 UNIT VIAL|1|EA|1.1832|02/08/2017||Yes|No||02/08/2017||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.7052|10/05/2021|1.68084|10/05/2021|1.6008|10/05/2021|||HEMOPHILIA TREATMENT|21335|||||No|No||CSL BEHRING LLC|No||||
antihem.FVIII,sin-chn,B-dm tru|No|No|No|No|75%|69911047502|AFSTYLA 500 UNIT VIAL|1|EA|1.1832|02/08/2017||Yes|No||02/08/2017||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.7052|10/05/2021|1.68084|10/05/2021|1.6008|10/05/2021|||HEMOPHILIA TREATMENT|21336|||||No|No||CSL BEHRING LLC|No||||
antihem.FVIII,sin-chn,B-dm tru|No|No|No|No|75%|69911047602|AFSTYLA 1,000 UNIT VIAL|1|EA|1.1832|02/08/2017||Yes|No||02/08/2017||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.7052|10/05/2021|1.68084|10/05/2021|1.6008|10/05/2021|||HEMOPHILIA TREATMENT|21337|||||No|No||CSL BEHRING LLC|No||||
antihem.FVIII,sin-chn,B-dm tru|No|No|No|No|75%|69911047702|AFSTYLA 2,000 UNIT VIAL|1|EA|1.1832|02/08/2017||Yes|No||02/08/2017||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.7052|10/05/2021|1.68084|10/05/2021|1.6008|10/05/2021|||HEMOPHILIA TREATMENT|21338|||||No|No||CSL BEHRING LLC|No||||
antihem.FVIII,sin-chn,B-dm tru|No|No|No|No|75%|69911047802|AFSTYLA 3,000 UNIT VIAL|1|EA|1.1832|02/08/2017||Yes|No||02/08/2017||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.7052|10/05/2021|1.68084|10/05/2021|1.6008|10/05/2021|||HEMOPHILIA TREATMENT|21339|||||No|No||CSL BEHRING LLC|No||||
factor IX recom,albumin fusion|No|No|No|No|75%|69911086402|IDELVION 250 UNIT RANGE VIAL|1|EA|3.2572|11/22/2016||Yes|No||11/22/2016||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|4.6942|10/05/2021|4.62714|10/05/2021|4.4068|10/05/2021|||HEMOPHILIA TREATMENT|21340|||||No|No||CSL BEHRING LLC|No||||
factor IX recom,albumin fusion|No|No|No|No|75%|69911086502|IDELVION 500 UNIT RANGE VIAL|1|EA|3.2572|11/22/2016||Yes|No||11/22/2016||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|4.6942|10/05/2021|4.62714|10/05/2021|4.4068|10/05/2021|||HEMOPHILIA TREATMENT|21341|||||No|No||CSL BEHRING LLC|No||||
factor IX recom,albumin fusion|No|No|No|No|75%|69911086602|IDELVION 1,000 UNIT RANGE VIAL|1|EA|3.2572|11/22/2016||Yes|No||11/22/2016||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|4.6942|10/05/2021|4.62714|10/05/2021|4.4068|10/05/2021|||HEMOPHILIA TREATMENT|21342|||||No|No||CSL BEHRING LLC|No||||
factor IX recom,albumin fusion|No|No|No|No|75%|69911086702|IDELVION 2,000 UNIT RANGE VIAL|1|EA|3.2572|11/22/2016||Yes|No||11/22/2016||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|4.6942|10/05/2021|4.62714|10/05/2021|4.4068|10/05/2021|||HEMOPHILIA TREATMENT|21343|||||No|No||CSL BEHRING LLC|No||||
factor IX recom,albumin fusion|No|No|No|No|75%|69911086902|IDELVION 3,500 UNIT RANGE VIAL|1|EA|3.2572|02/08/2021||Yes|No||02/08/2021||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|4.6942|10/05/2021|4.62714|10/05/2021|4.4068|10/05/2021|||HEMOPHILIA TREATMENT|21344|||||No|No||CSL BEHRING LLC|No||||
desmopressin acetate|No|No|No|No|75%|69918010101|DESMOPRESSIN ACETATE 0.1 MG TB|100|EA|.45098|12/01/2015||Yes|No||12/01/2015||Yes|No|12/01/2015||Yes|No||||No|No|||Prescription required|No|||Yes|.41734|03/29/2022|.40732|03/29/2022|.41003|03/29/2022||||21345|||||No|No||AMRING PHARMACE|No||||
desmopressin acetate|No|No|No|No|75%|69918020101|DESMOPRESSIN ACETATE 0.2 MG TB|100|EA|.50632|12/01/2015||Yes|No||12/01/2015||Yes|No|12/01/2015||Yes|No||||No|No|||Prescription required|No|||Yes|.446|03/29/2022|.43529|03/29/2022|.43819|03/29/2022||||21346|||||No|No||AMRING PHARMACE|No||||
tranexamic acid|No|No|No|No|75%|69918030130|TRANEXAMIC ACID 650 MG TABLET|30|EA|2.95482|03/15/2016||Yes|No||03/15/2016||Yes|No|01/01/2021||Yes|No||||No|No|||Prescription required|No|||No|1.67932|03/29/2022|1.63901|03/29/2022|1.64993|03/29/2022||||21347|||||No|No||AMRING PHARMACE|No||||
mesalamine|No|No|No|No|75%|69918056030|MESALAMINE 1,000 MG SUPP|30|EA|6.66084|09/12/2019||Yes|No||09/12/2019||Yes|No|09/12/2019||Yes|No||||No|No|||Prescription required|No||010|No|2.81018|03/29/2022|2.74273|03/29/2022|2.761|03/29/2022|||ULCERATIVE COLITIS AGENTS|21348|||||No|No||AMRING PHARMACE|No||||
desmopressin acetate|No|No|No|No|75%|69918089910|DESMOPRESSIN AC 4 MCG/ML AMPUL|1|ML|25.28099|05/01/2017||Yes|No||05/01/2017||Yes|No|05/01/2017||Yes|No||||No|No|||Prescription required|No|||Yes|57.61714|06/01/2016|56.79403|06/01/2016|54.08956|06/01/2016||||21349|||||No|No||AMRING PHARMACE|No||||
desmopressin acetate|No|No|No|No|75%|69918090110|DESMOPRESSIN 40 MCG/10 ML VIAL|10|ML|25.5936|12/01/2015||Yes|No||12/01/2015||Yes|No|12/01/2015||Yes|No||||No|No|||Prescription required|No|||Yes|58.3296|06/01/2016|57.49632|06/01/2016|54.7584|06/01/2016||||21350|||||No|No||AMRING PHARMACE|No||||
allopurinol|No|No|No|No|75%|69967000801|ALLOPURINOL 100 MG TABLET|100|EA|.0473|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|21351|||||No|No||ARISE PHARMACEU|No||||
allopurinol|No|No|No|No|75%|69967000803|ALLOPURINOL 100 MG TABLET|1000|EA|.04271|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|No||231|No|.05549|03/29/2022|.05415|03/29/2022|.05451|03/29/2022|||ANTIHYPERURICEMICS|21352|||||No|No||ARISE PHARMACEU|No||||
allopurinol|No|No|No|No|75%|69967000901|ALLOPURINOL 300 MG TABLET|100|EA|.086|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|21353|||||No|No||ARISE PHARMACEU|No||||
allopurinol|No|No|No|No|75%|69967000902|ALLOPURINOL 300 MG TABLET|500|EA|.08578|11/24/2020||Yes|No||11/24/2020||Yes|No|11/24/2020||Yes|No||||No|No|||Prescription required|No||231|No|.08312|03/29/2022|.08112|03/29/2022|.08166|03/29/2022|||ANTIHYPERURICEMICS|21354|||||No|No||ARISE PHARMACEU|No||||
oxymetazoline HCl|No|No|No|No|75%|70000000101|NASAL SPRAY 0.05%|30|ML||09/29/2020||Yes|No||||No|No|09/29/2020||Yes|No||||No|No|||Over the counter|No||182|Yes|.07205|03/29/2022|.07032|03/29/2022|.07078|03/29/2022|||COUGH AND COLD: COLD|21355|||||No|No||LEADER|No||||
pseudoephedrine HCl|No|No|No|No|75%|70000000201|NASAL DECONGESTANT 30 MG TAB|24|EA||06/19/2020||Yes|No||||No|No|06/19/2020||Yes|No||||No|No|||Over the counter|No|||No|.05204|03/29/2022|.05079|03/29/2022|.05112|03/29/2022||||21356|||||No|No||LEADER|No||||
pseudoephedrine HCl|No|No|No|No|75%|70000000202|NASAL DECONGESTANT 30 MG TAB|96|EA||09/18/2020||Yes|No||||No|No|09/18/2020||Yes|No||||No|No|||Over the counter|No|||No|.05204|03/29/2022|.05079|03/29/2022|.05112|03/29/2022||||21357|||||No|No||LEADER|No||||
ibuprofen|No|No|No|No|75%|70000000301|IBUPROFEN 200 MG CAPLET|50|EA||06/17/2020||Yes|No||||No|No|06/17/2020||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|21358|||||No|No||LEADER|No||||
guaifenesin/pseudoephedrne HCl|No|No|No|No|75%|70000000401|MUCUS RELIEF D ER 600-60 MG TB|36|EA||06/17/2020|03/08/2022|Yes|No||||No|No|06/17/2020|03/08/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|||||||||COUGH AND COLD: COLD|21359|No Longer Rebatable||No Longer Rebatable||No|No||LEADER|No||||
guaifenesin/pseudoephedrne HCl|No|No|No|No|75%|70000000402|MUCUS RELIEF D ER 600-60 MG TB|18|EA||06/17/2020|03/08/2022|Yes|No||||No|No|06/17/2020|03/08/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|||||||||COUGH AND COLD: COLD|21360|No Longer Rebatable||No Longer Rebatable||No|No||LEADER|No||||
diphenhyd/phenyleph/acetaminop|No|No|No|No|75%|70000000601|NIGHT SEVERE COLD-COUGH PKT|6|EA||10/16/2020||Yes|No||||No|No|10/16/2020||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|||||||.45036|10/16/2020|COUGH AND COLD: COLD|21361|||||No|No||LEADER|No||||
guaifen/dextromethorphan/PE|No|No|No|No|75%|70000000701|TUSSIN CF MULTI-SYMPTOM COLD|237|ML||06/24/2020||Yes|No||||No|No|06/24/2020||Yes|No||||No|No|||Over the counter|No||184|Yes|.01659|03/29/2022|.01619|03/29/2022|.01629|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21362|||||No|No||LEADER|No||||
naphazoline HCl/glycerin|No|No|No|No|75%|70000001001|REDNESS RELIEF EYE DROPS|15|ML||03/16/2020||Yes|No||||No|No|03/16/2020||Yes|No||||No|No|||Over the counter|No|||No|.104|03/29/2022|.1015|03/29/2022|.10218|03/29/2022||||21363|||||No|No||LEADER|No||||
naphazoline HCl/glycerin|No|No|No|No|75%|70000001002|REDNESS RELIEF EYE DROPS|30|ML||04/23/2021||Yes|No||||No|No|04/23/2021||Yes|No||||No|No|||Over the counter|No|||No|||||||.09034|04/23/2021||21364|||||No|No||LEADER|No||||
carboxymethylcellulose sodium|No|No|No|No|75%|70000001201|LUBRICANT 0.5% EYE DROPS|70|EA||12/08/2020||Yes|No||||No|No|12/08/2020||Yes|No||||No|No|||Over the counter|No|||No|||||||.32429|12/08/2020||21365|||||No|No||LEADER|No||||
carboxymethylcellulose sodium|No|No|No|No|75%|70000001202|LUBRICANT 0.5% EYE DROPS|30|EA||05/19/2021||Yes|No||||No|No|05/19/2021||Yes|No||||No|No|||Over the counter|No|||No|.18927|03/29/2022|.18472|03/29/2022|.18595|03/29/2022||||21366|||||No|No||LEADER|No||||
propylene glycol|No|No|No|No|75%|70000001302|LUBRICANT 0.6% EYE DROP|15|ML||11/23/2021||Yes|No||||No|No|11/23/2021||Yes|No||||No|No|||Over the counter|No|||No|.13933|01/25/2022|.13598|01/25/2022|.13689|01/25/2022||||21367|||||No|No||LEADER|No||||
sod borate/boric ac/water/NaCl|No|No|No|No|75%|70000001801|EYE WASH IRRIGATING SOLUTION|118|ML||04/23/2021||Yes|No||||No|No|04/23/2021||Yes|No||||No|No|||Over the counter|No|||No|.02249|05/25/2021|.02195|05/25/2021|.02209|05/25/2021||||21368|||||No|No||LEADER|No||||
miconazole nitrate|No|No|No|No|75%|70000002501|MICONAZOLE 3 COMBO PACK|1|EA||03/10/2020||Yes|No||||No|No|03/10/2020||Yes|No||||No|No|||Over the counter|No|||No|7.82889|03/29/2022|7.64099|03/29/2022|7.69188|03/29/2022||||21369|||||No|No||LEADER|No||||
miconazole nitrate|No|No|No|No|75%|70000002502|MICONAZOLE 3 COMBO PACK|1|EA||09/18/2020||Yes|No||||No|No|09/18/2020||Yes|No||||No|No|||Over the counter|No|||No|7.82889|03/29/2022|7.64099|03/29/2022|7.69188|03/29/2022||||21370|||||No|No||LEADER|No||||
esomeprazole magnesium|No|No|No|No|75%|70000003201|ESOMEPRAZOLE MAG DR 20 MG CAP|14|EA||05/06/2020||Yes|No||05/06/2020||Yes|No|05/06/2020||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.3522|03/29/2022|.34374|03/29/2022|.34603|03/29/2022|||PROTON PUMP INHIBITORS|21371|||||No|No||LEADER|No||||
esomeprazole magnesium|No|No|No|No|75%|70000003202|ESOMEPRAZOLE MAG DR 20 MG CAP|28|EA||05/06/2020||Yes|No||05/06/2020||Yes|No|05/06/2020||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.3522|03/29/2022|.34374|03/29/2022|.34603|03/29/2022|||PROTON PUMP INHIBITORS|21372|||||No|No||LEADER|No||||
esomeprazole magnesium|No|No|No|No|75%|70000003203|ESOMEPRAZOLE MAG DR 20 MG CAP|42|EA||05/07/2020||Yes|No||||No|No|05/07/2020||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.3522|03/29/2022|.34374|03/29/2022|.34603|03/29/2022|||PROTON PUMP INHIBITORS|21373|||||No|No||LEADER|No||||
calcium carbonate|No|No|No|No|75%|70000003401|ANTACID 500 MG CHEW TABLET|150|EA||03/10/2020||Yes|No||||No|No|03/10/2020||Yes|No||||No|No|||Over the counter|No|||No|.01526|03/29/2022|.01489|03/29/2022|.01499|03/29/2022||||21374|||||No|No||LEADER|No||||
permethrin|No|No|No|No|75%|70000004101|LICE TREATMENT 1% CREME RINSE|59|ML||05/18/2021||Yes|No||||No|No|05/18/2021||Yes|No||||No|No|||Over the counter|No||122|No|.10494|03/29/2022|.10242|03/29/2022|.1031|03/29/2022|||ANTIPARASITICS: TOPICAL|21375|||||No|No||LEADER|No||||
cetirizine HCl/pseudoephedrine|No|No|No|No|75%|70000004201|ALLERGY RELIEF-D TABLET|24|EA||09/18/2020||Yes|No||||No|No|09/18/2020||Yes|No||||No|No|||Over the counter|Yes|12/01/2021|030|Yes|.59854|03/29/2022|.58417|03/29/2022|.58806|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21376|||||No|No||LEADER|No||||
adapalene|No|No|No|No|75%|70000004301|ADAPALENE 0.1% GEL|15|GM||02/05/2021||Yes|No||||No|No|02/05/2021||Yes|No||||No|No|||Over the counter|No|||No|.46306|06/29/2021|.45194|06/29/2021|.45495|06/29/2021||||21377|||||No|No||LEADER|No||||
adapalene|No|No|No|No|75%|70000004302|ADAPALENE 0.1% GEL|45|GM||02/05/2021||Yes|No||||No|No|02/05/2021||Yes|No||||No|No|||Over the counter|No|||No|.3458|03/29/2022|.3375|03/29/2022|.33974|03/29/2022||||21378|||||No|No||LEADER|No||||
bismuth subsalicylate|No|No|No|No|75%|70000004401|STOMACH RLF 525 MG/30 ML SUSP|118|ML||12/08/2020||Yes|No||||No|No|12/08/2020||Yes|No||||No|No|||Over the counter|No|||No|.01273|03/29/2022|.01242|03/29/2022|.0125|03/29/2022||||21379|||||No|No||LEADER|No||||
bismuth subsalicylate|No|No|No|No|75%|70000004402|STOMACH RLF 525 MG/30 ML SUSP|237|ML||09/18/2020||Yes|No||||No|No|09/18/2020||Yes|No||||No|No|||Over the counter|No|||No|.01036|03/29/2022|.01011|03/29/2022|.01017|03/29/2022||||21380|||||No|No||LEADER|No||||
cetirizine HCl|No|No|No|No|75%|70000004701|ALL DAY ALLERGY 10 MG TABLET|365|EA||12/03/2020||Yes|No||||No|No|12/03/2020||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21381|||||No|No||LEADER|No||||
famotidine|No|No|No|No|75%|70000004801|ACID REDUCER 10 MG TABLET|30|EA||02/04/2021||Yes|No||||No|No|02/04/2021||Yes|No||||No|No|||Over the counter|No|||No|.09993|03/29/2022|.09753|03/29/2022|.09818|03/29/2022||||21382|||||No|No||LEADER|No||||
famotidine|No|No|No|No|75%|70000004901|ACID REDUCER 20 MG TABLET|25|EA||02/04/2021||Yes|No||||No|No|02/04/2021||Yes|No||||No|No|||Over the counter|No|||No|.14581|03/29/2022|.14231|03/29/2022|.14325|03/29/2022||||21383|||||No|No||LEADER|No||||
dextromethorphn/acetaminoph/cp|No|No|No|No|75%|70000005001|FLU HBP 325-2-10 MG CAPLET|20|EA||02/26/2021||Yes|No||||No|No|02/26/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|No|||||||.14168|02/26/2021|COUGH AND COLD: NON-NARCOTIC|21384|||||No|No||LEADER|No||||
simethicone|No|No|No|No|75%|70000005101|INFANTS' GAS RLF 20 MG/0.3 ML|30|ML||05/19/2021||Yes|No||||No|No|05/19/2021||Yes|No||||No|No|||Over the counter|No|||No|.0916|03/29/2022|.0894|03/29/2022|.08999|03/29/2022||||21385|||||No|No||LEADER|No||||
olopatadine HCl|No|No|No|No|75%|70000005301|EYE ALLERGY ITCH RLF 0.2% DROP|2.5|ML||08/12/2021||Yes|No||||No|No|08/12/2021||Yes|No||||No|No|||Over the counter|Yes|01/28/2021|002|No|3.64128|03/29/2022|3.55388|03/29/2022|3.57755|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|21386|||||No|No||LEADER|No||||
olopatadine HCl|No|No|No|No|75%|70000005401|EYE ALLERGY ITCH-RED 0.1% DROP|5|ML||08/12/2021||Yes|No||||No|No|08/12/2021||Yes|No||||No|No|||Over the counter|Yes|01/28/2021|002|No|1.29385|03/29/2022|1.26279|03/29/2022|1.2712|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|21387|||||No|No||LEADER|No||||
guaifenesin|No|No|No|No|75%|70000005501|CHEST CONGEST RLF 400 MG TAB|60|EA||01/10/2022||Yes|No||||No|No|01/10/2022||Yes|No||||No|No|||Over the counter|No||182|Yes|.06856|03/29/2022|.06691|03/29/2022|.06736|03/29/2022|||COUGH AND COLD: COLD|21388|||||No|No||LEADER|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|70000005601|CHEST CONG RLF DM 400-20 MG TB|60|EA||01/10/2022||Yes|No||||No|No|01/10/2022||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.07712|03/29/2022|.07526|03/29/2022|.07577|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21389|||||No|No||LEADER|No||||
mag hydrox/aluminum hyd/simeth|No|No|No|No|75%|70000006201|ANTACID ANTI-GAS MAX STR LIQ|355|ML||08/12/2021||Yes|No||||No|No|08/12/2021||Yes|No||||No|No|||Over the counter|No|||No|.00902|03/29/2022|.0088|03/29/2022|.00886|03/29/2022||||21390|||||No|No||LEADER|No||||
mag hydrox/aluminum hyd/simeth|No|No|No|No|75%|70000006301|ANTACID-ANTIGAS LIQUID|355|ML||08/13/2021||Yes|No||||No|No|08/13/2021||Yes|No||||No|No|||Over the counter|No|||No|.00773|03/29/2022|.00754|03/29/2022|.00759|03/29/2022||||21391|||||No|No||LEADER|No||||
lansoprazole|No|No|No|No|75%|70000006901|LANSOPRAZOLE DR 15 MG CAPSULE|14|EA||08/13/2021||Yes|No||||No|No|08/13/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.43525|03/29/2022|.4248|03/29/2022|.42763|03/29/2022|||PROTON PUMP INHIBITORS|21392|||||No|No||LEADER|No||||
lansoprazole|No|No|No|No|75%|70000006902|LANSOPRAZOLE DR 15 MG CAPSULE|28|EA||08/13/2021||Yes|No||||No|No|08/13/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.43525|03/29/2022|.4248|03/29/2022|.42763|03/29/2022|||PROTON PUMP INHIBITORS|21393|||||No|No||LEADER|No||||
lansoprazole|No|No|No|No|75%|70000006903|LANSOPRAZOLE DR 15 MG CAPSULE|42|EA||08/13/2021||Yes|No||||No|No|08/13/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|Yes|.43525|03/29/2022|.4248|03/29/2022|.42763|03/29/2022|||PROTON PUMP INHIBITORS|21394|||||No|No||LEADER|No||||
diphenhydramine HCl|No|No|No|No|75%|70000008601|SLEEP AID 25 MG LIQUID GEL|12|EA||08/26/2021||Yes|No||||No|No|08/26/2021||Yes|No||||No|No|||Over the counter|No|||No|||||||.35345|08/26/2021||21395|||||No|No||LEADER|No||||
acetaminophen|No|No|No|No|75%|70000009201|ACETAMINOPHEN 325 MG TABLET|100|EA||01/10/2022||Yes|No||||No|No|01/10/2022||Yes|No||||No|No|||Over the counter|No|||No|.02412|03/29/2022|.02354|03/29/2022|.02369|03/29/2022||||21396|||||No|No||LEADER|No||||
esomeprazole magnesium|No|No|No|No|75%|70000009501|ESOMEPRAZOLE MAG DR 20 MG TAB|14|EA||02/17/2022||Yes|No||||No|No|02/17/2022||Yes|No||||No|No|||Over the counter|Yes|03/01/2022|047|Yes|||||||.35214|02/17/2022|PROTON PUMP INHIBITORS|21397|||||No|No||LEADER|No||||
meclizine HCl|No|No|No|No|75%|70000009701|MOTION SICKNESS RLF 25 MG TAB|32|EA||01/10/2022||Yes|No||||No|No|01/10/2022||Yes|No||||No|No|||Over the counter|No||085|Yes|.13988|03/29/2022|.13652|03/29/2022|.13743|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|21398|||||No|No||LEADER|No||||
fluticasone propionate|No|No|No|No|75%|70000011001|ALLERGY RELIEF 50 MCG SPRAY|15.8|ML||11/13/2019||Yes|No||||No|No|11/13/2019||Yes|No||||No|No|||Over the counter|Yes|07/21/2016|019|No|.82699|03/29/2022|.80714|03/29/2022|.81251|03/29/2022|||INTRANASAL RHINITIS AGENTS|21399|||||No|No||LEADER|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|70000013101|CHILD MUCUS-COUGH RELIEF LIQ|118|ML||11/19/2019|05/19/2022|Yes|No||||No|No|11/19/2019|05/19/2022|Yes|No||||No|No|||Over the counter|No||184|Yes|.01924|03/29/2022|.01877|03/29/2022|.0189|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21400|No Longer Rebatable||No Longer Rebatable||No|No||LEADER|No||||
diphenhydramine HCl|No|No|No|No|75%|70000013602|ALLERGY RELIEF 25 MG TABLET|48|EA||11/13/2019||Yes|No||||No|No|11/13/2019||Yes|No||||No|No|||Over the counter|No||574|Yes|.03535|03/29/2022|.0345|03/29/2022|.03473|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|21401|||||No|No||LEADER|No||||
diphenhydramine HCl|No|No|No|No|75%|70000013603|ALLERGY RELIEF 25 MG TABLET|100|EA||11/13/2019||Yes|No||||No|No|11/13/2019||Yes|No||||No|No|||Over the counter|No||574|Yes|.03535|03/29/2022|.0345|03/29/2022|.03473|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|21402|||||No|No||LEADER|No||||
diphenhydramine HCl|No|No|No|No|75%|70000014401|ALLERGY RELIEF 25 MG SOFTGEL|24|EA||11/14/2019|07/06/2022|Yes|No||||No|No|11/14/2019|07/06/2022|Yes|No||||No|No|||Over the counter|No||574|Yes|.03464|03/29/2022|.0338|03/29/2022|.03403|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|21403|Discontinued by Manufacturer||Discontinued by Manufacturer||No|No||LEADER|No||||
chlorpheniramine maleate|No|No|No|No|75%|70000016001|ALLERGY RELIEF 4 MG TABLET|24|EA||11/14/2019||Yes|No||||No|No|11/14/2019||Yes|No||||No|No|||Over the counter|No||574|Yes|.01452|03/29/2022|.01417|03/29/2022|.01426|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|21404|||||No|No||LEADER|No||||
chlorpheniramine maleate|No|No|No|No|75%|70000016002|ALLERGY RELIEF 4 MG TABLET|100|EA||11/14/2019||Yes|No||||No|No|11/14/2019||Yes|No||||No|No|||Over the counter|No||574|Yes|.01452|03/29/2022|.01417|03/29/2022|.01426|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|21405|||||No|No||LEADER|No||||
phenylephrine HCl/acetaminophn|No|No|No|No|75%|70000016101|SINUS PRESSURE-PAIN CAPLET|24|EA||11/19/2019||Yes|No||||No|No|11/19/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|No|.06294|03/29/2022|.06142|03/29/2022|.06183|03/29/2022|||COUGH AND COLD: COLD|21406|||||No|No||LEADER|No||||
loratadine/pseudoephedrine|No|No|No|No|75%|70000016201|ALLERGY RELIEF D-24HR TABLET|10|EA||01/30/2020||Yes|No||||No|No|01/30/2020||Yes|No||||No|No|||Over the counter|Yes|01/31/2019|030|Yes|.51383|03/29/2022|.50149|03/29/2022|.50483|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21407|||||No|No||LEADER|No||||
loratadine/pseudoephedrine|No|No|No|No|75%|70000016202|ALLERGY RELIEF D-24HR TABLET|15|EA||01/30/2020||Yes|No||||No|No|01/30/2020||Yes|No||||No|No|||Over the counter|Yes|01/31/2019|030|Yes|.51383|03/29/2022|.50149|03/29/2022|.50483|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21408|||||No|No||LEADER|No||||
naproxen sodium|No|No|No|No|75%|70000017103|ALL DAY PAIN RELIEF 220 MG TAB|50|EA||05/07/2020||Yes|No||||No|No|05/07/2020||Yes|No||||No|No|||Over the counter|No||059|Yes|.0581|03/29/2022|.0567|03/29/2022|.05708|03/29/2022|||NSAIDS|21409|||||No|No||LEADER|No||||
diphenhydramine HCl|No|No|No|No|75%|70000017401|SLEEP AID 50 MG/30 ML LIQUID|354|ML||09/25/2020||Yes|No||||No|No|09/25/2020||Yes|No||||No|No|||Over the counter|No|||No|.00887|03/29/2022|.00865|03/29/2022|.00871|03/29/2022||||21410|||||No|No||LEADER|No||||
ibuprofen|No|No|No|No|75%|70000017502|IBUPROFEN 200 MG TABLET|50|EA||11/27/2019||Yes|No||||No|No|11/27/2019||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|21411|||||No|No||LEADER|No||||
ibuprofen|No|No|No|No|75%|70000017503|IBUPROFEN 200 MG TABLET|100|EA||11/27/2019||Yes|No||||No|No|11/27/2019||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|21412|||||No|No||LEADER|No||||
ibuprofen|No|No|No|No|75%|70000017505|IBUPROFEN 200 MG TABLET|500|EA||11/27/2019||Yes|No||||No|No|11/27/2019||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|21413|||||No|No||LEADER|No||||
aspirin|No|No|No|No|75%|70000017801|ADULT ASPIRIN REGIMEN EC 81 MG|32|EA||11/19/2019||Yes|No||||No|No|11/19/2019||Yes|No||||No|No|||Over the counter|No|||No|.01442|03/29/2022|.01407|03/29/2022|.01416|03/29/2022||||21414|||||No|No||LEADER|No||||
acetaminophen|No|No|No|No|75%|70000018002|8HR ARTHRITIS PAIN ER 650 MG|50|EA||11/27/2019||Yes|No||||No|No|11/27/2019||Yes|No||||No|No|||Over the counter|No|||No|.06737|03/29/2022|.06575|03/29/2022|.06619|03/29/2022||||21415|||||No|No||LEADER|No||||
acetaminophen|No|No|No|No|75%|70000018003|8HR ARTHRITIS PAIN ER 650 MG|100|EA||11/27/2019||Yes|No||||No|No|11/27/2019||Yes|No||||No|No|||Over the counter|No|||No|.06737|03/29/2022|.06575|03/29/2022|.06619|03/29/2022||||21416|||||No|No||LEADER|No||||
ibuprofen|No|No|No|No|75%|70000018101|CHILDREN IBUPROFEN 100 MG/5 ML|120|ML||02/10/2020||Yes|No||||No|No|02/10/2020||Yes|No||||No|No|||Over the counter|No||059|Yes|.03078|03/29/2022|.03004|03/29/2022|.03024|03/29/2022|||NSAIDS|21417|||||No|No||LEADER|No||||
DM/acetaminophen/doxylamine|No|No|No|No|75%|70000018201|NIGHTTIME COLD AND FLU LIQUID|355|ML||11/15/2019||Yes|No||||No|No|11/15/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|No|.00938|03/01/2022|.00915|03/01/2022|.00921|03/01/2022|||COUGH AND COLD: NON-NARCOTIC|21418|||||No|No||LEADER|No||||
DM/acetaminophen/doxylamine|No|No|No|No|75%|70000018302|NIGHTTIME COLD AND FLU LIQUID|237|ML||11/15/2019||Yes|No||||No|No|11/15/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|No|.01407|03/29/2022|.01373|03/29/2022|.01382|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21419|||||No|No||LEADER|No||||
DM/acetaminophen/doxylamine|No|No|No|No|75%|70000018402|NIGHTTIME COLD-FLU LIQUID|355|ML||11/15/2019|03/05/2022|Yes|No||||No|No|11/15/2019|03/05/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|No|||||||||COUGH AND COLD: NON-NARCOTIC|21420|No Longer Rebatable||No Longer Rebatable||No|No||LEADER|No||||
brompheniram/phenylephrine/DM|No|No|No|No|75%|70000018901|CHILDREN'S COLD-COUGH LIQUID|118|ML||11/14/2019||Yes|No||||No|No|11/14/2019||Yes|No||||No|No|||Over the counter|No||184|Yes|.01623|03/29/2022|.01584|03/29/2022|.01594|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21421|||||No|No||LEADER|No||||
d-methorphan/PE/acetaminophen|No|No|No|No|75%|70000019101|DAYTIME COLD-FLU RELIEF LIQUID|237|ML||11/26/2019||Yes|No||||No|No|11/26/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.01328|03/29/2022|.01296|03/29/2022|.01304|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21422|||||No|No||LEADER|No||||
d-methorphan/PE/acetaminophen|No|No|No|No|75%|70000019102|DAYTIME COLD-FLU RELIEF LIQUID|355|ML||11/20/2019||Yes|No||||No|No|11/20/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|||||||||COUGH AND COLD: NON-NARCOTIC|21423|||||No|No||LEADER|No||||
dextromethorphan polistirex|No|No|No|No|75%|70000019501|CHILD COUGH DM ER 30 MG/5 ML|89|ML||11/27/2019||Yes|No||||No|No|11/27/2019||Yes|No||||No|No|||Over the counter|No||184|Yes|.05873|03/29/2022|.05732|03/29/2022|.0577|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21424|||||No|No||LEADER|No||||
guaifen/phenyleph/acetaminophn|No|No|No|No|75%|70000019601|SINUS CONGST-PAIN 325-200-5 MG|24|EA||11/25/2019||Yes|No||||No|No|11/25/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|No|.10333|03/29/2022|.10085|03/29/2022|.10152|03/29/2022|||COUGH AND COLD: COLD|21425|||||No|No||LEADER|No||||
naproxen sodium|No|No|No|No|75%|70000020102|ALL DAY PAIN RLF 220 MG CAPLET|50|EA||05/07/2020||Yes|No||||No|No|05/07/2020||Yes|No||||No|No|||Over the counter|No||059|Yes|.0581|03/29/2022|.0567|03/29/2022|.05708|03/29/2022|||NSAIDS|21426|||||No|No||LEADER|No||||
naproxen sodium|No|No|No|No|75%|70000020103|ALL DAY PAIN RLF 220 MG CAPLET|100|EA||05/07/2020||Yes|No||||No|No|05/07/2020||Yes|No||||No|No|||Over the counter|No||059|Yes|.0581|03/29/2022|.0567|03/29/2022|.05708|03/29/2022|||NSAIDS|21427|||||No|No||LEADER|No||||
triamcinolone acetonide|No|No|No|No|75%|70000020401|NASAL ALLERGY 24HR SPRAY|16.9|ML||02/13/2020||Yes|No||||No|No|02/13/2020||Yes|No||||No|No|||Over the counter|Yes|07/27/2017|019|No|.77636|03/29/2022|.75772|03/29/2022|.76277|03/29/2022|||INTRANASAL RHINITIS AGENTS|21428|||||No|No||LEADER|No||||
diphenhydramine HCl|No|No|No|No|75%|70000020702|ALLERGY 25 MG CAPSULE|100|EA||11/14/2019||Yes|No||||No|No|11/14/2019||Yes|No||||No|No|||Over the counter|No||574|Yes|.03464|03/29/2022|.0338|03/29/2022|.03403|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|21429|||||No|No||LEADER|No||||
phenylephrine/acetaminophn/cpm|No|No|No|No|75%|70000021101|ALLERGY MULTI-SYMPTOM CAPLET|24|EA||11/25/2019||Yes|No||||No|No|11/25/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|Yes|.07275|03/29/2022|.071|03/29/2022|.07147|03/29/2022|||COUGH AND COLD: COLD|21430|||||No|No||LEADER|No||||
loratadine|No|No|No|No|75%|70000021301|ALLERGY RELIEF 10 MG TABLET|10|EA||12/06/2019||Yes|No||||No|No|12/06/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21431|||||No|No||LEADER|No||||
loratadine|No|No|No|No|75%|70000021302|ALLERGY RELIEF 10 MG TABLET|30|EA||12/06/2019||Yes|No||||No|No|12/06/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21432|||||No|No||LEADER|No||||
loratadine|No|No|No|No|75%|70000021303|ALLERGY RELIEF 10 MG TABLET|70|EA||12/06/2019||Yes|No||||No|No|12/06/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21433|||||No|No||LEADER|No||||
loratadine|No|No|No|No|75%|70000021304|ALLERGY RELIEF 10 MG TABLET|90|EA||12/06/2019||Yes|No||||No|No|12/06/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21434|||||No|No||LEADER|No||||
loratadine|No|No|No|No|75%|70000021306|ALLERGY RELIEF 10 MG TABLET|300|EA||09/18/2020||Yes|No||||No|No|09/18/2020||Yes|No||||No|No|||Over the counter|No||030|Yes|.05785|03/29/2022|.05646|03/29/2022|.05683|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21435|||||No|No||LEADER|No||||
cetirizine HCl|No|No|No|No|75%|70000021401|CHILD ALL DAY ALLERGY 1 MG/ML|118|ML||11/27/2019||Yes|No||||No|No|11/27/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.03462|03/29/2022|.03378|03/29/2022|.03401|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21436|||||No|No||LEADER|No||||
cetirizine HCl|No|No|No|No|75%|70000021501|CHILD ALL DAY ALLERGY 1 MG/ML|118|ML||11/27/2019||Yes|No||||No|No|11/27/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.03462|03/29/2022|.03378|03/29/2022|.03401|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21437|||||No|No||LEADER|No||||
aspirin|No|No|No|No|75%|70000021801|ADULT ASPIRIN REGIMEN EC 81 MG|36|EA||11/19/2019||Yes|No||||No|No|11/19/2019||Yes|No||||No|No|||Over the counter|No|||No|.01442|03/29/2022|.01407|03/29/2022|.01416|03/29/2022||||21438|||||No|No||LEADER|No||||
phenylephrine HCl/cocoa butter|No|No|No|No|75%|70000022301|HEMORRHOIDAL SUPPOSITORIES|12|EA||11/25/2019||Yes|No||||No|No|11/25/2019||Yes|No||||No|No|||Over the counter|No|||No|.18615|03/29/2022|.18168|03/29/2022|.18289|03/29/2022||||21439|||||No|No||LEADER|No||||
loperamide HCl|No|No|No|No|75%|70000022502|ANTI-DIARRHEAL 2 MG CAPLET|12|EA||06/17/2020||Yes|No||||No|No|06/17/2020||Yes|No||||No|No|||Over the counter|No|||No|.14456|03/29/2022|.14109|03/29/2022|.14203|03/29/2022||||21440|||||No|No||LEADER|No||||
omeprazole magnesium|No|No|No|No|75%|70000023201|ACID REDUCER DR 20 MG CAP|14|EA||02/13/2020||Yes|No||||No|No|02/13/2020||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|No|.34674|03/29/2022|.33841|03/29/2022|.34067|03/29/2022|||PROTON PUMP INHIBITORS|21441|||||No|No||LEADER|No||||
omeprazole magnesium|No|No|No|No|75%|70000023202|ACID REDUCER DR 20 MG CAP|28|EA||02/13/2020||Yes|No||||No|No|02/13/2020||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|No|.34674|03/29/2022|.33841|03/29/2022|.34067|03/29/2022|||PROTON PUMP INHIBITORS|21442|||||No|No||LEADER|No||||
omeprazole magnesium|No|No|No|No|75%|70000023203|ACID REDUCER DR 20 MG CAP|42|EA||02/13/2020||Yes|No||||No|No|02/13/2020||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|047|No|.34674|03/29/2022|.33841|03/29/2022|.34067|03/29/2022|||PROTON PUMP INHIBITORS|21443|||||No|No||LEADER|No||||
magnesium carb/aluminum hydrox|No|No|No|No|75%|70000023401|ANTACID EX-STR TABLET CHEW|100|EA||11/19/2019||Yes|No||||No|No|11/19/2019||Yes|No||||No|No|||Over the counter|No|||No|.03254|03/29/2022|.03175|03/29/2022|.03197|03/29/2022||||21444|||||No|No||LEADER|No||||
ibuprofen|No|No|No|No|75%|70000024001|IBUPROFEN JR STR 100 MG TB CHW|24|EA||02/10/2020|07/11/2022|Yes|No||||No|No|02/10/2020|07/11/2022|Yes|No||||No|No|||Over the counter|No||059|Yes|.13895|03/29/2022|.13561|03/29/2022|.13651|03/29/2022|||NSAIDS|21445|No Longer Rebatable||No Longer Rebatable||No|No||LEADER|No||||
aspirin/acetaminophen/caffeine|No|No|No|No|75%|70000024702|MIGRAINE 250-250-65 MG CPLT|100|EA||02/10/2020||Yes|No||||No|No|02/10/2020||Yes|No||||No|No|||Over the counter|No|||No|.05951|03/29/2022|.05808|03/29/2022|.05846|03/29/2022||||21446|||||No|No||LEADER|No||||
aspirin|No|No|No|No|75%|70000025304|ASPIRIN 325 MG TABLET|500|EA||01/10/2022||Yes|No||||No|No|01/10/2022||Yes|No||||No|No|||Over the counter|No|||No|.01006|03/29/2022|.00981|03/29/2022|.00988|03/29/2022||||21447|||||No|No||LEADER|No||||
ibuprofen|No|No|No|No|75%|70000025901|CHILDREN IBUPROFEN 100 MG/5 ML|118|ML||11/07/2019||Yes|No||||No|No|11/07/2019||Yes|No||||No|No|||Over the counter|No||059|Yes|.02649|03/29/2022|.02585|03/29/2022|.02602|03/29/2022|||NSAIDS|21448|||||No|No||LEADER|No||||
guaifen/dextromethorphan/PE|No|No|No|No|75%|70000026101|CHILD MUCUS RELIEF M-S COLD LQ|118|ML||11/25/2019||Yes|No||||No|No|11/25/2019||Yes|No||||No|No|||Over the counter|No||184|Yes|.02587|10/26/2021|.02524|10/26/2021|.02541|10/26/2021|||COUGH AND COLD: NON-NARCOTIC|21449|||||No|No||LEADER|No||||
ibuprofen|No|No|No|No|75%|70000026302|CHILDREN IBUPROFEN 100 MG/5 ML|240|ML||02/10/2020||Yes|No||||No|No|02/10/2020||Yes|No||||No|No|||Over the counter|No||059|Yes|.02479|03/29/2022|.02419|03/29/2022|.02435|03/29/2022|||NSAIDS|21450|||||No|No||LEADER|No||||
ibuprofen|No|No|No|No|75%|70000026401|CHILDREN IBUPROFEN 100 MG/5 ML|120|ML||02/10/2020||Yes|No||||No|No|02/10/2020||Yes|No||||No|No|||Over the counter|No||059|Yes|.03078|03/29/2022|.03004|03/29/2022|.03024|03/29/2022|||NSAIDS|21451|||||No|No||LEADER|No||||
menthol|No|No|No|No|75%|70000026701|COUGH DROPS 7.6 MG|25|EA||11/26/2019||Yes|No||||No|No|11/26/2019||Yes|No||||No|No|||Over the counter|No|||No|.03808|11/23/2021|.03716|11/23/2021|.03741|11/23/2021||||21452|||||No|No||LEADER|No||||
menthol|No|No|No|No|75%|70000026801|COUGH DROPS 5.4 MG|30|EA||11/26/2019||Yes|No||||No|No|11/26/2019||Yes|No||||No|No|||Over the counter|No|||No|.02604|03/29/2022|.02541|03/29/2022|.02558|03/29/2022||||21453|||||No|No||LEADER|No||||
menthol|No|No|No|No|75%|70000026901|COUGH DROPS 5.8 MG|25|EA||11/26/2019||Yes|No||||No|No|11/26/2019||Yes|No||||No|No|||Over the counter|No|||No|.0322|03/29/2022|.03142|03/29/2022|.03163|03/29/2022||||21454|||||No|No||LEADER|No||||
eucalyptus oil/menthol/camphor|No|No|No|No|75%|70000027501|CHEST RUB|50|GM||11/26/2019||Yes|No||||No|No|11/26/2019||Yes|No||||No|No|||Over the counter|No|||No|.03962|03/29/2022|.03866|03/29/2022|.03892|03/29/2022||||21455|||||No|No||LEADER|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|70000027802|MUCUS RELIEF DM COUGH TABLET|50|EA||11/21/2019|06/14/2022|Yes|No||||No|No|11/21/2019|06/14/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.07712|03/29/2022|.07526|03/29/2022|.07577|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21456|No Longer Rebatable||No Longer Rebatable||No|No||LEADER|No||||
phenylephrine/DM/acetaminop/GG|No|No|No|No|75%|70000028901|SEVERE COLD-FLU CAPLET|12|EA||11/21/2019||Yes|No||||No|No|11/21/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.21042|03/29/2022|.20536|03/29/2022|.20673|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21457|||||No|No||LEADER|No||||
menthol|No|No|No|No|75%|70000029001|COUGH DROPS 5.8 MG|25|EA||11/26/2019||Yes|No||||No|No|11/26/2019||Yes|No||||No|No|||Over the counter|No|||No|.0322|03/29/2022|.03142|03/29/2022|.03163|03/29/2022||||21458|||||No|No||LEADER|No||||
ibuprofen|No|No|No|No|75%|70000029101|IBUPROFEN 200 MG TABLET|100|EA||05/07/2020||Yes|No||||No|No|05/07/2020||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|21459|||||No|No||LEADER|No||||
ibuprofen|No|No|No|No|75%|70000029801|INFANT IBUPROFEN 50 MG/1.25 ML|30|ML||02/13/2020||Yes|No||||No|No|02/13/2020||Yes|No||||No|No|||Over the counter|No||059|Yes|.19584|03/29/2022|.19113|03/29/2022|.19241|03/29/2022|||NSAIDS|21460|||||No|No||LEADER|No||||
guaifenesin|No|No|No|No|75%|70000029901|TUSSIN MUCUS-CONG 200 MG/10|118|ML||11/25/2019||Yes|No||||No|No|11/25/2019||Yes|No||||No|No|||Over the counter|No||182|Yes|.01581|03/29/2022|.01543|03/29/2022|.01553|03/29/2022|||COUGH AND COLD: COLD|21461|||||No|No||LEADER|No||||
guaifenesin|No|No|No|No|75%|70000029902|TUSSIN MUCUS-CONG 200 MG/10|237|ML||11/25/2019||Yes|No||||No|No|11/25/2019||Yes|No||||No|No|||Over the counter|No||182|Yes|.01221|03/29/2022|.01191|03/29/2022|.01199|03/29/2022|||COUGH AND COLD: COLD|21462|||||No|No||LEADER|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|70000030101|TUSSIN DM LIQUID|118|ML||11/19/2019||Yes|No||||No|No|11/19/2019||Yes|No||||No|No|||Over the counter|No||184|Yes|.01867|03/29/2022|.01822|03/29/2022|.01834|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21463|||||No|No||LEADER|No||||
dextromethorphan polistirex|No|No|No|No|75%|70000030201|COUGH DM ER 30 MG/5 ML SUSP|89|ML||11/27/2019||Yes|No||||No|No|11/27/2019||Yes|No||||No|No|||Over the counter|No||184|Yes|.05873|03/29/2022|.05732|03/29/2022|.0577|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21464|||||No|No||LEADER|No||||
acetaminophen|No|No|No|No|75%|70000030601|8HR MUSCLE ACHE-PAIN ER 650 MG|100|EA||01/30/2020||Yes|No||||No|No|01/30/2020||Yes|No||||No|No|||Over the counter|No|||No|.06737|03/29/2022|.06575|03/29/2022|.06619|03/29/2022||||21465|||||No|No||LEADER|No||||
ibuprofen|No|No|No|No|75%|70000030801|IBUPROFEN 200 MG TABLET|50|EA||05/08/2020||Yes|No||||No|No|05/08/2020||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|21466|||||No|No||LEADER|No||||
ibuprofen|No|No|No|No|75%|70000030802|IBUPROFEN 200 MG TABLET|100|EA||06/17/2020||Yes|No||||No|No|06/17/2020||Yes|No||||No|No|||Over the counter|No||059|Yes|.03305|03/29/2022|.03225|03/29/2022|.03247|03/29/2022|||NSAIDS|21467|||||No|No||LEADER|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|70000031901|TUSSIN DM LIQUID|118|ML||11/21/2019||Yes|No||||No|No|11/21/2019||Yes|No||||No|No|||Over the counter|No||184|Yes|.01867|03/29/2022|.01822|03/29/2022|.01834|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21468|||||No|No||LEADER|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|70000031902|TUSSIN DM LIQUID|237|ML||11/21/2019||Yes|No||||No|No|11/21/2019||Yes|No||||No|No|||Over the counter|No||184|Yes|.01037|03/29/2022|.01012|03/29/2022|.01018|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21469|||||No|No||LEADER|No||||
miconazole nitrate|No|No|No|No|75%|70000032101|ATHLETE'S FOOT 2% POWDER SPRAY|130|GM||11/26/2019||Yes|No||||No|No|11/26/2019||Yes|No||||No|No|||Over the counter|Yes|03/09/2018|061|No|.02717|01/25/2022|.02651|01/25/2022|.02669|01/25/2022|||ANTIFUNGALS: TOPICAL|21470|||||No|No||LEADER|No||||
miconazole nitrate|No|No|No|No|75%|70000032301|ANTIFUNGAL 2% POWDER|71|GM||11/25/2019||Yes|No||||No|No|11/25/2019||Yes|No||||No|No|||Over the counter|No||061|No|.04437|03/29/2022|.0433|03/29/2022|.04359|03/29/2022|||ANTIFUNGALS: TOPICAL|21471|||||No|No||LEADER|No||||
chlorpheniramine/dextromethorp|No|No|No|No|75%|70000032401|COUGH-COLD HBP TABLET|16|EA||11/14/2019||Yes|No||||No|No|11/14/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.11661|03/29/2022|.11381|03/29/2022|.11456|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21472|||||No|No||LEADER|No||||
salicylic acid|No|No|No|No|75%|70000033001|CORN REMOVER 40% PATCH|18|EA||05/03/2021||Yes|No||||No|No|05/03/2021||Yes|No||||No|No|||Over the counter|No|||No|.1903|03/29/2022|.18573|03/29/2022|.18696|03/29/2022||||21473|||||No|No||LEADER|No||||
salicylic acid|No|No|No|No|75%|70000033201|LIQUID CORN-CALLUS REMOVER|9.8|ML||05/08/2020||Yes|No||||No|No|05/08/2020||Yes|No||||No|No|||Over the counter|No|||No|.22449|09/28/2021|.2191|09/28/2021|.22056|09/28/2021||||21474|||||No|No||LEADER|No||||
salicylic acid|No|No|No|No|75%|70000033301|CALLUS REMOVERS PATCH|10|EA||05/13/2020||Yes|No||||No|No|05/13/2020||Yes|No||||No|No|||Over the counter|No|||No|.1903|03/29/2022|.18573|03/29/2022|.18696|03/29/2022||||21475|||||No|No||LEADER|No||||
zinc oxide|No|No|No|No|75%|70000033401|ZINC OXIDE 20% OINTMENT|454|GM||12/19/2019||Yes|No||||No|No|12/19/2019||Yes|No||||No|No|||Over the counter|No|||No|.01539|01/25/2022|.01502|01/25/2022|.01512|01/25/2022||||21476|||||No|No||LEADER|No||||
nicotine polacrilex|No|No|No|No|75%|70000034101|NICOTINE 4 MG CHEWING GUM|50|EA||02/13/2020||Yes|No||||No|No|02/13/2020||Yes|No||||No|No|||Over the counter|No||040|No|.27548|03/29/2022|.26886|03/29/2022|.27065|03/29/2022|||SMOKING CESSATION|21477|||||No|No||LEADER|No||||
nicotine polacrilex|No|No|No|No|75%|70000034201|NICOTINE 4 MG CHEWING GUM|20|EA||02/13/2020||Yes|No||||No|No|02/13/2020||Yes|No||||No|No|||Over the counter|No||040|No|.27548|03/29/2022|.26886|03/29/2022|.27065|03/29/2022|||SMOKING CESSATION|21478|||||No|No||LEADER|No||||
nicotine polacrilex|No|No|No|No|75%|70000034301|NICOTINE 4 MG CHEWING GUM|10|EA||05/08/2020||Yes|No||||No|No|05/08/2020||Yes|No||||No|No|||Over the counter|No||040|No|.27548|03/29/2022|.26886|03/29/2022|.27065|03/29/2022|||SMOKING CESSATION|21479|||||No|No||LEADER|No||||
nicotine polacrilex|No|No|No|No|75%|70000034401|NICOTINE 4 MG CHEWING GUM|20|EA||02/13/2020||Yes|No||||No|No|02/13/2020||Yes|No||||No|No|||Over the counter|No||040|No|.27548|03/29/2022|.26886|03/29/2022|.27065|03/29/2022|||SMOKING CESSATION|21480|||||No|No||LEADER|No||||
nicotine polacrilex|No|No|No|No|75%|70000034402|NICOTINE 4 MG CHEWING GUM|100|EA||02/13/2020||Yes|No||||No|No|02/13/2020||Yes|No||||No|No|||Over the counter|No||040|No|.27548|03/29/2022|.26886|03/29/2022|.27065|03/29/2022|||SMOKING CESSATION|21481|||||No|No||LEADER|No||||
nicotine polacrilex|No|No|No|No|75%|70000034501|NICOTINE 2 MG CHEWING GUM|50|EA||02/13/2020||Yes|No||||No|No|02/13/2020||Yes|No||||No|No|||Over the counter|No||040|No|.22992|03/29/2022|.2244|03/29/2022|.22589|03/29/2022|||SMOKING CESSATION|21482|||||No|No||LEADER|No||||
nicotine polacrilex|No|No|No|No|75%|70000034701|NICOTINE 2 MG CHEWING GUM|10|EA||05/08/2020||Yes|No||||No|No|05/08/2020||Yes|No||||No|No|||Over the counter|No||040|No|.22992|03/29/2022|.2244|03/29/2022|.22589|03/29/2022|||SMOKING CESSATION|21483|||||No|No||LEADER|No||||
nicotine polacrilex|No|No|No|No|75%|70000034801|NICOTINE 2 MG CHEWING GUM|20|EA||02/13/2020||Yes|No||||No|No|02/13/2020||Yes|No||||No|No|||Over the counter|No||040|No|.22992|03/29/2022|.2244|03/29/2022|.22589|03/29/2022|||SMOKING CESSATION|21484|||||No|No||LEADER|No||||
nicotine polacrilex|No|No|No|No|75%|70000034802|NICOTINE 2 MG CHEWING GUM|100|EA||02/13/2020||Yes|No||||No|No|02/13/2020||Yes|No||||No|No|||Over the counter|No||040|No|.22992|03/29/2022|.2244|03/29/2022|.22589|03/29/2022|||SMOKING CESSATION|21485|||||No|No||LEADER|No||||
tioconazole|Yes|No|No|No|75%|70000035701|TIOCONAZOLE-1 6.5% OINTMENT|4.6|GM||02/13/2020||Yes|No||||No|No|02/13/2020||Yes|No||||No|No|03/20/2020||Over the counter|No|||No|2.21348|03/29/2022|2.16035|03/29/2022|2.17474|03/29/2022||||21486|||||No|No||LEADER|No||||
ibuprofen|No|No|No|No|75%|70000036001|IBUPROFEN 200 MG SOFTGEL|20|EA||02/20/2020||Yes|No||||No|No|02/20/2020||Yes|No||||No|No|||Over the counter|No||059|Yes|.07198|03/29/2022|.07025|03/29/2022|.07072|03/29/2022|||NSAIDS|21487|||||No|No||LEADER|No||||
ibuprofen|No|No|No|No|75%|70000036002|IBUPROFEN 200 MG SOFTGEL|40|EA||02/20/2020||Yes|No||||No|No|02/20/2020||Yes|No||||No|No|||Over the counter|No||059|Yes|.07198|03/29/2022|.07025|03/29/2022|.07072|03/29/2022|||NSAIDS|21488|||||No|No||LEADER|No||||
ibuprofen|No|No|No|No|75%|70000036003|IBUPROFEN 200 MG SOFTGEL|80|EA||02/20/2020|09/09/2022|Yes|No||||No|No|02/20/2020|09/09/2022|Yes|No||||No|No|||Over the counter|No||059|Yes|.07198|03/29/2022|.07025|03/29/2022|.07072|03/29/2022|||NSAIDS|21489|No Longer Rebatable||No Longer Rebatable||No|No||LEADER|No||||
fexofenadine HCl|No|No|No|No|75%|70000036101|ALLERGY RELIEF 180 MG TABLET|15|EA||11/27/2019||Yes|No||||No|No|11/27/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.28782|03/29/2022|.28091|03/29/2022|.28278|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21490|||||No|No||LEADER|No||||
fexofenadine HCl|No|No|No|No|75%|70000036102|ALLERGY RELIEF 180 MG TABLET|30|EA||11/27/2019||Yes|No||||No|No|11/27/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.28782|03/29/2022|.28091|03/29/2022|.28278|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21491|||||No|No||LEADER|No||||
fexofenadine HCl|No|No|No|No|75%|70000036103|ALLERGY RELIEF 180 MG TABLET|70|EA||11/27/2019||Yes|No||||No|No|11/27/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.28782|03/29/2022|.28091|03/29/2022|.28278|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21492|||||No|No||LEADER|No||||
fexofenadine HCl|No|No|No|No|75%|70000036104|ALLERGY RELIEF 180 MG TABLET|90|EA||11/27/2019||Yes|No||||No|No|11/27/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.28782|03/29/2022|.28091|03/29/2022|.28278|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21493|||||No|No||LEADER|No||||
fexofenadine HCl|No|No|No|No|75%|70000036105|ALLERGY RELIEF 180 MG TABLET|180|EA||12/08/2020||Yes|No||||No|No|12/08/2020||Yes|No||||No|No|||Over the counter|Yes|12/01/2021|030|Yes|.28782|03/29/2022|.28091|03/29/2022|.28278|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21494|||||No|No||LEADER|No||||
levocetirizine dihydrochloride|No|No|No|No|75%|70000036201|24HR ALLERGY(LEVOCETIRZN) 5 MG|10|EA||11/13/2019||Yes|No||||No|No|11/13/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.15309|03/29/2022|.14941|03/29/2022|.15041|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21495|||||No|No||LEADER|No||||
levocetirizine dihydrochloride|No|No|No|No|75%|70000036202|24HR ALLERGY(LEVOCETIRZN) 5 MG|35|EA||11/13/2019||Yes|No||||No|No|11/13/2019||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|030|Yes|.15309|03/29/2022|.14941|03/29/2022|.15041|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21496|||||No|No||LEADER|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|70000037202|MUCUS DM MAX ER 1,200-60 MG TB|28|EA||05/07/2020||Yes|No||||No|No|05/07/2020||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.54375|03/29/2022|.5307|03/29/2022|.53423|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21497|||||No|No||LEADER|No||||
cetirizine HCl|No|No|No|No|75%|70000038001|ALL DAY ALLERGY 10 MG TABLET|14|EA||11/27/2019||Yes|No||||No|No|11/27/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21498|||||No|No||LEADER|No||||
cetirizine HCl|No|No|No|No|75%|70000038002|ALL DAY ALLERGY 10 MG TABLET|30|EA||11/27/2019||Yes|No||||No|No|11/27/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21499|||||No|No||LEADER|No||||
cetirizine HCl|No|No|No|No|75%|70000038004|ALL DAY ALLERGY 10 MG TABLET|90|EA||11/27/2019||Yes|No||||No|No|11/27/2019||Yes|No||||No|No|||Over the counter|No||030|Yes|.07064|03/29/2022|.06894|03/29/2022|.0694|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21500|||||No|No||LEADER|No||||
omeprazole|No|No|No|No|75%|70000038102|OMEPRAZOLE DR 20 MG ODT|42|EA||05/24/2021||Yes|No||||No|No|05/24/2021||Yes|No||||No|No|||Over the counter|Yes|12/01/2021|047|No|.44299|03/29/2022|.43235|03/29/2022|.43523|03/29/2022|||PROTON PUMP INHIBITORS|21501|||||No|No||LEADER|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|70000038701|TUSSIN DM 400-20 MG/20 ML LIQ|118|ML||11/21/2019||Yes|No||||No|No|11/21/2019||Yes|No||||No|No|||Over the counter|No||184|Yes|.01924|03/29/2022|.01877|03/29/2022|.0189|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21502|||||No|No||LEADER|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|70000038702|TUSSIN DM 400-20 MG/20 ML LIQ|237|ML||01/27/2020||Yes|No||||No|No|01/27/2020||Yes|No||||No|No|||Over the counter|No||184|Yes|.01656|03/29/2022|.01616|03/29/2022|.01627|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21503|||||No|No||LEADER|No||||
pramoxine HCl/zinc acetate|No|No|No|No|75%|70000039701|CALAMINE CLEAR LOTION|177|ML||11/26/2019||Yes|No||||No|No|11/26/2019||Yes|No||||No|No|||Over the counter|No|||No|.01439|03/29/2022|.01404|03/29/2022|.01413|03/29/2022||||21504|||||No|No||LEADER|No||||
pramoxine HCl/calamine|No|No|No|No|75%|70000040001|CALAMINE PLUS 1%-8% LOTION|177|ML||11/25/2019||Yes|No||||No|No|11/25/2019||Yes|No||||No|No|||Over the counter|No|||No|.01376|03/29/2022|.01342|03/29/2022|.01351|03/29/2022||||21505|||||No|No||LEADER|No||||
dimenhydrinate|No|No|No|No|75%|70000040401|MOTION SICKNESS 50 MG TABLET|12|EA||11/25/2019||Yes|No||||No|No|11/25/2019||Yes|No||||No|No|||Over the counter|No||085|No|.05446|03/29/2022|.05315|03/29/2022|.0535|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|21506|||||No|No||LEADER|No||||
polyethylene glycol 3350|No|No|No|No|75%|70000041502|CLEARLAX POWDER|238|GM||12/06/2019||Yes|No||||No|No|12/06/2019||Yes|No||||No|No|||Over the counter|No|||No|.02672|03/29/2022|.02607|03/29/2022|.02625|03/29/2022||||21507|||||No|No||LEADER|No||||
polyethylene glycol 3350|No|No|No|No|75%|70000041503|CLEARLAX POWDER|510|GM||12/06/2019||Yes|No||||No|No|12/06/2019||Yes|No||||No|No|||Over the counter|No|||No|.02124|03/29/2022|.02073|03/29/2022|.02086|03/29/2022||||21508|||||No|No||LEADER|No||||
famotidine/Ca carb/mag hydrox|No|No|No|No|75%|70000041601|ACID REDUCER COMPLETE TAB CHEW|25|EA||02/10/2020||Yes|No||||No|No|02/10/2020||Yes|No||||No|No|||Over the counter|No|||No|.229|03/29/2022|.2235|03/29/2022|.22499|03/29/2022||||21509|||||No|No||LEADER|No||||
loperamide HCl|No|No|No|No|75%|70000041701|ANTI-DIARRHEAL 1 MG/7.5 ML SOL|120|ML||11/27/2019||Yes|No||||No|No|11/27/2019||Yes|No||||No|No|||Over the counter|No|||No|.02593|03/29/2022|.0253|03/29/2022|.02547|03/29/2022||||21510|||||No|No||LEADER|No||||
loperamide HCl|No|No|No|No|75%|70000041801|ANTI-DIARRHEAL 1 MG/7.5 ML SOL|120|ML||11/27/2019||Yes|No||||No|No|11/27/2019||Yes|No||||No|No|||Over the counter|No|||No|.02593|03/29/2022|.0253|03/29/2022|.02547|03/29/2022||||21511|||||No|No||LEADER|No||||
aspirin/sod bicarb/citric acid|No|No|No|No|75%|70000042101|EFFERVESCENT ANTACID-PAIN RLF|36|EA||02/05/2020||Yes|No||02/05/2020||Yes|No|02/05/2020||Yes|No||||No|No|||Over the counter|No|||No|||||||.03988|02/05/2020||21512|||||No|No||LEADER|No||||
phenyleph/pramoxin/glycr/w.pet|No|No|No|No|75%|70000042501|HEMORRHOIDAL CREAM|28|GM||02/04/2020||Yes|No||02/04/2020||Yes|No|02/04/2020||Yes|No||||No|No|||Over the counter|No|||No|.07947|06/29/2021|.07756|06/29/2021|.07807|06/29/2021||||21513|||||No|No||LEADER|No||||
calcium carbonate|No|No|No|No|75%|70000043002|ANTACID EX-STR 750 MG TAB CHEW|96|EA||03/10/2020||Yes|No||||No|No|03/10/2020||Yes|No||||No|No|||Over the counter|No|||No|.02533|03/29/2022|.02472|03/29/2022|.02488|03/29/2022||||21514|||||No|No||LEADER|No||||
calcium carbonate|No|No|No|No|75%|70000043101|ANTACID EX-STR 750 MG TAB CHEW|96|EA||03/10/2020||Yes|No||||No|No|03/10/2020||Yes|No||||No|No|||Over the counter|No|||No|.02533|03/29/2022|.02472|03/29/2022|.02488|03/29/2022||||21515|||||No|No||LEADER|No||||
bismuth subsalicylate|No|No|No|No|75%|70000043301|STOMACH RELIEF 262 MG CHEW TAB|30|EA||03/12/2020|07/29/2022|Yes|No||||No|No|03/12/2020|07/29/2022|Yes|No||||No|No|||Over the counter|No|||No|.08173|03/29/2022|.07976|03/29/2022|.08029|03/29/2022||||21516|No Longer Rebatable||No Longer Rebatable||No|No||LEADER|No||||
bismuth subsalicylate|No|No|No|No|75%|70000043302|STOMACH RELIEF 262 MG CHEW TAB|48|EA||04/23/2021|08/05/2022|Yes|No||||No|No|04/23/2021|08/05/2022|Yes|No||||No|No|||Over the counter|No|||No|.08173|03/29/2022|.07976|03/29/2022|.08029|03/29/2022||||21517|No Longer Rebatable||No Longer Rebatable||No|No||LEADER|No||||
simethicone|No|No|No|No|75%|70000043401|GAS RELIEF (SIMETH) 80 MG CHEW|100|EA||03/11/2020||Yes|No||||No|No|03/11/2020||Yes|No||||No|No|||Over the counter|No|||No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022||||21518|||||No|No||LEADER|No||||
calcium carbonate|No|No|No|No|75%|70000043601|ANTACID ULTRA STR 1,000 MG CHW|72|EA||03/10/2020||Yes|No||||No|No|03/10/2020||Yes|No||||No|No|||Over the counter|No|||No|.03472|01/25/2022|.03388|01/25/2022|.03411|01/25/2022||||21519|||||No|No||LEADER|No||||
guaifenesin|No|No|No|No|75%|70000045201|CHEST CONGEST RLF 400 MG TAB|60|EA||12/19/2019|04/27/2022|Yes|No||||No|No|12/19/2019|04/27/2022|Yes|No||||No|No|||Over the counter|No||182|Yes|.06856|03/29/2022|.06691|03/29/2022|.06736|03/29/2022|||COUGH AND COLD: COLD|21520|No Longer Rebatable||No Longer Rebatable||No|No||LEADER|No||||
guaifenesin|No|No|No|No|75%|70000045202|CHEST CONGEST RLF 400 MG TAB|24|EA||06/17/2020||Yes|No||||No|No|06/17/2020||Yes|No||||No|No|||Over the counter|No||182|Yes|.06856|03/29/2022|.06691|03/29/2022|.06736|03/29/2022|||COUGH AND COLD: COLD|21521|||||No|No||LEADER|No||||
DM/PE/acetaminophen/doxylamine|No|No|No|No|75%|70000045301|NIGHTTIME SEVERE COLD-FLU LIQ|237|ML||11/15/2019|02/08/2022|Yes|No||||No|No|11/15/2019|02/08/2022|Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|||||||||COUGH AND COLD: NON-NARCOTIC|21522|No Longer Rebatable||No Longer Rebatable||No|No||LEADER|No||||
tetrahydrozoline HCl|No|No|No|No|75%|70000045401|EYE DROPS 0.05%|15|ML||11/25/2019||Yes|No||||No|No|11/25/2019||Yes|No||||No|No|||Over the counter|No|||No|.10218|03/29/2022|.09972|03/29/2022|.10039|03/29/2022||||21523|||||No|No||LEADER|No||||
tetrahydroz/dext 70/peg 400/pv|No|No|No|No|75%|70000045601|EYE DROPS ADVANCED RELIEF|15|ML||11/26/2019||Yes|No||||No|No|11/26/2019||Yes|No||||No|No|||Over the counter|No|||No|.12262|03/29/2022|.11967|03/29/2022|.12047|03/29/2022||||21524|||||No|No||LEADER|No||||
propylene glycol/peg 400|No|No|No|No|75%|70000045701|ULTRA LUBRICANT EYE DROPS|15|ML||11/25/2019||Yes|No||||No|No|11/25/2019||Yes|No||||No|No|||Over the counter|No|||No|.31839|03/29/2022|.31074|03/29/2022|.31281|03/29/2022||||21525|||||No|No||LEADER|No||||
propylene glycol/peg 400|No|No|No|No|75%|70000045702|ULTRA LUBRICANT EYE DROPS|30|ML||09/08/2020||Yes|No||||No|No|09/08/2020||Yes|No||||No|No|||Over the counter|No|||No||||||||||21526|||||No|No||LEADER|No||||
calcium carbonate|No|No|No|No|75%|70000045901|ANTACID ULTRA STR 1,000 MG CHW|72|EA||11/19/2019||Yes|No||||No|No|11/19/2019||Yes|No||||No|No|||Over the counter|No|||No|.03472|01/25/2022|.03388|01/25/2022|.03411|01/25/2022||||21527|||||No|No||LEADER|No||||
calcium carbonate|No|No|No|No|75%|70000046001|ANTACID 750 MG CHEWABLE TABLET|90|EA||11/19/2019||Yes|No||||No|No|11/19/2019||Yes|No||||No|No|||Over the counter|No|||No|.02533|03/29/2022|.02472|03/29/2022|.02488|03/29/2022||||21528|||||No|No||LEADER|No||||
loperamide HCl|No|No|No|No|75%|70000046101|ANTI-DIARRHEAL 2 MG SOFTGEL|24|EA||05/06/2020||Yes|No||||No|No|05/06/2020||Yes|No||||No|No|||Over the counter|No|||No|.14602|03/29/2022|.14251|03/29/2022|.14346|03/29/2022||||21529|||||No|No||LEADER|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|70000046401|MUCUS RLF DM MAX ER 1200-60 MG|28|EA||04/23/2021||Yes|No||||No|No|04/23/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.54375|03/29/2022|.5307|03/29/2022|.53423|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21530|||||No|No||LEADER|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|70000046402|MUCUS RLF DM MAX ER 1200-60 MG|14|EA||04/23/2021||Yes|No||||No|No|04/23/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.54375|03/29/2022|.5307|03/29/2022|.53423|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21531|||||No|No||LEADER|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|70000046501|MUCUS RELIEF DM MAX LIQUID|177|ML||04/23/2021|09/04/2022|Yes|No||||No|No|04/23/2021|09/04/2022|Yes|No||||No|No|||Over the counter|No||184|Yes|.01897|12/28/2021|.01851|12/28/2021|.01863|12/28/2021|||COUGH AND COLD: NON-NARCOTIC|21532|No Longer Rebatable||No Longer Rebatable||No|No||LEADER|No||||
diphenhydramine HCl|No|No|No|No|75%|70000046701|SLEEP AID 25 MG CAPLET|24|EA||09/21/2020|07/08/2022|Yes|No||||No|No|09/21/2020|07/08/2022|Yes|No||||No|No|||Over the counter|No|||Yes|.06006|03/29/2022|.05861|03/29/2022|.059|03/29/2022||||21533|No Longer Rebatable||No Longer Rebatable||No|No||LEADER|No||||
lidocaine|No|No|No|No|75%|70000046801|HEMORRHOIDAL RELIEF 5% CREAM|30|GM||09/29/2020||Yes|No||||No|No|09/29/2020||Yes|No||||No|No|||Over the counter|No|||No|.41292|03/29/2022|.403|03/29/2022|.40569|03/29/2022||||21534|||||No|No||LEADER|No||||
zinc oxide|No|No|No|No|75%|70000046901|DIAPER RASH 40% OINTMENT|113|GM||05/19/2020||Yes|No||||No|No|05/19/2020||Yes|No||||No|No|||Over the counter|No|||No|.02761|09/29/2020|.02694|09/29/2020|.02712|09/29/2020||||21535|||||No|No||LEADER|No||||
bacitracin zinc|No|No|No|No|75%|70000047001|BACITRACIN ZN 500 UNIT/GM OINT|28.4|GM||11/25/2019|05/04/2022|Yes|No||||No|No|11/25/2019|05/04/2022|Yes|No||||No|No|||Over the counter|Yes|03/09/2018|114|No|.08139|03/29/2022|.07943|03/29/2022|.07996|03/29/2022|||ANTIBIOTICS: TOPICAL|21536|No Longer Rebatable||No Longer Rebatable||No|No||LEADER|No||||
bacitracin zinc/polymyxin B|No|No|No|No|75%|70000047101|POLY BACITRACIN OINTMENT|28.4|GM||12/19/2019|03/23/2022|Yes|No||||No|No|12/19/2019|03/23/2022|Yes|No||||No|No|||Over the counter|No|||No|.08294|03/29/2022|.08094|03/29/2022|.08148|03/29/2022||||21537|No Longer Rebatable||No Longer Rebatable||No|No||LEADER|No||||
loratadine|No|No|No|No|75%|70000047301|CHILD ALLERGY RELIEF 5 MG/5 ML|120|ML||09/18/2020||Yes|No||||No|No|09/18/2020||Yes|No||||No|No|||Over the counter|No||030|Yes|.04114|03/29/2022|.04015|03/29/2022|.04042|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21538|||||No|No||LEADER|No||||
diphenhydramine HCl|No|No|No|No|75%|70000047401|CHILD ALLERGY RLF 12.5 MG/5 ML|118|ML||06/17/2020||Yes|No||||No|No|06/17/2020||Yes|No||||No|No|||Over the counter|No||574|Yes|.01468|03/29/2022|.01432|03/29/2022|.01442|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|21539|||||No|No||LEADER|No||||
diphenhydramine HCl|No|No|No|No|75%|70000047402|CHILD ALLERGY RLF 12.5 MG/5 ML|237|ML||06/17/2020||Yes|No||||No|No|06/17/2020||Yes|No||||No|No|||Over the counter|No||574|Yes|.01487|03/29/2022|.01451|03/29/2022|.0146|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|21540|||||No|No||LEADER|No||||
pseudoephedrine HCl|No|No|No|No|75%|70000047501|12HR NASAL DECONGEST ER 120 MG|10|EA||03/11/2020||Yes|No||||No|No|03/11/2020||Yes|No||||No|No|||Over the counter|No|||No|.31485|03/29/2022|.30729|03/29/2022|.30934|03/29/2022||||21541|||||No|No||LEADER|No||||
guaifenesin|No|No|No|No|75%|70000047901|MUCUS RELIEF ER 1,200 MG TAB|14|EA||11/25/2019||Yes|No||||No|No|11/25/2019||Yes|No||||No|No|||Over the counter|No||182|Yes|.46517|03/29/2022|.454|03/29/2022|.45702|03/29/2022|||COUGH AND COLD: COLD|21542|||||No|No||LEADER|No||||
guaifenesin|No|No|No|No|75%|70000047902|MUCUS RELIEF ER 1,200 MG TAB|28|EA||11/26/2019||Yes|No||||No|No|11/26/2019||Yes|No||||No|No|||Over the counter|No||182|Yes|.46517|03/29/2022|.454|03/29/2022|.45702|03/29/2022|||COUGH AND COLD: COLD|21543|||||No|No||LEADER|No||||
eucalyptus oil/menthol/camphor|No|No|No|No|75%|70000048001|CHEST RUB|50|GM||11/26/2019||Yes|No||||No|No|11/26/2019||Yes|No||||No|No|||Over the counter|No|||No|.03962|03/29/2022|.03866|03/29/2022|.03892|03/29/2022||||21544|||||No|No||LEADER|No||||
zinc oxide|No|No|No|No|75%|70000048801|ZINC OXIDE 25% OINTMENT|28.4|GM||10/16/2020||Yes|No||||No|No|10/16/2020||Yes|No||||No|No|||Over the counter|No|||No|.04|11/23/2021|.03904|11/23/2021|.0393|11/23/2021||||21545|||||No|No||LEADER|No||||
carbamide peroxide|No|No|No|No|75%|70000049001|EAR WAX REMOVAL 6.5% DROP|15|ML||10/06/2020||Yes|No||||No|No|10/06/2020||Yes|No||||No|No|||Over the counter|No|||No|.12463|03/29/2022|.12163|03/29/2022|.12244|03/29/2022||||21546|||||No|No||LEADER|No||||
carbamide peroxide|No|No|No|No|75%|70000049002|EAR WAX REMOVAL 6.5% KIT|15|ML||06/17/2020||Yes|No||||No|No|06/17/2020||Yes|No||||No|No|||Over the counter|No|||No|.12463|03/29/2022|.12163|03/29/2022|.12244|03/29/2022||||21547|||||No|No||LEADER|No||||
guaifenesin/dextromethorphan|No|No|No|No|75%|70000049101|MUCUS RLF DM ER 600-30 MG TAB|20|EA||02/20/2020||Yes|No||||No|No|02/20/2020||Yes|No||||No|No|||Over the counter|No||184|Yes|.49455|03/29/2022|.48268|03/29/2022|.48589|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21548|||||No|No||LEADER|No||||
diphenhydramine HCl|No|No|No|No|75%|70000049201|CHILD ALLERGY RLF 12.5 MG/5 ML|118|ML||05/05/2020||Yes|No||||No|No|05/05/2020||Yes|No||||No|No|||Over the counter|No||574|Yes|.01468|03/29/2022|.01432|03/29/2022|.01442|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|21549|||||No|No||LEADER|No||||
tolnaftate|No|No|No|No|75%|70000049401|TOLNAFTATE 1% CREAM|28|GM||05/07/2020||Yes|No||||No|No|05/07/2020||Yes|No||||No|No|||Over the counter|No||061|No|||||||||ANTIFUNGALS: TOPICAL|21550|||||No|No||LEADER|No||||
peg 400/hypromellose/glycerin|No|No|No|No|75%|70000050201|DRY EYE RELIEF EYE DROPS|15|ML||04/07/2020||Yes|No||||No|No|04/07/2020||Yes|No||||No|No|||Over the counter|No|||No|.14158|03/29/2022|.13818|03/29/2022|.1391|03/29/2022||||21551|||||No|No||LEADER|No||||
loratadine/pseudoephedrine|No|No|No|No|75%|70000050401|ALLERGY RELIEF D-12 TABLET|10|EA||09/18/2020||Yes|No||||No|No|09/18/2020||Yes|No||||No|No|||Over the counter|Yes|01/30/2020|030|Yes|.85484|03/29/2022|.83432|03/29/2022|.83988|03/29/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21552|||||No|No||LEADER|No||||
nicotine|No|No|No|No|75%|70000051001|NICOTINE 7 MG/24HR PATCH|7|EA||03/10/2020||Yes|No||||No|No|03/10/2020||Yes|No||||No|No|||Over the counter|No||040|No|1.78989|03/29/2022|1.74693|03/29/2022|1.75856|03/29/2022|||SMOKING CESSATION|21553|||||No|No||LEADER|No||||
nicotine|No|No|No|No|75%|70000051002|NICOTINE 7 MG/24HR PATCH|14|EA||04/23/2021||Yes|No||||No|No|04/23/2021||Yes|No||||No|No|||Over the counter|No||040|No|1.78989|03/29/2022|1.74693|03/29/2022|1.75856|03/29/2022|||SMOKING CESSATION|21554|||||No|No||LEADER|No||||
nicotine|No|No|No|No|75%|70000051102|NICOTINE 14 MG/24HR PATCH|14|EA||03/10/2020||Yes|No||||No|No|03/10/2020||Yes|No||||No|No|||Over the counter|No||040|No|1.68083|03/29/2022|1.64049|03/29/2022|1.65141|03/29/2022|||SMOKING CESSATION|21555|||||No|No||LEADER|No||||
nicotine|No|No|No|No|75%|70000051201|NICOTINE 21 MG/24HR PATCH|7|EA||06/24/2020||Yes|No||||No|No|06/24/2020||Yes|No||||No|No|||Over the counter|No||040|No|1.70855|03/29/2022|1.66754|03/29/2022|1.67865|03/29/2022|||SMOKING CESSATION|21556|||||No|No||LEADER|No||||
nicotine|No|No|No|No|75%|70000051202|NICOTINE 21 MG/24HR PATCH|14|EA||03/10/2020||Yes|No||||No|No|03/10/2020||Yes|No||||No|No|||Over the counter|No||040|No|1.70855|03/29/2022|1.66754|03/29/2022|1.67865|03/29/2022|||SMOKING CESSATION|21557|||||No|No||LEADER|No||||
d-methorphan/PE/acetaminophen|No|No|No|No|75%|70000051501|DAYTIME COLD-FLU RELIEF SFTGL|24|EA||06/19/2020||Yes|No||||No|No|06/19/2020||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.16805|03/29/2022|.16401|03/29/2022|.1651|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21558|||||No|No||LEADER|No||||
DM/acetaminophen/doxylamine|No|No|No|No|75%|70000051601|NIGHTTIME COLD-FLU RLF SFTGL|16|EA||06/24/2020||Yes|No||||No|No|06/24/2020||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.1281|03/29/2022|.12502|03/29/2022|.12585|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21559|||||No|No||LEADER|No||||
DM/acetaminophen/doxylamine|No|No|No|No|75%|70000051602|NIGHTTIME COLD-FLU RLF SFTGL|24|EA||03/10/2020||Yes|No||||No|No|03/10/2020||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.1281|03/29/2022|.12502|03/29/2022|.12585|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21560|||||No|No||LEADER|No||||
docosanol|No|No|No|No|75%|70000051701|DOCOSANOL 10% CREAM|2|GM||02/26/2021||Yes|No||||No|No|02/26/2021||Yes|No||||No|No|||Over the counter|Yes|01/30/2020|123|No|6.21765|03/29/2022|6.06842|03/29/2022|6.10884|03/29/2022|||ANTIVIRALS: TOPICAL|21561|||||No|No||LEADER|No||||
fexofenadine/pseudoephedrine|No|No|No|No|75%|70000051801|ALLERGY-CONGEST 12HR 60-120 MG|20|EA||10/16/2020||Yes|No||||No|No|10/16/2020||Yes|No||||No|No|||Over the counter|Yes|12/01/2021|030|Yes|.58518|03/01/2022|.57113|03/01/2022|.57493|03/01/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|21562|||||No|No||LEADER|No||||
omeprazole magnesium|No|No|No|No|75%|70000052101|OMEPRAZOLE MAG DR 20 MG TABLET|14|EA||10/16/2020||Yes|No||||No|No|10/16/2020||Yes|No||||No|No|||Over the counter|Yes|12/01/2021|047|No|.50629|03/29/2022|.49413|03/29/2022|.49742|03/29/2022|||PROTON PUMP INHIBITORS|21563|||||No|No||LEADER|No||||
omeprazole magnesium|No|No|No|No|75%|70000052102|OMEPRAZOLE MAG DR 20 MG TABLET|14|EA||05/18/2021||Yes|No||||No|No|05/18/2021||Yes|No||||No|No|||Over the counter|Yes|12/01/2021|047|No|.50629|03/29/2022|.49413|03/29/2022|.49742|03/29/2022|||PROTON PUMP INHIBITORS|21564|||||No|No||LEADER|No||||
omeprazole magnesium|No|No|No|No|75%|70000052103|OMEPRAZOLE MAG DR 20 MG TABLET|28|EA||05/18/2021||Yes|No||||No|No|05/18/2021||Yes|No||||No|No|||Over the counter|Yes|12/01/2021|047|No|.50629|03/29/2022|.49413|03/29/2022|.49742|03/29/2022|||PROTON PUMP INHIBITORS|21565|||||No|No||LEADER|No||||
omeprazole magnesium|No|No|No|No|75%|70000052104|OMEPRAZOLE MAG DR 20 MG TABLET|42|EA||05/19/2021||Yes|No||||No|No|05/19/2021||Yes|No||||No|No|||Over the counter|Yes|12/01/2021|047|No|.50629|03/29/2022|.49413|03/29/2022|.49742|03/29/2022|||PROTON PUMP INHIBITORS|21566|||||No|No||LEADER|No||||
ketotifen fumarate|No|No|No|No|75%|70000052201|EYE ITCH RELIEF 0.025% DROPS|5|ML||08/12/2021||Yes|No||||No|No|08/12/2021||Yes|No||||No|No|||Over the counter|Yes|01/28/2021|002|No|1.3642|03/29/2022|1.33145|03/29/2022|1.34032|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|21567|||||No|No||LEADER|No||||
ketotifen fumarate|No|No|No|No|75%|70000052202|EYE ITCH RELIEF 0.025% DROPS|10|ML||05/18/2021||Yes|No||||No|No|05/18/2021||Yes|No||||No|No|||Over the counter|Yes|01/28/2021|002|No|.44223|07/27/2021|.43161|07/27/2021|.43449|07/27/2021|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|21568|||||No|No||LEADER|No||||
phenylephrine/DM/acetaminop/GG|No|No|No|No|75%|70000052501|SEVERE COLD-FLU CAPLET|24|EA||04/23/2021||Yes|No||||No|No|04/23/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|184|Yes|.21042|03/29/2022|.20536|03/29/2022|.20673|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21569|||||No|No||LEADER|No||||
diphenhydramine HCl|No|No|No|No|75%|70000052701|SLEEP AID 50 MG SOFTGEL|32|EA||09/18/2020||Yes|No||||No|No|09/18/2020||Yes|No||||No|No|||Over the counter|No|||Yes|.0936|03/01/2022|.09135|03/01/2022|.09196|03/01/2022||||21570|||||No|No||LEADER|No||||
simethicone|No|No|No|No|75%|70000052901|GAS RELIEF 125 MG SOFTGEL|30|EA||10/19/2020||Yes|No||||No|No|10/19/2020||Yes|No||||No|No|||Over the counter|No|||No|.06683|03/29/2022|.06522|03/29/2022|.06566|03/29/2022||||21571|||||No|No||LEADER|No||||
piperonyl butoxide/pyrethrins|No|No|No|No|75%|70000054001|LICE KILLING SHAMPOO|118|ML||12/08/2020||Yes|No||||No|No|12/08/2020||Yes|No||||No|No|||Over the counter|Yes|01/30/2020|122|No|.03958|03/29/2022|.03863|03/29/2022|.03888|03/29/2022|||ANTIPARASITICS: TOPICAL|21572|||||No|No||LEADER|No||||
clotrimazole|No|No|No|No|75%|70000054202|ATHLETE'S FOOT 1% CREAM|28|GM||08/20/2021||Yes|No||||No|No|08/20/2021||Yes|No||||No|No|||Over the counter|No||061|No|.07286|03/29/2022|.07111|03/29/2022|.07158|03/29/2022|||ANTIFUNGALS: TOPICAL|21573|||||No|No||LEADER|No||||
diclofenac sodium|No|No|No|No|75%|70000055501|ARTHRITIS PAIN RELIEVER 1% GEL|50|GM||04/15/2021||Yes|No||||No|No|04/15/2021||Yes|No||||No|No|||Over the counter|No||059|Yes|.10472|03/29/2022|.1022|03/29/2022|.10288|03/29/2022|||NSAIDS|21574|||||No|No||LEADER|No||||
diclofenac sodium|No|No|No|No|75%|70000055502|ARTHRITIS PAIN RELIEVER 1% GEL|100|GM||08/13/2021||Yes|No||||No|No|08/13/2021||Yes|No||||No|No|||Over the counter|No||059|Yes|.09419|03/29/2022|.09192|03/29/2022|.09254|03/29/2022|||NSAIDS|21575|||||No|No||LEADER|No||||
diclofenac sodium|No|No|No|No|75%|70000055503|ARTHRITIS PAIN RELIEVER 1% GEL|150|GM||08/13/2021||Yes|No||||No|No|08/13/2021||Yes|No||||No|No|||Over the counter|No||059|Yes|||||||.12772|08/13/2021|NSAIDS|21576|||||No|No||LEADER|No||||
nicotine polacrilex|No|No|No|No|75%|70000055901|NICOTINE 4 MG MINI LOZENGE|81|EA||08/20/2021||Yes|No||||No|No|08/20/2021||Yes|No||||No|No|||Over the counter|No||040|No|.3724|03/29/2022|.36346|03/29/2022|.36588|03/29/2022|||SMOKING CESSATION|21577|||||No|No||LEADER|No||||
nicotine polacrilex|No|No|No|No|75%|70000056001|NICOTINE 2 MG MINI LOZENGE|81|EA||05/18/2021||Yes|No||||No|No|05/18/2021||Yes|No||||No|No|||Over the counter|No||040|No|.4117|11/23/2021|.40181|11/23/2021|.40449|11/23/2021|||SMOKING CESSATION|21578|||||No|No||LEADER|No||||
nicotine polacrilex|No|No|No|No|75%|70000056101|NICOTINE 4 MG LOZENGE|72|EA||04/15/2021||Yes|No||||No|No|04/15/2021||Yes|No||||No|No|||Over the counter|No||040|No|.35064|03/29/2022|.34222|03/29/2022|.3445|03/29/2022|||SMOKING CESSATION|21579|||||No|No||LEADER|No||||
simethicone|No|No|No|No|75%|70000056601|GAS RELIEF 180 MG SOFTGEL|60|EA||04/15/2021||Yes|No||||No|No|04/15/2021||Yes|No||||No|No|||Over the counter|No|||No|.05902|03/29/2022|.0576|03/29/2022|.05798|03/29/2022||||21580|||||No|No||LEADER|No||||
doxylamine succinate|No|No|No|No|75%|70000056701|SLEEP AID 25 MG TABLET|48|EA||04/15/2021||Yes|No||||No|No|04/15/2021||Yes|No||||No|No|||Over the counter|No|||No|.11278|03/29/2022|.11007|03/29/2022|.1108|03/29/2022||||21581|||||No|No||LEADER|No||||
phenylephrine HCl/acetaminophn|No|No|No|No|75%|70000056801|SINUS-HEADACHE 5-325 MG CAPLET|24|EA||05/19/2021||Yes|No||||No|No|05/19/2021||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|182|No|.06294|03/29/2022|.06142|03/29/2022|.06183|03/29/2022|||COUGH AND COLD: COLD|21582|||||No|No||LEADER|No||||
dexmethylphenidate HCl|No|No|No|No|75%|70010000401|DEXMETHYLPHENIDATE ER 5 MG CAP|100|EA|.57267|04/12/2021||Yes|No||04/12/2021||Yes|No|04/12/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.46405|03/29/2022|1.42891|03/29/2022|1.43842|03/29/2022|||STIMULANTS AND RELATED AGENTS|21583|||||No|No||GRANULES PHARMA|No||||
dexmethylphenidate HCl|No|No|No|No|75%|70010000501|DEXMETHYLPHENIDATE ER 10 MG CP|100|EA|.99652|04/12/2021||Yes|No||04/12/2021||Yes|No|04/12/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.21716|03/29/2022|1.18794|03/29/2022|1.19585|03/29/2022|||STIMULANTS AND RELATED AGENTS|21584|||||No|No||GRANULES PHARMA|No||||
dexmethylphenidate HCl|No|No|No|No|75%|70010000601|DEXMETHYLPHENIDATE ER 15 MG CP|100|EA|.61924|04/12/2021||Yes|No||04/12/2021||Yes|No|04/12/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.90155|03/29/2022|.87991|03/29/2022|.88577|03/29/2022|||STIMULANTS AND RELATED AGENTS|21585|||||No|No||GRANULES PHARMA|No||||
dexmethylphenidate HCl|No|No|No|No|75%|70010000701|DEXMETHYLPHENIDATE ER 20 MG CP|100|EA|.97588|04/12/2021||Yes|No||04/12/2021||Yes|No|04/12/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.47249|03/29/2022|1.43715|03/29/2022|1.44672|03/29/2022|||STIMULANTS AND RELATED AGENTS|21586|||||No|No||GRANULES PHARMA|No||||
dexmethylphenidate HCl|No|No|No|No|75%|70010000801|DEXMETHYLPHENIDATE ER 25 MG CP|100|EA|1.34792|04/12/2021||Yes|No||04/12/2021||Yes|No|04/12/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.83308|03/29/2022|1.78908|03/29/2022|1.801|03/29/2022|||STIMULANTS AND RELATED AGENTS|21587|||||No|No||GRANULES PHARMA|No||||
dexmethylphenidate HCl|No|No|No|No|75%|70010000901|DEXMETHYLPHENIDATE ER 30 MG CP|100|EA|.91452|04/12/2021||Yes|No||04/12/2021||Yes|No|04/12/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|2.05596|03/29/2022|2.00661|03/29/2022|2.01998|03/29/2022|||STIMULANTS AND RELATED AGENTS|21588|||||No|No||GRANULES PHARMA|No||||
dexmethylphenidate HCl|No|No|No|No|75%|70010001001|DEXMETHYLPHENIDATE ER 35 MG CP|100|EA|1.44501|04/12/2021||Yes|No||04/12/2021||Yes|No|04/12/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|2.40563|01/25/2022|2.34789|01/25/2022|2.36353|01/25/2022|||STIMULANTS AND RELATED AGENTS|21589|||||No|No||GRANULES PHARMA|No||||
dexmethylphenidate HCl|No|No|No|No|75%|70010001101|DEXMETHYLPHENIDATE ER 40 MG CP|100|EA|.92686|04/12/2021||Yes|No||04/12/2021||Yes|No|04/12/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|2.72731|03/29/2022|2.66185|03/29/2022|2.67958|03/29/2022|||STIMULANTS AND RELATED AGENTS|21590|||||No|No||GRANULES PHARMA|No||||
methylphenidate HCl|No|No|No|No|75%|70010001201|METHYLPHENIDATE LA 10 MG CAP|100|EA|1.3115|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|5.98466|03/29/2022|5.84102|03/29/2022|5.87992|03/29/2022|||STIMULANTS AND RELATED AGENTS|21591|||||No|No||GRANULES PHARMA|No||||
methylphenidate HCl|No|No|No|No|75%|70010001301|METHYLPHENIDATE LA 20 MG CAP|100|EA|.87728|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.22563|03/29/2022|1.19621|03/29/2022|1.20418|03/29/2022|||STIMULANTS AND RELATED AGENTS|21592|||||No|No||GRANULES PHARMA|No||||
methylphenidate HCl|No|No|No|No|75%|70010001401|METHYLPHENIDATE LA 30 MG CAP|100|EA|.89831|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.80098|03/29/2022|1.75775|03/29/2022|1.76946|03/29/2022|||STIMULANTS AND RELATED AGENTS|21593|||||No|No||GRANULES PHARMA|No||||
methylphenidate HCl|No|No|No|No|75%|70010001501|METHYLPHENIDATE LA 40 MG CAP|100|EA|.91938|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|1.62914|03/29/2022|1.59004|03/29/2022|1.60063|03/29/2022|||STIMULANTS AND RELATED AGENTS|21594|||||No|No||GRANULES PHARMA|No||||
methylphenidate HCl|No|No|No|No|75%|70010001603|METHYLPHENIDATE LA 60 MG CAP|30|EA|4.62866|03/06/2020||Yes|No||03/06/2020||Yes|No|03/06/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|8.60407|09/28/2021|8.39757|09/28/2021|8.45349|09/28/2021|||STIMULANTS AND RELATED AGENTS|21595|||||No|No||GRANULES PHARMA|No||||
trospium chloride|No|No|No|No|75%|70010002703|TROSPIUM CHLORIDE ER 60 MG CAP|30|EA|1.85158|04/01/2021||Yes|No||04/01/2021||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|No|3.47514|03/29/2022|3.39173|03/29/2022|3.41432|03/29/2022|||BLADDER RELAXANT PREPARATIONS|21596|||||No|No||GRANULES PHARMA|No||||
amphetamine sulfate|No|No|No|No|90%|70010004001|AMPHETAMINE SULFATE 5 MG TAB|100|EA|.29166|03/05/2020||Yes|No||03/05/2020||Yes|No|03/05/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|007|Yes|.66473|09/08/2020|.65523|09/08/2020|.62403|09/08/2020|||STIMULANTS AND RELATED AGENTS|21597|||||No|No||GRANULES PHARMA|No||||
amphetamine sulfate|No|No|No|No|90%|70010004101|AMPHETAMINE SULFATE 10 MG TAB|100|EA|.29166|03/05/2020||Yes|No||03/05/2020||Yes|No|03/05/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|007|Yes|.77215|11/23/2021|.75361|11/23/2021|.75863|11/23/2021|||STIMULANTS AND RELATED AGENTS|21598|||||No|No||GRANULES PHARMA|No||||
methylphenidate HCl|No|No|No|No|75%|70010004201|METHYLPHENIDATE ER 10 MG TAB|100|EA|.23839|02/11/2021||Yes|No||02/11/2021||Yes|No|02/11/2021||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|.37583|03/29/2022|.36681|03/29/2022|.36925|03/29/2022|||STIMULANTS AND RELATED AGENTS|21599|||||No|No||GRANULES PHARMA|No||||
methylphenidate HCl|No|No|No|No|75%|70010004301|METHYLPHENIDATE ER 20 MG TAB|100|EA|.24557|02/11/2021||Yes|No||02/11/2021||Yes|No|02/11/2021||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|007|Yes|.50044|03/29/2022|.48842|03/29/2022|.49168|03/29/2022|||STIMULANTS AND RELATED AGENTS|21600|||||No|No||GRANULES PHARMA|No||||
metformin HCl|No|No|No|No|75%|70010006301|METFORMIN HCL 500 MG TABLET|100|EA|.01075|10/21/2021||Yes|No||10/21/2021||Yes|No|10/21/2021||Yes|No||||No|No|||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21601|||||No|No||GRANULES PHARMA|No||||
metformin HCl|No|No|No|No|75%|70010006305|METFORMIN HCL 500 MG TABLET|500|EA|.00866|10/21/2021||Yes|No||10/21/2021||Yes|No|10/21/2021||Yes|No||||No|No|||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21602|||||No|No||GRANULES PHARMA|No||||
metformin HCl|No|No|No|No|75%|70010006309|METFORMIN HCL 500 MG TABLET|90|EA|.01194|10/21/2021||Yes|No||10/21/2021||Yes|No|10/21/2021||Yes|No||||No|No|||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21603|||||No|No||GRANULES PHARMA|No||||
metformin HCl|No|No|No|No|75%|70010006310|METFORMIN HCL 500 MG TABLET|1000|EA|.00767|10/21/2021||Yes|No||10/21/2021||Yes|No|10/21/2021||Yes|No||||No|No|||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21604|||||No|No||GRANULES PHARMA|No||||
metformin HCl|No|No|No|No|75%|70010006401|METFORMIN HCL 850 MG TABLET|100|EA|.01543|10/21/2021||Yes|No||10/21/2021||Yes|No|10/21/2021||Yes|No||||No|No|||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21605|||||No|No||GRANULES PHARMA|No||||
metformin HCl|No|No|No|No|75%|70010006405|METFORMIN HCL 850 MG TABLET|500|EA|.01202|10/21/2021||Yes|No||10/21/2021||Yes|No|10/21/2021||Yes|No||||No|No|||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21606|||||No|No||GRANULES PHARMA|No||||
metformin HCl|No|No|No|No|75%|70010006409|METFORMIN HCL 850 MG TABLET|90|EA|.01714|10/21/2021||Yes|No||10/21/2021||Yes|No|10/21/2021||Yes|No||||No|No|||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21607|||||No|No||GRANULES PHARMA|No||||
metformin HCl|No|No|No|No|75%|70010006410|METFORMIN HCL 850 MG TABLET|1000|EA|.01164|10/21/2021||Yes|No||10/21/2021||Yes|No|10/21/2021||Yes|No||||No|No|||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21608|||||No|No||GRANULES PHARMA|No||||
metformin HCl|No|No|No|No|75%|70010006501|METFORMIN HCL 1,000 MG TABLET|100|EA|.0172|10/21/2021||Yes|No||10/21/2021||Yes|No|10/21/2021||Yes|No||||No|No|||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21609|||||No|No||GRANULES PHARMA|No||||
metformin HCl|No|No|No|No|75%|70010006505|METFORMIN HCL 1,000 MG TABLET|500|EA|.01368|10/21/2021||Yes|No||10/21/2021||Yes|No|10/21/2021||Yes|No||||No|No|||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21610|||||No|No||GRANULES PHARMA|No||||
metformin HCl|No|No|No|No|75%|70010006509|METFORMIN HCL 1,000 MG TABLET|90|EA|.0191|10/21/2021||Yes|No||10/21/2021||Yes|No|10/21/2021||Yes|No||||No|No|||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21611|||||No|No||GRANULES PHARMA|No||||
metformin HCl|No|No|No|No|75%|70010006510|METFORMIN HCL 1,000 MG TABLET|1000|EA|.01324|10/21/2021||Yes|No||10/21/2021||Yes|No|10/21/2021||Yes|No||||No|No|||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21612|||||No|No||GRANULES PHARMA|No||||
potassium chloride|No|No|No|No|75%|70010007244|POTASSIUM CL 10% (20 MEQ/15ML)|473|ML|.05244|12/28/2021||Yes|No||12/28/2021||Yes|No|12/28/2021||Yes|No||||No|No|||Prescription required|No|||No|.13625|03/29/2022|.13298|03/29/2022|.13386|03/29/2022||||21613|||||No|No||GRANULES PHARMA|No||||
potassium chloride|No|No|No|No|75%|70010013501|POTASSIUM CL ER 20 MEQ TABLET|100|EA|.15105|10/14/2021||Yes|No||10/14/2021||Yes|No|10/14/2021||Yes|No||||No|No|||Prescription required|No|||No|.19104|03/29/2022|.18645|03/29/2022|.18769|03/29/2022||||21614|||||No|No||GRANULES PHARMA|No||||
potassium chloride|No|No|No|No|75%|70010013505|POTASSIUM CL ER 20 MEQ TABLET|500|EA|.15107|10/21/2021||Yes|No||10/21/2021||Yes|No|10/21/2021||Yes|No||||No|No|||Prescription required|No|||No|.19104|03/29/2022|.18645|03/29/2022|.18769|03/29/2022||||21615|||||No|No||GRANULES PHARMA|No||||
potassium chloride|No|No|No|No|75%|70010013601|POTASSIUM CL ER 10 MEQ TABLET|100|EA|.14353|10/14/2021||Yes|No||10/14/2021||Yes|No|10/14/2021||Yes|No||||No|No|||Prescription required|No|||No|.18432|03/29/2022|.17989|03/29/2022|.18109|03/29/2022||||21616|||||No|No||GRANULES PHARMA|No||||
potassium chloride|No|No|No|No|75%|70010013610|POTASSIUM CL ER 10 MEQ TABLET|1000|EA|.14523|10/14/2021||Yes|No||10/14/2021||Yes|No|10/14/2021||Yes|No||||No|No|||Prescription required|No|||No|.18432|03/29/2022|.17989|03/29/2022|.18109|03/29/2022||||21617|||||No|No||GRANULES PHARMA|No||||
potassium chloride|No|No|No|No|75%|70010014801|POTASSIUM CL ER 10 MEQ CAPSULE|100|EA|.0774|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||||No|No|||Prescription required|No|||No|.15494|03/29/2022|.15122|03/29/2022|.15222|03/29/2022||||21618|||||No|No||GRANULES PHARMA|No||||
potassium chloride|No|No|No|No|75%|70010014805|POTASSIUM CL ER 10 MEQ CAPSULE|500|EA|.0774|02/01/2022||Yes|No||02/01/2022||Yes|No|02/01/2022||Yes|No||||No|No|||Prescription required|No|||No|.15494|03/29/2022|.15122|03/29/2022|.15222|03/29/2022||||21619|||||No|No||GRANULES PHARMA|No||||
metformin HCl|Yes|No|No|No|75%|70010049101|METFORMIN HCL ER 500 MG TABLET|100|EA|.02042|06/24/2020||Yes|No||06/24/2020||Yes|No|06/24/2020||Yes|No||||No|No|09/21/2020||Prescription required|No||012|No|.03646|03/29/2022|.03558|03/29/2022|.03582|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21620|||||No|No||GRANULES PHARMA|No||||
metformin HCl|Yes|No|No|No|75%|70010049105|METFORMIN HCL ER 500 MG TABLET|500|EA|.01844|06/24/2020||Yes|No||06/24/2020||Yes|No|06/24/2020||Yes|No||||No|No|09/21/2020||Prescription required|No||012|No|.03646|03/29/2022|.03558|03/29/2022|.03582|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21621|||||No|No||GRANULES PHARMA|No||||
metformin HCl|Yes|No|No|No|75%|70010049110|METFORMIN HCL ER 500 MG TABLET|1000|EA|.02098|06/24/2020||Yes|No||06/24/2020||Yes|No|06/24/2020||Yes|No||||No|No|09/21/2020||Prescription required|No||012|No|.03646|03/29/2022|.03558|03/29/2022|.03582|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21622|||||No|No||GRANULES PHARMA|No||||
metformin HCl|No|No|No|No|75%|70010049601|METFORMIN ER 500 MG GASTRC-TB|100|EA|2.1801|10/14/2021||Yes|No||10/14/2021||Yes|No|10/14/2021||Yes|No||||No|No|||Prescription required|No||012|No|2.40128|03/29/2022|2.34364|03/29/2022|2.35925|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21623|||||No|No||GRANULES PHARMA|No||||
metformin HCl|No|No|No|No|75%|70010049709|METFORMIN ER 1,000 MG GASTR-TB|90|EA|4.84466|10/14/2021||Yes|No||10/14/2021||Yes|No|10/14/2021||Yes|No||||No|No|||Prescription required|No||012|No|6.02577|03/29/2022|5.88115|03/29/2022|5.92031|03/29/2022|||HYPOGLYCEMICS: METFORMINS|21624|||||No|No||GRANULES PHARMA|No||||
methocarbamol|No|No|No|No|75%|70010075401|METHOCARBAMOL 500 MG TABLET|100|EA|.0215|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|No||116|Yes|.07091|03/29/2022|.0692|03/29/2022|.06966|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21625|||||No|No||GRANULES PHARMA|No||||
methocarbamol|No|No|No|No|75%|70010075405|METHOCARBAMOL 500 MG TABLET|500|EA|.0215|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|No||116|Yes|.07091|03/29/2022|.0692|03/29/2022|.06966|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21626|||||No|No||GRANULES PHARMA|No||||
methocarbamol|No|No|No|No|75%|70010077001|METHOCARBAMOL 750 MG TABLET|100|EA|.02687|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|No||116|Yes|.09307|03/29/2022|.09083|03/29/2022|.09144|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21627|||||No|No||GRANULES PHARMA|No||||
methocarbamol|No|No|No|No|75%|70010077005|METHOCARBAMOL 750 MG TABLET|500|EA|.02666|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|No||116|Yes|.09307|03/29/2022|.09083|03/29/2022|.09144|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21628|||||No|No||GRANULES PHARMA|No||||
cyanocobalamin (vitamin B-12)|No|No|No|No|75%|70069000501|CYANOCOBALAMIN 1,000 MCG/ML VL|1|ML|4.128|11/16/2016||Yes|No||11/16/2016||Yes|No|11/16/2016||Yes|No||||No|No|||Prescription required|No|||No|9.408|11/16/2016|9.2736|11/16/2016|8.832|11/16/2016||||21629|||||No|No||SOMERSET THERAP|No||||
cyanocobalamin (vitamin B-12)|No|No|No|No|75%|70069000510|CYANOCOBALAMIN 1,000 MCG/ML VL|1|ML|1.5308|06/12/2017||Yes|No||06/12/2017||Yes|No|06/12/2017||Yes|No||||No|No|||Prescription required|No|||No|2.89168|03/29/2022|2.82227|03/29/2022|2.84107|03/29/2022||||21630|||||No|No||SOMERSET THERAP|No||||
olopatadine HCl|No|No|No|No|75%|70069000701|OLOPATADINE HCL 0.1% EYE DROPS|5|ML|2.15|03/06/2017||Yes|No||03/06/2017||Yes|No|03/06/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|002|No|3.02733|03/29/2022|2.95467|03/29/2022|2.97435|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|21631|||||No|No||SOMERSET THERAP|No||||
epinastine HCl|No|No|No|No|75%|70069000801|EPINASTINE HCL 0.05% EYE DROPS|5|ML|7.353|03/07/2017||Yes|No||03/07/2017||Yes|No|03/07/2017||Yes|No||||No|No|||Prescription required|Yes|01/28/2016|002|No|15.8565|03/29/2022|15.47594|03/29/2022|15.57901|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|21632|||||No|No||SOMERSET THERAP|No||||
haloperidol decanoate|No|No|No|No|75%|70069003003|HALOPERIDOL DECAN 50 MG/ML AMP|1|ML|10.75|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|No||027|No|21.21556|03/01/2022|20.70638|03/01/2022|20.84428|03/01/2022|||ANTIPSYCHOTICS|21633|||||No|No||SOMERSET THERAP|No||||
haloperidol decanoate|No|No|No|No|75%|70069003105|HALOPERIDOL DEC 100 MG/ML AMP|1|ML|21.07|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|No||027|No|33.234|03/29/2022|32.43638|03/29/2022|32.6524|03/29/2022|||ANTIPSYCHOTICS|21634|||||No|No||SOMERSET THERAP|No||||
dorzolamide HCl/timolol maleat|No|No|No|No|75%|70069005101|DORZOLAMIDE-TIMOLOL EYE DROPS|10|ML|.86|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No||||No|No|||Prescription required|No||088|No|1.24117|03/29/2022|1.21138|03/29/2022|1.21944|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|21635|||||No|No||SOMERSET THERAP|No||||
naloxone HCl|No|No|No|No|75%|70069007101|NALOXONE 0.4 MG/ML VIAL|1|ML|6.8069|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|||||||15.5134|10/01/2020|OPIATE DEPENDENCE TREATMENTS|21636|||||No|No||SOMERSET THERAP|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|70069007110|NALOXONE 0.4 MG/ML VIAL|1|ML|6.43925|12/05/2017||Yes|No||12/05/2017||Yes|No|12/05/2017||Yes|No||||No|No|||Prescription required|No||145|No|14.6755|03/29/2022|14.46585|03/29/2022|13.777|03/29/2022|||OPIATE DEPENDENCE TREATMENTS|21637|||||No|Yes|12.56|SOMERSET THERAP|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|70069007201|NALOXONE 4 MG/10 ML VIAL|10|ML|6.7037|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|||||||||OPIATE DEPENDENCE TREATMENTS|21638|||||No|No||SOMERSET THERAP|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|70069007210|NALOXONE 4 MG/10 ML VIAL|10|ML|5.08539|12/05/2017||Yes|No||12/05/2017||Yes|No|12/05/2017||Yes|No||||No|No|||Prescription required|No||145|No|11.58997|12/05/2017|11.42439|12/05/2017|10.88038|12/05/2017|||OPIATE DEPENDENCE TREATMENTS|21639|||||No|Yes|12.56|SOMERSET THERAP|Yes|09/01/2020|||
azelastine HCl|No|No|No|No|75%|70069009101|AZELASTINE HCL 0.05% DROPS|6|ML|3.47583|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|002|No|1.22657|03/29/2022|1.19713|03/29/2022|1.2051|03/29/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|21640|||||No|No||SOMERSET THERAP|No||||
tropicamide|No|No|No|No|75%|70069012101|TROPICAMIDE 1% EYE DROPS|15|ML|.24366|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No|||No|.55532|12/29/2020|.54739|12/29/2020|.52132|12/29/2020||||21641|||||No|No||SOMERSET THERAP|No||||
tobramycin|No|No|No|No|75%|70069013101|TOBRAMYCIN 0.3% EYE DROP|5|ML|.43|11/07/2019||Yes|No||11/07/2019||Yes|No|11/07/2019||Yes|No||||No|No|||Prescription required|No||058|No|1.42908|03/29/2022|1.39478|03/29/2022|1.40407|03/29/2022|||OPHTHALMIC ANTIBIOTICS|21642|||||No|No||SOMERSET THERAP|No||||
pilocarpine HCl|No|No|No|No|75%|70069018101|PILOCARPINE 1% EYE DROPS|15|ML|2.12678|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No||088|No|4.04603|03/29/2022|3.94892|03/29/2022|3.97522|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|21643|||||No|No||SOMERSET THERAP|No||||
pilocarpine HCl|No|No|No|No|75%|70069019101|PILOCARPINE 2% EYE DROPS|15|ML|2.17522|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No||088|No|4.33357|03/29/2022|4.22956|03/29/2022|4.25773|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|21644|||||No|No||SOMERSET THERAP|No||||
pilocarpine HCl|No|No|No|No|75%|70069020101|PILOCARPINE 4% EYE DROPS|15|ML|2.28043|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No||088|No|4.37517|11/23/2021|4.27016|11/23/2021|4.2986|11/23/2021|||OPHTHALMICS: GLAUCOMA AGENTS|21645|||||No|No||SOMERSET THERAP|No||||
brimonidine tartrate|No|No|No|No|75%|70069023101|BRIMONIDINE 0.2% EYE DROP|5|ML|.86|11/06/2019||Yes|No||11/06/2019||Yes|No|11/06/2019||Yes|No||||No|No|||Prescription required|No||088|No|.85973|03/29/2022|.83909|03/29/2022|.84468|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|21646|||||No|No||SOMERSET THERAP|No||||
brimonidine tartrate|No|No|No|No|75%|70069023201|BRIMONIDINE 0.2% EYE DROP|10|ML|.516|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No||088|No|.62326|03/29/2022|.6083|03/29/2022|.61235|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|21647|||||No|No||SOMERSET THERAP|No||||
brimonidine tartrate|No|No|No|No|75%|70069023301|BRIMONIDINE 0.2% EYE DROP|15|ML|.43|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No||088|No|.58721|03/29/2022|.57311|03/29/2022|.57693|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|21648|||||No|No||SOMERSET THERAP|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|70069036110|SULFAMETHOXAZOLE-TMP IV VIAL|5|ML|.52313|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No|||No|1.19226|05/21/2020|1.17523|05/21/2020|1.11927|05/21/2020||||21649|||||No|No||SOMERSET THERAP|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|70069036210|SULFAMETHOXAZOLE-TMP IV VIAL|10|ML|.52305|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No|||No|1.19207|05/21/2020|1.17504|05/21/2020|1.11908|05/21/2020||||21650|||||No|No||SOMERSET THERAP|No||||
sulfamethoxazole/trimethoprim|No|No|No|No|75%|70069036301|SULFAMETHOXAZOLE-TMP IV VIAL|30|ML|.52302|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No|||No|1.192|05/21/2020|1.17497|05/21/2020|1.11902|05/21/2020||||21651|||||No|No||SOMERSET THERAP|No||||
haloperidol decanoate|No|No|No|No|75%|70069038101|HALOPERIDOL DEC 50 MG/ML VIAL|1|ML|9.1762|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No||||No|No|||Prescription required|No||027|No|20.9132|03/01/2022|20.61444|03/01/2022|19.6328|03/01/2022|||ANTIPSYCHOTICS|21652|||||No|No||SOMERSET THERAP|No||||
haloperidol decanoate|No|No|No|No|75%|70069038110|HALOPERIDOL DEC 50 MG/ML VIAL|1|ML|9.1762|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No||||No|No|||Prescription required|No||027|No|17.60088|09/28/2021|17.17845|09/28/2021|17.29286|09/28/2021|||ANTIPSYCHOTICS|21653|||||No|No||SOMERSET THERAP|No||||
haloperidol decanoate|No|No|No|No|75%|70069038301|HALOPERIDOL DEC 100 MG/ML VIAL|1|ML|16.684|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No||||No|No|||Prescription required|No||027|No|18.535|03/29/2022|18.09016|03/29/2022|18.21063|03/29/2022|||ANTIPSYCHOTICS|21654|||||No|No||SOMERSET THERAP|No||||
haloperidol decanoate|No|No|No|No|75%|70069038305|HALOPERIDOL DEC 100 MG/ML VIAL|1|ML|16.684|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No||||No|No|||Prescription required|No||027|No|29.246|03/29/2022|28.54409|03/29/2022|28.73419|03/29/2022|||ANTIPSYCHOTICS|21655|||||No|No||SOMERSET THERAP|No||||
haloperidol decanoate|No|No|No|No|75%|70069038310|HALOPERIDOL DEC 100 MG/ML VIAL|1|ML|16.684|01/29/2020||Yes|No||01/29/2020||Yes|No|01/29/2020||Yes|No||||No|No|||Prescription required|No||027|No|38.024|06/23/2020|37.4808|06/23/2020|35.696|06/23/2020|||ANTIPSYCHOTICS|21656|||||No|No||SOMERSET THERAP|No||||
haloperidol decanoate|No|No|No|No|75%|70069038405|HALOPERIDOL DEC 500 MG/5 ML VL|5|ML|16.77|12/30/2020||Yes|No||12/30/2020||Yes|No|12/30/2020||Yes|No||||No|No|||Prescription required|No||027|No|38.22|03/02/2021|37.674|03/02/2021|35.88|03/02/2021|||ANTIPSYCHOTICS|21657|||||No|No||SOMERSET THERAP|No||||
bimatoprost|No|No|No|No|75%|70069040101|BIMATOPROST 0.03% EYE DROPS|2.5|ML|17.96884|11/06/2019||Yes|No||11/06/2019||Yes|No|11/06/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|088|No|28.61527|03/29/2022|27.9285|03/29/2022|28.1145|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|21658|||||No|No||SOMERSET THERAP|No||||
bimatoprost|No|No|No|No|75%|70069040201|BIMATOPROST 0.03% EYE DROPS|5|ML|17.9611|11/06/2019||Yes|No||11/06/2019||Yes|No|11/06/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|088|No|26.52867|03/29/2022|25.89198|03/29/2022|26.06441|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|21659|||||No|No||SOMERSET THERAP|No||||
bimatoprost|No|No|No|No|75%|70069040301|BIMATOPROST 0.03% EYE DROPS|7.5|ML|17.96081|11/06/2019||Yes|No||11/06/2019||Yes|No|11/06/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|088|No|40.93394|11/06/2019|40.34917|11/06/2019|38.42778|11/06/2019|||OPHTHALMICS: GLAUCOMA AGENTS|21660|||||No|No||SOMERSET THERAP|No||||
latanoprost|No|No|No|No|75%|70069042101|LATANOPROST 0.005% EYE DROPS|2.5|ML|1.25044|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|No||088|No|1.89557|03/29/2022|1.85007|03/29/2022|1.86239|03/29/2022|||OPHTHALMICS: GLAUCOMA AGENTS|21661|||||No|No||SOMERSET THERAP|No||||
latanoprost|No|No|No|No|75%|70069042103|LATANOPROST 0.005% EYE DROPS|2.5|ML|1.25044|04/13/2021||Yes|No||04/13/2021||Yes|No|04/13/2021||Yes|No||||No|No|||Prescription required|No||088|No|2.84984|07/06/2021|2.80912|07/06/2021|2.67536|07/06/2021|||OPHTHALMICS: GLAUCOMA AGENTS|21662|||||No|No||SOMERSET THERAP|No||||
sumatriptan succinate|No|No|No|No|75%|70069080405|SUMATRIPTAN 6 MG/0.5 ML VIAL|.5|ML|10.32|03/14/2022||Yes|No||03/14/2022||Yes|No|03/14/2022||Yes|No||||No|No|||Prescription required|No||021|No|17.0535|03/14/2022|16.64421|03/14/2022|16.75506|03/14/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|21663|||||No|No||SOMERSET THERAP|No||||
pegfilgrastim-cbqv|No|No|No|No|75%|70114010101|UDENYCA 6 MG/0.6 ML SYRINGE|.6|ML|2992.08333|05/22/2019||Yes|No||05/22/2019||Yes|No|05/22/2019||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|148|No|6819.16666|05/22/2019|6721.74999|05/22/2019|6401.66666|05/22/2019|||COLONY STIMULATING FACTORS|21664|||||No|No||COHERUS BIOSCIE|No||||
triamcinolone acetonide|No|No|No|No|75%|70121104905|TRIAMCINOLONE ACET 40 MG/ML VL|1|ML|3.655|06/22/2018||Yes|No||06/22/2018||Yes|No|06/22/2018||Yes|No||||No|No|||Prescription required|No|||No|8.33|06/22/2018|8.211|06/22/2018|7.82|06/22/2018||||21665|||||No|No||AMNEAL BIOSCIEN|No||||
furosemide|No|No|No|No|75%|70121107605|FUROSEMIDE 100 MG/10 ML VIAL|10|ML|.26144|06/22/2018||Yes|No||06/22/2018||Yes|No|||No|No||||No|No|||Prescription required|No|||No|.59584|06/26/2018|.58732|06/22/2018|.55936|06/22/2018||||21666|||||No|No||AMNEAL BIOSCIEN|No||||
triamcinolone acetonide|No|No|No|No|75%|70121116801|TRIAMCINOLONE ACET 200 MG/5 ML|5|ML|3.7281|06/22/2018||Yes|No||06/22/2018||Yes|No|06/22/2018||Yes|No||||No|No|||Prescription required|No|||No|8.4966|06/26/2018|8.37522|06/22/2018|7.9764|06/22/2018||||21667|||||No|No||AMNEAL BIOSCIEN|No||||
fosphenytoin sodium|No|No|No|No|75%|70121138105|FOSPHENYTOIN 100 MG PE/2 ML VL|2|ML|3.225|01/09/2017||Yes|No||01/09/2017||Yes|No|01/09/2017||Yes|No||||No|No|||Prescription required|No|||No|7.35|01/09/2017|7.245|01/09/2017|6.9|01/09/2017||||21668|||||No|No||AMNEAL BIOSCIEN|No||||
fosphenytoin sodium|No|No|No|No|75%|70121139007|FOSPHENYTOIN 500 MG PE/10 ML|10|ML|2.064|01/09/2017||Yes|No||01/09/2017||Yes|No|01/09/2017||Yes|No||||No|No|||Prescription required|No|||No|4.704|01/09/2017|4.6368|01/09/2017|4.416|01/09/2017||||21669|||||No|No||AMNEAL BIOSCIEN|No||||
glycopyrrolate|No|No|No|No|75%|70121139405|GLYCOPYRROLATE 0.2 MG/ML VIAL|1|ML|3.02995|06/25/2018||Yes|No||06/25/2018||Yes|No|06/25/2018||Yes|No||||No|No|||Prescription required|No|||No|6.90547|06/25/2018|6.80682|06/25/2018|6.48268|06/25/2018||||21670|||||No|No||AMNEAL BIOSCIEN|No||||
glycopyrrolate|No|No|No|No|75%|70121139505|GLYCOPYRROLATE 0.4 MG/2 ML VL|2|ML|3.11724|06/25/2018||Yes|No||06/25/2018||Yes|No|06/25/2018||Yes|No||||No|No|||Prescription required|No|||No|7.10441|06/25/2018|7.00292|06/25/2018|6.66944|06/25/2018||||21671|||||No|No||AMNEAL BIOSCIEN|No||||
glycopyrrolate|No|No|No|No|75%|70121139605|GLYCOPYRROLATE 1 MG/5 ML VIAL|5|ML|2.68636|06/25/2018||Yes|No||06/25/2018||Yes|No|06/25/2018||Yes|No||||No|No|||Prescription required|No|||No|6.12241|06/25/2018|6.03494|06/25/2018|5.74757|06/25/2018||||21672|||||No|No||AMNEAL BIOSCIEN|No||||
glycopyrrolate|No|No|No|No|75%|70121139707|GLYCOPYRROLATE 4 MG/20 ML VIAL|20|ML|2.66535|06/25/2018||Yes|No||06/25/2018||Yes|No|06/25/2018||Yes|No||||No|No|||Prescription required|No|||No|6.07453|06/25/2018|5.98775|06/25/2018|5.70262|06/25/2018||||21673|||||No|No||AMNEAL BIOSCIEN|No||||
meropenem|No|No|No|No|75%|70121145307|MEROPENEM IV 1 GM VIAL|1|EA|4.73|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|No|||No|10.78|02/17/2017|10.626|02/17/2017|10.12|02/17/2017||||21674|||||No|No||AMNEAL BIOSCIEN|No||||
meropenem|No|No|No|No|75%|70121145407|MEROPENEM IV 500 MG VIAL|1|EA|2.58|02/17/2017||Yes|No||02/17/2017||Yes|No|02/17/2017||Yes|No||||No|No|||Prescription required|No|||No|5.88|02/17/2017|5.796|02/21/2017|5.52|02/17/2017||||21675|||||No|No||AMNEAL BIOSCIEN|No||||
tigecycline|No|No|No|No|75%|70121164707|TIGECYCLINE 50 MG VIAL|1|EA|44.72|02/03/2020||Yes|No||02/03/2020||Yes|No|02/03/2020||Yes|No||||No|No|||Prescription required|No|||No|101.92|02/03/2020|100.464|02/03/2020|95.68|02/03/2020||||21676|||||No|No||AMNEAL BIOSCIEN|No||||
cannabidiol (CBD)|No|No|No|No|75%|70127010010|EPIDIOLEX 100 MG/ML SOLUTION|100|ML||12/19/2018||Yes|No||12/19/2018||Yes|No|12/19/2018||Yes|No||||No|No|||Prescription required|No||056|No|15.092|01/18/2022|14.8764|01/18/2022|14.168|01/18/2022|||ANTICONVULSANTS|21677|||||No|No||GREENWICH/JAZZ|No||||
amphetamine|No|No|No|No|75%|70165000315|ADZENYS ER 1.25 MG/ML SUSP|450|ML|.64873|07/19/2018|09/01/2022|Yes|No||07/19/2018|09/01/2022|Yes|No|07/19/2018|09/01/2022|Yes|No||||No|No|||Prescription required|Yes|07/26/2018|007|No|1.4785|01/01/2019|1.45738|01/01/2019|1.38798|01/01/2019|||STIMULANTS AND RELATED AGENTS|21678|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||NEOS BRANDS/AYT|No||||
amphetamine|No|No|No|No|75%|70165000530|ADZENYS XR-ODT 3.1 MG TABLET|30|EA|6.2436|07/20/2016||Yes|No||07/20/2016||Yes|No|07/20/2016||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|007|Yes|14.00043|11/23/2021|13.66441|11/23/2021|13.75542|11/23/2021|||STIMULANTS AND RELATED AGENTS|21679|||||No|No||NEOS BRANDS/AYT|No||||
amphetamine|No|No|No|No|75%|70165001030|ADZENYS XR-ODT 6.3 MG TABLET|30|EA|6.2436|07/20/2016||Yes|No||07/20/2016||Yes|No|07/20/2016||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|007|Yes|13.87967|10/26/2021|13.54655|10/26/2021|13.63677|10/26/2021|||STIMULANTS AND RELATED AGENTS|21680|||||No|No||NEOS BRANDS/AYT|No||||
amphetamine|No|No|No|No|75%|70165001530|ADZENYS XR-ODT 9.4 MG TABLET|30|EA|6.2436|07/20/2016||Yes|No||07/20/2016||Yes|No|07/20/2016||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|007|Yes|13.93408|10/26/2021|13.59966|10/26/2021|13.69023|10/26/2021|||STIMULANTS AND RELATED AGENTS|21681|||||No|No||NEOS BRANDS/AYT|No||||
amphetamine|No|No|No|No|75%|70165002030|ADZENYS XR-ODT 12.5 MG TABLET|30|EA|6.2436|07/20/2016||Yes|No||07/20/2016||Yes|No|07/20/2016||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|007|Yes|13.88907|10/26/2021|13.55573|10/26/2021|13.64601|10/26/2021|||STIMULANTS AND RELATED AGENTS|21682|||||No|No||NEOS BRANDS/AYT|No||||
amphetamine|No|No|No|No|75%|70165002530|ADZENYS XR-ODT 15.7 MG TABLET|30|EA|6.2436|07/20/2016||Yes|No||07/20/2016||Yes|No|07/20/2016||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|007|Yes|13.82961|10/26/2021|13.49769|10/26/2021|13.58759|10/26/2021|||STIMULANTS AND RELATED AGENTS|21683|||||No|No||NEOS BRANDS/AYT|No||||
amphetamine|No|No|No|No|75%|70165003030|ADZENYS XR-ODT 18.8 MG TABLET|30|EA|6.2436|08/03/2016||Yes|No||08/03/2016||Yes|No|08/03/2016||Yes|No||||No|No|||Prescription required|Yes|01/26/2017|007|Yes|13.94276|10/26/2021|13.60813|10/26/2021|13.69876|10/26/2021|||STIMULANTS AND RELATED AGENTS|21684|||||No|No||NEOS BRANDS/AYT|No||||
methylphenidate|No|No|No|No|75%|70165010030|COTEMPLA XR-ODT 8.6 MG TABLET|30|EA|6.3812|11/09/2017||Yes|No||11/09/2017||Yes|No|11/09/2017||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|007|Yes|14.29025|10/26/2021|13.94728|10/26/2021|14.04017|10/26/2021|||STIMULANTS AND RELATED AGENTS|21685|||||No|No||NEOS BRANDS/AYT|No||||
methylphenidate|No|No|No|No|75%|70165020030|COTEMPLA XR-ODT 17.3 MG TABLET|30|EA|6.3812|11/09/2017||Yes|No||11/09/2017||Yes|No|11/09/2017||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|007|Yes|14.21829|03/01/2022|13.87705|03/01/2022|13.96946|03/01/2022|||STIMULANTS AND RELATED AGENTS|21686|||||No|No||NEOS BRANDS/AYT|No||||
methylphenidate|No|No|No|No|75%|70165030030|COTEMPLA XR-ODT 25.9 MG TABLET|30|EA|6.3812|11/09/2017||Yes|No||11/09/2017||Yes|No|11/09/2017||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|007|Yes|14.26509|10/26/2021|13.92272|10/26/2021|14.01545|10/26/2021|||STIMULANTS AND RELATED AGENTS|21687|||||No|No||NEOS BRANDS/AYT|No||||
telotristat etiprate|No|No|No|No|75%|70183012584|XERMELO 250 MG TABLET|84|EA|38.70793|01/05/2018|05/03/2022|Yes|No||01/05/2018|05/03/2022|Yes|No|01/05/2018|05/03/2022|Yes|No||||No|No|||Prescription required|No|||No|88.21808|04/06/2021|86.95782|04/06/2021|82.81697|04/06/2021||||21688|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LEXICON/TERSERA|No||||
meclizine HCl|No|No|No|No|75%|70199000401|ANTIVERT 50 MG TABLET|100|EA|1.54494|02/22/2022||Yes|No||02/22/2022||Yes|No|02/22/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|085|Yes|3.52104|02/22/2022|3.47074|02/22/2022|3.30546|02/22/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|21689|||||No|No||CASPER PHARMA L|No||||
nitrofurantoin|No|No|No|No|75%|70199000632|FURADANTIN 25 MG/5 ML SUSP|230|ML|5.23478|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No|||No|11.93043|05/30/2018|11.75999|05/30/2018|11.19999|05/30/2018||||21690|||||No|No||CASPER PHARMA L|No||||
cyclobenzaprine HCl|No|No|No|No|75%|70199001401|FEXMID 7.5 MG TABLET|100|EA|2.98119|07/20/2018||Yes|No||07/20/2018||Yes|No|07/20/2018||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|Yes|6.79434|07/20/2018|6.69727|07/20/2018|6.37836|07/20/2018|||SKELETAL MUSCLE RELAXANTS|21691|||||No|No||CASPER PHARMA L|No||||
chlorthalidone|No|No|No|No|75%|70199001730|THALITONE 15 MG TABLET|30|EA|1.58999|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||||No|No|||Prescription required|No|||No|3.6237|02/10/2022|3.57193|02/10/2022|3.40184|02/10/2022||||21692|||||No|No||CASPER PHARMA L|No||||
aloe vera extract/allantoin|No|No|No|No|75%|70211070202|COATS ALOE MOISTURIZING LOTION|59|ML|.02463|04/01/2016||Yes|No||||No|No|04/01/2016||Yes|No||||No|No|||Over the counter|No|||No|.05613|01/03/2017|.05533|01/03/2017|.05269|01/03/2017||||21693|||||No|No||TYCHASIS CORPOR|No||||
aloe vera extract/allantoin|No|No|No|No|75%|70211070208|COATS ALOE MOISTURIZING LOTION|237|ML|.02826|04/01/2016||Yes|No||||No|No|04/01/2016||Yes|No||||No|No|||Over the counter|No|||No|.06441|01/03/2017|.06349|01/03/2017|.06047|01/03/2017||||21694|||||No|No||TYCHASIS CORPOR|No||||
aloe vera extract/allantoin|No|No|No|No|75%|70211070233|COATS ALOE MOISTURIZING LOTION|976|ML|.02251|04/01/2016||Yes|No||||No|No|04/01/2016||Yes|No||||No|No|||Over the counter|No|||No|.05131|01/03/2017|.05057|01/03/2017|.04817|01/03/2017||||21695|||||No|No||TYCHASIS CORPOR|No||||
aloe vera extract/allantoin|No|No|No|No|75%|70211070304|COATS ALOE CREME|118|GM|.06001|04/01/2016||Yes|No||||No|No|04/01/2016||Yes|No||||No|No|||Over the counter|No|||No|.13677|01/03/2017|.13482|01/03/2017|.1284|01/03/2017||||21696|||||No|No||TYCHASIS CORPOR|No||||
aloe vera extract/allantoin|No|No|No|No|75%|70211070316|COATS ALOE CREME|454|GM|.05119|04/01/2016||Yes|No||||No|No|04/01/2016||Yes|No||||No|No|||Over the counter|No|||No|.11666|01/03/2017|.115|01/03/2017|.10952|01/03/2017||||21697|||||No|No||TYCHASIS CORPOR|No||||
aloe vera extract/allantoin|No|No|No|No|75%|70211070508|COATS ALOE GELLY|237|ML|.02826|04/01/2016||Yes|No||||No|No|04/01/2016||Yes|No||||No|No|||Over the counter|No|||No|.06441|01/03/2017|.06349|01/03/2017|.06047|01/03/2017||||21698|||||No|No||TYCHASIS CORPOR|No||||
binimetinib|No|No|No|No|75%|70255001002|MEKTOVI 15 MG TABLET|180|EA|31.34549|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|No||563|No|71.43857|01/04/2022|70.41801|01/04/2022|67.06478|01/04/2022|||ONCOLOGY: ORAL - SKIN|21699|||||No|No||ARRAY/PFIZER|No||||
encorafenib|No|No|No|No|75%|70255002501|BRAFTOVI 75 MG CAPSULE|90|EA|31.9483|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|No||563|No|72.81241|01/04/2022|71.77223|01/04/2022|68.3545|01/04/2022|||ONCOLOGY: ORAL - SKIN|21700|||||No|No||ARRAY/PFIZER|No||||
encorafenib|No|No|No|No|75%|70255002503|BRAFTOVI 75 MG CAPSULE|60|EA|47.92245|02/02/2021||Yes|No||02/02/2021||Yes|No|02/02/2021||Yes|No||||No|No|||Prescription required|No||563|No|109.21862|01/04/2022|107.65836|01/04/2022|102.53177|01/04/2022|||ONCOLOGY: ORAL - SKIN|21701|||||No|No||ARRAY/PFIZER|No||||
calcifediol|No|No|No|No|75%|70301100101|RAYALDEE ER 30 MCG CAPSULE|30|EA|16.43918|02/01/2021||Yes|No||02/01/2021||Yes|No|02/01/2021||Yes|No||||No|No|||Prescription required|No|||No|36.57017|10/26/2021|35.69248|10/26/2021|35.93019|10/26/2021||||21702|||||No|No||OPKO PHARMACEUT|No||||
metoprolol succinate|No|No|No|No|75%|70347002502|TOPROL XL 25 MG TABLET|100|EA|.56493|06/21/2018||Yes|No||06/21/2018||Yes|No|06/21/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|070|No|1.25947|10/26/2021|1.22924|10/26/2021|1.23742|10/26/2021|||BETA-BLOCKERS|21703|||||No|No||ARALEZ/NEW AMER|No||||
metoprolol succinate|No|No|No|No|75%|70347002503|TOPROL XL 25 MG TABLET|1000|EA|.56495|06/21/2018||Yes|No||06/21/2018||Yes|No|06/21/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|070|No|1.25947|10/26/2021|1.22924|10/26/2021|1.23742|10/26/2021|||BETA-BLOCKERS|21704|||||No|No||ARALEZ/NEW AMER|No||||
metoprolol succinate|No|No|No|No|75%|70347005002|TOPROL XL 50 MG TABLET|100|EA|.56493|06/21/2018||Yes|No||06/21/2018||Yes|No|06/21/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|070|No|1.25992|09/28/2021|1.22968|09/28/2021|1.23787|09/28/2021|||BETA-BLOCKERS|21705|||||No|No||ARALEZ/NEW AMER|No||||
metoprolol succinate|No|No|No|No|75%|70347005003|TOPROL XL 50 MG TABLET|1000|EA|.56495|06/21/2018||Yes|No||06/21/2018||Yes|No|06/21/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|070|No|1.25992|09/28/2021|1.22968|09/28/2021|1.23787|09/28/2021|||BETA-BLOCKERS|21706|||||No|No||ARALEZ/NEW AMER|No||||
metoprolol succinate|No|No|No|No|75%|70347010002|TOPROL XL 100 MG TABLET|100|EA|.84903|06/21/2018||Yes|No||06/21/2018||Yes|No|06/21/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|070|No|1.8965|03/29/2022|1.85098|03/29/2022|1.86331|03/29/2022|||BETA-BLOCKERS|21707|||||No|No||ARALEZ/NEW AMER|No||||
metoprolol succinate|No|No|No|No|75%|70347010003|TOPROL XL 100 MG TABLET|1000|EA|.84906|06/21/2018||Yes|No||06/21/2018||Yes|No|06/21/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|070|No|1.8965|03/29/2022|1.85098|03/29/2022|1.86331|03/29/2022|||BETA-BLOCKERS|21708|||||No|No||ARALEZ/NEW AMER|No||||
metoprolol succinate|No|No|No|No|75%|70347020002|TOPROL XL 200 MG TABLET|100|EA|1.3508|06/21/2018||Yes|No||06/21/2018||Yes|No|06/21/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|070|No|3.07857|06/21/2018|3.03459|06/21/2018|2.89008|06/21/2018|||BETA-BLOCKERS|21709|||||No|No||ARALEZ/NEW AMER|No||||
metoprolol succinate|No|No|No|No|75%|70347020003|TOPROL XL 200 MG TABLET|1000|EA|1.35084|06/21/2018||Yes|No||06/21/2018||Yes|No|06/21/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|070|No|3.07866|06/21/2018|3.03467|06/21/2018|2.89017|06/21/2018|||BETA-BLOCKERS|21710|||||No|No||ARALEZ/NEW AMER|No||||
vorapaxar sulfate|No|No|No|No|75%|70347020890|ZONTIVITY 2.08 MG TABLET|90|EA|5.00213|10/24/2017|12/31/2022|Yes|No||10/24/2017|12/31/2022|Yes|No|10/24/2017|12/31/2022|Yes|No||||No|No|||Prescription required|Yes|07/21/2016|004|No|11.40022|12/28/2021|11.23736|12/28/2021|10.70224|12/28/2021|||PLATELET AGGREGATION INHIBITORS|21711|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ARALEZ/XSPIRE P|No||||
valbenazine tosylate|No|No|No|No|75%|70370106001|INGREZZA 60 MG CAPSULE|30|EA|105.49333|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||572|No|240.42666|12/14/2021|236.99199|12/14/2021|225.70666|12/14/2021|||MOVEMENT DISORDERS|21712|||||No|No||NEUROCRINE BIOS|No||||
valbenazine tosylate|No|No|No|No|75%|70370108001|INGREZZA 80 MG CAPSULE|30|EA|105.49333|01/05/2018||Yes|No||01/05/2018||Yes|No|01/05/2018||Yes|No||||No|No|||Prescription required|No||572|Yes|240.42666|12/14/2021|236.99199|12/14/2021|225.70666|12/14/2021|||MOVEMENT DISORDERS|21713|||||No|No||NEUROCRINE BIOS|No||||
valbenazine tosylate|No|No|No|No|75%|70370204001|INGREZZA 40 MG CAPSULE|30|EA|96.019|07/02/2019||Yes|No||07/02/2019||Yes|No|07/02/2019||Yes|No||||No|No|||Prescription required|No||572|Yes|218.834|12/14/2021|215.7078|12/14/2021|205.436|12/14/2021|||MOVEMENT DISORDERS|21714|||||No|No||NEUROCRINE BIOS|No||||
valbenazine tosylate|No|No|No|No|75%|70370204806|INGREZZA INITIATION PACK|28|EA|113.02857|06/17/2021||Yes|No||06/17/2021||Yes|No|06/17/2021||Yes|No||||No|No|||Prescription required|No||572|Yes|257.59999|12/14/2021|253.91999|12/14/2021|241.82856|12/14/2021|||MOVEMENT DISORDERS|21715|||||No|No||NEUROCRINE BIOS|No||||
opicapone|No|No|No|No|75%|70370302502|ONGENTYS 25 MG CAPSULE|30|EA|8.815|06/17/2021||Yes|No||06/17/2021||Yes|No|06/17/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|015|No|20.09|12/14/2021|19.803|12/14/2021|18.86|12/14/2021|||ANTIPARKINSON'S AGENTS|21716|||||No|No||NEUROCRINE BIOS|No||||
opicapone|No|No|No|No|75%|70370305002|ONGENTYS 50 MG CAPSULE|30|EA|8.815|02/01/2021||Yes|No||02/01/2021||Yes|No|02/01/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|015|No|19.52832|12/21/2021|19.05964|12/21/2021|19.18657|12/21/2021|||ANTIPARKINSON'S AGENTS|21717|||||No|No||NEUROCRINE BIOS|No||||
simvastatin|Yes|No|No|No|75%|70377000112|SIMVASTATIN 5 MG TABLET|30|EA|.0602|08/21/2018||Yes|No||08/21/2018||Yes|No|08/21/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||063|Yes|.03036|03/29/2022|.02963|03/29/2022|.02982|03/29/2022|||LIPOTROPICS: STATINS|21718|||||No|No||BIOCON PHARMA I|No||||
simvastatin|Yes|No|No|No|75%|70377000114|SIMVASTATIN 5 MG TABLET|90|EA|.06837|08/21/2018||Yes|No||08/21/2018||Yes|No|08/21/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||063|Yes|.03036|03/29/2022|.02963|03/29/2022|.02982|03/29/2022|||LIPOTROPICS: STATINS|21719|||||No|No||BIOCON PHARMA I|No||||
simvastatin|Yes|No|No|No|75%|70377000115|SIMVASTATIN 5 MG TABLET|1000|EA|.02604|08/21/2018||Yes|No||08/21/2018||Yes|No|08/21/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||063|Yes|.03036|03/29/2022|.02963|03/29/2022|.02982|03/29/2022|||LIPOTROPICS: STATINS|21720|||||No|No||BIOCON PHARMA I|No||||
simvastatin|Yes|No|No|No|75%|70377000212|SIMVASTATIN 10 MG TABLET|30|EA|.04801|08/21/2018||Yes|No||08/21/2018||Yes|No|08/21/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||063|Yes|.02909|03/29/2022|.02839|03/29/2022|.02858|03/29/2022|||LIPOTROPICS: STATINS|21721|||||No|No||BIOCON PHARMA I|No||||
simvastatin|Yes|No|No|No|75%|70377000214|SIMVASTATIN 10 MG TABLET|90|EA|.04309|08/21/2018||Yes|No||08/21/2018||Yes|No|08/21/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||063|Yes|.02909|03/29/2022|.02839|03/29/2022|.02858|03/29/2022|||LIPOTROPICS: STATINS|21722|||||No|No||BIOCON PHARMA I|No||||
simvastatin|Yes|No|No|No|75%|70377000215|SIMVASTATIN 10 MG TABLET|1000|EA|.04308|08/21/2018||Yes|No||08/21/2018||Yes|No|08/21/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||063|Yes|.02909|03/29/2022|.02839|03/29/2022|.02858|03/29/2022|||LIPOTROPICS: STATINS|21723|||||No|No||BIOCON PHARMA I|No||||
simvastatin|Yes|No|No|No|75%|70377000312|SIMVASTATIN 20 MG TABLET|30|EA|.05919|09/05/2018||Yes|No||09/05/2018||Yes|No|09/05/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||063|Yes|.02604|03/29/2022|.02541|03/29/2022|.02558|03/29/2022|||LIPOTROPICS: STATINS|21724|||||No|No||BIOCON PHARMA I|No||||
simvastatin|Yes|No|No|No|75%|70377000314|SIMVASTATIN 20 MG TABLET|90|EA|.04572|09/05/2018||Yes|No||09/05/2018||Yes|No|09/05/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||063|Yes|.02604|03/29/2022|.02541|03/29/2022|.02558|03/29/2022|||LIPOTROPICS: STATINS|21725|||||No|No||BIOCON PHARMA I|No||||
simvastatin|Yes|No|No|No|75%|70377000315|SIMVASTATIN 20 MG TABLET|1000|EA|.0457|09/05/2018||Yes|No||09/05/2018||Yes|No|09/05/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||063|Yes|.02604|03/29/2022|.02541|03/29/2022|.02558|03/29/2022|||LIPOTROPICS: STATINS|21726|||||No|No||BIOCON PHARMA I|No||||
simvastatin|Yes|No|No|No|75%|70377000412|SIMVASTATIN 40 MG TABLET|30|EA|.0516|08/21/2018||Yes|No||08/21/2018||Yes|No|08/21/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||063|Yes|.04431|03/29/2022|.04324|03/29/2022|.04353|03/29/2022|||LIPOTROPICS: STATINS|21727|||||No|No||BIOCON PHARMA I|No||||
simvastatin|Yes|No|No|No|75%|70377000414|SIMVASTATIN 40 MG TABLET|90|EA|.05154|08/21/2018||Yes|No||08/21/2018||Yes|No|08/21/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||063|Yes|.04431|03/29/2022|.04324|03/29/2022|.04353|03/29/2022|||LIPOTROPICS: STATINS|21728|||||No|No||BIOCON PHARMA I|No||||
simvastatin|Yes|No|No|No|75%|70377000415|SIMVASTATIN 40 MG TABLET|1000|EA|.05153|08/21/2018||Yes|No||08/21/2018||Yes|No|08/21/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||063|Yes|.04431|03/29/2022|.04324|03/29/2022|.04353|03/29/2022|||LIPOTROPICS: STATINS|21729|||||No|No||BIOCON PHARMA I|No||||
simvastatin|Yes|No|No|No|75%|70377000512|SIMVASTATIN 80 MG TABLET|30|EA|.05389|09/05/2018||Yes|No||09/05/2018||Yes|No|09/05/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||063|Yes|.09322|03/29/2022|.09098|03/29/2022|.09158|03/29/2022|||LIPOTROPICS: STATINS|21730|||||No|No||BIOCON PHARMA I|No||||
simvastatin|Yes|No|No|No|75%|70377000514|SIMVASTATIN 80 MG TABLET|90|EA|.05393|09/05/2018||Yes|No||09/05/2018||Yes|No|09/05/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||063|Yes|.09322|03/29/2022|.09098|03/29/2022|.09158|03/29/2022|||LIPOTROPICS: STATINS|21731|||||No|No||BIOCON PHARMA I|No||||
simvastatin|Yes|No|No|No|75%|70377000515|SIMVASTATIN 80 MG TABLET|1000|EA|.05392|09/05/2018||Yes|No||09/05/2018||Yes|No|09/05/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||063|Yes|.09322|03/29/2022|.09098|03/29/2022|.09158|03/29/2022|||LIPOTROPICS: STATINS|21732|||||No|No||BIOCON PHARMA I|No||||
rosuvastatin calcium|No|No|No|No|75%|70377000612|ROSUVASTATIN CALCIUM 5 MG TAB|90|EA|.08188|09/19/2017||Yes|No||09/19/2017||Yes|No|09/19/2017||Yes|No||||No|No|||Prescription required|No||063|Yes|.06753|03/29/2022|.0659|03/29/2022|.06634|03/29/2022|||LIPOTROPICS: STATINS|21733|||||No|No||BIOCON PHARMA I|No||||
rosuvastatin calcium|Yes|No|No|No|75%|70377000613|ROSUVASTATIN CALCIUM 5 MG TAB|500|EA|.08188|08/02/2019||Yes|No||08/02/2019||Yes|No|08/02/2019||Yes|No||||No|No|09/27/2019||Prescription required|No||063|Yes|.06753|03/29/2022|.0659|03/29/2022|.06634|03/29/2022|||LIPOTROPICS: STATINS|21734|||||No|No||BIOCON PHARMA I|No||||
rosuvastatin calcium|No|No|No|No|75%|70377000712|ROSUVASTATIN CALCIUM 10 MG TAB|90|EA|.08188|09/19/2017||Yes|No||09/19/2017||Yes|No|09/19/2017||Yes|No||||No|No|||Prescription required|No||063|Yes|.05981|03/29/2022|.05837|03/29/2022|.05876|03/29/2022|||LIPOTROPICS: STATINS|21735|||||No|No||BIOCON PHARMA I|No||||
rosuvastatin calcium|Yes|No|No|No|75%|70377000713|ROSUVASTATIN CALCIUM 10 MG TAB|500|EA|.08188|08/02/2019||Yes|No||08/02/2019||Yes|No|08/02/2019||Yes|No||||No|No|09/27/2019||Prescription required|No||063|Yes|.05981|03/29/2022|.05837|03/29/2022|.05876|03/29/2022|||LIPOTROPICS: STATINS|21736|||||No|No||BIOCON PHARMA I|No||||
rosuvastatin calcium|No|No|No|No|75%|70377000812|ROSUVASTATIN CALCIUM 20 MG TAB|90|EA|.08188|09/19/2017||Yes|No||09/19/2017||Yes|No|09/19/2017||Yes|No||||No|No|||Prescription required|No||063|Yes|.07822|03/29/2022|.07634|03/29/2022|.07685|03/29/2022|||LIPOTROPICS: STATINS|21737|||||No|No||BIOCON PHARMA I|No||||
rosuvastatin calcium|Yes|No|No|No|75%|70377000813|ROSUVASTATIN CALCIUM 20 MG TAB|500|EA|.08188|08/02/2019||Yes|No||08/02/2019||Yes|No|08/02/2019||Yes|No||||No|No|09/27/2019||Prescription required|No||063|Yes|.07822|03/29/2022|.07634|03/29/2022|.07685|03/29/2022|||LIPOTROPICS: STATINS|21738|||||No|No||BIOCON PHARMA I|No||||
rosuvastatin calcium|No|No|No|No|75%|70377000911|ROSUVASTATIN CALCIUM 40 MG TAB|30|EA|.08198|09/19/2017||Yes|No||09/19/2017||Yes|No|09/19/2017||Yes|No||||No|No|||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|21739|||||No|No||BIOCON PHARMA I|No||||
rosuvastatin calcium|No|No|No|No|75%|70377000912|ROSUVASTATIN CALCIUM 40 MG TAB|90|EA|.11944|09/19/2017||Yes|No||09/19/2017||Yes|No|09/19/2017||Yes|No||||No|No|||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|21740|||||No|No||BIOCON PHARMA I|No||||
rosuvastatin calcium|Yes|No|No|No|75%|70377000913|ROSUVASTATIN CALCIUM 40 MG TAB|500|EA|.08188|08/02/2019||Yes|No||08/02/2019||Yes|No|08/02/2019||Yes|No||||No|No|09/27/2019||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|21741|||||No|No||BIOCON PHARMA I|No||||
everolimus|No|No|No|No|75%|70377001022|EVEROLIMUS 2.5 MG TABLET|28|EA|48.23678|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||548|No|109.93499|03/31/2022|108.36449|03/31/2022|103.20428|03/31/2022|||ONCOLOGY: ORAL - RENAL CELL|21742|||||No|No||BIOCON PHARMA I|No||||
everolimus|No|No|No|No|75%|70377001122|EVEROLIMUS 5 MG TABLET|28|EA|48.23678|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||548|No|109.93499|03/31/2022|108.36449|03/31/2022|103.20428|03/31/2022|||ONCOLOGY: ORAL - RENAL CELL|21743|||||No|No||BIOCON PHARMA I|No||||
everolimus|No|No|No|No|75%|70377001222|EVEROLIMUS 7.5 MG TABLET|28|EA|48.23678|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||548|No|109.93499|03/31/2022|108.36449|03/31/2022|103.20428|03/31/2022|||ONCOLOGY: ORAL - RENAL CELL|21744|||||No|No||BIOCON PHARMA I|No||||
everolimus|No|No|No|No|75%|70377001322|EVEROLIMUS 10 MG TABLET|28|EA|48.23678|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||548|No|109.93499|03/31/2022|108.36449|03/31/2022|103.20428|03/31/2022|||ONCOLOGY: ORAL - RENAL CELL|21745|||||No|No||BIOCON PHARMA I|No||||
tacrolimus|No|No|No|No|75%|70377001411|TACROLIMUS 0.5 MG CAPSULE (IR)|100|EA|.172|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||07/01/2021||Yes|No|||Prescription required|No||229|No|.26138|03/29/2022|.2551|03/29/2022|.2568|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|21746|||||No|No||BIOCON PHARMA I|No||||
tacrolimus|No|No|No|No|75%|70377001511|TACROLIMUS 1 MG CAPSULE (IR)|100|EA|.344|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||07/01/2021||Yes|No|||Prescription required|No||229|No|.35645|03/29/2022|.34789|03/29/2022|.35021|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|21747|||||No|No||BIOCON PHARMA I|No||||
tacrolimus|No|No|No|No|75%|70377001611|TACROLIMUS 5 MG CAPSULE (IR)|100|EA|1.72|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||07/01/2021||Yes|No|||Prescription required|No||229|No|2.05753|03/29/2022|2.00814|03/29/2022|2.02152|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|21748|||||No|No||BIOCON PHARMA I|No||||
atorvastatin calcium|Yes|No|No|No|75%|70377002711|ATORVASTATIN 10 MG TABLET|90|EA|.09106|05/31/2019||Yes|No||05/31/2019||Yes|No|05/31/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|21749|||||No|No||BIOCON PHARMA I|No||||
atorvastatin calcium|Yes|No|No|No|75%|70377002713|ATORVASTATIN 10 MG TABLET|1000|EA|.09106|11/05/2019||Yes|No||11/05/2019||Yes|No|11/05/2019||Yes|No||||No|No|01/16/2020||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|21750|||||No|No||BIOCON PHARMA I|No||||
atorvastatin calcium|Yes|No|No|No|75%|70377002811|ATORVASTATIN 20 MG TABLET|90|EA|.12961|03/13/2019||Yes|No||03/13/2019||Yes|No|03/13/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|21751|||||No|No||BIOCON PHARMA I|No||||
atorvastatin calcium|Yes|No|No|No|75%|70377002813|ATORVASTATIN 20 MG TABLET|1000|EA|.12961|11/05/2019||Yes|No||11/05/2019||Yes|No|11/05/2019||Yes|No||||No|No|01/16/2020||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|21752|||||No|No||BIOCON PHARMA I|No||||
atorvastatin calcium|Yes|No|No|No|75%|70377002911|ATORVASTATIN 40 MG TABLET|90|EA|.12961|03/13/2019||Yes|No||03/13/2019||Yes|No|03/13/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|21753|||||No|No||BIOCON PHARMA I|No||||
atorvastatin calcium|Yes|No|No|No|75%|70377002913|ATORVASTATIN 40 MG TABLET|1000|EA|.12961|11/05/2019||Yes|No||11/05/2019||Yes|No|11/05/2019||Yes|No||||No|No|01/16/2020||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|21754|||||No|No||BIOCON PHARMA I|No||||
atorvastatin calcium|Yes|No|No|No|75%|70377003012|ATORVASTATIN 80 MG TABLET|90|EA|.12961|03/13/2019||Yes|No||03/13/2019||Yes|No|03/13/2019||Yes|No||||No|No|09/04/2019||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|21755|||||No|No||BIOCON PHARMA I|No||||
atorvastatin calcium|Yes|No|No|No|75%|70377003014|ATORVASTATIN 80 MG TABLET|1000|EA|.12961|11/05/2019||Yes|No||11/05/2019||Yes|No|11/05/2019||Yes|No||||No|No|01/16/2020||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|21756|||||No|No||BIOCON PHARMA I|No||||
pravastatin sodium|No|No|No|No|75%|70377004512|PRAVASTATIN SODIUM 10 MG TAB|90|EA|.07166|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.07144|03/29/2022|.06972|03/29/2022|.07018|03/29/2022|||LIPOTROPICS: STATINS|21757|||||No|No||BIOCON PHARMA I|No||||
pravastatin sodium|No|No|No|No|75%|70377004514|PRAVASTATIN SODIUM 10 MG TAB|1000|EA|.07166|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.07144|03/29/2022|.06972|03/29/2022|.07018|03/29/2022|||LIPOTROPICS: STATINS|21758|||||No|No||BIOCON PHARMA I|No||||
pravastatin sodium|No|No|No|No|75%|70377004612|PRAVASTATIN SODIUM 20 MG TAB|90|EA|.086|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.05771|03/29/2022|.05632|03/29/2022|.0567|03/29/2022|||LIPOTROPICS: STATINS|21759|||||No|No||BIOCON PHARMA I|No||||
pravastatin sodium|No|No|No|No|75%|70377004614|PRAVASTATIN SODIUM 20 MG TAB|1000|EA|.086|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.05771|03/29/2022|.05632|03/29/2022|.0567|03/29/2022|||LIPOTROPICS: STATINS|21760|||||No|No||BIOCON PHARMA I|No||||
pravastatin sodium|No|No|No|No|75%|70377004712|PRAVASTATIN SODIUM 40 MG TAB|90|EA|.11944|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.08966|03/29/2022|.0875|03/29/2022|.08809|03/29/2022|||LIPOTROPICS: STATINS|21761|||||No|No||BIOCON PHARMA I|No||||
pravastatin sodium|No|No|No|No|75%|70377004714|PRAVASTATIN SODIUM 40 MG TAB|1000|EA|.11944|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.08966|03/29/2022|.0875|03/29/2022|.08809|03/29/2022|||LIPOTROPICS: STATINS|21762|||||No|No||BIOCON PHARMA I|No||||
pravastatin sodium|No|No|No|No|75%|70377004812|PRAVASTATIN SODIUM 80 MG TAB|90|EA|.16721|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.14996|03/29/2022|.14636|03/29/2022|.14733|03/29/2022|||LIPOTROPICS: STATINS|21763|||||No|No||BIOCON PHARMA I|No||||
pravastatin sodium|No|No|No|No|75%|70377004813|PRAVASTATIN SODIUM 80 MG TAB|500|EA|.16721|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.14996|03/29/2022|.14636|03/29/2022|.14733|03/29/2022|||LIPOTROPICS: STATINS|21764|||||No|No||BIOCON PHARMA I|No||||
esomeprazole magnesium|No|No|No|No|75%|70377005511|ESOMEPRAZOLE MAG DR 20 MG CAP|30|EA|.215|09/07/2021||Yes|No||09/07/2021||Yes|No|09/07/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|21765|||||No|No||BIOCON PHARMA I|No||||
esomeprazole magnesium|No|No|No|No|75%|70377005512|ESOMEPRAZOLE MAG DR 20 MG CAP|90|EA|.215|09/07/2021||Yes|No||09/07/2021||Yes|No|09/07/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|21766|||||No|No||BIOCON PHARMA I|No||||
esomeprazole magnesium|No|No|No|No|75%|70377005513|ESOMEPRAZOLE MAG DR 20 MG CAP|1000|EA|.215|09/07/2021||Yes|No||09/07/2021||Yes|No|09/07/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|Yes|.25175|03/29/2022|.2457|03/29/2022|.24734|03/29/2022|||PROTON PUMP INHIBITORS|21767|||||No|No||BIOCON PHARMA I|No||||
esomeprazole magnesium|No|No|No|No|75%|70377005611|ESOMEPRAZOLE MAG DR 40 MG CAP|30|EA|.215|09/07/2021||Yes|No||09/07/2021||Yes|No|09/07/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|21768|||||No|No||BIOCON PHARMA I|No||||
esomeprazole magnesium|No|No|No|No|75%|70377005612|ESOMEPRAZOLE MAG DR 40 MG CAP|90|EA|.215|09/07/2021||Yes|No||09/07/2021||Yes|No|09/07/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|21769|||||No|No||BIOCON PHARMA I|No||||
esomeprazole magnesium|No|No|No|No|75%|70377005613|ESOMEPRAZOLE MAG DR 40 MG CAP|1000|EA|.215|09/07/2021||Yes|No||09/07/2021||Yes|No|09/07/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|No|.20468|03/29/2022|.19976|03/29/2022|.20109|03/29/2022|||PROTON PUMP INHIBITORS|21770|||||No|No||BIOCON PHARMA I|No||||
labetalol HCl|No|No|No|No|75%|70377006012|LABETALOL HCL 100 MG TABLET|100|EA|.17647|09/07/2021||Yes|No||09/07/2021||Yes|No|09/07/2021||Yes|No||||No|No|||Prescription required|No||070|No|.12868|03/29/2022|.12559|03/29/2022|.12642|03/29/2022|||BETA-BLOCKERS|21771|||||No|No||BIOCON PHARMA I|No||||
labetalol HCl|No|No|No|No|75%|70377006013|LABETALOL HCL 100 MG TABLET|500|EA|.17647|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||||No|No|||Prescription required|No||070|No|.12868|03/29/2022|.12559|03/29/2022|.12642|03/29/2022|||BETA-BLOCKERS|21772|||||No|No||BIOCON PHARMA I|No||||
labetalol HCl|No|No|No|No|75%|70377006112|LABETALOL HCL 200 MG TABLET|100|EA|.25038|09/07/2021||Yes|No||09/07/2021||Yes|No|09/07/2021||Yes|No||||No|No|||Prescription required|No||070|No|.17218|03/29/2022|.16804|03/29/2022|.16916|03/29/2022|||BETA-BLOCKERS|21773|||||No|No||BIOCON PHARMA I|No||||
labetalol HCl|No|No|No|No|75%|70377006113|LABETALOL HCL 200 MG TABLET|500|EA|.25038|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||||No|No|||Prescription required|No||070|No|.17218|03/29/2022|.16804|03/29/2022|.16916|03/29/2022|||BETA-BLOCKERS|21774|||||No|No||BIOCON PHARMA I|No||||
labetalol HCl|No|No|No|No|75%|70377006212|LABETALOL HCL 300 MG TABLET|100|EA|.33307|09/02/2021||Yes|No||09/02/2021||Yes|No|09/02/2021||Yes|No||||No|No|||Prescription required|No||070|No|.21583|03/29/2022|.21065|03/29/2022|.21205|03/29/2022|||BETA-BLOCKERS|21775|||||No|No||BIOCON PHARMA I|No||||
labetalol HCl|No|No|No|No|75%|70377006213|LABETALOL HCL 300 MG TABLET|500|EA|.33307|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||||No|No|||Prescription required|No||070|No|.21583|03/29/2022|.21065|03/29/2022|.21205|03/29/2022|||BETA-BLOCKERS|21776|||||No|No||BIOCON PHARMA I|No||||
glycopyrronium tosylate|No|No|No|No|75%|70428001112|QBREXZA 2.4% CLOTH|30|EA|8.6913|05/16/2019||Yes|No||05/16/2019||Yes|No|05/16/2019||Yes|No||||No|No|||Prescription required|No|||No|19.40342|03/29/2022|18.93773|03/29/2022|19.06386|03/29/2022||||21777|||||No|No||DERMIRA/JOURNEY|No||||
potassium chloride|No|No|No|No|75%|70436000101|POTASSIUM CL ER 8 MEQ TABLET|100|EA|.18111|02/21/2019||Yes|No||02/21/2019||Yes|No|02/21/2019||Yes|No||||No|No|||Prescription required|No|||No|.17696|03/29/2022|.17271|03/29/2022|.17386|03/29/2022||||21778|||||No|No||SLATE RUN PHARM|No||||
potassium chloride|No|No|No|No|75%|70436000103|POTASSIUM CL ER 8 MEQ TABLET|1000|EA|.18111|02/21/2019||Yes|No||02/21/2019||Yes|No|02/21/2019||Yes|No||||No|No|||Prescription required|No|||No|.17696|03/29/2022|.17271|03/29/2022|.17386|03/29/2022||||21779|||||No|No||SLATE RUN PHARM|No||||
potassium chloride|No|No|No|No|75%|70436000201|POTASSIUM CL ER 10 MEQ TABLET|100|EA|.19362|02/21/2019||Yes|No||02/21/2019||Yes|No|02/21/2019||Yes|No||||No|No|||Prescription required|No|||No|.13824|03/29/2022|.13492|03/29/2022|.13582|03/29/2022||||21780|||||No|No||SLATE RUN PHARM|No||||
potassium chloride|No|No|No|No|75%|70436000203|POTASSIUM CL ER 10 MEQ TABLET|1000|EA|.19362|02/21/2019||Yes|No||02/21/2019||Yes|No|02/21/2019||Yes|No||||No|No|||Prescription required|No|||No|.13824|03/29/2022|.13492|03/29/2022|.13582|03/29/2022||||21781|||||No|No||SLATE RUN PHARM|No||||
galantamine HBr|No|No|No|No|75%|70436000406|GALANTAMINE HBR 4 MG TABLET|60|EA|.28128|06/11/2018||Yes|No||06/11/2018||Yes|No|06/11/2018||Yes|No||||No|No|||Prescription required|Yes|12/14/2017|011|No|.42975|03/29/2022|.41943|03/29/2022|.42222|03/29/2022|||ALZHEIMER'S AGENTS|21782|||||No|No||SLATE RUN PHARM|No||||
galantamine HBr|No|No|No|No|75%|70436000506|GALANTAMINE HBR 8 MG TABLET|60|EA|.28128|06/11/2018||Yes|No||06/11/2018||Yes|No|06/11/2018||Yes|No||||No|No|||Prescription required|Yes|12/14/2017|011|Yes|.48142|03/29/2022|.46986|03/29/2022|.47299|03/29/2022|||ALZHEIMER'S AGENTS|21783|||||No|No||SLATE RUN PHARM|No||||
galantamine HBr|No|No|No|No|75%|70436000606|GALANTAMINE HBR 12 MG TABLET|60|EA|.28128|06/11/2018||Yes|No||06/11/2018||Yes|No|06/11/2018||Yes|No||||No|No|||Prescription required|Yes|12/14/2017|011|No|.83193|01/25/2022|.81196|01/25/2022|.81737|01/25/2022|||ALZHEIMER'S AGENTS|21784|||||No|No||SLATE RUN PHARM|No||||
cinacalcet HCl|No|No|No|No|75%|70436000704|CINACALCET HCL 30 MG TABLET|30|EA|2.43666|08/07/2019||Yes|No||08/07/2019||Yes|No|08/07/2019||Yes|No||||No|No|||Prescription required|No|||No|.75588|03/29/2022|.73773|03/29/2022|.74265|03/29/2022||||21785|||||No|No||SLATE RUN PHARM|No||||
cinacalcet HCl|No|No|No|No|75%|70436000804|CINACALCET HCL 60 MG TABLET|30|EA|4.80166|08/07/2019||Yes|No||08/07/2019||Yes|No|08/07/2019||Yes|No||||No|No|||Prescription required|No|||No|1.7407|03/29/2022|1.69892|03/29/2022|1.71023|03/29/2022||||21786|||||No|No||SLATE RUN PHARM|No||||
cinacalcet HCl|No|No|No|No|75%|70436000904|CINACALCET HCL 90 MG TABLET|30|EA|5.59|08/07/2019||Yes|No||08/07/2019||Yes|No|08/07/2019||Yes|No||||No|No|||Prescription required|No|||No|3.64673|03/29/2022|3.5592|03/29/2022|3.58291|03/29/2022||||21787|||||No|No||SLATE RUN PHARM|No||||
bupropion HCl|Yes|No|No|No|75%|70436001002|BUPROPION HCL XL 150 MG TABLET|500|EA|.32709|07/29/2019||Yes|No||07/29/2019||Yes|No|07/29/2019||Yes|No||||No|No|09/27/2019||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|21788|||||No|No||SLATE RUN PHARM|No||||
bupropion HCl|Yes|No|No|No|75%|70436001004|BUPROPION HCL XL 150 MG TABLET|30|EA|.42168|07/29/2019||Yes|No||07/29/2019||Yes|No|07/29/2019||Yes|No||||No|No|09/27/2019||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|21789|||||No|No||SLATE RUN PHARM|No||||
bupropion HCl|Yes|No|No|No|75%|70436001006|BUPROPION HCL XL 150 MG TABLET|90|EA|.37017|07/29/2019||Yes|No||07/29/2019||Yes|No|07/29/2019||Yes|No||||No|No|09/27/2019||Prescription required|No||031|Yes|.1335|03/29/2022|.13029|03/29/2022|.13116|03/29/2022|||ANTIDEPRESSANTS: OTHER|21790|||||No|No||SLATE RUN PHARM|No||||
bupropion HCl|Yes|No|No|No|75%|70436001102|BUPROPION HCL XL 300 MG TABLET|500|EA|.36132|07/29/2019||Yes|No||07/29/2019||Yes|No|07/29/2019||Yes|No||||No|No|09/27/2019||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|21791|||||No|No||SLATE RUN PHARM|No||||
bupropion HCl|Yes|No|No|No|75%|70436001104|BUPROPION HCL XL 300 MG TABLET|30|EA|.57132|07/29/2019||Yes|No||07/29/2019||Yes|No|07/29/2019||Yes|No||||No|No|09/27/2019||Prescription required|No||031|No|.18442|03/29/2022|.17999|03/29/2022|.18119|03/29/2022|||ANTIDEPRESSANTS: OTHER|21792|||||No|No||SLATE RUN PHARM|No||||
desvenlafaxine succinate|No|No|No|No|75%|70436001204|DESVENLAFAXINE SUCCNT ER 50 MG|30|EA|.43774|02/01/2022||Yes|No||02/01/2022||Yes|No|02/01/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.57735|03/29/2022|.56349|03/29/2022|.56724|03/29/2022|||ANTIDEPRESSANTS: OTHER|21793|||||No|No||SLATE RUN PHARM|No||||
desvenlafaxine succinate|No|No|No|No|75%|70436001206|DESVENLAFAXINE SUCCNT ER 50 MG|90|EA|.29607|02/01/2022||Yes|No||02/01/2022||Yes|No|02/01/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.57735|03/29/2022|.56349|03/29/2022|.56724|03/29/2022|||ANTIDEPRESSANTS: OTHER|21794|||||No|No||SLATE RUN PHARM|No||||
desvenlafaxine succinate|No|No|No|No|75%|70436001304|DESVENLAFAXINE SUCCNT ER 100MG|30|EA|.43774|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.60974|03/29/2022|.5951|03/29/2022|.59906|03/29/2022|||ANTIDEPRESSANTS: OTHER|21795|||||No|No||SLATE RUN PHARM|No||||
desvenlafaxine succinate|No|No|No|No|75%|70436001306|DESVENLAFAXINE SUCCNT ER 100MG|90|EA|.29607|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.60974|03/29/2022|.5951|03/29/2022|.59906|03/29/2022|||ANTIDEPRESSANTS: OTHER|21796|||||No|No||SLATE RUN PHARM|No||||
azithromycin|No|No|No|No|75%|70436001982|AZITHROMYCIN I.V. 500 MG VIAL|1|EA|2.021|07/29/2019||Yes|No||07/29/2019||Yes|No|07/29/2019||Yes|No||||No|No|||Prescription required|No|||No|4.606|07/29/2019|4.5402|07/29/2019|4.324|07/29/2019||||21797|||||No|No||SLATE RUN PHARM|No||||
voriconazole|No|No|No|No|75%|70436002980|VORICONAZOLE 200 MG VIAL|1|EA|52.4901|07/29/2019||Yes|No||07/29/2019||Yes|No|07/29/2019||Yes|No||||No|No|||Prescription required|No|||No|119.6286|08/06/2019|117.91962|07/29/2019|112.3044|07/29/2019||||21798|||||No|No||SLATE RUN PHARM|No||||
desvenlafaxine succinate|No|No|No|No|75%|70436003604|DESVENLAFAXINE SUCCNT ER 25 MG|30|EA|.43774|02/01/2022||Yes|No||02/01/2022||Yes|No|02/01/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|.63768|03/29/2022|.62237|03/29/2022|.62652|03/29/2022|||ANTIDEPRESSANTS: OTHER|21799|||||No|No||SLATE RUN PHARM|No||||
cilostazol|No|No|No|No|75%|70436005006|CILOSTAZOL 50 MG TABLET|60|EA|.12204|06/08/2018||Yes|No||06/08/2018||Yes|No|06/08/2018||Yes|No||||No|No|||Prescription required|No|||No|.11608|03/29/2022|.11329|03/29/2022|.11404|03/29/2022||||21800|||||No|No||SLATE RUN PHARM|No||||
cilostazol|No|No|No|No|75%|70436005106|CILOSTAZOL 100 MG TABLET|60|EA|.14118|06/08/2018||Yes|No||06/08/2018||Yes|No|06/08/2018||Yes|No||||No|No|||Prescription required|No|||No|.13507|03/29/2022|.13182|03/29/2022|.1327|03/29/2022||||21801|||||No|No||SLATE RUN PHARM|No||||
ganciclovir sodium|No|No|No|No|75%|70436008955|GANCICLOVIR 500 MG VIAL|1|EA|36.3952|08/07/2019||Yes|No||08/07/2019||Yes|No|08/07/2019||Yes|No||||No|No|||Prescription required|No|||No|82.9472|08/07/2019|81.76224|08/13/2019|77.8688|08/07/2019||||21802|||||No|No||SLATE RUN PHARM|No||||
montelukast sodium|No|No|No|No|75%|70436009006|MONTELUKAST SOD 4 MG TAB CHEW|90|EA|.11108|02/21/2019||Yes|No||02/21/2019||Yes|No|02/21/2019||Yes|No||||No|No|||Prescription required|No||042|Yes|.09891|03/29/2022|.09653|03/29/2022|.09717|03/29/2022|||LEUKOTRIENE MODIFIERS|21803|||||No|No||SLATE RUN PHARM|No||||
montelukast sodium|No|No|No|No|75%|70436009106|MONTELUKAST SOD 5 MG TAB CHEW|90|EA|.11108|02/21/2019||Yes|No||02/21/2019||Yes|No|02/21/2019||Yes|No||||No|No|||Prescription required|No||042|Yes|.08451|03/29/2022|.08248|03/29/2022|.08303|03/29/2022|||LEUKOTRIENE MODIFIERS|21804|||||No|No||SLATE RUN PHARM|No||||
promethazine/dextromethorphan|No|No|No|No|75%|70436015541|PROMETHAZINE-DM 6.25-15 MG/5ML|118|ML|.03188|10/28/2021||Yes|No||10/28/2021||Yes|No|10/28/2021||Yes|No||||No|No|||Prescription required|No||184|Yes|.05718|03/29/2022|.0558|03/29/2022|.05617|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21805|||||No|No||SLATE RUN PHARM|No||||
promethazine/dextromethorphan|No|No|No|No|75%|70436015542|PROMETHAZINE-DM 6.25-15 MG/5ML|473|ML|.03181|10/28/2021||Yes|No||10/28/2021||Yes|No|10/28/2021||Yes|No||||No|No|||Prescription required|No||184|Yes|.05643|03/29/2022|.05507|03/29/2022|.05544|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|21806|||||No|No||SLATE RUN PHARM|No||||
neratinib maleate|No|No|No|No|75%|70437024018|NERLYNX 40 MG TABLET|180|EA|46.04583|01/05/2018||Yes|No||01/05/2018||Yes|No|01/05/2018||Yes|No||||No|No|||Prescription required|No||502|No|104.94166|01/11/2022|103.44249|01/11/2022|98.51666|01/11/2022|||ONCOLOGY: ORAL - BREAST|21807|||||No|No||PUMA BIOTECHNOL|No||||
flu vac qs 21-22(6ms up)cel/PF|No|No|No|No|75%|70461032103|FLUCELVAX QUAD 2021-2022 SYR|.5|ML|22.04868|09/01/2021||Yes|No||09/01/2021||Yes|No|||No|No||||No|No|||Prescription required|No|||No|50.25048|08/07/2021|49.53261|08/07/2021|47.17392|08/07/2021||||21808|||||No|No||SEQIRUS, INC.|No||||
flu vac qs 21-22(6ms up)cel/PF|No|No|No|No|75%|70461032104|FLUCELVAX QUAD 2021-2022 SYR|.5|ML||09/01/2021||Yes|No||09/01/2021||Yes|No|||No|No||||No|No|||Prescription required|No|||No||||||||||21809|||||No|No||SEQIRUS, INC.|No||||
amantadine HCl|No|No|No|No|75%|70482008560|GOCOVRI ER 68.5 MG CAPSULE|60|EA|20.43037|10/16/2018||Yes|No||10/16/2018||Yes|No|10/16/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|015|No|46.56225|01/04/2022|45.89707|01/04/2022|43.7115|01/04/2022|||ANTIPARKINSON'S AGENTS|21810|||||No|No||SUPERNUS/ ADAMA|No||||
amantadine HCl|No|No|No|No|75%|70482017060|GOCOVRI ER 137 MG CAPSULE|60|EA|20.43037|10/16/2018||Yes|No||10/16/2018||Yes|No|10/16/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|015|No|46.56225|01/04/2022|45.89707|01/04/2022|43.7115|01/04/2022|||ANTIPARKINSON'S AGENTS|21811|||||No|No||SUPERNUS/ ADAMA|No||||
factor IX human recomb,Thr 148|No|No|No|No|75%|70504028205|IXINITY 500 UNIT RANGE|1|EA|1.3056|07/19/2017||Yes|No||07/19/2017||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.8816|07/06/2021|1.85472|07/06/2021|1.7664|07/06/2021|||HEMOPHILIA TREATMENT|21812|||||No|No||APTEVO BIOTHERA|No||||
factor IX human recomb,Thr 148|No|No|No|No|75%|70504028305|IXINITY 1,000 UNIT RANGE|1|EA|1.3056|07/19/2017||Yes|No||07/19/2017||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.8816|07/06/2021|1.85472|07/06/2021|1.7664|07/06/2021|||HEMOPHILIA TREATMENT|21813|||||No|No||APTEVO BIOTHERA|No||||
factor IX human recomb,Thr 148|No|No|No|No|75%|70504028405|IXINITY 1,500 UNIT RANGE|1|EA|1.3056|07/19/2017||Yes|No||07/19/2017||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.8816|07/06/2021|1.85472|07/06/2021|1.7664|07/06/2021|||HEMOPHILIA TREATMENT|21814|||||No|No||APTEVO BIOTHERA|No||||
factor IX human recomb,Thr 148|No|No|No|No|75%|70504028905|IXINITY 3,000 UNIT RANGE|1|EA|1.3056|11/20/2019||Yes|No||11/20/2019||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.8816|07/06/2021|1.85472|07/06/2021|1.7664|07/06/2021|||HEMOPHILIA TREATMENT|21815|||||No|No||APTEVO BIOTHERA|No||||
doxylamine succinate/vit B6|No|No|No|No|75%|70505010010|DOXYLAMINE-PYRIDOXINE 10-10 MG|100|EA|2.54263|12/29/2020|12/31/2099|Yes|No||12/29/2020|12/31/2099|Yes|No|12/29/2020|12/31/2099|Yes|No||||No|No|||Prescription required|Yes|03/09/2018|085|No|2.71034|03/29/2022|2.64529|03/29/2022|2.6629|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|21816|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ANALOG PHARMA,|No||||
riluzole|No|No|No|No|75%|70510220102|EXSERVAN 50 MG FILM|60|EA|22.52483|09/09/2021||Yes|No||09/09/2021||Yes|No|09/09/2021||Yes|No||||No|No|||Prescription required|No|||No|51.33566|09/09/2021|50.60229|09/09/2021|48.19266|09/09/2021||||21817|||||No|No||MITSUBISHI TANA|No||||
ciclesonide|No|No|No|No|75%|70515070101|OMNARIS 50 MCG NASAL SPRAY|12.5|GM|10.13011|02/25/2020||Yes|No||02/25/2020||Yes|No|02/25/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|019|No|22.59623|07/27/2021|22.05392|07/27/2021|22.20079|07/27/2021|||INTRANASAL RHINITIS AGENTS|21818|||||No|No||COVIS PHARMA|No||||
ciclesonide|No|No|No|No|75%|70515071101|ALVESCO 80 MCG INHALER|6.1|GM|19.32955|11/09/2018||Yes|No||11/09/2018||Yes|No|11/09/2018||Yes|No||||No|No|||Prescription required|Yes|09/18/2020|033|Yes|43.27639|10/26/2021|42.23775|10/26/2021|42.51905|10/26/2021|||GLUCOCORTICOIDS: INHALED|21819|||||No|No||COVIS PHARMA|No||||
ciclesonide|No|No|No|No|75%|70515071201|ALVESCO 160 MCG INHALER|6.1|GM|19.32955|01/28/2019||Yes|No||01/28/2019||Yes|No|01/28/2019||Yes|No||||No|No|||Prescription required|Yes|09/18/2020|033|Yes|43.25842|12/28/2021|42.22021|12/28/2021|42.50139|12/28/2021|||GLUCOCORTICOIDS: INHALED|21820|||||No|No||COVIS PHARMA|No||||
abaloparatide|No|No|No|No|75%|70539000102|TYMLOS 80 MCG DOSE PEN INJECTR|1.56|ML|631.03602|01/05/2018||Yes|No||01/05/2018||Yes|No|01/05/2018||Yes|No||||No|No|||Prescription required|Yes|05/02/2017|060|No|1413.22962|01/18/2022|1379.3121|01/18/2022|1388.4981|01/18/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|21821|||||No|No||RADIUS HEALTH,|No||||
crofelemer|No|No|No|No|75%|70564080260|MYTESI 125 MG DR TABLET|60|EA|16.28481|11/21/2016||Yes|No||11/21/2016||Yes|No|11/21/2016||Yes|No||||No|No|||Prescription required|No|||No|37.11422|12/07/2021|36.58402|12/07/2021|34.84192|12/07/2021||||21822|||||No|No||NAPO/CARDINAL H|No||||
colistin (colistimethate Na)|No|No|No|No|75%|70594002301|COLISTIMETHATE 150 MG VIAL|1|EA|12.04|01/05/2021||Yes|No||01/05/2021||Yes|No|01/05/2021||Yes|No||||No|No|||Prescription required|No|||No|27.44|01/12/2021|27.048|01/05/2021|25.76|01/05/2021||||21823|||||No|No||XELLIA PHARMACE|No||||
colistin (colistimethate Na)|No|No|No|No|75%|70594002304|COLISTIMETHATE 150 MG VIAL|1|EA|12.04|01/05/2021||Yes|No||01/05/2021||Yes|No|01/05/2021||Yes|No||||No|No|||Prescription required|No|||No|27.44|01/12/2021|27.048|01/05/2021|25.76|01/05/2021||||21824|||||No|No||XELLIA PHARMACE|No||||
tigecycline|No|No|No|No|75%|70594003502|TIGECYCLINE 50 MG VIAL|1|EA|45.15|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|No|||No|102.9|05/25/2021|101.43|05/25/2021|96.6|05/18/2021||||21825|||||No|No||XELLIA PHARMACE|No||||
tobramycin/nebulizer|No|No|No|No|75%|70644089999|TOBRAMYCIN PAK 300 MG/5 ML|5|ML|5.53471|05/16/2017||Yes|No||05/16/2017||Yes|No|05/16/2017||Yes|No|Submit HHS Form 1143|||No|No|||Prescription required|Yes|07/21/2016|240|No|12.61399|05/16/2017|12.43379|05/16/2017|11.8417|05/16/2017|||ANTIBIOTICS: INHALED|21826|||||No|No||GENERICUS, INC.|No||||
fluconazole in NaCL,iso-osm|No|No|No|No|75%|70655000206|FLUCONAZOLE-NACL 200 MG/100 ML|100|ML|.0258|02/04/2020|04/30/2022|Yes|No||02/04/2020|04/30/2022|Yes|No|02/04/2020|04/30/2022|Yes|No||||No|No|||Prescription required|No|||No|.0588|02/04/2020|.05796|02/04/2020|.0552|02/04/2020||||21827|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||RENAISSANCE LAK|No||||
fluconazole in NaCL,iso-osm|No|No|No|No|75%|70655008806|FLUCONAZOLE-NACL 400 MG/200 ML|200|ML|.01505|02/04/2020|02/28/2022|Yes|No||02/04/2020|02/28/2022|Yes|No|02/04/2020|02/28/2022|Yes|No||||No|No|||Prescription required|No|||No|.0343|02/04/2020|.03381|02/04/2020|.0322|02/04/2020||||21828|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||RENAISSANCE LAK|No||||
norethindrone-e.estradiol-iron|No|Yes|No|No|75%|70700010185|NORETH-EE-FE 1-0.02(24)-75 CHW|28|EA|.30714|09/21/2020||Yes|No||09/21/2020||Yes|No|09/21/2020||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|.64997|03/29/2022|.63437|03/29/2022|.63859|03/29/2022||||21829|||||No|No||XIROMED, LLC|No|||Only covered for non-contraceptive (medical) purposes|
acyclovir|No|No|No|No|75%|70700010715|ACYCLOVIR 5% OINTMENT|15|GM|1.00333|09/21/2020||Yes|No||09/21/2020||Yes|No|09/21/2020||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.36934|03/29/2022|1.33647|03/29/2022|1.34537|03/29/2022|||ANTIVIRALS: TOPICAL|21830|||||No|No||XIROMED, LLC|No||||
acyclovir|No|No|No|No|75%|70700010716|ACYCLOVIR 5% OINTMENT|30|GM|1.00333|09/21/2020||Yes|No||09/21/2020||Yes|No|09/21/2020||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.03754|03/29/2022|1.01263|03/29/2022|1.01938|03/29/2022|||ANTIVIRALS: TOPICAL|21831|||||No|No||XIROMED, LLC|No||||
clobetasol propionate|No|No|No|No|75%|70700010915|CLOBETASOL 0.05% CREAM|15|GM|.35718|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||121|No|.42879|03/29/2022|.41849|03/29/2022|.42128|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|21832|||||No|No||XIROMED, LLC|No||||
clobetasol propionate|No|No|No|No|75%|70700010916|CLOBETASOL 0.05% CREAM|30|GM|.35704|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||121|No|.34489|03/29/2022|.33661|03/29/2022|.33885|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|21833|||||No|No||XIROMED, LLC|No||||
clobetasol propionate|No|No|No|No|75%|70700010918|CLOBETASOL 0.05% CREAM|45|GM|.35708|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||121|No|.31467|03/29/2022|.30711|03/29/2022|.30916|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|21834|||||No|No||XIROMED, LLC|No||||
testosterone|No|No|No|No|90%|70700011221|TESTOSTERONE 1.62% GEL PUMP|75|GM|.5074|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|084|No|.65888|03/29/2022|.64306|03/29/2022|.64734|03/29/2022|||ANDROGENIC AGENTS|21835|||||No|No||XIROMED, LLC|No||||
desogestrel-ethinyl estradiol|Yes|Yes|No|No|75%|70700011385|ISIBLOOM 28 DAY TABLET|28|EA|.24535|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No|Refer to program requirements|||No|No|06/18/2019||Prescription required|No|||No|.18364|03/29/2022|.17923|03/29/2022|.18042|03/29/2022||||21836|||||No|No||XIROMED, LLC|No|||Only covered for non-contraceptive (medical) purposes|
ethinyl estradiol/drospirenone|Yes|Yes|No|No|75%|70700011485|LORYNA 3 MG-0.02 MG TABLET|28|EA|.23035|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No|Refer to program requirements|||No|No|06/18/2019||Prescription required|No|||No|.36582|03/29/2022|.35704|03/29/2022|.35941|03/29/2022||||21837|||||No|No||XIROMED, LLC|No|||Only covered for non-contraceptive (medical) purposes|
ethinyl estradiol/drospirenone|Yes|Yes|No|No|75%|70700011585|SYEDA 28 TABLET|28|EA|.18975|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No|Refer to program requirements|||No|No|06/18/2019||Prescription required|No|||No|.2455|03/29/2022|.2396|03/29/2022|.2412|03/29/2022||||21838|||||No|No||XIROMED, LLC|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|70700011685|ALTAVERA-28 TABLET|28|EA|.07883|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No|Refer to program requirements|||No|No|06/18/2019||Prescription required|No|||No|.17306|03/29/2022|.1689|03/29/2022|.17003|03/29/2022||||21839|||||No|No||XIROMED, LLC|No|||Only covered for non-contraceptive (medical) purposes|
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|70700011885|VIENVA-28 TABLET|28|EA|.13115|02/25/2019||Yes|No||02/25/2019||Yes|No|02/25/2019||Yes|No|Refer to program requirements|||No|No|06/18/2019||Prescription required|No|||No|.21292|03/29/2022|.2078|03/29/2022|.20919|03/29/2022||||21840|||||No|No||XIROMED, LLC|No|||Only covered for non-contraceptive (medical) purposes|
norgestimate-ethinyl estradiol|Yes|Yes|No|No|75%|70700011985|ESTARYLLA 0.25-0.035 MG TABLET|28|EA|.16416|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No|Refer to program requirements|||No|No|06/18/2019||Prescription required|No|||No|.1742|03/29/2022|.17001|03/29/2022|.17115|03/29/2022||||21841|||||No|No||XIROMED, LLC|No|||Only covered for non-contraceptive (medical) purposes|
norgestimate-ethinyl estradiol|Yes|Yes|No|No|75%|70700012085|TRI-LO-ESTARYLLA TABLET|28|EA|.18018|08/28/2018||Yes|No||08/28/2018||Yes|No|08/28/2018||Yes|No|Refer to program requirements|||No|No|06/18/2019||Prescription required|No|||No|.16464|03/29/2022|.16068|03/29/2022|.16175|03/29/2022||||21842|||||No|No||XIROMED, LLC|No|||Only covered for non-contraceptive (medical) purposes|
desog-e.estradiol/e.estradiol|Yes|Yes|No|No|75%|70700012285|VOLNEA 0.15-0.02-0.01 MG TAB|28|EA|.25349|06/09/2020||Yes|No||06/09/2020||Yes|No|06/09/2020||Yes|No|Refer to program requirements|||No|No|09/21/2020||Prescription required|No|||No|.21935|03/29/2022|.21408|03/29/2022|.21551|03/29/2022||||21843|||||No|No||XIROMED, LLC|No|||Only covered for non-contraceptive (medical) purposes|
L-norgest/e.estradiol-e.estrad|Yes|Yes|No|No|75%|70700012387|JAIMIESS 0.15-0.03-0.01 MG TAB|91|EA|.35439|06/09/2020||Yes|No||06/09/2020||Yes|No|06/09/2020||Yes|No|Refer to program requirements|||No|No|09/21/2020||Prescription required|No|||No|.54912|03/29/2022|.53594|03/29/2022|.53951|03/29/2022||||21844|||||No|No||XIROMED, LLC|No|||Only covered for non-contraceptive (medical) purposes|
L-norgest/e.estradiol-e.estrad|Yes|Yes|No|No|75%|70700012487|LOJAIMIESS 0.1-0.02-0.01 TAB|91|EA|.18007|06/09/2020||Yes|No||06/09/2020||Yes|No|06/09/2020||Yes|No|Refer to program requirements|||No|No|09/21/2020||Prescription required|No|||No|.32321|03/01/2022|.31545|03/01/2022|.31755|03/01/2022||||21845|||||No|No||XIROMED, LLC|No|||Only covered for non-contraceptive (medical) purposes|
fluocinonide|No|No|No|No|75%|70700014615|FLUOCINONIDE 0.05% OINTMENT|15|GM|.53033|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|120|No|.57506|03/29/2022|.56125|03/29/2022|.56499|03/29/2022|||STEROIDS: TOPICAL HIGH|21846|||||No|No||XIROMED, LLC|No||||
fluocinonide|No|No|No|No|75%|70700014616|FLUOCINONIDE 0.05% OINTMENT|30|GM|.37137|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|120|No|.36243|03/29/2022|.35373|03/29/2022|.35608|03/29/2022|||STEROIDS: TOPICAL HIGH|21847|||||No|No||XIROMED, LLC|No||||
fluocinonide|No|No|No|No|75%|70700014617|FLUOCINONIDE 0.05% OINTMENT|60|GM|.27849|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|120|No|.32783|03/29/2022|.31996|03/29/2022|.32209|03/29/2022|||STEROIDS: TOPICAL HIGH|21848|||||No|No||XIROMED, LLC|No||||
omeprazole|No|No|No|No|75%|70700015001|OMEPRAZOLE DR 20 MG CAPSULE|100|EA|.03225|09/21/2021||Yes|No||09/21/2021||Yes|No|09/21/2021||Yes|No||||No|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|21849|||||No|No||XIROMED, LLC|No||||
omeprazole|No|No|No|No|75%|70700015010|OMEPRAZOLE DR 20 MG CAPSULE|1000|EA|.0215|07/21/2021||Yes|No||07/21/2021||Yes|No|07/21/2021||Yes|No||||No|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|21850|||||No|No||XIROMED, LLC|No||||
omeprazole|No|No|No|No|75%|70700015030|OMEPRAZOLE DR 20 MG CAPSULE|30|EA|.043|09/21/2021||Yes|No||09/21/2021||Yes|No|09/21/2021||Yes|No||||No|No|||Prescription required|No||047|Yes|.03558|03/29/2022|.03472|03/29/2022|.03495|03/29/2022|||PROTON PUMP INHIBITORS|21851|||||No|No||XIROMED, LLC|No||||
norethindrone-e.estradiol-iron|Yes|Yes|No|No|75%|70700015285|GEMMILY 1 MG-20 MCG CAPSULE|28|EA|1.22099|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No|Refer to program requirements|||No|No|03/22/2021||Prescription required|No|||No|2.32077|03/29/2022|2.26507|03/29/2022|2.28015|03/29/2022||||21852|||||No|No||XIROMED, LLC|No|||Only covered for non-contraceptive (medical) purposes|
midodrine HCl|No|No|No|No|75%|70700015701|MIDODRINE HCL 2.5 MG TABLET|100|EA|.129|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No|||No|.20233|03/29/2022|.19747|03/29/2022|.19878|03/29/2022||||21853|||||No|No||XIROMED, LLC|No||||
midodrine HCl|No|No|No|No|75%|70700015801|MIDODRINE HCL 5 MG TABLET|100|EA|.1935|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No|||No|.26381|03/29/2022|.25747|03/29/2022|.25919|03/29/2022||||21854|||||No|No||XIROMED, LLC|No||||
midodrine HCl|No|No|No|No|75%|70700015901|MIDODRINE HCL 10 MG TABLET|100|EA|.3225|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No|||No|.40773|03/29/2022|.39794|03/29/2022|.40059|03/29/2022||||21855|||||No|No||XIROMED, LLC|No||||
ketoconazole|No|No|No|No|75%|70700016019|KETOCONAZOLE 2% FOAM|50|GM|4.06126|12/08/2021||Yes|No||12/08/2021||Yes|No|12/08/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|061|No|9.2559|12/08/2021|9.12367|12/08/2021|8.68921|12/08/2021|||ANTIFUNGALS: TOPICAL|21856|||||No|No||XIROMED, LLC|No||||
ketoconazole|No|No|No|No|75%|70700016020|KETOCONAZOLE 2% FOAM|100|GM|2.37643|12/08/2021||Yes|No||12/08/2021||Yes|No|12/08/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|061|No|5.41606|12/08/2021|5.33869|12/08/2021|5.08447|12/08/2021|||ANTIFUNGALS: TOPICAL|21857|||||No|No||XIROMED, LLC|No||||
progesterone, micronized|No|No|No|No|75%|70700016201|PROGESTERONE 100 MG CAPSULE|100|EA|.172|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No|||No|.25967|03/29/2022|.25343|03/29/2022|.25512|03/29/2022||||21858|||||No|No||XIROMED, LLC|No||||
progesterone, micronized|No|No|No|No|75%|70700016301|PROGESTERONE 200 MG CAPSULE|100|EA|.344|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No|||No|.48257|03/29/2022|.47098|03/29/2022|.47412|03/29/2022||||21859|||||No|No||XIROMED, LLC|No||||
levonorgestrel|No|Yes|No|No|75%|70700016406|LEVONORGESTREL 1.5 MG TABLET|1|EA|8.6|09/21/2020||Yes|No||||No|No|||No|No||||No|No|||Over the counter|No|||No|10.215|03/29/2022|9.96984|03/29/2022|10.03623|03/29/2022||||21860|||||No|No||XIROMED, LLC|No||||
glycopyrrolate|No|No|No|No|75%|70700016525|GLYCOPYRROLATE 0.2 MG/ML VIAL|1|ML|1.1524|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|No|||No|2.6264|12/28/2020|2.58888|12/28/2020|2.4656|12/28/2020||||21861|||||No|No||XIROMED, LLC|No||||
glycopyrrolate|No|No|No|No|75%|70700016625|GLYCOPYRROLATE 0.4 MG/2 ML VL|2|ML|1.161|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|No|||No|2.646|12/28/2020|2.6082|12/28/2020|2.484|12/28/2020||||21862|||||No|No||XIROMED, LLC|No||||
glycopyrrolate|No|No|No|No|75%|70700016725|GLYCOPYRROLATE 1 MG/5 ML VIAL|5|ML|.94256|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|No|||No|2.14816|12/28/2020|2.11747|12/28/2020|2.01664|12/28/2020||||21863|||||No|No||XIROMED, LLC|No||||
irinotecan HCl|No|No|No|No|75%|70700016922|IRINOTECAN HCL 40 MG/2 ML VIAL|2|ML|3.1261|08/18/2020||Yes|No||08/18/2020||Yes|No|08/18/2020||Yes|No||||No|No|||Prescription required|No|||No|7.1246|08/25/2020|7.02282|08/25/2020|6.6884|08/18/2020||||21864|||||No|No||XIROMED, LLC|No||||
irinotecan HCl|No|No|No|No|75%|70700017022|IRINOTECAN HCL 100 MG/5 ML VL|5|ML|2.58516|08/18/2020||Yes|No||08/18/2020||Yes|No|08/18/2020||Yes|No||||No|No|||Prescription required|No|||No|5.89176|08/18/2020|5.80759|08/18/2020|5.53104|08/18/2020||||21865|||||No|No||XIROMED, LLC|No||||
tobramycin sulfate|No|No|No|No|75%|70700017322|TOBRAMYCIN 1.2 GM VIAL|1|EA|35.905|12/08/2021||Yes|No||12/08/2021||Yes|No|12/08/2021||Yes|No||||No|No|||Prescription required|No|||No|81.83|12/08/2021|80.661|12/08/2021|76.82|12/08/2021||||21866|||||No|No||XIROMED, LLC|No||||
darifenacin hydrobromide|No|No|No|No|75%|70700018230|DARIFENACIN ER 7.5 MG TABLET|30|EA|1.26807|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|Yes|1.71519|03/29/2022|1.67402|03/29/2022|1.68517|03/29/2022|||BLADDER RELAXANT PREPARATIONS|21867|||||No|No||XIROMED, LLC|No||||
darifenacin hydrobromide|No|No|No|No|75%|70700018290|DARIFENACIN ER 7.5 MG TABLET|90|EA|1.26807|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|Yes|1.71519|03/29/2022|1.67402|03/29/2022|1.68517|03/29/2022|||BLADDER RELAXANT PREPARATIONS|21868|||||No|No||XIROMED, LLC|No||||
darifenacin hydrobromide|No|No|No|No|75%|70700018330|DARIFENACIN ER 15 MG TABLET|30|EA|1.26807|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|No|2.08753|03/29/2022|2.03742|03/29/2022|2.05099|03/29/2022|||BLADDER RELAXANT PREPARATIONS|21869|||||No|No||XIROMED, LLC|No||||
darifenacin hydrobromide|No|No|No|No|75%|70700018390|DARIFENACIN ER 15 MG TABLET|90|EA|1.26807|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|No|2.08753|03/29/2022|2.03742|03/29/2022|2.05099|03/29/2022|||BLADDER RELAXANT PREPARATIONS|21870|||||No|No||XIROMED, LLC|No||||
chlordiazepoxide/clidinium Br|No|No|No|No|75%|70700018501|CHLORDIAZEPOXIDE-CLIDINIUM CAP|100|EA|5.9985|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|No|||Yes|.95937|03/29/2022|.93634|03/29/2022|.94258|03/29/2022||||21871|||||No|No||XIROMED, LLC|No||||
lansoprazole|No|No|No|No|75%|70700026305|LANSOPRAZOLE DR 30 MG CAPSULE|500|EA|.129|11/16/2017||Yes|No||11/16/2017||Yes|No|11/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.12249|03/29/2022|.11955|03/29/2022|.12034|03/29/2022|||PROTON PUMP INHIBITORS|21872|||||No|No||XIROMED, LLC|No||||
lansoprazole|No|No|No|No|75%|70700026330|LANSOPRAZOLE DR 30 MG CAPSULE|30|EA|.129|09/28/2017||Yes|No||09/28/2017||Yes|No|09/28/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.12249|03/29/2022|.11955|03/29/2022|.12034|03/29/2022|||PROTON PUMP INHIBITORS|21873|||||No|No||XIROMED, LLC|No||||
lansoprazole|No|No|No|No|75%|70700026390|LANSOPRAZOLE DR 30 MG CAPSULE|90|EA|.129|11/16/2017||Yes|No||11/16/2017||Yes|No|11/16/2017||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.12249|03/29/2022|.11955|03/29/2022|.12034|03/29/2022|||PROTON PUMP INHIBITORS|21874|||||No|No||XIROMED, LLC|No||||
fosfomycin tromethamine|No|No|No|No|75%|70700026894|FOSFOMYCIN 3 GM SACHET|1|EA|34.5376|03/05/2021||Yes|No||03/05/2021||Yes|No|03/05/2021||Yes|No||||No|No|||Prescription required|No|||No|68.855|03/29/2022|67.20248|03/29/2022|67.65003|03/29/2022||||21875|||||No|No||XIROMED, LLC|No||||
deferasirox|No|No|No|No|75%|70700026930|DEFERASIROX 90 MG TABLET|30|EA|.215|06/09/2020||Yes|No||06/09/2020||Yes|No|06/09/2020||Yes|No||||No|No|||Prescription required|No|||No|.49|07/14/2020|.483|07/14/2020|.46|07/14/2020||||21876|||||No|No||XIROMED, LLC|No||||
deferasirox|No|No|No|No|75%|70700027030|DEFERASIROX 180 MG TABLET|30|EA|.43|08/18/2020||Yes|No||08/18/2020||Yes|No|08/18/2020||Yes|No||||No|No|||Prescription required|No|||No|.98|08/18/2020|.966|08/18/2020|.92|08/18/2020||||21877|||||No|No||XIROMED, LLC|No||||
deferasirox|No|No|No|No|75%|70700027130|DEFERASIROX 360 MG TABLET|30|EA|.86|06/09/2020||Yes|No||06/09/2020||Yes|No|06/09/2020||Yes|No||||No|No|||Prescription required|No|||No|1.96|07/14/2020|1.932|07/14/2020|1.84|07/14/2020||||21878|||||No|No||XIROMED, LLC|No||||
nitisinone|No|No|No|No|75%|70709000060|NITYR 10 MG TABLET|60|EA|184.52052|02/01/2018||Yes|No||02/01/2018||Yes|No|02/01/2018||Yes|No||||No|No|||Prescription required|No|||Yes|420.53515|01/19/2021|414.5275|01/19/2021|394.7881|01/19/2021||||21879|||||No|No||CYCLE PHARMACEU|No||||
nitisinone|No|No|No|No|75%|70709000260|NITYR 2 MG TABLET|60|EA|36.9026|02/01/2018||Yes|No||02/01/2018||Yes|No|02/01/2018||Yes|No||||No|No|||Prescription required|No|||Yes|84.1036|01/19/2021|82.90212|01/19/2021|78.9544|01/19/2021||||21880|||||No|No||CYCLE PHARMACEU|No||||
nitisinone|No|No|No|No|75%|70709000560|NITYR 5 MG TABLET|60|EA|92.26402|02/01/2018||Yes|No||02/01/2018||Yes|No|02/01/2018||Yes|No||||No|No|||Prescription required|No|||Yes|210.27615|01/19/2021|207.2722|01/19/2021|197.4021|01/19/2021||||21881|||||No|No||CYCLE PHARMACEU|No||||
oseltamivir phosphate|No|No|No|No|75%|70710100802|OSELTAMIVIR PHOS 30 MG CAPSULE|10|EA|3.182|05/26/2017||Yes|No||05/26/2017||Yes|No|05/26/2017||Yes|No||||No|No|||Prescription required|No||025|No|1.58155|03/29/2022|1.54359|03/29/2022|1.55387|03/29/2022|||ANTIVIRALS: ORAL|21882|||||No|No||ZYDUS PHARMACEU|No||||
oseltamivir phosphate|No|No|No|No|75%|70710100902|OSELTAMIVIR PHOS 45 MG CAPSULE|10|EA|3.182|05/26/2017||Yes|No||05/26/2017||Yes|No|05/26/2017||Yes|No||||No|No|||Prescription required|No||025|No|1.5655|03/29/2022|1.52792|03/29/2022|1.5381|03/29/2022|||ANTIVIRALS: ORAL|21883|||||No|No||ZYDUS PHARMACEU|No||||
oseltamivir phosphate|No|No|No|No|75%|70710101002|OSELTAMIVIR PHOS 75 MG CAPSULE|10|EA|3.44|05/26/2017||Yes|No||05/26/2017||Yes|No|05/26/2017||Yes|No||||No|No|||Prescription required|No||025|No|1.29695|03/29/2022|1.26582|03/29/2022|1.27425|03/29/2022|||ANTIVIRALS: ORAL|21884|||||No|No||ZYDUS PHARMACEU|No||||
phytonadione (vit K1)|No|No|No|No|75%|70710101401|PHYTONADIONE 5 MG TABLET|100|EA|16.13033|08/20/2019||Yes|No||08/20/2019||Yes|No|08/20/2019||Yes|No||||No|No|||Prescription required|No|||No|36.76215|08/10/2021|36.23697|08/10/2021|34.5114|08/10/2021||||21885|||||No|No||ZYDUS PHARMACEU|No||||
albendazole|No|No|No|No|75%|70710102106|ALBENDAZOLE 200 MG TABLET|2|EA|51.1872|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No|||No|16.91042|03/29/2022|16.50456|03/29/2022|16.61448|03/29/2022||||21886|||||No|No||ZYDUS PHARMACEU|No||||
albendazole|No|No|No|No|75%|70710102108|ALBENDAZOLE 200 MG TABLET|2|EA|51.1872|02/26/2019|07/31/2022|Yes|No||02/26/2019|07/31/2022|Yes|No|02/26/2019|07/31/2022|Yes|No||||No|No|||Prescription required|No|||No|16.91042|03/29/2022|16.50456|03/29/2022|16.61448|03/29/2022||||21887|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||ZYDUS PHARMACEU|No||||
albuterol sulfate|No|No|No|No|75%|70710106101|ALBUTEROL SULFATE 2 MG TAB|100|EA|.4257|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|037|No|.67057|07/27/2021|.65447|07/27/2021|.65883|07/27/2021|||BRONCHODILATORS: BETA AGONIST|21888|||||No|No||ZYDUS PHARMACEU|No||||
albuterol sulfate|No|No|No|No|75%|70710106201|ALBUTEROL SULFATE 4 MG TAB|100|EA|.4257|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|037|No|1.0884|03/01/2022|1.06227|03/01/2022|1.06935|03/01/2022|||BRONCHODILATORS: BETA AGONIST|21889|||||No|No||ZYDUS PHARMACEU|No||||
clomipramine HCl|No|No|No|No|75%|70710106501|CLOMIPRAMINE 25 MG CAPSULE|100|EA|.68073|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|1.31238|03/29/2022|1.28088|03/29/2022|1.28941|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|21890|||||No|No||ZYDUS PHARMACEU|No||||
clomipramine HCl|No|No|No|No|75%|70710106503|CLOMIPRAMINE 25 MG CAPSULE|30|EA|.73114|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|1.31238|03/29/2022|1.28088|03/29/2022|1.28941|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|21891|||||No|No||ZYDUS PHARMACEU|No||||
clomipramine HCl|No|No|No|No|75%|70710106601|CLOMIPRAMINE 50 MG CAPSULE|100|EA|.68073|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.80238|03/29/2022|.78312|03/29/2022|.78833|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|21892|||||No|No||ZYDUS PHARMACEU|No||||
clomipramine HCl|No|No|No|No|75%|70710106603|CLOMIPRAMINE 50 MG CAPSULE|30|EA|.73114|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.80238|03/29/2022|.78312|03/29/2022|.78833|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|21893|||||No|No||ZYDUS PHARMACEU|No||||
clomipramine HCl|No|No|No|No|75%|70710106701|CLOMIPRAMINE 75 MG CAPSULE|100|EA|.68073|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.95054|03/29/2022|.92772|03/29/2022|.9339|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|21894|||||No|No||ZYDUS PHARMACEU|No||||
clomipramine HCl|No|No|No|No|75%|70710106703|CLOMIPRAMINE 75 MG CAPSULE|30|EA|.73114|12/06/2018||Yes|No||12/06/2018||Yes|No|12/06/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|215|No|.95054|03/29/2022|.92772|03/29/2022|.9339|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|21895|||||No|No||ZYDUS PHARMACEU|No||||
cyproheptadine HCl|No|No|No|No|75%|70710111000|CYPROHEPTADINE 4 MG TABLET|1000|EA|.18076|12/15/2020||Yes|No||12/15/2020||Yes|No|12/15/2020||Yes|No||||No|No|||Prescription required|No||574|Yes|.09783|03/29/2022|.09548|03/29/2022|.09611|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|21896|||||No|No||ZYDUS PHARMACEU|No||||
cyproheptadine HCl|No|No|No|No|75%|70710111001|CYPROHEPTADINE 4 MG TABLET|100|EA|.19027|11/29/2017||Yes|No||11/29/2017||Yes|No|11/29/2017||Yes|No||||No|No|||Prescription required|No||574|Yes|.09783|03/29/2022|.09548|03/29/2022|.09611|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|21897|||||No|No||ZYDUS PHARMACEU|No||||
tizanidine HCl|No|No|No|No|75%|70710111108|TIZANIDINE HCL 2 MG CAPSULE|150|EA|.11369|11/29/2017||Yes|No||11/29/2017||Yes|No|11/29/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|116|No|.0903|03/29/2022|.08813|03/29/2022|.08871|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21898|||||No|No||ZYDUS PHARMACEU|No||||
tizanidine HCl|No|No|No|No|75%|70710111208|TIZANIDINE HCL 4 MG CAPSULE|150|EA|.1441|11/29/2017||Yes|No||11/29/2017||Yes|No|11/29/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|116|No|.15367|03/29/2022|.14998|03/29/2022|.15098|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21899|||||No|No||ZYDUS PHARMACEU|No||||
tizanidine HCl|No|No|No|No|75%|70710111308|TIZANIDINE HCL 6 MG CAPSULE|150|EA|.21611|11/29/2017||Yes|No||11/29/2017||Yes|No|11/29/2017||Yes|No||||No|No|||Prescription required|Yes|09/14/2017|116|No|.27523|03/29/2022|.26862|03/29/2022|.27041|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21900|||||No|No||ZYDUS PHARMACEU|No||||
doxycycline monohydrate|No|No|No|No|75%|70710112101|DOXYCYCLINE MONO 50 MG TABLET|100|EA|.20313|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|.26397|03/29/2022|.25763|03/29/2022|.25935|03/29/2022|||TETRACYCLINES|21901|||||No|No||ZYDUS PHARMACEU|No||||
doxycycline monohydrate|No|No|No|No|75%|70710112201|DOXYCYCLINE MONO 75 MG TABLET|100|EA|.37926|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|.86436|12/16/2020|.85201|12/16/2020|.81144|12/16/2020|||TETRACYCLINES|21902|||||No|No||ZYDUS PHARMACEU|No||||
doxycycline monohydrate|No|No|No|No|75%|70710112307|DOXYCYCLINE MONO 100 MG TABLET|50|EA|.33178|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|.32436|03/29/2022|.31657|03/29/2022|.31868|03/29/2022|||TETRACYCLINES|21903|||||No|No||ZYDUS PHARMACEU|No||||
doxycycline monohydrate|No|No|No|No|75%|70710112403|DOXYCYCLINE MONO 150 MG TABLET|30|EA|1.88512|12/16/2020||Yes|No||12/16/2020||Yes|No|12/16/2020||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|213|No|4.29632|12/16/2020|4.23494|12/16/2020|4.03328|12/16/2020|||TETRACYCLINES|21904|||||No|No||ZYDUS PHARMACEU|No||||
ursodiol|No|No|No|No|75%|70710112701|URSODIOL 250 MG TABLET|100|EA|.60939|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||198|No|.5902|03/29/2022|.57603|03/29/2022|.57987|03/29/2022|||BILE SALTS|21905|||||No|No||ZYDUS PHARMACEU|No||||
ursodiol|No|No|No|No|75%|70710112801|URSODIOL 500 MG TABLET|100|EA|1.27391|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||198|No|.95342|03/29/2022|.93053|03/29/2022|.93673|03/29/2022|||BILE SALTS|21906|||||No|No||ZYDUS PHARMACEU|No||||
chlorpromazine HCl|No|No|No|No|75%|70710112901|CHLORPROMAZINE 10 MG TABLET|100|EA|.30229|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|1.29919|10/26/2021|1.268|10/26/2021|1.27645|10/26/2021|||ANTIPSYCHOTICS|21907|||||No|No||ZYDUS PHARMACEU|No||||
chlorpromazine HCl|No|No|No|No|75%|70710113001|CHLORPROMAZINE 25 MG TABLET|100|EA|.4312|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|1.39549|03/29/2022|1.36199|03/29/2022|1.37106|03/29/2022|||ANTIPSYCHOTICS|21908|||||No|No||ZYDUS PHARMACEU|No||||
chlorpromazine HCl|No|No|No|No|75%|70710113101|CHLORPROMAZINE 50 MG TABLET|100|EA|.80255|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|1.74791|03/29/2022|1.70596|03/29/2022|1.71732|03/29/2022|||ANTIPSYCHOTICS|21909|||||No|No||ZYDUS PHARMACEU|No||||
chlorpromazine HCl|No|No|No|No|75%|70710113201|CHLORPROMAZINE 100 MG TABLET|100|EA|1.1465|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|2.03394|03/29/2022|1.98512|03/29/2022|1.99834|03/29/2022|||ANTIPSYCHOTICS|21910|||||No|No||ZYDUS PHARMACEU|No||||
chlorpromazine HCl|No|No|No|No|75%|70710113301|CHLORPROMAZINE 200 MG TABLET|100|EA|1.63787|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No||027|Yes|4.21034|03/01/2022|4.10929|03/01/2022|4.13665|03/01/2022|||ANTIPSYCHOTICS|21911|||||No|No||ZYDUS PHARMACEU|No||||
fluconazole|No|No|No|No|75%|70710113703|FLUCONAZOLE 50 MG TABLET|30|EA|.20066|03/06/2018||Yes|No||03/06/2018||Yes|No|03/06/2018||Yes|No||||No|No|||Prescription required|No||069|No|.43933|03/29/2022|.42878|03/29/2022|.43164|03/29/2022|||ANTIFUNGALS: ORAL|21912|||||No|No||ZYDUS PHARMACEU|No||||
fluconazole|No|No|No|No|75%|70710113801|FLUCONAZOLE 100 MG TABLET|100|EA|.301|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||069|No|.34281|03/29/2022|.33458|03/29/2022|.33681|03/29/2022|||ANTIFUNGALS: ORAL|21913|||||No|No||ZYDUS PHARMACEU|No||||
fluconazole|No|No|No|No|75%|70710113803|FLUCONAZOLE 100 MG TABLET|30|EA|.301|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||069|No|.34281|03/29/2022|.33458|03/29/2022|.33681|03/29/2022|||ANTIFUNGALS: ORAL|21914|||||No|No||ZYDUS PHARMACEU|No||||
fluconazole|Yes|No|No|No|75%|70710113908|FLUCONAZOLE 150 MG TABLET|12|EA|.84315|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|03/07/2018||Prescription required|No||069|No|.74933|03/29/2022|.73134|03/29/2022|.73621|03/29/2022|||ANTIFUNGALS: ORAL|21915|||||No|No||ZYDUS PHARMACEU|No||||
fluconazole|No|No|No|No|75%|70710114001|FLUCONAZOLE 200 MG TABLET|100|EA|.40131|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||069|No|.52936|03/29/2022|.51665|03/29/2022|.52009|03/29/2022|||ANTIFUNGALS: ORAL|21916|||||No|No||ZYDUS PHARMACEU|No||||
fluconazole|No|No|No|No|75%|70710114003|FLUCONAZOLE 200 MG TABLET|30|EA|.40133|03/07/2018||Yes|No||03/07/2018||Yes|No|03/07/2018||Yes|No||||No|No|||Prescription required|No||069|No|.52936|03/29/2022|.51665|03/29/2022|.52009|03/29/2022|||ANTIFUNGALS: ORAL|21917|||||No|No||ZYDUS PHARMACEU|No||||
isosorbide dinitrate|No|No|No|No|75%|70710115101|ISOSORBIDE DINITRATE 30 MG TAB|100|EA|.39465|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No|||No|.46251|03/29/2022|.4514|03/29/2022|.45441|03/29/2022||||21918|||||No|No||ZYDUS PHARMACEU|No||||
isosorbide dinitrate|No|No|No|No|75%|70710115201|ISOSORBIDE DINITRATE 40 MG TAB|100|EA|5.74209|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No|||No|13.08662|03/02/2020|12.89967|03/02/2020|12.2854|03/02/2020||||21919|||||No|No||ZYDUS PHARMACEU|No||||
leflunomide|No|No|No|No|75%|70710115703|LEFLUNOMIDE 10 MG TABLET|30|EA|.47013|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||||No|No|||Prescription required|No|||No|.80538|03/29/2022|.78605|03/29/2022|.79128|03/29/2022||||21920|||||No|No||ZYDUS PHARMACEU|No||||
leflunomide|No|No|No|No|75%|70710115803|LEFLUNOMIDE 20 MG TABLET|30|EA|.47013|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||||No|No|||Prescription required|No|||No|.61902|03/29/2022|.60416|03/29/2022|.60818|03/29/2022||||21921|||||No|No||ZYDUS PHARMACEU|No||||
meclizine HCl|No|No|No|No|75%|70710116100|MECLIZINE 12.5 MG TABLET|1000|EA|.07386|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||085|Yes|.08309|03/29/2022|.08109|03/29/2022|.08163|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|21922|||||No|No||ZYDUS PHARMACEU|No||||
meclizine HCl|No|No|No|No|75%|70710116101|MECLIZINE 12.5 MG TABLET|100|EA|.07387|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||085|Yes|.08309|03/29/2022|.08109|03/29/2022|.08163|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|21923|||||No|No||ZYDUS PHARMACEU|No||||
meclizine HCl|No|No|No|No|75%|70710116200|MECLIZINE 25 MG TABLET|1000|EA|.08208|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||085|Yes|.11433|03/29/2022|.11158|03/29/2022|.11232|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|21924|||||No|No||ZYDUS PHARMACEU|No||||
meclizine HCl|No|No|No|No|75%|70710116201|MECLIZINE 25 MG TABLET|100|EA|.08208|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||085|Yes|.11433|03/29/2022|.11158|03/29/2022|.11232|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|21925|||||No|No||ZYDUS PHARMACEU|No||||
oseltamivir phosphate|No|No|No|No|75%|70710116506|OSELTAMIVIR 6 MG/ML SUSPENSION|60|ML|.50288|01/30/2018||Yes|No||01/30/2018||Yes|No|01/30/2018||Yes|No||||No|No|||Prescription required|No||025|No|.51688|03/29/2022|.50447|03/29/2022|.50783|03/29/2022|||ANTIVIRALS: ORAL|21926|||||No|No||ZYDUS PHARMACEU|No||||
atenolol/chlorthalidone|No|No|No|No|75%|70710116701|ATENOLOL-CHLORTHALIDONE 50-25|100|EA|.24037|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||||No|No|||Prescription required|No||070|Yes|.37465|03/29/2022|.36565|03/29/2022|.36809|03/29/2022|||BETA-BLOCKERS|21927|||||No|No||ZYDUS PHARMACEU|No||||
atenolol/chlorthalidone|No|No|No|No|75%|70710116801|ATENOLOL-CHLORTHALIDONE 100-25|100|EA|.33759|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||||No|No|||Prescription required|No||070|Yes|.47415|03/29/2022|.46277|03/29/2022|.46585|03/29/2022|||BETA-BLOCKERS|21928|||||No|No||ZYDUS PHARMACEU|No||||
ambrisentan|No|No|No|No|75%|70710117903|AMBRISENTAN 5 MG TABLET|30|EA|17.55833|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|No|40.01666|08/24/2021|39.44499|08/24/2021|37.56666|08/24/2021|||PAH AGENTS: ORAL AND INHALED|21929|||||No|No||ZYDUS PHARMACEU|No||||
ambrisentan|No|No|No|No|75%|70710118003|AMBRISENTAN 10 MG TABLET|30|EA|17.55833|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||171|No|40.01666|08/24/2021|39.44499|08/24/2021|37.56666|08/24/2021|||PAH AGENTS: ORAL AND INHALED|21930|||||No|No||ZYDUS PHARMACEU|No||||
rivastigmine|No|No|No|No|75%|70710119607|RIVASTIGMINE 4.6 MG/24HR PATCH|30|EA|1.82893|09/19/2019||Yes|No||09/19/2019||Yes|No|09/19/2019||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|011|No|2.88542|03/29/2022|2.81616|03/29/2022|2.83492|03/29/2022|||ALZHEIMER'S AGENTS|21931|||||No|No||ZYDUS PHARMACEU|No||||
rivastigmine|No|No|No|No|75%|70710119707|RIVASTIGMINE 9.5 MG/24HR PATCH|30|EA|1.82893|09/19/2019||Yes|No||09/19/2019||Yes|No|09/19/2019||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|011|No|2.83898|03/29/2022|2.77084|03/29/2022|2.78929|03/29/2022|||ALZHEIMER'S AGENTS|21932|||||No|No||ZYDUS PHARMACEU|No||||
rivastigmine|No|No|No|No|75%|70710119807|RIVASTIGMINE 13.3 MG/24HR PTCH|30|EA|1.82893|09/19/2019||Yes|No||09/19/2019||Yes|No|09/19/2019||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|011|No|3.24254|03/29/2022|3.16471|03/29/2022|3.18579|03/29/2022|||ALZHEIMER'S AGENTS|21933|||||No|No||ZYDUS PHARMACEU|No||||
trientine HCl|No|No|No|No|75%|70710120301|TRIENTINE HCL 250 MG CAPSULE|100|EA|8.6|09/19/2019||Yes|No||09/19/2019||Yes|No|09/19/2019||Yes|No||||No|No|||Prescription required|No|||No|19.6|11/03/2020|19.32|11/03/2020|18.4|11/03/2020||||21934|||||No|No||ZYDUS PHARMACEU|No||||
amitriptyline HCl|No|No|No|No|75%|70710122500|AMITRIPTYLINE HCL 10 MG TAB|1000|EA|.04376|03/21/2019||Yes|No||03/21/2019||Yes|No|03/21/2019||Yes|No||||No|No|||Prescription required|No||215|No|.04811|03/29/2022|.04695|03/29/2022|.04726|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|21935|||||No|No||ZYDUS PHARMACEU|No||||
amitriptyline HCl|No|No|No|No|75%|70710122501|AMITRIPTYLINE HCL 10 MG TAB|100|EA|.04613|03/21/2019||Yes|No||03/21/2019||Yes|No|03/21/2019||Yes|No||||No|No|||Prescription required|No||215|No|.04811|03/29/2022|.04695|03/29/2022|.04726|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|21936|||||No|No||ZYDUS PHARMACEU|No||||
amitriptyline HCl|No|No|No|No|75%|70710122600|AMITRIPTYLINE HCL 25 MG TAB|1000|EA|.08753|03/21/2019||Yes|No||03/21/2019||Yes|No|03/21/2019||Yes|No||||No|No|||Prescription required|No||215|No|.07343|03/29/2022|.07166|03/29/2022|.07214|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|21937|||||No|No||ZYDUS PHARMACEU|No||||
amitriptyline HCl|No|No|No|No|75%|70710122601|AMITRIPTYLINE HCL 25 MG TAB|100|EA|.09232|03/21/2019||Yes|No||03/21/2019||Yes|No|03/21/2019||Yes|No||||No|No|||Prescription required|No||215|No|.07343|03/29/2022|.07166|03/29/2022|.07214|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|21938|||||No|No||ZYDUS PHARMACEU|No||||
amitriptyline HCl|No|No|No|No|75%|70710122700|AMITRIPTYLINE HCL 50 MG TAB|1000|EA|.15319|03/21/2019||Yes|No||03/21/2019||Yes|No|03/21/2019||Yes|No||||No|No|||Prescription required|No||215|No|.14797|03/29/2022|.14441|03/29/2022|.14538|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|21939|||||No|No||ZYDUS PHARMACEU|No||||
amitriptyline HCl|No|No|No|No|75%|70710122701|AMITRIPTYLINE HCL 50 MG TAB|100|EA|.18429|03/21/2019||Yes|No||03/21/2019||Yes|No|03/21/2019||Yes|No||||No|No|||Prescription required|No||215|No|.14797|03/29/2022|.14441|03/29/2022|.14538|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|21940|||||No|No||ZYDUS PHARMACEU|No||||
amitriptyline HCl|No|No|No|No|75%|70710122801|AMITRIPTYLINE HCL 75 MG TAB|100|EA|.27692|03/21/2019||Yes|No||03/21/2019||Yes|No|03/21/2019||Yes|No||||No|No|||Prescription required|No||215|No|.26194|03/29/2022|.25565|03/29/2022|.25735|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|21941|||||No|No||ZYDUS PHARMACEU|No||||
amitriptyline HCl|No|No|No|No|75%|70710122901|AMITRIPTYLINE HCL 100 MG TAB|100|EA|.36863|03/21/2019||Yes|No||03/21/2019||Yes|No|03/21/2019||Yes|No||||No|No|||Prescription required|No||215|No|.30607|03/29/2022|.29872|03/29/2022|.30071|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|21942|||||No|No||ZYDUS PHARMACEU|No||||
amitriptyline HCl|No|No|No|No|75%|70710123001|AMITRIPTYLINE HCL 150 MG TAB|100|EA|.5528|03/21/2019||Yes|No||03/21/2019||Yes|No|03/21/2019||Yes|No||||No|No|||Prescription required|No||215|No|.58201|03/29/2022|.56804|03/29/2022|.57182|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|21943|||||No|No||ZYDUS PHARMACEU|No||||
clindamycin phosphate|No|No|No|No|75%|70710123102|CLINDAMYCIN PH 1% SOLUTION|30|ML|.28079|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No||104|No|.23242|03/29/2022|.22684|03/29/2022|.22835|03/29/2022|||ACNE AGENTS: TOPICAL|21944|||||No|No||ZYDUS PHARMACEU|No||||
clindamycin phosphate|No|No|No|No|75%|70710123103|CLINDAMYCIN PH 1% SOLUTION|60|ML|.28071|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No||104|No|.19863|03/29/2022|.19386|03/29/2022|.19515|03/29/2022|||ACNE AGENTS: TOPICAL|21945|||||No|No||ZYDUS PHARMACEU|No||||
betamethasone dipropionate|No|No|No|No|75%|70710123301|BETAMETHASONE DP 0.05% CRM|15|GM|1.00906|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|1.02286|03/29/2022|.99831|03/29/2022|1.00495|03/29/2022|||STEROIDS: TOPICAL HIGH|21946|||||No|No||ZYDUS PHARMACEU|No||||
betamethasone dipropionate|No|No|No|No|75%|70710123304|BETAMETHASONE DP 0.05% CRM|45|GM|.6727|09/26/2019||Yes|No||09/26/2019||Yes|No|09/26/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|.64604|03/29/2022|.63053|03/29/2022|.63473|03/29/2022|||STEROIDS: TOPICAL HIGH|21947|||||No|No||ZYDUS PHARMACEU|No||||
desonide|No|No|No|No|75%|70710123501|DESONIDE 0.05% CREAM|15|GM|.58938|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|118|No|.68707|03/29/2022|.67058|03/29/2022|.67504|03/29/2022|||STEROIDS: TOPICAL LOW|21948|||||No|No||ZYDUS PHARMACEU|No||||
desonide|No|No|No|No|75%|70710123503|DESONIDE 0.05% CREAM|60|GM|.58945|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|118|No|.61157|03/29/2022|.59689|03/29/2022|.60086|03/29/2022|||STEROIDS: TOPICAL LOW|21949|||||No|No||ZYDUS PHARMACEU|No||||
deferasirox|No|No|No|No|75%|70710127503|DEFERASIROX 90 MG TABLET|30|EA|1.17533|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No|||No|2.67866|07/14/2020|2.64039|07/14/2020|2.51466|07/14/2020||||21950|||||No|No||ZYDUS PHARMACEU|No||||
deferasirox|No|No|No|No|75%|70710127603|DEFERASIROX 180 MG TABLET|30|EA|2.35066|08/18/2020||Yes|No||08/18/2020||Yes|No|08/18/2020||Yes|No||||No|No|||Prescription required|No|||No|5.35732|08/18/2020|5.28079|08/18/2020|5.02932|08/18/2020||||21951|||||No|No||ZYDUS PHARMACEU|No||||
deferasirox|No|No|No|No|75%|70710127703|DEFERASIROX 360 MG TABLET|30|EA|4.70119|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No|||No|10.71434|07/14/2020|10.56127|07/14/2020|10.05836|07/14/2020||||21952|||||No|No||ZYDUS PHARMACEU|No||||
fluocinonide|No|No|No|No|75%|70710128403|FLUOCINONIDE 0.05% SOLUTION|60|ML|.4153|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|.3579|03/29/2022|.34931|03/29/2022|.35163|03/29/2022|||STEROIDS: TOPICAL HIGH|21953|||||No|No||ZYDUS PHARMACEU|No||||
baclofen|No|No|No|No|75%|70710128500|BACLOFEN 10 MG TABLET|1000|EA|.05919|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21954|||||No|No||ZYDUS PHARMACEU|No||||
baclofen|No|No|No|No|75%|70710128501|BACLOFEN 10 MG TABLET|100|EA|.06424|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21955|||||No|No||ZYDUS PHARMACEU|No||||
baclofen|No|No|No|No|75%|70710128505|BACLOFEN 10 MG TABLET|500|EA|.0623|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21956|||||No|No||ZYDUS PHARMACEU|No||||
baclofen|No|No|No|No|75%|70710128600|BACLOFEN 20 MG TABLET|1000|EA|.09161|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21957|||||No|No||ZYDUS PHARMACEU|No||||
baclofen|No|No|No|No|75%|70710128601|BACLOFEN 20 MG TABLET|100|EA|.09941|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21958|||||No|No||ZYDUS PHARMACEU|No||||
baclofen|No|No|No|No|75%|70710128605|BACLOFEN 20 MG TABLET|500|EA|.09643|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|21959|||||No|No||ZYDUS PHARMACEU|No||||
mesalamine|No|No|No|No|75%|70710130207|MESALAMINE 1,000 MG SUPP|30|EA|3.87|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No||010|No|2.81018|03/29/2022|2.74273|03/29/2022|2.761|03/29/2022|||ULCERATIVE COLITIS AGENTS|21960|||||No|No||ZYDUS PHARMACEU|No||||
clobazam|No|No|No|No|90%|70710132501|CLOBAZAM 10 MG TABLET|100|EA|.27692|12/29/2020||Yes|No||12/29/2020||Yes|No|12/29/2020||Yes|No||||No|No|||Prescription required|No||056|No|.37729|03/29/2022|.36823|03/29/2022|.37068|03/29/2022|||ANTICONVULSANTS|21961|||||No|No||ZYDUS PHARMACEU|No||||
clobazam|No|No|No|No|90%|70710132601|CLOBAZAM 20 MG TABLET|100|EA|.55384|12/29/2020||Yes|No||12/29/2020||Yes|No|12/29/2020||Yes|No||||No|No|||Prescription required|No||056|No|.71967|03/29/2022|.70239|03/29/2022|.70707|03/29/2022|||ANTICONVULSANTS|21962|||||No|No||ZYDUS PHARMACEU|No||||
ramelteon|No|No|No|No|75%|70710134401|RAMELTEON 8 MG TABLET|100|EA|.8271|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|054|Yes|1.10393|03/29/2022|1.07743|03/29/2022|1.08461|03/29/2022|||SEDATIVE HYPNOTICS|21963|||||No|No||ZYDUS PHARMACEU|No||||
ramelteon|No|No|No|No|75%|70710134403|RAMELTEON 8 MG TABLET|30|EA|.82717|12/12/2019||Yes|No||12/12/2019||Yes|No|12/12/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|054|Yes|1.10393|03/29/2022|1.07743|03/29/2022|1.08461|03/29/2022|||SEDATIVE HYPNOTICS|21964|||||No|No||ZYDUS PHARMACEU|No||||
colchicine|No|No|No|No|75%|70710135103|COLCHICINE 0.6 MG TABLET|30|EA|.39402|12/28/2020||Yes|No||12/28/2020||Yes|No|12/28/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|231|No|.64179|03/29/2022|.62638|03/29/2022|.63055|03/29/2022|||ANTIHYPERURICEMICS|21965|||||No|No||ZYDUS PHARMACEU|No||||
emtricitabine/tenofovir (TDF)|No|No|No|No|75%|70710136403|EMTRICITABINE-TENOFV 100-150MG|30|EA|8.40079|11/29/2021||Yes|No||11/29/2021||Yes|No|11/29/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|13.7213|11/29/2021|13.52528|11/29/2021|12.88122|11/29/2021|||HIV / AIDS|21966|||||No|No||ZYDUS PHARMACEU|No||||
emtricitabine/tenofovir (TDF)|No|No|No|No|75%|70710136503|EMTRICITABINE-TENOFV 133-200MG|30|EA|8.40079|12/08/2021||Yes|No||12/08/2021||Yes|No|12/08/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|13.7213|12/08/2021|13.52528|12/08/2021|12.88122|12/08/2021|||HIV / AIDS|21967|||||No|No||ZYDUS PHARMACEU|No||||
emtricitabine/tenofovir (TDF)|No|No|No|No|75%|70710136603|EMTRICITABINE-TENOFV 167-250MG|30|EA|8.40079|12/08/2021||Yes|No||12/08/2021||Yes|No|12/08/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|13.7213|12/08/2021|13.52528|12/08/2021|12.88122|12/08/2021|||HIV / AIDS|21968|||||No|No||ZYDUS PHARMACEU|No||||
emtricitabine/tenofovir (TDF)|No|No|No|No|75%|70710136703|EMTRICITABINE-TENOFV 200-300MG|30|EA|.84|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No||237|No|.70347|03/29/2022|.68658|03/29/2022|.69115|03/29/2022|||HIV / AIDS|21969|||||No|No||ZYDUS PHARMACEU|No||||
droxidopa|No|No|No|No|75%|70710138909|DROXIDOPA 100 MG CAPSULE|90|EA|1.75735|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No|||No|4.00514|08/24/2021|3.94792|08/24/2021|3.75992|08/24/2021||||21970|||||No|No||ZYDUS PHARMACEU|No||||
droxidopa|No|No|No|No|75%|70710139009|DROXIDOPA 200 MG CAPSULE|90|EA|3.51467|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No|||No|8.01018|08/24/2021|7.89575|08/24/2021|7.51976|08/24/2021||||21971|||||No|No||ZYDUS PHARMACEU|No||||
droxidopa|No|No|No|No|75%|70710139109|DROXIDOPA 300 MG CAPSULE|90|EA|5.27203|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No|||No|12.01533|08/24/2021|11.84369|08/24/2021|11.2797|08/24/2021||||21972|||||No|No||ZYDUS PHARMACEU|No||||
clobetasol propionate|No|No|No|No|75%|70710140101|CLOBETASOL 0.05% OINTMENT|15|GM|.688|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|||Prescription required|No||121|No|.35914|03/29/2022|.35052|03/29/2022|.35285|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|21973|||||No|No||ZYDUS PHARMACEU|No||||
clobetasol propionate|No|No|No|No|75%|70710140102|CLOBETASOL 0.05% OINTMENT|30|GM|.57921|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|||Prescription required|No||121|No|.3756|03/29/2022|.36658|03/29/2022|.36902|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|21974|||||No|No||ZYDUS PHARMACEU|No||||
clobetasol propionate|No|No|No|No|75%|70710140103|CLOBETASOL 0.05% OINTMENT|60|GM|.57906|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|||Prescription required|No||121|No|.32004|03/29/2022|.31235|03/29/2022|.31443|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|21975|||||No|No||ZYDUS PHARMACEU|No||||
clobetasol propionate|No|No|No|No|75%|70710140104|CLOBETASOL 0.05% OINTMENT|45|GM|.57915|06/04/2019||Yes|No||06/04/2019||Yes|No|06/04/2019||Yes|No||||No|No|||Prescription required|No||121|No|.36764|03/29/2022|.35881|03/29/2022|.3612|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|21976|||||No|No||ZYDUS PHARMACEU|No||||
clindamycin phos/benzoyl perox|No|No|No|No|75%|70710144504|CLIND PH-BENZOYL PEROX 1.2-5%|45|GM|.62206|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No||104|No|.73339|03/29/2022|.71578|03/29/2022|.72055|03/29/2022|||ACNE AGENTS: TOPICAL|21977|||||No|No||ZYDUS PHARMACEU|No||||
clobetasol propionate|No|No|No|No|75%|70710145601|CLOBETASOL 0.05% CREAM|15|GM|.46325|09/04/2019||Yes|No||09/04/2019||Yes|No|09/04/2019||Yes|No||||No|No|||Prescription required|No||121|No|.42879|03/29/2022|.41849|03/29/2022|.42128|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|21978|||||No|No||ZYDUS PHARMACEU|No||||
clobetasol propionate|No|No|No|No|75%|70710145602|CLOBETASOL 0.05% CREAM|30|GM|.46311|09/04/2019||Yes|No||09/04/2019||Yes|No|09/04/2019||Yes|No||||No|No|||Prescription required|No||121|No|.34489|03/29/2022|.33661|03/29/2022|.33885|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|21979|||||No|No||ZYDUS PHARMACEU|No||||
clobetasol propionate|No|No|No|No|75%|70710145603|CLOBETASOL 0.05% CREAM|60|GM|.41444|09/04/2019||Yes|No||09/04/2019||Yes|No|09/04/2019||Yes|No||||No|No|||Prescription required|No||121|No|.33784|03/29/2022|.32973|03/29/2022|.33192|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|21980|||||No|No||ZYDUS PHARMACEU|No||||
clobetasol propionate|No|No|No|No|75%|70710145604|CLOBETASOL 0.05% CREAM|45|GM|.46315|09/04/2019||Yes|No||09/04/2019||Yes|No|09/04/2019||Yes|No||||No|No|||Prescription required|No||121|No|.31467|03/29/2022|.30711|03/29/2022|.30916|03/29/2022|||STEROIDS: TOPICAL VERY HIGH|21981|||||No|No||ZYDUS PHARMACEU|No||||
azithromycin|No|No|No|No|75%|70710145701|AZITHROMYCIN 100 MG/5 ML SUSP|15|ML|.60372|01/18/2022||Yes|No||01/18/2022||Yes|No|01/18/2022||Yes|No||||No|No|||Prescription required|No||018|No|.56328|03/29/2022|.54976|03/29/2022|.55342|03/29/2022|||MACROLIDES/KETOLIDES|21982|||||No|No||ZYDUS PHARMACEU|No||||
azithromycin|No|No|No|No|75%|70710145802|AZITHROMYCIN 200 MG/5 ML SUSP|15|ML|.60372|12/04/2018||Yes|No||12/04/2018||Yes|No|12/04/2018||Yes|No||||No|No|||Prescription required|No||018|No|.46232|03/29/2022|.45122|03/29/2022|.45422|03/29/2022|||MACROLIDES/KETOLIDES|21983|||||No|No||ZYDUS PHARMACEU|No||||
azithromycin|No|No|No|No|75%|70710145902|AZITHROMYCIN 200 MG/5 ML SUSP|22.5|ML|.40248|12/04/2018||Yes|No||12/04/2018||Yes|No|12/04/2018||Yes|No||||No|No|||Prescription required|No||018|No|.35562|03/29/2022|.34708|03/29/2022|.34939|03/29/2022|||MACROLIDES/KETOLIDES|21984|||||No|No||ZYDUS PHARMACEU|No||||
azithromycin|No|No|No|No|75%|70710146002|AZITHROMYCIN 200 MG/5 ML SUSP|30|ML|.30186|12/04/2018||Yes|No||12/04/2018||Yes|No|12/04/2018||Yes|No||||No|No|||Prescription required|No||018|No|.28375|03/29/2022|.27694|03/29/2022|.27878|03/29/2022|||MACROLIDES/KETOLIDES|21985|||||No|No||ZYDUS PHARMACEU|No||||
haloperidol decanoate|No|No|No|No|75%|70710146106|HALOPERIDOL DEC 50 MG/ML VIAL|1|ML|9.245|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|No||027|No|17.60088|09/28/2021|17.17845|09/28/2021|17.29286|09/28/2021|||ANTIPSYCHOTICS|21986|||||No|No||ZYDUS PHARMACEU|No||||
haloperidol decanoate|No|No|No|No|75%|70710146109|HALOPERIDOL DEC 50 MG/ML VIAL|1|ML|9.245|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|No||027|No|21.07|06/01/2020|20.769|06/01/2020|19.78|06/01/2020|||ANTIPSYCHOTICS|21987|||||No|No||ZYDUS PHARMACEU|No||||
haloperidol decanoate|No|No|No|No|75%|70710146201|HALOPERIDOL DEC 250 MG/5 ML VL|5|ML|9.245|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|No||027|No|21.07|06/01/2020|20.769|06/01/2020|19.78|06/01/2020|||ANTIPSYCHOTICS|21988|||||No|No||ZYDUS PHARMACEU|No||||
haloperidol decanoate|No|No|No|No|75%|70710146301|HALOPERIDOL DEC 100 MG/ML VIAL|1|ML|18.06|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No||027|No|18.535|03/29/2022|18.09016|03/29/2022|18.21063|03/29/2022|||ANTIPSYCHOTICS|21989|||||No|No||ZYDUS PHARMACEU|No||||
haloperidol decanoate|No|No|No|No|75%|70710146305|HALOPERIDOL DEC 100 MG/ML VIAL|1|ML|18.49|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No||027|No|29.246|03/29/2022|28.54409|03/29/2022|28.73419|03/29/2022|||ANTIPSYCHOTICS|21990|||||No|No||ZYDUS PHARMACEU|No||||
haloperidol decanoate|No|No|No|No|75%|70710146401|HALOPERIDOL DEC 500 MG/5 ML VL|5|ML|17.2|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No||027|No|29.246|03/29/2022|28.54409|03/29/2022|28.73419|03/29/2022|||ANTIPSYCHOTICS|21991|||||No|No||ZYDUS PHARMACEU|No||||
haloperidol decanoate|No|No|No|No|75%|70710146405|HALOPERIDOL DEC 500 MG/5 ML VL|5|ML|17.028|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No||027|No|38.808|03/02/2021|38.2536|03/02/2021|36.432|03/02/2021|||ANTIPSYCHOTICS|21992|||||No|No||ZYDUS PHARMACEU|No||||
ursodiol|No|No|No|No|75%|70710148301|URSODIOL 300 MG CAPSULE|100|EA|.4515|08/23/2021||Yes|No||08/23/2021||Yes|No|08/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|198|No|.60006|03/29/2022|.58565|03/29/2022|.58955|03/29/2022|||BILE SALTS|21993|||||No|No||ZYDUS PHARMACEU|No||||
fluphenazine HCl|No|No|No|No|75%|70710148801|FLUPHENAZINE 1 MG TABLET|100|EA|.5934|11/29/2021||Yes|No||11/29/2021||Yes|No|11/29/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|1.56797|01/25/2022|1.53033|01/25/2022|1.54053|01/25/2022|||ANTIPSYCHOTICS|21994|||||No|No||ZYDUS PHARMACEU|No||||
fluphenazine HCl|No|No|No|No|75%|70710148901|FLUPHENAZINE 2.5 MG TABLET|100|EA|.92097|12/08/2021||Yes|No||12/08/2021||Yes|No|12/08/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|2.3014|01/25/2022|2.24616|01/25/2022|2.26112|01/25/2022|||ANTIPSYCHOTICS|21995|||||No|No||ZYDUS PHARMACEU|No||||
fluphenazine HCl|No|No|No|No|75%|70710149001|FLUPHENAZINE 5 MG TABLET|100|EA|1.24605|12/08/2021||Yes|No||12/08/2021||Yes|No|12/08/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|2.98385|03/29/2022|2.91223|03/29/2022|2.93163|03/29/2022|||ANTIPSYCHOTICS|21996|||||No|No||ZYDUS PHARMACEU|No||||
fluphenazine HCl|No|No|No|No|75%|70710149101|FLUPHENAZINE 10 MG TABLET|100|EA|1.57104|12/08/2021||Yes|No||12/08/2021||Yes|No|12/08/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|3.52974|03/29/2022|3.44502|03/29/2022|3.46796|03/29/2022|||ANTIPSYCHOTICS|21997|||||No|No||ZYDUS PHARMACEU|No||||
fondaparinux sodium|No|No|No|No|75%|70710151406|FONDAPARINUX 2.5 MG/0.5 ML SYR|.5|ML|20.21|12/01/2020||Yes|No||12/01/2020||Yes|No|12/01/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|068|Yes|46.06|03/23/2021|45.402|03/23/2021|43.24|03/23/2021|||ANTICOAGULANTS|21998|||||No|No||ZYDUS PHARMACEU|No||||
fondaparinux sodium|No|No|No|No|75%|70710151409|FONDAPARINUX 2.5 MG/0.5 ML SYR|.5|ML|34.7354|12/01/2020||Yes|No||12/01/2020||Yes|No|12/01/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|068|Yes|79.1644|12/01/2020|78.03348|12/01/2020|74.3176|12/01/2020|||ANTICOAGULANTS|21999|||||No|No||ZYDUS PHARMACEU|No||||
fondaparinux sodium|No|No|No|No|75%|70710151506|FONDAPARINUX 5 MG/0.4 ML SYR|.4|ML|59.44965|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|068|Yes|135.4899|06/01/2020|133.55433|06/01/2020|127.1946|06/01/2020|||ANTICOAGULANTS|22000|||||No|No||ZYDUS PHARMACEU|No||||
fondaparinux sodium|No|No|No|No|75%|70710151509|FONDAPARINUX 5 MG/0.4 ML SYR|.4|ML|102.1895|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|068|Yes|232.897|06/01/2020|229.5699|06/01/2020|218.638|06/01/2020|||ANTICOAGULANTS|22001|||||No|No||ZYDUS PHARMACEU|No||||
fondaparinux sodium|No|No|No|No|75%|70710151606|FONDAPARINUX 7.5 MG/0.6 ML SYR|.6|ML|39.6331|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|068|Yes|57.45472|12/28/2021|56.0758|12/28/2021|56.44926|12/28/2021|||ANTICOAGULANTS|22002|||||No|No||ZYDUS PHARMACEU|No||||
fondaparinux sodium|No|No|No|No|75%|70710151609|FONDAPARINUX 7.5 MG/0.6 ML SYR|.6|ML|68.12633|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|068|Yes|155.26466|06/01/2020|153.04659|06/01/2020|145.75866|06/01/2020|||ANTICOAGULANTS|22003|||||No|No||ZYDUS PHARMACEU|No||||
fondaparinux sodium|No|No|No|No|75%|70710151706|FONDAPARINUX 10 MG/0.8 ML SYR|.8|ML|29.72482|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|068|Yes|67.74495|06/01/2020|66.77716|06/01/2020|63.5973|06/01/2020|||ANTICOAGULANTS|22004|||||No|No||ZYDUS PHARMACEU|No||||
fondaparinux sodium|No|No|No|No|75%|70710151709|FONDAPARINUX 10 MG/0.8 ML SYR|.8|ML|51.09475|06/01/2020||Yes|No||06/01/2020||Yes|No|06/01/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|068|Yes|116.4485|06/01/2020|114.78495|06/01/2020|109.319|06/01/2020|||ANTICOAGULANTS|22005|||||No|No||ZYDUS PHARMACEU|No||||
acetazolamide|No|No|No|No|75%|70710159101|ACETAZOLAMIDE ER 500 MG CAP|100|EA|.5375|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No|||No|.39876|03/29/2022|.38918|03/29/2022|.39178|03/29/2022||||22006|||||No|No||ZYDUS PHARMACEU|No||||
baclofen|No|No|No|No|75%|70710160901|BACLOFEN 5 MG TABLET|100|EA|.39843|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|No||116|No|.53855|03/29/2022|.52562|03/29/2022|.52912|03/29/2022|||SKELETAL MUSCLE RELAXANTS|22007|||||No|No||ZYDUS PHARMACEU|No||||
enoxaparin sodium|No|No|No|No|75%|70710175706|ENOXAPARIN 30 MG/0.3 ML SYR|.3|ML|9.60046|12/08/2021||Yes|No||12/08/2021||Yes|No|12/08/2021||Yes|No||||No|No|||Prescription required|No||068|Yes|12.85641|03/29/2022|12.54785|03/29/2022|12.63142|03/29/2022|||ANTICOAGULANTS|22008|||||No|No||ZYDUS PHARMACEU|No||||
enoxaparin sodium|No|No|No|No|75%|70710175806|ENOXAPARIN 40 MG/0.4 ML SYR|.4|ML|9.60082|12/08/2021||Yes|No||12/08/2021||Yes|No|12/08/2021||Yes|No||||No|No|||Prescription required|No||068|Yes|11.94818|03/29/2022|11.66142|03/29/2022|11.73908|03/29/2022|||ANTICOAGULANTS|22009|||||No|No||ZYDUS PHARMACEU|No||||
enoxaparin sodium|No|No|No|No|75%|70710175906|ENOXAPARIN 60 MG/0.6 ML SYR|.6|ML|9.61193|12/08/2021||Yes|No||12/08/2021||Yes|No|12/08/2021||Yes|No||||No|No|||Prescription required|No||068|Yes|11.41069|03/29/2022|11.13683|03/29/2022|11.211|03/29/2022|||ANTICOAGULANTS|22010|||||No|No||ZYDUS PHARMACEU|No||||
enoxaparin sodium|No|No|No|No|75%|70710176006|ENOXAPARIN 80 MG/0.8 ML SYR|.8|ML|9.61157|12/08/2021||Yes|No||12/08/2021||Yes|No|12/08/2021||Yes|No||||No|No|||Prescription required|No||068|Yes|12.0025|03/29/2022|11.71444|03/29/2022|11.79245|03/29/2022|||ANTICOAGULANTS|22011|||||No|No||ZYDUS PHARMACEU|No||||
enoxaparin sodium|No|No|No|No|75%|70710176106|ENOXAPARIN 100 MG/ML SYRINGE|1|ML|9.61136|12/08/2021||Yes|No||12/08/2021||Yes|No|12/08/2021||Yes|No||||No|No|||Prescription required|No||068|Yes|11.81296|03/29/2022|11.52944|03/29/2022|11.60623|03/29/2022|||ANTICOAGULANTS|22012|||||No|No||ZYDUS PHARMACEU|No||||
enoxaparin sodium|No|No|No|No|75%|70710176206|ENOXAPARIN 120 MG/0.8 ML SYR|.8|ML|14.4222|12/08/2021||Yes|No||12/08/2021||Yes|No|12/08/2021||Yes|No||||No|No|||Prescription required|No||068|Yes|15.335|03/29/2022|14.96696|03/29/2022|15.06663|03/29/2022|||ANTICOAGULANTS|22013|||||No|No||ZYDUS PHARMACEU|No||||
enoxaparin sodium|No|No|No|No|75%|70710176306|ENOXAPARIN 150 MG/ML SYRINGE|1|ML|14.4222|12/08/2021||Yes|No||12/08/2021||Yes|No|12/08/2021||Yes|No||||No|No|||Prescription required|No||068|Yes|15.18|03/29/2022|14.81568|03/29/2022|14.91435|03/29/2022|||ANTICOAGULANTS|22014|||||No|No||ZYDUS PHARMACEU|No||||
riluzole|No|No|No|No|75%|70726030301|TIGLUTIK 50 MG/10 ML SUSP|600|ML|2.51473|05/16/2019||Yes|No||05/16/2019||Yes|No|05/16/2019||Yes|No||||No|No|||Prescription required|No|||No|5.73124|01/04/2022|5.64937|01/04/2022|5.38035|01/04/2022||||22015|||||No|No||ITF PHARMA, INC|No||||
netarsudil mesylate|No|No|No|No|75%|70727049725|RHOPRESSA 0.02% OPHTH SOLUTION|2.5|ML|51.1012|08/17/2018||Yes|No||08/17/2018||Yes|No|08/17/2018||Yes|No||||No|No|||Prescription required|No||088|No|114.08597|01/18/2022|111.3479|01/18/2022|112.08946|01/18/2022|||OPHTHALMICS: GLAUCOMA AGENTS|22016|||||No|No||AERIE PHARMACEU|No||||
leflunomide|No|No|No|No|75%|70748012906|LEFLUNOMIDE 10 MG TABLET|30|EA|1.14666|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No|||No|.80538|03/29/2022|.78605|03/29/2022|.79128|03/29/2022||||22017|||||No|No||LUPIN PHARMACEU|No||||
leflunomide|No|No|No|No|75%|70748013006|LEFLUNOMIDE 20 MG TABLET|30|EA|1.18966|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No|||No|.61902|03/29/2022|.60416|03/29/2022|.60818|03/29/2022||||22018|||||No|No||LUPIN PHARMACEU|No||||
penicillamine|No|No|No|No|75%|70748015301|PENICILLAMINE 250 MG TABLET|100|EA|20.00755|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No|||No|45.59861|06/08/2021|44.9472|06/08/2021|42.80686|06/08/2021||||22019|||||No|No||LUPIN PHARMACEU|No||||
mycophenolate mofetil|No|No|No|No|75%|70748018601|MYCOPHENOLATE 250 MG CAPSULE|100|EA|.17092|02/25/2020||Yes|No||02/25/2020||Yes|No|02/25/2020||Yes|No||||No|No|||Prescription required|No||229|No|.2129|03/29/2022|.20779|03/29/2022|.20917|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|22020|||||No|No||LUPIN PHARMACEU|No||||
mycophenolate mofetil|No|No|No|No|75%|70748018602|MYCOPHENOLATE 250 MG CAPSULE|500|EA|.17092|02/25/2020||Yes|No||02/25/2020||Yes|No|02/25/2020||Yes|No||||No|No|||Prescription required|No||229|No|.2129|03/29/2022|.20779|03/29/2022|.20917|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|22021|||||No|No||LUPIN PHARMACEU|No||||
mesalamine|No|No|No|No|75%|70748021416|MESALAMINE ER 0.375 GRAM CAP|120|EA|1.57816|09/30/2020||Yes|No||09/30/2020||Yes|No|09/30/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|010|No|1.86918|03/29/2022|1.82431|03/29/2022|1.83646|03/29/2022|||ULCERATIVE COLITIS AGENTS|22022|||||No|No||LUPIN PHARMACEU|No||||
naproxen/esomeprazole mag|No|No|No|No|75%|70748021507|NAPROXEN-ESOMEPRAZ DR 375-20MG|60|EA|11.56291|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|26.35269|09/18/2020|25.97622|09/18/2020|24.73926|09/18/2020|||NSAIDS|22023|||||No|No||LUPIN PHARMACEU|No||||
naproxen/esomeprazole mag|No|No|No|No|75%|70748021607|NAPROXEN-ESOMEPRAZ DR 500-20MG|60|EA|11.56291|09/18/2020||Yes|No||09/18/2020||Yes|No|09/18/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|17.77748|11/23/2021|17.35082|11/23/2021|17.46637|11/23/2021|||NSAIDS|22024|||||No|No||LUPIN PHARMACEU|No||||
mycophenolate sodium|No|No|No|No|75%|70748021716|MYCOPHENOLIC ACID DR 180 MG TB|120|EA|.6632|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|229|No|.54568|03/29/2022|.53258|03/29/2022|.53613|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|22025|||||No|No||LUPIN PHARMACEU|No||||
mycophenolate sodium|No|No|No|No|75%|70748021816|MYCOPHENOLIC ACID DR 360 MG TB|120|EA|1.3264|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|229|No|.56705|03/29/2022|.55344|03/29/2022|.55712|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|22026|||||No|No||LUPIN PHARMACEU|No||||
tacrolimus|No|No|No|No|75%|70748022001|TACROLIMUS 1 MG CAPSULE (IR)|100|EA|.3108|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No||229|No|.35645|03/29/2022|.34789|03/29/2022|.35021|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|22027|||||No|No||LUPIN PHARMACEU|No||||
tacrolimus|No|No|No|No|75%|70748022101|TACROLIMUS 5 MG CAPSULE (IR)|100|EA|1.48414|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No||229|No|2.05753|03/29/2022|2.00814|03/29/2022|2.02152|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|22028|||||No|No||LUPIN PHARMACEU|No||||
posaconazole|No|No|No|No|75%|70748025807|POSACONAZOLE DR 100 MG TABLET|60|EA|8.6|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|069|No|22.47154|03/29/2022|21.93222|03/29/2022|22.07828|03/29/2022|||ANTIFUNGALS: ORAL|22029|||||No|No||LUPIN PHARMACEU|No||||
mycophenolate mofetil|No|No|No|No|75%|70748026201|MYCOPHENOLATE 500 MG TABLET|100|EA|.21048|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No||229|No|.30426|03/29/2022|.29695|03/29/2022|.29893|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|22030|||||No|No||LUPIN PHARMACEU|No||||
mycophenolate mofetil|No|No|No|No|75%|70748026202|MYCOPHENOLATE 500 MG TABLET|500|EA|.21048|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No||229|No|.30426|03/29/2022|.29695|03/29/2022|.29893|03/29/2022|||IMMUNOSUPPRESSIVES: ORAL|22031|||||No|No||LUPIN PHARMACEU|No||||
ibuprofen/famotidine|No|No|No|No|75%|70748031209|IBUPROFEN-FAMOTIDIN 800-26.6MG|90|EA|2.3841|03/30/2022||Yes|No||03/30/2022||Yes|No|03/30/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|059|Yes|3.80728|03/30/2022|3.7159|03/30/2022|3.74065|03/30/2022|||NSAIDS|22032|||||No|No||LUPIN PHARMACEU|No||||
cyproheptadine HCl|No|No|No|No|75%|70752010112|CYPROHEPTADINE 2 MG/5 ML SOLN|473|ML|.04634|12/20/2019||Yes|No||12/20/2019||Yes|No|12/20/2019||Yes|No||||No|No|||Prescription required|No||574|Yes|.06009|03/29/2022|.05864|03/29/2022|.05903|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|22033|||||No|No||QUAGEN PHARMACE|No||||
albuterol sulfate|No|No|No|No|75%|70752010212|ALBUTEROL SULF 2 MG/5 ML SYRUP|473|ML|.03181|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No||037|No|.03624|03/29/2022|.03537|03/29/2022|.0356|03/29/2022|||BRONCHODILATORS: BETA AGONIST|22034|||||No|No||QUAGEN PHARMACE|Yes|09/01/2020|||
amitriptyline HCl|No|No|No|No|75%|70756020111|AMITRIPTYLINE HCL 10 MG TAB|100|EA|.02795|09/09/2021||Yes|No||09/09/2021||Yes|No|09/09/2021||Yes|No||||No|No|||Prescription required|No||215|No|.04811|03/29/2022|.04695|03/29/2022|.04726|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|22035|||||No|No||LIFESTAR PHARMA|No||||
amitriptyline HCl|No|No|No|No|75%|70756020112|AMITRIPTYLINE HCL 10 MG TAB|1000|EA|.02795|09/09/2021||Yes|No||09/09/2021||Yes|No|09/09/2021||Yes|No||||No|No|||Prescription required|No||215|No|.04811|03/29/2022|.04695|03/29/2022|.04726|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|22036|||||No|No||LIFESTAR PHARMA|No||||
amitriptyline HCl|No|No|No|No|75%|70756020211|AMITRIPTYLINE HCL 25 MG TAB|100|EA|.03655|09/09/2021||Yes|No||09/09/2021||Yes|No|09/09/2021||Yes|No||||No|No|||Prescription required|No||215|No|.07343|03/29/2022|.07166|03/29/2022|.07214|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|22037|||||No|No||LIFESTAR PHARMA|No||||
amitriptyline HCl|No|No|No|No|75%|70756020212|AMITRIPTYLINE HCL 25 MG TAB|1000|EA|.03655|09/09/2021||Yes|No||09/09/2021||Yes|No|09/09/2021||Yes|No||||No|No|||Prescription required|No||215|No|.07343|03/29/2022|.07166|03/29/2022|.07214|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|22038|||||No|No||LIFESTAR PHARMA|No||||
amitriptyline HCl|No|No|No|No|75%|70756020311|AMITRIPTYLINE HCL 50 MG TAB|100|EA|.07955|09/09/2021||Yes|No||09/09/2021||Yes|No|09/09/2021||Yes|No||||No|No|||Prescription required|No||215|No|.14797|03/29/2022|.14441|03/29/2022|.14538|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|22039|||||No|No||LIFESTAR PHARMA|No||||
amitriptyline HCl|No|No|No|No|75%|70756020312|AMITRIPTYLINE HCL 50 MG TAB|1000|EA|.0774|09/09/2021||Yes|No||09/09/2021||Yes|No|09/09/2021||Yes|No||||No|No|||Prescription required|No||215|No|.14797|03/29/2022|.14441|03/29/2022|.14538|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|22040|||||No|No||LIFESTAR PHARMA|No||||
amitriptyline HCl|No|No|No|No|75%|70756020411|AMITRIPTYLINE HCL 75 MG TAB|100|EA|.0946|09/09/2021||Yes|No||09/09/2021||Yes|No|09/09/2021||Yes|No||||No|No|||Prescription required|No||215|No|.26194|03/29/2022|.25565|03/29/2022|.25735|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|22041|||||No|No||LIFESTAR PHARMA|No||||
amitriptyline HCl|No|No|No|No|75%|70756020511|AMITRIPTYLINE HCL 100 MG TAB|100|EA|.129|09/09/2021||Yes|No||09/09/2021||Yes|No|09/09/2021||Yes|No||||No|No|||Prescription required|No||215|No|.30607|03/29/2022|.29872|03/29/2022|.30071|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|22042|||||No|No||LIFESTAR PHARMA|No||||
amitriptyline HCl|No|No|No|No|75%|70756020611|AMITRIPTYLINE HCL 150 MG TAB|100|EA|.16555|09/09/2021||Yes|No||09/09/2021||Yes|No|09/09/2021||Yes|No||||No|No|||Prescription required|No||215|No|.58201|03/29/2022|.56804|03/29/2022|.57182|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|22043|||||No|No||LIFESTAR PHARMA|No||||
fenofibrate|No|No|No|No|75%|70756021451|FENOFIBRATE 54 MG TABLET|500|EA|.0915|08/12/2021||Yes|No||08/12/2021||Yes|No|08/12/2021||Yes|No||||No|No|||Prescription required|No||055|No|.1459|03/29/2022|.14239|03/29/2022|.14334|03/29/2022|||LIPOTROPICS: OTHER|22044|||||No|No||LIFESTAR PHARMA|No||||
fenofibrate|No|No|No|No|75%|70756021490|FENOFIBRATE 54 MG TABLET|90|EA|.09149|08/12/2021||Yes|No||08/12/2021||Yes|No|08/12/2021||Yes|No||||No|No|||Prescription required|No||055|No|.1459|03/29/2022|.14239|03/29/2022|.14334|03/29/2022|||LIPOTROPICS: OTHER|22045|||||No|No||LIFESTAR PHARMA|No||||
fenofibrate|No|No|No|No|75%|70756021551|FENOFIBRATE 160 MG TABLET|500|EA|.16722|08/12/2021||Yes|No||08/12/2021||Yes|No|08/12/2021||Yes|No||||No|No|||Prescription required|No||055|No|.1612|03/29/2022|.15733|03/29/2022|.15837|03/29/2022|||LIPOTROPICS: OTHER|22046|||||No|No||LIFESTAR PHARMA|No||||
fenofibrate|No|No|No|No|75%|70756021590|FENOFIBRATE 160 MG TABLET|90|EA|.16721|08/12/2021||Yes|No||08/12/2021||Yes|No|08/12/2021||Yes|No||||No|No|||Prescription required|No||055|No|.1612|03/29/2022|.15733|03/29/2022|.15837|03/29/2022|||LIPOTROPICS: OTHER|22047|||||No|No||LIFESTAR PHARMA|No||||
clomipramine HCl|No|No|No|No|75%|70756040511|CLOMIPRAMINE 25 MG CAPSULE|100|EA|.1935|08/06/2020||Yes|No||08/06/2020||Yes|No|08/06/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|215|No|1.31238|03/29/2022|1.28088|03/29/2022|1.28941|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|22048|||||No|No||LIFESTAR PHARMA|No||||
clomipramine HCl|No|No|No|No|75%|70756040611|CLOMIPRAMINE 50 MG CAPSULE|100|EA|.1935|08/06/2020||Yes|No||08/06/2020||Yes|No|08/06/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|215|No|.80238|03/29/2022|.78312|03/29/2022|.78833|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|22049|||||No|No||LIFESTAR PHARMA|No||||
clomipramine HCl|No|No|No|No|75%|70756040711|CLOMIPRAMINE 75 MG CAPSULE|100|EA|.1935|08/06/2020||Yes|No||08/06/2020||Yes|No|08/06/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|215|No|.95054|03/29/2022|.92772|03/29/2022|.9339|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|22050|||||No|No||LIFESTAR PHARMA|No||||
alosetron HCl|No|No|No|No|75%|70756070130|ALOSETRON HCL 1 MG TABLET|30|EA|4.44333|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|534|Yes|8.58181|01/25/2022|8.37584|01/25/2022|8.43162|01/25/2022|||GI MOTILITY: CHRONIC|22051|||||No|No||LIFESTAR PHARMA|No||||
alosetron HCl|No|No|No|No|75%|70756070230|ALOSETRON HCL 0.5 MG TABLET|30|EA|2.22166|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|534|Yes|3.98973|03/01/2022|3.89397|03/01/2022|3.9199|03/01/2022|||GI MOTILITY: CHRONIC|22052|||||No|No||LIFESTAR PHARMA|No||||
ranolazine|No|No|No|No|75%|70756070360|RANOLAZINE ER 500 MG TABLET|60|EA|.12541|09/14/2020||Yes|No||09/14/2020||Yes|No|09/14/2020||Yes|No||||No|No|||Prescription required|No|||Yes|.28604|03/29/2022|.27917|03/29/2022|.28103|03/29/2022||||22053|||||No|No||LIFESTAR PHARMA|No||||
ranolazine|No|No|No|No|75%|70756070460|RANOLAZINE ER 1,000 MG TABLET|60|EA|.20102|09/14/2020||Yes|No||09/14/2020||Yes|No|09/14/2020||Yes|No||||No|No|||Prescription required|No|||Yes|.43283|03/29/2022|.42244|03/29/2022|.42525|03/29/2022||||22054|||||No|No||LIFESTAR PHARMA|No||||
acetazolamide|No|No|No|No|75%|70756072011|ACETAZOLAMIDE 125 MG TABLET|100|EA|.1118|07/09/2021||Yes|No||07/09/2021||Yes|No|07/09/2021||Yes|No||||No|No|||Prescription required|No|||No|.16397|03/29/2022|.16003|03/29/2022|.1611|03/29/2022||||22055|||||No|No||LIFESTAR PHARMA|No||||
acetazolamide|No|No|No|No|75%|70756072111|ACETAZOLAMIDE 250 MG TABLET|100|EA|.1505|07/09/2021||Yes|No||07/09/2021||Yes|No|07/09/2021||Yes|No||||No|No|||Prescription required|No|||No|.25723|03/29/2022|.25105|03/29/2022|.25272|03/29/2022||||22056|||||No|No||LIFESTAR PHARMA|No||||
lansoprazole|No|No|No|No|75%|70756080630|LANSOPRAZOLE DR 15 MG CAPSULE|30|EA|.07166|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|Yes|.24898|03/29/2022|.243|03/29/2022|.24462|03/29/2022|||PROTON PUMP INHIBITORS|22057|||||No|No||LIFESTAR PHARMA|No||||
lansoprazole|No|No|No|No|75%|70756080751|LANSOPRAZOLE DR 30 MG CAPSULE|500|EA|.04132|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.12249|03/29/2022|.11955|03/29/2022|.12034|03/29/2022|||PROTON PUMP INHIBITORS|22058|||||No|No||LIFESTAR PHARMA|No||||
lansoprazole|No|No|No|No|75%|70756080790|LANSOPRAZOLE DR 30 MG CAPSULE|90|EA|.04132|08/29/2018||Yes|No||08/29/2018||Yes|No|08/29/2018||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|047|No|.12249|03/29/2022|.11955|03/29/2022|.12034|03/29/2022|||PROTON PUMP INHIBITORS|22059|||||No|No||LIFESTAR PHARMA|No||||
olmesartan medoxomil|No|No|No|No|75%|70756080830|OLMESARTAN MEDOXOMIL 5 MG TAB|30|EA|.1075|09/14/2020||Yes|No||09/14/2020||Yes|No|09/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.07425|03/29/2022|.07246|03/29/2022|.07295|03/29/2022|||ANGIOTENSIN MODULATORS|22060|||||No|No||LIFESTAR PHARMA|No||||
olmesartan medoxomil|No|No|No|No|75%|70756080930|OLMESARTAN MEDOXOMIL 20 MG TAB|30|EA|.129|09/14/2020||Yes|No||09/14/2020||Yes|No|09/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.1002|03/29/2022|.09779|03/29/2022|.09844|03/29/2022|||ANGIOTENSIN MODULATORS|22061|||||No|No||LIFESTAR PHARMA|No||||
olmesartan medoxomil|No|No|No|No|75%|70756080990|OLMESARTAN MEDOXOMIL 20 MG TAB|90|EA|.11944|09/14/2020||Yes|No||09/14/2020||Yes|No|09/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.1002|03/29/2022|.09779|03/29/2022|.09844|03/29/2022|||ANGIOTENSIN MODULATORS|22062|||||No|No||LIFESTAR PHARMA|No||||
olmesartan medoxomil|No|No|No|No|75%|70756081030|OLMESARTAN MEDOXOMIL 40 MG TAB|30|EA|.172|09/14/2020||Yes|No||09/14/2020||Yes|No|09/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.15714|03/29/2022|.15336|03/29/2022|.15439|03/29/2022|||ANGIOTENSIN MODULATORS|22063|||||No|No||LIFESTAR PHARMA|No||||
olmesartan medoxomil|No|No|No|No|75%|70756081090|OLMESARTAN MEDOXOMIL 40 MG TAB|90|EA|.16721|09/14/2020||Yes|No||09/14/2020||Yes|No|09/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.15714|03/29/2022|.15336|03/29/2022|.15439|03/29/2022|||ANGIOTENSIN MODULATORS|22064|||||No|No||LIFESTAR PHARMA|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|70756081230|OLMESARTAN-HCTZ 20-12.5 MG TAB|30|EA|.14333|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.22565|03/29/2022|.22023|03/29/2022|.2217|03/29/2022|||ANGIOTENSIN MODULATORS|22065|||||No|No||LIFESTAR PHARMA|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|70756081290|OLMESARTAN-HCTZ 20-12.5 MG TAB|90|EA|.14333|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.22565|03/29/2022|.22023|03/29/2022|.2217|03/29/2022|||ANGIOTENSIN MODULATORS|22066|||||No|No||LIFESTAR PHARMA|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|70756081330|OLMESARTAN-HCTZ 40-12.5 MG TAB|30|EA|.172|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.29168|03/29/2022|.28467|03/29/2022|.28657|03/29/2022|||ANGIOTENSIN MODULATORS|22067|||||No|No||LIFESTAR PHARMA|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|70756081390|OLMESARTAN-HCTZ 40-12.5 MG TAB|90|EA|.172|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.29168|03/29/2022|.28467|03/29/2022|.28657|03/29/2022|||ANGIOTENSIN MODULATORS|22068|||||No|No||LIFESTAR PHARMA|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|70756081430|OLMESARTAN-HCTZ 40-25 MG TAB|30|EA|.172|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.29227|03/29/2022|.28525|03/29/2022|.28715|03/29/2022|||ANGIOTENSIN MODULATORS|22069|||||No|No||LIFESTAR PHARMA|No||||
olmesartan/hydrochlorothiazide|No|No|No|No|75%|70756081490|OLMESARTAN-HCTZ 40-25 MG TAB|90|EA|.172|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.29227|03/29/2022|.28525|03/29/2022|.28715|03/29/2022|||ANGIOTENSIN MODULATORS|22070|||||No|No||LIFESTAR PHARMA|No||||
capecitabine|No|No|No|No|75%|70756081560|CAPECITABINE 150 MG TABLET|60|EA|.21858|03/16/2021|01/31/2023|Yes|No||03/16/2021|01/31/2023|Yes|No|03/16/2021|01/31/2023|Yes|No||||No|No|||Prescription required|No||502|No|.49816|03/16/2021|.49104|03/16/2021|.46766|03/16/2021|||ONCOLOGY: ORAL - BREAST|22071|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LIFESTAR PHARMA|No||||
capecitabine|No|No|No|No|75%|70756081622|CAPECITABINE 500 MG TABLET|120|EA|.43|03/16/2021|01/31/2023|Yes|No||03/16/2021|01/31/2023|Yes|No|03/16/2021|01/31/2023|Yes|No||||No|No|||Prescription required|No||502|No|.61977|12/28/2021|.60489|12/28/2021|.60892|12/28/2021|||ONCOLOGY: ORAL - BREAST|22072|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||LIFESTAR PHARMA|No||||
aliskiren/hydrochlorothiazide|No|No|No|No|75%|70839011230|TEKTURNA HCT 150-12.5 MG TAB|30|EA|3.50622|07/31/2018||Yes|No||07/31/2018||Yes|No|07/31/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|113|Yes|7.99092|01/19/2021|7.87676|01/19/2021|7.50168|01/19/2021|||ANGIOTENSIN MODULATORS|22073|||||No|No||NODEN PHARMA D.|No||||
aliskiren/hydrochlorothiazide|No|No|No|No|75%|70839012530|TEKTURNA HCT 150-25 MG TABLET|30|EA|3.50622|07/31/2018||Yes|No||07/31/2018||Yes|No|07/31/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|113|Yes|7.99092|01/19/2021|7.87676|01/19/2021|7.50168|01/19/2021|||ANGIOTENSIN MODULATORS|22074|||||No|No||NODEN PHARMA D.|No||||
aliskiren hemifumarate|No|No|No|No|75%|70839015030|TEKTURNA 150 MG TABLET|30|EA|3.82184|07/31/2018||Yes|No||07/31/2018||Yes|No|07/31/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|8.55466|01/04/2022|8.34934|01/04/2022|8.40495|01/04/2022|||ANGIOTENSIN MODULATORS|22075|||||No|No||NODEN PHARMA D.|No||||
aliskiren hemifumarate|No|No|No|No|75%|70839030030|TEKTURNA 300 MG TABLET|30|EA|4.82159|07/31/2018||Yes|No||07/31/2018||Yes|No|07/31/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|10.76091|01/04/2022|10.50264|01/04/2022|10.57259|01/04/2022|||ANGIOTENSIN MODULATORS|22076|||||No|No||NODEN PHARMA D.|No||||
aliskiren/hydrochlorothiazide|No|No|No|No|75%|70839031230|TEKTURNA HCT 300-12.5 MG TAB|30|EA|4.82159|07/31/2018||Yes|No||07/31/2018||Yes|No|07/31/2018||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|113|Yes|10.75039|01/04/2022|10.49238|01/04/2022|10.56225|01/04/2022|||ANGIOTENSIN MODULATORS|22077|||||No|No||NODEN PHARMA D.|No||||
aliskiren/hydrochlorothiazide|No|No|No|No|75%|70839032530|TEKTURNA HCT 300-25 MG TABLET|30|EA|4.82159|07/31/2018||Yes|No||07/31/2018||Yes|No|07/31/2018||Yes|No||||No|No|||Prescription required|Yes|07/21/2016|113|Yes|10.73751|01/04/2022|10.4798|01/04/2022|10.5496|01/04/2022|||ANGIOTENSIN MODULATORS|22078|||||No|No||NODEN PHARMA D.|No||||
delafloxacin meglumine|No|No|No|No|75%|70842010101|BAXDELA 450 MG TABLET|20|EA|34.271|08/08/2018||Yes|No||08/08/2018||Yes|No|08/08/2018||Yes|No||||No|No|||Prescription required|Yes|01/31/2019|028|No|78.106|01/04/2022|76.9902|01/04/2022|73.324|01/04/2022|||FLUOROQUINOLONES: ORAL|22079|||||No|No||MELINTA THERAPE|No||||
azithromycin|No|No|No|No|75%|70860010010|AZITHROMYCIN I.V. 500 MG VIAL|1|EA|2.15|07/06/2017||Yes|No||07/06/2017||Yes|No|07/06/2017||Yes|No||||No|No|||Prescription required|No|||No|4.9|07/06/2017|4.83|07/06/2017|4.6|07/06/2017||||22080|||||No|No||ATHENEX PHARMAC|No||||
vancomycin HCl|No|No|No|No|75%|70860010410|VANCOMYCIN 500 MG VIAL|1|EA|3.01|08/30/2017||Yes|No||08/30/2017||Yes|No|08/30/2017||Yes|No||||No|No|||Prescription required|No|||No|6.86|09/05/2017|6.762|08/30/2017|6.44|08/30/2017||||22081|||||No|No||ATHENEX PHARMAC|No||||
vancomycin HCl|No|No|No|No|75%|70860010520|VANCOMYCIN 1 GM VIAL|1|EA|3.225|08/30/2017||Yes|No||08/30/2017||Yes|No|08/30/2017||Yes|No||||No|No|||Prescription required|No|||No|7.35|02/23/2021|7.245|02/23/2021|6.9|02/23/2021||||22082|||||No|No||ATHENEX PHARMAC|No||||
ondansetron HCl/PF|No|No|No|No|75%|70860077602|ONDANSETRON HCL 4 MG/2 ML VIAL|2|ML|.1075|07/07/2017||Yes|No||07/07/2017||Yes|No|07/07/2017||Yes|No||||No|No|||Prescription required|No|||No|.18088|01/25/2022|.17653|01/25/2022|.17771|01/25/2022||||22083|||||No|No||ATHENEX PHARMAC|No||||
ondansetron HCl|No|No|No|No|75%|70860077720|ONDANSETRON 40 MG/20 ML VIAL|20|ML|.215|07/07/2017||Yes|No||07/07/2017||Yes|No|07/07/2017||Yes|No||||No|No|||Prescription required|No|||No|.49|09/28/2021|.483|09/28/2021|.46|09/28/2021||||22084|||||No|No||ATHENEX PHARMAC|No||||
oxybutynin chloride|No|No|No|No|75%|70954000510|OXYBUTYNIN 5 MG TABLET|100|EA|.05052|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|22085|||||No|No||NOVITIUM PHARMA|No||||
oxybutynin chloride|No|No|No|No|75%|70954000520|OXYBUTYNIN 5 MG TABLET|500|EA|.04945|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|22086|||||No|No||NOVITIUM PHARMA|No||||
oxybutynin chloride|No|No|No|No|75%|70954000530|OXYBUTYNIN 5 MG TABLET|1000|EA|.04945|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|22087|||||No|No||NOVITIUM PHARMA|No||||
thiothixene|No|No|No|No|75%|70954001410|THIOTHIXENE 1 MG CAPSULE|100|EA|.40867|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|||Prescription required|No||027|Yes|.93139|09/13/2019|.91808|09/13/2019|.87436|09/13/2019|||ANTIPSYCHOTICS|22088|||||No|No||NOVITIUM PHARMA|No||||
thiothixene|No|No|No|No|75%|70954001510|THIOTHIXENE 2 MG CAPSULE|100|EA|.5402|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|||Prescription required|No||027|Yes|1.23117|09/13/2019|1.21358|09/13/2019|1.15579|09/13/2019|||ANTIPSYCHOTICS|22089|||||No|No||NOVITIUM PHARMA|No||||
thiothixene|No|No|No|No|75%|70954001610|THIOTHIXENE 5 MG CAPSULE|100|EA|.81923|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|||Prescription required|No||027|Yes|1.86709|09/13/2019|1.84042|09/13/2019|1.75278|09/13/2019|||ANTIPSYCHOTICS|22090|||||No|No||NOVITIUM PHARMA|No||||
thiothixene|No|No|No|No|75%|70954001710|THIOTHIXENE 10 MG CAPSULE|100|EA|1.15493|09/13/2019||Yes|No||09/13/2019||Yes|No|09/13/2019||Yes|No||||No|No|||Prescription required|No||027|Yes|2.63218|09/13/2019|2.59457|09/13/2019|2.47102|09/13/2019|||ANTIPSYCHOTICS|22091|||||No|No||NOVITIUM PHARMA|No||||
prazosin HCl|No|No|No|No|75%|70954001910|PRAZOSIN 1 MG CAPSULE|100|EA|.10827|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No|||No|.1999|03/29/2022|.1951|03/29/2022|.1964|03/29/2022||||22092|||||No|No||NOVITIUM PHARMA|No||||
prazosin HCl|No|No|No|No|75%|70954001920|PRAZOSIN 1 MG CAPSULE|1000|EA|.10825|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No|||No|.1999|03/29/2022|.1951|03/29/2022|.1964|03/29/2022||||22093|||||No|No||NOVITIUM PHARMA|No||||
prazosin HCl|No|No|No|No|75%|70954002010|PRAZOSIN 2 MG CAPSULE|100|EA|.15965|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No|||No|.29873|03/29/2022|.29156|03/29/2022|.2935|03/29/2022||||22094|||||No|No||NOVITIUM PHARMA|No||||
prazosin HCl|No|No|No|No|75%|70954002020|PRAZOSIN 2 MG CAPSULE|1000|EA|.15984|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No|||No|.29873|03/29/2022|.29156|03/29/2022|.2935|03/29/2022||||22095|||||No|No||NOVITIUM PHARMA|No||||
prazosin HCl|No|No|No|No|75%|70954002110|PRAZOSIN 5 MG CAPSULE|100|EA|.26174|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No|||No|.53856|03/29/2022|.52563|03/29/2022|.52913|03/29/2022||||22096|||||No|No||NOVITIUM PHARMA|No||||
prazosin HCl|No|No|No|No|75%|70954002120|PRAZOSIN 5 MG CAPSULE|250|EA|.26716|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No|||No|.53856|03/29/2022|.52563|03/29/2022|.52913|03/29/2022||||22097|||||No|No||NOVITIUM PHARMA|No||||
acetazolamide|No|No|No|No|75%|70954003330|ACETAZOLAMIDE 125 MG TABLET|100|EA|.1806|06/15/2020||Yes|No||06/15/2020||Yes|No|06/15/2020||Yes|No||||No|No|||Prescription required|No|||No|.16397|03/29/2022|.16003|03/29/2022|.1611|03/29/2022||||22098|||||No|No||NOVITIUM PHARMA|No||||
acetazolamide|No|No|No|No|75%|70954003430|ACETAZOLAMIDE 250 MG TABLET|100|EA|.2838|06/15/2020||Yes|No||06/15/2020||Yes|No|06/15/2020||Yes|No||||No|No|||Prescription required|No|||No|.25723|03/29/2022|.25105|03/29/2022|.25272|03/29/2022||||22099|||||No|No||NOVITIUM PHARMA|No||||
clotrimazole|No|No|No|No|75%|70954003620|CLOTRIMAZOLE 1% SOLUTION|30|ML|.79263|06/05/2019||Yes|No||06/05/2019||Yes|No|06/05/2019||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|061|No|.9845|03/29/2022|.96087|03/29/2022|.96727|03/29/2022|||ANTIFUNGALS: TOPICAL|22100|||||No|No||NOVITIUM PHARMA|No||||
prednisone|No|No|No|No|75%|70954005710|PREDNISONE 2.5 MG TABLET|100|EA|.05241|04/16/2020||Yes|No||04/16/2020||Yes|No|04/16/2020||Yes|No||||No|No|||Prescription required|No||168|Yes|.09048|03/29/2022|.0883|03/29/2022|.08889|03/29/2022|||GLUCOCORTICOIDS: ORAL|22101|||||No|No||NOVITIUM PHARMA|No||||
prednisone|No|No|No|No|75%|70954005810|PREDNISONE 5 MG TABLET|100|EA|.06161|04/16/2020||Yes|No||04/16/2020||Yes|No|04/16/2020||Yes|No||||No|No|||Prescription required|No||168|Yes|.07803|03/29/2022|.07615|03/29/2022|.07666|03/29/2022|||GLUCOCORTICOIDS: ORAL|22102|||||No|No||NOVITIUM PHARMA|No||||
prednisone|No|No|No|No|75%|70954005820|PREDNISONE 5 MG TABLET|1000|EA|.05914|04/16/2020||Yes|No||04/16/2020||Yes|No|04/16/2020||Yes|No||||No|No|||Prescription required|No||168|Yes|.07803|03/29/2022|.07615|03/29/2022|.07666|03/29/2022|||GLUCOCORTICOIDS: ORAL|22103|||||No|No||NOVITIUM PHARMA|No||||
prednisone|No|No|No|No|75%|70954005830|PREDNISONE 5 MG TAB DOSE PACK|21|EA|.25574|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|168|Yes|.39414|03/29/2022|.38468|03/29/2022|.38724|03/29/2022|||GLUCOCORTICOIDS: ORAL|22104|||||No|No||NOVITIUM PHARMA|No||||
prednisone|No|No|No|No|75%|70954005840|PREDNISONE 5 MG TAB DOSE PACK|48|EA|.18498|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|168|Yes|.39414|03/29/2022|.38468|03/29/2022|.38724|03/29/2022|||GLUCOCORTICOIDS: ORAL|22105|||||No|No||NOVITIUM PHARMA|No||||
prednisone|No|No|No|No|75%|70954005910|PREDNISONE 10 MG TABLET|100|EA|.06944|04/16/2020||Yes|No||04/16/2020||Yes|No|04/16/2020||Yes|No||||No|No|||Prescription required|No||168|Yes|.07092|03/29/2022|.06921|03/29/2022|.06967|03/29/2022|||GLUCOCORTICOIDS: ORAL|22106|||||No|No||NOVITIUM PHARMA|No||||
prednisone|No|No|No|No|75%|70954005920|PREDNISONE 10 MG TABLET|1000|EA|.06541|04/16/2020||Yes|No||04/16/2020||Yes|No|04/16/2020||Yes|No||||No|No|||Prescription required|No||168|Yes|.07092|03/29/2022|.06921|03/29/2022|.06967|03/29/2022|||GLUCOCORTICOIDS: ORAL|22107|||||No|No||NOVITIUM PHARMA|No||||
prednisone|No|No|No|No|75%|70954005930|PREDNISONE 10 MG TAB DOSE PACK|21|EA|.44167|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|168|Yes|.66148|03/29/2022|.6456|03/29/2022|.6499|03/29/2022|||GLUCOCORTICOIDS: ORAL|22108|||||No|No||NOVITIUM PHARMA|No||||
prednisone|No|No|No|No|75%|70954005940|PREDNISONE 10 MG TAB DOSE PACK|48|EA|.27448|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|168|Yes|.66148|03/29/2022|.6456|03/29/2022|.6499|03/29/2022|||GLUCOCORTICOIDS: ORAL|22109|||||No|No||NOVITIUM PHARMA|No||||
prednisone|No|No|No|No|75%|70954006010|PREDNISONE 20 MG TABLET|100|EA|.07417|04/16/2020||Yes|No||04/16/2020||Yes|No|04/16/2020||Yes|No||||No|No|||Prescription required|No||168|Yes|.11229|03/29/2022|.10959|03/29/2022|.11032|03/29/2022|||GLUCOCORTICOIDS: ORAL|22110|||||No|No||NOVITIUM PHARMA|No||||
prednisone|No|No|No|No|75%|70954006020|PREDNISONE 20 MG TABLET|500|EA|.0727|04/16/2020||Yes|No||04/16/2020||Yes|No|04/16/2020||Yes|No||||No|No|||Prescription required|No||168|Yes|.11229|03/29/2022|.10959|03/29/2022|.11032|03/29/2022|||GLUCOCORTICOIDS: ORAL|22111|||||No|No||NOVITIUM PHARMA|No||||
prednisone|No|No|No|No|75%|70954006030|PREDNISONE 20 MG TABLET|1000|EA|.07915|04/16/2020||Yes|No||04/16/2020||Yes|No|04/16/2020||Yes|No||||No|No|||Prescription required|No||168|Yes|.11229|03/29/2022|.10959|03/29/2022|.11032|03/29/2022|||GLUCOCORTICOIDS: ORAL|22112|||||No|No||NOVITIUM PHARMA|No||||
prednisone|No|No|No|No|75%|70954006110|PREDNISONE 50 MG TABLET|100|EA|.12951|04/16/2020||Yes|No||04/16/2020||Yes|No|04/16/2020||Yes|No||||No|No|||Prescription required|No||168|Yes|.26795|03/29/2022|.26151|03/29/2022|.26326|03/29/2022|||GLUCOCORTICOIDS: ORAL|22113|||||No|No||NOVITIUM PHARMA|No||||
meloxicam, submicronized|No|No|No|No|75%|70954007610|MELOXICAM 5 MG CAPSULE|30|EA|10.68177|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|059|No|24.3445|05/18/2021|23.99672|05/18/2021|22.85402|05/18/2021|||NSAIDS|22114|||||No|No||NOVITIUM PHARMA|No||||
meloxicam, submicronized|No|No|No|No|75%|70954007710|MELOXICAM 10 MG CAPSULE|30|EA|10.68177|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|059|No|24.3445|05/18/2021|23.99672|05/18/2021|22.85402|05/18/2021|||NSAIDS|22115|||||No|No||NOVITIUM PHARMA|No||||
chlorzoxazone|No|No|No|No|75%|70954008510|CHLORZOXAZONE 500 MG TABLET|100|EA|.13287|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|116|Yes|.26503|03/29/2022|.25866|03/29/2022|.26039|03/29/2022|||SKELETAL MUSCLE RELAXANTS|22116|||||No|No||NOVITIUM PHARMA|No||||
chlorzoxazone|No|No|No|No|75%|70954008520|CHLORZOXAZONE 500 MG TABLET|500|EA|.13287|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|116|Yes|.26503|03/29/2022|.25866|03/29/2022|.26039|03/29/2022|||SKELETAL MUSCLE RELAXANTS|22117|||||No|No||NOVITIUM PHARMA|No||||
dapsone|No|No|No|No|75%|70954013510|DAPSONE 25 MG TABLET|30|EA|.42283|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No|||No|.52333|03/29/2022|.51077|03/29/2022|.51417|03/29/2022||||22118|||||No|No||NOVITIUM PHARMA|No||||
dapsone|No|No|No|No|75%|70954013520|DAPSONE 25 MG TABLET|100|EA|.37861|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No|||No|.52333|03/29/2022|.51077|03/29/2022|.51417|03/29/2022||||22119|||||No|No||NOVITIUM PHARMA|No||||
dapsone|No|No|No|No|75%|70954013610|DAPSONE 100 MG TABLET|30|EA|.51972|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No|||No|.77747|03/29/2022|.75881|03/29/2022|.76386|03/29/2022||||22120|||||No|No||NOVITIUM PHARMA|No||||
dapsone|No|No|No|No|75%|70954013620|DAPSONE 100 MG TABLET|100|EA|.46422|08/30/2018||Yes|No||08/30/2018||Yes|No|08/30/2018||Yes|No||||No|No|||Prescription required|No|||No|.77747|03/29/2022|.75881|03/29/2022|.76386|03/29/2022||||22121|||||No|No||NOVITIUM PHARMA|No||||
levocarnitine (with sugar)|No|No|No|No|75%|70954013910|LEVOCARNITINE 1 G/10 ML SOLN|118|ML|.12641|06/02/2020||Yes|No||06/02/2020||Yes|No|06/02/2020||Yes|No||||No|No|||Prescription required|No|||No|.25813|03/29/2022|.25193|03/29/2022|.25361|03/29/2022||||22122|||||No|No||NOVITIUM PHARMA|No||||
levocarnitine|No|No|No|No|75%|70954014010|LEVOCARNITINE SF 1 G/10 ML SOL|118|ML|.12641|02/28/2020||Yes|No||02/28/2020||Yes|No|02/28/2020||Yes|No||||No|No|||Prescription required|No|||No|.2881|02/28/2020|.28398|02/28/2020|.27046|02/28/2020||||22123|||||No|No||NOVITIUM PHARMA|No||||
pyridostigmine bromide|No|No|No|No|75%|70954014810|PYRIDOSTIGMINE 60 MG/5 ML SOLN|473|ML|1.02272|08/22/2019||Yes|No||08/22/2019||Yes|No|08/22/2019||Yes|No||||No|No|||Prescription required|No|||No|2.33086|09/10/2019|2.29756|09/10/2019|2.18815|09/10/2019||||22124|||||No|No||NOVITIUM PHARMA|No||||
naproxen|No|No|No|No|75%|70954015110|NAPROXEN 125 MG/5 ML SUSPEN|500|ML|.19273|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|059|Yes|.43925|09/30/2021|.43298|09/30/2021|.41236|09/30/2021|||NSAIDS|22125|||||No|No||NOVITIUM PHARMA|No||||
sildenafil citrate|No|No|No|No|75%|70954016810|SILDENAFIL 10 MG/ML ORAL SUSP|112|ML|6.71875|11/20/2019||Yes|No||11/20/2019||Yes|No|11/20/2019||Yes|No|Refer to program requirements|||No|No|||Prescription required|Yes|07/26/2018|171|Yes|15.3125|01/14/2020|15.09375|01/14/2020|14.375|01/14/2020|||PAH AGENTS: ORAL AND INHALED|22126|||||No|No||NOVITIUM PHARMA|No||||
acyclovir|No|No|No|No|75%|70954018810|ACYCLOVIR 200 MG/5 ML SUSP|473|ML|.07932|02/03/2021||Yes|No||02/03/2021||Yes|No|02/03/2021||Yes|No||||No|No|||Prescription required|No||025|No|.2948|03/29/2022|.28772|03/29/2022|.28964|03/29/2022|||ANTIVIRALS: ORAL|22127|||||No|No||NOVITIUM PHARMA|No||||
trihexyphenidyl HCl|No|No|No|No|75%|70954021110|TRIHEXYPHENIDYL 5 MG TABLET|100|EA|.09554|08/25/2020||Yes|No||08/25/2020||Yes|No|08/25/2020||Yes|No||||No|No|||Prescription required|No||015|No|.10848|03/29/2022|.10587|03/29/2022|.10658|03/29/2022|||ANTIPARKINSON'S AGENTS|22128|||||No|No||NOVITIUM PHARMA|No||||
trihexyphenidyl HCl|No|No|No|No|75%|70954021120|TRIHEXYPHENIDYL 5 MG TABLET|1000|EA|.06726|08/25/2020||Yes|No||08/25/2020||Yes|No|08/25/2020||Yes|No||||No|No|||Prescription required|No||015|No|.10848|03/29/2022|.10587|03/29/2022|.10658|03/29/2022|||ANTIPARKINSON'S AGENTS|22129|||||No|No||NOVITIUM PHARMA|No||||
trihexyphenidyl HCl|No|No|No|No|75%|70954021210|TRIHEXYPHENIDYL 2 MG TABLET|100|EA|.06467|08/25/2020||Yes|No||08/25/2020||Yes|No|08/25/2020||Yes|No||||No|No|||Prescription required|No||015|No|.06083|03/29/2022|.05937|03/29/2022|.05976|03/29/2022|||ANTIPARKINSON'S AGENTS|22130|||||No|No||NOVITIUM PHARMA|No||||
trihexyphenidyl HCl|No|No|No|No|75%|70954021220|TRIHEXYPHENIDYL 2 MG TABLET|1000|EA|.03309|08/25/2020||Yes|No||08/25/2020||Yes|No|08/25/2020||Yes|No||||No|No|||Prescription required|No||015|No|.06083|03/29/2022|.05937|03/29/2022|.05976|03/29/2022|||ANTIPARKINSON'S AGENTS|22131|||||No|No||NOVITIUM PHARMA|No||||
fluphenazine HCl|No|No|No|No|75%|70954027310|FLUPHENAZINE 1 MG TABLET|100|EA|.5934|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|1.56797|01/25/2022|1.53033|01/25/2022|1.54053|01/25/2022|||ANTIPSYCHOTICS|22132|||||No|No||NOVITIUM PHARMA|No||||
fluphenazine HCl|No|No|No|No|75%|70954027410|FLUPHENAZINE 2.5 MG TABLET|100|EA|.92097|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|2.3014|01/25/2022|2.24616|01/25/2022|2.26112|01/25/2022|||ANTIPSYCHOTICS|22133|||||No|No||NOVITIUM PHARMA|No||||
fluphenazine HCl|No|No|No|No|75%|70954027510|FLUPHENAZINE 5 MG TABLET|100|EA|1.24605|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|2.98385|03/29/2022|2.91223|03/29/2022|2.93163|03/29/2022|||ANTIPSYCHOTICS|22134|||||No|No||NOVITIUM PHARMA|No||||
fluphenazine HCl|No|No|No|No|75%|70954027520|FLUPHENAZINE 5 MG TABLET|500|EA|1.24605|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|2.98385|03/29/2022|2.91223|03/29/2022|2.93163|03/29/2022|||ANTIPSYCHOTICS|22135|||||No|No||NOVITIUM PHARMA|No||||
fluphenazine HCl|No|No|No|No|75%|70954027610|FLUPHENAZINE 10 MG TABLET|100|EA|1.57104|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|3.52974|03/29/2022|3.44502|03/29/2022|3.46796|03/29/2022|||ANTIPSYCHOTICS|22136|||||No|No||NOVITIUM PHARMA|No||||
fluphenazine HCl|No|No|No|No|75%|70954027620|FLUPHENAZINE 10 MG TABLET|500|EA|1.57104|09/30/2021||Yes|No||09/30/2021||Yes|No|09/30/2021||Yes|No||||No|No|||Prescription required|No||027|Yes|3.52974|03/29/2022|3.44502|03/29/2022|3.46796|03/29/2022|||ANTIPSYCHOTICS|22137|||||No|No||NOVITIUM PHARMA|No||||
famotidine|No|No|No|No|75%|70954031610|FAMOTIDINE 40 MG/5 ML SUSP|50|ML|.8514|08/04/2021||Yes|No||08/04/2021||Yes|No|08/04/2021||Yes|No||||No|No|||Prescription required|No|||No|.81888|03/29/2022|.79922|03/29/2022|.80454|03/29/2022||||22138|||||No|No||NOVITIUM PHARMA|No||||
estazolam|No|No|No|No|90%|70954048010|ESTAZOLAM 1 MG TABLET|100|EA|1.01695|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|054|Yes|2.24434|12/28/2021|2.19047|12/28/2021|2.20506|12/28/2021|||SEDATIVE HYPNOTICS|22139|||||No|No||NOVITIUM PHARMA|No||||
estazolam|No|No|No|No|90%|70954048110|ESTAZOLAM 2 MG TABLET|100|EA|1.01695|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|054|Yes|3.59229|08/26/2021|3.50607|08/26/2021|3.52942|08/26/2021|||SEDATIVE HYPNOTICS|22140|||||No|No||NOVITIUM PHARMA|No||||
selegiline HCl|No|No|No|No|75%|70954050410|SELEGILINE HCL 5 MG CAPSULE|60|EA|.54022|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|1.0776|03/29/2022|1.05173|03/29/2022|1.05874|03/29/2022|||ANTIPARKINSON'S AGENTS|22141|||||No|No||NOVITIUM PHARMA|No||||
selegiline HCl|No|No|No|No|75%|70954050420|SELEGILINE HCL 5 MG CAPSULE|1000|EA|.4862|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|015|No|1.0776|03/29/2022|1.05173|03/29/2022|1.05874|03/29/2022|||ANTIPARKINSON'S AGENTS|22142|||||No|No||NOVITIUM PHARMA|No||||
dichlorphenamide|No|No|No|No|75%|71090000101|KEVEYIS 50 MG TABLET|100|EA|117.96895|10/09/2017||Yes|No||10/09/2017||Yes|No|10/09/2017||Yes|No||||No|No|||Prescription required|No|||No|268.85947|02/08/2022|265.01862|02/08/2022|252.39868|02/08/2022||||22143|||||No|No||STRONGBRIDGE US|No||||
gabapentin|No|No|No|No|75%|71093011104|GABAPENTIN 600 MG TABLET|100|EA|.0645|05/08/2018||Yes|No||05/08/2018||Yes|No|05/08/2018||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|22144|||||No|No||ACI HEALTHCARE|No||||
gabapentin|No|No|No|No|75%|71093011105|GABAPENTIN 600 MG TABLET|500|EA|.0645|05/08/2018||Yes|No||05/08/2018||Yes|No|05/08/2018||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|22145|||||No|No||ACI HEALTHCARE|No||||
gabapentin|No|No|No|No|75%|71093011204|GABAPENTIN 800 MG TABLET|100|EA|.086|05/08/2018||Yes|No||05/08/2018||Yes|No|05/08/2018||Yes|No||||No|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|22146|||||No|No||ACI HEALTHCARE|No||||
gabapentin|No|No|No|No|75%|71093011205|GABAPENTIN 800 MG TABLET|500|EA|.086|05/08/2018||Yes|No||05/08/2018||Yes|No|05/08/2018||Yes|No||||No|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|22147|||||No|No||ACI HEALTHCARE|No||||
gabapentin|No|No|No|No|75%|71093012004|GABAPENTIN 100 MG CAPSULE|100|EA|.0215|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|22148|||||No|No||ACI HEALTHCARE|No||||
gabapentin|No|No|No|No|75%|71093012005|GABAPENTIN 100 MG CAPSULE|500|EA|.0215|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||232|Yes|.03027|03/29/2022|.02954|03/29/2022|.02974|03/29/2022|||NEUROPATHIC PAIN|22149|||||No|No||ACI HEALTHCARE|No||||
gabapentin|No|No|No|No|75%|71093012104|GABAPENTIN 300 MG CAPSULE|100|EA|.0344|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|22150|||||No|No||ACI HEALTHCARE|No||||
gabapentin|No|No|No|No|75%|71093012105|GABAPENTIN 300 MG CAPSULE|500|EA|.0344|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||232|Yes|.04814|03/29/2022|.04698|03/29/2022|.04729|03/29/2022|||NEUROPATHIC PAIN|22151|||||No|No||ACI HEALTHCARE|No||||
gabapentin|No|No|No|No|75%|71093012204|GABAPENTIN 400 MG CAPSULE|100|EA|.0387|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|22152|||||No|No||ACI HEALTHCARE|No||||
gabapentin|No|No|No|No|75%|71093012205|GABAPENTIN 400 MG CAPSULE|500|EA|.0387|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||232|Yes|.06195|03/29/2022|.06046|03/29/2022|.06086|03/29/2022|||NEUROPATHIC PAIN|22153|||||No|No||ACI HEALTHCARE|No||||
metformin HCl|Yes|No|No|No|75%|71093013204|METFORMIN HCL 500 MG TABLET|100|EA|.0215|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|05/18/2018||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|22154|||||No|No||ACI HEALTHCARE|No||||
metformin HCl|Yes|No|No|No|75%|71093013205|METFORMIN HCL 500 MG TABLET|500|EA|.0215|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|05/18/2018||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|22155|||||No|No||ACI HEALTHCARE|No||||
metformin HCl|Yes|No|No|No|75%|71093013206|METFORMIN HCL 500 MG TABLET|1000|EA|.0215|05/21/2018||Yes|No||05/21/2018||Yes|No|05/21/2018||Yes|No||||No|No|05/21/2018||Prescription required|No||012|No|.01696|03/29/2022|.01655|03/29/2022|.01666|03/29/2022|||HYPOGLYCEMICS: METFORMINS|22156|||||No|No||ACI HEALTHCARE|No||||
metformin HCl|Yes|No|No|No|75%|71093013304|METFORMIN HCL 850 MG TABLET|100|EA|.0258|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|05/18/2018||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|22157|||||No|No||ACI HEALTHCARE|No||||
metformin HCl|Yes|No|No|No|75%|71093013305|METFORMIN HCL 850 MG TABLET|500|EA|.0258|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|05/18/2018||Prescription required|No||012|No|.02781|03/29/2022|.02714|03/29/2022|.02732|03/29/2022|||HYPOGLYCEMICS: METFORMINS|22158|||||No|No||ACI HEALTHCARE|No||||
metformin HCl|No|No|No|No|75%|71093013404|METFORMIN HCL 1,000 MG TABLET|100|EA|.0344|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|22159|||||No|No||ACI HEALTHCARE|No||||
metformin HCl|Yes|No|No|No|75%|71093013405|METFORMIN HCL 1,000 MG TABLET|500|EA|.0344|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|05/18/2018||Prescription required|No||012|No|.02625|03/29/2022|.02562|03/29/2022|.02579|03/29/2022|||HYPOGLYCEMICS: METFORMINS|22160|||||No|No||ACI HEALTHCARE|No||||
quetiapine fumarate|No|No|No|No|75%|71093013602|QUETIAPINE ER 150 MG TABLET|60|EA|.17916|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|.25256|03/29/2022|.24649|03/29/2022|.24814|03/29/2022|||ANTIPSYCHOTICS|22161|||||No|No||ACI HEALTHCARE|No||||
quetiapine fumarate|No|No|No|No|75%|71093013702|QUETIAPINE ER 200 MG TABLET|60|EA|.20066|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|.25825|03/29/2022|.25205|03/29/2022|.25373|03/29/2022|||ANTIPSYCHOTICS|22162|||||No|No||ACI HEALTHCARE|No||||
quetiapine fumarate|No|No|No|No|75%|71093013802|QUETIAPINE ER 300 MG TABLET|60|EA|.22933|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|.35477|03/29/2022|.34625|03/29/2022|.34856|03/29/2022|||ANTIPSYCHOTICS|22163|||||No|No||ACI HEALTHCARE|No||||
quetiapine fumarate|No|No|No|No|75%|71093013902|QUETIAPINE ER 400 MG TABLET|60|EA|.25083|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|027|Yes|.42833|03/29/2022|.41805|03/29/2022|.42083|03/29/2022|||ANTIPSYCHOTICS|22164|||||No|No||ACI HEALTHCARE|No||||
amlodipine besylate|No|No|No|No|75%|71093014706|AMLODIPINE BESYLATE 5 MG TAB|1000|EA|.0258|02/15/2022||Yes|No||02/15/2022||Yes|No|02/15/2022||Yes|No||||No|No|||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|22165|||||No|No||ACI HEALTHCARE|No||||
antihemoph.FVIII rec,Fc fusion|No|No|No|No|75%|71104080101|ELOCTATE 250 UNIT NOMINAL|1|EA|1.6184|09/04/2018||Yes|No||09/04/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.3324|01/11/2022|2.29908|01/11/2022|2.1896|01/11/2022|||HEMOPHILIA TREATMENT|22166|||||No|No||BIOVERATIV THER|No||||
antihemoph.FVIII rec,Fc fusion|No|No|No|No|75%|71104080201|ELOCTATE 500 UNIT NOMINAL|1|EA|1.6184|09/04/2018||Yes|No||09/04/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.3324|01/11/2022|2.29908|01/11/2022|2.1896|01/11/2022|||HEMOPHILIA TREATMENT|22167|||||No|No||BIOVERATIV THER|No||||
antihemoph.FVIII rec,Fc fusion|No|No|No|No|75%|71104080301|ELOCTATE 750 UNIT NOMINAL|1|EA|1.6184|09/04/2018||Yes|No||09/04/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.3324|01/11/2022|2.29908|01/11/2022|2.1896|01/11/2022|||HEMOPHILIA TREATMENT|22168|||||No|No||BIOVERATIV THER|No||||
antihemoph.FVIII rec,Fc fusion|No|No|No|No|75%|71104080401|ELOCTATE 1,000 UNIT NOMINAL|1|EA|1.6184|09/04/2018||Yes|No||09/04/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.3324|01/11/2022|2.29908|01/11/2022|2.1896|01/11/2022|||HEMOPHILIA TREATMENT|22169|||||No|No||BIOVERATIV THER|No||||
antihemoph.FVIII rec,Fc fusion|No|No|No|No|75%|71104080501|ELOCTATE 1,500 UNIT NOMINAL|1|EA|1.6184|09/04/2018||Yes|No||09/04/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.3324|01/11/2022|2.29908|01/11/2022|2.1896|01/11/2022|||HEMOPHILIA TREATMENT|22170|||||No|No||BIOVERATIV THER|No||||
antihemoph.FVIII rec,Fc fusion|No|No|No|No|75%|71104080601|ELOCTATE 2,000 UNIT NOMINAL|1|EA|1.6184|09/04/2018||Yes|No||09/04/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.3324|01/11/2022|2.29908|01/11/2022|2.1896|01/11/2022|||HEMOPHILIA TREATMENT|22171|||||No|No||BIOVERATIV THER|No||||
antihemoph.FVIII rec,Fc fusion|No|No|No|No|75%|71104080701|ELOCTATE 3,000 UNIT NOMINAL|1|EA|1.6184|09/04/2018||Yes|No||09/04/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.3324|01/11/2022|2.29908|01/11/2022|2.1896|01/11/2022|||HEMOPHILIA TREATMENT|22172|||||No|No||BIOVERATIV THER|No||||
antihemoph.FVIII rec,Fc fusion|No|No|No|No|75%|71104080801|ELOCTATE 4,000 UNIT NOMINAL|1|EA|1.6184|09/04/2018||Yes|No||09/04/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.3324|01/11/2022|2.29908|01/11/2022|2.1896|01/11/2022|||HEMOPHILIA TREATMENT|22173|||||No|No||BIOVERATIV THER|No||||
antihemoph.FVIII rec,Fc fusion|No|No|No|No|75%|71104080901|ELOCTATE 5,000 UNIT NOMINAL|1|EA|1.6184|09/04/2018||Yes|No||09/04/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.3324|01/11/2022|2.29908|01/11/2022|2.1896|01/11/2022|||HEMOPHILIA TREATMENT|22174|||||No|No||BIOVERATIV THER|No||||
antihemoph.FVIII rec,Fc fusion|No|No|No|No|75%|71104081001|ELOCTATE 6,000 UNIT NOMINAL|1|EA|1.6184|09/04/2018||Yes|No||09/04/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|2.3324|01/11/2022|2.29908|01/11/2022|2.1896|01/11/2022|||HEMOPHILIA TREATMENT|22175|||||No|No||BIOVERATIV THER|No||||
factor IX rec, Fc fusion protn|No|No|No|No|75%|71104091101|ALPROLIX 500 UNIT NOMINAL|1|EA|2.346|09/04/2018||Yes|No||09/04/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|3.381|01/11/2022|3.3327|01/11/2022|3.174|01/11/2022|||HEMOPHILIA TREATMENT|22176|||||No|No||BIOVERATIV THER|No||||
factor IX rec, Fc fusion protn|No|No|No|No|75%|71104092201|ALPROLIX 1,000 UNIT NOMINAL|1|EA|2.346|09/04/2018||Yes|No||09/04/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|3.381|01/11/2022|3.3327|01/11/2022|3.174|01/11/2022|||HEMOPHILIA TREATMENT|22177|||||No|No||BIOVERATIV THER|No||||
factor IX rec, Fc fusion protn|No|No|No|No|75%|71104093301|ALPROLIX 2,000 UNIT NOMINAL|1|EA|2.346|09/04/2018||Yes|No||09/04/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|3.381|01/11/2022|3.3327|01/11/2022|3.174|01/11/2022|||HEMOPHILIA TREATMENT|22178|||||No|No||BIOVERATIV THER|No||||
factor IX rec, Fc fusion protn|No|No|No|No|75%|71104094401|ALPROLIX 3,000 UNIT NOMINAL|1|EA|2.346|09/04/2018||Yes|No||09/04/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|3.381|01/11/2022|3.3327|01/11/2022|3.174|01/11/2022|||HEMOPHILIA TREATMENT|22179|||||No|No||BIOVERATIV THER|No||||
factor IX rec, Fc fusion protn|No|No|No|No|75%|71104096601|ALPROLIX 250 UNIT NOMINAL|1|EA|2.346|09/04/2018||Yes|No||09/04/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|3.381|01/11/2022|3.3327|01/11/2022|3.174|01/11/2022|||HEMOPHILIA TREATMENT|22180|||||No|No||BIOVERATIV THER|No||||
factor IX rec, Fc fusion protn|No|No|No|No|75%|71104097701|ALPROLIX 4,000 UNIT NOMINAL|1|EA|2.346|09/04/2018||Yes|No||09/04/2018||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|3.381|01/11/2022|3.3327|01/11/2022|3.174|01/11/2022|||HEMOPHILIA TREATMENT|22181|||||No|No||BIOVERATIV THER|No||||
coagulation VIIa,recomb-jncw|No|No|No|No|75%|71127100001|SEVENFACT 1 MG VIAL|1|EA|1557.2|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No||105|No|2244.2|02/23/2022|2212.14|02/23/2022|2106.8|02/23/2022|||HEMOPHILIA TREATMENT|22182|||||No|No||LFB S.A DBA HEM|No||||
coagulation VIIa,recomb-jncw|No|No|No|No|75%|71127500001|SEVENFACT 5 MG VIAL|1|EA|7786|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No||105|No|11221|02/23/2022|11060.7|03/01/2022|10534|02/23/2022|||HEMOPHILIA TREATMENT|22183|||||No|No||LFB S.A DBA HEM|No||||
fluticasone propionate|No|No|No|No|75%|71143037501|XHANCE 93 MCG NASAL SPRAY|16|ML|15.27951|08/24/2018||Yes|No||08/24/2018||Yes|No|08/24/2018||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|019|No|34.05546|01/18/2022|33.23812|01/18/2022|33.45948|01/18/2022|||INTRANASAL RHINITIS AGENTS|22184|||||No|No||OPTINOSE US, IN|No||||
hydroxyprogesterone caproate|No|No|No|No|75%|71225010401|HYDROXYPROGEST 1,250 MG/5 ML|5|ML|129|05/02/2019||Yes|No||05/02/2019||Yes|No|05/02/2019||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|151|Yes|294|06/22/2021|289.8|06/22/2021|276|06/22/2021|||PROGESTATIONAL AGENTS|22185|||||No|No||SLAYBACK PHARMA|No||||
hydroxyprogesterone caproat/PF|No|No|No|No|75%|71225010501|HYDROXYPROGEST 250 MG/ML VIAL|1|ML|122.55|05/02/2019||Yes|No||05/02/2019||Yes|No|05/02/2019||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|151|Yes|279.3|06/22/2021|275.31|06/22/2021|262.2|06/22/2021|||PROGESTATIONAL AGENTS|22186|||||No|No||SLAYBACK PHARMA|No||||
C1 esterase inhibitor, recomb|No|No|No|No|75%|71274035001|RUCONEST 2,100 UNIT VIAL|1|EA|2949.8|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|501|No|6722.8|01/11/2022|6626.76|01/11/2022|6311.2|01/11/2022|||HAE TREATMENTS|22187|||||No|No||PHARMING HEALTH|No||||
C1 esterase inhibitor, recomb|No|No|No|No|75%|71274035002|RUCONEST 2,100 UNIT VIAL|1|EA|2949.8|10/26/2018||Yes|No||10/26/2018||Yes|No|10/26/2018||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|501|No|6722.8|01/11/2022|6626.76|01/11/2022|6311.2|01/11/2022|||HAE TREATMENTS|22188|||||No|No||PHARMING HEALTH|No||||
fostamatinib disodium|No|No|No|No|75%|71332000101|TAVALISSE 100 MG TABLET|60|EA|88.86666|11/20/2018||Yes|No||11/20/2018||Yes|No|11/20/2018||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|235|No|202.53332|07/06/2021|199.63999|07/06/2021|190.13332|07/06/2021|||THROMBOPOIESIS STIMULATING PROTEINS|22189|||||No|No||RIGEL PHARMACEU|No||||
fostamatinib disodium|No|No|No|No|75%|71332000201|TAVALISSE 150 MG TABLET|60|EA|88.86666|11/20/2018||Yes|No||11/20/2018||Yes|No|11/20/2018||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|235|No|202.53332|07/06/2021|199.63999|07/06/2021|190.13332|07/06/2021|||THROMBOPOIESIS STIMULATING PROTEINS|22190|||||No|No||RIGEL PHARMACEU|No||||
ivosidenib|No|No|No|No|75%|71334010001|TIBSOVO 250 MG TABLET|60|EA|215.5934|10/16/2018|02/13/2023|Yes|No||10/16/2018|02/13/2023|Yes|No|10/16/2018|02/13/2023|Yes|No||||No|No|||Prescription required|No||173|No|491.3524|01/04/2022|484.33308|01/04/2022|461.2696|01/04/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|22191|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||AGIOS PHARMACEU|No||||
buprenorphine HCl|No|No|No|No|90%|71335095001|BUPRENORPHINE 2 MG TABLET SL|60|EA|.22933|07/12/2021||Yes|No||07/12/2021||Yes|No|07/12/2021||Yes|No||||No|No|||Prescription required|No|||Yes|.52266|07/12/2021|.51519|07/12/2021|.49066|07/12/2021||||22192|||||No|No||BRYANT RANCH PR|Yes|09/01/2020|||
buprenorphine HCl|No|No|No|No|90%|71335095002|BUPRENORPHINE 2 MG TABLET SL|90|EA|.22933|07/12/2021||Yes|No||07/12/2021||Yes|No|07/12/2021||Yes|No||||No|No|||Prescription required|No|||Yes|.52266|07/12/2021|.51519|07/12/2021|.49066|07/12/2021||||22193|||||No|No||BRYANT RANCH PR|Yes|09/01/2020|||
buprenorphine HCl|No|No|No|No|90%|71335095003|BUPRENORPHINE 2 MG TABLET SL|30|EA|.22933|07/12/2021||Yes|No||07/12/2021||Yes|No|07/12/2021||Yes|No||||No|No|||Prescription required|No|||Yes|.52266|07/12/2021|.51519|07/12/2021|.49066|07/12/2021||||22194|||||No|No||BRYANT RANCH PR|Yes|09/01/2020|||
buprenorphine HCl|No|No|No|No|90%|71335115401|BUPRENORPHINE 8 MG TABLET SL|90|EA|.57333|07/12/2021||Yes|No||07/12/2021||Yes|No|07/12/2021||Yes|No||||No|No|||Prescription required|No|||Yes|1.30666|07/12/2021|1.28799|07/12/2021|1.22666|07/12/2021||||22195|||||No|No||BRYANT RANCH PR|Yes|09/01/2020|||
buprenorphine HCl|No|No|No|No|90%|71335115402|BUPRENORPHINE 8 MG TABLET SL|60|EA|.57333|07/12/2021||Yes|No||07/12/2021||Yes|No|07/12/2021||Yes|No||||No|No|||Prescription required|No|||Yes|1.30666|07/12/2021|1.28799|07/12/2021|1.22666|07/12/2021||||22196|||||No|No||BRYANT RANCH PR|Yes|09/01/2020|||
buprenorphine HCl|No|No|No|No|90%|71335115403|BUPRENORPHINE 8 MG TABLET SL|30|EA|.5524|12/14/2020||Yes|No||12/14/2020||Yes|No|12/14/2020||Yes|No||||No|No|||Prescription required|No|||Yes|1.25896|12/14/2020|1.24098|12/14/2020|1.18188|12/14/2020||||22197|||||No|No||BRYANT RANCH PR|Yes|09/01/2020|||
buprenorphine HCl|No|No|No|No|90%|71335116301|BUPRENORPHINE 8 MG TABLET SL|90|EA|3.29308|07/12/2021||Yes|No||07/12/2021||Yes|No|07/12/2021||Yes|No||||No|No|||Prescription required|No|||Yes|7.50516|07/12/2021|7.39794|07/12/2021|7.04566|07/12/2021||||22198|||||No|No||BRYANT RANCH PR|Yes|09/01/2020|||
buprenorphine HCl|No|No|No|No|90%|71335116302|BUPRENORPHINE 8 MG TABLET SL|60|EA|3.29308|07/12/2021||Yes|No||07/12/2021||Yes|No|07/12/2021||Yes|No||||No|No|||Prescription required|No|||Yes|7.50516|07/12/2021|7.39794|07/12/2021|7.04566|07/12/2021||||22199|||||No|No||BRYANT RANCH PR|Yes|09/01/2020|||
buprenorphine HCl|No|No|No|No|90%|71335116303|BUPRENORPHINE 8 MG TABLET SL|30|EA|3.29523|07/12/2021||Yes|No||07/12/2021||Yes|No|07/12/2021||Yes|No||||No|No|||Prescription required|No|||Yes|7.51006|07/12/2021|7.40277|07/12/2021|7.05026|07/12/2021||||22200|||||No|No||BRYANT RANCH PR|Yes|09/01/2020|||
buprenorphine HCl/naloxone HCl|No|No|No|No|90%|71335129601|BUPRENORPHINE-NALOX 2-0.5MG TB|30|EA|1.84871|07/12/2021||Yes|No||07/12/2021||Yes|No|07/12/2021||Yes|No||||No|No|||Prescription required|No|||Yes|4.21334|07/12/2021|4.15315|07/12/2021|3.95538|07/12/2021||||22201|||||No|No||BRYANT RANCH PR|Yes|09/01/2020|||
avatrombopag maleate|No|No|No|No|75%|71369002010|DOPTELET (10 TAB PK) 20 MG TAB|10|EA|150.0356|12/07/2018||Yes|No||12/07/2018||Yes|No|12/07/2018||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|235|No|341.9416|07/06/2021|337.05672|07/06/2021|321.0064|07/06/2021|||THROMBOPOIESIS STIMULATING PROTEINS|22202|||||No|No||AKARX, INC.|No||||
avatrombopag maleate|No|No|No|No|75%|71369002015|DOPTELET (15 TAB PK) 20 MG TAB|15|EA|150.0356|12/07/2018||Yes|No||12/07/2018||Yes|No|12/07/2018||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|235|No|341.9416|07/06/2021|337.05672|07/06/2021|321.0064|07/06/2021|||THROMBOPOIESIS STIMULATING PROTEINS|22203|||||No|No||AKARX, INC.|No||||
avatrombopag maleate|No|No|No|No|75%|71369002030|DOPTELET (30 TAB PK) 20 MG TAB|30|EA|150.0356|08/01/2019||Yes|No||08/01/2019||Yes|No|08/01/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|235|No|341.9416|07/06/2021|337.05672|07/06/2021|321.0064|07/06/2021|||THROMBOPOIESIS STIMULATING PROTEINS|22204|||||No|No||AKARX, INC.|No||||
methylphenidate HCl|No|No|No|No|75%|71376020103|JORNAY PM 20 MG CAPSULE|100|EA|5.79566|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|12.89779|01/25/2022|12.58824|01/25/2022|12.67207|01/25/2022|||STIMULANTS AND RELATED AGENTS|22205|||||No|No||IRONSHORE PHARM|No||||
methylphenidate HCl|No|No|No|No|75%|71376020203|JORNAY PM 40 MG CAPSULE|100|EA|5.79566|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|12.86394|07/06/2021|12.5552|07/06/2021|12.63882|07/06/2021|||STIMULANTS AND RELATED AGENTS|22206|||||No|No||IRONSHORE PHARM|No||||
methylphenidate HCl|No|No|No|No|75%|71376020303|JORNAY PM 60 MG CAPSULE|100|EA|5.79566|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|12.94784|12/28/2021|12.63709|12/28/2021|12.72125|12/28/2021|||STIMULANTS AND RELATED AGENTS|22207|||||No|No||IRONSHORE PHARM|No||||
methylphenidate HCl|No|No|No|No|75%|71376020403|JORNAY PM 80 MG CAPSULE|100|EA|5.79566|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|12.85023|03/29/2022|12.54182|03/29/2022|12.62535|03/29/2022|||STIMULANTS AND RELATED AGENTS|22208|||||No|No||IRONSHORE PHARM|No||||
methylphenidate HCl|No|No|No|No|75%|71376020503|JORNAY PM 100 MG CAPSULE|100|EA|5.79566|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||||No|No|||Prescription required|No||007|Yes|12.86558|10/26/2021|12.5568|10/26/2021|12.64043|10/26/2021|||STIMULANTS AND RELATED AGENTS|22209|||||No|No||IRONSHORE PHARM|No||||
acyclovir|No|No|No|No|75%|71403004902|SITAVIG 50 MG BUCCAL TABLET|2|EA|196.9228|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|Yes|03/09/2018|025|No|448.8008|05/20/2019|442.38936|05/28/2019|421.3232|05/20/2019|||ANTIVIRALS: ORAL|22210|||||No|No||EPI HEALTH LLC|No||||
minocycline HCl|No|No|No|No|75%|71403010130|MINOLIRA ER 105 MG TABLET|30|EA|10.17408|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|213|No|23.18744|01/11/2022|22.85619|01/11/2022|21.7678|01/11/2022|||TETRACYCLINES|22211|||||No|No||EPI HEALTH LLC|No||||
minocycline HCl|No|No|No|No|75%|71403010230|MINOLIRA ER 135 MG TABLET|30|EA|10.17408|12/09/2019||Yes|No||12/09/2019||Yes|No|12/09/2019||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|213|No|23.18744|01/11/2022|22.85619|01/11/2022|21.7678|01/11/2022|||TETRACYCLINES|22212|||||No|No||EPI HEALTH LLC|No||||
clocortolone pivalate|No|No|No|No|75%|71403080445|CLODERM 0.1% CREAM|45|GM|3.56584|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|8.1268|01/11/2022|8.0107|01/11/2022|7.62924|01/11/2022|||STEROIDS: TOPICAL MEDIUM|22213|||||No|No||EPI HEALTH LLC|No||||
clocortolone pivalate|No|No|No|No|75%|71403080475|CLODERM 0.1% CREAM PUMP|75|GM|3.4123|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|7.77688|11/24/2020|7.66578|11/24/2020|7.30075|11/24/2020|||STEROIDS: TOPICAL MEDIUM|22214|||||No|No||EPI HEALTH LLC|No||||
clocortolone pivalate|No|No|No|No|75%|71403080490|CLODERM 0.1% CREAM|90|GM|3.41238|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|7.77705|11/24/2020|7.66595|11/24/2020|7.3009|11/24/2020|||STEROIDS: TOPICAL MEDIUM|22215|||||No|No||EPI HEALTH LLC|No||||
fluocinonide|No|No|No|No|75%|71428000160|FLUOCINONIDE 0.05% SOLUTION|60|ML|.31906|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|120|No|.3579|03/29/2022|.34931|03/29/2022|.35163|03/29/2022|||STEROIDS: TOPICAL HIGH|22216|||||No|No||GLASSHOUSE PHAR|No||||
fluocinolone acetonide|No|No|No|No|75%|71428000260|FLUOCINOLONE 0.01% SOLUTION|60|ML|.23936|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|119|No|.3936|03/29/2022|.38415|03/29/2022|.38671|03/29/2022|||STEROIDS: TOPICAL MEDIUM|22217|||||No|No||GLASSHOUSE PHAR|No||||
clindamycin phosphate|No|No|No|No|75%|71428000330|CLINDAMYCIN PH 1% SOLUTION|30|ML|.21199|10/06/2020||Yes|No||10/06/2020||Yes|No|10/06/2020||Yes|No||||No|No|||Prescription required|No||104|No|.23242|03/29/2022|.22684|03/29/2022|.22835|03/29/2022|||ACNE AGENTS: TOPICAL|22218|||||No|No||GLASSHOUSE PHAR|No||||
clindamycin phosphate|No|No|No|No|75%|71428000360|CLINDAMYCIN PH 1% SOLUTION|60|ML|.21191|06/11/2019||Yes|No||06/11/2019||Yes|No|06/11/2019||Yes|No||||No|No|||Prescription required|No||104|No|.19863|03/29/2022|.19386|03/29/2022|.19515|03/29/2022|||ACNE AGENTS: TOPICAL|22219|||||No|No||GLASSHOUSE PHAR|No||||
amikacin liposomal/neb.accessr|No|No|No|No|75%|71558059028|ARIKAYCE 590 MG/8.4 ML VIAL|8.4|ML|24.44749|01/23/2019||Yes|No||01/23/2019||Yes|No|01/23/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|240|No|55.71753|01/04/2022|54.92157|01/04/2022|52.30625|01/04/2022|||ANTIBIOTICS: INHALED|22220|||||No|No||INSMED INCORPOR|No||||
loteprednol etabonate|No|No|No|No|75%|71571012128|INVELTYS 1% EYE DROP|2.8|ML|43.91375|06/17/2019||Yes|No||06/17/2019||Yes|No|06/17/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|013|No|98.10551|01/18/2022|95.75097|01/18/2022|96.38866|01/18/2022|||OPHTHALMICS: ANTI-INFLAMMATORIES|22221|||||No|No||KALA PHARMACEUT|No||||
loteprednol etabonate|No|No|No|No|75%|71571033383|EYSUVIS 0.25% EYE DROPS|8.3|ML|25.05397|06/01/2021||Yes|No||06/01/2021||Yes|No|06/01/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|086|No|55.92235|01/18/2022|54.58021|01/18/2022|54.9437|01/18/2022|||OPHTHALMICS: ANTI-INFLAMMATORY/IMMUNOMODULATOR|22222|||||No|No||KALA PHARMACEUT|No||||
levonorgestrel/ethin.estradiol|Yes|Yes|No|No|75%|71671010003|TWIRLA 120-30 MCG/DAY PATCH|3|EA|25.05036|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No|Refer to program requirements|||No|No|04/15/2021||Prescription required|No|||No|55.40133|12/28/2021|54.07169|12/28/2021|54.4318|12/28/2021||||22223|||||No|No||AGILE THERAPEUT|No|||Only covered for non-contraceptive (medical) purposes|
cenobamate|No|No|No|No|75%|71699005030|XCOPRI 50 MG TABLET|30|EA|15.19634|09/08/2020||Yes|No||09/08/2020||Yes|No|09/08/2020||Yes|No||||No|No|||Prescription required|No||056|No|33.73882|01/11/2022|32.92908|01/11/2022|33.14839|01/11/2022|||ANTICONVULSANTS|22224|||||No|No||SK LIFE SCIENCE|No||||
cenobamate|No|No|No|No|75%|71699010030|XCOPRI 100 MG TABLET|30|EA|15.19634|09/08/2020||Yes|No||09/08/2020||Yes|No|09/08/2020||Yes|No||||No|No|||Prescription required|No||056|No|33.97592|01/11/2022|33.16049|01/11/2022|33.38134|01/11/2022|||ANTICONVULSANTS|22225|||||No|No||SK LIFE SCIENCE|No||||
cenobamate|No|No|No|No|75%|71699010256|XCOPRI 250 MG DAILY DOSE PACK|56|EA|7.90378|12/15/2020|08/02/2022|Yes|No||12/15/2020|08/02/2022|Yes|No|12/15/2020|08/02/2022|Yes|No||||No|No|||Prescription required|No||056|No|18.01327|01/12/2021|17.75593|01/12/2021|16.91041|01/12/2021|||ANTICONVULSANTS|22226|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||SK LIFE SCIENCE|No||||
cenobamate|No|No|No|No|75%|71699010356|XCOPRI 350 MG DAILY DOSE PACK|56|EA|16.28171|09/08/2020||Yes|No||09/08/2020||Yes|No|09/08/2020||Yes|No||||No|No|||Prescription required|No||056|No|37.10717|01/04/2022|36.57706|01/04/2022|34.8353|01/04/2022|||ANTICONVULSANTS|22227|||||No|No||SK LIFE SCIENCE|No||||
cenobamate|No|No|No|No|75%|71699010456|XCOPRI 250 MG DAILY DOSE PACK|56|EA|8.14089|10/04/2021||Yes|No||10/04/2021||Yes|No|10/04/2021||Yes|No||||No|No|||Prescription required|No||056|No|18.55367|01/04/2022|18.28862|01/04/2022|17.41773|01/04/2022|||ANTICONVULSANTS|22228|||||No|No||SK LIFE SCIENCE|No||||
cenobamate|No|No|No|No|75%|71699015030|XCOPRI 150 MG TABLET|30|EA|15.19634|09/08/2020||Yes|No||09/08/2020||Yes|No|09/08/2020||Yes|No||||No|No|||Prescription required|No||056|No|33.93563|01/25/2022|33.12117|01/25/2022|33.34175|01/25/2022|||ANTICONVULSANTS|22229|||||No|No||SK LIFE SCIENCE|No||||
cenobamate|No|No|No|No|75%|71699020030|XCOPRI 200 MG TABLET|30|EA|15.19634|09/04/2020||Yes|No||09/04/2020||Yes|No|09/04/2020||Yes|No||||No|No|||Prescription required|No||056|No|33.89392|01/11/2022|33.08046|01/11/2022|33.30077|01/11/2022|||ANTICONVULSANTS|22230|||||No|No||SK LIFE SCIENCE|No||||
cenobamate|No|No|No|No|75%|71699020128|XCOPRI 12.5-25 MG TITRATION PK|28|EA|1.48764|09/08/2020||Yes|No||09/08/2020||Yes|No|09/08/2020||Yes|No||||No|No|||Prescription required|No||056|No|3.31165|01/11/2022|3.23217|01/11/2022|3.25369|01/11/2022|||ANTICONVULSANTS|22231|||||No|No||SK LIFE SCIENCE|No||||
cenobamate|No|No|No|No|75%|71699020228|XCOPRI 50-100 MG TITRATION PAK|28|EA|16.28179|09/08/2020||Yes|No||09/08/2020||Yes|No|09/08/2020||Yes|No||||No|No|||Prescription required|No||056|No|36.413|01/11/2022|35.53908|01/11/2022|35.77577|01/11/2022|||ANTICONVULSANTS|22232|||||No|No||SK LIFE SCIENCE|No||||
cenobamate|No|No|No|No|75%|71699020328|XCOPRI 150-200 MG TITRATION PK|28|EA|16.28179|09/08/2020||Yes|No||09/08/2020||Yes|No|09/08/2020||Yes|No||||No|No|||Prescription required|No||056|No|37.10734|01/04/2022|36.57724|01/04/2022|34.83546|01/04/2022|||ANTICONVULSANTS|22233|||||No|No||SK LIFE SCIENCE|No||||
omadacycline tosylate|No|No|No|No|75%|71715000221|NUZYRA 150 MG TABLET|6|EA|100.53973|06/21/2019||Yes|No||06/21/2019||Yes|No|06/21/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|213|No|229.13706|01/11/2022|225.86367|01/11/2022|215.10826|01/11/2022|||TETRACYCLINES|22234|||||No|No||PARATEK PHARMAC|No||||
niacin|No|No|No|No|75%|71741002090|NIACIN 500 MG TABLET|90|EA||02/01/2022||Yes|No||||No|No|02/01/2022||Yes|No||||No|No|||Prescription required|No|||No||||||||||22235|||||No|No||REDMONT PHARMAC|No||||
hydroxyurea|No|No|No|No|75%|71770010560|SIKLOS 100 MG TABLET|60|EA|2.3693|05/19/2021|12/31/2099|Yes|No||05/19/2021|12/31/2099|Yes|No|05/19/2021|12/31/2099|Yes|No||||No|No|||Prescription required|No||580|No|5.3998|01/11/2022|5.32266|01/11/2022|5.0692|01/11/2022|||SICKLE CELL ANEMIA TREATMENTS|22236|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MEDUNIK USA|No||||
hydroxyurea|No|No|No|No|75%|71770012030|SIKLOS 1,000 MG TABLET|30|EA|23.7016|02/14/2019|12/31/2099|Yes|No||02/14/2019|12/31/2099|Yes|No|02/14/2019|12/31/2099|Yes|No||||No|No|||Prescription required|No||580|No|54.0176|01/11/2022|53.24592|01/11/2022|50.7104|01/11/2022|||SICKLE CELL ANEMIA TREATMENTS|22237|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||MEDUNIK USA|No||||
cetirizine HCl|No|No|No|No|75%|71776002430|ZERVIATE 0.24% EYE DROP|30|EA|3.28405|02/01/2021||Yes|No||02/01/2021||Yes|No|02/01/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|002|No|7.32303|07/27/2021|7.14727|07/27/2021|7.19487|07/27/2021|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|22238|||||No|No||EYEVANCE PHARMA|No||||
duvelisib|No|No|No|No|75%|71779011502|COPIKTRA 15 MG CAPSULE|56|EA|126.28293|04/10/2019||Yes|No||04/10/2019||Yes|No|04/10/2019||Yes|No||||No|No|||Prescription required|No||173|No|287.80762|11/23/2021|283.69608|11/23/2021|270.18675|11/23/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|22239|||||No|No||VERASTEM, INC.|No||||
duvelisib|No|No|No|No|75%|71779012502|COPIKTRA 25 MG CAPSULE|56|EA|126.28293|04/10/2019||Yes|No||04/10/2019||Yes|No|04/10/2019||Yes|No||||No|No|||Prescription required|No||173|No|287.80762|11/23/2021|283.69608|11/23/2021|270.18675|11/23/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|22240|||||No|No||VERASTEM, INC.|No||||
sargramostim|No|No|No|No|75%|71837584301|LEUKINE 250 MCG VIAL|1|EA||08/10/2021||Yes|No||08/10/2021||Yes|No|08/10/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|148|No|||||||283.46304|08/10/2021|COLONY STIMULATING FACTORS|22241|||||No|No||PARTNER THERAPE|No||||
sargramostim|No|No|No|No|75%|71837584305|LEUKINE 250 MCG VIAL|1|EA|127.4864|08/10/2021||Yes|No||08/10/2021||Yes|No|08/10/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|148|No|290.5504|01/04/2022|286.39968|01/04/2022|272.7616|01/04/2022|||COLONY STIMULATING FACTORS|22242|||||No|No||PARTNER THERAPE|No||||
daptomycin|No|No|No|No|75%|71839010701|DAPTOMYCIN 500 MG VIAL|1|EA|15.05|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No||||No|No|||Prescription required|No|||No|34.3|05/04/2021|33.81|05/04/2021|32.2|05/04/2021||||22243|||||No|No||BE PHARMACEUTIC|No||||
daptomycin|No|No|No|No|75%|71839010801|DAPTOMYCIN 350 MG VIAL|1|EA|12.9|12/11/2020||Yes|No||12/11/2020||Yes|No|12/11/2020||Yes|No||||No|No|||Prescription required|No|||No|29.4|05/04/2021|28.98|05/04/2021|27.6|05/04/2021||||22244|||||No|No||BE PHARMACEUTIC|No||||
levothyroxine sodium|No|No|No|No|75%|71858000504|TIROSINT 13 MCG CAPSULE|30|EA|1.9092|02/05/2019||Yes|No||02/05/2019||Yes|No|02/05/2019||Yes|No||||No|No|||Prescription required|No|||No|4.3512|03/01/2022|4.28904|03/01/2022|4.0848|03/01/2022||||22245|||||No|No||IBSA PHARMA INC|No||||
levothyroxine sodium|No|No|No|No|75%|71858001004|TIROSINT 25 MCG CAPSULE|30|EA|1.9092|02/05/2019||Yes|No||02/05/2019||Yes|No|02/05/2019||Yes|No||||No|No|||Prescription required|No|||No|4.25753|12/28/2021|4.15534|12/28/2021|4.18302|12/28/2021||||22246|||||No|No||IBSA PHARMA INC|No||||
levothyroxine sodium|No|No|No|No|75%|71858001504|TIROSINT 50 MCG CAPSULE|30|EA|1.9092|02/05/2019||Yes|No||02/05/2019||Yes|No|02/05/2019||Yes|No||||No|No|||Prescription required|No|||No|4.25484|08/24/2021|4.15272|08/24/2021|4.18038|08/24/2021||||22247|||||No|No||IBSA PHARMA INC|No||||
levothyroxine sodium|No|No|No|No|75%|71858002004|TIROSINT 75 MCG CAPSULE|30|EA|1.9092|02/05/2019||Yes|No||02/05/2019||Yes|No|02/05/2019||Yes|No||||No|No|||Prescription required|No|||No|4.25924|08/24/2021|4.15701|08/24/2021|4.1847|08/24/2021||||22248|||||No|No||IBSA PHARMA INC|No||||
levothyroxine sodium|No|No|No|No|75%|71858002504|TIROSINT 88 MCG CAPSULE|30|EA|1.9092|02/05/2019||Yes|No||02/05/2019||Yes|No|02/05/2019||Yes|No||||No|No|||Prescription required|No|||No|4.24222|08/24/2021|4.1404|08/24/2021|4.16798|08/24/2021||||22249|||||No|No||IBSA PHARMA INC|No||||
levothyroxine sodium|No|No|No|No|75%|71858003004|TIROSINT 100 MCG CAPSULE|30|EA|1.9092|02/05/2019||Yes|No||02/05/2019||Yes|No|02/05/2019||Yes|No||||No|No|||Prescription required|No|||No|4.25844|10/26/2021|4.15623|10/26/2021|4.18391|10/26/2021||||22250|||||No|No||IBSA PHARMA INC|No||||
levothyroxine sodium|No|No|No|No|75%|71858003504|TIROSINT 112 MCG CAPSULE|30|EA|1.9092|02/05/2019||Yes|No||02/05/2019||Yes|No|02/05/2019||Yes|No||||No|No|||Prescription required|No|||No|4.26497|08/24/2021|4.16261|08/24/2021|4.19033|08/24/2021||||22251|||||No|No||IBSA PHARMA INC|No||||
levothyroxine sodium|No|No|No|No|75%|71858004004|TIROSINT 125 MCG CAPSULE|30|EA|1.9092|02/05/2019||Yes|No||02/05/2019||Yes|No|02/05/2019||Yes|No||||No|No|||Prescription required|No|||No|4.26794|09/28/2021|4.1655|09/28/2021|4.19325|09/28/2021||||22252|||||No|No||IBSA PHARMA INC|No||||
levothyroxine sodium|No|No|No|No|75%|71858004504|TIROSINT 137 MCG CAPSULE|30|EA|1.9092|02/05/2019||Yes|No||02/05/2019||Yes|No|02/05/2019||Yes|No||||No|No|||Prescription required|No|||No|4.27533|08/24/2021|4.17272|08/24/2021|4.20051|08/24/2021||||22253|||||No|No||IBSA PHARMA INC|No||||
levothyroxine sodium|No|No|No|No|75%|71858005004|TIROSINT 150 MCG CAPSULE|30|EA|1.9092|02/05/2019||Yes|No||02/05/2019||Yes|No|02/05/2019||Yes|No||||No|No|||Prescription required|No|||No|4.25367|08/24/2021|4.15158|08/24/2021|4.17923|08/24/2021||||22254|||||No|No||IBSA PHARMA INC|No||||
levothyroxine sodium|No|No|No|No|75%|71858005504|TIROSINT 175 MCG CAPSULE|30|EA|1.9092|02/05/2019||Yes|No||02/05/2019||Yes|No|02/05/2019||Yes|No||||No|No|||Prescription required|No|||No|4.26989|11/23/2021|4.16741|11/23/2021|4.19516|11/23/2021||||22255|||||No|No||IBSA PHARMA INC|No||||
levothyroxine sodium|No|No|No|No|75%|71858006004|TIROSINT 200 MCG CAPSULE|30|EA|1.9092|02/05/2019||Yes|No||02/05/2019||Yes|No|02/05/2019||Yes|No||||No|No|||Prescription required|No|||No|4.25526|12/28/2021|4.15313|12/28/2021|4.18079|12/28/2021||||22256|||||No|No||IBSA PHARMA INC|No||||
levothyroxine sodium|No|No|No|No|75%|71858010505|TIROSINT-SOL 13 MCG/ML SOLN|1|ML|1.9092|06/07/2019||Yes|No||06/07/2019||Yes|No|06/07/2019||Yes|No||||No|No|||Prescription required|No|||No|4.3512|12/31/2019|4.28904|12/31/2019|4.0848|12/31/2019||||22257|||||No|No||IBSA PHARMA INC|No||||
levothyroxine sodium|No|No|No|No|75%|71858011005|TIROSINT-SOL 25 MCG/ML SOLN|1|ML|1.9092|06/07/2019||Yes|No||06/07/2019||Yes|No|06/07/2019||Yes|No||||No|No|||Prescription required|No|||No|4.3512|12/31/2019|4.28904|12/31/2019|4.0848|12/31/2019||||22258|||||No|No||IBSA PHARMA INC|No||||
levothyroxine sodium|No|No|No|No|75%|71858011505|TIROSINT-SOL 50 MCG/ML SOLN|1|ML|1.9092|06/07/2019||Yes|No||06/07/2019||Yes|No|06/07/2019||Yes|No||||No|No|||Prescription required|No|||No|4.26773|03/29/2022|4.1653|03/29/2022|4.19304|03/29/2022||||22259|||||No|No||IBSA PHARMA INC|No||||
levothyroxine sodium|No|No|No|No|75%|71858012005|TIROSINT-SOL 75 MCG/ML SOLN|1|ML|1.9092|06/07/2019||Yes|No||06/07/2019||Yes|No|06/07/2019||Yes|No||||No|No|||Prescription required|No|||No|4.3512|12/31/2019|4.28904|12/31/2019|4.0848|12/31/2019||||22260|||||No|No||IBSA PHARMA INC|No||||
levothyroxine sodium|No|No|No|No|75%|71858012505|TIROSINT-SOL 88 MCG/ML SOLN|1|ML|1.9092|06/07/2019||Yes|No||06/07/2019||Yes|No|06/07/2019||Yes|No||||No|No|||Prescription required|No|||No|4.3512|12/31/2019|4.28904|12/31/2019|4.0848|12/31/2019||||22261|||||No|No||IBSA PHARMA INC|No||||
levothyroxine sodium|No|No|No|No|75%|71858013005|TIROSINT-SOL 100 MCG/ML SOLN|1|ML|1.9092|06/07/2019||Yes|No||06/07/2019||Yes|No|06/07/2019||Yes|No||||No|No|||Prescription required|No|||No|4.3512|12/31/2019|4.28904|12/31/2019|4.0848|12/31/2019||||22262|||||No|No||IBSA PHARMA INC|No||||
levothyroxine sodium|No|No|No|No|75%|71858013505|TIROSINT-SOL 112 MCG/ML SOLN|1|ML|1.9092|06/07/2019||Yes|No||06/07/2019||Yes|No|06/07/2019||Yes|No||||No|No|||Prescription required|No|||No|4.3512|12/31/2019|4.28904|12/31/2019|4.0848|12/31/2019||||22263|||||No|No||IBSA PHARMA INC|No||||
levothyroxine sodium|No|No|No|No|75%|71858014005|TIROSINT-SOL 125 MCG/ML SOLN|1|ML|1.9092|06/07/2019||Yes|No||06/07/2019||Yes|No|06/07/2019||Yes|No||||No|No|||Prescription required|No|||No|4.3512|12/31/2019|4.28904|12/31/2019|4.0848|12/31/2019||||22264|||||No|No||IBSA PHARMA INC|No||||
levothyroxine sodium|No|No|No|No|75%|71858014505|TIROSINT-SOL 137 MCG/ML SOLN|1|ML|1.9092|06/07/2019||Yes|No||06/07/2019||Yes|No|06/07/2019||Yes|No||||No|No|||Prescription required|No|||No|4.3512|12/31/2019|4.28904|12/31/2019|4.0848|12/31/2019||||22265|||||No|No||IBSA PHARMA INC|No||||
levothyroxine sodium|No|No|No|No|75%|71858015005|TIROSINT-SOL 150 MCG/ML SOLN|1|ML|1.9092|06/07/2019||Yes|No||06/07/2019||Yes|No|06/07/2019||Yes|No||||No|No|||Prescription required|No|||No|4.3512|12/31/2019|4.28904|12/31/2019|4.0848|12/31/2019||||22266|||||No|No||IBSA PHARMA INC|No||||
levothyroxine sodium|No|No|No|No|75%|71858015505|TIROSINT-SOL 175 MCG/ML SOLN|1|ML|1.9092|06/07/2019||Yes|No||06/07/2019||Yes|No|06/07/2019||Yes|No||||No|No|||Prescription required|No|||No|4.3512|12/31/2019|4.28904|12/31/2019|4.0848|12/31/2019||||22267|||||No|No||IBSA PHARMA INC|No||||
hydrocortisone|No|No|No|No|75%|71863010950|ALKINDI SPRINKLE 0.5 MG CAP|50|EA|3.1844|05/12/2021||Yes|No||05/12/2021||Yes|No|05/12/2021||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|168|No|7.25748|01/18/2022|7.1538|01/18/2022|6.81315|01/18/2022|||GLUCOCORTICOIDS: ORAL|22268|||||No|No||ETON PHARMACEUT|No||||
hydrocortisone|No|No|No|No|75%|71863011050|ALKINDI SPRINKLE 1 MG CAPSULE|50|EA|6.36881|05/12/2021||Yes|No||05/12/2021||Yes|No|05/12/2021||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|168|No|14.51497|01/18/2022|14.30761|01/18/2022|13.6263|01/18/2022|||GLUCOCORTICOIDS: ORAL|22269|||||No|No||ETON PHARMACEUT|No||||
hydrocortisone|No|No|No|No|75%|71863011150|ALKINDI SPRINKLE 2 MG CAPSULE|50|EA|12.73763|05/12/2021||Yes|No||05/12/2021||Yes|No|05/12/2021||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|168|No|29.02995|01/18/2022|28.61523|01/18/2022|27.2526|01/18/2022|||GLUCOCORTICOIDS: ORAL|22270|||||No|No||ETON PHARMACEUT|No||||
hydrocortisone|No|No|No|No|75%|71863011250|ALKINDI SPRINKLE 5 MG CAPSULE|50|EA|31.84399|05/12/2021||Yes|No||05/12/2021||Yes|No|05/12/2021||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|168|No|72.57468|01/18/2022|71.5379|01/18/2022|68.13133|01/18/2022|||GLUCOCORTICOIDS: ORAL|22271|||||No|No||ETON PHARMACEUT|No||||
peanut allergen powder-dnfp|No|No|No|No|75%|71881010145|PALFORZIA 3 MG (LEVEL 1)|45|EA|5.09855|08/10/2020||Yes|No||08/10/2020||Yes|No|08/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|547|No|11.61996|01/18/2022|11.45396|01/18/2022|10.90854|01/18/2022|||ANTI-ALLERGENS: ORAL|22272|||||No|No||AIMMUNE THERAPE|No||||
peanut allergen powder-dnfp|No|No|No|No|75%|71881010290|PALFORZIA 6 MG (LEVEL 2)|90|EA|2.54927|08/10/2020||Yes|No||08/10/2020||Yes|No|08/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|547|No|5.80997|01/18/2022|5.72697|01/18/2022|5.45426|01/18/2022|||ANTI-ALLERGENS: ORAL|22273|||||No|No||AIMMUNE THERAPE|No||||
peanut allergen powder-dnfp|No|No|No|No|75%|71881010345|PALFORZIA 12 MG (LEVEL 3)|45|EA|5.09855|08/10/2020||Yes|No||08/10/2020||Yes|No|08/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|547|No|11.61996|01/18/2022|11.45396|01/18/2022|10.90854|01/18/2022|||ANTI-ALLERGENS: ORAL|22274|||||No|No||AIMMUNE THERAPE|No||||
peanut allergen powder-dnfp|No|No|No|No|75%|71881010415|PALFORZIA 20 MG (LEVEL 4)|15|EA|15.29567|08/10/2020||Yes|No||08/10/2020||Yes|No|08/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|547|No|34.8599|01/18/2022|34.3619|01/18/2022|32.72562|01/18/2022|||ANTI-ALLERGENS: ORAL|22275|||||No|No||AIMMUNE THERAPE|No||||
peanut allergen powder-dnfp|No|No|No|No|75%|71881010530|PALFORZIA 40 MG (LEVEL 5)|30|EA|7.64783|08/10/2020||Yes|No||08/10/2020||Yes|No|08/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|547|No|17.42994|01/18/2022|17.18094|01/18/2022|16.3628|01/18/2022|||ANTI-ALLERGENS: ORAL|22276|||||No|No||AIMMUNE THERAPE|No||||
peanut allergen powder-dnfp|No|No|No|No|75%|71881010660|PALFORZIA 80 MG (LEVEL 6)|60|EA|3.82391|08/10/2020||Yes|No||08/10/2020||Yes|No|08/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|547|No|8.71497|01/18/2022|8.59047|01/18/2022|8.1814|01/18/2022|||ANTI-ALLERGENS: ORAL|22277|||||No|No||AIMMUNE THERAPE|No||||
peanut allergen powder-dnfp|No|No|No|No|75%|71881010730|PALFORZIA 120 MG (LEVEL 7)|30|EA|7.64783|08/10/2020||Yes|No||08/10/2020||Yes|No|08/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|547|No|17.42994|01/18/2022|17.18094|01/18/2022|16.3628|01/18/2022|||ANTI-ALLERGENS: ORAL|22278|||||No|No||AIMMUNE THERAPE|No||||
peanut allergen powder-dnfp|No|No|No|No|75%|71881010860|PALFORZIA 160 MG (LEVEL 8)|60|EA|3.82391|08/10/2020||Yes|No||08/10/2020||Yes|No|08/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|547|No|8.71497|01/18/2022|8.59047|01/18/2022|8.1814|01/18/2022|||ANTI-ALLERGENS: ORAL|22279|||||No|No||AIMMUNE THERAPE|No||||
peanut allergen powder-dnfp|No|No|No|No|75%|71881010930|PALFORZIA 200 MG (LEVEL 9)|30|EA|7.64783|08/10/2020||Yes|No||08/10/2020||Yes|No|08/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|547|No|17.42994|01/18/2022|17.18094|01/18/2022|16.3628|01/18/2022|||ANTI-ALLERGENS: ORAL|22280|||||No|No||AIMMUNE THERAPE|No||||
peanut allergen powder-dnfp|No|No|No|No|75%|71881011060|PALFORZIA 240 MG (LEVEL 10)|60|EA|3.82391|08/10/2020||Yes|No||08/10/2020||Yes|No|08/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|547|No|8.71497|01/18/2022|8.59047|01/18/2022|8.1814|01/18/2022|||ANTI-ALLERGENS: ORAL|22281|||||No|No||AIMMUNE THERAPE|No||||
peanut allergen powder-dnfp|No|No|No|No|75%|71881011115|PALFORZIA 300 MG (LEVEL 11)|15|EA|15.29567|08/10/2020||Yes|No||08/10/2020||Yes|No|08/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|547|No|34.8599|01/18/2022|34.3619|01/18/2022|32.72562|01/18/2022|||ANTI-ALLERGENS: ORAL|22282|||||No|No||AIMMUNE THERAPE|No||||
peanut allergen powder-dnfp|No|No|No|No|75%|71881011130|PALFORZIA 300 MG (MAINTENANCE)|30|EA|15.29567|08/10/2020||Yes|No||08/10/2020||Yes|No|08/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|547|No|34.8599|01/18/2022|34.3619|01/18/2022|32.72562|01/18/2022|||ANTI-ALLERGENS: ORAL|22283|||||No|No||AIMMUNE THERAPE|No||||
peanut allergen powder-dnfp|No|No|No|No|75%|71881011313|PALFORZIA INITIAL DOSE PACK|13|EA|1.18977|08/10/2020||Yes|No||08/10/2020||Yes|No|08/10/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|547|No|2.71158|01/18/2022|2.67284|01/18/2022|2.54556|01/18/2022|||ANTI-ALLERGENS: ORAL|22284|||||No|No||AIMMUNE THERAPE|No||||
migalastat HCl|No|No|No|No|75%|71904010001|GALAFOLD 123 MG CAPSULE|14|EA|807.93928|01/08/2019||Yes|No||01/08/2019||Yes|No|01/08/2019||Yes|No||||No|No|||Prescription required|No|||Yes|1841.34999|08/10/2021|1815.04499|08/10/2021|1728.61428|08/10/2021||||22285|||||No|No||AMICUS THERAPEU|No||||
baclofen|No|No|No|No|75%|71930000612|BACLOFEN 10 MG TABLET|100|EA|.1161|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|22286|||||No|No||EYWA PHARMA INC|No||||
baclofen|No|No|No|No|75%|71930000613|BACLOFEN 10 MG TABLET|1000|EA|.12599|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||116|No|.06547|03/29/2022|.06389|03/29/2022|.06432|03/29/2022|||SKELETAL MUSCLE RELAXANTS|22287|||||No|No||EYWA PHARMA INC|No||||
baclofen|No|No|No|No|75%|71930000712|BACLOFEN 20 MG TABLET|100|EA|.1978|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|22288|||||No|No||EYWA PHARMA INC|No||||
baclofen|No|No|No|No|75%|71930000713|BACLOFEN 20 MG TABLET|1000|EA|.21242|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||116|No|.12287|03/29/2022|.11992|03/29/2022|.12071|03/29/2022|||SKELETAL MUSCLE RELAXANTS|22289|||||No|No||EYWA PHARMA INC|No||||
acetazolamide|No|No|No|No|75%|71930000812|ACETAZOLAMIDE 125 MG TABLET|100|EA|.7482|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|No|||No|.16397|03/29/2022|.16003|03/29/2022|.1611|03/29/2022||||22290|||||No|No||EYWA PHARMA INC|No||||
acetazolamide|No|No|No|No|75%|71930000912|ACETAZOLAMIDE 250 MG TABLET|100|EA|.989|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|No|||No|.25723|03/29/2022|.25105|03/29/2022|.25272|03/29/2022||||22291|||||No|No||EYWA PHARMA INC|No||||
ursodiol|No|No|No|No|75%|71930001512|URSODIOL 300 MG CAPSULE|100|EA|.5375|09/17/2020||Yes|No||09/17/2020||Yes|No|09/17/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|198|No|.60006|03/29/2022|.58565|03/29/2022|.58955|03/29/2022|||BILE SALTS|22292|||||No|No||EYWA PHARMA INC|No||||
ondansetron HCl|No|No|No|No|75%|71930001730|ONDANSETRON HCL 4 MG TABLET|30|EA|.1935|01/30/2019||Yes|No||01/30/2019||Yes|No|01/30/2019||Yes|No||||No|No|||Prescription required|No||085|No|.06763|03/29/2022|.066|03/29/2022|.06644|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|22293|||||No|No||EYWA PHARMA INC|No||||
ondansetron HCl|No|No|No|No|75%|71930001752|ONDANSETRON HCL 4 MG TABLET|500|EA|.1935|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No||085|No|.06763|03/29/2022|.066|03/29/2022|.06644|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|22294|||||No|No||EYWA PHARMA INC|No||||
ondansetron HCl|No|No|No|No|75%|71930001830|ONDANSETRON HCL 8 MG TABLET|30|EA|.22933|01/30/2019||Yes|No||01/30/2019||Yes|No|01/30/2019||Yes|No||||No|No|||Prescription required|No||085|No|.09975|03/29/2022|.09735|03/29/2022|.098|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|22295|||||No|No||EYWA PHARMA INC|No||||
ondansetron HCl|No|No|No|No|75%|71930001852|ONDANSETRON HCL 8 MG TABLET|500|EA|.22876|05/21/2020||Yes|No||05/21/2020||Yes|No|05/21/2020||Yes|No||||No|No|||Prescription required|No||085|No|.09975|03/29/2022|.09735|03/29/2022|.098|03/29/2022|||ANTIEMETIC/ANTIVERTIGO AGENTS|22296|||||No|No||EYWA PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|71930001912|HYDROCODONE-ACETAMIN 5-325 MG|100|EA|.129|01/30/2019||Yes|No||01/30/2019||Yes|No|01/30/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22297|||||No|No||EYWA PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|71930001952|HYDROCODONE-ACETAMIN 5-325 MG|500|EA|.11868|01/30/2019||Yes|No||01/30/2019||Yes|No|01/30/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.09602|03/29/2022|.09371|03/29/2022|.09433|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22298|||||No|No||EYWA PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|71930002012|HYDROCODONE-ACETAMIN 7.5-325|100|EA|.1333|01/30/2019||Yes|No||01/30/2019||Yes|No|01/30/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22299|||||No|No||EYWA PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|71930002052|HYDROCODONE-ACETAMIN 7.5-325|500|EA|.129|01/30/2019||Yes|No||01/30/2019||Yes|No|01/30/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.12518|03/29/2022|.12217|03/29/2022|.12298|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22300|||||No|No||EYWA PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|71930002112|HYDROCODONE-ACETAMIN 10-325 MG|100|EA|.1634|01/30/2019||Yes|No||01/30/2019||Yes|No|01/30/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22301|||||No|No||EYWA PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|71930002152|HYDROCODONE-ACETAMIN 10-325 MG|500|EA|.1634|01/30/2019||Yes|No||01/30/2019||Yes|No|01/30/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.12007|03/29/2022|.11718|03/29/2022|.11796|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22302|||||No|No||EYWA PHARMA INC|No||||
oxycodone HCl|No|No|No|No|90%|71930002243|OXYCODONE HCL 5 MG/5 ML SOLN|473|ML|.09817|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.14845|03/29/2022|.14488|03/29/2022|.14585|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22303|||||No|No||EYWA PHARMA INC|No||||
oxycodone HCl|No|No|No|No|90%|71930002330|OXYCODONE HCL 100 MG/5 ML CONC|30|ML|2.00666|01/30/2019||Yes|No||01/30/2019||Yes|No|01/30/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|109|Yes|3.65933|03/29/2022|3.5715|03/29/2022|3.59529|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22304|||||No|No||EYWA PHARMA INC|No||||
methylphenidate HCl|No|No|No|No|75%|71930002452|METHYLPHENIDATE 5 MG/5 ML SOLN|500|ML|.0903|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.15581|03/29/2022|.15207|03/29/2022|.15308|03/29/2022|||STIMULANTS AND RELATED AGENTS|22305|||||No|No||EYWA PHARMA INC|No||||
methylphenidate HCl|No|No|No|No|75%|71930002552|METHYLPHENIDATE 10 MG/5 ML SOL|500|ML|.13588|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|.17579|03/29/2022|.17157|03/29/2022|.17271|03/29/2022|||STIMULANTS AND RELATED AGENTS|22306|||||No|No||EYWA PHARMA INC|No||||
brompheniramine/pseudoephed/DM|No|No|No|No|75%|71930002643|BROMPHEN-PSE-DM 2-30-10 MG/5ML|473|ML|.06454|04/07/2021||Yes|No||04/07/2021||Yes|No|04/07/2021||Yes|No||||No|No|||Prescription required|No||184|Yes|.06501|03/29/2022|.06344|03/29/2022|.06387|03/29/2022|||COUGH AND COLD: NON-NARCOTIC|22307|||||No|No||EYWA PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|71930002743|HYDROCODONE-ACETAMN 7.5-325/15|473|ML|.10181|09/17/2019||Yes|No||09/17/2019||Yes|No|09/17/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.08003|03/29/2022|.0781|03/29/2022|.07862|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22308|||||No|No||EYWA PHARMA INC|No||||
pyridostigmine bromide|No|No|No|No|75%|71930002890|PYRIDOSTIGMINE BR 60 MG TABLET|90|EA|.4386|09/19/2019||Yes|No||09/19/2019||Yes|No|09/19/2019||Yes|No||||No|No|||Prescription required|No|||No|.31425|03/29/2022|.3067|03/29/2022|.30875|03/29/2022||||22309|||||No|No||EYWA PHARMA INC|No||||
labetalol HCl|No|No|No|No|75%|71930003512|LABETALOL HCL 100 MG TABLET|100|EA|.1677|08/29/2019||Yes|No||08/29/2019||Yes|No|08/29/2019||Yes|No||||No|No|||Prescription required|No||070|No|.12868|03/29/2022|.12559|03/29/2022|.12642|03/29/2022|||BETA-BLOCKERS|22310|||||No|No||EYWA PHARMA INC|No||||
labetalol HCl|No|No|No|No|75%|71930003552|LABETALOL HCL 100 MG TABLET|500|EA|.1634|08/29/2019||Yes|No||08/29/2019||Yes|No|08/29/2019||Yes|No||||No|No|||Prescription required|No||070|No|.12868|03/29/2022|.12559|03/29/2022|.12642|03/29/2022|||BETA-BLOCKERS|22311|||||No|No||EYWA PHARMA INC|No||||
labetalol HCl|No|No|No|No|75%|71930003612|LABETALOL HCL 200 MG TABLET|100|EA|.2322|08/29/2019||Yes|No||08/29/2019||Yes|No|08/29/2019||Yes|No||||No|No|||Prescription required|No||070|No|.17218|03/29/2022|.16804|03/29/2022|.16916|03/29/2022|||BETA-BLOCKERS|22312|||||No|No||EYWA PHARMA INC|No||||
labetalol HCl|No|No|No|No|75%|71930003652|LABETALOL HCL 200 MG TABLET|500|EA|.2322|08/29/2019||Yes|No||08/29/2019||Yes|No|08/29/2019||Yes|No||||No|No|||Prescription required|No||070|No|.17218|03/29/2022|.16804|03/29/2022|.16916|03/29/2022|||BETA-BLOCKERS|22313|||||No|No||EYWA PHARMA INC|No||||
labetalol HCl|No|No|No|No|75%|71930003712|LABETALOL HCL 300 MG TABLET|100|EA|.3182|08/29/2019||Yes|No||08/29/2019||Yes|No|08/29/2019||Yes|No||||No|No|||Prescription required|No||070|No|.21583|03/29/2022|.21065|03/29/2022|.21205|03/29/2022|||BETA-BLOCKERS|22314|||||No|No||EYWA PHARMA INC|No||||
labetalol HCl|No|No|No|No|75%|71930003752|LABETALOL HCL 300 MG TABLET|500|EA|.3225|08/29/2019||Yes|No||08/29/2019||Yes|No|08/29/2019||Yes|No||||No|No|||Prescription required|No||070|No|.21583|03/29/2022|.21065|03/29/2022|.21205|03/29/2022|||BETA-BLOCKERS|22315|||||No|No||EYWA PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|71930004212|HYDROCODONE-ACETAMIN 5-300 MG|100|EA|.5375|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.19231|03/29/2022|.18769|03/29/2022|.18894|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22316|||||No|No||EYWA PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|71930004252|HYDROCODONE-ACETAMIN 5-300 MG|500|EA|.559|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.19231|03/29/2022|.18769|03/29/2022|.18894|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22317|||||No|No||EYWA PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|71930004312|HYDROCODONE-ACETAMIN 7.5-300|100|EA|.645|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.2429|03/29/2022|.23707|03/29/2022|.23864|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22318|||||No|No||EYWA PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|71930004352|HYDROCODONE-ACETAMIN 7.5-300|500|EA|.602|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.2429|03/29/2022|.23707|03/29/2022|.23864|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22319|||||No|No||EYWA PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|71930004412|HYDROCODONE-ACETAMIN 10-300 MG|100|EA|.817|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.34815|03/29/2022|.33979|03/29/2022|.34205|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22320|||||No|No||EYWA PHARMA INC|No||||
hydrocodone/acetaminophen|No|No|No|No|90%|71930004452|HYDROCODONE-ACETAMIN 10-300 MG|500|EA|.774|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.34815|03/29/2022|.33979|03/29/2022|.34205|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22321|||||No|No||EYWA PHARMA INC|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|71930004512|OXYCODONE-ACETAMINOPHEN 5-325|100|EA|.1075|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.09091|03/29/2022|.08872|03/29/2022|.08931|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22322|||||No|No||EYWA PHARMA INC|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|71930004552|OXYCODONE-ACETAMINOPHEN 5-325|500|EA|.1032|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.09091|03/29/2022|.08872|03/29/2022|.08931|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22323|||||No|No||EYWA PHARMA INC|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|71930004612|OXYCODONE-ACETAMINOPHN 7.5-325|100|EA|.2537|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.14032|03/29/2022|.13695|03/29/2022|.13786|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22324|||||No|No||EYWA PHARMA INC|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|71930004652|OXYCODONE-ACETAMINOPHN 7.5-325|500|EA|.25628|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.14032|03/29/2022|.13695|03/29/2022|.13786|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22325|||||No|No||EYWA PHARMA INC|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|71930004712|OXYCODONE-ACETAMINOPHEN 10-325|100|EA|.2795|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.19233|03/29/2022|.18771|03/29/2022|.18896|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22326|||||No|No||EYWA PHARMA INC|No||||
oxycodone HCl/acetaminophen|No|No|No|No|90%|71930004752|OXYCODONE-ACETAMINOPHEN 10-325|500|EA|.2795|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.19233|03/29/2022|.18771|03/29/2022|.18896|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22327|||||No|No||EYWA PHARMA INC|No||||
potassium citrate|No|No|No|No|75%|71930004812|POTASSIUM CITRATE ER 5 MEQ TAB|100|EA|.42785|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|.46644|03/29/2022|.45524|03/29/2022|.45827|03/29/2022||||22328|||||No|No||EYWA PHARMA INC|No||||
potassium citrate|No|No|No|No|75%|71930004912|POTASSIUM CITRATE ER 10 MEQ TB|100|EA|.5375|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|.30433|03/29/2022|.29702|03/29/2022|.299|03/29/2022||||22329|||||No|No||EYWA PHARMA INC|No||||
potassium citrate|No|No|No|No|75%|71930005012|POTASSIUM CITRATE ER 15 MEQ TB|100|EA|.84925|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|No|||No|.5925|03/29/2022|.57828|03/29/2022|.58213|03/29/2022||||22330|||||No|No||EYWA PHARMA INC|No||||
oxybutynin chloride|No|No|No|No|75%|71930005112|OXYBUTYNIN 5 MG TABLET|100|EA|.1763|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|22331|||||No|No||EYWA PHARMA INC|No||||
oxybutynin chloride|No|No|No|No|75%|71930005113|OXYBUTYNIN 5 MG TABLET|1000|EA|.18705|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|22332|||||No|No||EYWA PHARMA INC|No||||
oxybutynin chloride|No|No|No|No|75%|71930005152|OXYBUTYNIN 5 MG TABLET|500|EA|.1978|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||006|No|.07858|03/29/2022|.07669|03/29/2022|.0772|03/29/2022|||BLADDER RELAXANT PREPARATIONS|22333|||||No|No||EYWA PHARMA INC|No||||
acetaminophen with codeine|No|No|No|No|90%|71930005412|ACETAMINOPHEN-COD #2 TABLET|100|EA|.0774|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.11854|03/29/2022|.11569|03/29/2022|.11646|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22334|||||No|No||EYWA PHARMA INC|No||||
acetaminophen with codeine|No|No|No|No|90%|71930005452|ACETAMINOPHEN-COD #2 TABLET|500|EA|.0645|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.11854|03/29/2022|.11569|03/29/2022|.11646|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22335|||||No|No||EYWA PHARMA INC|No||||
acetaminophen with codeine|No|No|No|No|90%|71930005512|ACETAMINOPHEN-COD #3 TABLET|100|EA|.0817|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.10921|03/29/2022|.10658|03/29/2022|.10729|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22336|||||No|No||EYWA PHARMA INC|No||||
acetaminophen with codeine|No|No|No|No|90%|71930005552|ACETAMINOPHEN-COD #3 TABLET|500|EA|.06966|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.10921|03/29/2022|.10658|03/29/2022|.10729|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22337|||||No|No||EYWA PHARMA INC|No||||
acetaminophen with codeine|No|No|No|No|90%|71930005612|ACETAMINOPHEN-COD #4 TABLET|100|EA|.1247|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.22352|03/29/2022|.21815|03/29/2022|.2196|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22338|||||No|No||EYWA PHARMA INC|No||||
acetaminophen with codeine|No|No|No|No|90%|71930005652|ACETAMINOPHEN-COD #4 TABLET|500|EA|.11868|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|No||109|Yes|.22352|03/29/2022|.21815|03/29/2022|.2196|03/29/2022|||ANALGESICS: NARCOTICS SHORT|22339|||||No|No||EYWA PHARMA INC|No||||
valproic acid|No|No|No|No|75%|71930005712|VALPROIC ACID 250 MG CAPSULE|100|EA|.1505|09/15/2020||Yes|No||09/15/2020||Yes|No|09/15/2020||Yes|No||||No|No|||Prescription required|No||056|No|.23326|03/29/2022|.22766|03/29/2022|.22917|03/29/2022|||ANTICONVULSANTS|22340|||||No|No||EYWA PHARMA INC|No||||
levetiracetam|No|No|No|No|75%|71930006215|LEVETIRACETAM 250 MG TABLET|120|EA|.12362|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No||056|No|.08073|03/29/2022|.07879|03/29/2022|.07931|03/29/2022|||ANTICONVULSANTS|22341|||||No|No||EYWA PHARMA INC|No||||
levetiracetam|No|No|No|No|75%|71930006315|LEVETIRACETAM 500 MG TABLET|120|EA|.14333|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|22342|||||No|No||EYWA PHARMA INC|No||||
levetiracetam|No|No|No|No|75%|71930006352|LEVETIRACETAM 500 MG TABLET|500|EA|.1419|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No||056|No|.10467|03/29/2022|.10215|03/29/2022|.10283|03/29/2022|||ANTICONVULSANTS|22343|||||No|No||EYWA PHARMA INC|No||||
levetiracetam|No|No|No|No|75%|71930006415|LEVETIRACETAM 750 MG TABLET|120|EA|.1935|03/02/2020||Yes|No||03/02/2020||Yes|No|03/02/2020||Yes|No||||No|No|||Prescription required|No||056|No|.15853|03/29/2022|.15472|03/29/2022|.15575|03/29/2022|||ANTICONVULSANTS|22344|||||No|No||EYWA PHARMA INC|No||||
levetiracetam|No|No|No|No|75%|71930006560|LEVETIRACETAM 1,000 MG TABLET|60|EA|.28666|04/09/2021||Yes|No||04/09/2021||Yes|No|04/09/2021||Yes|No||||No|No|||Prescription required|No||056|No|.22789|03/29/2022|.22242|03/29/2022|.2239|03/29/2022|||ANTICONVULSANTS|22345|||||No|No||EYWA PHARMA INC|No||||
cenegermin-bkbj|No|No|No|No|75%|71981002007|OXERVATE 0.002% EYE DROP|1|ML|781.28542|09/18/2019||Yes|No||09/18/2019||Yes|No|09/18/2019||Yes|No||||No|No|||Prescription required|No|||No|1780.60399|02/01/2022|1755.16679|02/01/2022|1671.58742|02/01/2022||||22346|||||No|No||DOMPE US, INC|No||||
pitolisant HCl|No|No|No|No|75%|72028004503|WAKIX 4.45 MG TABLET|30|EA|48.76873|08/12/2020||Yes|No||08/12/2020||Yes|No|08/12/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|No|111.14734|01/04/2022|109.55952|01/04/2022|104.3424|01/04/2022|||STIMULANTS AND RELATED AGENTS|22347|||||No|No||HARMONY BIOSCIE|No||||
pitolisant HCl|No|No|No|No|75%|72028017803|WAKIX 17.8 MG TABLET|30|EA|97.53761|08/12/2020||Yes|No||08/12/2020||Yes|No|08/12/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|No|222.29502|01/04/2022|219.11938|01/04/2022|208.68512|01/04/2022|||STIMULANTS AND RELATED AGENTS|22348|||||No|No||HARMONY BIOSCIE|No||||
lumateperone tosylate|No|No|No|No|75%|72060014230|CAPLYTA 42 MG CAPSULE|30|EA|21.23841|06/15/2020||Yes|No||06/15/2020||Yes|No|06/15/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|027|Yes|47.37349|01/11/2022|46.23652|01/11/2022|46.54445|01/11/2022|||ANTIPSYCHOTICS|22349|||||No|No||INTRA-CELLULAR|No||||
avapritinib|No|No|No|No|75%|72064011030|AYVAKIT 100 MG TABLET|30|EA|504.71966|08/03/2020||Yes|No||08/03/2020||Yes|No|08/03/2020||Yes|No||||No|No|||Prescription required|No||239|No|1150.29132|01/18/2022|1133.85859|01/18/2022|1079.86532|01/18/2022|||ONCOLOGY: ORAL - OTHER|22350|||||No|No||BLUEPRINT MEDIC|No||||
avapritinib|No|No|No|No|75%|72064012030|AYVAKIT 200 MG TABLET|30|EA|504.71966|08/03/2020||Yes|No||08/03/2020||Yes|No|08/03/2020||Yes|No||||No|No|||Prescription required|No||239|No|1150.29132|01/18/2022|1133.85859|01/18/2022|1079.86532|01/18/2022|||ONCOLOGY: ORAL - OTHER|22351|||||No|No||BLUEPRINT MEDIC|No||||
avapritinib|No|No|No|No|75%|72064012530|AYVAKIT 25 MG TABLET|30|EA|504.71966|09/21/2021||Yes|No||09/21/2021||Yes|No|09/21/2021||Yes|No||||No|No|||Prescription required|No||239|No|1150.29132|01/18/2022|1133.85859|01/18/2022|1079.86532|01/18/2022|||ONCOLOGY: ORAL - OTHER|22352|||||No|No||BLUEPRINT MEDIC|No||||
avapritinib|No|No|No|No|75%|72064013030|AYVAKIT 300 MG TABLET|30|EA|504.71966|08/03/2020||Yes|No||08/03/2020||Yes|No|08/03/2020||Yes|No||||No|No|||Prescription required|No||239|No|1150.29132|01/18/2022|1133.85859|01/18/2022|1079.86532|01/18/2022|||ONCOLOGY: ORAL - OTHER|22353|||||No|No||BLUEPRINT MEDIC|No||||
avapritinib|No|No|No|No|75%|72064015030|AYVAKIT 50 MG TABLET|30|EA|504.71966|09/21/2021||Yes|No||09/21/2021||Yes|No|09/21/2021||Yes|No||||No|No|||Prescription required|No||239|No|1150.29132|01/18/2022|1133.85859|01/18/2022|1079.86532|01/18/2022|||ONCOLOGY: ORAL - OTHER|22354|||||No|No||BLUEPRINT MEDIC|No||||
pralsetinib|No|No|No|No|75%|72064021060|GAVRETO 100 MG CAPSULE|60|EA|68.9548|02/01/2021|06/30/2022|Yes|No||02/01/2021|06/30/2022|Yes|No|02/01/2021|06/30/2022|Yes|No||||No|No|||Prescription required|No||551|No|157.1528|02/01/2021|154.90776|02/01/2021|147.5312|02/01/2021|||ONCOLOGY: ORAL - LUNG|22355|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPRINT MEDIC|No||||
pralsetinib|No|No|No|No|75%|72064021090|GAVRETO 100 MG CAPSULE|90|EA|68.9548|02/01/2021|06/30/2022|Yes|No||02/01/2021|06/30/2022|Yes|No|02/01/2021|06/30/2022|Yes|No||||No|No|||Prescription required|No||551|No|157.1528|02/01/2021|154.90776|02/01/2021|147.5312|02/01/2021|||ONCOLOGY: ORAL - LUNG|22356|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||BLUEPRINT MEDIC|No||||
glucagon|No|No|No|No|75%|72065012011|GVOKE HYPOPEN 1PK 0.5MG/0.1 ML|.1|ML|1280.97|02/27/2020||Yes|No||02/27/2020||Yes|No|02/27/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|583|No|2919.42|02/08/2022|2877.714|02/08/2022|2740.68|02/08/2022|||GLUCAGON AGENTS|22357|||||No|No||XERIS PHARMACEU|No||||
glucagon|No|No|No|No|75%|72065012012|GVOKE HYPOPEN 2PK 0.5MG/0.1 ML|.1|ML|1280.97|02/27/2020||Yes|No||02/27/2020||Yes|No|02/27/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|583|No|2853.5876|02/15/2022|2785.10149|02/15/2022|2803.64981|02/15/2022|||GLUCAGON AGENTS|22358|||||No|No||XERIS PHARMACEU|No||||
glucagon|No|No|No|No|75%|72065012111|GVOKE HYPOPEN 1-PK 1 MG/0.2 ML|.2|ML|640.485|02/27/2020||Yes|No||02/27/2020||Yes|No|02/27/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|583|No|1459.71|02/08/2022|1438.857|02/08/2022|1370.34|02/08/2022|||GLUCAGON AGENTS|22359|||||No|No||XERIS PHARMACEU|No||||
glucagon|No|No|No|No|75%|72065012112|GVOKE HYPOPEN 2-PK 1 MG/0.2 ML|.2|ML|640.485|02/27/2020||Yes|No||02/27/2020||Yes|No|02/27/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|583|No|1423.0761|02/15/2022|1388.92227|02/15/2022|1398.17226|02/15/2022|||GLUCAGON AGENTS|22360|||||No|No||XERIS PHARMACEU|No||||
glucagon|No|No|No|No|75%|72065013011|GVOKE PFS 1PK 0.5MG/0.1 ML SYR|.1|ML|1280.97|02/27/2020||Yes|No||02/27/2020||Yes|No|02/27/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|583|No|2919.42|02/08/2022|2877.714|02/08/2022|2740.68|02/08/2022|||GLUCAGON AGENTS|22361|||||No|No||XERIS PHARMACEU|No||||
glucagon|No|No|No|No|75%|72065013012|GVOKE PFS 2PK 0.5MG/0.1 ML SYR|.1|ML|1280.97|02/27/2020||Yes|No||02/27/2020||Yes|No|02/27/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|583|No|2919.42|02/08/2022|2877.714|02/08/2022|2740.68|02/08/2022|||GLUCAGON AGENTS|22362|||||No|No||XERIS PHARMACEU|No||||
glucagon|No|No|No|No|75%|72065013111|GVOKE PFS 1-PK 1 MG/0.2 ML SYR|.2|ML|640.485|02/27/2020||Yes|No||02/27/2020||Yes|No|02/27/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|583|No|1426.19439|02/15/2022|1391.96572|02/15/2022|1401.23598|02/15/2022|||GLUCAGON AGENTS|22363|||||No|No||XERIS PHARMACEU|No||||
glucagon|No|No|No|No|75%|72065013112|GVOKE PFS 2-PK 1 MG/0.2 ML SYR|.2|ML|640.485|02/27/2020||Yes|No||02/27/2020||Yes|No|02/27/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|583|No|1424.86296|02/15/2022|1390.66624|02/15/2022|1399.92785|02/15/2022|||GLUCAGON AGENTS|22364|||||No|No||XERIS PHARMACEU|No||||
aclidinium brom/formoterol fum|No|No|No|No|75%|72124000101|DUAKLIR PRESSAIR 400-12MCG INH|1|EA|427.85|02/27/2020||Yes|No||02/27/2020||Yes|No|02/27/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|098|Yes|975.1|02/27/2020|961.17|02/27/2020|915.4|02/27/2020|||COPD AGENTS|22365|||||No|No||ASTRAZENECA/COV|No||||
aclidinium bromide|No|No|No|No|75%|72124000201|TUDORZA PRESSAIR 400 MCG INHAL|1|EA|267.8513|11/22/2019||Yes|No||11/22/2019||Yes|No|11/22/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|098|No|610.4518|02/08/2022|601.73106|02/08/2022|573.0772|02/08/2022|||COPD AGENTS|22366|||||No|No||ASTRAZENECA/COV|No||||
aclidinium bromide|No|No|No|No|75%|72124000202|TUDORZA PRESSAIR 400 MCG INHAL|1|EA|122.8682|11/22/2019|06/30/2022|Yes|No||11/22/2019|06/30/2022|Yes|No|11/22/2019|06/30/2022|Yes|No||||No|No|||Prescription required|Yes|07/25/2019|098|No|280.0252|01/14/2020|276.02484|01/14/2020|262.8808|01/14/2020|||COPD AGENTS|22367|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||CIRCASSIA/ASTRA|No||||
inotersen sodium|No|No|No|No|75%|72126000701|TEGSEDI 284 MG/1.5 ML SYRINGE|1.5|ML|2630.67836|05/01/2019||Yes|No||05/01/2019||Yes|No|05/01/2019||Yes|No||||No|No|||Prescription required|No|||No|5995.49952|01/04/2022|5909.84953|01/04/2022|5628.42812|01/04/2022||||22368|||||No|No||AKCEA THERAPEUT|No||||
isotretinoin|No|No|No|No|75%|72143023230|ACCUTANE 20 MG CAPSULE|30|EA|2.86351|03/24/2022||Yes|No||03/24/2022||Yes|No|03/24/2022||Yes|No||||No|No|||Prescription required|No||144|No|6.52614|03/24/2022|6.43291|03/24/2022|6.12658|03/24/2022|||ACNE AGENTS: ORAL|22369|||||No|No||JG PHARMA, INC.|No||||
isotretinoin|No|No|No|No|75%|72143023330|ACCUTANE 30 MG CAPSULE|30|EA|2.86351|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|No||144|No|6.52614|03/28/2022|6.43291|03/28/2022|6.12658|03/28/2022|||ACNE AGENTS: ORAL|22370|||||No|No||JG PHARMA, INC.|No||||
isotretinoin|No|No|No|No|75%|72143023430|ACCUTANE 40 MG CAPSULE|30|EA|2.86351|03/28/2022||Yes|No||03/28/2022||Yes|No|03/28/2022||Yes|No||||No|No|||Prescription required|No||144|No|6.52614|03/28/2022|6.43291|03/28/2022|6.12658|03/28/2022|||ACNE AGENTS: ORAL|22371|||||No|No||JG PHARMA, INC.|No||||
moxifloxacin HCl|No|No|No|No|75%|72205000105|MOXIFLOXACIN HCL 400 MG TABLET|500|EA|1.26477|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|028|No|1.23895|03/29/2022|1.20921|03/29/2022|1.21726|03/29/2022|||FLUOROQUINOLONES: ORAL|22372|||||No|No||NOVADOZ PHARMAC|No||||
moxifloxacin HCl|No|No|No|No|75%|72205000130|MOXIFLOXACIN HCL 400 MG TABLET|30|EA|1.26477|05/20/2019||Yes|No||05/20/2019||Yes|No|05/20/2019||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|028|No|1.23895|03/29/2022|1.20921|03/29/2022|1.21726|03/29/2022|||FLUOROQUINOLONES: ORAL|22373|||||No|No||NOVADOZ PHARMAC|No||||
rosuvastatin calcium|Yes|No|No|No|75%|72205000290|ROSUVASTATIN CALCIUM 5 MG TAB|90|EA|.08121|02/22/2019|01/31/2022|Yes|No||02/22/2019|01/31/2022|Yes|No|02/22/2019|01/31/2022|Yes|No||||No|No|06/18/2019|01/31/2022|Prescription required|No||063|Yes|.1851|02/15/2022|.18245|02/15/2022|.17376|02/15/2022|||LIPOTROPICS: STATINS|22374|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NOVADOZ PHARMAC|No||||
rosuvastatin calcium|Yes|No|No|No|75%|72205000299|ROSUVASTATIN CALCIUM 5 MG TAB|1000|EA|.06416|02/22/2019|01/31/2022|Yes|No||02/22/2019|01/31/2022|Yes|No|02/22/2019|01/31/2022|Yes|No||||No|No|06/18/2019|01/31/2022|Prescription required|No||063|Yes|.14623|02/15/2022|.14414|02/15/2022|.13728|02/15/2022|||LIPOTROPICS: STATINS|22375|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NOVADOZ PHARMAC|No||||
rosuvastatin calcium|Yes|No|No|No|75%|72205000390|ROSUVASTATIN CALCIUM 10 MG TAB|90|EA|.04777|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|06/18/2019||Prescription required|No||063|Yes|.05981|03/29/2022|.05837|03/29/2022|.05876|03/29/2022|||LIPOTROPICS: STATINS|22376|||||No|No||NOVADOZ PHARMAC|No||||
rosuvastatin calcium|Yes|No|No|No|75%|72205000399|ROSUVASTATIN CALCIUM 10 MG TAB|1000|EA|.06416|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|06/18/2019||Prescription required|No||063|Yes|.05981|03/29/2022|.05837|03/29/2022|.05876|03/29/2022|||LIPOTROPICS: STATINS|22377|||||No|No||NOVADOZ PHARMAC|No||||
rosuvastatin calcium|Yes|No|No|No|75%|72205000490|ROSUVASTATIN CALCIUM 20 MG TAB|90|EA|.04777|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|06/18/2019||Prescription required|No||063|Yes|.07822|03/29/2022|.07634|03/29/2022|.07685|03/29/2022|||LIPOTROPICS: STATINS|22378|||||No|No||NOVADOZ PHARMAC|No||||
rosuvastatin calcium|Yes|No|No|No|75%|72205000499|ROSUVASTATIN CALCIUM 20 MG TAB|1000|EA|.06416|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|06/18/2019||Prescription required|No||063|Yes|.07822|03/29/2022|.07634|03/29/2022|.07685|03/29/2022|||LIPOTROPICS: STATINS|22379|||||No|No||NOVADOZ PHARMAC|No||||
rosuvastatin calcium|Yes|No|No|No|75%|72205000530|ROSUVASTATIN CALCIUM 40 MG TAB|30|EA|.07166|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|06/18/2019||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|22380|||||No|No||NOVADOZ PHARMAC|No||||
rosuvastatin calcium|Yes|No|No|No|75%|72205000590|ROSUVASTATIN CALCIUM 40 MG TAB|90|EA|.07166|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|06/18/2019||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|22381|||||No|No||NOVADOZ PHARMAC|No||||
rosuvastatin calcium|Yes|No|No|No|75%|72205000599|ROSUVASTATIN CALCIUM 40 MG TAB|1000|EA|.06416|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|06/18/2019||Prescription required|No||063|Yes|.12651|03/29/2022|.12347|03/29/2022|.12429|03/29/2022|||LIPOTROPICS: STATINS|22382|||||No|No||NOVADOZ PHARMAC|No||||
capecitabine|No|No|No|No|75%|72205000660|CAPECITABINE 150 MG TABLET|60|EA|.22245|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||502|No|.50698|03/03/2020|.49974|03/03/2020|.47594|03/03/2020|||ONCOLOGY: ORAL - BREAST|22383|||||No|No||NOVADOZ PHARMAC|No||||
capecitabine|No|No|No|No|75%|72205000792|CAPECITABINE 500 MG TABLET|120|EA|.215|02/22/2019||Yes|No||02/22/2019||Yes|No|02/22/2019||Yes|No||||No|No|||Prescription required|No||502|No|.61977|12/28/2021|.60489|12/28/2021|.60892|12/28/2021|||ONCOLOGY: ORAL - BREAST|22384|||||No|No||NOVADOZ PHARMAC|No||||
trientine HCl|No|No|No|No|75%|72205000891|TRIENTINE HCL 250 MG CAPSULE|100|EA|3.225|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|No|||No|7.35|10/13/2020|7.245|10/13/2020|6.9|10/13/2020||||22385|||||No|No||NOVADOZ PHARMAC|No||||
silodosin|No|No|No|No|75%|72205000930|SILODOSIN 4 MG CAPSULE|30|EA|.43|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|003|No|.60384|03/29/2022|.58934|03/29/2022|.59327|03/29/2022|||BPH TREATMENTS|22386|||||No|No||NOVADOZ PHARMAC|No||||
silodosin|No|No|No|No|75%|72205001030|SILODOSIN 8 MG CAPSULE|30|EA|.43|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|003|No|.68368|03/29/2022|.66727|03/29/2022|.67171|03/29/2022|||BPH TREATMENTS|22387|||||No|No||NOVADOZ PHARMAC|No||||
silodosin|No|No|No|No|75%|72205001090|SILODOSIN 8 MG CAPSULE|90|EA|.43|02/26/2019||Yes|No||02/26/2019||Yes|No|02/26/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|003|No|.68368|03/29/2022|.66727|03/29/2022|.67171|03/29/2022|||BPH TREATMENTS|22388|||||No|No||NOVADOZ PHARMAC|No||||
pregabalin|No|No|No|No|90%|72205001190|PREGABALIN 25 MG CAPSULE|90|EA|.02866|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.0795|03/29/2022|.07759|03/29/2022|.0781|03/29/2022|||NEUROPATHIC PAIN|22389|||||No|No||NOVADOZ PHARMAC|No||||
pregabalin|No|No|No|No|90%|72205001290|PREGABALIN 50 MG CAPSULE|90|EA|.02866|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.09128|03/29/2022|.08908|03/29/2022|.08968|03/29/2022|||NEUROPATHIC PAIN|22390|||||No|No||NOVADOZ PHARMAC|No||||
pregabalin|No|No|No|No|90%|72205001390|PREGABALIN 75 MG CAPSULE|90|EA|.02866|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.08098|03/29/2022|.07903|03/29/2022|.07956|03/29/2022|||NEUROPATHIC PAIN|22391|||||No|No||NOVADOZ PHARMAC|No||||
pregabalin|No|No|No|No|90%|72205001490|PREGABALIN 100 MG CAPSULE|90|EA|.02866|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.08763|03/29/2022|.08552|03/29/2022|.08609|03/29/2022|||NEUROPATHIC PAIN|22392|||||No|No||NOVADOZ PHARMAC|No||||
pregabalin|No|No|No|No|90%|72205001590|PREGABALIN 150 MG CAPSULE|90|EA|.03105|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.10646|03/29/2022|.1039|03/29/2022|.10459|03/29/2022|||NEUROPATHIC PAIN|22393|||||No|No||NOVADOZ PHARMAC|No||||
pregabalin|No|No|No|No|90%|72205001690|PREGABALIN 200 MG CAPSULE|90|EA|.03344|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.11395|03/29/2022|.11121|03/29/2022|.11195|03/29/2022|||NEUROPATHIC PAIN|22394|||||No|No||NOVADOZ PHARMAC|No||||
pregabalin|No|No|No|No|90%|72205001790|PREGABALIN 225 MG CAPSULE|90|EA|.03583|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.12393|03/29/2022|.12095|03/29/2022|.12176|03/29/2022|||NEUROPATHIC PAIN|22395|||||No|No||NOVADOZ PHARMAC|No||||
pregabalin|No|No|No|No|90%|72205001890|PREGABALIN 300 MG CAPSULE|90|EA|.03583|12/16/2019||Yes|No||12/16/2019||Yes|No|12/16/2019||Yes|No||||No|No|||Prescription required|No||232|No|.12181|03/29/2022|.11888|03/29/2022|.11967|03/29/2022|||NEUROPATHIC PAIN|22396|||||No|No||NOVADOZ PHARMAC|No||||
solifenacin succinate|No|No|No|No|75%|72205002030|SOLIFENACIN 5 MG TABLET|30|EA|.14333|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|Yes|.23024|03/29/2022|.22471|03/29/2022|.22621|03/29/2022|||BLADDER RELAXANT PREPARATIONS|22397|||||No|No||NOVADOZ PHARMAC|No||||
solifenacin succinate|No|No|No|No|75%|72205002090|SOLIFENACIN 5 MG TABLET|90|EA|.14333|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|Yes|.23024|03/29/2022|.22471|03/29/2022|.22621|03/29/2022|||BLADDER RELAXANT PREPARATIONS|22398|||||No|No||NOVADOZ PHARMAC|No||||
solifenacin succinate|No|No|No|No|75%|72205002130|SOLIFENACIN 10 MG TABLET|30|EA|.14333|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|No|.26101|03/29/2022|.25474|03/29/2022|.25644|03/29/2022|||BLADDER RELAXANT PREPARATIONS|22399|||||No|No||NOVADOZ PHARMAC|No||||
solifenacin succinate|No|No|No|No|75%|72205002190|SOLIFENACIN 10 MG TABLET|90|EA|.14333|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|006|No|.26101|03/29/2022|.25474|03/29/2022|.25644|03/29/2022|||BLADDER RELAXANT PREPARATIONS|22400|||||No|No||NOVADOZ PHARMAC|No||||
atorvastatin calcium|Yes|No|No|No|75%|72205002205|ATORVASTATIN 10 MG TABLET|500|EA|.05479|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|01/16/2020||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|22401|||||No|No||NOVADOZ PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|72205002290|ATORVASTATIN 10 MG TABLET|90|EA|.03563|07/30/2021||Yes|No||07/30/2021||Yes|No|07/30/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|22402|||||No|No||NOVADOZ PHARMAC|No||||
atorvastatin calcium|Yes|No|No|No|75%|72205002305|ATORVASTATIN 20 MG TABLET|500|EA|.06855|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|01/16/2020||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|22403|||||No|No||NOVADOZ PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|72205002390|ATORVASTATIN 20 MG TABLET|90|EA|.04457|07/30/2021||Yes|No||07/30/2021||Yes|No|07/30/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|22404|||||No|No||NOVADOZ PHARMAC|No||||
atorvastatin calcium|Yes|No|No|No|75%|72205002405|ATORVASTATIN 40 MG TABLET|500|EA|.06855|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|01/16/2020||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|22405|||||No|No||NOVADOZ PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|72205002490|ATORVASTATIN 40 MG TABLET|90|EA|.06454|07/30/2021||Yes|No||07/30/2021||Yes|No|07/30/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|22406|||||No|No||NOVADOZ PHARMAC|No||||
atorvastatin calcium|Yes|No|No|No|75%|72205002505|ATORVASTATIN 80 MG TABLET|500|EA|.07811|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|01/16/2020||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|22407|||||No|No||NOVADOZ PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|72205002590|ATORVASTATIN 80 MG TABLET|90|EA|.0664|07/30/2021||Yes|No||07/30/2021||Yes|No|07/30/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|22408|||||No|No||NOVADOZ PHARMAC|No||||
rosuvastatin calcium|Yes|No|No|No|75%|72205002790|ROSUVASTATIN CALCIUM 5 MG TAB|90|EA|.04777|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|01/16/2020||Prescription required|No||063|Yes|.06753|03/29/2022|.0659|03/29/2022|.06634|03/29/2022|||LIPOTROPICS: STATINS|22409|||||No|No||NOVADOZ PHARMAC|No||||
rosuvastatin calcium|Yes|No|No|No|75%|72205002799|ROSUVASTATIN CALCIUM 5 MG TAB|1000|EA|.06416|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||||No|No|01/16/2020||Prescription required|No||063|Yes|.06753|03/29/2022|.0659|03/29/2022|.06634|03/29/2022|||LIPOTROPICS: STATINS|22410|||||No|No||NOVADOZ PHARMAC|No||||
febuxostat|No|No|No|No|75%|72205002830|FEBUXOSTAT 40 MG TABLET|30|EA|1.08804|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|231|No|.89466|03/29/2022|.87318|03/29/2022|.879|03/29/2022|||ANTIHYPERURICEMICS|22411|||||No|No||NOVADOZ PHARMAC|No||||
febuxostat|No|No|No|No|75%|72205002930|FEBUXOSTAT 80 MG TABLET|30|EA|1.08804|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|231|No|.93355|03/29/2022|.91114|03/29/2022|.91721|03/29/2022|||ANTIHYPERURICEMICS|22412|||||No|No||NOVADOZ PHARMAC|No||||
abiraterone acetate|No|No|No|No|75%|72205003092|ABIRATERONE ACETATE 250 MG TAB|120|EA|.80625|12/17/2019||Yes|No||12/17/2019||Yes|No|12/17/2019||Yes|No||||No|No|||Prescription required|No||550|No|1.8375|09/28/2021|1.81125|09/28/2021|1.725|09/28/2021|||ONCOLOGY: ORAL - PROSTATE|22413|||||No|No||NOVADOZ PHARMAC|No||||
dofetilide|No|No|No|No|75%|72205003960|DOFETILIDE 125 MCG CAPSULE|60|EA|.68778|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|No|||No|1.27252|03/29/2022|1.24197|03/29/2022|1.25025|03/29/2022||||22414|||||No|No||NOVADOZ PHARMAC|No||||
dofetilide|No|No|No|No|75%|72205004060|DOFETILIDE 250 MCG CAPSULE|60|EA|.68778|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|No|||No|.89477|03/29/2022|.87329|03/29/2022|.87911|03/29/2022||||22415|||||No|No||NOVADOZ PHARMAC|No||||
dofetilide|No|No|No|No|75%|72205004160|DOFETILIDE 500 MCG CAPSULE|60|EA|.68778|02/04/2021||Yes|No||02/04/2021||Yes|No|02/04/2021||Yes|No||||No|No|||Prescription required|No|||No|.90796|03/29/2022|.88616|03/29/2022|.89207|03/29/2022||||22416|||||No|No||NOVADOZ PHARMAC|No||||
oseltamivir phosphate|No|No|No|No|75%|72205004211|OSELTAMIVIR PHOS 30 MG CAPSULE|10|EA|.7095|04/23/2021||Yes|No||04/23/2021||Yes|No|04/23/2021||Yes|No||||No|No|||Prescription required|No||025|No|1.58155|03/29/2022|1.54359|03/29/2022|1.55387|03/29/2022|||ANTIVIRALS: ORAL|22417|||||No|No||NOVADOZ PHARMAC|No||||
oseltamivir phosphate|No|No|No|No|75%|72205004311|OSELTAMIVIR PHOS 45 MG CAPSULE|10|EA|.7095|04/23/2021||Yes|No||04/23/2021||Yes|No|04/23/2021||Yes|No||||No|No|||Prescription required|No||025|No|1.5655|03/29/2022|1.52792|03/29/2022|1.5381|03/29/2022|||ANTIVIRALS: ORAL|22418|||||No|No||NOVADOZ PHARMAC|No||||
oseltamivir phosphate|No|No|No|No|75%|72205004411|OSELTAMIVIR PHOS 75 MG CAPSULE|10|EA|.7955|04/23/2021||Yes|No||04/23/2021||Yes|No|04/23/2021||Yes|No||||No|No|||Prescription required|No||025|No|1.29695|03/29/2022|1.26582|03/29/2022|1.27425|03/29/2022|||ANTIVIRALS: ORAL|22419|||||No|No||NOVADOZ PHARMAC|No||||
aminocaproic acid|No|No|No|No|75%|72205004930|AMINOCAPROIC ACID 500 MG TAB|30|EA|7.36666|04/15/2021||Yes|No||04/15/2021||Yes|No|04/15/2021||Yes|No||||No|No|||Prescription required|No|||No|10.61666|04/15/2021|10.46499|04/15/2021|9.96666|04/15/2021||||22420|||||No|No||NOVADOZ PHARMAC|No||||
toremifene citrate|No|No|No|No|75%|72205005030|TOREMIFENE CITRATE 60 MG TAB|30|EA|16.4045|04/23/2021||Yes|No||04/23/2021||Yes|No|04/23/2021||Yes|No||||No|No|||Prescription required|No||502|No|37.387|04/23/2021|36.8529|04/23/2021|35.098|04/23/2021|||ONCOLOGY: ORAL - BREAST|22421|||||No|No||NOVADOZ PHARMAC|No||||
albendazole|No|No|No|No|75%|72205005108|ALBENDAZOLE 200 MG TABLET|2|EA|12.84625|09/27/2021||Yes|No||09/27/2021||Yes|No|09/27/2021||Yes|No||||No|No|||Prescription required|No|||No|16.91042|03/29/2022|16.50456|03/29/2022|16.61448|03/29/2022||||22422|||||No|No||NOVADOZ PHARMAC|No||||
droxidopa|No|No|No|No|75%|72205007290|DROXIDOPA 100 MG CAPSULE|90|EA|.47777|09/27/2021||Yes|No||09/27/2021||Yes|No|09/27/2021||Yes|No||||No|No|||Prescription required|No|||No|1.08888|03/15/2022|1.07333|03/15/2022|1.02222|03/15/2022||||22423|||||No|No||NOVADOZ PHARMAC|No||||
droxidopa|No|No|No|No|75%|72205007390|DROXIDOPA 200 MG CAPSULE|90|EA|.95555|09/27/2021||Yes|No||09/27/2021||Yes|No|09/27/2021||Yes|No||||No|No|||Prescription required|No|||No|2.17777|03/15/2022|2.14666|03/15/2022|2.04444|03/15/2022||||22424|||||No|No||NOVADOZ PHARMAC|No||||
droxidopa|No|No|No|No|75%|72205007490|DROXIDOPA 300 MG CAPSULE|90|EA|1.43333|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|No|||No|3.26666|03/15/2022|3.21999|03/15/2022|3.06666|03/15/2022||||22425|||||No|No||NOVADOZ PHARMAC|No||||
deferasirox|No|No|No|No|75%|72205007530|DEFERASIROX 180 MG GRANULE PKT|30|EA|29.38304|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|No|||No|66.966|09/22/2021|66.00934|09/22/2021|62.86604|09/22/2021||||22426|||||No|No||NOVADOZ PHARMAC|No||||
deferasirox|No|No|No|No|75%|72205007630|DEFERASIROX 360 MG GRANULE PKT|30|EA|58.7648|09/28/2021||Yes|No||09/28/2021||Yes|No|09/28/2021||Yes|No||||No|No|||Prescription required|No|||No|133.92908|09/28/2021|132.01581|09/28/2021|125.72934|09/28/2021||||22427|||||No|No||NOVADOZ PHARMAC|No||||
pregabalin|No|No|No|No|90%|72205007730|PREGABALIN ER 82.5 MG TABLET|30|EA|4.12398|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|232|No|9.39884|09/22/2021|9.26457|09/22/2021|8.8234|09/22/2021|||NEUROPATHIC PAIN|22428|||||No|No||NOVADOZ PHARMAC|No||||
pregabalin|No|No|No|No|90%|72205007830|PREGABALIN ER 165 MG TABLET|30|EA|4.12398|09/27/2021||Yes|No||09/27/2021||Yes|No|09/27/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|232|No|9.39884|09/27/2021|9.26457|09/27/2021|8.8234|09/27/2021|||NEUROPATHIC PAIN|22429|||||No|No||NOVADOZ PHARMAC|No||||
pregabalin|No|No|No|No|90%|72205007930|PREGABALIN ER 330 MG TABLET|30|EA|4.12398|09/22/2021||Yes|No||09/22/2021||Yes|No|09/22/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|232|No|9.39884|09/22/2021|9.26457|09/22/2021|8.8234|09/22/2021|||NEUROPATHIC PAIN|22430|||||No|No||NOVADOZ PHARMAC|No||||
selinexor|No|No|No|No|75%|72237010101|XPOVIO 60 MG ONCE WEEKLY DOSE|12|EA|826.96166|08/14/2020|07/06/2022|Yes|No||08/14/2020|07/06/2022|Yes|No|08/14/2020|07/06/2022|Yes|No||||No|No|||Prescription required|No||173|No|1884.70332|04/06/2021|1857.77899|04/06/2021|1769.31332|04/06/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|22431|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||KARYOPHARM THER|No||||
selinexor|No|No|No|No|75%|72237010102|XPOVIO 80 MG ONCE WEEKLY DOSE|16|EA|620.22125|08/14/2020|07/06/2022|Yes|No||08/14/2020|07/06/2022|Yes|No|08/14/2020|07/06/2022|Yes|No||||No|No|||Prescription required|No||173|No|1413.5275|04/06/2021|1393.33425|04/06/2021|1326.985|04/06/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|22432|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||KARYOPHARM THER|No||||
selinexor|No|No|No|No|75%|72237010104|XPOVIO 80 MG TWICE WEEKLY DOSE|32|EA|331.51656|08/14/2020||Yes|No||08/14/2020||Yes|No|08/14/2020||Yes|No||||No|No|||Prescription required|No||173|No|755.54937|01/04/2022|744.75581|01/04/2022|709.29125|01/04/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|22433|||||No|No||KARYOPHARM THER|No||||
selinexor|No|No|No|No|75%|72237010105|XPOVIO 100 MG ONCE WEEKLY DOSE|20|EA|496.177|08/14/2020|07/06/2022|Yes|No||08/14/2020|07/06/2022|Yes|No|08/14/2020|07/06/2022|Yes|No||||No|No|||Prescription required|No||173|No|1130.822|04/06/2021|1114.6674|04/06/2021|1061.588|04/06/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|22434|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||KARYOPHARM THER|No||||
selinexor|No|No|No|No|75%|72237010202|XPOVIO 80 MG ONCE WEEKLY DOSE|8|EA|1326.06625|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||173|No|3022.1975|01/04/2022|2979.02325|01/04/2022|2837.165|01/04/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|22435|||||No|No||KARYOPHARM THER|No||||
selinexor|No|No|No|No|75%|72237010206|XPOVIO 40 MG TWICE WEEKLY DOSE|8|EA|1326.06625|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||173|No|3022.1975|01/04/2022|2979.02325|01/04/2022|2837.165|01/04/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|22436|||||No|No||KARYOPHARM THER|No||||
selinexor|No|No|No|No|75%|72237010207|XPOVIO 40 MG ONCE WEEKLY DOSE|4|EA|2652.1325|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||173|No|6044.395|01/04/2022|5958.0465|01/04/2022|5674.33|01/04/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|22437|||||No|No||KARYOPHARM THER|No||||
selinexor|No|No|No|No|75%|72237010305|XPOVIO 100 MG ONCE WEEKLY DOSE|8|EA|1326.06625|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||173|No|3022.1975|01/04/2022|2979.02325|01/04/2022|2837.165|01/04/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|22438|||||No|No||KARYOPHARM THER|No||||
selinexor|No|No|No|No|75%|72237010401|XPOVIO 60 MG ONCE WEEKLY DOSE|4|EA|2652.1325|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|No||173|No|6044.395|01/04/2022|5958.0465|01/04/2022|5674.33|01/04/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|22439|||||No|No||KARYOPHARM THER|No||||
diazepam|No|No|No|No|75%|72252050502|VALTOCO 5 MG NASAL SPRAY|2|EA|134.0052|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|No||056|No|305.4072|01/04/2022|301.04424|01/04/2022|286.7088|01/04/2022|||ANTICONVULSANTS|22440|||||No|No||NEURELIS INC.|No||||
diazepam|No|No|No|No|75%|72252051002|VALTOCO 10 MG NASAL SPRAY|2|EA|134.0052|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|No||056|No|298.9518|01/11/2022|291.77695|01/11/2022|293.72014|01/11/2022|||ANTICONVULSANTS|22441|||||No|No||NEURELIS INC.|No||||
diazepam|No|No|No|No|75%|72252051504|VALTOCO 15 MG NASAL SPRAY|2|EA|134.0052|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|No||056|No|299.79753|01/11/2022|292.60238|01/11/2022|294.55107|01/11/2022|||ANTICONVULSANTS|22442|||||No|No||NEURELIS INC.|No||||
diazepam|No|No|No|No|75%|72252052004|VALTOCO 20 MG NASAL SPRAY|2|EA|134.0052|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|No||056|No|298.96876|01/11/2022|291.7935|01/11/2022|293.7368|01/11/2022|||ANTICONVULSANTS|22443|||||No|No||NEURELIS INC.|No||||
levothyroxine sodium|No|No|No|No|75%|72305002530|EUTHYROX 25 MCG TABLET|30|EA|.15666|08/20/2020||Yes|No||08/20/2020||Yes|No|08/20/2020||Yes|No||||No|No|||Prescription required|No|||No|.35704|08/20/2020|.35194|08/20/2020|.33518|08/20/2020||||22444|||||No|No||PROVELL PHARMAC|No||||
levothyroxine sodium|No|No|No|No|75%|72305005030|EUTHYROX 50 MCG TABLET|30|EA|.17773|08/20/2020||Yes|No||08/20/2020||Yes|No|08/20/2020||Yes|No||||No|No|||Prescription required|No|||No|.40506|08/20/2020|.39927|08/20/2020|.38026|08/20/2020||||22445|||||No|No||PROVELL PHARMAC|No||||
levothyroxine sodium|No|No|No|No|75%|72305007530|EUTHYROX 75 MCG TABLET|30|EA|.19651|08/20/2020||Yes|No||08/20/2020||Yes|No|08/20/2020||Yes|No||||No|No|||Prescription required|No|||No|.44786|08/20/2020|.44146|08/20/2020|.42044|08/20/2020||||22446|||||No|No||PROVELL PHARMAC|No||||
levothyroxine sodium|No|No|No|No|75%|72305008830|EUTHYROX 88 MCG TABLET|30|EA|.1998|08/20/2020||Yes|No||08/20/2020||Yes|No|08/20/2020||Yes|No||||No|No|||Prescription required|No|||No|.45536|08/20/2020|.44886|08/20/2020|.42748|08/20/2020||||22447|||||No|No||PROVELL PHARMAC|No||||
levothyroxine sodium|No|No|No|No|75%|72305010030|EUTHYROX 100 MCG TABLET|30|EA|.20138|08/20/2020||Yes|No||08/20/2020||Yes|No|08/20/2020||Yes|No||||No|No|||Prescription required|No|||No|.45896|08/20/2020|.4524|08/20/2020|.43086|08/20/2020||||22448|||||No|No||PROVELL PHARMAC|No||||
levothyroxine sodium|No|No|No|No|75%|72305011230|EUTHYROX 112 MCG TABLET|30|EA|.23291|08/20/2020||Yes|No||08/20/2020||Yes|No|08/20/2020||Yes|No||||No|No|||Prescription required|No|||No|.53082|08/20/2020|.52324|08/20/2020|.49832|08/20/2020||||22449|||||No|No||PROVELL PHARMAC|No||||
levothyroxine sodium|No|No|No|No|75%|72305012530|EUTHYROX 125 MCG TABLET|30|EA|.23607|08/20/2020||Yes|No||08/20/2020||Yes|No|08/20/2020||Yes|No||||No|No|||Prescription required|No|||No|.53802|08/20/2020|.53033|08/20/2020|.50508|08/20/2020||||22450|||||No|No||PROVELL PHARMAC|No||||
levothyroxine sodium|No|No|No|No|75%|72305013730|EUTHYROX 137 MCG TABLET|30|EA|.24051|08/20/2020||Yes|No||08/20/2020||Yes|No|08/20/2020||Yes|No||||No|No|||Prescription required|No|||No|.54814|08/20/2020|.54031|08/20/2020|.51458|08/20/2020||||22451|||||No|No||PROVELL PHARMAC|No||||
levothyroxine sodium|No|No|No|No|75%|72305015030|EUTHYROX 150 MCG TABLET|30|EA|.24295|08/20/2020||Yes|No||08/20/2020||Yes|No|08/20/2020||Yes|No||||No|No|||Prescription required|No|||No|.5537|08/20/2020|.54579|08/25/2020|.5198|08/25/2020||||22452|||||No|No||PROVELL PHARMAC|No||||
levothyroxine sodium|No|No|No|No|75%|72305017530|EUTHYROX 175 MCG TABLET|30|EA|.28881|08/20/2020||Yes|No||08/20/2020||Yes|No|08/20/2020||Yes|No||||No|No|||Prescription required|No|||No|.65822|08/20/2020|.64882|08/20/2020|.61792|08/20/2020||||22453|||||No|No||PROVELL PHARMAC|No||||
levothyroxine sodium|No|No|No|No|75%|72305020030|EUTHYROX 200 MCG TABLET|30|EA|.28939|08/20/2020||Yes|No||08/20/2020||Yes|No|08/20/2020||Yes|No||||No|No|||Prescription required|No|||No|.65954|08/20/2020|.65011|08/20/2020|.61916|08/20/2020||||22454|||||No|No||PROVELL PHARMAC|No||||
naloxone HCl|No|No|No|No|75%|72336007719|LIFEMS NALOXONE 2 MG/2 ML KIT|1|EA|721.54|03/15/2021||Yes|No||03/15/2021||Yes|No|03/15/2021||Yes|No||||No|No|||Prescription required|No|||No|1644.44|03/15/2021|1620.948|03/23/2021|1543.76|03/15/2021||||22455|||||No|No||LIFSA DRUGS LLC|Yes|09/01/2020|||
minocycline HCl|No|No|No|No|75%|72356010103|AMZEEQ 4% FOAM|30|GM|6.95166|03/09/2020||Yes|No||03/09/2020||Yes|No|03/09/2020||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|104|No|15.54147|03/01/2022|15.16847|03/01/2022|15.26949|03/01/2022|||ACNE AGENTS: TOPICAL|22456|||||No|No||VYNE/JOURNEY|No||||
bempedoic acid|No|No|No|No|75%|72426011803|NEXLETOL 180 MG TABLET|30|EA|5.51016|06/19/2020||Yes|No||06/19/2020||Yes|No|06/19/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|055|No|12.27254|01/18/2022|11.97799|01/18/2022|12.05777|01/18/2022|||LIPOTROPICS: OTHER|22457|||||No|No||ESPERION THERAP|No||||
bempedoic acid/ezetimibe|No|No|No|No|75%|72426081803|NEXLIZET 180-10 MG TABLET|30|EA|5.51016|11/09/2020||Yes|No||11/09/2020||Yes|No|11/09/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|055|No|12.29756|01/18/2022|12.00241|01/18/2022|12.08235|01/18/2022|||LIPOTROPICS: OTHER|22458|||||No|No||ESPERION THERAP|No||||
diphenhydramine HCl|No|No|No|No|75%|72485010125|DIPHENHYDRAMINE 50 MG/ML VIAL|1|ML|2.15|12/20/2019||Yes|No||12/20/2019||Yes|No|12/20/2019||Yes|No||||No|No|||Prescription required|No|||Yes|.92147|03/29/2022|.89935|03/29/2022|.90534|03/29/2022||||22459|||||No|No||ARMAS PHARMACEU|No||||
azacitidine|No|No|No|No|75%|72485020101|AZACITIDINE 100 MG VIAL|1|EA|45.15|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No|||No|102.9|12/24/2019|101.43|12/24/2019|96.6|12/19/2019||||22460|||||No|No||ARMAS PHARMACEU|No||||
imatinib mesylate|No|No|No|No|75%|72485020290|IMATINIB MESYLATE 100 MG TAB|90|EA|.52555|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|No||173|No|1.19777|07/27/2021|1.18066|07/27/2021|1.12444|07/27/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|22461|||||No|No||ARMAS PHARMACEU|No||||
imatinib mesylate|No|No|No|No|75%|72485020330|IMATINIB MESYLATE 400 MG TAB|30|EA|1.86333|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|No||173|No|2.86988|03/01/2022|2.801|03/01/2022|2.81965|03/01/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|22462|||||No|No||ARMAS PHARMACEU|No||||
capecitabine|No|No|No|No|75%|72485020460|CAPECITABINE 150 MG TABLET|60|EA|.215|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No||502|No|.49|12/19/2019|.483|12/19/2019|.46|12/19/2019|||ONCOLOGY: ORAL - BREAST|22463|||||No|No||ARMAS PHARMACEU|No||||
capecitabine|No|No|No|No|75%|72485020512|CAPECITABINE 500 MG TABLET|120|EA|.43|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No||502|No|.61977|12/28/2021|.60489|12/28/2021|.60892|12/28/2021|||ONCOLOGY: ORAL - BREAST|22464|||||No|No||ARMAS PHARMACEU|No||||
irinotecan HCl|No|No|No|No|75%|72485021102|IRINOTECAN HCL 40 MG/2 ML VIAL|2|ML|1.935|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No|||No|4.41|12/19/2019|4.347|12/24/2019|4.14|12/19/2019||||22465|||||No|No||ARMAS PHARMACEU|No||||
irinotecan HCl|No|No|No|No|75%|72485021205|IRINOTECAN HCL 100 MG/5 ML VL|5|ML|1.548|12/19/2019||Yes|No||12/19/2019||Yes|No|12/19/2019||Yes|No||||No|No|||Prescription required|No|||No|3.528|12/19/2019|3.4776|12/19/2019|3.312|12/19/2019||||22466|||||No|No||ARMAS PHARMACEU|No||||
estradiol acetate|No|No|No|No|75%|72495020105|FEMRING 0.05 MG/DAY VAG RING|1|EA|273.5273|05/20/2019||Yes|No||||No|No|05/20/2019||Yes|No||||No|No|||Prescription required|No|||Yes|607.05124|01/04/2022|592.48201|01/04/2022|596.42784|01/04/2022||||22467|||||No|No||MILLICENT PHARM|No||||
estradiol acetate|No|No|No|No|75%|72495020210|FEMRING 0.10 MG/DAY VAG RING|1|EA|291.4798|05/20/2019||Yes|No||||No|No|05/20/2019||Yes|No||||No|No|||Prescription required|No|||Yes|650.48631|01/04/2022|634.87463|01/04/2022|639.10279|01/04/2022||||22468|||||No|No||MILLICENT PHARM|No||||
evolocumab|No|No|No|No|75%|72511075001|REPATHA 140 MG/ML SYRINGE|1|ML|108.5062|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|055|Yes|243.90009|02/08/2022|238.04648|02/08/2022|239.63183|02/08/2022|||LIPOTROPICS: OTHER|22469|||||No|No||AMGEN USA INC.|No||||
evolocumab|No|No|No|No|75%|72511076002|REPATHA 140 MG/ML SURECLICK|1|ML|108.50405|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|055|Yes|244.51762|02/08/2022|238.64919|02/08/2022|240.23856|02/08/2022|||LIPOTROPICS: OTHER|22470|||||No|No||AMGEN USA INC.|No||||
evolocumab|No|No|No|No|75%|72511077001|REPATHA 420 MG/3.5ML PUSHTRONX|3.5|ML|67.16968|02/27/2019||Yes|No||02/27/2019||Yes|No|02/27/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|055|Yes|151.95094|02/08/2022|148.30411|02/08/2022|149.29179|02/08/2022|||LIPOTROPICS: OTHER|22471|||||No|No||AMGEN USA INC.|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|72516001101|DEXTROAMP-AMPHETAMIN 30 MG TAB|100|EA|.13351|01/20/2022||Yes|No||01/20/2022||Yes|No|01/20/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.30925|03/29/2022|.30182|03/29/2022|.30383|03/29/2022|||STIMULANTS AND RELATED AGENTS|22472|||||No|No||ORYZA PHARMACEU|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|72516001201|DEXTROAMP-AMPHETAMIN 20 MG TAB|100|EA|.12491|01/20/2022||Yes|No||01/20/2022||Yes|No|01/20/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.31357|03/29/2022|.30604|03/29/2022|.30808|03/29/2022|||STIMULANTS AND RELATED AGENTS|22473|||||No|No||ORYZA PHARMACEU|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|72516001301|DEXTROAMP-AMPHETAMIN 15 MG TAB|100|EA|.12061|01/20/2022||Yes|No||01/20/2022||Yes|No|01/20/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.25605|03/29/2022|.2499|03/29/2022|.25156|03/29/2022|||STIMULANTS AND RELATED AGENTS|22474|||||No|No||ORYZA PHARMACEU|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|72516001401|DEXTROAMP-AMPHETAMIN 10 MG TAB|100|EA|.10341|01/20/2022||Yes|No||01/20/2022||Yes|No|01/20/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.24071|03/29/2022|.23493|03/29/2022|.23649|03/29/2022|||STIMULANTS AND RELATED AGENTS|22475|||||No|No||ORYZA PHARMACEU|No||||
dextroamphetamine/amphetamine|No|No|No|No|75%|72516001601|DEXTROAMP-AMPHETAMINE 5 MG TAB|100|EA|.08621|01/20/2022||Yes|No||01/20/2022||Yes|No|01/20/2022||Yes|No||||No|No|||Prescription required|No||007|Yes|.21985|03/29/2022|.21457|03/29/2022|.216|03/29/2022|||STIMULANTS AND RELATED AGENTS|22476|||||No|No||ORYZA PHARMACEU|No||||
daptomycin|No|No|No|No|75%|72572010201|DAPTOMYCIN 500 MG VIAL|1|EA|10.9263|04/13/2020||Yes|No||04/13/2020||Yes|No|04/13/2020||Yes|No||||No|No|||Prescription required|No|||No|24.9018|04/27/2021|24.54606|04/27/2021|23.3772|04/27/2021||||22477|||||No|No||CIVICA, INC.|No||||
naloxone HCl|No|No|No|No|75%|72572045001|NALOXONE 0.4 MG/ML VIAL|1|ML|6.8069|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|||||||15.5134|10/01/2020|OPIATE DEPENDENCE TREATMENTS|22478|||||No|No||CIVICA, INC.|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|72572045025|NALOXONE 0.4 MG/ML VIAL|1|ML|1.8877|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|4.3022|10/01/2020|4.24074|10/01/2020|4.0388|10/01/2020|||OPIATE DEPENDENCE TREATMENTS|22479|||||No|No||CIVICA, INC.|Yes|09/01/2020|||
vancomycin HCl|No|No|No|No|75%|72572080101|VANCOMYCIN 1 GM VIAL|1|EA||04/23/2021||Yes|No||04/23/2021||Yes|No|04/23/2021||Yes|No||||No|No|||Prescription required|No|||No|||||||1571920|04/23/2021||22480|||||No|No||CIVICA, INC.|No||||
vancomycin HCl|No|No|No|No|75%|72572080102|VANCOMYCIN 1 GM VIAL|1|EA|1.4835|04/13/2020||Yes|No||04/13/2020||Yes|No|04/13/2020||Yes|No||||No|No|||Prescription required|No|||No|3.381|04/13/2020|3.3327|04/13/2020|3.174|04/13/2020||||22481|||||No|No||CIVICA, INC.|No||||
vancomycin HCl|No|No|No|No|75%|72572080301|VANCOMYCIN HCL 5 GM VIAL|1|EA|7.0649|04/13/2020||Yes|No||04/13/2020||Yes|No|04/13/2020||Yes|No||||No|No|||Prescription required|No|||No|16.1014|04/21/2020|15.87138|04/21/2020|15.1156|04/13/2020||||22482|||||No|No||CIVICA, INC.|No||||
vancomycin HCl|No|No|No|No|75%|72572080501|VANCOMYCIN HCL 10 GM VIAL|1|EA|14.0395|04/13/2020||Yes|No||04/13/2020||Yes|No|04/13/2020||Yes|No||||No|No|||Prescription required|No|||No|31.997|04/21/2020|31.5399|04/13/2020|30.038|04/13/2020||||22483|||||No|No||CIVICA, INC.|No||||
doxycycline hyclate|Yes|No|No|No|75%|72578000105|DOXYCYCLINE HYCLATE 100 MG TAB|500|EA|.1204|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|03/20/2020||Prescription required|Yes|07/25/2019|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|22484|||||No|No||VIONA PHARMACEU|No||||
doxycycline hyclate|Yes|No|No|No|75%|72578000118|DOXYCYCLINE HYCLATE 100 MG TAB|50|EA|.129|02/21/2020||Yes|No||02/21/2020||Yes|No|02/21/2020||Yes|No||||No|No|03/20/2020||Prescription required|Yes|07/25/2019|213|No|.14445|03/29/2022|.14098|03/29/2022|.14192|03/29/2022|||TETRACYCLINES|22485|||||No|No||VIONA PHARMACEU|No||||
acyclovir|No|No|No|No|75%|72578000201|ACYCLOVIR 200 MG CAPSULE|100|EA|.0645|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||025|No|.11267|03/29/2022|.10996|03/29/2022|.11069|03/29/2022|||ANTIVIRALS: ORAL|22486|||||No|No||VIONA PHARMACEU|No||||
acyclovir|No|No|No|No|75%|72578000205|ACYCLOVIR 200 MG CAPSULE|500|EA|.06321|06/08/2021||Yes|No||06/08/2021||Yes|No|06/08/2021||Yes|No||||No|No|||Prescription required|No||025|No|.11267|03/29/2022|.10996|03/29/2022|.11069|03/29/2022|||ANTIVIRALS: ORAL|22487|||||No|No||VIONA PHARMACEU|No||||
memantine HCl|No|No|No|No|75%|72578000305|MEMANTINE HCL 5 MG TABLET|500|EA|.06888|03/03/2020||Yes|No||03/03/2020||Yes|No|03/03/2020||Yes|No||||No|No|||Prescription required|No||011|No|.08825|03/29/2022|.08613|03/29/2022|.0867|03/29/2022|||ALZHEIMER'S AGENTS|22488|||||No|No||VIONA PHARMACEU|No||||
memantine HCl|No|No|No|No|75%|72578000314|MEMANTINE HCL 5 MG TABLET|60|EA|.07238|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|No||011|No|.08825|03/29/2022|.08613|03/29/2022|.0867|03/29/2022|||ALZHEIMER'S AGENTS|22489|||||No|No||VIONA PHARMACEU|No||||
memantine HCl|No|No|No|No|75%|72578000405|MEMANTINE HCL 10 MG TABLET|500|EA|.08772|05/19/2020||Yes|No||05/19/2020||Yes|No|05/19/2020||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|22490|||||No|No||VIONA PHARMACEU|No||||
memantine HCl|No|No|No|No|75%|72578000414|MEMANTINE HCL 10 MG TABLET|60|EA|.08778|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|22491|||||No|No||VIONA PHARMACEU|No||||
metronidazole|Yes|No|No|No|75%|72578000701|METRONIDAZOLE 250 MG TABLET|100|EA|.08127|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||04/01/2020||Yes|No|01/16/2020||Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|22492|||||No|No||VIONA PHARMACEU|No||||
metronidazole|Yes|No|No|No|75%|72578000705|METRONIDAZOLE 250 MG TABLET|500|EA|.07568|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||04/01/2020||Yes|No|01/16/2020||Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|22493|||||No|No||VIONA PHARMACEU|No||||
metronidazole|Yes|No|No|No|75%|72578000721|METRONIDAZOLE 250 MG TABLET|250|EA|.0774|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||04/01/2020||Yes|No|01/16/2020||Prescription required|No||115|No|.12057|03/29/2022|.11767|03/29/2022|.11846|03/29/2022|||ANTIBIOTICS: GI|22494|||||No|No||VIONA PHARMACEU|No||||
metronidazole|Yes|No|No|No|75%|72578000801|METRONIDAZOLE 500 MG TABLET|100|EA|.1548|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||04/01/2020||Yes|No|01/16/2020||Prescription required|No||115|No|.15479|03/29/2022|.15107|03/29/2022|.15208|03/29/2022|||ANTIBIOTICS: GI|22495|||||No|No||VIONA PHARMACEU|No||||
metronidazole|Yes|No|No|No|75%|72578000805|METRONIDAZOLE 500 MG TABLET|500|EA|.14706|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||04/01/2020||Yes|No|01/16/2020||Prescription required|No||115|No|.15479|03/29/2022|.15107|03/29/2022|.15208|03/29/2022|||ANTIBIOTICS: GI|22496|||||No|No||VIONA PHARMACEU|No||||
metronidazole|Yes|No|No|No|75%|72578000818|METRONIDAZOLE 500 MG TABLET|50|EA|.16254|09/20/2019||Yes|No||09/20/2019||Yes|No|09/20/2019||Yes|No||04/01/2020||Yes|No|01/16/2020||Prescription required|No||115|No|.15479|03/29/2022|.15107|03/29/2022|.15208|03/29/2022|||ANTIBIOTICS: GI|22497|||||No|No||VIONA PHARMACEU|No||||
metformin HCl|Yes|No|No|No|75%|72578003601|METFORMIN HCL ER 750 MG TABLET|100|EA|.08268|06/02/2020||Yes|No||06/02/2020||Yes|No|06/02/2020||Yes|No||||No|No|09/21/2020||Prescription required|No||012|No|.09354|03/29/2022|.09129|03/29/2022|.0919|03/29/2022|||HYPOGLYCEMICS: METFORMINS|22498|||||No|No||VIONA PHARMACEU|No||||
felbamate|No|No|No|No|75%|72578005601|FELBAMATE 400 MG TABLET|100|EA|.60002|08/20/2021||Yes|No||08/20/2021||Yes|No|08/20/2021||Yes|No||||No|No|||Prescription required|No||056|No|1.17562|10/26/2021|1.1474|10/26/2021|1.15504|10/26/2021|||ANTICONVULSANTS|22499|||||No|No||VIONA PHARMACEU|No||||
felbamate|No|No|No|No|75%|72578005616|FELBAMATE 400 MG TABLET|90|EA|.63496|08/20/2021||Yes|No||08/20/2021||Yes|No|08/20/2021||Yes|No||||No|No|||Prescription required|No||056|No|1.17562|10/26/2021|1.1474|10/26/2021|1.15504|10/26/2021|||ANTICONVULSANTS|22500|||||No|No||VIONA PHARMACEU|No||||
felbamate|No|No|No|No|75%|72578005701|FELBAMATE 600 MG TABLET|100|EA|.77795|08/20/2021||Yes|No||08/20/2021||Yes|No|08/20/2021||Yes|No||||No|No|||Prescription required|No||056|No|1.94824|03/29/2022|1.90148|03/29/2022|1.91414|03/29/2022|||ANTICONVULSANTS|22501|||||No|No||VIONA PHARMACEU|No||||
felbamate|No|No|No|No|75%|72578005716|FELBAMATE 600 MG TABLET|90|EA|.8232|08/20/2021||Yes|No||08/20/2021||Yes|No|08/20/2021||Yes|No||||No|No|||Prescription required|No||056|No|1.94824|03/29/2022|1.90148|03/29/2022|1.91414|03/29/2022|||ANTICONVULSANTS|22502|||||No|No||VIONA PHARMACEU|No||||
voriconazole|No|No|No|No|75%|72578006206|VORICONAZOLE 50 MG TABLET|30|EA|.93166|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|069|No|2.12332|03/24/2020|2.09299|03/24/2020|1.99332|03/24/2020|||ANTIFUNGALS: ORAL|22503|||||No|No||VIONA PHARMACEU|No||||
voriconazole|No|No|No|No|75%|72578006306|VORICONAZOLE 200 MG TABLET|30|EA|3.225|12/18/2019||Yes|No||12/18/2019||Yes|No|12/18/2019||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|069|No|2.07998|03/29/2022|2.03006|03/29/2022|2.04358|03/29/2022|||ANTIFUNGALS: ORAL|22504|||||No|No||VIONA PHARMACEU|No||||
ranolazine|No|No|No|No|75%|72578006414|RANOLAZINE ER 500 MG TABLET|60|EA|.28666|05/19/2020||Yes|No||05/19/2020||Yes|No|05/19/2020||Yes|No||||No|No|||Prescription required|No|||Yes|.28604|03/29/2022|.27917|03/29/2022|.28103|03/29/2022||||22505|||||No|No||VIONA PHARMACEU|No||||
ranolazine|No|No|No|No|75%|72578006514|RANOLAZINE ER 1,000 MG TABLET|60|EA|.50166|05/19/2020||Yes|No||05/19/2020||Yes|No|05/19/2020||Yes|No||||No|No|||Prescription required|No|||Yes|.43283|03/29/2022|.42244|03/29/2022|.42525|03/29/2022||||22506|||||No|No||VIONA PHARMACEU|No||||
acyclovir|No|No|No|No|75%|72578008201|ACYCLOVIR 5% OINTMENT|15|GM|1.56118|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.36934|03/29/2022|1.33647|03/29/2022|1.34537|03/29/2022|||ANTIVIRALS: TOPICAL|22507|||||No|No||VIONA PHARMACEU|No||||
acyclovir|No|No|No|No|75%|72578008206|ACYCLOVIR 5% OINTMENT|30|GM|1.29|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|123|No|1.03754|03/29/2022|1.01263|03/29/2022|1.01938|03/29/2022|||ANTIVIRALS: TOPICAL|22508|||||No|No||VIONA PHARMACEU|No||||
clindamycin phosphate|No|No|No|No|75%|72578008402|CLINDAMYCIN PH 1% SOLUTION|30|ML|.26516|05/18/2021||Yes|No||05/18/2021||Yes|No|05/18/2021||Yes|No||||No|No|||Prescription required|No||104|No|.23242|03/29/2022|.22684|03/29/2022|.22835|03/29/2022|||ACNE AGENTS: TOPICAL|22509|||||No|No||VIONA PHARMACEU|No||||
clindamycin phosphate|No|No|No|No|75%|72578008403|CLINDAMYCIN PH 1% SOLUTION|60|ML|.258|05/17/2021||Yes|No||05/17/2021||Yes|No|05/17/2021||Yes|No||||No|No|||Prescription required|No||104|No|.19863|03/29/2022|.19386|03/29/2022|.19515|03/29/2022|||ACNE AGENTS: TOPICAL|22510|||||No|No||VIONA PHARMACEU|No||||
desonide|No|No|No|No|75%|72578008601|DESONIDE 0.05% CREAM|15|GM|.58938|12/07/2020||Yes|No||12/07/2020||Yes|No|12/07/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|118|No|.68707|03/29/2022|.67058|03/29/2022|.67504|03/29/2022|||STEROIDS: TOPICAL LOW|22511|||||No|No||VIONA PHARMACEU|No||||
desonide|No|No|No|No|75%|72578008602|DESONIDE 0.05% CREAM|60|GM|.58945|02/10/2021||Yes|No||02/10/2021||Yes|No|02/10/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|118|No|.61157|03/29/2022|.59689|03/29/2022|.60086|03/29/2022|||STEROIDS: TOPICAL LOW|22512|||||No|No||VIONA PHARMACEU|No||||
fluocinonide|No|No|No|No|75%|72578008702|FLUOCINONIDE 0.1% CREAM|60|GM|.20425|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|120|No|.22927|03/29/2022|.22376|03/29/2022|.22525|03/29/2022|||STEROIDS: TOPICAL HIGH|22513|||||No|No||VIONA PHARMACEU|No||||
fluocinonide|No|No|No|No|75%|72578008706|FLUOCINONIDE 0.1% CREAM|30|GM|.23707|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|120|No|.34413|01/25/2022|.33587|01/25/2022|.3381|01/25/2022|||STEROIDS: TOPICAL HIGH|22514|||||No|No||VIONA PHARMACEU|No||||
fluocinonide|No|No|No|No|75%|72578008707|FLUOCINONIDE 0.1% CREAM|120|GM|.19403|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|120|No|.44222|04/27/2021|.4359|04/27/2021|.41515|04/27/2021|||STEROIDS: TOPICAL HIGH|22515|||||No|No||VIONA PHARMACEU|No||||
nystatin/triamcin|No|No|No|No|75%|72578008801|NYSTATIN-TRIAMCINOLONE OINTM|15|GM|.59483|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|061|No|.4296|03/29/2022|.41928|03/29/2022|.42208|03/29/2022|||ANTIFUNGALS: TOPICAL|22516|||||No|No||VIONA PHARMACEU|No||||
nystatin/triamcin|No|No|No|No|75%|72578008802|NYSTATIN-TRIAMCINOLONE OINTM|60|GM|.3096|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|061|No|.24511|03/29/2022|.23922|03/29/2022|.24082|03/29/2022|||ANTIFUNGALS: TOPICAL|22517|||||No|No||VIONA PHARMACEU|No||||
nystatin/triamcin|No|No|No|No|75%|72578008804|NYSTATIN-TRIAMCINOLONE OINTM|30|GM|.4171|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|061|No|.33412|03/29/2022|.3261|03/29/2022|.32827|03/29/2022|||ANTIFUNGALS: TOPICAL|22518|||||No|No||VIONA PHARMACEU|No||||
nystatin|No|No|No|No|75%|72578008901|NYSTATIN 100,000 UNIT/GM OINT|15|GM|.344|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No||061|No|.33338|03/29/2022|.32537|03/29/2022|.32754|03/29/2022|||ANTIFUNGALS: TOPICAL|22519|||||No|No||VIONA PHARMACEU|No||||
nystatin|No|No|No|No|75%|72578008904|NYSTATIN 100,000 UNIT/GM OINT|30|GM|.27233|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|No||061|No|.27525|03/29/2022|.26864|03/29/2022|.27043|03/29/2022|||ANTIFUNGALS: TOPICAL|22520|||||No|No||VIONA PHARMACEU|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|72578009001|TRIAMTERENE-HCTZ 37.5-25 MG CP|100|EA|.09047|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No|||Yes|.14661|03/29/2022|.14309|03/29/2022|.14404|03/29/2022||||22521|||||No|No||VIONA PHARMACEU|No||||
triamterene/hydrochlorothiazid|No|No|No|No|75%|72578009010|TRIAMTERENE-HCTZ 37.5-25 MG CP|1000|EA|.08737|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No|||Yes|.14661|03/29/2022|.14309|03/29/2022|.14404|03/29/2022||||22522|||||No|No||VIONA PHARMACEU|No||||
desoximetasone|No|No|No|No|75%|72578009101|DESOXIMETASONE 0.25% CREAM|15|GM|.57333|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|120|No|.62238|03/29/2022|.60744|03/29/2022|.61148|03/29/2022|||STEROIDS: TOPICAL HIGH|22523|||||No|No||VIONA PHARMACEU|No||||
desoximetasone|No|No|No|No|75%|72578009102|DESOXIMETASONE 0.25% CREAM|60|GM|.258|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|120|No|.41664|03/29/2022|.40664|03/29/2022|.40934|03/29/2022|||STEROIDS: TOPICAL HIGH|22524|||||No|No||VIONA PHARMACEU|No||||
desoximetasone|No|No|No|No|75%|72578009103|DESOXIMETASONE 0.25% CREAM|100|GM|.473|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|120|No|.73438|06/29/2021|.71675|06/29/2021|.72152|06/29/2021|||STEROIDS: TOPICAL HIGH|22525|||||No|No||VIONA PHARMACEU|No||||
betamethasone dipropionate|No|No|No|No|75%|72578009301|BETAMETHASONE DP 0.05% OINT|15|GM|1.40753|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|120|No|1.65429|03/29/2022|1.61458|03/29/2022|1.62533|03/29/2022|||STEROIDS: TOPICAL HIGH|22526|||||No|No||VIONA PHARMACEU|No||||
betamethasone dipropionate|No|No|No|No|75%|72578009306|BETAMETHASONE DP 0.05% OINT|45|GM|.9393|03/16/2021||Yes|No||03/16/2021||Yes|No|03/16/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|120|No|1.30454|03/29/2022|1.27323|03/29/2022|1.28171|03/29/2022|||STEROIDS: TOPICAL HIGH|22527|||||No|No||VIONA PHARMACEU|No||||
desoximetasone|No|No|No|No|75%|72578009501|DESOXIMETASONE 0.25% OINTMENT|15|GM|.35833|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|120|No|.658|03/29/2022|.6422|03/29/2022|.64648|03/29/2022|||STEROIDS: TOPICAL HIGH|22528|||||No|No||VIONA PHARMACEU|No||||
desoximetasone|No|No|No|No|75%|72578009502|DESOXIMETASONE 0.25% OINTMENT|60|GM|.26875|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|120|No|.39246|03/29/2022|.38304|03/29/2022|.38559|03/29/2022|||STEROIDS: TOPICAL HIGH|22529|||||No|No||VIONA PHARMACEU|No||||
desoximetasone|No|No|No|No|75%|72578009503|DESOXIMETASONE 0.25% OINTMENT|100|GM|.645|03/17/2021||Yes|No||03/17/2021||Yes|No|03/17/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|120|No|1.47|03/17/2021|1.449|03/23/2021|1.38|03/17/2021|||STEROIDS: TOPICAL HIGH|22530|||||No|No||VIONA PHARMACEU|No||||
zanubrutinib|No|No|No|No|75%|72579001102|BRUKINSA 80 MG CAPSULE|120|EA|50.15591|04/24/2020||Yes|No||04/24/2020||Yes|No|04/24/2020||Yes|No||||No|No|||Prescription required|No||173|No|114.30882|02/08/2022|112.67584|02/08/2022|107.31032|02/08/2022|||ONCOLOGY: ORAL - HEMATOLOGIC|22531|||||No|No||BEIGENE USA, IN|No||||
triamcinolone acetonide|No|No|No|No|75%|72603010801|TRIAMCINOLONE ACET 40 MG/ML VL|1|ML|3.8442|06/02/2021|11/30/2022|Yes|No||06/02/2021|11/30/2022|Yes|No|06/02/2021|11/30/2022|Yes|No||||No|No|||Prescription required|No|||No|7|01/25/2022|6.832|01/25/2022|6.8775|01/25/2022||||22532|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
triamcinolone acetonide|No|No|No|No|75%|72603020201|TRIAMCINOLONE ACET 200 MG/5 ML|5|ML|3.8958|06/02/2021|11/30/2022|Yes|No||06/02/2021|11/30/2022|Yes|No|06/02/2021|11/30/2022|Yes|No||||No|No|||Prescription required|No|||No|8.8788|06/02/2021|8.75196|06/02/2021|8.3352|06/02/2021||||22533|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
triamcinolone acetonide|No|No|No|No|75%|72603040101|TRIAMCINOLONE ACET 400 MG/10ML|10|ML|2.90895|06/02/2021|11/30/2022|Yes|No||06/02/2021|11/30/2022|Yes|No|06/02/2021|11/30/2022|Yes|No||||No|No|||Prescription required|No|||No|6.6297|06/02/2021|6.53499|06/02/2021|6.2238|06/02/2021||||22534|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NORTHSTAR RX LL|No||||
linezolid|No|No|No|No|75%|72606000103|LINEZOLID 600 MG TABLET|30|EA|1.4749|05/26/2021||Yes|No||05/26/2021||Yes|No|05/26/2021||Yes|No||||No|No|||Prescription required|No||146|No|2.07915|03/29/2022|2.02925|03/29/2022|2.04276|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|22535|||||No|No||CELLTRION USA,|No||||
linezolid|No|No|No|No|75%|72606000107|LINEZOLID 600 MG TABLET|20|EA|1.04275|03/17/2020||Yes|No||03/17/2020||Yes|No|03/17/2020||Yes|No||||No|No|||Prescription required|No||146|No|2.07915|03/29/2022|2.02925|03/29/2022|2.04276|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|22536|||||No|No||CELLTRION USA,|No||||
linezolid|No|No|No|No|75%|72606000108|LINEZOLID 600 MG TABLET|30|EA|1.4749|05/26/2021||Yes|No||05/26/2021||Yes|No|05/26/2021||Yes|No||||No|No|||Prescription required|No||146|No|2.07915|03/29/2022|2.02925|03/29/2022|2.04276|03/29/2022|||LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS|22537|||||No|No||CELLTRION USA,|No||||
lamivudine/tenofovir disop fum|No|No|No|No|75%|72606000201|TEMIXYS 300-300 MG TABLET|30|EA|16.99999|01/03/2020|05/31/2023|Yes|No||01/03/2020|05/31/2023|Yes|No|01/03/2020|05/31/2023|Yes|No||||No|No|||Prescription required|No||237|No|27.76666|01/03/2020|27.36999|01/03/2020|26.06666|01/03/2020|||HIV / AIDS|22538|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||CELLTRION USA,|No||||
pregabalin|No|No|No|No|90%|72606000501|PREGABALIN 50 MG CAPSULE|90|EA|.03344|12/09/2020||Yes|No||12/09/2020||Yes|No|12/09/2020||Yes|No||||No|No|||Prescription required|No||232|No|.09128|03/29/2022|.08908|03/29/2022|.08968|03/29/2022|||NEUROPATHIC PAIN|22539|||||No|No||CELLTRION USA,|No||||
pregabalin|No|No|No|No|90%|72606000601|PREGABALIN 75 MG CAPSULE|90|EA|.03344|12/09/2020||Yes|No||12/09/2020||Yes|No|12/09/2020||Yes|No||||No|No|||Prescription required|No||232|No|.08098|03/29/2022|.07903|03/29/2022|.07956|03/29/2022|||NEUROPATHIC PAIN|22540|||||No|No||CELLTRION USA,|No||||
pregabalin|No|No|No|No|90%|72606000701|PREGABALIN 100 MG CAPSULE|90|EA|.03344|12/09/2020||Yes|No||12/09/2020||Yes|No|12/09/2020||Yes|No||||No|No|||Prescription required|No||232|No|.08763|03/29/2022|.08552|03/29/2022|.08609|03/29/2022|||NEUROPATHIC PAIN|22541|||||No|No||CELLTRION USA,|No||||
pregabalin|No|No|No|No|90%|72606000801|PREGABALIN 150 MG CAPSULE|90|EA|.03821|12/09/2020||Yes|No||12/09/2020||Yes|No|12/09/2020||Yes|No||||No|No|||Prescription required|No||232|No|.10646|03/29/2022|.1039|03/29/2022|.10459|03/29/2022|||NEUROPATHIC PAIN|22542|||||No|No||CELLTRION USA,|No||||
solifenacin succinate|No|No|No|No|75%|72606000901|SOLIFENACIN 5 MG TABLET|30|EA|.20453|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|Yes|.23024|03/29/2022|.22471|03/29/2022|.22621|03/29/2022|||BLADDER RELAXANT PREPARATIONS|22543|||||No|No||CELLTRION USA,|No||||
solifenacin succinate|No|No|No|No|75%|72606000902|SOLIFENACIN 5 MG TABLET|90|EA|.20453|01/03/2020|09/30/2022|Yes|No||01/03/2020|09/30/2022|Yes|No|01/03/2020|09/30/2022|Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|Yes|.23024|03/29/2022|.22471|03/29/2022|.22621|03/29/2022|||BLADDER RELAXANT PREPARATIONS|22544|Discontinued by Manufacturer|Discontinued by Manufacturer|Discontinued by Manufacturer||No|No||CELLTRION USA,|No||||
solifenacin succinate|No|No|No|No|75%|72606001001|SOLIFENACIN 10 MG TABLET|30|EA|.20453|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|No|.26101|03/29/2022|.25474|03/29/2022|.25644|03/29/2022|||BLADDER RELAXANT PREPARATIONS|22545|||||No|No||CELLTRION USA,|No||||
solifenacin succinate|No|No|No|No|75%|72606001002|SOLIFENACIN 10 MG TABLET|90|EA|.20453|01/03/2020||Yes|No||01/03/2020||Yes|No|01/03/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|006|No|.26101|03/29/2022|.25474|03/29/2022|.25644|03/29/2022|||BLADDER RELAXANT PREPARATIONS|22546|||||No|No||CELLTRION USA,|No||||
telmisartan|No|No|No|No|75%|72606050602|TELMISARTAN 20 MG TABLET|30|EA|.24366|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.30407|03/29/2022|.29677|03/29/2022|.29874|03/29/2022|||ANGIOTENSIN MODULATORS|22547|||||No|No||CELLTRION USA,|No||||
telmisartan|No|No|No|No|75%|72606050603|TELMISARTAN 20 MG TABLET|30|EA|.24366|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.30407|03/29/2022|.29677|03/29/2022|.29874|03/29/2022|||ANGIOTENSIN MODULATORS|22548|||||No|No||CELLTRION USA,|No||||
telmisartan|No|No|No|No|75%|72606050702|TELMISARTAN 40 MG TABLET|30|EA|.24366|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.35861|03/29/2022|.35|03/29/2022|.35233|03/29/2022|||ANGIOTENSIN MODULATORS|22549|||||No|No||CELLTRION USA,|No||||
telmisartan|No|No|No|No|75%|72606050703|TELMISARTAN 40 MG TABLET|30|EA|.24366|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.35861|03/29/2022|.35|03/29/2022|.35233|03/29/2022|||ANGIOTENSIN MODULATORS|22550|||||No|No||CELLTRION USA,|No||||
telmisartan|No|No|No|No|75%|72606050802|TELMISARTAN 80 MG TABLET|30|EA|.24366|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.33958|03/29/2022|.33143|03/29/2022|.33363|03/29/2022|||ANGIOTENSIN MODULATORS|22551|||||No|No||CELLTRION USA,|No||||
telmisartan|No|No|No|No|75%|72606050803|TELMISARTAN 80 MG TABLET|30|EA|.24366|02/16/2022||Yes|No||02/16/2022||Yes|No|02/16/2022||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|113|Yes|.33958|03/29/2022|.33143|03/29/2022|.33363|03/29/2022|||ANGIOTENSIN MODULATORS|22552|||||No|No||CELLTRION USA,|No||||
famotidine|No|No|No|No|75%|72606050902|FAMOTIDINE 20 MG TABLET|100|EA|.05117|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No|||No|.03262|03/29/2022|.03183|03/29/2022|.03204|03/29/2022||||22553|||||No|No||CELLTRION USA,|No||||
famotidine|No|No|No|No|75%|72606051002|FAMOTIDINE 40 MG TABLET|100|EA|.10234|04/14/2021||Yes|No||04/14/2021||Yes|No|04/14/2021||Yes|No||||No|No|||Prescription required|No|||No|.06888|03/29/2022|.06722|03/29/2022|.06767|03/29/2022||||22554|||||No|No||CELLTRION USA,|No||||
memantine HCl|No|No|No|No|75%|72606051402|MEMANTINE HCL 5 MG TABLET|60|EA|.06163|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||011|No|.08825|03/29/2022|.08613|03/29/2022|.0867|03/29/2022|||ALZHEIMER'S AGENTS|22555|||||No|No||CELLTRION USA,|No||||
memantine HCl|No|No|No|No|75%|72606051404|MEMANTINE HCL 5 MG TABLET|500|EA|.05848|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||011|No|.08825|03/29/2022|.08613|03/29/2022|.0867|03/29/2022|||ALZHEIMER'S AGENTS|22556|||||No|No||CELLTRION USA,|No||||
memantine HCl|No|No|No|No|75%|72606051502|MEMANTINE HCL 10 MG TABLET|60|EA|.06163|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|22557|||||No|No||CELLTRION USA,|No||||
memantine HCl|No|No|No|No|75%|72606051504|MEMANTINE HCL 10 MG TABLET|500|EA|.05848|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||011|No|.08261|03/29/2022|.08062|03/29/2022|.08116|03/29/2022|||ALZHEIMER'S AGENTS|22558|||||No|No||CELLTRION USA,|No||||
abiraterone acetate|No|No|No|No|75%|72606056601|ABIRATERONE ACETATE 250 MG TAB|120|EA|1.52291|09/15/2020||Yes|No||09/15/2020||Yes|No|09/15/2020||Yes|No||||No|No|||Prescription required|No||550|No|3.47082|09/28/2021|3.42124|09/28/2021|3.25832|09/28/2021|||ONCOLOGY: ORAL - PROSTATE|22559|||||No|No||CELLTRION USA,|No||||
zolmitriptan|No|No|No|No|75%|72606056701|ZOLMITRIPTAN 2.5 MG TABLET|6|EA|.50166|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|021|No|1.43567|03/29/2022|1.40121|03/29/2022|1.41054|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|22560|||||No|No||CELLTRION USA,|No||||
zolmitriptan|No|No|No|No|75%|72606056801|ZOLMITRIPTAN 5 MG TABLET|3|EA|.50166|08/26/2021||Yes|No||08/26/2021||Yes|No|08/26/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|021|No|1.62826|03/29/2022|1.58918|03/29/2022|1.59976|03/29/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|22561|||||No|No||CELLTRION USA,|No||||
pioglitazone HCl|No|No|No|No|75%|72606057001|PIOGLITAZONE HCL 15 MG TABLET|30|EA|.05733|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|22562|||||No|No||CELLTRION USA,|No||||
pioglitazone HCl|No|No|No|No|75%|72606057002|PIOGLITAZONE HCL 15 MG TABLET|90|EA|.05733|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|22563|||||No|No||CELLTRION USA,|No||||
pioglitazone HCl|No|No|No|No|75%|72606057003|PIOGLITAZONE HCL 15 MG TABLET|500|EA|.05676|05/26/2021||Yes|No||05/26/2021||Yes|No|05/26/2021||Yes|No||||No|No|||Prescription required|No||009|Yes|.09151|03/29/2022|.08931|03/29/2022|.0899|03/29/2022|||HYPOGLYCEMICS: TZD|22564|||||No|No||CELLTRION USA,|No||||
pioglitazone HCl|No|No|No|No|75%|72606057101|PIOGLITAZONE HCL 30 MG TABLET|30|EA|.07883|05/26/2021||Yes|No||05/26/2021||Yes|No|05/26/2021||Yes|No||||No|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|22565|||||No|No||CELLTRION USA,|No||||
pioglitazone HCl|No|No|No|No|75%|72606057102|PIOGLITAZONE HCL 30 MG TABLET|90|EA|.07883|05/26/2021||Yes|No||05/26/2021||Yes|No|05/26/2021||Yes|No||||No|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|22566|||||No|No||CELLTRION USA,|No||||
pioglitazone HCl|No|No|No|No|75%|72606057103|PIOGLITAZONE HCL 30 MG TABLET|500|EA|.07503|05/26/2021||Yes|No||05/26/2021||Yes|No|05/26/2021||Yes|No||||No|No|||Prescription required|No||009|Yes|.12434|03/29/2022|.12135|03/29/2022|.12216|03/29/2022|||HYPOGLYCEMICS: TZD|22567|||||No|No||CELLTRION USA,|No||||
pioglitazone HCl|No|No|No|No|75%|72606057201|PIOGLITAZONE HCL 45 MG TABLET|30|EA|.08241|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|22568|||||No|No||CELLTRION USA,|No||||
pioglitazone HCl|No|No|No|No|75%|72606057202|PIOGLITAZONE HCL 45 MG TABLET|90|EA|.08217|05/27/2021||Yes|No||05/27/2021||Yes|No|05/27/2021||Yes|No||||No|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|22569|||||No|No||CELLTRION USA,|No||||
pioglitazone HCl|No|No|No|No|75%|72606057203|PIOGLITAZONE HCL 45 MG TABLET|500|EA|.07912|05/26/2021||Yes|No||05/26/2021||Yes|No|05/26/2021||Yes|No||||No|No|||Prescription required|No||009|Yes|.14091|03/29/2022|.13752|03/29/2022|.13844|03/29/2022|||HYPOGLYCEMICS: TZD|22570|||||No|No||CELLTRION USA,|No||||
tazemetostat hydrobromide|No|No|No|No|75%|72607010000|TAZVERIK 200 MG TABLET|240|EA|31.79491|11/09/2020||Yes|No||11/09/2020||Yes|No|11/09/2020||Yes|No||||No|No|||Prescription required|No||239|No|72.46282|02/22/2022|71.42764|02/22/2022|68.02632|02/22/2022|||ONCOLOGY: ORAL - OTHER|22571|||||No|No||EPIZYME, INC|No||||
rimegepant sulfate|No|No|No|No|75%|72618300002|NURTEC ODT 75 MG TABLET|8|EA|49.4113|08/03/2020||Yes|No||08/03/2020||Yes|No|08/03/2020||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|537|No|110.19025|02/01/2022|107.54568|02/01/2022|108.26192|02/01/2022|||ANTIMIGRAINE AGENTS: OTHER|22572|||||No|No||BIOHAVEN PHARMA|No||||
ledipasvir/sofosbuvir|No|No|No|No|75%|72626260101|LEDIPASVIR-SOFOSBUVIR 90-400MG|28|EA|184.28571|09/25/2019||Yes|No||||No|No|09/01/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|064|Yes|419.99999|09/25/2019|413.99999|09/25/2019|394.2857|09/25/2019|||HEPATITIS C AGENTS|22573|||||No|No||ASEGUA THERAPEU|No||||
sofosbuvir/velpatasvir|No|No|No|No|75%|72626270101|SOFOSBUVIR-VELPATASVIR 400-100|28|EA|122.85714|09/25/2019||Yes|No||||No|No|09/01/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|064|Yes|279.99999|11/23/2021|275.99999|11/23/2021|262.85713|11/23/2021|||HEPATITIS C AGENTS|22574|||||No|No||ASEGUA THERAPEU|No||||
methylprednisolone|No|No|No|No|75%|72647033101|METHYLPREDNISOLONE 4 MG TABLET|100|EA|.1935|04/24/2020||Yes|No||04/24/2020||Yes|No|04/24/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|168|Yes|.21195|03/29/2022|.20686|03/29/2022|.20824|03/29/2022|||GLUCOCORTICOIDS: ORAL|22575|||||No|No||OAKRUM PHARMA,|No||||
methylprednisolone|No|No|No|No|75%|72647033104|METHYLPREDNISOLONE 4 MG DOSEPK|21|EA|.09214|04/24/2020||Yes|No||04/24/2020||Yes|No|04/24/2020||Yes|No||||No|No|||Prescription required|No||168|Yes|.17447|03/29/2022|.17028|03/29/2022|.17141|03/29/2022|||GLUCOCORTICOIDS: ORAL|22576|||||No|No||OAKRUM PHARMA,|No||||
deferasirox|No|No|No|No|75%|72647037130|DEFERASIROX 90 MG GRANULE PKT|30|EA|14.69181|09/28/2021||Yes|No||09/28/2021||Yes|No|09/28/2021||Yes|No||||No|No|||Prescription required|No|||No|33.48366|09/28/2021|33.00532|09/28/2021|31.43364|09/28/2021||||22577|||||No|No||OAKRUM PHARMA,|No||||
deferasirox|No|No|No|No|75%|72647037230|DEFERASIROX 180 MG GRANULE PKT|30|EA|29.38304|09/28/2021||Yes|No||09/28/2021||Yes|No|09/28/2021||Yes|No||||No|No|||Prescription required|No|||No|66.966|09/28/2021|66.00934|09/28/2021|62.86604|09/28/2021||||22578|||||No|No||OAKRUM PHARMA,|No||||
deferasirox|No|No|No|No|75%|72647037330|DEFERASIROX 360 MG GRANULE PKT|30|EA|58.7648|09/28/2021||Yes|No||09/28/2021||Yes|No|09/28/2021||Yes|No||||No|No|||Prescription required|No|||No|133.92908|09/28/2021|132.01581|09/28/2021|125.72934|09/28/2021||||22579|||||No|No||OAKRUM PHARMA,|No||||
nadolol|No|No|No|No|75%|72664021101|NADOLOL 20 MG TABLET|100|EA|.2497|01/12/2022||Yes|No||01/12/2022||Yes|No|01/12/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.34023|03/29/2022|.33206|03/29/2022|.33427|03/29/2022|||BETA-BLOCKERS|22580|||||No|No||VGYAAN PHARMACE|No||||
nadolol|No|No|No|No|75%|72664021201|NADOLOL 40 MG TABLET|100|EA|.33445|01/19/2022||Yes|No||01/19/2022||Yes|No|01/19/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.40202|03/29/2022|.39237|03/29/2022|.39498|03/29/2022|||BETA-BLOCKERS|22581|||||No|No||VGYAAN PHARMACE|No||||
nadolol|No|No|No|No|75%|72664021301|NADOLOL 80 MG TABLET|100|EA|.35831|01/12/2022||Yes|No||01/12/2022||Yes|No|01/12/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|070|No|.57501|03/29/2022|.5612|03/29/2022|.56494|03/29/2022|||BETA-BLOCKERS|22582|||||No|No||VGYAAN PHARMACE|No||||
clomipramine HCl|No|No|No|No|75%|72664021490|CLOMIPRAMINE 25 MG CAPSULE|90|EA|2.9001|01/12/2022||Yes|No||01/12/2022||Yes|No|01/12/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|215|No|1.31238|03/29/2022|1.28088|03/29/2022|1.28941|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|22583|||||No|No||VGYAAN PHARMACE|No||||
clomipramine HCl|No|No|No|No|75%|72664021590|CLOMIPRAMINE 50 MG CAPSULE|90|EA|2.9001|01/12/2022||Yes|No||01/12/2022||Yes|No|01/12/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|215|No|.80238|03/29/2022|.78312|03/29/2022|.78833|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|22584|||||No|No||VGYAAN PHARMACE|No||||
clomipramine HCl|No|No|No|No|75%|72664021690|CLOMIPRAMINE 75 MG CAPSULE|90|EA|2.9001|01/12/2022||Yes|No||01/12/2022||Yes|No|01/12/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|215|No|.95054|03/29/2022|.92772|03/29/2022|.9339|03/29/2022|||ANTIDEPRESSANTS: TRICYCLIC|22585|||||No|No||VGYAAN PHARMACE|No||||
infigratinib phosphate|No|No|No|No|75%|72730010101|TRUSELTIQ 125 MG DAILY DOSE PK|42|EA|220.11904|12/21/2021||Yes|No||12/21/2021||Yes|No|12/21/2021||Yes|No||||No|No|||Prescription required|No||239|No|501.66666|12/21/2021|494.49999|12/21/2021|470.95237|12/21/2021|||ONCOLOGY: ORAL - OTHER|22586|||||No|No||QED THERAPEUTIC|No||||
infigratinib phosphate|No|No|No|No|75%|72730011101|TRUSELTIQ 100 MG DAILY DOSE PK|21|EA|440.23809|12/21/2021||Yes|No||12/21/2021||Yes|No|12/21/2021||Yes|No||||No|No|||Prescription required|No||239|No|1003.33332|12/21/2021|988.99999|12/21/2021|941.90475|12/21/2021|||ONCOLOGY: ORAL - OTHER|22587|||||No|No||QED THERAPEUTIC|No||||
infigratinib phosphate|No|No|No|No|75%|72730020201|TRUSELTIQ 75 MG DAILY DOSE PK|63|EA|146.74603|12/21/2021||Yes|No||12/21/2021||Yes|No|12/21/2021||Yes|No||||No|No|||Prescription required|No||239|No|334.44444|12/21/2021|329.66666|12/21/2021|313.96825|12/21/2021|||ONCOLOGY: ORAL - OTHER|22588|||||No|No||QED THERAPEUTIC|No||||
infigratinib phosphate|No|No|No|No|75%|72730050601|TRUSELTIQ 50 MG DAILY DOSE PK|42|EA|220.11904|12/21/2021||Yes|No||12/21/2021||Yes|No|12/21/2021||Yes|No||||No|No|||Prescription required|No||239|No|501.66666|12/21/2021|494.49999|12/21/2021|470.95237|12/21/2021|||ONCOLOGY: ORAL - OTHER|22589|||||No|No||QED THERAPEUTIC|No||||
alirocumab|No|No|No|No|75%|72733590102|PRALUENT 75 MG/ML PEN|1|ML|96.75|06/05/2019||Yes|No||06/05/2019||Yes|No|06/05/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|055|Yes|224.37321|12/21/2021|218.98825|12/21/2021|220.44667|12/21/2021|||LIPOTROPICS: OTHER|22590|||||No|No||SANOFI/REGENERO|No||||
alirocumab|No|No|No|No|75%|72733590202|PRALUENT 150 MG/ML PEN|1|ML|96.75|06/05/2019||Yes|No||06/05/2019||Yes|No|06/05/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|055|Yes|224.55614|01/25/2022|219.16679|01/25/2022|220.6264|01/25/2022|||LIPOTROPICS: OTHER|22591|||||No|No||SANOFI/REGENERO|No||||
voxelotor|No|No|No|No|75%|72786010101|OXBRYTA 500 MG TABLET|90|EA|49.7701|02/18/2020||Yes|No||02/18/2020||Yes|No|02/18/2020||Yes|No||||No|No|||Prescription required|No||580|Yes|113.42955|02/18/2020|111.80912|02/18/2020|106.48488|02/18/2020|||SICKLE CELL ANEMIA TREATMENTS|22592|||||No|No||GLOBAL BLOOD TH|No||||
naloxone HCl|No|No|No|No|75%|72853005102|NALOXONE 2 MG AUTO-INJECTOR|.4|ML|95.675|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No|||No|218.05|10/01/2020|214.935|10/01/2020|204.7|10/01/2020||||22593|||||No|No||IJ THERAPEUTICS|Yes|09/01/2020|||
tizanidine HCl|No|No|No|No|75%|72888000115|TIZANIDINE HCL 2 MG CAPSULE|150|EA|.04586|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|116|No|.0903|03/29/2022|.08813|03/29/2022|.08871|03/29/2022|||SKELETAL MUSCLE RELAXANTS|22594|||||No|No||ADVAGEN PHARMA|No||||
tizanidine HCl|No|No|No|No|75%|72888000215|TIZANIDINE HCL 4 MG CAPSULE|150|EA|.0688|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|116|No|.15367|03/29/2022|.14998|03/29/2022|.15098|03/29/2022|||SKELETAL MUSCLE RELAXANTS|22595|||||No|No||ADVAGEN PHARMA|No||||
tizanidine HCl|No|No|No|No|75%|72888000315|TIZANIDINE HCL 6 MG CAPSULE|150|EA|.08026|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|116|No|.27523|03/29/2022|.26862|03/29/2022|.27041|03/29/2022|||SKELETAL MUSCLE RELAXANTS|22596|||||No|No||ADVAGEN PHARMA|No||||
amantadine HCl|No|No|No|No|75%|72888003301|AMANTADINE 100 MG CAPSULE|100|EA|.0645|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|No||015|No|.2857|03/29/2022|.27884|03/29/2022|.2807|03/29/2022|||ANTIPARKINSON'S AGENTS|22597|||||No|No||ADVAGEN PHARMA|No||||
amiodarone HCl|No|No|No|No|75%|72888003960|AMIODARONE HCL 200 MG TABLET|60|EA|.086|08/24/2021||Yes|No||08/24/2021||Yes|No|08/24/2021||Yes|No||||No|No|||Prescription required|No|||No|.12373|03/29/2022|.12076|03/29/2022|.12156|03/29/2022||||22598|||||No|No||ADVAGEN PHARMA|No||||
rabeprazole sodium|No|No|No|No|75%|72888005930|RABEPRAZOLE SOD DR 20 MG TAB|30|EA|.10391|06/21/2021||Yes|No||06/21/2021||Yes|No|06/21/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|No|.24287|03/29/2022|.23704|03/29/2022|.23861|03/29/2022|||PROTON PUMP INHIBITORS|22599|||||No|No||ADVAGEN PHARMA|No||||
rabeprazole sodium|No|No|No|No|75%|72888005990|RABEPRAZOLE SOD DR 20 MG TAB|90|EA|.09268|06/21/2021||Yes|No||06/21/2021||Yes|No|06/21/2021||Yes|No||||No|No|||Prescription required|Yes|12/01/2021|047|No|.24287|03/29/2022|.23704|03/29/2022|.23861|03/29/2022|||PROTON PUMP INHIBITORS|22600|||||No|No||ADVAGEN PHARMA|No||||
diclofenac potassium|No|No|No|No|75%|72888007301|DICLOFENAC POT 50 MG TABLET|100|EA|.129|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No||059|Yes|.33951|03/29/2022|.33136|03/29/2022|.33356|03/29/2022|||NSAIDS|22601|||||No|No||ADVAGEN PHARMA|No||||
diclofenac potassium|No|No|No|No|75%|72888007305|DICLOFENAC POT 50 MG TABLET|500|EA|.16684|02/01/2022||Yes|No||02/01/2022||Yes|No|02/01/2022||Yes|No||||No|No|||Prescription required|No||059|Yes|.33951|03/29/2022|.33136|03/29/2022|.33356|03/29/2022|||NSAIDS|22602|||||No|No||ADVAGEN PHARMA|No||||
methylphenidate HCl|No|No|No|No|75%|72912052530|ADHANSIA XR 25 MG CAPSULE|30|EA|4.95646|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|11.12091|01/11/2022|10.854|01/11/2022|10.92629|01/11/2022|||STIMULANTS AND RELATED AGENTS|22603|||||No|No||ADLON THERAPEUT|No||||
methylphenidate HCl|No|No|No|No|75%|72912053530|ADHANSIA XR 35 MG CAPSULE|30|EA|4.95646|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|10.95747|01/11/2022|10.69449|01/11/2022|10.76571|01/11/2022|||STIMULANTS AND RELATED AGENTS|22604|||||No|No||ADLON THERAPEUT|No||||
methylphenidate HCl|No|No|No|No|75%|72912054530|ADHANSIA XR 45 MG CAPSULE|30|EA|4.95646|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|11.08213|01/11/2022|10.81615|01/11/2022|10.88819|01/11/2022|||STIMULANTS AND RELATED AGENTS|22605|||||No|No||ADLON THERAPEUT|No||||
methylphenidate HCl|No|No|No|No|75%|72912055530|ADHANSIA XR 55 MG CAPSULE|30|EA|4.95646|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|11.0269|01/11/2022|10.76225|01/11/2022|10.83392|01/11/2022|||STIMULANTS AND RELATED AGENTS|22606|||||No|No||ADLON THERAPEUT|No||||
methylphenidate HCl|No|No|No|No|75%|72912057030|ADHANSIA XR 70 MG CAPSULE|30|EA|4.95646|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|10.99186|01/11/2022|10.72805|01/11/2022|10.7995|01/11/2022|||STIMULANTS AND RELATED AGENTS|22607|||||No|No||ADLON THERAPEUT|No||||
methylphenidate HCl|No|No|No|No|75%|72912058530|ADHANSIA XR 85 MG CAPSULE|30|EA|4.95646|12/11/2019||Yes|No||12/11/2019||Yes|No|12/11/2019||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|007|Yes|11.00426|01/11/2022|10.74015|01/11/2022|10.81168|01/11/2022|||STIMULANTS AND RELATED AGENTS|22608|||||No|No||ADLON THERAPEUT|No||||
relugolix|No|No|No|No|75%|72974012001|ORGOVYX 120 MG TABLET|30|EA|35.20854|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|No|||No|80.24272|01/04/2022|79.09639|01/04/2022|75.3299|01/04/2022||||22609|||||No|No||MYOVANT SCIENCE|No||||
relugolix/estradiol/norethindr|No|No|No|No|75%|72974041501|MYFEMBREE 40 MG-1 MG-0.5 MG TB|28|EA|15.89402|10/04/2021||Yes|No||10/04/2021||Yes|No|10/04/2021||Yes|No||||No|No|||Prescription required|No|||No|36.22359|01/04/2022|35.70611|01/04/2022|34.00582|01/04/2022||||22610|||||No|No||MYOVANT SCIENCE|No||||
ferric maltol|No|No|No|No|75%|73059000160|ACCRUFER 30 MG CAPSULE|60|EA|3.58333|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||||No|No|||Prescription required|No|||No|8.16666|02/10/2022|8.04999|02/10/2022|7.66666|02/10/2022||||22611|||||No|No||SHIELD THERAPEU|No||||
lonafarnib|No|No|No|No|75%|73079005030|ZOKINVY 50 MG CAPSULE|30|EA|320.63666|08/02/2021||Yes|No||08/02/2021||Yes|No|08/02/2021||Yes|No||||No|No|||Prescription required|No|||No|730.75332|01/04/2022|720.31399|01/04/2022|686.01332|01/04/2022||||22612|||||No|No||EIGER BIOPHARMA|No||||
lonafarnib|No|No|No|No|75%|73079007530|ZOKINVY 75 MG CAPSULE|30|EA|480.96933|08/02/2021||Yes|No||08/02/2021||Yes|No|08/02/2021||Yes|No||||No|No|||Prescription required|No|||No|1096.16266|01/04/2022|1080.50319|01/04/2022|1029.05066|01/04/2022||||22613|||||No|No||EIGER BIOPHARMA|No||||
umbralisib tosylate|No|No|No|No|75%|73150020012|UKONIQ 200 MG TABLET|120|EA|56.975|06/14/2021||Yes|No||06/14/2021||Yes|No|06/14/2021||Yes|No||||No|No|||Prescription required|No||173|No|129.85|06/14/2021|127.995|06/22/2021|121.9|06/14/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|22614|||||No|No||TG THERAPEUTICS|No||||
ripretinib|No|No|No|No|75%|73207010130|QINLOCK 50 MG TABLET|90|EA|168.173|11/09/2020||Yes|No||11/09/2020||Yes|No|11/09/2020||Yes|No||||No|No|||Prescription required|No||239|No|383.278|02/08/2022|377.8026|02/08/2022|359.812|02/08/2022|||ONCOLOGY: ORAL - OTHER|22615|||||No|No||DECIPHERA PHARM|No||||
ulipristal acetate|No|Yes|No|No|75%|73302045601|ELLA 30 MG TABLET|1|EA|16.6625|12/10/2020||Yes|No||||No|No|||No|No||||No|No|||Prescription required|No|||No|37.37356|07/13/2021|36.47659|07/13/2021|36.71952|07/13/2021||||22616|||||No|No||HRA PHARMA AMER|No||||
vibegron|No|No|No|No|75%|73336007530|GEMTESA 75 MG TABLET|30|EA|6.5704|02/09/2022||Yes|No||02/09/2022||Yes|No|02/09/2022||Yes|No||||No|No|||Prescription required|No|||No|14.69645|11/23/2021|14.34373|11/23/2021|14.43926|11/23/2021||||22617|||||No|No||UROVANT SCIENCE|No||||
clindamycin phosphate|No|No|No|No|75%|73473030030|CLINDAMYCIN PH 1% GEL|30|GM|.99043|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|No||104|No|.67613|03/29/2022|.6599|03/29/2022|.66429|03/29/2022|||ACNE AGENTS: TOPICAL|22618|||||No|No||SOLARIS PHARMA|No||||
clindamycin phosphate|No|No|No|No|75%|73473030060|CLINDAMYCIN PH 1% GEL|60|GM|.89203|12/18/2020||Yes|No||12/18/2020||Yes|No|12/18/2020||Yes|No||||No|No|||Prescription required|No||104|No|.47333|03/29/2022|.46197|03/29/2022|.46504|03/29/2022|||ACNE AGENTS: TOPICAL|22619|||||No|No||SOLARIS PHARMA|No||||
lipase/protease/amylase|No|No|No|No|75%|73562010410|VIOKACE 10,440-39,150 UNIT TAB|100|EA|1.51519|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|108|No|3.45322|01/04/2022|3.40389|01/04/2022|3.2418|01/04/2022|||PANCREATIC ENZYMES|22620|||||No|No||NESTLE NUTRITIO|No||||
lipase/protease/amylase|No|No|No|No|75%|73562011001|ZENPEP DR 10,000 UNIT CAPSULE|100|EA|1.6395|07/07/2021||Yes|No||07/07/2021||Yes|No|07/07/2021||Yes|No||||No|No|||Prescription required|No||108|No|3.66012|01/04/2022|3.57227|01/04/2022|3.59606|01/04/2022|||PANCREATIC ENZYMES|22621|||||No|No||NESTLE NUTRITIO|No||||
lipase/protease/amylase|No|No|No|No|75%|73562011101|ZENPEP DR 15,000 UNIT CAPSULE|100|EA|2.36796|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|No||108|No|5.29138|01/04/2022|5.16438|01/04/2022|5.19878|01/04/2022|||PANCREATIC ENZYMES|22622|||||No|No||NESTLE NUTRITIO|No||||
lipase/protease/amylase|No|No|No|No|75%|73562011201|ZENPEP DR 20,000 UNIT CAPSULE|100|EA|3.21657|06/29/2021||Yes|No||06/29/2021||Yes|No|06/29/2021||Yes|No||||No|No|||Prescription required|No||108|No|7.19514|01/04/2022|7.02245|01/04/2022|7.06922|01/04/2022|||PANCREATIC ENZYMES|22623|||||No|No||NESTLE NUTRITIO|No||||
lipase/protease/amylase|No|No|No|No|75%|73562011301|ZENPEP DR 3,000 UNIT CAPSULE|100|EA|.86928|11/24/2021||Yes|No||11/24/2021||Yes|No|11/24/2021||Yes|No||||No|No|||Prescription required|No||108|No|1.94212|01/04/2022|1.8955|01/04/2022|1.90813|01/04/2022|||PANCREATIC ENZYMES|22624|||||No|No||NESTLE NUTRITIO|No||||
lipase/protease/amylase|No|No|No|No|75%|73562011401|ZENPEP DR 40,000 UNIT CAPSULE|100|EA|6.34809|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|No||108|No|14.17938|01/04/2022|13.83907|01/04/2022|13.93124|01/04/2022|||PANCREATIC ENZYMES|22625|||||No|No||NESTLE NUTRITIO|No||||
lipase/protease/amylase|No|No|No|No|75%|73562011501|ZENPEP DR 5,000 UNIT CAPSULE|100|EA|.82942|06/21/2021||Yes|No||06/21/2021||Yes|No|06/21/2021||Yes|No||||No|No|||Prescription required|No||108|No|1.85294|01/04/2022|1.80846|01/04/2022|1.82051|01/04/2022|||PANCREATIC ENZYMES|22626|||||No|No||NESTLE NUTRITIO|No||||
lipase/protease/amylase|No|No|No|No|75%|73562011601|ZENPEP DR 25,000 UNIT CAPSULE|100|EA|3.98038|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|No||108|No|8.87797|01/04/2022|8.66489|01/04/2022|8.7226|01/04/2022|||PANCREATIC ENZYMES|22627|||||No|No||NESTLE NUTRITIO|No||||
lipase/protease/amylase|No|No|No|No|75%|73562020810|VIOKACE 20,880-78,300 UNITS TB|100|EA|2.98927|05/19/2021||Yes|No||05/19/2021||Yes|No|05/19/2021||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|108|No|6.81276|01/04/2022|6.71543|01/04/2022|6.39565|01/04/2022|||PANCREATIC ENZYMES|22628|||||No|No||NESTLE NUTRITIO|No||||
rilonacept|No|No|No|No|75%|73604091404|ARCALYST 220 MG VIAL|1|EA|2150|10/06/2021||Yes|No||10/06/2021||Yes|No|10/06/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|071|Yes|4900|10/06/2021|4830|10/06/2021|4600|10/06/2021|||CYTOKINE AND CAM ANTAGONISTS|22629|||||No|No||KINIKSA PHARMAC|No||||
pegcetacoplan|No|No|No|No|75%|73606001001|EMPAVELI 1,080 MG/20 ML VIAL|20|ML|94.68256|09/23/2021||Yes|No||09/23/2021||Yes|No|09/23/2021||Yes|No||||No|No|||Prescription required|No|||No|215.78816|09/23/2021|212.70547|09/23/2021|202.57664|09/23/2021||||22630|||||No|No||APELLIS PHARMAC|No||||
odevixibat|No|No|No|No|75%|74528002001|BYLVAY 200 MCG PELLET|30|EA|94.6|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|No|||No|215.6|11/16/2021|212.52|11/16/2021|202.4|11/16/2021||||22631|||||No|No||ALBIREO PHARMA|No||||
odevixibat|No|No|No|No|75%|74528004001|BYLVAY 400 MCG CAPSULE|30|EA|189.2|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|No|||No|431.2|01/06/2022|425.04|01/11/2022|404.8|01/06/2022||||22632|||||No|No||ALBIREO PHARMA|No||||
odevixibat|No|No|No|No|75%|74528006001|BYLVAY 600 MCG PELLET|30|EA|283.8|01/06/2022||Yes|No||01/06/2022||Yes|No|01/06/2022||Yes|No||||No|No|||Prescription required|No|||No|646.8|01/06/2022|637.56|01/06/2022|607.2|01/06/2022||||22633|||||No|No||ALBIREO PHARMA|No||||
odevixibat|No|No|No|No|75%|74528012001|BYLVAY 1,200 MCG CAPSULE|30|EA|567.6|12/03/2021||Yes|No||12/03/2021||Yes|No|12/03/2021||Yes|No||||No|No|||Prescription required|No|||No|1293.6|11/16/2021|1275.12|11/16/2021|1214.4|11/16/2021||||22634|||||No|No||ALBIREO PHARMA|No||||
voclosporin|No|No|No|No|75%|75626000101|LUPKYNIS 7.9 MG CAPSULE|60|EA|30.28991|08/04/2021||Yes|No||08/04/2021||Yes|No|08/04/2021||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|511|No|69.03282|01/04/2022|68.04664|01/04/2022|64.80632|01/04/2022||||22635|||||No|No||AURINIA PHARMA|No||||
voclosporin|No|No|No|No|75%|75626000102|LUPKYNIS 7.9 MG CAPSULE|180|EA|30.28991|08/04/2021||Yes|No||08/04/2021||Yes|No|08/04/2021||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|511|No|69.03282|01/04/2022|68.04664|01/04/2022|64.80632|01/04/2022||||22636|||||No|No||AURINIA PHARMA|No||||
ibrexafungerp citrate|No|No|No|No|75%|75788011504|BREXAFEMME 150 MG TABLET|4|EA|51.0625|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|069|No|116.375|02/10/2022|114.7125|02/15/2022|109.25|02/10/2022|||ANTIFUNGALS: ORAL|22637|||||No|No||SCYNEXIS, INC.|No||||
chlorthalidone|Yes|No|No|No|75%|75834010901|CHLORTHALIDONE 25 MG TABLET|100|EA|.07955|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||||No|No|06/18/2019||Prescription required|No|||No|.16117|03/29/2022|.1573|03/29/2022|.15834|03/29/2022||||22638|||||No|No||NIVAGEN PHARMAC|No||||
chlorthalidone|Yes|No|No|No|75%|75834010910|CHLORTHALIDONE 25 MG TABLET|1000|EA|.07955|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||||No|No|06/18/2019||Prescription required|No|||No|.16117|03/29/2022|.1573|03/29/2022|.15834|03/29/2022||||22639|||||No|No||NIVAGEN PHARMAC|No||||
chlorthalidone|Yes|No|No|No|75%|75834011001|CHLORTHALIDONE 50 MG TABLET|100|EA|.0946|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||||No|No|06/18/2019||Prescription required|No|||No|.3607|03/29/2022|.35204|03/29/2022|.35438|03/29/2022||||22640|||||No|No||NIVAGEN PHARMAC|No||||
chlorthalidone|Yes|No|No|No|75%|75834011010|CHLORTHALIDONE 50 MG TABLET|1000|EA|.0946|11/27/2018||Yes|No||11/27/2018||Yes|No|11/27/2018||Yes|No||||No|No|06/18/2019||Prescription required|No|||No|.3607|03/29/2022|.35204|03/29/2022|.35438|03/29/2022||||22641|||||No|No||NIVAGEN PHARMAC|No||||
ethinyl estradiol/drospirenone|Yes|Yes|No|No|75%|75834011529|DROSPIRENONE-EE 3-0.03 MG TAB|28|EA|.28262|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No|Refer to program requirements|||No|No|05/18/2018||Prescription required|No|||No|.2455|03/29/2022|.2396|03/29/2022|.2412|03/29/2022||||22642|||||No|No||NIVAGEN PHARMAC|No|||Only covered for non-contraceptive (medical) purposes|
ethinyl estradiol/drospirenone|Yes|Yes|No|No|75%|75834011629|DROSPIRENONE-EE 3-0.02 MG TAB|28|EA|.28999|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No|Refer to program requirements|||No|No|05/18/2018||Prescription required|No|||No|.36582|03/29/2022|.35704|03/29/2022|.35941|03/29/2022||||22643|||||No|No||NIVAGEN PHARMAC|No|||Only covered for non-contraceptive (medical) purposes|
acyclovir|Yes|No|No|No|75%|75834012401|ACYCLOVIR 200 MG CAPSULE|100|EA|.04708|11/27/2017||Yes|No||11/27/2017||Yes|No|11/27/2017||Yes|No||||No|No|11/27/2017||Prescription required|No||025|No|.11267|03/29/2022|.10996|03/29/2022|.11069|03/29/2022|||ANTIVIRALS: ORAL|22644|||||No|No||NIVAGEN PHARMAC|No||||
norethindrone ac-eth estradiol|No|No|No|No|75%|75834012929|NORETHIND-ETH ESTRAD 0.5-2.5|28|EA|1.34211|06/05/2017||Yes|No||06/05/2017||Yes|No|06/05/2017||Yes|No||||No|No|||Prescription required|No|||Yes|1.79681|03/29/2022|1.75368|03/29/2022|1.76536|03/29/2022||||22645|||||No|No||NIVAGEN PHARMAC|No||||
norethindrone ac-eth estradiol|No|No|No|No|75%|75834013029|NORETHIN-ETH ESTRAD 1 MG-5 MCG|28|EA|.85646|06/05/2017||Yes|No||06/05/2017||Yes|No|06/05/2017||Yes|No||||No|No|||Prescription required|No|||Yes|1.33067|03/29/2022|1.29873|03/29/2022|1.30738|03/29/2022||||22646|||||No|No||NIVAGEN PHARMAC|No||||
gemfibrozil|No|No|No|No|75%|75834013105|GEMFIBROZIL 600 MG TABLET|500|EA|.04912|05/17/2021|09/30/2022|Yes|No||05/17/2021|09/30/2022|Yes|No|05/17/2021|09/30/2022|Yes|No||||No|No|||Prescription required|No||055|No|.10518|03/29/2022|.10265|03/29/2022|.10333|03/29/2022|||LIPOTROPICS: OTHER|22647|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||NIVAGEN PHARMAC|No||||
fluoxetine HCl|No|No|No|No|75%|75834014830|FLUOXETINE HCL 60 MG TABLET|30|EA|.89583|05/18/2018||Yes|No||05/18/2018||Yes|No|05/18/2018||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|008|No|1.06507|03/29/2022|1.0395|03/29/2022|1.04643|03/29/2022|||ANTIDEPRESSANTS: SSRIs|22648|||||No|No||NIVAGEN PHARMAC|No||||
colesevelam HCl|No|No|No|No|75%|75834015218|COLESEVELAM 625 MG TABLET|180|EA|.24144|02/15/2021||Yes|No||02/15/2021||Yes|No|02/15/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|055|No|.48654|03/29/2022|.47486|03/29/2022|.47802|03/29/2022|||LIPOTROPICS: OTHER|22649|||||No|No||NIVAGEN PHARMAC|No||||
verapamil HCl|Yes|No|No|No|75%|75834015801|VERAPAMIL ER 180 MG TABLET|100|EA|.10406|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|01/16/2020||Prescription required|No||045|No|.19574|03/29/2022|.19104|03/29/2022|.19231|03/29/2022|||CALCIUM CHANNEL BLOCKERS|22650|||||No|No||NIVAGEN PHARMAC|No||||
verapamil HCl|No|No|No|No|75%|75834015805|VERAPAMIL ER 180 MG TABLET|500|EA|.10234|01/31/2022||Yes|No||01/31/2022||Yes|No|01/31/2022||Yes|No||||No|No|||Prescription required|No||045|No|.19574|03/29/2022|.19104|03/29/2022|.19231|03/29/2022|||CALCIUM CHANNEL BLOCKERS|22651|||||No|No||NIVAGEN PHARMAC|No||||
verapamil HCl|Yes|No|No|No|75%|75834015901|VERAPAMIL ER 240 MG TABLET|100|EA|.09976|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|01/16/2020||Prescription required|No||045|No|.17058|03/29/2022|.16648|03/29/2022|.16759|03/29/2022|||CALCIUM CHANNEL BLOCKERS|22652|||||No|No||NIVAGEN PHARMAC|No||||
verapamil HCl|Yes|No|No|No|75%|75834015905|VERAPAMIL ER 240 MG TABLET|500|EA|.08251|09/06/2019||Yes|No||09/06/2019||Yes|No|09/06/2019||Yes|No||||No|No|01/16/2020||Prescription required|No||045|No|.17058|03/29/2022|.16648|03/29/2022|.16759|03/29/2022|||CALCIUM CHANNEL BLOCKERS|22653|||||No|No||NIVAGEN PHARMAC|No||||
ofloxacin|No|No|No|No|75%|75834020001|OFLOXACIN 300 MG TABLET|100|EA|4.80525|08/13/2021||Yes|No||08/13/2021||Yes|No|08/13/2021||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|028|No|10.9515|08/13/2021|10.79505|08/13/2021|10.281|08/13/2021|||FLUOROQUINOLONES: ORAL|22654|||||No|No||NIVAGEN PHARMAC|No||||
ofloxacin|No|No|No|No|75%|75834020050|OFLOXACIN 300 MG TABLET|50|EA|5.28771|08/13/2021||Yes|No||08/13/2021||Yes|No|08/13/2021||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|028|No|12.05106|08/13/2021|11.8789|08/13/2021|11.31324|08/13/2021|||FLUOROQUINOLONES: ORAL|22655|||||No|No||NIVAGEN PHARMAC|No||||
ofloxacin|No|No|No|No|75%|75834020101|OFLOXACIN 400 MG TABLET|100|EA|6.40949|08/13/2021||Yes|No||08/13/2021||Yes|No|08/13/2021||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|028|No|14.60768|08/13/2021|14.399|08/13/2021|13.71333|08/13/2021|||FLUOROQUINOLONES: ORAL|22656|||||No|No||NIVAGEN PHARMAC|No||||
ofloxacin|No|No|No|No|75%|75834020150|OFLOXACIN 400 MG TABLET|50|EA|7.05028|08/13/2021||Yes|No||08/13/2021||Yes|No|08/13/2021||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|028|No|16.06808|08/13/2021|15.83853|08/13/2021|15.08432|08/13/2021|||FLUOROQUINOLONES: ORAL|22657|||||No|No||NIVAGEN PHARMAC|No||||
nateglinide|Yes|No|No|No|75%|75834020501|NATEGLINIDE 60 MG TABLET|100|EA|.19681|06/17/2020||Yes|No||06/17/2020||Yes|No|06/17/2020||Yes|No||||No|No|09/21/2020||Prescription required|No||022|Yes|.3103|03/29/2022|.30285|03/29/2022|.30486|03/29/2022|||HYPOGLYCEMICS: MEGLITINIDES|22658|||||No|No||NIVAGEN PHARMAC|No||||
nateglinide|Yes|No|No|No|75%|75834020601|NATEGLINIDE 120 MG TABLET|100|EA|.2045|06/17/2020||Yes|No||06/17/2020||Yes|No|06/17/2020||Yes|No||||No|No|09/21/2020||Prescription required|No||022|Yes|.33379|03/29/2022|.32577|03/29/2022|.32794|03/29/2022|||HYPOGLYCEMICS: MEGLITINIDES|22659|||||No|No||NIVAGEN PHARMAC|No||||
tizanidine HCl|No|No|No|No|75%|75834020715|TIZANIDINE HCL 2 MG CAPSULE|150|EA|.10033|05/05/2020||Yes|No||05/05/2020||Yes|No|05/05/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|No|.0903|03/29/2022|.08813|03/29/2022|.08871|03/29/2022|||SKELETAL MUSCLE RELAXANTS|22660|||||No|No||NIVAGEN PHARMAC|No||||
tizanidine HCl|No|No|No|No|75%|75834020815|TIZANIDINE HCL 4 MG CAPSULE|150|EA|.14046|05/05/2020||Yes|No||05/05/2020||Yes|No|05/05/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|No|.15367|03/29/2022|.14998|03/29/2022|.15098|03/29/2022|||SKELETAL MUSCLE RELAXANTS|22661|||||No|No||NIVAGEN PHARMAC|No||||
tizanidine HCl|No|No|No|No|75%|75834020915|TIZANIDINE HCL 6 MG CAPSULE|150|EA|.18862|05/05/2020||Yes|No||05/05/2020||Yes|No|05/05/2020||Yes|No||||No|No|||Prescription required|Yes|01/25/2018|116|No|.27523|03/29/2022|.26862|03/29/2022|.27041|03/29/2022|||SKELETAL MUSCLE RELAXANTS|22662|||||No|No||NIVAGEN PHARMAC|No||||
venlafaxine HCl|No|No|No|No|75%|75834021730|VENLAFAXINE HCL ER 75 MG TAB|30|EA|.44505|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|031|Yes|1.5965|03/29/2022|1.55818|03/29/2022|1.56856|03/29/2022|||ANTIDEPRESSANTS: OTHER|22663|||||No|No||NIVAGEN PHARMAC|No||||
venlafaxine HCl|No|No|No|No|75%|75834021790|VENLAFAXINE HCL ER 75 MG TAB|90|EA|.56502|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|031|Yes|1.5965|03/29/2022|1.55818|03/29/2022|1.56856|03/29/2022|||ANTIDEPRESSANTS: OTHER|22664|||||No|No||NIVAGEN PHARMAC|No||||
venlafaxine HCl|No|No|No|No|75%|75834021830|VENLAFAXINE HCL ER 150 MG TAB|30|EA|.15093|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|031|No|2.65947|03/29/2022|2.59564|03/29/2022|2.61292|03/29/2022|||ANTIDEPRESSANTS: OTHER|22665|||||No|No||NIVAGEN PHARMAC|No||||
venlafaxine HCl|No|No|No|No|75%|75834021890|VENLAFAXINE HCL ER 150 MG TAB|90|EA|.2236|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|031|No|2.65947|03/29/2022|2.59564|03/29/2022|2.61292|03/29/2022|||ANTIDEPRESSANTS: OTHER|22666|||||No|No||NIVAGEN PHARMAC|No||||
venlafaxine HCl|No|No|No|No|75%|75834021930|VENLAFAXINE HCL ER 225 MG TAB|30|EA|.45737|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|031|No|3.46235|03/29/2022|3.37925|03/29/2022|3.40175|03/29/2022|||ANTIDEPRESSANTS: OTHER|22667|||||No|No||NIVAGEN PHARMAC|No||||
venlafaxine HCl|No|No|No|No|75%|75834021990|VENLAFAXINE HCL ER 225 MG TAB|90|EA|.5805|05/20/2020||Yes|No||05/20/2020||Yes|No|05/20/2020||Yes|No||||No|No|||Prescription required|Yes|07/25/2019|031|No|3.46235|03/29/2022|3.37925|03/29/2022|3.40175|03/29/2022|||ANTIDEPRESSANTS: OTHER|22668|||||No|No||NIVAGEN PHARMAC|No||||
carbamazepine|No|No|No|No|75%|75834022100|CARBAMAZEPINE 200 MG TABLET|1000|EA|.0645|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||||No|No|||Prescription required|No||056|No|.20856|03/29/2022|.20355|03/29/2022|.20491|03/29/2022|||ANTICONVULSANTS|22669|||||No|No||NIVAGEN PHARMAC|No||||
carbamazepine|No|No|No|No|75%|75834022101|CARBAMAZEPINE 200 MG TABLET|100|EA|.0645|10/13/2020||Yes|No||10/13/2020||Yes|No|10/13/2020||Yes|No||||No|No|||Prescription required|No||056|No|.20856|03/29/2022|.20355|03/29/2022|.20491|03/29/2022|||ANTICONVULSANTS|22670|||||No|No||NIVAGEN PHARMAC|No||||
nystatin|No|No|No|No|75%|75834023516|NYSTATIN 100,000 UNIT/ML SUSP|473|ML|.02727|03/29/2022||Yes|No||03/29/2022||Yes|No|03/29/2022||Yes|No||||No|No|||Prescription required|No||069|No|.04529|03/29/2022|.0442|03/29/2022|.04449|03/29/2022|||ANTIFUNGALS: ORAL|22671|||||No|No||NIVAGEN PHARMAC|No||||
nystatin|No|No|No|No|75%|75834023560|NYSTATIN 100,000 UNIT/ML SUSP|60|ML|.07883|03/29/2022||Yes|No||03/29/2022||Yes|No|03/29/2022||Yes|No||||No|No|||Prescription required|No||069|No|.14005|03/29/2022|.13668|03/29/2022|.13759|03/29/2022|||ANTIFUNGALS: ORAL|22672|||||No|No||NIVAGEN PHARMAC|No||||
celecoxib|No|No|No|No|75%|75834023660|CELECOXIB 50 MG CAPSULE|60|EA|.05733|09/09/2021||Yes|No||09/09/2021||Yes|No|09/09/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|.1386|03/29/2022|.13527|03/29/2022|.13617|03/29/2022|||NSAIDS|22673|||||No|No||NIVAGEN PHARMAC|No||||
celecoxib|No|No|No|No|75%|75834023701|CELECOXIB 100 MG CAPSULE|100|EA|.0645|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|22674|||||No|No||NIVAGEN PHARMAC|No||||
celecoxib|No|No|No|No|75%|75834023705|CELECOXIB 100 MG CAPSULE|500|EA|.0516|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|.1081|03/29/2022|.1055|03/29/2022|.1062|03/29/2022|||NSAIDS|22675|||||No|No||NIVAGEN PHARMAC|No||||
celecoxib|No|No|No|No|75%|75834023801|CELECOXIB 200 MG CAPSULE|100|EA|.129|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|22676|||||No|No||NIVAGEN PHARMAC|No||||
celecoxib|No|No|No|No|75%|75834023805|CELECOXIB 200 MG CAPSULE|500|EA|.1032|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|.13496|03/29/2022|.13172|03/29/2022|.13259|03/29/2022|||NSAIDS|22677|||||No|No||NIVAGEN PHARMAC|No||||
celecoxib|No|No|No|No|75%|75834023960|CELECOXIB 400 MG CAPSULE|60|EA|.25083|09/09/2021||Yes|No||09/09/2021||Yes|No|09/09/2021||Yes|No||||No|No|||Prescription required|Yes|01/30/2020|059|Yes|.73632|03/29/2022|.71864|03/29/2022|.72343|03/29/2022|||NSAIDS|22678|||||No|No||NIVAGEN PHARMAC|No||||
erythromycin base|No|No|No|No|75%|75834024201|ERYTHROMYCIN 250 MG FILMTAB|100|EA|1.505|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|018|No|7.84358|03/31/2022|7.65533|03/31/2022|7.70631|03/31/2022|||MACROLIDES/KETOLIDES|22679|||||No|No||NIVAGEN PHARMAC|No||||
erythromycin base|No|No|No|No|75%|75834024230|ERYTHROMYCIN 250 MG FILMTAB|30|EA|2.41875|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|018|No|7.84358|03/31/2022|7.65533|03/31/2022|7.70631|03/31/2022|||MACROLIDES/KETOLIDES|22680|||||No|No||NIVAGEN PHARMAC|No||||
erythromycin base|No|No|No|No|75%|75834024301|ERYTHROMYCIN 500 MG FILMTAB|100|EA|2.84337|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|018|No|13.22133|03/31/2022|12.90401|03/31/2022|12.98995|03/31/2022|||MACROLIDES/KETOLIDES|22681|||||No|No||NIVAGEN PHARMAC|No||||
erythromycin base|No|No|No|No|75%|75834024330|ERYTHROMYCIN 500 MG FILMTAB|30|EA|3.58333|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|018|No|13.22133|03/31/2022|12.90401|03/31/2022|12.98995|03/31/2022|||MACROLIDES/KETOLIDES|22682|||||No|No||NIVAGEN PHARMAC|No||||
levetiracetam|No|No|No|No|75%|75834024560|LEVETIRACETAM ER 500 MG TABLET|60|EA|.31869|07/30/2021||Yes|No||07/30/2021||Yes|No|07/30/2021||Yes|No||||No|No|||Prescription required|No||056|No|.22713|03/29/2022|.22167|03/29/2022|.22315|03/29/2022|||ANTICONVULSANTS|22683|||||No|No||NIVAGEN PHARMAC|No||||
levetiracetam|No|No|No|No|75%|75834024660|LEVETIRACETAM ER 750 MG TABLET|60|EA|.47851|06/02/2021||Yes|No||06/02/2021||Yes|No|06/02/2021||Yes|No||||No|No|||Prescription required|No||056|No|.36799|03/29/2022|.35915|03/29/2022|.36155|03/29/2022|||ANTICONVULSANTS|22684|||||No|No||NIVAGEN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|75834025501|ATORVASTATIN 10 MG TABLET|1000|EA|.03206|06/06/2021||Yes|No||06/06/2021||Yes|No|06/06/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|22685|||||No|No||NIVAGEN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|75834025550|ATORVASTATIN 10 MG TABLET|500|EA|.05479|06/06/2021||Yes|No||06/06/2021||Yes|No|06/06/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|22686|||||No|No||NIVAGEN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|75834025590|ATORVASTATIN 10 MG TABLET|90|EA|.03563|06/06/2021||Yes|No||06/06/2021||Yes|No|06/06/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.03732|03/29/2022|.03642|03/29/2022|.03666|03/29/2022|||LIPOTROPICS: STATINS|22687|||||No|No||NIVAGEN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|75834025601|ATORVASTATIN 20 MG TABLET|1000|EA|.04011|06/06/2021||Yes|No||06/06/2021||Yes|No|06/06/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|22688|||||No|No||NIVAGEN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|75834025650|ATORVASTATIN 20 MG TABLET|500|EA|.06855|06/06/2021||Yes|No||06/06/2021||Yes|No|06/06/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|22689|||||No|No||NIVAGEN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|75834025690|ATORVASTATIN 20 MG TABLET|90|EA|.04457|06/06/2021||Yes|No||06/06/2021||Yes|No|06/06/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.0488|03/29/2022|.04762|03/29/2022|.04794|03/29/2022|||LIPOTROPICS: STATINS|22690|||||No|No||NIVAGEN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|75834025701|ATORVASTATIN 40 MG TABLET|1000|EA|.07591|06/06/2021||Yes|No||06/06/2021||Yes|No|06/06/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|22691|||||No|No||NIVAGEN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|75834025750|ATORVASTATIN 40 MG TABLET|500|EA|.06855|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|22692|||||No|No||NIVAGEN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|75834025790|ATORVASTATIN 40 MG TABLET|90|EA|.06454|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.063|03/29/2022|.06148|03/29/2022|.06189|03/29/2022|||LIPOTROPICS: STATINS|22693|||||No|No||NIVAGEN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|75834025801|ATORVASTATIN 80 MG TABLET|1000|EA|.07811|06/03/2021||Yes|No||06/03/2021||Yes|No|06/03/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|22694|||||No|No||NIVAGEN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|75834025850|ATORVASTATIN 80 MG TABLET|500|EA|.06308|06/07/2021||Yes|No||06/07/2021||Yes|No|06/07/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|22695|||||No|No||NIVAGEN PHARMAC|No||||
atorvastatin calcium|No|No|No|No|75%|75834025890|ATORVASTATIN 80 MG TABLET|90|EA|.0664|05/28/2021||Yes|No||05/28/2021||Yes|No|05/28/2021||Yes|No||||No|No|||Prescription required|No||063|Yes|.10164|03/29/2022|.0992|03/29/2022|.09986|03/29/2022|||LIPOTROPICS: STATINS|22696|||||No|No||NIVAGEN PHARMAC|No||||
buspirone HCl|No|No|No|No|75%|75834026601|BUSPIRONE HCL 5 MG TABLET|100|EA|.02085|09/07/2021||Yes|No||09/07/2021||Yes|No|09/07/2021||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|22697|||||No|No||NIVAGEN PHARMAC|No||||
buspirone HCl|No|No|No|No|75%|75834026605|BUSPIRONE HCL 5 MG TABLET|500|EA|.02086|09/09/2021||Yes|No||09/09/2021||Yes|No|09/09/2021||Yes|No||||No|No|||Prescription required|No||090|No|.02853|03/29/2022|.02784|03/29/2022|.02803|03/29/2022|||ANXIOLYTICS|22698|||||No|No||NIVAGEN PHARMAC|No||||
buspirone HCl|No|No|No|No|75%|75834026701|BUSPIRONE HCL 7.5 MG TABLET|100|EA|.19543|09/07/2021||Yes|No||09/07/2021||Yes|No|09/07/2021||Yes|No||||No|No|||Prescription required|No||090|No|.22186|03/29/2022|.21653|03/29/2022|.21797|03/29/2022|||ANXIOLYTICS|22699|||||No|No||NIVAGEN PHARMAC|No||||
buspirone HCl|No|No|No|No|75%|75834026801|BUSPIRONE HCL 10 MG TABLET|100|EA|.02992|09/07/2021||Yes|No||09/07/2021||Yes|No|09/07/2021||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|22700|||||No|No||NIVAGEN PHARMAC|No||||
buspirone HCl|No|No|No|No|75%|75834026805|BUSPIRONE HCL 10 MG TABLET|500|EA|.02993|09/07/2021||Yes|No||09/07/2021||Yes|No|09/07/2021||Yes|No||||No|No|||Prescription required|No||090|No|.03957|03/29/2022|.03862|03/29/2022|.03887|03/29/2022|||ANXIOLYTICS|22701|||||No|No||NIVAGEN PHARMAC|No||||
buspirone HCl|No|No|No|No|75%|75834026901|BUSPIRONE HCL 15 MG TABLET|100|EA|.03848|09/09/2021||Yes|No||09/09/2021||Yes|No|09/09/2021||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|22702|||||No|No||NIVAGEN PHARMAC|No||||
buspirone HCl|No|No|No|No|75%|75834026905|BUSPIRONE HCL 15 MG TABLET|500|EA|.03751|09/07/2021||Yes|No||09/07/2021||Yes|No|09/07/2021||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|22703|||||No|No||NIVAGEN PHARMAC|No||||
buspirone HCl|No|No|No|No|75%|75834026960|BUSPIRONE HCL 15 MG TABLET|60|EA|.03769|09/07/2021||Yes|No||09/07/2021||Yes|No|09/07/2021||Yes|No||||No|No|||Prescription required|No||090|No|.05601|03/29/2022|.05466|03/29/2022|.05502|03/29/2022|||ANXIOLYTICS|22704|||||No|No||NIVAGEN PHARMAC|No||||
buspirone HCl|No|No|No|No|75%|75834027060|BUSPIRONE HCL 30 MG TABLET|60|EA|.25083|09/09/2021||Yes|No||09/09/2021||Yes|No|09/09/2021||Yes|No||||No|No|||Prescription required|No||090|No|.17728|03/29/2022|.17302|03/29/2022|.17417|03/29/2022|||ANXIOLYTICS|22705|||||No|No||NIVAGEN PHARMAC|No||||
albuterol sulfate|No|No|No|No|75%|75834027301|ALBUTEROL SULFATE 2 MG TAB|100|EA|.258|09/09/2021||Yes|No||09/09/2021||Yes|No|09/09/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|037|No|.67057|09/09/2021|.65447|09/09/2021|.65883|09/09/2021|||BRONCHODILATORS: BETA AGONIST|22706|||||No|No||NIVAGEN PHARMAC|No||||
albuterol sulfate|No|No|No|No|75%|75834027401|ALBUTEROL SULFATE 4 MG TAB|100|EA|.258|09/09/2021||Yes|No||09/09/2021||Yes|No|09/09/2021||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|037|No|1.0884|03/01/2022|1.06227|03/01/2022|1.06935|03/01/2022|||BRONCHODILATORS: BETA AGONIST|22707|||||No|No||NIVAGEN PHARMAC|No||||
metformin HCl|No|No|No|No|75%|75834050001|METFORMIN HCL ER 500 MG TABLET|100|EA|.03745|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No||012|No|.03646|03/29/2022|.03558|03/29/2022|.03582|03/29/2022|||HYPOGLYCEMICS: METFORMINS|22708|||||No|No||NIVAGEN PHARMAC|No||||
metformin HCl|No|No|No|No|75%|75834050005|METFORMIN HCL ER 500 MG TABLET|500|EA|.0367|12/10/2020||Yes|No||12/10/2020||Yes|No|12/10/2020||Yes|No||||No|No|||Prescription required|No||012|No|.03646|03/29/2022|.03558|03/29/2022|.03582|03/29/2022|||HYPOGLYCEMICS: METFORMINS|22709|||||No|No||NIVAGEN PHARMAC|No||||
multivitamin no.36/folate no.6|No|No|No|No|75%|75854030630|PRENATE CHEWABLE TABLET|30|EA|4.67883|10/03/2013||Yes|No||10/03/2013||Yes|No|10/03/2013||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|10.66338|03/01/2022|10.51104|03/01/2022|10.01052|03/01/2022|||PRENATAL VITAMINS|22710|||||No|No||AVION PHARMACEU|No||||
multivit 38/folate no.6/ginger|No|No|No|No|75%|75854030730|PRENATE AM TABLET|30|EA|2.89504|10/07/2013||Yes|No||10/07/2013||Yes|No|10/07/2013||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|6.598|01/30/2018|6.50374|01/30/2018|6.19404|01/30/2018|||PRENATAL VITAMINS|22711|||||No|No||AVION PHARMACEU|No||||
prenatal vit69/iron/folate6/dh|No|No|No|No|75%|75854030830|PRENATE RESTORE SOFTGEL|30|EA|4.67883|10/07/2013||Yes|No||10/07/2013||Yes|No|10/07/2013||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|10.66338|03/01/2022|10.51104|03/01/2022|10.01052|03/01/2022|||PRENATAL VITAMINS|22712|||||No|No||AVION PHARMACEU|No||||
prenatal vit68/iron/FA no6/dha|No|No|No|No|75%|75854030930|PRENATE ENHANCE SOFTGEL|30|EA|1.419|10/03/2013||Yes|No||10/03/2013||Yes|No|10/03/2013||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|3.234|02/09/2021|3.1878|02/09/2021|3.036|02/09/2021|||PRENATAL VITAMINS|22713|||||No|No||AVION PHARMACEU|No||||
prenatal no.77/iron asp gly/FA|No|No|No|No|75%|75854031130|PRENATE STAR TABLET|30|EA|2.18081|01/16/2015||Yes|No||01/16/2015||Yes|No|01/16/2015||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|4.97022|06/01/2016|4.89922|06/01/2016|4.66592|06/01/2016|||PRENATAL VITAMINS|22714|||||No|No||AVION PHARMACEU|No||||
prenatal 78/iron/folate 1/dha|No|No|No|No|75%|75854031230|PRENATE DHA SOFTGEL|30|EA|4.67883|08/15/2014||Yes|No||08/15/2014||Yes|No|08/15/2014||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|10.66338|03/01/2022|10.51104|03/01/2022|10.01052|03/01/2022|||PRENATAL VITAMINS|22715|||||No|No||AVION PHARMACEU|No||||
multivit no.40/iron/folat1/dha|No|No|No|No|75%|75854031330|PRENATE ESSENTIAL SOFTGEL|30|EA|4.67883|08/15/2014||Yes|No||08/15/2014||Yes|No|08/15/2014||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|10.66338|03/01/2022|10.51104|03/01/2022|10.01052|03/01/2022|||PRENATAL VITAMINS|22716|||||No|No||AVION PHARMACEU|No||||
prenatal 114/iron a-g/folate 1|No|No|No|No|75%|75854031430|PRENATE ELITE TABLET|30|EA|4.67883|08/15/2014||Yes|No||08/15/2014||Yes|No|08/15/2014||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|10.66338|03/01/2022|10.51104|03/01/2022|10.01052|03/01/2022|||PRENATAL VITAMINS|22717|||||No|No||AVION PHARMACEU|No||||
prenatal vit 87/iron/folic/dha|No|No|No|No|75%|75854031530|PRENATE MINI SOFTGEL|30|EA|4.67883|01/16/2015||Yes|No||01/16/2015||Yes|No|01/16/2015||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|10.49497|03/08/2022|10.24309|03/08/2022|10.3113|03/08/2022|||PRENATAL VITAMINS|22718|||||No|No||AVION PHARMACEU|No||||
prenatal vit 85/iron/FA 1/dha|No|No|No|No|75%|75854031630|PRENATE PIXIE SOFTGEL|30|EA|4.67883|01/16/2015||Yes|No||01/16/2015||Yes|No|01/16/2015||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|243|No|10.66338|03/01/2022|10.51104|03/01/2022|10.01052|03/01/2022|||PRENATAL VITAMINS|22719|||||No|No||AVION PHARMACEU|No||||
iron/C/folate/B12/zinc/succin|No|No|No|No|75%|75854031828|FERIVA 21-7 TABLET|28|EA|11.91146|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|506|No|27.14704|03/01/2022|26.75923|03/01/2022|25.48498|03/01/2022|||IRON: ORAL|22720|||||No|No||AVION PHARMACEU|No||||
iron/C/folate/B12/biot/cupric|No|No|No|No|75%|75854031930|FERIVA FA CAPSULE|30|EA|9.36583|09/07/2015||Yes|No||09/07/2015||Yes|No|09/07/2015||Yes|No||||No|No|||Over the counter|Yes|07/29/2021|506|No|21.34538|03/24/2020|21.04044|03/24/2020|20.03852|03/24/2020|||IRON: ORAL|22721|||||No|No||AVION PHARMACEU|No||||
levonorgest/eth.estradiol/iron|Yes|Yes|No|No|75%|75854060203|BALCOLTRA TABLET|28|EA|3.76244|11/13/2018||Yes|No||11/13/2018||Yes|No|11/13/2018||Yes|No|Refer to program requirements|||No|No|06/18/2019||Prescription required|No|||No|8.46314|03/08/2022|8.26002|03/08/2022|8.31503|03/08/2022||||22722|||||No|No||AVION PHARMACEU|No|||Only covered for non-contraceptive (medical) purposes|
colchicine|No|No|No|No|75%|75854080101|GLOPERBA 0.6 MG/5 ML SOLUTION|150|ML|.93736|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|Yes|07/30/2020|231|No|2.13633|02/09/2021|2.10581|02/09/2021|2.00553|02/09/2021|||ANTIHYPERURICEMICS|22723|||||No|No||AVION PHARMACEU|No||||
ibuprofen/famotidine|No|No|No|No|75%|75987001003|DUEXIS 800-26.6 MG TABLET|90|EA|11.8594|01/01/2012||Yes|No||01/01/2012||Yes|No|01/01/2012||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|26.43149|09/28/2021|25.79713|09/28/2021|25.96893|09/28/2021|||NSAIDS|22724|||||No|No||HORIZON THERAPE|No||||
naproxen/esomeprazole mag|No|No|No|No|75%|75987003004|VIMOVO DR 500-20 MG TABLET|60|EA|17.7891|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|40.5426|01/25/2022|39.96342|01/25/2022|38.0604|01/25/2022|||NSAIDS|22725|||||No|No||HORIZON PHARMA|No||||
naproxen/esomeprazole mag|No|No|No|No|75%|75987003104|VIMOVO DR 375-20 MG TABLET|60|EA|17.7891|10/13/2014||Yes|No||10/13/2014||Yes|No|10/13/2014||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|059|Yes|40.5426|02/06/2018|39.96342|02/06/2018|38.0604|02/06/2018|||NSAIDS|22726|||||No|No||HORIZON PHARMA|No||||
diclofenac sodium|No|No|No|No|75%|75987004005|PENNSAID 2% PUMP|112|GM|9.54991|07/16/2015||Yes|No||07/16/2015||Yes|No|07/16/2015||Yes|No||||No|No|||Prescription required|Yes|01/22/2015|059|Yes|21.30089|07/27/2021|20.78966|07/27/2021|20.92812|07/27/2021|||NSAIDS|22727|||||No|No||HORIZON THERAPE|No||||
glycerol phenylbutyrate|No|No|No|No|75%|75987005006|RAVICTI 1.1 GRAM/ML LIQUID|25|ML|90.687|12/10/2015||Yes|No||12/10/2015||Yes|No|12/10/2015||Yes|No||||No|No|||Prescription required|Yes|07/27/2017|570|No|206.682|02/02/2021|203.7294|02/02/2021|194.028|02/02/2021|||UREA CYCLE DISORDERS: ORAL|22728|||||No|No||HORIZON THERAPE|No||||
sodium phenylbutyrate|No|No|No|No|75%|75987006008|BUPHENYL 500 MG TABLET|250|EA|11.7218|08/12/2016||Yes|No||08/12/2016||Yes|No|08/12/2016||Yes|No||||No|No|||Prescription required|No||570|No|26.7148|01/02/2018|26.33316|01/02/2018|25.0792|01/02/2018|||UREA CYCLE DISORDERS: ORAL|22729|||||No|No||HORIZON THERAPE|No||||
sodium phenylbutyrate|No|No|No|No|75%|75987007009|BUPHENYL POWDER|250|GM|23.4393|05/13/2016||Yes|No||05/13/2016||Yes|No|05/13/2016||Yes|No||||No|No|||Prescription required|No||570|No|53.4198|01/02/2018|52.65666|01/02/2018|50.1492|01/02/2018|||UREA CYCLE DISORDERS: ORAL|22730|||||No|No||HORIZON THERAPE|No||||
cysteamine bitartrate|No|No|No|No|75%|75987010004|PROCYSBI DR 25 MG CAPSULE|60|EA|45.6574|05/14/2018||Yes|No||05/14/2018||Yes|No|05/14/2018||Yes|No||||No|No|||Prescription required|No|||No|104.0564|02/02/2021|102.56988|02/02/2021|97.6856|02/02/2021||||22731|||||No|No||HORIZON THERAPE|No||||
cysteamine bitartrate|No|No|No|No|75%|75987010108|PROCYSBI DR 75 MG CAPSULE|250|EA|45.6574|05/14/2018||Yes|No||05/14/2018||Yes|No|05/14/2018||Yes|No||||No|No|||Prescription required|No|||No|104.0564|02/02/2021|102.56988|02/02/2021|97.6856|02/02/2021||||22732|||||No|No||HORIZON THERAPE|No||||
interferon gamma-1b,recomb.|No|No|No|No|75%|75987011110|ACTIMMUNE 100 MCG/0.5 ML VIAL|.5|ML|4324.2692|03/20/2018||Yes|No||03/20/2018||Yes|No|03/20/2018||Yes|No||||No|No|||Prescription required|No|||No|9855.3112|02/02/2021|9714.52104|02/02/2021|9251.9248|02/02/2021||||22733|||||No|No||HORIZON THERAPE|No||||
interferon gamma-1b,recomb.|No|No|No|No|75%|75987011111|ACTIMMUNE 100 MCG/0.5 ML VIAL|.5|ML|4324.2692|03/20/2018||Yes|No||03/20/2018||Yes|No|03/20/2018||Yes|No||||No|No|||Prescription required|No|||No|9855.3112|02/02/2021|9714.52104|02/02/2021|9251.9248|02/02/2021||||22734|||||No|No||HORIZON THERAPE|No||||
cysteamine bitartrate|No|No|No|No|75%|75987014013|PROCYSBI DR 75 MG GRANULE PKT|60|EA|45.6574|02/05/2021||Yes|No||02/05/2021||Yes|No|02/05/2021||Yes|No||||No|No|||Prescription required|No|||No|104.0564|02/05/2021|102.56988|02/05/2021|97.6856|02/05/2021||||22735|||||No|No||HORIZON THERAPE|No||||
cysteamine bitartrate|No|No|No|No|75%|75987014014|PROCYSBI DR 75 MG GRANULE PKT|120|EA|45.6574|02/05/2021||Yes|No||02/05/2021||Yes|No|02/05/2021||Yes|No||||No|No|||Prescription required|No|||No|104.0564|02/05/2021|102.56988|02/05/2021|97.6856|02/05/2021||||22736|||||No|No||HORIZON THERAPE|No||||
cysteamine bitartrate|No|No|No|No|75%|75987014513|PROCYSBI DR 300 MG GRANULE PKT|60|EA|182.6296|02/05/2021||Yes|No||02/05/2021||Yes|No|02/05/2021||Yes|No||||No|No|||Prescription required|No|||No|416.2256|02/05/2021|410.27952|02/05/2021|390.7424|02/05/2021||||22737|||||No|No||HORIZON THERAPE|No||||
cysteamine bitartrate|No|No|No|No|75%|75987014514|PROCYSBI DR 300 MG GRANULE PKT|120|EA|182.6296|02/05/2021||Yes|No||02/05/2021||Yes|No|02/05/2021||Yes|No||||No|No|||Prescription required|No|||No|416.2256|02/05/2021|410.27952|02/05/2021|390.7424|02/05/2021||||22738|||||No|No||HORIZON THERAPE|No||||
antihemophilic factor, human|No|No|No|No|75%|76125025620|KOATE 250 UNIT VIAL|1|EA|.9384|02/13/2017||Yes|No||02/13/2017||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.3524|01/02/2018|1.33308|01/02/2018|1.2696|01/02/2018|||HEMOPHILIA TREATMENT|22739|||||No|No||KEDRION BIOPHAR|No||||
antihemophilic factor, human|No|No|No|No|75%|76125066830|KOATE 500 UNIT VIAL|1|EA|.9384|02/13/2017||Yes|No||02/13/2017||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.3524|01/02/2018|1.33308|01/02/2018|1.2696|01/02/2018|||HEMOPHILIA TREATMENT|22740|||||No|No||KEDRION BIOPHAR|No||||
antihemophilic factor, human|No|No|No|No|75%|76125067650|KOATE 1,000 UNIT VIAL|1|EA|.9384|02/13/2017||Yes|No||02/13/2017||Yes|No|04/01/2021||Yes|No||||No|No|||Prescription required|No||105|No|1.3524|01/02/2018|1.33308|01/02/2018|1.2696|01/02/2018|||HEMOPHILIA TREATMENT|22741|||||No|No||KEDRION BIOPHAR|No||||
immune globul G/gly/IgA avg 46|No|No|No|No|75%|76125090001|GAMMAKED 1 GRAM/10 ML VIAL|10|ML|7.1767|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|||Prescription required|No||023|No|16.3562|02/15/2022|16.12254|02/15/2022|15.3548|02/15/2022|||IMMUNE GLOBULINS|22742|||||No|No||KEDRION BIOPHAR|No||||
immune globul G/gly/IgA avg 46|No|No|No|No|75%|76125090010|GAMMAKED 10 GRAM/100 ML VIAL|100|ML|7.1767|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|||Prescription required|No||023|No|16.3562|02/15/2022|16.12254|02/15/2022|15.3548|02/15/2022|||IMMUNE GLOBULINS|22743|||||No|No||KEDRION BIOPHAR|No||||
immune globul G/gly/IgA avg 46|No|No|No|No|75%|76125090020|GAMMAKED 20 GRAM/200 ML VIAL|200|ML|7.1767|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|||Prescription required|No||023|No|16.3562|02/15/2022|16.12254|02/15/2022|15.3548|02/15/2022|||IMMUNE GLOBULINS|22744|||||No|No||KEDRION BIOPHAR|No||||
immune globul G/gly/IgA avg 46|No|No|No|No|75%|76125090050|GAMMAKED 5 GRAM/50 ML VIAL|50|ML|7.1767|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|||Prescription required|No||023|No|16.3562|02/15/2022|16.12254|02/15/2022|15.3548|02/15/2022|||IMMUNE GLOBULINS|22745|||||No|No||KEDRION BIOPHAR|No||||
ipratropium bromide|No|No|No|No|75%|76204010001|IPRATROPIUM BR 0.02% SOLN|2.5|ML|.03612|08/09/2013||Yes|No||08/09/2013||Yes|No|08/09/2013||Yes|No||||No|No|||Prescription required|No||098|No|.05788|03/29/2022|.05649|03/29/2022|.05686|03/29/2022|||COPD AGENTS|22746|||||No|No||RITEDOSE PHARMA|No||||
ipratropium bromide|No|No|No|No|75%|76204010025|IPRATROPIUM BR 0.02% SOLN|2.5|ML|.03164|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|||Prescription required|No||098|No|.05484|03/29/2022|.05352|03/29/2022|.05388|03/29/2022|||COPD AGENTS|22747|||||No|No||RITEDOSE PHARMA|Yes|09/01/2020|||
ipratropium bromide|No|No|No|No|75%|76204010030|IPRATROPIUM BR 0.02% SOLN|2.5|ML|.03164|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|||Prescription required|No||098|No|.05788|03/29/2022|.05649|03/29/2022|.05686|03/29/2022|||COPD AGENTS|22748|||||No|No||RITEDOSE PHARMA|No||||
ipratropium bromide|No|No|No|No|75%|76204010060|IPRATROPIUM BR 0.02% SOLN|2.5|ML|.03164|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|||Prescription required|No||098|No|.0599|03/29/2022|.05846|03/29/2022|.05885|03/29/2022|||COPD AGENTS|22749|||||No|No||RITEDOSE PHARMA|Yes|09/01/2020|||
albuterol sulfate|No|No|No|No|75%|76204020001|ALBUTEROL SUL 2.5 MG/3 ML SOLN|3|ML|.02866|08/09/2013||Yes|No||08/09/2013||Yes|No|08/09/2013||Yes|No||||No|No|||Prescription required|No||037|Yes|.04903|03/29/2022|.04785|03/29/2022|.04817|03/29/2022|||BRONCHODILATORS: BETA AGONIST|22750|||||No|No||RITEDOSE PHARMA|Yes|09/01/2020|||
albuterol sulfate|No|No|No|No|75%|76204020025|ALBUTEROL SUL 2.5 MG/3 ML SOLN|3|ML|.02293|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|||Prescription required|No||037|Yes|.04199|03/29/2022|.04098|03/29/2022|.04125|03/29/2022|||BRONCHODILATORS: BETA AGONIST|22751|||||No|No||RITEDOSE PHARMA|Yes|09/01/2020|||
albuterol sulfate|No|No|No|No|75%|76204020030|ALBUTEROL SUL 2.5 MG/3 ML SOLN|3|ML|.02293|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|||Prescription required|No||037|Yes|.04903|03/29/2022|.04785|03/29/2022|.04817|03/29/2022|||BRONCHODILATORS: BETA AGONIST|22752|||||No|No||RITEDOSE PHARMA|Yes|09/01/2020|||
albuterol sulfate|No|No|No|No|75%|76204020060|ALBUTEROL SUL 2.5 MG/3 ML SOLN|3|ML|.02293|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|||Prescription required|No||037|Yes|.04406|03/29/2022|.043|03/29/2022|.04328|03/29/2022|||BRONCHODILATORS: BETA AGONIST|22753|||||No|No||RITEDOSE PHARMA|Yes|09/01/2020|||
ipratropium/albuterol sulfate|No|No|No|No|75%|76204060005|IPRAT-ALBUT 0.5-3(2.5) MG/3 ML|3|ML|.05733|08/09/2013||Yes|No||08/09/2013||Yes|No|08/09/2013||Yes|No||||No|No|||Prescription required|No||098|Yes|.07201|03/29/2022|.07028|03/29/2022|.07074|03/29/2022|||COPD AGENTS|22754|||||No|No||RITEDOSE PHARMA|No||||
ipratropium/albuterol sulfate|No|No|No|No|75%|76204060012|IPRAT-ALBUT 0.5-3(2.5) MG/3 ML|3|ML|.05733|08/09/2013||Yes|No||08/09/2013||Yes|No|08/09/2013||Yes|No||||No|No|||Prescription required|No||098|Yes|.06072|03/29/2022|.05926|03/29/2022|.05965|03/29/2022|||COPD AGENTS|22755|||||No|No||RITEDOSE PHARMA|No||||
ipratropium/albuterol sulfate|No|No|No|No|75%|76204060030|IPRAT-ALBUT 0.5-3(2.5) MG/3 ML|3|ML|.05733|03/02/2018||Yes|No||03/02/2018||Yes|No|03/02/2018||Yes|No||||No|No|||Prescription required|No||098|Yes|.07201|03/29/2022|.07028|03/29/2022|.07074|03/29/2022|||COPD AGENTS|22756|||||No|No||RITEDOSE PHARMA|Yes|09/01/2020|||
ipratropium/albuterol sulfate|No|No|No|No|75%|76204060060|IPRAT-ALBUT 0.5-3(2.5) MG/3 ML|3|ML|.05733|03/02/2018||Yes|No||03/02/2018||Yes|No|03/02/2018||Yes|No||||No|No|||Prescription required|No||098|Yes|.06072|03/29/2022|.05926|03/29/2022|.05965|03/29/2022|||COPD AGENTS|22757|||||No|No||RITEDOSE PHARMA|Yes|09/01/2020|||
levalbuterol HCl|No|No|No|No|75%|76204070001|LEVALBUTEROL 0.31 MG/3 ML SOL|3|ML|.22933|03/02/2018||Yes|No||03/02/2018||Yes|No|03/02/2018||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|.33735|03/01/2022|.32925|03/01/2022|.33144|03/01/2022|||BRONCHODILATORS: BETA AGONIST|22758|||||No|No||RITEDOSE PHARMA|No||||
levalbuterol HCl|No|No|No|No|75%|76204070025|LEVALBUTEROL 0.31 MG/3 ML SOL|3|ML|.172|03/02/2018||Yes|No||03/02/2018||Yes|No|03/02/2018||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|.392|03/23/2021|.3864|03/23/2021|.368|03/23/2021|||BRONCHODILATORS: BETA AGONIST|22759|||||No|No||RITEDOSE PHARMA|No||||
levalbuterol HCl|No|No|No|No|75%|76204080001|LEVALBUTEROL 0.63 MG/3 ML SOL|3|ML|.22933|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|.37606|03/29/2022|.36703|03/29/2022|.36947|03/29/2022|||BRONCHODILATORS: BETA AGONIST|22760|||||No|No||RITEDOSE PHARMA|Yes|09/01/2020|||
levalbuterol HCl|No|No|No|No|75%|76204080025|LEVALBUTEROL 0.63 MG/3 ML SOL|3|ML|.172|03/02/2018||Yes|No||03/02/2018||Yes|No|03/02/2018||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|.3279|03/29/2022|.32003|03/29/2022|.32216|03/29/2022|||BRONCHODILATORS: BETA AGONIST|22761|||||No|No||RITEDOSE PHARMA|Yes|09/01/2020|||
levalbuterol HCl|No|No|No|No|75%|76204090001|LEVALBUTEROL 1.25 MG/3 ML SOL|3|ML|.22933|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|.33214|03/29/2022|.32416|03/29/2022|.32632|03/29/2022|||BRONCHODILATORS: BETA AGONIST|22762|||||No|No||RITEDOSE PHARMA|No||||
levalbuterol HCl|No|No|No|No|75%|76204090025|LEVALBUTEROL 1.25 MG/3 ML SOL|3|ML|.172|03/05/2018||Yes|No||03/05/2018||Yes|No|03/05/2018||Yes|No||||No|No|||Prescription required|Yes|08/28/2020|037|Yes|.31144|03/29/2022|.30396|03/29/2022|.30598|03/29/2022|||BRONCHODILATORS: BETA AGONIST|22763|||||No|No||RITEDOSE PHARMA|Yes|09/01/2020|||
meloxicam|No|No|No|No|75%|76282015201|MELOXICAM 7.5 MG TABLET|100|EA|.01866|04/24/2015||Yes|No||04/24/2015||Yes|No|04/24/2015||Yes|No||||No|No|||Prescription required|No||059|Yes|.02308|03/29/2022|.02252|03/29/2022|.02267|03/29/2022|||NSAIDS|22764|||||No|No||EXELAN PHARMACE|No||||
meloxicam|No|No|No|No|75%|76282015210|MELOXICAM 7.5 MG TABLET|1000|EA|.01865|04/24/2015||Yes|No||04/24/2015||Yes|No|04/24/2015||Yes|No||||No|No|||Prescription required|No||059|Yes|.02308|03/29/2022|.02252|03/29/2022|.02267|03/29/2022|||NSAIDS|22765|||||No|No||EXELAN PHARMACE|No||||
meloxicam|No|No|No|No|75%|76282015301|MELOXICAM 15 MG TABLET|100|EA|.01969|04/24/2015||Yes|No||04/24/2015||Yes|No|04/24/2015||Yes|No||||No|No|||Prescription required|No||059|Yes|.02416|03/29/2022|.02358|03/29/2022|.02373|03/29/2022|||NSAIDS|22766|||||No|No||EXELAN PHARMACE|No||||
meloxicam|No|No|No|No|75%|76282015310|MELOXICAM 15 MG TABLET|1000|EA|.0197|04/24/2015||Yes|No||04/24/2015||Yes|No|04/24/2015||Yes|No||||No|No|||Prescription required|No||059|Yes|.02416|03/29/2022|.02358|03/29/2022|.02373|03/29/2022|||NSAIDS|22767|||||No|No||EXELAN PHARMACE|No||||
fosinopril sodium|Yes|No|No|No|75%|76282020010|FOSINOPRIL SODIUM 10 MG TAB|1000|EA|.1163|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.17684|03/29/2022|.17259|03/29/2022|.17374|03/29/2022|||ANGIOTENSIN MODULATORS|22768|||||No|No||EXELAN PHARMACE|No||||
fosinopril sodium|Yes|No|No|No|75%|76282020090|FOSINOPRIL SODIUM 10 MG TAB|90|EA|.14767|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.17684|03/29/2022|.17259|03/29/2022|.17374|03/29/2022|||ANGIOTENSIN MODULATORS|22769|||||No|No||EXELAN PHARMACE|No||||
fosinopril sodium|Yes|No|No|No|75%|76282020110|FOSINOPRIL SODIUM 20 MG TAB|1000|EA|.13137|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.153|03/29/2022|.14932|03/29/2022|.15032|03/29/2022|||ANGIOTENSIN MODULATORS|22770|||||No|No||EXELAN PHARMACE|No||||
fosinopril sodium|Yes|No|No|No|75%|76282020190|FOSINOPRIL SODIUM 20 MG TAB|90|EA|.18943|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||113|Yes|.153|03/29/2022|.14932|03/29/2022|.15032|03/29/2022|||ANGIOTENSIN MODULATORS|22771|||||No|No||EXELAN PHARMACE|No||||
fosinopril sodium|Yes|No|No|No|75%|76282020210|FOSINOPRIL SODIUM 40 MG TAB|1000|EA|.19107|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.20623|03/29/2022|.20128|03/29/2022|.20262|03/29/2022|||ANGIOTENSIN MODULATORS|22772|||||No|No||EXELAN PHARMACE|No||||
fosinopril sodium|Yes|No|No|No|75%|76282020290|FOSINOPRIL SODIUM 40 MG TAB|90|EA|.29535|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.20623|03/29/2022|.20128|03/29/2022|.20262|03/29/2022|||ANGIOTENSIN MODULATORS|22773|||||No|No||EXELAN PHARMACE|No||||
citalopram hydrobromide|Yes|No|No|No|75%|76282020810|CITALOPRAM HBR 40 MG TABLET|1000|EA|.05122|09/27/2012||Yes|No||09/27/2012||Yes|No|09/27/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.03726|03/29/2022|.03636|03/29/2022|.0366|03/29/2022|||ANTIDEPRESSANTS: SSRIs|22774|||||No|No||EXELAN PHARMACE|No||||
sertraline HCl|Yes|No|No|No|75%|76282021201|SERTRALINE HCL 25 MG TABLET|100|EA|.04446|09/28/2012||Yes|No||09/28/2012||Yes|No|09/28/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.05057|03/29/2022|.04935|03/29/2022|.04968|03/29/2022|||ANTIDEPRESSANTS: SSRIs|22775|||||No|No||EXELAN PHARMACE|No||||
sertraline HCl|Yes|No|No|No|75%|76282021205|SERTRALINE HCL 25 MG TABLET|500|EA|.01112|09/28/2012||Yes|No||09/28/2012||Yes|No|09/28/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.05057|03/29/2022|.04935|03/29/2022|.04968|03/29/2022|||ANTIDEPRESSANTS: SSRIs|22776|||||No|No||EXELAN PHARMACE|No||||
sertraline HCl|Yes|No|No|No|75%|76282021301|SERTRALINE HCL 50 MG TABLET|100|EA|.04446|09/28/2012||Yes|No||09/28/2012||Yes|No|09/28/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.04281|03/29/2022|.04178|03/29/2022|.04206|03/29/2022|||ANTIDEPRESSANTS: SSRIs|22777|||||No|No||EXELAN PHARMACE|No||||
sertraline HCl|Yes|No|No|No|75%|76282021305|SERTRALINE HCL 50 MG TABLET|500|EA|.00903|09/28/2012||Yes|No||09/28/2012||Yes|No|09/28/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.04281|03/29/2022|.04178|03/29/2022|.04206|03/29/2022|||ANTIDEPRESSANTS: SSRIs|22778|||||No|No||EXELAN PHARMACE|No||||
sertraline HCl|Yes|No|No|No|75%|76282021330|SERTRALINE HCL 50 MG TABLET|30|EA|.02264|09/28/2012||Yes|No||09/28/2012||Yes|No|09/28/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.04281|03/29/2022|.04178|03/29/2022|.04206|03/29/2022|||ANTIDEPRESSANTS: SSRIs|22779|||||No|No||EXELAN PHARMACE|No||||
sertraline HCl|Yes|No|No|No|75%|76282021401|SERTRALINE HCL 100 MG TABLET|100|EA|.04446|09/28/2012||Yes|No||09/28/2012||Yes|No|09/28/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|22780|||||No|No||EXELAN PHARMACE|No||||
sertraline HCl|Yes|No|No|No|75%|76282021405|SERTRALINE HCL 100 MG TABLET|500|EA|.01361|09/28/2012||Yes|No||09/28/2012||Yes|No|09/28/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.06021|03/29/2022|.05876|03/29/2022|.05915|03/29/2022|||ANTIDEPRESSANTS: SSRIs|22781|||||No|No||EXELAN PHARMACE|No||||
gemfibrozil|No|No|No|No|75%|76282022505|GEMFIBROZIL 600 MG TABLET|500|EA|.27862|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|||Prescription required|No||055|No|.10518|03/29/2022|.10265|03/29/2022|.10333|03/29/2022|||LIPOTROPICS: OTHER|22782|||||No|No||EXELAN PHARMACE|No||||
gemfibrozil|No|No|No|No|75%|76282022518|GEMFIBROZIL 600 MG TABLET|180|EA|.32686|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|||Prescription required|No||055|No|.10518|03/29/2022|.10265|03/29/2022|.10333|03/29/2022|||LIPOTROPICS: OTHER|22783|||||No|No||EXELAN PHARMACE|No||||
gemfibrozil|No|No|No|No|75%|76282022560|GEMFIBROZIL 600 MG TABLET|60|EA|.344|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|||Prescription required|No||055|No|.10518|03/29/2022|.10265|03/29/2022|.10333|03/29/2022|||LIPOTROPICS: OTHER|22784|||||No|No||EXELAN PHARMACE|No||||
amlodipine besylate|Yes|No|No|No|75%|76282023710|AMLODIPINE BESYLATE 2.5 MG TAB|1000|EA|.02092|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|22785|||||No|No||EXELAN PHARMACE|No||||
amlodipine besylate|Yes|No|No|No|75%|76282023790|AMLODIPINE BESYLATE 2.5 MG TAB|90|EA|.02326|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.01264|03/29/2022|.01233|03/29/2022|.01241|03/29/2022|||CALCIUM CHANNEL BLOCKERS|22786|||||No|No||EXELAN PHARMACE|No||||
amlodipine besylate|Yes|No|No|No|75%|76282023810|AMLODIPINE BESYLATE 5 MG TAB|1000|EA|.01638|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|22787|||||No|No||EXELAN PHARMACE|No||||
amlodipine besylate|Yes|No|No|No|75%|76282023890|AMLODIPINE BESYLATE 5 MG TAB|90|EA|.0214|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||045|Yes|.01104|03/29/2022|.01077|03/29/2022|.01084|03/29/2022|||CALCIUM CHANNEL BLOCKERS|22788|||||No|No||EXELAN PHARMACE|No||||
amlodipine besylate|Yes|No|No|No|75%|76282023910|AMLODIPINE BESYLATE 10 MG TAB|1000|EA|.03207|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|22789|||||No|No||EXELAN PHARMACE|No||||
amlodipine besylate|Yes|No|No|No|75%|76282023990|AMLODIPINE BESYLATE 10 MG TAB|90|EA|.03516|04/01/2012||Yes|No||04/01/2012||Yes|No|04/01/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||045|No|.01687|03/29/2022|.01646|03/29/2022|.01657|03/29/2022|||CALCIUM CHANNEL BLOCKERS|22790|||||No|No||EXELAN PHARMACE|No||||
escitalopram oxalate|Yes|No|No|No|75%|76282024910|ESCITALOPRAM 5 MG TABLET|1000|EA|.25702|06/09/2014||Yes|No||06/09/2014||Yes|No|06/09/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.0462|03/29/2022|.04509|03/29/2022|.04539|03/29/2022|||ANTIDEPRESSANTS: SSRIs|22791|||||No|No||EXELAN PHARMACE|No||||
escitalopram oxalate|Yes|No|No|No|75%|76282024930|ESCITALOPRAM 5 MG TABLET|30|EA|.28896|06/09/2014||Yes|No||06/09/2014||Yes|No|06/09/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.0462|03/29/2022|.04509|03/29/2022|.04539|03/29/2022|||ANTIDEPRESSANTS: SSRIs|22792|||||No|No||EXELAN PHARMACE|No||||
escitalopram oxalate|Yes|No|No|No|75%|76282024990|ESCITALOPRAM 5 MG TABLET|90|EA|.26626|10/08/2012||Yes|No||10/08/2012||Yes|No|10/08/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.0462|03/29/2022|.04509|03/29/2022|.04539|03/29/2022|||ANTIDEPRESSANTS: SSRIs|22793|||||No|No||EXELAN PHARMACE|No||||
escitalopram oxalate|Yes|No|No|No|75%|76282025010|ESCITALOPRAM 10 MG TABLET|1000|EA|.19017|07/03/2014||Yes|No||07/03/2014||Yes|No|07/03/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIDEPRESSANTS: SSRIs|22794|||||No|No||EXELAN PHARMACE|No||||
escitalopram oxalate|Yes|No|No|No|75%|76282025090|ESCITALOPRAM 10 MG TABLET|90|EA|.19163|10/08/2012||Yes|No||10/08/2012||Yes|No|10/08/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|Yes|.04972|03/29/2022|.04852|03/29/2022|.04884|03/29/2022|||ANTIDEPRESSANTS: SSRIs|22795|||||No|No||EXELAN PHARMACE|No||||
escitalopram oxalate|Yes|No|No|No|75%|76282025110|ESCITALOPRAM 20 MG TABLET|1000|EA|.19902|07/03/2014||Yes|No||07/03/2014||Yes|No|07/03/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.07845|03/29/2022|.07656|03/29/2022|.07707|03/29/2022|||ANTIDEPRESSANTS: SSRIs|22796|||||No|No||EXELAN PHARMACE|No||||
escitalopram oxalate|Yes|No|No|No|75%|76282025190|ESCITALOPRAM 20 MG TABLET|90|EA|.22139|10/08/2012||Yes|No||10/08/2012||Yes|No|10/08/2012||Yes|No||||No|No|07/01/2016||Prescription required|No||008|No|.07845|03/29/2022|.07656|03/29/2022|.07707|03/29/2022|||ANTIDEPRESSANTS: SSRIs|22797|||||No|No||EXELAN PHARMACE|No||||
nabumetone|No|No|No|No|75%|76282025701|NABUMETONE 500 MG TABLET|100|EA|.2795|06/10/2014||Yes|No||06/10/2014||Yes|No|06/10/2014||Yes|No||||No|No|||Prescription required|Yes|01/23/2013|059|Yes|.17691|03/29/2022|.17266|03/29/2022|.17381|03/29/2022|||NSAIDS|22798|||||No|No||EXELAN PHARMACE|No||||
nabumetone|No|No|No|No|75%|76282025801|NABUMETONE 750 MG TABLET|100|EA|.2924|06/10/2014||Yes|No||06/10/2014||Yes|No|06/10/2014||Yes|No||||No|No|||Prescription required|Yes|01/15/2014|059|Yes|.2074|03/29/2022|.20242|03/29/2022|.20377|03/29/2022|||NSAIDS|22799|||||No|No||EXELAN PHARMACE|No||||
alfuzosin HCl|No|No|No|No|75%|76282030201|ALFUZOSIN HCL ER 10 MG TABLET|100|EA|.05031|09/26/2012||Yes|No||09/26/2012||Yes|No|09/26/2012||Yes|No||||No|No|||Prescription required|No||003|No|.12775|03/29/2022|.12468|03/29/2022|.12551|03/29/2022|||BPH TREATMENTS|22800|||||No|No||EXELAN PHARMACE|No||||
alfuzosin HCl|No|No|No|No|75%|76282030205|ALFUZOSIN HCL ER 10 MG TABLET|500|EA|.0559|06/09/2014||Yes|No||06/09/2014||Yes|No|06/09/2014||Yes|No||||No|No|||Prescription required|No||003|No|.12775|03/29/2022|.12468|03/29/2022|.12551|03/29/2022|||BPH TREATMENTS|22801|||||No|No||EXELAN PHARMACE|No||||
calcium acetate|No|No|No|No|75%|76282037702|CALCIUM ACETATE 667 MG CAPSULE|200|EA|.129|09/15/2014||Yes|No||09/15/2014||Yes|No|09/15/2014||Yes|No||||No|No|||Prescription required|No||052|Yes|.28113|03/29/2022|.27438|03/29/2022|.27621|03/29/2022|||PHOSPHATE BINDERS|22802|||||No|No||EXELAN PHARMACE|No||||
gabapentin|No|No|No|No|75%|76282040501|GABAPENTIN 600 MG TABLET|100|EA|.06987|06/10/2014||Yes|No||06/10/2014||Yes|No|06/10/2014||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|22803|||||No|No||EXELAN PHARMACE|No||||
gabapentin|No|No|No|No|75%|76282040505|GABAPENTIN 600 MG TABLET|500|EA|.02523|06/10/2014||Yes|No||06/10/2014||Yes|No|06/10/2014||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|22804|||||No|No||EXELAN PHARMACE|No||||
gabapentin|No|No|No|No|75%|76282040590|GABAPENTIN 600 MG TABLET|90|EA|.02752|06/10/2014||Yes|No||06/10/2014||Yes|No|06/10/2014||Yes|No||||No|No|||Prescription required|No||232|Yes|.0921|03/29/2022|.08988|03/29/2022|.09048|03/29/2022|||NEUROPATHIC PAIN|22805|||||No|No||EXELAN PHARMACE|No||||
gabapentin|No|No|No|No|75%|76282040601|GABAPENTIN 800 MG TABLET|100|EA|.09675|06/10/2014||Yes|No||06/10/2014||Yes|No|06/10/2014||Yes|No||||No|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|22806|||||No|No||EXELAN PHARMACE|No||||
gabapentin|No|No|No|No|75%|76282040605|GABAPENTIN 800 MG TABLET|500|EA|.03762|06/10/2014||Yes|No||06/10/2014||Yes|No|06/10/2014||Yes|No||||No|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|22807|||||No|No||EXELAN PHARMACE|No||||
gabapentin|No|No|No|No|75%|76282040690|GABAPENTIN 800 MG TABLET|90|EA|.04051|06/10/2014||Yes|No||06/10/2014||Yes|No|06/10/2014||Yes|No||||No|No|||Prescription required|No||232|Yes|.12598|03/29/2022|.12295|03/29/2022|.12377|03/29/2022|||NEUROPATHIC PAIN|22808|||||No|No||EXELAN PHARMACE|No||||
sevelamer carbonate|No|No|No|No|75%|76282040727|SEVELAMER CARBONATE 800 MG TAB|270|EA|.37653|06/25/2020||Yes|No||06/25/2020||Yes|No|06/25/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|052|Yes|.27122|03/29/2022|.26471|03/29/2022|.26647|03/29/2022|||PHOSPHATE BINDERS|22809|||||No|No||EXELAN PHARMACE|No||||
finasteride|No|No|No|No|75%|76282041205|FINASTERIDE 5 MG TABLET|500|EA|.02881|06/10/2014||Yes|No||06/10/2014||Yes|No|06/10/2014||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|22810|||||No|No||EXELAN PHARMACE|No||||
finasteride|No|No|No|No|75%|76282041230|FINASTERIDE 5 MG TABLET|30|EA|.04113|06/10/2014||Yes|No||06/10/2014||Yes|No|06/10/2014||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|22811|||||No|No||EXELAN PHARMACE|No||||
finasteride|No|No|No|No|75%|76282041290|FINASTERIDE 5 MG TABLET|90|EA|.03793|06/10/2014||Yes|No||06/10/2014||Yes|No|06/10/2014||Yes|No||||No|No|||Prescription required|No||003|No|.07508|03/29/2022|.07327|03/29/2022|.07376|03/29/2022|||BPH TREATMENTS|22812|||||No|No||EXELAN PHARMACE|No||||
lisinopril|Yes|No|No|No|75%|76282041705|LISINOPRIL 2.5 MG TABLET|500|EA|.00452|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.01617|03/29/2022|.01578|03/29/2022|.01588|03/29/2022|||ANGIOTENSIN MODULATORS|22813|||||No|No||EXELAN PHARMACE|No||||
lisinopril|Yes|No|No|No|75%|76282041810|LISINOPRIL 5 MG TABLET|1000|EA|.00377|06/16/2014||Yes|No||06/16/2014||Yes|No|06/16/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.01549|03/29/2022|.01511|03/29/2022|.01521|03/29/2022|||ANGIOTENSIN MODULATORS|22814|||||No|No||EXELAN PHARMACE|No||||
lisinopril|Yes|No|No|No|75%|76282041845|LISINOPRIL 5 MG TABLET|45|EA|.00725|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.01549|03/29/2022|.01511|03/29/2022|.01521|03/29/2022|||ANGIOTENSIN MODULATORS|22815|||||No|No||EXELAN PHARMACE|No||||
lisinopril|Yes|No|No|No|75%|76282041890|LISINOPRIL 5 MG TABLET|90|EA|.00645|06/16/2014||Yes|No||06/16/2014||Yes|No|06/16/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.01549|03/29/2022|.01511|03/29/2022|.01521|03/29/2022|||ANGIOTENSIN MODULATORS|22816|||||No|No||EXELAN PHARMACE|No||||
lisinopril|Yes|No|No|No|75%|76282041910|LISINOPRIL 10 MG TABLET|1000|EA|.00483|06/16/2014||Yes|No||06/16/2014||Yes|No|06/16/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.01914|03/29/2022|.01868|03/29/2022|.0188|03/29/2022|||ANGIOTENSIN MODULATORS|22817|||||No|No||EXELAN PHARMACE|No||||
lisinopril|Yes|No|No|No|75%|76282041945|LISINOPRIL 10 MG TABLET|45|EA|.00946|06/16/2014||Yes|No||06/16/2014||Yes|No|06/16/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.01914|03/29/2022|.01868|03/29/2022|.0188|03/29/2022|||ANGIOTENSIN MODULATORS|22818|||||No|No||EXELAN PHARMACE|No||||
lisinopril|Yes|No|No|No|75%|76282041990|LISINOPRIL 10 MG TABLET|90|EA|.00788|06/16/2014||Yes|No||06/16/2014||Yes|No|06/16/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.01914|03/29/2022|.01868|03/29/2022|.0188|03/29/2022|||ANGIOTENSIN MODULATORS|22819|||||No|No||EXELAN PHARMACE|No||||
lisinopril|Yes|No|No|No|75%|76282042010|LISINOPRIL 20 MG TABLET|1000|EA|.00673|06/16/2014||Yes|No||06/16/2014||Yes|No|06/16/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANGIOTENSIN MODULATORS|22820|||||No|No||EXELAN PHARMACE|No||||
lisinopril|Yes|No|No|No|75%|76282042018|LISINOPRIL 20 MG TABLET|180|EA|.00874|06/16/2014||Yes|No||06/16/2014||Yes|No|06/16/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANGIOTENSIN MODULATORS|22821|||||No|No||EXELAN PHARMACE|No||||
lisinopril|Yes|No|No|No|75%|76282042045|LISINOPRIL 20 MG TABLET|45|EA|.01041|11/17/2014||Yes|No||11/17/2014||Yes|No|11/17/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANGIOTENSIN MODULATORS|22822|||||No|No||EXELAN PHARMACE|No||||
lisinopril|Yes|No|No|No|75%|76282042090|LISINOPRIL 20 MG TABLET|90|EA|.0096|06/16/2014||Yes|No||06/16/2014||Yes|No|06/16/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.02633|03/29/2022|.02569|03/29/2022|.02586|03/29/2022|||ANGIOTENSIN MODULATORS|22823|||||No|No||EXELAN PHARMACE|No||||
lisinopril|Yes|No|No|No|75%|76282042101|LISINOPRIL 30 MG TABLET|100|EA|.01591|06/16/2014||Yes|No||06/16/2014||Yes|No|06/16/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.05487|03/29/2022|.05355|03/29/2022|.0539|03/29/2022|||ANGIOTENSIN MODULATORS|22824|||||No|No||EXELAN PHARMACE|No||||
lisinopril|Yes|No|No|No|75%|76282042210|LISINOPRIL 40 MG TABLET|1000|EA|.01243|06/16/2014||Yes|No||06/16/2014||Yes|No|06/16/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.04778|03/29/2022|.04663|03/29/2022|.04694|03/29/2022|||ANGIOTENSIN MODULATORS|22825|||||No|No||EXELAN PHARMACE|No||||
lisinopril|Yes|No|No|No|75%|76282042218|LISINOPRIL 40 MG TABLET|180|EA|.01287|06/16/2014||Yes|No||06/16/2014||Yes|No|06/16/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.04778|03/29/2022|.04663|03/29/2022|.04694|03/29/2022|||ANGIOTENSIN MODULATORS|22826|||||No|No||EXELAN PHARMACE|No||||
lisinopril|Yes|No|No|No|75%|76282042245|LISINOPRIL 40 MG TABLET|45|EA|.01671|06/16/2014||Yes|No||06/16/2014||Yes|No|06/16/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.04778|03/29/2022|.04663|03/29/2022|.04694|03/29/2022|||ANGIOTENSIN MODULATORS|22827|||||No|No||EXELAN PHARMACE|No||||
lisinopril|Yes|No|No|No|75%|76282042290|LISINOPRIL 40 MG TABLET|90|EA|.0129|06/16/2014||Yes|No||06/16/2014||Yes|No|06/16/2014||Yes|No||||No|No|07/01/2016||Prescription required|No||113|No|.04778|03/29/2022|.04663|03/29/2022|.04694|03/29/2022|||ANGIOTENSIN MODULATORS|22828|||||No|No||EXELAN PHARMACE|No||||
lisinopril/hydrochlorothiazide|Yes|No|No|No|75%|76282044601|LISINOPRIL-HCTZ 10-12.5 MG TAB|100|EA|.08281|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||113|Yes|.03674|03/29/2022|.03585|03/29/2022|.03609|03/29/2022|||ANGIOTENSIN MODULATORS|22829|||||No|No||EXELAN PHARMACE|No||||
lisinopril/hydrochlorothiazide|Yes|No|No|No|75%|76282044605|LISINOPRIL-HCTZ 10-12.5 MG TAB|500|EA|.0828|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||113|Yes|.03674|03/29/2022|.03585|03/29/2022|.03609|03/29/2022|||ANGIOTENSIN MODULATORS|22830|||||No|No||EXELAN PHARMACE|No||||
lisinopril/hydrochlorothiazide|Yes|No|No|No|75%|76282044610|LISINOPRIL-HCTZ 10-12.5 MG TAB|1000|EA|.07503|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||113|Yes|.03674|03/29/2022|.03585|03/29/2022|.03609|03/29/2022|||ANGIOTENSIN MODULATORS|22831|||||No|No||EXELAN PHARMACE|No||||
lisinopril/hydrochlorothiazide|Yes|No|No|No|75%|76282044690|LISINOPRIL-HCTZ 10-12.5 MG TAB|90|EA|.08365|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||113|Yes|.03674|03/29/2022|.03585|03/29/2022|.03609|03/29/2022|||ANGIOTENSIN MODULATORS|22832|||||No|No||EXELAN PHARMACE|No||||
lisinopril/hydrochlorothiazide|Yes|No|No|No|75%|76282044701|LISINOPRIL-HCTZ 20-12.5 MG TAB|100|EA|.08733|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||113|Yes|.04909|03/29/2022|.04791|03/29/2022|.04823|03/29/2022|||ANGIOTENSIN MODULATORS|22833|||||No|No||EXELAN PHARMACE|No||||
lisinopril/hydrochlorothiazide|Yes|No|No|No|75%|76282044705|LISINOPRIL-HCTZ 20-12.5 MG TAB|500|EA|.08731|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||113|Yes|.04909|03/29/2022|.04791|03/29/2022|.04823|03/29/2022|||ANGIOTENSIN MODULATORS|22834|||||No|No||EXELAN PHARMACE|No||||
lisinopril/hydrochlorothiazide|Yes|No|No|No|75%|76282044710|LISINOPRIL-HCTZ 20-12.5 MG TAB|1000|EA|.0801|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||113|Yes|.04909|03/29/2022|.04791|03/29/2022|.04823|03/29/2022|||ANGIOTENSIN MODULATORS|22835|||||No|No||EXELAN PHARMACE|No||||
lisinopril/hydrochlorothiazide|Yes|No|No|No|75%|76282044790|LISINOPRIL-HCTZ 20-12.5 MG TAB|90|EA|.08819|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||113|Yes|.04909|03/29/2022|.04791|03/29/2022|.04823|03/29/2022|||ANGIOTENSIN MODULATORS|22836|||||No|No||EXELAN PHARMACE|No||||
lisinopril/hydrochlorothiazide|Yes|No|No|No|75%|76282044801|LISINOPRIL-HCTZ 20-25 MG TAB|100|EA|.12332|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||113|Yes|.04948|03/29/2022|.04829|03/29/2022|.04861|03/29/2022|||ANGIOTENSIN MODULATORS|22837|||||No|No||EXELAN PHARMACE|No||||
lisinopril/hydrochlorothiazide|Yes|No|No|No|75%|76282044805|LISINOPRIL-HCTZ 20-25 MG TAB|500|EA|.12331|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||113|Yes|.04948|03/29/2022|.04829|03/29/2022|.04861|03/29/2022|||ANGIOTENSIN MODULATORS|22838|||||No|No||EXELAN PHARMACE|No||||
lisinopril/hydrochlorothiazide|Yes|No|No|No|75%|76282044810|LISINOPRIL-HCTZ 20-25 MG TAB|1000|EA|.11611|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||113|Yes|.04948|03/29/2022|.04829|03/29/2022|.04861|03/29/2022|||ANGIOTENSIN MODULATORS|22839|||||No|No||EXELAN PHARMACE|No||||
lisinopril/hydrochlorothiazide|Yes|No|No|No|75%|76282044890|LISINOPRIL-HCTZ 20-25 MG TAB|90|EA|.12455|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|06/19/2020||Prescription required|No||113|Yes|.04948|03/29/2022|.04829|03/29/2022|.04861|03/29/2022|||ANGIOTENSIN MODULATORS|22840|||||No|No||EXELAN PHARMACE|No||||
pregabalin|No|No|No|No|90%|76282056890|PREGABALIN 25 MG CAPSULE|90|EA|.01032|02/07/2020||Yes|No||02/07/2020||Yes|No|02/07/2020||Yes|No||||No|No|||Prescription required|No||232|No|.0795|03/29/2022|.07759|03/29/2022|.0781|03/29/2022|||NEUROPATHIC PAIN|22841|||||No|No||EXELAN PHARMACE|No||||
pregabalin|No|No|No|No|90%|76282056990|PREGABALIN 50 MG CAPSULE|90|EA|.01533|02/07/2020||Yes|No||02/07/2020||Yes|No|02/07/2020||Yes|No||||No|No|||Prescription required|No||232|No|.09128|03/29/2022|.08908|03/29/2022|.08968|03/29/2022|||NEUROPATHIC PAIN|22842|||||No|No||EXELAN PHARMACE|No||||
pregabalin|No|No|No|No|90%|76282057090|PREGABALIN 75 MG CAPSULE|90|EA|.01695|02/07/2020||Yes|No||02/07/2020||Yes|No|02/07/2020||Yes|No||||No|No|||Prescription required|No||232|No|.08098|03/29/2022|.07903|03/29/2022|.07956|03/29/2022|||NEUROPATHIC PAIN|22843|||||No|No||EXELAN PHARMACE|No||||
pregabalin|No|No|No|No|90%|76282057190|PREGABALIN 100 MG CAPSULE|90|EA|.01915|02/07/2020||Yes|No||02/07/2020||Yes|No|02/07/2020||Yes|No||||No|No|||Prescription required|No||232|No|.08763|03/29/2022|.08552|03/29/2022|.08609|03/29/2022|||NEUROPATHIC PAIN|22844|||||No|No||EXELAN PHARMACE|No||||
pregabalin|No|No|No|No|90%|76282057290|PREGABALIN 150 MG CAPSULE|90|EA|.02345|02/07/2020||Yes|No||02/07/2020||Yes|No|02/07/2020||Yes|No||||No|No|||Prescription required|No||232|No|.10646|03/29/2022|.1039|03/29/2022|.10459|03/29/2022|||NEUROPATHIC PAIN|22845|||||No|No||EXELAN PHARMACE|No||||
pregabalin|No|No|No|No|90%|76282057390|PREGABALIN 200 MG CAPSULE|90|EA|.02761|02/07/2020||Yes|No||02/07/2020||Yes|No|02/07/2020||Yes|No||||No|No|||Prescription required|No||232|No|.11395|03/29/2022|.11121|03/29/2022|.11195|03/29/2022|||NEUROPATHIC PAIN|22846|||||No|No||EXELAN PHARMACE|No||||
pregabalin|No|No|No|No|90%|76282057490|PREGABALIN 225 MG CAPSULE|90|EA|.02961|02/07/2020||Yes|No||02/07/2020||Yes|No|02/07/2020||Yes|No||||No|No|||Prescription required|No||232|No|.12393|03/29/2022|.12095|03/29/2022|.12176|03/29/2022|||NEUROPATHIC PAIN|22847|||||No|No||EXELAN PHARMACE|No||||
pregabalin|No|No|No|No|90%|76282057590|PREGABALIN 300 MG CAPSULE|90|EA|.03563|02/07/2020||Yes|No||02/07/2020||Yes|No|02/07/2020||Yes|No||||No|No|||Prescription required|No||232|No|.12181|03/29/2022|.11888|03/29/2022|.11967|03/29/2022|||NEUROPATHIC PAIN|22848|||||No|No||EXELAN PHARMACE|No||||
budesonide|No|No|No|No|75%|76282064038|BUDESONIDE 0.25 MG/2 ML SUSP|2|ML|.46798|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|||Prescription required|No||033|Yes|.8321|03/29/2022|.81212|03/29/2022|.81753|03/29/2022|||GLUCOCORTICOIDS: INHALED|22849|||||No|No||EXELAN PHARMACE|No||||
budesonide|No|No|No|No|75%|76282064138|BUDESONIDE 0.5 MG/2 ML SUSP|2|ML|.4669|03/12/2020||Yes|No||03/12/2020||Yes|No|03/12/2020||Yes|No||||No|No|||Prescription required|No||033|Yes|.57313|03/29/2022|.55937|03/29/2022|.5631|03/29/2022|||GLUCOCORTICOIDS: INHALED|22850|||||No|No||EXELAN PHARMACE|No||||
naloxone HCl|No|No|No|No|75%|76329146901|NALOXONE 2 MG/2 ML SYRINGE|2|ML|7.095|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|16.17|10/01/2020|15.939|10/01/2020|15.18|10/01/2020|||OPIATE DEPENDENCE TREATMENTS|22851|||||No|No||INTERNATIONAL M|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|76329336901|NALOXONE 2 MG/2 ML SYRINGE|2|ML|7.095|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|16.17|10/01/2020|15.939|10/01/2020|15.18|10/01/2020|||OPIATE DEPENDENCE TREATMENTS|22852|||||No|No||INTERNATIONAL M|Yes|09/01/2020|||
naloxone HCl|No|No|No|No|75%|76329346901|NALOXONE 2 MG/2 ML SYRINGE|2|ML|7.095|10/01/2020||Yes|No||10/01/2020||Yes|No|10/01/2020||Yes|No||||No|No|||Prescription required|No||145|No|16.17|10/01/2020|15.939|10/01/2020|15.18|10/01/2020|||OPIATE DEPENDENCE TREATMENTS|22853|||||No|No||INTERNATIONAL M|Yes|09/01/2020|||
mitotane|No|No|No|No|75%|76336008060|LYSODREN 500 MG TABLET|100|EA|5.01122|02/26/2020||Yes|No||02/26/2020||Yes|No|02/26/2020||Yes|No||||No|No|||Prescription required|No|||No|11.42092|03/01/2022|11.25776|03/01/2022|10.72168|03/01/2022||||22854|||||No|No||LABORATOIRE HRA|No||||
mifepristone|No|No|No|No|75%|76346007301|KORLYM 300 MG TABLET|28|EA|248.11|03/14/2013||Yes|No||03/14/2013||Yes|No|03/14/2013||Yes|No||||No|No|||Prescription required|No|||No|565.46|01/11/2022|557.382|01/11/2022|530.84|01/11/2022||||22855|||||No|No||CORCEPT THERAPE|No||||
mifepristone|No|No|No|No|75%|76346007302|KORLYM 300 MG TABLET|280|EA|248.11|03/14/2013||Yes|No||03/14/2013||Yes|No|03/14/2013||Yes|No||||No|No|||Prescription required|No|||No|565.46|01/11/2022|557.382|01/11/2022|530.84|01/11/2022||||22856|||||No|No||CORCEPT THERAPE|No||||
methscopolamine bromide|No|No|No|No|75%|76385010001|METHSCOPOLAMINE BROM 2.5 MG TB|100|EA|.58148|04/09/2014||Yes|No||04/09/2014||Yes|No|04/09/2014||Yes|No||||No|No|||Prescription required|No|||No|1.01825|09/28/2021|.99381|09/28/2021|1.00043|09/28/2021||||22857|||||No|No||BAYSHORE PHARMA|No||||
methscopolamine bromide|No|No|No|No|75%|76385010160|METHSCOPOLAMINE BROM 5 MG TAB|60|EA|.95388|04/09/2014||Yes|No||04/09/2014||Yes|No|04/09/2014||Yes|No||||No|No|||Prescription required|No|||No|2.17396|01/26/2021|2.1429|01/26/2021|2.04086|01/26/2021||||22858|||||No|No||BAYSHORE PHARMA|No||||
primaquine phosphate|No|No|No|No|75%|76385010201|PRIMAQUINE 26.3 MG TABLET|100|EA|.57525|04/06/2020||Yes|No||04/06/2020||Yes|No|04/06/2020||Yes|No||||No|No|||Prescription required|No|||No|1.31104|06/15/2021|1.29231|06/15/2021|1.23077|06/15/2021||||22859|||||No|No||BAYSHORE PHARMA|No||||
benztropine mesylate|No|No|No|No|75%|76385010301|BENZTROPINE MES 0.5 MG TAB|100|EA|.04257|07/08/2014|01/31/2022|Yes|No||07/08/2014|01/31/2022|Yes|No|07/08/2014|01/31/2022|Yes|No||||No|No|||Prescription required|No||015|No|.09702|02/15/2022|.09563|02/15/2022|.09108|02/15/2022|||ANTIPARKINSON'S AGENTS|22860|No Longer Rebatable|No Longer Rebatable|No Longer Rebatable||No|No||BAYSHORE PHARMA|No||||
ketotifen fumarate|No|No|No|No|75%|76385010617|KETOTIFEN FUM 0.035% EYE DROPS|5|ML|.7568|03/30/2022||Yes|No||||No|No|03/30/2022||Yes|No||||No|No|||Over the counter|Yes|01/28/2021|002|No|1.3642|03/30/2022|1.33145|03/30/2022|1.34032|03/30/2022|||OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS|22861|||||No|No||BAYSHORE PHARMA|No||||
diphenoxylate HCl/atropine|No|No|No|No|75%|76385010710|DIPHENOXYLATE-ATROP 2.5-0.025|1000|EA|.18135|04/06/2020||Yes|No||04/06/2020||Yes|No|04/06/2020||Yes|No||||No|No|||Prescription required|No|||No|.22711|03/29/2022|.22165|03/29/2022|.22313|03/29/2022||||22862|||||No|No||BAYSHORE PHARMA|No||||
carvedilol|No|No|No|No|75%|76385011050|CARVEDILOL 3.125 MG TABLET|500|EA|.0344|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|No||070|No|.01877|03/29/2022|.01831|03/29/2022|.01844|03/29/2022|||BETA-BLOCKERS|22863|||||No|No||BAYSHORE PHARMA|No||||
carvedilol|No|No|No|No|75%|76385011150|CARVEDILOL 6.25 MG TABLET|500|EA|.0344|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|No||070|No|.02069|03/29/2022|.02019|03/29/2022|.02032|03/29/2022|||BETA-BLOCKERS|22864|||||No|No||BAYSHORE PHARMA|No||||
carvedilol|No|No|No|No|75%|76385011250|CARVEDILOL 12.5 MG TABLET|500|EA|.0344|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|No||070|No|.02277|03/29/2022|.02222|03/29/2022|.02237|03/29/2022|||BETA-BLOCKERS|22865|||||No|No||BAYSHORE PHARMA|No||||
carvedilol|No|No|No|No|75%|76385011350|CARVEDILOL 25 MG TABLET|500|EA|.0344|04/11/2019||Yes|No||04/11/2019||Yes|No|04/11/2019||Yes|No||||No|No|||Prescription required|No||070|No|.03449|03/29/2022|.03366|03/29/2022|.03388|03/29/2022|||BETA-BLOCKERS|22866|||||No|No||BAYSHORE PHARMA|No||||
sotalol HCl|No|No|No|No|75%|76385011401|SOTALOL 80 MG TABLET|100|EA|.12319|06/05/2018||Yes|No||06/05/2018||Yes|No|06/05/2018||Yes|No||||No|No|||Prescription required|No||070|No|.07746|03/29/2022|.0756|03/29/2022|.0761|03/29/2022|||BETA-BLOCKERS|22867|||||No|No||BAYSHORE PHARMA|No||||
sotalol HCl|No|No|No|No|75%|76385011501|SOTALOL 120 MG TABLET|100|EA|.16107|06/05/2018||Yes|No||06/05/2018||Yes|No|06/05/2018||Yes|No||||No|No|||Prescription required|No||070|No|.10056|03/29/2022|.09814|03/29/2022|.0988|03/29/2022|||BETA-BLOCKERS|22868|||||No|No||BAYSHORE PHARMA|No||||
sotalol HCl|No|No|No|No|75%|76385011601|SOTALOL 160 MG TABLET|100|EA|.20407|06/05/2018||Yes|No||06/05/2018||Yes|No|06/05/2018||Yes|No||||No|No|||Prescription required|No||070|No|.16372|03/29/2022|.15979|03/29/2022|.16085|03/29/2022|||BETA-BLOCKERS|22869|||||No|No||BAYSHORE PHARMA|No||||
etodolac|No|No|No|No|75%|76385011801|ETODOLAC 400 MG TABLET|100|EA|.22768|03/30/2022||Yes|No||03/30/2022||Yes|No|03/30/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|059|Yes|.33513|03/30/2022|.32708|03/30/2022|.32926|03/30/2022|||NSAIDS|22870|||||No|No||BAYSHORE PHARMA|No||||
methocarbamol|No|No|No|No|75%|76385012301|METHOCARBAMOL 500 MG TABLET|100|EA|.03315|06/05/2018||Yes|No||06/05/2018||Yes|No|06/05/2018||Yes|No||||No|No|||Prescription required|No||116|Yes|.07091|03/29/2022|.0692|03/29/2022|.06966|03/29/2022|||SKELETAL MUSCLE RELAXANTS|22871|||||No|No||BAYSHORE PHARMA|No||||
methocarbamol|No|No|No|No|75%|76385012350|METHOCARBAMOL 500 MG TABLET|500|EA|.03104|06/05/2018||Yes|No||06/05/2018||Yes|No|06/05/2018||Yes|No||||No|No|||Prescription required|No||116|Yes|.07091|03/29/2022|.0692|03/29/2022|.06966|03/29/2022|||SKELETAL MUSCLE RELAXANTS|22872|||||No|No||BAYSHORE PHARMA|No||||
methocarbamol|No|No|No|No|75%|76385012401|METHOCARBAMOL 750 MG TABLET|100|EA|.0396|06/05/2018||Yes|No||06/05/2018||Yes|No|06/05/2018||Yes|No||||No|No|||Prescription required|No||116|Yes|.09307|03/29/2022|.09083|03/29/2022|.09144|03/29/2022|||SKELETAL MUSCLE RELAXANTS|22873|||||No|No||BAYSHORE PHARMA|No||||
methocarbamol|No|No|No|No|75%|76385012450|METHOCARBAMOL 750 MG TABLET|500|EA|.04216|06/05/2018||Yes|No||06/05/2018||Yes|No|06/05/2018||Yes|No||||No|No|||Prescription required|No||116|Yes|.09307|03/29/2022|.09083|03/29/2022|.09144|03/29/2022|||SKELETAL MUSCLE RELAXANTS|22874|||||No|No||BAYSHORE PHARMA|No||||
sotalol HCl|No|No|No|No|75%|76385012501|SOTALOL AF 80 MG TABLET|100|EA|.20425|06/16/2020||Yes|No||06/16/2020||Yes|No|06/16/2020||Yes|No||||No|No|||Prescription required|No||070|No|.07746|03/29/2022|.0756|03/29/2022|.0761|03/29/2022|||BETA-BLOCKERS|22875|||||No|No||BAYSHORE PHARMA|No||||
sotalol HCl|No|No|No|No|75%|76385012601|SOTALOL AF 120 MG TABLET|100|EA|.26875|06/16/2020||Yes|No||06/16/2020||Yes|No|06/16/2020||Yes|No||||No|No|||Prescription required|No||070|No|.10056|03/29/2022|.09814|03/29/2022|.0988|03/29/2022|||BETA-BLOCKERS|22876|||||No|No||BAYSHORE PHARMA|No||||
sotalol HCl|No|No|No|No|75%|76385012701|SOTALOL AF 160 MG TABLET|100|EA|.33755|06/16/2020||Yes|No||06/16/2020||Yes|No|06/16/2020||Yes|No||||No|No|||Prescription required|No||070|No|.16372|03/29/2022|.15979|03/29/2022|.16085|03/29/2022|||BETA-BLOCKERS|22877|||||No|No||BAYSHORE PHARMA|No||||
metformin HCl|Yes|No|No|No|75%|76385012810|METFORMIN HCL ER 500 MG TABLET|1000|EA|.03526|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||012|No|.03646|03/29/2022|.03558|03/29/2022|.03582|03/29/2022|||HYPOGLYCEMICS: METFORMINS|22878|||||No|No||BAYSHORE PHARMA|No||||
metformin HCl|Yes|No|No|No|75%|76385012901|METFORMIN HCL ER 750 MG TABLET|100|EA|.0946|11/28/2018||Yes|No||11/28/2018||Yes|No|11/28/2018||Yes|No||||No|No|06/18/2019||Prescription required|No||012|No|.09354|03/29/2022|.09129|03/29/2022|.0919|03/29/2022|||HYPOGLYCEMICS: METFORMINS|22879|||||No|No||BAYSHORE PHARMA|No||||
cyproheptadine HCl|No|No|No|No|75%|76385013001|CYPROHEPTADINE 4 MG TABLET|100|EA|.1118|04/07/2021||Yes|No||04/07/2021||Yes|No|04/07/2021||Yes|No||||No|No|||Prescription required|No||574|Yes|.09783|03/29/2022|.09548|03/29/2022|.09611|03/29/2022|||ANTIHISTAMINES: FIRST GENERATION|22880|||||No|No||BAYSHORE PHARMA|No||||
pindolol|No|No|No|No|75%|76385013101|PINDOLOL 5 MG TABLET|100|EA|.4085|06/16/2020||Yes|No||06/16/2020||Yes|No|06/16/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|070|No|.74858|03/29/2022|.73061|03/29/2022|.73547|03/29/2022|||BETA-BLOCKERS|22881|||||No|No||BAYSHORE PHARMA|No||||
pindolol|No|No|No|No|75%|76385013201|PINDOLOL 10 MG TABLET|100|EA|.51062|06/16/2020||Yes|No||06/16/2020||Yes|No|06/16/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|070|No|1.16375|06/29/2021|1.14712|06/29/2021|1.0925|06/29/2021|||BETA-BLOCKERS|22882|||||No|No||BAYSHORE PHARMA|No||||
nadolol|No|No|No|No|75%|76385013301|NADOLOL 20 MG TABLET|100|EA|.3569|06/16/2020||Yes|No||06/16/2020||Yes|No|06/16/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|070|No|.34023|03/29/2022|.33206|03/29/2022|.33427|03/29/2022|||BETA-BLOCKERS|22883|||||No|No||BAYSHORE PHARMA|No||||
nadolol|No|No|No|No|75%|76385013401|NADOLOL 40 MG TABLET|100|EA|.4171|06/16/2020||Yes|No||06/16/2020||Yes|No|06/16/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|070|No|.40202|03/29/2022|.39237|03/29/2022|.39498|03/29/2022|||BETA-BLOCKERS|22884|||||No|No||BAYSHORE PHARMA|No||||
nadolol|No|No|No|No|75%|76385013501|NADOLOL 80 MG TABLET|100|EA|.4816|06/16/2020||Yes|No||06/16/2020||Yes|No|06/16/2020||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|070|No|.57501|03/29/2022|.5612|03/29/2022|.56494|03/29/2022|||BETA-BLOCKERS|22885|||||No|No||BAYSHORE PHARMA|No||||
metolazone|No|No|No|No|75%|76385013601|METOLAZONE 2.5 MG TABLET|100|EA|.2795|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No|||No|.75368|03/31/2022|.73559|03/31/2022|.74049|03/31/2022||||22886|||||No|No||BAYSHORE PHARMA|No||||
metolazone|No|No|No|No|75%|76385013701|METOLAZONE 5 MG TABLET|100|EA|.3225|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No|||No|.77158|03/31/2022|.75306|03/31/2022|.75807|03/31/2022||||22887|||||No|No||BAYSHORE PHARMA|No||||
metolazone|No|No|No|No|75%|76385013801|METOLAZONE 10 MG TABLET|100|EA|.387|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No|||No|1.18747|03/31/2022|1.15897|03/31/2022|1.16668|03/31/2022||||22888|||||No|No||BAYSHORE PHARMA|No||||
hydroxychloroquine sulfate|No|No|No|No|75%|76385014401|HYDROXYCHLOROQUINE 200 MG TAB|100|EA|.22037|06/09/2020||Yes|No||06/09/2020||Yes|No|06/09/2020||Yes|No||||No|No|||Prescription required|No|||No|.23831|03/29/2022|.23259|03/29/2022|.23413|03/29/2022||||22889|||||No|No||BAYSHORE PHARMA|No||||
hydroxychloroquine sulfate|No|No|No|No|75%|76385014450|HYDROXYCHLOROQUINE 200 MG TAB|500|EA|.22037|09/23/2020||Yes|No||09/23/2020||Yes|No|09/23/2020||Yes|No||||No|No|||Prescription required|No|||No|.23831|03/29/2022|.23259|03/29/2022|.23413|03/29/2022||||22890|||||No|No||BAYSHORE PHARMA|No||||
chlorambucil|No|No|No|No|75%|76388063525|LEUKERAN 2 MG TABLET|25|EA|11.40239|11/22/2016||Yes|No||11/22/2016||Yes|No|11/22/2016||Yes|No||||No|No|||Prescription required|No||173|No|25.98685|03/23/2021|25.61561|03/23/2021|24.39582|03/23/2021|||ONCOLOGY: ORAL - HEMATOLOGIC|22891|||||No|No||ASPEN/PRASCO LA|No||||
busulfan|No|No|No|No|75%|76388071325|MYLERAN 2 MG TABLET|25|EA|10.07197|10/01/2012||Yes|No||10/01/2012||Yes|No|10/01/2012||Yes|No||||No|No|||Prescription required|No||173|No|22.95473|06/01/2016|22.62681|06/01/2016|21.54934|06/01/2016|||ONCOLOGY: ORAL - HEMATOLOGIC|22892|||||No|No||ASPEN/PRASCO LA|No||||
thioguanine|No|No|No|No|75%|76388088025|TABLOID 40 MG TABLET|25|EA|10.86919|05/24/2013||Yes|No||05/24/2013||Yes|No|05/24/2013||Yes|No||||No|No|||Prescription required|No||173|No|24.77165|06/01/2016|24.41777|06/01/2016|23.25502|06/01/2016|||ONCOLOGY: ORAL - HEMATOLOGIC|22893|||||No|No||ASPEN/PRASCO LA|No||||
lomitapide mesylate|No|No|No|No|75%|76431010501|JUXTAPID 5 MG CAPSULE|28|EA|735.56383|05/03/2013||Yes|No||05/03/2013||Yes|No|05/03/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|055|No|1676.40129|01/04/2022|1652.4527|01/04/2022|1573.76448|01/04/2022|||LIPOTROPICS: OTHER|22894|||||No|No||AEGERION PHARMA|No||||
lomitapide mesylate|No|No|No|No|75%|76431011001|JUXTAPID 10 MG CAPSULE|28|EA|735.56383|05/03/2013||Yes|No||05/03/2013||Yes|No|05/03/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|055|No|1676.40129|01/04/2022|1652.4527|01/04/2022|1573.76448|01/04/2022|||LIPOTROPICS: OTHER|22895|||||No|No||AEGERION PHARMA|No||||
lomitapide mesylate|No|No|No|No|75%|76431012001|JUXTAPID 20 MG CAPSULE|28|EA|735.56383|06/07/2013||Yes|No||06/07/2013||Yes|No|06/07/2013||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|055|No|1676.40129|01/04/2022|1652.4527|01/04/2022|1573.76448|01/04/2022|||LIPOTROPICS: OTHER|22896|||||No|No||AEGERION PHARMA|No||||
lomitapide mesylate|No|No|No|No|75%|76431013001|JUXTAPID 30 MG CAPSULE|28|EA|735.56383|11/20/2019||Yes|No||11/20/2019||Yes|No|11/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|055|No|1676.40129|01/04/2022|1652.4527|01/04/2022|1573.76448|01/04/2022|||LIPOTROPICS: OTHER|22897|||||No|No||AEGERION PHARMA|No||||
lomitapide mesylate|No|No|No|No|75%|76431014001|JUXTAPID 40 MG CAPSULE|28|EA|686.67206|11/20/2019||Yes|No||11/20/2019||Yes|No|11/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|055|No|1564.97354|01/07/2020|1542.61677|01/07/2020|1469.15883|01/07/2020|||LIPOTROPICS: OTHER|22898|||||No|No||AEGERION PHARMA|No||||
lomitapide mesylate|No|No|No|No|75%|76431016001|JUXTAPID 60 MG CAPSULE|28|EA|686.67206|11/20/2019||Yes|No||11/20/2019||Yes|No|11/20/2019||Yes|No||||No|No|||Prescription required|Yes|07/26/2018|055|No|1564.97354|01/07/2020|1542.61677|01/07/2020|1469.15883|01/07/2020|||LIPOTROPICS: OTHER|22899|||||No|No||AEGERION PHARMA|No||||
metreleptin|No|No|No|No|75%|76431021001|MYALEPT 11.3 MG (5 MG/ML) VIAL|1|EA|2380.2306|03/16/2016||Yes|No||03/16/2016||Yes|No|03/16/2016||Yes|No||||No|No|||Prescription required|No|||No|5424.7116|01/04/2022|5347.21572|01/04/2022|5092.5864|01/04/2022||||22900|||||No|No||AEGERION PHARMA|No||||
mometasone furoate|No|No|No|No|75%|78206011101|ASMANEX HFA 50 MCG INHALER|13|GM|6.15495|11/24/2021||Yes|No||11/24/2021||Yes|No|11/24/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|033|No|13.66992|01/25/2022|13.34184|01/25/2022|13.43069|01/25/2022|||GLUCOCORTICOIDS: INHALED|22901|||||No|No||ORGANON LLC|No||||
mometasone furoate|No|No|No|No|75%|78206011201|ASMANEX HFA 100 MCG INHALER|13|GM|6.63952|11/24/2021||Yes|No||11/24/2021||Yes|No|11/24/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|033|Yes|14.84625|01/25/2022|14.48994|01/25/2022|14.58644|01/25/2022|||GLUCOCORTICOIDS: INHALED|22902|||||No|No||ORGANON LLC|No||||
mometasone furoate|No|No|No|No|75%|78206011301|ASMANEX HFA 200 MCG INHALER|13|GM|7.8035|11/24/2021||Yes|No||11/24/2021||Yes|No|11/24/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|033|Yes|17.4282|01/25/2022|17.00992|01/25/2022|17.1232|01/25/2022|||GLUCOCORTICOIDS: INHALED|22903|||||No|No||ORGANON LLC|No||||
mometasone furoate|No|No|No|No|75%|78206011401|ASMANEX TWISTHALR 220 MCG #120|1|EA|145.2884|11/24/2021||Yes|No||11/24/2021||Yes|No|11/24/2021||Yes|No||||No|No|||Prescription required|No||033|Yes|324.89512|01/25/2022|317.09763|01/25/2022|319.20945|01/25/2022|||GLUCOCORTICOIDS: INHALED|22904|||||No|No||ORGANON LLC|No||||
mometasone furoate|No|No|No|No|75%|78206011402|ASMANEX TWISTHALER 220 MCG #60|1|EA|101.3897|11/24/2021||Yes|No||11/24/2021||Yes|No|11/24/2021||Yes|No||||No|No|||Prescription required|No||033|Yes|225.91994|01/25/2022|220.49786|01/25/2022|221.96634|01/25/2022|||GLUCOCORTICOIDS: INHALED|22905|||||No|No||ORGANON LLC|No||||
mometasone furoate|No|No|No|No|75%|78206011403|ASMANEX TWISTHALER 220 MCG #14|1|EA|33.3637|11/24/2021||Yes|No||11/24/2021||Yes|No|11/24/2021||Yes|No||||No|No|||Prescription required|No||033|Yes|76.0382|01/18/2022|74.95194|01/18/2022|71.3828|01/18/2022|||GLUCOCORTICOIDS: INHALED|22906|||||No|No||ORGANON LLC|No||||
mometasone furoate|No|No|No|No|75%|78206011404|ASMANEX TWISTHALER 220 MCG #30|1|EA|86.3999|11/24/2021||Yes|No||11/24/2021||Yes|No|11/24/2021||Yes|No||||No|No|||Prescription required|No||033|Yes|192.46528|01/25/2022|187.84611|01/25/2022|189.09713|01/25/2022|||GLUCOCORTICOIDS: INHALED|22907|||||No|No||ORGANON LLC|No||||
mometasone furoate|No|No|No|No|75%|78206011501|ASMANEX TWISTHALER 110 MCG #30|1|EA|80.0144|11/24/2021||Yes|No||11/24/2021||Yes|No|11/24/2021||Yes|No||||No|No|||Prescription required|No||033|Yes|178.63736|01/25/2022|174.35006|01/25/2022|175.5112|01/25/2022|||GLUCOCORTICOIDS: INHALED|22908|||||No|No||ORGANON LLC|No||||
betamethasone acetate,sod phos|No|No|No|No|75%|78206011801|CELESTONE SOLUSPAN 30 MG/5 ML|5|ML|3.37378|12/22/2021||Yes|No||12/22/2021||Yes|No|12/22/2021||Yes|No||||No|No|||Prescription required|No|||No|7.68908|01/18/2022|7.57923|01/18/2022|7.21832|01/18/2022||||22909|||||No|No||ORGANON LLC|No||||
desloratadine|No|No|No|No|75%|78206011901|CLARINEX 5 MG TABLET|100|EA|3.29281|12/22/2021||Yes|No||12/22/2021||Yes|No|12/22/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|030|Yes|7.50454|01/18/2022|7.39733|01/18/2022|7.04508|01/18/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|22910|||||No|No||ORGANON LLC|No||||
desloratadine/pseudoephedrine|No|No|No|No|75%|78206012001|CLARINEX-D 12 HR 2.5-120 MG TB|100|EA|2.26438|02/10/2022||Yes|No||02/10/2022||Yes|No|02/10/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|030|Yes|5.06535|02/10/2022|4.94378|02/10/2022|4.9767|02/10/2022|||ANTIHISTAMINES: MINIMALLY SEDATING|22911|||||No|No||ORGANON LLC|No||||
losartan potassium|No|No|No|No|75%|78206012101|COZAAR 25 MG TABLET|90|EA|1.24948|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|2.84765|02/02/2022|2.80697|02/02/2022|2.6733|02/02/2022|||ANGIOTENSIN MODULATORS|22912|||||No|No||ORGANON LLC|No||||
losartan potassium|No|No|No|No|75%|78206012201|COZAAR 50 MG TABLET|30|EA|1.67341|12/20/2021||Yes|No||12/20/2021||Yes|No|12/20/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|3.72061|01/25/2022|3.63131|01/25/2022|3.65549|01/25/2022|||ANGIOTENSIN MODULATORS|22913|||||No|No||ORGANON LLC|No||||
losartan potassium|No|No|No|No|75%|78206012202|COZAAR 50 MG TABLET|90|EA|1.67346|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|3.72061|02/02/2022|3.63131|02/02/2022|3.65549|02/02/2022|||ANGIOTENSIN MODULATORS|22914|||||No|No||ORGANON LLC|No||||
losartan potassium|No|No|No|No|75%|78206012301|COZAAR 100 MG TABLET|30|EA|2.28244|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|5.12753|02/02/2022|5.00446|02/02/2022|5.03779|02/02/2022|||ANGIOTENSIN MODULATORS|22915|||||No|No||ORGANON LLC|No||||
losartan potassium|No|No|No|No|75%|78206012302|COZAAR 100 MG TABLET|90|EA|2.28238|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|5.12753|02/02/2022|5.00446|02/02/2022|5.03779|02/02/2022|||ANGIOTENSIN MODULATORS|22916|||||No|No||ORGANON LLC|No||||
betamethasone/propylene glyc|No|No|No|No|75%|78206012401|DIPROLENE 0.05% OINTMENT|15|GM|2.71989|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|120|No|6.19882|03/02/2022|6.11026|03/02/2022|5.8193|03/02/2022|||STEROIDS: TOPICAL HIGH|22917|||||No|No||ORGANON LLC|No||||
mometasone/formoterol|No|No|No|No|75%|78206012501|DULERA 50 MCG-5 MCG INHALER|13|GM|10.80325|11/24/2021||Yes|No||11/24/2021||Yes|No|11/24/2021||Yes|No||||No|No|||Prescription required|No||033|Yes|24.15861|01/25/2022|23.5788|01/25/2022|23.73583|01/25/2022|||GLUCOCORTICOIDS: INHALED|22918|||||No|No||ORGANON LLC|No||||
mometasone/formoterol|No|No|No|No|75%|78206012601|DULERA 200 MCG-5 MCG INHALER|13|GM|10.80325|11/24/2021||Yes|No||11/24/2021||Yes|No|11/24/2021||Yes|No||||No|No|||Prescription required|No||033|Yes|24.11624|01/25/2022|23.53745|01/25/2022|23.6942|01/25/2022|||GLUCOCORTICOIDS: INHALED|22919|||||No|No||ORGANON LLC|No||||
mometasone/formoterol|No|No|No|No|75%|78206012602|DULERA 200 MCG-5 MCG INHALER|8.8|GM|10.80325|11/24/2021||Yes|No||11/24/2021||Yes|No|11/24/2021||Yes|No||||No|No|||Prescription required|No||033|Yes|24.05939|01/25/2022|23.48196|01/25/2022|23.63835|01/25/2022|||GLUCOCORTICOIDS: INHALED|22920|||||No|No||ORGANON LLC|No||||
mometasone/formoterol|No|No|No|No|75%|78206012701|DULERA 100 MCG-5 MCG INHALER|13|GM|10.80325|11/24/2021||Yes|No||11/24/2021||Yes|No|11/24/2021||Yes|No||||No|No|||Prescription required|No||033|Yes|24.20081|01/25/2022|23.61999|01/25/2022|23.77729|01/25/2022|||GLUCOCORTICOIDS: INHALED|22921|||||No|No||ORGANON LLC|No||||
mometasone/formoterol|No|No|No|No|75%|78206012702|DULERA 100 MCG-5 MCG INHALER|8.8|GM|10.80325|11/24/2021||Yes|No||11/24/2021||Yes|No|11/24/2021||Yes|No||||No|No|||Prescription required|No||033|Yes|24.23588|01/25/2022|23.65421|01/25/2022|23.81175|01/25/2022|||GLUCOCORTICOIDS: INHALED|22922|||||No|No||ORGANON LLC|No||||
alendronate sodium|No|No|No|No|75%|78206013501|FOSAMAX 70 MG TABLET|4|EA|14.41575|02/02/2022||Yes|No||02/02/2022||Yes|No|02/02/2022||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|060|No|32.8545|02/08/2022|32.38515|02/08/2022|30.843|02/02/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|22923|||||No|No||ORGANON LLC|No||||
alendronate sodium/vitamin D3|No|No|No|No|75%|78206013601|FOSAMAX PLUS D 70 MG-5600 UNIT|4|EA|19.54457|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|060|No|44.54345|01/18/2022|43.90711|01/18/2022|41.8163|01/18/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|22924|||||No|No||ORGANON LLC|No||||
alendronate sodium/vitamin D3|No|No|No|No|75%|78206013701|FOSAMAX PLUS D 70 MG-2800 UNIT|4|EA|19.54457|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|060|No|44.54345|01/18/2022|43.90711|01/18/2022|41.8163|01/18/2022|||BONE RESORPTION SUPPRESSION AND RELATED AGENTS|22925|||||No|No||ORGANON LLC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|78206013901|HYZAAR 50-12.5 TABLET|30|EA|1.84943|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|4.21498|01/18/2022|4.15476|01/18/2022|3.95692|01/18/2022|||ANGIOTENSIN MODULATORS|22926|||||No|No||ORGANON LLC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|78206013902|HYZAAR 50-12.5 TABLET|90|EA|1.84937|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|4.21486|01/18/2022|4.15465|01/18/2022|3.9568|01/18/2022|||ANGIOTENSIN MODULATORS|22927|||||No|No||ORGANON LLC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|78206014001|HYZAAR 100-12.5 TABLET|30|EA|2.52596|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|5.75684|01/18/2022|5.6746|01/18/2022|5.40438|01/18/2022|||ANGIOTENSIN MODULATORS|22928|||||No|No||ORGANON LLC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|78206014002|HYZAAR 100-12.5 TABLET|90|EA|2.526|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|5.75695|01/18/2022|5.6747|01/18/2022|5.40448|01/18/2022|||ANGIOTENSIN MODULATORS|22929|||||No|No||ORGANON LLC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|78206014101|HYZAAR 100-25 TABLET|30|EA|2.52596|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|5.5924|03/01/2022|5.45818|03/01/2022|5.49453|03/01/2022|||ANGIOTENSIN MODULATORS|22930|||||No|No||ORGANON LLC|No||||
losartan/hydrochlorothiazide|No|No|No|No|75%|78206014102|HYZAAR 100-25 TABLET|90|EA|2.526|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|113|Yes|5.5924|03/01/2022|5.45818|03/01/2022|5.49453|03/01/2022|||ANGIOTENSIN MODULATORS|22931|||||No|No||ORGANON LLC|No||||
rizatriptan benzoate|No|No|No|No|75%|78206014201|MAXALT 10 MG TABLET|18|EA|16.49551|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|37.59442|03/02/2022|37.05736|03/02/2022|35.29272|03/02/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|22932|||||No|No||ORGANON LLC|No||||
rizatriptan benzoate|No|No|No|No|75%|78206014301|MAXALT MLT 10 MG TABLET|18|EA|16.49551|03/02/2022||Yes|No||03/02/2022||Yes|No|03/02/2022||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|021|No|37.59442|03/02/2022|37.05736|03/02/2022|35.29272|03/02/2022|||ANTIMIGRAINE AGENTS: TRIPTANS|22933|||||No|No||ORGANON LLC|No||||
etonogestrel|Yes|Yes|No|No|75%|78206014501|NEXPLANON 68 MG IMPLANT|1|EA|443.1752|09/23/2021||Yes|No||||No|No|||No|No||||No|No|09/23/2021||Prescription required|No|||No|1010.0272|09/23/2021|995.59824|09/23/2021|948.1888|09/23/2021||||22934|||||Yes|No||ORGANON LLC|No||||
etonogestrel/ethinyl estradiol|No|Yes|No|No|75%|78206014601|NUVARING VAGINAL RING|1|EA|69.9309|12/28/2021||Yes|No||12/28/2021||Yes|No|12/28/2021||Yes|No|Refer to program requirements|||No|No|||Prescription required|No|||No|156.19036|12/28/2021|152.44179|12/28/2021|153.45702|12/28/2021||||22935|||||No|No||ORGANON LLC|No|||Only covered for non-contraceptive (medical) purposes|
etonogestrel/ethinyl estradiol|Yes|Yes|No|No|75%|78206014603|NUVARING VAGINAL RING|1|EA|69.9309|09/23/2021||Yes|No||09/23/2021||Yes|No|||No|No||||No|No|09/23/2021||Prescription required|No|||No|156.19036|12/21/2021|152.44179|12/21/2021|153.45702|12/21/2021||||22936|||||No|No||ORGANON LLC|No|||Only covered for non-contraceptive (medical) purposes|
finasteride|No|No|No|No|75%|78206015201|PROPECIA 1 MG TABLET|30|EA|1.55617|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|No|||No|3.31901|01/25/2022|3.23935|01/25/2022|3.26092|01/25/2022||||22937|||||No|No||ORGANON LLC|No||||
finasteride|No|No|No|No|75%|78206015202|PROPECIA 1 MG TABLET|90|EA|1.40284|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|No|||No|3.31901|01/25/2022|3.23935|01/25/2022|3.26092|01/25/2022||||22938|||||No|No||ORGANON LLC|No||||
finasteride|No|No|No|No|75%|78206015301|PROSCAR 5 MG TABLET|30|EA|2.12448|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|003|No|4.84184|01/18/2022|4.77267|01/18/2022|4.5454|01/18/2022|||BPH TREATMENTS|22939|||||No|No||ORGANON LLC|No||||
finasteride|No|No|No|No|75%|78206015302|PROSCAR 5 MG TABLET|100|EA|2.12454|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|003|No|4.84198|01/18/2022|4.77281|01/18/2022|4.54553|01/18/2022|||BPH TREATMENTS|22940|||||No|No||ORGANON LLC|No||||
mirtazapine|No|No|No|No|75%|78206015601|REMERON 15 MG SOLTAB|30|EA|1.91708|12/21/2021||Yes|No||12/21/2021||Yes|No|12/21/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|Yes|4.36916|01/18/2022|4.30674|01/18/2022|4.10166|01/18/2022|||ANTIDEPRESSANTS: OTHER|22941|||||No|No||ORGANON LLC|No||||
mirtazapine|No|No|No|No|75%|78206015801|REMERON 30 MG SOLTAB|30|EA|1.9757|12/21/2021||Yes|No||12/21/2021||Yes|No|12/21/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|4.50276|01/18/2022|4.43844|01/18/2022|4.22708|01/18/2022|||ANTIDEPRESSANTS: OTHER|22942|||||No|No||ORGANON LLC|No||||
mirtazapine|No|No|No|No|75%|78206015901|REMERON 45 MG SOLTAB|30|EA|2.10198|12/21/2021||Yes|No||12/21/2021||Yes|No|12/21/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|4.79056|01/18/2022|4.72212|01/18/2022|4.49726|01/18/2022|||ANTIDEPRESSANTS: OTHER|22943|||||No|No||ORGANON LLC|No||||
mirtazapine|No|No|No|No|75%|78206016001|REMERON 15 MG TABLET|30|EA|2.40871|12/22/2021||Yes|No||12/22/2021||Yes|No|12/22/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|Yes|5.48962|01/18/2022|5.4112|01/18/2022|5.15352|01/18/2022|||ANTIDEPRESSANTS: OTHER|22944|||||No|No||ORGANON LLC|No||||
mirtazapine|No|No|No|No|75%|78206016101|REMERON 30 MG TABLET|30|EA|2.48095|12/21/2021||Yes|No||12/21/2021||Yes|No|12/21/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|031|No|5.65426|01/18/2022|5.57349|01/18/2022|5.30808|01/18/2022|||ANTIDEPRESSANTS: OTHER|22945|||||No|No||ORGANON LLC|No||||
carbidopa/levodopa|No|No|No|No|75%|78206016601|SINEMET 10-100 MG TABLET|100|EA|.46913|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|015|No|1.06918|01/18/2022|1.0539|01/18/2022|1.00372|01/18/2022|||ANTIPARKINSON'S AGENTS|22946|||||No|No||ORGANON LLC|No||||
carbidopa/levodopa|No|No|No|No|75%|78206016801|SINEMET 25-100 MG TABLET|100|EA|.52773|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|015|No|1.20275|01/18/2022|1.18557|01/18/2022|1.12911|01/18/2022|||ANTIPARKINSON'S AGENTS|22947|||||No|No||ORGANON LLC|No||||
montelukast sodium|No|No|No|No|75%|78206017001|SINGULAIR 4 MG TABLET CHEW|30|EA|3.43269|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|042|Yes|7.82334|01/18/2022|7.71157|01/18/2022|7.34436|01/18/2022|||LEUKOTRIENE MODIFIERS|22948|||||No|No||ORGANON LLC|No||||
montelukast sodium|No|No|No|No|75%|78206017101|SINGULAIR 4 MG GRANULES|30|EA|3.43269|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|042|Yes|7.82334|01/18/2022|7.71157|01/18/2022|7.34436|01/18/2022|||LEUKOTRIENE MODIFIERS|22949|||||No|No||ORGANON LLC|No||||
montelukast sodium|No|No|No|No|75%|78206017201|SINGULAIR 10 MG TABLET|30|EA|3.43269|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|042|Yes|7.7018|01/25/2022|7.51695|01/25/2022|7.56701|01/25/2022|||LEUKOTRIENE MODIFIERS|22950|||||No|No||ORGANON LLC|No||||
montelukast sodium|No|No|No|No|75%|78206017202|SINGULAIR 10 MG TABLET|90|EA|3.43263|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|042|Yes|7.7018|01/25/2022|7.51695|01/25/2022|7.56701|01/25/2022|||LEUKOTRIENE MODIFIERS|22951|||||No|No||ORGANON LLC|No||||
montelukast sodium|No|No|No|No|75%|78206017301|SINGULAIR 5 MG TABLET CHEW|30|EA|3.43269|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|01/28/2021|042|Yes|7.82334|01/18/2022|7.71157|01/18/2022|7.34436|01/18/2022|||LEUKOTRIENE MODIFIERS|22952|||||No|No||ORGANON LLC|No||||
ezetimibe/simvastatin|No|No|No|No|75%|78206017401|VYTORIN 10-10 MG TABLET|30|EA|5.13764|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|063|Yes|11.70904|01/18/2022|11.54176|01/18/2022|10.99216|01/18/2022|||LIPOTROPICS: STATINS|22953|||||No|No||ORGANON LLC|No||||
ezetimibe/simvastatin|No|No|No|No|75%|78206017402|VYTORIN 10-10 MG TABLET|90|EA|5.13768|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|063|Yes|11.70914|01/18/2022|11.54187|01/18/2022|10.99226|01/18/2022|||LIPOTROPICS: STATINS|22954|||||No|No||ORGANON LLC|No||||
ezetimibe/simvastatin|No|No|No|No|75%|78206017501|VYTORIN 10-20 MG TABLET|30|EA|5.13764|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|063|Yes|11.70904|01/18/2022|11.54176|01/18/2022|10.99216|01/18/2022|||LIPOTROPICS: STATINS|22955|||||No|No||ORGANON LLC|No||||
ezetimibe/simvastatin|No|No|No|No|75%|78206017502|VYTORIN 10-20 MG TABLET|90|EA|5.13768|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|063|Yes|11.70914|01/18/2022|11.54187|01/18/2022|10.99226|01/18/2022|||LIPOTROPICS: STATINS|22956|||||No|No||ORGANON LLC|No||||
ezetimibe/simvastatin|No|No|No|No|75%|78206017601|VYTORIN 10-40 MG TABLET|30|EA|5.13764|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|063|Yes|11.70904|01/18/2022|11.54176|01/18/2022|10.99216|01/18/2022|||LIPOTROPICS: STATINS|22957|||||No|No||ORGANON LLC|No||||
ezetimibe/simvastatin|No|No|No|No|75%|78206017602|VYTORIN 10-40 MG TABLET|90|EA|5.13768|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|063|Yes|11.70914|01/18/2022|11.54187|01/18/2022|10.99226|01/18/2022|||LIPOTROPICS: STATINS|22958|||||No|No||ORGANON LLC|No||||
ezetimibe/simvastatin|No|No|No|No|75%|78206017701|VYTORIN 10-80 MG TABLET|30|EA|5.13764|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|063|Yes|11.70904|01/18/2022|11.54176|01/18/2022|10.99216|01/18/2022|||LIPOTROPICS: STATINS|22959|||||No|No||ORGANON LLC|No||||
ezetimibe/simvastatin|No|No|No|No|75%|78206017702|VYTORIN 10-80 MG TABLET|90|EA|5.13768|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|063|Yes|11.70914|01/18/2022|11.54187|01/18/2022|10.99226|01/18/2022|||LIPOTROPICS: STATINS|22960|||||No|No||ORGANON LLC|No||||
ezetimibe|No|No|No|No|75%|78206017801|ZETIA 10 MG TABLET|30|EA|5.18737|09/23/2021||Yes|No||09/23/2021||Yes|No|09/23/2021||Yes|No||||No|No|||Prescription required|No||055|No|11.65334|01/25/2022|11.37365|01/25/2022|11.4494|01/25/2022|||LIPOTROPICS: OTHER|22961|||||No|No||ORGANON LLC|No||||
simvastatin|No|No|No|No|75%|78206018001|ZOCOR 10 MG TABLET|30|EA|2.08392|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|063|Yes|4.7494|01/18/2022|4.68155|01/18/2022|4.45862|01/18/2022|||LIPOTROPICS: STATINS|22962|||||No|No||ORGANON LLC|No||||
simvastatin|No|No|No|No|75%|78206018002|ZOCOR 10 MG TABLET|90|EA|2.08392|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|063|Yes|4.7494|01/18/2022|4.68155|01/18/2022|4.45862|01/18/2022|||LIPOTROPICS: STATINS|22963|||||No|No||ORGANON LLC|No||||
simvastatin|No|No|No|No|75%|78206018101|ZOCOR 20 MG TABLET|30|EA|3.63565|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|063|Yes|8.2859|01/18/2022|8.16753|01/18/2022|7.7786|01/18/2022|||LIPOTROPICS: STATINS|22964|||||No|No||ORGANON LLC|No||||
simvastatin|No|No|No|No|75%|78206018102|ZOCOR 20 MG TABLET|90|EA|3.63559|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|063|Yes|8.28578|01/18/2022|8.16741|01/18/2022|7.77848|01/18/2022|||LIPOTROPICS: STATINS|22965|||||No|No||ORGANON LLC|No||||
simvastatin|No|No|No|No|75%|78206018201|ZOCOR 40 MG TABLET|30|EA|3.63565|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|063|Yes|8.2859|01/25/2022|8.16753|01/25/2022|7.7786|01/25/2022|||LIPOTROPICS: STATINS|22966|||||No|No||ORGANON LLC|No||||
simvastatin|No|No|No|No|75%|78206018202|ZOCOR 40 MG TABLET|90|EA|3.63559|12/23/2021||Yes|No||12/23/2021||Yes|No|12/23/2021||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|063|Yes|8.28578|01/18/2022|8.16741|01/18/2022|7.77848|01/18/2022|||LIPOTROPICS: STATINS|22967|||||No|No||ORGANON LLC|No||||
lofexidine HCl|No|No|No|No|75%|78670005036|LUCEMYRA 0.18 MG TABLET|36|EA|8.8967|03/15/2021||Yes|No||03/15/2021||Yes|No|03/15/2021||Yes|No||||No|No|||Prescription required|No||145|No|19.77619|06/29/2021|19.30156|06/29/2021|19.4301|06/29/2021|||OPIATE DEPENDENCE TREATMENTS|22968|||||No|No||USWM, LLC, D.B.|Yes|09/01/2020|||
lofexidine HCl|No|No|No|No|75%|78670005096|LUCEMYRA 0.18 MG TABLET|96|EA|8.8967|03/15/2021||Yes|No||03/15/2021||Yes|No|03/15/2021||Yes|No||||No|No|||Prescription required|No||145|No|19.77619|06/29/2021|19.30156|06/29/2021|19.4301|06/29/2021|||OPIATE DEPENDENCE TREATMENTS|22969|||||No|No||USWM, LLC, D.B.|Yes|09/01/2020|||
belumosudil mesylate|No|No|No|No|75%|79802020030|REZUROCK 200 MG TABLET|30|EA|222.16666|02/23/2022||Yes|No||02/23/2022||Yes|No|02/23/2022||Yes|No||||No|No|||Prescription required|No|||No|506.33332|02/23/2022|499.09999|02/23/2022|475.33332|02/23/2022||||22970|||||No|No||KADMON PHARMACE|No||||
dasiglucagon HCl|No|No|No|No|75%|80644001201|ZEGALOGUE 0.6 MG/0.6ML AUTOINJ|.6|ML|221.45|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|583|No|504.7|08/25/2021|497.49|08/25/2021|473.8|08/25/2021|||GLUCAGON AGENTS|22971|||||No|No||ZEALAND PHARMA|No||||
dasiglucagon HCl|No|No|No|No|75%|80644001202|ZEGALOGUE 0.6 MG/0.6ML AUTOINJ|.6|ML|221.45|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|583|No|504.7|08/25/2021|497.49|08/25/2021|473.8|08/25/2021|||GLUCAGON AGENTS|22972|||||No|No||ZEALAND PHARMA|No||||
dasiglucagon HCl|No|No|No|No|75%|80644001301|ZEGALOGUE 0.6 MG/0.6 ML SYRING|.6|ML|221.45|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|583|No|504.7|08/25/2021|497.49|08/25/2021|473.8|08/25/2021|||GLUCAGON AGENTS|22973|||||No|No||ZEALAND PHARMA|No||||
dasiglucagon HCl|No|No|No|No|75%|80644001302|ZEGALOGUE 0.6 MG/0.6 ML SYRING|.6|ML|221.45|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|Yes|01/27/2022|583|No|504.7|08/25/2021|497.49|08/25/2021|473.8|08/25/2021|||GLUCAGON AGENTS|22974|||||No|No||ZEALAND PHARMA|No||||
levetiracetam|No|No|No|No|75%|80705010030|ELEPSIA XR 1,000 MG TABLET|30|EA|11.92691|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No||056|No|27.18226|03/15/2022|26.79394|03/15/2022|25.51804|03/15/2022|||ANTICONVULSANTS|22975|||||No|No||TRIPOINT THERAP|No||||
levetiracetam|No|No|No|No|75%|80705010130|ELEPSIA XR 1,500 MG TABLET|30|EA|14.93691|08/25/2021||Yes|No||08/25/2021||Yes|No|08/25/2021||Yes|No||||No|No|||Prescription required|No||056|No|34.04226|03/15/2022|33.55594|03/15/2022|31.95804|03/15/2022|||ANTICONVULSANTS|22976|||||No|No||TRIPOINT THERAP|No||||
atorvastatin calcium|No|No|No|No|75%|82009000110|ATORVASTATIN 10 MG TABLET|1000|EA|.09106|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.03732|03/31/2022|.03642|03/31/2022|.03666|03/31/2022|||LIPOTROPICS: STATINS|22977|||||No|No||QUALLENT PHARMA|No||||
atorvastatin calcium|No|No|No|No|75%|82009000190|ATORVASTATIN 10 MG TABLET|90|EA|.09106|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.03732|03/31/2022|.03642|03/31/2022|.03666|03/31/2022|||LIPOTROPICS: STATINS|22978|||||No|No||QUALLENT PHARMA|No||||
atorvastatin calcium|No|No|No|No|75%|82009000210|ATORVASTATIN 20 MG TABLET|1000|EA|.12961|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.0488|03/31/2022|.04762|03/31/2022|.04794|03/31/2022|||LIPOTROPICS: STATINS|22979|||||No|No||QUALLENT PHARMA|No||||
atorvastatin calcium|No|No|No|No|75%|82009000310|ATORVASTATIN 40 MG TABLET|1000|EA|.12961|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.063|03/31/2022|.06148|03/31/2022|.06189|03/31/2022|||LIPOTROPICS: STATINS|22980|||||No|No||QUALLENT PHARMA|No||||
atorvastatin calcium|No|No|No|No|75%|82009000410|ATORVASTATIN 80 MG TABLET|1000|EA|.12961|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.10164|03/31/2022|.0992|03/31/2022|.09986|03/31/2022|||LIPOTROPICS: STATINS|22981|||||No|No||QUALLENT PHARMA|No||||
pravastatin sodium|No|No|No|No|75%|82009000610|PRAVASTATIN SODIUM 20 MG TAB|1000|EA|.11237|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.05771|03/31/2022|.05632|03/31/2022|.0567|03/31/2022|||LIPOTROPICS: STATINS|22982|||||No|No||QUALLENT PHARMA|No||||
pravastatin sodium|No|No|No|No|75%|82009000710|PRAVASTATIN SODIUM 40 MG TAB|1000|EA|.16493|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.08966|03/31/2022|.0875|03/31/2022|.08809|03/31/2022|||LIPOTROPICS: STATINS|22983|||||No|No||QUALLENT PHARMA|No||||
pravastatin sodium|No|No|No|No|75%|82009000790|PRAVASTATIN SODIUM 40 MG TAB|90|EA|.16492|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.08966|03/31/2022|.0875|03/31/2022|.08809|03/31/2022|||LIPOTROPICS: STATINS|22984|||||No|No||QUALLENT PHARMA|No||||
pravastatin sodium|No|No|No|No|75%|82009000805|PRAVASTATIN SODIUM 80 MG TAB|500|EA|.16493|03/31/2022||Yes|No||03/31/2022||Yes|No|03/31/2022||Yes|No||||No|No|||Prescription required|No||063|Yes|.14996|03/31/2022|.14636|03/31/2022|.14733|03/31/2022|||LIPOTROPICS: STATINS|22985|||||No|No||QUALLENT PHARMA|No||||
COVID-19 antigen test|Yes|No|No|No|75%|82607066026|FLOWFLEX COVID-19 AG HOME TEST|1|EA|.0043|01/07/2022||Yes|No||01/07/2022||Yes|No|01/07/2022||Yes|No||01/07/2022||Yes|No|01/07/2022||Over the counter|No|||No||||||||||22986|||||No|No||ACON LABORATORI|No||||
ciclopirox|No|No|No|No|75%|99207001010|LOPROX 1% SHAMPOO|120|ML|.14931|08/02/2006||Yes|No||08/02/2006||Yes|No|||No|No||||No|No|||Prescription required|Yes|07/18/2006|061|No|.3403|10/29/2019|.33544|10/29/2019|.31947|10/29/2019|||ANTIFUNGALS: TOPICAL|22987|||||No|No||BAUSCH HEALTH U|No||||
imiquimod|No|No|No|No|75%|99207027028|ZYCLARA 3.75% CREAM|28|EA|18.92245|01/06/2012||Yes|No||01/06/2012||Yes|No|01/06/2012||Yes|No||||No|No|||Prescription required|No|||Yes|43.12559|01/16/2018|42.50951|01/16/2018|40.48525|01/16/2018||||22988|||||No|No||BAUSCH HEALTH U|No||||
clindamycin/tretinoin|No|No|No|No|75%|99207030030|ZIANA GEL|30|GM|5.26033|12/15/2006||Yes|No||12/15/2006||Yes|No|12/15/2006||Yes|No||||No|No|||Prescription required|Yes|01/23/2008|104|No|11.98866|06/01/2016|11.81739|06/01/2016|11.25466|06/01/2016|||ACNE AGENTS: TOPICAL|22989|||||No|No||BAUSCH HEALTH U|No||||
clindamycin/tretinoin|No|No|No|No|75%|99207030060|ZIANA GEL|60|GM|5.06059|12/15/2006||Yes|No||12/15/2006||Yes|No|12/15/2006||Yes|No||||No|No|||Prescription required|Yes|01/23/2008|104|No|11.53345|08/29/2017|11.36868|08/29/2017|10.82732|08/29/2017|||ACNE AGENTS: TOPICAL|22990|||||No|No||BAUSCH HEALTH U|No||||
minocycline HCl|No|No|No|No|75%|99207046330|SOLODYN ER 65 MG TABLET|30|EA|.89583|09/29/2009||Yes|No||09/29/2009||Yes|No|09/29/2009||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|213|No|2.04166|01/21/2020|2.01249|01/21/2020|1.91666|01/21/2020|||TETRACYCLINES|22991|||||No|No||BAUSCH HEALTH U|No||||
minocycline HCl|No|No|No|No|75%|99207046430|SOLODYN ER 115 MG TABLET|30|EA|.89583|09/29/2009||Yes|No||09/29/2009||Yes|No|09/29/2009||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|213|No|2.04166|01/21/2020|2.01249|01/21/2020|1.91666|01/21/2020|||TETRACYCLINES|22992|||||No|No||BAUSCH HEALTH U|No||||
minocycline HCl|No|No|No|No|75%|99207046530|SOLODYN ER 55 MG TABLET|30|EA|.89583|11/12/2010||Yes|No||11/12/2010||Yes|No|11/12/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|213|No|2.04166|01/21/2020|2.01249|01/21/2020|1.91666|01/21/2020|||TETRACYCLINES|22993|||||No|No||BAUSCH HEALTH U|No||||
minocycline HCl|No|No|No|No|75%|99207046630|SOLODYN ER 80 MG TABLET|30|EA|.89583|11/12/2010||Yes|No||11/12/2010||Yes|No|11/12/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|213|No|2.04166|01/21/2020|2.01249|01/21/2020|1.91666|01/21/2020|||TETRACYCLINES|22994|||||No|No||BAUSCH HEALTH U|No||||
minocycline HCl|No|No|No|No|75%|99207046730|SOLODYN ER 105 MG TABLET|30|EA|.89583|11/12/2010||Yes|No||11/12/2010||Yes|No|11/12/2010||Yes|No||||No|No|||Prescription required|Yes|02/02/2010|213|No|2.04166|01/21/2020|2.01249|01/21/2020|1.91666|01/21/2020|||TETRACYCLINES|22995|||||No|No||BAUSCH HEALTH U|No||||
fluocinonide|No|No|No|No|75%|99207052510|VANOS 0.1% CREAM|120|GM|11.17125|01/31/2006||Yes|No||01/31/2006||Yes|No|01/31/2006||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|120|No|25.46006|06/01/2016|25.09635|06/01/2016|23.90128|06/01/2016|||STEROIDS: TOPICAL HIGH|22996|||||No|No||BAUSCH HEALTH U|No||||
fluocinonide|No|No|No|No|75%|99207052530|VANOS 0.1% CREAM|30|GM|13.64906|03/15/2005||Yes|No||03/15/2005||Yes|No|03/15/2005||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|120|No|31.10716|06/01/2016|30.66277|06/01/2016|29.20264|06/01/2016|||STEROIDS: TOPICAL HIGH|22997|||||No|No||BAUSCH HEALTH U|No||||
fluocinonide|No|No|No|No|75%|99207052560|VANOS 0.1% CREAM|60|GM|11.75913|03/15/2005||Yes|No||03/15/2005||Yes|No|03/15/2005||Yes|No||||No|No|||Prescription required|Yes|07/29/2021|120|No|26.79989|06/01/2016|26.41703|06/01/2016|25.15908|06/01/2016|||STEROIDS: TOPICAL HIGH|22998|||||No|No||BAUSCH HEALTH U|No||||