For a printable version of the following information, please see: No-Cost Preventative Care Medications (PDF).
Last updated: 08/23/23
|
THERAPEUTIC CATEGORY |
BRAND NAME |
GENERIC NAME |
COMMENTS |
|---|---|---|---|
|
ANALGESICS |
ASPIRIN |
ASPIRIN |
GENERICS ONLY |
|
ANTIANGINAL AGENTS |
NITRO-BID |
NITROGLYCERIN |
|
|
ANTIANGINAL AGENTS |
NITRO-DUR |
NITROGLYCERIN |
|
|
ANTIANGINAL AGENTS |
NITROGLYCERIN |
NITROGLYCERIN |
|
|
ANTIANGINAL AGENTS |
NITROGLYCERIN PATCH |
NITROGLYCERIN |
|
|
ANTIANGINAL AGENTS |
NITRO-TIME |
NITROGLYCERIN |
|
|
ANTIARRHYTHMICS |
AMIODARONE HCL |
AMIODARONE HCL |
|
|
ANTIARRHYTHMICS |
DOFETILIDE |
DOFETILIDE |
|
|
ANTIARRHYTHMICS |
FLECAINIDE ACETATE |
FLECAINIDE ACETATE |
|
|
ANTIARRHYTHMICS |
MULTAQ |
DRONEDARONE HCL |
|
|
ANTIARRHYTHMICS |
PACERONE |
AMIODARONE HCL |
|
|
ANTIARRHYTHMICS |
PROPAFENONE HCL |
PROPAFENONE HCL |
|
|
ANTIARRHYTHMICS |
PROPAFENONE HCL ER |
PROPAFENONE HCL |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
ACCOLATE |
ZAFIRLUKAST |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
ADVAIR DISKUS |
FLUTICASONE PROPION/SALMETEROL |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
ADVAIR HFA |
FLUTICASONE PROPION/SALMETEROL |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
ALBUTEROL 100MG/20ML SOL |
ALBUTEROL SULFATE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
ALBUTEROL 2.5MG/0.5ML SOL |
ALBUTEROL SULFATE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
ALBUTEROL 25MG/5ML SOL |
ALBUTEROL SULFATE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
ALBUTEROL HFA 90MCG INH |
ALBUTEROL SULFATE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
ALBUTEROL SUL 0.63MG/3ML SOL |
ALBUTEROL SULFATE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
ALBUTEROL SUL 1.25MG/3ML SOL |
ALBUTEROL SULFATE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
ALBUTEROL SUL 2.5MG/3ML SOL |
ALBUTEROL SULFATE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
ALBUTEROL SULF 2MG/5ML SYP |
ALBUTEROL SULFATE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
ANORO ELLIPTA |
UMECLIDINIUM BRM/VILANTEROL TR |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
ARFORMOTEROL TARTRATE |
ARFORMOTEROL TARTRATE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
ARNUITY ELLIPTA |
FLUTICASONE FUROATE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
ATROVENT HFA |
IPRATROPIUM BROMIDE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
BREO ELLIPTA |
FLUTICASONE/VILANTEROL |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
BREZTRI AEROSPHERE |
BUDESONIDE/GLYCOPYR/FORMOTEROL |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
BUDESONIDE |
BUDESONIDE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
COMBIVENT RESPIMAT |
IPRATROPIUM/ALBUTEROL SULFATE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
FLOVENT DISKUS |
FLUTICASONE PROPIONATE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
FLOVENT HFA |
FLUTICASONE PROPIONATE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
FORMOTEROL FUMARATE |
FORMOTEROL FUMARATE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
IPRATROPIUM BROMIDE |
IPRATROPIUM BROMIDE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
IPRATROPIUM-ALBUTEROL |
IPRATROPIUM/ALBUTEROL SULFATE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
LEVALBUTEROL CONCENTRATE |
LEVALBUTEROL HCL |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
LEVALBUTEROL HCL |
LEVALBUTEROL HCL |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
LEVALBUTEROL TARTRATE HFA |
LEVALBUTEROL TARTRATE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
MONTELUKAST SODIUM |
MONTELUKAST SODIUM |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
ROFLUMILAST |
ROFLUMILAST |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
SEREVENT DISKUS |
SALMETEROL XINAFOATE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
SPIRIVA HANDIHALER |
TIOTROPIUM BROMIDE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
SPIRIVA RESPIMAT |
TIOTROPIUM BROMIDE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
STIOLTO RESPIMAT |
TIOTROPIUM BR/OLODATEROL HCL |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
STRIVERDI RESPIMAT |
OLODATEROL HCL |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
SYMBICORT |
BUDESONIDE/FORMOTEROL FUMARATE |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
TRELEGY ELLIPTA |
FLUTICASONE/UMECLIDIN/VILANTER |
|
|
ANTIASTHMATIC & BRONCHODILATOR AGENTS |
ZAFIRLUKAST |
ZAFIRLUKAST |
|
|
ANTICOAGULANTS |
ELIQUIS |
APIXABAN |
|
|
ANTICOAGULANTS |
ENOXAPARIN SODIUM |
ENOXAPARIN SODIUM |
|
|
ANTICOAGULANTS |
FONDAPARINUX SODIUM |
FONDAPARINUX SODIUM |
|
|
ANTICOAGULANTS |
FRAGMIN |
DALTEPARIN SODIUM,PORCINE |
|
|
ANTICOAGULANTS |
JANTOVEN |
WARFARIN SODIUM |
|
|
ANTICOAGULANTS |
WARFARIN SODIUM |
WARFARIN SODIUM |
|
|
ANTICOAGULANTS |
XARELTO |
RIVAROXABAN |
|
|
ANTIDEPRESSANTS |
BUPROPION HCL |
BUPROPION HCL |
|
|
ANTIDEPRESSANTS |
BUPROPION HCL SR |
BUPROPION HCL |
|
|
ANTIDEPRESSANTS |
BUPROPION XL |
BUPROPION HCL |
|
|
ANTIDEPRESSANTS |
CITALOPRAM HBR |
CITALOPRAM HYDROBROMIDE |
|
|
ANTIDEPRESSANTS |
DESVENLAFAXINE SUCCINATE ER |
DESVENLAFAXINE SUCCINATE |
|
|
ANTIDEPRESSANTS |
DULOXETINE HCL |
DULOXETINE HCL |
|
|
ANTIDEPRESSANTS |
ESCITALOPRAM OXALATE |
ESCITALOPRAM OXALATE |
|
|
ANTIDEPRESSANTS |
FETZIMA |
LEVOMILNACIPRAN HCL |
|
|
ANTIDEPRESSANTS |
FLUOXETINE DR |
FLUOXETINE HCL |
|
|
ANTIDEPRESSANTS |
FLUOXETINE HCL |
FLUOXETINE HCL |
|
|
ANTIDEPRESSANTS |
FLUVOXAMINE MALEATE |
FLUVOXAMINE MALEATE |
|
|
ANTIDEPRESSANTS |
MIRTAZAPINE |
MIRTAZAPINE |
|
|
ANTIDEPRESSANTS |
PAROXETINE HCL |
PAROXETINE HCL |
|
|
ANTIDEPRESSANTS |
SERTRALINE HCL |
SERTRALINE HCL |
|
|
ANTIDEPRESSANTS |
TRAZODONE HCL |
TRAZODONE HCL |
|
|
ANTIDEPRESSANTS |
TRINTELLIX |
VORTIOXETINE HYDROBROMIDE |
|
|
ANTIDEPRESSANTS |
VENLAFAXINE HCL |
VENLAFAXINE HCL |
|
|
ANTIDEPRESSANTS |
VENLAFAXINE HCL ER |
VENLAFAXINE HCL |
|
|
ANTIDEPRESSANTS |
VIIBRYD |
VILAZODONE HCL |
|
|
ANTIDEPRESSANTS |
VILAZODONE HCL |
VILAZODONE HCL |
|
|
ANTIDIABETICS |
BYDUREON BCISE |
EXENATIDE MICROSPHERES |
|
|
ANTIDIABETICS |
BYETTA |
EXENATIDE |
|
|
ANTIDIABETICS |
FARXIGA |
DAPAGLIFLOZIN PROPANEDIOL |
|
|
ANTIDIABETICS |
GLIMEPIRIDE |
GLIMEPIRIDE |
|
|
ANTIDIABETICS |
GLIPIZIDE |
GLIPIZIDE |
|
|
ANTIDIABETICS |
GLIPIZIDE ER |
GLIPIZIDE |
|
|
ANTIDIABETICS |
GLIPIZIDE XL |
GLIPIZIDE |
|
|
ANTIDIABETICS |
GLIPIZIDE-METFORMIN |
GLIPIZIDE/METFORMIN HCL |
|
|
ANTIDIABETICS |
GLUCAGON EMERGENCY KIT |
GLUCAGON |
|
|
ANTIDIABETICS |
GLYBURIDE |
GLYBURIDE |
|
|
ANTIDIABETICS |
GLYBURIDE MICRONIZED |
GLYBURIDE,MICRONIZED |
|
|
ANTIDIABETICS |
GLYBURIDE-METFORMIN HCL |
GLYBURIDE/METFORMIN HCL |
|
|
ANTIDIABETICS |
GLYXAMBI |
EMPAGLIFLOZIN/LINAGLIPTIN |
|
|
ANTIDIABETICS |
GVOKE |
GLUCAGON |
|
|
ANTIDIABETICS |
GVOKE HYPOPEN 1-PACK |
GLUCAGON |
|
|
ANTIDIABETICS |
GVOKE HYPOPEN 2-PACK |
GLUCAGON |
|
|
ANTIDIABETICS |
GVOKE PFS 1-PACK SYRINGE |
GLUCAGON |
|
|
ANTIDIABETICS |
GVOKE PFS 2-PACK SYRINGE |
GLUCAGON |
|
|
ANTIDIABETICS |
HUMALOG |
INSULIN LISPRO |
|
|
ANTIDIABETICS |
HUMALOG JUNIOR KWIKPEN |
INSULIN LISPRO |
|
|
ANTIDIABETICS |
HUMALOG KWIKPEN U-100 |
INSULIN LISPRO |
|
|
ANTIDIABETICS |
HUMALOG KWIKPEN U-200 |
INSULIN LISPRO |
|
|
ANTIDIABETICS |
HUMALOG MIX 50-50 |
INSULIN LISPRO PROTAMIN/LISPRO |
|
|
ANTIDIABETICS |
HUMALOG MIX 50-50 KWIKPEN |
INSULIN LISPRO PROTAMIN/LISPRO |
|
|
ANTIDIABETICS |
HUMALOG MIX 75-25 |
INSULIN LISPRO PROTAMIN/LISPRO |
|
|
ANTIDIABETICS |
HUMALOG MIX 75-25 KWIKPEN |
INSULIN LISPRO PROTAMIN/LISPRO |
|
|
ANTIDIABETICS |
HUMULIN R U-500 |
INSULIN REGULAR, HUMAN |
|
|
ANTIDIABETICS |
HUMULIN R U-500 KWIKPEN |
INSULIN REGULAR, HUMAN |
|
|
ANTIDIABETICS |
JANUMET |
SITAGLIPTIN PHOS/METFORMIN HCL |
|
|
ANTIDIABETICS |
JANUMET XR |
SITAGLIPTIN PHOS/METFORMIN HCL |
|
|
ANTIDIABETICS |
JANUVIA |
SITAGLIPTIN PHOSPHATE |
|
|
ANTIDIABETICS |
JARDIANCE |
EMPAGLIFLOZIN |
|
|
ANTIDIABETICS |
LEVEMIR |
INSULIN DETEMIR |
|
|
ANTIDIABETICS |
LEVEMIR FLEXPEN |
INSULIN DETEMIR |
|
|
ANTIDIABETICS |
LYUMJEV |
INSULIN LISPRO-AABC |
|
|
ANTIDIABETICS |
LYUMJEV KWIKPEN U-100 |
INSULIN LISPRO-AABC |
|
|
ANTIDIABETICS |
LYUMJEV KWIKPEN U-200 |
INSULIN LISPRO-AABC |
|
|
ANTIDIABETICS |
METFORMIN HCL |
METFORMIN HCL |
|
|
ANTIDIABETICS |
METFORMIN HCL ER |
METFORMIN HCL |
|
|
ANTIDIABETICS |
MOUNJARO |
TIRZEPATIDE |
|
|
ANTIDIABETICS |
OZEMPIC |
SEMAGLUTIDE |
|
|
ANTIDIABETICS |
PIOGLITAZONE HCL |
PIOGLITAZONE HCL |
|
|
ANTIDIABETICS |
PIOGLITAZONE-METFORMIN |
PIOGLITAZONE HCL/METFORMIN HCL |
|
|
ANTIDIABETICS |
RYBELSUS |
SEMAGLUTIDE |
|
|
ANTIDIABETICS |
SEMGLEE (YFGN) |
INSULIN GLARGINE-YFGN |
|
|
ANTIDIABETICS |
SEMGLEE (YFGN) PEN |
INSULIN GLARGINE-YFGN |
|
|
ANTIDIABETICS |
SOLIQUA 100-33 |
INSULIN GLARGINE/LIXISENATIDE |
|
|
ANTIDIABETICS |
SYNJARDY |
EMPAGLIFLOZIN/METFORMIN HCL |
|
|
ANTIDIABETICS |
SYNJARDY XR |
EMPAGLIFLOZIN/METFORMIN HCL |
|
|
ANTIDIABETICS |
TRESIBA |
INSULIN DEGLUDEC |
|
|
ANTIDIABETICS |
TRESIBA FLEXTOUCH U-100 |
INSULIN DEGLUDEC |
|
|
ANTIDIABETICS |
TRESIBA FLEXTOUCH U-200 |
INSULIN DEGLUDEC |
|
|
ANTIDIABETICS |
TRIJARDY XR |
EMPAGLIFLOZ/LINAGLIP/METFORMIN |
|
|
ANTIDIABETICS |
TRULICITY |
DULAGLUTIDE |
|
|
ANTIDIABETICS |
VICTOZA 2-PAK |
LIRAGLUTIDE |
|
|
ANTIDIABETICS |
VICTOZA 3-PAK |
LIRAGLUTIDE |
|
|
ANTIDIABETICS |
XIGDUO XR |
DAPAGLIFLOZ PROPANED/METFORMIN |
|
|
ANTIDIABETICS |
XULTOPHY 100-3.6 |
INSULIN DEGLUDEC/LIRAGLUTIDE |
|
|
ANTIDIABETICS |
ZEGALOGUE AUTOINJECTOR |
DASIGLUCAGON HCL |
|
|
ANTIDIABETICS |
ZEGALOGUE SYRINGE |
DASIGLUCAGON HCL |
|
|
ANTIHYPERLIPIDEMICS |
ATORVASTATIN CALCIUM |
ATORVASTATIN CALCIUM |
Age 40-75 years, No concurrent use of secondary prevention medications, quantity limited to statin dosages at low-to- moderate intensity |
|
ANTIHYPERLIPIDEMICS |
CHOLESTYRAMINE |
CHOLESTYRAMINE (WITH SUGAR) |
|
|
ANTIHYPERLIPIDEMICS |
CHOLESTYRAMINE LIGHT |
CHOLESTYRAMINE/ASPARTAME |
|
|
ANTIHYPERLIPIDEMICS |
COLESEVELAM HCL |
COLESEVELAM HCL |
|
|
ANTIHYPERLIPIDEMICS |
COLESTIPOL HCL |
COLESTIPOL HCL |
|
|
ANTIHYPERLIPIDEMICS |
EZETIMIBE |
EZETIMIBE |
|
|
ANTIHYPERLIPIDEMICS |
EZETIMIBE-SIMVASTATIN |
EZETIMIBE/SIMVASTATIN |
|
|
ANTIHYPERLIPIDEMICS |
FENOFIBRATE |
FENOFIBRATE |
|
|
ANTIHYPERLIPIDEMICS |
FENOFIBRIC ACID |
FENOFIBRIC ACID (CHOLINE) |
|
|
ANTIHYPERLIPIDEMICS |
FLUVASTATIN ER |
FLUVASTATIN SODIUM |
Age 40-75 years, No concurrent use of secondary prevention medications, quantity limited to statin dosages at low-to- moderate intensity |
|
ANTIHYPERLIPIDEMICS |
FLUVASTATIN SODIUM |
FLUVASTATIN SODIUM |
Age 40-75 years, No concurrent use of secondary prevention medications, quantity limited to statin dosages at low-to- moderate intensity |
|
ANTIHYPERLIPIDEMICS |
GEMFIBROZIL |
GEMFIBROZIL |
|
|
ANTIHYPERLIPIDEMICS |
LIVALO |
PITAVASTATIN CALCIUM |
Age 40-75 years, No concurrent use of secondary prevention medications, quantity limited to statin dosages at low-to- moderate intensity |
|
ANTIHYPERLIPIDEMICS |
LOVASTATIN |
LOVASTATIN |
Age 40-75 years, No concurrent use of secondary prevention medications, quantity limited to statin dosages at low-to- moderate intensity |
|
ANTIHYPERLIPIDEMICS |
NEXLETOL |
BEMPEDOIC ACID |
|
|
ANTIHYPERLIPIDEMICS |
NEXLIZET |
BEMPEDOIC ACID/EZETIMIBE |
|
|
ANTIHYPERLIPIDEMICS |
OMEGA-3 ACID ETHYL ESTERS |
OMEGA-3 ACID ETHYL ESTERS |
|
|
ANTIHYPERLIPIDEMICS |
PRALUENT PEN |
ALIROCUMAB |
|
|
ANTIHYPERLIPIDEMICS |
PRAVASTATIN SODIUM |
PRAVASTATIN SODIUM |
Age 40-75 years, No concurrent use of secondary prevention medications, quantity limited to statin dosages at low-to- moderate intensity |
|
ANTIHYPERLIPIDEMICS |
PREVALITE |
CHOLESTYRAMINE/ASPARTAME |
|
|
ANTIHYPERLIPIDEMICS |
REPATHA PUSHTRONEX |
EVOLOCUMAB |
|
|
ANTIHYPERLIPIDEMICS |
REPATHA SURECLICK |
EVOLOCUMAB |
|
|
ANTIHYPERLIPIDEMICS |
REPATHA SYRINGE |
EVOLOCUMAB |
|
|
ANTIHYPERLIPIDEMICS |
ROSUVASTATIN CALCIUM |
ROSUVASTATIN CALCIUM |
Age 40-75 years, No concurrent use of secondary prevention medications, quantity limited to statin dosages at low-to- moderate intensity |
|
ANTIHYPERLIPIDEMICS |
SIMVASTATIN |
SIMVASTATIN |
Age 40-75 years, No concurrent use of secondary prevention medications, quantity limited to statin dosages at low-to- moderate intensity |
|
ANTIHYPERLIPIDEMICS |
VASCEPA |
ICOSAPENT ETHYL |
|
|
ANTIHYPERTENSIVES |
AMLODIPINE BESYLATE- BENAZEPRIL |
AMLODIPINE BESYLATE/BENAZEPRIL |
|
|
ANTIHYPERTENSIVES |
AMLODIPINE-OLMESARTAN |
AMLODIPINE BES/OLMESARTAN MED |
|
|
ANTIHYPERTENSIVES |
AMLODIPINE-VALSARTAN |
AMLODIPINE BESYLATE/VALSARTAN |
|
|
ANTIHYPERTENSIVES |
ATENOLOL-CHLORTHALIDONE |
ATENOLOL/CHLORTHALIDONE |
|
|
ANTIHYPERTENSIVES |
BENAZEPRIL HCL |
BENAZEPRIL HCL |
|
|
ANTIHYPERTENSIVES |
BENAZEPRIL- HYDROCHLOROTHIAZIDE |
BENAZEPRIL/HYDROCHLOROTHIAZIDE |
|
|
ANTIHYPERTENSIVES |
BISOPROLOL- HYDROCHLOROTHIAZIDE |
BISOPROLOL/HYDROCHLOROTHIAZIDE |
|
|
ANTIHYPERTENSIVES |
CANDESARTAN CILEXETIL |
CANDESARTAN CILEXETIL |
|
|
ANTIHYPERTENSIVES |
CAPTOPRIL |
CAPTOPRIL |
|
|
ANTIHYPERTENSIVES |
ENALAPRIL MALEATE |
ENALAPRIL MALEATE |
|
|
ANTIHYPERTENSIVES |
ENALAPRIL- HYDROCHLOROTHIAZIDE |
ENALAPRIL/HYDROCHLOROTHIAZIDE |
|
|
ANTIHYPERTENSIVES |
EPLERENONE |
EPLERENONE |
|
|
ANTIHYPERTENSIVES |
FOSINOPRIL SODIUM |
FOSINOPRIL SODIUM |
|
|
ANTIHYPERTENSIVES |
FOSINOPRIL- HYDROCHLOROTHIAZIDE |
FOSINOPRIL/HYDROCHLOROTHIAZIDE |
|
|
ANTIHYPERTENSIVES |
IRBESARTAN |
IRBESARTAN |
|
|
ANTIHYPERTENSIVES |
IRBESARTAN- HYDROCHLOROTHIAZIDE |
IRBESARTAN/HYDROCHLOROTHIAZIDE |
|
|
ANTIHYPERTENSIVES |
LISINOPRIL |
LISINOPRIL |
|
|
ANTIHYPERTENSIVES |
LISINOPRIL- HYDROCHLOROTHIAZIDE |
LISINOPRIL/HYDROCHLOROTHIAZIDE |
|
|
ANTIHYPERTENSIVES |
LOSARTAN POTASSIUM |
LOSARTAN POTASSIUM |
|
|
ANTIHYPERTENSIVES |
LOSARTAN- HYDROCHLOROTHIAZIDE |
LOSARTAN/HYDROCHLOROTHIAZIDE |
|
|
ANTIHYPERTENSIVES |
METOPROLOL- HYDROCHLOROTHIAZIDE |
METOPROLOL/HYDROCHLOROTHIAZIDE |
|
|
ANTIHYPERTENSIVES |
MOEXIPRIL HCL |
MOEXIPRIL HCL |
|
|
ANTIHYPERTENSIVES |
OLMESARTAN MEDOXOMIL |
OLMESARTAN MEDOXOMIL |
|
|
ANTIHYPERTENSIVES |
OLMESARTAN- HYDROCHLOROTHIAZIDE |
OLMESARTAN/HYDROCHLOROTHIAZIDE |
|
|
ANTIHYPERTENSIVES |
PERINDOPRIL ERBUMINE |
PERINDOPRIL ERBUMINE |
|
|
ANTIHYPERTENSIVES |
QUINAPRIL HCL |
QUINAPRIL HCL |
|
|
ANTIHYPERTENSIVES |
QUINAPRIL- HYDROCHLOROTHIAZIDE |
QUINAPRIL/HYDROCHLOROTHIAZIDE |
|
|
ANTIHYPERTENSIVES |
RAMIPRIL |
RAMIPRIL |
|
|
ANTIHYPERTENSIVES |
TELMISARTAN |
TELMISARTAN |
|
|
ANTIHYPERTENSIVES |
TELMISARTAN- HYDROCHLOROTHIAZID |
TELMISARTAN/HYDROCHLOROTHIAZID |
|
|
ANTIHYPERTENSIVES |
TRANDOLAPRIL |
TRANDOLAPRIL |
|
|
ANTIHYPERTENSIVES |
VALSARTAN |
VALSARTAN |
|
|
ANTIHYPERTENSIVES |
VALSARTAN- HYDROCHLOROTHIAZIDE |
VALSARTAN/HYDROCHLOROTHIAZIDE |
|
|
ANTINEOPLASTICS & ADJUNCTIVE THERAPIES |
ANASTROZOLE |
ANASTROZOLE |
Age ≥35, Quantity limit of 1 per day |
|
ANTINEOPLASTICS & ADJUNCTIVE THERAPIES |
EXEMESTANE |
EXEMESTANE |
Age ≥35, Quantity limit of 1 per day |
|
ANTINEOPLASTICS & ADJUNCTIVE THERAPIES |
TAMOXIFEN CITRATE |
TAMOXIFEN CITRATE |
Age ≥35 |
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
ABILIFY MAINTENA |
ARIPIPRAZOLE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
ADASUVE |
LOXAPINE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
ARIPIPRAZOLE |
ARIPIPRAZOLE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
ARIPIPRAZOLE ODT |
ARIPIPRAZOLE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
ARISTADA |
ARIPIPRAZOLE LAUROXIL |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
ASENAPINE MALEATE |
ASENAPINE MALEATE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
CHLORPROMAZINE HCL |
CHLORPROMAZINE HCL |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
CLOZAPINE |
CLOZAPINE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
CLOZAPINE ODT |
CLOZAPINE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
COMPRO |
PROCHLORPERAZINE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
FLUPHENAZINE HCL |
FLUPHENAZINE HCL |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
HALOPERIDOL |
HALOPERIDOL |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
HALOPERIDOL LACTATE |
HALOPERIDOL LACTATE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
INVEGA HAFYERA |
PALIPERIDONE PALMITATE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
INVEGA SUSTENNA |
PALIPERIDONE PALMITATE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
INVEGA TRINZA |
PALIPERIDONE PALMITATE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
LITHIUM CARBONATE |
LITHIUM CARBONATE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
LITHIUM CARBONATE ER |
LITHIUM CARBONATE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
LOXAPINE |
LOXAPINE SUCCINATE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
LURASIDONE HCL |
LURASIDONE HCL |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
MOLINDONE HCL |
MOLINDONE HCL |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
NUPLAZID |
PIMAVANSERIN TARTRATE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
OLANZAPINE |
OLANZAPINE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
OLANZAPINE ODT |
OLANZAPINE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
PALIPERIDONE ER |
PALIPERIDONE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
PERPHENAZINE |
PERPHENAZINE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
PERSERIS |
RISPERIDONE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
PROCHLORPERAZINE |
PROCHLORPERAZINE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
PROCHLORPERAZINE MALEATE |
PROCHLORPERAZINE MALEATE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
QUETIAPINE FUMARATE |
QUETIAPINE FUMARATE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
QUETIAPINE FUMARATE ER |
QUETIAPINE FUMARATE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
REXULTI |
BREXPIPRAZOLE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
RISPERDAL CONSTA |
RISPERIDONE MICROSPHERES |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
RISPERIDONE |
RISPERIDONE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
RISPERIDONE ODT |
RISPERIDONE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
THIORIDAZINE HCL |
THIORIDAZINE HCL |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
THIOTHIXENE |
THIOTHIXENE |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
TRIFLUOPERAZINE HCL |
TRIFLUOPERAZINE HCL |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
VRAYLAR |
CARIPRAZINE HCL |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
ZIPRASIDONE HCL |
ZIPRASIDONE HCL |
|
|
ANTIPSYCHOTICS/ANTIMANIC AGENTS |
ZYPREXA RELPREVV |
OLANZAPINE PAMOATE |
|
|
ANTIVIRALS |
APRETUDE |
CABOTEGRAVIR |
|
|
ANTIVIRALS |
DESCOVY |
EMTRICITABINE/TENOFOV ALAFENAM |
|
|
ANTIVIRALS |
EMTRICITABINE |
EMTRICITABINE |
Quantity limit of 1 per day, No concurrent use of HIV medications for the treatment of HIV |
|
ANTIVIRALS |
EMTRICITABINE-TENOFOVIR DISOP |
EMTRICITABINE/TENOFOVIR (TDF) |
Quantity limit of 1 per day, No concurrent use of HIV medications for the treatment of HIV |
|
ANTIVIRALS |
TENOFOVIR DISOPROXIL FUMARATE |
TENOFOVIR DISOPROXIL FUMARATE |
Quantity limit of 1 per day, No concurrent use of HIV medications for the treatment of HIV |
|
BETA BLOCKERS |
ACEBUTOLOL HCL |
ACEBUTOLOL HCL |
|
|
BETA BLOCKERS |
ATENOLOL |
ATENOLOL |
|
|
BETA BLOCKERS |
BETAXOLOL HCL |
BETAXOLOL HCL |
|
|
BETA BLOCKERS |
BISOPROLOL FUMARATE |
BISOPROLOL FUMARATE |
|
|
BETA BLOCKERS |
CARVEDILOL |
CARVEDILOL |
|
|
BETA BLOCKERS |
LABETALOL HCL |
LABETALOL HCL |
|
|
BETA BLOCKERS |
METOPROLOL SUCCINATE |
METOPROLOL SUCCINATE |
|
|
BETA BLOCKERS |
METOPROLOL TARTRATE |
METOPROLOL TARTRATE |
|
|
BETA BLOCKERS |
NADOLOL |
NADOLOL |
|
|
BETA BLOCKERS |
NEBIVOLOL HCL |
NEBIVOLOL HCL |
|
|
BETA BLOCKERS |
PINDOLOL |
PINDOLOL |
|
|
BETA BLOCKERS |
PROPRANOLOL HCL |
PROPRANOLOL HCL |
|
|
BETA BLOCKERS |
PROPRANOLOL HCL ER |
PROPRANOLOL HCL |
|
|
BETA BLOCKERS |
SOTALOL |
SOTALOL HCL |
|
|
BETA BLOCKERS |
SOTALOL AF |
SOTALOL HCL |
|
|
BOWEL PREPARATION |
CLENPIQ |
SOD PICOSULF/MAG OX/CITRIC AC |
Age 45-75 years, Fill limit of 2 per year, Quantity limit per label |
|
BOWEL PREPARATION |
GAVILYTE-C |
PEG3350/SOD SULF,BICARB,CL/KCL |
Age 45-75 years, Fill limit of 2 per year, Quantity limit per label |
|
BOWEL PREPARATION |
GAVILYTE-G |
PEG3350/SOD SULF,BICARB,CL/KCL |
Age 45-75 years, Fill limit of 2 per year, Quantity limit per label |
|
BOWEL PREPARATION |
PEG 3350-ELECTROLYTE |
SODIUM CHLORIDE/NAHCO3/KCL/PEG |
Age 45-75 years, Fill limit of 2 per year, Quantity limit per label |
|
BOWEL PREPARATION |
PEG-3350 AND ELECTROLYTES |
PEG3350/SOD SULF,BICARB,CL/KCL |
Age 45-75 years, Fill limit of 2 per year, Quantity limit per label |
|
BOWEL PREPARATION |
PEG3350-SOD SUL-NACL-KCL-ASB- C |
PEG3350/SOD SUL/NACL/KCL/ASB/C |
Age 45-75 years, Fill limit of 2 per year, Quantity limit per label |
|
BOWEL PREPARATION |
PLENVU |
PEG3350/SOD SUL/NACL/KCL/ASB/C |
Age 45-75 years, Fill limit of 2 per year, Quantity limit per label |
|
BOWEL PREPARATION |
SOD SULF-POTASS SULF-MAG SULF |
SODIUM, POTASSIUM,MAG SULFATES |
Age 45-75 years, Fill limit of 2 per year, Quantity limit per label |
|
BOWEL PREPARATION |
SUTAB |
SOD SULF/POT CHLORIDE/MAG SULF |
Age 45-75 years, Fill limit of 2 per year, Quantity limit per label |
|
CALCIUM CHANNEL BLOCKERS |
AMLODIPINE BESYLATE |
AMLODIPINE BESYLATE |
|
|
CALCIUM CHANNEL BLOCKERS |
CARTIA XT |
DILTIAZEM HCL |
|
|
CALCIUM CHANNEL BLOCKERS |
DILTIAZEM 24HR ER |
DILTIAZEM HCL |
|
|
CALCIUM CHANNEL BLOCKERS |
DILTIAZEM 24HR ER (CD) |
DILTIAZEM HCL |
|
|
CALCIUM CHANNEL BLOCKERS |
DILTIAZEM 24HR ER (LA) |
DILTIAZEM HCL |
|
|
CALCIUM CHANNEL BLOCKERS |
DILTIAZEM 24HR ER (XR) |
DILTIAZEM HCL |
|
|
CALCIUM CHANNEL BLOCKERS |
DILTIAZEM HCL |
DILTIAZEM HCL |
|
|
CALCIUM CHANNEL BLOCKERS |
DILT-XR |
DILTIAZEM HCL |
|
|
CALCIUM CHANNEL BLOCKERS |
FELODIPINE ER |
FELODIPINE |
|
|
CALCIUM CHANNEL BLOCKERS |
LEVAMLODIPINE MALEATE |
LEVAMLODIPINE MALEATE |
|
|
CALCIUM CHANNEL BLOCKERS |
MATZIM LA |
DILTIAZEM HCL |
|
|
CALCIUM CHANNEL BLOCKERS |
NICARDIPINE HCL |
NICARDIPINE HCL |
|
|
CALCIUM CHANNEL BLOCKERS |
NIFEDIPINE |
NIFEDIPINE |
|
|
CALCIUM CHANNEL BLOCKERS |
NIFEDIPINE ER |
NIFEDIPINE |
|
|
CALCIUM CHANNEL BLOCKERS |
NIMODIPINE |
NIMODIPINE |
|
|
CALCIUM CHANNEL BLOCKERS |
NISOLDIPINE |
NISOLDIPINE |
|
|
CALCIUM CHANNEL BLOCKERS |
NYMALIZE |
NIMODIPINE |
|
|
CALCIUM CHANNEL BLOCKERS |
TAZTIA XT |
DILTIAZEM HCL |
|
|
CALCIUM CHANNEL BLOCKERS |
TIADYLT ER |
DILTIAZEM HCL |
|
|
CALCIUM CHANNEL BLOCKERS |
VERAPAMIL ER |
VERAPAMIL HCL |
|
|
CALCIUM CHANNEL BLOCKERS |
VERAPAMIL HCL |
VERAPAMIL HCL |
|
|
CALCIUM CHANNEL BLOCKERS |
VERAPAMIL SR |
VERAPAMIL HCL |
|
|
CARDIOTONICS |
DIGOXIN |
DIGOXIN |
|
|
CARDIOTONICS |
LANOXIN |
DIGOXIN |
|
|
CARDIOVASCULAR AGENTS - MISC. |
CORLANOR |
IVABRADINE HCL |
|
|
CARDIOVASCULAR AGENTS - MISC. |
ENTRESTO |
SACUBITRIL/VALSARTAN |
|
|
CONTRACEPTIVES |
AFIRMELLE |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
AFTER PILL |
LEVONORGESTREL |
|
|
CONTRACEPTIVES |
AFTERA |
LEVONORGESTREL |
|
|
CONTRACEPTIVES |
ALTAVERA |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
ALYACEN |
NORETHINDRONE-ETHIN. ESTRADIOL |
|
|
CONTRACEPTIVES |
AMETHIA |
L-NORGEST/E.ESTRADIOL-E.ESTRAD |
|
|
CONTRACEPTIVES |
AMETHYST |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
ANNOVERA |
SEGESTERONE AC/ETHIN ESTRADIOL |
|
|
CONTRACEPTIVES |
APRI |
DESOGESTREL-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
ARANELLE |
NORETHINDRONE-ETHIN. ESTRADIOL |
|
|
CONTRACEPTIVES |
ASHLYNA |
L-NORGEST/E.ESTRADIOL-E.ESTRAD |
|
|
CONTRACEPTIVES |
AUBRA EQ |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
AUROVELA |
NORETHINDRONE AC-ETH ESTRADIOL |
|
|
CONTRACEPTIVES |
AUROVELA 24 FE |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
AUROVELA FE |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
AVIANE |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
AYUNA |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
AZURETTE |
DESOG-E.ESTRADIOL/E.ESTRADIOL |
|
|
CONTRACEPTIVES |
BALZIVA |
NORETHINDRONE-ETHIN. ESTRADIOL |
|
|
CONTRACEPTIVES |
BLISOVI 24 FE |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
BLISOVI FE |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
BRIELLYN |
NORETHINDRONE-ETHIN. ESTRADIOL |
|
|
CONTRACEPTIVES |
CAMILA |
NORETHINDRONE |
|
|
CONTRACEPTIVES |
CAMRESE |
L-NORGEST/E.ESTRADIOL-E.ESTRAD |
|
|
CONTRACEPTIVES |
CAMRESE LO |
L-NORGEST/E.ESTRADIOL-E.ESTRAD |
|
|
CONTRACEPTIVES |
CHARLOTTE 24 FE |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
CHATEAL EQ |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
CRYSELLE |
NORGESTREL-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
CURAE |
LEVONORGESTREL |
|
|
CONTRACEPTIVES |
CYRED EQ |
DESOGESTREL-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
DASETTA |
NORETHINDRONE-ETHIN. ESTRADIOL |
|
|
CONTRACEPTIVES |
DAYSEE |
L-NORGEST/E.ESTRADIOL-E.ESTRAD |
|
|
CONTRACEPTIVES |
DEBLITANE |
NORETHINDRONE |
|
|
CONTRACEPTIVES |
DEPO-SUBQ PROVERA 104 |
MEDROXYPROGESTERONE ACETATE |
|
|
CONTRACEPTIVES |
DESOGESTR-ETH ESTRAD ETH ESTRA |
DESOG-E.ESTRADIOL/E.ESTRADIOL |
|
|
CONTRACEPTIVES |
DOLISHALE |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
DROSPIRENONE-ETH ESTRA- LEVOMEF |
DROSPIR/ETH ESTRA/LEVOMEFOL CA |
|
|
CONTRACEPTIVES |
DROSPIRENONE-ETHINYL ESTRADIOL |
ETHINYL ESTRADIOL/DROSPIRENONE |
|
|
CONTRACEPTIVES |
ECONTRA ONE-STEP |
LEVONORGESTREL |
|
|
CONTRACEPTIVES |
ELINEST |
NORGESTREL-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
ELLA |
ULIPRISTAL ACETATE |
|
|
CONTRACEPTIVES |
ELURYNG |
ETONOGESTREL/ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
ENPRESSE |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
ENSKYCE |
DESOGESTREL-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
ERRIN |
NORETHINDRONE |
|
|
CONTRACEPTIVES |
ESTARYLLA |
NORGESTIMATE-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
ETHYNODIOL-ETHINYL ESTRADIOL |
ETHYNODIOL D-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
ETONOGESTREL-ETHINYL ESTRADIOL |
ETONOGESTREL/ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
FALMINA |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
FINZALA |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
GEMMILY |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
HAILEY |
NORETHINDRONE AC-ETH ESTRADIOL |
|
|
CONTRACEPTIVES |
HAILEY 24 FE |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
HAILEY FE |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
HALOETTE |
ETONOGESTREL/ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
HEATHER |
NORETHINDRONE |
|
|
CONTRACEPTIVES |
HER STYLE |
LEVONORGESTREL |
|
|
CONTRACEPTIVES |
ICLEVIA |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
INCASSIA |
NORETHINDRONE |
|
|
CONTRACEPTIVES |
ISIBLOOM |
DESOGESTREL-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
JAIMIESS |
L-NORGEST/E.ESTRADIOL-E.ESTRAD |
|
|
CONTRACEPTIVES |
JASMIEL |
ETHINYL ESTRADIOL/DROSPIRENONE |
|
|
CONTRACEPTIVES |
JENCYCLA |
NORETHINDRONE |
|
|
CONTRACEPTIVES |
JOLESSA |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
JULEBER |
DESOGESTREL-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
JUNEL |
NORETHINDRONE AC-ETH ESTRADIOL |
|
|
CONTRACEPTIVES |
JUNEL FE |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
JUNEL FE 24 |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
KAITLIB FE |
NORETH-ETHINYL ESTRADIOL/IRON |
|
|
CONTRACEPTIVES |
KALLIGA |
DESOGESTREL-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
KARIVA |
DESOG-E.ESTRADIOL/E.ESTRADIOL |
|
|
CONTRACEPTIVES |
KELNOR 1-35 |
ETHYNODIOL D-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
KELNOR 1-50 |
ETHYNODIOL D-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
KURVELO |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
KYLEENA |
LEVONORGESTREL |
|
|
CONTRACEPTIVES |
LARIN |
NORETHINDRONE AC-ETH ESTRADIOL |
|
|
CONTRACEPTIVES |
LARIN 24 FE |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
LARIN FE |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
LAYOLIS FE |
NORETH-ETHINYL ESTRADIOL/IRON |
|
|
CONTRACEPTIVES |
LEENA |
NORETHINDRONE-ETHIN. ESTRADIOL |
|
|
CONTRACEPTIVES |
LESSINA |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
LEVONEST |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
LEVONORGESTREL |
LEVONORGESTREL |
|
|
CONTRACEPTIVES |
LEVONORGESTREL-ETH ESTRADIOL |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
LEVONORG-ETH ESTRAD ETH ESTRAD |
L-NORGEST/E.ESTRADIOL-E.ESTRAD |
|
|
CONTRACEPTIVES |
LEVORA-28 |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
LILETTA |
LEVONORGESTREL |
|
|
CONTRACEPTIVES |
LOESTRIN |
NORETHINDRONE AC-ETH ESTRADIOL |
|
|
CONTRACEPTIVES |
LOESTRIN FE |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
LOJAIMIESS |
L-NORGEST/E.ESTRADIOL-E.ESTRAD |
|
|
CONTRACEPTIVES |
LORYNA |
ETHINYL ESTRADIOL/DROSPIRENONE |
|
|
CONTRACEPTIVES |
LOW-OGESTREL |
NORGESTREL-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
LO-ZUMANDIMINE |
ETHINYL ESTRADIOL/DROSPIRENONE |
|
|
CONTRACEPTIVES |
LUTERA |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
LYLEQ |
NORETHINDRONE |
|
|
CONTRACEPTIVES |
LYZA |
NORETHINDRONE |
|
|
CONTRACEPTIVES |
MARLISSA |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
MEDROXYPROGESTERONE ACETATE |
MEDROXYPROGESTERONE ACETATE |
|
|
CONTRACEPTIVES |
MIBELAS 24 FE |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
MICROGESTIN |
NORETHINDRONE AC-ETH ESTRADIOL |
|
|
CONTRACEPTIVES |
MICROGESTIN 24 FE |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
MICROGESTIN FE |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
MILI |
NORGESTIMATE-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
MIRENA |
LEVONORGESTREL |
|
|
CONTRACEPTIVES |
MONO-LINYAH |
NORGESTIMATE-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
MY CHOICE |
LEVONORGESTREL |
|
|
CONTRACEPTIVES |
MY WAY |
LEVONORGESTREL |
|
|
CONTRACEPTIVES |
NATAZIA |
ESTRADIOL VALERATE/DIENOGEST |
|
|
CONTRACEPTIVES |
NECON |
NORETHINDRONE-ETHIN. ESTRADIOL |
|
|
CONTRACEPTIVES |
NEW DAY |
LEVONORGESTREL |
|
|
CONTRACEPTIVES |
NEXPLANON |
ETONOGESTREL |
Quantity limit of 1 per year |
|
CONTRACEPTIVES |
NEXTSTELLIS |
DROSPIRENONE/ESTETROL |
|
|
CONTRACEPTIVES |
NIKKI |
ETHINYL ESTRADIOL/DROSPIRENONE |
|
|
CONTRACEPTIVES |
NORA-BE |
NORETHINDRONE |
|
|
CONTRACEPTIVES |
NORETHINDRONE |
NORETHINDRONE |
|
|
CONTRACEPTIVES |
NORETHINDRONE-E.ESTRADIOL- IRON |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
NORETHINDRON-ETHINYL ESTRADIOL |
NORETHINDRONE AC-ETH ESTRADIOL |
|
|
CONTRACEPTIVES |
NORETHIN-ETH ESTRA-FERROUS FUM |
NORETH-ETHINYL ESTRADIOL/IRON |
|
|
CONTRACEPTIVES |
NORGESTIMATE-ETHINYL ESTRADIOL |
NORGESTIMATE-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
NORTREL |
NORETHINDRONE-ETHIN. ESTRADIOL |
|
|
CONTRACEPTIVES |
NYLIA |
NORETHINDRONE-ETHIN. ESTRADIOL |
|
|
CONTRACEPTIVES |
NYMYO |
NORGESTIMATE-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
OCELLA |
ETHINYL ESTRADIOL/DROSPIRENONE |
|
|
CONTRACEPTIVES |
OPCICON ONE-STEP |
LEVONORGESTREL |
|
|
CONTRACEPTIVES |
OPTION 2 |
LEVONORGESTREL |
|
|
CONTRACEPTIVES |
PARAGARD T 380-A |
COPPER |
|
|
CONTRACEPTIVES |
PHILITH |
NORETHINDRONE-ETHIN. ESTRADIOL |
|
|
CONTRACEPTIVES |
PIMTREA |
DESOG-E.ESTRADIOL/E.ESTRADIOL |
|
|
CONTRACEPTIVES |
PIRMELLA |
NORETHINDRONE-ETHIN. ESTRADIOL |
|
|
CONTRACEPTIVES |
PORTIA |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
RECLIPSEN |
DESOGESTREL-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
RIVELSA |
L-NORGEST/E.ESTRADIOL-E.ESTRAD |
|
|
CONTRACEPTIVES |
SETLAKIN |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
SHAROBEL |
NORETHINDRONE |
|
|
CONTRACEPTIVES |
SIMLIYA |
DESOG-E.ESTRADIOL/E.ESTRADIOL |
|
|
CONTRACEPTIVES |
SIMPESSE |
L-NORGEST/E.ESTRADIOL-E.ESTRAD |
|
|
CONTRACEPTIVES |
SKYLA |
LEVONORGESTREL |
|
|
CONTRACEPTIVES |
SLYND |
DROSPIRENONE |
|
|
CONTRACEPTIVES |
SPRINTEC |
NORGESTIMATE-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
SRONYX |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
SYEDA |
ETHINYL ESTRADIOL/DROSPIRENONE |
|
|
CONTRACEPTIVES |
TAKE ACTION |
LEVONORGESTREL |
|
|
CONTRACEPTIVES |
TARINA 24 FE |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
TARINA FE 1-20 EQ |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
TAYSOFY |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
TILIA FE |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
TRI-ESTARYLLA |
NORGESTIMATE-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
TRI-LEGEST FE |
NORETHINDRONE-E.ESTRADIOL-IRON |
|
|
CONTRACEPTIVES |
TRI-LINYAH |
NORGESTIMATE-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
TRI-LO-ESTARYLLA |
NORGESTIMATE-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
TRI-LO-MARZIA |
NORGESTIMATE-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
TRI-LO-MILI |
NORGESTIMATE-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
TRI-LO-SPRINTEC |
NORGESTIMATE-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
TRI-MILI |
NORGESTIMATE-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
TRI-NYMYO |
NORGESTIMATE-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
TRI-SPRINTEC |
NORGESTIMATE-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
TRIVORA-28 |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
TRI-VYLIBRA |
NORGESTIMATE-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
TRI-VYLIBRA LO |
NORGESTIMATE-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
TYDEMY |
DROSPIR/ETH ESTRA/LEVOMEFOL CA |
|
|
CONTRACEPTIVES |
VESTURA |
ETHINYL ESTRADIOL/DROSPIRENONE |
|
|
CONTRACEPTIVES |
VIENVA |
LEVONORGESTREL/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
VIORELE |
DESOG-E.ESTRADIOL/E.ESTRADIOL |
|
|
CONTRACEPTIVES |
VOLNEA |
DESOG-E.ESTRADIOL/E.ESTRADIOL |
|
|
CONTRACEPTIVES |
VYFEMLA |
NORETHINDRONE-ETHIN. ESTRADIOL |
|
|
CONTRACEPTIVES |
VYLIBRA |
NORGESTIMATE-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
WERA |
NORETHINDRONE-ETHIN. ESTRADIOL |
|
|
CONTRACEPTIVES |
WYMZYA FE |
NORETH-ETHINYL ESTRADIOL/IRON |
|
|
CONTRACEPTIVES |
XULANE |
NORELGESTROMIN/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
ZAFEMY |
NORELGESTROMIN/ETHIN.ESTRADIOL |
|
|
CONTRACEPTIVES |
ZOVIA 1-35 |
ETHYNODIOL D-ETHINYL ESTRADIOL |
|
|
CONTRACEPTIVES |
ZUMANDIMINE |
ETHINYL ESTRADIOL/DROSPIRENONE |
|
|
DIURETICS |
AMILORIDE HCL |
AMILORIDE HCL |
|
|
DIURETICS |
AMILORIDE- HYDROCHLOROTHIAZIDE |
AMILORIDE/HYDROCHLOROTHIAZIDE |
|
|
DIURETICS |
BUMETANIDE |
BUMETANIDE |
|
|
DIURETICS |
CHLORTHALIDONE |
CHLORTHALIDONE |
|
|
DIURETICS |
FUROSEMIDE |
FUROSEMIDE |
|
|
DIURETICS |
HYDROCHLOROTHIAZIDE |
HYDROCHLOROTHIAZIDE |
|
|
DIURETICS |
INDAPAMIDE |
INDAPAMIDE |
|
|
DIURETICS |
METOLAZONE |
METOLAZONE |
|
|
DIURETICS |
SPIRONOLACTONE |
SPIRONOLACTONE |
|
|
DIURETICS |
SPIRONOLACTONE-HCTZ |
SPIRONOLACT/HYDROCHLOROTHIAZID |
|
|
DIURETICS |
TORSEMIDE |
TORSEMIDE |
|
|
DIURETICS |
TRIAMTERENE- HYDROCHLOROTHIAZID |
TRIAMTERENE/HYDROCHLOROTHIAZID |
|
|
ENDOCRINE & METABOLIC AGENTS - MISC. |
ALENDRONATE SODIUM |
ALENDRONATE SODIUM |
|
|
ENDOCRINE & METABOLIC AGENTS - MISC. |
CALCITONIN-SALMON |
CALCITONIN,SALMON,SYNTHETIC |
|
|
ENDOCRINE & METABOLIC AGENTS - MISC. |
EVENITY |
ROMOSOZUMAB-AQQG |
|
|
ENDOCRINE & METABOLIC AGENTS - MISC. |
EVENITY (2 SYRINGES) |
ROMOSOZUMAB-AQQG |
|
|
ENDOCRINE & METABOLIC AGENTS - MISC. |
FORTEO |
TERIPARATIDE |
|
|
ENDOCRINE & METABOLIC AGENTS - MISC. |
FOSAMAX PLUS D |
ALENDRONATE SODIUM/VITAMIN D3 |
|
|
ENDOCRINE & METABOLIC AGENTS - MISC. |
IBANDRONATE SODIUM |
IBANDRONATE SODIUM |
|
|
ENDOCRINE & METABOLIC AGENTS - MISC. |
PROLIA |
DENOSUMAB |
|
|
ENDOCRINE & METABOLIC AGENTS - MISC. |
RALOXIFENE HCL |
RALOXIFENE HCL |
Age ≥35 |
|
ENDOCRINE & METABOLIC AGENTS - MISC. |
RISEDRONATE SODIUM |
RISEDRONATE SODIUM |
|
|
ENDOCRINE & METABOLIC AGENTS - MISC. |
TYMLOS |
ABALOPARATIDE |
|
|
ENDOCRINE & METABOLIC AGENTS - MISC. |
ZOLEDRONIC ACID |
ZOLEDRONIC ACID/MANNITOL-WATER |
|
|
ESTROGENS |
DUAVEE |
ESTROGENS,CONJ/BAZEDOXIFENE |
|
|
HEMATOLOGICAL AGENTS - MISC. |
ASPIRIN-DIPYRIDAMOLE ER |
ASPIRIN/DIPYRIDAMOLE |
|
|
HEMATOLOGICAL AGENTS - MISC. |
BRILINTA |
TICAGRELOR |
|
|
HEMATOLOGICAL AGENTS - MISC. |
CILOSTAZOL |
CILOSTAZOL |
|
|
HEMATOLOGICAL AGENTS - MISC. |
CLOPIDOGREL |
CLOPIDOGREL BISULFATE |
|
|
HEMATOLOGICAL AGENTS - MISC. |
PRASUGREL HCL |
PRASUGREL HCL |
|
|
HEMATOPOIETIC AGENTS |
ADAKVEO |
CRIZANLIZUMAB-TMCA |
|
|
HEMATOPOIETIC AGENTS |
ENDARI |
GLUTAMINE |
|
|
HEMATOPOIETIC AGENTS |
FOLIC ACID |
FOLIC ACID |
|
|
MEDICAL DEVICES & SUPPLIES |
CONDOMS |
CONDOMS |
Quantity limit |
|
MEDICAL DEVICES & SUPPLIES |
DIAPHRAGMS |
DIAPHRAGMS |
|
|
MEDICAL DEVICES & SUPPLIES |
FC2 FEMALE CONDOM |
CONDOMS, FEMALE |
|
|
MEDICAL DEVICES & SUPPLIES |
FEMCAP |
CERVICAL CAP |
|
|
MEDICAL DEVICES & SUPPLIES |
OMNIPOD 5 G6 INTRO KIT (GEN 5) |
INSULIN PUMP CART,AUTO,BT/CNTR |
|
|
MEDICAL DEVICES & SUPPLIES |
OMNIPOD 5 G6 PODS (GEN 5) |
INSULIN PUMP CART,AUTOMATED,BT |
|
|
MEDICAL DEVICES & SUPPLIES |
OMNIPOD CLASSIC PODS (GEN 3) |
INSULIN PUMP CART,CONT INF,RF |
|
|
MEDICAL DEVICES & SUPPLIES |
OMNIPOD DASH INTRO KIT (GEN 4) |
INSULIN PUMP CART,CONT BT/CNTR |
|
|
MEDICAL DEVICES & SUPPLIES |
OMNIPOD DASH PDM KIT (GEN 4) |
INSULIN PUMP CONTROLLER |
|
|
MEDICAL DEVICES & SUPPLIES |
OMNIPOD DASH PODS (GEN 4) |
INSULIN PUMP CART,CONT INF,BT |
|
|
MINERALS & ELECTROLYTES |
FLUORIDE |
FLUORIDE (SODIUM) |
Age 6 months to 6 years |
|
MINERALS & ELECTROLYTES |
SODIUM FLUORIDE |
FLUORIDE (SODIUM) |
Age 6 months to 6 years |
|
MISCELLANEOUS THERAPEUTIC CLASSES |
ATGAM |
LYMPHOCYTE IG,ANTITHYMOCYT,EQU |
|
|
MISCELLANEOUS THERAPEUTIC CLASSES |
AZASAN |
AZATHIOPRINE |
|
|
MISCELLANEOUS THERAPEUTIC CLASSES |
AZATHIOPRINE |
AZATHIOPRINE |
|
|
MISCELLANEOUS THERAPEUTIC CLASSES |
CYCLOSPORINE |
CYCLOSPORINE |
|
|
MISCELLANEOUS THERAPEUTIC CLASSES |
CYCLOSPORINE MODIFIED |
CYCLOSPORINE, MODIFIED |
|
|
MISCELLANEOUS THERAPEUTIC CLASSES |
ENSPRYNG |
SATRALIZUMAB-MWGE |
|
|
MISCELLANEOUS THERAPEUTIC CLASSES |
EVEROLIMUS |
EVEROLIMUS |
|
|
MISCELLANEOUS THERAPEUTIC CLASSES |
GAMIFANT |
EMAPALUMAB-LZSG |
|
|
MISCELLANEOUS THERAPEUTIC CLASSES |
GENGRAF |
CYCLOSPORINE, MODIFIED |
|
|
MISCELLANEOUS THERAPEUTIC CLASSES |
IMURAN |
AZATHIOPRINE |
|
|
MISCELLANEOUS THERAPEUTIC CLASSES |
LUPKYNIS |
VOCLOSPORIN |
|
|
MISCELLANEOUS THERAPEUTIC CLASSES |
MYCOPHENOLATE MOFETIL |
MYCOPHENOLATE MOFETIL |
|
|
MISCELLANEOUS THERAPEUTIC CLASSES |
MYCOPHENOLIC ACID |
MYCOPHENOLATE SODIUM |
|
|
MISCELLANEOUS THERAPEUTIC CLASSES |
NEORAL |
CYCLOSPORINE, MODIFIED |
|
|
MISCELLANEOUS THERAPEUTIC CLASSES |
NULOJIX |
BELATACEPT |
|
|
MISCELLANEOUS THERAPEUTIC CLASSES |
PROGRAF |
TACROLIMUS |
|
|
MISCELLANEOUS THERAPEUTIC CLASSES |
RAPAMUNE |
SIROLIMUS |
|
|
MISCELLANEOUS THERAPEUTIC CLASSES |
SANDIMMUNE |
CYCLOSPORINE |
|
|
MISCELLANEOUS THERAPEUTIC CLASSES |
SIMULECT |
BASILIXIMAB |
|
|
MISCELLANEOUS THERAPEUTIC CLASSES |
SIROLIMUS |
SIROLIMUS |
|
|
MISCELLANEOUS THERAPEUTIC CLASSES |
TACROLIMUS |
TACROLIMUS |
|
|
MISCELLANEOUS THERAPEUTIC CLASSES |
THYMOGLOBULIN |
ANTI-THYMOCYTE GLOBULIN,RABBIT |
|
|
PSYCHOTHERAPEUTIC & NEUROLOGICAL AGENTS - MISC. |
NICOTINE GUM |
NICOTINE POLACRILEX |
Age ≥ 18 years, Quantity limit |
|
PSYCHOTHERAPEUTIC & NEUROLOGICAL AGENTS - MISC. |
NICOTINE LOZENGE |
NICOTINE POLACRILEX |
Age ≥ 18 years, Quantity limit |
|
PSYCHOTHERAPEUTIC & NEUROLOGICAL AGENTS - MISC. |
NICOTINE PATCH |
NICOTINE |
Age ≥ 18 years, Quantity limit |
|
PSYCHOTHERAPEUTIC & NEUROLOGICAL AGENTS - MISC. |
NICOTROL |
NICOTINE |
Age ≥ 18 years, Quantity limit, Step Therapy: trial of nicotine transdermal patch |
|
PSYCHOTHERAPEUTIC & NEUROLOGICAL AGENTS - MISC. |
NICOTROL NS |
NICOTINE |
Age ≥ 18 years, Quantity limit, Step Therapy: trial of |
|
|
|
|
nicotine transdermal patch |
|
PSYCHOTHERAPEUTIC & NEUROLOGICAL AGENTS - MISC. |
QUIT 2 |
NICOTINE POLACRILEX |
Age ≥ 18 years, Quantity limit |
|
PSYCHOTHERAPEUTIC & NEUROLOGICAL AGENTS - MISC. |
QUIT 4 |
NICOTINE POLACRILEX |
Age ≥ 18 years, Quantity limit |
|
PSYCHOTHERAPEUTIC & NEUROLOGICAL AGENTS - MISC. |
STOP SMOKING AID |
NICOTINE POLACRILEX |
Age ≥ 18 years, Quantity limit |
|
PSYCHOTHERAPEUTIC & NEUROLOGICAL AGENTS - MISC. |
VARENICLINE TARTRATE |
VARENICLINE TARTRATE |
Age ≥ 18 years, Quantity limit |
|
TOXOIDS |
ADACEL TDAP |
DIPH,PERTUSS(ACELL),TET VAC/PF |
|
|
TOXOIDS |
BOOSTRIX TDAP |
DIPHTH,PERTUSS(ACELL),TET VAC |
|
|
TOXOIDS |
TDVAX |
TETANUS, DIPHTHERIA TOX,ADULT |
|
|
TOXOIDS |
TENIVAC |
TETANUS-DIPHTHERIA TOXOIDS/PF |
|
|
ULCER DRUGS/ANTISPASMODICS/ ANTICHOLINERGICS |
CIMETIDINE |
CIMETIDINE |
|
|
ULCER DRUGS/ANTISPASMODICS/ ANTICHOLINERGICS |
DEXLANSOPRAZOLE DR |
DEXLANSOPRAZOLE |
|
|
ULCER DRUGS/ANTISPASMODICS/ ANTICHOLINERGICS |
ESOMEPRAZOLE MAGNESIUM |
ESOMEPRAZOLE MAGNESIUM |
|
|
ULCER DRUGS/ANTISPASMODICS/ ANTICHOLINERGICS |
FAMOTIDINE |
FAMOTIDINE |
|
|
ULCER DRUGS/ANTISPASMODICS/ ANTICHOLINERGICS |
LANSOPRAZOLE |
LANSOPRAZOLE |
|
|
ULCER DRUGS/ANTISPASMODICS/ ANTICHOLINERGICS |
NEXIUM |
ESOMEPRAZOLE MAGNESIUM |
|
|
ULCER DRUGS/ANTISPASMODICS/A NTICHOLINERGICS |
NIZATIDINE |
NIZATIDINE |
|
|
ULCER DRUGS/ANTISPASMODICS/ ANTICHOLINERGICS |
OMEPRAZOLE |
OMEPRAZOLE |
|
|
ULCER DRUGS/ANTISPASMODICS/ ANTICHOLINERGICS |
PANTOPRAZOLE SODIUM |
PANTOPRAZOLE SODIUM |
|
|
ULCER DRUGS/ANTISPASMODICS/ ANTICHOLINERGICS |
RABEPRAZOLE SODIUM |
RABEPRAZOLE SODIUM |
|
|
ULCER DRUGS/ANTISPASMODICS/ ANTICHOLINERGICS |
SUCRALFATE |
SUCRALFATE |
|
|
VACCINES |
AFLURIA QUAD 2023-2024 |
FLU VACC QS 2023-24 (6 MOS UP) |
Quantity limit of 1 dose per 180 days |
|
VACCINES |
AFLURIA QUAD 2023-24 (3YR UP) |
FLU VACC QS2023-24 36MOS UP/PF |
Quantity limit of 1 dose per 180 days |
|
VACCINES |
BEXSERO |
MENINGOCOCCAL B VACCINE,4-COMP |
Age 10-25 years, Quantity limit of 2 doses per 365 days |
|
VACCINES |
ENGERIX-B ADULT |
HEPATITIS B VIRUS VACCINE/PF |
Age ≥18 years, Quantity limit of 4 doses per 365 days |
|
VACCINES |
FLUAD QUAD 2023-2024 |
FLU VACC QS2023(65UP)/MF59C/PF |
Age ≥ 65 years, Quantity limit of 1 dose per 180 days |
|
VACCINES |
FLUARIX QUAD 2023-2024 |
FLU VACC QS2023-24(6MOS UP)/PF |
Quantity limit of 1 dose per 180 days |
|
VACCINES |
FLUBLOK QUAD 2023-2024 |
FLU VAC QV 2023(18YR UP)RCM/PF |
Age ≥ 18 years, Quantity limit of 1 dose per 180 days |
|
VACCINES |
FLUCELVAX QUAD 2023-2024 |
FLU VAC QS 23-24 (6MS UP) CELL |
Quantity limit of 1 dose per 180 days |
|
VACCINES |
FLULAVAL QUAD 2023-2024 |
FLU VACC QS2023-24(6MOS UP)/PF |
Quantity limit of 1 dose per 180 days |
|
VACCINES |
FLUMIST QUAD 2023-2024 |
FLU VACC QV LIVE 2023(2-49YRS) |
Quantity limit of 1 dose per 180 days |
|
VACCINES |
FLUZONE HIGH-DOSE QUAD 2023- 24 |
FLU VACC QS2023-24(65YR UP)/PF |
Age ≥ 65 years, Quantity limit of 1 dose per 180 days |
|
VACCINES |
FLUZONE QUAD 2023-2024 |
FLU VACC QS 2023-24 (6 MOS UP) |
Quantity limit of 1 dose per 180 days |
|
VACCINES |
GARDASIL 9 |
HPV VACCINE 9-VALENT/PF |
Age 9-26 years, Quantity limit of 3 doses per 365 days |
|
VACCINES |
HAVRIX |
HEPATITIS A VIRUS VACCINE/PF |
Age ≥18 years, Quantity limit of 2 doses per 365 days |
|
VACCINES |
HEPLISAV-B |
HEPATITIS B VACCINE/CPG1018/PF |
Age ≥18 years, Quantity limit of 2 doses per 365 days |
|
VACCINES |
MENACTRA |
MENING VAC A,C,Y,W-135 DIP/PF |
Age 11-23 years, Quantity limit of 1 dose per 365 days |
|
VACCINES |
MENQUADFI |
MENING VAC A,C,Y,W135,C-TET/PF |
Age 11-23 years, Quantity limit of 1 dose per 365 days |
|
VACCINES |
MENVEO A-C-Y-W-135-DIP |
MENING VAC A,C,Y,W-135 DIP/PF |
Age 11-23 years, Quantity limit of 1 dose per 365 days |
|
VACCINES |
M-M-R II VACCINE |
MEASLES,MUMPS,RUBELLA VACC/PF |
Age ≥18 years, Quantity limit of 2 doses per 365 days |
|
VACCINES |
PNEUMOVAX 23 |
PNEUMOCOCCAL 23-VAL P-SAC VAC |
Age ≥65 years, Quantity limit of 1 dose per 365 days |
|
VACCINES |
PREHEVBRIO |
HEPATITIS B VIRUS VAC S,M,L/PF |
Age ≥18 years, Quantity limit of 3 doses per 365 days |
|
VACCINES |
PREVNAR 20 |
PNEUMOC 20-VAL CONJ-DIP CRM/PF |
Age ≥65 years, Quantity limit of 1 dose per 365 days |
|
VACCINES |
RECOMBIVAX HB |
HEPATITIS B VIRUS VACCINE/PF |
Age ≥18 years, Quantity limit of 3 doses per 365 days |
|
VACCINES |
SHINGRIX |
VARICELLA-ZOSTER GE/AS01B/PF |
Age ≥ 50 years, Quantity limit of 2 doses per 365 days |
|
VACCINES |
TRUMENBA |
N.MENINGITIDIS B,LIPID FHBP RC |
Age 10-25 years, Quantity limit of 3 doses per 365 days |
|
VACCINES |
TWINRIX |
HEPATITIS A AND B VACCINE/PF |
Age ≥18 years, Quantity limit of 4 doses per 365 days |
|
VACCINES |
VAQTA |
HEPATITIS A VIRUS VACCINE/PF |
Age ≥18 years, Quantity limit of 2 doses per 365 days |
|
VACCINES |
VARIVAX VACCINE |
VARICELLA VACCINE LIVE/PF |
Age ≥ 18 years, Quantity limit of 2 doses per 365 days |
|
VACCINES |
VAXNEUVANCE |
PNEUMOC 15-VAL CONJ-DIP CRM/PF |
Age ≥65 years, Quantity limit of 1 dose per 365 days |
|
VAGINAL PRODUCTS |
TODAY CONTRACEPTIVE SPONGE |
NONOXYNOL 9 |
|
|
VAGINAL PRODUCTS |
VCF |
NONOXYNOL 9 |
|
|
VASOPRESSORS |
EPINEPHRINE 0.15 MG AUTO-INJCT |
EPINEPHRINE |
|
|
VASOPRESSORS |
EPINEPHRINE 0.3 MG AUTO-INJECT |
EPINEPHRINE |
|
|
VASOPRESSORS |
SYMJEPI |
EPINEPHRINE |
|
|
VITAMINS |
VITAMIN D2 |
ERGOCALCIFEROL (VITAMIN D2) |
|
Last updated: 08/23/23