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PRESCRIPTION DRUG BENEFITS |
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TEKAMLO 150 MG-5 MG TABLET, TEKAMLO 150 MG-10 MG TABLET, TEKTURNA 150 MG TABLET, TEKTURNA HCT 150-12.5 MG TAB, TEKTURNA HCT 150-25 MG TABLET |
143 KB |
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AMTURNIDE 300-5-25 MG TAB, TEKTURNA 300 MG TABLET, TEKTURNA HCT 300-12.5 MG TAB, TEKTURNA HCT 300-25 MG TABLET |
143 KB |
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zafirlukast (ACCOLATE) |
59 KB |
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ABSORICA |
126 KB |
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tocilizumab (ACTEMRA) |
141 KB |
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pioglitazone (ACTOS), pioglitazone/metformin (ACTOPLUS MET), pioglitazone/glimepiride (DUETACT) |
148 KB |
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CERDELGA, CEREZYME, ELELYSO, miglustat (ZAVESCA), VPRIV |
20 KB |
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imiquimod 5% cream (ALDARA) |
45 KB |
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donepezil (ARICEPT), galantamine (RAZADYNE ER), titration pack (NAMENDA), memantine extended-release (NAMENDA XR), NAMZARIC, NAMZARIC PACK, rivastigmine (EXELON) |
213 KB |
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lubiprostone (AMITIZA) |
140 KB |
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amlodipine/olmesartan (AZOR), amlodipine/valsartan/hydrochlorothiazide (EXFORGE), LOTREL, olmesartan medoxomil/amlodipine/hydrochlorothiazide (TRIBENZOR), telmisartan/amlodipine, trandolapril/verapamil (TARKA) |
126 KB |
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AVALIDE, AVAPRO, benazepril/hydrochlorothiazide, candesartan/hydrochlorothiazide, candesartan (ATACAND), captopril/hydrochlorothiazide, captopril, COZAAR, EDARBI, edarbyclor, EPANED, fosinopril/hydrochlorothiazide, HYZAAR, moexipril, olmesartan/hydrochlorothiazide, olmesartan (BENICAR), perindopril, PRINIVIL, QBRELIS, quinapril (ACCUPRIL), quinapril/hydrochlorothiazide (ACCURETIC), telmisartan/hydrochlorothiazide, telmisartan (MICARDIS), trandolapril, valsartan/hydrochlorothiazide, valsartan (DIOVAN), VASERETIC, VASOTEC, ZESTORETIC |
54 KB |
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COUMADIN, fondaparinux (ARIXTRA), FRAGMIN, LOVENOX, SAVAYSA |
126 KB |
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bupropion (APLENZIN, FORFIVO XL, WELLBUTRIN), desvenlafaxine (PRISTIQ), EMSAM, FETZIMA, MARPLAN, NARDIL, nefazodone, REMERON, tranylcypromine, TRINTELLIX, venlafaxine (EFFEXOR XR), VIIBRYD |
127 KB |
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CELEXA, escitalopram (LEXAPRO), fluoxetine (PROZAC), fluvoxamine, paroxetine (PAXIL), ZOLOFT |
127 KB |
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amoxapine, clomipramine (ANAFRANIL), desipramine, imipramine pamoate (TOFRANIL), maprotiline, nortriptyline (PAMELOR), protriptyline, trimipramine |
127 KB |
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dronabinol (MARINOL), EMEND SUSPENSION, metoclopramide (REGLAN), prochlorperazine (COMPRO), scopolamine, TRANSDERM-SC, trimethobenzamide, ZUPLENZ |
130 KB |
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AKYNZEO, ANZEMET, aprepitant (EMEND), GRANISETRON, SANCUSO |
60 KB |
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CRESEMBA, DIFLUCAN, flucytosine (ANCOBON), griseofulvin, itraconazole (SPORANOX, TOLSURA), ORAVIG, posaconazole (NOXAFIL), voriconazole (VFEND) |
126 KB |
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24-Hour Allergy, Allergy D, Allergy Relief, Allergy Relief-D, antihistamine, cetirizine/pseudoephedrine, cetirizine, desloratadine (CLARINEX), fexofenadine/pseudoephedrine, fexofenadine, levocetirizine, loratadine-D, SEMPREX-D |
126 KB |
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CATAPRES tab, clonidine patch, methyldopa/hydrochlorothiazide |
126 KB |
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colchicine cap/tab (COLCRYS, MITIGARE), febuxostat (ULORIC), GLOPERBA, ZYLOPRIM |
126 KB |
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CAMBIA, dihydroergotamine (D.H.E. 45, MIGRANAL), REYVOW |
21 KB |
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almotriptan, naratriptan (AMERGE), eletriptan (RELPAX), frovatriptan (FROVA), sumatriptan (IMITREX, ONZETRA, ZEMBRACE), MAXALT, sumatriptan/naproxen (TREXIMET), zolmitriptan tab/ODT (ZOMIG**) |
126 KB |
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EURAX, LINDANE shampoo, malathion lotion (OVIDE), SKLICE lotion, VANALICE gel |
126 KB |
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carbidopa/levodopa tab (SINEMET), bromocriptine, carbidopa tab (LODOSYN), entacapone (COMTAN), DUOPA susp, GOCOVRI, pramipexole ER (MIRAPEX ER), NEUPRO, OSMOLEX ER, rasagiline (AZILECT), ropinirole ER (REQUIP XL 6mg and 12mg), RYTARY, selegiline, STALEVO, tolcapone (TASMAR), ZELAPAR |
212 KB |
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ABILIFY, ABILIFY DISCMELT, ABILIFY MAINTENA, ABILIFY MYCITE, AMITRIPTYLINE/PERPHENAZINE, ARIPIPRAZOLE, ARISTADA, CAPLYTA,
CHLORPROMAZINE, CLOZAPINE, CLOZARIL, FANAPT, FAZACLO, FLUPHENAZINE, GEODON, HALOPERIDOL, INVEGA, INVEGA SUSTENNA, INVEGA TRINZA, LATUDA, LOXAPINE, LOXITANE, MOLINDONE, OLANZAPINE, OLANZAPINE/FLUOXETINE, ORAP, PALIPERIDONE, PERPHENAZINE, PERSERIS, PIMOZIDE, QUETIAPINE, REXULTI, RISPERDAL, RISPERDAL CONSTA, RISPERIDONE, SAPHRIS, SECUADO,
SEROQUEL, SEROQUEL XR, SYMBYAX, THIORIDAZINE, THIOTHIXENE, TRIFLUOPERAZINE, VERSACLOZ, VRAYLAR, ZIPRASIDONE, ZIPRASIDONE INJECTION, ZYPREXA, ZYPREXA RELPREVV, ZYPREXA ZYDIS |
30 KB |
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rimantadine, SITAVIG, TAMIFLU, VALTREX, XOFLUZA |
126 KB |
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alprazolam (XANAX) |
64 KB |
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chlordiazepoxide, meprobamate, oxazepam |
72 KB |
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clonazepam (KLONOPIN), diazepam |
75 KB |
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clorazepate (TRANXENE) |
74 KB |
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lorazepam |
69 KB |
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darbepoetin alfa (ARANESP) |
26 KB |
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amikacin (ARIKAYCE) |
142 KB |
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clonidine ER |
58 KB |
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amphetamine salts (MYDAYIS), amphetamine/dextroamphetamine salts (ADDERALL XR, DYANAVEL XR, ADZENYS ER, ADZENYS XR-ODT), dexmethylphenidate (FOCALIN XR), dextroamphetamine (DEXEDRINE SPANSULE), methylphenidate (ADHANSIA XR, APTENSIO XR, CONCERTA, COTEMPLA XR-ODT, DAYTRANA TD, JORNAY PM, QUILLICHEW ER, QUILLIVANT XR, RITALIN LA) |
189 KB |
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amphetamine/dextroamphetamine salts (ADDERALL), amphetamine sulfate (EVEKEO, EVEKEO ODT), dexmethylphenidate (FOCALIN), dextroamphetamine (DEXEDRINE, PROCENTRA, ZENZEDI), methamphetamine (DESOXYN), methylphenidate (METHYLIN, RITALIN) |
196 KB |
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guanfacine SR (INTUNIV), atomoxetine (STRATTERA) |
59 KB |
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deutetrabenazine (AUSTEDO), tetrabenazine (XENAZINE) |
71 KB |
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rosiglitazone (AVANDIA) |
137 KB |
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CARDURA, dutasteride/tamsulosin (JALYN), dutasteride (AVODART), FLOMAX, PROSCAR, silodosin (RAPAFLO) |
124 KB |
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ALBUTEROL AEROSOL HFA, ALBUTEROL TABLETS, ARCAPTA CAPSULES, BROVANA, levalbuterol nebulizer (XOPENEX), metaproterenol syrup, PERFOROMIST, PROAIR RESPICLICK, SEREVENT DISKUS, STRIVERDI RESPIMAT, terbutaline tablets, VENTOLIN HFA |
24 KB |
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betaxolol, BYSTOLIC, carvedilol ER (COREG CR), COREG, metoprolol/hydrochlorothiazide, nadolol, pindolol, propranolol/hydrochlorothiazide, propranolol ER (INDERAL LA, INDERAL XL, INNOPRAN XL), SOTYLIZE, timolol maleate tab, TENORMIN, TENORETIC, TOPROL XL, ZIAC |
126 KB |
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CHENODAL, CHOLBAM, OCALIVA, URSO, URSO FORTE, ursodiol 300mg cap |
126 KB |
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lisdexamfetamine (VYVANSE) |
176 KB |
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darifenacin (ENABLEX), tolterodine (DETROL), tolterodine ER (DETROL LA), DITROPAN XL, flavoxate, GELNIQUE, MYRBETRIQ, OXYTROL, solifenacin, trospium, trospium ER |
126 KB |
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22 KB |
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risedronate (ACTONEL), alendronate soln, ATELVIA, BINOSTO, ibandronate (BONIVA), calcitonin, raloxifene (EVISTA), FORTEO, FOSAMAX, FOSAMAX+D, TYMLOS |
126 KB |
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doxylamine/pyridoxine (BONJESTA, DICLEGIS) |
137 KB |
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buprenorphine/naloxone (BUNAVAIL, SUBOXONE, ZUBSOLV) |
62 KB |
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buprenorphine |
54 KB |
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CALAN SR, CARDIZEM, CARDIZEM CD, CARDIZEM LA, isradipine capsule, KATERZIA, matzim la tablet, nicardipine capule, nifedipine capsule (ADALAT CC), nimodipine, nisoldipine, NORVASC, NYMALIZE, PROCARDIA, PROCARDIA XL, verapamil (VERELAN), VERELAN PM |
126 KB |
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CARISOPRODOL, CARISOPRODOL-ASPIRIN, CARISOPRODOL COMPOUND TAB, SOMA |
143 KB |
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amoxicillin and clavulanate potassium chewable, cefaclor, cefaclor ER, cefadroxil, cefixime (SUPRAX), cefpodoxime tablet, cefpodoxime proxetil oral suspension, cephalexin tablet |
126 KB |
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erenumab (AIMOVIG), fremanezumab (AJOVY), galcanezumab (EMGALITY) |
201 KB |
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certolizumab pegol (CIMZIA) |
141 KB |
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LEUKINE, NEULASTA, ZARXIO, ZIEXTENZO |
126 KB |
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30 KB |
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18 KB |
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18 KB |
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ANORO, DALIRESP, DUAKLIR, INCRUSE, LONHALA, SEEBRI, SPIRIVA Respimat (Handihaler is PDL), TUDORZA, UTIBRON, YUPELRI |
126 KB |
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secukinumab (COSENTYX) |
135 KB |
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ALA-HIST PE TABLET, APRODINE TABLET, BROTAPP LIQUID, CHEST CONGESTION RELIEF PE, CHEST CONGESTION RELIEF TABLET, CHL MUCINEX CHEST CONGEST LIQ, CHLD MUCINEX STUFFY NOSE-COLD, CHLO TUSS LIQUID, COUGH SYRUP 200 MG/10 ML, DECONEX IR TABLET, DIMAPHEN ELIXIR, ED BRON GP LIQUID, ED CHLORPED D PEDIATRIC DROPS, ED-A-HIST PSE TABLET, GUAIFENESIN 100 MG/5 ML SYRUP, HISTEX-PE SYRUP, IOPHEN NR LIQUID, KID'S MUCINEX MINI-MELTS PACK, LODRANE D CAPSULE, LORTUSS LQ LIQUID, MAXIPHEN TABLET, MUCUS RELIEF 400 MG TABLET, MUCUS RELIEF SINUS TABLET, NOSE DROPS, ORGAN-I NR 200 MG TABLET, POLY-HIST PD LIQUID, POLY-VENT IR TABLET, PROMETHAZINE VC SYRUP, Q-TUSSIN 100 MG/5 ML SOLUTION, RESCON-GG LIQUID, RESPAIRE-30 CAPSULE, ROBAFEN 100 MG/5 ML SYRUP, RU-HIST D 10-4 MG TABLET, RYNEX PE LIQUID, RYNEX PSE LIQUID, SILTUSSIN SA 100 MG/5 ML SYR, STAHIST AD LIQUID, STAHIST AD TABLET, TUSSIN 100 MG/5 ML SYRUP |
131 KB |
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ALAHIST, ALA-HIST DM LIQUID, ALLFEN DM TABLET, AP-HIST DM LIQUID, BROMFED DM COUGH SYRUP, BROMPHENIR-PSEUDOEPHED-DM SYR, BROTAPP DM LIQUID, CHILD DELSYM, CHILD MUCINEX, CHILDREN COLD & COUGH DM ELIXI, COUGH DM 30 MG/5 ML SUSPENSION,
DALLERGY, DECONEX DMX TABLET, DELSYM 30 MG/5 ML SUSPENSION, DEXTROMETHORPHAN ER 30 MG/5 ML, DIMAPHEN DM ELIXIR, ED A-HIST, ENDACOF-DM LIQUID, EXTRA ACTION COUGH SYRUP, HISTEX-DM SYRUP, IOPHEN DM-NR LIQUID, KIDKARE COUGH & COLD LIQUID,
LOHIST, LORTUSS DM LIQUID, MAXIPHEN DM TABLET, M-END DMX LIQUID, M-HIST DM LIQUID, MUCINEX, NASAL DECONGESTANT 0.05% SPRAY, NASOPEN PE LIQUID, NINJACOF LIQUID, NOHIST, PEDIATRIC COUGH-COLD LIQUID, PHENYLEPHRINE-PYRILAMINE 10-25, POLY HIST, POLYTUSSIN DM SYRUP, POLY-VENT DM TABLET, PROMETHAZINE-DM SYRUP, Q-TUSSIN DM SYRUP, RESCON-DM LIQUID, ROBAFEN, RYMED TABLET, RYNEX DM LIQUID, SILTUSSIN, SM NASAL SPRAY 0.05%, SM TUSSIN, TUSSIN, VANACOF, VANATAB |
120 KB |
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BENZONATATE |
96 KB |
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DELSYM COUGH + CHEST CONGST DM LQ, GUAIFENESIN ER 1,200 MG TABLET, GUAIFENESIN/PSE ER 600-60 MG, MUCINEX D ER 1,200-120 MG TABLET, MUCINEX D ER 600-60 MG TABLET, MUCINEX DM ER 1,200-60 MG TAB, MUCINEX DM ER 600-30 MG TABLET, MUCINEX ER 1,200 MG TABLET, MUCINEX ER 600 MG TABLET, MUCINEX FAST-MAX CONGEST-COUGH, MUCINEX FAST-MAX DM MAX LIQUID, RESCON TABLET, ROBAFEN COUGH 15 MG LIQUIDGEL, SUDOGEST SINUS & ALLERGY TAB |
252 KB |
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celecoxib (CELEBREX) |
148 KB |
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meloxicam (MOBIC) |
145 KB |
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cyclobenzaprine (FLEXERIL / AMRIX) |
138 KB |
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desmopressin injectable (DDAVP) |
21 KB |
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desmopressin oral (DDAVP) |
87 KB |
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19 KB |
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stiripentol (DIACOMIT) |
49 KB |
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diclofenac 1.5% topical solution, diclofenac 2% topical solution (PENNSAID 2% PUMP) |
57 KB |
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diclofenac 3% gel (SOLARAZE 3% GEL) |
53 KB |
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alogliptin 6.25 mg (NESINA 6.25 MG), JANUVIA 25 MG, ONGLYZA 2.5 MG, TRADJENTA 5 MG |
136 KB |
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alogliptin 12.5 mg (NESINA 12.5 MG), JANUVIA 50 MG |
135 KB |
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alogliptin 25 mg (NESINA 25 MG), JANUVIA 100 MG, ONGLYZA 5 MG |
139 KB |
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alogliptin-metformin (KAZANO), alogliptin-pioglitazone (OSENI), GLYXAMBI, JANUMET (XR), JENTADUETO (XR), KOMBIGLYZE XR, QTERN, STEGLUJAN |
137 KB |
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ramipril (ALTACE), valsartan (DIOVAN) |
58 KB |
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dupilumab (DUPIXENT) |
76 KB |
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dupilumab (DUPIXENT) |
30 KB |
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pimecrolimus (ELIDEL), tacrolimus (PROTOPIC 0.03%) |
70 KB |
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deflazacort (EMFLAZA) |
153 KB |
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deflazacort (EMFLAZA) |
134 KB |
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etanercept (ENBREL) |
138 KB |
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ALDURAZYME, ADAGEN, CEPROTIN, ELAPRASE, FABRAZYME, LUMIZYME, NAGLAZYME, NITYR, ORFADIN, REVCOVI, VIMIZIM |
60 KB |
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ALDURAZYME, ADAGEN, CEPROTIN, ELAPRASE, FABRAZYME, LUMIZYME, NAGLAZYME, NITYR, ORFADIN, REVCOVI, VIMIZIM |
60 KB |
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cannabidiol (EPIDIOLEX) |
49 KB |
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EPIPEN, EPIPEN-JR, SYMJEPI |
126 KB |
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epoetin alfa (EPOGEN) |
28 KB |
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crisaborole (EUCRISA) |
21 KB |
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39 KB |
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benralizumab (FASENRA) |
135 KB |
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carbinoxamine (KARBINAL ER, RYVENT), clemastine, cyproheptadine, ED CHLORPED, PEDIACLEAR, triprolidine (M-HIST PD), VANACLEAR, VANAMINE, VISTARIL |
126 KB |
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BAXDELA, CIPRO, levofloxacin soln, moxifloxacin tab |
126 KB |
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gabapentin (NEURONTIN) |
146 KB |
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DIFICID, metronidazole (FLAGYL), paromomycin, vancomycin (VANCOCIN HCL) |
21 KB |
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ADLYXIN, BYDUREON, BYDUREON BCISE, BYETTA, OZEMPIC, RYBELSUS, SOLIQUA, TRULICITY, VICTOZA, XULTOPHY |
156 KB |
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GVOKE, GLUCAGON EMR SOL |
126 KB |
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gabapentin extended release (GRALISE) |
135 KB |
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somatropin (SEROSTIM) |
143 KB |
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somatropin (ZORBITIVE) |
137 KB |
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GENOTROPIN, NORDITROPIN |
271 KB |
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GENOTROPIN, NORDITROPIN |
279 KB |
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GENOTROPIN, NORDITROPIN |
271 KB |
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HUMATROPE, NUTROPIN AQ, OMNITROPE, SAIZEN |
272 KB |
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HELIDAC, lansoprazole/amoxicillin/clarithromycin, omeprazole/clarithromycin/amoxicillin (listed as "omeclamox") |
21 KB |
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PEGASYS, RIBAPAK |
22 KB |
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sofosbuvir/velpatasvir (EPCLUSA), daclatasvir (DAKLINZA), ledipasvir/sofosbuvir (HARVONI), glecaprevir/pibrentasvir (MAVYRET), simeprevir (OLYSIO), sofosbuvir (SOVALDI), ombitasvir/paritaprevir/ritonavir (TECHNIVIE), ombitasvir/paritaprevir/ritonavir and dasabuvir (VIEKIRA PAK), ombitasvir/paritaprevir/ritonavir and dasabuvir (VIEKIRA XR), sofosbuvir/velpatasvir/voxilaprevir (VOSEVI), elbasvir/grazoprevir (ZEPATIER) |
97 KB |
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sofosbuvir/velpatasvir (EPCLUSA), daclatasvir (DAKLINZA), ledipasvir/sofosbuvir (HARVONI), glecaprevir/pibrentasvir (MAVYRET), simeprevir (OLYSIO), sofosbuvir (SOVALDI), ombitasvir/paritaprevir/ritonavir (TECHNIVIE), ombitasvir/paritaprevir/ritonavir and dasabuvir (VIEKIRA PAK), ombitasvir/paritaprevir/ritonavir and dasabuvir (VIEKIRA XR), sofosbuvir/velpatasvir/voxilaprevir (VOSEVI), elbasvir/grazoprevir (ZEPATIER) |
61 KB |
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BERINERT, CINRYZE, FIRAZYR, HAEGARDA, KALBITOR, RUCONEST, TAKHZYRO |
144 KB |
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gabapentin enacarbil (HORIZANT) |
138 KB |
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corticotropin (HP ACTHAR) |
66 KB |
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adalimumab (HUMIRA) |
162 KB |
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AFREZZA, APIDRA, BASAGLAR, FIASP, insulin lispro (HUMALOG, ADMELOG), NOVOLIN, NOVOLIN N, NOVOLIN R, TOUJEO, TRESIBA |
126 KB |
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repaglinide/metformin, STARLIX |
126 KB |
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FORTAMET, glipizide/metformin, GLUCOPHAGE, GLUCOPHAGE XR, GLUMETZA, RIOMET soln, metformin soln, metformin ER 1000mg tab |
126 KB |
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canakinumab (ILARIS) |
154 KB |
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tildrakizumab (ILUMYA) |
134 KB |
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BIVIGAM, CUVITRU, FLEBOGAMMA, HYQVIA, OCTAGAM, PRIVIGEN, XEMBIFY |
126 KB |
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ASTAGRAF XL, cyclosporine (SANDIMMUNE), ENVARSUS XR, everolimus (ZORTRESS), mycophenolic (MYFORTIC, CELLCEPT), NEORAL, sirolimus (RAPAMUNE) |
126 KB |
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mecasermin (INCRELEX) |
60 KB |
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valbenazine (INGREZZA) |
62 KB |
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BETHKIS, CAYSTON, KITABIS, tobramycin (TOBI, TOBI PODHALER) |
140 KB |
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ALVESCO, ARNUITY, ASMANEX HFA (Twisthaler is PDL), BREO, budesonide/formoterol, budesonide susp, FLOVENT Diskus (HFA is PDL), PULMICORT, QVAR, TRELEGY, fluticasone/salmeterol (WIXELA) |
126 KB |
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allergy relief spray, azelastine-fluticasone (DYMISTA), azelastine, BECONASE AQ, budesonide, flunisolide, ipratropium, fluticasone, mometasone (NASONEX), nasal allergy spray, olopatadine (PATANASE), OMNARIS, QNASL CHILD, QNASL, triamcinolone acetonide, XHANCE |
126 KB |
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CITRANATAL, CORVITE 150, CORVITE FE, EZFE 200, ferrous sulfate (FEOSOL, FER-IN-SOL, SLOW FE), ferrous gluconate (FERATE, FERGON), FERIVA, FERIVAFA, FERRAPLUS 90, FERREX 150, ferrous fumarate (FERRIMIN 150, HEMOCYTE), FOLITAB 500, FUSION PLUS, GNP IRON, ICAR PEDS, ICAR-C, INTEGRA, Iron 100/C, polysaccharide iron complex (FEOSOL bifera, POLY-IRON, NU-IRON 150), IROSPAN, TARON FORTE, WEE CARE |
135 KB |
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ivacaftor (KALYDECO) |
155 KB |
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ketorolac (TORADOL equiv) injection, ketorolac nasal spray |
160 KB |
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oral ketorolac (TORADOL equiv) |
76 KB |
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dichlorphenamide (KEVEYIS) |
50 KB |
PDF File
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sarilumab (KEVZARA) |
139 KB |
PDF File
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anakinra (KINERET) |
61 KB |
PDF File
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montelukast granules (SINGULAIR), SINGULAIR chewable 4mg/5mg, SINGULAIR tablets 10mg |
21 KB |
PDF File
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lidocaine (LIDODERM) 5% patch, ZTLIDO 1.8% |
136 KB |
PDF File
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CLEOCIN, LINCOCIN, SIVEXTRO, ZYVOX |
126 KB |
PDF File
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linaclotide (LINZESS) |
125 KB |
PDF File
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colesevelam (WELCHOL), colestipol (COLESTID), ezetimibe, fenofibrate (FENOGLIDE, LIPOFEN, TRICOR, TRILIPIX), fenofibric acid , JUXTAPID, LOPID, niacin extended-release (NIASPAN ER), QUESTRAN |
126 KB |
PDF File
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amlodipine/atorvastatin (CADUET), CRESTOR, ezetimibe/simvastatin (VYTORIN), fluvastatin, fluvastatin ER (LESCOL XL), LIPITOR, LIVALO, PRAVACHOL, ZOCOR, ZYPITAMAG |
126 KB |
PDF File
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alosetron (LOTRONEX) |
136 KB |
PDF File
|
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omega-3-acid ethyl esters (LOVAZA), icosapent ethyl (VASCEPA) |
136 KB |
PDF File
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CLARITHROMYCIN, E.E.S., ERYPED, ERY-TAB, ERYTHROCIN, ERYTHROMYCIN, ERYTHROMYCIN ETHYLSUCCINATE, ZITHROMAX |
23 KB |
PDF File
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hydroxyprogesterone caproate injection (MAKENA) |
45 KB |
PDF File
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hydroxyprogesterone caproate injection (MAKENA) |
47 KB |
PDF File
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prucalopride (MOTEGRITY) |
135 KB |
PDF File
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naloxegol (MOVANTIK) |
132 KB |
PDF File
|
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chlorzoxazone (LORZONE), dantrolene (DANTRIUM), metaxalone (SKELAXIN), orphenadrine extended-release, ROBAXIN-750, tizanidine |
21 KB |
PDF File
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duloxetine (CYMBALTA), pregabalin (LYRICA, LYRICA CR) |
126 KB |
PDF File
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diclofenac sodium/misoprostol (ARTHROTEC), diclofenac potassium, diclofenac 1% gel, diclofenac (FLECTOR), diflunisal, DUEXIS, EC-NAPROXEN, etodolac, etodolac extended-release, fenoprofen (NALFON), flurbiprofen, indomethacin (INDOCIN), ketoprofen, meclofenamic, nabumetone (RELAFEN), naproxen, naproxen/esomeprazole (VIMOVO), oxaprozin (DAYPRO), piroxicam (FELDENE), sulindac, tolmetin |
21 KB |
PDF File
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mepolizumab (NUCALA) |
173 KB |
PDF File
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pimavanserin (NUPLAZID) |
61 KB |
PDF File
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rimegepant (NURTEC) |
135 KB |
PDF File
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armodafinil (NUVIGIL) |
63 KB |
PDF File
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baricitinib (OLUMIANT) |
146 KB |
PDF File
|
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CEQUA, RESTASIS, XIIDRA |
176 KB |
PDF File
|
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ALOCRIL, ALOMIDE, ALREX, azelastine, BEPREVE, epinastine, LASTACAFT, olopatadine 0.1%, 0.2%, (PATANOL, PATADAY) |
126 KB |
PDF File
|
|
ACUVAIL, bromfenac, dexamethason sodium phosphate (MAXIDEX), FLAREX, fluoromethol (FML FORTE, FML), FML LIQUIFLM, ILEVRO, INVELTYS, ketorolac (ACULAR, ACULAR LS), loteprednol (LOTEMAX, LOTEMAX SM), prednisolone sodium acetate (PRED MILD, PRED FORTE) |
126 KB |
PDF File
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|
BLEPHAMIDE, MAXITROL, neomycin-bacitracin-poly-HC, neomycin-bacitracin-polymyxin, PRED-G, TIOBRADEX ST, tobramycin-dexamethasone (TOBRADEX), ZYLET |
212 KB |
PDF File
|
|
AZASITE, bacitracin, BESIVANCE, BLEPH-10, CILOXAN, gatofloxacin, levofloxacin, NATACYN, neomycin-bacitracin-polymyxin (NEO-POLYCIN), neo-poly-gramicidin, OCUFLOX, POLYTRIM, sodium sulfacetamide (SULFACET), TOBREX, moxifloxacin (VIGAMOX) |
126 KB |
PDF File
|
|
apraclonidine, betaxolol (BETOPTIC-S), bimatiprost (LUMIGAN), brimonidine (ALPHAGAN P), dorzolamide-timolol (COSOPT, COSOPT PF) , PHOSPHOLINE, timolol maleate (ISTALOL), TIMOPTIC, TIMOPTIC XE, TRAVOPROST, TRUSOPT, VYZULTA, XALATAN, ZIOPTAN |
126 KB |
PDF File
|
|
CARISOPRODOL ASPIRIN AND CODEINE PHOSPHATE |
168 KB |
PDF File
|
|
codeine-guaifenesin, GUAIATUSSIN, hydrocodone-homatropine (HYDROMET), hydrocodone-chlorpheniramine polistirex, NINJACOF-XG, VIRTUSSIN |
154 KB |
PDF File
|
|
oral transmucosal fentanyl (ACTIQ) |
171 KB |
PDF File
|
|
buccal fentanyl (FENTORA) |
175 KB |
PDF File
|
|
transdermal fentanyl (DURAGESIC) |
168 KB |
PDF File
|
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oxycodone (OXYCONTIN) 60mg & 80mg |
165 KB |
PDF File
|
|
oxycodone (OXYCONTIN) 10mg, 15mg, 20mg, 30mg, 40mg / XTAMPZA |
165 KB |
PDF File
|
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PROMETHAZINE VC-CODEINE SYRUP, PROMETHAZINE-CODEINE SYRUP |
150 KB |
PDF File
|
|
ACETAMINOPHEN/CAFFEINE/DIHYDROCODEINE, ACETAMINOPHEN/CODEINE, ASCOMP WITH CODEINE, BELBUCA, BELLADONNA/OPIUM, BENZHYDROCODONE/ACETAMINOPHEN, BUPRENORPHINE PATCH, BUTALBITAL/CAFFEINE/ACETAMINOPHEN/CODEINE, BUTALBITAL/CAFFEINE/ASPIRIN/CODEINE, BUTORPHANOL, BUTRANS, CODEINE SULFATE, DEMEROL, DILAUDID, ENDOCET, HYDROCODONE/ACETAMINOPHEN, HYDROCODONE/IBUPROFEN, HYDROMORPHONE, HYSINGLA ER, KADIAN, LEVORPHANOL, LORCET, MEPERIDINE, METHADONE, METHADOSE, MORPHABOND, MORPHINE SULFATE, MS CONTIN, NALBUPHINE, NALOCET, NORCO, NUCYNTA (ER), OPIUM TINCTURE, OXYCODONE, OXYCODONE/ACETAMINOPHEN, OXYCODONE/ASPIRIN, OXYCODONE/IBUPROFEN, OXYMORPHONE, PENTAZOCINE/NALOXONE, PERCOCET, ROXICODONE, TRAMADOL/ACETAMINOPHEN, TRAMADOL HYDROCHLORIDE, ULTRACET, ULTRAM |
154 KB |
PDF File
|
|
CORTEF, CORTISONE, dexamethasone, ENTOCORT, methylprednisolone (MEDROL), prednisolone (MILLIPRED), prednisone, TAPERDEX |
126 KB |
PDF File
|
|
valganciclovir soln/tab |
126 KB |
PDF File
|
|
Grass Pollen Allergen Extract (ORALAIR) |
57 KB |
PDF File
|
|
abatacept (ORENCIA) |
139 KB |
PDF File
|
|
elagolix, estradiol and norethindrone (ORIAHNN) |
142 KB |
PDF File
|
|
elagolix (ORILISSA) |
64 KB |
PDF File
|
|
lumacaftor / ivacaftor (ORKAMBI) |
59 KB |
PDF File
|
|
apremilast (OTEZLA) |
58 KB |
PDF File
|
|
hydrocortisone/acetic acid, PINNACAINE |
126 KB |
PDF File
|
|
CIPRO HC, ciprofloxacin/dexamethasone (CIPRODEX), CORTISPORIN, ofloxacin, OTOVEL |
126 KB |
PDF File
|
|
voxelotor (OXBRYTA) |
145 KB |
PDF File
|
|
cenegermin-bkbj (OXERVATE) |
52 KB |
PDF File
|
|
peanut allergen powder (PALFORZIA) |
57 KB |
PDF File
|
|
PANCREAZE, PERTZYE, VIOKACE |
126 KB |
PDF File
|
|
alirocumab (PRALUENT), evolocumab (REPATHA) |
274 KB |
PDF File
|
|
sildenafil (REVATIO), tadalafil (ADCIRCA) |
68 KB |
PDF File
|
|
mulitvitamin with fluoride (FLORIVA, POLY-VI-FLOR, QUFLORA, TRI-VI-FLOR suspension, TRI-VIT/FLUO drops), vitamin A, C, D and fluroide drops |
134 KB |
PDF File
|
|
AURYXIA, calcium acetate (PHOSLYRA), lanthanum (FOSRENOL), VELPHORO |
62 KB |
PDF File
|
|
sevelamer (RENVELA) |
29 KB |
PDF File
|
|
dipyridamole, EFFIENT, PLAVIX, ZONTIVITY |
126 KB |
PDF File
|
|
CITRANATAL, COMPLETENATE, CONCEPT DHA, CONCEPT OB, ELITE-OB, FOLIVANE-OB, NESTABS, NESTABS DHA, OB COMPLETE, PNV-DHA, PNV-OMEGA, PNV-SELECT, PRENAISSANCE, PRENATE, PRENATE AM, PRENATE DHA, PRENATE MINI, PRENATE STAR, SELECT-OB, SE-NATAL 19, TARON-C DHA, THRIVITE 19, THRIVITE RX, TRISTART DHA, VITAFOL, VP-CH-PNV, VP-PNV-DHA, ZATEAN-PN |
126 KB |
PDF File
|
|
epoetin alfa (PROCRIT) |
34 KB |
PDF File
|
|
megestrol ES 625mg/5ml susp |
126 KB |
PDF File
|
|
PHENADOZ, PHENERGAN, PROMETHAZINE, PROMETHAZINE VC SYRUP, PROMETHAZINE-DM SYRUP, PROMETHEGAN |
137 KB |
PDF File
|
|
propylthiouracil |
18 KB |
PDF File
|
|
ACIPHEX/rabeprazole, DEXILANT, esomeprazole, lansoprazole, NEXIUM cap, ZEGERID/omepra/bicar (omeprazole/bicarbonate), omeprazole cap 20.6mg, omeprazole tab, PREVACID cap/solutab, PROTONIX tab. |
126 KB |
PDF File
|
|
tacrolimus (PROTOPIC) 0.1% |
65 KB |
PDF File
|
|
modafinil (PROVIGIL) |
63 KB |
PDF File
|
|
ADEMPAS, bosentan, LETAIRIS, OPSUMIT, ORENITRAM, TRACLEER, TYVASO solution, TYVASO refill solution, TYVASO start solution, UPTRAVI, VENTAVIS solution |
126 KB |
PDF File
|
|
ranolazine (RANEXA) |
93 KB |
PDF File
|
|
methylnaltrexone (RELISTOR) |
135 KB |
PDF File
|
|
epoetin alfa (RETACRIT) |
28 KB |
PDF File
|
|
upadacitinib (RINVOQ) |
147 KB |
PDF File
|
|
milnacipran (SAVELLA) |
141 KB |
PDF File
|
|
doxepin (SILENOR) |
126 KB |
PDF File
|
|
AMBIEN, AMBIEN CR, BELSOMRA, EDLUAR, ESTAZOLAM, ESZOPICLONE, INTERMEZZO, LUNESTA, RESTORIL, SONATA, TEMAZEPAM, TRIAZOLAM, ZALEPLON, ZOLPIDEM, ZOLPIDEM ER |
65 KB |
PDF File
|
|
flurazepam |
64 KB |
PDF File
|
|
ramelteon (ROZEREM), tasimelteon (HETLIOZ) |
64 KB |
PDF File
|
|
INVOKAMET (XR), SEGLUROMET, SYNJARDY (XR), XIGDUO XR |
139 KB |
PDF File
|
|
FARXIGA, INVOKANA, JARDIANCE, STEGLATRO |
138 KB |
PDF File
|
|
ENDARI, SIKLOS |
21 KB |
PDF File
|
|
brodalumab (SILIQ) |
140 KB |
PDF File
|
|
golimumab (SIMPONI) |
147 KB |
PDF File
|
|
risankizumab (SKYRIZI) |
135 KB |
PDF File
|
|
NICOTROL |
126 KB |
PDF File
|
|
ustekinumab (STELARA) |
141 KB |
PDF File
|
|
alclometason, amcinonide, betamethsone dipropionate (DIPROLENE, SERNIVO), betamethasone valerate, BRYHALI, clobetasol (CLOBEX, OLUX, OLUX-E, TEMOVATE), desonide, desoximetas (TOPICORT, TOPICORT LP), diflorasone (APEXICON E), fluocinolone acetate oil, fluocinonide (VANOS), halcinonide (HALOG), hydrocortisone butyrate, hydrocortisone valerate, hydrocortisone (TEXACORT), LEXETTE, mometasone, prednicarbate, triamcinolone acetate (TRIANEX) |
126 KB |
PDF File
|
|
solriamfetol (SUNOSI) |
62 KB |
PDF File
|
|
tezacaftor/ivacaftor and ivacaftor (SYMDEKO) |
77 KB |
PDF File
|
|
pramlintide (SYMLIN) |
132 KB |
PDF File
|
|
naldemedine (SYMPROIC) |
139 KB |
PDF File
|
|
palivizumab (SYNAGIS) |
298 KB |
PDF File
|
|
palivizumab (SYNAGIS) |
284 KB |
PDF File
|
|
palivizumab (SYNAGIS) |
284 KB |
PDF File
|
|
palivizumab (SYNAGIS) |
284 KB |
PDF File
|
|
palivizumab (SYNAGIS) |
284 KB |
PDF File
|
|
palivizumab (SYNAGIS) |
284 KB |
PDF File
|
|
palivizumab (SYNAGIS) |
284 KB |
PDF File
|
|
palivizumab (SYNAGIS) |
283 KB |
PDF File
|
|
palivizumab (SYNAGIS) |
284 KB |
PDF File
|
|
palivizumab (SYNAGIS) |
282 KB |
PDF File
|
|
ixekizumab (TALTZ) |
140 KB |
PDF File
|
|
inotersen (TEGSEDI) |
59 KB |
PDF File
|
|
demeclocycline, doxyclycline hyclate (DORYX MPC), doxycycline monohydrate (ORACEA), doxycycline suspension (VIBRAMYCIN), minocycline (SOLODYN, MINOLIRA), NUZYRA, tetracycline |
126 KB |
PDF File
|
|
DOPTELET, MULPLETA, TAVALISSE |
126 KB |
PDF File
|
|
BENZACLIN GEL, BENZACLIN PUMP GEL, ERYTHROMYCIN-BENZOYL GEL, CLINDAMYCIN-BENZOYL PEROXIDE GEL 1.2-5%, CLINDAMYCIN-BENZOYL PEROXIDE GEL, DUAC 1.2-5% GEL |
26 KB |
PDF File
|
|
AZELEX, CLEOCIN-T, CLINDAMYCIN AEROSOL, CLINDAMYCIN LOTION, dapsone (ACZONE), erythromycin (ERY) pads, EVOCLIN, RETIN-A MICRO GEL, sulfacetamide lotion. |
21 KB |
PDF File
|
|
testosterone (ANDRODERM, ANDROGEL, FORTESTA, TESTIM, VOGELXO) |
126 KB |
PDF File
|
|
bacitracin zinc, gentamicin, mupirocin (CENTANY) |
126 KB |
PDF File
|
|
athletes foot spray, BENSAL HP, ciclopirox (LOPROX), clotrimazole/betamethasone, econazole, FUNGOID TINCTURE, JUBLIA, KERYDIN, ketoconazole (EXTINA), luliconazole, MENTAX, miconazole/petrolatum/zinc oxide, naftifine, nystatin/triamcinolone, oxiconazole (OXISTAT), VUSION |
126 KB |
PDF File
|
|
acyclovir cream, XERESE, ZOVIRAX cream/oint |
126 KB |
PDF File
|
|
ADAPALENE, ADAPALENE-BENZYL PEROXIDE, ALTRENO, ATRALIN, AVITA, CLINDAMYCIN-TRETINOIN, DIFFERIN, EPIDUO, EPIDUO FORTE, FABIOR, TAZAROTENE, TAZORAC, TRETINOIN, ZIANA |
26 KB |
PDF File
|
|
guselkumab (TREMFYA) |
134 KB |
PDF File
|
|
elexcaftor/tezacaftor/ivacaftor (TRIKAFTA) |
70 KB |
PDF File
|
|
plecanatide (TRULANCE) |
135 KB |
PDF File
|
|
treprostinil (TYVASO STARTER KIT) |
16 KB |
PDF File
|
|
ubrogepant (UBRELVY) |
144 KB |
PDF File
|
|
azulfidine, balsalazide (COLAZAL), budesonide ER, CANASA, DIPENTUM, mesalamine 800mg (ASACOL HD), mesalamine 0.375gm (APRISO, PENTASA), mesalamine 1.2 gm (LIALDA), mesalamine ENE 4gm, UCERIS |
126 KB |
PDF File
|
|
CARBAGLU, RAVICTI, sodium phenylbutyrate (BUPHENYL) |
25 KB |
PDF File
|
|
clindamycin (CLEOCIN), SOLOSEC, VANDAZOLE |
126 KB |
PDF File
|
|
eluxadoline (VIBERZI) |
139 KB |
PDF File
|
|
antacids - calcium salts, antacids - magnesium salts, antidotes, b-complex vitamins, b-complex w/ c, b-complex w/ folic acid, b-complex w/ iron, b-complex w/ minerals, bioflavonoid products, calcium, cobalamins, dietary management products, fluoride, folic acid/folates, hematopoietic mixtures, iron, magnesium, mineral combinations, misc. nutritional substances, multiple vitamins w/ calcium, multiple vitamins w/ iron, multiple vitamins w/ minerals, multivitamins, oil soluble vitamins, ped multiple vitamins w/ minerals, ped mv w/ fluoride, ped mv w/ iron, pediatric multiple vitamins, phosphate, saline laxatives, specialty vitamins products, trace minerals, vitamin mixtures, vitamins w/ lipotropics, water soluble vitamins, zinc |
124 KB |
PDF File
|
|
tafamidis (VYNDAMAX) and tafamidis meglumine (VYNDAQEL) |
58 KB |
PDF File
|
|
pitolisant (WAKIX) |
135 KB |
PDF File
|
|
tofacitinib citrate (XELJANZ / XELJANZ XR) |
145 KB |
PDF File
|
|
orlistat (XENICAL) |
44 KB |
PDF File
|
|
rifaximin 200mg (XIFAXAN 200mg) |
135 KB |
PDF File
|
|
rifaximin 550mg (XIFAXAN 550mg) |
139 KB |
PDF File
|
|
sodium oxybate (XYREM) / XYWAV |
131 KB |
PDF File
|
|
vemurafenib (ZELBORAF) |
22 KB |
PDF File
|
|
imiquimod 3.75 % cream (ZYCLARA) |
45 KB |
PDF File
|
|
zileuton (ZYFLO) |
57 KB |