Download - 2020 Cigna STAR+PLUS Quantity Limit Criteria · ambien 10 mg tablet tablet 30 30 ambien 5 mg tablet tablet 30 30 ambien cr 12.5 mg tablet tablet, extended release multiphase 30 30

Drug Name and Strength Dosage Form Quantity Limit Days Supply

ABILIFY 10 MG TABLET TABLET 90 30



ABILIFY MAINTENA ER 300 MG SYR SUSPENSION,EXTENDED RELEASE SYRINGE (EA) 1.07142 30

ABILIFY MAINTENA ER 300 MG VL SUSPENSION,EXTENDED RELEASE VIAL 1.07142 30

ABILIFY MAINTENA ER 400 MG SYR SUSPENSION,EXTENDED RELEASE SYRINGE (EA) 1.07142 30

ABILIFY MAINTENA ER 400 MG VL SUSPENSION,EXTENDED RELEASE VIAL 1.07142 30

ABSTRAL 100 MCG TAB SUBLINGUAL TABLET, SUBLINGUAL 120 30






ACARBOSE 100 MG TABLET TABLET 90 30



ACETAMIN-CODEIN 300-30 MG/12.5 SOLUTION, ORAL 4500 30

ACETAMINOP-CODEIN 240-24 MG/10 SOLUTION, ORAL 4500 30

ACETAMINOP-CODEINE 120-12 MG/5 SOLUTION, ORAL 4500 30

ACETAMINOPHEN-COD #2 TABLET TABLET 360 30



ACTEMRA 162 MG/0.9 ML SYRINGE SYRINGE (ML) 3.9 30

ACTIQ 1,200 MCG LOZENGE LOZENGE ON A HANDLE 120 30

ACTIQ 1,600 MCG LOZENGE LOZENGE ON A HANDLE 120 30

ACTIQ 200 MCG LOZENGE LOZENGE ON A HANDLE 120 30




ACTOPLUS MET 15 MG-500 MG TAB TABLET 90 30

ACTOPLUS MET 15 MG-850 MG TAB TABLET 90 30

ACTOPLUS MET XR 15-1,000 MG TB TABLET,EXTENDED RELEASE MULTIPHASE 24 HR 30 30

ACTOPLUS MET XR 30-1,000 MG TB TABLET,EXTENDED RELEASE MULTIPHASE 24 HR 30 30

ADALAT CC 30 MG TABLET TABLET, EXTENDED RELEASE 30 30

ADDERALL 10 MG TABLET TABLET 90 30

ADDERALL 12.5 MG TABLET TABLET 90 30





ADDERALL 7.5 MG TABLET TABLET 90 30

ADDERALL XR 10 MG CAPSULE CAPSULE, EXT RELEASE 24 HR 30 30






ADMELOG 100 UNIT/ML VIAL VIAL (ML) 90 30

ADMELOG SOLOSTAR 100 UNIT/ML INSULIN PEN (ML) 90 30

ADULT ROBITUSSIN PEAK COLD DM LIQUID (ML) 1800 30

ADULT WAL-TUSSIN DM SYRUP SYRUP 1800 30

AFEDITAB CR 30 MG TABLET TABLET, EXTENDED RELEASE 30 30

AFREZZA 12 UNIT CARTRIDGE CARTRIDGE WITH INHALER 180 30



ALINIA 100 MG/5 ML SUSPENSION SUSPENSION, RECONSTITUTED, ORAL (ML) 1500 30

ALINIA 500 MG TABLET TABLET 60 30

ALKA-SELTZER PLUS DAY CAP CAPSULE 360 30

ALKA-SELTZER PLUS SINUS-COUGH CAPSULE 360 30

ALOGLIPTIN 12.5 MG TABLET TABLET 30 30

ALOGLIPTIN 25 MG TABLET TABLET 30 30

ALOGLIPTIN 6.25 MG TABLET TABLET 30 30

ALOGLIPTIN-METFORMIN 12.5-1000 TABLET 60 30

2020 Cigna STAR+PLUS Quantity Limit Criteria

ALOGLIPTIN-METFORMIN 12.5-500 TABLET 60 30

ALOGLIPTIN-PIOGLIT 12.5-15 MG TABLET 30 30



ALOGLIPTIN-PIOGLIT 25-15 MG TB TABLET 30 30



ALPRAZOLAM 0.25 MG TABLET TABLET 90 30

ALPRAZOLAM 0.5 MG TABLET TABLET 90 30

ALPRAZOLAM 1 MG TABLET TABLET 300 30

ALPRAZOLAM 2 MG TABLET TABLET 150 30

ALPRAZOLAM ER 0.5 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

ALPRAZOLAM ER 1 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30



ALPRAZOLAM INTENSOL 1 MG/ML CONCENTRATE, ORAL 300 30

ALPRAZOLAM ODT 0.25 MG TAB TABLET,DISINTEGRATING 90 30

ALPRAZOLAM ODT 0.5 MG TAB TABLET,DISINTEGRATING 90 30

ALPRAZOLAM ODT 1 MG TAB TABLET,DISINTEGRATING 300 30

ALPRAZOLAM ODT 2 MG TAB TABLET,DISINTEGRATING 150 30

ALPRAZOLAM XR 0.5 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

ALPRAZOLAM XR 1 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30



ALTOPREV 20 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

AMARYL 1 MG TABLET TABLET 120 30



AMBI 20DM-4CPM TABLET TABLET 180 30

AMBI 40PSE-400GFN-20DM TABLET TABLET 180 30

AMBIEN 10 MG TABLET TABLET 30 30

AMBIEN 5 MG TABLET TABLET 30 30

AMBIEN CR 12.5 MG TABLET TABLET, EXTENDED RELEASE MULTIPHASE 30 30

AMBIEN CR 6.25 MG TABLET TABLET, EXTENDED RELEASE MULTIPHASE 30 30

AMITIZA 24 MCG CAPSULES CAPSULE 60 30

AMITIZA 8 MCG CAPSULE CAPSULE 60 30

AMLODIPINE BESYLATE 2.5 MG TAB TABLET 30 30

AMLODIPINE BESYLATE 5 MG TAB TABLET 30 30

AMLODIPINE-ATORVAST 2.5-10 MG TABLET 30 30



AMLODIPINE-ATORVAST 5-10 MG TABLET 30 30



ANECREAM5 5% CREAM CREAM (GRAM) 60 22

AP-HIST DM LIQUID LIQUID (ML) 1200 30

APIDRA 100 UNITS/ML VIAL VIAL (ML) 90 30

APIDRA SOLOSTAR 100 UNITS/ML INSULIN PEN (ML) 90 30

APTENSIO XR 10 MG CAPSULE CAPSULE, ER SPRINKLE, BIPHASIC 40-60 30 30



ARICEPT 5 MG TABLET TABLET 30 30

ARIPIPRAZOLE 1 MG/ML SOLUTION SOLUTION, ORAL 900 30

ARIPIPRAZOLE 10 MG TABLET TABLET 90 30



ARIPIPRAZOLE ODT 10 MG TABLET TABLET,DISINTEGRATING 90 30

ARIPIPRAZOLE ODT 15 MG TABLET TABLET,DISINTEGRATING 60 30

ARMODAFINIL 150 MG TABLET TABLET 30 30



ASA-BUTALB-CAFF-COD #3 CAPSULE CAPSULE 180 30

ASCOMP WITH CODEINE CAPSULE CAPSULE 180 30

ATACAND 16 MG TABLET TABLET 30 30



ATACAND HCT 16-12.5 MG TAB TABLET 30 30

ATIVAN 0.5 MG TABLET TABLET 120 30

ATIVAN 1 MG TABLET TABLET 120 30

ATIVAN 2 MG TABLET TABLET 120 30

ATIVAN 2 MG/ML VIAL VIAL (ML) 120 30

ATIVAN 20 MG/10 ML VIAL VIAL (ML) 120 30

ATIVAN 4 MG/ML VIAL VIAL (ML) 60 30

ATIVAN 40 MG/10 ML VIAL VIAL (ML) 60 30

ATORVASTATIN 10 MG TABLET TABLET 30 30



AVAPRO 150 MG TABLET TABLET 30 30

AVAPRO 75 MG TABLET TABLET 30 30

BASAGLAR 100 UNIT/ML KWIKPEN INSULIN PEN (ML) 90 30

BENICAR 20 MG TABLET TABLET 30 30

BIO T PRES-B LIQUID LIQUID (ML) 900 30

BIOCOTRON LIQUID LIQUID (ML) 1800 30

BPM-DM-PHEN SYRUP LIQUID (ML) 1800 30

BROMFED DM COUGH SYRUP SYRUP 1800 30

BROMPHENIR-PSEUDOEPHED-DM SYR SYRUP 1800 30

BUPRENORPHINE 10 MCG/HR PATCH PATCH, TRANSDERMAL WEEKLY 4 21




BUPRENORPHINE 7.5 MCG/HR PATCH PATCH, TRANSDERMAL WEEKLY 4 21

BUPROPION HCL XL 150 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

BUTALB-ACETAMINOPH-CAFF-CODEIN CAPSULE 180 30

BUTALB-CAFF-ACETAMINOPH-CODEIN CAPSULE 180 30

BUTALBITAL COMP-CODEINE #3 CAP CAPSULE 180 30

BUTALBITAL-ASA-CAFFEINE CAP CAPSULE 180 30

BUTORPHANOL 10 MG/ML SPRAY AEROSOL, SPRAY (ML) 5 22

BUTRANS 10 MCG/HR PATCH PATCH, TRANSDERMAL WEEKLY 4 21




BUTRANS 7.5 MCG/HR PATCH PATCH, TRANSDERMAL WEEKLY 4 21

BYDUREON 2 MG VIAL VIAL (EA) 4 21

BYETTA 10 MCG DOSE PEN INJ PEN INJECTOR (ML) 2.4 22

BYETTA 5 MCG DOSE PEN INJ PEN INJECTOR (ML) 2.4 22

CADUET 2.5 MG-40 MG TABLET TABLET 30 30

CADUET 5 MG-10 MG TABLET TABLET 30 30



CAFFEINE CIT 60 MG/3 ML ORAL SOLUTION, ORAL 30 30

CANDESARTAN CILEXETIL 16 MG TB TABLET 30 30

CANDESARTAN CILEXETIL 4 MG TAB TABLET 30 30

CANDESARTAN CILEXETIL 8 MG TAB TABLET 30 30

CANDESARTAN-HCTZ 16-12.5 MG TB TABLET 30 30

CAPITAL WITH CODEINE SUSP SUSPENSION, ORAL (FINAL DOSE FORM) 4500 30

CAPSAICIN 0.025% CREAM CREAM (GRAM) 120 22

CARDIZEM CD 120 MG CAPSULE CAPSULE, EXT RELEASE 24 HR 30 30

CARDIZEM CD 180 MG CAPSULE CAPSULE, EXT RELEASE 24 HR 30 30

CARDURA 1 MG TABLET TABLET 30 30



CARISOPRODOL 250 MG TABLET TABLET 168 30

CARISOPRODOL 350 MG TABLET TABLET 140 30

CARISOPRODOL-ASPIRIN-CODEIN TB TABLET 240 30

CARTIA XT 120 MG CAPSULE CAPSULE, EXT RELEASE 24 HR 30 30

CARTIA XT 180 MG CAPSULE CAPSULE, EXT RELEASE 24 HR 30 30

CARVEDILOL ER 10 MG CAPSULE CAPSULE,EXTENDED RELEASE MULTIPHASE 24HR 30 30



CELEXA 10 MG TABLET TABLET 90 30

CELEXA 20 MG TABLET TABLET 60 30

CETIRIZINE HCL 5 MG TABLET TABLET 30 30

CHEST CONGESTION RELIEF DM TAB TABLET 180 30

CHEST CONGST-COUGH RELIEF TAB TABLET 180 30

CHLORPROMAZINE 10 MG TABLET TABLET 120 30




CHLORPROMAZINE 25 MG/ML AMP AMPUL (ML) 180 30


CIMZIA 200 MG/ML SYRINGE KIT SYRINGE KIT (EA) 2.4 30

CITALOPRAM HBR 10 MG TABLET TABLET 90 30

CITALOPRAM HBR 20 MG TABLET TABLET 60 30

CLONIDINE HCL ER 0.1 MG TABLET TABLET, EXTENDED RELEASE 12 HR 120 30

CODEINE SULFATE 15 MG TABLET TABLET 180 30



COLD HEAD CONGESTION CAPLET TABLET 360 30

COLD MULTI-SYMPTOM CAPLET TABLET 360 30

COLD MULTI-SYMPTOM GELCAP TABLET 360 30

COLD MULTI-SYMPTOM NIGHT LIQ LIQUID (ML) 5400 30

COLD RELIEF MULTI-SYMPTOM CPLT TABLET 360 30

COLD RLF HEAD CONGESTION CPLT TABLET 360 30

COLD-FLU SEVERE CAPLET TABLET 360 30

CONCERTA ER 18 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30




CONZIP 100 MG CAPSULE CAPSULE,EXT.RELEASE 24 HR BIPHASIC 25-75 30 30



COREG CR 10 MG CAPSULE CAPSULE,EXTENDED RELEASE MULTIPHASE 24HR 30 30



COUGH DM SYRUP SYRUP 1800 30

COUGH FORMULA DM SYRUP SYRUP 1800 30

COUGH SYRUP SYRUP 1800 30

COUGH SYRUP DM SYRUP 1800 30

COZAAR 25 MG TABLET TABLET 30 30

COZAAR 50 MG TABLET TABLET 30 30

CRESTOR 10 MG TABLET TABLET 30 30



CVS CHEST CONGEST RELIEF DM TB TABLET 180 30

CVS CHEST CONGESTION RLF DM TB TABLET 180 30

CVS DAYTIME COLD-FLU RLF SFTGL CAPSULE 360 30

CVS ESOMEPRAZOLE MAG 20 MG CAP CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 30

CVS LANSOPRAZOLE DR 15 MG CAP CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 30

CVS TUSSIN COUGH LIQUID LIQUID (ML) 1800 30

CVS TUSSIN DM LIQUID LIQUID (ML) 1800 30

CVS TUSSIN MAX-STR SYRUP SYRUP 360 30

CYCLOBENZAPRINE 7.5 MG TABLET TABLET 63 30

CYCLOSET 0.8 MG TABLET TABLET 180 30

DARIFENACIN ER 7.5 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

DAY TIME COLD-FLU SOFTGEL CAPSULE 360 30

DAY TIME SOFTGEL CAPSULE 360 30

DAYTIME COLD MULTI-SYMP GELCAP TABLET 360 30

DAYTIME COLD RELIEF CAPLET TABLET 360 30

DAYTIME COLD-FLU RELIEF SOFTGL CAPSULE 360 30

DAYTRANA 10 MG/9 HR PATCH PATCH, TRANSDERMAL 24 HOURS 30 30

DAYTRANA 15 MG/9 HR PATCH PATCH, TRANSDERMAL 24 HOURS 30 30

DAYTRANA 20 MG/9 HOUR PATCH PATCH, TRANSDERMAL 24 HOURS 30 30

DAYTRANA 30 MG/9 HOUR PATCH PATCH, TRANSDERMAL 24 HOURS 30 30

DDAVP 0.1 MG TABLET TABLET 360 30

DDAVP 0.2 MG TABLET TABLET 180 30

DECONEX DMX TABLET TABLET 240 30

DEMEROL 100 MG TABLET TABLET 6 34

DESMOPRESSIN ACETATE 0.1 MG TB TABLET 360 30

DESMOPRESSIN ACETATE 0.2 MG TB TABLET 180 30

DESOXYN 5 MG TABLET TABLET 180 30

DESVENLAFAXINE SUC ER 25 MG TB TABLET, EXTENDED RELEASE 24 HR 30 30

DESVENLAFAXINE SUC ER 50 MG TB TABLET, EXTENDED RELEASE 24 HR 30 30

DETROL LA 2 MG CAPSULE CAPSULE, EXT RELEASE 24 HR 30 30

DEXEDRINE 10 MG TABLET TABLET 180 30

DEXEDRINE 5 MG TABLET TABLET 90 30

DEXEDRINE SPANSULE 10 MG CAPSULE, EXTENDED RELEASE 30 30



DEXILANT DR 30 MG CAPSULE CAPSULE, DELAYED RELEASE, BIPHASIC 30 30

DEXMETHYLPHENIDATE 10 MG TAB TABLET 150 30

DEXMETHYLPHENIDATE 2.5 MG TAB TABLET 60 30

DEXMETHYLPHENIDATE 5 MG TAB TABLET 60 30

DEXMETHYLPHENIDATE ER 10 MG CP CAPSULE,EXTENDED RELEASE BIPHASIC 50-50 30 30







DEXMETHYLPHENIDATE ER 5 MG CAP CAPSULE,EXTENDED RELEASE BIPHASIC 50-50 30 30

DEXTROAMP-AMPHET ER 10 MG CAP CAPSULE, EXT RELEASE 24 HR 30 30






DEXTROAMP-AMPHETAM 12.5 MG TAB TABLET 90 30

DEXTROAMP-AMPHETAM 7.5 MG TAB TABLET 90 30

DEXTROAMP-AMPHETAMIN 10 MG TAB TABLET 90 30




DEXTROAMP-AMPHETAMINE 5 MG TAB TABLET 90 30

DEXTROAMPHETAMINE 10 MG TAB TABLET 180 30

DEXTROAMPHETAMINE 5 MG TAB TABLET 90 30

DEXTROAMPHETAMINE 5 MG/5 ML SOLUTION, ORAL 1800 30

DEXTROAMPHETAMINE ER 10 MG CAP CAPSULE, EXTENDED RELEASE 30 30



DIABETIC SILTUSSIN-DM LIQUID LIQUID (ML) 1800 30

DIABETIC TUSSIN DM LIQUID LIQUID (ML) 1800 30

DIASTAT 2.5 MG PEDI SYSTEM KIT 120 30

DIASTAT ACUDIAL 12.5-15-20 MG KIT 120 30

DIASTAT ACUDIAL 5-7.5-10 MG KT KIT 120 30

DIAZEPAM 10 MG RECTAL GEL SYST KIT 120 30

DIAZEPAM 2.5 MG RECTAL GEL SYS KIT 120 30

DIAZEPAM 20 MG RECTAL GEL SYST KIT 120 30

DICLOFENAC 1.5% TOPICAL SOLN DROPS 300 30

DICLOFENAC EPOLAMINE 1.3% PTCH PATCH, TRANSDERMAL 12 HOURS 60 30

DICLOFENAC SODIUM 1% GEL GEL (GRAM) 1020 30

DICLOFENAC SODIUM 3% GEL GEL (GRAM) 300 365

DILAUDID 2 MG TABLET TABLET 240 30


DILAUDID 5 MG/5 ML ORAL LIQUID LIQUID (ML) 1200 30


DILTIAZEM 24H ER(CD) 120 MG CP CAPSULE, EXT RELEASE 24 HR 30 30

DILTIAZEM 24H ER(CD) 180 MG CP CAPSULE, EXT RELEASE 24 HR 30 30

DILTIAZEM 24H ER(XR) 120 MG CP CAPSULE,EXTENDED-RELEASE 24HR DEGRADABLE 30 30

DIOVAN 160 MG TABLET TABLET 60 30

DIOVAN 80 MG TABLET TABLET 60 30

DIOVAN HCT 160-12.5 MG TAB TABLET 60 30

DIOVAN HCT 80-12.5 MG TABLET TABLET 60 30

DONEPEZIL HCL 5 MG TABLET TABLET 30 30

DONEPEZIL HCL ODT 5 MG TABLET TABLET,DISINTEGRATING 30 30

DORAL 15 MG TABLET TABLET 30 30

DOXAZOSIN MESYLATE 1 MG TAB TABLET 30 30



DUETACT 30-2 MG TABLET TABLET 30 30

DUETACT 30-4 MG TABLET TABLET 30 30

DUEXIS 800-26.6 MG TABLET TABLET 90 30

DURAGESIC 100 MCG/HR PATCH PATCH, TRANSDERMAL 72 HOURS 15 30





ED-A-HIST DM LIQUID LIQUID (ML) 1200 30

EDLUAR 10 MG SL TABLET TABLET, SUBLINGUAL 30 30

EDLUAR 5 MG SL TABLET TABLET, SUBLINGUAL 30 30

EFFEXOR XR 37.5 MG CAPSULE CAPSULE, EXT RELEASE 24 HR 30 30

EFFEXOR XR 75 MG CAPSULE CAPSULE, EXT RELEASE 24 HR 30 30

EMLA CREAM CREAM (GRAM) 30 22

ENABLEX 7.5 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

ENBREL 50 MG/ML MINI CARTRIDGE CARTRIDGE (ML) 8.7 30

ENBREL 50 MG/ML SURECLICK SYR PEN INJECTOR (ML) 8.7 30

ENBREL 50 MG/ML SYRINGE SYRINGE (ML) 8.7 30

ENDOCET 10-325 MG TABLET TABLET 360 30

ENDOCET 2.5-325 MG TABLET TABLET 360 30

ENDOCET 5-325 TABLET TABLET 360 30

ENDOCET 7.5-325 MG TABLET TABLET 360 30

ENDUR-ACIN ER 500 MG TABLET TABLET, EXTENDED RELEASE 30 30

EQ COLD MULTI-SYMP SEVERE CPLT TABLET 360 30

EQ COLD MULTI-SYMPTOM GELCAP TABLET 360 30

EQ DAYTIME COLD-FLU SOFTGEL CAPSULE 360 30

EQ LANSOPRAZOLE DR 15 MG CAP CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 30

EQ NIGHTTIME COLD-FLU SOFTGEL CAPSULE 240 30

EQ TUSSIN DM COUGH-CHEST SYR SYRUP 1800 30

EQL COLD HEAD CONGESTION CPLT TABLET 360 30

EQL DAY COLD-FLU RELIEF SOFTGL CAPSULE 360 30

EQL LANSOPRAZOLE DR 15 MG CAP CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 30

EQL MUCUS RLF COLD-FLU-THROAT TABLET 360 30

EQL MUCUS RLF SEVERE COLD CPLT TABLET 360 30

EQL NIGHT COLD-FLU RELIEF SFGL CAPSULE 240 30

EQL NIGHT COLD-FLU RLF SOFTGEL CAPSULE 240 30

EQL NIGHT SEVERE COLD-FLU LIQ LIQUID (ML) 5400 30

EQL SEVERE COLD MULTI-SYM CPLT TABLET 360 30

EQL TUSSIN DM COUGH-CHEST SYR SYRUP 1800 30

ESCITALOPRAM 10 MG TABLET TABLET 60 30

ESCITALOPRAM 5 MG TABLET TABLET 90 30

ESOMEPRAZOLE MAG DR 20 MG CAP CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 30

ESTAZOLAM 1 MG TABLET TABLET 30 30

ESTAZOLAM 2 MG TABLET TABLET 30 30

ESZOPICLONE 1 MG TABLET TABLET 30 30



EXALGO ER 12 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30




EXTRA ACTION COUGH SYRUP SYRUP 1800 30

FARXIGA 10 MG TABLET TABLET 30 30

FARXIGA 5 MG TABLET TABLET 30 30

FELODIPINE ER 2.5 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

FELODIPINE ER 5 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

FENESIN DM IR TABLET TABLET 180 30

FENTANYL 100 MCG/HR PATCH PATCH, TRANSDERMAL 72 HOURS 15 30



FENTANYL 37.5 MCG/HR PATCH PATCH, TRANSDERMAL 72 HOURS 15 30





FENTANYL CIT OTFC 1,200 MCG LOZENGE ON A HANDLE 120 30

FENTANYL CIT OTFC 1,600 MCG LOZENGE ON A HANDLE 120 30

FENTANYL CITRATE OTFC 200 MCG LOZENGE ON A HANDLE 120 30




FENTORA 100 MCG BUCCAL TABLET TABLET, EFFERVESCENT 120 30





FEXMID 7.5 MG TABLET TABLET 63 30

FIASP 100 UNIT/ML FLEXTOUCH INSULIN PEN (ML) 90 30

FIASP 100 UNIT/ML VIAL VIAL (ML) 90 30

FIORICET-COD 50-300-40-30 CAP CAPSULE 180 30

FIORINAL WITH CODEINE #3 CAP CAPSULE 180 30

FIORINAL-COD 30-50-325-40 CAP CAPSULE 180 30

FLECTOR 1.3% PATCH PATCH, TRANSDERMAL 12 HOURS 60 30

FLUOXETINE HCL 10 MG CAPSULE CAPSULE 150 30

FLUOXETINE HCL 10 MG TABLET TABLET 150 30

FLUOXETINE HCL 20 MG CAPSULE CAPSULE 120 30

FLUOXETINE HCL 20 MG TABLET TABLET 120 30

FLUPHENAZINE 1 MG TABLET TABLET 120 30


FLUPHENAZINE 2.5 MG TABLET TABLET 120 30

FLUPHENAZINE 2.5 MG/5 ML ELIX ELIXIR 240 30

FLUPHENAZINE 2.5 MG/ML VIAL VIAL (ML) 120 22


FLUPHENAZINE 5 MG/ML CONC CONCENTRATE, ORAL 240 30

FLURAZEPAM 15 MG CAPSULE CAPSULE 30 30

FLURAZEPAM 30 MG CAPSULE CAPSULE 30 30

FLUVASTATIN SODIUM 20 MG CAP CAPSULE 30 30

FLUVASTATIN SODIUM 40 MG CAP CAPSULE 30 30

FOCALIN 10 MG TABLET TABLET 150 30

FOCALIN 2.5 MG TABLET TABLET 60 30

FOCALIN 5 MG TABLET TABLET 60 30

FOCALIN XR 10 MG CAPSULE CAPSULE,EXTENDED RELEASE BIPHASIC 50-50 30 30








FORTAMET ER 1,000 MG TABLET TABLET, EXTENDED RELEASE 24 HR 60 30

FORTAMET ER 500 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

GABAPENTIN 100 MG CAPSULE CAPSULE 270 30

GABAPENTIN 250 MG/5 ML SOLN SOLUTION, ORAL 2160 30


GABAPENTIN 300 MG/6 ML SOLN SOLUTION, ORAL 2160 30


GABAPENTIN 600 MG TABLET TABLET 180 30

GABAPENTIN 800 MG TABLET TABLET 120 30

GALANTAMINE HBR 8 MG TABLET TABLET 30 30

GERI-TUSSIN DM SYRUP SYRUP 1800 30

GLENMAX PEB DM FORTE LIQUID LIQUID (ML) 900 30

GLIMEPIRIDE 1 MG TABLET TABLET 120 30



GLIPIZIDE 10 MG TABLET TABLET 120 30

GLIPIZIDE 5 MG TABLET TABLET 240 30

GLIPIZIDE ER 10 MG TABLET TABLET, EXTENDED RELEASE 24 HR 60 30

GLIPIZIDE ER 2.5 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

GLIPIZIDE ER 5 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

GLIPIZIDE XL 10 MG TABLET TABLET, EXTENDED RELEASE 24 HR 60 30

GLIPIZIDE XL 2.5 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

GLIPIZIDE XL 5 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

GLIPIZIDE-METFORMIN 2.5-250 MG TABLET 120 30

GLIPIZIDE-METFORMIN 2.5-500 MG TABLET 120 30

GLIPIZIDE-METFORMIN 5-500 MG TABLET 120 30

GLUCOPHAGE 1,000 MG TABLET TABLET 75 30

GLUCOPHAGE 500 MG TABLET TABLET 150 30

GLUCOPHAGE 850 MG TABLET TABLET 90 30

GLUCOPHAGE XR 500 MG TAB TABLET, EXTENDED RELEASE 24 HR 150 30

GLUCOPHAGE XR 750 MG TAB TABLET, EXTENDED RELEASE 24 HR 90 30

GLUCOTROL 10 MG TABLET TABLET 120 30

GLUCOTROL 5 MG TABLET TABLET 240 30

GLUCOTROL XL 10 MG TABLET TABLET, EXTENDED RELEASE 24 HR 60 30

GLUCOTROL XL 2.5 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

GLUCOTROL XL 5 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

GLUCOVANCE 5-500 MG TABLET TABLET 120 30

GLUMETZA ER 1,000 MG TABLET TABLET, ER GASTRIC RETENTION 24 HR 60 30

GLUMETZA ER 500 MG TABLET TABLET, ER GASTRIC RETENTION 24 HR 30 30

GLYBURIDE 1.25 MG TABLET TABLET 120 30

GLYBURIDE 2.5 MG TABLET TABLET 120 30

GLYBURIDE 5 MG TABLET TABLET 120 30

GLYBURIDE MICRO 1.5 MG TAB TABLET 120 30

GLYBURIDE MICRO 3 MG TABLET TABLET 120 30

GLYBURIDE MICRO 6 MG TABLET TABLET 60 30

GLYBURIDE-METFORMIN 2.5-500 MG TABLET 120 30

GLYBURIDE-METFORMIN 5-500 MG TABLET 120 30

GLYBURID-METFORMIN 1.25-250 MG TABLET 240 30

GLYDO 2% JELLY SYRINGE JELLY WITH PREFILLED APPLICATOR (ML) 60 22

GLYNASE 1.5 MG PRESTAB TABLET 120 30

GLYNASE 3 MG PRESTAB TABLET 120 30

GLYNASE 6 MG PRESTAB TABLET 60 30

GLYXAMBI 10 MG-5 MG TABLET TABLET 30 30

GLYXAMBI 25 MG-5 MG TABLET TABLET 30 30

GNP CHEST CONGST-COUGH RLF TAB TABLET 180 30

GNP TUSSIN COUGH LIQUID LIQUID (ML) 360 30

GNP TUSSIN DM CLEAR SYRUP SYRUP 1800 30

GNP TUSSIN DM SYRUP SYRUP 1800 30

GRALISE 30-DAY STARTER PACK TABLET, EXTENDED RELEASE 24 HR 78 135

GRALISE ER 300 MG TABLET TABLET, EXTENDED RELEASE 24 HR 360 30

GRALISE ER 600 MG TABLET TABLET, EXTENDED RELEASE 24 HR 180 30

GS COLD MULTI-SYMPTOM CAPLET TABLET 360 30

GS DAYTIME COLD-FLU SOFTGEL CAPSULE 360 30

GS LANSOPRAZOLE DR 15 MG CAP CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 30

GS MUCUS RELIEF DM TABLET TABLET 180 30

GS NIGHTTIME COLD-FLU SOFTGEL CAPSULE 240 30

GS SEVERE DAY COLD-FLU CAPLET TABLET 360 30

GS TUSSIN DM COUGH SYRUP SYRUP 1800 30

GS TUSSIN DM COUGH-CHEST SOLN SYRUP 1800 30

GS TUSSIN DM LIQUID SYRUP 1800 30

G-TRON LIQUID LIQUID (ML) 1800 30

GUAIASORB DM LIQUID LIQUID (ML) 1800 30

GUAICON DMS LIQUID PACKET LIQUID IN PACKET (ML) 1800 30

GUAIFENESIN DM 400-20 MG TAB TABLET 180 30

GUAIFENESIN DM SYRUP SYRUP 1800 30

GUAIFENESIN-DM 400-20 MG CPLT TABLET 180 30

GUAIFENESIN-DM ER 1,200-60 MG TABLET, EXTENDED RELEASE 12 HR 60 30

GUAIFENESIN-DM SOLUTION LIQUID (ML) 1800 30

HALCION 0.25 MG TABLET TABLET 60 30

HALOPERIDOL 0.5 MG TABLET TABLET 90 30

HALOPERIDOL 1 MG TABLET TABLET 90 30





HEARTBURN TREATMENT 20 MG CAP CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 30

HEARTBURN TREATMNT 24 HR 15 MG CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 30

HM ADT TUSSIN COUGH CONG DM LQ LIQUID (ML) 1800 30

HM ADULT TUSSIN DM SYRUP SYRUP 1800 30

HM CHEST CONGEST RLF DM CAPLET TABLET 180 30

HM ESOMEPRAZOLE MAG DR 20 MG CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 30

HM LANSOPRAZOLE DR 15 MG CAP CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 30

HM NIGHT TIME LIQUID CAP CAPSULE 240 30

HM SEVERE COLD-FLU CAPLET TABLET 360 30

HORIZANT ER 300 MG TABLET TABLET, EXTENDED RELEASE 120 30

HORIZANT ER 600 MG TABLET TABLET, EXTENDED RELEASE 60 30

HUMALOG 100 UNIT/ML VIAL VIAL (ML) 90 30

HUMALOG 100 UNITS/ML KWIKPEN INSULIN PEN (ML) 90 30

HUMALOG 200 UNITS/ML KWIKPEN INSULIN PEN (ML) 30 30

HUMALOG JR 100 UNIT/ML KWIKPEN INSULIN PEN, HALF-UNIT (ML) 90 30

HUMALOG MIX 50-50 KWIKPEN INSULIN PEN (ML) 90 30

HUMALOG MIX 50-50 VIAL VIAL (ML) 90 30

HUMALOG MIX 75-25 KWIKPEN INSULIN PEN (ML) 90 30

HUMALOG MIX 75-25 VIAL VIAL (ML) 90 30

HUMIRA 40 MG/0.8 ML SYRINGE SYRINGE KIT (EA) 8.7 30

HUMIRA PEDI CROHN 40 MG/0.8 ML SYRINGE KIT (EA) 8.7 30

HUMIRA PEN 40 MG/0.8 ML PEN INJECTOR KIT (EA) 8.7 30

HUMIRA PEN CROHN-UC-HS 40 MG PEN INJECTOR KIT (EA) 8.7 30

HUMIRA PEN PS-UV-ADOL HS 40 MG PEN INJECTOR KIT (EA) 8.7 30

HUMULIN 70/30 KWIKPEN INSULIN PEN (ML) 90 30

HUMULIN 70-30 VIAL VIAL (ML) 90 30

HUMULIN N 100 UNIT/ML VIAL VIAL (ML) 90 30

HUMULIN N 100 UNITS/ML KWIKPEN INSULIN PEN (ML) 90 30

HUMULIN N 100 UNITS/ML VIAL VIAL (ML) 90 30

HUMULIN R 100 UNIT/ML VIAL VIAL (ML) 90 30

HUMULIN R 100 UNITS/ML VIAL VIAL (ML) 90 30

HUMULIN R 500 UNITS/ML VIAL VIAL (ML) 90 30

HYDROCODONE-ACETAMIN 10-300 MG TABLET 390 30


HYDROCODONE-ACETAMIN 10-325/15 SOLUTION, ORAL 5400 30

HYDROCODONE-ACETAMIN 2.5-108/5 SOLUTION, ORAL 5400 30

HYDROCODONE-ACETAMIN 5-163/7.5 SOLUTION, ORAL 5400 30

HYDROCODONE-ACETAMIN 5-217/10 SOLUTION, ORAL 5400 30



HYDROCODONE-ACETAMIN 7.5-300 TABLET 390 30

HYDROCODONE-ACETAMIN 7.5-325 TABLET 360 30

HYDROCODONE-ACETAMN 7.5-325/15 SOLUTION, ORAL 5400 30

HYDROCODONE-IBUPROFEN 10-200 TABLET 150 30

HYDROCODONE-IBUPROFEN 5-200 MG TABLET 150 30

HYDROCODONE-IBUPROFEN 7.5-200 TABLET 150 30

HYDROMORPHONE 1 MG/ML SOLUTION LIQUID (ML) 1200 30

HYDROMORPHONE 2 MG TABLET TABLET 240 30

HYDROMORPHONE 3 MG SUPPOS SUPPOSITORY, RECTAL 240 30


HYDROMORPHONE 5 MG/5 ML SOLN LIQUID (ML) 1200 30


HYDROMORPHONE HCL ER 12 MG TAB TABLET, EXTENDED RELEASE 24 HR 30 30




HYZAAR 50-12.5 TABLET TABLET 30 30

IBUDONE 10-200 MG TABLET TABLET 150 30

IBUDONE 5-200 MG TABLET TABLET 150 30

INSULIN LISPRO 100 UNIT/ML PEN INSULIN PEN (ML) 90 30

INSULIN LISPRO 100 UNIT/ML VL VIAL (ML) 90 30

INTERMEZZO 1.75 MG TAB SUBLING TABLET, SUBLINGUAL 30 30

INTERMEZZO 3.5 MG TAB SUBLING TABLET, SUBLINGUAL 30 30

INVEGA ER 1.5 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

INVEGA ER 3 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

INVEGA SUSTENNA 117 MG/0.75 ML SYRINGE (ML) 0.75 21

INVEGA SUSTENNA 156 MG/ML SYRG SYRINGE (ML) 1 21




INVOKAMET 150-1,000 MG TABLET TABLET 60 30

INVOKAMET 150-500 MG TABLET TABLET 60 30

INVOKAMET 50-1,000 MG TABLET TABLET 60 30

INVOKAMET 50-500 MG TABLET TABLET 60 30

INVOKANA 100 MG TABLET TABLET 60 30

INVOKANA 300 MG TABLET TABLET 30 30

IRBESARTAN 150 MG TABLET TABLET 30 30

IRBESARTAN 75 MG TABLET TABLET 30 30

JANUMET 50-1,000 MG TABLET TABLET 60 30

JANUMET 50-500 MG TABLET TABLET 60 30

JANUMET XR 100-1,000 MG TABLET TABLET,EXTENDED RELEASE MULTIPHASE 24 HR 30 30

JANUMET XR 50-1,000 MG TABLET TABLET,EXTENDED RELEASE MULTIPHASE 24 HR 60 30

JANUMET XR 50-500 MG TABLET TABLET,EXTENDED RELEASE MULTIPHASE 24 HR 30 30

JANUVIA 100 MG TABLET TABLET 30 30



JARDIANCE 10 MG TABLET TABLET 30 30

JARDIANCE 25 MG TABLET TABLET 30 30

JENTADUETO 2.5 MG-1000 MG TAB TABLET 60 30



KADIAN ER 10 MG CAPSULE CAPSULE, EXTENDED RELEASE PELLETS 60 30









KALYDECO 50 MG GRANULES PACKET GRANULES IN PACKET (EA) 56 21

KAPVAY ER 0.1 MG TABLET TABLET, EXTENDED RELEASE 12 HR 120 30

KAZANO 12.5-1,000 MG TABLET TABLET 60 30

KAZANO 12.5-500 MG TABLET TABLET 60 30

KETOROLAC 10 MG TABLET TABLET 120 30

KETOROLAC 60 MG/2 ML CARPUJECT CARTRIDGE (ML) 120 30

KETOROLAC 60 MG/2 ML SYRINGE SYRINGE (ML) 120 30

KETOROLAC 60 MG/2 ML VIAL VIAL (ML) 120 30

KLOFENSAID II 1.5% TOPICAL SOL DROPS 300 30

KOMBIGLYZE XR 2.5-1,000 MG TAB TABLET,EXTENDED RELEASE MULTIPHASE 24 HR 60 30

KOMBIGLYZE XR 5-1,000 MG TAB TABLET,EXTENDED RELEASE MULTIPHASE 24 HR 30 30

KOMBIGLYZE XR 5-500 MG TABLET TABLET,EXTENDED RELEASE MULTIPHASE 24 HR 30 30

KORLYM 300 MG TABLET TABLET 120 30

KRO TUSSIN DM COUGH-CHEST CONG LIQUID (ML) 1800 30

KRO TUSSIN DM LIQUID LIQUID (ML) 1800 30

LANSOPRAZOLE DR 15 MG CAPSULE CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 30

LANTUS 100 UNIT/ML VIAL VIAL (ML) 90 30

LANTUS SOLOSTAR 100 UNIT/ML INSULIN PEN (ML) 90 30

LATUDA 60 MG TABLET TABLET 30 30

LC-5 5% CREAM CREAM (GRAM) 60 22

LESCOL 20 MG CAPSULE CAPSULE 30 30

LEVEMIR 100 UNIT/ML VIAL VIAL (ML) 90 30

LEVEMIR FLEXTOUCH 100 UNIT/ML INSULIN PEN (ML) 90 30

LEVORPHANOL 2 MG TABLET TABLET 180 30

LEVORPHANOL 3 MG TABLET TABLET 180 30

LEXAPRO 10 MG TABLET TABLET 60 30

LEXAPRO 5 MG TABLET TABLET 90 30

LIDOCAINE 5% PATCH ADHESIVE PATCH, MEDICATED 90 30

LIDOCAINE ANORECTAL 5% CREAM CREAM (GRAM) 60 22

LIDOCAINE HCL 2% ABBOJECT SYRINGE (ML) 125 22

LIDOCAINE HCL 2% JEL UROJET AC JELLY WITH PREFILLED APPLICATOR (ML) 60 22

LIDOCAINE HCL 2% JELLY JELLY (ML) 60 22

LIDOCAINE HCL 2% JELLY URO-JET JELLY WITH PREFILLED APPLICATOR (ML) 60 22

LIDOCAINE HCL 2% LUER-JET SYRINGE (ML) 125 22

LIDOCAINE HCL 2% SYRINGE SYRINGE (ML) 125 22

LIDOCAINE HCL 2% VIAL VIAL (ML) 125 22

LIDOCAINE HCL 4% SOLUTION SOLUTION, NON-ORAL 50 22

LIDOCAINE-PRILOCAINE CREAM CREAM (GRAM) 30 22

LIDODERM 5% PATCH ADHESIVE PATCH, MEDICATED 90 30

LINDANE 1% SHAMPOO SHAMPOO 60 23

LIPITOR 10 MG TABLET TABLET 30 30



LIVALO 1 MG TABLET TABLET 30 30

LIVALO 2 MG TABLET TABLET 30 30

LMX 5 5% CREAM CREAM (GRAM) 60 22

LOHIST-DM SYRUP LIQUID (ML) 1800 30

LORAZEPAM 0.5 MG TABLET TABLET 120 30

LORAZEPAM 1 MG TABLET TABLET 120 30

LORAZEPAM 2 MG TABLET TABLET 120 30

LORAZEPAM 2 MG/ML CARPUJECT CARTRIDGE (ML) 120 30

LORAZEPAM 2 MG/ML ORAL CONCENT CONCENTRATE, ORAL 120 30

LORAZEPAM 2 MG/ML VIAL VIAL (ML) 120 30

LORAZEPAM 20 MG/10 ML VIAL VIAL (ML) 120 30

LORAZEPAM 4 MG/ML CARPUJECT CARTRIDGE (ML) 60 30

LORAZEPAM 4 MG/ML VIAL VIAL (ML) 60 30

LORAZEPAM 40 MG/10 ML VIAL VIAL (ML) 60 30

LORAZEPAM INTENSOL 2 MG/ML CONCENTRATE, ORAL 120 30

LORCET 5-325 MG TABLET TABLET 360 30

LORCET HD 10-325 MG TABLET TABLET 360 30

LORCET PLUS 7.5-325 MG TABLET TABLET 360 30

LOSARTAN POTASSIUM 25 MG TAB TABLET 30 30

LOSARTAN POTASSIUM 50 MG TAB TABLET 30 30

LOSARTAN-HCTZ 50-12.5 MG TAB TABLET 30 30

LOVASTATIN 10 MG TABLET TABLET 30 30

LOVASTATIN 20 MG TABLET TABLET 30 30

LOVAZA 1 GM CAPSULE CAPSULE 120 30

LOXAPINE 10 MG CAPSULE CAPSULE 150 30



LUNESTA 1 MG TABLET TABLET 30 30



LYRICA 100 MG CAPSULE CAPSULE 120 30








MAPAP COLD FORMULA CAPLET TABLET 360 30

MEPERIDINE 100 MG TABLET TABLET 6 34

MEPERIDINE 50 MG TABLET TABLET 12 34

MEPERIDINE 50 MG/5 ML SOLUTION SOLUTION, ORAL 120 34

METADATE CD 30 MG CAPSULE CAPSULE,EXTENDED RELEASE BIPHASIC 30-70 30 30

METADATE CD 50 MG CAPSULE CAPSULE,EXTENDED RELEASE BIPHASIC 30-70 60 30

METADATE ER 20 MG TABLET TABLET, EXTENDED RELEASE 150 30

METFORMIN ER 1,000 MG GASTR-TB TABLET, ER GASTRIC RETENTION 24 HR 60 30

METFORMIN ER 1,000 MG OSM-TAB TABLET, EXTENDED RELEASE 24 HR 60 30

METFORMIN ER 500 MG GASTRC-TB TABLET, ER GASTRIC RETENTION 24 HR 30 30

METFORMIN ER 500 MG OSMOTIC TB TABLET, EXTENDED RELEASE 24 HR 30 30

METFORMIN HCL 1,000 MG TABLET TABLET 75 30

METFORMIN HCL 500 MG TABLET TABLET 150 30

METFORMIN HCL 850 MG TABLET TABLET 90 30

METFORMIN HCL ER 500 MG TABLET TABLET, EXTENDED RELEASE 24 HR 150 30

METFORMIN HCL ER 750 MG TABLET TABLET, EXTENDED RELEASE 24 HR 90 30

METHAMPHETAMINE 5 MG TABLET TABLET 180 30

METHYLIN 10 MG CHEWABLE TABLET TABLET,CHEWABLE 60 30

METHYLIN 10 MG/5 ML SOLUTION SOLUTION, ORAL 1500 30

METHYLIN 2.5 MG CHEWABLE TAB TABLET,CHEWABLE 90 30

METHYLIN 5 MG CHEWABLE TABLET TABLET,CHEWABLE 90 30

METHYLIN 5 MG/5 ML SOLUTION SOLUTION, ORAL 450 30

METHYLPHENIDATE 10 MG CHEW TAB TABLET,CHEWABLE 60 30

METHYLPHENIDATE 10 MG TABLET TABLET 90 30

METHYLPHENIDATE 10 MG/5 ML SOL SOLUTION, ORAL 1500 30

METHYLPHENIDATE 2.5 MG CHEW TB TABLET,CHEWABLE 90 30


METHYLPHENIDATE 5 MG CHEW TAB TABLET,CHEWABLE 90 30


METHYLPHENIDATE 5 MG/5 ML SOLN SOLUTION, ORAL 450 30

METHYLPHENIDATE CD 10 MG CAP CAPSULE,EXTENDED RELEASE BIPHASIC 30-70 30 30






METHYLPHENIDATE ER 10 MG TAB TABLET, EXTENDED RELEASE 30 30

METHYLPHENIDATE ER 18 MG TAB TABLET, EXTENDED RELEASE 24 HR 30 30

METHYLPHENIDATE ER 20 MG TAB TABLET, EXTENDED RELEASE 150 30




METHYLPHENIDATE ER(CD) 10MG CP CAPSULE,EXTENDED RELEASE BIPHASIC 30-70 30 30






METHYLPHENIDATE ER(LA) 10MG CP CAPSULE,EXTENDED RELEASE BIPHASIC 50-50 30 30




METHYLPHENIDATE LA 10 MG CAP CAPSULE,EXTENDED RELEASE BIPHASIC 50-50 30 30




METOPROLOL SUCC ER 100 MG TAB TABLET, EXTENDED RELEASE 24 HR 30 30



MICARDIS 20 MG TABLET TABLET 30 30

MICARDIS 40 MG TABLET TABLET 30 30

MICARDIS HCT 40-12.5 MG TABLET TABLET 30 30

MIRTAZAPINE 15 MG ODT TABLET,DISINTEGRATING 90 30

MIRTAZAPINE 15 MG TABLET TABLET 90 30

MIRTAZAPINE 7.5 MG TABLET TABLET 90 30

MODAFINIL 100 MG TABLET TABLET 30 30

MODAFINIL 200 MG TABLET TABLET 60 30

MORPHINE 10 MG/0.5 ML ORAL SYR SYRINGE (EA) 540 30

MORPHINE 20 MG/ML ORAL SYRINGE SYRINGE (ML) 540 30

MORPHINE SULF 10 MG/5 ML SOLN SOLUTION, ORAL 5400 30

MORPHINE SULF 100 MG/5 ML CONC SOLUTION, ORAL 540 30

MORPHINE SULF 20 MG/5 ML SOLN SOLUTION, ORAL 2700 30

MORPHINE SULF CR 100 MG TABLET TABLET, EXTENDED RELEASE 90 30

MORPHINE SULF CR 60 MG TABLET TABLET, EXTENDED RELEASE 90 30

MORPHINE SULF ER 100 MG TABLET TABLET, EXTENDED RELEASE 90 30





MORPHINE SULFATE ER 10 MG CAP CAPSULE, EXTENDED RELEASE PELLETS 60 30








MORPHINE SULFATE IR 15 MG TAB TABLET 360 30

MORPHINE SULFATE IR 30 MG TAB TABLET 360 30

MS CONTIN ER 100 MG TABLET TABLET, EXTENDED RELEASE 90 30





MUCINEX DM ER 1,200-60 MG TAB TABLET, EXTENDED RELEASE 12 HR 60 30

MUCINEX DM ER 600-30 MG TABLET TABLET, EXTENDED RELEASE 12 HR 120 30

MUCINEX FAST-MAX COLD-FLU CPLT TABLET 360 30

MUCINEX FAST-MAX COLD-SINUS CP CAPSULE 360 30

MUCINEX FAST-MAX CONGEST-HEAD CAPSULE 360 30

MUCINEX FAST-MAX SEV COLD CPLT TABLET 360 30

MUCOSA DM 400-20 MG TABLET TABLET 180 30

MUCUS AND COUGH RELIEF TABLET TABLET 180 30

MUCUS DM 600-30 MG TABLET TABLET, EXTENDED RELEASE 12 HR 120 30

MUCUS DM MAX 1,200-60 MG TAB TABLET, EXTENDED RELEASE 12 HR 60 30

MUCUS DM MAX ER 1,200-60 MG TB TABLET, EXTENDED RELEASE 12 HR 60 30

MUCUS RELIEF DM 20-400 MG TAB TABLET 180 30

MUCUS RELIEF DM COUGH TABLET TABLET 180 30

MUCUS RELIEF DM TABLET TABLET 180 30

MUCUS RELIEF SEVERE COLD CPLT TABLET 360 30

MUCUS RLF COLD-FLU-THROAT CPLT TABLET 360 30

MUCUS RLF DM ER 600-30 MG TAB TABLET, EXTENDED RELEASE 12 HR 120 30

MUCUS RLF DM MAX ER 1200-60 MG TABLET, EXTENDED RELEASE 12 HR 60 30

MYRBETRIQ ER 25 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

NATEGLINIDE 120 MG TABLET TABLET 90 30

NATEGLINIDE 60 MG TABLET TABLET 90 30

NATROBA 0.9% TOPICAL SUSP SUSPENSION, TOPICAL (ML) 120 7

NEO-TUSS LIQUID LIQUID (ML) 1800 30

NESINA 12.5 MG TABLET TABLET 30 30

NESINA 25 MG TABLET TABLET 30 30

NESINA 6.25 MG TABLET TABLET 30 30

NEURONTIN 100 MG CAPSULE CAPSULE 270 30

NEURONTIN 250 MG/5 ML SOLN SOLUTION, ORAL 2160 30



NEURONTIN 600 MG TABLET TABLET 180 30

NEURONTIN 800 MG TABLET TABLET 120 30

NEXIUM 24HR 20 MG CAPSULE CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 30

NEXIUM DR 20 MG CAPSULE CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 30

NIACIN 500 MG CAPSULE SA CAPSULE, EXTENDED RELEASE 30 30

NIACIN ER 500 MG CAPLET TABLET, EXTENDED RELEASE 30 30

NIACIN ER 500 MG CAPSULE CAPSULE, EXTENDED RELEASE 30 30

NIACIN ER 500 MG TABLET TABLET, EXTENDED RELEASE 30 30

NIACIN TR 500 MG CAPLET TABLET, EXTENDED RELEASE 30 30

NIACIN TR 500 MG CAPSULE CAPSULE, EXTENDED RELEASE 30 30

NIACIN TR 500 MG TABLET TABLET, EXTENDED RELEASE 30 30

NIFEDIPINE ER 30 MG TABLET TABLET, EXTENDED RELEASE 30 30

NIGHT COLD-FLU RELIEF LIQ CAP CAPSULE 240 30

NIGHT COLD-FLU RELIEF LIQ GEL CAPSULE 240 30

NIGHT TIME COLD-FLU RLF SFTGL CAPSULE 240 30

NIGHT TIME COLD-FLU SOFTGEL CAPSULE 240 30

NIGHT TIME SOFTGELS CAPSULE 240 30

NIGHTTIME COLD-FLU RLF SOFTGEL CAPSULE 240 30

NIGHTTIME SEVERE COLD-FLU LIQ LIQUID (ML) 5400 30

NIGHTTIME SINUS-CONGESTION CP CAPSULE 240 30

NIGHT-TIME SOFTGEL CAPSULE 240 30

NISOLDIPINE ER 20 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

NIVA-HIST DM LIQUID LIQUID (ML) 1200 30

NIVANEX DMX TABLET TABLET 240 30

NOHIST-DM LIQUID LIQUID (ML) 1200 30

NORCO 10-325 TABLET TABLET 360 30

NORCO 5-325 TABLET TABLET 360 30

NORCO 7.5-325 TABLET TABLET 360 30

NORVASC 2.5 MG TABLET TABLET 30 30

NORVASC 5 MG TABLET TABLET 30 30

NOVOLIN 70-30 100 UNIT/ML VIAL VIAL (ML) 90 30

NOVOLIN 70-30 FLEXPEN INSULIN PEN (ML) 90 30

NOVOLIN N 100 UNIT/ML VIAL VIAL (ML) 90 30

NOVOLIN R 100 UNIT/ML VIAL VIAL (ML) 90 30

NOVOLOG 100 UNIT/ML FLEXPEN INSULIN PEN (ML) 90 30

NOVOLOG 100 UNIT/ML VIAL VIAL (ML) 90 30

NOVOLOG 100 UNITS/ML FLEXPEN INSULIN PEN (ML) 90 30

NOVOLOG MIX 70-30 FLEXPEN SYRN INSULIN PEN (ML) 90 30

NOVOLOG MIX 70-30 VIAL VIAL (ML) 90 30

NUCYNTA 100 MG TABLET TABLET 180 30



NUCYNTA ER 100 MG TABLET TABLET, EXTENDED RELEASE 12 HR 60 30





NUVIGIL 150 MG TABLET TABLET 30 30



OLANZAPINE 10 MG TABLET TABLET 60 30

OLANZAPINE 2.5 MG TABLET TABLET 90 30

OLANZAPINE 5 MG TABLET TABLET 90 30

OLANZAPINE 7.5 MG TABLET TABLET 60 30

OLANZAPINE ODT 10 MG TABLET TABLET,DISINTEGRATING 60 30

OLANZAPINE ODT 5 MG TABLET TABLET,DISINTEGRATING 90 30

OLANZAPINE-FLUOXETINE 3-25 MG CAPSULE 30 30

OLANZAPINE-FLUOXETINE 6-25 MG CAPSULE 30 30

OLMESARTAN MEDOXOMIL 20 MG TAB TABLET 30 30

OMEGA-3 ETHYL ESTERS 1 GM CAP CAPSULE 120 30

OMEPRAZOLE DR 10 MG CAPSULE CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 30

OMEPRAZOLE DR 20 MG CAPSULE CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 30

ONGLYZA 2.5 MG TABLET TABLET 30 30

ONGLYZA 5 MG TABLET TABLET 30 30

OPANA 10 MG TABLET TABLET 180 30

OPANA 5 MG TABLET TABLET 180 30

OPANA ER 10 MG TABLET TABLET,ORAL ONLY,EXTENDED RELEASE 12 HR 60 30






OPANA ER 7.5 MG TABLET TABLET,ORAL ONLY,EXTENDED RELEASE 12 HR 60 30

ORENCIA 125 MG/ML SYRINGE SYRINGE (ML) 4.5 30

ORENCIA CLICKJECT 125 MG/ML AUTO-INJECTOR (ML) 4.5 30

OSENI 12.5-15 MG TABLET TABLET 30 30



OSENI 25-15 MG TABLET TABLET 30 30



OTEZLA 30 MG TABLET TABLET 60 30

OXAZEPAM 10 MG CAPSULE CAPSULE 120 30



OXYBUTYNIN 5 MG TABLET TABLET 90 30

OXYCODON 10 MG/0.5 ML ORAL SYR SYRINGE (EA) 1200 30

OXYCODON-ACETAMINOPHEN 2.5-325 TABLET 360 30

OXYCODON-ACETAMINOPHEN 7.5-325 TABLET 360 30

OXYCODONE HCL 10 MG TABLET TABLET 240 30

OXYCODONE HCL 100 MG/5 ML CONC CONCENTRATE, ORAL 1200 30




OXYCODONE HCL 5 MG CAPSULE CAPSULE 240 30


OXYCODONE HCL 5 MG/5 ML SOLN SOLUTION, ORAL 1200 30

OXYCODONE HCL ER 10 MG TABLET TABLET,ORAL ONLY,EXTENDED RELEASE 12 HR 60 30







OXYCODONE-ACETAMINOPHEN 10-325 TABLET 360 30

OXYCODONE-ACETAMINOPHEN 5-325 TABLET 360 30

OXYCODONE-ASPIRIN 4.8355-325 TABLET 360 30

OXYCODONE-IBUPROFEN 5-400 TAB TABLET 150 30

OXYCONTIN ER 10 MG TABLET TABLET,ORAL ONLY,EXTENDED RELEASE 12 HR 60 30







OXYMORPHONE HCL 10 MG TABLET TABLET 180 30

OXYMORPHONE HCL 5 MG TABLET TABLET 180 30

OXYMORPHONE HCL ER 10 MG TAB TABLET, EXTENDED RELEASE 12 HR 60 30





OXYMORPHONE HCL ER 5 MG TABLET TABLET, EXTENDED RELEASE 12 HR 60 30

OXYMORPHONE HCL ER 7.5 MG TAB TABLET, EXTENDED RELEASE 12 HR 60 30

PALIPERIDONE ER 1.5 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

PALIPERIDONE ER 3 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

PANTOPRAZOLE SOD DR 20 MG TAB TABLET, ENTERIC COATED 30 30

PAROXETINE CR 12.5 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

PAROXETINE ER 12.5 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

PAROXETINE HCL 10 MG TABLET TABLET 90 30

PAROXETINE HCL 20 MG TABLET TABLET 90 30

PAXIL 10 MG TABLET TABLET 90 30

PAXIL 20 MG TABLET TABLET 90 30

PAXIL CR 12.5 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

PENNSAID 2% PUMP SOLUTION IN METERED-DOSE PUMP (GRAM) 240 30

PENTAZOCINE-NALOXONE TABLET TABLET 360 30

PERCOCET 10-325 MG TABLET TABLET 360 30

PERCOCET 2.5-325 MG TABLET TABLET 360 30

PERCOCET 5-325 MG TABLET TABLET 360 30

PERCOCET 7.5-325 MG TABLET TABLET 360 30

PIOGLITAZONE-GLIMEPIRIDE 30-2 TABLET 30 30

PIOGLITAZONE-GLIMEPIRIDE 30-4 TABLET 30 30

PIOGLITAZONE-METFORMIN 15-500 TABLET 90 30

PIOGLITAZONE-METFORMIN 15-850 TABLET 90 30

PRANDIN 0.5 MG TABLET TABLET 480 30

PRANDIN 1 MG TABLET TABLET 240 30

PRANDIN 2 MG TABLET TABLET 240 30

PRAVACHOL 20 MG TABLET TABLET 30 30

PRAVACHOL 40 MG TABLET TABLET 30 30

PRAVASTATIN SODIUM 10 MG TAB TABLET 30 30



PRECOSE 100 MG TABLET TABLET 90 30



PRESGEN B LIQUID LIQUID (ML) 900 30

PREVACID 15 MG SOLUTAB TABLET,DISINTEGRATING, DELAYED RELEASE 30 30

PREVACID 24HR DR 15 MG CAPSULE CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 30

PREVACID DR 15 MG CAPSULE CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 30

PRISTIQ ER 25 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

PRISTIQ ER 50 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

PROCARDIA XL 30 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

PROCENTRA 5 MG/5 ML SOLUTION SOLUTION, ORAL 1800 30

PROMETHAZINE-DM SOLUTION SYRUP 1200 30

PROMETHAZINE-DM SYRUP SYRUP 1200 30

PROTONIX DR 20 MG TABLET TABLET, ENTERIC COATED 30 30

PROVIGIL 100 MG TABLET TABLET 30 30

PROVIGIL 200 MG TABLET TABLET 60 30

PROZAC 10 MG PULVULE CAPSULE 150 30

PROZAC 20 MG PULVULE CAPSULE 120 30

PUB SEVERE COLD CAPLET TABLET 360 30

PUB SEVERE COLD MULTI-SYM CPLT TABLET 360 30

PUB TUSSIN DM LIQUID SYRUP 1800 30

PV COLD HEAD CONGESTION CAPLET TABLET 360 30

PV COLD MULTI-SYMPTOM CAPLET TABLET 360 30

PV COLD-FLU SEVERE CAPLET TABLET 360 30

PV DAY SEVERE COLD-FLU CAPLET TABLET 360 30

PV DAYTIME COLD-FLU RLF PLUS CAPSULE 360 30

PV DAYTIME COLD-FLU RLF SFTGL CAPSULE 360 30

PV LANSOPRAZOLE DR 15 MG CAP CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 30

PV MUCUS RELIEF DM TABLET TABLET 180 30

PV MUCUS RELIEF SEV COLD CPLT TABLET 360 30

PV MUCUS RLF COLD-FLU-THR CPLT TABLET 360 30

PV NIGHT COLD-FLU RELIEF SFTGL CAPSULE 240 30

PV NIGHTTIME SINUS SOFTGEL CAPSULE 240 30

PV NIGHT-TIME SINUS SOFTGEL CAPSULE 240 30

PV NIGHT-TIME SOFTGEL CAPSULE 240 30

PV NON-ASA SEVERE CONGEST CPLT TABLET 360 30

PV TUSSIN COUGH DM LIQUID LIQUID (ML) 1800 30

PV TUSSIN COUGH LIQUID LIQUID (ML) 360 30

PV TUSSIN DM LIQUID LIQUID (ML) 1800 30

PV TUSSIN DM MAX LIQUID LIQUID (ML) 1800 30

PV TUSSIN DM SYRUP SYRUP 1800 30

QC MUCUS RELIEF DM TABLET TABLET 180 30

QC TUSSIN DM LIQUID LIQUID (ML) 1800 30

Q-TUSSIN DM SYRUP SYRUP 1800 30

QUAZEPAM 15 MG TABLET TABLET 30 30

QUETIAPINE ER 150 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

QUETIAPINE ER 200 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

QUILLICHEW ER 20 MG CHEW TAB TABLET,CHEW,IR AND ER BIPHASIC REL 24HR 30 30

QUILLIVANT XR 25 MG/5 ML SUSP SUSPENSION,EXTENDED RELEASE,RECONST.24HR 360 30

RA ANTI-TUSSIVE DM SYRUP SYRUP 1800 30

RA COLD MULTI-SYMPTOM CAPLET TABLET 360 30

RA DAY COLD-FLU RELIEF SOFTGEL CAPSULE 360 30

RA ESOMEPRAZOLE MAG DR 20 MG CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 30

RA LANSOPRAZOLE DR 15 MG CAP CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 30

RA LIDOCAINE ANORECTAL 5% CRM CREAM (GRAM) 60 22

RA MUCUS RELIEF PLUS CAPLET TABLET 360 30

RA MUCUS RLF COLD-FLU-THROAT TABLET 360 30

RA MUCUS RLF SEV CONGEST-COLD TABLET 360 30

RA MULTI-SYMPTOM COLD CAPLET TABLET 360 30

RA NIGHT COLD-FLU RELIEF SFTGL CAPSULE 240 30

RA TUSSIN COUGH LIQUID LIQUID (ML) 1800 30

RA TUSSIN DM COUGH-CHEST SYRUP SYRUP 1800 30

RA TUSSIN DM SYRUP SYRUP 1800 30

RA TUSSIN MAX STRN COUGH SYRUP SYRUP 360 30

RAPAFLO 4 MG CAPSULE CAPSULE 30 30

RAZADYNE 8 MG TABLET TABLET 30 30

RECTASMOOTHE 5% CREAM CREAM (GRAM) 60 22

RECTICARE 5% CREAM CREAM (GRAM) 60 22

REFENESEN DM CAPLET TABLET 180 30

REGENECARE HA 2% GEL GEL (ML) 60 22

RELCOF DM 4-15-7.5 MG/5 ML LIQ LIQUID (ML) 1200 30

RELHIST DMX 15-380-10 MG TAB TABLET 240 30

RELION NOVOLIN 70-30 FLEXPEN INSULIN PEN (ML) 90 30

RELION NOVOLIN 70-30 VIAL VIAL (ML) 90 30

RELION NOVOLIN N 100 UNIT/ML VIAL (ML) 90 30

RELION NOVOLIN R 100 UNIT/ML VIAL (ML) 90 30

REMERON 15 MG SOLTAB TABLET,DISINTEGRATING 90 30

REMERON 15 MG TABLET TABLET 90 30

REPAGLINIDE 0.5 MG TABLET TABLET 480 30

REPAGLINIDE 1 MG TABLET TABLET 240 30

REPAGLINIDE 2 MG TABLET TABLET 240 30

REPREXAIN 10-200 MG TABLET TABLET 150 30

REPREXAIN 5-200 MG TABLET TABLET 150 30

RESCON-DM LIQUID LIQUID (ML) 1800 30

RESTORIL 15 MG CAPSULE CAPSULE 30 30

RESTORIL 22.5 MG CAPSULE CAPSULE 30 30

RESTORIL 30 MG CAPSULE CAPSULE 30 30

RESTORIL 7.5 MG CAPSULE CAPSULE 30 30

REVATIO 10 MG/ML ORAL SUSP SUSPENSION, RECONSTITUTED, ORAL (ML) 180 30

REVATIO 20 MG TABLET TABLET 90 30

RISPERDAL 0.25 MG TABLET TABLET 90 30

RISPERDAL 0.5 MG TABLET TABLET 90 30

RISPERDAL 1 MG TABLET TABLET 90 30

RISPERDAL 2 MG TABLET TABLET 90 30

RISPERDAL CONSTA 25 MG SYR SYRINGE (EA) 2.16 30

RISPERIDONE 0.25 MG TABLET TABLET 90 30

RISPERIDONE 0.5 MG ODT TABLET,DISINTEGRATING 90 30

RISPERIDONE 0.5 MG TABLET TABLET 90 30

RISPERIDONE 1 MG ODT TABLET,DISINTEGRATING 90 30

RISPERIDONE 1 MG TABLET TABLET 90 30

RISPERIDONE 2 MG ODT TABLET,DISINTEGRATING 90 30

RISPERIDONE 2 MG TABLET TABLET 90 30

RITALIN 10 MG TABLET TABLET 90 30



RITALIN LA 10 MG CAPSULE CAPSULE,EXTENDED RELEASE BIPHASIC 50-50 30 30




RI-TUSSIN DM SYRUP SYRUP 1800 30

ROBAFEN DM CGH-CHEST CONG SYRP SYRUP 1800 30

ROBAFEN DM COUGH LIQUID LIQUID (ML) 1800 30

ROBAFEN DM COUGH SYRUP LIQUID (ML) 1800 30

ROBAFEN-DM SYRUP SYRUP 1800 30

ROSUVASTATIN CALCIUM 10 MG TAB TABLET 30 30



ROXICODONE 15 MG TABLET TABLET 240 30



ROZEREM 8 MG TABLET TABLET 30 30

SAFETUSSIN DM LIQUID LIQUID (ML) 1800 30

SANTYL OINTMENT OINTMENT (GRAM) 270 30

SB COLD-FLU SEVERE CAPLET TABLET 360 30

SB COUGH CONTROL DM LIQUID LIQUID (ML) 1800 30

SB TAB TUSSIN DM 400-20 MG TABLET 180 30

SEROQUEL XR 150 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

SEROQUEL XR 200 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

SERTRALINE HCL 25 MG TABLET TABLET 90 30

SERTRALINE HCL 50 MG TABLET TABLET 90 30

SEVERE COLD MULTI-SYMPTOM CPLT TABLET 360 30

SEVERE COLD-FLU CAPLET TABLET 360 30

SEVERE COLD-FLU NIGHTTIME LIQ LIQUID (ML) 5400 30

SILDENAFIL 10 MG/ML ORAL SUSP SUSPENSION, RECONSTITUTED, ORAL (ML) 180 30

SILDENAFIL 20 MG TABLET TABLET 90 30

SILENOR 3 MG TABLET TABLET 30 30

SILENOR 6 MG TABLET TABLET 30 30

SILODOSIN 4 MG CAPSULE CAPSULE 30 30

SILTUSSIN DM COUGH SYRUP SYRUP 1800 30

SILTUSSIN DM DAS LIQUID LIQUID (ML) 1800 30

SIMPONI 100 MG/ML PEN INJECTOR PEN INJECTOR (ML) 3.3 30

SIMPONI 100 MG/ML SYRINGE SYRINGE (ML) 3.3 30

SIMPONI 50 MG/0.5 ML PEN INJEC PEN INJECTOR (ML) 0.6 30

SIMPONI 50 MG/0.5 ML SYRINGE SYRINGE (ML) 0.6 30

SIMVASTATIN 10 MG TABLET TABLET 30 30




SKLICE 0.5% LOTION LOTION (GRAM) 117 23

SLO-NIACIN 500 MG TABLET TABLET, EXTENDED RELEASE 30 30

SM CHEST CONGEST RLF DM CAPLET TABLET 180 30

SM COLD HEAD CONGESTION CAPLET TABLET 360 30

SM COLD-FLU SEVERE CAPLET TABLET 360 30

SM COUGH RELIEF LIQUID LIQUID (ML) 360 30

SM DAY TIME COLD-FLU RLF SFTGL CAPSULE 360 30

SM ESOMEPRAZOLE MAG DR 20 MG CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 30

SM LANSOPRAZOLE DR 15 MG CAP CAPSULE,DELAYED RELEASE (ENTERIC COATED) 30 30

SM NIGHTTIME COLD-FLU SFTGL CAPSULE 240 30

SM TUSSIN DM LIQUID LIQUID (ML) 1800 30

SM TUSSIN DM SYRUP SYRUP 1800 30

SOLIFENACIN 5 MG TABLET TABLET 30 30

SOMA 250 MG TABLET TABLET 168 30

SOMA 350 MG TABLET TABLET 140.001 30

SONATA 10 MG CAPSULE CAPSULE 30 30

SORBUGEN NR 150-15 MG/7.5 ML LIQUID (ML) 1800 30

SPINOSAD 0.9% TOPICAL SUSP SUSPENSION, TOPICAL (ML) 120 7

SPRIX 15.75 MG NASAL SPRAY SPRAY, NON-AEROSOL (EA) 30 30

STARLIX 120 MG TABLET TABLET 90 30

STARLIX 60 MG TABLET TABLET 90 30

SUBSYS 1,200 MCG SPRAY SPRAY, NON-AEROSOL (EA) 120 30

SUBSYS 1,600 MCG SPRAY SPRAY, NON-AEROSOL (EA) 120 30

SUBSYS 100 MCG SPRAY SPRAY, NON-AEROSOL (EA) 120 30





SYMBYAX 3-25 MG CAPSULE CAPSULE 30 30

SYMBYAX 6-25 MG CAPSULE CAPSULE 30 30

SYMLINPEN 120 PEN INJECTOR PEN INJECTOR (ML) 10.8 22

SYMLINPEN 60 PEN INJECTOR PEN INJECTOR (ML) 6 22

SYNAGIS 100 MG/1 ML VIAL VIAL (ML) 1 26

SYNAGIS 50 MG/0.5 ML VIAL VIAL (ML) 1 26

SYNALGOS-DC CAPSULE CAPSULE 180 30

SYNERA PATCH ADHESIVE PATCH, MEDICATED SELF-HEATING 10 22

SYNJARDY 12.5-1,000 MG TABLET TABLET 60 30

SYNJARDY 12.5-500 MG TABLET TABLET 60 30

SYNJARDY 5-1,000 MG TABLET TABLET 60 30

SYNJARDY 5-500 MG TABLET TABLET 60 30

TANZEUM 30 MG PEN INJECT PEN INJECTOR (EA) 4 22

TANZEUM 50 MG PEN INJECT PEN INJECTOR (EA) 4 22

TELMISARTAN 20 MG TABLET TABLET 30 30

TELMISARTAN 40 MG TABLET TABLET 30 30

TELMISARTAN-HCTZ 40-12.5 MG TB TABLET 30 30

TEMAZEPAM 15 MG CAPSULE CAPSULE 30 30

TEMAZEPAM 22.5 MG CAPSULE CAPSULE 30 30

TEMAZEPAM 30 MG CAPSULE CAPSULE 30 30

TEMAZEPAM 7.5 MG CAPSULE CAPSULE 30 30

TERAZOSIN 1 MG CAPSULE CAPSULE 30 30

TERAZOSIN 5 MG CAPSULE CAPSULE 30 30

TG 10PEH-380GFN-15DM TABLET TABLET 240 30

THERAFLU EXPRESSMAX DAY CAPLET TABLET 360 30

THERAGEN 0.025% CREAM CREAM (GRAM) 120 22

TOLTERODINE TART ER 2 MG CAP CAPSULE, EXT RELEASE 24 HR 30 30

TOPROL XL 100 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30



TOUJEO MAX SOLOSTAR 300UNIT/ML INSULIN PEN (ML) 30 30

TOUJEO SOLOSTAR 300 UNIT/ML INSULIN PEN (ML) 30 30

TOVIAZ ER 4 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

TRADJENTA 5 MG TABLET TABLET 30 30

TRAMADOL ER 100 MG TABLET TABLET,EXTENDED RELEASE MULTIPHASE 24 HR 30 30



TRAMADOL HCL 50 MG TABLET TABLET 240 30

TRAMADOL HCL ER 100 MG CAPSULE CAPSULE,EXT.RELEASE 24 HR BIPHASIC 25-75 30 30

TRAMADOL HCL ER 100 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30






TRAMADOL-ACETAMINOPHN 37.5-325 TABLET 240 30

TRANDOLAPRIL 1 MG TABLET TABLET 30 30

TRANDOLAPRIL 2 MG TABLET TABLET 30 30

TRESIBA FLEXTOUCH 100 UNIT/ML INSULIN PEN (ML) 45 30

TRESIBA FLEXTOUCH 200 UNIT/ML INSULIN PEN (ML) 45 30

TRIAZOLAM 0.125 MG TABLET TABLET 30 30

TRIAZOLAM 0.25 MG TABLET TABLET 60 30

TRIKLO 1 GM CAPSULE CAPSULE 120 30

TRULICITY 0.75 MG/0.5 ML PEN PEN INJECTOR (ML) 2 21

TRULICITY 1.5 MG/0.5 ML PEN PEN INJECTOR (ML) 2 21

TUSICOF CAPLET TABLET 180 30

TUSNEL DIABETIC LIQUID LIQUID (ML) 1800 30

TUSSI PRES-B LIQUID LIQUID (ML) 900 30

TUSSIN COUGH LIQUID LIQUID (ML) 360 30

TUSSIN COUGH SYRUP SYRUP 360 30

TUSSIN COUGH-CHEST CONGEST LIQ LIQUID (ML) 1800 30

TUSSIN DM 400-20 MG TABLET TABLET 180 30

TUSSIN DM CLEAR SYRUP SYRUP 1800 30

TUSSIN DM COUGH & CHEST SYRUP SYRUP 1800 30

TUSSIN DM COUGH SYRUP SYRUP 1800 30

TUSSIN DM LIQUID LIQUID (ML) 1800 30

TUSSIN DM SYRUP SYRUP 1800 30

TUSSI-PRES B LIQUID LIQUID (ML) 900 30

TYLENOL WITH CODEINE #3 TABLET TABLET 360 30

TYLENOL WITH CODEINE #4 TABLET TABLET 240 30

ULTRACET TABLET TABLET 240 30

ULTRAM 50 MG TABLET TABLET 240 30

ULTRAM ER 100 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30



VALSARTAN 160 MG TABLET TABLET 60 30

VALSARTAN 80 MG TABLET TABLET 60 30

VALSARTAN-HCTZ 160-12.5 MG TAB TABLET 60 30

VALSARTAN-HCTZ 80-12.5 MG TAB TABLET 60 30

VENLAFAXINE HCL ER 37.5 MG CAP CAPSULE, EXT RELEASE 24 HR 30 30

VENLAFAXINE HCL ER 37.5 MG TAB TABLET, EXTENDED RELEASE 24 HR 30 30

VENLAFAXINE HCL ER 75 MG CAP CAPSULE, EXT RELEASE 24 HR 30 30

VENLAFAXINE HCL ER 75 MG TAB TABLET, EXTENDED RELEASE 24 HR 30 30

VERAPAMIL ER PM 100 MG CAPSULE CAPSULE,24HR EXTENDED RELEASE PELLET CT 30 30

VERELAN PM 100 MG CAP PELLET CAPSULE,24HR EXTENDED RELEASE PELLET CT 30 30

VESICARE 5 MG TABLET TABLET 30 30

VICKS DAYQUIL LIQUICAPS CAPSULE 360 30

VICKS DAYQUIL SEVERE COLD-FLU TABLET 360 30

VICKS NATURE FUSION CAPLETS TABLET 360 30

VICKS NYQUIL LIQUICAPS CAPSULE 240 30

VICKS NYQUIL SEVERE COLD-FLU LIQUID (ML) 5400 30

VICKS NYQUIL SINEX LIQUICAPS CAPSULE 240 30

VICKS QLEARQUIL NIGHT LIQUICAP CAPSULE 240 30

VICKS SINEX NIGHTTIME LIQUICAP CAPSULE 240 30

VICODIN 5-300 MG TABLET TABLET 390 30

VICODIN ES 7.5-300 MG TABLET TABLET 390 30

VICODIN HP 10-300 MG TABLET TABLET 390 30

VICTOZA 2-PAK 18 MG/3 ML PEN PEN INJECTOR (ML) 9 22

VICTOZA 3-PAK 18 MG/3 ML PEN PEN INJECTOR (ML) 9 22

VOLTAREN 1% GEL GEL (GRAM) 1020 30

VYVANSE 20 MG CAPSULE CAPSULE 30 30






WAL-TUSSIN LONG ACT COUGH SYRP SYRUP 360 30

WAL-TUSSIN MAX STR COUGH SYRUP SYRUP 360 30

WAL-ZYR 10 MG TABLET TABLET 360 30

WELLBUTRIN XL 150 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

XANAX 0.25 MG TABLET TABLET 90 30

XANAX 0.5 MG TABLET TABLET 90 30

XANAX 1 MG TABLET TABLET 300 30

XANAX 2 MG TABLET TABLET 150 30

XANAX XR 0.5 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

XANAX XR 1 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30



XELJANZ 5 MG TABLET TABLET 60 30

XELJANZ XR 11 MG TABLET TABLET, EXTENDED RELEASE 24 HR 30 30

XIFAXAN 200 MG TABLET TABLET 90 30

XIFAXAN 550 MG TABLET TABLET 90 30

XIGDUO XR 10 MG-1,000 MG TAB TABLET,IMMED AND EXTEND REL BIPHASE 24HR 30 30

XIGDUO XR 10 MG-500 MG TABLET TABLET,IMMED AND EXTEND REL BIPHASE 24HR 30 30

XIGDUO XR 5 MG-1,000 MG TABLET TABLET,IMMED AND EXTEND REL BIPHASE 24HR 60 30

XIGDUO XR 5 MG-500 MG TABLET TABLET,IMMED AND EXTEND REL BIPHASE 24HR 60 30

XYLOCAINE IV 2% AMPUL AMPUL (ML) 125 22

XYLON 10-200 MG TABLET TABLET 150 30

XYREM 500 MG/ML ORAL SOLUTION SOLUTION, ORAL 540 30

ZALEPLON 10 MG CAPSULE CAPSULE 30 30

ZALEPLON 5 MG CAPSULE CAPSULE 30 30

ZAMICET 10-325 MG/15 ML SOLN SOLUTION, ORAL 5400 30

ZENZEDI 10 MG TABLET TABLET 180 30

ZENZEDI 5 MG TABLET TABLET 90 30

ZOCOR 10 MG TABLET TABLET 30 30




ZOLOFT 25 MG TABLET TABLET 90 30

ZOLOFT 50 MG TABLET TABLET 90 30

ZOLPIDEM TART 1.75 MG TAB SL TABLET, SUBLINGUAL 30 30

ZOLPIDEM TART 3.5 MG TABLET SL TABLET, SUBLINGUAL 30 30

ZOLPIDEM TART ER 12.5 MG TAB TABLET, EXTENDED RELEASE MULTIPHASE 30 30

ZOLPIDEM TART ER 6.25 MG TAB TABLET, EXTENDED RELEASE MULTIPHASE 30 30

ZOLPIDEM TARTRATE 10 MG TABLET TABLET 30 30

ZOLPIDEM TARTRATE 5 MG TABLET TABLET 30 30

ZOLPIMIST 5 MG ORAL SPRAY AEROSOL, SPRAY WITH PUMP (ML) 30 30

ZOSTRIX 0.025% CREAM CREAM (GRAM) 120 22

ZYNCOF 400-20 MG TABLET TABLET 180 30

ZYPREXA 10 MG TABLET TABLET 60 30

ZYPREXA 2.5 MG TABLET TABLET 90 30

ZYPREXA 5 MG TABLET TABLET 90 30

ZYPREXA 7.5 MG TABLET TABLET 60 30

ZYPREXA ZYDIS 10 MG TABLET TABLET,DISINTEGRATING 60 30

ZYPREXA ZYDIS 5 MG TABLET TABLET,DISINTEGRATING 90 30

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