basic annual drug list - bcbsil

2656-1C IL © Prime Therapeutics LLC 10/20

Basic Annual Drug List October 2020 Please consider talking to your doctor about prescribing preferred medications, which may help reduce your out-of-pocket costs. This list may help guide you and your doctor in selecting an appropriate medication for you.

The drug list is regularly updated. You can view the most up-to-date list, or the specialty drug list, at myprime.com or bcbsil.com.

ContentsS Introduction ...................................................................... I How drugs are selected ................................................... I How member payment is determined .............................. I How to use this list .......................................................... II Drugs used to treat multiple conditions .......................... II Generic drugs ................................................................ III Consider talking to your doctor about generic drugs ............................................................................ III

Coverage considerations ............................................... IV Specialty drugs .............................................................. VI AllianceRx Walgreens Prime ......................................... VI Abbreviation key ........................................................... VII

Therapeutic Class Drug List Anti-Infective Agents ....................................................... 1 Antineoplastic Agents ..................................................... 6 Endocrine and Metabolic Drugs ..................................... 9 Cardiovascular Agents .................................................. 18 Respiratory Agents ....................................................... 26 Gastrointestinal Drugs .................................................. 29 Genitourinary Drugs ...................................................... 32 Central Nervous System Drugs .................................... 33 Analgesics and Anesthetics .......................................... 41 Neuromuscular Drugs ................................................... 46 Nutritional Products ...................................................... 49 Hematological Agents ................................................... 49 Topical Products ........................................................... 56 Miscellaneous Products ................................................ 61 Index ............................................................................. 64

To search for a drug name within this PDF document, use the Control and F keys on your keyboard, or go to Edit in the drop-down menu and select Find/Search. Type in the word or phrase you are looking for and click on Search.

Blue Cross and Blue Shield October 2020 Basic Annual Drug List I

Introduction Blue Cross and Blue Shield of Illinois (BCBSIL) is pleased to present the 2020 Drug List. This is a list of preferred drugs which includes brand drugs and a partial listing of generic drugs. Members are encouraged to show this list to their physicians and pharmacists. Physicians are encouraged to prescribe drugs on this list, when right for the member. However, decisions regarding therapy and treatment are always between members and their physician.

Drug List updates – This list is regularly updated as generic drugs become available and changes take place in the pharmaceuticals market. For the most up-to-date information, visit myprime.com or bcbsil.com and log in to Blue Access for MembersSM (BAMSM) or call the number on your ID card. Physicians can access the list from the provider portal at bcbsil.com.

How drugs are selected Drugs on this list are selected based on the recommendations of a committee made up of physicians and pharmacists from throughout the country. The committee, which includes at least one representative from BCBSIL, reviews drugs regulated by the U.S. Food and Drug Administration (FDA).

Both drugs that are newly approved by the FDA as well as those that have been on the market for some time are considered. Drugs are selected based on safety, efficacy, cost and how they compare to other drugs currently on the list.

How member payment is determined Generally, each drug is placed into one of up to six member payment tiers: Preferred Generic (Tier 1), Non-Preferred Generic (Tier 2), Preferred Brand (Tier 3), Non-Preferred Brand (Tier 4), Preferred Specialty (Tier 5) and Non-Preferred Specialty (Tier 6). Non-Preferred Brand or Non-Preferred Specialty drugs are not listed in this document. Based on your benefit design, drugs can either be in these tiers or you may have fewer tiers, e.g., all generics in one tier. Some brands may be in a generic tier and some generics may be in a brand tier. Note: Covered substance use disorder drugs (those FDA-approved for treatment of opioid drug abuse, alcohol abuse and to quit tobacco use) may be in the lowest tiers. Substance use disorder brand drugs may be in the lowest brand tier and generic drugs in the lowest generic tier, based on your benefit plan. These drugs are those with such active ingredients as buprenorphine-naloxone, methadone, naltrexone, disulfiram, acamprosate, bupropion (smoking deterrent), varenicline and nicotine replacement therapy. To verify your payment amount for a drug, visit MyPrime.com and log in or call the number on your ID card.

Your pharmacy benefit includes coverage for many prescription drugs, although some exclusions may apply. For example, drugs indicated for cosmetic purposes, e.g., Propecia, for hair growth, may not be covered. Drugs that have not received FDA approval may not be covered. Prescription products that have over-the-counter (OTC) equivalents may not be covered. Drugs that are not FDA-approved for self-administration or vaccines may be available through your medical benefit. Check your plan materials for details.

Blue Cross and Blue Shield October 2020 Basic Annual Drug List II

How to use this list Generic drugs are shown in lower-case boldface type. Most generic drugs are followed by a reference brand drug in (parentheses). The reference brand drug is usually a non-preferred (NP) brand and is only included as a reference to the brand. Some generic products have no reference brand.

Example: atorvastatin (Lipitor)

Brand prescription drugs are shown in all CAPITAL letters followed by the generic name.

Example: NOVOLOG – Insulin aspart inj 100 unit/ml

Drugs used to treat multiple conditions

Some drugs in the same dosage form may be used to treat more than one medical condition. In these instances, each medication is classified according to its first FDA-approved use. Please check the index if you do not find your particular medication in the class/condition section that corresponds to your use.

Please note: Drugs that need a health care provider to administer them and are often given to you in a hospital, doctor’s office or other health care setting may be covered under your medical benefit. Some types of these drugs are contraceptive implants and chemo infusions. If you are taking or are prescribed a drug that is not on this drug list, call the number on your ID card to see if the drug may be covered.

Blue Cross and Blue Shield October 2020 Basic Annual Drug List III

Generic drugs Using generic drugs, when right for you, can help you save on your out-of-pocket medication costs. Generic drugs must be approved by the FDA just as brand drugs are, and must meet the same standards.

There are two types of generic drugs:

• A generic equivalent is made with the same active ingredient(s) at the same dosage as the reference drug. • A generic alternative is a drug typically used to treat the same condition, but the active ingredient(s)

differs from the brand drug.

According to the FDA, compared to its brand counterpart, an FDA-approved generic drug:

• Is chemically the same • Works just as well in the body

• Is as safe and effective

• Meets the same standards set by the FDA

The main difference between the reference brand drug and the generic equivalent is that the generic often costs much less.

Preferred brand drugs typically move to a non-preferred brand tier after a generic equivalent becomes available.

You may be responsible for your member cost-share payment amount (copay or coinsurance) plus the difference in cost between the brand and generic equivalent if you or your doctor requests the reference brand rather than the generic. Generic drugs generally have the lowest member payment amount.

Consider talking to your doctor about generic drugs

If your doctor writes a prescription for a brand drug that does not have a generic equivalent, consider asking if an appropriate generic alternative is available.

You can also let your pharmacist know that you would like a generic equivalent for a brand drug, whenever one is available. Your pharmacist can usually substitute a generic equivalent for its brand counterpart without a new prescription from your doctor.

Only your doctor can determine whether a generic alternative is right for you and must prescribe the medication.

Blue Cross and Blue Shield October 2020 Basic Annual Drug List IV

Coverage considerations Most prescription drug benefit plans provide coverage for up to a 30-day supply of medication, with some exceptions. Your plan may also provide coverage for up to a 90-day supply of maintenance medications. Maintenance medications are those drugs you may take on an ongoing basis for conditions such as high blood pressure, diabetes or high cholesterol. Some plans may exclude coverage for certain agents or drug categories, like those used for erectile dysfunction or weight loss. Also, some drugs may only be covered for members within a certain age range due to the drug being used for cosmetic purposes or for safety concerns. Drug coverage may be limited to recommendations based on FDA-approved labeling and recognized evidence-based or clinical practice guidelines.

Over-the-counter exclusions: Your benefit plan may not provide coverage for prescription medications that have an over-the-counter version. You should refer to your benefit plan material for details about your particular benefits.

Compounded medications: Your benefit plan may not provide coverage for compounded medications. Please see your plan materials or call the number on your ID card to determine whether compounded medications are covered and/or verify your payment amount.

Repackaged medications: Repackaged versions of medications already available on the market are not covered.

Non FDA-approved drugs: Drugs that have not received FDA approval are not covered.Prior Authorization (PA): Your benefit plan may require prior authorization for certain drugs. This means that your doctor will need to submit a prior authorization request for coverage of these medications, and the request will need to be approved, before the medication may be covered under your plan. For the medications listed in this document, if a prior authorization is commonly required, it will generally be noted next to the medication with a dot under the prior authorization column. Some plans may have prior authorization on additional medications beyond those noted in this document. Refer to your benefit plan materials for details about your particular benefits.

Step Therapy (ST): Your benefit plan may include a step therapy program. This means you may need to try another proven, cost-effective medication before coverage may be available for the drug included in the program. Many brand drugs have less-expensive generic or brand alternatives that might be an option for you. For the medications listed in this document, if a step therapy is commonly required, it will generally be noted next to the medication with a dot under the step therapy column. Some plans may have step therapy programs on additional medications beyond those noted in this document. Refer to your benefit plan materials for details about your particular benefits.

Dispensing Limits (DL): Drug dispensing limits help encourage medication use as intended by the FDA. Dispensing limits are placed on medications in certain drug categories. For the medications listed in this document, if a dispensing limit applies, it will generally be noted next to the medication with a dot under the dispensing limits column. Limits may include: quantity of covered medication per prescription or quantity of covered medication in a given time period. If your doctor prescribes a greater quantity of medication than what the dispensing limit allows, you can still get the medication. However, you may be responsible for the full cost of the prescription beyond what your coverage allows.* Some plans may have a dispensing limit on additional medications beyond those noted in this document. For a list of medications and their dispensing limits, visit myprime.com or bcbsil.com.

*Please note: For certain controlled substance medications, some state laws may not allow coverage by a health benefit plan of such medication if dispensed in a quantity beyond what the dispensing limit allows. You will be responsible for the full cost of the prescription with no benefits applied if the dispensed quantity exceeds the dispensing limit.

Blue Cross and Blue Shield October 2020 Basic Annual Drug List V

Remember, medication decisions are between you and your doctor. Only you and your doctor can determine which medication is right for you. Discuss any questions or concerns you have about medications you are taking or are prescribed with your doctor. BCBSIL does not provide health care services and, therefore, cannot guarantee any results or outcomes.

Blue Cross and Blue Shield October 2020 Basic Annual Drug List VI

Specialty drugs Specialty drugs are used in the treatment of medical conditions such as hepatitis, hemophilia, multiple sclerosis and rheumatoid arthritis. Specialty drugs may be oral, topical or injectable medications that can either be self-administered or administered by a health care professional. Medications administered by a health care professional are not covered under the pharmacy benefit. For a current list of specialty medications, visit myprime.com or bcbsil.com and log in to Blue Access for Members.

Note that some drug classes may be excluded by some plans and therefore may not be covered under your pharmacy benefit. Your plan may have a different coverage level for self-administered specialty drugs. If you have questions about your coverage for specialty medications or your prescription drug benefit, call the number on your ID card.

AllianceRx Walgreens Prime

Through AllianceRx Walgreens Prime, members can have covered specialty medications delivered directly to them or their doctor’s office. When you receive specialty medications through AllianceRx Walgreens Prime, you also receive at no additional charge the following services:

• Coordination of coverage between you, your doctor and your health plan • Educational materials about your particular condition and information about managing potential

medication side effects • Syringes, sharps containers and other supplies with every shipment for self-injectables

• 24/7/365 phone access to a pharmacist for urgent medication issues

To order through AllianceRx Walgreens Prime:

• Have your doctor call 877-627-6337 or e-prescribe your prescription to AllianceRx Walgreens Prime. Your doctor can find e-prescribing information at www.alliancerxwp.com.

• If you have an existing prescription for a covered specialty medication, you can call 877-627-6337 to transfer your prescription.

• A coordinator will contact you to arrange delivery of your medication. • The prescription can be shipped directly to you or your prescribing doctor’s office. Each package is

individually marked for each member. Refrigerated drugs are shipped in temperature-controlled packaging.

If you have questions, please contact AllianceRx Walgreens Prime at 877-627-6337, visit www.alliancerxwp.com, or call the number on your ID card.

* Blue Cross and Blue Shield of Illinois (BCBSIL) is a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. BCBSIL contracts with Prime Therapeutics to provide pharmacy benefit management and other related services. BCBSIL, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics LLC.

Blue Cross and Blue Shield October 2020 Basic Annual Drug List VII

Abbreviation key aer..................................................................... aerosol cap ................................................................. capsules chew ............................................................. chewable conc .......................................................... concentrate cr...................................................... controlled release dr ........................................................ delayed release ec ........................................................... enteric coated equiv ........................................................... equivalent er....................................................... extended release gm........................................................................ gram inhal................................................................... inhaler inj .................................................................... injection liqd....................................................................... liquid mg.................................................................. milligram ml ..................................................................... milliliter

nebu .............................................................. nebulizer odt. ....................................... orally disintegrating tabs oint .................................................................ointment ophth .......................................................... ophthalmic osm ..................................................... osmotic release pack ................................................................. packets powd ................................................................. powder pttw ................................................ twice-weekly patch sl .................................................................. sublingual soln .................................................................. solution suppos ................................................... suppositories susp ........................................................... suspension tab ...................................................................... tablets td ............................................................... transdermal w/ ........................................................................... with

2020

Blue Cross and Blue Shield October 2020 Basic Annual Drug List 1

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ANTI-INFECTIVE AGENTSPENICILLINSamoxicillin (trihydrate) cap 250 mgamoxicillin (trihydrate) cap 500 mgamoxicillin (trihydrate) for susp

125 mg/5mlamoxicillin (trihydrate) for susp



400 mg/5mlamoxicillin (trihydrate) tab 500 mgamoxicillin (trihydrate) tab 875 mgamoxicillin & k clavulanate for susp

200-28.5 mg/5mlamoxicillin & k clavulanate for susp

250-62.5 mg/5ml (Augmentin)amoxicillin & k clavulanate for susp

400-57 mg/5mlamoxicillin & k clavulanate for susp

600-42.9 mg/5ml (Augmentin es-600)amoxicillin & k clavulanate tab

250-125 mgamoxicillin & k clavulanate tab

500-125 mg (Augmentin)amoxicillin & k clavulanate tab

875-125 mg (Augmentin)dicloxacillin sodium cap 250 mgdicloxacillin sodium cap 500 mgpenicillin v potassium tab 250 mgpenicillin v potassium tab 500 mgCEPHALOSPORINScefaclor cap 250 mgcefaclor cap 500 mg

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cefadroxil cap 500 mgcefadroxil for susp 250 mg/5mlcefadroxil for susp 500 mg/5mlcefadroxil tab 1 gmcefdinir cap 300 mgcefdinir for susp 125 mg/5mlcefdinir for susp 250 mg/5mlcefixime cap 400 mg (Suprax)cefixime for susp 100 mg/5ml

(Suprax)cefixime for susp 200 mg/5ml

(Suprax)cefpodoxime proxetil for susp

50 mg/5mlcefpodoxime proxetil for susp

100 mg/5mlcefpodoxime proxetil tab 100 mgcefpodoxime proxetil tab 200 mgcefprozil for susp 125 mg/5mlcefprozil for susp 250 mg/5mlcefprozil tab 250 mgcefprozil tab 500 mgceftriaxone sodium for inj 250 mgceftriaxone sodium for inj 500 mgceftriaxone sodium for inj 1 gmceftriaxone sodium for inj 2 gmcefuroxime axetil tab 250 mg (Ceftin)cefuroxime axetil tab 500 mg (Ceftin)cephalexin cap 250 mg (Keflex)cephalexin cap 500 mg (Keflex)cephalexin for susp 125 mg/5mlcephalexin for susp 250 mg/5mlMACROLIDES

2020


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AZITHROMYCIN - azithromycin powdpack for susp 1 gm

azithromycin for susp 100 mg/5ml(Zithromax)

azithromycin for susp 200 mg/5ml(Zithromax)

azithromycin tab 250 mg (Zithromax) •azithromycin tab 500 mg (Zithromax) •azithromycin tab 600 mg (Zithromax) •clarithromycin tab er 24hr 500 mg •clarithromycin tab 250 mg (Biaxin)clarithromycin tab 500 mg (Biaxin)TETRACYCLINESdemeclocycline hcl tab 150 mgdemeclocycline hcl tab 300 mgdoxycycline hyclate cap 50 mgdoxycycline hyclate cap 100 mg

(Vibramycin)doxycycline hyclate tab 20 mgdoxycycline hyclate tab 100 mgdoxycycline monohydrate cap 50 mgdoxycycline monohydrate cap

100 mg (Monodox)doxycycline monohydrate tab 50 mg

(Adoxa)doxycycline monohydrate tab 75 mg

(Adoxa)doxycycline monohydrate tab

100 mg (Adoxa pak 1/100)doxycycline monohydrate tab

150 mg (Adoxa pak 1/150)•

minocycline hcl cap 50 mg (Minocin)minocycline hcl cap 75 mg (Minocin)minocycline hcl cap 100 mg (Minocin)minocycline hcl tab 50 mg

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minocycline hcl tab 75 mgminocycline hcl tab 100 mgtetracycline hcl cap 250 mg

(Tetracycline hcl)tetracycline hcl cap 500 mg

(Tetracycline hcl)FLUOROQUINOLONESciprofloxacin hcl tab 250 mg (base

equiv) (Cipro)ciprofloxacin hcl tab 500 mg (base

equiv) (Cipro)ciprofloxacin hcl tab 750 mg (base

equiv)levofloxacin oral soln 25 mg/ml

(Levaquin)levofloxacin tab 250 mg (Levaquin)levofloxacin tab 500 mg (Levaquin)levofloxacin tab 750 mg (Levaquin)ofloxacin tab 400 mgAMINOGLYCOSIDESneomycin sulfate tab 500 mgPAROMOMYCIN SULFATE -

paromomycin sulfate cap 250 mgtobramycin nebu soln 300 mg/5ml

(Tobi)• •

SULFONAMIDESSULFADIAZINE - sulfadiazine tab 500

mgANTIMYCOBACTERIAL AGENTSethambutol hcl tab 100 mg

(Myambutol)ethambutol hcl tab 400 mg

(Myambutol)isoniazid tab 300 mgPRIFTIN - rifapentine tab 150 mg

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pyrazinamide tab 500 mgrifabutin cap 150 mg (Mycobutin)rifampin cap 150 mg (Rifadin)rifampin cap 300 mg (Rifadin)ANTIFUNGALSfluconazole for susp 10 mg/ml

(Diflucan)fluconazole for susp 40 mg/ml

(Diflucan)fluconazole tab 50 mg (Diflucan)fluconazole tab 100 mg (Diflucan)fluconazole tab 150 mg (Diflucan)fluconazole tab 200 mg (Diflucan)flucytosine cap 250 mg (Ancobon)flucytosine cap 500 mg (Ancobon)griseofulvin microsize susp

125 mg/5mlgriseofulvin microsize tab 500 mg

(Grifulvin v)itraconazole cap 100 mg (Sporanox) •itraconazole oral soln 10 mg/ml

(Sporanox)•

NOXAFIL - posaconazole tab delayedrelease 100 mg

•

NOXAFIL - posaconazole susp 40 mg/ml

•

nystatin tab 500000 unitposaconazole tab delayed release

100 mg (Noxafil)•

terbinafine hcl tab 250 mg (Lamisil)voriconazole for susp 40 mg/ml

(Vfend)•

voriconazole tab 50 mg (Vfend) •voriconazole tab 200 mg (Vfend) •ANTIVIRALS

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abacavir sulfate soln 20 mg/ml (baseequiv) (Ziagen)

•

abacavir sulfate tab 300 mg (baseequiv) (Ziagen)

•

abacavir sulfate-lamivudine tab600-300 mg (Epzicom)

•

abacavir sulfate-lamivudine-zidovudine tab 300-150-300 mg(Trizivir)

•

acyclovir cap 200 mg (Zovirax)acyclovir susp 200 mg/5ml (Zovirax)acyclovir tab 400 mg (Zovirax)acyclovir tab 800 mg (Zovirax)adefovir dipivoxil tab 10 mg

(Hepsera)atazanavir sulfate cap 150 mg (base

equiv) (Reyataz)•

atazanavir sulfate cap 200 mg (baseequiv) (Reyataz)

•

atazanavir sulfate cap 300 mg (baseequiv) (Reyataz)

•

ATRIPLA - efavirenz-emtricitabine-tenofovir df tab 600-200-300 mg

•

BARACLUDE - entecavir oral soln 0.05mg/ml

BIKTARVY - bictegravir-emtricitabine-tenofovir af tab 50-200-25 mg

•

CIMDUO - lamivudine-tenofovirdisoproxil fumarate tab 300-300 mg

•

DELSTRIGO - doravirine-lamivudine-tenofovir df tab 100-300-300 mg

•

DESCOVY - emtricitabine-tenofoviralafenamide fumarate tab 200-25 mg

•

DOVATO - dolutegravir sodium-lamivudine tab 50-300 mg (base eq)

•

efavirenz cap 50 mg (Sustiva) •efavirenz cap 200 mg (Sustiva) •

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efavirenz tab 600 mg (Sustiva) •entecavir tab 0.5 mg (Baraclude)entecavir tab 1 mg (Baraclude)EPCLUSA - sofosbuvir-velpatasvir tab

400-100 mg• • •

famciclovir tab 125 mg (Famvir)famciclovir tab 250 mg (Famvir)famciclovir tab 500 mg (Famvir)GENVOYA - elvitegrav-cobic-emtricitab-

tenofov af tab 150-150-200-10 mg•

HARVONI - ledipasvir-sofosbuvir tab45-200 mg

• • •

HARVONI - ledipasvir-sofosbuvir tab90-400 mg

• • •

HARVONI - ledipasvir-sofosbuvir pelletpack 33.75-150 mg

• • •

HARVONI - ledipasvir-sofosbuvir pelletpack 45-200 mg

• • •

INTELENCE - etravirine tab 25 mg •INTELENCE - etravirine tab 100 mg •INTELENCE - etravirine tab 200 mg •ISENTRESS - raltegravir potassium

packet for susp 100 mg (base equiv)•

ISENTRESS - raltegravir potassium tab400 mg (base equiv)

•

ISENTRESS - raltegravir potassiumchew tab 25 mg (base equiv)

•

ISENTRESS - raltegravir potassiumchew tab 100 mg (base equiv)

•

ISENTRESS HD - raltegravir potassiumtab 600 mg (base equiv)

•

JULUCA - dolutegravir sodium-rilpivirinehcl tab 50-25 mg (base eq)

•

KALETRA - lopinavir-ritonavir tab100-25 mg

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KALETRA - lopinavir-ritonavir tab200-50 mg

•

lamivudine oral soln 10 mg/ml(Epivir)

•

lamivudine tab 100 mg (hbv) (Epivirhbv)

lamivudine tab 150 mg (Epivir) •lamivudine tab 300 mg (Epivir) •lamivudine-zidovudine tab

150-300 mg (Combivir)•

lopinavir-ritonavir soln400-100 mg/5ml (80-20 mg/ml)(Kaletra)

•

MAVYRET - glecaprevir-pibrentasvir tab100-40 mg

• • •

nevirapine susp 50 mg/5ml(Viramune)

•

nevirapine tab er 24hr 400 mg(Viramune xr)

•

nevirapine tab 200 mg (Viramune) •NORVIR - ritonavir oral soln 80 mg/ml •NORVIR - ritonavir powder packet 100

mg•

ODEFSEY - emtricitabine-rilpivirine-tenofovir af tab 200-25-25 mg

•

oseltamivir phosphate cap 30 mg(base equiv) (Tamiflu)

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•


•

oseltamivir phosphate for susp6 mg/ml (base equiv) (Tamiflu)

•

PEGASYS - peginterferon alfa-2a inj180 mcg/ml

• •

PEGASYS - peginterferon alfa-2a inj180 mcg/0.5ml

• •

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PEGASYS PROCLICK - peginterferonalfa-2a inj 180 mcg/0.5ml

• •

PREZISTA - darunavir ethanolate susp100 mg/ml (base equiv)

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PREZISTA - darunavir ethanolate tab 75mg (base equiv)

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PREZISTA - darunavir ethanolate tab150 mg (base equiv)

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ribavirin cap 200 mg (Rebetol) •ribavirin tab 200 mg (Copegus) •ritonavir tab 100 mg (Norvir) •SOVALDI - sofosbuvir tab 200 mg • • •SOVALDI - sofosbuvir tab 400 mg • • •SOVALDI - sofosbuvir pellet pack 150

mg• • •

SOVALDI - sofosbuvir pellet pack 200mg

• • •

stavudine cap 15 mg (Zerit) •stavudine cap 20 mg (Zerit) •stavudine cap 30 mg (Zerit) •stavudine cap 40 mg (Zerit) •SYMFI - efavirenz-lamivudine-tenofovir

df tab 600-300-300 mg•

SYMFI LO - efavirenz-lamivudine-tenofovir df tab 400-300-300 mg

•

TEMIXYS - lamivudine-tenofovirdisoproxil fumarate tab 300-300 mg

•

tenofovir disoproxil fumarate tab300 mg (Viread)

•

TIVICAY - dolutegravir sodium tab 10mg (base equiv)

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TRUVADA - emtricitabine-tenofovirdisoproxil fumarate tab 100-150 mg

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valacyclovir hcl tab 500 mg (Valtrex)valacyclovir hcl tab 1 gm (Valtrex)valganciclovir hcl for soln 50 mg/ml

(base equiv) (Valcyte)valganciclovir hcl tab 450 mg (base

equivalent) (Valcyte)VIREAD - tenofovir disoproxil fumarate

oral powder 40 mg/gm•

VIREAD - tenofovir disoproxil fumaratetab 150 mg

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•


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VOSEVI - sofosbuvir-velpatasvir-voxilaprevir tab 400-100-100 mg

• • •

zidovudine cap 100 mg (Retrovir) •zidovudine syrup 10 mg/ml (Retrovir) •zidovudine tab 300 mg •ANTIMALARIALSatovaquone-proguanil hcl tab

62.5-25 mg (Malarone)•

atovaquone-proguanil hcl tab250-100 mg (Malarone)

•

2020


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chloroquine phosphate tab 250 mgDARAPRIM - pyrimethamine tab 25 mg • •hydroxychloroquine sulfate tab

200 mg (Plaquenil)MEFLOQUINE HCL - mefloquine hcl tab

250 mgprimaquine phosphate tab 26.3 mg

(15 mg base) (Primaquinephosphate)

pyrimethamine tab 25 mg (Daraprim) • •ANTHELMINTICSalbendazole tab 200 mg (Albenza)BENZNIDAZOLE - benznidazole tab

12.5 mgBENZNIDAZOLE - benznidazole tab

100 mgivermectin tab 3 mg (Stromectol)praziquantel tab 600 mg (Biltricide)ANTI-INFECTIVE AGENTS - MISC.ALINIA - nitazoxanide tab 500 mg •ALINIA - nitazoxanide for susp 100

mg/5ml•

clindamycin hcl cap 75 mg (Cleocin)clindamycin hcl cap 150 mg (Cleocin)clindamycin hcl cap 300 mg (Cleocin)clindamycin palmitate hcl for soln

75 mg/5ml (base equiv) (Cleocinpediatric gr)

dapsone tab 25 mgdapsone tab 100 mgIMPAVIDO - miltefosine cap 50 mglinezolid for susp 100 mg/5ml (Zyvox) •linezolid tab 600 mg (Zyvox) •metronidazole tab 250 mg (Flagyl)metronidazole tab 500 mg (Flagyl)

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pentamidine isethionate fornebulization soln 300 mg(Nebupent)

SIVEXTRO - tedizolid phosphate tab200 mg

•

sulfamethoxazole-trimethoprim susp200-40 mg/5ml

sulfamethoxazole-trimethoprim tab400-80 mg (Bactrim)

sulfamethoxazole-trimethoprim tab800-160 mg (Bactrim ds)

trimethoprim tab 100 mgvancomycin hcl cap 125 mg (base

equivalent) (Vancocin hcl)vancomycin hcl cap 250 mg (base

equivalent) (Vancocin hcl)XIFAXAN - rifaximin tab 550 mg •ANTINEOPLASTIC AGENTSANTINEOPLASTICSabiraterone acetate tab 250 mg

(Zytiga)• • •

ACTIMMUNE - interferon gamma-1b inj100 mcg/0.5ml (2000000 unit/0.5ml)

•

AFINITOR - everolimus tab 2.5 mg • • •AFINITOR - everolimus tab 5 mg • • •AFINITOR - everolimus tab 7.5 mg • • •AFINITOR - everolimus tab 10 mg • • •anastrozole tab 1 mg (Arimidex)AYVAKIT - avapritinib tab 100 mg • • •AYVAKIT - avapritinib tab 200 mg • • •AYVAKIT - avapritinib tab 300 mg • • •bexarotene cap 75 mg (Targretin) • •bicalutamide tab 50 mg (Casodex) •CABOMETYX - cabozantinib s-malate

tab 20 mg (base equivalent)• • •

2020


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CABOMETYX - cabozantinib s-malatetab 40 mg (base equivalent)

• • •

CABOMETYX - cabozantinib s-malatetab 60 mg (base equivalent)

• • •

capecitabine tab 150 mg (Xeloda) • •capecitabine tab 500 mg (Xeloda) • •COTELLIC - cobimetinib fumarate tab

20 mg (base equivalent)• • •

cyclophosphamide cap 25 mg(Cyclophosphamide)

cyclophosphamide cap 50 mg(Cyclophosphamide)

EMCYT - estramustine phosphatesodium cap 140 mg

•

ERIVEDGE - vismodegib cap 150 mg • • •ERLEADA - apalutamide tab 60 mg • • •erlotinib hcl tab 25 mg (base

equivalent) (Tarceva)• • •

erlotinib hcl tab 100 mg (baseequivalent) (Tarceva)

• • •

erlotinib hcl tab 150 mg (baseequivalent) (Tarceva)

• • •

everolimus tab 2.5 mg (Afinitor) • • •everolimus tab 5 mg (Afinitor) • • •everolimus tab 7.5 mg (Afinitor) • • •exemestane tab 25 mg (Aromasin)flutamide cap 125 mghydroxyurea cap 500 mg (Hydrea)IBRANCE - palbociclib cap 75 mg • • •IBRANCE - palbociclib cap 100 mg • • •IBRANCE - palbociclib cap 125 mg • • •IBRANCE - palbociclib tab 75 mg • • •IBRANCE - palbociclib tab 100 mg • • •IBRANCE - palbociclib tab 125 mg • • •

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imatinib mesylate tab 100 mg (baseequivalent) (Gleevec)

• • •

imatinib mesylate tab 400 mg (baseequivalent) (Gleevec)

• • •

KISQALI - ribociclib succinate tab pack200 mg daily dose

• • •

KISQALI - ribociclib succinate tab pack400 mg daily dose (200 mg tab)

• • •

KISQALI - ribociclib succinate tab pack600 mg daily dose (200 mg tab)

• • •

KISQALI FEMARA 200 DOSE -ribociclib 200 mg dose (200 mg tab)& letrozole 2.5 mg tbpk

• • •


• • •


• • •

letrozole tab 2.5 mg (Femara)LEUCOVORIN CALCIUM - leucovorin

calcium tab 10 mgLEUCOVORIN CALCIUM - leucovorin

calcium tab 15 mgleucovorin calcium tab 5 mgleucovorin calcium tab 25 mgLEUKERAN - chlorambucil tab 2 mg •LYNPARZA - olaparib tab 100 mg • • •LYNPARZA - olaparib tab 150 mg • • •megestrol acetate susp 40 mg/ml

(Megace oral)megestrol acetate tab 20 mgmegestrol acetate tab 40 mgMEKINIST - trametinib dimethyl

sulfoxide tab 0.5 mg (baseequivalent)

• • •

2020


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MEKINIST - trametinib dimethylsulfoxide tab 2 mg (base equivalent)

• • •

melphalan tab 2 mg (Alkeran) •mercaptopurine tab 50 mgMESNEX - mesna tab 400 mgmethotrexate sodium tab 2.5 mg

(base equiv)MYLERAN - busulfan tab 2 mg •NEXAVAR - sorafenib tosylate tab 200

mg (base equivalent)• • •

nilutamide tab 150 mg (Nilandron) •NUBEQA - darolutamide tab 300 mg • • •PIQRAY 200MG DAILY DOSE - alpelisib

tab therapy pack 200 mg daily dose• • •

PIQRAY 250MG DAILY DOSE - alpelisibtab pack 250 mg daily dose (200 mg& 50 mg tabs)

• • •

PIQRAY 300MG DAILY DOSE - alpelisibtab pack 300 mg daily dose (2x150mg tab)

• • •

PURIXAN - mercaptopurine susp 2000mg/100ml (20 mg/ml)

•

ROZLYTREK - entrectinib cap 100 mg • • •ROZLYTREK - entrectinib cap 200 mg • • •RUBRACA - rucaparib camsylate tab

200 mg (base equivalent)• • •

RUBRACA - rucaparib camsylate tab250 mg (base equivalent)

• • •

RUBRACA - rucaparib camsylate tab300 mg (base equivalent)

• • •

RYDAPT - midostaurin cap 25 mg • • •SPRYCEL - dasatinib tab 20 mg • • •SPRYCEL - dasatinib tab 50 mg • • •SPRYCEL - dasatinib tab 70 mg • • •SPRYCEL - dasatinib tab 80 mg • • •SPRYCEL - dasatinib tab 100 mg • • •

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SPRYCEL - dasatinib tab 140 mg • • •SUTENT - sunitinib malate cap 12.5 mg

(base equivalent)• • •

SUTENT - sunitinib malate cap 25 mg(base equivalent)

• • •

SUTENT - sunitinib malate cap 37.5 mg(base equivalent)

• • •

SUTENT - sunitinib malate cap 50 mg(base equivalent)

• • •

TABLOID - thioguanine tab 40 mg •TAFINLAR - dabrafenib mesylate cap 50

mg (base equivalent)• • •

TAFINLAR - dabrafenib mesylate cap 75mg (base equivalent)

• • •

TALZENNA - talazoparib tosylate cap0.25 mg (base equivalent)

• • •

TALZENNA - talazoparib tosylate cap 1mg (base equivalent)

• • •

tamoxifen citrate tab 10 mg (baseequivalent)

tamoxifen citrate tab 20 mg (baseequivalent)

TASIGNA - nilotinib hcl cap 50 mg (baseequivalent)

• • •

TASIGNA - nilotinib hcl cap 150 mg(base equivalent)

• • •

TASIGNA - nilotinib hcl cap 200 mg(base equivalent)

• • •

temozolomide cap 5 mg (Temodar) • •temozolomide cap 20 mg (Temodar) • •temozolomide cap 100 mg (Temodar) • •temozolomide cap 140 mg (Temodar) • •temozolomide cap 180 mg (Temodar) • •temozolomide cap 250 mg (Temodar) • •toremifene citrate tab 60 mg (base

equivalent) (Fareston)•

2020


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tretinoin cap 10 mg • •TREXALL - methotrexate sodium tab 5

mg (base equiv)TREXALL - methotrexate sodium tab

7.5 mg (base equiv)TREXALL - methotrexate sodium tab 10

mg (base equiv)TREXALL - methotrexate sodium tab 15

mg (base equiv)VENCLEXTA - venetoclax tab 10 mg • • •VENCLEXTA - venetoclax tab 50 mg • • •VENCLEXTA - venetoclax tab 100 mg • • •VENCLEXTA STARTING PACK -

venetoclax tab therapy starter pack10 & 50 & 100 mg

• • •

VERZENIO - abemaciclib tab 50 mg • • •VERZENIO - abemaciclib tab 100 mg • • •VERZENIO - abemaciclib tab 150 mg • • •VERZENIO - abemaciclib tab 200 mg • • •VITRAKVI - larotrectinib sulfate oral soln

20 mg/ml (base equivalent)• • •

VITRAKVI - larotrectinib sulfate cap 25mg (base equivalent)

• • •

VITRAKVI - larotrectinib sulfate cap 100mg (base equivalent)

• • •

VOTRIENT - pazopanib hcl tab 200 mg(base equiv)

• • •

XALKORI - crizotinib cap 200 mg • • •XALKORI - crizotinib cap 250 mg • • •XTANDI - enzalutamide cap 40 mg • • •YONSA - abiraterone acetate tab 125

mg• • •

ZELBORAF - vemurafenib tab 240 mg • • •ZYTIGA - abiraterone acetate tab 500

mg• • •

ENDOCRINE AND METABOLIC DRUGS

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CORTICOSTEROIDSbudesonide delayed release

particles cap 3 mg (Entocort ec)CORTISONE ACETATE - cortisone

acetate tab 25 mgDEXAMETHASONE - dexamethasone

soln 0.5 mg/5mldexamethasone elixir 0.5 mg/5mldexamethasone tab 0.5 mgdexamethasone tab 0.75 mgdexamethasone tab 1.5 mgdexamethasone tab 4 mgdexamethasone tab 6 mgfludrocortisone acetate tab 0.1 mghydrocortisone tab 5 mg (Cortef)hydrocortisone tab 10 mg (Cortef)hydrocortisone tab 20 mg (Cortef)methylprednisolone tab therapy

pack 4 mg (21) (Medrol dosepak)methylprednisolone tab 4 mg

(Medrol)methylprednisolone tab 8 mg



(Medrol)prednisolone sod phosph oral

soln 6.7 mg/5ml (5 mg/5ml base)(Pediapred)

prednisolone sod phosphate oralsoln 15 mg/5ml (base equiv)

PREDNISONE - prednisone oral soln 5mg/5ml

PREDNISONE INTENSOL - prednisoneconc 5 mg/ml

2020


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prednisone tab therapy pack 5 mg(21)




prednisone tab 1 mgprednisone tab 2.5 mgprednisone tab 5 mgprednisone tab 10 mgprednisone tab 20 mgprednisone tab 50 mgANDROGEN-ANABOLICdanazol cap 50 mg •danazol cap 100 mg •danazol cap 200 mg •testosterone cypionate im inj in oil

100 mg/ml (Depo-testosterone)•

testosterone cypionate im inj in oil200 mg/ml (Depo-testosterone)

•

testosterone td gel 25 mg/2.5gm (1%)(Androgel)

• •

testosterone td gel 50 mg/5gm (1%)(Androgel)

• •

testosterone td gel 12.5 mg/act (1%)(Androgel pump)

• •

testosterone td gel 20.25 mg/1.25gm(1.62%) (Androgel)

• •

testosterone td gel 40.5 mg/2.5gm(1.62%) (Androgel)

• •

testosterone td gel 20.25 mg/act(1.62%) (Androgel pump)

• •

testosterone td soln 30 mg/act(Axiron)

• •

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ESTROGENSCOMBIPATCH - estradiol-norethindrone

ace td pttw 0.05-0.14 mg/dayCOMBIPATCH - estradiol-norethindrone

ace td pttw 0.05-0.25 mg/dayDIVIGEL - estradiol td gel 0.25

mg/0.25gm (0.1%)DIVIGEL - estradiol td gel 0.5 mg/0.5gm

(0.1%)DIVIGEL - estradiol td gel 0.75

mg/0.75gm (0.1%)DIVIGEL - estradiol td gel 1 mg/gm

(0.1%)DIVIGEL - estradiol td gel 1.25

mg/1.25gm (0.1%)DUAVEE - conjugated estrogens-

bazedoxifene tab 0.45-20 mgestradiol & norethindrone acetate

tab 0.5-0.1 mg (Activella)estradiol & norethindrone acetate

tab 1-0.5 mg (Activella)estradiol tab 0.5 mg (Estrace)estradiol tab 1 mg (Estrace)estradiol tab 2 mg (Estrace)estradiol td patch twice weekly

0.025 mg/24hr (Vivelle-dot)•

estradiol td patch twice weekly0.0375 mg/24hr (Vivelle-dot)

•


•


•


•

estradiol td patch weekly0.025 mg/24hr (Climara)

•

2020


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estradiol td patch weekly0.0375 mg/24hr (37.5 mcg/24hr)(Climara)

•


•


•


•


•

norethindrone acetate-ethinylestradiol tab 0.5 mg-2.5 mcg(Femhrt low dose)

norethindrone acetate-ethinylestradiol tab 1 mg-5 mcg

PREMARIN - estrogens, conjugated tab0.3 mg





PREMPHASE - conj est 0.625(14)/conjest-medroxypro ac tab 0.625-5mg(14)

PREMPRO - conjugated estrogen-medroxyprogest acetate tab 0.3-1.5mg

PREMPRO - conjugated estrogen-medroxyprogest acetate tab 0.45-1.5mg

PREMPRO - conjugated estrogen-medroxyprogest acetate tab0.625-2.5 mg

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PREMPRO - conjugated estrogen-medroxyprogest acetate tab 0.625-5mg

CONTRACEPTIVESdesogest-eth estrad & eth estrad tab

0.15-0.02/0.01 mg(21/5) (Mircette)•

desogest-ethin est tab0.1-0.025/0.125-0.025/0.15-0.025mg-mg (Cyclessa)

•

desogestrel & ethinyl estradiol tab0.15 mg-30 mcg (Desogen)

•

drospirenone-ethinyl estradiol tab3-0.02 mg (Yaz)

•

drospirenone-ethinyl estradiol tab3-0.03 mg (Yasmin 28)

•

ELLA - ulipristal acetate tab 30 mg •ethynodiol diacetate & ethinyl

estradiol tab 1 mg-35 mcg•

ethynodiol diacetate & ethinylestradiol tab 1 mg-50 mcg (Zovia1/50e)

•

levonorg-eth est tab 0.1-0.02mg(84)& eth est tab 0.01mg(7)(Loseasonique)

•

levonorg-eth est tab 0.15-0.03mg(84)& eth est tab 0.01mg(7)(Seasonique)

•

levonorgestrel & ethinyl estradiol(91-day) tab 0.15-0.03 mg

•

levonorgestrel & ethinyl estradiol tab0.1 mg-20 mcg

•

levonorgestrel & ethinyl estradiol tab0.15 mg-30 mcg

•

levonorgestrel-eth estra tab0.05-30/0.075-40/0.125-30mg-mcg

•

norethindrone & ethinyl estradiol tab0.4 mg-35 mcg (Ovcon-35)

•

2020


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norethindrone & ethinyl estradiol tab0.5 mg-35 mcg (Brevicon-28)

•

norethindrone & ethinyl estradiol tab1 mg-35 mcg (Norinyl 1+35)

•

norethindrone & ethinyl estradiol-fechew tab 0.4 mg-35 mcg (Femconfe)

•

norethindrone ac-ethinyl estrad-fe tab 1-20/1-30/1-35 mg-mcg(Estrostep fe)

•

norethindrone ace & ethinyl estradioltab 1 mg-20 mcg (Loestrin 1/20-21)

•

norethindrone ace & ethinyl estradioltab 1.5 mg-30 mcg (Loestrin1.5/30-21)

•

norethindrone ace & ethinylestradiol-fe tab 1 mg-20 mcg(Loestrin fe 1/20)

•

norethindrone ace & ethinylestradiol-fe tab 1.5 mg-30 mcg(Loestrin fe 1.5/30)

•

norethindrone tab 0.35 mg (Nor-qd) •norethindrone-eth estradiol tab

0.5-35/0.75-35/1-35 mg-mcg (Ortho-novum 7/7/7)

•

norethindrone-eth estradiol tab0.5-35/1-35/0.5-35 mg-mcg (Tri-norinyl 28)

•

norgestimate & ethinyl estradiol tab0.25 mg-35 mcg (Ortho-cyclen)

•

norgestimate-eth estrad tab0.18-25/0.215-25/0.25-25 mg-mcg(Ortho tri-cyclen lo)

•

norgestimate-eth estrad tab0.18-35/0.215-35/0.25-35 mg-mcg(Ortho tri-cyclen)

•

norgestrel & ethinyl estradiol tab0.3 mg-30 mcg

•

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NUVARING - etonogestrel-ethinylestradiol va ring 0.120-0.015 mg/24hr

•

PROGESTINSmedroxyprogesterone acetate tab

2.5 mg (Provera)medroxyprogesterone acetate tab

5 mg (Provera)medroxyprogesterone acetate tab

10 mg (Provera)norethindrone acetate tab 5 mg

(Aygestin)progesterone micronized cap 100 mg

(Prometrium)progesterone micronized cap 200 mg

(Prometrium)ANTIDIABETICSacarbose tab 25 mg (Precose)acarbose tab 50 mg (Precose)acarbose tab 100 mg (Precose)BAQSIMI ONE PACK - glucagon nasal

powder 3 mg/doseBAQSIMI TWO PACK - glucagon nasal

powder 3 mg/dosediazoxide susp 50 mg/ml (Proglycem)glimepiride tab 1 mg (Amaryl)glimepiride tab 2 mg (Amaryl)glimepiride tab 4 mg (Amaryl)glipizide tab er 24hr 2.5 mg (Glucotrol

xl)glipizide tab er 24hr 5 mg (Glucotrol

xl)glipizide tab er 24hr 10 mg (Glucotrol

xl)glipizide tab 5 mg (Glucotrol)glipizide tab 10 mg (Glucotrol)

2020


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glipizide-metformin hcl tab2.5-250 mg

glipizide-metformin hcl tab2.5-500 mg

glipizide-metformin hcl tab 5-500 mgGLUCAGON EMERGENCY KIT -

glucagon (rdna) for inj kit 1 mgGLUCAGON EMERGENCY KIT FO -

glucagon hcl for inj 1 mgglyburide micronized tab 1.5 mg

(Glynase)glyburide micronized tab 3 mg

(Glynase)glyburide micronized tab 6 mg

(Glynase)glyburide tab 1.25 mgglyburide tab 2.5 mgglyburide tab 5 mgglyburide-metformin tab 1.25-250 mg

(Glucovance)glyburide-metformin tab 2.5-500 mg

(Glucovance)glyburide-metformin tab 5-500 mg

(Glucovance)GLYXAMBI - empagliflozin-linagliptin tab

10-5 mg•

GLYXAMBI - empagliflozin-linagliptin tab25-5 mg

•

GVOKE HYPOPEN 1-PACK - glucagonsubcutaneous solution auto-injector0.5 mg/0.1ml

GVOKE HYPOPEN 1-PACK - glucagonsubcutaneous solution auto-injector 1mg/0.2ml

GVOKE HYPOPEN 2-PACK - glucagonsubcutaneous solution auto-injector0.5 mg/0.1ml

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GVOKE HYPOPEN 2-PACK - glucagonsubcutaneous solution auto-injector 1mg/0.2ml

GVOKE PFS - glucagon subcutaneoussoln pref syringe 0.5 mg/0.1ml

GVOKE PFS - glucagon subcutaneoussoln pref syringe 1 mg/0.2ml

INVOKAMET - canagliflozin-metforminhcl tab 50-500 mg

•


•


•


•

INVOKAMET XR - canagliflozin-metformin hcl tab er 24hr 50-500 mg

•


•


•

INVOKAMET XR - canagliflozin-metformin hcl tab er 24hr 150-1000mg

•

INVOKANA - canagliflozin tab 100 mg •INVOKANA - canagliflozin tab 300 mg •JANUMET - sitagliptin-metformin hcl tab

50-500 mg•

JANUMET - sitagliptin-metformin hcl tab50-1000 mg

•

JANUMET XR - sitagliptin-metformin hcltab er 24hr 50-500 mg

•


•


•

2020


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JANUVIA - sitagliptin phosphate tab 25mg (base equiv)

•


•


•

JARDIANCE - empagliflozin tab 10 mg •JARDIANCE - empagliflozin tab 25 mg •KOMBIGLYZE XR - saxagliptin-

metformin hcl tab er 24hr 2.5-1000mg

•

KOMBIGLYZE XR - saxagliptin-metformin hcl tab er 24hr 5-500 mg

•

KOMBIGLYZE XR - saxagliptin-metformin hcl tab er 24hr 5-1000 mg

•

metformin hcl tab er 24hr 500 mg(Glucophage xr)

metformin hcl tab er 24hr 750 mg(Glucophage xr)

metformin hcl tab 500 mg(Glucophage)



nateglinide tab 60 mg (Starlix)nateglinide tab 120 mg (Starlix)ONGLYZA - saxagliptin hcl tab 2.5 mg

(base equiv)•

ONGLYZA - saxagliptin hcl tab 5 mg(base equiv)

•

OZEMPIC - semaglutide soln pen-inj0.25 or 0.5 mg/dose (2 mg/1.5ml)

• •

OZEMPIC - semaglutide soln pen-inj 1mg/dose (2 mg/1.5ml)

• •

pioglitazone hcl tab 15 mg (baseequiv) (Actos)

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pioglitazone hcl-metformin hcl tab15-500 mg (Actoplus met)

pioglitazone hcl-metformin hcl tab15-850 mg (Actoplus met)

PROGLYCEM - diazoxide susp 50 mg/ml

repaglinide tab 0.5 mg (Prandin)repaglinide tab 1 mg (Prandin)repaglinide tab 2 mg (Prandin)RYBELSUS - semaglutide tab 3 mg • •RYBELSUS - semaglutide tab 7 mg • •RYBELSUS - semaglutide tab 14 mg • •SOLIQUA 100/33 - insulin glargine-

lixisenatide sol pen-inj 100-33 unit-mcg/ml

• •

SYNJARDY - empagliflozin-metforminhcl tab 5-500 mg

•

SYNJARDY - empagliflozin-metforminhcl tab 5-1000 mg

•

SYNJARDY - empagliflozin-metforminhcl tab 12.5-500 mg

•

SYNJARDY - empagliflozin-metforminhcl tab 12.5-1000 mg

•

SYNJARDY XR - empagliflozin-metformin hcl tab er 24hr 5-1000 mg

•


•

SYNJARDY XR - empagliflozin-metformin hcl tab er 24hr 12.5-1000mg

•


•

2020


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TRULICITY - dulaglutide soln pen-injector 0.75 mg/0.5ml

• •

TRULICITY - dulaglutide soln pen-injector 1.5 mg/0.5ml

• •

VICTOZA - liraglutide soln pen-injector18 mg/3ml (6 mg/ml)

• •

XULTOPHY 100/3.6 - insulin degludec-liraglutide sol pen-inj 100-3.6 unit-mg/ml

• •

Rapid-Acting InsulinsFIASP - insulin aspart (with

niacinamide) inj 100 unit/ml•

FIASP FLEXTOUCH - insulin aspart(with niacinamide) sol pen-inj 100unit/ml

•

FIASP PENFILL - insulin aspart (withniacinamide) soln cartridge 100 unit/ml

•

INSULIN ASPART - insulin aspart inj100 unit/ml

•

INSULIN ASPART FLEXPEN - insulinaspart soln pen-injector 100 unit/ml

•

INSULIN ASPART PENFILL - insulinaspart soln cartridge 100 unit/ml

•

NOVOLOG - insulin aspart inj 100 unit/ml

•

NOVOLOG FLEXPEN - insulin aspartsoln pen-injector 100 unit/ml

•

NOVOLOG PENFILL - insulin aspartsoln cartridge 100 unit/ml

•

Short-Acting InsulinsHUMULIN R U-500 (CONCENTR -

insulin regular (human) inj 500 unit/ml•

HUMULIN R U-500 KWIKPEN - insulinregular (human) soln pen-injector 500unit/ml

•

NOVOLIN R - insulin regular (human) inj100 unit/ml

•

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NOVOLIN R FLEXPEN - insulin regular(human) soln pen-injector 100 unit/ml

•

Intermediate-Acting InsulinsINSULIN ASPART PROTAMINE/ -

insulin aspart prot & aspart sus pen-inj 100 unit/ml (70-30)

•

INSULIN ASPART PROTAMINE/ -insulin aspart prot & aspart (human)inj 100 unit/ml (70-30)

•

NOVOLIN N - insulin nph (human)(isophane) inj 100 unit/ml

•

NOVOLIN N FLEXPEN - insulin nph(human) (isophane) susp pen-injector100 unit/ml

•

NOVOLIN 70/30 - insulin nph isophane& regular human inj 100 unit/ml(70-30)

•

NOVOLIN 70/30 FLEXPEN - insulin nph& regular susp pen-inj 100 unit/ml(70-30)

•

NOVOLOG MIX 70/30 - insulin aspartprot & aspart (human) inj 100 unit/ml(70-30)

•

NOVOLOG MIX 70/30 PREFILL - insulinaspart prot & aspart sus pen-inj 100unit/ml (70-30)

•

Basal InsulinsLANTUS - insulin glargine inj 100 unit/ml •LANTUS SOLOSTAR - insulin glargine

soln pen-injector 100 unit/ml•

LEVEMIR - insulin detemir inj 100 unit/ml

•

LEVEMIR FLEXTOUCH - insulindetemir soln pen-injector 100 unit/ml

•

TOUJEO MAX SOLOSTAR - insulinglargine soln pen-injector 300 unit/ml(2 unit dial)

•

2020


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TOUJEO SOLOSTAR - insulin glarginesoln pen-injector 300 unit/ml (1 unitdial)

•

TRESIBA - insulin degludec inj 100 unit/ml

•

TRESIBA FLEXTOUCH - insulindegludec soln pen-injector 100 unit/ml

•

TRESIBA FLEXTOUCH - insulindegludec soln pen-injector 200 unit/ml

•

THYROID AGENTSlevothyroxine sodium tab 25 mcg

(Synthroid)levothyroxine sodium tab 50 mcg











(Synthroid)liothyronine sodium tab 5 mcg

(Cytomel)

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liothyronine sodium tab 25 mcg(Cytomel)

liothyronine sodium tab 50 mcg(Cytomel)

methimazole tab 5 mg (Tapazole)methimazole tab 10 mg (Tapazole)propylthiouracil tab 50 mgOXYTOCICSmethylergonovine maleate tab

0.2 mgENDOCRINE and METABOLIC AGENTS - MISC.alendronate sodium tab 10 mg •alendronate sodium tab 35 mg •alendronate sodium tab 70 mg

(Fosamax)•

cabergoline tab 0.5 mgcalcitonin (salmon) nasal soln 200

unit/act (Miacalcin)calcitriol cap 0.25 mcg (Rocaltrol)calcitriol cap 0.5 mcg (Rocaltrol)calcitriol oral soln 1 mcg/ml

(Rocaltrol)cinacalcet hcl tab 30 mg (base equiv)

(Sensipar)cinacalcet hcl tab 60 mg (base equiv)

(Sensipar)cinacalcet hcl tab 90 mg (base equiv)

(Sensipar)CLOMIPHENE CITRATE - clomiphene

citrate tab 50 mgCYSTADANE - betaine powder for oral

solutiondesmopressin acetate inj 4 mcg/ml

(Ddavp)desmopressin acetate nasal spray

soln 0.01% (Ddavp)

2020


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desmopressin acetate nasal spraysoln 0.01% (refrigerated)

desmopressin acetate tab 0.1 mg(Ddavp)

desmopressin acetate tab 0.2 mg(Ddavp)

FOLLISTIM AQ - follitropin beta inj 300unit/0.36ml

• •


• •


• •

ganirelix acetate soln prefilledsyringe 250 mcg/0.5ml (Ganirelixacetate)

• •

ibandronate sodium tab 150 mg(base equivalent) (Boniva)

•

INCRELEX - mecasermin inj 40 mg/4ml(10 mg/ml)

•

levocarnitine oral soln 1 gm/10ml(10%) (Carnitor)

levocarnitine tab 330 mg (Carnitor)nitisinone cap 2 mg (Orfadin) •nitisinone cap 5 mg (Orfadin) •nitisinone cap 10 mg (Orfadin) •NITYR - nitisinone tab 2 mg •NITYR - nitisinone tab 5 mg •NITYR - nitisinone tab 10 mg •NORDITROPIN FLEXPRO - somatropin

inj 5 mg/1.5ml• •

NORDITROPIN FLEXPRO - somatropininj 10 mg/1.5ml

• •

NORDITROPIN FLEXPRO - somatropininj 15 mg/1.5ml

• •

NORDITROPIN FLEXPRO - somatropininj 30 mg/3ml

• •

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octreotide acetate inj 50 mcg/ml(0.05 mg/ml) (Sandostatin)

•


•


•


•

octreotide acetate inj 1000 mcg/ml(1 mg/ml) (Sandostatin)

•

ORFADIN - nitisinone susp 4 mg/ml •ORFADIN - nitisinone cap 2 mg •ORFADIN - nitisinone cap 5 mg •ORFADIN - nitisinone cap 10 mg •ORFADIN - nitisinone cap 20 mg •ORILISSA - elagolix sodium tab 150 mg

(base equiv)• •

ORILISSA - elagolix sodium tab 200 mg(base equiv)

• •

paricalcitol cap 1 mcg (Zemplar)paricalcitol cap 2 mcg (Zemplar)paricalcitol cap 4 mcgraloxifene hcl tab 60 mg (Evista)REVCOVI - elapegademase-lvlr im soln

2.4 mg/1.5ml (1.6 mg/ml)risedronate sodium tab 5 mg

(Actonel)•

risedronate sodium tab 30 mg(Actonel)

•


•


•

STIMATE - desmopressin acetate nasalsoln 1.5 mg/ml

2020


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STRENSIQ - asfotase alfasubcutaneous inj 18 mg/0.45ml

• •


• •

STRENSIQ - asfotase alfasubcutaneous inj 40 mg/ml

• •


• •

TYMLOS - abaloparatide subcutaneoussoln pen-injector 3120 mcg/1.56ml

• • •

CARDIOVASCULAR AGENTSCARDIOTONICSdigoxin oral soln 0.05 mg/ml

(Digoxin)digoxin tab 125 mcg (0.125 mg)

(Lanoxin)digoxin tab 250 mcg (0.25 mg)

(Lanoxin)ANTIANGINAL AGENTSisosorbide dinitrate tab 5 mg (Isordil

titradose)isosorbide dinitrate tab 10 mgisosorbide dinitrate tab 20 mgisosorbide dinitrate tab 30 mgisosorbide mononitrate tab er 24hr

30 mgisosorbide mononitrate tab er 24hr

60 mgisosorbide mononitrate tab er 24hr

120 mgisosorbide mononitrate tab 10 mgisosorbide mononitrate tab 20 mgnitroglycerin sl tab 0.3 mg (Nitrostat)nitroglycerin sl tab 0.4 mg (Nitrostat)nitroglycerin sl tab 0.6 mg (Nitrostat)

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nitroglycerin td patch 24hr 0.1 mg/hr(Nitro-dur)




BETA BLOCKERSacebutolol hcl cap 200 mg (Sectral)acebutolol hcl cap 400 mg (Sectral)atenolol tab 25 mg (Tenormin)atenolol tab 50 mg (Tenormin)atenolol tab 100 mg (Tenormin)bisoprolol fumarate tab 5 mg

(Zebeta)bisoprolol fumarate tab 10 mg

(Zebeta)carvedilol tab 3.125 mg (Coreg)carvedilol tab 6.25 mg (Coreg)carvedilol tab 12.5 mg (Coreg)carvedilol tab 25 mg (Coreg)INNOPRAN XL - propranolol hcl

sustained-release beads cap er 24hr80 mg

INNOPRAN XL - propranolol hclsustained-release beads cap er 24hr120 mg

labetalol hcl tab 100 mg (Trandate)labetalol hcl tab 200 mg (Trandate)labetalol hcl tab 300 mg (Trandate)metoprolol succinate tab er 24hr

25 mg (tartrate equiv) (Toprol xl)metoprolol succinate tab er 24hr

50 mg (tartrate equiv) (Toprol xl)

2020


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metoprolol succinate tab er 24hr100 mg (tartrate equiv) (Toprol xl)

metoprolol succinate tab er 24hr200 mg (tartrate equiv) (Toprol xl)

metoprolol tartrate tab 25 mgmetoprolol tartrate tab 50 mg

(Lopressor)metoprolol tartrate tab 100 mg

(Lopressor)nadolol tab 20 mg (Corgard)nadolol tab 40 mg (Corgard)nadolol tab 80 mg (Corgard)pindolol tab 5 mgpindolol tab 10 mgPROPRANOLOL HCL - propranolol hcl

oral soln 20 mg/5mlPROPRANOLOL HCL - propranolol hcl

oral soln 40 mg/5mlpropranolol hcl cap er 24hr 60 mg

(Inderal la)propranolol hcl cap er 24hr 80 mg



(Inderal la)propranolol hcl tab 10 mgpropranolol hcl tab 20 mgpropranolol hcl tab 40 mgpropranolol hcl tab 60 mgpropranolol hcl tab 80 mgsotalol hcl (afib/afl) tab 80 mg

(Betapace af)sotalol hcl (afib/afl) tab 120 mg

(Betapace af)

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sotalol hcl (afib/afl) tab 160 mg(Betapace af)

sotalol hcl tab 80 mg (Betapace)sotalol hcl tab 120 mg (Betapace)sotalol hcl tab 160 mg (Betapace)sotalol hcl tab 240 mgtimolol maleate tab 5 mgtimolol maleate tab 10 mgtimolol maleate tab 20 mgCALCIUM CHANNEL BLOCKERSamlodipine besylate tab 2.5 mg (base

equivalent) (Norvasc)amlodipine besylate tab 5 mg (base

equivalent) (Norvasc)amlodipine besylate tab 10 mg (base

equivalent) (Norvasc)diltiazem hcl coated beads cap er

24hr 120 mg (Cardizem cd)diltiazem hcl coated beads cap er




24hr 360 mg (Cardizem cd)diltiazem hcl extended release beads

cap er 24hr 120 mg (Tiazac)diltiazem hcl extended release beads




cap er 24hr 360 mg (Tiazac)

2020


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diltiazem hcl extended release beadscap er 24hr 420 mg (Tiazac)

diltiazem hcl tab 30 mg (Cardizem)diltiazem hcl tab 60 mg (Cardizem)diltiazem hcl tab 90 mgdiltiazem hcl tab 120 mg (Cardizem)felodipine tab er 24hr 2.5 mgfelodipine tab er 24hr 5 mgfelodipine tab er 24hr 10 mgnifedipine tab er 24hr 30 mg (Adalat

cc)nifedipine tab er 24hr 60 mg (Adalat

cc)nifedipine tab er 24hr 90 mg (Adalat

cc)nifedipine tab er 24hr osmotic

release 30 mg (Procardia xl)nifedipine tab er 24hr osmotic

release 60 mg (Procardia xl)nifedipine tab er 24hr osmotic

release 90 mg (Procardia xl)nimodipine cap 30 mgverapamil hcl cap er 24hr 120 mg

(Verelan)verapamil hcl cap er 24hr 180 mg

(Verelan)verapamil hcl cap er 24hr 240 mg

(Verelan)verapamil hcl tab er 120 mg (Calan

sr)verapamil hcl tab er 180 mg (Calan

sr)verapamil hcl tab er 240 mg (Calan

sr)verapamil hcl tab 40 mgverapamil hcl tab 80 mg (Calan)

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verapamil hcl tab 120 mg (Calan)ANTIARRHYTHMICSamiodarone hcl tab 100 mgamiodarone hcl tab 200 mg

(Cordarone)amiodarone hcl tab 400 mgdisopyramide phosphate cap 100 mg

(Norpace)disopyramide phosphate cap 150 mg

(Norpace)flecainide acetate tab 50 mgflecainide acetate tab 100 mgflecainide acetate tab 150 mgmexiletine hcl cap 150 mgmexiletine hcl cap 200 mgmexiletine hcl cap 250 mgMULTAQ - dronedarone hcl tab 400 mg

(base equivalent)propafenone hcl cap er 12hr 225 mg

(Rythmol sr)propafenone hcl cap er 12hr 325 mg

(Rythmol sr)propafenone hcl cap er 12hr 425 mg

(Rythmol sr)propafenone hcl tab 150 mg

(Rythmol)propafenone hcl tab 225 mg

(Rythmol)propafenone hcl tab 300 mgquinidine gluconate tab er 324 mgANTIHYPERTENSIVESamlodipine besylate-benazepril hcl

cap 2.5-10 mg (Lotrel)amlodipine besylate-benazepril hcl

cap 5-10 mg (Lotrel)

2020


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amlodipine besylate-benazepril hclcap 5-20 mg (Lotrel)




amlodipine besylate-valsartan tab5-160 mg (Exforge)




amlodipine-valsartan-hydrochlorothiazide tab5-160-12.5 mg (Exforge hct)

amlodipine-valsartan-hydrochlorothiazide tab5-160-25 mg (Exforge hct)

amlodipine-valsartan-hydrochlorothiazide tab10-160-12.5 mg (Exforge hct)



atenolol & chlorthalidone tab50-25 mg (Tenoretic 50)

atenolol & chlorthalidone tab100-25 mg (Tenoretic 100)

benazepril & hydrochlorothiazide tab5-6.25 mg

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benazepril & hydrochlorothiazide tab10-12.5 mg (Lotensin hct)

benazepril & hydrochlorothiazide tab20-12.5 mg (Lotensin hct)

benazepril & hydrochlorothiazide tab20-25 mg (Lotensin hct)

benazepril hcl tab 5 mgbenazepril hcl tab 10 mg (Lotensin)benazepril hcl tab 20 mg (Lotensin)benazepril hcl tab 40 mg (Lotensin)bisoprolol & hydrochlorothiazide tab

2.5-6.25 mg (Ziac)bisoprolol & hydrochlorothiazide tab

5-6.25 mg (Ziac)bisoprolol & hydrochlorothiazide tab

10-6.25 mg (Ziac)candesartan cilexetil tab 4 mg

(Atacand)candesartan cilexetil tab 8 mg



(Atacand)candesartan cilexetil-

hydrochlorothiazide tab 16-12.5 mg(Atacand hct)

candesartan cilexetil-hydrochlorothiazide tab 32-12.5 mg(Atacand hct)

candesartan cilexetil-hydrochlorothiazide tab 32-25 mg(Atacand hct)

captopril tab 12.5 mgcaptopril tab 25 mgcaptopril tab 50 mgcaptopril tab 100 mg

2020


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clonidine hcl tab 0.1 mg (Catapres)clonidine hcl tab 0.2 mg (Catapres)clonidine hcl tab 0.3 mg (Catapres)clonidine td patch weekly

0.1 mg/24hr (Catapres-tts-1)clonidine td patch weekly

0.2 mg/24hr (Catapres-tts-2)clonidine td patch weekly

0.3 mg/24hr (Catapres-tts-3)doxazosin mesylate tab 1 mg

(Cardura)doxazosin mesylate tab 2 mg



(Cardura)enalapril maleate &

hydrochlorothiazide tab 5-12.5 mgenalapril maleate &

hydrochlorothiazide tab 10-25 mg(Vaseretic)

enalapril maleate tab 2.5 mg(Vasotec)

enalapril maleate tab 5 mg (Vasotec)enalapril maleate tab 10 mg (Vasotec)enalapril maleate tab 20 mg (Vasotec)eplerenone tab 25 mg (Inspra)eplerenone tab 50 mg (Inspra)fosinopril sodium &

hydrochlorothiazide tab 10-12.5 mgfosinopril sodium &

hydrochlorothiazide tab 20-12.5 mgfosinopril sodium tab 10 mgfosinopril sodium tab 20 mgfosinopril sodium tab 40 mg

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guanfacine hcl tab 1 mg (Tenex)guanfacine hcl tab 2 mg (Tenex)hydralazine hcl tab 10 mghydralazine hcl tab 25 mghydralazine hcl tab 50 mghydralazine hcl tab 100 mgirbesartan tab 75 mg (Avapro)irbesartan tab 150 mg (Avapro)irbesartan tab 300 mg (Avapro)irbesartan-hydrochlorothiazide tab

150-12.5 mg (Avalide)irbesartan-hydrochlorothiazide tab

300-12.5 mg (Avalide)lisinopril & hydrochlorothiazide tab

10-12.5 mg (Zestoretic)lisinopril & hydrochlorothiazide tab

20-12.5 mg (Zestoretic)lisinopril & hydrochlorothiazide tab

20-25 mg (Zestoretic)lisinopril tab 2.5 mg (Zestril)lisinopril tab 5 mg (Prinivil)lisinopril tab 10 mg (Prinivil)lisinopril tab 20 mg (Prinivil)lisinopril tab 30 mg (Zestril)lisinopril tab 40 mg (Zestril)losartan potassium &

hydrochlorothiazide tab 50-12.5 mg(Hyzaar)

losartan potassium &hydrochlorothiazide tab100-12.5 mg (Hyzaar)

losartan potassium &hydrochlorothiazide tab 100-25 mg(Hyzaar)

losartan potassium tab 25 mg(Cozaar)

2020


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methyldopa tab 250 mgmethyldopa tab 500 mgmetoprolol & hydrochlorothiazide

tab 50-25 mg (Lopressor hct)metoprolol & hydrochlorothiazide

tab 100-25 mg (Lopressor hct)minoxidil tab 2.5 mgminoxidil tab 10 mgmoexipril hcl tab 7.5 mgmoexipril hcl tab 15 mgolmesartan medoxomil tab 5 mg

(Benicar)olmesartan medoxomil tab 20 mg

(Benicar)olmesartan medoxomil tab 40 mg

(Benicar)olmesartan medoxomil-

hydrochlorothiazide tab 20-12.5 mg(Benicar hct)

olmesartan medoxomil-hydrochlorothiazide tab 40-12.5 mg(Benicar hct)

olmesartan medoxomil-hydrochlorothiazide tab 40-25 mg(Benicar hct)

perindopril erbumine tab 2 mgperindopril erbumine tab 4 mg

(Aceon)perindopril erbumine tab 8 mg

(Aceon)phenoxybenzamine hcl cap 10 mg

(Dibenzyline)prazosin hcl cap 1 mg (Minipress)

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prazosin hcl cap 2 mg (Minipress)prazosin hcl cap 5 mg (Minipress)quinapril hcl tab 5 mg (Accupril)quinapril hcl tab 10 mg (Accupril)quinapril hcl tab 20 mg (Accupril)quinapril hcl tab 40 mg (Accupril)quinapril-hydrochlorothiazide tab

10-12.5 mg (Accuretic)quinapril-hydrochlorothiazide tab

20-12.5 mg (Accuretic)quinapril-hydrochlorothiazide tab

20-25 mg (Accuretic)ramipril cap 1.25 mg (Altace)ramipril cap 2.5 mg (Altace)ramipril cap 5 mg (Altace)ramipril cap 10 mg (Altace)telmisartan tab 20 mg (Micardis)telmisartan tab 40 mg (Micardis)telmisartan tab 80 mg (Micardis)telmisartan-hydrochlorothiazide tab

40-12.5 mg (Micardis hct)telmisartan-hydrochlorothiazide tab

80-12.5 mg (Micardis hct)telmisartan-hydrochlorothiazide tab

80-25 mg (Micardis hct)terazosin hcl cap 1 mg (base

equivalent)terazosin hcl cap 2 mg (base



equivalent)trandolapril tab 1 mg (Mavik)trandolapril tab 2 mg (Mavik)

2020


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trandolapril tab 4 mg (Mavik)valsartan tab 40 mg (Diovan)valsartan tab 80 mg (Diovan)valsartan tab 160 mg (Diovan)valsartan tab 320 mg (Diovan)valsartan-hydrochlorothiazide tab

80-12.5 mg (Diovan hct)valsartan-hydrochlorothiazide tab


160-25 mg (Diovan hct)valsartan-hydrochlorothiazide tab


320-25 mg (Diovan hct)DIURETICSacetazolamide cap er 12hr 500 mg

(Diamox)acetazolamide tab 125 mgacetazolamide tab 250 mgamiloride & hydrochlorothiazide tab

5-50 mgamiloride hcl tab 5 mgbumetanide tab 0.5 mgbumetanide tab 1 mgbumetanide tab 2 mgchlorthalidone tab 25 mgchlorthalidone tab 50 mgfurosemide oral soln 10 mg/mlfurosemide tab 20 mg (Lasix)furosemide tab 40 mg (Lasix)furosemide tab 80 mg (Lasix)hydrochlorothiazide cap 12.5 mg

(Microzide)hydrochlorothiazide tab 12.5 mg

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hydrochlorothiazide tab 25 mghydrochlorothiazide tab 50 mgindapamide tab 1.25 mgindapamide tab 2.5 mgmethazolamide tab 25 mgmethazolamide tab 50 mgmetolazone tab 2.5 mgmetolazone tab 5 mgmetolazone tab 10 mgspironolactone &

hydrochlorothiazide tab 25-25 mg(Aldactazide)

spironolactone tab 25 mg (Aldactone)spironolactone tab 50 mg (Aldactone)spironolactone tab 100 mg

(Aldactone)torsemide tab 5 mg (Demadex)torsemide tab 10 mg (Demadex)torsemide tab 20 mg (Demadex)torsemide tab 100 mg (Demadex)triamterene & hydrochlorothiazide

cap 37.5-25 mg (Dyazide)triamterene & hydrochlorothiazide

tab 37.5-25 mg (Maxzide-25)triamterene & hydrochlorothiazide

tab 75-50 mg (Maxzide)VASOPRESSORSepinephrine solution auto-injector

0.15 mg/0.3ml (1:2000) (Epipen-jr 2-pak)

epinephrine solution auto-injector0.3 mg/0.3ml (1:1000) (Epipen 2-pak)

EPIPEN-JR 2-PAK - epinephrinesolution auto-injector 0.15 mg/0.3ml(1:2000)

2020


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midodrine hcl tab 2.5 mgmidodrine hcl tab 5 mgmidodrine hcl tab 10 mgSYMJEPI - epinephrine soln prefilled

syringe 0.15 mg/0.3ml (1:2000)SYMJEPI - epinephrine solution prefilled

syringe 0.3 mg/0.3ml (1:1000)ANTIHYPERLIPIDEMICSatorvastatin calcium tab 10 mg (base

equivalent) (Lipitor)atorvastatin calcium tab 20 mg (base



equivalent) (Lipitor)cholestyramine light powder packets

4 gmcholestyramine light powder 4 gm/

dose (Questran light)cholestyramine powder packets

4 gm (Questran)cholestyramine powder 4 gm/dose

(Questran)choline fenofibrate cap dr 45 mg

(fenofibric acid equiv) (Trilipix)•

colesevelam hcl packet for susp3.75 gm (Welchol)

colesevelam hcl tab 625 mg (Welchol)colestipol hcl granule packets 5 gm

(Colestid flavored)colestipol hcl granules 5 gm (Colestid

flavored)colestipol hcl tab 1 gm (Colestid)ezetimibe tab 10 mg (Zetia) •

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ezetimibe-simvastatin tab 10-10 mg(Vytorin)




fenofibrate micronized cap 67 mg(Lofibra)

•


•


•

fenofibrate tab 48 mg (Tricor) •fenofibrate tab 54 mg (Lofibra) •fenofibrate tab 145 mg (Tricor) •fenofibrate tab 160 mg (Lofibra) •gemfibrozil tab 600 mg (Lopid) •lovastatin tab 10 mglovastatin tab 20 mglovastatin tab 40 mg (Mevacor)NEXLETOL - bempedoic acid tab 180

mgniacin tab er 500 mg

(antihyperlipidemic) (Niaspan)niacin tab er 750 mg

(antihyperlipidemic) (Niaspan)niacin tab er 1000 mg

(antihyperlipidemic) (Niaspan)pravastatin sodium tab 10 mgpravastatin sodium tab 20 mg

(Pravachol)pravastatin sodium tab 40 mg

(Pravachol)

2020


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pravastatin sodium tab 80 mg(Pravachol)

REPATHA - evolocumab subcutaneoussoln prefilled syringe 140 mg/ml

• •

REPATHA PUSHTRONEX SYSTEM -evolocumab subcutaneous solncartridge/infusor 420 mg/3.5ml

• •

REPATHA SURECLICK - evolocumabsubcutaneous soln auto-injector 140mg/ml

• •

rosuvastatin calcium tab 5 mg(Crestor)




simvastatin tab 5 mg (Zocor)simvastatin tab 10 mg (Zocor)simvastatin tab 20 mg (Zocor)simvastatin tab 40 mg (Zocor)simvastatin tab 80 mg (Zocor)CARDIOVASCULAR AGENTS - MISC.ambrisentan tab 5 mg (Letairis) • • •ambrisentan tab 10 mg (Letairis) • • •bosentan tab 62.5 mg (Tracleer) • • •bosentan tab 125 mg (Tracleer) • • •ENTRESTO - sacubitril-valsartan tab

24-26 mgENTRESTO - sacubitril-valsartan tab

49-51 mgENTRESTO - sacubitril-valsartan tab

97-103 mgOPSUMIT - macitentan tab 10 mg • • •sildenafil citrate tab 20 mg (Revatio) • •

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tadalafil tab 20 mg (pah) (Adcirca) • • •tadalafil tab 2.5 mg (Cialis) • •tadalafil tab 5 mg (Cialis) • •tadalafil tab 10 mg (Cialis) • •tadalafil tab 20 mg (Cialis) • •TRACLEER - bosentan tab for oral susp

32 mg• • •

TRACLEER - bosentan tab 62.5 mg • • •TRACLEER - bosentan tab 125 mg • • •UPTRAVI - selexipag tab therapy pack

200 mcg (140) & 800 mcg (60)• • •

UPTRAVI - selexipag tab 200 mcg • • •UPTRAVI - selexipag tab 400 mcg • • •UPTRAVI - selexipag tab 600 mcg • • •UPTRAVI - selexipag tab 800 mcg • • •UPTRAVI - selexipag tab 1000 mcg • • •UPTRAVI - selexipag tab 1200 mcg • • •UPTRAVI - selexipag tab 1400 mcg • • •UPTRAVI - selexipag tab 1600 mcg • • •VYNDAMAX - tafamidis cap 61 mg • • •VYNDAQEL - tafamidis meglumine

(cardiac) cap 20 mg• • •

ERECTILE DYSFUNCTIONtadalafil tab 2.5 mg (Cialis) • •tadalafil tab 5 mg (Cialis) • •tadalafil tab 10 mg (Cialis) • •tadalafil tab 20 mg (Cialis) • •RESPIRATORY AGENTSANTIHISTAMINEScetirizine hcl oral soln 1 mg/ml

(5 mg/5ml)cyproheptadine hcl syrup 2 mg/5mlcyproheptadine hcl tab 4 mgdesloratadine tab 5 mg (Clarinex)

2020


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levocetirizine dihydrochloride soln2.5 mg/5ml (0.5 mg/ml)

levocetirizine dihydrochloride tab5 mg (Xyzal)

promethazine hcl suppos 12.5 mgpromethazine hcl suppos 25 mgpromethazine hcl syrup 6.25 mg/5mlpromethazine hcl tab 12.5 mgpromethazine hcl tab 25 mgpromethazine hcl tab 50 mgNASAL AGENTS - SYSTEMIC and TOPICALazelastine hcl nasal spray 0.1%

(137 mcg/spray)•

azelastine hcl nasal spray 0.15%(205.5 mcg/spray) (Astepro)

•

fluticasone propionate nasal susp50 mcg/act

•

ipratropium bromide nasal soln0.03% (21 mcg/spray) (Atrovent)

•

ipratropium bromide nasal soln0.06% (42 mcg/spray) (Atrovent)

•

mometasone furoate nasal susp50 mcg/act (Nasonex)

•

COUGH/COLD/ALLERGYacetylcysteine inhal soln 10%acetylcysteine inhal soln 20%sodium chloride soln nebu 3%sodium chloride soln nebu 7%

(Hyper-sal)ANTIASTHMATIC and BRONCHODILATOR AGENTSADVAIR DISKUS - fluticasone-

salmeterol aer powder ba 100-50mcg/dose

•

ADVAIR DISKUS - fluticasone-salmeterol aer powder ba 250-50mcg/dose

•

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ADVAIR DISKUS - fluticasone-salmeterol aer powder ba 500-50mcg/dose

•

ADVAIR HFA - fluticasone-salmeterolinhal aerosol 45-21 mcg/act

•


•


•

albuterol sulfate inhal aero 108 mcg/act (90mcg base equiv) (Proventilhfa)

•

albuterol sulfate soln nebu 0.083%(2.5 mg/3ml)

•

albuterol sulfate soln nebu 0.5%(5 mg/ml)

•

albuterol sulfate soln nebu0.63 mg/3ml (base equiv)

•

albuterol sulfate soln nebu1.25 mg/3ml (base equiv)

•

albuterol sulfate syrup 2 mg/5mlalbuterol sulfate tab 2 mgalbuterol sulfate tab 4 mgANORO ELLIPTA - umeclidinium-

vilanterol aero powd ba 62.5-25 mcg/inh

•

ARNUITY ELLIPTA - fluticasone furoateaerosol powder breath activ 50 mcg/act

•


•


•

ASMANEX HFA - mometasone furoateinhal aerosol suspension 50 mcg/act

•

2020


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•


•

ASMANEX TWISTHALER 120 ME -mometasone furoate inhal powd 220mcg/inh (breath activated)

•

ASMANEX TWISTHALER 30 MET -mometasone furoate inhal powd 110mcg/inh (breath activated)

•


•


•

BREO ELLIPTA - fluticasone furoate-vilanterol aero powd ba 100-25 mcg/inh

•

BREO ELLIPTA - fluticasone furoate-vilanterol aero powd ba 200-25 mcg/inh

•

budesonide inhalation susp0.25 mg/2ml (Pulmicort)

•

budesonide inhalation susp0.5 mg/2ml (Pulmicort)

•

budesonide inhalation susp1 mg/2ml (Pulmicort)

•

COMBIVENT RESPIMAT - ipratropium-albuterol inhal aerosol soln 20-100mcg/act

•

cromolyn sodium soln nebu20 mg/2ml

•

DULERA - mometasone furoate-formoterol fumarate aerosol 50-5mcg/act

•


•

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•

FLOVENT DISKUS - fluticasonepropionate aer pow ba 50 mcg/blister

•


•


•

FLOVENT HFA - fluticasone propionatehfa inhal aero 44 mcg/act (50/valve)

•

FLOVENT HFA - fluticasone propionatehfa inhal aer 110 mcg/act (125/valve)

•

FLOVENT HFA - fluticasone propionatehfa inhal aer 220 mcg/act (250/valve)

•

FLUTICASONE PROPIONATE/SA -fluticasone-salmeterol aer powder ba55-14 mcg/act



INCRUSE ELLIPTA - umeclidinium braero powd breath act 62.5 mcg/inh(base eq)

•

ipratropium bromide inhal soln0.02%

•

ipratropium-albuterol nebu soln0.5-2.5(3) mg/3ml

•

levalbuterol hcl soln nebu conc1.25 mg/0.5ml (base equiv)(Xopenex concentrate)

•

levalbuterol hcl soln nebu0.31 mg/3ml (base equiv) (Xopenex)

•

2020


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•


•

montelukast sodium chew tab 4 mg(base equiv) (Singulair)

montelukast sodium chew tab 5 mg(base equiv) (Singulair)

montelukast sodium oral granulespacket 4 mg (base equiv) (Singulair)

montelukast sodium tab 10 mg (baseequiv) (Singulair)

PROAIR HFA - albuterol sulfate inhalaero 108 mcg/act (90mcg base equiv)

•

PROAIR RESPICLICK - albuterolsulfate aer pow ba 108 mcg/act (90mcg base equiv)

•

QVAR REDIHALER - beclomethasonediprop hfa breath act inh aer 40 mcg/act

•

QVAR REDIHALER - beclomethasonediprop hfa breath act inh aer 80 mcg/act

•

SEREVENT DISKUS - salmeterolxinafoate aer pow ba 50 mcg/dose(base equiv)

•

SPIRIVA HANDIHALER - tiotropiumbromide monohydrate inhal cap 18mcg (base equiv)

•

SPIRIVA RESPIMAT - tiotropiumbromide monohydrate inhal aerosol1.25 mcg/act

•

SPIRIVA RESPIMAT - tiotropiumbromide monohydrate inhal aerosol2.5 mcg/act

•

STIOLTO RESPIMAT - tiotropium br-olodaterol inhal aero soln 2.5-2.5mcg/act

•

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STRIVERDI RESPIMAT - olodaterol hclinhal aerosol soln 2.5 mcg/act (baseequiv)

•

SYMBICORT - budesonide-formoterolfumarate dihyd aerosol 80-4.5 mcg/act

•

SYMBICORT - budesonide-formoterolfumarate dihyd aerosol 160-4.5 mcg/act

•

terbutaline sulfate tab 2.5 mgterbutaline sulfate tab 5 mgtheophylline tab er 24hr 400 mgtheophylline tab er 24hr 600 mgTRELEGY ELLIPTA - fluticasone-

umeclidinium-vilanterol aepb100-62.5-25 mcg/inh

•

VENTOLIN HFA - albuterol sulfate inhalaero 108 mcg/act (90mcg base equiv)

•

zafirlukast tab 10 mg (Accolate)zafirlukast tab 20 mg (Accolate)RESPIRATORY AGENTS - MISC.KALYDECO - ivacaftor tab 150 mg • • •KALYDECO - ivacaftor packet 25 mg • • •KALYDECO - ivacaftor packet 50 mg • • •KALYDECO - ivacaftor packet 75 mg • • •PULMOZYME - dornase alfa inhal soln

1 mg/ml•

SYMDEKO - tezacaftor-ivacaftor 50-75mg & ivacaftor 75 mg tab tbpk

• • •

SYMDEKO - tezacaftor-ivacaftor100-150 mg & ivacaftor 150 mg tabtbpk

• • •

TRIKAFTA - elexacaf-tezacaf-ivacaf100-50-75 mg &ivacaftor 150 mg tbpk

• • •

GASTROINTESTINAL AGENTSLAXATIVES

2020


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lactulose solution 10 gm/15mlpeg 3350-kcl-sod bicarb-nacl for soln

420 gm (Nulytely/flavor pack)peg 3350-kcl-na bicarb-nacl-na

sulfate for soln 236 gm (Golytely)ANTIDIARRHEALSdiphenoxylate w/ atropine tab

2.5-0.025 mg (Lomotil)loperamide hcl cap 2 mgULCER DRUGScimetidine tab 300 mgcimetidine tab 400 mgcimetidine tab 800 mgdicyclomine hcl cap 10 mg (Bentyl)dicyclomine hcl oral soln 10 mg/5mldicyclomine hcl tab 20 mg (Bentyl)esomeprazole magnesium cap

delayed release 20 mg (base eq)(Nexium)

•

esomeprazole magnesium capdelayed release 40 mg (base eq)(Nexium)

•

esomeprazole magnesium fordelayed release susp packet 10 mg(Nexium)

•


•


•

famotidine for susp 40 mg/5mlfamotidine tab 20 mg (Pepcid)famotidine tab 40 mg (Pepcid)glycopyrrolate tab 1 mg (Robinul)

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glycopyrrolate tab 2 mg (Robinulforte)

lansoprazole cap delayed release15 mg (Prevacid)

•

lansoprazole cap delayed release30 mg (Prevacid)

•

methscopolamine bromide tab2.5 mg (Pamine)

methscopolamine bromide tab 5 mg(Pamine forte)

misoprostol tab 100 mcg (Cytotec)misoprostol tab 200 mcg (Cytotec)NEXIUM - esomeprazole magnesium for

delayed release susp pack 2.5 mg•

NEXIUM - esomeprazole magnesium fordelayed release susp packet 5 mg

•


•


•


•

omeprazole cap delayed release10 mg (Prilosec)

•


•


•

pantoprazole sodium ec tab 20 mg(base equiv) (Protonix)

•

pantoprazole sodium ec tab 40 mg(base equiv) (Protonix)

•

sucralfate tab 1 gm (Carafate)ANTIEMETICSaprepitant capsule therapy pack 80 &

125 mg (Emend)•

aprepitant capsule 40 mg (Emend) •

2020


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aprepitant capsule 80 mg (Emend) •aprepitant capsule 125 mg (Emend) •EMEND - aprepitant for oral susp 125

mg (125 mg/5ml)•

granisetron hcl tab 1 mg •meclizine hcl tab 12.5 mgmeclizine hcl tab 25 mgondansetron hcl inj 4 mg/2ml (2 mg/

ml)ondansetron hcl inj 40 mg/20ml

(2 mg/ml)ondansetron hcl oral soln 4 mg/5ml

(Zofran)•

ondansetron hcl tab 4 mg (Zofran) •ondansetron hcl tab 8 mg (Zofran) •ondansetron orally disintegrating tab

4 mg (Zofran odt)•

ondansetron orally disintegrating tab8 mg (Zofran odt)

•

scopolamine td patch 72hr1 mg/3days (Transderm-scop)

trimethobenzamide hcl cap 300 mg(Tigan)

DIGESTIVE AIDSCREON - pancrelipase (lip-prot-amyl) dr

cap 3000-9500-15000 unitCREON - pancrelipase (lip-prot-amyl) dr




cap 36000-114000-180000 unitZENPEP - pancrelipase (lip-prot-amyl)

dr cap 3000-10000-14000 unit

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ZENPEP - pancrelipase (lip-prot-amyl)dr cap 5000-17000-24000 unit






GASTROINTESTINAL AGENTS- MISC.APRISO - mesalamine cap er 24hr

0.375 gmbalsalazide disodium cap 750 mg

(Colazal)calcium acetate (phosphate binder)

cap 667 mg (169 mg ca) (Phoslo)calcium acetate (phosphate binder)

tab 667 mgCHENODAL - chenodiol tab 250 mg •DELZICOL - mesalamine cap dr 400 mglactulose (encephalopathy) solution

10 gm/15mlmesalamine cap dr 400 mg (Delzicol)mesalamine cap er 24hr 0.375 gm

(Apriso)mesalamine enema 4 gmmesalamine suppos 1000 mg

(Canasa)mesalamine tab delayed release

800 mg (Asacol hd)mesalamine tab delayed release

1.2 gm (Lialda)metoclopramide hcl soln 5 mg/5ml

(10 mg/10ml) (base equiv)

2020


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metoclopramide hcl tab 5 mg (baseequivalent) (Reglan)

metoclopramide hcl tab 10 mg (baseequivalent) (Reglan)

sevelamer carbonate packet 0.8 gm(Renvela)

sevelamer carbonate packet 2.4 gm(Renvela)

sevelamer carbonate tab 800 mg(Renvela)

sulfasalazine tab delayed release500 mg (Azulfidine en-tabs)

sulfasalazine tab 500 mg (Azulfidine)SYMPROIC - naldemedine tosylate tab

0.2 mg (base equivalent)• •

TRULANCE - plecanatide tab 3 mg • •ursodiol cap 300 mg (Actigall)ursodiol tab 250 mg (Urso 250)ursodiol tab 500 mg (Urso forte)VELPHORO - sucroferric oxyhydroxide

chew tab 500 mg•

VIBERZI - eluxadoline tab 75 mg •VIBERZI - eluxadoline tab 100 mg •GENITOURINARY AGENTSURINARY ANTI-INFECTIVESnitrofurantoin macrocrystalline cap

25 mg (Macrodantin)nitrofurantoin macrocrystalline cap

50 mg (Macrodantin)nitrofurantoin macrocrystalline cap

100 mg (Macrodantin)nitrofurantoin monohydrate

macrocrystalline cap 100 mg(Macrobid)

nitrofurantoin susp 25 mg/5ml(Furadantin)

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URINARY ANTISPASMODICSoxybutynin chloride syrup 5 mg/5mloxybutynin chloride tab er 24hr 5 mg

(Ditropan xl)oxybutynin chloride tab er 24hr

10 mg (Ditropan xl)oxybutynin chloride tab er 24hr

15 mgoxybutynin chloride tab 5 mgsolifenacin succinate tab 5 mg

(Vesicare)solifenacin succinate tab 10 mg

(Vesicare)tolterodine tartrate cap er 24hr 2 mg

(Detrol la)tolterodine tartrate cap er 24hr 4 mg

(Detrol la)tolterodine tartrate tab 1 mg (Detrol)tolterodine tartrate tab 2 mg (Detrol)VAGINAL PRODUCTSclindamycin phosphate vaginal

cream 2% (Cleocin)CRINONE - progesterone vaginal gel

4%•

CRINONE - progesterone vaginal gel8%

•

estradiol vaginal cream 0.1 mg/gm(Estrace)

estradiol vaginal tab 10 mcg(Vagifem)

ESTRING - estradiol vaginal ring 2 mg(7.5 mcg/24hrs)

metronidazole vaginal gel 0.75%(Metrogel-vaginal)

terconazole vaginal cream 0.4%(Terazol 7)

2020


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terconazole vaginal suppos 80 mgGENITOURINARY AGENTS - MISC.alfuzosin hcl tab er 24hr 10 mg

(Uroxatral)CYSTAGON - cysteamine bitartrate cap

50 mg•

CYSTAGON - cysteamine bitartrate cap150 mg

•

dutasteride cap 0.5 mg (Avodart)finasteride tab 5 mg (Proscar)potassium citrate tab er 5 meq

(540 mg) (Urocit-k 5)potassium citrate tab er 10 meq

(1080 mg) (Urocit-k 10)potassium citrate tab er 15 meq

(1620 mg) (Urocit-k 15)sodium citrate & citric acid soln

500-334 mg/5mltamsulosin hcl cap 0.4 mg (Flomax)CENTRAL NERVOUS SYSTEM DRUGSANTIANXIETY AGENTSalprazolam tab er 24hr 0.5 mg (Xanax

xr)alprazolam tab er 24hr 1 mg (Xanax



xr)alprazolam tab 0.25 mg (Xanax)alprazolam tab 0.5 mg (Xanax)alprazolam tab 1 mg (Xanax)alprazolam tab 2 mg (Xanax)buspirone hcl tab 5 mgbuspirone hcl tab 10 mg

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buspirone hcl tab 15 mgbuspirone hcl tab 30 mgDIAZEPAM - diazepam oral soln 1 mg/

mldiazepam tab 2 mg (Valium)diazepam tab 5 mg (Valium)diazepam tab 10 mg (Valium)hydroxyzine hcl syrup 10 mg/5mlhydroxyzine hcl tab 10 mghydroxyzine hcl tab 25 mghydroxyzine hcl tab 50 mghydroxyzine pamoate cap 25 mg

(Vistaril)hydroxyzine pamoate cap 50 mg

(Vistaril)lorazepam conc 2 mg/ml (Lorazepam

intensol)lorazepam tab 0.5 mg (Ativan) •lorazepam tab 1 mg (Ativan) •lorazepam tab 2 mg (Ativan) •ANTIDEPRESSANTSamitriptyline hcl tab 10 mgamitriptyline hcl tab 25 mgamitriptyline hcl tab 50 mgamitriptyline hcl tab 75 mgamitriptyline hcl tab 100 mgamitriptyline hcl tab 150 mgbupropion hcl tab er 12hr 100 mg

(Wellbutrin sr)bupropion hcl tab er 12hr 150 mg



(Wellbutrin xl)

2020


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bupropion hcl tab er 24hr 300 mg(Wellbutrin xl)

bupropion hcl tab 75 mg (Wellbutrin)bupropion hcl tab 100 mg (Wellbutrin)citalopram hydrobromide oral soln

10 mg/5mlcitalopram hydrobromide tab 10 mg

(base equiv) (Celexa)citalopram hydrobromide tab 20 mg

(base equiv) (Celexa)citalopram hydrobromide tab 40 mg

(base equiv) (Celexa)clomipramine hcl cap 25 mg

(Anafranil)clomipramine hcl cap 50 mg

(Anafranil)clomipramine hcl cap 75 mg

(Anafranil)desipramine hcl tab 10 mg

(Norpramin)desipramine hcl tab 25 mg





(Norpramin)desvenlafaxine succinate tab er 24hr

25 mg (base equiv) (Pristiq)•

desvenlafaxine succinate tab er 24hr50 mg (base equiv) (Pristiq)

•

desvenlafaxine succinate tab er 24hr100 mg (base equiv) (Pristiq)

•

doxepin hcl cap 10 mg

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doxepin hcl cap 25 mgdoxepin hcl cap 50 mgdoxepin hcl cap 75 mgdoxepin hcl cap 100 mgdoxepin hcl conc 10 mg/mlduloxetine hcl enteric coated pellets

cap 20 mg (base eq) (Cymbalta)•

duloxetine hcl enteric coated pelletscap 30 mg (base eq) (Cymbalta)

•

duloxetine hcl enteric coated pelletscap 60 mg (base eq) (Cymbalta)

•

escitalopram oxalate soln 5 mg/5ml(base equiv) (Lexapro)

escitalopram oxalate tab 5 mg (baseequiv) (Lexapro)

escitalopram oxalate tab 10 mg(base equiv) (Lexapro)

escitalopram oxalate tab 20 mg(base equiv) (Lexapro)

fluoxetine hcl cap 10 mg (Prozac)fluoxetine hcl cap 20 mg (Prozac)fluoxetine hcl cap 40 mg (Prozac)fluoxetine hcl solution 20 mg/5mlfluvoxamine maleate tab 25 mgfluvoxamine maleate tab 50 mgfluvoxamine maleate tab 100 mgimipramine hcl tab 10 mg (Tofranil)imipramine hcl tab 25 mg (Tofranil)imipramine hcl tab 50 mg (Tofranil)mirtazapine tab 7.5 mgmirtazapine tab 15 mg (Remeron)mirtazapine tab 30 mg (Remeron)mirtazapine tab 45 mg (Remeron)nortriptyline hcl cap 10 mg (Pamelor)

2020


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nortriptyline hcl cap 25 mg (Pamelor)nortriptyline hcl cap 50 mg (Pamelor)nortriptyline hcl cap 75 mg (Pamelor)paroxetine hcl tab er 24hr 12.5 mg

(Paxil cr)paroxetine hcl tab er 24hr 25 mg

(Paxil cr)paroxetine hcl tab er 24hr 37.5 mg

(Paxil cr)paroxetine hcl tab 10 mg (Paxil)paroxetine hcl tab 20 mg (Paxil)paroxetine hcl tab 30 mg (Paxil)paroxetine hcl tab 40 mg (Paxil)phenelzine sulfate tab 15 mg (Nardil)sertraline hcl oral concentrate for

solution 20 mg/ml (Zoloft)sertraline hcl tab 25 mg (Zoloft)sertraline hcl tab 50 mg (Zoloft)sertraline hcl tab 100 mg (Zoloft)tranylcypromine sulfate tab 10 mg

(Parnate)trazodone hcl tab 50 mgtrazodone hcl tab 100 mgtrazodone hcl tab 150 mgtrazodone hcl tab 300 mgvenlafaxine hcl cap er 24hr 37.5 mg

(base equivalent) (Effexor xr)venlafaxine hcl cap er 24hr 75 mg

(base equivalent) (Effexor xr)venlafaxine hcl cap er 24hr 150 mg

(base equivalent) (Effexor xr)venlafaxine hcl tab 25 mg (base

equivalent)venlafaxine hcl tab 37.5 mg (base

equivalent)

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venlafaxine hcl tab 50 mg (baseequivalent)



ANTIPSYCHOTICSaripiprazole tab 2 mg (Abilify) •aripiprazole tab 5 mg (Abilify) •aripiprazole tab 10 mg (Abilify) •aripiprazole tab 15 mg (Abilify) •aripiprazole tab 20 mg (Abilify) •aripiprazole tab 30 mg (Abilify) •chlorpromazine hcl tab 10 mgchlorpromazine hcl tab 25 mgchlorpromazine hcl tab 50 mgchlorpromazine hcl tab 100 mgchlorpromazine hcl tab 200 mgclozapine tab 25 mg (Clozaril) •clozapine tab 50 mg •clozapine tab 100 mg (Clozaril) •clozapine tab 200 mg •fluphenazine decanoate inj 25 mg/mlFLUPHENAZINE HCL - fluphenazine

hcl oral conc 5 mg/mlfluphenazine hcl tab 1 mgfluphenazine hcl tab 2.5 mgfluphenazine hcl tab 5 mgfluphenazine hcl tab 10 mgFLUPHENAZINE HYDROCHLORID -

fluphenazine hcl elixir 2.5 mg/5mlhaloperidol decanoate im soln

50 mg/ml (Haldol decanoate 50)

2020


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haloperidol decanoate im soln100 mg/ml (Haldol decanoate 100)

haloperidol lactate oral conc 2 mg/mlhaloperidol tab 0.5 mghaloperidol tab 1 mghaloperidol tab 2 mghaloperidol tab 5 mghaloperidol tab 10 mghaloperidol tab 20 mglithium carbonate cap 150 mg

(Lithium carbonate)lithium carbonate cap 300 mglithium carbonate cap 600 mg

(Lithium carbonate)lithium carbonate tab er 300 mg

(Lithobid)lithium carbonate tab er 450 mglithium carbonate tab 300 mgloxapine succinate cap 5 mgloxapine succinate cap 10 mgloxapine succinate cap 25 mgloxapine succinate cap 50 mgolanzapine orally disintegrating tab

5 mg (Zyprexa zydis)•

olanzapine orally disintegrating tab10 mg (Zyprexa zydis)

•


•


•

olanzapine tab 2.5 mg (Zyprexa) •olanzapine tab 5 mg (Zyprexa) •olanzapine tab 7.5 mg (Zyprexa) •olanzapine tab 10 mg (Zyprexa) •olanzapine tab 15 mg (Zyprexa) •

Drug Name Spe

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olanzapine tab 20 mg (Zyprexa) •perphenazine tab 2 mgperphenazine tab 4 mgperphenazine tab 8 mgperphenazine tab 16 mgprochlorperazine maleate tab 5 mg

(base equivalent)prochlorperazine maleate tab 10 mg

(base equivalent)prochlorperazine suppos 25 mgquetiapine fumarate tab er 24hr

50 mg (Seroquel xr)•

quetiapine fumarate tab er 24hr150 mg (Seroquel xr)

•


•


•


•

quetiapine fumarate tab 25 mg(Seroquel)

•


•


•


•


•


•

risperidone orally disintegrating tab0.5 mg (Risperdal m-tab)

•

risperidone orally disintegrating tab1 mg (Risperdal m-tab)

•

2020


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•


•


•

risperidone soln 1 mg/ml (Risperdal) •risperidone tab 0.25 mg (Risperdal) •risperidone tab 0.5 mg (Risperdal) •risperidone tab 1 mg (Risperdal) •risperidone tab 2 mg (Risperdal) •risperidone tab 3 mg (Risperdal) •risperidone tab 4 mg (Risperdal) •thiothixene cap 1 mgthiothixene cap 2 mgthiothixene cap 5 mgthiothixene cap 10 mgtrifluoperazine hcl tab 1 mg (base

equivalent)trifluoperazine hcl tab 2 mg (base



equivalent)ziprasidone hcl cap 20 mg (Geodon) •ziprasidone hcl cap 40 mg (Geodon) •ziprasidone hcl cap 60 mg (Geodon) •ziprasidone hcl cap 80 mg (Geodon) •HYPNOTICSBELSOMRA - suvorexant tab 5 mg • •BELSOMRA - suvorexant tab 10 mg • •BELSOMRA - suvorexant tab 15 mg • •BELSOMRA - suvorexant tab 20 mg • •

Drug Name Spe

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estazolam tab 1 mgestazolam tab 2 mgeszopiclone tab 1 mg (Lunesta) •eszopiclone tab 2 mg (Lunesta) •eszopiclone tab 3 mg (Lunesta) •phenobarbital elixir 20 mg/5mlphenobarbital tab 15 mgphenobarbital tab 16.2 mgphenobarbital tab 30 mgphenobarbital tab 32.4 mgphenobarbital tab 60 mgphenobarbital tab 100 mgtemazepam cap 7.5 mg (Restoril)temazepam cap 15 mg (Restoril)temazepam cap 22.5 mg (Restoril)temazepam cap 30 mg (Restoril)zaleplon cap 5 mg (Sonata) •zaleplon cap 10 mg (Sonata) •zolpidem tartrate tab er 6.25 mg

(Ambien cr)•

zolpidem tartrate tab er 12.5 mg(Ambien cr)

•

zolpidem tartrate tab 5 mg (Ambien) •zolpidem tartrate tab 10 mg (Ambien) •ADHD/ANTI-NARCOLEPSY/ANTI-OBESITY/ANOREXIANTSamphetamine-dextroamphetamine

cap er 24hr 5 mg (Adderall xr)•

amphetamine-dextroamphetaminecap er 24hr 10 mg (Adderall xr)

•


•


•

2020


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•


•

amphetamine-dextroamphetaminetab 5 mg (Adderall)

•

amphetamine-dextroamphetaminetab 7.5 mg (Adderall)

•


•

amphetamine-dextroamphetaminetab 12.5 mg (Adderall)

•


•


•


•

armodafinil tab 50 mg (Nuvigil) •armodafinil tab 150 mg (Nuvigil) •armodafinil tab 200 mg (Nuvigil) •armodafinil tab 250 mg (Nuvigil) •atomoxetine hcl cap 10 mg (base

equiv) (Strattera)•

atomoxetine hcl cap 18 mg (baseequiv) (Strattera)

•


•


•


•


•


•

Drug Name Spe

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caffeine citrate oral soln 60 mg/3ml(10 mg/ml base equiv)

dexmethylphenidate hcl cap er 24 hr5 mg (Focalin xr)

•


•


•


•


•


•


•


•

dexmethylphenidate hcl tab 2.5 mg(Focalin)

•

dexmethylphenidate hcl tab 5 mg(Focalin)

•

dexmethylphenidate hcl tab 10 mg(Focalin)

•

dextroamphetamine sulfate cap er24hr 5 mg (Dexedrine)

•


•


•

dextroamphetamine sulfate tab 5 mg •dextroamphetamine sulfate tab

10 mg•

guanfacine hcl tab er 24hr 1 mg(base equiv) (Intuniv)

•


•

2020


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•


•

methylphenidate hcl tab er osmoticrelease (osm) 18 mg (Concerta)

•


•


•


•

methylphenidate hcl tab er 10 mg •methylphenidate hcl tab er 20 mg •methylphenidate hcl tab 5 mg

(Ritalin)•

methylphenidate hcl tab 10 mg(Ritalin)

•

methylphenidate hcl tab 20 mg(Ritalin)

•

modafinil tab 100 mg (Provigil) •modafinil tab 200 mg (Provigil) •SUNOSI - solriamfetol hcl tab 75 mg

(base equiv)SUNOSI - solriamfetol hcl tab 150 mg

(base equiv)VYVANSE - lisdexamfetamine

dimesylate cap 10 mg•

VYVANSE - lisdexamfetaminedimesylate cap 20 mg

•


•


•


•

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•


•

VYVANSE - lisdexamfetaminedimesylate chew tab 10 mg

•


•


•


•


•


•

PSYCHOTHERAPEUTIC and NEUROLOGICALAGENTS - MISC.acamprosate calcium tab delayed

release 333 mgAUBAGIO - teriflunomide tab 7 mg • •AUBAGIO - teriflunomide tab 14 mg • •AVONEX - interferon beta-1a im

prefilled syringe kit 30 mcg/0.5ml• •

AVONEX PEN - interferon beta-1a imauto-injector kit 30 mcg/0.5ml

• •

BETASERON - interferon beta-1b for injkit 0.3 mg

• •

bupropion hcl (smoking deterrent)tab er 12hr 150 mg (Zyban)

CHANTIX - varenicline tartrate tab 0.5mg (base equiv)

CHANTIX - varenicline tartrate tab 1 mg(base equiv)

CHANTIX CONTINUING MONTH -varenicline tartrate tab 1 mg (baseequiv)

2020


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COPAXONE - glatiramer acetate solnprefilled syringe 20 mg/ml

• •

COPAXONE - glatiramer acetate solnprefilled syringe 40 mg/ml

• •

disulfiram tab 250 mg (Antabuse)disulfiram tab 500 mg (Antabuse)donepezil hydrochloride orally

disintegrating tab 5 mgdonepezil hydrochloride orally

disintegrating tab 10 mgdonepezil hydrochloride tab 5 mg

(Aricept)donepezil hydrochloride tab 10 mg

(Aricept)galantamine hydrobromide cap er

24hr 8 mg (Razadyne er)galantamine hydrobromide cap er

24hr 16 mg (Razadyne er)galantamine hydrobromide cap er

24hr 24 mg (Razadyne er)galantamine hydrobromide tab 4 mg

(Razadyne)galantamine hydrobromide tab 8 mg

(Razadyne)galantamine hydrobromide tab

12 mg (Razadyne)GILENYA - fingolimod hcl cap 0.5 mg

(base equiv)• •

glatiramer acetate soln prefilledsyringe 20 mg/ml (Copaxone)

• •

glatiramer acetate soln prefilledsyringe 40 mg/ml (Copaxone)

• •

MAVENCLAD - cladribine tab therapypack 10 mg (4 tabs)

• •


• •

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• •


• •


• •


• •


• •

MAYZENT - siponimod fumarate tab0.25 mg (base equiv)

• •

MAYZENT - siponimod fumarate tab 2mg (base equiv)

• •

memantine hcl oral solution 2 mg/ml(Namenda)

memantine hcl tab 5 mg (Namenda)memantine hcl tab 10 mg (Namenda)memantine hcl tab 28 x 5 mg & 21

x 10 mg titration pack (Namendatitration pa)

NICOTROL INHALER - nicotine inhalersystem 10 mg (4 mg delivered)

NICOTROL NS - nicotine nasal spray 10mg/ml (0.5 mg/spray)

PLEGRIDY - peginterferon beta-1a solnpen-injector 125 mcg/0.5ml

• •

PLEGRIDY - peginterferon beta-1a solnprefilled syringe 125 mcg/0.5ml

• •

PLEGRIDY STARTER PACK -peginterferon beta-1a soln pen-inj 63& 94 mcg/0.5ml pack

• •

PLEGRIDY STARTER PACK -peginterferon beta-1a soln pref syr 63& 94 mcg/0.5ml pack

• •

REBIF - interferon beta-1a soln pref syr22 mcg/0.5ml (12mu/ml)

• •

2020


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REBIF - interferon beta-1a soln pref syr44 mcg/0.5ml (24mu/ml)

• •

REBIF REBIDOSE - interferon beta-1asoln auto-inj 22 mcg/0.5ml (12mu/ml)

• •

REBIF REBIDOSE - interferon beta-1asoln auto-inj 44 mcg/0.5ml (24mu/ml)

• •

REBIF REBIDOSE TITRATION -interferon beta-1a auto-inj 6x8.8mcg/0.2ml & 6x22 mcg/0.5ml

• •

REBIF TITRATION PACK - interferonbeta-1a pref syr 6x8.8 mcg/0.2ml &6x22 mcg/0.5ml

• •

rivastigmine tartrate cap 1.5 mg(base equivalent)

rivastigmine tartrate cap 3 mg (baseequivalent)

rivastigmine tartrate cap 4.5 mg(base equivalent)

rivastigmine tartrate cap 6 mg (baseequivalent)

TECFIDERA - dimethyl fumaratecapsule delayed release 120 mg

• •

TECFIDERA - dimethyl fumaratecapsule delayed release 240 mg

• •

TECFIDERA STARTER PACK -dimethyl fumarate capsule dr starterpack 120 mg & 240 mg

• •

tetrabenazine tab 12.5 mg (Xenazine) • • •tetrabenazine tab 25 mg (Xenazine) • • •VUMERITY - diroximel fumarate

capsule dr starter bottle 231 mg• •

VUMERITY - diroximel fumaratecapsule delayed release 231 mg

• •

ZEPOSIA - ozanimod hcl cap 0.92 mg • •ZEPOSIA STARTER KIT - ozanimod

cap pack 4 x 0.23 mg & 3 x 0.46 mg& 30 x 0.92 mg

• •

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ZEPOSIA 7-DAY STARTER PAC -ozanimod cap pack 4 x 0.23 mg & 3 x0.46 mg

• •

ANALGESICS AND ANESTHETICSANALGESICS - NON-NARCOTICbutalbital-acetaminophen tab

50-325 mgbutalbital-acetaminophen-caffeine

tab 50-325-40 mg (Esgic)butalbital-aspirin-caffeine cap

50-325-40 mg (Fiorinal)ANALGESICS - NARCOTICacetaminophen w/ codeine soln

120-12 mg/5ml•

acetaminophen w/ codeine tab300-15 mg (Tylenol/codeine)

•

acetaminophen w/ codeine tab300-30 mg (Tylenol/codeine #3)

•

acetaminophen w/ codeine tab300-60 mg (Tylenol/codeine #4)

•

BELBUCA - buprenorphine hcl buccalfilm 75 mcg (base equivalent)

•


•


•


•


•


•


•

buprenorphine hcl sl tab 2 mg (baseequiv)

•

2020


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buprenorphine hcl sl tab 8 mg (baseequiv)

•

buprenorphine hcl-naloxone hclsl film 2-0.5 mg (base equiv)(SUBOXONE)

•

buprenorphine hcl-naloxonehcl sl film 4-1 mg (base equiv)(SUBOXONE)

•

buprenorphine hcl-naloxonehcl sl film 8-2 mg (base equiv)(SUBOXONE)

•

buprenorphine hcl-naloxone hclsl film 12-3 mg (base equiv)(SUBOXONE)

•

buprenorphine hcl-naloxone hcl sltab 2-0.5 mg (base equiv)

•

buprenorphine hcl-naloxone hcl sltab 8-2 mg (base equiv)

•

butalbital-aspirin-caff w/ codeine cap50-325-40-30 mg (Fiorinal/codeine#3)

•

codeine sulfate tab 30 mg (Codeinesulfate)

•

fentanyl citrate lozenge on a handle200 mcg (Actiq)

• •


• •


• •


• •


• •


• •

fentanyl td patch 72hr 12 mcg/hr(Duragesic)

• •

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• •


• •


• •


• •

hydrocodone-acetaminophen soln7.5-325 mg/15ml (Hycet)

•

hydrocodone-acetaminophen tab10-325 mg (Norco)

•

hydrocodone-acetaminophen tab5-325 mg (Norco)

•

hydrocodone-acetaminophen tab7.5-325 mg (Norco)

•

hydrocodone-ibuprofen tab 5-200 mg(Reprexain)

•

hydrocodone-ibuprofen tab7.5-200 mg (Vicoprofen)

•

hydrocodone-ibuprofen tab10-200 mg (Ibudone)

•

hydromorphone hcl liqd 1 mg/ml(Dilaudid)

•

hydromorphone hcl tab 2 mg(Dilaudid)

•


•


•

methadone hcl conc 10 mg/ml(Methadose)

•

methadone hcl soln 5 mg/5ml(Methadone hcl)

•

methadone hcl soln 10 mg/5ml(Methadone hcl)

•

2020


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methadone hcl tab for oral susp40 mg

•

methadone hcl tab 5 mg (Dolophinehcl)

•

methadone hcl tab 10 mg (Dolophine) •MORPHINE SULFATE - morphine

sulfate tab 15 mg•

MORPHINE SULFATE - morphinesulfate tab 30 mg

•

morphine sulfate oral soln 10 mg/5ml •morphine sulfate oral soln 20 mg/5ml •morphine sulfate oral soln

100 mg/5ml (20 mg/ml)•

morphine sulfate tab er 15 mg (Mscontin)

• •


• •


• •


• •


• •

morphine sulfate tab 15 mg(Morphine sulfate)

•

morphine sulfate tab 30 mg(Morphine sulfate)

•

oxycodone hcl cap 5 mg •oxycodone hcl conc 100 mg/5ml

(20 mg/ml) (Oxycodone hcl)•

oxycodone hcl soln 5 mg/5ml(Oxycodone hcl)

•

oxycodone hcl tab 5 mg (Roxicodone) •oxycodone hcl tab 10 mg •oxycodone hcl tab 15 mg

(Roxicodone)•

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oxycodone hcl tab 20 mg •oxycodone hcl tab 30 mg

(Roxicodone)•

oxycodone w/ acetaminophen tab5-325 mg (Percocet)

•

oxycodone w/ acetaminophen tab7.5-325 mg (Percocet)

•

oxycodone w/ acetaminophen tab10-325 mg (Percocet)

•

tramadol hcl tab er 24hr 100 mg • •tramadol hcl tab er 24hr 200 mg • •tramadol hcl tab er 24hr 300 mg • •tramadol hcl tab 50 mg (Ultram) • •tramadol-acetaminophen tab

37.5-325 mg (Ultracet)•

XTAMPZA ER - oxycodone cap er 12hrabuse-deterrent 9 mg

• •

XTAMPZA ER - oxycodone cap er 12hrabuse-deterrent 13.5 mg

• •


• •


• •


• •

ANALGESICS - ANTI-INFLAMMATORYACTEMRA - tocilizumab subcutaneous

soln prefilled syringe 162 mg/0.9ml• • •

ACTEMRA ACTPEN - tocilizumabsubcutaneous soln auto-injector 162mg/0.9ml

• • •

celecoxib cap 50 mg (Celebrex) •celecoxib cap 100 mg (Celebrex) •celecoxib cap 200 mg (Celebrex) •celecoxib cap 400 mg (Celebrex) •diclofenac potassium tab 50 mg

2020


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diclofenac sodium tab delayedrelease 25 mg



diclofenac sodium tab er 24hr100 mg

ENBREL - etanercept for subcutaneousinj 25 mg

• • •

ENBREL - etanercept subcutaneoussoln prefilled syringe 25 mg/0.5ml

• • •

ENBREL - etanercept subcutaneoussoln prefilled syringe 50 mg/ml

• • •

ENBREL MINI - etanerceptsubcutaneous solution cartridge 50mg/ml

• • •

ENBREL SURECLICK - etanerceptsubcutaneous solution auto-injector50 mg/ml

• • •

etodolac cap 200 mgetodolac cap 300 mgetodolac tab er 24hr 400 mgetodolac tab er 24hr 500 mgetodolac tab er 24hr 600 mgetodolac tab 400 mgetodolac tab 500 mgflurbiprofen tab 50 mgflurbiprofen tab 100 mgHUMIRA - adalimumab prefilled syringe

kit 10 mg/0.1ml• • •

HUMIRA - adalimumab prefilled syringekit 10 mg/0.2ml

• • •


• • •

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• • •


• • •


• • •

HUMIRA PEDIATRIC CROHNS D -adalimumab prefilled syringe kit 80mg/0.8ml

• • •

HUMIRA PEDIATRIC CROHNS D -adalimumab prefilled syringe kit 80mg/0.8ml & 40 mg/0.4ml

• • •

HUMIRA PEN - adalimumab pen-injector kit 40 mg/0.8ml

• • •

HUMIRA PEN - adalimumab pen-injector kit 40 mg/0.4ml

• • •

HUMIRA PEN-CD/UC/HS START -adalimumab pen-injector kit 40mg/0.8ml

• • •

HUMIRA PEN-CD/UC/HS START -adalimumab pen-injector kit 80mg/0.8ml

• • •

HUMIRA PEN-PS/UV STARTER -adalimumab pen-injector kit 40mg/0.8ml

• • •

HUMIRA PEN-PS/UV STARTER -adalimumab pen-injector kit 80mg/0.8ml & 40 mg/0.4ml

• • •

ibuprofen susp 100 mg/5mlibuprofen tab 400 mgibuprofen tab 600 mgibuprofen tab 800 mgindomethacin cap 25 mgindomethacin cap 50 mgleflunomide tab 10 mg (Arava)leflunomide tab 20 mg (Arava)meloxicam tab 7.5 mg (Mobic)

2020


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meloxicam tab 15 mg (Mobic)nabumetone tab 500 mgnabumetone tab 750 mgnaproxen sodium tab 275 mg

(Anaprox)naproxen sodium tab 550 mg

(Anaprox ds)naproxen tab ec 375 mg (Ec-

naprosyn)naproxen tab ec 500 mg (Ec-

naprosyn)naproxen tab 250 mg (Naprosyn)naproxen tab 375 mg (Naprosyn)naproxen tab 500 mg (Naprosyn)OTEZLA - apremilast tab starter therapy

pack 10 mg & 20 mg & 30 mg• • •

OTEZLA - apremilast tab 30 mg • • •oxaprozin tab 600 mg (Daypro)piroxicam cap 10 mg (Feldene)piroxicam cap 20 mg (Feldene)RINVOQ - upadacitinib tab er 24hr 15

mg• • •

SIMPONI - golimumab subcutaneoussoln auto-injector 100 mg/ml

• • •

SIMPONI - golimumab subcutaneoussoln prefilled syringe 100 mg/ml

• • •

sulindac tab 150 mgsulindac tab 200 mgXELJANZ - tofacitinib citrate tab 5 mg

(base equivalent)• • •

XELJANZ - tofacitinib citrate tab 10 mg(base equivalent)

• • •

XELJANZ XR - tofacitinib citrate tab er24hr 11 mg (base equivalent)

• • •

XELJANZ XR - tofacitinib citrate tab er24hr 22 mg (base equivalent)

• • •

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MIGRAINE PRODUCTSAIMOVIG - erenumab-aooe

subcutaneous soln auto-injector 70mg/ml

• •

AIMOVIG - erenumab-aooesubcutaneous soln auto-injector 140mg/ml

• •

dihydroergotamine mesylate inj1 mg/ml (D.h.e. 45)

•

dihydroergotamine mesylate nasalspray 4 mg/ml (Migranal)

•

eletriptan hydrobromide tab 20 mg(base equivalent) (Relpax)

•

eletriptan hydrobromide tab 40 mg(base equivalent) (Relpax)

•

EMGALITY - galcanezumab-gnlmsubcutaneous soln auto-injector 120mg/ml

• •

EMGALITY - galcanezumab-gnlmsubcutaneous soln prefilled syr 100mg/ml

• •

EMGALITY - galcanezumab-gnlmsubcutaneous soln prefilled syr 120mg/ml

• •

MIGRANAL - dihydroergotaminemesylate nasal spray 4 mg/ml

•

naratriptan hcl tab 1 mg (base equiv)(Amerge)

•

naratriptan hcl tab 2.5 mg (baseequiv) (Amerge)

•

rizatriptan benzoate oraldisintegrating tab 5 mg (base eq)

•

rizatriptan benzoate oraldisintegrating tab 10 mg (base eq)(Maxalt-mlt)

•

rizatriptan benzoate tab 5 mg (baseequivalent)

•

2020


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rizatriptan benzoate tab 10 mg (baseequivalent) (Maxalt)

•

sumatriptan nasal spray 5 mg/act(Imitrex)

•

sumatriptan nasal spray 20 mg/act(Imitrex)

•

sumatriptan succinate inj 6 mg/0.5ml(Imitrex)

•

sumatriptan succinate solution auto-injector 4 mg/0.5ml (Imitrex statdosesys)

•

sumatriptan succinate solution auto-injector 6 mg/0.5ml (Imitrex statdosesys)

•

sumatriptan succinate solutioncartridge 4 mg/0.5ml (Imitrexstatdose ref)

•

sumatriptan succinate solutioncartridge 6 mg/0.5ml (Imitrexstatdose ref)

•

sumatriptan succinate tab 25 mg(Imitrex)

•


•


•

GOUT AGENTSallopurinol tab 100 mg (Zyloprim)allopurinol tab 300 mg (Zyloprim)colchicine w/ probenecid tab

0.5-500 mgMITIGARE - colchicine cap 0.6 mgprobenecid tab 500 mgNEUROMUSCULAR DRUGSANTICONVULSANTScarbamazepine cap er 12hr 100 mg

(Carbatrol)

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carbamazepine cap er 12hr 200 mg(Carbatrol)

carbamazepine cap er 12hr 300 mg(Carbatrol)

carbamazepine chew tab 100 mgcarbamazepine susp 100 mg/5ml

(Tegretol)carbamazepine tab er 12hr 100 mg

(Tegretol-xr)carbamazepine tab er 12hr 200 mg

(Tegretol-xr)carbamazepine tab er 12hr 400 mg

(Tegretol-xr)carbamazepine tab 200 mg (Tegretol)CELONTIN - methsuximide cap 300 mgclonazepam tab 0.5 mg (Klonopin)clonazepam tab 1 mg (Klonopin)clonazepam tab 2 mg (Klonopin)DIASTAT ACUDIAL - diazepam rectal

gel delivery system 10 mgDIASTAT ACUDIAL - diazepam rectal

gel delivery system 20 mgDIASTAT PEDIATRIC - diazepam rectal

gel delivery system 2.5 mgDILANTIN - phenytoin sodium extended

cap 30 mgdivalproex sodium cap delayed

release sprinkle 125 mg (Depakotesprinkles)

divalproex sodium tab delayedrelease 125 mg (Depakote)



divalproex sodium tab er 24 hr250 mg (Depakote er)

2020


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divalproex sodium tab er 24 hr500 mg (Depakote er)

EPIDIOLEX - cannabidiol soln 100 mg/ml

•

ethosuximide cap 250 mg (Zarontin)ethosuximide soln 250 mg/5ml

(Zarontin)gabapentin cap 100 mg (Neurontin)gabapentin cap 300 mg (Neurontin)gabapentin cap 400 mg (Neurontin)gabapentin oral soln 250 mg/5ml

(Neurontin)gabapentin tab 600 mg (Neurontin)gabapentin tab 800 mg (Neurontin)lamotrigine tab chewable dispersible

5 mg (Lamictal chewable di)lamotrigine tab chewable dispersible

25 mg (Lamictal chewable di)lamotrigine tab 25 mg (Lamictal)lamotrigine tab 100 mg (Lamictal)lamotrigine tab 150 mg (Lamictal)lamotrigine tab 200 mg (Lamictal)levetiracetam oral soln 100 mg/ml

(Keppra)levetiracetam tab er 24hr 500 mg

(Keppra xr)levetiracetam tab er 24hr 750 mg

(Keppra xr)levetiracetam tab 250 mg (Keppra)levetiracetam tab 500 mg (Keppra)levetiracetam tab 750 mg (Keppra)levetiracetam tab 1000 mg (Keppra)LYRICA - pregabalin soln 20 mg/ml •LYRICA - pregabalin cap 25 mg •LYRICA - pregabalin cap 50 mg •

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LYRICA - pregabalin cap 75 mg •LYRICA - pregabalin cap 100 mg •LYRICA - pregabalin cap 150 mg •LYRICA - pregabalin cap 200 mg •LYRICA - pregabalin cap 225 mg •LYRICA - pregabalin cap 300 mg •oxcarbazepine susp 300 mg/5ml

(60 mg/ml) (Trileptal)oxcarbazepine tab 150 mg (Trileptal)oxcarbazepine tab 300 mg (Trileptal)oxcarbazepine tab 600 mg (Trileptal)phenytoin chew tab 50 mg (Dilantin

infatabs)phenytoin sodium extended cap

100 mg (Dilantin)phenytoin sodium extended cap

200 mg (Phenytek)phenytoin sodium extended cap

300 mg (Phenytek)phenytoin susp 125 mg/5ml

(Dilantin-125)pregabalin cap 25 mg (Lyrica) •pregabalin cap 50 mg (Lyrica) •pregabalin cap 75 mg (Lyrica) •pregabalin cap 100 mg (Lyrica) •pregabalin cap 150 mg (Lyrica) •pregabalin cap 200 mg (Lyrica) •pregabalin cap 225 mg (Lyrica) •pregabalin cap 300 mg (Lyrica) •pregabalin soln 20 mg/ml (Lyrica) •primidone tab 50 mg (Mysoline)primidone tab 250 mg (Mysoline)topiramate sprinkle cap 15 mg

(Topamax sprinkle)

2020


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topiramate sprinkle cap 25 mg(Topamax sprinkle)

topiramate tab 25 mg (Topamax)topiramate tab 50 mg (Topamax)topiramate tab 100 mg (Topamax)topiramate tab 200 mg (Topamax)valproate sodium oral soln

250 mg/5ml (base equiv)(Depakene)

valproic acid cap 250 mg (Depakene)vigabatrin powd pack 500 mg (Sabril) •vigabatrin tab 500 mg (Sabril) •zonisamide cap 25 mg (Zonegran)zonisamide cap 50 mgzonisamide cap 100 mg (Zonegran)ANTIPARKINSON AGENTSamantadine hcl cap 100 mgamantadine hcl syrup 50 mg/5mlbenztropine mesylate tab 0.5 mgbenztropine mesylate tab 1 mgbenztropine mesylate tab 2 mgcarbidopa & levodopa orally

disintegrating tab 10-100 mgcarbidopa & levodopa orally

disintegrating tab 25-100 mgcarbidopa & levodopa orally

disintegrating tab 25-250 mgcarbidopa & levodopa tab er

25-100 mg (Sinemet cr)carbidopa & levodopa tab er

50-200 mg (Sinemet cr)carbidopa & levodopa tab 10-100 mg

(Sinemet)carbidopa & levodopa tab 25-100 mg

(Sinemet)

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carbidopa & levodopa tab 25-250 mg(Sinemet)

entacapone tab 200 mg (Comtan)INBRIJA - levodopa inhal powder cap

42 mg•

pramipexole dihydrochloride tab0.125 mg (Mirapex)




pramipexole dihydrochloride tab1 mg (Mirapex)


rasagiline mesylate tab 0.5 mg (baseequiv) (Azilect)

rasagiline mesylate tab 1 mg (baseequiv) (Azilect)

ropinirole hydrochloride tab 0.25 mg(Requip)

ropinirole hydrochloride tab 0.5 mg(Requip)

ropinirole hydrochloride tab 1 mg(Requip)





selegiline hcl cap 5 mg (Eldepryl)

2020


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trihexyphenidyl hcl oral soln 0.4 mg/ml

trihexyphenidyl hcl tab 2 mgtrihexyphenidyl hcl tab 5 mgNEUROMUSCULAR AGENTSriluzole tab 50 mg (Rilutek)MUSCULOSKELETAL THERAPY AGENTSbaclofen tab 10 mgbaclofen tab 20 mgchlorzoxazone tab 500 mgcyclobenzaprine hcl tab 5 mgcyclobenzaprine hcl tab 10 mgdantrolene sodium cap 25 mg

(Dantrium)dantrolene sodium cap 50 mg

(Dantrium)dantrolene sodium cap 100 mgmethocarbamol tab 500 mg (Robaxin)methocarbamol tab 750 mg

(Robaxin-750)orphenadrine citrate tab er 12hr

100 mgtizanidine hcl tab 2 mg (base

equivalent)•

tizanidine hcl tab 4 mg (baseequivalent) (Zanaflex)

•

ANTIMYASTHENIC AGENTSpyridostigmine bromide tab 60 mg

(Mestinon)NUTRITIONAL PRODUCTSVITAMINSergocalciferol cap 1.25 mg (50000

unit) (Drisdol)phytonadione tab 5 mg (Mephyton)MULTIVITAMINS

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KOSHER PRENATAL PLUS IRON -prenatal vit w/ iron carbonyl-fa tab30-1 mg

PRENATAL VITAMINS PLUS LO -prenatal vit w/ fe fumarate-fa tab 27-1mg

PRENATAL 19 - prenatal vit w/ fefumarate-fa chew tab 29-1 mg

PRENATAL 19 - prenatal vit w/ dss-fefumarate-fa tab 29-1 mg

SE-NATAL 19 - prenatal vit w/ fefumarate-fa chew tab 29-1 mg

SE-NATAL 19 - prenatal vit w/ dss-fefumarate-fa tab 29-1 mg

MINERALS and ELECTROLYTESpot phos monobasic w/sod phos di

& monobas tab 155-852-130mg (K-phos neutral)

potassium chloride cap er 8 meqpotassium chloride cap er 10 meqpotassium chloride

microencapsulated crys er tab 10meq

potassium chloridemicroencapsulated crys er tab 20meq

potassium chloride oral soln 10% (20meq/15ml)

potassium chloride oral soln 20% (40meq/15ml)

potassium chloride powder packet20 meq

potassium chloride tab er 8 meq(600 mg)

potassium chloride tab er 10 meq (K-tab)

HEMATOLOGICAL AGENTS

2020


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HEMATOPOIETIC AGENTSARANESP ALBUMIN FREE -

darbepoetin alfa soln prefilled syringe10 mcg/0.4ml

• •

ARANESP ALBUMIN FREE -darbepoetin alfa soln prefilled syringe25 mcg/0.42ml

• •


• •


• •


• •


• •


• •


• •

ARANESP ALBUMIN FREE -darbepoetin alfa soln prefilled syringe500 mcg/ml

• •

ARANESP ALBUMIN FREE -darbepoetin alfa soln inj 25 mcg/ml

• •


• •


• •


• •


• •

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• •

cyanocobalamin inj 1000 mcg/mlDROXIA - hydroxyurea cap 200 mgDROXIA - hydroxyurea cap 300 mgDROXIA - hydroxyurea cap 400 mgEPOGEN - epoetin alfa inj 2000 unit/ml • •EPOGEN - epoetin alfa inj 3000 unit/ml • •EPOGEN - epoetin alfa inj 4000 unit/ml • •EPOGEN - epoetin alfa inj 10000 unit/ml • •EPOGEN - epoetin alfa inj 20000 unit/ml • •folic acid tab 1 mgFULPHILA - pegfilgrastim-jmdb soln

prefilled syringe 6 mg/0.6ml•

GRANIX - tbo-filgrastim soln prefilledsyringe 300 mcg/0.5ml

•

GRANIX - tbo-filgrastim soln prefilledsyringe 480 mcg/0.8ml

•

GRANIX - tbo-filgrastim subcutaneousinj 300 mcg/ml

•

GRANIX - tbo-filgrastim subcutaneousinj 480 mcg/1.6ml (300 mcg/ml)

•

NEULASTA - pegfilgrastim soln prefilledsyringe 6 mg/0.6ml

•

NEULASTA ONPRO KIT - pegfilgrastimsoln prefilled syringe kit 6 mg/0.6ml

•

NEUPOGEN - filgrastim soln prefilledsyringe 300 mcg/0.5ml

•

NEUPOGEN - filgrastim soln prefilledsyringe 480 mcg/0.8ml (600 mcg/ml)

•

NEUPOGEN - filgrastim inj 300 mcg/ml •NEUPOGEN - filgrastim inj 480

mcg/1.6ml (300 mcg/ml)•

NIVESTYM - filgrastim-aafi soln prefilledsyringe 300 mcg/0.5ml

•

2020


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NIVESTYM - filgrastim-aafi soln prefilledsyringe 480 mcg/0.8ml

•

NIVESTYM - filgrastim-aafi inj 300 mcg/ml

•

NIVESTYM - filgrastim-aafi inj 480mcg/1.6ml (300 mcg/ml)

•

PROCRIT - epoetin alfa inj 2000 unit/ml • •PROCRIT - epoetin alfa inj 3000 unit/ml • •PROCRIT - epoetin alfa inj 4000 unit/ml • •PROCRIT - epoetin alfa inj 10000 unit/

ml• •

PROCRIT - epoetin alfa inj 20000 unit/ml

• •

PROCRIT - epoetin alfa inj 40000 unit/ml

• •

RETACRIT - epoetin alfa-epbx inj 2000unit/ml

• •


• •


• •


• •


• •

UDENYCA - pegfilgrastim-cbqv solnprefilled syringe 6 mg/0.6ml

•

ZARXIO - filgrastim-sndz soln prefilledsyringe 300 mcg/0.5ml

•

ZARXIO - filgrastim-sndz soln prefilledsyringe 480 mcg/0.8ml

•

ZIEXTENZO - pegfilgrastim-bmez solnprefilled syringe 6 mg/0.6ml

•

ANTICOAGULANTSELIQUIS - apixaban tab 2.5 mg •ELIQUIS - apixaban tab 5 mg •

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ELIQUIS STARTER PACK - apixabantab 5 mg

•

enoxaparin sodium inj 30 mg/0.3ml(Lovenox)

•


•


•


•

enoxaparin sodium inj 100 mg/ml(Lovenox)

•


•

enoxaparin sodium inj 150 mg/ml(Lovenox)

•

enoxaparin sodium inj 300 mg/3ml(Lovenox)

•

warfarin sodium tab 1 mg (Coumadin)warfarin sodium tab 2 mg (Coumadin)warfarin sodium tab 2.5 mg

(Coumadin)warfarin sodium tab 3 mg (Coumadin)warfarin sodium tab 4 mg (Coumadin)warfarin sodium tab 5 mg (Coumadin)warfarin sodium tab 6 mg (Coumadin)warfarin sodium tab 7.5 mg

(Coumadin)warfarin sodium tab 10 mg

(Coumadin)XARELTO - rivaroxaban tab 2.5 mg •XARELTO - rivaroxaban tab 10 mg •XARELTO - rivaroxaban tab 15 mg •XARELTO - rivaroxaban tab 20 mg •

2020


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XARELTO STARTER PACK -rivaroxaban tab starter therapy pack15 mg & 20 mg

•

HEMATOLOGICAL AGENTS - MISC.ADVATE - antihemophilic factor rahf-pfm

for inj 250 unit•

ADVATE - antihemophilic factor rahf-pfmfor inj 500 unit

•


•


•


•


•


•

ADYNOVATE - antihemophilic factorrecomb pegylated for inj 250 unit

• • •


• • •


• • •


• • •


• • •


• • •


• • •

AFSTYLA - antihemophilic fact rcmbsingle chain for inj kit 250 unit

• • •


• • •

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• • •


• • •


• • •


• • •


• • •

ALPHANATE/VON WILLEBRAND -antihemophilic factor/vwf (human) forinj 250 unit

•


•


•


•


•

ALPHANINE SD - coagulation factor ixfor inj 500 unit

•


•


•

ALPROLIX - coagulation factor ix(recomb) (rfixfc) for inj 250 unit

• • •


• • •


• • •

2020


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• • •


• • •


• • •

anagrelide hcl cap 0.5 mg (Agrylin)anagrelide hcl cap 1 mgBENEFIX - coagulation factor ix

(recombinant) for inj kit 250 unit•

BENEFIX - coagulation factor ix(recombinant) for inj kit 500 unit

•


•


•


•

BRILINTA - ticagrelor tab 60 mgBRILINTA - ticagrelor tab 90 mgcilostazol tab 50 mg (Pletal)cilostazol tab 100 mg (Pletal)clopidogrel bisulfate tab 75 mg (base

equiv) (Plavix)COAGADEX - coagulation factor x

(human) for inj 250 unit•

COAGADEX - coagulation factor x(human) for inj 500 unit

•

CORIFACT - factor xiii concentrate(human) for inj kit 1000-1600 unit

•

dipyridamole tab 25 mg (Persantine)dipyridamole tab 50 mg (Persantine)dipyridamole tab 75 mg (Persantine)ELOCTATE - antihemophilic factor rcmb

(bdd-rfviiifc) for inj 250 unit• • •

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ELOCTATE - antihemophilic factor rcmb(bdd-rfviiifc) for inj 500 unit

• • •


• • •


• • •


• • •


• • •


• • •


• • •


• • •


• • •

FEIBA - antiinhibitor coagulant complexfor iv soln 500 unit

•


•


•

FIRAZYR - icatibant acetate inj 30mg/3ml (base equivalent)

• • •

HEMLIBRA - emicizumab-kxwhsubcutaneous soln 30 mg/ml

• • •

HEMLIBRA - emicizumab-kxwhsubcutaneous soln 60 mg/0.4ml (150mg/ml)

• • •

HEMLIBRA - emicizumab-kxwhsubcutaneous soln 105 mg/0.7ml(150 mg/ml)

• • •

HEMLIBRA - emicizumab-kxwhsubcutaneous soln 150 mg/ml

• • •

HEMOFIL M - antihemophilic factor(human) for inj 250 unit

•

2020


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•


•


•

HUMATE-P - antihemophilic factor/vwf(human) for inj 250-600 unit

•


•


•

icatibant acetate inj 30 mg/3ml (baseequivalent) (Firazyr)

• • •

IDELVION - coagulation factor ix(recomb) (rix-fp) for inj 250 unit

• • •


• • •


• • •


• • •


• • •

IXINITY - coagulation factor ix(recombinant) for inj 250 unit

•


•


•


•


•


•

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KOATE - antihemophilic factor (human)for inj 250 unit

•


•


•

KOATE-DVI - antihemophilic factor(human) for inj 250 unit

•


•


•

KOGENATE FS - antihemophilic factor(recombinant) for inj kit 250 unit

•


•


•


•


•

KOVALTRY - antihemophilic factor rahf-pfm for inj 250 unit

•


•


•


•


•

MONONINE - coagulation factor ix forinj 1000 unit

•

NOVOEIGHT - antihemophilic fact rcmb(bd trunc-rfviii) for inj 250 unit

•

2020


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•


•


•


•


•

NOVOSEVEN RT - coagulation factorviia (recomb) for inj 1 mg (1000 mcg)

•


•


•


•

NUWIQ - antihemophilic factor rcmb(bdd-rfviii,sim) for inj 250 unit

•

NUWIQ - antihemophilic factor rcmb(bdd-rfviii,sim) for inj 500 unit

•

NUWIQ - antihemophilic fact rcmb (bdd-rfviii,sim) for inj 1000 unit

•


•


•


•


•

NUWIQ - antihemophil fact rcmb (bdd-rfviii,sim) for inj kit 250 unit

•

NUWIQ - antihemophil fact rcmb (bdd-rfviii,sim) for inj kit 500 unit

•

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NUWIQ - antihemophil fact rcmb(bdd-rfviii,sim) for inj kit 1000 unit

•


•


•


•


•

OBIZUR - antihemophilic factor (recombporc) rpfviii for inj 500 unit

•

pentoxifylline tab er 400 mgprasugrel hcl tab 5 mg (base equiv)

(Effient)prasugrel hcl tab 10 mg (base equiv)

(Effient)PROFILNINE - factor ix complex for inj

500 unit•

PROFILNINE - factor ix complex for inj1000 unit

•

PROFILNINE - factor ix complex for inj1500 unit

•

PROFILNINE SD - factor ix complex forinj 1000 unit

•

PROFILNINE SD - factor ix complex forinj 1500 unit

•

REBINYN - coagulation factor ix recombglycopegylated for inj 500 unt

• • •


• • •


• • •

RECOMBINATE - antihemophilic factor(recombinant) for inj 220-400 unit

•


•

2020


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•


•


•

RIXUBIS - coagulation factor ix(recombinant) for inj 250 unit

•


•


•


•


•

TRETTEN - coagulation factor xiii a-subunit for inj 2000-3125 unit

•

VONVENDI - von willebrand factor(recombinant) for inj 650 unit

•

VONVENDI - von willebrand factor(recombinant) for inj 1300 unit

•

WILATE - antihemophilic factor/vwf(human) for inj 500-500 unit kit

•

WILATE - antihemophilic factor/vwf(human) for inj 1000-1000 unit kit

•

XYNTHA - antihemophilic factorrecombinant paf for inj kit 250 unit

•


•


•


•

XYNTHA SOLOFUSE - antihemophilicfactor recombinant paf for inj kit 250unit

•

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•


•


•


•

TOPICAL PRODUCTSOPHTHALMIC AGENTSALPHAGAN P - brimonidine tartrate

ophth soln 0.1%azelastine hcl ophth soln 0.05%AZOPT - brinzolamide ophth susp 1%BACITRACIN - bacitracin ophth oint 500

unit/gmbacitracin-polymyxin b ophth ointbacitracin-polymyxin-neomycin-hc

ophth oint 1%brimonidine tartrate ophth soln

0.15% (Alphagan p)brimonidine tartrate ophth soln 0.2%ciprofloxacin hcl ophth soln 0.3%

(base equivalent) (Ciloxan)cromolyn sodium ophth soln 4%cyclopentolate hcl ophth soln 1%

(Cyclogyl)diclofenac sodium ophth soln 0.1%dorzolamide hcl ophth soln 2%

(Trusopt)dorzolamide hcl-timolol maleate

ophth soln 22.3-6.8 mg/ml (Cosopt)erythromycin ophth oint 5 mg/gm

2020


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fluorometholone ophth susp 0.1%(Fml liquifilm)

gentamicin sulfate ophth soln 0.3%(Garamycin)

ketorolac tromethamine ophth soln0.4% (Acular ls)

ketorolac tromethamine ophth soln0.5% (Acular)

latanoprost ophth soln 0.005%(Xalatan)

•

LOTEMAX - loteprednol etabonateophth susp 0.5%

LOTEMAX - loteprednol etabonateophth oint 0.5%

LOTEMAX - loteprednol etabonateophth gel 0.5%

LOTEMAX SM - loteprednol etabonateophth gel 0.38%

loteprednol etabonate ophth susp0.5% (Lotemax)

LUMIGAN - bimatoprost ophth soln0.01%

• •

moxifloxacin hcl ophth soln 0.5%(base equiv) (Vigamox)

NATACYN - natamycin ophth susp 5%neomycin-bacitrac zn-polymyx

5(3.5)mg-400unt-10000unt op oinneomycin-polymyxin-

dexamethasone ophth oint 0.1%(Maxitrol)

neomycin-polymyxin-dexamethasone ophth susp 0.1%(Maxitrol)

ofloxacin ophth soln 0.3% (Ocuflox)olopatadine hcl ophth soln 0.1%

(base equivalent) (Patanol)

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olopatadine hcl ophth soln 0.2%(base equivalent) (Pataday)

PAZEO - olopatadine hcl ophth soln0.7% (base equivalent)

pilocarpine hcl ophth soln 1% (Isoptocarpine)



polymyxin b-trimethoprim ophthsoln 10000 unit/ml-0.1% (Polytrim)

PREDNISOLONE ACETATE -prednisolone acetate ophth susp 1%

PREDNISOLONE SODIUM PHOSP -prednisolone sodium phosphateophth soln 1%

SIMBRINZA - brinzolamide-brimonidinetartrate ophth susp 1-0.2%

sulfacetamide sodium ophth soln10% (Bleph-10)

timolol maleate ophth soln 0.25%(Timoptic)

timolol maleate ophth soln 0.5%(Timoptic)

tobramycin ophth soln 0.3% (Tobrex)tobramycin-dexamethasone ophth

susp 0.3-0.1% (Tobradex)TRAVATAN Z - travoprost ophth soln

0.004% (benzalkonium free) (bakfree)

• •

travoprost ophth soln 0.004%(benzalkonium free) (bak free)(Travatan z)

•

TRIFLURIDINE - trifluridine ophth soln1%

tropicamide ophth soln 0.5%

2020


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tropicamide ophth soln 1%(Mydriacyl)

ZYLET - loteprednol etabonate-tobramycin ophth susp 0.5-0.3%

OTIC AGENTSacetic acid otic soln 2%CIPRODEX - ciprofloxacin-

dexamethasone otic susp 0.3-0.1%hydrocortisone w/ acetic acid otic

soln 1-2%neomycin-polymyxin-hc otic soln 1%

(Cortisporin)neomycin-polymyxin-hc otic susp

3.5 mg/ml-10000 unit/ml-1%ofloxacin otic soln 0.3%MOUTH/THROAT/DENTAL AGENTScevimeline hcl cap 30 mg (Evoxac)chlorhexidine gluconate soln 0.12%

(Peridex)clotrimazole troche 10 mglidocaine hcl viscous soln 2%nystatin susp 100000 unit/mlpilocarpine hcl tab 5 mg (Salagen)pilocarpine hcl tab 7.5 mg (Salagen)triamcinolone acetonide dental paste

0.1%ANORECTAL AGENTShydrocortisone acetate suppos

25 mghydrocortisone enema 100 mg/60ml

(Cortenema)hydrocortisone perianal cream 2.5%

(Anusol-hc)DERMATOLOGICALSacitretin cap 10 mg (Soriatane)

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acitretin cap 17.5 mg (Soriatane)acitretin cap 25 mg (Soriatane)adapalene cream 0.1% (Differin)adapalene gel 0.1% (Differin)adapalene gel 0.3% (Differin)adapalene-benzoyl peroxide gel

0.1-2.5% (Epiduo)alclometasone dipropionate cream

0.05% (Aclovate)alclometasone dipropionate oint

0.05%azelaic acid gel 15% (Finacea)benzoyl peroxide-erythromycin gel

5-3% (Benzamycin)betamethasone dipropionate

augmented cream 0.05% (Diproleneaf)

•

betamethasone dipropionateaugmented lotion 0.05% (Diprolene)

•

betamethasone dipropionateaugmented oint 0.05% (Diprolene)

•

betamethasone dipropionate cream0.05%

•

betamethasone dipropionate lotion0.05%

•

betamethasone dipropionate oint0.05%

•

betamethasone valerate cream 0.1%(base equivalent)

betamethasone valerate lotion 0.1%(base equivalent)

betamethasone valerate oint 0.1%(base equivalent)

calcipotriene cream 0.005%(Dovonex)

calcipotriene oint 0.005%

2020


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calcipotriene soln 0.005% (50 mcg/ml)

CARAC - fluorouracil cream 0.5% • •ciclopirox gel 0.77%ciclopirox olamine cream 0.77%

(base equiv)ciclopirox olamine susp 0.77% (base

equiv)ciclopirox shampoo 1% (Loprox

shampoo)ciclopirox solution 8% (Penlac Nail

Lacquer)• •

clindamycin phosph-benzoylperoxide (refrig) gel 1.2 (1)-5%(Duac)

clindamycin phosphate gel 1%(Cleocin-t)

clindamycin phosphate lotion 1%(Cleocin-t)

clindamycin phosphate soln 1%(Cleocin-t)

clindamycin phosphate swab 1%(Cleocin-t)

clindamycin phosphate-benzoylperoxide gel 1-5% (Benzaclin)

clobetasol propionate cream 0.05%(Temovate)

•

clobetasol propionate emollient basecream 0.05% (Temovate e)

clobetasol propionate foam 0.05%(Olux)

•

clobetasol propionate gel 0.05%(Temovate)

clobetasol propionate oint 0.05%(Temovate)

•

clobetasol propionate soln 0.05%(Temovate)

•

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COSENTYX - secukinumabsubcutaneous soln prefilled syringe150 mg/ml

• • •

COSENTYX - secukinumabsubcutaneous pref syr 150 mg/ml(300 mg dose)

• • •

COSENTYX SENSOREADY PEN -secukinumab subcutaneous solnauto-injector 150 mg/ml

• • •

COSENTYX SENSOREADY PEN -secukinumab subcutaneous auto-inj150 mg/ml (300 mg dose)

• • •

desonide cream 0.05% (Desowen)desonide lotion 0.05% (Desowen)desonide oint 0.05% (Desowen)desoximetasone cream 0.25%

(Topicort)•

desoximetasone oint 0.25% (Topicort) •diclofenac sodium (actinic

keratoses) gel 3%• •

diclofenac sodium gel 1% (Voltaren) •econazole nitrate cream 1%erythromycin gel 2% (Erygel)erythromycin soln 2%FINACEA - azelaic acid foam 15%fluocinolone acetonide cream 0.01%fluocinolone acetonide cream

0.025% (Synalar)fluocinolone acetonide oil 0.01%

(body oil) (Derma-smoothe/fs bod)fluocinolone acetonide oil 0.01%

(scalp oil) (Derma-smoothe/fs sca)fluocinolone acetonide oint 0.025%

(Synalar)fluocinolone acetonide soln 0.01%

(Synalar)

2020


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fluocinonide cream 0.05% •fluocinonide emulsified base cream

0.05%•

fluocinonide gel 0.05% •fluocinonide oint 0.05% •fluocinonide soln 0.05% •FLUOROPLEX - fluorouracil cream 1% • •fluorouracil cream 5% (Efudex) •fluticasone propionate cream 0.05%

(Cutivate)fluticasone propionate oint 0.005%gentamicin sulfate cream 0.1%gentamicin sulfate oint 0.1%halobetasol propionate cream 0.05%

(Ultravate)•

halobetasol propionate oint 0.05%(Ultravate)

•

hydrocortisone cream 2.5%hydrocortisone lotion 2.5%hydrocortisone oint 2.5%hydrocortisone valerate cream 0.2%hydrocortisone valerate oint 0.2%

(Westcort)imiquimod cream 5% (Aldara) •isotretinoin cap 10 mg •isotretinoin cap 20 mg •isotretinoin cap 30 mg •isotretinoin cap 40 mg •ketoconazole cream 2%ketoconazole shampoo 2% (Nizoral)lidocaine hcl gel 2% •lidocaine hcl soln 4% (Xylocaine) •lidocaine hcl urethral/mucosal gel

prefilled syringe 2%•

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lidocaine oint 5% • •lidocaine patch 5% (Lidoderm) • •malathion lotion 0.5% (Ovide)metronidazole cream 0.75%

(Metrocream)metronidazole gel 0.75%metronidazole gel 1% (Metrogel)metronidazole lotion 0.75%

(Metrolotion)mometasone furoate cream 0.1%

(Elocon)mometasone furoate oint 0.1%

(Elocon)•

mometasone furoate solution 0.1%(lotion) (Elocon)

mupirocin oint 2% (Bactroban)nystatin cream 100000 unit/gmnystatin oint 100000 unit/gmnystatin topical powder 100000 unit/

gmnystatin-triamcinolone cream

100000-0.1 unit/gm-%nystatin-triamcinolone oint

100000-0.1 unit/gm-%permethrin cream 5% (Elimite)pimecrolimus cream 1% (Elidel) •podofilox soln 0.5% (Condylox)selenium sulfide lotion 2.5%silver sulfadiazine cream 1%

(Silvadene)SKYRIZI - risankizumab-rzaa sol

prefilled syringe 2 x 75 mg/0.83ml kit• • •

SOOLANTRA - ivermectin cream 1%STELARA - ustekinumab inj 45

mg/0.5ml• • •

2020


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STELARA - ustekinumab soln prefilledsyringe 45 mg/0.5ml

• • •

STELARA - ustekinumab soln prefilledsyringe 90 mg/ml

• • •

sulfacetamide sodium lotion 10%(acne) (Klaron)

tacrolimus oint 0.03% (Protopic) •tacrolimus oint 0.1% (Protopic) •tazarotene cream 0.1% (Tazorac)TAZORAC - tazarotene cream 0.05%TAZORAC - tazarotene gel 0.05%TAZORAC - tazarotene gel 0.1%TREMFYA - guselkumab soln pen-

injector 100 mg/ml• • •

TREMFYA - guselkumab soln prefilledsyringe 100 mg/ml

• • •

tretinoin cream 0.025% (Retin-a)tretinoin cream 0.05% (Retin-a)tretinoin cream 0.1% (Retin-a)tretinoin gel 0.01% (Retin-a)tretinoin gel 0.025% (Retin-a)tretinoin microsphere gel 0.04%

(Retin-a micro)tretinoin microsphere gel 0.1%

(Retin-a micro)triamcinolone acetonide cream

0.025%triamcinolone acetonide cream 0.1%triamcinolone acetonide cream 0.5%triamcinolone acetonide lotion

0.025%triamcinolone acetonide lotion 0.1%triamcinolone acetonide oint 0.025%triamcinolone acetonide oint 0.1%triamcinolone acetonide oint 0.5%

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VALCHLOR - mechlorethamine hcl gel0.016% (base equivalent)

•

ZYCLARA - imiquimod cream 3.75% • •ZYCLARA PUMP - imiquimod cream

2.5%• •

ZYCLARA PUMP - imiquimod cream3.75%

• •

MISCELLANEOUS PRODUCTSANTIDOTESCHEMET - succimer cap 100 mgJADENU - deferasirox tab 90 mg •JADENU - deferasirox tab 180 mg •JADENU - deferasirox tab 360 mg •naloxone hcl inj 0.4 mg/mlnaloxone hcl inj 4 mg/10mlnaltrexone hcl tab 50 mgNARCAN - naloxone hcl nasal spray 4

mg/0.1mlDIAGNOSTIC PRODUCTSINSULIN PEN NEEDLES – VARIOUS •INSULIN SYRINGES – VARIOUS •LANCETS – VARIOUSTEST STRIPS – CONTOUR,

CONTOUR NEXT•

MEDICAL DEVICESBREATHERITE - spacer/aerosol-holding

chambers - deviceASSORTED CLASSESazathioprine tab 50 mg (Imuran)CELLCEPT - mycophenolate mofetil cap

250 mgCELLCEPT - mycophenolate mofetil tab

500 mgcyclosporine cap 25 mg

(Sandimmune)

2020


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cyclosporine cap 100 mg(Sandimmune)

cyclosporine modified cap 25 mg(Neoral)

cyclosporine modified cap 50 mg(Cyclosporine modifie)

cyclosporine modified cap 100 mg(Neoral)

cyclosporine modified oral soln100 mg/ml (Neoral)

DEPEN TITRATABS - penicillamine tab250 mg

•

everolimus tab 0.25 mg (Zortress)everolimus tab 0.5 mg (Zortress)everolimus tab 0.75 mg (Zortress)LOKELMA - sodium zirconium

cyclosilicate for susp packet 5 gmLOKELMA - sodium zirconium

cyclosilicate for susp packet 10 gmmycophenolate mofetil cap 250 mg

(Cellcept)mycophenolate mofetil for oral susp

200 mg/ml (Cellcept)mycophenolate mofetil tab 500 mg

(Cellcept)mycophenolate sodium tab dr

180 mg (mycophenolic acid equiv)(Myfortic)

mycophenolate sodium tab dr360 mg (mycophenolic acid equiv)(Myfortic)

penicillamine tab 250 mg (Depentitratabs)

•

PROGRAF - tacrolimus cap 0.5 mgPROGRAF - tacrolimus cap 1 mgPROGRAF - tacrolimus cap 5 mg

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PROGRAF - tacrolimus packet for susp0.2 mg

PROGRAF - tacrolimus packet for susp1 mg

RAPAMUNE - sirolimus oral soln 1 mg/ml

REVLIMID - lenalidomide caps 2.5 mg • • •REVLIMID - lenalidomide cap 5 mg • • •REVLIMID - lenalidomide cap 10 mg • • •REVLIMID - lenalidomide cap 15 mg • • •REVLIMID - lenalidomide cap 20 mg • • •REVLIMID - lenalidomide cap 25 mg • • •sirolimus oral soln 1 mg/ml

(Rapamune)sirolimus tab 0.5 mg (Rapamune)sirolimus tab 1 mg (Rapamune)sirolimus tab 2 mg (Rapamune)sodium polystyrene sulfonate oral

susp 15 gm/60ml (Sps)sodium polystyrene sulfonate

powdertacrolimus cap 0.5 mg (Prograf)tacrolimus cap 1 mg (Prograf)tacrolimus cap 5 mg (Prograf)THALOMID - thalidomide cap 50 mg • • •THALOMID - thalidomide cap 100 mg • • •THALOMID - thalidomide cap 150 mg • • •THALOMID - thalidomide cap 200 mg • • •VELTASSA - patiromer sorbitex calcium

for susp packet 8.4 gm (base eq)VELTASSA - patiromer sorbitex calcium

for susp packet 16.8 gm (base eq)VELTASSA - patiromer sorbitex calcium

for susp packet 25.2 gm (base eq)ZORTRESS - everolimus tab 0.25 mg

2020


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ZORTRESS - everolimus tab 0.5 mgZORTRESS - everolimus tab 0.75 mgZORTRESS - everolimus tab 1 mg

2020


INDEX

Aabacavir sulfate-lamivudine tab 600-300 mg(Epzicom)............................................................................3

abacavir sulfate-lamivudine-zidovudine tab300-150-300 mg (Trizivir).................................................. 3

abacavir sulfate soln 20 mg/ml (base equiv)(Ziagen)............................................................................... 3

abacavir sulfate tab 300 mg (base equiv) (Ziagen).........3abiraterone acetate tab 250 mg (Zytiga).......................... 6acamprosate calcium tab delayed release 333 mg.......39acarbose tab 25 mg (Precose)........................................ 12acarbose tab 50 mg (Precose)........................................ 12acarbose tab 100 mg (Precose)...................................... 12acebutolol hcl cap 200 mg (Sectral)...............................18acebutolol hcl cap 400 mg (Sectral)...............................18acetaminophen w/ codeine soln 120-12 mg/5ml........... 41acetaminophen w/ codeine tab 300-15 mg (Tylenol/codeine)............................................................................ 41

acetaminophen w/ codeine tab 300-30 mg (Tylenol/codeine #3).......................................................................41

acetaminophen w/ codeine tab 300-60 mg (Tylenol/codeine #4).......................................................................41

acetazolamide cap er 12hr 500 mg (Diamox)................ 24acetazolamide tab 125 mg............................................... 24acetazolamide tab 250 mg............................................... 24acetic acid otic soln 2%...................................................58acetylcysteine inhal soln 10%.........................................27acetylcysteine inhal soln 20%.........................................27acitretin cap 10 mg (Soriatane).......................................58acitretin cap 17.5 mg (Soriatane)....................................58acitretin cap 25 mg (Soriatane).......................................58ACTEMRA ACTPEN- tocilizumab subcutaneous soln auto-injector 162 mg/0.9ml........................................................43

ACTEMRA- tocilizumab subcutaneous soln prefilledsyringe 162 mg/0.9ml........................................................43

ACTIMMUNE- interferon gamma-1b inj 100 mcg/0.5ml(2000000 unit/0.5ml)........................................................... 6

acyclovir cap 200 mg (Zovirax).........................................3acyclovir susp 200 mg/5ml (Zovirax)............................... 3acyclovir tab 400 mg (Zovirax)..........................................3acyclovir tab 800 mg (Zovirax)..........................................3adapalene-benzoyl peroxide gel 0.1-2.5% (Epiduo)......58adapalene cream 0.1% (Differin).....................................58adapalene gel 0.1% (Differin).......................................... 58adapalene gel 0.3% (Differin).......................................... 58adefovir dipivoxil tab 10 mg (Hepsera)............................3ADVAIR DISKUS- fluticasone-salmeterol aer powder ba100-50 mcg/dose...............................................................27

ADVAIR DISKUS- fluticasone-salmeterol aer powder ba250-50 mcg/dose...............................................................27

ADVAIR DISKUS- fluticasone-salmeterol aer powder ba500-50 mcg/dose...............................................................27

ADVAIR HFA- fluticasone-salmeterol inhal aerosol 45-21mcg/act...............................................................................27



ADVATE- antihemophilic factor rahf-pfm for inj 250unit......................................................................................52







ADYNOVATE- antihemophilic factor recomb pegylated forinj 250 unit.........................................................................52



ADYNOVATE- antihemophilic factor recomb pegylated forinj 1000 unit.......................................................................52




AFINITOR- everolimus tab 2.5 mg.......................................6AFINITOR- everolimus tab 5 mg..........................................6AFINITOR- everolimus tab 7.5 mg.......................................6AFINITOR- everolimus tab 10 mg........................................6AFSTYLA- antihemophilic fact rcmb single chain for inj kit250 unit..............................................................................52

AFSTYLA- antihemophilic fact rcmb single chain for inj kit500 unit..............................................................................52

AFSTYLA- antihemophilic fact rcmb single chain for inj kit1000 unit............................................................................52



2020




AIMOVIG- erenumab-aooe subcutaneous soln auto-injector 70 mg/ml...............................................................45

AIMOVIG- erenumab-aooe subcutaneous soln auto-injector 140 mg/ml.............................................................45

albendazole tab 200 mg (Albenza)....................................6albuterol sulfate inhal aero 108 mcg/act (90mcg baseequiv) (Proventil hfa)...................................................... 27

albuterol sulfate soln nebu 0.083% (2.5 mg/3ml)..........27albuterol sulfate soln nebu 0.5% (5 mg/ml)...................27albuterol sulfate soln nebu 0.63 mg/3ml (baseequiv).................................................................................27

albuterol sulfate soln nebu 1.25 mg/3ml (baseequiv).................................................................................27

albuterol sulfate syrup 2 mg/5ml....................................27albuterol sulfate tab 2 mg................................................27albuterol sulfate tab 4 mg................................................27alclometasone dipropionate cream 0.05%(Aclovate)..........................................................................58

alclometasone dipropionate oint 0.05%.........................58alendronate sodium tab 10 mg....................................... 16alendronate sodium tab 35 mg....................................... 16alendronate sodium tab 70 mg (Fosamax).................... 16alfuzosin hcl tab er 24hr 10 mg (Uroxatral)................... 33ALINIA- nitazoxanide for susp 100 mg/5ml..........................6ALINIA- nitazoxanide tab 500 mg........................................ 6allopurinol tab 100 mg (Zyloprim).................................. 46allopurinol tab 300 mg (Zyloprim).................................. 46ALPHAGAN P- brimonidine tartrate ophth soln 0.1%........56ALPHANATE/VON WILLEBRAND- antihemophilic factor/vwf (human) for inj 250 unit..............................................52

ALPHANATE/VON WILLEBRAND- antihemophilic factor/vwf (human) for inj 500 unit..............................................52

ALPHANATE/VON WILLEBRAND- antihemophilic factor/vwf (human) for inj 1000 unit............................................52



ALPHANINE SD- coagulation factor ix for inj 500 unit.......52ALPHANINE SD- coagulation factor ix for inj 1000 unit.....52ALPHANINE SD- coagulation factor ix for inj 1500 unit.....52alprazolam tab er 24hr 0.5 mg (Xanax xr)......................33alprazolam tab er 24hr 1 mg (Xanax xr).........................33alprazolam tab er 24hr 2 mg (Xanax xr).........................33alprazolam tab er 24hr 3 mg (Xanax xr).........................33alprazolam tab 0.25 mg (Xanax)......................................33alprazolam tab 0.5 mg (Xanax)........................................33alprazolam tab 1 mg (Xanax)...........................................33alprazolam tab 2 mg (Xanax)...........................................33

ALPROLIX- coagulation factor ix (recomb) (rfixfc) for inj250 unit..............................................................................52

ALPROLIX- coagulation factor ix (recomb) (rfixfc) for inj500 unit..............................................................................52

ALPROLIX- coagulation factor ix (recomb) (rfixfc) for inj1000 unit............................................................................52




amantadine hcl cap 100 mg............................................ 48amantadine hcl syrup 50 mg/5ml....................................48ambrisentan tab 5 mg (Letairis)......................................26ambrisentan tab 10 mg (Letairis)....................................26amiloride & hydrochlorothiazide tab 5-50 mg............... 24amiloride hcl tab 5 mg..................................................... 24amiodarone hcl tab 100 mg.............................................20amiodarone hcl tab 400 mg.............................................20amiodarone hcl tab 200 mg (Cordarone)....................... 20amitriptyline hcl tab 10 mg..............................................33amitriptyline hcl tab 25 mg..............................................33amitriptyline hcl tab 50 mg..............................................33amitriptyline hcl tab 75 mg..............................................33amitriptyline hcl tab 100 mg............................................33amitriptyline hcl tab 150 mg............................................33amlodipine besylate-benazepril hcl cap 2.5-10 mg(Lotrel)...............................................................................20

amlodipine besylate-benazepril hcl cap 5-10 mg(Lotrel)...............................................................................20





amlodipine besylate tab 2.5 mg (base equivalent)(Norvasc)...........................................................................19

amlodipine besylate tab 5 mg (base equivalent)(Norvasc)...........................................................................19

amlodipine besylate tab 10 mg (base equivalent)(Norvasc)...........................................................................19

amlodipine besylate-valsartan tab 5-160 mg(Exforge)........................................................................... 21




2020


amlodipine-valsartan-hydrochlorothiazide tab5-160-12.5 mg (Exforge hct)...........................................21

amlodipine-valsartan-hydrochlorothiazide tab 5-160-25mg (Exforge hct)..............................................................21

amlodipine-valsartan-hydrochlorothiazide tab10-160-12.5 mg (Exforge hct).........................................21

amlodipine-valsartan-hydrochlorothiazide tab10-160-25 mg (Exforge hct)............................................21

amlodipine-valsartan-hydrochlorothiazide tab10-320-25 mg (Exforge hct)............................................21

amoxicillin & k clavulanate for susp 200-28.5mg/5ml.................................................................................1

amoxicillin & k clavulanate for susp 400-57 mg/5ml...... 1amoxicillin & k clavulanate for susp 250-62.5 mg/5ml(Augmentin)........................................................................1

amoxicillin & k clavulanate for susp 600-42.9 mg/5ml(Augmentin es-600)...........................................................1

amoxicillin & k clavulanate tab 250-125 mg.................... 1amoxicillin & k clavulanate tab 500-125 mg(Augmentin)........................................................................1

amoxicillin & k clavulanate tab 875-125 mg(Augmentin)........................................................................1

amoxicillin (trihydrate) cap 250 mg..................................1amoxicillin (trihydrate) cap 500 mg..................................1amoxicillin (trihydrate) for susp 125 mg/5ml...................1amoxicillin (trihydrate) for susp 200 mg/5ml...................1amoxicillin (trihydrate) for susp 250 mg/5ml...................1amoxicillin (trihydrate) for susp 400 mg/5ml...................1amoxicillin (trihydrate) tab 500 mg...................................1amoxicillin (trihydrate) tab 875 mg...................................1amphetamine-dextroamphetamine cap er 24hr 5 mg(Adderall xr)..................................................................... 37

amphetamine-dextroamphetamine cap er 24hr 10 mg(Adderall xr)..................................................................... 37





amphetamine-dextroamphetamine tab 5 mg(Adderall).......................................................................... 38

amphetamine-dextroamphetamine tab 7.5 mg(Adderall).......................................................................... 38


amphetamine-dextroamphetamine tab 12.5 mg(Adderall).......................................................................... 38




anagrelide hcl cap 1 mg.................................................. 53anagrelide hcl cap 0.5 mg (Agrylin)............................... 53anastrozole tab 1 mg (Arimidex).......................................6ANORO ELLIPTA- umeclidinium-vilanterol aero powd ba62.5-25 mcg/inh.................................................................27

aprepitant capsule 40 mg (Emend).................................30aprepitant capsule 80 mg (Emend).................................31aprepitant capsule 125 mg (Emend)...............................31aprepitant capsule therapy pack 80 & 125 mg(Emend).............................................................................30

APRISO- mesalamine cap er 24hr 0.375 gm.................... 31ARANESP ALBUMIN FREE- darbepoetin alfa soln inj 25mcg/ml................................................................................50

ARANESP ALBUMIN FREE- darbepoetin alfa soln inj 40mcg/ml................................................................................50





ARANESP ALBUMIN FREE- darbepoetin alfa solnprefilled syringe 10 mcg/0.4ml..........................................50

ARANESP ALBUMIN FREE- darbepoetin alfa solnprefilled syringe 25 mcg/0.42ml........................................50







ARANESP ALBUMIN FREE- darbepoetin alfa solnprefilled syringe 500 mcg/ml.............................................50

aripiprazole tab 2 mg (Abilify).........................................35aripiprazole tab 5 mg (Abilify).........................................35aripiprazole tab 10 mg (Abilify).......................................35aripiprazole tab 15 mg (Abilify).......................................35aripiprazole tab 20 mg (Abilify).......................................35aripiprazole tab 30 mg (Abilify).......................................35armodafinil tab 50 mg (Nuvigil).......................................38armodafinil tab 150 mg (Nuvigil).....................................38

2020


armodafinil tab 200 mg (Nuvigil).....................................38armodafinil tab 250 mg (Nuvigil).....................................38ARNUITY ELLIPTA- fluticasone furoate aerosol powderbreath activ 50 mcg/act.....................................................27

ARNUITY ELLIPTA- fluticasone furoate aerosol powderbreath activ 100 mcg/act.................................................. 27

ARNUITY ELLIPTA- fluticasone furoate aerosol powderbreath activ 200 mcg/act.................................................. 27

ASMANEX HFA- mometasone furoate inhal aerosolsuspension 50 mcg/act..................................................... 27

ASMANEX HFA- mometasone furoate inhal aerosolsuspension 100 mcg/act................................................... 28

ASMANEX HFA- mometasone furoate inhal aerosolsuspension 200 mcg/act................................................... 28

ASMANEX TWISTHALER 120 ME- mometasone furoateinhal powd 220 mcg/inh (breath activated)...................... 28

ASMANEX TWISTHALER 30 MET- mometasone furoateinhal powd 110 mcg/inh (breath activated).......................28

ASMANEX TWISTHALER 30 MET- mometasone furoateinhal powd 220 mcg/inh (breath activated)...................... 28

ASMANEX TWISTHALER 60 MET- mometasone furoateinhal powd 220 mcg/inh (breath activated)...................... 28

atazanavir sulfate cap 150 mg (base equiv)(Reyataz)............................................................................. 3



atenolol & chlorthalidone tab 50-25 mg (Tenoretic50)...................................................................................... 21

atenolol & chlorthalidone tab 100-25 mg (Tenoretic100).................................................................................... 21

atenolol tab 25 mg (Tenormin)........................................ 18atenolol tab 50 mg (Tenormin)........................................ 18atenolol tab 100 mg (Tenormin)...................................... 18atomoxetine hcl cap 10 mg (base equiv) (Strattera).....38atomoxetine hcl cap 18 mg (base equiv) (Strattera).....38atomoxetine hcl cap 25 mg (base equiv) (Strattera).....38atomoxetine hcl cap 40 mg (base equiv) (Strattera).....38atomoxetine hcl cap 60 mg (base equiv) (Strattera).....38atomoxetine hcl cap 80 mg (base equiv) (Strattera).....38atomoxetine hcl cap 100 mg (base equiv)(Strattera)..........................................................................38

atorvastatin calcium tab 10 mg (base equivalent)(Lipitor)..............................................................................25




atovaquone-proguanil hcl tab 62.5-25 mg(Malarone)...........................................................................5

atovaquone-proguanil hcl tab 250-100 mg(Malarone)...........................................................................5

ATRIPLA- efavirenz-emtricitabine-tenofovir df tab600-200-300 mg.................................................................. 3

AUBAGIO- teriflunomide tab 7 mg.....................................39AUBAGIO- teriflunomide tab 14 mg...................................39AVONEX- interferon beta-1a im prefilled syringe kit 30mcg/0.5ml...........................................................................39

AVONEX PEN- interferon beta-1a im auto-injector kit 30mcg/0.5ml...........................................................................39

AYVAKIT- avapritinib tab 100 mg.........................................6AYVAKIT- avapritinib tab 200 mg.........................................6AYVAKIT- avapritinib tab 300 mg.........................................6azathioprine tab 50 mg (Imuran).....................................61azelaic acid gel 15% (Finacea)........................................58azelastine hcl nasal spray 0.1% (137 mcg/spray)......... 27azelastine hcl nasal spray 0.15% (205.5 mcg/spray)(Astepro)........................................................................... 27

azelastine hcl ophth soln 0.05%..................................... 56AZITHROMYCIN- azithromycin powd pack for susp 1gm........................................................................................ 2

azithromycin for susp 100 mg/5ml (Zithromax).............. 2azithromycin for susp 200 mg/5ml (Zithromax).............. 2azithromycin tab 250 mg (Zithromax).............................. 2azithromycin tab 500 mg (Zithromax).............................. 2azithromycin tab 600 mg (Zithromax).............................. 2AZOPT- brinzolamide ophth susp 1%................................56

BBACITRACIN- bacitracin ophth oint 500 unit/gm...............56bacitracin-polymyxin b ophth oint..................................56bacitracin-polymyxin-neomycin-hc ophth oint 1%.......56baclofen tab 10 mg...........................................................49baclofen tab 20 mg...........................................................49balsalazide disodium cap 750 mg (Colazal).................. 31BAQSIMI ONE PACK- glucagon nasal powder 3 mg/dose....................................................................................12

BAQSIMI TWO PACK- glucagon nasal powder 3 mg/dose....................................................................................12

BARACLUDE- entecavir oral soln 0.05 mg/ml.....................3BELBUCA- buprenorphine hcl buccal film 75 mcg (baseequivalent)......................................................................... 41

BELBUCA- buprenorphine hcl buccal film 150 mcg (baseequivalent)......................................................................... 41





2020



BELSOMRA- suvorexant tab 5 mg.................................... 37BELSOMRA- suvorexant tab 10 mg.................................. 37BELSOMRA- suvorexant tab 15 mg.................................. 37BELSOMRA- suvorexant tab 20 mg.................................. 37benazepril & hydrochlorothiazide tab 5-6.25 mg.......... 21benazepril & hydrochlorothiazide tab 10-12.5 mg(Lotensin hct)...................................................................21

benazepril & hydrochlorothiazide tab 20-12.5 mg(Lotensin hct)...................................................................21

benazepril & hydrochlorothiazide tab 20-25 mg(Lotensin hct)...................................................................21

benazepril hcl tab 5 mg................................................... 21benazepril hcl tab 10 mg (Lotensin)...............................21benazepril hcl tab 20 mg (Lotensin)...............................21benazepril hcl tab 40 mg (Lotensin)...............................21BENEFIX- coagulation factor ix (recombinant) for inj kit250 unit..............................................................................53

BENEFIX- coagulation factor ix (recombinant) for inj kit500 unit..............................................................................53

BENEFIX- coagulation factor ix (recombinant) for inj kit1000 unit............................................................................53



BENZNIDAZOLE- benznidazole tab 12.5 mg...................... 6BENZNIDAZOLE- benznidazole tab 100 mg....................... 6benzoyl peroxide-erythromycin gel 5-3%(Benzamycin)....................................................................58

benztropine mesylate tab 0.5 mg....................................48benztropine mesylate tab 1 mg.......................................48benztropine mesylate tab 2 mg.......................................48betamethasone dipropionate augmented cream 0.05%(Diprolene af)................................................................... 58

betamethasone dipropionate augmented lotion 0.05%(Diprolene)........................................................................ 58

betamethasone dipropionate augmented oint 0.05%(Diprolene)........................................................................ 58

betamethasone dipropionate cream 0.05%................... 58betamethasone dipropionate lotion 0.05%....................58betamethasone dipropionate oint 0.05%....................... 58betamethasone valerate cream 0.1% (baseequivalent)........................................................................ 58

betamethasone valerate lotion 0.1% (baseequivalent)........................................................................ 58

betamethasone valerate oint 0.1% (baseequivalent)........................................................................ 58

BETASERON- interferon beta-1b for inj kit 0.3 mg............39bexarotene cap 75 mg (Targretin).....................................6bicalutamide tab 50 mg (Casodex)...................................6

BIKTARVY- bictegravir-emtricitabine-tenofovir af tab50-200-25 mg...................................................................... 3

bisoprolol & hydrochlorothiazide tab 2.5-6.25 mg(Ziac)..................................................................................21

bisoprolol & hydrochlorothiazide tab 5-6.25 mg(Ziac)..................................................................................21

bisoprolol & hydrochlorothiazide tab 10-6.25 mg(Ziac)..................................................................................21

bisoprolol fumarate tab 5 mg (Zebeta)...........................18bisoprolol fumarate tab 10 mg (Zebeta).........................18bosentan tab 62.5 mg (Tracleer)..................................... 26bosentan tab 125 mg (Tracleer)...................................... 26BREATHERITE- spacer/aerosol-holding chambers -device.................................................................................61

BREO ELLIPTA- fluticasone furoate-vilanterol aero powdba 100-25 mcg/inh............................................................ 28

BREO ELLIPTA- fluticasone furoate-vilanterol aero powdba 200-25 mcg/inh............................................................ 28

BRILINTA- ticagrelor tab 60 mg......................................... 53BRILINTA- ticagrelor tab 90 mg......................................... 53brimonidine tartrate ophth soln 0.2%.............................56brimonidine tartrate ophth soln 0.15% (Alphaganp)........................................................................................ 56

budesonide delayed release particles cap 3 mg(Entocort ec)...................................................................... 9

budesonide inhalation susp 0.25 mg/2ml(Pulmicort)........................................................................ 28

budesonide inhalation susp 0.5 mg/2ml(Pulmicort)........................................................................ 28

budesonide inhalation susp 1 mg/2ml (Pulmicort).......28bumetanide tab 0.5 mg.................................................... 24bumetanide tab 1 mg........................................................24bumetanide tab 2 mg........................................................24buprenorphine hcl-naloxone hcl sl film 2-0.5 mg (baseequiv) (SUBOXONE)........................................................42

buprenorphine hcl-naloxone hcl sl film 4-1 mg (baseequiv) (SUBOXONE)........................................................42



buprenorphine hcl-naloxone hcl sl tab 2-0.5 mg (baseequiv).................................................................................42

buprenorphine hcl-naloxone hcl sl tab 8-2 mg (baseequiv).................................................................................42

buprenorphine hcl sl tab 2 mg (base equiv)................. 41buprenorphine hcl sl tab 8 mg (base equiv)................. 42bupropion hcl (smoking deterrent) tab er 12hr 150 mg(Zyban).............................................................................. 39

bupropion hcl tab er 12hr 100 mg (Wellbutrin sr).........33bupropion hcl tab er 12hr 150 mg (Wellbutrin sr).........33bupropion hcl tab er 12hr 200 mg (Wellbutrin sr).........33bupropion hcl tab er 24hr 150 mg (Wellbutrin xl)......... 33

2020


bupropion hcl tab er 24hr 300 mg (Wellbutrin xl)......... 34bupropion hcl tab 75 mg (Wellbutrin)............................ 34bupropion hcl tab 100 mg (Wellbutrin).......................... 34buspirone hcl tab 5 mg....................................................33buspirone hcl tab 10 mg..................................................33buspirone hcl tab 15 mg..................................................33buspirone hcl tab 30 mg..................................................33butalbital-acetaminophen-caffeine tab 50-325-40 mg(Esgic)............................................................................... 41

butalbital-acetaminophen tab 50-325 mg.......................41butalbital-aspirin-caffeine cap 50-325-40 mg(Fiorinal)............................................................................41

butalbital-aspirin-caff w/ codeine cap 50-325-40-30 mg(Fiorinal/codeine #3)....................................................... 42C

cabergoline tab 0.5 mg.................................................... 16CABOMETYX- cabozantinib s-malate tab 20 mg (baseequivalent)............................................................................6

CABOMETYX- cabozantinib s-malate tab 40 mg (baseequivalent)............................................................................7

CABOMETYX- cabozantinib s-malate tab 60 mg (baseequivalent)............................................................................7

caffeine citrate oral soln 60 mg/3ml (10 mg/ml baseequiv).................................................................................38

calcipotriene cream 0.005% (Dovonex)..........................58calcipotriene oint 0.005%.................................................58calcipotriene soln 0.005% (50 mcg/ml).......................... 59calcitonin (salmon) nasal soln 200 unit/act(Miacalcin)........................................................................ 16

calcitriol cap 0.25 mcg (Rocaltrol)..................................16calcitriol cap 0.5 mcg (Rocaltrol)....................................16calcitriol oral soln 1 mcg/ml (Rocaltrol).........................16calcium acetate (phosphate binder) cap 667 mg (169mg ca) (Phoslo)............................................................... 31

calcium acetate (phosphate binder) tab 667 mg...........31candesartan cilexetil-hydrochlorothiazide tab 16-12.5mg (Atacand hct).............................................................21

candesartan cilexetil-hydrochlorothiazide tab 32-12.5mg (Atacand hct).............................................................21

candesartan cilexetil-hydrochlorothiazide tab 32-25mg (Atacand hct).............................................................21

candesartan cilexetil tab 4 mg (Atacand)...................... 21candesartan cilexetil tab 8 mg (Atacand)...................... 21candesartan cilexetil tab 16 mg (Atacand).................... 21candesartan cilexetil tab 32 mg (Atacand).................... 21capecitabine tab 150 mg (Xeloda).................................... 7capecitabine tab 500 mg (Xeloda).................................... 7captopril tab 12.5 mg........................................................21captopril tab 25 mg...........................................................21captopril tab 50 mg...........................................................21captopril tab 100 mg.........................................................21CARAC- fluorouracil cream 0.5%.......................................59

carbamazepine cap er 12hr 100 mg (Carbatrol)............46carbamazepine cap er 12hr 200 mg (Carbatrol)............46carbamazepine cap er 12hr 300 mg (Carbatrol)............46carbamazepine chew tab 100 mg................................... 46carbamazepine susp 100 mg/5ml (Tegretol)..................46carbamazepine tab er 12hr 100 mg (Tegretol-xr).......... 46carbamazepine tab er 12hr 200 mg (Tegretol-xr).......... 46carbamazepine tab er 12hr 400 mg (Tegretol-xr).......... 46carbamazepine tab 200 mg (Tegretol)............................46carbidopa & levodopa orally disintegrating tab 10-100mg...................................................................................... 48

carbidopa & levodopa orally disintegrating tab 25-100mg...................................................................................... 48

carbidopa & levodopa orally disintegrating tab 25-250mg...................................................................................... 48

carbidopa & levodopa tab er 25-100 mg (Sinemetcr).......................................................................................48

carbidopa & levodopa tab er 50-200 mg (Sinemetcr).......................................................................................48

carbidopa & levodopa tab 10-100 mg (Sinemet)...........48carbidopa & levodopa tab 25-100 mg (Sinemet)...........48carbidopa & levodopa tab 25-250 mg (Sinemet)...........48carvedilol tab 3.125 mg (Coreg)......................................18carvedilol tab 6.25 mg (Coreg)........................................18carvedilol tab 12.5 mg (Coreg)........................................18carvedilol tab 25 mg (Coreg)...........................................18cefaclor cap 250 mg........................................................... 1cefaclor cap 500 mg........................................................... 1cefadroxil cap 500 mg........................................................1cefadroxil for susp 250 mg/5ml........................................ 1cefadroxil for susp 500 mg/5ml........................................ 1cefadroxil tab 1 gm.............................................................1cefdinir cap 300 mg............................................................1cefdinir for susp 125 mg/5ml............................................ 1cefdinir for susp 250 mg/5ml............................................ 1cefixime cap 400 mg (Suprax)...........................................1cefixime for susp 100 mg/5ml (Suprax)........................... 1cefixime for susp 200 mg/5ml (Suprax)........................... 1cefpodoxime proxetil for susp 50 mg/5ml....................... 1cefpodoxime proxetil for susp 100 mg/5ml..................... 1cefpodoxime proxetil tab 100 mg..................................... 1cefpodoxime proxetil tab 200 mg..................................... 1cefprozil for susp 125 mg/5ml...........................................1cefprozil for susp 250 mg/5ml...........................................1cefprozil tab 250 mg...........................................................1cefprozil tab 500 mg...........................................................1ceftriaxone sodium for inj 1 gm........................................1ceftriaxone sodium for inj 2 gm........................................1ceftriaxone sodium for inj 250 mg....................................1ceftriaxone sodium for inj 500 mg....................................1cefuroxime axetil tab 250 mg (Ceftin).............................. 1cefuroxime axetil tab 500 mg (Ceftin).............................. 1celecoxib cap 50 mg (Celebrex)......................................43

2020


celecoxib cap 100 mg (Celebrex)....................................43celecoxib cap 200 mg (Celebrex)....................................43celecoxib cap 400 mg (Celebrex)....................................43CELLCEPT- mycophenolate mofetil cap 250 mg.............. 61CELLCEPT- mycophenolate mofetil tab 500 mg............... 61CELONTIN- methsuximide cap 300 mg.............................46cephalexin cap 250 mg (Keflex)........................................1cephalexin cap 500 mg (Keflex)........................................1cephalexin for susp 125 mg/5ml.......................................1cephalexin for susp 250 mg/5ml.......................................1cetirizine hcl oral soln 1 mg/ml (5 mg/5ml)................... 26cevimeline hcl cap 30 mg (Evoxac)................................58CHANTIX CONTINUING MONTH- varenicline tartrate tab1 mg (base equiv).............................................................39

CHANTIX- varenicline tartrate tab 0.5 mg (baseequiv)................................................................................. 39

CHANTIX- varenicline tartrate tab 1 mg (base equiv)........39CHEMET- succimer cap 100 mg........................................61CHENODAL- chenodiol tab 250 mg...................................31chlorhexidine gluconate soln 0.12% (Peridex)..............58chloroquine phosphate tab 250 mg..................................6chlorpromazine hcl tab 10 mg........................................ 35chlorpromazine hcl tab 25 mg........................................ 35chlorpromazine hcl tab 50 mg........................................ 35chlorpromazine hcl tab 100 mg...................................... 35chlorpromazine hcl tab 200 mg...................................... 35chlorthalidone tab 25 mg.................................................24chlorthalidone tab 50 mg.................................................24chlorzoxazone tab 500 mg...............................................49cholestyramine light powder 4 gm/dose (Questranlight)...................................................................................25

cholestyramine light powder packets 4 gm.................. 25cholestyramine powder 4 gm/dose (Questran).............25cholestyramine powder packets 4 gm (Questran)........25choline fenofibrate cap dr 45 mg (fenofibric acidequiv) (Trilipix).................................................................25

ciclopirox gel 0.77%......................................................... 59ciclopirox olamine cream 0.77% (base equiv)...............59ciclopirox olamine susp 0.77% (base equiv).................59ciclopirox shampoo 1% (Loprox shampoo).................. 59ciclopirox solution 8% (Penlac Nail Lacquer)............... 59cilostazol tab 50 mg (Pletal)............................................53cilostazol tab 100 mg (Pletal)..........................................53CIMDUO- lamivudine-tenofovir disoproxil fumarate tab300-300 mg......................................................................... 3

cimetidine tab 300 mg......................................................30cimetidine tab 400 mg......................................................30cimetidine tab 800 mg......................................................30cinacalcet hcl tab 30 mg (base equiv) (Sensipar).........16cinacalcet hcl tab 60 mg (base equiv) (Sensipar).........16cinacalcet hcl tab 90 mg (base equiv) (Sensipar).........16CIPRODEX- ciprofloxacin-dexamethasone otic susp0.3-0.1%.............................................................................58

ciprofloxacin hcl ophth soln 0.3% (base equivalent)(Ciloxan)............................................................................56

ciprofloxacin hcl tab 750 mg (base equiv).......................2ciprofloxacin hcl tab 250 mg (base equiv) (Cipro)..........2ciprofloxacin hcl tab 500 mg (base equiv) (Cipro)..........2citalopram hydrobromide oral soln 10 mg/5ml............. 34citalopram hydrobromide tab 10 mg (base equiv)(Celexa)............................................................................. 34

citalopram hydrobromide tab 20 mg (base equiv)(Celexa)............................................................................. 34

citalopram hydrobromide tab 40 mg (base equiv)(Celexa)............................................................................. 34

clarithromycin tab er 24hr 500 mg................................... 2clarithromycin tab 250 mg (Biaxin).................................. 2clarithromycin tab 500 mg (Biaxin).................................. 2clindamycin hcl cap 75 mg (Cleocin)...............................6clindamycin hcl cap 150 mg (Cleocin).............................6clindamycin hcl cap 300 mg (Cleocin).............................6clindamycin palmitate hcl for soln 75 mg/5ml (baseequiv) (Cleocin pediatric gr)............................................ 6

clindamycin phosphate-benzoyl peroxide gel 1-5%(Benzaclin)........................................................................59

clindamycin phosphate gel 1% (Cleocin-t)....................59clindamycin phosphate lotion 1% (Cleocin-t)............... 59clindamycin phosphate soln 1% (Cleocin-t)..................59clindamycin phosphate swab 1% (Cleocin-t)................ 59clindamycin phosphate vaginal cream 2%(Cleocin)............................................................................32

clindamycin phosph-benzoyl peroxide (refrig) gel 1.2(1)-5% (Duac)....................................................................59

clobetasol propionate cream 0.05% (Temovate)...........59clobetasol propionate emollient base cream 0.05%(Temovate e).....................................................................59

clobetasol propionate foam 0.05% (Olux)......................59clobetasol propionate gel 0.05% (Temovate)................ 59clobetasol propionate oint 0.05% (Temovate)...............59clobetasol propionate soln 0.05% (Temovate).............. 59CLOMIPHENE CITRATE- clomiphene citrate tab 50mg...................................................................................... 16

clomipramine hcl cap 25 mg (Anafranil)........................34clomipramine hcl cap 50 mg (Anafranil)........................34clomipramine hcl cap 75 mg (Anafranil)........................34clonazepam tab 0.5 mg (Klonopin).................................46clonazepam tab 1 mg (Klonopin)....................................46clonazepam tab 2 mg (Klonopin)....................................46clonidine hcl tab 0.1 mg (Catapres)............................... 22clonidine hcl tab 0.2 mg (Catapres)............................... 22clonidine hcl tab 0.3 mg (Catapres)............................... 22clonidine td patch weekly 0.1 mg/24hr (Catapres-tts-1)...................................................................................22

clonidine td patch weekly 0.2 mg/24hr (Catapres-tts-2)...................................................................................22

2020


clonidine td patch weekly 0.3 mg/24hr (Catapres-tts-3)...................................................................................22

clopidogrel bisulfate tab 75 mg (base equiv)(Plavix).............................................................................. 53

clotrimazole troche 10 mg............................................... 58clozapine tab 50 mg......................................................... 35clozapine tab 200 mg....................................................... 35clozapine tab 25 mg (Clozaril).........................................35clozapine tab 100 mg (Clozaril).......................................35COAGADEX- coagulation factor x (human) for inj 250unit......................................................................................53

COAGADEX- coagulation factor x (human) for inj 500unit......................................................................................53

codeine sulfate tab 30 mg (Codeine sulfate).................42colchicine w/ probenecid tab 0.5-500 mg...................... 46colesevelam hcl packet for susp 3.75 gm(Welchol)........................................................................... 25

colesevelam hcl tab 625 mg (Welchol).......................... 25colestipol hcl granule packets 5 gm (Colestidflavored)............................................................................25

colestipol hcl granules 5 gm (Colestid flavored).......... 25colestipol hcl tab 1 gm (Colestid)...................................25COMBIPATCH- estradiol-norethindrone ace td pttw0.05-0.14 mg/day.............................................................. 10

COMBIPATCH- estradiol-norethindrone ace td pttw0.05-0.25 mg/day.............................................................. 10

COMBIVENT RESPIMAT- ipratropium-albuterol inhalaerosol soln 20-100 mcg/act............................................ 28

COPAXONE- glatiramer acetate soln prefilled syringe 20mg/ml..................................................................................40

COPAXONE- glatiramer acetate soln prefilled syringe 40mg/ml..................................................................................40

CORIFACT- factor xiii concentrate (human) for inj kit1000-1600 unit...................................................................53

CORTISONE ACETATE- cortisone acetate tab 25 mg........9COSENTYX- secukinumab subcutaneous pref syr 150mg/ml (300 mg dose)........................................................59

COSENTYX- secukinumab subcutaneous soln prefilledsyringe 150 mg/ml.............................................................59

COSENTYX SENSOREADY PEN- secukinumabsubcutaneous auto-inj 150 mg/ml (300 mg dose)............59

COSENTYX SENSOREADY PEN- secukinumabsubcutaneous soln auto-injector 150 mg/ml.....................59

COTELLIC- cobimetinib fumarate tab 20 mg (baseequivalent)............................................................................7

CREON- pancrelipase (lip-prot-amyl) dr cap3000-9500-15000 unit....................................................... 31

CREON- pancrelipase (lip-prot-amyl) dr cap6000-19000-30000 unit..................................................... 31

CREON- pancrelipase (lip-prot-amyl) dr cap12000-38000-60000 unit...................................................31

CREON- pancrelipase (lip-prot-amyl) dr cap24000-76000-120000 unit.................................................31

CREON- pancrelipase (lip-prot-amyl) dr cap36000-114000-180000 unit............................................... 31

CRINONE- progesterone vaginal gel 4%...........................32CRINONE- progesterone vaginal gel 8%...........................32cromolyn sodium ophth soln 4%....................................56cromolyn sodium soln nebu 20 mg/2ml........................ 28cyanocobalamin inj 1000 mcg/ml................................... 50cyclobenzaprine hcl tab 5 mg.........................................49cyclobenzaprine hcl tab 10 mg.......................................49cyclopentolate hcl ophth soln 1% (Cyclogyl)................56cyclophosphamide cap 25 mg (Cyclophosphamide)..... 7cyclophosphamide cap 50 mg (Cyclophosphamide)..... 7cyclosporine cap 25 mg (Sandimmune)........................ 61cyclosporine cap 100 mg (Sandimmune)...................... 62cyclosporine modified cap 50 mg (Cyclosporinemodifie)............................................................................. 62

cyclosporine modified cap 25 mg (Neoral)....................62cyclosporine modified cap 100 mg (Neoral)..................62cyclosporine modified oral soln 100 mg/ml(Neoral)..............................................................................62

cyproheptadine hcl syrup 2 mg/5ml...............................26cyproheptadine hcl tab 4 mg.......................................... 26CYSTADANE- betaine powder for oral solution.................16CYSTAGON- cysteamine bitartrate cap 50 mg..................33CYSTAGON- cysteamine bitartrate cap 150 mg................33

Ddanazol cap 50 mg............................................................10danazol cap 100 mg..........................................................10danazol cap 200 mg..........................................................10dantrolene sodium cap 100 mg...................................... 49dantrolene sodium cap 25 mg (Dantrium)..................... 49dantrolene sodium cap 50 mg (Dantrium)..................... 49dapsone tab 25 mg.............................................................6dapsone tab 100 mg...........................................................6DARAPRIM- pyrimethamine tab 25 mg............................... 6DELSTRIGO- doravirine-lamivudine-tenofovir df tab100-300-300 mg.................................................................. 3

DELZICOL- mesalamine cap dr 400 mg............................31demeclocycline hcl tab 150 mg........................................ 2demeclocycline hcl tab 300 mg........................................ 2DEPEN TITRATABS- penicillamine tab 250 mg................ 62DESCOVY- emtricitabine-tenofovir alafenamide fumaratetab 200-25 mg..................................................................... 3

desipramine hcl tab 10 mg (Norpramin)........................ 34desipramine hcl tab 25 mg (Norpramin)........................ 34desipramine hcl tab 50 mg (Norpramin)........................ 34desipramine hcl tab 75 mg (Norpramin)........................ 34desipramine hcl tab 100 mg (Norpramin)...................... 34desipramine hcl tab 150 mg (Norpramin)...................... 34desloratadine tab 5 mg (Clarinex).................................. 26desmopressin acetate inj 4 mcg/ml (Ddavp).................16

2020


desmopressin acetate nasal spray soln 0.01%(Ddavp)..............................................................................16

desmopressin acetate nasal spray soln 0.01%(refrigerated).....................................................................17

desmopressin acetate tab 0.1 mg (Ddavp)....................17desmopressin acetate tab 0.2 mg (Ddavp)....................17desogest-eth estrad & eth estrad tab 0.15-0.02/0.01mg(21/5) (Mircette).......................................................... 11

desogest-ethin est tab0.1-0.025/0.125-0.025/0.15-0.025mg-mg (Cyclessa).....11

desogestrel & ethinyl estradiol tab 0.15 mg-30 mcg(Desogen)......................................................................... 11

desonide cream 0.05% (Desowen)................................. 59desonide lotion 0.05% (Desowen).................................. 59desonide oint 0.05% (Desowen)......................................59desoximetasone cream 0.25% (Topicort).......................59desoximetasone oint 0.25% (Topicort)...........................59desvenlafaxine succinate tab er 24hr 25 mg (baseequiv) (Pristiq)................................................................. 34

desvenlafaxine succinate tab er 24hr 50 mg (baseequiv) (Pristiq)................................................................. 34

desvenlafaxine succinate tab er 24hr 100 mg (baseequiv) (Pristiq)................................................................. 34

DEXAMETHASONE- dexamethasone soln 0.5 mg/5ml...... 9dexamethasone elixir 0.5 mg/5ml..................................... 9dexamethasone tab 0.5 mg............................................... 9dexamethasone tab 0.75 mg............................................. 9dexamethasone tab 1.5 mg............................................... 9dexamethasone tab 4 mg.................................................. 9dexamethasone tab 6 mg.................................................. 9dexmethylphenidate hcl cap er 24 hr 5 mg (Focalinxr).......................................................................................38

dexmethylphenidate hcl cap er 24 hr 10 mg (Focalinxr).......................................................................................38







dexmethylphenidate hcl tab 2.5 mg (Focalin)............... 38dexmethylphenidate hcl tab 5 mg (Focalin).................. 38dexmethylphenidate hcl tab 10 mg (Focalin)................ 38dextroamphetamine sulfate cap er 24hr 5 mg(Dexedrine)....................................................................... 38

dextroamphetamine sulfate cap er 24hr 10 mg(Dexedrine)....................................................................... 38

dextroamphetamine sulfate cap er 24hr 15 mg(Dexedrine)....................................................................... 38

dextroamphetamine sulfate tab 5 mg.............................38dextroamphetamine sulfate tab 10 mg...........................38DIASTAT ACUDIAL- diazepam rectal gel delivery system10 mg.................................................................................46

DIASTAT ACUDIAL- diazepam rectal gel delivery system20 mg.................................................................................46

DIASTAT PEDIATRIC- diazepam rectal gel deliverysystem 2.5 mg...................................................................46

DIAZEPAM- diazepam oral soln 1 mg/ml...........................33diazepam tab 2 mg (Valium)............................................33diazepam tab 5 mg (Valium)............................................33diazepam tab 10 mg (Valium)..........................................33diazoxide susp 50 mg/ml (Proglycem)...........................12diclofenac potassium tab 50 mg.....................................43diclofenac sodium (actinic keratoses) gel 3%.............. 59diclofenac sodium gel 1% (Voltaren)..............................59diclofenac sodium ophth soln 0.1%...............................56diclofenac sodium tab delayed release 25 mg..............44diclofenac sodium tab delayed release 50 mg..............44diclofenac sodium tab delayed release 75 mg..............44diclofenac sodium tab er 24hr 100 mg.......................... 44dicloxacillin sodium cap 250 mg...................................... 1dicloxacillin sodium cap 500 mg...................................... 1dicyclomine hcl cap 10 mg (Bentyl)...............................30dicyclomine hcl oral soln 10 mg/5ml............................. 30dicyclomine hcl tab 20 mg (Bentyl)................................30digoxin oral soln 0.05 mg/ml (Digoxin).......................... 18digoxin tab 125 mcg (0.125 mg) (Lanoxin).................... 18digoxin tab 250 mcg (0.25 mg) (Lanoxin)...................... 18dihydroergotamine mesylate inj 1 mg/ml (D.h.e.45)...................................................................................... 45

dihydroergotamine mesylate nasal spray 4 mg/ml(Migranal)..........................................................................45

DILANTIN- phenytoin sodium extended cap 30 mg...........46diltiazem hcl coated beads cap er 24hr 120 mg(Cardizem cd)...................................................................19

diltiazem hcl coated beads cap er 24hr 180 mg(Cardizem cd)...................................................................19




diltiazem hcl extended release beads cap er 24hr 120mg (Tiazac).......................................................................19



2020





diltiazem hcl tab 90 mg....................................................20diltiazem hcl tab 30 mg (Cardizem)................................20diltiazem hcl tab 60 mg (Cardizem)................................20diltiazem hcl tab 120 mg (Cardizem)..............................20diphenoxylate w/ atropine tab 2.5-0.025 mg(Lomotil)............................................................................30

dipyridamole tab 25 mg (Persantine)............................. 53dipyridamole tab 50 mg (Persantine)............................. 53dipyridamole tab 75 mg (Persantine)............................. 53disopyramide phosphate cap 100 mg (Norpace).......... 20disopyramide phosphate cap 150 mg (Norpace).......... 20disulfiram tab 250 mg (Antabuse).................................. 40disulfiram tab 500 mg (Antabuse).................................. 40divalproex sodium cap delayed release sprinkle 125mg (Depakote sprinkles)................................................ 46

divalproex sodium tab delayed release 125 mg(Depakote)........................................................................ 46



divalproex sodium tab er 24 hr 250 mg (Depakoteer).......................................................................................46

divalproex sodium tab er 24 hr 500 mg (Depakoteer).......................................................................................47

DIVIGEL- estradiol td gel 0.25 mg/0.25gm (0.1%).............10DIVIGEL- estradiol td gel 0.5 mg/0.5gm (0.1%).................10DIVIGEL- estradiol td gel 0.75 mg/0.75gm (0.1%).............10DIVIGEL- estradiol td gel 1 mg/gm (0.1%)........................ 10DIVIGEL- estradiol td gel 1.25 mg/1.25gm (0.1%).............10donepezil hydrochloride orally disintegrating tab 5mg...................................................................................... 40

donepezil hydrochloride orally disintegrating tab 10mg...................................................................................... 40

donepezil hydrochloride tab 5 mg (Aricept)..................40donepezil hydrochloride tab 10 mg (Aricept)................40dorzolamide hcl ophth soln 2% (Trusopt)..................... 56dorzolamide hcl-timolol maleate ophth soln 22.3-6.8mg/ml (Cosopt)................................................................ 56

DOVATO- dolutegravir sodium-lamivudine tab 50-300 mg(base eq)..............................................................................3

doxazosin mesylate tab 1 mg (Cardura)........................22doxazosin mesylate tab 2 mg (Cardura)........................22doxazosin mesylate tab 4 mg (Cardura)........................22doxazosin mesylate tab 8 mg (Cardura)........................22doxepin hcl cap 10 mg.....................................................34doxepin hcl cap 25 mg.....................................................34

doxepin hcl cap 50 mg.....................................................34doxepin hcl cap 75 mg.....................................................34doxepin hcl cap 100 mg...................................................34doxepin hcl conc 10 mg/ml............................................. 34doxycycline hyclate cap 50 mg.........................................2doxycycline hyclate cap 100 mg (Vibramycin)................2doxycycline hyclate tab 20 mg......................................... 2doxycycline hyclate tab 100 mg....................................... 2doxycycline monohydrate cap 50 mg.............................. 2doxycycline monohydrate cap 100 mg (Monodox).........2doxycycline monohydrate tab 50 mg (Adoxa)................ 2doxycycline monohydrate tab 75 mg (Adoxa)................ 2doxycycline monohydrate tab 100 mg (Adoxa pak1/100)................................................................................... 2

doxycycline monohydrate tab 150 mg (Adoxa pak1/150)................................................................................... 2

drospirenone-ethinyl estradiol tab 3-0.03 mg (Yasmin28)...................................................................................... 11

drospirenone-ethinyl estradiol tab 3-0.02 mg (Yaz)......11DROXIA- hydroxyurea cap 200 mg....................................50DROXIA- hydroxyurea cap 300 mg....................................50DROXIA- hydroxyurea cap 400 mg....................................50DUAVEE- conjugated estrogens-bazedoxifene tab 0.45-20mg...................................................................................... 10

DULERA- mometasone furoate-formoterol fumarateaerosol 50-5 mcg/act........................................................ 28

DULERA- mometasone furoate-formoterol fumarateaerosol 100-5 mcg/act...................................................... 28

DULERA- mometasone furoate-formoterol fumarateaerosol 200-5 mcg/act...................................................... 28

duloxetine hcl enteric coated pellets cap 20 mg (baseeq) (Cymbalta)..................................................................34



dutasteride cap 0.5 mg (Avodart)................................... 33E

econazole nitrate cream 1%............................................ 59efavirenz cap 50 mg (Sustiva)...........................................3efavirenz cap 200 mg (Sustiva).........................................3efavirenz tab 600 mg (Sustiva)..........................................4eletriptan hydrobromide tab 20 mg (base equivalent)(Relpax).............................................................................45

eletriptan hydrobromide tab 40 mg (base equivalent)(Relpax).............................................................................45

ELIQUIS- apixaban tab 2.5 mg.......................................... 51ELIQUIS- apixaban tab 5 mg............................................. 51ELIQUIS STARTER PACK- apixaban tab 5 mg.................51ELLA- ulipristal acetate tab 30 mg.....................................11ELOCTATE- antihemophilic factor rcmb (bdd-rfviiifc) for inj250 unit..............................................................................53

2020


ELOCTATE- antihemophilic factor rcmb (bdd-rfviiifc) for inj500 unit..............................................................................53

ELOCTATE- antihemophilic factor rcmb (bdd-rfviiifc) for inj750 unit..............................................................................53

ELOCTATE- antihemophilic factor rcmb (bdd-rfviiifc) for inj1000 unit............................................................................53







EMCYT- estramustine phosphate sodium cap 140 mg....... 7EMEND- aprepitant for oral susp 125 mg (125mg/5ml).............................................................................. 31

EMGALITY- galcanezumab-gnlm subcutaneous soln auto-injector 120 mg/ml.............................................................45

EMGALITY- galcanezumab-gnlm subcutaneous solnprefilled syr 100 mg/ml......................................................45

EMGALITY- galcanezumab-gnlm subcutaneous solnprefilled syr 120 mg/ml......................................................45

enalapril maleate & hydrochlorothiazide tab 5-12.5mg...................................................................................... 22

enalapril maleate & hydrochlorothiazide tab 10-25 mg(Vaseretic).........................................................................22

enalapril maleate tab 2.5 mg (Vasotec)..........................22enalapril maleate tab 5 mg (Vasotec).............................22enalapril maleate tab 10 mg (Vasotec)...........................22enalapril maleate tab 20 mg (Vasotec)...........................22ENBREL- etanercept for subcutaneous inj 25 mg............. 44ENBREL- etanercept subcutaneous soln prefilled syringe25 mg/0.5ml.......................................................................44

ENBREL- etanercept subcutaneous soln prefilled syringe50 mg/ml............................................................................44

ENBREL MINI- etanercept subcutaneous solutioncartridge 50 mg/ml............................................................ 44

ENBREL SURECLICK- etanercept subcutaneous solutionauto-injector 50 mg/ml...................................................... 44

enoxaparin sodium inj 30 mg/0.3ml (Lovenox)............. 51enoxaparin sodium inj 40 mg/0.4ml (Lovenox)............. 51enoxaparin sodium inj 60 mg/0.6ml (Lovenox)............. 51enoxaparin sodium inj 80 mg/0.8ml (Lovenox)............. 51enoxaparin sodium inj 100 mg/ml (Lovenox)................ 51enoxaparin sodium inj 120 mg/0.8ml (Lovenox)........... 51enoxaparin sodium inj 150 mg/ml (Lovenox)................ 51enoxaparin sodium inj 300 mg/3ml (Lovenox).............. 51entacapone tab 200 mg (Comtan)...................................48

entecavir tab 0.5 mg (Baraclude)......................................4entecavir tab 1 mg (Baraclude).........................................4ENTRESTO- sacubitril-valsartan tab 24-26 mg................. 26ENTRESTO- sacubitril-valsartan tab 49-51 mg................. 26ENTRESTO- sacubitril-valsartan tab 97-103 mg............... 26EPCLUSA- sofosbuvir-velpatasvir tab 400-100 mg............. 4EPIDIOLEX- cannabidiol soln 100 mg/ml.......................... 47epinephrine solution auto-injector 0.15 mg/0.3ml(1:2000) (Epipen-jr 2-pak)...............................................24

epinephrine solution auto-injector 0.3 mg/0.3ml(1:1000) (Epipen 2-pak)...................................................24

EPIPEN-JR 2-PAK- epinephrine solution auto-injector 0.15mg/0.3ml (1:2000)............................................................. 24

eplerenone tab 25 mg (Inspra)........................................22eplerenone tab 50 mg (Inspra)........................................22EPOGEN- epoetin alfa inj 2000 unit/ml..............................50EPOGEN- epoetin alfa inj 3000 unit/ml..............................50EPOGEN- epoetin alfa inj 4000 unit/ml..............................50EPOGEN- epoetin alfa inj 10000 unit/ml............................50EPOGEN- epoetin alfa inj 20000 unit/ml............................50ergocalciferol cap 1.25 mg (50000 unit) (Drisdol).........49ERIVEDGE- vismodegib cap 150 mg.................................. 7ERLEADA- apalutamide tab 60 mg......................................7erlotinib hcl tab 25 mg (base equivalent) (Tarceva)........7erlotinib hcl tab 100 mg (base equivalent) (Tarceva)......7erlotinib hcl tab 150 mg (base equivalent) (Tarceva)......7erythromycin gel 2% (Erygel)..........................................59erythromycin ophth oint 5 mg/gm..................................56erythromycin soln 2%...................................................... 59escitalopram oxalate soln 5 mg/5ml (base equiv)(Lexapro)...........................................................................34

escitalopram oxalate tab 5 mg (base equiv)(Lexapro)...........................................................................34



esomeprazole magnesium cap delayed release 20 mg(base eq) (Nexium)..........................................................30

esomeprazole magnesium cap delayed release 40 mg(base eq) (Nexium)..........................................................30

esomeprazole magnesium for delayed release susppacket 10 mg (Nexium)...................................................30



estazolam tab 1 mg.......................................................... 37estazolam tab 2 mg.......................................................... 37estradiol & norethindrone acetate tab 0.5-0.1 mg(Activella)..........................................................................10

estradiol & norethindrone acetate tab 1-0.5 mg(Activella)..........................................................................10

2020


estradiol tab 0.5 mg (Estrace).........................................10estradiol tab 1 mg (Estrace)............................................10estradiol tab 2 mg (Estrace)............................................10estradiol td patch twice weekly 0.025 mg/24hr (Vivelle-dot).....................................................................................10

estradiol td patch twice weekly 0.0375 mg/24hr(Vivelle-dot)...................................................................... 10

estradiol td patch twice weekly 0.05 mg/24hr (Vivelle-dot).....................................................................................10



estradiol td patch weekly 0.025 mg/24hr (Climara).......10estradiol td patch weekly 0.05 mg/24hr (Climara).........11estradiol td patch weekly 0.06 mg/24hr (Climara).........11estradiol td patch weekly 0.075 mg/24hr (Climara).......11estradiol td patch weekly 0.1 mg/24hr (Climara)...........11estradiol td patch weekly 0.0375 mg/24hr (37.5mcg/24hr) (Climara).........................................................11

estradiol vaginal cream 0.1 mg/gm (Estrace)................32estradiol vaginal tab 10 mcg (Vagifem)..........................32ESTRING- estradiol vaginal ring 2 mg (7.5mcg/24hrs)......................................................................... 32

eszopiclone tab 1 mg (Lunesta)......................................37eszopiclone tab 2 mg (Lunesta)......................................37eszopiclone tab 3 mg (Lunesta)......................................37ethambutol hcl tab 100 mg (Myambutol)......................... 2ethambutol hcl tab 400 mg (Myambutol)......................... 2ethosuximide cap 250 mg (Zarontin)..............................47ethosuximide soln 250 mg/5ml (Zarontin)..................... 47ethynodiol diacetate & ethinyl estradiol tab 1 mg-35mcg....................................................................................11

ethynodiol diacetate & ethinyl estradiol tab 1 mg-50mcg (Zovia 1/50e)............................................................11

etodolac cap 200 mg........................................................ 44etodolac cap 300 mg........................................................ 44etodolac tab er 24hr 400 mg........................................... 44etodolac tab er 24hr 500 mg........................................... 44etodolac tab er 24hr 600 mg........................................... 44etodolac tab 400 mg.........................................................44etodolac tab 500 mg.........................................................44everolimus tab 2.5 mg (Afinitor)....................................... 7everolimus tab 5 mg (Afinitor).......................................... 7everolimus tab 7.5 mg (Afinitor)....................................... 7everolimus tab 0.25 mg (Zortress)..................................62everolimus tab 0.5 mg (Zortress)....................................62everolimus tab 0.75 mg (Zortress)..................................62exemestane tab 25 mg (Aromasin)...................................7ezetimibe-simvastatin tab 10-10 mg (Vytorin)...............25ezetimibe-simvastatin tab 10-20 mg (Vytorin)...............25ezetimibe-simvastatin tab 10-40 mg (Vytorin)...............25ezetimibe-simvastatin tab 10-80 mg (Vytorin)...............25

ezetimibe tab 10 mg (Zetia)............................................. 25F

famciclovir tab 125 mg (Famvir)....................................... 4famciclovir tab 250 mg (Famvir)....................................... 4famciclovir tab 500 mg (Famvir)....................................... 4famotidine for susp 40 mg/5ml....................................... 30famotidine tab 20 mg (Pepcid)........................................30famotidine tab 40 mg (Pepcid)........................................30FEIBA- antiinhibitor coagulant complex for iv soln 500unit......................................................................................53

FEIBA- antiinhibitor coagulant complex for iv soln 1000unit......................................................................................53

FEIBA- antiinhibitor coagulant complex for iv soln 2500unit......................................................................................53

felodipine tab er 24hr 2.5 mg.......................................... 20felodipine tab er 24hr 5 mg............................................. 20felodipine tab er 24hr 10 mg........................................... 20fenofibrate micronized cap 67 mg (Lofibra).................. 25fenofibrate micronized cap 134 mg (Lofibra)................ 25fenofibrate micronized cap 200 mg (Lofibra)................ 25fenofibrate tab 54 mg (Lofibra)....................................... 25fenofibrate tab 160 mg (Lofibra)..................................... 25fenofibrate tab 48 mg (Tricor)......................................... 25fenofibrate tab 145 mg (Tricor)....................................... 25fentanyl citrate lozenge on a handle 200 mcg(Actiq)................................................................................42

fentanyl citrate lozenge on a handle 400 mcg(Actiq)................................................................................42





fentanyl td patch 72hr 12 mcg/hr (Duragesic)...............42fentanyl td patch 72hr 25 mcg/hr (Duragesic)...............42fentanyl td patch 72hr 50 mcg/hr (Duragesic)...............42fentanyl td patch 72hr 75 mcg/hr (Duragesic)...............42fentanyl td patch 72hr 100 mcg/hr (Duragesic).............42FIASP FLEXTOUCH- insulin aspart (with niacinamide) solpen-inj 100 unit/ml.............................................................15

FIASP- insulin aspart (with niacinamide) inj 100 unit/ml........................................................................................15

FIASP PENFILL- insulin aspart (with niacinamide) solncartridge 100 unit/ml......................................................... 15

FINACEA- azelaic acid foam 15%..................................... 59finasteride tab 5 mg (Proscar)........................................ 33FIRAZYR- icatibant acetate inj 30 mg/3ml (baseequivalent)......................................................................... 53

flecainide acetate tab 50 mg........................................... 20

2020


flecainide acetate tab 100 mg......................................... 20flecainide acetate tab 150 mg......................................... 20FLOVENT DISKUS- fluticasone propionate aer pow ba 50mcg/blister..........................................................................28

FLOVENT DISKUS- fluticasone propionate aer pow ba100 mcg/blister.................................................................. 28

FLOVENT DISKUS- fluticasone propionate aer pow ba250 mcg/blister.................................................................. 28

FLOVENT HFA- fluticasone propionate hfa inhal aer 110mcg/act (125/valve)...........................................................28

FLOVENT HFA- fluticasone propionate hfa inhal aer 220mcg/act (250/valve)...........................................................28

FLOVENT HFA- fluticasone propionate hfa inhal aero 44mcg/act (50/valve)............................................................. 28

fluconazole for susp 10 mg/ml (Diflucan)........................3fluconazole for susp 40 mg/ml (Diflucan)........................3fluconazole tab 50 mg (Diflucan)......................................3fluconazole tab 100 mg (Diflucan)....................................3fluconazole tab 150 mg (Diflucan)....................................3fluconazole tab 200 mg (Diflucan)....................................3flucytosine cap 250 mg (Ancobon)...................................3flucytosine cap 500 mg (Ancobon)...................................3fludrocortisone acetate tab 0.1 mg...................................9fluocinolone acetonide cream 0.01%............................. 59fluocinolone acetonide cream 0.025% (Synalar)...........59fluocinolone acetonide oil 0.01% (body oil) (Derma-smoothe/fs bod).............................................................. 59

fluocinolone acetonide oil 0.01% (scalp oil) (Derma-smoothe/fs sca)............................................................... 59

fluocinolone acetonide oint 0.025% (Synalar)...............59fluocinolone acetonide soln 0.01% (Synalar)................59fluocinonide cream 0.05%............................................... 60fluocinonide emulsified base cream 0.05%...................60fluocinonide gel 0.05%.....................................................60fluocinonide oint 0.05%....................................................60fluocinonide soln 0.05%...................................................60fluorometholone ophth susp 0.1% (Fml liquifilm)........ 57FLUOROPLEX- fluorouracil cream 1%.............................. 60fluorouracil cream 5% (Efudex)...................................... 60fluoxetine hcl cap 10 mg (Prozac)..................................34fluoxetine hcl cap 20 mg (Prozac)..................................34fluoxetine hcl cap 40 mg (Prozac)..................................34fluoxetine hcl solution 20 mg/5ml.................................. 34fluphenazine decanoate inj 25 mg/ml.............................35FLUPHENAZINE HCL- fluphenazine hcl oral conc 5 mg/ml........................................................................................35

fluphenazine hcl tab 1 mg............................................... 35fluphenazine hcl tab 2.5 mg............................................ 35fluphenazine hcl tab 5 mg............................................... 35fluphenazine hcl tab 10 mg............................................. 35FLUPHENAZINE HYDROCHLORID- fluphenazine hclelixir 2.5 mg/5ml................................................................35

flurbiprofen tab 50 mg......................................................44

flurbiprofen tab 100 mg................................................... 44flutamide cap 125 mg.........................................................7FLUTICASONE PROPIONATE/SA- fluticasone-salmeterolaer powder ba 55-14 mcg/act...........................................28

FLUTICASONE PROPIONATE/SA- fluticasone-salmeterolaer powder ba 113-14 mcg/act.........................................28

FLUTICASONE PROPIONATE/SA- fluticasone-salmeterolaer powder ba 232-14 mcg/act.........................................28

fluticasone propionate cream 0.05% (Cutivate)............ 60fluticasone propionate nasal susp 50 mcg/act............. 27fluticasone propionate oint 0.005%................................60fluvoxamine maleate tab 25 mg......................................34fluvoxamine maleate tab 50 mg......................................34fluvoxamine maleate tab 100 mg....................................34folic acid tab 1 mg............................................................50FOLLISTIM AQ- follitropin beta inj 300 unit/0.36ml........... 17FOLLISTIM AQ- follitropin beta inj 600 unit/0.72ml........... 17FOLLISTIM AQ- follitropin beta inj 900 unit/1.08ml........... 17fosinopril sodium & hydrochlorothiazide tab 10-12.5mg...................................................................................... 22

fosinopril sodium & hydrochlorothiazide tab 20-12.5mg...................................................................................... 22

fosinopril sodium tab 10 mg........................................... 22fosinopril sodium tab 20 mg........................................... 22fosinopril sodium tab 40 mg........................................... 22FULPHILA- pegfilgrastim-jmdb soln prefilled syringe 6mg/0.6ml............................................................................ 50

furosemide oral soln 10 mg/ml....................................... 24furosemide tab 20 mg (Lasix)......................................... 24furosemide tab 40 mg (Lasix)......................................... 24furosemide tab 80 mg (Lasix)......................................... 24G

gabapentin cap 100 mg (Neurontin)...............................47gabapentin cap 300 mg (Neurontin)...............................47gabapentin cap 400 mg (Neurontin)...............................47gabapentin oral soln 250 mg/5ml (Neurontin)...............47gabapentin tab 600 mg (Neurontin)................................47gabapentin tab 800 mg (Neurontin)................................47galantamine hydrobromide cap er 24hr 8 mg(Razadyne er)...................................................................40

galantamine hydrobromide cap er 24hr 16 mg(Razadyne er)...................................................................40

galantamine hydrobromide cap er 24hr 24 mg(Razadyne er)...................................................................40

galantamine hydrobromide tab 4 mg (Razadyne).........40galantamine hydrobromide tab 8 mg (Razadyne).........40galantamine hydrobromide tab 12 mg (Razadyne).......40ganirelix acetate soln prefilled syringe 250 mcg/0.5ml(Ganirelix acetate)........................................................... 17

gemfibrozil tab 600 mg (Lopid).......................................25gentamicin sulfate cream 0.1%.......................................60gentamicin sulfate oint 0.1%........................................... 60

2020


gentamicin sulfate ophth soln 0.3% (Garamycin).........57GENVOYA- elvitegrav-cobic-emtricitab-tenofov af tab150-150-200-10 mg.............................................................4

GILENYA- fingolimod hcl cap 0.5 mg (base equiv)............40glatiramer acetate soln prefilled syringe 20 mg/ml(Copaxone)....................................................................... 40

glatiramer acetate soln prefilled syringe 40 mg/ml(Copaxone)....................................................................... 40

glimepiride tab 1 mg (Amaryl).........................................12glimepiride tab 2 mg (Amaryl).........................................12glimepiride tab 4 mg (Amaryl).........................................12glipizide-metformin hcl tab 2.5-250 mg..........................13glipizide-metformin hcl tab 2.5-500 mg..........................13glipizide-metformin hcl tab 5-500 mg.............................13glipizide tab er 24hr 2.5 mg (Glucotrol xl)..................... 12glipizide tab er 24hr 5 mg (Glucotrol xl)........................ 12glipizide tab er 24hr 10 mg (Glucotrol xl)...................... 12glipizide tab 5 mg (Glucotrol)..........................................12glipizide tab 10 mg (Glucotrol)........................................12GLUCAGON EMERGENCY KIT FO- glucagon hcl for inj 1mg...................................................................................... 13

GLUCAGON EMERGENCY KIT- glucagon (rdna) for inj kit1 mg...................................................................................13

glyburide-metformin tab 1.25-250 mg(Glucovance).................................................................... 13

glyburide-metformin tab 2.5-500 mg (Glucovance)...... 13glyburide-metformin tab 5-500 mg (Glucovance)......... 13glyburide micronized tab 1.5 mg (Glynase)...................13glyburide micronized tab 3 mg (Glynase)......................13glyburide micronized tab 6 mg (Glynase)......................13glyburide tab 1.25 mg.......................................................13glyburide tab 2.5 mg.........................................................13glyburide tab 5 mg............................................................13glycopyrrolate tab 1 mg (Robinul)..................................30glycopyrrolate tab 2 mg (Robinul forte).........................30GLYXAMBI- empagliflozin-linagliptin tab 10-5 mg............. 13GLYXAMBI- empagliflozin-linagliptin tab 25-5 mg............. 13granisetron hcl tab 1 mg................................................. 31GRANIX- tbo-filgrastim soln prefilled syringe 300mcg/0.5ml...........................................................................50

GRANIX- tbo-filgrastim soln prefilled syringe 480mcg/0.8ml...........................................................................50

GRANIX- tbo-filgrastim subcutaneous inj 300 mcg/ml.......50GRANIX- tbo-filgrastim subcutaneous inj 480 mcg/1.6ml(300 mcg/ml)......................................................................50

griseofulvin microsize susp 125 mg/5ml......................... 3griseofulvin microsize tab 500 mg (Grifulvin v)..............3guanfacine hcl tab er 24hr 1 mg (base equiv)(Intuniv).............................................................................38

guanfacine hcl tab er 24hr 2 mg (base equiv)(Intuniv).............................................................................38



guanfacine hcl tab 1 mg (Tenex).................................... 22guanfacine hcl tab 2 mg (Tenex).................................... 22GVOKE HYPOPEN 1-PACK- glucagon subcutaneoussolution auto-injector 0.5 mg/0.1ml...................................13

GVOKE HYPOPEN 1-PACK- glucagon subcutaneoussolution auto-injector 1 mg/0.2ml......................................13

GVOKE HYPOPEN 2-PACK- glucagon subcutaneoussolution auto-injector 0.5 mg/0.1ml...................................13

GVOKE HYPOPEN 2-PACK- glucagon subcutaneoussolution auto-injector 1 mg/0.2ml......................................13

GVOKE PFS- glucagon subcutaneous soln pref syringe0.5 mg/0.1ml......................................................................13

GVOKE PFS- glucagon subcutaneous soln pref syringe 1mg/0.2ml............................................................................ 13

Hhalobetasol propionate cream 0.05% (Ultravate)..........60halobetasol propionate oint 0.05% (Ultravate)..............60haloperidol decanoate im soln 50 mg/ml (Haldoldecanoate 50)...................................................................35

haloperidol decanoate im soln 100 mg/ml (Haldoldecanoate 100).................................................................36

haloperidol lactate oral conc 2 mg/ml............................36haloperidol tab 0.5 mg..................................................... 36haloperidol tab 1 mg........................................................ 36haloperidol tab 2 mg........................................................ 36haloperidol tab 5 mg........................................................ 36haloperidol tab 10 mg...................................................... 36haloperidol tab 20 mg...................................................... 36HARVONI- ledipasvir-sofosbuvir pellet pack 33.75-150mg........................................................................................ 4

HARVONI- ledipasvir-sofosbuvir pellet pack 45-200 mg..... 4HARVONI- ledipasvir-sofosbuvir tab 45-200 mg..................4HARVONI- ledipasvir-sofosbuvir tab 90-400 mg..................4HEMLIBRA- emicizumab-kxwh subcutaneous soln 30 mg/ml........................................................................................53

HEMLIBRA- emicizumab-kxwh subcutaneous soln 150mg/ml..................................................................................53

HEMLIBRA- emicizumab-kxwh subcutaneous soln 60mg/0.4ml (150 mg/ml)....................................................... 53

HEMLIBRA- emicizumab-kxwh subcutaneous soln 105mg/0.7ml (150 mg/ml)....................................................... 53

HEMOFIL M- antihemophilic factor (human) for inj 250unit......................................................................................53




2020


HUMATE-P- antihemophilic factor/vwf (human) for inj250-600 unit.......................................................................54

HUMATE-P- antihemophilic factor/vwf (human) for inj500-1200 unit.....................................................................54

HUMATE-P- antihemophilic factor/vwf (human) for inj1000-2400 unit...................................................................54

HUMIRA- adalimumab prefilled syringe kit 10mg/0.1ml............................................................................ 44






HUMIRA PEDIATRIC CROHNS D- adalimumab prefilledsyringe kit 80 mg/0.8ml.....................................................44

HUMIRA PEDIATRIC CROHNS D- adalimumab prefilledsyringe kit 80 mg/0.8ml & 40 mg/0.4ml............................44

HUMIRA PEN- adalimumab pen-injector kit 40mg/0.8ml............................................................................ 44

HUMIRA PEN- adalimumab pen-injector kit 40mg/0.4ml............................................................................ 44

HUMIRA PEN-CD/UC/HS START- adalimumab pen-injector kit 40 mg/0.8ml.....................................................44

HUMIRA PEN-CD/UC/HS START- adalimumab pen-injector kit 80 mg/0.8ml.....................................................44

HUMIRA PEN-PS/UV STARTER- adalimumab pen-injector kit 40 mg/0.8ml.....................................................44

HUMIRA PEN-PS/UV STARTER- adalimumab pen-injector kit 80 mg/0.8ml & 40 mg/0.4ml............................44

HUMULIN R U-500 (CONCENTR- insulin regular (human)inj 500 unit/ml.................................................................... 15

HUMULIN R U-500 KWIKPEN- insulin regular (human)soln pen-injector 500 unit/ml.............................................15

hydralazine hcl tab 10 mg............................................... 22hydralazine hcl tab 25 mg............................................... 22hydralazine hcl tab 50 mg............................................... 22hydralazine hcl tab 100 mg............................................. 22hydrochlorothiazide cap 12.5 mg (Microzide)............... 24hydrochlorothiazide tab 12.5 mg.................................... 24hydrochlorothiazide tab 25 mg....................................... 24hydrochlorothiazide tab 50 mg....................................... 24hydrocodone-acetaminophen soln 7.5-325 mg/15ml(Hycet)............................................................................... 42

hydrocodone-acetaminophen tab 7.5-325 mg(Norco).............................................................................. 42

hydrocodone-acetaminophen tab 5-325 mg(Norco).............................................................................. 42

hydrocodone-acetaminophen tab 10-325 mg(Norco).............................................................................. 42

hydrocodone-ibuprofen tab 10-200 mg (Ibudone)........ 42hydrocodone-ibuprofen tab 5-200 mg (Reprexain).......42hydrocodone-ibuprofen tab 7.5-200 mg(Vicoprofen)......................................................................42

hydrocortisone acetate suppos 25 mg.......................... 58hydrocortisone cream 2.5%.............................................60hydrocortisone enema 100 mg/60ml (Cortenema)........58hydrocortisone lotion 2.5%............................................. 60hydrocortisone oint 2.5%.................................................60hydrocortisone perianal cream 2.5% (Anusol-hc)........ 58hydrocortisone tab 5 mg (Cortef)..................................... 9hydrocortisone tab 10 mg (Cortef)................................... 9hydrocortisone tab 20 mg (Cortef)................................... 9hydrocortisone valerate cream 0.2%..............................60hydrocortisone valerate oint 0.2% (Westcort)...............60hydrocortisone w/ acetic acid otic soln 1-2%............... 58hydromorphone hcl liqd 1 mg/ml (Dilaudid)..................42hydromorphone hcl tab 2 mg (Dilaudid)........................42hydromorphone hcl tab 4 mg (Dilaudid)........................42hydromorphone hcl tab 8 mg (Dilaudid)........................42hydroxychloroquine sulfate tab 200 mg (Plaquenil).......6hydroxyurea cap 500 mg (Hydrea)................................... 7hydroxyzine hcl syrup 10 mg/5ml...................................33hydroxyzine hcl tab 10 mg.............................................. 33hydroxyzine hcl tab 25 mg.............................................. 33hydroxyzine hcl tab 50 mg.............................................. 33hydroxyzine pamoate cap 25 mg (Vistaril).................... 33hydroxyzine pamoate cap 50 mg (Vistaril).................... 33I

ibandronate sodium tab 150 mg (base equivalent)(Boniva).............................................................................17

IBRANCE- palbociclib cap 75 mg........................................ 7IBRANCE- palbociclib cap 100 mg...................................... 7IBRANCE- palbociclib cap 125 mg...................................... 7IBRANCE- palbociclib tab 75 mg......................................... 7IBRANCE- palbociclib tab 100 mg....................................... 7IBRANCE- palbociclib tab 125 mg....................................... 7ibuprofen susp 100 mg/5ml.............................................44ibuprofen tab 400 mg....................................................... 44ibuprofen tab 600 mg....................................................... 44ibuprofen tab 800 mg....................................................... 44icatibant acetate inj 30 mg/3ml (base equivalent)(Firazyr).............................................................................54

IDELVION- coagulation factor ix (recomb) (rix-fp) for inj250 unit..............................................................................54

IDELVION- coagulation factor ix (recomb) (rix-fp) for inj500 unit..............................................................................54

IDELVION- coagulation factor ix (recomb) (rix-fp) for inj1000 unit............................................................................54

2020




imatinib mesylate tab 100 mg (base equivalent)(Gleevec).............................................................................7

imatinib mesylate tab 400 mg (base equivalent)(Gleevec).............................................................................7

imipramine hcl tab 10 mg (Tofranil)............................... 34imipramine hcl tab 25 mg (Tofranil)............................... 34imipramine hcl tab 50 mg (Tofranil)............................... 34imiquimod cream 5% (Aldara).........................................60IMPAVIDO- miltefosine cap 50 mg.......................................6INBRIJA- levodopa inhal powder cap 42 mg..................... 48INCRELEX- mecasermin inj 40 mg/4ml (10 mg/ml)...........17INCRUSE ELLIPTA- umeclidinium br aero powd breath act62.5 mcg/inh (base eq).....................................................28

indapamide tab 1.25 mg...................................................24indapamide tab 2.5 mg.....................................................24indomethacin cap 25 mg................................................. 44indomethacin cap 50 mg................................................. 44INNOPRAN XL- propranolol hcl sustained-release beadscap er 24hr 80 mg............................................................ 18

INNOPRAN XL- propranolol hcl sustained-release beadscap er 24hr 120 mg.......................................................... 18

INSULIN ASPART FLEXPEN- insulin aspart soln pen-injector 100 unit/ml............................................................15

INSULIN ASPART- insulin aspart inj 100 unit/ml............... 15INSULIN ASPART PENFILL- insulin aspart soln cartridge100 unit/ml......................................................................... 15

INSULIN ASPART PROTAMINE/- insulin aspart prot &aspart (human) inj 100 unit/ml (70-30).............................15

INSULIN ASPART PROTAMINE/- insulin aspart prot &aspart sus pen-inj 100 unit/ml (70-30)..............................15

INSULIN PEN NEEDLES – VARIOUS...............................61INSULIN SYRINGES – VARIOUS......................................61INTELENCE- etravirine tab 25 mg.......................................4INTELENCE- etravirine tab 100 mg.....................................4INTELENCE- etravirine tab 200 mg.....................................4INVOKAMET- canagliflozin-metformin hcl tab 50-500mg...................................................................................... 13

INVOKAMET- canagliflozin-metformin hcl tab 150-500mg...................................................................................... 13



INVOKAMET XR- canagliflozin-metformin hcl tab er 24hr50-500 mg......................................................................... 13

INVOKAMET XR- canagliflozin-metformin hcl tab er 24hr50-1000 mg....................................................................... 13

INVOKAMET XR- canagliflozin-metformin hcl tab er 24hr150-500 mg....................................................................... 13

INVOKAMET XR- canagliflozin-metformin hcl tab er 24hr150-1000 mg..................................................................... 13

INVOKANA- canagliflozin tab 100 mg................................13INVOKANA- canagliflozin tab 300 mg................................13ipratropium-albuterol nebu soln 0.5-2.5(3) mg/3ml...... 28ipratropium bromide inhal soln 0.02%...........................28ipratropium bromide nasal soln 0.03% (21 mcg/spray)(Atrovent)..........................................................................27

ipratropium bromide nasal soln 0.06% (42 mcg/spray)(Atrovent)..........................................................................27

irbesartan-hydrochlorothiazide tab 150-12.5 mg(Avalide)............................................................................ 22

irbesartan-hydrochlorothiazide tab 300-12.5 mg(Avalide)............................................................................ 22

irbesartan tab 75 mg (Avapro)........................................ 22irbesartan tab 150 mg (Avapro)...................................... 22irbesartan tab 300 mg (Avapro)...................................... 22ISENTRESS HD- raltegravir potassium tab 600 mg (baseequiv)....................................................................................4

ISENTRESS- raltegravir potassium chew tab 25 mg (baseequiv)....................................................................................4

ISENTRESS- raltegravir potassium chew tab 100 mg(base equiv).........................................................................4

ISENTRESS- raltegravir potassium packet for susp 100mg (base equiv).................................................................. 4

ISENTRESS- raltegravir potassium tab 400 mg (baseequiv)....................................................................................4

isoniazid tab 300 mg.......................................................... 2isosorbide dinitrate tab 10 mg........................................18isosorbide dinitrate tab 20 mg........................................18isosorbide dinitrate tab 30 mg........................................18isosorbide dinitrate tab 5 mg (Isordil titradose)........... 18isosorbide mononitrate tab er 24hr 30 mg.................... 18isosorbide mononitrate tab er 24hr 60 mg.................... 18isosorbide mononitrate tab er 24hr 120 mg.................. 18isosorbide mononitrate tab 10 mg................................. 18isosorbide mononitrate tab 20 mg................................. 18isotretinoin cap 10 mg..................................................... 60isotretinoin cap 20 mg..................................................... 60isotretinoin cap 30 mg..................................................... 60isotretinoin cap 40 mg..................................................... 60itraconazole cap 100 mg (Sporanox)................................3itraconazole oral soln 10 mg/ml (Sporanox)................... 3ivermectin tab 3 mg (Stromectol)..................................... 6IXINITY- coagulation factor ix (recombinant) for inj 250unit......................................................................................54

IXINITY- coagulation factor ix (recombinant) for inj 500unit......................................................................................54



2020




JJADENU- deferasirox tab 90 mg........................................61JADENU- deferasirox tab 180 mg......................................61JADENU- deferasirox tab 360 mg......................................61JANUMET- sitagliptin-metformin hcl tab 50-500 mg..........13JANUMET- sitagliptin-metformin hcl tab 50-1000 mg........13JANUMET XR- sitagliptin-metformin hcl tab er 24hr 50-500mg...................................................................................... 13

JANUMET XR- sitagliptin-metformin hcl tab er 24hr50-1000 mg....................................................................... 13

JANUMET XR- sitagliptin-metformin hcl tab er 24hr100-1000 mg..................................................................... 13

JANUVIA- sitagliptin phosphate tab 25 mg (baseequiv)................................................................................. 14



JARDIANCE- empagliflozin tab 10 mg...............................14JARDIANCE- empagliflozin tab 25 mg...............................14JULUCA- dolutegravir sodium-rilpivirine hcl tab 50-25 mg(base eq)..............................................................................4

KKALETRA- lopinavir-ritonavir tab 100-25 mg.......................4KALETRA- lopinavir-ritonavir tab 200-50 mg.......................4KALYDECO- ivacaftor packet 25 mg................................. 29KALYDECO- ivacaftor packet 50 mg................................. 29KALYDECO- ivacaftor packet 75 mg................................. 29KALYDECO- ivacaftor tab 150 mg..................................... 29ketoconazole cream 2%................................................... 60ketoconazole shampoo 2% (Nizoral)..............................60ketorolac tromethamine ophth soln 0.5% (Acular)....... 57ketorolac tromethamine ophth soln 0.4% (Acularls)....................................................................................... 57

KISQALI FEMARA 200 DOSE- ribociclib 200 mg dose(200 mg tab) & letrozole 2.5 mg tbpk.................................7



KISQALI- ribociclib succinate tab pack 200 mg dailydose......................................................................................7

KISQALI- ribociclib succinate tab pack 400 mg daily dose(200 mg tab)........................................................................7

KISQALI- ribociclib succinate tab pack 600 mg daily dose(200 mg tab)........................................................................7

KOATE- antihemophilic factor (human) for inj 250 unit......54

KOATE- antihemophilic factor (human) for inj 500 unit......54KOATE- antihemophilic factor (human) for inj 1000unit......................................................................................54

KOATE-DVI- antihemophilic factor (human) for inj 250unit......................................................................................54



KOGENATE FS- antihemophilic factor (recombinant) for injkit 250 unit.........................................................................54

KOGENATE FS- antihemophilic factor (recombinant) for injkit 500 unit.........................................................................54

KOGENATE FS- antihemophilic factor (recombinant) for injkit 1000 unit.......................................................................54



KOMBIGLYZE XR- saxagliptin-metformin hcl tab er 24hr2.5-1000 mg...................................................................... 14

KOMBIGLYZE XR- saxagliptin-metformin hcl tab er 24hr5-500 mg............................................................................14

KOMBIGLYZE XR- saxagliptin-metformin hcl tab er 24hr5-1000 mg......................................................................... 14

KOSHER PRENATAL PLUS IRON- prenatal vit w/ ironcarbonyl-fa tab 30-1 mg....................................................49

KOVALTRY- antihemophilic factor rahf-pfm for inj 250unit......................................................................................54





Llabetalol hcl tab 100 mg (Trandate)................................18labetalol hcl tab 200 mg (Trandate)................................18labetalol hcl tab 300 mg (Trandate)................................18lactulose (encephalopathy) solution 10 gm/15ml......... 31lactulose solution 10 gm/15ml........................................ 30lamivudine oral soln 10 mg/ml (Epivir)............................ 4lamivudine tab 150 mg (Epivir)......................................... 4lamivudine tab 300 mg (Epivir)......................................... 4lamivudine tab 100 mg (hbv) (Epivir hbv)........................4lamivudine-zidovudine tab 150-300 mg (Combivir)........ 4lamotrigine tab chewable dispersible 5 mg (Lamictalchewable di)..................................................................... 47

lamotrigine tab chewable dispersible 25 mg (Lamictalchewable di)..................................................................... 47

2020


lamotrigine tab 25 mg (Lamictal)....................................47lamotrigine tab 100 mg (Lamictal)..................................47lamotrigine tab 150 mg (Lamictal)..................................47lamotrigine tab 200 mg (Lamictal)..................................47LANCETS – VARIOUS....................................................... 61lansoprazole cap delayed release 15 mg(Prevacid)..........................................................................30

lansoprazole cap delayed release 30 mg(Prevacid)..........................................................................30

LANTUS- insulin glargine inj 100 unit/ml........................... 15LANTUS SOLOSTAR- insulin glargine soln pen-injector100 unit/ml......................................................................... 15

latanoprost ophth soln 0.005% (Xalatan).......................57leflunomide tab 10 mg (Arava)........................................44leflunomide tab 20 mg (Arava)........................................44letrozole tab 2.5 mg (Femara)........................................... 7LEUCOVORIN CALCIUM- leucovorin calcium tab 10mg........................................................................................ 7

LEUCOVORIN CALCIUM- leucovorin calcium tab 15mg........................................................................................ 7

leucovorin calcium tab 5 mg.............................................7leucovorin calcium tab 25 mg...........................................7LEUKERAN- chlorambucil tab 2 mg.................................... 7levalbuterol hcl soln nebu conc 1.25 mg/0.5ml (baseequiv) (Xopenex concentrate)....................................... 28

levalbuterol hcl soln nebu 0.31 mg/3ml (base equiv)(Xopenex)..........................................................................28



LEVEMIR FLEXTOUCH- insulin detemir soln pen-injector100 unit/ml......................................................................... 15

LEVEMIR- insulin detemir inj 100 unit/ml...........................15levetiracetam oral soln 100 mg/ml (Keppra)..................47levetiracetam tab er 24hr 500 mg (Keppra xr)...............47levetiracetam tab er 24hr 750 mg (Keppra xr)...............47levetiracetam tab 250 mg (Keppra).................................47levetiracetam tab 500 mg (Keppra).................................47levetiracetam tab 750 mg (Keppra).................................47levetiracetam tab 1000 mg (Keppra)...............................47levocarnitine oral soln 1 gm/10ml (10%) (Carnitor)...... 17levocarnitine tab 330 mg (Carnitor)................................17levocetirizine dihydrochloride soln 2.5 mg/5ml (0.5 mg/ml)...................................................................................... 27

levocetirizine dihydrochloride tab 5 mg (Xyzal)............27levofloxacin oral soln 25 mg/ml (Levaquin).................... 2levofloxacin tab 250 mg (Levaquin)................................. 2levofloxacin tab 500 mg (Levaquin)................................. 2levofloxacin tab 750 mg (Levaquin)................................. 2levonorgestrel & ethinyl estradiol (91-day) tab0.15-0.03 mg.....................................................................11

levonorgestrel & ethinyl estradiol tab 0.1 mg-20mcg....................................................................................11

levonorgestrel & ethinyl estradiol tab 0.15 mg-30mcg....................................................................................11

levonorgestrel-eth estra tab0.05-30/0.075-40/0.125-30mg-mcg................................. 11

levonorg-eth est tab 0.1-0.02mg(84) & eth est tab0.01mg(7) (Loseasonique)..............................................11

levonorg-eth est tab 0.15-0.03mg(84) & eth est tab0.01mg(7) (Seasonique)..................................................11

levothyroxine sodium tab 25 mcg (Synthroid)..............16levothyroxine sodium tab 50 mcg (Synthroid)..............16levothyroxine sodium tab 75 mcg (Synthroid)..............16levothyroxine sodium tab 88 mcg (Synthroid)..............16levothyroxine sodium tab 100 mcg (Synthroid)............16levothyroxine sodium tab 112 mcg (Synthroid)............ 16levothyroxine sodium tab 125 mcg (Synthroid)............16levothyroxine sodium tab 137 mcg (Synthroid)............16levothyroxine sodium tab 150 mcg (Synthroid)............16levothyroxine sodium tab 175 mcg (Synthroid)............16levothyroxine sodium tab 200 mcg (Synthroid)............16levothyroxine sodium tab 300 mcg (Synthroid)............16lidocaine hcl gel 2%......................................................... 60lidocaine hcl soln 4% (Xylocaine)...................................60lidocaine hcl urethral/mucosal gel prefilled syringe2%...................................................................................... 60

lidocaine hcl viscous soln 2%........................................ 58lidocaine oint 5%...............................................................60lidocaine patch 5% (Lidoderm)....................................... 60linezolid for susp 100 mg/5ml (Zyvox)............................. 6linezolid tab 600 mg (Zyvox)............................................. 6liothyronine sodium tab 5 mcg (Cytomel)..................... 16liothyronine sodium tab 25 mcg (Cytomel)................... 16liothyronine sodium tab 50 mcg (Cytomel)................... 16lisinopril & hydrochlorothiazide tab 10-12.5 mg(Zestoretic)....................................................................... 22

lisinopril & hydrochlorothiazide tab 20-12.5 mg(Zestoretic)....................................................................... 22

lisinopril & hydrochlorothiazide tab 20-25 mg(Zestoretic)....................................................................... 22

lisinopril tab 5 mg (Prinivil)............................................. 22lisinopril tab 10 mg (Prinivil)........................................... 22lisinopril tab 20 mg (Prinivil)........................................... 22lisinopril tab 2.5 mg (Zestril)........................................... 22lisinopril tab 30 mg (Zestril)............................................ 22lisinopril tab 40 mg (Zestril)............................................ 22lithium carbonate cap 300 mg.........................................36lithium carbonate cap 150 mg (Lithium carbonate)......36lithium carbonate cap 600 mg (Lithium carbonate)......36lithium carbonate tab er 450 mg.....................................36lithium carbonate tab er 300 mg (Lithobid)................... 36lithium carbonate tab 300 mg......................................... 36

2020


LOKELMA- sodium zirconium cyclosilicate for susp packet5 gm...................................................................................62

LOKELMA- sodium zirconium cyclosilicate for susp packet10 gm.................................................................................62

loperamide hcl cap 2 mg................................................. 30lopinavir-ritonavir soln 400-100 mg/5ml (80-20 mg/ml)(Kaletra)...............................................................................4

lorazepam conc 2 mg/ml (Lorazepam intensol)............ 33lorazepam tab 0.5 mg (Ativan)........................................ 33lorazepam tab 1 mg (Ativan)........................................... 33lorazepam tab 2 mg (Ativan)........................................... 33losartan potassium & hydrochlorothiazide tab 50-12.5mg (Hyzaar)...................................................................... 22

losartan potassium & hydrochlorothiazide tab 100-12.5mg (Hyzaar)...................................................................... 22

losartan potassium & hydrochlorothiazide tab 100-25mg (Hyzaar)...................................................................... 22

losartan potassium tab 25 mg (Cozaar).........................22losartan potassium tab 50 mg (Cozaar).........................23losartan potassium tab 100 mg (Cozaar).......................23LOTEMAX- loteprednol etabonate ophth gel 0.5%............57LOTEMAX- loteprednol etabonate ophth oint 0.5%...........57LOTEMAX- loteprednol etabonate ophth susp 0.5%.........57LOTEMAX SM- loteprednol etabonate ophth gel0.38%................................................................................. 57

loteprednol etabonate ophth susp 0.5% (Lotemax)......57lovastatin tab 10 mg.........................................................25lovastatin tab 20 mg.........................................................25lovastatin tab 40 mg (Mevacor).......................................25loxapine succinate cap 5 mg.......................................... 36loxapine succinate cap 10 mg........................................ 36loxapine succinate cap 25 mg........................................ 36loxapine succinate cap 50 mg........................................ 36LUMIGAN- bimatoprost ophth soln 0.01%.........................57LYNPARZA- olaparib tab 100 mg.........................................7LYNPARZA- olaparib tab 150 mg.........................................7LYRICA- pregabalin cap 25 mg..........................................47LYRICA- pregabalin cap 50 mg..........................................47LYRICA- pregabalin cap 75 mg..........................................47LYRICA- pregabalin cap 100 mg........................................47LYRICA- pregabalin cap 150 mg........................................47LYRICA- pregabalin cap 200 mg........................................47LYRICA- pregabalin cap 225 mg........................................47LYRICA- pregabalin cap 300 mg........................................47LYRICA- pregabalin soln 20 mg/ml....................................47

Mmalathion lotion 0.5% (Ovide).........................................60MAVENCLAD- cladribine tab therapy pack 10 mg (4tabs)................................................................................... 40

MAVENCLAD- cladribine tab therapy pack 10 mg (5tabs)................................................................................... 40






MAVYRET- glecaprevir-pibrentasvir tab 100-40 mg............ 4MAYZENT- siponimod fumarate tab 0.25 mg (baseequiv)................................................................................. 40

MAYZENT- siponimod fumarate tab 2 mg (baseequiv)................................................................................. 40

meclizine hcl tab 12.5 mg................................................ 31meclizine hcl tab 25 mg................................................... 31medroxyprogesterone acetate tab 2.5 mg(Provera)........................................................................... 12

medroxyprogesterone acetate tab 5 mg (Provera).......12medroxyprogesterone acetate tab 10 mg (Provera).....12MEFLOQUINE HCL- mefloquine hcl tab 250 mg.................6megestrol acetate susp 40 mg/ml (Megace oral)............ 7megestrol acetate tab 20 mg.............................................7megestrol acetate tab 40 mg.............................................7MEKINIST- trametinib dimethyl sulfoxide tab 0.5 mg (baseequivalent)............................................................................7

MEKINIST- trametinib dimethyl sulfoxide tab 2 mg (baseequivalent)............................................................................8

meloxicam tab 7.5 mg (Mobic)........................................44meloxicam tab 15 mg (Mobic).........................................45melphalan tab 2 mg (Alkeran)...........................................8memantine hcl oral solution 2 mg/ml (Namenda)......... 40memantine hcl tab 5 mg (Namenda).............................. 40memantine hcl tab 10 mg (Namenda)............................ 40memantine hcl tab 28 x 5 mg & 21 x 10 mg titrationpack (Namenda titration pa).......................................... 40

mercaptopurine tab 50 mg................................................ 8mesalamine cap dr 400 mg (Delzicol)............................ 31mesalamine cap er 24hr 0.375 gm (Apriso)...................31mesalamine enema 4 gm................................................. 31mesalamine suppos 1000 mg (Canasa)......................... 31mesalamine tab delayed release 1.2 gm (Lialda)..........31mesalamine tab delayed release 800 mg (Asacolhd)......................................................................................31

MESNEX- mesna tab 400 mg..............................................8metformin hcl tab er 24hr 500 mg (Glucophage xr)......14metformin hcl tab er 24hr 750 mg (Glucophage xr)......14metformin hcl tab 500 mg (Glucophage)....................... 14metformin hcl tab 850 mg (Glucophage)....................... 14metformin hcl tab 1000 mg (Glucophage)..................... 14methadone hcl conc 10 mg/ml (Methadose)................. 42methadone hcl soln 5 mg/5ml (Methadone hcl)............42

2020


methadone hcl soln 10 mg/5ml (Methadone hcl).......... 42methadone hcl tab for oral susp 40 mg.........................43methadone hcl tab 10 mg (Dolophine)...........................43methadone hcl tab 5 mg (Dolophine hcl).......................43methazolamide tab 25 mg................................................24methazolamide tab 50 mg................................................24methimazole tab 5 mg (Tapazole)................................... 16methimazole tab 10 mg (Tapazole)................................. 16methocarbamol tab 750 mg (Robaxin-750)....................49methocarbamol tab 500 mg (Robaxin)...........................49methotrexate sodium tab 2.5 mg (base equiv)................8methscopolamine bromide tab 2.5 mg (Pamine).......... 30methscopolamine bromide tab 5 mg (Pamineforte).................................................................................. 30

methyldopa tab 250 mg................................................... 23methyldopa tab 500 mg................................................... 23methylergonovine maleate tab 0.2 mg...........................16methylphenidate hcl tab er 10 mg..................................39methylphenidate hcl tab er 20 mg..................................39methylphenidate hcl tab er osmotic release (osm) 18mg (Concerta).................................................................. 39

methylphenidate hcl tab er osmotic release (osm) 27mg (Concerta).................................................................. 39



methylphenidate hcl tab 5 mg (Ritalin).......................... 39methylphenidate hcl tab 10 mg (Ritalin)........................ 39methylphenidate hcl tab 20 mg (Ritalin)........................ 39methylprednisolone tab 4 mg (Medrol)............................9methylprednisolone tab 8 mg (Medrol)............................9methylprednisolone tab 16 mg (Medrol)..........................9methylprednisolone tab 32 mg (Medrol)..........................9methylprednisolone tab therapy pack 4 mg (21)(Medrol dosepak)...............................................................9

metoclopramide hcl soln 5 mg/5ml (10 mg/10ml) (baseequiv).................................................................................31

metoclopramide hcl tab 5 mg (base equivalent)(Reglan).............................................................................32

metoclopramide hcl tab 10 mg (base equivalent)(Reglan).............................................................................32

metolazone tab 2.5 mg.....................................................24metolazone tab 5 mg........................................................24metolazone tab 10 mg......................................................24metoprolol & hydrochlorothiazide tab 50-25 mg(Lopressor hct)................................................................ 23

metoprolol & hydrochlorothiazide tab 100-25 mg(Lopressor hct)................................................................ 23

metoprolol succinate tab er 24hr 25 mg (tartrate equiv)(Toprol xl)......................................................................... 18

metoprolol succinate tab er 24hr 50 mg (tartrate equiv)(Toprol xl)......................................................................... 18

metoprolol succinate tab er 24hr 100 mg (tartrateequiv) (Toprol xl)............................................................. 19

metoprolol succinate tab er 24hr 200 mg (tartrateequiv) (Toprol xl)............................................................. 19

metoprolol tartrate tab 25 mg......................................... 19metoprolol tartrate tab 50 mg (Lopressor).................... 19metoprolol tartrate tab 100 mg (Lopressor).................. 19metronidazole cream 0.75% (Metrocream).................... 60metronidazole gel 0.75%..................................................60metronidazole gel 1% (Metrogel).................................... 60metronidazole lotion 0.75% (Metrolotion)......................60metronidazole tab 250 mg (Flagyl)................................... 6metronidazole tab 500 mg (Flagyl)................................... 6metronidazole vaginal gel 0.75% (Metrogel-vaginal)..............................................................................32

mexiletine hcl cap 150 mg...............................................20mexiletine hcl cap 200 mg...............................................20mexiletine hcl cap 250 mg...............................................20midodrine hcl tab 2.5 mg.................................................25midodrine hcl tab 5 mg....................................................25midodrine hcl tab 10 mg..................................................25MIGRANAL- dihydroergotamine mesylate nasal spray 4mg/ml..................................................................................45

minocycline hcl cap 50 mg (Minocin).............................. 2minocycline hcl cap 75 mg (Minocin).............................. 2minocycline hcl cap 100 mg (Minocin)............................ 2minocycline hcl tab 50 mg................................................ 2minocycline hcl tab 75 mg................................................ 2minocycline hcl tab 100 mg.............................................. 2minoxidil tab 2.5 mg.........................................................23minoxidil tab 10 mg..........................................................23mirtazapine tab 7.5 mg.....................................................34mirtazapine tab 15 mg (Remeron).................................. 34mirtazapine tab 30 mg (Remeron).................................. 34mirtazapine tab 45 mg (Remeron).................................. 34misoprostol tab 100 mcg (Cytotec)................................ 30misoprostol tab 200 mcg (Cytotec)................................ 30MITIGARE- colchicine cap 0.6 mg.....................................46modafinil tab 100 mg (Provigil).......................................39modafinil tab 200 mg (Provigil).......................................39moexipril hcl tab 7.5 mg.................................................. 23moexipril hcl tab 15 mg................................................... 23mometasone furoate cream 0.1% (Elocon)................... 60mometasone furoate nasal susp 50 mcg/act(Nasonex)..........................................................................27

mometasone furoate oint 0.1% (Elocon)........................60mometasone furoate solution 0.1% (lotion)(Elocon).............................................................................60

MONONINE- coagulation factor ix for inj 1000 unit........... 54montelukast sodium chew tab 4 mg (base equiv)(Singulair)......................................................................... 29

montelukast sodium chew tab 5 mg (base equiv)(Singulair)......................................................................... 29

2020


montelukast sodium oral granules packet 4 mg (baseequiv) (Singulair)............................................................. 29

montelukast sodium tab 10 mg (base equiv)(Singulair)......................................................................... 29

MORPHINE SULFATE- morphine sulfate tab 15 mg......... 43MORPHINE SULFATE- morphine sulfate tab 30 mg......... 43morphine sulfate oral soln 10 mg/5ml........................... 43morphine sulfate oral soln 20 mg/5ml........................... 43morphine sulfate oral soln 100 mg/5ml (20 mg/ml)...... 43morphine sulfate tab er 15 mg (Ms contin)................... 43morphine sulfate tab er 30 mg (Ms contin)................... 43morphine sulfate tab er 60 mg (Ms contin)................... 43morphine sulfate tab er 100 mg (Ms contin)................. 43morphine sulfate tab er 200 mg (Ms contin)................. 43morphine sulfate tab 15 mg (Morphine sulfate)............43morphine sulfate tab 30 mg (Morphine sulfate)............43moxifloxacin hcl ophth soln 0.5% (base equiv)(Vigamox)..........................................................................57

MULTAQ- dronedarone hcl tab 400 mg (baseequivalent)......................................................................... 20

mupirocin oint 2% (Bactroban).......................................60mycophenolate mofetil cap 250 mg (Cellcept)..............62mycophenolate mofetil for oral susp 200 mg/ml(Cellcept)...........................................................................62

mycophenolate mofetil tab 500 mg (Cellcept)...............62mycophenolate sodium tab dr 180 mg (mycophenolicacid equiv) (Myfortic)......................................................62

mycophenolate sodium tab dr 360 mg (mycophenolicacid equiv) (Myfortic)......................................................62

MYLERAN- busulfan tab 2 mg.............................................8

Nnabumetone tab 500 mg.................................................. 45nabumetone tab 750 mg.................................................. 45nadolol tab 20 mg (Corgard)........................................... 19nadolol tab 40 mg (Corgard)........................................... 19nadolol tab 80 mg (Corgard)........................................... 19naloxone hcl inj 0.4 mg/ml.............................................. 61naloxone hcl inj 4 mg/10ml............................................. 61naltrexone hcl tab 50 mg................................................. 61naproxen sodium tab 275 mg (Anaprox)....................... 45naproxen sodium tab 550 mg (Anaprox ds)..................45naproxen tab ec 375 mg (Ec-naprosyn).........................45naproxen tab ec 500 mg (Ec-naprosyn).........................45naproxen tab 250 mg (Naprosyn)................................... 45naproxen tab 375 mg (Naprosyn)................................... 45naproxen tab 500 mg (Naprosyn)................................... 45naratriptan hcl tab 1 mg (base equiv) (Amerge)........... 45naratriptan hcl tab 2.5 mg (base equiv) (Amerge)........ 45NARCAN- naloxone hcl nasal spray 4 mg/0.1ml............... 61NATACYN- natamycin ophth susp 5%............................... 57nateglinide tab 60 mg (Starlix)........................................14nateglinide tab 120 mg (Starlix)......................................14

neomycin-bacitrac zn-polymyx5(3.5)mg-400unt-10000unt op oin..................................57

neomycin-polymyxin-dexamethasone ophth oint 0.1%(Maxitrol)...........................................................................57

neomycin-polymyxin-dexamethasone ophth susp0.1% (Maxitrol)................................................................. 57

neomycin-polymyxin-hc otic soln 1% (Cortisporin)..... 58neomycin-polymyxin-hc otic susp 3.5 mg/ml-10000unit/ml-1%.........................................................................58

neomycin sulfate tab 500 mg............................................2NEULASTA ONPRO KIT- pegfilgrastim soln prefilledsyringe kit 6 mg/0.6ml.......................................................50

NEULASTA- pegfilgrastim soln prefilled syringe 6mg/0.6ml............................................................................ 50

NEUPOGEN- filgrastim inj 300 mcg/ml..............................50NEUPOGEN- filgrastim inj 480 mcg/1.6ml (300 mcg/ml)...................................................................................... 50

NEUPOGEN- filgrastim soln prefilled syringe 300mcg/0.5ml...........................................................................50

NEUPOGEN- filgrastim soln prefilled syringe 480mcg/0.8ml (600 mcg/ml)................................................... 50

nevirapine susp 50 mg/5ml (Viramune)........................... 4nevirapine tab er 24hr 400 mg (Viramune xr)..................4nevirapine tab 200 mg (Viramune)....................................4NEXAVAR- sorafenib tosylate tab 200 mg (baseequivalent)............................................................................8

NEXIUM- esomeprazole magnesium for delayed releasesusp packet 5 mg..............................................................30

NEXIUM- esomeprazole magnesium for delayed releasesusp packet 10 mg............................................................30



NEXIUM- esomeprazole magnesium for delayed releasesusp pack 2.5 mg..............................................................30

NEXLETOL- bempedoic acid tab 180 mg..........................25niacin tab er 500 mg (antihyperlipidemic)(Niaspan)...........................................................................25

niacin tab er 750 mg (antihyperlipidemic)(Niaspan)...........................................................................25

niacin tab er 1000 mg (antihyperlipidemic)(Niaspan)...........................................................................25

NICOTROL INHALER- nicotine inhaler system 10 mg (4mg delivered).....................................................................40

NICOTROL NS- nicotine nasal spray 10 mg/ml (0.5 mg/spray)................................................................................. 40

nifedipine tab er 24hr 30 mg (Adalat cc)........................20nifedipine tab er 24hr 60 mg (Adalat cc)........................20nifedipine tab er 24hr 90 mg (Adalat cc)........................20nifedipine tab er 24hr osmotic release 30 mg(Procardia xl)....................................................................20

2020


nifedipine tab er 24hr osmotic release 60 mg(Procardia xl)....................................................................20

nifedipine tab er 24hr osmotic release 90 mg(Procardia xl)....................................................................20

nilutamide tab 150 mg (Nilandron)................................... 8nimodipine cap 30 mg......................................................20nitisinone cap 2 mg (Orfadin)......................................... 17nitisinone cap 5 mg (Orfadin)......................................... 17nitisinone cap 10 mg (Orfadin)....................................... 17nitrofurantoin macrocrystalline cap 25 mg(Macrodantin)................................................................... 32

nitrofurantoin macrocrystalline cap 50 mg(Macrodantin)................................................................... 32

nitrofurantoin macrocrystalline cap 100 mg(Macrodantin)................................................................... 32

nitrofurantoin monohydrate macrocrystalline cap 100mg (Macrobid)..................................................................32

nitrofurantoin susp 25 mg/5ml (Furadantin)..................32nitroglycerin sl tab 0.3 mg (Nitrostat)............................ 18nitroglycerin sl tab 0.4 mg (Nitrostat)............................ 18nitroglycerin sl tab 0.6 mg (Nitrostat)............................ 18nitroglycerin td patch 24hr 0.1 mg/hr (Nitro-dur)..........18nitroglycerin td patch 24hr 0.2 mg/hr (Nitro-dur)..........18nitroglycerin td patch 24hr 0.4 mg/hr (Nitro-dur)..........18nitroglycerin td patch 24hr 0.6 mg/hr (Nitro-dur)..........18NITYR- nitisinone tab 2 mg................................................17NITYR- nitisinone tab 5 mg................................................17NITYR- nitisinone tab 10 mg..............................................17NIVESTYM- filgrastim-aafi inj 300 mcg/ml.........................51NIVESTYM- filgrastim-aafi inj 480 mcg/1.6ml (300 mcg/ml)...................................................................................... 51

NIVESTYM- filgrastim-aafi soln prefilled syringe 300mcg/0.5ml...........................................................................50

NIVESTYM- filgrastim-aafi soln prefilled syringe 480mcg/0.8ml...........................................................................51

NORDITROPIN FLEXPRO- somatropin inj 5 mg/1.5ml.....17NORDITROPIN FLEXPRO- somatropin inj 10mg/1.5ml............................................................................ 17

NORDITROPIN FLEXPRO- somatropin inj 15mg/1.5ml............................................................................ 17

NORDITROPIN FLEXPRO- somatropin inj 30 mg/3ml......17norethindrone & ethinyl estradiol-fe chew tab 0.4mg-35 mcg (Femcon fe)................................................. 12

norethindrone & ethinyl estradiol tab 0.5 mg-35 mcg(Brevicon-28)....................................................................12

norethindrone & ethinyl estradiol tab 1 mg-35 mcg(Norinyl 1+35)...................................................................12

norethindrone & ethinyl estradiol tab 0.4 mg-35 mcg(Ovcon-35)........................................................................ 11

norethindrone ace & ethinyl estradiol-fe tab 1 mg-20mcg (Loestrin fe 1/20).....................................................12

norethindrone ace & ethinyl estradiol-fe tab 1.5 mg-30mcg (Loestrin fe 1.5/30)..................................................12

norethindrone ace & ethinyl estradiol tab 1 mg-20 mcg(Loestrin 1/20-21).............................................................12

norethindrone ace & ethinyl estradiol tab 1.5 mg-30mcg (Loestrin 1.5/30-21).................................................12

norethindrone acetate-ethinyl estradiol tab 1 mg-5mcg....................................................................................11

norethindrone acetate-ethinyl estradiol tab 0.5 mg-2.5mcg (Femhrt low dose).................................................. 11

norethindrone acetate tab 5 mg (Aygestin)...................12norethindrone ac-ethinyl estrad-fe tab 1-20/1-30/1-35mg-mcg (Estrostep fe)....................................................12

norethindrone-eth estradiol tab 0.5-35/0.75-35/1-35 mg-mcg (Ortho-novum 7/7/7)............................................... 12

norethindrone-eth estradiol tab 0.5-35/1-35/0.5-35 mg-mcg (Tri-norinyl 28).........................................................12

norethindrone tab 0.35 mg (Nor-qd)...............................12norgestimate & ethinyl estradiol tab 0.25 mg-35 mcg(Ortho-cyclen).................................................................. 12

norgestimate-eth estrad tab 0.18-35/0.215-35/0.25-35mg-mcg (Ortho tri-cyclen)..............................................12

norgestimate-eth estrad tab 0.18-25/0.215-25/0.25-25mg-mcg (Ortho tri-cyclen lo)......................................... 12

norgestrel & ethinyl estradiol tab 0.3 mg-30 mcg.........12nortriptyline hcl cap 10 mg (Pamelor)............................34nortriptyline hcl cap 25 mg (Pamelor)............................35nortriptyline hcl cap 50 mg (Pamelor)............................35nortriptyline hcl cap 75 mg (Pamelor)............................35NORVIR- ritonavir oral soln 80 mg/ml..................................4NORVIR- ritonavir powder packet 100 mg...........................4NOVOEIGHT- antihemophilic fact rcmb (bd trunc-rfviii) forinj 250 unit.........................................................................54

NOVOEIGHT- antihemophilic fact rcmb (bd trunc-rfviii) forinj 500 unit.........................................................................55

NOVOEIGHT- antihemophilic fact rcmb (bd trunc-rfviii) forinj 1000 unit.......................................................................55




NOVOLIN 70/30 FLEXPEN- insulin nph & regular susppen-inj 100 unit/ml (70-30)................................................15

NOVOLIN 70/30- insulin nph isophane & regular human inj100 unit/ml (70-30)............................................................15

NOVOLIN N FLEXPEN- insulin nph (human) (isophane)susp pen-injector 100 unit/ml............................................15

NOVOLIN N- insulin nph (human) (isophane) inj 100 unit/ml........................................................................................15

NOVOLIN R FLEXPEN- insulin regular (human) soln pen-injector 100 unit/ml............................................................15

NOVOLIN R- insulin regular (human) inj 100 unit/ml.........15

2020


NOVOLOG FLEXPEN- insulin aspart soln pen-injector 100unit/ml.................................................................................15

NOVOLOG- insulin aspart inj 100 unit/ml.......................... 15NOVOLOG MIX 70/30- insulin aspart prot & aspart(human) inj 100 unit/ml (70-30)........................................ 15

NOVOLOG MIX 70/30 PREFILL- insulin aspart prot &aspart sus pen-inj 100 unit/ml (70-30)..............................15

NOVOLOG PENFILL- insulin aspart soln cartridge 100unit/ml.................................................................................15

NOVOSEVEN RT- coagulation factor viia (recomb) for inj1 mg (1000 mcg)...............................................................55




NOXAFIL- posaconazole susp 40 mg/ml.............................3NOXAFIL- posaconazole tab delayed release 100 mg........3NUBEQA- darolutamide tab 300 mg....................................8NUVARING- etonogestrel-ethinyl estradiol va ring0.120-0.015 mg/24hr.........................................................12

NUWIQ- antihemophil fact rcmb(bdd-rfviii,sim) for inj kit1000 unit............................................................................55





NUWIQ- antihemophil fact rcmb (bdd-rfviii,sim) for inj kit250 unit..............................................................................55

NUWIQ- antihemophil fact rcmb (bdd-rfviii,sim) for inj kit500 unit..............................................................................55

NUWIQ- antihemophilic factor rcmb (bdd-rfviii,sim) for inj250 unit..............................................................................55

NUWIQ- antihemophilic factor rcmb (bdd-rfviii,sim) for inj500 unit..............................................................................55

NUWIQ- antihemophilic fact rcmb (bdd-rfviii,sim) for inj1000 unit............................................................................55





nystatin cream 100000 unit/gm.......................................60nystatin oint 100000 unit/gm........................................... 60nystatin susp 100000 unit/ml.......................................... 58

nystatin tab 500000 unit.....................................................3nystatin topical powder 100000 unit/gm........................60nystatin-triamcinolone cream 100000-0.1 unit/gm-%........................................................................................ 60

nystatin-triamcinolone oint 100000-0.1 unit/gm-%....... 60O

OBIZUR- antihemophilic factor (recomb porc) rpfviii for inj500 unit..............................................................................55

octreotide acetate inj 50 mcg/ml (0.05 mg/ml)(Sandostatin)....................................................................17




octreotide acetate inj 1000 mcg/ml (1 mg/ml)(Sandostatin)....................................................................17

ODEFSEY- emtricitabine-rilpivirine-tenofovir af tab200-25-25 mg...................................................................... 4

ofloxacin ophth soln 0.3% (Ocuflox)..............................57ofloxacin otic soln 0.3%...................................................58ofloxacin tab 400 mg..........................................................2olanzapine orally disintegrating tab 5 mg (Zyprexazydis)................................................................................. 36

olanzapine orally disintegrating tab 10 mg (Zyprexazydis)................................................................................. 36



olanzapine tab 2.5 mg (Zyprexa).....................................36olanzapine tab 5 mg (Zyprexa)........................................36olanzapine tab 7.5 mg (Zyprexa).....................................36olanzapine tab 10 mg (Zyprexa)......................................36olanzapine tab 15 mg (Zyprexa)......................................36olanzapine tab 20 mg (Zyprexa)......................................36olmesartan medoxomil-hydrochlorothiazide tab20-12.5 mg (Benicar hct)................................................ 23

olmesartan medoxomil-hydrochlorothiazide tab40-12.5 mg (Benicar hct)................................................ 23

olmesartan medoxomil-hydrochlorothiazide tab 40-25mg (Benicar hct)..............................................................23

olmesartan medoxomil tab 5 mg (Benicar)................... 23olmesartan medoxomil tab 20 mg (Benicar)................. 23olmesartan medoxomil tab 40 mg (Benicar)................. 23olopatadine hcl ophth soln 0.2% (base equivalent)(Pataday)...........................................................................57

olopatadine hcl ophth soln 0.1% (base equivalent)(Patanol)............................................................................57

omeprazole cap delayed release 10 mg (Prilosec)....... 30omeprazole cap delayed release 20 mg (Prilosec)....... 30

2020


omeprazole cap delayed release 40 mg (Prilosec)....... 30ondansetron hcl inj 4 mg/2ml (2 mg/ml)........................ 31ondansetron hcl inj 40 mg/20ml (2 mg/ml).................... 31ondansetron hcl oral soln 4 mg/5ml (Zofran)................31ondansetron hcl tab 4 mg (Zofran).................................31ondansetron hcl tab 8 mg (Zofran).................................31ondansetron orally disintegrating tab 4 mg (Zofranodt).....................................................................................31

ondansetron orally disintegrating tab 8 mg (Zofranodt).....................................................................................31

ONGLYZA- saxagliptin hcl tab 2.5 mg (base equiv).......... 14ONGLYZA- saxagliptin hcl tab 5 mg (base equiv)............. 14OPSUMIT- macitentan tab 10 mg......................................26ORFADIN- nitisinone cap 2 mg..........................................17ORFADIN- nitisinone cap 5 mg..........................................17ORFADIN- nitisinone cap 10 mg........................................17ORFADIN- nitisinone cap 20 mg........................................17ORFADIN- nitisinone susp 4 mg/ml................................... 17ORILISSA- elagolix sodium tab 150 mg (base equiv)........17ORILISSA- elagolix sodium tab 200 mg (base equiv)........17orphenadrine citrate tab er 12hr 100 mg....................... 49oseltamivir phosphate cap 30 mg (base equiv)(Tamiflu).............................................................................. 4

oseltamivir phosphate cap 45 mg (base equiv)(Tamiflu).............................................................................. 4

oseltamivir phosphate cap 75 mg (base equiv)(Tamiflu).............................................................................. 4

oseltamivir phosphate for susp 6 mg/ml (base equiv)(Tamiflu).............................................................................. 4

OTEZLA- apremilast tab 30 mg......................................... 45OTEZLA- apremilast tab starter therapy pack 10 mg & 20mg & 30 mg.......................................................................45

oxaprozin tab 600 mg (Daypro).......................................45oxcarbazepine susp 300 mg/5ml (60 mg/ml)(Trileptal)...........................................................................47

oxcarbazepine tab 150 mg (Trileptal)............................. 47oxcarbazepine tab 300 mg (Trileptal)............................. 47oxcarbazepine tab 600 mg (Trileptal)............................. 47oxybutynin chloride syrup 5 mg/5ml..............................32oxybutynin chloride tab er 24hr 15 mg..........................32oxybutynin chloride tab er 24hr 5 mg (Ditropan xl)......32oxybutynin chloride tab er 24hr 10 mg (Ditropanxl)....................................................................................... 32

oxybutynin chloride tab 5 mg......................................... 32oxycodone hcl cap 5 mg................................................. 43oxycodone hcl conc 100 mg/5ml (20 mg/ml)(Oxycodone hcl).............................................................. 43

oxycodone hcl soln 5 mg/5ml (Oxycodone hcl)............43oxycodone hcl tab 10 mg................................................ 43oxycodone hcl tab 20 mg................................................ 43oxycodone hcl tab 5 mg (Roxicodone).......................... 43oxycodone hcl tab 15 mg (Roxicodone)........................ 43oxycodone hcl tab 30 mg (Roxicodone)........................ 43

oxycodone w/ acetaminophen tab 5-325 mg(Percocet)......................................................................... 43

oxycodone w/ acetaminophen tab 7.5-325 mg(Percocet)......................................................................... 43

oxycodone w/ acetaminophen tab 10-325 mg(Percocet)......................................................................... 43

OZEMPIC- semaglutide soln pen-inj 1 mg/dose (2mg/1.5ml)........................................................................... 14

OZEMPIC- semaglutide soln pen-inj 0.25 or 0.5 mg/dose(2 mg/1.5ml)...................................................................... 14

Ppantoprazole sodium ec tab 20 mg (base equiv)(Protonix).......................................................................... 30

pantoprazole sodium ec tab 40 mg (base equiv)(Protonix).......................................................................... 30

paricalcitol cap 4 mcg......................................................17paricalcitol cap 1 mcg (Zemplar).................................... 17paricalcitol cap 2 mcg (Zemplar).................................... 17PAROMOMYCIN SULFATE- paromomycin sulfate cap 250mg........................................................................................ 2

paroxetine hcl tab er 24hr 12.5 mg (Paxil cr)................ 35paroxetine hcl tab er 24hr 25 mg (Paxil cr)................... 35paroxetine hcl tab er 24hr 37.5 mg (Paxil cr)................ 35paroxetine hcl tab 10 mg (Paxil).....................................35paroxetine hcl tab 20 mg (Paxil).....................................35paroxetine hcl tab 30 mg (Paxil).....................................35paroxetine hcl tab 40 mg (Paxil).....................................35PAZEO- olopatadine hcl ophth soln 0.7% (baseequivalent)......................................................................... 57

PEGASYS- peginterferon alfa-2a inj 180 mcg/ml................ 4PEGASYS- peginterferon alfa-2a inj 180 mcg/0.5ml........... 4PEGASYS PROCLICK- peginterferon alfa-2a inj 180mcg/0.5ml.............................................................................5

peg 3350-kcl-na bicarb-nacl-na sulfate for soln 236 gm(Golytely)...........................................................................30

peg 3350-kcl-sod bicarb-nacl for soln 420 gm(Nulytely/flavor pack)......................................................30

penicillamine tab 250 mg (Depen titratabs)...................62penicillin v potassium tab 250 mg....................................1penicillin v potassium tab 500 mg....................................1pentamidine isethionate for nebulization soln 300 mg(Nebupent).......................................................................... 6

pentoxifylline tab er 400 mg............................................55perindopril erbumine tab 2 mg....................................... 23perindopril erbumine tab 4 mg (Aceon).........................23perindopril erbumine tab 8 mg (Aceon).........................23permethrin cream 5% (Elimite)........................................60perphenazine tab 2 mg.................................................... 36perphenazine tab 4 mg.................................................... 36perphenazine tab 8 mg.................................................... 36perphenazine tab 16 mg.................................................. 36phenelzine sulfate tab 15 mg (Nardil)............................ 35

2020


phenobarbital elixir 20 mg/5ml........................................37phenobarbital tab 15 mg..................................................37phenobarbital tab 16.2 mg...............................................37phenobarbital tab 30 mg..................................................37phenobarbital tab 32.4 mg...............................................37phenobarbital tab 60 mg..................................................37phenobarbital tab 100 mg................................................37phenoxybenzamine hcl cap 10 mg (Dibenzyline)......... 23phenytoin chew tab 50 mg (Dilantin infatabs)...............47phenytoin sodium extended cap 100 mg (Dilantin)...... 47phenytoin sodium extended cap 200 mg(Phenytek).........................................................................47

phenytoin sodium extended cap 300 mg(Phenytek).........................................................................47

phenytoin susp 125 mg/5ml (Dilantin-125).................... 47phytonadione tab 5 mg (Mephyton)............................... 49pilocarpine hcl ophth soln 1% (Isopto carpine)............ 57pilocarpine hcl ophth soln 2% (Isopto carpine)............ 57pilocarpine hcl ophth soln 4% (Isopto carpine)............ 57pilocarpine hcl tab 5 mg (Salagen).................................58pilocarpine hcl tab 7.5 mg (Salagen)..............................58pimecrolimus cream 1% (Elidel)..................................... 60pindolol tab 5 mg..............................................................19pindolol tab 10 mg............................................................19pioglitazone hcl-metformin hcl tab 15-500 mg(Actoplus met)................................................................. 14

pioglitazone hcl-metformin hcl tab 15-850 mg(Actoplus met)................................................................. 14

pioglitazone hcl tab 15 mg (base equiv) (Actos)...........14pioglitazone hcl tab 30 mg (base equiv) (Actos)...........14pioglitazone hcl tab 45 mg (base equiv) (Actos)...........14PIQRAY 250MG DAILY DOSE- alpelisib tab pack 250 mgdaily dose (200 mg & 50 mg tabs)..................................... 8

PIQRAY 300MG DAILY DOSE- alpelisib tab pack 300 mgdaily dose (2x150 mg tab).................................................. 8

PIQRAY 200MG DAILY DOSE- alpelisib tab therapy pack200 mg daily dose...............................................................8

piroxicam cap 10 mg (Feldene).......................................45piroxicam cap 20 mg (Feldene).......................................45PLEGRIDY- peginterferon beta-1a soln pen-injector 125mcg/0.5ml...........................................................................40

PLEGRIDY- peginterferon beta-1a soln prefilled syringe125 mcg/0.5ml...................................................................40

PLEGRIDY STARTER PACK- peginterferon beta-1a solnpen-inj 63 & 94 mcg/0.5ml pack.......................................40

PLEGRIDY STARTER PACK- peginterferon beta-1a solnpref syr 63 & 94 mcg/0.5ml pack..................................... 40

podofilox soln 0.5% (Condylox)......................................60polymyxin b-trimethoprim ophth soln 10000 unit/ml-0.1% (Polytrim)...........................................................57

posaconazole tab delayed release 100 mg (Noxafil)...... 3potassium chloride cap er 8 meq...................................49potassium chloride cap er 10 meq.................................49

potassium chloride microencapsulated crys er tab 10meq....................................................................................49

potassium chloride microencapsulated crys er tab 20meq....................................................................................49

potassium chloride oral soln 10% (20 meq/15ml).........49potassium chloride oral soln 20% (40 meq/15ml).........49potassium chloride powder packet 20 meq.................. 49potassium chloride tab er 10 meq (K-tab)..................... 49potassium chloride tab er 8 meq (600 mg)....................49potassium citrate tab er 5 meq (540 mg) (Urocit-k5)........................................................................................ 33

potassium citrate tab er 10 meq (1080 mg) (Urocit-k10)...................................................................................... 33

potassium citrate tab er 15 meq (1620 mg) (Urocit-k15)...................................................................................... 33

pot phos monobasic w/sod phos di & monobas tab155-852-130mg (K-phos neutral)................................... 49

pramipexole dihydrochloride tab 0.125 mg(Mirapex)........................................................................... 48

pramipexole dihydrochloride tab 0.25 mg(Mirapex)........................................................................... 48

pramipexole dihydrochloride tab 0.5 mg (Mirapex)......48pramipexole dihydrochloride tab 0.75 mg(Mirapex)........................................................................... 48

pramipexole dihydrochloride tab 1 mg (Mirapex).........48pramipexole dihydrochloride tab 1.5 mg (Mirapex)......48prasugrel hcl tab 5 mg (base equiv) (Effient)................55prasugrel hcl tab 10 mg (base equiv) (Effient)..............55pravastatin sodium tab 10 mg........................................ 25pravastatin sodium tab 20 mg (Pravachol)....................25pravastatin sodium tab 40 mg (Pravachol)....................25pravastatin sodium tab 80 mg (Pravachol)....................26praziquantel tab 600 mg (Biltricide)................................. 6prazosin hcl cap 1 mg (Minipress)................................. 23prazosin hcl cap 2 mg (Minipress)................................. 23prazosin hcl cap 5 mg (Minipress)................................. 23PREDNISOLONE ACETATE- prednisolone acetate ophthsusp 1%.............................................................................57

PREDNISOLONE SODIUM PHOSP- prednisolone sodiumphosphate ophth soln 1%................................................. 57

prednisolone sod phosphate oral soln 15 mg/5ml(base equiv)........................................................................9

prednisolone sod phosph oral soln 6.7 mg/5ml (5mg/5ml base) (Pediapred)................................................ 9

PREDNISONE INTENSOL- prednisone conc 5 mg/ml........9PREDNISONE- prednisone oral soln 5 mg/5ml...................9prednisone tab 1 mg........................................................ 10prednisone tab 2.5 mg..................................................... 10prednisone tab 5 mg........................................................ 10prednisone tab 10 mg...................................................... 10prednisone tab 20 mg...................................................... 10prednisone tab 50 mg...................................................... 10prednisone tab therapy pack 5 mg (21)......................... 10

2020


prednisone tab therapy pack 5 mg (48)......................... 10prednisone tab therapy pack 10 mg (21)....................... 10prednisone tab therapy pack 10 mg (48)....................... 10pregabalin cap 25 mg (Lyrica).........................................47pregabalin cap 50 mg (Lyrica).........................................47pregabalin cap 75 mg (Lyrica).........................................47pregabalin cap 100 mg (Lyrica)...................................... 47pregabalin cap 150 mg (Lyrica)...................................... 47pregabalin cap 200 mg (Lyrica)...................................... 47pregabalin cap 225 mg (Lyrica)...................................... 47pregabalin cap 300 mg (Lyrica)...................................... 47pregabalin soln 20 mg/ml (Lyrica).................................. 47PREMARIN- estrogens, conjugated tab 0.3 mg................ 11PREMARIN- estrogens, conjugated tab 0.45 mg.............. 11PREMARIN- estrogens, conjugated tab 0.625 mg............ 11PREMARIN- estrogens, conjugated tab 0.9 mg................ 11PREMARIN- estrogens, conjugated tab 1.25 mg.............. 11PREMPHASE- conj est 0.625(14)/conj est-medroxypro actab 0.625-5mg(14).............................................................11

PREMPRO- conjugated estrogen-medroxyprogest acetatetab 0.3-1.5 mg................................................................... 11

PREMPRO- conjugated estrogen-medroxyprogest acetatetab 0.45-1.5 mg.................................................................11

PREMPRO- conjugated estrogen-medroxyprogest acetatetab 0.625-2.5 mg...............................................................11

PREMPRO- conjugated estrogen-medroxyprogest acetatetab 0.625-5 mg..................................................................11

PRENATAL 19- prenatal vit w/ dss-fe fumarate-fa tab 29-1mg...................................................................................... 49

PRENATAL 19- prenatal vit w/ fe fumarate-fa chew tab29-1 mg..............................................................................49

PRENATAL VITAMINS PLUS LO- prenatal vit w/ fefumarate-fa tab 27-1 mg................................................... 49

PREZISTA- darunavir ethanolate susp 100 mg/ml (baseequiv)....................................................................................5

PREZISTA- darunavir ethanolate tab 75 mg (baseequiv)....................................................................................5




PRIFTIN- rifapentine tab 150 mg......................................... 2primaquine phosphate tab 26.3 mg (15 mg base)(Primaquine phosphate)................................................... 6

primidone tab 50 mg (Mysoline)..................................... 47primidone tab 250 mg (Mysoline)................................... 47PROAIR HFA- albuterol sulfate inhal aero 108 mcg/act(90mcg base equiv).......................................................... 29

PROAIR RESPICLICK- albuterol sulfate aer pow ba 108mcg/act (90 mcg base equiv)........................................... 29

probenecid tab 500 mg.................................................... 46

prochlorperazine maleate tab 5 mg (baseequivalent)........................................................................ 36

prochlorperazine maleate tab 10 mg (baseequivalent)........................................................................ 36

prochlorperazine suppos 25 mg.....................................36PROCRIT- epoetin alfa inj 2000 unit/ml.............................51PROCRIT- epoetin alfa inj 3000 unit/ml.............................51PROCRIT- epoetin alfa inj 4000 unit/ml.............................51PROCRIT- epoetin alfa inj 10000 unit/ml...........................51PROCRIT- epoetin alfa inj 20000 unit/ml...........................51PROCRIT- epoetin alfa inj 40000 unit/ml...........................51PROFILNINE- factor ix complex for inj 500 unit................ 55PROFILNINE- factor ix complex for inj 1000 unit.............. 55PROFILNINE- factor ix complex for inj 1500 unit.............. 55PROFILNINE SD- factor ix complex for inj 1000 unit.........55PROFILNINE SD- factor ix complex for inj 1500 unit.........55progesterone micronized cap 100 mg(Prometrium).................................................................... 12

progesterone micronized cap 200 mg(Prometrium).................................................................... 12

PROGLYCEM- diazoxide susp 50 mg/ml...........................14PROGRAF- tacrolimus cap 0.5 mg....................................62PROGRAF- tacrolimus cap 1 mg.......................................62PROGRAF- tacrolimus cap 5 mg.......................................62PROGRAF- tacrolimus packet for susp 0.2 mg................. 62PROGRAF- tacrolimus packet for susp 1 mg.................... 62promethazine hcl suppos 12.5 mg................................. 27promethazine hcl suppos 25 mg.................................... 27promethazine hcl syrup 6.25 mg/5ml............................. 27promethazine hcl tab 12.5 mg.........................................27promethazine hcl tab 25 mg............................................27promethazine hcl tab 50 mg............................................27propafenone hcl cap er 12hr 225 mg (Rythmol sr)....... 20propafenone hcl cap er 12hr 325 mg (Rythmol sr)....... 20propafenone hcl cap er 12hr 425 mg (Rythmol sr)....... 20propafenone hcl tab 300 mg........................................... 20propafenone hcl tab 150 mg (Rythmol)......................... 20propafenone hcl tab 225 mg (Rythmol)......................... 20propranolol hcl cap er 24hr 60 mg (Inderal la)..............19propranolol hcl cap er 24hr 80 mg (Inderal la)..............19propranolol hcl cap er 24hr 120 mg (Inderal la)............19propranolol hcl cap er 24hr 160 mg (Inderal la)............19PROPRANOLOL HCL- propranolol hcl oral soln 20mg/5ml............................................................................... 19

PROPRANOLOL HCL- propranolol hcl oral soln 40mg/5ml............................................................................... 19

propranolol hcl tab 10 mg............................................... 19propranolol hcl tab 20 mg............................................... 19propranolol hcl tab 40 mg............................................... 19propranolol hcl tab 60 mg............................................... 19propranolol hcl tab 80 mg............................................... 19propylthiouracil tab 50 mg.............................................. 16PULMOZYME- dornase alfa inhal soln 1 mg/ml................ 29

2020


PURIXAN- mercaptopurine susp 2000 mg/100ml (20 mg/ml)........................................................................................ 8

pyrazinamide tab 500 mg...................................................3pyridostigmine bromide tab 60 mg (Mestinon)............. 49pyrimethamine tab 25 mg (Daraprim)...............................6Q

quetiapine fumarate tab er 24hr 50 mg (Seroquelxr).......................................................................................36





quetiapine fumarate tab 25 mg (Seroquel).................... 36quetiapine fumarate tab 50 mg (Seroquel).................... 36quetiapine fumarate tab 100 mg (Seroquel).................. 36quetiapine fumarate tab 200 mg (Seroquel).................. 36quetiapine fumarate tab 300 mg (Seroquel).................. 36quetiapine fumarate tab 400 mg (Seroquel).................. 36quinapril hcl tab 5 mg (Accupril).................................... 23quinapril hcl tab 10 mg (Accupril).................................. 23quinapril hcl tab 20 mg (Accupril).................................. 23quinapril hcl tab 40 mg (Accupril).................................. 23quinapril-hydrochlorothiazide tab 10-12.5 mg(Accuretic)........................................................................ 23

quinapril-hydrochlorothiazide tab 20-12.5 mg(Accuretic)........................................................................ 23

quinapril-hydrochlorothiazide tab 20-25 mg(Accuretic)........................................................................ 23

quinidine gluconate tab er 324 mg.................................20QVAR REDIHALER- beclomethasone diprop hfa breathact inh aer 40 mcg/act...................................................... 29

QVAR REDIHALER- beclomethasone diprop hfa breathact inh aer 80 mcg/act...................................................... 29

Rraloxifene hcl tab 60 mg (Evista)....................................17ramipril cap 1.25 mg (Altace).......................................... 23ramipril cap 2.5 mg (Altace)............................................ 23ramipril cap 5 mg (Altace)............................................... 23ramipril cap 10 mg (Altace)............................................. 23RAPAMUNE- sirolimus oral soln 1 mg/ml.......................... 62rasagiline mesylate tab 0.5 mg (base equiv)(Azilect)............................................................................. 48

rasagiline mesylate tab 1 mg (base equiv) (Azilect)..... 48REBIF- interferon beta-1a soln pref syr 22 mcg/0.5ml(12mu/ml)...........................................................................40

REBIF- interferon beta-1a soln pref syr 44 mcg/0.5ml(24mu/ml)...........................................................................41

REBIF REBIDOSE- interferon beta-1a soln auto-inj 22mcg/0.5ml (12mu/ml).........................................................41

REBIF REBIDOSE- interferon beta-1a soln auto-inj 44mcg/0.5ml (24mu/ml).........................................................41

REBIF REBIDOSE TITRATION- interferon beta-1a auto-inj6x8.8 mcg/0.2ml & 6x22 mcg/0.5ml................................. 41

REBIF TITRATION PACK- interferon beta-1a pref syr6x8.8 mcg/0.2ml & 6x22 mcg/0.5ml................................. 41

REBINYN- coagulation factor ix recomb glycopegylated forinj 500 unt..........................................................................55

REBINYN- coagulation factor ix recomb glycopegylated forinj 1000 unt........................................................................55

REBINYN- coagulation factor ix recomb glycopegylated forinj 2000 unt........................................................................55

RECOMBINATE- antihemophilic factor (recombinant) forinj 220-400 unit..................................................................55

RECOMBINATE- antihemophilic factor (recombinant) forinj 401-800 unit..................................................................55

RECOMBINATE- antihemophilic factor (recombinant) forinj 801-1240 unit................................................................56

RECOMBINATE- antihemophilic factor (recombinant) forinj 1241-1800 unit..............................................................56

RECOMBINATE- antihemophilic factor (recombinant) forinj 1801-2400 unit..............................................................56

repaglinide tab 0.5 mg (Prandin).................................... 14repaglinide tab 1 mg (Prandin)....................................... 14repaglinide tab 2 mg (Prandin)....................................... 14REPATHA- evolocumab subcutaneous soln prefilledsyringe 140 mg/ml.............................................................26

REPATHA PUSHTRONEX SYSTEM- evolocumabsubcutaneous soln cartridge/infusor 420 mg/3.5ml..........26

REPATHA SURECLICK- evolocumab subcutaneous solnauto-injector 140 mg/ml.................................................... 26

RETACRIT- epoetin alfa-epbx inj 2000 unit/ml.................. 51RETACRIT- epoetin alfa-epbx inj 3000 unit/ml.................. 51RETACRIT- epoetin alfa-epbx inj 4000 unit/ml.................. 51RETACRIT- epoetin alfa-epbx inj 10000 unit/ml................ 51RETACRIT- epoetin alfa-epbx inj 40000 unit/ml................ 51REVCOVI- elapegademase-lvlr im soln 2.4 mg/1.5ml (1.6mg/ml)................................................................................ 17

REVLIMID- lenalidomide cap 5 mg....................................62REVLIMID- lenalidomide cap 10 mg..................................62REVLIMID- lenalidomide cap 15 mg..................................62REVLIMID- lenalidomide cap 20 mg..................................62REVLIMID- lenalidomide cap 25 mg..................................62REVLIMID- lenalidomide caps 2.5 mg............................... 62ribavirin cap 200 mg (Rebetol)..........................................5ribavirin tab 200 mg (Copegus)........................................ 5rifabutin cap 150 mg (Mycobutin).....................................3rifampin cap 150 mg (Rifadin)...........................................3rifampin cap 300 mg (Rifadin)...........................................3riluzole tab 50 mg (Rilutek)............................................. 49RINVOQ- upadacitinib tab er 24hr 15 mg..........................45

2020


risedronate sodium tab 5 mg (Actonel)......................... 17risedronate sodium tab 30 mg (Actonel)....................... 17risedronate sodium tab 35 mg (Actonel)....................... 17risedronate sodium tab 150 mg (Actonel)..................... 17risperidone orally disintegrating tab 0.5 mg (Risperdalm-tab)................................................................................ 36

risperidone orally disintegrating tab 1 mg (Risperdalm-tab)................................................................................ 36




risperidone soln 1 mg/ml (Risperdal).............................37risperidone tab 0.25 mg (Risperdal)...............................37risperidone tab 0.5 mg (Risperdal).................................37risperidone tab 1 mg (Risperdal)....................................37risperidone tab 2 mg (Risperdal)....................................37risperidone tab 3 mg (Risperdal)....................................37risperidone tab 4 mg (Risperdal)....................................37ritonavir tab 100 mg (Norvir).............................................5rivastigmine tartrate cap 1.5 mg (base equivalent)...... 41rivastigmine tartrate cap 3 mg (base equivalent)......... 41rivastigmine tartrate cap 4.5 mg (base equivalent)...... 41rivastigmine tartrate cap 6 mg (base equivalent)......... 41RIXUBIS- coagulation factor ix (recombinant) for inj 250unit......................................................................................56

RIXUBIS- coagulation factor ix (recombinant) for inj 500unit......................................................................................56




rizatriptan benzoate oral disintegrating tab 5 mg (baseeq)...................................................................................... 45

rizatriptan benzoate oral disintegrating tab 10 mg(base eq) (Maxalt-mlt).....................................................45

rizatriptan benzoate tab 5 mg (base equivalent)...........45rizatriptan benzoate tab 10 mg (base equivalent)(Maxalt)..............................................................................46

ropinirole hydrochloride tab 0.25 mg (Requip)............. 48ropinirole hydrochloride tab 0.5 mg (Requip)............... 48ropinirole hydrochloride tab 1 mg (Requip).................. 48ropinirole hydrochloride tab 2 mg (Requip).................. 48ropinirole hydrochloride tab 3 mg (Requip).................. 48ropinirole hydrochloride tab 4 mg (Requip).................. 48ropinirole hydrochloride tab 5 mg (Requip).................. 48rosuvastatin calcium tab 5 mg (Crestor)....................... 26rosuvastatin calcium tab 10 mg (Crestor)..................... 26rosuvastatin calcium tab 20 mg (Crestor)..................... 26

rosuvastatin calcium tab 40 mg (Crestor)..................... 26ROZLYTREK- entrectinib cap 100 mg................................. 8ROZLYTREK- entrectinib cap 200 mg................................. 8RUBRACA- rucaparib camsylate tab 200 mg (baseequivalent)............................................................................8

RUBRACA- rucaparib camsylate tab 250 mg (baseequivalent)............................................................................8

RUBRACA- rucaparib camsylate tab 300 mg (baseequivalent)............................................................................8

RYBELSUS- semaglutide tab 3 mg................................... 14RYBELSUS- semaglutide tab 7 mg................................... 14RYBELSUS- semaglutide tab 14 mg................................. 14RYDAPT- midostaurin cap 25 mg........................................ 8

Sscopolamine td patch 72hr 1 mg/3days (Transderm-scop)..................................................................................31

selegiline hcl cap 5 mg (Eldepryl).................................. 48selenium sulfide lotion 2.5%........................................... 60SE-NATAL 19- prenatal vit w/ dss-fe fumarate-fa tab 29-1mg...................................................................................... 49

SE-NATAL 19- prenatal vit w/ fe fumarate-fa chew tab 29-1mg...................................................................................... 49

SEREVENT DISKUS- salmeterol xinafoate aer pow ba 50mcg/dose (base equiv)......................................................29

sertraline hcl oral concentrate for solution 20 mg/ml(Zoloft)...............................................................................35

sertraline hcl tab 25 mg (Zoloft)..................................... 35sertraline hcl tab 50 mg (Zoloft)..................................... 35sertraline hcl tab 100 mg (Zoloft)................................... 35sevelamer carbonate packet 0.8 gm (Renvela)............. 32sevelamer carbonate packet 2.4 gm (Renvela)............. 32sevelamer carbonate tab 800 mg (Renvela).................. 32sildenafil citrate tab 20 mg (Revatio)............................. 26silver sulfadiazine cream 1% (Silvadene)...................... 60SIMBRINZA- brinzolamide-brimonidine tartrate ophth susp1-0.2%................................................................................57

SIMPONI- golimumab subcutaneous soln auto-injector100 mg/ml..........................................................................45

SIMPONI- golimumab subcutaneous soln prefilled syringe100 mg/ml..........................................................................45

simvastatin tab 5 mg (Zocor).......................................... 26simvastatin tab 10 mg (Zocor)........................................ 26simvastatin tab 20 mg (Zocor)........................................ 26simvastatin tab 40 mg (Zocor)........................................ 26simvastatin tab 80 mg (Zocor)........................................ 26sirolimus oral soln 1 mg/ml (Rapamune).......................62sirolimus tab 0.5 mg (Rapamune)...................................62sirolimus tab 1 mg (Rapamune)......................................62sirolimus tab 2 mg (Rapamune)......................................62SIVEXTRO- tedizolid phosphate tab 200 mg.......................6SKYRIZI- risankizumab-rzaa sol prefilled syringe 2 x 75mg/0.83ml kit..................................................................... 60

2020


sodium chloride soln nebu 3%....................................... 27sodium chloride soln nebu 7% (Hyper-sal)................... 27sodium citrate & citric acid soln 500-334 mg/5ml.........33sodium polystyrene sulfonate oral susp 15 gm/60ml(Sps).................................................................................. 62

sodium polystyrene sulfonate powder.......................... 62solifenacin succinate tab 5 mg (Vesicare).....................32solifenacin succinate tab 10 mg (Vesicare)...................32SOLIQUA 100/33- insulin glargine-lixisenatide sol pen-inj100-33 unit-mcg/ml............................................................14

SOOLANTRA- ivermectin cream 1%................................. 60sotalol hcl (afib/afl) tab 80 mg (Betapace af).................19sotalol hcl (afib/afl) tab 120 mg (Betapace af)...............19sotalol hcl (afib/afl) tab 160 mg (Betapace af)...............19sotalol hcl tab 240 mg......................................................19sotalol hcl tab 80 mg (Betapace)....................................19sotalol hcl tab 120 mg (Betapace)..................................19sotalol hcl tab 160 mg (Betapace)..................................19SOVALDI- sofosbuvir pellet pack 150 mg............................5SOVALDI- sofosbuvir pellet pack 200 mg............................5SOVALDI- sofosbuvir tab 200 mg........................................ 5SOVALDI- sofosbuvir tab 400 mg........................................ 5SPIRIVA HANDIHALER- tiotropium bromide monohydrateinhal cap 18 mcg (base equiv)......................................... 29

SPIRIVA RESPIMAT- tiotropium bromide monohydrateinhal aerosol 1.25 mcg/act................................................29

SPIRIVA RESPIMAT- tiotropium bromide monohydrateinhal aerosol 2.5 mcg/act..................................................29

spironolactone & hydrochlorothiazide tab 25-25 mg(Aldactazide).....................................................................24

spironolactone tab 25 mg (Aldactone)...........................24spironolactone tab 50 mg (Aldactone)...........................24spironolactone tab 100 mg (Aldactone).........................24SPRYCEL- dasatinib tab 20 mg...........................................8SPRYCEL- dasatinib tab 50 mg...........................................8SPRYCEL- dasatinib tab 70 mg...........................................8SPRYCEL- dasatinib tab 80 mg...........................................8SPRYCEL- dasatinib tab 100 mg.........................................8SPRYCEL- dasatinib tab 140 mg.........................................8stavudine cap 15 mg (Zerit)...............................................5stavudine cap 20 mg (Zerit)...............................................5stavudine cap 30 mg (Zerit)...............................................5stavudine cap 40 mg (Zerit)...............................................5STELARA- ustekinumab inj 45 mg/0.5ml...........................60STELARA- ustekinumab soln prefilled syringe 45mg/0.5ml............................................................................ 61

STELARA- ustekinumab soln prefilled syringe 90 mg/ml........................................................................................61

STIMATE- desmopressin acetate nasal soln 1.5 mg/ml........................................................................................17

STIOLTO RESPIMAT- tiotropium br-olodaterol inhal aerosoln 2.5-2.5 mcg/act..........................................................29

STRENSIQ- asfotase alfa subcutaneous inj 18mg/0.45ml.......................................................................... 18

STRENSIQ- asfotase alfa subcutaneous inj 28mg/0.7ml............................................................................ 18

STRENSIQ- asfotase alfa subcutaneous inj 40 mg/ml...... 18STRENSIQ- asfotase alfa subcutaneous inj 80mg/0.8ml............................................................................ 18

STRIVERDI RESPIMAT- olodaterol hcl inhal aerosol soln2.5 mcg/act (base equiv).................................................. 29

sucralfate tab 1 gm (Carafate).........................................30sulfacetamide sodium lotion 10% (acne) (Klaron)........61sulfacetamide sodium ophth soln 10% (Bleph-10)....... 57SULFADIAZINE- sulfadiazine tab 500 mg........................... 2sulfamethoxazole-trimethoprim susp 200-40mg/5ml.................................................................................6

sulfamethoxazole-trimethoprim tab 400-80 mg(Bactrim)............................................................................. 6

sulfamethoxazole-trimethoprim tab 800-160 mg(Bactrim ds)........................................................................6

sulfasalazine tab delayed release 500 mg (Azulfidineen-tabs)............................................................................. 32

sulfasalazine tab 500 mg (Azulfidine)............................ 32sulindac tab 150 mg......................................................... 45sulindac tab 200 mg......................................................... 45sumatriptan nasal spray 5 mg/act (Imitrex)...................46sumatriptan nasal spray 20 mg/act (Imitrex).................46sumatriptan succinate inj 6 mg/0.5ml (Imitrex).............46sumatriptan succinate solution auto-injector 4mg/0.5ml (Imitrex statdose sys)....................................46

sumatriptan succinate solution auto-injector 6mg/0.5ml (Imitrex statdose sys)....................................46

sumatriptan succinate solution cartridge 4 mg/0.5ml(Imitrex statdose ref)...................................................... 46

sumatriptan succinate solution cartridge 6 mg/0.5ml(Imitrex statdose ref)...................................................... 46

sumatriptan succinate tab 25 mg (Imitrex)....................46sumatriptan succinate tab 50 mg (Imitrex)....................46sumatriptan succinate tab 100 mg (Imitrex)..................46SUNOSI- solriamfetol hcl tab 75 mg (base equiv)............. 39SUNOSI- solriamfetol hcl tab 150 mg (base equiv)........... 39SUTENT- sunitinib malate cap 12.5 mg (baseequivalent)............................................................................8

SUTENT- sunitinib malate cap 25 mg (base equivalent).....8SUTENT- sunitinib malate cap 37.5 mg (baseequivalent)............................................................................8

SUTENT- sunitinib malate cap 50 mg (base equivalent).....8SYMBICORT- budesonide-formoterol fumarate dihydaerosol 80-4.5 mcg/act..................................................... 29

SYMBICORT- budesonide-formoterol fumarate dihydaerosol 160-4.5 mcg/act................................................... 29

SYMDEKO- tezacaftor-ivacaftor 50-75 mg & ivacaftor 75mg tab tbpk....................................................................... 29

2020


SYMDEKO- tezacaftor-ivacaftor 100-150 mg & ivacaftor150 mg tab tbpk................................................................ 29

SYMFI- efavirenz-lamivudine-tenofovir df tab 600-300-300mg........................................................................................ 5

SYMFI LO- efavirenz-lamivudine-tenofovir df tab400-300-300 mg.................................................................. 5

SYMJEPI- epinephrine soln prefilled syringe 0.15mg/0.3ml (1:2000)............................................................. 25

SYMJEPI- epinephrine solution prefilled syringe 0.3mg/0.3ml (1:1000)............................................................. 25

SYMPROIC- naldemedine tosylate tab 0.2 mg (baseequivalent)......................................................................... 32

SYNJARDY- empagliflozin-metformin hcl tab 12.5-1000mg...................................................................................... 14

SYNJARDY- empagliflozin-metformin hcl tab 12.5-500mg...................................................................................... 14

SYNJARDY- empagliflozin-metformin hcl tab 5-500mg...................................................................................... 14

SYNJARDY- empagliflozin-metformin hcl tab 5-1000mg...................................................................................... 14

SYNJARDY XR- empagliflozin-metformin hcl tab er 24hr5-1000 mg......................................................................... 14

SYNJARDY XR- empagliflozin-metformin hcl tab er 24hr10-1000 mg....................................................................... 14

SYNJARDY XR- empagliflozin-metformin hcl tab er 24hr12.5-1000 mg.................................................................... 14

SYNJARDY XR- empagliflozin-metformin hcl tab er 24hr25-1000 mg....................................................................... 14

TTABLOID- thioguanine tab 40 mg........................................ 8tacrolimus cap 0.5 mg (Prograf)..................................... 62tacrolimus cap 1 mg (Prograf)........................................ 62tacrolimus cap 5 mg (Prograf)........................................ 62tacrolimus oint 0.03% (Protopic).................................... 61tacrolimus oint 0.1% (Protopic)...................................... 61tadalafil tab 2.5 mg (Cialis).........................................26,26tadalafil tab 5 mg (Cialis)............................................26,26tadalafil tab 10 mg (Cialis)..........................................26,26tadalafil tab 20 mg (Cialis)..........................................26,26tadalafil tab 20 mg (pah) (Adcirca)................................. 26TAFINLAR- dabrafenib mesylate cap 50 mg (baseequivalent)............................................................................8

TAFINLAR- dabrafenib mesylate cap 75 mg (baseequivalent)............................................................................8

TALZENNA- talazoparib tosylate cap 0.25 mg (baseequivalent)............................................................................8

TALZENNA- talazoparib tosylate cap 1 mg (baseequivalent)............................................................................8

tamoxifen citrate tab 10 mg (base equivalent)................8tamoxifen citrate tab 20 mg (base equivalent)................8tamsulosin hcl cap 0.4 mg (Flomax).............................. 33TASIGNA- nilotinib hcl cap 50 mg (base equivalent)...........8

TASIGNA- nilotinib hcl cap 150 mg (base equivalent)......... 8TASIGNA- nilotinib hcl cap 200 mg (base equivalent)......... 8tazarotene cream 0.1% (Tazorac)....................................61TAZORAC- tazarotene cream 0.05%.................................61TAZORAC- tazarotene gel 0.05%...................................... 61TAZORAC- tazarotene gel 0.1%........................................ 61TECFIDERA- dimethyl fumarate capsule delayed release120 mg...............................................................................41

TECFIDERA- dimethyl fumarate capsule delayed release240 mg...............................................................................41

TECFIDERA STARTER PACK- dimethyl fumarate capsuledr starter pack 120 mg & 240 mg.................................... 41

telmisartan-hydrochlorothiazide tab 40-12.5 mg(Micardis hct)................................................................... 23

telmisartan-hydrochlorothiazide tab 80-12.5 mg(Micardis hct)................................................................... 23

telmisartan-hydrochlorothiazide tab 80-25 mg(Micardis hct)................................................................... 23

telmisartan tab 20 mg (Micardis).................................... 23telmisartan tab 40 mg (Micardis).................................... 23telmisartan tab 80 mg (Micardis).................................... 23temazepam cap 7.5 mg (Restoril)................................... 37temazepam cap 15 mg (Restoril).................................... 37temazepam cap 22.5 mg (Restoril)................................. 37temazepam cap 30 mg (Restoril).................................... 37TEMIXYS- lamivudine-tenofovir disoproxil fumarate tab300-300 mg......................................................................... 5

temozolomide cap 5 mg (Temodar).................................. 8temozolomide cap 20 mg (Temodar)................................ 8temozolomide cap 100 mg (Temodar)..............................8temozolomide cap 140 mg (Temodar)..............................8temozolomide cap 180 mg (Temodar)..............................8temozolomide cap 250 mg (Temodar)..............................8tenofovir disoproxil fumarate tab 300 mg (Viread)......... 5terazosin hcl cap 1 mg (base equivalent)......................23terazosin hcl cap 2 mg (base equivalent)......................23terazosin hcl cap 5 mg (base equivalent)......................23terazosin hcl cap 10 mg (base equivalent)....................23terbinafine hcl tab 250 mg (Lamisil).................................3terbutaline sulfate tab 2.5 mg......................................... 29terbutaline sulfate tab 5 mg............................................ 29terconazole vaginal cream 0.4% (Terazol 7).................. 32terconazole vaginal suppos 80 mg.................................33testosterone cypionate im inj in oil 100 mg/ml (Depo-testosterone).................................................................... 10

testosterone cypionate im inj in oil 200 mg/ml (Depo-testosterone).................................................................... 10

testosterone td gel 12.5 mg/act (1%) (Androgelpump)................................................................................ 10

testosterone td gel 20.25 mg/act (1.62%) (Androgelpump)................................................................................ 10

testosterone td gel 25 mg/2.5gm (1%) (Androgel)........ 10testosterone td gel 50 mg/5gm (1%) (Androgel)........... 10

2020


testosterone td gel 20.25 mg/1.25gm (1.62%)(Androgel).........................................................................10

testosterone td gel 40.5 mg/2.5gm (1.62%)(Androgel).........................................................................10

testosterone td soln 30 mg/act (Axiron)........................ 10TEST STRIPS – CONTOUR, CONTOUR NEXT...............61tetrabenazine tab 12.5 mg (Xenazine)............................ 41tetrabenazine tab 25 mg (Xenazine)............................... 41tetracycline hcl cap 250 mg (Tetracycline hcl)................2tetracycline hcl cap 500 mg (Tetracycline hcl)................2THALOMID- thalidomide cap 50 mg.................................. 62THALOMID- thalidomide cap 100 mg................................ 62THALOMID- thalidomide cap 150 mg................................ 62THALOMID- thalidomide cap 200 mg................................ 62theophylline tab er 24hr 400 mg.....................................29theophylline tab er 24hr 600 mg.....................................29thiothixene cap 1 mg........................................................37thiothixene cap 2 mg........................................................37thiothixene cap 5 mg........................................................37thiothixene cap 10 mg......................................................37timolol maleate ophth soln 0.25% (Timoptic)................57timolol maleate ophth soln 0.5% (Timoptic)..................57timolol maleate tab 5 mg................................................. 19timolol maleate tab 10 mg............................................... 19timolol maleate tab 20 mg............................................... 19TIVICAY- dolutegravir sodium tab 10 mg (base equiv)........5TIVICAY- dolutegravir sodium tab 25 mg (base equiv)........5TIVICAY- dolutegravir sodium tab 50 mg (base equiv)........5tizanidine hcl tab 2 mg (base equivalent)......................49tizanidine hcl tab 4 mg (base equivalent)(Zanaflex).......................................................................... 49

tobramycin-dexamethasone ophth susp 0.3-0.1%(Tobradex).........................................................................57

tobramycin nebu soln 300 mg/5ml (Tobi)........................ 2tobramycin ophth soln 0.3% (Tobrex)............................ 57tolterodine tartrate cap er 24hr 2 mg (Detrol la)............32tolterodine tartrate cap er 24hr 4 mg (Detrol la)............32tolterodine tartrate tab 1 mg (Detrol)............................. 32tolterodine tartrate tab 2 mg (Detrol)............................. 32topiramate sprinkle cap 15 mg (Topamax sprinkle)..... 47topiramate sprinkle cap 25 mg (Topamax sprinkle)..... 48topiramate tab 25 mg (Topamax).................................... 48topiramate tab 50 mg (Topamax).................................... 48topiramate tab 100 mg (Topamax).................................. 48topiramate tab 200 mg (Topamax).................................. 48toremifene citrate tab 60 mg (base equivalent)(Fareston)............................................................................8

torsemide tab 5 mg (Demadex).......................................24torsemide tab 10 mg (Demadex).....................................24torsemide tab 20 mg (Demadex).....................................24torsemide tab 100 mg (Demadex)...................................24TOUJEO MAX SOLOSTAR- insulin glargine soln pen-injector 300 unit/ml (2 unit dial)........................................ 15

TOUJEO SOLOSTAR- insulin glargine soln pen-injector300 unit/ml (1 unit dial)..................................................... 16

TRACLEER- bosentan tab for oral susp 32 mg.................26TRACLEER- bosentan tab 62.5 mg...................................26TRACLEER- bosentan tab 125 mg....................................26tramadol-acetaminophen tab 37.5-325 mg(Ultracet)........................................................................... 43

tramadol hcl tab er 24hr 100 mg.....................................43tramadol hcl tab er 24hr 200 mg.....................................43tramadol hcl tab er 24hr 300 mg.....................................43tramadol hcl tab 50 mg (Ultram).....................................43trandolapril tab 1 mg (Mavik).......................................... 23trandolapril tab 2 mg (Mavik).......................................... 23trandolapril tab 4 mg (Mavik).......................................... 24tranylcypromine sulfate tab 10 mg (Parnate)................35TRAVATAN Z- travoprost ophth soln 0.004%(benzalkonium free) (bak free)......................................... 57

travoprost ophth soln 0.004% (benzalkonium free)(bak free) (Travatan z).....................................................57

trazodone hcl tab 50 mg.................................................. 35trazodone hcl tab 100 mg................................................ 35trazodone hcl tab 150 mg................................................ 35trazodone hcl tab 300 mg................................................ 35TRELEGY ELLIPTA- fluticasone-umeclidinium-vilanterolaepb 100-62.5-25 mcg/inh................................................29

TREMFYA- guselkumab soln pen-injector 100 mg/ml....... 61TREMFYA- guselkumab soln prefilled syringe 100 mg/ml........................................................................................61

TRESIBA FLEXTOUCH- insulin degludec soln pen-injector100 unit/ml......................................................................... 16

TRESIBA FLEXTOUCH- insulin degludec soln pen-injector200 unit/ml......................................................................... 16

TRESIBA- insulin degludec inj 100 unit/ml........................ 16tretinoin cap 10 mg.............................................................9tretinoin cream 0.025% (Retin-a).....................................61tretinoin cream 0.05% (Retin-a).......................................61tretinoin cream 0.1% (Retin-a).........................................61tretinoin gel 0.01% (Retin-a)............................................ 61tretinoin gel 0.025% (Retin-a)..........................................61tretinoin microsphere gel 0.04% (Retin-a micro).......... 61tretinoin microsphere gel 0.1% (Retin-a micro)............ 61TRETTEN- coagulation factor xiii a-subunit for inj2000-3125 unit...................................................................56

TREXALL- methotrexate sodium tab 5 mg (base equiv)..... 9TREXALL- methotrexate sodium tab 7.5 mg (baseequiv)....................................................................................9

TREXALL- methotrexate sodium tab 10 mg (baseequiv)....................................................................................9

TREXALL- methotrexate sodium tab 15 mg (baseequiv)....................................................................................9

triamcinolone acetonide cream 0.025%......................... 61triamcinolone acetonide cream 0.1%............................. 61triamcinolone acetonide cream 0.5%............................. 61

2020


triamcinolone acetonide dental paste 0.1%.................. 58triamcinolone acetonide lotion 0.025%..........................61triamcinolone acetonide lotion 0.1%..............................61triamcinolone acetonide oint 0.025%............................. 61triamcinolone acetonide oint 0.1%................................. 61triamcinolone acetonide oint 0.5%................................. 61triamterene & hydrochlorothiazide cap 37.5-25 mg(Dyazide)........................................................................... 24

triamterene & hydrochlorothiazide tab 37.5-25 mg(Maxzide-25)..................................................................... 24

triamterene & hydrochlorothiazide tab 75-50 mg(Maxzide)...........................................................................24

trifluoperazine hcl tab 1 mg (base equivalent)..............37trifluoperazine hcl tab 2 mg (base equivalent)..............37trifluoperazine hcl tab 5 mg (base equivalent)..............37trifluoperazine hcl tab 10 mg (base equivalent)............37TRIFLURIDINE- trifluridine ophth soln 1%.........................57trihexyphenidyl hcl oral soln 0.4 mg/ml.........................49trihexyphenidyl hcl tab 2 mg...........................................49trihexyphenidyl hcl tab 5 mg...........................................49TRIKAFTA- elexacaf-tezacaf-ivacaf 100-50-75 mg&ivacaftor 150 mg tbpk.....................................................29

trimethobenzamide hcl cap 300 mg (Tigan).................. 31trimethoprim tab 100 mg................................................... 6tropicamide ophth soln 0.5%.......................................... 57tropicamide ophth soln 1% (Mydriacyl)......................... 58TRULANCE- plecanatide tab 3 mg.................................... 32TRULICITY- dulaglutide soln pen-injector 0.75mg/0.5ml............................................................................ 15

TRULICITY- dulaglutide soln pen-injector 1.5mg/0.5ml............................................................................ 15

TRUVADA- emtricitabine-tenofovir disoproxil fumarate tab100-150 mg......................................................................... 5




TYMLOS- abaloparatide subcutaneous soln pen-injector3120 mcg/1.56ml...............................................................18

UUDENYCA- pegfilgrastim-cbqv soln prefilled syringe 6mg/0.6ml............................................................................ 51

UPTRAVI- selexipag tab 200 mcg......................................26UPTRAVI- selexipag tab 400 mcg......................................26UPTRAVI- selexipag tab 600 mcg......................................26UPTRAVI- selexipag tab 800 mcg......................................26UPTRAVI- selexipag tab 1000 mcg....................................26UPTRAVI- selexipag tab 1200 mcg....................................26UPTRAVI- selexipag tab 1400 mcg....................................26UPTRAVI- selexipag tab 1600 mcg....................................26

UPTRAVI- selexipag tab therapy pack 200 mcg (140) &800 mcg (60)..................................................................... 26

ursodiol cap 300 mg (Actigall)........................................32ursodiol tab 250 mg (Urso 250)...................................... 32ursodiol tab 500 mg (Urso forte).................................... 32V

valacyclovir hcl tab 1 gm (Valtrex)................................... 5valacyclovir hcl tab 500 mg (Valtrex)............................... 5VALCHLOR- mechlorethamine hcl gel 0.016% (baseequivalent)......................................................................... 61

valganciclovir hcl for soln 50 mg/ml (base equiv)(Valcyte).............................................................................. 5

valganciclovir hcl tab 450 mg (base equivalent)(Valcyte).............................................................................. 5

valproate sodium oral soln 250 mg/5ml (base equiv)(Depakene)........................................................................48

valproic acid cap 250 mg (Depakene)............................48valsartan-hydrochlorothiazide tab 80-12.5 mg (Diovanhct).....................................................................................24

valsartan-hydrochlorothiazide tab 160-12.5 mg (Diovanhct).....................................................................................24

valsartan-hydrochlorothiazide tab 160-25 mg (Diovanhct).....................................................................................24

valsartan-hydrochlorothiazide tab 320-12.5 mg (Diovanhct).....................................................................................24

valsartan-hydrochlorothiazide tab 320-25 mg (Diovanhct).....................................................................................24

valsartan tab 40 mg (Diovan).......................................... 24valsartan tab 80 mg (Diovan).......................................... 24valsartan tab 160 mg (Diovan)........................................ 24valsartan tab 320 mg (Diovan)........................................ 24vancomycin hcl cap 125 mg (base equivalent)(Vancocin hcl).................................................................... 6

vancomycin hcl cap 250 mg (base equivalent)(Vancocin hcl).................................................................... 6

VELPHORO- sucroferric oxyhydroxide chew tab 500mg...................................................................................... 32

VELTASSA- patiromer sorbitex calcium for susp packet8.4 gm (base eq)...............................................................62

VELTASSA- patiromer sorbitex calcium for susp packet16.8 gm (base eq).............................................................62

VELTASSA- patiromer sorbitex calcium for susp packet25.2 gm (base eq).............................................................62

VENCLEXTA STARTING PACK- venetoclax tab therapystarter pack 10 & 50 & 100 mg.......................................... 9

VENCLEXTA- venetoclax tab 10 mg....................................9VENCLEXTA- venetoclax tab 50 mg....................................9VENCLEXTA- venetoclax tab 100 mg..................................9venlafaxine hcl cap er 24hr 37.5 mg (base equivalent)(Effexor xr)....................................................................... 35

venlafaxine hcl cap er 24hr 75 mg (base equivalent)(Effexor xr)....................................................................... 35

2020


venlafaxine hcl cap er 24hr 150 mg (base equivalent)(Effexor xr)....................................................................... 35

venlafaxine hcl tab 25 mg (base equivalent).................35venlafaxine hcl tab 37.5 mg (base equivalent)..............35venlafaxine hcl tab 50 mg (base equivalent).................35venlafaxine hcl tab 75 mg (base equivalent).................35venlafaxine hcl tab 100 mg (base equivalent)...............35VENTOLIN HFA- albuterol sulfate inhal aero 108 mcg/act(90mcg base equiv).......................................................... 29

verapamil hcl cap er 24hr 120 mg (Verelan).................. 20verapamil hcl cap er 24hr 180 mg (Verelan).................. 20verapamil hcl cap er 24hr 240 mg (Verelan).................. 20verapamil hcl tab er 120 mg (Calan sr)..........................20verapamil hcl tab er 180 mg (Calan sr)..........................20verapamil hcl tab er 240 mg (Calan sr)..........................20verapamil hcl tab 40 mg.................................................. 20verapamil hcl tab 80 mg (Calan).....................................20verapamil hcl tab 120 mg (Calan)...................................20VERZENIO- abemaciclib tab 50 mg.....................................9VERZENIO- abemaciclib tab 100 mg...................................9VERZENIO- abemaciclib tab 150 mg...................................9VERZENIO- abemaciclib tab 200 mg...................................9VIBERZI- eluxadoline tab 75 mg........................................32VIBERZI- eluxadoline tab 100 mg......................................32VICTOZA- liraglutide soln pen-injector 18 mg/3ml (6 mg/ml)...................................................................................... 15

vigabatrin powd pack 500 mg (Sabril)........................... 48vigabatrin tab 500 mg (Sabril).........................................48VIREAD- tenofovir disoproxil fumarate oral powder 40 mg/gm........................................................................................ 5

VIREAD- tenofovir disoproxil fumarate tab 150 mg............. 5VIREAD- tenofovir disoproxil fumarate tab 200 mg............. 5VIREAD- tenofovir disoproxil fumarate tab 250 mg............. 5VITRAKVI- larotrectinib sulfate cap 25 mg (baseequivalent)............................................................................9

VITRAKVI- larotrectinib sulfate cap 100 mg (baseequivalent)............................................................................9

VITRAKVI- larotrectinib sulfate oral soln 20 mg/ml (baseequivalent)............................................................................9

VONVENDI- von willebrand factor (recombinant) for inj650 unit..............................................................................56

VONVENDI- von willebrand factor (recombinant) for inj1300 unit............................................................................56

voriconazole for susp 40 mg/ml (Vfend)..........................3voriconazole tab 50 mg (Vfend)........................................3voriconazole tab 200 mg (Vfend)......................................3VOSEVI- sofosbuvir-velpatasvir-voxilaprevir tab400-100-100 mg.................................................................. 5

VOTRIENT- pazopanib hcl tab 200 mg (base equiv)...........9VUMERITY- diroximel fumarate capsule delayed release231 mg...............................................................................41

VUMERITY- diroximel fumarate capsule dr starter bottle231 mg...............................................................................41

VYNDAMAX- tafamidis cap 61 mg.....................................26VYNDAQEL- tafamidis meglumine (cardiac) cap 20mg...................................................................................... 26

VYVANSE- lisdexamfetamine dimesylate cap 10 mg........ 39VYVANSE- lisdexamfetamine dimesylate cap 20 mg........ 39VYVANSE- lisdexamfetamine dimesylate cap 30 mg........ 39VYVANSE- lisdexamfetamine dimesylate cap 40 mg........ 39VYVANSE- lisdexamfetamine dimesylate cap 50 mg........ 39VYVANSE- lisdexamfetamine dimesylate cap 60 mg........ 39VYVANSE- lisdexamfetamine dimesylate cap 70 mg........ 39VYVANSE- lisdexamfetamine dimesylate chew tab 10mg...................................................................................... 39

VYVANSE- lisdexamfetamine dimesylate chew tab 20mg...................................................................................... 39





Wwarfarin sodium tab 1 mg (Coumadin).......................... 51warfarin sodium tab 2 mg (Coumadin).......................... 51warfarin sodium tab 2.5 mg (Coumadin)....................... 51warfarin sodium tab 3 mg (Coumadin).......................... 51warfarin sodium tab 4 mg (Coumadin).......................... 51warfarin sodium tab 5 mg (Coumadin).......................... 51warfarin sodium tab 6 mg (Coumadin).......................... 51warfarin sodium tab 7.5 mg (Coumadin)....................... 51warfarin sodium tab 10 mg (Coumadin)........................ 51WILATE- antihemophilic factor/vwf (human) for inj 500-500unit kit................................................................................ 56

WILATE- antihemophilic factor/vwf (human) for inj1000-1000 unit kit..............................................................56

XXALKORI- crizotinib cap 200 mg......................................... 9XALKORI- crizotinib cap 250 mg......................................... 9XARELTO- rivaroxaban tab 2.5 mg....................................51XARELTO- rivaroxaban tab 10 mg.....................................51XARELTO- rivaroxaban tab 15 mg.....................................51XARELTO- rivaroxaban tab 20 mg.....................................51XARELTO STARTER PACK- rivaroxaban tab startertherapy pack 15 mg & 20 mg...........................................52

XELJANZ- tofacitinib citrate tab 5 mg (baseequivalent)......................................................................... 45

XELJANZ- tofacitinib citrate tab 10 mg (baseequivalent)......................................................................... 45

XELJANZ XR- tofacitinib citrate tab er 24hr 11 mg (baseequivalent)......................................................................... 45

2020


XELJANZ XR- tofacitinib citrate tab er 24hr 22 mg (baseequivalent)......................................................................... 45

XIFAXAN- rifaximin tab 550 mg........................................... 6XTAMPZA ER- oxycodone cap er 12hr abuse-deterrent 9mg...................................................................................... 43

XTAMPZA ER- oxycodone cap er 12hr abuse-deterrent13.5 mg..............................................................................43

XTAMPZA ER- oxycodone cap er 12hr abuse-deterrent 18mg...................................................................................... 43



XTANDI- enzalutamide cap 40 mg.......................................9XULTOPHY 100/3.6- insulin degludec-liraglutide sol pen-inj 100-3.6 unit-mg/ml....................................................... 15

XYNTHA- antihemophilic factor recombinant paf for inj kit250 unit..............................................................................56

XYNTHA- antihemophilic factor recombinant paf for inj kit500 unit..............................................................................56

XYNTHA- antihemophilic factor recombinant paf for inj kit1000 unit............................................................................56

XYNTHA- antihemophilic factor recombinant paf for inj kit2000 unit............................................................................56

XYNTHA SOLOFUSE- antihemophilic factor recombinantpaf for inj kit 250 unit........................................................56

XYNTHA SOLOFUSE- antihemophilic factor recombinantpaf for inj kit 500 unit........................................................56

XYNTHA SOLOFUSE- antihemophilic factor recombinantpaf for inj kit 1000 unit......................................................56



YYONSA- abiraterone acetate tab 125 mg............................ 9

Zzafirlukast tab 10 mg (Accolate)..................................... 29zafirlukast tab 20 mg (Accolate)..................................... 29zaleplon cap 5 mg (Sonata).............................................37zaleplon cap 10 mg (Sonata)...........................................37ZARXIO- filgrastim-sndz soln prefilled syringe 300mcg/0.5ml...........................................................................51

ZARXIO- filgrastim-sndz soln prefilled syringe 480mcg/0.8ml...........................................................................51

ZELBORAF- vemurafenib tab 240 mg................................. 9ZENPEP- pancrelipase (lip-prot-amyl) dr cap3000-10000-14000 unit..................................................... 31

ZENPEP- pancrelipase (lip-prot-amyl) dr cap5000-17000-24000 unit..................................................... 31

ZENPEP- pancrelipase (lip-prot-amyl) dr cap10000-32000-42000 unit...................................................31



ZENPEP- pancrelipase (lip-prot-amyl) dr cap25000-79000-105000 unit.................................................31

ZENPEP- pancrelipase (lip-prot-amyl) dr cap40000-126000-168000 unit...............................................31

ZEPOSIA 7-DAY STARTER PAC- ozanimod cap pack 4 x0.23 mg & 3 x 0.46 mg.....................................................41

ZEPOSIA- ozanimod hcl cap 0.92 mg............................... 41ZEPOSIA STARTER KIT- ozanimod cap pack 4 x 0.23 mg& 3 x 0.46 mg & 30 x 0.92 mg.........................................41

zidovudine cap 100 mg (Retrovir).....................................5zidovudine syrup 10 mg/ml (Retrovir)..............................5zidovudine tab 300 mg.......................................................5ZIEXTENZO- pegfilgrastim-bmez soln prefilled syringe 6mg/0.6ml............................................................................ 51

ziprasidone hcl cap 20 mg (Geodon)............................. 37ziprasidone hcl cap 40 mg (Geodon)............................. 37ziprasidone hcl cap 60 mg (Geodon)............................. 37ziprasidone hcl cap 80 mg (Geodon)............................. 37zolpidem tartrate tab er 6.25 mg (Ambien cr)................37zolpidem tartrate tab er 12.5 mg (Ambien cr)................37zolpidem tartrate tab 5 mg (Ambien)..............................37zolpidem tartrate tab 10 mg (Ambien)............................37zonisamide cap 50 mg..................................................... 48zonisamide cap 25 mg (Zonegran)................................. 48zonisamide cap 100 mg (Zonegran)............................... 48ZORTRESS- everolimus tab 0.25 mg................................62ZORTRESS- everolimus tab 0.5 mg.................................. 63ZORTRESS- everolimus tab 0.75 mg................................63ZORTRESS- everolimus tab 1 mg..................................... 63ZYCLARA- imiquimod cream 3.75%..................................61ZYCLARA PUMP- imiquimod cream 2.5%........................ 61ZYCLARA PUMP- imiquimod cream 3.75%...................... 61ZYLET- loteprednol etabonate-tobramycin ophth susp0.5-0.3%.............................................................................58

ZYTIGA- abiraterone acetate tab 500 mg............................9

basic annual drug list - bcbsil

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