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1 of 2 2019 FORMULARY$10 $20 $30 $40 $50 $60 $70

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Brand/Generic Product Name | Dosage Form Brand/Generic Product Name | Dosage Form

Generic Acetaminophen-Codeine #2 Tabs 300-15MG Tablet Brand Ferrotrin Caps Capsule

Brand Adrenal C Formula Tabs Tablet Generic Fluoxetine HCl Caps 20MG Capsule

Generic Allopurinol Tabs 100MG Tablet Generic Folic Acid Tabs 1MG Tablet

Generic Alprazolam Tabs 0.25MG Tablet Generic Furosemide Tabs 20MG Tablet

Generic Alprazolam Tabs 0.5MG Tablet Generic Furosemide Tabs 40MG Tablet

Generic Alprazolam Tabs 1MG Tablet Generic Gabapentin Caps 100MG Capsule

Generic Alprazolam Tabs 2MG Tablet Generic Gabapentin Caps 300MG Capsule

Generic Alprazolam XR Tb24 1MG Tablet 24-Hr ER Generic Glimepiride Tabs 2MG Tablet

Generic Amitriptyline HCl Tabs 10MG Tablet Generic Glipizide ER Tb24 2.5MG Tablet 24-Hr ER

Generic Amlodipine Besylate Tabs 10MG Tablet Generic Glipizide ER Tb24 5MG Tablet 24-Hr ER

Generic Amlodipine Besylate Tabs 2.5MG Tablet Generic Glipizide Tabs 5MG Tablet

Generic Amlodipine Besylate Tabs 5MG Tablet Generic Glyburide Micronized Tabs 1.5MG Tablet

Generic Amoxicillin Caps 250MG Capsule Generic Glyburide Micronized Tabs 3MG Tablet

Brand Amoxicillin Chew 125MG Chewable Tablet Generic Glyburide Tabs 1.25MG Tablet

Brand Anaspaz TbDp 0.125MG Disintegrating Tablet Brand Guanidine HCl Tabs 125MG Tablet

Generic Atenolol Tabs 25MG Tablet Generic Haloperidol Tabs 0.5MG Tablet

Generic Atorvastatin Calcium Tabs 10MG Tablet Generic Hemocyte-F Tabs 324-1MG Tablet

Brand B-6 Folic Acid Caps 400-1000-50MCG-MCG-MG Capsule Generic Hydralazine HCl Tabs 10MG Tablet

Generic Benztropine Mesylate Tabs 0.5MG Tablet Generic Hydralazine HCl Tabs 25MG Tablet

Generic Benztropine Mesylate Tabs 1MG Tablet Generic Hydrochlorothiazide Caps 12.5MG Capsule

Generic B-Plex Plus Tabs Tablet Generic Hydrochlorothiazide Tabs 12.5MG Tablet

Brand Capsule Coni-Snap #1 White Caps Capsule Generic Hydrochlorothiazide Tabs 25MG Tablet

Brand Capsule Coni-Snap #3 Clear Caps Capsule Generic Hydrochlorothiazide Tabs 50MG Tablet

Generic Carisoprodol Tabs 350MG Tablet Generic Hydrocodone-Acetaminophen Tabs 7.5-325MG Tablet

Generic Carvedilol Tabs 25MG Tablet Generic Hydrocortisone Tabs 5MG Tablet

Generic Cephalexin Caps 500MG Capsule Generic Hydroxyzine Pamoate Caps 25MG Capsule

Generic Chlordiazepoxide HCl Caps 10MG Capsule Generic Hydroxyzine Pamoate Caps 50MG Capsule

Generic Chlordiazepoxide HCl Caps 25MG Capsule Generic Ibuprofen Tabs 400MG Tablet

Generic Chlordiazepoxide HCl Caps 5MG Capsule Generic Imipramine HCl Tabs 10MG Tablet

Generic Citalopram Hydrobromide Tabs 20MG Tablet Generic Indomethacin Caps 25MG Capsule

Generic Clonazepam Tabs 0.5MG Tablet Generic Isoniazid Tabs 300MG Tablet

Generic Clonazepam Tabs 1MG Tablet Generic Lisinopril Tabs 10MG Tablet

Generic Clonazepam Tabs 2MG Tablet Generic Lisinopril Tabs 2.5MG Tablet

Generic Clonidine HCl Tabs 0.1MG Tablet Generic Lisinopril Tabs 20MG Tablet

Generic Clonidine HCl Tabs 0.2MG Tablet Generic Lisinopril Tabs 40MG Tablet

Generic Clopidogrel Bisulfate Tabs 75MG Tablet Generic Lisinopril Tabs 5MG Tablet

Brand Co-Natal Fa Tabs Tablet Generic Lisinopril-Hydrochlorothiazide Tabs 20-12.5MG Tablet

Generic Cyclobenzaprine HCl Tabs 10MG Tablet Generic Lisinopril-Hydrochlorothiazide Tabs 20-25MG Tablet

Generic Dexamethasone Tabs 0.5MG Tablet Generic Lithium Carbonate Caps 150MG Capsule

Generic Dexamethasone Tabs 0.75MG Tablet Brand Lithium Carbonate Caps 150MG Capsule

Brand Dexamethasone Tabs 1MG Tablet Generic Lithium Carbonate Caps 300MG Capsule

Generic Dexmethylphenidate HCl Tabs 5MG Tablet Generic Lithium Carbonate Caps 600MG Capsule

Brand Dialyvite 3000 Tabs 3MG Tablet Generic Lithium Carbonate ER TbCR 300MG Tablet ER

Brand Dialyvite Supreme D Tabs 3MG Tablet Generic Lithium Carbonate ER TbCR 450MG Tablet ER

Brand Dialyvite/Zinc Tabs Tablet Generic Lithium Carbonate Tabs 300MG Tablet

Generic Diazepam Tabs 10MG Tablet Generic Lorazepam Tabs 0.5MG Tablet

Generic Diazepam Tabs 2MG Tablet Generic Lorazepam Tabs 1MG Tablet

Generic Diazepam Tabs 5MG Tablet Generic Losartan Potassium Tabs 100MG Tablet

Generic Dicyclomine HCl Caps 10MG Capsule Generic Losartan Potassium Tabs 25MG Tablet

Generic Dicyclomine HCl Tabs 20MG Tablet Generic Losartan Potassium Tabs 50MG Tablet

Generic Diethylpropion HCl Tabs 25MG Tablet Generic Losartan Potassium-HCTZ Tabs 100-12.5MG Tablet

Generic Eszopiclone Tabs 1MG Tablet Generic Losartan Potassium-HCTZ Tabs 100-25MG Tablet

Generic Fa-Vitamin B-6-Vitamin B-12 Tabs 2.2-25-0.5MG Tablet Generic Losartan Potassium-HCTZ Tabs 50-12.5MG Tablet

Generic Ferotrinsic Caps Capsule Brand Magnebind 400 Tabs 400-200-1MG Tablet

Generic Ferrocite Plus Tabs 106-1MG Tablet Generic Meclizine HCl Tabs 12.5MG Tablet

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Generic Meclizine HCl Tabs 25MG Tablet Generic Prednisone Tabs 20MG Tablet

Generic Medroxyprogesterone Acetate Tabs 2.5MG Tablet Generic Prednisone Tabs 5MG Tablet

Generic Meloxicam Tabs 15MG Tablet Brand Prenata Chew 29-1MG Chewable Tablet

Generic Meloxicam Tabs 7.5MG Tablet Generic Propranolol HCl Tabs 10MG Tablet

Generic Metformin HCl ER Tb24 500MG Tablet 24-Hr ER Brand Quinidine Sulfate Tabs 200MG Tablet

Generic Metformin HCl Tabs 500MG Tablet Generic Sertraline HCl Tabs 100MG Tablet

Generic Methadone HCl Tabs 10MG Tablet Generic Sertraline HCl Tabs 25MG Tablet

Generic Methadone HCl Tabs 5MG Tablet Generic Sertraline HCl Tabs 50MG Tablet

Generic Methyldopa Tabs 250MG Tablet Generic Simvastatin Tabs 10MG Tablet

Generic Methylprednisolone Tabs 4MG Tablet Generic Simvastatin Tabs 20MG Tablet

Generic Metoclopramide HCl Tabs 10MG Tablet Generic Simvastatin Tabs 40MG Tablet

Generic Metoclopramide HCl Tabs 5MG Tablet Generic Sodium Fluoride Chew 0.55 (0.25 F)MG Chewable Tablet

Generic Metoprolol Tartrate Tabs 25MG Tablet Generic Sodium Fluoride Chew 1.1 (0.5 F)MG Chewable Tablet

Generic Minoxidil Tabs 2.5MG Tablet Generic Sodium Fluoride Chew 2.2 (1 F)MG Chewable Tablet

Generic Montelukast Sodium Tabs 10MG Tablet Brand Sodium Fluoride Tabs 1.1 (0.5 F)MG Tablet

Brand Multivitamin/Fluoride Chew 0.25-0.3MG Chewable Tablet Brand Sodium Fluoride Tabs 2.2 (1 F)MG Tablet

Brand Multivitamin/Fluoride Chew 0.25MG Chewable Tablet Generic Spironolactone Tabs 25MG Tablet

Brand Multivitamin/Fluoride Chew 0.5-0.3MG Chewable Tablet Generic Sulfamethoxazole-Trimethoprim Tabs 800-160MG Tablet

Brand Multivitamin/Fluoride Chew 0.5MG Chewable Tablet Generic Sulfasalazine Tabs 500MG Tablet

Brand Multivitamin/Fluoride Chew 1-0.3MG Chewable Tablet Generic Tamsulosin HCl Caps 0.4MG Capsule

Brand Multivitamin/Fluoride Chew 1MG Chewable Tablet Generic Terazosin HCl Caps 10MG Capsule

Generic MVC-Fluoride Chew 0.25MG Chewable Tablet Generic Terazosin HCl Caps 5MG Capsule

Generic MVC-Fluoride Chew 0.5MG Chewable Tablet Generic Theochron Tb12 100MG Tablet 12-Hr ER

Generic MVC-Fluoride Chew 1MG Chewable Tablet Generic Theochron Tb12 200MG Tablet 12-Hr ER

Brand Mynatal Caps Capsule Brand Tl Folate Tabs 27-0.5-0.5MG Tablet

Brand Mynatal Tabs 90-1MG Tablet Generic Tl Gard Rx Tabs 2.2-25-1MG Tablet

Brand Mynate 90 Plus TbCR Tablet ER Brand Tl G-Fol Os Tabs 500-1.1MG Tablet

Brand Natalvit Tabs Tablet Generic Topiramate Tabs 50MG Tablet

Generic Nortriptyline HCl Caps 75MG Capsule Generic Tramadol HCl Tabs 50MG Tablet

Brand O-Cal Fa Tabs 27-1MG Tablet Brand Traumeel Tabs Tablet

Brand O-Cal Prenatal Tabs Tablet Generic Trazodone HCl Tabs 50MG Tablet

Generic Omeprazole CpDR 20MG Capsule DR/EC Generic Triamterene-HCTZ Caps 37.5-25MG Capsule

Generic Pantoprazole Sodium TbEC 40MG Tablet DR/EC Generic Triamterene-HCTZ Tabs 37.5-25MG Tablet

Generic Paroxetine HCl Tabs 10MG Tablet Generic Trihexyphenidyl HCl Tabs 5MG Tablet

Generic Paroxetine HCl Tabs 20MG Tablet Brand Trinatal Rx 1 Tabs 60-1MG Tablet

Generic Paroxetine HCl Tabs 30MG Tablet Generic Valsartan Tabs 40MG Tablet

Generic Pharbedryl Caps 50MG Capsule Generic Valsartan-Hydrochlorothiazide Tabs 160-12.5MG Tablet

Generic Phendimetrazine Tartrate Tabs 35MG Tablet Generic Valsartan-Hydrochlorothiazide Tabs 160-25MG Tablet

Generic Phenobarbital Tabs 15MG Tablet Generic Valsartan-Hydrochlorothiazide Tabs 320-12.5MG Tablet

Generic Phenobarbital Tabs 30MG Tablet Generic Valsartan-Hydrochlorothiazide Tabs 80-12.5MG Tablet

Generic Phenobarbital Tabs 60MG Tablet Generic Verapamil HCl Tabs 120MG Tablet

Generic Phenytoin Sodium Extended Caps 100MG Capsule Generic Verapamil HCl Tabs 40MG Tablet

Brand Placebo #00 Caps Capsule Brand Vinate Ii Tabs 29-1MG Tablet

Generic Polysaccharide Iron Forte Caps 150-25-1MG-MCG-MG Capsule Brand Vinate M Tabs 27-1MG Tablet

Generic Prednisone Tabs 10MG Tablet Generic Vita-Min Caps Capsule

Generic Prednisone Tabs 1MG Tablet Brand WP Thyroid Tabs 16.25MG Tablet

Generic Prednisone Tabs 2.5MG Tablet Generic Zonisamide Caps 25MG Capsule

1 of 3 2019 FORMULARY$10 $20 $30 $40 $50 $60 $70

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Generic Acarbose Tabs 100MG Tablet Generic Dexamethasone Tabs 1.5MG Tablet

Generic Acarbose Tabs 25MG Tablet Brand Dexamethasone Tabs 2MG Tablet

Generic Acebutolol HCl Caps 200MG Capsule Generic Dexmethylphenidate HCl Tabs 2.5MG Tablet

Generic Acebutolol HCl Caps 400MG Capsule Brand Dialyvite 5000 Tabs 5MG Tablet

Generic Acetaminophen-Codeine #3 Tabs 300-30MG Tablet Generic Diltiazem HCl ER Beads Cp24 180MG Capsule 24 Hr ER

Generic Acetaminophen-Codeine #4 Tabs 300-60MG Tablet Generic Dilt-XR Cp24 120MG Capsule 24 Hr ER

Generic Acyclovir Caps 200MG Capsule Generic Diphenoxylate-Atropine Tabs 2.5-0.025MG Tablet

Generic Airavite Tabs 2.5-25-1MG Tablet Generic Dipyridamole Tabs 25MG Tablet

Generic Alendronate Sodium Tabs 35MG Tablet Generic Divalproex Sodium ER Tb24 250MG Tablet 24-Hr ER

Generic Allopurinol Tabs 300MG Tablet Generic Divalproex Sodium ER Tb24 500MG Tablet 24-Hr ER

Generic Amiloride-Hydrochlorothiazide Tabs 5-50MG Tablet Generic Divalproex Sodium TbEC 125MG Tablet DR/EC

Generic Amitriptyline HCl Tabs 25MG Tablet Brand Dolophine Tabs 10MG Tablet

Brand Amoxapine Tabs 25MG Tablet Brand Dolophine Tabs 5MG Tablet

Generic Amoxicillin Caps 500MG Capsule Generic Doxepin HCl Caps 10MG Capsule

Brand Amoxicillin Chew 250MG Chewable Tablet Generic Doxepin HCl Caps 25MG Capsule

Generic Amoxicillin Tabs 500MG Tablet Generic Doxycycline Hyclate Tabs 20MG Tablet

Generic Amoxicillin Tabs 875MG Tablet Generic Duloxetine HCl CpEP 30MG Capsule DR/EC

Brand Ampicillin Caps 500MG Capsule Generic Duloxetine HCl CpEP 60MG Capsule DR/EC

Brand Armour Thyroid Tabs 15MG Tablet Brand Duraxin Caps 300-200-20MG Capsule

Brand Armour Thyroid Tabs 30MG Tablet Generic Ed-Spaz TbDp 0.125MG Disintegrating Tablet

Brand Atabex EC TbEC 29-1MG Tablet DR/EC Brand Effer-K TbEf 10Meq Effervescent Tablet

Generic Atenolol Tabs 100MG Tablet Brand Effer-K TbEf 20Meq Effervescent Tablet

Generic Atenolol Tabs 50MG Tablet Generic Effervescent Pot Chloride TbEf 25Meq Effervescent Tablet

Generic Atorvastatin Calcium Tabs 20MG Tablet Generic Enalapril-Hydrochlorothiazide Tabs 10-25MG Tablet

Generic Atorvastatin Calcium Tabs 40MG Tablet Generic Enalapril-Hydrochlorothiazide Tabs 5-12.5MG Tablet

Generic Atorvastatin Calcium Tabs 80MG Tablet Generic Escitalopram Oxalate Tabs 10MG Tablet

Brand Availnex Chew 750MG Chewable Tablet Generic Estazolam Tabs 1MG Tablet

Generic Benazepril HCl Tabs 5MG Tablet Generic Estradiol Tabs 0.5MG Tablet

Generic Benztropine Mesylate Tabs 2MG Tablet Generic Estradiol Tabs 1MG Tablet

Generic Betaxolol HCl Tabs 10MG Tablet Generic Estradiol Tabs 2MG Tablet

Generic Bethanechol Chloride Tabs 5MG Tablet Generic Ethambutol HCl Tabs 100MG Tablet

Brand Bio-Statin Caps 1000000Unit Capsule Generic Fenofibrate Micronized Caps 67MG Capsule

Brand Bio-Statin Caps 500000Unit Capsule Generic Fenofibrate Tabs 54MG Tablet

Generic Bupropion HCl Tabs 75MG Tablet Brand Ferraplus 90 Tabs 90-1MG Tablet

Generic Buspirone HCl Tabs 5MG Tablet Brand Ferro-Plex Hematinic Tabs 115-1MG Tablet

Brand Butalbital-Aspirin-Caffeine Tabs 50-325-40MG Tablet Generic Fludrocortisone Acetate Tabs 0.1MG Tablet

Generic Calcium Acetate (Phos Binder) Caps 667MG Capsule Brand Flurazepam HCl Caps 15MG Capsule

Generic Calcium Acetate (Phos Binder) Tabs 667MG Tablet Generic Flurbiprofen Tabs 100MG Tablet

Generic Carbamazepine Chew 100MG Chewable Tablet Generic Flurbiprofen Tabs 50MG Tablet

Generic Carbidopa-Levodopa ER TbCR 25-100MG Tablet ER Brand Focalin Tabs 2.5MG Tablet

Generic Carbidopa-Levodopa Tabs 10-100MG Tablet Brand Folbee Plus CZ Tabs 5MG Tablet

Generic Carbidopa-Levodopa Tabs 25-100MG Tablet Generic Folbee Plus Tabs Tablet

Generic Carbidopa-Levodopa Tabs 25-250MG Tablet Generic Folbic Tabs 2.5-25-2MG Tablet

Generic Carbidopa-Levodopa TbDp 10-100MG Disintegrating Tablet Brand Folgard Rx Tabs 2.2-25-1MG Tablet

Generic Carbinoxamine Maleate Tabs 4MG Tablet Brand Folivane-F Caps 125-1MG Capsule

Brand Cardiovid Plus Caps Capsule Brand Folivane-Plus Caps Capsule

Generic Carvedilol Tabs 3.125MG Tablet Brand Foltrate Tabs 500-1MCG-MG Tablet

Generic Cephalexin Caps 250MG Capsule Brand Fortavit Caps Capsule

Brand Chlorothiazide Tabs 250MG Tablet Generic Fosinopril Sodium Tabs 40MG Tablet

Generic Chlorothiazide Tabs 500MG Tablet Generic Furosemide Tabs 80MG Tablet

Generic Clonidine HCl Tabs 0.3MG Tablet Generic Gabapentin Tabs 600MG Tablet

Generic Codeine Sulfate Tabs 15MG Tablet Generic Gabapentin Tabs 800MG Tablet

Brand Completenate Chew 29-1MG Chewable Tablet Generic Gemfibrozil Tabs 600MG Tablet

Brand Cystagon Caps 50MG Capsule Generic Glimepiride Tabs 1MG Tablet

Generic Dantrolene Sodium Caps 25MG Capsule Generic Glimepiride Tabs 4MG Tablet

2 of 3 2019 FORMULARY$10 $20 $30 $40 $50 $60 $70

$80 $90 $100 $120 $150 $200$20 Co-Pay Drugs


Generic Glipizide ER Tb24 10MG Tablet 24-Hr ER Brand Lithium Carbonate Caps 600MG Capsule

Generic Glipizide Tabs 10MG Tablet Brand Lomaira Tabs 8MG Tablet

Generic Glipizide-Metformin HCl Tabs 2.5-250MG Tablet Generic Lorazepam Tabs 2MG Tablet

Generic Glyburide Micronized Tabs 6MG Tablet Generic Loxapine Succinate Caps 10MG Capsule

Generic Glyburide Tabs 2.5MG Tablet Generic Loxapine Succinate Caps 5MG Capsule

Generic Glyburide Tabs 5MG Tablet Generic Medroxyprogesterone Acetate Tabs 10MG Tablet

Generic Glyburide-Metformin Tabs 1.25-250MG Tablet Generic Medroxyprogesterone Acetate Tabs 5MG Tablet

Generic Guanfacine HCl Tabs 1MG Tablet Generic Megestrol Acetate Tabs 20MG Tablet

Generic Haloperidol Tabs 1MG Tablet Generic Methenamine Mandelate Tabs 0.5GM Tablet

Generic Haloperidol Tabs 2MG Tablet Generic Methimazole Tabs 10MG Tablet

Brand Hematogen Fa Caps 200-250-0.01-1MG Capsule Generic Methimazole Tabs 5MG Tablet

Brand Hemocyte Plus Caps 106-1MG Capsule Generic Methocarbamol Tabs 500MG Tablet

Generic Hydralazine HCl Tabs 100MG Tablet Generic Methocarbamol Tabs 750MG Tablet

Generic Hydralazine HCl Tabs 50MG Tablet Generic Methyldopa Tabs 500MG Tablet

Generic Hydrocodone-Acetaminophen Tabs 10-325MG Tablet Generic Methylphenidate HCl Tabs 10MG Tablet

Generic Hydrocodone-Acetaminophen Tabs 5-325MG Tablet Generic Methylphenidate HCl Tabs 20MG Tablet

Generic Hydrocodone-Homatropine Tabs 5-1.5MG Tablet Generic Methylphenidate HCl Tabs 5MG Tablet

Generic Hydrocortisone Tabs 10MG Tablet Generic Methylprednisolone TbPk 4MG Tablet Dose Pack

Generic Hydromorphone HCl Tabs 2MG Tablet Generic Metoprolol Tartrate Tabs 100MG Tablet

Generic Hydromorphone HCl Tabs 4MG Tablet Generic Metoprolol Tartrate Tabs 50MG Tablet

Generic Hydroxyzine HCl Tabs 10MG Tablet Generic Metronidazole Tabs 250MG Tablet

Generic Hydroxyzine HCl Tabs 25MG Tablet Generic Metronidazole Tabs 500MG Tablet

Generic Hyoscyamine Sulfate Tabs 0.125MG Tablet Generic Minoxidil Tabs 10MG Tablet

Generic Ibuprofen Tabs 600MG Tablet Generic Misoprostol Tabs 100MCG Tablet

Generic Ibuprofen Tabs 800MG Tablet Generic Morphine Sulfate ER TbCR 15MG Tablet ER

Generic Imipramine HCl Tabs 25MG Tablet Brand Myambutol Tabs 100MG Tablet

Generic Indapamide Tabs 1.25MG Tablet Generic N-Acetyl-L-Cysteine Caps 600MG Capsule

Generic Indomethacin Caps 50MG Capsule Generic Naproxen Tabs 250MG Tablet

Generic Indomethacin ER CpCR 75MG Capsule ER Brand Nature-Throid Tabs 146.25MG Tablet

Generic Isoniazid Tabs 100MG Tablet Brand Nature-Throid Tabs 162.5MG Tablet

Generic Isosorbide Dinitrate Tabs 5MG Tablet Brand Nature-Throid Tabs 260MG Tablet

Generic Isosorbide Mononitrate Tabs 10MG Tablet Brand Nature-Throid Tabs 325MG Tablet

Generic Isosorbide Mononitrate Tabs 20MG Tablet Brand Nephron Fa Tabs Tablet

Generic Isoxsuprine HCl Tabs 10MG Tablet Brand Nephro-Vite Rx Tabs 1MG Tablet

Brand Isoxsuprine HCl Tabs 20MG Tablet Generic Nifedipine Caps 10MG Capsule

Generic K-Effervescent TbEf 25Meq Effervescent Tablet Generic Nitro-Time CpCR 2.5MG Capsule ER

Generic Kelnor 1/50 Tabs 1-50MG-MCG Tablet Generic Nitro-Time CpCR 6.5MG Capsule ER

Brand K-Phos Tabs 500MG Tablet Generic Nitro-Time CpCR 9MG Capsule ER

Brand K-Tab TbCR 8Meq Tablet ER Generic Nortriptyline HCl Caps 10MG Capsule

Generic K-Tan Plus Caps 162-115.2-1MG Capsule Generic Np Thyroid Tabs 15MG Tablet

Generic Labetalol HCl Tabs 100MG Tablet Generic Np Thyroid Tabs 30MG Tablet

Generic Labetalol HCl Tabs 200MG Tablet Generic Np Thyroid Tabs 60MG Tablet

Generic Lamotrigine Tabs 150MG Tablet Brand Obstetrix EC Tabs 29-1MG Tablet

Brand Lasix Tabs 20MG Tablet Generic Omeprazole CpDR 40MG Capsule DR/EC

Generic Levo-T Tabs 137MCG Tablet Generic Oxcarbazepine Tabs 150MG Tablet

Generic Levothyroxine Sodium Tabs 100MCG Tablet Generic Oxcarbazepine Tabs 300MG Tablet

Generic Levothyroxine Sodium Tabs 112MCG Tablet Generic Oxybutynin Chloride Tabs 5MG Tablet

Generic Levothyroxine Sodium Tabs 125MCG Tablet Generic Oxycodone HCl Tabs 10MG Tablet

Generic Levothyroxine Sodium Tabs 150MCG Tablet Generic Oxycodone HCl Tabs 5MG Tablet

Generic Levothyroxine Sodium Tabs 175MCG Tablet Generic Oxycodone-Acetaminophen Tabs 5-325MG Tablet

Generic Levothyroxine Sodium Tabs 200MCG Tablet Generic Paroxetine HCl Tabs 40MG Tablet

Generic Levothyroxine Sodium Tabs 25MCG Tablet Generic Penicillin V Potassium Tabs 250MG Tablet

Generic Levothyroxine Sodium Tabs 50MCG Tablet Generic Penicillin V Potassium Tabs 500MG Tablet

Generic Levothyroxine Sodium Tabs 75MCG Tablet Generic Phenelzine Sulfate Tabs 15MG Tablet

Generic Levothyroxine Sodium Tabs 88MCG Tablet Generic Phenobarbital Tabs 100MG Tablet

3 of 3 2019 FORMULARY$10 $20 $30 $40 $50 $60 $70

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Generic Phenobarbital Tabs 16.2MG Tablet Generic Terazosin HCl Caps 2MG Capsule

Generic Phenobarbital Tabs 32.4MG Tablet Generic Thioridazine HCl Tabs 10MG Tablet

Generic Phenobarbital Tabs 64.8MG Tablet Generic Thioridazine HCl Tabs 25MG Tablet

Generic Phentermine HCl Tabs 37.5MG Tablet Generic Thiothixene Caps 1MG Capsule

Generic Phenytoin Chew 50MG Chewable Tablet Brand Thyrolar-1 Tabs 60 (12.5-50)MG (MCG) Tablet

Generic Phospho-Trin 250 Neutral Tabs 155-852-130MG Tablet Brand Thyrolar-1/2 Tabs 30 (6.25-25)MG (MCG) Tablet

Brand PKU Easy Microtabs TbEC Tablet DR/EC Brand Thyrolar-1/4 Tabs 15 (3.1-12.5)MG (MCG) Tablet

Generic Potassium Chloride Crys ER TbCR 10Meq Tablet ER Generic Tizanidine HCl Tabs 2MG Tablet

Generic Potassium Chloride Crys ER TbCR 20Meq Tablet ER Generic Tizanidine HCl Tabs 4MG Tablet

Generic Potassium Chloride ER CpCR 8Meq Capsule ER Brand Tl-Fluorivite Chew 0.25-7.5MG Chewable Tablet

Generic Potassium Chloride ER TbCR 10Meq Tablet ER Generic Tl-Hem 150 Tabs 150-1MG Tablet

Generic Potassium Chloride ER TbCR 20Meq Tablet ER Brand Tl-Icare Caps Capsule

Generic Potassium Chloride ER TbCR 8Meq Tablet ER Brand Tolmetin Sodium Tabs 200MG Tablet

Generic Pravastatin Sodium Tabs 80MG Tablet Generic Torsemide Tabs 10MG Tablet

Generic Prazosin HCl Caps 1MG Capsule Generic Torsemide Tabs 20MG Tablet

Brand Prednisone Tabs 50MG Tablet Generic Torsemide Tabs 5MG Tablet

Brand Prednisone TbPk 5MG (21) Tablet Dose Pack Generic Trandolapril Tabs 1MG Tablet

Brand Prednisone TbPk 5MG (48) Tablet Dose Pack Generic Trandolapril Tabs 2MG Tablet

Generic Primidone Tabs 50MG Tablet Generic Trandolapril Tabs 4MG Tablet

Generic Prochlorperazine Maleate Tabs 10MG Tablet Brand Tricor Tabs 48MG Tablet

Generic Prochlorperazine Maleate Tabs 5MG Tablet Generic Trifluoperazine HCl Tabs 1MG Tablet

Generic Promethazine HCl Tabs 12.5MG Tablet Generic Trigels-F Forte Caps 460-60-0.01-1MG Capsule

Generic Promethazine HCl Tabs 25MG Tablet Generic Trihexyphenidyl HCl Tabs 2MG Tablet

Generic Promethazine HCl Tabs 50MG Tablet Generic Trimethoprim Tabs 100MG Tablet

Generic Propranolol HCl Tabs 20MG Tablet Generic Triphrocaps Caps 1MG Capsule

Generic Propranolol HCl Tabs 40MG Tablet Brand Tryptophan Caps 500MG Capsule

Generic Propranolol HCl Tabs 80MG Tablet Brand Udamin Sp Tabs 1MG Tablet

Generic Propylthiouracil Tabs 50MG Tablet Generic Urosex Tabs Tablet

Brand Purefe OB Plus Caps 162-115.2-1MG Capsule Generic Valsartan-Hydrochlorothiazide Tabs 320-25MG Tablet

Generic Quinapril HCl Tabs 5MG Tablet Generic Verapamil HCl Tabs 80MG Tablet

Brand Quinidine Sulfate Tabs 300MG Tablet Brand Vital-D Rx Tabs 1MG Tablet

Generic Ramipril Caps 1.25MG Capsule Generic Vol-Care Rx Tabs 1MG Tablet

Brand Renatabs Tabs 1MG Tablet Brand Vol-Nate Tabs 28-1MG Tablet

Brand Ritalin Tabs 5MG Tablet Brand Vol-Tab Rx Tabs 29-1MG Tablet

Generic Rizatriptan Benzoate Tabs 10MG Tablet Generic Warfarin Sodium Tabs 1MG Tablet

Generic Ropinirole HCl Tabs 0.25MG Tablet Generic Warfarin Sodium Tabs 2.5MG Tablet

Generic Salsalate Tabs 500MG Tablet Generic Warfarin Sodium Tabs 2MG Tablet

Generic Simvastatin Tabs 5MG Tablet Generic Warfarin Sodium Tabs 3MG Tablet

Generic Spironolactone Tabs 50MG Tablet Generic Warfarin Sodium Tabs 4MG Tablet

Generic Sucralfate Tabs 1GM Tablet Generic Warfarin Sodium Tabs 5MG Tablet

Generic Sulfamethoxazole-Trimethoprim Tabs 400-80MG Tablet Generic Warfarin Sodium Tabs 6MG Tablet

Generic Sulfasalazine TbEC 500MG Tablet DR/EC Generic Warfarin Sodium Tabs 7.5MG Tablet

Generic Sulindac Tabs 150MG Tablet Generic Wera Tabs 0.5-35MG-MCG Tablet

Brand Tandem F Caps 162-115.2-1MG Capsule Brand Westhroid Tabs 195MG Tablet

Brand Tandem Plus Caps 162-115.2-1MG Capsule Brand WP Thyroid Tabs 113.75MG Tablet

Brand Taron Forte Caps Capsule Brand WP Thyroid Tabs 32.5MG Tablet

Generic Telmisartan Tabs 80MG Tablet Brand WP Thyroid Tabs 48.75MG Tablet

Generic Temazepam Caps 15MG Capsule Brand WP Thyroid Tabs 65MG Tablet

Generic Temazepam Caps 30MG Capsule Brand WP Thyroid Tabs 81.25MG Tablet

Brand Tencon Tabs 50-325MG Tablet Brand WP Thyroid Tabs 97.5MG Tablet

Generic Terazosin HCl Caps 1MG Capsule

1 of 3 2019 FORMULARY$10 $20 $30 $40 $50 $60 $70

$80 $90 $100 $120 $150 $200$30 Co-Pay Drugs


Generic Acarbose Tabs 50MG Tablet Generic Clonazepam TbDp 0.5MG Disintegrating Tablet

Generic Alprazolam TbDp 0.25MG Disintegrating Tablet Generic Clonazepam TbDp 1MG Disintegrating Tablet

Generic Alprazolam XR Tb24 0.5MG Tablet 24-Hr ER Generic Clozapine Tabs 25MG Tablet

Generic Amiloride HCl Tabs 5MG Tablet Brand Codeine Sulfate Tabs 15MG Tablet

Generic Amitriptyline HCl Tabs 50MG Tablet Generic Codeine Sulfate Tabs 30MG Tablet

Generic Amlodipine Besy-Benazepril HCl Caps 2.5-10MG Capsule Brand Codeine Sulfate Tabs 30MG Tablet

Generic Amlodipine Besy-Benazepril HCl Caps 5-10MG Capsule Generic Colchicine-Probenecid Tabs 0.5-500MG Tablet

Generic Amlodipine Besy-Benazepril HCl Caps 5-20MG Capsule Generic Colestipol HCl Tabs 1GM Tablet

Brand Amoxapine Tabs 50MG Tablet Brand Cortef Tabs 5MG Tablet

Generic Amphetamine-Dextroamphetamine Tabs 10MG Tablet Generic Corvita Tabs 1.25MG Tablet

Generic Amphetamine-Dextroamphetamine Tabs 12.5MG Tablet Brand Corvite Tabs 1.25MG Tablet

Generic Amphetamine-Dextroamphetamine Tabs 15MG Tablet Generic Cryselle-28 Tabs 0.3-30MG-MCG Tablet

Generic Amphetamine-Dextroamphetamine Tabs 20MG Tablet Generic Cyclafem 1/35 Tabs 1-35MG-MCG Tablet

Generic Amphetamine-Dextroamphetamine Tabs 30MG Tablet Generic Cyclafem 7/7/7 Tabs 0.5/0.75/1-35MG-MCG Tablet

Generic Amphetamine-Dextroamphetamine Tabs 5MG Tablet Generic Cyclobenzaprine HCl Tabs 5MG Tablet

Generic Amphetamine-Dextroamphetamine Tabs 7.5MG Tablet Generic Cyproheptadine HCl Tabs 4MG Tablet

Generic Aranelle Tabs 0.5/1/0.5-35MG-MCG Tablet Brand Cystagon Caps 150MG Capsule

Brand Armour Thyroid Tabs 180MG Tablet Brand Dantrium Caps 25MG Capsule

Brand Armour Thyroid Tabs 60MG Tablet Generic Dantrolene Sodium Caps 50MG Capsule

Brand Baclofen Tabs 5MG Tablet Generic Desipramine HCl Tabs 10MG Tablet

Generic Balsalazide Disodium Caps 750MG Capsule Generic Desipramine HCl Tabs 25MG Tablet

Generic Benazepril HCl Tabs 10MG Tablet Generic Desmopressin Acetate Tabs 0.1MG Tablet

Generic Benazepril HCl Tabs 20MG Tablet Generic Dexamethasone Tabs 4MG Tablet

Generic Benazepril HCl Tabs 40MG Tablet Generic Dexmethylphenidate HCl Tabs 10MG Tablet

Generic Benzphetamine HCl Tabs 50MG Tablet Generic Diclofenac Sodium TbEC 25MG Tablet DR/EC

Generic Bethanechol Chloride Tabs 10MG Tablet Generic Diclofenac Sodium TbEC 50MG Tablet DR/EC

Generic Bethanechol Chloride Tabs 25MG Tablet Generic Diclofenac Sodium TbEC 75MG Tablet DR/EC

Generic Bisoprolol-Hydrochlorothiazide Tabs 10-6.25MG Tablet Generic Dicloxacillin Sodium Caps 250MG Capsule

Generic Bumetanide Tabs 0.5MG Tablet Generic Dicloxacillin Sodium Caps 500MG Capsule

Generic Bumetanide Tabs 1MG Tablet Brand Diethylpropion HCl ER Tb24 75MG Tablet 24-Hr ER

Generic Bupropion HCl Tabs 100MG Tablet Brand Dilantin Caps 30MG Capsule

Generic Buspirone HCl Tabs 10MG Tablet Generic Diltiazem HCl ER Beads Cp24 120MG Capsule 24 Hr ER

Generic Butalbital-Acetaminophen Tabs 50-325MG Tablet Generic Diltiazem HCl ER Beads Cp24 240MG Capsule 24 Hr ER

Generic Calcitriol Caps 0.25MCG Capsule Generic Diltiazem HCl ER Coated Beads Cp24 120MG Capsule 24 Hr ER

Generic Candesartan Cilexetil Tabs 16MG Tablet Generic Diltiazem HCl ER Coated Beads Cp24 180MG Capsule 24 Hr ER

Generic Captopril Tabs 12.5MG Tablet Generic Diltiazem HCl Tabs 30MG Tablet

Generic Captopril Tabs 25MG Tablet Generic Diltiazem HCl Tabs 90MG Tablet

Generic Carbamazepine ER Tb12 100MG Tablet 12-Hr ER Generic Dilt-XR Cp24 180MG Capsule 24 Hr ER

Generic Carbidopa-Levodopa ER TbCR 50-200MG Tablet ER Generic Dilt-XR Cp24 240MG Capsule 24 Hr ER

Generic Carbidopa-Levodopa TbDp 25-100MG Disintegrating Tablet Generic Dipyridamole Tabs 75MG Tablet

Generic Carbidopa-Levodopa TbDp 25-250MG Disintegrating Tablet Brand Divista Caps 1MG Capsule

Brand Cardiotek Rx Tabs Tablet Generic Doxazosin Mesylate Tabs 1MG Tablet

Brand Carnitor Tabs 330MG Tablet Generic Doxazosin Mesylate Tabs 2MG Tablet

Generic Caziant Tabs 0.1/0.125/0.15-0.025 MG Tablet Generic Doxazosin Mesylate Tabs 4MG Tablet

Brand Cenfol Tabs 2.3-24.5-2MG Tablet Generic Doxepin HCl Caps 50MG Capsule

Generic Chateal Tabs 0.15-30MG-MCG Tablet Generic Doxycycline Monohydrate Caps 50MG Capsule

Brand Chlorpropamide Tabs 100MG Tablet Brand Droxia Caps 200MG Capsule

Generic Chlorthalidone Tabs 25MG Tablet Brand Droxia Caps 300MG Capsule

Generic Chlorthalidone Tabs 50MG Tablet Brand Droxia Caps 400MG Capsule

Brand Chlorzoxazone Tabs 500MG Tablet Generic Duloxetine HCl CpEP 20MG Capsule DR/EC

Generic Cilostazol Tabs 100MG Tablet Generic Enalapril Maleate Tabs 2.5MG Tablet

Generic Clindamycin HCl Caps 150MG Capsule Generic Enpresse-28 Tabs Tablet

Generic Clindamycin HCl Caps 75MG Capsule Generic Escitalopram Oxalate Tabs 20MG Tablet

Generic Clonazepam TbDp 0.125MG Disintegrating Tablet Generic Esomeprazole Magnesium CpDR 40MG Capsule DR/EC

Generic Clonazepam TbDp 0.25MG Disintegrating Tablet Generic Estazolam Tabs 2MG Tablet

2 of 3 2019 FORMULARY$10 $20 $30 $40 $50 $60 $70

$80 $90 $100 $120 $150 $200$30 Co-Pay Drugs


Generic Ethambutol HCl Tabs 400MG Tablet Generic Liothyronine Sodium Tabs 5MCG Tablet

Generic Ethynodiol Diac-Eth Estradiol Tabs 1-35MG-MCG Tablet Generic Lisinopril-Hydrochlorothiazide Tabs 10-12.5MG Tablet

Generic Etodolac Caps 200MG Capsule Brand L-Methylfolate-B6-B12 Tabs 3-35-2MG Tablet

Generic Etodolac Tabs 400MG Tablet Generic Loperamide HCl Caps 2MG Capsule

Generic Famciclovir Tabs 500MG Tablet Generic Lovastatin Tabs 10MG Tablet

Generic Felodipine ER Tb24 2.5MG Tablet 24-Hr ER Generic Loxapine Succinate Caps 25MG Capsule

Brand Fenofibric Acid Tabs 35MG Tablet Brand Maprotiline HCl Tabs 25MG Tablet

Generic Flavoxate HCl Tabs 100MG Tablet Brand Maxfe Tabs 160-1MG Tablet

Generic Fluphenazine HCl Tabs 1MG Tablet Generic Meperidine HCl Tabs 50MG Tablet

Brand Flurazepam HCl Caps 30MG Capsule Brand Metaproterenol Sulfate Tabs 10MG Tablet

Brand Focalin Tabs 5MG Tablet Generic Metformin HCl ER Tb24 750MG Tablet 24-Hr ER

Brand Folbic RF Tabs 1.13-25-2MG Tablet Generic Metformin HCl Tabs 850MG Tablet

Brand Folivane-OB Caps 130-92.4-1MG Capsule Generic Metoprolol Succinate ER Tb24 25MG Tablet 24-Hr ER

Generic Fosinopril Sodium Tabs 10MG Tablet Generic Metoprolol Succinate ER Tb24 50MG Tablet 24-Hr ER

Generic Fosinopril Sodium Tabs 20MG Tablet Generic Metoprolol-Hydrochlorothiazide Tabs 50-25MG Tablet

Brand Fusion Plus Caps Capsule Brand Micro-K CpCR 10Meq Capsule ER

Generic Gengraf Caps 25MG Capsule Brand Micro-K CpCR 8Meq Capsule ER

Brand Gilphex TR Tabs 10-388MG Tablet Generic Minocycline HCl Caps 75MG Capsule

Brand Giltuss TR Tabs 10-28-388MG Tablet Generic Misoprostol Tabs 200MCG Tablet

Generic Glipizide-Metformin HCl Tabs 2.5-500MG Tablet Generic Moexipril HCl Tabs 15MG Tablet

Generic Glipizide-Metformin HCl Tabs 5-500MG Tablet Generic Moexipril HCl Tabs 7.5MG Tablet

Brand Glucophage Tabs 500MG Tablet Generic Moexipril-Hydrochlorothiazide Tabs 15-12.5MG Tablet

Brand Glucophage XR Tb24 500MG Tablet 24-Hr ER Generic Moexipril-Hydrochlorothiazide Tabs 15-25MG Tablet

Generic Glyburide-Metformin Tabs 2.5-500MG Tablet Generic Moexipril-Hydrochlorothiazide Tabs 7.5-12.5MG Tablet

Generic Glyburide-Metformin Tabs 5-500MG Tablet Brand Morphine Sulfate Tabs 15MG Tablet

Generic Glycopyrrolate Tabs 1MG Tablet Brand Multigen Folic Tabs 70-150-2-1MG Tablet

Generic Guanfacine HCl Tabs 2MG Tablet Brand Multigen Plus Tabs 50-101-1MG Tablet

Generic Haloperidol Tabs 10MG Tablet Brand Multigen Tabs 70MG Tablet

Generic Haloperidol Tabs 5MG Tablet Brand Myambutol Tabs 400MG Tablet

Brand Hematron-AF Tabs 150-1MG Tablet Generic Nabumetone Tabs 500MG Tablet

Generic Hydrocodone-Ibuprofen Tabs 7.5-200MG Tablet Generic Naproxen Sodium Tabs 275MG Tablet

Generic Hydrocortisone Tabs 20MG Tablet Generic Naproxen Tabs 375MG Tablet

Generic Hydromorphone HCl Tabs 8MG Tablet Generic Naproxen Tabs 500MG Tablet

Generic Hydroxyurea Caps 500MG Capsule Generic Nateglinide Tabs 120MG Tablet

Generic Hydroxyzine HCl Tabs 50MG Tablet Generic Nateglinide Tabs 60MG Tablet

Brand Hydroxyzine Pamoate Caps 100MG Capsule Generic Neomycin Sulfate Tabs 500MG Tablet

Generic Imipramine HCl Tabs 50MG Tablet Generic Nifedipine ER Osmotic Release Tb24 30MG Tablet 24-Hr ER

Generic Irbesartan Tabs 75MG Tablet Generic Nifedipine ER Tb24 30MG Tablet 24-Hr ER

Generic Isosorbide Dinitrate Tabs 10MG Tablet Generic Norethin Ace-Eth Estrad-Fe Tabs 1-20MG-MCG Tablet

Generic Isosorbide Dinitrate Tabs 20MG Tablet Generic Norethindrone Acet-Ethinyl Est Tabs 1-20MG-MCG Tablet

Generic Isosorbide Dinitrate Tabs 30MG Tablet Generic Nortriptyline HCl Caps 25MG Capsule

Generic Isradipine Caps 2.5MG Capsule Generic Np Thyroid Tabs 120MG Tablet

Brand Klor-Con M15 TbCR 15Meq Tablet ER Generic Np Thyroid Tabs 90MG Tablet

Brand K-Phos No 2 Tabs 305-700MG Tablet Generic Nystatin Tabs 500000Unit Tablet

Brand K-Phos-Neutral Tabs 155-852-130MG Tablet Brand Obstetrix One Caps 38-1-225MG Capsule

Brand K-Tab TbCR 10Meq Tablet ER Generic Oxazepam Caps 10MG Capsule

Brand K-Tab TbCR 20Meq Tablet ER Generic Oxazepam Caps 15MG Capsule

Generic Labetalol HCl Tabs 300MG Tablet Generic Oxycodone HCl Tabs 20MG Tablet

Generic Lamotrigine Tabs 25MG Tablet Generic Oxycodone HCl Tabs 30MG Tablet

Generic Larin 1.5/30 Tabs 1.5-30MG-MCG Tablet Generic Oxycodone-Acetaminophen Tabs 7.5-325MG Tablet

Generic Larin Fe 1.5/30 Tabs 1.5-30MG-MCG Tablet Generic Oxycodone-Aspirin Tabs 4.8355-325MG Tablet

Brand Lasix Tabs 40MG Tablet Brand Pancreaze CpEP 2600Unit Capsule DR/EC

Generic Levonorgestrel-Ethinyl Estrad Tabs 0.1-20MG-MCG Tablet Generic Pentoxifylline ER TbCR 400MG Tablet ER

Generic Levothyroxine Sodium Tabs 300MCG Tablet Generic Perindopril Erbumine Tabs 2MG Tablet

Generic Liothyronine Sodium Tabs 25MCG Tablet Generic Perindopril Erbumine Tabs 4MG Tablet

3 of 3 2019 FORMULARY$10 $20 $30 $40 $50 $60 $70

$80 $90 $100 $120 $150 $200$30 Co-Pay Drugs


Generic Perphenazine Tabs 2MG Tablet Generic Sotalol HCl (AF) Tabs 80MG Tablet

Generic Phenobarbital Tabs 97.2MG Tablet Generic Spironolactone Tabs 100MG Tablet

Generic Phentermine HCl Caps 15MG Capsule Generic Sulindac Tabs 200MG Tablet

Generic Phentermine HCl Caps 30MG Capsule Generic Tamoxifen Citrate Tabs 10MG Tablet

Generic Phentermine HCl Caps 37.5MG Capsule Brand Taron-C DHA Caps 53.5-38-1MG Capsule

Generic Pindolol Tabs 10MG Tablet Generic Theochron Tb12 300MG Tablet 12-Hr ER

Generic Pindolol Tabs 5MG Tablet Generic Theophylline ER Tb24 400MG Tablet 24-Hr ER

Generic Piroxicam Caps 10MG Capsule Generic Thioridazine HCl Tabs 100MG Tablet

Brand Potaba Caps 500MG Capsule Generic Thioridazine HCl Tabs 50MG Tablet

Generic Potassium Chloride ER CpCR 10Meq Capsule ER Generic Thiothixene Caps 2MG Capsule

Generic Prazosin HCl Caps 2MG Capsule Brand Thyrolar-2 Tabs 120 (25-100)MG (MCG) Tablet

Brand Precose Tabs 25MG Tablet Brand Thyrolar-3 Tabs 180 (37.5-150)MG (MCG) Tablet

Brand Precose Tabs 50MG Tablet Brand Tolbutamide Tabs 500MG Tablet

Brand Prednisone TbPk 10MG (48) Tablet Dose Pack Generic Tramadol-Acetaminophen Tabs 37.5-325MG Tablet

Brand Prenatal 19 Tabs Tablet Generic Trazodone HCl Tabs 100MG Tablet

Brand Prenatal-U Caps 106.5-1MG Capsule Generic Triamterene-HCTZ Tabs 75-50MG Tablet

Generic Primidone Tabs 250MG Tablet Brand Tricor Tabs 145MG Tablet

Generic Propafenone HCl Tabs 225MG Tablet Generic Trifluoperazine HCl Tabs 2MG Tablet

Generic Propranolol HCl Tabs 60MG Tablet Generic Tri-Vylibra Tabs 0.18/0.215/0.25MG-35 MCG Tablet

Brand Propranolol-HCTZ Tabs 40-25MG Tablet Generic Valproic Acid Caps 250MG Capsule

Brand Provida OB Caps 20-20-1.25MG Capsule Brand Vascazen Caps 1GM Capsule

Generic Pyridostigmine Bromide Tabs 60MG Tablet Brand Vayarin Caps 75-21.5-8.5MG Capsule

Generic Quinapril HCl Tabs 10MG Tablet Brand Vayarol Caps 630-232.5-92.5MG Capsule

Generic Quinapril HCl Tabs 20MG Tablet Generic Venlafaxine HCl ER Cp24 150MG Capsule 24 Hr ER

Generic Quinapril HCl Tabs 40MG Tablet Generic Venlafaxine HCl ER Cp24 75MG Capsule 24 Hr ER

Generic Quinapril-Hydrochlorothiazide Tabs 10-12.5MG Tablet Generic Venlafaxine HCl Tabs 100MG Tablet

Generic Quinapril-Hydrochlorothiazide Tabs 20-12.5MG Tablet Generic Venlafaxine HCl Tabs 50MG Tablet

Generic Quinapril-Hydrochlorothiazide Tabs 20-25MG Tablet Generic Verapamil HCl ER TbCR 120MG Tablet ER

Generic Ranitidine HCl Tabs 150MG Tablet Generic Verapamil HCl ER TbCR 180MG Tablet ER

Generic Reclipsen Tabs 0.15-30MG-MCG Tablet Generic Vitamin D (Ergocalciferol) Caps 50000Unit Capsule

Brand Ritalin Tabs 10MG Tablet Generic Warfarin Sodium Tabs 10MG Tablet

Brand Rocaltrol Caps 0.25MCG Capsule Brand WP Thyroid Tabs 130MG Tablet

Generic Ropinirole HCl Tabs 3MG Tablet Generic Zidovudine Caps 100MG Capsule

Generic Ropinirole HCl Tabs 4MG Tablet Generic Zolpidem Tartrate Tabs 10MG Tablet

Generic Ropinirole HCl Tabs 5MG Tablet Generic Zolpidem Tartrate Tabs 5MG Tablet

Brand Sinemet Tabs 10-100MG Tablet Generic Zonisamide Caps 50MG Capsule

1 of 2 2019 FORMULARY$10 $20 $30 $40 $50 $60 $70

$80 $90 $100 $120 $150 $200$40 Co-Pay Drugs


Generic Acamprosate Calcium TbEC 333MG Tablet DR/EC Generic Diflunisal Tabs 500MG Tablet

Generic Acyclovir Tabs 400MG Tablet Generic Digitek Tabs 250MCG Tablet

Generic Alendronate Sodium Tabs 10MG Tablet Brand Dilantin Caps 100MG Capsule

Generic Alendronate Sodium Tabs 5MG Tablet Brand Dilantin Infatabs Chew 50MG Chewable Tablet

Generic Alprazolam TbDp 0.5MG Disintegrating Tablet Generic Diltiazem HCl ER Beads Cp24 300MG Capsule 24 Hr ER

Generic Amantadine HCl Caps 100MG Capsule Generic Diltiazem HCl ER Beads Cp24 360MG Capsule 24 Hr ER

Brand Amaryl Tabs 1MG Tablet Generic Diltiazem HCl ER Beads Cp24 420MG Capsule 24 Hr ER

Generic Amitriptyline HCl Tabs 100MG Tablet Generic Diltiazem HCl ER Coated Beads Cp24 240MG Capsule 24 Hr ER

Generic Amitriptyline HCl Tabs 75MG Tablet Generic Diltiazem HCl Tabs 60MG Tablet

Generic Amlodipine Besy-Benazepril HCl Caps 10-20MG Capsule Generic Dipyridamole Tabs 50MG Tablet

Generic Amlodipine Besy-Benazepril HCl Caps 10-40MG Capsule Generic Divalproex Sodium TbEC 250MG Tablet DR/EC

Brand Animi-3/Vitamin D Caps 1MG Capsule Generic Doxazosin Mesylate Tabs 8MG Tablet

Generic Aripiprazole Tabs 10MG Tablet Generic Doxepin HCl Caps 100MG Capsule



Brand Armour Thyroid Tabs 120MG Tablet Brand Elite-OB Tabs 50-1.25MG Tablet

Brand Armour Thyroid Tabs 240MG Tablet Generic Enalapril Maleate Tabs 10MG Tablet

Brand Armour Thyroid Tabs 90MG Tablet Generic Enalapril Maleate Tabs 5MG Tablet

Generic Atenolol-Chlorthalidone Tabs 100-25MG Tablet Generic Epitol Tabs 200MG Tablet

Generic Atenolol-Chlorthalidone Tabs 50-25MG Tablet Generic Etodolac Caps 300MG Capsule

Brand Bactrim Tabs 400-80MG Tablet Generic Etodolac Tabs 500MG Tablet

Generic Benazepril-Hydrochlorothiazide Tabs 10-12.5MG Tablet Generic Felodipine ER Tb24 5MG Tablet 24-Hr ER

Generic Benazepril-Hydrochlorothiazide Tabs 20-25MG Tablet Generic Fenofibrate Micronized Caps 134MG Capsule

Generic Benazepril-Hydrochlorothiazide Tabs 5-6.25MG Tablet Generic Fenofibrate Micronized Caps 43MG Capsule

Generic Benzonatate Caps 100MG Capsule Generic Fenofibrate Tabs 48MG Tablet

Generic Betaxolol HCl Tabs 20MG Tablet Generic Fenofibric Acid CpDR 45MG Capsule DR/EC

Generic Bisoprolol Fumarate Tabs 5MG Tablet Generic Fluphenazine HCl Tabs 2.5MG Tablet

Brand Brompheniramine Tannate Chew 12MG Chewable Tablet Brand Focalin Tabs 10MG Tablet

Generic Bumetanide Tabs 2MG Tablet Generic Fosinopril Sodium-HCTZ Tabs 10-12.5MG Tablet

Generic Bupropion HCl ER (Smoking Det) Tb12 150MG Tablet 12-Hr ER Generic Fosinopril Sodium-HCTZ Tabs 20-12.5MG Tablet

Generic Bupropion HCl ER (SR) Tb12 100MG Tablet 12-Hr ER Generic Gabapentin Caps 400MG Capsule

Generic Bupropion HCl ER (SR) Tb12 150MG Tablet 12-Hr ER Brand Hydrea Caps 500MG Capsule

Generic Bupropion HCl ER (XL) Tb24 150MG Tablet 24-Hr ER Generic Hyoscyamine Sulfate ER Tb12 0.375MG Tablet 12-Hr ER

Generic Buspirone HCl Tabs 7.5MG Tablet Brand Ibudone Tabs 10-200MG Tablet

Generic Butalbital-Apap-Caff-Cod Caps 50-325-40-30MG Capsule Brand Icar-C Plus Tabs 100-250-0.025-1MG Tablet

Generic Butalbital-Apap-Caffeine Tabs 50-325-40MG Tablet Generic Indapamide Tabs 2.5MG Tablet

Generic Butalbital-Aspirin-Caffeine Caps 50-325-40MG Capsule Generic Irbesartan Tabs 300MG Tablet

Generic Calcitriol Caps 0.5MCG Capsule Generic Irbesartan-Hydrochlorothiazide Tabs 150-12.5MG Tablet

Generic Carbamazepine ER Cp12 100MG Capsule 12 Hr ER Generic Isradipine Caps 5MG Capsule

Generic Carbamazepine ER Cp12 200MG Capsule 12 Hr ER Brand Kapspargo Sprinkle Cs24 25MG Capsule Sprinkle 24Hr

Generic Carbamazepine ER Cp12 300MG Capsule 12 Hr ER Brand Kapspargo Sprinkle Cs24 50MG Capsule Sprinkle 24Hr

Generic Carisoprodol-Aspirin Tabs 200-325MG Tablet Brand Ketoprofen Caps 25MG Capsule

Generic Cefaclor Caps 250MG Capsule Generic Lamotrigine Chew 25MG Chewable Tablet

Generic Cefdinir Caps 300MG Capsule Generic Lamotrigine Chew 5MG Chewable Tablet

Brand Chlordiazepoxide-Amitriptyline Tabs 5-12.5MG Tablet Brand Lasix Tabs 80MG Tablet

Generic Cilostazol Tabs 50MG Tablet Generic Levocarnitine Tabs 330MG Tablet

Generic Clonazepam TbDp 2MG Disintegrating Tablet Generic Levonorgest-Eth Estrad 91-Day Tabs 0.15-0.03MG Tablet

Generic Clozapine Tabs 50MG Tablet Generic Liothyronine Sodium Tabs 50MCG Tablet

Generic Codeine Sulfate Tabs 60MG Tablet Generic Lisinopril Tabs 30MG Tablet

Brand Codeine Sulfate Tabs 60MG Tablet Generic Loxapine Succinate Caps 50MG Capsule

Brand Creon CpEP 3000-9500Unit Capsule DR/EC Brand Maprotiline HCl Tabs 50MG Tablet

Brand Creon CpEP 6000Unit Capsule DR/EC Generic Megestrol Acetate Tabs 40MG Tablet

Brand Crixivan Caps 200MG Capsule Generic Meperidine HCl Tabs 100MG Tablet

Generic Dantrolene Sodium Caps 100MG Capsule Brand Metaproterenol Sulfate Tabs 20MG Tablet

Generic Desmopressin Acetate Tabs 0.2MG Tablet Generic Methenamine Mandelate Tabs 1GM Tablet

2 of 2 2019 FORMULARY$10 $20 $30 $40 $50 $60 $70

$80 $90 $100 $120 $150 $200$40 Co-Pay Drugs


Generic Metoprolol Succinate ER Tb24 100MG Tablet 24-Hr ER Brand Ritalin Tabs 20MG Tablet

Brand Metoprolol Tartrate Tabs 37.5MG Tablet Generic Ropinirole HCl Tabs 0.5MG Tablet

Generic Metoprolol-Hydrochlorothiazide Tabs 100-25MG Tablet Generic Ropinirole HCl Tabs 1MG Tablet

Generic Mexiletine HCl Caps 150MG Capsule Generic Selegiline HCl Tabs 5MG Tablet

Generic Mexiletine HCl Caps 200MG Capsule Generic Sevelamer Carbonate Tabs 800MG Tablet

Brand Microzide Caps 12.5MG Capsule Brand Sinemet Cr TbCR 25-100MG Tablet ER

Generic Midodrine HCl Tabs 2.5MG Tablet Brand Sinemet Tabs 25-100MG Tablet

Generic Minocycline HCl Caps 50MG Capsule Generic Sotalol HCl (AF) Tabs 120MG Tablet

Brand Molindone HCl Tabs 5MG Tablet Generic Sotalol HCl (AF) Tabs 160MG Tablet

Brand Morphine Sulfate Tabs 30MG Tablet Generic Sotalol HCl Tabs 120MG Tablet

Generic Nabumetone Tabs 750MG Tablet Generic Spironolactone-HCTZ Tabs 25-25MG Tablet

Generic Naproxen DR TbEC 375MG Tablet DR/EC Brand Synthroid Tabs 100MCG Tablet

Generic Naproxen DR TbEC 500MG Tablet DR/EC Brand Synthroid Tabs 112MCG Tablet

Brand Newgen Tabs 32-1MG Tablet Brand Synthroid Tabs 125MCG Tablet

Generic Nicardipine HCl Caps 20MG Capsule Brand Synthroid Tabs 137MCG Tablet

Generic Nifedipine Caps 20MG Capsule Brand Synthroid Tabs 150MCG Tablet

Generic Nifedipine ER Osmotic Release Tb24 60MG Tablet 24-Hr ER Brand Synthroid Tabs 175MCG Tablet

Generic Nizatidine Caps 150MG Capsule Brand Synthroid Tabs 200MCG Tablet

Generic Norethin Ace-Eth Estrad-Fe Tabs 1-20MG-MCG(24) Tablet Brand Synthroid Tabs 25MCG Tablet

Brand Ogestrel Tabs 0.5-50MG-MCG Tablet Brand Synthroid Tabs 300MCG Tablet

Brand Ortho-Novum 7/7/7 (28) Tabs 0.5/0.75/1-35MG-MCG Tablet Brand Synthroid Tabs 50MCG Tablet

Generic Oxycodone HCl Caps 5MG Capsule Brand Synthroid Tabs 75MCG Tablet

Generic Oxycodone HCl Tabs 15MG Tablet Brand Synthroid Tabs 88MCG Tablet

Generic Oxycodone-Acetaminophen Tabs 10-325MG Tablet Brand Taron-Prex Caps 30-1.2-265MG Capsule

Brand Oxycodone-Ibuprofen Tabs 5-400MG Tablet Brand Tegretol-XR Tb12 100MG Tablet 12-Hr ER

Brand Pancreaze CpEP 4200Unit Capsule DR/EC Generic Telmisartan Tabs 40MG Tablet

Generic Perphenazine Tabs 4MG Tablet Generic Theophylline ER Tb24 600MG Tablet 24-Hr ER

Generic Perphenazine Tabs 8MG Tablet Brand Timolol Maleate Tabs 10MG Tablet

Brand Perphenazine-Amitriptyline Tabs 2-10MG Tablet Brand Timolol Maleate Tabs 5MG Tablet

Brand Perphenazine-Amitriptyline Tabs 4-10MG Tablet Generic Tizanidine HCl Caps 2MG Capsule

Brand Phenytek Caps 200MG Capsule Generic Topiramate CpSp 15MG Capsule DR Sprinkle

Generic Pilocarpine HCl Tabs 5MG Tablet Brand Toprol XL Tb24 25MG Tablet 24-Hr ER

Generic Potassium Citrate ER TbCR 5 Meq(540 MG) Tablet ER Brand Toprol XL Tb24 50MG Tablet 24-Hr ER

Generic Pramipexole Dihydrochloride Tabs 0.75MG Tablet Brand Tricare Prenatal DHA One Caps 0.8MG Capsule

Brand Precose Tabs 100MG Tablet Generic Trifluoperazine HCl Tabs 10MG Tablet

Brand Prednisone TbPk 10MG (21) Tablet Dose Pack Generic Trifluoperazine HCl Tabs 5MG Tablet

Brand Prinivil Tabs 5MG Tablet Generic Tri-Legest Fe Tabs 1-20/1-30/1-35MG-MCG Tablet

Generic Probenecid Tabs 500MG Tablet Generic Trimethobenzamide HCl Caps 300MG Capsule

Generic Progesterone Micronized Caps 100MG Capsule Brand Tylenol With Codeine #3 Tabs 300-30MG Tablet

Generic Propafenone HCl Tabs 150MG Tablet Brand Ultimatecare One Caps 27-1MG Capsule

Generic Propranolol HCl ER Cp24 60MG Capsule 24 Hr ER Generic Ustell Caps 120MG Capsule

Brand Propranolol-HCTZ Tabs 80-25MG Tablet Brand Vascepa Caps 0.5GM Capsule

Brand Protectiron Tabs 60-1MG Tablet Generic Venlafaxine HCl Tabs 25MG Tablet

Generic Quetiapine Fumarate ER Tb24 300MG Tablet 24-Hr ER Generic Verapamil HCl ER Cp24 180MG Capsule 24 Hr ER

Generic Quetiapine Fumarate ER Tb24 400MG Tablet 24-Hr ER Generic Verapamil HCl ER TbCR 240MG Tablet ER

Generic Ramipril Caps 2.5MG Capsule Generic Vicodin Tabs 5-300MG Tablet

Generic Ramipril Caps 5MG Capsule Brand Vitafol Gummies Chew 3.33-0.333-34.8MG Chewable Tablet

Generic Ranitidine HCl Caps 150MG Capsule Generic Vyfemla Tabs 0.4-35MG-MCG Tablet

Generic Ranitidine HCl Caps 300MG Capsule Generic Vylibra Tabs 0.25-35MG-MCG Tablet

Brand Regimex Tabs 25MG Tablet Brand Xaquil XR TbCR 30MG Tablet ER

Generic Repaglinide Tabs 2MG Tablet Generic Zafirlukast Tabs 10MG Tablet

Brand Rescriptor Tabs 100MG Tablet Generic Zafirlukast Tabs 20MG Tablet

Brand Restora Rx Caps 60-1.25MG Capsule Generic Zaleplon Caps 5MG Capsule

1 of 2 2019 FORMULARY$10 $20 $30 $40 $50 $60 $70

$80 $90 $100 $120 $150 $200$50 Co-Pay Drugs


Generic Acetazolamide ER Cp12 500MG Capsule 12 Hr ER Generic Finasteride Tabs 5MG Tablet

Generic Acetazolamide Tabs 125MG Tablet Generic Flecainide Acetate Tabs 50MG Tablet

Brand Albuterol Sulfate ER Tb12 4MG Tablet 12-Hr ER Generic Flutamide Caps 125MG Capsule

Generic Alprazolam TbDp 1MG Disintegrating Tablet Generic Fluvoxamine Maleate Tabs 25MG Tablet

Generic Amantadine HCl Tabs 100MG Tablet Brand Foltanx RF Caps 3-90.314-2-35MG Capsule

Generic Amethyst Tabs 90-20MCG Tablet Brand Galzin Caps 25MG Capsule

Generic Amitriptyline HCl Tabs 150MG Tablet Brand Glucophage Tabs 850MG Tablet

Generic Amlodipine Besy-Benazepril HCl Caps 5-40MG Capsule Brand Glucophage XR Tb24 750MG Tablet 24-Hr ER

Brand Amoxapine Tabs 100MG Tablet Brand Glucotrol Tabs 5MG Tablet

Brand Armour Thyroid Tabs 300MG Tablet Brand Glucotrol XL Tb24 2.5MG Tablet 24-Hr ER

Generic Azathioprine Tabs 50MG Tablet Brand Glucotrol XL Tb24 5MG Tablet 24-Hr ER

Brand Azulfidine Tabs 500MG Tablet Generic Glycopyrrolate Tabs 2MG Tablet

Generic Baclofen Tabs 10MG Tablet Brand Glynase Tabs 1.5MG Tablet

Generic Benazepril-Hydrochlorothiazide Tabs 20-12.5MG Tablet Generic Haloperidol Tabs 20MG Tablet

Generic Benzphetamine HCl Tabs 25MG Tablet Brand Hemetab Tabs 22-6-1-0.025MG Tablet

Generic Bethanechol Chloride Tabs 50MG Tablet Generic Ibudone Tabs 5-200MG Tablet

Generic Bisoprolol Fumarate Tabs 10MG Tablet Brand Isentress Chew 25MG Chewable Tablet

Generic Bisoprolol-Hydrochlorothiazide Tabs 5-6.25MG Tablet Generic Isosorbide Mononitrate ER Tb24 30MG Tablet 24-Hr ER

Generic Buspirone HCl Tabs 15MG Tablet Generic Isosorbide Mononitrate ER Tb24 60MG Tablet 24-Hr ER

Generic Camrese Lo Tabs 0.1-0.02 & 0.01MG Tablet Generic Ketorolac Tromethamine Tabs 10MG Tablet

Generic Candesartan Cilexetil Tabs 4MG Tablet Generic Lamotrigine Tabs 100MG Tablet

Generic Candesartan Cilexetil Tabs 8MG Tablet Generic Leucovorin Calcium Tabs 5MG Tablet

Generic Captopril Tabs 50MG Tablet Generic Levonorgest-Eth Estrad 91-Day Tabs 0.15-0.03 &0.01MG Tablet

Generic Carbamazepine ER Tb12 200MG Tablet 12-Hr ER Generic Lovastatin Tabs 20MG Tablet

Brand Carbatrol Cp12 100MG Capsule 12 Hr ER Brand Maxzide-25 Tabs 37.5-25MG Tablet

Brand Carbatrol Cp12 200MG Capsule 12 Hr ER Brand Medrol Tabs 2MG Tablet

Brand Carbatrol Cp12 300MG Capsule 12 Hr ER Brand Menest Tabs 0.3MG Tablet

Generic Carisoprodol-Aspirin-Codeine Tabs 200-325-16MG Tablet Generic Metformin HCl Tabs 1000MG Tablet

Generic Carvedilol Tabs 12.5MG Tablet Generic Methenamine Hippurate Tabs 1GM Tablet

Generic Carvedilol Tabs 6.25MG Tablet Generic Methscopolamine Bromide Tabs 2.5MG Tablet

Generic Celecoxib Caps 50MG Capsule Brand Methyclothiazide Tabs 5MG Tablet

Brand Chlordiazepoxide-Amitriptyline Tabs 10-25MG Tablet Brand Methyldopa-Hydrochlorothiazide Tabs 250-15MG Tablet

Generic Cimetidine Tabs 200MG Tablet Brand Methyldopa-Hydrochlorothiazide Tabs 250-25MG Tablet

Generic Cimetidine Tabs 300MG Tablet Generic Methylprednisolone Tabs 8MG Tablet

Generic Ciprofloxacin HCl Tabs 500MG Tablet Generic Metolazone Tabs 10MG Tablet

Generic Citalopram Hydrobromide Tabs 10MG Tablet Generic Mexiletine HCl Caps 250MG Capsule

Brand C-Nate DHA Caps 28-1-200MG Capsule Generic Mirtazapine TbDp 15MG Disintegrating Tablet

Brand Cortef Tabs 10MG Tablet Generic Mirtazapine TbDp 30MG Disintegrating Tablet

Generic Corvita 150 Tabs 150-1.25MG Tablet Generic Mirtazapine TbDp 45MG Disintegrating Tablet

Brand Corvite 150 Tabs 150-1.25MG Tablet Brand Molindone HCl Tabs 10MG Tablet

Brand Dantrium Caps 50MG Capsule Generic Nifedipine ER Osmotic Release Tb24 90MG Tablet 24-Hr ER

Generic Dapsone Tabs 25MG Tablet Generic Nifedipine ER Tb24 60MG Tablet 24-Hr ER

Brand Depakote TbEC 125MG Tablet DR/EC Generic Nifedipine ER Tb24 90MG Tablet 24-Hr ER

Generic Desipramine HCl Tabs 50MG Tablet Generic Nitrofurantoin Macrocrystal Caps 50MG Capsule

Generic Desogestrel-Ethinyl Estradiol Tabs 0.15-0.02/0.01MG (21/5) Tablet Generic Norethindrone Tabs 0.35MG Tablet

Generic Digitek Tabs 125MCG Tablet Generic Norethin-Eth Estradiol-Fe Chew 0.4-35MG-MCG Chewable Tablet

Generic Diltiazem HCl ER Coated Beads Tb24 180MG Tablet 24-Hr ER Brand Norpramin Tabs 10MG Tablet

Generic Doxycycline Hyclate Caps 50MG Capsule Generic Olmesartan Medoxomil Tabs 5MG Tablet

Generic Doxycycline Monohydrate Caps 100MG Capsule Generic Olmesartan Medoxomil-HCTZ Tabs 40-25MG Tablet

Generic Doxycycline Monohydrate Tabs 50MG Tablet Generic Omega-3-Acid Ethyl Esters Caps 1GM Capsule

Brand Elfolate Plus Tabs 3-43.75-2.72MG Tablet Generic Orphenadrine Citrate ER Tb12 100MG Tablet 12-Hr ER

Generic Enalapril Maleate Tabs 20MG Tablet Brand Oxazepam Caps 30MG Capsule

Generic Etodolac ER Tb24 400MG Tablet 24-Hr ER Generic Oxycodone-Acetaminophen Tabs 2.5-325MG Tablet

Generic Famotidine Tabs 20MG Tablet Generic Oxymorphone HCl Tabs 5MG Tablet

Generic Fenofibrate Tabs 160MG Tablet Generic Pantoprazole Sodium TbEC 20MG Tablet DR/EC

2 of 2 2019 FORMULARY$10 $20 $30 $40 $50 $60 $70

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Generic Pentazocine-Naloxone HCl Tabs 50-0.5MG Tablet Generic Ropinirole HCl Tabs 2MG Tablet

Generic Perphenazine Tabs 16MG Tablet Generic Rosuvastatin Calcium Tabs 5MG Tablet

Brand Perphenazine-Amitriptyline Tabs 2-25MG Tablet Brand Roxicodone Tabs 5MG Tablet

Brand Perphenazine-Amitriptyline Tabs 4-25MG Tablet Brand Salagen Tabs 5MG Tablet

Brand Pertzye CpEP 4000Unit Capsule DR/EC Brand Select-OB Chew 29-1MG Chewable Tablet

Brand Phenytek Caps 300MG Capsule Generic Selegiline HCl Caps 5MG Capsule

Generic Phenytoin Sodium Extended Caps 200MG Capsule Brand Sinemet Tabs 25-250MG Tablet

Generic Pilocarpine HCl Tabs 7.5MG Tablet Generic Sotalol HCl Tabs 160MG Tablet

Brand Pnv-DHA+Docusate Caps 27-1.25-300MG Capsule Generic Tacrolimus Caps 0.5MG Capsule

Generic Prazosin HCl Caps 5MG Capsule Generic Tizanidine HCl Caps 4MG Capsule

Brand Prenaissance Plus Caps 28-1-250MG Capsule Brand Tl-Care DHA Caps 27-1-500MG Capsule

Brand Primaquine Phosphate Tabs 26.3MG Tablet Generic Topiramate CpSp 25MG Capsule DR Sprinkle

Brand Prinivil Tabs 10MG Tablet Generic Topiramate Tabs 25MG Tablet

Brand Prinivil Tabs 20MG Tablet Brand Toprol XL Tb24 100MG Tablet 24-Hr ER

Generic Propafenone HCl Tabs 300MG Tablet Generic Uretron D/S Tabs Tablet

Generic Propranolol HCl ER Cp24 80MG Capsule 24 Hr ER Brand Urocit-K 5 TbCR 5 Meq(540 MG) Tablet ER

Generic Protriptyline HCl Tabs 5MG Tablet Generic Ursodiol Tabs 250MG Tablet

Brand Provida DHA Caps 16-16-1.25-110MG Capsule Generic Uryl Tabs 81.6MG Tablet

Generic Ramipril Caps 10MG Capsule Generic Valsartan Tabs 160MG Tablet

Generic Repaglinide Tabs 0.5MG Tablet Generic Venlafaxine HCl Tabs 37.5MG Tablet

Generic Rifampin Caps 150MG Capsule Generic Venlafaxine HCl Tabs 75MG Tablet

Generic Rivastigmine Tartrate Caps 1.5MG Capsule Generic Verapamil HCl ER Cp24 240MG Capsule 24 Hr ER

Generic Rivastigmine Tartrate Caps 3MG Capsule Generic Vicodin ES Tabs 7.5-300MG Tablet

Generic Rivastigmine Tartrate Caps 4.5MG Capsule Brand Vp-Pnv-DHA Caps 28-1-215.8MG Capsule

Generic Rivastigmine Tartrate Caps 6MG Capsule Brand Zenpep CpEP 3000-14000Unit Capsule DR/EC

Brand Robaxin Tabs 500MG Tablet Brand Zenpep CpEP 5000-24000Unit Capsule DR/EC

Generic Ropinirole HCl ER Tb24 2MG Tablet 24-Hr ER Generic Zonisamide Caps 100MG Capsule

1 of 2 2019 FORMULARY$10 $20 $30 $40 $50 $60 $70

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Generic Abacavir Sulfate Tabs 300MG Tablet Generic Fluvoxamine Maleate Tabs 100MG Tablet

Generic Acetazolamide Tabs 250MG Tablet Generic Fluvoxamine Maleate Tabs 50MG Tablet

Brand Adalat Cc Tb24 30MG Tablet 24-Hr ER Generic Galantamine Hydrobromide Tabs 12MG Tablet

Brand Adipex-P Caps 37.5MG Capsule Generic Galantamine Hydrobromide Tabs 4MG Tablet

Brand Adipex-P Tabs 37.5MG Tablet Generic Galantamine Hydrobromide Tabs 8MG Tablet

Generic Alprazolam XR Tb24 3MG Tablet 24-Hr ER Generic Gianvi Tabs 3-0.02MG Tablet

Brand Amaryl Tabs 2MG Tablet Brand Glucophage Tabs 1000MG Tablet

Brand Apptrim Caps Capsule Brand Isosorbide Dinitrate ER TbCR 40MG Tablet ER

Generic Atovaquone-Proguanil HCl Tabs 62.5-25MG Tablet Generic Isosorbide Mononitrate ER Tb24 120MG Tablet 24-Hr ER

Brand Azulfidine En-Tabs TbEC 500MG Tablet DR/EC Generic Jinteli Tabs 1-5MG-MCG Tablet

Generic Bisoprolol-Hydrochlorothiazide Tabs 2.5-6.25MG Tablet Brand Kapspargo Sprinkle Cs24 100MG Capsule Sprinkle 24Hr

Generic Butalbital-Apap-Caffeine Caps 50-300-40MG Capsule Generic Levetiracetam Tabs 250MG Tablet

Generic Butalbital-Asa-Caff-Codeine Caps 50-325-40-30MG Capsule Brand Lopressor HCT Tabs 50-25MG Tablet

Generic Captopril Tabs 100MG Tablet Brand Lotensin Tabs 10MG Tablet

Generic Celecoxib Caps 100MG Capsule Brand Lotensin Tabs 20MG Tablet

Brand Chlorpropamide Tabs 250MG Tablet Brand Lotensin Tabs 40MG Tablet

Generic Cimetidine Tabs 400MG Tablet Brand Maprotiline HCl Tabs 75MG Tablet

Generic Ciprofloxacin HCl Tabs 250MG Tablet Brand Marnatal-F Caps 60-1MG Capsule

Generic Ciprofloxacin HCl Tabs 750MG Tablet Generic Methylphenidate HCl Chew 2.5MG Chewable Tablet

Generic Citalopram Hydrobromide Tabs 40MG Tablet Generic Methylprednisolone Tabs 16MG Tablet

Generic Clarithromycin Tabs 250MG Tablet Generic Metolazone Tabs 2.5MG Tablet

Brand Clemastine Fumarate Tabs 2.68MG Tablet Generic Metolazone Tabs 5MG Tablet

Generic Clozapine TbDp 25MG Disintegrating Tablet Generic Metoprolol Succinate ER Tb24 200MG Tablet 24-Hr ER

Brand Colestid Tabs 1GM Tablet Brand Metoprolol Tartrate Tabs 75MG Tablet

Brand Coumadin Tabs 1MG Tablet Brand Metoprolol-Hydrochlorothiazide Tabs 100-50MG Tablet

Brand Coumadin Tabs 2.5MG Tablet Generic Miglitol Tabs 25MG Tablet

Brand Coumadin Tabs 2MG Tablet Brand Minipress Caps 1MG Capsule

Brand Coumadin Tabs 3MG Tablet Generic Mirtazapine Tabs 15MG Tablet

Brand Coumadin Tabs 4MG Tablet Generic Mirtazapine Tabs 30MG Tablet

Brand Cytomel Tabs 5MCG Tablet Generic Mirtazapine Tabs 45MG Tablet

Generic Dapsone Tabs 100MG Tablet Generic Mirtazapine Tabs 7.5MG Tablet

Generic Dexamethasone Tabs 6MG Tablet Brand Molindone HCl Tabs 25MG Tablet

Generic Dextroamphetamine Sulfate Tabs 5MG Tablet Generic Morphine Sulfate ER TbCR 30MG Tablet ER

Generic Diclofenac Potassium Tabs 50MG Tablet Brand Neoral Caps 25MG Capsule

Generic Diclofenac Sodium ER Tb24 100MG Tablet 24-Hr ER Brand Neurontin Caps 100MG Capsule

Brand Dilaudid Tabs 2MG Tablet Generic Niacin ER (Antihyperlipidemic) TbCR 500MG Tablet ER

Generic Diltiazem HCl ER Coated Beads Cp24 300MG Capsule 24 Hr ER Generic Nicardipine HCl Caps 30MG Capsule

Generic Diltiazem HCl ER Coated Beads Tb24 240MG Tablet 24-Hr ER Generic Nizatidine Caps 300MG Capsule

Generic Diltiazem HCl Tabs 120MG Tablet Generic Norethindrone Acetate Tabs 5MG Tablet

Generic Disopyramide Phosphate Caps 100MG Capsule Brand Norpramin Tabs 25MG Tablet

Generic Disulfiram Tabs 250MG Tablet Generic Nortriptyline HCl Caps 50MG Capsule

Generic Drospirenone-Ethinyl Estradiol Tabs 3-0.03MG Tablet Generic Olmesartan Medoxomil Tabs 40MG Tablet

Brand Dyazide Caps 37.5-25MG Capsule Generic Olmesartan Medoxomil-HCTZ Tabs 20-12.5MG Tablet

Brand Escavite D Chew 0.25-6MG Chewable Tablet Generic Omeprazole CpDR 10MG Capsule DR/EC

Generic Escitalopram Oxalate Tabs 5MG Tablet Brand Orap Tabs 1MG Tablet

Generic Ethosuximide Caps 250MG Capsule Brand Ortho Micronor Tabs 0.35MG Tablet

Generic Etodolac ER Tb24 600MG Tablet 24-Hr ER Generic Oxybutynin Chloride ER Tb24 10MG Tablet 24-Hr ER

Generic Felodipine ER Tb24 10MG Tablet 24-Hr ER Brand Oxymorphone HCl ER Tb12 5MG Tablet 12-Hr ER

Brand Ferralet 90 Tabs 90-1MG Tablet Generic Perindopril Erbumine Tabs 8MG Tablet

Generic Finasteride Tabs 1MG Tablet Generic Phenazopyridine HCl Tabs 100MG Tablet

Generic Flecainide Acetate Tabs 150MG Tablet Brand Phendimetrazine Tartrate ER Cp24 105MG Capsule 24 Hr ER

Generic Fluconazole Tabs 50MG Tablet Generic Phosphasal Tabs 81.6MG Tablet

Brand Flumadine Tabs 100MG Tablet Generic Pimozide Tabs 1MG Tablet

Generic Fluoxetine HCl Caps 10MG Capsule Generic Potassium Citrate ER TbCR 10 Meq(1080 MG) Tablet ER

Generic Fluoxetine HCl Tabs 10MG Tablet Generic Potassium Citrate ER TbCR 15 Meq(1620 MG) Tablet ER

2 of 2 2019 FORMULARY$10 $20 $30 $40 $50 $60 $70

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Generic Pramipexole Dihydrochloride Tabs 0.25MG Tablet Generic Thiothixene Caps 5MG Capsule

Generic Pramipexole Dihydrochloride Tabs 0.5MG Tablet Brand Tiazac Cp24 120MG Capsule 24 Hr ER

Generic Pramipexole Dihydrochloride Tabs 1.5MG Tablet Brand Tolazamide Tabs 250MG Tablet

Generic Pravastatin Sodium Tabs 40MG Tablet Generic Trazodone HCl Tabs 150MG Tablet

Generic Propranolol HCl ER Cp24 120MG Capsule 24 Hr ER Generic Trospium Chloride Tabs 20MG Tablet

Generic Propranolol HCl ER Cp24 160MG Capsule 24 Hr ER Brand Tylenol With Codeine #4 Tabs 300-60MG Tablet

Generic Protriptyline HCl Tabs 10MG Tablet Brand Urecholine Tabs 5MG Tablet

Generic Ranitidine HCl Tabs 300MG Tablet Brand Urocit-K 10 TbCR 10 Meq(1080 MG) Tablet ER

Brand Salagen Tabs 7.5MG Tablet Generic Valsartan Tabs 80MG Tablet

Generic Salsalate Tabs 750MG Tablet Brand Vayacog Caps 100-19.5-6.5MG Capsule

Generic Sotalol HCl Tabs 80MG Tablet Generic Verapamil HCl ER Cp24 120MG Capsule 24 Hr ER

Brand Tapazole Tabs 5MG Tablet Generic Vicodin Hp Tabs 10-300MG Tablet

Brand Tessalon Perles Caps 100MG Capsule Brand Zatean-Pn DHA Caps 27-0.6-0.4-300MG Capsule

Brand Theo-24 Cp24 100MG Capsule 24 Hr ER Brand Zatean-Pn Plus Caps 28-0.6-0.4-340MG Capsule

Generic Theophylline ER Tb12 450MG Tablet 12-Hr ER Generic Zidovudine Tabs 300MG Tablet

Generic Thiothixene Caps 10MG Capsule

1 of 2 2019 FORMULARY$10 $20 $30 $40 $50 $60 $70

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Brand Aldactazide Tabs 25-25MG Tablet Brand L-Methyl-MC NAC Tabs 6-2-600MG Tablet

Brand Aldactone Tabs 25MG Tablet Brand Lopressor Tabs 50MG Tablet

Generic Alfuzosin HCl ER Tb24 10MG Tablet 24-Hr ER Brand Lotensin HCT Tabs 10-12.5MG Tablet

Generic Alprazolam XR Tb24 2MG Tablet 24-Hr ER Brand Lotensin HCT Tabs 20-12.5MG Tablet

Brand Amoxapine Tabs 150MG Tablet Brand Lotensin HCT Tabs 20-25MG Tablet

Brand Amoxicillin-Pot Clavulanate Chew 200-28.5MG Chewable Tablet Brand Lovaza Caps 1GM Capsule

Generic Amoxicillin-Pot Clavulanate Tabs 500-125MG Tablet Brand Malarone Tabs 62.5-25MG Tablet

Brand Astagraf XL Cp24 0.5MG Capsule 24 Hr ER Brand Menest Tabs 0.625MG Tablet

Brand Bactrim DS Tabs 800-160MG Tablet Brand Metafolbic Tabs 6-1-50-5MG Tablet

Brand Benznidazole Tabs 12.5MG Tablet Generic Methscopolamine Bromide Tabs 5MG Tablet

Brand Bumex Tabs 0.5MG Tablet Generic Midodrine HCl Tabs 5MG Tablet

Brand Bumex Tabs 1MG Tablet Generic Miglitol Tabs 50MG Tablet

Brand Captopril-Hydrochlorothiazide Tabs 25-15MG Tablet Generic Minocycline HCl Caps 100MG Capsule

Brand Captopril-Hydrochlorothiazide Tabs 25-25MG Tablet Generic Minocycline HCl Tabs 50MG Tablet

Generic Carbamazepine ER Tb12 400MG Tablet 12-Hr ER Generic Nadolol Tabs 20MG Tablet

Generic Carisoprodol Tabs 250MG Tablet Brand Nardil Tabs 15MG Tablet

Brand Catapres Tabs 0.1MG Tablet Generic Nitrofurantoin Macrocrystal Caps 100MG Capsule

Generic Cefaclor Caps 500MG Capsule Brand OB Complete/DHA Caps 30-10-1-200MG Capsule

Generic Cevimeline HCl Caps 30MG Capsule Brand Ortho-Novum 1/35 (28) Tabs 1-35MG-MCG Tablet

Generic Clorazepate Dipotassium Tabs 7.5MG Tablet Generic Oxybutynin Chloride ER Tb24 15MG Tablet 24-Hr ER

Generic Clozapine Tabs 100MG Tablet Generic Oxybutynin Chloride ER Tb24 5MG Tablet 24-Hr ER

Generic Clozapine TbDp 12.5MG Disintegrating Tablet Generic Pacerone Tabs 200MG Tablet

Generic Colesevelam HCl Tabs 625MG Tablet Brand Peganone Tabs 250MG Tablet

Brand Contrave Tb12 8-90MG Tablet 12-Hr ER Brand Pertzye CpEP 8000Unit Capsule DR/EC

Brand Cortisone Acetate Tabs 25MG Tablet Generic Phenytoin Sodium Extended Caps 300MG Capsule

Brand Coumadin Tabs 5MG Tablet Generic Pioglitazone HCl-Metformin HCl Tabs 15-500MG Tablet

Brand Crixivan Caps 400MG Capsule Generic Pioglitazone HCl-Metformin HCl Tabs 15-850MG Tablet

Brand Cyclosporine Modified Caps 50MG Capsule Brand Pnv-Select Tabs 27-0.6-0.4MG Tablet

Brand Cytomel Tabs 25MCG Tablet Generic Pramipexole Dihydrochloride Tabs 0.125MG Tablet

Generic Desipramine HCl Tabs 75MG Tablet Generic Pramipexole Dihydrochloride Tabs 1MG Tablet

Generic Dextroamphetamine Sulfate Tabs 10MG Tablet Generic Pravastatin Sodium Tabs 10MG Tablet

Generic Diclofenac-Misoprostol TbEC 50-0.2MG Tablet DR/EC Generic Pravastatin Sodium Tabs 20MG Tablet

Generic Diclofenac-Misoprostol TbEC 75-0.2MG Tablet DR/EC Brand Propantheline Bromide Tabs 15MG Tablet

Generic Diltiazem HCl ER Cp12 60MG Capsule 12 Hr ER Brand Provera Tabs 2.5MG Tablet

Generic Disopyramide Phosphate Caps 150MG Capsule Generic Quetiapine Fumarate ER Tb24 50MG Tablet 24-Hr ER

Generic Divalproex Sodium TbEC 500MG Tablet DR/EC Brand Rescriptor Tabs 200MG Tablet

Generic Doxycycline Monohydrate Tabs 75MG Tablet Generic Risperidone TbDp 2MG Disintegrating Tablet

Brand EC-Naprosyn TbEC 375MG Tablet DR/EC Brand Robaxin-750 Tabs 750MG Tablet

Generic Eplerenone Tabs 50MG Tablet Brand Sinemet Cr TbCR 50-200MG Tablet ER

Generic Etodolac ER Tb24 500MG Tablet 24-Hr ER Generic Sotalol HCl Tabs 240MG Tablet

Brand E-Z-Disk Tabs 700MG Tablet Brand Symax Duotab TbCR 0.375MG Tablet ER

Generic Fenofibrate Micronized Caps 200MG Capsule Brand Tegretol Tabs 200MG Tablet

Brand Fenofibric Acid Tabs 105MG Tablet Brand Tegretol-XR Tb12 200MG Tablet 12-Hr ER

Generic Fenoprofen Calcium Tabs 600MG Tablet Generic Telmisartan Tabs 20MG Tablet

Brand Galzin Caps 50MG Capsule Brand Tiazac Cp24 180MG Capsule 24 Hr ER

Brand Hemenatal OB Tabs 28-6-1MG Tablet Brand Timolol Maleate Tabs 20MG Tablet

Generic Irbesartan Tabs 150MG Tablet Generic Tizanidine HCl Caps 6MG Capsule

Generic Jevantique Lo Tabs 0.5-2.5MG-MCG Tablet Brand Tl-Select Caps 29-1.25-325MG Capsule

Brand Klonopin Tabs 0.5MG Tablet Generic Tolterodine Tartrate Tabs 1MG Tablet

Generic Lansoprazole CpDR 15MG Capsule DR/EC Generic Tolterodine Tartrate Tabs 2MG Tablet

Generic Levetiracetam Tabs 500MG Tablet Generic Torsemide Tabs 100MG Tablet

Generic Levocetirizine Dihydrochloride Tabs 5MG Tablet Generic Tramadol HCl ER (Biphasic) Tb24 100MG Tablet 24-Hr ER

Brand Levsin Tabs 0.125MG Tablet Generic Tramadol HCl ER Tb24 100MG Tablet 24-Hr ER

Brand L-Methylfolate Tabs 15MG Tablet Generic Trimipramine Maleate Caps 25MG Capsule

Brand L-Methylfolate Tabs 7.5MG Tablet Generic Uribel Caps 118MG Capsule

2 of 2 2019 FORMULARY$10 $20 $30 $40 $50 $60 $70

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Brand Vascepa Caps 1GM Capsule Brand Vistaril Caps 25MG Capsule

Generic Verapamil HCl ER Cp24 100MG Capsule 24 Hr ER Brand Zanaflex Tabs 4MG Tablet

Generic Verapamil HCl ER Cp24 200MG Capsule 24 Hr ER

1 of 1 2019 FORMULARY$10 $20 $30 $40 $50 $60 $70

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Brand Active Fe Tabs 75-1.25MG Tablet Generic Minocycline HCl Tabs 75MG Tablet

Generic Acyclovir Tabs 800MG Tablet Generic Morphine Sulfate ER Cp24 10MG Capsule 24 Hr ER

Brand Albuterol Sulfate ER Tb12 8MG Tablet 12-Hr ER Generic Mycophenolate Mofetil Caps 250MG Capsule

Generic Alprazolam TbDp 2MG Disintegrating Tablet Generic Mycophenolate Sodium TbEC 180MG Tablet DR/EC

Generic Amlodipine Besylate-Valsartan Tabs 10-160MG Tablet Generic Nadolol Tabs 40MG Tablet

Brand Apap-Caff-Dihydrocodeine Caps 320.5-30-16MG Capsule Generic Naproxen Sodium Tabs 550MG Tablet

Brand Astamed Myo Caps Capsule Brand Norco Tabs 5-325MG Tablet

Brand Benznidazole Tabs 100MG Tablet Generic Norethin-Eth Estradiol-Fe Chew 0.8-25MG-MCG Chewable Tablet

Brand Bumex Tabs 2MG Tablet Brand Orap Tabs 2MG Tablet

Generic Bupropion HCl ER (SR) Tb12 200MG Tablet 12-Hr ER Generic Oxaprozin Tabs 600MG Tablet

Generic Buspirone HCl Tabs 30MG Tablet Brand Pancreaze CpEP 10500Unit Capsule DR/EC

Generic Cefadroxil Caps 500MG Capsule Brand Perphenazine-Amitriptyline Tabs 4-50MG Tablet

Generic Chlordiazepoxide-Clidinium Caps 5-2.5MG Capsule Generic Phenazo Tabs 200MG Tablet

Generic Chlorpromazine HCl Tabs 10MG Tablet Generic Pimozide Tabs 2MG Tablet

Brand Citranatal Rx Tabs 27-1MG Tablet Brand Procardia Caps 10MG Capsule

Generic Clindamycin HCl Caps 300MG Capsule Generic Progesterone Micronized Caps 200MG Capsule

Generic Clorazepate Dipotassium Tabs 15MG Tablet Brand Prograf Caps 0.5MG Capsule

Generic Clorazepate Dipotassium Tabs 3.75MG Tablet Generic Quetiapine Fumarate Tabs 25MG Tablet

Brand Coumadin Tabs 6MG Tablet Brand Quflora Gummies Chew 0.125MG Chewable Tablet

Brand Cozaar Tabs 25MG Tablet Brand Radiogardase Caps 0.5GM Capsule

Brand Creon CpEP 12000Unit Capsule DR/EC Brand Reglan Tabs 10MG Tablet

Generic Danazol Caps 50MG Capsule Brand Reglan Tabs 5MG Tablet

Brand Demadex Tabs 10MG Tablet Generic Repaglinide Tabs 1MG Tablet

Generic Dextroamphetamine Sulfate ER Cp24 5MG Capsule 24 Hr ER Brand Retrovir Caps 100MG Capsule

Generic Diltiazem HCl ER Coated Beads Tb24 300MG Tablet 24-Hr ER Generic Ribavirin Caps 200MG Capsule

Generic Diltiazem HCl ER Coated Beads Tb24 360MG Tablet 24-Hr ER Generic Risperidone Tabs 0.25MG Tablet

Generic Diltiazem HCl ER Cp12 90MG Capsule 12 Hr ER Generic Risperidone TbDp 0.5MG Disintegrating Tablet

Brand Drisdol Caps 50000Unit Capsule Generic Rivelsa Tabs 42-21-21-7Days Tablet

Generic Dronabinol Caps 2.5MG Capsule Brand Rocaltrol Caps 0.5MCG Capsule

Generic Entacapone Tabs 200MG Tablet Brand Rytary CpCR 23.75-95MG Capsule ER

Brand Eprosartan Mesylate Tabs 600MG Tablet Brand Rytary CpCR 36.25-145MG Capsule ER

Brand Fazaclo TbDp 12.5MG Disintegrating Tablet Brand Rytary CpCR 48.75-195MG Capsule ER

Brand Fenofibrate Caps 50MG Capsule Brand Sustiva Caps 50MG Capsule

Generic Flecainide Acetate Tabs 100MG Tablet Generic Tamoxifen Citrate Tabs 20MG Tablet

Brand Glyset Tabs 25MG Tablet Generic Telmisartan-HCTZ Tabs 40-12.5MG Tablet

Generic Hydrocodone-Ibuprofen Tabs 10-200MG Tablet Brand Theo-24 Cp24 200MG Capsule 24 Hr ER

Brand Hyophen Tabs 81.6MG Tablet Generic Tinidazole Tabs 250MG Tablet

Brand Intelence Tabs 25MG Tablet Brand Tolazamide Tabs 500MG Tablet

Generic Irbesartan-Hydrochlorothiazide Tabs 300-12.5MG Tablet Brand Tolmetin Sodium Caps 400MG Capsule

Brand Kapspargo Sprinkle Cs24 200MG Capsule Sprinkle 24Hr Generic Topiramate Tabs 200MG Tablet

Generic Ketoconazole Tabs 200MG Tablet Brand Trilipix CpDR 45MG Capsule DR/EC

Brand Klonopin Tabs 1MG Tablet Brand Tri-Norinyl (28) Tabs 0.5/1/0.5-35MG-MCG Tablet

Generic Lansoprazole CpDR 30MG Capsule DR/EC Brand Ultracet Tabs 37.5-325MG Tablet

Brand Lomotil Tabs 2.5-0.025MG Tablet Generic Ursodiol Tabs 500MG Tablet

Brand Macrodantin Caps 50MG Capsule Brand Verdrocet Tabs 2.5-325MG Tablet

Generic Methazolamide Tabs 25MG Tablet Brand Viokace Tabs 10440Unit Tablet

Generic Methylphenidate HCl Chew 5MG Chewable Tablet Brand Vistaril Caps 50MG Capsule

Generic Methylphenidate HCl ER TbCR 20MG Tablet ER Generic Zaleplon Caps 10MG Capsule

Generic Miglitol Tabs 100MG Tablet Brand Zanaflex Caps 2MG Capsule

1 of 1 2019 FORMULARY$10 $20 $30 $40 $50 $60 $70

$80 $90 $100 $120 $150 $200$90 Co-Pay Drugs


Brand Adalat Cc Tb24 60MG Tablet 24-Hr ER Generic Lovastatin Tabs 40MG Tablet

Brand Alogliptin-Metformin HCl Tabs 12.5-1000MG Tablet Brand Medrol Tabs 4MG Tablet

Brand Alogliptin-Metformin HCl Tabs 12.5-500MG Tablet Brand Medrol TbPk 4MG Tablet Dose Pack

Brand Aminopmrms Caps Capsule Brand Metafolbic Plus RF Tabs 6-90.314-2-600MG Tablet

Generic Amlodipine Besylate-Valsartan Tabs 5-320MG Tablet Generic Methotrexate Tabs 2.5MG Tablet

Generic Amlodipine-Olmesartan Tabs 10-20MG Tablet Generic Methylprednisolone Tabs 32MG Tablet

Generic Amlodipine-Olmesartan Tabs 5-20MG Tablet Generic Mimvey Lo Tabs 0.5-0.1MG Tablet

Generic Amlodipine-Valsartan-HCTZ Tabs 5-160-25MG Tablet Brand Minipress Caps 2MG Capsule

Generic Amphetamine-Dextroamphet ER Cp24 15MG Capsule 24 Hr ER Generic Moderiba Tabs 200MG Tablet

Brand App Slim RMS Caps Capsule Generic Morphine Sulfate ER Cp24 20MG Capsule 24 Hr ER

Generic Aripiprazole Tabs 5MG Tablet Generic Nadolol Tabs 80MG Tablet

Brand Bidil Tabs 20-37.5MG Tablet Generic Naltrexone HCl Tabs 50MG Tablet

Generic Bromocriptine Mesylate Tabs 2.5MG Tablet Brand Niacor Tabs 500MG Tablet

Brand Calan Tabs 80MG Tablet Generic Olmesartan Medoxomil-HCTZ Tabs 40-12.5MG Tablet

Generic Candesartan Cilexetil Tabs 32MG Tablet Brand Oxymorphone HCl ER Tb12 7.5MG Tablet 12-Hr ER

Generic Candesartan Cilexetil-HCTZ Tabs 32-12.5MG Tablet Generic Oxymorphone HCl Tabs 10MG Tablet

Generic Candesartan Cilexetil-HCTZ Tabs 32-25MG Tablet Generic Paromomycin Sulfate Caps 250MG Capsule

Brand Carbidopa-Levodopa-Entacapone Tabs 12.5-50-200MG Tablet Brand Pentasa CpCR 250MG Capsule ER

Brand Carbidopa-Levodopa-Entacapone Tabs 25-100-200MG Tablet Generic Pioglitazone HCl Tabs 30MG Tablet

Brand Carbidopa-Levodopa-Entacapone Tabs 37.5-150-200MG Tablet Generic Piroxicam Caps 20MG Capsule

Generic Cefprozil Tabs 250MG Tablet Brand Prezista Tabs 75MG Tablet

Generic Cefuroxime Axetil Tabs 250MG Tablet Generic Pyrazinamide Tabs 500MG Tablet

Generic Clonidine HCl ER Tb12 0.1MG Tablet 12-Hr ER Brand Rifadin Caps 150MG Capsule

Generic Clozapine Tabs 200MG Tablet Generic Rifampin Caps 300MG Capsule

Brand Cortef Tabs 20MG Tablet Generic Risperidone Tabs 0.5MG Tablet

Brand Coumadin Tabs 10MG Tablet Generic Risperidone Tabs 1MG Tablet

Brand Coumadin Tabs 7.5MG Tablet Generic Risperidone TbDp 1MG Disintegrating Tablet

Generic Cyclobenzaprine HCl Tabs 7.5MG Tablet Brand R-Natal OB Caps 20-1-320MG Capsule

Generic Danazol Caps 100MG Capsule Generic Ropinirole HCl ER Tb24 4MG Tablet 24-Hr ER

Brand Demadex Tabs 20MG Tablet Generic Stavudine Caps 15MG Capsule

Brand Depakote ER Tb24 250MG Tablet 24-Hr ER Generic Stavudine Caps 20MG Capsule

Generic Desipramine HCl Tabs 100MG Tablet Generic Stavudine Caps 30MG Capsule

Generic Dextroamphetamine Sulfate ER Cp24 10MG Capsule 24 Hr ER Generic Stavudine Caps 40MG Capsule

Generic Diltiazem HCl ER Coated Beads Tb24 420MG Tablet 24-Hr ER Generic Tacrolimus Caps 1MG Capsule

Generic Donepezil HCl TbDp 10MG Disintegrating Tablet Generic Telmisartan-Amlodipine Tabs 40-10MG Tablet

Generic Donepezil HCl TbDp 5MG Disintegrating Tablet Generic Telmisartan-Amlodipine Tabs 40-5MG Tablet

Generic Efavirenz Caps 50MG Capsule Generic Telmisartan-Amlodipine Tabs 80-5MG Tablet

Generic Eplerenone Tabs 25MG Tablet Brand Tiazac Cp24 240MG Capsule 24 Hr ER

Generic Felbamate Tabs 400MG Tablet Brand Tolmetin Sodium Tabs 600MG Tablet

Generic Fenofibrate Tabs 145MG Tablet Brand Toprol XL Tb24 200MG Tablet 24-Hr ER

Brand Fenoprofen Calcium Caps 400MG Capsule Generic Trandolapril-Verapamil HCl ER TbCR 2-180MG Tablet ER

Generic Fluoxetine HCl Tabs 20MG Tablet Generic Trandolapril-Verapamil HCl ER TbCR 2-240MG Tablet ER

Generic Fluphenazine HCl Tabs 10MG Tablet Generic Trandolapril-Verapamil HCl ER TbCR 4-240MG Tablet ER

Generic Fluvastatin Sodium Caps 20MG Capsule Generic Trazodone HCl Tabs 300MG Tablet

Generic Fluvastatin Sodium Caps 40MG Capsule Brand Triazolam Tabs 0.125MG Tablet

Brand Glucotrol Tabs 10MG Tablet Brand Ultram Tabs 50MG Tablet

Brand Glucotrol XL Tb24 10MG Tablet 24-Hr ER Brand Uta Caps 120MG Capsule

Brand Glynase Tabs 3MG Tablet Generic Venlafaxine HCl ER Cp24 37.5MG Capsule 24 Hr ER

Brand Glyset Tabs 50MG Tablet Brand Vinate DHA RF Caps 27-1.13MG Capsule

Generic Griseofulvin Ultramicrosize Tabs 125MG Tablet Brand Zenpep CpEP 10000-32000Unit Capsule DR/EC

Generic Hydroxychloroquine Sulfate Tabs 200MG Tablet Generic Zolpidem Tartrate ER TbCR 12.5MG Tablet ER

Generic Levetiracetam ER Tb24 500MG Tablet 24-Hr ER Brand Zyloprim Tabs 100MG Tablet

1 of 1 2019 FORMULARY$10 $20 $30 $40 $50 $60 $70

$80 $90 $100 $120 $150 $200$100 Co-Pay Drugs


Brand Adalat Cc Tb24 90MG Tablet 24-Hr ER Brand Maxzide Tabs 75-50MG Tablet

Generic Albuterol Sulfate Tabs 4MG Tablet Brand Meclofenamate Sodium Caps 50MG Capsule

Generic Amlodipine Besylate-Valsartan Tabs 10-320MG Tablet Brand Menest Tabs 1.25MG Tablet

Generic Amoxicillin-Pot Clavulanate Tabs 250-125MG Tablet Generic Mimvey Tabs 1-0.5MG Tablet

Generic Amoxicillin-Pot Clavulanate Tabs 875-125MG Tablet Generic Minocycline HCl Tabs 100MG Tablet

Generic Anagrelide HCl Caps 0.5MG Capsule Generic Morphine Sulfate ER Cp24 30MG Capsule 24 Hr ER

Generic Armodafinil Tabs 50MG Tablet Generic Nevirapine Tabs 200MG Tablet

Generic Baclofen Tabs 20MG Tablet Brand Norco Tabs 7.5-325MG Tablet

Generic Benzonatate Caps 200MG Capsule Brand OB Complete Premier Tabs 30-20-1MG Tablet

Generic Candesartan Cilexetil-HCTZ Tabs 16-12.5MG Tablet Generic Olmesartan Medoxomil Tabs 20MG Tablet

Brand Carafate Tabs 1GM Tablet Generic Oxcarbazepine Tabs 600MG Tablet

Brand Celebrex Caps 50MG Capsule Brand Plaquenil Tabs 200MG Tablet

Generic Celecoxib Caps 200MG Capsule Brand Propecia Tabs 1MG Tablet

Brand Cephalexin Tabs 250MG Tablet Brand Provera Tabs 5MG Tablet

Brand Corvite 150 Tabs Tablet Generic Rajani Tabs 3-0.02-0.451MG Tablet

Brand Cozaar Tabs 50MG Tablet Generic Rimantadine HCl Tabs 100MG Tablet

Generic Cyclosporine Caps 25MG Capsule Brand Risperidone TbDp 0.25MG Disintegrating Tablet

Brand Delzicol CpDR 400MG Capsule DR/EC Generic Rosuvastatin Calcium Tabs 40MG Tablet

Brand Depakote TbEC 250MG Tablet DR/EC Brand Rytary CpCR 61.25-245MG Capsule ER

Generic Desloratadine Tabs 5MG Tablet Generic Ryvent Tabs 6MG Tablet

Brand Dilaudid Tabs 4MG Tablet Brand Sandimmune Caps 25MG Capsule

Generic Diltiazem HCl ER Cp12 120MG Capsule 12 Hr ER Generic Simvastatin Tabs 80MG Tablet

Generic Disulfiram Tabs 500MG Tablet Brand Starlix Tabs 120MG Tablet

Generic Doxycycline Hyclate Caps 100MG Capsule Brand Starlix Tabs 60MG Tablet

Generic Doxycycline Monohydrate Tabs 100MG Tablet Brand Tapazole Tabs 10MG Tablet

Generic Eemt Hs Tabs 0.625-1.25MG Tablet Generic Telmisartan-Amlodipine Tabs 80-10MG Tablet

Generic Eemt Tabs 1.25-2.5MG Tablet Generic Telmisartan-HCTZ Tabs 80-12.5MG Tablet

Brand Envarsus XR Tb24 0.75MG Tablet 24-Hr ER Generic Terbutaline Sulfate Tabs 2.5MG Tablet

Brand Equetro Cp12 100MG Capsule 12 Hr ER Brand Theo-24 Cp24 300MG Capsule 24 Hr ER

Brand Etidronate Disodium Tabs 200MG Tablet Generic Tramadol HCl ER Tb24 200MG Tablet 24-Hr ER

Generic Famotidine Tabs 40MG Tablet Brand Tricare Prenatal Chew 4.5-1MG Chewable Tablet

Generic Fluoxetine HCl Caps 40MG Capsule Brand Urecholine Tabs 10MG Tablet

Generic Galantamine Hydrobromide ER Cp24 16MG Capsule 24 Hr ER Brand Urocit-K 15 TbCR 15 Meq(1620 MG) Tablet ER

Generic Galantamine Hydrobromide ER Cp24 24MG Capsule 24 Hr ER Brand Urogesic-Blue Tabs 81.6MG Tablet

Generic Galantamine Hydrobromide ER Cp24 8MG Capsule 24 Hr ER Brand Valium Tabs 2MG Tablet

Brand Glyset Tabs 100MG Tablet Generic Verapamil HCl ER Cp24 300MG Capsule 24 Hr ER

Brand Hiprex Tabs 1GM Tablet Brand Vitamedmd One Rx/Quatrefolic Caps 30-0.6-0.4-200MG Capsule

Generic Lamivudine Tabs 150MG Tablet Brand Vitamedmd Redichew Rx Chew 1.4MG Chewable Tablet

Generic Lamotrigine ER Tb24 25MG Tablet 24-Hr ER Brand Vitapearl CpCR 30-1.4-200MG Capsule ER

Generic Levetiracetam Tabs 750MG Tablet Brand Welchol Tabs 625MG Tablet

Brand L-Methylfolate Forte Caps 15-90.314MG Capsule Brand Zanaflex Caps 4MG Capsule

Brand L-Methylfolate Forte Caps 7.5-90.314MG Capsule Brand Zarontin Caps 250MG Capsule

Brand Lopressor Tabs 100MG Tablet Brand Zocor Tabs 5MG Tablet

1 of 2 2019 FORMULARY$10 $20 $30 $40 $50 $60 $70

$80 $90 $100 $120 $150 $200$120 Co-Pay Drugs


Brand Accolate Tabs 10MG Tablet Generic Demeclocycline HCl Tabs 150MG Tablet

Brand Accolate Tabs 20MG Tablet Generic Desvenlafaxine Succinate ER Tb24 25MG Tablet 24-Hr ER

Generic Albuterol Sulfate Tabs 2MG Tablet Generic Dextroamphetamine Sulfate ER Cp24 15MG Capsule 24 Hr ER

Brand Aldactone Tabs 50MG Tablet Brand Dilatrate-SR CpCR 40MG Capsule ER

Brand Amaryl Tabs 4MG Tablet Generic Dofetilide Caps 125MCG Capsule

Generic Aminorelief RMS Caps Capsule Generic Donepezil HCl Tabs 23MG Tablet

Generic Amlodipine Besylate-Valsartan Tabs 5-160MG Tablet Generic Doxycycline Hyclate Tabs 100MG Tablet

Generic Amlodipine-Atorvastatin Tabs 2.5-10MG Tablet Generic Duloxetine HCl CpEP 40MG Capsule DR/EC

Generic Amlodipine-Atorvastatin Tabs 5-10MG Tablet Generic Dutasteride Caps 0.5MG Capsule

Generic Amlodipine-Olmesartan Tabs 10-40MG Tablet Generic Dutasteride-Tamsulosin HCl Caps 0.5-0.4MG Capsule

Generic Amlodipine-Olmesartan Tabs 5-40MG Tablet Brand Enbrace HR Caps Capsule

Generic Amlodipine-Valsartan-HCTZ Tabs 10-160-12.5MG Tablet Brand Equetro Cp12 200MG Capsule 12 Hr ER

Generic Amlodipine-Valsartan-HCTZ Tabs 10-160-25MG Tablet Brand Equetro Cp12 300MG Capsule 12 Hr ER

Brand Amoxicillin-Pot Clavulanate Chew 400-57MG Chewable Tablet Generic Erythromycin Base CpEP 250MG Capsule DR/EC

Generic Amphetamine-Dextroamphet ER Cp24 10MG Capsule 24 Hr ER Generic Famciclovir Tabs 125MG Tablet

Generic Amphetamine-Dextroamphet ER Cp24 20MG Capsule 24 Hr ER Generic Famciclovir Tabs 250MG Tablet

Generic Amphetamine-Dextroamphet ER Cp24 25MG Capsule 24 Hr ER Brand Fazaclo TbDp 25MG Disintegrating Tablet

Generic Amphetamine-Dextroamphet ER Cp24 30MG Capsule 24 Hr ER Generic Felbamate Tabs 600MG Tablet

Generic Amphetamine-Dextroamphet ER Cp24 5MG Capsule 24 Hr ER Generic Fenofibrate Micronized Caps 130MG Capsule

Brand Apriso Cp24 0.375GM Capsule 24 Hr ER Generic Fenofibric Acid CpDR 135MG Capsule DR/EC

Generic Asilnasal RMS Caps Capsule Generic Gengraf Caps 100MG Capsule

Generic Aspirin-Dipyridamole ER Cp12 25-200MG Capsule 12 Hr ER Generic Griseofulvin Ultramicrosize Tabs 250MG Tablet

Brand Avandia Tabs 2MG Tablet Generic Guanfacine HCl ER Tb24 1MG Tablet 24-Hr ER

Brand Aygestin Tabs 5MG Tablet Generic Guanfacine HCl ER Tb24 2MG Tablet 24-Hr ER

Generic Bupropion HCl ER (XL) Tb24 300MG Tablet 24-Hr ER Generic Guanfacine HCl ER Tb24 4MG Tablet 24-Hr ER

Brand Butisol Sodium Tabs 30MG Tablet Generic Hematogen Caps Capsule

Brand Bystolic Tabs 10MG Tablet Brand Hyzaar Tabs 50-12.5MG Tablet

Brand Bystolic Tabs 2.5MG Tablet Brand Invirase Caps 200MG Capsule

Brand Bystolic Tabs 20MG Tablet Brand Kaletra Tabs 100-25MG Tablet

Brand Bystolic Tabs 5MG Tablet Brand Klonopin Tabs 2MG Tablet

Brand Byvalson Tabs 5-80MG Tablet Brand Kosher Prenatal Plus Iron Tabs 30-1MG Tablet

Brand Calan Tabs 120MG Tablet Generic Lamotrigine Tabs 200MG Tablet

Generic Capecitabine Tabs 150MG Tablet Brand Levbid Tb12 0.375MG Tablet 12-Hr ER

Brand Captopril-Hydrochlorothiazide Tabs 50-15MG Tablet Brand Loestrin Fe 1.5/30 Tabs 1.5-30MG-MCG Tablet

Brand Captopril-Hydrochlorothiazide Tabs 50-25MG Tablet Brand Loestrin Fe 1/20 Tabs 1-20MG-MCG Tablet

Brand Cardizem La Tb24 120MG Tablet 24-Hr ER Brand Loseasonique Tabs 0.1-0.02 & 0.01MG Tablet

Brand Cardizem La Tb24 180MG Tablet 24-Hr ER Brand Macutek TbDp Disintegrating Tablet

Brand Cardizem La Tb24 240MG Tablet 24-Hr ER Brand Marplan Tabs 10MG Tablet

Brand Catapres Tabs 0.2MG Tablet Brand Medrol Tabs 8MG Tablet

Generic Cefadroxil Tabs 1GM Tablet Generic Memantine HCl Tabs 10MG Tablet

Generic Cefpodoxime Proxetil Tabs 100MG Tablet Generic Memantine HCl Tabs 5MG Tablet

Generic Celecoxib Caps 400MG Capsule Generic Meprobamate Tabs 200MG Tablet

Brand Celontin Caps 300MG Capsule Generic Metaxalone Tabs 800MG Tablet

Brand Cetylev TbEf 500MG Effervescent Tablet Generic Methylphenidate HCl Chew 10MG Chewable Tablet

Brand Chloroquine Phosphate Tabs 250MG Tablet Generic Methylphenidate HCl ER (Cd) CpCR 10MG Capsule ER

Generic Cimetidine Tabs 800MG Tablet Generic Methylphenidate HCl ER (Cd) CpCR 20MG Capsule ER

Brand Citranatal Bloom Tabs 90-1MG Tablet Generic Methylphenidate HCl ER (Cd) CpCR 30MG Capsule ER

Brand Citranatal Harmony Caps 27-1-260MG Capsule Generic Methylphenidate HCl ER (La) Cp24 20MG Capsule 24 Hr ER

Brand Citranatal Medley Caps 27-1-200MG Capsule Generic Methylphenidate HCl ER (La) Cp24 40MG Capsule 24 Hr ER

Generic Clarithromycin ER Tb24 500MG Tablet 24-Hr ER Brand Mircette Tabs 0.15-0.02/0.01MG (21/5) Tablet

Generic Clarithromycin Tabs 500MG Tablet Generic Montelukast Sodium Chew 4MG Chewable Tablet

Brand Corgard Tabs 20MG Tablet Generic Montelukast Sodium Chew 5MG Chewable Tablet

Brand Cycloset Tabs 0.8MG Tablet Generic Morphine Sulfate ER TbCR 60MG Tablet ER

Brand Cytomel Tabs 50MCG Tablet Brand Ms Contin TbCR 15MG Tablet ER

Brand Cytotec Tabs 100MCG Tablet Brand Nalfon Tabs 600MG Tablet

2 of 2 2019 FORMULARY$10 $20 $30 $40 $50 $60 $70

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Brand Natachew Chew 28-1MG Chewable Tablet Generic Telmisartan-HCTZ Tabs 80-25MG Tablet

Brand Nefazodone HCl Tabs 100MG Tablet Generic Terbutaline Sulfate Tabs 5MG Tablet

Brand Nefazodone HCl Tabs 150MG Tablet Brand Tiazac Cp24 300MG Capsule 24 Hr ER

Brand Nefazodone HCl Tabs 200MG Tablet Brand Tiazac Cp24 360MG Capsule 24 Hr ER

Brand Nefazodone HCl Tabs 250MG Tablet Brand Tigan Caps 300MG Capsule

Brand Nefazodone HCl Tabs 50MG Tablet Brand Tirosint Caps 100MCG Capsule

Generic Nevirapine ER Tb24 100MG Tablet 24-Hr ER Brand Tirosint Caps 112MCG Capsule

Brand Nexa Plus Caps 29-1.25-350MG Capsule Brand Tirosint Caps 125MCG Capsule

Generic Niacin ER (Antihyperlipidemic) TbCR 750MG Tablet ER Brand Tirosint Caps 137MCG Capsule

Generic Nisoldipine ER Tb24 8.5MG Tablet 24-Hr ER Brand Tirosint Caps 13MCG Capsule

Generic Norethindrone Acet-Ethinyl Est Chew 1-20MG-MCG(24) Chewable Tablet Brand Tirosint Caps 150MCG Capsule

Generic Norgestim-Eth Estrad Triphasic Tabs 0.18/0.215/0.25MG-25 MCG Tablet Brand Tirosint Caps 25MCG Capsule

Brand Norpace Caps 100MG Capsule Brand Tirosint Caps 50MCG Capsule

Brand Norpace Cr Cp12 100MG Capsule 12 Hr ER Brand Tirosint Caps 88MCG Capsule

Brand OB Complete Gold Caps 27.5-1-200MG Capsule Generic Topiramate Tabs 100MG Tablet

Generic Olmesartan-Amlodipine-HCTZ Tabs 20-5-12.5MG Tablet Generic Tramadol HCl ER (Biphasic) Tb24 200MG Tablet 24-Hr ER

Generic Oxandrolone Tabs 2.5MG Tablet Brand Trandolapril-Verapamil HCl ER TbCR 1-240MG Tablet ER

Brand Oxymorphone HCl ER Tb12 10MG Tablet 12-Hr ER Generic Tranexamic Acid Tabs 650MG Tablet

Generic Paroxetine HCl ER Tb24 12.5MG Tablet 24-Hr ER Generic Tranylcypromine Sulfate Tabs 10MG Tablet

Generic Paroxetine HCl ER Tb24 25MG Tablet 24-Hr ER Generic Triazolam Tabs 0.25MG Tablet

Generic Paroxetine HCl ER Tb24 37.5MG Tablet 24-Hr ER Brand Trileptal Tabs 150MG Tablet

Generic Paroxetine Mesylate Caps 7.5MG Capsule Generic Trimipramine Maleate Caps 50MG Capsule

Brand Pravachol Tabs 20MG Tablet Brand Tristart One Caps 35-1-215MG Capsule

Brand Prefest Tabs 1/1-0.09MG (15/15) Tablet Generic Trospium Chloride ER Cp24 60MG Capsule 24 Hr ER

Brand Priftin Tabs 150MG Tablet Generic Tydemy Tabs 3-0.03-0.451MG Tablet

Brand Pyridium Tabs 100MG Tablet Generic Urelle Tabs 81MG Tablet

Generic Quetiapine Fumarate ER Tb24 150MG Tablet 24-Hr ER Brand Urimar-T Tabs 120MG Tablet

Generic Quinine Sulfate Caps 324MG Capsule Generic Venlafaxine HCl ER Tb24 37.5MG Tablet 24-Hr ER

Brand Remeron Soltab TbDp 15MG Disintegrating Tablet Brand Videx EC CpDR 125MG Capsule DR/EC

Brand Remeron Soltab TbDp 30MG Disintegrating Tablet Brand Viracept Tabs 250MG Tablet

Brand Rifater Tabs 50-120-300MG Tablet Brand Vitafol Tabs Tablet

Generic Risperidone Tabs 4MG Tablet Brand Vitafol Ultra Caps 29-0.6-0.4-200MG Capsule

Generic Ropinirole HCl ER Tb24 8MG Tablet 24-Hr ER Brand Vitafol-Nano Tabs 18-0.6-0.4MG Tablet

Brand Seasonique Tabs 0.15-0.03 &0.01MG Tablet Brand Vitafol-OB Tabs Tablet

Brand Segluromet Tabs 2.5-1000MG Tablet Brand Vitafol-One Caps 29-1-200MG Capsule

Brand Segluromet Tabs 2.5-500MG Tablet Brand Xanax Tabs 0.25MG Tablet

Brand Segluromet Tabs 7.5-1000MG Tablet Brand Yasmin 28 Tabs 3-0.03MG Tablet

Brand Segluromet Tabs 7.5-500MG Tablet Brand Zenpep CpEP 15000-47000Unit Capsule DR/EC

Brand Select-OB Chew 29-0.6-0.4MG Chewable Tablet Generic Zolpidem Tartrate ER TbCR 6.25MG Tablet ER

Brand Selzentry Tabs 25MG Tablet Brand Zorvolex Caps 18MG Capsule

Brand Seroquel Tabs 25MG Tablet Brand Zorvolex Caps 35MG Capsule

Brand Sulfadiazine Tabs 500MG Tablet Brand Zyban Tb12 150MG Tablet 12-Hr ER

1 of 2 2019 FORMULARY$10 $20 $30 $40 $50 $60 $70

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Brand Accupril Tabs 10MG Tablet Brand Desloratadine TbDp 2.5MG Disintegrating Tablet

Brand Accupril Tabs 20MG Tablet Brand Desloratadine TbDp 5MG Disintegrating Tablet

Brand Accupril Tabs 40MG Tablet Brand Desvenlafaxine ER Tb24 100MG Tablet 24-Hr ER

Brand Accupril Tabs 5MG Tablet Generic Dexmethylphenidate HCl ER Cp24 15MG Capsule 24 Hr ER

Brand Accuretic Tabs 10-12.5MG Tablet Generic Dexmethylphenidate HCl ER Cp24 30MG Capsule 24 Hr ER

Brand Accuretic Tabs 20-12.5MG Tablet Generic Dexmethylphenidate HCl ER Cp24 5MG Capsule 24 Hr ER

Brand Accuretic Tabs 20-25MG Tablet Generic Doxycycline Monohydrate Tabs 150MG Tablet

Brand Aldactazide Tabs 50-50MG Tablet Brand Duavee Tabs 0.45-20MG Tablet

Brand Alendronate Sodium Tabs 40MG Tablet Brand Envarsus XR Tb24 1MG Tablet 24-Hr ER

Brand Altace Caps 1.25MG Capsule Brand Esgic Tabs 50-325-40MG Tablet

Generic Amlodipine-Atorvastatin Tabs 10-10MG Tablet Generic Esomeprazole Magnesium CpDR 20MG Capsule DR/EC

Generic Amlodipine-Atorvastatin Tabs 10-20MG Tablet Brand Estrace Tabs 0.5MG Tablet

Generic Amlodipine-Atorvastatin Tabs 10-40MG Tablet Brand Estrace Tabs 1MG Tablet

Generic Amlodipine-Atorvastatin Tabs 10-80MG Tablet Generic Eszopiclone Tabs 2MG Tablet

Generic Amlodipine-Atorvastatin Tabs 2.5-20MG Tablet Generic Ezetimibe-Simvastatin Tabs 10-10MG Tablet

Generic Amlodipine-Atorvastatin Tabs 2.5-40MG Tablet Generic Ezetimibe-Simvastatin Tabs 10-40MG Tablet

Generic Amlodipine-Atorvastatin Tabs 5-20MG Tablet Generic Ezetimibe-Simvastatin Tabs 10-80MG Tablet

Generic Amlodipine-Atorvastatin Tabs 5-40MG Tablet Brand Femhrt Low Dose Tabs 0.5-2.5MG-MCG Tablet

Generic Amlodipine-Atorvastatin Tabs 5-80MG Tablet Brand Fioricet Caps 50-300-40MG Capsule

Generic Amlodipine-Valsartan-HCTZ Tabs 5-160-12.5MG Tablet Brand Fiorinal Caps 50-325-40MG Capsule

Generic Amoxicillin-Pot Clavulanate ER Tb12 1000-62.5MG Tablet 12-Hr ER Brand Floriva Chew 0.25MG Chewable Tablet

Brand Astagraf XL Cp24 1MG Capsule 24 Hr ER Brand Floriva Chew 0.5MG Chewable Tablet

Brand Atacand Tabs 4MG Tablet Brand Floriva Chew 1MG Chewable Tablet

Generic Atovaquone-Proguanil HCl Tabs 250-100MG Tablet Generic Fluconazole Tabs 100MG Tablet

Brand Auryxia Tabs 1 GM210 MG(Fe) Tablet Generic Fluvastatin Sodium ER Tb24 80MG Tablet 24-Hr ER

Brand Avandia Tabs 4MG Tablet Brand Generess Fe Chew 0.8-25MG-MCG Chewable Tablet

Brand Avapro Tabs 75MG Tablet Brand Glycate Tabs 1.5MG Tablet

Brand Belviq Tabs 10MG Tablet Brand Glynase Tabs 6MG Tablet

Brand Cardura Tabs 1MG Tablet Brand Halcion Tabs 0.25MG Tablet

Brand Cardura Tabs 2MG Tablet Brand Hyzaar Tabs 100-12.5MG Tablet

Brand Cardura Tabs 4MG Tablet Brand Hyzaar Tabs 100-25MG Tablet

Brand Cardura Tabs 8MG Tablet Generic Ivermectin Tabs 3MG Tablet

Brand Cardura XL Tb24 4MG Tablet 24-Hr ER Generic Lamotrigine TbDp 25MG Disintegrating Tablet

Brand Cardura XL Tb24 8MG Tablet 24-Hr ER Generic Levetiracetam ER Tb24 750MG Tablet 24-Hr ER

Brand Catapres Tabs 0.3MG Tablet Generic Levetiracetam Tabs 1000MG Tablet

Generic Cephalexin Caps 750MG Capsule Brand Lo Loestrin Fe Tabs 1 MG-10 MCG /10 MCG Tablet

Brand Cetylev TbEf 2.5GM Effervescent Tablet Brand Lysodren Tabs 500MG Tablet

Generic Chlorpromazine HCl Tabs 25MG Tablet Brand Lysteda Tabs 650MG Tablet

Brand Cipro Tabs 250MG Tablet Brand Macrodantin Caps 100MG Capsule

Brand Clarinex-D 12 Hr Tb12 2.5-120MG Tablet 12-Hr ER Generic Meprobamate Tabs 400MG Tablet

Brand Cleocin Caps 75MG Capsule Generic Mercaptopurine Tabs 50MG Tablet

Brand Clozaril Tabs 25MG Tablet Brand Metaxalone Tabs 400MG Tablet

Brand Coartem Tabs 20-120MG Tablet Generic Methazolamide Tabs 50MG Tablet

Brand Colazal Caps 750MG Capsule Generic Methylphenidate HCl ER (Cd) CpCR 40MG Capsule ER

Brand Colchicine Caps 0.6MG Capsule Brand Methylphenidate HCl ER Tb24 18MG Tablet 24-Hr ER

Brand Colchicine Tabs 0.6MG Tablet Brand Methylphenidate HCl ER Tb24 27MG Tablet 24-Hr ER

Brand Coreg Tabs 12.5MG Tablet Brand Methylphenidate HCl ER Tb24 36MG Tablet 24-Hr ER

Brand Coreg Tabs 25MG Tablet Generic Methylphenidate HCl ER TbCR 10MG Tablet ER

Brand Coreg Tabs 3.125MG Tablet Generic Midodrine HCl Tabs 10MG Tablet

Brand Coreg Tabs 6.25MG Tablet Brand Minipress Caps 5MG Capsule

Brand Corgard Tabs 40MG Tablet Brand Minocin Caps 50MG Capsule

Brand Cozaar Tabs 100MG Tablet Brand Morphine Sulfate ER Beads Cp24 30MG Capsule 24 Hr ER

Brand Cytotec Tabs 200MCG Tablet Generic Morphine Sulfate ER TbCR 100MG Tablet ER

Brand Depakene Caps 250MG Capsule Brand Myfortic TbEC 180MG Tablet DR/EC

Generic Desipramine HCl Tabs 150MG Tablet Generic Nadolol-Bendroflumethiazide Tabs 40-5MG Tablet

2 of 2 2019 FORMULARY$10 $20 $30 $40 $50 $60 $70

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Brand Natelle One Caps 28-1-250MG Capsule Brand Requip Tabs 0.25MG Tablet

Brand Nestabs One Caps 38-1-225MG Capsule Brand Requip Tabs 0.5MG Tablet

Brand Neurontin Caps 300MG Capsule Brand Requip Tabs 1MG Tablet

Brand Niaspan TbCR 500MG Tablet ER Brand Requip Tabs 2MG Tablet

Generic Nisoldipine ER Tb24 17MG Tablet 24-Hr ER Brand Requip XL Tb24 2MG Tablet 24-Hr ER

Generic Nisoldipine ER Tb24 34MG Tablet 24-Hr ER Brand Rifadin Caps 300MG Capsule

Generic Nitrofurantoin Macrocrystal Caps 25MG Capsule Brand Rifamate Caps 150-300MG Capsule

Brand Norco Tabs 10-325MG Tablet Generic Risedronate Sodium Tabs 5MG Tablet

Brand Norpace Caps 150MG Capsule Generic Risperidone Tabs 2MG Tablet

Brand Norpace Cr Cp12 150MG Capsule 12 Hr ER Generic Ritonavir Tabs 100MG Tablet

Brand OB Complete One Caps 50-1-476MG Capsule Generic Ropinirole HCl ER Tb24 6MG Tablet 24-Hr ER

Brand OB Complete Petite Caps 35-5-1-200MG Capsule Generic Rosuvastatin Calcium Tabs 10MG Tablet

Generic Olmesartan-Amlodipine-HCTZ Tabs 40-10-12.5MG Tablet Brand Roxicodone Tabs 15MG Tablet

Generic Olmesartan-Amlodipine-HCTZ Tabs 40-5-12.5MG Tablet Brand Semprex-D Caps 8-60MG Capsule

Brand Orenitram TbCR 0.125MG Tablet ER Brand Siklos Tabs 100MG Tablet

Brand Ortho Tri-Cyclen Lo Tabs 0.18/0.215/0.25MG-25 MCG Tablet Generic Sirolimus Tabs 0.5MG Tablet

Brand Oxymorphone HCl ER Tb12 15MG Tablet 12-Hr ER Brand Stromectol Tabs 3MG Tablet

Generic Pacerone Tabs 100MG Tablet Generic Sumatriptan Succinate Tabs 50MG Tablet

Generic Pacerone Tabs 400MG Tablet Brand Surmontil Caps 25MG Capsule

Brand Pancreaze CpEP 16800Unit Capsule DR/EC Brand Taperdex 12-Day TbPk 1.5MG (49) Tablet Dose Pack

Generic Paricalcitol Caps 1MCG Capsule Brand Tegretol-XR Tb12 400MG Tablet 12-Hr ER

Brand Parlodel Tabs 2.5MG Tablet Brand Tenoretic 100 Tabs 100-25MG Tablet

Brand Pertzye CpEP 16000Unit Capsule DR/EC Brand Theo-24 Cp24 400MG Capsule 24 Hr ER

Generic Pioglitazone HCl Tabs 15MG Tablet Generic Tiagabine HCl Tabs 2MG Tablet

Brand Pravachol Tabs 40MG Tablet Generic Tiagabine HCl Tabs 4MG Tablet

Brand Pravachol Tabs 80MG Tablet Brand Tiazac Cp24 420MG Capsule 24 Hr ER

Brand Premarin Tabs 0.3MG Tablet Brand Tivorbex Caps 20MG Capsule

Brand Premarin Tabs 0.45MG Tablet Brand Tivorbex Caps 40MG Capsule

Brand Premarin Tabs 0.625MG Tablet Generic Tolterodine Tartrate ER Cp24 2MG Capsule 24 Hr ER

Brand Premarin Tabs 0.9MG Tablet Brand Topamax Sprinkle CpSp 15MG Capsule DR Sprinkle

Brand Premarin Tabs 1.25MG Tablet Brand Topamax Tabs 25MG Tablet

Brand Prestalia Tabs 14-10MG Tablet Generic Tramadol HCl ER (Biphasic) Tb24 300MG Tablet 24-Hr ER

Brand Prestalia Tabs 3.5-2.5MG Tablet Brand Trecator Tabs 250MG Tablet

Brand Prestalia Tabs 7-5MG Tablet Generic Trimipramine Maleate Caps 100MG Capsule

Generic Propafenone HCl ER Cp12 225MG Capsule 12 Hr ER Brand Tristart DHA Caps 31-0.6-0.4-200MG Capsule

Brand Proscar Tabs 5MG Tablet Brand Urecholine Tabs 25MG Tablet

Brand Provera Tabs 10MG Tablet Brand Urso 250 Tabs 250MG Tablet

Brand Pyridium Tabs 200MG Tablet Generic Ursodiol Caps 300MG Capsule

Brand Quartette Tabs 42-21-21-7Days Tablet Generic Valacyclovir HCl Tabs 1GM Tablet

Generic Quetiapine Fumarate ER Tb24 200MG Tablet 24-Hr ER Generic Valacyclovir HCl Tabs 500MG Tablet

Generic Quetiapine Fumarate Tabs 100MG Tablet Brand Valium Tabs 5MG Tablet

Generic Quetiapine Fumarate Tabs 50MG Tablet Generic Valsartan Tabs 320MG Tablet

Generic Quinidine Gluconate ER TbCR 324MG Tablet ER Generic Venlafaxine HCl ER Tb24 150MG Tablet 24-Hr ER

Generic Raloxifene HCl Tabs 60MG Tablet Generic Venlafaxine HCl ER Tb24 75MG Tablet 24-Hr ER

Brand Razadyne Tabs 12MG Tablet Brand Verelan Pm Cp24 100MG Capsule 24 Hr ER

Brand Razadyne Tabs 4MG Tablet Brand Xanax Tabs 0.5MG Tablet

Brand Razadyne Tabs 8MG Tablet Brand Yaz Tabs 3-0.02MG Tablet

Brand Remeron Soltab TbDp 45MG Disintegrating Tablet Brand Yosprala TbEC 325-40MG Tablet DR/EC

Brand Remeron Tabs 15MG Tablet Brand Yosprala TbEC 81-40MG Tablet DR/EC

Brand Remeron Tabs 30MG Tablet Brand Zanaflex Caps 6MG Capsule

Brand Renvela Tabs 800MG Tablet Brand Zocor Tabs 10MG Tablet

Brand Repaglinide-Metformin HCl Tabs 1-500MG Tablet Brand Zovirax Caps 200MG Capsule

Brand Repaglinide-Metformin HCl Tabs 2-500MG Tablet

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Generic Abacavir Sulfate-Lamivudine Tabs 600-300MG Tablet Brand Calan SR TbCR 120MG Tablet ER

Brand Adderall Tabs 10MG Tablet Brand Cardizem La Tb24 300MG Tablet 24-Hr ER

Brand Adderall Tabs 12.5MG Tablet Brand Cardizem La Tb24 360MG Tablet 24-Hr ER

Brand Adderall Tabs 15MG Tablet Brand Cardizem La Tb24 420MG Tablet 24-Hr ER

Brand Adderall Tabs 20MG Tablet Brand Cardizem Tabs 30MG Tablet

Brand Adderall Tabs 30MG Tablet Generic Carvedilol Phosphate ER Cp24 10MG Capsule 24 Hr ER

Brand Adderall Tabs 5MG Tablet Generic Carvedilol Phosphate ER Cp24 20MG Capsule 24 Hr ER

Brand Adderall Tabs 7.5MG Tablet Generic Carvedilol Phosphate ER Cp24 40MG Capsule 24 Hr ER

Brand Adderall XR Cp24 10MG Capsule 24 Hr ER Generic Carvedilol Phosphate ER Cp24 80MG Capsule 24 Hr ER

Brand Adderall XR Cp24 15MG Capsule 24 Hr ER Generic Cefpodoxime Proxetil Tabs 200MG Tablet

Brand Adderall XR Cp24 20MG Capsule 24 Hr ER Generic Cefprozil Tabs 500MG Tablet

Brand Adderall XR Cp24 25MG Capsule 24 Hr ER Generic Cefuroxime Axetil Tabs 500MG Tablet

Brand Adderall XR Cp24 30MG Capsule 24 Hr ER Brand Celebrex Caps 100MG Capsule

Brand Adderall XR Cp24 5MG Capsule 24 Hr ER Brand Cephalexin Tabs 500MG Tablet

Brand Aldactone Tabs 100MG Tablet Brand Chantix Continuing Month Pak Tabs 1MG Tablet

Brand Alogliptin Benzoate Tabs 12.5MG Tablet Brand Chantix Starting Month Pak Tabs 0.5 MG X 11 &1 MG X 42 Tablet

Brand Alogliptin Benzoate Tabs 25MG Tablet Brand Chantix Tabs 0.5MG Tablet

Brand Alogliptin Benzoate Tabs 6.25MG Tablet Generic Chlorpromazine HCl Tabs 50MG Tablet

Brand Alogliptin-Pioglitazone Tabs 25-15MG Tablet Brand Cipro Tabs 500MG Tablet

Brand Alogliptin-Pioglitazone Tabs 25-30MG Tablet Brand Clarinex Tabs 5MG Tablet

Brand Alogliptin-Pioglitazone Tabs 25-45MG Tablet Brand Clomiphene Citrate Tabs 50MG Tablet

Brand Altace Caps 10MG Capsule Generic Clomipramine HCl Caps 25MG Capsule

Brand Altace Caps 2.5MG Capsule Generic Clomipramine HCl Caps 50MG Capsule

Brand Altace Caps 5MG Capsule Generic Clomipramine HCl Caps 75MG Capsule

Brand Amitiza Caps 24MCG Capsule Generic Clozapine TbDp 100MG Disintegrating Tablet

Brand Amitiza Caps 8MCG Capsule Brand Corgard Tabs 80MG Tablet

Generic Amlodipine-Valsartan-HCTZ Tabs 10-320-25MG Tablet Brand Corlanor Tabs 5MG Tablet

Brand Angeliq Tabs 0.25-0.5MG Tablet Brand Corlanor Tabs 7.5MG Tablet

Brand Angeliq Tabs 0.5-1MG Tablet Brand Creon CpEP 24000-76000Unit Capsule DR/EC

Brand Antabuse Tabs 250MG Tablet Generic Cyclophosphamide Caps 25MG Capsule

Brand Antara Caps 30MG Capsule Brand Cymbalta CpEP 20MG Capsule DR/EC

Generic Apap-Caff-Dihydrocodeine Tabs 325-30-16MG Tablet Generic Danazol Caps 200MG Capsule

Brand Atacand HCT Tabs 16-12.5MG Tablet Generic Darifenacin Hydrobromide ER Tb24 15MG Tablet 24-Hr ER

Brand Atacand Tabs 16MG Tablet Generic Darifenacin Hydrobromide ER Tb24 7.5MG Tablet 24-Hr ER

Brand Atacand Tabs 8MG Tablet Brand Ddavp Tabs 0.1MG Tablet

Generic Atomoxetine HCl Caps 100MG Capsule Brand Depakote ER Tb24 500MG Tablet 24-Hr ER

Generic Atomoxetine HCl Caps 60MG Capsule Brand Depakote TbEC 500MG Tablet DR/EC

Brand Augmentin XR Tb12 1000-62.5MG Tablet 12-Hr ER Generic Desvenlafaxine Succinate ER Tb24 50MG Tablet 24-Hr ER

Brand Avalide Tabs 150-12.5MG Tablet Brand Detrol Tabs 1MG Tablet

Brand Avapro Tabs 150MG Tablet Brand Detrol Tabs 2MG Tablet

Brand Avapro Tabs 300MG Tablet Generic Dexmethylphenidate HCl ER Cp24 10MG Capsule 24 Hr ER

Brand Avodart Caps 0.5MG Capsule Generic Dexmethylphenidate HCl ER Cp24 20MG Capsule 24 Hr ER

Brand Azasan Tabs 100MG Tablet Generic Dexmethylphenidate HCl ER Cp24 25MG Capsule 24 Hr ER

Generic Azithromycin Tabs 250MG Tablet Generic Dexmethylphenidate HCl ER Cp24 35MG Capsule 24 Hr ER

Brand Balcoltra Tabs 0.1-20MG-MCG(21) Tablet Generic Dexmethylphenidate HCl ER Cp24 40MG Capsule 24 Hr ER

Brand Benicar HCT Tabs 20-12.5MG Tablet Brand Diclegis TbEC 10-10MG Tablet DR/EC

Brand Benicar Tabs 20MG Tablet Generic Didanosine CpDR 200MG Capsule DR/EC

Brand Benicar Tabs 5MG Tablet Brand Dilaudid Tabs 8MG Tablet

Brand Beyaz Tabs 3-0.02-0.451MG Tablet Generic Diltiazem HCl ER Coated Beads Cp24 360MG Capsule 24 Hr ER

Generic Bicalutamide Tabs 50MG Tablet Brand Diovan HCT Tabs 160-12.5MG Tablet

Brand Brilinta Tabs 60MG Tablet Brand Diovan Tabs 40MG Tablet

Brand Brilinta Tabs 90MG Tablet Brand Diovan Tabs 80MG Tablet

Brand Brisdelle Caps 7.5MG Capsule Brand Ditropan XL Tb24 10MG Tablet 24-Hr ER

Generic Bromocriptine Mesylate Caps 5MG Capsule Brand Ditropan XL Tb24 5MG Tablet 24-Hr ER

Generic Butalbital-Apap-Caffeine Caps 50-325-40MG Capsule Generic Dofetilide Caps 250MCG Capsule

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Generic Dofetilide Caps 500MCG Capsule Generic Lamivudine-Zidovudine Tabs 150-300MG Tablet

Generic Donepezil HCl Tabs 10MG Tablet Generic Lamotrigine ER Tb24 100MG Tablet 24-Hr ER

Generic Donepezil HCl Tabs 5MG Tablet Generic Lamotrigine ER Tb24 50MG Tablet 24-Hr ER

Generic Doxycycline Hyclate TbEC 50MG Tablet DR/EC Generic Lamotrigine TbDp 100MG Disintegrating Tablet

Generic Doxycycline Hyclate TbEC 75MG Tablet DR/EC Generic Lamotrigine TbDp 200MG Disintegrating Tablet

Brand Durlaza Cp24 162.5MG Capsule 24 Hr ER Generic Lamotrigine TbDp 50MG Disintegrating Tablet

Brand Dutoprol Tb24 100-12.5MG Tablet 24-Hr ER Generic Leflunomide Tabs 10MG Tablet

Brand Dutoprol Tb24 25-12.5MG Tablet 24-Hr ER Brand Leucovorin Calcium Tabs 10MG Tablet

Brand Dutoprol Tb24 50-12.5MG Tablet 24-Hr ER Brand Loestrin 1.5/30 (21) Tabs 1.5-30MG-MCG Tablet

Brand EC-Naprosyn TbEC 500MG Tablet DR/EC Brand Loestrin 1/20 (21) Tabs 1-20MG-MCG Tablet

Brand Edarbi Tabs 40MG Tablet Brand Lopid Tabs 600MG Tablet

Brand Edarbi Tabs 80MG Tablet Brand Lorzone Tabs 375MG Tablet

Brand Edarbyclor Tabs 40-12.5MG Tablet Brand Lyrica Caps 200MG Capsule

Brand Edarbyclor Tabs 40-25MG Tablet Brand Lyrica Caps 225MG Capsule

Brand Eliquis Tabs 2.5MG Tablet Brand Lyrica Caps 25MG Capsule

Brand Eliquis Tabs 5MG Tablet Brand Lyrica Caps 300MG Capsule

Brand Embeda CpCR 20-0.8MG Capsule ER Brand Macrobid Caps 100MG Capsule

Brand Epivir Tabs 150MG Tablet Brand Malarone Tabs 250-100MG Tablet

Brand Ergoloid Mesylates Tabs 1MG Tablet Brand Meclofenamate Sodium Caps 100MG Capsule

Brand Ery-Tab TbEC 250MG Tablet DR/EC Brand Medactiv Tabs Tablet

Brand Estrace Tabs 2MG Tablet Brand Medrol Tabs 16MG Tablet

Brand Estrostep Fe Tabs 1-20/1-30/1-35MG-MCG Tablet Generic Memantine HCl Tabs 5 (28)-10 (21)MG Tablet

Generic Eszopiclone Tabs 3MG Tablet Generic Mesalamine TbEC 1.2GM Tablet DR/EC

Brand Etidronate Disodium Tabs 400MG Tablet Generic Metformin HCl ER (Osm) Tb24 500MG Tablet 24-Hr ER

Brand Evekeo Tabs 10MG Tablet Generic Methamphetamine HCl Tabs 5MG Tablet

Brand Evekeo Tabs 5MG Tablet Generic Methylphenidate HCl ER (Cd) CpCR 50MG Capsule ER

Brand Evista Tabs 60MG Tablet Generic Methylphenidate HCl ER (Cd) CpCR 60MG Capsule ER

Brand Evoxac Caps 30MG Capsule Generic Methylphenidate HCl ER (La) Cp24 10MG Capsule 24 Hr ER

Brand Fenofibrate Caps 150MG Capsule Brand Methylphenidate HCl ER Tb24 54MG Tablet 24-Hr ER

Generic Fenofibrate Tabs 40MG Tablet Generic Methylphenidate HCl ER TbCR 18MG Tablet ER

Brand Fexmid Tabs 7.5MG Tablet Generic Methylphenidate HCl ER TbCR 27MG Tablet ER

Brand Fluoxetine HCl (Pmdd) Caps 10MG Capsule Generic Methylphenidate HCl ER TbCR 36MG Tablet ER

Brand Fluoxetine HCl (Pmdd) Caps 20MG Capsule Brand Micardis HCT Tabs 40-12.5MG Tablet

Generic Fluoxetine HCl Tabs 60MG Tablet Brand Micardis HCT Tabs 80-12.5MG Tablet

Generic Fluphenazine HCl Tabs 5MG Tablet Brand Micardis HCT Tabs 80-25MG Tablet

Generic Fluvoxamine Maleate ER Cp24 100MG Capsule 24 Hr ER Brand Micardis Tabs 20MG Tablet

Generic Fluvoxamine Maleate ER Cp24 150MG Capsule 24 Hr ER Brand Micardis Tabs 40MG Tablet

Generic Griseofulvin Microsize Tabs 500MG Tablet Brand Micardis Tabs 80MG Tablet

Brand Imuran Tabs 50MG Tablet Brand Minastrin 24 Fe Chew 1-20MG-MCG(24) Chewable Tablet

Brand Isentress Chew 100MG Chewable Tablet Brand Mirapex Tabs 0.125MG Tablet

Generic Itraconazole Caps 100MG Capsule Brand Mirapex Tabs 0.25MG Tablet

Brand Jalyn Caps 0.5-0.4MG Capsule Brand Mirapex Tabs 0.5MG Tablet

Brand Janumet Tabs 50-1000MG Tablet Brand Mirapex Tabs 0.75MG Tablet

Brand Janumet Tabs 50-500MG Tablet Brand Mirapex Tabs 1.5MG Tablet

Brand Janumet XR Tb24 50-1000MG Tablet 24-Hr ER Brand Mirapex Tabs 1MG Tablet

Brand Janumet XR Tb24 50-500MG Tablet 24-Hr ER Brand Morphine Sulfate ER Beads Cp24 45MG Capsule 24 Hr ER

Brand Jentadueto Tabs 2.5-1000MG Tablet Generic Morphine Sulfate ER Cp24 50MG Capsule 24 Hr ER

Brand Jentadueto Tabs 2.5-500MG Tablet Generic Morphine Sulfate ER Cp24 60MG Capsule 24 Hr ER

Brand Jentadueto Tabs 2.5-850MG Tablet Brand Motofen Tabs 1-0.025MG Tablet

Brand Jentadueto XR Tb24 2.5-1000MG Tablet 24-Hr ER Brand Ms Contin TbCR 30MG Tablet ER

Brand Kapvay Tb12 0.1MG Tablet 12-Hr ER Generic Mycophenolate Mofetil Tabs 500MG Tablet

Brand Keppra Tabs 250MG Tablet Generic Mycophenolate Sodium TbEC 360MG Tablet DR/EC

Brand Keppra XR Tb24 500MG Tablet 24-Hr ER Brand Namenda Tabs 10MG Tablet

Brand Kombiglyze XR Tb24 2.5-1000MG Tablet 24-Hr ER Brand Namenda Tabs 5MG Tablet

Generic Lamivudine Tabs 300MG Tablet Brand Namenda Titration Pak Tabs 5 (28)-10 (21)MG Tablet

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Brand Naprosyn Tabs 500MG Tablet Brand Procardia XL Tb24 30MG Tablet 24-Hr ER

Brand Natazia Tabs 3/2-2/2-3/1MG Tablet Brand Prograf Caps 1MG Capsule

Brand Neurontin Caps 400MG Capsule Generic Propafenone HCl ER Cp12 325MG Capsule 12 Hr ER

Generic Niacin ER (Antihyperlipidemic) TbCR 1000MG Tablet ER Generic Propafenone HCl ER Cp12 425MG Capsule 12 Hr ER

Brand Niaspan TbCR 750MG Tablet ER Brand Pylera Caps 140-125-125MG Capsule

Brand Nicazel Tabs Tablet Brand Qsymia Cp24 11.25-69MG Capsule 24 Hr ER

Generic Nimodipine Caps 30MG Capsule Brand Qsymia Cp24 15-92MG Capsule 24 Hr ER

Brand Nisoldipine ER Tb24 25.5MG Tablet 24-Hr ER Brand Qsymia Cp24 3.75-23MG Capsule 24 Hr ER

Brand Norvasc Tabs 2.5MG Tablet Brand Qsymia Cp24 7.5-46MG Capsule 24 Hr ER

Brand Norvasc Tabs 5MG Tablet Brand Qualaquin Caps 324MG Capsule

Brand Nucynta ER Tb12 50MG Tablet 12-Hr ER Brand Qudexy XR Cs24 25MG Capsule Sprinkle 24Hr

Brand Nucynta Tabs 50MG Tablet Generic Quetiapine Fumarate Tabs 400MG Tablet

Brand Nucynta Tabs 75MG Tablet Brand Quflora Fe Chew 0.25MG Chewable Tablet

Generic Olanzapine-Fluoxetine HCl Caps 3-25MG Capsule Brand Ranexa Tb12 500MG Tablet 12-Hr ER

Generic Olmesartan-Amlodipine-HCTZ Tabs 40-10-25MG Tablet Brand Renagel Tabs 800MG Tablet

Generic Olmesartan-Amlodipine-HCTZ Tabs 40-5-25MG Tablet Brand Requip Tabs 4MG Tablet

Brand Opana Tabs 5MG Tablet Brand Requip Tabs 5MG Tablet

Brand Osmoprep Tabs 1.102-0.398GM Tablet Generic Risperidone Tabs 3MG Tablet

Brand Osphena Tabs 60MG Tablet Generic Risperidone TbDp 3MG Disintegrating Tablet

Brand Oxtellar XR Tb24 150MG Tablet 24-Hr ER Generic Ropinirole HCl ER Tb24 12MG Tablet 24-Hr ER

Brand Oxymorphone HCl ER Tb12 20MG Tablet 12-Hr ER Generic Rosuvastatin Calcium Tabs 20MG Tablet

Brand Pancreaze CpEP 21000Unit Capsule DR/EC Brand Safyral Tabs 3-0.03-0.451MG Tablet

Brand Parnate Tabs 10MG Tablet Brand Savella Tabs 100MG Tablet

Brand Paxil Cr Tb24 12.5MG Tablet 24-Hr ER Brand Savella Tabs 12.5MG Tablet

Brand Paxil Cr Tb24 25MG Tablet 24-Hr ER Brand Savella Tabs 25MG Tablet

Brand Paxil Cr Tb24 37.5MG Tablet 24-Hr ER Brand Savella Tabs 50MG Tablet

Brand Paxil Tabs 10MG Tablet Brand Seebri Neohaler Caps 15.6MCG Capsule

Brand Paxil Tabs 20MG Tablet Brand Seroquel Tabs 100MG Tablet

Brand Paxil Tabs 30MG Tablet Brand Seroquel Tabs 50MG Tablet

Brand Paxil Tabs 40MG Tablet Brand Singulair Chew 4MG Chewable Tablet

Brand Pentasa CpCR 500MG Capsule ER Brand Singulair Chew 5MG Chewable Tablet

Brand Pertzye CpEP 24000-86250Unit Capsule DR/EC Brand Singulair Tabs 10MG Tablet

Generic Phenohytro Tabs 16.2MG Tablet Brand Soma Tabs 250MG Tablet

Brand Plavix Tabs 75MG Tablet Brand Stalevo 125 Tabs 31.25-125-200MG Tablet

Brand Pradaxa Caps 110MG Capsule Brand Stalevo 200 Tabs 50-200-200MG Tablet

Brand Pradaxa Caps 150MG Capsule Brand Stalevo 75 Tabs 18.75-75-200MG Tablet

Brand Pradaxa Caps 75MG Capsule Brand Tarka TbCR 2-180MG Tablet ER

Brand Prandin Tabs 1MG Tablet Brand Tarka TbCR 2-240MG Tablet ER

Brand Prandin Tabs 2MG Tablet Brand Tarka TbCR 4-240MG Tablet ER

Generic Prasugrel HCl Tabs 5MG Tablet Brand Taytulla Caps 1-20MG-MCG(24) Capsule

Brand Premesisrx Tabs 1MG Tablet Brand Tekturna HCT Tabs 150-12.5MG Tablet

Brand Premphase Tabs 0.625-5MG Tablet Brand Tekturna HCT Tabs 150-25MG Tablet

Brand Prempro Tabs 0.3-1.5MG Tablet Brand Tekturna HCT Tabs 300-12.5MG Tablet

Brand Prempro Tabs 0.45-1.5MG Tablet Brand Tekturna HCT Tabs 300-25MG Tablet

Brand Prempro Tabs 0.625-2.5MG Tablet Brand Tekturna Tabs 150MG Tablet

Brand Prempro Tabs 0.625-5MG Tablet Brand Tekturna Tabs 300MG Tablet

Brand Prenate Chew 0.6-0.4MG Chewable Tablet Generic Temazepam Caps 22.5MG Capsule

Brand Prenate Elite Tabs 20-0.6-0.4MG Tablet Generic Temazepam Caps 7.5MG Capsule

Brand Prenate Enhance Caps 28-0.6-0.4-400MG Capsule Generic Temozolomide Caps 5MG Capsule

Brand Prenate Essential Caps 18-0.6-0.4-300MG Capsule Generic Tetracycline HCl Caps 250MG Capsule

Brand Prenate Mini Caps 18-0.6-0.4-350MG Capsule Brand Tetracycline HCl Caps 250MG Capsule

Brand Prenate Pixie Caps 10-0.6-0.4-200MG Capsule Generic Tiagabine HCl Tabs 12MG Tablet

Brand Prenate Restore Caps 27-0.6-0.4-400MG Capsule Generic Tolterodine Tartrate ER Cp24 4MG Capsule 24 Hr ER

Brand Prezista Tabs 150MG Tablet Brand Topamax Sprinkle CpSp 25MG Capsule DR Sprinkle

Brand Primacare Caps 30-1-470MG Capsule Brand Twynsta Tabs 40-10MG Tablet

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Brand Twynsta Tabs 40-5MG Tablet Brand Xenical Caps 120MG Capsule

Brand Twynsta Tabs 80-10MG Tablet Brand Zenpep CpEP 20000-63000Unit Capsule DR/EC

Brand Twynsta Tabs 80-5MG Tablet Brand Zenpep CpEP 25000-79000Unit Capsule DR/EC

Brand Tybost Tabs 150MG Tablet Brand Zenzedi Tabs 15MG Tablet

Brand Utibron Neohaler Caps 27.5-15.6MCG Capsule Brand Zenzedi Tabs 2.5MG Tablet

Brand Venlafaxine HCl ER Tb24 37.5MG Tablet 24-Hr ER Brand Zenzedi Tabs 20MG Tablet

Brand Verelan Cp24 120MG Capsule 24 Hr ER Brand Zenzedi Tabs 30MG Tablet

Brand Verelan Cp24 180MG Capsule 24 Hr ER Brand Zenzedi Tabs 7.5MG Tablet

Brand Verelan Cp24 240MG Capsule 24 Hr ER Brand Zerit Caps 15MG Capsule

Brand Verelan Pm Cp24 200MG Capsule 24 Hr ER Brand Zerit Caps 20MG Capsule

Brand Videx EC CpDR 200MG Capsule DR/EC Brand Zerit Caps 30MG Capsule

Brand Viokace Tabs 20880Unit Tablet Brand Ziac Tabs 10-6.25MG Tablet

Generic Voriconazole Tabs 50MG Tablet Brand Ziac Tabs 2.5-6.25MG Tablet

Brand Wellbutrin SR Tb12 100MG Tablet 12-Hr ER Brand Ziac Tabs 5-6.25MG Tablet

Brand Wellbutrin SR Tb12 150MG Tablet 12-Hr ER Generic Ziprasidone HCl Caps 20MG Capsule

Brand Xanax Tabs 1MG Tablet Generic Ziprasidone HCl Caps 40MG Capsule

Brand Xarelto Tabs 2.5MG Tablet

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