2018 Cigna-HealthSpring Quantity Limit Criteria - Cigna ... · Drug Name Strength Dosage Form Quantity Limit Days Supply ABACAVIR 20MG/ML SOLN 960 30 ABACAVIR 300MG TABS 60 30 ABACAVIR

Drug Name Strength Dosage Form Quantity Limit Days Supply

ABACAVIR 20MG/ML SOLN 960 30

ABACAVIR 300MG TABS 60 30

ABACAVIR

SULFATE/LAMIVUDINE/ZIDOVUDI

NE

300MG; 150MG; 300MG TABS 60 30

ABACAVIR/LAMIVUDINE 600MG; 300MG TABS 30 30

ABILIFY MAINTENA 300MG PRSY 1 28

ABILIFY MAINTENA 400MG PRSY 1 28

ABILIFY MAINTENA 300MG SRER 1 28

ABILIFY MAINTENA 400MG SRER 1 28

ACARBOSE 100MG TABS 90 30



ACETAMINOPHEN/CODEINE 120MG/5ML; 12MG/5ML SOLN 2700 30

ACETAMINOPHEN/CODEINE 300MG; 15MG TABS 360 30



ACETAMINOPHEN/CODEINE

PHOSPHATE

300MG; 30MG TABS 360 30

ACTEMRA 400MG/20ML SOLN 40 28



ACTEMRA 162MG/0.9ML SOSY 3.6 28

ACYCLOVIR 5% OINT 30 30

ADACEL 15.5MCG/0.5ML; 2LF/0.5ML;

5LF/0.5ML

SUSP 0.5 365

ADACEL 15.5MCG/0.5ML; 2LF/0.5ML;

5LF/0.5ML

SUSP 0.5 365

ADEFOVIR DIPIVOXIL 10MG TABS 30 30

ADEMPAS 1.5MG TABS 90 30



ADEMPAS 2MG TABS 90 30

ADEMPAS 1MG TABS 90 30

ADVAIR DISKUS 250MCG/DOSE; 50MCG/DOSE AEPB 60 30



ADVAIR HFA 115MCG/ACT; 21MCG/ACT AERO 12 30



AFEDITAB CR 30MG TB24 60 30

AFEDITAB CR 60MG TB24 60 30

AFINITOR 10MG TABS 56 28

AFINITOR 2.5MG TABS 28 28

AFINITOR 5MG TABS 28 28

AFINITOR 7.5MG TABS 28 28

AFINITOR DISPERZ 5MG TBSO 112 28



AGGRENOX 25MG; 200MG CP12 60 30

ALBUTEROL SULFATE 0.5% NEBU 180 30

ALBUTEROL SULFATE 0.63MG/3ML NEBU 360 30

ALBUTEROL SULFATE 1.25MG/3ML NEBU 360 30

ALBUTEROL SULFATE 0.083% NEBU 360 30

ALECENSA 150MG CAPS 240 30

ALENDRONATE SODIUM 5MG TABS 30 30





ALFUZOSIN HCL ER 10MG TB24 30 30

ALINIA 100MG/5ML SUSR 150 30

ALINIA 500MG TABS 20 30

ALIQOPA 60MG SOLR 3 28

ALORA 0.075MG/24HR PTTW 8 28




ALOSETRON HYDROCHLORIDE 0.5MG TABS 60 30

ALOSETRON HYDROCHLORIDE 1MG TABS 60 30

ALPRAZOLAM 0.5MG TABS 90 30

ALPRAZOLAM 0.25MG TABS 90 30

ALPRAZOLAM 1MG TABS 90 30

ALPRAZOLAM 2MG TABS 150 30

ALPRAZOLAM ODT 1MG TBDP 90 30

ALPRAZOLAM ODT 2MG TBDP 150 30

ALPRAZOLAM ODT 0.25MG TBDP 90 30

ALPRAZOLAM ODT 0.5MG TBDP 90 30

ALUNBRIG 90MG TABS 30 30



ALUNBRIG 0 TBPK 60 365

AMETHIA 0; 0 TABS 91 91

AMETHIA LO 0; 0 TABS 91 91

AMITIZA 8MCG CAPS 60 30

AMITIZA 24MCG CAPS 60 30

AMLODIPINE BESYLATE 5MG TABS 60 30

AMLODIPINE BESYLATE 2.5MG TABS 120 30

AMLODIPINE BESYLATE 10MG TABS 30 30

AMLODIPINE

BESYLATE/BENAZEPRIL

HYDROCHLORIDE

2.5MG; 10MG CAPS 60 30

AMLODIPINE

BESYLATE/BENAZEPRIL

HYDROCHLORIDE

5MG; 40MG CAPS 60 30

AMLODIPINE

BESYLATE/BENAZEPRIL

HYDROCHLORIDE


AMLODIPINE

BESYLATE/BENAZEPRIL

HYDROCHLORIDE


2018 Cigna-HealthSpring Quantity Limit Criteria - Cigna-HealthSpring Rx Secure (PDP)

AMLODIPINE

BESYLATE/BENAZEPRIL

HYDROCHLORIDE

10MG; 40MG CAPS 30 30

AMLODIPINE

BESYLATE/BENAZEPRIL

HYDROCHLORIDE

10MG; 20MG CAPS 30 30

AMLODIPINE

BESYLATE/VALSARTAN

10MG; 160MG TABS 30 30

AMLODIPINE

BESYLATE/VALSARTAN

5MG; 320MG TABS 30 30

AMLODIPINE

BESYLATE/VALSARTAN

5MG; 160MG TABS 30 30

AMLODIPINE

BESYLATE/VALSARTAN

10MG; 320MG TABS 30 30

AMLODIPINE/VALSARTAN/HCTZ 5MG; 25MG; 160MG TABS 30 30


AMLODIPINE/VALSARTAN/HCTZ 5MG; 12.5MG; 160MG TABS 30 30


AMLODIPINE/VALSARTAN/HCTZ 10MG; 12.5MG; 160MG TABS 30 30

AMPHETAMINE/DEXTROAMPHET

AMINE

1.25MG; 1.25MG; 1.25MG; 1.25MG CP24 60 30


AMINE

6.25MG; 6.25MG; 6.25MG; 6.25MG CP24 60 30


AMINE

3.75MG; 3.75MG; 3.75MG; 3.75MG CP24 30 30


AMINE

5MG; 5MG; 5MG; 5MG CP24 30 30


AMINE

2.5MG; 2.5MG; 2.5MG; 2.5MG CP24 30 30


AMINE

7.5MG; 7.5MG; 7.5MG; 7.5MG CP24 30 30


AMINE

5MG; 5MG; 5MG; 5MG TABS 90 30


AMINE

1.25MG; 1.25MG; 1.25MG; 1.25MG TABS 60 30


AMINE

1.875MG; 1.875MG; 1.875MG;

1.875MG

TABS 60 30


AMINE

3.75MG; 3.75MG; 3.75MG; 3.75MG TABS 60 30


AMINE

2.5MG; 2.5MG; 2.5MG; 2.5MG TABS 60 30


AMINE

3.125MG; 3.125MG; 3.125MG;

3.125MG

TABS 60 30


AMINE

7.5MG; 7.5MG; 7.5MG; 7.5MG TABS 60 30

AMPYRA 10MG TB12 60 30

ANASTROZOLE 1MG TABS 30 30

ANORO ELLIPTA 62.5MCG/INH; 25MCG/INH AEPB 60 30

APOKYN 30MG/3ML SOCT 60 30

APREPITANT 80MG CAPS 4 28


APREPITANT 0 CAPS 6 28


APRISO 0.375GM CP24 120 30

APTIOM 200MG TABS 30 30




APTIVUS 250MG CAPS 120 30

APTIVUS 100MG/ML SOLN 285 28

ARANESP ALBUMIN FREE 25MCG/ML SOLN 4 28






ARANESP ALBUMIN FREE 500MCG/ML SOSY 1 21

ARANESP ALBUMIN FREE 25MCG/0.42ML SOSY 1.68 28





ARANESP ALBUMIN FREE 100MCG/0.5ML SOSY 2 28



ARIPIPRAZOLE 1MG/ML SOLN 900 30

ARIPIPRAZOLE 20MG TABS 30 30






ARIPIPRAZOLE ODT 15MG TBDP 60 30

ARIPIPRAZOLE ODT 10MG TBDP 60 30

ARISTADA 1064MG/3.9ML PRSY 3.9 60




ARMODAFINIL 200MG TABS 30 30




ARNUITY ELLIPTA 100MCG/ACT AEPB 30 30

ARNUITY ELLIPTA 200MCG/ACT AEPB 30 30

ASCOMP/CODEINE 325MG; 50MG; 40MG; 30MG CAPS 180 30

ASHLYNA 0; 0 TABS 91 91

ASPIRIN/DIPYRIDAMOLE 25MG; 200MG CP12 60 30

ATAZANAVIR 150MG CAPS 30 30



ATAZANAVIR SULFATE 150MG CAPS 30 30



ATOMOXETINE 10MG CAPS 60 30







ATORVASTATIN CALCIUM 40MG TABS 30 30




ATRIPLA 600MG; 200MG; 300MG TABS 30 30

ATROVENT HFA 17MCG/ACT AERS 25.8 30

AURYXIA 210MG TABS 360 30

AVITA 0.025% CREA 45 30

AVITA 0.025% GEL 45 30

AVONEX 30MCG/VIAL KIT 4 28

AVONEX 30MCG/0.5ML PSKT 4 28

AVONEX PEN 30MCG/0.5ML AJKT 4 28

AZELASTINE HCL 0.15% SOLN 30 25

AZELASTINE HCL 0.1% SOLN 30 25

AZITHROMYCIN 200MG/5ML SUSR 75 30

AZITHROMYCIN 100MG/5ML SUSR 150 30

AZITHROMYCIN 250MG TABS 12 28





BANZEL 40MG/ML SUSP 2400 30

BANZEL 400MG TABS 240 30

BANZEL 200MG TABS 60 30

BD ECLIPSE

SYRINGE/1ML/30GX1/2"

MISC 200 30

BD INSULIN SYRINGE

SAFETYGLIDE/1ML/29G X 1/2"

MISC 200 30

BD INSULIN SYRINGE

ULTRAFINE/0.3ML/31G X 5/16"

MISC 200 30

BD INSULIN SYRINGE

ULTRAFINE/0.5ML/30G X 1/2"

MISC 200 30

BD INSULIN SYRINGE

ULTRAFINE/1ML/31G X 5/16"

MISC 200 30

BD PEN

NEEDLE/MINI/ULTRAFINE/31G X

3/16"

MISC 200 30

BD PEN NEEDLE/NANO/ULTRA

FINE/32G X 4MM

MISC 200 30

BD PEN NEEDLE/ULTRAFINE/29G

X 12.7MM

MISC 200 30

BD SAFETYGLIDE 27G X 5/8" MISC 200 30

BENAZEPRIL HCL 5MG TABS 60 30




BENAZEPRIL

HCL/HYDROCHLOROTHIAZIDE

20MG; 12.5MG TABS 60 30

BENAZEPRIL


10MG; 12.5MG TABS 30 30

BENAZEPRIL


20MG; 25MG TABS 30 30

BENAZEPRIL


5MG; 6.25MG TABS 30 30

BENDEKA 100MG/4ML SOLN 8 21

BENICAR 20MG TABS 30 30



BENICAR HCT 12.5MG; 40MG TABS 30 30

BENICAR HCT 12.5MG; 20MG TABS 30 30

BENICAR HCT 25MG; 40MG TABS 30 30

BENLYSTA 400MG SOLR 9 28

BENLYSTA 120MG SOLR 30 28

BETASERON 0.3MG KIT 14 28

BICALUTAMIDE 50MG TABS 30 30

BIDIL 37.5MG; 20MG TABS 180 30

BIKTARVY 50MG; 200MG; 25MG TABS 30 30

BIMATOPROST 0.03% SOLN 5 30

BOOSTRIX 18.5MCG/0.5ML; 2.5LF/0.5ML;

5LF/0.5ML

SUSP 0.5 365

BOOSTRIX 18.5MCG/0.5ML; 2.5LF/0.5ML;

5LF/0.5ML

SUSP 0.5 365

BORTEZOMIB 3.5MG SOLR 14 21

BOSULIF 400MG TABS 30 30



BREO ELLIPTA 100MCG/INH; 25MCG/INH AEPB 60 30

BREO ELLIPTA 200MCG/INH; 25MCG/INH AEPB 60 30

BRILINTA 60MG TABS 60 30

BRILINTA 90MG TABS 60 30

BRIVIACT 50MG/5ML SOLN 600 30

BRIVIACT 10MG/ML SOLN 1200 30

BRIVIACT 75MG TABS 60 30





BUDESONIDE 1MG/2ML SUSP 120 30

BUDESONIDE 0.25MG/2ML SUSP 120 30

BUDESONIDE 0.5MG/2ML SUSP 120 30

BUDESONIDE NASAL SPRAY 32MCG/ACT SUSP 17.2 30

BUPRENORPHINE HCL 0.3MG/ML SOLN 150 30

BUPRENORPHINE HCL 0.3MG/ML SOLN 150 30

BUPRENORPHINE HCL 2MG SUBL 90 30

BUPRENORPHINE HCL 8MG SUBL 90 30

BUPRENORPHINE

HCL/NALOXONE HCL

2MG; 0.5MG SUBL 90 30

BUPRENORPHINE

HCL/NALOXONE HCL

8MG; 2MG SUBL 90 30

BUPROBAN 150MG TB12 60 30

BUPROPION HCL 75MG TABS 180 30

BUPROPION HCL 100MG TABS 120 30

BUPROPION HCL ER 150MG TB12 60 30



BUPROPION HCL SR 200MG TB12 60 30




BUPROPION HCL XL 300MG TB24 30 30

BUPROPION HCL XL 150MG TB24 30 30

BUTALBITAL/ACETAMINOPHEN/

CAFFEINE

325MG; 50MG; 40MG CAPS 180 30


CAFFEINE

300MG; 50MG; 40MG CAPS 180 30


CAFFEINE

325MG; 50MG; 40MG TABS 180 30


CAFFEINE/CODEINE

325MG; 50MG; 40MG; 30MG CAPS 180 30


CAFFEINE/CODEINE

300MG; 50MG; 40MG; 30MG CAPS 180 30

BUTALBITAL/ASPIRIN/CAFFEINE 325MG; 50MG; 40MG CAPS 180 30

BUTALBITAL/ASPIRIN/CAFFEINE/

CODEINE

325MG; 50MG; 40MG; 30MG CAPS 180 30

BUTORPHANOL TARTRATE 2MG/ML SOLN 240 30



BYDUREON 2MG SRER 4 28

BYDUREON BCISE 2MG/0.85ML AUIJ 4 28

BYDUREON PEN 2MG PEN 4 28

BYETTA 5MCG/0.02ML SOPN 1.2 30

BYETTA 10MCG/0.04ML SOPN 2.4 30

BYSTOLIC 20MG TABS 60 30

BYSTOLIC 2.5MG TABS 30 30



BYVALSON 5MG; 80MG TABS 30 30

CABERGOLINE 0.5MG TABS 16 28

CABOMETYX 20MG TABS 30 30



CALCIPOTRIENE 0.005% CREA 120 30

CALCIPOTRIENE 0.005% OINT 120 30

CALCIPOTRIENE 0.005% SOLN 60 30

CALCITONIN-SALMON 200UNIT/ACT SOLN 3.7 30

CALCITRENE 0.005% OINT 120 30

CALCITRIOL 3MCG/GM OINT 800 30

CALQUENCE 100MG CAPS 60 30

CAMRESE 0; 0 TABS 91 91

CAMRESE LO 0; 0 TABS 91 91

CANDESARTAN CILEXETIL 4MG TABS 30 30




CANDESARTAN

CILEXETIL/HYDROCHLOROTHIA

ZIDE

32MG; 25MG TABS 30 30

CANDESARTAN


ZIDE

16MG; 12.5MG TABS 30 30

CANDESARTAN


ZIDE

32MG; 12.5MG TABS 30 30

CAPACET 325MG; 50MG; 40MG CAPS 180 30

CAPRELSA 100MG TABS 60 30

CAPRELSA 300MG TABS 30 30

CAPTOPRIL 25MG TABS 90 30

CAPTOPRIL 12.5MG TABS 90 30

CARVEDILOL PHOSPHATE 10MG CP24 30 30




CAYSTON 75MG SOLR 84 56

CELECOXIB 50MG CAPS 60 30




CHANTIX 1MG TABS 336 365

CHANTIX 0.5MG TABS 336 365

CHANTIX CONTINUING MONTH

PAK

1MG TABS 336 365

CHANTIX STARTING MONTH PAK 0 TABS 336 365

CIMDUO 300MG; 300MG TABS 30 30

CINRYZE 500UNIT SOLR 100 30

CIPROFLOXACIN ER 500MG; 0 TB24 3 3

CIPROFLOXACIN ER 1000MG; 0 TB24 14 14

CITALOPRAM HYDROBROMIDE 10MG/5ML SOLN 600 30

CITALOPRAM HYDROBROMIDE 20MG TABS 60 30

CITALOPRAM HYDROBROMIDE 40MG TABS 30 30

CLARITHROMYCIN 250MG TABS 42 14

CLARITHROMYCIN 500MG TABS 42 14

CLARITHROMYCIN ER 500MG TB24 60 30

CLONAZEPAM 1MG TABS 120 30

CLONAZEPAM 2MG TABS 300 30

CLONAZEPAM 0.5MG TABS 90 30

CLONAZEPAM ODT 1MG TBDP 120 30

CLONAZEPAM ODT 2MG TBDP 300 30

CLONAZEPAM ODT 0.125MG TBDP 90 30



CLONIDINE HCL 0.1MG/24HR PTWK 4 28



CLONIDINE HCL ER 0.1MG TB12 120 30

CLOPIDOGREL 300MG TABS 2 365

CLOPIDOGREL 75MG TABS 30 30

CLORAZEPATE DIPOTASSIUM 15MG TABS 180 30

CLORAZEPATE DIPOTASSIUM 3.75MG TABS 90 30

CLORAZEPATE DIPOTASSIUM 7.5MG TABS 90 30

CLOZAPINE 200MG TABS 120 30

CLOZAPINE 100MG TABS 270 30

CLOZAPINE ODT 150MG TBDP 180 30



COARTEM 20MG; 120MG TABS 24 30

COLCHICINE 0.6MG CAPS 60 30

COLCHICINE 0.6MG TABS 120 30

COMBIVENT RESPIMAT 100MCG/ACT; 20MCG/ACT AERS 8 30

COMETRIQ 0 KIT 56 28

COMETRIQ 0 KIT 112 28

COMETRIQ 20MG KIT 84 28

COMPLERA 200MG; 25MG; 300MG TABS 30 30

COPAXONE 40MG/ML SOSY 12 28

COPAXONE 20MG/ML SOSY 30 30

COREG CR 10MG CP24 30 30




CORLANOR 5MG TABS 60 30

CORLANOR 7.5MG TABS 60 30

COTELLIC 20MG TABS 63 28

CRIXIVAN 400MG CAPS 180 30

CRIXIVAN 200MG CAPS 270 30

CROMOLYN SODIUM 20MG/2ML NEBU 240 30

CYCLOBENZAPRINE HCL 5MG TABS 90 30

CYCLOBENZAPRINE HCL 10MG TABS 90 30

CYSTARAN 0.44% SOLN 60 28

DALIRESP 250MCG TABS 60 365

DALIRESP 500MCG TABS 30 30

DARAPRIM 25MG TABS 90 30

DARIFENACIN HYDROBROMIDE

ER

7.5MG TB24 30 30

DARIFENACIN HYDROBROMIDE

ER

15MG TB24 30 30

DAYSEE 0; 0 TABS 91 91

DEPO-PROVERA 400MG/ML SUSP 10 28

DESCOVY 200MG; 25MG TABS 30 30

DESLORATADINE 5MG TABS 30 30

DESMOPRESSIN ACETATE 0.01% SOLN 15 30



DESVENLAFAXINE ER 50MG TB24 30 30



DEXMETHYLPHENIDATE HCL 2.5MG TABS 60 30

DEXMETHYLPHENIDATE HCL 5MG TABS 60 30

DEXMETHYLPHENIDATE HCL 10MG TABS 60 30

DEXTROAMPHETAMINE

SULFATE

5MG/5ML SOLN 1800 30

DEXTROAMPHETAMINE

SULFATE

10MG TABS 180 30

DEXTROAMPHETAMINE

SULFATE

5MG TABS 60 30

DEXTROAMPHETAMINE

SULFATE ER

15MG CP24 120 30

DEXTROAMPHETAMINE

SULFATE ER

10MG CP24 90 30

DEXTROAMPHETAMINE

SULFATE ER

5MG CP24 60 30

DIASTAT ACUDIAL 10MG GEL 20 30

DIASTAT ACUDIAL 20MG GEL 40 30

DIASTAT PEDIATRIC 2.5MG GEL 5 30

DIAZEPAM 1MG/ML SOLN 1200 30

DIAZEPAM 2MG TABS 120 30



DIAZEPAM 2.5MG GEL 5 30

DIAZEPAM 10MG GEL 20 30

DIAZEPAM 20MG GEL 40 30

DIAZEPAM RECTAL GEL 20MG GEL 40 30

DIAZEPAM RECTAL GEL 2.5MG GEL 5 30

DIAZEPAM RECTAL GEL 10MG GEL 20 30

DICLOFENAC SODIUM 1% GEL 1000 30

DICLOFENAC SODIUM 1.5% SOLN 1050 30

DIDANOSINE 125MG CPDR 30 30




DIGITEK 0.125MG TABS 30 30

DIGOX 125MCG TABS 30 30

DIGOXIN 125MCG TABS 30 30

DIHYDROERGOTAMINE

MESYLATE

1MG/ML SOLN 30 28

DOFETILIDE 500MCG CAPS 60 30



DONEPEZIL HCL 23MG TABS 30 30



DONEPEZIL HCL 10MG TBDP 60 30

DONEPEZIL HCL 5MG TBDP 30 30

DONEPEZIL HYDROCHLORIDE 5MG TABS 30 30

DONEPEZIL HYDROCHLORIDE 10MG TABS 60 30

DORZOLAMIDE HCL 2% SOLN 10 30

DORZOLAMIDE HCL/TIMOLOL

MALEATE

22.3MG/ML; 6.8MG/ML SOLN 10 30

DOXAZOSIN 4MG TABS 30 30

DOXAZOSIN MESYLATE 1MG TABS 30 30



DOXERCALCIFEROL 2.5MCG CAPS 120 30

DOXERCALCIFEROL 0.5MCG CAPS 90 30

DOXERCALCIFEROL 1MCG CAPS 240 30

DOXYCYCLINE MONOHYDRATE 100MG CAPS 60 30



DRONABINOL 5MG CAPS 60 30

DRONABINOL 2.5MG CAPS 60 30

DRONABINOL 10MG CAPS 60 30

DULOXETINE HCL 20MG CPEP 60 30



DURAMORPH 1MG/ML SOLN 180 30

DURAMORPH 0.5MG/ML SOLN 180 30

DUTASTERIDE 0.5MG CAPS 30 30

DUTASTERIDE/TAMSULOSIN

HYDROCHLORIDE

0.5MG; 0.4MG CAPS 30 30

EDURANT 25MG TABS 30 30

EFAVIRENZ 50MG CAPS 90 30

EFAVIRENZ 200MG CAPS 60 30

EFAVIRENZ 600MG TABS 30 30

ELIDEL 1% CREA 100 90

ELIGARD 22.5MG KIT 1 90

ELIGARD 30MG KIT 1 120

ELIGARD 45MG KIT 1 180

ELIGARD 7.5MG KIT 1 30

ELIQUIS 2.5MG TABS 60 30

ELIQUIS 5MG TABS 74 30

ELIQUIS STARTER PACK 5MG TABS 74 30

EMEND 125MG SUSR 6 28

EMSAM 9MG/24HR PT24 30 30



EMTRIVA 200MG CAPS 30 30

EMTRIVA 10MG/ML SOLN 680 28

ENABLEX 7.5MG TB24 30 30

ENABLEX 15MG TB24 30 30

ENALAPRIL MALEATE 10MG TABS 60 30



ENALAPRIL MALEATE 2.5MG TABS 60 30

ENALAPRIL

MALEATE/HYDROCHLOROTHIAZ

IDE

5MG; 12.5MG TABS 60 30

ENALAPRIL

MALEATE/HYDROCHLOROTHIAZ

IDE

10MG; 25MG TABS 60 30

ENBREL 25MG SOLR 8 28

ENBREL 50MG/ML SOSY 8 28

ENBREL 25MG/0.5ML SOSY 4.08 28

ENBREL MINI 50MG/ML SOCT 8 28

ENBREL SURECLICK 50MG/ML SOAJ 8 28

ENDOCET 325MG; 2.5MG TABS 360 30

ENDOCET 325MG; 5MG TABS 360 30

ENDOCET 325MG; 7.5MG TABS 240 30

ENDOCET 325MG; 10MG TABS 180 30

ENGERIX-B 20MCG/ML SUSP 8 365

ENGERIX-B 10MCG/0.5ML SUSP 3 365

ENOXAPARIN SODIUM 300MG/3ML SOLN 30 90

ENOXAPARIN SODIUM 30MG/0.3ML SOLN 9 90




ENOXAPARIN SODIUM 100MG/ML SOLN 30 90

ENOXAPARIN SODIUM 150MG/ML SOLN 30 90


ENTACAPONE 200MG TABS 240 30

ENTECAVIR 1MG TABS 30 30

ENTECAVIR 0.5MG TABS 30 30

ENTRESTO 97MG; 103MG TABS 60 30



EPCLUSA 400MG; 100MG TABS 28 28

EPINEPHRINE 0.3MG/0.3ML SOAJ 2 30




EPIPEN 2-PAK 0.3MG/0.3ML SOAJ 2 30

EPIPEN-JR 2-PAK 0.15MG/0.3ML SOAJ 2 30

ERGOTAMINE

TARTRATE/CAFFEINE

100MG; 1MG TABS 40 28

ERIVEDGE 150MG CAPS 28 28

ERLEADA 60MG TABS 120 30

ERWINAZE 10000UNIT SOLR 60 28

ESBRIET 267MG CAPS 270 30

ESBRIET 267MG TABS 270 30

ESBRIET 801MG TABS 90 30

ESCITALOPRAM OXALATE 5MG/5ML SOLN 600 30

ESCITALOPRAM OXALATE 5MG TABS 30 30



ESGIC 325MG; 50MG; 40MG CAPS 180 30

ESOMEPRAZOLE MAGNESIUM 20MG CPDR 60 30

ESOMEPRAZOLE MAGNESIUM 40MG CPDR 60 30

ESTRADIOL 0.06MG/24HR PTWK 4 28


ESTRADIOL 37.5MCG/24HR PTWK 4 28




ESTRADIOL 0.025MG/24HR PTTW 8 28





ESTRADIOL 10MCG TABS 18 28

ESTRING 2MG RING 1 90

EVOTAZ 300MG; 150MG TABS 30 30

EXEMESTANE 25MG TABS 60 30

EZETIMIBE 10MG TABS 30 30

EZETIMIBE/SIMVASTATIN 10MG; 80MG TABS 30 30




FAMCICLOVIR 500MG TABS 60 30



FANAPT 8MG TABS 60 30







FANAPT TITRATION PACK 0 TABS 16 365

FARESTON 60MG TABS 30 30

FARXIGA 10MG TABS 30 30

FARXIGA 5MG TABS 30 30

FARYDAK 10MG CAPS 6 21



FASLODEX 250MG/5ML SOLN 30 30

FELODIPINE ER 5MG TB24 60 30

FELODIPINE ER 10MG TB24 60 30

FELODIPINE ER 2.5MG TB24 60 30

FEMRING 0.1MG/24HR RING 1 90

FEMRING 0.05MG/24HR RING 1 90

FENOFIBRATE 50MG CAPS 60 30




FENOFIBRATE 160MG TABS 30 30




FENOFIBRATE MICRONIZED 67MG CAPS 60 30



FENOFIBRIC ACID DR 135MG CPDR 30 30

FENOFIBRIC ACID DR 45MG CPDR 60 30

FENTANYL 75MCG/HR PT72 10 30


FENTANYL 62.5MCG/HR PT72 10 30






FENTANYL CITRATE ORAL

TRANSMUCOSAL

400MCG LPOP 120 30


TRANSMUCOSAL

600MCG LPOP 120 30


TRANSMUCOSAL

1200MCG LPOP 120 30


TRANSMUCOSAL

1600MCG LPOP 120 30


TRANSMUCOSAL

200MCG LPOP 120 30


TRANSMUCOSAL

800MCG LPOP 120 30

FETZIMA 20MG CP24 30 30




FETZIMA TITRATION PACK 0 C4PK 56 365

FINASTERIDE 5MG TABS 30 30

FIRAZYR 30MG/3ML SOLN 18 30

FIRMAGON 80MG SOLR 1 28

FIRMAGON 120MG SOLR 4 365

FLOVENT DISKUS 250MCG/BLIST AEPB 240 30



FLOVENT HFA 110MCG/ACT AERO 12 30

FLOVENT HFA 44MCG/ACT AERO 10.6 30

FLOVENT HFA 220MCG/ACT AERO 24 30

FLUNISOLIDE 0.025% SOLN 50 30

FLUOXETINE 10MG CAPS 30 30

FLUOXETINE 20MG CAPS 120 30

FLUOXETINE DR 90MG CPDR 4 28

FLUOXETINE HCL 20MG CAPS 120 30



FLUOXETINE HCL 20MG/5ML SOLN 600 30

FLUOXETINE HCL 10MG TABS 30 30

FLUOXETINE HCL 20MG TABS 120 30

FLUTICASONE PROPIONATE 50MCG/ACT SUSP 16 30

FLUVOXAMINE MALEATE 25MG TABS 30 30



FONDAPARINUX SODIUM 2.5MG/0.5ML SOLN 15 90

FONDAPARINUX SODIUM 5MG/0.4ML SOLN 12 90

FONDAPARINUX SODIUM 10MG/0.8ML SOLN 24 90

FONDAPARINUX SODIUM 7.5MG/0.6ML SOLN 18 90

FORTEO 600MCG/2.4ML SOLN 2.4 28

FOSAMPRENAVIR CALCIUM 700MG TABS 120 30

FOSINOPRIL SODIUM 20MG TABS 60 30



FOSINOPRIL

SODIUM/HYDROCHLOROTHIAZI

DE

10MG; 12.5MG TABS 120 30

FOSINOPRIL

SODIUM/HYDROCHLOROTHIAZI

DE

20MG; 12.5MG TABS 120 30

FUZEON 90MG SOLR 60 30

FYCOMPA 0.5MG/ML SUSP 720 30

FYCOMPA 2MG TABS 30 30






GABAPENTIN 300MG CAPS 270 30



GABAPENTIN 250MG/5ML SOLN 2160 30

GABAPENTIN 600MG TABS 180 30

GABITRIL 16MG TABS 90 30

GABITRIL 12MG TABS 120 30

GALANTAMINE HYDROBROMIDE 4MG/ML SOLN 200 30

GALANTAMINE HYDROBROMIDE 8MG TABS 60 30



GALANTAMINE HYDROBROMIDE

ER

16MG CP24 30 30


ER

24MG CP24 30 30


ER

8MG CP24 30 30

GARDASIL 0 SUSP 1.5 365

GARDASIL 0 SUSP 1.5 365

GARDASIL 9 0 SUSP 1.5 365

GARDASIL 9 0 SUSY 1.5 365

GATTEX 5MG KIT 30 30

GEMFIBROZIL 600MG TABS 60 30

GENVOYA 150MG; 150MG; 200MG; 10MG TABS 30 30

GEODON 20MG SOLR 6 30

GILENYA 0.5MG CAPS 30 30

GILOTRIF 30MG TABS 30 30



GLIMEPIRIDE 1MG TABS 240 30



GLIPIZIDE 10MG TABS 120 30

GLIPIZIDE 5MG TABS 60 30

GLIPIZIDE ER 2.5MG TB24 240 30

GLIPIZIDE ER 5MG TB24 120 30

GLIPIZIDE ER 10MG TB24 60 30

GLIPIZIDE XL 5MG TB24 120 30

GLIPIZIDE XL 2.5MG TB24 240 30

GLIPIZIDE XL 10MG TB24 60 30

GLIPIZIDE/METFORMIN HCL 2.5MG; 500MG TABS 120 30

GLIPIZIDE/METFORMIN HCL 5MG; 500MG TABS 120 30

GLIPIZIDE/METFORMIN HCL 2.5MG; 250MG TABS 240 30

GLUCAGEN HYPOKIT 1MG SOLR 4 30

GLUCAGON EMERGENCY KIT 1MG KIT 4 30

GLYXAMBI 25MG; 5MG TABS 30 30

GLYXAMBI 10MG; 5MG TABS 30 30

GRANISETRON HCL 1MG TABS 30 30

HARVONI 90MG; 400MG TABS 28 28

HEPLISAV-B 20MCG/0.5ML SOLN 3 365

HETLIOZ 20MG CAPS 30 30

HUMIRA 40MG/0.4ML PSKT 4 28






HUMIRA PEDIATRIC CROHNS

DISEASE STARTER PACK

80MG/0.8ML PSKT 6 365



0 PSKT 4 365



40MG/0.8ML PSKT 6 365



40MG/0.8ML PSKT 6 365

HUMIRA PEN 40MG/0.4ML PNKT 4 28

HUMIRA PEN 40MG/0.8ML PNKT 4 28

HUMIRA PEN-CROHNS

DISEASESTARTER

40MG/0.8ML PNKT 12 365

HUMIRA PEN-PSORIASIS

STARTER

40MG/0.8ML PNKT 8 365

HYDROCODONE

BITARTRATE/ACETAMINOPHEN

325MG/15ML; 7.5MG/15ML SOLN 2700 30

HYDROCODONE


300MG; 10MG TABS 180 30

HYDROCODONE


300MG; 5MG TABS 360 30

HYDROCODONE


300MG; 7.5MG TABS 180 30

HYDROCODONE


325MG; 2.5MG TABS 360 30

HYDROCODONE/ACETAMINOPHE

N

325MG; 5MG TABS 360 30


N

325MG; 7.5MG TABS 180 30


N

325MG; 10MG TABS 180 30

HYDROCODONE/IBUPROFEN 5MG; 200MG TABS 150 30

HYDROCODONE/IBUPROFEN 10MG; 200MG TABS 150 30

HYDROCODONE/IBUPROFEN 7.5MG; 200MG TABS 150 30

HYDROCODONE/IBUPROFEN 2.5MG; 200MG TABS 150 30

HYDROMORPHONE HCL 1MG/ML LIQD 1200 30

HYDROMORPHONE HCL 8MG TABS 120 30



IBANDRONATE SODIUM 150MG TABS 1 28

IBRANCE 75MG CAPS 21 28



IBUDONE 5MG; 200MG TABS 150 30

ICLUSIG 45MG TABS 30 30

ICLUSIG 15MG TABS 60 30

IDHIFA 50MG TABS 30 30

IDHIFA 100MG TABS 30 30

ILARIS 150MG/ML SOLN 2 28

ILARIS 150MG SOLR 2 28

IMATINIB MESYLATE 100MG TABS 60 30

IMATINIB MESYLATE 400MG TABS 60 30

IMBRUVICA 70MG CAPS 30 30

IMBRUVICA 140MG CAPS 120 30

IMBRUVICA 280MG TABS 30 30




IMIQUIMOD 5% CREA 12 30

INCRUSE ELLIPTA 62.5MCG/INH AEPB 30 30

INFUMORPH 200 10MG/ML SOLN 200 30

INFUMORPH 500 25MG/ML SOLN 200 30

INLYTA 1MG TABS 120 30

INLYTA 5MG TABS 120 30

INTELENCE 200MG TABS 60 30



INTROVALE 0.03MG; 0.15MG TABS 91 91

INVEGA SUSTENNA 39MG/0.25ML SUSP 0.25 28




INVEGA SUSTENNA 156MG/ML SUSP 1 28

INVEGA TRINZA 273MG/0.875ML SUSP 0.88 90




INVIRASE 200MG CAPS 300 30

INVIRASE 500MG TABS 120 30

INVOKAMET 150MG; 500MG TABS 60 30




INVOKAMET XR 50MG; 500MG TB24 60 30




INVOKANA 100MG TABS 30 30

INVOKANA 300MG TABS 30 30

IPRATROPIUM BROMIDE 0.02% SOLN 300 30



IPRATROPIUM

BROMIDE/ALBUTEROL SULFATE

2.5MG/3ML; 0.5MG/3ML SOLN 540 30

IRBESARTAN 150MG TABS 30 30



IRBESARTAN/HYDROCHLOROTHI

AZIDE

12.5MG; 150MG TABS 30 30

IRBESARTAN/HYDROCHLOROTHI

AZIDE

12.5MG; 300MG TABS 30 30

IRESSA 250MG TABS 30 30

ISENTRESS 100MG CHEW 180 30

ISENTRESS 25MG CHEW 180 30

ISENTRESS 100MG PACK 180 30

ISENTRESS 400MG TABS 60 30

ISENTRESS HD 600MG TABS 60 30

ITRACONAZOLE 100MG CAPS 120 30

JAKAFI 5MG TABS 60 30





JANUMET 500MG; 50MG TABS 60 30

JANUMET 1000MG; 50MG TABS 60 30

JANUMET XR 500MG; 50MG TB24 30 30



JANUVIA 50MG TABS 30 30



JARDIANCE 10MG TABS 30 30

JARDIANCE 25MG TABS 30 30

JENTADUETO 2.5MG; 500MG TABS 60 30



JENTADUETO XR 2.5MG; 1000MG TB24 60 30

JENTADUETO XR 5MG; 1000MG TB24 30 30

JOLESSA 0.03MG; 0.15MG TABS 91 91

JULUCA 50MG; 25MG TABS 30 30

KALETRA 400MG/5ML; 100MG/5ML SOLN 480 30

KALETRA 200MG; 50MG TABS 120 30

KALETRA 100MG; 25MG TABS 300 30

KALYDECO 50MG PACK 60 30

KALYDECO 75MG PACK 60 30

KALYDECO 150MG TABS 60 30

KETEK 400MG TABS 20 30

KETEK 300MG TABS 20 30

KINERET 100MG/0.67ML SOSY 20.1 30

KISQALI 200MG TABS 63 28



KISQALI FEMARA 200 DOSE 2.5MG; 200MG TBPK 49 28



KORLYM 300MG TABS 120 30

LAMIVUDINE 10MG/ML SOLN 900 30

LAMIVUDINE 150MG TABS 60 30

LAMIVUDINE 300MG TABS 30 30

LAMIVUDINE/ZIDOVUDINE 150MG; 300MG TABS 60 30

LANOXIN 125MCG TABS 30 30

LATANOPROST 0.005% SOLN 5 30

LATUDA 120MG TABS 30 30





LEFLUNOMIDE 10MG TABS 30 30

LEFLUNOMIDE 20MG TABS 30 30

LENVIMA 10 MG DAILY DOSE 10MG CPPK 30 30

LENVIMA 14 MG DAILY DOSE 0 CPPK 60 30





LETAIRIS 5MG TABS 30 30

LETAIRIS 10MG TABS 30 30

LETROZOLE 2.5MG TABS 30 30

LEVALBUTEROL TARTRATE HFA 45MCG/ACT AERO 30 30

LEVETIRACETAM ER 500MG TB24 180 30

LEVETIRACETAM ER 750MG TB24 120 30

LEVOCETIRIZINE

DIHYDROCHLORIDE

2.5MG/5ML SOLN 300 30

LEVOCETIRIZINE

DIHYDROCHLORIDE

5MG TABS 30 30

LEVOFLOXACIN 250MG TABS 30 30



LEVONORGESTREL AND

ETHINYL ESTRADIOL

0; 0 TABS 91 91

LEVONORGESTREL/ETHINYL

ESTRADIOL

0.03MG; 0.15MG TABS 91 91

LEVONORGESTREL/ETHINYL

ESTRADIOL

0; 0 TABS 91 91

LEVORPHANOL TARTRATE 2MG TABS 120 30

LEXIVA 50MG/ML SUSP 1575 28

LEXIVA 700MG TABS 120 30

LIALDA 1.2GM TBEC 120 30

LIDOCAINE 5% OINT 120 30

LIDOCAINE 5% PTCH 90 30

LINEZOLID 100MG/5ML SUSR 1800 30

LINEZOLID 600MG TABS 60 30

LINZESS 72MCG CAPS 30 30



LISINOPRIL 20MG TABS 60 30





LISINOPRIL 2.5MG TABS 60 30

LISINOPRIL/HYDROCHLOROTHI

AZIDE

12.5MG; 10MG TABS 60 30


AZIDE

25MG; 20MG TABS 60 30


AZIDE

12.5MG; 20MG TABS 120 30

LIVALO 1MG TABS 30 30



LONSURF 8.19MG; 20MG TABS 80 28

LONSURF 6.14MG; 15MG TABS 100 28

LOPINAVIR/RITONAVIR 400MG/5ML; 100MG/5ML SOLN 480 30

LORAZEPAM 2MG/ML CONC 150 30

LORAZEPAM 1MG TABS 90 30

LORAZEPAM 0.5MG TABS 90 30

LORAZEPAM 2MG TABS 150 30

LORAZEPAM INTENSOL 2MG/ML CONC 150 30

LORCET 325MG; 5MG TABS 360 30

LORCET HD 325MG; 10MG TABS 180 30

LORCET PLUS 325MG; 7.5MG TABS 180 30

LORTAB 325MG; 7.5MG TABS 180 30

LORTAB 325MG; 5MG TABS 360 30

LORTAB 325MG; 10MG TABS 180 30

LOSARTAN POTASSIUM 25MG TABS 60 30



LOSARTAN

POTASSIUM/HYDROCHLOROTHI

AZIDE

12.5MG; 50MG TABS 60 30

LOSARTAN


AZIDE

25MG; 100MG TABS 30 30

LOSARTAN


AZIDE

12.5MG; 100MG TABS 30 30

LOVASTATIN 10MG TABS 30 30



LOXAPINE 5MG CAPS 120 30

LOXAPINE 10MG CAPS 120 30

LOXAPINE SUCCINATE 5MG CAPS 120 30

LOXAPINE SUCCINATE 10MG CAPS 120 30

LUMIGAN 0.01% SOLN 5 30

LUPRON DEPOT (1-MONTH) 7.5MG KIT 1 30




LUPRON DEPOT (4-MONTH) 30MG KIT 1 112

LUPRON DEPOT (6-MONTH) 45MG KIT 1 168

LUPRON DEPOT-PED (1-MONTH) 7.5MG KIT 1 30


LUPRON DEPOT-PED (1-MONTH) 15MG KIT 1 30

LUPRON DEPOT-PED (3-MONTH) 30MG KIT 1 84


LYNPARZA 100MG TABS 120 30

LYNPARZA 150MG TABS 120 30

LYNPARZA 50MG CAPS 448 28

LYRICA 100MG CAPS 90 30








LYRICA 20MG/ML SOLN 900 30

LYRICA CR 82.5MG TB24 90 30

LYRICA CR 165MG TB24 90 30

LYRICA CR 330MG TB24 60 30

MAPROTILINE HCL 75MG TABS 90 30



MARGESIC 325MG; 50MG; 40MG CAPS 180 30

MARPLAN 10MG TABS 180 30

MEDROXYPROGESTERONE

ACETATE

150MG/ML SUSP 1 90

MEDROXYPROGESTERONE

ACETATE

150MG/ML SUSY 1 90

MEKINIST 2MG TABS 30 30

MEKINIST 0.5MG TABS 90 30

MELOXICAM 7.5MG TABS 30 30

MELOXICAM 15MG TABS 30 30

MEMANTINE HCL 5MG TABS 90 30

MEMANTINE HCL 10MG TABS 60 30

MEMANTINE HCL TITRATION

PAK

0 TABS 49 28

MEMANTINE HYDROCHLORIDE 2MG/ML SOLN 300 30

MEMANTINE HYDROCHLORIDE

ER

7MG CP24 30 30


ER

28MG CP24 30 30


ER

14MG CP24 30 30


ER

21MG CP24 30 30

MENOSTAR 14MCG/24HR PTWK 4 28

METADATE ER 20MG TBCR 90 30

METFORMIN HCL 850MG TABS 90 30



METFORMIN HCL ER 500MG TB24 60 30




METHADONE HCL 10MG/ML CONC 500 30

METHADONE HCL 10MG/ML SOLN 150 30

METHADONE HCL 5MG/5ML SOLN 600 30

METHADONE HCL 10MG/5ML SOLN 450 30

METHADONE HCL 10MG TABS 120 30

METHADONE HCL 5MG TABS 180 30

METHADONE HCL INTENSOL 10MG/ML CONC 500 30

METHYLPHENIDATE HCL 10MG TABS 90 30



METHYLPHENIDATE HCL ER 27MG TB24 30 30




METHYLPHENIDATE HCL ER 18MG TBCR 120 30






METHYLPHENIDATE HCL SR 20MG TBCR 90 30

METOPROLOL SUCCINATE ER 25MG TB24 60 30




MIGERGOT 100MG; 2MG SUPP 20 28

MIGLITOL 100MG TABS 90 30



MIGLUSTAT 100MG CAPS 90 30

MINITRAN 0.1MG/HR PT24 30 30




MINIVELLE 0.05MG/24HR PTTW 8 28





MIRTAZAPINE 7.5MG TABS 30 30

MIRTAZAPINE 15MG TABS 30 30



MIRTAZAPINE ODT 45MG TBDP 30 30



MITIGARE 0.6MG CAPS 60 30

M-M-R II 0; 0; 0 INJ 2 365

MODAFINIL 200MG TABS 30 30

MODAFINIL 100MG TABS 30 30

MOEXIPRIL/HYDROCHLOROTHI

AZIDE

25MG; 15MG TABS 60 30


AZIDE

12.5MG; 15MG TABS 60 30


AZIDE

12.5MG; 7.5MG TABS 30 30

MONDOXYNE NL 75MG CAPS 60 30



MONTELUKAST SODIUM 5MG CHEW 30 30

MONTELUKAST SODIUM 4MG CHEW 30 30

MONTELUKAST SODIUM 4MG PACK 30 30

MONTELUKAST SODIUM 10MG TABS 30 30

MORPHINE SULFATE 0.5MG/ML SOLN 180 30

MORPHINE SULFATE 1MG/ML SOLN 180 30








MORPHINE SULFATE 10MG/5ML SOLN 700 30



MORPHINE SULFATE 15MG TABS 120 30

MORPHINE SULFATE 30MG TABS 120 30

MORPHINE SULFATE ER 60MG TBCR 90 30





MOXIFLOXACIN HCL 400MG TABS 30 30

MOZOBIL 24MG/1.2ML SOLN 9.6 30

MULTAQ 400MG TABS 60 30

MYRBETRIQ 25MG TB24 30 30

MYRBETRIQ 50MG TB24 30 30

NADOLOL/BENDROFLUMETHIAZI

DE

5MG; 40MG TABS 30 30

NADOLOL/BENDROFLUMETHIAZI

DE

5MG; 80MG TABS 30 30

NALBUPHINE HCL 10MG/ML SOLN 180 30

NALBUPHINE HCL 20MG/ML SOLN 90 30

NAMENDA XR 7MG CP24 30 30




NAMENDA XR TITRATION PACK 0 CP24 56 365

NAMZARIC 10MG; 0 C4PK 56 365

NAMZARIC 10MG; 28MG CP24 30 30




NARATRIPTAN HCL 1MG TABS 9 30

NARATRIPTAN HCL 2.5MG TABS 9 30

NARCAN 4MG/0.1ML LIQD 4 30

NATEGLINIDE 60MG TABS 90 30

NATEGLINIDE 120MG TABS 90 30

NATPARA 75MCG CART 2 28




NEBUPENT 300MG SOLR 6 28

NEFAZODONE HCL 200MG TABS 60 30





NERLYNX 40MG TABS 180 30

NEUPRO 8MG/24HR PT24 30 30






NEVIRAPINE 50MG/5ML SUSP 1200 30

NEVIRAPINE 200MG TABS 60 30

NEVIRAPINE ER 400MG TB24 30 30

NEVIRAPINE ER 100MG TB24 90 30

NEXAVAR 200MG TABS 120 30

NIACIN ER 500MG TBCR 30 30



NICOTROL INHALER 10MG INHA 1008 90

NIFEDICAL XL 30MG TB24 60 30

NIFEDICAL XL 60MG TB24 60 30

NIFEDIPINE ER 30MG TB24 60 30






NILUTAMIDE 150MG TABS 60 30

NINLARO 3MG CAPS 3 28

NINLARO 4MG CAPS 3 28

NINLARO 2.3MG CAPS 3 28

NITROGLYCERIN TRANSDERMAL 0.1MG/HR PT24 30 30




NORTHERA 300MG CAPS 180 30



NORVIR 100MG PACK 360 30

NORVIR 100MG CAPS 360 30

NORVIR 80MG/ML SOLN 480 30

NORVIR 100MG TABS 360 30

NOVOFINE 30GX8MM MISC 200 30

NOVOFINE 31 MISC 200 30

NOVOFINE 32GX6MM MISC 200 30

NOVOFINE AUTOCOVER

30GX8MM

MISC 200 30

NOVOTWIST 30GX8MM MISC 200 30

NOVOTWIST 32GX5MM MISC 200 30

NOXAFIL 40MG/ML SUSP 600 30

NOXAFIL 100MG TBEC 96 30

NUEDEXTA 20MG; 10MG CAPS 60 30

NULOJIX 250MG SOLR 150 30

NUPLAZID 17MG TABS 60 30

ODEFSEY 200MG; 25MG; 25MG TABS 30 30

ODOMZO 200MG CAPS 30 30

OFEV 150MG CAPS 60 30

OFEV 100MG CAPS 60 30

OLANZAPINE 10MG SOLR 30 30

OLANZAPINE 2.5MG TABS 30 30

OLANZAPINE 20MG TABS 30 30



OLANZAPINE 7.5MG TABS 30 30


OLANZAPINE ODT 5MG TBDP 30 30




OLANZAPINE/FLUOXETINE 25MG; 3MG CAPS 30 30





OLMESARTAN MEDOXOMIL 20MG TABS 30 30



OLMESARTAN

MEDOXOMIL/HYDROCHLOROTH

IAZIDE

12.5MG; 20MG TABS 30 30

OLMESARTAN


IAZIDE

12.5MG; 40MG TABS 30 30

OLMESARTAN


IAZIDE

25MG; 40MG TABS 30 30

OLOPATADINE HCL 0.1% SOLN 5 30

OLOPATADINE HYDROCHLORIDE 0.2% SOLN 2.5 30

OMEGA-3-ACID ETHYL ESTERS 375MG; 465MG; 1GM CAPS 120 30

OMEPRAZOLE 20MG CPDR 60 30



ONDANSETRON HCL 4MG/5ML SOLN 450 30

ONDANSETRON HCL 4MG TABS 90 30



ONDANSETRON ODT 8MG TBDP 90 30

ONDANSETRON ODT 4MG TBDP 90 30

ONFI 2.5MG/ML SUSP 480 30

ONFI 10MG TABS 60 30

ONFI 20MG TABS 60 30

OPDIVO 240MG/24ML SOLN 48 28



OPSUMIT 10MG TABS 30 30

ORKAMBI 125MG; 100MG TABS 120 30

ORKAMBI 125MG; 200MG TABS 120 30

ORPHENADRINE CITRATE ER 100MG TB12 60 30

OSELTAMIVIR PHOSPHATE 75MG CAPS 56 365



OSELTAMIVIR PHOSPHATE 6MG/ML SUSR 700 365

OXANDROLONE 2.5MG TABS 120 30

OXANDROLONE 10MG TABS 60 30

OXAZEPAM 10MG CAPS 120 30



OXYBUTYNIN CHLORIDE 5MG/5ML SYRP 600 30

OXYBUTYNIN CHLORIDE 5MG TABS 120 30

OXYBUTYNIN CHLORIDE ER 5MG TB24 30 30



OXYCODONE HCL 5MG CAPS 120 30

OXYCODONE HCL 100MG/5ML CONC 120 30

OXYCODONE HCL 5MG/5ML SOLN 1200 30

OXYCODONE HCL 5MG TABS 120 30





OXYCODONE/ACETAMINOPHEN 325MG; 5MG TABS 360 30

OXYCODONE/ACETAMINOPHEN 325MG; 2.5MG TABS 360 30

OXYCODONE/ACETAMINOPHEN 325MG; 7.5MG TABS 240 30

OXYCODONE/ACETAMINOPHEN 325MG; 10MG TABS 180 30

OXYCODONE/ASPIRIN 325MG; 4.835MG TABS 180 30

OXYCODONE/IBUPROFEN 400MG; 5MG TABS 28 30

OZEMPIC 2MG/1.5ML SOPN 3 28

OZEMPIC 2MG/1.5ML SOPN 3 28

PALIPERIDONE ER 6MG TB24 60 30



PALIPERIDONE ER 1.5MG TB24 30 30

PANTOPRAZOLE SODIUM 40MG TBEC 60 30

PANTOPRAZOLE SODIUM 20MG TBEC 60 30

PARICALCITOL 4MCG CAPS 60 30



PAROXETINE HCL 20MG TABS 90 30




PAXIL 10MG/5ML SUSP 900 30

PAZEO 0.7% SOLN 2.5 30

PEGASYS 180MCG/0.5ML KIT 2 28

PEGASYS 180MCG/ML SOLN 4 28

PEGASYS 180MCG/0.5ML SOLN 2 28

PEGASYS PROCLICK 180MCG/0.5ML SOLN 2 28

PEGASYS PROCLICK 135MCG/0.5ML SOLN 2 28

PERFOROMIST 20MCG/2ML NEBU 120 30

PERINDOPRIL ERBUMINE 4MG TABS 60 30



PHENOBARBITAL 20MG/5ML ELIX 1500 30

PHENOBARBITAL 60MG TABS 120 30




PHENOBARBITAL 32.4MG TABS 120 30




PICATO 0.05% GEL 2 56

PICATO 0.015% GEL 3 56

PIOGLITAZONE HCL 15MG TABS 30 30



PIOGLITAZONE

HCL/METFORMIN HCL

850MG; 15MG TABS 90 30

PIOGLITAZONE

HCL/METFORMIN HCL

500MG; 15MG TABS 90 30

POMALYST 1MG CAPS 21 28




PORTRAZZA 800MG/50ML SOLN 100 21

POTIGA 300MG TABS 90 30




PRADAXA 75MG CAPS 60 30



PRAMIPEXOLE

DIHYDROCHLORIDE

0.125MG TABS 90 30

PRAMIPEXOLE

DIHYDROCHLORIDE

0.25MG TABS 90 30

PRAMIPEXOLE

DIHYDROCHLORIDE

0.5MG TABS 90 30

PRAMIPEXOLE

DIHYDROCHLORIDE

1MG TABS 90 30

PRAMIPEXOLE

DIHYDROCHLORIDE

0.75MG TABS 90 30

PRAMIPEXOLE

DIHYDROCHLORIDE

1.5MG TABS 90 30

PRAMIPEXOLE

DIHYDROCHLORIDE ER

1.5MG TB24 90 30

PRAMIPEXOLE

DIHYDROCHLORIDE ER

0.75MG TB24 90 30

PRAMIPEXOLE

DIHYDROCHLORIDE ER

3MG TB24 30 30

PRAMIPEXOLE

DIHYDROCHLORIDE ER

0.375MG TB24 90 30

PRAMIPEXOLE

DIHYDROCHLORIDE ER

4.5MG TB24 30 30

PRAMIPEXOLE

DIHYDROCHLORIDE ER

2.25MG TB24 30 30

PRAMIPEXOLE

DIHYDROCHLORIDE ER

3.75MG TB24 30 30

PRASUGREL 5MG TABS 30 30

PRASUGREL 10MG TABS 30 30

PRAVASTATIN SODIUM 80MG TABS 30 30




PREMARIN 0.9MG TABS 30 30





PREZCOBIX 150MG; 800MG TABS 30 30

PREZISTA 100MG/ML SUSP 400 30

PREZISTA 800MG TABS 30 30




PRISTIQ 25MG TB24 30 30



PROAIR HFA 108MCG/ACT AERS 17 30

PROAIR RESPICLICK 108MCG/ACT AEPB 2 30

PROCRIT 20000UNIT/ML SOLN 12 28






PROLIA 60MG/ML SOLN 1 180

PROMACTA 25MG TABS 30 30


PROMACTA 12.5MG TABS 30 30


PROQUAD 0; 0; 0; 0 INJ 2 365

PULMOZYME 1MG/ML SOLN 150 30

PURIXAN 2000MG/100ML SUSP 300 30

QUASENSE 0.03MG; 0.15MG TABS 91 91

QUETIAPINE FUMARATE 25MG TABS 60 30






QUETIAPINE FUMARATE ER 400MG TB24 60 30





QUINAPRIL HCL 5MG TABS 60 30




QUINAPRIL/HYDROCHLOROTHIA

ZIDE

12.5MG; 20MG TABS 60 30


ZIDE

25MG; 20MG TABS 60 30


ZIDE

12.5MG; 10MG TABS 30 30

QUININE SULFATE 324MG CAPS 42 7

RALOXIFENE HYDROCHLORIDE 60MG TABS 30 30

RAMIPRIL 1.25MG CAPS 60 30

RAMIPRIL 2.5MG CAPS 60 30

RAMIPRIL 5MG CAPS 60 30

RAMIPRIL 10MG CAPS 60 30

RANEXA 1000MG TB12 60 30

RANEXA 500MG TB12 60 30

RASAGILINE MESYLATE 1MG TABS 30 30

RASAGILINE MESYLATE 0.5MG TABS 30 30

RECOMBIVAX HB 5MCG/0.5ML SUSP 3 365

RECOMBIVAX HB 10MCG/ML SUSP 3 365



REGRANEX 0.01% GEL 15 30

RELISTOR 12MG/0.6ML SOLN 16.8 28



RENVELA 2.4GM PACK 180 30

RENVELA 0.8GM PACK 180 30

RENVELA 800MG TABS 540 30

REPAGLINIDE 1MG TABS 120 30

REPAGLINIDE 2MG TABS 240 30

REPAGLINIDE 0.5MG TABS 120 30

REPATHA 140MG/ML SOSY 3 30

REPATHA PUSHTRONEX SYSTEM 420MG/3.5ML SOCT 3.5 30

REPATHA SURECLICK 140MG/ML SOAJ 3 30

REPREXAIN 10MG; 200MG TABS 150 30

RESCRIPTOR 200MG TABS 180 30

RESCRIPTOR 100MG TABS 270 30

RESTASIS 0.05% EMUL 60 30

REVLIMID 2.5MG CAPS 28 28

REVLIMID 5MG CAPS 28 28





REXULTI 1MG TABS 30 30


REXULTI 0.5MG TABS 30 30

REXULTI 0.25MG TABS 30 30



REYATAZ 200MG CAPS 60 30



REYATAZ 50MG PACK 180 30

RIBAVIRIN 200MG CAPS 168 28

RIBAVIRIN 200MG TABS 168 28

RIOMET 500MG/5ML SOLN 750 30

RISPERDAL CONSTA 12.5MG SUSR 2 28

RISPERDAL CONSTA 25MG SUSR 2 28

RISPERDAL CONSTA 50MG SUSR 2 28

RISPERDAL CONSTA 37.5MG SUSR 2 28

RISPERIDONE 1MG/ML SOLN 240 30

RISPERIDONE 0.25MG TABS 60 30

RISPERIDONE 1MG TABS 60 30




RISPERIDONE 0.5MG TABS 60 30

RISPERIDONE M-TAB 0.5MG TBDP 60 30

RISPERIDONE M-TAB 1MG TBDP 60 30




RISPERIDONE ODT 0.25MG TBDP 60 30

RISPERIDONE ODT 0.5MG TBDP 60 30

RISPERIDONE ODT 2MG TBDP 60 30




RITONAVIR 100MG TABS 360 30

RIVASTIGMINE TARTRATE 1.5MG CAPS 60 30

RIVASTIGMINE TARTRATE 3MG CAPS 60 30

RIVASTIGMINE TARTRATE 4.5MG CAPS 60 30

RIVASTIGMINE TARTRATE 6MG CAPS 60 30

RIVASTIGMINE TRANSDERMAL

SYSTEM

4.6MG/24HR PT24 30 30


SYSTEM

9.5MG/24HR PT24 30 30


SYSTEM

13.3MG/24HR PT24 30 30

RIZATRIPTAN BENZOATE 5MG TABS 12 30

RIZATRIPTAN BENZOATE 10MG TABS 12 30

RIZATRIPTAN BENZOATE ODT 5MG TBDP 12 30

RIZATRIPTAN BENZOATE ODT 10MG TBDP 12 30

ROSUVASTATIN CALCIUM 5MG TABS 30 30




ROWEEPRA XR 500MG TB24 180 30

ROWEEPRA XR 750MG TB24 120 30

ROZEREM 8MG TABS 30 30

RUBRACA 250MG TABS 120 30



RUCONEST 2100UNIT SOLR 8 30

RYDAPT 25MG CAPS 224 28

SABRIL 500MG PACK 200 30

SABRIL 500MG TABS 180 30

SAMSCA 30MG TABS 60 30

SAMSCA 15MG TABS 30 30

SANCUSO 3.1MG/24HR PTCH 4 28

SAPHRIS 10MG SUBL 60 30

SAPHRIS 2.5MG SUBL 60 30

SAPHRIS 5MG SUBL 60 30

SAVAYSA 30MG TABS 30 30



SCOPOLAMINE 1MG/3DAYS PT72 10 30

SELZENTRY 20MG/ML SOLN 1610 26

SELZENTRY 150MG TABS 60 30




SENSIPAR 30MG TABS 60 30



SEREVENT DISKUS 50MCG/DOSE AEPB 60 30

SERTRALINE HCL 20MG/ML CONC 300 30

SERTRALINE HCL 50MG TABS 120 30



SETLAKIN 0.03MG; 0.15MG TABS 91 91

SHINGRIX 50MCG SUSR 2 999

SIGNIFOR 0.6MG/ML SOLN 60 30



SILDENAFIL 20MG TABS 90 30

SILENOR 6MG TABS 30 30

SILENOR 3MG TABS 30 30

SIMVASTATIN 80MG TABS 30 30





SIRTURO 100MG TABS 188 365

SOLIQUA 100/33 100UNIT/ML; 33MCG/ML SOPN 18 30

SOMATULINE DEPOT 60MG/0.2ML SOLN 0.2 28



SOMAVERT 25MG SOLR 30 30





SPRITAM 250MG TB3D 60 30




SPRYCEL 20MG TABS 30 30






STAMARIL 0 SUSR 1 999

STAVUDINE 15MG CAPS 60 30




STAVUDINE 1MG/ML SOLR 2400 30

STRIBILD 150MG; 150MG; 200MG; 300MG TABS 30 30

SUBOXONE 8MG; 2MG FILM 90 30

SUBOXONE 2MG; 0.5MG FILM 90 30



SUMATRIPTAN 5MG/ACT SOLN 12 30

SUMATRIPTAN 20MG/ACT SOLN 12 30

SUMATRIPTAN SUCCINATE 6MG/0.5ML SOAJ 4 30



SUMATRIPTAN SUCCINATE 6MG/0.5ML SOLN 4 30

SUMATRIPTAN SUCCINATE 6MG/0.5ML SOSY 4 30

SUMATRIPTAN SUCCINATE 25MG TABS 9 30



SUMATRIPTAN SUCCINATE

REFILL

6MG/0.5ML SOCT 4 30

SUMATRIPTAN SUCCINATE

REFILL

4MG/0.5ML SOCT 8 30

SUSTIVA 50MG CAPS 90 30

SUSTIVA 200MG CAPS 60 30

SUSTIVA 600MG TABS 30 30

SUTENT 25MG CAPS 28 28

SUTENT 37.5MG CAPS 28 28

SUTENT 50MG CAPS 28 28

SUTENT 12.5MG CAPS 28 28

SYLATRON 600MCG KIT 4 28




SYMFI 600MG; 300MG; 300MG TABS 30 30

SYMFI LO 400MG; 300MG; 300MG TABS 30 30

SYNJARDY 5MG; 500MG TABS 60 30

SYNJARDY 12.5MG; 1000MG TABS 60 30

SYNJARDY 5MG; 1000MG TABS 60 30

SYNJARDY 12.5MG; 500MG TABS 60 30

SYNJARDY XR 5MG; 1000MG TB24 60 30


SYNJARDY XR 12.5MG; 1000MG TB24 60 30


SYNRIBO 3.5MG SOLR 28 28

TACROLIMUS 0.03% OINT 100 90

TACROLIMUS 0.1% OINT 100 90

TAFINLAR 50MG CAPS 120 30

TAFINLAR 75MG CAPS 120 30

TAGRISSO 80MG TABS 30 30

TAGRISSO 40MG TABS 30 30

TAMIFLU 75MG CAPS 56 365



TAMIFLU 6MG/ML SUSR 700 365

TAMSULOSIN HCL 0.4MG CAPS 60 30

TARCEVA 25MG TABS 60 30



TARGRETIN 1% GEL 60 30

TASIGNA 50MG CAPS 420 30



TAZAROTENE 0.1% CREA 120 30

TAZORAC 0.05% CREA 120 30

TAZORAC 0.1% CREA 120 30

TAZORAC 0.05% GEL 100 30

TAZORAC 0.1% GEL 100 30

TECENTRIQ 1200MG/20ML SOLN 20 21

TECFIDERA 120MG CPDR 14 30

TECFIDERA 240MG CPDR 60 30

TECFIDERA STARTER PACK 0 MISC 120 365

TECHLITE PEN NEEDLES/31G X 6

MM

MISC 200 30

TECHLITE PEN NEEDLES/31G X

8MM

MISC 200 30


4MM

MISC 200 30


6MM

MISC 200 30


8MM

MISC 200 30

TELMISARTAN 40MG TABS 30 30



TELMISARTAN/AMLODIPINE 5MG; 80MG TABS 30 30




TELMISARTAN/HYDROCHLOROT

HIAZIDE

12.5MG; 80MG TABS 30 30


HIAZIDE

25MG; 80MG TABS 30 30


HIAZIDE

12.5MG; 40MG TABS 30 30

TEMAZEPAM 22.5MG CAPS 60 365

TEMAZEPAM 30MG CAPS 60 365

TEMAZEPAM 15MG CAPS 60 365

TEMAZEPAM 7.5MG CAPS 60 365

TENIVAC 2LFU; 5LFU INJ 0.5 28

TENOFOVIR DISOPROXIL

FUMARATE

300MG TABS 30 30

TERAZOSIN HCL 10MG CAPS 60 30

TERBINAFINE HCL 250MG TABS 90 365

TESTOSTERONE 25MG/2.5GM GEL 300 30

TESTOSTERONE 50MG/5GM GEL 300 30

TESTOSTERONE ENANTHATE 200MG/ML SOLN 5 30

TESTOSTERONE PUMP 1% GEL 300 30

TETRABENAZINE 12.5MG TABS 90 30

TETRABENAZINE 25MG TABS 120 30

THALOMID 200MG CAPS 56 28




TIAGABINE HYDROCHLORIDE 12MG TABS 120 30



TIVICAY 25MG TABS 60 30



TOBI PODHALER 28MG CAPS 1568 365

TOBRAMYCIN 300MG/5ML NEBU 280 56

TOLTERODINE TARTRATE 1MG TABS 60 30

TOLTERODINE TARTRATE 2MG TABS 60 30

TORISEL 25MG/ML SOLN 4 28

TRACLEER 62.5MG TABS 60 30

TRACLEER 125MG TABS 60 30

TRACLEER 32MG TBSO 60 30

TRADJENTA 5MG TABS 30 30

TRAMADOL HCL 50MG TABS 240 30

TRANDOLAPRIL 2MG TABS 60 30



TRANEXAMIC ACID 650MG TABS 30 28

TRANSDERM-SCOP 1MG/3DAYS PT72 10 30

TRAVATAN Z 0.004% SOLN 5 30

TREANDA 45MG/0.5ML SOLN 6 21

TREANDA 180MG/2ML SOLN 4 21

TREANDA 25MG SOLR 8 21

TRELEGY ELLIPTA 100MCG/INH; 62.5MCG/INH;

25MCG/INH

AEPB 60 30

TRELSTAR 3.75MG SUSR 1 28

TRELSTAR 11.25MG SUSR 1 84

TRELSTAR MIXJECT 22.5MG SUSR 1 168



TRETINOIN 0.025% CREA 45 30



TRETINOIN 0.025% GEL 45 30



TRINTELLIX 20MG TABS 30 30



TRIPTODUR 22.5MG SRER 1 168

TRIUMEQ 600MG; 50MG; 300MG TABS 30 30

TRULANCE 3MG TABS 30 30

TRULICITY 1.5MG/0.5ML SOPN 2 28

TRULICITY 0.75MG/0.5ML SOPN 2 28

TRUVADA 133MG; 200MG TABS 30 30




TYBOST 150MG TABS 30 30

TYKERB 250MG TABS 180 30

TYSABRI 300MG/15ML CONC 15 28

TYZEKA 600MG TABS 30 30

ULORIC 80MG TABS 30 30

ULORIC 40MG TABS 30 30

VALACYCLOVIR HCL 500MG TABS 30 30

VALACYCLOVIR HCL 1GM TABS 30 30

VALCHLOR 0.016% GEL 60 30

VALSARTAN 40MG TABS 30 30




VALSARTAN/HYDROCHLOROTHI

AZIDE

12.5MG; 80MG TABS 30 30


AZIDE

12.5MG; 160MG TABS 30 30


AZIDE

25MG; 160MG TABS 30 30


AZIDE

12.5MG; 320MG TABS 30 30


AZIDE

25MG; 320MG TABS 30 30

VANCOMYCIN HCL 125MG CAPS 40 10

VANCOMYCIN HCL 250MG CAPS 80 10

VARIVAX 1350PFU/0.5ML INJ 1 365

VARIZIG 125UNIT SOLR 12 30

VARIZIG 125UNIT/1.2ML SOLN 12 30

VASCEPA 0.5GM CAPS 240 30

VASCEPA 1GM CAPS 120 30

VELCADE 3.5MG SOLR 14 21

VELPHORO 500MG CHEW 180 30

VENCLEXTA 50MG TABS 30 30



VENCLEXTA STARTING PACK 0 TBPK 84 365

VENLAFAXINE HCL 75MG TABS 90 30



VENLAFAXINE HCL 37.5MG TABS 90 30


VENLAFAXINE HCL ER 75MG CP24 90 30

VENLAFAXINE HCL ER 37.5MG CP24 30 30

VENLAFAXINE HCL ER 150MG CP24 60 30

VENTAVIS 10MCG/ML SOLN 270 30

VENTAVIS 20MCG/ML SOLN 270 30

VENTOLIN HFA 108MCG/ACT AERS 36 30

VERAPAMIL HCL ER 240MG CP24 30 30






VERAPAMIL HCL SR 360MG CP24 30 30

VERSACLOZ 50MG/ML SUSP 540 30

VERZENIO 50MG TABS 60 30




VESICARE 5MG TABS 30 30

VESICARE 10MG TABS 30 30

VIBERZI 75MG TABS 60 30

VIBERZI 100MG TABS 60 30

VICODIN 300MG; 5MG TABS 360 30

VICODIN ES 300MG; 7.5MG TABS 180 30

VICODIN HP 300MG; 10MG TABS 180 30

VICTOZA 18MG/3ML SOPN 9 30

VIDEX EC 125MG CPDR 30 30

VIDEX PEDIATRIC 4GM SOLR 1200 30

VIDEX PEDIATRIC 2GM SOLR 1200 30

VIGABATRIN 500MG PACK 200 30

VIIBRYD 0 KIT 30 30

VIIBRYD 40MG TABS 30 30



VIIBRYD STARTER PACK 0 KIT 30 30

VIMPAT 200MG/20ML SOLN 1200 30

VIMPAT 10MG/ML SOLN 1200 30

VIMPAT 150MG TABS 60 30




VIRACEPT 625MG TABS 120 30

VIRACEPT 250MG TABS 270 30

VIRAMUNE 50MG/5ML SUSP 1200 30

VIREAD 40MG/GM POWD 240 30

VIREAD 250MG TABS 30 30




VITEKTA 150MG TABS 30 30

VITEKTA 85MG TABS 30 30

VORICONAZOLE 40MG/ML SUSR 300 30

VORICONAZOLE 50MG TABS 90 30

VORICONAZOLE 200MG TABS 90 30

VOSEVI 400MG; 100MG; 100MG TABS 30 30

VOTRIENT 200MG TABS 120 30

VRAYLAR 3MG CAPS 30 30

VRAYLAR 1.5MG CAPS 30 30

VRAYLAR 4.5MG CAPS 30 30

VRAYLAR 6MG CAPS 30 30

VRAYLAR 0 CPPK 14 365

XALKORI 200MG CAPS 60 30

XALKORI 250MG CAPS 60 30

XARELTO 10MG TABS 90 90



XARELTO STARTER PACK 0 TBPK 102 365

XGEVA 120MG/1.7ML SOLN 1.7 28

XIFAXAN 200MG TABS 9 30

XIFAXAN 550MG TABS 90 30

XIGDUO XR 2.5MG; 1000MG TB24 30 30

XIGDUO XR 10MG; 1000MG TB24 30 30




XOLAIR 150MG SOLR 6 28

XTAMPZA ER 9MG C12A 60 30

XTAMPZA ER 13.5MG C12A 60 30




XTANDI 40MG CAPS 120 30

XULTOPHY 100/3.6 100UNIT/ML; 3.6MG/ML SOPN 15 30

XYLON 10MG; 200MG TABS 150 30

XYREM 500MG/ML SOLN 540 30

YERVOY 200MG/40ML SOLN 80 21

YUVAFEM 10MCG TABS 18 28

ZAFIRLUKAST 20MG TABS 60 30

ZAFIRLUKAST 10MG TABS 60 30

ZALEPLON 5MG CAPS 30 30

ZALEPLON 10MG CAPS 30 30

ZALTRAP 200MG/8ML SOLN 40 28

ZALTRAP 100MG/4ML SOLN 40 28

ZAVESCA 100MG CAPS 90 30

ZEBUTAL 325MG; 50MG; 40MG CAPS 180 30

ZEJULA 100MG CAPS 90 30

ZELBORAF 240MG TABS 240 30

ZERIT 1MG/ML SOLR 2400 30

ZETIA 10MG TABS 30 30

ZIAGEN 20MG/ML SOLN 960 30

ZIDOVUDINE 100MG CAPS 180 30

ZIDOVUDINE 50MG/5ML SYRP 1680 28

ZIDOVUDINE 300MG TABS 60 30

ZIOPTAN 0.015MG/ML SOLN 30 30

ZIPRASIDONE HCL 60MG CAPS 60 30




ZMAX 2GM SUSR 60 30

ZOLEDRONIC ACID 4MG/5ML CONC 15 21

ZOLEDRONIC ACID 5MG/100ML SOLN 100 365

ZOLEDRONIC ACID 4MG SOLR 3 21

ZOLINZA 100MG CAPS 120 30

ZOLPIDEM TARTRATE 10MG TABS 30 30

ZOLPIDEM TARTRATE 5MG TABS 30 30

ZORTRESS 0.5MG TABS 120 30



ZOSTAVAX 19400UNT/0.65ML SUSR 1 999

ZUBSOLV 8.6MG; 2.1MG SUBL 90 30






ZYCLARA 3.75% CREA 56 30

ZYCLARA PUMP 3.75% CREA 56 30

ZYCLARA PUMP 2.5% CREA 15 30

ZYDELIG 100MG TABS 60 30

ZYDELIG 150MG TABS 60 30

ZYKADIA 150MG CAPS 140 28

ZYPREXA RELPREVV 210MG SUSR 2 28



ZYTIGA 500MG TABS 60 30

ZYTIGA 250MG TABS 120 30

Documents

2018 Cigna-HealthSpring Quantity Limit Criteria - Cigna ... · Drug Name Strength Dosage Form Quantity Limit Days Supply ABACAVIR 20MG/ML SOLN 960 30 ABACAVIR 300MG TABS 60 30 ABACAVIR